Worth Noting GAO Warns of ‘High Risk’ Gaps in Food Safety The U.S. Government Accountability Office (GAO) has identified food safety as a high-risk area for the federal government. The GAO points out that responsibility for keeping the human food supply safe is fragmented among 15 federal agencies that administer at least 30 laws related to food safety; the two agencies with biggest responsibilities are the U.S. Department of Agriculture (USDA), which is responsible for the safety of meat, poultry, and processed egg products, and the Food and Drug Administration (FDA), which is responsible for virtually all other food. The majority of federal expenditures for food safety inspections are directed to USDA programs, even though the USDA has authority over only about 20 percent of the food supply. The FDA, which is responsible for regulating the other 80 percent of the food supply, gets only about 24 percent of federal food safety expenditures. And in one of the most critical gaps, the federal agencies have no authority to require food recalls and no authority to compel companies to carry out recalls (with one exception--the FDA can require recalls of infant formula). The GAO points out that because of those limitations, federal agencies never know how promptly or completely recalls are carried out, whether the recall information reaches all segments of the distribution chain, or whether consumers are alerted to a recall. “Limitations in the federal government’s food recalls heighten the risk that unsafe food will remain in the food supply and ultimately be consumed,” the GAO warns. HPV Vaccine Is Controversial in States In New Hampshire, where the vaccine is being provided free, demand for the new human papillomavirus vaccine (HPV) is outstripping demand. But in California, state legislators in April decided not to mandate HPV vaccination for seventh-grade girls and are considering waiting five years before adding the vaccine to the list required for school enrollment. In New Mexico, Governor Bill Richardson vetoed legislation to require vaccination of sixth graders, saying there isn’t enough time to educate parents, schools, and health care providers about the vaccine. In Texas, an executive order by the governor requiring HPV vaccination of 11- and 12-year-old girls has been put on hold by a judge; and in South Carolina, the legislature voted down a bill requiring vaccination. Still awaiting action in at least 18 state legislatures, many of which have adjourned for the year, mandatory immunization against HPV and ovarian cancer does not seem likely for next school year in most parts of the country, according to infectious disease specialists. Among the problems cited by legislators is uncertainty about the “window of effectiveness” of the vaccine, now believed to be about five years. That would mean that girls vaccinated at age 12 would no longer be protected when they were 17 and beyond, the ages at which women seem to become most vulnerable to HPV. The vaccine, Gardasil, is manufactured by Merck, which called off lobbying state legislatures for mandatory immunizations in February. Setting a Higher Bar for Health Care America’s Health Insurance Plans (AHIP), an organization of private health insurers who claim to cover 200 million Americans, says the United States can do better to improve health care. For starters, the AHIP suggests we should:
The AHIP would like to create a system for resolving medical disputes that would replace the current tort system with review of claims by independent third parties, fair compensation for damages, and quick resolution of disputes. The AHIP also calls for finding innovative ways to manage chronic conditions, which it says account for large parts of the national medical bill. The following information appeared during the month of April 2007 in the News Alerts section of the website of the Center for Health and Health Care in Schools, at www.healthinschools.org. The American Academy of Pediatrics (AAP) in a special announcement today said it is alarmed that the soaring costs of vaccines, combined with lower reimbursements from insurance companies, will lead to under-immunization of the nation’s children and unnecessary outbreaks of preventable diseases. “The system for delivering vaccines is broken, and we’re going to be in real trouble if it isn’t fixed soon,” said AAP President Jay Berkelhammer. The AAP points out that pediatricians must often wait months for payments from insurers, including Medicaid and private health plans, and that in addition to the cost of a vaccine, additional costs of ordering, storing, inventory control, insurance, and spoilage are not taken into consideration by insurers. Approximately 85 percent of American children are vaccinated at pediatricians’ offices, but flaws in the current system “threaten to greatly reduce or even eliminate the physician provider role, causing many children not to get the comprehensive and