First Edition: April 2, 2018
Today's early morning highlights from the major news organizations.
Kaiser Health News:
Medicaid Minus Stigma: In Indian Country, It’s Part Of The Fabric Of Life
On a crisp sunny day, Tyson Toledo, a precocious 5-year-old boy, hobbled into a private health clinic to have his infected foot examined. Pediatrician Gayle Harrison told his mother to continue to apply antibiotic ointment and reminded them to come back if the swelling and redness worsened. The appointment at Rehoboth McKinley Christian Health Care Services’ outpatient center comes at no charge for the Toledo family, who live 30 miles away on the Navajo Nation Reservation. That’s because Tyson is covered by Medicaid, the state-federal health insurance program for the poor. (Galewitz, 4/2)
California Healthline:
California Takes On Health Giant Over High Costs
Taken together, Sutter’s actions “improperly block any and all practical efforts to foster or encourage price competition between Sutter and any rival Healthcare Providers or Hospital Systems,” according to the state’s complaint. “Sutter’s conduct injured the general economy of Northern California and thus of the state.” (Terhune and Ibarra, 4/1)
California Healthline:
Staying Alive: How To Fight An Opioid Addiction
Rule No. 1: Stay alive. If you or a loved one wants to beat an opioid addiction, first make sure you have a handy supply of naloxone, a medication that can reverse an overdose and save your life. “Friends and families need to keep naloxone with them,” says Dr. David Kan, an addiction medicine specialist in Walnut Creek who is president of the California Society of Addiction Medicine. “People using opioids should keep it with them, too.” (Bazar, 3/30)
Politico:
Did Shulkin Get Fired Or Resign? This Is Why It Matters.
The White House is now asserting that recently departed Veterans Affairs Secretary David Shulkin resigned. Shulkin has made it clear in his public comments that he was forced out. While Washington often wraps firings in the verbal cloak of a resignation, the distinction this time could have far-reaching implications that could throw the Department of Veterans Affairs, the second-largest federal agency, into further disarray. (Restuccia, 3/31)
The Associated Press:
White House Goes On Attack Over Shulkin's Claim He Was Fired
The White House is hitting back at former Veterans Affairs Secretary David Shulkin for claiming that he was fired from his job and that he was only informed about it shortly before President Donald Trump tweeted about his replacement. The Trump administration says he left his job willingly amid a bruising ethics scandal and mounting rebellion within the agency. The semantics of whether Shulkin resigned or was fired could be relevant to Trump's ability to name an acting VA secretary to temporarily fill his place. (Yen, 4/2)
The Associated Press:
Ousted Shulkin Rejects White House Claim He Resigned VA Job
But in television interviews, Shulkin said he had not submitted a resignation letter, or planned to, and was only told of Trump's decision shortly before the Twitter announcement. He said he had spoken to Trump by phone earlier that day about VA improvements, with no mention of his job status, and was scheduled to meet with the president the next morning. "I came to run the Department of Veterans Affairs because I'm committed to veterans," Shulkin said. "And I would not resign because I'm committed to making sure this job was seen through to the very end." (Yen, 4/2)
Politico:
Shulkin Denies He Resigned As VA Chief
“We actually spoke the day that he sent the tweet out just a few hours before," Shulkin said of Trump. "And we talked a lot about issues at VA that were important and how we could continue to make progress on policy issues." Shulkin’s ouster came after months of internal turmoil at VA. He was dinged by an inspector general report for misuse of government travel. In the days since his departure, Shulkin, the lone Obama holdover in Trump’s Cabinet, has argued he was forced out because he had resisted efforts to privatize VA services. (O'Brien, 4/1)
Bloomberg:
Ousted Veterans Affairs Head Warns Of Privatization Push
Trump announced Shulkin’s ouster Thursday in a Twitter message, in which he said he was nominating White House physician Ronny L. Jackson to head the department, which is second in size only to the Defense Department. Shulkin has warned that service members and their families could see a decrease in care if the agency goes ahead with plans to broaden its use of the private sector. (Decker and Edgerton, 4/1)
Politico:
Sanders: 'We Know Nothing' About Trump's VA Pick
Sen. Bernie Sanders wouldn't commit to supporting President Donald Trump's pick to lead the Department of Veterans Affairs, Rear Adm. Ronny Jackson, on Sunday. In an interview on CBS’ "Face the Nation," the Vermont independent noted that Jackson, Trump's personal physician, is a virtual unknown on veterans issues. He also expressed concerns the Trump administration is pushing to privatize the nearly $200 billion bureaucracy, citing the conservative agenda of the influential donors Charles and David Koch. (O'Brien, 4/1)
The Hill:
Trump VA Pick Hesitated To Take Job: Report
White House physician Ronny Jackson initially hesitated at the suggestion that he be nominated to lead the Department of Veterans Affairs, The Washington Post reported Thursday. Jackson was reportedly shocked when Trump tapped him for the top job at the nation's second largest government agency, the Post reported, citing senior White House officials. (Greenwood, 3/30)
The New York Times:
Massachusetts, A Health Pioneer, Turns Its Focus To Drug Prices. It’s In For A Fight.
