Bipartisan report from ex-secretaries of health and agriculture makes 26 recommendations for fighting obesity epidemic

Four former secretaries of heath and agriculture and the Bipartisan Policy Center have released a lengthy report aimed at the nation's obesity epidemic. With 26 recommendations, the report promotes public and private sectors working together to create healthy families, schools, workplaces and communities.

The report, called "Lots to Lose," recommends extending federal guidelines for diet and physical activity to all children under 6 years old, along with offering more support to promote breastfeeding. "Learning to be active and staying active is a critical piece of the puzzle," said Republican Mike Leavitt, former secretary of health and human services and former governor of Utah. "Government has a role to play, but it is not the answer."

"If you think this is fluffy stuff about diet and exercise or about creating a nanny state you are wrong," said Dan Glickman, who was a Democratic congressman from Kansas and agriculture secretary under Bill Clinton. "Americans like silver bullets to solve problems. This one requires silver buckshot."

Former agriculture secretary Ann Veneman, a Republican who served under George W. Bush, spoke of the importance of good nutrition during the first 1,000 days of a child's life. "Improving health outcomes early in life is a critical element in helping to shift our current health care system toward prevention," she said.

Democrat Donna Shalala, president of the University of Miami and health secretary under Clinton, also participated. While The Washington Post's Janice D'Arcy called the report "an earnest and comprehensive effort," she asked, "Haven't we been down this road before?" For the report, click here.

Four former secretaries of heath and agriculture and the Bipartisan Policy Center have released a lengthy report aimed at the nation's obesity epidemic. With 26 recommendations, the report promotes public and private sectors working together to create healthy families, schools, workplaces and communities.

The report, called "Lots to Lose," recommends extending federal guidelines for diet and physical activity to all children under 6 years old, along with offering more support to promote breastfeeding. "Learning to be active and staying active is a critical piece of the puzzle," said Republican Mike Leavitt, former secretary of health and human services and former governor of Utah. "Government has a role to play, but it is not the answer."

"If you think this is fluffy stuff about diet and exercise or about creating a nanny state you are wrong," said Dan Glickman, who was a Democratic congressman from Kansas and agriculture secretary under Bill Clinton. "Americans like silver bullets to solve problems. This one requires silver buckshot."

Former agriculture secretary Ann Veneman, a Republican who served under George W. Bush, spoke of the importance of good nutrition during the first 1,000 days of a child's life. "Improving health outcomes early in life is a critical element in helping to shift our current health care system toward prevention," she said.

Democrat Donna Shalala, president of the University of Miami and health secretary under Clinton, also participated. While The Washington Post's Janice D'Arcy called the report "an earnest and comprehensive effort," she asked, "Haven't we been down this road before?" For the report, click here.

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Cats and sweet tastes

Jiang P, Josue J, Li X, et al. Major taste loss in carnivorous mammals. Proc Natl Acad Sci U S A 2012;109:4956-4961.
 
Believe it or not, the ability to taste sweets is not universal. Sweetness is detected by a specific receptor protein (‘taste bud’) in the tongue. Cats are known to be insensitive to sweet tastes, at least behaviorally, but the specific reason was not known until a few years ago. These researchers analyzed the genes encoding the taste buds in twelve different carnivorous species, including cats. They found that those species such as cats, whose diet is exclusively meat-based, had lost the gene encoding the taste bud for sweetness. Other affected species included dolphins, sea lions, seals, otters, and hyenas. It appears that the ability to taste sweets has been lost in most carnivorous species – what a terrible loss! [MK]

See also: Li X, Li W, Wang H, et al. Pseudogenization of a sweet-receptor gene accounts for cats' indifference toward sugar. PLoS genetics 2005;1:27-35. [Free, full text]

More on cat health:
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Jiang P, Josue J, Li X, et al. Major taste loss in carnivorous mammals. Proc Natl Acad Sci U S A 2012;109:4956-4961.
 
Believe it or not, the ability to taste sweets is not universal. Sweetness is detected by a specific receptor protein (‘taste bud’) in the tongue. Cats are known to be insensitive to sweet tastes, at least behaviorally, but the specific reason was not known until a few years ago. These researchers analyzed the genes encoding the taste buds in twelve different carnivorous species, including cats. They found that those species such as cats, whose diet is exclusively meat-based, had lost the gene encoding the taste bud for sweetness. Other affected species included dolphins, sea lions, seals, otters, and hyenas. It appears that the ability to taste sweets has been lost in most carnivorous species – what a terrible loss! [MK]

See also: Li X, Li W, Wang H, et al. Pseudogenization of a sweet-receptor gene accounts for cats' indifference toward sugar. PLoS genetics 2005;1:27-35. [Free, full text]

More on cat health:
Winn Feline Foundation Library
Find us on Facebook
Follow us on Twitter
Read the Cat Health News Weekly
Join us on Google+

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Free dental, health, vision clinic to help hundreds this weekend

This weekend, about 1,000 people will get free dental, medical and vision care in Pike County. The effort is sponsored by Kentucky's Remote Area Medical Volunteer Corps, which hosts a free clinic that provides free treatment to those who come from all over the state to receive it. (University of Louisville video)

Last year, 882 patients received services from volunteer health-care professionals. That meant 455 pairs of eyeglasses were given to 407 people who needed them; 386 patients received free dental services, including 974 extractions, 348 fillings and 264 cleanings; and 303 patients got free medical services.

