HEALTH REPORTING All Daily DivisionFIRST PLACE IT BACK GETTING Moxie, 1F The Post and Courier Doctors’ paid talks in y August 7, 2011 meless female vets on rise T H E S O U T H’S O L D E S T DA I LY N E W S PA P E R . F O U N D E D 1803 POSTANDCOURIER.COM Charleston . North Charleston, S.C. ✯✯ $ question Renee Dudley Charleston, S.C. ✯✯ $2.00 Drug makers compensate presents specific challenges to shelters, VA hospitals ‘Proviso’ physicians for appearances BY RENEE DUDLEY ARKER ndcourier.com for adventure and op- forces veterans Sandra Perkins and Catherine Premo found it increas- ingly difficult to find a job. Then they had no roof over their percent of the national population of homeless vets, which can number about 200,000 on any given night, ac- cording to the National Coalition for keeping email@example.com d to escape what they heads. the Homeless. be a dead-end life. Now they are living at Crisis Minis- The Department of Veterans Af- The pharmaceutical industry fun- d up with the military tries, Charleston’s homeless shelter. fairs also said it expects the number neled nearly $3 million to South Caro- es were changing and Perkins, 54, and Premo, 56, are of homeless female veterans to rise docs paid lina doctors in 18 months, prompting being encouraged to among a growing number of homeless dramatically in years to come. concerns over whether the cash pay- were promised a college female veterans turning up at shelters Homelessness tends to afflict vet- ments influence physicians’ prescrip- d a career path. and VA hospitals around the country, erans some years after they have GRACE tion writing. e — after failed relation- and they present specific challenges to left the military, according to Crisis Navy veteran Catherine Premo (center) and Sharron Wilson t The data, compiled by national h of children, personal service providers. education classes from Peter Maravel at Crisis Ministries. Prem S.C. Medicaid one of a few that investigative news organization ProPublica, shows the payments of ubstance abuse — armed Women account for 3 percent to 4 Please see VETS, Page 10A is homeless, hopes that the class will help her find a job. can’t adjust reimbursements $258 million that seven drug com- panies made to doctors across the Invest Treatment DENIED BY RENEE DUDLEY country between January 2009 and firstname.lastname@example.org June 2010. While the payments are legal, critics The state Medicaid agency in recent charge that they are unethical, creat- months has slashed dozens of pro- grams, including those that aid dia- betics, the disabled and the dying. ing a conflict of interest that could cause doctors to ramp up prescrip- tions for drugs they are paid to hawk s unsure psyche g g y y But the budget ax has spared pay- during speaking engagements. Cross resident with breast cancer disqualified at risk ments to doctors, dentists and other “Their decision to prescribe a drug providers. becomes influenced by money instead rmon The reason? of which drug is the most effective, idates for Medicaid program because he is a man Dialysis alert A “proviso” stuck in the budget in least dangerous or least expensive,” October 2008 restricts the state De- said Sidney Wolfe, director of the te, 1B partment of Health and Human Ser- Health Research Group of Public Citi- vices from cutting payments Medic- zen, a nonprofit consumer watchdog Fallout of debt dow aid makes to health care providers. National health care observers said group in Washington, D.C. Local doctors say the paid talks are among could slam U.S. ma this week that South Carolina appears necessary forums for educating their oops killed 21 clinics in S.C., including 1 in Moncks Corner, to be one of the only states where a state Medicaid agency is barred from colleagues on new medicines that could help patients. istan BY PAUL WISEMAN Associated Press Costs vs. Care adjusting reimbursement rates. Dur- Caught in the crossfire between pa- orld, 13A listed as having alarmingly high death rates ing the recession, all but a handful of states have used the tactic to save tients and doctors are academic hos- pitals, whose teacher-physicians are WASHINGTON — The r from the downgrade of U money and stave off cuts to entire recruited heavily by the industry. ment debt by Standard & programs that help the needy, such Officials at the Medical University higher interest rates. It’s th as hospice and dental services. of South Carolina, whose doctors nation’s fragile economic p In South Carolina, the groups spared have received the lion’s share of in- rattled financial markets. S&P’s decision to strip th Dispute arises over state plan to cut hospice option Please see PROVISO, Page 10A dustry payments to the Lowcountry, said they have struggled to enforce policies that provide oversight on the sterling AAA credit rating time and move it down on relationships between their staff and AA+, deals a blow to the con BY RENEE DUDLEY email@example.com Upcoming Medicaid cuts that elimi- States drug companies. MUSC administrators are consid- ering toughening the school’s con- flict of interest policy, which will consumers and businesses a ous time, economists said The agency is “striking a of what makes the globa nate hospice care coverage for termi- nally ill adults could end up costing South Carolina more