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Fertility Donor Debate, UK
Dr Gedis Grudzinskas the UK-based fertility expert issued the following statement in response to the statement by the Human Fertilisation and Embryology Authority:
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Malpractice Suits, Other Factors Contribute To Rise In Caesarean Births, Experts Say
Many doctors believe that the increase in caesarean section births in the U.S. over the last decade has been fueled by three main factors -- fear of malpractice lawsuits, a decrease in vaginal births after c-sections and rising rates of obesity -- the St. Petersburg Times reports. According to the Times, 31.8% of U.S. births were c-sections in 2007, compared with 21% a decade earlier, making c-sections the most commonly performed procedure in the nation"s hospitals.A few decades ago, c-section births were relatively rare, representing only 4% of U.S. births in 1965. According to the Times, c-section rates began to increase when it was believed that many cerebral palsy cases were the result of infants being deprived of oxygen during traumatic vaginal deliveries, which led to malpractice suits against doctors. At the same time, advancements in neonatal care and electronic fetal monitoring in recent decades have helped make the procedure safer and therefore more common. Robert Yelverton, a physician and board member of the Florida Obstetric and Gynecologic Society, said that doctors "tend to opt for the method of childbirth most likely to withstand a legal challenge." Whereas doctors in the past were more likely to use techniques such as vacuum extraction or manually turning an infant during a difficult birth, doctors today automatically opt for a c-section, according to Yelverton. According to the Times, one study found that 76% of U.S. obstetricians reported at least one litigation event, with an average award of $2.3 million for negligence in childbirth.An increase in obesity and a decline in VBACs also have driven the rise in c-section births, the Times reports. VBACs have declined from nearly 30% in the 1990s to 7.9% in 2005, which some doctors say is a result of fear of litigation because of the chance for rare but serious complications during birth. Similarly, obesity puts women at an increased risk for gestational diabetes, delivering prematurely or having larger infants, which can make birth more risky, the Times reports. More than one-third of U.S. women of childbearing age are overweight or obese (Martin, St. Petersburg Times, 6/17).
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Massachusetts' Budget Forces Retreat From Universal Coverage
"The new state budget in Massachusetts eliminates health care coverage for some 30,000 legal immigrants to help close a growing deficit, reversing progress toward universal coverage just as Congress looks to the state as a model for overhauling the nation"s health care system," the New York Times reports. The affected immigrants are permanent residents who have had green cards for less than five years and are insured through the Commonwealth Care program, an insurance program created by the 2006 law that brought near-universal coverage to Massachusetts. The cuts would save around $130 million (Goodnough, 7/14).
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Business Groups Note Faults In House Democrats' Overhaul Plan

House Democrats readying a health reform bill without a price tag or a budget analysis will hear from business interests today that their plan is irrevocably broken and that they need to start from scratch, CongressDaily reports. "With its strongest language yet, the business community today will condemn House Democrats" health reform proposal and tell lawmakers the bill is "broken beyond repair. ... Congress should take this legislation back to the drawing board," U.S. Chamber of Commerce senior vice president Randel Johnson said in testimony prepared for a House Ways and Means Committee hearing on health care today." Sticking points in the bill include the public plan that "would adhere to the same rules as private plans with pay rates similar to Medicare" and individual and employer insurance coverage mandates, the latter getting a decisive thumbs-down from the Chamber. "The shift comes after months of generally positive rhetoric on health care from a variety of interest groups, a tone that has shifted markedly as details of plans have emerged from both sides of the Capitol. ò€¦ The Chamber criticized the process used to develop the bill, echoing congressional Republicans who have complained that Democrats are moving too quickly and not allowing the minority adequate time to evaluate proposals" (Hunt, 6/24). The public plan remains contentious, The San Francisco Chronicle reports: "Sharp ideological divisions emerged at Tuesday"s hearing before Miller"s House Education and Labor Committee, with Republicans asking how a public plan would work better to contain costs than Medicaid and Medicare, and warning that any public plan would destroy the employer-based system of health insurance. Blue Cross/Blue Shield and the insurance industry trade group, America"s Health Insurance Plans, warned Tuesday that a government health plan would dismantle private insurers" (Lochhead, 6/24). Other groups are also criticizing parts of the House bill - like cutting Medicare payments for tests such as MRIs and other medical scans, The Associated Press reports: "Patients, rural doctors and advocacy groups who back the procedures will gather in the House Wednesday for a panel discussion." "Use of the procedures grew to 182 million in 2007, according to an industry study. The Obama administration cites figures showing Medicare"s price tag for the services doubled from $7 billion in 2000 to $14 billion in 2006. Though that spending dropped to $12 billion in 2007 as cuts enacted by Congress took effect, the administration says overly generous reimbursement rates and other factors encourage doctors to overuse imaging equipment. Obama has proposed reducing the Medicare payments by $5.9 billion over the next decade - a plan doctors and equipment makers say is based on flawed, outdated data" (Fram, 6/24). This information was reprinted from kaiserhealthnews.org with kind permission from the Henry J. Kaiser Family Foundation. You can view the entire Kaiser Daily Health Policy Report, search the archives and sign up for email delivery at kaiserhealthnews.org. © Henry J. Kaiser Family Foundation. All rights reserved.


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