This is the fourth year of the effort. The clinic opens at 6 a.m. Saturday and closes Sunday afternoon at Pike County Central High School. Patients are seen on a first-come, first-served basis. Numbers will be handed out starting at 3:30 a.m. each day. For the best chance of being seen, patients should plan to arrive by 3:30 a.m. on the day they wish to be treated.

RAM-KY, modeled after a national organization with a similar name, was founded by Dr. Bill Collins in 2008. Since then, the Kentucky General Assembly has passed a law that allows licensed dental practitioners from other states to apply for and received charitable licenses so they can participate in events like Saturday's.

For more information about RAM-KY, click here.

This weekend, about 1,000 people will get free dental, medical and vision care in Pike County. The effort is sponsored by Kentucky's Remote Area Medical Volunteer Corps, which hosts a free clinic that provides free treatment to those who come from all over the state to receive it. (University of Louisville video)

Last year, 882 patients received services from volunteer health-care professionals. That meant 455 pairs of eyeglasses were given to 407 people who needed them; 386 patients received free dental services, including 974 extractions, 348 fillings and 264 cleanings; and 303 patients got free medical services.

This is the fourth year of the effort. The clinic opens at 6 a.m. Saturday and closes Sunday afternoon at Pike County Central High School. Patients are seen on a first-come, first-served basis. Numbers will be handed out starting at 3:30 a.m. each day. For the best chance of being seen, patients should plan to arrive by 3:30 a.m. on the day they wish to be treated.

RAM-KY, modeled after a national organization with a similar name, was founded by Dr. Bill Collins in 2008. Since then, the Kentucky General Assembly has passed a law that allows licensed dental practitioners from other states to apply for and received charitable licenses so they can participate in events like Saturday's.

For more information about RAM-KY, click here.

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Herald-Leader dislikes mental health agency's 'clubby glow'

In an editorial today, the Lexington Herald-Leader criticized the "clubby glow emanating from the inner circle" of the Bluegrass Regional Mental Health-Mental Retardation Board, whose financial status was featured in Sunday's issue of the newspaper.

Though the paper didn't take issue with top executives earning large salaries, it did have a problem with the makeup of the board and its staff. First, the current CEO, Shannon Ware, is married to the former CEO, Joseph Troy. Troy's son-in-law is director of information technology. And at least eight of the 25 members of the board have served since the 1980s. Another three have served since the 1990s.

"Collectively, these offer the potential for an organization where the status quo is rarely challenged," the editorial reads. The editorial board took particular issue with the nepotism in place: "While it is theoretically possible that a supervisor might treat a family member exactly the same as an unrelated employee, in reality it is hard to imagine. Regardless, the very appearance of favoritism can be damaging to an organization." (Read more)

In an editorial today, the Lexington Herald-Leader criticized the "clubby glow emanating from the inner circle" of the Bluegrass Regional Mental Health-Mental Retardation Board, whose financial status was featured in Sunday's issue of the newspaper.

Though the paper didn't take issue with top executives earning large salaries, it did have a problem with the makeup of the board and its staff. First, the current CEO, Shannon Ware, is married to the former CEO, Joseph Troy. Troy's son-in-law is director of information technology. And at least eight of the 25 members of the board have served since the 1980s. Another three have served since the 1990s.

"Collectively, these offer the potential for an organization where the status quo is rarely challenged," the editorial reads. The editorial board took particular issue with the nepotism in place: "While it is theoretically possible that a supervisor might treat a family member exactly the same as an unrelated employee, in reality it is hard to imagine. Regardless, the very appearance of favoritism can be damaging to an organization." (Read more)

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To help curb childhood obesity, Disney will ban ads for products that don't fit federal nutrition guidelines for kids

The Mickey Check logo will be
placed on Disney-licensed products
that meet nutrition guidelines.

By 2015, the Walt Disney Co. will require advertising that targets kids and families to be in line with federal nutrition guidelines that promote eating fruit and vegetables; limiting calories; and reducing fat, sodium and sugar.

The Disney Channel, its sisters (Disney XD, Disney Junior, Radio Disney) and Disney-owned online sites will follow suit. 

"Under the new rules, products like Capri Sun drinks and Kraft Lunchables meals — both current Disney advertisers — along with a wide range of candy, sugared cereal and fast food, will no longer be acceptable advertising material," reports Brooks Barnes for The New York Times. (Read more)

"This new initiative is truly a game changer for the health of our children," said First Lady Michelle Obama, who helped make today's announcement. "This is a major American company — a global brand — that is literally changing the way it does business so that our kids can lead healthier lives. With this new initiative, Disney is doing what no major media company has ever done before in the U.S. — and what I hope every company will do going forward. When it comes to the ads they show and the food they sell, they are asking themselves one simple question: Is this good for our kids?"

