Health & Medicine
Healthcare: Let the discussion begin
Americans spend $1.8 trillion a year on healthcare, yet 45 million are uninsured, and those who are insured don't always have access to the care they need. Employers, who cover 170 million workers and their families, are feeling the pinch. The bottom line is that after all that spending, Americans aren't much healthier.
What do you think of that? The federal government, under a provision of the 2003 law revising Medicare, is going to show you where all that money comes from and goes--and then give you a chance to have your say. "We're going to take this right to the American people. We're looking for consensus on how to improve the healthcare system," says Sen. Orrin Hatch, a Utah Republican, coauthor of the provision with Democratic Sen. Ron Wyden of Oregon. "We'll end up with a citizens' road map," says Wyden. A nonpartisan group, chaired by Randall Johnson, director of human resources for Motorola, will spend the next six months compiling information on healthcare costs and challenges.
Then, after putting it all online and in libraries, the group will hold Internet discussions and town hall meetings across the country. Get ready to speak your mind.
Down Syndrome: How you say it
One parent of a Down syndrome child compared the experience to planning a vacation in Italy and then landing in Holland instead. You need new guidebooks, but then you begin to notice the tulips. How quickly a parent appreciates the potential joys of having a child with the syndrome can depend on the doctor who delivers the diagnosis. A study in the current American Journal of Obstetrics and Gynecology says many are falling short. Researchers asked 141 mothers of children diagnosed prenatally with Down syndrome about the notification process. Among the findings: Fewer than 27 percent received the news in person, and 71 percent found out without the father present. Brian Skotko, a student at Harvard Medical School and author of the study, suggests offering a more careful explanation of the initial screening test, delivering the news in person and to both parents, and offering up-to-date information about the condition and contacts at local support groups. "Doctors do a good job providing medical information," he says. "But they don't do an adequate job in describing the full possibilities of having a child with Down syndrome." -Katherine Hobson
Bioterrorism: It was unbelievable
The nation's smallpox vaccination program, announced by the president on Dec. 13, 2002, may have damaged the credibility of the agency charged with protecting Americans from bioterrorism. And it failed to show how prepared the nation's healthcare system needs to be in the event of an attack. That's the conclusion of a report issued last week by the Institute of Medicine.
The smallpox program set out to first vaccinate 500,000 medical personnel in only 30 days and then 9.5 million police and firefighters within a year. In devoting resources to the effort, local health agencies cut back on childhood immunizations, disease surveillance, and more.
The goals of the smallpox program were never articulated by the Centers for Disease Control and Prevention. Many doctors questioned the need to vaccinate so many against a disease that no longer exists when the risk of a smallpox attack was thought to be tiny. "This was a high-risk vaccine that people were not going to benefit from personally," says Brian Strom, chair of the IOM review committee. When serious cardiac events and deaths occurred in volunteers, the IOM called for a pause in the program. Still, no one at CDC addressed the scientific concerns. "I think the implication was a huge loss in credibility for the CDC," says Strom. The program petered out after only 40,000 were vaccinated. -Amanda Spake
This story appears in the March 14, 2005 print edition of U.S. News & World Report.
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