|
|
1 |
|
CONGRESS: House Likely To Pass Rx Price Negotiations Bill
|
House Democrats likely will have an adequate number of votes to pass a bill (HR 4) that would require the HHS secretary to negotiate directly with pharmaceutical companies on prices for medications under the Medicare prescription drug benefit, USA Today reports. The House likely will vote on the legislation on Friday. However, the bill "faces a closer battle in the Senate," USA Today reports (Wolf, USA Today, 1/10). "Unlike their party colleagues in the House, Senate Democratic leaders are sending high-priority bills through regular order, a move that underscores their promise of bipartisanship," The Hill reports. Senate Finance Committee Chair Max Baucus (D-Mont.) on Thursday will hold a hearing on the legislation, but Baucus last year voted against two similar bills. Sens. Ron Wyden (D-Ore.) and Olympia Snowe (R-Maine) on Wednesday plan to introduce a revised version of a bill that received 54 votes in the Senate last year. Wyden said, "I'm going to work very closely with chairman Baucus. I'm pleased with the discussions we've had" (Schor/Young, The Hill, 1/10). According to USA Today, the issue might lead to a "debate about the government's role in the marketplace" that "could signify a series of political conflicts over health care policy reminiscent of the Clinton administration's first two years" (USA Today, 1/10).
Filibuster Possible
Senate Finance Committee ranking member Chuck Grassley (R-Iowa) on Tuesday said he would join with other senators to filibuster the legislation. According to CongressDaily, Grassley and other senators who oppose the bill "are likely to warn of government price controls." Grassley said, "I think for sure we'd have to say it's got the votes to pass. Now, does it have 60 votes? I don't know." Grassley said that he opposes the legislation because the bill would provide "an opening, when they get a Democratic president, to do away with the marketplace." Grassley added that, "eventually, we have to ask them to prove how they're going to save more money than we are" with the current Medicare prescription drug benefit (Johnson, CongressDaily, 1/10).
Association Health Plans
In other congressional news, House Republicans have drafted a minimum wage bill that includes a provision to allow small businesses to form association health plans across state lines (Johnson, CongressDaily, 1/9). The provision would allow businesses with fewer than 100 employees to form the association health plans. AHPs would not have to meet state benefits requirements (Rogers, Wall Street Journal, 1/10). House Republicans maintain that AHPs would "help small businesses that would be affected by a wage hike," CongressDaily reports. According to CongressDaily, some "senators have discussed offering a small business health care bill as an amendment" to minimum wage legislation, but the "move probably would not attract enough Democrats to pass. Senate Health, Education, Labor and Pensions Committee ranking member Mike Enzi (R-Wyo.) said that the Senate likely will not consider AHPs as part of the debate over a minimum wage bill (CongressDaily, 1/9).
Kennedy Calls for Universal Health Insurance
Senate HELP Committee Chair Edward Kennedy (D-Mass.) on Tuesday said he plans to draft legislation that would provide health insurance for all U.S. residents, the AP/Boston Herald reports. Kennedy said that he supports an extension of Medicare to all U.S. residents but added that he would consider other proposals (AP/Boston Herald, 1/10).
Related Broadcast Coverage
NPR's "Morning Edition" on Monday reported on congressional efforts to pass mental health parity legislation. The segment includes comments from Andrew Sperling, chief lobbyist of the National Alliance on Mental Illness, and Neil Troutwine, vice president of the National Retail Federation (Rovner, "Morning Edition," NPR, 1/8). The complete segment is available online in RealPlayer.
(Back to Contents)
|
2 |
|
STEM CELLS: White House To Release Report on Research Progress
|
The White House Domestic Policy Council on Wednesday is scheduled to release a report highlighting the progress and benefits of nonembryonic stem cell research, including a study published in the Jan. 7 online edition of the journal Nature Biotechnology that found stem cells derived from human amniotic fluid appear to offer many of the same benefits of embryonic stem cells, the Wall Street Journal reports. According to the Journal, White House officials confirmed that they have been drafting a possible executive order related to the stem cell research. White House spokesperson Tony Fratto declined to give details about the content and potential timing of the order but said, "[W]e are clearly working on ways we can direct whatever tools and funding we can" for stem cell research that does not involve harming human embryos. According to the Journal, some stem cell research supporters said the executive order would endorse federal funding for research of nonembryonic stem cells and would not reverse restrictions President Bush placed on federal funding for human embryonic stem cell research in 2001 (Lueck, Wall Street Journal, 1/10). Federal funding for embryonic stem cell research is allowed only for research using embryonic stem cell lines created on or before Aug. 9, 2001, under a policy announced by Bush on that date (American Health Line, 1/9).
