Citizens' Council on Health Care
CCHC HEALTH eNEWS
Tuesday, August 14, 2001


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Providing news and commentary on health care policy,
health insurance issues, and medical confidentiality.
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* NO INSURANCE FOR THE HEALTHY - includes CCHC commentary

* CDC DOESN'T TELL TRUTH ABOUT CONDOMS

* DOCTORS' ASSN. PROFITS FROM GOVERNMENT CODING AGREEMENT

* NATIONAL ID ADVOCATES TURN TO CELL PHONES - IN FINLAND

* FEWER UNINSURED THAN PREVIOUSLY ESTIMATED

* FULL BODY SCREENING - RETAIL RADIOLOGY

* RATIONING MEDICATION IN OREGON

* OREGON'S "LESS NEEDY" GET ELIBILITY FOR STATE HEALTH PLAN

* PARENTS DON'T WANT/NEED THE CHILDREN'S INSURANCE PLAN

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NO INSURANCE FOR THE HEALTHY

Getting health insurance as an individual is more than having the
money to buy it. Health insurance companies are rejecting applicants
for as little as year-round allergies, hay fever, asthma, according
to a USA Today article.

Although 16 million Americans buy individual insurance, many of those
who want it find themselves either rejected, priced out of the market
or encouraged to join a state high-risk insurance plan which is also
more expensive than traditional insurance.

Inability to get coverage has limited career options. Some individuals
who want to work for themselves give up the dream and take a job that
offers coverage. The Kaiser Family Foundation studied the problem,
releasing a study in June 2001. The Foundation asked 19 insurance
companies to write policies with $500 deductibles and $20 copays for
seven individuals who were fictional. The companies understood that
the "patients" were not real, but were asked to underwrite them as if
they were.

The study found that all seven got turned down for insurance at least
once. Pre-existing conditions included hay fever (rejected 8% of the
time), injured knee in college, family with an asthmatic son, breast
cancer survivor, situational depression after death of spouse (23%
rejection), overweight smoker with high blood pressure (55% rejection),
and HIV-positive (100% rejection).

Although the Heritage Foundation suggests tax credits for insurance
to "spur some large employers to open their group policies to non-
employees, allowing them to buy in at group rates," the Kaiser
Foundation called for expanding government programs.

CCHC COMMENTARY: The study did not study insurance. It studied low-
deductible prepaid health care. Had the deductible been at the $3000 -
5000 range of true insurance, more of the "patients" would likely have
been accepted. In addition, it appears that the high-deductible MSA
insurance policy was not explored.

Source: "Healthy individuals often turned down for coverage,"
Julie Appleby, USA TODAY, 07/31/2001.

-Citizens' Council on Health Care
-August 14, 2001


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CDC DOESN'T TELL TRUTH ABOUT CONDOMS

The 10,000-member Physicians Consortium claimed at a Washington,
DC press conference that the US. Centers for Disease Control and
Prevention has known for at least a year that condoms offer little
protection against sexually-transmitted diseases other than HIV. The
announcement comes with the release of a panel report by the National
Institutes of Health which found "a lack of evidence" that condoms
protection against STDs such as syphillis, chlamydia, gonorrhea and
genital herpes. The human papillomavirus (HPV), which affects an
estimated 20 million Americans, is primarily transmitted by sexual
contact and can lead to cervical cancer in women.

"This is not about whether or not people should use condoms, it's about
whether people ought to be told the whole truth about the efficacy of
condoms," said physician Tom Coburn, a former congressman. The consortium
sent a letter to President Bush, July 23, asking for the resignation of
Dr. Jeffrey Koplan, the Director of the CDC.

According to the NIH report there are approximately 15 million new
STD infections every year. Thus far 493,000 Americans have died from
AIDS and between 800,000 and 900,000 are living with HIV.

The Consortium called on the Federal Drug Administration to raise
public awareness about the ineffectiveness of condoms and to mandate
that all government contractors, including Planned Parenthood, update
their information with accurate statistics.

While the CDC had no comment other than to welcome more studies, Planned
Parenthood vowed to resist efforts to advance abstinence-only education
which it says "has not been shown to be effective [and] serves neither
public health nor the public interest."

Source: "CDC Knew About Condoms' Limitations,Doctors Say," July 24, 2001,
Kelley Beaucar, Fox News
http://www.foxnews.com/story/0,2933,30376,00.html

-Citizens' Council on Health Care
-August 14, 2001


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DOCTORS' ASSN. PROFITS FROM GOVERNMENT CODING AGREEMENT

U.S. Senate Minority Leader Trent Lott (R-Miss) has called for an
end to the American Medical Association (AMA) copyright of medical
codes. Federal and state governments require that doctors and health
care professionals use the codes to bill for services to Medicare
and Medicaid recipients.

In a letter to Tommy Thompson, Secretary of the U.S. Department of
Health and Human Services, Lott notes that the AMA makes about $133
million in non-dues revenue--revenue from other sources than money
collected from doctors and medical students that join the AMA.
Revenue from selling the CPT (Current Procedural Terminology) code
books is included in that figure.

