I'm a doctor. So sue me. No, really

The doctors' lobby says capping malpractice suits will make healthcare cheaper.
I'm an M.D. and I don't believe it
Salon.com
By Rahul K. Parikh, M.D.
Oct. 27, 2009

Flu season has come early and I'm writing far too many prescriptions for Tamiflu. I'm trying my best to adhere to the guidelines set by the Centers for Disease Control for who should get the drug (kids under 5 years of age, or kids who have a chronic illness like asthma or diabetes). But in more than a few instances, I've ignored the guidelines and given Tamiflu to perfectly healthy kids with no risk factors for influenza-related complications.

Part of the reason I'm writing so many extra prescriptions stems from stories about healthy people getting sick with H1N1 and ending up critically ill or dead. One of those stories aired recently on "60 Minutes" -- a healthy high school football player in Arkansas developed a fever after a game. He went to his doctor, who thought he had a garden variety flu and sent him home. Two days later, the boy collapsed and was airlifted to the nearest pediatric intensive care unit. He developed a bacterial pneumonia on top of his H1N1 flu, which led to severe damage to his lungs. He couldn't breathe on his own, so he remains in the ICU on a ventilator.

The H1N1 strain of influenza is no more lethal than any other strain of flu. Mortality is less than 1 percent. Nevertheless, by over-prescribing an expensive drug that has only marginal benefits, I'm unequivocally practicing what is known as defensive medicine. As in, the kind of medicine that protects doctors as much as patients.

Mine isn't an extreme example of defensive medicine. I'm a pediatrician. Obstetricians and emergency room doctors are sued at far higher rates, and would have more dramatic stories to share. But my motivations are the same as theirs: I'm afraid that if I don't do something, one of my patients may get sick or die, and I'll end up in court being asked why I didn't do everything I could have.

Defensive medicine is just one of the supposed systemic ills that doctors, doctors' lobbies and doctors' insurers invoke when they shill for what they call malpractice reform. Proponents of reform say that defensive medicine, frivolous lawsuits and high premiums are behind the surge in healthcare expenses. They insist that malpractice costs are forcing doctors to close their doors and depriving patients of care. Recently, three past presidents of the American Medical Association coauthored an opinion piece for the Wall Street Journal that bundled all of these arguments into an attack on the public option. Their piece attempted to shift the blame for America's healthcare crisis away from private insurers and onto a supposed scourge of ambulance chasers. "The nation needs comprehensive medical malpractice reform," they wrote. "It is the surest and quickest way to slow down the rising cost of healthcare."

Their refrain is familiar to anybody following the healthcare reform debate. The only problem is that it's not true. There's nothing "sure or quick" about changing medical liability laws that will improve healthcare or its costs. Defensive medicine adds very little to healthcare's price tag, and rising malpractice premiums have had very little impact on access to care.

Let's look at the numbers. First, based on the current rhetoric, it's easy to assume we have an epidemic of malpractice suits in America. We don't.

There are many statistics out there, and it's not always possible to make an apples to apples comparison between one study and another. Some surveys cover the nation, some cover one group of states, some cover another cluster, and results vary. But according to the Congressional Budget Office, nationally, between the mid-1990s to the mid-2000s, the frequency of malpractice suits per capita remained stable at about 15 claims per 100 physicians per year. Another report, from the National Center for State Courts, actually shows that the number of cases between 1996 and 2006 dropped 8 percent.
Quantcast

Although the payout per claim has increased, the Justice Department, in a 2007 report about medical malpractice -- in fact, the same report cited by the authors of the Wall Street Journal piece mentioned above -- provided an explanation quite different from an epidemic of lawsuits. "Growing healthcare costs and an increasing effort by many attorneys to litigate only those medical malpractice claims involving severe injuries or wrongful death claims may explain some of these increases," they wrote. Still, even with the rise in payouts, the Congressional Budget Office, using statistics from the government's Centers for Medicare and Medicaid Services, estimates that malpractice costs account for less than 2 percent of healthcare spending. Saving 2 percent of the over $2 trillion we spend on healthcare isn’t going to bend the cost curve.

Next is the question of frivolous lawsuits. Tort reformers push the notion that junk lawsuits dominate the legal system. The Wall Street Journal article cited above refers to studies that show that 80 percent of claims are settled without payment to the patient and that when a case does make it to trial, doctors win 89 percent of the cases.

But the private studies cited often involve small numbers of claims, or focus on a single hospital, insurer, specialty or type of injury, or were commissioned by interested parties, aka the malpractice insurers themselves. The 2007 Department of Justice study cited by the Journal trio covers only seven states, and nowhere does it mention the numbers 80 percent and 89 percent. Repeated attempts to contact and ask one of the authors of the WSJ story about the specific source of their data were unsuccessful. The DOJ report shows that in one state, Illinois, 88 percent of claims were closed without a payout. But for the other states it examined, the number was between 62 percent and 69 percent. Regarding the percentages of cases doctors win, a 2001 analysis by the Bureau of Justice Statistics, examining malpractice trends in the 75 most populous counties in the U.S., put that number closer to 70 percent.

In 2006, researchers from Harvard published a study in the New England Journal of Medicine that was designed to avoid the limits, and the biases, of prior research. What they found kills the notion of frivolous lawsuits. It suggests that most people who sue are suing for good reason.

Next page: Tort reformers neglect the fact that malpractice reform won't save one extra life

Healthcare system wastes up to $800 billion a year

Healthcare system wastes up to $800 billion a year
Mon Oct 26, 2009
By Maggie Fox, Health and Science Editor

WASHINGTON (Reuters) - The U.S. healthcare system is just as wasteful as President Barack Obama says it is, and proposed reforms could be paid for by fixing some of the most obvious inefficiencies, preventing mistakes and fighting fraud, according to a Thomson Reuters report released on Monday.

The U.S. healthcare system wastes between $505 billion and $850 billion every year, the report from Robert Kelley, vice president of healthcare analytics at Thomson Reuters, found.

"America's healthcare system is indeed hemorrhaging billions of dollars, and the opportunities to slow the fiscal bleeding are substantial," the report reads.

"The bad news is that an estimated $700 billion is wasted annually. That's one-third of the nation's healthcare bill," Kelley said in a statement.

The CIO 50 West winners include David Hudson, VP IT, Keenan & Associate

Everything Channel Announces the CIO 50 West Winners
press release
Sept. 21, 2009

--New Recognition Honors IT Executives for Influence, Innovation and Ability to Collaborate with Integrators and Vendors

FRAMINGHAM, Mass., Sept 21, 2009 /PRNewswire-FirstCall via COMTEX/ -- Everything Channel, a division of United Business Media, today announced the CIO 50 West winners, a new recognition that honors IT executives for their influence, innovation and ability to collaborate with integrators and vendors. The awards were presented at Everything Channel's Midsize Enterprise Summit West 2009, which took place at the Hyatt Regency Century Plaza in Los Angeles, CA.

