THIS ISSUE AVAILABLE ONLINE WITH EXPANDED INFORMATION AND PHOTOS AT:
http://www.hhs.gov/news/newsletter/weekly

IN THIS ISSUE:
1) New HHS report shows problems in health care system are worsening as medical litigation crisis deepens
2) Secretary Thompson designates April as "National Donate Life Month"
3) HHS proposes smallpox vaccination compensation plan
4) HHS releases additional $151.26 million in low income energy assistance funds
5) Scientists to start Bovine Genome Project

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New HHS report shows problems in health care system are worsening as medical litigation crisis deepens

The Department of Health and Human Services released a report showing that problems associated with medical litigation have significantly worsened in the past year. In many states, the spiraling cost of insurance for health care providers is impairing patients' access to care, as well as the cost and quality of health care.

HHS originally published a report on the problem in July 2002, with two supplements also released last year. The latest report report states that "the crisis has only worsened, in both scope and intensity," since the earlier reports.

"This is a problem for every American, and a danger to the quality of our health care system," HHS Secretary Tommy G. Thompson said. "Some Americans are already finding it increasingly difficult to find a doctor when they need one because their doctors cannot afford malpractice insurance, driven up by excessive litigation costs. It is important to fix this broken litigation system now, and continue to make meaningful quality improvements in our health care system to reduce medical errors."

Trauma centers across many states have had to close down, and many obstetricians and surgeons have closed their practices, or moved to states with affordable malpractice insurance premiums, says the report, "Addressing the New Health Care Crisis." The report finds dramatically better situations in states that have enacted reforms in their legal systems. However, it says, the crisis is having repercussions throughout the nation's health care system.

One-third of hospitals saw an increase of 100 percent or more in liability insurance premiums in 2002, according to a study cited by the report. And over one-fourth of hospitals reported either a curtailment or complete discontinuation of a service as a result of growing liability premium expenses.

The report also contains numerous documented accounts of physicians who have had to close their practices and services that have been shut down because of the crisis.

HHS identifies states that have faced "crisis" situations due to problems stemming from medical litigation. These are states in which there are significant reports of impediments to access to care, extreme increases in premium costs and/or significantly reduced availability of insurance.

In 2001, the highest premiums charged to specialists in states without meaningful non-economic caps had increased by 39 percent. Since that time, using the same measure, premiums in these states have gone up an additional 51 percent. Thus, on this basis, specialty premiums have almost doubled in two years.

The main factor causing the crisis is the rise in mega-awards and settlements, particularly for non-economic damages. New data shows that the number of payments of $1 million or more reported to the National Practitioners Data Bank (NPDB) has grown rapidly in the past seven years, not only in crisis states such as New Jersey, Pennsylvania and Ohio, but nationwide. Between 1991 and 2002, the number of payments each year of $1 million or more that were reported to the NPDB increased from 298 to 806.

President Bush has proposed a framework for improving the medical litigation system. It includes allowing unlimited compensation for "economic losses," while placing reasonable limits on non-economic damages, as has been enacted in many states, and payment of judgments over time. In addition, HHS is devoting new efforts to improving quality of care and reducing medical errors. The President's framework also calls for confidentiality provisions that would encourage communication among health care professionals to identify weaknesses and improve health care quality and patient safety.

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Secretary Thompson designates April as "National Donate Life Month"

HHS Secretary Tommy G. Thompson announced that the month of April will be observed as National Donate Life Month to help raise public awareness of the critical need for organ, tissue, marrow and blood donation.

"Each year the month of April brings springtime and nature's renewal," Secretary Thompson said. "Now, each April will remind all Americans of their own ability to renew and enhance life through the gift of donation."

In past years, the third week in April was designated as "National Organ and Tissue Donor Awareness Week." The change to a month-long observance underscores Secretary's Thompson's commitment to donation, which began with his launching of the Gift of Life Donation Initiative just 75 days after taking office, and gives donation and transplant organizations more time to sponsor public awareness activities in their communities.

Thousands of people have already recognized the importance of giving the gift of life to others. In 2002, 22,741 organ transplants and more than 46,000 corneal transplants were performed in the United States, and an average of 173 transplants were facilitated each month by the National Bone Marrow Donor Registry.

The need, however, is still enormous. Close to 81,000 individuals are on the waiting list for organ transplants, and thousands need tissue and corneal transplants each year. About 30,000 people a year are diagnosed with blood diseases that may be cured by a marrow/blood stem cell transplant. And each day approximately 32,000 units of blood are needed, yet only about 5 percent of eligible blood donors give blood regularly.

To honor living donors and deceased donors and their families from across the nation, following the April observance, the National Donor Recognition Ceremony and Workshop will be held from July 12-13 in Washington, D.C. Transplant recipients will be in attendance, along with representatives of regional organ procurement organizations and key transplant organizations.

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HHS proposes smallpox vaccination compensation plan

HHS Secretary Tommy G. Thompson proposed a plan to create a smallpox vaccination compensation program to provide benefits to public health and medical response team members who are injured as a result of receiving the smallpox vaccine. It is based on a similar compensation package that is currently available to police officers and firefighters.

In December, President Bush announced a plan for public health and medical response teams to be vaccinated voluntarily against smallpox as part of an overall effort to better prepare the nation against terrorism. Smallpox is a disease that is very contagious and can spread rapidly, so it is important to have medical response teams prepared to respond and protect the American people should an outbreak occur.

