Reminders Effective for Screening
Mailed reminders to patients do work in prompting colorectal cancer screening, and electronic reminders to physicians may increase screening among some patients, a study in the Archives of Internal Medicine indicated. The researchers randomly sent reminders to patients and physicians in 11 ambulatory health care centers. Screening rates were higher for patients who received mailings, which contained an educational pamphlet, fecal occult blood test kit, and instructions for scheduling a flexible sigmoidoscopy or colonoscopy. Overall screening rates were similar between patients of physicians who received electronic reminders and of those who did not, but screening rates did trend higher among patients who had frequent primary care visits, the study found.
Boston Limits Tobacco Sales
Boston has banned tobacco-product sales at pharmacies—becoming the second city to do so—and on college campuses. The Boston Public Health Commission's board of health also banned new permits for smoking bars, such as hookah and cigar bars, and prohibited the sale of blunt wraps, a tobacco leaf often used to roll marijuana. The board said it was working with pharmacies, health centers, and hospitals in the city to increase people's access to smoking cessation resources. Last year, San Francisco imposed the first municipal ban on cigarette sales by pharmacies. Many college campuses already ban tobacco.
Metabolic Drugs Top List
Medications that affect a person's metabolism by lowering cholesterol, controlling diabetes, and trimming weight accounted for $38 billion of the $208 billion that American adults spent on drugs in 2006, according to a report on prescription drugs by the Agency for Healthcare Research and Quality. Cardiovascular drugs accounted for $33 billion; central nervous system drugs cost $28 billion; psychotherapeutic drugs cost more than $17 billion; and hormones cost $14 billion. The AHRQ also found that spending for outpatient prescription analgesics increased from about $4 billion in 1996 to more than $13 billion in 2006.
Most Unemployed Lack Coverage
More than half of low-income workers who have lost their jobs in the recession also have lost their health insurance, according to a report from advocacy group Families USA. The report, which focuses on workers with annual incomes below 200% of the federal poverty level, found that only one in four of these unemployed workers received health care coverage through Medicaid or another public program. In addition, many low-wage workers don't qualify to buy continued employer-provided insurance after leaving a job. For those who do have access to that program, called COBRA, the premiums often are unaffordable, the report found. Low-income workers represent half of the unemployed under age 65, according to Families USA.
Court Upholds Calorie Rule
A federal appeals court has upheld New York City's rule requiring chain restaurants to provide calorie information on their printed and posted menus. The New York State Restaurant Association had asked the United States Court of Appeals for the Second Circuit to strike down the 2008 rule as a violation of federal nutrition labeling law and the First Amendment. But the court rejected those arguments and said the requirement to reveal calories on menu boards “clearly reasonably related” to the city's goal of reducing obesity. The appeals court cited evidence that eating out is a major contributor to obesity and said that consumers generally are unable to assess the caloric content of foods. “A smoked turkey sandwich at Chili's contains 930 calories, more than a sirloin steak, which contains 540, [and] two jelly-filled doughnuts at Dunkin' Donuts have fewer calories than a sesame bagel with cream cheese,” the court noted.
AMA Sues Aetna, Cigna
The American Medical Association and several state medical associations have filed separate class-action lawsuits against insurers Aetna Health Inc. and CIGNA, each suit claiming that the company used faulty data to undercompensate physicians. Filed in February in New Jersey federal court, the two lawsuits are similar to an earlier AMA suit against UnitedHealth Group, owner of the Ingenix billing database used by Aetna and CIGNA to determine fees for patients' visits to out-of-network physicians. As a result of the UnitedHealth lawsuit and an investigation by New York Attorney General Andrew Cuomo, UnitedHealth agreed to shut down the database and pay $50 million to establish a new one run by a nonprofit organization. Among other things, the suits against Aetna and CIGNA seek a declaration that the insurers violated federal antitrust law and that they are liable to the plaintiffs for three times their damages, costs, and attorney fees. The medical associations also want the insurers to calculate and issue unpaid benefits to physicians. “Through our lawsuits, the AMA and our partner medical societies seek to reform the payment systems used by Aetna and CIGNA by ending their dependence on the Ingenix database,” said Dr. Nancy H. Nielsen, AMA president.