Tuesday, February 28, 2006
A survey of older adults in rural North Carolina shows that they widely use complementary medicine therapies, but tend to focus on folk or home remedies, such as taking a daily "tonic" of vinegar or using Epsom salts.
"What most people think about as complementary medicine – acupuncture, homeopathy and massage therapy – they aren't using at all," said Thomas Arcury, Ph.D., lead researcher, from Wake Forest University School of Medicine. "Their use is largely limited to home remedies, vitamins and minerals."
The goal of the study, which is reported in the March issue of Journal of Gerontology: Social Sciences, was to learn more about what complementary and alternative medicine (CAM) therapies older adults are using and why.
"We want to understand how people make decisions about managing their health," said Arcury. "If we understand how people are treating themselves, the information can be useful for physicians."
Researchers found that the majority of participants don't use CAM therapies to treat diabetes or other chronic diseases.
"They are using CAM for prevention or for treating symptoms (a headache, a sore throat, a cut) but not for treating a chronic condition," wrote the authors. "CAM use among these rural older adults is largely a form of self-care."
Arcury said it is common to use some of the therapies, such as vinegar or honey, as a general "tonic."
"I've talked to older adults who'll tell you should take two tablespoons of vinegar every day in a glass of warm water because it's good for you," he said. "They aren't treating anything in particular."
The 2005 National Healthcare Quality Report (NHQR) is a comprehensive national overview of quality of health care in the United States.
The 2005 NHQR includes 179 performance measures that can be used to monitor the Nation's progress toward improved health care quality for all Americans. This year's report focuses on a group of 46 "core" measures representing the most important and scientifically sound measures of quality.
The 2005 NHQR includes a report and two online appendixes.
Via the Detroit Free Press:
Transforming Medicare could help lead the country toward a more affordable health care system, U.S. Sen. Bill Frist said Monday at the Detroit Economic Club.
Frist, a medical doctor, proposes Medicare reform as a way to prevent the eventual collapse of the government health plan while pushing advancements that could hold down medical-cost inflation for the rest of the nation.
Without fundamental reform, the Medicare program -- the government health plan for senior and disabled Americans -- will run out of money in about 14 years, the Tennessee Republican and Senate Majority Leader said. With the aging population growing faster than the birth rate, even raising taxes and cutting benefits wouldn't work very long, he said.
So he proposes reforms that include: establishing chronic-disease management programs, getting Americans to participate in their own health care choices and improving medical information technology.
"More than 90% of Medicare dollars are spent treating people with chronic disease," Frist said.
Monday, February 27, 2006
A new policy brief from the Kaiser Family Foundation examines the latest estimates for enrollment in Medicare’s new drug benefit. In addition, updated state-by-state enrollment breakdowns have been posted on the Foundation’s statehealthfacts.org website.
The new enrollment analysis, which assesses enrollment statistics released Wednesday by the U.S. Department of Health and Human Services, presents five different approaches to understanding the enrollment numbers:
- What share of the total Medicare population has creditable prescription drug coverage? In January 2005, HHS projected that 39.1 million beneficiaries would have prescription drug coverage either from the new Medicare drug benefit or another source with benefits at least as generous as Medicare’s. The latest HHS enrollment numbers show that so far 25.9 million (60%) of the estimated 43.4 million Medicare beneficiaries have creditable coverage. Of the 25.9 million beneficiaries with creditable drug coverage, 15.9 million are in Medicare drug plans and 10 million are in employer plans. Most had drug coverage prior to the start of the new benefit.
- What share of the total Medicare population is enrolled in a Medicare drug plan? HHS reports that 15.9 million beneficiaries are enrolled in Medicare prescription drug plans. This total includes 6.2 million Medicare beneficiaries with Medicaid, 4.8 million Medicare Advantage enrollees, and another 4.9 million beneficiaries who signed up for one of the new stand-alone drug plans. Together, they make up 37% of the total Medicare population.
- How do current drug plan enrollment numbers compare to projections previously released by the Administration? In January 2005, HHS projected that 29.3 million Medicare beneficiaries would be enrolled in Medicare drug plans by the end of 2006. The 15.9 million beneficiaries currently enrolled amount to more than half (54%) of that initial enrollment target.
