Morning Briefing
Summaries of health policy coverage from major news organizations
First Edition: February 12, 2019
Kaiser Health News: Vaccine Storage Too Often Fails To Meet Standards
By correcting one potential error, the Ventura County (Calif.) Health Care Agency accidentally made another — and jeopardized vaccines given to thousands of people in the process. In October 2017, county health officials, concerned that vaccines were getting too warm while being transported to clinics, changed their protocol. But a routine audit in November found that the ice packs they were using may have frozen some of the medicines and lowered their effectiveness. The agency then offered to reimmunize everyone who had received a vaccine that was delivered in faulty packaging. (Heredia Rodriguez, 2/12)
Kaiser Health News: Americans Cross Border Into Mexico To Buy Insulin At A Fraction Of U.S. Cost
When Michelle Fenner signed up to run this year’s Los Angeles Marathon, it got her thinking: Tijuana, Mexico, is only a 2½-hour drive from L.A. Why not take a trip across the border and buy some insulin for her son? “It’s so easy to just go across the border,” mused Fenner. This idea had been in the back of Fenner’s mind for a while. Her son was diagnosed with Type 1 diabetes nine years ago, meaning he needs daily injections of insulin to live. (Sable-Smith, 2/12)
The New York Times: F.D.A. Warns Supplement Makers To Stop Touting Cures For Diseases Like Alzheimer’s
The Food and Drug Administration on Monday warned 12 sellers of dietary supplements to stop claiming their products can cure Alzheimer’s disease. At the same time, Dr. Scott Gottlieb, the agency’s commissioner, suggested that Congress strengthen the F.D.A.’s authority over an estimated $40 billion industry, which sells as many as 80,000 kinds of powders and pills with little federal scrutiny. (Kaplan, 2/11)
The Washington Post: FDA Launches Tougher Oversight Of Supplements
FDA Commissioner Scott Gottlieb said the agency is planning policy changes that could lead to the most important regulatory modernization since enactment of the 1994 Dietary Supplement Health and Education Act, which set up the regulatory regime. Under the law, dietary supplements are regulated as food and, therefore, are not subject to premarket approval or the kind of safety and effectiveness testing required for drugs. Since the law was enacted, the industry has grown from 4,000 products and $4 billion a year in sales to as many as 80,000 products and $50 billion in sales, according to the FDA. (McGinley, 2/11)
The Wall Street Journal: FDA Challenges Supplement Makers’ Marketing Claims
“Legitimate industry benefits from a framework that inspires the confidence of consumers and providers,” Mr. Gottlieb said. “Patients benefit from products that meet high standards for quality.” Dietary supplements are a booming industry, with some 80,000 kinds of supplements sold in 2016, according to a recent government report. U.S. supplement sales reached nearly $133 billion in 2016, according to the most recent data from Zion Market Research. (Hopkins, 2/11)
The Associated Press: What The FDA's Actions Mean For Dietary Supplements
The agency warned 17 companies for illegally making claims about their products' ability to treat diseases. Here's a look at what the FDA's announcement means. (Choi, 2/11)
Modern Healthcare: Other States Likely To Follow Utah's Partial Medicaid Expansion
The Utah Legislature on Monday passed a bill to replace the voter-approved Medicaid expansion with a skinny expansion, a move that may encourage other states to seek similar scaled-back expansions with full federal funding. The Republican-controlled Utah Senate approved legislation passed by the state House of Representatives Friday that replaces the voter-passed expansion to adults with incomes up to 138% of the federal poverty level with an expansion only to 100% of the poverty level. It passed on a near party-line vote, with one Republican joining all Democrats in opposition. (Meyer, 2/11)
The Associated Press: Utah Reduces Voter-Backed Medicaid Expansion In Rare Move
It's drawn vocal protest from advocates who say the changes go further than any of the four other conservative-leaning states where voters expanded Medicaid after state lawmakers refused. "This is a dark day for democracy in Utah," said Andrew Roberts, a spokesman for the group Utah Decides. "State legislators turned their backs on voters and on families in need." (Whitehurst, 2/11)
Politico: Utah GOP Shrinks Medicaid Expansion, Defying Voters
The Utah law marks the second time Republican leaders have blocked ballot measures approving Medicaid expansion in states that had long refused the program. For more than a year, former Maine Gov. Paul LePage fought a 2017 ballot measure ordering the state to expand coverage to 70,000 low-income adults, and the program only took effect after his Democratic successor Janet Mills took office last month. The Utah legislation, spearheaded by Republican leaders critical of the Obamacare expansion, will extend Medicaid for low-income adults with incomes below the federal poverty line, short of Obamacare’s eligibility threshold. (Pradhan, 2/11)
The Washington Post: Utah Defies Will Of The Voters By Passing Bill To Limit Medicaid Expansion
