We know Baltimore lost its independent public health department in Reagan/Clinton years if it ever had one. Bloomberg School of Public Health has been Baltimore's public health and guess what......
A MAYOR OF WALL STREET SEES PUBLIC HEALTH AS FEDERAL FUNDING TO MOVE TO CORPORATE PROFIT---PERIOD.
This is when the positioning of ending all New Deal and War on Poverty Federal health plans hit hard-----in the Clinton 1990s era at the same time of financial deregulation that gave us predatory global Wall Street.
'Bloomberg began his career at the securities brokerage Salomon Brothers before forming his company in 1981 and spending the next twenty years as its chairman and CEO. He also served as chairman of the board of trustees at his alma mater Johns Hopkins University from 1996 to 2002'
So, this is the problem and the solution for citizens in Maryland, Baltimore, and the world in rebuilding our first world public health and safety structures====GET VERY, VERY, VERY NEO-CONSERVATIVE JOHNS HOPKINS AND WALL STREET BALTIMORE DEVELOPMENT OUT OF PUBLIC HEALTH. Below you see a health commissioner in Dr Wen who has no idea of what US Constitutional and Federal laws are----and for whom she works. Wen is also tied to the corrupt medical examiner's office that protected the officers on the sidewalk in Freddie Gray's death. We know when we have leadership that works for global corporations that they are not providing oversight and accountability in health care outcomes and drug and medical device product safety.....they will provide data that promotes these patents to maximize profits.
Whether Environmental Protection Agency, Food and Drug Administration, or National Institutes of Health---all Federal agencies under Clinton neo-liberals and Republicans break down the public protections and gear these departments to work overseas protecting US health and PHARMA corporations against patent infringements in other nations---
ALL FEDERAL FUNDING TO HEALTH AGENCIES ARE GOING TO POLICING CORPORATE PATENT INFRINGEMENTS.
The importance of data in medical innovation-----how does that fit with the reduction of clinical trials----with a litany of medical class action lawsuits claiming extreme harm and death----indeed, the data coming from BioTech facilities as those connected to Johns Hopkins are juking the stats to move research to patent and then to billions in profit BEFORE MILLIONS OF PEOPLE ARE IDENTIFIED AS HARMED----then the FDA will reprimand the brand and apply a small fine. This has been the process for FDA and NIH since Clinton neo-liberals joined Republicans -----
AND IT IS KILLING MILLIONS OF PEOPLE UNNECESSARILY AND MAKING PEOPLE AFRAID AND UNSURE OF WHAT ACTUALLY HELPS THEM IN HEALTH CARE.
- Tuesday, December, 22nd, 2015
City had plans to make zero degrees the trigger to shelter homeless people this winter
The plan has shocked homeless advocates and providers. "People will die," says one. Mark Reutter December 18, 2015 at 7:45 am
'Fasanelli said the zero-degree plan stems from a “Severe Code Blue Alert” recently established by Dr. Leana Wen, commissioner of the Health Department'.
FDA, NIH Emphasize Importance of Data in Medical Innovation Efforts
Friday, March 13, 2015RELATED TOPICS:Clinical Innovation & Technology reports.
At the Senate Health, Education, Labor and Pensions Committee's hearing on Tuesday, Chair Lamar Alexander (R-Tenn.) said that the process of developing drugs is slow and costly and called on stakeholders to make improvements.
During the hearing, NIH Director Francis Collins said the agency is planning to launch an initiative involving at least one million volunteers that aims to improve chronic disease prevention.
He said, "This venture will pioneer a new model for doing science that emphasizes engaged participants, technologically advanced collection of many different data types, responsible data sharing and privacy protection."
Meanwhile, FDA Commissioner Margaret Hamburg said the agency has approved 51 drugs and biologics in the last year -- the most in nearly two decades -- noting that review times are "consistently faster than other ... regulatory agencies" (Walsh, Clinical Innovation & Technology, 3//11).
Hamburg also discussed the agency's Sentinel program, noting its large use of health care data (Slabodkin, Health Data Management, 3/12). In late December 2014, FDA announced plans to expand the five-year pilot program -- which uses electronic health records and claims data to monitor the safety of medical products regulated by the agency -- and launch a full-scale rollout (iHealthBeat, 1/5).
Hamburg said, "Real-world data provides a vital tool to monitor medical products in use in the marketplace." She added that while the "science of using big data to establish product effectiveness is still in its infancy," the use of "appropriate privacy protections" and "leveraging large databases containing patient EHR, disease registry and claims data" has:
- Advanced understanding of health and disease;
- Provided "insights into potential relationships between health-related factors and outcomes"; and
- Provided valuable product safety data (Health Data Management, 3/12).
