Citizens' Council on Health Care
CCHC HEALTH eNEWS
Monday, October 1, 2001


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Providing news and commentary on health care policy,
health insurance issues, and medical confidentiality.
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* SELLING DNA DATA PROPOSED IN ENGLAND

* HEALTH CARE LOBBY IS BIG SPENDER

* MELDING OF PUBLIC AND PRIVATE HEALTH SYSTEMS BEGUN

* GAO CALLS FOR MORE CENTRALIZATION IN MEDICARE

* RESIGNATION OF CDC CHIEF CALLED FOR: CONDOMS AT ISSUE

* HAWAII'S MEDICAID DENTAL PROGRAM DROPS MANAGED CARE

* NUMBER OF UNINSURED DECLINED LAST YEAR

* ORAL HEALTH "DISPARITIES" TARGETED


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SELLING DNA DATA PROPOSED IN ENGLAND

Leaked government documents find the British government considering
the sale of DNA data to pharmaceutical companies. British Health
Secretary Alan Milburn formed a panel to discuss the issue which has
been warned by biotech companies that unless the industry is allowed
to use the national health care system's data, Britain will become
'a third world genetics country'. A number of ideas are under
consideration:

* Collection of DNA samples of patients during routine hospital
treatment would be stored on a massive national database and
auctioned to pharmaceutical companies to assist with the lucrative
development of new drugs.

* Genetically screening the whole British population at birth and
then again at age 18.

* Following Iceland's example and selling the entire country's DNA
database to a private company.

* Developing a genetic smart card for every citizen - like a credit
card, but with individual genetic details encoded.

Citizens, bio-ethicists, and privacy experts are concerned. The highly
intimate information could be stolen, or used against individuals.
The information could be leaked to the police, insurance companies,
or employers. Dr. David King, coordinator of Human Genetics Alert,
criticized the proposals saying they would lead to "privatising the
nation's DNA."

Source: "Fury at plan to sell off DNA Secrets, Antony Barnett and
Gaby Hinsliff, The Guardian (UK), September 23, 2001.
http://observer.co.uk/uk_news/story/0,6903,556511,00.html

-Citizens' Council on Health Care
-October 1, 2001


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HEALTH CARE LOBBY IS BIG SPENDER

Since 1999, the health care industry has spent more than any
other sector on federal lobbying efforts, a study from the
independent research group Political Money Line found.

CongressDaily/AM reports that in the last six months of 2000, the
industry spent $123.3 million on federal lobbying (CongressDaily/AM,
9/26). This figure is up $16.5 million from the $106.8 million the
industry spent in the previous six month period (Political Money Line
release, 9/25). Within the health care sector, the pharmaceutical
industry spent the most, "laying out" $44.6 million between June and
December 2000 (CongressDaily/AM, 9/26). During that time period,
Schering-Plough Corp. spent $3.7 million, while the Pharmaceutical
Research & Manufacturers Association spent $3.5 million. Abbott
Laboratories finished third among pharmaceutical organizations at $3
million (Political Money Line release, 9/25).

By comparison, the communications and technology sector finished
second in lobbying expenses at $113 million. Overall, federal
lobbying in the second half of 2000 totaled $831 million, an increase
of 9% from the first half of the year (CongressDaily/AM, 9/26).

Source: Taken directly from "Health Care Sector Tops Lobbying
Spending in 2000," KAISER DAILY HEALTH POLICY REPORT, 9/26/01.


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MELDING PUBLIC AND PRIVATE HEALTH SYSTEMS

To process Medicare, 53 private insurance companies use their own
systems to pay the nearly 3 million Medicare claims paid per
day across the country--over 1 billion per year.

According to a press release, the U.S. Department of Health and
Human Services has just launched a project to combine all payment
and accounting systems into a "single, unified system that will
better ensure that the program pays correctly for the care Medicare
beneficiaries need."

The new Healthcare Integrated General Ledger Accounting System
(HIGLAS), a web-based seamless accounting system, will replace the
53 systems. At a cost of $328.4 million over the entire period of
the contract, the Centers for Medicare and Medicaid Services (CMS)
will contract with PricewaterhouseCoopers. Oracle Corporation will
provide the financial accounting software and EDS will provide
Application Service Provider services.

The project will begin with Palmetto Government Benefit Administrators
and Empire Blue Cross & Blue Shield, re-engineering the accounting
process of these contractors to support HIGLAS. Once tested and
approved, the public accounting system will be installed in the private
systems of all 53 Medicare contractors. Full implementation is projected
by the end of fiscal year 2006.

Source: "HHA launches project to integrate Medicare Accounting
Systems," Centers for Medicare and Medicaid Services Press Release,
September 27, 2001.

-Citizens' Council on Health Care
-October 1, 2001


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GAO CALLS FOR MORE CENTRALIZATION IN MEDICARE

The U.S. General Accounting Office found a high rate of errors
in the information doctors and hospitals receive from Medicare
carriers. The GAO found incomplete, inaccurate, unclear, and
untimely guidance on Medicare billing and payment policies.