American children see about $1.6 billion a year worth of food and beverage marketing, much of which are ads that sell food that is high in calories and sugar and low in nutrition. The effort is meant to curb childhood obesity, which is a growing problem in Kentucky and nationwide. In 2007, 37 percent of Kentucky children were either obese or overweight, National Conference of State Legislatures numbers show.

The Mickey Check logo will be
placed on Disney-licensed products
that meet nutrition guidelines.

By 2015, the Walt Disney Co. will require advertising that targets kids and families to be in line with federal nutrition guidelines that promote eating fruit and vegetables; limiting calories; and reducing fat, sodium and sugar.

The Disney Channel, its sisters (Disney XD, Disney Junior, Radio Disney) and Disney-owned online sites will follow suit. 

"Under the new rules, products like Capri Sun drinks and Kraft Lunchables meals — both current Disney advertisers — along with a wide range of candy, sugared cereal and fast food, will no longer be acceptable advertising material," reports Brooks Barnes for The New York Times. (Read more)

"This new initiative is truly a game changer for the health of our children," said First Lady Michelle Obama, who helped make today's announcement. "This is a major American company — a global brand — that is literally changing the way it does business so that our kids can lead healthier lives. With this new initiative, Disney is doing what no major media company has ever done before in the U.S. — and what I hope every company will do going forward. When it comes to the ads they show and the food they sell, they are asking themselves one simple question: Is this good for our kids?"

American children see about $1.6 billion a year worth of food and beverage marketing, much of which are ads that sell food that is high in calories and sugar and low in nutrition. The effort is meant to curb childhood obesity, which is a growing problem in Kentucky and nationwide. In 2007, 37 percent of Kentucky children were either obese or overweight, National Conference of State Legislatures numbers show.

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NYC deeply split on Bloomberg plan to ban supersize sodas

Bloomberg with Linda I. Gibbs, deputy mayor for health.
(New York Times photo by Chang W. Lee)

In a bold move to curb obesity, New York City Mayor Michael Bloomberg wants to ban the sale of supersize sodas and other sugary drinks by restaurants, movie theaters and street carts.

"The sale of any cup or bottle of sweetened drink larger than 16 fluid ounces — about the size of a medium coffee, and smaller than a common soda bottle — would be prohibited under the first-of-the-nation plan, which could take effect as soon as next March," reports Michael Grynbaum for The New York Times.

Exempt from the measure are diet sodas, fruit juice, dairy-based drinks and alcoholic drinks. The ban would include drinks sold in grocery or convenience stores.

"New York City is not about wringing your hands; it's about doing something," Bloomberg said. "I think that's what the public wants the mayor to do." In NYC, more than half of adults are obese or overweight.

A poll conducted Sunday showed about half of New Yorkers feel Bloomberg is going too far, while 42 percent said it would be good health policy, reports Samantha Gross for The Associated Press. The idea has been harshly criticized, with an editorial in the Times calling the plan "overreaching" and saying "Too much nannying with a ban might well cause people to tune out."

But conservative David Frum, a contributing editor for Newsweek and The Daily Beast, said "good for Bloomberg," pointing out: "Sugary drinks now provide 7 percent of the calories in the American diet, the largest single national source of calories. Teen boys average more than a quart of sugary soda per day. Even adults who say they are trying to lose weight still drink more two 12-ounces cans per day, on average."

"The campaign against obesity will have to look a lot less like the campaign against smoking (which involves just one decision, to smoke or not to smoke) and much more like the generation-long campaign against highway fatalities, which required the redesign of cars, the redesign of highways, and changes in personal behavior like seat-belt use and drunk driving," Frum argues.

Bloomberg with Linda I. Gibbs, deputy mayor for health.
(New York Times photo by Chang W. Lee)

In a bold move to curb obesity, New York City Mayor Michael Bloomberg wants to ban the sale of supersize sodas and other sugary drinks by restaurants, movie theaters and street carts.

"The sale of any cup or bottle of sweetened drink larger than 16 fluid ounces — about the size of a medium coffee, and smaller than a common soda bottle — would be prohibited under the first-of-the-nation plan, which could take effect as soon as next March," reports Michael Grynbaum for The New York Times.

Exempt from the measure are diet sodas, fruit juice, dairy-based drinks and alcoholic drinks. The ban would include drinks sold in grocery or convenience stores.

"New York City is not about wringing your hands; it's about doing something," Bloomberg said. "I think that's what the public wants the mayor to do." In NYC, more than half of adults are obese or overweight.

A poll conducted Sunday showed about half of New Yorkers feel Bloomberg is going too far, while 42 percent said it would be good health policy, reports Samantha Gross for The Associated Press. The idea has been harshly criticized, with an editorial in the Times calling the plan "overreaching" and saying "Too much nannying with a ban might well cause people to tune out."

But conservative David Frum, a contributing editor for Newsweek and The Daily Beast, said "good for Bloomberg," pointing out: "Sugary drinks now provide 7 percent of the calories in the American diet, the largest single national source of calories. Teen boys average more than a quart of sugary soda per day. Even adults who say they are trying to lose weight still drink more two 12-ounces cans per day, on average."

