Jane Anderson

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 Committee 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 that 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 Government Reform Committee's 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 committee's report focuses on just 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, while 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. Overall, 86% said they are currently recruiting physicians; 80% of those are looking for primary care physicians, and 74% are seeking specialists.

Washington, Kansas Pass Reforms

Governors in two states last month signed legislation aimed at expanding access to health coverage. 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 with similar health problems, according to a Rand Corp. study published in the May/June edition of the journal Women's Health Issues. Researchers studied more than 50,000 patients, 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 an 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 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 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 data from a Commonwealth Fund scorecard, and compares the U.S. health system with 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 Committee 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 that 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 Government Reform Committee's 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 committee's report focuses on just 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, while 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. Overall, 86% said they are currently recruiting physicians; 80% of those are looking for primary care physicians, and 74% are seeking specialists.

Washington, Kansas Pass Reforms

Governors in two states last month signed legislation aimed at expanding access to health coverage. 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 with similar health problems, according to a Rand Corp. study published in the May/June edition of the journal Women's Health Issues. Researchers studied more than 50,000 patients, 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 an 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 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 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 data from a Commonwealth Fund scorecard, and compares the U.S. health system with 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 Committee 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 that 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 Government Reform Committee's 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 committee's report focuses on just 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, while 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. Overall, 86% said they are currently recruiting physicians; 80% of those are looking for primary care physicians, and 74% are seeking specialists.

Washington, Kansas Pass Reforms

Governors in two states last month signed legislation aimed at expanding access to health coverage. 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 with similar health problems, according to a Rand Corp. study published in the May/June edition of the journal Women's Health Issues. Researchers studied more than 50,000 patients, 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 an 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 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 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 data from a Commonwealth Fund scorecard, and compares the U.S. health system with 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.

IOM: Better School Snacks Needed

The federal government should mandate healthier snack and beverage options for schools, the Institute of Medicine (IOM) recommended in a report requested by Congress. The report is expected to fuel federal efforts to restrict the sale of snack foods and beverages in vending machines and as à la carte items outside of the federal school breakfast and lunch programs. The IOM said that opportunities for children to purchase snack foods and drinks should be limited, and that most snack foods should consist of nutritious fruits, vegetables, whole grains, and nonfat or low-fat milk and dairy products. The IOM also recommended that student access to soda and sports drinks be severely limited. Sen. Tom Harkin (D-Iowa) and Sen. Lisa Murkowski (R-Alaska) are sponsoring legislation that would require the U.S. Department of Agriculture to update its school nutrition standards. “USDA currently uses outdated and incoherent nutritional guidelines for school foods,” Sen. Harkin said in a statement. “Making matters worse, those guidelines apply only to the school cafeteria during mealtime. Kids need only walk outside of the cafeteria in order to purchase soft drinks, chips, and candy bars. This is a junk food loophole big enough to drive a soda pop delivery truck through.”

Depression, Drugs, Alcohol Linked

Recent depression doubled the likelihood that a youth aged 12–17 years dabbled in alcohol or drugs, according to a report by the Substance Abuse and Mental Health Services Administration (SAMHSA). The report showed that 29% of those who faced depression had taken their first drink in the past year, compared with 14% of those who did not face major depression. And, 16% of youths who faced depression and had not previously used illicit drugs began drug use, compared with 7% of youths who had not faced depression. The rates of first-time use for specific drugs, such as marijuana, cocaine, heroin, hallucinogens, inhalants, and nonmedical use of prescription drugs, showed a similar association.

NIH Launches Anti-Obesity Program

The National Institutes of Health is seeking to help communities prevent childhood overweight through a program called We Can! (Ways to Enhance Children's Activity and Nutrition). Launched in South Bend and Gary, Ind., and Roswell, Ga., the program focuses on improved food choices, increased physical activity, and reduced recreational screen time. NIH will provide technical assistance on planning, as well as materials such as parent handbooks, posters, videos, and other tools. In addition, each city will distribute We Can! tips and information to city employees.

THC Levels Highest Ever

With a warning that “this isn't your father's marijuana,” John Walters, the director of the White House Office of National Drug Control Policy, issued a report this spring showing that the levels of tetrahydrocannabinol (THC) in marijuana currently available in this country are the highest ever recorded. The University of Mississippi Potency Monitoring Project found that the average THC level was 8.5%, compared with 4% reported in the early 1980s. Further, a larger proportion of pot has a potency of 9% or higher—a trend that has been increasing since the late 1990s, according to the Potency Monitoring Project. The project receives funding from the National Institute on Drug Abuse and has been analyzing seized marijuana samples since 1976. Mr. Walters said the report should serve “as a wake-up call for parents who may still hold outdated notions about the harms of marijuana.”

Teen Smoking Linked to Ads

The more cigarette marketing that teens are exposed to in retail stores, the more likely they are to smoke, according to a study published in the May issue of Archives of Pediatrics and Adolescent Medicine. Researchers from Bridging the Gap, a policy research program based at the University of Illinois at Chicago and the University of Michigan, Ann Arbor, examined several marketing strategies, including cigarette point-of-sale advertising, cigarette price, and promotions such as multipack discounts and gifts with purchase. They found that point-of-sale advertising is associated with youth trying smoking, that pricing strategies contribute to increases all along the smoking continuum, and that cigarette promotions increase the likelihood that youth will move from experimentation to regular smoking. “Our study shows that the marketing of cigarettes in places where teens shop clearly increases their cigarette use,” said Dr. Sandy Slater, the study's lead author, in a statement. “Restricting these marketing practices would reduce youth smoking.”

IOM: Better School Snacks Needed

The federal government should mandate healthier snack and beverage options for schools, the Institute of Medicine (IOM) recommended in a report requested by Congress. The report is expected to fuel federal efforts to restrict the sale of snack foods and beverages in vending machines and as à la carte items outside of the federal school breakfast and lunch programs. The IOM said that opportunities for children to purchase snack foods and drinks should be limited, and that most snack foods should consist of nutritious fruits, vegetables, whole grains, and nonfat or low-fat milk and dairy products. The IOM also recommended that student access to soda and sports drinks be severely limited. Sen. Tom Harkin (D-Iowa) and Sen. Lisa Murkowski (R-Alaska) are sponsoring legislation that would require the U.S. Department of Agriculture to update its school nutrition standards. “USDA currently uses outdated and incoherent nutritional guidelines for school foods,” Sen. Harkin said in a statement. “Making matters worse, those guidelines apply only to the school cafeteria during mealtime. Kids need only walk outside of the cafeteria in order to purchase soft drinks, chips, and candy bars. This is a junk food loophole big enough to drive a soda pop delivery truck through.”

Depression, Drugs, Alcohol Linked

Recent depression doubled the likelihood that a youth aged 12–17 years dabbled in alcohol or drugs, according to a report by the Substance Abuse and Mental Health Services Administration (SAMHSA). The report showed that 29% of those who faced depression had taken their first drink in the past year, compared with 14% of those who did not face major depression. And, 16% of youths who faced depression and had not previously used illicit drugs began drug use, compared with 7% of youths who had not faced depression. The rates of first-time use for specific drugs, such as marijuana, cocaine, heroin, hallucinogens, inhalants, and nonmedical use of prescription drugs, showed a similar association.

NIH Launches Anti-Obesity Program

The National Institutes of Health is seeking to help communities prevent childhood overweight through a program called We Can! (Ways to Enhance Children's Activity and Nutrition). Launched in South Bend and Gary, Ind., and Roswell, Ga., the program focuses on improved food choices, increased physical activity, and reduced recreational screen time. NIH will provide technical assistance on planning, as well as materials such as parent handbooks, posters, videos, and other tools. In addition, each city will distribute We Can! tips and information to city employees.

THC Levels Highest Ever

With a warning that “this isn't your father's marijuana,” John Walters, the director of the White House Office of National Drug Control Policy, issued a report this spring showing that the levels of tetrahydrocannabinol (THC) in marijuana currently available in this country are the highest ever recorded. The University of Mississippi Potency Monitoring Project found that the average THC level was 8.5%, compared with 4% reported in the early 1980s. Further, a larger proportion of pot has a potency of 9% or higher—a trend that has been increasing since the late 1990s, according to the Potency Monitoring Project. The project receives funding from the National Institute on Drug Abuse and has been analyzing seized marijuana samples since 1976. Mr. Walters said the report should serve “as a wake-up call for parents who may still hold outdated notions about the harms of marijuana.”

Teen Smoking Linked to Ads

The more cigarette marketing that teens are exposed to in retail stores, the more likely they are to smoke, according to a study published in the May issue of Archives of Pediatrics and Adolescent Medicine. Researchers from Bridging the Gap, a policy research program based at the University of Illinois at Chicago and the University of Michigan, Ann Arbor, examined several marketing strategies, including cigarette point-of-sale advertising, cigarette price, and promotions such as multipack discounts and gifts with purchase. They found that point-of-sale advertising is associated with youth trying smoking, that pricing strategies contribute to increases all along the smoking continuum, and that cigarette promotions increase the likelihood that youth will move from experimentation to regular smoking. “Our study shows that the marketing of cigarettes in places where teens shop clearly increases their cigarette use,” said Dr. Sandy Slater, the study's lead author, in a statement. “Restricting these marketing practices would reduce youth smoking.”

IOM: Better School Snacks Needed

The federal government should mandate healthier snack and beverage options for schools, the Institute of Medicine (IOM) recommended in a report requested by Congress. The report is expected to fuel federal efforts to restrict the sale of snack foods and beverages in vending machines and as à la carte items outside of the federal school breakfast and lunch programs. The IOM said that opportunities for children to purchase snack foods and drinks should be limited, and that most snack foods should consist of nutritious fruits, vegetables, whole grains, and nonfat or low-fat milk and dairy products. The IOM also recommended that student access to soda and sports drinks be severely limited. Sen. Tom Harkin (D-Iowa) and Sen. Lisa Murkowski (R-Alaska) are sponsoring legislation that would require the U.S. Department of Agriculture to update its school nutrition standards. “USDA currently uses outdated and incoherent nutritional guidelines for school foods,” Sen. Harkin said in a statement. “Making matters worse, those guidelines apply only to the school cafeteria during mealtime. Kids need only walk outside of the cafeteria in order to purchase soft drinks, chips, and candy bars. This is a junk food loophole big enough to drive a soda pop delivery truck through.”

Depression, Drugs, Alcohol Linked

Recent depression doubled the likelihood that a youth aged 12–17 years dabbled in alcohol or drugs, according to a report by the Substance Abuse and Mental Health Services Administration (SAMHSA). The report showed that 29% of those who faced depression had taken their first drink in the past year, compared with 14% of those who did not face major depression. And, 16% of youths who faced depression and had not previously used illicit drugs began drug use, compared with 7% of youths who had not faced depression. The rates of first-time use for specific drugs, such as marijuana, cocaine, heroin, hallucinogens, inhalants, and nonmedical use of prescription drugs, showed a similar association.

NIH Launches Anti-Obesity Program

The National Institutes of Health is seeking to help communities prevent childhood overweight through a program called We Can! (Ways to Enhance Children's Activity and Nutrition). Launched in South Bend and Gary, Ind., and Roswell, Ga., the program focuses on improved food choices, increased physical activity, and reduced recreational screen time. NIH will provide technical assistance on planning, as well as materials such as parent handbooks, posters, videos, and other tools. In addition, each city will distribute We Can! tips and information to city employees.

THC Levels Highest Ever

With a warning that “this isn't your father's marijuana,” John Walters, the director of the White House Office of National Drug Control Policy, issued a report this spring showing that the levels of tetrahydrocannabinol (THC) in marijuana currently available in this country are the highest ever recorded. The University of Mississippi Potency Monitoring Project found that the average THC level was 8.5%, compared with 4% reported in the early 1980s. Further, a larger proportion of pot has a potency of 9% or higher—a trend that has been increasing since the late 1990s, according to the Potency Monitoring Project. The project receives funding from the National Institute on Drug Abuse and has been analyzing seized marijuana samples since 1976. Mr. Walters said the report should serve “as a wake-up call for parents who may still hold outdated notions about the harms of marijuana.”

