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California Govenor Outlines Cuts To Address State's Budget Deficit Problems
California Gov. Arnold Schwarzenegger (R) outlined two budget proposals to address the state"s budget problems, and both plans would affect health care, the Los Angeles Times reports. The first proposal addresses the situation if California voters approve a set of special ballot measures intended to provide funds for fiscal year 2009-2010. The state would still face a $15.4 billion budget deficit even if voters approve the measures, and the second proposal addresses that scenario (Rothfeld, Los Angeles Times, 5/15). The governor proposed $750 million in cuts to Medi-Cal, the state"s Medicaid program, that would reduce eligibility and provider rates. The state would need to seek a federal waiver to implement the cuts. The governor also proposed eliminating eligibility for non-emergency Medi-Cal benefits for documented immigrants (Colliver, San Francisco Chronicle, 5/15). Spending for centers that provide services to people with developmental disabilities would be cut by $234 million (Zapler, San Jose Mercury News, 5/14).If voters do not approve three ballot measures, Schwarzenegger outlined $800 million in additional cuts to health and human services programs, including a proposal to eliminate Healthy Families coverage for about 225,000 children. Healthy Families is California"s CHIP (Yi et al., San Francisco Chronicle, 5/15).
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'Swift Action Driven By Courage Needed' To Remove Ban On Federal Funding For Needle-Exchange Programs, Letter To Editor Says
"The Obama administration"s budget dealt a serious blow to those who support syringe exchange programs to prevent the transmission of HIV, hepatitis C and other infectious diseases," Paola Barahona, senior global health policy analyst for Physicians for Human Rights and founding executive director of Prevention Works!, writes in a Washington Post letter to the editor. She adds, "On the campaign trail, during the transition and in the White House, President Obama has expressed support for removing the federal ban prohibiting the use of federal funds for these programs. But he kept the ban in his budget despite research clearly showing that such programs work."Barahona writes, "Addressing the personal and pubic dangers of injection drug use may not have wide political support, but doing so is an important health and human rights issue with serious public health ramifications." She adds, "As supports of disease prevention policy rooted in science rather than politics or ideology, we have waited too long for "change" that makes sense." Barahona concludes, "We have a bold and courageous leader in President Obama. Swift action driven by courage is needed now to remove this anachronistic ban" (Barahona, Washington Post, 5/17).
News of the day
Proposed Budget Cuts Worry Hospitals
The Wall Street Journal/Dow Jones Newswires reports on reaction to the Obama administration"s proposed cuts that may acutely affect hospitals. It notes: "President Obama last weekend called for $313 billion in savings over 10 years through adjustments in Medicare and Medicaid payments - a plan that a "deeply disappointed" American Hospital Association said would mean $220 billion in payment cuts to hospitals, on top of billions in other proposed Medicare cuts."
Medical Devices

Managing Patient Expectations Of Antibiotics, Australia

Health professionals are being given clear guidelines for prescribing particular antibiotics in different diagnostic scenarios in the latest National Prescribing Service (NPS) education program, Management of specific respiratory tract infections. The therapeutic program aims to address inappropriate antibiotic use, particularly for treating acute bronchitis, sore throat and other respiratory tract infections, but also gives prescribers the facts to be confident prescribing symptomatic treatments. "Prescribing for antibiotics in acute bronchitis continues, even though the illness is usually viral and antibiotics are only appropriate when a cough is the result of pneumonia or an exacerbation of chronic obstructive pulmonary disease (COPD)," NPS Deputy CEO, Karen Kaye said. "GPs have told us they often feel pressured by patients to prescribe something but they aren"t confident to only recommend rest, saline solution, steam inhalation*, and analgesics if the patient has pain and fever," Ms Kaye said. Acute sore throat is usually viral and clinical features that distinguish a sore throat requiring antibiotics include fever over 38°C, exudate on the tonsils, tender cervical lymphadenopathy and the absence of cough. These features indicate infection by group A Streptococcus and require antibiotics. Management of specific respiratory tract infections reinforces the following: - Antibiotics are only appropriate in acute cough if a chest X-ray suggests pneumonia or in exacerbations of chronic obstructive pulmonary disease (COPD) with sputum purulence, plus increased sputum volume and/or dyspnoea - Antibiotics are only appropriate in sore throat if all four diagnostic criteria (fever, exudate, lymphadenopathy and absence of cough) for streptococcal infection are present - Use penicillin V for 10 days in uncomplicated sore throat that appears to be streptococcal - Reserve macrolides when treating respiratory tract infections for those with pertussis or those hypersensitive to penicillin - Cough and cold medicines have limited efficacy - Provide advice to patients on appropriate symptomatic relief "Home remedies such as honey and lemon, rather than a cough medicine which has limited efficacy, are the simplest and cheapest treatment options for uncomplicated acute coughs," Ms Kaye said. As part of the therapeutic program, NPS provides health professionals with: - Case study (58): Antibiotics and respiratory tract illness - thinking of patient-centred care - GP Clinical Audit: Management of specific respiratory tract infections (enrol by 7 August 2009) - Prescribing Practice Review (46): Management of specific respiratory tract infections - NPS News (63): Managing expectations for antibiotics in respiratory tract infections The GP clinical audit is recognised by the RACGP Quality Assurance & Continuing Professional Development Program, total points 40 (category 1) and in the ACRRM Professional Development Program, 30 points (extended skills). It also qualifies as an activity for QPI of the PIP (Quality Prescribing Initiative of the Practice Incentives Program), year ending April 2010. To enrol in the clinical audit visit http://www.nps.org.au/health_professionals. *steam inhalation should not be used by children National Prescribing Service


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