"The campaign against obesity will have to look a lot less like the campaign against smoking (which involves just one decision, to smoke or not to smoke) and much more like the generation-long campaign against highway fatalities, which required the redesign of cars, the redesign of highways, and changes in personal behavior like seat-belt use and drunk driving," Frum argues.

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Health-care system not ready to deal with baby boomers as they get old, expert says at seminar on aging

When it comes to dealing with aging baby boomers, the nation's health-care system isn't ready to deal with them, Dr. Gregg Warshaw, left, said at the University of Kentucky's Summer Series on Aging in Lexington yesterday. "We've made progress," he said, but "We have a lot more to do, and we are running out of time." (Photo by Jonathan Palmer)

Warshaw's figures show "patients with five or more chronic conditions account for about 68 percent of spending on Medicare," Mike Wynn reports for The Courier-Journal. "Around 141 million people suffered with chronic conditions in 2010, and that number is expected to jump by 30 million in the next two decades."

The shift from primary-care doctors to specialists is another big, expensive problem that is hurting the quality of health care for seniors, Warshaw argued. Ageism and frustrations over health networks are also challenges. "Like a lot of things in American medicine right now, we know the answers to those questions," he said. "We just don't know how to get from here to there."

Warshaw, who is the director of the Geriatric Medicine Program at the University of Cincinnati College of Medicine, was one of more than 350 professionals who attended the seminar, hosted by the UK College of Public Health. (Read more)

When it comes to dealing with aging baby boomers, the nation's health-care system isn't ready to deal with them, Dr. Gregg Warshaw, left, said at the University of Kentucky's Summer Series on Aging in Lexington yesterday. "We've made progress," he said, but "We have a lot more to do, and we are running out of time." (Photo by Jonathan Palmer)

Warshaw's figures show "patients with five or more chronic conditions account for about 68 percent of spending on Medicare," Mike Wynn reports for The Courier-Journal. "Around 141 million people suffered with chronic conditions in 2010, and that number is expected to jump by 30 million in the next two decades."

The shift from primary-care doctors to specialists is another big, expensive problem that is hurting the quality of health care for seniors, Warshaw argued. Ageism and frustrations over health networks are also challenges. "Like a lot of things in American medicine right now, we know the answers to those questions," he said. "We just don't know how to get from here to there."

Warshaw, who is the director of the Geriatric Medicine Program at the University of Cincinnati College of Medicine, was one of more than 350 professionals who attended the seminar, hosted by the UK College of Public Health. (Read more)

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Prescription pill abuse 'a holocaust' in Kentucky, hitting 1 in 16; big drug firms and even well-meaning doctors are to blame

Another in-depth look at Kentucky's prescription drug abuse problem hit the pages of The Courier-Journal yesterday, this time exploring the history of OxyContin and how well-meaning doctors started over-prescribing opioids in the 1990s in response to vigorous marketing campaigns. 

The problem continues to be gargantuan, with Laura Ungar reporting about one in 16 Kentuckians misused prescription painkillers in the past year. Kentucky ranks "as the fourth-most-medicated state in a nation that fills enough painkiller prescriptions each year to keep every American adult medicated around the clock for a month," Ungar writes.

A review published in the journal Pain Physician last year found evidence is lacking for how effective opioids are in treating long-term pain. "They're not M&Ms," said Dr. Lee Tannenbaum, founder of the Bel Air Center for Addictions in Maryland. "As physicians, we need to be really, really, really careful as to when we put someone on these drugs. Cancer pain may need opioids, but someone out shoveling snow who hurt his back doesn't. We have created so many addicts."

A C-J investigation found physicians fuel the problem in three ways. First, they do not screen patients adequately. They prescribe powerful pills for moderate pain. And they do not use the state's monitoring program, Kentucky All Schedule Prescription Electronic Reporting, known as KASPER.

The problem started in the 1990s when "medical organizations, concerned that pain wasn't being treated adequately, encouraged doctors to do more to relieve suffering," Ungar reports. OxyContin was approved by the Federal Food and Drug Administration in 1995, with OxyContin prescriptions for noncancer pain increasing by tenfold between 1997 and 2002. A report found the drug's maker, Purdue Pharma "directed its drug representatives to focus on physicians in their sales territories who were high opioid prescribers, while also issuing OxyContin 'starter coupons' for patients and distributing promotional items, such as fishing hats and plush toys," Ungar reports.

In October 2007, Kentucky and Pike County sued Purdue Pharma for its deceptive marketing campaign, alleging it misled doctors about the potency of the drug, which is twice as powerful as morphine. U.S. Rep. Harold "Hal" Rogers, R-5th District, called OxyContin "the guilty party that got this epidemic going." In Kentucky, the retail distribution of oxycodone grew from 83,000 grams in 1997 to 950,000 grams in 2010.

Part of the problem is that doctors do not have the time they need to properly assess patients for potential abuse. "You've got an awful lot of doctors prescribing not out of ill intents. They've got a limited amount of time, and pain patients require a lot of time," said Robert Walker, assistant professor of behavioral science at University of Kentucky's Center on Drug and Alcohol Research. "The easiest solution is the opioid."

