Medicare spending in hospitals Gets treatment Web

"," date ":" 20100408 "," pageTypeId ":" 1 "," orgId ":" 1 "," byline ":" NPR Science Desk "," aggIds ":" 103537970 "," commentCount ": 0}; npr.metrics.pageimpression ();} catch (e) {npr.messaging.exception (e, ' in metrics .js ', ' ready ' document.);}}); < previous="" postnext="" post=""> 3: 52April 8, 2010.

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Author: Christopher Weaver

You may ship during the debate on purpose health is that spending wildly different health between States, and even between tiny hamlets.

But seeing trust, right? Well now you can check out them for yourself, thanks to online tools simply issued by the Government. You can use it to see how much Medicare hospital costs by the State.

Dashboard contains numbers and total cost of payments to hospitals for treatment of 25 best diagnosis and to compare expenditure by the State. Replacements lead list with more than 400,000 executed last year.

The chart also provides hospitals, which were by most providers of care for the diagnosis. Bubble separate illustrates total expenditure for each State in 2006 and March this year.

However, we must say charts don't tell us how we'd like for instance the graphics do not contain data population which could enter figures in the perspective. More patients in California, Florida, New York and Texas--four States most populous--received treatment than in another State in all three of the 25 diagnosis.No big surprises.

The site is part of a President Obama much broader Open government Initiative. In announcing the initiative last year, said Obama "penness [o] will strengthen our democracy", and he called on heads of agencies to the plans and tools to achieve this objective.These plans were duly yesterday.White House gave each agency except Office of personnel management and the Council on Environmental Quality top marks for transparency.

Yet Obama Administration has zmagały with making government data, both available and useful in the same czasie.recovery.gov was sold as part of "unprecedented" push for transparency incentives package. However, at least at the beginning, the recovery.gov was a hodgepodge of confusing jargon and missing data.One report described, funding for "NTIA DTACBP," bureaucratese for t.v. converter box.

This site has become increasingly better, however.Now a detailed map lets users know the location, cost and contractors for specific projects at street level CMS Tool, currently in beta phase, may go through the same life cycle.CQ HealthBeat reported yesterday that the officials plan to Release much more data later this year.You can let CMS know what you want to see here by posting a comment.

Weaver is a reporter in Kaiser Health News, nonprofit news service.

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The Truth About Grass-Fed Beef

by Allison Aubrey

Video, Tiny Desk Kitchen: Watch These Four-Legged Lawnmowers In Action

This graphic requires version 9 or higher of the Adobe Flash Player.Get the latest Flash Player.

Tiny Desk Kitchen Episode 1: Grass Fed Beef Vs. Corn Fed Beef

Source: NPR

Credit: Allison Aubrey, Vikki Valentine, Maggie Starbard

text sizeAAAApril 8, 2010

What's old is new again. Across the U.S. farmers are turning back to a traditional method of cattle raising: feeding cows on grassy pastures instead of troughs filled with corn. A decade ago, there were only about 50 grass-fed-cattle operations left in the United States. Now, there are thousands and the numbers are growing.

Just look to your local farmer's market or specialty grocer for the evidence. It's much easier these days to get your hands on grass-fed beef from farms where cows spend their days out on pasture grazing on all sorts of grasses — from clover to wild onions to different types of tufted grasses called fescue. And beef eaters notice a difference from corn-fed cattle. (Watch my Tiny Desk Kitchen video above with NPR's Susan Stamberg and Ari Shapiro to see which beef they preferred.)

Enlarge Maggie Starbard/NPR

Tiny Desk Kitchen host Allison Aubrey (left) gave a blind taste test of grass-fed beef and corn-fed beef to NPR's Ari Shapiro and Susan Stamberg. See the video for the results.

Maggie Starbard/NPRTiny Desk Kitchen host Allison Aubrey (left) gave a blind taste test of grass-fed beef and corn-fed beef to NPR's Ari Shapiro and Susan Stamberg. See the video for the results.

The Taste

So there's more of this meat on the market, but is it really any different? I was curious about differences — both in taste and nutrition — so I called on farmer Forrest Pritchard, who runs Smithfield Farm in Berryville, Va.

