patients are also less likely to question prescribed medi- cations, assuming that their physicians "know best."

Another aspect of the trial involved the suggestion to restrict subjects to women at higher risk of developing breast cancer. The NCI, however, did not think it would be possible to recruit enough subjects to achieve the study objective if the more restrictive criterion was used. The FDA ultimately did not require the NCI to recruit higher risk women.

Some researchers have noted that until the informed- consent documents are reviewed and rewritten to provide omitted data women in the study may be misled about the expected risks and benefits, which could result in costly legal ramifications.

The subcommittee is continuing its investigation of changes in the study, as well as research on tamoxifen, and will report its findings later this year.

Low-risk Patients Fare Better with Angioplasty than Coronary Bypass Surgery

According to an article published in Research Activi- ties, patients in generally good health with good cardiac function, except for clogged cardiac arteries, are twice as likely to die after coronary artery bypass surgery than after coronary angioplasty.

When patient risk factors were considered, the relative risk of dying during an 18-month period after bypass sur- gery was 1.72 for all patients, 2.15 for low-risk patients, and 0.90 for high-risk patients. The l-year mortality rate was similar for high-risk angioplasty patients (19.8%) and high-risk patients (17%). The l-year mortality rate was twice as high for low-risk bypass patients as for low- risk angioplasty patients (8.7% versus 4.2%).

AARP Cites Medicare Patients' Overpayments

Medicare enrollees who used hospital outpatient de- partments increasingly are being charged more than their fair share of the hospital bill, the AARP has reported. Ordinarily, beneficiaries pay only 20% of hospital or phy- sician charges approved by Medicare, but with outpatient surgery bills, the ratio can be as high as 50%, with the pa- tient as the loser. The problem does not apply to bills ben- eficiaries receive as hospital inpatients, doctors' patients, or patients at medical labs.

Bob Jackson, coordinator of AARP's Medicare/ Medicaid Assistance Program, told the A A R P Bulletin that beneficiary complaints are on the rise around the country, with no exact figure for the amount overpaid by Medicare patients each year. Some estimates put the amount in the hundreds of millions of dollars.

National Caregiving Information Project Funded

The Administration on Aging has awarded a $100,000 grant to the Older Women's League (OWL) to fund "Caregiving: The First Line of Defense," a 17-month national eldercare information project. The project will link caregivers and health care professionals to support caregiving in the community. Caregivers in selected com- munities will speak at public forums organized by OWL chapters. Caregivers will also be provided essential infor- mation to help them keep elder family members-- especially low-income and minority elders--in the community.

Family members provide most of the care for the na- tion's disabled elderly, 90% of whom live at home. Amer- ican women spend more years caring for dependent par- ents than for their children.

For more information, contact OWL at (800) 825- 3695.

GAO Reports on Elderly

A General Accounting Office report emphasizes gaps between the poor and nonpoor in the areas of health, housing, and nutritional status. The report found that, in general, older Americans have benefitted from federal in- itiatives, particularly Social Security, aimed at reducing poverty among the elderly. In 1990, 12% of the elderly were characterized as being poor, compared with 35% in 1959. However, widowed and minority women were found to be especially vulnerable to poverty. Despite Medicare coverage, poor older adults spent 20% of their income on out-of-pocket health care expenses, versus 13% for the nonpoor elderly. Older persons with less than $10,000 in income also experience higher rates of both acute and chronic medical conditions.

Copies of the report, "Elderly Americans: Health, Housing and Nutrition Gaps Between the Poor and Non- poor" (GAO/PEMD-92-29), may be obtained from the U.S. General Accounting Office, P. O. Box 6015, Gaith- ersburg, MD 20877, or by calling (202) 275-6241.

Some Prescription Drug Prices Soar

A study of 29 widely used prescription drugs showed that the prices of most of the agents increased by at least 100% between 1985 and 1991. The increase in price was even higher for some drugs.

The General Accounting Office study, requested by Reps. Byron Dorgan (D-ND) and Forney (Pete) Stark (D-CA), found that prices of 19 of the 29 drugs had at least doubled in that time. Increases for nearly all 29

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