NEW THIS WEEK

• Health Insurance Premium Growth Moderates in 2006, But Still Increases Twice As Fast as Wages
• Survey Captures Public’s Views of Medical Errors and Quality of Care
• Fact Sheet on Teen Sexual Activity

AT THE BARBARA JORDAN CONFERENCE CENTER

WEBCASTS THIS WEEK

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NEW THIS WEEK

Health Insurance Premium Growth Moderates in 2006, But Still Increases Twice As Fast as Wages
Premiums for employer-sponsored health coverage rose an average 7.7 percent in 2006, less than the 9.2 percent increase recorded in 2005 and the recent peak of 13.9 percent in 2003, according to the 2006 Employer Health Benefits Survey released this week by the Kaiser Family Foundation and Health Research and Educational Trust. Premiums still increased twice as fast as workers’ wages and overall inflation last year. Since 2000, premiums have grown 87 percent while wages have gone up 20 percent and inflation has gone up 18 percent. The annual survey, which Kaiser and HRET have been conducting since 1999, also found modest enrollment in consumer-driven health plans.

Survey Captures Public’s Views of Medical Errors and Quality of Care
This week Kaiser and the U.S. Agency for Healthcare Research and Quality released an updated survey capturing the public’s views and knowledge of medical errors and their experiences in taking steps aimed at improving the quality of their care. Since the Institute of Medicine issued a landmark study seven years ago on medical errors in hospitals, there have been a wide range of efforts by hospitals, doctors, health plans and purchasers to improve the quality and coordination of health care. The new survey updates key questions about these issues that had been asked in 2000, 2002 and 2004 surveys. The nationally representative telephone survey of 1,216 adults was conducted Aug. 3-8 and the margin of sampling error is plus or minus 3 percentage points. Foundation staff created and analyzed the survey in collaboration with experts at the Agency for Healthcare Research and Quality. On the question of mandatory reporting, 87% of the respondents stated that reporting of serious medical errors should be mandatory, and 2/3 of the respondents said that the reports should be available to the public.  For full report, go to: http://www.kff.org/kaiserpolls/upload/7559.pdf 

BidRx.com, a new competitive online marketplace for consumers to find the best medications for  at the best prices, changes the way prescription drugs are marketed, sold, distributed and dispensed in the United States, and the way employers offer prescription benefits.
“In light of Walmart’s recent move to sell 291 generic drugs at reduced prices, we’d just like to remind consumers that BidRx.com is a great way to check more than 13,000 prescription products to determine if any drug you’re taking now has a lower cost alternative,” says Tom Kellenberger, Pharm.D, vice president, BidRx, LLC. “Walmart may not be the best solution. Other pharmacies may charge less than Walmart, but consumers won’t know until they shop and compare. BidRx.com can help consumers find reduced prices for any prescription, even if they aren’t generics, or even for all the generics that aren’t on Walmart’s list. Our customers have found savings of up to 85 percent or more on all their prescriptions.”
go to www.bidrx.com

“This survey, which is the only study to track what really is actually happening with nurse staffing in our hospitals, shows once and for all that the hospital’s ‘Patients First’ initiative is a farce, providing patients with a false promise of patient safety, and that the hospital’s actual staffing practices are oftentimes patently dangerous and irresponsible,” said Beth Piknick, RN, president of the Massachusetts Nurses Association. “The fact that there is so much variation in hospital staffing levels and the fact that they are incapable of adhering to their own self-created plans is the best argument for legislation creating enforceable safe limits on the number of patients assigned to an RN.”

“‘BlackBerry Thumb,’ the latest in a string of techno-related, workplace maladies, is a catch-all phrase for repetitive stress injury, causing pain and/or numbness in the thumbs and joints of the hand,” says Margot Miller, PT, a physical therapist with WorkWell Systems in Duluth, MN and president of APTA’s Occupational Health Special Interest Group. Miller notes that the condition is caused by spending too much time checking and composing e-mails, instant messaging, and accessing the Internet for both work and personal use through a handheld wireless personal digital assistant (PDA).
Miller points out that users who abuse their PDAs — that is, those who use them for more than short intervals, several times a day — are more likely to develop symptoms ranging from swelling and hand throbbing to tendonitis. Additionally, because so many PDA users are middle-aged businesspeople, overuse can aggravate underlying arthritis, she says. “Because the keyboard of a PDA is so small and because the thumb, which is the least dexterous part of the hand, is overtaxed (for faster typing), the risk of injury just skyrockets.”
The best solution to prevent BlackBerry Thumb, says Miller? “Listen to your body, be aware of your symptoms and take personal responsibility,” she says. Typical treatments include applying ice to the affected area, stretching, using a properly fitted thumb split, and possibly even a cortisone injection. In worse-case scenarios, some may need surgery to remove scar tissue that has thickened the tendons inside tunnels that sheath them. “But my first suggestion is that individuals who have these symptoms see a physical therapist,” Miller concludes.

Created by the Commonwealth Fund Commission on a High Performance Health System, the National Scorecard on U.S. Health System Performance is the first-ever comprehensive means of measuring and monitoring health care outcomes, quality, access, efficiency, and equity in one report. Its findings indicate that America’s health system falls far short of what is attainable, especially given the resources the nation invests. Across 37 indicators of performance, the U.S. achieves an overall score of 66 out of a possible 100 when comparing actual national performance to achievable benchmarks. Scores on efficiency are particularly low. This report explains how the Scorecard works, describes results for each domain of performance, and discusses implications for policies to improve quality, access, and cost performance.

for remainder of story, see link at http://www.cmwf.org/publications/publications_show.htm?doc_id=401577.