"I commend all of the public health and medical response team members who have already volunteered to be vaccinated against smallpox so we as a nation will be better prepared to protect the public," Secretary Thompson said. "A smallpox release is possible and we therefore must prepare by offering vaccine to those most likely to respond. By preparing our emergency responders and giving them assistance with this compensation program, we are better able to protect the American people, which is our highest priority."

The proposed compensation program - which the department will continue to work with Congress on addressing - includes four elements similar to the benefits package currently available to police officers and firefighters. Under the Public Safety Officers Benefit (PSOB) program, administered by the Department of Justice, the federal government currently pays a $262,100 death and a $262,100 permanent and total disability benefit to police officers and firefighters. State and local governments provide short-term disability benefits and health care benefits.

The benefits package would be administered by HHS and be retroactive to cover those who already have been vaccinated under the program. The four elements of the plan include:

· Permanent and total disability benefit: HHS would create a benefit modeled on the PSOB to offer a $262,100 permanent and total disability benefit for disability caused by the administration of the vaccine. This benefit would be paid regardless of other death benefits available to the individual (except the approximately one-third of first responders who are already covered by the PSOB).

· Death benefit: HHS would create a benefit modeled on the PSOB to offer a $262,100 death benefit for deaths caused by administration of the vaccine. This benefit would be paid regardless of other death benefits available to the individual (except the approximately one-third of first responders who are already covered by the PSOB).

· Temporary or partial disability benefit: HHS would compensate individuals for two-thirds of lost wages after the fifth day from work, up to a maximum of $50,000. This benefit would be secondary to any workers compensation or disability insurance benefits that might be available to the individual.

· Health care benefit: HHS would compensate individuals for their reasonable out-of-pocket medical expenses for other than minor injuries. This benefit would be secondary to any health insurance benefit that might be available to the individual.

Additionally, HHS would provide compensation to third parties who contract vaccinia from public health and medical response team workers who have been vaccinated.

HHS and CDC are working with state and local governments to vaccinate health care workers and other crucial personnel - as part of Smallpox Response Teams - to volunteer to receive the smallpox vaccine. All states have submitted smallpox response plans and as of March 4, 45 jurisdictions have vaccinated nearly 12,404 individuals - up from 7,354 one week earlier and 4,213 two weeks ago.

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HHS releases additional $151.26 million in low income energy assistance funds

HHS Secretary Tommy G. Thompson announced the release of $151.26 million in Low Income Home Energy Assistance (LIHEAP) funding. This brings to $1.76 billion the total amount granted to states so far during fiscal year 2003 to support assistance to low-income persons for their home energy costs.

"We are giving states full access to the entire amount that Congress has provided for this fiscal year, and leaving it up to states to decide how much of their grant they wish to receive at this point in time," Secretary Thompson said. "This gives each state the maximum flexibility and support to use the funds that have been appropriated for this year in the manner they feel will serve their low-income families the best."

As of today's distribution, 33 states will have received 90 percent or more of their fiscal year 2003 LIHEAP funding.

"The cold weather and high energy prices make LIHEAP funding especially important this year," said Wade Horn, HHS assistant secretary for children and families. "We want states to have the resources to provide assistance to their low-income families immediately."

LIHEAP helps more than 4 million low-income households each year deal with energy costs related to extreme cold and heat. States determine which low-income families receive LIHEAP support. Many of the families who benefit from the program include small children, senior citizens and persons with disabilities.

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SCIENCE IN THE NEWS

Scientists to start Bovine Genome Project

The National Human Genome Research Institute (NHGRI) gave its provisional go-ahead to the Cow Genome Project, a landmark sequencing effort expected to generate widespread benefits for biology and agriculture.

In a declaration of intent, the NHGRI and the state of Texas have indicated their plan to support the efforts of the Baylor College of Medicine and Texas A&M University to sequence the bovine genome. The entire project will cost $50 million. The genome institute will put up half the money if the remaining $25 million can be raised from other sources, said NHGRI Director Francis S. Collins, M.D., Ph.D. Sequencing would start in September 2003 if the additional funds can be raised.

To move funding for the research forward, Texas Gov. Rick Perry announced state support of up to $10 million over the next three years, starting in 2003, for the Cow Genome Project, saying that the project promises long-term benefits for human health and the biotechnology industry, as well as enormous gains for the beef and dairy industries. He has also offered to assist the project by helping to raise the additional $15 million needed to make the project a reality.

"We are thrilled that Gov. Perry and the state of Texas have stepped up to the plate and committed to providing crucial funds needed to get this important project rolling," said Dr. Collins, who is leader of the Human Genome Project. "We hope others in the public and private sectors will follow the lead of Texas and lend their support to this pioneering endeavor."

Richard Gibbs, Ph.D., director of Baylor College of Medicine's Human Genome Sequencing Center in Houston, said, "We are extremely excited by the level of enthusiasm for this project by the NHGRI and Governor Perry's commitment to make the Cow Genome Project a reality in Texas. This effort will have a great impact on health, agriculture and for building biotechnology in the state."

The bovine genome is similar in size to the genomes of humans and other mammals, with an estimated size of 3 billion base pairs. Besides its obvious potential for improving dairy and meat products and enhancing food safety, adding the genomic sequence of the cow (Bos taurus) to the growing list of sequenced animal genomes will help researchers learn more about the human genome.

"By comparing the human genome with the genomes of different organisms, we can better understand the structure and function of human genes and thereby develop new strategies in the battle against human disease," Dr. Collins explained. "The more genomes we have, the more powerful this tool becomes."

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Last updated 11 March 2003
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