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RECENT HEALTH ARTICLES

February 12, 2007

Florida News & Opinions

KidCare, SCHIP, Healthy Start

Medicare and Medicaid

Medicare Drug Coverage, Drug Costs

Other Medicare, Medicaid

Health Insurance and Costs

Other Health Issues

National News & Opinions

Medicare, Medicaid, SCHIP

Medicare Drug Coverage, Drug Costs

Other Medicare, Medicaid, SCHIP

Health Insurance and Costs

Other National Health Issues

FLORIDA NEWS & OPINIONS

KidCare, SCHIP, Healthy Start

Healthy Start Calls For Help
As the birthrate accelerates, health advocates say Florida must spend much more to reduce infant deaths and underweight babies, especially in the Tampa Bay area. The cry for help came Monday from leaders of Healthy Start, a program started by Gov. Lawton Chiles 16 years ago to reduce Florida's infant mortality rate. Advocates say that while infant deaths in Florida have declined in recent years, they remain "shockingly" high, the result of too many young women living in poverty with poor education and nutrition and no access to health care. (2/12/07, St. Petersburg Times)

EDITORIAL: Our view: Covering all kids
Enrolling eligible children in state's KidCare insurance program must be goal
Consensus is growing that America's health care system is broken and requires a major overhaul, such as a national health coverage plan. But while politicians and analysts debate options, real people, including an estimated 750,000 Florida children, are uninsured for basic medical needs. That won't be solved overnight, but here's one measure Florida lawmakers can take to quickly improve the childrens' health: Build back enrollment at KidCare, the subsidized health insurance program for lower-income working families, to cover all eligible children across the state -- a half-million by some estimates. (2/11/07, Florida Today)

EDITORIAL: Put Care in KidCare
With more than 600,000 uninsured children in the state and at least 150,000 unfilled slots in its subsidized health insurance program for children, Florida cannot justify having to forfeit $20 million to the federal government. But, again, the state is returning millions it could have used to enroll needy children in the KidCare program. So, the interest newly elected Chief Financial Officer Alex Sink has shown in KidCare is needed. Florida repeatedly has made it harder for parents who work but cannot afford insurance to get coverage for their children.Ms. Sink is showing her commitment by serving as board chairwoman of the Healthy Kids Corp., which runs KidCare and other similar programs, instead of appointing an unelected designee. She also is pushing for more money to be spent telling parents about KidCare and helping to enroll more children. (2/8/07, Palm Beach Post)

EDITORIAL: Careful with KidCare: Efforts to improve program should, first, do no harm

The last time Florida lawmakers felt the urge to "fix" the state's subsidized health-insurance program for needy children, they scribbled a prescription that damaged the patient's health. So it's a bit worrisome to hear talk of the Legislature searching for another cure for KidCare's troubles. Clearly, though, the program needs Tallahassee's attention. Careful attention. Fixing KidCare -- the right way, this time - is in the interest of poor children and all Floridians. (2/5/07, Sarasota Herald-Tribune)

EDITORIAL: Stingy Budget For Health Care Leaves Florida Kids Uncovered
What a shame that Florida will lose out on $20 million from the federal government this year to provide health insurance for children of the working poor. These kids are not entitled to Medicaid and come mostly from working families who can't afford coverage on their own. Yet because of budget cuts to Florida KidCare and anemic enrollment numbers, the federal money will be redirected to other states more aggressive about providing insurance for uninsured children. Gov. Charlie Crist should make insurance coverage for children a priority this spring when state lawmakers gather in Tallahassee. The Legislature also should increase funding for Florida KidCare and make it easier for working families to hear about the program and enroll in it. (2/2/07, Tampa Tribune)

EDITORIAL: All children need coverage
This is a critical time for the future of efforts to provide badly needed health care coverage to uninsured children. In Washington, President Bush and Congress are preparing to renew the 10-year-old state Children's Health Insurance Program but are arguing over money and coverage limits. In Tallahassee, Gov. Charlie Crist is recommending a reasonable increase in spending on Florida's version of the program, which is still recovering from earlier shortsighted efforts to rein in the cost. The focus in both capitals should be on covering as many children as possible, eliminating red tape and avoiding changes that could take health care away from some kids. (2/8/07, St. Petersburg Times)

EDITORIAL: Cherish them: Tailoring public policy to kids

This could be the year of the child in Florida, where the pendulum is constantly swinging and shifting governing priorities. Florida's new chief financial officer, Alex Sink, plans to be chairman of the Health Kids Corp., which runs KidCare and other state programs meant to reach the estimated half-million uninsured children in Florida, some hard-to-reach children of immigrant families and others in poor urban settings, and get them enrolled so they can receive health care. (2/4/07, Tallahassee Democrat)

KidCare's ills are legion, advocates tell senators
A woman told a panel of state legislators a joke that's been circulating: There must be a trash can underneath the fax machine at Florida KidCare, the state health insurance program for uninsured children. Because it seems like all the applications get lost in cyberspace, mail or in red tape, several low-income people and advocates testified Wednesday. Members of the state Senate Health Policy Committee listened to three hours of comments from worried parents and health care advisers and providers at a town meeting at the University Area Community Center. They were searching for ways to streamline enrollment into KidCare, which serves more than 230,500 low-income children. The program served nearly 337,000 children in 2004, but went into a free fall after state legislators stiffened eligibility requirements and the application process. Fewer kids enrolled means less federal funding, and Florida won't cash in on about $17-million available in federal funds for the program this year, said Rose Naff, executive director of Florida Healthy Kids Corp., which administers KidCare. (2/1/07, St. Petersburg Times)

