First Edition: October 29, 2018
Today's early morning highlights from the major news organizations.
Kaiser Health News and NPR:
That’s A Lot Of Scratch: The $48,329 Allergy Test
Janet Winston had a rash that wouldn’t go away. The English professor from Eureka, Calif., always had been sensitive to ingredients in skin creams and cosmetics. This time, however, the antifungal cream she was prescribed to treat her persistent rash seemed to make things worse. Was she allergic to that, too? ... Her Stanford-affiliated doctor had warned her that the extensive allergy skin-patch testing she needed might be expensive, Winston said, but she wasn’t too worried. After all, Stanford was an in-network provider for her insurer — and her insurance, one of her benefits as an employee of the state of California, always had been reliable. Then the bill came. (Feder Ostrov, 10/29)
Kaiser Health News:
In California, Novel Initiatives Test Cities’ Power — And Will — To Tame Health Costs
At a time of mounting national anger about rising health care prices, the country’s largest union of health workers has sponsored ballot measures in two San Francisco Bay Area cities that would limit how much hospitals and doctors can charge for patient care. The twin measures in Palo Alto and Livermore, sponsored by the Service Employees International Union-United Healthcare Workers West, take aim primarily at Stanford Health Care, which operates Stanford Hospital and Clinics, the facility with the third-highest profits in the country from patient care services, according to a 2016 study. (Waters, 10/29)
Kaiser Health News:
Trump Adds A Global Pricing Plan To Wide Attack On Drug Prices, But Doubts Persist
President Donald Trump’s new pledge to crack down on “the global freeloading” in prescription drugs had a sense of déjà vu. Five months ago, Trump unveiled a blueprint to address prohibitive drug prices, and his administration has been feverishly rolling out ideas ranging from posting drug prices on television ads to changing the rebates that flow between drugmakers and industry middlemen. Last week, Trump proposed having Medicare base what it pays for some expensive drugs on the average prices in other industrialized countries, such as France and Germany, where prices are much lower. (Tribble, 10/26)
Kaiser Health News:
Dialysis Giant DaVita Defends Itself In Court And At The Polls
It’s been a year of playing defense for DaVita Inc., one of the country’s largest dialysis providers. A federal jury in Colorado this summer awarded $383.5 million to the families of three of its dialysis patients in wrongful death lawsuits. Then this month, the Denver-based company announced it would pay $270 million to settle a whistleblower’s allegation that one of its subsidiaries cheated the government on Medicare payments. But its biggest financial threat is a ballot initiative in California that one Wall Street firm says could cost DaVita $450 million a year in business if the measure succeeds. (Young, 10/29)
The New York Times:
To Rally Voters, Democrats Focus On Health Care As Their Closing Argument
Senator Claire McCaskill isn’t subtle in reminding voters what her campaign is all about. She’s rechristened it the “Your Health Care, Your Vote” tour. The turnaround could not be more startling. After years of running as far as they could from President Barack Obama’s health care law, Ms. McCaskill and vulnerable Senate Democrats in Florida, West Virginia and other political battlegrounds have increasingly focused their closing argument on a single issue: saving the Affordable Care Act. Now, with Republicans desperate to reposition themselves and come up with their own health care pitch, and with the elections roiled by gale-force winds on immigration and Justice Brett M. Kavanaugh’s confirmation hearings, the question is whether health care will be enough to save her and Democrats in other key Senate races. (Gabriel, 10/28)
The Wall Street Journal:
Pre-Existing Condition Discord Shows Health Care Still A Hot-Button Issue
As President Trump pushes ahead with efforts to chip away at the Affordable Care Act, Democrats are seizing on his moves to attack Republicans’ claims that they will protect people with pre-existing medical conditions. Republicans are hitting back, saying Mr. Trump’s actions will increase consumer choice and that they strongly favor covering pre-existing conditions. In either case, the back-and-forth shows the continuing potency of health care as an issue less than two weeks before the midterm elections. (Armour, 10/28)
The Washington Post:
These Republicans Are Misleading Voters About Our Obamacare Fact Checks
Somewhere, somehow, a memo must have gone out to Republican lawmakers who voted for the American Health Care Act (AHCA), the Republican bill to repeal and replace Obamacare: If you are attacked for undermining protections for people with existing health problems, jab back by saying the claim got Four Pinocchios from The Washington Post. That’s not true. Republicans are twisting an unrelated fact check and are misleading voters. We have found at least seven politicians who have done this. (Kessler, 10/29)
The New York Times:
Republicans Look To Safety Net Programs As Deficit Balloons
With the federal deficit growing and President Trump suddenly talking about another tax cut, the conversation in Washington has turned to the inevitable question of how — or whether — Congress will engage in any type of fiscal discipline. Senator Mitch McConnell, the majority leader and Kentucky Republican, got people in Washington talking — and generated some new campaign ads from Democrats — when he suggested this month that changes to Medicare, Social Security and Medicaid were needed to tame the deficit. So what does that presage should Republicans maintain control of Congress? (Steinhauer, 10/26)
