KHN: Kaiser Health News

Only the most seriously injured of the 188 marathon bombing patients remain hospitalized.  Patrick Downes and Jessica Kensky Downes are among them.  The couple was cheering runners near the finish line of the Boston Marathon when the explosions threw them apart. Patrick and Jessica each lost the lower part of their left legs.

Friends are having a hard time reconciling this news with memories of the joyful pair who married just last August.  Smiles in photos of Jessica and Patrick jump off the screen.

“But that’s not just a photograph,” says Leslie Kelly, who watched Jessica grow up just outside Sacramento, Calif.  “Those two are the happiest, most optimistic, wonderful people,” continues Kelly, which provides “a real good foundation for both of them going forward.”

Jessica’s right foot was also badly damaged in the blast, but the family has told friends it looks like it can be saved. And Patrick’s third surgery went well. Family members declined requests for an interview, but a few friends are sharing their story.

“When Patrick came to, he asked if the Red Sox had won,” says Boston College buddy Tom Treacy. “It sounded like they were certainly in good spirits.”

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After bashing President Barack Obama’s health law as part of their Tampa convention festivities,  House Republicans will focus on the measure once again when they return to Capitol Hill next week.

Photo by Karl Eisenhower/KHN

Two Ways and Means subcommittees will hold hearings focused on the Internal Revenue Service’s role in implementing the law’s tax provisions and on the measure’s creation of health insurance exchanges where eligible individuals and small businesses can purchase coverage in 2014. The panel’s oversight subcommittee will hold the IRS hearing on Tuesday at 10 a.m., while the committee’s health subcommittee will have its exchange hearing Wednesday at 10 a.m.

The GOP-controlled House has voted 33 times to repeal all or sections of the health law or to defund its implementation. The party has made attacking the law a centerpiece of its campaign to win back the White House and control Congress. With the public split over the health law, Republicans see a benefit in calling more attention to the entire measure as well as individual provisions.

Democrats are just as adamant in their defense of the health law, with former President Bill Clinton singing its praises in a speech to party delegates Wednesday night at the Democratic National Convention in Charlotte.

Tax changes in the health law include changes to flexible spending arrangements and health savings accounts, a new 3.8 percent tax on investment income, a new Medicare payroll tax and taxes on medical devices.  The oversight subcommittee’s hearing will focus on how the IRS intends to handle these duties in addition to its current workload of collecting taxes, processing tax returns and administering the Earned Income Tax Credit, among other tasks.

“It is imperative that we take a close look at these new duties and consider the impact they will have on the agency and the taxpayers it serves,” subcommittee chairman Rep. Charles W. Boustany Jr., R-La., said in a news release.

While the law’s health insurance exchanges are scheduled to be up and running beginning in 2014, “the necessary regulations for exchange operation, plan design and eligibility still have not been finalized by the Obama Administration, leaving many to question whether political motivations are delaying the release of much-needed guidance for states, employers and health plans,” health subcommittee chairman Rep. Wally Herger, R-Calif., said in a release.

Inside the marble palace, as some justices have called it, the regulars in the Supreme Court bar, and in the news media, all knew that the odds of getting high drama today via health care — the decision, we mean, not the real thing — were maybe one in ten.

But they were almost all there anyway. If the health care ruling did come down, it might well be the biggest decision in decades. And these reporters and lawyers would no more take a one-in-ten chance of missing it than play Russian roulette with one bullet in the chamber.

Besides, they also knew that a second Big One (immigration), and a third (mandatory life without parole for juveniles), were a lot more likely today, and likely to deliver high drama of their own.

The chatter before the justices started talking was about what could be read into tea leaves, such as Justice Ruth Bader Ginsburg’s cheerful demeanor when she alluded to the health care case in recent public remarks.

The chatter after was about the angry dissents in those other two cases.

But inside the palatial courtroom, the real drama came when the justices were the ones talking.

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Working in a real hospital isn’t usually as dramatic as is portrayed in TV shows like Grey’s Anatomy or House, MD, but a new study has identified unprofessional behaviors to which hospital-based doctors most frequently admit, including badmouthing fellow doctors and finding medical excuses to get out of having to care for patients.

Two-thirds of doctors surveyed at three Chicago hospitals copped to having personal conversations, such as discussing evening plans, in earshot of patients, and 62 percent said they had mischaracterized a routine test as “urgent” to get it done faster. Four out of 10 said they mocked another physician to colleagues. The same number said they bad-mouthed emergency room doctors for missing part of a patient’s medical problems.

Three out of 10 said they made disparaging comments about a patient on rounds. Twenty-nine percent said they had attended a dinner or social event sponsored by a drug or medical device manufacturer or other business that stood to gain by a doctor’s decision.

The study, published in the Journal of Hospital Medicine, was based on the responses of 77 hospital-based doctors–known as hospitalists–from the University of Chicago Pritzker School of Medicine, Northwestern University Feinberg School of Medicine and NorthShore University HealthSystem.

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Over the past two weeks, 18 scathing messages hammering the Obama administration on health care matters have been e-mailed to reporters and congressional staff from an address associated with the congressional Joint Economic Committee – a panel of Democrats and Republicans from the House and Senate.

Photo by Andreas Praefcke via Wikimedia Commons

Isn’t the JEC a bipartisan, bicameral panel that alternates chairman among the parties and usually forgoes partisan attacks? What gives?

The JEC’s stated mission is to make a continuing study of matters relating to the U.S. economy. The committee, which has 10 Democrats and 10 Republicans, holds hearings and advises Congress on economic policy.

As it turns out, however, the committee rarely – if ever – works as a cohesive unit, and disclosure about who is sponsoring messages can be fuzzy or nonexistent. The JEC has separate Republican and Democratic staffs that function autonomously — and that regularly rip apart reports and messages from the other party.

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