Debate begins again over money for KidCare, Sink to push outreach
Lawmakers should put more money into the state's KidCare subsidized health insurance program to get more children signed up, says Chief Financial Officer Alex Sink, who plans to make the program one of her priorities in her new job. In her role as CFO, Sink gets to choose the chairman of the board that oversees the Healthy Kids Corp., which runs KidCare and other state programs that provide health coverage for uninsured children. In an interview last week, Sink said she plans to take the position herself and push for more money to be spent on reaching out to find some of the estimated half a million uninsured children in Florida and get them enrolled so they can get health care. (1/29/07, Gainesville Sun)

Florida To Forfeit $20 Million For KidCare
Florida will forfeit $20 million of federal money this fall that could have expanded a health insurance program for children, and if it does not increase spending at the state level, it could lose millions more. But KidCare administrators say that unless Florida steps up enrollment in the program, the state will continue to leave federal funding on the table. The program serves 230,000 low-income uninsured children, roughly 35 percent of the state's children under age 19. According to the U.S. Census Bureau, Florida has nearly 750,000 uninsured children, the third-highest number among the states. Of those children, 494,000 qualify for KidCare. "Thousands of children are still uninsured," said Karen Woodall, a Tallahassee advocate pushing to expand the program. "It's a basic philosophical discussion. Hopefully we have leadership now who will take the risk and spend on behalf of our kids." (1/31/07, Tampa Tribune)

Healthy Kids contract targets disadvantaged children: $87M deal with Dallas company
The Florida Healthy Kids Corporation has signed a new five-year, $87 million contract with a Dallas company to take over administration of several insurance programs for disadvantaged children in the hope that services to families can be improved. The new contract is costing $1.44 more per child but is expected to bring improvements in application processing, eligibility determination and customer service, she said. The new contract will be paid for by the three insurance programs proportionate to each program’s enrollment. “The old contract was based on technology of six years ago,” Rose Naff, executive director of Healthy Kids said. “We have new technology. We think it will mean better customer service, quicker processing time and more flexibility.” (1/26/07, Naples News)

Medicare and Medicaid

Medicare Drug Coverage, Drug Cost

OPINION: Next: Ration drugs, care
by Sarah Berk, executive director of Health Care America, a free-market advocacy group funded by pharmaceutical manufacturers and other healthcare industries
The new Medicare prescription-drug program has reduced consumer drug prices and premiums by an estimated $13 billion and is projected to expand those savings to an impressive $180 billion during the next 10 years. More than 90 percent of American seniors are enrolled and average $1,100 per year in savings. An overwhelming majority -- 80 percent -- like the program, according to several opinion surveys. The new congressional leaders favorably compare government price negotiations with pharmaceutical manufacturers with those used by the Veterans Administration to control prices. Yet they are reluctant to tell seniors what most veterans already know -- the VA plan comes with an unpalatable trade off. It emphasizes drug pricing over drug choice. The VA gets its prices by excluding some companies' breakthrough products. No wonder so many veterans with VA drug benefits enroll in the various Medicare prescription plans that deliver seniors both low prices and a wide choice of prescribed medicines. Other lawmakers are proposing to ''fix'' the current Medicare drug benefit. They would allow a government-run plan to compete with private plans that already offer a prescription-drug benefit. The logic behind that is problematic. The government could only offer lower prices than other plans by coercing -- not negotiating -- prices and by restricting drug choices and access to care. (2/2/07, Miami Herald)

Other Medicare, Medicaid

EDITORIAL: Bush: Rich win, again
The way President Bush's proposed 2008 budget handles taxes says a lot about the administration's priorities. The wealthiest Americans would pocket roughly $1.6 trillion in tax savings over the next decade. Over the same period, middle-class taxpayers would have to pay an additional $1 trillion. That would be the result if Congress goes along with Mr. Bush's budget, which extends tax cuts for the very rich but does not try to fix the Alternative Minimum Tax. In 2007 alone, it is projected to take $40 billion from taxpayers it never was intended to affect. That's just one way in which Mr. Bush's budget gets its priorities wrong. To help pay for the tax cuts to which he is ideologically welded, Mr. Bush over the next five years would cut Medicare spending by $76 billion and Medicaid by $26 billion. That would hurt poor people and the hospitals that treat them. St. Mary's Medical Center in West Palm Beach, for example, would lose $10 million a year. The budget would shortchange by $10 billion a program that is supposed to provide health insurance for low-income children. That provision would prevent 6 million children who qualify from signing up. The administration's response: Let the states pay. Indeed, if Mr. Bush's budget were approved, state and local taxpayers would have to close the gap. Cutting Medicare and Medicaid and reducing payments to hospitals won't stop recipients from needing treatment - even if they have to go to emergency rooms. Places such as Palm Beach County, with health-care taxing districts, will have to step in. (2/10/07, Palm Beach Post)

