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Medicare/Medicaid

Reports | Articles 

Reports

Medicare Now and in The Future (September 2008)
Virtually all people aged 65 and over are covered by Medicare in the US. However, there are policy challenges facing the program, including the financing of care for future generations, assessing the role of private plans, improving the Medicare Prescription Drug Benefit and keeping the Program's benefits affordable. This report, prepared by the Kaiser Family Foundation, describes the present and future of Medicare and assesses the Presidential candidates' positions on Medicare issues.

Millions of Low-Income Americans Can't Get Medicaid: What Can Be Done? (September 2008)
The majority of adults in the US do not fit into any of the defined categories of people eligible for Medicaid. The report describes the characteristics of low-income uninsured adults who do not have access to Medicaid, highlights the impact of the lack of insurance on their health status and offers ways to provide greater access to Medicaid by this vulnerable group of low-income Americans. 

Examining Sources of Coverage Among Medicare Beneficiaries: Supplemental Insurance, Medicare Advantage, and Prescription Drug Coverage -- Findings from the Medicare Current Beneficiary Survey, 2006 (August 2008)
The Kaiser Family Foundation prepared this chartpack showing the sources of supplemental and prescription drug coverage among Medicare Part D drug beneficiaries in 2006. Sources of such coverage vary by income, race/ethnicity, health status and other characteristics. In additional, the report compares the characteristics of enrollees of the traditional Medicare plan to those enrolled into Medicare Advantage plans. This chartpack will help everyone track how race and poverty impact older US citizens' in negative ways--- the long arm of discrimination. 

Characteristics and Perceptions of the Medicare Population: 2001-2005 (July 2008)
Researcher Maggie Murgolo presents the results of a national survey of enrollees in the Medicare program. The survey collected the information on social, economic, demographic characteristics of Medicare population, beneficiaries' health status, their health care services, costs and sources of payments. According to the report, Medicare beneficiaries are generally satisfied with their health care. 

Medicare Part D: Complaint Rates Are Declining, but Operational and Oversight Challenges Remain (July 2008)
Medicare Part D program offers voluntary outpatient prescription drug coverage to eligible Medicare beneficiaries. Under this program, CMS (the agency that administers the program) contracts private companies to provide benefits. This audit report prepared by the US Government Accountability Office investigates the beneficiaries' complaint rates for the past three years. Although complaint rates are declining, some aspect of the program's operation continues to pose challenges to its beneficiaries. 

An Assessment for Pay for Performance for Nursing Homes with Recommendations for Policy Makers (July 2008)
Many have recommended Payment for Performance (P4P) as the solution to the low efficiency and increasing costs of health care in the United States. Under P4P, the government can reward excellent service and penalize noncompliance to regulatory standards. P4P is a promising initiative that may standardize care across the country but can it curtail the seemingly limitless increase of health care costs? 

A Balancing Act: State Long-Term Care Reform (July 2008)
The authors of this report look at how states allocate Medicaid resources to home-based and institutional care. Currently, Medicaid is heavily biased in favor of institutional care, which both denies older persons their right to choose their personal care and is highly inefficient, as home-care costs one-third per person as much as institutionalized care. The report also finds great variation amongst the states and examines what steps states have taken to increase funding for home-based care.

Making Affordable Assisted Living a Reality: A White Paper for State Policy Makers (July 2008)
Affordable long term care (LTC) is not impossible to achieve. However, with current Medicaid policies, many older persons still face financial challenges. Many are forced to enter Nursing homes in order to obtain government subsidies that will support their spouses. Effective allocation of government funding and implementation of updated policies can solve this problem. In this report, the Long Term Care Community Coalition (LTCCC) suggests several measures, including providing affordable housing and long term care through government trust funds and policy changes. 

Have Health Reformers Forgotten Medicare? (July 2008)
Congress is not considering any substantial reforms of Medicare system although there is a growing consensus in the United States that the system is flawed. If action is not taken now, Medicare may soon be “unable to fulfill the public's expectation of generous health coverage.

Medicare: Congress is Poised to Block Savings for Taxpayers and Seniors Alike (June 2008)
Under the current Medicare system, the Department of Health and Human Services (HHS), which administers Medicare, must make Medicare payments based on a government system of administrative pricing. HHS is specifically not allowed to accept competitive bids for medical supplies. This non-competitive pricing system makes the government pay more for medical goods and services than under prevailing market prices. To remedy the situation, Congress passed a bill in 2003 authorizing HHS to create a competitive bid process for Medicare. This law, which will come into effect July 1, 2008, is estimated to lower Medicare prices by 26%, saving taxpayers up to $1 billion annually as well as seniors, who pay 20% of their Medicare costs. Unsurprisingly, medical supply companies prefer the non-competitive system and are furiously lobbying Congress to maintain the old system for at least another year. 

AOA's Nursing Home Diversion Program (May 2008)
The authors review the Older Americans Act (AOA) and the role of the Administration on Aging (AOA) in delivering home and community-based services. Lawmakers wanted the Administration on Aging to insure that older persons could (1) make informed choices about their long term care services, (2) access to expanded "prevention" programs to help the frail maintain themselves in the community and to (3) enjoy expanded choices and services for individuals at risk of institutionalization. The report highlights programs in West Virginia, New Hampshire and Kentucky.

Fixing Health Care in New Mexico: An AARP Survey of New Mexico Residents Age 50+ (May 2008) 
According to AARP sources, the health care changes in New Mexico impact many residents who want to be certain that health care services are affordable. Equally important, nearly 30 percent of the adult population currently has no health insurance, making it difficult to enter old age in top health. 

Out-of-Pocket Costs and Affordability of Medicare (May 2008)
In light of continuing increases in Medicare costs, AARP commissioned study on affordability of Medicare in the US. This time researchers surveyed more than 1,000 older Americans to ascertain their views on their current out-of-pocket health care costs and a proposed increase in Medicare Part B premiums. 

Improving the Medicare Savings Programs Would Help Low-Income Seniors Cope With Higher Medical Expenses (May 2008)
Out-of-pocket health care expenses were almost three times as high for seniors as for typical non-elderly adults in 2003. US Senators are currently discussing legislation that would delay a cut in Medicare physician payments scheduled for the end of June. The legislation will also include needed improvements to the Medicare Savings Programs which could significantly help Medicare beneficiaries pay their out-of-pocket health costs.

Medicare Premium Support Survey (May 2008)
Researchers asked US persons age 50 and older about the proposed increase in Medicare Part B premiums. Eight out of 10 said they were very worried about paying their current out-of-pocket health care costs. A majority considered any additional cost increase as very unfair. 

Medicare Part D 2008: Data Spotlight; Low-Income Subsidy Plan Availability (April 2008)
The authors of this report show that 21% of the persons eligible for the Medicare Part D Low Income Subsidy (LIS) do not receive this important subsidy. (The Medicare Part D drug benefit program provides premium and cost-sharing assistance to beneficiaries who qualify for the program’s Low Income Subsidy or LIS.) Unfortunately, the eligibility requirements are difficult to meet.

Health Care Costs Drive Up the National Retirement Risk Index (February 2008)
Studies show that forty-four percent of US households will be unable to maintain their standard of living in retirement even if they continue to work up to age 65 (which is above the current average retirement age) and annuitize their financial assets. This percentage increases dramatically once rapidly increasing health costs are included into the calculations. 

A Profile of Medicaid Institutional and Community-Based Long-Term Care Service Use and Expenditures Among the Aged and Disabled Using MAX 2002 (January 2008)
The study evaluates how Medicaid enrollees use community-based long-term care services and examines how such community-based services are used across the US. The results indicate significant variation in patterns of long-term care services use and expenditures in 37 states. 

Do We Know If Medicare Advantage Special Needs Plans Are Special? (January 2008)
Enrollment in Medicare Special Needs Plans have doubled during the last year, but how do these plans actually perform in relation to other Medicare Advantage plans? SNPs are a new type of Medicare Advantage managed care plan limited to subgroups of Medicare beneficiaries in three categories: (1) those dually eligible for Medicare and Medicaid; (2) those who are institutionalized; and (3) those with severe or disabling chronic conditions. The researchers at Mathematica Policy Research ask if SNPs are doing anything special, and if so, how will we know? At this point, the jury is still out and the answers to these questions are not yet fully known.

Health Care Reform and Long Term Care: A Survey of AARP Members in New Mexico (January 2008)
One in five inhabitants of New Mexico lives without health care coverage. A survey of AARP members showed that 60% worry about whether they can afford health care. They said they would support “expanding health care for all even if it means an increase in taxes.”

Financing Medicare: An Issue Brief (January 2008)
The report provides an overview of how Medicare programs are financed and describes its financial challenges. Medicare program expenditures continue to grow steadily, reaching $440 billion in fiscal year 2007. This cost represents 16% of the total federal budget, exceeded only by Social Security benefits (21%) and military (19%) spending in 2007. 

Are Americans Talking with Their Parents About Independent Living: A 2007 Study Among Boomer Women (November 2007)
As people age, they and their children become more concerned with how they will receive long-term care and maintain their independence as long as possible. This study asked American women age 45 and older whether they had conversations with their parents about living independently in their old age or if they planned on receiving assistance. About two-thirds of respondents (69%) reported having this type of conversations yet only 40% said they had actively planned how to care for their parents. Of those who had discussed the matter, the most popular options were having their parents move in (43%) and providing home-care assistance (33%.) Interestingly, only 17% had considered a nursing home. It is quite possible that many women would like to plan their parent’s care, yet lack proper guidance.

