Jane Anderson

Although formularies under Medicare Part D plans vary widely, nearly all plans cover at least one brand-name drug in many commonly prescribed treatment classes, according to research published in the Journal of the American Medical Association.

The researchers, who looked at Part D plans in California, studied eight treatment classes, including angiotensin-converting enzyme inhibitors, angiotensin II receptor blockers, β-blockers, calcium channel blockers, loop diuretics, selective serotonin reuptake inhibitors, statins, and thiazide diuretics. They looked at how often drugs were included in at least 90% of formularies at copayments of $35 or less without prior authorization.

"Providers can have a difficult time knowing which drug is paid for by Medicare Part D because there are over 1,800 plans and there's a great deal of variation among these formularies," Dr. Chien-Wen Tseng, a researcher at the University of Hawaii and the Pacific Health Research Institute, said in an interview.

But "despite the large number of plans and variation among their formularies, for most of the treatment classes we examined we found one or more drugs that were covered by nearly 100% of Part D formularies," Dr. Tseng said.

Nearly all of these widely covered drugs are generics, according to the study, which also noted that the drugs covered by Part D formularies are likely to change over time as generics become available and as new clinical data are released (JAMA 2007;297:2596–602).

For example, simvastatin (Zocor) and sertraline (Zoloft) became available as generics in 2006. Earlier that year, 71% of formularies had covered simvastatin as a brand name, while 74% covered sertraline as a brand name. But by Dec. 8, 2006, after both drugs had generic equivalents, the study authors found that 93% of the formularies examined covered simvastatin as a generic, while 100% covered sertraline as a generic.

Dr. Tseng said that a Web site that tracks the list of these "widely covered" drugs potentially could help physicians determine which drugs are most likely to be covered and therefore more affordable for patients.

"While the large number of formularies and variation among these formularies is an inconvenience for doctors, it's a real health problem for patients because they may not get the drug they need if it's not covered or too expensive," he said.

Although formularies under Medicare Part D plans vary widely, nearly all plans cover at least one brand-name drug in many commonly prescribed treatment classes, according to research published in the Journal of the American Medical Association.

The researchers, who looked at Part D plans in California, studied eight treatment classes, including angiotensin-converting enzyme inhibitors, angiotensin II receptor blockers, β-blockers, calcium channel blockers, loop diuretics, selective serotonin reuptake inhibitors, statins, and thiazide diuretics. They looked at how often drugs were included in at least 90% of formularies at copayments of $35 or less without prior authorization.

"Providers can have a difficult time knowing which drug is paid for by Medicare Part D because there are over 1,800 plans and there's a great deal of variation among these formularies," Dr. Chien-Wen Tseng, a researcher at the University of Hawaii and the Pacific Health Research Institute, said in an interview.

But "despite the large number of plans and variation among their formularies, for most of the treatment classes we examined we found one or more drugs that were covered by nearly 100% of Part D formularies," Dr. Tseng said.

Nearly all of these widely covered drugs are generics, according to the study, which also noted that the drugs covered by Part D formularies are likely to change over time as generics become available and as new clinical data are released (JAMA 2007;297:2596–602).

For example, simvastatin (Zocor) and sertraline (Zoloft) became available as generics in 2006. Earlier that year, 71% of formularies had covered simvastatin as a brand name, while 74% covered sertraline as a brand name. But by Dec. 8, 2006, after both drugs had generic equivalents, the study authors found that 93% of the formularies examined covered simvastatin as a generic, while 100% covered sertraline as a generic.

Dr. Tseng said that a Web site that tracks the list of these "widely covered" drugs potentially could help physicians determine which drugs are most likely to be covered and therefore more affordable for patients.

"While the large number of formularies and variation among these formularies is an inconvenience for doctors, it's a real health problem for patients because they may not get the drug they need if it's not covered or too expensive," he said.

Although formularies under Medicare Part D plans vary widely, nearly all plans cover at least one brand-name drug in many commonly prescribed treatment classes, according to research published in the Journal of the American Medical Association.

The researchers, who looked at Part D plans in California, studied eight treatment classes, including angiotensin-converting enzyme inhibitors, angiotensin II receptor blockers, β-blockers, calcium channel blockers, loop diuretics, selective serotonin reuptake inhibitors, statins, and thiazide diuretics. They looked at how often drugs were included in at least 90% of formularies at copayments of $35 or less without prior authorization.

"Providers can have a difficult time knowing which drug is paid for by Medicare Part D because there are over 1,800 plans and there's a great deal of variation among these formularies," Dr. Chien-Wen Tseng, a researcher at the University of Hawaii and the Pacific Health Research Institute, said in an interview.

But "despite the large number of plans and variation among their formularies, for most of the treatment classes we examined we found one or more drugs that were covered by nearly 100% of Part D formularies," Dr. Tseng said.

Nearly all of these widely covered drugs are generics, according to the study, which also noted that the drugs covered by Part D formularies are likely to change over time as generics become available and as new clinical data are released (JAMA 2007;297:2596–602).

For example, simvastatin (Zocor) and sertraline (Zoloft) became available as generics in 2006. Earlier that year, 71% of formularies had covered simvastatin as a brand name, while 74% covered sertraline as a brand name. But by Dec. 8, 2006, after both drugs had generic equivalents, the study authors found that 93% of the formularies examined covered simvastatin as a generic, while 100% covered sertraline as a generic.

Dr. Tseng said that a Web site that tracks the list of these "widely covered" drugs potentially could help physicians determine which drugs are most likely to be covered and therefore more affordable for patients.

"While the large number of formularies and variation among these formularies is an inconvenience for doctors, it's a real health problem for patients because they may not get the drug they need if it's not covered or too expensive," he said.

Federal lawmakers were called upon last month to fund an expansion of the State Children's Health Insurance Program by approving a tobacco tax increase of 61 cents; the American Academy of Pediatrics and the American Medical Association, along with 65 other organizations, made the request.

In a joint letter, the groups said that reauthorization of the State Children's Health Insurance Program (SCHIP) is “one of the most important tasks before Congress this year.”

They noted that SCHIP has significantly improved low-income children's access to care.

“By discouraging smoking through an increase in the tobacco tax and using the resulting revenues to improve enrollment in children's health insurance programs, we are creating a win-win proposition in support of our children's health,” the groups said in the joint letter.

“It will also result in long-term savings as children become healthier and more productive members of society,” the letter explained.

Congress has set aside $50 billion in new federal funds over the next 5 years for use in SCHIP, which is scheduled to be reauthorized this year.

However, under new “pay-as-you-go” rules, the $50 billion only will be available for SCHIP if Congress cuts other programs or approves new taxes to raise new revenue.

Raising the tobacco tax to provide more funding for SCHIP would help cover many of the 8 million to 9 million uninsured children in the United States while also helping to reduce youth smoking, which would help save health costs down the road, the groups said in the letter, which was presented to congressional leaders.

“Studies show that every 10% increase in the price of cigarettes reduces youth smoking by 7% and overall cigarette consumption by 4%,” the groups wrote.

“Increasing the tobacco tax will also generate hundreds of millions of dollars in health care savings because fewer smokers means fewer people with strokes, heart attacks, cancer, and other smoking-related health conditions,” the joint letter asserted.

The groups included the American College of Obstetricians and Gynecologists and the American College of Physicians, along with the advocacy group Families USA.

Federal lawmakers were called upon last month to fund an expansion of the State Children's Health Insurance Program by approving a tobacco tax increase of 61 cents; the American Academy of Pediatrics and the American Medical Association, along with 65 other organizations, made the request.

In a joint letter, the groups said that reauthorization of the State Children's Health Insurance Program (SCHIP) is “one of the most important tasks before Congress this year.”

They noted that SCHIP has significantly improved low-income children's access to care.

“By discouraging smoking through an increase in the tobacco tax and using the resulting revenues to improve enrollment in children's health insurance programs, we are creating a win-win proposition in support of our children's health,” the groups said in the joint letter.

“It will also result in long-term savings as children become healthier and more productive members of society,” the letter explained.

Congress has set aside $50 billion in new federal funds over the next 5 years for use in SCHIP, which is scheduled to be reauthorized this year.

However, under new “pay-as-you-go” rules, the $50 billion only will be available for SCHIP if Congress cuts other programs or approves new taxes to raise new revenue.

Raising the tobacco tax to provide more funding for SCHIP would help cover many of the 8 million to 9 million uninsured children in the United States while also helping to reduce youth smoking, which would help save health costs down the road, the groups said in the letter, which was presented to congressional leaders.

“Studies show that every 10% increase in the price of cigarettes reduces youth smoking by 7% and overall cigarette consumption by 4%,” the groups wrote.

“Increasing the tobacco tax will also generate hundreds of millions of dollars in health care savings because fewer smokers means fewer people with strokes, heart attacks, cancer, and other smoking-related health conditions,” the joint letter asserted.

The groups included the American College of Obstetricians and Gynecologists and the American College of Physicians, along with the advocacy group Families USA.

Federal lawmakers were called upon last month to fund an expansion of the State Children's Health Insurance Program by approving a tobacco tax increase of 61 cents; the American Academy of Pediatrics and the American Medical Association, along with 65 other organizations, made the request.

In a joint letter, the groups said that reauthorization of the State Children's Health Insurance Program (SCHIP) is “one of the most important tasks before Congress this year.”

They noted that SCHIP has significantly improved low-income children's access to care.

“By discouraging smoking through an increase in the tobacco tax and using the resulting revenues to improve enrollment in children's health insurance programs, we are creating a win-win proposition in support of our children's health,” the groups said in the joint letter.

“It will also result in long-term savings as children become healthier and more productive members of society,” the letter explained.

Congress has set aside $50 billion in new federal funds over the next 5 years for use in SCHIP, which is scheduled to be reauthorized this year.

However, under new “pay-as-you-go” rules, the $50 billion only will be available for SCHIP if Congress cuts other programs or approves new taxes to raise new revenue.

Raising the tobacco tax to provide more funding for SCHIP would help cover many of the 8 million to 9 million uninsured children in the United States while also helping to reduce youth smoking, which would help save health costs down the road, the groups said in the letter, which was presented to congressional leaders.