Effect on Legislation
Some stem cell research supporters also said an executive order might help the Bush administration respond to criticism of an expected veto of a pending bill (HR 3, S 5) that would expand federal funding for embryonic stem cell research, the Journal reports (Wall Street Journal, 1/10). The legislation -- called the Stem Cell Research Enhancement Act of 2007 -- is identical to a measure (HR 810) Bush vetoed in July 2006 that would have expanded stem cell lines that are eligible for federal funding and allowed funding for research using stem cells derived from embryos originally created for fertility treatments and willingly donated by patients (American Health Line, 1/9). "We are exploring all the alternative science that maybe will make this question moot so we as a society do not have to deal with this moral grudge match," Fratto said. Supporters of the legislation have "dismissed the strategy as a distraction" and are "frustrated" that opponents, including Bush, "have seized" on the amniotic stem cell study "to bolster claims" that additional embryonic stem cell research is unnecessary, the Journal reports (Wall Street Journal, 1/10). Anthony Atala, senior author of the study and director of the Wake Forest University Institute for Regenerative Medicine, on Tuesday in a letter to Reps. Diana DeGette (D-Colo.) and Michael Castle (D-Del.), co-sponsors of the legislation, said that it is "essential that NIH-funded researchers are able to fully pursue embryonic stem cell research as a complement to research into other forms of stem cells" (Mulkern, Denver Post, 1/10). Atala wrote, "Some may be interpreting my research as a substitute for the need to pursue other forms of regenerative medicine therapies, such as those involving embryonic stem cells," adding, "I disagree with that assertion" (Kellman, AP/Winston-Salem Journal, 1/9). Sen. Tom Harkin (D-Iowa) on Tuesday said the Stem Cell Research Enhancement Act lacks one vote in the Senate before having a veto-proof majority, CongressDaily reports. "We have 66 (votes) with Sen. [Tim] Johnson (D-S.D.)," Harkin said. Johnson, who had suffered a brain hemorrhage and underwent brain surgery last month, is expected to undergo several months of recovery, CongressDaily reports. Senate Majority Leader Harry Reid (D-Nev.) has scheduled the vote for February or March (CongressDaily, 1/9). The House is scheduled to vote on the legislation on Thursday (Denver Post, 1/10).
(Back to Contents)
|
3 |
|
CMS: To Post Online Additional Data on Hospital Performance
|
CMS in June will post online additional data about the performance of hospitals in the treatment of heart attack and heart failure patients, USA Today reports. CMS will post the data -- based on a statistical analysis of the 30-day death rates of heart attack and heart failure patients from July 1, 2005, through June, 30, 2006 -- on the Hospital Compare Web site. According to CMS, the Web site will not include the 30-day death rates of heart attack and heart failure patients at individual hospitals but will report on whether the facilities performed more effectively, less effectively or at the same level as the national average. The 30-day death rates of heart attack and heart failure patients offer "a more reliable index of a hospital's performance than inpatient deaths and don't reward hospitals that transfer or discharge patients before death," USA Today reports. The Web site currently provides data on the performance of hospitals in the treatment of heart disease and other conditions. Michael Rapp of CMS said, "The main purpose of all this is to improve quality," adding, "If I'm running a hospital and see that I fall in a category that's worse than 98% of hospitals, that's going to grab my attention. I'd look to see if we can improve." Harlan Krumholz, a Yale University professor who with colleagues at Yale and Harvard University developed the statistical model that CMS used in the analysis, said, "If we could get the higher-mortality hospitals to achieve the performance of lower-mortality hospitals, we could save probably 10,000 or more lives a year." However, Gary Noskin of Northwestern Memorial Hospital in Chicago, said, "It clearly needs to be done, but I'm not sure 30-day mortality is the right measure," adding, "A patient could have a heart attack (and be treated successfully) and get hit by a bus after he leaves the hospital" (Sternberg, USA Today, 1/10).
(Back to Contents)
|
4 |
|
MEDPAC: Makes Recommendations for FY 2008
|
The Medicare Payment Advisory Commission is considering a set of recommendations to be included in its annual report to Congress in March, CQ HealthBeat reports. Summaries of recommendations appear below.
- Doctors: MedPAC in its March report to Congress will "chart two alternative paths to fixing the flawed Medicare mechanism for paying doctors," CQ HealthBeat reports. One of the paths would repeal the sustainable growth rate and involve "developing and adopting new approaches for improving the value" of Medicare spending. The other path would extend the SGR formula currently used to calculate doctor reimbursements to all health care providers. CQ HealthBeat reports that the commission "appears divided on whether the SGR should be repealed altogether" (Reichard [1], CQ HealthBeat, 1/9).
- Home health agencies/skilled nursing facilities: MedPAC recommended that Congress not increase payments in fiscal year 2008 for home health agencies or skilled nursing facilities, in part because of "[h]ealthy profits" in both industries, CQ HealthBeat reports. The lack of a payment update for home health agencies in 2008 would reduce Medicare spending by between $250 million and $750 million next year and by between $1 billion and $5 billion over five years, according to MedPAC estimates. The lack of an update would have no impact on patient care through home health agencies, according to MedPAC (Carey, CQ HealthBeat, 1/9).
- Hospitals: MedPAC voted unanimously to give hospitals a full "market basket" increase in FY 2008 payments for inpatient and outpatient care. The payment increase -- currently projected at 3.1% -- would be tied to the adoption of a "quality incentive payment program." CQ HealthBeat reports that the "net effect" of the recommendation "would be that if Congress sets up a [payment program] paying up to 2% more, some facilities would receive an update in fiscal 2008 higher than the market basket amount if they performed well on quality." MedPAC member and former Congressional Budget Office Director Douglas Holtz-Eakin said that the incentive program "really has to be a central part of the message to Congress" (Reichard [2], CQ HealthBeat , 1/9).