Articles

Medicaid Patients Get More Authority to Direct Personal Care in Some States (September 29, 2008)
A new Medicaid rule, which becomes effective on November 3, allows some Medicaid beneficiaries to take charge of their own personal assistance services like bathing, preparing meals, household chores and other related services. Beneficiaries could even hire qualified family members who may already be familiar with the individual’s needs. The guidelines apply to states that adopt the self-directed personal assistance services option for their programs. The beneficiaries could either have their cash benefit allotment managed for them or receive a cash allowance to hire their own workers to help.

Poor People, Those on Medicaid Are Much Slower to Arrive at Hospital after Heart Attack (September 22, 2008) 
Patients who receive medical treatment in a timely manner tend to have better outcomes after a heart attack. However, the time elapsed between the onset of symptoms and arrival at the hospital as well as pre-treatment delay times have not improved over the years. Patients with Medicaid, and those who live in neighborhoods with lower household incomes, are less likely than others to reach the hospital within two hours. Reducing socio-economic and insurance disparities in pre-treatment delay is critical since excess delay time may hinder effective care.

The Cost, Choices of Health Care in Final Months (September 19, 2008)
There are five primary ways people cover the cost of care in the final months of life: Medicare (ages 65 and over and those with disabilities), Medicaid (for low-income people), insurance, out-of-pocket and unpaid care by family and friends. The use of medical care in the last months of life varies enormously depending on the geographic location. A comparison of Miami, Florida and Portland, Oregon is described in the article. 

No Rise in Monthly Medicare Premiums for 2009 (September 19, 2008)
For the first time since 2000, Medicare's standard Part B monthly premium in 2009 will remain the same as in 2008 for the vast majority of old people and disabled. In addition, the 2009 Part B deductible will be the same as this year. Medicare's Part B program covers a portion of the cost of physicians' services, outpatient hospital services, certain home health services, and durable medical equipment. However, the Centers for Medicare and Medicaid Services also announced that the Part A deductible will rise in 2009. It covers hospital and nursing home care. About 99 percent of beneficiaries do not pay a monthly charge for that coverage, but they will pay a deductible when admitted to a hospital.

Advertising by Insurers Favors Medicare Advantage Over Stand-Alone Drug Plans (September 16, 2008) 
Recently a new Kaiser Family Foundation investigation was carried out concerning Medicare Advantage plans. Results indicated that, in 2007, insurance companies placed three times more advertisements to promote Medicare Advantage plans than they did to promote stand-alone Medicare drug plans. Also, expenditures differed enormously--an estimated $30.1 million and $13.7 million, respectively. Other key findings of the study referred to the contents of the advertisements such as the specific type of plan, the images and the restrictions and limitations.

US Bans Free Meals, Cold Calls for Medicare Pitches (September 15, 2008) 
The US government recently prohibited unsolicited sales calls and free meals for Medicare promotional pitches. The bans are to protect beneficiaries from deceptive or high-pressure marketing tactics by insurance companies. Companies that break the new rules could face penalties of up to $25,000 for each person that was harmed or might have been harmed by the practices.

Critics: Medicare Helpline Not So Helpful (September 11, 2008)
Some seniors have learned the hard way that the Medicare hotline is not so helpful. Elderly callers have been given inaccurate information by poorly trained representatives and are being put on hold for close to one hour. An investigation conducted by a Senate committee revealed that 90 per cent of the time, Medicare hotline services could not answer questions or provide accurate information. 

Largest US Hospice Member Organization Files Suit Against Bush Administration (September 5, 2008)
The National Hospice and Palliative Care Organization (NHPCO) is attempting to stop a proposal to cut Medicare reimbursement rates for hospice care. Despite independent research that shows that hospice care saves the Medicare system an average of $2,300 per patient, the Bush administration wants to cut hospice reimbursement by almost $2.2 billion. More than 1.3 million Americans received hospice care from the nation’s hospice providers last year.

Medicare’s Troubling Drug Gap (September 2, 2008) 
The new Medicare drug program is confusing and costly. For millions of beneficiaries, it is also disappointing. Congress crafted gaps in coverage, such as the so-called "doughnut hole," in order to limit federal spending on the drug benefit. It forces patients who had been getting their drugs cheaply to suddenly pay the full price out of pocket. Beneficiaries with chronic diseases are particularly affected, and as a consequence stop taking their medication, skip doses or even switch to a cheaper but less effective drug. 

Overriding (President George) Bush Veto to Save Original Medicare (August 23, 2008)
Medicare's reform bill is intended to save the nation's health care system. After a dramatic battle, the President's veto was over-ruled by Congress, saving and transforming the traditional Medicare health care system. The bill not only stops a substantial cut in doctor's fees but also offers low-income beneficiaries adequate funding for individual health care programs. With Congress taking the first step to amend the nation's health care, Medicare may be able to offer more to both seniors and their doctors.

Hospitals on Edge about New Medicare Rules (August 23, 2008)
Hospitals have been placed under more pressure following Medicare's new stringent compensation rules. Patients who suffer from bedsores and other afflictions during their stay will be exempt from reimbursement by Medicare, as these ailments are deemed as hospital errors. These new rules will place more of an onus on hospital staff to improve caregiver quality. As insurance companies are now currently reviewing this policy, hospitals are facing the task of meticulously inspecting patients before and after treatment to minimize costs. 

Voters View Home Care As A Solution To Rising Medicare Spending (August 19, 2008)
Through national telephone surveys, the American Association for Homecare has found that a majority of US voters feel that home care is a viable solution for the Medicare crisis. Both US presidential candidates Barack Obama and John McCain agree on the need for Medicare to be more cost-effective. Home healthcare will allow seniors to maintain their autonomy and delay institutionalization by allowing them to age in place, which may ultimately improve their overall quality of life. 

Candidates Soft On Medicare On The Trail (August 19, 2008)
Medicare has been a perpetual hot topic in presidential campaigns, but due to the current state of the US economy, both presidential candidates are avoiding the topic of fiscally strengthening the federal healthcare program. Although Barack Obama and John McCain have differing views on how the Medicare crisis should be handled, Global Action on Aging believes that seniors must continue to have access to healthcare, a human right.

Confront Rising Drug Prices (August 12, 2008)
Drug prices in the United States have risen to incredulous levels. Some prescription drug prices have gone up by over 100 percent and a few over 1,000 percent. This means that many Americans are increasingly deprived of the medicine they need, while government spending on health care balloons. The government should be given the right to negotiate drug prices to keep costs down. If implemented, estimates suggest $90 billion savings every year. Why should older persons have to guarantee the high profit margins of pharmaceutical companies?

Payment for Performance in Nursing Homes (August 11, 2008)
Last week, Global Action on Aging published a report on the Long-Term Care Community Coalition’s (LTCCC) assessment of payment for performance (P4P) in long-term care. P4P seems to be a promising initiative and a possible answer to the lack of accountability in the health care industry. However, will this new system be able to tackle ever-increasing costs of care? Do we have alternatives? 

Medicare Expands Online Health Records Programs (August 10, 2008)
US patients will now have the opportunity to access their health records online. The records will contain patient data from Medicare records and will allow individuals to share information with physicians and other healthcare providers. The huge increase in health information technology is a major step forward in patient interaction. With technology tycoons such as Microsoft and Google endorsing digital health record systems, this signals a new era in health care.

Medicare Approves Fake Suppliers of Wheelchairs, Prosthetics (August 4, 2008)
Bogus medical equipment companies have cheated Medicare prompting the US government to set up fake companies to detect weaknesses in the Medicare billing system. With fraudulence a past experience and a future possibility, the Centers for Medicare and Medicaid are now implementing new stringent requirements for all medical suppliers.

Medicare Part D a Boon for Drug Companies, House Report Says (July 25, 2008)
While senior's have found obtaining prescription drugs through Medicare's privatized program Part D costly, US drug companies have reaped large profits. In contrast, Medicaid offers the same drugs at a far lower cost to seniors, and far lower profit to pharmaceuticals. Unsurprisingly, Republicans support expanding privatization while Democrats oppose it. Greater efforts need to be made to justify levying such hefty costs on seniors for necessary drugs.

Medicare Moves to Limit Costs in Drug Plans: Some Benefit Managers Charge More than Cost at Pharmacy, Boosting Expense for Patients (July 22, 2008)
Some pharmacy-benefit managers (PBMs) contracted by private Medicare insurers are involved in lock-in pricing schemes. PBMs negotiate for lower drug prices from pharmacies, but charge Medicare enrollees extra. Private insurance companies pay small fixed amounts; the ‘gaps’ created are covered by the government and the enrollee, increasing costs for both. ‘Gaps’ could reach above $100 for every prescription. The government is working on new policies to curb this avaricious scheme. However, intense lobbying with legislators seems to stall progress. 

Texas Senators Say They Would Override a Veto on Medicare Legislation (July 11, 2008)
On Thursday, US Senators John Cornyn and Kay Bailey Hutchison of Texas voted to override the President’s veto after reviewing the reality of what the bill means for all Medicare patients. Both Senators voted for the bill after feeling pressured that doctors could refuse to see Medicare patients as a result. Although faced with much opposition from the White House, it seems that passing the bill is inevitable, leaving many more Americans hopeful for a better quality of life.

White House Vows Veto of Medicare Bill (July 11, 2008)
Democrats and Republicans still oppose the Medicare bill to cut doctors’ fees. The proposed bill affects 44 million seniors. Doctors warn that limits will be imposed for the number of patients treated if the bill collapses. It appears that there are enough votes to override a possible veto by President Bush.

