Deadline near for Mass. health insurance
Sat, 30 Jun 2007 16:50:40 GMT
By STEVE LeBLANC, Associated Press Writer
BOSTON - The goal was as audacious as it was simple: Plug the holes in Massachusetts' health care network without resorting to the politically nuclear option of a single government-funded program.
The result is a landmark insurance law praised as innovative, derided as a house of cards and touted by former Gov. Mitt Romney as he runs for president.
As of Sunday, nearly everyone in Massachusetts must be insured or face a series of increasing tax penalties.
The law won't result in universal coverage immediately, but the deadline is a critical mile marker.
"July 1 is really a call to action," said Leslie Kirwan, chairwoman of the Health Care Connector Authority Board, which oversees implementation of the law. "We are looking to insure people, not penalize them."
The law divides the population into three segments:
_The poorest, making less than the federal poverty level, are eligible for free care.
_People making slightly more, up to three times the federal poverty level, can enroll in state subsidized plans.
_Those making more than three times the federal poverty level — at least $30,630 for an individual and $61,950 for a family of four — can choose their own coverage from new, lower-cost private plans, if they aren't already insured through work.
Massachusetts' health care experiment could spur or slow health care reform efforts nationally depending on its success or failure, said Drew Altman, president of the Kaiser Family Foundation, which studies health policy.
Key to that success is whether average people embrace the idea of an "individual mandate" — the requirement that they obtain health care.
"It has huge implications for other states, but even more importantly for the push for health care reform building nationally," said Altman. "It's the first real-world test of this idea of an individual mandate. This idea is either going to build steam or lose a lot steam."
Amy Cassidy and her family have already taken advantage of the new law.
Cassidy, 38, provides day care and her husband runs a small flooring operation. Before the law, they were spending more than $1,200 a month on health care for themselves and their two small children.
Now, Cassidy said, they spend about $969 a month with a policy purchased through the Connector, a $250 savings.
"That's grocery money," she said. "But I still haven't had to use it yet. It hasn't been put to the test."
The state already has enrolled about 130,000 formerly uninsured people in health care plans, virtually all of them in the free or subsidized plans.
The far more challenging task is persuading the estimated 160,000 still uninsured residents not eligible for subsidized plans to pay monthly premiums. Even the lower cost plans can run several hundred dollars a month.
And while one recent poll found nine out of 10 residents were aware of the health care law, 49 percent said residents shouldn't be required to buy insurance.
Even some advocates are reserving judgment.
John McDonough, executive director of Health Care for All, said the group pushed to have all health care policies include drug coverage, something businesses fought. Under a deal, a drug mandate will kick in at the start of 2009.
McDonough said the group is monitoring businesses' reactions. Some employers are expected to boost benefits to hold on to workers and others to drop coverage, hoping workers will be eligible for state subsidized programs.
"It's really a multilayered question," McDonough said.
Eileen McAnneny, senior vice president of government affairs for Associated Industries of Massachusetts, said most businesses support the health care reform law, although some have been frustrated with the way it has been put into effect.
Companies with 11 or more workers must offer insurance or face annual fees of $295 per worker.
One way they can satisfy that requirement is to offer special accounts that allow employees to buy insurance with pretax dollars, but the regulations needed to let businesses create those accounts were only approved earlier this month.
"For all that to be up and ready by July 1 ... is a Herculean task," McAnneny said.
Insurance companies also have found the law challenging, according to Marylou Buyse, president of the Massachusetts Association of Health Plans.
"Insurers have worked very hard to put out attractive and affordable products," she said. "But if the new law is going to work in the long run we all have to address the fundamental issues driving health care costs."
The new state budget has $472 million to cover the subsidized plans, and Kirwan said that number could rise. It's hoped the state could phase out its so-called "free care" pool — money paid to hospitals for treating the uninsured — by moving people into insurance programs.
Kirwan said the state is in it for the long haul.
"There will be glitches in it and there will be gaffes at some point, but if we waited until every one of those things were nailed down, this would never get off the ground," Kirwan said.
