News in brief - Aug. 25, 2003

Doctors call for national health plan - Medicare revises payments for new outpatient drugs and technology - Medicare coverage boosts access to preventive services

Doctors call for national health plan

Nearly 8,000 physicians signed a proposal for a national health plan likened to an expanded and improved Medicare. The proposal by the Physicians' Working Group for Single-Payer National Health Insurance was published in the Aug. 13 Journal of the American Medical Association.

"Single-payer national health insurance would save at least $200 billion annually on paperwork and administration, enough to cover all of the uninsured and to upgrade coverage for Medicare enrollees and others who are underinsured," said lead author Steffie Woolhander, MD, an associate professor at Harvard Medical School and founder of Physicians for a National Health Program.

AMA President Donald J. Palmisano, MD, responded: "A solution to the problem of the uninsured is desperately needed -- but a single-payer health care system is not the answer. ... The United States would be trading one problem for a whole set of others."

Medicare revises payments for new outpatient drugs and technology

The Centers for Medicare & Medicaid Services has proposed a new way to pay for new drugs and devices provided in hospital outpatient departments. The proposed rule would include in the procedure payment rate the cost of drugs and biologicals with median prices less than $150 and all implantable devices. Less-expensive drugs would be covered under separate payment categories.

AdvaMed, which represents medical device manufacturers, said the rule improves payment for medical technology in outpatient departments but expressed concern about the level of funding provided.

Medicare coverage boosts access to preventive services

Enrollment in Medicare increases beneficiaries' access to preventive health care services, but especially helps those who previously had no health insurance, according to a study published in the Aug. 13 JAMA.

Researchers from Brigham and Women's Hospital and Harvard Medical School in Boston found that 41% of uninsured adults younger than 65 received cholesterol testing, compared with 76% of their insured counterparts. For individuals eligible for Medicare, testing rates rose for both groups. But the gap between previously uninsured and insured patients dropped to 18 percentage points.

Similar results were found for mammography and prostate cancer screening. "The marked increases in the use of mammography and cholesterol testing show distinct benefits for previously uninsured adults who gain Medicare coverage," said John Ayanian, MD, the lead researcher for the study. "Extending Medicare coverage to these adults before age 65 has the potential to save many lives."