Brain’s Mechanisms Governing Exploration Are Among Those That Malfunction In Addiction And Mental Illness

Researchers have found the brain region that controls the decision to halt your midnight exploration of the refrigerator and commence enjoyment of that leftover chicken leg. What’s more, they said, such mechanisms governing exploration are among those that malfunction in addiction and mental illness.

Emmanuel Procyk and colleagues published their findings in the January 24, 2008, issue of the journal Neuron, published by Cell Press.

In their experiments, the researchers presented monkeys with a choice of touch targets on a computer screen, requiring the monkeys to spend time exploring which target would trigger a juice reward. Once the monkeys discovered the reward target, the researchers then gave the animals a period during which they could repeatedly touch the reward target to obtain more juice.

During the trials, the researchers recorded the electrical activity of hundreds of neurons in the anterior cingulate cortex (ACC), a brain region known to be active in adaptive behaviors such as the shift between exploring and exploiting.

In their analysis, the researchers measured the electrophysiological activity of cells during four different types of feedback – incorrect choices, first reward, repetition of the reward, and the ending of a trial by breaking fixation on the targets.

Analyzing the results, the researchers concluded that “Our data show that ACC discriminates between different types of feedback, allowing appropriate behavioral adaptations.”

They wrote that “Thus, the function we attribute to ACC activations is clearly not only to evaluate feedbacks but is also to participate in monitoring the different steps of the task at hand to optimize action adaptation and valuation. A dysfunction of these mechanisms represents the core feature of cognitive alterations observed in addiction and mental illness.”

Wrote Procyk and colleagues, “The ACC produces signals that discriminate between various behaviorally relevant positive and negative feedbacks, suggesting a role in triggering appropriate adaptations. Our data reinforce the proposal that ACC is important for establishing action valuations. But they also emphasize a combined role in monitoring events/actions for behavioral regulation when task control is high, underlining the intimate link between control and action valuation.”

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The researchers include ReneВґ Quilodran, Marie Rothe, and Emmanuel Procyk, of both the Inserm, U846, Stem Cell and Brain Research Institute, Bron, France, and UniversiteВґ de Lyon, Lyon, France.

Source: Cathleen Genova

Cell Press

American Journal Of Lifestyle Medicine Looks At The Health Benefit Of Oats

The first issue of Volume 2 (January/February 2008) explores the results of the “Oats at 10 Years” study, marking the 10th anniversary of the U.S. Food and Drug Administration claim that oats, as part of an overall heart healthy diet, could lower the risk of heart disease. The article, Mark B. Andon, PhD, and James W. Anderson, MD, looks at the history of the first food-specific health claim, theorizing that foods containing whole-oat sources of soluble fiber (oats, oat bran, and oat flour) could reduce the risk of coronary heart disease.

“This is an extremely important study,” said the journal’s Editor, Dr. James M. Rippe, who is also a nationally renowned cardiologist, author, and authority on health, fitness and weight loss. “It tracked the value of oat-based products and showed the correlation between consumption and a healthier lifestyle. It is an outstanding benchmark.”

Launched one year ago, AJLM is a bimonthly journal for practitioners seeking to incorporate lifestyle practices and activities into clinical medicine, emphasizing the interaction between traditional therapies and lifestyle changes. In 2007, AJLM explored cardiovascular disease; stress/anxiety; pain/arthritis; diabetes/metabolic disease, and obesity, and will examine lifestyle interventions in children; metabolic syndrome; women’s health; hypertension; men’s health, and dyslipidemia in 2008.

“I’m extremely proud of this journal,” added Ron Epstein, Director of Controlled Circulation Publications at SAGE. “Our first-year response among practitioners has been phenomenal, and we’re off to an even better start this year, beginning with the ‘Oats at 10 Years’ study.”

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To peruse the “Oats at 10 Years” study results article visit, ajl.sagepub/cgi/reprint/2/1/51.

