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Saturday, July 31, 2010

Calcium Supplements May Increase Heart Risk

Calcium Supplements May Increase Heart Risk
by April Fulton
NPR - July 30, 2010

Before you pop that calcium supplement, you might want to talk to your doctor.

A new analysis out in the British Medical Journal says calcium supplements may increase the risk of heart attack by 30 percent.

Calcium supplements have become practically de rigueur components of the pill boxes of 50-something women. They've been touted as a simple way to improve bone density and help guard against fractures for both genders.

The researchers suggest that while the increased risk is small, the widespread use of calcium supplements makes it a pretty big deal.

"Even a small increase in incidence of cardiovascular disease could translate into a large burden of disease in the population," the researchers conclude.

"The risks outweigh the benefits," Professor Ian Reid at the University of Auckland, who headed up the analysis team, told NutraIngredients.com.

Another researcher, Alison Avenell, told the BBC that taking the supplements is a matter of "balancing risks."

The analysis also suggested the supplements might slightly increase hip fractures and have only a modest overall effect on reducing all kinds of fractures.

But cardiologist John Cleland of the Hull York Medical School in England told WebMD that the analysis is "concerning but not convincing."

He said he was surprised that there was no increase in deaths, only heart attacks.

The analysis looked at data from 11,000 people pooled across 12 different calcium clinical trials from the last 20 years. They were aged 40 and up.

It specifically excluded patients given calcium supplements plus Vitamin D supplements. Vitamin D deficiency has been linked to increased risk of heart problems, and is being studied separately.

And, it did not find an increase in heart attacks among those who boosted their calcium the old-fashioned way, through food.

Reid suggests that this could be related to higher blood calcium levels found in supplements, which can lead to hardening of the arteries, which can then cause heart attacks.

"Food remains the best source of calcium. Calcium supplements should only be used when adequate dietary intake cannot be achieved," a spokeswoman for the National Osteoporosis Foundation told Shots.

The U.S. Recommended Daily Allowance for calcium for adult men and women is 800 to 1200 mg per day. For those under 50, it's up to 1,000 mg.

That's a lot of milk, salmon, cheese and sardines.

CORRECTION: An earlier version of this post grouped prescription Fosamax, Boniva and Actonel in with calcium supplements. These products are not calcium supplements, although they are often prescribed along with calcium supplements to help prevent osteoporosis. [Copyright 2010 National Public Radio]

Thursday, July 29, 2010

Cholesterol Screening Rates Too Low in Young U.S. Adults

Jul. 19, 2010 10:00 AM


MONDAY, July 19 (HealthDay News) -- Only about half of young adults in the United States undergo cholesterol screening, even though up to one-quarter of them have elevated levels of "bad" cholesterol, a new study has found.

U.S. Centers for Disease Control and Prevention researchers analyzed data from nearly 2,600 young adults (men aged 20 to 35, women aged 20 to 45) who took part in the U.S. National Health and Nutrition Examination Survey.

Elevated levels of low-density lipoprotein (LDL, or "bad") cholesterol were present in 7 percent of the participants with no other heart disease risk factors, 12 percent of those with one other risk factor, and 26 percent of those with two or more other risk factors, the researchers found. However, the cholesterol screening rate for young adults is under 50 percent, they noted.

A high level of LDL cholesterol is a common risk factor for coronary heart disease, but it can be managed with lifestyle changes or treated with medication. Other risk factors include high blood pressure, smoking, family history and obesity, the study authors noted.

"What's surprising and, quite frankly, rather concerning, is that we are doing such a poor job of identifying young adults in America who have elevated LDL cholesterol," study lead author Dr. Elena Kuklina, a nutritional epidemiologist with the CDC Division for Heart Disease and Stroke Prevention, said in an agency news release.

"Young men and women experience a high burden of risk factors for heart disease, the nation's leading cause of mortality," she added.

The study findings, published in the July/August issue of the journal Annals of Family Medicine, highlight the need to improve screening for, and management of, high LDL cholesterol among young adults, according to the researchers.

How the Massachusetts gift ban hurts primary care doctors

Great opinion piece on "gift bans". In the end, these bans will be just as hurtful as they are helpful.


