Current Awareness in Aging Research (CAAR) Report #266--December 9, 2004


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:


I. Data:

1. MEPS DATA UPDATES: The US Agency for Healthcare Research and Quality has issued the following data updates for the Medical Expenditure Panel Survey. All are dated Dec. 8, 2004.

A. "Update Note for HC-059F: 2001 Outpatient Visits File".

B. "Update Note for HC-051G: 2000 Office-Based Medical Provider Visits File".

C. "Update Note for HC-051F: 2000 Outpatient Visits File".

D. "Update Note for HC-059G: 2001 Office-Based Medical Provider Visits File".


II. Reports and articles:


A. "Medicare: Accuracy to Responses from 1-800-MEDICARE Help Line Can Be Improved," (US Government Accountability Office, GAO-05-130, December 8, 2004, .pdf format, 55p.).

B."Medicare: Advisory Opinions as a Means of Clarifying Program Requirements," (US Government Accountability Office, GAO-05-129, December 8, 2004, .pdf format, 25p.).

Note: This is a temporary address. GAO correspondence may be available at:


A. "Addition of Qualified Drugs to the Medicaid Federal Upper Limit List," (US Department of Health and Human Services, Office of Inspector General, OEI-03-04-00320, December 2004, .pdf format, 21p.).


This inspection was requested by the United States House of Representatives Committee on Energy and Commerce, Subcommittee on Oversight and Investigations. The OIG found that CMS does not consistently add qualified drugs to the Federal upper limit list in a timely manner. Of the 252 first-time generic drugs approved between January 2001 and December 2003, 109 products met the statutory and regulatory criteria for inclusion on the Federal upper limit list. However, only 25 were actually added to the Federal upper limit list. For the 25 drugs that were added, CMS took an average of 36 weeks to place the products on the Federal upper limit list once the drugs were qualified for inclusion. As of July 15, 2004, the 84 drugs that were not added had been qualified for an average of 55 weeks. Qualified drugs not being added to the Federal upper limit list in a timely manner cost the Medicaid program an estimated $167 million between 2001 and 2003. The OIG recommended that CMS establish an administrative procedure and schedule to govern the determination and publication of Federal upper limits. The CMS concurred with intent of our recommendation and stated that it had taken steps to support this objective. However, CMS did not concur with the OIG's methodology and the subsequent savings estimates.

B. "Medicare Lifetime Reserve Days: Report to Congress," (US Department of Health and Human Services, Office of Inspector General, OEI-09-04-00100, December 2004, .pdf format, 17p.).


The Medicare Prescription Drug, Improvement, and Modernization Act of 2003 (MMA), Public Law 108-173, enacted December 8, 2003, required that the Inspector General of the Department of Health and Human Services conduct a study relating to the use of hospital lifetime reserve days (LRDs) and, not later than 1 year after the date of the enactment, submit to the Congress a report on the study. The purpose of the study was to (1) determine the extent and means by which hospitals comply with the current requirement to notify Medicare beneficiaries about LRDs and (2) assess the appropriateness and feasibility of providing an additional notification prior to beneficiaries' exhausting their LRDs. This report is in response to the MMA requirement. CMS has provided comments, which we have incorporated in the report. Based on a survey of hospitals, 86 percent provide written and/or verbal notices to beneficiaries who have used or will use 90 days of benefits. Eight percent of hospitals do not provide any information about LRDs. Hospitals that do not provide notices indicated that they lacked timely information about the number of LRDs beneficiaries have available. While 64 percent of hospitals believe a second notice could be helpful, 66 percent said an additional notice would affect operational costs and staff time. According to beneficiaries, the LRD election is confusing and does not have an effect on their decisions about their care. Hospitals and beneficiaries agree that an additional notice would not be feasible or appropriate.

C. "Alternative Medicare Payment Methodologies for the Costs of Training Medical Residents in Nonhospital Settings," (US Department of Health and Human Services, Office of Inspector General, A-02-04-01012, December 2004, .pdf format, 14p.).


