Idaho First to Sign Law to Sue Fed Government Over Healthcare

March 18, 2010

Associated Press

By: John Miller

Idaho took the lead in a growing, nationwide fight against health care overhaul Wednesday when its governor became the first to sign a measure requiring the state attorney general to sue the federal government if residents are forced to buy health insurance.

Similar legislation is pending in 37 other states.

Constitutional law experts say the movement is mostly symbolic because federal laws supersede those of the states.

But the state measures reflect a growing frustration with President Barack Obama’s health care overhaul. The proposal would cover some 30 million uninsured people, end insurance practices such as denying coverage to those with pre-existing conditions, require almost all Americans to get coverage by law, and try to slow the cost of medical care nationwide.

Democratic leaders hope to vote on it this weekend.

With Washington closing in on a deal in the months-long battle over health care overhaul, Republican state lawmakers opposed to the measure are stepping up opposition.

Otter, a Republican, said he believes any future lawsuit from Idaho has a legitimate shot of winning, despite what the naysayers say.

“The ivory tower folks will tell you, ‘No, they’re not going anywhere,’ ” he told reporters. “But I’ll tell you what, you get 36 states, that’s a critical mass. That’s a constitutional mass.”

Last week, Virginia legislators passed a measure similar to Idaho’s new law, but Otter was the first state chief executive to sign such a bill, according to the American Legislative Exchange Council, which created model legislation for Idaho and other states. The Washington, D.C.,-based nonprofit group promotes limited government.

“Congress is planning to force an unconstitutional mandate on the states,” said Herrera, the group’s health task force director.

Otter already warned U.S. House Speaker Nancy Pelosi and Senate Majority Leader Harry Reid in December that Idaho was considering litigation. He signed the bill during his first public ceremony of the 2010 Legislature.

“What the Idaho Health Freedom Act says is that the citizens of our state won’t be subject to another federal mandate or turn over another part of their life to government control,” Otter said.

Minority Democrats in Idaho who opposed the bill called the lawsuits frivolous.

Senate Minority Leader Kate Kelly, D-Boise, also complained about the bill’s possible price tag. Those who drafted the new law say enforcement may require an additional Idaho deputy attorney general with an annual salary of $100,000 a year.

Kelly said that was irresponsible when Idaho is grappling with a $200 million budget hole.

“For Democrats in the Legislature, our priority is jobs,” she said. “We’d rather Gov. Otter was holding a signing ceremony for (a jobs package) meant to put Idaho residents back to work.”

Click here for the full report.

House May Try to Pass Senate Healthcare Bill Without Voting on It!

March 16, 2010

The Washington Post

By Lori Montgomery and Paul Kane

After laying the groundwork for a decisive vote this week on the Senate’s health-care bill, House Speaker Nancy Pelosi suggested Monday that she might attempt to pass the measure without having members vote on it.

Instead, Pelosi (D-Calif.) would rely on a procedural sleight of hand: The House would vote on a more popular package of fixes to the Senate bill; under the House rule for that vote, passage would signify that lawmakers “deem” the health-care bill to be passed.

The tactic — known as a “self-executing rule” or a “deem and pass” — has been commonly used, although never to pass legislation as momentous as the $875 billion health-care bill. It is one of three options that Pelosi said she is considering for a late-week House vote, but she added that she prefers it because it would politically protect lawmakers who are reluctant to publicly support the measure.

“It’s more insider and process-oriented than most people want to know,” the speaker said in a roundtable discussion with bloggers Monday. “But I like it,” she said, “because people don’t have to vote on the Senate bill.”

Republicans quickly condemned the strategy, framing it as an effort to avoid responsibility for passing the legislation, and some suggested that Pelosi’s plan would be unconstitutional.

“It’s very painful and troubling to see the gymnastics through which they are going to avoid accountability,” Rep. David Dreier (Calif.), the senior Republican on the House Rules Committee, told reporters. “And I hope very much that, at the end of the day, that if we are going to have a vote, we will have a clean up-or-down vote that will allow the American people to see who is supporting this Senate bill and who is not supporting this Senate bill.”

