Have you tried out Blackjack Multihand 5 yet? It's a fantastic game from Casino770 and it's free with bonuses!
A look at how states are putting in place President Barack Obama’s health care law, including health insurance exchanges and expansion of Medicaid coverage, along with the number of people in each state who don’t have health insurance:
x-governor supports Medicaid expansion; legislature must approve
xx-state will oversee exchange insurance plans under federal law
Sources: Associated Press Research, U.S. Health and Human Services Department and the Urban Institute.
WASHINGTON (AP) — If you’re uninsured, getting on Medicaid clearly improves your mental health, but it doesn’t seem to make much difference in physical conditions such as high blood pressure.
The counterintuitive findings by researchers at Harvard and MIT, from an experiment involving low-income, able-bodied Oregonians, appear in Thursday’s New England Journal of Medicine. The study offers a twist for states weighing a major Medicaid expansion under President Barack Obama’s health care law, to serve a similar population of adults around the country.
“The study did not generate any evidence that Medicaid coverage translated to measurable improvements in physical health outcomes over a two-year window,” said lead researcher Katherine Baicker of the Harvard School of Public Health. “It did generate robust improvements in mental health and enormous reductions in financial strain and hardship.”
That leaves policymakers with “a much more nuanced and complex picture” of the potential benefits of expanding Medicaid, said Baicker, an economist.
It also debunks a widespread perception that having Medicaid is no better, and maybe even worse, than being uninsured. A federal-state partnership, Medicaid covers more than 55 million low-income and severely disabled people, ranging from poor children to nursing home residents. It pays providers less than Medicare or private insurance.
Obama’s health care law envisioned expanding Medicaid to anyone making up to 138 percent of the federal poverty line, or nearly $15,860 for an individual. About 15 million people — mostly adults with no children living at home — could eventually be covered if all states expand. But the Supreme Court last year gave states the right to reject the expansion without jeopardizing the rest of their federal Medicaid funds.
The study found that having Medicaid reduced rates of depression by 30 percent and virtually eliminated catastrophic medical expenses due to a serious accident or the sudden onset of a life-threatening illness. People with Medicaid had better access to doctors, preventive care, prescriptions and hospitals. They also used their benefits, consuming about $1,200 a year more per person in health care services than do the uninsured.
But Medicaid had no significant effect on blood-pressure readings, high cholesterol or elevated blood sugar levels, although it did increase the probability that people with diabetes would be diagnosed.
The study is unusual because it took advantage of a state policy decision to create a natural experiment. A 2008 Medicaid expansion in Oregon used lottery drawings from a waiting list to determine who would get coverage. That created two populations: those who got in, and those left out — a control group of people who remained mostly uninsured. Comparing the two randomly selected groups gives the research a high degree of scientific rigor.
Obama administration officials, in a written reaction published alongside the study, suggested that two years might not be enough time for differences to emerge in physical health results, particularly for patients with chronic conditions influenced by lifestyle choices. They also noted that the Oregon group was relatively small, about 12,000 people, compared to the millions who will gain coverage next year. The Oregon pool might not have been large enough to tease out valid results, they suggested.
“This study did not or could not address many important health benefits of health insurance, including early detection of cancer, a reduction in sick days from school or work, and a reduction in mortality,” wrote Richard Kronick and Andrew Bindman, health policy experts with the federal Health and Human Services department.
Lead researcher Baicker said it’s possible that having insurance alone isn’t enough to get control of lifestyle-related health problems like high cholesterol. “That said,” she emphasized, “there are known treatments for these conditions, and the clinical literature suggests improvements are gettable within less than two years.”
Expanded Medicaid will be available starting Jan. 1, and uninsured people can start signing up this fall. So far, 21 states plus Washington, D.C., have accepted the expansion, while 14 states have turned it down. Another 15 states are still weighing options.