OIG will issue a final report on December 8, 2004 to the Congress and to the Centers for Medicare and Medicaid Services (CMS) entitled, "Alternative Medicare Payment Methodologies for the Costs of Training Medical Residents in Nonhospital Settings." Section 713 of the Medicare Prescription Drug, Improvement, and Modernization Act of 2003 mandated that the OIG conduct a study and report to the Congress on alternative Medicare payment methodologies for the costs of training medical residents in nonhospital settings. This final report identifies and describes five alternative methodologies for paying the training costs of such residents. Each of the five payment options has both positive and negative aspects. Therefore, before implementing any option, we are recommending that CMS work with Congress to: (1) further analyze the current financial arrangements and incentives among teaching hospitals, nonhospital settings, and supervisory physicians in nonhospital settings, (2) study the potential impact of any revisions to the current policy, and (3) clarify the definition of "all or substantially all" of the costs associated with training residents in nonhospital settings.


A. "Medicare Modernization Act Guidelines -- Formularies," (US Centers for Medicare and Medicaid Services, December 3, 2004).

B. "Age Estimates in the National Health Accounts," by Sean P. Keehan, Helen C. Lazenby, Mark A. Zezza, and Aaron C. Catlin (Health Care Financing Review, December 2004, .pdf format, 16p.). Note: CMS is making this article available for no charge. "This article presents historical trends of health spending by age. Personal health care is broken out into seven age groups for 1987, 1996, and 1999. Analysis of trends in health care spending is provided separately for children (age 0-18), working-age adults (age 19-64), and the elderly (age 65 or over). Future impacts of aging are also discussed, including using the historical estimates in a simulation to show only the effect of changing the age mix of the population over the next 50 years."

Press Release:

C. "CMS Announces the Establishment of 26 Medicare Advantage Regions and 34 Prescription Drug Plan Regions," (US Centers for Medicare and Medicaid Research, December 6, 2004).

D. "Medicare Awards Programs To Improve Care of Beneficiaries with Chronic Illnesses," (US Centers for Medicare and Medicaid Research, December 8, 2004).

E. "Medicare Modernization Benefits in the First Year," (US Centers for Medicare and Medicaid Research, December 8, 2004).

5. SSA PERIODICAL: "International Update, November 2004," (US Social Security Administration, Office of Policy, November 2004, HTML and .pdf format, 4p.).


A. "A Profile of Older Workers in Idaho," by Nick Carroll and Cynthia Taeuber (US Census Bureau Local Employment Dynamics LED/OW-ID, November 2004, .pdf format, 22p.). The Report is linked to from a Census Bureau news release: "Census Bureau Releases Analysis of Idaho's Older Workers," (US Census Bureau, CB04-238, December 8, 2004).

Click on "A Profile of Older Workers in Idaho" for full text.

B. _Statistical Abstract_ 2004-2005_, (US Census Bureau, December 2004, .pdf format 1006p.). As always the best way to use the electronic version is to use the index as a guide to the table numbers for relevant tables. This issue, along with most others back to 1878, as well as _ Bicentennial Edition: Historical Statistics of the United States, Colonial Times to 1970_, is linked to from a Census Bureau news release: "U.S. Cell Phone Use Up More Than 300 Percent, Statistical Abstract Reports" (CB04-236, Dec. 9, 2004).

Click on "Statistical Abstract of the United States: 2004-2005" for link to full texts.

7. NCHS CHARTBOOK: _Health, United States, 2004_ (US National Center for Health Statistics Chartbook, December 2004, .pdf format, 498p., with tables in Microsoft Excel format and figures in Microsoft PowerPoint format).

Direct access to Excel tables:

8. MEPS STATISTICAL BRIEF: "Hypertension in America, 2002: Estimates for the U.S. Civilian Non-institutionalized Population Ages 18 and Older," by William Carroll (US Agency for Healthcare Research and Quality, Medical Expenditure Panel Study, Statistical Brief #59, December 2004, .pdf format, 6p.)


A. "HHS Announces Regions to Administer New Medicare Prescription Drug Benefit and Medicare Advantage Program," (US Department of Health and Human Services, December 6, 2004).

