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News Affecting YouHow Not to Handle Health Care Experience overseas shows that governments that pay for prescription drugs tend to involve themselves extensively in both pricing and availability. So, while the EU drug approval process is relatively speedy, individual nations throw up their own hurdles to slow the introduction of new drugs. In a recent study, the University of Pennsylvania's Patricia Danzon found that in regulation-heavy counties like Greece, Belgium and France, new medications don't usually reach patients until nine months after EU approval. Some drugs are delayed longer still. Taxol, a medication used to treat advanced breast cancer and refractory ovarian cancer, was approved for use in Europe in 1995, but it wasn't made available to British cancer patients on the National Health Service for another five years. Not coincidentally, a study by industry analyst Datamonitor finds that the U.K. has lower breast cancer survival rates than the U.S. and much of Europe. Oliver Schoffski, at the University of Erlangen-Nurmeberg, provides the most exhaustive review. In his recent report on European pharmaceuticals, Prof. Schoffski looks at the treatment of twenty illnesses across Europe and incorporates nearly 200 studies of how people were treated. He paints a picture of non-treatment and under-treatment for common diseases such as schizophrenia, heart disease, and asthma. The reasons are complex and not exclusively related to government policies; but he finds the governments - and specifically their funding decisions - are a major source of the woes. In France, for example, 90% of patients with acute asthma do not receive adequate care, while half of all patients who should be receiving continuous basic drug therapy are prescribed medications on an ad hoc basis. One million people in Germany suffer from migraines unnecessarily, and only 5% of German women are treated with up-to-date pharmaceuticals. He finds that 83% of Italian patients who could benefit from statins, such as Lipitor and other lipid-lowering medications that reduce cholesterol and thereby protect against heart disease, don't receive them. European Bureaucrats aren't the only ones to influence the use of medicines. In Ontario, Canada's largest province, the provincial government declined to add any new medications to its drug formulary for a full two years in the late 1990's. Even today, if a Canadian doctor wants to prescribe certain very basic medications - such as the anti-inflammatory Celebrex, or the antibiotic Cipro - they need special approval first (forms and bureaucratic review). Why are all these governments working to keep doctors from prescribing proven and effective medications? It's a matter of money. In Ontario, the state pays more than 40% of prescription drug costs; in Germany, public spending approaches 70%. To bureaucrats eager to keep to their budgets, new drugs are seen only as new expenses - even if thy save lives. The closest parallel Americans have to a governmentally run program today is Medicare. Medicare bureaucrats have been only too happy to involve themselves in the micro-management of expenses. Take physician billing. Medicare doesn't pay doctor the market rates. Instead, the federal government sets its own fee schedule and underpays doctors. Not surprisingly, many physicians hesitate to take new Medicare patients. In places like Denver, it's hard to find a doctor for the elderly; only a third will accept Medicare patients. Hospitals, too, have long complained that Medicare fees are overly stingy. While the American health care system is far from perfect, the medical care is the finest in the world. When Egyptian twins connected at the head are scheduled for separation surgery, they are not checked into a hospital in Germany, Great Britain or France, but in Texas. Modeling the US system after a fatally flawed European one, such as France where over 11,000 elderly died due to a summer heat wave, is absolutely ludicrous. Rate of Obesity has Quadrupled Since 1980's in United States The findings by the RAND Corp show that the number of extremely obese adults has surged twice as fast at the number of less severely obese adults. On the scale of obesity, "as the whole population shifts to the right, the extreme categories grow the fastest," said RAND economist Roland Sturm. "These people have the highest healthcare costs". Health problems associated with obesity include diabetes, heart disease, high blood pressure and arthritis. These effect the extremely obese disproportionately