Morning Briefing
Summaries of health policy coverage from major news organizations
From 麻豆女优 Health News - Latest Stories:
麻豆女优 Health News Original Stories
Kaiser Permanente Faulted Again For Mental Health Care Lapses In California
Following up on a critical report in 2013, the California Department of Managed Health Care found Kaiser Permanente had not resolved concerns about providing timely and appropriate access to treatment.
May I Move My Son From My Insurance Plan To A Better Option On The Marketplace?
KHN consumer columnist Michelle Andrews answers readers鈥 questions about enrolling at this point in marketplace plans, CHIP enrollment and Medicare disability.
Summaries Of The News:
Health Law
IRS Issues Reprieve To Those Who Filed Taxes Before Faulty Forms Were Detected
The Internal Revenue Service won鈥檛 collect any additional taxes from about 50,000 people who already have filed returns using an incorrect government form on their coverage under the federal health insurance exchange. About 800,000 people who obtained insurance on the federal exchange received incorrect tax statements, known as 1095-A forms, regarding their 2014 coverage. Some of the 50,000 who filed using those forms may have owed more had they received the correct statements. The IRS won鈥檛 collect those additional taxes, a senior Treasury Department official said. (Armour, 2/24)
The Treasury Department has an easy fix for taxpayers who filed their returns using inaccurate data sent by HealthCare.gov: They don鈥檛 have to do anything at all. Last week, the federal government said that it sent incorrect tax forms to about 800,000 people who bought insurance through the federal health care exchange. An estimated 50,000 taxpayers had already filed their returns using inaccurate information. (Siegel Bernard, 2/24)
Taxpayers who've filed their 2014 returns only to learn that the government provided them with erroneous information on health care subsidies won't be required to submit corrected returns, the Treasury Department said Tuesday. The decision amounts to a reprieve from paperwork headaches for an estimated 50,000 early filers, out of a pool of some 800,000 HealthCare.gov customers affected by a tax reporting goof disclosed last week. (Alonso-Zaldivar, 2/24)
The Obama administration took a step on Tuesday toward containing the damage from sending the wrong Obamacare tax data to hundreds of thousands of taxpayers. The 50,000 taxpayers who filed returns based on inaccurate subsidy data they got from the government will not need to file amended returns and the IRS won鈥檛 collect for any underpayment, the Treasury Department said. (Snell, 2/25)
People who have already filed their taxes using one of the erroneous health insurance forms sent by the federal government will not be required to file an amended return or owe additional taxes, the Treasury Department said Tuesday. About 800,000 consumers who have health insurance purchased on the federal exchange were contacted beginning late last week because the 1095-A tax form sent by the Centers for Medicare and Medicaid Services contained a mistake in the benchmark plan used to calculate how much tax they owe. (O'Donnell and Ungar, 2/24)
Stakes Are High In Supreme Court's Review Of Health Law's Subsidies
Twenty-two out of 24. And 206 to 96. Those numbers tell much about the political impact of a Supreme Court case in which conservatives and Republicans hope to demolish a pillar of President Barack Obama's health care overhaul. ... Here's why. Of the 24 GOP senators facing re-election in 2016, 22 are from states using the federal marketplace. ... In addition, in the 37 federal marketplace states, 206 House members are Republicans and 96 are Democrats, including one GOP vacancy. (Fram, 2/25)
The Obama administration's most significant legislative achievement is now, once again, teetering before the Supreme Court. The justices aren't weighing the fate of the entire statute this time. In fact, the dispute concerns what Congress meant in just four words in one section of the law. But the impact could be nearly as dramatic. (de Vogue, 2/25)
Neither the Obama administration nor the states nor Congress is taking aggressive action to fix a potential problem with the Affordable Care Act, even with a Supreme Court decision looming that could raise the prices for health insurance for more than 6 million people in 34 states. (Bacon, Jr., 2/24)
