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New postings and analysis from Health Affairs, the leading journal of health policy. Health Affairs publishes new research each week online at For more information, contact Chris Fleming at 301-347-3944.

Dearth Of Full Medicare Drug Coverage In "Doughnut Hole" To Persist

The existing plethora of Medicare Part D plans will expand further in 2007. However, as in 2006, most of the stand-alone prescription drug plans and Medicare Advantage prescription drug plans offered next year will not provide full prescription drug coverage in the infamous "doughnut hole," the coverage gap in the standard Part D benefit that occurs between $2,250 and $5,100 of total drug spending in 2006.

So report researchers from the Henry J. Kaiser Family Foundation in a comprehensive Medicare Part D status update, published Nov. 21 on the Health Affairs Web site. The authors detail organization- and plan-level market share, as well as enrollment by plan type, benefit design, and gap coverage.

Employers And Health Benefits: Perhaps Wedded, But Not Blissfully

Business leaders Robert Galvin and Suzanne Delbanco say that employers are in a Gordian knot when it comes to providing health benefits. The authors say that employers have "largely been ineffective and unenthusiastic managers" of the health benefits they sponsor. Galvin and Delbanco report that employers are becoming more interested than ever before in exiting their roles as health benefit providers, but the authors doubt that this will happen imminently. A more likely result, they say, is that employers will continue their current course and generally resist proactively managing the health care of their employees, leading to continued frustration.

The Galvin/Delbanco article is the free access "editor's choice" paper from the November-December issue of Health Affairs, released November 14 and supported by the California HealthCare Foundation, on the theme of employer-sponsored health coverage.

Print editions of Health Affairs may be ordered for $35 each from Health Affairs' Customer Service at 301-347-3900 or online at

On Insurance, Americans Want More For Less

A national survey of 1500 Americans, published November 14 on the Health Affairs Web site, found that 80% believe the U.S. health insurance system needs fixing, but they don't want to pay higher costs. The survey, supported by the California HealthCare Foundation and conducted by researchers from NORC at the University of Chicago, also reports that uninsured Americans are more likely to reject policies that mandate the purchase of health insurance. And, as noted in numerous press reports on the survey, from the Los Angeles Times to Le Matin, 60 percent of those polled said smokers should pay higher premiums, while 30 percent said the obese should pay more. The survey is free access until November 28.

On The Health Affairs Blog: Public Health And Human Rights

This week, the Health Affairs Blog features a discussion of public health and human rights, the topic of the American Public Health Association's 2006 annual meeting. ---Health Affairs Deputy Editor Parmeeth Atwal traces the history of the health and human rights movement back through Jonathan Mann's seminal writings of a decade ago. In an interview with Atwal, APHA President Georges Benjamin says his group chose health and human rights as its 2006 theme partly because of Iraq: "Now we have a war which we went into based on things that we now know to be absolutely not true. ... I think the theme...will reenergize us to begin looking at public health as a peace movement again. George Annas, James Colgrove, Larry Gostin, and Sofia Gruskin offer their perspectives as well.


Health Affairs, published by Project HOPE, is the leading journal of health policy. The nonpartisan, peer-reviewed journal appears bimonthly in print, with additional online-only papers published weekly as Health Affairs Web Exclusives at The full text of each Health Affairs Web Exclusive is available free of charge to all Web site visitors for a two-week period following posting, after which it switches to pay-per-view for nonsubscribers. The abstracts of all articles are free. The Nov/Dec 2006 issue was supported by the California HealthCare Foundation. Web Exclusives are supported in part by a grant from the Commonwealth Fund.


Subscribe today for full online access to Health Affairs--"the bible of health policy" (Washington Post, January 12, 2005).


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