Subject: Studies in the News 05-18 (June 27, 2005)


CALIFORNIA RESEARCH BUREAU
CALIFORNIA STATE LIBRARY
Studies in the News
Health Care Supplement


Contents This Week

Introductory Material HEALTH
   Expenditures for AIDS drugs
   State school health policies on asthma
   Diet as cancer treatment
   Arbitration system for disputes with health plan members
   Soaring healthcare costs bring pressure for reform
   Illness and injury as contributors to bankruptcy
   Job-based health coverage drops for adults and children
   Health trends of Americans
   Tax reform and health insurance
   Financing long-term care
   Federal and state roles in financing long-term care
   Medicaid enrollment estimates
   Medicaid drug rebate program
   Federal medical assistance percentage projects
   Making medicaid work for the 21st century
   Churning in Medi-Cal
   Reforming the sustainable growth rate system
   Role of public health improvements in health advances
   Long-range trends in adult mortality
   Price increases in prescription drugs
   Evaluation of the Arkansas tobacco settlement program
   Growth and shifts in federal immunization grants
PREVIOUSLY IN STUDIES IN THE NEWS
   Studies in the News, April - June 2005
Introduction to Studies in the News

Studies in the News is a very current compilation of items significant to the Legislature and Governor's Office. It is created weekly by the State Library's Research Bureau to supplement the public policy debate in California’s Capitol. To help share the latest information with state policymakers, these reading lists are now being made accessible through the State Library’s website. This week's list of current articles in various public policy areas is presented below.

Service to State Employees:

  • When available, the URL for the full text of each item is provided.

  • California State Employees may contact the State Information & Reference Center (916-654-0206; cslsirc@library.ca.gov) with the SITN issue number and the item number [S#].

  • All other interested individuals should contact their local library - the items may be available there, or may be borrowed by your local library on your behalf.

The following studies are currently on hand:

HEALTH

AIDS

National AIDS Drug Assistance Programs Monitoring Project: Annual Report. By Jennifer Kates and others, The Henry Kaiser Family Foundation. (The Foundation, Menlo Park, California) 2005. 94 p.

Full Text at: www.kff.org/hivaids/loader.cfm?url=/commonspot/security/getfile.cfm&PageID=52593

["Five states (lead by California) accounted for 61% of drug expenditures. These states are primarily the same ones that accounted for the most clients served in June 2004, although their ranking differs slightly. Drug expenditures in June 2004 ranged from $14,410 in North Dakota to $21.2 million in California." (April 20, 2005) 1.]

[Request #S51801]

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ASTHMA

State School Health Policy Issue Brief: Summary and Analyses of State Policies on Asthma Education, Medications, and Triggers. By Patricia H. Lee, National Association of State Boards of Education. (The Association, Alexandria, Virginia) 2005. 19 p.

Full Text at: www.nasbe.org/HealthySchools/States/Asthma%20brief.pdf

["This 50-state survey finds that asthma-related education policies encompass a broad array of issues. This analysis shows that nearly all states have addressed asthma in at least one major policy area, but that no state has a comprehensive set of written policies on asthma."]

[Request #S51802]

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CANCER

Dietary Fat Reduction in Postmenopausal Women with Primary Breast Cancer: Phase III Women's Intervention Nutrition Study: Abstract. By Rowan Chlebowski and others. Presented to the American Society of Clinical Oncology Conference. (The Authors, Orlando, Florida) May 16, 2005. 1 p.

["A large study has shown that breast cancer patients may be able to reduce the chances that their tumors will return by following a stringent low-fat diet. Although some scientists doubt that the findings are robust enough to warrant great confidence, any breast cancer patient who can forgo the pleasures of fatty foods would probably be wise to do so.... The greatest effect was found in women whose breast cancers were not fueled by estrogen." New York Times (May 18, 2005) 22.]

[Request #S51803]

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HEALTH CARE

Mandatory Arbitration System for Disputes with Health Plan Members January 1, 2004 - December 31, 2004. By the Office of the Independent Administrator and the Law Office of Sharon Oxborough. (The Office, Los Angeles, California) 2005. Various pagings.

[“Since 1999, the Office of the Independent Administrator (OLA) has administered arbitrations between Kaiser Foundation Health Plan and its members…. This is the sixth year that the OLA has reported on the status of its arbitration system. This report, allows readers to gauge how well the OLA system is meeting its goal of providing arbitration that is fair, timely, lower in cost than litigation, and consistently.”]