One thing we know for sure----the FDA gets next to nothing to monitor food or medical products grown and/or built in developing nations----we know they are not providing protections for what could simply be manufactured in the US. Think of the profit margin on PHARMA and medical devices even as they are made by sweat shop labor and you see why US citizens have no avenue of assurance for medical data or quality of product. If made in China is now on our medical products---is that why Medicare is paying to replace products every three years----like our cheaply made clothing?
The FDA gets absolutely NO funding from Congress to assure overseas safety and quality and they know it----and yet, as the article above showed global pols are using all the progressive language that makes people think they are building all kinds of structures to assure these protections exist. Well, if you are breaking down Federal clinical trial structures for example in deregulation of health care-----that one structure is a major protector and they don't seen to think it necessary.
Focus on funding FDA overseas clinical trial policing, says ACRO
By Alexandria Pešić, 29-Oct-2010
ACRO wants the US FDA’s overseas offices to play more of a role in monitoring clinical trials, and is calling for an additional $35m (€25.3m) to fund the work.
What we see is lots of media being released from Federal agencies that pretend something is being done to monitor food and medical products/PHARMA being outsourced overseas----BUT THAT IS HOGWASH. IT IS NOT HAPPENING.
This is what deregulation looks like-----under Federal drug and medical device safety laws this kind of outsourcing would never have happened. IT IS NOT LEGAL. So, now we have the Congress spending all kinds of Federal taxpayer money to build an oversight system in Asian nations like China that used to go to our US health and safety oversight----and it is being lost to fraud, corruption, and mismanagement.
IT IS INSANE. Cities like Baltimore with a heavy presence of BioTech product mills like Johns Hopkins and University of Maryland Medical Systems already knowing no oversight and accountability occurs in Baltimore and Maryland is set to behave just as in China-----and US citizens are dying right and left from tainted PHARMA and defective medical devices.
Keep in mind----it is not the working class or poor that has health coverage to allow access to all this----this is American citizens with health plans that allow access to hospital procedure and PHARMA.
FDA seeks presence in China
By Shan Juan (China Daily)
Updated: 2008-03-21 10:17
While the US Food and Drug Administration (FDA) is pushing to establish a presence in China, SFDA spokeswoman Yan Jiangying said yesterday that neither Chinese authorities nor the FDA had contacted them about the presence of hypersulfated chondroitin sulfate in exported heparin products.
"There are set procedures, and the FDA might first apply to the Chinese Ministry of Foreign Affairs," she said.
The FDA planned to establish eight full-time, permanent positions at US diplomatic posts in Beijing, Shanghai and Guangzhou, pending authorization from the Chinese government, a March 14 notice on its website said. OH REALLY????? THESE ARE GLOBAL FACTORIES PRODUCING BILLIONS OF PRODUCT AND WE HAVE 8 STAFF----
Intended to improve information exchange and cooperation, the move is a significant step toward ensuring access to safe food, drugs and medical devices in the global market, the statement said.
"There is a very real interest in pursuing this, and obviously the spotlight has been on China ... but this is not just a China issue," FDA Deputy Commissioner for International and Special Programs Murray Lumpkin said in December.
FDA Works with China to Ensure Medical-Product Safety
Posted on April 17, 2014 by FDA VoiceBy: Christopher Hickey, Ph.D.
Americans benefit greatly from medical products produced by other countries. Approximately 40 percent of finished drugs in the United States come from overseas, as well as more than 50 percent of all medical devices. About 80 percent of the manufacturers of active pharmaceutical ingredients are located outside the United States.
Christopher Hickey, Ph.D., testifies April 3, 2014.
However, this rapid globalization of commerce presents challenges to regulators who oversee the safety and quality of medical products. Many of these challenges manifest themselves in China. As FDA’s country director for the People’s Republic of China, I testified on April 3, 2014 before the U.S.-China Economic and Security Review Commission, an advisory panel created by Congress, on our work to ensure the safety and quality of medical products produced in China and imported into the United States.
China is the source of a large and growing volume of imported foods, medical products and ingredients. In the years spanning fiscal years 2007 and 2013, the total number of shipments of FDA-regulated products from China to the United States almost quadrupled.
The challenges we see in China mirror those we see in other countries with developing regulatory systems. These issues include problems with data integrity, inadequate implementation of quality systems in manufacturing, and inconsistent regulatory oversight, among others.
As China’s role on the global stage expands, FDA has significantly increased drug and medical device inspections there, but we need to continue to strengthen our efforts. FDA is currently working to use Congressionally-appropriated funding to increase from eight to 27 the number of U.S. staff it posts in China. Visa issues that arose with the Chinese government over new FDA staff assigned there were addressed during Vice President Joe Biden’s visit to Beijing in December, and FDA continues its work to post new staff in Beijing in the coming months.
