Health care bill moves forward
Following the Senate vote on the health care bill, reporters have rushed to cover the latest developments. Here is just a bit of the coverage:
Ricardo Alonso-Zaldivar and Erica Warner of The Associated Press have a point-by-point comparison of the Senate and House health care bills. Werner also has an interesting look at the winners and losers in the bill, including the residents of Libby, Mont., many of whom suffer from asbestos-related illnesses from a now-closed mineral mining operation.
On The Wall Street Journal’s health blog, Jacob Goldstein reports on the Congressional Budget Office’s estimates on the Senate bill with the “public option lite” - with private plans overseen by a government agency.
Reuters’ Donna Smith offers an overview of the Senate health care bill in a Q&A format.
Scott Hensley of NPR’s Shots blog notes the weekend’s key development that led to the bill moving forward and he looks ahead to reconciliation.
In a piece that appears in USA Today, Phil Galewitz of Kaiser Health News points out that mandates, such as requiring all Americans to have health insurance, do not guarantee compliance. His article explains the mandate and the penalties for those who choose to go uninsured.
In the Los Angeles Times, Kim Geiger and James Oliphant also look at the mandate: why its in the bill, how it can cover people with expensive illnesses and “age rating.”
Plenty more coverage is emerging by the minute. Here is the bill.
Scripps finds inequalities in nursing home care
Lee Bowman and Thomas Hargrove of Scripps Howard News Service looked into nursing homes around the country and found the quality of care to be quite uneven, highlighting the difficulty of finding a good nursing home.
Despite the differences in care, Bowman and Hargrove were able to draw some conclusions from their analysis of the Nursing Home Compare data:
- Institutions run by for-profit corporations generally get lower scores than those run by nonprofits.
- Homes with more nursing staff per patient generally do better in the ratings.
- Homes with more than 100 beds tend to get lower scores
- Ratings are lowest in South and highest for homes in the Northeast.
- Slightly more than 20 percent of nursing homes nationwide have been regularly given the lowest ratings, and 12 percent to 13 percent have received the top rating.
Bowman found that, because of medical concerns, many families are forced to choose a nursing home on a very tight timetable, usually related to a loved one’s hospital discharge date. Concerns like expedience and geographic proximity, then, often end up trumping nursing home quality. To help better direct this process, Bowman offered “Ten things to consider in nursing home care,” only one of which directly relates to the Nursing Home Compare database.
For ideas on how to localize stories on this general theme, check out the rest of the Scripps package.
Slim guide:
Covering the Health of Local Nursing Homes
Check out AHCJ’s latest volume in its ongoing Slim Guide series. This reporting guide gives a head start to journalists who want to pursue stories about one of the most vulnerable populations – nursing home residents. It offers advice about Web sites, datasets, research and other resources. After reading this book, journalists can have more confidence in deciphering nursing home inspection reports, interviewing advocacy groups on all sides of an issue, locating key data, and more. The book includes story examples and ideas.
AHCJ publishes these reporting guides, with the support of the Robert Wood Johnson Foundation, to help journalists understand and accurately report on specific subjects.
Recent workshop
AHCJ’s Aging in the 21st Century workshop, held Oct. 16 and 17 in Miami, addressed many topics raised by the Tribune’s reports, as well as the changing picture of aging Americans and key research and issues related to this growing population. Tip sheets and presentations from that workshop are available to AHCJ members, as are these related tip sheets:
- Aging Nation: Troublesome Health Care Issues
- Headlines an advocate for seniors would like to see
- The impact of aging upon health care
- Covering nursing homes and other issues of aging
- How will retiring boomers affect the national health agenda?
- You Can Run, but You Can’t Hide: Policy and Problems in Long-Term Care
- Biology of Aging: Sources and Resources
CDC: Nearly 1 percent of U.S. kids have autism
An average of one in 110 children have an autism spectrum disorder, according to a new study of the health and education records of 8 percent of 8-year-old children in the United States. In its release, the CDC says “These results reflect data collected in multiple communities throughout the U.S. from 2006 showing an estimated prevalence of ASDs to be about one percent of 8-year-olds in the U.S.”