[Request #S51804]

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HEALTH CARE FINANCE

Health Costs Absorb One Quarter of Economic Growth, 2000 – 2005: Recent Federal Report Unintentionally Obscures Massive Rise; Physicians’ Decisions Key to Controlling Cost. By Alan Sager and Deborah Socolar, Health Reform Program, Boston University School of Public Health. Data Brief No. 8. (The University, Boston, Massachusetts) 2005. 56 p.

Full Text at: tinyurl.com/c7tpr

["Increased spending for healthcare is gobbling up about one-quarter of the growth in the economy according to a report just released by researchers at the Boston University School of Public Health. This limits the ability of the nation's families, employers to pay for education, housing or anything else they might hope to afford. Continued cost increases have prompted renewed calls for tackling an overhaul of the healthcare system."]

[Request #S51805]

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HEALTH CARE FINANCING

"Illness and Injury as Contributors to Bankruptcy." By David U. Himmeistein and others. IN: Health Affairs (February 2, 2005) 11 p.

Full Text at: content.healthaffairs.org/cgi/reprint/hlthaff.w5.63v1

["In 2001, 1.458 million American families filed for bankruptcy.... About half cited medical causes, which indicates that 1.9 - 2.2 million Americans (filers plus dependents) experienced medical bankruptcy. Among those whose illness led to bankruptcy, out-of-pocket costs averaged $11,854 since the start of illness; 75.7 percent had insurance at the onset of illness. Medical debtors were 42 percent more likely than other debtors to experience lapses in coverage. Even middle-class insured families often fell prey to financial catastrophe when sick."]

[Request #S51806]

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HEALTH INSURANCE

Job-based Coverage Drops for Adults and Children but Public Programs Boost Children's Coverage. By E. Richard Brown and Shana Alex Lavarreda, UCLA Center for Health Policy Research. (The Center, Los Angeles, California) 2005. 8 p.

Full Text at: www.healthpolicy.ucla.edu/pubs/files/Coverage_Drops_PB_020705.pdf

["Over six and a half million nonelderly Californians were uninsured at some time during the year in 2003.... The majority of these 6.6 million Californians were uninsured for at least an entire year."]

[Request #S51807]

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HEALTH STATISTICS

Health, United States, 2004 with Chartbook on Trends in the Health of Americans with Special Feature on Drugs. By the Center for Disease Control and Prevention, U.S. Department of Health and Human Services. (The Center, Hyattsville, Maryland) 2004. Various pagings.

Full Text at: www.cdc.gov/nchs/hus.htm

["This report assesses the state of the nation’s health and how it has changed over time, both positively and negatively, by presenting trends and current information on selected determinants and measures of health status." Journal of the American Medical Association (March 2, 2005) 1.]

[Request #S51808]

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INSURANCE

Tax Reform and Health Insurance. By Robert B. Helms, American Enterprise Institute for Public Policy Research. (The Institute, Washington, DC) January/February 2005. 9 p.

Full Text at: www.aei.org/docLib/20050203_HPOJang.pdf

["President George W. Bush's second-term agenda includes proposals to reform the tax system and, more specifically, to use it to make our increasingly costly health-care system more efficient. After explaining the decisive influence of tax policy in shaping the current system, with its preference for employer-based health insurance, this essay discusses the main options for altering the tax treatment of medical expenses and identifies three measures that could lead the way toward more comprehensive health-care reform."]

[Request #S51809]

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LONG TERM CARE

The Cost and Financing of Long-term Care Services: Statement. By Douglas Holtz-Eakin, Congressional Budget Office. (The Office, Washington, DC) April 19, 2005. 18 p.

Full Text at: www.cbo.gov/ftpdocs/62xx/doc6294/04-19-LongTermCare_testimony.pdf

["Currently, donated care is the largest source of financing for long-term care (LTC) costs, followed by the combined public programs -— Medicaid and Medicare -— and out-of-pocket expenditures. Private long-term care insurance is a small portion of the current financing.... Rules governing public LTC programs ... create incentives that discourage people from making their own financial preparations and encourage them to rely on government assistance."]