The Associated Press:
Shoppers May Face Hard Choices Again On Health Marketplaces
Insurance shoppers likely will have several choices for individual health coverage this fall. The bad news? There’s no guarantee they will cover certain doctors or prescriptions. Health insurers have stopped fleeing the Affordable Care Act’s marketplaces and they’ve toned down premium hikes that gouged consumers in recent years. Some are even dropping prices for 2019. But the market will still be far from ideal for many customers when open enrollment starts Thursday. (Murphy, 10/28)
The New York Times:
Shopping For Insurance? Don’t Expect Much Help Navigating Plans
When the annual open enrollment period begins in a few days, consumers across the country will have more choices under the Affordable Care Act, but fewer sources of unbiased advice and assistance to guide them through the labyrinth of health insurance. The Trump administration has opened the door to aggressive marketing of short-term insurance plans, which are not required to cover pre-existing medical conditions. Insurers are entering or returning to the Affordable Care Act marketplace, expanding their service areas and offering new products. But the budget for the insurance counselors known as navigators has been cut more than 80 percent, and in nearly one-third of the 2,400 counties served by HealthCare.gov, no navigators have been funded by the federal government. (Pear, 10/27)
USA Today:
Insurance Open Enrollment 2019: How To Choose The Right Plan, Benefits
Every fall, open enrollment season means complicated forms to read and big decisions to make about insurance and other benefits offered at your job. You may find the process a headache, but taking the time to evaluate your choices could save you thousands of dollars. Three out of five (60 percent) workers say their employer offers an open enrollment period for benefits, according to a recent Nationwide Financial consumer survey. Workers typically can switch health care plans, add disability or life insurance, or sign up for other benefits. (Herron, 10/29)
The New York Times:
Why You Shouldn’t Wait To Sign Up For Medicare Part B
[George Zeppenfeldt-Cestero] should have signed up for Medicare Part B three years earlier when he turned 65. By delaying, he had missed the best window — the so-called Initial Enrollment Period — to apply for Part B, which covers much of what we consider health care: doctor visits, tests, injectable drugs (including chemotherapy), ambulances, physical therapy and other non-hospital services. As a result, he has to pay permanently higher premiums, and he had to endure an unsettlingly long period — from December to July — before the coverage actually kicked in. (Span, 10/27)
Stat:
Here's What Happened The Last Time The President Tried To Overhaul Medicare's Drug Pricing System
President Trump is trying to do what President Obama failed to accomplish: stand up to the pharmaceutical industry and doctors to change the way that the government pays for drugs. In a sweeping proposal Thursday that lacked critical details, his Department of Health and Human Services detailed a plan to change the way that Medicare pays for doctor-administered drugs in the Part B program, with one goal of removing the current incentive for doctors to prescribe high-cost drugs. The end goal: to bring down costs for the government and ultimately, for patients. (Swetlitz, 10/26)
Politico:
Verdict On Trump Drug Plan: A Tough Sale Ahead
The Trump administration faces a lengthy battle to make its plan to lower Medicare drug costs a reality, with resistance coming from its own party, Democrats and large segments of the health care industry. Conservatives and the drug industry say it’s tantamount to government price controls and socialized medicine. Democrats are beating up the president for not going far enough and doctors are worried their patients could lose access to critical medicines. (Karlin-Smith, 10/26)
The Wall Street Journal:
Caregivers Do Double Duty To Make Ends Meet
Demand for these workers, who provide the majority of hands-on non-medical care to older adults, is strong now and for the foreseeable future because of the aging baby-boom generation, longer life expectancies and growing rates of chronic conditions. In the next decade, home-care work is expected to add more jobs than any other occupation, with an additional 1.2 million needed by 2026, according to the Bureau of Labor Statistics. ... Yet even with high demand and tight supply, wages remain stubbornly low. Between 2007 and 2017, inflation-adjusted median hourly wages for direct-care workers—including home-health aides, personal-care aides and nursing assistants—fell 2% to $11.83 from $12.08, according to PHI, an organization that works with the direct-care industry. A 40-hour work week at that rate yields an annual income of around $24,600. (Ansberry, 10/27)
The New York Times:
A Sense Of Alarm As Rural Hospitals Keep Closing
Hospitals are often thought of as the hubs of our health care system. But hospital closings are rising, particularly in some communities. “Options are dwindling for many rural families, and remote communities are hardest hit,” said Katy Kozhimannil, an associate professor and health researcher at the University of Minnesota. Beyond the potential health consequences for the people living nearby, hospital closings can exact an economic toll, and are associated with some states’ decisions not to expand Medicaid as part of the Affordable Care Act. (Frakt, 10/29)
