Co-author of Obama health care law sees ‘huge train wreck’ in implementation
By Associated Press,
WASHINGTON — A senior Democratic senator who helped write President Barack Obama’s health care law stunned administration officials Wednesday, saying openly he thinks it’s headed for a “train wreck” because of bumbling implementation.
“I just see a huge train wreck coming down,” Senate Finance Committee Chairman Max Baucus, D-Mont., told Obama’s health care chief during a routine budget hearing that suddenly turned tense.
Baucus is the first top Democrat to publicly voice fears about the rollout of the new health care law, designed to bring coverage to some 30 million uninsured people through a mix of government programs and tax credits for private insurance. Polls show that Americans remain confused by the complex law, and even many uninsured people are skeptical they will be helped by benefits that start next year.
A six-term veteran, Baucus expects a tough re-election in 2014. He’s still trying to recover from approval ratings that nosedived amid displeasure with the health care law in his home state.
Normally low-key and supportive, Baucus challenged Health and Human Services Secretary Kathleen Sebelius at Wednesday’s hearing.
He said he’s “very concerned” that new health insurance marketplaces for consumers and small businesses will not open on time in every state, and that if they do, they might just flop because residents don’t have the information they need to make choices.
“The administration’s public information campaign on the benefits of the Affordable Care Act deserves a failing grade,” he told Sebelius. “You need to fix this.”
Responding to Baucus, Sebelius pointedly noted that Republicans in Congress last year blocked funding for carrying out the health care law, and she had to resort to raiding other legally available departmental funds.
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Max Baucus worried about health law 'train wreck'
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| Senate Finance Committee Chairman Max Baucus, one of the health reform law's chief authors, says he’s worried about a “huge train wreck coming down” if the Obama administration doesn’t improve its public outreach about the legislation. Baucus, a Montana Democrat who is up for reelection in 2014, sharply criticized the administration’s outreach efforts in a budget hearing on Wednesday. He told Health and Human Services Secretary Kathleen Sebelius that people and businesses “have no idea what to do, what to expect” from the law. "If the administration implements it correctly, millions more Americans will gain access to health care next year," Baucus said. "I am concerned that not every state, including Montana, will have an insurance marketplace established in time." After the hearing, Baucus explained that the train wreck is “that consumers and businesses will just not have enough information. That it will be too confusing.” He also expressed frustration that the White House and HHS are not providing details of its outreach efforts. “My main concern is that when I ask them for information about the navigators … that I don’t get anything back,” Baucus told reporters. Sebelius defended the administration’s efforts, arguing that there will be navigators — guides to help consumers through the exchanges — ahead of the Oct. 1 enrollment date. Sebelius also said that people will be in the states this summer to inform people about the law. She said HHS officials and the Small Business Administration are holding webinars and seminars and will be holding more through the summer. But when Baucus asked for the number of people and which states, Sebelius declined to reveal specifics. http://dyn.politico.com/printstory.cfm?uuid=FD82C7D3-17AD-40D6-A8CF-199A626420EA |
Posted April 18, 2013, at 4:32 p.m.
BREWER and PORTLAND, Maine — Eastern Maine Healthcare Systems plans to spend at least $115 million over the next five years to fold Portland’s Mercy Health System of Maine into its network of health providers, according to new documents filed with the state.
EMHS and Mercy, which announced plans to merge in late December, late last week filed a certificate of need application with the Maine Department of Health and Human Services, which will review the proposed deal. The application, provided to the Bangor Daily News by DHHS on Thursday, shed further light on on the merger plan, revealing that EMHS was just one of seven potential suitors for Mercy.
EMHS, parent organization to Bangor’s Eastern Maine Medical Center and six other hospitals throughout northern and eastern Maine, would invest in the financially ailing Mercy as well as restructure $73 million of its existing debt, according to the application. Pending approval from its board, EMHS would spend at least $115 million in coming years to consolidate Mercy’s operations, which are now split between its original 230-bed hospital on Portland’s State Street and its newer Fore River campus. The money also would finance Mercy’s integration into EMHS and both organizations’ pursuit of better ways to deliver care in light of national health reform, according to the application.
EMHS additionally will pick up the $15.7 million tab that Mercy owes to its parent organization, Pennsylvania-based Catholic Health East, according to Mercy’s affiliation agreement with EMHS, another document that was filed with the certificate of need application. The Brewer-based health system also offered to float Mercy a revolving line of credit of up to $7 million before the deal closes, which Mercy can tap into for capital and operating needs, the agreement states.
“While we continue to make good progress toward finalizing the affiliation between EMHS and Mercy, much still needs to be accomplished,” Suzanne Spruce, chief communications officer for EMHS, wrote in an email. “One upcoming milestone is the public hearing related to the certificate of need. This event will take place in early May, and is an early step in the process of obtaining CON approval from the Maine Department of Health and Human Services.”