FDA recognizes that strategic engagement in China starts first and foremost with Chinese regulators. China’s Food and Drug Administration, or CFDA, is responsible for the regulation of food, drugs, and devices for domestic distribution in China, and for regulation of certain exported drugs and medical devices.
Christopher Hickey, Ph.D., testifies before the U.S.-China Economic and Security Review Commission.
FDA has established a strong working relationship with CFDA. Our office has trained hundreds of Chinese inspectors in areas that include inspecting for good manufacturing practices and assessing the quality of data from sites that conduct clinical trials. Experts from FDA’s Center for Devices and Radiological Health now meet regularly with their counterparts from CFDA under the auspices of the International Medical Devices Regulatory Forum. These investments will pay long-term dividends for the American people: a stronger Chinese regulatory system can only strengthen FDA’s efforts to promote and protect U.S. public health.
Finally, in the area of inspections and enforcement, CFDA inspectors now regularly observe FDA inspections in China. And since 2012, FDA’s Office of Criminal Investigations has worked closely with CFDA to fight against Internet-based, illegal distribution into the U.S. of falsified, counterfeit and adulterated drugs.
FDA’s priorities in China match its global priorities: we work to ensure the safety and efficacy of FDA-regulated products. Manufacturers are best situated to make certain that appropriate processes are in place to ensure safety and quality in production. Regulatory bodies should hold companies accountable for lapses in the production process. Inspections and testing are important tools in that process, but they must be used as part of a larger system that emphasizes a preventive, approach to the production of safe, effective, high-quality medical products.
And in our globalized world, it’s increasingly important that regulatory partners work together to ensure the safety of products as they move through increasingly complex supply chains. Patients and consumers – whether in Beijing or Boston – deserve no less.
NONE OF THIS ADVANCES QUALITY OF HEALTH CARE---IT SIMPLY ALLOWS A GROCERY STORE SHELF OF CEREALS BECOME OUR HEALTH PRODUCTS.
Americans will remember last decade as it was uncovered by government watchdogs that reformulation facilities across the US were found to fail every measure of safety and sanitation in states like NY, PA,OH here on the East Coast and Maryland was found to allow import of these drugs across state lines never making sure the source was indeed inspected and regulated. Maryland of course does not care-----as long as those reformulation corporations were able to make profit.
What was captured in the US last decade under Bush is what happens overseas in developing nations and it is what will soar now that 'innovation' medicine and medical product mills are set loose in a deregulated and profit-drive health care under Clinton neo-liberals and Republicans. Reformulation of PHARMA means that a slight change in chemical makeup in creating a pill allows a corporation to claim it a different drug all without doing another set of clinical trials to see what that change in drug formulation does to the human body----and it only takes slight changes to do harm and/or death.
So, you have profit-driven Hopkins and its BioTech product mill trying to patent and patent its way to billions of dollars----what is it going to do as BALTIMORE PUBLIC HEALTH when people are found to be killed by these newly-patented drugs?
IT WILL JUKE THE STATS TO COVERUP HOW PEOPLE DIE AND WHAT CAUSED IT---AS HOPKINS HAS DONE IN THE PAST ----NOW THIS WILL BE SUPER-SIZED.
Under social Democracy all of these Federal agencies enforced regulations----did inspections-----made sure outsourcing did not occur without meeting same standards. These Federal, state, and local agencies still exist-----
WE SIMPLY NEED THEM BACK IN THE HANDS OF SOCIAL DEMOCRATS THAT WANT OVERSIGHT AND ACCOUNTABILITY AND PUBLIC INTEREST PUBLIC HEALTH.
Reformulation trend capturing pharma
By Kirsty Barnes, 17-Jan-2007
More and more drug makers are turning to reformulation to prolong the lifecycle of their top sellers and protect precious revenue from generic copies, as well as supplement dwindling pipelines.
THIS IS WHAT THE AFFORDABLE CARE ACT DID WITH ITS HUNDREDS OF PAGES FILLED WITH DEREGULATION LANGUAGE ALL WHILE MEDIA SHOUTED SOMETHING PROGRESSIVE WAS HAPPENING.
What this article doesn't tell you is most of these new biotech startups taking the place of US PHARMA corporations going overseas are coming from universities like Hopkins tied to global Wall Street investment firms----so these are not small businesses----
Federal regulations would never have allowed US PHARMA and medical devices be outsourced to where absolutely no public protections existed----Affordable Care Act seeks to completely deregulate health care making this outsourcing soar----and it will include actual medical procedure through robotics and telemedicine.
