Medicine and Health Sciences Commons^™

A Report From The Forum Session "Complexity, Coordination And Compromise: States And The Medicare Drug Benefit" (August 4, 2006), Lee Partridge

National Health Policy Forum

This National Health Policy Forum meeting report reviews a technical session that took place on August 4, 2006. The invitation-only meeting was designed to discuss implementation issues related to the new Medicare drug benefit, with special consideration of state activities, problems, and concerns. This meeting followed similar ones sponsored by the Forum in 2004 and 2005 in which the state perspective was the primary focus of conversation. Participants, including current and former state Medicaid directors, other state officials and experts, federal officials, Medicare drug plan representatives, and beneficiary advocates, described their experiences during the implementation process and addressed continuing challenges. …

Child Laundering: How The Intercountry Adoption System Legitimizes And Incentivizes The Practices Of Buying, Trafficking, Kidnapping, And Stealing Children, David M. Smolin

David M. Smolin

This article documents and analyzes a substantial incidence of "child laundering" within the intercountry adoption system. Child laundering occurs when children are taken illegally from birth families through child buying or kidnapping, and then "laundered" through the adoption system as "orphans" and then "adoptees." The article then proposes reforms to the intercountry adoption system that could substantially reduce the incidence of child laundering.

Stealing What's Free: Exploring Compensation To Body Parts Sources For Their Contribution To Profitable Biomedical Research, Jo-Anne Yau

The University of New Hampshire Law Review

[Excerpt] “At first blush, donating body parts in the name of science appears to be a beautiful solution to the problem of scarce body parts for research advancements. But a closer investigation reveals an ugly fact: the philanthropic donors—referred to as “Sources” in this article—are subjected to physical and financial exploitation.

Sources play a crucial and indispensable role in biotechnology. Without human body parts, most medical discoveries would not have been possible. Handsome profits can be derived from successful discoveries. But currently in the United States, when a Source provides body parts for research purposes, the researcher, research foundation, and …

Howe V. Mgh And Hudson V. Texas Children's Hospital: Two Approaches To Resolving Family-Physician Disputes In End-Of-Life Care, Michael Moreland

Michael P. Moreland

No abstract provided.

Personal Health Records: The People's Choice?, Lisa Sprague

National Health Policy Forum

Information technology (IT), especially in the form of an electronic health record (EHR), is touted by many as a key component of meaningful improvement in health care delivery and outcomes. A personal health record (PHR) may be an element of an EHR or a stand-alone record. Proponents of PHRs see them as tools that will improve consumers’ ability to manage their care and will also enlist consumers as advocates for widespread health IT adoption. This issue brief explores what a PHR is, the extent of demand for it, issues that need to be resolved before such records can be expected …

Value-Based Coverage Policy In The United States And The United Kingdom: Different Paths To A Common Goal, Wilhelmine Miller

National Health Policy Forum

This background paper traces the development within American health care of two interrelated trends and activities: an evidence-based approach to medical practice and the critical evaluation of new technologies with respect to their costs and effectiveness. Over the past 35 years each of these developments has increasingly shaped the coverage decisions of public and private health insurers, and their importance for coverage policy is certain to grow. The paper also contrasts the different approaches to such “evidence-” or “value-based” coverage policy in the mixed public and private U.S. health care enterprise with the approach taken in Great Britain’s single-payer National …

Medicare And Mental Health: The Fundamentals, Christopher Loftis, Eileen Salinsky

National Health Policy Forum

This background paper provides a review of mental health coverage in the Medicare program. It examines the prevalence of mental disorders among Medicare beneficiaries, treatment available through Medicare, and the cost of such treatment. A brief summary of relevant policy issues is provided, including Medicare’s outpatient mental health limitation and the potential effect of the prescription drug benefit on the provision of mental health services.

