Health care is top-spending legislative lobby in Kentucky

Kentucky's health-care industry spent about $1.5 million, more than any other industry, to lobby state legislators in  in the first four months of the year.

"Health care spending was led by hospital operators, who spent about $300,000, including Kentucky Hospital Association ($56,000), Norton Healthcare ($44,631), Baptist Healthcare System ($42,800) and St. Elizabeth Healthcare ($28,182)," the Lexington Herald-Leader's Jack Brammer writes, from a report by the Kentucky Legislative Ethics Commission.

Pharmaceutical companies and pharmacies spent the second highest amount, about $281,000. That includes contributions from the Consumer Healthcare Products Association ($67,333), Pharmaceutical Research & Manufacturers of America/PhRMA ($23,362), Amgen ($19,389), Glaxo SmithKline ($18,500), American Pharmacy Cooperative ($18,000) and Pfizer ($15,000).

Other big spenders include the Kentucky Medical Association ($71,415); All Things Good, a Louisville-based chiropractic business ($65,000); Kentucky Optometric Association ($61,604); and Kentucky Academy of Eye Physicians & Surgeons ($26,000).

A total of about $7 million was spent on legislative lobbying in Kentucky in the first four months of 2011. About $6.5 million of that was spent by 660 employers of lobbyists and about $445,000 was spent by lobbyists themselves. The insurance industry, which is often related to the health industry, spent about $354,000. Energy and utility interests like coal and natural gas spent $516,000. Reports filed by employers and legislative agents are compiled on the Legislative Ethics Commission's website. For the Herald-Leader story, go here.

Watching 3-D movies may strain eyes but doesn't harm them and can help detect vision impairment, optometrists say

With summer blockbusters set to be released in the coming months, the Kentucky Optometric Association says watching 3-D movies is not harmful to eyes, but can cause eye strain and headaches.

To help with those conditions, the association recommends sitting farther back from the movie screen.

In some cases, some viewers won't be able to recognize 3-D pictures because they lack binocular vision. "Although this doesn't pose any problem viewing the screen, it serves as a vision screening that something is abnormal with the viewer's binocular vision," the association says in a news release used by the Journal-Enterprise of Providence.

"That means 3-D actually has a benefit," said Dr. Joe Ellis, an optometrist in Benton and president of the optometric association. "It can alert people to undetected vision disorders and eye diseases that, if caught early, are fully treatable."

Viewers might consider seeing an optometrist or ophthalmologist if they get headaches while watching 3-D, if they feel nauseous or dizzy after viewing or if it is difficult for their eyes to adjust back to normal after viewing. (Read more)

National system needed to battle pill abuse, newspaper says

Despite Georgia's recent move to implement a system that will track prescription pill use, a national system is needed to help prevent the problem flowing "to the next crack in the system," the Lexington Herald-Leader says in an editorial today.

"We know it's popular now to howl about big government," the paper says. "But if a national government has any legitimate use, it is certainly to stop something like the pill pipeline that operates across state lines. . . . "As long as even a few states don't have monitoring systems the market will move to those areas of opportunity."

The piece cites a story that ran in the Herald-Leader May 17. In it, reporter Bill Estep discussed Georgia's move to approve a tracking system, meant to prevent people from "doctor shopping," filling the resulting prescriptions and selling the pills illegally. "Florida has been the leading source of pills flowing into Kentucky from outside the state, but Georgia has been a growing source of concern," Estep reported.

While Georgia's monitoring system is approved, money is still needed to fund it. "We hope Georgia will get those grants. But we'd be more optimistic if funding weren't based on hope," the paper says. "There's every indication the rate of prescription drug abuse is outpacing the monitoring system."