Bush Budget Plan
Medical centers face millions in cuts: South Florida hospitals stand to lose $300 million annually as the Bush administration tries to balance the budget
South Florida hospitals would stand to lose more than $300 million annually under a Bush administration plan to slash funding for facilities that do the most for the poor and the uninsured. Most at risk are public facilities. Jackson Memorial stands to lose $125 million annually. The North Broward Hospital District would lose $55 million. The South Broward District would lose $33 million, according to the Florida Hospital Association. Private hospitals that give extensive care to low-income groups would be hurt as well, including the nonprofit Miami Children's ($31 million lost) and Mount Sinai Medical Center ($22 million). Even for-profit facilities such as Tenet's North Shore and Hialeah and HCA's Kendall Regional and Plantation General would suffer. Overall, state hospitals could lose $4 billion over five years, according to the FHA. (2/7/07, Miami Herald)

South Florida hospitals could lose millions under new Bush federal budget
Hospitals in South Florida and the rest of the country could lose billions of dollars in payments for the poor and uninsured over the next five years under a federal government plan to cut the cost of health care. Some hospitals could fail, one state trade group warns. (2/8/07, South Florida Sun-Sentinel)

Hospitals set to lose Medicaid millions
Hospitals that treat large numbers of poor people stand to lose millions of dollars a year under a Medicaid rule change proposed by the Bush administration. St. Mary's Medical Center in West Palm Beach would lose $10 million a year. Lawnwood Regional Medical Center & Heart Institute in Fort Pierce would lose nearly $8 million. Bethesda Memorial Hospital in Boynton Beach would lose almost $7 million. (2/9/07, Palm Beach Post)

Shands hospitals may lose $120M
Shands hospitals could lose more than $120 million a year under a plan proposed by the Bush administration to cut funding to hospitals that serve the poor and uninsured. The move by the Centers for Medicare and Medicaid Services, or CMS, is part of an attempt to curtail soaring health-care costs and balance the federal budget. It would change the complex formula by which hospitals are reimbursed based on how many poor and uninsured patients they serve. Hospitals that serve as a "safety net" in providing health care to low-income Florida residents describe the proposal as "a killer" that would tear that protective net apart. (2/10/07, Gainesville Sun)

Tampa General facing $64 million loss
Almost 70,000 times a year, someone comes into the TGH emergency room. Thousands of patients are seen at the TGH clinics. Many who come in are on Medicaid, but under a new plan that cuts payments to hospitals, those patients could be in trouble. TGH spokesman John Dunn says people who have no insurance are facing a threat to their ability to receive health insurance. Last year TGH operated in the black with $41 million on the positive side of the ledger. But with the proposed $64 million in cuts, the hospital would be $17 million in the red. That would be the biggest loss in TGH history. And while the proposal is a code red emergency for the hospital, all the effort is geared toward stopping from going into effect, because TGH has no idea what it will do if it loses the $64 million. (2/8/07, TampaBays10.com)

How Bush's budget treats programs vital to Florida
Here are highlights of programs important to Florida: Medicare: Three million Floridians are beneficiaries of the health plan for seniors and the disabled. Bush would cut $66 billion over five years by reducing the amount hospitals and doctors are paid and by charging wealthier seniors more for premiums. Medicare would still grow -- 6.7 percent during the next 10 years, but less than previously planned. Medicaid, the health program for the poor, would be cut $25 billion over five years. Children's health: Bush would trim the State Children's Health Insurance Program, which provides coverage for children in moderate-income families. Florida has one of the largest such programs in the country and gets $214 million in federal aid. The cut would affect families between 200 percent and 300 percent of the federal poverty level. (2/6/07, Orlando Sentinel)

OPINION: Cutbacks on backs of the poor
Last month, the government proposed deep cuts in Medicaid, the federal-state partnership health program for the poor, as part of changes in both Medicaid and Medicare that seek to save an estimated $70 billion over the next five years. The Florida Hospital Association projects that the proposed change to the rules governing reimbursement to states and public hospitals for treating Medicaid patients will cost Florida $932 million a year. The proposed cutbacks, according to the FHA, would also affect services in trauma units, rural facilities and teaching hospitals such as Shands in Gainesville, whose revenue would plunge $42 million. Some offer even more dire warnings. "This proposal will have a disastrous impact on Florida's hospital community," FHA President Wayne NeSmith said in a prepared statement. "If this rule is allowed to go into effect, hospitals across the state and the country will be forced to dramatically reduce services and in some cases, hospitals will close." (2/5/07, Ocala Star-Banner)

Medicare change will hurt Florida

A proposed changed by Medicare and Medicaid Services could cost Florida hospitals more than $4 billion over the next five years, according to a study by the Florida Hospital Association released this afternoon. The proposed rule, published Jan. 18, rejects policies that had previously approved of Florida's Low Income Pool program and certain Medicaid measures. ''This proposal will have a disastrous impact on Florida's hospital community''' said Wayne NeSmith, FHA president. ``We are asking the Florida Congressional delegation to protect our state's hospitals from these cuts and the communities we serve.'' The FHA analysis shows the annual financial impact on hospitals in Florida exceeds $932 million per year by drastically changing the way Florida funds its Low Income Pool, which assists hospitals that have a large number of Medicaid patients. (2/1/07, Miami Herald)

SW Florida hospitals could lose $26M in reimbursement next year for trauma care, treating poor

