First Edition: March 18, 2019
Today's early morning highlights from the major news organizations.
Kaiser Health News:
Death By A Thousand Clicks
The pain radiated from the top of Annette Monachelli’s head, and it got worse when she changed positions. It didn’t feel like her usual migraine. The 47-year-old Vermont attorney turned innkeeper visited her local doctor at the Stowe Family Practice twice about the problem in late November 2012, but got little relief. Two months later, Monachelli was dead of a brain aneurysm, a condition that, despite the symptoms and the appointments, had never been tested for or diagnosed until she turned up in the emergency room days before her death. (Schulte and Fry, 3/18)
Kaiser Health News:
Podcast: KHN’s ‘What The Health?’ The Karma Of Cutting Medicare
Like those of his recent predecessors, President Donald Trump’s proposed budget for the fiscal year that starts in October will not be adopted by Congress. Still, a presidential budget plan is an important indicator of the administration’s priorities. The Trump administration’s priority for health is for the federal government to spend less. In some cases much less, as evidenced by its proposed funding for the National Institutes of Health and Centers for Disease Control and Prevention. (3/15)
The New York Times:
Democrats Pledged To Lower Health Costs. They Just Haven’t Figured Out How.
No issue animated the Democrats’ 2018 congressional campaigns like health care and the promises to expand access to insurance and to lower costs. But as House Democrats sit down to draft their vision of governance in the coming weeks, lawmakers find themselves badly divided on the issue that delivered their majority. Centrists from swing districts, with the tacit support of Speaker Nancy Pelosi, favor incremental moves to shore up the Affordable Care Act and to lower the out-of-pocket costs of prescription drugs and medical care. They are pushing a variety of measures, such as shutting down cheap, short-term insurance plans that do not cover pre-existing medical conditions and allowing people to buy into Medicare at age 50 or 55. (Stolberg and Pear, 3/18)
The Hill:
O'Rourke Faces Pressure From Left On 'Medicare For All'
Beto O'Rourke has offered conflicting messages on 'Medicare for all,' drawing fire from progressive activists who accuse him of backing off an idea they say he once supported. The issue has become an important litmus test for those on the party's left and an early question for O'Rourke, who announced his presidential run on Thursday. (Sullivan, 3/117)
The Hill:
Dems Shift Strategy For Securing Gun Violence Research Funds
Congressional Democrats are shifting tactics in their effort to secure gun violence research funds for the first time in 23 years by drawing on a decades-old policy initially backed by the National Rifle Association (NRA). House Democrats are abandoning their goal of getting rid of the Dickey amendment, a policy rider that’s discouraged federal agencies like the Centers for Disease Control and Prevention (CDC) from studying ways to prevent gun-related deaths. (Hellmann, 3/16)
The Wall Street Journal:
Red States Seek To Remake Medicaid
Republican-led states are stepping up their efforts with the Trump administration to pursue work requirements and other changes to Medicaid, in the face of legal challenges and Democratic opposition. Tennessee Republicans want permission to revamp Medicaid in exchange for a fixed amount from the federal government. Utah is testing whether it can get approval for a partial Medicaid expansion with capped payments from the federal government. And Kentucky lawmakers have weighed drug-testing recipients with criminal or substance-abuse histories, among other steps. (Armour, 3/15)
Stat:
MedPAC Criticizes Congress For ‘Donut Hole’ Changes
Congress’ Medicare advisers are chiding lawmakers for a controversial change they made to the Medicare prescription drug program’s so-called donut hole last year. The group, known as MedPAC, argued in its annual report Friday that the change — which puts drug makers, rather than insurers, on the hook for a higher percentage of the cost of some Medicare drugs — disincentivizes insurance companies from managing high drug costs. (Florko, 3/15)
The Associated Press:
Maryland House Advances Bill On Trump Family-Planning Rule
Maryland would become the first state to stop participating in a federal family planning program known as Title X due to a new Trump administration rule, under a measure that has advanced in the state's House of Delegates. The House gave the bill preliminary approval Friday. (3/15)
The Associated Press:
Veterans Court May Be Collateral Damage In Immigration Fight