"I think of my cows as four-legged lawn mowers," Pritchard told me as we walked his pastures one morning. After he pointed this out, I noticed that his cows were always on the move. That exercise leads to more muscle tone. And the resulting beef? Well it can taste a little chewier than most folks are accustomed to. Taste testers say the flavor is more varied than the typical grocery store cuts of beef that come from corn-raised cows.

Enlarge Zac Visco for NPR

Cows love to eat clover, which is rich in omega-3 fatty acids. Eating clover and other grasses gets those heart healthy fats into their meat.

Zac Visco for NPRCows love to eat clover, which is rich in omega-3 fatty acids. Eating clover and other grasses gets those heart healthy fats into their meat.

From Pasture To Trough

Farmers first made the switch from grass to corn years ago because corn allows them to fatten up their cattle faster.

It's the difference, for humans, between eating bags of spinach all day vs. dense, calorie-rich oatmeal. A lot of corn-fed-cattle raisers still start their animals out on pasture, but then quickly move them to troughs of grain for fattening.

That means farmers can raise more cattle and in smaller spaces — because they don't need all of that pasture. And yes, that means there's more beef for the millions and millions of hungry Americans.

Something Fishy

All right, there is a difference in taste, for sure. But what I'm really interested in is whether it's nutritionally any different. And the story gets a little fishy here. You know how nutritionists are always recommending fish? Well, that's because many fish are rich in heart-healthy omega-3 fatty acids.

And where do the fish get these omega-3s? They eat it. (Well, generally, the tiniest sea creatures eat algae, and it moves up the food chain to bigger fish.) With grass-fed cows, it's a similar story. Omega-3s are in their meat— because they're eating grasses and clover rich in these heart-healthy fatty acids.

Enlarge Zac Visco for NPR

Grass-fed cows almost always have less total fat in their meat than corn-fed cows.

Zac Visco for NPRGrass-fed cows almost always have less total fat in their meat than corn-fed cows.

A recent analysis from the Union of Concerned Scientists found that grass-fed steak has about twice as many omega-3s as a typical grain-fed steak. Another study published in March in Nutrition Journal backed up those numbers.

Still, with 35 milligrams of heart-healthy fats per serving, grass-fed steak can't compete with a salmon dinner, which has about 1,100 milligrams. But it's a significant difference in omega-3s between grass-fed and corn-fed beef. (You can calculate the fat/protein or micronutrients of any food in your diet with this USDA tool.)

And since grass-fed cattle are typically leaner, almost all cuts of grass-fed beef have less total fat than beef from corn-raised cattle. Of course, the breed of cattle leads to variation, too.

The Cost

There's a lot of variation in price on both sides of the aisle — and grass-fed will usually cost more. Farmers have to pay for all that pasture. A random price check found Whole Foods selling a pound of grass-fed sirloin for $9.99; Safeway was selling its corn-fed sirloin for $7.99 a pound. (On the day we checked, Safeway had the sirloin on sale for $5.99 a pound.)

My conclusion? On the whole, grass-fed beef is better for you than corn-fed. But it may not give you that melt-in-your-mouth sensation you grew up on, and it's going to cost you a more. So are these differences worth the price? That's up to you.

Produced by Vikki Valentine and Maggie Starbard

America's Test Kitchen: Pan-Seared Sirloin Steak

Tiny Desk Kitchen doesn't have a stove, so we used an indoor grill. In the video, we only cook the steak for three minutes, because both sides are seared at once. If you're doing this at home on a stove, follow this recipe from America's Test Kitchen:

Serves 4

Ingredients

2 tablespoons vegetable oil

2 boneless shell sirloin steaks (top butt) or whole flap meat steaks, each about 1 pound and 1 1/4 inches thick

Instructions

1. Heat oil in heavy-bottomed 12-inch skillet over medium-high heat until smoking. Meanwhile, season both sides of steaks with salt and pepper. Place steaks in skillet; cook, without moving steaks, until well browned, about 2 minutes. Using tongs, flip steaks; reduce heat to medium. Cook until well browned on second side and internal temperature registers 125 degrees on instant-read thermometer for medium-rare (about 5 minutes) or 130 degrees for medium (about 6 minutes).

2. Transfer steaks to large plate and tent loosely with foil; let rest until internal temperature registers 130 degrees for medium-rare or 135 degrees for medium, 12 to 15 minutes. Meanwhile, prepare pan sauce, if making.