The study, from the CDC’s Autism and Developmental Disabilities Monitoring Network, looked at the records of 307,790 children in 11 study sites and identified 2,757 with an autism spectrum disorder. ASD prevalence was higher in boys than in girls and varied by race and ethnicity. The study also found that the overall prevalence of ASD has increased since earlier studies.
“These results indicate an increased prevalence of identified ASDs among U.S. children aged 8 years and underscore the need to regard ASDs as an urgent public health concern.” In the report, the CDC acknowledges the need to “understand how complex genetic and environmental factors interact to result in the symptoms which make up the autism spectrum.”
The CDC reports that, based on its examination of the records, most children with an ASD are getting special education services in the public schools, though not all were categorized as having an ASD. Other reasons for them receiving special education included specific learning disabilities, speech and language impairments, other health impairments and intellectual disabilities.
Interestingly, the Age of Autism blog reported the news from this study as early as Wednesday, despite the CDC’s embargo that didn’t lift until noon Eastern time on Friday, bringing to mind earlier questions about embargoes. More about that here.
Media briefing
The CDC is having a telephone-only briefing with Catherine Rice, Ph.D., a behavioral health scientist with the National Center on Birth Defects and Developmental Disabilities, to discuss the data at noon Eastern time. The briefing will be available via listen-only audio web site. The CDC will make a transcript of the briefing available on its Web site.
Daschle pushes health IT to Obama, clients profit
Filed under: Conflicts of interest, Hot Health Headline
South Dakota Democrat and former Senate Majority Leader Tom Daschle is not registered as a lobbyist, and has not held public office since he lost a re-election bid in 2004. Instead, Fred Schulte and Emma Schwartz report for the Huffington Post Investigative Fund, that Daschle has existed in a nebulous limbo that’s allowed him to pivot deftly from pushing electronic medical records as an almost-HHS secretary to helping private firms profit handsomely from their implementation.
Daschle, as Obama’s first choice to head the Department of Health and Human Services last year, was a forceful advocate for using billions of dollars in economic stimulus money to help doctors and hospitals buy electronic medical records systems.
Tax problems led him to withdraw his name from consideration for the cabinet post. Then, a few weeks after Obama signed off on a stimulus plan that provided some $45 billion for digitizing the health system, Daschle began assisting private clients seeking to profit from the new law.
Public interest groups take issue with Daschle’s activities:
“He was in a position to drive public policy and develop connections within HHS that could provide his clients with an unfair competitive advantage in receiving taxpayer dollars, at the same time he and his firm benefits from his previous activities,” said Scott Amey, a lawyer with the Project on Government Oversight.
In the rest of the solid, in-depth piece, the reporters track both the breadth of Daschle’s influence (he has the ear of the president) and the impact he’s had on bottom lines across corporate America.
Calif. SSI payouts insufficient, lacking in oversight
Capital Public Radio’s Kelley Weiss explored how cuts to California’s Supplemental Security Income were impacting older disabled Californians and, in a second story, the lack of oversight in the massive state program. According to Weiss, the state doesn’t track how the money is spent by recipients or whether the $845 a month is enough to live on. Weiss even found recipients who admitted using the money to buy everything from beer to crack cocaine.
“I don’t have any, I don’t have any background on this…yeah, we’ll have to set up a different time for that.”
Learn more about the national system here.
Lieberman: Joe’s looking out for folks at home
Sen. Joe Lieberman (I-Conn.) has been a vocal burr in the saddle of the Democrat majority’s push for health care reform. Writing for CJR.org, Trudy Lieberman seeks to explain why Joe Lieberman has so vigorously opposed measures like the “public option” and the long-term care CLASS Act. Trudy Lieberman says the senator’s position would seem to have something to do with his constituent base.
Independent Sen. Joe Lieberman at the 2008 Republican National Convention. Photo by NewsHour via Flickr.
