Thursday, May 24, 2007

Fixing A System Where Children Die For Lack of Health Coverage

May 18, 2007 by The Baltimore Sun | Fixing A System Where Children Die For Lack of Health Coverage | by Clarence Page

WASHINGTON — Residents in and around the nation’s capital woke up one recent morning to the sort of bad news that we like to think doesn’t happen in America: A child died from lack of dental care. Deamonte Driver, a seventh-grader in Prince George’s County, died Feb. 25. Bacteria from an abscessed tooth had spread to his brain, doctors said. Two operations and eight weeks of care and therapy failed to save him. Total cost: more than $250,000.

His mother, Alyce Driver, worked at low-wage jobs. She did not have health insurance. Between her struggles to get coverage and wide cracks in Maryland’s public health-care system, her child never got the $60 tooth extraction that would have saved his life.
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Some children get caught without coverage because their parents must constantly reapply for it, even when they stay in the same state. Others are trapped in the gap when state Medicaid eligibility levels or the federal Children’s Health Insurance Program levels are too low and private insurance too expensive. That $40 billion, 10-year program, commonly known as SCHIP, is up for reauthorization. The program provided health-care coverage for an estimated 6 million children who otherwise would not have been covered. States are free to design their programs, helped by federal grants and subsidies.

There’s a good chance the program will be reauthorized at current funding levels, insiders say. But with health costs skyrocketing, that would be, in effect, a cut. ...

Wednesday, May 16, 2007

International comparison: US gets an F, last: 30 percent of spending each year is inappropriate, redundant or unnecessary.

An F In Health Care | Alec Dubro | May 16, 2007

The New York-based Commonwealth Fund released a comprehensive cross-border study of health care systems in rich countries and, no surprise, ranks the U.S. as pretty much last. Except when it comes to cost, that is. We pay more overall and get less.

What everyone who cares to look knows is that there are two health care systems in America—one for those with money and for those without. The report spelled it out plainly:

The U.S. ranks a clear last on all measures of equity. Americans with below-average incomes were much more likely than their counterparts in other countries to report not visiting a physician when sick, not getting a recommended test, treatment or follow-up care, not filling a prescription or not seeing a dentist when needed because of costs.

Many people have enough money, or otherwise identify themselves with money, that they’re grateful for what they believe is class-A health care. Thank god, they say, we’re not plagued with bureaucratic stasis and long wait times as are people at public hospitals or in socialist countries like Britain or Germany. They’re wrong. We’re at the bottom in most everything and for everybody.
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Other countries are further along than the U.S. in using information technology and a team approach to manage chronic conditions and coordinate care. Information systems in countries like Germany, New Zealand and the U.K. enhance the ability of physicians to identify and monitor patients with chronic conditions. Such systems also make it easy for physicians to print out medication lists, including those prescribed by other physicians.

In short, as you have probably experienced, your primary care physician has no idea what your specialists are doing and vice versa. Not only are patient records not mutually accessible among medical personnel, they’re not even computerized. That’s right, a majority of U.S. health care providers still rely on written records. According to the U.S. Health and Human Services Department, 30 percent of current health care spending (up to $300 billion) each year nationwide is inappropriate, redundant or unnecessary. One result, said the U.S. Institute of Medicine, is that up to 98,000 people in the United States die every year from medical errors.

US health care ranks last among major rich countries for quality, access and efficiency, ... most years lost due to to circulatory, diabetes, ...

US health system ranks last compared to other countries: studies | By Jocelyne Zablit

05/16/07 "AFP" --- - The US health care system ranks last among other major rich countries for quality, access and efficiency, according to two studies released Tuesday by a health care think tank.

The studies by the Commonwealth Fund found that the United States, which has the most expensive health system in the world, underperforms consistently relative to other countries and differs most notably in the fact that Americans have no universal health insurance coverage.
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In "Mirror, Mirror on the Wall: An International Update on the Comparative Performance of American Health Care", the study focused on interviews with physicians and patients in Australia, Britain, Canada, Germany, New Zealand and the United States who were asked to speak about their experiences and views on their health systems.

The US ranked last in most areas, including access to health care, patient safety, timeliness of care, efficiency and equity. Americans were also last in terms of whether they had a regular physician.

