A study on diabetic patients by the University at Buffalo School of Pharmacy and Pharmaceutical Sciences identified cost savings with improvements in a key indicator of glucose control in diabetes patients, the hemoglobin A1C measurement. The A1C provides a three-month average of the amount of excess glucose in the blood. Higher A1Cs indicate that a patient is at higher risk for developing long-term complications associated with diabetes, such as kidney disease or vision problems.

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Published last spring in the Journal of the American Pharmacists Association, the UB study of 50 patients with Type 2 diabetes demonstrated that in just six months clinical pharmacists, in collaboration with primary care providers, were able to significantly reduce patients’ A1C levels.

In the UB study, patients’ A1C levels were reduced by an average of 1.1 percent, from an average of 8.5 percent to 7.4 percent, one year after being enrolled in the program, while also improving the overall metabolic profile.

“Our results show that enhancing the patient’s access to care through collaborative physician-pharmacist relationships can yield lower blood glucose levels, improve the overall metabolic profile and reduce costs to the payer,” says Erin Slazak, PharmD, UB clinical assistant professor of pharmacy practice and board certified pharmacotherapy specialist.

These clinical improvements occurred while monthly costs per patient went down by approximately $212, around $2,500 per year, even though there were nominal increases in the cost of medications prescribed.

The key to success?

“Patients had unlimited access to pharmacists throughout the year,” says Slazak.

School of Pharmacy, Buffalo School of Pharmacy, University, Pharmaceutical Sciences, Pharmaceutical, pharmacists, Pharmacy, School, health care, health, care, Pharmacy Schools and University

Patients referred to the UB program had been identified by their primary care providers as having difficulty controlling their blood sugar. Slazak notes that it was not uncommon to see patients with glucose levels as high as 400 mg/dl (normal levels are below 100 mg/dl).

The UB pharmacists spent an initial one-hour appointment with each patient, where they worked up detailed health records covering dietary information and all medications and disease conditions, and then reviewed them with each patient.

After that, patients could call or make appointments with pharmacists at will.

“We did extensive education with patients about how to manage their conditions,” says Slazak. “In many cases, we were instrumental in getting them to start insulin. There is a lot of resistance to that, and not just because it’s an injection.”

For patients in the initial stages of administering insulin, she says it was common to be contacted once every few days. The pharmacists then made suggestions to physicians about changes in medications, dosages or lifestyle that might be beneficial to their patients.

That kind of individualized attention is far from the norm for diabetic patients.

“Nationwide, the standard of care is that the primary care provider manages diabetes alone,” says Slazak. “Pharmacists typically do not have direct involvement.”

That is partly because some states, including New York, have not yet approved collaborative practice agreements between physicians and pharmacists. In the Buffalo study, for example, physicians were required to review pharmacists’ recommendations and approve all interventions first. Completion of the review process and approval occurred in only half of the cases, potentially limiting the overall benefit to the patient.

“We know there’s a long-term clinical and economic benefit to pharmacists working directly with patients and we think that can continue to grow,” says Scott V. Monte, PharmD, UB clinical assistant professor of pharmacy practice and director of Diabetes and Cardiovascular Research, CPL Associates, LLC, in Buffalo. “Pharmacists can help achieve better outcomes if given the chance.”

The study was conducted through MedSense™, part of the Pharmacotherapy Research Initiative, a collaborative effort between Lifetime Health Medical Group and UB, to study how pharmacists impact patient care. MedSense™ is one of many program sites that are part of the UB Pharmacotherapy Research Initiative in the School of Pharmacy and Pharmaceutical Sciences, which was established to study how pharmacy medication management can improve the health of patients while cutting costs through patient-centered pharmacotherapy.

In addition to Slazak and Monte, other co-authors on the paper include Nicole Paolini Albanese, PharmD, UB clinical assistant professor; Martin Adelman, PhD, chief information officer at CPL Associates, LLC; Gauri Rao, a student in the UB School of Pharmacy and Pharmaceutical Sciences, and Joseph A. Paladino, PharmD, UB professor of pharmacy and director of outcomes research at CPL Associates, LLC.

The program is jointly funded by Lifetime Health Medical Group and the UB School of Pharmacy and Pharmaceutical Sciences.

Pharmacists Improve Care of Diabetics While Cutting Costs, Research Shows is a post from: Pharmacy in jobs, news, schools

The health-care industry added an additional 29,000 jobs in October, nearly the same amount it grew in September. In total, since the start of the recession, the industry has added 597,000 jobs, according to the BLS.