From the BlackBerry

Sunday, July 25, 2010

FDA Approves Generic Blood-Thinner, Opening Door For More Biotech Copycats

FDA Approves Generic Blood-Thinner, Opening Door For More Biotech Copycats

by Scott Hensley
NPR - July 23, 2010

Enoxaparin is a mouthful. But if you're at risk for developing blood clots, you might practice saying it.

The soothing female voice at Davis's Drug Guide says e-nox-a-PA-rin (click on link to listen). So why might you care?

Well, the Food and Drug Administration just gave a thumbs-up to a generic version of enoxaparin, an anticoagulant, that will be sold by a unit of the Swiss drug giant Novartis.

That's a big deal because for years the drug -- nearly a $3 billion-a-year seller in the U.S. -- has been available under the brand-name Lovenox from Sanofi-Aventis. The FDA also says pharmacists can substitute the generic drug for the brand. And it should be cheaper, too.

On all those counts, the generic approval is important. But even more significant, the FDA's approval of generic Lovenox, which is a complicated mixture of long chains of sugars, shows the agency can move ahead on generic versions of biotech-style drugs.

The drugmaker now known as Sanofi-Aventis fought against the approval all the way. But the agency didn't buy the company's arguments, which are refuted here.

As Forbes Robert Langreth explains, the FDA requirements for generic Lovenox are "a test case" for how the agency could handle "copycat versions of complex biological drugs." [Copyright 2010 National Public Radio]

Monday, July 19, 2010

Florida Hospitals Seek To Reduce Post-Operative Infections, Complications

This sounds like a terrific idea - we should be doing something like this in CT

The Orlando Sentinel (7/18, Shrieves) reported that 81 "hospitals in
Florida are teaming up with one important goal: to reduce the number
of infections and complications that occur after surgery." For
hospitals, "fewer complications could reduce the sorts of costs that
will come under increasing scrutiny with the new federal
health-overhaul law." The paper says "currently about one in five
patients" discharged from the hospital is readmitted for
complications, costing an additional "$11,000 or more." Starting this
fall, hospitals will study four types of hospital patients such as
those who developed urinary-tract infections, and find out which
hospitals have low rates of surgical complications, so others can
learn from them.

A New Pumping Device Brings Hope for Cheney

Great article from the NYTimes -- enjoy
July 19, 2010

A New Pumping Device Brings Hope for Cheney

Former Vice President Dick Cheney is recuperating from surgery to implant the kind of mechanical pump now being given to a small but growing number of people with heart failure so severe that they would most likely die within a few months without it.

The pumps are partial artificial hearts known as ventricular assist devices, and they come in various models. Mr. Cheney's kind is about the size of a D battery and leaves most recipients without a pulse because it pushes blood continuously instead of mimicking the heart's own pulsatile beat. Most such pulse-less patients feel nothing unusual. But they are urged to wear bracelets or other identifications to alert emergency room doctors as to why they have no pulse.

The pumps are not cures and do not replace the heart. They pose significant risks and are implanted as a last resort either for permanent use or as a bridge to transplant until a donor heart can be found. An estimated five million people in the United States are in various stages of heart failure. Patients in end-stage heart failure are severely short of breath, able to walk only a few yards at a time, or confined to a chair or bed.

As a small number of published studies have shown increasing success with the devices — which are powered by batteries that are about 4-by-6 inches and are connected by a wire that goes through the skin — leaders in the field are trying to increase public and physician awareness that such therapy is available and relatively safe if the patients are carefully chosen. Current belief is that the best time to refer patients for such therapy is before kidney, liver and lung damage develops.

By supplementing the amount of blood pumped through the body, the devices allow many recipients to lead active lives from home. They can bicycle, golf, play tennis, drive cars, shop and generally do what they could before they developed severe heart failure. Patients need to take an anticoagulant, like Coumadin (warfarin) and have blood tests to monitor the amount.

The latest model devices, "though imperfect, are a stupendous advance compared to 36 years ago," said Dr. O.H. Frazier of the Texas Heart Institute at St. Luke's Episcopal Hospital in Houston. Dr. Frazier has been developing and implanting mechanical hearts over that time.

