The Washington Post: Trump Administration Proposes Further Dismantling Of Affordable Care Act Through Medicare
The Trump administration is proposing to restrict an innovation in the Affordable Care Act, which was intended to improve Medicare and slow spending in the vast federal insurance system for older Americans. Health-care researchers hail the model’s promise to improve quality and efficiency, but government data suggest it is not saving enough money. The changes, announced Thursday by the administrator of the Department of Health and Human Services’ Centers for Medicare and Medicaid Services, would significantly curtail Accountable Care Organizations. The ACOs can be teams of doctors, hospitals or other providers who become responsible for all the health-care needs of a specific group of patients. (Goldstein, 8/9)

Modern Healthcare: CMS Plans To 'Retire' Some ACOs
Currently, 460 of the 561 ACOs in the Shared Savings Program this year are in Track 1. Another eight are in Track 2, 38 are in Track 3 and 55 are in Track 1+. Over 10.5 million Medicare fee-for-service beneficiaries are in the models. The majority are in arrangements that do not take risks for increases in cost. "After six years of experience, the time has come to put real 'accountability' in Accountable Care Organizations," CMS Administrator Seema Verma said in a statement. "Medicare cannot afford to support programs with weak incentives that do not deliver value." The agency proposes that ACOs in the two years of an upside risk arrangement would get 25% rather than 50% of savings. (Dickson, 8/9)

Kaiser Health News: Medicare To Overhaul ACOs But Critics Fear Less Participation
Medicare ACOs began in 2012 and today enroll more than 10 million beneficiaries. If they provide care for less than certain cost targets — while meeting quality of care standards — then they get to share in any of the savings. Commercial insurers and Medicaid have also adopted ACOs in the past decade. (Galewitz, 8/9)

In other health law news —

Kaiser Health News: Podcast: KHN’s ‘What The Health?’ Coming Soon: ‘Long-Term Short-Term’ Plans
The Trump administration’s new rule allowing “short-term” insurance plans to be used for up to three years has touched off a big reaction in health policy circles. Supporters of the change say those who can no longer afford comprehensive health insurance will have the ability to purchase lesser but cheaper plans. But opponents worry that consumers who fail to read the fine print will end up with plans that won’t cover care they need. (8/9)

The Wall Street Journal: The Democratic Party’s New Litmus Test: Gun Control
During her 2010 U.S. House campaign, Democrat Ann Kirkpatrick of Arizona highlighted her “A” rating from the National Rifle Association. She opposed gun-control measures and regaled constituents in her largely rural district with stories of hunting with her father. In 2018, Ms. Kirkpatrick is running to return to the House espousing a gun-control platform that is among the country’s most aggressive. She is for universal background checks and a ban on guns described as assault weapons. She disavows her longstanding position as a “proud gun owner,” saying she gave away the hunting rifles inherited from her father. “I do not have any guns in my home,” she says. (Epstein, 8/9)

Meanwhile, Parkland students are still navigating the psychological aftereffects of the mass shooting —

The Washington Post: Surviving Parkland: A Teen’s Road To Recovery After A Mass School Shooting
Marie Laman carefully removes a black bow tie from its box and slips it around her son’s neck. It’s his first bow tie, for his first formal dance. A moment for a mother to savor. “I don’t want to do this,” Kyle says. He is slumped on his bed, tugging at the sleeves of his dress shirt. “This is so stupid.” Marie, still struggling with the tie’s clasp, doesn’t respond. Suddenly, Kyle shoves her away. “You’re choking me,” he says. “Stop. Stop!” (Kaplan, 8/9)

The Hill: Ocasio-Cortez: 'Medicare For All' Is ‘Not A Pipe Dream’
New York congressional candidate Alexandria Ocasio-Cortez (D) on Wednesday said her policy proposal of "Medicare for all" is "not a pipe dream." "I think at the end of the day, we see that this is not a pipe dream," Ocasio-Cortez said on CNN's "Cuomo Prime Time." (Birnbaum, 8/9)

Cleveland Plain Dealer: Medicare For All Gaining Political Popularity On The Left, But Support From Ohio Democrats Varies
Nationally, "Medicare for All" is growing in popularity within the political left. But three politicians help illustrate a more halting level of current support among Ohio Democrats when it comes to universal, government-provided health insurance. (Tobias, 8/9)

In other news —

The Associated Press: North Dakota Senate Hopefuls Chase The Veterans' Vote
At the American Veterans club in Bismarck where former military men and others are drawn by camaraderie, card games and affordable gravy-laden lunch specials, there's no clear favorite in North Dakota's sharply contested U.S. Senate race. But when it comes to the barrage of television ads begging for these veterans' votes, they couldn't agree more. Make them stop. (8/9)

The Hill: HHS Backs Off Plan To Cut Funding For Certain Teen Pregnancy Prevention Groups 
The Department of Health and Human Services (HHS) on Thursday said it will resume grants for groups working to prevent teen pregnancies, a reversal from last year's announcement that it would end funding two years earlier than expected. An agency spokesperson told The Hill that HHS will continue grant funding this year for groups participating in the Teen Pregnancy Prevention Program. Several federal judges have ruled against HHS for its plan to end the five-year grants, which began in 2015, after three years. (Hellmann, 8/9)