The CIO 50 West winners include:

1. Mohinder Chopra, SVP & CIO, OSI Systems
2. David Hudson, VP IT, Keenan & Associates
3. Tracy Cleeton, Director of IT, Saga Communications
4. Keenan Lersch, Technology Manager, American Railcar Industries
5. Thomas Smith, CTO, PSRS/PEERS of Missouri
6. Brad Cackler, IT Director, Micro Power Electronics
7. Dave McDowell, Director of IT, West Liberty Foods
8. Greg McLean, Director of Technical Services, Green Bay Packaging
9. Christopher Holda, Director, IT, Integrated Health Associates
10. Randy Nye, IT Manager, Oak Harbor Freight Lines, Inc.
11. Rita Lazar-Tippe, IS Manager, Edmonton Journal
12. Michael Gauthier, CIO, IMTT
13. Michelle George, First VP - Application Development, Securities America
14. Nathan Church, VP & IT Manager, Columbia River Bank
15. Dave Ploch, CIO/Director, IT, Novus International
16. Greg Katers, Director of IT, Green Bay Packaging
17. David Chin, Director of IT, Stanford Hotels Corporation
18. David Price, IT Director, Resource Management, Inc.
19. Michael Brown, VP of IS, Peter Piper Pizza
20. Neil Stewart, Director Technical Operations, QuikTrip Corp
21. Dirk Anderson, VP Technology, C R England
22. Paul Dupree, CIO, Assistant VP of I.S., Asbury College
23. Bruce Hagen, VP Corporate IS, Bemis Manufacturing Co
24. Robert Bence, VP, Technology, Southwest Credit Systems
25. Larry Freed, Vice President & CIO, Atrium Companies, Inc.
26. Seth Hansen, VP - IT, Daktronics, Inc
27. David Cresswell, Director, IT Planning & Strategy, British Columbia
Institute of Technology
28. Lawrence Frederick, CIO, University of the Pacific
29. Raman Krishnaswami, Director, IT, Healthcare Benefit Trust
30. John DeLuca, Director of Information Technology, Hydranautics
31. Craig Crosby, Director, Information Services, Procopio, Cory, Hargreaves
& Savitch LLP
32. Adam Farkas, VP IT, Crown Media
33. Leonardo Imana, Director of Technology, Adelman Travel Group
34. Sergey Bushlyar, CIO, IT Director, Paul Capital Partners
35. Neil Ferguson, Technology Director, Orrick, Herrington, & Sutclife
LLP
36. Peter Mills, Executive Director, Information Technology, Canadian
Tourism Commission
37. David Cropper, CIO, Mamiye Brothers
38. Susan Faulkner, Director, Information Systems and Technology, Bluewave
Energy
39. Eric Vlam, Director of Information Systems, Equipment Depot
40. Michael Gibbons, Director, Northeastern State University
41. Aaron Bukhari, CIO & CSO, SNC Lavalin Nuclear Inc.
42. Chris Daly, Director, Infrastructure & Application Support,
Corporation Service Company
43. Niel Nickolaisen, CIO, Headwaters, Inc.
44. Lawrence Frederick, CIO, University of the Pacific
45. Carl Gammon, Director, Information Systems, Minntech Corporation
46. James Fielder, Vice President Information Technology, Farm Credit
Services of Illinois
47. Matthew Sharp, Director of I.T., David and Lucile Packard Foundation
48. Brian Mackay, Associate VP and CIO, Thompson Rivers University
49. Nick Barakat, IT Manager, Clean Energy Fuels Corp

50. Gary Allen, Chief Technology Officer, Amarillo Independent School
District





The professionals comprising the CIO 50 West were chosen for their leadership in utilizing technology to help increase corporate efficiencies, drive revenue and achieve other key business goals within their midsize company or organization. In particular,

Obama attacks insurance companies for capping coverage and charging "outrageous fees"

http://www.reuters.com/article/healthNews/idUSTRE57D47P20090816?feedType=nl&feedName=ushealth1100
Sat Aug 15, 2009
By Jeff Mason and Matt Spetalnick

GRAND JUNCTION, Colorado (Reuters) - U.S. President Barack Obama reignited his criticism of health insurance companies on Saturday, promising reforms that would prevent firms from capping coverage or charging "outrageous" fees.

Traveling to a conservative area of Colorado, a western state that supported Obama in the 2008 election, the president continued his assault on companies that the White House has painted as being at the root of the country's healthcare woes while defending his proposals to fix the system.

"Insurance companies will no longer be able to ... place an arbitrary cap on the amount of coverage you can receive or charge outrageous out-of-pocket expenses on top of your premiums," Obama told the crowd of roughly 1,500 people.

"No one in America should go broke because they get sick," he said to loud applause.

The "death panels" are already here

Is our current system "downright evil"?

The "death panels" are already here

Sorry, Sarah Palin -- rationing of care? Private companies are already doing it, with sometimes fatal results
Salon.com
By Mike Madden
Aug. 11, 2009

The future of healthcare in America, according to Sarah Palin, might look something like this: A sick 17-year-old girl needs a liver transplant. Doctors find an available organ, and they're ready to operate, but the bureaucracy -- or as Palin would put it, the "death panel" -- steps in and says it won't pay for the surgery. Despite protests from the girl's family and her doctors, the heartless hacks hold their ground for a critical 10 days. Eventually, under massive public pressure, they relent -- but the patient dies before the operation can proceed.

It certainly sounds scary enough to make you want to go show up at a town hall meeting and yell about how misguided President Obama's healthcare reform plans are. Except that's not the future of healthcare -- it's the present. Long before anyone started talking about government "death panels" or warning that Obama would have the government ration care, 17-year-old Nataline Sarkisyan, a leukemia patient from Glendale, Calif., died in December 2007, after her parents battled their insurance company, Cigna, over the surgery. Cigna initially refused to pay for it because the company's analysis showed Sarkisyan was already too sick from her leukemia; the liver transplant wouldn't have saved her life.

That kind of utilitarian rationing, of course, is exactly what Palin and other opponents of the healthcare reform proposals pending before Congress say they want to protect the country from. "Such a system is downright evil," Palin wrote, in the same message posted on Facebook where she raised the "death panel" specter. "Health care by definition involves life and death decisions."

Coverage of Palin's remarks, and former House Speaker Newt Gingrich's defense of them, over the weekend did point out that the idea that the reform plans would encourage government-sponsored euthanasia is one of a handful of deliberate falsehoods being peddled by opponents of the legislation. But the idea that only if reform passes would the government start setting up rationing and interfering with care goes beyond just the bogus euthanasia claim.

Opponents of reform often seem to skip right past any problems with the current system -- but it's rife with them. A study by the American Medical Association found the biggest insurance companies in the country denied between 2 and 5 percent of claims put in by doctors last year (though the AMA noted that not all the denials were improper). There is no national database of insurance claim denials, though, because private insurance companies aren't required to disclose such stats. Meanwhile, a House Energy and Commerce Committee report in June found that just three insurance companies kicked at least 20,000 people off their rolls between 2003 and 2007 for such reasons as typos on their application paperwork, a preexisting condition or a family member's medical history. People who buy insurance under individual policies, about 6 percent of adults, may be especially vulnerable, but the 63 percent of adults covered by employer-provided insurance aren't immune to difficulty...

SEC: Ex-AIG CEO Greenberg settles fraud charges
AP

By STEPHEN BERNARD, AP Business Writer Stephen Bernard, Ap Business Writer

August 6, 2009

NEW YORK – The Securities and Exchange Commission said Thursday that former American International Group Inc. CEO Maurice "Hank" Greenberg agreed to pay a $15 million fine to settle fraud charges.

The charges are tied to an accounting scandal earlier this decade at AIG that led to Greenberg's ouster in 2005. The following year, AIG paid more than $1.6 billion to settle charges of improper accounting.

The case is unrelated to the government bailout of AIG, which is in the process of trying to sell off assets to pay off the $182.5 billion in loans it has received since last September.

