Barack Obama Calls For Universal Health Care Coverage

By NEDRA PICKLER
Associated Press
WASHINGTON - Every American should have health care coverage within six years, Democratic Sen. Barack Obama said Thursday as he set an ambitious goal soon after jumping into the 2008 presidential race.

"The time has come for universal health care in America," Obama said at a conference of Families USA, a health care advocacy group.
"I am absolutely determined that by the end of the first term of the next president, we should have universal health care in this country," the Illinois senator said.

Obama was previewing what is shaping up to be a theme of the 2008 Democratic primary. His chief rivals, Sen. Hillary Rodham Clinton and John Edwards, also are strong proponents of universal health care and have promised to offer their plans.

Obama said while plans are offered in every campaign season with "much fanfare and promise," they collapse under the weight of Washington politics, leaving citizens to struggle with the skyrocketing costs.

He said it's wrong that 46 million in this country are uninsured when the country spends more than any one else on health care. He said Americans pay $15 billion in taxes to help care for the uninsured.

"We can't afford another disappointing charade in 2008, 2009 and 2010," Obama said. "It's not only tiresome, it's wrong."

Obama's call was an echo of a speech he made last April when he said Democrats "need to cling to the core values that make us Democrats, the belief in universal health care, the belief in universal education, and then we should be agnostic in terms of how to achieve those values."

His argument Thursday not only will be considered through the prism of the presidential campaign, but weighed against rival Sen. Hillary Rodham Clinton's ill-fated plan to overhaul the health care insurance system when she was first lady.

Even after leading that calamitous attempt in 1993, Clinton remains in favor of universal health care and has made it a central theme of her presidential bid.

"One of the goals that I will be presenting ... is health insurance for every child and universal health care for every American," she said at a community health clinic in New York Sunday, the day after entering the 2008 Democratic field. "That's a very major part of my campaign and I want to hear people's ideas about how we can achieve that goal."

She criticized Bush's proposal to make health care more affordable through tax breaks, arguing that it would lead to less funding for hospitals.

Major Airport Officially Declared UnsafeVirulent Tuberculosis May Imperil MillionsEgypt Scoffs at 'Worlds Wonders' ContestBody of Missing Boy Found in Septic TankDog Reunites With Family After Six YearsAddressing the U.S. Conference of Mayors, Clinton was self-deprecating in describing her own experience in the health care debate and joked that Bush would need some heavy-duty protection as he wades into the fight.

"I welcome his participation in the health care debate. I'm going to send him a suit of armor because I know anybody who puts a foot in the health care debate is gonna need that. I've got the scars and experience to show for it," said the New York senator.

Another candidate, Ohio Rep. Dennis Kucinich, also backs universal health care.

Blacks at Higher Risk for Death from Heart Failure

NHLBI Study

The results of a new study suggest that black patients with congestive heart failure are at higher risk for death and for worsening of their disease than similarly treated white patients.

"Congestive heart failure is a devastating disease affecting 600,000 black patients. If research confirms a difference between black and white survival and identifies the underlying cause of this difference, we may see improved treatment of blacks with heart failure and a greater understanding of this disease among all patients," said Dr. Claude Lenfant, Director of the National Heart, Lung, and Blood Institute (NHBLI), which funded the study.

The new findings, published in the February 25 issue of the "New England Journal of Medicine", are based on data collected from the Studies of Left Ventricular Dysfunction (SOLVD). SOLVD found that patients with chronic congestive heart failure had fewer deaths and hospitalizations when treated with an ACE inhibitor, a drug which blocks the constriction of blood vessels.

In the new "retrospective" analysis, Dr. Daniel Dries of the NHLBI and colleagues looked back at the SOLVD results and analyzed racial differences. They reported that 42 percent of blacks in the treatment component of the study (patients with symptoms) and 22 percent of blacks in the prevention component (without symptoms) died compared to 36 and 14 percent of whites respectively. In addition, black patients were at increased risk for progression of the disease.

Although other research has shown that the death rate for congestive heart failure is more than twice as high in black patients as in whites, not all studies have come to this conclusion. Some studies have attributed differences in death rates to factors such as differences in access to care or differences in the severity of the disease. Other studies have not found a racial difference.

In the new study, the higher risk of death and disease progression among black patients was found even after the scientists adjusted the data to minimize any influences from age, other coexisting medical conditions, severity and causes of heart failure, socioeconomic status, and medications. Also, since SOLVD is a clinical trial, management and follow-up of patients was standardized.

Dr. Dries and his colleagues speculate that the differences between blacks and whites with heart failure may be due to physiological differences in the neuroendocrine and renin/angiotensinogen systems. These systems release various hormones affecting heart rate and blood flow in response to the heart's decreased ability to pump blood. Over time, it is believed that the initial beneficial effect of these hormones is stopped and instead they actually contribute to the progression of heart failure.

The neuroendocrine system governs "catecholamines," a group of hormones that includes norepinephrine; the renin/angiotensinogen system involves the release of angiotensin II.

Black patients with heart failure may have a greater activation of the neuroendocrine rather than the renin/angiotensinogen system, suggest the study's authors. Another possible explanation is that ACE inhibitors, which block the renin/angiotensinogen system, may be less effective in halting the progression of the disease in black compared to white patients. ACE inhibitors are commonly used to treat heart failure.

If future studies confirm this racial difference, there may be implications for improved treatment of black patients with heart failure.

For example, some previous studies have suggested that when used alone for the treatment of hypertension, ACE inhibitors may be less effective in black patients. Beta-blockers, on the other hand, antagonize or "block" the neuroendocrine system. If further research finds that the neuroendocrine system is overactive in black patients, they may be ideal candidates for early therapy combining beta blockers with ACE inhibitors.

"The stakes are high -- over 4 1/2 million people have congestive heart failure and hospitalizations for this disease are on the rise," said Dr. Lenfant. "The NHLBI is committed to conducting further research not only to confirm this apparent racial difference but also to find ways to improve the treatment of all patients with heart failure."
 

Obesity Tied to Worsening Kidney Function in Kids RENO, NEV. — Increased body mass index is correlated with worsening proteinuria in children, according to study findings presented at the annual meeting of the American College of Nutrition. The data confirm the hypothesis that obesity contributes to a decline in the glomerular filtration rate, an indicator of kidney function, said Dr. Carolyn Abitbol of the Division of Pediatric Nephrology at the University of Miami. The study included 40 obese children: 16 low-birth-weight children (less than 1,200 grams) and 24 children of normal birth weight (more than 2,500 grams). Obesity was defined as a body mass index (BMI) of greater than the 95th percentile for age and gender. The study also included 20 nonobese children of normal birth weight as clinical controls. All of the children in the study had proteinuric kidney disease. The researchers excluded any patients who had acute glomerulonephritis immune-mediated nephritis, overt diabetes, as well as patients who had HIV nephropathy. Dr. Abitbol and colleagues performed kidney biopsies of nine children in the obese, low-birth-weight group; all had focal segmental glomerulosclerosis (FSGS). Of the children in the normal birth weight, obese group, 16 were biopsied and 14 had FSGS. One patient had focal mesangial proliferative glomerulonephropathy, probably an early form of FSGS. Another had a membranous nephropathy, which is unique and immune mediated. In the nonobese control group, all of the children were biopsied and 14 had FSGS, 4 had mesangial glomerulonephropathy, 1 had minimal change, and 1 was membranous. Researchers compared the mean renal survival relative with birth weight and found low-birth-weight patients had a loss of glomerular filtration rate significantly earlier than those of normal birth weight.