Across the Nation

Medicaid to cover breast cancer costs

WASHINGTON - President Clinton called on the states yesterday to make rapid use of a major expansion of Medicaid to pay full treatment costs for thousands of uninsured women with breast or cervical cancer, the first time such coverage has been offered.

The new program, created by Congress in October, covers the expenses of patients with these diseases whose incomes are too high to meet the traditional guidelines of Medicaid, the federal-state welfare program.

Uninsured patients with incomes up to 250 percent of the federal poverty line - about $35,000 a year for a family of three - would be eligible to have the government pay for all medical expenses in connection with the cancers. Such costs as surgery, radiation, chemotherapy and any follow-up care and medications would be covered.

In addition, the cancer must have been detected through the free screening programs operated by the federal Centers for Disease Control and Prevention through local health centers, clinics and hospitals. More than 1.5 million women have had the screenings since the program began in 1990, receiving free mammograms to check for breast cancer and free pap smears to detect cervical cancer.

Because the program offered detection without treatment, experts believe that many women skipped the chance to get the test because they feared that they would be unable to pay for treatment if they learned they had cancer.

"It was a flawed policy," said Fran Visco, president of the National Breast Cancer Coalition, who helped lead a successful lobbying effort on the issue. Visco received a standing ovation yesterday at a White House ceremony announcing efforts to speed up implementation of the policy.

More Asians smoke at younger age

WASHINGTON - The number of Asian-American youths who smoke increases dramatically between middle school and high school - from 3.8 percent in sixth grade to 33.1 percent by 12th grade - a rate much steeper than any other ethnic group, according to a report released yesterday.

The survey of 35,000 young people is the first to look at youth smoking rates among Asian-Americans, researchers said. It was conducted by the American Legacy Foundation, the anti-smoking organization formed by the 1998 settlement agreement between the states and the tobacco industry.

In middle school, the survey found, overall smoking rates among students of Asian decent are the lowest of all ethnic groups - about 5.5 percent compared to 10.7 percent of whites, 11.3 percent of blacks and 11.2 percent of Latinos.

However, by high school graduation, the situation has reversed dramatically - with a third of Asian-Americans smoking in the 12th grade, second only to whites.

The report stressed what researchers have long believed: that middle school, "when barriers to smoking begin to drop dramatically," is when smoking rates begin to increase among students of all ethnic backgrounds.

The report "confirms that the middle school years are the real breeding ground for... smoking," said Alan Leshner, director of the National Institute on Drug Abuse, part of the National Institutes of Health.

The foundation, which is also developing counter-marketing campaigns aimed at specific ethnic groups, has asked researchers to examine the reasons for the trends in each group, with the idea of ultimately designing new approaches to keep kids from starting to smoke.

Thus far, foundation experts believe, the reason smoking explodes so rapidly among Asian-American youth after middle school and upon entering high school may be related to parenting styles that differ from other ethnic groups.

"The theory - and it is only a theory - is that (Asian-American youths) have more parental supervision at a younger age" than other groups, said Cheryl Healton, president of the foundation. "They think that (cigarette) use burgeons as they spend more time away from the home environment."

Clinton discusses drug report findings

WASHINGTON - President Clinton praised recent signs of progress in curbing drug use yesterday but bemoaned the fact that "drugs continue to exact a tremendous toll" on young people dabbling in steroids and club drugs such as ecstasy.

In receiving the final report from his drug policy adviser, Clinton said he was glad that the report showed drug-related murders are at their lowest level in 10 years and that drug use by young people aged 12-17 is down 21 percent since 1997.

But, he said, studies also are providing disturbing evidence of increased use of steroids, ecstasy and other drugs. "Too many young people are still using alcohol, tobacco and illegal substances," Clinton said.

"We must never give up on making our children's futures safe and drug-free," he said. "Despite our progress, drugs continue to exact a tremendous toll on our nation."

Barry McCaffrey, director of the Office of National Drug Control Policy, noted that drug education and prevention efforts have not kept up with the onslaught of new drugs such as ecstasy, known chemically as methylenedioxymenthylamphetamine, or MDMA.

Those who use ecstasy normally experience feelings of euphoria and an increased desire for social interaction. They also experience dramatic increases in blood pressure, heart rate and body temperature.

Use of MDMA, once mainly an East Coast drug, has spread rapidly across the country, McCaffrey said, with an "explosive increase in exposure among our children."

"They think it's a hug drug, it's a dance-all-night, feel-good drug," McCaffrey said. But ecstasy also may permanently impair the brain's neurochemical functions, McCaffrey said, "never mind the possibility of dropping dead the first time you use it."