- What share of beneficiaries voluntarily signed up for a Medicare drug plan, among those without another source of creditable drug coverage? Many Medicare beneficiaries were not expected to voluntarily sign up for a new Medicare drug plan because they already have drug coverage at least as generous as Medicare’s benefit from another source, or were automatically enrolled in a Medicare drug plan. Excluding those groups, the latest enrollment numbers suggest that 5.4 million (24%) of the 22.9 million remaining beneficiaries have voluntarily enrolled in a Medicare drug plan or newly enrolled in a Medicare Advantage plan.
- Among beneficiaries who lacked prescription drug coverage, how many signed up for a Medicare drug plan? This approach would be ideal for assessing how well the Medicare Modernization Act of 2003 achieved the goal of providing coverage to those who were without drug coverage before the new drug benefit went into effect. However, information on the number of Medicare beneficiaries lacking prescription drug coverage in 2005 – and the enrollment decisions those beneficiaries have made – is not available.
This year's Elder Law Lecture (newly designated as the Ann F. Baum Memorial Lecture) will take place on Monday, March 6, 2006 at 12:30 P.M. in the Max Rowe Auditorium of the College of Law. The speaker will be Laura Watts, program director of the Canadian Centre for Elder Law Studies at the University of British Columbia in Vancouver, and she will address "Parallel Systems, Second-Class Citizens: The Failure of Elder Abuse Legislation." The lecture will examine whether elder abuse legislation actually makes older people more vulnerable because these statutes are essentially unenforceable and their underlying assumptions are ageist, sexist, ableist, and paternalistic. In addition, elder abuse laws interfere with the principles of liberal legal theory. The lecture will focus on criminal code provisions as well as fiduciary laws and their enforcement mechanisms in Canada and the United States and will consider the proper locus of these responsibilities in a federal legal system.
Ms. Watts founded the upcoming peer-reviewed Canadian Journal of Elder Law and organized the first Canadian Conference on Elder Law that was held last October. Prior to coming to the Canadian Centre for Elder Law Studies, she handled sexual abuse and fiduciary-related cases with the Vancouver law firm of Dives, Grauer & Harper. A barrister and solicitor, she previously clerked in the Criminal Justice Division, Provincial Crown Counsel, and with the civil litigation firm of Bull, Houser & Tupper. Ms. Watts received her law degree from the University of Victoria in British Columbia and her undergraduate degree from Queen's University in Ontario. A reception will follow the lecture in the Peer and Sarah Pedersen Pavilion.
Ed: Thanks to Dick Kaplan for this item.
Thursday, February 23, 2006
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Wednesday, February 22, 2006
The Center for Social Gerontology, Inc. (TCSG), since its inception in 1972, has been a non-profit research, training and social policy organization dedicated to promoting the individual autonomy of older persons and advancing their well-being in society. TCSG has pursued this goal through a wide variety of projects, including serving since 1985 as an Administration on Aging-funded National Support Center in Law & Aging.
TCSG's mission is to help society adapt to the dramatic increase in the numbers of old and very old, and to insure that older persons at all socio-economic and health levels are able to meet their needs and use their talents and abilities in a changing society. We undertake to lead, and even prod, policy makers and others to consider carefully the implications of the aging of America in formulating social policies and programs.
In these roles, TCSG has, since the early 1970s, been actively involved in working on aging programs and advocacy related to the Older American's Act. A primary focus of TCSG's activities has been on legal services development on the national, state and local levels. A major part of our legal services development activities has been the promotion of the effective and efficient delivery of legal services for the most vulnerable older persons. A key component of a states' legal services delivery system and of its elder rights advocacy is the State Legal Services Developer, a position which originated in 1976 through the actions of the federal Administration on Aging and which now exists in all 50 states. TCSG has been deeply committed to the Legal Services Developer concept since its inception and has worked closely with the Developers in the 50 states since they began. TCSG also was instrumental in the creation of the National Association of Legal Services Developers in the late 1980s and continues to provide support to this important organization.
