Barriers in 5 Midwest states chill public access
A study from the the Citizen Advocacy Center finds that open government laws in Michigan, Ohio, Illinois, Wisconsin and Minnesota have systemic barriers that chill public participation and access to government.
The Center analyzed each state’s Freedom of Information and Open Meetings Acts and found striking similarities between all states, including:
- Open government laws are sporadically enforced, which means public bodies are more likely to be unresponsive to records requests and employ exemptions to keep meetings closed.
- No state surveyed has a government office with statutory authority specifically created to oversee and enforce sunshine laws.
- State employees are not adequately trained to carry out open government policies and may be unintentionally violating the laws.
- Citizens may be able to attend meetings, but there are very few opportunities to participate.
The Midwest Open Goverment Project is a comprehensive study of the Freedom of Information and Open Meetings Acts in those five states, under the auspices of the Citizen Advocacy Center.
Obama fought internal opposition to health reform
Filed under: Government, Health care reform, Hot Health Headline
Jonathan Cohn at The New Republic writes about how health care reform nearly got pushed aside in President Obama’s budget proposal.
Cohn's article says this Jan. 29 photo was taken during a meeting about how to fund health reform. (White House photo by by Pete Souza)
Indeed, there were moments during the transition and the early weeks of the administration when it appeared that the push for comprehensive health care reform might collapse before it had even begun. During this time, a debate raged inside the administration, with some senior officials arguing that the new president should wade into health care gingerly - or even postpone it altogether - because it would cost too much, distract from other priorities, and carry huge political risks.
However, Cohn reports, Obama insisted that health care remain on the agenda and, according to a senior adviser was the aspect of the budget the president discussed most.
Cohn’s interviews with more than a dozen administration insiders provide “a window onto the political and personal dynamics that dominate the new White House. It also offers insights, some of them surprising, into the management style of the president himself.”
Award winner urges coverage of nursing homes
Last summer, Theo Francis, then working for The Wall Street Journal, wrote a compelling report about a disturbing trend in which nursing homes are evicting residents, sometimes because these people are simply too costly or inconvenient. His story noted that residents on Medicaid bring facilities as little as half what they can get from people who pay out of pocket, with private health insurance or through Medicare. Meanwhile, he wrote, formal complaints about nursing-home discharge practices have doubled over a decade, to 8,500 nationally in 2006.
The story has earned Francis, who is an AHCJ member, the Jack Newfield Award for Excellence in Investigative Reporting from FRIA, a New York-based, nonprofit organization that tries to foster dignity and independence of seniors in long term care settings. The goal of the award is to encourage socially conscious reporting on the challenges of elderly life, in general, and especially those related to long-term care. FRIA hopes the award provides incentives to journalists to report on issues important to the nation’s aging population.
“No one tracks nursing-home evictions nationally, and even complaints are tracked inconsistently. Few states go farther,” Francis writes us. “So it took a lot of phone work to confirm and flesh out the pattern of evictions that I had heard about. Moreover, many of those who have been evicted are unaware of their rights under federal law, and may never know they were forced out of their homes improperly. Others are afraid to complain, fearing they may retaliation when they depend on their nursing homes to eat, bathe or use the toilet. And assisted-living facility residents, while more independent, have more to fear in some ways. In many states, they can be evicted for no reason at all. As a result, it was also challenging to find residents and families both able to articulate their experiences and willing to do so publicly.
“As news organizations cut back, investigative reporting is often one of the early casualties. Even so, I want to encourage other reporters to write about nursing homes, assisted-living facilities and their residents, many of whom are among the most vulnerable people in America today. Writing about long-term care can be a real challenge, thanks in part to a byzantine regulatory system, the incredibly decentralized nature of the industry an the anxieties that often surround those living in institutional settings. But it is also incredibly rewarding. For one thing, you meet people who’ve lived long and colorful lives. But beyond that, there are few opportunities for reporters to make more of a concrete difference in their communities and in the lives of individuals.”
Malpractice reform joins health system debate
Erica Werner of The Associated Press reports that Ezekiel Emanuel, a key adviser on health issues to President Obama and brother of White House chief of staff Rahm Emanuel, offered some hints recently about the role of malpractice lawsuit reform in the debate over changes to the country’s health care system.
Ezekiel Emanuel
At a meeting of the American Medical Association, Ezekiel Emanuel said:
“I’m not going to give you any details because I can’t. I just can tell you I’ve been thinking long and hard about that,” Emanuel, an oncologist and the brother of White House chief of staff Rahm Emanuel, told the doctors when asked about malpractice lawsuit reform. “It hasn’t gone unnoticed. So stay tuned.”
Mary Ann Geier, organizer of Health Camp Philadelphia, posted on Twitter that she wonders what the hidden agenda is and whether it might not be incompatible with true reform. She says it’s something the average person can’t figure out. Reporters, what can you tell us?
Senate Finance Committee Chairman Max Baucus, D-Mont., has proposed developing “alternate litigation models,” similar to proposals offered by Obama and Hillary Clinton.
