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Am Fam Physician. 2005;72(3):367-368

Senate Subcommittee Votes to Increase Funds for Medical Schools

The Senate Appropriations Subcommittee on Labor, Health and Human Services, Education, and Related Agencies has voted to provide $90 million to support primary care training. The members voted to set aside $90 million for Section 747 of Title VII in the Public Health Service Act, a $1.2 million increase over the fiscal year 2005 level. Section 747 includes funds for family medicine academic departments for predoctoral education, departmental support, and faculty development. If passed by the full committee and the Senate, then approved in a House-Senate conference committee, the appropriation would mark the second consecutive year that Section 747 funding was increased. Section 747 of Title VII is designed to increase the number of primary care physicians, particularly those who practice in rural and underserved communities. In June, the House voted to provide no funding for the program. In previous years, Congress had regularly restored funding to the program after presidential budget cuts.

Bill Would Help Physicians Buy or Upgrade EHR Technology

Physicians could qualify for grants to buy or upgrade electronic health record (EHR) systems under a new legislative proposal by Sens. Michael Enzi, R-Wyo., and Edward Kennedy, D-Mass. The Better Healthcare Through Information Technology Act (Senate bill number S.1355) would provide three new funding mechanisms to help physicians buy health information technology; develop care-quality measures and systems for reporting on those measures to the Center for Medicare and Medicaid Services; create a public-private partnership to establish national technical and interoperability standards for EHR systems; and create services to increase the health care community’s understanding and efficient use of EHR systems. The Better Healthcare Through Information Technology Act is the second bill that calls for financial help for physicians. An earlier proposal, the Health Information Technology Act, introduced by Sens. Olympia Snowe, R-Maine, and Debbie Stabenow, D-Mich., would provide up to $15,000 to each physician who buys or upgrades an EHR system. Additional information is available online at

Smoking Costs U.S. $92 Billion Per Year in Lost Productivity

Smoking cost the United States about $92 billion annually in lost productivity from 1997 to 2001, an increase of about $10 billion from 1995 to 1999, from annual mortality-related productivity losses, according to new data from the Centers for Disease Control and Prevention (CDC). When combined with smoking-related health care costs, smoking costs the nation more than $167 billion per year. The report also found that an estimated 438,000 premature deaths occurred each year from 1997 to 2001 as a result of smoking and exposure to secondhand smoke.

Senate Leader Seeks Restrictions on Drug Advertisements

Senate Majority Leader Bill Frist, M.D., R-Tenn., recently called for pharmaceutical companies to voluntarily forgo direct-to-consumer (DTC) advertising of new drugs for two years after the drugs were first marketed in the United States. Frist, a cardiologist, also is seeking a Government Accountability Office (GAO) review of the U.S. Food and Drug Administration’s oversight of prescription drug activities. In a July 1, 2005, letter to U.S. Comptroller General David Walker, Frist noted that a 2002 GAO report found that pharmaceutical manufacturers had increased spending on DTC advertising more rapidly than spending on research and new drug development. Between 1997 and 2001, spending on DTC ads increased 145 percent, compared with a 59 percent increase in research and development spending during that period. According to Frist, the 2002 report concluded that “DTC advertising appears to increase prescription drug spending and utilization. Drugs that are promoted directly to consumers often are among the best-selling drugs, and sales for DTC-advertised drugs have increased faster than sales for drugs that are not heavily advertised to consumers.”

Health Insurance Coverage for Children Increased in 2004

Health insurance coverage for children continued to improve in 2004, according to a new report from the Centers for Disease Control and Prevention (CDC). The CDC also found that the percentage of working-age adults without insurance coverage, which had been increasing in recent years, did not increase last year. The data are based on the CDC’s National Health Interview Survey, which tracks insurance coverage since 1997. The report found that the improvement in coverage for children reflects an increase in public coverage for poor children, including the State Children’s Health Insurance Program. In 2004, more than 90 percent of U.S. children had health insurance at the time of the interview, a steady increase from the first report in 1997. In 2004, 9.4 percent of children younger than 18 years did not have health insurance, compared with 14 percent in 1997. Additional information is available online at

AHRQ Finds Weight-Loss Surgeries Quadrupled Over Five-Year Period

The number of Americans having weight-loss surgery more than quadrupled between 1998 and 2002, according to a new study by the Agency for Healthcare Research and Quality (AHRQ). Part of the increase was driven by a 900 percent increase in bariatric surgeries in patients between the ages of 55 and 64 years. During the same period, hospital costs for treating patients who underwent weight-loss surgery increased more than sixfold—from $157 million a year to $948 million a year—and the average cost per surgery increased by roughly 13 percent, from $11,705 to $13,215. To be considered medically eligible for weight-loss surgery, a patient must have a body mass index of greater than 40 (or greater than 35 with serious obesity-related complications such as type 2 diabetes or obstructive sleep apnea). Nearly 400,000 Americans between 65 and 69 years of age will be medically eligible to have bariatric surgery this year, and this number could increase by approximately 20 percent in 2010. Such an increase could have significant cost implications for the Medicare program. The study was published in the July 12 issue of Health Affairs.

SAMHSA Awards $15.5 Million for Substance Abuse Interventions

The Substance Abuse and Mental Health Services Administration (SAMHSA) has awarded 12 grants totaling $15.5 million over three years to promote screening, brief interventions, and treatment referral for college students with a high risk of substance use disorders. The Targeted Capacity Expansion Campus Screening and Brief Intervention grants are designed to expand existing campus-based medical services by integrating screening for substance abuse and brief interventions into student health programs. The grant-recipient colleges and universities are expected to screen and refer students in need to appropriate treatment, using university or community-based providers. The grant recipients include the University of Arizona, Tucson; Bristol Community College, Fall River, Mass.; The University of California, Los Angeles; the University of Delaware, Newark; the University of Hartford, West Hartford, Conn.; the University of Hawaii at Manoa; the University of Massachusetts, Amherst; New Mexico Highlands University, Las Vegas; Northeastern University, Boston; State University of New York at Albany; the University of Tennessee, Knoxville; and the University of Texas at El Paso.

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