One physician's association, the Association of American Physicians
and Surgeons (AAPS) has suggested collusion between the government
and the AMA. An AAPS search through court documents discovered a
secret agreement between the AMA and the U.S. Health Care Financing
Administration (Medicare and Medicaid), a contract the president of
the AMA acknowledged in a public meeting in 1997. In addition, a
federal court ruled that the AMA abused their copyright privileges.

Current AAPS president Robert Cihak, writing in WorldNetDaily, notes
that AMA executives have six-figure salaries and the AMA has only
292,000 members of 750,000 physicians. He concludes his article by
saying "while the AMA, in its own words, 'is a successful business
entity,' medical practice must remain an ethical profession focused
on providing quality care and value to patients - not extracting
multi-million dollar publishing revenues and fees from doctors to pay
big salaries to AMA honchos."

Source: "Cut the AMA's feeding tube,", Drs. Michael Arnold Glueck,
MD, and Robert J. Cihak MD, World Net Daily, August 14, 2001, http://www.worldnetdaily.com/news/article.asp?24050

-Citizens' Council on Health Care
-August 14, 2001


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NATIONAL ID ADVOCATES TURN TO CELL PHONES

The Finnish government is considering using SIMs -- the subscriber
information modules inside every cell phone -- to take the place of
its national identity card, and eventually even a passport. Under
the plan, the computer chip embedded in every SIM would store
personal information,transforming the SIM into a person's legal
proof of identity.

Of course the drawback would be what would happen if you lost
your phone -- about 9,000 cell phones are left on the London
Underground alone every year. The solution, according to Roger
Needham, manager of Microsoft's British research lab, is to store
the information on secure servers accessible via a WAP connection
to the Web. The SIM in this case would store only a personal
identifier -- an encryption key -- that the owner would have to
punch in a PIN to use.

The system would use the evolving public key encryption system.
"The identifier, kept safe inside the phone, acts as a key, known
to no one else. To read a message locked with this private key
requires a second, public key, which can be freely distributed,"
according to the New Scientist. More countries, including the U.S.,
are passing laws to give private keys the same legal force as a
written signature.

The Finnish government is already taking the initiative with a
national technical standard called FINEID. Currently FINEID uses a
smart card and a card reader attached to a PC, but the plan
is to migrate to an SIM, says Vesa Vatka of the Finnish Population
Register Center in Helsinki. (New Scientist)

Source: taken directly from listserv email to CCHC: "FINLAND MULLS
PUTTING NATIONAL IDs ON CELL PHONES," unknown writer, some additional
information from the original article added by CCHC.
Original article: "Your phone is you," New Scientist.com, no date, http://www.newscientist.com/hottopics/tech/yourphoneisyou.jsp

-Citizens' Council on Health Care
-August 14, 2001


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FEWER UNINSURED THAN PREVIOUSLY ESTIMATED

The Census Bureau has recalculated its estimate of the uninsured
and discovered the problem is less severe than previously
thought. Since the early 1980s, the Bureau has used questions in
its annual March Current Population Survey (CPS) to come up with
estimates of the uninsured. Its estimates have been higher than
others, such as those produced by the Urban Institute in recent
years.

o However, using follow-up verification questions beginning
with the March 2000 CPS, the Bureau has discovered that
"about 8 percent of those previously classified as not
having health insurance reported that they were in fact
insured."

o This lowers the Bureau's count of uninsured in 1999 from
42.6 million to 39.3 million -- a difference of 3.3
million people.

o According to researchers, "private coverage appears to be
the type of coverage most affected by reporting
differences between the CPS and other surveys."

Additionally, in analyzing the household characteristics of those
who initially reported they (or someone in their household) was
uninsured -- but answered a verification question affirmatively -
-researchers found that they more closely resembled those who
have insurance, rather than those who are uninsured. For
example, the verification question lowered the estimate of
uninsured among people living in households with annual incomes
of $75,000 or more by 16 percent. But the additional questions
uncovered that only 4 percent of those in households with incomes
under $25,000 who had been classified as uninsured had in fact
been insured at some point in 1999.

Numbers for 2000 will be released in September.

Source: Charles T. Nelson and Robert J. Mills, "The March CPS
Health Insurance Verification Question And Its Effect On
Estimates Of The Uninsured," August 2001, Housing and Household
Economic Statistics Division, U.S. Bureau of the Census.

For text http://www.census.gov/hhes/hlthins/verif.html

Source: Taken directly from the Daily Policy Digest, National Center
for Policy Analysis, http://www.ncpa.org, 8/10/01



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FULL BODY SCREENING - RETAIL RADIOLOGY

According to AmeriScan, a retail medical imaging center at the
Scottsdale Fashion Square shopping mall: "The full body health
scan is the best way to show you care for those you love."

