Current Awareness in Aging Research (CAAR) Report #229--March 18, 2004

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CAAR (Current Awareness in Aging Research) is a weekly email report produced by the Center for Demography of Health and Aging at the University of Wisconsin-Madison that helps researchers keep up to date with the latest developments in the field. For more information, including an archive of back issues and subscription information see:

http://www.ssc.wisc.edu/cdha/caar.html

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I. Data:

1. HUD CENSUS SPECIAL TABULATIONS: The US Department of Housing and Urban Development has released an interactive web based data extractor for the"1990 and 2000 Decennial Census Special Tabulations of Households by Income, Tenure, Age of Householder, and Housing Conditions."

http://www.huduser.org/datasets/spectabs.html

Click on "Special Tabulations of Households" at the bottom of the page.

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II. Reports and articles:

2. DHHS PRESS RELEASE: "HHS Names Members to Task Force on Drug Importation," (March 16, 2004).

http://www.hhs.gov/news/press/2004pres/20040316.html
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3. CMMS COVERAGE DETERMINATION, DECISION MEMORANDUMS, FACTSHEET:

A. "Laboratory National Coverage Determinations (NCDs): April 2004 Coding Manual," (US Centers for Medicare and Medicaid Services, March 2004, .pdf and MSWord format).

http://www.cms.hhs.gov/ncd/labindexlist.asp

B. "NCA Tracking Sheet for Automatic Implantable Defibrillators - Clinical Trials (CAG-00157R)," (US Centers for Medicare and Medicaid Services, March 12, 2004).

http://www.cms.hhs.gov/mcd/viewtrackingsheet.asp?id=102

Scroll down to or "find in page" "March 12" (without the quotes).

C. "Decision Memo for Cardiac Pacemaker (CAG-00063R2)," (US Centers for Medicare and Medicaid Services, March 12, 2004).

http://www.cms.hhs.gov/mcd/viewtrackingsheet.asp?id=106

Scroll down to or "find in page" "March 12" (without the quotes).

D. "NCA Tracking Sheet for Positron Emission Tomography (FDG) and Other Neuroimaging Devices for Suspected Dementia (CAG-00088R)," (US Centers for Medicare and Medicaid Services, March 15, 2004). Note: On March 15, 2004 CMMS put out a request for public input on questions about this NCA. Responses must be in by March 31, 2004.

http://www.cms.hhs.gov/mcd/viewtrackingsheet.asp?id=104

Scroll down to or "find in page" "March 15, 2004" (without the quotes).

E. "Federal Payment Methodology to Medicare Health Plans," (US Centers for Medicare and Medicaid Services, Mar. 15, 2004).

http://www.cms.hhs.gov/media/press/release.asp?Counter=978
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4. DHHS OIG AUDIT REPORT:

A. "Medicare Payments to Ambulatory Surgical Centers for Intraocular Lenses," (US Department of Health and Human Services, Office of Inspector General, OEI-06-02-00710, 2004, .pdf format, 21p.).

Executive Summary:

The OIG found that the current $150 per lens payment for IOLs is not"reasonable and related to the cost." For the 12 months ending June 2002, 40 percent of IOL payments by Medicare and its beneficiaries were in excess of ASC IOL cost. Overall, IOL cost averaged $90.30 per lens, $59.70 below the $150 Medicare payment. IOL cost varied significantly by lens type (grouped by lens material), with the highest cost IOL averaging $125 per soft acrylic lens, followed by an average $69 per silicone lens, and an average $39 per polymethyl methacrylate lens. The most frequently used lens type is the silicone lens at $69 average. We estimated that Medicare and its beneficiaries could have achieved substantial savings through the use of alternative payments rates. The OIG recommends that CMS reduce Medicare payment to ASCs for IOLs in a manner that takes into account the different types and cost of IOLs. CMS agreed to take into account our recommendation and IOL cost data in developing the revised payment system for ASCs, which the Medicare Prescription Drug, Improvement, and Modernization Act of 2003 requires be implemented, beginning on or after January 1, 2006 and not later than January 1, 2008.

http://oig.hhs.gov/oei/reports/oei-06-02-00710.pdf

B. "Medicare-Approved Heart Transplant Centers," (US Department of Health and Human Services, Office of Inspector General, OEI-01-02-00520, 2004, .pdf format, 30p.).

