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A handful of U.S. Senators last week blocked a floor vote on a bill that would allow federal officials to negotiate discounts with drug manufacturers.

The Medicare Fair Prescription Drug Price Act of 2007 is co-sponsored by Florida's U.S. Sen. Bill Nelson and is backed by the AARP, among other consumer advocates.

According to Families USA: “When the vote was completed, 55 Senators had voted to allow Medicare to negotiate lower drug prices and 42 had voted to preserve the considerable profits of drug companies rather than relieve a burden from the shoulders of millions of older Americans. Alas, 60 votes were needed to allow floor action.”

TAKE ACTION: Florida's U.S. Sen. Nelson voted yes, and U.S. Sen. Mel Martinez voted no.

Sen. Nelson: 202/224-5274 - Thank him for co-sponsoring the Medicare Fair Prescription Drug Price Act, and for voting to move the bill forward.

Sen. Martinez: 202/224-3041 - Express your disappointment for his vote against moving the Medicare Fair Prescription Drug Price Act forward.

Some senators voting against the floor debate say the bill doesn’t go far enough - the Secretary of U.S. Health and Human Services would still be prohibited from negotiating a particular formulary or price structure.

A report from the Congressional Budget Office states, “Without the authority to establish a formulary or other tools to reduce drug prices, we believe that the Secretary would not obtain significant discounts from drug manufacturers across a broad range of drugs.”

RECENT HEALTH NEWS AND OPINIONS

May 1, 2007

Florida News

KidCare, SCHIP, Healthy Start

Medicare and Medicaid

Medicare Drug Coverage, Drug Costs

Other Medicare, Medicaid

Health Insurance and Costs

Other Health Issues

National News

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

OPINION: Lawmakers: Time to jump-start KidCare

Health-care insurance coverage for Florida's uninsured children has justifiably become a top priority this year for the governor and many Florida legislators. Along with the critical tax issues, the shocking number of uninsured children in Florida has reached crisis proportions and drawn the determination of legislators from both major political parties to resolve. It's unfortunate that 700,000 children live without the basic safety net of health care in this state. That is roughly 10 percent of all uninsured children in the nation. Only two states have a greater percentage of uninsured children. (4/30/07, Tallahassee Democrat)

OPINION: Prioritize children's health

Over the next months, the U.S. Senate and House of Representatives will likely reauthorize the State Children's Health Insurance Program (SCHIP). SCHIP began 10 years ago and currently provides health-insurance coverage to 6 million children in the U.S. and has reduced the number of low-income children who are uninsured by one-third. Receiving health insurance through SHCIP improves the health status of low-income children, yet an estimated 9 million children in the U.S are without health-insurance coverage. This includes 431,000 low-income children in the state of Florida. The current funding levels appropriated at the inception of SCHIP in 1997 are inadequate to protect low-income children's health over the next decade. If funding is not increased, children will be cut from the program over the next five years. In fact, 2.1 million children now receiving health insurance through SCHIP will need to be dropped. Thousands more children will be uninsured in the state of Florida, putting them at risk of increased illness and poor school attendance. Congress must prioritize the health of our nation's children. (4/30/07, Orlando Sentinel)

More funding for KidCare is vital

"Suffer little children and forbid them not ..." Matthew 19:14 reminds us that children hold a special place in the heart of the Lord. And, we shall be judged by how we care for them. This year, the Florida Legislature can extend health care to uninsured children through the KidCare program. This program offers families access to low-cost health insurance. Premiums are paid by the federal government (70 percent), the state (15 percent) and participating families (15 percent). Most of the families enrolled in the program have two working parents, but they still cannot afford health insurance. Many changes are proposed this year to fix the problems that prevented families from taking advantage of this program. I congratulate state leaders for making these changes. But now, it's time for funding. (4/27/07, Jacksonville Times-Union)

Lawmakers Vote To Reform KidCare Program

Children of illegal immigrants could qualify for taxpayer-funded health insurance under a measure that passed after emotional debate Wednesday in the Florida House. The significance may be more symbolic than practical. Advocates for immigrants say the program's application process may be an impossible barrier for those who are in this country illegally. (4/26/07, Tampa Tribune)

Crist backs bill to add kids to insurance rolls: Bill covers state employees, immigrants

Gov. Charlie Crist, flanked by two state senators, gave his support Thursday for a KidCare bill designed to increase enrollment in the health insurance program and include families of state employees and immigrants. "Anything we can do to help Florida's children, we're going to do," Crist said. The Florida KidCare program insures children under age 19, at deeply reduced rates, whose family income is at or below 200 percent of the federal poverty level — that was $40,000 for a family of four in 2006. (4/20/07, Southwest Florida News-Press)

First aid on tap for KidCare

Lawmakers and children's advocates are working on bills to simplify KidCare, a $418 million state program that provides health coverage to children. After years of declining enrollment and unspent federal funds, state lawmakers are doing an about-face on KidCare, attempting to overhaul and expand the program that offers cheap health insurance to 1.4 million low-income children in Florida. The Legislature, which once voted to trim enrollment and raise barriers to people who wanted to use the program, is working on a proposal to undo the damage. Measures before the House and Senate seek to untangle a complex program that has left about 500,000 eligible children without coverage. Advocates believe this year -- the program's 10th anniversary -- is the time to improve access to KidCare. ''This is a historical moment,'' said Linda Merrell, a children's advocate and member of the KidCare Coordinating Council. ``It's incredibly encouraging, particularly for our young children.'' (4/20/07, Miami Herald)

