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Wall Street Journal Examines Patients' Confusion Over Coverage Of Preventive Exams
As employers increasingly offer no-cost preventive care as a means of controlling health costs, some people under such plans are being charged for services not deemed preventive by the insurer, the Wall Street Journal reports. According to Watson Wyatt Worldwide, 72% of large employers in 2009 cover 100% of preventive care -- such as physicals, colonoscopies or mammograms -- for employees, an increase from 55% of large companies in 2008. The Journal reports that the charges often result from billing errors or from a physician"s office being unaware of an insurer"s procedures. Charges that are the result of billing errors often can be reversed. However, others -- such as a test or treatment not being defined by the insurer as preventive -- force some patients to "wage a protracted battle" to get the charges reversed, according to the Journal. When unexpected charges appear on patients" bills, physicians and employers often receive complaints but they have little control over how insurers classify treatments. The Journal reports that patients can prevent being charged for preventive services by checking with their insurer before seeking care; asking for specific, covered screenings and treatments at physicians" offices; reviewing explanation of benefits forms supplied by insurers; asking supervisors at insurers to review disputed claims; and seeking help from employees in company human re departments (Wilde Mathews, Wall Street Journal, 5/21).
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Expert Group To Review Pharmacy Services In Wales
An expert group has been set up to review pharmacy services across Wales as part of the Welsh Assembly Government"s commitment to develop community pharmacy services and pharmacy-based drop-in centres.
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Justice Ginsburg Discusses Abortion Rights, Women On Supreme Court In NYT Magazine Interview
In an interview to be published in this weekend"s New York Times Magazine, Supreme Court Justice Ruth Bader Ginsburg discusses the role of female justices on the court, including the effect on issues related to reproductive rights. When asked if "part of a future feminists legal wish list" could include "repositioning Roe [v. Wade] so that the right to abortion is rooted in the constitutional promise of sex equality," Ginsburg replied, "I think it will be." In response to a follow-up question on what Ginsburg would want to see accomplished in future feminist legal agenda, she said, "Reproductive choice has to be straightened out." She later clarified that she meant that the "basic thing is that the government has no business making that choice for any woman." Ginsburg said that there "will never be a woman of means without choice anymore" and that the "states that had changed their abortion laws before Roe (to make abortion legal) are not going to change it back." However, "we have a policy that only affects poor women, and it can never be otherwise, and I don"t know why this hasn"t been said more often," she said. She continued that she was "surprised" by the Supreme Court"s 1980 ruling in Harris v. McRae, which upheld the Hyde Amendment prohibiting states from using federal Medicaid funds to pay for abortion. Ginsburg also discussed state restrictions on abortion rights, such as waiting periods, and other limits to accessing the procedure. She added that the "possibility of stopping a pregnancy very early is significant" and predicted that emergency contraception "will become more accessible and easier to take." Ginsburg said, "So I think the side that wants to take the choice away from women and give it to the state, they"re fighting a losing battle. Time is on the side of change" (Bazelon, New York Times Magazine, 7/12).
Endocrinology

Hospital Workers Smoking -- Only The Most Addicted Flout The Rules

A survey of staff at Addenbrooke"s hospital has shown that those who break the smoke-free policy are generally more addicted than those who respect it. Researchers writing in the open access journal BMC Public Health also investigated staff"s attitude to the smoke-free policy and found that smokers were less likely to believe that the policy would protect people from second hand smoke. With funding from the Addenbrooke"s Charitable Trust, Tom Parks was one of a team of four medical students from the University of Cambridge School of Clinical Medicine (UK), based at Addenbrooke"s, who carried out the survey. He said, "We found that those who smoke in contravention to the smoke-free policy do so neither for pleasure nor to avoid feeling low; instead it is a resistant habit, which has little or no influence on the smoker"s mood, and is determined in part by chemical dependence". All 6,981 members of staff at the hospital were given the opportunity to take part in the anonymous survey, and 704 completed and returned the questionnaires. Among the 101 smokers, 69 were compliant with the hospital"s smoke-free policy while 32 were non-compliant. Gender, age and ethnicity were similar between compliant and non-compliant smokers. Contract ancillary workers were less likely to comply, while clerical and managerial staff were more likely to comply. Importantly the results showed for the first time that the non-compliant smokers were also the most nicotine dependent and smoked most out of habit. According to Parks, "Habitual smoking is a form of psychological addiction, which may coexist with chemical dependence, where there is no true reason for smoking except that it has become learned and automatic, with no influence on the smoker"s mood or affect. For example, the smoker may not even be aware of smoking and may even light one cigarette while another is still burning in an ashtray". Parks and his colleagues hope that their research will inform future NHS smoking policy. They write, "There may be merit in screening the working population for individuals with the particular smoking behaviours we identified and offering them evidence-based workplace interventions for smoking cessation. This might not only improve their compliance but also, more importantly, increase the likelihood that they quit smoking". Notes: Failure of hospital employees to comply with smoke-free policy is associated with nicotine dependence and motives for smoking: a descriptive cross-sectional study at a teaching hospital in the United Kingdom Tom Parks, Clare VR Wilson, Kenrick Turner and Joel WE Chin BMC Public Health (in press) Article available here. All articles are available free of charge, according to BioMed Central"s open access policy. Graeme Baldwin BioMed Central


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