Nearly all the states refusing are led by Republicans. Several of the states accepting have Republican governors, but most are led by Democrats. Washington will pick up the entire cost of the expansion for the first three years, and 90 percent over the longer haul. It’s estimated that less than $100 billion in state spending could trigger nearly $1 trillion in federal dollars over a decade.
SUMMIT, N.J. (AP) — A panel that advises the European Union’s chief medical agency is recommending a new approval for the cancer drug Revlimid, the drug’s maker, Celgene Corp., said Friday.
The panel recommended that the European Medicines Agency approve Revlimid as a treatment for anemia in patients with certain forms of a group of blood disorders called myelodysplastic syndromes. Celgene said the EU is expected to make a final decision within three months.
Revlimid is approved as a treatment for multiple myeloma, a cancer of the blood, in patients who have been treated with at least one other therapy. It is already approved in the U.S. as a treatment for anemia in MDS patients, and Revlimid is running further trials of the drug to win new marketing approvals. New approvals are a key part of the company’s growth plans.
Celgene is studying Revlimid as a treatment for chronic lymphocytic leukemia, non-Hodgkin lymphoma, and myelodysplastic syndromes.
Celgene expects to report about $6 billion in revenue in 2013, with $4.1 billion to $4.2 billion coming from Revlimid sales.
A New Jersey mother faces arrest for an alleged scam in which she told her 9-year-old son, family and friends that the boy had stage three cancer.
Susan Stillwaggon, 35, of Pennsauken, N.J., has been charged with theft by deception, forgery, endangering the welfare of a child and using a child to commit a criminal offense.
Stillwaggon allegedly told her son, that he had stage three Hodgkin’s lymphoma, and she accepted at least $3,500 in funds raised for the boy.
Police said “quite a few” people have been identified as victims of the scam, and they are looking for others.
“Stillwaggon led her son to believe that he suffered from the fatal illness,” the Pennsauken Township Police Department said in a news release. “Investigation confirmed that the boy does not suffer from any life-threatening illnesses.”
An anonymous tip led police to investigate Stillwaggon.
“There were events held,” Pennsauken Detective Sgt. Cheryl Duffy told ABCNews.com. “There were probably 10 different people that organized some kind of something, be it a cupcake sale or those little Livestrong-type rubber bracelets. I’ve got kids walking around with canisters, and I’ve got Bingo events.”
Stillwaggon has not been arrested yet, because she’s in the hospital receiving psychiatric treatment, her mother told Duffy, he said.
“She told him he has cancer,” Duffy said of the young boy. “That’s why she’s charged with endangering the welfare of a child.”
The New Jersey Division of Children and Families has become involved in the case but said it found no signs of physical abuse. The charge of endangering the welfare of a child stems from mental abuse or neglect as defined by law.
Police do not believe that any other family members knew about the alleged hoax, including the boy’s father.
“It’s actually plausible why he didn’t catch on,” Duffy said. “It’s a single-income family, and he’s the sole breadwinner. He’s a truck driver gone for extended periods of time. Mom’s a stay-at-home mom in charge of all the kids’ appointments, so it was whatever she relayed to him.”
Members of the Stillwaggon family did not respond to requests for comment by ABC News. Duffy said that as of Thursday, Stillwaggon had not retained an attorney.
Yale University professor of psychology Alan Kazdin said that caring for the child right now was very important.
“Is there a potential for trauma? Absolutely,” Kazdin told ABCNews.com. “We’re concerned about trauma. We’re concerned about anxiety.”
Kazdin, who is not involved in the case, said the boy is the victim of a “double whammy.” He was told he was sick and then found out he wasn’t, but learned that his mother was allegedly lying.
“He’s got two things going on that are really bad,” Kazdin said. “He’s got the weird situation that a horrible thing happened — he was told he was [really sick] — and once it comes out in the open, it gets worse in another way.”
It’s possible that the boy could be humiliated or potentially even have people try to take things out on him as a result of his mom’s alleged actions, Kazdin said.