Senate limits who can use KidCare: Lawmaker will seek original form of bill

Children advocates and Sen. Mandy Dawson were broadsided Tuesday by an amendment to the Senate version of a KidCare bill designed to expand the number of children benefiting from the insurance program for working-class families. The amendment was approved in the Senate Health and Human Services Appropriations committee and excludes children of state employees and legal immigrants. “There is no way to leave children of state employees and immigrant children unattended, that’s just unacceptable,” said Dawson, D-Fort Lauderdale, who sponsored SB 930 and is chair of the Health Policy Committee. “For most state employees, their income doesn’t keep up with the economy.” The House KidCare bill, passed by the Healthcare Council Tuesday, still includes state employees and legal immigrants in the program. If both House and Senate pass the bills in their current forms the differences in funding would be negotiated before session comes to an end May 4. (4/18/07, Southwest Florida News-Press)

Medicare and Medicaid

Medicare Drug Coverage, Drug Cost

Other Medicare, Medicaid

State budget includes Medicaid dollars for low-income hospital patients

Florida hospital officials can breathe easier now that a critical source of funding for treating uninsured patients appears intact rather than on the verge of disappearing. State legislative leaders have drafted a budget plan for the new year, which includes $81 million to continue funding a Medicaid program that helps hospitals treating large numbers of uninsured patients. House and Senate leaders agreed during the weekend to allocate the money to the low-income pool program, which can be used to draw down more than $1.1 billion from the federal government in Medicaid funding for hospitals. In addition, local governments contribute $723 million to the low-income pool program. (4/30/07, Naples News)

Bill would make Miami seniors eligible for new Medicaid plans

A pilot health plan for seniors on Medicaid would shift one of its two test markets from Pensacola to Miami-Dade and Monroe counties under a bill approved by the Florida House of Representatives. Instead of being mandatory for the 5,743 Medicaid recipients over age 60 in Escambia County, Florida Senior Care would be voluntary for the eligible population of 97,179 here. The state would give its Medicaid dollars to health plans to cover home health care services, assisted living and nursing home stays. (4/27/07, South Florida Business Journal)

Medigap bill cuts through Fla. rules: The measure, bound for Crist, exempts the out-of-state insurers from regulation.

A bill that allows out-of-state businesses to offer supplemental Medicare insurance, or Medigap, policies to their retirees living in Florida through unregulated insurance companies was passed by lawmakers Thursday and is headed for Gov. Charlie Crist's desk. But state regulators still hold hope for a veto, saying the measure could set up seniors to get stung. (4/27/07, St. Petersburg Times)

Senate budget would cut Medicaid funding

Cuts in the Florida Senate's proposed budget would leave Duval County with $20 million less in state money for Medicaid, according to an alliance of 14 health care systems in the state. The state's system for paying for the care of its poor and uninsured would be cut by $209 million under the Senate's proposed budget, and would forfeit $85 million in federal funding. The cuts would affect one hospital each in Clay, Flagler, Nassau and St. Johns counties, but 96 percent of the cuts in Northeast Florida are among six hospitals in Duval County. And the hardest hit would be Shands Jacksonville, which would lose $15.2 million in annual funding. (4/17/07, Jacksonville Business Journal)

Cuts affect in-home care for disabled children and adults
Faced with a budget crunch, Florida lawmakers agreed Friday to cut services for some people with autism, Down syndrome and other developmental disabilities. Lawmakers promised the cuts won't force institutionalization of anyone and could even provide services to people who have been waiting for years. But advocacy groups worry the Legislature's budget proposal would reduce services for the disabled by as much as 16 percent. (4/28/07. Southwest Florida Herald Tribune)

House: Fund disabilities deficit

Facing a money crisis in a program serving the developmentally disabled, Republican lawmakers in the Florida House have proposed filling a projected deficit in the program by shifting money away from spending money on hometown pet projects. The maneuver, offered during budget negotiations, puts pressure on the Florida Senate to change its stance that would make sharp reductions in spending and services for thousands of the physically and mentally disabled served by the Agency for Persons with Disabilities. Using $32 million taken from hometown spending projects, House lawmakers were able to add it to other money in the budget to plug the $68 million state-spending deficit in the program. The state money would be matched by the federal government, which will spend 57 cents of every dollar on the Medicaid-related program. (4/21/07, Miami Herald)

Cuts to disabled services proposed

Jaclyn Berens works all day advocating on behalf of people like her 22-year-old son. But if cuts to the developmentally disabled proposed by Florida senators are approved, she says she would have to quit her job to stay home and care for son Daniel Rubenstein, who has autism. The state Agency for Persons with Disabilities and both chambers of the legislature have proposed cuts for the agency in next year's budget because the agency has a $104 million deficit this year and projects a $150 million deficit next year. The Senate cuts, while not as much as those the agency proposed, are being vigorously opposed by advocates for the disabled. They would affect up to 6,000 people who are neither severely nor mildly disabled, but rather have medium cases of disabilities, including those who are blind or deaf or have cerebral palsy or Down syndrome. (4/17/07, Palm Beach Post)

Florida Medicaid Program doesn’t make the grade, study says
Despite its huge budget, Florida’s Medicaid Program scored poorly in a new national study that ranks state Medicaid programs based on eligibility, scope of services, provider reimbursement and quality of care. Florida Medicaid ranks 26th, with an overall score of 467.7 out of a possible 1,000 points. With an annual budget of $15 billion, Florida Medicaid serves 2.1 million people—the fourth largest number in the country. For the full report, “Unsettling Scores,” as well as the Florida analysis, go to: http://www2.citizen.org/hrg/medicaid/ Unlike Medicare, which has uniform coverage across all states, Medicaid programs vary from state to state in terms who is covered and what services they receive. States with the highest median household incomes tend to offer the best benefits, while states with lower median incomes have lower-ranked programs. (4/18/07, Florida Health News)

Health Insurance and Costs

Program necessary for needy

By Tony Carvalho, president of the Safety Net Hospital Alliance of Florida.

