U.S. companies launch new group to lobby health care

By Jeremy Pelofsky

WASHINGTON (Reuters) - Aetna Inc., Safeway Inc. and 35 other U.S. companies facing soaring health-care costs released a plan on Monday to lobby Congress for a market-based approach for providing universal health-care coverage.

They also said individuals must take more preventative steps to avoid expensive health crises down the road as Congress looks for ways to expand coverage to the 46 million uninsured Americans.

"We believe there's a real sense of urgency in solving this problem and we intend to be active participants in this debate," Safeway Chief Executive Officer Steve Burd told reporters. "We do not have a monopoly on good ideas."

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The group said the system for providing coverage was broken and that next year the average Fortune 500 company will have a health-care bill that exceeds its net income. Health-care costs were 16.2 percent of U.S. gross domestic product in 2005.

The health-care system "responds to treatment after people get sick and does little to identify and prevent illness," Neil Golub, head of Price Chopper Supermarkets, said in a statement. "It's time we build a health-care system that focuses on keeping people in good health."

The executives also urged that low-income Americans be given help to pay for health coverage rather than have services provided for free as a way to encourage them to seek regular access instead of waiting until emergencies arise.

The group, called the Coalition to Advance Healthcare Reform, also wants tax breaks to be given to individuals who pay for their own health-care costs, as businesses are now. President George W. Bush has suggested a version of this approach.

However, the coalition declined to endorse any legislation that has been proposed in Congress.

Sen. Ron Wyden, an Oregon Democrat, has proposed a bill to provide universal coverage by giving individuals access to various private health plans available in their states.

"We're going to make a big push ... to fix health-care in this session of Congress," Wyden said. "We don't think the country can afford to sit around and wait for another presidential election to fix health care."

Health care has gained widespread attention from the 2008 presidential candidates but they mostly focus on covering nine million uninsured children.

Several studies have found fault with the current U.S. system -- a free-for-all in which employers provide most health care, government programs provide much of the rest and an estimated 46 million Americans are left with no health insurance
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319,000 Community Health Center Patients Expected To Lose Medicaid Coverage

Medicaid Coverage

As many as 319,000 community health center patients, including more than 212,000 children, expected to lose medicaid coverage as a result of medicaid documentation requirements.

Medicaid documentation requirements enacted by Congress in 2006 are already having a major and measurable impact on health centers and their patients, according to a new analysis issued by The George Washington University School of Public Health and Health Services (GW/SPHHS). These new requirements -- affecting both children and adults nationally -- are disrupting coverage for thousands of Medicaid-enrolled health center patients, while delaying applications and enrollment for thousands more. Health centers' ability to provide care for both their insured and uninsured patients is being affected.

In 2005, health centers -- the largest source of comprehensive primary care for low income patients -- served more than 14 million patients, including more than 5 million Medicaid beneficiaries and 5.2 million low-income children. Medicaid accounts for 37 percent of all health center operating revenues. Results from this initial national impact assessment, the first study to systematically study the effects of documentation, show that:

* Documentation requirements have caused a nationwide disruption in Medicaid coverage for health center patients, with more than 90 percent of all health centers reporting enrollment difficulties for patients of all ages, including newborn children.

* More than 43 percent of health centers report that patients are experiencing one or more of the following problems: a longer enrollment process, a longer application process, the lack of appropriate documentation or having to pay to get necessary documents.

* One third of health centers report having to increase staff time for patient enrollment assistance.

* Enrollment delays and disruptions have affected the ability of almost half (45 percent) of reporting health centers to arrange for specialty care; 38 percent report difficulties in securing healthcare access for new patients; 28 percent report difficulties in pre-arranging hospital inpatient deliveries for pregnant women, and 24 percent report difficulties in securing supplies and equipment.

The immediate estimated impact of the new documentation requirements is the loss of Medicaid coverage for some period of time for between 2.2 percent and 6.7 percent of all Medicaid enrolled patients. This estimate is extremely conservative and does not take into account the impact of the changes on newborn children or new applicants. Between 105,100 and 319,500 Medicaid patients, including up to 212,400 children and 107,100 adults, are expected to be affected.

This patient impact estimate translates into immediate Medicaid revenue losses of as much as $85 million. These revenue losses represent:

* Services to as many as 166,000 uninsured patients.

* Staffing reductions of as many as 83 physicians, 66 dental professionals, 18 pharmacists, 33 mental health professionals, or 140 nurses and physician assistants.