A spokesman for Greenberg was not immediately available to comment. An AIG spokesman declined to comment.

The SEC said AIG's former chief financial officer, Howard Smith, will pay a $1.5 million fine tied to the investigation.

In complaints against Greenberg and Smith, the SEC said the pair were responsible for making misstatements that falsely showed AIG met or exceeded earnings and growth targets between 2000 and 2005. The pair did not admit or deny any wrongdoing as part of the settlement.

Greenberg was forced out of AIG after charges that the company had engaged in deceptive accounting practices surfaced.

Greenberg, who built AIG over his 35-year career from a small company into the world's largest insurer, have been fighting in court in an unrelated case over who controls an employee retirement fund. AIG had accused Greenberg of plundering the AIG retirement program composed of $4.3 billion in stock through a company called Starr International Co. that Greenberg controls. A jury last month sided with Greenberg in the civil case saying he did not have to reimburse AIG for the stock, but the decision was only an advisory recommendation.

The judge hearing the case will make a final ruling on who controls the fund, and its purpose, by the end of the month. This case is also unrelated to the insurer's bailout by the government.

AIG is currently in the middle of a major overhaul as it looks to repay the government for the loans it received to avoid collapsing last fall at the peak of the credit crisis. In return for the loan package, which is worth up to $182.5 billion, the government received about an 80 percent stake in the insurance giant.

Vicki Forman's twins weighed only a pound at birth. She thought they should be allowed to die. Doctors disagreed

Born too soon
By Katharine Mieszkowski
Salon.com
July 25, 2009

After years of trying to conceive, writer Vicki Forman's twins were finally coming. Way too early.

Evan and Ellie were only 23 weeks gestation when Forman went into labor. They were so premature Forman thought she was having a miscarriage. At birth, each baby weighed only about a pound.

"One of life's great illusions is the notion that we can want -- and get -- things on our own terms, no matter what. It's human nature to seek pleasure and avoid suffering, but what happens when suffering finds you?" Forman writes in her harrowing new book "This Lovely Life: A Memoir of Premature Motherhood." "My husband and I had tried for two long years to conceive these twins, had lived through miscarriages and fertility treatments to bear them. When I learned they were coming so early and so fragile, I had only one wish: to let them go."

While Forman thought the twins should be allowed to die, their doctors struggled to save them. While Ellie lived for only four days, Evan, who endured severe disabilities including the inability to speak or see, died just shy of his eighth birthday...

Dr. Yorobe and Kaiser Permanente both guilty of "repeated negligent acts"

Dr. Yorobe sounds just like the Kaiser Permanente doctors who treated my friend Sandra Wiltgen.

Sandra died of uterine cancer in 1992 at the age of 44. She went to the Kaiser Emergency Room on Zion in San Diego with bleeding, and each time the doctors did the same thing: a blood test. Each time the blood test revealed that Sandy was severely anemic, so doctors did the usual: a blood transfusion. Each time they sent her home. This went on for a year and a half, at which time the doctors had the brilliant idea of checking for uterine cancer. Sandy received external radiation at a non-Kaiser clinic where the radiologist recommended--no, urged--that a radioactive implant be used. But the gynecologist at Kaiser did not approve this idea. Sandy died without ever having seen an oncologist.



Treatment of patient who died draws fire
Medical Board claims doctor was negligent
By David Hasemyer
San Diego Union-Tribune Staff Writer
July 13, 2009

COLORECTAL CANCER

Incidence: The third most common cancer and the third most common cause of cancer death in the United States.

Detection: Usually no symptoms in the early stages. Can be detected by colorectal cancer screenings. As it progresses, the disease may cause symptoms such as a change in bowel habits, bleeding from the rectum or blood in the stool, or cramping or gnawing stomach pain.

Risks: Chance of developing colorectal cancer increases as people age. Over 90 percent of cases occur in people older than 50. The mortality rate for males was 25.3 per 100,000 and 17.7 per 100,000 for females from 1997 to 2001.

Prevention: About 26,000 deaths a year could be prevented in the U.S. if everyone older than 50 were screened for colorectal cancer.

Source: American Cancer Society

Online: For the California Medical Board accusation against Dr. Edwin Yorobe, go to uniontrib.com/more/documents

When Teodoro Galvez started feeling ill with back pain and rectal bleeding, he sought treatment from a doctor from his native Philippines.

The Navy veteran and Rancho Peñasquitos resident just felt more comfortable in the care of a doctor from his homeland, said his daughter Sucett Galvez. So he became a patient of Edwin Mendez Yorobe, a 1970 graduate of Far Eastern University in Manila who had his medical practice in Tierrasanta.

But the doctor Galvez placed so much trust in has been accused of negligence and incompetence by the Medical Board of California, which says Yorobe overlooked signs of rectal cancer in Galvez for more than a year before Galvez died of the disease.

Yorobe, who has been licensed in California since 1975, did not respond to numerous requests for an interview.

The Medical Board accusation filed in Administrative Law Court says Yorobe failed to properly diagnose the cause of Galvez's rectal bleeding with appropriate diagnostic studies and seeks the revocation or suspension of Yorobe's license.

“(Yorobe) departed extremely from the standard of care for treatment of a 73-year-old man with rectal bleeding by failing to properly and fully investigate the exact cause of (Galvez's) rectal bleeding with timely and appropriate diagnostic studies,” the accusation says.

A hearing date for the case has not been set.

“My dad put his trust in his doctor,” Sucett Galvez said, but throughout repeated visits, he began to wonder why he wasn't starting to feel better. “But we just thought he's going to see a doctor, so he's being taken care of.”

According to the court documents:

Yorobe first examined Teodoro Galvez in March 2003 and noted hemorrhoids, bleeding in the gastrointestinal tract and a stool sample that suggested colorectal cancer.

In response to those findings, Yorobe directed his patient to stop taking ibuprofen, which increases bleeding by thinning the blood, and to start taking Zantac, which is used to treat bleeding ulcers. He told Galvez to come back in three weeks.

After the follow-up visit, Yorobe again noted the bleeding and the warning signs associated with cancer but then “concluded his inquiry into this condition,” the accusation says.

Yorobe, 63, examined Galvez 11 more times between May 2003 and August 2004 without any mention of the bleeding or signs indicating cancer.

During an August 2004 visit, Galvez told Yorobe that he had developed a painful mass in his groin and had lost his appetite.

The doctor diagnosed Galvez with a hernia and recommended the use of an athletic supporter.

Galvez was back in three weeks. He was diagnosed with rectal bleeding and told to take hot baths, use Anusol, watch his diet and exercise.

Two weeks later, in mid-September, with Galvez still bleeding, Yorobe referred his patient to another doctor for a consultation.

“However, before (Galvez) was seen by a specialist, he went to the emergency room at Sharp Memorial Hospital where he was admitted and diagnosed with metastatic inoperable rectal cancer to the liver,” the accusation says.

Galvez died October 27, 2004.

Medical Board authorities say the acceptable standard of care would have been to conduct physical examinations and tests to establish the location of the bleeding and to rule out cancer. Yorobe did not perform those tests, including a colonoscopy and rectal exam.

The Medical Board said that failure constitutes “repeated negligent acts” by the doctor in his care of Galvez.

In 2006, Yorobe and another doctor settled a malpractice lawsuit filed by Sucett Galvez, her brother and mother for $125,000.

