Daily Rounds: Pharmacy Oversight Failures; Overdiagnosed Breast Cancer; Einstein’s Brain Revealed

Oversight Failures Documented In Meningitis Outbreak (The New York Times) — “Newly released documents add vivid detail to the emerging portrait of the Food and Drug Administration’s ineffective and halting efforts to regulate a Massachusetts company implicated in a national meningitis outbreak that has sickened nearly 500 people and killed 34. In the documents, released on Tuesday in response to a Freedom of Information Act request, the agency would threaten to bring the full force of its authority down on the company, only to back away, citing lack of jurisdiction. The company, the New England Compounding Center, at times cooperated with F.D.A. inspectors and promised to improve its procedures, and at other times challenged the agency’s legal authority to regulate it, refused to provide records and continued to ship a drug in defiance of the agency’s concerns.”

One million women ‘overdiagnosed’ with breast cancer due to mammograms, controversial study suggests ( — “Researchers estimated…that mammograms caused more than 1 million American women over the past three decades to be diagnosed with early-stage breast cancers that would not have proved fatal if left undetected and untreated — a controversial finding sure to provoke more heated debate over the benefits of the screenings. The study, published in the New England Journal of Medicine, concluded that these women were “overdiagnosed” and “overtreated” because there was not a corresponding decline in the diagnosis of tough-to-cure breast cancers that have already spread. The authors said mammography has saved few lives.”

Scientists Get A New Look At Einstein’s Brain (NPR) — ‘So what did they find? Well, they analyzed 14 of these photographs and compared the visible parts of Einstein’s outer brain with 85 human brains previously described in scientific studies. “Einstein’s brain differs from the average human brain,” says Falk. “In various parts, it’s more convoluted. It’s bumpier, and that may be related to an increase in the neurons.” The museum released an iPad app to view the slides back in September. Witelson says the new analysis and photos may encourage other scientists to take a crack at Einstein’s brain. “Einstein’s aura lives on,” she says.’

Daily Rounds: Cell Phones And Turkey; Steward Job Cuts; Diet Soda For Weight Gain? Happy Thanksgiving!

When Phones Come Out Long Before The Turkey (The New York Times) – “Not long ago, pulling out a phone to send a photograph of Thanksgiving dinner or a text about the proceedings was considered rude, a violation of the “eat it, don’t tweet it” rule. But almost 40 percent of the 234 million Americans over the age of 13 with a mobile phone now use a social network, according to the analyst group comScore, and the numbers are growing fast. Instagram, the darling of people who love to share pictures of what they’re eating, has more than doubled its members to more than 100 million in less than a year, according to Facebook, the company that bought Instagram this spring. Facebook says Thanksgiving is one of its busiest days of the year.”

Steward Health Care Systems To Cut Jobs At Three Of Its Community Hospitals ( — “Managers at three community hospitals owned by Steward Health Care System have notified representatives of Local 1199 of the Service Employees International Union that they plan to eliminate as many as 35 service and technical jobs, union leaders said Wednesday. Over the past week, they said, Steward officials alerted them of its intention to cut 15 union jobs at Norwood Hospital, 12 at Carney Hospital in Dorchester, and seven or eight at Morton Hospital in Taunton. Because the union is proposing alternatives to job cuts and other union members have “bumping rights,” Local 1199 officials said they expect fewer than 35 members will lose their positions. Other workers who are not Local 1199 members also could be affected by the cuts. In an internal letter to colleagues, Norwood Hospital president Emily Holliman warned of “challenging times in our industry,” citing federal cuts to Medicare reimbursements along with the Massachusetts health care payment overhaul, which seeks to reduce costs. Steward spokesman Chris Murphy declined to discuss the number of job cuts planned at the hospitals.”