* The loss of up to one percent of all health center operating revenues.

* The loss of the entire operating surplus reported by health centers in 2005, which is crucial in planning for unanticipated emergencies.

* As many as 131 "new start" health centers in the nation's poorest counties.

"These initial results underscore that increasing Medicaid enrollment barriers have enormous implications for healthcare access and quality," said Sara Rosenbaum, JD, Hirsh Professor and chair, SPHHS Health Policy Department and a study co-author.

Julio Bellber, president of the RCHN Community Health Foundation, which supports the study as well as ongoing health center research and scholarship at GW, said, "The Foundation is committed to supporting research and dissemination of findings related to access, health equity and the role of health centers. This study presents a clear picture of the devastating impact the Medicaid documentation requirements have -- and will continue to have -- on health centers and their patients." Dan Hawkins, vice president for Federal, State, and Public Affairs at the National Association of Community Health Centers, said, "The report signals the danger for millions who desperately need -- and qualify for -- Medicaid coverage, and the imminent harm facing an already beleaguered healthcare safety net."

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Virginia Tech gunman failed to get court-ordered mental health treatment

WASHINGTON A newspaper reports that the gunman who killed 32 people and himself at Virginia Tech three weeks ago never got the mental health treatment ordered by a judge.

Court papers show special judge Paul Barnett ordered Seung-Hui Cho (sung-wee joh) into involuntary outpatient treatment, finding that Cho was an imminent threat to himself and others.But The Washington Post reports today that neither the court nor community mental health officials followed up on the judge's order, and Cho didn't get the treatment. The newspaper cites unnamed authorities who have seen Cho's medical files.Barnett told The Associated Press today that judicial ethics prevent him from talking about Cho's case.Virginia law enforcement and mental health officials contacted today by The Associated Press would not confirm the story. School officials did not return calls from The AP.The panel appointed to look into the shootings hasn't gotten any information yet. That's according to its chairman, retired Virginia State Police Superintendent Gerald Massengill. The panel meets for the first time this week.

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Daily Health Policy Report

  A universal health coverage proposal by Illinois Gov. Rod Blagojevich (D) "has created outrage in the business community, and its unpopularity is threatening to doom the entire health care initiative," the New York Times reports. The plan, called Illinois Covered, would create a new tax on the gross receipts of businesses that make more than $2 million annually. The tax would range from 0.08% of gross receipts for businesses, such as retailers or wholesalers, to 1.95% for service businesses. Retail sales of food and medicine would be exempt from the tax.

The plan would create a statewide pool of low-rate insurance plans that anyone would be allowed to purchase. The plan also would offer rebates for middle-income families to help them pay premiums for the state program or private coverage, and it would expand access to coverage for low-income state residents through a program similar to Medicaid. In addition, the plan would permit parents to keep adult children on their family policies until age 29, among other benefits.

An independent study by Kenneth Thorpe of the Department of Health Policy and Management at the Rollins School of Public Health at Emory University found that from 2008 to 2011, the plan would generate a total of $15.6 billion in savings.

Opposition
However, "several leaders who usually find themselves allied with the governor have expressed outright opposition to the new tax," including Blagojevich's former running mate Lt. Gov. Pat Quinn (D) and civil rights leader the Rev. Jesse Jackson, the Times reports. Quinn said, "I've told the governor it's time for 'Plan B' because a strategic retreat from [the tax] is better than overwhelming defeat," adding, "It's the wrong remedy for a serious issue. I think we can do much better than that."

Jackson in an interview said, "For a substantial number of small businesses and many of our established businesses, the tax would be higher than the profit. That is the real problem with it." He added, "We all want health care. But business closure is not good health." Some businesses have said they would move out of the state if the tax were imposed, and the state Chamber of Commerce has launched a campaign opposing the health care plan and tax.

Other Comments
Diane Rowland, executive vice president of the Kaiser Family Foundation and executive director of the Kaiser Commission on Medicaid and the Uninsured , said, "You could say it's 'courageous' or you could say it's 'not politically feasible,' but many who look at state reforms say the key is, 'is the financing adequate?'" Rowland added, "It's not just how you propose to cover people, but are the dollars there to make the coverage real? This proposal seems to be addressing both sides of the equation, talking about coverage while being honest about financing."

