Tobacco Documents Online

CHANGES IN MIDICAC COVFRAGE. Tax Eqwity & Fiscal Csponsibiility Actof 1982 (TEFRA) results in first major overhaul in Medicare program in 17-year history. Among major changes: Medflcare beneficiaries may enroll inihealth maintenance organizations (antici- patedi 25% of eligible Medicare recipients expected to enroll in H1i0s). TEFRA provision placing,inflation-adjusted reimbursement cap on hospitals at 9.6% in 1983 designed to put pressure on health care industry to improve efficiencies. Costs above 1983!cap reimbursed upito 25% of extra costs. Beginning 1984 costs exceeding cap will not be paid. TEFRA provisions call for three-year trial program to reimburse cost of home care for Medicare enrollees with terminal illnesses now living in hospices. NECd TREATZfENT FOR'ACVPE ACNE. Food & Drug Administration approves Accutaner (Hoff- man-IaRoche . Drug vitamin A derivative. Inhibits seeretion of sebum (oily substance secreted by sebacous glands) which clogs pores, causes cystic acne. Over 90% of 160 patients taking capsules twice daily for 15 to 20 weeks showed marked improvement in clinical trials sponsored by NationaT Institutes of Health. Many had complete or pro- longed cure. Adverse effects of new medication: cheilitis (acute eczema of lip area),, conjunctivitis ("pink eye"), increased plasma triglyceride levels, muscular aches/pains. Treatment runs estimated $4004500 for 15-20 week period. Medication considered miLe- stone in dermatologic therapy for patientswith acne resistant to conventional medica- tion including orali antibiotics. . amytrophic lateral sclerosis -- "Lou Gehrig disease"). "CAFE CORONARY" PROBLEM AMONG NIdRSIl`PG HOME RESIDENTS. Condition resembLes heart attack. Caused by foodilodging in upper trachea to prevent breathing. According to data from Dade County (F1a.) Medical Eka.miner's Office, University of Mi'ami's School of Medicine other contributing factors to fatal food asphyxiation include alcohol, sedative/hypnotic drugs, retardation, senility, diseases affecting motor coordination and mentaL functioning (e.g., Parkinson's). 20-year study shows soft foods cause of 15%deaths among institutionalized patients. People in 40s, 60s, 70s most prone to ac- eident. Estimated 85°fo of'deaths from food asphyxiation occur in presence of witnesses (indicates need'for improved public awarenessof rescue techniques). LEGI6LATIVE UPDATE. American Medical Assoeiation's Rouse of Delegates presses Congress for legislation to mandate "self-extinguishing" st'andards for cigarets to avoid catastrophes created by smokers who fall asleep. . . Look for legislation to provide tax breaks, relaxation of FDA approval process plus•24-year exclusive marketing rights for "orphan drugs" (new treatments,for rare serious diseases a la muscular dystropY>,y, MI= REVIEWS FOR LOW-TAR, LOW-NICOTINE CIGARETS!` National Research Council tudy indicates smokers of low-tar, low-nicotine cigarets likesy-t ~,, in- hale more deeply than smokers of stronger cigarets. Council cites studies showing-switch to low-tar brands often~inereases individual cigaret consumption. Claims research in- dicates men 35 years or older who smoke die of lung, related cancers as frequently now as smokers same age in 1955 despite fact past 25 years 1) average tar content in cigarets reducedifrom 43 miliigrams to 15 miligrams; 2):nicotine level down from 2.8'miligrams to 1.0 miligrams. Deaths from respiratory cancers up 70% during period. Data contra- dicts results of American Cancer Society study (shows slight reduction in cancer deaths among Low-tar cigaret smokers vis-a-vis high-tar cigaret smokers). ACS results indicate lung cancer deaths on,decrease among men in 30s. May level off between ages 45-64. No smoking still best alternative in view of conflicting,evidence. ACTIVITY. Health authorities unable to predict 1) if flurepidemic to hit i7.S, this winter; 2 which strain to predominate (global surveillance by World Health Organization indicates two strains of influenza A, one strain of influenza B widespread),. Elderly, chronically ilil advisedito protect against all three types with Federalliy approved/recom- mended 1982=83 multiple-strain flu vaccine. THE GALLAGHEF REPORT . Edltor-Iirohl.l:Bernard P. Gallegher: Editcr:Cynthla A. B(Itlnqs .