In health care debate Uword is back
Sun, 16 Sep 2007 06:26:33 GMTBy NANCY BENAC, Associated Press Writer
WASHINGTON - It's been 14 years since first lady Hillary Rodham Clinton's health care reform plan sank like a stone, swallowed by fears of a big-government power grab. In the years since, wary presidential candidates at first avoided the issue altogether, then gingerly dipped one toe, then another, back into the pool.
This year, no self-respecting presidential candidate wants to be without a health care overhaul plan, and talk about "universal coverage" is back.
There is a stark difference between the medicine being prescribed by Democrats and Republicans.
Democratic candidates argue it is the government's job to make sure everyone has health insurance they cannot lose. Republicans are pushing more limited incentives and subsidies to help people obtain affordable coverage.
Both sides are trying to steer clear of anything resembling the 1993 plan. Clinton — this time the candidate rather than the spouse — comes out with her own plan Monday, adamant that "we're going to get it done this time."
Democrats in general and the New York senator in particular approach the debate this time with better bedside manners than in the last major go-around.
Even defenders of Clinton's 1993 effort to change the system say the process scared the patient — namely, middle-income people who may want a better way, but have insurance and do not want to step into the unknown with health care.
Those fears were embodied by a middle-class couple named Harry and Louise, characters in an advertising campaign sponsored by the health insurance industry. The ads, targeting mainly opinion-makers in Washington and New York, showed the couple fretting over having to get their insurance through a new "billion-dollar bureaucracy" that would include mandatory health insurance purchasing alliances.
This time, the candidates are all "being very careful to say that, look, if you have health insurance today, you can keep it," said Kenneth Thorpe, a professor of health policy at Emory University. He has helped the top four Democrats crunch the numbers of their plans and was involved in Clinton's 1993 effort.
"The Harry and Louise ad was one of those things where people were concerned that people have to move from what they have to a plan they didn't really know." Thorpe said. "The lesson is, the less disruptive you make it, it makes it very difficult for Harry and Louise to come out and criticize it."
Already, the GOP candidates are branding Democratic proposals a step on the road to socialized medicine while they offer incremental steps such as tax breaks to expand coverage and make it more affordable.
"Let me tell ya, if we don't do it, the Democrats will," warns Republican Mitt Romney. "And if the Democrats do it, it'll be socialized medicine. It will be government-managed care. It'll be what's known as Hillary-care or Barack Obama-care or whatever you want to call it."
Polls indicate health coverage ranks high with voters as a concern and that people are willing to pay higher taxes to ensure those without coverage get it.
Two-thirds in a Pew poll this year supported government-financed health insurance for all. But that is absent the sticky details of how it would work or how much it would cost.
Robert Blendon, who directs the Harvard Program on Public Opinion and Health and Social Policy, said the current climate favors Democratic activism on health care but that could change quickly if the insured believe there is a threat to what they have.
"The Democrats have tried to tone it down," Blendon said, and for the most part are trying to avoid alienating insurers, physicians and hospitals. John Edwards, whose plan is the boldest among the top tier of candidates because it mandates universal coverage, has not been shy about taking on the industry.
"But I think you will find Clinton reaching out to these groups with plans that many find quite acceptable," Blendon said.
Clinton has said she wants to "figure out how we provide universal health care without putting billions more into the system." Her goal has been universal coverage in eight years.
And what might Harry and Louise think of all this?
The health insurance association that sponsored the ads has since merged into a new trade group called America's Health Insurance Plans. Chief executive Karen Ignagni strikes a conciliatory tone, saying there is greater consensus this time to move toward universal coverage — and a better understanding of the political realities in getting there.
"We're in a different place than we were," she said. "I think that both sides are going to have to be very, very careful."
Democrats, she said, look at the Clinton-era debacle and know they have to be careful to avoid overreaching. Republicans, likewise, know they should not underreach, she said.
"The sweet spot in the middle is trying to create a workable program that individuals who currently have coverage believe is the right direction and will not cause them to lose coverage."
Romney pans Clinton on health care
Sun, 16 Sep 2007 06:29:55 GMTBy NAFEESA SYEED, Associated Press Writer
ANAMOSA, Iowa - Republican presidential candidate Mitt Romney panned Hillary Rodham Clinton's health care plan sight unseen Saturday, eager to remind voters she failed at "socialized medicine" once before.
Speaking to more than 160 people at a Republican fundraiser, Romney said he didn't expect anything new from the Democratic presidential candidate and New York senator. Clinton is scheduled to lay out proposals for universal coverage in a speech at a Des Moines hospital on Monday.
