Citizens' Council on Health Care
CCHC HEALTH eNEWS
Thursday, September 6, 2001
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Providing news and commentary on health care
policy,
health insurance issues, and medical confidentiality.
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* ANOTHER LAWSUIT FILED AGAINST PRIVACY RULE - CONTRIBUTIONS ACCEPTED
* NO MSAs, NATIONALIZE HEALTH CARE - SAYS NEWSPAPER
* PROTECTING GENETIC TESTING TO INCREASE UNINSURED, SAY ACTUARIES *
* UNIVERSAL CARE FOR MASSACHUSETTS? - SECOND ATTEMPT *
* PHARMACISTS OUT TO REGULATE DRUG-BENEFITS MANAGERS
* PHARMACIST SHORTAGE MAY LEAD TO MEDICATION ERRORS
* SOCIAL SECURITY NUMBERS (SORT OF) NOT REQUIRED TO RECEIVE LICENSURE
* STATE KIDCARE PROGRAM CAPTURES PARENTS, NOT KIDS *
* CANADIAN PREMIERS WADE INTO GENE PATENTING DEBATE
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* CCHC Commentary included
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ANOTHER LAWSUIT FILED AGAINST PRIVACY RULE
The Association of American Physicians and Surgeons (AAPS)
and Congressman Ron E. Paul (R-TX) joined together in a lawsuit
against the U.S. Department of Health and Human Services.
The new federal privacy rule is unconstitutional, according
to their press release.
According to Rep. Paul, "Far from protecting privacy, these
rules give government officials and certain private interest
a new federal right to access medical records without consent
....AAPS deserves the gratitude of every American for fighting
to stop these regulations and I am pleased to support their
efforts."
The lawsuit seeks declaratory judgments that
* the regulations violate the Fourth Amendment
against warrantless search of seizure of personal effects and papers by
government agencies
* violate the First Amendment by chilling free speech between patients and
doctors
* violate the Tenth Amendment by governing activities of physicians within each
state
* violate the Health Insurance Portability and Accountability Act by extending
to paper medical records, and
* violate the Paperwork Reduction Act by placing immense burdens on small
medical practices.
AAPS President Jane Orient said the lawsuit was the last
remaining option. After appealing to Congress, testifying, and
generating public comments in opposition to the regulation, AAPS
had to sue she said: "We had nothing left to do short of leaving
our patients to the mercy of government spies or resorting to
civil disobedience by refusing to violate our ethical code and
our patients privacy, or file a lawsuit. We choose to work
through the courts."
AAPS is now appealing to the public for financial support.
Contributions can be sent to:
American Health Legal Foundation
1601 N. Tucson Blvd. Suite 9
Tucson AZ 85716.
According to AAPS, you may also fax your credit card number,
expiration date, name and signature to (520) 325-4230.
Please specify that this is for the AHLF.
-Citizens' Council on Health Care
-September 6, 2001
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NO MSAs, NATIONALIZE HEALTH CARE
The Raleigh News and Observer published an editorial this week
that says MSAs "simply add grease to the Rube Goldberg health
care machinery." It says health care should be "a right of
citizenship." "Every American... ought to be entitled to a basic
menu of services needed for a healthy lifespan." It should be paid
for from income taxes and administered by government agencies.
SOURCE: "The Price of Health," Raleigh News and Observer
editorial, August 29, 2001.
CCHC Source: Taken directly from Greg Scandlen, National Center
for Policy Analysis, SCANDLEN'S HEALTH POLICY COMMENTS,
Tuesday, September 4, 2001
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PROTECTING GENETIC TESTING TO INCREASE UNINSURED, SAY ACTUARIES
Restricting insurance company access to genetic test results
may limit the industry's ability to underwrite affordable
insurance says the American Academy of Actuaries at a Capitol
Hill briefing on September 5, 2001.
They warned that insurance premiums may rise as a result, leading
to more uninsured individuals. Insurers warn that patients prone
to diseases may seek out companies with the best benefits, forcing
them to pay more to care for sicker patients.
Congressman Thomas Daschle (D-SD) has introduced one of many bills
to protect the confidentiality of genetic testing. Insurers are
concerned with his definition of genetic testing: analysis of human
DNA, RNA, chromosomes, proteins, and metabolites that detect
genotypes, mutations, or chromosomal changes, according to Reuters.
