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Am Fam Physician. 2006;74(8):1267-1268

Physician Leaders, Congress Discuss Medicare Physician Payment Cuts

Representatives of the American Academy of Family Physicians (AAFP), the American College of Physicians, and the American Osteopathic Association met with members of the U.S. House and Senate in September to protest a 5.1 percent reduction in Medicare physician payments scheduled to begin in January 2007. Under the current system, Medicare physician payment cuts are likely to continue for the next eight years, with an overall reduction of 40 percent. Presidents and physician leaders from the associations, who arrived in Washington, D.C., as part of an American Medical Association fly-in involving hundreds of physicians, pressed lawmakers to pass legislation on the issue before Congress breaks for the November elections. Senators and representatives agreed that the Medicare physician payment program is flawed, according to AAFP President-Elect Rick Kellerman, M.D., of Wichita, Kan., but action on the issue before November is unlikely without a surge of grassroots support. The AAFP and other groups advocate a payment formula based on the Medicare Economic Index rather than the sustainable growth rate. Although legislators are open to change, their plans for reform vary, and two proposed fixes have been rejected by the AAFP because they do not guarantee a positive update in 2007. For more information, visit

Insurance Data May Build Pressure for Overhaul of Health Care System

A U.S. Census Bureau report found that 46.6 million Americans—almost 16 percent—had no health insurance in 2005, representing an increase of 1.3 million over the previous year. This could put pressure on lawmakers to overhaul the health care system and to provide health care coverage for all persons in the United States, according to health policy analysts. The biggest increase, the report found, was among families with annual incomes of $50,000 to $75,000. The report, “Income, Poverty, and Health Insurance Coverage in the United States: 2005,” also found that although the percentage of those covered by Medicaid remained the same, the percentage of persons with employer-based health insurance has decreased—from 63.6 percent in 2000 to 59.5 percent in 2005. This could be a reason for the overall coverage decline, the report notes. For more information, visit To access the full report, visit

IOM Finds Investment of Resources Inadequate to Address Obesity Crisis

Although the United States recognizes childhood obesity as a public health epidemic, investment of resources to address the crisis remains inadequate, according to a report released by the Institute of Medicine (IOM). The report, “Progress in Preventing Childhood Obesity: How Do We Measure Up?,” contains an analysis of U.S. obesity prevention initiatives during the past two years and calls on key sectors to lead and commit to prevention policies and programs. Current interventions promoting physical activity and healthful eating are fragmented and small in scale, according to the authors of the report, and progress is hampered by a lack of systematic monitoring and evaluation. Commitment to evaluation is essential to build an evidence base for identifying and institutionalizing effective practices, the report states. The report recommends that the federal government provide long-term investment in childhood obesity prevention initiatives; that state and local governments develop policies supporting a healthy school environment; that schools boost physical activity requirements; and that families ensure that healthful foods are served in reasonable portion sizes and that video screen time is limited. For more information and the report summary, go to

Researchers Assess Ways to Involve Communities in Diabetes Prevention

Researchers at three prevention research centers (PRCs) funded by the Centers for Disease Control and Prevention are examining ways in which families and social groups in Hispanic communities can help manage or prevent diabetes. A disproportionate number of Hispanics in the United States are affected by obesity and diabetes, but researchers have found that working with multiple generations simultaneously makes efforts to promote healthier habits more successful. In the program at the University of Arizona Southwest Center for Community Health Promotion, Tucson, persons with diabetes are taught how to manage the disease, relatives are taught how to lower their own risks, and family members encourage each other to eat healthfully and stay active. Researchers at the San Diego (Calif.) PRC are studying how walking clubs and soccer leagues may increase physical activity, and those at the University of Illinois at Chicago PRC are training residents to teach diabetes prevention at churches, schools, and work sites. For more information, visit

Drug Company Offers Free Vaccines for Low-Income, Uninsured Adults

Pharmaceutical company Merck has created a Vaccine Patient Assistance Program to provide free vaccines to eligible adults. The program is available through licensed prescribers and requires submission and approval of an application before vaccine administration, although the aim is to make processing time quick enough for patients to receive the vaccine during their visit. Eligible patients must be older than 19 years and reside in the United States (but do not need to be a U.S. citizen); have no health insurance coverage; and have an annual household income of less than $19,600 for individuals, $26,400 for couples, or $40,000 for a family of four. Exceptions may be made in cases of financial and medical hardship. The vaccines available through the program are Gardasil (human papillomavirus vaccine, types 6, 11, 16, 18 recombinant vaccine); MMR II (measles, mumps, and rubella virus vaccine live); Pneumovax 23 (pneumococcal vaccine polyvalent); Recombivax HB (hepatitis B vaccine, recombinant); Vaqta (hepatitis A vaccine, inactivated); Varivax (varicella virus vaccine live); and Zostavax (zoster vaccine live). More information is available on the Merck Web site at, or by calling 800–293–3881.

HHS Awards States Grants to Promote Community-Based Services

The Department of Health and Human Services (HHS) awarded grants to eight states supporting programs that help persons with chronic illnesses or disabilities to live in their homes rather than institutions. The grants are intended to facilitate the movement of Medicaid away from what has been described by Mark B. McClellan, M.D., Ph.D., administrator of the Centers for Medicare and Medicaid Services, as an “institutional bias.” States who receive the awards must address at least three of six goals designed to transform Medicaid program incentives, including improvement of access to information about community-based services; promulgation of self-directed service delivery systems; and flexible financing arrangements to promote community living options. Recipients of the 2006 awards, which totaled nearly $20 million, were California, Kansas, Michigan, New Jersey, New York, North Carolina, Rhode Island, and Virginia. For more information, visit

Experts Meet to Determine Physical Activity Guidelines for Americans

Expert research scientists and physical activity practitioners from various sectors will attend an IOM workshop on October 23 and 24 to determine whether there is enough evidence to develop a set of physical activity guidelines for Americans. The workshop will explore issues such as fitness, weight control, disease injury and prevention, and psychosocial health. A summary of the workshop discussions will be prepared after the event. For more information, visit the IOM Web site at

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