than it saves, feel pinch Please see DOCTORS, Page 10A doubt, rls Clubs tick,” said Chris Rupkey, c cial economists for the Ban Mitsubishi UFJ. “It isn’t j hospice providers said this week. With the cuts taking effect Feb. 1, advocates are warning state officials about potential fallout beyond the financially FAITH & VALUES nefactor te, 1B and cents.” One economist, Paul Capital Economics, worri downgrade could even trig human toll on patients and families: With revenues down, key GRACE BEAHM/STAFF er financial crisis that send Medicaid patients denied hospice care will seek medical attention elsewhere services being threatened Raymond Johnson of Cross found a lump in his left breast and was diagnosed with breast cancer in July. Please see PSYCHE, Page 11A Q&A at a higher cost. Uninsured, Johnson, 26, must rely on the generosity of hospitals and doctors for treatment. “Folks in hospice are sick and dy- BY SHANNON MCCAFFREY ing,” statewide hospice advocate and JUDY LIN BY RENEE DUDLEY firstname.lastname@example.org Inside Cancer WADE SPEES/STAFF Tamra West said. “If they’re not in Associated Press Tony Simmons is trying to bring attention to problems in the kidney dialysis business — with hospice, they’re going to be sick and doesn’t particular attention to the RAI clinic in Moncks Corner (background). BY RENEE DUDLEY email@example.com Simmons is among about 10,000 people who regularly receive dialysis in a state Inside dying somewhere else. Cutting hos- pice is going to cost the state more, so why do it?” State officials said they are aware SACRAMENTO, CALIF. — If 2011 is hinting at a national recovery, there is little sign of it in statehouses across the country. Creche re-created in big, small ways R aymond Johnson checked himself into the emergency room last month for a throbbing pain in his chest. The 26-year-old was stunned when the Specifics of the Breast and Cervical Cancer Prevention and Treatment Act of 2000. 10A discriminate, so this program on Standard & P that has fallen behind in monitoring di- S.C. lags in clinic of the economic risks and that they States that already have raided their o if doctors delivered his diagnosis — breast enacted in 2000, uses Medicaid funds to inspection. 6A cancer. cover treatment for breast cancer or cervi- shouldn’t A machine stands in the center of Tony Simmons’ world. alysis clinics, even the ones that have re- ported alarmingly high death rates. have no choice but to make immediate cuts to grapple with crippling budget reserve funds, relied on borrowing or accounting gimmicks, and im- ff- ing The Christmas Nativity displays in Mepkin Abbey’s have a Uninsured and unable to pay for costly cal cancer patients who otherwise wouldn’t downgrade of U.S For 3½ hours, three times a week, the In fact, 11 of the 21 South Carolina di- Graphic shortfalls. posed deep cuts on schools, parks g festival celebrate a spiritual l foyer surgery and chemotherapy, the Cross resi- qualify for the state and federally funded discriminate. single father of two is tethered to a di- alysis clinics listed as having the highest depiction of “We recognize a danger of driving and public transit systems no longer journey. 1G dent followed the advice of his patient ad- health insurance program for the poor and BY PALLAVI GOGOI vocate and applied for a Medicaid program disabled. Raymond Johnson alysis machine that removes all his blood death rates are the same ones state inspec- how dialysis up long-term costs, but we don’t have can protect key services in the face of rden, 1D and PETER SVENSSON through a tube in his arm, stripping the tors admit they haven’t had a chance to works. 6A the luxury of being able to think long- another round of multibillion-dollar that covers breast cancer treatment. Patients must meet a host of eligibil- Associated Press impurities, salt and excess fluid before check out in more than four years. term in that regard,” said S.C. Depart- deficits. F Mostly sunny. A few days later, Johnson got another ity requirements. According to the South pumping it back into his body. Simmons’ former clinic is among Dialysis ment of Health and Human Services As governors roll out their bud- High 74. Low 41. surprise. He was denied for the program Carolina Medicaid agency, Johnson met all Standard & Poor’s has The 38-year-old Summerville resident the 11. clinics by the spokesman Jeff Stensland. “We have At top, a Bible is open to Psalms in a waiting room at get proposals and legislatures con- Complete 5-day because he is a man. except one: Men aren’t allowed. unprecedented step of low has chronic kidney disease stemming numbers. 6A to make cuts that chip away at this the Hospice of Charleston in Mount Pleasant. Above vene this month, they do so amid a A forecast, 8B The Breast and Cervical Cancer Pre- top credit rating that the U from a genetic disorder. Please see DIALYSIS, Page 6A year’s deficit.” is the facility’s chapel. In February, South Carolina vention and Treatment Act, a federal law Please see DENIED, Page 10A for 70 years. A look at this d will be the only state in the U.S. in which Medicaid Please see STATES, Page 10A and downgrades in gene Please see DISPUTE, Page 11A does not cover adult hospice care. what they mean: Q: What did Standard
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