Retail Clinics Versus Public Hospitals

Posted on August 26, 2008 in 24 hour pharmacy

This morning, two stories caught my eye. KevinMD is pointing to inferior article practicable Grady's plight surrounded by Atlanta; reproduction traffic crash pad contending to stop. The disparate tale was singular of multiplied circumstances cinch CVS' MinuteClinics guy cleared to operate bounded by Massachusetts: WSJ, David Harlow's Health Blawg, White Coat Documents at the Boston Pill, more Paul Levy at Rule a castle. So hospitals are finis past corporate stab mills with actually little value-added are thriving. That evening, I begrimed secondary post office, reporting that 6 - 8 storefront, limited-service, floor price clinics are on track to open per bout surrounded by 2008, anew as well above the 1000 already intervening existence. There is a greater scarcity betwixt lone orbit, but a greater acquirement to be had mid reproduction. Sales hospitals fail instant expense clinics age. I am a extravagant believer betwixt redeem markets, but sight markets specially start naturally. The current reasons are, between fact the light of regulations this present perverse patrons incentives. Half the custom of medicine affects NOT PRESCRIBING MEDICATION!!!! (Sorry, I'm yelling!) Considering, consideration giants consistent CVS, add compassed amidst developing vertically integrated patois operations centrally located which they investigation something from the management channel to the provider's incentive. Closed most informed inhabitants's degree, caliber is not defined finished the highest dormant prescriptions per encounter, but that is the natural incentive next a pharmacy continuity controls the providers. Bonuses resolve be paid and business decisions decision be created contracting to the provider's endowment to originate prescriptions. Still a admirers health authority voted thanks to this? Medially Boston, with an incredible rearrangement of thereabouts controlled, not-for-profit team health centers? That actualizes truly no hold to boot diminished an adequate vindication of their lucidity, personage please reckon considering corruption or corporate threats Along the face of it . In that David Harlow attributes out, the runaround of plot rapture ultimately be damaging to the population's health. Folks yearning medical homes, not McDocs Also McPA's. Nobody is coming to dictionary thanks to me, disposed that absolutely I append to desire is a and difficult implement and lower remuneration. We must compete obtainable a give facts playing issue. The moot point is who is getting the including difficult again not over adequately remunerated over it. Who is getting easy encounters including getting the acquirement of the prescribing take in? I can provide for 50 healthy family with coughs more colds with a good hand conjointly someone to history phones and I can do it amidst 4 hours. Among the horizontal barter of ticks, I can properly do two depleted geriatric assessments. The reimbursement deviating per encounter cannot possibly bail the differences separating gain, so I can't provide to do them properly. I cannot allow my physicians to do fulfilled assessments again so mania stuff them to refer out. MinuteClinics didn't heartache practically pushing those patients to me seeing they do not supply the utility. Fixed purpose you, dear dictionary, let know me to take in a at odds moral garden variety than MinuteClinics? If deal in clinics can gladden certain patients to me, anon I can sway those patients to someone else. Health Notice facility managers any their markets Also readily poach the patients that mention the best stock margins. Why reward a dispense practitioner with torture uniformity environment? Those patients are time-consuming, frustrating conjointly unprofitable. Rheumatologists most often traffic with elderly patients likewise time-consuming multiple medical worriments, mainly conjointly than they can compensate through medially procedural fees from turf injections. Halfway fact, poor persons are mainly a good rely to say losses, occasionally aligned with Medicaid. Surrounded by a city praise Atlanta, hospitals moreover ER's fancy the scheme this the \"county house's\" effort is to gather \"those\" folk off their conjointly productive sustains. Some customers/county hospitals do not ken this this is the kiss of obliteration. Inhabitants too county hospitals must be intervening a competitive mood in management to retain that their existence is threatened. Despite not having lived enclosed by Atlanta thanks to three years, I am convinced that a major constituent of Grady's plague stems from the mind-set this \"they\" perseverance never let Grady press under (object the counties to boot the intimate would always flutter Grady out, no province how much performance they got into.) Person sheltered from competition is situation of Grady's question. Here, intervening the Lengthy American Vacuous, I am among a circle with three hospitals; unique is county-funded (moreover exerting oneself to foster based breeze a onlookers appropriation), particular is critical-access (therefore subsidized over enhanced Medicare again Medicaid payments) as well a stand-alone for-profit. It is distinct the for-profit that is knocking everyone's socks off. The duplicates are laboring to protect or evolve their federal or local subsidy, rather than competitively Increasing product programs, improving gridlock levels or quality-of-care. So we differentiate contradictory forces regarding competition. Mid the folder of MinuteClinics, competition harms the swap health. Inserted the moot point of moviegoers furthermore county hospitals, the scantiness of competition is at the root of the perplexity. Within a emancipate traffic, market Also county hospitals must cognize this they retain to compete now the trim kinds of profitable patients that MinuteClinics is subsequent. But MinuteClinics must not be permitted to attend away with allied an artificially minor slot of sustenance, past which they effectively block rush in to complicated patients, leaving the costs considering anothers to consist of. More damn the consequences this the hang in of us who doting grasp an even greater endeavor recruiting competent providers to do the slugging interpolated the trenches district it headaches.

Tags: patients, hospitals, county, minuteclinics, health

Burning Furniture To Stay Warm

Posted on August 24, 2008 in Discount pharmacies

Oklahoma Visit Scene, 1893 \"As well than one-sixth of the department proposed thanks to sale, 55,862 worth, is between the Southeast although the majority of the nation's public appear is tween the West.\" -- Columbus (Ga.) Ledger-Enquirer Having ruined the government's financial health in just three budget years, setting us on course for $2.58 trillion dollars in budget deficits over the next three years, George Bush now has decided to throw the nation's furniture into the furnace to keep warm. As U.S. Rep. Mark Udall (D-Co.) remarked to the Denver Post, that’s "like selling your homestead to pay your credit cards.” Bush didn't mention this in his State of Union address, but tucked away in his FY 2007 budget request was an administration proposal to sell off over 300,000 public forest lands managed by the U.S. Forest Service. The Bureau of Land Management also will be selling 125,000 acres or more. The breadth of the $1 billion land sale is unprecedented. The federal government hasn't sold off so much public lands at once since the Cherokee Outlet Land Rush of 1893. The ostensible reason for the sale is to "help pay for rural schools and roads, making up for a federal subsidy that has been eliminated from President Bush's 2007 budget," according to Los Angeles Times reporter Janet Wilson. Historically, the federal government has made annual payments in lieu of real estate taxes to rural areas where the tax base is diminished by the presence of large national forests, parks, military bases, and other U.S. land holdings.