While easy, they are not necessarily effective for all pain. Evidence is "very, very mixed" on whether the drugs work in the long term on chronic pain and "the evidence is pretty scant" that they are effective against treating chronic lower back pain, said Dr. Timothy Ives of the University of North Carolina.

Though the problem is never expected to be solved completely, there are steps being taken to combat the issue. In 2010, the FDA approved a reformulation of OxyContin which makes it more resistant to being cut, chewed, crushed or dissolved — methods that make the drug more powerful. The Kentucky Board of Medical Licensure has spelled out "the steps physicians need to take as they seek to help patients control pain unrelated to terminal illness," Ungar reports. And the Kentucky General Assembly passed a comprehensive bill that requires doctors to use KASPER when prescribing certain drugs and take a full medical history of patients to whom they are considering prescribing drugs. (Read more)

Another in-depth look at Kentucky's prescription drug abuse problem hit the pages of The Courier-Journal yesterday, this time exploring the history of OxyContin and how well-meaning doctors started over-prescribing opioids in the 1990s in response to vigorous marketing campaigns. 

The problem continues to be gargantuan, with Laura Ungar reporting about one in 16 Kentuckians misused prescription painkillers in the past year. Kentucky ranks "as the fourth-most-medicated state in a nation that fills enough painkiller prescriptions each year to keep every American adult medicated around the clock for a month," Ungar writes.

A review published in the journal Pain Physician last year found evidence is lacking for how effective opioids are in treating long-term pain. "They're not M&Ms," said Dr. Lee Tannenbaum, founder of the Bel Air Center for Addictions in Maryland. "As physicians, we need to be really, really, really careful as to when we put someone on these drugs. Cancer pain may need opioids, but someone out shoveling snow who hurt his back doesn't. We have created so many addicts."

A C-J investigation found physicians fuel the problem in three ways. First, they do not screen patients adequately. They prescribe powerful pills for moderate pain. And they do not use the state's monitoring program, Kentucky All Schedule Prescription Electronic Reporting, known as KASPER.

The problem started in the 1990s when "medical organizations, concerned that pain wasn't being treated adequately, encouraged doctors to do more to relieve suffering," Ungar reports. OxyContin was approved by the Federal Food and Drug Administration in 1995, with OxyContin prescriptions for noncancer pain increasing by tenfold between 1997 and 2002. A report found the drug's maker, Purdue Pharma "directed its drug representatives to focus on physicians in their sales territories who were high opioid prescribers, while also issuing OxyContin 'starter coupons' for patients and distributing promotional items, such as fishing hats and plush toys," Ungar reports.

In October 2007, Kentucky and Pike County sued Purdue Pharma for its deceptive marketing campaign, alleging it misled doctors about the potency of the drug, which is twice as powerful as morphine. U.S. Rep. Harold "Hal" Rogers, R-5th District, called OxyContin "the guilty party that got this epidemic going." In Kentucky, the retail distribution of oxycodone grew from 83,000 grams in 1997 to 950,000 grams in 2010.

Part of the problem is that doctors do not have the time they need to properly assess patients for potential abuse. "You've got an awful lot of doctors prescribing not out of ill intents. They've got a limited amount of time, and pain patients require a lot of time," said Robert Walker, assistant professor of behavioral science at University of Kentucky's Center on Drug and Alcohol Research. "The easiest solution is the opioid."

While easy, they are not necessarily effective for all pain. Evidence is "very, very mixed" on whether the drugs work in the long term on chronic pain and "the evidence is pretty scant" that they are effective against treating chronic lower back pain, said Dr. Timothy Ives of the University of North Carolina.

Though the problem is never expected to be solved completely, there are steps being taken to combat the issue. In 2010, the FDA approved a reformulation of OxyContin which makes it more resistant to being cut, chewed, crushed or dissolved — methods that make the drug more powerful. The Kentucky Board of Medical Licensure has spelled out "the steps physicians need to take as they seek to help patients control pain unrelated to terminal illness," Ungar reports. And the Kentucky General Assembly passed a comprehensive bill that requires doctors to use KASPER when prescribing certain drugs and take a full medical history of patients to whom they are considering prescribing drugs. (Read more)

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To fight meds-for-meth bill, Consumer Healthcare Products Association spent almost $500,000 in last session, a record

The biggest spender to lobby the Kentucky legislature in the 2012 session was the Consumer Healthcare Products Association, which represents the over-the-counter drug industry. Of the $8.8 million spent in 2012 overall, the group spent nearly $500,000, breaking the record it set in 2010 by spending $311,000.

The group was fighting a bill that would have made cold medicines that contain pseudoephedrine, the key ingredient to make methamphetamine, available only by prescription. Its report did not include several hundred thousand dollars spent on advertising to the general public, asking citizens to contact legislators. That does not fall under the state's legal definition of lobbying, which does include other methods CHPA used, such as phone banks, social media and other Internet activities.

The Senate and House ultimately passed a compromise bill that lowers the amount of pseudoephedrine a person can buy in a month from 9 grams to 7.2 grams. The maximum a person can buy in a year without a prescription is 24 grams. For a story from the Lexington Herald-Leader, click here. Gor one from The Courier-Journal, go here.