B. "HHS Purchases 1.2 Million Doses of Flu Vaccine," (US Department of Health and Human Services, December 7, 2004).

10. NIH NEWS RELEASE: "NIH Panel Issues State-of-the-Science Statement on End-of-Life Care," (National Institutes of Health, December 8, 2004).

11. NIA NEWS RELEASE: "How Are We Doing? Researchers Aim to Measure National Well Being," (US National Institute on Aging, December 2, 2004).

12. REPUBLIC OF SOUTH AFRICA NATIONAL TREASURY REPORT: "Retirement Fund Reform Discussion Paper," (December 2004, .pdf format, 77p.).

Click on PDF icon at the top of the page for link to full text.


A. "WHO WILL CARE? Ageing and the Future Demand and Supply of Informal Carers," by Simon Kelly (November 2004, .pdf format, 26p.).

B. "Impact of Health on the Ability of Older Australians to Stay in the Workforce - with Possible Contributions to Economic Sustainability," by Agnes Walker (Conference Paper 2004-013, December 2004, .pdf format, 20p.).


The ageing of the population, combined with increasing life expectancies, is raising concerns about the sustainability of current economic and social structures. This paper studies the likelihood and impact of more older Australians staying in the labour force - subject to individuals' own health, socioeconomic status (SES), sex, age and family characteristics. A dynamic microsimulation model is used to estimate the probability that, in a changed employment environment, more Australians aged 65-70 would work more than 15 hours per week. Under that scenario, the findings are that around 500,000 additional persons aged 65-70 years would remain in the workforce - with the related earnings totaling up to $20 billion in 1998 ($35 billion in 2018). The estimated savings by government on the age pension would be around $2 billion ($4 billion in 2018).

Click on "Download as PDF" at the bottom of the abstract for full text.


A. "Relation of Body Mass Index in Young Adulthood and Middle Age to Medicare Expenditures in Older Age," by Martha L. Daviglus, Kiang Liu, Lijing L. Yan, Amber Pirzada, Larry Manheim, Willard Manning, Daniel B. Garside, Renwei Wang, Alan R. Dyer, Philip Greenland, and Jeremiah Stamler (_Journal of the American Medical Association_, Vol. 292, No. 22 December 8, 2004, .pdf and HTML format, p. 2743-2749).

B. "Accumulated Lead Exposure and Risk of Age-Related Cataract in Men," by Debra A. Schaumberg, Flavia Mendes, Mini Balaram, M. Reza Dana, David Sparrow, and Howard Hu (_Journal of the American Medical Association_, Vol. 292, No. 22 December 8, 2004, .pdf and HTML format, p. 2750-2754).

Note: The _JAMA_ web site was inaccessible as of 5pm 12/9/04. You may need to check back at a later time in order to access these items.


A. "Rivastigmine for Dementia Associated with Parkinson's Disease," by Murat Emre, Dag Aarsland, Alberto Albanese, E. Jane Byrne, Günther Deuschl, Peter P. De Deyn, Franck Durif, Jaime Kulisevsky, Teus van Laar, Andrew Lees, Werner Poewe, Alain Robillard, Mario M. Rosa, Erik Wolters, Peter Quarg, Sibel Tekin, and Roger Lane (_New England Journal of Medicine_, Vol. 351, No. 24, December 9, 2004, .pdf and HTML format, p. 2509-2518).

B. "Levodopa and the Progression of Parkinson's Disease," by The Parkinson Study Group (_New England Journal of Medicine_, Vol. 351, No. 24, December 9, 2004, .pdf and HTML format, p. 2498-2508).


A. "Non-steroidal anti-inflammatory drugs, including cyclo-oxygenase-2 inhibitors, in osteoarthritic knee pain: meta-analysis of randomised placebo controlled trials," by Jan Magnus Bjordal, Anne Elisabeth Ljunggren, Atle Klovning, Lars Slørdal (_British Medical Journal_, Vol. 329, No. 7478, December 3, 2004, .pdf and HTML format, 1317).

B. "Managing osteoarthritis of the knee," by Domhnall MacAule (_British Medical Journal_, Vol. 329, No. 7478, December 3, 2004, .pdf and HTML format, p. 1300-1301).


