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Am Fam Physician. 2006;74(9):1467-1468

Family Physicians, AAFP Rally on Capitol Hill for Health Care Reform

In September, family physicians joined leaders of the American Academy of Family Physicians (AAFP) in a Capitol Hill rally, calling on Congress to take action on health care reform. Rick Kellerman, M.D. (Wichita, Kan.), the incoming AAFP president, pressed lawmakers to replace Medicare’s sustainable growth rate formula with a predictable and positive system for updating physician pay. Outgoing AAFP president Larry Fields, M.D. (Ashland, Ky.), spoke on liability insurance reform, and Mary Frank, M.D. (Mill Valley, Calif.), the outgoing AAFP board chair, talked of the growing need for family physicians. Speakers raised other issues for Congress to address, including the rising number of uninsured Americans, increasing health insurance premiums, and a lack of support for medical research. Senator Jon Kyl (R-Ariz.) told attendees that their input would be crucial in passing a measure before the current session of Congress closes. However, discussion on many of the reforms will be delayed until after the November elections. For more information, visithttps://www.aafp.org/news-now/government-medicine/20060920paymentreform.html.

Analysis Finds U.S. Health Care System Below International Benchmarks

An analysis of the U.S. health care system concluded that the U.S. performance must improve by at least 50 percent to reach national and international benchmark targets. Although U.S. health care spending is twice the median for industrialized countries, the United States ranks low among these countries on indicators such as mortality rates and healthy life expectancy, according to the report. In addition, there are wide disparities in care outcomes across states and population groups. The authors of the report (“U.S. Health System Performance: A National Scorecard,” published in the September 20, 2006, issue of Health Affairs) rated U.S. performance on health outcomes, quality, access, efficiency, and equity compared with the top performances in other industrialized nations or within the United States. By this analysis, the United States ranked 15 out of 19 countries on the indicator of deaths from preventable conditions before age 75, and was last among 23 countries on infant mortality. Furthermore, U.S. patients are less likely to have rapid access to physicians; U.S. insurance administrative costs are more than three times those of the benchmark countries (and at least 20 percent higher than in countries with similarly complex systems); and in 2004, 40 percent of U.S. adults—four times more than the benchmark—reported going without care because of the cost. For more information, go tohttps://www.aafp.org/news-now/health-of-the-public/20060925scorecard.printerview.html.

Experts Concerned About Pace of Pandemic Influenza Preparedness

The Trust for America’s Health and the Infectious Diseases Society of America raised concerns that efforts to prepare for pandemic influenza are not keeping pace with scientific and technological advances. The two groups called for an expansion and acceleration of research efforts in the United States, particularly in influenza vaccination production and delivery, and issued a set of recommended actions to better prepare the United States for a pandemic flu outbreak. Among the recommendations were: development of a pandemic vaccine research and development master plan bringing together government and private industry scientists; adoption of policies to increase seasonal influenza vaccination rates; streamlining of the licensure process for pandemic influenza vaccine; and expansion and strengthening of international relations. For more information, visithttp://healthyamericans.org/reports/fluscience.

Surveyed Physicians Cite Benefits and Burdens of Medicare Part D

Physicians have mixed views about the new Medicare Part D prescription drug benefit, according to a Kaiser Family Foundation survey report. Although about 70 percent of physicians agreed that the benefit helps Medicare beneficiaries save money on their prescriptions, 92 percent found it too complicated, with 55 percent agreeing that beneficiaries have too many plans to choose from. Most physicians (83 percent) thought their patients did not have a good understanding of the benefit. One half of physicians had been asked by patients for help or advice, but only one third believed they understood the benefit well themselves. About 60 percent of physicians with patients on Medicare plans knew their patients had experienced problems filling prescriptions, some with serious consequences. Despite the perceived financial benefits for patients, 56 percent of physicians had an overall unfavorable impression of the benefit. Almost two thirds agreed that it was too beneficial for private plans and drug companies, and many found the administrative burden to be worse than that under commercial plans. The survey was conducted between April and July 2006 and included a nationally representative sample of 834 physicians. Most responders said morale among physicians has gone down in the past five years, and almost 40 percent would not recommend the profession, with government and insurance interference or regulations being the most commonly cited reason. For the full survey results, visithttp://www.kff.org/kaiserpolls/pomr090706pkg.cfm.

Committee Advocates Pay-for-Performance Medicare Reimbursement

According to an Institute of Medicine committee, Medicare’s fee-for-service payment system does not promote improvements in health care quality for its beneficiaries and should be replaced by a pay-for-performance scheme. Although acknowledging that data on the effects of pay-for-performance systems are limited, the committee said that gradual implementation of the system would allow for concurrent monitoring and assessment. The committee recommended that Congress reduce base Medicare payments across the board for an initial period of three to five years, using the money to fund rewards for strong performance. Organizations with the capacity to participate should do so as soon as the system is launched, whereas small-practice participation in the first three years should be voluntary, the committee said. To view the report brief, go tohttp://www.iom.edu/CMS/3809/19805/37232/37236.aspx.

CMS Names Deputy Administrator Leslie Norwalk Acting Administrator

Former deputy administrator of the Centers for Medicare and Medicaid Services (CMS) Leslie Norwalk, J.D., became acting administrator of the agency on October 15, succeeding Mark McClellan, M.D., Ph.D., who had announced his resignation in September. In her new role, Norwalk will oversee Medicaid and Medicare, including the Medicare Part D prescription drug program. She has previously served as chief operating officer of CMS and acting director of the CMS Center for Beneficiary Choices, before which she was an attorney in Washington, D.C. Herbert Kuhn, head of the CMS Center for Medicare Management, will replace Norwalk as deputy administrator. Kuhn has been with CMS since 2004. For more information, visithttps://www.aafp.org/news-now/government-medicine/20061006norwalkcms.html.

NCCAM Announces Complementary Medicine Research Training Award

The National Center for Complementary and Alternative Medicine (NCCAM) announced the introduction of a career development award created in partnership with the Bernard Osher Foundation. The award is designed to reduce barriers that prevent health care professionals in complementary and alternative medicine from pursuing a career in research and will grant recipients up to five years of supervised research training. Applicants must hold a health professional doctoral degree from a complementary and alternative medicine institution. Those interested in the award can visithttp:www.nccam.nih.gov/training.

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