“Studies show that every 10% increase in the price of cigarettes reduces youth smoking by 7% and overall cigarette consumption by 4%,” the groups wrote.

“Increasing the tobacco tax will also generate hundreds of millions of dollars in health care savings because fewer smokers means fewer people with strokes, heart attacks, cancer, and other smoking-related health conditions,” the joint letter asserted.

The groups included the American College of Obstetricians and Gynecologists and the American College of Physicians, along with the advocacy group Families USA.

AMA: Investigate Store Clinics

The American Medical Association has called for investigations into potential conflicts of interest posed by joint ventures between store-based health clinics and pharmacy chains. Physicians at the AMA's House of Delegates in Chicago voted to ask state and federal agencies to determine whether these joint ventures pose a threat to patients' welfare. “There are clear incentives for retailers to participate in the implementation and operation of store-based health clinics,” said AMA board member Dr. Peter Carmel in a statement. “The nation's physicians want the AMA to ensure these incentives do not compromise the basic obligation of store-based clinics to provide patients with quality care.” The AMA also noted that some insurers are allowing store-based clinics to waive or lower patient copayments, while still requiring physicians to collect such payments. The House of Delegates, noting concerns that these lower copayments for in-store clinics could inappropriately steer patients to the clinics on the basis of cost, rather than quality of care, voted to seek equal treatment for physicians regarding health insurers' copayment policies.

CDC: 43 Million Lack Coverage

Nearly 15% of Americans—43.6 million—lacked health insurance in 2006, according to the Centers for Disease Control and Prevention. Among Americans ages 18 through 64, nearly 20% lacked health insurance in 2006, a slight increase from about 19% in 2005, the CDC said. About 9% of children did not have health coverage in 2006, a marked drop from 14% in 1997, the year the State Children's Health Insurance Program (SCHIP) was enacted. The CDC noted that the percentage of uninsured Americans in the 20 largest states varied from less than 8% in Michigan to nearly 24% in Texas. The CDC study was based on data collected from interviews in more than 100,000 households nationwide.

CMS Launches Health Record Pilot

The Centers for Medicare and Medicaid Services has launched a pilot program to enable certain beneficiaries to access and use a personal health record provided through participating health plans and accessible through

www.mymedicare.gov

Hawaii to Offer Kids Free Flu Shots

This fall, Hawaii will become the first state to offer free influenza vaccinations to school children aged 5–13 years. The shots will be available October 2007-January 2008 at school during the school day. Funding for the estimated $2.5-million program is being provided primarily by the Centers for Disease Control and Prevention and the State of Hawaii, with additional support from the state's largest insurer, the Hawaii Medical Service Association. Nationally, school children have very high rates of influenza illness, exceeding 10% in most years, according to the Hawaii State Department of Health.

Services Behind Medicare Growth

The growth in Medicare's per-beneficiary spending can be explained by growth in the volume and intensity of physicians' services, rather than by changes in Medicare's payment rates, according to a Congressional Budget Office study. Between 1997 and 2005, Medicare's inflation-adjusted payment rates for services actually declined slightly, but per-beneficiary spending jumped by more than 34%, the CBO study found, with volume and intensity of services growing by about 4% per year. The CBO said that physicians tended to increase volume and intensity of services provided when payment rates were cut, but added that this behavioral response accounted for just a small fraction of the change in per-beneficiary spending. Still, projected cuts in Medicare payments to physicians may result in a different behavioral response from doctors, the CBO noted.

CMS Enhances Hospital Web Site

The CMS said that it has improved the hospital comparison tool available on its Hospital Compare consumer Web site (

www.hospitalcompare.hhs.gov

AMA: Investigate Store Clinics

The American Medical Association has called for investigations into potential conflicts of interest posed by joint ventures between store-based health clinics and pharmacy chains. Physicians at the AMA's House of Delegates in Chicago voted to ask state and federal agencies to determine whether these joint ventures pose a threat to patients' welfare. “There are clear incentives for retailers to participate in the implementation and operation of store-based health clinics,” said AMA board member Dr. Peter Carmel in a statement. “The nation's physicians want the AMA to ensure these incentives do not compromise the basic obligation of store-based clinics to provide patients with quality care.” The AMA also noted that some insurers are allowing store-based clinics to waive or lower patient copayments, while still requiring physicians to collect such payments. The House of Delegates, noting concerns that these lower copayments for in-store clinics could inappropriately steer patients to the clinics on the basis of cost, rather than quality of care, voted to seek equal treatment for physicians regarding health insurers' copayment policies.

CDC: 43 Million Lack Coverage

Nearly 15% of Americans—43.6 million—lacked health insurance in 2006, according to the Centers for Disease Control and Prevention. Among Americans ages 18 through 64, nearly 20% lacked health insurance in 2006, a slight increase from about 19% in 2005, the CDC said. About 9% of children did not have health coverage in 2006, a marked drop from 14% in 1997, the year the State Children's Health Insurance Program (SCHIP) was enacted. The CDC noted that the percentage of uninsured Americans in the 20 largest states varied from less than 8% in Michigan to nearly 24% in Texas. The CDC study was based on data collected from interviews in more than 100,000 households nationwide.

CMS Launches Health Record Pilot

The Centers for Medicare and Medicaid Services has launched a pilot program to enable certain beneficiaries to access and use a personal health record provided through participating health plans and accessible through

www.mymedicare.gov

Hawaii to Offer Kids Free Flu Shots

This fall, Hawaii will become the first state to offer free influenza vaccinations to school children aged 5–13 years. The shots will be available October 2007-January 2008 at school during the school day. Funding for the estimated $2.5-million program is being provided primarily by the Centers for Disease Control and Prevention and the State of Hawaii, with additional support from the state's largest insurer, the Hawaii Medical Service Association. Nationally, school children have very high rates of influenza illness, exceeding 10% in most years, according to the Hawaii State Department of Health.

Services Behind Medicare Growth

The growth in Medicare's per-beneficiary spending can be explained by growth in the volume and intensity of physicians' services, rather than by changes in Medicare's payment rates, according to a Congressional Budget Office study. Between 1997 and 2005, Medicare's inflation-adjusted payment rates for services actually declined slightly, but per-beneficiary spending jumped by more than 34%, the CBO study found, with volume and intensity of services growing by about 4% per year. The CBO said that physicians tended to increase volume and intensity of services provided when payment rates were cut, but added that this behavioral response accounted for just a small fraction of the change in per-beneficiary spending. Still, projected cuts in Medicare payments to physicians may result in a different behavioral response from doctors, the CBO noted.

CMS Enhances Hospital Web Site

The CMS said that it has improved the hospital comparison tool available on its Hospital Compare consumer Web site (

www.hospitalcompare.hhs.gov

AMA: Investigate Store Clinics

The American Medical Association has called for investigations into potential conflicts of interest posed by joint ventures between store-based health clinics and pharmacy chains. Physicians at the AMA's House of Delegates in Chicago voted to ask state and federal agencies to determine whether these joint ventures pose a threat to patients' welfare. “There are clear incentives for retailers to participate in the implementation and operation of store-based health clinics,” said AMA board member Dr. Peter Carmel in a statement. “The nation's physicians want the AMA to ensure these incentives do not compromise the basic obligation of store-based clinics to provide patients with quality care.” The AMA also noted that some insurers are allowing store-based clinics to waive or lower patient copayments, while still requiring physicians to collect such payments. The House of Delegates, noting concerns that these lower copayments for in-store clinics could inappropriately steer patients to the clinics on the basis of cost, rather than quality of care, voted to seek equal treatment for physicians regarding health insurers' copayment policies.

CDC: 43 Million Lack Coverage

Nearly 15% of Americans—43.6 million—lacked health insurance in 2006, according to the Centers for Disease Control and Prevention. Among Americans ages 18 through 64, nearly 20% lacked health insurance in 2006, a slight increase from about 19% in 2005, the CDC said. About 9% of children did not have health coverage in 2006, a marked drop from 14% in 1997, the year the State Children's Health Insurance Program (SCHIP) was enacted. The CDC noted that the percentage of uninsured Americans in the 20 largest states varied from less than 8% in Michigan to nearly 24% in Texas. The CDC study was based on data collected from interviews in more than 100,000 households nationwide.

CMS Launches Health Record Pilot

The Centers for Medicare and Medicaid Services has launched a pilot program to enable certain beneficiaries to access and use a personal health record provided through participating health plans and accessible through

www.mymedicare.gov

Hawaii to Offer Kids Free Flu Shots

This fall, Hawaii will become the first state to offer free influenza vaccinations to school children aged 5–13 years. The shots will be available October 2007-January 2008 at school during the school day. Funding for the estimated $2.5-million program is being provided primarily by the Centers for Disease Control and Prevention and the State of Hawaii, with additional support from the state's largest insurer, the Hawaii Medical Service Association. Nationally, school children have very high rates of influenza illness, exceeding 10% in most years, according to the Hawaii State Department of Health.

Services Behind Medicare Growth

The growth in Medicare's per-beneficiary spending can be explained by growth in the volume and intensity of physicians' services, rather than by changes in Medicare's payment rates, according to a Congressional Budget Office study. Between 1997 and 2005, Medicare's inflation-adjusted payment rates for services actually declined slightly, but per-beneficiary spending jumped by more than 34%, the CBO study found, with volume and intensity of services growing by about 4% per year. The CBO said that physicians tended to increase volume and intensity of services provided when payment rates were cut, but added that this behavioral response accounted for just a small fraction of the change in per-beneficiary spending. Still, projected cuts in Medicare payments to physicians may result in a different behavioral response from doctors, the CBO noted.

CMS Enhances Hospital Web Site

The CMS said that it has improved the hospital comparison tool available on its Hospital Compare consumer Web site (

www.hospitalcompare.hhs.gov

AMA: Investigate Store Clinics

The American Medical Association has called for investigations into potential conflicts of interest posed by joint ventures between store-based health clinics and pharmacy chains. Physicians at the AMA's House of Delegates in Chicago voted to ask state and federal agencies to determine whether these joint ventures pose a threat to patients' welfare. “There are clear incentives for retailers to participate in the implementation and operation of store-based health clinics,” AMA board member Dr. Peter Carmel said in a statement. “The nation's physicians want the AMA to ensure these incentives do not compromise the basic obligation of store-based clinics to provide patients with quality care.” The AMA also noted that some insurers are allowing store-based clinics to waive or lower patient copayments, while still requiring physicians to collect such payments. The House of Delegates, noting concerns that these lower copayments for in-store clinics could inappropriately steer patients to the clinics on the basis of cost, rather than quality of care, voted to seek equal treatment for physicians regarding health insurers' copayment policies.

