Medical Emissions Curbed
The Environmental Protection Agency has proposed tougher air pollution standards for medical waste incinerators, which environmental groups said have been among the country's worst emitters of mercury and dioxins. The new rule, subject to public comment until late January, resulted from an 11-year legal challenge to existing standards by environmental groups Earthjustice, the Sierra Club, and the Natural Resources Defense Council. Earthjustice attorney Jim Pew said in a statement that, in recent years, incineration of medical waste has shifted from individual hospitals to commercial incinerators. Pollution reductions at these larger facilities will be significant under the new rules, he said, which is good for nearby communities.
Clinic Discloses Industry Ties
The Cleveland Clinic has begun public disclosure of the business relationships its staff physicians and scientists have with drug and medical device makers. The organization said its Web site will list the names of companies with which each staff professional has collaborations. It also will identify whether a physician or scientist owns equity or has the right to royalties, a fiduciary position, or a consulting relationship that pays $5,000 or more per year. Cleveland Clinic physicians and researchers are subject to the organization's conflict of interest rules, and must submit for approval all industry relationships. “We want our patients to have abundant information about our physicians and let them decide what's relevant to their situations,” said Dr. Joseph Hahn, Cleveland Clinic chief of staff. Dr. Hahn added that to the best of his knowledge, Cleveland Clinic is the first academic medical center in the United States to disclose these ties.
HHS Issues Final PSO Rules
The Department of Health and Human Services has issued the final requirements for Patient Safety Organizations, new entities through which health care providers can collect and analyze data to identify and reduce patient care risks. PSOs allow this activity in an environment that is legally secure for practitioners and confidential for patients, according to the HHS. The Agency for Healthcare Research and Quality, which administers the PSO program, already has listed 15 PSOs. “The Patient Safety Organization final rule describes the clear, legally protected framework for how hospitals, clinicians, and health care organizations can work together to improve patient safety and the quality of care nationwide,” said AHRQ director Dr. Carolyn Clancy in a statement.
Lawmaker Asks for Heparin Review
U.S. Rep. Joe Barton (R-Tex.), ranking minority member of the House Energy and Commerce Committee, has asked the Government Accountability Office for a thorough review of the Food and Drug Administration's handling of the recent problems with tainted heparin coming from China. In February 2008, Baxter Healthcare Corp. recalled several heparin products and the FDA identified a previously unknown contaminant in the heparin. According to the FDA, 246 people died after heparin administration between Jan. 1, 2007, and May 31, 2008, and 149 of those deaths involved allergic symptoms or the appearance of hypotension, the group of symptoms that prompted the drug recalls. Rep. Barton's letter to the FDA challenges the agency's attribution of several deaths to heparin and questions whether the FDA used “all of the tools available” to investigate the deaths. “My hope is that the GAO's review will determine the strengths and weaknesses in the FDA's response to the heparin drug safety problem, and will make recommendations on what the FDA could do better in dealing real-time with an emerging drug safety problem in the future,” Rep. Barton wrote.
Defensive Medicine: $1.4 Billion
Defensive medicine—physicians ordering tests, procedures, referrals, hospitalizations, or prescriptions because of fear of being sued—is widespread and adds a minimum of $1.4 billion per year to the cost of health care in Massachusetts, according to a physician survey conducted by the Massachusetts Medical Society. The physicians' group said that defensive practices also reduce access to care and may be unsafe for patients. The survey queried nearly 900 physicians in eight specialties between November 2007 and April 2008 about their use of seven tests and procedures. Of the respondents, 83% said they practice defensive medicine. The survey also found that 13% of hospitalizations and 18%–28% of various tests, procedures, referrals, and consultations were ordered for defensive reasons. The society said that patients are unnecessarily exposed to radiation and possible severe allergic reactions when subjected to tests ordered for defensive purposes.
Workers Have Uninsured Children
Approximately 8.6 million children in the United States are uninsured, and most of these are in working families, according to a report from the advocacy group Families USA. In fact, almost 90% of uninsured children are in families where one parent works, and more than two-thirds live in households where at least one family member works full-time, year-round. The report, based on new Census Bureau data from 2005 through 2007, does not reflect the worsening economic situation in 2008, Families USA Executive Director Ron Pollack said at a press briefing. Mr. Pollack said the report points out the need for Congress to move quickly to pass legislation to reauthorize and expand the State Children's Health Insurance Program, now scheduled to expire on March 31.