Teen Smoking Linked to Ads

The more cigarette marketing that teens are exposed to in retail stores, the more likely they are to smoke, according to a study published in the May issue of Archives of Pediatrics and Adolescent Medicine. Researchers from Bridging the Gap, a policy research program based at the University of Illinois at Chicago and the University of Michigan, Ann Arbor, examined several marketing strategies, including cigarette point-of-sale advertising, cigarette price, and promotions such as multipack discounts and gifts with purchase. They found that point-of-sale advertising is associated with youth trying smoking, that pricing strategies contribute to increases all along the smoking continuum, and that cigarette promotions increase the likelihood that youth will move from experimentation to regular smoking. “Our study shows that the marketing of cigarettes in places where teens shop clearly increases their cigarette use,” said Dr. Sandy Slater, the study's lead author, in a statement. “Restricting these marketing practices would reduce youth smoking.”

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 last month by the American Academy of Pediatrics 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.”

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 last month by the American Academy of Pediatrics 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.”

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 last month by the American Academy of Pediatrics 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.”

Rural children are much more dependent on the State Children's Health Insurance Program than are urban children and also have less of a safety net to fall back on if the popular public insurance program is cut, a new study found.

The study, released in May by the Carsey Institute at the University of New Hampshire, Durham, found that in 2005, 32% of children in rural areas relied on SCHIP or Medicaid, compared with 26% of children in cities. The report also found more rural children living in economically vulnerable families, with 47% of rural children living in low-income families in 2005, compared with 38% of urban families.

“Rural leaders should realize that SCHIP reauthorization is vitally important for rural areas,” said William O'Hare, report author and senior fellow at the Carsey Institute, in an interview.

Nationwide, approximately 28 million children receive health insurance from Medicaid, and an additional 6 million are covered by SCHIP. About 4 million children in rural areas relied on SCHIP or Medicaid in 2005.

Congress is due to reauthorize SCHIP this year and proposals to expand coverage to more families and to increase funding are under consideration.

Ron Pollack, executive director of the Washington-based advocacy group Families USA, said in a statement that the report demonstrates how important it is to expand the SCHIP program to cover uninsured children in rural communities.

While Medicaid and SCHIP are covering more children each year, more than 8 million children under age 18 still lack health insurance. In rural areas, the Carsey Institute study found that a majority of uninsured children (54%) live in families where the head of the household works full-time year-round.

Meanwhile, from 1996 to 2005, the number of children covered by private health insurance steadily declined, while the number of those covered by SCHIP and Medicaid steadily increased. In rural communities, the steady loss of manufacturing jobs has contributed to the loss of private health insurance coverage, the study said.

The shift from private insurance to public programs is much more prominent in rural areas, Mr. O'Hare said. “The jobs being lost in rural areas have good benefits,” he said. Among rural children in low-income families, the share covered by SCHIP and Medicaid increased from 38% in 1998 to 54% in 2005, while children covered through parents' employers fell by 10 percentage points over the same period.

Previous studies also have found that as many as 20 million children live without health insurance at some point in the year, and that is especially true in families in which a parent is employed in seasonal or cyclical work, which can be more prevalent in rural areas.

Mr. O'Hare said that access to health care in rural areas also is impeded by a shortage of providers, especially pediatricians. In addition to insurance, there are other medical or health care disadvantages,” he said. “The reauthorization of SCHIP is just the tip of the iceberg in trying to get good medical care to rural children. It's an important first step, but it's just a first step.”

Rural children are much more dependent on the State Children's Health Insurance Program than are urban children and also have less of a safety net to fall back on if the popular public insurance program is cut, a new study found.

The study, released in May by the Carsey Institute at the University of New Hampshire, Durham, found that in 2005, 32% of children in rural areas relied on SCHIP or Medicaid, compared with 26% of children in cities. The report also found more rural children living in economically vulnerable families, with 47% of rural children living in low-income families in 2005, compared with 38% of urban families.

“Rural leaders should realize that SCHIP reauthorization is vitally important for rural areas,” said William O'Hare, report author and senior fellow at the Carsey Institute, in an interview.

Nationwide, approximately 28 million children receive health insurance from Medicaid, and an additional 6 million are covered by SCHIP. About 4 million children in rural areas relied on SCHIP or Medicaid in 2005.

Congress is due to reauthorize SCHIP this year and proposals to expand coverage to more families and to increase funding are under consideration.

Ron Pollack, executive director of the Washington-based advocacy group Families USA, said in a statement that the report demonstrates how important it is to expand the SCHIP program to cover uninsured children in rural communities.

While Medicaid and SCHIP are covering more children each year, more than 8 million children under age 18 still lack health insurance. In rural areas, the Carsey Institute study found that a majority of uninsured children (54%) live in families where the head of the household works full-time year-round.

Meanwhile, from 1996 to 2005, the number of children covered by private health insurance steadily declined, while the number of those covered by SCHIP and Medicaid steadily increased. In rural communities, the steady loss of manufacturing jobs has contributed to the loss of private health insurance coverage, the study said.

The shift from private insurance to public programs is much more prominent in rural areas, Mr. O'Hare said. “The jobs being lost in rural areas have good benefits,” he said. Among rural children in low-income families, the share covered by SCHIP and Medicaid increased from 38% in 1998 to 54% in 2005, while children covered through parents' employers fell by 10 percentage points over the same period.

Previous studies also have found that as many as 20 million children live without health insurance at some point in the year, and that is especially true in families in which a parent is employed in seasonal or cyclical work, which can be more prevalent in rural areas.

Mr. O'Hare said that access to health care in rural areas also is impeded by a shortage of providers, especially pediatricians. In addition to insurance, there are other medical or health care disadvantages,” he said. “The reauthorization of SCHIP is just the tip of the iceberg in trying to get good medical care to rural children. It's an important first step, but it's just a first step.”

Rural children are much more dependent on the State Children's Health Insurance Program than are urban children and also have less of a safety net to fall back on if the popular public insurance program is cut, a new study found.

The study, released in May by the Carsey Institute at the University of New Hampshire, Durham, found that in 2005, 32% of children in rural areas relied on SCHIP or Medicaid, compared with 26% of children in cities. The report also found more rural children living in economically vulnerable families, with 47% of rural children living in low-income families in 2005, compared with 38% of urban families.

“Rural leaders should realize that SCHIP reauthorization is vitally important for rural areas,” said William O'Hare, report author and senior fellow at the Carsey Institute, in an interview.

Nationwide, approximately 28 million children receive health insurance from Medicaid, and an additional 6 million are covered by SCHIP. About 4 million children in rural areas relied on SCHIP or Medicaid in 2005.

Congress is due to reauthorize SCHIP this year and proposals to expand coverage to more families and to increase funding are under consideration.

Ron Pollack, executive director of the Washington-based advocacy group Families USA, said in a statement that the report demonstrates how important it is to expand the SCHIP program to cover uninsured children in rural communities.

While Medicaid and SCHIP are covering more children each year, more than 8 million children under age 18 still lack health insurance. In rural areas, the Carsey Institute study found that a majority of uninsured children (54%) live in families where the head of the household works full-time year-round.

Meanwhile, from 1996 to 2005, the number of children covered by private health insurance steadily declined, while the number of those covered by SCHIP and Medicaid steadily increased. In rural communities, the steady loss of manufacturing jobs has contributed to the loss of private health insurance coverage, the study said.

The shift from private insurance to public programs is much more prominent in rural areas, Mr. O'Hare said. “The jobs being lost in rural areas have good benefits,” he said. Among rural children in low-income families, the share covered by SCHIP and Medicaid increased from 38% in 1998 to 54% in 2005, while children covered through parents' employers fell by 10 percentage points over the same period.

Previous studies also have found that as many as 20 million children live without health insurance at some point in the year, and that is especially true in families in which a parent is employed in seasonal or cyclical work, which can be more prevalent in rural areas.

Mr. O'Hare said that access to health care in rural areas also is impeded by a shortage of providers, especially pediatricians. In addition to insurance, there are other medical or health care disadvantages,” he said. “The reauthorization of SCHIP is just the tip of the iceberg in trying to get good medical care to rural children. It's an important first step, but it's just a first step.”

CMS Urged to Improve Efficiency

Medicare patients who see an “outlier generalist,” a physician who treats a disproportionate share of overly expensive patients, were more likely to have been hospitalized, more likely to have been hospitalized multiple times, and more likely to have used home health services than were other Medicare patients, the Government Accountability Office found in a report. Based on those findings, the GAO recommended the Centers for Medicare & Medicaid Services develop a system that identifies individual physicians with inefficient practice patterns and uses the results to improve the efficiency of care in the Medicare system. Although CMS has discussed only using profiling results for educating physicians, the optimal system, says the GAO, would include financial or other incentives to encourage efficiency.

Overcrowded Hospitals Riskier?

Hospitals that operate at or over their capacity might be at increased risk of adverse events that injure patients, according to a study led by investigators from Massachusetts General Hospital (MGH) and Brigham and Woman's Hospital, both in Boston. The report in the May issue of the journal Medical Care suggests that efforts to reduce costs and improve patient safety might work against each other. The researchers reviewed data from four hospitals in two states over 12 months and identified 1,530 preventable injuries not resulting from patients' underlying medical conditions. At three of the four hospitals, the rate of adverse events did not appear to increase at times of peak workload. But at the fourth—a major urban teaching hospital with consistently high occupancy rates that exceeded 100% for more than 3 months—workload increases and higher patient-to-nurse ratios were associated with more adverse events. “Our study suggests that pushing efficiency efforts to their limits could be a double-edged sword that may jeopardize patient safety,” said study lead author Dr. Joel Weissman of the MGH Institute of Public Policy in a statement.

N.H. Rx Law Struck Down

A federal judge in New Hampshire has struck down a state law that banned the commercial use of provider-identifiable prescription information, finding that it is “unconstitutionally restricted speech.” Judge Paul Barbadoro ruled in favor of health information companies IMS Health, Norwalk, Conn., and Verispan LLC, Yardley, Pa., which jointly filed a lawsuit seeking to prevent the state from enforcing the statute, which went into effect last June. The law was the first in the nation to ban the commercial use of information on what medications individual physicians prescribe. New Hampshire had argued that the law aimed to protect physicians' privacy, end inappropriate pharmaceutical marketing, and cut health care costs. The plaintiffs, meanwhile, said that using physicians' prescription data is crucial to improving quality. “The free flow of health care information is central to evidence-based medicine and improved patient outcomes,” said IMS vice president Randolph Frankel in a statement.

Debridement Restrictions Lifted

The American Academy of Family Physicians (AAFP) said it has succeeded in its drive to remove restrictive language from a Medicare carrier's draft local coverage determination on wound care. The restriction would have affected physicians in Texas, Delaware, Maryland, and Virginia. Last December, AAFP questioned TrailBlazer Health Enterprises' proposed debridement limits of three times for one wound. AAFP said that although repetitive debridement of one wound is uncommon, sometimes, serial debridement is the only option. TrailBlazer removed the restrictions from its final policy, released in April.

IT Bill Would Aid Small Practices

In an effort to help physicians who want to adopt health information technology (HIT) systems but can't afford the investment, Reps. Charlie Gonzalez (D-Tex.) and Phil Gingrey (R-Ga.) have introduced legislation that would provide grants, loans, and tax incentives to small practices that implement computer systems. The bill is designed to facilitate the development and adoption of national standards and to provide initial financial support and ongoing reimbursement incentives for physicians in smaller practices to adopt HIT to support quality improvement activities. The legislation is based in large part on ideas developed by the American College of Physicians (ACP), the physicians' group said. Studies have estimated that the initial cost for an electronic health records system averages $44,000 per physician, and the systems cost $8,500 per physician annually to maintain. “The proposed financial incentives would make it possible for physicians in small practices to invest in the technology and encourage its continued use to improve patient care,” said Dr. Lynne Kirk, ACP president.

