Medicare has met its target of 90 percent enrollment for its prescription drug coverage for seniors, but millions of older people who could benefit from the Medicare Part D program are still not enrolled, according to a study published August 2 on the Health Affairs Web site. The study, the first to provide early results on the demographics of those enrolling in Medicare Part D, shows that enrollment rates are lowest among people who are healthy now and are using no prescription drugs and among the less healthy who currently use prescription drugs but had no insurance coverage prior to Part D. The most problematic groups are widows, unmarried women, and less-educated people who were not previously covered through veterans, employer, or union plans.

Largely because of increased and ongoing federal funding, the capabilities of local public health and emergency preparedness agencies to deal with bioterrorism are much improved from two years ago, Aaron Katz, Andrea Staiti, and Kelly McKenzie say in the July/August Health Affairs. However, the authors report, the same can not be said for hospitals. Because federal hospital preparedness funds had to be spread over thousands of hospitals, most hospitals received only a few thousand dollars - enough to buy new equipment and provide one-time training for staff, but not enough to permanently add the extra staff and space that would be needed to treat a surge of victims in a bioterrorism disaster.

Despite the fact that the United States health care budget is a great deal larger than Canada's, insured American adults fare roughly the same as Canadian adults when it comes to health care, while uninsured Americans lag behind. That's the finding reported by Claudia Sanmartin and coauthors in the July/August Health Affairs. The least well-off Americans, who are most at risk for being uninsured, were more likely than their Canadian low-income counterparts to report being in fair or poor health or having a mobility impairment; there were no systematic health differences among more affluent adults on either side of the border. Canadians and insured Americans reported similar access to health care, while uninsured Americans reported worse access.