The biggest month-to-month jump came in the category of health care and social assistance, which added approximately 3,400 positions.

keys: Pharmacy, pharmaceutical, Health Care, Health

And like in September, there was growth across all health-care sectors, including in hospitals, ambulatory-care settings and in doctors’ offices.

Pharmacy – Looking for a Job? Health Care Is Still a Good Bet is a post from: Pharmacy in jobs, news, schools

THE ISSUE: How much do Americans who have employer-sponsored health insurance pay in premiums? What do their employers pay? Would that change if the system is overhauled?

THE POLITICS: Health care costs have been increasing. For Americans and the businesses that insure most of them, that translates into higher insurance premiums. The average premium cost for employer-provided insurance has doubled since 2000. These days, coverage for an individual with employer-provided insurance costs on average $4,824 a year, with the employee paying $779 of that amount, according to a 2009 survey by the Kaiser Family Foundation and Health Research and Educational Trust. For a family plan, the premium is $13,375 with the employee paying $3,515. Under current law, the Congressional Budget Office estimates that in 2016 average premiums for employer-based insurance will rise to about $7,500 for a single policy and about $19,000 for a family policy.

WHAT IT MEANS: Numerous factors will affect the cost of insurance under proposed health care bills, making their impact hard to predict. But President Barack Obama has vowed to lower the cost of health care. A recent study by America’s Health Insurance Plans said the most moderate of the Democrats’ health insurance plans would increase premiums. But the study only examined select aspects of the bill and ignored provisions aimed at making health care more affordable. The legislation would set up exchanges where companies would compete for customers. It also would provide subsidies for lower-income people.

_ Jim Kuhnhenn

Health care issues: The cost of health insurance is a post from: Pharmacy in jobs, news, schools

The town hall meetings, not unusual for the August Congressional recesses, according to FGCU public affairs professor Peter Bergerson, have been marked with near riotous conditions this year, all from health care foes. On Wednesday, Sen. Arlen Specter, D-Pa., was met with jeers and taunts in State College, Pa.

Many meetings have had so much disruption, discussion of the issues had to be suspended.

Someone painted a swastika on a sign outside the office of Democratic Rep. David Scott of Georgia.

Presidential spokesman Robert Gibbs called the spray painting “ridiculous,” saying it’s a sign the national debate over Obama’s health care plan has gotten “completely out of hand.”

No town hall meetings have been held in Lee County, although opponents and supporters of an overhaul have held rallies.

Obama came through the Portsmouth meeting unscathed Tuesday, facing a mostly friendly and, with Hershenson as an example, courteous crowd.

Hershenson’s courtesy and good humor make him no less critical of Obama’s health care plans. Nor is he any less critical of what he considers to be rampant spending of taxpayer money in Washington, D.C., the real cause, he believes, for the rowdy, anger-filled town meetings.

Hershenson, 69, who summers in Maine, was picked randomly by a White House staffer after applying online to attend the meeting and then, there, was selected again, perhaps not so randomly this time, by Obama to ask a question.

Hope remains for civility in health care debate is a post from: Pharmacy in jobs, news, schools

