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Obama's deficit plan would cut more slowly than competing ones
Washington -- President Obama's deficit reduction plan would lower the nation's debt by about $4 trillion, just as much as a plan offered by a presidential commission and another approved by the House. But Obama's proposal would not hit that $4 trillion target until 2023, two years after the other proposals, according to an analysis released April 21 by the Committee for a Responsible Federal Budget, a nonpartisan policy center in Washington, D.C. Obama's proposal would maintain Medicare's defined benefits, but also strengthen an independent board's ability to reduce federal spending on Medicare and prescription drugs, among other changes. In contrast, the plan proposed April 5 by House Budget Committee Chair Paul Ryan (R, Wis.) -- and approved by the House on April 14 -- would save $4.02 trillion over a decade. It would repeal the national health reform law, cap federal spending on Medicaid and turn Medicare into a voucher program to help seniors buy private insurance. The pr [Read more]
ACOG's message to ob-gyns: Be clear when talking with patients
New recommendations from the American College of Obstetricians and Gynecologists encourage ob-gyns to tailor health information to individual patients and use plain language during medical discussions. The organization's four opinion statements, published online April 20 in Obstetrics & Gynecology, are intended to improve patient-physician communication. The reports address effective patient-physician communication, cultural sensitivity and awareness, health literacy and partnering with patients to improve safety. "We recognize that one of the key components to [achieving positive] health care outcomes is communication," said Patrice Weiss, MD, chair of ACOG's Committee on Patient Safety and Quality Improvement, which helped write several of the statements. "Compliance with medical treatments, even patients getting their prescriptions filled, is really dependant on how well" they understand the health information discussed during the office visit, Dr. Weiss said. ACOG recommen [Read more]
Appeals court overturns stem cell research funding ban
Washington -- A federal appeals court on April 29 overturned a lower court's ruling banning federal funding of any research that leads to the destruction of human embryos. The three-judge panel of the U.S. Appeals Court for the District of Columbia ruled 2-1 in favor of the Dept. of Health and Human Services, which had argued on behalf of the National Institutes of Health. The lawsuit, aimed at blocking federal funding of human embryonic stem cell research, was brought against the Obama administration by two researchers who use nonembryonic stem cells, the Christian Medical & Dental Assn., an adoption agency, and others. "This is a momentous day -- not only for science, but for the hopes of thousands of patients and their families who are relying on NIH-funded scientists to pursue life-saving discoveries and therapies that could come from stem cell research," said NIH Director Francis Collins, MD, PhD. At issue was the intent of the Dickey-Wicker amendment, which Congress has [Read more]
Health disparities persist despite VA quality improvements
Significant quality improvement initiatives in the Veterans Affairs health care system have failed to eliminate health disparities between white and black patients, says a study in the April issue of Health Affairs. The VA underwent major organizational changes between 1995 and 1999 that led to quality improvements, such as higher cholesterol-screening rates for all patients, said Amal Trivedi, MD, MPH, lead study author and research investigator at the Providence VA Medical Center in Rhode Island. But racial disparities persist in health outcomes with cardiovascular disease, diabetes and hypertension, he said. "Quality improvement is not synonymous with disparity reduction," said Dr. Trivedi, assistant professor at the Warren Alpert Medical School of Brown University in Providence, R.I. "It is possible to still be left with lingering disparities in care." For example, although 96% of whites and 94% of blacks received low-density lipoprotein cholesterol tests in 2009, there [Read more]
Many paid caregivers lack health literacy skills
More than a third of the people paid to care for seniors are not health literate, and 60% wrongly interpret the instructions on prescription labels, a study says. Caregivers often are hired by families to help care for seniors with cognitive loss, dementia or Alzheimer's disease and who have trouble performing daily activities such as toileting, bathing, cooking and shopping. This makes it especially important that caregivers have the ability to understand health-related instructions, said Lee A. Lindquist, MD, MPH, lead author of the study published in May's Journal of General Internal Medicine (www.ncbi.nlm.nih.gov/pubmed/21161420/). Caregivers' poor health literacy skills can affect patient care, said Dr. Lindquist, a geriatrician at Northwestern Memorial Hospital in Chicago. "Many times, I see patients cared for by caregivers. They come with the senior to the doctor's visit," she said. "You can't really tell the senior information because they have cognitive issues that do [Read more]
Medicare criticized for $4 million drug overpayment
Washington -- The Centers for Medicare & Medicaid Services overpaid for dozens of drugs in 2009 by an estimated $4.4 million, the Dept. of Health and Human Services Office of Inspector General said in an April report. The OIG examined payment levels for drug codes in 2009 and found that 34 of the 493 drugs in the Part B payment system exceeded the average manufacturing price by 5% or more during at least one quarter of that year. For instance, Medicare paid $346.57 in October 2009 for the injection drug Dexrazoxane, exceeding the 105% mark. Payments had surpassed this threshold throughout the year, according to the report. Medicare expenditures for Part B drugs would have been reduced by $4.4 million if CMS had paid 103% of the manufacturer's price, which the Medicare agency has the authority to do when prices exceed the 105% mark. CMS concurred with just one out of four OIG recommendations in the report on drug prices, according to a memo from CMS Administrator Donald M. B [Read more]
Ban menthol cigarettes, FDA panel urges
Menthol cigarettes have a higher risk of causing tobacco-related diseases than other cigarettes and should be pulled from shelves, according to a report by the Food and Drug Administration's Tobacco Product Scientific Advisory Committee. Research shows that menthol cigarette smokers inhale more smoke and tar particles than other cigarette smokers and that the products are more addictive, the March 18 report said. The findings were based on the committee's analysis of studies, tests and surveys conducted during the last several decades. The committee was formed under the Family Smoking Prevention and Tobacco Control Act to provide recommendations to the FDA about tobacco-related issues. The agency is reviewing the report and plans to provide an update on its review in three months, said Lawrence R. Deyton, MD, director of the FDA's Center for Tobacco Products. R.J. Reynolds, one of the major U.S. tobacco companies, pledged to work with the FDA as it begins its analysis of the r [Read more]
Communicating health risks can be tricky
How medical risks are perceived can vary by the way in which the statistical reality is portrayed. A new systematic review finds that patients and physicians struggle to interpret health probabilities. The review, published March 16 by The Cochrane Collaboration, which analyzes the evidence for the efficacy of health care interventions, examined 35 studies of how well patients, physicians and medical students understand various methods of communicating risks (www.ncbi.nlm.nih.gov/pubmed/21412897/). For example, most people have an easier time understanding the three-year risk of a hip fracture due to not taking an osteoporotic drug if it is expressed as a frequency, 100 patients in 1,000 will have a fracture. This is in contrast with expressing this as a percentage -- a 10% probability. If the drug benefits the patient by cutting the 10% risk in half, the so-called relative risk has been cut by 50%. In this case, the risk is 50% lower, relative to the 10% of patients who would [Read more]
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