The stakes are getting higher in the looming Supreme Court case that threatens to rip apart the president鈥檚 health care law. A new Gallup poll released today shows that Obamacare鈥檚 provisions are largely responsible for driving America鈥檚 uninsured rate down to a 7-year-low鈥攆urther illustrating how serious an adverse ruling could be for millions of people who currently have coverage under the law. (Ehley, 2/24)
Burwell: No Back-Up Plan If High Court Overturns Obamacare Tax Credits
The Obama administration told Congress on Tuesday that it had no plans to help low- and moderate-income people if the Supreme Court ruled against the administration and cut off health insurance subsidies for millions of Americans. Sylvia Mathews Burwell, the secretary of health and human services, said a court decision against the administration would do 鈥渕assive damage鈥 that could not be undone by executive action. (Pear, 2/24)
The Obama administration has no way to repair the damage that would result from a Supreme Court decision against Obamacare that would make health care unaffordable for millions of Americans, a top health adviser said on Tuesday. The Supreme Court is expected to rule by the end of June on whether residents in at least 34 U.S. states are eligible for federal tax subsidies to help them buy health coverage under President Barack Obama's Affordable Care Act. Oral arguments are scheduled for March 4. (Abutaleb, 2/24)
Supporters and opponents of the challenge agree that if the court abruptly rules the credits invalid, the impact on the law would be considerable. That is where the consensus ends. Supporters say this disruption is a reason the court should uphold the tax credits. Opponents maintain the Obama administration is being irresponsible by refusing to detail solutions. 鈥淭his letter is clear and it is consequential. If the Supreme Court rules against the administration, President Obama does not have the authority to use administrative actions to undo the decision,鈥 said [Sen. John] Barrasso, who is one of three Senate Republicans tasked by Majority Leader Mitch McConnell with shaping a GOP replacement plan if the court sides with the challengers in the case. 鈥淩epublicans are preparing for the ruling and are committed to helping the millions of Americans who have been hurt by the White House鈥檚 decision to illegally implement Obamacare.鈥 (Radnofsky, 2/24)
The letter from Health and Human Services Secretary Sylvia M. Burwell continued the administration's tough stance in its building confrontation with Republican lawmakers in advance of an expected Supreme Court decision in June. In that case, conservatives and Republicans argue that Obama's 2010 health care law only provides government subsidies for people buying health coverage through marketplaces established by the states. Just 13 states established their own marketplaces, while the remaining 37 use the federal government's HealthCare.gov. (Fram, 2/24)
Burwell acknowledged the severe damage that a decision against the administration would cause. 鈥淔irst, millions of people would lose their health insurance subsidies and therefore would no longer be able to afford health insurance; second, without tax subsidies healthy individuals would be far less likely to purchase health insurance, leaving a disproportionate number of sick individuals in the (non-group) market, which would raise the costs for everyone else; and, third, states that did not establish a state marketplace would return to a time when the recourse for those without insurance was to seek care in hospital emergency rooms, further driving up insurance costs for everyone,鈥 Burwell wrote. (Pugh, 2/24)
If the Supreme Court rules against a key Obamacare provision, the White House won鈥檛 be able to save it. On Tuesday, Health and Human Services Secretary Sylvia Mathews Burwell told lawmakers on Capitol Hill that the Obama administration has no tricks up its sleeve to manage the potentially looming disaster if the Court strikes down federal subsidies for millions of Americans in the 37 states that rely on the federal exchange. (Ehley, 2/24)
