News in brief - Feb. 9, 2004

Physicians continue to fight for change - Public has doubts about drug benefit - Bill would make ED check citizenship - Guarding against abuse - Medicare increases payments for critical access hospitals - NIMH's leader defends funding priorities

Physicians continue to fight for change

The tort reform issue is heating up again in the states and in Washington, D.C. An estimated 3,000 physicians turned out for a rally in Annapolis, Md., on Jan. 21. Maryland doctors are calling for a $350,000 cap on noneconomic damage awards and for a larger portion of jury awards to go to injured patients.

Meanwhile, Wyoming doctors gathered in mid-January as the AMA made a National House Call to the state. In Kentucky, the Senate passed a bill calling for a ballot measure to amend the state constitution to allow a $250,000 cap on noneconomic damages in medical malpractice cases.

At the federal level, President Bush on Jan. 26 visited Arkansas to renew a push for national tort reform.

Public has doubts about drug benefit

A Gallup poll in early January found adults divided on the impact of Medicare's new prescription drug benefit, with 53% saying the benefit did not go far enough.

Some 62% of Medicare-eligible Americans said the changes did not do enough. Adults ages 18 to 29 were more evenly split between feeling the drug benefits are about right (42%) and feeling they are insufficient (38%).

Bill would make ED check citizenship

Emergency department personnel would be required to report undocumented immigrants who come in for treatment, according to a bill introduced by Rep. Dana Rohrabacher (R, Calif.) in January.

The measure would require hospitals that accept federal funds for care of illegal immigrants to ask patients if they are U.S. citizens and to report those who are not to the Dept. of Homeland Security. Rohrabacher opposed last year's Medicare bill because of a $1 billion provision funding care for illegal immigrants but said House leaders told him he could write legislation to mitigate the impact of that provision if he voted for the bill.

"If we know that an illegal alien is in the United States ... taking health care resources away from our people, they should be deported and their own country should be taking care of them," he said.

Guarding against abuse

To help prevent misuse of prescription drugs, the federal government should encourage new drug applications to include a strategy for monitoring the drugs' use and identifying potential abuse and diversion problems, the U.S. General Accounting Office stated in a recent report.

The recommendation comes after the GAO looked at how Purdue Pharma marketed and promoted OxyContin and examined what factors contributed to the abuse and diversion of the pain killer. The report, "Prescription Drugs: OxyContin Abuse and Diversion and Efforts to Address the Problem," can be found online (www.gao.gov/new.items/d04110.pdf).

Medicare increases payments for critical access hospitals

The Centers for Medicare & Medicaid Services announced in January a pay increase of $900 million over the next 10 years for critical access hospitals serving Medicare beneficiaries. Critical access hospitals are limited-service hospitals located in rural areas more than 35 miles from a hospital or other health care facility and certified by the state as a necessary provider of health care services to residents in the area.

The hospitals are reimbursed their costs in providing care, rather than under the prospective payment system used by most hospitals. The increase was signed into the Medicare reform bill last year.

NIMH's leader defends funding priorities

The National Institute of Mental Health spends 60% of its budget on research on serious mental disorders, according to the institute's director, Thomas R. Insel, MD. He made his announcement after a recent report from the Treatment Advocacy Center estimated that less than a third of NIMH's budget went to studying serious mental disorders. The report was authored by the center's president, E. Fuller Torrey, MD, who has long criticized NIMH funding priorities. Dr. Torrey also wrote a letter, which appeared recently in the Wall Street Journal, alleging that the institute spends less than 6% of its budget on research that could lead to effective treatments for schizophrenia, bipolar disorder, severe depression and other serious disorders.

Dr. Insel defended the institute's research on basic science, which he said could help lead to new diagnostic tests and therapies based on genomic and neuroimaging findings.