Problem nurses stay on the job as patients suffer

Problem nurses stay on the job as patients suffer

By Charles Ornstein, Tracy Weber and Maloy Moore
July 12, 2009


Nurse Owen Jay Murphy Jr. twisted the jaw of one patient until he screamed.

He picked up another one -- an elderly, frail man -- by the shoulders, slammed him against a mattress and barked, "I said, 'Stay in bed.' "

He ignored the alarms on vital-sign monitors in the emergency room, shouted at co-workers and once hurled a thirsty patient's water jug against the wall, yelling, "How do you like your water now?" according to state records.

Murphy's fellow nurses at Kaiser Permanente Riverside Medical Center finally pleaded with their bosses for help. "They were afraid of him," a hospital spokesman said.

Under pressure, Murphy resigned in May 2005. Within days, Kaiser alerted California's Board of Registered Nursing: This nurse is dangerous.

Tracy Weber and Charles Ornstein, both former Los Angeles Times staff writers, did significant reporting for this article before leaving The Times last year and have continued to cover the issue for ProPublica.

Maloy Moore is a Times researcher. Doug Smith, The Times’ director of database reporting, contributed to this report.
But the board didn't stop Murphy from working elsewhere, nor did it take steps over the next two years to warn potential employers of the complaints against him. In the meantime, Murphy was accused of assaulting patients at two nearby hospitals, leading to convictions for battery and inflicting pain, board and court records show.

Even Murphy, who has since taken classes to curb his anger, was surprised the board didn't step in earlier.

"The nursing board is there to protect the public from me," he said in an interview.

The board charged with overseeing California's 350,000 registered nurses often takes years to act on complaints of egregious misconduct, leaving nurses accused of wrongdoing free to practice without restrictions, an investigation by The Times and the nonprofit news organization ProPublica found.

It's a high-stakes gamble that no one will be hurt as nurses with histories of drug abuse, negligence, violence and incompetence continue to provide care across the state. While the inquiries drag on, many nurses maintain spotless records. New employers and patients have no way of knowing the risks.

Reporters examined the case of every nurse who faced disciplinary action from 2002 to 2008 -- more than 2,000 cases in all -- as well as hundreds of pages of court, personnel and regulatory reports. They interviewed scores of nurses, patients, families, hospital officials, regulators and experts.

Among the findings:

* The board took more than three years, on average, to investigate and discipline errant nurses, according to its own statistics. In at least six other large states, the process typically takes a year or less.

"It's really discouraging that when you do report people . . . they don't take action," said Joan Jessop, a retired chief nursing officer in Los Angeles who filed multiple complaints with the board during her 43-year career. "What is so frightening to me is that these people will go on and do it to somebody else."

* The board failed to act against nurses whose misconduct already had been thoroughly documented and sanctioned by others. Reporters identified more than 120 nurses who were suspended or fired by employers , disciplined by another California licensing board or restricted from practice by other states -- yet have blemish-free records with the nursing board.

* The board gave probation to hundreds of nurses -- ordering monitoring and work restrictions -- then failed to crack down as many landed in trouble again and again. One nurse given probation in 2005 missed 38 drug screens, tested positive for alcohol five times and was fired from a job before the board revoked his probation three years later.

* The board failed to use its authority to immediately stop potentially dangerous nurses from practicing. It obtained emergency suspensions of nurses' licenses just 29 times from 2002 to 2007. In contrast, Florida's nursing regulators, which oversee 40% fewer nurses, take such action more than 70 times each year.

In interviews last week, the board's leaders and other state officials defended its record. "We take what we do -- protecting the public -- very, very seriously," said Executive Officer Ruth Ann Terry.

Terry, at the helm for nearly 16 years and on staff for 25, acknowledged that the pace of the disciplinary process has "always been unacceptable" and said the system was being streamlined. But she blamed other parts of the state bureaucracy for delays and was vague about what changes would be made...

This report, one in a series of occasional articles about oversight of nurses, was prepared in collaboration with ProPublica, an independent investigative newsroom in New York.

Antibiotic rapamycin delays aging in mice

Antibiotic Delayed Aging In Experiments With Mice
New York Times
By NICHOLAS WADE
Published: July 8, 2009

A new star has appeared in the field of drugs that delay aging in laboratory animals, and are therefore candidates for doing the same in people.

The drug is an antibiotic, rapamycin, already in use for suppressing the immune system in transplant patients and for treating certain cancers.

...[T]here are now many ways of extending life in small laboratory animals through a variety of compounds, including resveratrol and sirtuins, PGC1-alpha and now rapamycin. All these compounds seem to be involved in helping an organism detect and respond to the level of nutrients in its environment.

“It’s no longer irresponsible to say that following these up could lead to medicines that increase human life span by 10, 20 or 30 percent,” Dr. Miller said.

But it will be at least 10 years before matters are sorted out, in his view. As of right now, he said, “I don’t think there’s any evidence for people that there’s any drug that can slow aging down.”

Do we need more ethics screening for medical students and doctors?

Apparently this medical student was not motivated by the desire to help his fellow humans be healthier. I wonder how many doctors are motivated by the desire to help others?



Suspect in Craigslist slaying indicted
June 21, 2009
CNN

A Massachusetts grand jury late last week indicted a 23-year-old medical student on seven counts, including first-degree murder, in the fatal shooting of one woman and the robbery of another in Boston hotels.
Philip Markoff is charged with killing a woman and robbing another in Boston hotels in April.

Philip Markoff is charged with killing a woman and robbing another in Boston hotels in April.

Philip Markoff is charged with the April 14 fatal shooting and attempted robbery of Julissa Brisman, 25, and the armed robbery of a 29-year-old Las Vegas woman on April 10. Investigators have linked both incidents to advertisements on the Craigslist classified ad Web site.

Markoff also is charged with "the armed and forcible confinement" of the two women, as well as two counts of unlawful firearm possession, the Suffolk County District Attorney's Office said Sunday.

The grand jury returned the seven-count indictment late Thursday, and it moves the case from Boston Municipal Court to Suffolk Superior Court, where Markoff is expected to appear for a Monday morning arraignment. He previously pleaded not guilty in the city court and is being held without bail.

Markoff's attorney, John Salzberg, had no comment on the new indictment.

Prosecutors said Brisman, a model from New York who advertised as a masseuse on Craigslist, was shot three times at close range and suffered blunt head trauma at the Marriott Copley Place hotel.

The Las Vegas woman was robbed of $800 in cash and $250 in American Express gift cards at the Westin Copley Place hotel, police reports said.

Markoff, a second-year medical student at Boston University's School of Medicine, also has been charged in a nonfatal hotel assault in Rhode Island.

He has been charged with assault with the intent to rob, assault with a dangerous weapon, possession of a handgun and use of a firearm while committing a crime of violence, stemming from an April 16 robbery attempt at a Holiday Inn Express in Warwick, Rhode Island.

Doctor paid to make false report on behalf of medical company

Medtronic paid doctor accused of false study: report
Jun 18, 2009
Reuters

Medical device maker Medtronic Inc paid almost $800,000 in consulting fees to a former U.S. Army surgeon accused of fabricating a key study, according to published reports.

The New York Times and The Wall Street Journal said the payments were made to Timothy Kuklo, who is accused of making up a report that showed positive results for Infuse, one of Medtronic's important spine products.

The newspapers reported that the Army had said the study was based on false information, and that Kuklo had forged signatures of purported co-authors of the study.

Medtronic told The Wall Street Journal that the payments were compensation for Kuklo's work developing products for the company, training doctors and speaking at company events.