(Back to Contents)
|
5 |
|
MEDICARE: CMS To Waive Late Fee for Rx Drug Benefit for Some
|
CMS officials on Tuesday announced that the agency in 2007 will waive the late enrollment fee for the Medicare prescription drug benefit for low-income beneficiaries who qualify for federal subsidies, CQ HealthBeat reports. Acting CMS Administrator Leslie Norwalk in a statement said that the late enrollment fee seeks to encourage Medicare beneficiaries to participate in the prescription drug benefit but might prompt some low-income beneficiaries to avoid the program. She said, "This is our most difficult population to reach and the one for which we continue to focus our efforts," adding, "By continuing to remove the fear of a late fee for those who may not be able to pay, we are taking a positive step aimed at broader coverage for everyone." Sen. Chuck Grassley (R-Iowa), who has sponsored legislation to waive the late enrollment fee, called the decision to waive the fee for low-income beneficiaries "a good move." James Firman, chair of the Access to Benefits Coalition and president and CEO of the National Council on Aging, said that the decision to waive the fee for low-income beneficiaries will "make it easier for local organizations all over the country to find and persuade more people to sign up for this valuable benefit" (Agnes Carey, CQ HealthBeat, 1/9).
(Back to Contents)
|
6 |
|
FDA: To Increase Efforts To Remove Unapproved Medications
|
Deborah Autor, director of the Office of Compliance at FDA, on Tuesday told representatives from 65 companies that the agency plans to increase efforts to remove unapproved prescription and over-the-counter medications from the market, USA Today reports. Autor said, "We do intend to accelerate removal of unapproved drugs this year." In addition, Autor said that FDA will take a "concerted and concentrated approach" to the removal of unapproved medications, adding, "We are constantly evaluating potential targets." Autor said that FDA will focus on the removal of unapproved versions of approved medications. According to a USA Today article published in September 2006, many physicians, patients and pharmacists are unaware that some medications on the market are unapproved by FDA (Rubin, USA Today, 1/10).
(Back to Contents)
|
7 |
|
Rx DRUGS: Cost Less Through VA Than Medicare Part D, Study Finds
|
Prices in Medicare Part D prescription drug plans are on average of 58% more for the most commonly prescribed medications than prices paid by the U.S. Department of Veteran Affairs, according to a study released Tuesday by Families USA, the Arizona Daily Star reports (Arizona Daily Star, 1/10). The study used data submitted in November 2006 by the five health plans with the highest Part D enrollment figures. The prices represent charges that would be paid in full by Medicare beneficiaries in the so-called "doughnut hole" coverage gap. Researchers considered Part D and VA prices for the top 20 drugs prescribed to seniors (Lade, South Florida Sun-Sentinel, 1/10). The study found that the VA was able to use its purchasing power to negotiate for lower drug prices. Under the 2003 Medicare law, Medicare does not have the right to negotiate with drug companies. All 20 drugs cost more under Medicare Part D than under VA programs (Arizona Daily Star, 1/10). The differences in price ranged from 34% higher for the bloodthinner Plavix to as much as 10 times higher for the statin Zocor. Families USA Executive Director Ron Pollack in a statement said, "These high prices devastate seniors who need to take multiple medicines," adding, "They are also a rip-off of American taxpayers" (South Florida Sun-Sentinel, 1/10). The report also "challenged assertions" that pharmaceutical companies need Medicare's revenue to fund research and development, according to the Detroit Free Press. The report suggested that drug companies could shift money from marketing, advertising and administration -- which consumes 32% of the top seven companies' budgets -- to research and development, which takes up 13.9% of revenue, according to 2005 filings with the Securities and Exchange Commission. "The industry could absorb a reduction in revenues resulting from negotiations with Medicare without paring back R&D spending," the report stated (Anstett, Detroit Free Press, 1/10). The study is available online. Note: You will need Adobe Acrobat Reader to view the study.
(Back to Contents)
|
8 |
|
AMERICAN HEART ASSOCIATION: Launches Exercise, Nutrition Tracker
|
The American Heart Association on Monday launched a new online program to help participants track exercise and nutrition, the AP/Los Angeles Times reports. The program -- called Start! -- has components for individuals and businesses. Start! allows participants to input data on diet and exercise and offers summaries of calories consumed and expended. The company plan encourages participating businesses to sponsor walking programs and "sneaker days," when employees are allowed to wear sneakers to the office. The program focuses on walking because it is "the easiest activity for most people," AHA President Raymond Gibbons said. AHA hopes Start! will help more U.S. residents follow through with their New Year's resolutions to get in shape, the AP/Times reports. "I think we all know that as a nation, we are not active enough," Gibbons said (Stengle, AP/Los Angeles Times, 1/8).