3. Using sharp knife, slice steak about 1/4 inch thick against grain on bias, arrange on platter or on individual plates, and spoon sauce (if using) over steak; serve immediately.

Copyright America's Test Kitchen

Related NPR StoriesAre We Overselling The Sunshine Vitamin? March 29, 2010Eat More Fat, Just Make Sure It's The Right Kind March 23, 2010Argentine Cattle No Longer Just Home On The Range Sep. 14, 2009Getting Brain Food Straight from the Source Nov. 1, 2007Kitchen Window April 6, 2010Trout Season: A Fish Tale May 6, 2009Making Bacon That's Healthier for You March 26, 2006 E-mailShareComments PrintFacebookStumble UponRedditTwitterDiggWhat is this?

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Looking Abroad For Lessons In Health Care

by Jaclyn Schiff

text sizeAAAApril 9, 2010

A few months ago, GE Healthcare rolled out a portable electrocardiogram machine, trumpeting the new product's ability to help patients wherever they might need it.

But the most interesting thing about the MAC 800 is not where it can go, but where it came from: China.

Chinese engineers funded by GE Healthcare helped develop the machine for sale in China. Although initially tailored to local needs, the MAC 800 has found a new market – the United States, where hospitals with community programs can easily take it on the road to treat patients.

The company is betting that other products originally created for the developing world ultimately also can be useful here. GE is tapping into the increasingly popular idea that medical innovation should be a global two-way street in which the West benefits from the resourcefulness and frugality poorer nations apply to health problems. The idea isn't new, but it's gaining traction, beyond the creation of products and technology, as public health experts rethink ways to prevent disease and deliver care.

Health care in the developing world holds several "general lessons for richer countries," Nigel Crisp, a former permanent secretary of Britain's Department of Health, observed in a recent Times of London op-ed. "Unconstrained by our history, [developing countries] train people differently, create new sorts of organisations, involve families and communities and concentrate more on promoting health rather than on just tackling disease."

With interest in international health expanding, this type of thinking is likely to become more common. A 2009 survey by the Consortium of Universities for Global Health found that enrollment in global health courses had doubled since 2006. This rapid growth is changing the way people think about health care abroad, says Dr. Michael Merson, director of the Duke Global Health Institute. "I think the old days of development … where the rich helped the poor, for the most part have passed," he says. "I think we go into this with a true sense of shared partnership."

The Roots Of 'Kangaroo Care'

While some experts doubt the U.S. is really ready to embrace lessons from abroad, there is a growing number of examples. They run the gamut from basic to high-tech – including an electronic medical records program in use in more than 20 countries.

The Boston-based Prevention and Access to Care and Treatment project, which serves HIV/AIDS patients, is modeled on a community health worker program pioneered in Haiti. Since the late 1990s, the project has sought out the most difficult-to-treat HIV patients: those who fail in conventional programs because of factors such as mental illness and poverty. The program reports good results and has been sharing its methods with the New York City health department and hospitals with similar programs.

"Kangaroo care," an approach developed in Colombia, is another example. With a major shortage of incubators, doctors advised mothers to cradle preterm babies in a sling. They did so well that it changed what had been the conventional approach in the U.S., which encouraged only limited human contact while newborns were in incubators.

Merson participated in what became one of the best known illustrations of a borrowed idea. During the 1970s he was in Bangladesh working with other doctors to treat an outbreak of cholera, an acute infectious disease whose symptoms include severe diarrhea. The team made extensive use of a cheaper, simpler treatment for diarrhea, which can result in life-threatening dehydration, and it is now the recommended standard for care worldwide.

"It took a while for pediatricians to use here," Merson says, "but now we have products like Pedialyte and other kinds of oral rehydration fluids that are used to treat kids."

These days, it's increasingly common to find experts without medical backgrounds collaborating on health-related projects for developing countries. One example is OpenMRS, an open-source electronic medical record system that started in 2004 as a collaboration between the Boston-based nonprofit Partners in Health and the Regenstrief Institute, an informatics and health care research organization in Indianapolis. Both programs use the system to manage projects in the developing world. It's especially critical for hospitals that track large numbers of HIV-positive patients, says William Tierney, an informatics expert at Regenstrief.

Without electronic information, "How do you know when patients aren't coming in, so you can go out and chase them down to enhance adherence to the drug?" Tierney asks.