THE FEDERAL AGENCIES ARE STILL THERE---THEY SIMPLY HAVE APPOINTED LEADERS THAT IGNORE CONSTITUTIONAL LAWS AND FEDERAL PUBLIC PROTECTIONS.
A Mayor of Baltimore can use those agencies to provide oversight and accountability and the funds coming to the city to do that. Right now all funds for this simply go to Hopkins as the Baltimore Public Health Department ------they need to come to city coffers and rebuild our public health oversight. All of Baltimore City Council persons in various committees simply sit and wait until Baltimore Development or Hopkins sends down the written public policy and pass it.
Keep in mind generics are not the same either----once the reformulation had to be minor enough to make sure effects on people would not harm-----today, they are reformulating in ways that could create grave harm with no new clinical trial.
N.J. pharmaceutical job losses mirror industry-wide transformation
Changes to the pharmaceutical industry have been felt across the country, nowhere more than in New Jersey, which has lost thousands of drug manufacturing jobs in the last decade. This week, Merck announced it would shutter its Summit campus, where scientists from its animal health division work, in photo above. (Robert Sciarrino/The Star-Ledger)
By Alexi Friedman | The Star-Ledger
on October 02, 2013 at 7:46 PM, updated December 11, 2013 at 6:19 PM
Nowhere has the pharmaceutical industry’s tumultuous reformulation been more evident than in New Jersey, which has shed 14,000 manufacturing jobs over the last decade, but which has also recently seen an uptick in smaller biotech firms.
While Big Pharma’s manufacturing job losses in the one-time “Medicine Chest” of the United States have been particularly acute, analysts and state officials say they also reflect a nationwide trend, as name-brand drugs going off patent have been replaced by cheaper generic versions and where research and development has moved to specialty drugs and away from primary care medicines.
This week has cast a spotlight on some of those shifts. On Tuesday, Whitehouse Station-based Merck announced it would shutter its Summit campus. The move was part of a companywide restructuring plan that includes about 16,000 layoffs or, 20 percent of its total global workforce. Merck employs more than 8,500 people in New Jersey, and cuts are expected.
Even generic drug companies are not immune from the layoffs.
On Wednesday, Warner Chilcott disclosed it will eliminate 88 jobs from its Rockaway Township facility, a day after Parsippany-based Actavis, the world’s largest generic drugmaker, was given final approval for its $8.5 billion acquisition.
It is that presence of generics that has turned Big Pharma’s tradition of high-priced name-brand medicines on its head, forcing the industry to change. There have been growing pains along the way.
“There has been a huge wave of drugs going off patent that has drawn billions and billions of dollars away from these companies, which hasn’t been replaced,” said Erik Gordon, a professor of law and business at the University of Michigan. “When the drug companies look into their pipelines, they don’t see those billions coming back. That revenue has disappeared, which is a major factor that drives mergers.”
The past decade has seen numerous pharmaceutical companies in New Jersey merge and scale back operations, like in the case of Schering Plough, when Merck bought it; and Wyeth, when it was acquired by Pfizer, or simply cut staff, like Johnson & Johnson has done.
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Drugmaker Roche last year announced it would vacate its Nutley campus, and lay off 1,000 employees. On Tuesday, company officials celebrated the opening of its new biotech research facility on Manhattan’s East Side.
Still, New Jersey’s pharmaceutical and life-sciences sector remains a strong presence despite a decade of layoffs, employing more than 120,000 people, according to state labor statistics.
Debbie Hart, president of the biotechnology industry trade group BioNJ, said, “the good news is the biotech industry is growing in New Jersey, and is hiring some of those people that have been laid off from the bigger companies.” Companies like Roche and Merck have had to adapt as biotechs pour money into specialty care and cancer drugs R&D. Merck now says it will focus in that area after recent pipeline drug failures and drug patent expirations.
After Merck’s layoff and restructuring plan announcement this week, Union County officials said they will expand job-search programs, preparing for pending layoffs to the 1,600-person Summit office. Merck will also close its Whitehouse Station headquarters in Hunterdon County — where 2,100 people work — shifting its base to the Kenilworth campus.
“We are seeing some downsizing happening in New Jersey but this has been an industry evolution,” Hart said. “There hasn’t been any mass exodus from New Jersey.”
And while Boston and San Francisco are the current hot spots for biotech firms, geography can only offer so much, said Les Funtleyder, a health care strategist at private equity fund Poliwogg.
“Innovation is not something you can just order up like a Big Mac,” he said. “It’s a combination of incrementalism and that eureka moment.”
Throwing money at any idea that will make a new product----I listened to two Hopkins students on a bus disturbed that they were being made to debate whether clinical trials were needed at all-------
The American people were really hoodwinked with the Affordable Care Act in that it sends hundreds of billions of what was funding for quality care with oversight and accountability to expand this compromised model of product mills.