Medicare: What's Good for Old People? (July 10, 2008) 
During the last three weeks, legislators convened to ratify a bill that will divert funds from private insurance companies to prevent fee cuts for doctors. Based on the arguments of the two parties, seniors seem to face a “lose-lose” situation. Vying groups argue that access to healthcare will be impeded. On Wednesday, July 9, 2008, the bill was ratified in Congress. However, looking at the percentage enrolled with private insurance companies, the bill, in the short term, may be beneficial to older people. 

Kennedy Back in Senate to Approve Medicare Bill (July 10, 2008)
Wednesday, July 9, 2008, the Senate ratified the controversial Medicare bill, preventing a cut in the fees paid to doctors. The cuts will be pushed off another 18 months, allowing Medicare doctors to accept new Medicare patients. However, the government cut the funds for paying private insurers. Democrats credit the victory to Senator Edward Kennedy who voted at the session, despite undergoing recent brain surgery. 

Report Links Dead Doctors to Payments by Medicare (July 9, 2008)
Congressional investigators have recently uncovered a Medicare scam. Suppliers had been using the identification numbers of deceased doctors to obtain payments from the government. Many of these fraudulent activities remained largely undetected, costing the government between $60-92 million. Unfortunately, the government has no reliable system to identify claims made through deceased doctors. Worse, in some cases, doctors were colluding with suppliers. 

Doctors Press Senate to Undo Medicare Cuts (July 7, 2008)
Congress is again reviewing Medicare after recent radio and television advertisements clamoring for Congress to pay out payments due to physicians who care for the elderly. The American Medical Association (AMA) stated that doctors have experienced a 10.6 percent cut in payments. The Senate is now urging its Republican members to vote for the recent bill that will prevent these pay cuts in the future.

The Senate Stalls on Medicare (July 5, 2008)
The White House and Republican Senators have discarded a new Medicare bill that is intended to benefit millions of patients and improve health care plans for the future. Senate Republicans are adamant about protecting private plans. As Medicare is in deep financial trouble. US Citizens should urge their Senate representatives to protect a public system so vital to the country’s health.

Some Medicare Benefits Might Fall, Co-pays Rise: Fee-for-service 'Advantage' Plans Would Change Under House-passed Bill, Affecting 100,000 in Pennsylvania (July 5, 2008)
The pending Medicare bill may spell trouble for beneficiaries if passed. According to America’s Health Insurance Plans, a national trade association, policyholders benefiting from Medicare Advantage may be at risk for a reduction in benefits. The Medicare Improvements for Patients and Providers Act lacked a majority of votes within the Senate and remains a pending bill. The bill is intended to offset the reductions in physician reimbursements, which have been generating a great deal of strife between healthcare providers and the government. As long as the US healthcare system remains fragmented, consumers will suffer the consequences.

The Housing Crash and the End of Granny Bashing (June 24, 2008)
David Walker, the former Comptroller General of the Government Accountability Office, has concluded that US health care costs are out of control. For the money citizens pay, they get very little in return. More and more money will be needed to support retirees as their numbers increase. This is a long-term problem requiring serious solutions, not accusations that the “granny” generation is costing too much.

Settlement to Ease Drug Costs for Some on Medicare (June 20, 2008)
New medical protection may give new hope for low-income Medicare beneficiaries. The Bush Administration has promised this proposed settlement to help those who have difficulty obtaining the medications they need. Stay tuned.

Doctors Say Medication Is Overused in Dementia (June 23, 2008)
“My mother was screaming and out of it, drooling on herself and twitching,” said Ms. Lamascola, describing her mother’s reaction to treatment with antipsychotic drugs. The sales for antipsychotic drugs aimed to tamp down agitation and combative behavior in dementia patients have soared in the US. However, instead of prescribing these drugs as a last resort, doctors often overuse them. Read the story of Ms. Lamascola, who believed “she was losing her 88-year old mother to dementia. Instead, she was losing her to overmedication.”

Suppliers Fight Plan to Cut Medicare's Equipment Costs (June 10, 2008)
In 2003, the US government opted for a bidding system among medical equipment suppliers to offer cheaper prices to older consumers. Beginning July 1, the new competitive bidding system in ten metropolitan areas will take only bids from accredited suppliers. Many predict that this new system will save the government over one hundred million dollars in Medicare spending and ensure high quality products to Medicare beneficiaries.

Silver Alert: For When Elders Go Missing (May 12, 2008) 
In the US, some 5.2 million people suffer from dementia. Also, researchers have learned that six out of 10 of people with dementia will wander. They often cannot find their way back home and sometimes die before they can be rescued. However, the Silver Alert program helps caregivers find lost elders. This system exists in only six States. Now many communities are demanding a national wide implementation program. 

Elderly In Long-term Care Setting Suffer Depression More Than Those Cared For At Home (May 9, 2008)
Indiana State student researchers interviewed 272 elders, with an average age of 81 years to learn about their experience with depression. Often patients who live in a Long Term Care facility reported feeling depressed and some 30 percent said that they took prescribed antidepressants at the facility. On the other hand, only 11 percent of the residents in a home-care setting took anti-depressants. The researchers would like to find out more about patterns of anti-depressant use.

El Paso, Texas, Region Can Serve as 'Model' for Minority Health Care, Opinion Piece States (May 05, 2008)
The population in the El Paso, Texas, area is 80% Hispanic. This region can serve as a model to the rest of the country in the way it provides quality health care to a diverse community. There are clear disparities among minority groups that lead to higher rates of chronic disease and death, simply because adequate care is not available in this Mexican border area. Experts suggest that the US move away from national reforms and focus on what is needed locally.

Medicare Plans Affected by Rising Drug Costs (April 19, 2008)

Since 2006, drug companies have raised the price of specialty medications that seniors use, due to an overall increase in drug prices. Many Medicare Part D plans require policyholders to pay a certain percentage of the cost of a specialty drug. Once patients reach a cap on out-of-pocket spending, the percentage of their payments is reduced while the proportion paid by the federal government increases. According to a Harvard-based study, this practice puts a strain on the federal budget.  

Medicare Data Should Stay Private, Government Says in Appeal: The Bush Administration Wants to Keep Limits on Healthcare Records that Could be Used to Rate Doctors (April 19, 2008)

The Bush administration has used a court appeal to keep Medicare billing records confidential. Consumer groups, health insurance companies and healthcare employers are demanding a release of these records that will inform the public of physicians’ track records. Physicians, on the other hand, support the appeal because it will protect their information. They say it can be misleading and misconstrued because statistics do not accurately represent doctors’ skills. If the information is released, presumably, Medicare patients can compare hospitals and other care facilities and come to their own conclusions about a “good doctor.”

Crisis Ahead for Elderly Health Care? (April 14, 2008)
Millions of US elders may not receive proper health care in the next three decades. An alarming report issued by the Institute of Medicine warns that the United States “faces a massive health care shortage” due to lack of geriatricians and nurses trained to care for older persons in the country.

When a Mind Begins to Disappear: A Young Family's Journey to the Dark Side (April 11, 2008) 
This sad story is worthy of reflection. Alzheimer’s is mostly defined as an illness of elderly people. But the number of those suffering from early-onset Alzheimer’s come to about 500,000 in the US. For persons with families, this situation dramatically affects the future of the family, including their economic security.

Crisis of Age Requires Cure (April 5, 2008)
Every day 6,000 Americans turn 65. The Baby Boomer population now reaching retirement age foretells a critical situation about the availability of medical care. More and more older people will need support and care but few medical students want to specialize in geriatrics. Geriatrician Mark Lachs speaks about that problem is this article and how important it is to consider the implications. The idea of aging is not particularly a topic of interest to young people, making it difficult to raise awareness of the impending crisis. 

Gov't Raises Payments to Health Insurers (April 7, 2008)
The US government has proposed a payment increase to private insurance companies participating in the Medicare Advantage program starting next year. This proposed 3.6% increase in payments is intended to be an incentive for companies to improve their services to attract new enrollees. Democrats oppose these payment increases, arguing that the Medicare Advantage program is costing the government more than traditional Medicare. Unions and consumer groups are appealing to Congress to end bonus subsidies to private insurers, but President Bush is determined to veto any cuts to these bonus payments. 

Care for Elderly Ill Costliest in N.Y., New Jersey, California (April 7, 2008)
With 23% of Medicare beneficiaries suffering from 5 or more chronic illnesses, medical bills are stacking up. Studies have found that the average cost of medicals bills of New York, New Jersey and California elders exceeds the national average by 20%. A Medicare expenditure of $81,143 on an elderly Manhattan resident in the last two years of his or her life compares to only $29,116 spent for the same care in Dubuque, Iowa. 

Doctors May Limit Patients After Change in Medicare (April 1, 2008)
Hundreds of doctors will gather in Washington D.C. to rally against the proposed cuts in Medicare payments that will affect how much doctors will be paid for their services. Expenses for doctors seeing Medicare patients are increasing and the practitioners expect to be paid accordingly. Instead of paying doctors the appropriate fees, the US government is redirecting funds to private insurance companies offering Medicare Advantage programs. The article argues that the government needs to stop the cuts in Medicare payments to doctors before a shortage of doctors caring for Medicare patients becomes dire in the US.