But possible solutions have not evolved either, in part because new proposals seldom build on old ones. Obama’s broad, leave-the-details-to-Congress proposal has little in common with the 1,300-page measure President Bill Clinton couldn’t even get to a vote in a Democratic Senate in 1993.
The Obama strategy was designed to avoid mistakes Clinton made in confronting Congress with a massive bill written in the White House under the management of Hillary Rodham Clinton and essentially telling the House and Senate to take it or leave it. Clinton threatened to veto any bill that did not deliver universal health care. He got nothing to veto.
The Obama team missed part of the lesson when the president pressed for passage of House and Senate bills before Congress took its summer vacation so that they could negotiate a final version when they reconvene in September. What he got was narrow committee approval in the House, a preface to debate and action after Labor Day. In the Senate, the Finance Committee was trying to meet a Sept. 15 deadline to deliver its bill.
Obama’s push for action before the summer recess created a goal the Democrats couldn’t meet and a psychological setback he didn’t need to risk. He now says that it was no big deal and that what he wants is a reform law by the end of the year, to get all Americans insured and curb medical costs.
That is a big deal, underscored by his aggressive television and traveling campaign to try to build public support — and pressure in Congress — to enact health care overhaul this time.
“Now is the hard part — because the history is clear — every time we come close to passing health insurance reform, the special interests fight back with everything they’ve got,” Obama told a town hall in Portsmouth, N.H., on Tuesday. “They use their influence. They use their political allies to scare and mislead the American people. They start running ads. This is what they always do.”
Short of it, he and the Democrats could have a major political burden going into the 2010 congressional elections, just as Clinton did when Democrats lost the 1994 elections after his health care failure.
An issue that affects all Americans, their doctors, insurers and employers is bound to carry political risk.
Franklin D. Roosevelt wanted national health insurance but, even with his power in the New Deal Congress, he did not dare to tie it to Social Security in 1935 lest he lose the whole program. Harry S. Truman pushed it on a Congress that wouldn’t buy it.
While Dwight D. Eisenhower balked at national insurance, he tried to get Congress to support a reinsurance program to buttress private insurers and gain coverage for high-risk patients and the needy.
Congress said no, twice.
John F. Kennedy made health care a major issue in his 1960 campaign. He concentrated on what then was called medical care for the aged, a title that wouldn’t play well with the current Medicare set, people now described as senior citizens. He couldn’t get it through Congress.
Lyndon B. Johnson did, but even with his legendary legislative skills and the overwhelming Democratic majorities in Congress after the 1964 elections, it took more than a year of hard, sometimes arm-bending persuasion to get Medicare enacted. It was a hard sell with conservative Democrats, not unlike the problem Obama faces now.
That one major victory for government health insurance was an exception to the pattern of starting each attempt from scratch instead of evolving it from what had gone before. When Johnson signed the Medicare bill in 1965 and gave Truman card No. 1, he traveled to Independence, Mo., to share “this moment of triumph” with the president who had first proposed it 20 years before.
It provided government health insurance at age 65, tied to Social Security. Broader coverage, which FDR, Truman and Johnson all would have liked to gain, was beyond political reach.
Not only for LBJ, but also for Republican Richard M. Nixon, who proposed universal health insurance in 1974, seeking to use employer-based coverage along with federal subsidies so that all Americans would be insured. It was to be done by private insurers, not the government. There was bipartisan support until Watergate intervened.
The political perils of change were dramatized in 1988 after Congress enacted a Medicare overhaul that included prescription drug benefits financed with higher fees on upper-income recipients, who rebelled. They protested, demonstrated and even chased the sponsor, then-Rep. Dan Rostenkowski, D-Ill., to his car. Those changes were repealed the next year.
Prescription drug coverage was added to Medicare in 2003, pushed by President George W. Bush, who claimed it as one of his major achievements in winning re-election. It did not come easily. The administration understated cost estimates by half, and Republican leaders muscled it through the House by one vote. To hold down the cost, they wrote a gap into the coverage.
That may be changed in an Obama health plan. It points to a chronic challenge in health overhaul efforts: the price of change. Covering nearly 50 million uninsured Americans would cost an estimated $1 trillion-plus over the next decade. Obama promised to do it without adding to the deficit. Now he and Congress have to figure out how.

EDITOR’S NOTE _ Walter R. Mears reported on government and politics for The Associated Press for more than 45 years. He is retired and lives in Chapel Hill, N.C.

Analysis: Health care debate a long-running story is a post from: Pharmacy in jobs, news, schools

“In the past, these certificate programs have been very successful, drawing community members from throughout Metro Detroit,” said Joan Stephens, director of Madonna’s Continuing Education program. “The majority of those enrolling are laid-off workers, stay-at-home mothers returning to the workforce, and people looking to switch careers.”

The fall schedule for Madonna University’s medical certificate programs is as follows:

Madonna offers training for health care jobs is a post from: Pharmacy in jobs, news, schools

The National Federation of Independent Business (NFIB), National Rural Health Association (NRHA), American Association of Diabetes Educators (AADE), and the Diabetes Access to Care Coalition (DACC) have all sent letters to the Senate and House committees of jurisdiction supporting accreditation exemption bills.

Also, House Democratic leaders have included similar provisions in their healthcare reform bill H.R. 3200, America’s Affordable Health Care Choice of 2009. And key U.S. lawmakers have written to the Centers for Medicare and Medicaid Services (CMS) asking that pharmacies be exempted.