___
On the Net:
Massachusetts Health Connector: http://www.mahealthconnector.org/
Law requires N.M. to grow its own pot
Sat, 30 Jun 2007 11:52:38 GMT
By DEBORAH BAKER, Associated Press Writer
SANTA FE, N.M. - New Mexico has a new medical marijuana law with a twist: It requires the state to grow its own.
The law, effective Sunday, not only protects medical marijuana users from prosecution — as 11 other states do — but requires New Mexico to oversee a production and distribution system for the drug.
"The long-term goal is that the patients will have a safe, secure supply that doesn't mean drug dealers, that doesn't mean growing their own," said Reena Szczepanski, director of Drug Policy Alliance New Mexico.
The state Department of Health must issue rules by Oct. 1 for the licensing of marijuana producers and in-state, secured facilities, and for developing a distribution system.
The law was passed in March and signed by Gov. Bill Richardson, who is running for the Democratic presidential nomination.
Other states with medical marijuana laws are Alaska, California, Colorado, Hawaii, Maine, Montana, Nevada, Oregon, Rhode Island, Vermont and Washington. Maryland's law doesn't protect patients from arrest, but it keeps defendants out of jail if they can convince judges they needed marijuana for medical reasons.
Connecticut's governor vetoed a medical marijuana bill recently.
The distribution and use of marijuana are illegal under federal law, and the U.S. Supreme Court ruled in 2005 in a California case that medical marijuana users can be prosecuted.
Faced with that dilemma, the health department has asked state Attorney General Gary King whether its employees could be federally prosecuted for running the medical marijuana registry and identification card program, and whether the agency can license marijuana producers and facilities.
"The production part is unprecedented. ... No other state law does that," said Dr. Steve Jenison, who is running the program for the health department. "So we're trying to be very thoughtful in how we proceed."
In the meantime, however, patients must obtain their own supplies.
The state will immediately begin taking applications from patients whose doctors certify they are eligible for the program.
Within weeks, approved patients — or their approved primary caregivers — would receive temporary certificates allowing them to possess up to six ounces of marijuana, four mature plants and three immature seedlings. That's enough for three months, the department says.
The law allows the use of marijuana for specified conditions including cancer, glaucoma, multiple sclerosis, epilepsy and HIV-AIDS, as well as by some patients in hospice care.
An eight-member advisory board of doctors could recommend that other conditions be added to the list.
Martin Walker was diagnosed four years ago as HIV positive and uses marijuana to combat nausea and depression. He said he looks forward to being able to obtain the drug legally.
"If there's a system in place that's going to allow me to do this treatment without having to break the law ... I'll just be able to sleep better at night," said Walker, who runs HIV prevention and other outdoor-based adult health programs for the Santa Fe Mountain Center.
N.H. repeals parental notice of abortion
Sat, 30 Jun 2007 06:16:12 GMT
By NORMA LOVE, Associated Press Writer
CONCORD, N.H. - Gov. John Lynch signed legislation Friday that made New Hampshire the first state to repeal a law requiring a parent be notified before a minor received an abortion.
The 2003 law never took effect because of a court challenge, and the repeal took effect immediately.
"I strongly believe parents should be involved in these decisions, providing important support and guidance. Unfortunately that is not possible in every case," Lynch said.
Lynch cited the law's lack of a provision regarding the pregnant minor's health, agreeing with the judge who ruled the law unconstitutional in 2003.
New Hampshire is the first state to repeal a parental notice law, according to Dawn Touzin of Planned Parenthood of Northern New England. Washington state removed a parental consent law in 1991.
Forty-four states have laws requiring parental notification or consent for a minor seeking an abortion. Nine laws, including New Hampshire's, were unenforceable, according to NARAL Pro-Choice America, which filed a brief supporting the lawsuit brought by Planned Parenthood.
GOP Party Chairman Fergus Cullen said Lynch took a radical approach to a moderate law that could have been fixed.
"One can be pro-choice and still believe that parents have a right to know whether their minor daughter became pregnant," said Cullen. "Governor Lynch is saying that parents don't have a right to know their minor children became pregnant."