What has been playing out within Utah’s granite state Capitol has ripple effects that stretch beyond the sparsely populated Western state. The actions of Utah’s lawmakers are testing the legitimacy of the citizen initiative, a staple of small-d democracy in about half the states. Idaho lawmakers also are considering restrictions to a Medicaid expansion approved by voters there. Maine residents approved a similar ballot initiative in 2017 but had to wait for the arrival of a Democratic governor for the expansion to begin finally this month. (Goldstein, 2/11)
The Wall Street Journal: Medicare For All Bill Puts Pressure On Democrats’ 2020 Field
House Democrats are planning to unveil Medicare for All legislation soon, turning up the heat on Democratic presidential candidates facing questions over how far they want to go in embracing a national government health system. The bill from Rep. Pramila Jayapal and other House Democrats is expected to closely mirror a Senate Medicare for All bill from Sen. Bernie Sanders (I., Vt.), which would expand government-run health insurance to all and do away with the current system of employer-provided coverage. At the same time, more than 100 organizing events will take place this week nationwide to help build grass-roots support for Medicare for All. (Armour, 2/11)
The Washington Post: Sen. Amy Klobuchar’s 2020 Policy Agenda: Lower Drug Costs, Prepare For ‘Digital Disruption,’ Expand Savings Accounts
Sen. Amy Klobuchar (D-Minn.) is running for president on a policy agenda of lowering prescription drug costs, expanded savings accounts to help people save for their educations, and a slew of Internet-related policies, including expanding rural broadband and tougher privacy laws, according to aides to the senator. Klobuchar, who has withheld her support from the more liberal proposals made by Democratic lawmakers, will also push for automatically registering all eligible voters, an overhaul of election security, and committing the United States to the Paris agreement to combat climate change, aides said. (Stein, 2/11)
Stat: Cory Booker Looks To Shake His Reputation For Drug Industry Coziness
For the past two years, [Cory] Booker has been repeatedly reminded of that kind of anger over high drug prices — and hounded by criticism that he has an overly cozy relationship with the pharma industry. Last week, the hosts of “Pod Save America,” a progressive political podcast, said he had taken “a bad vote on pharmaceuticals.” A viral Facebook video viewed nearly a quarter-million times questions whether Booker is a “Big Pharma” candidate. And on the left-leaning “Breakfast Club” radio show last week, Booker was pointedly asked whether he could be trusted to hold large pharmaceutical companies accountable. That reputation, deserved or not, could become a major political liability for Booker, particularly at a time of concern over drug prices and in a race with other progressive lawmakers like Sens. Elizabeth Warren and Bernie Sanders whose disdain for large drug companies is palpable. (Facher, 2/12)
Los Angeles Times: Why Opioids Hit White Areas Harder: Doctors There Prescribe More Readily, Study Finds
Across California, a blessing has become a curse for patients who dwell in overwhelmingly white communities: their ready access to opioid pain relievers. A new study of prescribing practices across all of California’s 1,760 ZIP codes helps explain why opiates, some of medicine’s most addictive drugs, have wreaked more havoc on white communities than on communities of color. The answer, at least in part, appears to lie in unconscious physician biases about race, ethnicity and pain that more typically leave minority patients underserved and undermedicated, authors of the new study said. (Healy, 2/11)
NPR: Naloxone And Needles: Group Hands Out Drug-Use Supplies To Prevent Opioid Deaths
On a bitter cold afternoon in front of the central bus stop in Bangor, Maine, about a half-dozen people recently surrounded a folding table covered with handmade signs offering free clean syringes, coffee and naloxone, the drug also known as Narcan that can reverse an opioid overdose. They're with a group called the Church of Safe Injection that is handing out clean drug-using supplies in cities around the U.S. (Becker, 2/12)
The Associated Press: Doctor, Hospital Face 15th Lawsuit Over Drug Doses, Deaths
A 15th wrongful-death lawsuit has been filed against an Ohio hospital system and a now-fired intensive care doctor who's under investigation for ordering possibly fatal pain medication doses for dozens of patients. Many of the lawsuits allege patients in the Columbus-based Mount Carmel Health System received lethal doses of the powerful painkiller fentanyl ordered by Dr. William Husel without families knowing. (2/11)
The Wall Street Journal: New Rules Could Ease Patients’ Access To Their Own Health Records
The Trump administration is proposing steps aimed at improving patients’ access to their own health data, bolstering efforts to bring information including insurance claims, hospital and doctor records to digital devices such as smartphones. Federal health regulators unveiled two major proposed regulations closely watched by health and technology companies, amid a growing flood of health data that has become an ever-more-valuable asset. (Wilde Mathews, 2/11)
The New York Times: A.I. Shows Promise As A Physician Assistant
This year, one in every twenty Americans will walk into a medical clinic and receive the wrong diagnosis. That’s more than 10 million people, and for half of them, the misdiagnosis could be harmful, a 2014 study in the British Medical Journal concluded. Doctors try to be systematic when identifying illness and disease, but they’re only human. Bias creeps in. Alternatives are overlooked. (Metz, 2/11)