"She says what we need to do is have the government take over health care," Romney asserted. "The last thing we need is 'Hillary care.' The last thing we need is socialized medicine."
Mark Daley, a Clinton spokesman, brushed off the comments. "Considering Governor Romney's penchant for flip-flopping, he will be the first to endorse it on Monday," Daley cracked.
Clinton said she has learned about the need for consensus since leading the failed reform effort in 1993 and wants to "figure out how we provide universal health care without putting billions more into the system."
"She'll have health care run by Washington," Romney said. "I don't want to have the people who did the Katrina cleanup taking care of my health care."
The former Massachusetts governor favors federal incentives for states to expand affordable coverage, and not a federal guarantee that everyone is insured.
He signed a state law aimed at ensuring universal coverage in Massachusetts through a mix of subsidies, sliding scale premiums and penalties for those who do not get insurance.
Pam Domer, 59, of Anamosa, liked Romney's approach. "I don't want the government running my health care," Domer said. "I would like to have choices that are affordable to me. I like free enterprise health care."
Romney was the host at a tailgate party in Ames before the Iowa State-Iowa football game, and took the politician's way out when asked which team he wanted to win: "I'm for both teams." Iowa State won 15-13.
Doctors Protocol key to helping players
Sun, 16 Sep 2007 06:41:56 GMTBy RACHEL COHEN, AP Sports Writer
Winston Moss was still wearing his pads when he went in for the CT scan. The Seattle Seahawks linebacker suffered a neck fracture during a road game in Baltimore in 1997, and the Ravens medical staff's emergency protocol ensured that that he quickly received the proper treatment.
In the aftermath of Buffalo Bills tight end Kevin Everett's severe spinal cord injury, several neurological specialists who work with NFL teams said that the key to giving a player the best chance at recovery from a catastrophic injury is to have a well-rehearsed emergency protocol in place.
Dr. Ralph Dacey, a St. Louis Rams neurosurgeon, said that each year team physicians simulate with trainers how they would respond to a serious spinal injury.
Not all NFL teams require a neurological specialist to attend every game.
"I don't consider it an essential element," said Dr. Joseph Maroon, a neurological surgeon for one of the clubs that does insist on it, the Pittsburgh Steelers. "But I think it is essential that trainers and medical personnel be very well-versed in acute management of concussions and spinal injuries."
The Carolina Panthers' team neurosurgeon, Dr. Tim Adamson, said his presence is less important than the existence of a predetermined plan that immediately gets an injured player to the right hospital and into the necessary diagnostic tests.
"The difference I make is knowing how to quickly get them through the process of treatment and evaluation," Adamson said. "There's nothing magical to do with my presence at the stadium other than to be available to get started quickly with them."
Having a neurological specialist on call near the stadium would serve equally well, he said.
On that day 10 years ago, Moss' CT scan showed no neurological damage. Dr. Kevin Auld, the Seahawks' former team physician who recalled the treatment the player received, said he wasn't completely confident that Moss would've have gotten that needed test as promptly and efficiently in every NFL city.
Before Seattle's road games, the home team's medical staff would often share information about the emergency protocol with Seahawks doctors, but not always. Auld hoped every club had the proper procedures in place but wasn't sure.
The NFL requires that the home team have on hand a physician trained in rapid sequence intubation as part of the on-field emergency crew. There must also be a medevac helicopter, ambulance, stretchers and carts, X-ray service, oxygen and emergency medical information for that city.
Dr. Andrew Cappuccino, a Bills team physician who oversaw Everett's initial treatment, specializes in spinal surgery. He's a "real star" in his field, Auld said, but what most helped Everett was Buffalo's excellent emergency protocol system. Auld observed the Bills doctors' care in formulating the plan during conversations between the Buffalo and Seattle staffs at the annual NFL pre-draft combines.
While the Everett saga has focused attention on spinal injuries, the doctors agreed that the greatest need for the input of neurological specialists is with concussions, which are far more common in football.
Chicken chain takes on Southern fryers
Sun, 16 Sep 2007 06:23:11 GMTBy DANIEL YEE, Associated Press Writer
HIRAM, Ga. - Robert Bowman loves his chicken, especially when it's breaded and loaded in a fryer. "When I go on a trip, that's all I'll eat is fried chicken. I just like fried chicken," the 67-year-old retired postal worker says.
