As little as a few days ago, pundits were claiming the Minnesota US senate race as being incumbent’s Norm Coleman to lose. That’s changed, as Democratic challenger and Republican whipping boy Al Franken is steadily closing that gap.

The former Air America talk show host appears to be capitalizing on the shrinkage in polling data by capitalizing on healthcare reform as it applies to a rather vocal majority against the backdrop of the aging Operation Iraqi Freedom campaign: the veteran. According to Franken, reforms in the administrative sector of VA healthcare would lead to savings in those healthcare costs — allowing him to promise

Military veterans should be guaranteed medical care for life, Democratic U.S. Senate candidate Al Franken said Tuesday as part of a package of proposals that also would expand the level of care.

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It’s something that we have always done as physicians, and usually quite well at that. The treatment of chronic pain has attracted much in the way of media exposure during the last 10 years or so, and that increased public awareness has usually arisen out of news which has largely been negative.

The concern of punitive actions by law, licensing authorities, and — god forbid — the DEA have all placed undue gravity on a situation for prescribing physicians who have nothing but the best intentions for the care of their patients who suffer from chronic pain. Add to this the possibility of litigation for the undertreatment of chronic (nonmalignant) pain, and it is easy to see why — for many providers — the use of narcotics in these patients represents a futile ethical treatment quagmire.

The FDA is considering attacking this problem head on — but not without its share of criticism to come its way from concerned healthcare providers all over the country who contend that, at the very least, the FDA shouldn’t even venture into the land of the regulation of medical providers. | LINK

• CA Supreme Court: Physicians cannot deny care to homosexuals on religious grounds.
• Since the antidiabetic drug exenatide (Byetta) was approved by the FDA, its role in the cause of adverse events resulting in death has largely flown under the radar of the media….until now.
• WP: For teens, access to prescription drugs easier than trying to procure beer.
• Cool study result: Those who survived the extremely deadly influenza pandemic of 1918 are still producing antibodies over 90 years later.
• Ignorance versus inaccessibility — thousands of Kentucky children missing out on available state funded care.

Huntington’s disease (HD) is a genetic neurological disorder characterized by abnormal body movements called chorea and a lack of coordination; it also affects a number of mental abilities and some aspects of behavior. In more advanced stages it can cause complications that significantly reduce life expectancy.

The disorder is named after George Huntington, the American physician who first described it in 1872. Just over 120 years later, the altered gene that causes HD was discovered, making it one of the first inherited genetic disorders for which an accurate test could be performed. Because of this, and because of the characteristics the disorder shares with some other neurological disorders, it has been extensively researched since then.

Now, you can count a drug for HD among the priorities of researchers. | LINK

The music industry cognoscenti are all atwitter on the Material Girl’s 50th birthday (not to mention the fact that both Michael Jackson and Prince are celebrating their Big Five-Oh’s this month, as well). Pundits all over the mainstream media are truly gushing over Madonna’s iconic influence within the strange but compelling world of popular culture over the past quarter century. From the moment of her debut in 1984, she hit the charts with such a force, even the most jaded music snob had to take notice of her certain longevity.

All of which got me to thinking: who is this decade’s Madonna? While said pundits and music snobs could debate this issue until the end of the 2010’s, I’ll just suffice it to say, that in terms of immediate Billboard chartistry, Rihanna would have to be at the top of the list.

Since debuting with her Music Of The Sun collection in 2005, she has scored no less than nine top ten hits, either as a featured or main artist, and has had four of those ascend all the way to #1. The most recent of those is the addictive “Disturbia”, an upbeat yet melancholic party jam whose video stoked the Internet flames in its journey to cerebral-nagging bliss.

For the moment, the song does its job, succeeding in getting her silly but equally addictive “Umbrella” out of my noggin’, and it’s also the subject of this week’s Music Club. Hmmm. Is this what ear candy really tastes like? | LINK

Yet another story describing wrong-side surgery. Although not surprising in their incidence, one would think that the rate of wrong-side surgical procedures is on the decline in this country, or at the very least, leveling off. Can the quality assurance admonitions of healthcare organizations occur soon enough?

Medicare officials have just announced rate increases in prescription drug premiums for beneficiaries in stand-alone Part D plans.  Starting next year, the average monthly premium will mean $3 more per month for beneficiaries out of pocket.  CMS is quick to buttress news of this increase with the acknowledgement that the popular program continues to function in the financial black.

There are three reasons behind the premium increase, [Kerry Weems, acting administrator of the U.S. Centers for Medicare and Medicaid Services] said.

“First, there is a trend in prescription drug cost growth generally — prices tend to increase because of price increases for existing drugs, the growth in the average number of prescriptions per person, and the introduction of new drugs,” he said.

Second, the 2008 premiums were calculated as part of a demonstration project that has now expired. This project resulted in premiums being 50 cents less in 2008 than had been projected.

“That change is now reflected in the 2009 premium,” Weems said.