Getting Out of a Nursing Home Just Got Harder (March 24, 2008)
The US government recently implemented new restrictions on Medicaid funding that will require recipients to coordinate their various medical services through “targeted case management.” These restrictions are suggested to have a negative impact on seniors in nursing homes. Per the new policy, states will receive federal Medicaid reimbursement for providing targeted case management for 60 days instead of the former 160 days, which gave nursing home residents more time to seek independent housing. Residents with disabilities and chronic health problems may find it more difficult to get back on their feet after institutionalization and most likely will need more than 60 days.

(Montana Senator Max) Baucus Tackles Cuts in Subsidies for Medicare Advantage (March 23, 2008)

Senator Max Baucus of Montana, who is also chairman of the Senate Finance Committee, hopes to cut subsidies for private insurance companies selling Medicare Advantage plans. The subsidies for the Advantage plans cost the US treasury additional tens of billions along with to traditional Medicare fees. While private insurance companies administering certain Medicare services are being overpaid, seniors are paying more for these services and physicians are not being paid enough. Over 10 percent of the subsidies for private insurance companies go toward marketing and profit rather than physician fees. 

Congress Rejects Medicare, Medicaid Cuts (March 14, 2008)
President Bush proposed cuts to Medicare spending that could have caused some New Jersey hospitals to cut back on services or close altogether. However, both Democratic and Republican members of Congress rejected the proposal. On March 14, Congress voted to adopt a budget for 2009 and the House voted for its version of the budget plan. While Democrats suggest their plan will increase spending on education and health care, Republicans oppose it. Congress will ultimately have the final say on federal spending and will work on a budget resolution over the next few months.

Heart-Device Hacking Risks Seen (March 12, 2008)
Researchers from Medtronic learned that it is possible for hackers to shock, shut down your heart or publish personal medical information. This is possible through interference with radio waves used to control defibrillators. These machines are used to 
restart the heart with an electrical jolt. It is important to know that this is only a theoretical risk.

Deadline Looms for Medicare Choice (March 9, 2008)
This article offers advice for seniors to consider before the March 31 deadline for changing Medicare program plans. Some individuals have experienced health benefits from Silver Sneakers, a senior exercise program that is part of the Humana Medicare Advantage plan. Seniors are advised to remain with their current plan if their medical care is complicated and they already have an established team of health care providers. Consider asking your doctor for advice and looking at costs and types of treatments covered and how many area healthcare providers exist within the plan’s network. Also, take precautions against fraudulent plans.

Exercise Promoted in Nursing Homes (March 9, 2008)
Due to numerous studies showing the health benefits of exercise for the elderly, physical fitness is being promoted in nursing homes. Such benefits include increase in muscle mass, improved posture and balance and the promotion of healing wounds. Exercise is usually not part of nursing home activities, but should be included in the daily regimen of care to meet the physical fitness needs of most residents. Linda Thurston, who formed the Senior Fitness Movement in Ohio, engages seniors in physical activity that promotes positive health outcomes. 

More Prescriptions, Greater Confusion: Medications Improve the Lives of Seniors, but Errors in Taking Them can be Lethal (March 9, 2008)
Medication mismanagement often leads to hospitalizations of older persons. A single senior can be prescribed a variety of medications to treat various medical conditions. But sometimes the drugs’ effects may be antagonistic to other medications, leading to serious health risks. Seniors are also more likely to administer their medications incorrectly, either taking too much or not enough, ending up in emergency situations. It is important for caregivers and home health aides to carefully monitor the drug intake of older persons who cannot manage on their own.

Early Onset Alzheimer's On The Rise (March 8, 2008)
The number of Americans with Alzheimer’s is expected to reach sixteen million by 2050, tripling the current total. As the number rises, the age of onset among those affected will be lower. Early onset Alzheimer’s is becoming more prominent, affecting individuals in their early 50’s. Some people have a genetic disposition to Alzheimer’s and should be aware of their family’s medical history. 

Kohl Reacts To AHIP's Most Recent Pledge To Clean Up Sales And Marketing Tactics Of Medicare Advantage Plans (March 05, 2008)
In 2007, America's Health Insurance Plans, a political advocacy group that works with more than a thousand health insurance companies, pledged to stop selling confusing Medicare plans to the elderly. Members of the Senate Special Committee on Aging are skeptical of the company’s ability to clean up its act and are looking into other ways to reduce problems in the health system. A bill, proposed last year, would move responsibility for healthcare out of the hands of the federal government and make individual states the sole champions of regulating and standardizing a state system. Perhaps taking the profit out healthcare would help.

Massachusetts Hospitals Win Suit on Medicare: Reimbursement Must Be Refigured (February 29, 2008)
Hospitals in Massachusetts are winning the battle in a long-running dispute with Medicare. The federal government has been ordered to pay $200 million in reimbursement fees to all sixty-two hospitals involved because the government used the wrong wage index. Medicare officials are disappointed with the decision and are studying the case further to explore other options.

Congress Seeks Parity for Medicare Bills (February 29, 2008)
The US Congress has pressured Medicare to change Palm Beach, Broward and Miami-Dade counties to a single payment unit for Medicare Advantage plans. Payments made to private managed care plans differ from county to county, producing dispazities based on statistical information used to assess local communities. A larger unit system is currently under review.

Honeywell Lobbied on Medicare Issues (February 28, 2008)
International manufacturer Honeywell, with the support of former government officials, lobbied against the federal government, including the Centers for Medicare and Medicaid (CMS), about issues of reimbursement. 

Hospitals Say Medicare Law Won't Spur Changes (February 22, 2008)
A new Medicare law enacted to stop reimbursing hospitals for treating preventable errors will not have a major effect on some institutions as believed, local hospital officials claim. The article suggests the most important problem within hospitals is urinary tract infection from catheters. Hospitals that have a low rate of problems follow stringent regulations, including training a central line team to adhere strictly to protocols, implementing an aggressive hand washing policy, using unique colored clothing to identify patients at risk for falls and putting in new mattresses to reduce the occurrence of bed sores. 

Maine’s Aging Boomers: Who Will Pay for Long-term Care (February 19, 2008)
As Maine is on the verge of a 'baby boomer' wave, employees at long-term care facilities are feeling the strain caused from inadequate funding from MaineCare, Maine's state Medicaid program. The industry has improved overall wages, created more categories of workers and offered better compensation for more skilled and educated workers in an attempt to ease the strain. In spite of funding issues, a customer satisfaction survey commissioned by Maine Health Care Association found that 91% of relatives of health care patients rated the care as 'good' or 'excellent.'

Medicare Won't Pay Hospitals for Errors (February 18, 2008)
Medicare will reject payments for errors caused by hospital staff. In some cases, patients have had surgical sponges left in their bodies after operations and the list of errors is constantly growing. Private insurance giants such as Aetna are pressuring hospitals to assume responsibility for these costs generated by preventable errors. Next year, Medicare will impose a move to add three more errors to the “no-pay” list and asserts that this will reduce government spending by $190 million over a five-year period. Hospitals claim to monitor these issues closely to prevent such errors from arising in the future.

Senate Finance Committee Bans American Medical Association From Medicare Reform Bill Talks (February 15, 2008)
The American Medical Association (AMA) is pushing for an increase in physician payments while the Senate Finance Committee wants to cut physician fees. However, Congress has banned the AMA from taking part in these discussions due to its failure to comply with a confidentiality agreement about Medicare talks last year. At this point, Congress is the legislative authority that can intervene to stop the cuts.

To Boost Medicare, Cut Industry Giveaways (February 15, 2008)
In this opinion piece, the author suggests that legislative decisions made under the Bush administration have seriously jeopardized the stability of Medicare, considered one of the most effective public programs in the nation’s history to date. The author argues that Medicare assures medical services for seniors who would otherwise have difficulty obtaining them via private insurance. Furthermore, the introduction of Medicare Part D in 2003 is hindering, rather than helping, seniors acquire their medications. The Bush administration is eating away at the heart of Medicare.

Medicare Orders Health Net to Stop Selling Orange Drug Plans (February 15, 2008)
Health Net Inc., one of the largest US health insurers, offers prescription drug plans to seniors. However, the Centers for Medicare and Medicaid (CMS) have ordered the company to halt marketing and enrollment in its drug plans due to violations of federal regulations. This CMS decision is part of the larger attempt to enforce proper conduct among insurers to prevent seniors from becoming victims of marketing abuse. Medicare officials have ordered Health Net, Inc., one of the largest publicly traded health insurers in the nation, to stop marketing its “Health Net Orange” prescription drug plans.

O'Malley to Unveil CareFirst (BlueCross BlueShield) Program: CareFirst Pledges to Plug Medicare Drug Gap in Maryland (February 15, 2008)
Maryland Governor Martin O’Malley has proposed a partnership with CareFirst, a BlueCross BlueShield program, to help seniors pay for prescription drugs. The program is intended to cover the gap left by the Medicare prescription drug program. CareFirst will provide enough coverage to spare the State any costs. Lower-income seniors will be covered by the program, which is intended to reduce the number of uninsured elderly.

Need for Geriatric Nurses Growing (February 2, 2008)
A growing elderly population has created a demand for geriatric nurses in the Upper Midwest region of the US. Regional colleges have developed a program to provide resources to improve geriatric nursing education based on a Hartford Foundation grant. The funding will also be used to increase the number of quality faculty within those academic institutions. It is important not only to improve geriatric nursing, but also to encourage students to enter the field to reduce current shortages.

Long-Term Care Authority to Address Issues Raised by Audit (January 26, 2008)
An audit by the Oklahoma State Department of Human Services raised issues with the Long-Term Care Authority regarding payroll errors, excessive administrative salaries and lack of program controls. The Long-Term Care Authority, based in Tulsa, has created a plan of action to address the issues after failing to seek an appeal. The Authority hopes to renew its Advantage Waiver program contract, thus compliance with the Department is critical.