"We found shortcomings in print,electronic, and telephone
communications that Medicare contractors use to provide information
to physicians and respond to their questions. To substantially
improve Medicare contractors+ provider communications, we believe
that CMS needs to develop a more centralized and coordinated
approach. This is consistent with several provisions in MRCRA,
which require CMS to centrally coordinate contractors+ provider
education activities, establish communications performance
standards, appoint a Medicare Provider Ombudsman, and create a
demonstration program to offer technical assistance to small
providers."

The GAO also found few incentives for efficient operations, and a
lack of bidding arrangements that encourage full competition between
all health insurance companies that could possibly be chosen as a
Medicare contractor.

Source: "Medicare: GAO Finds High Error Rate in Information
Providers Receive From Medicare Carriers", BNA Health Care Daily,
Volume 6 Number 185, September 26, 2001.
Also: http://waysandmeans.house.gov/health/107cong/hl-10wit.htm

-Citizens' Council on Health Care
-October 1, 2001


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RESIGNATION OF CDC CHIEF CALLED FOR

The Physicians Consortium joined the Catholic Medical Association
in asking President Bush to call for the resignation of CDC chief
Dr. Jeffrey Koplan because the CDC gave the public inaccurate
information on the actual effectiveness of condoms in protecting
potential victims from STDs. The campaign to demand Koplan's
resignation continues.

Reading: Background information and action items on the American Family Association web site: http://www.afa.net/activism/aa073001.asp

Source: Taken directly from "CDC CHIEF MUST RESIGN," Communique,
Judie Brown, American Life League, 9/28/01.


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HAWAII's MEDICAID DENTAL PROGRAM DROPS MANAGED CARE

Beginning Oct. 1, Hawaii's QUEST, the state's managed health
care program for low-income individuals, will increase Medicaid
reimbursements for dentists by switching from a managed care payment
structure back to a traditional fee-for-service system, the Honolulu
Star-Bulletin reports.

In the past, reimbursement rates have been set by the state
Legislature, but the final version of the new dental fee schedule
will be established with "input from private dentists."
Currently, dentists are reimbursed at about 40% of cost, but Dr.
Mark Greer, chief of the state Dental Health Division, expects the
new rate to cover "at least" 75% of dentists' costs (Altonn, Honolulu
Star-Bulletin, 9/23).

Source: "Hawaii QUEST Program Moves From Managed Care Dental
Reimbursements to Fee-For-Service Structure," KAISER DAILY HEALTH
POLICY REPORT, September 26, 2001.


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NUMBER OF UNINSURED DECLINED LAST YEAR

For the second year in a row, the number of Americans without
health insurance dropped last year -- after rising steadily for
more than a decade.

The Census Bureau reports that:

o The number of uninsured declined in 2000 by 551,000 to
38.7 million from 39.3 million in 1999.

o The proportion of people without coverage declined from
14.e percent to 14 percent.

o The number of uninsured children dropped by 693,000 to 8.5
million.

o The number of people with employer-sponsored coverage rose
by more than 3 million last year to 177 million, as
employers competed for workers in a tight labor market.

Experts aren't looking for the declines to continue this year.
That's because tens of thousands of people have been laid off in
2001, the economy has weakened and the cost of health care and
health insurance have escalated.

The proportion of Hispanic people without insurance, 32 percent,
remains higher than that of other groups. About 18.5 percent of
blacks and 9.7 percent of non-Hispanic whites were uninsured last
year.

Residents of New Mexico tend to have the lowest rates of
coverage, while only 6.9 percent of Rhode Islanders go without
insurance.

Source: Robert Pear, "Number of Uninsured Drops for Second Year,"
New York Times, September 28, 2001.

For text
http://www.nytimes.com/2001/09/28/politics/28INSU.html?searchpv=nytToday

Source: Taken directly from Health Policy Digest, National Center
for Policy Analysis, http://www.ncpa.org, 9/28/01.


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ORAL HEALTH "DISPARITIES" TARGETED

Five new Centers for Research To Reduce Oral Health Disparities
will receive funding, according to an announcement by the National
Institute of Dental and Craniofacial Research (NIDCR). "The centers,
which are the first step in implementing the Institute's strategic
plan for eradicating health disparities, will identify factors
contributing to oral health disparities and develop and test
strategies for eliminating them."

Along with the National Center on Minority Health and Health
Disparities, the NIDCR will provide "approximately $7 million per year
over a seven-year period to support the centers through cooperative
agreements."

The need for the centers is supported, according to the National
Institutes of Health press release, by the Surgeon General's first-ever
Report on Oral Health, which "identified a 'silent epidemic' of dental
and oral diseases that disproportionately burden the nation's poor,
especially children and the elderly, as well as members of minority
racial and ethnic groups."

Source: "NIDCR Funds Centers For Research To Reduce Oral Health
Disparities," National Institutes of Health Press Release,
October 1, 2001.

-Citizens' Council on Health Care
-October 1, 2001


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