House leaders have worked for days to round up support for the legislation, but the Senate measure has drawn fierce opposition from a broad spectrum of members. Antiabortion Democrats say it would permit federal funding for abortion, liberals oppose its tax on high-cost insurance plans, and Republicans say the measure overreaches and is too expensive.

Some senior lawmakers have acknowledged in recent days that Democrats lack the votes for passage. Pelosi, however, predicted Monday that she would deliver.

“When we have a bill, then we will let you know about the votes. But when we bring the bill to the floor, we will have the votes,” she told reporters.

Pelosi said Monday that House Democrats have yet to decide how to approach the vote. But she added that any strategy involving a separate vote on the Senate bill “isn’t too popular,” and aides said the leadership is likely to bow to the wishes of its rank and file.

As Pelosi and other congressional leaders pressed wavering lawmakers, President Obama highlighted how close the result may be as he focused his attention Monday on Rep. Dennis Kucinich (D-Ohio), who has been a stalwart no vote on health-care reform.

Kucinich, an uncompromising liberal, has rejected any measure without a government-run insurance plan. Obama invited Kucinich to join him aboard Air Force One for a trip to suburban Cleveland, where the president made a plea for reform, the third such pitch in eight days.

As he addressed a crowd of more than 1,400, Obama repeatedly called on lawmakers to summon the “courage to pass the far-reaching package.” He painted the existing insurance system as a nightmare for millions of American who cannot afford quality coverage.

The president lashed out at Republican critics who have argued that the health-care initiative would undermine Medicare, and he argued that the measure would end “the worst practices” of insurance companies.

“I don’t know about the politics, but I know what’s the right thing to do,” he said, nearly shouting as the crowd cheered. “And so I’m calling on Congress to pass these reforms — and I’m going to sign them into law. I want some courage. I want us to do the right thing.”

Asked whether he was reconsidering his position, Kucinich demurred. But Sen. Sherrod Brown (D-Ohio) said Kucinich is coming under intense pressure from Ohioans who want Congress to act, and from his colleagues in Washington.

“All of us — the governor, the congressional delegation, the president — are making clear to Dennis that we won’t have another chance for a decade if this doesn’t happen,” Brown said.

Persuading liberals such as Kucinich to support the Senate bill is critical to the Democratic strategy, which has been rewritten since January, when Democrats lost their supermajority in the Senate. The Senate Democratic caucus, reduced to 59 seats, lost its ability to override Republican filibusters and soon abandoned plans to pass a revised version of the health-care bill that would reflect a compromise with House leaders.

As House leaders looked for a path that could get the Senate legislation through the chamber and onto Obama’s desk, conservatives warned that Pelosi’s use of deem-and-pass in this way would run afoul of the Constitution. They pointed to a 1998 Supreme Court ruling that said each house of Congress must approve the exact same text of a bill before it can become law. A self-executing rule sidesteps that requirement, former federal appellate judge Michael McConnell argued in a Wall Street Journal op-ed.

Democrats were also struggling Monday to put the finishing touches on the package of fixes. Under reconciliation rules, it is protected from filibusters and could pass the Senate with only 50 votes, but can include only provisions that would affect the budget.

Democratic leaders learned over the weekend that they may not be able to include a number of favored items, including some Republican proposals to stem fraud in federal health-care programs and a plan to weaken a new board that would be empowered to cut Medicare payments.

Click here for the full report.

Obama Attempts To Save His Health Bill

February 26, 2010

Yahoo News

By Ricardo Alonso-Zaldivar

Cue the cameras. President Barack Obama and his Republican arch foes will argue their case on health care overhaul at a bipartisan summit expected to stretch out for a solid six hours on live, daytime television Thursday for millions of Americans.

Expect them to collide, not come together. Without a no-nonsense referee to slam the gavel on mind-fogging jargon, not to mention apocalyptic rhetoric, some viewers might wish Judge Judy was presiding.

Obama is hoping to resurrect his signature issue and restore his reputation as a different kind of politician who can deliver real results. Congressional leaders of both parties are worried about self-preservation and political control in the November elections.

The goal for Obama is to draw a glaring contrast between the big bill he’s backing and the limited steps Republicans are willing to take, hoping he can fire up anxious Democrats for what may be their last chance in a generation to provide health insurance coverage to nearly all Americans. They have the votes, but do they have the will?