“Separation from mom is a third part,” he said. “Separation from your most significant other. That’s huge for a child.”
Kazdin said it was important for the boy to connect to a support system and maintain routines during this time. He suggested that the people around him should look out for red flags, such as sleepless nights, depression or avoiding going to school, where people may ridicule him.
The scam had allegedly been going on since the beginning of March, but Duffy believes it might have been going on for longer.
By David Lawder and Doug Palmer
WASHINGTON (Reuters) - Congress got rid of a headache on Friday when it rescued the flying public from flight delays caused by its budget cutting. But in the view of many lawmakers, the pain is just about to begin.
Members of Congress and groups representing people hit by across-the-board budget cuts, ranging from cancer patients to welfare recipients, say the quick action on air traffic control staffing underscored the importance of being visible to millions of Americans.
“What are we going to do, every time there’s a fire we’re going to put it out by moving some funds around? That’s a shell game,” said Representative Gerald Connolly, a Democrat from northern Virginia.
“I’m going to predict that there’s going to be more weeping and gnashing of teeth, as sequestration sets in and we’re going to continue to approach this on a piecemeal basis,” he said.
Next in line for individual funding relief will be advocates for national parks, low-income housing, AIDS funding, meals on wheels and Community Development Block Grants, Connolly said, adding that budget cuts for these and other safety-net services will be felt severely by local communities.
Representatives for some of these other programs said it was the television images of lines in airports and the interviews with angry passengers that led to action, combined with the lobbying power of the travel industry.
“It means we worry about who’s going to scream the loudest now,” said Chris Hansen, president of theAmerican Cancer Society Cancer Action Network, which has been lobbying against cuts in federal funding of medical research.
A heavy dose of lobbying from the airline and travel industry preceded the legislation enacted Friday, which permitted the Federal Aviation Administration to move money to avoid the furloughs of air traffic controllers that were causing the delays.
Sequestration – the $109 billion in automatic across-the-board budget cuts enacted by Congress and signed by President Barack Obama - formally took effect in March and barring Congressional action to replace it may continue for a decade.
Some programs won relief from Congress in March, notably the meat and poultry industry, which fought successfully to prevent furloughs of U.S. Department of Agriculture meat inspectors.
But because the furloughs in other programs, such as the FAA, were not immediately implemented, the impact was slow to build.
TRAVEL LOBBY
The travel industry began to accelerate its lobbying effort after it learned early last week from the FAA that as many as 6,700 flights per day could be delayed, potentially reducing capacity at major airports by 30 to 40 percent.
Nicholas Calio, president of Airlines for America, or A4A, the main airlines industry group, worked the phones throughout the week, said Jean Medina, senior vice president for communications at A4A.
“He certainly was in very close contact with a lot of people to make sure they understood what needed to happen,” she said.
Its first course of action was to ask the administration for a 30-day delay.
When that was denied, the industry group began focusing on a legislative fix that would clear both houses with bipartisan support and be signed into law by Obama.
US Airways Chief Executive Doug Parker, who would head the world’s largest airline if his carrier’s merger with AMR Corp’s American Airlines is approved, said he spent the past week making calls to government officials in his airline’s hub markets to express concern about the furloughs.
“What I know is we’re doing great disservice to the flying public and to the citizens of the United States and we need for this to get resolved,” Parker told Reuters from Arizona earlier this week.
The non-profit U.S. Travel Association said it mounted its own “sequester offensive” in response to the furloughs and began a consumer texting campaign that connected travelers who had been delayed at airports to members of Congress.
The association also asked industry workers to contact their representatives in Congress to explain that the travel delays put their jobs at risk.
“We were in frequent contact with Congress urging them to solve this problem as soon as possible,” Erik Hansen, director of domestic policy at the U.S. Travel Association, said on Friday. “We were able to generate hundreds of calls and emails to Congress and we’re hoping that helped to move the ball forward,” Hansen said.