CDC: 43 Million Lack Coverage

Nearly 15% of Americans—43.6 million—lacked health insurance in 2006, according to the Centers for Disease Control and Prevention. Among Americans ages 18 through 64, nearly 20% lacked health insurance in 2006, a slight increase from about 19% in 2005, the CDC said. About 9% of children did not have health coverage in 2006, a marked drop from 14% in 1997, the year the State Children's Health Insurance Program (SCHIP) was enacted. The CDC noted that the percentage of uninsured Americans in the 20 largest states varied from less than 8% in Michigan to nearly 24% in Texas. The CDC study was based on data collected from interviews in more than 100,000 households nationwide.

Hospital Comparison Site Upgraded

The CMS said that it has improved the hospital comparison tool available on its Hospital Compare consumer Web site (

www.hospitalcompare.hhs.gov

CMS Tests Personal Health Records

The Centers for Medicare and Medicaid Services has launched a pilot program to enable certain beneficiaries to access and use a personal health record provided through participating health plans and accessible through

www.mymedicare.gov

Hawaii to Offer Kids Free Flu Shots

This fall, Hawaii will become the first state to offer free influenza vaccinations to schoolchildren aged 5–13 years. The shots will be available October 2007-January 2008 at school during the school day. Funding for the estimated $2.5-million program is being provided primarily by the Centers for Disease Control and Prevention and the State of Hawaii, with additional support from the state's largest insurer, the Hawaii Medical Service Association. Nationally, schoolchildren have very high rates of influenza illness, exceeding 10% in most years, according to the Hawaii State Department of Health.

Services Behind Medicare Growth

The growth in Medicare's per-beneficiary spending can be explained by growth in the volume and intensity of physicians' services, rather than by changes in Medicare's payment rates, according to a Congressional Budget Office study. Between 1997 and 2005, Medicare's inflation-adjusted payment rates for services actually declined slightly, but per-beneficiary spending jumped by more than 34%, the CBO study found, with volume and intensity of services growing by about 4% per year. The CBO said that physicians tended to increase volume and intensity of services provided when payment rates were cut, but added that this behavioral response accounted for just a small fraction of the change in per-beneficiary spending. Still, projected cuts in Medicare payments to physicians may result in a different behavioral response from doctors, the CBO noted.

AMA: Investigate Store Clinics

The American Medical Association has called for investigations into potential conflicts of interest posed by joint ventures between store-based health clinics and pharmacy chains. Physicians at the AMA's House of Delegates in Chicago voted to ask state and federal agencies to determine whether these joint ventures pose a threat to patients' welfare. “There are clear incentives for retailers to participate in the implementation and operation of store-based health clinics,” AMA board member Dr. Peter Carmel said in a statement. “The nation's physicians want the AMA to ensure these incentives do not compromise the basic obligation of store-based clinics to provide patients with quality care.” The AMA also noted that some insurers are allowing store-based clinics to waive or lower patient copayments, while still requiring physicians to collect such payments. The House of Delegates, noting concerns that these lower copayments for in-store clinics could inappropriately steer patients to the clinics on the basis of cost, rather than quality of care, voted to seek equal treatment for physicians regarding health insurers' copayment policies.

CDC: 43 Million Lack Coverage

Nearly 15% of Americans—43.6 million—lacked health insurance in 2006, according to the Centers for Disease Control and Prevention. Among Americans ages 18 through 64, nearly 20% lacked health insurance in 2006, a slight increase from about 19% in 2005, the CDC said. About 9% of children did not have health coverage in 2006, a marked drop from 14% in 1997, the year the State Children's Health Insurance Program (SCHIP) was enacted. The CDC noted that the percentage of uninsured Americans in the 20 largest states varied from less than 8% in Michigan to nearly 24% in Texas. The CDC study was based on data collected from interviews in more than 100,000 households nationwide.

Hospital Comparison Site Upgraded

The CMS said that it has improved the hospital comparison tool available on its Hospital Compare consumer Web site (

www.hospitalcompare.hhs.gov

CMS Tests Personal Health Records

The Centers for Medicare and Medicaid Services has launched a pilot program to enable certain beneficiaries to access and use a personal health record provided through participating health plans and accessible through

www.mymedicare.gov

Hawaii to Offer Kids Free Flu Shots

This fall, Hawaii will become the first state to offer free influenza vaccinations to schoolchildren aged 5–13 years. The shots will be available October 2007-January 2008 at school during the school day. Funding for the estimated $2.5-million program is being provided primarily by the Centers for Disease Control and Prevention and the State of Hawaii, with additional support from the state's largest insurer, the Hawaii Medical Service Association. Nationally, schoolchildren have very high rates of influenza illness, exceeding 10% in most years, according to the Hawaii State Department of Health.

Services Behind Medicare Growth

The growth in Medicare's per-beneficiary spending can be explained by growth in the volume and intensity of physicians' services, rather than by changes in Medicare's payment rates, according to a Congressional Budget Office study. Between 1997 and 2005, Medicare's inflation-adjusted payment rates for services actually declined slightly, but per-beneficiary spending jumped by more than 34%, the CBO study found, with volume and intensity of services growing by about 4% per year. The CBO said that physicians tended to increase volume and intensity of services provided when payment rates were cut, but added that this behavioral response accounted for just a small fraction of the change in per-beneficiary spending. Still, projected cuts in Medicare payments to physicians may result in a different behavioral response from doctors, the CBO noted.

AMA: Investigate Store Clinics

The American Medical Association has called for investigations into potential conflicts of interest posed by joint ventures between store-based health clinics and pharmacy chains. Physicians at the AMA's House of Delegates in Chicago voted to ask state and federal agencies to determine whether these joint ventures pose a threat to patients' welfare. “There are clear incentives for retailers to participate in the implementation and operation of store-based health clinics,” AMA board member Dr. Peter Carmel said in a statement. “The nation's physicians want the AMA to ensure these incentives do not compromise the basic obligation of store-based clinics to provide patients with quality care.” The AMA also noted that some insurers are allowing store-based clinics to waive or lower patient copayments, while still requiring physicians to collect such payments. The House of Delegates, noting concerns that these lower copayments for in-store clinics could inappropriately steer patients to the clinics on the basis of cost, rather than quality of care, voted to seek equal treatment for physicians regarding health insurers' copayment policies.

CDC: 43 Million Lack Coverage

Nearly 15% of Americans—43.6 million—lacked health insurance in 2006, according to the Centers for Disease Control and Prevention. Among Americans ages 18 through 64, nearly 20% lacked health insurance in 2006, a slight increase from about 19% in 2005, the CDC said. About 9% of children did not have health coverage in 2006, a marked drop from 14% in 1997, the year the State Children's Health Insurance Program (SCHIP) was enacted. The CDC noted that the percentage of uninsured Americans in the 20 largest states varied from less than 8% in Michigan to nearly 24% in Texas. The CDC study was based on data collected from interviews in more than 100,000 households nationwide.

Hospital Comparison Site Upgraded

The CMS said that it has improved the hospital comparison tool available on its Hospital Compare consumer Web site (

www.hospitalcompare.hhs.gov

CMS Tests Personal Health Records

The Centers for Medicare and Medicaid Services has launched a pilot program to enable certain beneficiaries to access and use a personal health record provided through participating health plans and accessible through

www.mymedicare.gov

Hawaii to Offer Kids Free Flu Shots

This fall, Hawaii will become the first state to offer free influenza vaccinations to schoolchildren aged 5–13 years. The shots will be available October 2007-January 2008 at school during the school day. Funding for the estimated $2.5-million program is being provided primarily by the Centers for Disease Control and Prevention and the State of Hawaii, with additional support from the state's largest insurer, the Hawaii Medical Service Association. Nationally, schoolchildren have very high rates of influenza illness, exceeding 10% in most years, according to the Hawaii State Department of Health.

Services Behind Medicare Growth

The growth in Medicare's per-beneficiary spending can be explained by growth in the volume and intensity of physicians' services, rather than by changes in Medicare's payment rates, according to a Congressional Budget Office study. Between 1997 and 2005, Medicare's inflation-adjusted payment rates for services actually declined slightly, but per-beneficiary spending jumped by more than 34%, the CBO study found, with volume and intensity of services growing by about 4% per year. The CBO said that physicians tended to increase volume and intensity of services provided when payment rates were cut, but added that this behavioral response accounted for just a small fraction of the change in per-beneficiary spending. Still, projected cuts in Medicare payments to physicians may result in a different behavioral response from doctors, the CBO noted.

Too few pediatricians in training are following best-practice guidelines for addressing parental smoking and the risks that secondhand smoke poses for their patients, said Bradley N. Collins, Ph.D., a public health expert at Temple University, Philadelphia, and his associates.

“This is not a criticism of the efforts of pediatricians with respect to trying to protect their patients from the effects of secondhand smoke,” Dr. Collins said in an interview. “But the vast majority of pediatricians surveyed said they were not confident in their ability to change parental smoking habits or their patients' exposure to smoke.”

Dr. Collins and his associates asked 66 pediatric residents and 27 preceptors in a teaching hospital how they intervened when treating different environmental tobacco smoke (ETS)-related illnesses. Almost all of them (93%) said they received less than 2 hours' training about smoking cessation during residency. Survey results showed these pediatricians inconsistently intervened across treatment settings and when treating different ETS-related illnesses.

For example, 60% “always” assessed ETS during asthma visits and just 13% “always” assessed ETS during otitis visits. Fewer than 50% “always” explained ETS risks to smoking parents, and fewer than 33% “always” offered advice on creating a smoke-free home, the investigators reported (J. Pediatr. 2007;150:547–52).