The biggest spender to lobby the Kentucky legislature in the 2012 session was the Consumer Healthcare Products Association, which represents the over-the-counter drug industry. Of the $8.8 million spent in 2012 overall, the group spent nearly $500,000, breaking the record it set in 2010 by spending $311,000.

The group was fighting a bill that would have made cold medicines that contain pseudoephedrine, the key ingredient to make methamphetamine, available only by prescription. Its report did not include several hundred thousand dollars spent on advertising to the general public, asking citizens to contact legislators. That does not fall under the state's legal definition of lobbying, which does include other methods CHPA used, such as phone banks, social media and other Internet activities.

The Senate and House ultimately passed a compromise bill that lowers the amount of pseudoephedrine a person can buy in a month from 9 grams to 7.2 grams. The maximum a person can buy in a year without a prescription is 24 grams. For a story from the Lexington Herald-Leader, click here. Gor one from The Courier-Journal, go here.

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Coventry offers to keep paying ARH, but less, for treating Medicaid patients; asks Danville chain to renegotiate

Coventry Cares has offered to pay for treatments at Appalachian Regional Healthcare as a "non-contracted provider," which would mean ARH would be paid far less than it is now, but coverage for ARH's 25,000 Medicaid patient members would not be interrupted.

"Medicaid's rates pay 75 percent of the cost of treating patients on an in-patient basis," reports Valarie Honeycutt Spears for the Lexington Herald-Leader. "Coventry has asked for a further reduction."

"The ultimate issue is whether patients in that region are going to have access to care or not. ARH needs to be paid if they are going to treat these patients," said Steve Price, an attorney for ARH.

Stephen Amato, Coventry's attorney, said Coventry's offer is a sign the company "remains committed to the best interest of its members in hopes that its willingness to preserve its members' access to ARH takes its members out of the middle of the contract dispute."

Coventry is one of four companies chosen by the state to provide care to Medicaid recipients. ARH sued Coventry, and another managed-care company, saying they owed the hospital chain more than $18 million for services. But Coventry says the state allowed another managed-care company not to include ARH in its network, which means a lot of higher-risk, higher-cost patients covered by Coventry.

Meanwhile, Coventry has given notice to the Ephraim McDowell Health System, which has facilities in six counties including hospitals in Danville and Stanford, that it wants to renegotiate its contract. (Read more)

Coventry Cares has offered to pay for treatments at Appalachian Regional Healthcare as a "non-contracted provider," which would mean ARH would be paid far less than it is now, but coverage for ARH's 25,000 Medicaid patient members would not be interrupted.

"Medicaid's rates pay 75 percent of the cost of treating patients on an in-patient basis," reports Valarie Honeycutt Spears for the Lexington Herald-Leader. "Coventry has asked for a further reduction."

"The ultimate issue is whether patients in that region are going to have access to care or not. ARH needs to be paid if they are going to treat these patients," said Steve Price, an attorney for ARH.

Stephen Amato, Coventry's attorney, said Coventry's offer is a sign the company "remains committed to the best interest of its members in hopes that its willingness to preserve its members' access to ARH takes its members out of the middle of the contract dispute."

Coventry is one of four companies chosen by the state to provide care to Medicaid recipients. ARH sued Coventry, and another managed-care company, saying they owed the hospital chain more than $18 million for services. But Coventry says the state allowed another managed-care company not to include ARH in its network, which means a lot of higher-risk, higher-cost patients covered by Coventry.

Meanwhile, Coventry has given notice to the Ephraim McDowell Health System, which has facilities in six counties including hospitals in Danville and Stanford, that it wants to renegotiate its contract. (Read more)

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Bluegrass mental-health nonprofit flush with cash, despite cuts in public health; spends big on executive pay and lobbying

The new Eastern State Hospital being built in Lexington. The
Bluegrass Regional MH-MR Board runs the existing facility
and wants to run the new one. (Pablo Alcla, Herald-Leader)

Despite deep cuts in state public-health funding, the non-profit Bluegrass Regional Mental Health-Mental Retardation Board, which serves 17 counties in central Kentucky, is flush with cash, making some critics question whether it is transparent enough with its finances.

"In 2011, it reported having $33.7 million in cash reserves and similar assets — more money than 10 of the state's 13 other regional mental health boards had in their entire budgets," reports John Cheeves for the Lexington Herald-Leader.

The board spends freely in executive pay (four top executives collected nearly $2 million in 2010 for compensation), political lobbying (since 2008 it has spent nearly $500,000 to pay four lobbyists in Frankfort) and real estate (it bought a $295,000 home near Lake Cumberland for its senior management team to use when in Somerset).

"We have received some concerns regarding the Bluegrass board in the last few days, and we're going to be looking into those," state auditor spokeswoman Stephenie Steitzer told Cheves.

Scott Gould, who chairs the 25-member Bluegrass MH-MR Board, said "there has been no inappropriate practice or action taken by any board member, CEO or staff member."