VISIBILITY
Airlines for America reported about $6.3 million in lobbying expenses in 2012 according to the Center for Responsive Politics; the U.S. Travel Association spent about $1.7 million; US Airways and Delta about $2.8 million each.
While other interest groups have a lobbying presence in the national capital, they are hard pressed to match the visibility of air travel.
Compared to “longer lines at airports,” said Cynthia Pellegrini, a vice president at the March of Dimes, which raises funds to improve the health of mothers and babies, “you can’t see that a child’s belly is emptier because her family couldn’t get food assistance.”
“We are not as well-heeled as the travel industry,” said Deborah Weinstein, executive director of the Coalition on Human Needs, an alliance of social welfare organizations. “But I think as more people learn of this appalling choice,” that Congress made on Friday, “they will get as mad as I am.”
Senator Amy Klobuchar, a Democrat from Minnesota, home to a major Delta Air Lines hub in Minneapolis, was among the members backing an FAA budget fix on Thursday when the Senate passed it.
She called it a “practical, pragmatic answer to an immediate problem,” but acknowledged that it does nothing to get Congress closer to fixing the problems caused by sequestration. More effects of the cuts, demonstrated dramatically to the public, could do that, she added.
She may not have long to wait. Organizations that have been more quietly protesting the budget cuts were rethinking their strategy on Friday in the wake of Congress’ action.
“It is inexplicable why proven and effective Meals on Wheels programs get overlooked from exemption from the sequester when both the business and social case exists,” said Ellie Hollander, President and CEO of Meals on Wheels Association of America.
“I guess that’s because we need to be a different kind of squeaky wheel.”
NEW YORK (Reuters Health) – Doctors should talk about breast cancer-reducing drugs with women and offer tamoxifen or raloxifene to those that have a high risk of cancer and aren’t likely to suffer side effects, a government-backed panel said on Monday.
The drugs work by blocking the effects of estrogen in breast tissue, lowering the chance of hormone-related cancers. But they also increase the risk of blood clots and hot flashes, among other side effects – so they shouldn’t be handed out to everyone, the U.S. Preventive Services Task Force (USPSTF) said in its new draft guidelines.
“Currently only a minority of women for whom the medication might be indicated are actually taking it,” said Dr. Mark Ebell, a member of the Task Force from the University of Georgia College of Public Health in Athens.
“I don’t think there’s a right or wrong answer for women,” he told Reuters Health. “The main thing is just for women to be aware of this as an option and to talk to their doctor if they think they might be at increased risk.”
Women are considered at high risk if they have a five-year chance of developing breast cancer of at least one in 60. Tools such as the Gail model (http://1.usa.gov/6eW4G) take into account a woman’s age, race, personal history of breast exams and family history of cancer to estimate her own risk of breast cancer.
A review conducted for the USPSTF and published concurrently found tamoxifen (marketed as Nolvadex and Soltamox) and raloxifene (Evista) decreased women’s chances of developing breast cancer by 30 to 56 percent.
Both drugs also doubled the risk of blood clots and tamoxifen increased the chance of endometrial cancer and cataracts, according to findings published in the Annals of Internal Medicine.
The review did not include studies that focused on women with breast-cancer related BRCA gene mutations.
Angie Fagerlin, a bioethicist from the University of Michigan Medical School and the Ann Arbor VA, said it’s important to consider an approximately 50-percent relative reduction in breast cancer risk in context.
For a woman who starts out with a one in 40 chance of developing cancer, she told Reuters Health, “Your risk goes from 2.5 to 1.25 (percent). It’s a 1 percent difference in your risk of breast cancer, having to take a drug every day for five years that has some side effects.”
But for some women who have a much higher short-term risk of breast cancer – as high as 16 percent – the drugs are more likely to be worth potential side effects, said Fagerlin, who wasn’t involved in the new review or the Task Force decision.
“There are a lot of things that play into this decision,” she said. “Women should know that this is an option, and they should be told their risks and benefits in a way they can understand.”