The case, King v. Burwell, involves the tax credits meant to subsidize health insurance under President Barack Obama's landmark health law. The Affordable Care Act says people who sign up for health insurance through state-run exchanges are eligible for federal credits, but doesn't state specifically that people who enroll on the federal exchanges also qualify. The tax subsidies are essential to Obamacare's success; the vast majority of people who have enrolled receive some type of credit. (Acosta and Liptak, 2/24)
The case, King v. Burwell, involves the tax credits meant to subsidize health insurance under President Barack Obama's landmark health law. The Affordable Care Act says people who sign up for health insurance through state-run exchanges are eligible for federal credits, but doesn't state specifically that people who enroll on the federal exchanges also qualify. The tax subsidies are essential to Obamacare's success; the vast majority of people who have enrolled receive some type of credit. (Williams, 2/24)
Half Of Obamacare Enrollees Must Pay Back Part Of Insurance Subsidies
A majority of ObamaCare customers, 52 percent, are being forced to pay back some of their subsidies during this year鈥檚 tax season, according to new data from H&R Block. Customers are paying back an average of $530, which has caused a 17 percent drop in the average return so far this spring, according to the analysis by the tax services giant. (Ferris, 2/24)
More than half of Obamacare enrollees are having to cough up hundreds of dollars for Uncle Sam this tax season because they received too big a premium subsidy, according to a new study released Tuesday. And Americans who remained uninsured in 2014 are paying a higher fine than they expected, too. (Bade and Wheaton, 2/24)
The government鈥檚 top healthcare watchdog plans to amplify its focus on ObamaCare this year, with a particular focus on subsidies and the security of personal data. The auditor鈥檚 office in the Department of Health and Human Services (HHS) announced Tuesday that it will add between five and 10 investigations specifically on ObamaCare this year. (Ferris, 2/24)
About 13,000 people with accounts in the Washington Healthplanfinder insurance exchange were sent emails Monday that indicated a payment of their monthly health insurance premium had been made automatically. There was one problem. In many cases, many of them saw three times the correct amount deducted from their bank accounts. (Marshall, 2/24)
MNsure is still working to get tax documents out to about 3,500 people who purchased private health coverage for last year through Minnesota's health insurance exchange. (Zdechlik, 2/24)
Fight Over Medicaid Expansion Creating Stark North-South Divide
When it comes to health care coverage, America is becoming a land of geographically based haves and have-nots. States with the lowest uninsured rates are clustered in the Northeast and upper Midwest, while those with the highest rates of uninsured Americans are mostly in Southern states such as Georgia and Louisiana, according to a new study from Gallup. One reason is that many Southern states opted out of expanding Medicaid coverage under Obamacare. (Picchi, 2/24)
Gov. Gary Herbert's proposal to expand Medicaid passed a key test Tuesday afternoon as Utah's Republican-controlled Senate voted to give an initial approval of the plan. After an hour-long debate, the Senate voted 21-8 to advance the plan for a final vote in the chamber, which is expected to happen Wednesday. Final approval in the Senate would send the measure to the House, where it will face a chilly reception. (Price, 2/25)
The Utah Senate voted 21-8 Tuesday to send Gov. Gary Herbert's Healthy Utah plan for a final vote, which could come as early as Wednesday. "We're just passing the buck if we don't do something," said Sen. Todd Weiler, R-Woods Cross, who voted yes. "We're delivering health care to many of these people, but we're doing it in the most expensive way possible: through emergency rooms and prisons," Weiler said. Several of the senators indicated they may change their "yes" vote to "no" on the final vote, but even if they do, Senate Bill 164, sponsored by Sen. Brian Shiozawa, R-Cottonwood Heights, is likely to pass the Senate. (Moulton, 2/24)
In Oregon, the legal battle between the state and Oracle over the computer system used for the Oregon's Medicaid program is intensifying.