The company told the Journal that the payments were not connected to the study.

Medtronic told the Times that it was not involved in any way with the challenged report. The newspaper said Kuklo, now an assistant medical professor at Washington University in St. Louis, has repeatedly declined to comment on the situation...

$500 million profit for owner of World Trade Center Building 7: it wasn't hit by a plane, so why did it fall?

To see a video narrated by architect David Gage showing the collapse of WTC 7 CLICK HERE.

World Trade Center building 7, where SEC files were kept, is the only steel skyscraper has ever collapsed due primarily to fire. In all other skyscraper fires, the steel frame has been left intact even after fires burned uncontrolled and destroyed everything else.

SEC & EEOC: Attack Delays Investigations
New York Lawyer
By Margaret Cronin Fisk
National Law Journal
September 17, 2001

Additional details emerged Friday about the effect of the collapse of 7 World Trade Center on investigations being conducted by the New York offices of the Securities and Exchange Commission...

Reuters news service and the Los Angeles Times published reports estimating them at 3,000 to 4,000. They include the agency's major inquiry into the manner in which investment banks divvied up hot shares of initial public offerings during the high-tech boom.

The EEOC said documents from about 45 active cases were missing and could not be easily retrieved from any backup system. One of these cases was a sexual harassment charge filed on Sept. 10 against Morgan Stanley, one of the prime corporate victims of the World Trade Center disaster...



Files relating Citigroup to the WorldCom scandal were lost:

Citigroup Facing Subpoena in IPO Probe
08/09/02
Matthew Goldstein

The chairman of the House Financial Services Committee, frustrated by Citigroup's (C Quote) unwillingness to turn over information about any WorldCom executives who may have gotten shares in initial public offerings, will try to pry the information out with a subpoena.

Rep. Michael Oxley (R., Ohio) said Friday that a subpoena is necessary because Citigroup provided insufficient information about what, if any, special treatment its Salmon Smith Barney investing banking division may have given WorldCom executives. Salomon had been one of the now-bankrupt telecom's principal investment bankers.

The issue of whether Salomon may have doled out shares in some bull-market IPOs to WorldCom executives came up during a committee hearing last month into the accounting fraud at the big long-distance carrier. Citigroup maintains it would be an invasion of federal privacy law for it to provide that information without a subpoena.



The collapse of 7 World Trade Center is remarkable because it was the first known instance of a tall building collapsing primarily as a result of uncontrolled fires:

NIST (NATIONAL INSTITUTE OF STANDARDS AND TECHNOLOGY
Questions and Answers about the NIST WTC 7 Investigation
Updated 04/21/2009




Silverstein is Clearly Talking about the Demolition of WTC7 on Sept. 11th
PBS Documentary: Silverstein, FDNY Razed WTC 7
Infowars.com

In a stunning and belated development concerning the attacks of 9/11 Larry Silverstein, the controller of the destroyed WTC complex, stated plainly in a PBS documentary that he and the FDNY decided jointly to demolish the Solomon Bros. building, or WTC 7, late in the afternoon of Tuesday, Sept. 11, 2001.

This admission appeared in a PBS documentary originally aired in Sept. of 2002 entitled "America Rebuilds". Mr Silverstein's comments came after FEMA and the Society of Civil Engineers conducted an extensive and costly investigation into the curious collapse of WTC 7. The study specifically concluded that the building had collapsed as a result of the inferno within, sparked, apparently, by debris falling from the crumbling North Tower.

In the documentary Silverstein makes the following statement;

I remember getting a call from the, er, fire department commander, telling me that they were not sure they were gonna be able to contain the fire, and I said, "We've had such terrible loss of life, maybe the smartest thing to do is pull it." And they made that decision to pull and we watched the building collapse.

[This can be heard in the audio file. Thanks to Sir Dave 'tmo' Soule for transfering this from the video to an MP3 file. "America Rebuilds", PBS Home Video, ISBN 0-7806-4006-3, is available from http://shop.pbs.org/products/AREB901/.]

Mr. Silverstein's comments stand in direct contradiction to the findings of the extensive FEMA report. They even negate Kevin Spacey's narrative in the very documentary in which they appear; "WTC 7 fell after burning for 7 hours." If it had been generally known that the building was "pulled" wouldn't Mr. Spacey have phrased it that way?...

In the same program a cleanup worker referred to the demolition of WTC 6: "... we're getting ready to pull the building six." There can be little doubt as to how the word "pull" is being used in this context.

[This can be heard in the audio file taken from the video.]

This shocking contradiction is yet another curious twist in a disturbing series of events surrounding the "collapse" of WTC 7, and the WTC complex in general.

Among these is the fact that, in all the history of high-rise fires, not one has ever resulted in a collapse.





Ownership, Control, and Insurance of The World Trade Center

The World Trade Center complex came under the control of a private owner for the first time only in mid-2001, having been built and managed by the Port Authority as a public resource...

The new controllers acquired a handsome insurance policy for the complex including a clause that would prove extremely valuable: in the event of a terrorist attack, the partnership could collect the insured value of the property, and be released from their obligations under the 99-year lease...

On April 26 of 2001 the Board of Commissioners for the Port Authority of New York and New Jersey awarded Silverstein Properties and mall-owner Westfield America a 99-year-lease on the following assets: The Twin Towers, World Trade Center Buildings 4 and 5, two 9-story office buildings, and 400,000 square feet of retail space.

The partners' winning bid was $3.2 billion for holdings estimated to be worth more than $8 billion. JP Morgan Chase, a prestigious investment-bank that's the flagship firm of its kind for Rockefeller family interests, advised the Port Authority...

The lead partner and spokesperson for the winning bidders, Larry Silverstein, age 70... Larry Silverstein also owned Runway 69, a nightclub in Queens that was alleged 9 years ago to be laundering money made through sales of Laotian heroin...

The lease deal didn't close until July 24th, just 6 weeks before the attack.

Don Paul also documented the money flows surrounding the loss of Building 7.
In February of 2002 Silverstein Properties won $861 million from Industrial Risk Insurers to rebuild on the site of WTC 7. Silverstein Properties' estimated investment in WTC 7 was $386 million. So: This building's collapse resulted in a profit of about $500 million...


1. Westfield Nabs Trade Center mall, ICSC.org, 6/2/2001 [cached]
2. Governor Pataki, Acting Governor DiFrancesco Laud Historic Port Authority Agreement to Privatize World Trade Center, Port Authority on NY & NJ, 7/24/01 [cached]
3. Reinsurance Companies Wait to Sort Out Cost of Damage, New York Times, 9/12/01, page C6
4. Facing Our Fascist State, I/R Press, 2002, page 38
5. MetLife Will Sell Sears Tower, Wall Street Journal Online, 3/12/04 [cached]
6. Most of WTC Down Payment to Be Returned, 11/22/03 [cached]
7. Insurers Debate: One Accident or Two?, Bloomberg News, 10/10/01
8. Facing Our Fascist State, , page 47
9. Double Indemnity, law.com, 9/3/02 [cached]
10. Judge John S. Martin Jr.'s Latest Opinion in Swiss Re v. WTC., Newsday, 09/25/02 [cached]
11. Twin Tower Insurers Win Discovery Fight, 6/20/02 [cached]
12. World Trade Center's Mortgage Holder Loses Discovery Fight, 7/8/02 [cached]
13. Jury Awards $2.2 Billion in 9/11 Insurance, United Press International, 12/6/04 [cached]

Insurance companies alone have pocketed $600 million in excessive profits in Iraq

Insurance companies alone have pocketed $600 million in excessive profits
over the past five years, says a staff report from the House Oversight and
Government Reform Committee, but the Defense Department refuses to
adjust its approach for managing the program.

