Here are some questions and answers about how the reforms will affect the Medicare healthcare program for the elderly.

WILL THE LEGISLATION CUT MEDICARE BENEFITS?

There are no cuts to the traditional Medicare benefit. The lion’s share of spending cuts are in Medicare Advantage — a program that uses private firms such as Humana and UnitedHealth Group to deliver Medicare benefits. Many of these providers offer extra coverage and some of those extras could be dropped as Medicare Advantage subsidies are bought more in line with the cost of traditional Medicare benefits. Medicare Advantage payment rates will be frozen in 2011 and then gradually reduced giving companies time to adjust to the changes.

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Q+A: How does healthcare overhaul affect Medicare? | Reuters.

The bill that the House passed on a 220-211 vote yesterday expands coverage to 32 million uninsured Americans, according to Congressional number crunchers. That means more sales for Pfizer Inc., the world’s largest drugmaker, UnitedHealth Group Inc., the largest health insurer, as well as a cluster of companies led by Amerigroup Corp. that specialize in managing service though Medicaid, a program that will grow in the remake.

The revamp will cost $940 billion over 10 years, with industry fees and taxes helping defray the cost of adding to the ranks of customers who can afford to pay their doctors, drugstores and hospitals. Because the legislation creates pressure to curb medical costs, companies may merge as a way to lower expenses, said Paul H. Keckley, executive director of the Deloitte Center for Health Solutions, a Washington-based research firm.

“You have some that are able to manage more efficiently and strategically and some that can’t,” Keckley said by telephone March 19. “You’ll see an acceleration of acquisitions.”

TO CONTINUE READING THIS ARTICLE, CLICK THIS LINK TO BUSINESS WEEK:

Health-Care Overhaul Adds Millions of Drug, Insurer Customers – BusinessWeek.

The closing of an unusual gap in Medicare drug coverage — a gap that Republicans had, when they controlled Capitol Hill and the White House, insisted was needed for the government to be able to afford the program — would “forever end this indefensible injustice for American’s seniors,” Senate Majority Leader Harry M. Reid (D-Nev.) said in announcing that the Senate would join the House in supporting the change.

But details of the change underscore that, for patients and the federal budget alike, the implications of the sprawling health-care bills pushed through by congressional Democrats are more nuanced than lawmakers’ talking points.

The Democrats and President Obama have been clear that the “doughnut hole,” as the gap is known, would disappear gradually over the next 10 years. They have not mentioned that Medicare patients would, according to House figures, face a slightly larger hole in coverage during two of the next three years than they do today.

Proponents say the government can afford to eliminate the gap because the pharmaceutical industry would pay for the phaseout. But less than half of the $80 billion that drugmakers agreed to provide, under a health-care reform agreement over the summer with Senate Democrats and the White House, would be used to help fill the gap, according to Senate Democratic aides. Moreover, there are no budget forecasts far enough into the future to show how much the expanded drug benefit would cost the government once the gap is fully closed.

The not-so-sweet side of closing ‘doughnut hole’ – washingtonpost.com.

On Tuesday, the matter came to the Senate floor — and President Obama forgot the “no, thanks” part. Siding with the pharmaceutical lobby, the administration successfully fought against the very idea Obama had championed.

“It’s got to be a little awkward,” said Sen. Tom Carper (D-Del.).

It’s even more awkward for millions of Americans who are forced to pay up to 10 times the prices Canadians and Europeans pay for identical medication, often produced in the same facilities by the same manufacturers, simply because the U.S. government refuses to rein in drug prices.

Those favoring cheaper prescriptions amassed an impressive ideological coalition, from socialist Sen. Bernie Sanders (I-Vt.) to conservative Sen. David Vitter (R-La.). But they were no match for industry-friendly senators backed by the administration, who on Tuesday night easily voted down “reimportation,” as it is called.

No surprise here: Lawmakers, and the White House, are addicted to drug money. The industry has pumped upwards of $130 million into federal elections over the past decade and is now among the top 10 donors, according to the Center for Responsive Politics. At the same time, the White House needed the industry to spend its millions of dollars in advertising money on support of the health-care legislation, not against it.

FOR CONTINUATION OF THIS ARTICLE, CLICK THIS LINK FOR THE WASHINGTON POST:   President Obama writes a new health reform prescription – washingtonpost.com.