"The concern that we have, or might have, with this definition is
that you've just described everything about your body," said Cecil
D. Bykerk, the chief actuary for corporate actuarial and strategic
planning operations with the Mutual of Omaha Companies.
Source: "Actuaries Say Protecting Genetic
Information Is Dangerous," REUTERS MEDICAL NEWS, August 29, 2001:
http://managedcare.medscape.com/reuters/prof/2001/08/08.30/20010829legi002.html
CCHC COMMENTARY: These are the same folks that blasted MSAs several
years ago.
-Citizens' Council on Health Care
-September 6, 2001
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UNIVERSAL CARE FOR MASSACHUSETTS - SECOND ATTEMPT
Massachusetts Attorney General Thomas Reilly (D) will decide
today the constitutionality of 27 proposed questions for the November
2002 ballot, including one that would ask voters to "deny
taxpayer-funded health insurance to every [state] lawmaker ...
including the governor, unless the politicians enact a health care
program that covers everyone in the state," the Boston Globe reports.
If the question receives approval from the attorney general,
supporters can begin collecting the required 57,100 signatures needed
by Dec. 5. The state Legislature would then "have a chance to act on
the question." If the Legislature does not approve the question,
supporters could gather another 9,517 signatures by July 2002 to get
the question on the November 2002 ballot. The universal care ballot
question was submitted by the group behind the "bulky" Question 5 in
2000, which also would have created a universal health care system in
Massachusetts but was rejected by voters.
Question 5 "had so much detail" that opponents were able to argue
that "its effects were unknown," the Globe reports. The health
insurance industry "mounted" a $5 million campaign against Question
5; this year, the same faction has hired "prominent law firms" to try
to defeat the new question. The opponents view the "question's attempt
to deny care to lawmakers as petty and mischievous" and say it is
unconstitutional because it is the same as Question 5, a violation of
a law prohibiting the reappearance of a ballot question for six years,
the Globe reports.
Supporters, including two former New England Journal of Medicine
editors, a Nobel laureate and a former U.S. surgeon general, say the
question is a "populist vehicle" to make legislators expand health
coverage when the economic slowdown is expected to leave many
residents without insurance. Dr. Steffie Woolhandler, an associate
professor at Harvard Medical School and a primary care doctor, said,
"The Legislature and governor have taxpayer-funded insurance. The
citizens of the Commonwealth deserve what they have. What we're
really saying is, we want what you've got" (Mishra, Boston Globe,
9/5).
CCHC COMMENTARY: This is the state of residence for universal
health care advocate U.S. Senator Edward Kennedy (D).
Source: Taken directly from "Universal Coverage Might Be on 2002
Massachusetts Ballot." KAISER DAILY HEALTH POLICY REPORT
http://www.kaisernetwork.org/daily_reports/rep_hpolicy.cfm
Wednesday, September 5, 2001
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PHARMACISTS OUT TO REGULATE DRUG-BENEFITS MANAGERS
Health plans and self-insured employers often hire firms known as
pharmacy-benefits managers to design drug benefits packages that
help contain costs. The firms steer patients toward certain
drugs -- or switch them to another drug in a therapeutic class --
and negotiate rebates with drug manufacturers in return.
But pharmacists, through their trade association the National
Community Pharmacists Association -- which represents 25,000
independent pharmacies -- are planning a push to require states
to step up regulation of the firms.
About half of state insurance agencies already regulate the firms
-- either as claims processors or "utilization-review agents,"
which determine if prescribed services are medically necessary.
o Idaho, Mississippi, North Carolina, New Mexico and
Wisconsin regulate claims-processing activities of drug
benefits managers.
o Pennsylvania, South Dakota and Texas monitor utilization
review -- which is checking to see if delivered care is
appropriate.
o Another 14 states perform both regulatory functions.
o Illinois conducts a third-party prescription-
administration function.
Pharmacy benefits managers serve 170 million people nationally
and see the proposed regulations as an unnecessary layer of
rules.
While pharmacists contend new regulations are needed to protect
consumers, PBMs argue they are intended to protect pharmacists'
businesses. Indeed, PBMs have been taking profits away from
independent pharmacists for years.
Source: Russell Gold, "Drug Benefits Managers Under Fire," Wall
Street Journal, September 5, 2001.