Keep in mind states like Maryland have no public justice-----no Baltimore States Attorney or Maryland Attorney General with branches that protect against this. The Maryland Attorney General's Office has a rule that states it will not become involved until tens of millions of dollars in citizen losses to fraud and illegal actions harm the public----by then, corporations have pocketed huge profits and then get a fine -----and go bankrupt....just as with the subprime mortgage frauds----and now it is happening to our health care.
AGAIN, THE EXECUTIVE OFFICES OF MAYOR AND GOVERNOR CAN ENFORCE FEDERAL LAWS-----WE MUST USE OUR CITIES AS PLATFORMS TO REBUILD OUR SOCIAL DEMOCRATIC STRUCTURES THAT PROTECT CITIZENS.
Defective Medical Device Injuries
Every year, sales from medical devices such as heart valves and stents, bone graft material, heart defibrillators and pacemakers, orthopedic joint prosthetics, surgical mesh, and medical infusion devices, just to name a few, bring in a combined total of over $200 billion in revenue worldwide, making one of the most profitable enterprises in the health care industry. It is for this reason that medical device companies are in a constant race to invent the next groundbreaking medical device or make advancements to existing medical devices, even if it comes at a cost to public safety.
- Lawyers Investigate Hospitals Where Spine Surgeries Caused Patients Severe Pain, Excessive Bone Growth and Other Complications
- Patients File Olympus Medical Lawsuits After ‘Superbug’ Duodenoscope Exposure
- Medtronic Infuse Bone Graft cases (off-label)
- Stryker OP-1 Putty and Calstrux cases (off-label)
- Laparoscopic Power Morcellator Cancer Lawsuit
Here you see the progressive posing that resulted when all kinds of major medical frauds and harm was exposed last decade--------Maryland Assembly creates a bill that says----
YOU BAD GUYS HAD BETTER REPORT ALL THOSE INJURIES AND DEATHS CAUSED BY A COMPLETELY DEREGULATED HEALTH INDUSTRY OUTSOURCED AND GLOBAL WITH NO OVERSIGHT AND ACCOUNTABILITY.
The Maryland Assembly does this all the time----it has tons of legislation with NO TEETH passed to appease public outrage with no intentions of funding oversight and accountability. I speak often to Maryland Department of Health who pushes this deregulation about accountability and the executives get mad----tell me there are no problems -----and tell me to get out of the way.
When you have people who sit around a table able to look beyond public interest at only what will create the next profit------YOU HAVE A CORPORATE EXECUTIVE BOARD----NOT A US GOVERNMENT ASSEMBLY.
Please stop allowing these same pols get re-elected each year-----all Maryland pols are Clinton neo-liberals or Bush neo-cons and need to go!
March 3, 2011
Maryland Bill Aims to Reduce Deadly Medical Errors
Assembly Health Committee to Consider Bill On March 3rd
to Require Hospitals to Publicly Report Medical Errors
ANNAPOLIS, MD — Maryland hospitals would be required to publicly disclose medical errors that occur while patients are being treated under a bill sponsored by Delegate Michael G. Summers. HB 821 is designed to inform the public about a serious patient safety issue and prompt hospitals to improve care and prevent medical harm.
The Assembly Health & Government Operations Committee is scheduled to consider HB 821 at a hearing scheduled for Thursday, March 3, beginning at 1:00pm.
“When mistakes are made in the hospital, the consequences can be serious and even deadly,” said Lisa McGiffert, Director of Consumers Union’s Safe Patient Project (www.safepatientproject.org). “The public should know their hospitals record on patient harm. Maryland lawmakers should pass this measure to help improve care and protect patients.”
McGiffert submitted testimony to the Assembly Health Committee in support of HB 821.
Recent research has found that medical errors are even more common than previously estimated. A November 2010 study by the Department of Health and Human Services’ Office of the Inspector General found that one in seven Medicare patients or 13.5 percent experienced serious or long-term medical harm (including infections) or death, while they were receiving care in the hospital. Another 13 percent of patients experienced temporary harm. The researchers estimated that hospital infections and medical errors contributed to approximately 180,000 deaths and $4.4 billion in additional hospital care costs each year for Medicare patients alone.
Likewise, a November 2010 New England Journal of Medicine study in North Carolina hospitals found that one in four patients were harmed by the care they received, ranging from hospital acquired infections, surgical errors, and medication dosage mistakes. Other medical errors include serious bed sores, patient falls in the hospital from inattentive care, and diagnostic mistakes.
