Archive for December, 2012

School Cafeterias Join Fight Against Childhood Obesity

Kathy Del Tonto started cooking school food 30 years ago in the Montrose school district at the foot of Colorado’s San Juan Mountains. Back then, the cafeteria workers made everything from scratch.

“My first kitchen that I managed was a little country school out south of town, and we made our own ketchup and everything,” she says.

But times changed. Families started eating more fast food, and processing companies started offering schools fast-food kinds of choices. The companies would take the food that the U.S. Department of Agriculture gives to schools, turn it into chicken nuggets and other processed items kids want, and then send it to cafeterias — for less than cooking it on site would cost.

Del Tonto went along with it. “By doing processed food you can cut your labor because you don’t have to do the hard cooking, or you’re just reheating and that kind of thing,” she explains.

Increasingly, though, the movement to reduce childhood obesity by improving what kids eat in school has changed the game. It means schools are now required to serve more fresh fruits and vegetables. And there’s a movement within the movement that promotes the retro notion of cooking meals from scratch. And that takes a change in the hearts and minds of those behind the lunch line.

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Friday, December 28th, 2012

HHS Stops Short Of Calling For Safety Regulation Of Digital Records

The Obama administration Friday urged cooperation between software companies and caregivers to prevent patient harm caused by faulty electronic records. But it stopped short of calling for regulation or a federal requirement to report computer mistakes that pose a risk to patients.

“We are saying to the vendors: Step up and prove your ability to create a code of conduct that would be enforceable, that would bind you voluntarily to reporting safety events,” Dr. Farzad Mostashari, the administration’s coordinator for health information technology, said about the report. “And what we’re saying is: If you don’t step up, we can always look at more classic regulatory approaches.”

That doesn’t go far enough, said Arthur Levin, director of the Center for Medical Consumers, which promotes safety and effectiveness in health care.

“These are very baby steps,” he said. “They’re all voluntary. They rely on the goodwill of everybody involved, including the vendor industry, which really hasn’t been willing to admit there may be real problems here.”

Thanks to Medicare payment incentives, hospitals and doctors are swiftly installing computerized patient information systems. Nearly 100,000 health care providers are using electronic health records (EHRs), the Department of Health and Human Services said in June. (more…)

Friday, December 21st, 2012

Today’s Headlines – Dec. 21, 2012

Today’s early morning highlights from the major news organizations, including reports about the House Republicans’ failure to pass Speaker John Boehner’s tax and federal debt plan.

The New York Times: Boehner Cancels Tax Vote In Face Of G.O.P. Revolt
Speaker John A. Boehner’s effort to pass fallback legislation to avert a fiscal crisis in less than two weeks collapsed Thursday night in an embarrassing defeat after conservative Republicans refused to support legislation that would allow taxes to rise on the most affluent households in the country. … The stunning turn of events in the House left the status of negotiations to head off a combination of automatic tax increases and significant federal spending cuts in disarray with little time before the start of the new year (Weisman, 12/20).

The Wall Street Journal: Boehner’s Budget ‘Plan B’ Collapses
House Speaker John Boehner, facing a rebellion in his party’s conservative ranks, abandoned his own plan to avert tax increases for most Americans Thursday night, throwing Washington’s high-stakes budget negotiations into disarray and bringing the prospect of tumbling over the fiscal cliff into sudden focus. … Mr. Boehner was already under pressure from party conservatives for concessions he had made in earlier talks with Mr. Obama, including a weekend offer to raise tax rates on millionaires and allow a one-year increase in the debt limit, in exchange for Mr. Obama proposing cuts in Medicare and other fast-growing entitlement programs. Administration officials now say they doubt whether Mr. Boehner would have been able to pass that proposal (Hook, Bendavid and Lee, 12/21).

For more headlines … (more…)

Friday, December 21st, 2012

The Gun Lobby’s Favorite Part Of The Health Law

Updated at 12:00 noon.

Did you know the Affordable Care Act stands up for gun rights?  The “Protection of Second Amendment Gun Rights” section (page 19 in this PDF) says the health law’s wellness programs can’t require participants to give information about guns in the house. It also keeps the Department of Health and Human Services from collecting data on gun use and stops insurance companies from denying coverage or raising premiums on members because of gun use.

The massacre in Newtown, Conn., renews the controversy about whether gun violence is a public health issue. Should health authorities view guns in the same category as pneumonia and car crashes? The debate has been going on for years, with epidemiologists arguing firearms can kill just as many as a bad flu season and gun-rights advocates viewing any attention from public health officials as a step toward gun confiscation — the beginning of the end of the Second Amendment.