preventive health care they need,” the AAP said. “Pediatricians are not looking to make huge profits off vaccines,” said Jon Almquist, chair of the AAP’s Task Force on Immunization. “We’re in pediatrics because we care about children—but we shouldn’t be expected to subsidize the public health system and perform our jobs at a loss. We have carried this burden for long enough.” One of the techniques for controlling weight—bariatric surgery, which restricts stomach size, thereby decreasing the amounts of calories and nutrients the body absorbs—is being recommended for extremely overweight adolescents, but the effects of such treatment on young persons has not been studied, according to the National Institute of Diabetes and Digestive and Kidney Diseases in the National Institutes of Health. To try to determine if bariatric surgery is an appropriate treatment for adolescents, the Institute over the next five years will collect data on some 200 adolescents who are scheduled for bariatric surgery and compare that information to data obtained from a similar number of adults who had the surgery after being obese in their adolescent years. The project, Teen-LABS, is being conducted by children’s hospitals in Alabama, Ohio, Pennsylvania, and Texas. Study participants will be expected to pay the cost of their surgery and related medical care through medical insurance or other means. Adolescents between 14 and 19 years are eligible for the study but younger patients will also be considered under some circumstances. For more information, the central study coordinator can be contacted by e-mail at Rosemary.Miller@cchmc.org. Recent outbreaks have shown that too many people in the United States are getting sick each year from foodborne illnesses, according to the federal Centers for Disease Control and Prevention (CDC). Specifically, recent cases involving tomatoes, lettuce, and spinach underscore the need to more effectively prevent contamination of produce, said CDC Director Julie Gerberding. In a report released April 12, the CDC cited data on foodborne illnesses reported to the agency in 2006 as part of a surveillance network known as FoodNet. The most recent data show little improvement in the incidence of Salmonella and E. coli 0157, possibly as the result of contamination of foods not previously associated with those illnesses, such as spinach and peanut butter, the CDC said. “Previous efforts to decrease the incidence of E. coli 0157 in ground beef and Salmonella in eggs have been successful, but contamination of other foods may be the problem now,”according to Dr. Robert Tauxe, deputy director of the CDC’s Division of Foodborne, Bacterial, and Mycotic Diseases. The full report, “Preliminary FoodNet Data on the Incidence of Infection with Pathogens Transmitted Commonly Through Food” appears in the April 13, 2007, issue of Morbidity and Mortality Weekly Report and is available online at www.cdc.gov/mmwr. The American Academy of Pediatrics is calling attention to resources posted on its website that aim to help teachers, students, physicians, children, and teens cope with disasters such as the campus shooting at Virginia Tech University. The website includes tips on talking to children after a disaster, stress management guidelines for children and teens, and gun violence prevention. Pediatricians who are mental health and violence prevention experts are available to discuss the emotional impact of school and community violence. The resources are posted at www.aap.org and the AAP may be contacted for more information or to set up interviews at 847-434-7131 or mweinstein@aap.org. The United States Supreme Court today said a federal law banning a method of ending fetal life in the later stages of pregnancy—often referred to as “partial birth”—is constitutional. In a 5-to-4 decision, with Justices Kennedy, Roberts, Scalia, Thomas, and Alito concurring and Justices Ginsburg, Stevens, Souter, and Breyer dissenting, the Court said its ruling leaves women free to choose an abortion “before fetal viability” but prohibits a doctor from performing an “intact D&E procedure” in the later stages of pregnancy. Planned Parenthood immediately announced that “There is no way we will let this stand,” saying the Supreme Court’s majority “turned its back on more than 30 years of decisions that protected women’s health from dangerous laws that restrict abortion.” The case before the Court was Gonzales v. Carhart. In a report released today, the Institute of Medicine (IOM) lays out 10 principles “to support the creation of healthful eating environments for U.S. schoolchildren” and cites foods and beverages that would meet “Tier l” and “Tier 2” standards. Tier l options, which “are to be encouraged,” would include a la carte entrées that meet fat and sugar limits, and “Tier 2” options would be snack foods that do not exceed 200 calories per portion. The full text of the IOM report is available at www.nap.edu. |
