TB patient questions CDC isolation rules
Sat, 07 Jul 2007 05:49:40 GMT
By MIKE STOBBE, AP Medical Writer
ATLANTA - The globe-trotting tuberculosis patient who sparked an international public health incident in May said Friday he was tricked into a federal quarantine.
Andrew Speaker, a 31-year-old Atlanta attorney, he would have gladly gone into isolation if health officials had asked him to. Instead, he said they asked him to swing by a New York City hospital for testing after his European vacation, then posted armed guards outside his door.
"They tried to trick me when it was unnecessary," Speaker said, said in a telephone interview from a Colorado hospital where he has been under treatment for a month.
Speaker, the first person quarantined by the U.S. government since 1963, disclosed new details about the discussions he had with health officials while in Europe, and about an aborted plan in which he would have driven to Denver for treatment after he returned.
He said he has no current plans to sue health officials at the U.S. Centers for Disease Control and Prevention or other government agencies.
"I'm worried about people coming after me," he said in a lengthy interview with The Associated Press.
Speaker became the focus of a CDC investigation — and an international uproar — when proceeded in May with a long-planned wedding trip to Europe after health officials said they advised him not to fly.
CDC officials also said a May 22 test result indicated Speaker had extensively drug-resistant tuberculosis, or XDR-TB, which is extremely difficult to treat. But Speaker's doctors said this week that subsequent testing has shown only the less-dangerous multidrug-resistant TB.
Speaker said the XDR diagnosis escalated media coverage and made him internationally vilified. In a two-page statement posted Friday on his law firm blog, he said: "I can only hope that this news calms the fears of those people that were on the flights with me."
He also noted that an early May CDC lab result — from a test which looks for evidence of drug resistance in TB bacteria genes — showed the less dangerous TB.
CDC officials said that test is experimental and had to be confirmed with more standard testing. They stand by the May 22 test, and said the public health response should be the same regardless.
The quarantine order was driven in part because Speaker flew to Europe after state and local health officials advised him not to travel in commercial aircraft, then he flew home from Italy after a CDC official repeated and emphasized the same message, CDC spokesman Tom Skinner said.
"He had shown a history," Skinner said Friday. "He had left to go, and he had left to come back, against orders."
Speaker argued that county health officials told him he was not a danger to his fiancee or others, and did not forbid him from traveling.
"They said, 'You don't need to be sequestered.' How can they turn around later and say, 'You should have been in isolation'?" Speaker said.
In Rome, Speaker said he got a message to call CDC official Dr. David Kim. It was then that Speaker said he first heard of the XDR diagnosis.
Kim asked them to cancel a planned train trip to Florence and said he would get back to the couple with news of travel arrangements back to the United States for treatment, Speaker said Friday.
They stayed in Rome. When Speaker called Kim the next night, Kim offered only two options: Go into isolation in Italy, or pay for a private air ambulance. Speaker said he couldn't afford the air ambulance, and didn't want to spend as long as two years in an Italian hospital.
Kim ended the conversation by suggesting, "Get some fresh air, get something to eat, because I know it's been a stressful day," Speaker recalled. Speaker and his wife then booked flights to travel through the Czech Republic to Montreal.
But Skinner said Kim would not have advised Speaker to mingle in crowds. "He advised cancellation of the train trip," Skinner noted.
Speaker said he talked with a CDC official after he crossed the U.S. border, and the official asked him to go to a New York hospital for testing, to make sure his condition had not changed. In the hospital room, a health official walked in holding faxed copy of a quarantine order, he said.
"It was the first time anyone ever mentioned an isolation order to me," Speaker said.
After he was transferred to an Atlanta hospital, officials suggested Speaker drive cross-country with his wife to Denver for treatment. But that was canceled when Speaker's health insurer agreed to pay for an air ambulance, Speaker said.
Skinner confirmed that account. "He would have been accompanied by public health personnel all along the way," he said.
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On the Net:
Andrew Speaker's blog: http://www.speakerlawfirm.com/blog.html
Centers for Disease Control and Prevention: http://www.cdc.gov
Tobacco taxes may go to child health
Sat, 07 Jul 2007 07:11:35 GMT
By KEVIN FREKING, Associated Press Writer
WASHINGTON - The nation's 45 million smokers will probably help pay for the spending increase that Democrats want for children's health insurance, say analysts familiar with deliberations on Capitol Hill.
Democratic lawmakers will push for $50 billion in new funding for the State Children's Health Insurance Program over the next five years. To pay for that increase, they must find new sources of revenue or cut existing programs.
Powerful trade groups representing doctors, hospitals and insurers have united around the idea of taxing tobacco. Democratic leaders have not said to what extent they will agree.
Still, the question now is not whether the tobacco tax will go up — but how much it will go up, said Ron Pollack, executive director of Families USA, an advocacy group that promotes universal health insurance.
"I've every reason to believe an increase in the tobacco tax will be part of the way expanded health insurance for children is paid for," Pollack said.
Pollack said his assessment was based on "frequent and relatively recent conversations" with the committees that have jurisdiction over SCHIP. Democrats from the House and the Senate are expected to unveil their respective SCHIP proposals soon.
The federal tax on tobacco stands at 39 cents per pack, and it generated about $7.2 billion in 2005. The money goes into the general fund of the U.S. Treasury.