The ACA language, which does not prohibit doctors from inquiring about guns in the household, was included at the request of Nevada Democrat Sen. Harry Reid, the Senate majority leader and a gun rights supporter. Reid’s office did not respond to a request for comment.

The language was inserted after the act cleared the Senate Finance Committee and before it was voted on by the full Senate.

The National Rifle Association did not respond to a request for comment.

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Thursday, December 20th, 2012

Today’s Headlines – Dec. 20, 2012

Today’s early morning highlights from the major news organizations, including news about the efforts to reach a deal on curbing the federal deficit.

The New York Times: Obama And Boehner Diverge Sharply On Fiscal Plan
Hopes for a broad deficit-reduction agreement faded on Wednesday as President Obama insisted he had offered Republicans “a fair deal” while Speaker John A. Boehner moved for a House vote as early as Thursday on a scaled-down plan to limit tax increases to yearly incomes of $1 million and up, despite Senate opposition and Mr. Obama’s veto threat (Calmes and Weisman, 12/19).

The Washington Post: ‘Cliff’ Standoff: Boehner Works To Wrangle Votes For ‘Plan B’; Obama Threatens Veto
House GOP leaders scrambled to rally their members Wednesday behind a plan to extend tax cuts on income up to $1 million, defying President Obama’s veto threat and setting up a showdown that could send Washington over the year-end “fiscal cliff.” … If Boehner’s limited proposal were to be enacted, the economy would still take a hit: Jobless benefits would begin to expire for the long-term unemployed; physicians with elderly patients would see a sharp drop in Medicare reimbursements; and $100 billion in across-the-board cuts to federal agencies would begin (Kane and Helderman, 12/19).

For more headlines … (more…)

Thursday, December 20th, 2012

Today’s Headlines – Dec. 19, 2012

Today’s early morning highlights from the major news organizations, including reports about the “fiscal cliff” negotiations.

The New York Times: Hospitals Fear They’ll Bear Brunt Of Medicare Cuts
As President Obama and Congress try to thrash out a budget deal, the question is not whether they will squeeze money out of Medicare, but how much and who will bear the brunt of the cuts. … But any significant tinkering with the benefits for older Americans comes with significant political risks, and most Democrats in Congress strenuously oppose raising the age when Medicare coverage begins. With growing pressure to reach an agreement on deficit reduction by the end of the year, some consensus is building around the idea that the largest Medicare savings should come from hospitals and other institutional providers of care (Pear and Abelson, 12/18).

The Wall Street Journal: Cleveland Clinic Diagnoses Health-Care Act
Just over a year from now, the Affordable Care Act is set to unleash enormous change in the health-care sector, and Cleveland Clinic Chief Executive Delos “Toby” Cosgrove is preparing his institution by expanding its reach and striving to make caregivers more cost-conscious. … Dr. Cosgrove has pushed efforts to translate the system’s research work into new commercial opportunities ranging from a social-media site on beauty to a medical-device startup developing artificial-heart technologies. Cleveland Clinic is also striking deals with employers such as Wal-Mart Stores Inc. to send workers to there for complex procedures, moves that lock in patients for high-end surgeries. The new federal provisions—which include cutbacks to Medicare payments and the creation of new health-insurance marketplaces for consumers—will test institutions like Cleveland Clinic (Mathews, 12/18).

For more headlines … (more…)

Wednesday, December 19th, 2012

Colorado Gov Pitches Plan To Mend Mental Health Safety Net

In a grim coincidence, just days after the mass killing in Newtown, Conn., Colorado Gov. John Hickenlooper is proposing an $18.5 million plan to strengthen the state’s mental health system. The proposal is the result of five months of work by a group of advisors convened by Hickenlooper in the wake of a mass shooting in July at an Aurora, Colo., movie theater that left 12 dead.

The governor’s announcement had been set well before Friday’s massacre.

“We really have a duty after tragedies to look at what we do, how we act, and how we help each other,” Hickenlooper, a Democrat, said. “How do we increase the probability that we can keep those who are suffering from some sort of mental illness from being a danger to themselves and to others?”

The plan calls for 50 new treatment beds for those transitioning from institutional care,  20 more for those in jail or prison and 107 housing vouchers for people being released from in-patient treatment. It would also expand a 24 hour crisis telephone line from beyond Denver to the rest of the state. The plan also calls for five “crisis stabilization centers” people could drop in to 24 hours a day for help.

