As part of the Affordable Care Act, every state must have a health insurance exchange in place by January 2014. An exchange is a clearinghouse of sorts where people and small business can go to buy insurance and also find out which tax rebates they may use to help them buy coverage.
"I’ve heard people compare it to Expedia or Travelocity," says Lisa Kaplan Howe, policy director for NH Voices for Health. "You can do an apples to apples comparison of premiums and benefits and for the first time have all the information laid out in one place and be able to go to that place to purchase something to suit your needs."
Parents and doctors around the world have been alarmed by the dramatic increase in childhood asthma.
One factor in the upswing is better detection by doctors, but at least one doctor thinks a common over-the-counter drug also has something to do with it.
One tool doesn't fit all when it comes to surgery.
Pediatric surgeons know this all too well when it's time to operate on a baby. Some infants are born prematurely. Others have congenital defects — some part of their internal anatomy that just didn't develop the way it was supposed to.
In other words, plumbing problems. That's what Dr. Sanjeev Dutta, a pediatric surgeon at Lucile Packard Children's Hospital in Palo Alto, Calif., calls it. His job is to fix exactly these kinds of problems.
Tracy Grant was just 39 when she got the diagnosis.
"They asked me to stay a little bit longer because they saw something a little weird," she remembers. "In my mind I was saying, ... 'Here we go, this doesn't look good.' "
It was breast cancer. As devastating as the news was, it wasn't a surprise. Her mother, Catherine Grant, was diagnosed at age 51.
Breast cancer runs in the family. Three of Catherine's sisters also had it. They have all survived, but that's three generations of Grant women, including Tracy. Catherine says the whole family works to try to break that pattern.
New Hampshire lawmakers are proposing a law that would do away with the Certificate of Need process. This is a state requirement for hospitals and other healthcare facilities that want to expand or establish new medical facilities. The aim of CON is to keep redundant healthcare out of the system.
Cancer Treatment Centers of America is eyeing a spot in New Hampshire. The for profit chain wants to build a hospital in the Northeast. CTCA successfully lobbied Georgia to change its regulations so a specialty hospital could be built in that state. The company is hoping lawmakers in New Hampshire will make similar changes. A proposed law would exempt specialty cancer hospitals from certain regulations and also from Medicaid taxes. Representatives from CTCA were noticeably absent from a committee hearing on the bill Tuesday, but showed up on Thursday to make their case to lawmakers.
Lawmakers are now considering whether to give exemptions to for-profit cancer centers so they can do business in the state. Under current regulations these cancer centers are likely to be deemed redundant. But a new bill would allow them to avoid what is known as a Certificate of Need--to which all other hospitals must comply. These centers would also be exempt from Medicaid taxes.
A little over a year ago, a Massachusetts bone marrow registry made headlines for hiring models in blue wigs and black skirts to attract prospective donors. To make matters worse, the registry was part of a scheme to charge insurance companies extremely high fees for lab tests.
Both New Hampshire and Massachusetts launched investigations of UMASS Memorial Health Care, the home of the registry and the testing lab, for deceptive practices. Today, they announced a settlement involving hundreds of thousands of dollars. But individuals touched by the scheme sense the hospital largely got off scott free.
New Hampshire has one of the worst prescription drug abuse problems in the country. The state now ranks 5th in the nation for percentage of residents who abuse medications such as percocet, vicodin, and oxycodone, according to the Federal Centers for Disease Control. The problem is especially alarming among young people. New Hampshire has the second highest rate of 18-25 year olds who abuse prescription drugs in the nation.
Danielle Fiore , 24, says she was addicted to painkillers for most of her childhood.
"I had fractured my ankle and I was prescribed vicodin and it felt good. I was ten or eleven," she says. "As time went on I would get something else hurt or a toothache or something and I would get more painkillers. I have a bunch of teeth missing because I would complain and get them pulled so I would get pain killers."
Currently New Hampshire has no prescription drug monitoring program. The program, which is up and running in 48 other states, is initially funded through federal grants. The proposal to create a centralized prescription database that doctors and law enforcement could check to track so called "doctor shoppers" has been defeated several times in the state Legislature. A new bill is now being considered this session and its sponsor Senator Majority Leader Jeb Bradley, R-Wolfeboro, is hopeful that there is enough support for a statewide prescription monitoring program this time. He cites the growing number of overdose deaths in the state from prescription drugs. In the last decade overdose deaths from these medications have more than tripled.
For those who oppose a statewide prescription drug database privacy is a major issue. Rep. Neal Kurk, R-Weare, says such a program goes against the Granite State's core philosophy.
"This is New Hampshire, this is the 'Live Free or Die' state, " says Kurk. "One of the major reasons this bill has not been adopted is because most people feel it’s the independent philosophy, personal responsibility philosophy that prevails and that government should be small and not interfere with people’s lives."
Many of the state's independent pharmacists are also against a monitoring program because they worry they will end up footing the bill. The database would be drawn from pharmacy records. Rick Newman, a lobbyist for the New Hampshire Independent Pharmacy Association, says the small business people he represents will be end up carrying the burden of the costs of such a database.
"I can’t sit here as anyone with any kind of intelligence and disagree that’s there's a problem with people abusing prescription drugs in this country, of course there is," says Newman. "The question becomes whose burden is that? We can’t pass laws to put the burden on the small business person because they happen to be one part of the pipeline."
Emergency room doctors and those that treat pain say they are often confronted by patients who may be faking symptoms to get narcotics for their addiction or to sell on the street.
"I want people who have legitimate pain to get the proper pain medications that they need," say Dr. David Heller, an emergency room physician at Portsmouth Hospital. "But I don’t want to feed somebody’s addiction and I don’t want to write a prescription for drugs that are going to be sold to my kids or my kid's friends."
