Stem cell bill approved by Senate
Thu, 12 Apr 2007 09:20:36 GMT
By DAVID ESPO, AP Special Correspondent
WASHINGTON - A stubborn Senate voted Wednesday to ease restrictions on federally funded embryonic stem cell research, ignoring
President Bush's threat of a second veto on legislation designed to lead to new medical treatments.
The 63-34 vote was shy of the margin that would be needed to enact the measure over presidential opposition, despite gains made by supporters in last fall's elections.
"Not every day do we have the opportunity to vote to heal the sick," said Claire McCaskill , D-Mo., a senator less than 100 days following a tough 2006 campaign in which the stem cell controversy played a particularly prominent role. "It is a noble cause," she added.
"We're going to use federal money, indirectly or directly, to destroy embryos," countered Sen. Tom Coburn , R-Okla., echoing Bush's argument against the measure. Coburn said claims of imminent scientific breakthroughs from embryonic stem cell research are unsubstantiated and that adult stem cells have been shown to be useful in a variety of cases.
The House, which passed similar legislation earlier in the year, is expected to adopt the Senate's version in the next several weeks for Bush's veto.
The Senate bill, Bush said, "is very similar to legislation I vetoed last year. This bill crosses a moral line that I and many others find troubling. If it advances all the way through Congress to my desk, I will veto it," the president said in a statement after the vote.
Despite the criticism, the bill's chief sponsor urged the president to give the bill another look. "I urge him to reconsider this bill and sign it. Unleash America's scientists," said Sen. Tom Harkin , D-Iowa.
Capping two days of debate, the Senate also voted 70-28 to pass a separate measure backed by Republicans. It supported research in adult stem cells.
Bush said this legislation builds on "ethically appropriate research" and he urged Congress to pass the measure "so stem cell science can progress, without ethical and cultural conflict."
The Senate's action was the latest act in a drama that blends science and politics on an issue that affects millions of disease sufferers and their families.
"It's extremely frustrating to go through this Kabuki dance a second time with the president," said Peter Kiernan, head of the Christopher and Dana Reeve Foundation, which funds research.
"The one thing we know is we will outlast him."
Stem cells are created in the first days after conception. They are typically culled from frozen embryos, which are destroyed in the process. According to the
National Institutes of Health Web site, scientists have been able to conduct experiments with embryonic stem cells only since 1998.
The embryonic stem cells have the ability to transform into a "dazzling array of specialized cells," the Web site says — the property that scientists and others say offers the potential for the development of treatment for diseases as varied as juvenile diabetes, Parkinson's and Alzheimer's.
There was no federal money for the work until Bush announced on Aug. 9, 2001, that his administration would make it available for lines of stem cells that were in existence. Elected with the strong support of abortion foes and other conservatives, he said at the time his decision was designed to balance concerns about "protecting life and improving life."
He also limited the funds to cell lines derived from embryos that were surplus at fertility clinics, and that had been donated from adults who had given informed consent.
Advocates of the veto-threatened legislation argue that the number of stem cell lines available for research is smaller than needed, and that some of the material has become contaminated over time by mouse embryonic skin cells that typically are placed at the bottom of culture dishes used in the research.
The bill would permit funding for research on embryonic stem cells regardless of the date of their creation, so long as they were donated from in-vitro fertilization clinics, they would "otherwise be discarded" and donors gave their approval.
Bush cast the only veto of his presidency on a stem cell bill last year, but public support for the research is strong, and Democrats sought to use that to their advantage in the 2006 election campaigns.
Missouri became a testing ground, McCaskill challenging GOP Sen. Jim Talent, who opposed expanded federally funded research. Michael J. Fox appeared in a television ad advocating greater research, and the visual image was arresting — the 45-year-old actor swaying from his Parkinson's disease.
With federal funding limited, several states and private institutions have moved into the void.
California, New York and New Jersey have programs. Gov. Deval Patrick of Massachusetts recently announced he hoped to overturn restrictions left in place by his Republican predecessor.
"We in Massachusetts increasingly see this as a competitive issue," said Dr. George Daley of Children's Hospital and the Harvard Stem Cell Institute. He said private institutions compete to hire promising scientists drawn to the field.
"I would say it's revolutionized biomedical research," he said. Rebutting claims by critics, he said, "You can't expect a cell which burst on the scene only as recently as 1998 to have found its way into patients yet. I don't know of any biological technology that translates into patients that soon."
But Carrie Gordon Earll, bioethics analyst at Focus on the Family, said that apart from the issue of embryo destruction, the inevitable result of the contested legislation would be to reduce funding available for adult stem cell work, which she said is more advanced.
"To our knowledge there are no clinical trials with human embryonic stem cells under way and there are 1,300 adult stem cell trials," she said, adding, "The destruction of embryos is not necessary for the advancement of regenerative research," she added.
Schools improve Mich. students health
Wed, 11 Apr 2007 19:47:50 GMT
By DAVID AGUILAR, Associated Press Writer
ANN ARBOR, Mich - Preston Brooks replaced lunchtime bacon double-cheeseburgers with submarine sandwiches loaded with vegetables.
And never looked back.
The 12-year-old sixth-grader credits his healthier outlook to an ambitious effort to tackle obesity in five middle schools.
"I've learned how to make better choices about what I eat," Brooks said.
So have more than 1,000 other students. Since the Healthy Schools program began as a pilot program at one middle school three years ago, sixth-graders who have taken part in it have lost weight and lowered their blood pressure and cholesterol levels.
The project uses 20-minute lessons, motivational speakers and eye-catching props to teach kids about basic nutrition and encourage exercise. The program is a collaboration between Ann Arbor public schools and the University of Michigan Health System.
