President's Health Care Agenda
The federal government has a responsibility to provide health care for the poor and the elderly, as well as confront its rising costs, strengthen the doctor-patient relationship, and help people afford insurance coverage, President Bush said in his State of the Union address. “Medical liability reform is a top priority of the AAFP, whose members include family physicians in small and large practices and in rural and urban areas. It is imperative that the president fulfills his promise for tort reform and that Senator Frist fulfills his to bring the issue to a floor vote in 2006,” Dr. Larry S. Fields, president of the American Academy of Family Physicians said in a statement. But Ron Pollack, executive director of the consumer group Families USA, noted that the president failed to mention the recent efforts by the White House and Congress to cut Medicaid funding. “These Medicaid cuts will drive many low-income seniors and children out of the system and leave millions of people without any health care coverage whatsoever.”
Health Care Spending 2004
Growth in U.S. health care spending slowed for the second straight year in 2004, increasing by only 7.9%, according to the Centers for Medicare and Medicaid Services' annual report on health care spending. This compares with an 8.2% growth rate in 2003 and a 9.1% growth rate in 2002. The report attributed slower growth in prescription drug spending as a contributor to this overall slowdown. In 2004, prescription drugs accounted for only 11% of the growth in national health care expenditures, a smaller share of the increase than in recent years. In a statement, the Pharmaceutical Care Management Association attributed the slowdown to increased reliance on generic drugs and mail-service pharmacies. Spending for physician services grew 9.0% in 2004, nearly the same as 2003's 8.6% increase.
Foreign Drug, Wrong Drug
Filling prescriptions abroad may have adverse health consequences because of confusion with drug brand names, the Food and Drug Administration cautioned in an advisory. In an investigation, the agency found that many foreign medications, although marketed under the same or similar-sounding brand names as those in the United States, contain different active ingredients. For example, Norpramin is the brand name for the antidepressant desipramine in the United States. In Spain, the same brand name is used for a drug that contains the proton pump inhibitor omeprazole. The FDA also found 105 U.S. brand names with foreign counterparts that look or sound so similar that consumers who fill such prescriptions abroad may receive a drug containing the wrong active ingredient. For example, in the United Kingdom, Amyben is the brand name for the antiarrhythmia medication amiodarone. And in the United States, Ambien is the brand name for the hypnotic drug zolpidem.
Emergency Care Gets a 'C-'
Emergency care provided in 80% of the states earned mediocre or near-failing grades according to the first-ever National Report Card on the State of Emergency Medicine, conducted by the American College of Emergency Physicians. Overall, the nation's emergency medical care system received a grade of C-. Half the states provided less-than-average support for their emergency medical systems, earning poor or near-failing grades. No state received an overall A grade, although the highest overall B grades were given to California, ranked first in the nation, followed by Massachusetts, Connecticut, and the District of Columbia. Arkansas, Idaho, and Utah had the weakest systems, receiving the worst overall grade of D. Emergency care suffers from overcrowding, declining access, high liability costs, and a dwindling capacity to deal with public health or terrorist disasters, the report stated. “Americans assume they will receive lifesaving emergency care when and where they need it, but increasingly this isn't the case,” said Dr. Frederick C. Blum, ACEP president.
Evidence-Based Research
More cost-effectiveness studies are needed to evaluate public health interventions, Barbara K. Rimer, Dr.P.H., a member of the Task Force on Community Preventive Services, said at an audioconference sponsored by AcademyHealth, Washington. The task force is an independent, nonfederal group that was convened by the Department of Health and Human Services. There are a number of areas where researchers can build on existing evidence-based public health research, said Dr. Rimer, who is also the dean of the school of public health at the University of North Carolina in Chapel Hill. Researchers should evaluate the most effective sites and providers for public health interventions.
Help for Vets With MS Proposed
Sen. Patty Murray (D-Wash.) has proposed legislation to help more veterans with multiple sclerosis qualify for disability benefits from the Department of Veterans Affairs. “A growing number of veterans from the first Gulf War are now developing symptoms of MS, but they often face an uphill battle in obtaining disability benefits from the VA,” the senator's office noted in a press release. Under current law, veterans have 7 years after discharge to link MS to their military service; however, many veterans don't start developing symptoms of the disease until after that time, forcing them to go through a long appeals process. The bill would remove the 7-year limitation and make MS a “presumptive disability,” entitling them to care no matter when their symptoms appear. So far, about 500 Gulf War veterans have been diagnosed with service-connected MS, and many more are symptomatic but not yet diagnosed, according to Julie Mock, president of the National Gulf War Resource Center and an MS patient.