Americans trust nurses

A new Harris poll reveals that Americans trust nurses and think nursing is a great profession. Ninety-two percent say they trust information about health care provided by registered nurses, just 1 percent below doctors. Eighty-five percent say they would be pleased if a son or daughter became a registered nurse. That's a higher approval rating than for journalists, lawyers or police officers.

Public Pays for Mergers

Hospitals that merge usually boost their prices, according to a government-funded study. When hospitals seek permission to merge, they often say they will save money and pass the savings along to patients in the form of lower prices. The new study says that this rarely happens. Both for-profit and nonprofit hospitals raise their prices after mergers, but for-profits raise them more. The study, reported in the May 3 issue of Modern Healthcare, looked at price changes for private-pay patients in 400 merging hospitals. For-profit mergers were followed by price hikes averaging 20 percent. Public hospital mergers led to 13 percent increases. Private nonprofits raised prices 6.7 percent. Mergers reduce competition, making price increases possible. A 1993 study for the American Hospital Association found that hospitals that merge reduce costs and cut services but don't pass the savings on to consumers--they just keep the money.

For-profit HMOs score lower

Investor-owned HMOs give their patients lower quality care, and the difference means needless death for thousands, according to a study published in the July 14 Journal of the American Medical Association. The study compared 329 HMOs, some investor-owned and some nonprofit, using 14 measures of quality care. The measures ranged from preventive care like childhood immunization and mammography, to care for seriously ill patients, such as eye exams for diabetics. On every measure, the investor-owned HMOs performed worse. Between 1995 and 1998, the proportion of HMO members in for-profit plans grew from 26 percent to 62 percent. The authors calculated that if every American woman between the ages of 50 and 69 were enrolled in investor-owned HMOs, about 5,925 more women would die of breast cancer because these HMOs conduct fewer mammograms.

Care less, cost more

For-profit hospitals spend less on staff, provide less charity care and have shorter stays. Yet they are 3 percent to 11 percent more expensive than nonprofits. How do they do it? They spend more on administration and exploit funding loopholes more avidly, according to a strongly worded editorial in the Aug. 5 New England Journal of Medicine titled "When Money Is the Mission." The editorial cites studies that show for-profit hospitals spend one-third more than public hospitals and one-quarter more than nonprofit private hospitals on administration. For-profit administrators get much more of their income through incentive bonuses. "Exploiting loopholes is more lucrative than improving efficiency or quality, and creative cheaters have a decisive market advantage," the editorial says. The authors calculate that Medicare alone spent more than $5 billion extra in 1995 on for-profit hospitals, which also have higher patient death rates. The FNHP Web site has a link to the New England Journal of Medicine editorial so you can read it online. Go to www.aft.org/fnhp and click on "What's New."

AIDs deaths rise worldwide

Although new drugs have led to a steep plunge in AIDs deaths in the United States, most of the world can't afford them. AIDs is now the world's fourth biggest cause of death, with 1.8 million victims in 1998, according to the World Health Organization. It was number seven on the list in 1997. AIDs is also the number-one infectious cause of death in Africa, where only $150 million per year is being spent to fight it.

"Flo" fights senior drug benefit

The pharmaceutical industry has launched a massive public relations campaign to convince Americans that President Clinton's proposal for Medicare drug coverage would be bad for them. "I don't want big government in my medicine cabinet," says "Flo," the silver-haired star of the new ads. The companies are afraid Clinton's plan would lead to government pressure to lower drug prices, which are twice as high in the U.S. as they are in other countries. But the companies are not pinning all their hopes on "Flo." They also spend more on lobbying than any other industry and contribute many millions of dollars to Congressional campaigns.