Is Diet Soda Making You Overweight? (Everyday Health) — “Of top concern, drinking diet soda has been linked to developing metabolic syndrome. Metabolic syndrome is a group of conditions that include expanding waist size, increased blood pressure, elevated triglycerides, lower levels of good cholesterol, and high fasting blood sugar levels. Having three or more of these findings increases your risk of diabetes and heart disease. Here are some other research findings you should know about diet soda: According to the San Antonio Heart Study, the more diet sodas you drink, the greater the chance that you will be overweight or obese. For each diet soda you drink there is a 65 percent increase in your risk of becoming overweight. According to the Framingham Heart Study, if you drink diet soda you are at risk for weight gain and metabolic syndrome. According to research done at Purdue University, rats that were fed artificial sweeteners gained more weight than rats fed normal sugar. Findings from the Atherosclerosis Risk in Communities Study sponsored by the National Heart, Lung, and Blood Institute, show that meat, fried food, and diet soda are all significantly associated with metabolic syndrome.”

Daily Rounds: ‘Essential’ Obamacare Benefits; Call For OTC Birth Control Pills; Criminal Steroid Charges? Toilet Technicolor

Administration defines benefits that must be offered under health law (The New York Times) – “The proposed rules, issued more than two and a half years after President Obama signed the Affordable Care Act, had been delayed as the administration tried to avoid stirring criticism from lobbyists and interest groups in the final weeks of the presidential campaign. Insurance companies are rushing to devise health benefit plans that comply with the federal standards. Starting in October, people can enroll in the new plans, for coverage that begins on Jan. 1, 2014. The rules translate the broad promises of the 2010 law into detailed standards that can be enforced by state and federal officials. Under the rules, insurers cannot deny coverage or charge higher premiums to people because they are sick or have been ill. They also cannot charge women more than men, as many now do.”

Pharmacy case may see call for jail time (The Boston Globe) – “The top executives of New England Compounding Center are likely to be criminally prosecuted on federal charges that carry possible prison sentences, according to former prosecutors who cite the large number of people harmed, allegedly by contaminated steroids made by the Framingham pharmacy. US Attorney Carmen M. ­Ortiz, whose Boston office is known for aggressive prosecution of health care companies, acknowledged in a statement last month that she is probing New England Compounding, but has declined further comment. Agents from the US Food and Drug Administration’s ­Office of Criminal Investigations were seen last month combing through the company’s Framingham offices.”

OB/GYNs back over-the-counter birth control pills (AP in San Jose Mercury-News) – “The nation’s largest group of obstetricians and gynecologists says birth control pills should be sold over the counter, like condoms, without a prescription or doctor’s exam. Tuesday’s surprise opinion from these gatekeepers of contraception could boost longtime efforts by women’s advocates to make the pill more accessible. But no one expects the pill to be sold without a prescription any time soon: A company would have to seek government permission first, and it’s not clear if any are considering it. Plus there are big questions about what such a move would mean for many women’s wallets if it were no longer covered by insurance.
Still, momentum may be building.”

Making sense of colors and shapes in the toilet (NPR-Shots) – “If you haven’t heard, yesterday was World Toilet Day, and its sponsors, the Water Supply and Sanitation Collaborative Council and the World Toilet Organization, suggest you take a moment to consider the profound luxury of good sanitation. A mind-boggling 2.6 billion people on Earth don’t have toilets, and WSSCC and WTO are among the parties set on bringing that number down. Here at Shots, we’re all for “breaking the taboo around the toilet” (see our recent posts on squatting and fake feces). And we get the sense that there’s more confusion out there about what ends up in the toilet than most people would care to admit. And so for World Toilet Day, we’re sharing a couple of infographics we stumbled upon recently.”

Daily Rounds: Ecstasy For Trauma; Gas Leaks In Boston; Feds Confront Pot Laws; MS Pill’s Downside

A ‘party drug’ may help the brain cope with trauma (The New York Times) — “The soldiers have no interest in traditional talking cures or prescription drugs that have given them little relief. They are lining up to try an alternative: MDMA, better known as Ecstasy, a party drug that surfaced in the 1980s and ’90s that can induce pulses of euphoria and a radiating affection. Government regulators criminalized the drug in 1985, placing it on a list of prohibited substances that includes heroin and LSD. But in recent years, regulators have licensed a small number of labs to produce MDMA for research purposes. “I feel survivor’s guilt, both for coming back from Iraq alive and now for having had a chance to do this therapy,” said Anthony, a 25-year-old living near Charleston, S.C., who asked that his last name not be used because of the stigma of taking the drug. “I’m a different person because of it.” In a paper posted online Tuesday by the Journal of Psychopharmacology, Michael and Ann Mithoefer, the husband-and-wife team offering the treatment — which combines psychotherapy with a dose of MDMA — write that they found 15 of 21 people who recovered from severe post-traumatic stress in the therapy in the early 2000s reported minor to virtually no symptoms today.”