Researchers Weigh Benefits of Medicare Part D for Seniors (January 25, 2008)
While research analysts have found the Medicare prescription drug plan (Part D) to be effective in lowering seniors’ drug expenditures, it is yet to be determined whether the program is cost-effective for the federal government. Although research shows that individual recipients are saving money, they are also increasing their prescription pills. Researchers suggest that in order to justify federal spending for the program, an analysis is needed to determine whether there is an overall improvement in beneficiaries health.

State's Lawmakers Grapple with Retirement Issues: Nursing-home Payments, Long Term Care Insurance on the Agenda for this Session (January 24, 2008)
Washington State legislators are currently addressing issues of long-term residential facility payment systems, premium increases for long-term care insurance policies, and increasing pay for low-income workers in the field of long-term care. A task force formed last year issued a report that included recommendations for long-term elder care services.

Mayo in Rochester Unlikely to Limit Medicare Patients (January 24, 2008)
Due to conflicting interests in care priorities, the Mayo Clinic in Rochester is proposing to set limits on care for Medicare patients at its Arizona campus. Care needs in Arizona tend to focus on specialty services while the Mayo Clinic mainly provides primary health care. Mayo maintains that it provides services based on need, regardless of ability to pay. The Mayo Clinic will have to address the growing aging population in a time of capacity shortage. 

6,300 Medical Equipment Suppliers Participated in First Round of Medicare Competitive Bidding Program (January 18, 2008)
A Medicare competitive bidding program was mandated in 2003. Last week, during the first round of the program, more than 6,300 bids from medical equipment suppliers were received. The Centers for Medicare and Medicaid Services (CMS) hopes to save billions of dollars for the agency and its policyholders by setting prices for medical products through competitive bidding. So far the program has taken place only in a select few places, but is expected to take bids nationwide next year. 

Medicare Helps Push Drug Spending Up (January 8, 2008)
Since Congress created the Medicare prescription drug plan in 2006, pharmaceutical costs have increased rapidly. Influenced by industry lobbyists, the government ruled out any bargaining for lower drug prices. Over a year later, both out-of-pocket spending and public funds used to pay for medications have risen. Even worse, a study shows that despite higher drug expenditures, the US has the worst health outcomes. 

Health Spending Exceeded Record $2 Trillion in 2006 (January 8, 2008)
The journal, Health Affairs, reported that Medicaid spending has gone down since it was introduced in 1965. Thanks to Medicare Part D, more beneficiaries are able to acquire prescription drugs, hence the increase in drug expenses. Health care spending currently accounts for 16 percent of the gross domestic product and experts speculate federal funding covers most of the spending. 

Retiree Healthcare Crisis Brewing in State (January 8, 2008)
A California commission studying post-employment benefits for public employees says that the State needs $1.2 billion to cover healthcare for state employees. While California is struggling to balance its budget, the appointed commission has advised the State to figure the sum into the budget now as employees are near retirement age. As healthcare costs are expected to rise in the next few years, the commission anticipates a financial crisis. 

Feds to Enforce Tighter Restrictions to Help Prevent Medicare Fraud (January 8, 2008)
In recent years, greedy salespersons pushing medical equipment have targeted Medicare beneficiaries. In some cases, they wrangle vulnerable seniors into purchasing unwanted or unnecessary medical equipment, which is paid for by Medicare. Aware of such fraud, federal officials want to end such activity by putting medical equipment suppliers under critical scrutiny by accredited agencies. Suppliers will also be required to set prices through a competitive bidding process. 

State OKs Medicare Supplement Plan (January 4, 2008)
A health care insurance company based in Florida has been allowed by the state to market its Medicare supplement plan. Approval was obtained from both the state insurance office and the federal Centers for Medicare & Medicaid (CMS) before the insurance plan was allowed to enroll new members. Prior to the recent approval, the insurance company could not financially support enrollment for the plan, thus marketing was suspended and enrollees dropped. Enrollment for the plan is currently ongoing.

Private Insurance/Other

Reports

How Much Do Older Workers Value Employee Health Insurance? (July 2008)
Why do some US workers have access to health insurance and others do not, especially when they enter their retirement years and still lack this option in their lives. This report provides answers. The authors focus on the fact that some workers must buy their own insurance while others have employer-paid insurance. First, it’s difficult to find health insurance that’s affordable, particularly for low income persons. Second, some employers require workers to buy health insurance but provide subsidies to low-income workers. Others voluntarily offer such households subsidized insurance. basis. Some employers pay health insurance for high-ranking workers as a way to attract workers. This report also highlights discrimination between low-income and well-paid jobs regarding health insurance.

How Can We Improve Long-Term Care Financing? (June 2008)
The US system of long-term care is “deeply flawed.” Every year more and more elderly and disabled fail to receive care they need. Long-term care can be made more widely accessible by either enhancing private long-term care insurance, replacing the current income-based system with a public social insurance program, or introducing a hybrid public-private system — although none of these alternatives is optimal. 

Do Out-of-Pocket Health Care Costs Delay Retirement? (February 2008)
The answer to the question is “Yes!” Cutbacks in employer-sponsored retiree health benefits add to the difficulty that many older Americans face paying for health care. The results of the study show that the premium costs associated with retirement before age 65 and expected out-of-pocket health care costs after age 65 do substantially delay retirement.

Articles

Long-term Care Insurance Rises (September 15, 2008)
Just when America was warming up to the idea of purchasing long-term care insurance to protect family assets from the devastating costs of custodial care, the three largest insurance companies have shaken up the market by raising prices on existing policies, not just on policies to be sold in the future. The insurers have made a pricing mistake and now realize they are liable for much bigger payouts than originally expected. Despite this bad news, long-term care insurance may still be better than depending solely on the Medicaid program, which may have economic problems of its own in caring for a growing elderly population.

Palliative Care Programs Lead to Cost Savings (September 8, 2008)
When seriously ill patients and their families were involved in setting goals for their care, the costs were reduced dramatically. This was usually because the patient and the palliative care team chose treatments that emphasized improving quality of life over prolonging life. In this case, a patient might then be spared critical-care unit admissions and long hospital stays and the associated costs. Dr. Morrison said in an interview that conventional care "is not overtreatment, but treatment not matched to goals."

Innovative Honor-Providence Hospital Receives Award for Palliative Care Programs in D.C. (September 8, 2008)
Providence hospital in Washington D.C. recently received an award for its innovative programs for end-of-life care. These innovations include a four-week structured series where patients and their families discuss care goals with hospice physicians and medical residents. The program encourages continued spiritual support from the patient's faith community, as well as providing spiritual counseling as part of the care. 

Aging Baby Boomers Drive Hospital Growth: Aging Population Creates New Needs (August 10, 2008)
Montgomery County, Maryland, has experienced a huge demand in the health care sector due to the growing population of aging baby boomers. Although the county's medical centers have expanded through the years to address the demand, the strain is still felt. Maryland’s government must now improve its health care infrastructure to update and modernize all old and new medical centers to accommodate its increasing baby boomer population.

Millions With Chronic Disease Get Little to No Treatment (August 5, 2008)
Millions of people in the US are suffering due to lack of healthcare insurance. A study from the Annals of Internal Medicine found that one out of three adults suffers from chronic illnesses for lack of financing to pay medical and insurance fees. With the rising expenses of health care, a bleak future awaits those uninsured unless more affordable options are introduced. People suffering from untreated chronic illness younger in life may have a lower quality of life in old age or may never reach the later stages of their lives. Why can’t US residents enjoy the same healthcare protection that Europeans do?

Retiree Health Coverage on the Decline (July 25, 2008)
As more and more companies announce cutbacks on health benefits, the full health coverage retired employees once enjoyed seems a thing of the past. Companies are cutting health-care benefits for their pensioners, often fully eliminating them. Although some companies still provide varying degrees of coverage, many seniors have had to turn to Medicare for help.

Health Care Workforce Not Enough for Aging Boomers (July 25, 2008)
With aging population comes greater demand for medical care and yet, as alarm bells ring, the nation's health care workforce is shrinking. While enrollment schemes for nursing schools have been modified and enhanced to deal with the change, the lack of funds to hire additional faculty and training is a critical problem bound to affect many seniors seeking healthcare.

FDA Approves Generic Antipsychotic Drug (July 3, 2008)
(Article also available in Arabic)
The US Food and Drug Administration (FDA) approved the first generic versions of Risperdal (risperidone) tablets.  Risperdal is an antipsychotic used to treat schizophrenia, bipolarity, and other mental illness.  The labeling of the generic may differ from the brand name due to patent and exclusivity restrictions. The use of such antipsychotic medications for the treatment of dementia is left to the doctor’s decision.

AMA Calls Physician Reimbursements Flawed (June 17, 2008)
According to the American Medical Association (AMA), the US healthcare system accrued a $200 billion annual deficit due to reimbursements left unpaid by insurance companies. Medical staff and doctors find themselves losing 14 percent of this figure, due to costs of collecting the monies. AMA is campaigning to hold health insurance companies accountable, making claims processing more cost-effective and transparent. 

Terrifying ‘Stat’! ER Overstuffing is Fatal Many Docs Saw Death of Patient (May 18, 2008)
Overcrowding in New York City hospitals has reached epidemic proportions due to an increase in elderly and sicker patients, the beginning of flu season, and a decrease in hospital beds. This fresh increase comes on top of a study last years which found that 28% of New York City doctors have personally seen a patient die because of overcrowded emergency rooms and 69% have seen patients “harmed” by overcrowding. One 85-year-old woman, a legally blind diabetic amputee, spent two days in the Maimonides Medical Center ER in Brooklyn waiting for medical treatment after she passed out at home in January. Over the last 10 years illnesses treated in hospital ERs have increased by 20%. 