In other women's health news —

KCUR: Judge Postpones Decision On Missouri Medication Abortion Rule 
A judge has put on hold a case challenging Missouri’s regulation of medication abortions because two pending cases on appeal address some of the same issues. U.S. District Judge Beth Phillips reasoned that a decision in one of the appellate cases “forms part of the facts that bear on the Court’s analysis in this case.” Phillips acted on a motion filed by the Planned Parenthood affiliates in Kansas City and St. Louis, the two plaintiffs challenging the Missouri regulation. She said the delay would not prejudice the state since, in the meantime, it’s free to enforce the regulation. (Margolies, 8/9)

The Associated Press: Doctors Nudged By Overdose Letter Prescribe Fewer Opioids
In a novel experiment, doctors got a letter from the medical examiner's office telling them of their patient's fatal overdose. The response: They started prescribing fewer opioids. Other doctors, whose patients also overdosed, didn't get letters. Their opioid prescribing didn't change. (Johnson, 8/9)

Los Angeles Times: Coroner Sent Letters To Doctors Whose Patients Died Of Opioid Overdoses. Doctors' Habits Quickly Changed
Addressed directly to the doctor, the letter arrived in a plain business envelope with a return address of the San Diego County medical examiner’s office. Its contents were intended, ever so carefully, to focus the physician on a national epidemic of opioid abuse — and his or her possible role in it. “This is a courtesy communication to inform you that your patient [name, date of birth inserted here] died on [date inserted here]. Prescription drug overdose was either the primary cause of death or contributed to the death,” the letter read. (Healy, 8/9)

Kaiser Health News: Clinicians Who Learn Of A Patient’s Opioid Death Modestly Cut Back On Prescriptions 
“You can hear a lot of statistics about the crisis,” said Jason Doctor, lead author of the study, published Thursday in the journal Science. “But it always feels like it is happening elsewhere if you are not aware of any deaths in your own practice.” (Gorman, 8/10)

The Washington Post: Death Reports Make The Opioid Crisis Personal For Doctors
The letters were successful, although the effects were modest. Doctors who were informed of their patients' deaths were 7 percent less likely to start new patients on opioids and issued fewer high-dose prescriptions over the next three months, compared with those who did not receive a letter. In total, there was a 9.7 percent reduction in the total amount of opioids they prescribed, according to results published Thursday in the journal Science. (Johnson, 8/9)

NPR: 'Dear Doctor' Letters Reduce Opioid Prescribing
"What's important about what we've found is that you can do very simple things to change prescribing and make prescribing safer," says coauthor Jason Doctor, an associate professor of health policy and management at the University of Southern California. (Watson, 8/9)

Stat: Opioid Prescribing Fell After Clinicians Told Their Patient Had Died Of Overdose 
“I think it’s a no-brainer,” said Dr. Andrew Kolodny, co-director of Brandeis University’s Opioid Policy Research Collaborative, who was not involved with the study. “If a prescriber’s patient ultimately loses their life to a drug overdose, that prescriber should be notified — there should be that feedback.” Still, such an effort wouldn’t be feasible everywhere, said Dr. Kim Collins, a forensic pathologist in South Carolina and 2018 president of the National Association of Medical Examiners. Depending on a jurisdiction’s policies and coroner and medical examiner system, pathologists can’t always disclose causes of death of individual patients. (Joseph, 8/9)

The Associated Press: Report: Jump In Deliveries Involving Moms Hooked On Opioids
U.S. health officials say they found a dramatic rise in the number of women who are hooked on opioids and delivering babies in hospitals. Opioid use during pregnancy can cause death of the mother or baby, preterm birth and infant withdrawal symptoms like seizures, excessive crying and breathing problems. (Stobbe, 8/9)

Bloomberg: Opioid Abuse By Pregnant Women Worsens Across U.S., Data Show 
The prevalence of “opioid use disorder” more than quadrupled from 1.5 per 1,000 hospital births in 1999 to 6.5 per 1,000 births in 2014, according to the Morbidity and Mortality Weekly Report, published by the U.S. Centers for Disease Control and Prevention. The analysis is based on statistics from 30 states and the District of Columbia. (Del Guidice and Lu, 8/9)

Boston Globe: Number Of Opioid-Addicted Women Who Delivered Babies Quadrupled In 16 Years
“These findings illustrate the devastating impact of the opioid epidemic on families across the U.S., including on the very youngest,” Dr. Robert R. Redfield, CDC director, said in a statement. “Untreated opioid use disorder during pregnancy can lead to heartbreaking results. Each case represents a mother, a child, and a family in need of continued treatment and support.” (Freyer, 8/9)

In other news on the epidemic —

Miami Herald: Study: Opioids For Wisdom Teeth Removal Increase Long-Term Use
Millions of people each year go through the dreaded experience of getting their wisdom teeth pulled out. A new study from researchers at the University of Michigan suggests that for some people, the experience could set them up for long-term possible opioid use. (Magness, 8/9)