State Rep. Fran Wendelboe, who fought to keep the law on the books, said its supporters have not decided whether to introduce a new law in January or wait until after the 2008 elections.
Previously, the Legislature consistently voted for abortion rights before passing the law under then-Gov. Craig Benson, a Republican, and a Republican-controlled Legislature.
Democrats took charge in December, and abortion-rights activists moved quickly to strip the law from the books.
___
On the Net:
N.H. parental notification law, RSA 132:24: http://www.gencourt.state.nh.us/rsa/html/x/132/132-mrg.htm
Text of repeal bill: http://www.gencourt.state.nh.us/legislation/2007/hb0184.html
Hookah cafe fans worry about smoking ban
Sat, 30 Jun 2007 07:59:14 GMT
By TARIQ PANJA, Associated Press Writer
LONDON - Shrouded in a sweet-smelling haze, clusters of men and women unwind as they inhale fragrant tobacco from water pipes in the myriad cafes that line London's Arab quarter.
But Britain is going smoke free on Sunday, and cafe regulars will soon be deprived of one of their favorite pastimes. The smoking ban applies to covered public places and brings the nation in line with the more than 35 other countries and territories.
"It's going to take a big part of my social life away," said 24-year-old Rizwan Hussain, drawing in grape-flavored smoke at a cafe on Edgware Road. "I don't do pubs and this was an alternative."
Experts say smoking bans are spreading because of soaring health costs. Some of the strictest are in the United States, even though there is no federal anti-smoking policy. Spain, Italy, Iran, Norway, Sweden, Singapore, South Africa, Uruguay and New Zealand have passed anti-smoking laws. France banned smoking in many public places in February and plans to extend the ban to cafes and restaurants next year.
"It's a matter of time, but it will happen all around the world," said Jean King, director of tobacco control for Cancer Research UK, a charity. "It's the most important public health measure for a generation."
Few public spaces are exempt from the ban in England, which extends even to Buckingham Palace. Pubs, clubs and restaurants must be smoke-free. Taxi and delivery drivers have been warned that they face $100 fines if caught lighting up inside work vehicles.
In advance of the ban, the British government has subsidized programs to help smokers quit. The rest of Britain — Scotland, Wales and Northern Ireland — already has smoking bans in place.
But many who gather at the Arab quarter's shisha or hookah cafes — which started in London in the 1970s — say they're addicted to the social aspects of a smoke, not necessarily to the tobacco itself.
Around 30,000 visitors join locals to sample grape, apple, rose and peppermint tobacco, surrounded by fixtures from across the Arab world. Britain has around 1.8 million Muslims.
"Isn't it a shame if this doesn't exist anymore," said retired lawyer Ibrahim El-Nour, raising his hands to the sky and taking a long drag of an extra-strong tobacco called saloom.
El-Nour gathered the signatures of 10,000 people in a petition urging the government to make an exception for hookah cafes. There was also a petition posted on the Internet social-networking site Facebook.
But officials say there is no chance of a last minute reprieve.
"Creating an exemption for premises that offer shisha and hookah would not be in keeping with the primary objective of the legislation, which is to reduce the risks to health of secondhand smoke," said a spokeswoman for the Department of Health, speaking on condition of anonymity in line with department policy.
The World Health Organization said last month that smoking from a water pipe may pose the same health risks as cigarettes.
Shisha will be allowed in outdoor areas in Britain. But many fear the cafes will go away.
"It's bad. I think it's finished after Sunday," said Amhed Ali, a 25-year-old Iraqi Kurd waiter at the Palms Palace, speaking in halting English.
The government argues that many of the businesses will not suffer because they also serve food. But the majority of visitors come for the water pipes, said Al-Nour.
At the Palms Palace, about 60 people were crammed into the ornately carved booths with hookah pipes. None were eating.
"It's a little bit of the Middle East in London, which they are totally going to destroy," said Baija Choutai, a 39-year-old businessman who has been a regular on the Edgware Road for 12 years.
The government said it will review the smoking legislation in three years.
Despite the spread of bans, the World Health Organization says it expects tobacco sales will be steady. In its Tobacco Atlas, the WHO said that by 2030 there will be "at least another 2 billion smokers in the world," and an expected decrease in male smokers "will be offset by an increase in female smoking rates, especially in developing countries."
