U.S. health officials issued more rules related to the 2010 health reform law this week. They said that polyp removal during a routine colonoscopy is preventive care. Therefore, private insurance must cover the service at no cost to patients. The government also released numbers on how well this season's flu vaccine worked. The vaccine provided only 9% protection for seniors against the worst type of flu that's making people sick. A study released this week looked at costs for hysterectomy. Far more of the operations are being done with robotic assistance. The costs are higher, but results are no better, the study said.
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U.S. Classifies Polyp Removal as Preventive Care
Health insurance policies must cover at no cost the removal of pre-cancerous polyps during a routine colonoscopy. That was the ruling this week from the Obama administration. The policy clarifies that polyp removal is considered preventive care. Under the 2010 health care law, private health insurance must cover preventive care at no cost to the patient. Colonoscopy is covered for people age 50 and older because it is a screening test for colorectal cancer. The test sometimes finds polyps that can develop into cancers. These usually are removed. Since the law went into effect, some insurance plans had been charging if polyps were removed. The government also ruled this week on other services that must be covered free as preventive care. They include all forms of birth control, not just pills, and testing for genes that increase the risk of breast cancer. The Associated Press wrote about the rulings.

Vaccine Didn't Prevent Most Severe Flu in Seniors
Flu shots offered only 9% protection for people over 65 against the most severe strain of flu circulating this season, the government said this week. That strain was the most common this season as well as the one that caused the worst illness. Overall, the vaccine provided about 27% protection against 3 strains of influenza for adults over 65, the new report said. Protection was about 56% for all age groups. The statistics came from the Centers for Disease Control and Prevention (CDC). Flu generally hits older adults harder, and flu shots don't work as well for them. Overall, the effectiveness of this season's vaccine was not much below average, experts told the Associated Press (AP). Because flu changes quickly, there's a lot of guesswork in creating the vaccine. So 30% to 40% effectiveness is considered good for seniors, AP said. About 60% to 70% is acceptable for all groups. But the 9% rate of protection was particularly low. Perhaps partly as a result, hospital stays for older adults hit one of the highest levels in a decade.

More Get Robotic Hysterectomy, at Higher Costs
Robotic surgery rates for hysterectomy soared in recent years. But a study released this week found little added benefit over other techniques. And costs were about $2,200 higher. The study looked at data on 260,000 hysterectomies performed at 441 U.S. hospitals. Robotic surgery was used in one-half of 1% in 2007. By early 2010, the rate was almost 10%. Average costs were about $8,900 for a robotic operation and $6,700 for a standard laparoscopic operation. Laparoscopy uses a camera and instruments inserted through very small incisions. However, it does not use robotic assistance. Problems after surgery were about 5% in both groups. Women were slightly less likely to stay in the hospital more than 2 days after a robotic procedure. But most women stayed less than that. Laparoscopic operations also rose during the study period. They rose from 24.3% to 30.5%. Procedures done through the vagina or through a large open incision fell. In 2010, about 40% had open surgery. Just under 20% had vaginal surgery. The Journal of the American Medical Association published the study. The Associated Press wrote about it.

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