Three decades ago, Lori Ann Bourgeois was guarding fighter jets at an air base. After her discharge, she fell into drug addiction. She wound up living on the streets and was arrested for possession of methamphetamine. But on a recent day, the former Air Force Security Police member walked into a Veterans Treatment Court after completing a 90-day residential drug treatment program. Two dozen fellow vets sitting on the courtroom benches applauded. A judge handed Bourgeois a special coin marking the occasion, inscribed with the words "Change Attitude, Change Thinking, Change Behavior." (3/17)
The New York Times:
Two Veterans Groups, Left And Right, Join Forces Against The Forever Wars
The relationship began in the most Washington way ever: on the set of C-Span. Will Fischer, then the director of government relations for VoteVets, the liberal political action committee, was tapped to face off with Dan Caldwell, the executive director of the conservative Concerned Veterans for America. It was a continuation of a yearslong and contentious dialogue over veterans issues, including disputes over health care, which candidates care more about matters important to veterans, as well as their dueling views on the nefarious nature of the Republican or Democratic parties. (Steinhauer, 3/16)
The New York Times:
Tens Of Thousands Of Heart Patients May Not Need Open-Heart Surgery
The operation is a daring one: To replace a failing heart valve, cardiologists insert a replacement through a patient’s groin and thread it all the way to the heart, maneuvering it into the site of the old valve. The procedure, called transcatheter aortic valve replacement (TAVR), has been reserved mostly for patients so old and sick they might not survive open-heart surgery. Now, two large clinical trials show that TAVR is just as useful in younger, healthier patients. (Kolata, 3/16)
The Associated Press:
Newer Heart Valves May Let More People Avoid Surgery
A decade ago, expandable aortic valves were developed that can be guided to the heart through a catheter into a blood vessel and placed inside the old valve. But they're only used now in people at high or moderate risk of dying from surgery. The new studies tested these valves in people at low risk for the operation, as most patients are, and found them as good or superior to surgical ones. "This is our last frontier" to make these devices a standard of care, said Dr. Joseph Cleveland, a University of Colorado heart surgeon with no role in the studies or ties to the companies that sponsored them. "It's a great thing" for patients to be able to avoid major surgery, he said. (3/16)
The Wall Street Journal:
Smaller Hospitals Press For Chance To Offer Heart-Valve Procedure
TAVR has transformed treatment of certain heart-disease patients by giving them an alternative to open-heart surgery. Many of these patients are too sick to undergo the risks of open-heart surgery; yet patients undergoing TAVR also are at risk of complications, including stroke. To ensure safety, TAVR’s use has been effectively limited to bigger hospitals performing at least 20 of the procedures annually. That is because the federal Medicare health insurance program for the elderly, the biggest payer of TAVR bills in the U.S., has limited reimbursement to hospitals that would perform higher volumes of the procedures. (Loftus, 3/16)
The New York Times:
Are Eggs Bad For Your Heart Health? Maybe
Some nutrition experts say eggs are good for you, even though they are high in cholesterol. Others are sure they are bad. A large new study may help resolve at least some of the confusion. The new analysis looked at data from six large prospective studies involving almost 30,000 participants, with an average follow-up of more than 17 years. It found that for each additional 300 milligrams a day of cholesterol in the diet, there was a 17 percent increased risk of cardiovascular disease and an 18 percent increased risk of premature death from any cause. (Bakalar, 3/15)
The Associated Press:
Are Eggs Good Or Bad For You? New Research Rekindles Debate
The researchers say the culprit is cholesterol, found in egg yolks and other foods, including shellfish, dairy products and red meat. The study focused on eggs because they're among the most commonly eaten cholesterol-rich foods. They can still be part of a healthy diet, but in smaller quantities than many Americans have gotten used to, the researchers say. U.S. dietary guidelines that eased limits on cholesterol have helped eggs make a comeback. (3/15)
NPR:
Cholesterol Redux: As Eggs Make A Comeback, New Questions About Health Risks
What we found in this study was that if you consumed two eggs per day, there was a 27 percent increased risk of developing heart disease," says researcher Norrina Allen, an associate professor in the Department of Preventive Medicine at Northwestern University. "It was surprising," Allen says. (Aubrey, 3/16)
NPR:
Heart Guidelines Often Based On Evidence That Falls Short