American Journal of Lifestyle Medicine (AJLM), a bimonthly, peer-reviewed journal, focuses on recognizing and addressing the impact that lifestyle decisions have on health, emphasizing the interaction between traditional therapies and lifestyle modalities to achieve superior outcomes in disease treatment. It also provides information about therapies that minimize the extent to which illness impacts lifestyle. For more information, visit hajlm.sagepub/

SAGE is a leading international publisher of journals, books, and electronic media for academic, educational, and professional markets. Since 1965, SAGE has helped inform and educate a global community of scholars, practitioners, researchers, and students spanning a wide range of subject areas including business, humanities, social sciences, and science, technology and medicine. A privately owned corporation, SAGE has principal offices in Los Angeles, London, New Delhi, and Singapore. www.sagepublications

Source: Andrea Rulfo

SAGE Publications

AMA Urges Governments To Adopt Food Labelling Recommendations, Australia

The AMA urged all Australian governments to act quickly and adopt the key recommendations of the Labelling Logic report.

The Labelling Logic report was prepared by the Independent Review of Food Labelling Law and Policy, which was chaired by Dr Neal Blewett.

AMA President, Dr Andrew Pesce, said that Australia is facing a growing epidemic of chronic disease and obesity.

“It is important that food products are all appropriately labelled so that Australian families have all the relevant information they need to make healthy choices about what they eat,” Dr Pesce said.

“The Labelling Logic report has set out practical achievable goals to help Australians become more knowledgeable about their food and to make better choices.

“Many of the Review’s recommendations reflect positions that the AMA put forward in its submission to the Review, and which we have consistently promoted to governments and the public for many years.”

These recommendations include:

– the Food Standards Australia and New Zealand Act be amended to include a definition of public health that focuses on the importance of the promotion of health and prevention of illness, as well as protecting health;

– mandatory declaration of all trans fatty acids above an agreed threshold be introduced in the nutrition information panel (NIP) if manufactured trans fatty acids have not been phased out of the food supply by January 2013;

– improvements be made to labelling in relation to the presence of potential allergens in foods;

– warnings be placed on alcohol products concerning the harms of alcohol consumption to pregnant women;

– the energy content (eg. calories/kilojoules) of alcohol products be included in labelling;

– the Perceptible Information Principle be used as a guide for labelling presentation to maximise label comprehension among a wide range of consumers; and

– a front-of-pack labelling system be developed, including a traffic-light labelling system, which should be mandatory for products making health claims.

These and other Labelling Logic report recommendations will now be considered by the Australia and New Zealand Food Regulation Ministerial Council.

“The AMA welcomes the report and we will be encouraging all governments to bring in new labelling laws,” Dr Pesce said.

“We will also support Parliamentary Secretary for Health and Ageing, Catherine King, in encouraging all States and Territories to adopt and act on the Review’s recommendations.”

Source:

Australian Medical Association

AAP Recommendations On Limiting Sun Exposure In Children And Supporting Legislation To Prohibit Salon Tanning By Minors

Numerous public health campaigns encourage people to protect themselves from the risk of developing skin cancer, but people of all ages continue to overexpose themselves to harmful ultraviolet radiation (UVR) from the sun. Teenagers and young adults are also exposed to UVR in tanning salons. Rates of skin cancer – including melanoma, the most serious form of skin cancer – continue to rise, even in young people. A new American Academy of Pediatrics (AAP) policy statement and corresponding technical report, “Ultraviolet Radiation: a Hazard to Children and Adolescents,” published in the March 2011 print issue of Pediatrics (published online Feb. 28), offer guidance to parents and pediatricians on skin cancer prevention and safe sun exposure practices.

Lifelong sun protection is recommended starting at an early age. Education about UVR exposure is important for all children, especially those at high risk for developing skin cancer: children with light skin and eyes, who freckle or sunburn easily, or have a family history of melanoma. Pediatricians should advise children, parents and teens about the dangers of UVR exposure. Recommendations include wearing proper clothing and hats, timing outdoor activities to minimize peak midday sun (10 am-4 pm) when possible, applying sunscreen, and wearing sunglasses. Infants younger than 6 months should be kept out of direct sunlight and protected with clothing and hats.

