First Edition: June 10, 2016

Kaiser Health News: For Doctors-In-Training, A Dose Of Health Policy Can Help The Medicine Go Down
Doctors-in-training learn a lot about the workings of the human body during medical school and residency. But many are taught next to nothing about the workings of the health care system. One university in Washington, D.C., is trying to change that. The three-week fellowship in health policy for medical residents is run jointly by the George Washington University schools of medicine and public health. In addition to hearing lectures from policy experts in and around the nation’s capital, the residents take field trips to Capitol Hill, the Supreme Court, other federal and local health-related agencies, as well as local health care facilities. (Rovner, 6/10)

Kaiser Health News: Medicare’s Efforts To Curb Backlog Of Appeals Not Sufficient, GAO Reports
Despite interventions by Medicare officials, the number of appeals from health care providers and patients challenging denied claims continues to spiral, increasing the backlog of cases and delaying many decisions well beyond the timeframes set by law, according to a government study released Thursday. The report from the Government Accountability Office, said the backlog "shows no signs of abating." It called for the Department of Health and Human Services to improve its oversight of the process and to streamline appeals so that prior decisions are taken into account and repetitive claims are handled more efficiently. (Jaffe, 6/10)

Kaiser Health News: Customers’ Pot Smoking May Not Be A Deal Breaker For Life Insurers
If you smoke marijuana and you’re shopping for life insurance, chances are you can find a company that won’t penalize you for your habit, but you may have to weed out several insurers to find the best policy. Eighty percent of the 148 underwriters who were surveyed by reinsurer Munich Re at the Association of Home Office Underwriters annual conference last year said their company factors marijuana use into its decisions on how to price policies and whether to offer coverage. Yet, of those, 29 percent classify marijuana users as nonsmokers, potentially allowing them to qualify for the best nonsmoker rates. (Andrews, 6/10)

The New York Times: Why Do Health Costs Keep Rising? These People Know
The Geisinger Health Plan, run by one of the nation’s top-rated health care organizations, foresees medical costs increasing next year by 7.5 percent for people buying insurance under the Affordable Care Act. So when Geisinger requested a rate increase of 40 percent for 2017, consumer advocates were amazed. And Kurt J. Wrobel, Geisinger’s chief actuary, found himself, along with other members of his profession, in the middle of the health care wars still raging in this political year. Actuaries normally toil far from the limelight, anonymous technicians stereotyped as dull and boring. But as they crunch the numbers for their Affordable Care Act business, their calculations are feeding a roaring national debate over insurance premiums, widely used to gauge the success of President Obama’s health care law. (Pear, 6/9)

Politico: Alaska Scrambles To Prevent Obamacare Collapse
Alaska, one of the reddest states in the country, is essentially bailing out its insurance market to prevent Obamacare from collapsing. A bill passed by the heavily GOP state Legislature to shore up its lone surviving Obamacare insurer is awaiting the signature of Gov. Bill Walker, a Republican-turned-independent who was endorsed two years ago by former vice presidential candidate Sarah Palin. The legislation, originally proposed by Walker, sets up a $55 million fund — financed through an existing tax on all insurance companies — to subsidize enrollees’ costs as the state struggles with Obamacare price spikes and an exodus by all but one insurance company. (Pradhan, 6/10)

The Wall Street Journal: U.S. Files Antitrust Case Against North Carolina’s Largest Health System
North Carolina’s largest health system faces allegations that it quashed competition with demands that insurers not steer consumers to rivals, in the latest sign of antitrust scrutiny across the consolidating health-care sector. The U.S. Justice Department and North Carolina Attorney General Roy Cooper filed a civil antitrust case against Carolinas HealthCare System on Thursday, alleging the system used the market power of its 10 hospitals in and around Charlotte, N.C., to win concessions from commercial insurers that stifled competition on hospital price and quality. (Evans, 6/9)

The New York Times: Delay Pregnancy In Areas With Zika, W.H.O. Suggests
People living in areas where the Zika virus is circulating should consider delaying pregnancy to avoid having babies with birth defects, the World Health Organization has concluded. The advice affects millions of couples in 46 countries across Latin America and the Caribbean where Zika transmission is occurring or expected. ... At the moment, Puerto Rico, the United States Virgin Islands and American Samoa are the only parts of the United States with local transmission of the virus. But clusters of cases are expected to appear in Florida and along the Gulf Coast this summer. (McNeil, 6/9)