NPR: Empathy Replaces 'Tough Love' As An Approach To Addiction
It was Bea Duncan who answered the phone at 2 a.m. on a January morning. Her son Jeff had been caught using drugs in a New Hampshire sober home and was being kicked out. Bea and her husband, Doug Duncan, drove north that night nine years ago to pick Jeff up. On the ride back home, to Natick, Mass., the parents delivered an ultimatum: Their son had to go back to rehab, or leave home. Jeff chose the latter, Bea says. She remembers a lot of yelling, cursing and tears as they stopped the car, in the dead of night, a few miles from the house. (Bebinger, 8/10)

Kansas City Star: Kansas City Sues Opioid Manufacturers And Distributors
Kansas City has joined cities and counties across the country in filing suit against a host of opioid manufacturers and distributors, saying the companies created a crisis by deceiving the public about the addictiveness of opioids and failing to properly control their flow. The suit, filed Thursday in federal court, is much like one filed last month by Jackson County that called the opioid crisis “the worst man-made epidemic in modern medical history,” and the city has retained some of the same lawyers as the county. (Marso and Ryan, 8/9)

The New York Times: Companies Respond To An Urgent Health Care Need: Transportation
As America’s baby boomers are hitting 65 at a rate of 10,000 a day, and healthier lifestyles are keeping them in their homes longer, demand is escalating for a little talked-about — yet critical — health care-related job: Transporting people to and from nonemergency medical appointments. “It’s going to become a massive phenomena,” said Ken Dychtwald, founder and chief executive of Age Wave, a consulting firm specializing in age-related issues. “This is an unmet need that’s going to be in the tens of millions of people.” (Morrissey, 8/9)

The Associated Press: Merger Cancellation Pushes Rite Aid Into Uncertain Future
Rite Aid shares plunged Thursday as the company headed into an uncertain future after calling off its merger with the grocer Albertsons. Analysts and retail insiders questioned the drugstore chain's prospects after it ended a planned takeover by Albertsons before Rite Aid shareholders could vote on it. That vote also faced shaky prospects due to opposition from shareholders and influential proxy advisory firms. (Murphy, 8/9)

The Wall Street Journal: The High Cost Of Getting Your Wish At Rite Aid
Rite Aid investors might have to get used to the single life. The drugstore chain and grocer Albertsons announced Wednesday evening that they terminated their planned merger. That marks the second Rite Aid deal in about a year to fall through: Walgreens Boots Alliance had planned to buy Rite Aid last summer before regulatory concerns forced a much less ambitious asset sale. (Grant, 8/9)

Bloomberg: Glenview, Icahn Face Off Over Cigna/Express Scripts Deal 
Activist investor Carl Icahn’s push to derail Cigna Corp.’s proposed $54 billion takeover of pharmacy-benefits firm Express Scripts Holding Co. isn’t convincing one big shareholder. Glenview Capital Management LLC publicly backed the deal on Thursday in a letter to Cigna shareholders, urging other investors to do the same, saying the company is actually paying a cheap price for Express Scripts compared with similar takeovers in the past. That rebuts Icahn’s statements that the health insurer is “dramatically overpaying” for a company facing existential threats. (Darie and Deveau, 8/9)

Seattle Times: Amazon Considering Opening Seattle Health Clinics For Employees, Report Says 
Amazon is weighing opening primary care clinics to treat employees at its Seattle headquarters, CNBC reported  Thursday, citing two people familiar with the matter. A preliminary plan, CNBC reported, calls for the retail and technology giant to open a pilot clinic later this year staffed by a small number of doctors, and to expand it to more employees in early 2019. (Day, 8/9)

The Associated Press: Court Orders Ban On Harmful Pesticide, Says EPA Violated Law
A federal appeals court ruled Thursday that the Trump administration endangered public health by keeping a widely used pesticide on the market despite extensive scientific evidence that even tiny levels of exposure can harm babies' brains. The 9th U.S. Circuit Court of Appeals in San Francisco ordered the Environmental Protection Agency to remove chlorpyrifos from sale in the United States within 60 days. (8/9)

The Washington Post: Federal Appeals Court Orders EPA To Ban Controversial Pesticide
Judge Jed Rakoff, writing for the majority, said that over the past two decades, scientists at the agency had documented the likely adverse effects of chlorpyrifos on the mental and physical development of infants and children. But he said the EPA had “stalled” for years in banning the chemical and accused the agency of an “utter failure” in responding to objections over Pruitt’s denial last year. (Dennis, 8/9)

In other news —

PBS NewsHour: This EPA Rule May Expand Asbestos Use, And There’s One More Day To Give Feedback
On Friday, the Environmental Protection Agency is scheduled to stop taking public comments for a proposed rule that critics say could expand the use of asbestos — an industrial material known to cause cancer and lung disease. (Akpan, 8/9)