Southwest Florida hospitals stand to lose $26 million in reimbursement next year for trauma care and treating the poor if a federal proposal goes forward that restricts states from tapping additional federal Medicaid funds, according to an analysis the Florida Hospital Association released today. Specifically, the Lee Memorial Health System would lose $18.4 million in Medicaid reimbursement for Lee Memorial Hospital near downtown Fort Myers, which has the region's only trauma center, and at its HealthPark Medical Center that operates the only children's hospital in Southwest Florida. The Lee Memorial system would lose another $5.2 million next year in Medicaid reimbursement at its Cape Coral Hospital and the recently acquired Gulf Coast Hospital and Southwest Florida Regional Medical Center. In Collier County, the NCH Healthcare System would lose nearly $2 million in Medicaid reimbursement and Physicians Regional Medical Center-Pine Ridge would lose $647,000, according to the FHA analysis. Statewide, hospitals would face $932 million a year less in federal Medicaid dollars that they rely on to stay afloat and to continue offering expensive services, such as trauma care, against an increasing uninsured population. (2/1/07, Naples News)

Bush's health-care cure: How it affects Floridians

Laid out during his State of the Union address, President Bush's plan to offer tax breaks to people who lack health insurance would affect tens of thousands of Floridians - or about one in every five residents - who are not covered. Such incentives, however, fall far short of what's needed to fix the health-insurance crisis in the United States, critics say. Critics lashed out at the proposal, saying it would not come close to insuring the 46.5 million Americans -- including 3.6 million Floridians - who lack health coverage. "The real solution is universal health care," said Parmer Heacox, advocacy director of the Human Services Coalition in Miami-Dade County, which counsels uninsured patients. "Until our government understands that, we're just going to build layers of bureaucracy on what exists. A tax break is not the solution." The problem is especially acute in Florida, where thousands of low-paid service workers, many of them recent immigrants, are living without insurance. A Census Bureau study found that 19.6 percent of Florida residents were uninsured, using a three-year average from 2003 to '05. Florida had the third-highest uninsured rate, behind Texas and New Mexico. (1/25/07, Orlando Sentinel)

Clinics accused of false claims: Lawsuits allege U.S. programs lost $30 million
Federal authorities took legal action Friday against nearly two-dozen South Florida clinics and medical equipment companies they said defrauded federal insurance programs out of more than $30 million. Civil suits filed in Miami federal court seek reimbursement for false claims paid by Medicare and Medicaid, tax-funded programs providing insurance coverage to the elderly and poor. Government officials said an earlier phase of the crackdown resulted in payments of $10.5 million. (2/10/07, South Florida Sun-Sentinel)

Baptist does well in Medicare pilot program
Several South Florida hospitals scored in the top 20 percent in several categories of a large national pay-for-performance pilot sponsored by Medicare that may change the face of insurer payments. The results, released this afternoon, show that Baptist Hospital of Miami, South Miami Hospital, Homestead Hospital and Mariners Hospital in the Upper Florida Keys scored near the top in various areas. Several Memorial hospitals in South Broward also achieved a high ranking, according to the data collected by Premier, a national healthcare alliance that compiled the statistics. Premier reported the push for national improvement in quality saved 1,284 lives in heart attack cases, the study stated. Medicare is paying $8.7 million to the 115 best-performing hospitals -- those in the top 10 or 20 percent of each category. (1/26/07, Miami Herald)

Health Insurance and Costs

'Any, Any, Any' Health Insurance Plan Under Fire
A Florida health insurance company is under fire for selling plans that promise access to all doctors and hospitals after patients are turned away from help, according to a Problem Solvers investigation. The report featured Paulette and Jim Carollo, who saw an advertisement in the newspaper promoting Universal Health Care's Medicare Advantage plan. The plan promised that people can go to any doctor, anytime, anywhere. The ad said there was no premium and no deductible for Medicare Part D prescription drug coverage. Also, Universal Health Care promised to pay people back the $93.50 Social Security takes out of paychecks to pay Medicare -- a savings of $1,100 per person, per year, according to the report. The Carollos were surprised when the company would not pay after each had a medical procedure in January. The couple was stuck paying more than $2,000 out of pocket -- and they are not alone, the report said. Thousands of seniors are signing up for the plan, like Sylvia Bathrolemew in Volusia County, who soon found out few, if any providers had even heard of it, the report said. (2/9/07, Local6News.com)

Crist has plan for mentally ill in jail; Advocates say an infusion of $79M will help now but won't solve the problem
The governor's budget recommendations for the upcoming year include more in cash to help the severely mentally ill in jails, a move that advocates say is long overdue. But some say the $79 million Gov. Charlie Crist has proposed adding to the Department of Children & Families' budget only would address the current crisis. That funding level doesn't keep jails from becoming warehouses for people with mental illness, they said. "We have to be realistic and realize this is not a strong budget year," said Orange-Osceola Public Defender Bob Wesley, who was among several statewide who sued DCF over mentally ill inmates not receiving timely treatment. "But we still need to keep going to find ways to address the problem, rather than continue jumping on the criminal-justice system," Wesley said. DCF has been under fire for months for stranding mentally ill inmates in jail longer than the 15 days that Florida law allows. At the peak of the crisis, more than 300 inmates were waiting for beds statewide. (2/6/07, Orlando Sentinel)