Sen. Ron Wyden, D-Ore., says malpractice reforms are key to overhauling the health care system.
“I think it’s an essential piece for there to be enduring reform, reform that will stick and will get a significant bipartisan vote in the United States Senate,” Wyden said.
Perhaps Wyden will expand on those comments when he speaks at Health Journalism 2009 on April 17.
Investigation of drug-trial suicide earns award
For a story on ethical issues in a drug trial that may have contributed to a patient’s suicide, St. Paul Pioneer Press reporters Jeremy Olson and Paul Tosto earned the Minnesota Journalism Center’s Frank Premack Public Affairs Journalism Award for excellence in investigative or analytical reporting about public affairs in the Twin Cities metro area.
Through the eyes of grieving mother Mary Weiss, Tosto and Olson followed Dan Markingson’s schizophrenia diagnosis, his participation in a University of Minnesota clinical trial for AstraZeneca’s Seroquel and his eventual suicide in 2004. Markingson was diagnosed, treated and enrolled in the study by Dr. Stephen Olson, who also happened to be looking for hard-to-find patients with Markingson’s symptoms for the psychiatric drug trial he was running.
From the judges:
In this piece, Olson and Tosto reported for the first time on schizophrenia patient Dan Markingson’s death and the resulting lawsuit and probes. In the process, they pulled back the curtain on the rarely viewed world of industry-funded clinical research and the financial incentives that can compromise a doctor’s decision-making.
Premack judges in this category said: “Through the eyes of one patient, this story shed considerable light on the complicated and competing interests between the development and path to market of new drugs, funding needs of the University and the integrity of medical research. The judges are hopeful that the new ethics task force implemented at the U of M is resulting in changes in conflict of interest policies.”
Olson and Tosto said Markingson’s death also raised “questions about why the Institutional Review Board, the internal group charged with protecting people in university studies, didn’t intervene.” The reporters also used the the $782,000 paid by drug companies to the two psychiatrists overseeing Markingson’s trial (including $261,000 from AstraZeneca) to highlight national criticism of the conflict of interest inherent in pharmaceutical-company funding of clinical trials and questioned whether study staff would be willing to let the public know if something untoward occurred during a trial.
“Physicians face a difficult choice,” testified Dr. Greg Rosenthal, an Ohio eye specialist. “One path is to go along. With drug company money, you can increase your income, prestige, build your practice or fund a department, research or professorships. The middle ground is to simply look away. The hard choice is to fight back.”
Native American death rates top all groups
Death rates among native Americans are high and climbing for men, women and infants, Vanessa Ho reported in the Seattle Post-Intelligencer. Ho found that “the downward drift, which reflects national trends, stems from entrenched health disparities exacerbated by years of inadequate funding.”
A recent state Department of Health report showed that the march against cancer, heart disease and infant mortality has largely bypassed Native Americans. In 2006, the latest year studied, Native American men were dying at the highest rate of all people, with little change since the early ’90s. Their life expectancy was 71, the lowest age of all men, and six years lower than that of white men.
The news was just as grim for Native American women. Their death rate had surged by 20 percent in a 15-year period, while the overall death rate had decreased by 17 percent.
But the starkest health disparity was among babies. Native American babies were dying at a rate 44 percent higher than a decade ago, while the overall rate of infant deaths had declined.
Ho discovered that tribes are running out of annual health-care money sooner than ever, and that lack of preventative medicine and poor dietary habits have only exacerbated health problems among Native Americans.
Seroquel user asks for side-effect documents
Lawyers for a Vietnam veteran who is among the thousands of patients suing AstraZeneca over claims that Seroquel caused diabetes and other ailments have requested the release of confidential documents about the drug’s side effects, AP business writer Linda Johnson reports.
Lawyers obtained the documents in question during the discovery process, and say they contain “internal company analyses of safety data on Seroquel that the lawyers believe FDA staff and advisers have never seen.” The judge in the case has set late March deadlines for the consideration of related motions, deadlines which take into consideration an April 8 FDA hearing FDA on the safety of proposed additional uses of Seroquel.
Lawyers for Ted Baker, 60, of Bastrop, La., have asked New Jersey Superior Court Judge Jamie Happas to unseal 19 specific documents - out of roughly 2.85 million generated so far in the litigation - so that they can present them to the FDA advisory panel members at the hearing.
“We think it’s important that they have the benefit of what we have learned,” Ellen Relkin, one of Baker’s lawyers, told The Associated Press in an exclusive interview Wednesday. “What we believe the FDA does not have are internal memos where they analyze the studies (and state) their real opinions or concerns about the data.”
According to Johnson’s report, “plaintiffs lawyers believe the drug causes Type 2 diabetes through two mechanisms: stimulating appetite and significant weight gain, and by raising levels of blood sugar and cholesterol.”