(Back to Contents)
|
9 |
|
MEDICAID: Proof-of-Citizenship Law Might Be Affecting Enrollment
|
Seventeen states in 2006 increased access to health coverage, but new federal proof-of-citizenship rules might be leading to a decline in children's Medicaid enrollment in some states, according to a survey released Tuesday by the Kaiser Family Foundation's Commission on Medicaid and the Uninsured, CQ HealthBeat reports (Carey, CQ HealthBeat, 1/9). The survey is the sixth in an annual series that examines policy and funding changes that impact enrollment in Medicaid and SCHIP programs in all 50 states and Washington, D.C. (Kaiser Family Foundation release, 1/9). The survey found that in 2006 -- for the first time in four years -- no state cut eligibility for Medicaid or SCHIP, and one-third of the states increased access to health coverage (CongressDaily, 1/9). However, according to Donna Cohen Ross, a survey author and outreach director at the Center on Budget and Policy Priorities, a growing number of states are reporting declines in enrollment and a backlog of applications since the proof-of-citizenship law was implemented on July 1, 2006 (CQ HealthBeat, 1/9). The law is a response to concerns about undocumented immigrants obtaining access to government-sponsored health coverage, according to AP/Yahoo! News (Freking, AP/Yahoo! News, 1/9). The survey indicates that Iowa, Louisiana, New Hampshire, Virginia and Wisconsin are some of the states reporting enrollment declines and backlogs since the law took effect (Kaiser Family Foundation release, 1/9). Officials in states with declining enrollment and processing backlogs contend that the law is preventing U.S. citizens and certain legal immigrants from obtaining benefits, rather than undocumented immigrants (Freking, AP/Yahoo! News, 1/9). The survey concludes, "This new federal requirement restricts state flexibility to establish simple and efficient procedures and appears to be compromising efforts to cover eligible individuals" (CQ HealthBeat, 1/9). The survey also profiles Illinois' effort to provide universal health care for children, Utah's SCHIP enrollment freeze and new enrollment procedures in Connecticut. In addition, the survey found that Medicaid eligibility remains more restrictive for adults than for children (Kaiser Family Foundation release, 1/9).
Reaction
Anita Smith of the Iowa Department of Human Services said, "There is no evidence that the decline is due to undocumented aliens leaving the program." She added, "Rather, we believe that these new requirements are keeping otherwise eligible citizens from receiving Medicaid because they cannot provide the documents required to prove their citizenship or identity" (Freking, AP/Yahoo! News, 1/9). CMS spokesperson Jeff Nelligan said, "We believe we have given the states the tools they need to both implement the law and provide sufficient flexibility to assist individuals in establishing their citizenship. We continue to monitor state implementation and are not aware of any data that shows there are significant barriers to enrollment." He added that states should report any problems to CMS (CQ HealthBeat, 1/9). The survey is available online.
(Back to Contents)
|
10 |
|
Rx DRUGS: Doctors Accommodate Patient Requests for Advertised Drugs
|
A majority of primary care physicians report that their patients ask for drugs they have seen in advertisements and that they often accommodate their requests, according to a survey published in the February issue of Consumer Reports, the Atlanta Journal-Constitution reports. The survey questioned 335 doctors and 39,090 U.S. residents. It found that 78% of PCPs received patient requests for specific drugs they have seen advertised on television and that 67% reported they sometimes grant the requests. In addition, the survey found that 41% of doctors feel patients are poorly informed. According to Robert Thompson, a professor of popular culture at Syracuse University, direct-to-consumer drug ads "have completely turned around the old relationship when the doctor was this godlike character and you used to go in there all deferentially." Consumer Reports urges readers to "ignore drug ads" and cautions that the drug industry "spends billions of dollars a year trying to get you to pester your doctor for expensive, new brand-name drugs" (Hendrick, Atlanta Journal-Constitution, 1/9).
(Back to Contents)
|
11 |
|
Rx INDUSTRY: AHL Features Recent Developments
|
Summaries of several recent developments in the pharmaceutical, biotechnology and medical device industries appear below.- Boston Scientific: Boston Scientific on Monday announced plans to eliminate 500 to 600 jobs, about 2% of the company work force, in the cardiac rhythm division as part of an effort to eliminate some research and development projects and focus on those with the most potential, the AP/Indianapolis Star reports. In addition, Boston Scientific reported that fourth-quarter cardiac rhythm device sales increased by 10% to $489 million from $446 million in the third quarter and that defibrillator sales, which accounted for most of the cardiac rhythm device sales, increased by 13% to $356 million (AP/Indianapolis Star, 1/9).
- Cephalon: Cephalon this week said a Phase III clinical trial found that the dissolvable lozenge Fentora, which FDA approved in September 2006 as a treatment for "breakthrough pain" in cancer patients, can effectively treat neuropathic pain, the Philadelphia Inquirer reports. According to Cephalon, the trial found that Fentora had a statistically significant effect in pain reduction within 10 minutes compared with a placebo (Loyd, Philadelphia Inquirer, 1/8).
- Eli Lilly: Lilly on Friday announced plans to pay as much as $385 million for the rights to PSN010, an experimental diabetes medication manufactured by OSI Pharmaceuticals, Long Island Newsday reports. Under the agreement, OSI will receive an initial payment of $25 million and as much as $360 million in milestone payments (Bernstein, Long Island Newsday, 1/6).