Will Florida turn its back on millions of dollars in federal aid for health services to the uninsured and create over $200 million of uncompensated care--a tab that local taxpayers, safety net hospitals and health insurance premiums must absorb? That crucial health care question will be answered in the coming days as the state House and Senate battle out their spending priorities in the next state budget. As legislative budget talks unfold, the Senate is proposing $209 million in cuts to Florida's health care safety net for our neediest citizens and the uninsured. Amazingly, as part of those cuts, the Senate would forfeit $85 million in federal matching money that is already earmarked for our state. This issue impacts every taxpayer in Florida, along with the quality and availability of health care in our communities. Tell the Florida Senate to support our state's health care safety net, and bring home the federal support we desperately need--before the legislative session ends May 4 and it's too late. (4/23/07, South Florida Sun-Sentinel)

HMO pay raise slipped into bill
In a year when lawmakers have warned there isn't enough money to go around, the GOP-controlled Legislature has quietly agreed to help out Florida's managed-care companies. After weeks of lobbying by such companies as Tampa-based WellCare, lawmakers over the weekend agreed to boost the amount of state money that health maintenance organizations will get paid to take care of patients covered by Medicaid, the $15 billion state and federal healthcare program for the poor. (5/01/07, Miami Herald)

OPINION: Editorial-Trauma for Florida hospitals-Legislature's cuts would hit ER frontlines worst

The Legislature spared little attention this session for the plight of Florida's low-income workers struggling to afford basic health care. But there's one issue that should be a no-brainer for lawmakers: Whether or not to accept $85 million in federal money intended to shore up the hospitals that deal most with people whose only source of care is the emergency room. Volusia County hospitals could lose close to $4 million if the Legislature doesn't provide the match needed to secure the federal money, with the majority of the shortfall hitting Halifax Medical Center in Daytona Beach. The hardest hit are the facilities that already treat large numbers of emergency-room clients who can't afford to pay their bills. This cut is part of an overall reduction state Senate leaders have proposed to hospitals across the state, which also includes a Medicaid rate reduction. Taken together, the cuts total $209 million -- and shift another $60 million to local property-tax payers, ironic in light of the Legislature's push to cut property taxes overall. (4/21/07, Daytona Beach News-Journal)

Money Short For Hospitals, Poor

Rep. Aaron Bean opened Friday's negotiations over the state health care budget with a warning for patients and families. "We've come to the reality that there's going to be a lot of folks that are going to go away empty-handed," said Bean, R-Fernandina Beach, the House's main budget writer for health and human services. It was an ominous beginning for the joint conference committee, which is negotiating hot-button funding issues such as services for the developmentally disabled. Conference meetings continue today. Funding for the disabled has risen to the fore of the budget battles, given the $153 million projected deficit at the Agency for Persons With Disabilities and the waiting list of thousands seeking services. Talk of budget cuts prompted a rally Thursday at the Capitol of hundreds of disabled people and their families. The event drew appearances - but no promises - from Gov. Charlie Crist and several leading lawmakers. (4/21/07, Tampa Tribune)

State budget cuts may hurt Broward, Palm Beach hospitals that treat poor

As part of budget wrangling in Tallahassee, Florida hospitals that treat large numbers of uninsured and indigent patients stand to lose $209 million -- about $34 million in Broward and Palm Beach counties. The Florida House version of the 2007-08 state budget would cut hospital funding by $27 million, but the Senate version would eliminate the entire amount, with less than three weeks remaining for the two bodies to resolve the issue before the Legislature adjourns. Hospital officials stepped up their lobbying this week. (4/19/07, South Florida Sun-Sentinel)

Trauma centers’ financial fate up to state Senate

Officials with the Lee Memorial Health System and other Florida hospitals with trauma centers and huge numbers of uninsured patients are increasingly anxious about a budget plan the state Senate has put forth. The state House’s budget includes $65 million in state Medicaid money to tap $85 million in federal Medicaid money for Florida’s low-income pool program, which provides crucial dollars to trauma centers and other “safety net” hospitals with disproportionate numbers of charity patients who don’t qualify for traditional Medicaid. But if Senate leaders don’t have a change of heart and allocate the $65 million in that chamber’s budget, the state will face a $209 million blow in funding to care for trauma patients, the poor and uninsured, hospital industry officials say. (4/19/07, Naples News)

Hospitals take hit in state Senate budget

Polk County hospitals, struggling each year with Medicaid payments that don’t cover what it costs to treat patients, would face another hit under the Florida Senate’s proposed budget for next year.They would lose $3.8 million, with Lakeland Regional Medical Center absorbing three-fourths of that. (4/17/07, Lakeland Ledger)

Many artists live without health insurance: One-third of artists don't have health coverage

Three months ago, full-time professional musician Bo Frazer came down with bronchitis. Rather than go to the doctor, he took herbs to try to boost his immune system. It took him about a month to get better. "I only go to the doctor when I think I'm going to die," said Frazer, 56. "It costs money. When you have a deductible as high as mine, bronchitis is not serious." Frazer is better off than professional dancer Jeff Heiden. At least he has major/medical coverage, despite the $5,000 deductible. (4/22/07, Florida Today)