The use of tanning salons is a common practice among teenagers, especially females. In a national survey, 24 percent of non-Hispanic white teenagers 13 to 19 years of age used a tanning facility at least once. The intensity of UVR radiation produced by some tanning units can be 10 to 15 times higher than the midday sun. Along with the World Health Organization, the American Medical Association, and the American Academy of Dermatology, the AAP supports legislation prohibiting access to tanning salons or use of artificial tanning devices by children under the age of 18.

Source:

American Academy of Pediatrics

2008 May Is Mental Health Month: Stressed “Sandwich Generation” Mothers Must Care For Themselves

Today’s mother often juggles full-time employment, household chores and parenting, but a growing number of women are taking on yet another responsibility-caring for an aging loved one. Next week, as Americans observe both Mother’s Day and Mental Health Month, Mental Health America encourages mothers to take the Mental Health Connection Challenge by building their social support networks to help cope with the stress of their demanding lives.

Of the 22 million Americans caring for both children and parents or older relatives, nearly two-thirds are women. In a survey of “Sandwich Generation” mothers conducted by the National Association of Social Workers (NASW) and the New York Academy of Medicine (NYAM), only 20 percent said they were “very happy,” and almost 1 in 5 said it was directly due to the stress of caring for both parents and children.

While the demands of modern motherhood may seem overwhelming, it’s important for these women to protect their own health. Mental Health America suggests five tips to help them cope:

- Get Connected with family and friends. Having fun, laughing and focusing on things other than your responsibilities helps you keep your emotional balance and makes you a much better caregiver.

- Use community resources, such as adult day services, meal or shopping services, and caregiver support groups to help lighten your workload.

- Talk to your supervisor at work about your caregiving responsibilities, so he or she knows what difficulties you may experience. Ask your human resources department for information on the Family and Medical Leave Act, which allows up to 12 weeks a year unpaid leave for family caregivers who meet certain requirements.

- Ask for help when you need it. There will be times when you can’t do everything that needs to be done, so call on friends and family members for help with different tasks.

- Do not drink excessively or use drugs to cope with the stress. If the feelings continue, talk to a trusted friend, relative, clergy or health professional.

“If someone feels overwhelmed, unable to cope and the stress is affecting how they function every day, it could be something more,” David Shern, Ph.D., president & CEO of Mental Health America said. “They can’t let those feelings go unchecked.”

Mental Health America urges all mothers to take time this Mother’s Day to consider these symptoms:

- Feeling angry, irritable or easily frustrated
- Feeling overwhelmed
- Change in eating habits
- Problems concentrating
- Feeling nervous or anxious
- Trouble sleeping
- Problems with memory
- Feeling burned out from work
- Feeling that you can’t overcome difficulties in your life
- Having trouble functioning in your job or personal life

Mental Health America founded “May is Mental Health Month” 50 years ago to raise awareness about mental health conditions and the importance of mental health for all. This year’s theme — “Get Connected” — is focused on the important role social connectedness plays in maintaining and protecting mental health and wellness.

For more information on Mental Health Month, including tips for how to “Get Connected,” please visit: mentalhealthamerica/go/may.

Mental Health America is the country’s leading nonprofit dedicated to helping ALL people live mentally healthier lives. With our more than 320 affiliates nationwide, we represent a growing movement of Americans who promote mental wellness for the health and well-being of the nation – everyday and in times of crisis.

Mental Health America

CMS Begins Third Annual Medicare Provider Satisfaction Survey , USA

The Centers for Medicare & Medicaid Services (CMS) announced it has begun its third annual provider satisfaction survey of Medicare fee-for-service contractors who process and pay more than $280 billion in Medicare claims each year.

