James Eagan Holmes Used Prescription Drugs (Vicodin); Had Sex Site Profile

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Bobbi Kristina Brown's Future: Can She Be Saved From Whitney's Fate?

The Road Ahead for Bobbi Kristina

Despite her rich musical lineage, the path ahead for Bobbi Kristina Brown won't be easy.

For better or worse, the 18-year-old with musical aspirations of her own will undoubtedly be compared to her mother, the incomparable Whitney Houston.

"There is no way people are not going to compare her to her mother -- not to Rihanna, to her mother -- and if she doesn't sound on par with her mother or better, people are going to say horrible things," Billy Johnson Jr., a senior editor at Yahoo! Music, told ABCNews.com. "The public scrutiny is so great."

The only child of Houston and singer Bobby Brown had been in Los Angeles with her mother to attend pre-Grammy festivities and was staying at the Beverly Hilton Hotel when Houston was found dead Saturday night in the bathtub of her hotel room.

Whitney Houston's brother-in law, Billy Watson, told ABCNews.com that Bobbi Kristina was "doing OK" after she "broke down" over the weekend and had to be taken to the hospital twice for stress and anxiety.

Bobbi Kristina, along with much of her mother's family and entourage, returned to New Jersey Monday night in advance of Houston's funeral, which is scheduled for Saturday. Her father canceled his tour to be with his daughter and reportedly traveled to New Jersey as well.

"She ... is presently with my family, including her siblings," Bobby Brown told Access Hollywood, referring to his five other children from other relationships.

On the family's reality-TV show, "Being Bobby Brown," it was Brown who often acted more like the parent in the often-erratic relationship between her mother and father. Sources close to the family say that Houston's well-known battles with addiction were also a heavy burden for her daughter to bear.

"It's very common, when a parent has an addiction, for the child to be parentalized," Dr. Drew Pinsky, host of HLN's "Dr. Drew," told ABC News. "It's almost a survival mode to try and control and maintain that addictive parent safely, the child takes on the role of parent or parents."

When stories surfaced last year that Bobbi Kristina Brown might have started using drugs herself, it was her father who came to her defense with a strong denial, telling media outlets, "She doesn't do that."

Drew says Brown should be careful about how she handles the inevitable fallout from her mother's death.

"When people are stressed, when they turn to substances, is when they can turn the switch on for addiction," he said. "That is my greatest fear for Bobbi Kristina."

Mother and daughter had begun working together on songs in the recording studio, according to Us Weekly.

With Houston's death Saturday, the world is eager to see -- and hear -- more from Bobbi-Kris, as she is known to her family.

"She idolized Whitney," a source told US Weekly, and "wanted to be just like her mother."

Brown comes from a musical family. Her father is a former member of New Edition, her grandmother is gospel legend Cissy Houston and her cousin is 1960s pop icon Dionne Warwick.

"People want to know if she has the gift," Yahoo! Music's Johnson said.

Brown posted a video in September of her singing a capella Adele's "Someone Like You" on her Twitter page.

Johnson thought the aspiring singer had shown some improvement since the last time he heard her, performing alongside her mother on "Good Morning America" in 2009.

But Us Weekly's senior editor Ian Drew wasn't sure Brown had grown enough.

"She's not her mother, but she's not the worst singer either," he told ABCNews.com. "With the right songs and auto tuning anyone can be big.

"I would encourage her to take her time," Johnson said. "People said the same thing about Michael Jackson's children. She needs to sort out things in life a little bit more before rushing into this adult world.

"I think she's already dealing with a lot," he said, "and I hate to see her end up in a similar type of situation as her mother."





WHITNEY FORCES COKE-Y DAUGHTER BOBBI TO REHAB


A heartbroken WHITNEY HOUSTON will put her daughter BOBBI KRISTINA into rehab after The ENQUIRER published world exclusive photos in our print edition of the troubled teen snorting cocaine.

Crushed by our report that her daughter - known to friends as "Krissi" - is hopelessly addicted to cocaine and alcohol, Whitney begged her: "Don't let drugs ruin your life the way they ruined mine," sources say.

The Grammy-winning diva and her ex-husband, Krissi's father Bobby Brown, are blaming each other for their only child's problems, according to insiders.

"Whitney was devastated over the photos showing Krissi using cocaine, and The ENQUIRER story that quoted her telling friends, 'I'm just like my mother,'" a friend divulged.
"She called a family meeting and sobbed as she told Krissi, 'I don't want to lose you.'"

The singer, 47, also canceled plans to celebrate Krissi's 18th birthday on March 4 in Atlantis, the luxury resort in the Bahamas, the source revealed.

"Whitney called Bobby, and they agreed that Krissi needs rehab," the friend said. "They also agreed on a tough-love move to shake Krissi up, and Whitney returned a Lexus convertible that she'd bought for Krissi's birthday."

Despite her parents' decision, Krissi is fighting the idea of rehab, said the source.

"Krissi is denying that she has a problem. She says that she does cocaine for fun and isn't addicted," said the source.

Meanwhile, Whitney and Bobby - who have both battled serious drug habits - are blaming each other for Krissi's problems, sources say.