"Still, it is a big operation with risks because we are operating on mortally ill patients," Dr. Frazier added.

In interviews, he and others not connected with Mr. Cheney's case said the implants required opening the chest and could be as arduous for a surgeon as risky for a patient, particularly one like Mr. Cheney, 69, who has had earlier open-heart surgery. Mr. Cheney had a quadruple bypass operation in 1988.

Among the risks are bleeding that requires transfusions, infections, strokes and device malfunctions.

The most recently licensed pumps are smaller, quieter, easier to implant, allow quicker recovery time and last longer than earlier models. Recent reports show improvement over the earlier model mechanical hearts that carried a high rate of complications and death.

Nevertheless, said Dr. Allen S. Stewart, who directs the aortic surgery program at New York-Presbyterian Hospital/Columbia University Medical Center in Manhattan, "everyone wants a better device."

One reason, said Dr. Stuart Katz, who directs heart-failure programs at New York University, is that many pump recipients still have symptoms from their heart failure.

Mr. Cheney has not said whether he intends to live with the device until his death or to sign up as a candidate for a human heart transplant. Inova Fairfax Hospital in Virginia, where a very ill Mr. Cheney with worsening heart failure received his pump earlier this month, performs heart transplants.

Mr. Cheney's heart has been severely damaged from five heart attacks, starting at age 37, with the most recent in February. Doctors cite him as a model for the benefits of modern cardiac care.

Over the years, Mr. Cheney has had angioplasty to unblock coronary arteries and stents to keep them open; an implanted pacemaker and defibrillator; surgery to repairaneurysms, or ballooning of arteries, behind both knees; and a number of visits to George Washington University Hospital for monitoring and observation, the last in June.

In a statement issued on July 14, Mr. Cheney said that he "was entering a new phase of the disease" with "increasing congestive heart failure" and chose a pump to "enable me to resume an active life."

Mr. Cheney went to Ivona Fairfax Hospital apparently because George Washington University Hospital does not perform heart transplants or implant VADs. George Washington did not respond to inquiries.

Mr. Cheney received a HeartMate II device, according to a health care worker who did not want to be identified because he was not authorized to speak for Mr. Cheney.Thoratec of Pleasanton, Calif., sells the device and did not respond to inquiries.

After heart transplants were first performed in 1967, they became the only treatment for end-stage heart disease. But with donor hearts in very short supply, and with improved drugs and other therapies allowing more people to live longer with chronic heart failure, the disparity between demand and supply has accelerated the need for researchers to come up with safe and effective mechanical heart replacements.

Over the years, doctors have implanted various kinds of mechanical hearts with definite, though erratic, progress.

The Food and Drug Administration has licensed two ventricular assist devices for both permanent and bridge-to-transplant use — Thoratec Heartmate XVE and Heartmate II. The agency has licensed four additional devices as bridges to transplant: WorldHeart Novacor, Thoratec PVAD, Thoratec IVAD and MicroMed Heartassist V (for pediatric use).

Also, the agency has licensed two total artificial hearts: SynCardia Cardiowest for bridge to transplant and Abiomed Abiocor on a "probable benefit" basis.

The current continuous-flow pumps are modified derivatives of one that Dr. Richard K. Wampler developed in the 1980s. The latest devices contain an impeller, or a rotor, that spins 8,000 to 10,000 times a minute to pump up to 10 liters of blood a minute without causing major damage to red blood cells.

The limited success has proved wrong the many experts who said people could not live without a pulse. The thought was that since the heart had a beat, that beat was needed for blood pressure and circulation. But now doctors believe that continuous-flow devices, which can be smaller and last longer, may function well. Doctors must use a Doppler machine to measure and monitor the blood pressure of such patients because it cannot be measured through standard cuffs. Some have developed high blood pressure that requires drug treatment, said Dr. Frazier, who implanted the first HeartMate II in November 2003.

Dr. Frazier said he had implanted a total of 170 such pumps as of June 1, more than any other surgeon. Of those, 24 were in patients 65 and older and 11 of the 24 were in patients older than 70. The oldest was 76. Nine of the 24 have died, and seven of the nine did not leave the hospital. Six of the 15 survivors received heart transplants. The remaining nine are living with the pump. The longest survivor at his hospital had an implant in his 30s and has lived five and a half years.

