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Am Fam Physician. 2003;67(4):683-684

House Bill May Reclaim Title VII Family Practice Training Funds

Funds for training in primary care, including family practice, received no money in the proposed 2003 fiscal year federal budget. However, an appropriations bill was introduced in the House on January 8 that includes funding for the Public Health Service Act, Title VII, Section 747 that is similar to 2002 levels. Section 747 includes funding for the Primary Care and Dentistry cluster, which includes family medicine, general internal medicine and general pediatrics, physician assistants, and general and pediatric dentistry. The proposed figures are $294 million for all Title VII funding, including $90 million for the primary care and dentistry cluster. The bill was introduced by Rep. Ralph Regula (R-Ohio), chair of the House Appropriations Subcommittee on Labor, Health and Human Services, and Education. “The (Title VII) programs for family medicine are designed to increase the number of family physicians overall and the number of family physicians who provide health care services and access to medically underserved populations,” said James C. Martin, M.D., president of the American Academy of Family Physicians (AAFP). “These programs also contribute significantly to solving health status disparities by creating diversity in the health care workforce.”

Health Care Spending in the United States Increased by 8.7 Percent in 2001

Health care spending in the United States increased by 8.7 percent to $1.4 trillion in 2001, according to a report by the Centers for Medicare and Medicaid Services (CMS). The report listed the three leading causes of the overall increase in health care spending as: an 8.3 percent increase in hospital spending, a 15.7 percent increase in prescription drug spending, and an 8.6 percent increase in spending for physician services in 2001, compared with 2000. Health care spending averaged $5,035 per person in 2001, up from $4,672 in 2000. Public spending, accounting for 45 percent of national health expenditures, increased 9.4 percent in 2001. Important sources of this public spending growth were Medicare spending, which increased to 7.8 percent from 5.0 percent, and Medicaid spending, which increased 10.8 percent and totaled more than $224.3 billion. The report also showed that the health share of gross domestic product in the United States increased from 13.3 percent in 2000 to 14.1 percent in 2001.

Two Surveys Demonstrate Negative Economic Impact of Medicaid Reductions

An updated survey of all 50 states and the District of Columbia (D.C.) shows that the increasing fiscal crisis at the state level is threatening Medicaid coverage for low-income families. The report, “Medicaid Spending Growth: A 50 State Update for FY 2003,” was performed by the Kaiser Commission on Medicaid and the Uninsured. Halfway through the fiscal year 2003, nearly two thirds of states have had to implement or are planning to implement a second round of Medicaid cuts. For more information on the Kaiser study, go online towww.kff.org/content/2003/20030113, and click on “News Release.” A second survey demonstrated the effect of these Medicaid program cuts in state budgets on the overall economy of those states. The report, issued by the health care consumer watchdog organization Families, USA, showed that states would lose an average of 37 jobs and $3.4 million in business activity for every $1 million in cuts in the Medicaid program. The report also focused on the positive effects of state money invested in the Medicaid program: in 2001, state Medicaid spending generated over 2.9 million jobs, and the 50 states generated $279 billion in new business activity from the $98 billion they spent on Medicaid. For a copy of this report, and to compute how present Medicaid proposals will affect each state's business activities, jobs, and wages, go online towww.familiesusa.org.

AHRQ Releases Fact Book on Women's Health Care in U.S. Hospitals

Pregnancy and childbirth accounted for one of every four hospital stays for women (4.4 million hospital admissions) in 2000, according to a new fact book on women's health care from the Agency for Healthcare Research and Quality (AHRQ). The second leading reason for hospitalization of women 18 to 44 years of age in 2000 was depression (250,000 hospital admissions), followed by fibroids of the uterus (139,000 admissions), gallbladder disease (117,000 admissions), back problems (85,000 admissions), and asthma (70,000 admissions). These statistics were presented in Care of Women in U.S. Hospitals, 2000, a fact book that lists data on why women of different ages are hospitalized, what happens to them during their hospital stay, how much hospitals charge for their stay, and who pays for their stay. The report is based on data from AHRQ's Nationwide Inpatient Sample, a database that is part of the Healthcare Cost and Utilization Project, which provides national estimates based on a sample of approximately 1,000 hospitals and 7 million hospital discharges. To obtain a copy of the fact book, call the AHRQ Publication Clearinghouse at 800–358–9295 or go to the AHRQ Web site atwww.ahrq.gov/data/hcup/factbk3/factbk3.htm.

FDA Establishes Task Force on Consumer Nutrition Health Information

The U.S. Food and Drug Administration (FDA) Commissioner Mark B. McClellan, M.D., recently announced the creation of the Task Force on Consumer Health Information for Better Nutrition that will develop scientific guidance for establishing standards for qualified health claims in foods. This task force is a key element of an FDA initiative to make information about the health benefits of food and dietary supplements available to consumers. The chair of the 13-member task force will be FDA Deputy Commissioner Lester M. Crawford, M.D., and the vice chair will be Joseph A. Levitt, director of the Center for Food Safety and Applied Nutrition.

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