News in brief - Nov. 27, 2000

Ergonomic standards unveiled

The Clinton administration earlier this month released ergonomic standards aimed at minimizing on-the-job repetitive stress injuries. Under the regulation, employed doctors, like other workers, could ask their employers to adjust their workplaces to meet their ergonomic needs. Physicians who employ workers whose duties involve repetitive motions, such as typing, would have to give employees basic information about common musculoskeletal disorders and make workplace adjustments once an injury occurred.

The rules, drafted by the Occupational Safety and Health Administration, are to go into effect Jan. 16, 2001, but employers would not be required to distribute information on the standards to their workers or respond to injury reports until October.

OSHA says the regulation, which would cover 102 million workers at 6.1 million sites, would prevent 4.6 million injuries in its first 10 years. It would cost employers $4.5 billion a year but save $9.1 billion. The average cost of fixing an individual workstation would be $250 a year, OSHA says.

The regulation, however, may never see the light of day. During its lame duck session next month, Congress might pass legislation to block funding for the standards' enforcement or to allow the next president to roll back the regulation.

The Health Care Financing Administration in November authorized Medicare coverage for ocular photodynamic therapy with verteporfin -- a treatment for age-related macular degeneration.

Jeffrey Kang, MD, director of HCFA's Office of Clinical Standards and Quality, said age-related macular degeneration is one of the leading causes of blindness among the elderly. "Our goal was to provide a nationally consistent, evidence-based coverage decision that would promote beneficiary access to this breakthrough therapy," he said.

Health care costs grew 6.6% last year -- much faster than the 2.4% growth in costs for 1993 to 1997, says a new study by the Center for Studying Health System Change.

The study found that 44% of that increase was due to prescription drug price growth. Physician fees accounted for 32% of the rise, and hospital outpatient spending accounted for 21%. Inpatient hospitalization registered a smaller 3% increase in costs.

Although cost-cutting efforts have focused on inpatient hospital care and specialist use, "these findings suggest an increased role for cost-cutting approaches that keep drug spending in check," said study author and center President Paul B. Ginsburg, PhD.