Keeping the unemployed healthy: the effect of means-tested and entitlement benefits in Britain, Germany, and the United States.
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OBJECTIVES: Although considerable evidence about the health effects of unemployment exists, little is known about the possible protective effects of various social interventions. This study examined the role that means-tested and entitlement programs could have in ameliorating the health impact of unemployment in Britain, Germany, and the United States. METHODS: Logistic regression models were used to analyze panel data from Britain (1991-1993), Germany (1991-1993), and the United States (1985-1987) available in the Household Panel Comparability Project database. The analysis included 8,726 respondents from Britain, 11,086 from Germany, and 11,668 from the United States. The health-dependent variable used was a single measure of perceived health status. RESULTS: Evidence was found of differences in perceived health status between groups of unemployed people characterized by the types of benefits they receive. When socioeconomic characteristics and previous health and employment status are controlled for, means-tested benefits do not seem sufficient to reduce the impact of unemployment on health. CONCLUSIONS: Monitoring the possible health effects of changes in public assistance benefits should be given priority in the research and political agenda. (+info)
Job-based health insurance in 2001: inflation hits double digits, managed care retreats.
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Drawing on the results of a national survey of 1,907 firms with three or more workers, this paper reports on several facets of job-based health insurance, including the cost to employers and workers; plan offerings and enrollments; patient cost sharing and benefits; eligibility, coverage, and take-up rates; and results from questions about employers' knowledge of market trends and health policy initiatives. Premiums increased 11 percent from spring 2000 to spring 2001, and the percentage of Americans in health maintenance organizations (HMOs) fell six percentage points to its lowest level since 1993, while preferred provider organization (PPO) enrollment rose to 48 percent. Despite premium increases, the percentage of firms offering coverage remained statistically unchanged, and a relatively strong labor market has continued to shield workers from the higher cost of coverage. (+info)
Growth in prescription drug spending among insured elders.
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We examine growth in prescription drug use and spending in a well-insured elderly population in 1997 and 2000. We describe the high-cost segment of this population, identifying how it differs from the rest of the elderly regarding use and types of medications, and how stable this group is over time. Drug spending by the insured elderly rose more than 18 percent annually between 1997 and 2000. High-cost elders use more brand-name drugs, treat more conditions, and use more medications per condition. Once an insured elder becomes a high-cost user of prescription drugs, that person is likely to remain so. Our study suggests that a growing population of elderly is using many medications and may require considerable drug management. (+info)
General Practitioners' views on the provision of nicotine replacement therapy and bupropion.
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BACKGROUND: Nicotine replacement therapies (NRT) and a new drug, bupropion, are licensed in several countries as aids to smoking cessation. General practitioners (GPs) play a crucial role in recommending or prescribing these medications. In the UK there has been discussion about whether the medications should be reimbursable by the National Health Service (NHS). This study assessed English GPs' attitudes towards reimbursement of NRT and bupropion. METHODS: Postal survey of a randomly selected national sample of GPs; 376 GPs completed the questionnaire after one reminder; effective response rate: 53%. There was no difference between the responses of GPs who responded to the initial request and those who responded only after a reminder suggesting minimal bias due to non-response. RESULTS: Attitudes of GPs were remarkably divided on most issues relating to the medications. Forty-three percent thought that bupropion should not be on NHS prescription while 42% thought that it should be (15% did not know); Fifty percent thought that NRT should not be on NHS prescription while 42% thought it should be (8% did not know). Requiring that smokers attend behavioural support programmes to be eligible to receive the medications on NHS prescription made no appreciable difference to the GPs' views. GPs were similarly divided on whether having the medications reimbursable would add unacceptably to their workload or offer a welcome opportunity to discuss smoking with their patients. A principal components analysis of responses to the individual questions on NRT and bupropion revealed that GPs' attitudes could be understood in terms of a single 'pro-con' dimension accounting for 53% of the total variance which made no distinction between the two medications. CONCLUSIONS: GPs in England appear to be divided in their attitudes to medications to aid smoking cessation and appear not to discriminate in their views between different types of medication or different aspects of their use. This suggests that their attitudes are generated by quite fundamental values. Addressing these values may be important in encouraging GPs to adhere more closely to national and international guidelines. (+info)
Disease associated with exposure to certain herbicide agents: type 2 diabetes. Final rule.
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The Department of Veterans Affairs (VA) is amending its adjudication regulations concerning presumptive service connection for certain diseases for which there is no record during service. This amendment is necessary to implement a decision of the Secretary of Veterans Affairs under the authority granted by 38 U.S.C. 1116 that there is a positive association between exposure to herbicides used in the Republic of Vietnam during the Vietnam era and the subsequent development of Type 2 diabetes. The intended effect of this amendment is to establish presumptive service connection for that condition based on herbicide exposure. (+info)
Montgomery GI Bill--active duty. Final rule.
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This document amends the educational assistance regulations of the Department of Veterans Affairs (VA). The amendments reflect statutory changes contained in the Veterans Millennium Health Care and Benefits Act of 1999 and statutory interpretations. This document also makes changes for the purpose of clarification. (+info)
TRICARE; Civilian Health and Medical Program of the Uniformed Services (CHAMPUS); eligibility and payment procedures for CHAMPUS beneficiaries age 65 and over. Interim final rule.
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This interim final rule implements Section 712 of the Floyd D.Spence National Defense Authorization Act for Fiscal Year 2001. Section 712 extends TRICARE eligibility to persons age 65 and over who would otherwise have lost their TRICARE eligibility due to attainment of entitlement to hospital insurance benefits under Part A of Medicare. In order for these individuals to retain their TRICARE eligibility, they must be enrolled in the supplementary medical insurance program under Part B of Medicare. In general, in the case of medical or dental care provided to these individuals for which payment may be made under both Medicare and TRICARE, Medicare is the primary payer and TRICARE will normally pay the actual out-of-pocket costs incurred by the person. This rule prescribes TRICARE payment procedures and makes revisions to TRICARE rules to accommodate Medicare-eligible CHAMPUS beneficiaries. The Department is publishing this rule as an interim final rule in order to meet the statutorily required effective date. Public comments, however, are invited and will be considered when the rule is published as a final rule. (+info)
Veterans Benefits Administration nomenclature changes. Final rule.
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This document makes nomenclature changes in VA regulations in 38 CFR Chapter I to reflect current Veterans Benefits Administration titles and office designations. References to the "Chief Benefits Director" are changed to "Under Secretary for Benefits." Also, references to "Vocational Rehabilitation and Counseling" and its abbreviation "VR&C" are changed to "Vocational Rehabilitation and Employment" and "VR&E," respectively. In addition, references to the "Vocational Rehabilitation and Education Service" are changed to "Vocational Rehabilitation and Employment Service" or "Education Service" as appropriate. (+info)