Adults Disregard MDs' Orders

Forty-four percent of U.S. adults say they or an immediate family member have ignored a doctor's course of treatment or sought a second opinion because they felt the doctor's orders were unnecessary or overly aggressive, according to a survey. Most adults reported that they didn't view disregarding a doctor's recommendations as problematic or consequential. Only 1 in 10 adults who chose to disregard a physician's instructions at some time believes that he or she or a family member experienced problems because of this decision, with the most common consequence being lost time from work or school. The survey, by Harris Interactive for the Wall Street Journal Online's health industry edition, also found that a majority of adults think patients who have medical conditions often experience problems because of overtreatment as well as undertreatment by medical providers.

CMS Urged to Improve Efficiency

Medicare patients who see an “outlier generalist,” a physician who treats a disproportionate share of overly expensive patients, were more likely to have been hospitalized, more likely to have been hospitalized multiple times, and more likely to have used home health services than were other Medicare patients, the Government Accountability Office found in a report. Based on those findings, the GAO recommended the Centers for Medicare & Medicaid Services develop a system that identifies individual physicians with inefficient practice patterns and uses the results to improve the efficiency of care in the Medicare system. Although CMS has discussed only using profiling results for educating physicians, the optimal system, says the GAO, would include financial or other incentives to encourage efficiency.

Overcrowded Hospitals Riskier?

Hospitals that operate at or over their capacity might be at increased risk of adverse events that injure patients, according to a study led by investigators from Massachusetts General Hospital (MGH) and Brigham and Woman's Hospital, both in Boston. The report in the May issue of the journal Medical Care suggests that efforts to reduce costs and improve patient safety might work against each other. The researchers reviewed data from four hospitals in two states over 12 months and identified 1,530 preventable injuries not resulting from patients' underlying medical conditions. At three of the four hospitals, the rate of adverse events did not appear to increase at times of peak workload. But at the fourth—a major urban teaching hospital with consistently high occupancy rates that exceeded 100% for more than 3 months—workload increases and higher patient-to-nurse ratios were associated with more adverse events. “Our study suggests that pushing efficiency efforts to their limits could be a double-edged sword that may jeopardize patient safety,” said study lead author Dr. Joel Weissman of the MGH Institute of Public Policy in a statement.

N.H. Rx Law Struck Down

A federal judge in New Hampshire has struck down a state law that banned the commercial use of provider-identifiable prescription information, finding that it is “unconstitutionally restricted speech.” Judge Paul Barbadoro ruled in favor of health information companies IMS Health, Norwalk, Conn., and Verispan LLC, Yardley, Pa., which jointly filed a lawsuit seeking to prevent the state from enforcing the statute, which went into effect last June. The law was the first in the nation to ban the commercial use of information on what medications individual physicians prescribe. New Hampshire had argued that the law aimed to protect physicians' privacy, end inappropriate pharmaceutical marketing, and cut health care costs. The plaintiffs, meanwhile, said that using physicians' prescription data is crucial to improving quality. “The free flow of health care information is central to evidence-based medicine and improved patient outcomes,” said IMS vice president Randolph Frankel in a statement.

Debridement Restrictions Lifted

The American Academy of Family Physicians (AAFP) said it has succeeded in its drive to remove restrictive language from a Medicare carrier's draft local coverage determination on wound care. The restriction would have affected physicians in Texas, Delaware, Maryland, and Virginia. Last December, AAFP questioned TrailBlazer Health Enterprises' proposed debridement limits of three times for one wound. AAFP said that although repetitive debridement of one wound is uncommon, sometimes, serial debridement is the only option. TrailBlazer removed the restrictions from its final policy, released in April.

IT Bill Would Aid Small Practices

In an effort to help physicians who want to adopt health information technology (HIT) systems but can't afford the investment, Reps. Charlie Gonzalez (D-Tex.) and Phil Gingrey (R-Ga.) have introduced legislation that would provide grants, loans, and tax incentives to small practices that implement computer systems. The bill is designed to facilitate the development and adoption of national standards and to provide initial financial support and ongoing reimbursement incentives for physicians in smaller practices to adopt HIT to support quality improvement activities. The legislation is based in large part on ideas developed by the American College of Physicians (ACP), the physicians' group said. Studies have estimated that the initial cost for an electronic health records system averages $44,000 per physician, and the systems cost $8,500 per physician annually to maintain. “The proposed financial incentives would make it possible for physicians in small practices to invest in the technology and encourage its continued use to improve patient care,” said Dr. Lynne Kirk, ACP president.

Adults Disregard MDs' Orders

Forty-four percent of U.S. adults say they or an immediate family member have ignored a doctor's course of treatment or sought a second opinion because they felt the doctor's orders were unnecessary or overly aggressive, according to a survey. Most adults reported that they didn't view disregarding a doctor's recommendations as problematic or consequential. Only 1 in 10 adults who chose to disregard a physician's instructions at some time believes that he or she or a family member experienced problems because of this decision, with the most common consequence being lost time from work or school. The survey, by Harris Interactive for the Wall Street Journal Online's health industry edition, also found that a majority of adults think patients who have medical conditions often experience problems because of overtreatment as well as undertreatment by medical providers.

CMS Urged to Improve Efficiency

Medicare patients who see an “outlier generalist,” a physician who treats a disproportionate share of overly expensive patients, were more likely to have been hospitalized, more likely to have been hospitalized multiple times, and more likely to have used home health services than were other Medicare patients, the Government Accountability Office found in a report. Based on those findings, the GAO recommended the Centers for Medicare & Medicaid Services develop a system that identifies individual physicians with inefficient practice patterns and uses the results to improve the efficiency of care in the Medicare system. Although CMS has discussed only using profiling results for educating physicians, the optimal system, says the GAO, would include financial or other incentives to encourage efficiency.

Overcrowded Hospitals Riskier?

Hospitals that operate at or over their capacity might be at increased risk of adverse events that injure patients, according to a study led by investigators from Massachusetts General Hospital (MGH) and Brigham and Woman's Hospital, both in Boston. The report in the May issue of the journal Medical Care suggests that efforts to reduce costs and improve patient safety might work against each other. The researchers reviewed data from four hospitals in two states over 12 months and identified 1,530 preventable injuries not resulting from patients' underlying medical conditions. At three of the four hospitals, the rate of adverse events did not appear to increase at times of peak workload. But at the fourth—a major urban teaching hospital with consistently high occupancy rates that exceeded 100% for more than 3 months—workload increases and higher patient-to-nurse ratios were associated with more adverse events. “Our study suggests that pushing efficiency efforts to their limits could be a double-edged sword that may jeopardize patient safety,” said study lead author Dr. Joel Weissman of the MGH Institute of Public Policy in a statement.

N.H. Rx Law Struck Down

A federal judge in New Hampshire has struck down a state law that banned the commercial use of provider-identifiable prescription information, finding that it is “unconstitutionally restricted speech.” Judge Paul Barbadoro ruled in favor of health information companies IMS Health, Norwalk, Conn., and Verispan LLC, Yardley, Pa., which jointly filed a lawsuit seeking to prevent the state from enforcing the statute, which went into effect last June. The law was the first in the nation to ban the commercial use of information on what medications individual physicians prescribe. New Hampshire had argued that the law aimed to protect physicians' privacy, end inappropriate pharmaceutical marketing, and cut health care costs. The plaintiffs, meanwhile, said that using physicians' prescription data is crucial to improving quality. “The free flow of health care information is central to evidence-based medicine and improved patient outcomes,” said IMS vice president Randolph Frankel in a statement.

Debridement Restrictions Lifted

The American Academy of Family Physicians (AAFP) said it has succeeded in its drive to remove restrictive language from a Medicare carrier's draft local coverage determination on wound care. The restriction would have affected physicians in Texas, Delaware, Maryland, and Virginia. Last December, AAFP questioned TrailBlazer Health Enterprises' proposed debridement limits of three times for one wound. AAFP said that although repetitive debridement of one wound is uncommon, sometimes, serial debridement is the only option. TrailBlazer removed the restrictions from its final policy, released in April.

IT Bill Would Aid Small Practices

In an effort to help physicians who want to adopt health information technology (HIT) systems but can't afford the investment, Reps. Charlie Gonzalez (D-Tex.) and Phil Gingrey (R-Ga.) have introduced legislation that would provide grants, loans, and tax incentives to small practices that implement computer systems. The bill is designed to facilitate the development and adoption of national standards and to provide initial financial support and ongoing reimbursement incentives for physicians in smaller practices to adopt HIT to support quality improvement activities. The legislation is based in large part on ideas developed by the American College of Physicians (ACP), the physicians' group said. Studies have estimated that the initial cost for an electronic health records system averages $44,000 per physician, and the systems cost $8,500 per physician annually to maintain. “The proposed financial incentives would make it possible for physicians in small practices to invest in the technology and encourage its continued use to improve patient care,” said Dr. Lynne Kirk, ACP president.

Adults Disregard MDs' Orders

Forty-four percent of U.S. adults say they or an immediate family member have ignored a doctor's course of treatment or sought a second opinion because they felt the doctor's orders were unnecessary or overly aggressive, according to a survey. Most adults reported that they didn't view disregarding a doctor's recommendations as problematic or consequential. Only 1 in 10 adults who chose to disregard a physician's instructions at some time believes that he or she or a family member experienced problems because of this decision, with the most common consequence being lost time from work or school. The survey, by Harris Interactive for the Wall Street Journal Online's health industry edition, also found that a majority of adults think patients who have medical conditions often experience problems because of overtreatment as well as undertreatment by medical providers.

CMS Urged to Improve Efficiency

Medicare patients who see an “outlier generalist,” a physician who treats a disproportionate share of overly expensive patients, were more likely to have been hospitalized, more likely to have been hospitalized multiple times, and more likely to have used home health services than were other Medicare patients, the Government Accountability Office found in a report. Based on those findings, the GAO recommended that the Centers for Medicare and Medicaid Services develop a system that identifies individual physicians with inefficient practice patterns and uses the results to improve the efficiency of care in the Medicare system. Although CMS has discussed only using profiling results for educating physicians, the optimal system, according to the GAO, would include financial or other incentives to encourage efficiency.

Overcrowded Hospitals Riskier?

Hospitals that operate at or over their capacity might be at increased risk of adverse events that injure patients, according to a study led by investigators from Massachusetts General Hospital (MGH) and Brigham and Woman's Hospital, both in Boston. The report in the May issue of the journal Medical Care suggests that efforts to reduce costs and improve patient safety might work against each other. The researchers reviewed data from four hospitals in two states over 12 months and identified 1,530 preventable injuries not resulting from patients' underlying medical conditions. At three of the four hospitals, the rate of adverse events did not appear to increase at times of peak workload. But at the fourth—a major urban teaching hospital with consistently high occupancy rates that exceeded 100% for more than 3 months—workload increases and higher patient-to-nurse ratios were associated with more adverse events. “Our study suggests that pushing efficiency efforts to their limits could be a double-edged sword that may jeopardize patient safety,” said study lead author Dr. Joel Weissman of the MGH Institute of Public Policy in a statement.

N.H. Rx Law Struck Down

A federal judge in New Hampshire has struck down a state law banning commercial use of provider-identifiable prescription information, finding that it “unconstitutionally restricted speech.” Judge Paul Barbadoro ruled in favor of health information companies IMS Health and Verispan LLC, which jointly filed a lawsuit seeking to prevent the state from enforcing the statute, which went into effect last June. The law was the first in the nation to ban the commercial use of information on what medications individual physicians prescribe. New Hampshire argued that the law aimed to protect physicians' privacy, end inappropriate pharmaceutical marketing, and cut costs. The plaintiffs said that using physicians' prescription data is crucial to improving quality. “The free flow of health care information is central to evidence-based medicine and improved patient outcomes,” said IMS vice president Randolph Frankel in a statement.

IT Bill Would Aid Small Practices

Seeking to help physicians who might like to adopt health information technology (HIT) systems but cannot afford the investment, Reps. Charlie Gonzalez (D-Tex.) and Phil Gingrey (R-Ga.) have introduced legislation that would provide grants, loans, and tax incentives to small practices that implement computer systems. The bill is designed to facilitate the development and adoption of national standards, and to provide initial financial support and ongoing reimbursement incentives for physicians in smaller practices to adopt HIT to support quality improvement activities. The legislation is based in large part on ideas originally developed by the American College of Physicians (ACP), the physicians' group said. Studies have estimated that an electronic health records system averages $44,000 per physician initially, and $8,500 per physician annually to maintain. “The proposed financial incentives would make it possible for physicians in small practices to invest in the technology and encourage its continued use to improve patient care,” said Dr. Lynne Kirk, ACP president.