Four days before a contract to host Oregon's health insurance system for low-income Oregonians is due to expire, state officials asked a judge on Tuesday to force technology contractor Oracle Inc. to continue running the system. Lawyers representing Oregon told Marion County Circuit Judge Courtland Geyer during the first of a two-day hearing that Oracle's plans to pull hosting services would result in Medicaid enrollment grinding to a halt. That, in turn, would cause "irreparable harm" to thousands of people who would not be able to enroll in Medicaid and access health services, said attorney Lisa Kaner, who represents the state. (Wozniacka, 2/24)
In other Medicaid news -
Due to an unexpected federal policy reversal sought by advocates for nearly 10 years, schools could start billing Medicaid for health services such as asthma screenings, vaccinations and care for chronic diseases provided to some low-income students. (Gaitan, 2/24)
Marketplace
FBI Closing In On Culprits Behind Massive Cyberattack On Anthem's Database
The FBI said it鈥檚 close to finding the hackers responsible for the attack on health-insurance company Anthem Inc. that exposed personal data on about 80 million customers. Federal Bureau of Investigation officials are still deciding whether to publicly reveal information about the attackers in one of the biggest thefts of medical-related customer data in U.S. history, Robert Anderson, the bureau鈥檚 executive assistant director for cybersecurity, said Tuesday. (Strohm, 2/24)
Health insurer Anthem Inc. said the database that was penetrated in a previously disclosed hacker attack included personal information for 78.8 million people, including 60 million to 70 million of its own current and former customers and employees. The figures, provided by an Anthem spokeswoman, provide extra detail beyond what Anthem disclosed earlier this month, which was that the compromised database included records for around 80 million people. (Wilde Mathews, 2/24)
Social Security numbers, names and addresses for millions of people who aren鈥檛 customers of Anthem Inc. may have been breached in a massive cyberattack disclosed by the health insurer earlier this month. Anthem, which runs Blue Cross and Blue Shield plans in 14 states, believes information on 78.8 million people was accessed by hackers. Of those, about 60 million to 70 million were customers of the Indianapolis, Indiana-based insurer, spokeswoman Kristin Binns said in an e-mailed statement Tuesday. (Pettypiece, 2/24)
Health insurance giant Anthem Inc. said 13.5 million Californians were affected by the company's massive data breach that was disclosed earlier this month. The nation's second-largest health insurer said a cyberattack had exposed names, Social Security numbers, dates of birth and other sensitive details on up to 80 million Americans. (Terhune, 2/24)
More than 300,000 Minnesotans were affected by the massive data security breach reported earlier this month by health insurer Anthem Inc., and the Indianapolis-based company plans to send letters soon about the incident. (Snowbeck, 2/24)
Health insurer Anthem Inc, which earlier this month reported that it was hit by a massive cyberbreach, said on Tuesday that 8.8 million to 18.8 million people who were members of other Blue Cross Blue Shield plans could be victims in the attack. (2/24)
Insurer Anthem Tuesday acknowledged in a new financial filing that its recent data breach involving 80 million people could result in 鈥渟ignificant鈥 expenses that its cybersecurity insurance policy may not fully cover. Some observers were quick to note the disclosure was likely done as a defensive measure by Anthem, trying to alert investors to any and all possible outcomes from the breach to preclude future lawsuits for failing to disclose key financial information. The disclosure was in the company's annual 10-K report filed with the Securities and Exchange Commission. (Herman, 2/24)
Medical identity theft jumped 22 percent last year as more U.S. health data becomes electronic and easier for cyber criminals to steal from doctors鈥 offices, hospitals and insurers. Incidents of medical identity theft in 2014 saw almost 500,000 people fall victim to sham companies committing insurance fraud, or impostors seeking free medical care, according to a report released this week by the Ponemon Institute, a Traverse City, Michigan-based data-privacy research firm. (Pettypiece, 2/24)
Capitol Watch
Rehab Hospitals Lobby To Keep Payments Away From 'Doc Fix' Cuts
