Uninsurance Rate Jumps for First Time Since ACA
The number of people in the United States who lack health insurance is climbing. In September, the US Census Bureau released its annual findings on income, poverty, and health insurance in the United States, reporting that 27.5 million people lacked health insurance in 2018, for an overall uninsurance rate of 8.5%. That rate is up from 2017, when 7.9%, or 25.6 million people, were uninsured.
Antibiotic stewardship programs are rare in veterinary medicine. Nearly two thirds of medically important antibiotics are used in animal agriculture.
Photo by Bizoo_n, courtesy iStockphoto.
The jump is the first year-to-year increase in the national uninsurance rate since 2008–2009 and the first since passage of the Affordable Care Act in 2010. Researchers attributed much of the increase to enrollment declines in public insurance programs such as Medicaid and the Children’s Health Insurance Program.
The bureau also reported a turnaround in children’s coverage—an additional 425 000 US children joined the uninsured ranks in 2018, with Hispanic children experiencing the worst impacts. “Sadly, this is what we were expecting to see, especially as we watched Medicaid and CHIP enrollment going down,” Eliot Fishman, PhD, senior director of health policy at Families USA, told The Nation’s Health. “But it’s terribly disappointing.”
There was an overall decline in health insurance coverage of 0.4 percentage points among people with public coverage between 2017 and 2018. Medicaid coverage decreased by 0.7 percentage points, whereas the rate of Medicare coverage went up by 0.4 percentage points. In general, public health insurance covered about 34% of the country, whereas private coverage continued to be the most prevalent form of health insurance.
—Kim Krisberg
Read the full article in The Nation’s Health at http://thenationshealth.aphapublications.org/content/49/9/1.2
Antibiotic Stewardship Slow to Catch on Among Veterinarians
Overprescribing antibiotics is relatively common at veterinary clinics. Although progress has been made in stewardship, the lifesaving medicines are still used generously on both companion animals and farm animals. The public health and medical fields share antibiotic stewardship programs in which doctors strive to use antibiotics responsibly on human patients. But similar programs are rare in veterinary medicine, said American Public Health Association member David Wallinga, MD, a senior health advisor at the National Resources Defense Council who specializes in antibiotic overuse on farm animals.
As much as 50% of antibiotics prescribed by veterinarians for pets may not be needed, according to a 2015 report from an American Veterinary Medical Association task force on antimicrobial stewardship. At a veterinary teaching hospital, 38% of canine antibiotics prescribed over a 12-month period were for dogs with no infections, a study published in 2011 in the Journal of Small Animal Practice found.
And in a study published this year in Veterinary and Animal Science, almost 90% of students surveyed at a major veterinary medical center had not read or rarely read the antimicrobial resistance guidelines for judicious use created by the American Veterinary Medical Association and the US Food and Drug Administration (FDA).
The stakes are high for human and animal health. “On this issue, we are literally talking about resistance changing the face of modern medicine,” Wallinga told The Nation’s Health. Although antimicrobial resistance in pets is a problem, most of the concern in veterinary medicine is antibiotic use on farm animals. Nearly two thirds of medically important antibiotics—those used in human medicine—are used in animal agriculture, the FDA estimates.
In January 2017, the FDA issued a rule requiring veterinary oversight on antibiotic use in feed and water on farms and banned antibiotic use to promote growth.
—Mark Barna
Read the full article in The Nation’s Health at http://thenationshealth.aphapublications.org/content/49/9/1.3