FEDERAL HEALTH UPDATE
October 24, 2008Produced by Kate Connelly Theroux in collaboration with the Institute of Federal Health Care (IFHC) To subscribe, please visit http://fedhealthinst.org/subscriber.cfm. Sponsored by
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Congressional Schedule
Medicare Part A covers inpatient care in hospitals and skilled nursing facilities. It also covers hospice and some home health care. Medicare Part B is medical insurance. It helps cover outpatient and physician services as well as some physical and occupational therapies and home health care. The Medicare Part B monthly premium is currently $96.40 and will remain the same for 2009. Individual premiums could be higher, based on income. When Medicare coverage is effective, it becomes the primary insurance, while TRICARE becomes the secondary. Beneficiaries who take appropriate steps to maintain their TRICARE eligibility will often have no out-of-pocket expenses for health care services covered by Medicare and TRICARE. Generally, beneficiaries who receive social security disability benefits begin receiving Medicare benefits after two years and they may choose between options such as TRICARE Prime or TRICARE for Life. Most will need to have Medicare Part B, although there are some exceptions. Factors beneficiaries must take into consideration before making a decision when it comes to Medicare and TRICARE include: whether their spouse is on active duty; if they are disabled due to injuries while serving on active duty; if they have other health insurance; or if they are enrolled in the Uniformed Services Family Health Plan or TRICARE Reserve Select. Other factors may also apply, but help is available to understand the complexities of this benefit. Detailed information on how Medicare and TRICARE work together for eligible beneficiaries under 65 is available through the TRICARE Web site at http://www.tricare.mil/medicare, where users can also download a new “Using TRICARE and Medicare” flyer. Additional resources for Medicare, TRICARE and Social Security information: FAQs at http://www.tricare.mil/faqs/ (select the TRICARE For Life category); visit http://www.medicare.gov or call 1-800-633-4227; visit http://www.ssa.gov or call 1-800-772-1213; or contact Wisconsin Physicians Service at 1-866-773-0404.
Gate addressed an audience of wounded warriors, families of wounded and fallen troops and representatives of family support programs and veteran service organizations and pledged that “Other than winning the wars we are in, my highest priority is providing the best possible care for those who are wounded in combat.” He also promised that he and his team will do everything possible to set up the next leadership team for success and ensure that work continues without interruption. Gates praised the “grit and resilience” of wounded warriors and acknowledged the families of the severely wounded and fallen who “have sacrificed and suffered for our country in the most challenging ways.” He also extended thanks to volunteer groups and individuals who have worked on behalf of the troops and their families. Gates cited broad strides in treating wounded warriors, including warrior transition units created to help wounded service members navigate the system as they get treatment and return to their units or transition to veteran status. During the last 19 months, the Army has dedicated more than 3,200 permanent cadre and staff to this effort to help nearly 8,500 soldiers. In addition, Gates described efforts to merge the Defense Department’s and Department of Veterans Affairs’ disability evaluation systems so one process will result in one legally binding determination. He noted that a pilot program is under way and that early indications show the effort will cut by half the time required for veterans to receive full VA compensation. Gates mentioned the progress in providing care for traumatic brain injury, combat stress and other mental-health issues and in eliminating the stigma attached with seeking this care. He pointed to improved evaluation and screening for anyone affected by blast or blunt trauma in the combat zone to help identify TBI, and the new Defense and Veterans Brain Injury Center that centralizes responsibility for consolidating information as it promotes TBI research. Gates noted that today’s Wounded Warriors Family Summit served as a prelude to next month’s Warrior Care Month observance.
Representatives from various CRDAMC departments will be on hand Saturday, Oct. 25, dispensing information, conducting screenings, and answering questions for central Texas retired military personnel and their spouses. Flu vaccine, always the biggest draw for retirees, arrived unexpectedly in early October and will be available. A separate flu shot area will be set up for handicapped/disabled/special needs beneficiaries to reduce their wait time. Information and screening opportunities cover such health care problems as diabetes, loss of hearing, glaucoma, and cataract screening. The allergy and immunization clinic at Thomas Moore will offer pneumonia vaccine during the health fair. All beneficiaries over age 65 are strongly encouraged to get the vaccine. Retirees who may have received the pneumonia vaccine from another source should bring immunization records so that their medical records can be updated in CRDAMC’s electronic record system. Tetanus vaccine will also be available for those needing a booster (recommended every 10 years).
