Drug discount; uninsured kids
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As Congress takes up the issue of prescription drug benefits, it might consider a recent report from Pfizer on its Share Card experience. Launched in January 2002, the program has helped more than 350,000 seniors and Americans with disabilities to fill more than 2 million prescriptions. Available in about 20 states, the program entitles enrollees to purchase up to a 30-day supply of most Pfizer medicines for $15 per prescription.
A survey by the Marist College Institute for Public Opinion suggests that a prescription discount programeven one that's not freecan seriously improve the medical compliance of low-income Medicare beneficiaries. According to the study, 97 percent of Share Card members finished their full course of medication as prescribedan increase of 14 percent prior to enrollment. Similarly, only 8 percent of enrollees delayed filling a prescription, compared to 37 percent before they had Share Cards. What's more, some 93 percent of enrollees believed that a $15 fee was about the right amount.
Although the number of children receiving health coverage from employer-sponsored plans fell from 1999 to 2002, the number of uninsured children under age 19 declined as well, from 9.6 million to 7.8 million, according to the National Survey of America's Families. Moreover, that improvement was concentrated among children whose family income was below 200 percent of the federal poverty thresholds, or less than $36,614 for a family of four.
Researchers credit increased coverage through Medicaid and State Children's Health Insurance Programs, which grew 12 percentage points during the study period. Children covered by those programs are about 1.5 times more likely than uninsured children to make office visits and receive well-child and dental care.
|Family income||One or more well-child visits||One or more office visits||One or more dental visits|
|0-99% of poverty thresholds||64.9||66.7||74.4||78.4||68.3||68.8|
|100-200% of poverty thresholds||60.9||65.7||76.5||81.4||69.6||72.8|
|200% and more||67.0||70.1||87.1||87.6||85.4||85.9|
The American Academy of Family Physicians has dropped its plan to offer members a low-cost, Internet-based electronic medical record system. Earlier this year, the society intended to set up a foundation that would have charged doctors about $150 a month for the EMR, but canceled the plan after other specialty societies declined to join the effort.
The AAFP will, however, continue trying to get a CMS grant to test an EMR in family practices. Simultaneously, it will talk with commercial vendors about group purchasing arrangements that could deliver a low-cost product to doctors. The sticking point is that the society wants any EMR it endorses to be compatible with other EMRs and with all practice management systemstwo conditions that major vendors are unlikely to meet until national standards are in place.
Two of three respondents to a Harris Interactive poll believe that a doctor's reputation is the most important indicator of the quality of care he renders. Yet just 36 percent actually considered that in choosing a personal physician. Instead, the factor most often cited by respondents (45 percent) was whether the physician participates in their health plans.
Other criteria include recommendations from people they know (36 percent), a recommendation or referral from another trusted physician (35 percent), and a friendly, helpful, efficient office staff (27 percent).
Joan Rose. UPDATE: Focus on practice. Medical Economics Oct. 10, 2003;80:17.