The National Institute of Standards and Technology (NIST) has released its final report on the Sept. 11, 2001, collapse of the 47-story World Trade Center building 7 (WTC 7) in New York City. The final report is strengthened by clarifications and supplemental text suggested by organizations and individuals worldwide in response to the draft WTC 7 report, released for public comment on Aug. 21, but the revisions did not alter the investigation team’s major findings and recommendations, which include identification of fire as the primary cause for the building’s failure.

The extensive three-year scientific and technical building and fire safety investigation found that the fires on multiple floors in WTC 7, which were uncontrolled but otherwise similar to fires experienced in other tall buildings, caused an extraordinary event. Heating of floor beams and girders caused a critical support column to fail, initiating a fire-induced progressive collapse that brought the building down.

In response to comments from the building community, NIST conducted an additional computer analysis. The goal was to see if the loss of WTC 7′s Column 79 – the structural component identified as the one whose failure on 9/11 started the progressive collapse – would still have led to a complete loss of the building if fire or damage from the falling debris of the nearby WTC 1 tower were not factors. The investigation team concluded that the column’s failure under any circumstance would have initiated the destructive sequence of events.

Other revisions to the final WTC 7 report included:
Expanding the discussion of firestopping, the material placed between floors to prevent floor-to-floor fire spread;

Clarifying the description of thermal expansion as it related to WTC 7′s shear studs and floor beams; and

Explaining in greater detail the computer modeling approach used to define where and when the fire in WTC 7 started and the extent of window breakage as a result of fire.

With the release of the final WTC 7 report, NIST has completed its federal building and fire safety investigation of the WTC disaster that began in August 2002. A three-year study of the collapses of the WTC towers (WTC 1 and 2) was completed in October 2005. More than 20 changes in the U.S. model building and fire codes have already been adopted based on the findings and recommendations from the investigation.

NIST will now work with various public and private groups toward implementing additional changes to the U.S. model building and fire codes including those based on the 13 recommendations from the WTC 7 report (one new and 12 reiterated from the towers investigation).

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The complete text of the final WTC 7 report, a video describing the WTC 7 investigation findings, a of all comments received on the draft WTC 7 report, a chart tracking the progress toward implementing all of the NIST WTC recommendations, and other materials may be accessed at wtc.nist.

Source: Michael E. Newman

National Institute of Standards and Technology (NIST)

Congenital heart defects are the most common type of major birth defects in the U.S., affecting about 34,000 babies each year. Twenty percent of these patients are born with a malformation of the pulmonary valve, which is a flap-like opening on the right side of the heart that is responsible for regulating the blood flow to the lungs. Now, a new replacement valve being used at Rush University Medical Center can help patients with damaged heart valves delay or avoid multiple open-heart surgeries.

Rush is the first hospital in the region to offer the new, less invasive treatment option called the Melody Transcatheter Pulmonary valve, which has been used in Europe since 2000 and was recently approved by the FDA for use in the U.S.

Patients who are missing or have a narrowed pulmonary valve require multiple invasive, open-heart surgeries during their lifetime in order to implant a prosthetic conduit or tube to replace the missing or malformed pulmonary valve.

The conduits used to bridge the right ventricle to the pulmonary arteries may last only a decade, or in some cases, only a couple of years because the body outgrows the tubes and they become narrowed or leaky.

“With this new device, we are able to implant a heart valve using a small catheter inserted into a vein in the patient’s leg without opening up the patient’s chest,” said Dr. Ziyad M. Hijazi, director of the Center for Congenital and Structural Heart Disease at Rush. “This procedure could revolutionize care for patients – saving them from multiple open heart surgeries and improving their quality of life.”

Avoiding open-heart surgery is key to improving the quality of life of any patient with a congenital heart defect. Every time a patient has to undergo open-heart surgery, more and more scar tissue develops. The next time a surgeon has to go in to do the surgery it becomes riskier because there is so much scar tissue, which can make the surgery longer and more difficult. Also, there is considerable pain, morbidity and recovery time associated with open-heart surgery.