But one former employee, Eleisha Kiefer, said the company cuts costs in unfair ways, saying there was a weekly lunch budget of $100 at a therapeutic rehabilitation program for about 20 mentally handicapped adults in Harrison County. "We had a lot of soup beans and corn bread," she said.

Gould disputed the allegation, saying there has "never, ever" been a weekly budget placed on client meals.

Mental health experts praise the work Bluegrass does. "I'd have to put them high up on the star chart in terms of what they provide their consumers and their family members," said Sheila Schuster, executive director of the Kentucky Mental Health Coalition. "It's one thing to deliver quality care, but I feel that Bluegrass goes the extra mile."

Though is it chiefly funded by the Cabinet for Health and Family Services, Bluegrass considers itself part of the private sector. Its executive pay reflects that approach. In 2010, its current and previous chief executive officers — who are married to each other —"took home more than $1 million in total compensation," Cheeves reports.

Comparatively, Howard Bracco, the recently retired CEO of the mental health board in Louisville, Seven Counties Services, made $179,868. "We had different cultures," Bracco said. "They operate on a business model, a corporate model, versus the social model. I think, frankly, they were better business people than many of us. They lobbied hard to win contracts, they fulfilled those contracts, and they've been very successful." (Read more)

The new Eastern State Hospital being built in Lexington. The
Bluegrass Regional MH-MR Board runs the existing facility
and wants to run the new one. (Pablo Alcla, Herald-Leader)

Despite deep cuts in state public-health funding, the non-profit Bluegrass Regional Mental Health-Mental Retardation Board, which serves 17 counties in central Kentucky, is flush with cash, making some critics question whether it is transparent enough with its finances.

"In 2011, it reported having $33.7 million in cash reserves and similar assets — more money than 10 of the state's 13 other regional mental health boards had in their entire budgets," reports John Cheeves for the Lexington Herald-Leader.

The board spends freely in executive pay (four top executives collected nearly $2 million in 2010 for compensation), political lobbying (since 2008 it has spent nearly $500,000 to pay four lobbyists in Frankfort) and real estate (it bought a $295,000 home near Lake Cumberland for its senior management team to use when in Somerset).

"We have received some concerns regarding the Bluegrass board in the last few days, and we're going to be looking into those," state auditor spokeswoman Stephenie Steitzer told Cheves.

Scott Gould, who chairs the 25-member Bluegrass MH-MR Board, said "there has been no inappropriate practice or action taken by any board member, CEO or staff member."

But one former employee, Eleisha Kiefer, said the company cuts costs in unfair ways, saying there was a weekly lunch budget of $100 at a therapeutic rehabilitation program for about 20 mentally handicapped adults in Harrison County. "We had a lot of soup beans and corn bread," she said.

Gould disputed the allegation, saying there has "never, ever" been a weekly budget placed on client meals.

Mental health experts praise the work Bluegrass does. "I'd have to put them high up on the star chart in terms of what they provide their consumers and their family members," said Sheila Schuster, executive director of the Kentucky Mental Health Coalition. "It's one thing to deliver quality care, but I feel that Bluegrass goes the extra mile."

Though is it chiefly funded by the Cabinet for Health and Family Services, Bluegrass considers itself part of the private sector. Its executive pay reflects that approach. In 2010, its current and previous chief executive officers — who are married to each other —"took home more than $1 million in total compensation," Cheeves reports.

Comparatively, Howard Bracco, the recently retired CEO of the mental health board in Louisville, Seven Counties Services, made $179,868. "We had different cultures," Bracco said. "They operate on a business model, a corporate model, versus the social model. I think, frankly, they were better business people than many of us. They lobbied hard to win contracts, they fulfilled those contracts, and they've been very successful." (Read more)

Read More

With crackdown on pill abuse, will legitimate patients be able to get the prescriptions they need?

The crackdown on prescription-pill abuse has some patients worried they won't be able to get the medicine they need because doctors are fearful of over-prescribing. "It's a huge concern in a nation where chronic pain afflicts 116 million American adults and is associated with up to $635 billion in health care costs," reports Laura Ungar in an ongoing series for The Courier-Journal.

"Pain patients feel ashamed or weak that they have to take these medications ... (and) shy away from being treated," said Dr. James Murphy, a pain specialist in Louisville. 

But there is little evidence that pain patients who really need medicine are unable to find treatment. Ungar reports: "It may take longer for them to find a doctor, experts said, and they may be subjected to urine tests and pill counts to ensure they're not abusing their medicines. But most eventually are able to get the medication they need."

"I don't see any decrease in the amount of opioid prescribing in any jurisdiction," Dr. Nathaniel Katz, president and chief executive officer of the Masschusetts-based consulting firm Analgesic Solutions, told Ungar. "So it's difficult to justify a position that legitimate opioid prescribing is being chilled."

Some worry that making physicians use the state's prescription drug monitoring system — commonly known as KASPER — for new patients could create that chilling effect. A survey of controlled-substance prescribers made to use KASPER found about half didn't change their prescribing habits and about 13 percent said they actually prescribed more opioids. But 35 percent, or 190 prescribers, said they had decreased the amount of controlled substance they subscribed because of "media coverage of abuse, increased law enforcement activity related to prescription-drug abuse and fear of investigations by law enforcement or the medical board," Ungar reports.