‘TAKE A TEST RUN’
About one in 8 women will be diagnosed with breast cancer during her lifetime and one in 36 will die of the disease, according to the American Cancer Society.
The new draft recommendations echo guidelines released by the Task Force a decade ago but now have more evidence behind them, according to Ebell. They will be posted for public comment until May 13 here: http://bit.ly/cy0SzP.
Other doctor groups, including the American Society of Clinical Oncology, also recommend some women at high risk of breast cancer be offered tamoxifen or raloxifene.
Elissa Ozanne, who studies decision science at the University of California, San Francisco, said the most common problems reported with tamoxifen and raloxifene include hot flashes and other “quality-of-life” side effects.
“The serious ones are very rare,” Ozanne, who wasn’t involved in the new research, told Reuters Health. If women are worried about side effects and how they might feel on the drugs, she added, “It’s something that they could try out and take a test run of it.”
Generic tamoxifen can be bought for about $100 per month or less.
Ozanne pointed out that research suggests women can reduce their risk of breast cancer through lifestyle changes, as well as medication.
“There are a lot of things women can think about doing, and tamoxifen is one of them, and so are things like maintaining a healthy body weight,” she said.
Four years after Jaclyn Michalos, now 28, graduated from college, she felt a lump in one of her breasts. Living in Norwood, Massachusetts, Michalos had no insurance, figuring, she says, that she was healthy and any ailments that hit her could be treated with over-the-counter medicines from the drugstore. But once she felt the lump, Michalos saved up some money so she could have it checked. The doctor examined the lump and told her she was fine and that it wasn’t cancer.
A Quickie Guide to Obamacare: Four Big Changes You Need to Understand
But Michalos continued to worry. A year later, she applied for health insurance through Healthconnector, Massachusetts’ health insurance exchange, opened in 2006 when the state passed health insurance reform requiring every adult in the state to be covered. Like the Affordable Care Act (ACA), whose “individual mandate” becomes effective in January 2014, Massachusetts offers assistance to people with low incomes. Michalos found out several surprising things: Comprehensive health insurance cost less than she expected; the HealthConnector exchange was able to easily help her find the best plan for her needs; and she did indeed have cancer. Now, a few years later, Michalos is cancer-free, and recently filmed a testimonial to urge others in her state to sign up for coverage.
If Michalos’ experience sounds a lot like what many of us expect from Obamacare, you’re right—there is a lot of overlap. Massachusetts’ seven-year-old health reform program is a model for what’s about to happen across the nation, says Vicky Pulos, a staff attorney with the Massachusetts Health Reform Institute (MHRI). “Massachusetts was successful in reducing the number of the uninsured, which we did through several different programs,” says Pulos.
Why Everyone Under 26 Should Thank Obamacare
However, she adds that Massachusetts started out with a much lower rate of uninsured people than some other states, and a pretty high rate of employer insurance. “And we chose to expand [Medicaid] coverage, while some states are choosing not to expand Medicaid for 2014, or saying they won’t, and that includes a lot of states with the largest number of uninsured in the country,” Pulos explains. “So our success in reducing the number of uninsured may not be equaled across the country, at least not right away.”
Communication was also critical to Massachusetts’ success, says Pulos. The commonwealth sent a postcard about the new insurance opportunities to all tax filers and gave out millions of dollars to community organizations to create education programs to explain the new ways people could get coverage. “Both the carrot and the stick were certainly important,” says Pulos. “The ‘carrot’ of coverage, and the ‘stick’ of the penalty for those who didn’t sign up.” As with Obamacare, most people who don’t have health insurance by a specified time will face a penalty.