Formula redistributes state Healthy Start funds
A St. Lucie County program aimed at helping poor mothers deliver healthy babies could get a 34 percent budget increase over the next five years at the expense of similar services in counties such as Martin and Okeechobee. Similarly, the Palm Beach County Healthy Start Coalition would get a $475,000 boost while the Broward County program would lose $1.1'million, according to figures from the St. Lucie County Healthy Start Coalition. The changes stem from a new formula to distribute state and federal money based more heavily on factors such as need and program performance. But Healthy Start officials, who agreed to the new formula, are hoping state lawmakers give them enough in the next budget to boost funds for each of their 32 chapters. "This isn't Darfur," said Dr. Charles Mahan, who helped create the 15-year-old state program aimed at lowering the state's infant mortality rate. "We live in the wealthiest nation in history and yet, in some parts of our state, the infant mortality rate is the same as countries in the developing world. We can do better." (2/6/07, Palm Beach Post)

Lawmakers urged to spend more to make babies healthier
Last year in Madison County, in rural north central Florida, 36 black infants died for every 1,000 babies born, giving the county a startling infant mortality rate. "We calculated that put us right between the Dominican Republic and Tajikistan," said George Hinchcliffe, director of the region's Healthy Start Coalition, which seeks to get pregnant women, particularly the poor, linked up with services that will make their babies healthy. Florida dramatically lowered its infant mortality rate in the 1990s, but recently has failed to continue the improvements, and even saw a small uptick in 2005. Advocates say the lack of recent improvements corresponds to a simple fact - the Healthy Start program hadn't received the amount of money it once did or anywhere near what child health experts say is needed to increase the number of healthy babies. (2/5/07, Bradenton Herald)

Nemours reaches insurance agreement
While still at loggerheads with the state's largest health-insurance carrier, the Nemours Foundation said Friday it had "extended and deepened" its relationship with the state's No. 2 carrier, UnitedHealthcare. Nemours and UHC in Florida have reached a multiyear agreement "to assure UnitedHealthcare members long-term access to the services of Nemours physicians," according to a joint statement from both organizations. While Nemours and UnitedHealthcare were touting their new agreement, Nemours and Blue Cross and Blue Shield of Florida could not even agree on whether they were still negotiating. Their old contract expired as of Jan. 1, meaning Blue Cross members now must pay out-of-network costs if they visit Nemours' doctors. ever. (1/27/07, Orlando Sentinel)

Prison, indictments in S. Florida healthcare frauds
The U.S. Attorney's Office announced the indictments and prison sentences of several people involved in South Florida healthcare fraud cases, reported to be a $1 billion a year business in South Florida alone. (2/1/07, Bradenton Herald)

Other Health Issues

Doctors Can Work Without Malpractice Insurance
Marcia Beaird's life changed forever about a year and a half ago. She has to wear a pressure garment for the rest of her life. It's basically a body suit that helps keep the swelling down. From her breasts on down to her ankles she is covered with scars. She lost her skin because of a flesh eating bacteria infection. She says her doctor used unsterile instruments in surgery. Beaird says she realizes she will get little if anything in her case. Her doctor is one of the more than 2,000 doctors statewide that elect not to carry medical malpractice insurance. The doctors who do "go bare" are not breaking the rules. The state statute says if the doctor meets certain requirements, the doctor can go without the maximum coverage. (2/9/07, First Coast News)

Communities have trouble attracting doctors
Even if Lee Memorial Health System succeeds in starting a medical residency program, the initiative may not be enough to counter other forces dissuading physicians from practicing in Florida. Some of the problems, such as the doctors' choices of specialties and government insurance rates, aren't really controllable at a local level. In 2004, Lee Memorial Health System commissioned a study that found the county might be short as many as 225 doctors by 2009. The research firm looked at population growth and factored in the number of doctors expected to retire. The biggest holes, it found, could be in family care and pediatrics. (2/4/07, Southwest Florida News-Press)

Medical network offers a remedy: Training program looks to rein in physician shortage

Second-year medical school students are part of the first wave of future physicians studying in Palm Beach County, where a burgeoning network of medical school and training programs is expected to transform health care in an area facing a crisis of emergency department on-call coverage and physician shortages. What's begun at Florida Atlantic University in Boca Raton, considered the regional campus of the University of Miami's Miller School of Medicine, will feed into the residency program that JFK Medical Center in Atlantis hopes to start next year. At the same time, the Florida Institute for Public Health is planning a major research collaborative with several universities. Markowitz, the UM professor guiding the class of second-year med students, said one of the goals is to build up the physician base in Palm Beach County. "I get calls every day: `Can you get me an internist?' It's impossible," said Markowitz, UM's associate dean for medical affairs. "There's a dramatic shortage of physicians here." (2/4/07, South Florida Sun-Sentinel)

University Counseling Centers Feel Strain
Ask any counselor at a Florida university why students drop out, and most will say mental illness is the No. 1 reason. The demand for counseling has spiked in recent years as students struggle with day-to-day life. And more students entering universities are already receiving treatment for serious mental disorders, particularly depression. Counseling centers at large public universities nationwide report being overwhelmed. There's an upswing of two to four times more depression, more medication, more suicide. Compounding that is the lack of mental health counselors on public college campuses statewide. Students seeking help usually are placed on waiting lists. Last fall, the University of Florida's chief student affairs officer, Patricia Telles-Irvin, pleaded before the state's university oversight panel for more counselors at all of Florida's public universities. The issue has received little attention from policy-makers. The Legislature has capped the fees students pay annually for health services. (2/11/07, Tampa Tribune)

