Policy & Practice


Teen Boys Ignore Sun Protection

Boys aged 15–17 years are the group least likely to protect their skin from sun exposure, according to a survey released by the American Academy of Dermatology. Only 32% of these boys said that they are "very careful" or "somewhat careful" about sun protection, compared with 58% of girls of the same age. "Our focus has primarily been on young women," Darrell S. Rigel, M.D., professor of dermatology and dermatologic surgery at New York University Medical Center, New York, said in an interview. The survey results mean that dermatologists should also be directing their sun safety messages to teen boys as well. However, he said that getting that message out can be difficult because dermatologists generally see more women, of all ages, than men in their practice. The results are based on a national telephone survey conducted among 505 adolescent boys and girls (aged 12–17 years).

Bill to Thwart Medicare Cuts

A bipartisan bill (H.R. 2356) introduced by Rep. Clay Shaw (R-Fla.) and Rep. Ben Cardin (D-Md.) seeks to halt impending cuts to Medicare physician payments and replace the flawed formula that determines those payments. Following up on a recommendation of the Medicare Payment Advisory Commission, the bill would increase payments by no less than 2.7% in 2006. It would also repeal the sustainable growth rate adjustment, replacing it "with a methodology that ensures adequate and appropriate payments as well as stable updates for Medicare providers," Rep. Cardin said in a statement. Physicians face a 4.3% cut in Medicare payments in 2006 and subsequent cuts totaling 30% from 2007 and 2012, if the formula isn't fixed. The bill was referred to the House Ways and Means and Energy and Commerce committees. A similar Senate bill (S. 1081) would provide a positive update for 2 years.

Sunscreen Use Falls

More and more Americans are going outside without their sunscreen, according to the results of a survey released by the Sun Safety Alliance. About 60% of American adults reported using sunscreen when outdoors this year, a drop from the 72% who reported using sunscreen in a 2004 survey. When asked why they aren't using sunscreen, about 35% of survey respondents said they forgot. Respondents reported other reasons for not applying sunscreen, including that they liked the feel of the sun on their skin and the way they looked with a tan, or they did not have sunscreen handy. However, more respondents reported having encouraged others to practice sun safety behaviors; in 2004, 79% of respondents said they encouraged sun safety in others, compared with 82% this year. The survey respondents also favored public policy to address sunscreen use among children. About 51% of those surveyed said that one state's recent legislation requiring sunscreen education for all children in kindergarten through grade 8 should be passed in all states. The national telephone survey, which was conducted by Harris Interactive in May, polled 1,000 adults.

Few Seeking Quality Improvement

A majority of physicians are not actively engaged in quality improvement practices and are reluctant to share information about the quality of care they provide with the general public, a survey of more than 1,800 physicians revealed. Only one-fourth of respondents said they were using an electronic medical record routinely or occasionally, and one-third said they were redesigning their systems to improve care. In addition, just one-third said they had access to any data about the quality of their own clinical performance. Although 7 out of 10 thought physicians' clinical information should be shared with leaders of the health care systems at which they work, fewer respondents (55%) thought patients should have access to quality data about their own doctors. The survey was conducted by the Commonwealth Fund between March and May 2003 and published in the journal Health Affairs.

Medicaid Patients and Drug Access

Medicaid patients are finding it just as difficult as the uninsured to get access to prescription drugs. Researchers from the Center for Studying Health System Change found that 22% of Medicaid beneficiaries aged 18 and older could not afford to get at least one prescription filled in the previous year. Although access problems experienced by Medicaid beneficiaries were comparable with those experienced by the uninsured, only 9% of adults with employer-sponsored health coverage said they could not afford a prescribed drug in the previous year. The findings were drawn from HSC's Community Tracking Study Household Survey, a national survey involving 46,600 people in 2003 and 60,000 people in 2001.


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