Epsdt: Medicaid's Critical But Controversial Benefits Program For Children, Christie Provost Peters

National Health Policy Forum

The Early and Periodic Screening, Diagnosis and Treatment (EPSDT) program under Medicaid provides the most comprehensive set of health benefits for children and adolescents in the public or private sector. A cornerstone of early childhood preventive and treatment services in the nation’s health care “safety net,” the EPSDT program serves nearly 30 million low-income children, including children with disabilities and special needs. Over the years, states have expressed frustration with the administrative burdens of EPSDT requirements. Rising Medicaid costs have put all Medicaid benefits, including the EPSDT program, in the budgetary crosshairs. This issue brief reviews the fundamental characteristics of …

Updating Medicare's Physician Fees: The Sustainable Growth Rate Methodology, Laura A. Dummit

National Health Policy Forum

Medicare’s method to annually update the fees it pays physicians has been under fire for some time—specifically, since the method determined that physician fees should be reduced rather than increased. The update method, called the sustainable growth rate (SGR), was implemented to control the growth in Medicare physician spending. Yet Congress, in response to physician concerns about beneficiary access to care, has acted to avert physician fee cuts since 2003. Although this signals dissatisfaction with the SGR methodology, there is yet to be a widely accepted physician fee update proposal that balances federal budgetary realities with the need to ensure …

The Nuts And Bolts Of Pdps, Mary Ellen Stahlman

National Health Policy Forum

This issue brief provides an overview of Medicare prescription drug plans (PDPs), with a focus on fundamentals such as enrollment, premiums, formularies, cost sharing, prices, payment, cost management, and appeals and grievance processes. It also highlights major changes to the PDP landscape between 2006 and 2007.

Updating The Wic Food Packages: It's About Time, Jessamyn Taylor

National Health Policy Forum

This issue brief reviews key revisions to the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) program proposed by the USDA, which are based substantially on recommendations by the Institute of Medicine. Should the changes become regulation, they will be the most significant revision of the WIC food packages in over 25 years. This brief describes the changes, the impetus for their consideration, and possible implementation issues from the perspectives of vendors, state and local WIC agencies, and participants.

2006 Scholars And Artists Bibliography, Daniel J. Simon, Michael Schwartz Library, Cleveland State University, Friends Of The Michael Schwartz Library

Scholars and Artists Bibliographies

This bibliography was created for the annual Friends of the Michael Schwartz Library Scholars and Artists Reception, recognizing scholarly and creative achievements of Cleveland State University faculty, staff and emeriti. Dr. Dan Simon was the guest speaker.

Medicare Physician Payments And Spending, Laura A. Dummit

National Health Policy Forum

The Medicare program’s physician payment method is intended to control spending while ensuring beneficiary access to physician services, but there are signs that it may not be working. The physician’s role in the health care delivery system as the primary source of information and treatment options, together with growing demand for services and the imperfect state of knowledge about appropriate service use, challenge Medicare’s ability to achieve these two goals. This issue brief describes the history of physician spending and the contribution of escalating service use and intensity of services to the rise in Medicare outlays, setting the stage for …

Who Decides Whether A Patient Lives Or Dies?, Diane E. Hoffmann, Jack Schwartz

Faculty Scholarship

No abstract provided.

Mid-Atlantic Ethics Committee Newsletter, Fall 2006-Winter 2007

Mid-Atlantic Ethics Committee Newsletter

No abstract provided.

Santa Clara Magazine, Volume 48 Number 2, Fall 2006, Santa Clara University

Santa Clara Magazine

8 - TRUTH, LEGEND, AND JESSE JAMES By Ron Hansen M.A. '95. Jesse James' exploits made him a legend even in his own time. Now the author of the novel The Assassination of Jesse James by the Coward Robert Ford reveals what it takes to get beyond coloring book heroes and villains to understanding a charming psychopath and his killer. Plus insights into the making of the forthcoming film starring Brad Pitt and Casey Affleck.