On July 19, 2006, President George W. Bush exercised his constitutional prerogative to veto a congressional act for the first time in the 6 years he has been in office. The bill, passed by a Republican-controlled Congress, would have allowed a modest extension of embryonic stem-cell research. It called for federal funding to enable the derivation of embryonic stem-cell lines from fertilized eggs that are stored in freezers and already tagged for destruction. In his veto message, the President explained that, “stem cells . . . can be drawn from children, adults, and the blood in umbilical cords with no harm to the donor, and these stem cells are currently being used in medical treatments.” According to the New York Times, Karl Rove, head of the White House’s Office of Political Affairs, has declared that embryonic stem cells aren’t required because there is “far more promise from adult stem cells.” Yet the notion that adult stem cells have the same developmental potential as embryonic stem cells, let alone “more promise,” is dubious. It seems that the White House received this idea from David Prentice, a senior fellow for life sciences at the Family Research Council and an advisor to Republican members of Congress. In a report of the President’s Council on Bioethics, Prentice claimed that adult stem cells can effectively treat more than 65 diseases. Not only is this assertion patently false, but the information purveyed on the Family Research Council’s Web site is pure hokum.

^{see rest of story in New England Journal of Medicine at: http://content.nejm.org/cgi/content/full/355/12/1189}

More than $1.7 billion in big checks of $5,000 or more have been written to influence California elections the past five years, according to a new analysis of state data compiled by proponents of Proposition 89, a November measure that would reduce the influence of special interest donors and level the playing field in elections. For specific information on your county, contact the Yes on 89 campaign.
Based on an analysis of campaign finance filings from the Political Reform Division of the California Secretary of State’s Office, the data documents both the tilt toward wealthy donors in California politics — the average check in the group was $33,000 — and the rapid escalation of political spending in the state — more than two-thirds of the biggest donations were made in the past three years.
The survey compiles 52,686 checks of $5,000 or more from January 2001 through May 20, 2006, the latest date for which the full data set was available. The report was compiled by the California Nurses Association, the sponsors of Prop. 89.
Major findings include:
* A total of $1,741,838,790 was contributed to all statewide candidates and initiatives. The data set includes some checks written by big donors to initiative political action committees from which money was rerouted in separate checks to initiative campaigns. The list is headed by a $14.25 million contribution in the 2005 special election by the Pharmaceutical Research and Manufacturers of America, a trade association representing big drug companies. The top 20 includes tribes, other drug companies, the California Teachers Association Issues PAC, and gubernatorial candidates Steve Westly and William Simon.

A recent report from the Institute of Medicine states that at least 1.5 million Americans are injured every year by medication errors that could have been prevented. Nothing disturbs pharmacists more than medication errors in hospitals. It’s a significant problem that needs to be fixed..  New systems will make a significant reduction in medication errors, and  proactive education can take hold nationwide.

We are in the midst of several major movements in patient safety and quality, driven by health-care powerhouses. The Joint Commission on Accreditation of Healthcare Organizations, the nation’s predominant standards-setting and accrediting body in health care, has taken on this problem rigorously. In one small but dramatic example, this agency now requires hospitals to stop using certain abbreviations in patient orders that previously caused a host of problems.  For full text of a letter to the editor of Seattle Times, go here:

http://seattletimes.nwsource.com/html/opinion/2003264624_overlake19.html

The American Osteopathic Association’s Commission on Osteopathic College Accreditation has awarded provisional accreditation to A.T. Still University’s new college of osteopathic medicine in Mesa, Arizona. This represents the highest accreditation possible at this phase of development. The school’s unique curriculum will emphasize delivering whole person, compassionate care and cutting-edge science and technology. In addition, students will spend three of their four years in community health centers located in underserved communities.
The inaugural class of 100 students will enter the school in July 2007. The new medical school will operate in a 100,000-square-foot building on the 50-acre campus of A.T. Still University in Mesa, which is the anchor of the Arizona Health & Technology Park, a 132-acre, half-billion dollar education, healthcare, and technology park owned by the University and Vanguard Health Systems. The master plan for the new park includes hospitals, long-term and acute care facilities, student and senior housing, professional offices, a YMCA, and product development research facilities.
“By starting a school without old presumptions, we have an opportunity to use new medical research findings and technologies, as well as the latest cognitive principles,” says James J. McGovern, Ph.D., president of A.T. Still University.
“In the U.S., our current medical system is perceived as expensive, impersonal, and inefficient,” McGovern explains. “To solve these problems, we need to challenge the status quo, beginning with the way doctors are trained. We need to educate our new doctors to treat the whole person in mind, body, and spirit and to practice cost-effectively with integrity, compassion, and the latest technology. We also need to encourage them to be lifelong learners because the basis of knowledge is increasing every year.”

According to a recent Wall Street Journal Online/Harris Interactive Health-Care Poll, four out of five (80%) U.S. adults indicate that they favor allowing people to import prescription drugs from Canada and other countries if they are much less expensive. A vast majority (84%) of the public strongly or somewhat agrees that the law banning pharmaceutical imports is intended to protect drug companies’ profits, while only thirty-six percent say this law helps protect Americans from potentially harmful drugs.
These are some of the results of an online survey of 2,295 U.S. adults conducted by Harris Interactive(R) between August 23 and 25, 2006 for The Wall Street Journal Online’s Health Industry Edition (http://www.wsj.com/health).
While some pharmaceutical companies want to make it impossible for Canadian pharmacies to sell drugs over the Internet, a majority of adults (72%) state that this policy is very or somewhat unreasonable. Additionally, 83 percent agree that it should be legal to import drugs from Canada that are approved and vetted by Health Canada, Canada’s equivalent of the Food and Drug Administration (FDA). Since last year, Customs has been confiscating packages mailed to U.S. consumers by Canadian pharmacies, with 37,154 packages seized as of July 2006.