___
On the Net:
http://www.smokefreeengland.co.uk
http://petitions.pm.gov.uk/Shisha
Being breastfed may not cut kids39 obesity risk
Fri, 29 Jun 2007 19:20:39 GMT
By Anne Harding
NEW YORK -
Breastfeeding has many benefits
for babies, but protection from obesity may not be one of them,
a UK research team reports.
Instead, the researchers say, the protective effect of
breastfeeding some studies have found is likely due to the fact
that women who breastfeed their infants also tend to have
qualities that make them less likely to raise obese children.
&;There are several reasons for why mothers should
breastfeed their children, independent of obesity,&; Dr. Andre
M. Toschke of Kings College London, the study's lead author,
told Reuters Health. &; study questions a little bit the
argument of breastfeeding for protection against obesity.&;
To better understand the breastfeeding-obesity link,
Toschke and his team used a technique called dual-energy X-ray
absorptiometry to measure fat mass in a group of 4,325,
9- to 10-year-olds. Most studies to date have used body mass
index to measure overweight, which is less precise, the
researchers note in the June issue of the American Journal of
Clinical Nutrition.
Children who were breastfed, who represented 82 percent of
the total, had lower fat mass percentages. But once the
researchers used statistical techniques to control for factors
linked to both breastfeeding and obesity risk, including
mother's education and socioeconomic class, maternal BMI, time
the mother spent watching television daily, and time spent in a
car for each weekday, the effect of breastfeeding was weakened.
The association did remain strong, however, for children
who had been breastfed for six months or longer. They were 55
percent less likely than their non-breastfed peers to fall into
the top tenth of the group based on body fat percentage.
To get a definitive answer on whether breastfeeding truly
protects children from becoming overweight later on, it would
be necessary to randomly assign mother-infant pairs to breast
or bottle-feeding, which would be unethical, Toschke said.
But studies of breastfeeding promotion interventions with
adequate follow-up could also help answer this question, he
added, and would be free of the confounding factors at play in
other research.
SOURCE: American Journal of Clinical Nutrition, June 2007.
U.S. tracks serious form of syphilis in gay men
Thu, 28 Jun 2007 22:03:42 GMT
By Will Dunham
WASHINGTON -
A particularly serious form of the
sexually transmitted bacterial disease syphilis has been
detected in gay and bisexual U.S. men infected with the AIDS
virus, federal health officials reported on Thursday.
The U.S. Centers for Disease Control and Prevention tracked
49 HIV-infected gay and bisexual men who had &;symptomatic early
neurosyphilis&; from January 2002 to June 2004 in four cities --
Los Angeles, San Diego, Chicago, New York.
The CDC cited the report as further evidence that gay and
bisexual men, many also infected with HIV, are the driving
force behind increases in U.S. syphilis cases this decade.
The findings also indicate that these men are engaging in
the same risky, unprotected sex that can spread the human
immunodeficiency virus, which causes AIDS.
&;These are primarily infections that people are probably
getting because they're not using condoms,&; Dr. Thomas Peterman
of the CDC's Division of STD Prevention, an author of the
report.
In some instances, the men involved have the attitude that
they do not need safe-sex practices because they already are
infected with HIV, Peterman said.
Since dropping to the lowest level on record in 2000, the
U.S. rate of syphilis has risen steadily. Gay and bisexual men
accounted for 7 percent of syphilis cases in 2000, but more
than 60 percent in 2005, CDC officials have said.
Symptomatic early neurosyphilis is a rare manifestation of
syphilis usually occurring within the first year of infection.
Ordinary syphilis is readily curable with antibiotics in
its early stages. Neurosyphilis can lead to blindness or
stroke, Peterman said.
&;There are a number of studies that continue to show that
there are some HIV-infected and some uninfected men who have
sex with men who continue to have large numbers of
partners and anonymous sex. This is one of the consequences of
that,&; Peterman said.