In addition, TCSG played a significant role in the formulation and adoption by Congress in 1992 of Title VII of the Older Americans Act - the Elder Rights title - and particularly the State Elder Rights and Legal Assistance Development Program chapter of Title VII. This web site on State Legal Services Development has been created to provide information and resources which will enhance efforts by Legal Services Developers, providers of legal services for the elderly, state and area agencies on aging, policymakers and others to promote the delivery of legal services to the most vulnerable older Americans.
Prices for some of the most popular medicines used by seniors have jumped an average of 4 percent under the new Medicare drug benefit since it began last month, according to a report released on Tuesday. The report, released by the Democratic staff of the House of Representatives Government Reform Committee, found prices for Pfizer Inc.'s (PFE.N: Quote, Profile, Research) pain reliever Celebrex, Merck Inc.'s (MRK.N: Quote, Profile, Research) cholesterol drug Zocor and eight other top drugs offered by 10 major plans rose during the controversial program's first seven weeks. In some cases, drug prices rose 10 percent, it also found.
The report looked at plans offered by Aetna Inc. (AET.N: Quote, Profile, Research), Humana Inc. (HUM.N: Quote, Profile, Research), Medco Health Solutions Inc. (MHS.N: Quote, Profile, Research) and senior consumer group AARP, which offers its plan with UnitedHealth Group Inc. (UNH.N: Quote, Profile, Research). "The private insurers offering the new Medicare drug plans are not providing seniors and individuals with disabilities with low drug prices," it said, adding the rise outpaced inflation as well as drug price increases found via drugstore.com and in Canada.
Medicare said Tuesday that it will pay for three forms of an expensive surgery to treat obesity, so long as the patients are treated in "high-volume centers that achieve low mortality rates."
The move comes after device makers, surgeons and some patient advocates urged the agency to create a uniform national policy on bariatric surgery, which can cost $15,000 to $20,000 per procedure. Previously, coverage decisions varied by region.
The impact will go beyond Medicare: Private insurers, which vary widely on whether they cover the surgery, often follow Medicare's lead. For example, when Medicare decided to cover organ transplants, insurers began to pay for them.
Previously, Medicare officials said they were considering limiting the surgery to those under age 65, for safety reasons. But after reviewing new data, Medicare officials said experienced surgeons have similar outcomes for patients of all ages and they will pay for the surgery for any age.
An article just published in Health Affairs says
"Growth in national health spending is projected to slow in 2005 to 7.4 percent, from a peak of 9.1 percent in 2002. Private health insurance premiums are projected to slow to 6.6 percent in 2005, with a rebound expected in 2007. The introduction of Medicare Part D drug coverage in 2006 produces a dramatic shift in spending across payers but has little net effect on aggregate spending growth. Health spending is expected to consistently outpace gross domestic product (GDP) over the coming decade, accounting for 20 percent of GDP by 2015.
Tuesday, February 21, 2006
News from Washington State:
The state's tough new anti-smoking law has an unlikely opponent: a retired doctor who argues the ban is forcing elderly smokers in nursing homes to take unnecessary risks.
Dr. Robert Guild, 71, says the law is forcing him and other smokers at the Maplewood Gardens Retirement Apartments - some in wheelchairs and walkers - to brave an ice- and snow-covered lawn to get to a structure that is far enough away from the retirement facility to meet the ban's requirements.
The smokers have dubbed the structure "Butt Hutt," and argue that it is a poor replacement to the well-ventilated smoking lounge management provided before the ban on indoor smoking went into effect in December.
"There's overhead heating, but it's very inconvenient, and there are no facilities," Guild said, noting that restrooms are important for folks his age.
The state's new smoking ban, which went into effect Dec. 8, is the strictest in the country. In addition to banning smoking indoors, it requires a 25-foot smoke-free buffer around doorways, windows that open and ventilation intakes.
International Federation on Ageing 8th Global Conference Copenhagen, Denmark in May 2006 DaneAge is hosting the IFA's 8th Global Conference 30 May - 2 June 2006 in Copenhagen, Denmark and aims to highlight cross-cultural co-operation to meet the challenges of global ageing, and at the same time address important region-specific issues of ageing.
