President-elect Barack Obama has approached CNN's chief medical correspondent, Sanjay Gupta, to be the country's next surgeon general, the cable news network said Tuesday. CNN said it has kept Gupta from reporting on health care policy and other matters involving the incoming Obama administration since learning he was under consideration for the post.
A Democrat with knowledge of the discussions over the surgeon general spot cautioned that there was not yet a final decision on who would fill the post. The person spoke on a condition of anonymity because they were not authorized to speak to the media on the matter.
Obama's transition office did not immediately respond to requests for comment.
Gupta hosts "House Call" on CNN, contributes reports to CBS News, and writes a column for Time magazine. He is a neurosurgeon and is on the faculty at Emory University School of Medicine in Atlanta. During the Clinton administration, he was a White House fellow and special adviser to then-first lady Hillary Rodham Clinton.
The surgeon general typically isn't heavily involved in shaping an administration's policy, but it can be a very effective bully pulpit. Past surgeons general have proved instrumental in battling tobacco and AIDS.
The AP reports that laws went into effect yesterday in five states -- Delaware, Iowa, Oklahoma, Pennsylvania, and Texas -- that mandate the sales of "slow-burning and fire-safe" cigarettes. The five joined 17 other states that already had laws on the books. (thanks to reader R.K. for the heads-up on this)
The paper on these "fire-safe" cigarettes is thicker in two separate spots so they will go out if not puffed when they burn to these areas. The idea is to prevent fires caused when cigarettes are left unattended. [...]
About 800 Americans die each year in fires caused by careless smoking and the coalition estimates that number will be reduced if at least half the states pass the law.
"There has been a rash of smoking materials deaths," Oklahoma Fire Marshal Robert Doke said Monday. "A cigarette will fall into overstuffed furniture or mattresses when people fall asleep, or it rolls off an ashtray and on to the carpet, then the possibility for ignition happens.
"This cigarette is supposed to snuff out before it can cause enough heat to start a flame."
Now, I have nothing against these laws, and if they can prevent deadly fires and save lives, I can only hope every state will pass similar measures.
North Carolina lawmakers pushed Thursday to offer reparations to thousands of victims of a forced sterilization program now recognized as a shameful part of U.S. history.
A state House panel recommended the state give $20,000 to victims of the eugenics program, which sterilized about 7,600 people between 1929 and 1975 who were considered to be mentally handicapped or genetically inferior. Though North Carolina and several other states have apologized for such programs, none have offered reparations.
The organizers of National Handwashing Awareness Week, which runs through Saturday, want you to know that washing your hands with soap and warm water, or using an alcohol-based hand sanitizer, is the best way to stop the spread of germs. In fact, the Centers for Disease Control and Prevention cite handwashing as the “single most effective way to prevent the transmission of disease.”
Dr. William Sawyer’s Henry the Hand Foundation is the driving force behind the public awareness week, which began in 1999 in response to a flu vaccine shortage in Cincinnati, Ohio. “Spread the word, not the germs,” is a favorite catchphrase for the campaign that encourages everyone to follow the CDC recommendations for handwashing the right way.
But routine handwashing isn’t just about staying healthy through the winter. It’s also about improving public health for everyone, and getting better value out of health care.
Calling an overhaul of the health care system a basic element of his administration's economic recovery programs, President-elect Barack Obama on Thursday presented former Senator Tom Daschle as his choice to become secretary of health and human services and to lead efforts to secure "affordable, accessible health care for every single American." [...]
Mr. Obama, noting that more than 45 million people have no health insurance, said, "The runaway cost of health care is punishing families and businesses across the country."
A major health care initiative "has to be intimately woven into our overall economic recovery plan," Mr. Obama said, adding: "It's not something that we can put off because we are in an emergency. This is part of the emergency." (emphasis added)
Obama left no doubt that this issue ranks near the top of his priority list: "[S]ome may ask how, at this moment of economic challenge, we can afford to invest in reforming our health care system. Well, I ask a different question -- I ask how we can afford not to. Right now, small businesses across America are laying people off or shutting their doors for good because of rising health care costs. And some of the largest corporations in America -- including major American car makers -- are struggling to compete with foreign companies unburdened by these costs. Instead of investing in research and development, instead of expanding and creating new jobs, our companies are pouring more and more money into a health care system that is failing too many families. So let's be clear: if we want to overcome our economic challenges, we must also finally address our health care challenge."