“The DME accreditation and surety bond requirement deadlines are fast approaching, and for patients who depend on supplies such as diabetes test strips, this is problematic,” said Bruce T. Roberts, RPh, NCPA executive vice president and CEO. “The reason is many community pharmacies might stop selling these supplies, which complement the medications patients get from their stores. In underserved communities the ensuing access problems could be even more acute.”

Other healthcare providers have already been exempted from these redundant, cost-prohibitive, and time-consuming regulations that are designed to prevent fraud by Medicare Part B suppliers. No evidence has been brought forward to suggest that pharmacists have engaged in any illegal behavior.

NCPA continues fight against surety bond is a post from: Pharmacy in jobs, news, schools

In all, CDC’s Advisory Committee on Immunization Practices (ACIP) recommended five groups to receive the initial doses of vaccine. These groups are pregnant women, household contacts of children less than six months of age, health care workers and emergency medical services personnel, people age 6 months through 24 years, and adults age 25–64 years with chronic conditions that increase the risk of influenza-related complications.

“These are groups that had higher risk of disease or who had greater burden of complications” so far during the pandemic, said Anne Schuchat, director of CDC’s National Center for Immunization and Respiratory Diseases, at a media briefing after the advisory meeting. In all, about 159 million people are included in the targeted groups.

Initial epidemiologic data suggested that obese people could be at increased risk for death after infection with the pandemic H1N1 2009 influenza virus. But newer data indicate that obesity is not an independent risk factor for death, Anthony Fiori of CDC’s influenza division told the committee members.

Notably absent from the priority list is the 65-and-older population, a group at high priority for vaccination against seasonal influenza viruses. The advisers agreed that epidemiologic data show that the H1N1 2009 influenza virus targets younger age groups.

“The H1N1 outbreak so far has, to a large extent, spared [the elderly] population,” Schuchat said.

The advisers recommended that once local public health officials believe the demand for vaccine has largely been met among the priority groups, efforts should be made to vaccinate adults 25&ndash64 years. Only after the demand for vaccine has been met among these adults should those age 65 or older be targeted for vaccination.

The overall consensus was to define the targeted groups for vaccination as broadly as possible, taking into account the estimated initial vaccine supply.

Several committee members expressed concern that many people who should be protected may not seek vaccination if the prioritization plan is too narrow or complex.

“Tight prioritization will result in vaccine being unused,” warned William Shaffner, president-elect of the National Foundation for Infectious Diseases. “When you have it, just give it.”

Federal officials are projecting that at least 120 million doses of monovalent, licensed H1N1 2009 influenza vaccine will be available in October, and about 80 million doses will become available each month thereafter through next spring.

But more than 300 million doses of vaccine will probably be required to fully protect the initially targeted population.

“The working assumption is that you need two doses for everyone,” Fiori said.

Fiori said that during a normal influenza season, “about 20–50%” of those who should get vaccinated actually do so. Federal planners said that they do not know what the demand for H1N1 2009 influenza vaccine will be, but they do not expect all those targeted to seek vaccination.

Because of uncertainties about vaccine supply and demand, the committee was asked to consider whether certain subgroups should be targeted if there is a serious vaccine shortfall.

In this case, the group decided, vaccine should be recommended for five subgroups: pregnant women, close contacts of children younger than 6 months of age, health care and emergency services personnel with direct patient contact, children 6 months through 4 years of age, and children age 5–18 years with chronic medical conditions.

Fiori said about 42 million Americans would be targeted for vaccination under this plan.

A final recommendation from the advisers was to keep vaccinating priority patients as they arrive and not hold vaccine in reserve for patients for their second dose.

“Don’t set aside in your mind or your refrigerator a second dose,” Fiori said.

The federal government is stockpiling adjuvants for emergency use if clinical data indicate that these pharmacologic agents are needed to boost immunity and, potentially, stretch the vaccine supply.

“The decision to use or not use adjuvants has not been made at this point, but we want to be prepared for the worst-case scenario,” Robin Robinson, director of the Biomedical Advanced Research and Development Authority, told the advisers.

But the committee members based their recommendations on the monovalent, unadjuvanted vaccines that FDA has indicated can be licensed as a strain change to currently approved influenza vaccines. Licensure as a strain change is the regulatory path used each year when manufacturers prepare updated versions of trivalent seasonal influenza vaccines.

Kathy Neuzil, chair of ACIP’s influenza working group emphasized that no one knows how the pandemic will continue to unfold. She said plans for administering vaccines “may need to be reconsidered as the pandemic progresses.”

