Highlights

MENTAL HEALTH

Veterans’ Suicide

New research from the Department of Veterans Affairs (VA) finds that the majority of veterans from the Iraq and Afghanistan wars who commit suicides are from the National Guard or Reserves. From 2001, when the conflict in Afghanistan commenced, until to the end of 2005, Guard or Reserve members accounted for 53 percent of suicides. Although these members make up only 28 percent of American armed forces, they comprise nearly half the troops in Iraq. Veterans’ groups attribute the high rate to the stress experienced by soldiers who normally serve in their home state, but must deploy and then re-adjust to civilian life when they return, the Associated Press reports. This is the first demographic study of suicide among veterans from the wars in Afghanistan and Iraq. In November, President Bush signed the Joshua Omvig Veterans Suicide Prevention Act, which directed the VA to improve its mental health training for staff and to increase screening and treatment of veterans.

PROVIDERS

Fewer Homegrown Primary Care Docs

Fewer U.S. physicians are focusing on primary care, but the decline is covered by foreign doctors practicing in the U.S., according to a Government Accountability Office report. The report compared primary care physician residency program data in the U.S. from 1995 to 2006 and found that the number of U.S. primary care physicians declined from 23,801 to 22,146 during that time period. Meanwhile, the number of foreign medical school graduates training in primary care increased from 13,025 in 1995 to 15,565 in 2006. The number of U.S. residents training as specialists increased from 45,300 in 1995 to 47,575 in 2006, and the number of international specialists increased from 11,957 to 12,611 during the same period, GAO found. The report indicates that research in recent years shows that the nation's over reliance on specialty care services at the expense of primary care leads to a health care system that is less efficient, while preventive care, care coordination for the chronically ill, and continuity of care—all hallmarks of primary care medicine—can achieve improved outcomes and cost savings. However, conventional payment systems tend to undervalue primary care services relative to specialty services, says the report.
To view the report click here http://www.gao.gov/new.items/d08472t.pdf .

ACCESS

Insurance Mandates

Part of the steady increases in health insurance premiums can be attributed to state mandates on coverage, says a new report from the Council for Affordable Health Insurance. Currently, states impose 1,961 mandated benefits and providers for health insurance coverage, compared to just a handful in the 1960’s. The Council reports that these mandates can increase the cost of health insurance premiums from 20 percent to upwards of 50 percent, depending on the state and its mandates. The report also claims that mandates can lead to higher rates of uninsurance, as individuals are forced to choose between an expansive plan with higher premiums or no plan at all. “Mandating benefits is like saying to someone in the market for a new car, if you can’t afford a Cadillac loaded with options, you have to walk,” said the report’s authors.