June 23, 2009
Host: Ted Simons
- The Arizona Supreme Court decides not to force lawmakers to send Governor Jan Brewer the budget bills they have already passed as long as they do so by June 30th. ASU Law Professor, Paul Bender talks about the decision.
See the Supreme Court oral arguments
| Keywords: governor
, supreme court
Ted Simons: GOOD EVENING AND WELCOME TO "HORIZON." I'M TED SIMONS. THE ARIZONA SUPREME COURT TODAY DECIDES AGAINST GOVERNOR BREWER'S REQUEST TO FORCE THE LEGISLATURE TO SEND HER THE BUDGET BILLS THEY'VE ALREADY PASSED. THE COURT ACCEPTED JURISDICTION IN THE CASE AND MADE ITS DECISION AFTER BOTH SIDES PRESENTED ORAL ARGUMENTS.
Justice Michael D. Ryan: What injury has the governor suffered at this point given the legislature has not passed a budget bill until June 30th?
Joseph Kanefield: Your honor, the governor has suffered a particular injury as explained in the petition. There for the constitution clearly says when a bill is finally passed it shall be presented to the governor. By not presenting, she is not able to perform the constitutional duties required under the constitution.
David Cantelme: I think it's been recognized or at least discussed if she wants to sign the bills, why are we here? We will adjourn and give her the bills and get them signed today. That's not a problem. What she wants to do is veto them because she thinks it gives her a political advantage in the negotiations that are taking place.
Justice W. Scott Bales: Isn't it also true that the reason the legislative leaders don't want to give her the bills because they think it's political leverage in the budget negotiations?
David Cantelme: Absolutely, your honor, it's a tool they are given and they want to exercise it.
Ted Simons: HERE NOW TO TALK ABOUT THE CASE AND TODAY'S ORAL ARGUMENTS IS A.S.U.'S LAW PROFESSOR, PAUL BENDER. Always a pleasure, thanks for joining us. Are you surprised by what happened today?
Paul Bender: Yes, somewhat. Although I thought they wouldn't take jurisdiction. They took jurisdiction and didn't give the governor the relief she wanted. They held that what the legislature is doing is unconstitutional. They have a constitutional obligation to send the bills to the governor when they are finished with them and finally passed the language. She was right on the law. They said it was a case of first impression and there are five days left and they say they are doing it on the 30th. What's the difference really? We get back then the second because I was surprised by that. So we're not giving her relief here. I think they are saying in the future the constitutional rule is you have to send it to the governor when you have passed it. I guess they are threatening to enforce that constitutionally. That surprised me that they would get in the middle of that political dispute.
Ted Simons: You mentioned first impression. That phrase means we haven't seen it before and if we see it again, we will do it different?
Paul Bender: Yeah. Both sides in good faith could believe they were right and the governor could believe they were right and the legislature has been acting unconstitutionally. They said to the governor, you're right. You don't get relief. It's only five days and they were in good faith so we're not going to make them do it. That seemed to me to be a non sequitur. She was asking for them for five days early and now she has to wait for the 30th. The relief she wanted was to have a few days in order to veto them and negotiate them after that. They denied her that relief and she's not going to get them. She doesn't have the right before the 30th even though they said not to give her the bills now.
Ted Simons: The court agreed with the governor as you mentioned save for the unique circumstances. The unique circumstances were?
Paul Bender: It was a case of first impression. That's the main uniqueness of it. It's never been a case like this before. It's unique. They have never had a case like this before and each side was acting in good faith.
Ted Simons: The governor wanted bills by 5:00 today. She's not going to get them. The governor also was saying, you know, this was usurping her power in the executive branch. Did the court agree with that?
Paul Bender: They didn't say they usurped her power. I think they are right the constitution says when you pass a bill, you're supposed to give it to the governor. You can take time to complete the administrative duties and sign it and package and collect it and send it over. That's a short amount of time and once you pass it, you have to send it to the governor. In this case you didn't do that so you operated unconstitutionally but we're not going to give her the relief she wants because you acted in good faith and it's only five days. Why should we get involved? That's what surprised me. If she has a right to them, she has a reason to want them now rather than five days from now. Why are they denying her the relief that she's entitled to?
Ted Simons: If it's five days okay, so what it is 10 days? 7 days? What is it?
Paul Bender: In the future if this happens and the governor comes to them, they will give her or him relief. So in the future they are saying hey, when the bill is passed, you got to send it to the governor. If it happens in the future and they don't and a governor in the future I think would get an injunction and get the bills.
Ted Simons: Technically this is a political not a legal issue. This as a political issue they 5 didn't necessarily buy it.
Paul Bender: They didn't buy it at all and said it was a legal issue and resolved it and didn't give the relief that they would have given normally and resolve the legal issue in her favor. It was a strange opinion.