The Melody valve is a tissue valve that is sewn inside of a wire stent and crimped onto an angioplasty balloon on the end of the catheter. The catheter is inserted through a small incision in the leg and navigated through the blood vessels up into the heart. Once in place, the balloon is inflated and that deploys the valve.

The procedural success for the new valve replacement is over 95 percent and the vast majority of patients have minimal leakage and very minimal narrowing after the new valve is placed.

Alexander Williams, a 20-year-old congenital heart patient from Harvey, Ill., was the first patient to have a transcatheter valve replacement at Rush in July 2010.

“I had a few different conditions affecting my heart,” said Williams.

Williams was born with transposition of the great arteries, which is a congenital heart defect in which the two major vessels that carry blood away from the heart — the aorta and the pulmonary artery — are switched. He also had pulmonary atresia, which is an extremely rare form of congenital heart disease in which the pulmonary valve does not form properly, and he also was diagnosed with a ventricular septal defect or a hole in the heart.

To correct the malformations, Williams had to undergo several open heart surgeries.

“When I found out I needed another valve replacement, I was so glad to hear that I could have an implantation that did not require me to undergo yet another open surgery,” said Williams.

The procedure took only four-to-five hours and Williams was able to go home after a short, 24-hour stay in the ICU.

“This is a huge breakthrough,” said Hijazi. “Patients can go home the next day and avoid the long recovery time and avoid the risk of surgery which requires opening up the patient’s chest and stopping the patient’s heart.”

Source:

Rush University Medical Center

A major shake-up of one of the government’s central health policy reforms to devolve greater power to GPs and deliver higher quality services to local communities is urgently needed, concludes a two-year study of practice-based commissioning published today by The King’s Fund.

Practice-based commissioning: reinvigorate, replace or abandon? says Lord Darzi’s recent review of the NHS was right to commit the government to persevering with practice-based commissioning as, if implemented well, it has the potential to help GPs plan and deliver better and more accessible services to patients, provide more choice of treatment and to use financial resources more effectively.

However, it concludes the policy has so far proved to be an expensive investment that has delivered little in terms of better services for patients or financial savings for the NHS since its introduction in 2005. Progress has been slow and appears to be stalling completely in some areas – very few GPs are using it to commission new services despite family doctors having been paid almost ВЈ100 million in incentives payments alone. The report warns the government must commit to a fundamental reassessment of the policy and tackle waning enthusiasm among GPs if it is to build on the limited progress the scheme has made.

Analysis by The King’s Fund reveals that many of the barriers that have stalled progress should have been predicted given the experience of the previous Conservative government in the 1990s when it devolved budgets to family doctors through GP fundholding and its variants*. Lessons that could have been learnt included problems with engaging GPs; the need to give GP commissioners the freedom to contract independently by handing them real budgets for specific areas; and the importance of investing in managerial capacity to support and lead the process by ensuring the right skills, data systems and governance arrangements are in place. The fall-out from NHS reorganisations and the impact of financial deficits have also hamstrung innovation and progress.

Report co-author Nick Goodwin, Senior Fellow at The King’s Fund, said: ‘Practice-based commissioning has the potential to deliver better services for patients and financial savings for the NHS, but progress has been painfully slow over the past three years. As a policy established to pump-prime the transition of care out of hospitals by investing in alternative care in local communities it has so far failed due to a lack of real investment, leadership, ambition and drive. The NHS must harness what remains of the limited enthusiasm of GPs and commit to a fundamental redesign of the policy if it’s to live up to its potential.’

Niall Dickson, Chief Executive at The King’s Fund, added: ‘The government is right to keep faith with practice-based commissioning but it must be prepared to set a clear direction, define the commissioning roles of both primary care trusts (PCTs) and practices, ensure GPs have access to the support they need to make it work and put in place the correct incentives. Now is the time for a fundamental reassessment of the policy.’