Three-quarters of those surveyed agreed that ETS is one of the most important health hazards for children. But when these pediatricians identified a parent smoker, they rarely intervened beyond brief advice to eliminate children's ETS exposure or to quit smoking. Most cited lack of time and low confidence in their effectiveness when reporting why they failed to intervene on parental smoking.

Dr. Collins said it's understandable for pediatricians to believe they alone could not inspire a smoking parent to quit. But he said pediatricians and primary care physicians can provide some counseling and incentives for parents to stop smoking, and that understanding the barriers to ETS intervention could promote transdisciplinary training and intervention approaches that effectively promote pediatrician advice while minimizing the time commitment.

Too few pediatricians in training are following best-practice guidelines for addressing parental smoking and the risks that secondhand smoke poses for their patients, said Bradley N. Collins, Ph.D., a public health expert at Temple University, Philadelphia, and his associates.

“This is not a criticism of the efforts of pediatricians with respect to trying to protect their patients from the effects of secondhand smoke,” Dr. Collins said in an interview. “But the vast majority of pediatricians surveyed said they were not confident in their ability to change parental smoking habits or their patients' exposure to smoke.”

Dr. Collins and his associates asked 66 pediatric residents and 27 preceptors in a teaching hospital how they intervened when treating different environmental tobacco smoke (ETS)-related illnesses. Almost all of them (93%) said they received less than 2 hours' training about smoking cessation during residency. Survey results showed these pediatricians inconsistently intervened across treatment settings and when treating different ETS-related illnesses.

For example, 60% “always” assessed ETS during asthma visits and just 13% “always” assessed ETS during otitis visits. Fewer than 50% “always” explained ETS risks to smoking parents, and fewer than 33% “always” offered advice on creating a smoke-free home, the investigators reported (J. Pediatr. 2007;150:547–52).

Three-quarters of those surveyed agreed that ETS is one of the most important health hazards for children. But when these pediatricians identified a parent smoker, they rarely intervened beyond brief advice to eliminate children's ETS exposure or to quit smoking. Most cited lack of time and low confidence in their effectiveness when reporting why they failed to intervene on parental smoking.

Dr. Collins said it's understandable for pediatricians to believe they alone could not inspire a smoking parent to quit. But he said pediatricians and primary care physicians can provide some counseling and incentives for parents to stop smoking, and that understanding the barriers to ETS intervention could promote transdisciplinary training and intervention approaches that effectively promote pediatrician advice while minimizing the time commitment.

Too few pediatricians in training are following best-practice guidelines for addressing parental smoking and the risks that secondhand smoke poses for their patients, said Bradley N. Collins, Ph.D., a public health expert at Temple University, Philadelphia, and his associates.

“This is not a criticism of the efforts of pediatricians with respect to trying to protect their patients from the effects of secondhand smoke,” Dr. Collins said in an interview. “But the vast majority of pediatricians surveyed said they were not confident in their ability to change parental smoking habits or their patients' exposure to smoke.”

Dr. Collins and his associates asked 66 pediatric residents and 27 preceptors in a teaching hospital how they intervened when treating different environmental tobacco smoke (ETS)-related illnesses. Almost all of them (93%) said they received less than 2 hours' training about smoking cessation during residency. Survey results showed these pediatricians inconsistently intervened across treatment settings and when treating different ETS-related illnesses.

For example, 60% “always” assessed ETS during asthma visits and just 13% “always” assessed ETS during otitis visits. Fewer than 50% “always” explained ETS risks to smoking parents, and fewer than 33% “always” offered advice on creating a smoke-free home, the investigators reported (J. Pediatr. 2007;150:547–52).

Three-quarters of those surveyed agreed that ETS is one of the most important health hazards for children. But when these pediatricians identified a parent smoker, they rarely intervened beyond brief advice to eliminate children's ETS exposure or to quit smoking. Most cited lack of time and low confidence in their effectiveness when reporting why they failed to intervene on parental smoking.

Dr. Collins said it's understandable for pediatricians to believe they alone could not inspire a smoking parent to quit. But he said pediatricians and primary care physicians can provide some counseling and incentives for parents to stop smoking, and that understanding the barriers to ETS intervention could promote transdisciplinary training and intervention approaches that effectively promote pediatrician advice while minimizing the time commitment.

Virginia Children Wait for Medicaid

More than half of Virginia children whose parents applied for Medicaid coverage waited for 4–6 months for their applications to be processed—and 90% went without coverage during that time—as a result of a new federal law requiring proof of citizenship to receive benefits, according to a state survey. The survey of 800 families, conducted by the Virginia Health Care Foundation in partnership with the Virginia Department of Medical Assistance Services, found that the new requirements resulted in a significant decrease in the number of children enrolled in Medicaid in the state, in an inability of citizen children to obtain medical care, and in a dramatic increase in emergency department utilization by those caught up in lengthy eligibility determinations.

Report Disputes SCHIP Numbers

An Urban Institute analysis of uninsured children eligible for the State Children's Health Insurance Program (SCHIP) indicates that far fewer children than previously thought may be eligible for SCHIP. The new study focuses on children who were uninsured for an entire year, unlike other studies that have looked at children who were uninsured for just part of a year. The Health and Human Services Department, which released the new Urban Institute study, said the lower estimate shows that adding $50 billion in additional funding to the SCHIP program is unnecessary. But Democratic senators, who are slated to consider SCHIP reauthorization legislation soon, dismissed the report.

MDs Should Use the Term 'Obese'

Physicians should use blunt, clinical terms such as “overweight” and “obese” to describe conditions currently called “at risk for overweight” and “overweight,” a panel of health experts representing 15 major medical associations said in a report. In recommending the changes, the panel members said that the terms used now allow physicians to avoid counseling patients in need of intervention. The panel also recommended that physicians assess children's weight and body mass index at least once a year and evaluate nutrition and activity habits for all pediatric patients during regular checkups. The panel was convened by the American Medical Association, with funding from federal agencies, and the voluntary guidelines have been endorsed by the American Academy of Pediatrics.

Improved Ped Paxil Settlement

Public Citizen said it has won greater compensation for parents of children who took the antidepressant Paxil but can't provide documentation of their purchase or related costs. In an earlier complaint (Hoormann et al. v. SmithKline Beecham Corp.), the defendants alleged the company misled parents by not disclosing that the drug was dangerous and ineffective for children younger than age 18 years. Paxil maker GlaxoSmithKline Inc. was required to put $63.8 million into a fund to pay class members' out-of-pocket expenses and attorneys' fees, but members who could not provide proof of expenses were limited to a $15 payout and a pro rata share of $300,000, depending on the number of claimants. In a revised settlement approved by the Third Judicial Circuit of Madison County, Ill., claimants without documentation will now get up to $100, and the $300,000 pro rata cap is eliminated, according to the organization Public Citizen. Information on the settlement is at

www.paxilpediatricsettlement.com

Hawaii to Offer Kids Free Flu Shots

This fall, Hawaii will become the first state to offer free influenza vaccinations to school children aged 5–13 years. The shots will be available October 2007-January 2008 at school during the school day. Funding for the estimated $2.5 million program is being provided primarily by the Centers for Disease Control and Prevention and the State of Hawaii, with additional support from the state's largest insurer, the Hawaii Medical Service Association. Nationally, school children have very high rates of influenza illness, exceeding 10% in most years, according to the Hawaii State Department of Health.

AAOS Warns About Wheeled Shoes

The American Academy of Orthopaedic Surgeons (AAOS) has warned that children who wear roller shoes or street gliders—shoes with wheels in the heel—should wear protective gear such as wrist guards and helmets to avoid injuries. According to AAOS President James Beaty, a pediatric orthopaedic surgeon, physicians are seeing children come into their practices with injuries—mostly fractures within the hand, wrist, or elbow—that are attributable to these shoes. The Consumer Product Safety Commission said the agency received reports of one death and at least 64 injuries related to wheeled sneakers between September 2005 and December 2006.

Virginia Children Wait for Medicaid

More than half of Virginia children whose parents applied for Medicaid coverage waited for 4–6 months for their applications to be processed—and 90% went without coverage during that time—as a result of a new federal law requiring proof of citizenship to receive benefits, according to a state survey. The survey of 800 families, conducted by the Virginia Health Care Foundation in partnership with the Virginia Department of Medical Assistance Services, found that the new requirements resulted in a significant decrease in the number of children enrolled in Medicaid in the state, in an inability of citizen children to obtain medical care, and in a dramatic increase in emergency department utilization by those caught up in lengthy eligibility determinations.

Report Disputes SCHIP Numbers

An Urban Institute analysis of uninsured children eligible for the State Children's Health Insurance Program (SCHIP) indicates that far fewer children than previously thought may be eligible for SCHIP. The new study focuses on children who were uninsured for an entire year, unlike other studies that have looked at children who were uninsured for just part of a year. The Health and Human Services Department, which released the new Urban Institute study, said the lower estimate shows that adding $50 billion in additional funding to the SCHIP program is unnecessary. But Democratic senators, who are slated to consider SCHIP reauthorization legislation soon, dismissed the report.

MDs Should Use the Term 'Obese'

Physicians should use blunt, clinical terms such as “overweight” and “obese” to describe conditions currently called “at risk for overweight” and “overweight,” a panel of health experts representing 15 major medical associations said in a report. In recommending the changes, the panel members said that the terms used now allow physicians to avoid counseling patients in need of intervention. The panel also recommended that physicians assess children's weight and body mass index at least once a year and evaluate nutrition and activity habits for all pediatric patients during regular checkups. The panel was convened by the American Medical Association, with funding from federal agencies, and the voluntary guidelines have been endorsed by the American Academy of Pediatrics.

