12-10-2012 07:22 A study by the American Cancer Society concludes that one out of two women diagnosed with breast cancer contacts the Society for help and support. In 2011, the Society provided information and services to 115270 of the estimated 230480 women diagnosed with breast cancer in the US The organization is currently funding more than 240 breast cancer grants totaling $88 million. The Janssen Pharmaceutical Companies of Johnson and Johnson have released a report that examines the growing demand for sustainability in health care. Results from Janssen's report, The Growing Important of Sustainable Productions in the Global Health Care Industry, were presented recently at the CleanMed Europe conference, the world's leading conference focused on sustainable health care and the environmental impact of the health care sector on local, regional, and global levels. Cabot Creamery has teamed up with the Green Education Foundation for a Holiday Cheese Party raffle to promote health behaviors in elementary and middle schools. Classrooms around the country are eligible to win a nutritious party with $100 from GEF and Cabot's cheeses by completing a lesson on health and sustainability. For more information on these and other stories, go to http://www.csrminute.com. The Health Minute is produced for 3BL Media by Video4Good

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Janssen Sustainability Report; Cabot School Program; ACS Helps 50% of Breast Ca- Health Min 10/12/12 - Video

Michigan taxpayers could save nearly $1 billion over a 10-year period if the state expands its Medicaid program under federal health care reform, according to a newly released report.

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Report: Medicaid expansion could save Michigan $1 billion

By Jack Torry

The Columbus Dispatch Sunday October 14, 2012 7:15 AM

Thomas West gets a checkup at the University of Chicago Medicine Primary Care Clinic. The number of Medicare beneficiaries is projected to grow to more than 64 million by 2020.

WASHINGTON The signature achievement of President Barack Obamas term could be out the door if Republican challenger Mitt Romney wins in November, but the debate over the future of health care in America will continue and possibly dominate the next term no matter who gets elected.

The candidates competing visions could scarcely be more dissimilar, even though Obamas Affordable Care Act was closely modeled after the health-care plan that Romney signed into law while governor of Massachusetts.If Obama wins re-election, he can be expected to fully phase in the health-care law, which is designed to extend coverage to millions of Americans without insurance.

And he likely will retain the basic structures of Medicare and Medicaid, the Great Society programs that provide health coverage to the elderly and the poor, respectively.

Should Romney win the presidency, count on him to try to repeal the 2010 law which has earned the nickname Obamacare while launching a sweeping transformation of Medicare and Medicaid.

The competing ways to deal with the millions of Americans without health insurance while simultaneously trying to restrain the growth of federal health programs that eventually will devour much of the annual federal budget has been a dominant dispute in the testy presidential race.

During the first presidential debate in Denver, Obama complained that Romney wants to replace the health law but he hasnt described what exactly wed replace it with other than saying were going to leave it to the states.

By contrast, Romney says that the law has discouraged small companies from hiring. During the same debate, he assailed Obama for spending his energy and passion during his first two years in office fighting for Obamacare instead of fighting for jobs for the American people. It has killed jobs.

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Health care: Will Americans go ahead with Obama or change direction with Romney?

Its hard to tell what Mitt Romney would do to solve the problem of sick uninsured Americans. Right now, these people often cant find insurers willing to sell them policies or, if they can, the costs are prohibitive. Under Obamas Affordable Care Act, insurance companies will be required, beginning in 2014, to sell policies to anyone who wants one and to ignore customers health status when setting prices. This is possible because the ACA also requires nearly everyone to buy health insurance, flooding the market with millions of new customers, including healthy people, whose premiums will subsidize the cost of covering the sick.

Covering people with pre-existing conditions is one of the most popular pieces of Obamacare, and Mitt Romney is doing his best to imply that his health care plan would accomplish this lofty goal as well. But there are a few problems. Romney wants to repeal Obamacare and he doesnt really have a comprehensive plan to replace it, at least not one that hes made publicly available. In the absence of this, voters can look at his runningmate Paul Ryans budget proposals that include health care policy or they can look at Massachusetts, which essentially has a state version of Obamacare championed by Romney when he was governor.

Hes at the top of the ticket, so its not fair to judge him by Ryans past proposals, he says. And the Massachusetts health care reform was right for Massachusetts, but not the nation, he says, so its not fair to judge his presidential plans based on that. Thats fine. But surely it must be fair to judge what Romney said about the problem of the uninsured last time he was running for president, right?