A trade group representing rehabilitation hospitals is pressuring Congress not to cut programs it cares about to offset the cost of paying doctors under Medicare. Officials with the American Medical Rehabilitation Providers Association are meeting with members of the Senate Finance Committee, House Ways and Means Committee and other lawmakers on Tuesday as part of a push to prevent the cuts. (Sullivan, 2/24)
Physicians who treat Medicare patients wouldn't be the only health professionals to feel pain if Congress fails to step in to avert scheduled payment cuts at the end of March, or permanently repeal the formula that dictates them. Any provider who is paid for services under the Medicare physician fee schedule would be affected by the reductions prescribed by the oft-criticized sustainable growth formula, or SGR. The cohort includes nurse practitioners, physician assistants, psychologists, social workers, physical therapists and diagnostic testing facilities. (Attias, 2/24)
Health IT
Study: Electronic Health Records Lead To More Patient-Doctor Collaboration
When Stacey Whiteman was diagnosed with multiple sclerosis two years ago, she didn鈥檛 realize the toughest challenge would be its impact on her brain. The 53-year-old from Massachusetts was forced to quit work as an executive assistant after becoming easily confused and prone to forget, even about priorities like doctor appointments. When her physician suggested OpenNotes, an electronic portal allowing patients full access to their medical records, including doctors鈥 notes, Whiteman was eager to log on. (Belisomo, 2/24)
The Defense Department has eliminated PricewaterhouseCoopers and its bid partners from contention for a 10-year, $11 billion contract to modernize its electronic health-record system. The consultancy acknowledged in a statement that its bid is out of the running. The consulting firm last month created a buzz by name-dropping Google as a partner on its proposal to build the new Defense Department EHR system on the open-source code for the Veterans Affairs Department's VistA system. The bid team also included EHR vendors DSS and MedSphere, and systems integrator General Dynamics Information Technology. (Tahir, 2/24)
Public Health
Newspaper's HPV Vaccine 'Expos茅' Scrutinized After Criticism
The Toronto Star鈥檚 front-page feature on the 鈥渄ark side鈥 of a widely-used HPV vaccine had all the makings of a blockbuster: a grim, gripping headline, vivid accounts from teenagers who died or were debilitated, a wrenching image of a woman holding a framed photo of her dead daughter. But it lacked a crucial component of any scientific investigation: good data. (Kaplan, 2/25)
Deaths from prescription narcotic painkillers have soared as the opioid drugs became more popular and powerful, a new federal study found. Four out of five people who used a prescription narcotic painkiller in 2011 to 2012 took pills equal to or stronger than morphine, according to statistics made public Wednesday by the Centers for Disease Control National Center for Health Statistics. The percentage of people who took painkillers stronger than morphine, which include such drugs as fentanyl, hydromorphone, methadone and oxycodone, grew from 17% in 1999 to 37% in 2012, the study found. (Leinwand Leger, 2/25)
State Watch
California Regulators Fault Kaiser Permanente For Mental Health Care Delays
For the second time in two years, California regulators slammed HMO giant Kaiser Permanente for causing mental health patients, including some who were severely depressed or suicidal, to endure long delays for treatment. The state Department of Managed Health Care said in a report Tuesday that some Kaiser patients continue to wait weeks to see therapists and psychiatrists. The agency also criticized Kaiser for giving patients misleading information about the extent of their mental health coverage. (Pfeifer and Terhune, 2/24)
For the second time in two years, the state of California has faulted HMO giant Kaiser Permanente for failing to provide patients with appropriate access to mental health care. Some Kaiser patients still have to wait weeks or even months to see a therapist or psychiatrist, which violates state laws intended to ensure timely access to mental health treatment, the state Department of Managed Health Care said in a report released Tuesday. (Gold, 2/25)
The New Mexico Senate has passed a proposal that would require some New Mexico residents with severe mental illness to receive court-ordered outpatient treatment. Senators approved Tuesday by a 30-11 vote a measure strongly supported by mental health advocates. (2/24)