"Bobby reminded Whitney that she used to have drugs all over their house," a friend divulged.
"He also accused her of being 'coked up' in public, looking like a mess and setting a bad example all along to their daughter," the friend said.

But "The Bodyguard" star was quick to snap back at her bad boy ex, said the source.

"Whitney told Bobby that he did drugs too and got into more legal trouble than she ever did," the friend said.

Bobby, 42, has been arrested for DUI, possession of marijuana, driving without a license, probation violations and misdemeanor battery for slapping Whitney.
The former "New Edition" singer, who has five children with four different women, has also been dragged into court numerous times for failure to pay child support.

"Bobby and Whitney are pointing fingers at each other, but the truth is that they're both responsible. Krissi has been around while her parents and their friends were drinking and drugging ever since she was a little girl," said another pal.

Krissi was only 12 when she was photographed drinking from a wine glass as her parents looked on.

In 2008 she was admitted to a psychiatric ward after attempting to slash her wrists with a razor blade. As The ENQUIRER reported, Krissi's suicide bid came after she tried to stab her mother during a heated argument.

And she was just 17 when a former boyfriend - who dated her for 2 1/2 years - snapped the coke-snorting photos that appeared in The ENQUIRER. He also claimed that he saw Krissi smoke pot and guzzle beer and the potent grain alcohol Everclear.

After The ENQUIRER's explosive story hit newsstands, Krissi took to her Twitter account to blast her ex-boyfriend. But she admitted that it was her in the photos, and said her mother "comforted me to the max."

Now with Bobby's blessing, Whitney is planning to send Krissi to an outpatient rehab program, said the source.






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Sources: ABC News, CBS News, CNN, Daily Mail, National Enquirer, TMZ, Youtube, Google Maps

Whitney Houston's Death "Teachable Moment" (Obama Drug Czar: Gil Kerlikowske)

White House drug czar says Whitney Houston's death is a 'teachable moment'

White House Drug Czar Gil Kerlikowske called the death of singer Whitney Houston a "teachable moment" in addressing the problem of prescription drug abuse in the United States.

"I think it's what we might call a teachable moment, when someone passes. Particularly someone that was as highly thought of and was such an incredible performer as Whitney Houston," said Kerlikowske to CBS News in an online video released Monday.

Kerlikowske, the director of the Office of National Drug Control Policy, said Houston's passing puts a spotlight on the issue of prescription drug use. The superstar had opened up about in past interviews admitting to problems with substance abuse, however the Los Angeles County coroner however has still not ruled on the cause of her death.
Houston was found dead at the Beverly Hilton hotel on Los Angeles Saturday. The music icon was 48.

"We can use this a moment to help people understand and remember that there are literally billions of Americans suffering from this problem," he said.
The nation's top drug-policy enforcer told CBS that this type of drug use affects a "huge number" of people throughout the country and causes deaths in "very, very high numbers."

"They're coming right out of our medicine cabinets and yet these drugs are as addictive and dangerous as any other drug," he added.

Kerlikowske said that Houston's struggles with substance abuse highlight the fact that the issue spans all demographics and socioeconomic barriers.

He said that perception drug abuse needs to be recognized as a disease that can be managed and treated with the right help.

Kerlikowske said that when he took office the problem was "not on the public's mind," but after a review which revealed the significance of the problem, President Obama released a strategy to deal with the issue by coordinating state, local and federal involvement.

"We can use this a moment to help people understand and remember that there are literally billions of Americans suffering from this problem," he said.


Sources: CBS News, The Hill, Wikipedia

Whitney Houston's Cause Of Death? Most Likely Prescription Drug Cocktail

Questions surrounding Houston death echo past


Whitney Houston's life was a doleful cover of other addiction-riddled pop stars who put their talent and themselves at risk.

Her death has created more heartrending echoes of tragedies past: The painstaking investigation that follows the shocking loss. Why was Houston found in a Beverly Hills hotel bathtub, beyond resuscitation?

The 48-year-old singer, who had prescription drugs in her room, left behind disconsolate family and friends and unfulfilled dreams.

Her body was flown Monday by private jet to New Jersey, where she was born and where her funeral is planned for Saturday. Late Monday, a hearse under heavy police escort arrived at the Newark, N.J., funeral home that was handling the arrangements for the late pop star.

After an autopsy Sunday, authorities said there were no indications of foul play and no obvious signs of trauma on Houston. It could be weeks, however, before the coroner's office completes toxicology tests to establish the cause of death.

The singer had struggled for years with cocaine, marijuana and pills and her behavior had become erratic, including in the period before her death. Some described her as upbeat and eager to perform at producer Clive Davis' pre-Grammy Awards bash.

Others described an unfocused woman, unkempt and smelling of alcohol and cigarettes.

Law enforcement sources have confirmed to CBS News that prescription drugs were also found in the room, creating speculation that a mixture of drugs and alcohol could have contributed to her death.

It recalled the end of Michael Jackson's life, as he tried to turn his career around with an ambitious series of London concerts. The 50-year-old struck many as youthfully energetic and upbeat, while others said he was bedeviled by insomnia that led him to a fatal dosage of prescription drugs in June 2009.

Jackson's death was quickly linked to the anesthetic propofol, although the criminal prosecution of his doctor was played out through 2011. It took three months for a London coroner to rule that Amy Winehouse drank herself to death last July.