Ted Simons: When finally passed, they had concerns about the particular phrase. What do you think the phrase means?
Paul Bender: In most cases it's clear. Each house passed it. It's finally passed. Occasionally, apparently, they have reopened the bill after they finally passed it. It's hard to know when something has finally passed and the legislative said, no, we still want to work on it. This is in the opinion, now that they have laid out the rule, they have made it clear that the legislature can get away and manipulate it by not passing it. They can say we are passing a straw vote and get to it when we want to or they can say we will postpone the real vote and take a vote now and do the real vote later. They can leave up to the vote and know they have it and not take the final vote and probably other ways they can do it that I'm not thinking of now. It's an interesting thing. It's a rule but it's not a rule that they are really going to be able to enforce because they recognize in the opinion that the legislature it can if it wants to delay sending something to the governor just by not doing the formal things it needs to do to pass the legislation.
Ted Simons: If you were on the bench and you were there and passed this, would you say no jurisdiction or the governor's argument has enough merit to compel the legislature to get the bills over to her?
Paul Bender: You asked what I would have done if I was on the court?
Ted Simons: Yeah.
Paul Bender: I think it's a political question and the court should not get involved. Ultimately they have to decide if it's a legal question when the thing is finally passed. It might seem easy to do. I don't think it's all that easy. The legislature can do all the manipulating to pass it and not finally pass it and I'm not sure that the a court wants to get involved in that if the legislature passed it. I think it's a question of the timing of the legislative process and up to the legislature and the governor. They could wait to pass it and wait until the 30th to do that. Since they can do that, what's the sense of telling them, hey, when you pass it, you have to send it. They will wait to pass it and find some way to do it. It's a strange decision. I think on the surface it looks right but the governor must be kind of confused because she won but she lost.
Ted Simons: Indeed. Thank you for joining us.
Paul Bender: Nice to be here.
Cancer Clinical Trials
- The non-profit charity, Stand Up to Cancer, has awarded a Scottsdale-based pancreatic cancer research project $18 million to find a way to fight the disease. Scottsdale Healthcare is the primary site for clinical trials in this research project that’s a partnership between Scottsdale Healthcare and the Translational Genomics Research Institute. Our studio guest is Dr. Mark Slater, Scottsdale Healthcare’s Vice President for Research.
Translational Genomics Research Institute
Scottsdale Healthcare TGen Clinical Research Services
- Dr. Mark Slater - Vice President for Research,Scottsdale Healthcare
Ted Simons: AN ARIZONA-BASED RESEARCH TEAM IS GETTING AN $18 MILLION GRANT TO FIGHT PANCREATIC CANCER. THE MONEY COMES FROM "STAND UP TO CANCER", A CHARITY SPONSORED BY THE ENTERTAINMENT INDUSTRY. LATE LAST MONTH, IT AWARDED NEARLY $74 MILLION TO FIVE CANCER RESEARCH DREAM TEAMS ACROSS THE COUNTRY. ONE OF THOSE TEAMS IS A PARTNERSHIP BETWEEN PHOENIX-BASED T-GEN AND THE UNIVERSITY OF PENNSYLVANIA. AS DAVID MAJURE REPORTS, THE TEAM WILL DO ITS RESEARCH AT T-GEN CLINICAL RESEARCH SERVICES AT SCOTTSDALE HEALTHCARE.
Joyce Ingold, RN: How are you feeling today?
Patrick Ryan: Well, pretty good considering I've just come off another cycle of chemotherapy.
David Majure: Patrick Ryan is part of a cancer clinical trial conducted by T-gen clinical research at Scottsdale healthcare. He's getting quality medical care, while helping researchers test new drugs and new procedures for treating cancer.
Ramesh Ramanathan, MD: Clinical research is very important. One of the things that held us back is very few patients in the country get treated on a clinical trial, less than 5%. That has really slowed incorporating new drugs into treatment. We would encourage patients to look into clinical trials when they are diagnosed with cancer.
David Majure: Clinical trails by very nature experimental but they are regulated by the federal government to minimize risk and maximize patient safety.
Joyce Ingold, RN: Clinical trial is for standard of care for cancer and the cancer is resistant to that and cancers that there's not a standard of therapy for and depending on the cancer they jump into a clinical trial.
David Majure: Patrick Ryan is a good example.
Patrick Ryan: A little more than a year ago I was diagnosed with pancreatic cancer. When you are first diagnosed, it's almost told like you got a death sentence.
>> I would let the patient know.
Ramesh Ramanathan, MD: Few patients live more than a year with advanced pancreatic cancer. The goal is to increase initially the one-year survival rate because we see very few patients living more than a year. We are on the verge of making major break throughs.
David Majure: On the new $18 million Grant from Stand Up To Cancer will help. The money will be used by T-gen in partnership with university of Pennsylvania to find new ways to fight pancreatic cancer.