How soon into his administration can we expect movement?
After inexplicably describing the September bailout of Wall Street as a package that would "help those who are concerned about health care reform," Republican Alaska Gov. Sarah Palin yesterday unveiled a patchwork of health care proposals to "improve Alaska's health and education." Palin's initiatives include a greater emphasis on outdoor activity:
With amazing outdoor activities in fresh clean air and consumption of healthy clean protein in the form of wild game and Alaska's seafood. We got berries, we've got Alaskan-grown produce, and those things need to be promoted.
Barack Obama unveiled a fairly ambitious healthcare plan during the presidential campaign, and during the transition, he and his team have reiterated their interest in pursuing a national policy during the first term. Pushing back against this, of course, are those who insist that the financial crisis, and the scarcity of funding, necessarily means healthcare will have to wait. It's more important, the argument goes, to stimulate growth than it is to expand access and coverage to healthcare.
This approach is not only wrong, it's backwards. Jonathan Gruber, an economics professor at MIT, explains in the New York Times today, "[H]ealth care reform is good for our economy."
As the country slips into what is possibly the worst downturn since the Depression, nearly all experts agree that Washington should stimulate demand with new spending. And one of the most effective ways to spend would be to give states money to enroll more people in Medicaid and the State Children's Health Insurance Plan. This would free up state money for rebuilding roads and bridges and other public works projects -- spending that could create jobs.
Health care reform can be an engine of job growth in other ways, too. Most proposals call for investments in health information technology, including the computerization of patient medical records. During the campaign, for example, Mr. Obama proposed spending $50 billion on such technology. The hope is that computerized recordkeeping, and the improved sharing of information among doctors that it would enable, would improve the quality of patient care and perhaps also lower medical costs. More immediately, it would create jobs in the technology sector. After all, somebody would need to develop the computer systems and operate them for thousands of American health care providers.
Expanded insurance coverage would also drive demand for high-paying, rewarding jobs in health services. Most reform proposals emphasize primary care, much of which can be provided by nurse practitioners, registered nurses and physician's assistants. These jobs could provide a landing spot for workers who have lost jobs in other sectors of the economy.
Marvelyn Brown is a 24 year-old native Tennessean who is now an avid AIDS activist and author of a new autobiography entitled The Naked Truth: Young, Beautiful, and (HIV) Positive.
For two months, ostracized and alone, nineteen year-old Marvelyn Brown slept on the gray vinyl seats of her 1996 Nissan Sentra in the parking lot of a Nashville, Tennessee, Walmart. When she visited her family, she used paper plates and plastic forks to eat so she wouldn't share dishes; all surfaces that she touched were wiped down with bleach. Her newly pregnant friend told her that she did not want Marvelyn around her child. In a matter of a few weeks, Marvelyn had lost the support of her friends and family -- all because she had been diagnosed as HIV positive.
But Marvelyn's story is neither new nor unique. Her friends and relatives were suddenly confronting the realities of a potentially life-threatening infectious disease, and they responded to their lack of understanding about HIV/AIDS as many people do -- with fear and mistrust.
Today is the 20th anniversary of World AIDS Day, and its message, "Stop AIDS. Keep the Promise," calls on global leaders to deliver on the promise of universal access to prevention, treatment, and care. Yet, despite two decades of progress in the fight against this disease, there is still widespread stigma surrounding HIV/AIDS in the United States and across the world -- fueled by myths, a lack of knowledge about how the disease is transmitted, and value judgments about how it is acquired. Though many people are familiar with the concepts of ageism and racism, there is another pervasive, pernicious form of discrimination that deeply affects many people's lives and must also be given a name -- "aidsism."
Zimbabwe is encountering a severe water and humanitarian crisis. Two weeks ago, the High Court in Zimbabwe shut down because of a lack of water supply. And, over the last month, approximately 8,887 people have contracted cholera and 366 people have died. Four large hospitals and many local clinics in the country have closed or turn away new patients because of a lack of medical supplies.