Heres what Romney said in January 2008, explaining why, prior to reform in Massachusetts, uninsured people who could afford insurance nonetheless didnt buy it:

They said why should we buy it? If we get sick, we can go to the hospital and get care for freeThey shouldnt be allowed just to show up at the hospital and say somebody else should pay for me, so we said no more free ridersWe said if you can afford insurance, then either have the insurance or get a health savings account, pay your own way, but no more free rideI think its the conservative approach to make sure that people who can afford insurance are getting it at their expense, not at the expense of the taxpayers or the government. That I consider a step towards socialism.

Four years later, Romney talks about emergency room hospital care for the uninusured as a safety net, not as proof of irresponsibility. Heres how the Columbus Post Dispatch reported what Romney told its editorial board on Wednesday:

We dont have a setting across this country where if you dont have insurance, we just say to you, Tough luck, youre going to die when you have your heart attack, he said as he offered more hints as to what he would put in place of Obamacare, which he has pledged to repeal.

No, you go to the hospital, you get treated, you get care, and its paid for, either by charity, the government or by the hospital. We dont have people that become ill, who die in their apartment because they dont have insurance.

He pointed out that federal law requires hospitals to treat those without health insurance although hospital officials frequently say that drives up health-care costs.

Romney made similar comments to 60 Minutes back in September, explaining that people without insurance have an option to get carein the hospital.

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What We Still Don't Know About Romney and Health Care

The Barbara Ann Karmanos Cancer Institute stands to be a big loser under health care reform -- $40 million over 10 years -- and it's for a non-intuitive reason: It doesn't provide uncompensated care.

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Karmanos braces for reform's cut

The candidates for New Mexicos open U.S. Senate seat would approach the countrys Affordable Care Act in different ways if elected in November.

Democrat U.S. Rep. Martin Heinrich says he supports and would stick with the plan, while Wilson said she would repeal it.

Heinrich called the law a step in the right direction to help make health care more affordable and keep insurance companies from taking advantage of consumers including denying coverage to people with pre-existing conditions and canceling coverage when someone gets sick.

Wilson, a Republican and former House member, called the Supreme Courts vote on health care a mistake and said it should be undone.

But its not just enough to simply repeal the health care act, she said in a statement. The health care status quo is not acceptable either. We need to allow doctors and patients to make decisions about care, make health care more affordable, pass medical liability reform and continue to lead the world in health care research.

While the Affordable Care Act affects nearly every American, the candidates, who responded to questions from The New Mexican, havent focused much on the topic, said Gabriel Sanchez, a University of New Mexico political science professor. The health care law didnt come up in the candidates first televised debate earlier this week, and it hasnt been the most popular TV ad topic either, although one anti-Heinrich ad blasts him for supporting it.

I see it kind of couched more in the presidential discussion of the issue. But I think its important that the voters have a clear idea of where the candidates stand on this, said Sanchez, who also teaches a summer class in racial and ethnic health disparities at The University of Michigan.

With the Supreme Courts approval of the law, health care has moved up on voters radars, Sanchez said, but the issue still is behind the economy and immigration, at least for Latino voters.

One specific part of the Affordable Care Act that Wilson and Heinrich have addressed somewhat is whether New Mexico should expand its Medicaid program under the federal law.

Gov. Susana Martinez has yet to announce a decision on what the state will do.

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U.S. Senate candidates disagree on health care law

A message to all physicians from Steven J. Stack, MD, chair of the AMA Board of Trustees.

Health information technology, sustainable health care financing and quality health care delivery all rely on complex systems involving a variety of processes and people. All of them require a systems-based, not individual-focused approach to achieve success. Yet what makes obvious sense at a system level may be untenable at the individual level, and often physicians at the bedside feel alone in their recognition of this reality.

To demonstrate the point, lets consider a few clinical examples:

Notwithstanding the above, physicians use ankle x-rays, CT scans and antibiotics at times in a manner contrary to established treatment guidelines.

Sometimes this may be a knowledge deficiency or even a professional shortfall. For these instances, educational efforts such as those undertaken by the American Medical Association and the AMA-convened Physician Consortium for Performance Improvement play a useful role. More commonly, though, the true culprit is our fragmented and inequitable health system.