Reuters: U.S. Citizen Who Leaked Singapore HIV-Cases May Have More 'Files'
A U.S. citizen who leaked the names of more than 14,000 HIV-positive individuals in Singapore may be in possession of more "files" from the database, the city-state's health minister said on Tuesday. The news follows outrage last month after Singapore disclosed the leak by Mikhy Farrera Brochez, who was deported last year after being convicted on numerous drug-related and fraud offences, including lying about his own HIV status. (2/12)
The Associated Press: Separated Migrant Families Demand Millions From US Agencies
Eight immigrant families who were separated under Trump administration policy filed claims Monday seeking millions of dollars in damages for what a lawyer called "inexplicable cruelty" that did lasting damage to parents and children. The parents accused immigration officers of taking their children away without giving them information and sometimes mocking them or denying them a chance to say goodbye. (Merchant, 2/11)
Stat: In Small Brain Cancer Study, Immunotherapy Results In Extended Survival
Giving patients with lethal brain tumors a powerful new form of cancer treatment before they underwent surgery helped them live longer on average than patients who started the drugs after surgery, researchers reported in a study published Monday. While the study was small, and while most patients still died by the end of the study period, researchers said the results suggested timing could be an important factor when trying to treat glioblastoma, or GBM, with immunotherapies, which are designed to unleash the immune system on cancer cells. (Joseph, 2/11)
NPR: Gov. Northam's Blackface Scandal Points To Medicine's Racism Problem
Virginia Gov. Ralph Northam is embroiled in controversy for admitting that he wore blackface at a party in the 1980s and for a racist photo on his medical school yearbook page. But the governor, a pediatric neurologist by training, told CBS he isn't resigning, because "Virginia needs someone that can heal. There's no better person to do that than a doctor." NPR spoke with another doctor, Damon Tweedy, about what message it sends to black patients to hear a prominent doctor tell the country that he has worn blackface. Tweedy is the author of Black Man in a White Coat: A Doctor's Reflections on Race and Medicine and is an associate professor of psychiatry at Duke University. (Kelly and Gordon, 2/11)
Stat: Experts Raise Questions About Facebook's Suicide Prevention Tools
Over the past few years, Facebook has stepped up its efforts to prevent suicide, but its attempt to help people in need has opened the tech giant to a series of issues concerning medical ethics, informed consent, and privacy. It has also raised a critical question: Is the system working?Facebook trained an algorithm to recognize posts that might signal suicide risk and gave users a way to flag posts. A Facebook team reviews those posts and contacts local authorities if a user seems at imminent risk. First responders have been sent out on “wellness checks” more than 3,500 times. (Thielking, 2/11)
The Associated Press: Youth Smoking Decline Stalls, And Vaping May Be To Blame
There may be several reasons, but a recent boom in vaping is the most likely explanation, said Brian King of the Centers for Disease Control and Prevention. "We were making progress, and now you have the introduction of a product that is heavily popular among youth that has completely erased that progress," King said. (Stobbe, 2/11)
The Wall Street Journal: Your Company Wants To Know If You’ve Lost Weight
Across the U.S., more employers are handing out activity trackers and rolling out high-tech wellness programs that aim to keep closer tabs on workers’ exercise, sleep and nutrition, and ultimately cut ballooning health-care costs. Disney, Whole Foods and dozens of other companies have introduced programs to reward employees for meeting certain criteria on health indicators such as weight-to-height ratio and blood pressure. (Chen, 2/11)
CNN: Eating 'Ultraprocessed' Foods Accelerates Your Risk Of Early Death, Study Says
The quick and easy noshes you love are chipping away at your mortality one nibble at a time, according to new research from France: We face a 14% higher risk of early death with each 10% increase in the amount of ultraprocessed foods we eat. "Ultraprocessed foods are manufactured industrially from multiple ingredients that usually include additives used for technological and/or cosmetic purposes," wrote the authors of the study, published Monday in the journal JAMA Internal Medicine. "Ultraprocessed foods are mostly consumed in the form of snacks, desserts, or ready-to-eat or -heat meals," and their consumption "has largely increased during the past several decades." (Scutti, 2/11)
NPR: The 'Strange Science' Behind The Big Business Of Exercise Recovery
From sports drinks to protein powders, from compression therapy to cupping — there's a whole industry of products and services designed to help us adapt to and recover from exercise. But does any of it work? That's the question science writer Christie Aschwanden set out to answer in her new book, Good to Go: What the Athlete in All of Us Can Learn from the Strange Science of Recovery. A former high school and college athlete, Aschwanden is the lead science writer for the website fivethirtyeight and was previously a health columnist for The Washington Post. (Gross, 2/11)
The New York Times: Why Do South Asians Have Such High Rates Of Heart Disease?
