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Denver Post Examines Efforts To Establish Needle-Exchange Programs In Colorado
The Denver Post on Friday examined efforts to establish needle-exchange programs in Colorado to reduce the risk of HIV and hepatitis C among injection drug users. According to the Post, 185 cities in Colorado have needle-exchange programs, but legislation that would have legalized needle exchanges statewide did not advance in the Legislature this year. "The issue is more complex than it perhaps first appears," Evan Dreyer, a spokesperson for Gov. Bill Ritter (D), said, adding that "law enforcement and the Colorado Department of Public Health and Environment both expressed serious reservations" about a proposal that would have legalized needle-exchanges statewide. A coalition of public health officials, treatment providers and advocates are increasing efforts to establish a needle-exchange program in Denver, the Post reports. The Denver Drug Strategy Commission in February recommended that Mayor John Hickenlooper consider a pilot needle-exchange program, DDSC Director Karla Maraccini said. The commission is looking at different programs to develop a model following Hickenlooper"s request for additional research. However, Denver District Attorney Mitch Morrissey has concerns that a local needle-exchange program would violate state law, according to Morrissey"s spokesperson Lynn Kimbrough. Eric Brown, a spokesperson for Hickenlooper, added, "Anything in contradiction to city or state law would have to be carefully considered." Proponents of needle-exchange programs say they prevent HIV and hepatitis C, but opponents say they condone injection drug use. Mark Thrun, director of HIV prevention for Denver Public Health, said, adding that needle-exchange programs prevent IDUs from "getting these chronic, potentially fatal diseases" and give public health workers "an opportunity to link them into treatment; and it lessens the economic burden on the already overburdened health care system." Thrun noted that several studies have found that needle-exchange programs do not encourage or prolong injection drug use and make IDUs more likely to seek treatment. In addition, a 2005 CDC study found that 86% of exchange programs make treatment referrals and that more than 80% offer counseling and testing for HIV/AIDS and hepatitis C.Nancy Steinfurth, executive director of the Hep C Connection, noted that an estimated 10% of HIV cases and 70% of hepatitis C cases are transmitted through needles (Auge, Denver Post, 5/15).
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Senate Weighs New Taxes To Fund Reform

"Senate Finance Committee Chairman Max Baucus (D-Mont.) presented his members Thursday with more than a dozen ways to pay for health care legislation, ranging from new fees on industry to an income-tax hike on couples making more than $1 million a year," Politico reports. "Faced with a $320 billion hole in his reform plan, Baucus revisited options that were considered in the past, but never emerged as top-tier options because he believed taxing employer-provided health benefits was the best way to provide that revenue. The Senate Democratic leadership nixed the idea this week, saying the caucus could not support it because it would hurt the middle class. ... Instead of relying on one major of funding, the committee will have to piece together revenue from a variety of places." Possible funding s include "broadening the 1.45-percent Medicare tax on earned income to "passive income,"" levying a "five-percent surtax on individuals who earn more than $500,000 and couples that make $1 million," taxing employer-provided health benefits "at a higher level than had been considered," "capping the tax break on itemized deductions at 28 percent," issuing "tax credit bonds to pay for the proposed Medicaid expansion," charging fees to drug companies and hospitals and raising taxes on sodas and sugary drinks. The Finance Committee will also "renew their efforts to find more savings in the health system," but "the challenge is convincing the Congressional Budget Office to recognize these initiatives as true cost-savers" (Brown and Rogers, 7/9). Roll Call adds that Sen. Olympia Snowe, R-Maine, said that a value-added tax was off the table (Drucker, 7/9). Meanwhile, Majority Leader Harry Reid, D-Nev., did "an about-face" when he said he supports the Finance Committee"s "efforts to strike a deal," Roll Call reports in a separate article. His statement of support was "a stark contrast" from Tuesday, when he urged Baucus "to rein in his pursuit of GOP support for a package for fear it would cost too many Democratic votes." On Thursday, however, Reid was "effusive in his praise for the Finance Committee"s work." He also "reaffirmed that he is committed to the August deadline" (Drucker, 7/9). The Wall Street Journal reports that Reid and Sen. Charles Schumer, D-N.Y., "said they were amenable to considering a [non-government] cooperative - perhaps in lieu of a government-run insurance plan - to compete with private insurers." Schumer said that a public competitor should "keep the companies honest ò€¦ be available right at the beginning to everybody, and have the strength to borrowò€¦If it can do those things in a co-op form, I think we"re open to it." Whether Republicans would support such a cooperative remains unclear, because "a co-op with close ties to the government might be viewed by Republicans as a predecessor to a government-run plan" (Yoest and Boles, 7/10). In addition, "Senators working on health-care legislation are considering provisions to pare back the billions of dollars in tax breaks enjoyed by U.S. hospitals," The Wall Street Journal reports in a separate article. "More than half of the 5,482 hospitals in the U.S. are nonprofits that don"t pay federal, state or local taxes, according to the American Hospital Directory," but "in the past decade, some nonprofit hospitals have amassed big cash surpluses, even as they engaged in aggressive bill-collection tactics. Some provide less in charity care than the value of their tax breaks." Baucus and Sen. Charles Grassley, R-Iowa, are floating a proposal that would require hospitals "to offer a minimum amount of charity care, limit charges to the uninsured and tame their collection practices -- or face an excise tax." Nonprofit hospitals would "have a lot to lose. In a report issued in December 2006, the Congressional Budget Office estimated nonprofit hospitals were spared $12.6 billion in taxes annually, on top of the $32 billion in federal, state and local subsidies the hospital industry as a whole received each year" (Martinez, 7/10). This information was reprinted from kaiserhealthnews.org with kind permission from the Henry J. Kaiser Family Foundation. You can view the entire Kaiser Daily Health Policy Report, search the archives and sign up for email delivery at kaiserhealthnews.org. © Henry J. Kaiser Family Foundation. All rights reserved.


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