The cholera outbreak is spreading fast because of poor water and sanitation conditions around the country. Government-run water treatment facilities have not imported enough chemicals for treatment, raw sewage is found in neighborhoods as sewer lines are broken, and many individuals do not have access to clean drinking water. There is no stable government in Zimbabwe to provide these basic governmental services.
Robert Mugabe, of the ZANU-PF party, held power in the country for the last 28 years. In March, Morgan Tsvangirai, of the Movement for Democratic Change, won the first round of elections. But after much violence and intimidation against his supporters, Tsvangirai decided to concede. Both parties agreed to a power-sharing agreement in September, but Mugabe did not grant Tsvangirai adequate access to governmental offices. Now the two leaders are attempting to discuss the power-sharing agreement in South Africa; meanwhile the country waits in despair.
Barack Obama's selection of Tom Daschle as Health and Human Services Secretary, as well as "health reform czar," signals that the incoming president is serious about passing comprehensive healthcare reform. Over at the think tank Cato, Michael Cannon warns that blocking any such legislation is vital for the GOP's survival (h/t Kos):
Ditto Baucus' health plan. And Kennedy's. And Wyden's.
Why? Norman Markowitz, a contributing editor at PoliticalAffairs.net (motto: "Marxist Thought Online"), makes an interesting point about how making citizens dependent on the government for their medical care can change the fates of political parties:
A "single payer" national health system -- known as "socialized medicine" in the rest of the developed world -- should be an essential part of the change that the core constituencies which elected Obama desperately need. Britain serves as an important political lesson for strategists. After the Labor Party established the National Health Service after World War II, supposedly conservative workers and low-income people under religious and other influences who tended to support the Conservatives were much more likely to vote for the Labor Party...
Former Senate Minority Leader Tom Daschle has been tapped by Obama to lead the Department of Health and Human Services, and, according to Roll Call, has accepted the position. Think Progress reports that he will also
take on the position of "health care czar" in the Obama White House. CNN's Ed Henry is also reporting he negotiated the "health care czar" position in order to be "the point person on all White House health-related issues."
I'm okay with this selection -- and that's exactly as noncommittal a reaction as it sounds.
On the plus side, Daschle has (literally) written the book on the healthcare crisis. He knows the ins and outs of Congress and how to get shit done; as Drum says, he "is plainly dedicated to healthcare reform, he understands the legislative realities as well as anyone." Steve notes: "The Daschle announcement reinforces the notion that an Obama administration is going to take the push for healthcare reform very seriously" and "the Daschle news makes me even more encouraged about the prospect of a healthcare package actually passing.
Emanuel is insisting that an incremental approach won't do; Baucus and Kennedy are laying the groundwork on the Hill; and Daschle has been preparing for this fight for quite awhile."
This past week, the New York Times heralded a new theory of brain development as providing "psychiatry with perhaps its grandest working theory since Freud." ("In a Novel Theory of Mental Disorders, Parents' Genes Are in Competition," November 11, 2008) Even if the theory is flawed, the Times noted, it is "likely to provide new insights into the biology of mental disease."
The new theory posits that an "evolutionary tug of war between genes from the father's sperm and the mother's egg can, in effect, tip brain development in one of two ways." If there's a bias toward the father, the developing brain is pushed along the autistic spectrum; if the bias is toward the mother, the growing brain moves along what researchers call "the psychotic spectrum" (schizophrenia, bipolar disorder, depression).
While the more we know about mental disorders, the more we may be able to find useful treatments for them, this new theory seems, in fact, to reinforce old, unproven deterministic notions: that mental disorders are primarily biological and/or chemical and genetic in origin and course, and that since (if!) they are, what follows is that "science" will some day be able to "cure" them by treating and/or manipulating our genes (or biology, or chemistry).
We heard encouraging words from Michael Myers, staff director for the Senate Health, Education, Labor, and Pensions (HELP) committee, chaired by Senator Ted Kennedy, at Families USA's post-election health care briefing:
"With the Obama victory, the question is no longer whether we'll pursue comprehensive healthcare reform, but when and in what form."