About 91 million doses of seasonal flu vaccine have also been shipped, and manufacturers expect to ship a record 114 million doses before the season is over, she said.

Widespread influenza activity is being seen in 48 states “and virtually everything is H1N1,” she noted. Influenza-like illnesses last week accounted for 7.7% of visits to doctors’ offices last week, down slightly from 8% the week before. “That’s way higher than we would normally see at this time of year.”

More than half of the hospitalizations continue to be in people under are 25, and 90% of the deaths are in people under 65, she said. In a typical flu season, the vast majority of deaths are in those over 65. There have now been 129 pediatric deaths from laboratory-confirmed swine flu, an increase of 15 since last week. There have been others who have died from flu but typing wasn’t done, Schuchat said. About two-thirds of the children had underlying conditions that increased their risk — particularly severe neurological problems such as cerebral palsy and muscular dystrophy, and asthma.

FOR CONTINUATION OF THIS STORY, CLICK THIS LINK FOR THE LOS ANGELES TIMES: Booster Shots | flu | Los Angeles Times.

The organization suggested the situation could worsen if the rate of premature births increases.

Each year, 12.9 million infants — or nearly 10 percent of the annual worldwide birth total — are born before 37 weeks of development in the womb, the organization said. More than 85 percent of the premature births occur in developing countries in Africa and Asia.

“Premature births are an enormous global problem that is exacting a huge toll emotionally, physically and financially on families, medical systems and economies,” March of Dimes President Jennifer Howse said in a statement. “In the United States alone, the annual cost of caring for preterm babies and their associated health problems tops $26 billion.”

The March of Dimes report, which used data collected by the World Health Organization, breaks down premature birth rates by continent.

The highest premature birth rate is in Africa, where 11.9 percent of births each year are preterm, with more than 4 million premature deliveries annually. In populous Asia, although the preterm birth rate is lower at 9.1 percent, the number of premature births is higher, at nearly 7 million a year.

While North America — consisting of the United States and Canada in this report — counts fewer than 500,000 premature births a year, its preterm birth rate is close to that of Africa, at 10.6 percent of all births, according to the report. The rate is the world’s second highest.

In the United States, the rate of preterm births has increased 36 percent in the past 25 years, with births between the 34th and 36th week of gestation accounting for the majority of the increase, the organization found. Much of the hike in preterm births is linked to more pregnancies after the age of 35 and the use of fertility treatments that can lead to multiple births.

“Wherever trend data are available, rates of preterm birth are increasing,” the report said.

Infants who survive premature birth face lifelong health risks, including the possible development of cerebral palsy, blindness, hearing loss, learning disabilities and other chronic conditions, according to the March of Dimes.

“Preterm birth is a global problem that needs greater attention by policymakers, researchers, health care providers, the media, donor organizations and other stakeholders,” the report said.

“The marked disparities in preterm birth along racial/ethnic lines in many high-income countries and the concentration of preterm births in Africa and Asia also clearly indicate that addressing preterm birth is essential for reducing the pronounced inequities in neonatal health and for the world to achieve,” it added.

FOR THE CONTINUATION OF THIS STORY, CLICK THIS LINK FOR CNN.COM: Report: More than 1M preemies die in first month annually – CNN.com.

In an article published Friday in the medical journal Lancet, the researchers write that the process of aging may be “modifiable.”

James Vaupel of the Max Planck Institute in Germany and colleagues in Denmark examined studies published globally in 2004-2005 on numerous issues related to aging. They found life expectancy is increasing steadily in most countries, even beyond the limits of what scientists first thought possible. In Japan, for instance, which has the world’s longest life expectancy, more than half of the country’s 80-year-old women are expected to live to 90.

“Improvements in health care are leading to ever slowing rates of aging, challenging the idea that there is a fixed ceiling to human longevity,” said David Gems, an aging expert at University College London. Gems was not connected to the research, and is studying drugs that can lengthen the life span of mice, which may one day have applications for people.

“Laboratory studies of mice, including our own, demonstrate that if you slow aging even just a little, it has a strong protective effect,” he said. “A pill that slowed aging could provide protection against the whole gamut of aging-related diseases.”