"The US spends twice what the average industrialized country spends on health care but we're clearly not getting value for the money," Davis told AFP.
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The United States is also far behind in adopting modern health information technology, which translates into spiralling costs and poor care.

"We pride ourselves on being advanced on so many areas of technology but it's not the case on health information technology," Davis said. "Other countries have just moved ahead."

Britain got the top score in overall ranking among the countries in the study, followed by Germany. New Zealand and Australia tied for third followed by Canada and the United States.

The second study delves into why health costs in the United States are so much higher than in eight other countries of the Organization for Economic Cooperation and Development: Australia, Britain, Canada, France, Germany, Japan, the Netherlands and New Zealand.

The study, "Multinational Comparisons of Health Systems Data," found that even though the US spends the most on publicly and privately financed health insurance, its citizens had the most potential years of life lost due to circulatory and respiratory diseases as well as diabetes.

"This study blows a lot of myths about the US health system," Davis said. "We spend three times what the average country spends on a day of hospital care and we also spend twice what the average country spends on prescription medication." ...

Monday, May 14, 2007

Senators who weakened drug bill got millions from industry

Senators who weakened drug bill got millions from industry | By Ken Dilanian, USA TODAY

WASHINGTON — Senators who raised millions of dollars in campaign donations from pharmaceutical interests secured industry-friendly changes to a landmark drug-safety bill, according to public records and interviews.
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However, the powers granted to the FDA in the bill's original version were pared back during private meetings. And efforts to curb conflicts of interest among FDA advisers and allow consumers to buy cheaper drugs from other countries were defeated in close votes.

• A measure that blocked an effort to allow drug importation passed, 49-40. The 49 senators who voted against drug importation received about $5 million from industry executives and political action committees since 2001 — nearly three quarters of the industry donations to current members of the Senate, according to a USA TODAY analysis of data compiled by two non-partisan groups, Center for Responsive Politics and PoliticalMoneyLine.

• Sen. Pat Roberts, R-Kan., said he demanded removal of language that would have allowed the FDA to ban advertising of high-risk drugs for two years because it would restrict free speech. Roberts has raised $18,000 from drug interests so far this year, records show, and $66,000 since 2001. His spokeswoman, Sarah Little, said he "takes great pains to keep fundraising and official actions separate."

• Sen. Judd Gregg, R-N.H., claimed authorship of a change that reduced the FDA's power to require post-market safety studies. He said he wanted to target drugs only if there was evidence of harm. Gregg has raised $168,500 from drug executives and PACs since 2001 and sided with them in four key votes.

• The bill's chief sponsors — Sens. Edward Kennedy, D-Mass., and Mike Enzi, R-Wyo., — agreed after consultations with industry officials and others to modify a proposal that all clinical drug studies be made public, said Craig Orfield, Enzi's spokesman. Under the change, only those studies submitted to the FDA would be available.

Enzi took in $174,000
from drug interests since 2001; Kennedy, $78,000. Their spokesmen said the money did not influence them. ...

Price Increase in [Medicare] Prescription Program Is Twice That Seen in Wholesale Rates

Costs Grow for Common Medicare DrugsPrice Increase in Prescription Program Is Twice That Seen in Wholesale Rates | By Jonathan Weisman | Washington Post Staff Writer | Sunday, May 13, 2007; A10

After some initial success containing drug prices, private insurers in the new Medicare prescription drug program may be losing their leverage over drug manufacturers as they try to hold down medicine costs for seniors and the federal government, House investigators have found.

Prices for 10 of the most prescribed brand-name medications have shot up an average of 6.8 percent since December under Medicare private insurance plans, while wholesale prices for the same drugs have risen just 3 percent, House Oversight and Government Reform investigators say. The cost of a month's supply of cholesterol-controlling Lipitor had climbed 9.6 percent, to $84.27 in mid-April, from $76.91 in mid-December. Over the same time, list prices climbed 5 percent.

Premiums for Medicare drug plans have jumped 13 percent over the past year, when the drug plans went into effect, the investigators say.

And the rebates that insurance companies are wringing out of drug manufacturers are expected to total 4.6 percent of total drug costs, down from 5.2 percent last year. A year ago, Medicare actuaries had expected insurers in 2007 to secure manufacturers' rebates of 6 percent, then pass those savings on to seniors and the government.
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