Massachusetts, which led the nation in expanding health insurance coverage, now wants to rein in the growth of prescription drug spending for low-income people on Medicaid, but its proposals have met an icy reaction from patients and drug companies. The state has asked the Trump administration for permission to limit the number of drugs that will be covered in its Medicaid program, seeking to exclude “drugs with limited or inadequate evidence of clinical efficacy.” (Pear, 3/31)
The New York Times:
After Gun Control Marches, ‘It’ll Go Away’ Vs. ‘We Are Not Cynical Yet’
For more than a month now, the questions have ricocheted down this Main Street culled from a Norman Rockwell dreamscape — past the dueling barbershops and the outdoor broom sale and the mural with the horse — quietly at first, when the Florida massacre was still fresh, and then not so quietly. Why would this time be different? Why should it be? (Flegenheimer and Bidgood, 4/1)
The Wall Street Journal:
Hospitals Fear Competitive Threat From Potential Walmart-Humana Deal
Early-stage deal talks between Walmart Inc. and Humana Inc. are deepening anxiety in the hospital sector, which already has been grappling with sluggish growth and competition from cheaper health-care options. Hospitals have been eyeing Walmart nervously for years as it advances into health care, seeking to leverage its enormous purchasing heft, physical reach and focus on price. The Bentonville, Ark., retailer already operates pharmacies and primary-care clinics and plans to begin offering lab-testing services. It has also recently increased its direct negotiations with hospitals for competitive prices on some procedures for its employees. (Evans, 4/1)
The Wall Street Journal:
Walmart-Humana Talks Put New Pressure On Remaining Players In Health Care
The emergence of talks between Walmart Inc. and Humana Inc. creates pressure on the health-care companies that haven’t yet made deals, amid the rapid-fire integration that is reshaping the business of managing health care. A Walmart-Humana deal—which is far from assured, as the companies are in early-stage talks about a variety of possible options—would become the latest sign of the sector’s rapid move toward combinations that unite different businesses under one roof. (Wilde Mathews and Terlep, 3/30)
The Wall Street Journal:
Walmart Courts New Risk In Its Hunt For Humana
Walmart Inc.’s potential acquisition of a health insurer would push it far beyond its big-box roots, enabling it to diversify away from the competitive pressures of retailing yet also thrusting it into a complicated and rapidly evolving health-care sector. Walmart is holding preliminary discussions to buy U.S. health insurer Humana Inc. and the companies are discussing various options, The Wall Street Journal reported Thursday. There is no guarantee the companies will agree on a merger or pursue some other partnership. (Nassauer and Wilde Mathews, 3/30)
The Washington Post:
California Ordered To Add Cancer Warning To Coffee, But The Science Doesn’t Hold Up
Storm clouds are brewing in California’s coffee cups. Companies across the state will have to add a cancer-warning label to coffee, a judge ruled this week, because the drink contains a chemical called acrylamide. Los Angeles County Superior Court Judge Elihu M. Berle sided with a nonprofit organization in a case against Starbucks, Peets and dozens of other coffee chains, saying that businesses that sold coffee were in violation of a state regulation called Proposition 65. Prop 65 requires businesses with at least 10 employees to disclose any carcinogens and toxic chemicals in their products. (Guarino and Rosenberg, 3/30)
Los Angeles Times:
Go Ahead And Drink Your Coffee, Public Health Experts Say
The decision has put public health experts at odds with a state law aimed at safeguarding the health of Californians. "I can understand the logic of the judge, by going by the book. But I can also understand the science," said Mariana Carla Stern, a USC professor who studies diet and cancer. "From the science standpoint, there's no reason the public should worry about drinking coffee." (Karlamangla and Kim, 3/30)
The Washington Post:
Popular Drug Seroquel, First Meant For Schizophrenia, Reveals 'Off-Label' Issues
The first warning came a dozen years ago, when the Food and Drug Administration accused the drug company AstraZeneca of “false or misleading” information about health risks in the marketing material for its blockbuster medication Seroquel, an antipsychotic developed to treat schizophrenia but increasingly prescribed “off label” for insomnia. What followed was an onslaught of litigation by state attorneys general, who charged AstraZeneca with fraudulently promoting Seroquel for unapproved uses, and by individual patients, who claimed that it had failed to alert consumers about some of the drug’s most pernicious side effects. Although the company never admitted wrongdoing, by the end of 2011 it had paid out more than $1 billion to settle many of the cases. (Nutt and Keating, 3/30)
The New York Times:
Is This Tissue A New Organ? Maybe. A Conduit For Cancer? It Seems Likely.