A. "Accelerated telomere shortening in response to life stress," by Elissa S. Epel, Elizabeth H. Blackburn, Jue Lin, Firdaus S. Dhabhar, Nancy E. Adler, Jason D. Morrow, and Richard M. Cawthon (_Proceeding of the National Academy of Sciences_, Vol. 101, No. 49, December 7, 2004, .pdf and HTML format, p. 17312-17315).

B. "A critical role for p27kip1 gene dosage in a mouse model of prostate carcinogenesis," by Hui Gao, Xuesong Ouyang, Whitney Banach-Petrosky, Alexander D. Borowsky, Yong Lin, Minjung Kim, Hansol Lee, Weichung-Joseph Shih, Robert D. Cardiff, Michael M. Shen, and Cory Abate-Shen (_Proceeding of the National Academy of Sciences_, Vol. 101, No. 49, December 7, 2004, .pdf and HTML format, p. 17204-17209).

Note: The _PNAS_ web site was inaccessible as of 5pm 12/9/04. You may need to check back at a later time in order to access these items.


A. "By Carrot or by Stick: Cognitive Reinforcement Learning in Parkinsonism," by Michael J. Frank, Lauren C. Seeberger, and Randall C. O'Reilly (_Science_, Vol. 306, No. 5703, December 10, 2004, .pdf and HTML format, p. 1940-1943).

B. "COX-2-Derived Prostacyclin Confers Atheroprotection on Female Mice," by Karine M. Egan, John A. Lawson, Susanne Fries, Beverley Koller, Daniel J. Rader, Emer M. Smyth, and Garret A. FitzGerald (_Science_, Vol. 306, No. 5703, December 10, 2004, .pdf and HTML format, p. 1954-1957).


A. "Medicare Drug Discount Card Program: How Much Does Card Choice Affect Price Paid?" by Keith Lind (November 2004, .pdf format, 39p.)

B. "Pension Participant Knowledge about Plan Fees," (November 2004, .pdf and HTML format, 2p.).

To view the .pdf, scroll down to or "find in page" "Download or view" (without the quotes).

20. MRRC WORKSHOP PROCEEDINGS: "Workshop on Global Aging," a conference held May 17, 2004 (Michigan Retirement Research Center, December 2004, .pdf format, 35p.). Note: The conference was co-sponsored by the Social Security Administration.

Papers from the Workshop can be found at:


A. _Global Report on Aging_ (AARP Global Aging Program, Special Edition 2004).

B. "Prescription Drug Spending and Coverage Among Rural Medicare Beneficiaries in 2003," (AARP Data Digest, November 2004, .pdf format, 5p.).

Click on "Download or view" at the bottom of the page for full text.

22. MICHIGAN RETIREMENT RESEARCH CENTER NEWSLETTER: "MRRC Newsletter," (Michigan Retirement Research Center, Vol. 5, No. 4, December 2004, HTML and .pdf format, 7p.).


III. Working Papers:

23. NBER: "Has the Unified Budget Undermined the Federal Government Trust Funds?" by Sita Nataraj and John B. Shoven (NBER Working Paper No. w10953, December 2004, .pdf format, 26p.).


In order to ease the burden on workers during the retirement of the baby boom generation, the 1983 Social Security Reforms set payroll taxes above the level needed to pay current benefits, thus partially prefunding the baby boomers' retirement. The military and civil service retirement programs followed suit in the mid-1980s and switched from pay-as-you-go financing to funded systems. The excess income generated by these retirement programs was held in the federal trust funds, which have accumulated almost $3 trillion since the reforms took place. However, this paper presents evidence that the trust fund build-up may not help future generations due to the adoption of the Unified Budget in 1970. The Unified Budget includes trust fund receipts as income and trust fund payments as expenditures. The empirical evidence suggests that attempts to balance the Unified Budget while the trust funds were generating surpluses has led to increased government spending and personal and corporation income tax cuts within the rest of the federal government. There is no evidence of increased government saving as a result of the trust fund accumulations. An alternate theory of increased national saving is also explored, where increased payroll taxes accompanied by decreased income taxes induces higher personal saving. This mechanism, suggested by Diamond, also does not appear to have significantly enhanced the wealth of future generations.