Executive Summary:

OIG released a final inspection report that documents the ongoing volume and survival rate performance of Medicare-approved heart transplant centers, which have been operating since 1987 without criteria for ongoing performance or recertification. OIG found that many centers have performed at volume and survival rates below the minimum levels required for their initial Medicare approval, sometimes for several consecutive years. In addition, OIG found that CMS receives incomplete information from centers regarding their volume and survival rate performance and that CMS does not regularly obtain center volume and survival rate data from the Scientific Registry of Transplant Recipients. OIG recommends that CMS expedite the development of standards for continuing performance and for the re-approval of approved centers as well as guidelines for what levels of performance trigger specific responses from CMS. OIG also recommends, in the short term, that CMS improve its oversight of centers by entering into an arrangement with HRSA for the regular exchange of volume and survival rate data.

http://oig.hhs.gov/oei/reports/oei-01-02-00520.pdf

C "Medicare Payments for Enteral Nutrition," (US Department of Health and Human Services, Office of Inspector General, OEI-03-02-00700, 2004, .pdf format, 14p.).

Executive Summary:

This report compares the amount Medicare reimburses for Category I enteral nutrition formulas (procedure code B4150) to prices available to the supplier community. OIG obtained contract prices for Category I formulas through one national wholesaler, one group purchasing organization, and one supplier who negotiated contracts directly with two enteral formula manufacturers. In total, OIG reviewed 177 individual contract prices. OIG found that Medicare's reimbursement amount for Category I formulas ($0.61 in 2001) exceeded median contract prices available to suppliers from the 3 sources reviewed by 70 to 115 percent. The median contract prices ranged from $0.28 per unit to $0.36 per unit. While individual contract prices for Category I formulas varied from a low of $0.18 per unit to a high of $0.86 per unit, OIG found that the majority (75 percent) of individual contract prices were lower than $0.42 per unit. OIG recommends that CMS review the current reimbursement amount for Category I enteral nutrition formulas to determine whether it is appropriate.

http://oig.hhs.gov/oei/reports/oei-03-02-00700.pdf
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5. GAO REPORT: "Medicaid: Improved Federal Oversight of State Financing Schemes Is Needed," (US General Accounting Office, GAO-04-228, February 13, 2004, .pdf format, 88p.).

http://www.gao.gov/new.items/d04228.pdf

Note: These are temporary addresses. GAO reports are always available at:

http://www.gpoaccess.gov/gaoreports/index.html
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6. NATIONAL INSTITUTE OF PUBLIC HEALTH [SWEDEN] REPORT: "A Healthier Elderly Population in Sweden," by Goran Berleen (Natioanl Institute of Public Health, 2004, .pdf format, 72p.).

http://www.fhi.se/shop/material_pdf/healthierelderly0403(1).pdf
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7. WHO PERIODICAL ARTICLE: "Population ageing in Lebanon: current status, future prospects and implications for policy," by Abla Mehio Sibai, Kasturi Sen, May Baydoun, and Prem Saxena (_Bulletin of the World Health Organization_, Vol. 82, No. 3, March 2004, .pdf format, p. 219-225).

http://www.who.int/bulletin/volumes/82/3/en/219-225.pdf
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8. AUSTRALIAN INSTITUTE OF HEALTH AND WELFARE REPORT: "The Comparability of Dependency Information Across Three Aged and Community Care Programs," by Mieke Van Doeland and Christine Benham (AIHA AGE 36, March 2004, .pdf format, 90p.).

