MedPAC: Give Doctors a 2% Hike
Medicare should increase physician payments by 2.7% in 2006 to keep pace with the cost of providing care, the Medicare Payment Advisory Commission recommended. Such an increase will help physicians continue to treat Medicare patients, John C. Nelson, M.D., president of the American Medical Association, said in a statement. “Unless Medicare payments keep up with the cost of providing care, there is a real concern that some physicians will be forced to stop taking new Medicare patients,” he said. However, unless Congress fixes a flaw in Medicare's physician payment formula, doctors face a 5% cut next year and cumulative cuts of 30% through 2012. Several MedPAC commissioners supported the idea of taking outpatient or Part B drugs from the formula, although the Government Accountability Office has warned that this solution would not prevent several years of declines in physician payments.
Fatigue and Driving Don't Mix
Tired residents on the road lead to more automobile accidents, according to a Web-based survey of 2,737 residents in their first postgraduate year (N. Engl. J. Med. 2005;352:125–134). Investigators found that in any month, each extended work shift increased the risk of any motor vehicle crash by 9% and increased the risk of a crash on the way home from work by more than 16%. Those who worked five or more extended shifts in a month were also more likely to fall asleep behind the wheel. “These results have implications for medical residency programs, which routinely schedule physicians to work more than 24 consecutive hours,” the researchers said. The respondents had completed more than 17,000 monthly reports that provided detailed information about work hours, work shifts of an extended duration, documented motor vehicle crashes, near-miss accidents, and incidents involving involuntary sleeping.
Compensation for Vaccine Injuries
The National Vaccine Injury Compensation Program (VICP) will now cover injuries related to the hepatitis A vaccine. Hepatitis A is the most common type of hepatitis reported in the United States, and causes an estimated 125,000 to 200,000 cases per year. The vaccine is recommended for children in certain states and high-incidence communities, in addition to people with chronic diseases or those traveling to countries where the disease is common. Most people who receive the hepatitis A vaccine don't experience serious problems. However, those who believe they've been injured by the vaccine must file a claim within 3 years of the first symptom of the vaccine injury or within 2 years of the vaccine-related death, but not more than 4 years after the start of the first symptom of the vaccine-related injury from which the death occurred. Administered by the Health Resources and Services Administration, the VICP program provides financial compensation to eligible individuals thought to be injured by vaccines.
Feds Flunk on Tobacco Regulation
Congress and the White House got failing grades on tobacco control policies in 2004, the American Lung Association said in its annual State of Tobacco Control report. The House of Representatives, for example, blocked legislation to grant the Food and Drug Administration authority to regulate tobacco products. Although President Bush signed an international treaty that sets standards to control tobacco use and addiction, he has not sent it to the Senate for ratification, the lung association said. In contrast, a number of state and local governments have stepped up efforts to enact strong tobacco control policies, such as approving laws to protect people from secondhand smoke and increase cigarette taxes, the report stated. Several states and communities, including Idaho; Rhode Island; Columbus, Ohio; and Lexington, Ky., achieved smoke-free workplaces.
Lawsuit Over Delay in Plan B
An advocacy group is suing the FDA for delaying its decision on over-the-counter status for the emergency contraceptive Plan B (levonorgestrel). “Half of the 3 million pregnancies in the U.S. are unintended each year. By denying women over-the-counter access to a safe and effective drug that would significantly reduce those numbers—including pregnancies that end in abortion—the FDA is acting unlawfully,” said Nancy Northrup, president of the Center for Reproductive Rights, which filed its suit in a New York district court. The FDA had been scheduled to issue a decision in late January on a second application for OTC status for Plan B by its manufacturer, Barr Pharmaceuticals. Steven Galson, M.D., acting director of the FDA's Center for Drug Evaluation and Research, had rejected Barr's initial request for over-the-counter marketing status last spring, citing insufficient evidence regarding the effects of OTC availability of emergency contraception in younger women. The FDA should be completing its review in the near future, Barr indicated in a statement. “The company remains optimistic that the agency will approve Plan B for OTC sale.”