Medicare will pay for the pump and for implanting it, which is $150,000 to $200,000, said Dr. Ranjit John, who directs the device program at the University of MinnesotaMedical Center, Fairview.

In The European Journal of Heart Failure in May, Dr. Roland Hetzer's team at the Berlin Heart Institute in Germany reported a study of 60- to 80-year-old recipients showing that the continuous-flow devices have a significantly higher survival rate than the pulsatile devices in such patients.

Over recent years, doctors have significantly advanced the upper age limit for a heart transplant to about 72.

Doctors generally wait at least three months to allow the body to adjust to the new pump and recover from the major surgery before a possible transplant.

Patients and doctors give varying accounts of the quality of life with either a pump or transplant. Some patients prefer transplants. Others have chosen to stay with a pump because they do not like the prospect of taking the immunosuppressive and other drugs that are standard for transplant recipients.

Experts like Dr. Stewart and Dr. Frazier said they were awaiting development of newer and smaller pumps that could fit in the arm and not require chest surgery. They said that while the devices would pump about two liters of blood a minute, about one-fifth the amount current devices do, that would be sufficient to aid a failing heart.

Wednesday, July 14, 2010

Tweet via Heart Disease (@heartdisease)

Heart Disease (@heartdisease)
Obstructive Sleep Apnea Linked With Later Risk of Heart Disease: After adjusting for known heart risk factors, res... http://bit.ly/czrGil

Wed Jul 14 04:08:47 2010

Sent via Osfoora

Tuesday, July 13, 2010

Diabetes Drug Maker Hid Test Data, Files Indicate - NYTimes.com


Cholesterol Drugs Grow More Common For Adolescents

Cholesterol Drugs Grow More Common For Adolescents

by Scott Hensley

NPR - July 13, 2010

Researchers who screened 20,000 kids for high cholesterol in West Virginia suggest the time has come to start looking at the fat in all kids' blood -- not just those who have a family history of cholesterol trouble.

How come? The West Virginia team found 98 children among the nearly 6,000 who wouldn't normally be tested for high cholesterol had cholesterol levels bad enough to warrant treatment with drugs. The results appear in the latest issue of Pediatrics.

Many cholesterol drugs, such as statins like Lipitor, are approved for the treatment of kids with genetically linked high cholesterol that can lead to early heart trouble.

Better diet, weight loss and exercise remain the first options for most kids with too much fat in their blood. Side effects, such as muscle pain, and limited data on long-term use of the drugs in kids are reasons to proceed cautiously with the medicines in children.

But, we wondered, how many kids are already getting cholesterol medicines?

We asked the folks at the big pharmacy benefit manager Medco if they could look over their data for us. Here's what they found. Among kids, from newborns up to 19, about 7 in 10,000 got a cholesterol-lowering prescription drug in 2009. For comparison, the figure was about 6 kids per 10,000 in 2001, according to the Medco.

Drill down a little and things get more interesting. The biggest increase in kids' cholesterol drug use was in girls, ages 10 to 19. In 2009, about 8 in 10,000 girls in that group took a cholesterol drug -- a 155 percent increase compared with slightly more than 3 per 10,000 who were taking a cholesterol drug in 2001.

For boys in that age range, cholesterol drug use rose a more modest 13 percent over the same period to nearly 10 in 10,000 from about 9 per 10,000.

"There's no question that we've seen an increase in the lipid values in children, and that's probably due to the obesity epidemic," Donald Pittman, a pharmacist who leads the cardiovascular drug group at Medco, tells Shots.

Still, the use of cholesterol drugs fell by around a third for the youngest boys and girls, from birth to age 9, between 2001 and 2009. For boys in that group, use fell to 5 per 10,000 from 8 per 10,000. For girls that age, use declined to almost 4 per 10,000 from a little more than 5 per 10,000. [Copyright 2010 National Public Radio]

To learn more about the NPR iPad app, go to http://ipad.npr.org/recommendnprforipad

Saturday, July 10, 2010

Emergency angioplasty saves coach's life


Times Staff Writer


STAMFORD -- May 6 appeared to be just another Thursday for Curtis Tinnin, the head girls basketball coach at Stamford High School.