Determined to see health care reform come to fruition, Senator Kennedy has wasted no time in convening regular meetings with key stakeholders in the hopes of introducing comprehensive legislation in early January. In an op-ed in Sunday's Washington Post., Kennedy reiterated the urgency for reform:
"...despite the current economic downturn, we must forge ahead with this urgent priority. The system is broken. And it's no longer just patients demanding change. Businesses, doctors and even many insurance companies are demanding it as well."
The specifics of his reform proposal remain under wraps, according to Kennedy's office, but Myers suggested that it will look much like Obama's plan and the Senator will pursue a "single bill" Strategy.
Senator
Obama's proposal builds on our current system of health coverage, preserving what works and strengthening aspects of the system that need improvement. Under his plan, workers who are satisfied with their employer-based coverage would keep it. A new National Health Insurance Exchange would enable individuals and businesses to purchase health coverage that's as good as the coverage for members of Congress and other federal employees. His proposal requires that all children have insurance. It would also cap out-of-pocket expenses and regulate insurance companies so that they can no longer cherry-pick the young and healthy and deny coverage to people with pre-existing conditions.
Many observers are poised to see reform finally happen. Having learned a thing or two from the last reform efforts in 1993 led by President Clinton, and understanding that reform is not inevitable, many stakeholders (who don't always see eye-to-eye) are searching for common ground. In Congress, staff from three jurisdictional committees -- Finance, Budget, and Health, Education, Labor and Pensions (HELP) -- have met to form working groups to discuss coverage expansion, systems reform, and financing. In addition, Senator Baucus, chair of the Finance Committee, which must approve any legislation before it goes to the Senate floor, is also committed to reform:
"I made sure the finance committee spent this year learning and preparing for action on a comprehensive overhaul of the healthcare system, and I intend for us to move swiftly and decisively with legislation in early 2009."
We'll hear more from Baucus this week when he releases his white paper on health reform.
In the era of eBay, you can buy just about anything from just about anywhere. Senator McCain and other lawmakers have proposed putting health insurance on a similar nationwide auctioning block by allowing consumers to purchase health insurance from any other state. This may sound harmless, but the effects of buying and selling health insurance across state lines would be far more dangerous than, say, your latest treasure found on eBay.
Those who support purchasing health insurance from any state argue that it will invigorate market competition and drive down premiums. However, a recent study by the New America Foundation showed that:
The primary source of "savings" under [this kind of proposal] is not more competition or more efficient insurers. The savings comes from separating the healthy from the sick.... [It] would lower premiums for the healthiest Americans, but it would raise premiums and reduce coverage options for everyone else.
Indeed, permitting the sale of health insurance across state lines would undermine all existing consumer protections, which are determined state by state. As Families USA revealed, state consumer protections-particularly in the individual health insurance market-vary dramatically from state to state. Some states have made tremendous strides in creating accessible, functional insurance markets for individuals and small businesses. As the New America Foundation points out, Senator McCain's proposal would eliminate the best protections and bring all states down to the lowest common denominator:
[Selling health insurance across state lines] would have the ultimate effect of standardizing state regulation to the least restrictive level, thus de facto de-regulating individual insurance markets. Politically, this allows the de-regulatory preferences of one state to negate the regulatory preferences of the 49 other states, without either a national or state-specific vote.
This proposal has far more insidious implications for consumers than its proponents will admit. Crossing state lines to find a great deal on a limited edition autographed book is one thing. Crossing state lines to find health insurance just crosses the line.
One thing Karl Rove has never lacked is hubris. A few days ago, Rove, an informal adviser for John McCain, appeared on FOX News and claimed McCain has been "an open book about his health issues for years and years and years." Obviously, Rove thinks he knows more than the 2,900 doctors who have signed our open letter calling on McCain to provide full disclosure of his medical records. Not to mention Dr. Lawrence Altman, a physician and journalist who has covered the health of presidential candidates for the past 36 years.
In an article for The New York Times last Monday, Dr. Altman expressed grave concerns about McCain's lack of candor regarding his health history. Dr. Altman wrote:
Last May, [McCain's] campaign and his doctors released nearly 1,200 pages of medical information, far more than the three other nominees. But the documents were released in a restricted way that leaves questions, even confusion, about his cancer.
A critical question concerns inconsistencies in medical opinions about the severity of his melanoma; if the classification of his melanoma is more severe, it would increase the statistical likelihood of death from a recurrence of the cancer.
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