CDC Advisers Say Half of U.S. Population Should Get Pandemic Vaccine is a post from: Pharmacy in jobs, news, schools

WASHINGTON — On June 19, Arkansas Rep. Mike Ross made clear that he and a group of other fiscally conservative Democrats known as the Blue Dogs were increasingly unhappy with the direction that health-care legislation was taking in the House.

“The committees’ draft falls short,” the former pharmacy owner said in a statement that day, citing, among other things, provisions that major insurance companies also strongly oppose.

Ross was the guest of honor five days later at a “health-care industry reception,” one of at least seven fundraisers for the Arkansas lawmaker held by health-care companies or their lobbyists this year, according to publicly available invitations.

The roiling debate about an overhaul of the nation’s health-care system has been a boon to the political fortunes of Ross and 51 other members of the Blue Dog Coalition, who have become key brokers in shaping House legislation. Objections from the group resulted in a compromise bill this week that includes higher payments for rural providers and softens a public insurance option that industry groups object to.

The deal also would allow states to set up nonprofit cooperatives to offer coverage, a Republican idea that insurers favor as an alternative to a public insurance option.

At the same time, the group has set a record pace for fundraising this year through its political-action committee, surpassing other congressional leadership PACs in collecting more than $1.1 million through June.

More than half the money came from the health-care, insurance and financial-services industries, marking a notable surge compared with earlier years, according to the Center for Public Integrity.

A look at career contribution patterns also shows that typical Blue Dogs receive significantly more money — about 25 percent — from the health-care and insurance sectors than other Democrats, putting them closer to Republicans in attracting industry support.

Most major corporations and trade groups in those sectors are regular contributors to the Blue Dog PAC. They include drugmakers such as Pfizer and Novartis; insurers such as WellPoint and Northwestern Mutual Life; and industry organizations such as America’s Health Insurance Plans.

The American Medical Association also has been a top contributor to individual Blue Dog members.

Many liberal Democrats and advocates of health-care reform were angry about the compromise bill and view the Blue Dogs as being too cozy with drugmakers, hospitals and insurers and argue that they should be more supportive of the agenda set by President Obama and Democratic leaders.

“The Blue Dogs are carrying water for the industry instead of their constituents,” said Richard Kirsch, national campaign manager for Health Care for America Now, a liberal group. “In effect, the Blue Dogs and the Republicans are taking positions that are closer all the time and further away from what most Americans want.”

Aides to Ross and several other key Blue Dogs did not respond to requests for comment about their campaign contributions. But the lawmakers have said they are striving to represent the moderate views of their constituents, and that leaving health-care legislation to more liberal lawmakers such as Rep. Henry Waxman, D-Calif., would imperil the Democratic Party’s future.

Most Blue Dogs are from rural Southern and Midwestern districts that overwhelmingly voted for Republican Sen. John McCain over Obama in the presidential election.

“I know there were some that thought we were trying to stop health-care reform,” Ross told The Washington Post this week. “Nothing could be further from the truth. We simply wanted to slow the process down and ensure that we were working toward the kind of health-care reform that the American people need and want.”

Ross has received nearly $1 million in contributions from the health-care sector and insurance industry during five terms in Congress, according to the Center for Responsive Politics (CRP), which tracks campaign contributions.

The lawmaker founded Ross Pharmacy of Prescott, Ark., which he and his wife sold in 2007. The couple received $100,000 to $1 million in dividends last year from the sale, according to House financial-disclosure forms.

Records of political fundraisers since 2008 compiled by the Sunlight Foundation, a Washington, D.C.-based watchdog group, show a steady schedule of events for Ross sponsored by the health industry or lobbying firms that represent health-care companies.

Overall, the typical Blue Dog has received $63,000 more in campaign contributions from the health-care sector than other House Democrats over the past two decades, according to CRP. The top three recipients were North Dakota Rep. Earl Pomeroy, with $1.5 million, and Tennessee Reps. Bart Gordon and John Tanner, each of whom collected more than $1.2 million, according to the data.

David Donnelly, national campaigns director for the Public Campaign Action Fund, which favors public financing of political races, said the contributions cast doubt on the Blue Dogs’ motives.

“The public believes that campaign contributions shape or stop public policy,” Donnelly said. “When we see significant fundraising to one segment of Congress, it raises serious questions about the campaign-finance system and whether it works to the benefit of all Americans.”