http://www.aihw.gov.au/publications/age/cditaccp/cditaccp.pdf
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9. _PNAS_ ARTICLE ABSTRACT: "Acute myeloid leukemia with complex karyotypes and abnormal chromosome 21: Amplification discloses overexpression of APP, ETS2, and ERG genes," by Claudia D. Baldus, Sandya Liyanarachchi, Krzysztof Mrozek, Herbert Auer, Stephan M. Tanner, Martin Guimond, Amy S. Ruppert, Nehad Mohamed, Ramana V. Davuluri, Michael A. Caligiuri, Clara D. Bloomfield, and Albert de la Chapelle (_Proceedings of the National Academy of Sciences_, Vol. 101, No. 11, March 16, 2004, .pdf and HTML format, p. 3915-3920).

http://www.pnas.org/cgi/content/abstract/101/11/3915
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10. _JAMA_ ARTICLE ABSTRACTS:

A. "Salvage Radiotherapy for Recurrent Prostate Cancer After Radical Prostatectomy," by Andrew J. Stephenson, Shahrokh F. Shariat, Michael J. Zelefsky, Michael W. Kattan, E. Brian Butler, Bin S. Teh, Eric A. Klein, Patrick A. Kupelian, Claus G. Roehrborn, David A. Pistenmaa, Heather D. Pacholke, Stanley L. Liauw, Matthew S. Katz, Steven A. Leibel, Peter T. Scardino, and Kevin M. Slawin (_Journal of the American Medical Association_, Vol 291, No. 11, March 17, 2004, .pdf and HTML format, p. 1325-1332).

http://jama.ama-assn.org/cgi/content/abstract/291/11/1325

B. "Cardiovascular Prognosis of 'Masked Hypertension' Detected by Blood Pressure Self-measurement in Elderly Treated Hypertensive Patients," by Guillaume Bobrie, Gilles Chatellier, Nathalie Genes, Pierre Clerson, Laurent Vaur, Bernard Vaisse, Jol Menard, and Jean-Michel Mallion (_Journal of the American Medical Association_, Vol 291, No. 11, March 17, 2004, .pdf and HTML format, p. 1342-1349).

http://jama.ama-assn.org/cgi/content/abstract/291/11/1342

C. "Comprehensive Discharge Planning With Postdischarge Support for Older Patients With Congestive Heart Failure: A Meta-analysis," by Christopher O. Phillips, Scott M. Wright, David E. Kern, Ramesh M. Singa, Sasha Shepperd, and Haya R. Rubin (_Journal of the American Medical Association_, Vol 291, No. 11, March 17, 2004, .pdf and HTML format, p. 1358-1367).

http://jama.ama-assn.org/cgi/content/abstract/291/11/1358
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11. _NEJM_ ARTICLE ABSTRACT: "Ten Years' Experience with Alendronate for Osteoporosis in Postmenopausal Women," by Henry G. Bone, David Hosking, Jean-Pierre Devogelaer, Joseph R. Tucci, Ronald D. Emkey, Richard P. Tonino, Jose Adolfo Rodriguez-Portales, Robert W. Downs, Jayanti Gupta, Arthur C. Santora, and Uri A. Liberman, for the Alendronate Phase III Osteoporosis Treatment Study Group (_New England Journal of Medicine_, Vol. 350, No. 12, March 18, 2004, .pdf and HTML format, p. 1189-1199).

http://content.nejm.org/cgi/content/abstract/350/12/1189
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12. _BMJ_ PAPER, CASE NOTES:

A. "Use of hospitals, physician visits, and hospice care during last six months of life among cohorts loyal to highly respected hospitals in the United States," by John E. Wennberg, Elliott S. Fisher, Thrse A. Stukel, Jonathan S. Skinner, Sandra M. Sharp, and Kristen K. Bronner (_British Medical Journal_, Vol. 328, No. 7440, March 13, 2004, .pdf and HTML format, p. 607-607).

http://bmj.bmjjournals.com/cgi/content/full/328/7440/607

B. "Discharge destination and length of stay: differences between US and English hospitals for people aged 65 and over," by Brian Jarman, Paul Aylin, Alex Bottle (_British Medical Journal_, Vol. 328, No. 7440, March 13, 2004, .pdf and HTML format, p. 605).

http://bmj.bmjjournals.com/cgi/content/full/328/7440/605
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13. MEDSCAPE ARTICLE: Note: Medscape requires free registration before providing articles. "Should Older Adults Be Screened for Cognitive Impairment?" by Soo Borson (Medscape General Medicine, Vol. 6, No. 1, 2004).

http://www.medscape.com/viewarticle/470897
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14. _DEMOGRAPHIC RESEARCH_ ARTICLE: Note: "_DR_ is a free, expedited, peer-reviewed journal of the population sciences published by the Max Planck Institute for Demographic Research." "Life expectancy among LDS and Non-LDS in Utah," by Ray M. Merrill (Vol. 10, No. 3, March 12, 2004, .pdf format, 24p.).

