Health
Care Briefs -- November, 2005 Issue
compiled by Dan Butts
"(19) States Take Health Care Problems in Own Hands"
Clinics in Pharmacies (for people who don't have health insurance)
"British Journal Faults Rival Over New (Breast Cancer) Drug"
Health Care Briefs
American Healthcare Update
(the medical experience of "sicker adults" is WORSE; economic
advantages of universal coverage)
(highlights)
An internal Wal-Mart memo describes plans to cut health
costs by hiring temporary workers, who aren't entitled to health
insurance, and screening out employees likely to have high medi-
cal bills (almost half of Wal-Mart employees can't afford the
premiums or are on Medicaid--db).
Between 2000 and 2004 the numberof Americans under
65 rose by 10 million. Yet the number of nonelderly Americans
covered by employment-based insurance fell by 4.9 MILLION.
In 2002 the United States spent $5,267 per person on health
care. Canada spent $2,931; Germany spent $2,817; Britain spent
only $2,160. Yet the United States has lower life expectancy and
higher infant mortality than any of these countries (plus the U.S.
is at or near the bottom on more than a dozen additional health
care indicators--db).
The journal Health Affairs recently published the results
of a survey of the medical experience of "sicker adults"
in six
countries, including Canada, Britain, Germany, and the United
States.
Sicker Adults Worse Off in the United States
It's true that Americans generally have shorter waits for
elective surgery than Canadians or Britons, although German
waits are even shorter. But Americans do worse by some
important measures: we find it harder than citizens of other
advanced countries to see a doctor when we need one, and our
system is more, not less, rife with medical errors.
**Above all, Americans are far more likely than others to
forgo treatment because they can't afford it. Forty (40) per-
cent of the Americans surveyed failed to fill a prescription
because of cost. A third were deterred by cost from seeing
a doctor when sick or from getting recommended tests or follow-
up.
Economic Advantages of Universal Coverage
Taiwan, which moved 10 years ago from a U.S.-style system
to a Canadian-style single-payer system, offers an object lesson
in the economic advantages of universal coverage.
**In 1995 less than 60 % of Taiwan's residents had health
insurance; by 2001 the number was 97 %. Yet according to a
careful study published in Health Affairs two years ago, this huge
expansion in coverage came virtually free: it led to little if any
increase in overall health care spending beyond normal growth
due to rising population and incomes.
-- Paul Krugman, "Pride, Prejudice, Insurance," NY Times,
November 7, 2005
***
"States Take Health Care Problem in Own Hands"
Rising health care costs and increased concern among
the middle class about paying for medical care have prompted
a growing number of states to consider ways to extend health
insurance to everyone.
Lawmakers in at least 19 states have considered proposals
to expand health coverage this year, according to the National
Conference of State Legislatures. That's up from 12 in 2003.
"It reflects frustration with the growing problem of the
uninsured and rising health care costs at the state level,"
says
Drew Altman, head of the Kaiser Family Foundation, a non-partisan
research group based in Menlo Park, Calif.
In Congress, Rep. Jim Langevin, D-RI, says he will introduce
a bill today that would create a nationwide insurance program
similar to one that now covers federal workers. But policy experts
don't expect Washington to pass major health reforms soon. New
programs are more likely to come from the states.
"I cannot imagine anything significant going through Congress
anytime soon," says Stuart Butler of the Heritage Foundation.
"Another approach, the preferable one, is to let people try
what
they want to do in their state, providing it meets certain stand-
ards."
State proposals vary widely. Some propose government-
overseen insurance. Others would require either employers or
individuals or both to buy insurance. Some simply would create
commissions to study ways to cover all residents.
Among the more active states:
* Massachusetts - A plan initiated by Gov. Mitt Romney would
require all individuals to buy insurance and would establish two
different programs through which they could purchase coverage.
A House version of the bill passed Thursday, with a provision that
employers provide health coverage or pay a payroll tax. A Senate
version, without the tax, has been filed and is likely to be debated
in the next few weeks.
* California - Lawmakers introduced a bill that would create
a statewide insurance program, funded by taxes.
* Minnesota - Lawmakers have introduced a measure calling for
a state universal health care program. New York has two similar
bills.
At least two states have approved measures:
* Maine - Has 8,000 people enrolled in a statewide program begun
two years ago to help cover the uninsured.
* Illinois - In October approved a plan that starts July 1, 2006,
to
offer low-cost health insurance to all the state's children.
Some measures have failed. Vermont lawmakers passed a
measure calling for government-funded universal coverage, but
the governor vetoed it in June.