Bill would mandate vaccine for girls
In what's sure to become one of this session's hot-button topics, two separate bills mandating pre-teenage girls be inoculated against a sexually-transmitted virus that causes cervical cancer have been introduced in the state Legislature. Backers say the human papillomavirus, or HPV, vaccine will eventually wipe out cervical cancer -- the third most common cancer for women in the world. Opponents say parents should have a choice whether they want their children vaccinated against something so closely linked with a sexual disease. Yet most agree the vaccine is a wonderful medical breakthrough that does not need to be mandated at this time. (2/11/07, Florida Today)

Legislators may require all middle school girls to get cervical cancer vaccine
A vaccine to prevent cervical cancer, one of the leading causes of death in women, would be required for Florida middle school girls under bills to be introduced in the Florida Legislature session that begins March 6. (2/7/07, South Florida Sun-Sentinel)

NATIONAL NEWS & OPINIONS

Medicare, Medicaid, SCHIP

Medicare Drug Coverage, Drug Cost

Generic Medications Account For 61% Of Medicare Prescriptions Filled
Generic medications, rather than brand-name treatments, account for almost two-thirds of prescriptions filled for Medicare beneficiaries, a trend that has helped reduce the estimated cost of the prescription drug benefit, according to data that CMS plans to release on Feb. 14. (2/12/07, Wall Street Journal)

Many Eligible Beneficiaries Not In Medicare Prescription Drug Benefit Subsidy Program
CMS and the Social Security Administration must improve efforts to enroll eligible Medicare beneficiaries in a subsidy program under the prescription drug benefit, Senate Special Committee on Aging Chair Herb Kohl (D-Wis.) said at a hearing of the committee. About 600,000 Medicare beneficiaries enrolled in the subsidy program in 2006 must reapply to enroll in 2007, Kohl said. "And since the application process is so onerous, we know that some seniors will simply give up," he said, adding, "As we enter the second year of the Medicare drug benefit, we have an obligation to make sure it is working for all seniors but particularly for our poorest seniors, who need help the most. We are not there today." (2/5/07, CQ HealthBeat)

More Than 39M Enrolled In Medicare Prescription Drug Plans; Beneficiaries On Average Save $1,200 Per Year, CMS Says
More than 39 million Medicare beneficiaries are enrolled in Medicare prescription drug plans, CMS officials have announced. According to CMS, 1.6 million beneficiaries have signed up for a Medicare plan since June 2006 (Anstett, Detroit Free Press, 1/31). CMS Director Leslie Norwalk said since June 2006, enrollment for dual eligible beneficiaries, who qualify for Medicare and Medicaid but receive drug coverage under the Medicare benefit, increased from 6.02 million to 6.27 million; enrollment in Medicare Advantage plans with drug coverage increased from 6.04 million to 6.65 million; and enrollment in stand-alone plans increased from 10.37 million to 10.98 million beneficiaries. (2/2/07, CQ HealthBeat)

Medicare drug plan boosts firms' sales, earnings
The Medicare prescription drug benefit last year increased U.S. medication sales by $2.5 billion, or 1%, a trend that has contributed to increased earnings for Pfizer and other pharmaceutical companies. According to IMS Health, purchases last year under the Medicare prescription benefit accounted for one-sixth of the total increase in medication sales. The Medicare prescription benefit last year also contributed to increased earnings for UnitedHealth Group and other health insurers that sold plans to 22.6 million beneficiaries under the program. (1/20/06, Bloomberg/Philadelphia Inquirer)

Humana Profit More Than Doubles, Aided by Medicare Gains
Health insurer Humana’s profit for 2006 more than doubled, due to increased enrollment in its Part D and Medicare Advantage plans. The company posted a profit of $155 million, up from $61.8 million a year earlier.(2/6/07, New York Times)

House Ways And Means Health Subcommittee Make Medicare Prescription Drug Benefit Oversight 2007 Priority
The House Ways and Means Subcommittee on Health will examine oversight of the Medicare prescription drug benefit among other priorities for the 110th Congress, House Ways and Means Committee Chair Charles Rangel (D-N.Y.) and ranking member Jim McCrery (R-La.) wrote in a letter sent Wednesday to leaders of the House Oversight and Government Reform Committee and the House Administration Committee. (1/18/07, CQ HealthBeat)

All Medicare Prescription Drug Plans Should Be Required To Cover Heart Medication BiDil For Black Beneficiaries, According To NAACP Letter
NAACP's New England council President Juan Cofield sent a "sharply worded letter" to the Boston regional office of CMS stating that NitroMed's heart failure drug BiDil, the only drug approved by FDA for use in a single race, should be required to be covered under all Medicare Part D prescription drug plans. The letter "blamed government policy for disparity in the treatment of blacks with heart failure." (1/25/06, Wall Street Journal)

CMS Urged to Broaden Low-Income Drug Coverage
Medicare and Social Security officials said that they're doing their best to identify and enroll Medicare beneficiaries who qualify for the drug program's financial assistance, but members of a Senate panel said more must be done. (1/31/07, CQ HealthBeat)