- Icos: HealthCor Management, the fifth-largest Icos shareholder, this week announced plans to vote against an acquisition offer from Lilly valued at $2.28 billion, or $34 per share, Bloomberg/Seattle Post-Intelligencer reports. In a letter to Icos, HealthCor wrote that the offer, on which shareholders plan to vote on Jan. 25, "still does not represent adequate compensation" and that Lilly should increase the offer to at least $40 per share (Bloomberg/Seattle Post-Intelligencer, 1/9).
- Procter & Gamble: P&G on Monday announced plans to purchase a minority stake in MDVIP, a company that helps physicians establish concierge medical practices, the Miami Herald reports. The companies did not disclose the details of the agreement (Dorschner, Miami Herald, 1/9).
- Ranbaxy Laboratories: Ranbaxy officials on Tuesday said that the company might seek to acquire the generic prescription drug business of Merck KGaA, a move that "could propel the Indian company into the top league of the generic drug makers," the Boston Globe reports. The acquisition would make Ranbaxy the third-largest generic pharmaceutical company worldwide after Teva Pharmaceuticals and Sandoz, a division of Novartis (Boston Globe, 1/9).
- Scripps Florida: Scripps has spun off Xcovery, a private company that will seek to develop medications to treat inflammation and cancer, the South Florida Sun-Sentinel reports. Xcovery, financed by Biocatalyst International and Biocatalyst CEO Sheridan Snyder, has licensed the rights to experimental medications discovered by Chris Liang at a Scripps laboratory and in the first year will seek to determine potential candidates for development (Singe, South Florida Sun-Sentinel, 1/8).
- Seattle Genetics: Seattle Genetics on Monday announced a partnership with Genentech to develop an experimental medication for multiple myeloma and other blood cancers, Bloomberg/Seattle Times reports. Under the agreement, Genentech will make an initial $60 million payment for the worldwide rights to SGN-40, a monoclonal antibody, and as much as $800 million in milestone payments (Bloomberg/Seattle Times, 1/8).
- St. Jude Medical: St. Jude officials this week said that the company likely will report fourth-quarter earnings of 42 cents per share and sales of about $864 million, the Wall Street Journal reports. Analysts surveyed by Thompson Financial on average estimated that St. Jude would report fourth-quarter earnings of 39 cents per share and sales of about $844 million. In addition, St. Jude officials said that the company likely will report fourth-quarter implantable cardioverter defibrillator sales of $289 million, "toward the upper end of its earlier forecast of $265 million to $295 million," the Journal reports (Wall Street Journal, 1/9).
- VaxGen: VaxGen on Friday announced the termination of 112 employees, about half of the company work force, and the resignation of CEO Lance Gordon after the company last month lost an $877.5 million contract with HHS to develop a new anthrax vaccine, the San Jose Mercury News reports. VaxGen Executive Vice President James Panek will replace Gordon as CEO, and Gordon will remain with the company as a consultant. VaxGen also has hired investment bank Lazard to help seek potential mergers or business agreements with other companies (Johnson, San Jose Mercury News, 1/6).
(Back to Contents)
|
12 |
|
HEALTH CARE INDUSTRY: AHL Examines Recent Developments
|
Below, American Health Line summarizes recent developments in the health care industry.
- Advanced Medical Optics/IntraLase: California-based Advanced Medical Optics, the nation's leading manufacturer of Lasik eye surgery equipment, on Monday announced plans to acquire California-based IntraLase for $808 million, the Los Angeles Times reports. IntraLase makes a laser device that allows doctors to perform Lasik surgery without a blade, an advance that AMO "hopes ... will make the vision correction procedure more popular with consumers," the Times reports (Yi, Los Angeles Times, 1/9). The agreement has been approved by both company boards. The price represents a 12.5% premium over IntraLase's closing stock price on Friday of $22.23. AMO Chair, President and CEO Jim Mazzo said, "One area that has been gaining a lot of momentum is the 'all laser all Lasik' concept and we felt that was a key area missing from our portfolio." IntraLase President and CEO Robert Palmisano said AMO's offer was "very fair," adding that with "these two technologies working in coordination, we can make the procedure better" (Rundle, Wall Street Journal, 1/8). The companies said they expect to complete the deal by the end of the second quarter (Los Angeles Times, 1/9).
- United Surgical Partners International: Texas-based United Surgical, which has ownership interests or operates 141 short-stay surgical facilities, on Monday said it has agreed to be acquired by private equity firm Welsh, Carson, Anderson & Stowe for $1.8 billion, Reuters/New York Times reports (Reuters/New York Times, 1/9). Welsh Carson, the company's founding shareholder in 1998, has agreed to pay $31.05 per share for United Surgical, representing a 13% premium over the company's Friday closing price (Wall Street Journal, 1/8). Standard & Poor's in a research note said the offer "represents a fair price based on other health care facility deals." The agreement allows United Surgical to seek other bidders until Feb. 17 (Bloomberg/Boston Globe, 1/9). The transaction is expected to close during the second quarter (Wall Street Journal, 1/8).