Researchers have made new discoveries about the in-between spaces in the human body, and some say it’s time to rewrite the anatomy books. A study published in Scientific Reports this week described a fluid-filled, 3-D latticework of collagen and elastin connective tissue that can be found all over the body, in or near our lungs, skin, digestive tracts and arteries. (Fortin, 3/31)
NPR:
IV 'Normal Saline': A Medical Habit
During a recent walk around the emergency room where I work, I noted the number of patients with bags of intravenous fluids hanging above them. Almost everyone had one. Our ER in Boston isn't unique. IV fluids are among the most common medical interventions worldwide. Several kinds are available, but one called normal saline is by far the most popular. Over 200 million liters are used every year in the United States. (Dalton, 3/31)
The Wall Street Journal:
Prostate-Cancer Gene Test Helps Patients Decide On Treatment
In 37 years as a police officer, Edwin Michel coped with a plane crash, a sniper, wildfires and three bullet wounds. Nothing much rattled him until he was diagnosed with prostate cancer in November 2016. His doctor said the cancer wouldn’t kill him but Mr. Michel, now 76 years old, wasn’t entirely reassured. He felt more confident after a genomics test later revealed his prostate cancer was very low risk. The test, known as Oncotype DX, takes a sample from a prostate biopsy and analyzes 17 genes in it to estimate how aggressive a cancer may be. (Lagnado, 3/31)
The Washington Post:
Teen Depression Is A Big Problem And It's Hard To Find Treatment
Mental-health treatment in America has plenty of room for improvement. Depression, in particular, is underdiagnosed and undertreated. The American Academy of Pediatrics took a big step in February to address one deficit — early identification of depression in adolescents. The group called for every child to be screened for depression every year, starting at age 12. (Adams, 3/31)
The New York Times:
Devices To Quit Smoking Become The Devices Teenagers Can’t Quit
The student had been caught vaping in school three times before he sat in the vice principal’s office at Cape Elizabeth High School in Maine this winter and shamefacedly admitted what by then was obvious.“I can’t stop,” he told the vice principal, Nate Carpenter. So Mr. Carpenter asked the school nurse about getting the teenager nicotine gum or a patch, to help him get through the school day without violating the rules prohibiting vaping. (Zernike, 3/2)
The Washington Post:
Mysterious 'Smoker's Cough' Took Little Girl's Doctors 12 Years To Figure Out
Why does she keep coughing, Eva Shea wondered about her daughter Mimi, as she had countless times. And why did the preschooler sound as though she had a two-pack-a-day cigarette habit? Over the years, Shea had asked about the wet cough during frequent visits to the pediatrician and specialists across Northern Virginia. Although doctors sometimes seemed concerned, many were reassuring. Kids get frequent respiratory infections, it doesn’t bother her, nothing showed up on tests, they variously told Shea. (Boodman, 3/31)
The Associated Press:
Cooking Classes Aim To Restore Health After Addiction
At Boston Medical Center, patients recovering from addiction are getting healthier one slab, stick and cube at a time. For years, the hospital has offered cooking classes tailored to specific medical conditions such as heart disease and diabetes, and it runs a food pantry for low-income patients who are prescribed fresh food as part of their treatments. The newest class is "Cooking for Recovery" and is part of a growing trend toward taking a more comprehensive approach to treating addiction. (Ramer, 4/1)
The Washington Post:
Maryland Lawmakers Advance Bill That Requires Schools To Teach Sexual Consent
Sex education classes in Maryland would have to include instruction on consent under a bill that is moving through the General Assembly, a measure an advocate called “one of the most important things that we can do to prevent college sexual assaults.” Under the measure, middle and high school students would learn what consent means and about how to respect personal boundaries. (Wiggins and Chason, 3/30)
The Associated Press:
Ohio Treatment Center Owner Target Of Medicaid Fraud Probe
A man viewed as a local superhero with a matching car collection and a penchant for completing daring feats for charity is under investigation for his alleged involvement in a multi-million dollar Medicaid fraud scheme at his two Ohio substance abuse treatment centers. A forfeiture complaint filed last week by the U.S. Attorney's Office in Cleveland seeks to keep around $3.5 million in assets from 38-year-old Ryan Sheridan, whose Braking Point Recovery Services operated centers in suburban Youngstown and suburban Columbus. (3/31)