Sen. Chris Dodd, D.-Conn., who will be among the lawmakers participating, worked a rally of supporters on the eve of Thursday’s meeting, scheduled to start at 10 a.m. EST.

“After that meeting, you can either join us or get out of the way,” Dodd said.

Not if Republicans have anything to do with it. Riding a populist backlash against the widening reach of government, they insist that Obama start from scratch, a notion the White House rejects. They’re unified in opposing the Democratic bills passed last year and have pulled back from more ambitious GOP-backed plans that might have provided a foundation for compromise.

With premiums going up by double digits for some consumers, polls show the public wants Congress and the president to deal with spiraling medical costs, shrinking coverage and questionable quality. But Americans are split over the Democratic bills. If Obama and the Democrats can’t get their legislation passed, there may still be a chance for a modest measure this year that smooths the rough edges of the current system but stops well short of coverage for all.

Obama will be the moderator in chief for talks on four topics: revamping insurance, cost containment, expanding coverage and the impact of health care legislation on deficit reduction. The summit will take place at Blair House, the presidential guest quarters across the street from the White House. Here’s a viewer’s guide for consumers on issues critical to working families, seniors and businesses:

• WORKING FAMILIES

While the cost of health insurance is a worry for most Americans, it’s a crisis for the nearly 50 million uninsured and about 27 million who buy their own coverage directly from an insurer. The $1-trillion, 10-year plan Obama and the Democrats have drafted focuses mainly on these two groups.

People with coverage from large employers would get some benefits, like being able to keep children in their late 20s on the company plan — but wouldn’t face major changes unless they lose their jobs or strike out on their own.

People who buy insurance directly, as well as small employers, would be able pick a plan in a new kind of competitive marketplace offering choices similar to what federal employees and Congress members get. But it wouldn’t be a free ride.

Most Americans would be required to carry health insurance and prove it to the IRS.

Obama and the Democrats say their plan would make coverage affordable by providing federal subsidies to help more than 30 million now uninsured. But solid middle-class families may still have to stretch to pay premiums. The help is a lot better for people on the lower income rungs.

Under the plan Obama released Monday — his opening bid at the summit — a family of four making $66,000 would have to pay $6,257 in premiums, close to 10 percent of its income. That’s even after receiving $3,000 in federal tax credits.

By comparison, a similar family making only $44,000 would pay $2,763 — about 6 percent of its income. The estimates come from the nonpartisan Kaiser Family Foundation.

“There’s no question that it’s better than the status quo,” said Larry Levitt, an analyst with Kaiser.

Most Republicans are opposed to an insurance mandate, although they generally like the idea of allowing 20-year-olds to remain on parental coverage. They want to concentrate on stimulating the private market to provide affordable alternatives. One idea: allowing consumers in high-cost states to buy coverage from insurers in low-cost areas.

Republicans also want to help people denied coverage because of medical problems by pumping federal money to high-risk insurance pools run by the states. Obama sees that only as a temporary measure; his plan would ban pre-existing condition denials starting in 2014.

Click here for the full report

The Pushing of Annual Flu Vaccinations

February 26, 2010

The Washington Post

By Mike Stobbe

A government panel is now recommending that virtually all Americans get a flu shot each year, starting this fall.

The Advisory Committee on Immunization Practices had gradually been expanding its recommendation for flu shots – 85 percent of Americans were already included.

On Wednesday, the panel voted to recommend a seasonal flu vaccination for everyone except babies younger than 6 months and those with egg allergies or other unusual conditions.

The panel’s recommendation now goes to the Centers for Disease Control and Prevention. The CDC usually follows the panel’s advice and spreads the message to doctors and hospitals across the country.

“Now no one should say ‘Should I or shouldn’t I?’” said Dr. Anthony Fiore, a CDC flu specialist.

CDC vaccination recommendations tend to be influential with the doctors who give the shots and the health insurers who pay for them.

Flu shots are already recommended for 85 percent of the U.S. public, including pregnant women, children older than 6 months, adults 50 and older, people with certain chronic health conditions, health care workers and those who take care of people in a recommended group. The only people who weren’t specifically included were healthy people ages 19 to 49 who don’t have close contact with anyone at risk of flu and its complications.