Even the Insured Feel Strain of Health Costs (May 4, 2008)
Even with healthcare insurance, insured individuals do not feel very secure with the US economy in a serious slump. Nearly 50 million US citizens are without healthcare insurance and those who are insured are paying more for healthcare these days. Concerns about limited coverage and inability to pay out-of-pocket deductibles and co-payments abound, especially now that medical costs continue to rise. It has reached such dire straits that US citizens are avoiding medical expenses by neglecting to see a healthcare provider, even if a medical concern absolutely warrants a visit to the doctor. In view of these concerns, healthcare will have a significant bearing on the 2008 US Presidential Elections. 

Aging Inmates Push Up Cost of Medical Care (March 23, 2008)
The cost of medical care is on the rise this year, due to the costs accrued by inmates aging during their incarceration. The additional costs are speculated to sum up to more than $1 million. Medical care for cardiac problems, surgeries and cancer treatments contribute largely to this sum. It is suggested that most of these health conditions stem from the inmates’ lifestyles before incarceration and are exacerbated through old age. 

State Denies License for Vets Nursing Home (January 18, 2008)
Due to problems with the facility, the West Virginia Veterans Nursing Home has been denied a license by the state. Problems ranged from mechanical errors in setting up equipment to inadequate personal and medical care. The report by state inspectors also cited the facility’s failure to screen job applicants. The million-dollar facility hopes to resolve the problems by the end of the month. It is important to meet state requirements for inspection in order to ensure that residents receive quality care. 

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DRUGS/ PHARMACEUTICALS

Reports

Report: Seniors and Drug Prices in Canada and the United States, 2008 Edition (August 2008)
The Fraser Institute’s report compares Canadian and US prescription drug prices. The results show that Canadians pay an average of 101% more for generic drugs yet they pay 57% less for brand name drugs. The report suggests that a lack of competition among retail pharmacies and generic manufacturers may be the cause of high generic drug prices in Canada. 

Rx Watchdog Report: Trends in Prices of Brand Name Prescription Drugs Used by Medicare Beneficiaries (May 2008)
Here AARP investigators explore the trends in prices of brand-name prescription drugs which “have far outstripped the price increases for other consumer goods and services between 2002 and 2007.” Their findings show that manufacturers increased the prices substantially with the average price increase continuing to exceed the rate of inflation. 

Rx Watchdog Report: Trends in Prices of Generic Prescription Drugs Used by Medicare Beneficiaries (May 2008)
Staff from the AARP Public Policy Institute present their most recent studies of price changes in generic prescription drugs. Specifically, their study compares changes of generic prescription drugs average costs over time and investigates differences in average price changes by manufacturer and by major therapeutic category. 

Inducing Seizures Among Seniors (May 6, 2008)
In recent years the number of Canadian seniors willing to undergo Electroconvulsive Shock Therapy (ECT) for depression has greatly increased with the number of senior citizens treated with electroconvulsive shock in Ontario rising from 7,800 in 1999 to 10,800 in 2005. Depression is a particularly acute problem for seniors, who are both more likely to suffer from the disorder and to take their own lives from it. ECT, which uses electricity to induce brain seizures, has been a depression therapy for decades and has seen previous such swings in its usage. 

Older American Indians and Alaska Natives Have Higher Rates of Chronic Disease Risk Factors and Fewer Vaccinations (May 2008)
The results of a Center for Disease Control (CDC) survey reveal that older American Indians and Alaska Natives (AIAN) have greater rates of diabetes, obesity, tobacco use, and physical inactivity compared to Caucasian Americans. In addition, they have lower rates of vaccinations for pnuemococcus, a form of strep which causes nose and ear infections. 

Global Action on Aging Research Bibliography: Psychotropic Drug Use in Nursing Homes
An estimated 80% of elderly nursing home residents suffer from mental disorders, such as Alzheimer's disease, depression, and anxiety and psychotic disorders. While psychotropic medications can be effective in treating mental disorders, there are concerns that overmedication of these vulnerable people can occur. Global Action on Aging is actively involved in researching and documenting the many aspects of overmedication in nursing homes. We have created a page providing links to information and studies on psychotropic drugs use in nursing homes, both in the United States and internationally.

Articles 

Flu Shots: What's Your Excuse? (September 25, 2008) 
Despite huge supply, too few people get flu vaccine. Young children and older persons are especially vulnerable to serious flu complications. Overall, 72% of seniors get their flu shots, ranging from 63.7% in Florida to 81% in Rhode Island. The Centers for Disease Control goal is to vaccinate 90% of seniors in 2010. The CDC advises people to do a second shot after Christmas because over 80% of the time peak flu season does not arrive until January or later, and over 60% of the time peak flu season doesn't hit until February or later.

Prostate Cancer Hormone Therapy May Raise Mortality (September 23, 2008)
Researchers reviewed records of more than 1,700 men at least 70 years of age with early-stage prostate cancer who were treated with a 3.5 months hormone therapy before undergoing brachytherapy. Results suggest that hormone therapy decreases levels of androgen, a hormone that stimulates the growth of prostate cancer cells. After an average follow-up of five years, the men who received hormone therapy were 20% more likely to die from any cause compared with the men who received brachytherapy alone.

New Research Could Lead to a Vaccine for Pneumococcus Disease (September 22, 2008) 
Pneumococcus is a bacterium that particularly affects children and elderly people. The carriage of pneumococcus in the nose is a necessary first step for most infections. Now researchers have learned that the immune system detects and destroys the pneumococcal bug when it colonizes the nose. This knowledge could help in the development of a new vaccine against the disease, including pneumonia and meningitis. In addition, the new vaccine might be an attractive alternative to the existing vaccines that are often not ideal for use and are prohibitively expensive. 

Study Confirms Benefit of Combination Therapy for Alzheimer's Disease (September 22, 2008)
Researchers from Massachusetts General Hospital found that extended treatment with drugs can significantly slow the rate at which Alzheimer's disease advances. Additionally, a combination therapy with two different classes of drugs is even better at helping patients maintain their ability to perform daily activities. Results suggest that the longer patients keep receiving combination therapy, the smaller their rate of decline is. Even if symptoms get worse it does not mean that the drug is ineffective, since the decline probably would have been much greater without therapy.

Pills, Pills, Pill (August 24, 2008)
In today's world there seems to be a pill for every illness. As the demand for prescription drugs continues to rise, more and more seniors find themselves consuming more pills on a daily basis. Getting a detailed diagnosis can be difficult, and in some cases, doctors tend to pacify patients with drugs and medications, rather than offer the patient a detailed synopsis of their illnesses. Polypharmacy (the practice of prescribing too many medications) is a major issue and creates many problems for seniors. However, with careful interventions, prescribing only necessary medications will ensure a better quality of life and longevity.

FDA: Older Psych Drugs Have Fatal Risks in Seniors (June 16, 2008)
The FDA recently updated its announcement for active caution when prescribing psychiatric drugs to seniors. Many medications now provoke fatal side effects for those suffering from dementia. Although these drugs carry huge risks for elders, the FDA continues to approve new drugs and their marketing plans. Almost 20 percent of patients prescribed these medications have never been diagnosed with psychiatric problems, according to Medicare reports. Will doctors use their better judgment before prescribing these dangerous medications? Can we count on it? 

Americans Taking Prescription Drugs in Greater Numbers (May 14, 2008)
More than half of US persons with health insurance are taking prescription drugs for chronic health problems and the numbers are rising. As more persons get heart disease, obesity and diabetes, they turn to drug treatments. Why? Widespread drug marketing campaigns, efficacy of some medications and lack of public health services push up drug use. For the past six years, three-quarters of older adults (65 years and older) use prescription medicines. GAA believes that citizens should demand more public health services to curb dependency on prescription drug use, which often can lead to more serious health problems. Restricted drug advertising can also reduce use as the European experience shows.

Antibiotics Questioned in Care at Life’s End (March 9, 2008)
A recent study has shown that antibiotics administered in nursing homes for dementia patients show evidence of long term damage. The treatments often cause resistance to germs and bacteria which can easily attack already weak immune systems of the elderly. In a study of about 200 patients, 52 who died received the treatment during the last few weeks of life. To raise even more concerns, research also suggests that doctors gave the antibiotics without consideration to the effectiveness of the drugs.

Program Aims to Help Seniors with Drug Costs (February 19, 2008)
Jay Nixon, Attorney General of Missouri, announced last week that his state government intends to provide technology grants to local health organizations to assist seniors with applying for free or reduced-cost prescription drug programs. Nearly 200 programs offered by pharmaceutical companies provide drugs to seniors pro bono or at low cost. 

CBO (Congressional Budget Office) Analysis Suggests Allowing Pharmacies To Negotiate Contracts With Part D Plans Would Cost $681M Over Five Years (January 18, 2008)
A report from the Congressional Budget Office (CBO) suggested that a measure permitting independent pharmacies to directly negotiate contracts with health insurance companies would cost the government hundreds of millions. It is believed that the legislation would affect the Medicare prescription drug program by increasing the cost of drugs. This increase would in effect raise the premiums for group health insurance plans. 