AITS Annual Conference on Health Technologies
Montreal, March 15 & 16, 2006
An excellent opportunity to spread information and basic awareness concerning issues, perspectives, and innovations in the health sector.
International Consortium for Intergenerational Programmes Melbourne, June 26 – 29, 2006 Connecting Intergenerational Communities through Creative Exchange Conference
5th International Conference on Social Work in Health and Mental Health
December 10-14, 2006
An occasion to share recent discoveries of new knowledge and skills of social work in health and mental health, creating synergy to address the needs of people in our time.
The Jerusalem Post reported yesterday:
The Jerusalem Post reported yesterday:
The Social Workers' Organization reported Sunday that one in five elderly in Israel are abused, either by family members or caregivers.
While previous poverty reports reported that 25 percent of the elderly population lives under the poverty line, the Social Workers' Organization reported that "more than one in four elderly…are unable to lead a dignified existence."
"Something in our moral system has been completely lost," said Itzik Peri, representative of the Organization to the Histadrut. "The country needs to come out and say that this is a population at risk that contributed, toiled, and was partner in building many of the things in this state. And suddenly we see that after we've used them, we throw them to the dogs."
The annual Social Workers' Conference is set to open on Monday in Haifa.
Here's just a taste of the scale of the global pension crisis:
Monday, February 20, 2006
Lt. Laurel A. Hester, the terminally ill Ocean County (NJ) nvestigator whose battle to pass on her pension to her partner led to wider discussion and use of state domestic partnership laws, died of lung cancer Saturday morning.
The intensely private woman worked for 24 years as an investigator with the Ocean County Prosecutor's Office.
She kept her sexual orientation private throughout her career, fearing retribution and saying it was no one's business but her own.
She only sought attention in the final three months of her life when she tried to get the Ocean County Board of Chosen Freeholders to award her pension to Stacie Andree, her long-time partner. Andree declined to comment Saturday when reached by telephone.
The board initially refused Hester's request, citing the $13,000 cost. It backed down in late January, less than a month before Hester's death.
Hester's case spurred debate about the state's two-year-old domestic partnership law, which allows, but doesn't require, local governments to provide benefits to employees' same-sex partners.
A new KFF tracking poll finds that 45% of seniors say they have enrolled or plan to enroll in a drug plan, 29% say they do not intend to enroll in a drug plan and another 23% say they are uncertain. The majority of those who do not plan to enroll say they have another program or plan that helps pay for their prescriptions.
This bodes ill for the financial health of Part D, whose cost estimates were based on the premise that more than 30 million Part D eligibles would enroll in the program. Current enrollment stands at 14.2 million, most of whom are dual-eligibles automatically enrolled by CMS last fall.
Fiscal Year 2005 Financial Report of the United States Government
The Secretary of the Treasury, in coordination with the Director of the Office of Management and Budget (OMB), is required annually to submit financial statements for the U.S. government to the President and the Congress. GAO is required to audit these statements.
The FY 2005 Financial Report of the United States Government (Financial Report) published by the Department of the Treasury includes GAO's report on the accompanying U.S. government's consolidated financial statements for the fiscal years ended September 30, 2005 and 2004, and the associated reports on internal control and compliance with significant laws and regulations.
We recently issued a guide to the Financial Report to help those who seek to obtain a better understanding of the Financial Report.
Ed: Check out pages 16 and 18 for the truth about The State of the Union.
The New Mexico legislature has cleared a bill that will allow patients to specify their wishes for mental health treatment though an advance directive. HB459/SB234 would allow people with mental illness to set forth treatment preferences and service needs in a legal document to be used if they can no longer make their own decisions. New Mexico would join 22 states that have passed laws specific to mental-health advance directives.
For more information on this kind of health care directive, visit The Bazelon Center for Mental Health Law.
Friday, February 17, 2006
Shocking news via the Chicago Sun-Times:
The Bush administration told Congress on Thursday it had begun to use a government pension fund to keep from hitting the $8 trillion debt limit.