A state-run mental hospital in Iowa fired three workers because administrators say the three didn't act quickly enough when they noticed a patient trying to hang himself. The Mental Health Institute in Mount Pleasant has also made several changes to better protect patients in response to the Oct. 19 incident, which revealed safety gaps. The hospital is one of two that Gov. Terry Branstad is seeking to close. (2/24)
State Highlights: Pa. House OKs 'Chemo Parity' Bill; Texas Lawmakers Push To Expand Experimental Drug Access
Patient and physician groups cheered Monday as the Pennsylvania House overwhelmingly passed legislation to equalize patients' out-of-pocket costs for oral and intravenous cancer drugs. Patients currently may be charged thousands of dollars a month for cancer pills, vs. a $50 co-payment for a dose of a drug given through a vein, because most insurers cover the two formulations in different ways. (McCullough, 2/25)
It鈥檚 kind of like Dallas Buyers Club: A group of sick Texans is seeking to gain access to experimental drugs 鈥 only this time, a flurry of state lawmakers is rushing to help them. Eleven of Texas' 31 state senators have put their names on a proposal that would allow terminally ill patients to try investigational drugs that have passed at least the first of three FDA trial phases, once the patient has exhausted other treatment options. There is a similar proposal in the House. (Walters, 2/25)
Nearly half the states use higher copayments to dissuade Medicaid recipients from unnecessary visits to emergency rooms, where care is more costly. These states require patients to make the payments, which are as high as $30 per visit in Oklahoma, when it is later determined that they did not experience a true medical emergency. (Ollove, 2/24)
Legislative budget writers are continuing their review of budget requests for one of Delaware's biggest government agencies, the Department of Health and Social Services. Wednesday's agenda includes a discussion of the Medicaid and medical assistance programs, which account for more than half of the entire department's budget. (2/25)
The long-awaited 鈥淐TCA bill鈥 has finally arrived 鈥 and Georgia鈥檚 hospital industry immediately pounced on it in opposition. Legislation that would end major regulatory restrictions on the Cancer Treatment Centers of America鈥檚 hospital in Newnan was introduced in the Georgia General Assembly on Tuesday. The lead sponsor is state Rep. Wendell Willard (R-Sandy Springs), chairman of the House Judiciary Committee. (Miller, 2/24)
Tenet Healthcare Corp. remains bullish on Texas. ... The Dallas-based company, which operates in 16 states, doubled its revenue from Texas in 2013 when it acquired Nashville-based Vanguard Health Systems. Since then, it has steadily added Texas assets. (Jacobson, 2/24)
On Monday, the bill to expand scope-of-practice for nurse practitioners returned to the Legislature with a provision to allow NPs to prescribe medication. (Gorn, 2/24)
If your infant has a high fever or you鈥檙e experiencing an unusual pain in your abdomen and you live in New Mexico, you may want to call the NurseAdvice line before you do anything else. New Mexico is the only state with a 24/7 registered nurse call center that is free to all residents, whether insured or not. In operation since 2006, it has kept tens of thousands of New Mexicans out of emergency rooms and saved the state more than $68 million in health care expenses. (Vestal, 2/25)
The end is near for CoOportunity Health. Polk County District Judge Arthur Gamble agreed Tuesday to sign an order putting the troubled Iowa-based health-insurer into liquidation as of midnight Saturday. (Leys, 2/24)
Editorials And Opinions
Viewpoints: Burwell Shifts Tone On Supreme Court Case; Need For New CMS Director
Next week, the Supreme Court hears arguments in a case that could upend Obamacare insurance coverage for millions of people. Tuesday, the Secretary of Health and Human Services said there was little the administration could do to limit the impact of such a ruling. ... The message represented a shift in tone from Ms. Burwell, who has been asked repeatedly by reporters and members of Congress what the administration would do in the aftermath of such a decision. ... The new message is consistent with her previous stance, but considerably more alarmist in tone. (Margot Sanger-Katz, 2/24)
