Q:        Why do you support the Keystone XL Pipeline?

A:        The crude oil pipeline from Canada to the U.S. Gulf Coast called the Keystone XL pipeline would provide 830,000 barrels of crude oil a day and help to counteract insufficient domestic oil supplies and reduce America's dependence on less reliable foreign sources.  The way I see it, the energy and economic development benefits of this pipeline are too important to delay any longer.  Keystone XL contributes to a necessary, three-pronged approach for America's energy policy.  We need to develop traditional oil and gas resources in America.  We need development, production and use of alternative renewable fuels.  We need to conserve energy.  What's needed now is an increased supply of oil.  The Keystone XL pipeline would help maintain adequate crude oil supplies for U.S. refineries and let us decrease dependence on foreign crude oil supplies from the Persian Gulf and Venezuela.

Q:        What have you done to advance this pipeline?

A:        In March, I voted for an amendment offered by Senator John Hoeven to the Senate budget resolution.  The amendment expressed support for the approval and construction of the pipeline and passed with a bipartisan vote of 62 to 37.  It was mostly a symbolic vote because the budget resolution does not become law and isn't binding.  But the vote demonstrates strong support within the Senate for approval of the Keystone XL pipeline.

Q:        How has President Obama delayed the Keystone XL?

A:        Authority for siting oil pipelines generally lies with the states, but the construction of facilities at the U.S. border for exporting or importing petroleum or other fuels requires a Presidential Permit issued by the Department of State.  In this case, consideration has been drawn out, most likely to try to stop the pipeline from being built.  In 2008, TransCanada applied for a presidential permit from the State Department to construct and operate the pipeline.  In January 2012, the State Department recommended that the Presidential permit be denied.  The same day, the President stated his determination that the Keystone XL pipeline project would not serve the national interest.  This year, in January, the Governor of Nebraska approved a proposed reroute of the Keystone XL pipeline to avoid the Sand Hills due to the area's unique soil properties.  So, TransCanada reapplied to the State Department in May 2012, along the new route through Nebraska.  This year, in March, the State Department released a draft Supplemental Environmental Impact Statement (SEIS) on the new Presidential permit application.  The report basically found that the pipeline would not accelerate greenhouse gas emissions or significantly harm the environment along its route.  A final decision from the State Department and the Obama Administration on whether to grant the Presidential permit is expected after expiration of the comment period for the draft SEIS at the end of this month.

Thursday, April 18, 2013

Grassley, Cassidy Seek Answers from Georgia Hospital on Discount Drug Program

WASHINGTON - Sen. Chuck Grassley of Iowa and Rep. Bill Cassidy of Louisiana today asked a Georgia hospital for details of its use of a federal discount prescription drug program, known as 340B.  They wrote to the Columbus Regional Healthcare System after a hospital executive said during a public interview that the hospital does not receive a "windfall of profits" from participating in the program and puts the proceeds into the hospital.

"When I looked at three North Carolina hospitals' use of this program, the numbers showed the hospitals were reaping sizeable 340B discounts on drugs and then upselling them to fully insured patients to maximize their spread," Grassley said.  "If 'non-profit' hospitals are essentially profiting from the 340B program without passing those savings to their patients, then the 340B program is not functioning as intended.  Our inquiry into the Georgia hospital will help us continue to examine hospitals' use of the 340B program."

Cassidy said, "As a physician who has spent 20 years caring for the uninsured, I recognize the value and importance of the 340B drug discount program. Given this importance, we must be sure that its good work is not threatened by those who misuse. Our common goal must be better care for those who are less fortunate."

The 340B program requires drug manufacturers to give deep discounts on certain outpatient drugs to hospitals that serve large numbers of uninsured and under-insured patients.  Grassley and Cassidy are among the members of Congress who are concerned that hospitals increasingly appear to be making sizeable profits from the program at the expense of Medicare, Medicaid and private health insurance.  The federal Health Resources and Services Administration (HRSA) conducted poor oversight of the program for a long period but is beginning to exert more scrutiny under pressure from Congress.