Houston's funeral service will be held Saturday in the church where she first showcased her singing talents as a child.

The owner of the Whigham Funeral Home in Newark said Tuesday that Houston's funeral would be held at noon Saturday at the New Hope Baptist Church in Newark, where her mother, Grammy-winning gospel singer Cissy Houston, led the music program for many years. The funeral home said there would be no wake.

It will likely be smaller than Jackson's Los Angeles memorial service, which included members of the public, 1.6 million of whom had vied for about 9,000 tickets, along with songs from Usher, Jennifer Hudson and Mariah Carey and speeches from other celebrities.

An impromptu memorial for Houston was held during a sadness-tinged Grammys, with Hudson saluting her memory with a performance of "I Will Always Love You." Viewership for the awards show soared over last year by 50 percent, with about 40 million viewers tuning in to the program on CBS.

"It was the greatest honor of my life to be able to be the one to pay tribute to Whitney's memory," Hudson said in a statement Monday. "It was from my heart. I haven't stopped crying since she passed."

Houston was found at the Beverly Hilton Hotel by a member of her staff about 3:30 p.m. PST Saturday, just hours before she was supposed to appear at Davis' party, police Lt. Mark Rosen said. She was pulled from the tub by members of her staff, and hotel security was promptly notified, Rosen said. She was pronounced dead about a half-hour later.

A sensation from her first album, Houston was one of the world's best-selling artists from the mid-1980s to the late 1990s, turning out such hits as "I Wanna Dance With Somebody," "How Will I Know," "The Greatest Love of All" and "I Will Always Love You." But as she struggled with drugs, her majestic voice became raspy, and she couldn't hit the high notes.

Houston left behind one child, daughter Bobbi Kristina Brown, 18, from her marriage to singer Bobby Brown.






Whitney Houston 'died from drugs and NOT from drowning' family 'are told by coroner' as fears grow over mental state of her daughter


1) Coroner tells family not enough water in singer's lungs to conclude she had drowned'

2) She had already died before her head went under the water'

3) Daughter Bobbi Kristina, 18, found asleep in hotel bathtub just 24 hours before

4) Fears grow teenager is suicidal after she is hospitalised TWICE since mother's death

5) Star found under water after mixing a cocktail of prescription drugs with alcohol, it is claimed

6) Award-winning star was on 'brink of bankruptcy' having 'frittered away pop fortune on crack cocaine'


Whitney Houston died from mixing a cocktail of Xanax and other powerful prescription drugs with alcohol, it has been reported.

Her family has allegedly been told by Los Angeles County Coroner officials there was not enough water in her lungs to conclude she had drowned in her luxury hotel bathtub and in fact died before her head went under water, said gossip website TMZ.

The revelations come as it emerged that her daughter Bobbi Kristina, 18, allegedly fell asleep in a bathtub in the same Beverly Hilton hotel just 24 hours before her mother died. TMZ claims security was called to unlock the door and to help the 18-year-old on that occasion.

Relatives now fear Bobbi Kristina has become suicidal - after she was rushed to hospital twice in the 24 hours following the discovery of her mother’s dead body in the bathtub of a Hollywood hotel.

The teenager was first admitted after allegedly passing out, after drinking alcohol and then taking a sedative pill given to her by one of her mother's entourage to calm her down, upon learning of the devastating news.

She was then pictured being taken out of the Beverly Hilton - the same hotel where her mother had died just hours earlier- on a stretcher at 10.30am yesterday and being rushed to Cedars-Sinai where she was treated for extreme anxiety.

She was released several hours later, but friends and family are still very concerned about her mental state.

Crack cocaine user Houston, 48, was found dead under the bath water in luxury suite number 434 at the Beverly Hilton Hotel on Saturday afternoon, which is said to have been littered with bottles of prescription pills.

Reports vary who found her. Some suggest her aunt Mary Jones discovered her body, while others say it was her hairdresser Tiffanie Dixon.

On Thursday she is said to have gone on a 'wild binge' where she clashed with security guards. The next evening she 'partied heavily, drank and chatted loudly' with friends at the hotel bar.

Bottles of Lorazepam, Valium, Xanax and a sleeping medication were found in the hotel room, it has been claimed.

The drugs were believed to have acted as sedatives, causing her to fall asleep in the bathtub once they had been mixed with alcohol from the previous evenings.

Paramedics battled to revive the singer but she was pronounced dead at 3.55pm, hours before she had been due to perform at a pre-Grammys party at the same hotel.

Los Angeles coroner's office has officially refused to comment on rumours that water was found on her lungs, indicating she had drowned.

It said further details will not be officially released until a police investigation is completed, which may take between one and two months, and revealed no one may visit the body while it is in their custody. But TMZ has reported otherwise.

Houston's ex-husband Bobby Brown, with whom she had a notoriously turbulent 14-year relationship riddled with drug use, was in Nashville at the time of her death and his daughter's trips to the hospital.

Brown - whom she blamed partly for her drug issues - was said to be 'in and out of crying fits' upon hearing the news - but still appeared on stage on Saturday with his band New Edition, and cried out 'I love you, Whitney!' in the middle of the concert.

