Flu vaccines for healthcare professionals are an ethical responsibility that should be mandatory, infectious disease experts are arguing this week.

In a paper published Tuesday, the Society for Healthcare Epidemiology of America (SHEA) recommends that all healthcare workers — even students, volunteers, contractors and those without direct patient contact — receive annual flu shots as a condition of their employment. Only workers known to react adversely to the vaccine should be excepted, SHEA argues. 

“Healthcare providers are ethically obligated to take measures proven to keep patients from acquiring influenza in healthcare settings," SHEA President Neil Fishman said in a statement. 

"Mandatory vaccination is the cornerstone to a comprehensive program designed to prevent the spread of influenza which also includes identification and isolation of infected patients, adherence to hand hygiene and cough etiquette, the appropriate use of protective equipment, and restriction of ill healthcare personnel and visitors in the facility."

The report — published in the latest edition of the Infection Control and Healthcare Epidemiology journal — won the quick endorsement of the Infectious Diseases Society of America (IDSA).

“The scientific evidence shows significant reductions in the risk of influenza in both acute and long-term care settings as a result of strong immunization policies and programs,” said IDSA President Richard Whitley. “Vaccination of healthcare personnel saves patients’ lives and reduces illness."

The issue drew headlines last year amid an outbreak of the H1N1 flu. A survey conducted by the RAND Corporation during that pandemic found that, despite the severity of the outbreak, almost 40 of healthcare workers had no plans to get a flu shot. 

The survey is indication, Fishman and Whitley argue, that voluntary vaccination programs simply don't work well enough.

About two dozen businesses associated with high-profile opposition to the healthcare reform law are taking advantage of a provision that helps pay for their retirees' medical bills, according to a review of federal records by The Hill. The Department of Health and Human Services on Tuesday announced that almost 2,000 employers and unions have been accepted into the $5 billion Early Retiree Reinsurance Program, with more applications pending.

The application by Koch Industries of Kansas immediately raised eyebrows because its principal owners — Charles and David Koch — have been high-profile opponents of healthcare reform and bankrollers of the Tea Party movement.

But a state-by-state review of approved applicants reveals that more than a dozen members of the board of directors of the U.S. Chamber of Commerce have also been accepted into the program. The Chamber has been a leading foe of the law.

"We’re pleased the Affordable Care Act is delivering much-needed relief to businesses that provide coverage for their retirees," said an administration official.

The Chamber members include: 

• Pfizer, PepsiCo, New York Life Insurance Company, Eastman Kodak and IBM of New York; 
• Rolls-Royce North America, the Norfolk Southern Corporation and the Altria Group of Virginia;
• UPS and Southern Company of Georgia;
• John Deere and Navistar of Illinois;
• AT&T and the Fluor Corporation of Texas; 
• U.S. Airways of Arizona;
• Entergy Services Inc. of Louisiana;
• The Dow Chemical Company of Michigan;
• Anheuser-Busch of Missouri;
• FedEx Express of Tennessee;
• CUNA Mutual Group of Wisconsin;
• And Pepco Holdings Co. of Washington, D.C.

Being members of the Chamber's board of directors doesn't mean the companies agree with all of its stances. Pfizer, for example, has been a vocal proponent of the law and even gave its CEO Jeff Kindler a raise in salary and bonuses after it passed, according to CBS News and other reports.

Healthcare lobbyist Jill Dowell has left her job as the vice president of federal affairs at America’s Health Insurance Plans, an AHIP spokeswoman confirmed to The Hill.

Dowell joined the organization in 2001, and she played an influential role in last year's healthcare negotiations.

"Now that healthcare reform has passed, the landscape has shifted to focus more on the regulatory functions and the role of the administration," Dowell told The Hill. "I thought that this would be the right time for me to shift directions, too."

"We will miss her and wish her all the best," said Susan Pisano, AHIP's vice president of communications.

Dowell is undecided as to what her next professional move will be. "It's been a great ride, and I'm proud to have been a part of this chapter in American healthcare."

Prior to joining AHIP, Dowell represented Motorola and Diageo on Capitol Hill. From 1993-96 she served on the legislative staff of former Ways and Means Committee Chairman Bill Archer (R-Texas).

The Obama administration this week rebuffed a request from House lawmakers that Medicare announce the first round winners of the agency's competitive bidding program for durable medical equipment (DME).

"We do not believe it would be appropriate or in the public interest to release any bidders' names before the contracting process is complete, as there are a number of risks associated with doing so," Donald Berwick, head of the Centers for Medicare and Medicaid Services (CMS), wrote in an Aug. 30 letter to Rep. Jason Altmire (D-Pa.).

Altmire had spearheaded the lawmakers' request that CMS announce the winners more quickly.

"Without knowing the identity as well as the appropriate overall qualifications of these providers, we cannot evaluate the program's impact in terms of quality and access to care for seniors we represent," the lawmakers wrote in an Aug. 11 letter to Berwick.

More than 130 House members representing both parties endorsed the move. 

CMS has said it will announce the contract winners later in September, "once all contracts have been finalized."

Berwick reiterated that timeline Monday, arguing that providing "interim lists" of winning bidders would both confuse beneficiaries and undermine "the orderly and effective implementation of the program."

"In addition, we have not yet notified the suppliers whose bids were not among the winning bids, and we believe that these suppliers should be notified before the names of the suppliers with winning bids are released to the public," Berwick wrote. 

