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Wednesday
Jul302008

PREGNANCY & CHILDBIRTH | Detroit News Examines Debate Over Certified Professional Midwives' Qualifications

The Detroit News on Tuesday examined the debate between the medical community and home birth advocates over where women should give birth and who is best qualified to perform deliveries. According to CDC's National Center for Health Statistics, about 1% of births annually are performed outside of hospitals.The American Medical Association last month issued a statement that said the "safest setting for labor, delivery and the immediate postpartum period is in the hospital, or a birthing center within a hospital complex." AMA and the American College of Obstetricians and Gynecologists also have said a hospital is the safest place to give birth because medical staff are readily available if complications arise. The groups also have said that physicians and certified nurse midwives, who have formal nursing certification, are the most appropriate professionals to oversee deliveries. Certified nurse-midwives are licensed in all states and most often practice in hospitals or medical centers.However, many home birth advocates have said that formal nursing certification is not necessary for a midwife to oversee home births and that certified professional midwives, who do not have nursing certification, are able to oversee births successfully. About one-half of states license CPMs, although many midwife advocates are calling for universal licensure of CPMs to expand birthing options for women. Many medical groups have said CPMs, who must deliver 40 infants to be certified, do not have enough training to handle complications. Steffany Hedenkamp, communications coordinator for The Big Push for Midwives Campaign, said medical groups' efforts to limit CPMs are "anti-competitive," adding, "With this integration of [CPMs] we see increased access to care." Erin Tracy, an ob-gyn at Massachusetts General Hospital, said the 40 deliveries CPMs are required to oversee is "less than ... interns do in one month," adding, "You need more of a medical background to understand medical complications" (Detroit News, 7/29).
Wednesday
Jul302008

Public funds make up bulk of health outlays: study

Public spending—including safety net insurance, tax exemptions and deductions, and subsidies for medical research and education—made up roughly 56% of U.S. health expenditures, according to an analysis published online in the journal Health Affairs. The estimate, by the Agency for Healthcare Research and Quality economists Thomas Selden and Merrile Sing, shows public spending for those not in long-term care or other institutions was $752.9 billion in 2002, or $2,612 per person, on average.
Of that, the economists said that tax subsidies, which aid middle- and upper-income families to a greater degree than the poor, accounted for $214.8 billion, or nearly 30% of public spending. For those earning at least 400% of the federal poverty threshold, or $21,200 for a family of four, public spending covered 46% of expenditures. That’s compared with 80% for those with incomes that fall below the poverty level. The poor were more likely to receive means-tested public benefits, the authors said. “Clearly, the distribution of overall public spending across income groups depends upon more than just the incidence of means-tested public insurance programs,” the authors wrote.
Public spending for seniors easily outpaced aid for children. On average, seniors received $6,921 in 2002 compared with $1,225 for children. -- by Melanie Evans

Article from Modern Healthcare
Wednesday
Jul302008

Senators reach out to Obama, McCain on reform

All 16 Senate sponsors of the Healthy Americans Act—a broad bill that would effectively end employer-sponsored healthcare in favor of insurance from a pool of providers—have called on the two major-party presidential candidates to work with them on health reform legislation.
“We believe it is vital that we start working now to ensure that all of our people have high-quality care early in the next administration without breaking the bank,” the senators wrote in a letter sent to Sens. Barack Obama (D-Ill.) and John McCain (R-Ariz.). The senators go on to say that a strong, bipartisan coalition “will allow a reform initiative to survive the assaults of politics and interests that afflict any serious reform proposal.”
In May, congressional budget auditors said that the bill, primarily sponsored by Sen. Ron Wyden (D-Ore.), a member of the Senate Finance Committee, and Sen. Robert Bennett (R-Utah), would be “self-financing” or budget-neutral in its first year, eventually yielding a surplus.
As written, the legislation would provide incentives to buy basic private health plans and make health insurance more portable. People with incomes below the federal poverty level could receive subsidies to buy insurance, and states would be given more flexibility to give consumers more choices in insurance available on the private market. -- by Matthew DoBias.

Article from Modern Healthcare
Monday
Jul282008

House Subcommittee Examines Rural Health Care Disparities

Critical telecommunication and work force challenges contribute to greater disparities in access to health care in rural areas, according to panelists at a House Agriculture Subcommittee on Specialty Crops, Rural Development and Foreign Agriculture hearing last week, CQ HealthBeat reports.
Wayne Myers of the Maine Health Access Foundation, representing the National Rural Health Association, said it is "extremely difficult and expensive" to recruit and retain physicians and health care providers in rural areas. Tom Morris, acting associate administrator for HHS' Health Resources and Services Administration's Office of Rural Health Policy, discussed current programs meant to retain doctors in rural communities including the National Health Service Corps -- where more than half of the participants go to practice in rural areas -- and the National Rural Recruitment and Retention Network, which over the past four years has placed about 2,900 clinicians in rural areas.
Subcommittee Chair Mike McIntyre (D-N.C.) said that federal grant and loan programs are essential to improving rural health care. McIntyre said, "With limited dollars available for rural health care programs, we must ensure they are used in ways that address the challenges and with sufficient federal coordination."

read_more: http://www.kaisernetwork.org/daily_reports/rep_index.cfm?DR_ID=53541
Monday
Jul282008

Law Banning Rewards for Rescissions Caps Statewide Effort

Gov. Arnold Schwarzenegger's (R) signature this week on a bill banning health insurers from rewarding their employees for rescinding or limiting coverage comes on the heels of state regulators reaching deals with the state's five major insurers over rescissions.
The governor signed AB 1150 by Assembly member Ted Lieu (D-Torrance) on Tuesday. It is one of several bills aimed at the individual insurance market that lawmakers introduced following state investigations into rescissions, a practice in which insurers revoke policies after people get sick and file claims.
Only people who buy coverage in the individual health insurance market are subject to rescissions; members of group plans cannot have their coverage rescinded. An estimated 14 million Americans, including three million in California, have individual policies.

read_more: http://www.californiahealthline.org/theweekly.aspx?article=legislative&w=07/25/2008