But only about 33 percent of Americans actually get a flu shot, and unusually millions and millions of doses get thrown away annually.

The swine flu pandemic that hit last year caused a new momentum for flu vaccinations. Virtually all the 114 million doses of seasonal flu vaccine doses made were distributed, and more young adults and children got the swine flu vaccine than usually come out for seasonal flu.

The panel voted 11 to 0 – with one abstention – for the recommendation, prompting a short round of applause in the CDC auditorium where the meeting was held. Some public health experts and physicians had been pushing for a universal flu vaccination recommendation for more than 10 years.

Also on Wednesday, the panel gave its nod to a proposed formulation of next year’s seasonal flu vaccine. The vaccine will be built to protect against three strains of flu scientists think will be circulating next fall and winter. Swine flu is to be one of the strains incorporated into the vaccine.

At past meetings, the panel stopped short of recommending flu shots for everyone. Panel members were mindful of a history of temporary flu vaccine shortages in the United States. They worried a universal recommendation might cause demand to far surpass supply and endanger those at the highest risk of life-threatening flu complications.

Click here for the full report

Third of Young U.S. Adults Lack Health Insurance

February 26, 2010

Reuters

By JoAnne Allen

A third of young U.S. adults — nearly 13 million people — had no health insurance coverage in 2008, according to a government report released on Wednesday.

The survey of more than 9,000 people aged 20 to 29 by the National Center for Health Statistics found that 30 percent of young adults had no coverage and were almost twice as likely as adults aged 30 to 64 to be uninsured.

People aged 20 to 29 account for more than a quarter of the estimated 45 million uninsured people in the United States, although they make up just 14 percent of the overall population, said Robin Cohen, who worked on the report.

The uninsured rates for people aged 20 to 29 are typically high because their coverage is disrupted as they move from childhood into adulthood, when they may be losing the coverage they had through their parents’ insurance or have reached the age limit for coverage under a public program, Cohen said in a telephone interview.

“They may be taking jobs of lower wages or temporary jobs typically available to young adults and many of these jobs often come with limited or no health benefits,” Cohen added.

The White House offered a plan on Monday that would allow young adults up to age 26 to stay on a parent’s health insurance plan but would not require employers to offer insurance.

The administration plan is aimed at closing gaps between House of Representatives and Senate legislation in order to revive its effort to overhaul the $2.5 trillion healthcare industry.

The government’s report said lack of health insurance coverage may “leave young adults vulnerable to high out-of-pocket expenses in the event of a serious illness or injury.”

“Young adulthood is also a time that there’s a high risk created for unintended pregnancy, sexually transmitted diseases, substance abuse and injury and these are things that are directly related to the need for health care services,” Cohen said.

More findings from 2008 National Health survey:

* Although 58 percent of those surveyed had private health insurance coverage, men with insurance were less likely than women to seek medical services.

* Young adults with no insurance were four times as likely as those with private insurance and two times as likely as those with Medicaid to have unmet medical need.

* Uninsured young women were almost twice as likely as uninsured young men to have had unfilled prescriptions in the past year.

* 10 percent of young adults needed medical care in the past year but did not get it due to cost.

Click here for the full report

White House to Unveil Health Care Plan

February 22, 2010

Good Morning America

By Jake Tapper

The White House this morning unveiled President Obama’s health care plan and the changes he wants to make to the Senate Democratic health care bill. Even before the release of the proposal, it had already met with fierce Republican resistance.

The plan will reduce the deficit by $100 billion over the next decade, and more than $1 trillion in the years after that, and expand health care to 31 million more Americans, according to the White House.

Administration officials call the health care bill a “jumping-off” point for Thursday’s televised, bipartisan discussions on health care overhaul.

“This is our take on the best way to merge the House and Senate bills,” a senior White House official told ABC News. The official said the proposal was “informed by our conversations from negotiations” before Sen. Scott Brown, R-Mass., was elected, thus depriving Democrats of their 60-vote majority, as well as from subsequent discussions.

“We thought it would be a more productive meeting if we brought one consolidated plan to use as jumping-off point,” the official said. “We hope the Republicans do the same.”

The White House proposal doesn’t just represent ideas but a potential strategy — to have the House pass the Senate bill, with fixes to come to make it more palatable.