The Medicare Contractor Provider Satisfaction Survey (MCPSS) offers providers the opportunity to contribute directly to CMS’ understanding of contractor performance as well as aid future process improvement efforts at the contractor level. Specifically, the survey is used by CMS as an additional measure to evaluate contractor performance. In fact, all Medicare Administrative Contractors (MACs) will be required to achieve performance targets on the MCPSS as part of their contract requirements by 2009.

“CMS and the Medicare contractor community are committed to high quality relationships with the provider community,” CMS Acting Administrator Kerry Weems said. “The MCPSS provides contractors with greater insight into their provider communities, and allows them to make process improvements based on provider feedback.”

The MCPSS is designed to gather quantifiable data on provider satisfaction levels with the key services that comprise the provider-contractor relationship. The survey focuses on seven major parts of the relationship – provider inquiries, provider outreach and education, claims processing, appeals, provider enrollment, medical review, and provider audit and reimbursement.

Respondents are asked to rate their experience working with contractors using a scale of 1 to 6 with “1″ representing “not at all satisfied” and “6″ representing “completely satisfied.” The results of the second MCPSS — which are available to health care providers and contractors on Medicare’s public website — showed that 85 percent of respondents rated their contractors between 4 and 6.

The 2007 MCPSS results indicate that the provider inquiry function has the greatest influence on whether providers are satisfied with their contractors. This indicated a shift from 2006, when the claims processing function was the strongest predictor of a provider’s overall satisfaction.

“The shift from claims processing to provider inquiries as the top predictor of satisfaction is a perfect example of the type of trend data the MCPSS will reveal,” Weems said. “Contractors are able to factor this insight into how they prioritize their provider-focused efforts.”

CMS is sending the 2008 survey to about 35,000 randomly selected providers, including physicians and other health care practitioners, suppliers and institutional

facilities that serve Medicare beneficiaries across the country. Those providers selected to participate in the survey will be notified by December 2007. The survey is designed so that

it can be completed in about 15 minutes. Providers can submit their responses via a secure website, mail, fax or over the telephone. CMS is urging all Medicare providers selected to participate in the survey to complete and return their surveys upon receipt.

CMS plans to make the survey results publicly available in July 2008. Further information about the MCPSS is available here.

Centers for Medicare & Medicaid Services

BMA report calls for action as low numbers of state school students enter medical school, UK

The extra funding English medical schools will receive from top-up fees should be used to widen access to the profession, the BMA says today (Thursday 22 September, 2005) as new figures show that the proportion of medical students from state schools is far lower than the national average.

Figures published by the Higher Education Statistics Agency today show that little over two thirds (67.3%) of UK entrants to degrees in medicine, dentistry and veterinary science in 2003 came from state schools. This is lower than the proportion on any other group of courses, and contrasts with the average of 86.8% for all subjects.*

The call to tackle the imbalance comes as part of Medicine in the 21st Century, the BMA Medical Students Committee’s new manifesto for undergraduate medical education, published today (Thursday 22 September, 2005). It argues that medical schools, which are all expected to charge students in England the full Ј3000 a year to study medicine, should invest the extra money to improve the quality of teaching and resources, and on outreach schemes to encourage applications from students who might not traditionally consider a career in medicine.

Commenting on Medicine in the 21st Century, Kirsty Lloyd, chair of the BMA’s Medical Students committee, said: “The domination of the medical profession by the highest socioeconomic groups has to be tackled. The debt burden on medical students in the UK is going to discourage those from the poorest backgrounds from becoming doctors, and there’s a risk that the good work the government has done to widen access could be undone. Government policies on access to medical school must be fair and equitable, and must encourage diversity.”

Medicine in the 21st Century also calls for:

· NHS bursaries – currently available to medical students in their fifth and sixth years – to be extended to all years

· Tuition fee bursary schemes to be available to mature and graduate medical students

· Medical schools to audit their selection procedures to ensure no discrimination is taking place

The report was authored by Jonathan Beavers, a medical student at the University of Edinburgh, Leigh Bissett at the University of East Anglia, David Burke at the University of Nottingham, and Emily Rigby at the University of Bristol.

