1. Freeman, Rachel

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Nurses around the country picketed outside of hospitals, protesting for wage increases and for more nurses on staff. Above, nurses picketed in front of Wilcox Memorial Hospital in Lihue, Hawaii, after negotiations between the hospital and the Hawaii Nurses Association broke down. At press time, nurses had been striking since June 24. And below, nurses who are members of the Health Professionals and Allied Employees protested outside of Englewood Hospital and Medical Center in Englewood, New Jersey, after contract discussions came to a halt in mid-July. Another protest in July occurred at Finely Hospital in Dubuque, Iowa, where nurses of the Service Employees International Union Local 199 went on strike over issues including wages, disciplinary procedures, and the reinstatement of nurse Alice Weick, vice president of the local union, who was fired after she publicly spoke out against the hospital in a union-sponsored radio ad.

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Rachel Freeman



Financial caps on prescriptions endanger health. According to an analysis of outcomes in 2003 of almost 200,000 members of a California health plan, Medicare beneficiaries whose individual insurance coverage limited their annual prescription drug benefit had a higher mortality rate than did patients whose medication coverage had no annual cap. Published in the June 1 issue of the New England Journal of Medicine, the study shows that patients with a $1,000 annual limit on prescription drug costs had lower rates of adherence to prescribed antihypertensive, diabetes, and lipid-lowering medications, accompanied by higher levels of systolic blood pressure, glycosylated hemoglobin, and serum low-density lipoprotein cholesterol.


Drug caps resulted in 28% lower pharmacy costs but increased rates of hospitalization and ED visits-resulting in statistically negligible net savings in health care dollars with significant human costs.