States also tax cigarettes. The rates range from $2.58 cents a pack in New Jersey to 7 cents a pack in South Carolina.
Tobacco companies oppose another tax increase on their product, but it's unclear whether the industry has enough clout to fend this one off. The ban on unlimited contributions to the political parties, called soft money, has resulted in a significant drop-off in campaign contributions from the industry.
The Center for Responsive Politics reports that total campaign contributions from the tobacco industry fell from $9.2 million in the 2002 election cycle to $3.5 million in last year's cycle. The center also ranks industries when it comes to campaign contributions; since 1996, tobacco has fallen from 26th in the center's rankings to 62nd.
Most of the industry's contributions in recent elections — about three quarters — have gone to Republicans.
Bill Phelps, spokesman for Philip Morris USA, the nation's largest tobacco company, said tax increases have already led to an 80 percent increase in the cost of a pack of cigarettes since 1999. The average cost of a pack now stands at $4.13, though those costs vary dramatically from state to state.
"We feel this trend is unfair to adult smokers as well as to tobacco retailers," Phelps said.
He said an excise tax increase may have unintended consequences because sales of cigarettes have been declining at about 2 percent a year while the cost of medical services provided through SCHIP have grown at least 4 percent annually.
"Relying on the cigarette excise tax to fund an important government program such as SCHIP will create long-term funding shortfalls," Phelps said.
But a tax increase on cigarettes would also have its benefits, said supporters of a tobacco tax increase.
For example, the American Medical Association, the trade group for doctors, said that for each 10 percent increase in the price of cigarettes, youth smoking is reduced by 7 percent, and overall consumption by 4 percent.
"The higher the tax, the more substantial the future public health benefit," said Dr. Ronald M. Davis, president of the American Medical Association. "Fewer smokers means fewer people with strokes, heart attacks, cancer, and other smoking-related health conditions."
The Centers for Disease Control and Prevention says that about 440,000 people in the U.S. die prematurely each year as a result of illnesses attributable to smoking.
Pollack acknowledged that support for the tobacco tax increase from health providers is not entirely selfless. With more revenue coming into the treasury, there's less pressure to make cuts to their funding.
For example, doctors face a 10 percent cut in their reimbursement when they treat seniors and the disabled through Medicare next year. Hospitals claim that changes set to kick in later this year would trim overall Medicare payments by $25 billion over five years.
Also, insurers face potential cuts in their government pay. An advisory commission to Congress has recommended that the government's payments to insurers should equal those provided through traditional Medicare — where doctors and other providers are paid a set fee for providing a particular service.
The Congressional Budget Office has estimated that eliminating the difference in the payment rates would save about $54 billion over the next five years.
"We have supported the tobacco tax purely because the funds raised will be used for SCHIP," said Mohit Ghose, a spokesman for American's Health Insurance Plans. "We have also pointed out repeatedly that we do not believe there should be money taken from one government program for the Medicare population in order to provide funding for SCHIP. We believe that it is an unfair trade-off and we've worked diligently to find other funding sources."
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On the Net:
State Cigarette Excise Taxes:
http://www.ncsl.org/programs/health/Cigarette.htm#ranking
Burger King to use transfatfree oil
Fri, 06 Jul 2007 15:18:34 GMT
By ADRIAN SAINZ, AP Business Writer
MIAMI - Burger King said Friday it will use trans-fat-free cooking oil at all its U.S. restaurants by the end of next year, following in the footsteps of other leading fast-food restaurants.
The world's second largest hamburger chain said it was already using zero trans-fat oil in hundreds of its more than 7,100 U.S. restaurants nationwide.
Burger King is known for its flame-broiled burgers, but uses cooking oil for its french fries and most of its chicken products.
In tests, consumers determined that more than a dozen items cooked in the new oil, such as french fries and hash browns, tasted the same or better than products cooked in the trans-fat oil, the company said.
Miami-based Burger King Corp. said two trans-fat-free oil blends passed tests. If adequate supply becomes available, the U.S. rollout of the oils could be completed sooner than 2008, the company said.
Trans fats are listed on food labels as partially hydrogenated vegetable oil. They can raise bad cholesterol and lower healthy cholesterol, increasing the risk of heart disease, doctors say.
Critics have said Burger King was taking too long to move toward the healthier oils. The Washington-based Center for Science in the Public Interest sued Burger King in May, saying the company was moving too slowly and had failed to set a definite timetable for removal of trans fats.
In response to the lawsuit, Burger King said in May it expected to begin the national rollout its new zero trans-fat oil by the end of this year.
Among Burger King's main competitors, McDonald's Corp. said earlier this year it had selected a new trans-fat-free oil. Wendy's International Inc. started using cooking oil with zero grams of trans fat in August 2006.
Starbucks Corp. announced in May that it will cut artificial trans fats out of food and drinks in its stores in the continental United States, Alaska and Canada by the end of the year.
Yum Brands Inc. said in April that all of its KFC restaurants are now serving fried chicken with zero grams of trans fats. Yum Brands also said its Taco Bell restaurants switched to a trans fat-free frying oil.
Burger King is owned by Burger King Holdings Inc. and operates more than 11,200 restaurants worldwide. About 90 percent its restaurants are owned and operated by franchisees.