The Grassley-Cassidy letter to Columbus Regional Healthcare System is available here.

A Grassley letter to HRSA earlier this month citing the three N.C. hospitals is available here.

There are at least two aspects of a misdiagnosis that can cause patients harm, says Dr. Steven Hotze.

"First, it means you are not being treated for what's actually causing illness; second, a misdiagnosis can lead to inappropriate treatments and medicines with side effects that can cause you harm," says Dr. Hotze, founder of the Hotze Health & Wellness Center, (www.hotzehwc.com), and author of "Hormones, Health, and Happiness."

"But there's a quality of life issue that's important as well. Many of my patients are women at or near middle age, and they often suffer from a multitude of symptoms including fatigue, low body temperature, brain fog, weight gain, loss of libido, hair loss and depression. Too often, they're told by their physician that 'nothing is wrong.' "

Women are more apt than men to pay attention to their bodies - and they're right for doing so, he says. A women's body includes a much more complex hormonal balancing act, with dramatic swings involved in the menstrual cycle.

Often, the women who come to him with that litany of symptoms do have a medical issue: hypothyroidism. Hotze calls it a "hidden epidemic" because it is so frequently un- or misdiagnosed.

The condition means the thyroid is not producing enough thyroid hormone, which affects hormone regulation. Hypothyroidism affects women seven times more frequently than men, Dr. Hotze says.

He reviews three ways in which a missed hypothyroidism diagnosis can affect a patient's life:

•  Living with unrelieved symptoms. When a person experiences the constellation of symptoms associated with hypothyroidism and is told by multiple doctors that it's  "just a normal part of aging," the future can seem bleak. Many physicians will order blood work and tell the patient she's fine because the results are "normal." However, 95 percent of people tested for hypothyroidism fall within a range considered normal. Also, keep in mind that two different labs testing identical blood samples can provide different results.

•  Prescribed unnecessary medication with undesirable side effects. Wellbutrin, Lexapro, Paxil, Effexor, Zoloft and Fluoxetine - these are just some of the antidepressants that one in four women take, according to a recent report from MedCo. One in 10 Americans, or 30 million people, are taking pills to fight depression, and 30 percent of the women aged 35 to 60 who are taking them are doing so because of misdiagnosed hypothyroidism. Antidepressants can have numerous side effects, from nausea and irritability to sexual dysfunction and homicidal or suicidal thoughts.

•  Uncomfortable, unhealthy physical changes. Untreated hypothyroidism  causes weight gain, which can further affect a person's emotional health. The weight gain comes with all the risks any excessive weight brings, from diabetes to heart disease.

"It has long been a cliché in our society that 'pills are not often the answer for our mental and physical wellbeing,' yet pharmaceutical companies continue to dominate treatment in our country," Dr. Hotze says. "Hormone replacement therapy, as long as bioidentical hormones are used, has been proven to be a healthy and effective treatment for women suffering hypothyroidism."

The distinction between synthetic and bioidentical hormones is important, he says; the latter have the same molecular structure as the hormones that are found naturally in the body, which means bioidentical hormone treatments cannot hurt patients. Counterfeit hormones - those that do not perfectly match the molecular structure of hormones in one's body - can be dangerous, he says.

"Hypothyroidism and aging share an important common denominator - diminished or faulty hormone production -- so it's easy to see how doctors can miss a diagnosis," Hotze says. "But that makes it all the more important for physicians to listen to their patients, and that takes time. Hormone replacement therapy using bioidentical hormones help patients who are suffering extreme symptoms in both cases."

About Steven F. Hotze, MD

Dr. Steven Hotze is the founder and CEO of the Hotze Health & Wellness Center in Houston, Texas. He's a member of the American Academy of Otolaryngic Allergy and the Association of American Physicians and Surgeons, and is the former president of the Pan American Allergy Society. He earned his medical degree from the University of Texas. Dr. Hotze and his wife of 44 years have eight children and 16 grandchildren.