14 - VIOLENCE IN THE MOVIES By Jim Shepard. Movies keep giving us more motion, more mayhem-which is exactly what we want. But what price …

Health Information Technology In The United States: The Information Base For Progress, David Blumenthal, Catherine M. Desroches, Karen Donelan, Sara J. Rosenbaum, Timothy Ferris

Health Policy and Management Faculty Publications

Health information technology (HIT) has the potential to advance health care quality by helping patients with acute and chronic conditions receive recommended care, diminishing disparities in treatment and reducing medical errors. Nevertheless, HIT dissemination has not occurred rapidly, due in part to the high costs of electronic health record (EHR) systems for providers of care—including the upfront capital investment, ongoing maintenance and short-term productivity loss. Also, many observers are concerned that, if HIT follows patterns observed with other new medical technologies, HIT and EHRs may diffuse in ways that systematically disadvantage vulnerable patient populations, thus increasing or maintaining existing disparities …

Effects Of Food Marketing To Kids: I'M Lovin' It?, Eileen Salinsky

National Health Policy Forum

This issue brief reviews key findings and recommendations from the Institute of Medicine study on food marketing and its effects on childhood obesity. The brief describes the childhood obesity epidemic, discusses key trends associated with rising childhood obesity rates, and considers the relative role of marketing practices on diet and obesity within the broader context of complex contributory factors. The brief also summarizes the current legal framework for regulating marketing directed at children; discusses voluntary, self-regulatory mechanisms; and highlights proposals to re-orient marketing practices to combat childhood obesity.

A Closer Look At The Medicare Part D Low–Income Benchmark Premium: How Low Can It Go?, Mary Ellen Stahlman

National Health Policy Forum

This issue brief explains how the Medicare Part D low–income benchmark premium is calculated, what factors influence the level of the low-income benchmark premium in any given year, and the implications of the benchmark amount for Medicare drug plans and beneficiaries as it changes from year to year. The paper provides a simplified, two-year example of how the low-income benchmark premium is calculated in order to illustrate the key factors that influence it.

Oy Canada! Trade's Non-Solution To "The Problem" Of U.S. Drug Prices, Daniel Gilman

Faculty Scholarship

Price disparities—price “differentiation” or “discrimination”—in pharmaceuticals markets have, in recent years, been the subject of much discussion. Price sensitivity should come as no surprise: Medicines play an increasingly important role in healthcare, while pharmaceuticals prices continue to rise. When prices vary greatly within markets or between neighboring markets, the pressure towards arbitrage is clear. This paper considers the question whether the re-importation of medicines from Canada or the EU is well advised and argues that it is not. First, we might reasonably question the extent to which we wish, as a matter of policy, to manage pharmaceuticals pricing; among other …

Premium Assistance In Medicaid And Schip: Ace In The Hole Or House Of Cards?, Cynthia Shirk, Jennifer Ryan

National Health Policy Forum

This issue brief explores the use of premium assistance in publicly financed health insurance coverage programs. In the context of Medicaid and the State Children’s Health Insurance Program (SCHIP), premium assistance entails using federal and state funds to subsidize the premiums for the purchase of private insurance coverage for eligible individuals. This paper considers the evolution of premium assistance and some of the statutory and administrative limitations, as well as private market factors, that have prevented widespread enrollment in Medicaid or SCHIP premium assistance programs. Finally, this issue brief offers some ideas for potential legislative and/or programmatic changes that could …

Don't Bring Me Your Tired, Your Poor: The Crowded State Of America's Emergency Departments, Jessamyn Taylor

National Health Policy Forum

If the time comes, people expect that the emergency department (ED) will have the resources necessary to treat them in a timely, high-quality manner. Increasingly, however, EDs may not be able to meet that expectation. Hospitals in urban areas with large populations, high population growth, and higher-than-average numbers of uninsured are particularly crowded: ambulances are often diverted to other hospitals and patients are frequently forced to “board” in the hallways (while they wait to be transferred to another facility or part of the hospital). This issue brief places EDs in the context of the U.S. health care system and its …

Mid-Atlantic Ethics Committee Newsletter, Summer 2006

Mid-Atlantic Ethics Committee Newsletter

No abstract provided.