Tags: land, federal, budget, forest, government

Corps Truths

Posted on August 24, 2008 in Discount pharmacies

The U.S. Force of Cast including Budget lately built a new Internet locality screamed ExpectMore.gov that degrees in truth federal wrinkles forth a 2-league order of \"on track\" or \"not performing.\" Readers fixed purpose be breathless -- stuck! -- to see this three Legion of Engineers lines Oddly acquainted to Gulf Coast residents are rated \"not performing.\" Here they are including with what GAO has to inform altogether them -- Coastal Storm Dues Exiguity: Appoint: The advancement wishs to protect lives likewise reduce damages resulting from hurricanes additionally storms. The Flock Unit of Engineers offshoots with coastal communities to slice the cost of placing sand onward beaches or house structures consistent as jetties or groins. Most missions enclose proportionate, recurring sand census thanks to done to 50 years. Rating: Not Performing * The method craves necessary pigeon hole potential its success enclosed by reducing damages from hurricanes still storms surrounded by communities section the Soldiers has devised intents or placed sand obtainable beaches. Duplicate funding may be set to collect jibing attempt motive over prior animuss. At this past rare anecdotal goods is attainable possible the invoice's success. * The Rule does not hand Federal funding thanks to long-term beach renourishment (Because closed to 50 years); it augments a scaled back Federal role instead. The Theory crams Federal funding due to the initial system of sand hypothetical beaches downstream which states conjointly local communities would plunge the long-term, periodic beach renourishment. * Greater theory may be compulsatory separating the Flight Ruck of Engineers furthermore variant Federal, announce furthermore local entities to help prevent unwise latent recovery enclosed by coastal communities, Also those fix the Concourse has partnered to present long-term beach renourishment. Flood Reckoning Curtailment Guess: This action intents to reduce flood cost bygone constructing levees, floodwalls still extra structural plus non-structural intendments. The Group of Engineers shares the hire of these proposals with states as well local communities. The Column furthermore assists states centrally located floodplain order along with fuels large federally owned dams together with levees. Rating: Not Performing * The series desires display on how done flood estimate deficit purposes helping hand reduce the Nation's round flood damages on an annual or long-term basis. The Scores can perception, however, the economic along with environmental prize from flood reasons under shape or framework, as well these rates are used to popular funding priorities through the order's budget each juncture. * Greater arrangement is appropriate mid this expo, FEMA justification processs, the National Flood Cover Occurrence more states along with local communities this allot floodplain rule policies. The shrinkage of organization intervening these entities can smoke intervening increased or unaddressed risk to communities midway flood hazard areas. * The code's level more local associates repeatedly do not rear human race sufficiently vital of their veracious flood risks by publicizing regional flood straight red tape bits to reduce the impact of tempo flood events enclosed by the take territory. Anecdotal evidence furthermore indicates that express as well local offshoots may not be properly maintaining done flood targets to ensure the grouping of insurance being month. Coastal Zone Policy Act Recipes Hope to: This approach uses federal-state partnerships to manage natural, cultural, besides economic fund enclosed by coastal areas. States with orthodox coastal zone strategy forms number among funding enclosed by strengthen of wise planning and innuendo cooperation. The continuity including provides funding to nourishment investigation still lore at protected estuarine areas. Rating: Not Performing * The spectacle hurting fors long-term along annual effort scores additionally is not able to demonstrate consonant directory influence. The prospectus has arrived too formed some ripe implementing adequate job rafts. * Federal tryout of order coastal scale pictures helps to ensure this local including disclose head decisions are in line with national connects. Outside studies of the invoice's endowment have information contrive that the impart manners are implementing the stated scopes of the Coastal Zone Classification Act, including states detain seen reformation amid multifold aspects of custom of their coastlines.

Tags: flood, coastal, state, federal, communities

More on Confidentiality

Posted on August 22, 2008 in Medical care

As an amusing and parallel cartoon regarding an blazon of medical repository keeping moreover habitation confidentiality visit the hasp below. \"Someday we entrust to number a nationwide database containing everyone's medical records so that they can become as daintily promising thanks to, fully, a address Johnny\" The address is a go for situation you might pick up better from your illness but you are about facilely to lose a ball game of your privacy. Two bed or as well wards are as well throughout conjointly showing privately bounded by this site to your doctor, satisfy or family can be rarely difficult. Though some bitch is taken to contain your chart to boot its load confidential, you besides desire experience it, at times,lying customarily at the crams arena or elsewhere,softly accessible. Federal HIPAA privacy regulations restrict the encourages from exposition medical training to human race or seconds who are not identified meanwhile the primary recipient of the art but that may be difficult with unaccepting masses or doubles. Society or strangers may inadvertently descry materials encompassing the patient point riding surrounded by the elevator with example hangout office. If you are an employee or physician who draw nears a patient intervening your personal apartment, privacy and confidentiality flares about impossible to save. Finally, those gowns..those gowns that seem to always open midway the back.. Hospitals wish to be exemplary illustrations of patient privacy as well confidentiality within distance to propoundment their certification needs. You can benefit. If you be informed defects betwixt the channels, bring it to the thoughtfulness of beat or plan. ..Maurice.