Enjoy an intimate evening of literature and music during the second Brucemore Arts Share on May 14 at 7:00 p.m. The event continues the tradition started by Brucemore's second family, the Douglases, who frequently entertained guests and celebrated local artists in the Mansion's Great Hall. Graduate students from the Iowa Writers' Workshop, Andres Carlstein and Anna Morrison, will read original fiction and poetry. Doctoral candidates at the University of Iowa, Akilah Bryant and Jessica Altfillisch, will follow with a flute and viola duo.  A light reception will be held after the hour-long program. Doors open at 6:30 p.m. Tickets purchased in advance are $7 per adult and $5 per Brucemore member or student.  All tickets at the door (if available) are $10. Space is limited; purchase tickets by visiting www.brucemore.org or calling (319) 362-7375. This performance is made possible by a Better Futures for Iowans grant through The University of Iowa's Office of the Provost.

Andrés Carlstein is an Adjunct Assistant Professor of Creative Writing at the University of Iowa and the author of Odyssey to Ushuaia, a Motorcycling Adventure from New York to Tierra del Fuego. He is a 2012 MacDowell Colony Fellow and Yaddo Residency Fellow, and his short stories have been finalists for the 2013 Doug Fir Fiction Prize and the 2013 Gertrude Stein Fiction Award. Carlstein holds a Master of Fine Arts in Fiction from the Iowa Writers' Workshop, where he was an Arts Fellow. He lives in Iowa City and is working on a novel.

Julia Anna Morrison is a second-year Master of Fine Arts candidate at the Iowa Writers' Workshop from Atlanta, Georgia.  She teaches creative writing to undergraduates at the University of Iowa.  Julia's work has recently appeared in Redivider and Gulf Coast.

A native of Birmingham, Alabama, Akilah Bryant is a flute performer, teacher, and clinician currently living in Iowa City. In 2012, Akilah received the prestigious Dean's Graduate Research Fellowship from the University of Iowa, where she is currently pursuing a Doctor of Musical Arts degree in Performance and Pedagogy. She also holds degrees from the University of Michigan and the University of Alabama. In addition to extensive performing throughout Alabama and the Midwest, Akilah has been the recipient of many awards including those from the Nelson Hauenstein Memorial Fellowship, the National Federation of Music Clubs, the Josie Etta Daley Memorial Fund, Tuesday Musicale, and the Birmingham Music Clubs Guild.

Violist Jessica Altfillisch is a doctoral candidate at the University of Iowa and Director of the CR Suzuki Academy, LLC, a violin and viola school in Cedar Rapids. Jessica has served as resident violist in the Aiyanna Piano Quartet, the University of Iowa Center for New Music Ensemble, and is currently violist of the Lierre Duo. As an undergraduate at the University of Northern Iowa, Jessica performed with the Northern Iowa Chamber Orchestra in Moscow and St. Petersburg. She finished her undergraduate studies at the University of Kansas, and has since appeared as a soloist and chamber musician in throughout the Midwest. Jessica has also played professionally as a member of the Des Moines, Dubuque, Waterloo/Cedar Falls, and Cedar Rapids Symphony Orchestras.

About Arts Share

Arts Share continues The University of Iowa's long tradition of sharing creative resources from the Division of Performing Arts (music, dance, theater), the School of Art and Art History, and the Writers' Workshop. Arts Share aims to strengthen the arts in underserved areas, reaching out to provide access to life-enriching arts experiences throughout Iowa. Through this program, artists have traveled as far as Council Bluffs, Sioux City, Buffalo Center, Keokuk, and Lamoni to present interactive performances, workshops, readings, residencies, master classes, and more.

About Brucemore

Experience Brucemore, an unparalleled blend of tradition and culture, located at 2160 Linden Drive SE, Cedar Rapids, Iowa. At the heart of the historic 26-acre estate stands a nineteenth-century mansion filled with the stories of three Cedar Rapids families.  Concerts, theater, programs, and tours enliven the site and celebrate the heritage of a community.  For more information, call (319) 362-7375 or visit www.brucemore.org.