Maryland residents have no way of knowing whether their hospital does a good job when it comes to preventing medical harm. That’s because hospitals in the state are not required to disclose this information to the public. Under HB 821, Maryland hospitals will be required to report to the Department of Health when patients are harmed by the care they receive. Hospitals must file reports no later than five days after the event or within 24 hours if the patient is seriously harmed. To ensure hospitals provide an accurate accounting of these events, the Department will compare hospital reports on errors against other publicly available data on patient harm, including periodic audits of medical records.
Each quarter the Department will publish a report disclosing which hospitals failed to report medical harm events and the fines that were assessed as a result. Every year, the Department will submit to the state legislature and post on its web site a report detailing the number and type of medical harm events at each hospital, the level of arm to patients, fines that were assessed and enforcement actions that were taken. The first report must be made public by April 1, 2013.
“Disclosing medical errors will enable patients to find out how their hospital stacks up against others when it comes to keeping patients safe,” said McGiffert. “And making this information public will motivate hospitals to work harder to prevent medical errors in the first place.”
More information about medical errors can be found at www.safepatientproject.org
Michael McCauley – 415-431-6747, ext 126 or firstname.lastname@example.org
What kind of data do you get from a completely deregulated health system with no oversight and accountability? Here is Maryland's Health Commission---which acts just like Maryland's Public Service Commission----it has appointed members that are corporate shills.
The law passed above pretends to create mechanisms for data integrity at the same time all structures that would assure that are being dismantled.
A Mayor of Baltimore would be shouting at these meeting at the state level and at the Maryland Health Commission----but Baltimore's mayors are always working for very neo-conservative Johns Hopkins and Wall Street Baltimore Development.
Think about last week when I talked about how the homeless system fails those poorest ----and then look at how it all goes up the income ladder------it does not matter if you have a Silver, Gold, or Platinum health plan---everyone gets these devices and PHARMA from the same places.
Look below----already regulated by Medicare----only, Maryland is the only one having sought exemption from Medicare so that it is not regulated.
"They believe that the access to good quality care would be jeopardized," Weglein said.
Supporters of relaxing regulations argue that home health agencies are already regulated by the federal Medicare program and say the state could benefit by eliminating a time-consuming regulatory process'.
Home health care facing deregulation
Dec 5, 2005, 12:00am EST Updated Dec 1, 2005, 4:11pm EST
Industries & Tags
Alan Zibel Staff
Health care agencies that provide medical care to elderly and sick patients at home, would no longer need state permission to open in Maryland under a new proposal.
The recommendation by a 24-member task force set up by the Maryland Health Care Commission to streamline state health care regulations has sparked opposition from some home health care companies.
They say eliminating state regulations would enable new companies to enter the state and not serve poor patients. Opponents say those firms could pay higher wages to nurses and other staff, making it tougher for existing companies to recruit workers in an already difficult market for nursing staff.
"This will have a serious negative impact on agencies such as ours [that are] committed to servicing all types of patients, a problem that will only stress an already difficult recruitment environment" wrote Daniel B. Smith, president of Johns Hopkins Home Care Group in a September letter to the health care commission.
Elizabeth Weglein, president of the Maryland National Capital Homecare Association, which represents the agencies in Maryland and Washington, D.C., said some of her group's members hope to convince the health care commission not to enact the panel's recommendation.
"They believe that the access to good quality care would be jeopardized," Weglein said.
Supporters of relaxing regulations argue that home health agencies are already regulated by the federal Medicare program and say the state could benefit by eliminating a time-consuming regulatory process.
The panel was split on whether to eliminate the home health care regulations. State law would have to be changed to do so.
The health care commission is scheduled to consider the proposed changes at its Dec. 15 meeting.
The task force worked from May to November examining state regulations for hospitals and other health care facilities. In Maryland, health providers must get state approval, or a "certificate of need" for new buildings or services.
In addition to hospitals, the law also applies to nursing homes, surgery centers and home health and hospice agencies.
It was FDR's social democracy that created Federal agencies tasked with oversight and accountability just so the public interest would be protected over corporate profiteering. Look how all this is called redistributionist-----just as today's Congress calls recovering tens of trillions of dollars in corporate fraud---redistributionist. When Republican voters allow their Republican pols sell them on the idea that all these Federal agencies are a waste of taxpayer money-----look now as they have these few decades dismantled all those Federal agencies to see how twice the funding went to these agencies just to be lost to corporate fraud---and now all that funding is going to build overseas structures. So, the taxpayer funds get used either way------taxation on small business and citizens never goes down---it simply is a decision of whether we are going to have the taxes we pay protect public interest-----social democracy----or simply be lost to expanding corporate wealth and power and all the fraud and corruption to get them there.
