FDA Approves Use

Of Artificial Heart

Federal regulators approved the use of an artificial heart, marking the first time a mechanical device has been made widely available to replace a failing human organ.

In contrast with early hopes of permanently replacing an ailing heart with a man-made pump, the new device substitutes for the bottom half of the heart and can be used only to sustain critically ill patients in the hospital until they can get a heart transplant.

But the CardioWest Total Artificial Heart offers hope to the dozens of Americans who would otherwise die each year without it, and its approval by the Food and Drug Administration was hailed as an important, long-sought moment in the troubled quest to replace the human heart with a machine.

Critics, however, questioned the value of the $100,000 device, saying it will only add to the nation's already bloated health care bill without increasing the number of heart patients who survive.

About 4,000 Americans need heart transplants every year, but only about 2,200 donor hearts are available. Small implantable pumps can keep some patients alive while they await transplants by supplementing their weakened organs. But some patients -- the FDA estimates about 100; SynCardia Systems Inc., which developed the new device, estimates several hundred -- need something more because both sides of their hearts are failing.

-- Rob Stein

Medicare Costs Pare

Social Security Gain

Social Security payments to more than 47 million retired and disabled workers will rise 2.7 percent in January to help recipients keep up with inflation, lifting the average monthly benefit by $25, to $955, the government reported.

But for senior citizens enrolled in Medicare, nearly half that increase will be consumed by rising health insurance premiums. The premiums, which are deducted from Social Security checks, will rise 17.5 percent next year, an average $11.60 per month.

More than 10 million more recipients of other federal benefits will also get a cost-of-living adjustment in their monthly checks based on changes in the Labor Department's consumer price index over the past year.

Payments will grow by 2.7 percent beginning on Dec. 30 for beneficiaries of Supplemental Security Income, which is paid to low-income people. Recipients of military and Foreign Service annuities and most federal civilian pensions will also get the 2.7 percent increase, beginning in January.

Federal retirees covered by the Civil Service Retirement System will get the full 2.7 percent boost to their pension benefits in January. Workers who retired under the newer Federal Employees Retirement System and who are 62 or older will get a 2 percent increase, officials said.

The increases are based on changes to the consumer price index for urban wage earners and clerical workers over the year that ended Sept. 30.

-- Nell Henderson

Obesity Is Partly Blamed

For Growing Health Care Costs

More than a quarter of the phenomenal growth in health care spending over the past 15 years is attributable to obesity, Emory University researchers reported.

With 60 percent of the U.S. population deemed overweight or obese, study author Kenneth Thorpe said the only way to control soaring medical costs is to begin targeting prevention efforts and treatment on the most costly weight-related illnesses, such as diabetes, high cholesterol and heart disease.

From 1987 to 2001, medical bills for obese people constituted 27 percent of the growth in overall health care spending, he found. The jump in spending was attributable to both a rise in the number of obese Americans and higher costs for treating those patients.

Treating obese patients was 37 percent more expensive than medical care for normal-weight people, Thorpe and colleagues wrote in the journal Health Affairs.

-- Ceci Connolly

Texas Redistricting

To Be Reexamined

The Supreme Court kept alive a Democratic constitutional challenge to a Republican redistricting plan in Texas, ordering a three-judge district court to reexamine its January decision upholding the plan.

The court's action will not affect the 2004 elections in Texas. Voting for the state's 32 seats in the House of Representatives will go forward under the contested plan, which was approved in 2003.

But the Supreme Court told the district court to take account of the justices' split decision in April in a similar case in Pennsylvania. In that case, the court upheld a pro-Republican plan but refused to rule out the possibility that extreme partisan gerrymandering could violate the Constitution.

This means that Texas's lines, which were redrawn with the aid of House Majority Leader Tom DeLay (R-Tex.) to boost the GOP's share of a congressional delegation that is now evenly divided, could still be struck down and redrawn at some later date. Republican hopes for control of the House hinge on the new Texas lines.

-- Charles Lane

DEA Withdraws Its Support

Of Guidelines on Painkillers

The Drug Enforcement Administration has reversed its support for a set of negotiated guidelines designed to end a controversy over the arrests of hundreds of pain specialists who prescribed powerful narcotics for their patients.

The agency took the document off its Web site earlier this month, less than two months after announcing it with great fanfare.

The DEA wrote on its Web site that the document "contained misstatements" and "was not approved as an official statement of the agency." The agency declined to give any more specifics, saying that it hoped to issue a statement "in one or two weeks."

Doctors who had worked on crafting the "consensus" document -- written over the past year by DEA officials and prominent pain management specialists -- criticized the unannounced decision to disavow it. They said they were given no explanation or told whether the agency had changed its position on the contentious question of when and how doctors can prescribe the popular painkillers without risking prosecution.

Advocates for aggressive pain management said DEA's decision appears to have been triggered when defense lawyers tried to introduce it in the upcoming drug-trafficking trial of William Hurwitz, a McLean, Va., physician.

DEA spokesman Ed Childress said the agency intends to re-work the guidelines and publish them again. He said he could not comment on whether the decision to remove them had anything to do with any legal case.

-- Marc Kaufman

Prime Minister Is Fired

And Arrested in Burma

Burma's ruling military junta fired the country's prime minister, Gen. Khin Nyunt, who was seen by Southeast Asian leaders as the best hope for returning the country to democracy.

Khin Nyunt, who also headed Burma's powerful military intelligence organization, was placed under house arrest and charged with corruption, according to Thai officials, regional analysts and Burmese exiles with contacts inside the country.

He was replaced by Army Lt. Gen. Soe Win, considered to be part of a younger generation of hard-liners and who was reportedly involved in a May 2003 attack on supporters of the opposition National League for Democracy and its leader, Aung San Suu Kyi. Scores of people are said to have been killed in that attack.

Richard Boucher, the U.S. State Department spokesman, said: "The events that we're watching don't point in the direction of allowing freedom . . . of political and human rights."

Political leaders in Southeast Asia had hoped that Khin Nyunt would help build a policy of engagement with the reclusive government, a policy they favored over the strong economic sanctions imposed by the United States.

-- Ellen Nakashima