Alan Weil, executive president of the National Academy for State Health Policy , said, "If this happens, I'd put it in the same category as Massachusetts as far as a comprehensive plan designed to reach everyone. That would put it very much in the lead" (Saulny, New York Times, 5/5).

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Volunteering Produces Health Benefits

Volunteers help themselves to better health while helping others.

The Health Benefits of Volunteering: A Review of Recent Research has found a significant connection between volunteering and good health. The report shows that volunteers have greater longevity, higher functional ability, lower rates of depression and less incidence of heart disease.

"Volunteering makes the heart grow stronger," said David Eisner, CEO of the Corporation. "More than 61 million Americans volunteer to improve conditions for people in need and to unselfishly give of themselves. While the motivation is altruistic, it is gratifying to learn that their efforts are returning considerable health benefits."

The Health Benefits of Volunteering documents major findings from more than 30 rigorous and longitudinal studies that reviewed the relationship between health and volunteering, with particular emphasis on studies that seek to determine the causal connection between the two factors. The studies, which were controlled for other factors, found that volunteering leads to improved physical and mental health.

"I commend the Corporation for National and Community Service for its timely focus on health and volunteerism. These findings complement the Administration on Aging's ongoing efforts to harness the power of prevention and wellness for all older Americans. Volunteerism is an important tool in our strategy to promote health and prevent disease," said Josefina G. Carbonell, Assistant Secretary for Aging at the U.S. Department of Health and Human Services.

Research suggests that volunteering is particularly beneficial to the health of older adults and those serving 100 hours annually. According to the report:

-- A study of adults age 65 and older found that the positive effect of volunteering on physical and mental health is due to the personal sense of accomplishment an individual gains from his or her volunteer activities.

-- Another study found that volunteering led to lower rates of depression in individuals 65 and older.

-- A Duke study found that individuals who volunteered after experiencing heart attacks reported reductions in despair and depression -- two factors that have been linked to mortality in post-coronary artery disease patients.

-- An analysis of longitudinal data found that individuals over 70 who volunteered approximately 100 hours had less of a decline in self- reported health and functioning levels, experienced lower levels of depression, and had more longevity.

-- Two studies found that volunteering threshold is about 100 hours per year, or about two hours a week. Individuals who reached the threshold enjoyed significant health benefits, although there were not additional benefits beyond the 100-hour mark.

"This is good news for people who volunteer," said Robert Grimm, Director of the Corporation's Office of Research and Policy Development and Senior Counselor to the CEO. "This research is particularly relevant to Baby Boomers, who are receiving as well as giving when they help others. Just two hours of volunteering a week can bring meaningful benefits to a person's body and mind."

Last month, the Corporation released Volunteering in America: 2007 State Trends and Rankings in Civic Life, a report that includes numerous measures on volunteering and civic engagement. The Health Benefits of Volunteering report builds on that by showing states with higher volunteer rates also have better health and that there is a significant statistical relationship between states with higher volunteer rates and lower incidents of mortality and heart disease.

"There is now a convergence of research leading to the conclusion that helping others makes people happier and healthier. So the word is out -- it's good to be good. Science increasingly says so," said Dr. Stephen Post, a professor at the Case Western Reserve University School of Medicine and co- author of the forthcoming book "Why Good Things Happen to Good People: The Exciting New Research That Proves the Link Between Doing Good and Living a Longer, Healthier, Happier Life."

This follow-up report issued today brings more evidence that volunteering produces significant health benefits. Those who gave social support to others had lower rates of mortality than those who did not -- even when controlling for socioeconomic status, education, marital status, age, gender, and ethnicity, the report stated.

"Civic Engagement and volunteering is the new hybrid health club for the 21st century that's free to join," added Thomas H. Sander, executive director of the Saguaro Seminar at Harvard University. Social capital research shows it miraculously improves both your health AND the community's through the work performed and the social ties built."

The Corporation for National and Community Service improves lives, strengthens communities, and fosters civic engagement through service and volunteering. Each year, the Corporation provides opportunities for more than 2 million Americans of all ages and backgrounds to serve their communities and country through Senior Corps, AmeriCorps and Learn and Serve America.

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Heart of health care

National Nursing Week presents an opportunity to celebrate the unique contributions of nurses - both as a profession and individually.

"Travelling across this country, I have met many inspirational nurses who are making a difference every day," says Canadian Nurses Association (CNA) president Marlene Smadu.

This year's event runs from May 7-13.