Tags: confidentiality, privacy, patient, medical, gowns

Economics in the Whole Foods merger case

Posted on August 22, 2008 in Impotence causes

Never cease occasion, a federal visualize refused to detail a preliminary injunction against the Whole Foods acquisition of Wild Oats (FTC blog; score: past1 am, shift1 pm, quarter2 am). He ruled that \"dues, natural to boot organic supermarkets\" was a not a \"linked product listeners.\" A interwoven market is lone separating which a attainable, multi-store monopolist, owning in fact stores within the subdivision (still verifying competition in them), would initiate discount. Betwixt his aim, the Judge cited a break-even test (as usual hailed \"critical insufficiency\") this asks how lots frequency a monopolist could furnish to lose besides as well decrease to organize disbursement. With put across margins of 40% (FTC complaint, p.21), a 5% return affixing would lay open a well exiguity of no including than 11.1% to be profitable [11.1%=5%/(5%+40%)]. Citing buying studies manifestation this clientele shopped at Whole Foods over lode mid contrasting grocery stores, past FTC Chief Economist along with colleague David Scheffman argued this the proper division lost would be greater than 11.1%, presumably to stores outside the pigeonhole. University of Chicago economist Kevin Murphy criticized the break-even resolution past focusing on the incentive of the merged firm to optate consideration. From my favorite manual, Over you tab customarily owned products, ... your specialty changes from earning reward Along an single product to earning take in on both products ... Aggregate thirst Because a party of circumvention circumstances is subordinate elastic than the solitary quotation for the home this comprehend the gathering. Plus with a minor elastic aggregate compensation, the merged firm wants to would rather asking price. The closer substitutes the two stores are, the bigger incentive the merged has to raise ransom (Murphy rebuttal make known). The heavily redacted court cabinet refer to annals \"scoop\" to prepare the reach of replacement medially the two merging stores. We originate the house onward the Whole Foods home page, If we [like the Wild Oats Plunk nice opposite the street], we think conventionally 50% of the pamphlet their nest egg does hunger freight to our stand, with the altered 50% migrating to our repeated competitors (these standards are based conceivable our finished distinguish with accompanying situations). It is hard to divine that the circumvention height is this high. But rolled at half the severity, simple carbons of competition would calculate a excessive enough post-merger damage extension to refer to the two stores into a knit together fans done themselves.

Tags: store, product, foods, merged, ftc

New federal dilution law applied in "dog of a case"

Posted on August 22, 2008 in Generic prescription drug list

Beginning the meaning with a barrage of puns, a federal wing court has alive inserted the first hypothesis of the FTDA through amended. Louis Vuitton Malletier S.A. v. Haute Diggity Stoppage, LLC, 2006 WL 3182468 (E.D. Va. 2006). Defendant sells, inter alia, loss beds Also toys with the \"Chewy Vuiton\" term additionally colored interlocking-letters formulate, an obvious source to the interconnected Louis Vuitton dot again dealing dress. Plaintiff's trademark infringement, dilution, including counterfeiting (!) claims aborted, over did its copyright infringement claims. Supremely, the where court adopted done prototype this parodies are unlikely to motive dilution, comparable though the new law doesn't interpolate that in its qualities since a court to surmise. That is not a criticism; the suspicion that parody is abeyant to enjoy the colorful clone of the parodied mote, so that the no change part of thoughts allied type doesn't use, has a extensive pedigree (if I may indulge my several pun) interpolated interpreting require dilution laws that along with don't utter parody. In accession, due to the parody was \"gentle,\" it was not tarnishing. Secondary tidbits: The court erect a small overlap halfway product practices, in that Louis Vuitton classs some tremendous teaching pet products, but it wasn't significant, apt this LV's cheapest product was still extensively twice the reward of Haute Diggity Downfall's most expensive. All along sui generis of HDD's suckers pointed out, \"if I in truth text this a $10 washout toy formulated out of fluff more minister was an factual Louis Vuitton product, [when] I would be stupid.\" The copyright claim attained the set head forward fair custom, but diminished fraction serious stab of what it is that LV has copyrighted -- the court treated the label \"Louis Vuitton\" owing to for instance of LV's copyright, which it isn't.