Groups exchange ideas on dental health issue

Access to dental care is a crisis around the country, health-care workers visiting Tallahassee said Thursday. The Capital Area Healthy Start Coalition hosted representatives from private nonprofit groups organized by the Greater Twin Cities United Way and from the National Association for Education of Young Children. The visitors were in Tallahassee to exchange ideas on how better to address the lack of access to dental care. Healthy Start was selected to mentor as part of a peer match program by the NAEYC and the Knight Foundation. The coalition offers a program to combat poor dental care through its "Brush for Baby" project that is financed by a grant from the John S. and James L. Knight Foundation. The Leon County Health Department has been providing basic dental care to pregnant women or expectant mothers at its center at 912 Railroad Ave. (4/27/07, Tallahassee Democrat)

Private Medical Group Helps Babies

The medical team at Lakeland OB-GYN feels a little left out with all the talk about the primary care medical clinic that Central Florida Health Care is establishing in Lakeland with help from Polk County's indigent-care sales tax. That clinic, due to open in four months, will offer general care 76 hours per week. With an income-based fee scale, it will see patients who lack insurance as well as some who have coverage. It's expected to increase access to health care and to reduce inappropriate emergency room visits. (4/25/07, Lakeland Ledger)

An effort to keep doors open

It's been a struggle this past year for the Willa Carson Health Resource Center, the North Greenwood center that provides free medical care for the low-income and underprivileged. The center has shut its doors two days a week because of a lack of funding. It's facing a nearly $30,000 deficit. (4/17/07, St. Petersburg Times)

Other Health Issues

House approves creation of Children's Cabinet

The Florida House approved the creation of a Children's Cabinet this morning without debate, a similar bill will soon go to the Senate floor. 'It's a great step and No. 1 priority of the Children's Summit that we held in October,' said Rep. Loranne Ausley, who sponsored the bill. Gov. harlie Crist gave his support for the bill (HB 509) in his State of the State address earlier this year. Ausley said the Cabinet would force the heads of state agencies to work together on a host of challenges that prevent state services from reaching the children most in need. The proposal for the cabinet comes from more than 1,000 parents, teachers, social workers and children advocates who attended a children's summit in October in Orlando. (4/25/07, Southwest Florida's News-Press)

Supermarkets, drugstores authorized to give flu shots
Soon your grocery list in Florida could include a flu shot. Florida lawmakers approved a bill that would end a tug of war between the state's doctors and pharmacists and give pharmacists the right to give out flu shots. Florida would join 44 other states that allow pharmacists to give the injections. Gov. Charlie Crist said he plans to sign the bill into law. (5/01/07, Miami Herald)

Guest Column: Mental health system's gaps pose threat to us all

By Dr. Marc J. Yacht, retired director of the Pasco Health Department

Mental health treatment represents one of the largest holes in our health care system. Health coverage eludes 47-million U.S. residents, but millions more have inadequate mental health coverage. Surveys suggest that about 15 percent of the U.S. population seek mental health services each year. Half that number have significant mental health problems and one in three of that group receives services. That translates to 15-million people with serious mental disorders with little or no care. (4/25/07, St. Petersburg Times)

Funded communities to tackle forensic mental health issues

House and Senate Health and Human Services budget conferees rearched agreement this morning on how much to earmark for a new matching grant program aimed at developing treatment options for people with mental illnesses involved in the criminal justice system. Senate budget negotiators agreed to match the $2 million already recommended by their House counterparts. (4/24/07, Florida Health News)

Local neurosurgeons scarce, updated study reports

Palm Beach County already has a shortage of neurosurgeons, and the situation is expected to worsen in the next four years, according to updated data being released today by the county medical society. Of the county's 15 full-service neurosurgeons who handle both brain and spinal cord injuries, 13 currently treat emergency patients. That number is expected to drop to seven by 2011 with projected retirements, assuming no new neurosurgeons move to the area, the new data shows. By contrast, the county should have 18 neurosurgeons handling emergencies today and will need 20 in 2011 to meet forecasted population increases, according to the report by the Palm Beach County Medical Society. (4/27/07, Palm Beach Post)

OPINION: Restore state's anti-smoking program to save lives

In Florida, nearly 29,000 deaths are attributable annually to tobacco use. More than 35,900 children under the age of 18 adopt a daily smoking habit each year, and about one third of those eventually will lose their lives to this addiction. In November, voters overwhelmingly approved Amendment 4 - a citizen initiative that requires the Legislature to once again annually pay for a comprehensive, statewide tobacco education and prevention program. Rep. Gayle Harrell, R-Port St. Lucie, chairwoman of the House Committee on Health Quality, demonstrated great leadership by allowing health groups and concerned citizens unprecedented access to participate in the implementation of this citizen initiative. The result is an implementing bill voters can be confident will carry out their will to protect young people from the dangers of tobacco addiction. (4/17/07, Palm Beach Post)

NATIONAL NEWS & OPINIONS

Medicare, Medicaid, SCHIP

Medicare Drug Coverage, Drug Cost

Senate Unable to Lift Ban on Drug Negotiations

The newly elected Democratic Congress made lifting the ban on negotiations one of its first priorities in the 110th Congress. In January the House moved quickly, passing, 255-170, legislation not only to lift the ban on negotiation, but to require the Secretary of the Department of Health and Human Services to bargain with pharmaceutical companies. This week the Senate failed to adopt a weaker bill that would simply lift the ban on negotiating. The procedural vote, needing 60 to pass, failed 55-42. (4/20/07, Coalition on Human Needs)