Boston riddled with mostly small natural gas leaks, Boston University study finds (The Boston Globe) — “Natural gas is escaping from more than 3,300 leaks in Boston’s underground pipelines, according to a new Boston University study that underscores the explosion risk and environmental damage from aging infrastructure under city sidewalks and streets. The vast majority of the leaks are tiny, although six locations had gas levels higher than the threshold at which explosions could occur. Although there have been no reports of explosions in Boston from any of the leaks, the study comes three years after a Gloucester house exploded probably because of a cracked and corroded gas main dating to 1911. The research, being published Tuesday in the journal Environmental Pollution, confirms what Bostonians sometimes smell on city streets: a telltale whiff of gas.”

Will U.S. Try To Snuff Out State Marijuana Laws? (NPR) — “Here’s the problem: A federal law called the Controlled Substances Act still ranks marijuana as a dangerous and addictive drug, in the same class as heroin. That old law is rubbing against a new coalition of voters, particularly in Western states. In fact, on Election Day, more voters in Colorado and Washington cast their ballots for marijuana legalization than for President Obama.”

As MS Pill Debuts, Doctors Prescribe A Dose Of Caution (The Wall Street Journal) — “Generally, Dr. Steinman says he will prescribe Gilenya to new patients who haven’t tried one of the older therapies, have aggressive cases of multiple sclerosis and want to take a pill. Gilenya reduced relapses by 54% at two years treatment, according to Novartis AG, NOVN.VX -0.72% its maker. Yet Dr. Steinman says Gilenya won’t work for some patients. He wouldn’t give it to heart patients, because it could dangerously slow their heart beats, which could lead to death. Another concern with Gilenya, which works by suppressing the immune system, is that it increases the risk of herpes virus infections that can lead to shingles.”

Daily Rounds: Risky Asthma Drug; Obamacare Unknowns; Boys’ Body Image; 911 Lags For Los Angeles Rich

Advair boomed amid health risks (Milwaukee Journal Sentinel) – “Millions of people with asthma, including many children, have gone on the drug and Advair sales have exceeded $4 billion every year since 2007. Yet medical studies, independent doctors and court records indicate the drug can be dangerous, especially to children, and has been massively overused and often inappropriately prescribed. Advair and other drugs that contain long-acting beta-agonists have been linked to 1,900 asthma deaths from 2004 through 2011, according to an estimate by AdverseEvents Inc., a private firm that analyzes incidents reported to the U.S. Food and Drug Administration. The incident reporting system is voluntary, so the estimate likely is low. In a different analysis in 2008, an FDA researcher estimated the drugs contributed to 14,000 asthma deaths from 1994 through 2007. Advair, approved in 2000, is by far the biggest seller.”

Physician pay a major unknown despite health reform certainty ( – “Physicians and other health care professionals will be entering a new world “where many more of the people they see will have some kind of insurance coverage. That’s the good news,” said Joel Ario, former director of the Dept. of Health and Human Services Office of Insurance Exchanges, currently a managing director at Manatt Health Solutions. The bad news is some disruptions may occur as the health care market transitions to these new coverage options, and it’s unclear how all of the changes are going to affect payments, he said. Within a week of the election came the first new wrinkle in ACA implementation. With the possibility of ACA repeal out of the way, many health care observers assumed that HHS would move quickly in issuing guidance and regulations that effectively had been on hold before the election. But because some states were in a holding pattern on preparing for the health insurance exchanges that will handle much of the ACA’s new coverage in 2014, HHS decided to give states more time on at least one area of implementation.”