Milwaukee Journal Sentinel: EPA Silent On Case Against Chemical Barrel Plants Months After Violations
Months after issuing violations against a chain of industrial barrel refurbishing plants, the U.S. Environmental Protection Agency has said nothing publicly about the case. U.S. Sen. Tammy Baldwin is asking why.Citing a Milwaukee Journal Sentinel investigation that documented danger in the plants to workers and residents in surrounding neighborhoods, Baldwin (D-Wis.) sent a letter to the EPA this week calling for action. (Dierich, 8/9)

Stat: Tumor Cells Can Unleash Tiny Weapons To Ward Off Immune System Attacks 
Scientists have discovered that cancer cells can release tiny weapons called exosomes that target immune cells before they have a chance to reach a tumor. The findings, published Wednesday in Nature, point to the exosomes as a potential biomarker to predict which patients might respond to anti-PD-1 therapies. The cancer treatments target PD-1, a checkpoint protein on immune T cells. Tumor cells that express another protein, PD-L1, can bind to the PD-1 on T cells to inhibit the immune system’s ability to attack cancer cells. The University of Pennsylvania researchers are hoping that measuring exosome levels might offer insight into whether an anti-PD-1 therapy would work for a particular patient. (Thielking, 8/9)

The New York Times: Psychologists’ Group Maintains Ban On Work At Military Detention Facilities
After an escalating debate about the role of psychologists in military prisons, the American Psychological Association voted on Wednesday to reject a proposed change in policy that would have allowed members to treat detainees held at sites that do not comply with international human rights laws. The proposed change would have reversed a 2015 determination by the association that prohibited such work, effectively blocking military psychologists from sites like the military detention facility at Guantánamo Bay, Cuba, maintained by the United States. (Carey, 8/9)

USA Today: Cancer-Killing Drug BXQ-350 Gets Its First Human Trials
Properly mixed, the medicine came out as a dark brown liquid. A nurse brought the intravenous bag to the side of a recliner, where a man with brain cancer sat. The nurse hung the plump bag on a stand and prepared the treatment for delivery. The moment had arrived for BXQ-350 to meet its first human patient. For the man, and for the medicine, the stakes could not have been higher. (Saker, 8/9)

Kaiser Health News/USA Today: Lax Oversight Leaves Surgery Center Regulators And Patients In The Dark
The first man died in April 2014. Another died later that month. Then on July 18 of that year, a woman was rushed to a hospital where she was told she was lucky to be alive. They all went to the same Little Rock, Ark., surgery center for a colonoscopy, among the safest procedures a patient can have. And each stopped breathing soon afterward, court records say, sustaining the same type of brain damage seen in a drowning victim. (Jewett and Alesia, 8/9)

Stat: Can Kelvin Droegemeier Bring Science Back To The White House? 
For the past 19 months, the White House Office of Science and Technology Policy has operated with a skeleton crew. For over a year, the top-ranking adviser has not even been a scientist, but rather a 30-something political science major who most recently worked for Silicon Valley billionaire Peter Thiel. Desperate former employees even set up a secret shadow network to provide advice to lawmakers. Gone are the days when science was high on the agenda, when a staff of more than a hundred helped coordinate the federal government’s response to the Ebola outbreak, launched the Precision Medicine Initiative to personalize health treatments, and spearheaded a $100 million BRAIN Initiative that boosted research into conditions like Alzheimer’s and Parkinson’s disease. (Swetlitz, 8/10)

The New York Times: Can You Screen For Early Pancreatic Cancer?
Pancreatic cancer is the fourth leading cause of cancer death in the United States, claiming some 44,330 lives a year, but there is currently no standard screening test that can detect this cancer early and “has actually been proven to save lives,” said Dr. Otis Brawley, chief medical and scientific officer for the American Cancer Society. Individuals with a strong family history of pancreatic cancer, such as having a parent, sibling or child who developed the cancer before turning 50 or two such close relatives who developed it at any age, are at increased risk of developing the disease themselves. (Rabin, 8/10)

The Washington Post: Loa Loa: His Health Had Been Failing For Years. Then He Saw Something Crawling In His Eye.
The painting was not an image of anything in particular, just an abstract confluence of psychedelic colors and wormlike patterns inside a perfectly round circle. Ben Taylor didn’t like it much, and he said he didn’t know why he painted it. But the wormlike patterns represent years of spiraling into unknown illness that had driven the 47-year-old painter and musician to depression, sometimes even thoughts of suicide. Taylor gave up on the painting and in 2014 shelved the unfinished work he had simply called “Untitled.” (Phillips, 8/9)

The Associated Press: Puerto Rico: 1,400 Died From Hurricane But Toll Still At 64
Puerto Rico is estimating in a report to Congress that Hurricane Maria killed more than 1,400 people, though an island official said Thursday that the confirmed toll remains frozen at 64 pending a scientific review due out soon. The government, relying on updated statistics it first reported in June, said in a report to Congress detailing a $139 billion reconstruction plan that there were 1,427 more deaths from September to December 2017 than the average for the same time period over the previous four years. (8/9)