White House Says President Bush Would Veto Legislation Allowing Federal Government To Negotiate Medicare Prescription Drug Prices

The White House on Tuesday said President Bush would veto Senate that would allow the government to negotiate prices with pharmaceutical companies under the Medicare prescription drug benefit, CongressDaily reports. A Statement of Administration Policy issued Tuesday said that the bill would "impede competition and reduce convenience for beneficiaries." (4/17/07, Congress Daily)

Other Medicare, Medicaid, SCHIP News

Editorial: Medicare’s Troubling Prospects

The trustees' "projections will now force the [Bush] administration and Congress to propose solutions under rules that are perversely skewed to rule out the most progressive financing," according to a New York Times editorial. Proposals will "have to focus on increases in the regressive payroll tax, increases in premiums charged to beneficiaries, cuts in payments to health care providers and cuts in benefits," the editorial states, adding, "This is a distorted and unfair way to reform Medicare, and Congress needs to eliminate the cap" on the percentage of Medicare funding that can come from general revenues or "find a way around it." The editorial concludes, "One good place to look for savings is surely in the lavish subsidies provided to the private health plans that participate in Medicare. That would help lower the overall program's costs and slow the approach of insolvency." (4/26/07, New York Times)

Social Security, Medicare Panel Adjusts Forecast

The Medicare hospital trust fund will become insolvent by 2019, one year later than estimated last year, according to a report released by the board of trustees for Medicare and Social Security. Democrats on Capitol Hill said the trustees' report shows that Medicare is a more pressing problem than Social Security and warned against making cuts that would hurt seniors. (4/24/07, Washington Post)

Editorial: The Medicare Privatization Scam

If private health plans are supposedly so great at delivering high-quality care while holding down costs, why does the government have to keep subsidizing them so lavishly to participate in the Medicare program? "Congress ought to eliminate the subsidies" for private Medicare Advantage plans "unless it is willing to subsidize the same benefits -- at enormous cost -- for the far greater number of people enrolled in standard Medicare." (4/21/07, New York Times)

OPINION: The Plot Against Medicare (Paul Krugman)

The plot against Social Security failed: President Bush’s attempt to privatize the system crashed and burned when the public realized what he was up to. But the plot against Medicare is faring better: the stealth privatization embedded in the Medicare Modernization Act, which Congress literally passed in the dead of night back in 2003, is proceeding apace. Medicare — originally a system in which the government paid people’s medical bills — is becoming, instead, a system in which the government pays the insurance industry to provide coverage. And a lot of the money never makes it to the people Medicare is supposed to help. (4/20/07, New York Times)

Fifth Annual Cover the Uninsured Week Kicks Off With Focus on Kids

Newspapers around the nation covered the launch of Cover the Uninsured Week, the largest nonpartisan mobilization in history to seek solutions for the uninsured, which is focusing its fifth year on encouraging sufficient funding of the State Children's Health Insurance Program (SCHIP), slated for Congressional reauthorization this year, and enrolling eligible children.

OPINION: The Wall Street Journal Criticizes Efforts to Expand SCHIP
The reason the State Children’s Health Insurance Fund has run out of money is because states exceeded SCHIP’s mandate by expanding the program beyond poor children--even as 8.3 million children remain uninsured. (4/24/07, Wall Street Journal)

Nontraditional Children’s Defense Fund Campaign Promotes Children’s Coverage
The Children’s Defense Fund is sponsoring an unusual campaign to garner support for ensuring that all children in the United States have health insurance. (4/17/07, New York Times)

Health Insurance and Costs

Medicare for All Bills Introduced

Senate Health, Education, Labor and Pensions Committee Chair Edward Kennedy and House Energy and Commerce Committee Chair John Dingell introduced companion bills that would allow U.S. residents younger than age 65 to enroll in Medicare. Under the "Medicare for All" bill, residents would be eligible to enroll in Medicare or any of the health insurance plans offered through the Federal Employees Health Benefit Program, or they could continue to receive coverage under private plans. The legislation would shift the cost of coverage to the federal government, which would increase federal spending by about $600 billion annually. Kennedy and Dingell said payroll taxes and general revenue would cover the costs of the proposal. According to a summary of the proposal, "A preliminary estimate of the payroll tax financing necessary will be a payment of 7% of payroll by businesses and 1.7% by workers." (4/25/07, CQ HealthBeat)

AARP Says It Will Become Major Medicare Insurer While Remaining a Consumer Lobby
The group said it would offer a health maintenance organization to Medicare recipients and several other products to people 50 to 64. products for people under 65 include a managed care plan, known as a preferred provider organization, and a high-deductible insurance policy that could be used with a health savings account. When the new coverage becomes available next year, AARP will be the largest provider of private insurance to Medicare recipients. In addition to the new H.M.O., AARP will continue providing prescription drug coverage and policies to supplement Medicare, known as Medigap coverage. (4/17/07, New York Times)

Small Businesses, Fearing Higher Costs, Oppose Coverage for all Americans
Faced with soaring health costs, major corporations have come to support covering all Americans, but small businesses are "a big barrier to a sweeping overhaul of the U.S. health-care system." (4/16/07, BusinessWeek)

In Survey, Workers Rank Health Benefits as Most Important
Employees of large businesses consider their health coverage plan their most important benefit and would rather take a salary cut or reduction in retirement benefits than lose any part of their health benefits, according to a survey by the National Business Group on Health. (4/13/07, Washington Times)

