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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• Federal panel: stop prostate exams at 75 years of age.

Most oncologists already argue against treating most men in that age group for prostate cancer because they are more likely to die from some other cause than from their tumor. The new guidelines go one step further, saying, in effect, why test if the patient is unlikely to be treated? The guidelines, published in the Annals of Internal Medicine, are only recommendations, but they are relied on by many physicians in determining patient care. The recommendations could therefore trigger a decline in prostate cancer testing in the elderly. The recommendations provoked a backlash from some experts.

• So much for privacy concerns.  Apparently more UCLA Medical Center employees helped themselves to celebrities’ medical records.
• Can estrogens relieve psychosis in women with schizophrenia?

Schizophrenic women who get an estrogen patch along with their regular antipsychotic medications have fewer symptoms than women who get inactive placebo patches. The finding, from a four-week study of 102 women of childbearing age with schizophrenia, comes from Jayashri Kulkarni, MBBS, PhD, and colleagues at Monash University in Melbourne, Australia. During her psychiatric training, Kulkarni spoke with many schizophrenic women who kept telling her, “It’s my hormones, Doc.” They also told her, “No one takes any notice when I say that it’s to do with my hormones.” Kulkarni took notice. She and her colleagues have now completed a series of small studies showing that estrogen can be very effective in reducing symptoms such as delusions, hallucinations, and disordered thinking.

• What to the Democrats think of Obama’s message of healthcare reform?  Why, they’re all for it.
• Since 2000, the World Bank has spent over $1.6B to combat AIDS-related illness in Africa.  But is it enough?

In an effort to assuage the increasing antipathy of medical lobbyists and physicians against the recent GOP-led campaign to enforce Medicare reimbursement cuts to healthcare providers, Republican leaders recently held a private meeting with top healthcare thought leaders to mend a relationship which has increasingly favored Democrats as of late.  The last time Republicans seemed as though they were in the good graces of the medical leadership community was in 2003, when George W. Bush held his own against those in the medical provider cohort who were being bruised by unfair tort practices nationwide.  That was also the year in which bold GOP initiatives were easily passed and yielded, among other things, a complete overhaul in how the government, Pharma, and patients later obtained prescription medications — under Medicare Part D. 

However, recent spikes in the number of uninsured and a general sense of healthcare management malaise on the part of legislators on both sides of the ideological divide have made a tenuous relationship even more fragile.  Can the Republicans make it up to physicians this time?

In the run-up to the 2006 midterm elections, doctors and the groups that represent them gave 62 percent of their combined $52.4 million war chest to Republicans, compared with 37 percent to Democrats, according to the Center for Responsive Politics. That breakdown mirrors previous cycles since Bush entered the White House.  But since 2006, doctors and related groups have given Democrats 53 percent of their combined $53 million in campaign contributions, according to the watchdog group.  The switch is even more stark for the AMA.  In the run-up to the 2006 election, the AMA’s political action committee gave Republicans 70 percent of its campaign cash, according to the Center for Responsive Politics. In 2004, the AMA’s PAC contributed 80 percent of its total donations to Republican lawmakers and candidates.  Since 2006, that PAC has directed 53 percent of its contributions to Democrats.

If the current state of re-election possibilities continues to wane for the GOP, don’t bet on it. | LINK

There’s no easy money.  That’s the mantra echoed in an interesting piece today in the NYT.  Critics of Barack Obama’s healthcare financing plan are beginning to question the senator’s rationale for major policy points behind his pledge to “bring down premiums by $2,500 for the typical family”.  They also contend that the presidential candidate has no essential timeline with which to carry out his audacious initiatives.  Potential roadblocks:

• How does one begin to consider cost of healthcare savings if upfront costs for policy changes are daunting?  For example, take his pledge to spend $50 billion over five years to speed the computerization of health records,  or what about $6 billion a year on tax credits to small businesses that provide coverage to workers?
• When could one actually begin to realize the $2500 savings? Obama’s camp says by the end of the first term, but that’s not entirely a sure thing.
• Getting around the fact that Obama’s projecting that a robust overhaul consisting of 15 broad initiatives would generate savings of only 6 percent after 10 years (according to the Commonwealth Fund).

The heatlhcare debate just got a little more interesting. | LINK

• Colorado veterans oppose VA hospital plan to partner with an existing private non-profit.
• Wisconsin Medicaid fraud unit exposes tactics of neuroleptic drug maker.
• Holy menu, Batman!  NYC restaurants can be fined for not showing calorie counts on their offerings.
• House committee will investigate healthcare plan rescissions nationwide.

A congressional committee will investigate health insurers’ practice of canceling coverage when policyholders get sick, its chairman said Thursday.
The problem first came to light in California, but witnesses testifying before the House Oversight and Government Reform Committee suggested that it was more widespread. The problem affects the individual insurance market, in which 14 million Americans, including nearly 3 million Californians, purchase medical benefits on their own. In light of proposals to expand the individual market, the committee’s chairman, Rep. Henry A. Waxman (D-Beverly Hills), said the individual market demanded more scrutiny, especially of cancellation practices.

• McCain criticizes Obama for voting against so-called “partial birth” abortion ban.

