NATL: The National Federation of Independent Business, normally a dependable ally of Republicans, criticized President Bush. "While we are relieved that the administration's health care principles don't support an unlimited right to sue, we are also disappointed that the principles do not include options for access to affordable health care," said NFIB Senior Vice President Dan Danner. "We are afraid this means the plight of the uninsured -- largely a plight of small business owners -- will continue to be ignored."

NATL: A survey of 300 doctors over age 50 found that 10 percent were planning to seek jobs outside clinical practice. They would not choose medicine if they were starting their careers today say 46% and 56% would not encourage their children to choose medicine as a career. Also 56% said managed care was their single greatest source of personal frustration.

NATL: Unlike previous nursing shortages that tended to be cyclical in nature, this shortage will get worse before it gets better. Dire consequences will follow unless changes are made. "This is the issue in health care for the next 10 years. Several developments have encouraged nurses to flee the profession including hospital layoffs in 1990s and replacement with aides.

* NATL: Morehouse School of Medicine hosts major conference on primary care, March 8-10. Finding ways to make health insurance more available and affordable for working Americans. Our first priority should be increasing health insurance for the nation's 10 million uninsured children. That would contribute toward the elimination of health disparities.

KANS: Sisters of Charity took over Bethany Medical Center in Kansas City, two years ago when the economy was booming and the hospital was losing money. They cut costs and consolidated programs, but Bethany still lost $10.2 million and is on track to lose an additional $8-10 million this year. In part Bethany's woes result from the high percentage of indigent care it provides. With a potential recession on the horizon, more financial pain could be inflicted on organizations already on the edge.

VIEWPOINT DC: DC should seeking federal funds to support its health care safety net and should develop backup plans for trial privatization of DC General. Can we build "a model indigent health care system for the 21st century"?

MARYL: Mercy, a volunteer-run clinic is a safety net for the estimated 100,000 uninsured workers in Montgomery County. "Its a stopgap measure, but something's better than nothing." If we didn't have these clinics, it would be a disaster, but we shouldn't have to have these clinics."

NATL: Overall health-care spending will more than double to $2.6 trillion by 2010, in part because drug costs are projected to rise on average 12.6 percent every year. The drug spending boom comes with an aging population and as more patients ask for newer, high-priced drugs marketed on television.

ILLIN: The state health insurance program for retired teachers faces a deficit of as much as $50 million, possibly forcing a substantial hike in premiums. Premiums may have to increase more than 70 percen. A retiree 65 or older would see the premium increase from $136 a month to more than $230. The program covers more than 40,000 retired teachers and their dependents.


NATL: The report found that spending on drugs for seniors without coverage was 45 percent lower in 1998 than for those with insurance, and that the uninsured used nearly a third fewer prescriptions. The disparity was even greater among seniors in poor health and those with chronic health problems


MARY: The Maryland Health Care Foundation (funded by conversions to for-profit managed care companies) will continue to help the uninsured and medically underserved as mandated. It will receive many times its current budget though if CareFirst BlueCross BlueShield converts to for-profit status - then MHCF could receive hundreds of millions.

NWJY: Fourteen communities receive 3yr Communities in Charge grants to develop programs to help organize, finance and provide health care to the uninsured. Encouraging communities to rethink how funds and services are organized for the Uninsured.


NATL: Spending for prescription drugs grew faster than any other category of health care expenditures in 1999 and is expected to drive increases in US health care costs over the next decade. President Bush proposes giving temporary grants to states that have created prescription drug subsidy programs. Even some Republicans believe it would be better to include drug subsidies with broader reforms of Medicare.

DC: Loss of DC Generals level 1 trauma center will leave the eastern section of DC dangerously short of trauma services and loss of inpatient care beds with the inability of other hospitals to absorb DC General patients will spell trouble.

NATL: In the past decade, more American women received prenatal care and fewer smoked during pregnancy, but a number of other neonatal health indicators slipped, especially in cities. Babies born in the nation's 50 biggest cities where poverty and minorities are concentrated begin life at a disadvantage compared to those born elsewhere.

OHIO: HMO pulling out of Columbus. That says something about the sorry state of health care and the complete lack of solutions on the table. HMOs were "The Idea" less than a decade ago - the salvation of health care, keeping down costs while keeping people healthier. President Bush, beyond pushing for some tax credits and "saving" Medicare somewhere down the road, doesn't want to toy with the managed care structure. But health care is going to hit a wall in the not-too-distant future.

MAINE: Bills take aim at lowering drug prices for the uninsured and finding out what pharmaceutical companies spend on advertising. We're at war involving the people least able to afford drugs.

MARYL: The recent Calif blackouts highlight problems of a public utility squeezed between customers and suppliers. Our nation's hospitals are in a similar situation. A decade of cost cutting by insurance companies, and the federal government effectively has created price controls on what health care providers can charge. In Maryland alone, eight hospitals have closed. Forty percent of Maryland acute-care hospitals had operating losses during the last fiscal year, compared with only 16 percent five years ago.

