(Circulation. 2001;103:e9056.)
© 2001 American Heart Association, Inc.
Cardiovascular News
Houston Medical Schools and Hospitals Hit by Massive Flooding
In Houston, Texas, hospitals and 2 medical schools, the University of Texas Medical School at Houston and Baylor College of Medicine, lost power and were put out of commission temporarily by massive flooding that hit the Texas Medical Center in the wake of Tropical Storm Allison on June 9, 2001.
Both Baylor College of Medicine and the University of Texas Medical School lost thousands of research animals, most of them mice, in the floodwaters that swamped basements and cut power to the 2 institutions. Both institutions scrambled immediately to save remaining animals and research that was imperiled by the power loss. By midweek, each was clear of water in the basements and at least emergency power was restored in both centers. Neither anticipates a glitch in educational activities, but it will take time to replace animals lost in the storms and to repair and revamp facilities damaged by water.
Memorial Hermann Hospital and the Methodist Hospital in the Texas Medical Center took the hardest hits in the storm. Both transferred patients to other facilities and discharged those who could go home. Memorial Hermann anticipates reopening in mid-July, and Methodist officials said they anticipated accepting new patients on a very limited basis by June 23, 2001. Methodist officials said they had 73 patients who remained in the hospital as of June 14, 2001. Texas Children’s Hospital’s basements took in some water, but the hospital was at full operation by midweek after the storm. St Luke’s Episcopal Hospital, which is home to the Texas Heart Institute, lost power during the storm as well and suffered research losses. The institution’s emergency room was closed for a time, and services were curtailed while recovery operations continued. The Institute for Rehabilitation and Research was at full operation by midweek.
The floodwaters caused damage to the Texas Medical Center that is estimated in the hundreds of millions of dollars. Houston’s Mayor, Lee Brown, speculated that damage to the rest of the city was in excess of $2 billion.
Federal Agency Asks for Chelation Clinical Trial
The National Center for Complementary and Alternative Medicine (NCCAM) has sequestered $30 million in funds over the next 5 years to pay for a clinical trial of chelation therapy to treat coronary artery disease (The Scientist. 2001;15:33). The controversial alternative treatment includes intravenous injections of vitamins plus EDTA (ethylene diamine tetra-acetic acid), a synthetic amino acid that can pull divalent and trivalent metallic cations such as magnesium and calcium from solution.
The treatment began in the 1950s, when some physicians theorized that EDTA might soften "hard" arteries by sequestering calcium ions. Because debate about the validity of the treatment has waxed and waned between established medicine and chelation practitioners, NCCAM and the National Heart, Lung, and Blood Institute are proposing large-scale clinical trials without the usual preclinical studies.
Christine Goertz, program director at NCCAM, told The Scientist, "We are interested in jumping ahead to clinical therapies and looking at treatments that are widely used by the public."
The request for application calls for a randomized, 2-arm, double-blind, placebo-controlled, multisite trial of EDTA chelation therapy.
Order Flu Vaccine Now, Urge Federal Officials
Although manufacturers of next season’s flu vaccine say they are on schedule, officials of the US Centers for Disease Control and Prevention are urging physicians to order their vaccine now. Letters urging physicians and clinics to place their orders went out in May.
"Last year, it was a highly unusual situation," Len Lavenda, a spokesman for Aventis Pasteur Inc, one of the manufacturers of the vaccine, told American Medical News in a story in the publication’s June 18, 2001, issue. "Several things happened at one time. It was a difficult strain. There were compliance problems that shut down plants." Those were the reasons that flu vaccine production was delayed last year, causing many in the population to defer their shots.
Although production seems to be going well this year, public health experts warn that there is always the possibility of a shortage because only a few companies undertake the complex task of manufacturing the vaccine.
Old Agency Gets New Name
Health and Human Services Secretary Tommy G. Thompson renamed the beleaguered Health Care Financing Administration June 14, 2001, as part of his plan to restructure the agency. The new Center for Medicare and Medicaid Services was rechristened, he said in a statement, to reflect an increased emphasis on responsiveness to beneficiaries and providers and on improving quality of care delivered to Medicare and Medicaid beneficiaries. The new name puts to rest the rumor that Secretary Thompson would call the agency the Medicare and Medicaid Administration, or MAMA, a moniker that had invited derision.
Secretary Thompson said his agency plans to:
- Launch a national
media campaign to give seniors and other Medicare beneficiaries more
information to help them make decisions about how they want to get
their health care;
- Instill a new culture of responsiveness at the Centers for Medicare and Medicaid Services in serving beneficiaries, physicians and other healthcare providers, states, and lawmakers;
- Enhance 1-800-MEDICARE (1-800-633-4227) to a 24-hour a day, 7 days a week service that will provide far more detailed information to help beneficiaries make Medicare decisions;
- Restructure the agency around 3 centers that reflect the agency’s major lines of business;
- Reform the contractor process to improve the quality and efficiency of the Medicare claims processing services (Medicare carriers and fiscal intermediaries) that pay nearly a billion fee-for-service Medicare claims each year.
- Instill a new culture of responsiveness at the Centers for Medicare and Medicaid Services in serving beneficiaries, physicians and other healthcare providers, states, and lawmakers;
"We’re making quality service the number one priority in this agency," said Secretary Thompson. "These sweeping reforms will strengthen our programs and enable our dedicated employees to better serve Medicare and Medicaid beneficiaries, as well as healthcare providers. We’re going to encourage innovation, better educate consumers about their options, and be more responsive to the healthcare needs of Americans."
The 3 new business centers being created as part of the reforms are the Center for Beneficiary Choices, the Center for Medicare Management, and the Center for Medicaid and State Operations. The Center for Medicare Management focuses on the management of the traditional fee-for-service Medicare program, including the development and implementation of payment policy and management of the Medicare carriers and fiscal intermediaries. The Center for Beneficiary Choices focuses on beneficiary education, providing beneficiaries with the information they need to make their healthcare decisions. This center also includes management of the Medicare+Choice program, consumer research and demonstrations, and grievance and appeals. The Center for Medicaid and State Operations focuses on programs administered by the states, including Medicaid, the State Children’s Health Insurance Program, private insurance, survey and certification, and the Clinical Laboratory Improvement Amendments (CLIA).
To manage the Medicare program more effectively and
responsively, the Centers for Medicare and Medicaid Services will
develop a legislative proposal to be submitted to Congress that would
provide for competitive bidding of claims processing services. Medicare
currently contracts with private health insurance companies to process
and pay Medicare claims. Collectively, these contractors employ
22 000 individuals and handle >900 million Medicare claims each
year.
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