View Medicine in the 21st Century at: bma/ap.nsf/content/m21c

*Figures from the HESA are available at: hesa.ac/pi/0304/sp4_0304.xls

bma

Adolescents Who Play Sports Have Better Eating Habits

Adolescents who play sports have better eating habits and nutrient intake than those who do not, according to researchers at the University of Minnesota.

Eating habits and nutrient intake are two important factors that contribute to performance in sports. The need for adequate energy and nutrients is especially important for adolescents, since their total nutrient needs are higher than during any other time in their lives, and participating in sports can increase energy and nutrient requirements even more.

More than 4,700 junior high and high school students were studied for their meal and snack frequency, energy and nutrient intake and physical activity. The researchers found “sport-involved youth generally ate breakfast more frequently and had higher mean protein, calcium, iron and zinc intakes than their non-sport involved peers.”

According to the researchers, “These findings, like others, support a positive association between adolescent sport participation and health.”

The Journal of the American Dietetic Association is the official research publication of the American Dietetic Association and is the premier peer-reviewed journal in the field of nutrition and dietetics.

With approximately 65,000 members, the American Dietetic Association is the nation’s largest organization of food and nutrition professionals. The Chicago-based ADA serves the public by promoting optimal nutrition, health and well-being.

To locate a registered dietitian in your area, visit ADA at eatright.

Benefits Of Minimally Invasive Removal For Tumors Quantified By UC Researchers

A minimally invasive endoscopic procedure holds promise for safely removing large brain tumors from an area at the bottom of the skull, near the sinus cavities, clinical researchers at the Brain Tumor Center at the University of Cincinnati Neuroscience Institute (UCNI) at University Hospital have found.

The findings, to be published in the April 2010 issue of the Journal of Neurosurgery and previously published online in October 2009, have important implications for patients with large pituitary tumors (pituitary macroadenomas).

“This is the first time that a quantitative advantage has been shown for the use of endoscopy in cranial surgery,” says Philip Theodosopoulos, MD, principal investigator of the study, director of skull base surgery at UC and a neurosurgeon with the Mayfield Clinic.

“This signals the dawn of a new era in minimally invasive cranial surgery. We have moved from the realm of assessing whether it is feasible to studying its clinical effectiveness. In this way, it is slowly starting to change from a novelty to standard treatment, setting the bar for the quality of surgical outcomes higher than ever before.”

Although tumors of the pituitary gland, located near the base of the skull, are benign, pituitary macroadenomas can wreak havoc, causing acromegaly (an overproduction of growth hormone), Cushing disease (an overproduction of the hormone cortisol) and hyperthyroidism, as well as visual problems, headaches and dizziness.

When removing pituitary macroadenomas (tumors that are larger than 10 millimeters), surgeons have employed three distinct routes to the tumor:
Through the skull, in a procedure called a craniotomy.

Through an incision under the upper lip and then through the septum, which must be split apart.

Through the nostrils — a transnasal approach — without an incision.

The endoscopic transsphenoidal approach, Theodosopoulos says, follows natural anatomical corridors and causes less disruption of nasal tissues. This approach, as the new study reveals, also holds benefits related to complete tumor removal, which is important for the patient’s quality of life.

Removing an entire pituitary macroadenoma can be difficult because the tumor’s growth pattern can cause it to extend through the sinus corridor, which is out of the surgeon’s view.

Surgeons can ensure that the entire tumor has been removed if their hospital operating room is equipped with a technology known as intraoperative MRI, or ioMRI. The surgery-prolonging technology enables surgeons to take MRI scans while the patient is still under anesthesia and on the operating table. The UC Neuroscience Institute at University Hospital has had ioMRI since 1999, but the expensive technology is not available at most hospitals.

An endoscopic approach, by contrast, allows the surgeon to check for remaining tumor with “intrasellar endoscopy.” Using a tiny, sophisticated camera on an angled endoscope, the surgeon can peer around bends and into crevasses to identify any remaining tumor. “The endoscopic approach holds the potential for less invasive treatment for all patients and more complete tumor resections for individuals treated in hospitals without access to intraoperative MRI,” Theodosopoulos says.