With Brown’s win in Massachusetts last month, Democrats no longer have a supermajority, so they would pass the “fix” using a controversial maneuver that requires only 51 votes.

White House officials are signaling that Thursday’s discussion won’t be just a parlor meeting to chat about health care principles, though they insist their minds will be open to incorporate some Republican ideas.

“Maybe we’ll sit across from each other and identify 10 things we can move forward on,” the official said. “We hope new ideas come to the table. The proposal we’re walking into the meeting with is not the same one we will walk out of the meeting with.”

House Speaker Nancy Pelosi, D-Calif., believes passing the bill is “possibly doable,” the senior White House official said. “But she may ultimately decide the math is impossible.”

If that does not work, the next plan is to push a more modest bill — a smaller expansion of health insurance reform, some tax breaks for small businesses to help provide insurance for employees, a more modest expansion of Medicaid and the creation of the health insurance exchanges.

Among the fixes to the Senate bill that the president is proposing are “an additional series of measures proposed by Republicans to eliminate waste, fraud and abuse,” a White House official said. “The president believes the bipartisan discussion on Thursday will be the most productive if Democrats come to the table with a consolidated proposal — what he’s releasing today — and he hopes the Republicans will follow suit and come with their own unified proposal. He’ll be open to Republican ideas, and he hopes they’ll be open to ours.”

For the president, the conversation starts with four key parts of the Senate health care bill, which passed on Christmas Eve after weeks of deadlock.

First are insurance reforms, such as prohibiting insurers from denying coverage because of pre-existing conditions, a reform that Republicans have also said they would like to see happen.

Second, as proposed in both the House and Senate bills, the president wants to see health insurance exchanges created at the state level to ensure competition, a thorny point for Republicans.

Third, there would be no option of a government-run insurance plan that would compete with the private sector. The House health care bill includes a public option, but the Senate legislation does not, and even though the president initially pushed a public option as part of a health care overhaul package, he has said that to achieve compromise that aspect would need to be given up. Republicans are staunchly against any public option, saying it would hurt competition and the private sector.

Fourth, all Americans would be required to have health insurance coverage, and Medicaid would be expanded for low- and middle-income Americans to purchase health insurance. Both are points of contention for Republicans.

Click here for the full report

Affordable Healthcare in Mexico

February 22, 2010

Natural News

By David Gutierrez

As the debate over health care reform remains stalled in Congress, many U.S. residents are taking matters into their own hands by simply driving to Mexico for affordable care and prescriptions.

“I’m very lucky to live near enough to Mexico to get good healthcare at a reasonable price,” said retired police officer Bob Ritz, who lives in Tombstone, Ariz. Although Ritz does have insurance, many of his medical costs are simply not covered, or the co-pays and deductibles are so high that he cannot afford them on his fixed income.

“I pay $400 a month for my health insurance, and it’s still cheaper to come to Mexico,” he said.

In contrast to Ritz, approximately 46 million U.S. residents live without any medical insurance at all.

According to a study by the University of California-Los Angeles’ Center for Health Policy Research, roughly one million people go to Mexico for dental or medical care or prescriptions every year from California alone.

The primary difference between Mexican and U.S. health care is the cost — with many U.S. doctors having trained at Mexican medical schools and vice versa, and similar hygienic standards in place. Responding to the influx of people from the U.S. seeking affordable care, clinics in Mexican border towns now offer everything from regular dental care to cosmetic and weight-loss surgeries or other major procedures like hysterectomies.

In Naco, Mexico, Dr. Sixto de la Pena Cortes charges roughly $20 for a standard checkup. He says he gets about 15 patients from the United States every week. The most common complaints that he treats are “bronchitis, pneumonia and stomach problems,” he said, but he has also treated broken bones. Once, he referred a patient to a hospital for an appendix removal operation that cost $2,000.

“I waste up to four hours coming to an appointment, but it’s worth it as we’ll save thousands of dollars,” said Beatriz Iturriaga of Eastlake, California, who paid $6,500 for bariatric surgery in Tijuana.

A typical bariatric surgery in the United States costs as much as $40,000.

Click here for the full report

Can Healthy Eating Be a Disorder?