Debridement Restrictions Lifted

The American Academy of Family Physicians (AAFP) said it has succeeded in its drive to remove restrictive language from a Medicare carrier's draft local coverage determination on wound care. The restriction would have affected physicians in Delaware, Maryland, Texas, and Virginia. Last December, AAFP questioned TrailBlazer Health Enterprises' proposed debridement limits of three times for one wound. AAFP said that although repetitive debridement of one wound is uncommon, sometimes serial debridement is the only option. TrailBlazer removed the restrictions from its final policy, released in April.

Adults Disregard MDs' Orders

In a recent survey, 44% of U.S. adults said that they or an immediate family member have ignored a doctor's course of treatment or sought a second opinion because they felt the doctor's orders were unnecessary or overly aggressive. Most adults reported that they didn't view disregarding a doctor's recommendations as problematic or consequential. Only 1 in 10 adults who chose to disregard a physician's instructions at some time believes that he or she or a family member experienced problems because of this decision, with the most common consequence being lost time from work or school. The survey, conducted by Harris Interactive for the Wall Street Journal Online's health industry edition, also found that a large majority of adults think patients who have medical conditions often experience problems because of overtreatment as well as undertreatment by medical providers.

CMS Urged to Improve Efficiency

Medicare patients who see an “outlier generalist,” a physician who treats a disproportionate share of overly expensive patients, were more likely to have been hospitalized, more likely to have been hospitalized multiple times, and more likely to have used home health services than were other Medicare patients, the Government Accountability Office found in a report. Based on those findings, the GAO recommended that the Centers for Medicare and Medicaid Services develop a system that identifies individual physicians with inefficient practice patterns and uses the results to improve the efficiency of care in the Medicare system. Although CMS has discussed only using profiling results for educating physicians, the optimal system, according to the GAO, would include financial or other incentives to encourage efficiency.

Overcrowded Hospitals Riskier?

Hospitals that operate at or over their capacity might be at increased risk of adverse events that injure patients, according to a study led by investigators from Massachusetts General Hospital (MGH) and Brigham and Woman's Hospital, both in Boston. The report in the May issue of the journal Medical Care suggests that efforts to reduce costs and improve patient safety might work against each other. The researchers reviewed data from four hospitals in two states over 12 months and identified 1,530 preventable injuries not resulting from patients' underlying medical conditions. At three of the four hospitals, the rate of adverse events did not appear to increase at times of peak workload. But at the fourth—a major urban teaching hospital with consistently high occupancy rates that exceeded 100% for more than 3 months—workload increases and higher patient-to-nurse ratios were associated with more adverse events. “Our study suggests that pushing efficiency efforts to their limits could be a double-edged sword that may jeopardize patient safety,” said study lead author Dr. Joel Weissman of the MGH Institute of Public Policy in a statement.

N.H. Rx Law Struck Down

A federal judge in New Hampshire has struck down a state law banning commercial use of provider-identifiable prescription information, finding that it “unconstitutionally restricted speech.” Judge Paul Barbadoro ruled in favor of health information companies IMS Health and Verispan LLC, which jointly filed a lawsuit seeking to prevent the state from enforcing the statute, which went into effect last June. The law was the first in the nation to ban the commercial use of information on what medications individual physicians prescribe. New Hampshire argued that the law aimed to protect physicians' privacy, end inappropriate pharmaceutical marketing, and cut costs. The plaintiffs said that using physicians' prescription data is crucial to improving quality. “The free flow of health care information is central to evidence-based medicine and improved patient outcomes,” said IMS vice president Randolph Frankel in a statement.

IT Bill Would Aid Small Practices

Seeking to help physicians who might like to adopt health information technology (HIT) systems but cannot afford the investment, Reps. Charlie Gonzalez (D-Tex.) and Phil Gingrey (R-Ga.) have introduced legislation that would provide grants, loans, and tax incentives to small practices that implement computer systems. The bill is designed to facilitate the development and adoption of national standards, and to provide initial financial support and ongoing reimbursement incentives for physicians in smaller practices to adopt HIT to support quality improvement activities. The legislation is based in large part on ideas originally developed by the American College of Physicians (ACP), the physicians' group said. Studies have estimated that an electronic health records system averages $44,000 per physician initially, and $8,500 per physician annually to maintain. “The proposed financial incentives would make it possible for physicians in small practices to invest in the technology and encourage its continued use to improve patient care,” said Dr. Lynne Kirk, ACP president.

Debridement Restrictions Lifted

The American Academy of Family Physicians (AAFP) said it has succeeded in its drive to remove restrictive language from a Medicare carrier's draft local coverage determination on wound care. The restriction would have affected physicians in Delaware, Maryland, Texas, and Virginia. Last December, AAFP questioned TrailBlazer Health Enterprises' proposed debridement limits of three times for one wound. AAFP said that although repetitive debridement of one wound is uncommon, sometimes serial debridement is the only option. TrailBlazer removed the restrictions from its final policy, released in April.

Adults Disregard MDs' Orders

In a recent survey, 44% of U.S. adults said that they or an immediate family member have ignored a doctor's course of treatment or sought a second opinion because they felt the doctor's orders were unnecessary or overly aggressive. Most adults reported that they didn't view disregarding a doctor's recommendations as problematic or consequential. Only 1 in 10 adults who chose to disregard a physician's instructions at some time believes that he or she or a family member experienced problems because of this decision, with the most common consequence being lost time from work or school. The survey, conducted by Harris Interactive for the Wall Street Journal Online's health industry edition, also found that a large majority of adults think patients who have medical conditions often experience problems because of overtreatment as well as undertreatment by medical providers.

CMS Urged to Improve Efficiency

Medicare patients who see an “outlier generalist,” a physician who treats a disproportionate share of overly expensive patients, were more likely to have been hospitalized, more likely to have been hospitalized multiple times, and more likely to have used home health services than were other Medicare patients, the Government Accountability Office found in a report. Based on those findings, the GAO recommended that the Centers for Medicare and Medicaid Services develop a system that identifies individual physicians with inefficient practice patterns and uses the results to improve the efficiency of care in the Medicare system. Although CMS has discussed only using profiling results for educating physicians, the optimal system, according to the GAO, would include financial or other incentives to encourage efficiency.

Overcrowded Hospitals Riskier?

Hospitals that operate at or over their capacity might be at increased risk of adverse events that injure patients, according to a study led by investigators from Massachusetts General Hospital (MGH) and Brigham and Woman's Hospital, both in Boston. The report in the May issue of the journal Medical Care suggests that efforts to reduce costs and improve patient safety might work against each other. The researchers reviewed data from four hospitals in two states over 12 months and identified 1,530 preventable injuries not resulting from patients' underlying medical conditions. At three of the four hospitals, the rate of adverse events did not appear to increase at times of peak workload. But at the fourth—a major urban teaching hospital with consistently high occupancy rates that exceeded 100% for more than 3 months—workload increases and higher patient-to-nurse ratios were associated with more adverse events. “Our study suggests that pushing efficiency efforts to their limits could be a double-edged sword that may jeopardize patient safety,” said study lead author Dr. Joel Weissman of the MGH Institute of Public Policy in a statement.

N.H. Rx Law Struck Down

A federal judge in New Hampshire has struck down a state law banning commercial use of provider-identifiable prescription information, finding that it “unconstitutionally restricted speech.” Judge Paul Barbadoro ruled in favor of health information companies IMS Health and Verispan LLC, which jointly filed a lawsuit seeking to prevent the state from enforcing the statute, which went into effect last June. The law was the first in the nation to ban the commercial use of information on what medications individual physicians prescribe. New Hampshire argued that the law aimed to protect physicians' privacy, end inappropriate pharmaceutical marketing, and cut costs. The plaintiffs said that using physicians' prescription data is crucial to improving quality. “The free flow of health care information is central to evidence-based medicine and improved patient outcomes,” said IMS vice president Randolph Frankel in a statement.

IT Bill Would Aid Small Practices

Seeking to help physicians who might like to adopt health information technology (HIT) systems but cannot afford the investment, Reps. Charlie Gonzalez (D-Tex.) and Phil Gingrey (R-Ga.) have introduced legislation that would provide grants, loans, and tax incentives to small practices that implement computer systems. The bill is designed to facilitate the development and adoption of national standards, and to provide initial financial support and ongoing reimbursement incentives for physicians in smaller practices to adopt HIT to support quality improvement activities. The legislation is based in large part on ideas originally developed by the American College of Physicians (ACP), the physicians' group said. Studies have estimated that an electronic health records system averages $44,000 per physician initially, and $8,500 per physician annually to maintain. “The proposed financial incentives would make it possible for physicians in small practices to invest in the technology and encourage its continued use to improve patient care,” said Dr. Lynne Kirk, ACP president.

Debridement Restrictions Lifted

The American Academy of Family Physicians (AAFP) said it has succeeded in its drive to remove restrictive language from a Medicare carrier's draft local coverage determination on wound care. The restriction would have affected physicians in Delaware, Maryland, Texas, and Virginia. Last December, AAFP questioned TrailBlazer Health Enterprises' proposed debridement limits of three times for one wound. AAFP said that although repetitive debridement of one wound is uncommon, sometimes serial debridement is the only option. TrailBlazer removed the restrictions from its final policy, released in April.

Adults Disregard MDs' Orders

In a recent survey, 44% of U.S. adults said that they or an immediate family member have ignored a doctor's course of treatment or sought a second opinion because they felt the doctor's orders were unnecessary or overly aggressive. Most adults reported that they didn't view disregarding a doctor's recommendations as problematic or consequential. Only 1 in 10 adults who chose to disregard a physician's instructions at some time believes that he or she or a family member experienced problems because of this decision, with the most common consequence being lost time from work or school. The survey, conducted by Harris Interactive for the Wall Street Journal Online's health industry edition, also found that a large majority of adults think patients who have medical conditions often experience problems because of overtreatment as well as undertreatment by medical providers.

Medicare Funding Woes

The first-ever “Medicare funding warning” was issued by the program's trustees in their annual report, which requires the President to propose funding reforms within 15 days of submission of the fiscal 2008 budget and Congress to address the proposal on an “expedited basis.” The warning—mandated by the Medicare Modernization Act of 2003—was triggered by the fact that for the second consecutive year, more than 45% of next year's projected total Medicare outlays will come from general government revenues. In their report, the Medicare trustees noted that higher tax revenues and lower projected benefit payouts have extended by 1 year the date that the Medicare Hospital Insurance Trust Fund (Part A) will be exhausted, but added that the impending retirement of 78 million baby boomers still will deplete the Medicare trust fund by 2019 unless lawmakers enact major changes. Medicare Part B and Part D both are projected to remain funded because current law automatically provides financing each year to meet next year's costs. However, expected steep cost increases in those programs will result in rapid increases in financing needs from general revenue and substantial increases in beneficiaries' premiums, the trustees' report said. The report highlights the need for a comprehensive, long-term fiscal plan for Medicare, American Medical Association Board Chair Cecil Wilson said in a statement. “Arbitrary, drastic payment cuts to the physicians who are the foundation of Medicare are not the answer,” Dr. Wilson said, adding that lawmakers should act to stop next year's automatic 10% Medicare physician payment cut to protect seniors' access to care in the short term.

Texas Rejects Gardasil Mandate

Texas lawmakers last month rejected Gov. Rick Perry's mandate that 11- to 12-year-old girls in the state be vaccinated against human papillomavirus (HPV) before entry into the 6th grade. The legislature overwhelmingly approved a bill that bars the state from ordering the shots for at least the next 4 years. In February, Gov. Perry signed an executive order requiring the shots, but many legislators opposed the move, saying parents should decide whether to vaccinate against a sexually transmitted disease. The Texas Medical Association (TMA) did not support the state mandate, even though “the science behind the HPV vaccine is strong and physicians are excited that this vaccine will prevent about 70% of cervical cancer cases and 90% of cases of genital warts,” Dr. William Hinchey, TMA President, said in a statement.

