THIS ISSUE AVAILABLE ONLINE WITH EXPANDED INFORMATION AND PHOTOS
AT:
http://www.hhs.gov/news/newsletter/weekly
IN THIS ISSUE:
1) Secretary Thompson and President Bush push for medical liability
reform
2) Secretary Thompson renews HHS commitment to reducing health
disparities
3) Secretary Thompson calls for strengthening of Medicare
4) Secretary Thompson discusses importance of Prevention at Austin
Town Hall
5) Researchers discover how embryo attaches to the uterus
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Secretary Thompson and President Bush push for medical liability reform
Secretary Tommy G. Thompson reaffirmed HHS and Administration support for the reform of America's medical liability system.
The Secretary's comments came in remarks at the University of Scranton, PA, on January 16th, where he introduced President George W. Bush. The President spoke about his commitment to ensuring that Americans receive the highest quality of medical care in the world. Both Secretary Thompson and President Bush discussed the Administration's plans for medical liability reform.
"There is a threat to our nation's doctors and a threat to their ability to provide good health care to Americans. That threat is the spiraling cost of medical liability insurance, litigation, and defensive medicine," Secretary Thompson said.
Because of excessive litigation and enormous payouts, the cost of liability insurance has risen more than 10 percent in recent years and could increase by an average of 20 percent more this year. States with no limits on non-economic damages are experiencing the sharpest increase.
This crisis affects ordinary men, women, and children as it denies basic and quality care to those who need it most. Across the country, physicians are abandoning their practices because of rapidly increasing medical liability premiums. Health care costs, already high, are forced higher. This cost is borne by all Americans through out-of-pocket payments, increased health insurance premiums, and taxes. The total cost to the system is $72 billion per year.
President Bush has proposed a framework for addressing the medical liability
crisis.
National adoption of proven standards to make the medical liability system more
fair, predictable, and timely. Experience in many states has demonstrated that
these standards can reduce Federal government costs by at least $28 billion
per year or more, freeing up needed funds for making health care more affordable.
These standards can reduce health care costs for all Americans by $60 billion
or more, and improve access to quality health care as well. The President proposes
that Congress take action to:
· Secure the ability of injured patients to get quick, unlimited compensation
for their "economic losses," including the loss of ability to provide
unpaid services like care for children or parents.
· Ensure that recoveries for non-economic damages do not exceed a reasonable
amount ($250,000).
· Reserve punitive damages for cases where they are justified, and limit
punitive damages to reasonable amounts.
· Provide for payments of judgments over time rather than in a single
lump sum, to ensure that appropriate payments are there when patients need them.
· Ensure that old cases cannot be brought years after an event.
· Reduce the amount that doctors must pay if a plaintiff has received
other payments from an insurer to compensate for their losses.
· Provide that defendants pay judgments in proportion to their fault.
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Secretary Thompson renews HHS commitment to reducing health disparities
In honor of the Martin Luther King Jr. holiday, Secretary Thompson renewed HHS' commitment to protecting and improving the health of minority communities by reducing the disparities of care in racial and ethnic minority populations.
"We have done a good job of identifying where the disparities in care exist," Secretary Thompson said. "Now, we are committed to dedicating resources to those areas and those populations to close the health gap. We will get information and resources to doctors and families in those communities where the health gap exists."
HHS and the Bush Administration are aggressively addressing health disparities with several programs and initiatives, including:
· Closing the Health Gap - Launched in November 2001, Closing the Health Gap is a health education and information campaign for communities of color.
· Take a Loved One to the Doctor Day - Part of Closing the Health Gap, this campaign encourages people to take a loved one to the doctor for a checkup.
· Increasing funding for research - NIH's National Center for Minority Health and Health Disparities proposed budget is $187 million for fiscal year 2003 - an 18 percent increase over 2002.
· Prevention Initiative - Launched in April 2002, this initiative is a comprehensive effort to improve the nation's health through healthier living, particularly in racial and ethnic minorities.
· Expanded SCHIP - More than 4.6 million children who otherwise would not have had access to health care were covered under the State Children's Health Insurance Program.
· Community Health Centers - President Bush and Secretary Thompson are committed to adding 1,200 new community health centers by 2006, largely in communities that serve racial and ethnic minorities, regardless of their ability to pay.
The African-American community suffers disproportionately from diabetes, heart disease, HIV/AIDS, cancer, stroke and infant mortality. As with so many health issues facing America today, prevention is the primary key to closing the health gap: Americans must work to eat right, exercise more, stop smoking and visit a health professional for regular checkups.
Facts about racial disparities in American health care:
· Rates of death from cardiovascular disease are about 30 percent higher among African-American adults than among white adults.
· African Americans suffer from diabetes at 70 percent high rates than whites.
· A baby born to an African-American mother has more than twice the risk of dying the first year of life than a baby born to a white mother.
· African Americans and Hispanics accounted for roughly 75 percent of all adult AIDS cases in 2000, even though they comprise just 25 percent of the U.S. population.
· African Americans and Hispanics make up 81 percent of all pediatric AIDS cases.
· In 2000, 67 percent of older white Americans received the flu vaccine - compared to 48 percent of African Americans and 56 percent of Hispanics.