Related
Hearing over sealed Seroquel documents is tomorrow
Advocates call for enhanced prosthetic insurance
Unlike Medicare or Medicaid, private insurers often cap annual coverage for prosthetics. In recent years, some insurers have reduced or eliminated these caps, driving up patient costs for already-expensive prosthetics and sparking a nationwide push for so-called “prosthetic parity,” or an equality in prosthetic coverage for public and private insurers. The almost decade-long effort is making headlines again, with several states passing or considering legislation in 2008 and 2009.
by Susan Schulman via Flickr
Eleven states have passed laws requiring private insurers to offer prosthetic coverage equal to Medicare standards or to hip and joint replacement coverage, and amputee advocates are pushing for legislation in a number of other states (including Pennsylvania, Utah, Texas, Idaho and Iowa) and at the federal level (alternative link).
The organization behind the campaign, the Amputee Coalition of America, estimates that almost 2 million Americans are living without limbs, and says 185,000 more amputations are performed each year. The ACA says that while prosthetic limbs often have a lifespan of 3 to 5 years, many private insurers either place a lifetime cap on coverage of prosthetic purchases or will only cover the purchase of one such device during a patient’s lifetime. According to the ACA, financial hardship is the main obstacle preventing amputees from gaining access to prosthetics.
It is well known that lack of access to these devices leads to poor rehabilitation outcomes, and places amputees at a greater risk of developing dangerous and costly secondary conditions such as obesity, diabetes, cardiovascular disease and additional amputation. These in turn lead to decreases in mobility, productivity and the ability to live independently. These factors combine to create additional costs of care, significantly impact the quality of life and shorten life expectancy.
Here’s the ACA’s campaign and talking points (PDF).
Obama announces FDA officials, food safety plan
In his weekly address, President Barack Obama announced new FDA leadership and a new Food Safety Working Group in which the Departments of Health and Human Services and Agriculture work to organize food safety efforts across all levels of government.
There are certain things only a government can do. And one of those things is ensuring that the foods we eat, and the medicines we take, are safe and don’t cause us harm. That is the mission of our Food and Drug Administration and it is a mission shared by our Department of Agriculture, and a variety of other agencies and offices at just about every level of government.
The President called food-borne illness a “hazard to public health” and “unacceptable” and said new FDA officials would work with other agencies to prevent and contain outbreaks as part of the Food Safety Working Group.
This Working Group will bring together cabinet secretaries and senior officials to advise me on how we can upgrade our food safety laws for the 21st century; foster coordination throughout government; and ensure that we are not just designing laws that will keep the American people safe, but enforcing them. And I expect this group to report back to me with recommendations as soon as possible.
New FDA Commissioner: Dr. Margaret Hamburg
Experience: Nuclear Threat Initiative’s founding Vice President for the Biological Program; Assistant Secretary for Planning and Evaluation, U.S. Department of Health and Human Services; Commissioner of Health for the City of New York; Assistant Director of the National Institute of Allergy and Infectious Diseases of the National Institutes of Health.
New Principal Deputy Commissioner: Dr. Joshua Sharfstein
Experience: Baltimore Commissioner of Health; member of the Board on Population Health and Public Health Practice of the Institute of Medicine.
At the end of the address, President Obama also announced several specific policy changes.
As part of our commitment to public health, our Agriculture Department is closing a loophole in the system to ensure that diseased cows don’t find their way into the food supply. And we are also strengthening our food safety system and modernizing our labs with a billion dollar investment, a portion of which will go toward significantly increasing the number of food inspectors, helping ensure that the FDA has the staff and support they need to protect the food we eat.
Vegetables, healthy food on Obama agenda
In yet another break with the Bush family legacy, the Obamas, led by matriarch Michelle, have embraced broccoli and other local greens and encourage others to do the same. New York Times reporter Rachel L. Swarns chronicled the pro-vegetable, pro-local eating agenda of the first family. Swarns leads with the First Lady praising a local soup kitchen’s steamed broccoli and homemade mushroom risotto, then digs deeper into her struggles to promote a healthy agenda both around the country and around her own dinner table.
White House officials say the focus on healthy living will be a significant item on Mrs. Obama’s agenda, which already includes supporting working families and military spouses. As the nation battles an obesity epidemic and a hard-to-break taste for oversweetened and oversalted dishes, her message is clear: Fresh, nutritious foods are not delicacies to be savored by the wealthy, but critical components of the diets of ordinary and struggling families.
Some healthy-eating advocates want the Obamas to go even further, Swarn found.
(Gourmet magazine Editor Ruth) Reichl would like the White House kitchen to issue regular news releases that describe what the first couple and their daughters are eating. (Then parents across the country could tell their children, “You know, Malia and Sasha were eating salad yesterday. …”)
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Awards for Excellence in Health Care JournalismDeadline: Feb. 3
- How I did it: Falsified charts in nursing homes linked to patient care
- Access Denied: Looking at a lack of health care availability
- Transparency & medical errors: Public reporting of patient harm is a potent force
- Focus on freelancing: Tips for buying liability insurance
- Why do some patients get stuck in hospitals for weeks, months?
- Investigate health professionals and the boards that regulate them
- Presidents of AHCJ, SPJ call for more openness from Obama administration