Improved Ped Paxil Settlement

Public Citizen said it has won greater compensation for parents of children who took the antidepressant Paxil but can't provide documentation of their purchase or related costs. In an earlier complaint (Hoormann et al. v. SmithKline Beecham Corp.), the defendants alleged the company misled parents by not disclosing that the drug was dangerous and ineffective for children younger than age 18 years. Paxil maker GlaxoSmithKline Inc. was required to put $63.8 million into a fund to pay class members' out-of-pocket expenses and attorneys' fees, but members who could not provide proof of expenses were limited to a $15 payout and a pro rata share of $300,000, depending on the number of claimants. In a revised settlement approved by the Third Judicial Circuit of Madison County, Ill., claimants without documentation will now get up to $100, and the $300,000 pro rata cap is eliminated, according to the organization Public Citizen. Information on the settlement is at

www.paxilpediatricsettlement.com

Hawaii to Offer Kids Free Flu Shots

This fall, Hawaii will become the first state to offer free influenza vaccinations to school children aged 5–13 years. The shots will be available October 2007-January 2008 at school during the school day. Funding for the estimated $2.5 million program is being provided primarily by the Centers for Disease Control and Prevention and the State of Hawaii, with additional support from the state's largest insurer, the Hawaii Medical Service Association. Nationally, school children have very high rates of influenza illness, exceeding 10% in most years, according to the Hawaii State Department of Health.

AAOS Warns About Wheeled Shoes

The American Academy of Orthopaedic Surgeons (AAOS) has warned that children who wear roller shoes or street gliders—shoes with wheels in the heel—should wear protective gear such as wrist guards and helmets to avoid injuries. According to AAOS President James Beaty, a pediatric orthopaedic surgeon, physicians are seeing children come into their practices with injuries—mostly fractures within the hand, wrist, or elbow—that are attributable to these shoes. The Consumer Product Safety Commission said the agency received reports of one death and at least 64 injuries related to wheeled sneakers between September 2005 and December 2006.

Virginia Children Wait for Medicaid

More than half of Virginia children whose parents applied for Medicaid coverage waited for 4–6 months for their applications to be processed—and 90% went without coverage during that time—as a result of a new federal law requiring proof of citizenship to receive benefits, according to a state survey. The survey of 800 families, conducted by the Virginia Health Care Foundation in partnership with the Virginia Department of Medical Assistance Services, found that the new requirements resulted in a significant decrease in the number of children enrolled in Medicaid in the state, in an inability of citizen children to obtain medical care, and in a dramatic increase in emergency department utilization by those caught up in lengthy eligibility determinations.

Report Disputes SCHIP Numbers

An Urban Institute analysis of uninsured children eligible for the State Children's Health Insurance Program (SCHIP) indicates that far fewer children than previously thought may be eligible for SCHIP. The new study focuses on children who were uninsured for an entire year, unlike other studies that have looked at children who were uninsured for just part of a year. The Health and Human Services Department, which released the new Urban Institute study, said the lower estimate shows that adding $50 billion in additional funding to the SCHIP program is unnecessary. But Democratic senators, who are slated to consider SCHIP reauthorization legislation soon, dismissed the report.

MDs Should Use the Term 'Obese'

Physicians should use blunt, clinical terms such as “overweight” and “obese” to describe conditions currently called “at risk for overweight” and “overweight,” a panel of health experts representing 15 major medical associations said in a report. In recommending the changes, the panel members said that the terms used now allow physicians to avoid counseling patients in need of intervention. The panel also recommended that physicians assess children's weight and body mass index at least once a year and evaluate nutrition and activity habits for all pediatric patients during regular checkups. The panel was convened by the American Medical Association, with funding from federal agencies, and the voluntary guidelines have been endorsed by the American Academy of Pediatrics.

Improved Ped Paxil Settlement

Public Citizen said it has won greater compensation for parents of children who took the antidepressant Paxil but can't provide documentation of their purchase or related costs. In an earlier complaint (Hoormann et al. v. SmithKline Beecham Corp.), the defendants alleged the company misled parents by not disclosing that the drug was dangerous and ineffective for children younger than age 18 years. Paxil maker GlaxoSmithKline Inc. was required to put $63.8 million into a fund to pay class members' out-of-pocket expenses and attorneys' fees, but members who could not provide proof of expenses were limited to a $15 payout and a pro rata share of $300,000, depending on the number of claimants. In a revised settlement approved by the Third Judicial Circuit of Madison County, Ill., claimants without documentation will now get up to $100, and the $300,000 pro rata cap is eliminated, according to the organization Public Citizen. Information on the settlement is at

www.paxilpediatricsettlement.com

Hawaii to Offer Kids Free Flu Shots

This fall, Hawaii will become the first state to offer free influenza vaccinations to school children aged 5–13 years. The shots will be available October 2007-January 2008 at school during the school day. Funding for the estimated $2.5 million program is being provided primarily by the Centers for Disease Control and Prevention and the State of Hawaii, with additional support from the state's largest insurer, the Hawaii Medical Service Association. Nationally, school children have very high rates of influenza illness, exceeding 10% in most years, according to the Hawaii State Department of Health.

AAOS Warns About Wheeled Shoes

The American Academy of Orthopaedic Surgeons (AAOS) has warned that children who wear roller shoes or street gliders—shoes with wheels in the heel—should wear protective gear such as wrist guards and helmets to avoid injuries. According to AAOS President James Beaty, a pediatric orthopaedic surgeon, physicians are seeing children come into their practices with injuries—mostly fractures within the hand, wrist, or elbow—that are attributable to these shoes. The Consumer Product Safety Commission said the agency received reports of one death and at least 64 injuries related to wheeled sneakers between September 2005 and December 2006.

Federal lawmakers were called upon to approve a tobacco tax increase of 61 cents to fund an expansion of the State Children's Health Insurance Program by the American Academy of Family Physicians and the American Medical Association, along with 65 other organizations. In a joint letter, the groups said that reauthorization of the State Children's Health Insurance Program (SCHIP) is “one of the most important tasks before Congress this year.” They noted that SCHIP has significantly improved low-income children's access to care.

“By discouraging smoking through an increase in the tobacco tax and using the resulting revenues to improve enrollment in children's health insurance programs, we are creating a win-win proposition in support of our children's health,” the groups said in the joint letter. “It will also result in long-term savings as children become healthier and more productive members of society.”

Congress has set aside $50 billion in new federal funds over the next 5 years for use in SCHIP, which is scheduled to be reauthorized this year. However, under new “pay-as-you-go” rules, the $50 billion only will be available for SCHIP if Congress cuts other programs or approves new taxes to raise new revenue.

Raising the tobacco tax to provide more funding for SCHIP would help cover many of the 8–9 million uninsured children in the United States while also helping to reduce youth smoking, which would help save health costs down the road, the groups said in the letter to congressional leaders.

“Studies show that every 10% increase in the price of cigarettes reduces youth smoking by 7% and overall cigarette consumption by 4%,” the groups wrote. “Increasing the tobacco tax will also generate hundreds of millions of dollars in health care savings because fewer smokers means fewer people with strokes, heart attacks, cancer, and other smoking-related health conditions.” The groups also included the American Academy of Pediatrics and the American College of Physicians.

Federal lawmakers were called upon to approve a tobacco tax increase of 61 cents to fund an expansion of the State Children's Health Insurance Program by the American Academy of Family Physicians and the American Medical Association, along with 65 other organizations. In a joint letter, the groups said that reauthorization of the State Children's Health Insurance Program (SCHIP) is “one of the most important tasks before Congress this year.” They noted that SCHIP has significantly improved low-income children's access to care.

“By discouraging smoking through an increase in the tobacco tax and using the resulting revenues to improve enrollment in children's health insurance programs, we are creating a win-win proposition in support of our children's health,” the groups said in the joint letter. “It will also result in long-term savings as children become healthier and more productive members of society.”

Congress has set aside $50 billion in new federal funds over the next 5 years for use in SCHIP, which is scheduled to be reauthorized this year. However, under new “pay-as-you-go” rules, the $50 billion only will be available for SCHIP if Congress cuts other programs or approves new taxes to raise new revenue.

Raising the tobacco tax to provide more funding for SCHIP would help cover many of the 8–9 million uninsured children in the United States while also helping to reduce youth smoking, which would help save health costs down the road, the groups said in the letter to congressional leaders.

“Studies show that every 10% increase in the price of cigarettes reduces youth smoking by 7% and overall cigarette consumption by 4%,” the groups wrote. “Increasing the tobacco tax will also generate hundreds of millions of dollars in health care savings because fewer smokers means fewer people with strokes, heart attacks, cancer, and other smoking-related health conditions.” The groups also included the American Academy of Pediatrics and the American College of Physicians.

Federal lawmakers were called upon to approve a tobacco tax increase of 61 cents to fund an expansion of the State Children's Health Insurance Program by the American Academy of Family Physicians and the American Medical Association, along with 65 other organizations. In a joint letter, the groups said that reauthorization of the State Children's Health Insurance Program (SCHIP) is “one of the most important tasks before Congress this year.” They noted that SCHIP has significantly improved low-income children's access to care.

“By discouraging smoking through an increase in the tobacco tax and using the resulting revenues to improve enrollment in children's health insurance programs, we are creating a win-win proposition in support of our children's health,” the groups said in the joint letter. “It will also result in long-term savings as children become healthier and more productive members of society.”

Congress has set aside $50 billion in new federal funds over the next 5 years for use in SCHIP, which is scheduled to be reauthorized this year. However, under new “pay-as-you-go” rules, the $50 billion only will be available for SCHIP if Congress cuts other programs or approves new taxes to raise new revenue.

Raising the tobacco tax to provide more funding for SCHIP would help cover many of the 8–9 million uninsured children in the United States while also helping to reduce youth smoking, which would help save health costs down the road, the groups said in the letter to congressional leaders.

“Studies show that every 10% increase in the price of cigarettes reduces youth smoking by 7% and overall cigarette consumption by 4%,” the groups wrote. “Increasing the tobacco tax will also generate hundreds of millions of dollars in health care savings because fewer smokers means fewer people with strokes, heart attacks, cancer, and other smoking-related health conditions.” The groups also included the American Academy of Pediatrics and the American College of Physicians.

Federal lawmakers have been called upon to approve a tobacco tax increase of 61 cents to fund an expansion of the State Children's Health Insurance Program by the American Academy of Child and Adolescent Psychiatry, the American Academy of Pediatrics, the American Medical Association, along with 64 other organizations.

In a joint letter issued in May, the groups said that reauthorization of the State Children's Health Insurance Program (SCHIP) is “one of the most important tasks before Congress this year.”

They noted that SCHIP has significantly improved access to care for the country's low-income children.