The Associated Press: Investigator: FDA Still Taking Months To Recall Tainted Food
Federal health officials failed to force a recall of peanut butter and almond products for three months after advanced DNA testing confirmed salmonella contamination, government investigators reported Thursday. Despite new legal powers to compel recalls and sophisticated technology to fingerprint pathogens, the Food and Drug Administration allowed some food-safety investigations to drag on, placing consumers in jeopardy of death or serious illness, according to the inspector general's office at the Department of Health and Human Services. (6/9)

The Washington Post: Investigators: Consumers Are ‘At Risk Of Illness Or Death’ Because Of Slow FDA Food Recalls
The Food and Drug Administration did not force a recall of tainted peanut butter that caused salmonella poisoning in 14 people until 165 days after confirming the contamination, the agency’s watchdog said in report released Thursday. And in a similarly alarming case, it took the government 81 days to recall a variety of cheese products made by a Virginia firm — after eight people had fallen ill from a bacteria in the food and a baby died. This lax approach to food safety put consumers “at risk of illness or death” after testing showed the food was potentially hazardous, investigators for Inspector General Daniel R. Levinson at the Department of Health and Human Services, the FDA’s parent agency, wrote in a rare urgent warning. The “early alert” called the issue a “significant matter” that “requires FDA’s immediate attention.” (Rein, 6/9)

The New York Times: Research Traces Link Between Combat Blasts And PTSD
They are among war’s invisible wounds: the emotional and cognitive problems that many troops experience years after combat explosions sent huge shock waves through their brains. Whereas the link between concussions and post-traumatic stress disorder has become clearer in recent years, a specific connection between PTSD and blast waves has remained elusive. Now, a prominent neuropathologist who researches brain injuries among military personnel says his team has identified evidence of tissue damage caused by blasts alone, not by concussions or other injuries. The team’s study was published on Thursday in The Lancet Neurology. (Schwarz, 6/9)

The New York Times: What If PTSD Is More Physical Than Psychological?
In early 2012, a neuropathologist named Daniel Perl was examining a slide of human brain tissue when he saw something odd and unfamiliar in the wormlike squiggles and folds. It looked like brown dust; a distinctive pattern of tiny scars. Perl was intrigued. At 69, he had examined 20,000 brains over a four-decade career, focusing mostly on Alzheimer’s and other degenerative disorders. He had peered through his microscope at countless malformed proteins and twisted axons. He knew as much about the biology of brain disease as just about anyone on earth. But he had never seen anything like this. The brain under Perl’s microscope belonged to an American soldier who had been five feet away when a suicide bomber detonated his belt of explosives in 2009. (Worth, 6/10)

The Washington Post: Fentanyl And Heroin Deaths Continue Steep Rise In Maryland
Overdose deaths from the powerful synthetic opioid that killed rock legend Prince in April increased 83 percent in Maryland last year, according to the state’s Department of Health and Mental Hygiene. The latest data on Maryland overdose deaths, which the department released Thursday, showed 340 fentanyl-related fatalities in 2015, compared with 186 the previous year. The rise continues an alarming trend that began in 2013. Since that year, the number of fentanyl-related deaths has increased ­12-fold. (Hicks, 6/9)

The Wall Street Journal: Ohio County Seeks Federal Help To Deal With Fentanyl Crisis
Officials in Cuyahoga County in northern Ohio, where nearly 200 people have died of heroin and fentanyl overdoses so far this year, are asking the federal government to help them combat an accelerating drug epidemic that reached new heights last month. A total of 45 people died of heroin and fentanyl overdoses in and around Cleveland in May, with 15 such deaths occurring over the final week of the month. The county is asking for additional funds and increased access to naloxone, which can reverse an overdose, as well as changes to Medicaid reimbursement rules so hospitals can treat more people with drug addictions. (Maher and Kamp, 6/9)