Singer Johnny Gill, one of Brown's New Edition bandmates on tour in Memphis with the star, said: 'Bobby is struggling and he's devastated.'

Brown then cancelled a concert in order to be by Bobbi Kirstina's side and was pictured last night arriving at LAX Airport.

He said: 'I am deeply saddened at the passing of my ex-wife, Whitney Houston.

At this time, we ask for privacy, especially for my daughter, Bobbi-Kristina. I appreciate all of the condolences that have been directed towards my family and I at this most difficult time.'

Houston's family also released a statement yesterday expressing their grief: 'We are devastated by the loss of our beloved Whitney. This is an unimaginable tragedy and we will miss her terribly. We appreciate the outpouring of love and support from her fans and friends.'

Celebrities, from singers and rappers to television personalities and business leaders, took to Twitter to express their sadness at the news.

Stars praised the singer's unmatched talent and passed on their wishes to her bereaved family, while others expressed their shock at how the award-winning singer passed away at the age of just 48.

'Heartbroken and in tears over the shocking death of

my friend, the incomparable Ms. Whitney Houston,' said Mariah Carey, who recorded the Oscar-winning song When You Believe with the late star in 1998.

'Shocked we've lost the immensely talented Whitney Houston!' wrote fellow singer Gloria Estefan. Rihanna tweeted: 'No words! Just tears. I honestly can't think of anything else!!! Feels so strange being at the Grammy rehearsal right now!!'

Bee Gees singer Robin Gibb added his condolences, saying: 'In my estimation we have lost one of the greatest voices in popular music today...but as we always learn too late....we never cherish it until it's gone. My thoughts are with her family.'

A 'devastated' Mitch Winehouse, the father of late Amy Winehouse who died last year after a public battle with class A drugs, paid tribute on Twitter, writing: 'Amy, Etta, Whitney. Their music will NEVER die. What a great girl group in heaven. Mitch'.

Former Boyzone star Ronan Keating said the severity of the singer's problems had become apparent two years ago at the start of her comeback.

He told Sky: 'I'm devastated. I cannot believe it. It's hard to believe she's gone. Another legend, we've lost another singer, probably the greatest singer the world has ever seen.'

'It's very sad to see the tough times in her life. I saw her two years ago when she was trying to make her comeback and I could see that she was weathered and you could see that she had been through tough time but you could see the voice was still there and she was trying.'

Asked if the music industry does enough to look after vulnerable performers, he said: 'It's about the people you surround yourself with. She really got involved in bad situations and the wrong crowd of people who led her down the wrong road.'

And music mogul Simon Cowell said that before her death he had approached her to ask if she would consider becoming a judge on the next season of the U.S. X-Factor.

He also paid tribute to Ms Houston and said the warning signs that she ‘still had problems’ came after the singer made an erratic appearance on the X Factor in 2009.

The performance was to promote a new album after seven years off the scene.

He said: ‘There are always moments in your life that are horrible to remember.

The day John Lennon died, the day Elvis died. More recently Michael Jackson, last year Amy Winehouse and now Whitney.

'I know quite a few people who had been working with her over the years. We all knew Whitney had issues. I last met her when she came on the X Factor.

You could see at the time there were still a few problems but she was a delight to work with on the day.'

The guest appearance on X Factor - her first UK TV appearance for 12 years - was billed as the start of her comeback but the worrying performance raised concerns for her well being and she suffered an embarrassing wardrobe malfunction when her dress straps snapped.

Miss Houston then embarked on her Nothing But Love World Tour tour in 2010, but the UK leg was beset by cancellations. She was forced to reschedule the first three dates in Manchester and Glasgow after picking up a respiratory infection.

She finally played her first UK gig in 11 years at the Birmingham LG Arena.

The talent show judge told Sky: ‘She probably wasn’t all together but it was still Whitney Houston and you were in the presence of a legend and I will never forget that day.
'There are so few people like her in the world. They are a rarefied breed, these are true superstar legendary divas, but I say diva that in the nicest possible way. She had one of the best voices I heard in my life ever.’

And it was not just the music industry that felt the influence of Houston, with other celebrities expressing their condolences and thanks to the award-winning singer.

One high-profile figure to speak out was Facebook boss Mark Zuckerberg, who said: 'R.I.P. Whitney Houston. Thank you for the amazing music you brought into the world.'
Whitney Houston's death cast a shadow over the music industry's most prestigious event - last night's Grammys.

Stars lined up to pay tribute to the singer, who had previously won six of the awards, with X-Factor judge Kelly Rowland saying on the red carpet: 'We lost our hero.

'I would not be standing here today if it was not for her. My prayers go out to her mother and her daughter. If we feel this loss, I can only imagine how heavy their loss is.'


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Sources: AP, ABC News, CBS News, CNN, Daily Mail, Youtube, Google Maps

Walgreen Stores Turning Away New Medicaid Patients

Walgreens: No New Medicaid Patients As of April 16, 2010


Effective April 16, Walgreens drugstores across the state won't take any new Medicaid patients, saying that filling their prescriptions is a money-losing proposition — the latest development in an ongoing dispute over Medicaid reimbursement.

The company, which operates 121 stores in the state, will continue filling Medicaid prescriptions for current patients.