Tinnin, 52, who also serves as head of security for the school, then got his blood pressure checked at the nurse's office. Those numbers were an alarming 180 over 110, and Tinnin was told he needed to go to the hospital.

"I told (Assistant Principal Angela Thomas-Graves) that I was going home, and the nurse told me I shouldn't be driving," Tinnin said. "The assistant principal and I went back and forth about how I would get home. The time spent arguing with (Thomas-Graves) about how I would get home allowed for the heart attack to take hold."

While that development is never good news, the time spent arguing prevented Tinnin from being behind the wheel of his car when the heart attack hit.

"It was about 2:20 or 2:30 (p.m.) when I got up to make a phone call to my girlfriend," Tinnin said. "I felt a pain in my chest, and I was soaking wet with sweat."

An ambulance rushed the veteran of 16 years on the Black Knight sidelines to Stamford Hospital, where an emergency balloon angioplasty performed by Dr. Ted Portnay saved Tinnin's life.

"I was fortunate to be in the right place at the right time, because he was put in the right place at the right time by the ambulance crew," Portnay said. "We brought Curtis back to life (with defibrillator paddles). We told him he fell asleep for a few minutes and we started the procedure. We were able to identify a totally blocked artery that caused the heart attack. When he came in, Curtis had cardiac arrest. His heart rhythm was not sustainable for life."

Dr. Joonun "Chris" Choi was even more blunt about bringing Tinnin back from a brief death. Tinnin "flatlined" for a few seconds, according to Portnay.

"We shocked him back to life," Choi said. "We have a joke in cardiology that time is muscle. The fact we did this procedure so fast saved his heart. Two, three, four hours later (doing the procedure), Curtis would have been left with more permanent damage."

For his part, Tinnin -- who led Stamford to a 14-6 record last winter, including reaching the FCIAC quarterfinals and second round of the Class LL state tournament -- appreciates being whisked away to the hospital in the ambulance.

"This was one time where being stubborn saved my life -- and maybe someone else's," Tinnin said. "I don't want to think about (having a heart attack) in my car, when I could have rolled back into someone on the street. I'm thankful I'm here, and I'm thankful these guys were so close. Arguing with (Thomas-Graves) saved my life. It could have been my last day."

Tinnin began feeling some shortness of breath in December, after a two-point win at the buzzer at Fairfield Warde. Two games later he had more difficulty in Trumbull, and a few games later emergency medical service workers took him in for an electrocardiogram, where everything appeared normal.

As it turned out, there was some plaque in an artery, which was opened with catheterization -- but not the artery that would cause the heart attack and require the balloon catheter that put the "stent."

Portnay described the stent as a small, tubular cage "that acts as scaffolding to keep the artery open."

"An angioplasty is basically a balloon on a catheter, and it's threaded into the artery," Portnay said. "A wire acts as a rail to guide the stent. The balloon is inflated, with the stent crimped onto the balloon. The balloon opens, the stent is set in place, and then the balloon is taken out of the stent to keep the artery open."

Stamford Hospital has had this emergency angioplasty protocol and equipment for five years. Portnay said the hospital handles up to 50 patients a year in Tinnin's dire condition, while performing about 300 non-emergency angioplasty procedures each year.

"The Catheterization Lab staff is always on call, 24 hours a day, 365 days a year," Portnay said. "The system is set to be mobilized within 30 minutes of a call. This is a multi-discipline team. We work very hard to keep it a well-oiled machine."

A restricted diet -- including eliminating saturated fats, sodas, sweets and restricting sodium intake -- will remind Tinnin of his close call.

Ever the optimist, Tinnin noted that during his ordeal and recovery he had lost nearly 20 pounds "and it didn't cost me anything in the gym."

Now back on half days as of June 1 -- "Dr. Choi wanted me home," Tinnin said, "but I wanted to do something" -- Tinnin is again looking ahead to his next coaching challenge.

