Recent Health Care Developments - new Medicaid options for HIV, breast and cervical cancer treatment; help for paying Medicare Part B premium; Pennsylvania State Children's Health Program expansion approved; environmental causes of disease researched

Health Care Financing Review, Spring, 2000

Studies tracking patterns of cancer development, birth defects, and other diseases suggest the influence of environmental contaminants.

Of the 120,000 U.S. babies born each year with a birth defect, 8,000 die during their first year of life, making birth defects the leading cause of infant mortality in the United States and contributing substantially to childhood morbidity and long-term disability. Hundreds of thousands of cases of asthma and lead poisoning are also associated with environmental contaminants.

Initial scientific evidence demonstrates that increased risk of breast cancer may be associated with unknown environmental factors. According to the American Cancer Society, one out of nine American women will develop breast cancer in her lifetime, and breast cancer is now the leading cause of cancer for women between the ages of 35 and 54. Despite decades of research, over half of all breast cancer cases cannot be explained by known risk factors, such as genetic predisposition, reproductive history, and diet

In addition, initial scientific evidence demonstrates that increased risk of prostate cancer may be associated with unknown environmental factors. Prostate cancer is the most common type of cancer found in American men other than skin cancer, and disproportionately impacts African-American men. Researchers estimate that there will be about 180,000 new cases of prostate cancer in the United States this year, 36 percent of all cancer cases, and that about 37,000 men will die of this disease. However, researchers estimate that only 10 percent of prostate cancers are due to genetic predisposition.

Lack of research on the association between environmental exposure and breast cancer, prostate cancer, and other diseases represents a lost opportunity to improve public health. Research on the impact of environmental contaminants on individual health will promote the development of improved diagnostic techniques, prevention strategies, and treatments. If exposure to chemicals in the environment is shown to be associated with only 10 percent of breast and prostate cancer cases, and we reduce or eliminate the identified hazards, the development of these diseases in 30,000 men and women could potentially be prevented each year.

The President's FY 2001 budget will include a $27 million investment to:

* Double the level of assistance provided to State and local public health officials investigating adverse health events potentially linked to environmental exposures.

* Identify regions of the country where individuals are exposed to toxic sub. stances that cause cancer and other diseases.

* Ensure rapid evaluation of the impact of public health emergencies.

Office-Based Medicaid Managed Care Physicians Serve Few Medicaid Patients

According to an analysis by the United Hospital Fund, the majority of office-based physicians in New York City who participate in Medicaid managed care plans serve very few Medicaid patients.

The analysis, released in the Fund's publication Medicaid Managed Care Currents, reports that although slightly more than one-half (54 percent) of the 4,352 physicians participating in Medicaid managed care plans are office-based physicians, these physicians see only-34 percent of Medicaid managed care patients.