(Back to Contents)
|
13 |
|
GM: Official Says Company Will Seek To Reduce Health Care Costs
|
GM and other automakers will continue with efforts to reduce health care costs, GM North America President Troy Clarke said on Monday at the North American International Auto Show in Detroit, the AP/Denver Post reports. According to Clarke, GM spends about $5 billion annually on health care. He said, "There's few, if any, other costs in our business or anybody's business that tend to inflate at that kind of level" (AP/Denver Post, 1/8).
(Back to Contents)
|
14 |
|
CALIFORNIA: Health Insurance Proposal Faces 'Hard Fight'
|
A proposal announced on Monday by California Gov. Arnold Schwarzenegger (R) that would require all state residents to obtain health insurance "is promising and ambitious but faces a long, hard fight before enactment," the New York Times reports (McKinley, New York Times, 1/10). Under the proposal, employers with 10 or more employees would have to offer health insurance for workers or pay a fee of 4% of payroll to a state pool that would help workers purchase coverage, with the amount that they pay based on income. Employees could pay for health insurance with pretax income. The proposal would require health insurers to sell policies to all state residents, regardless of whether they have medical conditions. State residents who refuse to obtain health insurance could face reductions in their state income tax refunds or have their wages garnished. The proposal also would extend coverage under Medi-Cal, the state Medicaid program, to all adults with annual incomes of as much as 100% of the federal poverty level and to children -- regardless of their immigration status -- in households with annual incomes of as much as 300% of the federal poverty level. The proposal would provide additional subsidies to help state residents with annual incomes of as much as 250% of the federal poverty level purchase health insurance. In addition, the proposal would increase by $4 billion reimbursements to health care providers under Medi-Cal. Under the proposal, physicians would have to pay 2% and hospitals would have to pay 4% of their revenue to help cover the cost. According to Schwarzenegger aides, the governor would finance the proposal in part with about $5 billion in federal matching funds that the state will receive as a result of restructured health care programs and with state funds currently used to finance charity care (American Health Line 1/9).
Concerns From Many Players
According to lawmakers and policy analysts, enactment of the proposal remains uncertain because of the "enormous number of political players -- from big labor and big insurance to small-county government -- that would be affected by any universal health care bill," the Times reports. State Senate Pro Tem Don Perata (D) said, "I cannot think of another topic that requires so many people to be heard to build consensus. You'd have to rent out Madison Square Garden to get them all in there" (McKinley, New York Times, 1/10). State Assembly member Robert Huff (R) said, "Health coverage for illegal aliens is a nonstarter for us. It creates a magnet for them coming here rather than staying there" (McKinley, New York Times, 1/10). State Assembly Republican Leader Michael Villines said, "Imposing a new jobs tax on employers of any size and expanding costly government mandates is the wrong approach" (Wood, Christian Science Monitor, 1/10).
Additional Concerns
Some groups raised concerns about the proposed requirement that physicians and hospitals pay a share of their revenue. Jan Emerson, a spokesperson for the California Hospital Association, said, "What we don't understand is the impact of (the 4% fee) versus the additional money that we'll get from increases in Medi-Cal reimbursements. We don't understand the trade-offs" (Colliver, San Francisco Chronicle, 1/9). Anmol Singh Mahal, president of the California Medical Association, said, "We feel it's a regressive tax" (McKinley, New York Times, 1/10). Art Pulaski, executive secretary treasurer of the California Labor Federation, criticized the proposal as a "boon to insurance companies" and a "bust for most workers." Pulaski said, "This plan requires all Californians to buy health insurance with no guarantee that it will be affordable or that coverage will be adequate. We are concerned that the plan creates an incentive for employers who currently provide health care to drop coverage and instead pay only a minimal tax." Other groups raised concerns about the plan to finance the proposal in part with about $5 billion in federal matching funds. Jeffrey Miles, spokesperson for the California Association of Health Underwriters, said, "To try to make the assumption that the money is going to drop out of the sky from Washington is unrealistic" (San Francisco Chronicle, 1/9). In addition, some groups raised concerns about enforcement of the proposal.
Some Support
Kim Belshé, the secretary of the state Health and Human Services Agency, said, "Without an individual mandate, people will continue to forgo coverage and thus continue to shift the costs of unpaid bills to insured individuals," adding, "One of the goals is to create a more functional market where everyone is insured, providers are more fairly compensated" (Chorneau/Colliver, San Francisco Chronicle, 1/10). According to the Christian Science Monitor, the proposed extension of coverage under Medi-Cal to children in low-income households, regardless of their immigration status, "is winning kudos from family groups nationally." Ron Pollack, executive director of Families USA, said that the proposal "will not only be enormously helpful for California children but will also play a very significant role at the national level." He added, "This will no doubt lend enormous support for the federal government's providing states with significant funding to expand coverage to uninsured children" through the SCHIP program, which requires reauthorization this year (Christian Science Monitor, 1/10). Health insurers also have expressed support for the proposal (AP/Washington Times, 1/10).
Massachusetts as Model?