Other Health Issues

Healthy Families Act Introduced

Under the provisions of the bill most employers with 15 or more employees must provide a minimum of 7 days of paid sick leave for those who work at least 30 hours per week, and a prorated amount for those who work at least 20 but less than 30 hours. The leave can be used by workers to care for their own and their families’ medical needs. According to the National Partnership for Women and Families, 48 percent of full-time, private sector workers have no paid sick days and 79 percent of low-wage workers have no paid sick days. Lack of sick days is particularly acute for working women who are still predominately responsible for meeting family caregiving needs and must miss work without pay when a child or elderly parent is sick. (4/20/07, Coalition on Human Needs)

In Turnabout, Infant Deaths Climb in South

The reversal after years of progress in reducing infant death has raised questions about the impact of cuts in welfare and Medicaid and of poor access to doctors. (4/21/07, New York Times)

Baby Boomers Appear to Be Less Healthy Than Parents

As the first wave of baby boomers edges toward retirement, a growing body of evidence suggests that they may be the first generation to enter their golden years in worse health than their parents. While not definitive, the data sketch a startlingly different picture than the popular image of health-obsessed workout fanatics who know their antioxidants from their trans fats and look 10 years younger than their age. Boomers are healthier in some important ways -- they are much less likely to smoke, for example -- but large surveys are consistently finding that they tend to describe themselves as less hale and hearty than their forebears did at the same age. They are more likely to report difficulty climbing stairs, getting up from a chair and doing other routine activities, as well as more chronic problems such as high cholesterol, blood pressure and diabetes. (4/20/07, Washington Post)

Covering Kids & Families Video
Parents' Action for Children, a 2006 national supporter, has created a flash animation video in partnership with Covering Kids & Families that promotes the availability of low-cost and free health care coverage for eligible families. Parents’ Action for Children plans to promote the video to their membership of more than 35,000 parents across the country who are working to improve the lives of children and families in their communities. View the video today! For more information, contact 202/338-7227 or coveringkidsandfamilies@gmmb.com

Pocket Guide on Cultural Competence
The Intercultural Cancer Council recently unveiled the latest 121-page edition of the “Pocket Guide,” Cultural Competence in Cancer Care: A Health Care Professional’s Passport, giving health care professionals a systematic approach for interacting with multicultural and economically disadvantaged cancer patients and their families. It highlights the influences of culture, geography, socioeconomic status and geography on the health behaviors of the rural poor and the five largest racial/ethnic groups in the U.S.: African Americans, Latinos/Hispanics, American Indians and Alaskan Natives, Asians and Asian Americans, and Native Hawaiian and other Pacific Island Populations. To improve the cultural competency of physicians and other health professionals, the guide provides a primer on the culturally appropriate behaviors and attitudes toward cancer prevention and control that differ by multicultural and socio-economic status of patients. This includes common verbal and nonverbal communications, such as shaking hands, looking the patient in the eye, how far to sit or stand from the patient and the use of touch. The guide can be purchased for $6.00 per copy plus shipping charges by contacting 1.877.243.6642 or downloading the order form.

State Medicaid programs have severe deficiencies and suffer from a great disparity of coverage and eligibility from state to state, according to report released today by Public Citizen. The report concludes that the federal Medicaid program, which provides health care coverage to 55 million mostly low-income Americans, is failing to deliver adequate services to millions of people because of differing state eligibility requirements, benefits and performance. (4/17/07, Public Citizen)

As a way to address the flaws of traditional payment methods, like fee-for-service and capitation, the authors of this report suggest a new payment model, based on evidence-informed case rates (ECRs). Under this system, providers are paid a single, risk-adjusted payment across inpatient and outpatient settings to care for a patient diagnosed with a specific condition. Working with experts in the health care field, the authors selected 10 conditions for ECR development, examining issues like diagnosis, services covered by the ECR, and criteria for successful completion of care. This new model, say the authors, can improve health care quality, lower administrative burden, enhance transparency, and support a patient-centered, consumer-driven environment. To further promote quality care, the ECR model calls for a portion of the payment to be withheld and re-distributed based on provider performance on measures of clinical process, outcomes of care, and patient experiences. (April 2007, Commonwealth Fund)

The majority of practices represented by internists that have Limited English Proficiency (LEP) patients provide language services, the American College of Physicians (ACP) reported today as it released a report on language access in health care.(April 2007, ACP and National Health Law Program)

(By Carol Brady of Florida Association of Healthy Start Coalitions)
This one-page report responds to these questions: Why is health care coverage important during pregnancy?How does Medicaid impact health care coverage for pregnant women? Why do we need to expand Medicaid eligibility for pregnant women? How can Florida expand coverage for pregnant women? Expanded eligibility would leverage federal funding for the uninsured, increasing access to prenatal care for at-risk women and matching SCHIP Medicaid eligibility for infants through age one. Expanding Medicaid coverage for uninsured women up to 200% of the federal poverty level would provide needed support to the working, uninsured families for whom pregnancy-related health care is a significant burden.

Florida Children’s Action Agenda 2007/2008 Available Online
Florida state Senators Nan Rich and Durell Peaden and Representatives Loranne Ausley and J.C. Planas have released the final recommendations of the 2006 Florida Children’s Summit. The Summit participants learned a lot, and the next Summit in Fall 2008 will reflect that. In 2008 they will spend substantially more time in workshops hashing out recommendations and will secure experienced workshop facilitators who are knowledgeable about the topics they are facilitating. Also, they will institute a process to ensure that when leaving the 2008 Summit - or very shortly thereafter - all will know the Summit recommendations.

Miami-Dade and Monroe County 2006 Health Profiles
Health Council of South Florida has released downloadable Health Profiles that provide answers to 10 commonly asked questions about county demographics, health needs, and resources.