The report is based on an in-depth, two-year analysis of practice-based commissioning in four PCT areas in England, with the findings and conclusions tested in an expert seminar with key policymakers and health professionals. It found a strong commitment to making practice-based commissioning work but very few GPs were using it to deliver new services for their patients. GPs in the study had limited time to engage in the policy and often lacked the skills and health care information they needed to make it work – they needed far greater support than was being provided by their PCTs. There was also concern over conflicts of interest in the role of GPs as both providers and commissioners of services, potentially restricting patient choice.

The policy had helped to improve relationships between GPs and PCT managers in some cases but, in other areas, it had caused already poor relationships to deteriorate further. The lack of national guidance from the government had compounded these problems and had led to widespread disagreement between GPs and PCTs over their roles and responsibilities. There was also a strong feeling that the breakdown in relationships between the government and medical profession over the past year had discouraged some GPs and PCTs to invest enough time and energy in the policy.

The report makes a number of recommendations to overcome these barriers including the following.

The government should set out a clear vision for the future of practice-based commissioning and provide national guidance for GPs and PCTs – that can be translated locally – on how best to implement the policy.

The government should develop a new approach to commissioning where PCTs maintain responsibility for strategic, population-wide commissioning but be informed by GPs and other clinicians, while real budgets for specific services should be devolved to GPs and groups of practice-based commissioners, providing them with more freedom and stronger incentives to develop innovative services for patients.

High performing GPs and practice-based commissioning groups should be rewarded with increased independence but should not become responsible for the entire health care budget. Budgets should only be devolved for tightly defined areas so that GPs can only commission specific services directly, which would reduce clinical and financial risks.

Conflicts of interest in the role of GPs being both providers and commissioners of care should be tackled head on through robust governance arrangements to ensure that patient choice and the quality of GP referrals are not compromised and that clinical risk is managed.

Notes

1. For further information or interviews, please contact The King’s Fund press office on 020 7307 2585, 020 7307 2632 or 020 7307 2581. An ISDN line is available for interviews on 020 7637 0185. Embargoed copies of the report are available.

2. Practice-based commissioning: reinvigorate, replace or abandon?, by Natasha Curry, Nick Goodwin, Chris Naylor and Ruth Robertson is free to download from The King’s Fund website. The report represents one of the most significant studies of practice-based commissioning since its introduction in 2005. The policy was not subject to a trial or pilot phase and a formal evaluation of the initiative has only recently been commissioned by the Department of Health this is not due to be published until 2010. As a result, the evidence on how practice-based commissioning has influenced the care provided in local communities is limited.

3. *GP fundholding ran from 1991-1997 as a voluntary scheme within which GPs could purchase elective care with a real negotiated budget from health authorities whilst simultaneously managing a prescribing budget. Variations to GP fundholding over this period, such as Total Purchasing Pilots (1994-7), enabled GP practices to extend their responsibility for managing budgets to non-elective care, though in most cases these used indicative budgets as financial responsibility remained with health authorities. The election of a New Labour government ended the experiment with all forms of GP-led purchasing – primarily on the grounds that it increased transaction costs and promoted two-tier access to care.

4. The Audit Commission estimated that ВЈ98 million of incentive payments had been made to GP practices involved in practice-based commissioning in 2006/7 alone. About half was associated with signing up to accepting an indicative budget and the rest conditional on developing local PBC plans (Audit Commission, Putting commissioning into practice, November 2007).

5. The King’s Fund seeks to understand how the health system in England can be improved. Using that insight, we help shape policy, transform services and bring about behaviour change. Our work includes research, analysis, developing leaders and improving services. We also offer a wide range of resources to help everyone working in health share knowledge, learning and ideas.