Abstract
This paper compares life expectancy between members of the Church of Jesus Christ of Latter-day Saints (LDS or Mormons) and non-LDS in Utah. It examines the extent to which tobacco-related deaths explain variation in life expectancy between LDS and non-LDS. Complete life table estimates were derived using conventional methods and cross-sectional data for white males and females from 1994-1998. Life expectancy was 77.3 for LDS males, 70.0 for non-LDS males, 82.2 for LDS females, and 76.4 for non-LDS females. For those alive at age 80, the remaining years of life expected were 8.2 for LDS males, 6.5 for non-LDS males, 10.3 for LDS females, and 7.1 for non-LDS females. Years of life expected increased more so among non-LDS after we removed deaths associated with tobacco use from the life table. A comparison between LDS and non-LDS of the adjusted life expectancy estimates indicates that although differential tobacco use explains some of the higher life expectancy in LDS, it only accounts for about 1.5 years of the 7.3 year difference for males and 1.2 years of the 5.8 year difference for females. Higher life expectancy experienced among LDS not explained by tobacco-related deaths may be due to factors associated with religious activity in general, such as better physical health, better social support, and healthier lifestyle behaviors. Religious activity may also have an independent protective effect against mortality.

http://www.demographic-research.org

Click on "Enter".
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15. AARP POLICY INSTITUTE REPORT:

A. "Self-Employment and the 50+ Population," by Lynn A. Karoly and Julie Zissimopoulos (AARP Policy Institute Issue Paper 2004-03, March 2004, .pdf format, 121p.).

http://research.aarp.org/econ/2004_03_self_employ.pdf

B. "Aging and Work -- A View from the United States," by Sara Rix (AARP Policy Institute Issue Paper 2004-02, February 2004, .pdf format, 62p.).

http://research.aarp.org/econ/2004_02_work.pdf

C. "Pension Coverage Lessons for the United States from Other Countries," by Martin Rein and John Turner (AARP Policy Institute Issue Paper 2004-01, February 2004, .pdf format, 14p.).

http://research.aarp.org/econ/2004_01_intl_coverage.pdf
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16. _AARP_ PERSPECTIVES ARTICLE, PERIODICAL, FACT SHEETS:

A. "Aging of the Population: Two Enigmas, One Challenge," by Jrgen Mortensen (AARP, March 2004).

http://www.aarp.org/international/Articles/a2004-03-11-globalperspectives.html

B. Selected articles from the March 2004 _AARP Bulletin_ have been made available.

http://www.aarp.org/bulletin/toc/Articles/tableofcontents.html

Note: This is a temporary address. When the next _AARPB_ is released, selected articles from this one, along with others back to 2001, can be found by clicking the drop-down menu on the right side of the page.

C. "State Fact Sheets for Grandparents and Other Relatives Raising Children," (AARP, March 2004, .pdf format). Note: Click on the individual state name to view the .pdf of the fact sheet.

http://research.aarp.org/general/kinship_care.html

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III. Working Papers:

17. NBER:

A. "The Impact of Nearly Universal Insurance Coverage on Health Care Utilization and Health: Evidence from Medicare," by David Card, Carlos Dobkin, and Nicole Maestas (National Bureau of Economic Research w10365, March 2004, .pdf format, 41p.).