Ramesh Ramanathan, MD: We will look at new ways of starving the pancreatic cancer growth and new ways to add to the ongoing clinical trails. One of the main areas we focus on here is pancreatic cancer. It's been a difficult cancer to treat. There's very few treatment options and most patients don't respond to chemotherapy and this Grant will help us take discoveries made in the laboratory to patient's care.
Patrick Ryan: Hopefully these researchers and doctors will keep learning more about this disease and will eventually be able to through their research and trails come up with a cure for this disease.
David Majure: It's a disease that's usually fatal in less than a year. Now in his 14th month of treatment, Patrick Ryan is beating those odds.
Patrick Ryan: Thanks to your faith and support from the family and wonderful people at T-gen, you keep fighting. I think that's what is important. Keep up the good fight.
Ted Simons: HERE NOW TO TALK ABOUT THE CLINICAL TRIALS AND THE $18 MILLION GRANT IS DR. MARK SLATER, VICE PRESIDENT OF RESEARCH FOR SCOTTSDALE HEALTHCARE. Thanks for joining us tonight. We appreciate it.
Mark Alater, Ph.D.: Thank you.
Ted Simons: Why was T-gen and Scottsdale healthcare targeted for this money?
Mark Alater, Ph.D.: You know, we put together a partnership between T-gen and Scottsdale healthcare in late 2005. It's a joint program that brings the best of the bench science research with the best of patient care together. So we have physician scientists who are paired up with Ph.D. scientists in the laboratory and use the advanced technology from T-gen and molecular diagnostics and target patient's tumors to better understand what makes them live and where they might be vulnerable and better prescribe treatments that are target to the therapies. This pulling tonight the science and clinical care is unique in a community hospital setting to allow this kind of work. That's why I think we are recognized as one of the sites for the dream team studies.
Ted Simons: I noticed in the tape the goal here is to starve the cancer cells. How does that differ from most cancer research? Isn't that the goal of most cancer research?
Mark Alater, Ph.D.: The goal is to try to poison the tumor and you basically hope the cancer dies before the patient does. It's toxic and very difficult kinds of therapies for patients to tolerate. New thinking has been if we can understand more about the molecular basis of those cancers, what feeds them, what makes them grow and replicate, we can target therapies that go straight to the cell. Shutoff in this case the fuel supply that helps those cells to grow and replicate and that way spare the person and be able to starve the cancer.
Ted Simons: Why is pancreatic cancer such a tough customer?
Mark Alater, Ph.D.: It has been one of our biggest challenges. It has some of the poorest survival. There's very few new treatments that have come along. We've been really stuck for a long time. Fortunately we have one of the world's experts in pancreatic cancer and drug development here in Dr. Von Hoff who is the chief scientific officer and P.I. on the study. We think the new interventions that are targeted and take advantage of the new science of understanding the disease can have a real difference. In fact during the past year Dr. Von Hoff’s team presented results from life expectancy of patients.
Ted Simons: The goal for Stand Up To Cancer is to quickly turn scientific discoveries into better care. Why is that not happening quicker now?
Mark Alater, Ph.D.: That's the goal of the transitional approach. We have been marrying the bedside together. Traditionally they are doing this in isolated areas in universities or research institutes that are separate from patient care. What we have tried to do is shorten that time but putting those teams together so that the scientists learn from the doctors who learn from the patients and the findings from the laboratory go straight into patient care. We are not waiting for new break throughs but we are bringing those new technologies to the patients today for benefits today.
Ted Simons: How careful do you have to be as far as experimental technology and drugs, you have to be careful, don't you?
Mark Alater, Ph.D.: Absolutely. These are patients' lives at stake. There's a strict process we go through in development before any treatments are given to people. They are tested in laboratories. There's preclinical studies done first. Then we have conducted more than 40 first in human studies in our facility where patients are monitored very closely and one of the things we find that patients often do better in clinical trails than in routine care because of all the careful monitoring and extra services they get as a part of the study.
Ted Simons: Briefly, can patients still get involved in some of the trails?
Mark Alater, Ph.D.: Absolutely, patients can get involved in this. The best way to do this is contact the patient care coordinator who can understand where they are at in their cancer journey, where the best opportunities are for them and patients don't have to be at the end stage of their illness to qualify for clinical trails and benefit from them. It's sorting out what's best for each individual.
Ted Simons: Doctor, congratulations and thank you for joining us.
Mark Alater, Ph.D.: Thank you for your interest
Obama Health Care Plan
- President Obama spoke to members of the American Medical Association recently. Hear from Dr. Jacqueline Chadwick of the Arizona Medical Association about the speech and the president’s plan.