While illnesses affecting the elderly like heart disease, cancer and diabetes are rising, advances in medical treatment are also making it possible for them to remain active for longer. The obesity epidemic, however, may complicate matters. Extra weight makes people more susceptible to diseases and may increase their risk of dying.

In the U.S., data from 1982 to 2000 showed a major drop in illness and disability among the elderly, though that has now begun to reverse, probably linked to the rise in obesity.

The graying population will slowly radically transform society, and retirement ages may soon be pushed back, said Richard Suzman, an aging expert at the U.S. National Institute on Aging.

FOR CONTINUATION OF THIS STORY, CLICK THIS LINK FOR USATODAY: Most babies born this century will live to 100 – USATODAY.com.

Nearing the end of a 13-hour opening day of work on Baucus’s bill to overhaul the nation’s health-care system, several committee members pressed Tuesday night for an amendment extracting larger company rebates on medications the government purchases for low-income senior citizens.

The proposal jeopardizes an agreement that Baucus and the Obama White House struck to limit the drug industry’s exposure over the next 10 years to $80 billion. Proponents said it would produce an additional $86 billion in revenue for federal coffers, money that could be dedicated to expanding the health bill in other areas. The money also would help efforts by the chief sponsor of the drug company amendment, Sen. Bill Nelson (D-Fla.), to reduce cuts to the Medicare Advantage private insurance program, which is popular with seniors in his state.

“This is a metaphor for where this bill is headed,” said Sen. Charles E. Schumer (D-N.Y.), who supports the amendment and described it as a measure of “whose side you are on.”

The lone committee Democrat to speak against the amendment was Sen. Thomas R. Carper (D-Del.), who said it “doesn’t seem fair” to renege on an agreement struck many months ago. The pharmaceutical giant AstraZeneca is one of the top 10 employers in Carper’s home state.

Baucus, who remained silent during the drug debate, postponed a vote on the amendment at least until Wednesday.

The debate capped a day that opened with battle lines clearly drawn. Democrats and Republicans both found plenty to criticize in the legislation, particularly its requirement that all U.S. citizens and legal residents must buy health insurance at potentially high costs.

FOR CONTINUATION OF THIS STORY, CLICK THIS LINK FOR THE WASHINGTON POST: Democrats Question Baucus’s $80B Deal With Drug Makers – washingtonpost.com.

The newest calculations show the nation won’t have the long-promised 120 million doses ready to dispense by Oct. 15, but just 45 million instead. It appears to be more of a delay than a shortage: More are expected to arrive rapidly, about 20 million doses shipped every week, according to the latest estimates by the Department of Health and Human Services.

“Hopefully there are ways to bring that number up,” Dr. Robin Robinson, the department’s chief of vaccine procurement, said Tuesday.

“We’re trying to bring on more manufacturing” for the final packaging step, he said, such as having companies that finish first share their facilities with stragglers.

Swine flu vaccinations still are planned for mid-October, and Robinson noted that 45 million doses means a lot of people inoculated. Add in the weekly deliveries, and there should be 85 million doses on hand by October’s end, and the full 195 million the government has ordered by December, the long-set date for final delivery.

But he acknowledged that if there are early outbreaks in September and October, there could be higher-than-anticipated demand for the swine flu vaccine.

“As we’ve all along said, if things can go wrong they will,” Robinson said.

Manufacturers around the world revealed in July that they were having serious problems brewing vaccine. The chief ingredient is grown in eggs, and companies were getting far fewer doses per egg than they usually do for regular winter flu vaccine.

Health authorities have delivered new “seed strains” of the virus to manufacturers to help with that problem, Robinson said.

In addition to the packaging logjam, other factors are adding to the delay, including:

• One manufacturer, Sanofi-Pasteur, took longer than expected to finish brewing the regular winter flu vaccine, delaying the swine flu work, Robinson said. “We knew there were problems,” but only recently the extent of them, he said.

• Another supplier, Australia’s CSL, recently notified the U.S. that its shipments would arrive later than promised because it first must provide batches to its home country, where the flu season is winding down. Although the U.S. signed a contract with CSL first, “there was always the possibility they could do that,” Robinson said. “Our laws can do the same thing. We don’t, but we could.”

• And it took health authorities longer than anticipated to develop the tests, called reagents, required to ensure doses are at the proper strength before they’re cleared for use.