Click on "PDF" or submit your email address for full text.

24. BOSTON COLLEGE CENTER FOR RETIREMENT RESEARCH: "Projecting Immigration A Survey of the Current State of Practice and Theory," by Neil Howe and Richard Jackson (WP 2004-32, December 2004, .pdf format, 44p.).


Assumptions about long-term trends in international migration are an increasingly important component of the demographic projection module. Yet most official immigration projections both in the United States and abroad rely on ad-hoc assumptions based on little theory and virtually no definable methodology. The purpose of this paper is twofold: to assess where projection-making agencies stand in their practice of immigration projection and to explore how theoretical insights about immigration may help them improve their practice. The first section describes the current projection methods of leading national and international agencies, from the U.S. Census Bureau and Social Security Administration to the United Nations and the World Bank. The second section scans the wide and varied array of "theoretical frameworks" that attempt to explain international migration flows. The paper identifies six important ones: the policy, the neoclassical, the world systems, the new economics, the social networks, and the dual labor market frameworks. We conclude that much progress might be achievable if the explanatory richness of immigration theory could somehow be consolidated and integrated into a useable projection method. The third section briefly outlines some first steps to start harnessing theory and improving practice.

25. NATIONAL BANK OF BELGIUM: "Voting on pensions: A Survey," by G. de Walque (Working Paper No. 62, October 2004, .pdf format, 50p.)


The paper presents a non-exhaustive survey of the literature designed to explain emergence, size and political sustainability of pay-as-you-go pension systems. It proposes a simple framework of analysis (a small open two overlapping generation economy model), around which some variants are displayed. Dictatorship of the median voter is assumed. The text is organized to answer the following questions: (i) do political equilibria with PAYG pension schemes exist, (ii) why do they emerge, (iii) what are the conditions for the participation constraint of the pension game to be verified, and finally (iv) what is the size of the pension system chosen by the median voter and how is this size influenced by an exogenous (e.g. demographic) shock.

26. FEDERAL RESERVE BANK OF ATLANTA: "Understanding 401(k) Plans," by Ramon P. DeGennaro and Deborah L. Murphy (Working Paper 2004-21, September 2004, .pdf format, 14p.).


Questions about the future of the Social Security system continue to surface. As a result, interest in employer-sponsored retirement plans and other retirement investment options increases. But the restrictions and rules associated with various defined benefit plans such as 401(k), 403 (b), and 457 plans can be confusing, and these plans have risks of their own. The authors explore these plans and explain the need to view retirement savings as only one part of a portfolio.


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

27. American Journal of Epidemiology (Vol. 160, No. 12, December 15, 2004).

28. INGENTA Tables of Contents: INGENTA provides fee based document delivery services for selected journals.

A. Point your browser to:

B. click on "advanced search"
C. Type in your publication name and click "Exact title" radio button
D. Under "Show", click the "fax/ariel" radio button.
E. View the table of contents for the issue noted.

International Journal of Ageing and Human Development (Vol. 59, No. 3, 2004).

Journal of Health and Social Behavior (Vol. 45, No. 3, 2004). Note: Full electronic text of these journals is available in the ProQuest Research Library. Check your library for the availability of these databases and these issues.


29. 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 December 8, 2004:

B. Alzheimer's Disease: Literature for the week of December 8, 2004:

C. Parkinson's Disease: Literature for the week of December 8, 2004:

D. Prostate Cancer: Literature for the week of December 8, 2004:

AMADEO Literature Guide:


V. Funding Opportunities:

30. NIH NOTICE: "Announcing the NIA Aged Non-Human Primate Tissue Bank," (National Institute on Aging, NOT-AG-05-002, December 3, 2004).


VI. Legislation Information Updates:

31. US HOUSE COMMITTEE ON ENERGY AND COMMERCE, SUBCOMMITTEE ON OVERSIGHT AND INVESTIGATIONS HEARING TESTIMONY: "Medicaid Prescription Drug Reimbursement: Why the Government Pays Too Much," a hearing held December 7, 2004.

Hearing testimony (At present, you can listen to the hearing via RealPlayer. A printed version of the hearing testimony will be available shortly):




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