'Moreover, the new Bill of Rights requires a redistributionist state that demands an ever-expanding bureaucracy with increasing budgets. The wealth of some pays for others’ newly coined rights. The new conception of rights diminishes the older notion, in particular an individual’s claim on his own property and even his own conscience and intellect, as life becomes more socialized in all its spheres'.
FDR’s Second Bill of Rights
January 11, 1944 Heritage Foundation
President Franklin Roosevelt used his 1944 State of the Union address to advance his “Second Bill of Rights”: a broad vision of the role of government in making lives more secure through expanded government programs. The recurring theme throughout is “security” and the necessary action called for is unrelenting war against the enemies of the New Deal, both foreign and domestic.
“Necessitous men are not free men,” FDR proclaims. Since “true individual freedom cannot exist without economic security and independence,” the original Bill of Rights must be supplemented by eight rights that “spell security.” The proposed rights include the “right to a useful and remunerative job”—not the right to work, but the right to demand a job, and a well-paying one at that. “Farmers have the right to obtain “a decent living” from their toil, and businessmen have the right to be free of “unfair competition and domination by monopolies.” There are as well rights to “adequate medical care,” education, and the “right to earn enough to provide adequate food and clothing and recreation.”
While no Congress has formally adopted these as rights, legislation has expanded the meaning of these benefits such that we now speak of rights to health care, work, education, housing, and salary levels. In what sense are these goods rights? The original Bill of Rights supposed that self-government required certain civic traits and freedoms, so it declared these activities, such as the freedom of speech, to be protected from federal government interference. By contrast, Roosevelt’s rights require ever-expanding federal government programs for them to exist. The right to “adequate protection from the economic fears of old age, sickness, accident, and unemployment” is a right to be free of an anxiety. Yet, if one is free of fear of unemployment, will one ever want work? How much does one need to earn to enjoy “adequate…recreation”? What is a right to “a good education,” a “decent home,” or “good health”? The questions never end, because the standards of what is “good,” “adequate,” or “decent” constantly rise.
Moreover, the new Bill of Rights requires a redistributionist state that demands an ever-expanding bureaucracy with increasing budgets. The wealth of some pays for others’ newly coined rights. The new conception of rights diminishes the older notion, in particular an individual’s claim on his own property and even his own conscience and intellect, as life becomes more socialized in all its spheres.
Roosevelt made it clear what might be the consequence should Congress fail to adopt his Second Bill of Rights. “[I]f history were to repeat itself and we were to return to the so-called “normalcy” of the 1920’s—then it is certain that even though we shall have conquered our enemies on the battlefields abroad, we shall have yielded to the spirit of Fascism here at home.” Should Americans elect Presidents such as Calvin Coolidge they would have become allies of Hitler.
Roosevelt tenaciously expanded the state at home, even as he battled America’s enemies abroad. He saw these battles as two fronts in one war to achieve a more secure world.
Everyone knew this----that is what Republican policy does-----there is no FDR moment in this---there is no building of a public option platform in the making------it is Wall Street reforms on steroids-----with all protections for Americans in health care being dismantled.
All national labor and justice organization leaders that marched people out in support of ACA knew this------they again used the Democratic base of labor and justice to promote what they knew would kill health care for all.
Part of knowing public policy is knowing when these pols are lying, cheating, and stealing. If you knew Obama and Clinton are tied to global markets, International Economic Zones, and Trans Pacific Trade Pact---which by 2009 we knew of Obama---you knew these reforms were corporate and global . Social Democrats can reverse all this----it starts as I have stated at local levels by making Baltimore City a public health system--------easily done.
Below you see what everyone knew before Obama was elected-----Obama came to office posing progressive with every intent of doing to health care what Clinton did to banking----and yet not one media outlet exposed these goals until after all of it happens. People like me shouted in 2009-----and now Wall Street is telling us in 2015----while making people seem to be fighting it that corporations want to move up----like Kamala Harris who protected Wall Street from the subprime mortgage fraud justice centered in her state of California and who allowed merger and acquisition in health care long before ACA----with Kaiser Permenente California exploding all over the US as soon as ACA passed.
If you are really fighting against corporate power you shout BEFORE ALL POLICY IS PASSED---NOT AFTER.
This author----Makary is a Johns Hopkins employee and Hopkins has made a monopoly of itself entirely----especially in health care and Makary has not opened his mouth in Baltimore about this since 2009------again, it means nothing to come out with a voice against globalization or corporatization if you do it after all policies to do so are in place.
Coming out in media stating policy is bad AFTER THE POLICY IS INSTALLED is like starting a fire in a theater, coming back to your seat and yelling FIRE.
The ObamaCare Effect: Hospital Monopolies
Makary, Marty. Wall Street Journal, Eastern edition [New York, N.Y] 20 Apr 2015: A.13.