Medicaid Changes: What will they mean for Broward and Duval counties, and beyond?
This document is Briefing #1 by researchers at Georgetown University’s Health Policy Institute engaged in a two-year evaluation of the Medicaid reform pilot counties for both Florida counties. The evaluation is assessing how these changes affect Medicaid beneficiaries’ ability to access needed care as well as the impact on community health providers.(September 2006, Georgetown University Health Policy Institute)

Report looks at uninsured in Florida
This report from the Research Institute on Social and Economic Policy at FIU documents and breaks down Florida's uninsured figures, finding 18.5% of the total Florida population uninsured. The report looks at employment and industry data related to lack of coverage, and proposes a partial solution.

How Stable Is Medicaid Coverage for Children?
The researchers find that while the program provides a "long-term continuous source of coverage for millions of children," it also creates "a revolving door for others." Many children are covered for reasonably long periods, but many others experience short gaps—from two to four months—in coverage. The authors note that "[e]ven brief gaps are likely to cause disruption in care management and possibly in heath care itself." (March/April 2007, Health Affairs)

Transforming the U.S. Child Health System
Researchers look at the current child health system--fragmented, underperforming, and fraught with inefficiencies--and propose an agenda for radical system change. Instead of the current patchwork system of programs and funding streams. They recommend integrated care that takes "a more comprehensive and holistic approach to optimizing health development." (March/April 2007, Health Affairs)

IMPROVING CHILDREN'S HEALTH: A Chartbook about the Roles of Medicaid and SCHIP
This publication provides 30 graphs summarizing current information about health insurance coverage and the health needs of low-income children, as well as the effects of Medicaid and SCHIP coverage on children's health. (2007 Edition, Center on Budget and Policy Priorities)

Medicaid: Health Promotion and Disease Prevention for School Readiness
Medicaid’s child health program, Early and Periodic Screening, Diagnosis, and Treatment (EPSDT), emphasizes health promotion and disease prevention as vehicles to ensure that children are ready for school and able to succeed in life. Required components of preventive care can be mapped to specific health outcomes that are important attributes of school readiness and prerequisites for educational success. The federal government and states can take specific action to assure that children receive all of the health care services, including preventive services, necessary to promote their optimal health and development and, thus, to maximize their future productivity. (March/April 2007, Health Affairs)

The State Children's Health Insurance Program: Past, Present, and Future
At the end of the 2007 fiscal year, congressional authorization for the State Children's Health Insurance Program (SCHIP) is set to expire. For SCHIP, the reauthorization process--historically a chance to review, refine, and revamp programs--will take place at a time when the uninsured rate for children is once again on the rise. This new report examines the array of policy options that Congress is likely to consider for SCHIP, a program widely hailed for assisting children whose families have too much income to qualify for Medicaid but too little to afford private insurance. In addition to reviewing the program's history, goals, and performance, it describes how eligibility, benefits, and financing might be modified during reauthorization; it also discusses the policy and political implications of change.

Kaiser Health Tracking Poll: Election 2008
Health care ranked as the second most important issue to voters, after the war in Iraq, in the 2008 presidential election, according to a recent Kaiser Family Foundation poll. Fifty-two percent of respondents said they would like to see a health care reform proposal from a candidate “that would make a major effort to provide insurance for nearly all of the uninsured and would involve a substantial increase in spending. (March 2007, Kaiser Family Foundation)

FamiliesUSA has added three new pieces documenting the risks of Health Savings Accounts (HSAs).

The Illusion of Coverage: How Health Insurance Fails People When They Get Sick
This report tells the personal, emotional, and physical hardships of the millions of hard-working, insured Americans who are struggling with medical debt.With stories of dozens of insured individuals and families from seven states, the report demonstrates how private insurance companies fail to protect health consumers from substantial financial losses. Some of key findings: Shifting more costs of care onto patients -- through high deductibles, co-insurance, and less comprehensive coverage -- has significant consequences for both health and financial well-being; Insurance company policies and procedures leave patients confused, in debt, reluctant to seek health care, and vulnerable to predatory scam products; When it comes to health insurance, you can’t measure "affordability" by looking only at premiums: You also have to consider the costs that people will face when they get sick. As this report shows, more and more insured people face staggering out-of-pocket medical bills that leave them asking whether it was worth having insurance at all. (Mar. 2007, The Access Project)

Access Denied: A Look at America's Medically Disenfranchised
This study examines access to basic health care among U.S. residents of all races and ethnicities, income levels and insurance statuses. According to the study, 56 million residents, or nearly one in five, do not have a medical home," and a shortage of local primary care physicians is one reason people lack access to basic medical care (March 2007, National Association of Community Health Centers)

Covering the Uninsured: Growing Need, Strained Resources
This report explains the continued increase in the number of uninsured Americans and examines how federal programs have struggled to stem these increases.(Jan. 2007, Kaiser Family Foundation)

Whose Kids Are Covered? A State-by-State Look at Uninsured Children
New research data shows lower-income families are often doubly squeezed: They are less likely to be offered health coverage by their employers, and less able to afford it on their own. View the entire report or the press release. (March 2007, Robert Wood Johnson Foundation)

Cumulative Social Disadvantage and Child Health
The accumulation of social disadvantage among children was strongly associated with poorer child health and having insurance did not reduce the observed health disparities. (Pediatrics, vol 117, No. 4)