"We've got a good-looking class coming in," Tinnin said of the 2010-11 Black Knights, which includes a 5-foot-10 prospect. "That's what keeps me going."

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Kids see fewer ads for sweets, more for fast food - USATODAY.com

Check out this article that I saw in USA TODAY

Kids see fewer ads for sweets, more for fast food

From Tires To Cereal, New Mobile App Helps Consumers Track Recalls

From Tires To Cereal, New Mobile App Helps Consumers Track Recalls

by April Fulton

NPR - July 6, 2010

Dog and now cat vitamins recalled due to salmonella.

A child's coin purse recalled because of concerns about lead.

Even Bridgestone tires for trucks and buses are on the recall track these days, not to mention the highly publicized SpaghettiOs' uh-oh and Kellogg's cereal recalls.

At the risk of getting what the Washington Post dubs "recall fatigue," how can you keep track of the ones you care about? There's now an app for that.

Instead of tracking down various websites, the new mobile app lets you see it all in one place, wherever you are.

The Consumer Product Safety Commission, National Highway Traffic Safety Administration, Food and Drug Administration, and Department of Agriculture teamed up to create Recalls.gov.

It lets consumers search for products by brand name or category (i.e. car seats or pet food), see available photos, and even report potential problems with unsafe products.

"Alerting consumers quickly to food and product recall information through this technology can prevent untold illness and save lives," said Agriculture Secretary Tom Vilsack in announcing the app, located on the newly-revamped GSA website.

But there's a catch -- a big one. You have to have a phone that uses the Android operating system.

Blackberry and iPhone apps are coming soon, the government says.

Meanwhile, you can see the lists of recent recalls across the participating agencies here. [Copyright 2010 National Public Radio]

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Doctor-Patient E-Mails Can Help Heal

Doctor-Patient E-Mails Can Help Heal
by Chao Deng

NPR - July 8, 2010

If you've ever dreamed about e-mailing the doctor when you have a quick question, read on.

Most doctors have little incentive to e-mail their patients because they don't get paid for it. But when it comes to quality of care, e-mails can make a difference.

Patients with diabetes and hypertension had better health outcomes when they emailed their docs, says a recent study published in Health Affairs.

Results were based on patient data from one giant electronic health record system -- KP HealthConnect (implemented by Kaiser Permanente), but suggest that more patients could benefit if electronic health records incorporate secure patient-physician messaging by 2013 under the American Recovery and Reinvestment Act of 2009.

The study looked at over 35,000 patients and about half a million e-mail conversations that were stripped of identifying information like patient names and addresses. The patients initiated most of the e-mails, often to discuss changing health conditions or lab results.

After two months, those who used KP's electronic health system, which includes email, scored better on cholesterol and blood pressure tests than those who didn't. The electronic system also included perks like ordering drug refills online, but researchers think that doctor-patient e-mails played the biggest role.

"It's not just about quantitative analysis. It's what we hear from physicians and patients," says Terhilda Garrido, VP of health information technology at KP. She says that patients feel empowered when they can e-mail their doctors.

Despite the convenience for patients, doctor-patient e-mailing remains low -- only 9 percent of Americans currently use e-mails to communicate with their doctors, according to a poll on HarrisInteractive.com. That number is up from 4 percent in 2006.

Low usage isn't surprising when doctors have to be cautious about disclosing too much of the patient's health information when responding.

Patients should sign consent forms for using e-mail, according to guidelines from the American Medical Association.  And doctors should switch to in-person or phone conversations when "e-mail messages become too lengthy or the correspondence is prolonged."

E-mails work well for patients with chronic illnesses or long-term conditions like pregnancy, says Garrido.  In other words, patients benefit when they follow up via email after an initial doctor's visit.

But there's no evidence that e-mailing your doctor out of the blue about a new problem will give you any sort of an advantage. [Copyright 2010 National Public Radio]

To learn more about the NPR iPad app, go to http://ipad.npr.org/recommendnprforipad

Friday, July 2, 2010

Fwd: From Senator Christopher J. Dodd





July 2, 2010




Dr. Edward Portnay

1177 Summer St

Stamford, Connecticut 06905


Dear Dr. Portnay:


Thank you for contacting me regarding federal payments to physicians participating in the Medicare program. I appreciate hearing from you on this important matter.