10 Things Your Health Insurance Plan Will Soon Have to Cover
A May 2012 report from the Kaiser Family Foundation gave kudos to several specific parts of the Massachusetts health reform program:
• Expansion of coverage to nearly all state residents;
• Within a year of implementation the state experienced an unprecedented drop in the number of uninsured and, despite the economic recession, it continues to retain the lowest rate of uninsured residents in the country; and
• More adults in Massachusetts than before reform now get preventive care and report a regular source of healthcare (having a medical “home” is important for keeping people well, which in turn helps keeps healthcare costs down).
Bad News: Obamacare Is Going to Make the Doctor Shortage Worse
But Masschusetts isn’t an unqualified success, according to the Kaiser report. With more people covered, the demand for healthcare—particularly in underserved communities—has increased. That means people often have to wait a lot longer to see a doctor, and may need to be routed to physicians farther from where they live. The state is working to increase the number of providers by creating loan repayment opportunities for doctors and other providers in underserved areas. Many Americans can probably expect a similar side effect once Obamacare kicks in fully in January 2014.
Another issue the state is facing, according to the Kaiser report, is rising healthcare costs, because so many more people are seeking preventive care and treatment. The result is that Massachusetts has the highest individual market premiums in the country. Some experts are also predicting that premiums under the ACA will climb—or even skyrocket, though it remains to be seen if this will in fact happen.
“Cost containment” for the national health reform program—meaning efforts to keep both the cost of care and the cost of insurance premiumds down—has been built into the ACA, though MHRI’s Vicky Pulos says it will take a few years to see how well that works. One important effort is the Patient-Centered Outcomes Research Institute aimed at finding and sharing the most appropriate treatment choices for best outcomes as well as shoring up costs.
On the whole, outside of a crystal ball, Massachusetts is as good a bellwether as we currently have to imagine what life under Obamacare will look like—both the strengths and the weaknesses of the program. That’s because no other state has taken such a bold step in an attempt to offer more of its citizens quality healthcare and reform out-of-control healthcare costs.
CARACAS (Reuters) – Venezuelan President-elect Nicolas Maduro faces a difficult economic panorama of rising inflation and slowing growth, further complicated by his slim election victory that is being challenged by the opposition.
Maduro won by the smallest margin of any Venezuelan election in the last 50 years after a whirlwind campaign triggered by the death of Hugo Chavez from cancer last month.
The late president’s lavish social spending financed by an unprecedented oil boom created a following of millions, and Chavez’s endorsement of Maduro before his death appeared to put his protégé on track for an easy victory.
Instead, the winning margin was just 1.6 percentage points and opposition candidate Henrique Capriles refused to accept the official result. He is demanding a full recount.
A perception that Maduro has a weak mandate could prompt challenges from within the disparate ruling coalition that formed around Chavez, just as overstretched state finances force him to slow the very oil-funded largesse he staked his reputation on maintaining.
The OPEC nation’s strong growth is seen by most private economists as dropping this year as the government pares back following hefty spending in 2012 that was a key driver of the economy and helped Chavez win re-election in October.
At the same time, annual inflation may head toward 30 percent thanks to a currency devaluation and expanding money supply, while periodic shortages of products such as medicine and corn flour look likely to remain an annoyance.
“We’re going to see a reduction in government spending, most notably in the home construction program, and the devaluation is also going to limit growth,” said Angel Garcia of consulting firm Econometrica, which is critical of the government.
“It’s going to be a year of inflation with stagnant growth.”
There are few signs, however, that the situation could descend into a full-blown crisis or force Venezuela to default on its debt.
Wall Street investors who have for years sneered at Venezuelan socialism are likely to continue buying up its lucrative and high-yielding paper.
Government supporters have long chuckled at doomsday predictions by the opposition of economic mayhem that in retrospect were exaggerated or simply wrong.
But with the opposition questioning his legitimacy, Maduro may have little room for pragmatic measures such as unwinding the Byzantine system of price and currency controls that have created economic distortions.
His narrow win may also dampen speculation that he is seeking a market-friendly replacement for Finance Minister Jorge Giordani, who led the Chavez-era expansion of state control.