Treasury Secretary John Snow warned in a letter to congressional leaders that he would run out of room to make such maneuvers in about four weeks, meaning the government would lose the ability to meet its obligations unless Congress had raised the borrowing limit by then.
As of Tuesday, the government's borrowing subject to the limit stood $38.8 billion below the current debt limit of $8.184 trillion.
In his letter, Snow said Treasury would begin taking investments out of a $65.3 billion government employee pension fund called the G-fund.
By withdrawing investments, Treasury is making room on the government's books for increased borrowing.
Snow said he is utilizing a maneuver that has been employed by other Treasury secretaries during times when the government's borrowing levels were approaching the debt limit. Without the action, the debt limit would have been reached on Thursday, said Treasury spokeswoman Brookly McLaughlin.
Thanks, as always, to Jack Solock of CAAR. The full listing is viewable at
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2. HEALTH AND RETIREMENT STUDY:
The University of Michigan Institute for Social Research HRS has announced the following data update: "HRS 1998 Post-Exit (Final, Version 1.0)" (Feb. 10, 2006). http://hrsonline.isr.umich.edu/news/sho_news.php?hfyle=news207&xtyp=1 Data access: https://ssl.isr.umich.edu/hrs/ -----------------------------------------------------------------------
II. Reports and articles:
4. US CENSUS BUREAU REPORT: "The Effects of Government Taxes and Transfers on Income and Poverty: 2004" (February 2006, .pdf, HTML, Microsoft Excel, or ASCII text format). The report is linked from a Census Bureau news release: "Census Bureau Releases Income and Poverty Estimates Reflecting Expanded Income Definitions" (CB06-25, Feb. 14, 2006). http://www.census.gov/Press-Release/www/releases/archives/income_wealth/006450.html Click on title for link to full text. -----------------------------------------------------------------------
5. US DEPARTMENT OF HEALTH AND HUMAN SERVICES NEWS RELEASE: "Lower Costs of Medicare Drug Coverage to Help States Save 700 Million Dollars in 2006" (Feb. 9, 2006). http://www.hhs.gov/news/press/2006pres/20060209.html -----------------------------------------------------------------------
6. US DEPARTMENT OF HEALTH AND HUMAN SERVICES, OFFICE OF ASSISTANCE SECRETARY FOR PLANNING AND EVALUATION REPORT: "Medicaid Estate Recovery Collections," (September 2005, HTML and .pdf format, 12p.). http://aspe.hhs.gov/daltcp/reports/estreccol.htm -----------------------------------------------------------------------
7. US DEPARTMENT OF HEALTH AND HUMAN SERVICES, OFFICE OF THE INSPECTOR GENERAL REPORT: " Effect of the Home Health Prospective Payment System on the Quality of Home Health Care" (OEI-01-04-00160, February 2006, .pdf format, 15p.). Abstract: This report determines how hospital readmission and emergency department visit rates for Medicare beneficiaries discharged from hospitals to home health care have changed since implementation of the home health prospective payment system. OIG found that hospital readmission rates remained unchanged from 2000 through 2003, and the analysis showed no consistent trend in hospital readmission rates for beneficiaries with at-risk diagnoses. OIG also found that the overall rate of emergency department visits for Medicare home health beneficiaries discharged from hospitals increased slightly, from 29 to 30 percent, from 2000 to 2003. The analysis showed a slight increase in rates of emergency department visits for beneficiaries with at-risk diagnoses, including renal failure and heart failure. These results suggest that the change in payment systems has not increased the use of hospital and emergency services because of inadequacies in the home health services provided. OIG has no recommendations for CMS. In its comments on the draft report, CMS agreed with our findings and agreed that it would be prudent to continue monitoring indicators of quality in home health care. http://www.oig.hhs.gov/oei/reports/oei-01-04-00160.pdf -----------------------------------------------------------------------