The Hill: Puerto Rico Says Hurricane Death Toll 20 Times Higher Than First Reported 
“Although the official death count from the Puerto Rico Department of Public Safety was initially 64, the toll appears to be much higher,” the report stated. “According to initial reports, 64 lives were lost. That estimate was later revised to 1,427," it added in a separate section. (Samuels, 8/9)

Pioneer Press: One Patient Paid $12,326 For A Spinal Fusion Surgery, Another $80,518 — At The Same Hospital
The cost of four common inpatient surgeries can vary by more than six times at the same Minnesota hospital. That is a key takeaway from the Minnesota Department of Health’s latest examination of the cost of medical care. One patient might pay $12,326 for a spinal fusion surgery and another patient in the same hospital might have a bill for $80,518. Prices for procedures also vary widely among different hospitals. The average cost of that spinal fusion surgery ranges from $26,803 at one facility to $58,770 at another. (Magan, 8/9)

The Star Tribune: Rare Look At Minnesota Hospital Costs Finds Huge Swings 
The findings, released Thursday by the state Health Department, came from a study of thousands of records detailing payments by private health insurers and consumers to hospitals for four common procedures: a simple appendectomy, spinal fusion, major bowel surgery, and removal of uterine fibroids. While much of the cost was covered by insurance, the wide swings can ultimately affect out-of-pocket costs for patients and contribute to premium increases for employer-sponsored health coverage. (Howatt, 8/9)

MPR: They Charged What? Price Of Surgical Procedures Vary Widely By Hospital, Patient
The report didn't explain why there were such large variations. But Gildemeister said national research shows the market power of hospitals and insurance companies plays a big role. "An insurance company with a really large book of business, that brings a lot of patients to a hospital, that insurer can probably negotiate discounts that are much greater than a small [insurer] that absolutely needs that hospital in its network in order to be certified and conducting business," he said. Department of Health commissioner Jan Malcolm said the lack of transparency about prices being charged contributes to the rising cost of health care. (Kraker, 8/9)

Stateline: Just How Profitable Should Your Disease Be?
Dialysis, which treats patients with advanced kidney disease, is lifesaving. The question is whether California’s ballot initiative to limit the profit of dialysis clinics, Proposition 8, would be more likely to protect lives or end them. ...The number of kidney disease patients in the state rose 46 percent from 2009 to 2016, mostly because patients are living longer, according to the California Office of Statewide Health Planning and Development. In that time, 123 new dialysis centers were opened in the state, mostly by DaVita and Fresenius, the two largest dialysis companies nationwide. (Povich, 8/10)

The Star Tribune: Optum Running New Clinic For 9/11 Survivors
The federal government has hired Eden Prairie-based Optum to operate a new clinic in Manhattan for survivors of the 9/11 attacks who have enrolled in an ongoing health program. The clinic, which is expected to open this month, will be run by the Optum business that already manages care across much of the country for people at risk for health issues connected to the Sept. 11, 2001, attacks on the World Trade Center and the Pentagon. (Snowbeck, 8/9)

Detroit Free Press: 3 Beaumont Doctors Claim Innocence Over $84.5M Settlement
Three doctors named last week in Beaumont Health's $84.5-million settlement with the U.S. Justice Department insist they did nothing wrong and have hired an attorney to defend their reputations. The trio — Dr. Joel Kahn, Dr. Dinesh Shah and Dr. Renato Ramos — were among the eight Beaumont doctors identified in the settlement agreement as having enjoyed improper pay arrangements with the hospital system and other perks in potential violation of federal laws. (Reindl, 8/9)

PBS NewsHour: How Wildfires Can Threaten Your Health
For many Californians, the crimson sky was another reminder of the 19 wildfires burning across the state, a larger and more destructive threat than in recent years. It could become the worst fire season in state history. For [Thomas] Dailey, a pulmonologist who has treated asthma patients for 29 years, it also signaled a growing health risk for his patients and the public. (Santhanam, 8/9)

Kansas City Star: Kansas Insurance Department Requires 3D Mammogram Coverage
The Kansas Insurance Department put out an official bulletin Wednesday saying it will require all health insurers to cover 3D mammograms starting next year. The move comes after Missouri legislators voted to enact a similar policy, joining at least seven other states. (Marso, 8/9)

Miami Herald: Florida Ranks Almost Last In Cancer Report On State Policies
An advocacy affiliate of the American Cancer Society graded Florida among the worst-performing states in implementing policies to fight and prevent cancer, largely for failing to expand access to Medicaid and not taking sufficiently aggressive efforts to discourage smoking, according to a report released Thursday. Only two states — Mississippi and Idaho — had worse grades with no positive indicators on the nine recommended public health policy stances in the American Cancer Society Cancer Action Network writeup. (Koh, 8/9)

Cleveland Plain Dealer: Rape Kit Tracking System To Allow Victim Access, System Accountability In Ohio
Attorney General Mike DeWine today announced the creation of a system to track rape evidence that gives sexual assault survivors the option to access information about testing in their case and would help ensure that an "accumulation of untested rape kits will never again happen" in Ohio. DeWine said the free, online system will allow victims to anonymously check the status of their rape kits from the time they are collected at a medical facility and then sent to police, a lab for forensic testing or later stored or destroyed. (Dissell, 8/9)

