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  October 26, 2010, 1:48 pm

Senators in both parties want drug-settlement ban out of approps bill

By Julian Pecquet

Senators from both parties are urging their leaders to remove a ban on generic drug settlements from an appropriations bill that will be considered during the lame-duck session.

The provision would end the practice of brand-name drug makers settling patent challenges from generic manufacturers by paying them to delay their products.

The Federal Trade Commission (FTC) argues the settlements are a form of collusion that keeps cheaper generics off the market and says banning them would save American consumers at least $3.5 billion a year in cheaper medications.

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  October 26, 2010, 1:36 pm

HHS announces $335 million for community health centers

By Mike Lillis

The Health and Human Services Department (HHS) is accepting applications for $335 million in grants to help community health centers serve low-income patients, the agency announced Tuesday.

The grants — part of $11 billion in new funding for community health centers included in the health reform law — will be available to existing facilities able to demonstrate the money will expand capacity and care for the underserved (and underinsured) patients they tend to treat.

“These new investments will allow existing health centers to improve and expand vital primary health care services, and continue to meet the increased demand for services,” Mary Wakefield, head of the Health Resources and Services Administration, said in a statement. 

Earlier in the month, HHS announced the recipients of $727 million in grants for community health centers — funding also included in the new healthcare law.

Applications for the new grants are due Jan. 6.

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  October 26, 2010, 12:52 pm

In Kentucky, Senate hopeful slams Dems' deal with Big Pharma

By Mike Lillis

The Senate Democratic candidate in Kentucky wants to rein in Medicare spending by allowing the government to negotiate prices directly with drug makers — a proposal rejected by Democrats as part of a healthcare reform deal cut with the pharmaceutical lobby last year.

State Attorney General Jack Conway (D), running to replace retiring GOP Sen. Jim Bunning, said the deal represented a missed opportunity to save taxpayers hundreds of billions of dollars.

"It made no sense to me, in talking about trying to achieve savings in Medicare, that a sweetheart deal was cut with the pharmaceutical companies," Conway said during a Monday night debate with GOP candidate Rand Paul. "The Medicaid system negotiates for lower prices. The VA system negotiates for lower prices. 

"If Medicare were allowed to do that … it would be $200 billion — that's 200 billion with a "B" — in savings. That's some real money."

When Congress created Medicare's prescription drug benefit in 2003, the law explicitly prohibited the government from negotiating with drug makers on behalf of the millions of seniors who would enroll in the program. 

The law also moved low-income seniors — those eligible for both Medicare and Medicaid — into Medicare drug plans. Previously, those "dual eligibles" got their drugs through state Medicaid programs, which are allowed to negotiate prices directly with pharmaceutical companies.

Those provisions brought the drug lobby behind the bill, but didn't come cheap for taxpayers. Indeed, a 2008 study from the House Oversight and Government Reform Committee found that the government currently pays about 30 percent more for dual eligibles’ drugs under Medicare than it would under Medicaid.

A more recent analysis from the National Committee to Preserve Social Security and Medicare found that allowing the government to negotiate Part D prices would save taxpayers $24 billion each year.

That didn't happen. Instead, in the early months of the healthcare reform debate, Senate Finance Committee Chairman Max Baucus (D-Mont.) reached a deal with the Pharmaceutical Research and Manufacturers of America (PhRMA) vowing not to allow government negotiation if the powerful lobbying group would support the bill. As part of the deal, PhRMA also agreed to put up $80 billion toward the cost of the bill over the next decade — most of that dedicated to closing Part D's coverage gap.  

Conway on Monday also pushed a plan to establish Medicare anti-fraud units in every state.

"I know from having Medicaid fraud units on the ground in each and every state that we're able to stay close and understand what's going on and ferret out fraud," he said. "The problem with Medicare is it's done from a big bureaucracy. I mean, put it in the AG's office or put it in some other office, but just have someone on the ground."

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  October 26, 2010, 12:24 pm

Sen. Coburn: GOP should repeatedly attempt to repeal health reform

By Michael O'Brien

Conservative Republican senator thinks repeal is "highly unlikely" but predicts a "change of heart" for some Democrats.

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  October 26, 2010, 11:12 am

Taking on childhood obesity by attacking subsidized corn starch

By Mike Lillis

Why, when faced with a childhood obesity epidemic, would the federal government continue to subsidize corn-based sweeteners suspected of contributing to the problem?