Special interest groups of various political ideologies are holding nothing back in their quest to shift the prime focus on the ‘08 election back to healthcare. In recent weeks, the tenor of both the Obama and McCain campaigns has taken to talk on reforming Big Oil with special emphasis on Iraq. Groups such as the newly formed left-tilting Health Care for America Now and the venerable AARP are spending a combined $60 million to get the word out about the one entity that seems to be driving healthcare in this country — the insurance companies. | LINK

This is not as much a post related to healthcare as it is a document. Make that an historical document. In the ever-increasing Internet that is at once fluid yet static, news organizations, blogs, and multiple other Web portals are documenting one ironclad fact that no one — not even Hillary Clinton — can deny: that today marks the first time in the history of this country that a Black man is the choice of a major political party in its quest to claim the Top Job In The World.

Yesterday Sen. Barack Obama precisely claimed such in a rousing speech in my homebase of Saint Paul, MN. Obviously pouncing headfirst in a game of political one-upsmanship, the now-presumptive Democratic party nominee for POTUS drew a line in the sand for his across-the-aisle counterpart, Sen. John McCain — essentially calling the Arizona senator to take notice of his campaign for change when McCain’s party’s coronation occurs in this exact location some three months from now.

A truly historic day indeed. Now, if he can only make his future oratory on healthcare reform just as classic has his nomination kickoff speech, his speech on race relations, and his speech on the day he announced his candidacy, we will perhaps have an even better idea of the altruism we hope this man can muster for those thirsty for true change in this country.

• Presumptive Republican presidential nominee John McCain releases health records.
• Is there a role for a simple blood test in predicting cardiac risk in post-menopausal females taking estrogens?
• Panel: Those with hypertension should be monitoring their blood pressures at home regularly.

The advice was published online yesterday in the journal Hypertension, will be printed in the June issue of the Journal of Cardiovascular Nursing and comprises a joint statement from three medical organizations: the American Heart Association, American Society of Hypertension and the Preventive Cardiovascular Nurses’ Association.

The panel wrote that an increasing number of patients are measuring their blood pressure regularly at home, and although this practice has been endorsed by national and international guidelines, there are no detailed guidelines.

• More on the launch of Google Health.
• Florida’s governor and possible VP candidate, Charlie Crist, signs law giving that state’s uninsured “access” to healthcare with low-cost premiums.

Although we haven’t hit the Democratic party’s end of the primary season, its certain nominee, Barack Obama, is already looking toward staking his claims on the designation and the general election in the fall.

This, of course, includes adopting certain positions; today, he has his sights on the Iraq war and its effects on returning veterans — specifically, those returning to our shores with the diagnosis of PTSD.

Obama has written a letter to the VA secretary asking for an investigation of the department’s knowledge of a Texas VA hospital’s treating psychologist’s email asking other treating staff to “refrain from giving a diagnosis of PTSD straight out”.  The Bush administration says that it does not condone the practice of underdiagnosing posttraumatic stress disorder to save money.

The government pays out over $2500/month for those vets diagnosed with the disorder. | LINK

• Carotid bruits could warn of heart attack risk.
• McCain’s healthcare delivery plan smacks of open market bullishness, leaving its intentions as anything but noble.
• Nebraska man gives self own tracheostomy — for the second time.

“I didn’t feel no pain. I was just trying to survive,” Wilder said in his high-pitched, gravelly voice. “I got relief right away. There was a big gush of blood, and I was able to start sucking in air.”

Wilder said he fell asleep watching television in his basement but awakened when he felt himself suffocating. His wife, Cora, called an ambulance.

“I thought they might get here fast enough that I wouldn’t have to do that,” he said. “But I couldn’t breathe no more.”

He bolted for the kitchen and picked up a steak knife and made a quarter-inch incision.

• More than 75 new cases of hepatitis tied to Las Vegas clinic.
• Diabetes and arthritis: more like kissin’ cousins?

Wither healthcare as a campaign ‘08 issue, at least an issue for a good-ol’ fashioned townhall meeting?  Don’t hold your breath.  Although Republican candidate and presumptive nominee John McCain recently held a press conference of sorts in Florida to address the issue of health policy, it was a cursory acknowledgement at best — a move designed more for a photo-op than for a precursor to informed commentary.  Is healthcare really the 500-pound gorilla in the room?  Probably not.  That would be the esteemed Rev. Wright. | LINK

If it’s one thing that has been lacking in the much of the campaign rhetoric among the Democratic presidential nominees this election cycle, it is a constant and reasoned debate on heatlhcare reform in this country. The candidates’ recent desires to focus on each other’s gaffes have apparently been deemed more important than the more substantive issues by the mainstream media.

There is no doubt that Sens. Obama and Clinton missed out on opportunities to discuss reform as it applies on a national level in states where the controversy over universal coverage has played out (albeit on a micro scale) — states like Massachusetts (which has a program in place) and California (where voters apparently wish such a measure was in existence, if you believe polling data there). | LINK

Previous Doctor Pundit coverage here.

It’s nothing short of a miracle.  The Bush administration has announced the immediate need for universal, complete government backed and sponsored healthcare coverage.  Starting today, any patient can go anywhere for his or her healthcare and the government will pick up the tab.  They can be seen for anything without regard to cost.  Sky’s the limit.  Big Pharma, all major managed care organizations, device companies, and yes — even CMS — are all on board with this sudden change in healthcare policy.  It appears as though the Democratic candidates for president, Hillary Clinton and Barack Obama, are a little perplexed over this breaking news — as they now have no compelling healthcare platform to differentiate themselves from what the current president is proposing.