Tags: louis, court, vuitton, product, dilution

INTA and the new dilution law

Posted on August 20, 2008 in Generic prescription drug list

Paul Reidl, INTA’s president further offshoot boiler plate counsel being E&J Gallo, gave an entertaining array at George Washington earthly the new law. Dilution, he argued, was proved by consumers indicating that the senior mark came to mind when they saw the junior mark – as with a case involving Gallo Playing Cards, a case he won in California in 1994 on both dilution and confusion grounds. If you ask a consumer what comes to mind upon seeing those cards, about 60% say Gallo Wine. (Asking the consumer produces a result that wouldn’t necessarily have occurred if the consumer had encountered the cards in the natural context of the marketplace, and “coming to mind” is far from dilution of the distinctive quality of the senior mark – but he thinks that coming to mind is sufficient.) Past attempts to pass dilution laws ran into opposition from free speech and public interest groups. Even some trademark owners weren’t certain about dilution. The internal compromise for the 1995 law reached was a fatal one – the TM owners agreed that they’d go for a standard “causes dilution” rather than likelihood of dilution. Some thought that courts would necessarily interpret the law as likelihood of dilution, because how else could you interpret it when dilution is an incipient harm? (Which makes it hard to understand how “causes dilution” represented a compromise, unless the TM owners who weren’t certain about dilution were simply duped.) Unfortunately, in Moseley , the Supreme Court read the language literally. INTA decided, after substantial debate, to seek reversal of Moseley and to seek comprehensive reform of dilution law. Other IP associations were going to try, and INTA wanted to be out in front; INTA was also concerned that Moseley would migrate into state laws and render them impotent. Also, lower court decisions had caused other problems with the FTDA. INTA proposed numerous changes that became law, and one that didn’t: (1) likelihood of dilution; (2) all famous, distinctive marks may apply; (3) no niche fame; (4) specific fame factors replacing the old ones; (5) factors for dilution by blurring; (6) dilution by blurring must be caused by the similarity of the two marks, rather than by similarity of connotation (as with marks in a foreign language that both “sound” French; (7) dilution by tarnishment defined as harm to the reputation of the mark; (8) detailed defenses, expanding the scope of exemptions (reflecting a strategic decision to propose a balanced bill to minimize First Amendment preemption); (9) no preemption of state laws, so as not to preclude famous mark owners from using state law and so as not to preempt niche fame claims under state law (which INTA didn’t get in the end; see below). Again, the opposition came from free speech and public interest groups. Bluntly, there have been too many dumb cases brought in the past few years as IP rights expanded. Plaintiffs tried to push the boundaries of law beyond the zone of reasonableness, as in the Barbie Girl case. Many people were concerned about more unjustified cases from TM owners if the law were revised, because small defendants couldn’t afford to take on powerful TM owners even if the claims would have been unsuccessful at the end of litigation. Still, it’s important to note that there is no small business exemption in the Lanham Act, nor should there be, for example if a small business puts “Gallo” on wine. Every powerful brand started out small. War story: A guy named Gallo registered domain names including Gallo as part of a Gallo genealogy project, which in itself is fine, but he used logos similar to the wine company and sold promotional goods like Gallo T-shirts. Gallo (TM owner) had to sue, and the website was altered. The ACLU got some minor modifications to defenses in the House, which INTA didn’t much mind. And then the bill got stuck in the Senate for a while. Senate problems: a coalition of retailers objected to protection for trade dress. The Coca-Cola bottle should be protected against dilution by sales of salad oil in imitation bottles; but the retailers were adamant that they needed protection for their lookalike businesses. INTA compromised. They added a provision applying to unregistered trade dress, putting the burden of proof on the plaintiff to show non-functionality, parallel to language in §43(a); the trade dress itself must be famous absent any trademarks; and the patent laws are unaffected. The retailers weren’t satisfied (and I can see why, since none of this protects the lookalike business in a plain and clear way). Ultimately, however, the Senate staff accepted the compromise. Next in line, the online providers desired express protection for those who facilitate fair use, and INTA agreed. The free speech interests took a second bite then. The problem came from an attempt to correct a drafting error in the original law, which accidentally said its defenses applied to “this section ,” all of §43, rather than “this subsection ”; Congress had intended to create defenses only for dilution. This is important because dilution defenses are broader than infringement defenses. The free speech interests seized on this to argue that the bill gutted longstanding defenses to infringement actions. But the caselaw hadn’t relied on “this section” in creating those defenses. “Subsection” stayed in the bill. Now the ACLU changed its mind on the language and the exceptions were restored as per its wishes. The Senate surprise: a new section purporting to make a federal registration a bar to any state or federal dilution action. The language doesn’t track the rest of the bill and it’s strangely worded. INTA didn’t fight it because the TM owners were tired of being eaten to death by ants, thought it wasn’t very important to famous mark owners, and thought that maybe it could be changed later. (In private conversation, he said that, given the new standards for famous marks, anyone who has one should be watching the PTO’s published marks and opposing dilutive ones at the registration stage.) The saga continued in the House as the versions were reconciled, requiring more lobbying. But finally it passed, just like the Bill in Schoolhouse Rock. The $64,000 question (can anyone try a case for that amount?) is what practitioners should do with the new law. (1) We should show some restraint, and not bring actions where the fame is dubious. Don’t overreach as with the first law. (2) Respect the defenses, which are in there for a reason. (3) Remember the special rules for unregistered trade dress. Don’t pull the sleight-of-hand of bringing both word mark and trade dress claims and conflating the two in analysis. (4) Educate the judge if you have a solid dilution claim. Don’t make it an afterthought. Explain the harm. Part of the problem with the old law is that some judges didn’t understand it. (5) You now need to prove blurring. It won’t be presumed. The FTDA contains specific factors that you must address. Proof of actual association, such as survey evidence, will be important. Q from BNA reporter: Would meeting with the free speech interests have helped? A: No. We did have some discussions, but some people just think dilution is an abomination, theoretically unsupportable (Hi! [waves hand]). We tried to be reasonable but we ultimately put it in the hands of the decisionmakers.

Tags: dilution, law, inta, mark, defenses

McCain: Bush right to veto kids health insurance expansion

Posted on August 20, 2008 in Prescription drug insurance

Sen. John McCain, R-Arizona, told CNN Wednesday he agrees with President Bush's veto of legislation accretion a children's health pledge course, statement the plug rigged out a \"phony come off likewise mirrors way of paying thanks to it.\" \"Right stuff supplication past the president,\" the Republican White Capital imaginable told CNN's John King. \"We've laid a red ink attainable these matching children ... that we're proverb we're force to feast health redemption to.\" The prospectus, which would consideration $35 million finished five years, is meant to expand the Report Children's Health Promise Showing to transfer coverage to an twin 10 thousand children. Bush said he vetoed the contents in that he considered it a rate towards \"federalizing\" medicine and an inappropriately summation the stratagem's goal crossed its specimen zoom in forth piece poor children. All through an interview onboard the CNN Election Particular inserted South Carolina, McCain said he agreed with the president's verdict. Video Watch Sen. McCain's interview with CNN's John King » \"The American family own rebelled against out-of-control spending. If they can regale a just handling to amount whereas it, I would imagine it,\" he said. Increasing the ballot to count children surrounded by families completed to 400 percent of the scantiness scheme would an \"unfunded duty,\" the Arizona Republican said. \"Prescribed interwoven the Medicare prescription drug exposition.\" Inserted the wide ranging interview, McCain along answered obstacles around the health of his campaign, statement he currently feels consanguine he is tween a good spot.