That's the question being posed Tuesday by several leading research physicians at Mount Sinai, who took out an ad in The New York Times asking why Congress subsidizes corn starch but not cauliflower. 

"High-fructose corn syrup [HFCS] now represents 40 percent of the non-calorie-free sweeteners added to U.S. foods. It is virtually the only sweetener used in soft drinks," write Philip Landrigan, Mount Sinai's dean for global health; Lisa Satlin, chair of the pediatrics department; and Paolo Boffetta, deputy director of the school's Tisch Cancer Institute. "Because of the subsidies, the cost of soft drinks containing HFCS has decreased by 24 percent since 1985, while the price of fruits and vegetables has gone up by 39 percent."

It's no coincidence, the doctors claim, that childhood obesity — which has tripled over the past 30 years — is skyrocketing at the same time that HFCS consumption has done the same.

Congress has contributed  — in 2008, lawmakers passed a five-year, $307 billion farm bill that provided billions of dollars in subsidies to farming families earning as much as $2.5 million per year, and often times more. Corn farmers were among the top beneficiaries. 

The law also created a new program to have the government buy surplus sugar for ethanol production. Critics noted that the provision reduces market supply, keeping sugar prices artificially high on the grocery store shelves — and encouraging food and soft-drink manufacturers to use less expensive corn sweeteners.

Although then-President George W. Bush tried to block the farm bill  — arguing that the subsidies shouldn't go to wealthy farmers — lawmakers from both parties stepped in to override his veto.

If Congress ever hopes to get the childhood obesity problem under control, health experts argue, a new look at farm subsidies will be vital. 

"Curbing the obesity epidemic requires a multifaceted approach: education, increased physical activity, healthy school food, promotion of unprocessed foods — and a change in agriculture policy," the doctors write. "Coordinated national leadership is essential." 

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  October 26, 2010, 6:12 am

Healthcare Roundup: Health experts urge a payment overhaul

By Julian Pecquet

Experts would prefer a government authority sets the rates, or an all-payer system.

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  October 25, 2010, 4:57 pm

Report: 'Society simply doesn't value primary care'

By Mike Lillis

By a wide margin, specialists are paid more than doctors in general practice, according to an independent report released Monday.

In a nationwide survey, researchers at the University of California, Davis, found medical specialists are paid as much as 52 percent more than primary-care physicians.

The trend — while hardly news within the medical community — nonetheless quantifies some of the gaps in physician compensation that are encouraging more physicians to enter lucrative specialties and avoid general practice. 

The result is not only much higher healthcare costs for everyone, the researchers warn, but a less healthy population as patients lose access to preventive care services. 

"Addressing the generalist-specialist income gap is critical to increasing access to cost-effective preventive care," J. Paul Leigh, professor at the UC Davis Center for Healthcare Policy and Research and lead author of the study, said in a statement. "There is a huge shortage of primary-care physicians, and in years to come many more of them will be needed to meet health-care reform goals."

After examining the wages of more than 6,000 physicians nationwide, researchers compared hourly wages of various specialties versus primary-care doctors — a break from many other compensation studies that have focused on annual pay.

The findings, based on figures from 2004 and 2005:

• Primary-care doctors — including those focused on pediatrics, geriatrics, family practice and internal medicine — made $60.48 per hour.

• Internal medicine and pediatric sub-specialists — including those focused on immunology, gastrointestinal conditions, cardiovascular diseases, rheumatology, pulmonary medicine, critical care, medical oncology and neonatal care — pulled in $84.85 per hour.

• Other specialists — like those focused on radiation oncology, rehabilitation, emergency medicine, psychiatry, neurology, ophthalmology and dermatology — made $88.08 per hour.

• Surgeons brought in $92.10 per hour.

The difference between the primary-care and specialist salaries adds up to millions of dollars over the physician's lifetime, according to Richard Kravitz, a professor of internal medicine and investigator with the Center for Healthcare Policy and Research. 

"There is this sense that society simply doesn't value primary care," Kravitz said.

The study was published in the latest issue of the journal Archives of Internal Medicine.

