House of Representatives Passes Comprehensive Managed Care Reform

On October 7, the House of Representatives passed the Bipartisan Consensus Managed Care Improvement Act, HR 2723. The vote on the bill was 275 to 151 with 68 Republicans joining in the positive vote. The measure, which covers all health plans, provides several patient protections, including prohibitions on gag clauses and a right to sue health plans in state court if patients are harmed by a decision to deny care. The legislation passed in the House is much stronger than the version passed by the Senate earlier in the fall, which provides limited patient protections, does not cover all health plans and does not permit lawsuits against health plans. Conferees from the House and Senate will meet to determine whether a compromise bill can be developed and sent to each body for approval.

Number of Uninsured on the Rise Despite Healthy Economy

A new report from the Census Bureau shows that an estimated 44.3 million Americans lack health insurance. This is an increase of about 1 million uninsured persons from 1997 to 1998, despite a growing economy. According to the report, “Those more likely to lack health insurance continue to include young adults in the 18- to 24-year-old age group, people with lower levels of education, people of Hispanic origin, those who work parttime and people born in another country.” Despite the initiation of the Children's Health Insurance Program (CHIP), which has enrolled nearly 1 million children, the number of uninsured children increased by 330,000 from 1997 to 1998. Children ages 12 to 17 years were slightly more likely to be uninsured than those under age 12 (16.0 percent, compared with 15.1 percent).

AAFP Elects New Officers and Board of Directors at 1999 Annual Meeting

New officers of the American Academy of Family Physicians (AAFP) were installed at the 1999 AAFP Scientific Assembly in Orlando, Fla., in September. Bruce Bagley, M.D., Latham, N.Y., was installed as president. Immediate past president Lanny R. Copeland, M.D., Albany, Ga., became chair of the AAFP Board of Directors. Richard G. Roberts, M.D., J.D., Madison, Wisc., was inaugurated as president-elect. Michael O. Fleming, M.D., Shreveport, La., and Carolyn C. Lopez, M.D., Chicago, Ill., will be speaker and vice speaker, respectively, of the Congress of Delegates. Elected to the AAFP Board of Directors were Karla Birkholz, M.D., Glendale, Ariz.; Frank Burton Dibble, M.D., Kingston, N.H.; and Daniel Van Durme, M.D., Tampa, Fla. The new resident board member is David Meyers, M.D., Washington, D.C. The student board member is Mauguerite Duane, Stony Brook, N.Y.

About 4,500 physicians attended the 51st AAFP Annual Scientific Assembly, which was shortened by the onset of Hurricane Floyd. Travel into the area was disrupted and the opening of the assembly was delayed by one day. Total attendance, including guests and exhibitors, topped 12,000. Actions of the 1999 Congress of Delegates is available on the AAFP Web site (https://www.aafp.org/congress).

Vice President Al Gore Launches New Rural Hospital Flexibility Program

In an effort to improve access to health care in rural communities and develop health care networks to expand services, Vice President Al Gore has announced the first grant awards under the new Rural Hospital Flexibility Program. The first round of grants totals $13 million, which will be divided among 43 states. “For people living in rural communities, rural hospitals are a lifeline, and yet today 20 million Americans in our rural communities do not have adequate access to quality health care,” Vice President Al Gore said. “These grants will help rescue financially at-risk hospitals and make sure they continue to provide much needed care,” stated Department of Health and Human Services Secretary Donna E. Shalala.

The Rural Hospital Flexibility Program is a five-year, $125 million program administered by the Health Resources and Services Administration's Office of Rural Health Policy. States will use the money to develop a rural health plan, help communities decide which hospitals should convert to “critical access” hospitals and promote the development of rural health networks that include enhanced delivery of emergency medical services. The new program is modeled after two successful demonstration projects that were conducted in the early 1990s: the Montana Medical Assistance Facility program and the Essential Access Critical Hospitals/Rural Primary Care Hospital program in New York, West Virginia, North Carolina, Kansas, South Dakota, Colorado and California.

American Medical Association Names New Editor of JAMA

Catherine D. De Angelis, M.D., M.P.H., has been named the new editor of the Journal of the American Medical Association (JAMA) and editor-in-chief of the Division of Scientific Information and Multimedia of the American Medical Association (AMA). Dr. De Angelis will be the 15th editor of JAMA and is the first woman to be the editor in the journal's 116-year history. She has been editor-in-chief for the AMA's Archives of Pediatrics and Adolescent Medicine and has been a member of the editorial board of JAMA. She is currently vice dean for academic affairs and faculty, and professor of pediatrics at Johns Hopkins University School of Medicine, Baltimore, Md.

AHCPR Publishes a Detailed Report on Hospital Inpatient Statistics

A new report from the Agency for Health Care Policy and Research (AHCPR) gives a detailed picture of hospital inpatient care in the United States. The statistics, which are organized by principal diagnosis and principal procedures, include numbers of discharges, mean lengths-of-stay, mean charges, percentage of patients who died in the hospital and mean age of patients. According to the report, the five most costly conditions treated in 1996 were spinal cord injury, infant respiratory distress syndrome, low birth weight in infants, leukemia and heart valve disorders. The information is based on data from the AHCPR's all-payer Nationwide Inpatient Sample. Free copies of “Hospital Inpatient Statistics, 1996” (AHCPR 99-0053) are available from the AHCPR Publications Clearinghouse, P.O. Box 8547, Silver Spring, MD 20907-8547; telephone: 800-358-9295.