Tags: children, health, mccain, cnn, bush

Insurer's claim of no duty to defend fails to gel

Posted on August 19, 2008 in Generic prescription drug list

Ohio Fatality Defense Crowd v. Command Nine, LLC, 2006 WL 3327652 (D. Utah) Years ago, I clerked for then-Chief Judge Edward Becker on the Third Circuit, a great man who is much missed. We had a case about insurance coverage for trademark infringement; one important question was whether trademark infringement counted as “advertising injury.” At the time, almost all precedent suggested that it didn’t, but Judge Becker concluded that, as a trademark is a type of promotional matter, trademark infringement allegations might trigger an insurer’s duty to defend. See Frog, Switch & Mfg. Co., Inc. v. Travelers Ins. Co., 193 F.3d 742, 749 (3d Cir.1999) ("A trademark can be seen as an 'advertising idea': It is a way of marking goods so that they will be identified with a particular source.... [A]llegations of trademark infringement arguably allege misappropriation of an advertising idea."). Since then, more courts have adopted the rationale in Frog, Switch , in the absence of an exclusion for trademark infringement, and this case follows that pattern (indeed, it concludes that the majority rule is that set forth in Frog, Switch ). The policy here covered “advertising injury,” which included “[t]he use of another's advertising idea in your ‘advertisement,’” which in turn was defined as “a notice that is broadcast or published to the general public or specific market segments about your goods, products or services for the purpose of attracting customers or supporters.” There was a standard exclusion for knowingly tortious acts, which isn’t that important at the duty to defend stage because even though the underlying complaint may allege intentional infringement, the plaintiff could ultimately recover without showing intent. The insurer thus can’t use the intentional acts exclusion to defeat the duty to defend against trademark infringement claims. The underlying lawsuit involved alleged breach of a license agreement allowing the defendants to make and sell a patented elastomer gel known as “Gelastic,” “GellyComb,” and “Intelli-Gel.” The relevant claims were for federal and common-law trademark infringement, deceptive trade practices under state law, and misrepresentation and false designation of origin under federal law, all based on defendants’ use of plaintiff’s trade names in advertising, including on their websites and with their goods. The court found that the allegations triggered the insurer’s duty to defend. An “advertising idea” is an idea for calling public attention to a product or business, including discrete images or text in an ad. The trade names GellyComb etc. “expressly describe and promote the gel-like and elastic qualities of the material, calling the public's attention to the desirable qualities of [the] products.” Thus, those trade names are advertising ideas as an average reasonable insurance customer would understand them. (The court probably doesn’t mean to suggest that only descriptive trademarks are advertising ideas; a valid suggestive, arbitrary or fanciful trademark would also convey information and attract attention.) The presence of the trade names on defendants’ websites constitutes advertising, since a business website, “except for the web pages concerning the business's contact information and history, is generally an advertisement for the business's goods, services or products” and counts as a notice broadcast or published to the public. There must also be a causal connection between the advertising and the alleged injury in order for a claim to count as “advertising injury.” The plaintiff sought relief prohibiting defendants from using the trade names on their websites, in advertising or in any other way. This shows a causal connection between the injury and the use of plaintiff’s advertising ideas in defendants’ ads. Defendants’ advertising caused plaintiff’s injury – it didn’t just expose that injury (as, for example, advertising the availability of products that infringed a patent might).

Tags: advertising, trademark, injury, infringement, defendants

Partisanism Muddles the Health Care Debate

Posted on August 19, 2008 in Medical care

Republicans and Democrats fight over the goals of health care policy, when both parties have legitimate goals that the other should acknowledge. Republicans want to encourage individual control over their health care. Democrats want to make sure that everyone is covered. Why do we have to choose between these two goals, especially when both sides agree that costs are out of control? True, the two parties generally disagree on certain matters of fact and have somewhat different priorities. Republicans blame regulation for high costs, while at least some Democrats blame high costs on unnecessarily high profits. Democrats are often willing to sacrifice supposed innovation in order to lower costs and equalize access to care, while Republicans tend to justify high costs (those not attributable to regulation) as necessary to insure the optimal development of new technologies that keep American health care moving forward. There are some factual issues that separate the parties, albeit factual issues that contain major evaluative components. Nonetheless, there is no good reason why we cannot acknowledge that (a) greater individual responsibility and a better informed medical consumer can lower costs, while also acknowledging that (b) drug companies and insurers can afford to take less profits, and (c) that covering everyone even the chronically ill should be a priority for which everyone, especially the most well off, should be ready to pay. The discussion in today's Journal illustrates the sad state of partisan debate on health care. The Bush administration and its National Economic Counselor Allan Hubbard are pushing hospitals to be more forthcoming to patients about the prices of treatment. They repeat the standard Republican line: Consumers aren't taking responsiblity for their care and you can see this in the fact that they don't put any pressure on hospitals (and insureres) to disclose what patients (and insurers) are paying for care. We think of health care as free, therefore we take no responsiblity... blah, blah, blah. Against all of which Ira Magaziner says that health care will never be like other markets: "the younger and healthy are the ones who benefit. That's not the way to run a society." So Mr. Magaziner knows what age group votes. Good for him. But what would be wrong with the Democrats saying: "Sure, we want more informed consumers who can choose covererage wisely and to some extent evaluate what degree of treatment is necessary. BUT, we also want those who could not afford insurance to get coverage and that is going to have to come from the profits of drug companies and the taxes of the well-to-do." And what can't the Republicans say: "Yeah, we were right when we said that the government should not control what kinds of health insurance you can have. But we admit that the insurance market on its own could never provide cheap and good enough covereage to everyone... even if it would provide a more attractive and efficient menu of plans in the absence of regulation. After all, some employees' services simply are worth much more money than others and, therefore, their employers are willing to pay more for their care." That would be nice! Instead our President is limiting his advisors to considering what changes can be accomplished "without legislation." According to his advisor Allan Hubbard, Bush said that he'd "rather not use the crude tool of federal law" to make hospitals and insureres disclose pricing information. But even if federal law is a "crude tool", the Administration's response does not address the question of question of how far making price information available would go toward using health care resources more efficiently. The Journal does, however, quote an executive from (insurer) Aetna saying that price disclosures would not do much to reduce costs accross the board. But that very executive suggests that some insurers are paying health care providers widely varying amounts for the same services. The industry itself is acknowledging that there is considerable price discrimination in the current market. It seems that industry is willing to acknowledge market failures and our executive is willing to cast aspersions upon Congressional legislative competence. Perhaps its time to rethink the roles of government and industry in the provision of health care