Drug Price Negotiation Blocked

Republicans in the Senate have blocked a proposal to allow Medicare to negotiate lower drug prices within Part D plans, which will likely shelve the issue. Even though the House passed a bill 255–170 requiring the Secretary of Health and Human Services to negotiate prices in Part D, Senate Democrats were unable to gather the 60 votes needed to take up debate on similar legislation. Just 55 senators, including 6 Republicans, supported a Democratic motion to bring up the bill, while 42 senators voted against it. President Bush had threatened to veto the bill if it were passed. Republican senators had argued that the pharmacy benefit managers who run Part D plans already are negotiating large discounts for enrollees. “In blocking this bill from even being debated, Senate Republicans have resorted to obstructionism in an effort to protect the drug industry at the expense of our seniors,” said Senate Majority Leader Harry Reid.

AARP to Offer Health Insurance

Senior advocacy group AARP said that it will add a Medicare Advantage plan run by UnitedHealth Group to its offerings next year, along with several other health insurance products from Aetna Inc. aimed at adults ages 50–64 years. The Medicare Advantage product, to be launched Jan. 1, is expected to enroll 1 million Medicare beneficiaries initially, AARP officials said. In addition to the new Medicare Advantage plan, AARP's agreement with UnitedHealth includes Medicare Supplemental insurance, Part D plans, and indemnity insurance products. AARP said that it will dedicate $500 million of its royalty payments from the two insurers over the next 10 years to fund a new program designed to help Americans find health information and assistance.

Juries Side with Doctors

Contrary to popular belief, juries in malpractice cases usually sympathize more with physicians and less with their patients, according to a law professor who performed an extensive review of studies involving malpractice cases from 1989 to 2006. University of Missouri-Columbia School of Law professor Philip Peters found that plaintiffs rarely win weak cases, although they have more success in cases viewed as a “toss-up” and better outcomes in cases with strong evidence of medical negligence. Mr. Peters, whose study appeared in the May edition of the Michigan Law Review, said that several factors systemically favor medical defendants in the courtroom, including the defendant's superior resources, physicians' social standing, social norms against “profiting” by injury, and the jury's willingness to give physicians the benefit of the doubt when evidence conflicts. “The data show that defendants and their hired experts are more successful than plaintiffs and their hired experts in persuading juries to reach verdicts that are contrary to the evidence,” Mr. Peters said.

Medicare Funding Woes

The first-ever “Medicare funding warning” was issued by the program's trustees in their annual report, which requires the President to propose funding reforms within 15 days of submission of the fiscal 2008 budget and Congress to address the proposal on an “expedited basis.” The warning—mandated by the Medicare Modernization Act of 2003—was triggered by the fact that for the second consecutive year, more than 45% of next year's projected total Medicare outlays will come from general government revenues. In their report, the Medicare trustees noted that higher tax revenues and lower projected benefit payouts have extended by 1 year the date that the Medicare Hospital Insurance Trust Fund (Part A) will be exhausted, but added that the impending retirement of 78 million baby boomers still will deplete the Medicare trust fund by 2019 unless lawmakers enact major changes. Medicare Part B and Part D both are projected to remain funded because current law automatically provides financing each year to meet next year's costs. However, expected steep cost increases in those programs will result in rapid increases in financing needs from general revenue and substantial increases in beneficiaries' premiums, the trustees' report said. The report highlights the need for a comprehensive, long-term fiscal plan for Medicare, American Medical Association Board Chair Cecil Wilson said in a statement. “Arbitrary, drastic payment cuts to the physicians who are the foundation of Medicare are not the answer,” Dr. Wilson said, adding that lawmakers should act to stop next year's automatic 10% Medicare physician payment cut to protect seniors' access to care in the short term.

Texas Rejects Gardasil Mandate

Texas lawmakers last month rejected Gov. Rick Perry's mandate that 11- to 12-year-old girls in the state be vaccinated against human papillomavirus (HPV) before entry into the 6th grade. The legislature overwhelmingly approved a bill that bars the state from ordering the shots for at least the next 4 years. In February, Gov. Perry signed an executive order requiring the shots, but many legislators opposed the move, saying parents should decide whether to vaccinate against a sexually transmitted disease. The Texas Medical Association (TMA) did not support the state mandate, even though “the science behind the HPV vaccine is strong and physicians are excited that this vaccine will prevent about 70% of cervical cancer cases and 90% of cases of genital warts,” Dr. William Hinchey, TMA President, said in a statement.

Drug Price Negotiation Blocked

Republicans in the Senate have blocked a proposal to allow Medicare to negotiate lower drug prices within Part D plans, which will likely shelve the issue. Even though the House passed a bill 255–170 requiring the Secretary of Health and Human Services to negotiate prices in Part D, Senate Democrats were unable to gather the 60 votes needed to take up debate on similar legislation. Just 55 senators, including 6 Republicans, supported a Democratic motion to bring up the bill, while 42 senators voted against it. President Bush had threatened to veto the bill if it were passed. Republican senators had argued that the pharmacy benefit managers who run Part D plans already are negotiating large discounts for enrollees. “In blocking this bill from even being debated, Senate Republicans have resorted to obstructionism in an effort to protect the drug industry at the expense of our seniors,” said Senate Majority Leader Harry Reid.

AARP to Offer Health Insurance

Senior advocacy group AARP said that it will add a Medicare Advantage plan run by UnitedHealth Group to its offerings next year, along with several other health insurance products from Aetna Inc. aimed at adults ages 50–64 years. The Medicare Advantage product, to be launched Jan. 1, is expected to enroll 1 million Medicare beneficiaries initially, AARP officials said. In addition to the new Medicare Advantage plan, AARP's agreement with UnitedHealth includes Medicare Supplemental insurance, Part D plans, and indemnity insurance products. AARP said that it will dedicate $500 million of its royalty payments from the two insurers over the next 10 years to fund a new program designed to help Americans find health information and assistance.

Juries Side with Doctors

Contrary to popular belief, juries in malpractice cases usually sympathize more with physicians and less with their patients, according to a law professor who performed an extensive review of studies involving malpractice cases from 1989 to 2006. University of Missouri-Columbia School of Law professor Philip Peters found that plaintiffs rarely win weak cases, although they have more success in cases viewed as a “toss-up” and better outcomes in cases with strong evidence of medical negligence. Mr. Peters, whose study appeared in the May edition of the Michigan Law Review, said that several factors systemically favor medical defendants in the courtroom, including the defendant's superior resources, physicians' social standing, social norms against “profiting” by injury, and the jury's willingness to give physicians the benefit of the doubt when evidence conflicts. “The data show that defendants and their hired experts are more successful than plaintiffs and their hired experts in persuading juries to reach verdicts that are contrary to the evidence,” Mr. Peters said.

Medicare Funding Woes

The first-ever “Medicare funding warning” was issued by the program's trustees in their annual report, which requires the President to propose funding reforms within 15 days of submission of the fiscal 2008 budget and Congress to address the proposal on an “expedited basis.” The warning—mandated by the Medicare Modernization Act of 2003—was triggered by the fact that for the second consecutive year, more than 45% of next year's projected total Medicare outlays will come from general government revenues. In their report, the Medicare trustees noted that higher tax revenues and lower projected benefit payouts have extended by 1 year the date that the Medicare Hospital Insurance Trust Fund (Part A) will be exhausted, but added that the impending retirement of 78 million baby boomers still will deplete the Medicare trust fund by 2019 unless lawmakers enact major changes. Medicare Part B and Part D both are projected to remain funded because current law automatically provides financing each year to meet next year's costs. However, expected steep cost increases in those programs will result in rapid increases in financing needs from general revenue and substantial increases in beneficiaries' premiums, the trustees' report said. The report highlights the need for a comprehensive, long-term fiscal plan for Medicare, American Medical Association Board Chair Cecil Wilson said in a statement. “Arbitrary, drastic payment cuts to the physicians who are the foundation of Medicare are not the answer,” Dr. Wilson said, adding that lawmakers should act to stop next year's automatic 10% Medicare physician payment cut to protect seniors' access to care in the short term.

Texas Rejects Gardasil Mandate

Texas lawmakers last month rejected Gov. Rick Perry's mandate that 11- to 12-year-old girls in the state be vaccinated against human papillomavirus (HPV) before entry into the 6th grade. The legislature overwhelmingly approved a bill that bars the state from ordering the shots for at least the next 4 years. In February, Gov. Perry signed an executive order requiring the shots, but many legislators opposed the move, saying parents should decide whether to vaccinate against a sexually transmitted disease. The Texas Medical Association (TMA) did not support the state mandate, even though “the science behind the HPV vaccine is strong and physicians are excited that this vaccine will prevent about 70% of cervical cancer cases and 90% of cases of genital warts,” Dr. William Hinchey, TMA President, said in a statement.

Drug Price Negotiation Blocked

Republicans in the Senate have blocked a proposal to allow Medicare to negotiate lower drug prices within Part D plans, which will likely shelve the issue. Even though the House passed a bill 255–170 requiring the Secretary of Health and Human Services to negotiate prices in Part D, Senate Democrats were unable to gather the 60 votes needed to take up debate on similar legislation. Just 55 senators, including 6 Republicans, supported a Democratic motion to bring up the bill, while 42 senators voted against it. President Bush had threatened to veto the bill if it were passed. Republican senators had argued that the pharmacy benefit managers who run Part D plans already are negotiating large discounts for enrollees. “In blocking this bill from even being debated, Senate Republicans have resorted to obstructionism in an effort to protect the drug industry at the expense of our seniors,” said Senate Majority Leader Harry Reid.

AARP to Offer Health Insurance

Senior advocacy group AARP said that it will add a Medicare Advantage plan run by UnitedHealth Group to its offerings next year, along with several other health insurance products from Aetna Inc. aimed at adults ages 50–64 years. The Medicare Advantage product, to be launched Jan. 1, is expected to enroll 1 million Medicare beneficiaries initially, AARP officials said. In addition to the new Medicare Advantage plan, AARP's agreement with UnitedHealth includes Medicare Supplemental insurance, Part D plans, and indemnity insurance products. AARP said that it will dedicate $500 million of its royalty payments from the two insurers over the next 10 years to fund a new program designed to help Americans find health information and assistance.

Juries Side with Doctors

Contrary to popular belief, juries in malpractice cases usually sympathize more with physicians and less with their patients, according to a law professor who performed an extensive review of studies involving malpractice cases from 1989 to 2006. University of Missouri-Columbia School of Law professor Philip Peters found that plaintiffs rarely win weak cases, although they have more success in cases viewed as a “toss-up” and better outcomes in cases with strong evidence of medical negligence. Mr. Peters, whose study appeared in the May edition of the Michigan Law Review, said that several factors systemically favor medical defendants in the courtroom, including the defendant's superior resources, physicians' social standing, social norms against “profiting” by injury, and the jury's willingness to give physicians the benefit of the doubt when evidence conflicts. “The data show that defendants and their hired experts are more successful than plaintiffs and their hired experts in persuading juries to reach verdicts that are contrary to the evidence,” Mr. Peters said.

Medicare Funding Woes

The first-ever “Medicare funding warning” was issued by the program's trustees in their annual report, which requires the President to propose funding reforms within 15 days of submission of the fiscal 2008 budget and Congress to address the proposal on an “expedited basis.” The warning—mandated by the Medicare Modernization Act of 2003—was triggered by the fact that for the second year in a row, more than 45% of next year's projected total Medicare outlays will come from general government revenues. In their report, the Medicare trustees noted that higher tax revenues and lower projected benefit payouts have extended by 1 year the date that the Medicare Hospital Insurance Trust Fund (Part A) will be exhausted, but added that the impending retirement of 78 million baby boomers still will deplete the Medicare trust fund by 2019 unless lawmakers enact major changes. Medicare Part B and Part D both are projected to remain funded because current law automatically provides financing each year to meet next year's costs. But expected steep cost increases in those programs will result in rapid increases in financing needs from general revenue and substantial increases in beneficiaries' premiums, the trustees' report said. The report highlights the need for a comprehensive, long-term fiscal plan for Medicare, American Medical Association Board Chair Dr. Cecil Wilson said in a statement. “Arbitrary, drastic payment cuts to the physicians who are the foundation of Medicare are not the answer,” Dr. Wilson said, adding that lawmakers should act to stop next year's automatic 10% Medicare physician payment cut to protect seniors' access to care in the short term.

