FRIDAY, Dec. 29, 2006 (HealthDay News) -- The top health story for 2006 focused on a fundamental issue: how to pay for medical care.
A study published in December found that nearly one in six Americans -- 50 million people -- now spend more than 10 percent of their income on medical expenses. That's an increase of nearly 10 million people struggling to pay their medical bills, compared with a decade ago.
And while uninsured or underinsured Americans used to live in predominantly poorer households, "the level of risk is creeping up the income scale," said Carol Pryor, senior policy analyst at the health-care advocacy group The Access Project in Boston. "The problem is becoming an issue for more and more people."
Another poll, released in October, found 25 percent of Americans admitting they were hard-pressed to pay for health care in 2006. And 60 percent of people with health insurance said they are worried about their ability to cover expenses in the future.
Drug coverage may have gotten a bit easier for older Americans, however. After a bumpy start -- including confusing private-plan choices, Medicaid recipients getting temporarily locked out of plans, and the "donut hole" gap in coverage -- Medicare Part D has met with approval from most users. A recent Kaiser Family Foundation poll found 76 percent of enrollees agreeing that their experience with Part D has been "positive."
Other top health news for 2006, as determined by HealthDay editors:
Tainted-Food Scares Rattle Public. Grocery items as innocuous as spinach, tomatoes and iceberg lettuce had the nation on edge in 2006, as hundreds of consumers were sickened with food-borne illnesses, prompting calls for tighter controls on food safety.
In September, an outbreak of E.coli 0157:H7 illness that killed three and sickened nearly 200 people in 26 states and Canada was traced to contaminated spinach grown in California. Also in September, salmonella-tainted tomatoes caused serious illness in 183 people in 21 states and Canada.
Finally, after an exhaustive investigation, federal experts traced another E.coli outbreak to iceberg lettuce used in Taco Bell restaurants across the Northeast. That outbreak sickened more than 70 people in five northeastern states in early December.
Drug-Eluting Stents May Stay. Early in December, a U.S. Food and Drug Administration advisory panel concluded that there's just not enough evidence to pull drug-eluting stents from the market -- even though some studies suggest the artery-propping devices boost risks for blood clots.
The panel did advise that the millions of heart patients who receive the stents -- which slowly emit drugs to prevent artery re-closure -- take blood-thinning medications for at least one year after receiving such a device. Since that advice is in keeping with standard care, the FDA recommendations probably won't change clinical practice, doctors said.
Cervical Cancer Vaccine Approved. In a major breakthrough, the FDA in June approved a vaccine against the human papilloma virus (HPV), thought to be responsible for most cases of cervical cancer. Later that month, a federal advisory panel overwhelmingly recommended that the vaccine, called Gardasil, be given routinely to girls as young as 9 and to women up to age 26.
Silicone Breast Implants Make Comeback. Amid heated debate, FDA regulators in November allowed the re-introduction to the market of silicone breast implants -- banned since 1992 because of concerns they raised the risk for cancer and connective tissue disease.
In making their decision, agency officials cited a comprehensive Institute of Medicine report that found no cases of illness linked to the implants.
Consumer group Public Citizen opposed the decision, however, calling silicone breast implants "the most defective medical device ever approved by the FDA."
'Morning-After' Pill Goes OTC. After three years of what Planned Parenthood President Cecile Richards called "foot-dragging," the FDA heeded the advice of its advisory committees and in August approved the over-the-counter sale of the "Plan B" emergency contraceptive.
The move was not without restrictions: women under the age of 18 cannot obtain the controversial "morning-after" pill without a doctor's prescription. To work, the pill must be taken within 72 hours to delay ovulation and prevent conception.
Public Increasingly Backs Stem Cell Research. Criticism of actor and Parkinson's disease patient Michael J. Fox for his support of embryonic stem cell research only seemed to bolster public enthusiasm for the technology in 2006.
The Fox furor put the issue back in the spotlight in November, five months after President Bush vetoed a bill that would have eased federal restrictions on funding for the controversial research. An NBC News/Wall Street Journal poll conducted in July found 63 percent of Americans opposing the President's decision.
In the meantime, advances in stem cell research continued. Scientists made promising discoveries in the use of stem cells to fight cancer, heart disease, diabetes, blindness and a host of other conditions. And in August, a group of U.S. scientists discovered a way to harvest these cells without destroying the embryo -- offering a potential way around the controversy.
Antidepressants' Link to Suicide Debated. Data from a number of studies published this year muddied the debate about whether SSRIs raise or lower the risk of suicide among teens, putting the FDA's 2004 decision to require a "black box" label warning on these antidepressant drugs in doubt.
One study, published in November, found that the use of SSRIs actually lowered the overall child and adolescent suicide rate by treating kids' depression. Another study, published a month later, found a link between SSRIs and attempted, but not completed, suicide.
An FDA panel reviewed the issue in December and concluded that antidepressant use is linked to increased suicide risk in an age-related fashion. They recommended further labeling changes -- perhaps extending the black-box warning to young adults -- but offered no exact wording.
More Progress Against Alzheimer's Disease. The race to find effective treatments for the brain-robbing illness quickened in 2006, as deaths linked to Alzheimer's continued to rise. In one advance, U.S. scientists got closer to a gene-based test that might someday allow doctors to spot the disease early.
Scientists, Regulators Lose Their Luster. A number of "faked research" scandals shook the public's faith in medical research over the past 12 months. First up: disgraced South Korean stem cell scientist Hwang Woo-suk, who admitted faking what he had described as the world's first cloned human embryo.
Later in the year, leading journals retracted articles by Norwegian cancer research Jon Sudbo, who fabricated data for a study that postulated a link between over-the-counter painkillers and cardiovascular disease.
These and other infractions caused editors at some of the world's leading medical journals to put stricter guidelines on publication.
Over at the FDA, critics hit regulators with charges of bias and industry interference after debacles such as the withdrawal of painkillers Vioxx and Bextra and continuing controversies over the emergency contraceptive Plan B and SSRI antidepressants.
The agency's critics gained ammunition from research published in April in the Journal of the American Medical Association. The study found that three-quarters of the FDA's advisory panels included members who had conflicts of interest due to financial ties to industry.