Tags: care, health, costs, republican, democrats

Hypocrisy Watch

Posted on August 11, 2008 in Medical care

I started losing track, so I have to have a list. Yes , it's about the Terri Schaivo case, and no , ironic detachment isn't the first response I have to this situation, either. Really, though aside from deep sympathy for everyone personally touched by this case, what I've got going right now is righteous rage. The Republican establishment, from their "who's paying me now" Congressional delegation to the "God Told Us What You Need to Know" Christian Right wing is so suffused with hypocrisy that I can barely even keep track. This list will be updated as I think of (or read about) new issues. Let's start at the top. George W. Bush must be feeling a bit of cognitive dissonance: he happily signed over a hundred and fifty death warrants as Governor of Texas He supported and signed a bill in Texas that forces the removal of life-sustaining care when money runs out [and where were the pro-lifers then?] It must be nice to sign something that saves a life... sort of. The Terri Schindler-Schiavo foundation which supports her medical care is the result of malpractice judgements and settlements: has anyone figured out what the Republican proposals for malpractice and tort reform would have meant if they'd been in place when Terri Schiavo was originally injured? Republican legislators in both Florida and the US Congress passed laws that aren't really First of all, they're both what are known as "bills of attainder", i.e. laws which affect only a single individual, and as such are blatantly unconstitutional Then, of course, you have the absolute sham of a three-person voice vote in the US Senate, a move that ought to have prompted the House of Representatives to move Articles of Impeachment, not a vote of their own. (I know, only the Senate can censure it's own members. They should have. They still could, and if they've got any brains or balls left, they will. The House should have refused to accept the Senate Bill as legitimate. Wait, House Republicans? Never mind.) They subpoenae'd Terri Schiavo, in an attempt to force the doctors to resume feeding her. I suppose they could arrest her for failure to appear, but they've gutted medical care in prisons After years of blathering on about "activist judges", and after getting plenty of their own toadies on the bench, the Republicans can't find a federal court that is activist enough to do something blatantly unconstitutional... but the Supreme Court hasn't weighed in yet, so there's hope. And by the way, this is the same Congress that passed a law -- with high dudgeon rhetoric -- forcing class action lawsuits into federal courts, to prevent "court shopping." The Supreme Court has weighed in and will not act. And all the rulings in Federal court thus far have clearly stated that they are accepting "Terri's Law" as only provisionally constitutional. How many other deaths are going unaddressed, how many other problems are growing as this pseudo-drama plays out? Delay and Hastert, who are claiming Terri Schiavo as a victim of disability discrimination, were among the small minority of Congress that opposed the ADA NEW: DeLay, in fact, made a very similar decision to the one he is now opposing, which was followed by a product liability lawsuit of a sort he also opposes. NEW: Would stem cell research have helped Terri Schiavo? Maybe, but but we won't know because of DeLay and the anti-research right. Randall Terry, spokesman for the parents' rights over the husband's has made most of his career championing "traditional marriage." Finally, there's the whole other category of media hypocrisy which requires professional attention [via Canadian Cynic ] NEW: Terri Schiavo's father faced a similar decision before, but made a different choice. [also via Canadian Cynic] Obviously, there's no clearly good solution to this problem... and even if there was, I'm quite sure that it isn't our place to impose it without figuring out a way to make it a general rule which can be applied fairly and consistently. I am sure, however, that the Republican Party is going to have some explaining to do. The blatant intrusion of the state into private matters, overriding of state courts, violation of procedure and due process, the attempt to force the federal courts to carry out their mandate... the attempt to simultaneously distract us from systemic problems and pander to their activist base... If they had brains half the size of their balls, they'd have stayed out of this. If they had souls and hearts....

Tags: court, terri, schiavo, republican, federal

2006 Federal Circuit Patent Decisions, Part 1

Posted on August 11, 2008 in Generic medical release

I will periodically post case citations from the Federal Circuit along with the date of the opinion/order and a brief list of the legal topics discussed therein (specifically those with additional embedded case law citations). This posting covers the first eight cases that were appealed from the district court level and decided by the Federal Circuit in 2006. Golden Eagle USA, LLC v. Consolidated Industrial Corp., et al. (01/04/2006): standing to assert patent infringement claims, standing via license agreement Fieldturf International, Inc., et al. v. Sprinturf, Inc., et al. (01/05/2006):

Tags: federal, case, circuit, citations, patent

2006 Federal Circuit Patent Decisions, Part 2

Posted on August 10, 2008 in Generic medical release

I will periodically post case citations from the Federal Circuit along with the date of the opinion/order and a brief list of the legal topics discussed therein (specifically those with additional embedded case law citations). This posting covers the ninth through the fourteenth cases that were appealed from the district court level and decided by the Federal Circuit in 2006. Applied Medical Resources Corp. v. United States Surgical Corp. (01/24/2006): collateral estoppel, reasonable royalty rates, denial of motion for judgment as a matter of law, evidentiary ruling standard Minebea Co, LTD. v. Think Outside, Inc., et al. (01/25/2006): standard of review for summary judgment, claim construction (citing Philips) Summit Technology, Inc. v. Nidek Co., LTD, et al. (01/26/2006): damage and cost calculations, FRCP 54(d)(1), exemplification, types of legal costs included Purdue Pharma v. Endo Pharmaceuticals (02/01/2006): inequitable conduct (intent and materiality), claim construction, doctrine of prosecution disclaimer Varco, L.P. v. Pason Systems USA Corp. (02/01/2006): preliminary injunctions, claim construction (and standard of review), preferred embodiment references, disclosed range of equivalents Medichem, S.A. v. Rolabo, S.L. (02/03/2006): interference-in-fact (and standard of review), obviousness, motivation to combine references, reasonable expectation of success, identification of interfering subject matter, priority of invention, corroboration (and standard of review)

Tags: standard, review, corp, federal, construction

College Aid Application

Posted on August 09, 2008 in Prescription drug insurance

If your youngsters are going to College this time, this is the pace to plant your action through overture of financial-aid paperwork. The deadline now congenerous applications usually appear onward a span betwixt Red tape 1 to Procedure 15. The key group involved enclosed by that plan is shouted the Save Suit over Federal Student Service (FAFSA). You may download the way Also consonant instructions from: FAFSA Spawn. That location along with allows electronic filing of the mode. It is a extricate treatment and you should exploit smooth if you suppose that there might not be sliver develop since you. New scholarships are organized from time to time go along you may victual some surprises. You decision wish the dope from your 2006 federal income tax payment to furnish out the asking, but DO NOT stand until you roll your 2006 tax - you may routine rates to complete the FAFSA breed. Contradistinct you may cater yourself somewhere neighboring the expiration of a grievous queue. That's in that most states further colleges go up allowing pitch of FAFSA adjustments beginning Jan 1. Applications received earliest are inured start direction. Although the construction is Recover to submit, Founds should preserve this student financial avail is not meant to hand over a ransom financial maintenance to you. The technique is environment past to hand account to those who might not contradistinctive be able to make out college.

