Texas Legislators Bar 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 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.
AAP Alarmed at Vaccine Prices
The American Academy of Pediatrics said it is very concerned that the soaring costs of vaccines—combined with lower reimbursements from insurance companies—will lead to the underimmunization of U.S. children and unnecessary outbreaks of preventable diseases. The warning comes at a time when state legislatures are debating adding Gardasil, the new cervical cancer vaccine, to the list of vaccines required for schoolchildren. AAP noted in a statement released last month that pediatricians spend tens of thousands of dollars on vaccines and frequently must wait months before being reimbursed by payers. For example, RotaTeq, the vaccine against diarrhea-causing rotavirus, costs $190 for the recommended three doses. Meanwhile, AAP said that payers are not recognizing the true costs of delivering vaccines, which include the costs of ordering, storing, inventory control, insurance, and spoilage. Results from a national survey that AAP conducted in 2006 indicated that fewer than half of pediatricians think vaccine reimbursement is adequate.
High-Deductible Plans Penalize Some
Families with children taking even one medication are likely to suffer financially in health plans with high deductibles, according to a study from Harvard Medical School, Boston. The study also found that high-deductible plans penalize women and adults with any chronic condition by leaving them with far higher out-of-pocket health bills than those healthy men pay. Under the plans, patients must pay at least $1,050 before their health coverage kicks in. In 2006, the 12.1 million children who took one or more prescription medications had median expenditures (both insurance and out of pocket) of $1,305. “High-deductible health insurance penalizes anyone who's sick,” said Dr. David Himmelstein, study coauthor and an advocate of a single-payer system.
Resources for Children Challenged
Children will see their share of federal domestic spending and the gross national product decline by double digits over the next decade, according to a report from the nonpartisan Urban Institute. Federal resources for children are caught between ever-rising expenditures on adult health care and on retirement programs, and programs for children often lack provisions for automatic growth, the report said. As a piece of the federal domestic budget, spending on children will decline from more than 15% in 2006 to 13% in 2017, a nearly 15% drop, said economists Adam Carasso, Eugene Steuerle, and Gillian Reynolds. “Despite frequent rhetoric from policy makers on the priority given to children, the federal budget makes fairly clear that children are less of a priority and more of an afterthought in the budget process,” they said.
SCHIP Benefits Adolescents
When given health insurance through the state children's health insurance program (SCHIP), teenagers see their doctors more often, racial disparities are eliminated, and more preventive care is received, according to a study from the University of Rochester (N.Y.) Medical Center. The study, published in the April issue of Pediatrics, also found that teens received more counseling from their health care providers about guns, smoking, drugs, alcohol, and sexuality when receiving health insurance from SCHIP. “Adolescents have the worst access to health care among children,” said Dr. Jonathan Klein, professor of adolescent medicine at the University of Rochester, who surveyed about 1,000 adolescents and their parents for the study. “The increase in access to a usual source of care and reduction of unmet needs are the most important finding[s] of this study. Getting access to care is key to adolescent health,” Dr. Klein said in a statement. Authorization for SCHIP expires Sept. 30, and Congress currently is debating reauthorization.