But during a recent lunch at a restaurant near his home, the poultry on Bowman's plate was prepared differently from the Southern style he was used to. Instead of being fried, it was grilled and marinated with citrus, herbs and spices.
It's part of a move by a California-based fast food chain to sell Mexican-style grilled chicken deep inside the deep-fried South and begin expanding beyond its West Coast markets.
"We're giving the South, which loves its chicken, a healthy, wholesome alternative to fried chicken," said Steve Carley, CEO of Irvine, Calif.-based El Pollo Loco Inc. .
The suburban Atlanta restaurant, which opened at the end of August, is the first Southern location for the chain, which is ranked 70th in the nation's list of top restaurant chains based on sales according to Restaurants & Institutions magazine.
Last month, the privately held company of 340 restaurants reported a net income of $1.59 million for the 26 weeks ended June 30, a 26.4 percent increase over the $1.26 million in net income it reported for the same period a year ago. The company was purchased in November 2005 by affiliates of the New York-based equity investment firm Trimaran Capital L.L.C. and company management.
El Pollo Loco is under contract with a company led by a former Church's Chicken executive to open 50 restaurants in the Atlanta area in the next six years. The chain also plans to open restaurants in the Orlando and Tampa, Fla., areas, in Charlotte, N.C., and in Norfolk, Va.
"We think the South is ready for El Pollo Loco," Carley said. "We have a high level of confidence this is going to be a big winner."
Although grilled chicken is not new to the South — it's often found on backyard grills, a labor of love for weekend chefs — it's not the traditional focus of Southern palates, said John T. Edge, director of the University of Mississippi's Southern Foodways Alliance.
"We tend to argue about the foods to which we are devoted — fried chicken and barbecue," Edge said. "Nobody's fussing and fighting over grilled chicken in the South."
Indeed, the South's chicken wars tend to be of the fried variety. Some of the nation's Top 100 restaurant chains built upon their success serving up fried chicken in the South, including Louisville, Ky.-based KFC, which is part of Yum Brands Inc., the Atlanta-based chains Chick-fil-A and Popeyes Chicken & Biscuits, San Antonio-based Church's Chicken, Charlotte, N.C.-based Bojangles' Restaurants Inc. and Athens, Ga.-based Zaxby's.
"The heaviest weighting of our outlets are in the South, testimony to the fact that fried chicken is a Southern staple," said Kirk Waisner, vice president of menu development for Popeyes Chicken & Biscuits.
Most of the country's "major chicken players" in the $15.1 billion industry of limited service chicken chains — which includes fried chicken outlets — are based in the South, said Darren Tristano, executive vice president of the Chicago-based Technomic, Inc., a research and consulting firm that serves the food industry.
If successful, El Pollo Loco's move into the heavily competitive Southern market gives the company a good chance to become a national chain instead of remaining a regional West Coast brand, Tristano said.
"The more they are able to grow in larger cities in the East, the stronger their brand is, which allows them to leverage their advertising, marketing and customer loyalty as their brand grows," he said.
Once in the South, Carley said, the chain will stick to its roots, meaning fried chicken won't be served anytime soon. Instead, the chain is banking on the view that offering grilled chicken instead of fried food will be attractive in a region that struggles with obesity.
Last month Mississippi was named the first state to pass the 30 percent mark of adults considered obese, with Alabama and West Virginia not far behind, according to the Trust for America's Health, a research group that focuses on disease prevention.
"Everybody I think needs to change their eating habits," said Kimberly Newkirk, a 38-year-old nurse from Dallas, Ga., who came to El Pollo Loco at a friend's recommendation.
Chris Elliott is a former Church's Chicken COO and the CEO of Fiesta Brands, Inc., which has contracted with El Pollo Loco to open the 50 new restaurants. He said grilling the chicken provides "healthy overtones."
"For the same size chicken breast if you fry one versus grill it, it's about 300 calories difference," he said.
El Pollo Loco's plan of attack also includes a year's worth of marketing to people who live within a few miles of a store, including offers to try the chicken for free. In addition to Hiram, the chain initially will focus on suburban Atlanta. It January the company plans to open a restaurant inside the city.
"We know we do have to work to get in people's considerations, we have to change their routines," Carley said.
Bowman said he's not sure all lovers of fried chicken will turn to the grilled variety. But he hopes many will at least try it.
"That's the way Southerners are — a bunch of them will stick to fried chicken," Bowman said. "But when something new comes to them, they'll get used to it."
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On the Net:
El Pollo Loco: http://www.elpolloloco.com/