The King’s Fund

“Racial and Ethnic Disparities in Influenza and Pneumococcal Immunization Rates Among Medicare Beneficiaries” (.pdf), AARP Public Policy Institute: The issues report discusses factors that might contribute to black and Hispanic Medicare beneficiaries’ access to immunizations. The report presents data on racial and ethnic immunization disparities that indicate black and Hispanic Medicare beneficiaries have lower inoculation rates for pneumonia and influenza, despite Medicare’s coverage of such immunizations. The report also examines current Medicare immunization coverage policies and makes recommendations on how governments can address the disparities (Flowers et al., AARP Public Policy Institute, October 2008).

Reprinted with kind permission from kaisernetwork. You can view the entire Kaiser Daily Health Policy Report, search the archives, or sign up for email delivery at kaisernetwork/dailyreports/healthpolicy. The Kaiser Daily Health Policy Report is published for kaisernetwork, a free service of The Henry J. Kaiser Family Foundation.

© 2008 Advisory Board Company and Kaiser Family Foundation. All rights reserved.

The John D. and Catherine T. MacArthur Foundation is creating a new inter-disciplinary research network to help America prepare for the challenges and opportunities posed by our aging society. In the middle of the next decade, the United States will become an aging society, one feature of which is that those over age 60 will outnumber those under age 15. Although the nation will become increasingly gray in subsequent decades, we are not well prepared to deal with the myriad consequences of this impending reality.

“By 2050, American society may well have more walkers than strollers,” said MacArthur Vice President Julia Stasch, who announced the Network in remarks at The Gerontological Society of America’s 61st Annual Scientific Meeting. “This new research network will address the broad social implications of this uncharted demographic territory, examining questions like: how can a large, longer-living, elderly population maintain its productivity and contribute to its well-being – and society’s? How will it change our economy, our culture, our politics? Over time, will America look better, worse, or just different? And how can public policies – in immigration, work force development, health care, and others – and reform of our civic institutions affect our future in a positive direction?”

The MacArthur Research Network on an Aging Society, supported by a three-year, $3.9 million MacArthur grant, will be chaired by Dr. John Rowe, Professor at the Columbia University Mailman School of Public Health and former CEO of Aetna. In the 1990s, Rowe chaired MacArthur’s Network on Successful Aging, which found that most of the factors that predict successful aging are not solely genetic but at least equally related to lifestyle. The Network published a best-selling book, Successful Aging.

“Much prior work in this area has focused on the economic implications of the looming demographic transition, including the increasing burden of entitlements,” said Rowe. “The new Network will supplement these efforts by exploring the substantial opportunities that may be derived by harnessing the wisdom and energy of the elderly in new organizations and arrangements that provide them with meaningful roles and yield economic, social, behavioral, and health benefits for them and other generations.”

Early next year, the Network will present new U.S. population and mortality projections based on emerging evidence and will compare these to current government forecasts. The projections will forecast mortality under scenarios that take account of advances in bio-gerontology with its life-extending potential and the effects of unhealthy life conditions. Such projections have major implications for the development of social, economic, and health policy.

Drawing on the collective expertise of its members, the Network will examine the potential benefits of remodeling the distribution of key activities, including education, work, and leisure, across the life course. Research and projects will focus on three themes:
the positive and negative impact of key intergenerational issues on families and society;

the development of meaningful roles for older people; and

the potential effects that the various sources of diversity and inequalities may have on the structure, economy, and overall health of an aging society.

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The Network’s members represent a wide range of disciplines, including gerontology, psychology and health behavior, macroeconomics and public policy, social epidemiology, cognitive neuroscience, demography, and aging policy. In addition to Dr. Rowe, members of the Network are Dr. Lisa Berkman, Director, Center for Population and Development Studies, Harvard University; Dr. Robert Binstock, Professor of Aging, Health, and Society, Case Western Reserve University; Dr. Axel BГ¶rsch-Supan, Director, Mannheim Research Institute for the Economics of Aging, University of Mannheim, Germany; Dr. John T. Cacioppo, Professor and Director, Center for Cognitive and Social Neuroscience, The University of Chicago; Dr. Laura L. Carstensen, Professor of Psychology and Director, Stanford Center on Longevity, Stanford University; Dr. Linda Fried, Dean and DeLamar Professor of Public Health, Mailman School of Public Health, Columbia University; Dr. Dana Goldman, Director, Health Economics, Finance, and Organization, RAND; Dr. James S. Jackson, Director, Institute for Social Research and Professor of Psychology, University of Michigan; Dr. Martin Kohli, Professor of Sociology, European University Institute, Florence, Italy; Dr. S. Jay Olshansky, Professor, School of Public Health, University of Illinois at Chicago; and Mr. John Rother, Executive Vice President for Policy and Strategy, AARP.

