Prescription Heroin Programs - How far is too far?

Posted on: November 28, 2008  |   Author: Megan
Filed Under: Public Health Policy   |   Leave a Comment

Information from: Swiss likely to approve prescription heroin

Eliane Engeler, Associated Press

Houston Chronicle, November 28, 2008

On November 30, 2008, Swiss voters will head to the polls to decide whether a prescription heroin system will be permanently approved. The Swiss initiated a program 14 years ago in an attempt to eliminate drug addicts using drugs in public places. Supporters of this initiative claim heroin is used as a medicine. Addicts for which other therapies have failed to help are given doses in approved doctor’s offices which will satisfy their cravings without causing a high. The addicts inject themselves while nurses watch. In addition to the heroin prescription, many addicts also receive additional treatments such as therapy with a psychiatrist and counseling from social workers. The goal of the program is to help addicts learn how to function in society. Generally, after two to three years in the program, 1/3 of patients start abstinence programs and 1/3 change to methadone treatment.

The prescription heroin program is primarily paid for by health insurance and costs about $22 million a year. Critics of the program do not feel that health insurance should pay the costs of the program. Additionally, U.S. and U.N. narcotics boards feel that it will fuel drug abuse. However, several countries including Australia, are considering starting a program similar to the Swiss which has seen a reduction in crime and an improvement in the health of addicts. It will be interesting to see the effect these prescription programs have on future policies regarding illegal drugs throughout the world.

For more information, please see:

http://www.chron.com/disp/story.mpl/ap/world/6136744.html

For additional information about heroin laws around Europe, please see:

http://www.chron.com/disp/story.mpl/ap/world/6136757.html

Medical Repatriation and Immigrants

Posted on: November 23, 2008  |   Author: Uduak
Filed Under: Access to Care, HMOs & Health Plans, Hospitals & Health Systems, Medicaid, Medicare, Other, Public Health Policy   |   Leave a Comment

This article walks through stories of both legal and illegal immigrants who sustain medical emergencies that require urgent care.  Because Federal law does not regulate what hospitals can do with uninsured immigrants, many face the possibility of repatriation.  Repatriation is a popular route for hospitals facing this dilemma because the options are very limited.  The hospital must choose between indefinite care (with little to no federal reimbursement), finding nursing homes that would accept uninsured patients (very difficult to do), and finding relatives willing to accept and care for the patient (also very difficult especially if the patient has no relatives in the U.S. or the relatives are not financially capable of supporting the patient).

http://www.nytimes.com/2008/11/09/us/09deport.html?_r=1&hp

The true cost of care?

Posted on: November 23, 2008  |   Author: Holli
Filed Under: Access to Care, HMOs & Health Plans, Other, Public Health Policy   |   2 Comments

High health care costs harm more than our wallets.  A recent Health Affairs study compared the United States to countries that provide universal health care and found that many Americans (more than 50%) with chronic health problems skip recommended treatments due to cost.  In the countries providing universal care, the percentages ranged from seven to 34.

 NY Times: Americans Skip Care

Full report: Health Affairs

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