The editorial notes that overdose deaths in Kentucky continue to rise, doubling from 403 in 2000 to 978 in 2009: "Confirmed overdose deaths in Floyd County jumped from 15 in 2009 to 43 in 2010, according to Brent Turner, the commonwealth's attorney there. Florida averages seven overdose deaths a day." (Read more)

More Americans are choosing health insurance with high deductibles, lower premiums; study says that strategy pays off

In order to pay lower premiums on their health insurance, Americans are opting for plans that have cheaper  monthly premiums but higher deductibles, USA Today's Kelly Kennedy reports.

In 2007, about 4.5 million people opted for high-deductible plans. By 2010 that number had more than doubled to 10 million, an America's Health Insurance Plans survey found. Having high deductibles saves $85 to $100 a month on premiums, but runs the risk of paying more when services are used. It's important for purchasers to understand that lower premiums can mean higher doctors' bills, said Karen Ignagni, president of the industry group.

However, a RAND Corp. study found that people on high-deductible plans pay considerably less than people on traditional plans. "RAND researchers also found that people on high-deductible plans — no matter their income level — received less preventive care: fewer annual exams, fewer cervical cancer screenings and fewer colonoscopies," Kennedy reports. The federal health reform law is preventing some of that from happening, however. Now, most high-deductible plans have to include basic preventive care like colonoscopies.

High-deductible plans are expected to become more common, especially since 47 percent of people who are insured through their employers have high-deductible plans. "Employers like the plans because it's cheaper to insure an employee — about $133 less per family at companies that offer only the high-deductible plans, according to a study in the American Journal of Managed Care," Kennedy reports. (Read more)

Teenager set to return to Haiti after Louisville docs fix her heart

After Louisville doctors performed a life-saving operation on her failing heart, a 16-year-old girl is set to return to her native Haiti. Stephanie Privert, left, came to Kentucky after she became ill following the deadly 7.0-magnitude earthquake that devastated the country, The Courier-Journal's Chris Kenning reports. (C-J photo by Pam Spaulding)

"We hate to see that she's obliged to return to a tough situation, but we can't keep her here forever," said Dr. Erle Austin, the lead heart surgeon during Privert's operation. "She's so much better than when she arrived."

Privert was watching her mother cook soup when the earthquake struck. Her family was able to escape, but her home near Port-au-Prince was destroyed. Privert's health quickly deteriorated and she was brought to a clinic run by American doctors from Medical Teams International. Deciding she could not be treated in hospitals in Haiti or neighboring Dominican Republic, the doctors got in touch with non-profit group Healing the Children, which has a chapter in Louisville. Its members helped her fly to Kentucky. She arrived weighing just 70 pounds.

Doctors determined she had a leaking heart valve, which was causing severe pulmonary hypertension and lung problems, Kenning reports. In August, doctors at Kosair Children's Hospital decided to repair the valve, rather than replace it with a mechanical one, which would require expensive anti-rejection drugs, or a pig valve that would wear out more quickly.

Since, she has been recovering, staying with host families, learning English and attending school. The Haitian Christian Outreach has raised money needed to start rebuilding Privert's family home in Haiti. (Read more)

Rural Training Track programs get more health professionals to rural areas, but live 'on the edge' of funding and personnel

By Tara Kaprowy
Kentucky Health News

With the Obama administration offering more funding to improve rural health care, Rural Training Track programs to steer medical students to rural areas are hoping to expand, a move that would benefit underserved areas of Kentucky.

"Over 62 million Americans live in rural America and there is a significant crisis in terms of having access to care for these people," said Amy Elizondo, vice president of program services at the National Rural Health Association. "There is a very uneven distribution of health care professionals and an acute shortage of primary care physicians in rural areas. If we can recruit and retain physicians to serve rural areas, we improve access for rural America." (University of Washington map; click for larger version)

RTT programs aim to educate family physician residents in rural environments with the hope they will continue to practice there, Candi Helseth reports in a deailed article for the Rural Assistance Center. "These residency programs are a proven model for addressing rural family physician workforce shortages, with more than 70 percent of graduates praticing in rural areas," Helseth reports. The first such program started in Colville, Wash., in 1985. There are 25 RTTs in 17 states, including one in Morehead by the University of Kentucky and St. Claire Regional Medical Center. Eight physicians have graduated from the program there since it was established in 2000, five of whom are practicing in Kentucky. Of those five, three have joined the SCR medical staff.