I share your concern about this important issue. Throughout my career, I have been proud to sponsor and support many bills to help address the nation's critical health care needs and have supported efforts to provide high-quality, affordable health care to all Americans, including seniors. In my view, no senior should be forced to skip doses of medication, go without a visit to their doctor, or make the untenable choice of paying for necessary health care or buying groceries and other necessities. As you know, Medicare serves as the foundation of our nation's health care system for more than 44 million Americans, and I will continue to fight for programs such as Medicare that serve to provide for the health and welfare of America's seniors.


I have long fought to prevent scheduled physician payment cuts. In my view, these cuts could harm Medicare recipients by leading fewer doctors to accept Medicare beneficiaries as patients. Cuts in payments to physicians treating Medicare beneficiaries have the ability to undermine health care for seniors, and I will oppose any measure that harms our nation's seniors. You may know that I was a cosponsor of the Medicare Physician Payment Fairness Act of 2001, which would have halted the adverse Medicare physician payment update that went into effect January 1, 2002. This 5.4 percent reduction in physician payments would have negatively impacted the ability of approximately one million physicians and other health care professionals to continue to provide valuable care to the nation's Medicare beneficiaries.


I am pleased to tell you that in 2008, the Senate passed H.R. 6331, the Medicare Improvement for Patients and Providers Act of 2008. This legislation eliminated the reduction in physician payments until 2010, and instead provided a 1.1 percent update in Medicare physician payments for 2009. This bill also extended and improved low-income assistance programs, added new preventive benefits to the Medicare program, and reduced beneficiary out of pocket costs for mental health care. H.R. 6331 also protected access to therapy services by extending the exceptions process to limits on therapy visits in nursing homes, postpones the Durable Medical Equipment competitive bidding program, and eliminates the clinical laboratory competitive bidding program. I am a proud supporter of this bill and am pleased to tell you that it was passed into law, overriding the President's veto, on July 15, 2008.


As you may know, last fall Senator Debbie Stabenow (D-MI) introduced the Medicare Physician Fairness Act, Senate bill 1776. S. 1776, would have averted a scheduled 21 percent cut in physician reimbursement rates for 2010 and would have eliminated the sustainable growth rate (SGR) formula that has caused most of the cuts over the last decade. Majority Leader Harry Reid (D-NV) attempted to bring debate on the bill to a close as the first step in order to get the bill passed, but while I voted for the measure, with a sixty vote threshold, it was defeated by a vote of 47-53.


It was my hope that a fix of the SGR would have been included in the comprehensive health care reform bill, but it was unable to garner enough support to be included. You may be pleased to know that on June 25th, President Obama signed H.R. 3962, the Preservation of Access to Care for Medicare Beneficiaries and Pension Relief Act, into law. This measure, which I supported, retroactively eliminates the rate cut that went into effect on June 1st, and provides a 2.2 percent rate increase through November 30th, 2010. H.R. 3962 will serve as a patch until a long term fix can be worked out.

You and I agree on the importance of passing additional comprehensive Medicare readjustment legislation that addresses the needs of all health care providers, including physicians, in the future. Please be assured that I remain committed to continue to work to permanently eliminate any cuts in payments to doctors who care for our nation's Medicare beneficiaries. In the meantime, please know that I remain committed to strengthening the federal government's support for all Medicare beneficiaries.


Again, thank you for taking the time to contact me. If you would like to stay in touch with me on this and other issues of importance, please visit my website at http://dodd.senate.gov and subscribe to receive my regular e-mail issue alerts. Please do not hesitate to contact me again if I can be of assistance to you in any way.













United States Senator




NOTE: This message has been sent using my e-mail reply system. Please do not hit "reply" to respond to this message. If you would like to submit further comments to me, please use the e-mail form on my web page at http://dodd.senate.gov/webmail/index.html.




NYTimes: Genetic Finding May Provide a Test for Longevity

From The New York Times:

Genetic Finding May Provide a Test for Longevity

Scientists say they have identified genetic variants that predict extreme longevity with 77 percent accuracy.