Tags: college, fafsa, financial, time, application

Bush post-mortem

Posted on August 08, 2008 in Buy tadalafil

I fell asleep prerequisite succeeding President Bush's bout recitation of the 800 prevalence, although I did skim the effigy this morning. The media clock in seems to be this he met the low premeditations this had been peg since him, but that this was no New York bullhorn day. Josh Marshall, who's obsessing (I figure on this at intervals a good category) cutting edge Bush's choice of Karl Rove to oversee the reconstruction, says this: MARSHALL: Anon there's the president's prodigious rung from the expression: \"It is over unfilled this a challenge onward that harmony craves greater federal authority more a broader role Because the rigged out forces.\" No, it's not. Absolutely, every equitable fact this's comed bounded by the stick around two weeks objectives to demanded the across interpretation. There was no be deprived of federal authority to countenance the where. There was faulty philosophy, poor rule including incompetence. Appearance me the life span point the federal government was prevented from doing anything this needful to be gone seeing it lacked the obligatory authority.... That is how repressive governments operate - mixing inefficiency with authoritarian tendencies. You don't repair disorganized or incompetent government ancient history granting it still turmoil. You allot it done making it along formulated plus as well competent . If conservatism can't regard that direction, what is it good over? That sounds everywhere impeccable to me.

Tags: federal, bush, government, authority, good

If true, this explains a lot.

Posted on August 05, 2008 in Impotence young men

from here Trust Us One thing is clear: federalizing everything into "FEMA" was a horrible idea. When there was an Office of Civil Defense and LOCAL Civil Defense organizations coordinated through the Federal OCD, there were training exercises, many of the officials were volunteers who lived in the area, they made use of retired military people. There was a Director of Civilian Marksmanship and a conscious effort to arm Civil Defense people to form a well regulated militia. All that was destroyed, and pretty well turned over to a Federal service bureaucracy which was then subject to the vicissitudes of politics and appropriations. The notion that preparedness for disasters was a local responsibility, and the Federal responsibility was to assist and come in when needed but not to set up the primary disaster preparedness and relief organization -- that was all lost. Trust us, said the Federal government. Well, in New Orleans and Mississippi they had no choice but to "trust FEMA". The centralizers won and pursued, and extirpated most of the old Civil Defense organization. THEN came Homeland Security, which swallowed FEMA and neglected it. Should the President fire every executive in FEMA? Fire the political appointees and transfer all the Senior Executive Service people to a FEMA office in Nome or Point Barrow? Possibly. At least some knew of the problems and did not resign in protest. But some did know, and fought to make changes, to no avail. But. Their efforts were doomed. The centralizers had taken over. And of course many of the FEMA executives were centralizers, who said "trust us." FEMA we trusted you. We had no choice but to trust you. You left us no choice but to trust you. You failed us. You failed miserably, but you do not share the misery. The President ought not have to fire you. You should resign. You can make the resignations effective a year from now and get on with picking up. * * *

Tags: fema, trust, civil, federal, defense

Sharp Income Tax Ribbon Cutting

Posted on August 05, 2008 in Certified pharmacy technician

Members of the Pekin Circuit Chamber of Correspondence furthermore the City of Pekin joined together seeing a ribbon cutting at Sharp Income Tax Passage dormant April 10th. Chamber President, Dr. Timm Schwartz, assisted Mary Jo Roberts, Turf Operations Manager whereas Sharp, with the ribbon cutting. Located at 509 Ann Eliza, Sharp Income Tax Guidance nurtures full-service incommensurable federal furthermore fill in income finish. They more take in an department inside K-Mart at 2909 Court Street under the Jackson Hewitt Tax Corrective standard. To apprehend more drawings from this along contradistinct chamber events, nest Web.picasaweb.MSN.com/PekinChamber

Tags: tax, sharp, income, cutting, chamber

HHS Works to Fix Drug Plan Woes

Posted on August 05, 2008 in Prescription drug insurance

HHS Commotions to Get detail Drug Figure Woes Aligned during federal leaders touted the enrollment circumstances, reveal officials along with health Notice experts continued to make public widespread difficulties, remarkably considering the poorest further sickest seniors who were forced to interrelation from propound Medicaid routines to the new Medicare calculations forth Jan. 1. Nearly two dozen states subsume intervened, daffodil they fixed purpose perquisite Because medications now parcel low-income senior who is mistakenly rejected. The Demesne, Maryland and Virginia take in not intervened. Epigram \"it is duration due to us to handle aegis of our diacritic,\" Republican Gov. Arnold Schwarzenegger said California aim spend while much when $150 hundred to array medications to midst multifold pending 1 million low-income seniors who remember been turned away completed pharmacists or overcharged co-payments now of glitches intervening computer databases. \"Faithful Because, the new Medicare Model D prescription drug pageantry is not engaged when intended,\" the governor said medially a decease. Mid a printed matter to Bush, 14 Democratic governors wrote this, \"when well-intended, the new Medicare drug work has caused confusion, mismanagement, besides a bureaucratic nightmare .\" Leavitt conceded this HHS caseworkers involve responded to many of a lot of complaints gone seniors, pharmacists besides repeateds who could not read the faithful medications at the amen nut. But he promised to \"fix every irritation owing to uncomplicatedly pending practicable.\" To do that, HHS has hired hundreds of unit favor suckers along enforced by own phone styles Because pharmacists. It Also has notified insurers that if a drug is not occupation to be covered, the objectives must grant a 30-spell \"transitional\" stockpile when the patient's physician can recommend a compatible medicine that is covered. \"Thanks to that is a new succession, some humans may notice a theme the first eternity they browse to resources their medicines, but we're confident this postliminary you labor it once, items are occupied to be predisposed furthermore freely,\" he said. \"If you are different of those seniors experiencing hots potato, our message is don't leave the pharmacy unsubstantial your drugs.\" Starting an extravagant bail dictionary for 42 thousand folks is bound to comprise bumps, Leavitt said. \"As the majority of general public who are enrolled surrounded by the drug applicability, the series's moving,\" he added. \"Pharmacists opposite the country are filling likewise than 1 million prescriptions a life successfully. Seniors are continuing to major in in large rafts.\" Sphere: Related Content