Abstract:

We use the increases in health insurance coverage at age 65 generated by the rules of the Medicare program to evaluate the effects of health insurance coverage on health related behaviors and outcomes. The rise in overall coverage at age 65 is accompanied by a narrowing of disparities across race and education groups. Groups with bigger increases in coverage at 65 experience bigger reductions in the probability of delaying or not receiving medical care, and bigger increases in the probability of routine doctor visits. Hospital discharge records also show large increases in admission rates at age 65, especially for elective procedures like bypass surgery and joint replacement. The rises in hospitalization are bigger for whites than blacks, and for residents of areas with higher rates of insurance coverage prior to age 65, suggesting that the gains arise because of the relative generosity of Medicare, rather than the availability of insurance coverage. Finally, there are small impacts of reaching age 65 on self-reported health, with the largest gains among the groups that experience the largest gains in insurance coverage. In contrast we find no evidence of a shift in the rate of growth of mortality rates at age 65.

http://papers.nber.org/papers/W10365

Click on "PDF" or submit your email address at the bottom of the abstract for full text.

B. "Mortality Risk and Educational Attainment of Black and White Men," by Li Gan and Guan Gong (w10381, March 2004, .pdf format, 26p.).

Abstract:

This paper investigates to what extent the differences in education between black and white men can be explained by the differences in their mortality risks. A dynamic optimal stopping-point life cycle model is examined, in which group-level mortality risk plays an important role in determining individual-level mortality risk, health expenditure, and the amount of schooling. The model is calibrated to quantify the effect of mortality risks on schooling by taking the black and white male population as the respective reference groups for black men and white men. We find that the impact of mortality risk on schooling explains more than two-thirds of the empirical education differences between black and white males. This conclusion is robust to a set of plausible parameter values.

http://papers.nber.org/papers/W10381

Click on "PDF" or submit your email address at the bottom of the abstract for full text.
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18. POPULATION COUNCIL: "Population aging and the rising cost of public pensions," by John Bongaarts (Working Paper No. 185, 2004, .pdf format, 24p.).

Abstract:

Rapid population aging is raising concerns about the sustainability of public pension systems in high-income countries. The first part of this study identifies the four factors that determine trends in public pension expenditures: population aging, pension benefit levels, the mean age at retirement, and the labor force participation rate. The second part presents projections to 2050 of the impact of demographic trends on public pension expenditures in the absence of changes in pension benefits, labor force participation, and age at retirement. These projections demonstrate that current trends are unsustainable, because without reforms population aging will produce an unprecedented and harmful accumulation of public debt. A number of projection variants assess the potential impact of policy options aimed at improving the sustainability of public pension systems. Although the conventional responses are considered, particular attention is given to the demographic options of encouraging higher fertility and permitting more immigration. This analysis is illustrated with data from the seven largest OECD countries.

http://www.popcouncil.org/publications/wp/prd/185.html

Click on "Download the full Working Paper in PDF format" at the bottom of the abstract for full text.
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19. STATISTICS NORWAY, RESEARCH DEPARTMENT: "Population ageing and fiscal sustainability: An integrated micro-macro analysis of required tax changes," by Rolf Aaberge, Ugo Colombino, Erling Holmy, Birger Strm and Tom Wennemo (Statistics Norway, February 2004, .pdf format, 45p.).

Abstract:

Most studies on the economic consequences of ageing rely on Computable General Equilibrium (CGE) models that account for feedback mechanisms through changes in relative prices, tax bases etc. However, since individual labour supply behaviour is considered to be a key element in CGE-analyses of fiscal sustainability problems, the results of these analyses may depend crucially on how the labour supply behaviour is modelled. The current practice of combining a simplified representation of the tax and transfer system with the labour supply behaviour of a few representative agents may render a misleading description of incentives and revenue effects. The purpose of this paper is to demonstrate the importance of using an alternative strategy by integrating a detailed microeconometric model of labour supply, that is sufficiently flexible to capture a large variety of labour supply responses, with a large-scale CGE model. The integrated micro-macro CGE model is employed to explore how endogenous household labour supply behaviour affects and interacts with sustainability problems in Norway. The empirical results suggest that the required increase in the future tax burden is less dramatic when the analysis allows for a flexible representation of the labour supply behaviour. Moreover, by replacing the current progressive tax system with a flat tax system it is found that the pressure on future public finances is significantly reduced.

http://www.ssb.no/publikasjoner/DP/pdf/dp367.pdf
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20. NETHERLANDS CENTRAL BANK [DNB]: "Optimal Investment Policies for Defined Benefit Pension Funds," by Arjen Siegmann (DNB Staff Report No. 112, 2004, .pdf format, 24p.).