The Wars Come Home

A poorly run Pentagon program for providing workman's compensation for
civilian taxpayers, a House oversight committee said Thursday.

Insurance companies alone have pocketed $600 million in excessive profits
over the past five years, says a staff report from the House Oversight and
Government Reform Committee, but the Defense Department refuses to
adjust its approach for managing the program.

According to the committee, the Pentagon allows its contractors to
negotiate their own insurance contracts. By contrast, the State Department,
U.S. Agency for International Development and the Army Corps of Engineers
have all selected a single insurance carrier to provide the insurance at
fixed rates.

"What makes the situation even worse is the people this program is
supposed to benefit - the injured employees working for contractors -
have to fight the insurance companies to get their benefits,"
committee Chairman Henry Waxman, D-Calif., said at a hearing
Thursday. "Delays and denials in paying claims are the rule."

KBR Inc., one of the largest defense contractors in Iraq, paid the insurance
giant AIG $284 million for medical and disability coverage under the Defense
Base Act, a reference to the federal law mandating the insurance. Due to
the way KBR's contract is structured, this premium, along with an $8 million
markup for KBR, gets billed to the taxpayer.

"Out of this amount, just $73 million actually goes to injured contractors, and
AIG and KBR pocket over $100 million as profit," Waxman said.

Full Story

Health Insurance lobbyist Zirkelbach says "we've got concerns"; insurers want to operate outside the exchanges

Industry Groups Push Back on Kennedy's Health Bill
By JANET ADAMY
June 10, 2009
Wall Street Journal

Employers and health-insurance companies are pushing back against parts of a health bill proposed by Sen. Edward Kennedy, in a sign of the challenges that loom for Democratic-led legislation.

Lobbyists spent Wednesday combing through the "Affordable Health Choices Act" that the Senate Committee on Health, Education, Labor and Pensions released a day earlier. The bill would require most Americans to buy health insurance and would create government-run exchanges where they could buy policies. It also calls for a new government health-insurance plan and indicates employers would be required to help pay for employees' plans...

"The president, I thought, was very flexible except on one thing, and that was getting it done,'' said Sen. Charles Grassley, the top Republican on the Senate Finance Committee.

...Health insurers are also strongly against a public plan.

The Kennedy bill, like others being discussed in Congress, envisions consumers and some businesses comparison-shopping for health insurance on the exchanges. That concept has enjoyed widespread support so far, but industry groups are finding fault with some of the details...

...Insurers are pushing for some plans to be able to operate outside the exchanges -- a move that worries lawmakers.

"We've got concerns," said Robert Zirkelbach, a spokesman for America's Health Insurance Plans, the main lobby for the health-insurance industry...

CNA and AIG insurance companies love taxpayer dollars, but find reasons not to pay when defense contractors are injured

Contractor Tim Newman, left; contractor Kevin Smith-Idol, middle; widow Rita Richardson, whose husband was killed by a roadside blast in Iraq. (Photos courtesy of Tim Newman, ABC News, Francine Orr/Los Angeles Times)

Injured War Zone Contractors Fight to Get Care From AIG and Other Insurers
by T. Christian Miller
April 16, 2009

Reporting from Los Angeles and Washington — Civilian workers who suffered devastating injuries while supporting the U.S. war effort in Iraq and Afghanistan have come home to a grinding battle for basic medical care, artificial limbs, psychological counseling and other services.

The insurance companies responsible for their treatment under taxpayer-funded policies have routinely denied the most serious medical claims. Those insurers -- primarily American International Group (AIG) -- recorded hundreds of millions of dollars in profits on this business.

The civilian contractors have played an indispensable role in the two conflicts, delivering fuel to frontline troops, guarding U.S. diplomats and translating for soldiers during dangerous raids. More than 1,400 civilian workers have died and 31,000 have been wounded or injured in the two war zones.

Yet unlike wounded soldiers, who are offered health care, rehabilitation and support services by the military, the civilians have to battle a federally supervised insurance system marked by high costs and excessive delays, an investigation by the Los Angeles Times, ABC News and ProPublica has found.

In contrast to the public outcry over squalid conditions at some military hospitals, the contractors' plight has drawn little attention.






Could it be true CNA is worse than AIG?
Posted on April 29, 2009 by defensebaseactcomp

That’s what we’ve been hearing. We are getting numerous reports on dealing with CNA’s claims adjusters.

We are reposting this from ProPublica

Note that Daniel is typing with two fingers, the two that they didn’t amputate.

JUST LOOK HOW I HAVE TO BATTLE TO GET MEDICATION. THIS E-MAIL WAS ADDRESSED TO DONNA SRPAGS.

Donna
I’m disputing the facts as per your attorney’s letter claiming I have reached MMI. The fact that I need medication on a continuous base has nothing to do with the fact that have an attorney.

In the time that you used the services of Roger Levy you continued to speak to me via e-mail. Please stop ignoring Unitas’s request to provide me with medication. You sent them a letter requesting that they forward all detail about the medication that i need.

If I do not receive my medication, my health would seriously be affected. IF my health is affected as a result of your refusal to talk to me, I would not hesitate to charge you with criminal negligence is that understood!!!!!!!!!
I’m not one of the locals that are messing with. Stop your childish behavior and pay for my medication. Your are not even attempting to settle any dispute. I will post my e-mails to you on every site on the net possible until you start paying my debts.

I worked in the intelligence/security branch of the Police in my country. Please do not underestimate my intelligence. I leave you with i final thought………….
“I wonder if your friends in Sienna Girls High School in the USA no that your are killings innocent contractors by refusing them medication and benefits”
Please have a good nights sleep and pray before you go to sleep.

Daniel Brink






WORKERS COMPENSATION INSURANCE (DEFENSE BASE ACT)
(OCT 2008)
(a) This Special Contract Requirement supplements FAR Clause 52.228-3 Workers’ Compensation Insurance (Defense Base Act).
(b) The contractor agrees to procure Defense Base Act (DBA) insurance pursuant to the terms of the contract between the U.S. Army Corps of Engineers (USACE) and CNA Insurance unless the contractor has a DBA self-insurance program approved by the Department of Labor.

AIG insurance lawyer Roger Levy writes a book

From Krash April 17, 2009 2:37 pm EDT

How can AIG say that they are paying DBA contractor claims when one of their own attorneys published a book on how NOT TO PAY THE CLAIMS (Defense Base Act and War Hazards Compensation Act Handbook 2008 Edition by Roger A. Levy).

Taxpayers bailout AIG, and AIG repays them--by dumping injured defense employees on Social Security

Blog: The Modern Day DBA Casualty

Injured War Zone Contractors often find themselves in this battle for medical care and other benefits afforded them under the Defense Base Act.
AIG and CNA ruthlessly delay and deny claims with no remorse for the lives they destroy.
The Department of Labor has served as a poor administrator allowing these insurance company tactics and sometimes even supporting them.
The Defense Base Act itself has been twisted to better meet the needs of the insurance company.

We are injured war zone contractors and family members living this in real time.

U.S. health system discourages innovation

U.S. health system discourages innovation
May 25, 2009
By Andy Sullivan

WASHINGTON (Reuters) - Countless workers in the United States are trapped in jobs they would like to leave because they cannot get health insurance elsewhere, calcifying innovation and mobility in the world's largest economy.