There are similar success stories across the country. In Caldwell, Idaho, 95 percent of graduates have chosen to practice in rural areas over the past 16 years. "We heavily recruit residents who are rural-oriented," said Dr. Samantha Portenier, a practicing physician and director of the Caldwell RTT. "We've had some who were not and we converted them. Part of it was that they really saw where the training we give them and the skills they learn are so needed in rural areas. I emphasize that in rural areas you can specialize in areas that particularly interest you."

Despite the success, 10 RTT programs have closed in the past 10 years. "Every RTT lives on the edge in terms of funding," said Dr. Randall Longenecker, who is project director of Rural Training Track Assistance Demonstration Project. "In general RTTs are small, have limited faculty and are vulnerable to personnel changes, a bad year for recruiting, loss of funding and many other factors beyond their control."

Morehead's RTT is funded by St. Claire. Residents spend their first year at the UK College of Medicine in Lexington and their second and third years at St. Claire, which is accredited by the Accreditation Council for Graduate Education. Carla Terry, St. Claire's graduate medical education coordinator, acknowledged the difficulty in maintaining an RTT program. "The reason why the RTTs are in jeopardy is that all the faculty that teach them are voluntary," she told Kentucky Health News. "They are not paid to teach, they still have to keep their patient load. If it were a university program, all the faculty would be paid."

But St. Claire physicians believe strongly in rural-based education and also see how they can benefit from their investment. "We actually had a physician that when he came here he was interested in starting a residency because he wanted to use that as future recruitment," she said. "We look at it as training future partners."

Now, RTTs are under a federal microscope. The health care reform law created the Rural Training Track Assistance Demonstration Project, a three-year pilot program that plans to "collect comprehensive information to better understand the collective forces challenging RTT models and develop solutions that will strengthen existing RTTs and encourage development of new RTTs," Helseth reports.

The time is ripe, given that more medical students are choosing to be family medicine physicians, up by 11 percent last year and 8 percent the year before. "We have a real opportunity here to redefine the importance of primary care being foundational in rural workforces," Dr. Ted Epperly, past president and past board chairman of the American Academy of Family Physicians, told Helseth. "Right now, only 9 percent of physicians are choosing to practice in rural areas while 20 percent of the population lives there. RTTs offer a way to give family physicians a broad scope of practice, which they need practicing in a rural area, and to get them to stay in those rural areas." (Read more)

Fight is on against mosquitoes, West Nile virus after flooding

The fight is on to rid Western Kentucky of a mosquito infestation  worsened by recent flooding. Treatment to kill adult mosquitoes began Wednesday night, The Gleaner of Henderson reports.

The effort is partly to prevent the spread of the West Nile virus, a potentially serious illness. Mild infection can result in fever, headache, body ache and a skin rash. Severe infection, which affects about 1 in 150 infected people, can lead to high fever, disorientation, sleepiness and even coma, paralysis and death. Mosquitoes can transmit the infection to humans with a bite. (Centers for Disease Control and Prevention diagram)

The state's plan is a two-part process, killing adult mosquitoes and their larvae. It uses aerial spraying over 700,000 acres in Western Kentucky, concentrating on areas along or near waterways where flooding was most problematic. Planes will spray from dusk until after midnight until treatment is complete. Afterward, ground crews with the Transportation Cabinet will treat against mosquito larvae in standing water. The state Department of Agriculture will also spray ditch lines along roads. Chemicals used in the treatments are only harmful to mosquitoes, gnats and black flies, a state press release reads. It is safe for humans, pets and livestock.

Residents are asked to eliminate standing water in containers on their property and wear insect repellent and long-sleeved clothing. (Read more)