[Request #S51810]

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Long-term Care Financing: Growing Demand and Cost of Services Are Straining Federal and State Budgets: Testimony. By Kathryn G. Allen, Government Accountability Office. GAO-05-564T. (The Office, Washington, DC) April 27, 2005. 24 p.

Full Text at: www.gao.gov/new.items/d05564t.pdf

["The increasing demand for long-term care services fueled in part by the baby boom generation will also further strain federal and state budgets.... Medicaid can be expected to remain one of the largest funding sources, straining both federal and state governments.... A key question for policymakers will be to consider what options exist for rethinking the federal, state, and private roles in financing long-term care."]

[Request #S51811]

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MEDICAID

Medicaid/SCHIP Enrollees: Comparison of Counts from Administrative Data and Survey Estimates. By Chris L. Peterson and April Grady. (Congressional Research Service, Washington, D.C.) March 30, 2005. 15 p.

Full Text at: www.aei.org/docLib/20050407_CRSMemoonMedicaidUndercount.pdf

["It is estimated that 40.5 million to 44.7 million noninstitutionalized people were enrolled in Medicaid or State Children's Health Insurance Program (SCHIP) at some time during fiscal year (FY) 2000. Several population surveys also estimate the number of Medicaid/SCHIP enrollees, but these estimates historically have been substantially lower than those reported in the administrative data, 'a phenomenon often referred to as the 'Medicaid undercount.'"]

[Request #S51812]

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Medicaid Drug Rebate Program: Inadequate Oversight Raises Concerns about Rebates Paid to States. By Government Accoutability Office. GAO-05-102. (The Office, Washington, DC) February 2005. 37 p.

Full Text at: www.gao.gov/cgi-bin/getrpt?GAO-05-102

["Concerns have been raised about rising Medicaid drug spending. GAO studied 1) federal oversight of manufacturer-reported best prices and average manufacturers' prices and the methods used to determine them; 2) how manufacturers’ determinations of those prices could have affected rebates; and 3) how the rebate program reflects financial concessions in the private market."]

[Request #S51813]

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FY 2007 Federal Medical Assistance Percentage Projects. By Federal Funds Information for States. Issue Brief 05-14. (FFIS, Washington, DC) March 29, 2005. 9 p.

Full Text at: www.ncsl.org/ffis/subs/ib/2005/IB05-14.pdf

[“The release of preliminary personal income data for calendar year 2004 and revised estimates for 2002-2003 permits projections of fiscal year (FY) 2007 federal Medicaid matching rates (FMAP). Based on new data … nine states would receive increased FMAPs in FY 2007 and 30 would see decreases.”]

[Request #S51814]

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Making Medicaid Work for the 21st Century. By Vernon Smith and others, the National Academy for State Health Policy. (The Academy, Portland, Maine) 2005. 103 p.

Full Text at: www.nashp.org/Files/Making_Medicaid_Work_for_the_21st_Century.pdf

["The National Academy for State Health Policy convened a workgroup of state officials and national experts representing the broad range of stakeholder interests in Medicaid for the purpose of identifying changes that would make the program more effective and successful.... Key recommendations were developed for Medicaid eligibility, benefits, and financing."]

[Request #S51815]

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MEDI-CAL

How Much Does Churning in Medi-Cal Cost? By Gerry Fairbrother. (The Endowment, Oakland, California) April 2005. 12 p.

Full Text at: www.100percentcampaign.org/assets/pdf/misc-050502a.pdf

["California spent more than $120 million during a three-year period to re-enroll children who were dropped from Medi-Cal because of untimely or incomplete paperwork. About 600,000 eligible children were removed from the program at some point. Most were re-enrolled within four months." Sacramento Bee (April 21, 2005) A3.]

[Request #S51816]

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MEDICARE

Medicare Physician Payments: Considerations for Reforming the Sustainable Growth Rate System: Testimony. By A. Bruce Steinwald, U.S. Government Accountability Office. Presented to the Subcommittee on Health, Committee on Ways and Means, House of Representatives. GAO-05-326T. (The Office, Washington, DC) February 10, 2005. 19 p.

Full Text at: www.gao.gov/new.items/d05326t.pdf

["Concerns were raised about the system Medicare uses to determine annual changes to physician fees -— the sustainable growth rate (SGR) system. Specifically, this statement addresses the following: 1) how the SGR system is designed to moderate the growth in spending for physician services; 2) why physician fees are projected to decline under the SGR system; and 3) options for revising or replacing the SGR system and their implications for physician fee updates and Medicare spending."]