Doctors turn to professional guidelines to help them identify the latest thinking on appropriate medical treatments, but a study out Friday finds that in the realm of heart disease, most of those guidelines aren't based on the highest level of evidence. A paper in JAMA, the journal of the American Medical Association, that was released online ahead of print, finds that less than 10 percent of cardiovascular guidelines are based on the most carefully conducted scientific studies, known as randomized controlled trials. A lot of the rest are based on much weaker evidence. (Harris, 3/15)
The Wall Street Journal:
New Guidelines Advise Against Aspirin To Prevent Heart Disease
Most healthy people shouldn’t take aspirin to prevent a first heart attack or cardiovascular disease, major heart-health organizations now recommend, saying the risk of serious bleeding outweighs the benefits. Aspirin, the pain reliever, became increasingly used for the purpose of preventing a first heart attack after studies in the 1980s and 1990s showed a benefit. (Loftus, 3/17)
The Wall Street Journal:
Apple Watch Has Mixed Results In Big Heart Study
A massive new study found that the pulse sensor in Apple Inc.’s watch helped detect a heart-rhythm disorder in a small number of users but may have caused false alarms for others. The study’s mixed findings hinted at the potential of “wearable” gadgets to detect asymptomatic health conditions in people that might otherwise go unnoticed. But doctors said the potential false positives and other aspects of the study show that people should be cautious about relying on the technology as diagnostic tools. (Loftus, 3/16)
CNN:
Apple Watch App Could Save Your Life By Detecting Irregular Heartbeat, Study Says
Has a new bar been set for wearable technologies? An Apple Watch may detect heart rate irregularities that subsequent medical tests confirm to be atrial fibrillation, according to preliminary findings from a new study. AFib is often undiagnosed since it might not cause noticeable symptoms, but it contributes to 130,000 deaths and 750,000 hospitalizations in the United States each year. (Scutti, 3/16)
Stat:
Next For Apple Watch: A Clinical Trial With J&J To Track Heart Health
Results from a study conducted by Stanford researchers working with Apple showed that using the Apple Watch to detect atrial fibrillation probably won’t cause an epidemic of worrisome diagnoses. But it didn’t really answer most of the questions doctors or consumers have about using the watch in this way. But Apple is taking the next step, teaming with Johnson & Johnson to a conduct a study of 180,000 people over the age of 65 to get a better understanding of the Apple Watch’s impact on health. (Herper, 3/16)
The New York Times:
Methadone Helped Her Quit Heroin. Now She’s Suing U.S. Prisons To Allow The Treatment.
A Massachusetts woman recovering from heroin addiction sued the Federal Bureau of Prisons on Friday over its policy prohibiting methadone treatment, which she wants to continue when she starts a yearlong sentence next month. Her suit comes four months after a federal judge ordered a county jail outside Boston to let an incoming inmate stay on methadone instead of requiring him to go through forced withdrawal, as was its policy. It adds to growing pressure on the criminal justice system to provide methadone or other evidence-based treatments to the staggering number of inmates with opioid addiction. (Goodnough, 3/15)
The New York Times:
E.P.A., Scaling Back Proposed Ban, Plans Limits On Deadly Chemical In Paint Strippers
The Environmental Protection Agency announced on Friday new limits on a lethal chemical found in paint stripping products that has been linked to more than 50 deaths since the 1980s. Chemical safety activists called the plan a significant scaling-back of the ban that the Obama administration had proposed. In 2017 the Obama administration concluded the chemical, methylene chloride, represented an “unreasonable risk” and moved to ban it from commercial as well as consumer use. (Friedman, 3/15)
The Associated Press:
EPA Bans Consumer Use Of Deadly Paint Stripper, In Rare Step
The EPA cited "the acute fatalities that have resulted from exposure to the chemical" and an "unreasonable" risk to consumers. Retail stores have until later this year to remove the product from sale. Many big chains already stopped sale of products with methylene chloride in recent months, amid a campaign led by environmental groups and families of men overcome and killed by fumes from the paint stripper. (3/15)
Stat:
What's In A Name? For Haven, Maybe Another Legal Fight
By naming their company Haven, leaders of the health venture formed by Amazon, Berkshire Hathaway, and JPMorgan Chase & Co. sought to create a brand unlike anything else in American medicine — a business uniquely capable of sheltering customers from insurance hassles and unreasonable costs. There’s just one hitch: Dozens of other companies already use the same name, including a large handful that deliver or facilitate health services, according to a review of registrations on file with the U.S. Patent and Trademark Office. (Ross and Sheridan, 3/18)
The New York Times:
Health Savings Accounts Can Reduce Tax Bills. But Beware The Paperwork.