For WSJ text (requires interactive subscription)
http://interactive.wsj.com/articles/SB999639029584947861.htm
Source: Taken directly from Daily Policy Digest, National
Center for Policy Analysis, 9/5/01, http://www.ncpa.org
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PHARMACIST SHORTAGE MAY LEAD TO MED ERRORS
A growing pharmacist shortage caused in part by rising demand
for prescription drugs is sparking concerns that medication errors
"will increase as pharmacists become increasingly overworked" and
that pharmacies will reduce their services in underserved areas, the
New York Times reports. According to Phillip Schneider, a vice
president at the National Association of Chain Drug Stores, roughly
6,500, or 6%, of pharmacist positions at U.S. chain pharmacies are
vacant, an increase of nearly 4,000 since February 1998.
And a June survey by the American Hospital Association found that
12,600, or 21%, of hospital pharmacist positions are unfilled.
Attempting to reduce these vacancy rates, pharmacies have increased
their starting salaries, with the average initial wage for hospital
pharmacists rising from $56,000 in March 2000 to $60,740 in September
of that year, according to HHS. While the number of pharmacists
nationwide has increased from roughly 181,000 in 1995 to about
196,000 today, according to HHS figures, the demand for prescription
drugs has outstripped this "slight" increase -- 3.15 billion
prescriptions were filled in the United States in 2000, up from
2 billion in 1990, Schneider said.
Meanwhile, enrollment in pharmacy schools has declined every year
since 1994, Will Lang, a spokesperson for the American Association
of Colleges of Pharmacy, said.
Source: Taken directly from " Pharmacist Shortage Leads to
Greater Concern About Medication Errors," KAISER DAILY
HEALTH POLICY REPORT, Monday, August 27, 2001
http://www.kaisernetwork.org/daily_reports/rep_hpolicy_recent_rep.cfm?show=yes&dr_DateTime=27-Aug-01
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SOCIAL SECURITY NUMBERS NOT REQUIRED TO RECEIVE LICENSURE - SORT OF
OFFICIAL MEMO FROM GOVERNMENT OFFICE:
"U.S. Department of Health and Human Services Administration for
Children & Families Office of Child Support Enforcement
PIQ-99-05
http://www.acf.dhhs.gov/programs/cse/pol/piq-9905.htm
DATE: July 14, 1999
TO: State IV-D Directors and Regional Program Managers
FROM: David Gray Ross Commissioner Office of Child Support Enforcement
RE: Inclusion of Social Security Numbers on License Applications and Other
Documents
It has come to our attention that there is some confusion regarding the
issue of inclusion of social security numbers on license applications and
other documents.
Section 466(a)(13) of the Social Security Act (Act) requires States to
implement procedures requiring that the social security number(s) of any
applicant for a professional, driver's, occupational, recreational or
marriage license be recorded on the application. In addition, section
466(a)(13) of the Act requires procedures requiring that the social security
number(s) of any individual subject to a divorce decree, support order or
paternity determination or acknowledgment be placed in the records relating
to the matter and that the social security number(s) of any individual who
has died be place in the death records and recorded on the death
certificate. Some States have asked how this requirement applies to those
applicants or individuals that do not have social security numbers.
We interpret the statutory language in section 466(a)(13) of the Act to
require that States have procedures which require an individual to furnish
any social security number that he or she may have. Section 466(a)(13) of
the Act does not require that an individual have a social security number as
a condition of receiving a license, etc. We would advise States to require
persons who wish to apply for a license who do not have social security
numbers to submit a sworn affidavit, under penalty of perjury, along with
their application stating that they do not have a social security number.
Such an affidavit should also be required for divorce, support or paternity
matters where an individual indicates that he or she does not have a social
security number or in death cases where a family member, next of kin
indicates that the deceased did not have a social security number.
This is consistent with the position we took in PIQ-97-04 regarding the
requirement for inclusion of social security numbers on voluntary paternity
acknowledgement affidavits. In PIQ-97-04 we stated that, although section
452(a)(7) of the Act specified that the social security number of each
parent is one of the minimum requirements of an affidavit to be used for the
voluntary acknowledgment of paternity, the omission of one or both of the
social security numbers would not invalidate the acknowledgment.
If you have questions regarding this subject, please contact Jan Rothstein
of my staff at (202) 401-5073."