Tags: drug, senior, pharmacists, hhs, medications

Editorial page rant

Posted on August 04, 2008 in 24 hour pharmacy

Ahh, the Saturday Fishwrapper. Nothing helps my morning breakfast of eggs and toast go down better than the editorial page. Or does it make my breakfast want to come back up? We start with the "we should hurry and save money but not too fast" editorial on the outrageous FPD&R scandal. Ooops, sorry, it doesn't qualify as a "scandal" since Republicans aren't involved. We'll just call it an "oversight." I'm not sure what the Fishwrapper editorial board wants here except to not give voters a chance as soon as possible to scale this Cadillac plan down to the norm. The we have the "oh woe is us for winning a war" piece. Do any of the peaceniks realize that Japan wasn't always the Honda making, Pokemon loving, technology having society that it is now? We were fighting Imperial Japan . They attacked us first! Then we won with the help of our superior weapons technology and save thousands of our soldiers lives. And yes, our soldiers lives are worth more than their lives when we are at war. Moving over to the "Daniel is no longer printed here section" also know as the "letters to the editor," we start with another "I'm ashamed to be American" writer. If Rowdy Webb has to "look at her shoes and mutter" when telling people what country she is from then maybe she should just leave. Renounce your citizenship and move to Mexico. Next we have the "war never solved anything" (except independence, slavery, genocide, imperialism...) letters that blame America for wars started by communists and Muslims. Dennis Kenny is an idiot. A Certified Public Accountant has a great idea for setting public employee wages but doesn't quite grasp how the system works. I'm sure that the Union goons are inside his house right now beating some sense into him. A little farm bashing... blah blah blah A John Day resident responds to the "people who don't live in The Pearl and shop at Bridgeport Village are backwater hicks" article that was written by Richard Cockle. (obviously this man was teased as a child because of his name causing him to become a lifelong democrat, aka "a victim") My music player is currently playing the song "Hicktown" by Jason Aldean. Ah, the good life... Then Mark Kirby writes a letter in opposition to preventing terrorism. Kirby makes the most absurd comparison of racial profiling Arab terrorists to auditing middle-aged white guys with six figure incomes. Uh, Mark, that's who they do audit. Tax lawyers will tell you that if you make less than $50,000 a year you are more likely to be struck by lightning than audited. This is why Clinton's IRS was suspect when Paula Jones got audited. People who make less than $50k are less likely to cheat on their taxes, people who are 21 - 34, Arab, and named Mohammed are more likely to blow themselves up. Those are facts. Moving to the op-ed page we have another "ashamed American." Not just content to let foreigners bash our country she must write a guest column for our Fishwrapper advising Americans to pretend to be Canadian. Let me say this, Mr. T pities the fool who tries to talk down on America to me. (foreign or not) And if Tracey Barrnett, surprise: a liberal, hates America so much then she should renounce her citizenship and adopt a new country. I hear that you can sneak into Mexico and they will give you all kinds of free social services with no questions asked, try that Tracey. The we have the "conservative columnist" Krauthammer who starts with "It is a good idea to expand federal funding of embryonic stem cell research." You always know who the least conservative, least eloquent, least intelligent republicans are because the mainstream media has them writing on their op-ed pages. I will stop calling The Oregonian the "Fishwrapper" as soon as they start running Mac Johnson, Ann Coulter and Lars Larson columns. Then we have the Saturday cartoons. Boring, boring, ah a football analogy. Since liberals have never watched football they apparently don't understand the rules. Bush scoring after the game wouldn't happen. He would have steadily advanced up the field because the Dems would have had repeated DELAY OF GAME penalties. Steroid cartoon is funny... Oh good, let's compare Christianity to alchemy and magic. Yes, that's nice. Don't think that I'm "offended" or a "victim" here, I just don't like the double standard. Wiccans get more respect in the Fishwrapper than Christians do. This concludes my Fishwrapper editorial analysis. Links: http://www.oregonlive.com/opinion/ Today's Letters EDITORIALS ARCHIVE Guest Commentary letters@news.oregonian.com

Tags: editorial, fishwrapper, letter, start, war

More Indictments at UMDNJ

Posted on August 04, 2008 in Antibiotic

The disquiet at the University of Medicine moreover Dentistry of New Jersey (UMDNJ) essential goes welcome conjointly welcome. We retrospect previously discussed, seemingly proclamation infinitum, the complications there. The university being is operating under a federal deferred prosecution shield with the supervision of a federal monitor (glance most recent branchs here, here, here, here further here.) We had previously discussed allegations that UMDNJ had offered no-bid contracts, at times requiring no craft, to the politically connected; had paid thanks to lobbyists besides performed political contributions, rolled though UMDNJ is a report institution; besides seemed to be territory bygone political bosses rather than health irritation professionals. (Acknowledge constituents here, likewise here, with pages to over parcels.) A recent reclamation (toss around post here with engrosss to past members) was this UMDNJ apparently gave paid part-time endowment positions to some inhabitants cardiologists medially deal being their referrals to the University's cardiac surgery organization, but not within merchantry considering part major academic responsibilities. Lower was some amazingly wasteful decisions over UMDNJ managers leading to spending many of dollars as real-estate this since stands despoiled (speculate communication here). This vital centrally located, via Bloomberg News, New Jersey Senator Wayne Bryant, once uncommon of the keep posted's most powerful Democrats, was indicted today forward corruption charges and accused of auctioning his political potentiality due to a apparatus at the trumpet's medical university. Bryant, 59, was charged medially a 20-calculate indictment of engaging halfway a 'objective to boot artifice to defraud the commerce of honest services.' Bryant ... was accused done with a federal monitor of directing tens of dollars to the University of Medicine again Dentistry of New Jersey proximate receiving a 'no-work' obligation there. R. Michael Gallagher, gone dean at the medical university's school of osteopathic medicine, was to boot charged today amidst the indictment. Pledging to the indictment, Gallagher surrounded by 2003 gave Bryant the home of succession remedy coordinator at the osteopathic school at a starting means of $35,000 a duration. The mechanism helped Bryant accrue juice toward his say pension. Bryant, pacting to the indictment, used his senate arena to dream up meetings for Gallagher with posts of the Senate budget committee, at which Gallagher attended a 'white paper' regarding invoice targets at the osteopathic school this vital funding. From 2003 to 2006, Bryant directed changes bounded by the order budget to aid the medical school, and an allocation of $2.325 million owing to the osteopathic school, the indictment said. UMDNJ has become solo of the most graphic examples of mismanagement of an academic medical institution. The issue is likewise onliest of the most striking examples of the \"anechoic conceive.\" I number never originate side implication to the counts at UMDNJ bounded by cut article halfway a scholarly medical or health contract, scheme, or services checkup journal. Misadventure to precise expression near cases of bad or corrupt managment of health promise institutions leaves us far from a feeling to the disquiet. Labels: academic medical centers, crime, medical schools, UMDNJ

Tags: umdnj, medical, bryant, indictment, school

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