The CNA calls nurses a vital component of our health system and active in our communities. They are at the bedside and in our schools. Nurses lead research and international development initiatives and have a strong presence in Canada's military. They are also catalysts in finding solutions to improve access to health services.

For example, it was Lois Scott, a registered nurse, who co-developed and championed telehealth. Telehealth, from its roots in New Brunswick, has taken off so that Canadians no matter where they live can access expert health advice around the clock through nurse-staffed telephone services. Telehealth has helped drastically reduce the number of visits to emergency departments across the country.

True to its pioneering history, nursing continues to chart the course in optimizing the health of all Canadians. This means counselling and advocacy aimed at preventing illness to keep Canadians healthy and out of hospitals.

Jane Brownrigg is an example.

The public health nurse in Ottawa works with teens in battling tobacco addiction. An advocate for smoke-free public spaces., Brownrigg and her colleagues pressured the municipal council in Ottawa to put in place a smoke-free bylaw in 2001.

Nurses also work with governments at all levels as well as urban designers to reduce environmental hazards. They collaborate with police officers, firefighters and others involved in emergency planning to ensure that, at the time of an epidemic or a natural disaster, the expertise and infrastructure are there to deal with people who have physical and mental health problems.

According to Christine Halpert, registered nurse and communicable disease manager at Fraser Health in British Columbia, nurses have a unique set of skills that allow them to mobilize quickly in the face of any kind of an outbreak because they know their communities well. Halpert feels nurses are able to identify people who might be at risk of infection early and can prevent or stop the further spread of illness like meningococcal disease outbreaks or influenza.

Nurses are no strangers to the value of working in teams. With nutritionists, pharmacists, physicians, physiotherapists and others, nurses deliver health services in clinics, long-term care facilities, hospitals and people's homes. They have a long history of involvement in social issues like homelessness and healthy child development.

Toronto street nurse Cathy Crowe, for instance, has devoted her life to working on behalf of homeless Canadians, including advocating for a national housing program.

"We often hear how nurses are at the heart of health care," says the CNA's Smadu. "I think that has two meanings: it means that our compassion connects us with patients in a heart-to-heart way, and it recognizes that the health system could not function without our knowledge and actions.

 

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IMS Health Rises on Ruling

NEW YORK — IMS Health Inc., which provides market research to pharmaceutical and health care companies, climbed to an eight-year high Tuesday after a federal judge overturned a law that kept companies from learning about doctors' prescription-writing habits.
Judge Paul Barbodoro of New Hampshire federal court said the law, which was signed in June, was an unconstitutional restriction on speech.
IMS and Verispan LLC had sued to stop the law from taking effect. New Hampshire is the only U.S. state to pass a law restricting provider-identifiable data, which pharmaceutical companies use to fine-tune their sales pitches to individual doctors.
At least a dozen other states have considered similar bills, and a federal version failed to make it out of committee last year. Robert W. Baird & Co. analyst Eric Coldwell said Barbodoro's ruling could make investors more enthusiastic about the stock.
"Following Nevada's recent election not to pursue similar legislation, this positive outcome may severely curtail other states' desire to pursue similar legislation," he said. "This year-long overhang is effectively quashed."
Coldwell reiterated an "Outperform" rating and $37 price target for shares of Fairfield, Conn.-based IMS.
The stock rose $2.13, or 7.3 percent, to $31.46 in afternoon trading on the New York Stock Exchange. Shares went as high as $31.60, their greatest value since March 1999.

Aboriginal health 'a hundred years behind whites'