Texas Rejects Gardasil Mandate

Texas lawmakers last month rejected Gov. Rick Perry's mandate that 11- to 12-year-old girls in the state be vaccinated against human papillomavirus (HPV) before entry into the 6th grade. The legislature overwhelmingly approved a bill that bars the state from ordering the shots for at least the next 4 years. In February, Gov. Perry signed an executive order requiring the shots, but many legislators opposed the move, saying parents should decide whether to vaccinate against a sexually transmitted disease. The Texas Medical Association (TMA) did not support the state mandate, even though “the science behind the HPV vaccine is strong and physicians are excited that this vaccine will prevent about 70% of cervical cancer cases and 90% of cases of genital warts,” TMA President Dr. William Hinchey said in a statement.

Drug Price Negotiation Blocked

Republicans in the Senate have blocked a proposal to allow Medicare to negotiate lower drug prices within Part D plans, which will likely shelve the issue. Even though the House passed a bill 255–170 requiring the Secretary of Health and Human Services to negotiate prices in Part D, Senate Democrats were unable to gather the 60 votes needed to take up debate on similar legislation. Just 55 senators, including 6 Republicans, supported a Democratic motion to bring up the bill, while 42 senators voted against it. President Bush had threatened to veto the bill if it were passed. Republican senators had argued that the pharmacy benefit managers who run Part D plans already are negotiating large discounts for enrollees. “In blocking this bill from even being debated, Senate Republicans have resorted to obstructionism in an effort to protect the drug industry at the expense of our seniors,” said Senate Majority Leader Harry Reid.

AARP to Offer Health Insurance

Senior advocacy group AARP said that it will add a Medicare Advantage plan run by UnitedHealth Group to its offerings next year, along with several other health insurance products from Aetna Inc. aimed at adults ages 50–64 years. The Medicare Advantage product, to be launched Jan. 1, is expected to enroll 1 million Medicare beneficiaries initially, AARP officials said. In addition to the new Medicare Advantage plan, AARP's agreement with UnitedHealth includes Medicare Supplemental insurance, Part D plans, and indemnity insurance products. AARP said that it will dedicate $500 million of its royalty payments from the two insurers over the next 10 years to fund a new program designed to help Americans find health information and assistance.

Juries Side With Doctors

Contrary to popular belief, juries in malpractice cases usually sympathize more with physicians and less with their patients, according to a law professor who performed an extensive review of studies involving malpractice cases from 1989 to 2006. University of Missouri-Columbia School of Law professor Philip Peters found that plaintiffs rarely win weak cases, although they have more success in cases viewed as a “toss-up” and better outcomes in cases with strong evidence of medical negligence. Mr. Peters, whose study appeared in the May edition of the Michigan Law Review, said that several factors systemically favor medical defendants in the courtroom, including the defendant's superior resources, physicians' social standing, social norms against “profiting” by injury, and the jury's willingness to give physicians the benefit of the doubt when evidence conflicts. “The data show that defendants and their hired experts are more successful than plaintiffs and their hired experts in persuading juries to reach verdicts that are contrary to the evidence,” Mr. Peters said.

Medicare Funding Woes

The first-ever “Medicare funding warning” was issued by the program's trustees in their annual report, which requires the President to propose funding reforms within 15 days of submission of the fiscal 2008 budget and Congress to address the proposal on an “expedited basis.” The warning—mandated by the Medicare Modernization Act of 2003—was triggered by the fact that for the second year in a row, more than 45% of next year's projected total Medicare outlays will come from general government revenues. In their report, the Medicare trustees noted that higher tax revenues and lower projected benefit payouts have extended by 1 year the date that the Medicare Hospital Insurance Trust Fund (Part A) will be exhausted, but added that the impending retirement of 78 million baby boomers still will deplete the Medicare trust fund by 2019 unless lawmakers enact major changes. Medicare Part B and Part D both are projected to remain funded because current law automatically provides financing each year to meet next year's costs. But expected steep cost increases in those programs will result in rapid increases in financing needs from general revenue and substantial increases in beneficiaries' premiums, the trustees' report said. The report highlights the need for a comprehensive, long-term fiscal plan for Medicare, American Medical Association Board Chair Dr. Cecil Wilson said in a statement. “Arbitrary, drastic payment cuts to the physicians who are the foundation of Medicare are not the answer,” Dr. Wilson said, adding that lawmakers should act to stop next year's automatic 10% Medicare physician payment cut to protect seniors' access to care in the short term.

Texas Rejects Gardasil Mandate

Texas lawmakers last month rejected Gov. Rick Perry's mandate that 11- to 12-year-old girls in the state be vaccinated against human papillomavirus (HPV) before entry into the 6th grade. The legislature overwhelmingly approved a bill that bars the state from ordering the shots for at least the next 4 years. In February, Gov. Perry signed an executive order requiring the shots, but many legislators opposed the move, saying parents should decide whether to vaccinate against a sexually transmitted disease. The Texas Medical Association (TMA) did not support the state mandate, even though “the science behind the HPV vaccine is strong and physicians are excited that this vaccine will prevent about 70% of cervical cancer cases and 90% of cases of genital warts,” TMA President Dr. William Hinchey said in a statement.

Drug Price Negotiation Blocked

Republicans in the Senate have blocked a proposal to allow Medicare to negotiate lower drug prices within Part D plans, which will likely shelve the issue. Even though the House passed a bill 255–170 requiring the Secretary of Health and Human Services to negotiate prices in Part D, Senate Democrats were unable to gather the 60 votes needed to take up debate on similar legislation. Just 55 senators, including 6 Republicans, supported a Democratic motion to bring up the bill, while 42 senators voted against it. President Bush had threatened to veto the bill if it were passed. Republican senators had argued that the pharmacy benefit managers who run Part D plans already are negotiating large discounts for enrollees. “In blocking this bill from even being debated, Senate Republicans have resorted to obstructionism in an effort to protect the drug industry at the expense of our seniors,” said Senate Majority Leader Harry Reid.

AARP to Offer Health Insurance

Senior advocacy group AARP said that it will add a Medicare Advantage plan run by UnitedHealth Group to its offerings next year, along with several other health insurance products from Aetna Inc. aimed at adults ages 50–64 years. The Medicare Advantage product, to be launched Jan. 1, is expected to enroll 1 million Medicare beneficiaries initially, AARP officials said. In addition to the new Medicare Advantage plan, AARP's agreement with UnitedHealth includes Medicare Supplemental insurance, Part D plans, and indemnity insurance products. AARP said that it will dedicate $500 million of its royalty payments from the two insurers over the next 10 years to fund a new program designed to help Americans find health information and assistance.

Juries Side With Doctors

Contrary to popular belief, juries in malpractice cases usually sympathize more with physicians and less with their patients, according to a law professor who performed an extensive review of studies involving malpractice cases from 1989 to 2006. University of Missouri-Columbia School of Law professor Philip Peters found that plaintiffs rarely win weak cases, although they have more success in cases viewed as a “toss-up” and better outcomes in cases with strong evidence of medical negligence. Mr. Peters, whose study appeared in the May edition of the Michigan Law Review, said that several factors systemically favor medical defendants in the courtroom, including the defendant's superior resources, physicians' social standing, social norms against “profiting” by injury, and the jury's willingness to give physicians the benefit of the doubt when evidence conflicts. “The data show that defendants and their hired experts are more successful than plaintiffs and their hired experts in persuading juries to reach verdicts that are contrary to the evidence,” Mr. Peters said.

Medicare Funding Woes

The first-ever “Medicare funding warning” was issued by the program's trustees in their annual report, which requires the President to propose funding reforms within 15 days of submission of the fiscal 2008 budget and Congress to address the proposal on an “expedited basis.” The warning—mandated by the Medicare Modernization Act of 2003—was triggered by the fact that for the second year in a row, more than 45% of next year's projected total Medicare outlays will come from general government revenues. In their report, the Medicare trustees noted that higher tax revenues and lower projected benefit payouts have extended by 1 year the date that the Medicare Hospital Insurance Trust Fund (Part A) will be exhausted, but added that the impending retirement of 78 million baby boomers still will deplete the Medicare trust fund by 2019 unless lawmakers enact major changes. Medicare Part B and Part D both are projected to remain funded because current law automatically provides financing each year to meet next year's costs. But expected steep cost increases in those programs will result in rapid increases in financing needs from general revenue and substantial increases in beneficiaries' premiums, the trustees' report said. The report highlights the need for a comprehensive, long-term fiscal plan for Medicare, American Medical Association Board Chair Dr. Cecil Wilson said in a statement. “Arbitrary, drastic payment cuts to the physicians who are the foundation of Medicare are not the answer,” Dr. Wilson said, adding that lawmakers should act to stop next year's automatic 10% Medicare physician payment cut to protect seniors' access to care in the short term.

Texas Rejects Gardasil Mandate

Texas lawmakers last month rejected Gov. Rick Perry's mandate that 11- to 12-year-old girls in the state be vaccinated against human papillomavirus (HPV) before entry into the 6th grade. The legislature overwhelmingly approved a bill that bars the state from ordering the shots for at least the next 4 years. In February, Gov. Perry signed an executive order requiring the shots, but many legislators opposed the move, saying parents should decide whether to vaccinate against a sexually transmitted disease. The Texas Medical Association (TMA) did not support the state mandate, even though “the science behind the HPV vaccine is strong and physicians are excited that this vaccine will prevent about 70% of cervical cancer cases and 90% of cases of genital warts,” TMA President Dr. William Hinchey said in a statement.

Drug Price Negotiation Blocked

Republicans in the Senate have blocked a proposal to allow Medicare to negotiate lower drug prices within Part D plans, which will likely shelve the issue. Even though the House passed a bill 255–170 requiring the Secretary of Health and Human Services to negotiate prices in Part D, Senate Democrats were unable to gather the 60 votes needed to take up debate on similar legislation. Just 55 senators, including 6 Republicans, supported a Democratic motion to bring up the bill, while 42 senators voted against it. President Bush had threatened to veto the bill if it were passed. Republican senators had argued that the pharmacy benefit managers who run Part D plans already are negotiating large discounts for enrollees. “In blocking this bill from even being debated, Senate Republicans have resorted to obstructionism in an effort to protect the drug industry at the expense of our seniors,” said Senate Majority Leader Harry Reid.

AARP to Offer Health Insurance

Senior advocacy group AARP said that it will add a Medicare Advantage plan run by UnitedHealth Group to its offerings next year, along with several other health insurance products from Aetna Inc. aimed at adults ages 50–64 years. The Medicare Advantage product, to be launched Jan. 1, is expected to enroll 1 million Medicare beneficiaries initially, AARP officials said. In addition to the new Medicare Advantage plan, AARP's agreement with UnitedHealth includes Medicare Supplemental insurance, Part D plans, and indemnity insurance products. AARP said that it will dedicate $500 million of its royalty payments from the two insurers over the next 10 years to fund a new program designed to help Americans find health information and assistance.

Juries Side With Doctors

Contrary to popular belief, juries in malpractice cases usually sympathize more with physicians and less with their patients, according to a law professor who performed an extensive review of studies involving malpractice cases from 1989 to 2006. University of Missouri-Columbia School of Law professor Philip Peters found that plaintiffs rarely win weak cases, although they have more success in cases viewed as a “toss-up” and better outcomes in cases with strong evidence of medical negligence. Mr. Peters, whose study appeared in the May edition of the Michigan Law Review, said that several factors systemically favor medical defendants in the courtroom, including the defendant's superior resources, physicians' social standing, social norms against “profiting” by injury, and the jury's willingness to give physicians the benefit of the doubt when evidence conflicts. “The data show that defendants and their hired experts are more successful than plaintiffs and their hired experts in persuading juries to reach verdicts that are contrary to the evidence,” Mr. Peters said.