In addition to the financial commitment it’s making to Mercy, EMHS also recently revived plans to construct a seven-story tower at Eastern Maine Medical Center as part of a $250 million project. In the application, EMHS assured regulators that it has the financial resources to support Mercy as a new member, one criteria of the state approval process.
“The proposed affiliation considers the evolution of care in hospitals in Maine, recognizes the financial constraints of purchasers of health care services, puts the financial resources of Mercy and EMHS and the surrounding communities to good use, and assures continuing access to patient centered care in southern Maine,” the application states.
For many, chronic pain leads to endless loop of doctors, drugs and desperation
Posted April 18, 2013, at 10:08 a.m.
Quickly, fill in the following blank: “Ow, my aching [blank]!”
For a growing number of people, the answer is automatic. Maybe it’s an old sport injury, a flare-up of nagging back pain, a headache, knee sprain or an arthritic shoulder.
More than 100 million people in the United States and 1.5 billion people worldwide are in persistent chronic pain, according to the U.S. Committee on Advancing Pain Care, Research and Education at the Institute of Medicine, which published an extensive report of their findings to Congress in 2011. Life for them is an agonizing experience complicated by factors such as depression and anxiety that costs the economy $600 billion per year in lost wages, productivity and hospital care.
In Maine, the costs are compounded by a high percentage of the population addicted to painkillers, a class of prescription drugs classified as opioids. In 2012, more than 37 percent of the patients admitted to the state’s hospitals for drug abuse treatment were addicted to prescription painkillers, three times more than were admitted for heroin, at a cost of approximately $400 million, according to an annual report by the Department of Health and Human Services’ Office of Substance Abuse.
Short bouts of acute pain are a universal part of life. Pain keeps us from repeating life-threatening or harmful behavior. The process appears simple enough, but on a molecular level, pain is actually very complicated and occurs across separate centers of the brain, including sensory, emotional and cognitive. These centers overlap and communicate with one another, but each requires a different mechanism to normalize once the crisis has passed. Chronic pain occurs when that communication gets fuzzy, and the brain cannot return to normal functioning. If pain persists for more than three months, it can take on a life of its own, changing brain chemistry to the point where the brain may begin to read any stimuli as pain-inducing, even if it isn’t.
For some sufferers of fibromyalgia or Complex Regional Pain Syndrome, something as minor as a drop in air temperature can hit them like a hammer. For them, pain is like a broken car alarm that never stops blaring, robbing them of peace and rest even when the original injury has long since healed.
Paula Orecklin, 25, of Winnipeg, Canada, has suffered with Complex Regional Pain Syndrome since age 13, when a twisted ankle quickly devolved into a nightmare of agony and revolving doctor’s offices.
“For me, on some days, even a dog hair on my leg can set off excruciating spasms,” she recently told an audience at the University of New England’s April 4 symposium on chronic pain in Biddeford. “On my good days, I experience a pain level of 5.5 out of 10, and that’s with medication. Everything affects my pain and my pain impacts everything else: my memory, my intellect, my ability to communicate. At my age, choosing to treat my pain over my education has been devastating and I’ve had to spend a lot of time convincing heath care practitioners that I’m not a difficult person, I’m a person with a difficult disease.”
Report: Drug pipeline failing to keep up with ‘nightmare bacteria’
Posted April 18, 2013, at 9:21 a.m.
CHICAGO — Only seven new drugs are in development for the treatment of infections caused by an especially nasty class of superbugs that include E. coli and CRE, the so-called “nightmare bacteria” that the U.S. Centers for Disease Control and Prevention raised alarms about last month.
The data come from the latest report by the Infectious Diseases Society of America, or IDSA, released on Thursday, which has been tracking the rising number of bacteria that resist even the most potent antibiotics.
“We’re on the precipice of returning to the dark days before antibiotics enabled safer surgery, chemotherapy and the care of premature infants,” said Dr. Helen Boucher, an infectious diseases expert at Tufts Medical Center in Boston and a member of IDSA’s board, whose report was published online in Clinical Infectious Diseases.
“Simply put, the antibiotic pipeline is on life support and novel solutions are required to resuscitate it — now,” IDSA President Dr. David Relman said in a statement.
Boucher said health officials are losing ground because companies are not developing drugs quickly enough to keep up with the superbugs’ ability to develop resistance, adding: “We’re all at risk.”
Almost as soon as penicillin was introduced in the 1940s, bacteria began to develop resistance to its effects, prompting researchers to develop many new generations of antibiotics. But their overuse and misuse have helped fuel the rise of drug-resistant superbugs.
In the past month, public health officials in the United States and Britain have sounded alarms about the growing threat.
On March 5 the CDC warned of the spread of Carbapenem-Resistant Enterobacteriaceae (CRE), a class of what CDC Director Thomas Frieden called “nightmare bacteria” that kill up to half of patients who get bloodstream infections from them.
A week later, Sally Davies, the chief medical officer for England, said antibiotic resistance was a “catastrophic threat” and called for global action to fill a drug “discovery void.”
‘ALARMINGLY LOW’
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