Daunted by health-care costs, a would-be technology entrepreneur in Texas decides not to start her own business. A communications expert in Washington decides not to strike out on his own. And a freelance magazine editor in Brooklyn decides to take a less satisfying corporate job...

Economists call this phenomenon "job lock," and studies suggest that it keeps between 20 percent and 50 percent of workers from leaving their current jobs.

Because health insurance is tied to employment in the United States, workers who leave their jobs can see health bills skyrocket if they strike out on their own or take a position with a company that offers fewer benefits. Workers who would like to retire early stay on, unable to qualify for the government's Medicare program until they turn 65.

And those who have existing health problems may not be able to get coverage at all.

Job lock is difficult to measure because many employees don't like to advertise their unhappiness. But economists and small-business advocates say it takes an enormous toll on productivity.

SLOWING INNOVATION

"We can definitely say that it's slowing down the rate of innovation," said Tim Kane, an economist with the Kauffman Foundation which promoted entrepreneurship...

Richard L. Scott: Healthcare Enemy #1?

Richard L. Scott: Healthcare Enemy Number One
The Rag Blog
By Christopher Hayes
March 11, 2009

...for my money, Rick Scott is the man who best embodies the spirit of the current conservative opposition... Politico recently reported that the millionaire Republican would be heading up Conservatives for Patients' Rights (CPR), a new group that plans to spend around $20 million to kill President Obama's efforts at healthcare reform.

Having Scott lead the charge against healthcare reform is like tapping Bernie Madoff to campaign against tighter securities regulation...the for-profit hospital chain Scott helped found--the one he ran and built his entire reputation on--was discovered to be in the habit of defrauding the government out of hundreds of millions of dollars.

This is the man who will be delivering what Politico called the "pro-free-market message."

A Texas lawyer who shared a business partner with George W. Bush, Scott started his health company, Columbia Hospital Corporation, in 1987. Its growth was meteoric, expanding from just a few hospitals to more than 1,000 facilities in thirty-eight states and three other countries in 1997. As his firm gobbled up chains, like the Frist family's Hospital Corporation of America (HCA), it became the largest for-profit hospital chain in the country. By 1994, Columbia/HCA was one of the forty largest corporations in America, and Scott had acquired a reputation as the Gordon Gecko of the healthcare world. "Whose patients are you stealing?" he would ask employees at his newly acquired hospitals.

He promised to put nonprofit hospitals--which he insisted on referring to as "nontaxpaying" hospitals--out of business and touted his company's single-minded pursuit of profit as a model for the nation's entire healthcare system. "What's happening in Washington is not healthcare reform," he told the New York Times in 1994. "Healthcare reform is happening in the marketplace."

The press portrayed Scott as a guru to be admired and feared, "a private capitalist dictator," in the words of one Princeton health economist. "Probably the lowest body fat of anybody I've been in business with," his partner told the Times.

"Other hospitals were intimidated," recalls John Schilling, who worked for Columbia/HCA in the 1990s. Scott was "like the bully that would come into town and if you didn't sell to him or partner with him, he would open up shop across the street from you and put you out of business."

Not long after joining the company in 1993 as the supervisor of reimbursement for the Fort Myers, Florida, office, Schilling noticed things weren't quite kosher. "They were looking for ways to maximize reimbursement...which ultimately would improve the bottom line."

One way they did this was to fudge the costs on their Medicare expense reports. They were "basically keeping two sets of books," says Schilling. The company would maintain an internal expense report, what it called a "reserve" report, which accurately tallied its expenses. "And then they would have a second report, which...they would file with the government, which was more aggressive." That report would "include inflated costs and expenses they knew weren't allowable or reimbursable. The one they filed with government might claim $5 million and the reserve would claim $4.5." Columbia/HCA would pocket the difference...

Group wants to cut $2 trillion from US health care costs over 10 years

Interested parties are discussing "legislation that would direct Medicare to reward health-care providers who get better outcomes for patients using less costly procedures."

MAY 11, 2009
Industry Officials Dismiss Concerns About Health Costs Plan
By Patrick Yoest
DOW JONES NEWSWIRES

A team of health-care industry groups that announced a $2 trillion cost-saving initiative Monday expressed little worry about the effect of cuts on their bottom lines, saying that skepticism about the plan is unwarranted.

The groups, which represent health insurers, hospitals, doctors and other health workers, met with President Obama on Monday to discuss their initiative. They have sketched out a 10-year plan to slow the growth of health costs by $2 trillion by drawing down the rate of cost increases in the sector by 1.5% each year...

Meetings among the groups - which also include the American Medical Association, PhRMA and the Service Employees International Union (SEIU) - intensified in recent weeks, with the SEIU taking a lead role. The groups recently have taken to meeting on Saturdays, they said...

Doctors trying to silence patients

Doctors Seek to Silence Online Reviews
By LINDSEY TANNER
AP
March 6, 2009

The anonymous comment on the Web site RateMDs.com was unsparing: "Very unhelpful, arrogant," it said of a doctor. "Did not listen and cut me off, seemed much too happy to have power (and abuse it!) over suffering people."

Such reviews are becoming more common as consumer ratings services like Zagat's and Angie's List expand beyond restaurants and plumbers to medical care, and some doctors are fighting back. They're asking patients to agree to what amounts to a gag order that bars them from posting negative comments online.

Going to the doctor is often a hassle, but it can turn into a nightmare if you feel you feel disrespected or mistreated while you're there. Medical ethics expert and hospital management consultant Arthur S. Shorr offers advice on what to do when a trip to the MD goes awry.

"Consumers and patients are hungry for good information" about doctors, but Internet reviews provide just the opposite, contends Dr. Jeffrey Segal, a North Carolina neurosurgeon who has made a business of helping doctors monitor and prevent online criticism.
Some sites "are little more than tabloid journalism without much interest in constructively improving practices," and their sniping comments can unfairly ruin a doctor's reputation, Segal said.

Segal said such postings say nothing about what should really matter to patients — a doctor's medical skills — and privacy laws and medical ethics prevent leave doctors powerless to do anything it.

His company, Medical Justice, is based in Greensboro, N.C. For a fee, it provides doctors with a standardized waiver agreement. Patients who sign agree not to post online comments about the doctor, "his expertise and/or treatment."

"Published comments on Web pages, blogs and/or mass correspondence, however well intended, could severely damage physician's practice," according to suggested wording the company provides.

Segal's company advises doctors to have all patients sign the agreements. If a new patient refuses, the doctor might suggest finding another doctor. Segal said he knows of no cases where longtime patients have been turned away for not signing the waivers.

The gas from rotten eggs could lead to a new form of Viagra? A study found that hydrogen sulfide prompts arousal in men. The discovery, published in the Proceedings of the National Academy of Sciences, could lead to other forms of erectile dysfunction drugs.

Doctors are notified when a negative rating appears on a Web site, and, if the author's name is known, physicians can use the signed waivers to get the sites to remove offending opinion.

RateMd's postings are anonymous, and the site's operators say they do not know their users' identities. The operators also won't remove negative comments.
Angie's List's operators know the identities of users and warn them when they register that the site will share names with doctors if asked.

Since Segal's company began offering its service two years ago, nearly 2,000 doctors have signed up. In several instances, he said, doctors have used signed waivers to get sites to remove negative comments.