Source: Distributed by Scott McDonald, ScanThisNews, at Fight
the Fingerprint, http://www.networkusa.org/fingerprint.shtml
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STATE KIDCARE PROGRAM CAPTURES PARENTS, NOT KIDS
Since its inception in October, New Jersey's FamilyCare
program has enrolled 121,000 adults -- "outpacing" its goal of
125,000 adult enrollees by 2003, but only attracted 5,000 new
children, the Fort Worth Star-Telegram reports.
The program, a CHIP expansion program that covers children
from low-income families, their parents and childless adults
in October with the goal of enrolling more children by offering
coverage to families. To qualify for coverage, children from
families earning up 350% FPL, or $61,775 for a family of four,
may enroll, while parents's eligibility is limited to up to 200%
FPL, or $35,300 annually for a family of four. Childless couples
and single adults earning up to 100% FPL, or $11,610 and $8,590
per year, respectively, are also eligible for coverage. Officials
believed that by "casting a wider net," they could attract more
low-income parents to "a viable health insurance options for their
children."
However, since the expansion, FamilyCare has enrolled about 97%
of the eligible adults and "only" 48% of the estimated 161,800
eligible children. According to FamilyCare Executive Director
Heidi Smith, "Everyone believes that if you offer the insurance
to the adults, you are going to get insurance for the children."
She added there were "no guarantees" that child enrollments would
increase with the program and that the state was "learning." For
example, FamilyCare administrators found that covering childless
adults cost more than expected, which could lead to changes in
eligibility requirements. However, Lisa Dubay, with the Urban
Institute, said that while the long term "effectiveness" of the
expansion strategy is unknown, the "growing consensus" is that
such programs will enroll more children.
New Efforts, Old Obstacles
When the program expanded, the state attempted to market the
program towards children already using government services, the
Star-Telegram reports. Now, the plan's administrators are attempting
to reach a different demographic -- children of parents with higher
incomes who do not think their children qualify. Besides lack of
knowledge, Dubay said that other obstacles, such as stigma
surrounding subsidized insurance and the "war[iness] of dealing with
a state bureaucracy," will make attracting this population difficult.
To better publicize the program to higher income families, the
Star-Telegram reports that the state will "forgo" broadcast
advertising in favor of working with schools to provide parents with
materials about FamilyCare, and will hold events at malls and health
centers across the state. Smith added, "If we don't find them after
this kind of concerted effort, we are going to have to rethink our
strategy" (Star-Telegram, 8/9). For further information on state
health policy in New Jersey, visit State Health Facts Online.
Source: Taken directly from, "New Jersey FamilyCare Succeeds in
Enrolling Parents, Not Children," KAISER DAILY HEALTH POLICY REPORT
Friday, August 10, 2001
CCHC COMMENTARY: Option 2 and Option 3 of the Clinton Health Plan,
as obtained from the National Archives, discuss use of KidCare
programs to bring adults into the government system. As is well
known, Option 1, the Clinton Health Security Act, failed in 1994.
It seems as though Options 2 and 3 are moving forward gradually in
every state through the Childrens Health Insurance Program.
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CANADIAN PREMIERS WADE INTO GENE PATENTING DEBATE
New patents on human genes threaten to inflate health care costs and
deny patients life-saving tests and treatments in Canada's already
troubled medical system, provincial leaders warned on Friday.
Source: Reuters
http://news.findlaw.com/legalnews/s/20010803/n03287182.html
Canadian Legal Resources
http://www.findlaw.com/12international/countries/ca/provinces.html
Source: Taken directly from HEALTH LAW PULSE
http://www.findlaw.com
A FindLaw Resource on Health Law
August 14, 2001: Issue # 17
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* CCHC Commentary included
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NOTE: These news items have been taken directly
from email received by CCHC or from Internet
newspaper publications. Titles in ALL CAPS are
CCHC creations except for those heading articles
from the National Center for Policy Analysis,
the Health Law Pulse, PrivacySecurityNetwork,
and LIST.HEALTHPLAN. Credit to the sending
organization or news service is listed at the
end of each article.
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CITIZENS' COUNCIL ON HEALTH CARE
1954 UNIVERSITY AVE. W., SUITE 8
ST. PAUL, MN 55104, 651-646-8935
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