Bill to Thwart Medicare Cuts
A bipartisan bill (H.R. 2356) introduced by Rep. Clay Shaw (R-Fla.) and Rep. Ben Cardin (D-Md.) seeks to halt impending cuts to Medicare physician payments and replace the flawed formula that determines those payments. Following up on a recommendation of the Medicare Payment Advisory Commission, the bill would increase payments by no less than 2.7% in 2006. It would also repeal the sustainable growth rate adjustment, replacing it “with a methodology that assures adequate and appropriate payments as well as stable updates for Medicare providers,” Rep. Cardin said in a statement. Physicians face a 4.3% cut in Medicare payments in 2006 and subsequent cuts totaling 30% from 2007 and 2012, if the formula isn't fixed. The bill was referred to the House Ways and Means and Energy and Commerce committees. A similar bill introduced in the Senate (S. 1081) would provide a positive update to Medicare payments for 2 years.
Few Seeking Quality Improvement
A majority of physicians are not actively engaged in quality improvement practices and are reluctant to share information about the quality of care they provide with the general public, a survey of more than 1,800 physicians revealed. Only one-fourth of the respondents said they were using an electronic medical record routinely or occasionally, and one-third said they were redesigning their systems to improve care. In addition, just one-third said they had access to any data about the quality of their own clinical performance. Although 7 out of 10 thought physicians' clinical information should be shared with leaders of the health care systems at which they work, fewer respondents (55%) thought patients should have access to quality data about their own doctors, and only 29% thought the general public should have access to such data. The survey was conducted by the Commonwealth Fund between March and May 2003 and published in the journal Health Affairs.
Medicaid Patients and Drug Access
Medicaid patients are finding it just as difficult as the uninsured to get access to prescription drugs. Researchers from the Center for Studying Health System Change found that 22% of Medicaid beneficiaries aged 18 and older could not afford to get at least one prescription filled in the previous year. Although access problems experienced by Medicaid beneficiaries were comparable with those experienced by the uninsured, only 9% of adults with employer-sponsored health coverage said they could not afford a prescribed drug in the previous year. The findings were drawn from HSC's Community Tracking Study Household Survey, a national survey involving 46,600 people in 2003 and 60,000 people in 2001.
Vaccine Underinsurance
Just because you have insurance does not mean you're covered for immunizations, a survey of 995 Americans conducted by researchers at the University of Michigan, Ann Arbor, indicated. As many as 36 million privately insured adults and 5 million privately insured children are not covered for immunizations, a factor that may be contributing to low immunization rates. “Over the past few years, newly approved vaccines have been increasingly expensive, so insurance plans have been less likely to cover them,” said lead study author Matthew Davis. “This means that new vaccines of the future may be available to many people only if they can pay out of pocket.” A majority of the respondents said they'd be willing to pay higher premiums for vaccine coverage, and most strongly believed that vaccines were effective and generally safe (Health Affairs 2005;24:770–9).
Depression and Marijuana Use
The evidence for a link between marijuana use and depression is getting stronger, according to the White House Office for National Drug Control Policy. “There certainly are people who self-medicate, but the danger we're talking about is the growing evidence that use itself may be triggering and may be worsening the onset of mental health problems,” ONDCP Director John Walters said at a Washington press conference. “Now would some of those people have mental health problems anyway? That's entirely possible. But it's also entirely possible that some of these people may not subsequently show these mental health problems, and the evidence suggests that the use of marijuana may trigger the onset of problems that would not otherwise be there.” The office's National Survey on Drug Use and Health shows that, among persons aged 18 years or older, those who first used marijuana before age 12 were twice as likely to have serious mental illness in the last year as those who first used marijuana at age 18 or older.