Muscular body image lures boys into gym, and obsession (The New York Times) – “Pediatricians are starting to sound alarm bells about boys who take unhealthy measures to try to achieve Charles Atlas bodies that only genetics can truly confer. Whether it is long hours in the gym, allowances blown on expensive supplements or even risky experiments with illegal steroids, the price American boys are willing to pay for the perfect body appears to be on the rise. In a study to be published on Monday in the journal Pediatrics, more than 40 percent of boys in middle school and high school said they regularly exercised with the goal of increasing muscle mass. Thirty-eight percent said they used protein supplements, and nearly 6 percent said they had experimented with steroids. Over all, 90 percent of the 2,800 boys in the survey — who lived in the Minneapolis-St. Paul area, but typify what doctors say is a national phenomenon — said they exercised at least occasionally to add muscle.”

Medical response time lags in many pricey L.A. neighborhoods (The Los Angeles Times) – “Waits for 911 medical aid vary dramatically across Los Angeles and many of the city’s most exclusive neighborhoods have the longest response times, according to a Times investigation. Under national standards adopted by the Los Angeles Fire Department, rescuers are supposed to arrive within six minutes to almost all medical emergencies. But the Times analysis found that in affluent hillside communities stretching from Griffith Park to Pacific Palisades, firefighters failed to hit that mark nearly 85% of the time. In contrast, rescuers beat the six-minute standard in most of their responses in the more densely populated neighborhoods in and around downtown, where 911 calls are more frequent and the department deploys more resources.”

Daily Rounds: Sick Health Spending; Tele-Abortions; Meds For Aging; Older And Colder; ‘Weight-Loss’ Pepsi?

Health spending’s sick (The Boston Herald) – “State officials and business leaders yesterday blasted out-of-control health-care spending that gobbles up more than 40 percent of the state budget — six years after Romneycare reform — and they laid out Massachusetts’ last-ditch plan to rein in costs. “If we don’t deal with this problem, our economy will deteriorate, and so will our ability to take care of our most vulnerable citizens,” Rick Lord, president and CEO of Associated Industries of Massachusetts, said during a panel discussion at the Massachusetts Association of Health Plans’ annual conference. In 2013, health care will consume 41 percent — roughly $13.3 billion — of the state budget, compared to 23 percent in 2000.”

Study: Telemedicine hasn’t increased Iowa abortion rate (Des Moines Register) – “A remote-control abortion-pill distribution method pioneered in Iowa four years ago improved access to women living in rural areas and did not increase the number of abortions performed in the state, according to a study released Thursday by the American Journal of Public Health. The study examined the number of abortions in the two years before and after Planned Parenthood of the Heartland introduced abortions by telemedicine, which allows a woman to visit a clinic and take a pill administered by a doctor after a video conference. The results showed the rate of abortions declined in Iowa after the procedure was made available in June 2008. At the same time, Planned Parenthood reported a slight increase in abortions performed as more women opted for the new procedure, said Daniel Grossman, the study’s co-author.”

Fighting off age at the pharmacy counter (The New Old Age blog, NYT) – “We wrinkle. We have night sweats. We forget names and wake, with brittle, unwanted consciousness, in the middle of the night. And we hate those indignities of aging — including those that extend to the bedroom — and mobilize to fight them using the tools of modern medicine. As a consequence, sales of medications that target symptoms of normal aging are soaring, according to data recently released at the American Public Health Association’s annual meeting. Spending on this prescription category now ranks third for people with private insurance, behind spending on drugs for diabetes and high cholesterol. Use of the medications climbed 32 percent between 2007 and 2011 for older adults on Medicare.”

Related: Why do I feel colder as I get older? (The New York Times) “Healthy people may also find themselves feeling colder than they used to. Among the reasons: a decrease in circulation as the walls of the blood vessels lose their elasticity and the thinning of the fat layer under the skin that helps conserve body heat. And as people age, their metabolic responses to the cold may be slower.”

Pepsi launches new ‘weight loss’ soda (Yahoo Health) – “Pepsi Tuesday launched a version of its popular cola in Japan that claims to block the absorption of fat. Could this new version of Pepsi solve Americans’ neck-and-neck desires for weight loss and sugary, super-sized beverages? Simply called Pepsi Special, the caffeinated soft drink has the added ingredient dextrin, a natural water-soluble dietary fiber derived from potatoes. Japanese commercials touting the product’s effectiveness for weight loss even go as far as to ask, “Why choose between a hamburger and a slice of pizza? If you choose Pepsi Special, you can have both!” But does it work? Pepsi claims that dextrin slows the absorption of fat in the body by binding with it and eliminating it as waste, not reserving it as empty calories.”