Language Proficiency and Adverse Events in U.S. Hospitals: A Pilot Study
Commonwealth Fund–supported researchers from the Joint Commission report on the type and frequency of adverse events experienced by LEP and English-speaking patients in six U.S. hospitals. Their findings are startling: LEP hospital patients are more likely than their English-speaking counterparts to experience adverse events that result in harm, and the severity of that harm is often greater. The availability of language translation services, provided by trained medical interpreters, is crucial for ensuring the safety and quality of care that LEP patients receive, the authors say. They also recommend that hospitals indicate patients' native language and communication needs in their record and document the language services provided during medical encounters. (April 2007, International Journal for Quality in Health Care)

This updated quick reference source on health disparities presents the best available data and analysis, ncluding data on the uninsured and access to care by race/ethnicity as well as information about the isproportionate effect that specific conditions such as diabetes, HIV/AIDS, and asthma have on racial and thnic minority populations in the U.S. New in the 2007 Key Facts are demographic data on the racial/ethnic minority population in each state and the U.S. territories. This edition of Key Facts also includes data from the National Healthcare Disparities Report, examining changes in health care disparities over time. (Jan 2007,

America's Health Rankings: A Call to Action for People and their Communities
The United Health Foundation, the American Public Health Association and Partnership for Prevention?, have released this 2006 edition, to stimulate public conversation concerning health in our states, as well as provide information to facilitate citizen participation. Participation in all elements is encouraged: personal behaviors, community environment, clinical care and public and health policies. Florida's rank among states went from 40 in 2005 to 41 in 2006.

2007 Governor's Conference on Women's Health: Putting the Pieces Together: Working to Improve Women's Health in Florida
May 15-16 Tampa Convention Center
The conference is strategically scheduled during National Women's Health week each year. The purpose of the Governor's Conference on Women's Health is to provide an educational forum for women's health stakeholders to discuss the major issues affecting women and to identify solutions in the areas of research, awareness and education to improve the overall health status of Florida women. The intended audience includes, but is not limited to, healthcare providers, public health leaders, public policymakers, private employers, state agency officials, community partners and advocates who shape, implement and assess women's health policies, programs and practices in Florida. All women are encouraged to attend.

2007 Summer Conference on Florida's Young Children
July 18-20 Tampa
The One Goal: Building the Future Together "Putting Families and Children First" Conference brings together early education and care providers and leaders from around the state. It is designed to share innovative programs, practices and techniques for improving services and outcomes for all Florida’s children.” The previous conference “Providing Childcare For Children With Disabilities And Special Health Care Needs” coordinated by the Florida Inclusion Advisory Council is now fully integrated with this event. Registration fee $45, waived for primary presenter. Cosponsors include health organizations. 850/893-6270, frankieallen_2000@yahoo.com.

The Human Services Coalition (HSC) will host a two-day conference, The Access through Action Healthcare Access Summit II: CHARITY or JUSTICE, Overcoming Health Care Access Barriers WHAT WE LEARNED FROM THE FIELD AND WHERE DO WE GO FROM HERE? to address how to improve access to healthcare programs and services in Miami-Dade County. HSC will unveil proposals drafted by healthcare discussion groups and draft a plan to turn put their ideas into action. RSVP by April 30to ashal@hscdade.org or 305/576-5001 x42

Talk with Dr. Elizabeth Tan-Chiu, Medical and Research Director, Florida Cancer Care Research Institute. Free program open to all; dinner served. RSVP sue@gildasclubsouthflorida.org or 954/763-6776.

Documentary Highlights Healthcare Woes
May 9 3:00 pm University of Miami Mailman Center Auditorium, 1601 NW 12th Ave, Miami
The Children's Trust hosts a screening of the documentary Collateral Damage - Bad Medicine in Tennessee. The screening will be followed by a discussion about Medicaid reform with the film's director Julie Winokar and Georgetown University professor Joan Alker, Ph.D. For details call 305/571-5700 x507. Refreshments will be served.

Building Our Future 7th Annual Infant Mental Health Conference
Registration deadline: April 30

May 17-18 Bahia Mar Beach Resort and Yachting Center, Ft. Lauderdale
Pre-Conference Institutes: May 16

This annual conference features the latest research and best practices in infant mental health. National experts will provide cutting-edge knowledge in prevention and treatment for young children exposed to stress and trauma. Local communities will showcase implementation of Florida's Strategic Plan toward creating a birth-to-five mental health system. The event will bring together early educators and caregivers, physicians, nurses, mental health professionals, college professors, law enforcement personnel, social workers, therapists from many different disciplines, child advocates, psychologists, program administrators, and policy makers who are in a position to implement a mental health strategic plan in Florida and in other states or countries. For more information contact 305/592-3638 or lzeefe@mdahec.org.

Hip Hop 4 Health Dance Competition Finale
May 19 3:00-6:00 pm Parrot Jungle Island
This outreach effort encourages physical activity among middle school kids in Miami-Dade County, while educating them about how to lead healthier lives. The crux of the in-school
program is a dance competition with a health fair component and entertainment/activities for all ages. Exhibitors invited. The health fair will include screenings, complete access to all the amenities at Parrot Jungle Island for participants' families, and free health information for everyone in attendance. This event is in collaboration with The Parent Academy of Miami-Dade County Public Schools and the After-School All-Stars. To exhibit or for more information, email maria@agency21consulting.com or call 305/577-6034, ext. 3

Outstanding Keynote Speakers, Leadership Academy, Pre-Conference Intensives, Over 50 Workshop Sessions, CEUs for many professions, Registration includes many meals, Single day/full conference registration available

Women and Health Coverage: The Affordability Gap.

Health Coverage in America: Understanding the Issues and Proposed Solutions