The Associated Press:
Dialysis Companies Spend $111 Million To Kill Ballot Measure
Dialysis companies have contributed an extraordinary $111 million and counting to defeat a California ballot initiative that would cap their profits, the most any one side has spent on a U.S. ballot issue since at least 2002. A $5 million donation from this week from dialysis provider Fresenius Medical Care pushed the anti-Proposition 8 campaign's total past the $109 million pharmaceutical companies spent two years ago to defeat a measure limiting prescription drug costs. More than $70 million has been spent on television and radio ads as well as consulting services in the last two months. (Bollag, 10/26)
Politico:
Don’t Lock Them Up: Opioid Policy Shakes Up Ohio Governor’s Race
Two years after Ohio swooned over Donald Trump’s law-and-order presidential campaign, the state is weighing a decidedly un-Trumplike solution to its spiraling opioid epidemic: Stop locking up drug users, and instead use the money to treat them. Democratic gubernatorial candidate Richard Cordray is embracing a proposal on the ballot that would downgrade all drug possession crimes to misdemeanors and prohibit jail time for all but the most frequent offenders, a move that has put him out of step with key state officials and even some in his own party — and sets up a test of how far leftward Ohio’s frustrated voters will go to escape a deepening drug crisis. (Cancryn, 10/27)
The Washington Post:
Facing An Overdose Epidemic, Some ERs Now Offer Addiction Treatment
For Zachary Dezman, an emergency physician in heroin-plagued Baltimore, there is no question that offering addiction medicine to emergency room patients is the right thing to do. People with a drug addiction are generally in poorer health than the rest of the population, he said. “These patients are marginalized from the health-care system. We see people every day who have nowhere else to go. “If they need addiction medicine — and many do — why wouldn’t we give it to them in the ER? We give them medicine for every other life-threatening disease.” But elsewhere in the country, all but a few emergency doctors and hospital administrators see things differently. (Vestal, 10/28)
NPR:
A Rural Community Decided To Treat Its Opioid Problem Like A Natural Disaster
But heroin addiction and abuse are not just a big city problem, as [Ty] Trenary had thought. While the bulk of fatal overdoses still happen in urban areas, the rural overdose rate has increased to slightly surpass that of cities. Rural Americans say drug addiction and abuse are the most urgent health problems facing their local community, according to a new poll by NPR, the Robert Wood Johnson Foundation and the Harvard T.H. Chan School of Public Health. In the poll, 48 percent of people said opioid addiction has gotten worse in their community in the past five years. (Boiko-Weyrauch, 10/28)
The Associated Press:
Ex-DEA Official Says Blackburn Had Warning On Opioid Law
A former top Drug Enforcement Administration official says he told staffers who work with Tennessee Rep. Marsha Blackburn exactly what to expect from a 2016 law she co-sponsored during the nation's opioid crisis. He ripped into her later suggestion the law may have had "unintended consequences." Joe Rannazzisi, former head of DEA's Office of Diversion Control, said in an interview with The Associated Press that he told the congressional staffers during a July 2014 conference call that the bill would hamper the DEA's ability to go after companies illicitly distributing opioids. (Mattise, 10/26)
The Associated Press:
Recreational Pot Measure Has High Interest In North Dakota
Backers of legalizing marijuana in North Dakota have high hopes that voters will approve the drug's use for anyone old enough to drink alcohol. But they could be in for a bummer because opponents have spent far more money against the proposal. Critics say it would mean big problems for law enforcement and society. It comes as North Dakota still is setting up a medical marijuana system that voters approved by a wide margin two years ago. (MacPherson, 10/28)
The Associated Press:
Pot Group Predicts $1B In Nevada Tax Revenue Over 7 Years
A report for a marijuana trade group says pot production, processing and sales could reap more than $1 billion in tax revenue for Nevada over seven years. ... The analysis by Las Vegas-based RCG Economics didn't look at public safety, health, human services, schools or criminal justice costs associated with legalization. (10/26)
The New York Times:
Why Private Equity Is Furious Over A Paper In A Dermatology Journal
Early this month, a respected medical journal published a research paper on its website that analyzed the effects of a business trend roiling the field of dermatology: the rapid entrance of private equity firms into the specialty by buying and running practices around the country. Eight days later, after an outcry from private equity executives and dermatologists associated with private equity firms, the editor of the publication removed the paper from the site. No reason was given. Furor over the publication and subsequent removal of the article has deepened a rift in the field over what some see as the “corporatization” of dermatology and other areas of medicine. (Hafner, 10/26)
Stat:
A New Drug Lowers Cholesterol. Can It Spoil A Multibillion-Dollar Market?