On a national level, physician groups bought by large hospital systems are often prodded to send patients for ambulatory surgery and diagnostic procedures to the departments of their parent hospital, which may charge more than other outpatient centers the doctor might prefer. A study of more than 150 hospital-owned and physician-owned organizations published last October in the Journal of the American Medical Association found that patient costs are 19.8% higher for physician groups in multi-hospital systems compared with physician-owned organizations.
During the 2008 financial crisis, "too big to fail" became a familiar phrase in the U.S. financial system. Now the U.S. health-care system is heading down the same path with a record number of hospital mergers and acquisitions -- 95 last year -- some creating regional monopolies that, as in all monopolies, will likely result in higher prices from decreased competition.
Hospital consolidation, done properly in a competitive marketplace, can have positive effects. Multi-hospital conglomerates can quickly disseminate best practices and quality initiatives, for example. But competition and the choices it provides can also disappear.
Health-care conglomeration aligns with the Affordable Care Act, which created incentives for physicians and hospitals to work together in "accountable care organizations." But an important and often forgotten prerequisite for this model is hospital competition.
Some see the dangers. In a rare move, Massachusetts Superior Court Judge Janet Sanders recently blocked Partners HealthCare -- Harvard's affiliated 10-hospital conglomerate and Massachusetts' largest private employer -- from acquiring three competitor hospitals. Judge Sanders argued that the expansion "would cement Partners' already strong position in the health-care market and give it the ability, because of this market muscle, to exact higher prices." This threat is even greater in rural areas where one hospital is often the only provider.
Today's frenzy of hospital mergers and physician practice acquisitions is giving hospital systems even greater leverage to inflate opaque "charge-master" medical bills that even hospitals are sometimes unable to itemize sensibly. With no mechanism to allow free-market forces to keep prices in check, this translates into higher health-insurance deductibles and copays for insured Americans, and in the case of Medicare and Medicaid, higher taxes.
When you're the only game in town, you call the shots. That is one reason California Attorney General Kamala Harris is insisting on "strong conditions" before approving Prime Healthcare Services' $843 million takeover of the six-hospital Daughters of Charity Health System. Prime is a hospital management company operating 34 acute-care hospitals in 10 states.
Ms. Harris required Prime to continue operating four Daughters' facilities as acute-care hospitals with emergency services over the next 10 years. She also required that all six hospitals remain in the state's Medi-Cal program, maintain charity care benefits at their historical levels, and continue providing essential health services such as reproductive health care.
Those conditions only begin to address the concerns surrounding such a merger. A San Bernardino, Calif., court recently held a Prime hospital, Chino Valley Medical Center, in contempt for needlessly admitting patients through the emergency room. On a national level, physician groups bought by large hospital systems are often prodded to send patients for ambulatory surgery and diagnostic procedures to the departments of their parent hospital, which may charge more than other outpatient centers the doctor might prefer.
A study of more than 150 hospital-owned and physician-owned organizations published last October in the Journal of the American Medical Association found that patient costs are 19.8% higher for physician groups in multi-hospital systems compared with physician-owned organizations.
The Affordable Care Act did not repeal antitrust laws. The Federal Trade Commission prevailed in three litigated hospital mergers in the last three years, and in 2014 it won its first-ever litigated case challenging a health-system acquisition of a physician group. But these victories are few. The great majority of mergers occur with little if any public debate about how they will effect prices or patients.
U.S. Oncology, for example, boasts more than 1,000 oncologists in its network and serves nearly 20% of all U.S. cancer patients. In 2010 it was acquired by McKesson Corp., one of the largest U.S. drug distributors, in what some called a savvy move to get cancer doctors and the drugs they prescribe under the same roof. Specialty hospitals are also sprouting around the country, even franchising, exemplified by the rapid spread of the MD Anderson Cancer Center, which aims to have a center within three hours of every American. But is it wise to have one corporation in charge of cancer care for an entire state or region?
Advocates say such expansion brings standardized care and clinical trials to more of the population, but it also results in an undeniable homogenization that may limit options for patients. If management decides that its doctors can only use one chemo drug for a particular cancer, or if the central leadership elects to not adopt a new surgical technology system-wide, will patients be told about the other options?
As a busy surgeon, I have serious concerns about the race to consolidate America's hospitals because of the risk that very large organizations may govern without valuing the wisdom of their front-line employees. Already many doctors are frustrated by the electronic medical records, strategic planning and hospital processes that they feel have marginalized their medical insights into their own patients.
We can encourage the good work of hospitals to create networks of coordinated care, while at the same time insist that hospitals compete on price and quality outcomes. Achieving this balance in the wake of the Affordable Care Act is critical to ensure that one-fifth of the U.S. economy functions in a competitive and competent market.