Rwanda, Tanzania and Peru are among the countries where the program has caught on. Since the software platform is open source it can be customized by anyone and tailored to specific programs, which would be more challenging with bigger commercial systems. Now it is being used at Indiana University's School of Medicine – where Tierney is a professor – as well as at sites in Maryland, Boston and Los Angeles.

'What Can The U.S. Learn From Ghana?'

Students now in school might lead a new wave of innovation. Anjali Sastry, a global health delivery and system dynamics researcher who lectures at the MIT Sloan School of Management, says her MBA students are increasingly using what they learn to experiment with different models for care delivery. "Ghana tried a national health insurance system, for instance," she says. "What can the U.S. learn from Ghana?"

Dr. Jaspal Sandhu, a global health designer and researcher with an engineering background, is among those asking such questions. In 2004, Sandhu and two other researchers traveled to Tamil Nadu state in India to closely examine the workings of Aurolad, an affiliate of Aravind Eye Care System, which developed an intraocular lens that significantly reduced the cost of cataract surgery in India. Today, Aurolab exports the lenses to 120 countries, including Canada, Denmark and Israel, though not the U.S.

It's not just the lenses that interest Sandhu, a consultant who has worked with the World Bank, Microsoft and other clients. It's the way the Aravind system works. This includes the use of health workers rather than doctors for certain basic procedures—one of a handful of strategies that could promote "lower costs and shorter waiting periods," he says.

Not every expert is as optimistic. Josh Ruxin, an assistant professor at Columbia University's Mailman School of Public Health, says in the U.S., "hyper-technologization of everything" leads to rejection of simple solutions in favor of "the stuff that has some incredibly overly technical basis."

"I think there are a ton of lessons that can be applied in primary care and at community health centers from countries like Rwanda," says Ruxin, who runs a health and poverty program in that country. "But I haven't sensed that the United States is ready for that."

GE Healthcare, a believer, is investing $3 billion over six years in its "Healthymagination" initiative to create low-cost, high-quality products worldwide. It aims to use "reverse innovation," the same development process that produced the MAC 800. GE learned a hard lesson prior to the initiative. "Quite frankly, when we develop stuff in the U.S. and try to make it available for lower-cost markets, it just doesn't work," says Melanie Varin, GE's general manager of marketing for diagnostic cardiology. Products created that way tend to be too expensive for those markets and are unable to capture "the mindset of the local user."

That experience led GE to pursue its current approach, which is outlined in an October 2009 Harvard Business Review article, coauthored by GE's CEO, Jeffrey R. Immelt. "Once products have proven themselves in emerging markets," the article says, "they must be taken global."

This story was produced through collaboration between NPR and Kaiser Health News (KHN), an editorially independent program of the Henry J. Kaiser Family Foundation, a nonpartisan health-care policy research organization. The Kaiser Family Foundation is not affiliated with Kaiser Permanente.

 

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All politics is local, And Nothing more than a local health care

11: 33April 9, 2010.

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Author: Andrew Villegas

If you are moving to the new health rights might somehow knock health issues off political agenda, does not have a breath.

In England, which may cover the upcoming elections are fast, universal is constant political battles, especially over the cuts to the National health service.

Americans may recognize some arguments, although with small spoons: conservative Tories are arguing for more spending on cancer treatment, something not oppose more liberal Labourites. Economist reports that both parties say they will keep expenditure on the NHS for the next several years, and that a large part of their fight still centers around how money is spent on the system.The Economist, the health care system is still one of the three hottest topics this year competitions, writes.

If racing in Great Britain, Michigan and Massachusetts any suggestions of what Americans can expect in the coming years, Republican talk of repealing the law care may be just the beginning.

Villegas is a reporter in Kaiser Health News, nonprofit news service.

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Stupak's Health Legacy Goes Beyond Abortion Battles

1:15

April 9, 2010

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Rep. Bart Stupak of Michigan, who said he won't run for reelection, holds up a tomato at a 2008 hearing on a salmonella outbreak. (Susan Walsh/AP)

Rep. Bart Stupak of Michigan, who said he won't run for reelection, holds up a tomato at a 2008 hearing on a salmonella outbreak. (Susan Walsh/AP)

-->

By Julie Rovner

When staunch abortion opponent Rep. Bart Stupak of Michigan said today that he would retire at the end of this year after 9 terms in Congress, he said: "My main legislative goal was accomplished," referring to health care overhaul.