February 15, 2010

Time

By Bonnie Rochman

Kristie Rutzel was in high school when she began adhering precisely to the government food pyramids. As the Virginia native learned more about healthy eating, she stopped ingesting anything processed, then restricted herself to whole foods and eventually to 100% organic. By college, the 5-ft. 4-in. communications major was on a strict raw-foods diet, eating little else besides uncooked broccoli and cauliflower and tipping the scales at just 68 lb. Rutzel, now 27, has a name for her eating disorder: orthorexia, a controversial diagnosis characterized by an obsession with avoiding foods perceived to be unhealthy.

As the list of foods to steer clear of (bye-bye, trans fats and high-fructose corn syrup) continues to grow, eating-disorder experts are increasingly confronted with patients like Rutzel who speak of nervously shunning foods with artificial flavors, colors or preservatives and rigidly following a particular diet, such as vegan or raw foods. Women may be more prone to this kind of restrictive consumption than men, keeping running tabs of verboten foods and micromanaging food prep. Many opt to go hungry rather than eat anything less than wholesome.

Yet when Rutzel first sought help for anemia and osteopenia, a precursor of osteoporosis triggered by her avoidance of calcium, her doctor in upstate New York, where she attended college, had never heard of orthorexia. “You should be trying to eat healthy,” she remembers him telling her. He couldn’t quite grasp that he was talking to a health nut who believed there were few truly healthy foods she felt were safe to eat. Her condition was eventually identified as anorexia, a diagnosis that organizations like the Washington-based Eating Disorders Coalition think is a mistake. The group, which represents more than 35 eating-disorder organizations in the U.S., wants orthorexia to have a separate entry in the bible of psychiatric illness, the Diagnostic and Statistical Manual of Mental Disorders (DSM).

For the past decade, psychiatrists have been working on the fifth edition of the DSM — referred to as DSM-V — to refine the classifications used by mental-health professionals to diagnose and research disorders. Without a listing in the DSM, it’s tough to get treatment covered by insurance. And for researchers angling for grant money, a disorder’s absence from the DSM makes it hard to get research funded.

On Wednesday, the first draft of DSM-V was published online, kicking off a three-year process of public comment and further revisions that will culminate in a new and improved version come 2013. Orthorexia is not listed in this new draft and, despite the ongoing efforts of various eating-disorder groups, is unlikely to make its way into the final edition.

“We’re not in a position to say it doesn’t exist or it’s not important,” says Tim Walsh, a professor of psychiatry at Columbia University who led the American Psychiatric Association’s work group that reviewed eating disorders for inclusion in DSM-V. “The real issue is significant data.” Getting listed as a separate entry in the DSM requires extensive scientific knowledge of a syndrome and broad clinical acceptance, neither of which orthorexia has.

Most doctors think a separate diagnosis is unwarranted. Orthorexia might be connected to an anxiety disorder or it might be a precursor to a more commonly diagnosed condition, says Cynthia Bulik, director of the eating-disorders program at the University of North Carolina at Chapel Hill. “We don’t want people to be mislabeled and not get the care they need because they’re actually on the slippery slope to anorexia,” she says.

Kathleen MacDonald, who oversees legislative policy at the Eating Disorders Coalition, agrees with Bulik that people should get the care they need. Which is precisely why she thinks orthorexia should have its own classification. Although Bulik and others often use cognitive behavioral therapy, in which patients like Rutzel are coached to replace obsessive thoughts with healthy ones, MacDonald worries there is not enough known about which treatments work best for orthorexia. “It’s hit-or-miss,” she says.

After seeking help at three different facilities, Rutzel finally embraced a program of meal plans that challenged her to gradually incorporate foods she had blacklisted. Still slim in a size 2, she is engaged to a man whose oldest daughter is 9. And Rutzel says she is looking forward to sharing her experiences with food with her soon-to-be stepdaughter. “It’s O.K. to eat potato chips and Pop-Tarts,” says Rutzel, “but only every now and then.”

Click here for the full report

Tantrums in Children May be Labeled ‘Psychiatric Disorder’

February 15, 2010

Guardian

By Daniel Nasaw

Childhood temper tantrums, teenage irritability and binge eating may soon rate as psychiatric disorders in the US, according to proposed changes to the Diagnostic and Statistical Manual, the bible of the psychiatric profession.