Georgia Health News: Good News For Teachers, State Employees As Insurance Rates Hold Steady For 2019
Their 2019 premiums, deductibles, copays and co-insurance will remain the same as this year in the State Health Benefit Plan (SHBP), Geogia’s Department of Community Health said Thursday. The same benefit offerings – from HMO through high-deductible health plan – will also be the same. (Miller, 8/9)

The CT Mirror: First Human Milk Depot To Open In Greater Hartford This Month
John Dempsey Hospital will open the first human milk depot in the Greater Hartford region on Aug. 30, giving moms with an oversupply of breast milk a local place to donate. ...The donated milk will then all be shipped by Merlo to the Mother’s Milk Bank Northeast facility in Newton, Mass., where it is mixed, pasteurized and redistributed to over 85 hospitals and outpatient facilities across the northeast, including UConn Health, to support premature infants. (Werth, 8/9)

Boston Globe: State’s New Marijuana Ads Strike Friendly Tone
A new public awareness campaign is adopting a gentler, non-judgmental tone as officials work to educate Massachusetts residents on the state’s cannabis laws and to decrease youth use rates. The campaign, dubbed “More About Marijuana,” was unveiled Thursday by the state Cannabis Control Commission and Department of Public Health, and includes two 30-second animated videos and a website. (Adams, 8/10)

Houston Chronicle: Fighting Cancer On Two Fronts: Despite Texas Law, Firefighters Denied Workers Comp For Treatment 
In the past six years, more than nine in 10 Texas firefighters with cancer have had their workers comp claims denied, according to state statistics. Union leaders and state legislators say cities have ignored Texas’ presumptive cancer statute for first responders, and face few consequences for denying claims. The result, they say, is that firefighters often see their personal savings evaporate even as they compromise on their care. (Despart, 8/9)

JAMA Internal Medicine: Lessons From The Canadian Experience With Single-Payer Health Insurance: Just Comfortable Enough With The Status Quo
With single-payer public health insurance again on the political radar in the United States at both the state (California) and federal (Democrat party) levels, the performance of the Canadian health care system during the last 50 years and the lessons it may offer should be considered. Canadians are proud of their universal approach to health insurance based on need rather than income. The system has many strengths, such as the ease of obtaining care, relatively low costs, and low administrative costs, with effectiveness and safety roughly on par with other countries, including those, such as the United States, that spend considerably more per capita. (Ivers et al, 8/6)

Commonwealth Fund: Health Care Sharing Ministries: What Are The Risks To Consumers And Insurance Markets?
Health care sharing ministries (HCSMs) are a form of health coverage in which members — who typically share a religious belief — make monthly payments to cover expenses of other members. HCSMs do not have to comply with the consumer protections of the Affordable Care Act and may provide value for some individuals, but pose risks for others. Although HCSMs are not insurance and do not guarantee payment of claims, their features closely mimic traditional insurance products, possibly confusing consumers. Because they are largely unregulated and provide limited benefits, HCSMs may be disproportionately attractive to healthy individuals, causing the broader insurance market to become smaller, sicker, and more expensive. (Volk, Curran and Giovannelli, 8/8)

JAMA Cardiology: Efficacy And Safety Of Further Lowering Of Low-Density Lipoprotein Cholesterol In Patients Starting With Very Low Levels: A Meta-Analysis
There is a consistent relative risk reduction in major vascular events per change in LDL-C in patient populations starting as low as a median of 1.6 mmol/L (63 mg/dL) and achieving levels as low as a median of 0.5 mmol/L (21 mg/dL), with no observed offsetting adverse effects. These data suggest further lowering of LDL-C beyond the lowest current targets would further reduce cardiovascular risk. (Sabatine et al, 8/1)

The Henry J. Kaiser Family Foundation: The Relationship Between Work And Health: Findings From A Literature Review
A central question in the current debate over work requirements in Medicaid is whether such policies promote health and are therefore within the goals of the Medicaid program. Work requirements in welfare programs in the past have had different goals of strengthening self-esteem and providing a ladder to economic progress, versus improving health. This brief examines literature on the relationship between work and health and analyzes the implications of this research in the context of Medicaid work requirements. We review literature cited in policy documents, as well as additional studies identified through a search of academic papers and policy evaluation reports, focusing primarily on systematic reviews and meta-analyses. (Antonisse and Garfield, 8/7)

Los Angeles Times: New In GOP Logic: Antipoverty Programs Worked So Well, We Must Get Rid Of Them
For many decades now the GOP has sought to undo the New Deal and the Great Society. But a report released last month from the White House’s Council of Economic Advisors, lost in a sea of grabbier news items, applies a new logic to the goal of shredding the safety net. According to “Expanding work requirements in non-cash welfare programs,” comprehensive antipoverty programs are no longer necessary because 50 years of antipoverty programs — yes, those same interventions long hated, and their effectiveness belittled, by the GOP — have succeeded so spectacularly that poverty is largely a thing of the past. (Sasha Abramsky, 8/10)