Mahendra Agrawal never imagined he would have a heart attack. He followed a vegetarian diet, exercised regularly and maintained a healthy weight. His blood pressure and cholesterol levels were normal. But when Mr. Agrawal experienced shortness of breath in June 2013, his wife urged him to go to a hospital. There, tests revealed that Mr. Agrawal, who was 63 at the time, had two obstructed coronary arteries choking off blood flow to his heart, requiring multiple stents to open them. (O'Connor, 2/12)
The New York Times: The Best Exercises To Prevent Falls
A large review of studies confirms that exercise can be a good way to help reduce the frequency of falls in the elderly. The analysis, in the Cochrane Database of Systematic Reviews, included 108 randomized controlled trials with more than 23,000 participants. Their average age was 76, and 77 percent were women. As controls, the trials used either educational information about fall prevention, or no intervention at all. (Bakalar, 2/12)
The Washington Post: Mother’s Friendships May Be Good For Babies’ Brains
New mothers who have friends ready to step in and help them, tend to have toddlers who score better on cognitive tests than the babies of women with smaller social support networks, a U.S. study suggests. Strong social ties to friends and family have long been linked to better behavioral and physical health outcomes for adults. And plenty of previous research also indicates that infants’ and toddlers’ bonds with caregivers can have a lasting impact on children’s emotional, intellectual and social development. (Rapaport, 2/12)
The Wall Street Journal: As A Doctor She Treated Children, Now Health Commissioner Cares For An Entire City
Oxiris Barbot is waiting patiently to hold the baby. A pediatrician, Dr. Barbot is visiting an East New York apartment on a recent morning to observe a staff member as she counsels a postpartum mother on breast-feeding, safe sleeping practices and general pediatric care. This home-visit program is one of hundreds offered by the New York City Department of Health and Mental Hygiene, which Dr. Barbot now leads as its commissioner. Hers is one of the highest-profile jobs in the public health field. (West, 2/11)
The Associated Press: Ohio Abortion 'Heartbeat Bill' Returns To Legislature
Republican lawmakers in Ohio proposed again on Monday one of the most restrictive abortion measures in the nation, and this time around, they have the governor's support. New Republican Gov. Mike DeWine has indicated he would sign the so-called heartbeat bill that was twice vetoed by his GOP predecessor. The measure would ban abortion once a fetal heartbeat is detected. That can be as early as six weeks into pregnancy, before many women know they're pregnant. (Franko, 2/11)
The Wall Street Journal: A Year After Parkland: Making Sure To Say, ‘I Love You’ At Morning Drop-Off
The horror of the shooting here nearly a year ago that left 17 people dead crosses Ina Berlingeri-Vincenty’s mind every morning when she drops her son Nico off at Marjory Stoneman Douglas High School. Before he gets out of the car, she says, “I make sure I say, ‘I love you.’” (Campo-Flores, 2/12)
Tampa Bay Times: All Children’s Says 13 Heart Surgery Patients Were Hurt By Care
An internal review by Johns Hopkins All Children’s Hospital has found more than a dozen incidents in which children in the hospital’s heart unit were harmed by the care they received. The cases should have been immediately reported to state officials, the hospital’s interim president told employees during private town halls this week. None were reported until recently. The hospital’s former leaders also didn’t properly notify the board of trustees about safety concerns in the heart surgery department. That led to the federal government’s recent declaration that All Children’s had left patients in danger, the interim president said. (McGrory and Bedi, 2/9)
Los Angeles Times: More Than 70 Detainees Condemn Conditions At San Diego Immigration Facility
More than 70 people being held at the Otay Mesa Detention Center while they wait for immigration court hearings have signed a letter decrying conditions at the facility. The letter, written in December, alleges that detainees have experienced medical neglect, safety issues, and racism and discrimination, according to Freedom for Immigrants, the group to whom the letter was addressed. The detainees also said their complaints were not being heard at the facility. (Morrissey, 2/11)
The Associated Press: California Judge Will Keep Planned Parenthood Names Sealed
A California judge ruled Monday that the names of 14 Planned Parenthood workers and others will remain sealed during the prosecution of two anti-abortion activists charged with secretly recording them. San Francisco Superior Court Judge Christopher Hite made the ruling despite the publication of the names on an anti-abortion website over the weekend. Hite said he would punish anyone discovered to have provided the names, which have been ordered to be kept confidential since charges were filed in 2017 against David Daleiden and Sandra Merritt of the Center for Medical Progress. (Elias, 2/11)