A small biotech company has a shot at shaking up a market roosted by giants, moving toward approval with a pill it believes can lower bad cholesterol at a discount to other medicines. On Sunday, Esperion Therapeutics said a combination of its once-a-day treatment and a maximum dose of statin lowered LDL cholesterol 18 percent more than statins alone after 12 weeks. The results come from the last of five successful trials on Esperion’s drug, called bempedoic acid. The company plans to submit all of its data to the Food and Drug Administration in the early months of 2019. (Garde, 10/28)
The Associated Press:
Maryland Settles With Nursing Homes That Discharged Patients
The state of Maryland on Thursday announced a $2.2 million settlement in its suit against the owners of Neiswanger Management Services, a nursing home company that routinely discharged patients when their Medicare coverage ran out and they had no income for further care. Capital News Service ran a series in September 2016, called “Discharging Trouble ,” that shared the stories of several patients who, at the end of their coverage, had been left at the doorstep of unlicensed assisted living homes where they alleged they were assaulted and robbed. (Williams and Dubose, 10/26)
NPR:
Scientists And Parents Band Together To Research Cures For Rare Childhood Cancer
Epithelioid sarcoma is exceedingly rare — estimates vary but at most, no more than around 100 cases per year. Of those, 10 percent occur in children and adolescents. For this and many other rare cancers that kids get, it takes a long time to find enough patients to test new therapies. Even worse, small patient numbers mean there's less motivation to allocate resources to study the diseases and develop potential drugs. Dozens of childhood cancers fall in this category, some so rare that few pediatric oncologists hear about them. (Landhuis, 10/26)
Los Angeles Times:
Here’s What Happened After California Got Rid Of Personal Belief Exemptions For Childhood Vaccines
Health authorities in California have more power to insist that a dog is vaccinated against rabies than to ensure that a child enrolled in public school is vaccinated against measles. That’s just one of the frustrations faced by health officials in the first year after California did away with “personal belief exemptions” that allowed parents to send their kids to school unvaccinated, according to a study published Monday in the journal Pediatrics. In the 2014-15 school year, when parents could still opt out of vaccinations for any reason they chose, only 90.4% of kindergartners in California public schools were fully immunized. That’s below the 94% threshold needed to establish community immunity for measles, according to experts. (Kaplan, 10/29)
USA Today Network:
Adenovirus Outbreak: 9th Child Dies At New Jersey Health-Care Center
A ninth child has died of respiratory illness at the Wanaque Center for Nursing and Rehabilitation in the Haskell section of Wanaque, New Jersey, the state’s Department of Health announced Sunday morning. The latest victim was someone who had a confirmed case of adenovirus and fell ill before Oct. 22. There have been 25 pediatric cases associated with the outbreak. A staff member also was ill but has recovered, according to the health department. (Sobko, 10/28)
USA Today Network:
Cesar Sayoc: Early Signs Of Mental Health Problems For Mail Bomber Suspect
Even as a young man, Cesar Sayoc showed signs that he struggled with mental health problems, but his family could not persuade him to seek help. Sayoc, now facing federal charges in connection with mailing bomb-like devices across the country to top Democrats and media personalities, would get angry when his relatives asked him to seek help, said Ronald Lowy, a Miami lawyer who has represented Sayoc and the family for years. (Marino and Mills, 10/28)
The Washington Post:
Want To Avoid The Flu? Wash Hands, Clean Counters, Crack A Window, Consider A Surgical Mask.
Influenza viruses cause about 200,000 hospitalizations every year in the United States. Annual seasonal vaccination is our best line of defense, but in recent years, mismatches in the vaccine can clearly limit its effectiveness. We study how the flu virus spreads between people. While we strongly encourage everyone to get the flu vaccine, the findings from our study on the stability of flu viruses in the air can provide useful information for parents, teachers and health-care officials to limit the spread of the flu in the community. By employing simple strategies to reduce the amount of the flu virus in our environment, we can decrease the number of infections every year. (Lakdawala and Marr, 10/27)
The New York Times:
Confused By Nutrition Research? Sloppy Science May Be To Blame
Confused about what to eat and drink to protect your health? I’m not surprised. For example, after decades of research-supported dietary advice to reduce saturated fats to minimize the risk of heart disease and stroke, along comes a new observational study of 136,384 people in 21 countries linking consumption of full-fat (read saturated) dairy foods to a lower risk of death from cardiovascular disease. ... Caution is in order, especially since another new study, this one a randomly assigned clinical trial, found that three weeks on a diet rich in saturated fat caused liver fat and insulin resistance to rise far higher than diets high in sugar or unsaturated fat. (Brody, 10/29)