During the retrospective study at University Hospital, the team analyzed surgical outcomes of 27 consecutive patients between 2005 and 2007 who had undergone endoscopic removal of pituitary macroadenomas. The search for unexpected residual tumor was conducted two ways in all patients: first with the tiny endoscopic camera (intrasellar endoscopy) and then with intraoperative MRI.

Following the initial endoscopic tumor removal, intrasellar endoscopy revealed that 23 of the 27 patients (85 percent) had no unexpected residual tumor. Surgeons were able to safely perform additional surgery on three of the four patients who had unacceptable residual tumor.

Following the endoscopic procedures, all patients were checked with intraoperative MRI, which revealed that tumor removal was successful in 26 patients (96 percent).

The study results show that maximum tumor removal can be successfully achieved with endoscopy and without intraoperative MRI, Theodosopoulos says. He adds, however, that the findings could be strengthened by a larger study.

Additional study participants included John Tew, MD (Mayfield Clinic, UC Department of Neurosurgery and UCNI), Lee Zimmer, MD (UC Department of Otolaryngology and UCNI), James Leach, MD (Cincinnati Children’s Hospital Medical Center and UCNI), Bharat Guthikonda, MD (UC Department of Neurosurgery) and Amanda Denny, MD (UC Department of Endocrinology). Also participating was Sebastien Froelich, MD (Department of Neurosurgery, University of Strasbourg, France).

Source:
Cindy Starr

University of Cincinnati Academic Health Center

Bills Would Require Prompt Payment Of Pharmacists’ Medicare Rx Benefit Claims

Senate Republicans and Democrats have introduced separate bills that would require Medicare prescription drug plans to reimburse pharmacists’ claims within specified timeframes, CQ HealthBeat reports. One bill (S 2563) — by Republican Sens. Thad Cochran (R-Miss.), Michael Enzi (R-Wyo.) and Jim Talent (R-Mo.) — would require pharmacists to be reimbursed within 14 days of filing electronic claims and within 30 days of filing paper claims. Under the second bill (S 2551), by Democrats Sens. Robert Menendez (D-N.J.) and Frank Lautenberg (D-N.J.), all prescription drug plan providers would be required to reimburse pharmacists, physicians and hospitals within 14 days of an electronic claim being filed and within 30 days of a paper claim being filed. The bills follow complaints from many pharmacists that they are losing money under the Medicare drug benefit because of slow payments from pharmacy benefits managers and other payers. Some pharmacists allege that pharmacy benefit managers are intentionally delaying payments or offering low reimbursements to increase profits, CQ HealthBeat reports.

Comments
Menendez said, “A federal prompt pay law is critical to ensuring that our pharmacies and health care providers maintain adequate cash flows to continue functioning.” Mike James, vice president of the Association of Community Pharmacists Congressional Network, said the Republican bill addresses “the urgent need to protect the world’s best drug delivery system by ensuring PBMs reimburse pharmacies in a timely manner.” However, Phil Blando, a spokesperson for the Pharmaceutical Care Management Association, said the legislation is “premature,” adding, “We’re troubled that less than 100 days into this program policymakers are already trying to open it up and rewrite the rules that govern the program.” Blando said PBMs currently are paying routine claims within 15 to 30 days. HHS Secretary Mike Leavitt said his agency has sufficient authority to address the reimbursement delays without legislation. Leavitt said HHS will take steps to ensure that plans pay reimbursements within the timeframes specified in their contracts. “[T]he plans need to meet their contracts,” he said (Carey, CQ HealthBeat, 4/7).