Massachusetts, which recently enacted a similar health insurance law, "could offer some guideposts" as "California maps out its path near universal health insurance," the Times reports. Michael Widmer, president of the Massachusetts Taxpayers Foundation, said, "We're really changing the culture of providing health care. For some people, it's changing the mind-set from one of showing up at the emergency room or at the local health center with a problem to understanding that they can be insured" (Belluck, New York Times, 1/10).
(Back to Contents)
|
15 |
|
HEART DISEASE: Blood Test Could Determine Risk, Study Finds
|
An inexpensive blood test used to screen heart failure patients could help determine risk for future complications and death in heart disease patients, according to a study published on Wednesday in the Journal of the American Medical Association, Bloomberg/Philadelphia Inquirer reports (Fay Cortez, Bloomberg/Philadelphia Inquirer, 1/10). The test determines levels of the protein NT-proBNP, a marker in the blood for BNP, a hormone that increases during times of cardiac stress (Scripps Howard/Arizona Daily Star, 1/10). For the study, researchers led by Kirsten Bibbins-Domingo, a San Francisco General Hospital internist, tested levels of NT-proBNP in the blood of 987 heart disease patients (Russell, San Francisco Chronicle, 1/10). Researchers divided participants into four groups based on their levels of NT-proBNP in their blood and tracked them for an average of 3.7 years. During the study, 256 participants experienced adverse cardiovascular events, 34 of whom who died from heart disease. The study found that participants with the highest levels of NT-proBNP were 3.4 times more likely to experience adverse cardiovascular events or die from heart disease than those with the lowest levels (Scripps Howard/Arizona Daily Star, 1/10). The National Heart, Lung and Blood Institute, the Robert Wood Johnson Foundation and the University of California-San Francisco funded the study, and Roche Holding provided funds for the tests, which cost less than $50.
Reaction
Bibbins-Domingo said, "The results of a simple blood test at the very beginning of our study seemed to be able to predict who, four years later, would go on to develop one of those complications." She added, "The ultimate goal of a test like this is to help clinicians guide the use of more aggressive medical or surgical therapies we know to be life-saving" (Bloomberg/Philadelphia Inquirer, 1/10). However, in an editorial that accompanied the study, Marvin Konstam of the Tufts University School of Medicine wrote that additional studies are necessary to determine the effectiveness of the test as an indicator of risk for future complications and death in heart disease patients. He wrote, "I'd stop short of getting people excited enough to say, 'Doctor, I've got to have this test.' That would be a mistake" (San Francisco Chronicle, 1/10). An estimated 71 million U.S. residents have some form of heart disease (Griffith, Contra Costa Times, 1/10). An abstract of the study in available online.
(Back to Contents)
|
16 |
|
BEVERAGES: Studies Funded by Industry More Likely To Be Favorable
|
Scientific research on beverages that is sponsored by the industry is four to eight times more likely to have favorable results than research sponsored by a neutral party, according to a study published online in PLoS Medicine, the Boston Globe reports (Smith, Boston Globe, 1/9). Lead researcher David Ludwig, a pediatric endocrinologist and director of the Optimal Weight for Life program at Children's Hospital Boston, and colleagues reviewed 111 studies on soft drinks, juices and milk. Two scientists then analyzed the studies' conclusions without knowing who sponsored them, and another researcher identified the sponsor without knowing the conclusions. Researchers classified the studies according to whether a favorable finding would be beneficial, negative or neutral to the sponsor's financial interests (Hellmich, USA Today, 1/9). Of the 111 studies, 22% had been fully funded by the food and beverage industry and 32% received partial funding from industry. Overall, studies funded entirely by industry were four to eight times more likely to be favorable to their sponsors, and none of the studies fully funded by industry that were tested with a control group had negative results (Marchione, AP/Lexington Herald-Leader, 1/9). USA Today reports that the "analysis raises concerns about how bias in nutrition research may affect dietary advice." Ludwig suggested that the government improve nutrition funding so that scientists -- who "face a stark choice of taking industry money to fund their work while still trying to maintain their integrity" -- can avoid "having to face this awkward decision." Beverage industry officials deny that they publish biased studies (USA Today, 1/9). NPR's "Morning Edition" on Tuesday reported on the study. The segment includes comments from Ludwig; Kelly Brownell, director of the Yale University Rudd Center for Food Policy & Obesity; and Greg Miller, vice president of science and innovation at the National Dairy Council (Aubrey, "Morning Edition," NPR, 1/9). The complete segment is available online in RealPlayer.
Many U.S. Residents Consuming Sugary Beverages, Report Finds
U.S. residents consume nearly 25% of their total daily calories in sugary beverages, a practice that has been linked with obesity, according to report released Monday by the Milk Processors Board, the Chicago Tribune reports. Using data from a federal study, the report found that roughly 50% of U.S. residents over age four consume sugary beverages -- such as soft drinks, sweetened fruit juices or presweetened iced teas -- on any given day. In addition, most individuals do not consume fewer food calories to compensate for the added beverage calories. "The point is that you are drinking your calories," Richard Mattes, a professor of food and nutrition at Purdue University, said, adding, "Beverages elicit a very weak response" in terms of feeling full (Keller, Chicago Tribune, 1/9).