SPENDING SLOWS, GROWTH SLOWS
From a program of cash-handouts to poor mothers to a massive home-building campaign that gave new apartments to grateful supplicants, voters were showered with state spending in 2012 as part of Chavez’s re-election just months before his death.
It was financed in part by nearly $21 billion in bond issuance over two years and at least $36 billion in loans from China. That spending was crucial in spurring economic growth of 5.6 percent last year.
But growth for this year is seen by many private economists at 2 percent or less, as the government slows spending as it normally does following presidential races. Central government outlays fell in the fourth quarter of 2012 compared to the previous quarter, according to the central bank.
State oil company PDVSA also cut contributions to state development fund Fonden that has provided infrastructure financing. That signals a slowdown in the construction sector, which delivered a fifth of last year’s growth.
Chavez’s wave of nationalizations helped stir up nationalist sentiment and expand state control over the economy, but also severely weakened the private sector and made business leaders reluctant to make new investments.
Many of the companies nationalized under Chavez have seen their output tumble amid under-investment and chronic labor problems. Steelmaker Sidor, taken over five years ago to much celebration, is operating at less than half its capacity according to local media reports.
The economy has become increasingly dependent on imports, which constitutes a drain on growth because they generate jobs abroad rather than at home.
“Last year’s growth came on the back of booming domestic demand, with both consumption and investment soaring,” said JPMorgan analysts in a research note. “But in the context of a domestic supply side that has been crippled in recent years by nationalizations and regulatory uncertainty, imports have necessarily had to rise.”
The government maintains growth projections of 6 percent for this year, and Maduro’s allies dismiss talk of a slowdown as a politically-motivated smear campaign.
“There should not be a slowdown, growth should be similar to 2012,” said Jose Pina, an economist whose analyses tend to be similar to those of government officials.
He said the inflation rate in 2013 would be close to last year’s 20 percent, but that it was not of great concern to workers because planned minimum wage hikes would boost spending power.
Critics of Wall Street analysts note that their projections last year considerably overestimated Venezuela’s inflation rate and debt issuance.
Joe Andruzzi, a former Patriots offensive lineman, annually puts together a team for the Boston Marathon to benefit pediatric brain cancer. Andruzzi is a cancer survivor himself and has three brothers who responded to the 9/11 attacks in New York, reports NBC.
Clearly a man with such character would immediately spring to help with the terrible and chaotic attack in Boston Monday. The picture says it all.
WASHINGTON (AP) — The Supreme Court seemed worried Monday about the idea of companies patenting human genes in a case that could profoundly reshape the multibillion-dollar biomedical industry and U.S. research in the fight against diseases like breast and ovarian cancer.
Justices argued not only about snipping DNA strands but also about chewing the leaves of Amazonian jungle plants, the shaping of baseball bats and the ingredients of chocolate chip cookies as they tried to figure out whether companies can gain government protection — and profits — for their work with human genes.
The ability to claim control of genetic information found inside every American could hang on the nine justices’ decision later this summer, a ruling that could affect the intersection of science and the law for years to come.
“The issue here is a very difficult one,” Justice Samuel Alito said.
Abstract ideas, natural phenomena and laws of nature cannot be awarded patents, the legal protection that gives inventors the right to prevent others from making, using or selling a novel device, process or application. The U.S. Patent and Trademark Office has been awarding patents on human genes for almost 30 years, but opponents of Myriad Genetics Inc.’s patents on two genes linked to an increased risk of breast and ovarian cancer say such protection should not be given to something that can be found inside the human body.
“Finding a new use for a product of nature, if you don’t change the product of nature, is not patentable,” said lawyer Christopher Hansen, arguing against the patents. “If I find a new way of taking gold and making earrings out of it, that doesn’t entitle me to a patent on gold. If I find a new way of using lead, it doesn’t entitle me to a patent on lead.”
Several organizations, including the American Civil Liberties Union, the Association for Molecular Pathology, a number of doctors and researchers and some people at risk for hereditary breast and ovarian cancer, have challenged the patents.