“By discouraging smoking through an increase in the tobacco tax and using the resulting revenues to improve enrollment in children's health insurance programs, we are creating a win-win proposition in support of our children's health,” the groups said in the joint letter.

“It will also result in long-term savings as children become healthier and more productive members of society.”

Congress has set aside $50 billion in new federal funds over the next 5 years for use in SCHIP, which is scheduled to be reauthorized this year.

However, under new “pay-as-you-go” rules, the $50 billion only will be available for SCHIP if Congress cuts other programs or approves new taxes to raise new revenue.

Raising the tobacco tax to provide more funding for SCHIP would help cover many of the 8–9 million uninsured children in the United States while also helping to reduce youth smoking, which would help save health costs down the road, the groups said in the letter to congressional leaders.

“Studies show that every 10% increase in the price of cigarettes reduces youth smoking by 7% and overall cigarette consumption by 4%,” the organizations wrote. Increasing the tobacco tax would also generate hundreds of millions of dollars in health care savings because fewer smokers means fewer people with strokes, heart attacks, cancer, and other smoking-related health conditions.”

Federal lawmakers have been called upon to approve a tobacco tax increase of 61 cents to fund an expansion of the State Children's Health Insurance Program by the American Academy of Child and Adolescent Psychiatry, the American Academy of Pediatrics, the American Medical Association, along with 64 other organizations.

In a joint letter issued in May, the groups said that reauthorization of the State Children's Health Insurance Program (SCHIP) is “one of the most important tasks before Congress this year.”

They noted that SCHIP has significantly improved access to care for the country's low-income children.

“By discouraging smoking through an increase in the tobacco tax and using the resulting revenues to improve enrollment in children's health insurance programs, we are creating a win-win proposition in support of our children's health,” the groups said in the joint letter.

“It will also result in long-term savings as children become healthier and more productive members of society.”

Congress has set aside $50 billion in new federal funds over the next 5 years for use in SCHIP, which is scheduled to be reauthorized this year.

However, under new “pay-as-you-go” rules, the $50 billion only will be available for SCHIP if Congress cuts other programs or approves new taxes to raise new revenue.

Raising the tobacco tax to provide more funding for SCHIP would help cover many of the 8–9 million uninsured children in the United States while also helping to reduce youth smoking, which would help save health costs down the road, the groups said in the letter to congressional leaders.

“Studies show that every 10% increase in the price of cigarettes reduces youth smoking by 7% and overall cigarette consumption by 4%,” the organizations wrote. Increasing the tobacco tax would also generate hundreds of millions of dollars in health care savings because fewer smokers means fewer people with strokes, heart attacks, cancer, and other smoking-related health conditions.”

Federal lawmakers have been called upon to approve a tobacco tax increase of 61 cents to fund an expansion of the State Children's Health Insurance Program by the American Academy of Child and Adolescent Psychiatry, the American Academy of Pediatrics, the American Medical Association, along with 64 other organizations.

In a joint letter issued in May, the groups said that reauthorization of the State Children's Health Insurance Program (SCHIP) is “one of the most important tasks before Congress this year.”

They noted that SCHIP has significantly improved access to care for the country's low-income children.

“By discouraging smoking through an increase in the tobacco tax and using the resulting revenues to improve enrollment in children's health insurance programs, we are creating a win-win proposition in support of our children's health,” the groups said in the joint letter.

“It will also result in long-term savings as children become healthier and more productive members of society.”

Congress has set aside $50 billion in new federal funds over the next 5 years for use in SCHIP, which is scheduled to be reauthorized this year.

However, under new “pay-as-you-go” rules, the $50 billion only will be available for SCHIP if Congress cuts other programs or approves new taxes to raise new revenue.

Raising the tobacco tax to provide more funding for SCHIP would help cover many of the 8–9 million uninsured children in the United States while also helping to reduce youth smoking, which would help save health costs down the road, the groups said in the letter to congressional leaders.

“Studies show that every 10% increase in the price of cigarettes reduces youth smoking by 7% and overall cigarette consumption by 4%,” the organizations wrote. Increasing the tobacco tax would also generate hundreds of millions of dollars in health care savings because fewer smokers means fewer people with strokes, heart attacks, cancer, and other smoking-related health conditions.”

IOM Offers Smoking Measures

A combination of increased excise taxes, nationwide indoor smoking bans, and other measures would significantly lower the U.S. smoking rate, which now hovers at around 21% of the adult population, according to a report from the Institute of Medicine. But to achieve faster, more certain reductions, the Food and Drug Administration should be given broad regulatory authority over tobacco marketing, packaging, and distribution, said the report, Ending the Tobacco Problem: A Blueprint for the Nation. The IOM also recommended requiring all health insurance plans to cover smoking cessation programs and launching new efforts aimed at curbing youth interest in smoking and access to tobacco. The report urged federal lawmakers to limit tobacco advertising to text-only, black-and-white formats, and to prohibit tobacco companies from using terms such as “mild” and “light.” “Aggressive policy initiatives will be necessary to end the tobacco problem,” the report said. “Any slackening of the public health response may reverse decades of progress in reducing tobacco-related disease and death.”

Retiree Plans Offer Rx Coverage

A majority of retiree health benefit sponsors said that for 2006 they continued to offer prescription drug coverage, despite the availability of the new Medicare Part D drug benefit, according to a Government Accountability Office report. Most plans also accepted the government's retiree drug subsidy (RDS) payments, which were created along with the Part D benefit as an incentive for privately sponsored retiree health plans to continue offering drug coverage. The GAO found that, in the short term, retiree health plan sponsors appear to have left drug benefits largely unchanged. But over the longer term, it's not clear whether the availability of the Medicare Part D drug benefit may make it more likely that sponsors will stop offering prescription drug benefits, the GAO said.

Group Medical Costs Rise

The cost of providing group health benefits to employees increased sharply during the past 6 months, with the vast majority of employers, regardless of business size, paying significantly more for account renewals than in the fall of 2006, according to a survey by the Council of Insurance Agents & Brokers. Despite the cost increases, most employers are continuing their traditional coverage plans and shifting costs to employees in the form of higher deductibles and copayments as opposed to limiting options or discontinuing coverage.

AMA Fights Medicare Cuts

Physicians report that they will severely limit the numbers of Medicare patients they treat if Congress doesn't act to avert planned Medicare physician payment cuts, which will total 10% on Jan. 1, 2008, and will reach about 40% over the next 9 years, according to an American Medical Association survey of nearly 9,000 physicians. If Medicare payment rates are cut by 10% in January, 60% of physicians report that they will limit new Medicare patients, and 40% say they will limit established Medicare patients, the AMA survey found. “As physicians brace for nine years of steep payment cuts, it will be extremely difficult for them to continue accepting new Medicare patients into their practices,” said AMA Board Chair Dr. Cecil Wilson. “The baby boomers begin entering the program in 2010, and the Medicare cuts increase the likelihood that there may not be enough doctors to care for the huge influx of new Medicare patients.” MedPAC, Congress' advisory committee on Medicare, has recommended that Congress halt next year's 10% cut and update payments 1.7% in line with practice cost increases. The AMA has launched a publicity campaign to urge federal lawmakers to deflect the cuts and update payment rates based on practice cost increases.

Call to Share Student Mental Info

Legislation in the U.S. House of Representatives would allow schools and universities to share a student's mental health information with parents or guardians, but only if the student is considered a danger to himself or others. Rep. Tim Murphy (R-Pa.), a child psychologist and cochair of the Congressional Mental Health Caucus, sponsored the legislation (H.R. 2220). The bill would clarify the Family Educational Rights and Privacy Act of 1974, which currently inhibits schools from notifying parents when a student might pose a significant risk of suicide, homicide, or assault, according to Rep. Murphy. “We want to remove the barrier that prevents schools from contacting parents to get them the help they need, not only for the safety of their child, but also of others on campus,” he said in a statement.

Bipolar Disorder More Common

A new survey indicates that as many as 4% of American adults might have bipolar disorder at some point in their lifetime, higher than the 1% prevalence found in previous surveys. Researchers from the National Institute of Mental Health queried about 9,282 people from 2001 to 2003 as part of the National Comorbidity Survey-Replication. Based on the survey, the authors reached lifetime estimates of 1% for bipolar I disorder; 1.1% for bipolar II disorder; and 2.4% for subthreshold bipolar disorder. Most patients with a lifetime history of bipolar disorder and lifetime treatment were under the care of psychiatrists; patients with subthreshold bipolar disorder were more likely to receive care from a general medical professional. The study appeared in the May issue of the Archives of General Psychiatry.

IOM Offers Smoking Measures

A combination of increased excise taxes, nationwide indoor smoking bans, and other measures would significantly lower the U.S. smoking rate, which now hovers at around 21% of the adult population, according to a report from the Institute of Medicine. But to achieve faster, more certain reductions, the Food and Drug Administration should be given broad regulatory authority over tobacco marketing, packaging, and distribution, said the report, Ending the Tobacco Problem: A Blueprint for the Nation. The IOM also recommended requiring all health insurance plans to cover smoking cessation programs and launching new efforts aimed at curbing youth interest in smoking and access to tobacco. The report urged federal lawmakers to limit tobacco advertising to text-only, black-and-white formats, and to prohibit tobacco companies from using terms such as “mild” and “light.” “Aggressive policy initiatives will be necessary to end the tobacco problem,” the report said. “Any slackening of the public health response may reverse decades of progress in reducing tobacco-related disease and death.”

Retiree Plans Offer Rx Coverage

A majority of retiree health benefit sponsors said that for 2006 they continued to offer prescription drug coverage, despite the availability of the new Medicare Part D drug benefit, according to a Government Accountability Office report. Most plans also accepted the government's retiree drug subsidy (RDS) payments, which were created along with the Part D benefit as an incentive for privately sponsored retiree health plans to continue offering drug coverage. The GAO found that, in the short term, retiree health plan sponsors appear to have left drug benefits largely unchanged. But over the longer term, it's not clear whether the availability of the Medicare Part D drug benefit may make it more likely that sponsors will stop offering prescription drug benefits, the GAO said.