Aging: Mental Health Overlooked in Care of Elderly Patients (January 8, 2008)
A new study suggests that primary care physicians may not spend enough time treating psychiatric disorders commonly found in their older patients. It seems that self-reported depressed patients never discussed their condition with their doctors.  Patients who reportedly spoke with their doctors about their emotional state found it unhelpful. Findings point anew to better communication between doctors and their older patients.

Aging AIDS Patients Beset by Complex Health Problems (January 6, 2008)
According to the US Centers for Disease Control, the rate of older persons living with AIDS disease has increased 77 percent between 2001 and 2005. However, only a few studies show the correlation between AIDS among older patients and other health problems, such as pulmonary disease, diabetes, ulcer, cancers, and more. Experts expect that the immune system of older AIDS patients may be weakened as they age further due to cocktails of drugs that they took earlier to fight the disease.

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HEALTHY LIVING

Reports

Assessing Longitudinal Relationships between Social Factors and Health (August 2008)
Do social factors play a role in the way we age? Social support, participation and religious participation all have been shown to have a positive impact on our health. The study conducted by the University of Wisconsin – Madison investigated the issues and found a positive relationship between social participation and health but with a good deal of gender discrepancy. 

Will People Be Healthy Enough to Work Longer? (August 2008)
Healthy life expectancy has increased by three years over 1970 – 2000 for an average 50 year old man living in the US. Does that mean that the nation is ready to increase the age of retirement up to 63 years to avoid income shortfalls at an older age? The results of the National Health Interview Survey reveal that health expectancy varies significantly by race and education. These disparities may indicate that a vulnerable portion of the population may not be healthy enough to stay in the workforce for additional years. 

The Future of Nursing Homes in New York State (August 2008)
New York State already supports one of the largest populations of old people who need nursing homes in the United States. As the baby boomer generation ages, policymakers and citizens alike are searching for less restrictive, more cost-efficient forms of long term care. In this document, the Long Term Care Community Coalition (LTCCC) reports on the result of two roundtable discussions on the future of Nursing Homes. The discussions touched on topics that included culture-specific care, financial difficulties faced by institutions and skilled personnel shortages.

Serious Psychological Distress Among Adults Aged 50 or Older: 2005 & 2006 (July 2008)
Data from the 2005 and 2006 National Surveys on Drug Use and Health show that 7% of the American seniors experience serious psychological distress. Adults were more likely to be stressed if they did not have a high school diploma, earned less than $20,000 a year and lacked health insurance. The study also found that only half of adults with serious psychological distress received mental health treatment in the past year. 

Evaluation of the AARP Red Hat Society Step & Stride with Ruby: A Year-Long Walking Program (July 2008)
In 2007, in response to a survey highlighting older women’s needs, AARP in partnership with the Red Hat Society designed a walking program called Step and Stride with Ruby. The program organizes teams who compete to walk the most miles every month. In this report AARP assesses its success in keeping older women active. The report also highlights the important link between social groups and exercise and the effectiveness of walking in maintaining fitness. 

Senior Citizen and E-commerce Websites: the Role of Perceived Usefulness, Perceived Ease of Use and Website Usability (July 2008)
Many enterprises use the Internet to conduct business. For web sites to be successful, they need to be easy to understand, easy to use and easy to navigate. Aging persons bring new challenges to the business model. Old people often have deteriorating vision, dexterity and hearing, thus making web sites inaccessible to them. Fortunately, the Technology Acceptance Model, a method used to assess the interaction between people and websites, can measure the effects of aging on e-commerce. Companies now use this tool to make their websites more accessible to old people.

Socioeconomic Status and Health Disparities in Old Age (June 2008)
In case you had any doubt, poor persons in the US have worse health in old age than do those with more assets. The reverse also seems to be true: “Poorer health translates into lower SES (socioeconomic status).” 

Older People? The ACOVE Approach (June 2008)
Neil S. Wegner, Professor of Medicine at UCLA, points out that 1) that many measures of medical care quality exist in the US, but few focus on the precise healthcare needs of older, vulnerable adults, and 2) that as patients become sicker, current national evaluation measures become less relevant to them. This report describes the Assessing Care of Vulnerable Elders (ACOVE) project begun in 1998 and asks if researchers and others in the US population really want to know about the quality of care for the most health-threatened older adults. 

'Healthy Eating Index Scores Among Adults, 60 Years of Age and Over' (May 2008)
Experts at the US National Centre for Health Statistics analyzed the healthy eating habits among adults over age 60. Their research differentiates into the categories of sex, age, race and ethnicity, education, smoking status, tooth retention, self-reported health and body-mass index. The researchers paid a lot of attention to diet behavior. They found out that older persons’ diets need improvement. Not surprisingly, the researchers found great correlation between a good diet and the health of older people. 

No Pain, No Strain: Impact of Health Care on Older Americans’ Financial Security (Spring 2008)
Recent studies on health and retirement show the danger rising health care expenditures pose to seniors’ financial stability. Households with one or more people above age 75 have seen their debt rise 160 percent, from $7,769 in 1992 to $20,234 in 2004, with the most elderly shouldering the greatest burdens. The study projects that by 2030, people over 65 will spend 30% of their income on health care.

The Longitudinal Elder Initiative: Helping Students Learn to Care for Older Adults (April, 2008)
According to the Centers for Disease Control and Prevention, people over 65 amassed 50% of hospital visits and 60% of primary care visits in 2004. In recognition of these facts, nursing programs are now adding geronotological content into their curricula. In addition, the Longitudinal Elder Initiative, a Baccalaureate of Science in Nursing program, pairs students with older persons in the community. The Initiative directors think that this pairing will help the students understand the health needs and care of older adults and give students concrete knowledge of how social, financial and health issues affect older persons over time.

Healthy @ Home (March 2008)
Older adults want to stay independent for as long as possible. In the future, new technologies such as tele-pharmacy or electronic wellness devices may reduce social isolation and decrease the costs of care services. However, the question is whether seniors are aware of the new technologies and willing to use them at home. For answers, the researchers asked seniors and caregivers for their opinions on technology use at home. 

Five Million Senior Citizens With Alzheimer’s, 10 Million Baby Boomers to Join Them (March 18, 2008)
The new Alzheimer’s Association report posts current figures about those suffering from the disease in the US. At the moment 5.2 million US people live with this condition. By 2010, the victims will increase by 500,000 more people each year and by 2050 one million people more per year, as a result of the baby boomer wave. Alzheimer’s is the 7th ranking cause of death in the US . This study shows how the disease will impact the lives of individuals, their families and the long term care system.

Treating Depression in Older Adults: Challenges to Implementing the Recommendations of an Expert Panel (January 2008)
Overcoming challenges in treating depression among older adults should be an important public health priority. In this report, an expert panel identifies interventions which are effective and appropriate in depression treatment among older adults. The report also suggests a close partnership between health care providers, researchers and policy makers to overcome financial and training obstacles that would block the expert panel’s recommendations. 

Depression as a Major Component of Public Health for Older Adults (January 2008)
By 2020, depression is projected to occupy the second place (after heart disease) among the illnesses that people have at an older age. Understanding depressive disorders is vital to public health since the rates for the disease rose rapidly in the recent years. Depression is also a strong predictor of suicide among the elderly. The research analyzes risk factors, diagnostic criteria and challenges in treatment of depressive disorders among the elderly.

Articles

Vitamin C Protects Some Elderly Men from Bone Loss (September 26, 2008)
Bone mineral density, bone status and fracture risk are related to many more nutrients than just calcium. Researchers from Tufts University found that one of the essential nutrients is Vitamin C, particularly contained in fruits and vegetables. It protects against inflammation—a contributor to bone absorption and bone loss--as well as being essential for the creation of collagen to strengthen bones. However this applies exclusively to men. Women who suffer from bone loss, often associated with osteoporosis, earlier and more frequently than men do not benefit from Vitamin C.

Why Kidneys from Older Donors Do Not Last As Long As Those from Younger Individuals (September 25, 2008)
A high donor deficit in kidney transplants led to an increase of transplants from older deceased people. The Stanford University Medical Center analyzed the structures of kidneys from 20 aging (over 55 years) and 23 youthful (under 40 years) deceased donors. Results indicated a 32% depression of the glomerular filtration rate, a measure of the kidneys' ability to filter and remove waste products, in the aging versus youthful groups. This leads to a self-perpetuating injury in the rest of the kidney, ultimately contributing to a shortened survival of the transplanted organ.

Boomers Should Add Muscle Before It's Too Late (September 24, 2008)
A Ball State University study finds that seniors should strengthen their whole muscle and fiber size through resistance training. They advise starting the training at the age of 60 or 70, rather than 80. Aging eventually causes a loss of "fast-twitch" muscle fibers that reduce the ability to produce the explosive movements that allow us to move our feet and arms rapidly to avoid falling.

Seniors Not Seeking Treatment for Common, Debilitating Swallowing and Voice Problems (September 23, 2008)
According to a new study of Duke University Medical Center, elderly patients often accept their voice and swallowing issues as part of the natural process of aging. Among 248 patients with an average age of 82, while over 50% were interested in treatment, only 20% actually sought medical advice. Researchers therefore suggest developing outreach programs that educate seniors and healthcare providers of the signs, symptoms and available treatments of these disorders.

Lowering Blood Pressure In Elderly Using Audio Relaxation Program (September 20, 2008)
In a study of 41 older participants with high blood pressure, researchers found that systolic blood pressure decreased more in the audio-guided relaxation training program (ATP) group than in the group listening to Mozart: 6.4 percent (9 mmHg) versus almost 5 percent (7 mmHg). Overall, ATP is a self-regulation tool that promotes patient autonomy in managing their health. Also, nursing homes or senior living facilities may use this procedure without a doctor's order. However long-term adherence to the program may be a problem in elderly people. A three-month follow-up showed that only 52% of participants continued to use the relaxation technique regularly.

