Bill Would Address Medicare Cuts
A bipartisan bill (H.R. 2356) introduced by Rep. Clay Shaw (R-Fla.) and Rep. Ben Cardin (D-Md.) seeks to halt cuts to Medicare physician payments and replace the flawed formula that sets those payments. Following up on a recommendation of the Medicare Payment Advisory Commission, the bill would increase payments by no less than 2.7% in 2006. It would also repeal the sustainable growth rate adjustment, replacing it “with a methodology that assures adequate and appropriate payments as well as stable updates for Medicare providers,” Rep. Cardin said in a statement. If the formula isn't fixed, physicians face a 4.3% cut in Medicare payments in 2006 and later cuts totaling 30% from 2007 and 2012. The bill was referred to the House Ways and Means and Energy and Commerce committees. A similar bill introduced in the Senate (S. 1081) would boost Medicare payments for 2 years.
Medicaid Patients and Drug Access
Medicaid patients are finding it just as difficult as the uninsured to get access to prescription drugs. Researchers from the Center for Studying Health System Change found that 22% of adult Medicaid beneficiaries couldn't afford to get at least one prescription filled in the previous year. Medicaid beneficiaries and the uninsured has similar access problems, but only 9% of adults with employer-sponsored health coverage said they couldn't afford a prescribed drug in the previous year. The findings were drawn from HSC's Community Tracking Study Household Survey, a national survey involving 46,600 people in 2003 and 60,000 people in 2001. States have been intensifying efforts to control rising Medicaid drug spending, but the proportion of Medicaid beneficiaries reporting they couldn't afford prescription drugs remained unchanged from 2001 to 2003.
Vaccine Underinsurance
Having insurance doesn't mean you're covered for immunizations, according to a survey of 995 Americans conducted by researchers at the University of Michigan, Ann Arbor. As many as 36 million privately insured adults and 5 million privately insured children are not covered for immunizations, a factor that may be contributing to low immunization rates. “Over the past few years, newly approved vaccines have been increasingly expensive, so insurance plans have been less likely to cover them,” said lead study author Matthew Davis. “New vaccines of the future may be available to many people only if they can pay out of pocket.” Most respondents said they'd be willing to pay higher premiums for vaccine coverage, and most strongly believed that vaccines were effective and generally safe (Health Affairs 2005;24:770–9).
Limits to Quality Improvement
Most physicians are not using quality improvement measures and are reluctant to make public any information about the quality of care they provide, a survey of more than 1,800 physicians revealed. Only one-fourth of the respondents said they were using an electronic medical record routinely or occasionally, and one-third said they were redesigning their systems to improve care. Just one-third said they had access to any data about the quality of their own clinical performance. Although 7 out of 10 thought physicians' clinical information should be shared with leaders of the health care systems at which they work, only 55% thought patients should have access to quality-related data about their own doctors, and only 29% thought the general public should have access to such data. The survey, conducted by the Commonwealth Fund between March and May 2003, was published in the journal Health Affairs.
Depression and Marijuana Use
The evidence for a link between marijuana use and depression is getting stronger, according to the White House Office for National Drug Control Policy. “There certainly are people who self-medicate, but the danger we're talking about is the growing evidence that use itself may be triggering and may be worsening the onset of mental health problems,” ONDCP Director John Walters said at a Washington press briefing. “Now would some of those people have mental health problems anyway? That's entirely possible. But it's also entirely possible that some of these people may not subsequently show these mental health problems, and the evidence suggests that the use of marijuana may trigger the onset of problems that would not otherwise be there.” The office's National Survey on Drug Use and Health shows that, among persons aged 18 years or older, those who first used marijuana before age 12 were twice as likely to have serious mental illness in the past year as those who first used marijuana at age 18 or older.
AMA: Ban Booze Ads at NCAA Events