The Associated Press: Cuomo: Expand Help For Heroin Addiction, Limit Prescriptions
A new 25-point strategy for dealing with New York's heroin and opioid problem calls for limiting prescriptions, boosting treatment and greater support for those trying to stay clean. Gov. Andrew Cuomo released the recommendations Thursday. They now go to the state Legislature, which is expected to approve a comprehensive plan to combat the rise in heroin and opioid addiction before ending the 2016 session next week. The proposals announced by Cuomo include changes in insurance rules to encourage addicts to get help, greater funding for treatment, new training for doctors who prescribe opioids, new rules to limit acute pain medication to seven-day prescriptions, and expanded access to overdose antidotes. (6/9)

The New York Times: Who May Die? California Patients and Doctors Wrestle With Assisted Suicide
On Thursday, California became the fourth state in the country to put in effect a law allowing assisted suicide for the terminally ill, what has come to be known as aid in dying. Lawmakers here approved the legislation last year, after Brittany Maynard, a 29-year-old schoolteacher who had brain cancer, received international attention for her decision to move to Oregon, where terminally ill patients have been allowed to take drugs to die since 1997. Oregon was the first state to pass an assisted suicide law, and was followed by Washington and Vermont. Under a Montana court ruling, doctors cannot be prosecuted for helping terminally ill patients die, as long as the patient makes a written request. With the California law, 16 percent of the country’s population has a legal option for terminally ill patients to determine the moment of their death, up from 4 percent. (Medina, 6/9)

Los Angeles Times: Opponents Sue To Overturn California's New Aid-In-Dying Law
As a law went into effect Thursday allowing physicians to prescribe medicines to terminally ill patients to hasten their deaths, a group of doctors tried to overturn it in court. The Life Legal Defense Foundation, American Academy of Medical Ethics and several physicians have filed a lawsuit in Riverside County Superior Court claiming that the state’s new aid-in-dying law is unconstitutional. The End of Life Option Act allows patients with less than six months to live to obtain medicines from their doctor that would kill them. On Thursday, California became one of five states in the U.S. where the practice is legal. (Karlamangla, 6/9)

The Associated Press: More Americans Are Dying Each Year By Accident
Accidents are killing more Americans each year, increasingly from overdoses and falls. A new report from the National Safety Council said that in 2014, more than 136,000 Americans died accidentally. That’s up 4.2 percent from the year before and a jump of 15.5 percent over a decade. And the accident rate has risen despite a 22 percent plunge in car crash deaths since 2005. Overdose and accidental poisonings are up 78 percent over a decade — pushing aside car crashes as the No. 1 accidental killer in the U.S. (Borenstein, 6/9)

The Wall Street Journal: NY Bill Would Require Mental Health Education In Schools
New York's Assembly has passed legislation to require that health education in schools includes mental health. A companion bill is poised for a Senate vote. It would take effect in July 2018. Lawmakers have inserted similar requirements in the law concerning health education about alcohol, drugs, tobacco, and the prevention and detection of cancers. (6/9)

The Washington Post: 25 States Now Call Marijuana 'Medicine.' Why Doesn’t The DEA?
John Kasich signed Ohio's medical marijuana bill into law yesterday, making it the 25th state (26 counting Washington, D.C.) to allow some form of medical marijuana use. Ohio's measure is more restrictive than medical marijuana bills in many other states. It does not allow patients to smoke marijuana -- they must ingest it orally via edible products, or use a vaporizer. It doesn't allow patients to grow their own marijuana, and only a handful of conditions, including epilepsy, chronic pain and cancer, qualify for a medical marijuana recommendation. (Ingraham, 6/9)

NPR: A Scientist's Dream Fulfilled: Harnessing The Immune System To Fight Cancer
Sharon Belvin's nightmare with cancer began in 2004, when she was just 22. Belvin was an avid runner, but said she suddenly found she couldn't climb the stairs without "a lot of difficulty breathing." Eventually, after months of fruitless treatments for lung ailments like bronchitis, she was diagnosed with melanoma — a very serious skin cancer. It had already spread to her lungs, and the prognosis was grim. She had about a 50-50 chance of surviving the next six months. (Davis and Palca, 6/9)