However, established medical organizations do not recommend such
scanning. The American College of Radiology issued a statement in
November 2000 stating that it "does not believe there is sufficient
scientific evidence to justify recommending total body CT screening
for patients with no symptoms or family history suggesting disease."..."
For more information: http://www.healthscreenamerica.com/

Source: "Centers Offer Medical Imaging to Target Consumers Directly,"
Rhonda L. Rundle, The Wall Street Journal, July 24, 2001.

-Citizens' Council on Health Care
-August 14, 2001



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RATIONING MEDICATION IN OREGON

Gov. John Kitzhaber (D) on Aug. 2 signed into law a measure
that could reduce prescription drug costs in the Oregon Health Plan,
predicting that pharmaceutical companies -- "once unified in
opposing" the law -- will "soon compete among themselves to be
included" on a new state drug formulary, the Portland Oregonian reports
(Lednicer, Portland Oregonian, 8/3).

The new law will establish a panel of medical experts to study medical
literature about classes of drugs to determine which treatment "is
the most effective in its class" and to release the findings to the
public. Under the law, the state will "discourage" physicians in the
Oregon Health Plan, which covers 260,000 Medicaid beneficiaries and
90,000 other low-income residents, from prescribing a drug that "is
more expensive but not more effective" than the treatment recommended
by the panel.

Kitzhaber said that the law will help control costs in the Oregon
Health Plan, which will likely spend $885.3 million on prescription
drugs in the next two years -- a 61% increase from the previous budget
(Kaiser Daily Health Policy Report, 8/1). John Santa, administrator
for the state Office for Oregon Health Plan Policy and Research, said
that the state will place between 15 and 20 preferred drugs on the
formulary, including treatments for heartburn and high cholesterol.
However, the formulary will not include cancer, mental illness and
AIDS drugs. According to Kitzhaber, the law will likely save the state
about $7 million over the next two years.

Source: Taken directly from "Oregon Governor Signs Law to Establish
Rx Drug Formulary for State Health Plan," KAISER DAILY HEALTH POLICY
REPORT, August 6, 2001,
http://www.kaisernetwork.org/daily_reports/rep_hpolicy.cfm


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OREGON'S "LESS NEEDY" GET STATE PLAN ELIGIBILITY

Meanwhile, Kitzhaber also signed a bill last week that would
extend Oregon Health Plan coverage to 50,000 uninsured residents and
limit benefits for the "less needy," such as single residents and
couples without children. State health plan administrators are now
awaiting federal approval of the new limits (Portland Oregonian,
8/3). For further information on state health policy in Oregon,
visit State Health Facts Online.

Source: Taken directly from "Limits for 'Less Needy', KAISER DAILY
HEALTH POLICY REPORT, August 6, 2001, http://www.kaisernetwork.org/daily_reports/rep_hpolicy.cfm


_________________________________________
SURVEY: PARENTS DON'T WANT OR NEED S-CHIP

The Urban Institute has two new reports on problems in the State
Children's Health Insurance Program (S-CHIP). According to
researchers, "public health insurance programs have the potential
to reach 80 percent of uninsured children, yet many eligible
children still lack coverage."

This has been an issue ever since the program began. Policy-
makers assumed that people would rush to enroll their kids. When
that didn't happen they assumed it was because people hadn't
heard of the program and they invested many millions of dollars
into "outreach" programs, including printing information on pizza
boxes. But still, few parents have enrolled their kids.

To find out why, the Urban Institute surveyed 2,485 low-income
families and found that 88 percent had heard of S-CHIP and
Medicaid, but 76 percent of those never inquired about the
program.

o Of those who had heard of the program but had not
inquired about it, a plurality (40 percent) said they
"did not need or want the program."

o Some 30 percent said they didn't think their child was
eligible and 14 percent thought there was too much
administrative hassle involved.

o Of those who said they didn't want the program, 96.8
percent said they were in excellent or good health.

And there is the rub, says health policy expert Greg Scandlen,
editor of NCPA's Health Policy Week. In a "guaranteed issue"
environment where you cannot be turned down for coverage and you
know you can quickly get coverage when a need arises, why bother
enrolling ahead of time? It may frustrate policy makers who want
to be able to count enrolled noses, but it makes perfect sense to
real people living real lives.

Source: Genevieve Kenney and Jennifer Haley, "Why Aren't More
Uninsured Children Enrolled in Medicaid or SCHIP?" Series B, No.
B-35, May 2001, and Genevieve Kenney, Jennifer Haley and Lisa
Dubay, "How Familiar Are Low-Income Parents with Medicaid and
SCHIP?" Series B, No. B-34, May 20, 2001, both New Federalism
National Survey of America's Families, Urban Institute, 2100 M
Street, N.W., Washington, D.C. 20037, (202) 833-7200.

For text
http://newfederalism.urban.org/html/series_b/b34/b34.html

For text
http://newfederalism.urban.org/html/series_b/b35/b35.html

Source: Taken directly from the Daily Policy Digest, National Center
for Policy Analysis, http://www.ncpa.org, 8/10/01



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