Daily Rounds: Energy Drink Deaths; Scramble For Meds; Smoking (Pot) In Seattle; Alzheimer’s InflammationGene

Caffeinated Drink Cited In Reports Of 13 Deaths (The New York Times) — “Federal officials have received reports of 13 deaths over the last four years that cited the possible involvement of 5-Hour Energy, a highly caffeinated energy shot, according to Food and Drug Administration records and an interview with an agency official. The disclosure of the reports is the second time in recent weeks that F.D.A. filings citing energy drinks and deaths have emerged. Last month, the agency acknowledged it had received five fatality filings mentioning another popular energy drink, Monster Energy. Since 2009, 5-Hour Energy has been mentioned in some 90 filings with the F.D.A., including more than 30 that involved serious or life-threatening injuries like heart attacks, convulsions and, in one case, a spontaneous abortion, a summary of F.D.A. records reviewed by The New York Times showed.”

Shutdown Spurs Hunt For Medication Sources (The Boston Globe) — “Hospitals and the government are devising plans to ensure an uninterrupted supply of critical medications after the disclosure of numerous problems with sterility procedures at Ameridose LLC, a major drug supplier that suspended operations after the national meningitis outbreak. Ameridose — a sister company of the Framingham phamacy that produced contaminated steroids blamed for hundreds of cases of meningitis and more than 30 deaths — is slated to remain closed until Monday, but its reopening date is now in question. A spokesman for the state Department of Public Health said in an e-mail the date is “under review.”

What Are They Smoking In Seattle? (NPR) — “We love when police departments put some personality and pizzazz into their public statements. So the Seattle Police Department’s blog post headlined “Marijwhatnow? A Guide to Legal Marijuana Use In Seattle,” definitely got our attention. Written to help explain what happens now that Washington State voters have approved Initiative 502, which decriminalizes possession of small amounts of marijuana (effective on Dec. 6), the post has a bit of attitude. Some of the Q&As: “Can I legally carry around an ounce of marijuana? “According to the recently passed initiative, beginning December 6th, adults over the age of 21 will be able to carry up to an ounce of marijuana for personal use. Please note that the initiative says it “is unlawful to open a package containing marijuana…in view of the general public,” so there’s that. Also, you probably shouldn’t bring pot with you to the federal courthouse (or any other federal property).”

Inflammation Gene Defect Linked To Alzheimer’s In Study (Bloomberg) — “A newly discovered gene variant may point to another route Alzheimer’s disease takes to ravage the brain: through the immune system. The variant, found in less than 1 percent of the population, almost triples the odds of Alzheimer’s disease among its carriers, according to papers published in the New England Journal of Medicine. The findings may provide clues to how the aging brain functions. The gene helps regulate inflammation, the process by which the body protects itself from invaders. The results released yesterday are encouraging for researchers targeting the immune system as playing a role in the mind-wasting disease, said Norman Relkin, the director of the Memory Disorders Program and a neurologist at New York Presbyterian/Weill Cornell Medical Center.”

Daily Rounds: Meningitis Probes Deepen; Mental Checkups; Health Insider Trading; Mayor Menino’s Woes

State was lax on Framingham drugmaker (The Boston Globe) – “State pharmacy regulators on at least two occasions in the past decade displayed indifference in their oversight of a troubled Framingham specialty pharmacy that has now been blamed for a national fungal meningitis outbreak, ­according to documents ­obtained by the Globe Tuesday…The revelations come as lawmakers convene hearings Wednesday in Washington and on Beacon Hill to investigate the causes of the meningitis outbreak and whether it could have been prevented. Cadden has been subpoenaed to testify before the US House Committee on Energy and Commerce, Oversight and Investigations Subcommittee.”