The 12-week program, which includes medical screenings OK'ed by parents, now is offered at all five Ann Arbor middle schools. About 1,200 sixth-graders are signed up, and about half of those are part of an ongoing study that's tracking results and lifestyle changes.
Early survey results are promising.
Forty percent of those studied last year were considered "at-risk" in at least one medical screening category. Thirty-two percent were overweight, 9 percent had high blood pressure and nearly 10 percent had cholesterol levels above 200, a troubling sign at such an early age.
Those numbers belied Ann Arbor's well-educated, health-conscious image, where the University of Michigan casts a long shadow and many children come from white-collar homes. The results also affirmed a long-standing belief held by the program's lead organizer.
"We know child obesity is an epidemic, but we never want to believe it's a problem locally," said Dr. Kim Eagle, a University of Michigan cardiologist who helped raise $100,000 in donations and public grants to launch the project in 2004.
By last spring, students who were being tracked in the program showed improvement in every medical screening category.
Of the 292 students who took part in the study of 2005-06, 47 of 142 with high triglycerides reduced their levels. Nine of the 21 students who had cholesterol levels above 200 reduced them below that mark. Researchers didn't make numbers available on the students who lost weight but note that several did.
So, how did Ann Arbor do it?
Organizers followed this simple lesson plan: Teach good eating habits, promote fitness, and nudge school administrators into offering healthier foods.
Along with exercise and 20-minute lessons from teachers and the Michigan Health System staff, Ann Arbor middle school students were offered better food choices.
In the Clague Middle School cafeteria, for instance, french fries were replaced with baked potatoes. Bacon-double-cheeseburgers, high-fat meat pizzas and foot-long hot dogs were downsized or eliminated. Vegetables with dip and a fruit salad bar were added to the daily menu. School vending machines now offer water and fruit juice instead of soda.
Making these changes also meant challenging food service contractors whose bottom line relied on high-profit — and high-fat — lunch items.
"We really pushed the district and the food vendors more," said Michael Hecker, the principal of Clague, the pilot school. "It may cost more, but it's better for kids."
Susan Aaronson, a university health system dietitian, delivers the program message with props, such as Crisco-filled test tubes representing the amount of fat found in various foods and a plastic model showing the four stages of clogged arteries. She said sixth-graders are a perfect audience.
"Until now, they've been handed a lunch tray," she said. "For the first time, they have choices."
At Clague, some choices include more exercise, especially for sixth-graders who are no longer required to take P.E. after they move into seventh grade.
"I've had kids tell me playing their musical instrument is exercise," said Kim Jackson, 30, a Clague P.E. and health teacher.
She said Clague seventh- and eighth-graders are remembering what they learned in sixth grade. "They know they have to increase their heart rate to get the benefits of exercise."
Dr. Gary Edelson, an endocrinologist and president of the American Diabetes Association of Michigan, said he thinks the early intervention is a good idea. "If our children learn good habits, they will carry them into adulthood."
Clague sixth-grader Sabrina Dotimas, 12, said she is eating better and exercising more because of Project Healthy Schools.
"I used to be really lazy, but now I can run around this place 10 times," she said. She still craves soda pop, but avoids it because of its high sugar content.
"Now, healthy eating to me is five fruits and vegetables every day and not eating so much junk food," she said.
That's a good sign to Eagle, who has seen his share of heart-related deaths, including a woman who died after a heart attack during childbirth. To him, battling child obesity is Job 1.
"I see the future, and it scares me," said Eagle, who next year plans to expand the project into a second Michigan school district. "We're hoping to create an army of volunteers who can spread the word about good health."
___
On the Net:
Project Healthy Schools: http://projecthealthyschools.org
State rewarding doctors for quality care
Thu, 12 Apr 2007 04:22:14 GMT
By MATTHEW PERRONE, AP Business Writer
WASHINGTON - More than half of all U.S. states reward doctors for delivering high-quality care to patients in government health care programs for the poor, according to a survey released Thursday.
The survey's findings suggest states continue to move faster than the federal government to adopt pay-for-performance measures aimed at encouraging physicians to deliver high-quality health care that is cost effective.
Almost 85 percent of state Medicaid programs plan to have pay-for-performance measures in place within five years, according to figures from the Commonwealth Fund, a private foundation that finances health care research. The group says the survey of all 50 state Medicaid directors is the first nationwide review of pay-for-performance trends in the health care program, which covers 55 million low-income Americans. Medicaid is funded by both the federal and state governments, but it is managed by separate state officials.
The American Medical Association and other physician groups have stressed that doctors should play a major part in designing measures that are used to promote better medical care.
"Physicians are dedicated to providing high quality care to their patients, and pay-for-performance programs may help if they are designed with quality improvement as the primary goal," said Dr. Cecil Wilson, chairman of the AMA.
Many physicians are concerned that pay-for-performance measures favoring cost savings over quality could actually make care worse.
The Commonwealth Fund study comes a week after Medicare officials unveiled a program that allows physicians to earn bonus payments for recording certain quality-promoting measures when they see patients. Physicians are not required to participate in the program, but Medicare officials say the initiative represents a major step toward promoting higher-quality care.
More than 43 million senior citizens are covered by Medicare, which, unlike Medicaid, is solely managed by the federal government.
Independent government advisers told Congress last year that Medicare's current system of paying a set fee for individual medical services encourages unnecessary care and excessive, high-cost procedures. The Institute of Medicine recommended that Medicare transition to a pay-for-performance system by cutting base payments to doctors and hospitals and using the savings to reward them when they follow practices that improve patients' health.
The recommendation drew criticism from hospital and physician associations, which said their members already face steep payment cuts from the government entitlement program.