Other Medicare, Medicaid, SCHIP News

Medicare Payment Cuts Will Accelerate Primary Care Collapse
By not including funds to offset a pending cut in Medicare payments to physicians, the president's FY 2008 budget will accelerate the collapse of primary care, create access problems, and manufacture obstacles to fundamental reform of physician payment policies, the American College of Physicians (ACP) said. The organization of 120,000 internists and medical students noted that the budget assumes at least an 8 percent cut in Medicare payments to doctors -- which is not sustainable -- and is certain to have a multitude of adverse effects. The administration's budget seeks to squeeze some $101.5 billion of savings from Medicare and Medicaid over the next five years. The two plans cover more than one in four Americans. The FY 2008 budget proposes changes in the State Children's Health Insurance Program (S-CHIP) to focus more on low-income families. The changes would reduce S-CHIP spending by $223 million, or 4 percent, from this year's level. ACP instead proposes that Congress provide increased funding to sustain and expand the S-CHIP program to more low-income children and their parents. The College also recommends that Congress take steps to expand Medicaid to all individuals with incomes below the federal poverty level. (2/12/07, Medical News Today)

SCHIP Formula Penalizes States with Effective Programs, Officials Tell Congress
State officials today told the Senate Finance Committee that the funding formula for the State Children's Health Insurance Program penalizes states when they cover more children because funding is based on the number of uninsured children as opposed to the number of children enrolled. Georgia Gov. Sonny Perdue and Anita Smith, an official with the Iowa Department of Human Services, called for changes to the formula so states do not lose money for effective SCHIP programs. Perdue said governors value flexibility in the program but would embrace standards if funding were more predictable. He said the National Governors Association has been working on such standards and could "fine-tune" them quickly for the committee's consideration. The hearing was on the future of SCHIP, which will expire this year and is slated for reauthorization by Congress. (2/1/07, AHA News Now)

Bush's 2008 Budget Would Raise Some Medicare Premiums
More and more Medicare beneficiaries would have to pay higher premiums for coverage of prescription drugs and doctors' services under President Bush's 2008 budget, to be unveiled on Monday. Single people with annual incomes over $80,000 and married couples with incomes over $160,000 already have to pay higher premiums for the part of Medicare that covers doctors' services. The income thresholds rise with inflation. Budget documents show that Mr. Bush will propose a similar surcharge on premiums for Medicare's new prescription drug benefit. In addition, the president will ask Congress to ''eliminate annual indexing of income thresholds,'' so that more people would eventually have to pay the higher premiums. (2/4/07, New York Times)

President's Proposed Budget Asks for Cuts to SCHIP, Other Health Programs
In a move that "is likely to touch off a fight on Capitol Hill," President George W. Bush's $2.9 trillion proposed budget released Monday pushes for cuts to the State Children's Health Insurance Program (SCHIP), according to the New York Times and Bloomberg. (2/2/07, New York Times)

Bush Seeks Big Medicare and Medicaid Saving
President Bush will ask Congress in his budget next week to squeeze more than $70 billion of savings from Medicare and Medicaid over the next five years, administration officials and health care lobbyists said Thursday. The proposals, part of a White House plan to balance the budget by 2012, set the stage for a battle with Congress over entitlement spending. Even some administration officials say they cannot imagine approval of such large cutbacks in a Congress now controlled by Democrats. Mr. Bush is also expected to propose changes in the Children’s Health Insurance Program to sharpen its focus on low-income families. The changes could reduce federal payments to states that cover children with family incomes exceeding twice the poverty level. Under federal guidelines, a family of four is considered poor if its annual income is less than $20,650. The child health proposal, like those for Medicare and Medicaid, is likely to touch off a fight on Capitol Hill. (2/2/07, New York Times)

OPINION: Fix the system with Medicare for all
"Medicare for all is the only reform that has a prayer of providing universal coverage while containing costs," Marcia Angell, former editor in chief of the New England Journal of Medicine, writes. Medicare "is far more efficient than private insurance, with overhead of less than 4%," and that, because "it is administered by a single public agency, controlling costs would be possible." In addition, Medicare "cannot select whom to cover or deny care to those who need it most," Angell writes. According to Angell, other health care reform proposals "all have the same fatal flaw: They offer no workable mechanism to control costs, mainly because they leave the private insurance industry in place." (1/29/07, Boston Globe)

Bonus Pay by Medicare Lifts Quality
Hospitals participating in a Medicare experiment that pays them more to follow medical recommendations have steadily improved the quality of patient care. (1/25/07, New York Times)

Health Insurance and Costs

Senate HELP Committee Likely To Pass Mental Health Parity Bill

The Senate Health, Education, Labor and Pensions Committee likely will pass legislation that would require health insurance companies to cover mental illnesses at the same level as they cover physical illnesses, committee Chair Edward Kennedy (D-Mass.) said, CQ HealthBeat reports. The legislation would bar insurers that cover mental illnesses from imposing limits on care not applied to physical illnesses, but it would not require all insurers to provide mental health coverage. Mental health parity legislation has had support from a majority of both chambers for the past decade, but it never moved out of conference committees. (2/8/07, CQ HealthBeat)

House Passes $463.5B FY 2007 Omnibus Appropriations Bill That Includes Increases For Health Programs
The House has voted 286-140 to approve a $463.5 billion fiscal year 2007 omnibus appropriations bill that includes increased funds for NIH, health care for veterans and other health programs. (2/5/07, AP)

OPINION: Nation's Newspapers Have a Range of Responses to Bush's Health Proposal
President Bush's tax-based health proposal received widespread coverage on the editorial pages of the nation's newspapers, with opinions ranging from the Detroit News endorsing it as "the best start we've seen for addressing America's health care crisis," to the New York Times condemning it for "fall[ing] miles short of what is needed to fix a system where – scandalously - 47 million Americans go without health insurance."