Joe Lieberman comes from Connecticut, and Hartford is America’s insurance capital. It’s home base to Aetna, one of the country’s largest health insurers and a huge lobbying force this year, not to mention some lesser carriers that dabble in the health insurance business.
Trudy then goes down Lieberman’s reform stances issue-by-issue, pointing out exactly how vested interests in his constituency could have influenced each one.
There certainly seems to be some data to back Trudy Lieberman’s insights. OpenSecrets.org shows that the “Finance, Insurance & Real Estate” sector has been the largest donor to the senator.
Survey: Nation lacking in epidemiologists
Nearly 1,500 more epidemiologists are needed nationwide to sufficiently carry out public health duties, according to a survey of state epidemiologists earlier this year.
The Council of State and Territorial Epidemiologists has released its 2009 Epidemiology Capacity Assessment (PDF), intended to report on the “epidemiology capacity of state and territorial health departments in the United States, structured around the Ten Essential Services of Public Health” in eight areas: bioterrorism/emergency response, chronic diseases, environmental health, infectious diseases, injury, maternal and child health, occupational health, and oral health.
The analysis found that there are fewer epidemiologists resulting in a reduced capacity for surveillance and epidemiology – especially in the areas of bioterrorism and emergency response. It also reveals that a number of states lack the ability to perform several of the essential services of public health, that states are lacking in the technology to conduct surveillance and that many epidemiologists with high levels of training are leaving the public health sector.
The assessment is based on an online survey filled out by state epidemiologists or their delegates between April and July of 2009.
The 122-page report includes recommendations and an in-depth examination of the workforces, the functions that are in jeopardy, the funding sources for state health departments and more.
The CSTE Web site also has a handy directory of state epidemiologists that includes e-mail addresses.
Medicaid kids more likely to get antipsychotics
Filed under: Hot Health Headline, Pharmaceuticals
New York Times reporter Duff Wilson reports on federally funded research that has revealed that children covered by Medicaid are four times more likely to get antipsychotic drugs than those covered by private insurers. Wilson puts the story in context with discussion of possible new FDA regulations on antipsychotics for children, as well as state efforts to curb the Medicaid-related prescriptions.
A group of Medicaid medical directors from 16 states, under a project they call Too Many, Too Much, Too Young, has been experimenting with ways to reduce prescriptions of antipsychotic drugs among Medicaid children. They plan to publish a report early next year.
Wilson explores a number of potential causes for the disparity, noting that, at the very least, children on Medicaid don’t get adequate mental health services.
Panel recommends FDA restrict MRI scan drugs
An advisory panel has “recommended Tuesday that the Food and Drug Administration effectively ban, for patients with severe kidney disease, the use of two drugs used to create high-contrast images on magnetic resonance imaging (MRI) scans.” ProPublica’s Jeff Gerth has been reporting on the issue for some time and offers some valuable background on the topic.
The drugs in question are GE’s Omniscan and Covidien’s Optimark. Bayer’s Magnevist, the category’s market leader, escaped the most serious censure, but all three agents have been linked to nephrogenic systemic fibrosis, a rare but very serious disease.
Series examines life expectancy disparities
In their Contra Costa Times series “Shortened Lives,” Suzanne Bohan and Sandy Kleffman start by profiling three different people from three very different (though nearby) ZIP codes, noting the life expectancy for each. Then they deliver the kicker on which all subsequent reporting hinges:
The Contra Costa Times team also produced a wonderful interactive Google Map breaking down life expectancy by ZIP code.
Though Angelis, Orantes and Rettig all have health coverage, a growing body of research shows that where they live, their social status, and the toll of chronic stress have a much more decisive effect on their health and life span than visits to a doctor’s office.
The pair explains the effect these disparities have on health care costs, as well as how they are caused and how they might be addressed, themes which are all explored further in other stories in the package.
In a companion piece, Bohan and Kleffman explain how they put the multimedia series together. Their step-by-step breakdown of how to go from census data and death certificates to an in-depth series is particularly interesting. The series was a project for the California Endowment Health Journalism Fellowships.
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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