The Hill: Major Medicaid Cuts To Address The Increasing Federal Deficit Are Misdirected 
Words are weapons in the Trump administration’s “War on Poverty, 2018,” a term recently coined by Sara Rosenbaum, a professor at the George Washington University Milken Institute School of Public Health. The original War on Poverty, announced by President Lyndon Johnson in 1964, included a number of programs designed to “not only to relieve the symptom of poverty, but to cure it and, above all, to prevent it.” Medicaid and Medicare are the crown jewels of Johnson’s War on Poverty. The Trump War on Poverty 2018 is misnamed as “A Brighter American Future.” Rather than painting a picture of a brighter future for poor people, the Republican budget proposal makes a dim picture dimmer. It signals a switch in the War on Poverty from one that addresses the root causes of poverty and provides assistance to poor people to one attacking poor people with words and a million cuts. (Carole R. Myers, 8/9)

Cleveland Plain Dealer: Push For New Medicaid Work Requirements Just A Way To Distract Attention From Health Care Inequities
In compliance with a law passed by a heartless majority in the legislature last year, a few months ago the Ohio Department of Medicaid requested a waiver to implement work requirements for "able-bodied" Medicaid recipients. ...Their motivation appears to be purely political - to deepen the divide between those struggling to pay the increasing copays and deductibles for private insurance and those who qualify for public coverage through Medicaid. (Kenneth Frisof, 8/20)

The Hill: GOP Tax Law Isn’t Just About Taxes — It’s Undermining American Health Care
As President Trump and Republicans in Congress push for a second round of tax cuts, it’s important to look at how the first Trump-GOP tax law adopted last December hurt working families. One of the worst ways has nothing to do with taxes. Besides giving most of the benefits to the wealthy and corporations and failing to increase worker pay as promised, the tax law also jeopardizes health care for millions.It does this in two ways. (Frank Clemente an Magarida Jorge, 8/9)

Stat: The Tale Of Two Medicares: Canadian And American
Medicare for all — or the idea that every American should have some form of public health insurance — continues to forge its way into political debates. With such momentum, however, can come fearmongering and obstructionism. History and data may be of some help in disentangling any distortions.The United States and Canada launched their respective Medicare programs within a few years of each another: July 30, 1965 in the U.S. and July 1, 1968 in Canada. In the U.S., amid pushback from health care industry groups, American seniors were the only ones who received health insurance coverage, whereas all Canadians gained coverage regardless of their age or income. This divergence was really a matter of politics — there is, after all, no constitutional right to health care in Canada. But it’s now hard to argue that there is a more unifying social program up north than Medicare. (Andrew S. Boozary, 8/10)

Real Clear Health: Do Democrats Want Obamacare To Fail Under Donald Trump?
In their quest to take back the House and Senate in November’s midterm elections, Democrats have received a bit of bad news. The Hill recently noted: Health insurers are proposing relatively modest premium bumps for next year, despite doomsday predictions from Democrats that the Trump administration’s changes to ObamaCare would bring massive increases in 2019. That could make it a challenge for Democrats looking to weaponize rising premiums heading into the midterm elections. Administration officials confirmed the premium trend last Friday, when they indicated that proposed 2019 rates for the 38 states using healthcare.gov averaged a 5.4 percent increase—a number that may come down even further after review by state insurance commissioners. So much for that “sabotage.” (Christopher Jacobs, 8/8)

The Washington Post: Three Reasons Trump’s New Immigration Rule Should Make Your Blood Boil
Once again, the Trump administration is looking to punish immigrants. And once again, innocent children are getting hurt in the process. This time, however, many of those innocent children are likely to be U.S. citizens. On Tuesday, NBC News reported that the Trump administration is readying a new rule that should make your blood boil. The initiative, in the works for more than a year, would make it harder for legal immigrants to receive either green cards or citizenship if they — or anyone in their households — has ever benefited from a long list of safety-net programs. These include the Children’s Health Insurance Program (CHIP), food stamps or even health insurance purchased on the Obamacare exchanges. (Catherine Rampell, 8/9)

Miami Herald: Healthcare Policy: By The Elite, For The Elite
While many of us, particularly in medical institutions, interact with those in less rarified circumstances, we have the luxury of retreating into our fortunate bubble when we leave the office. This bright, monochromatic life skews our thinking about public policy. When we ask ourselves, “What can the government or employers do to improve people’s health?” we tend to conjure up solutions we imagine would work on ourselves or the half-marathon runner in the adjacent office or the overweight colleague across the hall. (Robert Graboyes, 8/9)

The New York Times: The Toll Of America’s Obesity
Obesity rates in the United States continue to worsen. So, too, does economic inequality. Are these trends related? After remaining essentially flat in the 1950s and 1960s, the prevalence of obesity doubled in adults and tripled in children between the 1970s and 2000. According to new data from the Centers for Disease Control, the epidemic shows no signs of abating. Nearly four out of 10 adults are obese; for children, it’s nearly two out of 10. Most 2-year-olds today will develop obesity by age 35, according to a recent projection from our colleagues at Harvard. (David S. Ludwig and Kenneth S. Rogoff, 8/9)