Connecticut tax laws provide veterans and their surviving spouses with state, county or local tax relief. VA helps eligible veterans receive these benefits by providing letters verifying their military service and disability evaluations. Although people can obtain these verification letters at any time by contacting their nearest VA regional office or calling the Department’s toll-free telephone number, VA is performing a special computer run to automatically generate these letters for Connecticut veterans. Connecticut veterans who receive VA disability compensation benefits may expect to receive their verification letters from VA later this month. Veterans do not have to make a special request to obtain this verification. Any Connecticut veteran who receives VA disability compensation, but does not receive a letter by the end of October should contact the Hartford VA Regional Office in Newington by e-mail at pctc.vbahar@va.gov; by fax at 860-665-7654; or by calling VA’s toll-free number, 1-800-827-1000. Veterans and survivors are advised to contact their local town tax assessor's office with any questions about Connecticut tax abatement programs. Additional information about the Connecticut tax abatement programs is also available at www.ct.gov/opm/cwp/view.asp?A=2986&Q=390068.
Each vehicle will be assigned to one of VA's existing Vet Centers, enabling the center to improve access to counseling by bringing services closer to veterans. The 38-foot motor coaches, manufactured by Farber Specialty Vehicles of Columbus, Ohio, will carry Vet Center counselors and outreach workers to events and activities to reach veterans in broad geographic areas, supplementing VA's 232 current Vet Centers, which are scheduled to increase to 271 facilities by the end of 2009. Vet Centers, operated by VA's Readjustment Counseling Service, provide non-medical readjustment counseling in easily accessible, consumer-oriented facilities, addressing the social and economic dimensions of post-war needs. This includes psychological counseling for traumatic military-related experiences and family counseling when needed for the veteran’s readjustment. The team leader at each Vet Center will develop an outreach plan for use of the vehicle within that region, without being limited to the traditional catchment area of a particular Vet Center. These vehicles will be used to provide outreach and direct readjustment counseling at active-duty, reserve and National Guard activities, including post-deployment health reassessments for returning combat service members. The vehicles will also be used to visit events typically staffed by local Vet Center staff, including homeless "stand downs," veteran community events, county fairs, and unit reunions at sites ranging from Native American reservations to colleges. While most of their use will be in Vet Centers' delivery of readjustment counseling services, the local manager may arrange with VA hospitals or clinics in the region to provide occasional support for health promotion activities such as health screenings. The normal counseling layout can be converted to support emergency medical missions, such as hurricanes and other natural disasters. http://www1.va.gov/opa/pressrel/pressrelease.cfm?id=1604
The contract is the fourth win announced by Denver-based Qwest under the federal government’s massive Networx contracting programs. Qwest was among five companies chosen last year to compete for an estimated $68 billion worth of contracts to be awarded by 2010 to update federal agencies’ communications infrastructure. Qwest will connect VA hospitals with a secure broadband network capable of handling data related to medical treatment, diagnosis and record keeping. Qwest had previously announced Networx contracts from the Social Security Administration, the National Labor Relations Board and the federal Railroad Retirement Board. The VA is the third-largest contracting agency buying services through Networx, behind the Department of Defense and the Department of Homeland Security. http://www.bizjournals.com/denver/stories/2008/10/20/daily27.html
The new centers are being established at the University at Hawaii, Manoa, to study reproductive biology; University of Kentucky to identify mechanisms linking the epidemic of obesity to cardiovascular disease; University of Louisville Research Foundation Inc. to study the cardiovascular causes and consequences of diabetes and obesity; University of Nebraska Medical Center to research nanomedicine, drug delivery, therapeutics, and diagnostics; and The Mind Research Network, a non-profit research organization in Albuquerque, to study the neural mechanisms of schizophrenia. Through the IDeA program, NCRR supports institutions and communities in 23 states and Puerto Rico with grants that fund multiple areas of biomedical research and reach out to diverse populations. This funding enables academic health centers to:
Each award includes a principal investigator with established credentials relevant to the center’s research theme; three to five individual research projects that share that theme and are supervised by a single junior investigator; and a development and mentoring plan that will prepare these investigators to secure competitive federal research funding. http://www.nih.gov/news/health/oct2008/ncrr-23.htm