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Secretary Thompson calls for strengthening of Medicare
Secretary Thompson called for the strengthening of Medicare with expanded services and options, including a prescription drug benefit, in response to a new Centers for Medicare & Medicaid Services (CMS) study.
"Our efforts to improve the quality of Medicare are working," Secretary Thompson said. "However, we must do more to ensure that Medicare beneficiaries get what they deserve - a strong Medicare program with high quality, meaningful choice and effective coverage. They deserve prescription drug coverage and preventive services that are often already available to those under 65."
The CMS study, published in the Journal of the American Medical Association, found the following:
· There was improvement in 20 out of 22 health care measures surveyed.
· Nevertheless, a quarter of Medicare beneficiaries do not receive adequate
services.
· The percentage of patients receiving beta-blockers at hospital discharge,
which reduce complications and death in patients after heart attack, rose from
72 percent of appropriate patients to 79 percent.
· The percentage of patients receiving an effective combination of antibiotics
for pneumonia rose from 79 percent to 85 percent.
· The percentage of patients with high blood pressure and acute stroke
who received medication to decrease blood pressure (an inappropriate treatment)
dropped from 3 percent to 1 percent.
· The percentage of diabetic patients screened for cholesterol problems
rose from 56 percent to 74 percent.
· The percentage of diabetics who received appropriate eye exams to help
prevent blindness increased from 68 percent to 70 percent.
HHS is taking several steps to address the issue of quality care. One of these
steps is the National Nursing Home Quality Initiative that CMS launched last
November. This Initiative helps make quality of care information available to
consumers about the nation's nursing homes. In 2003, CMS will provide similar
information for-in-home health agencies. Another quality care step is HHS' partnership
with hospitals, consumers and others to develop public reporting of quality
measures for hospitals - including a three-state pilot and a standardized patient
survey method.
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Secretary Thompson discusses importance of Prevention at Austin Town Hall
HHS Secretary Tommy G. Thompson will discuss the importance of prevention at a Town Hall meeting to be held in Austin, Texas on Thursday, January 23.
"In the past few decades, medical science has made great advances in understanding the treatment of disease," Secretary Thompson said. "Yet while the medical community puts great effort into curing illnesses, we often put too little effort into taking the steps to prevent disease in our own lives. Today, millions of Americans face diseases that are, for the most part, preventable."
The Secretary's Town Hall will discuss with consumers, employees, large and small business owners, and healthcare providers the importance of prevention in their own lives. The meeting will help increase awareness of the health benefits of prevention as well as the risks of obesity-related illnesses and other preventable conditions. Mark McClellan, Commissioner of the Food and Drug Administration, will also deliver remarks outlining the state of health in America today.
The Town Hall meeting was organized with assistance from the Public Forum Institute,
a non-profit group that plans and promotes citizen engagement activities throughout
the country. Over the past few months, Secretary Thompson has participated in
other Public Forum Institute Town Hall meetings Jacksonville, Florida and Minneapolis,
Minnesota.
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Researchers discover how embryo attaches to the uterus
Researchers funded by the National Institutes of Health have discovered how an embryo initially attaches to the wall of the uterus - what appears to be one of the earliest steps needed to establish a successful pregnancy.
Specifically, the researchers found that six days after an egg is fertilized, the embryo uses specialized molecules on its surface and molecules on the surface of the uterus to attach itself to the wall of the uterus.
"This discovery opens up a promising new realm of research," said Duane Alexander, M.D., Director of the National Institute of Child Health and Human Development (NICHD). "It may lead to insight into infertility, early pregnancy loss, and perhaps to an understanding of the life-threatening complication of pregnancy known as preeclampsia."
The finding appears in the January 17th Science. The research was conducted by scientists at the University of California at San Francisco, the Nevada Center for Reproductive Medicine in Reno, the Lawrence Berkeley National Laboratory in Berkeley, California, and the University of Wisconsin, Madison.
About six days after fertilization, the embryo is shaped like a sphere. The surface of the sphere is made up of a layer of specialized cells called the trophoblast. At this phase of development, the embryo is called the blastocyst. The trophoblast later gives rise to the cells that will form the fetus' part of the placenta. (The placenta is made up of both maternal and fetal tissues.) The trophoblast is coated with a protein known as L-selectin. The wall of the uterus is coated with carbohydrate molecules. The researchers believe that as the blastocyst travels along the uterine wall, L-selectin on its surface binds to the carbohydrates on the uterine wall, until the blastocyst gradually slows to a complete stop.
After this happens, the cells that later become the fetus' contribution to the placenta develop. The placental tissue from the fetus then attaches to the uterine wall by sending finger-like extensions into it. These projections make contact with the maternal blood supply, becoming the pipeline through which the fetus derives nutrients and oxygen, and rids itself of carbon dioxide and wastes.
The study's senior author, Dr. Susan Fisher from the University of California at San Francisco, explained that learning about the molecular processes leading up to implantation may provide information useful for treating infertility and preeclampsia. Preeclampsia is a condition in which pregnant women develop dangerously high blood pressure that may lead to convulsions and even death.
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Last updated 21 January 2003
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