and at younger ages. Furthermore, hospitals are challenged to treat the extremely obese, who may not fit into imaging equipment, on operating tables or in wheel chairs. New Nurse-to-Patient Ratio Law Set for 1 Jan 2003 The laws objective is to make conditions safer for patients in hospitals. According to an American Medical Association study conducted last year, people who have common surgeries in hospitals with poor nurse staffing levels have up to a 31% increased chance of dying. According to a PriceWaterhouseCoopers study, health-care premiums in the U.S. rose 14%, or $67 billion, between 2001 and 2002. One of the key cost drivers was governmental mandates consisting of 15% of the increase or $10 billion. Prilosec OTC Now Available The active ingredient in both Prilosec and Prilosec OTC is omeprazole. Prilosec OTC includes the same dose of omeprazole (20 mg) that millions of patients have taken by prescription for the past 15 years. All other strengths of Prilosec remain non-formulary under Blue Cross of California and BC Life & Health Insurance Company plans, and are subject to Blue Cross Quantity Supply Limits and Prior Authorization of Benefits programs. Health Costs to Slow in 2004 but Continue to Rise The survey, one of the largest to forecast 2004 health care costs, shows a trend of is slowing health care costs. Health care increased in 2003 by 16% and is forecasted in 2004 to increase by 12%. Employers continue to shift increases to employees with a combination of higher premiums, deductibles or copays and benefit changes. Is 2004, employees are expected to contribute an average of 19% of the cost for individual health care, and 22% for dependent coverage, about the same as 2003. Prescription drugs, medical innovation, and increased hospital costs are key drivers in higher premiums. Furthermore, employee expectations of health insurance have drastically changed. According to Blue Cross of California, in 1970 consumers paid 34% of health care costs. In 2000, consumers paid 14% of health care costs indicating we are transitioning to more of a pre-paid health insurance system. The advent of the $0 co-pay for HMO's completely changed individual's expectations of health care and health insurance plans. Length of Hospital Stays Shrinking According to Centers for Disease
Control Health Care Cost Increases
Escalating Regulatory Requirements
More than 20% of new health care spending has been driven by mandates, regulation and litigation (PriceWaterhouseCoopers, April 2002). Rising Pharmaceutical Costs Prescription drugs are increasingly utilized to treat chronic diseases, manage long-term conditions and avoid hospitalization. Pharmacy spending rose 13.8% in 2001 (The Center for Studying Health System Change). It is predicted that between 2001 and 2011, drug spending growth will exceed overall spending by 5% per year (The Centers for Medicare and Medicaid Services). Increased Expenses for Physician Services The number of physicians has increased steadily over the eyars, primarily due to an increase nt he number of specialists. Specialist charges average more than twice those of Primary Care Physicians, and are escalating at an even faster pace. Higher Hospital Costs Hospital spending makes up 37% of total health care cost increases, and rose 16.3% in 2001 (The Center for Studying Health System Change). The rate of increase in hospital services utilization was 8% in 2001 (Health Affairs Web Exclusive, September 2002). MSA's and Long Term Care Insurance and the 2003 Budget Reconciliation
Bill Maternity Parity Act Wellpoint Purchases Golden West Dental and Vision French Hospital and Arroyo Grande Community Hospital reach Blue Cross
Agreement Expansion of Blue Shield's Dental PPO Network New COBRA and CAL-COBRA Rules Effective 1 January 2003 Blue Cross of California Announces Generic Select New HealthyExtensions Vendors and a Tobacco Cessation Program Available on
Blue Cross Web Site Rising Costs of Health Care
Sign up Online for Blue Cross Individual and Family Plans Blue Cross Announces New Short Term Health A New Kardel at Kardel Insurance Services CalPers Selects Blue Shield as its Principal Network-Model
HMO Blue Cross Signs Three Year Contract with Cottage
Hospital Health Net of California Launches Innovative Web-based "Women Matter''
Initiative This document is not intended to be authoritative, and its accuracy is not guaranteed. It is believed to be correct at the time of its printing. Any questions about official interpretations of the law should be directed to legal counsel.
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