- Dr. Jacqueline Chadwick - Arizona Medical Association
Ted Simons: LAST WEEK, PRESIDENT OBAMA SHARED HIS HEALTH CARE REFORM IDEAS WITH MEMBERS OF THE AMERICAN MEDICAL ASSOCIATION. DR. JACQUELINE CHADWICK OF THE ARIZONA MEDICAL ASSOCIATION WAS THERE AND NOW SHE'S HERE TO TALK ABOUT THE PRESIDENT'S PLAN. Thank you so much for joining us.
Jacqueline Chadwick: Thank you.
Ted Simons: Your thoughts of what you heard from the president regarding healthcare reform.
Jacqueline Chadwick: The president was very well received at the A. M. A. Its unfortunate that the only thing that made the news was the boo that happened when he mentioned he was not in favor of caps on malpractice awards. There was a dozen standing ovations of his speech. A little disappointed in the lack of some detail about some of the key items in his proposal and disappointment that we wanted to hear for substance on the liability reform issue.
Ted Simons: I want to get to tort reform in a second. Let's start with the option which government gets in the insurance business and competes against private firms.
Jacqueline Chadwick: We had a significant discussion with half the delegates after that. I would say there's as much polarization as much as the public. There's an espousal significant option and those who say we don't want another Medicare-type system. I would say a majority of physicians feel we would not like to have another Medicare-type system to run the insurance program. We would like to see private insurance reform and other aspects of that. He was not clear in public option and made it difficult for us to respond.
Ted Simons: I know he said the public option would increase competition and that would be a good thing as well. Do you agree with that?
Jacqueline Chadwick: I think it's important but if they don't allow for the leveling of the playing field among private insurance of the companies, ultimately there won't be private insurance companies. Is this slippery slope to the government running health insurance. While the president denied that case, it's hard to understand that it's hard for the private sector to operate on the same level.
Ted Simons: It would seem this was the compromise on his part of the single-payer system. Single pair to public option and regional co-op. What do you think of the co-op ideas?
Jacqueline Chadwick: There's not enough information in the programs to comment yet. It's nice that's the physicians and A. M. A. is at the table and we are operating on the principles we wish to see maintained in reform. We don't know the definitions of public option and co-ops. We have to get details before we can adequately respond.
Ted Simons: Is there agreement that reform is necessary.
Jacqueline Chadwick: I would say the vast majority of physicians speaking think system reform is necessary. Doctors want to take care of patients. There's so much between our ability to take care of patients and all of the business side of medicine that that's a problem.
Ted Simons: Do most doctors--and I've seen different studies where most doctors say even a single-payer system is okay by them where most doctors may be with the American Medical Association aren't that positive about it. What is wrong with the single-payer system?
Jacqueline Chadwick: It's a totally government-run system and we have seen the difficulties, for example, with Medicare. When you talk about the main issue being cost, a bottom line approach, the only thing that can happen in what the president called a deficit neutral situation is ultimately rationing. The way the government does things is just by addressing ratcheting down payments. That's not the answer to problems including malpractice and tort reform.
Ted Simons: Let's get to tort reform. Obviously the president is not quite ready to go that far. Again we have seen studies and incidents where certain areas go into tort reforms and medical costs aren't lowering. Why is tort reform so important? How do you make it fair for someone who has been wronged by medical malpractice?
Jacqueline Chadwick: I don't think physicians feel that patients who have been truly wronged by malpractice don't deserve compensation. What we are talking about is mal occurrence if a doctor does everything right and a standard of care in a particular area and done everything that's correct without having studies or research behind it but there's a bad outcome for lots of different reasons. That's a mal occurrence. That's nothing the physician did wrong. The other thing about malpractice is over the last--i'm going to say two decades--i've been in practice 30 years now. Over the past two decades there's an increase in defensive medicine that we as physicians don't recognize that we're doing it. We order tests and do things out of fear over being sued and not rightfully so but patients are demanding things. You are fearful that you are going to be sued and your entire resources will be consumed by that much less the agony of going through it that I think it's added huge costs to the systems. If we could get rid of tort reform and defensive medicine and compensate for real malpractice, I think that's a good approach.
Ted Simons: Let me ask you this question and I get it all the time. Folks don't think doctors see healthcare as a right. They see it as a privilege. Is healthcare a right in America?
Jacqueline Chadwick: You would have to ask every single individual physician. I think you hit on the underlying topic here for both of the professionals and the public to have that debate. You know, personally I have gravitated more towards a basic healthcare--if we are talking about healthcare, that is a right. Because all patients should be taken care of no matter what's wrong with them. If we are talking about health insurance being a right or type of healthcare being a right that's a thornier issue because you get in the different aspects of what is right for me.
Ted Simons: We have to stop it there. Thank you for joining me on horizon.
Jacqueline Chadwick: Thank you Ted.