In a news release, Walgreens said its decision to not take new Medicaid patients stemmed from a "continued reduction in reimbursement" under the state's Medicaid program, which reimburses it at less than the break-even point for 95 percent of brand-name medications dispensed to Medicaid patents.

Walgreens follows Bartell Drugs, which stopped taking new Medicaid patients last month at all 57 of its stores in Washington, though it still fills Medicaid prescriptions for existing customers at all but 15 of those stores.

Doug Porter, the state's director of Medicaid, said Medicaid recipients should be able to readily find another pharmacy because "we have many more pharmacy providers in our network than we need" for the state's 1 million Medicaid clients.

He said those who can't can contact the state's Medical Assistance Customer Service Center at 1-800-562-3022 for help in locating one.

Along with Walgreens and Bartell, the Ritzville Drug Company in Adams County announced in November that it would stop participating in Medicaid.

Fred Meyer and Safeway said their pharmacies would continue to serve existing Medicaid patients and to take new ones, though both expressed concern that the reimbursement rate is too low for pharmacies to make a profit.

The amount private insurers and Medicaid pay pharmacies for prescriptions isn't the actual cost of those drugs but rather is based on what's called the drug's estimated average wholesale price. But that figure is more like the sticker price on a car than its actual wholesale cost.

Washington was reimbursing pharmacies 86 percent of a drug's average wholesale price until July, when it began paying them just 84 percent. While pharmacies weren't happy about the reimbursement reduction, the Department of Social and Health Services said that move was expected to save the state about $10 million.

Then in September came another blow. The average wholesale price is calculated by a private company, which was accused in a Massachusetts lawsuit of fraudulently inflating its figures. The company did not admit wrongdoing but agreed in a court settlement to ratchet its figures down by about 4 percent.

That agreement took effect in September — and prompted a lawsuit by a group of pharmacies and trade associations that said Washington state didn't follow federal law in setting its reimbursement rate, and that that rate is too low. The lawsuit is pending.

"Washington state Medicaid is now reimbursing pharmacies less than their cost of participation," said Jeff Rochon, CEO of the Washington State Pharmacy Association.

Pharmacies that continue to fill Medicaid prescriptions at the current state reimbursement rate are "at risk of putting themselves out of business altogether," he said.




With Medicaid Cuts, Doctors & Patients To Drop Out



Carol Y. Vliet’s cancer returned with a fury last summer, the tumors metastasizing to her brain, liver, kidneys and throat.

As she began a punishing regimen of chemotherapy and radiation, Mrs. Vliet found a measure of comfort in her monthly appointments with her primary care physician, Dr. Saed J. Sahouri, who had been monitoring her health for nearly two years.

She was devastated, therefore, when Dr. Sahouri informed her a few months later that he could no longer see her because, like a growing number of doctors, he had stopped taking patients with Medicaid.

Dr. Sahouri said that his reimbursements from Medicaid were so low — often no more than $25 per office visit — that he was losing money every time a patient walked in his exam room.

The final insult, he said, came when Michigan cut those payments by 8 percent last year to help close a gaping budget shortfall.

“My office manager was telling me to do this for a long time, and I resisted,” Dr. Sahouri said. “But after a while you realize that we’re really losing money on seeing those patients, not even breaking even. We were starting to lose more and more money, month after month.”

It has not taken long for communities like Flint to feel the downstream effects of a nationwide torrent of state cuts to Medicaid, the government insurance program for the poor and disabled. With states squeezing payments to providers even as the economy fuels explosive growth in enrollment, patients are finding it increasingly difficult to locate doctors and dentists who will accept their coverage. Inevitably, many defer care or wind up in hospital emergency rooms, which are required to take anyone in an urgent condition.

Mrs. Vliet, 53, who lives just outside Flint, has yet to find a replacement for Dr. Sahouri. “When you build a relationship, you want to stay with that doctor,” she said recently, her face gaunt from disease, and her head wrapped in a floral bandanna. “You don’t want to go from doctor to doctor to doctor and have strangers looking at you that don’t have a clue who you are.”

The inadequacy of Medicaid payments is severe enough that it has become a rare point of agreement in the health care debate between President Obama and Congressional Republicans. In a letter to Congress after their February health care meeting, Mr. Obama wrote that rates might need to rise if Democrats achieved their goal of extending Medicaid eligibility to 15 million uninsured Americans.

In 2008, Medicaid reimbursements averaged only 72 percent of the rates paid by Medicare, which are themselves typically well below those of commercial insurers, according to the Urban Institute, a research group. At 63 percent, Michigan had the sixth-lowest rate in the country, even before the recent cuts.

In Flint, Dr. Nita M. Kulkarni, an obstetrician, receives $29.42 from Medicaid for a visit that would bill $69.63 from Blue Cross Blue Shield of Michigan. She receives $842.16 from Medicaid for a Caesarean delivery, compared with $1,393.31 from Blue Cross.

If she takes too many Medicaid patients, she said, she cannot afford overhead expenses like staff salaries, the office mortgage and malpractice insurance that will run $42,800 this year. She also said she feared being sued by Medicaid patients because they might be at higher risk for problem pregnancies, because of underlying health problems.