Texas Legislators Bar Gardasil Mandate

Texas lawmakers last month rejected Gov. Rick Perry's mandate that 11- to 12-year-old girls in the state be vaccinated against human papillomavirus before entry into the 6th grade. The legislature overwhelmingly approved a bill that bars the state from ordering the shots for at least the next 4 years. In February, Gov. Perry signed an executive order requiring the shots, but many legislators opposed the move, saying parents should decide whether to vaccinate against a sexually transmitted disease. The Texas Medical Association (TMA) did not support the state mandate, even though “the science behind the HPV vaccine is strong and physicians are excited that this vaccine will prevent about 70% of cervical cancer cases and 90% of cases of genital warts,” Dr. William Hinchey, TMA President, said in a statement.

AAP Alarmed at Vaccine Prices

The American Academy of Pediatrics said it is very concerned that the soaring costs of vaccines—combined with lower reimbursements from insurance companies—will lead to the underimmunization of U.S. children and unnecessary outbreaks of preventable diseases. The warning comes at a time when state legislatures are debating adding Gardasil, the new cervical cancer vaccine, to the list of vaccines required for schoolchildren. AAP noted in a statement released last month that pediatricians spend tens of thousands of dollars on vaccines and frequently must wait months before being reimbursed by payers. For example, RotaTeq, the vaccine against diarrhea-causing rotavirus, costs $190 for the recommended three doses. Meanwhile, AAP said that payers are not recognizing the true costs of delivering vaccines, which include the costs of ordering, storing, inventory control, insurance, and spoilage. Results from a national survey that AAP conducted in 2006 indicated that fewer than half of pediatricians think vaccine reimbursement is adequate.

High-Deductible Plans Penalize Some

Families with children taking even one medication are likely to suffer financially in health plans with high deductibles, according to a study from Harvard Medical School, Boston. The study also found that high-deductible plans penalize women and adults with any chronic condition by leaving them with far higher out-of-pocket health bills than those healthy men pay. Under the plans, patients must pay at least $1,050 before their health coverage kicks in. In 2006, the 12.1 million children who took one or more prescription medications had median expenditures (both insurance and out of pocket) of $1,305. “High-deductible health insurance penalizes anyone who's sick,” said Dr. David Himmelstein, study coauthor and an advocate of a single-payer system.

Resources for Children Challenged

Children will see their share of federal domestic spending and the gross national product decline by double digits over the next decade, according to a report from the nonpartisan Urban Institute. Federal resources for children are caught between ever-rising expenditures on adult health care and on retirement programs, and programs for children often lack provisions for automatic growth, the report said. As a piece of the federal domestic budget, spending on children will decline from more than 15% in 2006 to 13% in 2017, a nearly 15% drop, said economists Adam Carasso, Eugene Steuerle, and Gillian Reynolds. “Despite frequent rhetoric from policy makers on the priority given to children, the federal budget makes fairly clear that children are less of a priority and more of an afterthought in the budget process,” they said.

SCHIP Benefits Adolescents

When given health insurance through the state children's health insurance program (SCHIP), teenagers see their doctors more often, racial disparities are eliminated, and more preventive care is received, according to a study from the University of Rochester (N.Y.) Medical Center. The study, published in the April issue of Pediatrics, also found that teens received more counseling from their health care providers about guns, smoking, drugs, alcohol, and sexuality when receiving health insurance from SCHIP. “Adolescents have the worst access to health care among children,” said Dr. Jonathan Klein, professor of adolescent medicine at the University of Rochester, who surveyed about 1,000 adolescents and their parents for the study. “The increase in access to a usual source of care and reduction of unmet needs are the most important finding[s] of this study. Getting access to care is key to adolescent health,” Dr. Klein said in a statement. Authorization for SCHIP expires Sept. 30, and Congress currently is debating reauthorization.

Texas Legislators Bar Gardasil Mandate

Texas lawmakers last month rejected Gov. Rick Perry's mandate that 11- to 12-year-old girls in the state be vaccinated against human papillomavirus before entry into the 6th grade. The legislature overwhelmingly approved a bill that bars the state from ordering the shots for at least the next 4 years. In February, Gov. Perry signed an executive order requiring the shots, but many legislators opposed the move, saying parents should decide whether to vaccinate against a sexually transmitted disease. The Texas Medical Association (TMA) did not support the state mandate, even though “the science behind the HPV vaccine is strong and physicians are excited that this vaccine will prevent about 70% of cervical cancer cases and 90% of cases of genital warts,” Dr. William Hinchey, TMA President, said in a statement.

AAP Alarmed at Vaccine Prices

The American Academy of Pediatrics said it is very concerned that the soaring costs of vaccines—combined with lower reimbursements from insurance companies—will lead to the underimmunization of U.S. children and unnecessary outbreaks of preventable diseases. The warning comes at a time when state legislatures are debating adding Gardasil, the new cervical cancer vaccine, to the list of vaccines required for schoolchildren. AAP noted in a statement released last month that pediatricians spend tens of thousands of dollars on vaccines and frequently must wait months before being reimbursed by payers. For example, RotaTeq, the vaccine against diarrhea-causing rotavirus, costs $190 for the recommended three doses. Meanwhile, AAP said that payers are not recognizing the true costs of delivering vaccines, which include the costs of ordering, storing, inventory control, insurance, and spoilage. Results from a national survey that AAP conducted in 2006 indicated that fewer than half of pediatricians think vaccine reimbursement is adequate.

High-Deductible Plans Penalize Some

Families with children taking even one medication are likely to suffer financially in health plans with high deductibles, according to a study from Harvard Medical School, Boston. The study also found that high-deductible plans penalize women and adults with any chronic condition by leaving them with far higher out-of-pocket health bills than those healthy men pay. Under the plans, patients must pay at least $1,050 before their health coverage kicks in. In 2006, the 12.1 million children who took one or more prescription medications had median expenditures (both insurance and out of pocket) of $1,305. “High-deductible health insurance penalizes anyone who's sick,” said Dr. David Himmelstein, study coauthor and an advocate of a single-payer system.

Resources for Children Challenged

Children will see their share of federal domestic spending and the gross national product decline by double digits over the next decade, according to a report from the nonpartisan Urban Institute. Federal resources for children are caught between ever-rising expenditures on adult health care and on retirement programs, and programs for children often lack provisions for automatic growth, the report said. As a piece of the federal domestic budget, spending on children will decline from more than 15% in 2006 to 13% in 2017, a nearly 15% drop, said economists Adam Carasso, Eugene Steuerle, and Gillian Reynolds. “Despite frequent rhetoric from policy makers on the priority given to children, the federal budget makes fairly clear that children are less of a priority and more of an afterthought in the budget process,” they said.

SCHIP Benefits Adolescents

When given health insurance through the state children's health insurance program (SCHIP), teenagers see their doctors more often, racial disparities are eliminated, and more preventive care is received, according to a study from the University of Rochester (N.Y.) Medical Center. The study, published in the April issue of Pediatrics, also found that teens received more counseling from their health care providers about guns, smoking, drugs, alcohol, and sexuality when receiving health insurance from SCHIP. “Adolescents have the worst access to health care among children,” said Dr. Jonathan Klein, professor of adolescent medicine at the University of Rochester, who surveyed about 1,000 adolescents and their parents for the study. “The increase in access to a usual source of care and reduction of unmet needs are the most important finding[s] of this study. Getting access to care is key to adolescent health,” Dr. Klein said in a statement. Authorization for SCHIP expires Sept. 30, and Congress currently is debating reauthorization.

Texas Legislators Bar Gardasil Mandate

Texas lawmakers last month rejected Gov. Rick Perry's mandate that 11- to 12-year-old girls in the state be vaccinated against human papillomavirus before entry into the 6th grade. The legislature overwhelmingly approved a bill that bars the state from ordering the shots for at least the next 4 years. In February, Gov. Perry signed an executive order requiring the shots, but many legislators opposed the move, saying parents should decide whether to vaccinate against a sexually transmitted disease. The Texas Medical Association (TMA) did not support the state mandate, even though “the science behind the HPV vaccine is strong and physicians are excited that this vaccine will prevent about 70% of cervical cancer cases and 90% of cases of genital warts,” Dr. William Hinchey, TMA President, said in a statement.

AAP Alarmed at Vaccine Prices

The American Academy of Pediatrics said it is very concerned that the soaring costs of vaccines—combined with lower reimbursements from insurance companies—will lead to the underimmunization of U.S. children and unnecessary outbreaks of preventable diseases. The warning comes at a time when state legislatures are debating adding Gardasil, the new cervical cancer vaccine, to the list of vaccines required for schoolchildren. AAP noted in a statement released last month that pediatricians spend tens of thousands of dollars on vaccines and frequently must wait months before being reimbursed by payers. For example, RotaTeq, the vaccine against diarrhea-causing rotavirus, costs $190 for the recommended three doses. Meanwhile, AAP said that payers are not recognizing the true costs of delivering vaccines, which include the costs of ordering, storing, inventory control, insurance, and spoilage. Results from a national survey that AAP conducted in 2006 indicated that fewer than half of pediatricians think vaccine reimbursement is adequate.

High-Deductible Plans Penalize Some

Families with children taking even one medication are likely to suffer financially in health plans with high deductibles, according to a study from Harvard Medical School, Boston. The study also found that high-deductible plans penalize women and adults with any chronic condition by leaving them with far higher out-of-pocket health bills than those healthy men pay. Under the plans, patients must pay at least $1,050 before their health coverage kicks in. In 2006, the 12.1 million children who took one or more prescription medications had median expenditures (both insurance and out of pocket) of $1,305. “High-deductible health insurance penalizes anyone who's sick,” said Dr. David Himmelstein, study coauthor and an advocate of a single-payer system.

Resources for Children Challenged

Children will see their share of federal domestic spending and the gross national product decline by double digits over the next decade, according to a report from the nonpartisan Urban Institute. Federal resources for children are caught between ever-rising expenditures on adult health care and on retirement programs, and programs for children often lack provisions for automatic growth, the report said. As a piece of the federal domestic budget, spending on children will decline from more than 15% in 2006 to 13% in 2017, a nearly 15% drop, said economists Adam Carasso, Eugene Steuerle, and Gillian Reynolds. “Despite frequent rhetoric from policy makers on the priority given to children, the federal budget makes fairly clear that children are less of a priority and more of an afterthought in the budget process,” they said.

SCHIP Benefits Adolescents

When given health insurance through the state children's health insurance program (SCHIP), teenagers see their doctors more often, racial disparities are eliminated, and more preventive care is received, according to a study from the University of Rochester (N.Y.) Medical Center. The study, published in the April issue of Pediatrics, also found that teens received more counseling from their health care providers about guns, smoking, drugs, alcohol, and sexuality when receiving health insurance from SCHIP. “Adolescents have the worst access to health care among children,” said Dr. Jonathan Klein, professor of adolescent medicine at the University of Rochester, who surveyed about 1,000 adolescents and their parents for the study. “The increase in access to a usual source of care and reduction of unmet needs are the most important finding[s] of this study. Getting access to care is key to adolescent health,” Dr. Klein said in a statement. Authorization for SCHIP expires Sept. 30, and Congress currently is debating reauthorization.

Abortion Procedure Ban Upheld

The U.S. Supreme Court last month narrowly upheld the controversial ban on so-called partial-birth abortions, marking the first time the court has forbidden a specific abortion procedure. The 5–4 decision said that the Partial Birth Abortion Ban Act, approved by Congress in 2003, does not violate a woman's constitutional right to an abortion, even though it does not contain an exception to protect the health of the mother. “The law need not give abortion doctors unfettered choice in the course of their medical practice,” Justice Anthony Kennedy wrote for the majority. In separate statements, National Right to Life applauded the ruling, while Planned Parenthood Federation of America noted that with the decision the high court took away an important option for physicians. The American College of Obstetricians and Gynecologists had filed an amicus brief in support of those challenging the law.

