Medicare Funding Woes
The first-ever “Medicare funding warning” was issued by the program's trustees in their annual report, which requires the President to propose funding reforms within 15 days of submission of the fiscal 2008 budget and Congress to address the proposal on an “expedited basis.” The warning—mandated by the Medicare Modernization Act of 2003—was triggered by the fact that for the second consecutive year, more than 45% of next year's projected total Medicare outlays will come from general government revenues. In their report, the Medicare trustees noted that higher tax revenues and lower projected benefit payouts have extended by 1 year the date that the Medicare Hospital Insurance Trust Fund (Part A) will be exhausted, but added that the impending retirement of 78 million baby boomers still will deplete the Medicare trust fund by 2019 unless lawmakers enact major changes. Medicare Part B and Part D both are projected to remain funded because current law automatically provides financing each year to meet next year's costs. However, expected steep cost increases in those programs will result in rapid increases in financing needs from general revenue and substantial increases in beneficiaries' premiums, the trustees' report said. The report highlights the need for a comprehensive, long-term fiscal plan for Medicare, American Medical Association Board Chair Cecil Wilson said in a statement. “Arbitrary, drastic payment cuts to the physicians who are the foundation of Medicare are not the answer,” Dr. Wilson said, adding that lawmakers should act to stop next year's automatic 10% Medicare physician payment cut to protect seniors' access to care in the short term.
Texas Rejects Gardasil Mandate
Texas lawmakers last month rejected Gov. Rick Perry's mandate that 11- to 12-year-old girls in the state be vaccinated against human papillomavirus (HPV) before entry into the 6th grade. The legislature overwhelmingly approved a bill that bars the state from ordering the shots for at least the next 4 years. In February, Gov. Perry signed an executive order requiring the shots, but many legislators opposed the move, saying parents should decide whether to vaccinate against a sexually transmitted disease. The Texas Medical Association (TMA) did not support the state mandate, even though “the science behind the HPV vaccine is strong and physicians are excited that this vaccine will prevent about 70% of cervical cancer cases and 90% of cases of genital warts,” Dr. William Hinchey, TMA President, said in a statement.
Drug Price Negotiation Blocked
Republicans in the Senate have blocked a proposal to allow Medicare to negotiate lower drug prices within Part D plans, which will likely shelve the issue. Even though the House passed a bill 255–170 requiring the Secretary of Health and Human Services to negotiate prices in Part D, Senate Democrats were unable to gather the 60 votes needed to take up debate on similar legislation. Just 55 senators, including 6 Republicans, supported a Democratic motion to bring up the bill, while 42 senators voted against it. President Bush had threatened to veto the bill if it were passed. Republican senators had argued that the pharmacy benefit managers who run Part D plans already are negotiating large discounts for enrollees. “In blocking this bill from even being debated, Senate Republicans have resorted to obstructionism in an effort to protect the drug industry at the expense of our seniors,” said Senate Majority Leader Harry Reid.
AARP to Offer Health Insurance
Senior advocacy group AARP said that it will add a Medicare Advantage plan run by UnitedHealth Group to its offerings next year, along with several other health insurance products from Aetna Inc. aimed at adults ages 50–64 years. The Medicare Advantage product, to be launched Jan. 1, is expected to enroll 1 million Medicare beneficiaries initially, AARP officials said. In addition to the new Medicare Advantage plan, AARP's agreement with UnitedHealth includes Medicare Supplemental insurance, Part D plans, and indemnity insurance products. AARP said that it will dedicate $500 million of its royalty payments from the two insurers over the next 10 years to fund a new program designed to help Americans find health information and assistance.
Juries Side with Doctors
Contrary to popular belief, juries in malpractice cases usually sympathize more with physicians and less with their patients, according to a law professor who performed an extensive review of studies involving malpractice cases from 1989 to 2006. University of Missouri-Columbia School of Law professor Philip Peters found that plaintiffs rarely win weak cases, although they have more success in cases viewed as a “toss-up” and better outcomes in cases with strong evidence of medical negligence. Mr. Peters, whose study appeared in the May edition of the Michigan Law Review, said that several factors systemically favor medical defendants in the courtroom, including the defendant's superior resources, physicians' social standing, social norms against “profiting” by injury, and the jury's willingness to give physicians the benefit of the doubt when evidence conflicts. “The data show that defendants and their hired experts are more successful than plaintiffs and their hired experts in persuading juries to reach verdicts that are contrary to the evidence,” Mr. Peters said.