As a result, she takes new Medicaid patients only if they are relatives or friends of existing patients. But her guilt is assuaged somewhat, she said, because her husband, who is also her office mate, Dr. Bobby B. Mukkamala, an ear, nose and throat specialist, is able to take Medicaid. She said he is able to do so because only a modest share of his patients have it.

The states and the federal government share the cost of Medicaid, which saw a record enrollment increase of 3.3 million people last year. The program now benefits 47 million people, primarily children, pregnant women, disabled adults and nursing home residents. It falls to the states to control spending by setting limits on eligibility, benefits and provider payments within broad federal guidelines.

Michigan, like many other states, did just that last year, packaging the 8 percent reimbursement cut with the elimination of dental, vision, podiatry, hearing and chiropractic services for adults.

When Randy C. Smith showed up recently at a Hamilton Community Health Network clinic near Flint, complaining of a throbbing molar, Dr. Miriam L. Parker had to inform him that Medicaid no longer covered the root canal and crown he needed.

A landscaper who has been without work for 15 months, Mr. Smith, 46, said he could not afford the $2,000 cost. “I guess I’ll just take Tylenol or Motrin,” he said before leaving.

This year, Gov. Jennifer M. Granholm, a Democrat, has revived a proposal to impose a 3 percent tax on physician revenues. Without the tax, she has warned, the state may have to reduce payments to health care providers by 11 percent.

In Flint, the birthplace of General Motors, the collapse of automobile manufacturing has melded with the recession to drive unemployment to a staggering 27 percent. About one in four non-elderly residents of Genesee County are uninsured, and one in five depends on Medicaid. The county’s Medicaid rolls have grown by 37 percent since 2001, and the program now pays for half of all childbirths.

But surveys show the share of doctors accepting new Medicaid patients is declining. Waits for an appointment at the city’s federally subsidized health clinic, where most patients have Medicaid, have lengthened to four months from six weeks in 2008. Parents like Rebecca and Jeoffrey Curtis, who had brought their 2-year-old son, Brian, to the clinic, say they have struggled to find a pediatrician.

“I called four or five doctors and asked if they accepted our Medicaid plan,” said Ms. Curtis, a 21-year-old waitress. “It would always be, ‘No, I’m sorry.’ It kind of makes us feel like second-class citizens.”

As physicians limit their Medicaid practices, emergency rooms are seeing more patients who do not need acute care.

At Genesys Regional Medical Center, one of three area hospitals, Medicaid volume is up 14 percent over last year. At Hurley Medical Center, the city’s safety net hospital, Dr. Michael Jaggi detects the difference when advising emergency room patients to seek follow-up treatment.

“We get met with the blank stare of ‘Where do I go from here?’ ” said Dr. Jaggi, the chief of emergency medicine.

New doctors, with their mountains of medical school debt, are fleeing the state because of payment cuts and proposed taxes. Dr. Kiet A. Doan, a surgeon in Flint, said that of 72 residents he had trained at local hospitals only two had stayed in the area, and both are natives.

Access to care can be even more challenging in remote parts of the state. The MidMichigan Medical Center in Clare, about 90 miles northwest of Flint, closed its obstetrics unit last year because Medicaid reimbursements covered only 65 percent of actual costs. Two other hospitals in the region might follow suit, potentially leaving 16 contiguous counties without obstetrics.

Medicaid enrollees in Michigan’s midsection have grown accustomed to long journeys for care. This month, Shannon M. Brown of Winn skipped work to drive her 8-year-old son more than two hours for a five-minute consultation with Dr. Mukkamala. Her pediatrician could not find a specialist any closer who would take Medicaid, she said.

Later this month, she will take the predawn drive again so Dr. Mukkamala can remove her son’s tonsils and adenoids. “He’s going to have to sit in the car for three hours after his surgery,” Mrs. Brown said. “I’m not looking forward to that one.”

Sources: NY Times, Walgreens, Fox News, Seattle Times, Youtube

TLC's "Addicted" (Show Intro. Video)

TLC's Addicted Issues A Desperate Cry For Help


TLC will debut a new reality show on Wednesday, to go head to head with A & E's Intervention, called Addicted. For the kick-off episode, according to a report in the Sunday Boston Globe, we can look forward to watching a young woman named Amanda shoot heroin in her bathroom.

I am not a media critic. This is not a media critic's blog. I am not a doctor or a social worker or therapist, nor a recovering addict with an ability to understand. I do not watch much reality TV, have never watched Intervention, and will not be tuning in to watch poor Amanda fall under the spell of the cameras, lights and "action" shooting through her veins.

So, for the sake of anyone that wants to jump-in on behalf of TLC's better intentions (TLC President, Eileen O'Neill, calls Addicted "...a series about family, change and hope"), or the tragedy that is Amanda and countless other victims of substance abuse, or the good that might come from bringing their stories to light in an insensitive world, I am here to say only, fine. Sure. If you think so.

For anyone else that may be driving up and down the broad boulevards of television staring out the window, wondering what ever happened to the old neighborhood that was once lined by trees and decorative front yards, Addicted is a good metaphor. The answer is that people moved away and the place got too expensive for those that remained. And, inevitably, this is what happens.

It can remain an open question whether TV can help Amanda -- or New Jersey housewives, or hoarders, or top models, or anyone else issuing a desperate cry for help. Let's hope so. In the meantime, their voices mingle with desperate cries from the media world -- and, not unfittingly, it is sometimes hard to tell the cries apart.

