Thursday, January 15, 2009

Health Headlines - January 15

House OKs Widened Coverage in Children's Health Insurance Program

The U.S. House of Representatives approved Wednesday an expansion of a children's health insurance program that would extend coverage to about 400,000 to 600,000 children, including those of legal immigrants and pregnant legal immigrants, the Associated Press reported.

The vote was 289 to 139, and the Senate was expected to take up the measure Thursday, AP said.

The State Children's Health Insurance Program (SCHIP) legislation was vetoed twice by President George W. Bush in 2007, but supporters were confident the bill would pass soon after President-elect Barack Obama's inauguration.

"In this moment of crisis, ensuring that every child in America has access to affordable health care is not just good economic policy, but a moral obligation we hold as parents and citizens," Obama said after the House vote.

Current law requires legal immigrants to wait five years before becoming eligible for coverage under the SCHIP and Medicaid programs. The new bill means, supporters say, that children can get quicker treatment for acute conditions such as asthma and diabetes without having to seek care in an emergency room. Critics had opposed lifting the five-year waiting period, saying it violated a pledge by immigrant sponsors that people coming into the United States would not be dependent on government assistance, AP reported.

The measure adds $33 billion to fund SCHIP over the next four years, and will come from a 61-cent increase in the federal excise tax on a pack of cigarettes and comparable increases for other tobacco products.

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Software Glitch Exposed Vets to Wrong Drug Doses

A glitch during an annual software upgrade last August at Veterans Affairs health centers around the country exposed some patients to incorrect drug doses, delayed treatments and other medical errors, according to internal documents obtained by the Associated Press.

While no evidence of serious harm was shown, the VA only began issuing safety alerts to medical centers on Oct. 10, and all the glitches were corrected in December. Nine patients at VA centers in Milwaukee, Durham, N.C., and Marion, Ind., were given incorrect drug doses, six of them involving heparin drips given for up to 11 hours longer than necessary, the AP reported Wednesday. Other errors involved drug infusions that continued for up to 15 hours past the doctor's prescribed deadline. Nearly one-third of the VA's 153 medical centers reported seeing some kind of glitch.

The problems are of concern since the federal government is pushing toward universal use of electronic medical records to curb medical errors blamed on paper systems, such as poorly written prescriptions. President George W. Bush supported the effort, and incoming President-elect Barack Obama has proposed spending an additional $50 billion a year for health IT programs, AP said.

But health care experts say the VA's problems highlight the need for closer monitoring. Dr. Jeffrey A. Linder, an assistant professor of medicine at Harvard Medical School who has studied electronic health systems, told the news service, "There's a lot of hype out there about electronic health records, that there is some unfettered good. It's a big piece of the puzzle, but they're not magic. There is also a potential for unintended consequences."

The VA's glitches involved medical data that sometimes popped up under another patient's name on the computer screen, the AP said. When doctors pulled up records of different patients within 10 minutes of each other, the first patient's data sometimes appeared under the second person's name. In some records, a doctor's stop order for intravenous injections also failed to clearly display.

VA officials told the AP that veterans with questions can request a copy of their medical records by accessing the "My HealtheVet" online system at http://www.myhealth.va.gov.

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Anti-Smoking Advocate Tapped for HHS Deputy

President-elect Barack Obama has nominated William V. Coor, executive director of the Campaign for Tobacco-Free Kids, a nonprofit group that seeks to reduce tobacco use among children and adults, for deputy secretary at the U.S. Department of Health and Human Services (HHS), the New York Times reported.

If confirmed by the Senate, Coor would serve as No. 2 in the department under former Senate majority leader Sen. Tom Daschle (D-S.D.), who was selected last month by Obama to head the health agency. Coor worked as Daschle's chief counsel and policy director when Daschle was minority leader. As a member of Obama's transition team, Coor also led efforts to evaluate the department he is now nominated to join and previously had served as chief of staff at HHS under former secretary Donna Shalala in the Clinton administration, according to the Times.

"Reforming our health care system will be a top priority of my administration and key to putting our economy back on track," Obama said in a statement. "Under the leadership of Tom Daschle and Bill Corr, I am confident that my Department of Health and Human Services will bring people together to reach consensus on how to move forward with health care reform."

The new Congress is expected to aggressively pursue federal regulation of cigarettes, raising taxes on tobacco products and approving an international tobacco control treaty, the newspaper said. As a senator, Obama, an occasional smoker himself, co-sponsored a bill that would have given the U.S. Food and Drug Administration broad powers to regulate tobacco products, including cigarettes.

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FDA Approves Guidelines for 'Off-Label' Drug Use

The U.S. Food and Drug Administration has OK'd guidelines that would make it easier for drug companies to use medical journal articles to promote drugs for unapproved uses, the Associated Press reported.

While pharmaceutical firms are not allowed to advertise products for "off-label" uses, the agency has allowed salespeople to distribute articles about such uses if they have been published in a peer-reviewed medical journal. A law permitting that distribution expired in 2006, and drug makers have been lobbying for its renewal ever since. The FDA said the new guidelines, posted online Monday, are designed to discourage "ghostwriting" of medical reviews and recommended that companies disclose financial relationships with article authors, the wire service said.

The veracity of some journal articles were questioned last year when Merck & Co. was accused of ghostwriting articles about its painkiller Vioxx. The drug was withdrawn from the market in 2004 for safety reasons, the AP reported.

Companies such as Pfizer Inc. and Eli Lilly said the guidelines merely reauthorize a longstanding policy that benefits doctors and patients, but critics contend the new directives contain a loophole allowing firms to distribute product articles to doctors even when they involve uses that have not been federally approved, AP reported.

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