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  October 25, 2010, 3:26 pm

Challenge against abortion-funding ads to go forward in Ohio

By Julian Pecquet

Rep. Steve Driehaus has called billboard ads claiming he "voted for taxpayer-funded abortion” false; a hearing is set for Thursday.

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  October 25, 2010, 2:29 pm

Pallone asks World Series teams to ban chewing tobacco

By Julian Pecquet

The New Jersey Democrat wants the smokeless tobacco banned in the dugout and on the field during the series.

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  October 25, 2010, 12:17 pm

Limbaugh cites eyewitnesses to GOP strategy of non-repeal

By Mike Lillis

Republican leaders are insisting they'll make good on the party's election-season pledge to fight for full repeal of the new healthcare reform law.

But don't try to convince Rush Limbaugh. 

The conservative talk-radio host said last week that, at a recent closed-door meeting in Florida, unnamed GOP "senators" told party donors that the Republican strategy is to restructure the healthcare law, not repeal it. 

"I talked to a couple people that were there and they told me they went up to the senators and said, "Well, if this is your attitude, you can kiss 2012 goodbye,'" Limbaugh said on his show last Tuesday. "If this is the way you're looking at it, you can kiss any money from us and you can kiss 2012 goodbye.' So that's what [the lawmakers] were told by, quote-unquote, big donors and quasi-important people.  

"That's just two of them that I know who were there."

The controversy over the GOP's approach to the healthcare law took off last week after outgoing Sen. Judd Gregg (N.H.), the senior Republican on the Budget Committee, suggested that repealing the law isn't the right strategy. 

"I don't think starving or repealing is probably the best approach here," Gregg told the Fox Business Network last Tuesday. "You basically go in and restructure it."

On the same day, the Davis Intelligence Group reported that Sen. Bob Corker (R-Tenn.) recently told "high-dollar GOP donors" that most Senate Republicans — including Minority Leader Mitch McConnell (R-Ky.) — also don't support the full repeal being pushed by conservatives on the campaign trail.  

Both Corker and McConnell say that report is simply wrong, noting that Senate Republicans voted unanimously in March for full repeal of the law, just days after it was enacted. 

"While we were unable to block the Democrats from passing the health spending bill — the single worst piece of legislation that’s passed since I’ve been in the Senate — the Republican leadership in the House and Senate is committed to its repeal," McConnell said last week in an e-mail. 

"While Democrats will filibuster our efforts — and if we’re successful the President will veto — I believe we should give them that opportunity. We should vote, again, for repeal. Americans have spoken out, loud and clear, and we heard them. Repeal is part of the Pledge to America, and the Republican leadership is united in that effort."

Still, the idea that Republicans won't urge full repeal took off in the conservative blogosphere, with RedState's Erick Erickson taking shots at GOP leaders for being too moderate.

"You can be sure that Judd Gregg is not speaking out of turn and is not a lone wolf on this issue," Erickson wrote. "His view reflects that of the Senate GOP leadership despite their protestations to the contrary."

More recently, Limbaugh spokesman Kit Carson said Limbaugh's conversation with Florida donors only bolsters the credibility of reports that GOP leaders won't fight for full repeal. 

"Rush spoke to people directly who attended the fundraiser in [Florida]," Carson said in an e-mail, "and the Davis Intelligence Group seems to in essence back up the conversation he had with the couple who attended the fundraiser."

It remains unclear which "senators" attended the Florida fundraiser to which Limbaugh referred. Corker's office said he wasn't in Florida for any recent fundraisers, and Carson didn't respond when asked about the identity of the GOP lawmakers. 

The saga highlights a dilemma facing Republicans running on a platform of full repeal. Aside from the likely veto of such a measure by Obama, many of the consumer protections contained in the bill are enormously popular. On top of that, a full repeal is estimated to cost roughly $100 billion. 

Still, Limbaugh's comments highlight that conservatives aren't ready to accept anything less. 

"I had a bunch of people over for a Monday Night Football party, and I couldn't make it," he said of his invitation to the Florida fundraiser.

"But I did talk to a couple people who went. And they tell me full-force that they said after the message, 'If this is what you're thinking, that you can't repeal and that you don't have that much power, and you're not gonna really be able to effect change, then you can kiss 2012 good-bye.  

"'Obama and the Democrats are gonna be back in power if that's the way you're gonna approach this.'"

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