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House, Senate Committees Release Draft Health Care Reform Proposals
Democratic leaders in the House and Senate on Tuesday released draft versions of health care reform legislation in their respective chambers that outline several initiatives, including a public health insurance option that has been the focus of debate between Democratic leaders who favor it and Republicans and moderate Democrats who oppose the provision, The Hill reports (Soraghan, The Hill, 6/9). According to the New York Times, the draft bills represent an emerging consensus between the Senate and House on how to move forward with health reform (Pear, New York Times, 6/10).The Senate Health, Education, Labor and Pensions Committee"s 615-page draft health care bill would expand eligibility for Medicaid and allow families with incomes up to 500% of the federal poverty level to qualify for subsidies to purchase insurance. In addition, the bill includes an individual mandate requiring U.S. residents to purchase insurance, reforms for the insurance market, suspension of coverage denials based on pre-existing conditions and the establishment of a health insurance exchange where U.S. residents can compare and buy coverage (Budoff Brown, Politico, 6/9). Sen. Christopher Dodd (D-Conn.), the second-ranking Democrat on the HELP Committee, will lead mark-up sessions scheduled to begin June 16 while Committee Chair Edward Kennedy (D-Mass.) undergoes treatment for brain cancer (The Hill, 6/9). At a meeting of the House Democratic Caucus, the leaders of the three House committees charged with crafting health reform legislation outlined a bill with similar provisions to the one being written in the Senate (New York Times, 6/10). The bill -- which is being drafted by the chairs of the House Ways and Means, Energy and Commerce, and Education and Labor committees -- calls for a public plan, an individual mandate, a mandate for employers to help pay for coverage and the creation of a health insurance exchange. Under the House bill, families with incomes up to 400% of the federal poverty level would qualify for subsidies for insurance. The House bill also would expand Medicaid by determining eligibility entirely on income, according to a House aide. Currently, many Medicaid applicants must meet other criteria, such as being a parent, in addition to having a low income, to qualify. The House is expected to release a formal version of the bill next week.Both draft bills released on Tuesday did not include details on how the proposals would be financed. According to the Wall Street Journal the omission gives lawmakers time to better assess the costs involved and promote health reform to the public (Bendavid/Adamy, Wall Street Journal, 6/10).
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Also In Global Health News: HIV Aid For Vietnam; Gates To Meet With WHO; Women's Health In Philippines; Zambian Health Workers; HIV In Ghana
U.K. Pledges $30M To Vietnam HIV/AIDS Efforts
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IOM Vitamin D And Calcium Workshop On Aug. 4
As part of its study of how much vitamin D and calcium people need, a committee convened by the Institute of Medicine will hold a public workshop to gather insights and data from experts on Tuesday, Aug. 4. Among the workshop"s presentations will be a discussion of a recent vitamin D and calcium report released by the Agency for Healthcare Research and Quality, which can be found at http://www.ahrq.gov/clinic/tp/vitadcaltp.htm. A workshop agenda with a list of presentations is available at http://www.iom.edu/?id=68400.
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Medtronic Demonstrates Positive Results On First Pacemaker Designed For Use With MRI

New data announced at Heart Rhythm 2009, the annual congress of the Heart Rhythm Society, demonstrate that patients implanted with the investigational EnRhythm MRI™ SureScan™ pacing system experienced no complications related to the use of magnetic resonance imaging (MRI). Sponsored by Medtronic, Inc. (NYSE: MDT), the study confirms that the pacing system can help cardiac device patients benefit from the use of MRI, a critical imaging technique commonly used in disease diagnosis. Currently, due to safety considerations, there are no implantable pacemakers or defibrillators approved for use with MRI in the United States. Commercially released in Europe last fall, the EnRhythm MRI SureScan system is the world"s first and only pacing system designed and approved for use with MRI. Patients with currently implanted pacemaker and defibrillator systems are strongly discouraged from receiving an MRI scan, according to medical guidelines and the U.S. Food and Drug Administration. Studies have shown that commonly used MRI scanners can interrupt or withhold pacing therapy, deliver unnecessary pacing therapy that may be hazardous and possibly life-threatening, and/or cause damage to the device, regardless of which company manufactured the device. "Each year, approximately one million people are implanted with a pacemaker, thousands of whom should receive diagnostic MRI scans," said Bruce L. Wilkoff, M.D., director of Cardiac Pacing & Tachyarrhythmia Devices, Department of Cardiovascular Medicine and professor of medicine at Cleveland Clinic Lerner College of Medicine of Case Western Reserve University. "This investigational study showed positive results, indicating that many more patients may have access to MRI, a vital and often irreplaceable tool in detecting and managing conditions such as cancer and neurological disorders." Dr. Wilkoff is a paid consultant assisting Medtronic in the development of this therapy. Results showed that Medtronic"s investigational EnRhythm MRI SureScan pacing system still performs as intended during and after an MRI when used according to the product"s labeling. The data showed no MRI-related complications, and no arrhythmias, or asystole (absence of electrical activity in the heart) during MRI scans. "Despite well-documented risks and warnings of MRI-related complications, pacemaker patients do receive MRI scans off label," said David Steinhaus, M.D., medical director of the Cardiac Rhythm Disease Management business at Medtronic. "Physicians and patients faced with urgent clinical needs have had to make difficult risk/benefit decisions and accept the risks of an MRI scan. Through our development process, we identified real risks and designed a system to address these risks for pacemaker patients. We are encouraged by the clinical results of the EnRhythm MRI SureScan pacing system, as we believe that providing safe access to MRI for pacemaker patients can reduce risk and lead to better health outcomes." About the EnRhythm MRI SureScan Pacing System Clinical Trial This prospective, randomized, controlled trial involved 464 individuals successfully implanted at 41 centers in the U.S., Canada, Europe and the Middle East. After successful implant of pacemaker and leads, 258 patients were randomized to MRI and 206 to no MRI (control). All patients were evaluated before and after the scan, and one week and one month after MRI scan/control visit. There was no difference in performance between the MRI group and the control group. Medtronic


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