10. EUROPEAN COMMISSION REPORT: "The impact of ageing on public expenditure: projections for the EU25 Member States on pensions, health care, long-term care, education and unemployment transfers (2004-2050)," (Special Report No. 1, 2006, .pdf format, 207p.). http://europa.eu.int/comm/economy_finance/publications/european_economy/2006/eespecialreport0106_en.htm Press release: http://europa.eu.int/rapid/pressReleasesAction.do?reference=IP/06/150&format=HTML&aged=0&language=EN&guiLanguage=en -----------------------------------------------------------------------
11. ORGANISATION FOR ECONOMIC COOPERATION AND DEVELOPMENT REPORT, PRESS RELEASE: A. "Live Longer, Work Longer" (February 2006, browsable only .pdf format, 146p.). Pricing information for a print copy is available at the site. http://www.oecd.org/document/42/0,2340,en_2649_37435_36104426_1_1_1_37435,00.html Click on "browse-it" at the bottom of the page for link to .pdf. B. "Study projects growing pressure on public health spending over and above effects of ageing society" (Feb. 9, 2006). http://www.oecd.org/document/12/0,2340,en_2649_37435_36079116_1_1_1_37435,00.html -----------------------------------------------------------------------
13. AUSTRALIAN BUREAU OF STATISTICS REPORT: "Retirement and Retirement Intentions, Australia, Aug 2004 to Jun 2005" (February 2006, Microsoft Excel format). http://www.abs.gov.au/AUSSTATS/abs@.nsf/DetailsPage/6238.0Aug%202004%20to%20Jun%202005?OpenDocument -----------------------------------------------------------------------
14. STATISTICS CANADA/STATISTIQUE CANADA REPORTS: "Health Reports supplement: How healthy are Canadians? Annual report 2005: (February 2006, .pdf format). The supplementary reports: "Seniors' health care use"; "Predictors of death in seniors";" Healthy living among seniors"; "Dependency, chronic conditions and pain in seniors"; and "Successful aging in health care institutions," are linked to from a StatsCan "The Daily" release: "Health Reports: Seniors' health care use" (Feb. 6, 2006). http://www.statcan.ca/Daily/English/060207/d060207a.htm Click on "82-003-SIE" near the bottom of the release, then click on "View". -----------------------------------------------------------------------
15. STATISTICS NEW ZEALAND REPORT: "Older People's Access to Motor Vehicles" (2006, .pdf format, 32p.). http://www.stats.govt.nz/analytical-reports/older-peoples-access-to-motor-vehicles-2006 Link to full text is at the bottom of the page. ----------------------------------------------------------------------- -
17. AARP REPORTS, PRIME TIME RADIO: A. "Long-term Care in Tennessee: A Survey of Registered Voters Age 35+," by Joanne Binette (AARP Research Report, February 2006, .pdf format, 23p.). http://www.aarp.org/research/longtermcare/resources/tn_ltc.html B. "Long-Term Care: A Survey of South Dakota AARP Members," by Susan L. Silberman (AARP Research Report, February 2006, .pdf format, 32p.). http://www.aarp.org/research/longtermcare/resources/sd_ltc_06.html C. "Prescription Drug Affordability: AARP Survey of Hispanic New Yorkers," by Katherine Bridges and Erica L. Dinger (AARP Research Report, January 2006, .pdf format, 15p.). http://www.aarp.org/research/health/drugs/ny_rx_hisp.html
18. EMPLOYEE BENEFIT RESEARCH INSTITUTE ISSUE BRIEF "Retirement Plan Participation and Retirees' Perception of Their Standard of Living," by Craig Copeland, (Issue Brief No. 289, January 2006, .pdf format, 42p.). http://www.ebri.org/publications/ib/index.cfm?fa=ibDisp&content_id=3613 More information about EBRI: http://www.ebri.org/ Click on "ABOUT EBRI". -----------------------------------------------------------------------
19. BOSTON COLLEGE CENTER FOR RETIREMENT RESEARCH ISSUE BRIEF: "Does Working Longer Make People Healthier and Happier?" by Esteban Calvo (WOB #2, February 2006, .pdf format, 9p.). http://www.bc.edu/centers/crr/wob_2.shtml -----------------------------------------------------------------------