(Back to Contents)
|
17 |
|
WARFARIN: Increases Risk for Brain Hemorrhages, Study Finds
|
The rate of brain hemorrhages among individuals who took the blood thinner warfarin, marketed as Coumadin, increased by five times from 1988 through 1999, during which time use of the medication in the U.S. increased by 400%, according to a study published on Monday in the journal Neurology, the Cincinnati Enquirer reports (O'Farrell, Cincinnati Enquirer, 1/9). In addition, the study found that the rate of brain hemorrhages among individuals older than age 80 who took warfarin increased by 10 times from 1988 through 1999. For the study, Matthew Flaherty and colleagues at the Cincinnati College of Medicine examined data on Cincinnati patients hospitalized for brain hemorrhages for the first time. The study found that, among all participants, the annual rate of brain hemorrhages related to warfarin use increased from 0.8 cases per 100,000 in 1998 to 4.4 cases per 100,000 in 1999. Among participants older than age 80, the annual rate of brain hemorrhages related to warfarin use increased from 2.5 cases per 100,000 in 1988 to 45.9 cases per 100,000 in 1999, the study found (Washington Post, 1/9). Use of warfarin increased from 1988 through 1999 after studies found that the medication reduced risk for ischemic strokes caused by blood clots in individuals with atrial fibrillation. Flaherty said that the risk for ischemic strokes is higher than the risk for brain hemorrhages related to warfarin use. However, he said that the risk for brain hemorrhages related to warfarin use might outweigh the benefits of the medication for individuals older than age 80. Flaherty added that individuals should consult their physicians before they end treatment with warfarin. He said, "We need to know who is likely to benefit and who is likely to be harmed" by warfarin use, adding, "The dose of warfarin needs to be adjusted to get to the proper therapeutic levels" (Talan, Long Island Newsday, 1/9). An abstract of the study is available online.
(Back to Contents)
|
18 |
|
TOBACCO: Maine Ranks First in Anti-Tobacco Efforts, Report Finds
|
Maine ranked first in the nation for anti-tobacco efforts, according to the annual American Lung Association report released on Tuesday, the New York Times reports (Pérez-Peña, New York Times, 1/9). The report, titled the American Lung Association State of Tobacco Control 2006, rated the 50 states; Washington, D.C.; and Puerto Rico in four areas -- smoke-free air in workplaces, cigarette taxes, spending on tobacco prevention and cessation programs, and restrictions on youth access to tobacco products -- with grades from "A" through "F" (ALA release, 1/9). According to the report, for the second consecutive year, Maine received A grades in each of the four areas. Eighteen states received F grades in at least three of the four areas, the report found (New York Times, 1/9). In addition, the report found that 34 states received F grades for spending on tobacco prevention and cessation programs and that 23 states received F grades for smoke-free air in workplaces. The report also found that a record 26 states and Washington, D.C., received at least C grades for smoke-free air (Manchester Union Leader, 1/9). Cigarette taxes increased in eight states in 2006, and the national average increased to $1 per pack, according to the report (ALA release, 1/9). Five states received A grades for restrictions on youth access to tobacco products, the report found (New York Times, 1/9). The report is available online.
(Back to Contents)
|
19 |
|
RETIREMENT: Reductions Needed in Medicare, Social Security
|
If lawmakers were "serious" about "pledges of 'fiscal responsibility'" they would propose cuts in Social Security and Medicare, Washington Post columnist Robert Samuelson writes in an opinion piece. According to Samuelson, "Preserving present retirement benefits automatically imposes huge costs on the young," and the "tax increases required by 2030 could hit 50%, if other spending is maintained as a share of national income." Samuelson writes that retirees "have adopted a policy of selfish silence" with regard to government-sponsored retirement benefits. He adds, "Baby boomers seem eager to 'reinvent retirement' in all ways except those that might threaten their pocketbooks." Samuelson suggests that in addition to reducing benefits, raising taxes and cutting spending, "much of the adjustment should come from increasing eligibility ages (ultimately to 70) and curbing payments to wealthier retirees." He writes, "Pundits usually speak in bland generalities" about Social Security and Medicare. "They support 'fiscal responsibility' and 'entitlement reform' and oppose big budget deficits," but less "often do they say plainly that people need to work longer and that retirees need to lose some benefits," Samuelson says. Samuelson predicts that "this Congress will do nothing" to address Social Security and Medicare, "just as previous Congresses have done nothing" (Samuelson, Washington Post, 1/10).
(Back to Contents)
Editorial: 202/266-5381 ·
Fax: 202/266-5767 ·
Mailbag:
ahl@advisory.com
|
Josh Kotzman, Cheryl Skrzat, Editors
Amanda Wolfe, Editor in Chief
Allison Czapp, Amy Dietterich, Daniel Esquibel, Jennifer Haliski, Kimberley Lufkin, Contributing Editors
Bryn Lansdowne, Tessa Moran, Justyn Ware, Sherkiya Wedgeworth, Cameron Williams, Staff Writers
Sarah Mann, Chris Sowerwine, Copy Editors
|
|
New Orders/Customer Service: 1-800-717-3245
|
|
Pricey Prescriptions
1