The proposals are the product of a 10-year effort to update the handbook, which influences the vast network of American healthcare providers, insurance companies, courts, prisons and universities. At stake are billions of dollars in insurance payments, pharmaceutical sales and medical fees. The proposed revisions, published online today , will be subject to public comment until late April.

“It not only determines how mental disorders are diagnosed, it can impact how people see themselves and how we see each other,” Alan Schatzberg, president of the American Psychiatric Association, which publishes the guide, told reporters. “It influences how research is conducted as well as what is researched. It affects legal matters, industry and government programmes.”

The DSM is in its fourth edition. It has been criticised for formalising character traits and emotions into mental conditions and for encouraging their medical treatment, often with drugs that have powerful side effects.

Christopher Lane, a professor at Northwestern University and author of 2007 DSM critique Shyness: How Normal Behavior Became a Sickness, said: “The organisation is clearly opening another Pandora’s box here, as well as paving the way for the medication of even-greater numbers of children and teenagers cycling through emotional stages as part of normal development.”

In an email, Lane said that categorising binge eating as a psychiatric disorder risks classifying millions of Americans as mentally ill at a time when the country is trying to rein in health care costs.

Among the proposals is a new condition, “temper dysregulation with dysphoria”, characterised by “severe, recurrent outbursts of temper” several times a week, that are “grossly out of proportion to the situation or provocation and that interfere significantly with functioning”. To be considered, the “symptoms” must have been “diagnosed” before age 10.

The proposed revisions would also recognise binge eating as a disorder. The condition is “characterised by recurring episodes of the consumption of unusually large amounts of food, accompanied by a sense of loss of control and strong feelings of embarrassment and guilt”. These episodes would need to occur at least once a week over the last three months, and the writers were keen to distinguish it from mere overeating.

“While overeating is a challenge for many Americans, recurrent binge eating is much less common and far more severe and is associated with significant physical and psychological problems,” wrote Dr B Timothy Walsh.

The panels proposed a new category of condition called “risk syndromes”, in which a patient is at risk for a mental disorder that is not yet present.

For example, a moody teenager who displays “excessive suspicion, delusions and disorganised speech or behaviour” may be labelled as having psychosis risk syndrome. The panel estimated that a quarter to a third of people who suffer from those “symptoms” go on to develop a psychotic disorder, and the writers acknowledged the new category could lead to inaccurate diagnosis of some who are not at risk.

“Given the severity of psychotic disorders, and evidence that early treatment may mitigate its long-term consequences, we believed that it was important to begin to recognise these conditions as early as possible,” wrote Dr William Carpenter of the American Psychiatric Association’s psychotic disorders work group.

The panels who proposed the revisions also took into account how race, ethnicity and gender affect the incidence of psychiatric disorders, and studied how those categories affect the expression of symptoms. For example, researchers noted differing ways of experiencing and describing symptoms of panic among some Asian and Hispanic patients.

The panel also recommended discarding the term “mental retardation” in diagnoses, replacing it with “intellectual disability”.

Click here for the full report

Top 5 Health Insurers Post 57% Profit Gain

February 12, 2010

The Raw Story

By John Byrne

If no health care overhaul passes Congress, health insurers may be in for a windfall — and one far larger that most Americans probably realize.

According to a study by a pro-health reform group published Thursday, the nation’s largest five health insurance companies posted a 56 percent gain in 2009 profits over 2008. The insurers including Wellpoint, UnitedHealth, Cigna, Aetna and Humana, which cover the majority of Americans with insurance.

The insurers’ hefty profit gains came even as 2.7 million more Americans lost their insurance coverage due to the declining economy.

A lobbyist for American’s Health Insurance Plans, the trade group that represents insurers in Washington, D.C., attributed the gain in 2009 profits to a poor performance in 2008. In 2008, insurers were forced to write down their stock holdings because of the US market’s declines. Insurance companies keep a great deal of money in the markets, earning interest from the time between premiums are paid and the time when health providers are paid.

“It is disingenuous to look at the profits at one company today compared to where it was in the depth of a recession,” Robert Zirkelbach, a spokesman for America’s Health Insurance Plans, told the Cleveland Plain Dealer.

Click here for the full report

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