Retail Clinics Replacing PCPs

More than 1 in 10 retail medical clinic users said the clinics have mostly or completely replaced their primary care physicians for the types of treatments offered at such facilities, according to a study from Market Strategies Inc., a research firm. “Consumers are telling us in no uncertain terms that convenience is so critical to them that they will forego traditional primary care providers in exchange for access to the kind of quick and convenient basic care services offered by retail clinics,” said John Thomas, MSI vice president, in a statement. The study also indicated that consumers who have used retail clinics are open to treatment for a wider range of conditions, including migraine hypertension. Of the all the consumers polled, 30% said the clinics should compete with primary care physicians by offering a broader variety of services. The American Academy of Family Physicians said in a February policy statement that retail clinics should have a “well-defined and limited cope of clinical services,” and that they should encourage all patients to have a medical home. “The retail clinic is not a substitute for the personal medical home,” said Dr. Rick Kellerman, AAFP president, in an interview. He said although the study appears biased toward retail clinics, “there is a shift toward consumerism, and we do need to reengineer practices to make them more convenient.”

Penalized by High Deductible Plans

High-deductible health insurance plans discriminate against women by leaving them with far higher out-of-pocket health bills than men, according to a study from Harvard Medical School, Boston. The study also found that adults 45–64 years, those with any chronic condition such as asthma or high blood pressure, and children taking even one medication were likely to suffer financially in high-deductible plans. Under the plans, patients must pay at least $1,050 before their health coverage kicks in. In 2006, the median cost of care (both insurance and out-of-pocket) for women ages 18–64 was $1,844, compared with $847 for men. For middle-aged adults, the mean expenditure was $1,849 for men and $2,871 for women. High blood pressure patients had a mean annual expenditure of $3,161, while diabetics taking at least one medication had a mean expenditure of $5,774. “Even common, mild problems like arthritis and high blood pressure make you a loser in a high deductible plan,” said Dr. David Himmelstein, study coauthor.

Negotiation Could Save $30 Billion

Legislation that would allow Medicare to use its bulk purchasing power to negotiate for lower prescription drug prices under Part D could save U.S. taxpayers and seniors more than $30 billion annually, an advocacy group reported. The Institute for American Research said that about $10 billion of those savings would accrue to U.S. seniors in the form of cheaper prices, and the U.S. government could save roughly $20 billion a year by having Medicare negotiate for the same prices the Department of Veterans Affairs already gets. However, the Pharmaceutical Research and Manufacturers of America (PhRMA), which represents drug makers and opposes the legislation, said pharmacy benefit managers already are negotiating with manufacturers for lower prices under Part D.

Cuts Would Harm Seniors

Three-fourths of physicians said they believe that seniors will be harmed if Congress cuts the Medicare Advantage program, and most doctors said lawmakers should cut other programs or raise taxes rather than cut Medicare Advantage, according to the industry group America's Health Insurance Plans (AHIP). In addition, 35% of seniors enrolled in Medicare Advantage said they would skip some of the health care treatments they currently receive if the option of choosing a Medicare health plan is taken away. The findings are from two surveys released by AHIP in March.

Changing MD Demographics

A major demographic shift is underway in medicine as female physicians become more numerous, and this trend will influence how medical groups recruit and retain physicians throughout their career cycles, according to the 2006 Retention Survey from the American Medical Group Association and Cejka Search, an executive search organization. In 2006, female physicians accounted for 35% of physicians in the medical groups responding to the survey, compared with 28% in the previous survey. Factors such as “poor cultural fit” and family issues are the driving forces in physician turnover. Part-time and flexible work options also are growing in importance, the survey found.

Abortion Procedure Ban Upheld

The U.S. Supreme Court last month narrowly upheld the controversial ban on so-called partial-birth abortions, marking the first time the court has forbidden a specific abortion procedure. The 5–4 decision said that the Partial Birth Abortion Ban Act, approved by Congress in 2003, does not violate a woman's constitutional right to an abortion, even though it does not contain an exception to protect the health of the mother. “The law need not give abortion doctors unfettered choice in the course of their medical practice,” Justice Anthony Kennedy wrote for the majority. In separate statements, National Right to Life applauded the ruling, while Planned Parenthood Federation of America noted that with the decision the high court took away an important option for physicians. The American College of Obstetricians and Gynecologists had filed an amicus brief in support of those challenging the law.

Retail Clinics Replacing PCPs

More than 1 in 10 retail medical clinic users said the clinics have mostly or completely replaced their primary care physicians for the types of treatments offered at such facilities, according to a study from Market Strategies Inc., a research firm. “Consumers are telling us in no uncertain terms that convenience is so critical to them that they will forego traditional primary care providers in exchange for access to the kind of quick and convenient basic care services offered by retail clinics,” said John Thomas, MSI vice president, in a statement. The study also indicated that consumers who have used retail clinics are open to treatment for a wider range of conditions, including migraine hypertension. Of the all the consumers polled, 30% said the clinics should compete with primary care physicians by offering a broader variety of services. The American Academy of Family Physicians said in a February policy statement that retail clinics should have a “well-defined and limited cope of clinical services,” and that they should encourage all patients to have a medical home. “The retail clinic is not a substitute for the personal medical home,” said Dr. Rick Kellerman, AAFP president, in an interview. He said although the study appears biased toward retail clinics, “there is a shift toward consumerism, and we do need to reengineer practices to make them more convenient.”

Penalized by High Deductible Plans

High-deductible health insurance plans discriminate against women by leaving them with far higher out-of-pocket health bills than men, according to a study from Harvard Medical School, Boston. The study also found that adults 45–64 years, those with any chronic condition such as asthma or high blood pressure, and children taking even one medication were likely to suffer financially in high-deductible plans. Under the plans, patients must pay at least $1,050 before their health coverage kicks in. In 2006, the median cost of care (both insurance and out-of-pocket) for women ages 18–64 was $1,844, compared with $847 for men. For middle-aged adults, the mean expenditure was $1,849 for men and $2,871 for women. High blood pressure patients had a mean annual expenditure of $3,161, while diabetics taking at least one medication had a mean expenditure of $5,774. “Even common, mild problems like arthritis and high blood pressure make you a loser in a high deductible plan,” said Dr. David Himmelstein, study coauthor.

Negotiation Could Save $30 Billion

Legislation that would allow Medicare to use its bulk purchasing power to negotiate for lower prescription drug prices under Part D could save U.S. taxpayers and seniors more than $30 billion annually, an advocacy group reported. The Institute for American Research said that about $10 billion of those savings would accrue to U.S. seniors in the form of cheaper prices, and the U.S. government could save roughly $20 billion a year by having Medicare negotiate for the same prices the Department of Veterans Affairs already gets. However, the Pharmaceutical Research and Manufacturers of America (PhRMA), which represents drug makers and opposes the legislation, said pharmacy benefit managers already are negotiating with manufacturers for lower prices under Part D.

Cuts Would Harm Seniors

Three-fourths of physicians said they believe that seniors will be harmed if Congress cuts the Medicare Advantage program, and most doctors said lawmakers should cut other programs or raise taxes rather than cut Medicare Advantage, according to the industry group America's Health Insurance Plans (AHIP). In addition, 35% of seniors enrolled in Medicare Advantage said they would skip some of the health care treatments they currently receive if the option of choosing a Medicare health plan is taken away. The findings are from two surveys released by AHIP in March.

Changing MD Demographics

A major demographic shift is underway in medicine as female physicians become more numerous, and this trend will influence how medical groups recruit and retain physicians throughout their career cycles, according to the 2006 Retention Survey from the American Medical Group Association and Cejka Search, an executive search organization. In 2006, female physicians accounted for 35% of physicians in the medical groups responding to the survey, compared with 28% in the previous survey. Factors such as “poor cultural fit” and family issues are the driving forces in physician turnover. Part-time and flexible work options also are growing in importance, the survey found.

Abortion Procedure Ban Upheld

The U.S. Supreme Court last month narrowly upheld the controversial ban on so-called partial-birth abortions, marking the first time the court has forbidden a specific abortion procedure. The 5–4 decision said that the Partial Birth Abortion Ban Act, approved by Congress in 2003, does not violate a woman's constitutional right to an abortion, even though it does not contain an exception to protect the health of the mother. “The law need not give abortion doctors unfettered choice in the course of their medical practice,” Justice Anthony Kennedy wrote for the majority. In separate statements, National Right to Life applauded the ruling, while Planned Parenthood Federation of America noted that with the decision the high court took away an important option for physicians. The American College of Obstetricians and Gynecologists had filed an amicus brief in support of those challenging the law.

Retail Clinics Replacing PCPs

More than 1 in 10 retail medical clinic users said the clinics have mostly or completely replaced their primary care physicians for the types of treatments offered at such facilities, according to a study from Market Strategies Inc., a research firm. “Consumers are telling us in no uncertain terms that convenience is so critical to them that they will forego traditional primary care providers in exchange for access to the kind of quick and convenient basic care services offered by retail clinics,” said John Thomas, MSI vice president, in a statement. The study also indicated that consumers who have used retail clinics are open to treatment for a wider range of conditions, including migraine hypertension. Of the all the consumers polled, 30% said the clinics should compete with primary care physicians by offering a broader variety of services. The American Academy of Family Physicians said in a February policy statement that retail clinics should have a “well-defined and limited cope of clinical services,” and that they should encourage all patients to have a medical home. “The retail clinic is not a substitute for the personal medical home,” said Dr. Rick Kellerman, AAFP president, in an interview. He said although the study appears biased toward retail clinics, “there is a shift toward consumerism, and we do need to reengineer practices to make them more convenient.”

Penalized by High Deductible Plans

High-deductible health insurance plans discriminate against women by leaving them with far higher out-of-pocket health bills than men, according to a study from Harvard Medical School, Boston. The study also found that adults 45–64 years, those with any chronic condition such as asthma or high blood pressure, and children taking even one medication were likely to suffer financially in high-deductible plans. Under the plans, patients must pay at least $1,050 before their health coverage kicks in. In 2006, the median cost of care (both insurance and out-of-pocket) for women ages 18–64 was $1,844, compared with $847 for men. For middle-aged adults, the mean expenditure was $1,849 for men and $2,871 for women. High blood pressure patients had a mean annual expenditure of $3,161, while diabetics taking at least one medication had a mean expenditure of $5,774. “Even common, mild problems like arthritis and high blood pressure make you a loser in a high deductible plan,” said Dr. David Himmelstein, study coauthor.

Negotiation Could Save $30 Billion

Legislation that would allow Medicare to use its bulk purchasing power to negotiate for lower prescription drug prices under Part D could save U.S. taxpayers and seniors more than $30 billion annually, an advocacy group reported. The Institute for American Research said that about $10 billion of those savings would accrue to U.S. seniors in the form of cheaper prices, and the U.S. government could save roughly $20 billion a year by having Medicare negotiate for the same prices the Department of Veterans Affairs already gets. However, the Pharmaceutical Research and Manufacturers of America (PhRMA), which represents drug makers and opposes the legislation, said pharmacy benefit managers already are negotiating with manufacturers for lower prices under Part D.

Cuts Would Harm Seniors

Three-fourths of physicians said they believe that seniors will be harmed if Congress cuts the Medicare Advantage program, and most doctors said lawmakers should cut other programs or raise taxes rather than cut Medicare Advantage, according to the industry group America's Health Insurance Plans (AHIP). In addition, 35% of seniors enrolled in Medicare Advantage said they would skip some of the health care treatments they currently receive if the option of choosing a Medicare health plan is taken away. The findings are from two surveys released by AHIP in March.

Changing MD Demographics

A major demographic shift is underway in medicine as female physicians become more numerous, and this trend will influence how medical groups recruit and retain physicians throughout their career cycles, according to the 2006 Retention Survey from the American Medical Group Association and Cejka Search, an executive search organization. In 2006, female physicians accounted for 35% of physicians in the medical groups responding to the survey, compared with 28% in the previous survey. Factors such as “poor cultural fit” and family issues are the driving forces in physician turnover. Part-time and flexible work options also are growing in importance, the survey found.