• Bush Health Insurance Proposal Would Undercut Employer Coverage
• Ending Subsidies to Medicare Advantage Plans Could Save $5 Billion a Year
• Senate May Halt Drug Companies’ Delay of Generics
• Study Linking Breast Cancer to Hormone Replacement Therapy Sparks Controversy
• Poll Shows Strong Support for Unions
• Family Member or Friend in a Nursing Home?
• Web Site of the Week: http://www.donotcall.gov/

BUSH HEALTH INSURANCE PROPOSAL WOULD UNDERCUT EMPLOYER COVERAGE
The healthcare proposals promoted by President Bush in his State of the Union address Jan. 23 would tax individuals with comprehensive health coverage to help increase access to basic coverage for the uninisured. The president’s plan offers a $7,500 credit for individual coverage premiums and a $15,000 credit for family plans. Under his proposal, individuals and families with employer-sponsored health insurance plans worth more than the proposed allowable deductions—such as some union members and their families—would pay taxes on the difference. According to healthcare experts, the Bush subsidy would likely help only about 3 million or 4 million people. Forty-three percent of today’s 46 million uninsured have no tax liability. But the cost to the 175 million people currently with employer coverage could be high, as younger and healthier workers opt for the tax credit, leaving employer plans with older, sicker participants who are more expensive to cover. “Rather than undermine existing employer-provided health insurance for workers and their families,” said AFT president Edward J. McElroy “we should move toward universal healthcare coverage by expanding Medicare coverage to the uninsured—especially disadvantaged children.” Analysts and critics have raised concerns that Bush's tax proposal also could create an incentive for employers to get out of the business of offering healthcare to workers, further eroding employment-based coverage. Some have worried about the cost of coverage for pre-Medicare retirees, older workers, those with serious medical problems and other high-cost individuals who might be forced to buy private insurance. Others have warned that premiums for individuals could increase due to the higher marketing and administrative costs of private insurers.

ENDING SUBSIDIES TO MEDICARE ADVANTAGE PLANS COULD SAVE $5 BILLION A YEAR
Democrats this year likely will seek to reduce payments to private Medicare Advantage plans to cover the cost of other healthcare proposals, such as revisions to the Medicare physician reimbursement system, House Ways and Means Health Subcommittee Chair Pete Stark (D-Calif.) told a group of healthcare policy analysts on Jan. 23. In a recent study of health costs, George Washington University analyst Brian Biles found that the transfer of beneficiaries enrolled in Medicare Advantage plans to the traditional fee-for-service program would save Medicare $5 billion annually. According to the Medicare Payment Advisory Commission, Medicare on average spends 10 percent more on beneficiaries enrolled in Medicare Advantage plans than on those in the traditional fee-for-service program.

SENATE MAY HALT DRUG COMPANIES’ DELAY
OF GENERICS
Key senators from both political parties said Jan. 24 that they would back legislation to stop drug makers from striking deals to restrict the introduction of generic drugs. The bill, proposed by Patrick Leahy (D-Vt.) and Herb Kohl (D-Wis.), targets an increasingly common tactic used by brand-name drug makers—legal settlements that involve payments to generic rivals to delay the introduction of generic alternatives. The deals cheat Americans of billions of dollars in savings, regulators told lawmakers seeking to ban the arrangements. The Federal Trade Commission (FTC) and others allege the settlements allow brand-name pharmaceutical companies to pay off would-be generic competitors, which then agree to delay introduction of their less costly but otherwise identical versions of the original medicines. An FTC report coinciding with the Jan. 24 Senate Judiciary Committee hearing showed that settlements have become more common since two 2005 appeals court decisions upheld their legality. Typically, a generic manufacturer makes more from such a payment than it would from actually selling its version of the generic drug.

STUDY LINKING BREAST CANCER TO HORMONE REPLACEMENT THERAPY SPARKS CONTROVERSY
Health experts’ reaction ranged from acceptance to anger when a study presented in late December said that a 7 percent drop in breast cancer incidence among U.S. women from 2002 to 2003 may have been due to a decrease in hormone replacement therapy (HRT). According to the study, there were about 124 breast cancer cases per 100,000 women in 2003, compared with about 134 cases per 100,000 women in 2002. Breast cancer rates dropped by 15 percent among women ages 50 and older. About 14,000 fewer women were diagnosed with breast cancer in 2003 than in 2002, the study said. The decline was the largest since 1990. The report attributed the decrease in breast cancer rates to a drop in both HRT use and mammography rates. HRT use decreased by about 30 percent in 2002, after the Women's Health Initiative found that breast cancer risk increased for women who used the treatment for an extended period of time. In addition, mammography rates between 2000 and 2003 dropped by 1 percent overall and by 3 percent among women between ages 50 and 64, which could in part explain why fewer breast cancer cases were detected. The report’s author, Peter Ravdin, a research professor in the Department of Biostatistics at the University of Texas M.D. Anderson Cancer Center in Houston, said that it is possible that other factors—including anti-estrogen drugs, such as raloxifene; statin drugs that reduce cholesterol; or drugs used to treat pain—also might have contributed to the decrease. While many doctors and health experts welcomed the findings, Ronald Strickler, chief of women's health services at the Henry Ford Health System in Michigan, cautioned that such statistics vary from year to year.

POLL SHOWS STRONG SUPPORT FOR UNIONS
More than half of America's workers who don't have a union say they would join one tomorrow if they could, according to a new national poll by Peter D. Hart Research Associates. Workers also support strong laws that give employees the freedom to improve their lives through a union without interference from management. The positive attitudes toward unions also translate into solid support for the Employee Free Choice Act, proposed federal legislation that would make it more difficult for employers to thwart employees' efforts to form unions. The legislation, which is expected to be re-introduced in Congress this spring with strong bipartisan support, would strengthen penalties for employers who violate workers' freedom to choose a union, allow a neutral third party to determine a first contract if the management and employees can't reach an agreement, and enable a union to be formed when a majority of employees indicate in writing that they want one. The poll also showed strong disapproval of employer anti-union campaigns. A special section of the AFL-CIO Web site has extensive information on the Employee Free Choice Act. The AFT is urging its members to visit the legislative action center and contact their representatives and senators to support the Employee Free Choice Act.

FAMILY MEMBER OR FRIEND IN A NURSING HOME?
A simple-to-understand and easy-to-use guide, “20 Common Nursing Home Problems—and How To Resolve Them,” allows you to help residents get more and better care from nursing homes. Author and attorney Eric Carlson of the National Senior Citizens Law Center draws on first-hand experience with hundreds of cases involving residents' rights to help you solve some of the most common problems in nursing-home care. Click here to download a free copy of the guide.

QUOTE OF NOTE: Bush Healthcare Proposal
"The fear is that if it becomes more attractive for people to decline employer coverage and buy on the open market, then you could get great spirals in the employer plans. I'm not convinced we should take away one of the pillars that has been supporting the healthcare system."

                               Neil Trautwein, Vice President
                               National Retail Federation

WEB SITE OF THE WEEK: www.donotcall.gov
Tired of unsolicited telephone calls from unscrupulous individuals? The National Do Not Call Registry allows you to limit telemarketing calls you receive. Once you register your phone number, telemarketers covered by the National Do Not Call Registry have up to 31 days from the date you register to stop calling you. If you don’t have an e-mail address, you can register by phone at 888/382-1222. It's free.