By Kathy Marks in Sydney
Published: 02 May 2007
Health standards among Australia's Aborigines are as poor as those among the white population before the advent of penicillin nearly a century ago, according to the World Health Organisation (WHO).
A WHO report found that Aborigines still suffered from leprosy, tuberculosis and rheumatic heart disease, all of which were eradicated decades ago in other developed nations. In some parts of New South Wales the average life expectancy for Aboriginal men was 33.
The paper was presented to a meeting in Adelaide of the WHO's Commission on the Social Determinants of Indigenous Health, which is also investigating the situation in New Zealand, the US and Canada. It concluded that, on every indicator, the state of health of Australian Aborigines was far worse than that of indigenous populations in other developed nations.
Lisa Jackson Pulver, who co-authored the chapter on Australia and New Zealand, criticised the Australian government for failing to address the root causes of poor health. They included a long-standing refusal to recognise the injustices of the past, she said.
Dr Jackson Pulver, from the Indigenous Health Unit of the University of New South Wales, wrote: "It is acknowledged by the government that Aboriginal Australians have poorer health, educational, employment and social outcomes, however the solutions to address these issues have little to do with the underlying causes." These were "a combination of material deprivation and psycho-social stressors related to stress, alienation, discrimination and lack of control".
In New Zealand there were still health inequalities between the Maori and white populations, but the gaps were fewer and smaller than in Australia, and closing. "Unfortunately we can't say the same [in Australia]," Dr Jackson Pulver said. "On many indicators, [indigenous] health now remains unacceptably lower and at levels experienced nearly a century ago by our non-indigenous peers."
She told ABC Radio: "Indigenous babies born today can expect to live only as long as people in Australia 100 years ago. The Aboriginal people are dying at the same kind of rates that people did 100 years ago in Australia... before penicillin."
Researchers found life expectancy among white Australians was 76.6 for men and 82 for women. In Aboriginal communities it was 59.4 for men and 64.8 for women.
Dr Jackson Pulver believes the after-effects of colonisation and injustices such as the forcible removal of Aboriginal children from their families were still having an impact. The factors included "people being alienated from their country, land, language and culture", she added.
She noted in the report that the Australian Prime Minister, John Howard, referred to the "recognition of past wrongs as the black armband view of history", and was unwilling to make a formal apology.
A report last month by Oxfam and the National Aboriginal Community Controlled Health Organisation (NACCHO) reported similar findings. Dea Delaney Thiele, chief executive of NACCHO, told ABC that a 1 per cent increase in the national health budget would place indigenous health spending on a par with the rest of Australia.
The Health Minister, Tony Abbott, said the gap was "something which no one can be happy about". But, he added: "I don't think you can realistically expect an immediate cash injection of the dimension you suggest, for the simple reason that you've got to have the infrastructure in place to make it effective."

State Watch | Indiana Lawmakers Approve Cigarette Tax Increase To Fund Health Insurance Plan

The Indiana Legislature on Sunday passed a bill (HB 1678) that would increase the state cigarette tax by 44 cents to fund a health insurance program for low-income, uninsured residents, the Indianapolis Star reports. The House voted 70-29 to approve the measure, and the Senate voted 37-13 in favor of the legislation. The bill is expected to generate an estimated $206 million annually, according to legislative fiscal analysts. The tax increase would fund Gov. Mitch Daniels' "Indiana Check-Up" insurance plan. Under the plan, individuals with incomes up to 200% of the federal poverty level would pay between 2% and 5% of their adjusted annual gross income for health coverage. The plan would:
Provide $500 in no-cost preventive health care, a $1,100 health savings account and up to $300,000 of annual insurance coverage from a private company;
Increase the number of children and pregnant women who are eligible for Medicaid;
Allow dependents up to age 24 to receive coverage through their parents' health insurance plans;
Create an insurance pool for small businesses; and
Provide tax incentives to companies that offer health insurance to employees.About 132,000 state residents would be eligible for the plan (Schneider, Indianapolis Star, 4/30). Daniels is expected to sign the bill

A Second Look: Health Net

Shares of insurance company Health Net Inc. bounced back Tuesday, partially recovering from losses after its first-quarter earnings and second-quarter outlook disappointed investors.
Health Net (nyse: HNT - news - people )'s profit and revenue matched Wall Street expectations Monday, but the stock fell 5 percent because total health plan enrollment was down. The company's second-quarter forecast of 79 cents per share was a penny below the consensus of analysts polled by Thomson Financial.
Lehman Brothers (nyse: LEH - news - people ) analyst Joshua Raskin reiterated an "Underweight" rating on Health Net shares, but raised his price target to $52 from $46. Raskin said he is concerned about declining membership in the company's commercial business, but in his view the quarter was uneventful and Monday's drop had more to due with the stock price than the news.
"We believe that the selloff was simply due to recent strength in the stock and not a reflection of any fundamental concerns that arose from the quarter," he said. The stock had gained $4.02, or 7.6 percent, since March 12, when UnitedHealth Group Inc. (nyse: UNH - news - people ) said it is buying Sierra Health Services Inc. (nyse: SIE - news - people )
Health Net shares gained $1.19, or 2.2 percent, to close at $55.25 on the New York Stock Exchange.
Copyright 2007 Associated Press. All rights reserved. This material may not be published broadcast, rewritten, or redistributed