At this time of year, many people are looking for ways to reduce their tax bills. One option may be to make a contribution to a health savings account. You can still make contributions for the 2018 tax year to an H.S.A. until the federal tax filing deadline in April, if you qualify. “It’s not too late to save on your 2018 taxes,” said Todd Berkley, vice president of BenefitWallet, a division of Conduent that manages H.S.A.s and other employee benefits. “Most people don’t know that.” (Carrns, 3/15)
The New York Times:
When Email Comes To The Doctor’s Office, Wait Times Decrease
The kind of thing we have done instinctively in our workplaces for two decades — sending a quick email instead of setting up a meeting — has until recently eluded many doctors. Electronic consultations, or eConsults (sometimes called eReferrals), are a growing way for primary care doctors and specialists to communicate with each other securely. They can help patients avoid additional visits to specialists and free up capacity in crowded health systems, reducing waiting times for others. (Frakt, 3/18)
NPR:
Racism, Poverty And Homophobia Are Still Big Obstacles To Ending HIV
Ending HIV transmission in America within the next decade — a stated goal of the Trump Administration — isn't a question of coming up with new medication. The medicines to prevent and treat HIV infections already exist. But the road to eliminating HIV and AIDS runs through the deep South, where racism, poverty, and homophobia can be formidable obstacles to testing and treatment, particularly for black gay men. According to a Centers for Disease Control and Prevention report in 2017, more than half the new HIV diagnoses in the U.S. were in Southern states, where gay and bisexual black men make up a disproportionate share of people with HIV. (Shapiro and Blanchard, 3/16)
Los Angeles Times:
Light And Sound Stimulus Therapy Generates A Buzz In Alzheimer’s Research World
The often-discouraging search for ways to prevent or treat Alzheimer’s disease may have flickered to life this week with a bright new idea — and a buzzy new soundtrack as well. In experiments conducted on mice, scientists used light and sound to orchestrate a series of episodes that were marked by an unusual state of electronic synchrony inside the animals’ brains. Prompted by a gently flickering light and a pulsating buzz — both timed to fire 40 times per second — their brains began to hum to the same frequency. The results, published this week in the journal Cell, are already yielding some powerful insights about what may go wrong in Alzheimer’s disease, and how that process might be halted or reversed. (Healy, 3/15)
NPR:
Diagnosis Of Dementias Other Than Alzheimer's Can Affect Care
In the U.S., older people with dementia are usually told they have Alzheimer's disease.But a range of other brain diseases can also impair thinking, and memory and judgment, according to scientists attending a summit on dementias held Thursday and Friday at the National Institutes of Health. These include strokes, a form of Parkinson's disease, and a disease that damages brain areas that regulate emotion and behavior. (Hamilton, 3/18)
The Washington Post:
Depression May Respond To Exercise
I hear it often: A friend swears that her running practice staves off bouts of low spirits. Another says going to the gym before work keeps him mentally steady. Perhaps you’ve heard similar stories; perhaps you believe it for yourself. Those anecdotes prompt some questions. Is there evidence to support the idea that exercise can have an effect on depression? (Adams, 3/17)
The Washington Post:
Deciding Whether To Have Kids Has Never Been More Complex. Enter Parenthood-Indecision Therapists.
They arrive anxious for an answer. Or maybe, finally, a sense of peace. They arrive because they haven’t been able to resolve the biggest question of their lives: Do I want to be a parent? And so they come to the California therapy practice of Ann Davidman — by plane, by car, by phone — in the hope that the self-titled “motherhood clarity mentor” might deliver an epiphany. Next comes a simple instruction: Write down every fear, every loaded question, every disapproving comment and every panic-inducing headline that has coalesced into a stranglehold of indecision. (Gibson, 3/17)
The New York Times:
Talking To Children About Terminal Illness
“One of the most difficult things we ever have to do is to tell a child he or she has a very serious condition and may not survive it, or that a parent has a condition they may not survive,” said Dr. Alan Stein, a professor of child and adolescent psychiatry at the University of Oxford. Dr. Stein is the senior author on two articles published last week in the British medical journal The Lancet, which suggested guidelines for talking to children about life-threatening illness, one on when the illness is the child’s own and the other on when a parent is ill. (Klass, 3/18)
The New York Times:
Ebola Epidemic In Congo Could Last Another Year, C.D.C. Director Warns
The Ebola outbreak in the Democratic Republic of Congo is not under control and could continue for another year, Dr. Robert R. Redfield, director of the Centers for Disease Control and Prevention, said in an interview on Friday. “Let’s not underestimate this outbreak,” he said. (Grady, 3/16)
The New York Times:
Older Americans Are Awash In Antibiotics
Last month, Caryn Isaacs went to see her primary care doctor for her annual Medicare wellness visit. A patient advocate who lives in Manhattan, Ms. Isaacs, 68, felt perfectly fine and expected a clean bill of health. But her doctor, who’d ordered a variety of blood and urine tests, said she had a urinary tract infection and prescribed an antibiotic. “The nurse said, ‘Can you take Cipro?’” Ms. Isaacs recalled. “I didn’t have any reason not to, so I said yes.” (Span, 3/15)
The New York Times:
Can TV Dumb You Down?