But Myriad argues — and the patent office and a federal appeals court have agreed — that the company’s genes can be patented because the DNA that Myriad isolated from the body has a “markedly different chemical structure” from DNA within the body.
“What was ‘merely snipped’ out of the body here is fundamentally different in kind from what was in the body,” Myriad lawyer Gregory A. Castanias said. “The most important reason it’s different in kind is that it cannot be used in the body to detect the risk of breast and ovarian cancers.”
The company has used its patent to come up with its BRACAnalysis test, which looks for mutations on the breast cancer predisposition gene, or BRCA. Those mutations are associated with much greater risks of breast and ovarian cancer. Women with a faulty gene have a three to seven times greater risk of developing breast cancer and also a higher risk of ovarian cancer.
Myriad sells the only BRCA gene test. Opponents of its patents say the company can use its patents to keep other researchers from working with the BRCA gene to develop other tests.
In such matters, companies can have billions of dollars of investment and years of research on the line. Their advocates argue that without the ability to recoup their investment through the profits that patents bring, breakthrough scientific discoveries to combat all kinds of medical maladies wouldn’t happen. That concerned several justices.
“Why shouldn’t we worry that Myriad or companies like it will just say, ‘Well, you know, we’re not going to do this work anymore?’” Justice Elena Kagan asked.
Hansen said that a company could get recognition for its work and that money for research would always be available, a statement that Justice Anthony Kennedy said wasn’t sufficient.
“I don’t think we can decide the case on, ‘Don’t worry about investment. It’ll come,’” Kennedy said.
Justices attempted to break the argument down to an everyday level by discussing things like chocolate chip cookies, baseball bats and jungle plants.
Castanias, the Myriad lawyer, argued that the justices could think about the gene question like a baseball bat. “A baseball bat doesn’t exist until it’s isolated from a tree. But that’s still the product of human invention to decide where to begin the bat and where to end the bat,” he said.
That didn’t work for Chief Justice John Roberts.
“The baseball bat is quite different. You don’t look at a tree and say, well, I’ve cut the branch here and cut it here and all of a sudden I’ve got a baseball bat. You have to invent it, if you will,” Roberts said. “You don’t have to invent the particular segment of the strand. You just have to cut it off.”
The court moved on to body parts. Said Justice Sonia Sotomayor, “If you cut off a piece of the whole in the kidney or liver, you’re saying that’s not patentable, but you take a gene and snip off a piece, that is? What’s the difference between the two?”
Castanias tried again, comparing the company’s patented genes to medicine.
“It’s important to note that molecules have been patented for a very long time. That’s what drugs are. And drugs are often made by taking one molecule and another molecule, both of which are known, reacting them in a test tube,” he said. “Reactions have been around 100 years just like snipping has been, but they make something new and useful and lifesaving from that.”
Roberts still wasn’t convinced. “Well, I don’t understand how this is at all like that, because there you’re obviously combining things and getting something new. Here you’re just snipping, and you don’t have anything new, you have something that is a part of something that has existed previous to your intervention,” he said.
That was the ruling of the original judge who looked at Myriad’s patents after they were challenged by the ACLU in 2009. U.S. District Judge Robert Sweet said he invalidated the patents because DNA’s existence in an isolated form does not alter the fundamental quality of DNA as it exists in the body or the information it encodes. But the federal appeals court reversed him in 2011, saying Myriad’s genes can be patented because the isolated DNA has a “markedly different chemical structure” from DNA within the body.
The Supreme Court threw out that decision and sent the case back to the lower courts for rehearing. That came after the high court unanimously threw out patents on a Prometheus Laboratories Inc. test that could help doctors set drug doses for autoimmune diseases like Crohn’s disease. The justices said the laws of nature are unpatentable.
But the federal circuit upheld Myriad’s patents again in August, leading to the current review.
The court will rule before the end of the summer.