But he will no doubt be remembered for his thorny but pivotal role as the guy who almost took down that bill over abortion funding.

However, the abortion fight was not this former state trooper's full rap sheet on health matters. He leaves a legacy of collaring the Food and Drug Administration over its lax drug warnings and weak oversight of food safety, too.

So let's get the abortion rehash out of the way first. Back in November, Stupak won language in the House-passed bill that would not merely ban federal abortion funding, but, according to many abortion-rights groups, would have scaled back private abortion funding as well.

That language was modified in the Senate, and Stupak, not wanting to kill the health bill, but neither wanting to compromise his career-long anti-abortion values and voting record, cut an eleventh-hour deal with President Obama.

Under that deal, the President would issue an executive order promising not to interpret the Senate bill to allow any federal abortion funding. Stupak and the band of anti-abortion Democrats said they were satisfied no abortions would be federally subsidized under the new law, and voted for the bill.

Anti-abortion groups, however, were not convinced.

But Stupak leaves a much broader legacy as a member and then the chairman of the powerful oversight subcommittee of the House Energy and Commerce Committee. From that perch he presided over dozens of hearings and investigations, most of them aimed at FDA's shortcomings.

Stupak didn't exactly come at the FDA with a neutral viewpoint. In May of 2000, Stupak's 17 year-old son B.J., committed suicide while taking the acne drug Accutane. That led Stupak to launch a crusade to get the agency to strengthen the warnings about suicidal thoughts associated with some who take the drug.

After taking over the helm of the powerful investigatory subcommittee in 2006, Stupak used his dogged, if a bit plodding, style to play Javert to the FDA's Jean Valjean.

He took the FDA to task for alleged conflicts of interest, for failure to do its job in policing everything from poisoned spinach and peanut butter to the tainted blood thinner heparin.

Stupak played a significant role in the passage of the 2007 law that revamped FDA's food and drug safety powers.

Those accomplishments, however, will almost certainly be overshadowed by the more recent fireworks over abortion.

categories: Health Overhaul

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Abortion Foe Stupak Two Leave Congress

Author Julie RovnerApril 9, 2010Listen to StoryAll Things included [2 min 9 s] add to PlaylistDownload text sizeAAAApril 9, 2010.

Michigan Democrat Bart Stupak announced his retirement today after playing a key role as an opponent of Abortion in the passage of the new health care law.

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MELISSA BLOCK, host:

It is another pension, other large Washington story today.And that is the transition to retirement Michigan Democratic congressman Bart Stupak,. He was facing challenges with candidates on both sides of the debate on abortion and announced today that it will not work on 10th term.

First, we're going to hear more on this story from NPR's Julie Rovner.

JULIE ROVNER: Stupak represents your entire swath of Northern State, socially conservative, but politically moderate zone were his pro universal healthcare credentials, anti-abortion have served him well for most of the last two decades in fact said in a news conference in Marquette, his voice to push new right care over the finish line helped persuade it to order early.

Representative BART STUPAK (Democrat, Michigan: After 18 years, we have already achieved what you send me to Washington to do: health care for all Americans.

ROVNER: Besides Stupak came close to not vote for the Bill. He voted last November for BOM House only after adding hotfixes to impose strict restrictions on abortion.It was great to causes anti-abortion.And it almost immediately drew primary challenge from Democrat who supports abortion rights.

However, the language's Stupak not survive was considered to be more restrictive than current law and cropped when you return to the Senate. Now in Senate abortion language displeased both sides, like many compromises and vote's Stupak was probably needed to pass the Bill, when they returned home last month But wanted to vote for him. I just hours before the historic vote, Stupak residing transaction with President Obama. Would vote for the Bill. The President promised to not interpret the new law to allow more federal funding for abortion, than at present.

Still groups anti-abortion dubbing, traitor to cause him.Dan Benishek is doctor of Michigan's Upper Peninsula, which acts as a Republican in the district's Stupak.

Dr. DAN BENISHEK (surgeon, Michigan first candidate, Republican District): After defining himself as the great cause of pro-life to bail on weak excuse is unbelievable to me.

ROVNER: Most pundits agree Stupak probably could have kept his seat, but former State trooper said he simply tired fight.

Julie Rovner, NPR news in Washington.

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