-- Julie Appleby, USA Today, November 8, 2005
***
Clinics in Pharmacies ("for people who can't get insurance")
(highlights)
CVS, the $30 BILLION drugstore chain, is introducing clinics
within their stores, staffed with nurse practitioners who can
diagnose common ear infections, screen for high blood pressure,
give school vaccinations. There are three stores up, two in
Minnesota. They're partnering with the MinuteClinic in Minneapolis,
and hope to have 60 soon.
Their care is linked to a primary physician if customers have
one, or will be referred to one if they don't. They don't treat
infants or the elderly. The visits cost between $25 and $40.
Based in Woonsocket, R.I., and neck and neck with Walgreen
for the most prescriptions filled, CVS plans to open 250 to 275
stores this year.
-- Interview with CVS CEO Thomas Ryan, NY Times, October 8,
2005
***
"British Journal Faults Rival Over New (Breast Cancer) Drug"
(highlights)
"The available evidence is insufficient to make reliable
judg-
ments (on Herceptin)," wrote the editors of the British journal,
The Lancet, in an editorial published online yesterday.
"It is profoundly misleading to suggest, even rhetorically,
that
the published data may be indicative of a cure for breast cancer.
Study results are preliminary, inconsistent and raise extremely
serious concerns about safety."
In a phone interview, The Lancet's chief editor, Dr. Richard
Horton, said he was "quite angry" that Herceptin (which
costs
$45,000 for a full treatment course) was portrayed so positively
in The New England Journal of Medicine (on October 20).
-- NY Times, November 10, 2005
***
Health Care Briefs
Merck: Cervical Cancer Vaccine Effective
(truthout.org/issues_05/100705HA.shtml)
The first major study of an experimental vaccine to prevent
cervical cancer found it was 100 % effective, in the short term,
at blocking both the disease and the lesions likely to turn cancer-
ous.
****
Warning Issued for Birth-Control Patch
(truthout.org/issues_05/111105HA.shtml)
The Food and Drug Administration warned users of the popu-
lar Ortho Evra birth control patch that they are being exposed
to increased hormones, and are therefore at higher risk of blood
clots and other serious side effects than previously disclosed.
****
California Voters Defeat Abortion Notification
(truthout.org/issues_05/110905WA.shtml)
The Proposition 73 abortion amendment requiring parental
notification was overwhelmingly defeated. The measure contained
a provision that would have defined abortion as an act that causes
"the death of the unborn child, a child conceived but not yet
born,"
deviating from more neutral language used in similar statutes
elsewhere.
****
Robert Scheer | Bringing Down the Bully
(truthout.org/issues_05/111005O.shtml)
(California nurses help defeat legislation reducing hospital
nursing staffs--db)
Robert Scheer writes that Schwarzenegger was defeated
primarily by the hardworking public sector workers of the state:
the teachers, firefighters and other civil servants who are sick
and tired of being pitted by politicians against those they are
so dedicated to serving. "We're the mighty, mighty nurses,"
the joyous healers chanted in a victory conga line the night they
brought the bully down.
****
Another Choice for Elderly: Charity or Medicare?
(truthout.org/issues?05/110805HB.shtml)
The new Medicare plan is having an unintended effect on the
pharmaceutical industry's charity drug programs. Some compan-
ies are simply eliminating their charity programs for older people,
taking the position that the recipients are now eligible for Medicare
drug coverage. For the recipients, it's not so simple.
****
Cardiologist Goes Toe-to-Toe with Drug Companies
(truthout.org/issues_05/110305HB.shtml)
Whistleblowing physician, Dr. Steven E. Nissen, challenges
dangerous prescription drugs and drug company bribes.
****
Baby Boomers Fuel Rise in Drug Deaths
(truthout.org/docs_2005/101005G.shtml)
Californians age 40 and older are dying of drug overdoses
at double the rate recorded in 1990, a little-noticed trend that
upends the notion of hardcore drug use as primarily a young
person's peril.
****
States Protest Contributions to Drug Plan
(truthout.org/issues_05/101805HC.shtml)
It looks like bait and switch. The Bush administration notified
states that they would have to pay billions of dollars to the fed-
eral government to help finance the new Medicare prescription
drug benefit. The law that was supposed to relieve the burden
on states may actually cost them more.
****
GM's Workers Ratify Healthcare Deal
(truthout.org/issues_05/111005LC.shtml)
Unionized workers at General Motors Corp., the world's largest
automaker, have ratified a landmark deal to help the automaker
cut its massive healthcare costs, the United Auto Workers Union
said on Friday. GM, which is one of the biggest providers of health
insurance outside of the federal government, said it would reduce
its health care liabilities by about $15 billion, or 25 %.
Dan Butts
November 13, 2005
*****
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