Health Care News: November 2006 Archives

SAN FRANCISCO (Reuters) - With California facing a $5.5-billion budget gap, Gov. Arnold Schwarzenegger may have to pare his goal of providing health-care coverage to the nearly 7 million uninsured in the state, analysts said on Monday.

The Republican governor crushed his Democratic challenger in an easy re-election victory this month, and aims to use the political momentum to push a plan that on its face should excite California's Democrat-led legislature.

But observers of the state's political scene wonder where money for the plan, which aides are writing, would come from.

"The math doesn't add up," said Larry Gerston, a political scientist at San Jose State University. "I don't understand the means at the moment."

The quality of cardiac care for Medicaid patients lags behind the care given to those with HMOs and private insurance according to a new study. The study by Dr. James Calvin, lead study author and director of cardiology at Rush University Medical Center, found Medicaid patients were less likely to receive short term medications and to undergo invasive cardiac procedures. They also had higher in-hospital mortality rates and were less likely to receive recommended discharge care. Differences were fewer and smaller for Medicare patients.

The study is published in the November 21st issue of the Annals of Internal Medicine. In addition to Rush, study participants included Duke University Medical Center, New York University School of Medicine, Northwestern University School of Medicine, University of Cincinnati College of Medicine, and the University of North Carolina at Chapel Hill.

WASHINGTON - States should be given more freedom to enroll the poorest of the poor into managed care programs and adopt changes that have worked elsewhere, a Medicaid reform panel recommended Friday.

However, Democratic lawmakers have contended that the panel, formed nearly 18 months ago by the Bush administration, has lacked independence. Now that the Democrats control Congress, some analysts are predicting the group's recommendations will be "dead on arrival."

"While some in Congress thought this effort would bear fruit, I see no proof of that in this report," said Rep. John Dingell, D-Mich. "It is the job of the Congress to review the Medicaid program and legislate necessary changes, not a hand-picked commission stacked against working families."

One of the nation's leading suppliers of pharmaceutical services to the elderly has agreed to pay $49.5 million to settle large-scale Medicaid fraud claims, federal officials announced Tuesday.

The fraud claims were contained in lawsuits filed in U.S. District Court in Chicago by the federal government and two whistleblowers who formerly were employees of Omnicare Inc., based in Covington, Ky.

The lawsuits charged that Omnicare gave Medicaid patients Ranitidine capsules instead of less expensive tablets of the same drug; Fluoxetine tablets rather than cheaper Fluoxetine capsules; and two 7.5-milligram Buspirone tablets instead of the less costly single 15-milligram tablets.

Switching the form of the drugs increased the amounts Omnicare charged Medicaid by millions of dollars, officials said.

Policy makers are expected to spend the next two years cementing their positions on how to fix the out-of-control costs, mediocre quality, and high uninsured rates plaguing the U.S. health care system.

But it doesn't look like the public is going to be much help.

A national survey released Tuesday showed that eight in 10 American adults believe that the health system has problems and needs improvement. But while that may sound like a consensus for big changes, respondents confirmed what researchers noticed long ago: few are willing to sacrifice to get them.

The technology for calibrating transparent rating scale-based measures of health and functional status is over 50 years old.^[1] It is well researched and documented. It has been used to construct scientifically and legally defensible admissions and professional certification tests for over 30 years, in healthcare and other industries.^[2,3]

So how is it that this technology is virtually unknown in health services research? I say virtually unknown, because there are a growing number of applications in healthcare of the mathematical models at issue.^[4]

What healthcare does not have, however, is an overarching plan for decentralized networks of different brands and configurations of instruments that measure the same things in the same units.

by Robert M Centor, MD

While thinking about how to answer this question, I have changed my list several times. My first list included malpractice reform, but I have since decided that although malpractice is a major issue, it does not make my top 3.

The best way to address such a question is to consider the biggest problems with our current healthcare system. In addition to malpractice, I have weighed issues such as transitions of care between different sites, medical training, and continuing education. However, I must restrict my list to 3, so here are my top issues in 2006: access to excellent generalists; accurate, complete patient data; and better pharmaceutical data.

My first reform would be to create an agency to perform unbiased research on proposed new drugs. Each pharmaceutical company would have to help fund this agency, but it would need to be kept free of drug company influence. The agency would have the responsibility of determining drug safety and efficacy as well as determining relative efficacy of different drugs.

AUSTRALIA - The most prescribed drug in the country is costing patients and taxpayers almost $200 million a year more than it should because of marketing expenses.

Australians spend $94 million a year at the pharmacist's counter on the cholesterol-lowering drug Lipitor, according to Pharmaceutical Benefits Scheme data.

But more than double that figure is spent on marketing the drug, taking the total cost to the taxpayer — after the PBS subsidy is added — to $581.5 million each year.

WASHINGTON, Nov. 10 (UPI) -- Healthcare reform will emerge as a key political issue over the next two years, says Joel E. Miller, senior vice president for operations at the National Coalition on Health Care.

"Because more and more employers are dropping coverage and more and more workers are deciding that coverage is too expensive even when it's offered, we think that over the next couple of years there will be a full-scale debate on health reform leading up to the presidential elections," he said.

The number of uninsured Americans rose 800,000 between 2003 and 2004 and has increased by 6 million since 2000, according to the NCHC. Approximately 46 million Americans, or 15.7 percent of the population, were without health insurance in 2004, according to the latest government data available.

PARIS (Reuters) - The French, among Europe's most avid consumers of prescription drugs, are popping fewer pills and powders -- not because they have become healthier, but because the government is on a mission to cut the country's healthcare bill.

In a major break with previous years, growth in medicine sales has slowed this year, to just 1 percent in the year to August compared with 5 to 7 percent between 1990 and 2005.

Drugmaker Sanofi-Aventis has announced job cuts in France and Germany and French sector body LEEM has warned of more to come, urging the government to see drugs not just as a cost but as products that help the economy and jobs.

HealthDay News -- U.S. doctors often fail to discuss costs, prescription drug insurance coverage and other related issues when they give new prescriptions to patients, a new study finds.

These are all important issues because they're linked to whether patients will continue taking their medications, the researchers note.

"Though cost discussions are not always necessary, especially if physicians know a patient's financial situation and the best formulary choice for a medication, physicians must have a high level of awareness about medication cost and issues impeding acquisition to medication, because these can be important barriers to patient medication adherence," lead author Dr. Derjung Tarn, assistant professor of family medicine at the University of California, Los Angeles, David Geffen School of Medicine, said in a prepared statement.

Her team's published the findings in the November issue of the American Journal of Managed Care.

According to a global study on effective primary health care for patients that was released by the Commonwealth Fund, Canada ranks much lower than other developed countries, except the U.S.

In the survey conducted on over 6,000 doctors in 7 countries, it was found that Canada lagged in several aspects including wait times for tests, usage of electronic medical records, doctors availability after hours, multi-discipline teams for treatment of chronic illness and financial incentives for care quality improvement.

The survey reveals that Canada is far behind several other countries like New Zealand, Australia, U.K., Netherlands and Germany.