Abstract:

This paper analyzes optimal investment policies for pension funds of a defined benefit (DB) type. The nature of a DB fund induces a natural modeling of preferences being of the mean-downside risk type. With compensation for inflation as an explicit goal of a pension fund, a natural reference point for the risk measure is the real or indexed value of the liabilities. Results are presented for a mean-shortfall model and different assumptions for inflation uncertainty, correlation between inflation and stock returns, and the level of the risk-free rate. Comparative statistics show increased risk-taking for funding ratios moving away from the reference point. We provide intuition for the results and compare the outcomes with actual investment policies of six large Dutch pension funds.

http://www.dnb.nl/dnb/bin/doc/sr112_tcm7-21438.pdf

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IV. Journal Tables of Contents (check your library for availability):

21. Journals of Gerontology Series A: Biological Sciences and Medical Sciences (Vol. 59, No. 3, March 2004). Note: Full electronic text of this journal is available in the ProQuest Research Library. Check your library for the availability of this database and this issue.

http://biomed.gerontologyjournals.org/content/vol59/issue3/index.shtml
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22. AMEDEO MEDICAL LITERATURE: Note: "AMEDEO has been created to serve the needs of healthcare professionals, including physicians, nurses, pharmacists, administrators, other members of the health professions, and patients and their friends. They can easily access timely, relevant information within their respective fields... All AMEDEO services are free of charge. This policy was made possible thanks to generous unrestricted educational grants provided by AMGEN, Berlex, Eisai, Glaxo Wellcome, Novartis, Pfizer, Roche, and Schering AG."

A. Osteoporosis: Literature for the week of March 17, 2004:

http://www.amedeo.com/medicine/ost.htm

B. Alzheimer's Disease: Literature for the week of March 17, 2004:

http://www.amedeo.com/medicine/ad.htm

C. Parkinson's Disease: Literature for the week of March 17, 2004:

http://www.amedeo.com/medicine/pd.htm

D. Prostate Cancer: Literature for the week of March 17, 2004:

http://www.amedeo.com/medicine/prc.htm

AMADEO Literature Guide:

http://www.amedeo.com/index.htm

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V. Legislation Information Updates:

23. US HOUSE COMMITTEE ON APPROPRIATIONS, SUBCOMMITTEE ON LABOR, HEALTH AND HUMAN SERVICES, EDUCATION, AND RELATED AGENCIES HEARING TESTIMONY: "Older American Programs Panel (AOA, NIA, CSEOA, CNCS)," a hearing held March 17, 2004. Note: The testimony of Josefina G. Carbonell and Dr. Richard Hodge will be of most interest.

To view hearing testimony (HTML and .pdf format):

http://appropriations.house.gov/index.cfm?FuseAction=Hearings.Detail&HearingId=357&Month=3&Year=2004
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24. US HOUSE COMMITTEE ON EDUCATION AND THE WORKFORCE, SUBCOMMITTEE ON EMPLOYER-EMPLOYEE RELATIONS HEARING TESTIMONY: "Reforming and Strengthening Defined Benefit Plans: Examining the Health of the Multiemployer Pension System," a hearing held March 18, 2004.

To view hearing testimony (HTML and .pdf format):

http://edworkforce.house.gov/hearings/108th/eer/multipension031804/wl031804.htm

Thanks,

Charlie

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Charlie Fiss
Information Manager
Center for Demography and Ecology and
Center for Demography of Health and Aging
Rm. 4470A Social Science Bldg
1180 Observatory Drive
Madison, WI 53706-1393
Phone: (608) 265-9240
Fax: (608) 262-8400
Email: fiss@ssc.wisc.edu

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