Bush Rallying Florida Seniors

President Bush is in Florida for a last push to get seniors to sign up for Medicare prescription drug coverage.

The president is playing first salesman this week, urging seniors on both coasts of the state to sign up for new Medicare drug coverage before next Monday's enrollment deadline. Between 6 million and 8 million of Medicare's 43-million beneficiaries remain uncovered for their prescription expenses, and if they don't sign up now, they'll face higher premiums not just next year, but for the rest of their lives.

Still, many seniors remain confused by the plethora of plans — more than 40 in most states.

Many members of Congress have been urging that the deadline be extended — something the Bush administration has so far strenuously resisted. But it remains possible that either the president or Congress — or both — could act before the end of the week. — Julie Rovner

Survey Points to Funding Gaps for Mental-Health Care

May 8, 2006 — A survey of 12 communities shows serious gaps in funding for people with mental illness.

In the current issue of the journal Health Affairs, researchers with the nonprofit Center for Studying Health System Change report that the switch from an emphasis on mental hospitals to care in the community is not working well. In most places, the joint state/federal Medicaid program isn't spending enough on community care. They say payments to psychotherapists at half the rate of Medicare, for example, has led to long waits for appointments.

The survey does point to some successes: increased community housing and treatment in New Jersey, and more emergency-department beds for mental illness in Greenville, S.C. — Joanne Silberner

OB/GYN Group Recommends Emergency Contraception

May 8, 2006 — The professional group representing the nation's obstetricians and gynecologists is recommending that fertile women ask for prescriptions for the so-called "morning-after pill," before the women need them.

At their annual meeting, the American College of Obstetricians and Gynecologists announced a campaign to educate women about emergency contraception: high-dose birth control pills that can prevent pregnancies if taken within 72 hours of sexual intercourse.

Emergency contraception is a highly political issue. Some people oppose it, saying it's a form of abortion. Those who support it say it prevents unwanted pregnancies and subsequent abortions. The OB/GYN group says fertile women should ask their doctors for a prescription, since any delays in taking the pills after unprotected sex decreases the chance they will work. The American Medical Association made a similar recommendation two years ago. — Joanne Silberner

Study: Doctors Often Prescribe Drugs 'Off-Label'

May 8, 2006 — A new study shows doctors commonly prescribe drugs for unapproved uses. The Food and Drug Administration (FDA) approves drugs for specific symptoms. But sometimes doctors prescribe them for other problems, a practice called "off-label" prescribing.

But just how common it is has been a mystery. Researchers analyzed doctors' records and found that about 20 percent of prescriptions — 1 in 5 — are off-label. The research appears in the current issue of the Archives of Internal Medicine.

Off-label prescribing is legal, but the FDA doesn't allow drug companies to promote or advertise their products for an unapproved use. Doctors defend the practice by saying that drug companies often don't apply for approval for a second use of a drug once they're already allowed to sell it. The FDA says it's been helping companies go through the process for additional approvals. — Joanne Silberner

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