The MacArthur Foundation supports creative people and effective institutions committed to building a more just, verdant, and peaceful world. In addition to selecting the MacArthur Fellows, the Foundation works to defend human rights, advance global conservation and security, make cities better places, and understand how technology is affecting children and society. More information is available at macfound/.

The Gerontological Society of America (GSA) is the nation’s oldest and largest interdisciplinary organization devoted to research, education, and practice in the field of aging. The principal mission of the Society – and its 5,500+ members – is to advance the study of aging and disseminate information among scientists, decision makers, and the general public. GSA’s structure also includes a policy institute, the National Academy on an Aging Society, and an educational branch, the Association of Gerontology in Higher Education.

Source: Andy Solomon

The Gerontological Society of America

“Factors Influencing Physician Referrals of Patients to Clinical Trials” (.pdf), Journal of the National Medical Association: The study, by University of South Carolina medical researchers, looks at physicians’ attitudes and beliefs about recruiting patients to clinical trials, particularly minorities. Researchers surveyed 200 physicians from areas near clinics that recruited patients for Parkinson’s disease. Researchers found that black physicians and physicians with a large minority patient population measured low on the Trust in Medical Researchers Scale, which indicated their likelihood of referring a patient to a clinical trial. Respondents also were more likely to refer a patient to a trial if they had previously referred patients to trials. The study concludes that the findings “emphasize the importance of developing a trusting relationship with local physicians if investigators expect these physicians to refer their patients to clinical trials” and that the “trust-related barriers for minority-serving physicians, regardless of their own race/ethnicity, seem to mirror the trust-related issues for their minority patients” (Mainous et al., Journal of the National Medical Association, November 2008).

Reprinted with kind permission from kaisernetwork. You can view the entire Kaiser Daily Health Policy Report, search the archives, or sign up for email delivery at kaisernetwork/dailyreports/healthpolicy. The Kaiser Daily Health Policy Report is published for kaisernetwork, a free service of The Henry J. Kaiser Family Foundation.

© 2008 Advisory Board Company and Kaiser Family Foundation. All rights reserved.

At least 15 states facing widening budget shortfalls are cutting funding for services for low-income elderly residents and people with disabilities, mostly for programs that allow low-income “shut-ins” to receive personal care in their own homes, according to the Center on Budget and Policy Priorities, the Wall Street Journal reports. In recent years, Medicaid has encouraged home-based care because nursing homes cost more per person, the Journal reports. In 2006, Medicaid spent about $47 billion on nursing home care compared with $15 billion on home- and community-based care.

The Journal reports that while home-based services for the elderly and disabled “are just one of the areas facing cuts, … the cuts hit hard because the population is especially vulnerable.” JoAnn Lamphere, director of state government relations at AARP, said, “We are beginning to see serious cuts and we are expecting those cuts to get worse.”

According to the Journal, the cuts are “exacerbating the already long waiting lists for home care support services in many states,” such as Florida, where the waiting list for one home and community care service doubled to 8,505 people in the year ending July 2008. Florida Medicaid Director Dyke Snipes said, “We are going to be facing a tight year,” adding, “It wouldn’t surprise me if the list is increasing.” A class-action lawsuit against Florida alleges that the state “unnecessarily” puts people with disabilities in nursing homes because it does not allocate enough resources for community-based care.

In addition, Alabama ended homemaker services for approximately 1,200 disabled and elderly adults to save $2 million, leaving social workers and local officials trying to find help for those now without subsidized home care, the Journal reports (Shishkin, Wall Street Journal, 11/20).