NATL: Chip Kahn, President of the Health Insurance Association of America (HIAA): President Bush is to be commended for his commitment to assist millions of Americans who lack health insurance coverage. It is critically important that policymakers find the means to help Americans who lack the wherewithal to obtain PRIVATE health insurance (profits to companies from public dollars).

NATL: The President's proposed tax-cut legislation suggests to public health professionals that many of the programs integral to maintaining and improving the health of Americans could suffer. "We'd hoped that the budget surplus would be used for bolstering important health programs, instead of using the surplus for an enormous tax cut," said the executive director of the American Public Health Association.

NATL: Democrats charged that because the tax cut is so large, President Bush can only pay for his priorities by spending the estimated $526 billion Medicare Part A surplus on other programs. For the uninsured, the budget proposes an expansion of Medical Savings Accounts, and new tax credits for those with low incomes. Bush is also proposing to slowly increase funds for new community clinics (see button above Free Clinics No Solution).

CALIF: Fully 34 percent of San Francisco residents had no health insurance in 1999, compared to a 32 percent uninsured rate in Los Angeles -- the city that historically has been the uninsured capital of California. The UCLA study is a snapshot of California insurance coverage during the height of an economic boom. "The bad news is that we are at the end of that boom, and are perhaps facing a contracting economy."

UTAH: Some Utahns will be healthier thanks to the 2001 Legislature. But others among them women, minorities, the poor and the mentally ill will remain underserved in the public health system because legislators failed to either pass or fund some bills. Substance abuse programs, mental health and HIV education all suffer.

MASS: In November 2000, Blue Cross Blue Shield of Massachusetts reported a third-quarter net gain of $38.2 million, up from $16.3 million during the same period last year. It also posted a third-quarter operating gain of $34.4 millions. The company announced it will spend $55 million over 4 years to endow a healthcare foundation dedicated to expanding healthcare access. The endowment's yield will be invested in solutions for improving access to care among the disadvantaged.

Instead of acquiring stable hospitals in the suburbs, CDHC is preparing to take over the DCs indigent health care system. It always looks for troubled institutions in impoverished and minority communities. "We've been investing in poor hospitals in poor neighborhoods, and our profits have been minimal, but in the long term, this can be an ongoing, profitable enterprise" owner Paul Tuft said.

A $416 million proposal from DCHC to privatize health care at D.C. General does not address the nearly 30,000 uninsured residents who receive health care at the city's nonprofit clinics. Last year, uninsured patients made a total of 5,805 visits to Bread for the City's clinic. The free clinic is based on the belief that everyone deserves access to medical treatment. Unfortunately, access to specialty care for patients is almost unavailable and we often have to instruct our patients to go to the nearest emergency room. Still not treated they are often handed ER bills they cannot pay.


DC: The mayor and council agree that health insurance coverage needs to be expanded to more DC residents. The council has voiced concerns over current plans including: The resulting lack of trauma services East DC given that D.C. General is the only Level I trauma center serving that geographic area and the high volume of cases it handles and the resulting lack of inpatient beds.


WASH: Total state spending on medical care for people on public assistance, state and school employees and people on the state's Basic Health Plan is projected to grow by $1.2 billion in the next biennium. With the increase, medical costs will make up nearly a fifth of the total state budget. Seventy state agencies - including several entire departments, a state college and the State Patrol - that could be eliminated entirely and still not cover the increase in medical costs.

MAINE: A federal judge issued a preliminary injunction against the new drug price control law that established the Maine Rx Program The court held that Maine could not regulate the actions of out-of-state drug manufacturers. States have authority to regulate only entities within state boundaries.

HHS Secretary Tommy Thompson announced that nine states have received one-year grants totaling $10.2 million to develop plans for providing their uninsured citizens with affordable health insurance. The nine latest recipients of State Planning Grants join 11 others that last year received grants totaling $13.6 million.

COLO: The state's largest health insurer is threatening to withdraw from the small-group health insurance market, while other providers are taking a similar stance. An estimated 480,000 Coloradans are included in the small-group insurance market.

NEWJ: Thousands of the state's most vulnerable citizens will soon get their healthcare through managed care. The care for 75,000 disabled Medicaid recipients is being transferred from a fee-for-service system to a managed-care plan. Medicaid's new HMO customers are among the costliest and most vulnerable patients in New Jersey, spending seven times more than the average patient each year on healthcare.

NATL: Tommy Thompson, the new secretary of health and human services, said Monday that he will delay and reconsider rules that President Bill Clinton issued in late December to protect the privacy of individuals' medical records.

NATL: For the first time in nearly a decade, the managed-care industry is shifting to offense from defense. The AAHP says growing support from large self-insured employers and small businesses is helping it fend off political attacks and stall momentum for a patients' bill of rights in Washington. The association spent a record $5 million last year on advertising, public relations and so-called grassroots expenditures typically used to educate employers and their workers.

The following stories are located on the MEDSCAPE website. If you are unfamiliar with MEDSCAPE please CLICK HERE to look over a brief explanation of using this free site.