Group Medical Costs Rise

The cost of providing group health benefits to employees increased sharply during the past 6 months, with the vast majority of employers, regardless of business size, paying significantly more for account renewals than in the fall of 2006, according to a survey by the Council of Insurance Agents & Brokers. Despite the cost increases, most employers are continuing their traditional coverage plans and shifting costs to employees in the form of higher deductibles and copayments as opposed to limiting options or discontinuing coverage.

AMA Fights Medicare Cuts

Physicians report that they will severely limit the numbers of Medicare patients they treat if Congress doesn't act to avert planned Medicare physician payment cuts, which will total 10% on Jan. 1, 2008, and will reach about 40% over the next 9 years, according to an American Medical Association survey of nearly 9,000 physicians. If Medicare payment rates are cut by 10% in January, 60% of physicians report that they will limit new Medicare patients, and 40% say they will limit established Medicare patients, the AMA survey found. “As physicians brace for nine years of steep payment cuts, it will be extremely difficult for them to continue accepting new Medicare patients into their practices,” said AMA Board Chair Dr. Cecil Wilson. “The baby boomers begin entering the program in 2010, and the Medicare cuts increase the likelihood that there may not be enough doctors to care for the huge influx of new Medicare patients.” MedPAC, Congress' advisory committee on Medicare, has recommended that Congress halt next year's 10% cut and update payments 1.7% in line with practice cost increases. The AMA has launched a publicity campaign to urge federal lawmakers to deflect the cuts and update payment rates based on practice cost increases.

Call to Share Student Mental Info

Legislation in the U.S. House of Representatives would allow schools and universities to share a student's mental health information with parents or guardians, but only if the student is considered a danger to himself or others. Rep. Tim Murphy (R-Pa.), a child psychologist and cochair of the Congressional Mental Health Caucus, sponsored the legislation (H.R. 2220). The bill would clarify the Family Educational Rights and Privacy Act of 1974, which currently inhibits schools from notifying parents when a student might pose a significant risk of suicide, homicide, or assault, according to Rep. Murphy. “We want to remove the barrier that prevents schools from contacting parents to get them the help they need, not only for the safety of their child, but also of others on campus,” he said in a statement.

Bipolar Disorder More Common

A new survey indicates that as many as 4% of American adults might have bipolar disorder at some point in their lifetime, higher than the 1% prevalence found in previous surveys. Researchers from the National Institute of Mental Health queried about 9,282 people from 2001 to 2003 as part of the National Comorbidity Survey-Replication. Based on the survey, the authors reached lifetime estimates of 1% for bipolar I disorder; 1.1% for bipolar II disorder; and 2.4% for subthreshold bipolar disorder. Most patients with a lifetime history of bipolar disorder and lifetime treatment were under the care of psychiatrists; patients with subthreshold bipolar disorder were more likely to receive care from a general medical professional. The study appeared in the May issue of the Archives of General Psychiatry.

IOM Offers Smoking Measures

A combination of increased excise taxes, nationwide indoor smoking bans, and other measures would significantly lower the U.S. smoking rate, which now hovers at around 21% of the adult population, according to a report from the Institute of Medicine. But to achieve faster, more certain reductions, the Food and Drug Administration should be given broad regulatory authority over tobacco marketing, packaging, and distribution, said the report, Ending the Tobacco Problem: A Blueprint for the Nation. The IOM also recommended requiring all health insurance plans to cover smoking cessation programs and launching new efforts aimed at curbing youth interest in smoking and access to tobacco. The report urged federal lawmakers to limit tobacco advertising to text-only, black-and-white formats, and to prohibit tobacco companies from using terms such as “mild” and “light.” “Aggressive policy initiatives will be necessary to end the tobacco problem,” the report said. “Any slackening of the public health response may reverse decades of progress in reducing tobacco-related disease and death.”

Retiree Plans Offer Rx Coverage

A majority of retiree health benefit sponsors said that for 2006 they continued to offer prescription drug coverage, despite the availability of the new Medicare Part D drug benefit, according to a Government Accountability Office report. Most plans also accepted the government's retiree drug subsidy (RDS) payments, which were created along with the Part D benefit as an incentive for privately sponsored retiree health plans to continue offering drug coverage. The GAO found that, in the short term, retiree health plan sponsors appear to have left drug benefits largely unchanged. But over the longer term, it's not clear whether the availability of the Medicare Part D drug benefit may make it more likely that sponsors will stop offering prescription drug benefits, the GAO said.

Group Medical Costs Rise

The cost of providing group health benefits to employees increased sharply during the past 6 months, with the vast majority of employers, regardless of business size, paying significantly more for account renewals than in the fall of 2006, according to a survey by the Council of Insurance Agents & Brokers. Despite the cost increases, most employers are continuing their traditional coverage plans and shifting costs to employees in the form of higher deductibles and copayments as opposed to limiting options or discontinuing coverage.

AMA Fights Medicare Cuts

Physicians report that they will severely limit the numbers of Medicare patients they treat if Congress doesn't act to avert planned Medicare physician payment cuts, which will total 10% on Jan. 1, 2008, and will reach about 40% over the next 9 years, according to an American Medical Association survey of nearly 9,000 physicians. If Medicare payment rates are cut by 10% in January, 60% of physicians report that they will limit new Medicare patients, and 40% say they will limit established Medicare patients, the AMA survey found. “As physicians brace for nine years of steep payment cuts, it will be extremely difficult for them to continue accepting new Medicare patients into their practices,” said AMA Board Chair Dr. Cecil Wilson. “The baby boomers begin entering the program in 2010, and the Medicare cuts increase the likelihood that there may not be enough doctors to care for the huge influx of new Medicare patients.” MedPAC, Congress' advisory committee on Medicare, has recommended that Congress halt next year's 10% cut and update payments 1.7% in line with practice cost increases. The AMA has launched a publicity campaign to urge federal lawmakers to deflect the cuts and update payment rates based on practice cost increases.

Call to Share Student Mental Info

Legislation in the U.S. House of Representatives would allow schools and universities to share a student's mental health information with parents or guardians, but only if the student is considered a danger to himself or others. Rep. Tim Murphy (R-Pa.), a child psychologist and cochair of the Congressional Mental Health Caucus, sponsored the legislation (H.R. 2220). The bill would clarify the Family Educational Rights and Privacy Act of 1974, which currently inhibits schools from notifying parents when a student might pose a significant risk of suicide, homicide, or assault, according to Rep. Murphy. “We want to remove the barrier that prevents schools from contacting parents to get them the help they need, not only for the safety of their child, but also of others on campus,” he said in a statement.

Bipolar Disorder More Common

A new survey indicates that as many as 4% of American adults might have bipolar disorder at some point in their lifetime, higher than the 1% prevalence found in previous surveys. Researchers from the National Institute of Mental Health queried about 9,282 people from 2001 to 2003 as part of the National Comorbidity Survey-Replication. Based on the survey, the authors reached lifetime estimates of 1% for bipolar I disorder; 1.1% for bipolar II disorder; and 2.4% for subthreshold bipolar disorder. Most patients with a lifetime history of bipolar disorder and lifetime treatment were under the care of psychiatrists; patients with subthreshold bipolar disorder were more likely to receive care from a general medical professional. The study appeared in the May issue of the Archives of General Psychiatry.

Costs Grow for Medicare Drugs

Prices for 10 of the most prescribed brand-name medications have risen nearly 7% since December under Medicare Part D insurance plans, while wholesale prices for the same drugs have risen just 3%, investigators from the House Oversight and Government Reform Committe reported. The increases could indicate that despite initial success in containing drug prices, Part D plans may be losing some leverage over drug makers and drug prices, according to the investigators, who added that Part D premiums have jumped 13% over the past year. Meanwhile, the rebates insurers are getting from drug manufacturers are less than expected. The committee looked at prices for the top 10 drugs of 2004, most of which have no generic alternatives. For example, they found the cost of a month's supply of Lipitor (atorvastatin) had climbed nearly 10% to more than $84 in mid-April, from about $77 in mid-December. Wholesale prices climbed 5% in that time. Pharmaceutical industry representatives disputed the panel's conclusions. “There is one big glaring omission in the report: The Medicare prescription drug program continues to provide large cost savings to tens of millions of seniors and disabled Americans,” PhRMA Senior Vice President Ken Johnson said in a statement. “Unfortunately, the report focuses on a handful of medicines and tries to draw sweeping conclusions.”

Hospital CEOs See MD Shortage

More than two-thirds of hospital CEOs responding to a survey identified physician shortages as a serious problem that must be addressed soon, and more than three-quarters said that the nurse shortage is a serious problem, according to the Council on Physician and Nurse Supply, which commissioned the survey from health care staffing company AMN Healthcare. Almost all of the 400 CEOs responding said recruiting physicians was difficult or challenging, and almost all favored an expansion of physician training. Eighty-six percent said they are recruiting physicians; 80% of those are looking for primary care physicians and 74% are seeking specialists.

Washington, Kansas Pass Reforms

Governors in Washington and Kansas last month signed legislation to expand access to health coverage in their states. In Washington, Gov. Chris Gregoire (D) gave final approval to a new law that includes a plan for covering more children and young adults by requiring that insurance carriers and state employee programs offer enrollees the opportunity to extend coverage for unmarried children up to age 25. The legislation also creates health record banks to improve provider-patient connectivity, and includes measures aimed at managing chronic illness better. In Kansas, Gov. Kathleen Sebelius (D) signed into law a bipartisan measure that falls short of her goal of providing coverage for all state residents, but nonetheless puts the state “on a path toward coverage for all,” she said. The new law provides assistance to low-income uninsured families to help them buy private coverage, and includes grants to small businesses and loan guarantees to clinics that serve the uninsured. The measure also requires the state to develop a plan for full coverage by next year's legislative session.

Gender Differences in Care

Women with heart disease and diabetes are less likely to receive several types of routine outpatient care than are men who have similar health problems, according to a Rand Corporation study published in the May/June edition of the journal Women's Health Issues. Researchers studied more than 50,000 men and women, examining 11 different screening tests, treatments, or measurements of health status. Among people in commercial plans, women were significantly less likely than were men to receive the care evaluated in 6 of the 11 measures, while women enrolled in Medicare managed care plans were less likely to receive the care evaluated in 4 of the 11 measures. The largest disparity found by researchers was that women were less likely to lower their cholesterol to recommended levels after suffering a heart attack or other acute cardiac event, or if they had diabetes.