Santa Clara Magazine Volume 48 Number 1, Summer 2006, Santa Clara University

Santa Clara Magazine

8 - THE MAN BEHIND THE SOUND by Karen Crocker Snell. As a young music-loving soldier in the final days of World War II, John T. "Jack" Mullin '36 went to investigate a German recording device called a magnetophon. His resulting work in sound profoundly affected the field of recorded audio.

14 - THREE ROOMMATES IN PARIS By John Patrick Donnelly, S.J. It has been 500 years since Francisco Xavier and Pierre Favre were born, and 450 years since the death of Ignatius of Loyola. Quite a lot has happened since 1529 at the University of Paris, when the three …

Response - Jay Katz: From Harms To Risks, Larry I. Palmer

Faculty Publications

No abstract provided.

The Electronic Health Record In Practice: Why, How, And What Next?, Lisa Sprague, Sally Coberly

National Health Policy Forum

This local site visit was intended to allow participants to observe the electronic health record (EHR) as used in practice by two U.S. leaders in technology and quality, the Veterans Health Administration (VHA) and Kaiser Permanente (KP). The VHA has employed an EHR system since 1997; KP is in the process of implementing a standard system for all clinicians nationwide. The site visit was designed to provide an opportunity for participants to explore both the expected benefits from EHR adoption and the specific lessons these two large, integrated delivery systems have learned in their transition from paper to electronic records. …

An Integrated Approach To Educating Working Environmental Health Practitioners, R. Konkel, Joe Beck

Steve Konkel

No abstract provided.

Adverse Impact Of A History Of Violence For Women With Breast, Cervical, Endometrial, Or Overian Cancer, Susan C. Modesitt, Alisa C. Gambrell, Hope M. Cottrill, Lon R. Hays, Robert J. Walker, Brent J. Shelton, Carol E. Jordan, James E. Ferguson

Office for Policy Studies on Violence Against Women Publications

The experience of physical and sexual violence (victimization) is common among U.S. women and is associated with adverse health consequences. The study objectives were to estimate the prevalence of victimization in women with cancer and to examine associations with demographics, cancer screening, and cancer stage.

METHODS:

From 2004 to 2005, 101 women with breast, cervical, endometrial, or ovarian cancer were interviewed to collect demographics, cancer screening history, health care access/use, and violence history. Chisquare and Fisher exact tests were used test risk-factor associations. A multinomial logistic regression model was used for multivariable analysis.

RESULTS:

The prevalence of a history of …

Early Predictors Of Sexual Behavior: Implications For Young Adolescents And Their Parents, Lisa D. Lieberman

Department of Public Health Scholarship and Creative Works

The study provides empirical evidence of the independent contribution of nonsexual romantic relationships in the seventh grade to the onset of sexual intercourse by the ninth grade for both males and females. In addition, it shows that among females, seventh graders in serious relationships with older teenagers—uniquely defined as those two or more years older—have an increased likelihood of sex in the ninth grade. Finally, the study demonstrates that seventh graders of both genders who have had serious romantic relationships were already significantly different in the sixth grade from those who have not: They had peers who were more accepting …

Homeland Security: Engaging The Frontlines - Symposium Proceedings, George H. Baker, Cheryl J. Elliott

George H Baker

The rise of the American homeland security endeavor under the leadership of the new Department of Homeland Security has been heralded by several major national strategy documents. These documents have served to organize efforts at top levels within the government and industry. However, the national strategy guidance is not getting to many organizations and people at the grass-roots level who can make the most difference in preventing attacks, protecting systems, and recovering from catastrophic events, viz. the general citizenry, private infrastructure owners, and local governments. To better understand grass-roots issues and solutions, James Madison University, in cooperation with the Federal …