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Triglycerides Implicated In Diabetes Nerve Loss
A common blood test for triglycerides - a well-known cardiovascular disease risk factor - may also for the first time allow doctors to predict which patients with diabetes are more likely to develop the serious, common complication of neuropathy.

Spend More, Get Less? The Health Care 'Conundrum'
On NPR"s Fresh Air, New Yorker staff writer Atul Gawande spoke about his article on the high cost of health care in McAllen, Texas. He found that costs in McAllen were higher than in the rest of the country because doctors ordered more tests and treatments for their patients, which did not result in a better quality of care. Gawande told NPR that "the difficulty comes in the conflict between when medicine is a business versus when it"s a profession. In a grey-zone case, whether a patient should get that endoscopy for heartburn, whether you send them to have a particular operation like a carpal-tunnel release for carpal tunnel syndrome, we make more money, and there is a temptation and a strong incentive to do more rather than less. At the same time, if we"ve crossed the border to the point where over-treatment is actually producing harm, we now have to think about how to rein in that part of what we do, even though it can sometimes mean losing money."
News of the day
Report Examines Zimbabwean Refugees In South Africa
According to a report released Tuesday by Medicins Sans Frontiers (MSF), "Zimbabweans continue to cross the border [into South Africa] every day, legally and illegally, in massive numbers as a matter of survival," AFP/Google.com reports (AFP/Google.com, 6/2). An estimated "three million Zimbabweans - about a quarter of the entire population" have fled "the economic collapse and human rights abuses at home, as well as a cholera outbreak that has infected about 100,000 people," according to the BBC, and the "inauguration in February of a fractious power-sharing government in Zimbabwe has not stemmed the flight" (BBC, 6/2).
Endocrinology

Senate Panel Advances Health-Care Overhaul, But Battle Lines Sharpen

"President Obama"s ambitious drive to overhaul the nation"s $2.3 trillion health-care system cleared a key Senate committee yesterday. But the administration was promptly buffeted by criticism from some of the industry players and moderate Democrats it has courted for months, calling into question the prospects for a bipartisan landmark bill," The Washington Post reports. This is the "the first time in 15 years a congressional panel has endorsed coverage for all. ̣€¦ But the 13 to 10 party-line vote, after rancorous comments by the top Republican on the committee, underscored the mounting tensions in Congress and the country over the president"s signature item. From one end of Pennsylvania Avenue to the other, lawmakers, lobbyists and the president himself all moved quickly to position themselves for the intensifying battle." Meanwhile, "Senate Finance negotiators last night were working to resolve a number of issues, including how to structure a consumer-run insurance co-operative and how to address abortion. They also were struggling to close the financial gap, with Democrats pushing for additional tax increases and Republicans pressing to carve back subsidies" (Connolly and Montgomery, 7/16). The New York Times reports that the Senate"s "partisan split signified potential trouble ahead. Republicans on the panel, who voted unanimously against the measure, described the idea of a new public insurance option as a deal-breaker. They said they still hoped that a consensus bill would emerge from the Senate Finance Committee." Meanwhile, "Senators said the White House had been sending mixed signals. For months, they said, it emphasized the need for a bipartisan bill. But in the last 10 days, one Democrat said, the message has been: "Hurry up. If you have to go without Republicans, it"s not the end of the world."" "It is unclear how long the White House and Democratic leaders in Congress will give [Senator Max] Baucus to work things out," but Republicans said they were prepared for the possibility that Mr. Baucus or leaders of his party would lose patience and plow ahead on their own, in the absence of a bipartisan agreement" (Pear and Herszenhorn, 7/15). Meanwhile, the Christian Science Monitor reports, "[A]cross town, Republican senators said that the Senate"s proposed fix for the healthcare problem would only make things worsẹ€¦ At the GOP press conference, defeated presidential candidate Sen. John McCain (R) of Arizona said that the health bill would add another $1 trillion on top of the debt already accumulated in the fight against the recession" (Grier, 7/15). CNN: The bill "includes a government-run health insurance program that would compete with private insurers, requires companies with more than 25 employees to provide medical coverage for their workers and sets up an "exchange" that would let people choose among a variety of insurance options." Bloomberg: "The Congressional Budget Office issued a preliminary estimate of the health committee bill, saying it would cost $611 billion over 10 years. That estimate did not include a provision to expand Medicaid, the U.S. government program for the poor, to those earning 133 percent of the federal poverty rate. The national standard would replace the current system in which states set their own thresholds for Medicaid eligibility. The budget office said the health committee plan may still leave 15 million to 20 million people uninsured" (Gaouette and Larkin, 7/15). The Wall Street Journal: "Senate aides say that the Finance Committee"s proposal for new fees on insurers would be based on market share. It"s not clear if any new government-run plan would have to pay the assessment" (Meckler, 7/16). The Los Angeles Times: "Sen. John. D. Rockefeller IV (D-W.V.) said, "The insurance companies are the people who are just rapaciously, greedily, unstoppably making money by underpaying the patient, underpaying the provider and by overpaying . . . themselves"" (Levey and Nicholas, 7/16). This information was reprinted from kaiserhealthnews.org with kind permission from the Henry J. Kaiser Family Foundation. You can view the entire Kaiser Daily Health Policy Report, search the archives and sign up for email delivery at kaiserhealthnews.org. © Henry J. Kaiser Family Foundation. All rights reserved.


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