President Bush Promotes His Tax-Incentive Health Proposal
President George Bush traveled to a Missouri medical center to argue that the ideas he presented in his recent State of the Union address "offer the best remedy to the nation's health insurance crisis." (1/26/07, Washington Post)

Experts Predict Outcomes of Bush's Health Care Proposal
An article in the Washington Post examining the "winners and losers" from the health proposal President George Bush outlined in his recent State of the Union address concluded that winners "offer the best remedy for the nation's health insurance crisis." (1/26/07, Washington Post)

Democratic Presidential Hopefuls Endorse Universal Coverage

Leading candidates for the 2008 Democratic presidential nomination "are showing a passion for ambitious plans to provide health-care coverage to all Americans that the party has not shown since the Clinton administration's health plan" failed in 1994. (1/26/07, Chicago Tribune)

Self-Pay Markets in Health Care: Consumer Nirvana or Caveat Emptor?
As consumers face more incentives to make cost-conscious medical care decisions, some policymakers cite self-pay markets as models for consumer shopping. Given that consumer shopping is not prevalent in most self-pay markets, we expect the extent of shopping to be even more limited for many services covered by insurance. (2/6/0/7, Health Affairs)

America's Struggle with Healthcare
Forty-seven million Americans are without health insurance, dependent on the emergency room, or getting no care at all. And here we go again with a complicated plan going nowhere. I say "again" because in 1970 I wrote a book, "Don't Get Sick in America," on the financing of healthcare. I predicted that, because of rising costs, 1970 would be the year for national health insurance - the next big step after Medicare and Medicaid. It didn't happen then, and not much has happened, legislatively, since. (2/2/07, Christian Science Monitor)

COMMENTARY: Now is the Time to Fix What's Broken
by Risa Lavizzo-Mourey, MD, MBA, RWJF President and CEO
While much of our nation's attention has been focused on what's happening around the world, something remarkable has been taking place right here at home. Unlikely partners and leaders in government, the health care sector and the business community are stepping forward together to propose new ways of fixing what's broken with our health care system. Thanks to the efforts of diverse and influential organizations, and government leaders from Connecticut to California, a growing number of approaches and solutions are on the table; now it's up to the politicians and those talking about it agreeing to actually do something about it. 1/29/07, RWJF)

OPINION: Health Care Proposals Will Spur Public Debate and Action
In separate Washington Post opinion pieces, columnist David Broder writes that, "piece by piece, the stage is being set for the long-overdue effort to rebuild America's creaky health-care system," and columnist Robert Samuelson says that new health care proposals will start our "overdue," "needed debate." (1/31/07, Wall Street Journal)

Businesses Endorse Overhaul of Nation's Health Care System, but Are Wary of State Efforts

Corporate America is traditionally reluctant about government stepping into the health care arena, but, confronted with soaring costs, businesses acknowledge change is needed, although they are cautious about new state proposals. (1/25/07, New York Times)

Many Businesses Fear Health Care Costs
Businesses are wary of a crop of new state health care proposals to reduce the number of uninsured, fearing the programs will drive up their expenses without solving the problem. Dissension already has surfaced: Maine's health insurers and businesses have balked at how the state's program to expand coverage has been funded and have filed several lawsuits over the policy. (1/20/07, AP)

OPINION: Health Savings Accounts Are Gaining in Popularity
David Gratzer, a physician and a senior fellow at the Manhattan Institute, writes that despite "critical" reports, health savings accounts, introduced three years ago, are quietly gaining traction. (1/31/07, Wall Street Journal)

Other Health Issues

Community Should Promote Preventive Care Among Immigrants
Community groups, not medical providers, "are in the best position to spread health information and push for prevention among immigrants," according to experts. (1/22/07, AP/Washington Times)

The Danger of Hospital Language Barriers
What happens when a patients and health care providers don't speak the same language? Jaime Holguin looks at some of the consequences -- physical, emotional and financial. (1/29/07, AP)

Pandemic Flu to Hit Poor Hardest
There is still a serious threat of a global flu pandemic, health experts said Thursday, and uninsured and low-income Americans could be among those hit hardest. Experts say that it is not a question of "if" but "when" another flu pandemic -- on the scale of the disastrous one that struck in 1918 -- will occur. (1/30/07, UPI)

Hearing on the Economic and Societal Costs of Poverty
In testimony before the U.S. House Ways and Means Committee, visiting fellow Harry Holzer says the costs to the United States associated with childhood poverty total about $500 billion per year, or the equivalent of nearly 4 percent of GDP. This suggests that investing significant resources in poverty reduction might be more cost-effective than previously thought. (1/24/07, Center for American Progress)

Educate your colleagues and/or employees on Florida Medicaid Reform basics. with Florida CHAIN's PowerPoint presentation for public use. Feel free to call Florida CHAIN for more information about Medicaid reform or about the PowerPoint: 954/791-7314.