But Charles Stenholm, a former Texas congressman who was part of the original Blue Dog group in the mid-1990s, disagrees. “The idea behind giving to a group like the Blue Dogs is that you believe that they will agree with your positions most of the time,” said Stenholm, who now lobbies for agricultural companies and some health-care firms. “The same is true for liberals or anyone else. It’s normal in politics.”

Washington Post reporter Lois Romano contributed to this report.

Copyright © 2009 The Seattle Times Company

Health-care legislation – Conservative Democrats unhappy is a post from: Pharmacy in jobs, news, schools

WASHINGTON — As the House Energy and Commerce Committee resumed work on major health-care legislation, top Republicans stepped up their criticism of the Democratic proposals Thursday as Congress nears its summer recess.

Democrats also were dealing with rising discontent in the left wing of their party over the deal that House leaders struck with Blue Dog Coalition, a group of fiscally conservative Democrats.

The liberal lawmakers voiced concern that the deal would reduce federal subsidies intended to help people with low or moderate incomes buy insurance. They also contended a proposed government-run plan that would compete with private insurers would be weakened.

Moreover, the liberals said House leaders had compromised too early. “Under the agreement, private insurers are coming off unscathed,” said Rep. Peter Welch, D-Vt.

Rep. Eliot Engel, D-N.Y., also was less than enthusiastic. “The public plan was eviscerated,” he said. “It’s not a terrible bill, but it’s not what I had hoped for.”

In the Senate, where efforts to produce a bipartisan measure continued in the Finance Committee, top Republicans seemed eager to avoid early compromises that would let Democrats head home for the August recess boasting of progress.

And Sens. Charles Grassley of Iowa and Michael Enzi of Wyoming, two of the top Republican negotiators, have expressed frustration with suggestions that an agreement is near.

Grassley, senior Republican on the Finance Committee, and Enzi, senior Republican on the Senate health committee, are among six senators working to draft compromise legislation.

After a meeting Thursday night, five of the six appeared before reporters and said that they were committed to a deal but that they would not complete the legislation before the Senate leaves on its August recess.

“We are committed to find a bipartisan solution as expeditiously as possible,” said Finance Committee Chairman Max Baucus, D-Mont.

Grassley and Enzi face a tough balancing act, as their party’s leadership maneuvers to torpedo a compromise.

The third Republican among the six negotiators, Sen. Olympia Snowe of Maine, is a centrist with a history of working with Democrats, and GOP leaders are under no illusion that they can control her vote.

Grassley dismissed suggestions he and Enzi were under pressure. “What you are observing is a continuation of where we have been for a doggone long time,” he said. “The trouble is you all are looking for news and there ain’t no news.”

Some Republicans have begun to warn that Grassley should tread carefully on the health-care bill if he wants to become the senior Republican on the Judiciary Committee, a post he is in line to take in the next Congress.

And there have been suggestions that Grassley, who is up for re-election next year, could face a primary challenge because of unhappiness among Iowa conservatives over his support of the $787 billion bailout of the financial system last fall.

Earlier in the day, Enzi said the legislation simply was not finished. “The bill is not ready for prime time, so I don’t know any way that it could be completed today or next week and then we are at the August break,” he said.

Republican leader Mitch McConnell of Kentucky has attacked the health-care proposals as unworkable.

He and other party leaders do not want to lose an opportunity to keep President Obama and fellow Democrats on the defensive at a time when poll numbers show sagging support for the president.

And McConnell used a speech on the Senate floor Thursday to capitalize on fears among elderly Americans about proposed cuts in Medicare spending to help pay for the health-care bill.

Although the proposals are aimed at reducing payments and on reducing administrative costs, McConnell warned that some older Americans might be unable to get needed care.

With the Senate Finance Committee unable to finish its bill, the House Energy and Commerce Committee chairman, Rep. Henry Waxman, D-Calif., is under pressure to get his bill approved.

The panel was voting on amendments late into the night, and Waxman said he expected to finish work on the measure today, when the House is scheduled to adjourn for the recess.

Notably, Republicans and conservative Democrats banded together late Thursday to attach an amendment ensuring that requirements for coverage of abortion would not be imposed, except when a woman’s life is endangered or her pregnancy resulted from rape or incest. Hours later, the amendment was voted down after Waxman invoked rules that allowed him to force a second vote on the amendment.

The Associated Press

contributed to this report.

Copyright © 2009 The Seattle Times Company

House health-care plan – Neither right nor left happy is a post from: Pharmacy in jobs, news, schools