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Showing posts with label Georgia. Show all posts
Showing posts with label Georgia. Show all posts

Monday, September 23, 2013

State Politics and the Fate of the Safety Net

Lacking workers' compensation coverage, injured workers rely upon a safety net of Federally provided medical benefits. Under the Affordable Care Act that safety net is shrinking. Today's post was shared by WCBlog and comes from www.nejm.org


Only 2% of acute care hospitals nationwide are safety-net facilities, but they provide 20% of uncompensated care to the uninsured. Because most are in low-income communities, they typically generate scant revenue from privately insured patients. The Medicaid Disproportionate Share Hospital (DSH) program was established to help defray their costs for uncompensated care.

Currently, Medicaid DSH disburses $11.5 billion annually to the states, which have considerable latitude in allocating these funds. Some states carefully target their DSH payments to hospitals providing large volumes of uncompensated care, but others, such as Ohio and Georgia, spread their payments broadly, transforming the program into a de facto subsidy of their hospital industry.

Because the Affordable Care Act (ACA) was expected to dramatically expand insurance coverage, safety-net hospitals were expected to need less DSH money. Therefore, to reduce the cost of expanding Medicaid, the ACA reduced Medicaid DSH funding by $18.1 billion between fiscal years 2014 and 2020. To allow time for coverage expansion to take effect, the cuts are back-loaded — starting at $500 million (4% of current national DSH spending) in 2014 but reaching $5.6 billion (49% of current spending) in 2019.

The DSH cuts are so deep in part because Congress assumed that all...
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Saturday, August 28, 2010

There is No Good Asbestos -- It Is All a Killer


Chrysotile Asbestos and Mesothelioma

Richard A. Lemen
Assistant Surgeon General, U.S. Public Health Service (retired), National Institute for Occupational Safety and Health (retired), Canton, Georgia, E-mail: richard@ralemen.org
The Editor’s Summary for the article by Tse et al. (2010) stated the following:

Assuming an average latency of 42 years, the authors predict that incidence rates will peak in 2009 and that diagnoses will peak in 2014. However, they caution that ongoing use of chrysotile asbestos (which has been implicated but not conclusively established as a cause of mesothelioma) and the release of asbestos fibers from older buildings during demolition or renovation may slow the projected decline.
The statement concerning chrysotile asbestos being “implicated but not conclusively established as a cause of mesothelioma” is inconsistent with current scientific opinion. I refer you to the most recent evaluation by the International Agency for Research on Cancer in which Straif et al. (2009) stated,
Epidemiological evidence has increasingly shown an association of all forms of asbestos (chrysotile, crocidolite, amosite, tremolite, actinolite, and anthophyllite) with an increased risk of lung cancer and mesothelioma. Although the potency differences with respect to lung cancer or mesothelioma for fibres of various types and dimensions are debated, the fundamental conclusion is that all forms of asbestos are “carcinogenic to humans” (Group 1).
In addition, opinions such as that expressed in the Editor’s Summary are advanced only by scientists with prochrysotile industry bias.
When I wrote the draft for the first IARC Monograph on asbestos in 1976, which the expert committee accepted and published in 1977 as IARC Monograph Volume 14, a similar conclusion was stated: “Many pleural and peritoneal mesotheliomas have been observed after occupational exposure to crocidolite, amosite and chrysotile.” Since then—more than 30 years—science has not changed its opinion that all forms of asbestos, including chrysotile, cause mesothelioma.
In fact, in the article that is the subject of the Editor’s Summary, Tse et al. (2010) did not indicate that chrysotile is not a cause of mesothelioma; on the contrary, they stated the following:
Although the mesothelioma incidence is anticipated to decline in the coming decades, it may not decrease to background risk levels given that chrysotile consumption has not been banned under the current legislation and that secondary asbestos exposure from the environment will likely continue. Nevertheless, the hypotheses generated from this ecologic study need further confirmation by subsequent analytic studies. The present study provides supportive evidence for an immediate and global ban on asbestos use.
I hope that future Editor’s Summaries will reflect the conclusions of the article and not put forth statements that are not supported by mainstream science. I also support the conclusion of Tse e al. (2010) for “an immediate and global ban on asbestos use.”

References Top

  1. IARC 1977. Asbestos. IARC Monogr Eval Carcinog Risk Hum 14: 1–106. FIND THIS ARTICLE ONLINE
  2. Straif K, Benbrahim-Tallaa L, Baan R, Grosse Y, Secretan B, El Ghissassi F, et al. 2009. A review of human carcinogens—part C: metals, arsenic, dusts, and fibres. Lancet Oncol 10: 453. –454. FIND THIS ARTICLE ONLINE
  3. Tse LA, Yu IT, Goggins W, Clements M, Wang XR, Au JS, et al. 2010. Are current or future mesothelioma epidemics in Hong Kong the tragic legacy of uncontrolled use of asbestos in the past? Environ Health Perspect 118: 382–386. FIND THIS ARTICLE ONLINE
Click here to read more about asbestos related disease and claims for benefits. For over 3 decades the Law Offices of Jon L. Gelman 1.973.696.7900 jon@gelmans.com  have been representing injured workers and their families who have suffered asbestos related illnesses.

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