Sixteen percent of all Americans and 34% of the patients in my suburban emergency department are uninsured. For these patients, there is no ready access to appropriate outpatient follow-up care. Watchful waiting may mean more time off the job or a costly repeat visit to an ED. See your primary care doctor or Follow up with the orthopedist can be a cruel joke, not useful advice. For the uninsured and patients on Medicaid, problems with transportation, employer inflexibility, no or low insurance coverage, and educational limitations add additional challenges.

Against this backdrop, many physicians have ordered an ankle x-ray or prescribed an antibiotic to a patient whose personal circumstances make outpatient follow-up particularly burdensome or unlikely. For a patient with unrelenting abdominal pain, even if nonemergent, a CT scan may be the only available option to exclude a whole host of worrisome diagnoses within the short time of an ED visit. Technology and/or pills, even with their own costs and undesirable consequences, become surrogates for unattainable access to affordable and reliable outpatient medical care.

Please note that I am not relying on the fear of trial lawyers or the pressures faced by busy clinicians to justify suboptimal care. Defensive medicine and work force shortages (real or artificial) are challenges in their own right, but those arent the topic of this column. Nor am I proposing that we physicians dont have an obligation to optimize the care we provide to be cost-effective and consistent with scientific evidence.

Instead, I assert that medical treatment for 50 million uninsured and 60 million Medicaid patients, fully a third of our population, adheres to rules of pragmatism not captured by evidence-based medicine. Rather than being a failure of physician professionalism, quite a few seemingly inappropriate tests and treatments are the result of a physicians imperfect but sincere attempt to help a patient in a nation replete with First-World technology but financed and administered in a Third World manner. Until our nation moves past the delusion that individual professionals are at fault for societal choices and systems-based problems, we will not succeed as we could and should.

The solution to this problem of allegedly unnecessary tests and antibiotic use goes well beyond physician education and professionalism. If, as a nation, we want to seriously and successfully address these challenges, we must reform our current fragmented, costly and inequitable health system to support access to quality care that facilitates adherence to scientific evidence. Until then, it is misplaced and unfair for policymakers and standard-setters to impugn the physicians professionalism for treating the patient immediately before him in a manner considerate to the patients personal circumstances.

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Health care’s big picture: Fix the systems to support individuals

A 10-minute wait to see a health care professional at the St. Joseph Medical Center Emergency Room Hold on Now theres only a three-minute wait.

Thats the news updated every 15 minutes on the medical centers website and available as an application on your phone.

With routine five- and six-hour waits in some ERs around the state, this is amazing.

Vivienne Stearns Elliott, media relations officer for St. Josephs, says, Weve seen greater patient satisfaction. We also hear, I drove here from Bel Air or the I-83 corridor because of the wait time.

People do seem to respond to the lure of a minimal wait time when they have just broken an arm or had some other affliction that needs immediate attention but does not require an ambulance response.

Across the country from San Jose, Calif., to Fort Lauderdale, Fla., to right here at St. Josephs in Towson hospitals are working to reduce the time a patient has to wait to be seen in the emergency room.

They are also hyping their success through electronic billboards, TV, radio and newspaper advertisements and phone apps.

Whats going on? Is it something beyond wait times?

The Centers for Medicare and Medicaid Services issued a report Monday showing that growth in health care spending in the United States experienced historically low rates in 2009 and 2010. The reports summary highlights the effects of health care reform in reducing costs and, therefore, the need to spend. It also notes that hospital spending by private health insurance companies is greatly reduced.

The CMS recognizes that something else is happening, too. As reported in the January issue of the journal Health Affairs, CMS economist Anne Martin says, Medical goods and services are generally viewed as necessities, but the recession led consumers to be a lot more cautious about using them. High unemployment, loss of private health insurance, lower household income and increased costs to the consumer are cited.

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Gazette.Net: Gail Ewing: Winning over patients

For most people in the health policy community, the word “coverage” carries a certain emotional power. People without health insurance coverage, we believe, are one bad break away from disability and destitution. Hence, many politicians, researchers, and activists believe that expanding coverage is more important than any other policy goal. But not all health insurance is created equal. Indeed ...

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Why Health Insurance is Not the Same Thing as Health Care