Pain is Common in Parkinson's Disease (September 19, 2008) 
Patients with Parkinson's disease often complain of painful sensations, which may involve body parts affected or unaffected by dystonia. Researchers investigated 402 Parkinson's disease patients and 317 healthy control patients regarding their pain. Results suggest that pain among Parkinson's disease patients is heterogeneous in quality, body localization and relationship with the clinical onset of Parkinson's disease. Additionally, findings may have clinical implications for designing studies to better understand the nature of pain and identifying specific treatment strategies.

High-Risk Elderly Patients Benefit From Minimally-Invasive Aortic Valve Bypass (September 19, 2008) 
Aortic stenosis is the most common heart valve disease of the elderly in the US, and more than 50,000 people require surgery each year. A new study from the University of Maryland Medical Center in Baltimore found a safe alternative to conventional aortic valve surgery. The uncommonly used procedure bypasses a narrowed aortic valve, rather than replacing it, and effectively restores blood flow from the heart to the rest of the body. Patients typically considered inoperable could also benefit from this procedure.

Surgeon General Calls for Action to Prevent Deep Vein Thrombosis and Pulmonary Embolism (September 15, 2008) 
US Surgeon General Steven K. Galson’s concern is based on over 100,000 cases of death, including many senior citizens. As a necessary precaution, Galson advises that public awareness be increased and more research be conducted on the causes, prevention and treatment of the disease. The Agency for Healthcare Research and Quality contributed to the Call to Action with the release of two new guides that provide patients and clinicians with valuable information which will help them improve care.

Changes in Seniors' Sleep Patterns Need Attention (September 13, 2008)
Dr. Charles Cefalu, a member of the American Geriatrics Society, recommended caution when sleep pattern changes last for longer than two weeks. Signs of a sleep disorder could include frequent waking through the night, being tired but having trouble falling asleep or even morning headaches. If these symptoms keep appearing, seniors should consult their geriatrician to determine if there is a problem and learn about treatment options.

Simple Blood Test for Alzheimer's? Researchers Seeking To Identify Alzheimer's Risk Focus on Specific Blood Biomarker (September 10, 2008)
The Columbia research group found out that a simple blood test enables doctors to detect a person's predisposition to developing Alzheimer's disease. Results suggest that certain levels of the Amyloid Beta 42 peptide in the blood plasma indicate different stages of Alzheimer's disease. In contrast to the spinal taps normally used, blood samples can be taken with relative ease and greater frequency. Consequently clinicians can forecast the onset of Alzheimer's disease much earlier.

New Website to Improve Pain Patients’ Communications with Healthcare Pros (September 8, 2008)
Three pain management associations (American Pain Foundation, American Academy of Pain Management, and American Society for Pain Management Nursing) and a pharmaceutical company (PriCara) have launched a new interactive website. An on-line national survey of physicians and pain patients found that, despite the substantial impact of pain and pain medications on patients, a sizable gap exists between patients and healthcare professionals when it comes to understanding and discussing pain.

Older Vietnamese Report More Mental Health Problems (September 4, 2008)
Vietnamese Americans over 55 were twice as likely as non-Hispanic whites to report needing mental health care, but less likely to discuss such issues with their doctor. Dr. Quyen Ngo-Metzger, who studies health disparities facing Vietnamese Americans, commented that there is no word in the Vietnamese language for depression, which compounds the difficulties of diagnosing and treating mental health problems.

National Hospice and Palliative Care Organization Calls for Increased Access to Palliative Care in Critical Care Settings (September 4, 2008)
The National Hospice and Palliative Care Organization has issued a statement calling for increased access to palliative care for patients admitted to hospitals for critical care. More than one out of five deaths in the US occur during or following admission to an Intensive Care Unit. This is the critical time when palliative care providers can complement the knowledge and skills of hospital professionals by assisting with decision-making and end-of-life care.

Getting the Care They Want: Baby Boomers Expect More from Health Providers (August 24, 2008)
Baby boomers look to technology to educate themselves for future health-care quality. Today's baby boomers are fully aware of the advancements in health care technology thanks to their access to information online. More and more boomers recognize the importance of a healthy lifestyle. This is never more apparent than now, as members of this generation are living longer lives. With many of this generation wanting to age at home, the need for home care is now in huge demand. Seniors are also advocating for themselves by asking more questions about alternative health care opportunities.

Wrinkle Removers, Backed by Science (August 18, 2008)
Anti-aging serums and wrinkle removing elixirs usually promise more than they can deliver, but recent research shows that some promises can be kept. Topical application of retinol, carbon dioxide laser resurfacing and injection of hyaluronic acid are science-supported treatments that have been shown to ward off facial signs of aging. Current anti-aging research is focusing on strengthening connective tissue in the skin. It is important that anti-aging enthusiasts be wary of commercial products promising more than they can deliver.

‘Wii-habilitation' Provides Fun and Exercise for Senior Citizens (August 11, 2008)
Nintendo's Wii has proven to be a huge hit with seniors. Providing ample exercise and endless fun and laughter, many retirement communities are now considering the health benefits of technology for seniors. Coined "Wii-habilitation," the introduction of the Wii into the lives of older persons is met with great approval from occupational therapists and caregivers alike. Contrary to the view that technology is just for the youth, many seniors are proving that you are never too old to have fun.

Caregivers at Eight Bay Area Nursing Homes Protest Resident Conditions (July 29, 2008)
Caregivers from Windsor Skyline Care Center and Windsor Ridge Care Center, together with other supporters, are staging a protest against Windsor. Together, the two facilities have made over $2,000,000 in profit. Unfortunately, these profits have come at a price to residents, who have received inadequate care due to understaffing and a lack of safety measures. The Windsor group owns and manages six other long-term care facilities in the Bay Area in California.  

Overweight Elderly Americans Contribute to Financial Burdens of the US Healthcare System (July 24, 2008)
Obesity in America today is not just a health issue, but a financial problem as well. Obesity leads to chronic health conditions which require more medical care and, for seniors, higher Medicare costs. These costs are straining the whole healthcare system. Public health campaigns have been launched to increase aware through early interventions to modify unhealthy eating habits that lead to obesity.

Two American Seniors Cross the US on Scooters (July 18, 2008)
(Article in French)
Two septuagenarians traveled 5.500 Km on scooters from San Francisco to New York. This trip from one part of the US continent (California) to the other (New York) seems impossible looking at the distance itself. But, this didn’t stop Bernard Rosenbaum, 71, a retired doctor, and Robert Chase, 72, an ex-CEO, from trying to prove that aging does not mean stopping any kind of activity; while aging it’s possible to keep our passions alive. Now that both bikers have reached their destination, they are going to rest in preparation for their next stop, Alaska.

Rise Seen in Medical Efforts to Treat the Very Old (July 18, 2008)
Hazel Homer, 104, is one of the 90,422 centenarians currently living in the United States. She received a heart pacemaker five years ago and currently lives with a health aide. Before the operation, she was in the hospital every other month due to heart problems. The surgery greatly improved her well being, and she only went back to the hospital once due to pneumonia. Many argue that letting her undergo such a risky procedure was wasteful and barbaric. However, many consider her case an emblem of the new frontier in medicine: health care that extends the quality of life. 

Faced with Care Giving, Even Experts Struggle (July 14, 2008)
“In this dream, I tell my mother and my brother that he has gone peacefully to sleep,” wrote Dr. Winakur, recounting the nightmare where he gave his octogenarian father a morphine overdose. The old man did die in his sleep, at the age of 87, due to natural causes. Even for health care professionals, caring for an ailing parent is a difficult task. However, real heart-rending stories are rarely published and often inaccessible. Women’s magazines publish inspiring stories with ‘happy endings’ while medical journals are too technical for an average person to read. Perhaps it is time to publish stories that intertwine the subjective and objective, providing both solace and information for people taking care of their aging parents. 

Falls are a Danger to Seniors, but Many are Avoidable (July 11, 2008)
With a staggering 75 percent of senior deaths caused from falls, extreme caution needs to be taken by elders in their homes and when carrying out daily chores. As old age approaches, the speed of reflexes and coordination slows. With the recurrence of falls, prevention methods need to be incorporated to help seniors become aware that once small obstacles can become life threatening. With regular exercise and good healthy eating patterns, it is possible to keep limbs agile and minds alert. Despite old age and its afflictions, accidents and injuries are avoidable.

What's the Deadliest State for Elderly Drivers? You're in It (July 11, 2008)
The AAA Foundation has called for all states to enhance awareness about elder traffic fatalities nationwide. A report indicates that older persons in Florida are more at risk from such incidents than anywhere else in the US. As 15% of the nation's drivers are 65 or older, citizens need a new approach to safe road practice for older people.

Silver Alerts Could Help Pinpoint Missing Seniors’ Location (July 9, 2008)
"Those seven days were so grueling," said Mary Lalucci as she described the week that her mother, Mary Zelter, went missing. Fishermen later recovered Mrs. Zelter’s body and car in the Intercoastal Waterway off Clear Water Beach, Florida. Dementia and Alzheimer’s greatly reduce older persons’ ability to navigate. Silver Alerts, already available in nine states, have been an effective way to help find missing seniors. Silver Alert, a notification system, provides quick information dissemination to relevant authorities and the media.