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Wednesday, December 19th, 2012

Today’s Headlines – Dec. 18, 2012

Today’s early morning highlights from the major news organizations, including reports about some of the health program specifics involved in offers traded in the ongoing fiscal cliff negotiations.

The New York Times: Obama’s New Offer On Fiscal Crisis Could Lead To Deal
The offer is close to a plan proposed by the speaker on Friday, and both sides expressed confidence that they were closing in on a major deficit-reduction plan that could be passed well before January, when more than a half-trillion dollars in automatic tax increases and spending cuts would kick in (Weisman, 12/17).

The Washington Post: Obama, Boehner Move Closer To ‘Cliff’ Deal
Obama laid out a counteroffer that included significant concessions on taxes, reducing the amount of new revenue he is seeking to $1.2 trillion over the next decade and limiting the hike in tax rates to households earning more than $400,000 a year. … Obama also gave ground on a key Republican demand — applying a less-generous measure of inflation across the federal government. … In addition, Obama increased his overall offer on spending cuts. … Meanwhile, the possibility remains that the deal could get even more distasteful for Democrats, particularly if Republicans counter Obama’s request for $1.2 trillion in new taxes with a demand for an additional concession on health care, such raising as the eligibility age for Medicare beneficiaries from 65 to 67 (Montgomery and Kane, 12/17).

For more headlines … (more…)

Tuesday, December 18th, 2012

Today’s Headlines – Dec. 17, 2012

Today’s early morning highlights from the major news organizations, including weekend updates regarding the fiscal cliff negotiations as well as news regarding states’ decisions on health exchanges.

The Associated Press/Washington Post: Movement Seen In ‘Fiscal Cliff’ Talks  As Boehner Offers Revenue Boost
In return, Boehner is asking for $1 trillion in spending cuts from government benefit programs like Medicare. Those cuts would defer most of a painful set of across-the-board spending cuts set to slash many domestic programs and the Pentagon budget by 8-9 percent, starting in January (12/17).

Politico: Fiscal Cliff Deal Still Faces Many Hurdles
House Speaker John Boehner jump-started the budget talks by offering to raise tax rates, but major differences on entitlements and revenue could prove difficult to bridge with only two weeks until the fiscal cliff deadline. … But proposed cuts to Medicare are now the key to any fiscal cliff deal. Boehner needs robust changes to the hugely popular seniors health program to sell any kind of tax-rate increase to his conservative-dominated Republican Conference (Sherman and Bresnahan, 12/16).

For more headlines … (more…)

Monday, December 17th, 2012

Med Students Switch Gears After Sandy KO’s Training Hospitals

After completing a medical rotation in pediatrics, Hannah Kirsch was looking forward to starting another one in psychiatry at New York City’s Bellevue Hospital – but then Hurricane Sandy hit. Kirsch is among about 170 third-year and fourth-year medical students at NYU School of Medicine who were required to change their plans after two of NYU’s academic training hospitals, NYU Langone Medical Center and Bellevue, temporarily closed due to extensive flood damage.

Photo by Alvin Tran/KHN

The hospital closures left them with two options: take their rotations at other New York-area hospitals or defer them to a later time – possibly early next year when Langone and Bellevue are expected to reopen.

Kirsch, a third-year medical student, chose to defer her psychiatric rotation and instead began an elective course in neuroimmunology at Johns Hopkins University School of Medicine. “This is going to help in my applications. … I’m working somewhere that’s number one in the country in what I want to do,” she said, adding that she hopes to begin a residency program in neurology after medical school.

Dr. Lynn Buckvar-Keltz, associate dean for student affairs at NYU Langone, said “students just have had some minor concerns.” Most are interested in training at Bellevue, she said, and some “have chosen to defer their clinical rotation at Bellevue [until it’s] back up and running.”

She said a limited number of Bellevue outpatient clinics reopened in late November, allowing some medical students back on site. Bellevue Hospital, however, won’t fully reopen until February.  NYU Langone Medical Center expects to fully reopen by the end of January.

Buckvar-Keltz said many medical students have found it “interesting to go to another hospital and see how medicine is practiced differently.” Their experiences with Hurricane Sandy, she said, have even helped many fourth-year students distinguish themselves from other applicants during medical residency interviews.

“I think in the aftermath, our students, as well as everyone here at the NYU medical center, have really been impressed with how the community has come together, helped each other,” Buckvar-Keltz said. “It’s really a good feeling and good vibe here. They’re interested in staying here [at NYU] for residency.”

Monday, December 17th, 2012

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