Daily Rounds: Conservative Judge Upholds Health Law; Mandating Primary Care; Shaken Baby Wars; Death In A Public Pool

Federal Appeals Court Upholds Health Care Law : NPR "The Cincinnati-based 6th Circuit Court of Appeals said Wednesday that the health care mandate requiring everyone to have health insurance or pay a penalty does not violate the Constitution. Though other federal appeals courts are expected to rule on the law soon, Wednesday's decision took on a special importance because one of the judges upholding the law, Jeffrey Sutton, is a prominent conservative. Appointed to the appeals court by President George W. Bush in 2003, Judge Sutton is no ordinary conservative. He served as a law clerk for Justice Antonin Scalia, an icon of the conservative movement. And, as a litigator, he was at the forefront of making modern states' rights arguments in the U.S. Supreme Court. But in this case, he rejected similar arguments in the context of the national health care law." (npr.org)

Mandate Residents To Have Primary Care Doctors? The Boston Globe: "It’s the PPOs, Berman said at today’s hearings on health care costs, that are pushing up costs and harming the quality of care in Massachusetts. When a patient in a PPO has back pain, he or she may seek care from a neurologist, an orthopedist and a chiropractor, he said. They “refer themselves to teaching hospitals assuming that is where the best care is going to be.’’ “Having patients self-direct is part of the problem today,’’ said Berman, chief operating officer of Acton Medical Associates. “Patients can’t diagnose themselves; they need help.’’ Berman wants the state to pass a law requiring all PPO members to choose a primary care doctor who can coordinate their care. Until then, he said, a new way of paying primary care doctors that puts them on a budget to cover all of a patient’s care — called global payments — won’t work. Panelists at the hearings sponsored by Governor Deval Patrick’s administration discussed how to move to a global payment system today." (boston.com)

Rethinking Shaken Baby Syndrome : NPR (npr.org) "The dispute over shaken baby syndrome is a bitter civil war. On one side, doctors, lawyers and other experts say the diagnosis is key to winning convictions of people accused of the most horrible acts of child abuse. Opponents say the diagnosis is used too freely and that sometimes, innocent people go to prison. Norman Guthkelch, the pediatric neurosurgeon who is credited with first observing the condition in young children, is speaking out for the first time about his concerns regarding how that diagnosis is used. He worries that it is too often applied by medical examiners and doctors without considering other possible causes for a child's death or injury."

Mass. shuts 30 facilities after death in Fall River - The Boston Globe "The body of a 36-year-old woman was pulled from a state-run pool in Fall River Tuesday night, apparently after being in the water since Sunday, prompting the temporary closure of all state-operated deep-water pools in Massachusetts while officials investigate, authorities said. It was not clear yesterday if any swimmers noticed the woman’s body between Sunday and Tuesday. The Herald News, a local newspaper, ran a photo in Tuesday’s paper showing swimmers in the water on Monday." (boston.com)