HIV Policy Changes Urged
A small change in how the Centers for Disease Control and Prevention tracks new HIV/AIDS cases could help capture data on infections in women, especially minorities, more accurately, potentially helping to get infected women into treatment much earlier, according to a coalition advocating the change. The National Women and AIDS Collective (NWAC), along with Sen. Hillary Clinton (D-N.Y.) and Sen. Edward Kennedy (D-Mass.), is asking the CDC to revise the model it uses to capture data on new cases of HIV/AIDS so it records more information on environmental and socioeconomic factors. “Research shows that women of color remain at disproportionate risk of HIV infection even when they aren't engaging in high-risk behavior such as drug use, sex with men who have sex with men, [and] sex work,” the NWAC said in a statement. “As such, a data collection method that takes into account only high-risk behaviors falls far short of addressing the prevention needs of women of color and other populations whose HIV rates are influenced by a range of environmental and socioeconomic factors.” The NWAC, together with Senator Clinton and Senator Kennedy, plans to set up a working group with the CDC to try to enact the changes, a spokesperson for the NWAC said.
Abstinence Programs Don't Work
There is no strong evidence that any abstinence program delays the initiation of sex, hastens a return to abstinence, or reduces the number of sexual partners, according to findings in a study from the nonpartisan National Campaign to Prevent Teen and Unplanned Pregnancy. “Many of the abstinence programs improved teens' values about abstinence or their intentions to abstain, but these improvements did not always endure and often did not translate into changes in behavior,” said the report, “Emerging Answers 2007.” But two-thirds of programs that support both abstinence and the use of condoms and contraceptives for sexually active teens had positive behavioral effects, according to the report. However, the report said that researchers should not conclude that all abstinence-only programs are ineffective, because fewer than 10 rigorous studies of these programs have been carried out, and studies of two programs provided “modestly encouraging results.” More investigation is needed before the programs are disseminated widely, the report concluded.
Preventive Coverage Widespread
Almost all of the health savings account/high-deductible health plans (HSA/HDHPs) that are offered by the employment-based insurance market provide “first-dollar” coverage for preventive care, regardless of whether the deductible has been met. In a July 2007 survey by America's Health Insurance Plans, 96% of small groups (50 or fewer employees), 99% of large groups (51 or more employees), and 99% of jumbo groups (3,000 or more employees) said they cover preventive care on a first-dollar basis. Conversely, only 59% of individually purchased HSA/HDHPs do so. The 36 companies surveyed had more than 1.7 million HSA/HDHP enrollees (there are 4.5 million HSA/HDHP enrollees nationwide). The preventive care services commonly covered include recommended immunizations and preventive screenings. All of the plans that were surveyed covered mammograms, Pap smears, and annual physicals, and most of them covered colonoscopies and prostate cancer screening.
Improvement Through Transparency
Transparency of quality and price information is important or very important for improving the U.S. health care system, according to 77% of 241 health care opinion leaders who were surveyed in October 2007 by Harris Interactive on behalf of the Commonwealth Fund and Modern Healthcare. Stimulating provider performance-improvement activities was rated as an important or very important goal of transparency by 84% of respondents; 76% also cited encouraging payers to reward quality, and 66% thought helping patients make informed choices was an important or very important goal. More than half (56%) of the respondents thought that a new public-private national entity should be responsible for setting the standards for measurement and reporting, with 75% of them saying that the costs of such measurement and reporting should be shared by providers, insurers, and the government. Most of the respondents (88%) felt that the adoption of health information technology was an important or very important component of any system of transparency. The online poll surveyed peer-identified leaders and experts in academia, research, health care delivery, business, insurance, government, and labor and advocacy groups.
Generics and Part D
Under Medicare Part D plans, 56% of drugs dispensed were generics, and generics were dispensed 88% of the time when they were available, according to a November 2007 report by the Office of Inspector General of the Department of Health and Human Services. However, 37% of prescriptions were for drugs with no generic substitute, said the report. Overall utilization of generic drugs varied among Part D plans, from a low of 37% to a high of 83%. The data were derived from 341 million Part D prescriptions dispensed in January through June 2006. The generic usage rates of Part D plans are comparable to those of state Medicaid programs in 2004.