Ping your blog


Sources: TLC, AP, Huffington Post, Youtube

24,000 North Carolina Senior Citizens Could Lose Medicare Part D

Medicare Suspension Affects 24,000 Senior Citizens In N.C.


Contact: CMS Office of Public Affairs
202-690-6145

As many as 24,000 North Carolina Medicare recipients may be affected by the suspension of a New York-based drug plan.

Federal Medicare regulators have ordered Fox Insurance Company of New York to suspended new enrollments and marketing for its Medicare Part D drug plan because the company was not providing drugs to customers quickly, according to the federal Centers for Medicare & Medicaid Services.

The company, without permission from Medicare, was suggesting patients use cheaper drugs than those prescribed by doctors. Given the drugs were for drugs for treating cancer, diabetes and HIV/AIDS, delays in medications could have had serious implications.

More than 24,000 Medicare recipients in North Carolina were enrolled with the company, said Kristin Milam, a spokeswoman for the N.C. Department of Insurance. Mecklenburg County had more than 1,400 enrollees and Wake County had about 1,000.

Many of those enrolled were also enrolled in Medicaid and should be able to change drug providers on a monthly basis, she said. Others may have to follow a special procedures. Milam said anyone with questions is encouraged to contact the state's Free Seniors' Health Insurance Information Program, which provides unbiased, expert advice and information.

"If you've got a question about it and you think you're affected by this, go ahead and call," Milam said. "You will get a live person when you call that 1-800 number."

Individual, in person appointments are also available in every county. For more information visit www.ncshiip.com or call 1-800-443-9354.


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Sources: McClatchy Newspapers, Centers For Medicaid & Medicare Services, Google Maps

Tiger's Prescription Drug Use Linked To His Sex Addiction...Ambien

Tiger and Pills


The golfer’s ability to play through pain made him a hero. But now his prescription-drug use has been linked to his accident, sex habits, and, Gerald Posner reports, prompted a doctor’s warning.

Florida police have not yet released a full report from Tiger Woods' immediately infamous SUV crash on November 27, but the most curious detail to emerge came from a neighbor, Jarius Adams, who reached the accident scene almost immediately, dashed into his sister’s house to call 911, then returned.

"At that point, he was, uh, he [Tiger Woods] was snoring," Adams told the police.

"He was snoring?" asked the investigator.

"He was actually snoring."

Trauma doctors I interviewed said that Woods should have been hyper-alert because of the adrenaline rush naturally associated with such unexpected excitement and stress. Various reports have suggested that Woods’ crash was influenced by prescription medication, taken for an injury. But one law-enforcement officer, familiar with the investigation, tells The Daily Beast that police on the scene suspected that Woods was disoriented and loopy because he had taken Ambien, a highly popular prescription sleeping pill. A person familiar with Woods’ medical treatment two years ago tells me that Woods has used prescription sedatives, when injured, to help him sleep.

Ambien has increasingly emerged as a cause of impaired driving, best evidenced by the celebrated 2006 car accident in which Congressman Patrick Kennedy smashed into a Capitol Hill traffic barrier at 3 a.m. Despite the talk of pain pills and sedatives, the Florida Highway Patrol did not administer any drug or alcohol tests to Tiger, telling the Orlando Sentinel that it did not have the “probable cause” for such tests.

But the incident also raises questions about Woods, and his pill habits. The suggestion of an Ambien link to the 2:30 a.m. crash comes on the heels of reports that one of Woods’ mistresses told friends that she and Tiger liked to have “crazy” sex in an “Ambien haze.” Meanwhile, a source familiar with Tiger’s medical treatment in the latter half of 2007 tells me that Tiger’s regular dosing of painkillers was “potentially a problem” during those six months because of the addictive nature of his medications. That coincides with Woods tearing his left knee ACL, a common athlete injury, in July 2007. Woods and his advisers decided against surgery then and instead he continued playing and winning on the PGA Tour.

As far as Tiger’s advisers and family were concerned, the potential problem, this source stressed, was more focused on whether the prescription pills might take a minute edge off Tiger’s reaction time and somehow adversely affect his game. But at least one physician was concerned enough to directly raise with Woods the potential of addiction and his need to wean off the pain pills.

After surgery for injuries—Woods has endured four operations on his left knee—almost every patient gets a prescription for painkillers. And every athlete plays through pain at some point in a professional career. It’s part of sports. Cortisone shots, pain pills, ice packs, physical therapy—it’s how athletes prevent injuries from sidelining them. On any given Sunday in the NFL, a post-game locker room looks like a veritable pharmacy, with painkillers seemingly being popped like M&Ms. But the downside remains omnipresent. The closest thing football has to a Tiger Woods, Brett Favre, battled a Vicodin addiction early in his career, and had to check himself into a rehab facility.