[Request #S51818]

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MORTALITY

“The Role of Public Health Improvements in Health Advances: The Twentieth-Century United States.” By David Cutler and Grant Miller. IN: Demography, vol. 42 no. 1 (February 2005) pp 1-22.

[“Mortality rates in the United States fell more rapidly during the late nineteenth and early twentieth centuries than in any other period in American history.... In this article, we report the causal influence of clean water technologies -– filtration and chlorination -- on mortality in major cities during the early twentieth century…. We found that clean water was responsible for nearly half the total mortality reduction in major cities, three quarters of the infant mortality reduction, and nearly two thirds of the child mortality reduction.”]

[Request #S51819]

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“Long-range Trends in Adult Mortality: Models and Projection Methods.” By John Bongaarts. IN: Demography, vol. 42 no. 1 (February 2005) pp 23-49.

[“(The objectives in this study were 1) to test a new version of the logistic model for the pattern of change over time in age-specific adult mortality rates and 2) to develop a new method for projecting future trends in adult mortality.”]

[Request #S51820]

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PRESCRIPTION DRUGS

Trends in Manufacturer Prices of Brand Name Prescription Drugs Used By Older Americans – 2004 Year-End Update. By David Gross. AARP Public Policy Institute. (The Institute, Washington, DC) April 2005. 17 p.

Full Text at: assets.aarp.org/rgcenter/post-import/dd112_brand_drugs.pdf

[“Wholesale prices for brand-name drugs commonly used by seniors rose an average of 7.1 percent last year, far outpacing the general inflation rate, according to a study…. The study analyzed 195 widely prescribed brand-name drugs based on changes in the baseline price at which wholesalers purchase them from manufacturers.” San Francisco Chronicle (April 13, 2005) 1.]

[Request #S51821]

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SMOKING

Evaluation of the Arkansas Tobacco Settlement Program: Progress from Program Inception to 2004. By Donna O. Farley and others, RAND Health, the RAND Corporation. (The Corporation, Santa Monica, California) 2005. 308 p.

Full Text at: www.rand.org/pubs/technical_reports/2004/RAND_TR221.pdf

[“This report documents the initiation and first two years of activity by the seven funded programs. First, it provides a summary of the history and context of the funding in Arkansas... This report also describes measures that were developed to monitor effects of the funded programs on smoking and other health-related outcomes and early results from those measures. Finally, it provides both program-specific and statewide recommendations for future program activities and funding.”]

[Request #S51823]

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VACCINES

Growth and Shifts in Federal Immunization Grants. By Federal Funds Information for States, FFIS Issue Brief, 05-07. (FFIS, Washington, DC) March 2, 2005. 7 p.

Full Text at: www.ffis.org/exec_sum/issue/IB05-07s.htm

["This issue brief summarizes changes in federal efforts to finance, provide guidance and to coordinate immunization efforts in the United States. It also explains the structure of grants to state and local government for these purposes;"]

[Request #S51824]

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PREVIOUSLY IN STUDIES IN THE NEWS
[This section links to items in Studies in the News since the last Health Care Supplement.]

HEALTH CARE

"Health." IN: Studies in the News, 05-10 - 05-17, April - June 2005.

[Includes: "Restaurant ratings and hospitalizations;" "Reorganizing state health agencies;" "Health care inflation slows;" "Health policy at the ballot box;" "Medicaid fiscal relief spending and baseline projections;" "Medicare prescription drug coverage plan;" "Medi-Cal program and health insurance;" "Californians support doctor-assisted suicide;" "Out of control childhood asthma;" "Kids' time spent with 'new media';" "Chemicals in home products;" "Indoor air quality and child care;" "Availability and cost of healthier food items;" "Second hand smoke and breast cancer;" "Air quality;" "Guidelines on human embryonic stem cell research;" "Medical bills and bankruptcy;" "Office of Public Guardian in Los Angeles;" "New dietary guidelines;" "Economic cost of obesity in California;" "Cost of California prescription drugs;" "Physicians' involvement in quality improvements;" "Rising cost of health care;" "Declining job-based health coverage;" "Increasing health costs for families;" "Wage difference for overweight workers;" "Court rules against medical marijuana;" "Creating a state minority health policy report card;" and others.]

[Request #S51826]

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