Push for Medicare E-Prescribing
A coalition of 22 health, business, and consumer organizations has asked Congress to pass legislation requiring physicians who see Medicare patients to adopt electronic prescribing by the year 2010. “Last year, the Institute of Medicine estimated that preventable medication errors harm an estimated 1.5 million Americans each year,” said a letter from the coalition, which includes Aetna Inc., Consumers Union, the Corporate Health Care Coalition, and the Pharmaceutical Care Management Association, to leaders of the Senate Finance Committee, the House Ways and Means Committee, and the House Energy and Commerce Committee. “In the report, the IOM called on all physicians to adopt electronic prescribing (e-prescribing) by 2010 to address this problem. Unfortunately, fewer than 1 in 10 physicians are meeting this challenge.” The coalition has urged Congress to approve legislation this year calling for full physician adoption of e-prescribing in Medicare.
Medicaid Enrollment Declines
Enrollment in Medicaid declined in 2007 for the first time in nearly a decade, primarily because new documentation requirements have caused significant delays in processing applications and because the strong economy and lower unemployment have reduced enrollment, according to a new 50-state survey from the Kaiser Family Foundation. But states expect enrollment and spending to increase in 2008 as they move forward with program enhancements, according to the survey. “States are turning to Medicaid to address the rising number of uninsured to help fill in the gaps for low-income families,” Diane Rowland, executive vice president of the Kaiser Family Foundation, said in a statement. With the nation's growing uninsured population, 42 states report efforts to expand coverage for the uninsured using Medicaid as a financing vehicle. In addition, every state implemented at least one provider payment increase in 2007, and almost all the states have adopted an increase for 2008.
Chronic Disease: $1 Trillion a Year
Seven chronic diseases—cancer, diabetes, hypertension, stroke, heart disease, pulmonary conditions, and mental illness—have a total impact on the economy of $1.3 trillion annually, including $1.1 trillion in lost productivity, according to a study by the Milken Institute. That figure could be nearly $6 trillion by midcentury, the report said. “By investing in good health, we can add billions of dollars in economic growth in the coming decades,” said Ross C. DeVol, the institute's director of regional economics and principal author of the report. He noted that much of this cost was avoidable. “With moderate improvements in prevention and early intervention, such as reducing the rate of obesity, the savings to the economy would be enormous.” West Virginia, Tennessee, Arkansas, Kentucky, and Mississippi have the highest rates of chronic disease. Utah, Alaska, Colorado, New Mexico, and Arizona have the lowest.
Traditional Medicare a Better Deal
Private Medicare Part D plans have higher administrative expenses and negotiated lower drug rebates, compared with traditional Medicare, according to a report released in October by the House Committee on Oversight and Government Reform. The total 2007 administrative costs of the 12 leading private Part D plans (9.8% of total benefit costs) were almost six times those of Medicare (1.7%), and will reach $4.6 billion this year, $1 billion of which is profit. In addition, the private insurers negotiated drug rebates from manufacturers of only 8%, compared with 26% obtained by Medicaid; the drug prices paid by enrollees of Part D insurers are no better than prices at discounters like Costco and Wal-Mart. However, private insurers will pocket $1 billion in rebates on drugs that are paid for entirely by beneficiaries during coverage gap periods. “The program's inflated administrative costs and meager drug rebates will cost taxpayers and seniors $15 billion this year alone,” Committee chairman Henry A. Waxman (D-Calif.) said in a statement. The report can be found at
Low Health Literacy Is Costly
Researchers found that 87 million adults, or 36% of the adult U.S. population, have basic or below basic health literacy skills. Using data from the 2003 Department of Education National Assessment of Health Literacy, they estimated that low health literacy costs the U.S. economy between $106 billion and $236 billion a year. “Our findings suggest that low health literacy exacts enormous costs on both the health system and society,” lead author John A. Vernon, Ph.D., said in a statement. The researchers also found that while 7% of those with employer-provided insurance had low health literacy, 30% of those on Medicaid, 27% of those on Medicare, and 28% of those with no insurance had low health literacy. The report, “Low Health Literacy: Implications for National Health Policy,” was supported by a grant from Pfizer Inc.