"Further, announcing a subset of suppliers before the contracting process is complete could be viewed as giving those suppliers an unfair competitive advantage." 

Finally, Berwick added, "standard procurement rules prohibit disclosing the identities of bidders until after contracts are final."

Medicare's competitive bidding program is designed to control costs and rein in fraud in the durable medical equipment industry.

In July, CMS announced Medicare patients in the nine regions affected by the first round of the program would save, on average, 32 percent on DME products, which include oxygen supplies, power wheelchairs and hospital beds.

The DME lobby, however, says the program will put many small companies out of business, threatening seniors' access to vital equipment. The industry has fought to have the program scrapped altogether. 

This post was updated at 1:51 p.m.

Some hospitals in a recent survey have reported having more than a 50 percent operating margin.

Healthcare reform showdown in Minnesota:  Gov. and potential 2012 presidential candidate Tim Pawlenty makes headlines with his executive order barring state agencies from participation in the healthcare reform law. http://bit.ly/bJdcli
 
The executive order directs state agencies to decline all discretionary participation in the new law. As a result, none of Minnesota's executive branch departments and agencies can submit applications for grants or demonstration projects unless required by the new law or approved by the governor's office. http://bit.ly/9XXAHV



"Obamacare is an intrusion by the federal government into personal healthcare matters and it's an explosion of federal spending that does nothing to make healthcare more affordable," Pawlenty said in a statement. "To the fullest extent possible, we need to keep Obamacare out of Minnesota. This executive order will stop Minnesota's participation in projects that are laying the groundwork for a federally-controlled healthcare system."

 

Democrats are unimpressed: The order is immediately dismissed as a political stunt by Democrats. Health and Human Services (HHS) Secretary Kathleen Sebelius says she's "afraid the citizens of Minnesota may be the victims of whatever it is that’s coming their way." http://bit.ly/bgi1FN

The Obama administration this week asked a federal judge to suspend his recent ruling that prohibits the federal funding of human embryonic stem cell (hESC) research.

Last week, U.S. District Judge Royce Lamberth found that the administration's 2009 expansion of such research violates a ban on the federally funded destruction of human embryos.

That ruling, the Department of Justice (DOJ) argued in an emergency motion filed Tuesday, threatens years of research, causing "irrevocable harm to the millions of extremely sick or injured people who stand to benefit from continuing hESC research."

The agency is asking Lamberth to stay — or suspend — his ruling while the DOJ appeals it.

The move is necessary, DOJ says, "to avoid terminating research projects midstream, invalidating results in process, and impeding or negating years of scientific progress toward finding new treatments for devastating illnesses."

Anti-abortion groups, who cheered Lamberth's ruling, are now slamming the White House for appealing it.

"With our tax dollars, we should be investing in the adult stem cell research that works now and holds the greatest long-term promise for all Americans," Charmaine Yoest, head of Americans United for Life, said in a statement. 

The possible 2012 White House contender signed an executive order restricting his state's involvement in the healthcare reform law.

Sen. Ben Nelson (D-Neb.) this week lashed out at Nebraska Gov. Dave Heineman after the Republican lawmaker urged state educators to back a repeal of healthcare reform — or risk losing their jobs.

Heineman, Nelson said in a statement issued Monday, is using "misinformation to intimidate groups involved in all aspects of our children’s health, safety and education, pitting one against the other."

"What I’m hearing from Nebraskans is they don’t want this kind of divisive politics to be played," Nelson added. 

Last week, Heineman sent a letter to state education groups warning that the Medicaid expansion under the Democrats' healthcare reform law would steal vital funding from state education programs, thereby threatening education jobs.

"Increased funding for Medicaid is likely to result in less funding for education," Heineman wrote. "Don't sit on the sidelines. I strongly urge you to support the repeal of the recently enacted federal health care law."

Nelson fired back Monday, arguing that Heineman is using healthcare reform as a scapegoat for the state's budget woes.

“In the end, the governor really is trying to avoid his biggest problem: an estimated $750 million state budget shortfall," Nelson said. "He’s doing so with misinformation and with divisive politics, and Nebraskans do not expect that from the governor’s office."

Nelson also slammed Heineman for touting a recent report — commissioned by the governor and conducted by Milliman, Inc. — that found healthcare reform's Medicaid expansion would saddle Nebraska with new costs totaling between $526 million and $766 million over the next decade.

That report, Nelson charged, "is incomplete at best and intentionally misleading people at the worst."

Among the criticisms, Nelson said Milliman analysts assumed that everyone eligible for Medicaid under the expansion would enroll — an unrealistic projection because "Medicaid is voluntary and voluntary programs never see 100 percent participation," Nelson noted.

"He builds his campaign against health reform on misinformation."

It's hardly the first time Nelson and Heineman have butted heads. Late last year, in the midst of the contentious debate over healthcare reform, the Republican governor urged Nelson to oppose the bill on the grounds that the state couldn't afford the Medicaid expansion. Those concerns led Democratic leaders — who needed Nelson's vote to pass the bill — to include a provision exempting Nebraska from assuming any new costs related to the Medicaid expansion.

Heineman later went out of his way to distance himself from that provision, arguing that he "didn't want a special deal." 

"All we want," he said in January, "is to be treated fairly and equally."