So it’s completely normal that Tiger Woods used painkillers through his discomfort, and completely appropriate that doctors worried about him developing an addiction. Especially since playing through the pain is part of his legacy. The 2008 U.S. Open is such a case. Tiger had torn his ACL the previous year. What no one knew at the time of the U.S. Open was that just a couple of weeks before, Tiger had suffered a double stress fracture in his left tibia, known popularly as the shinbone. Although his doctors advised he go on crutches for three weeks, followed by a month of rest, he refused. His swing coach, Hank Hanley, later told a reporter that, “Every night, I kept thinking there was no chance he's going to play. He had to stop in his tracks for 30 seconds walking from the dining room table to the refrigerator.”

But not only did Tiger limp and grimace through 91 holes, including sudden death, but he won one of the most exciting Opens in memory. That he did so on pain medications was just another reminder to sports writers and fans that he was a living legend.

I asked Tiger’s agent, Mark Steinberg, about Woods’ prescription drug history. His response came by email on Friday:

“As any doctor would attest, patients are universally prescribed medication for bone fractures and following major orthopedic surgery. Tiger's care has been managed with especially attentive observation by leading medical professionals, and others simply aren’t in a responsible position to make any assessments. Most importantly, the specifics of his medical care ought to be private, which is why unending Internet innuendo about his condition is so irresponsible and offensive. For amateurs to make speculative judgments about the quantity, propriety, or duration of a patient’s care is reprehensible.”

In some ways this answer sounded similar to part of the statement that was first issued under Tiger’s name after the car accident. In that case, they said, "This is a private matter, and I want to keep it that way. Although I understand there is curiosity, the many false, unfounded, and malicious rumors that are currently circulating about my family and me are irresponsible.”

When I followed up with specific questions about Tiger’s 2007 regimen, he did not answer, nor did anyone else in the Woods camp.



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Sources: The Daily Beast, Google Maps

FDA Recommends Banning Vicodin & Percocet

MSNBC----

Visit msnbc.com for Breaking News, World News, and News about the Economy

ADELPHI, Md. - Government experts say prescription drugs like Vicodin and Percocet that combine a popular painkiller with stronger narcotics should be eliminated because of their role in deadly overdoses.

A Food and Drug Administration panel on Tuesday voted 20-17 that prescription drugs that combine acetaminophen with other painkilling ingredients should be pulled off the market.

The FDA has assembled a group of experts to vote on ways to reduce liver damage associated with acetaminophen, one of the most widely used drugs in the U.S.

Despite years of educational campaigns and other federal actions, acetaminophen remains the leading cause of liver failure in the U.S., according to the FDA.

Panelists cited FDA data indicating 60 percent of acetaminophen-related deaths are related to prescription products. Acetaminophen is also found in popular over-the-counter medications like Tylenol and Excedrin.

“We’re here because there are inadvertent overdoses with this drug that are fatal and this is the one opportunity we have to do something that will have a big impact,” said Dr. Judith Kramer of Duke University Medical Center.

Many opposed to recommendation:

But many panelists opposed a sweeping withdraw of products that are so widely used to control severe, chronic pain.

“To make this shift without very clear understanding of the implications on the management of pain would be a huge mistake,” said Dr. Robert Kerns of Yale University.

In a separate vote, the panel voted overwhelmingly, 36-1, that if the drugs stay on the market they should carry a black box warning, the most serious safety label available.

The FDA is not required to follow the advice of its panels, though it usually does.

Prescription acetaminophen combination drugs were prescribed 200 million times last year, according to FDA data. Vicodin is marketed by Abbott Laboratories, while Percocet is marketed by Endo Pharmaceuticals. Both painkillers also are available in cheaper generic versions.

The FDA convened the two-day meeting to ask experts to discuss and vote on a slew of proposals to reduce overdoses with acetaminophen. The drug has been on the market for about 50 years and many patients find it easier on the stomach than ibuprofen and aspirin, which can cause ulcers.

Panel voted to lower maximum acetaminophen dose:

Earlier in the day, panelists took aim at safety problems with Tylenol and dozens of other over-the-counter painkillers. In a series of votes, the panel endorsed lowering the maximum dose of those products.

FDA’s experts voted 21-16 to lower the current maximum daily dose of nonprescription acetaminophen, which is 4 grams, or eight pills of a medication like Extra Strength Tylenol.

The group was not asked to recommend an alternative maximum daily dose.

The panel also voted 24-13 to limit the maximum single dose of the drug to 650 milligrams. The current single dose of Johnson & Johnson’s Extra Strength Tylenol is 1,000 milligrams, or two tablets.

In a third vote, a majority of panelists said the 1,000-milligram dose should only be available by prescription.

However, panelists rejected a proposal to pull certain cold and cough medicines off the market because of their role in overdosing.

The drugs in question, such as Procter & Gamble’s NyQuil or Novartis’ Theraflu, combine acetaminophen with other ingredients that treat cough and runny nose.

The FDA says patients often pair the cold medications with pure acetaminophen drugs, like Tylenol, exposing themselves to unsafe levels of the drug.

But panelists cited FDA data that said the medications play a minor role in acetaminophen overdoses, with only 10 percent of acetaminophen-related deaths involving a cold and cough product.

“I don’t think we should be advocating a solution to a problem that really is not there,” said Dr. Osemwota Omoigui, of the Los Angeles pain clinic.

The panel voted 24-13 to keep the products on the market.


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Sources: MSNBC, U.S. National Library of Medicine, Wikipedia, Addiction Helpline, Google Maps