Third, drug distributors participating in Part D have found coverage for catastrophic care to be higher than expected. “So they have adjusted their 2009 bids to reflect those higher-than-anticipated costs,” Weems said.

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A single room for the healthcare of an institution’s entire patient population. The relative squalor of certain facilities that threatens the spread of disease to staff and other patients on an almost daily basis. Treatment conditions which one judicial official characterized as one of “incompetence and outright depravity in the rendering of medical care.”

Are these citations from healthcare facilities in some underdeveloped nations? Think again.

The California state prison system is apparently notorious for the substandard and despicable care environments it houses. The problem is so pervasive, the feds became involved and ordered sweeping reforms in how prison medical care is delivered in that state. In fact, the fiscal tug of war between California and the apparent unconstitutionality of its prison system’s healthcare delivery has led to a court order compelling the state to start financing improvements. With a significant budget deficit, the last thing Arnold Schwarzenegger wants to hear is that the bill for this overhaul amounts to $8 billion. | LINK

In earlier times (throughout the last 15 years or so), the use of telemedicine was relegated to inferior analog video technologies.  It was often seen as an “interesting” curiosity to those global thinkers in healthcare delivery as the Next Big Thing.  Of course, that sentiment is not to detract from the effect that telemedical devices have shown both in the late 1990s and in the earlier part of this decade — as it bridged the treatment gap between patients in more remote areas with those in urban, tertiary care centers.

But all previous incarnations of telemedical communication will certainly take a backseat to the now-confirmed potential of telemedical conferencing via broadband Internet and intranet networks.   The medical journal, Lancet, is out with a study involving the emergent treatment of stroke patients that will have medical device companies involved in its development salivating with the potential of their Next Big Thing. | LINK

You’ve got to be asking yourself if medical device companies are going to feel the effects of this finding: the utilization of coronary stents in the treatment of heart disease becomes less crucial the longer the patient survives this particular diagnosis; that is, the role of medical (non-surgical) therapy leads to — at the very least — equivalent outcomes in the long run. According to the NEJM:

The equivalent benefit seen after 36 months for optimal medical therapy alone, reported in the Aug. 14 issue of the New England Journal of Medicine, was the latest finding to emerge from the 2,287-patient COURAGE (Clinical Outcomes Utilizing Revascularization and Aggressive Drug Evaluation) trial. It was designed to compare the efficacy of [stenting vs. optimal medical therapy].

[…]

In the stent group, patients who had the most severe angina at baseline received the greatest benefit….The incremental benefit for stenting was apparent for six to 24 months, and then the two groups began to converge because “there was significant and rapid improvement in Seattle Angina Questionnaire scores among patients in the medical therapy group,” wrote Dr. Weintraub and colleagues.

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Although this data comes from a peer reviewed specialty journal whose catchment is not exactly in the medical mainstream, its findings are no less compelling.

The American Physical Therapy Association (APTA) concurs with findings from a recent study published in Spine (Volume 33, Number 16) demonstrating that active physical therapy for patients with acute low back pain is associated with better clinical outcomes, decreased use of prescription medications, MRI and epidural injections, and lower healthcare costs than passive physical therapy.

Physical therapist management is a low-cost, high-value alternative to medication and surgery to deal with certain musculoskeletal pain. According to Fritz, “Considering that low back pain will affect between sixty and eighty percent of Americans during their lifetime, the potential cost savings of an early, effective intervention to prevent individuals from progressing to chronic disability may be considerable.”

Can we bottle this? | LINK

• A case study in greed?  Minute clinics saturate the healthcare marketplace.
• Minn.-based Allina hospital cited for safety violations.

A patient having heart pacemaker surgery at Abbott Northwestern Hospital was burned on her face, lips and shoulder when a fire burst out from under the sterile drapes covering her body. Doctors and nurses immediately doused the fire and completed the surgery, according to a state investigative report made public Monday.

State health investigators found that the hospital violated safety and procedural policies that contributed to the June 24 incident. The unidentified patient, who was lightly sedated, woke up when the fire ignited and “was very frightened,” according to the report. She suffered first- and second-degree burns, and was kept in the hospital for two days after the accident.

• TX state AG’s office sues nursing home for patient neglect.
• New data emerges on the rare phenomenon of a hightened immune system in keeping HIV from advancing in some patients.
• Take your vitamin D.  Your health may suffer otherwise.

According to a recent poll commissioned by a prominent health insurance lobby, the percentage of Medicare beneficiaries satisfied with their Medicare Part D coverage approached 87%, and that 75% spent less on formulary drugs after Part D was enacted in 2006.

Did someone forget to tell Rep. Dennis Kucinich this?

Rep. Dennis Kucinich (D-Ohio) recently introduced a bill that would replace the Medicare prescription drug benefit with a new program in an effort to reduce costs, CQ HealthBeat reports. The legislation would require Medicare to negotiate directly with pharmaceutical companies for discounts on prescription drugs and eliminate copayments, premiums and deductibles for medications for beneficiaries.

The Kucinich bill is here. | LINK