Copayments
In related news, the New York Times on Saturday published two articles examining how the drug benefit is affecting access to medications for cancer patients. Summaries appear below.
“Drug Plans’ Side Effect Is Severe”: The article examines how some beneficiaries have been unable to obtain certain cancer medications under the drug benefit because they cannot afford to pay for the treatments in the so-called “doughnut hole” coverage gap. Under the doughnut hole provision of the 2003 Medicare law, beneficiaries are responsible for all annual drug costs between $2,250 and $5,100. Before the drug benefit began, many beneficiaries without prescription drug coverage were able to obtain the medications at no cost from the drugs’ manufacturers or through other assistance programs. However, some pharmaceutical companies ended assistance programs for beneficiaries once the drug benefit began. Because of the high cost of the oral cancer treatments, beneficiaries taking the drugs reach the doughnut hole more quickly than others and “often must meet their entire annual co-payment requirement when they fill their first two prescriptions,” the Times reports. The problem mostly affects beneficiaries prescribed medications that are taken orally in pill form and cost up to $4,000 monthly, including Gleevec, a stomach cancer treatment; Thalomid, a multiple myeloma treatment; and Tarceva, a lung cancer treatment (Berenson [1], New York Times, 4/8).

“In Drug-Aid Foundations, a Web of Corporate Interests”: The article examines the role of the pharmaceutical industry in funding foundations that help patients make copayments for high-cost prescription drugs. The foundations have been “busier than ever” since the Medicare drug benefit began as many beneficiaries face high copays under the doughnut hole provision, the Times reports. The article looks at the HealthWell Foundation, which was founded by for-profit health care consulting company Covance and receives most of its funding from pharmaceutical companies. According to the Times, critics of HealthWell and similar foundations claim “they are little more than ways for drug makers to sustain their high prices by funneling patients enough money to meet their copayments, while letting insurers pick up most of the bill.” HealthWell President Stephen Weiner said the foundation is trying to diversify its funding sources to include donors other than pharmaceutical companies (Berenson [2], New York Times, 4/8).

‘Success Stories’
AP/Long Island Newsday on Sunday examined how congressional supporters of the drug benefit are “stress[ing]” the benefits of the program amid concerns that “problems that marked its beginnings have drowned out success stories.” According to Medicare Rx Education Network, about three-fourths of enrolled beneficiaries say they are satisfied with the drug benefit after they enroll. The article profiles beneficiaries who had difficulties with the enrollment process but now are saving money under the program (Freking, AP/Long Island Newsday, 4/9). Meanwhile, House Republicans have scheduled dozens of meetings and workshops during the two-week congressional recess to encourage their constituents to enroll in the drug benefit and counter “continuing attacks on the program from Democrats and others,” the Washington Times reports. House Republicans have 200 events scheduled, and more are likely to be added, the Times reports (Fagan, Washington Times, 4/9).

Letter to the Editor
“A one-time delay” of the May deadline for enrolling in the drug benefit “is a sensible solution” for increasing enrollment, “given the confusion in this beginning period,” Reps. Pete Stark (D-Calif.) and Jan Schakowsky (D-Ill.) and Sen. Bill Nelson (D-Fla.) write in a letter to the editor of the New York Times. Responding to a Times editorial published on April 3, the lawmakers say they “disagree” with assertions that “the 16 million elderly and people with disabilities on Medicare who haven’t signed up for a Part D plan are ‘dawdling’ or that the deadline is a ‘useful prod’ to assure enrollment.” In calling for the deadline to be extended until the end of the year, the lawmakers write, “We don’t believe that America’s elderly and people with disabilities should be forced to pay a lifetime of higher premiums or be rushed into making an uninformed choice” (Stark et al., New York Times, 4/9).

“Reprinted with permission from kaisernetwork. You can view the entire Kaiser Daily Health Policy Report, search the archives, or sign up for email delivery at kaisernetwork/dailyreports/healthpolicy. The Kaiser Daily Health Policy Report is published for kaisernetwork, a free service of The Henry J. Kaiser Family Foundation . © 2005 Advisory Board Company and Kaiser Family Foundation. All rights reserved.

View drug information on Gleevec; Tarceva; Thalomid.