A regular checkup is good for the mind as well as the body (The New York Times) – “Everyone  is familiar with the concept of a periodic medical checkup — some sort of scheduled doctor’s visit to check your blood pressure, weight and other physical benchmarks. The notion of a regular mental healthcheckup is less established, perhaps because of the historical stigma about mental illness. But taking periodic stock of your emotional well-being can help identify warning signs of common ailments like depression or anxiety. Such illnesses are highly treatable, especially when they are identified in their early stages, before they get so severe that they precipitate some sort of personal — and perhaps financial — crisis.”

Insider mulls suicide as health care tipping wave grows (Bloomberg News) – “The markets are awash in insider trading, and the health-care industry has been particularly hard-hit. Health-care businesses offer illegal traders more opportunities to profit than the finance and technology sectors that have traditionally been prime victims of insiders who leaked confidential data about earnings or deals. Health companies can live or die on the results of drug trials, which stretch for years before regulators make decisions that can trigger hundreds of millions of dollars in profits or losses. And the industry has undergone significant consolidation, leading to several multibillion-dollar mergers.”

Mayor’s health woes trigger speculation on his political future (The Boston Herald) – “Mayor Thomas M. Menino’s extended hospitalization — the latest in a long line of health woes to hobble the city’s longest-serving mayor — has his doctors searching for answers while City Hall swirls with speculation about the Hyde Park legend’s political future. “Anytime anyone in politics is in the hospital, you’ll always have that speculation,” said Democratic strategist Michael Goldman. “Politics is about opportunity. And the only people talking about him not being a candidate are those who want to be a candidate.” The mayor, who would be running for an unprecedented sixth term next year, hasn’t made his plans public. Yesterday, as doctors offered vague explanations about his three-week hospitalization, a Menino aide urged political sharks circling the waters not to count out the beloved politician.”

Daily Rounds: Pharmacy Probe Deepens; Tribal Politics; The New Heartburn; The Fat Tax Debate

Co-Owner Of Pharmacy At Center Of Meningitis Outbreak Is Faulted (The Boston Globe) — “Pharmacist Barry Cadden, co-owner of the Framingham pharmacy blamed for the deadly national meningitis outbreak, has a long history of not cooperating with federal regulators, including one 2004 inspection when he initially denied having an eye medication that was the subject of a complaint, according to a memo released Monday by a congressional committee. An inspector later spotted a drawer labeled with the drug’s name, Trypan blue, and asked Cadden to open it. Inside were 189 vials. The memo, based on documents and briefings from the US Food and Drug Administration, was prepared by the Republican staff of a House committee holding a hearing Wednesday on the causes of the outbreak and whether it could have been prevented. They raise questions about why the Massachusetts pharmacy board did not take stronger action against New England Compounding Center, despite having investigated 12 complaints about the company’s practices over a decade…”

Emotions Come To Fore In Political Losses And Wins (The New York Times) — “Once you’ve selected your party, you are likely to retrofit your beliefs and philosophy to align with it. In this sense, political parties are like tribes; membership in the tribe shapes your values and powerfully influences your allegiance to the group. So strong is the social and emotional bond among members of a political tribe that they are likely to remain loyal to their party even when they give it low marks for performance. Yankees fans don’t jump ship when their team loses any more than Republicans switch parties when they lose an election. Research has shown that when a team wins an athletic contest, fans the next day speak about how “we won,” and feel generally more optimistic, stronger and self-confident. Conversely, the losing side feels depressed, defeated and angry. Interestingly, some studies found that testosterone levels rose in a group of male fans whose team went on to win and fell in fans whose team was defeated. Testosterone is well known to elevate both mood and aggression. Thus, winning or losing doesn’t just change your mood; it changes your physiology and brain function.”

Why Your Heartburn Drugs Don’t Work (The Wall Street Journal) “Gastrointestinal experts now estimate that 50% to 70% of GERD patients actually have NERD, and studies show they are more likely to be female—and younger and thinner—than typical acid-reflux sufferers. They are also about 20% to 30% less likely to get relief from acid-blocking drugs. But their episodes of heartburn are just as frequent, just as severe and just as disruptive of their quality of life, studies show. Doctors suspect some may be suffering from a reflux of bile, a digestive liquid produced in the liver, rather than stomach acid, or from hypersensitivity to sensations in the esophagus. Another guess is psychological stress. A 2004 study of 60 patients conducted at the University of California, Los Angeles, found that those with severe, sustained stress in the previous six months were more likely to have heartburn symptoms during the next four months. “It’s probably a bunch of different conditions put together in one basket,” says Loren Laine, a professor of medicine at Yale University School of Medicine and president of the American Gastroenterological Association. “The ones we worry about are the ones who don’t respond to standard therapy,” he says. “Then we have to figure out why they don’t respond.”