Reprinted with kind permission from kaisernetwork. You can view the entire Kaiser Daily Health Policy Report, search the archives, or sign up for email delivery at kaisernetwork/dailyreports/healthpolicy. The Kaiser Daily Health Policy Report is published for kaisernetwork, a free service of The Henry J. Kaiser Family Foundation.

© 2008 Advisory Board Company and Kaiser Family Foundation. All rights reserved.

A new CDC study published in the American Journal of Industrial Medicine has found that health care workers face an increased risk of dying from bloodborne diseases, such as HIV, and related illnesses compared with workers in other fields, Reuters reports. The study also found that male health care workers face a more than twofold risk of dying from HIV/AIDS-related causes. According to researchers Sara Luckhaupt and Geoffrey Calvert of CDC’s National Institute for Occupational Safety and Health, accidental needle sticks and other workplace accidents can put health care workers at an increased risk of exposure to bloodborne diseases. Luckhaupt notes that evidence over the past 20 to 25 years shows that health care workers have been more likely to die from bloodborne diseases than workers in other fields, Reuters reports.

The study examined data from the National Occupational Mortality Surveillance system from 1984 to 2004, which included 248,550 deaths from HIV/AIDS, hepatitis B and C, liver cancer and cirrhosis. According to Reuters, the researchers in a previous study found that male health care workers were at an increased risk of HIV and hepatitis but conducted the new study to determine if deaths from these infections also were higher in the health care field.

Results pointed to a more than doubled risk of dying from HIV/AIDS-related causes for male health care workers — as well as a nearly doubled likelihood of dying from hepatitis B — compared with workers in other fields. Hepatitis C and cirrhosis deaths were also more likely among male health care workers. For female health care workers, hepatitis C was more frequent than in other occupations. An analysis of mortality risk based on occupation showed that male nurses faced the highest risk of HIV/AIDS and hepatitis B mortality, while female nurses were 31% less likely to die from HIV/AIDS-related causes than women outside of the health care industry, Reuters reports.

Luckhaupt said that the researchers are unable to say how much the increased risk is because of occupational or non-occupational exposure but added that it is “important to look at both.” The researchers wrote, “The greatest limitation to our study was that information was not available on possible confounding factors, such as sexual risk behaviors, history of blood transfusions, intravenous drug use and alcohol use.” They added that previous studies indicate that most infections among health care workers are not contracted on the job and that occupational factors could be a stand-in for other risk factors. They suggest that “interventions to decrease the risk of bloodborne pathogens among health-care workers may need to be gender-specific” in order to better understand why male health care workers show an increased risk for bloodborne disease mortality (Harding, Reuters, 11/19).

Reprinted with kind permission from kaisernetwork. You can view the entire Kaiser Daily Health Policy Report, search the archives, or sign up for email delivery at kaisernetwork/dailyreports/healthpolicy. The Kaiser Daily Health Policy Report is published for kaisernetwork, a free service of The Henry J. Kaiser Family Foundation.

© 2008 Advisory Board Company and Kaiser Family Foundation. All rights reserved.

Former Senate Majority Leader Tom Daschle (D-S.D.) has accepted an offer from President-elect Barack Obama to become the new HHS secretary, according to Democratic officials, the AP/San Francisco Chronicle reports (Freking, AP/San Francisco Chronicle, 11/19). Obama likely will make an official announcement about the nomination of Daschle early next week, according to a Democratic official familiar with the process (Hook et al., “The Swamp,” Chicago Tribune, 11/19). According to the AP/Chronicle, the “job is Daschle’s barring an unforeseen problem as Obama’s team reviews” his background.

Daschle, who lost his Senate seat in 2004, currently serves as a public policy adviser and member of the legislative and public policy group at the law firm Alston & Bird, but he is not a registered lobbyist (AP/San Francisco Chronicle, 11/19). “Daschle will likely face easy confirmation by his former Senate colleagues,” Reuters reports (Smith, Reuters, 11/19).