Some are concerned that "if more doctors make that choice, desperate pain patients may feel forced to seek relief at unscrupulous pain clinics," Ungar reports. (Read more)

The crackdown on prescription-pill abuse has some patients worried they won't be able to get the medicine they need because doctors are fearful of over-prescribing. "It's a huge concern in a nation where chronic pain afflicts 116 million American adults and is associated with up to $635 billion in health care costs," reports Laura Ungar in an ongoing series for The Courier-Journal.

"Pain patients feel ashamed or weak that they have to take these medications ... (and) shy away from being treated," said Dr. James Murphy, a pain specialist in Louisville. 

But there is little evidence that pain patients who really need medicine are unable to find treatment. Ungar reports: "It may take longer for them to find a doctor, experts said, and they may be subjected to urine tests and pill counts to ensure they're not abusing their medicines. But most eventually are able to get the medication they need."

"I don't see any decrease in the amount of opioid prescribing in any jurisdiction," Dr. Nathaniel Katz, president and chief executive officer of the Masschusetts-based consulting firm Analgesic Solutions, told Ungar. "So it's difficult to justify a position that legitimate opioid prescribing is being chilled."

Some worry that making physicians use the state's prescription drug monitoring system — commonly known as KASPER — for new patients could create that chilling effect. A survey of controlled-substance prescribers made to use KASPER found about half didn't change their prescribing habits and about 13 percent said they actually prescribed more opioids. But 35 percent, or 190 prescribers, said they had decreased the amount of controlled substance they subscribed because of "media coverage of abuse, increased law enforcement activity related to prescription-drug abuse and fear of investigations by law enforcement or the medical board," Ungar reports.

Some are concerned that "if more doctors make that choice, desperate pain patients may feel forced to seek relief at unscrupulous pain clinics," Ungar reports. (Read more)

Read More

Is ‘wool sucking’ behavior inherited in cats?

Each year, the Winn Feline Foundation receives proposals from veterinary researchers around the world who are interested in improving feline health. To date, Winn’s cumulative total in feline health research funding exceeds $4 million. Forty-four proposals were submitted by researchers seeking funding in this review cycle. This year, our team of veterinary consultants helped Winn select 10 projects for funding, for a total of $174,018. Here is one of those projects:

W12-040
“Wool sucking” behavior in Siamese and Birman cats
Investigators: Nicholas Dodman, Edward Ginns; Tufts University

“Wool sucking” is a behavioral condition that involves the repetitive searching, suckling, chewing and ingestion of non-food items. While items made of wool can be the preferred substrate, cats may also seek out and chew items made of cotton, rubber, nylon, paper, cardboard and plastic. A negative consequence of this behavior is breakdown of the human-animal bond due to owners’ frustration with property damage. In its most severe form, the cat cannot be maintained safely as an indoor cat. While wool sucking behavior can occur in any cat breed, the incidence is higher in oriental breeds, suggesting a genetic susceptibility. To identify potential genetic components of the compulsive “wool sucking” behavior in cats, DNA samples will be collected via saliva from normal and affected Siamese and Birman cats. Since “wool sucking” is an excellent animal model of human obsessive-compulsive behaviors, the identification of a genetic cause could lead to development of carrier testing, as well as better treatment options for both cats and humans with these disorders.

More on cat health:
Winn Feline Foundation Library
Find us on Facebook
Follow us on Twitter
Read the Cat Health News Weekly
Join us on Google+

Each year, the Winn Feline Foundation receives proposals from veterinary researchers around the world who are interested in improving feline health. To date, Winn’s cumulative total in feline health research funding exceeds $4 million. Forty-four proposals were submitted by researchers seeking funding in this review cycle. This year, our team of veterinary consultants helped Winn select 10 projects for funding, for a total of $174,018. Here is one of those projects:

W12-040
“Wool sucking” behavior in Siamese and Birman cats
Investigators: Nicholas Dodman, Edward Ginns; Tufts University

“Wool sucking” is a behavioral condition that involves the repetitive searching, suckling, chewing and ingestion of non-food items. While items made of wool can be the preferred substrate, cats may also seek out and chew items made of cotton, rubber, nylon, paper, cardboard and plastic. A negative consequence of this behavior is breakdown of the human-animal bond due to owners’ frustration with property damage. In its most severe form, the cat cannot be maintained safely as an indoor cat. While wool sucking behavior can occur in any cat breed, the incidence is higher in oriental breeds, suggesting a genetic susceptibility. To identify potential genetic components of the compulsive “wool sucking” behavior in cats, DNA samples will be collected via saliva from normal and affected Siamese and Birman cats. Since “wool sucking” is an excellent animal model of human obsessive-compulsive behaviors, the identification of a genetic cause could lead to development of carrier testing, as well as better treatment options for both cats and humans with these disorders.

More on cat health:
Winn Feline Foundation Library
Find us on Facebook
Follow us on Twitter
Read the Cat Health News Weekly
Join us on Google+

Read More