Danes May Bring Back Butter As Government Rolls Back Fat Tax (NPR) — “Toothbutter: noun. Butter spread so thickly as to reveal teeth marks upon biting. The fact that this word exists in the Danish language should help to explain what politicians were up against when they introduced the so-called “fat tax” just over a year ago. This is a country that loves it some butter (and meat, and all things dreadful to the arteries). The goal of reducing waistlines and increasing life expectancy may have been laudable, but the previous administration’s decision to charge consumers 16 kroner (about $2.75) per kilogram of saturated fat in order to achieve that goal was much maligned from the get-go. Social advocates said it would unfairly affect the poor and worsen their health by sending them toward more caloric, lower quality food. Business leaders said it would cost Danish jobs as consumers scampered across the border to Germany to stock up on groceries. Danish butchers sued, saying the tax violated European Union trade rules. Some consumers accused supermarkets of using the tax as a screen to inch prices even higher. Other skeptical residents saw it as just one more way for the government to line its coffers. This cacophony of dissent meant no one was particularly surprised this weekend when the government announced that the fat tax would be abolished as part of the 2013 budget agreement. In the same breath, the administration also put the brakes on a “sugar tax,” which had yet to take affect. As you can imagine, the world is watching.”

Daily Rounds: Mass. Obamacare Curve; Coakley On Mental Illness; Painkiller Deaths; Tamiflu Questions

Mass. health law thrown a curve by Obamacare (The Boston Globe) – “In Massachusetts, implementation of the ­federal health care law could be more complex and confusing because of the state’s own universal health care law. While the laws are similar — Obamacare is based on the Massachusetts system adopted under former governor Mitt Romney — they have conflicting provisions. How those conflicts might be resolved remains unclear. “The Massachusetts law and the federal law don’t sync up,” said Ellen Kaplan, who owns Group Health Specialists in Framingham, which helps small companies with their health insurance plans. “And who’s going to trump whom? Nobody knows.” Many of the requirements that will be put in place through 2014 will primarily affect employers. But workers will also see changes affecting how they choose and pay for health insurance.”

Society must stand up for mentally ill (Attorney general Martha Coakley in The Boston Herald) – “In October 1996, at the age of 33, Edward Coakley Jr. hanged himself. He was our brother. Edward was the baby of the family, a talented pianist, and brilliant. He battled mental illness for much of his life, suffering from bipolar disorder (also known as manic-depression). Our family, and our parents in particular, did what we could to get Edward help. At one desperate point he was arrested because we thought that was the only way he would be safe. His life was shattered by, and lost to, mental illness. We loved him very much and were devastated by his suffering and death. This is our story. But we aren’t unique.”

Legal drugs, deadly outcomes (The Los Angeles Times) – “Terry Smith collapsed face-down in a pool of his own vomit. Lynn Blunt snored loudly as her lungs slowly filled with fluid. Summer Ann Burdette was midway through a pear when she stopped breathing. Larry Carmichael knocked over a lamp as he fell to the floor. Jennifer Thurber was curled up in bed, pale and still, when her father found her. Karl Finnila sat down on a curb to rest and never got up. These six people died of drug overdoses within a span of 18 months. But according to coroners’ records, that was not all they had in common. Bottles of prescription medications found at the scene of each death bore the name of the same doctor: Van H. Vu.”

British Medical Journal slams Roche on Tamiflu (The Associated Press) – “A leading British medical journal is asking the drug maker Roche to release all its data on the flu drug Tamiflu, claiming there is insufficient information on its safety. The drug has been stockpiled by dozens of governments worldwide in case of a global flu outbreak and was widely used during the 2009swine flu pandemic. On Monday, one of the researchers linked to the BMJ called for European governments to sue Roche.