Boston Globe: Driving Stoned: Massachusetts Standard Needed 
State public safety officials see the problem of stoned driving coming at them like a freight train. They may be doing their best to head it off, but without changes in the law, their best won’t be good enough. With medical marijuana already on the scene and the first recreational pot shops being licensed, the case for keeping drugged drivers from getting behind the wheel has grown more urgent. “Right now it’s not uncommon to hear people say, ‘I drive better when I’m high,’ ” Undersecretary for Public Safety and Security Jennifer Queally said at a news conference to introduce the department’s latest anti-impaired-driving campaign. “It’s not true for alcohol and it’s not true for marijuana.'' (8/9)

The Hill: Zika Prevention Begins With Educated And Empowered Patients 
Unfortunately, the Zika story is not over. To date, 4,900 pregnancy-related cases of Zika have been confirmed in the U.S. territories and a recent study released by the CDC found 1 in 7 babies exposed to Zika have birth defects and other health problems. These findings are tragic and prove that while there is no vaccine for the virus, we — meaning consumers, patients, healthcare providers, the healthcare industry, etc. — need to be more mindful and proactive with "our" health and the health of Americans as a whole by first considering preventative care and second by better understanding diagnosing of the virus. (Robert Segal, 8/9)

WBUR: The World Needs More Birth Control, Not Less. Can Someone Please Tell The Catholic Church?
Better than debating the minority view against contraception is focusing on the globally restricted access to it. The world, especially the developing world, needs more condoms, not fewer. (Rich Barlow, 8/9)

The New York Times: How To Quantify A Nurse’s ‘Gut Feelings’
At the start of my shift, at 7 a.m., my patient, newly admitted a few days before for a blood cancer, was talking and acting normally. By the end of my shift, 12 hours later, she had grown confused and her speech was garbled. A CT scan revealed bleeding in her brain. She was sent to intensive care and died the next day. This was years ago, but the case still haunts me. I believe that moving faster on her treatment might have prevented her sharp decline. But the medical team didn’t share my sense of urgency, and no obvious red flags signaled a coming emergency. Without a worrisome clinical value or test result to point to, my concern alone wasn’t persuasive. (Theresa Brown, 8/9)

San Antonio Press-Express: Kavanaugh Puts LGBT Community’s Health Care At Risk
As a proud transgendered Latina woman living in Texas, I’m extremely concerned about President Donald Trump’s latest nominee to the Supreme Court. Brett Kavanaugh’s record and positions on the Affordable Care Act and abortion rights, and his support for “religious freedom,” which largely allows Christian fundamentalists to discriminate against those who don’t share their beliefs, spell loss of liberty for the rest of us. (Sofia Sepulveda, 8/9)

USA Today: To Reduce Opioid Prescribing, Tell Doctors When Overdoses Kill Patients
Although prescribing peaked in 2011, it has declined only moderately and is still much higher than it was prior to the epidemic. As a behavioral scientist and a county medical examiner who has to deal with more and more bodies arriving at the morgue, we wondered why physicians continued to overprescribe despite the obvious harms. ...Let’s close the loop in opioid prescribing. Doctors need to know what’s happened to their patients, and that someone is paying attention, so they can help avoid deaths while they seek to alleviate pain. (Jason Doctor and Jonathan Lucas, 8/9)

Stat: Graduate Biomedical Education Needs An Overhaul. 
One of the great educational success stories is that graduate training can teach individuals how to do deep scientific investigation. Today, such training, which dates back to the middle of the 19th century, is in desperate need of an overhaul. ...The R3 Initiative focuses on the fundamental principles that unite all scientific disciplines: rigorous research methods that insure reproducibility and awareness of the responsibility all practitioners of science should feel toward society and their discipline. While preserving the strength of traditional doctoral training — the capacity for deep investigation through laboratory-based thesis work — the R3 approach moves away from teaching mainly factual, discipline-specific knowledge to providing tools for continual learning in many spheres. (Gundula Bosch and Arturo Casadevall, 8/10)

The Washington Post: D.C. Is Beating HIV/AIDS. There’s No Excuse To Drop The Ball Now.
At its peak, the HIV rate in the District stood at approximately 3 percent — higher than in parts of West Africa. After nine consecutive years of decline between 2007 and 2016, the rate has fallen to 1.9 percent, a remarkable achievement for city health officials who deployed a multipronged strategy against the virus that causes AIDS. But a new public-health report from the D.C. Department of Health raises concerns that these efforts may be stalling. (8/9)

Kansas City Star: Kansas City Leaders Need To Get A Handle On Gun Violence
To stem the toll homicides are taking on Kansas City, Mayor Sly James wants to regulate guns like vehicles in Missouri. And Kansas City Police Chief Rick Smith says the public could help solve some murder cases if residents cooperated with law enforcement. Both arguments are intriguing. But it’s going to take much more than appealing talking points and frustrated finger-pointing at state lawmakers to quell gun violence in the city. At least 25 people were wounded by gunfire last week. Six of the shootings were fatal. (8/9)