Large Role
“Daschle could end up being the point man on any efforts to overhaul the country’s health care delivery and insurance system, a tall order, health policy experts say, given the current economic situation,” the New York Times’ “The Caucus” reports (Cooper, “The Caucus,” New York Times, 11/19). According to the Wall Street Journal, Daschle “is expected to play an important role in moving Mr. Obama’s ambitious health care agenda through Congress” (Meckler/Weisman, Wall Street Journal, 11/20). “Daschle has positioned himself as Obama’s central adviser on efforts to dramatically expand health care coverage next year, while at the same time lowering costs,” according to the Washington Post’s “44″ (Connolly/Cillizza, “44,” Washington Post, 11/19). Senate Democrats said that Daschle “would greatly help with efforts to overhaul the health care system next year,” CQ Today reports (Wayne, CQ Today, 11/19).

On Wednesday, the Obama transition team announced that Daschle will lead a transition policy working group on health care (Cooper/Baker, New York Times, 11/20). According to the Times’ “The Caucus,” Daschle “was concerned that he not just be the head of a huge bureaucracy but a chief player on the subject he has literally written a book on” (“The Caucus,” New York Times, 11/19).

Background
In February, Daschle wrote a book about health care policy titled “Critical: What We Can Do About the Health Care Crisis.” In the book, Daschle proposed to establish a board modeled on the Federal Reserve Board to “offer a public framework within which a private health care system can operate more effectively and efficiently — insulated from political pressure yet accountable to elected officials and the American people” (Goldstein, “Health Blog,” Wall Street Journal, 11/19).

He serves as a senior fellow and a board member at the Center for American Progress. In addition, Daschle serves on the advisory boards of Intermedia Partners and BP America, as well as on the boards of CB Richard Ellis, Mascoma, Prime BioSolutions, The Freedom Forum, the Mayo Clinic, the LBJ Foundation, and the National Democratic Institute for International Affairs. Daschle also is a member of the Council on Foreign Relations (AP/San Francisco Chronicle, 11/19). He co-chaired the ONE Vote ’08 campaign to address health care and poverty issues in developing nations (Rhee, “Political Intelligence,” Boston Globe, 11/19).

Reaction From Lawmakers
House Rules Committee Chair Louise Slaughter (D-N.Y.) said that she hopes Daschle can “go down deep and clean out some of the 19th-century ideas at HHS” implemented by the Bush administration (Bellantoni, Washington Times, 11/20).

Daschle “knows health care, he knows the Congress and the rhythms of the Senate in particular,” Senate Finance Committee Chair Max Baucus (D-Mont.) said (Talev, McClatchy/Philadelphia Inquirer, 11/20).

Sen. Ron Wyden (D-Ore.) said, “Tom Daschle sees this as a once-in-a-lifetime opportunity,” adding, “On the premier domestic issue of our time, the president-elect sees Tom Daschle with the skills and abilities to bring people together and get this over the finish line” (Connolly, Washington Post, 11/20).

Republican National Committee spokesperson Alex Conant said, “Barack Obama is filling his administration with long-time Washington insiders. Since losing his Senate seat, Tom Daschle has worked for a major lobbying firm. For voters hoping to see new faces and fewer lobbyist connections in government, Daschle’s nomination will be another disappointment. Obama promised to change America’s health care system, but his nominee to be secretary is no change agent” (“The Swamp,” Chicago Tribune, 11/19).

Additional Reaction
Kaiser Family Foundation President and CEO Drew Altman said, “You wouldn’t appoint Tom Daschle to be secretary” of HHS “if you weren’t serious about making health care reform a priority” (Hook/Levey, Baltimore Sun, 11/20).

Ron Pollack, executive director of Families USA, said, “Sen. Daschle has a deep commitment to securing high-quality, affordable health care for everyone in our nation,” adding, “His new leadership position confirms that the incoming Obama administration has made health care reform a top and early priority for action in 2009″ (AP/San Francisco Chronicle, 11/19).