The new study, published in the October 22/29, 2008, online issue of JAMA, is one of the first to examine the characteristics of uninsured children under age 19 whose parents were insured all year. These children account for a quarter of the estimated 9 million uninsured children in the United States. Researchers led by Jennifer DeVoe, M.D., of the Oregon Health & Science University in Portland, studied 2002-2005 national data from AHRQ's Medical Expenditure Panel Survey and found that children from low-income families where at least one parent had health insurance were more than twice as likely to be uninsured at some point during the year as were similar children from high-income families. They were also 73 percent more likely to be uninsured for more than six months. In 2005, a typical, low-income family of four earned between roughly $24,000 and $39,000, whereas the typical high-income family of four earned more than $77,000 a year. Children from middle-income families—those earning between $39,000 and $77,000 a year for a typical four-member family—had a 48 percent greater chance of being uninsured with at least one insured parent at some point during the year compared with high-income children and had a 56 percent higher likelihood of being uninsured for over six months. The researchers also found that:
The study was supported in part by the Biostatistics Shared Resource of the Oregon Health & Science University and the Oregon Clinical Translational Research Institute, which is part of a national Clinical and Translational Science Award consortium funded through the National Center for Research Resources of the National Institutes of Health. http://www.ahrq.gov/news/press/pr2008/childuninspr.htm
American soldiers, British sailors and a group of British civilians who were afflicted by the first mild wave of influenza in early 1918 apparently were more immune than others to the severe clinical effects of a more virulent strain later in the year, according to the paper, which will be published in the Nov. 15 issue of the Journal of Infectious Diseases by medical historian John Barry, staff scientist Cécile Viboud, Ph.D., of the NIH’s Fogarty International Center and epidemiologist Lone Simonson, Ph.D., of The George Washington University. Researchers believe the findings could have implications for future pandemics. The researchers pored over medical data from U.S. Army bases, the British fleet and several British civilian communities, applying modern mathematical models to study the pandemic. They determined that in the spring of 1918, influenza occurred at different levels of severity throughout the United States and was not always recognized as a pandemic. By the fall, however, the rate of illness among soldiers was 3.4 times higher among those who had not previously had the flu and the rate of death per case was about five times as high. The disparity was not as great for the British sailors and civilians whose records were studied. For people who were infected in the first wave, the risk of illness in the second wave was reduced by between 35 percent to 94 percent, about the same protection as for modern vaccines — 70 percent to 90 percent. The risk of death was reduced between 56 percent to 89 percent. The authors found that while there were variations in overall influenza cases among the 37 U.S. Army bases in the spring of 1918, soldiers who had been sick in the spring experienced lower rates of illness and death during the more lethal pandemic outbreak in the fall. The study suggests two possible reasons for the difference in incidence and lethality between the first two waves: a relatively weak virus mutating into a stronger one or a respiratory bug in the fall making flu patients sicker. The 1918-1919 pandemic killed between 50 million and 100 million people worldwide and was unusually deadly in young adults, including soldiers. http://www.nih.gov/news/health/oct2008/fic-20.htm
Federal officials usually adopt recommendations made by the panel. The vote means more than 31 million adult smokers probably will soon be called on to get the shot. Studies have shown that smokers are about four times more likely than nonsmokers to suffer pneumococcal disease. Also, the more cigarettes an individual smokes each day, the higher the odds he or she will develop the illness. Why smokers are more susceptible is not known for sure, but some scientists believe it has to do with smoking-caused damage that allows the bacteria to more easily attach to the lungs and windpipe. Pneumococcal infections are considered the top killer among vaccine-preventable diseases. It's a common complication of influenza, especially in the elderly, and is considered responsible for many of the 36,000 annual deaths attributed to flu. The committee voted 11 to 3 to pass the recommendation, with one member abstaining. The panel also added a call for smoking cessation counseling. Some members said it might be more cost-effective to recommend the vaccine for smokers who were at least age 40, because pneumococcal disease is relatively uncommon in younger smokers. The shot is less than perfect. First licensed in 1983, it is designed to protect against 23 strains of pneumococcal bacteria. But it hasn't proved very effective against pneumonia, and hasn't been very effective in warding off other pneumococcal illnesses in people with weakened immune systems and people age 80 or older. It's to be given to smokers as a one-time dose with no booster, but its protection drops off after five to 10 years. Made by Merck & Co., it's sold under the trade name Pneumovax and costs about $30 a dose.
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If you need further information on any of the items in the Federal Health Update, please contact Kate Connelly Theroux at (703) 447-3257 or by e-mail at katetheroux@fedhealthinst.org. To subscribe, please visit http://fedhealthinst.org/subscriber.cfm. To unsubscribe, please send an email to newsletter@fedhealthinst.org with UNSUBSCRIBE as the subject. Back issues availiable at Federal Health Update Archives. |
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