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Texas Lawmakers Divert Millions From Family Planning Clinics To Community Health Centers
Specialty clinics that provide family planning services in Texas have seen a significant decrease in state funding over the past four years because lawmakers have redirected millions of dollars to expand family planning at community health centers, the Dallas Morning News reports. The funding changes began in 2005, when lawmakers said they were shifting funding to community health centers because they offered more comprehensive health care to low-income patients. Advocates for the family planning clinics argue that the policy is an attempt by antiabortion-rights advocates to shut the clinics down. Although clinics that receive state funding are prohibited from offering abortion services, some conservative lawmakers believe that limiting the funding will hurt groups like Planned Parenthood, which offers abortion services at other locations, according to some family planning advocates. The Morning News reports that state lawmakers might return some of the funding to the specialty clinics during the current legislative session; however, the funding only would equal any money left unused by the community health centers.The most significant funding change occurred in 2005, when almost 25% of the state"s $45 million annual family planning budget was set aside for "federally qualified health centers" -- community health centers that offer services to uninsured and underserved people. Advocates for family planning clinics say that the number of patients receiving state-funded reproductive services declined by nearly 22%, from 326,000 patients in 2005 to 255,000 in the last fiscal year. They also note that the community health centers have an unused surplus of more than $11.5 million since 2005, which they say the family planning clinics could have used.According to the Morning News, many public health experts believe that specialty clinics that have family planning services offer more efficient and effective reproductive care than community health centers. David Warner, a health care finance and policy expert at the University of Texas Lyndon B. Johnson School of Public Affairs, said the specialty clinics are "very targeted" and "don"t have a lot of overhead," whereas the community clinics have "limited enrollment and can be a lot less accessible." He added, "Continuing to starve those clinics means that you"re not going to be reaching the number of people you could be reaching with family planning services." Family planning clinics in Texas offer more than a dozen services ranging from birth control prescriptions to breast and cervical cancer screening and sexually transmitted infection testing. However, reproductive health advocates say many people often associate the clinics with abortion services, which gives antiabortion-rights lawmakers an incentive to shut down the clinics by withholding funding. Fran Hagerty, CEO of the Women"s Health and Family Planning Association of Texas, said, "Some lawmakers believe if they can prevent Planned Parenthood from participating in the state"s family planning program, then they"ve accomplished their goal."Supporters of community health centers say that billing issues and other administrative problems have distorted their data on how many reproductive health patients they are treating. Many women receive care at the community centers for family planning services along with treatment of other health problems, so they often are not recorded as reproductive health patients, according to the centers (Ramshaw, Dallas Morning News, 5/22).
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St. Gallen Consensus 2009: A Radically Different Approach To Treating Early Breast Cancer
A radically different approach to choosing the best treatment options for early breast cancer has been proposed by an international panel of experts in a report from the 11th St Gallen conference.
News of the day
CDC Issues Fact Sheet On Oral Sex, HIV Transmission
The CDC has released a fact sheet informing people that there is some risk of transmitting HIV to others through oral sex, even though it is much lower than the risk of transmission from vaginal or anal intercourse, the Lakeland Ledger"s "Robin"s Rx: Medical Blogging in Polk County" reports. According to the CDC, many people believe that oral sex is safe or has no risk of transmitting disease. The CDC fact sheet said that abstaining from any sexual activity or engaging in mutual monogamy where both partners are uninfected are the only ways to completely prevent HIV transmission, but that condoms and other barriers between the mouth and genitals can reduce the risk of transmission through oral sex (Adams, "Robin"s Rx: Medical Blogging in Polk County," Lakeland Ledger, 6/4).
Nutrition

Self-Treatment Results In Lower Overall Health Care Costs For COPD Sufferers

Individuals suffering from chronic obstructive pulmonary disorder (COPD) can experience significant savings in healthcare costs by employing a self-treatment program with the judicious use of medications, according to the results of a new study. The self-treatment program achieves these savings by reducing the duration of flare-ups. Dutch researchers presented their findings on Sunday, May 17, at the American Thoracic Society"s 105th International Conference in San Diego. "The course of COPD is characterized by episodes of acute deteriorations in respiratory health, termed "exacerbations,"" said lead author Tanja Effing, Ph.D., a researcher with the Department of Pulmonary Disease at the Medisch Spectrum Twente in Enschede, the Netherlands. "These exacerbations account for much of the morbidity, mortality and hospital admissions in COPD patients." The investigators tracked the outcomes of 142 patients divided into two groups. Participants in the first group were instructed in individual drug therapy and other responses to take in the event of an exacerbation. Patients in the second group received no instruction in the self-treatment of exacerbations. Exacerbations were defined as a clearly negative change in two major symptoms, or one major symptom and one minor symptom. Major symptoms included breathlessness and mucous production and color, while minor symptoms included cough, wheeze, running nose, sore throat and fever. Patients in both groups were also instructed to maintain journals recording any COPD-related events, as well as medication routines. In comparing the results of the two groups, researchers noted a significant decrease in doctor"s office visits during the study period for the group that received self-treatment training. "Our results showed that the self-treatment of exacerbations leads to fewer exacerbation days, in combination with an increase in the use of medications," Dr. Effing noted. "Moreover, analyses of the cost-effectiveness of the self-treatment strategy indicated this group experienced cost savings as a result of fewer hospitalizations and healthcare contacts." Researchers also sought to determine if the self-treatment group would tend to overmedicate when given the option, but Dr. Effing said the study"s results indicated that over-medication was not an issue. "The number of reported courses of medication in the self-treatment group was still lower than the actual number of exacerbations reported in the diaries," Dr. Effing noted. "Given the rise in prevalence of COPD and the costs associated with its treatment, we suggest implementation of programs incorporating careful instruction in self-treatment as part of effective self-management programs in COPD patients with frequent exacerbations." Keely Savoie American Thoracic Society


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