OxyContin Maker Pays Fine

Purdue Pharma and three current and former executives pleaded guilty last month in federal court to criminal charges that they misbranded the company's product, OxyContin (oxycodone). The company agreed to pay about $600 million in fines and other payments, while three top executives, including the company's president and its top attorney, agreed to pay a total of $34.5 million in fines. Misbranding involves promoting a drug in unauthorized ways, potentially for unintended and unapproved uses. U.S. Attorney John Brownlee said that Purdue and its executives had deliberately downplayed OxyContin's potential for addiction when promoting it and therefore persuaded physicians to prescribe it.

U.S. Scores Last on Health Care

The United States again ranked last among six nations studied by the Commonwealth Fund on health access, safety, efficiency, and equity measures of health care, the Washington think tank reported. The study, “Mirror, Mirror,” draws on survey responses from primary care physicians and from data from the Commonwealth Fund Commission on a High Performance Health System scorecard, and pits the U.S. health system against those in Australia, Canada, Germany, New Zealand, and the United Kingdom. The United States outperformed all other nations on preventive care delivery but lagged behind on health care information technology and on coordinating chronic disease care. In addition, U.S. patients were more likely than were their peers to forgo treatment because of high costs, the study found.

Costs Grow for Medicare Drugs

Prices for 10 of the most prescribed brand-name medications have risen nearly 7% since December under Medicare Part D insurance plans, while wholesale prices for the same drugs have risen just 3%, investigators from the House Oversight and Government Reform Committe reported. The increases could indicate that despite initial success in containing drug prices, Part D plans may be losing some leverage over drug makers and drug prices, according to the investigators, who added that Part D premiums have jumped 13% over the past year. Meanwhile, the rebates insurers are getting from drug manufacturers are less than expected. The committee looked at prices for the top 10 drugs of 2004, most of which have no generic alternatives. For example, they found the cost of a month's supply of Lipitor (atorvastatin) had climbed nearly 10% to more than $84 in mid-April, from about $77 in mid-December. Wholesale prices climbed 5% in that time. Pharmaceutical industry representatives disputed the panel's conclusions. “There is one big glaring omission in the report: The Medicare prescription drug program continues to provide large cost savings to tens of millions of seniors and disabled Americans,” PhRMA Senior Vice President Ken Johnson said in a statement. “Unfortunately, the report focuses on a handful of medicines and tries to draw sweeping conclusions.”

Hospital CEOs See MD Shortage

More than two-thirds of hospital CEOs responding to a survey identified physician shortages as a serious problem that must be addressed soon, and more than three-quarters said that the nurse shortage is a serious problem, according to the Council on Physician and Nurse Supply, which commissioned the survey from health care staffing company AMN Healthcare. Almost all of the 400 CEOs responding said recruiting physicians was difficult or challenging, and almost all favored an expansion of physician training. Eighty-six percent said they are recruiting physicians; 80% of those are looking for primary care physicians and 74% are seeking specialists.

Washington, Kansas Pass Reforms

Governors in Washington and Kansas last month signed legislation to expand access to health coverage in their states. In Washington, Gov. Chris Gregoire (D) gave final approval to a new law that includes a plan for covering more children and young adults by requiring that insurance carriers and state employee programs offer enrollees the opportunity to extend coverage for unmarried children up to age 25. The legislation also creates health record banks to improve provider-patient connectivity, and includes measures aimed at managing chronic illness better. In Kansas, Gov. Kathleen Sebelius (D) signed into law a bipartisan measure that falls short of her goal of providing coverage for all state residents, but nonetheless puts the state “on a path toward coverage for all,” she said. The new law provides assistance to low-income uninsured families to help them buy private coverage, and includes grants to small businesses and loan guarantees to clinics that serve the uninsured. The measure also requires the state to develop a plan for full coverage by next year's legislative session.

Gender Differences in Care

Women with heart disease and diabetes are less likely to receive several types of routine outpatient care than are men who have similar health problems, according to a Rand Corporation study published in the May/June edition of the journal Women's Health Issues. Researchers studied more than 50,000 men and women, examining 11 different screening tests, treatments, or measurements of health status. Among people in commercial plans, women were significantly less likely than were men to receive the care evaluated in 6 of the 11 measures, while women enrolled in Medicare managed care plans were less likely to receive the care evaluated in 4 of the 11 measures. The largest disparity found by researchers was that women were less likely to lower their cholesterol to recommended levels after suffering a heart attack or other acute cardiac event, or if they had diabetes.

OxyContin Maker Pays Fine

Purdue Pharma and three current and former executives pleaded guilty last month in federal court to criminal charges that they misbranded the company's product, OxyContin (oxycodone). The company agreed to pay about $600 million in fines and other payments, while three top executives, including the company's president and its top attorney, agreed to pay a total of $34.5 million in fines. Misbranding involves promoting a drug in unauthorized ways, potentially for unintended and unapproved uses. U.S. Attorney John Brownlee said that Purdue and its executives had deliberately downplayed OxyContin's potential for addiction when promoting it and therefore persuaded physicians to prescribe it.

U.S. Scores Last on Health Care

The United States again ranked last among six nations studied by the Commonwealth Fund on health access, safety, efficiency, and equity measures of health care, the Washington think tank reported. The study, “Mirror, Mirror,” draws on survey responses from primary care physicians and from data from the Commonwealth Fund Commission on a High Performance Health System scorecard, and pits the U.S. health system against those in Australia, Canada, Germany, New Zealand, and the United Kingdom. The United States outperformed all other nations on preventive care delivery but lagged behind on health care information technology and on coordinating chronic disease care. In addition, U.S. patients were more likely than were their peers to forgo treatment because of high costs, the study found.

Costs Grow for Medicare Drugs

Prices for 10 of the most prescribed brand-name medications have risen nearly 7% since December under Medicare Part D insurance plans, while wholesale prices for the same drugs have risen just 3%, investigators from the House Oversight and Government Reform Committe reported. The increases could indicate that despite initial success in containing drug prices, Part D plans may be losing some leverage over drug makers and drug prices, according to the investigators, who added that Part D premiums have jumped 13% over the past year. Meanwhile, the rebates insurers are getting from drug manufacturers are less than expected. The committee looked at prices for the top 10 drugs of 2004, most of which have no generic alternatives. For example, they found the cost of a month's supply of Lipitor (atorvastatin) had climbed nearly 10% to more than $84 in mid-April, from about $77 in mid-December. Wholesale prices climbed 5% in that time. Pharmaceutical industry representatives disputed the panel's conclusions. “There is one big glaring omission in the report: The Medicare prescription drug program continues to provide large cost savings to tens of millions of seniors and disabled Americans,” PhRMA Senior Vice President Ken Johnson said in a statement. “Unfortunately, the report focuses on a handful of medicines and tries to draw sweeping conclusions.”

Hospital CEOs See MD Shortage

More than two-thirds of hospital CEOs responding to a survey identified physician shortages as a serious problem that must be addressed soon, and more than three-quarters said that the nurse shortage is a serious problem, according to the Council on Physician and Nurse Supply, which commissioned the survey from health care staffing company AMN Healthcare. Almost all of the 400 CEOs responding said recruiting physicians was difficult or challenging, and almost all favored an expansion of physician training. Eighty-six percent said they are recruiting physicians; 80% of those are looking for primary care physicians and 74% are seeking specialists.

Washington, Kansas Pass Reforms

Governors in Washington and Kansas last month signed legislation to expand access to health coverage in their states. In Washington, Gov. Chris Gregoire (D) gave final approval to a new law that includes a plan for covering more children and young adults by requiring that insurance carriers and state employee programs offer enrollees the opportunity to extend coverage for unmarried children up to age 25. The legislation also creates health record banks to improve provider-patient connectivity, and includes measures aimed at managing chronic illness better. In Kansas, Gov. Kathleen Sebelius (D) signed into law a bipartisan measure that falls short of her goal of providing coverage for all state residents, but nonetheless puts the state “on a path toward coverage for all,” she said. The new law provides assistance to low-income uninsured families to help them buy private coverage, and includes grants to small businesses and loan guarantees to clinics that serve the uninsured. The measure also requires the state to develop a plan for full coverage by next year's legislative session.

Gender Differences in Care

Women with heart disease and diabetes are less likely to receive several types of routine outpatient care than are men who have similar health problems, according to a Rand Corporation study published in the May/June edition of the journal Women's Health Issues. Researchers studied more than 50,000 men and women, examining 11 different screening tests, treatments, or measurements of health status. Among people in commercial plans, women were significantly less likely than were men to receive the care evaluated in 6 of the 11 measures, while women enrolled in Medicare managed care plans were less likely to receive the care evaluated in 4 of the 11 measures. The largest disparity found by researchers was that women were less likely to lower their cholesterol to recommended levels after suffering a heart attack or other acute cardiac event, or if they had diabetes.

OxyContin Maker Pays Fine

Purdue Pharma and three current and former executives pleaded guilty last month in federal court to criminal charges that they misbranded the company's product, OxyContin (oxycodone). The company agreed to pay about $600 million in fines and other payments, while three top executives, including the company's president and its top attorney, agreed to pay a total of $34.5 million in fines. Misbranding involves promoting a drug in unauthorized ways, potentially for unintended and unapproved uses. U.S. Attorney John Brownlee said that Purdue and its executives had deliberately downplayed OxyContin's potential for addiction when promoting it and therefore persuaded physicians to prescribe it.

U.S. Scores Last on Health Care

The United States again ranked last among six nations studied by the Commonwealth Fund on health access, safety, efficiency, and equity measures of health care, the Washington think tank reported. The study, “Mirror, Mirror,” draws on survey responses from primary care physicians and from data from the Commonwealth Fund Commission on a High Performance Health System scorecard, and pits the U.S. health system against those in Australia, Canada, Germany, New Zealand, and the United Kingdom. The United States outperformed all other nations on preventive care delivery but lagged behind on health care information technology and on coordinating chronic disease care. In addition, U.S. patients were more likely than were their peers to forgo treatment because of high costs, the study found.