Of the 49 HIV-positive gay and bisexual men with
symptomatic early neurosyphilis, 63 percent were non-Hispanic
whites, 18 were non-Hispanic blacks and 14 percent were
Hispanic. Their average age was 38.
&;I think the bigger message is that we need to get control
of syphilis. And control of syphilis would require safe-sex
behavior, reducing the number of partners, and using condoms
with those partners,&; Peterman said.
&;And for men who have sex with men, it means getting tested
for HIV and other STDs at least once a year,&; Peterman added.
Syphilis, like many other sexually transmitted diseases,
raises the likelihood of infection by or transmission of HIV.
Egypt officials ban female circumcision
Sat, 30 Jun 2007 05:26:21 GMT
By MAGGIE MICHAEL, Associated Press Writer
CAIRO, Egypt - The death of a 12-year-old Egyptian girl at the hands of a doctor performing female circumcision has sparked a public outcry and prompted health and religious authorities to ban the practice.
The girl, Badour Shaker, died this month while undergoing the procedure in an illegal clinic in the southern town of Maghagh. Her mother, Zeniab Abdel Ghani, told the Al-Masry Al-Youm newspaper that she paid about $9 to a female physician to perform the procedure.
The mother also told the paper the doctor tried to bribe her to withdraw a lawsuit accusing the physician of murdering her daughter, in return for $3,000, but she refused.
A forensic inquiry into the case showed the girl's death was caused by an anesthesia overdose.
The case sparked widespread condemnation of female circumcision, or genital mutilation, and was closely followed in Egyptian newspapers, which also reported the girl had passed out sweets to pupils in her class earlier on the day of her death, to celebrate her good grades.
It also evoked memories of a 1995 CNN television documentary depicting a barber circumcising a 10-year-old girl in a Cairo slum.
On Thursday, the Egyptian Health Ministry issued a decree stating that it is "prohibited for any doctors, nurses, or any other person to carry out any cut of, flattening or modification of any natural part of the female reproductive system, either in government hospitals, nongovernment hospitals or any other places."
It warned that violators would be punished, but did not specify the penalty. The ban is not as enforceable as a law, which requires passage in the national legislature.
Female genital mutilation usually involves the removal of the clitoris and other parts of female genitalia. Those who practice it say it tames a girl's sexual desire and maintains her honor.
It is practiced by Muslims and Christians alike, deeply rooted in the Nile Valley region and parts of sub-Saharan African, and is also done in Yemen and Oman.
The ban by the Health Ministry marks a return to a 1950s government order prohibiting hospitals and doctors from carrying out the procedure.
After that order, the practice continued in Egypt, mostly carried out by barbers, midwives and other amateurs. The order was reversed in 1995, shortly after the CNN documentary, with only medical staff permitted to perform the procedure.
Although the documentary embarrassed Cairo internationally, it failed to propel the parliament to pass legislation penalizing female circumcision.
A 2003 survey by UNICEF said that 97 percent of married women in Egypt have undergone genital mutilation.
A recent study by Egypt's Ministry of Health and Population found that 50.3 percent of girls between the age of 10-18 years have been circumcised.
After the girl's death, the country's supreme religious authorities stressed that Islam is against female circumcision.
"Its prohibited, prohibited, prohibited," Grand Mufti Ali Gomaa said on the privately owned al-Mahwar network.
While top clerics insist the practice has nothing to do with Islam, parents, especially in villages and Cairo slums, believe they are helping their daughters. They think circumcision is necessary for cleanliness and to protect a girl's virginity before marriage.
Opponents say girls can bleed to death, suffer chronic urinary infections and have life-threatening complications in childbirth as a result of the procedure.
The Al-Masry Al-Youm daily reported the doctor in Shaker's case denied allegations of malpractice and said the girl was in a "bad condition" to start with, and was immediately transferred to a regular hospital where she died. The doctor was not identified.
Egypt's renowned feminist activist, Nawal el-Saadawi, 76, who has published a biography on her own experience with circumcision, wrote: "Badour, did you have to die for some light to shine in the dark minds? Did you have to pay with your dear life a price ... for doctors and clerics to learn that the right religion doesn't cut children's organs."