When Marilyn Tavenner steps down as head of the Centers for Medicare and Medicaid Services this month, one of the federal government鈥檚 most powerful positions will once again come open. History and President Barack Obama鈥檚 actions toward the post suggest that finding a replacement might prove difficult. Before Ms. Tavenner was confirmed in May 2013, CMS had gone without a permanent, Senate-confirmed administrator for nearly seven years. (Chris Jacobs, 2/24)
Consumers will be able to get more accurate ratings of nursing homes under a revised system that the federal government put into effect on Friday. The change is a step toward ensuring that a five-star rating really means that the home provides exemplary service and is not simply inflating its scores by lying about its performance. Perhaps, not surprisingly, the overall ratings of nearly a third of the nation鈥檚 nursing homes dropped under the new rules. (2/25)
To keep nurses and doctors in health care, and prevent them from shifting to information technology or other sectors, hospitals must pay more and more. This, argued economist William Baumol, is why average costs in labor-intensive industries (such as health care or education) rise over time: They have to compete with other industries experiencing productivity growth. The result for health care? Higher costs but little productivity growth. This matters for Medicare. When the Affordable Care Act was passed, it was financed in part by planned reductions to future increases in payments to Medicare providers, including hospitals, skilled nursing facilities, and home health agencies. By 2019, the reductions would amount to $575 billion in savings, and in 2014, Medicare spending was reduced by $54 billion, according to the Congressional Budget Office. (Drew Altman and Dana Goldman, 2/25)
But as I talked to many e-cigarette users, known as 鈥渧apers,鈥 conducted research (Journal of Public Health Policy, 2011) and reviewed a growing body of scientific evidence, I became convinced that e-cigarettes have dramatic potential for reducing disease and death caused by smoking. Yet many in the antismoking movement鈥攊n which I have been involved for decades鈥攁re conducting a misleading campaign against these products. And this campaign may be doing harm to public health. (Michael B. Siegel, 2/24)
You need a good doctor. You try the Internet. It is baffling. The rankings seem better suited to restaurants鈥攖hree stars, four stars. Comments from patients can be nothing short of ridiculous. ... For the last few years, however, New York State has provided patients with some unvarnished relief. It came in the form of a website called nydoctorprofile.com. That website has been carrying information, good and bad, about most New York doctors. Not only does it provide basic details鈥攚here a doctor was trained, any board-certified specialties, whether Medicaid is okay. It also lists any court judgments for malpractice or any loss of medical privileges or criminal convictions. ... Now Gov. Andrew Cuomo wants to close the site, arguing that it costs too much at $1.2 million a year. (Eleanor Randolph, 2/24)
Too often, doctors don鈥檛 understand chronic fatigue syndrome. They don鈥檛 know how to diagnose it, and they frequently even believe that patients with the disease are just whining or suffering from psychological problems. This needs to change. That was the message from the Institute of Medicine鈥檚 recent report on the illness, which proposed new criteria to diagnose it and recommended ditching the syndrome鈥檚 confusing and demeaning name. The proposed alternative: systemic exertion intolerance disease, or S.E.I.D. (Julie Rehmeyer, 2/25)
The patient, whom I鈥檒l call Mohammed, was an American citizen, fully employed with health insurance, although with limited English language skills and health literacy. I had been his primary care doctor for seven years, and he came to me about two years ago with a lesion on his scalp after hitting his head on the door. I didn鈥檛 know exactly what it was, although my best guess was some sort of post-traumatic injury. I sent him to surgery for another opinion. The surgeon concurred with my diagnosis, but scheduled a biopsy. What I didn鈥檛 know was that Mohammed didn鈥檛 return for the planned procedure. He was struggling as a new single parent to his two young children who had just arrived from a war-torn African country, while his wife was left behind, her visa delayed by bureaucratic obstacles. He had deferred the biopsy because of his life circumstances without understanding the significance, and without catching anyone鈥檚 attention. The ball was dropped, and he fell through the cracks in the mighty apparatus. (Sondra S. Crosby, 2/25)