Rich and Educated Burn More
Wealthier and better-educated Americans get sunburn more often, according to a study published in the Journal of the American Academy of Dermatology. University of Pennsylvania researchers used data from the 2003 Behavioral Risk Factor Surveillance Survey, a random sample of 248,000 Americans conducted by the Centers for Disease Control and Prevention. About 85% of the respondents self-identified as white; overall, half were female, and the mean age was 47 years. Thirty-nine percent said they'd had at least one sunburn in the year before their interview; 26% said they'd had two or more burns, 15% had three or more, and 9% had four or more. Not surprisingly, sunburns were more prevalent in the 18- to 24-year-old age group, and decreased with age, becoming least prevalent in those over age 75. Prevalence was highest in those making more than $50,000 annually and who had a college degree, and decreased with less income and lower education. Adjusting for age and alcohol and tobacco use attenuated some of the income and wealth effect, but higher education and earnings were still positively associated with sunburn, said the researchers.
Report Faults Wound Payment
Medicare needs to improve the way it pays for wound management, according to a new report by AdvaMed, a trade association for medical device companies. "Coverage and reimbursement policies in the nation's Medicare system currently do not reflect technological advances in wound care management, are too comprehensive, and can cause disruptions in delivering appropriate care to patients," the report's authors said. "Medicare often focuses narrowly on a specific unit cost or the cost of wound care at a specific site, while not considering the long-term costs of caring for patients." AdvaMed urged the Centers for Medicare and Medicaid Services to increase the amount of money the agency pays for wound care supplies used by hospitals, nursing homes, and outpatient clinics. The recommendations also included prevention: AdvaMed suggested the agency provide coverage as part of Medicare's surgical dressing benefit for "preventive and early intervention technologies for tissue damage."
Fix the SGR, Delay Imaging Cuts
Rep. Michael Burgess (R-Tex.), an ob.gyn., has introduced legislation (H.R. 5866) that would put an end to physician fee cuts under Medicare by halting application of the sustainable growth rate by Jan. 1, 2007. Each year, the SGR has contributed to a decrease in payments; in 2007, that cut will be at least 4.6%. Rep. Burgess is proposing to tie physician fees to one factor only: the Medicare Economic Index minus 1%. According to Rep. Burgess, this places "more value on actual cost inputs." The bill also would establish a system of quality measures to give patients more information about Medicare providers, delay by 1 year proposed cuts in imaging services reimbursement, and require the Institute of Medicine to perform a study on the question of whether imaging saves money. The American Medical Association called the Medicare Physician Payment Reform Bill and Quality Improvement Act of 2006 an "important step toward replacing the flawed Medicare physician payment formula." Rep. Burgess' bill is the third in the House to delay or repeal the cuts in imaging fees. Rep. Joseph Pitts (R-Pa.) has called for a 2-year delay in H.R. 5704; a similar bill was recently introduced by Sen. Gordon Smith (R-Ore.) and Sen. Jay Rockefeller (D-W.Va.).
Senate Bill to Boost Drug Safety
After months of public discourse, Sen. Edward Kennedy (D-Mass.) and Sen. Mike Enzi (R-Wyo.) have introduced a bill that aims to increase assurances that drugs are safe before they reach the marketplace, or at least have a plan in place to more closely monitor when they need to be withdrawn. The Enhancing Drug Safety and Innovation Act would require pharmaceutical manufacturers to be more proactive about safety problems. Companies would have to establish risk evaluation and management strategies that will be agreed upon by the manufacturer and the Food and Drug Administration before the product is approved. The companies would have to submit adverse event reports every 15 days, quarterly, and annually. If a company knowingly does not comply with the agreed-upon strategy, the FDA can impose monetary penalties. The senators also proposed that manufacturers make clinical trial results public. Fuller disclosure "will help patients and their health care providers make better informed decisions about treatment," Sen. Kennedy said in a statement. Finally, the bill would overhaul the FDA's process for vetting outside advisory panel members, with a goal of minimizing conflicts of interest and then ensuring that they are fully disclosed.