John Swapceinski, co-founder of RateMDs.com, said that in recent months, six doctors have asked him to remove negative online comments based on patients' signed waivers. He has refused.

"They're basically forcing the patients to choose between health care and their First Amendment rights, and I really find that repulsive," Swapceinski said.
He said he's planning to post a "Wall of Shame" listing names of doctors who use patient waivers.

AIG paid Stamford-based Gen Re in a secret deal to take out reinsurance policies

Ex-Gen Re executive gets 1 year in prison
By DAVE COLLINS
Associated Press Writer

A former senior vice president at General Re Corp. was sentenced Wednesday to a year and a day in federal prison for an accounting fraud scandal that artificially propped up the stock price of insurer American International Group Inc.

Christopher Garand, 61, was also fined $150,000 for his role in the case, which authorities say cost AIG shareholders more than $500 million.

Garand is one of five former executives convicted in the case.

Federal prosecutors say New York-based AIG paid Stamford-based Gen Re in a secret deal to take out reinsurance policies with AIG in 2000 and 2001. They say the scheme propped up AIG's stock prices and inflated reserves by $500 million with the goal of quelling criticism by analysts and concerns by investors.

U.S. District Judge Christopher Droney noted at Wednesday's hearing that Garand didn't try to benefit personally from the stock manipulation, and he said the scandal was not comparable with higher-profile ones involving Enron Corp., Adelphia or other companies.

But the judge said Garand knew he was breaking the law.

"Mr. Garand knew and understood the scope of the ... fraud," the judge said, adding that a message needed to be sent to the business community that this kind of conduct will not be tolerated.

Garand had faced up to 160 years in prison and a fine of up to $29.5 million.

Defendants in the case have said in court papers that there was no link between the eight-year-old deal and AIG's recent financial troubles that sparked a federal financial-rescue package.

Garand, of Upper Saddle River, N.J., begged Droney for a lenient sentence, saying he didn't know how he and his family would cope with a prison sentence.

"I'm profoundly sorry, your honor," Garand said. "I ask for your wisdom, compassion and mercy."

His wife, Barbara, a school board official in their New Jersey community, also pleaded with Droney.

"These past few years have caused a great deal of pain to our family," she said. "Please don't take him from us. Our lives are in your hands."

Garand, his wife, his two daughters, ages 26 and 15, and many in the crowd of nearly 80 people cried during parts of the 2 1/2-hour proceeding. Garand said his main concerns were how his wife, children and granddaughter would cope if he was imprisoned.

Garand's family and friends sent numerous letters to the judge, saying Garand was a family man, Army veteran and tireless community volunteer.

Neither Garand nor his wife would comment after the hearing. He was ordered to report to prison on April 22, but defense attorneys have asked that he remain free on bond pending an appeal.

The prosecutor, Assistant U.S. Attorney Ray Patricco, also declined to comment about the sentence. He had sought a "substantial" prison term.

During the hearing, Patricco said Garand played a significant role in the fraud, including coming up with the ideas for using sham contracts and leaving a deceptive paper trail. Garand denied those claims.

"The evidence at trial shows that he was much more than a bit player in this deal," Patricco said. "He knew that he was getting involved in a fraud and a serious crime. The seriousness of the offense cannot be overstated in this case."

Garand was the third executive to be sentenced. Former General Re chief executive Ronald Ferguson was sentenced in December to two years in prison and fined $200,000, while former AIG vice president Christian Milton was sentenced to four years in prison and fined $200,000.

Still to be sentenced are Elizabeth Monrad, former General Re chief financial officer, and Robert Graham, a former General Re senior vice president.

AIG executive gets 4 years in prison; it could have been life sentence

AIG executive handed 4-year sentence
Jan. 28, 2009
UPI.com
HARTFORD, Conn.

A federal court in Hartford, Conn., handed a former American International Group Inc. (NYSE:AFF) executive a four-year sentence for his role in a $500 million fraud scheme.

Judge Christopher Droney ignored sentencing guidelines that could have given former vice president of reinsurance Christopher Milton a life sentence, Business Insurance reported Wednesday.

Droney said Milton's actions were deliberate. "He knew this was not a bona fide transaction, but rather one designed to cook the books of AIG," Droney said.

Milton was convicted along with former General Re executives Christopher Garand, Robert Graham and Elizabeth Monrad, and former General Re Chief Executive Officer Ronald Ferguson. Prosecutors said the executives created General Re Corp. for the purpose of making AIG appear wealthier than it was.

The federal government last fall stepped in to rescue AIG, the nation's largest insurance company, with a $150 billion rescue package.

Victory bittersweet for drug liability case victim

By JOHN CURRAN
March 5, 2009

MARSHFIELD, Vt. (AP) — A Vermont musician who lost her arm after a botched drug injection says the U.S. Supreme Court's decision to uphold a $6.7 million verdict against the pharmaceutical company that made the drug is a victory for consumers.

"I just feel really good for what this means for the whole country," said Diana Levine, 63. "The money, to me, means the company was held accountable for something that didn't need to happen, number one.

"So hopefully, they'll learn their lesson from it and change the label so this doesn't happen to any more people," she said.

Rejecting calls for limits on lawsuits against drug companies, the high court on Wednesday upheld the award against Wyeth Pharmaceuticals, the maker of anti-nausea drug Phenergan. In a 6-3 ruling, the court turned away Wyeth's claim that U.S. Food and Drug Administration approval of the drug and its warning label should have shielded the company from Levine's suit.

Levine's nightmare began in 2000.

Suffering from a migraine headache, she went to a local clinic and was given painkillers and received an intramuscular injection of Phenergan. When she still felt nauseated, she was given an "IV-push" of the drug, with the second injection accidentally puncturing an artery. Gangrene set in. Several weeks later, her right arm was amputated.

"It basically took away my whole musical identity. I'd been playing music for 30 years, working with kids, writing songs. I played guitar, piano, bass in a rock band. I couldn't do any of those things anymore," she said.

She lost more than her music and her livelihood.

Suddenly, what was routine became a challenge. The drawers in her 150-year-old farmhouse needed two hands to be opened. A left-hander, she still had one hand to use, but she relied on it to compensate so much that she injured it with overuse.

She couldn't shovel or scrape ice off the windshield of her car, a real hardship in rural Vermont. In summer, she can't open a window without help.

"Nobody, nobody understands what it's like to just operate with one hand. Everything you do requires two hands, even when you think you only need one," she said.

For years, Levine wondered whether Wyeth would ever be held accountable.

On Wednesday, it was.

In the majority opinion, Justice John Paul Stevens said Wyeth could "unilaterally strengthen its warning," especially after it learned of at least 20 cases before Levine's injury in which an injection led to gangrene and amputation.

AIG Price Tag: $1,400 per Taxpayer Family

AIG Price Tag: $1,400 per Taxpayer Family
By ALICE GOMSTYN
ABC NEWS Business Unit
March 2, 2009

How much will each American family pay, on average, to bail out beleaguered insurance giant American International Group? Try more than $1,400.

The government's bailout of AIG now tops $160 billion. That and other government bailout spending could result in higher taxes down the road, experts say.
(ABC News/Getty)

The government's newly overhauled rescue package for AIG is $162.5 billion, according to government officials. Divide that by 111,609,629 -- the total number of U.S. households, according to the U.S. Census' 2005-2007 American Community Survey -- and the result is $1,455.97. That's nearly double the maximum tax benefit U.S. couples will receive under the federal stimulus package approved last month...