AARP Executive Vice President Nancy LeaMond said, “Senator Daschle would bring a wealth of experience to HHS as the new Congress and administration begin their work to solve our health care crisis” (Reuters, 11/19).

Former Rep. John Porter (R-Ill.), chair of Research! America, said of Daschle, “He’ll do an outstanding job” (AP/San Francisco Chronicle, 11/19).

Broadcast Coverage

ABC’s “World News Tonight” on Wednesday reported on the Daschle nomination (Stark et al., “World News Tonight,” ABC, 11/19).


CNN’s “CNN Newsroom” on Wednesday reported on the Daschle nomination (Henry, “CNN Newsroom,” CNN, 11/19).


CNN’s “Lou Dobbs Tonight” on Wednesday reported on possible ties between Daschle and the pharmaceutical industry (Dobbs, “Lou Dobbs Tonight,” CNN, 11/19). A transcript of the show is available online.


CNN’s “Situation Room” on Wednesday reported on the Daschle nomination (Blitzer, “Situation Room,” CNN, 11/19). A transcript of the show is available online.


Fox News’ “Special Report with Brit Hume” on Wednesday reported on the Daschle nomination (Angle, “Special Report with Brit Hume,” Fox News, 11/19).


NPR’s “Day to Day” on Wednesday reported on the Daschle nomination (Brand/Elving, “Day to Day,” 11/19).


NPR’s “Morning Edition” on Thursday reported on the Daschle nomination (Rovner/Inskeep, “Morning Edition,” NPR, 11/20).
Reprinted with kind permission from kaisernetwork. You can view the entire Kaiser Daily Health Policy Report, search the archives, or sign up for email delivery at kaisernetwork/dailyreports/healthpolicy. The Kaiser Daily Health Policy Report is published for kaisernetwork, a free service of The Henry J. Kaiser Family Foundation.

© 2008 Advisory Board Company and Kaiser Family Foundation. All rights reserved.

Senate Finance Committee Chair Max Baucus (D-Mont.) and ranking member Chuck Grassley (R-Iowa) on Wednesday released a draft bill that would link Medicare reimbursement levels for inpatient hospital care to the quality of care, rather than the number of services provided, CQ HealthBeat reports. Under the legislation, the new policy would begin in fiscal year 2012 and take full effect in FY 2016. Medicare reimbursement levels would increase from 1% to 2% during that time. The legislation would base quality standards on a list of measures established by several medical organizations, such as the National Quality Forum (Carey, CQ HealthBeat, 11/19). According to CongressDaily, the lawmakers likely will seek to attach the bill to larger health care reform or Medicare legislation (Edney, CongressDaily, 11/20).

In a news release, Baucus and Grassley said that the bill “would re-focus the Medicare program on quality care, which will result in improved patient care and could lower costs throughout the entire health care system” (CQ HealthBeat, 11/19). Grassley said, “Medicare’s payment system is set up to reward volume rather than quality,” adding, “The value-based purchasing initiative we’ve been pursuing would reverse those incentives in order to improve quality and reduce costs” (CongressDaily, 11/20).

The bill “includes all the right pieces of the puzzle, but as it evolves, it needs to be more specific,” Chip Kahn, president of the Federation of American Hospitals, said, adding, “We really need to have everyone understand their roles” (CQ HealthBeat, 11/19). He said, “If the purpose of this is improvement, then you should have the payment connected to the areas that have improvements” (CongressDaily, 11/20).

Reprinted with kind permission from kaisernetwork. You can view the entire Kaiser Daily Health Policy Report, search the archives, or sign up for email delivery at kaisernetwork/dailyreports/healthpolicy. The Kaiser Daily Health Policy Report is published for kaisernetwork, a free service of The Henry J. Kaiser Family Foundation.

© 2008 Advisory Board Company and Kaiser Family Foundation. All rights reserved.