Experts generally agree that watching a lot of television is bad for children. Now a new study suggests it may not be very good for adults, either. The British study, in Scientific Reports, included 3,590 people, average age 67, who were free of dementia at the start of the study. All reported their TV watching time at the study’s start. Participants took two tests. One was of verbal memory, in which they were asked to recall, after a short delay, a list of spoken words. (Bakalar, 3/15)
The Wall Street Journal:
No Gym Can Match Her Hula Hoop
Marah Kabaservice jokes that she’s a closet exerciser. You won’t find the 50-year-old nurse practitioner at the gym or in spin class. She finds more motivation hula hooping and doing jumping jacks in the privacy of her home in Rutledge, Tenn., a town near Knoxville. As an unathletic teen, Ms. Kabaservice was turned off from fitness by the forced activities of high school gym class. She flailed through dodgeball, softball, even warm-ups. “I nearly flunked P.E. because I couldn’t run four laps around the track,” she says. “By my 20s, I was a complete slug, smoking a pack of cloves a day.” (Murphy, 3/16)
NPR:
If Mouth Noise Like Chewing Or Swallowing Drive You Mad, You May Have Misophonia
For 18-year-old high school senior Ellie Rapp of Pittsburg, the sound of her family chewing their dinner can be ... unbearable. "My heart starts to pound. I go one of two ways. I either start to cry or I just get really intensely angry. It's really intense. I mean, it's as if you're going to die," she says. Rapp has been experiencing this reaction to certain noises since she was a toddler. She recalls a ride home from preschool when her mother turned on the radio and started singing, which caused Rapp to scream and cry hysterically. (Fulton, 3/18)
The Associated Press:
Tennessee Judge Rebuked For Nixing Out-Of-State Abortion
A Tennessee judge has been rebuked for denying the request of a woman on house arrest to travel to Atlanta for an abortion. The Chattanooga Times Free Press reports the 23-year-old woman was at least 10 weeks pregnant with twins when accepted into General Sessions Court Judge Lila Statom's Mental Health Court in February. The woman, who had pleaded guilty to theft and domestic assault, asked for permission to get the abortion last week, while on house arrest. (3/15)
The Associated Press:
Indiana Moves To Expanding Religious Objection To Abortion
Indiana lawmakers are moving closer to allowing nurses, physician assistants and pharmacists to object on religious or other grounds to having any role in an abortion. The Indiana House voted 69-25 on Thursday in favor of the legislation, which would expand the statute for medical professionals who don't want to perform an abortion or participate in any procedure that results in an abortion. That includes prescribing, administering or dispensing an abortion-inducing drug, The (Northwest Indiana) Times reported. (3/15)
The Hill:
Maine Governor Submits Bill Allowing Medical Professionals Who Aren't Doctors Perform Abortions
Maine Gov. Janet Mills (D) submitted a bill to expand the number of medical professionals besides physicians who could perform abortions, The Bangor Daily News reported. The bill was sponsored by House Speaker Sara Gideon (D) Thursday and would allow a physician assistant, an advanced practice registered nurse, certified nurse-midwives or other medical professional to perform the procedure. (Gstalter, 3/16)
CNN:
Online Abortion Pill Provider Ordered To Cease Delivery By FDA
A European organization that provides doctor-prescribed abortion pills by mail is under order by the US Food and Drug Administration to stop deliveries. The federal agency sent a warning letter to Aid Access this month requesting that it "immediately cease causing the introduction of these violative drugs into U.S. Commerce." "The sale of misbranded and unapproved new drugs poses an inherent risk to consumers who purchase those products," the letter says. "Drugs that have circumvented regulatory safeguards may be contaminated; counterfeit, contain varying amounts of active ingredients, or contain different ingredients altogether." (Ravitz, 3/17)
The Washington Post:
Transgender Healthcare Gaps Persist In Maryland. These Activists Are Trying To Change That.
For seven years, Kyndra Purnell could find no clinic near her home on Maryland’s Eastern Shore that would prescribe the hormones she desperately needed. She was forced to rely on the black market, buying estrogen injections from the few other transgender women she knew in the area. Then, about three years ago, she found Chase Brexton Health Services, a medical provider in Baltimore that offers hormone replacement therapy and other types of health care for the transgender community. But the clinic was more than two hours from Purnell’s home in Ocean City. Still, every three months, she made the drive, taking time off from her full-time job. (Schmidt, 3/17)
The Associated Press:
Puzzling Number Of Men Tied To Ferguson Protests Have Died
Two young men were found dead inside torched cars. Three others died of apparent suicides. Another collapsed on a bus, his death ruled an overdose. Six deaths, all involving men with connections to protests in Ferguson, Missouri, drew attention on social media and speculation in the activist community that something sinister was at play. Police say there is no evidence the deaths have anything to do with the protests stemming from a white police officer's fatal shooting of 18-year-old Michael Brown, and that only two were homicides with no known link to the protests. (3/17)