NATL: Pres G.Walker Bush seeks to combine provision of Rx drugs for seniors with plan to overhaul entire Medicare program, instead of passing a prescription drug plan on its own. Proposes handing over administration of Medicare benefits to private insurance companies as a way to control costs. http://managedcare.medscape.com/reuters/prof/2001/03/03.07/20010306pltl001.html

NATL: Leading Senate Democrats blasted Pres G.Walker Bush's proposed budget, saying that it would not deliver a meaningful Medicare prescription drug benefit for America's elderly. Every 'yea' vote for that tax cut means a death knell for the prescription drugs guaranteed to the seniors of this country," said Sen. Edward Kennedy (D-Mass.), the senior Democrat on the Health, Education, Labor, and Pensions Committee. http://managedcare.medscape.com/reuters/prof/2001/03/03.05/20010302legi001.html

NATL: Skepticism is echoed throughout the medical profession, despite the glowing publicity Aetna has garnered for its new "physician friendly" management policies. In December, the insurer announced it was "relaxing" its requirement that doctors wanting to see Aetna patients had to participate in all Aetna plans, a policy known as an all-products clause. "I think they realize that it's to their benefit to have better relationships with physicians, and with patients" said Walter Kahn, president of the Medical Society of New Jersey. http://managedcare.medscape.com/Medscape/MoneyMedicine/journal/2001/v02.n03/mm0305.wieb/mm0305.wieb.html

NATL: While most US employers believe quality of care is very important in selecting and evaluating health plans, only 25-33% regularly receive data on plan quality. Interestingly, insurers tend to overstate importance employers place on cost in plan selection while understating factors such as quality of care. http://managedcare.medscape.com/reuters/prof/2001/03/03.09/20010308econ001.html

MASS: The quality of relationships between primary care physicians and patients is declining in Massachusetts, perhaps because of changes in health care delivery systems. The investigators observed significant declines on three of four relationship scales: communication, interpersonal treatment, and trust. They noted improvement in physician's knowledge of the patients. http://managedcare.medscape.com/reuters/prof/2001/03/03.09/20010308manc004.html

NATL: Uninsured Americans who have certain chronic diseases are less likely to receive appropriate care for those conditions than individuals who have insurance coverage. NOTE THE ORIGINAL REPORT IS LINKED ON HOMEPAGE AS DOCUMENT.

http://managedcare.medscape.com/reuters/prof/2001/03/03.08/20010307publ002.html

NATL: The National Governors' Association has prepared a plan for congress which would allow states "to guarantee eligibility and benefits for additional populations with Medicare. States would be able to expand guarantees to all individuals up to a certain percentage of the poverty level." http://managedcare.medscape.com/reuters/prof/2001/02/02.28/20010227legi004.html

NATL: A patients' bill of rights, anti-trust relief to put physicians on a more equal footing with insurance companies, and ways to provide health insurance to uninsured Americans top the legislative agenda AMA in 2001. The AMA hopes to "level the playing field by empowering physicians to jointly negotiate with health plans." Also of top concern to the nation's doctors is the plight of the uninsured. http://managedcare.medscape.com/reuters/prof/2001/02/02.28/20010227legi001.html

CALIF: California's largest purchaser of healthcare voted unanimously to reject all HMO bids submitted for 2002. The California Public Employees' Retirement System (CalPERS) said the proposed premium increases of up to 41% were unjustified. The move by CalPERS, the second largest US public purchaser of employee health benefits signals trouble ahead as employers across the country attempt to cope with double-digit rates of increase. http://managedcare.medscape.com/reuters/prof/2001/02/02.26/20010223manc001.html

NATL: One of the nation's top attorneys warned managed care plans that if they do not change their practices, they could be bankrupted by the class action suits being filed against them. A spate of class action suits was filed against several managed care plans in late 1999, most claiming that the plans had not met their contractual obligations under ERISA, or that they engaged in fraud by giving out misleading information to plan enrollees. http://managedcare.medscape.com/reuters/prof/2001/02/02.27/20010226manc002.html

NATL: Stating that the quality of American healthcare is substandard, an Institute of Medicine panel called for a complete overhaul of healthcare delivery and reimbursement. The IOM panel described a badly disjointed health system that ignores patient needs and treats patients as less-than-human, is given incentives to manage acute episodes but not chronic disease, loses money when it makes quality improvements, and wastes huge amounts of resources, both human and technical. http://managedcare.medscape.com/reuters/prof/2001/03/03.02/20010301plcy002.html

NEWYK: Restoring eligibility for public health insurance to the tens of thousands of illegal immigrants who reside in New York would cost the state relatively little, according to a new report by the Commonwealth Fund. Over 160,000 adult immigrants in New York are ineligible for Medicaid and Family Health Plus because of restrictions implemented in 1996. "New York's economy would clearly reap benefits by providing healthcare coverage to its immigrant population, in terms of improved health for vital members of the workforce, and more efficient use of the resources of New York's healthcare system". http://managedcare.medscape.com/reuters/prof/2001/02/02.28/20010227econ001.html

Coalition of hospital workers, union leaders, clergymen and anti-globalization activists protesting the plans to end inpatient care at DC General are unlikely to sway authorities. May leave DC's poor without access to health care.

http://managedcare.medscape.com/SCP/DBT/2001/v13.n01/d1301.03.ohli/d1301.03.ohli-01.html

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