Los Angeles Times: Trump And The GOP Are Charging Forward With Obamacare Repeal, But Few Are Eager To Follow
As they race to repeal large parts of the Affordable Care Act, President-elect Donald Trump and congressional Republicans are leaving behind nearly everyone but their base voters and a handful of conservative activists. Not a single major organization representing patients, physicians, hospitals or others who work in the nation’s healthcare system backs the GOP’s Obamacare strategy. New polls also show far more Americans would like to expand or keep the healthcare law, rather than repeal it. (Levey, 12/12)

Politico: GOP Will Kill Obamacare … And Then Fund It
Republicans are going to kill Obamacare — but first they might have to save it. The already fragile Obamacare markets — beset by soaring premiums and fleeing insurers — are likely to collapse unless Republicans take deliberate steps to stabilize them while they build consensus on a replacement plan, say health care experts. That could lead to a mess for the roughly 10 million Americans currently getting coverage through the government-run marketplaces — and backlash against the GOP. (Demko, 12/9)

The Wall Street Journal: Republicans Face Dilemma On Timing Of Health-Law Replacement
Republicans united in their desire to overturn the Affordable Care Act are divided over whether to replace it before or after the 2018 elections, a choice that holds political peril either way. Waiting until after the midterms could pose a political risk to the most conservative Republicans who campaigned on the repeal and whose constituents want the law to be gone as quickly as possible. (Armour and Peterson, 12/9)

The Associated Press: GOP's 'Obamacare' Repeal Path Worries Health Care Industry 
One by one, key health care industry groups are telling the incoming Republican administration and Congress that it's not a good idea to repeal the 2010 health care law without clear plans to address the consequences. Hospitals, insurers and actuaries — bean-counters who make long-range economic estimates — have weighed in, and more interest groups are expected to make their views known soon. Representing patients, the American Cancer Society Cancer Action Network reminded lawmakers that lives are at stake. (12/10)

The Associated Press: After Health-Care Repeal Vote, Some In GOP Fear A Cliff 
Republicans are eagerly planning initial votes next month on dismantling President Barack Obama's health care law, a cherished GOP goal. But many worry that while Congress tries to replace it, the party will face ever-angrier voters, spooked health insurers and the possibility of tumbling off a political cliff. Republicans have said they first want to vote to unwind as much of the health care law as they can, though it wouldn't take effect for perhaps three years. That's to give them and new President Donald Trump time to write legislation constructing a new health care system — a technically and politically daunting task that has frustrated GOP attempts for unity for years. (Fram, 12/12)

The Washington Post: New Push To Replace Obamacare Reignites Old GOP Tensions
Republicans on Capitol Hill are already laying the groundwork for a rapid repeal of President Obama’s signature health-care law beginning on the first day of the new Congress, before President-elect Donald Trump is even sworn in. But the urgent efforts to make good on a Republican campaign promise six years in the making obscure major GOP divisions over what exactly to replace Obamacare with and how to go about it, and how long a transition period to allow before the law’s insurance would go away. (DeBonis and Snell, 12/11)

Roll Call: Immigration, Obamacare Repeal Seen Headlining Trump’s First 100 Days
Trump and his top lieutenants are vowing to hit the ground running on Inauguration Day, with the 45th president’s expected first act — likely not long after taking the oath — being signing a slew of orders to undo many executive actions and orders enacted by his predecessor, President Barack Obama. ... Trump and Pence, a former House GOP leadership team member, want to pounce early — and often — by quickly repealing Obama’s 2010 health care law, overhauling Medicaid, and rescinding a slew of Obama-era regulations. The new administration wants to use block grants to give states more sway over Medicaid, a rare policy detail. (Bennett, 12/12)

CQ Roll Call: Obamacare Goes Under The Knife
Voters in Racine, Wis., helped elect Donald Trump president in November and House Speaker Paul D. Ryan to be their representative. But now, longtime resident Mary McIlvaine — and about 6,000 of her neighbors — are left wondering whether those Republicans will kick them off their health insurance.  “I’m worried we’re going to lose coverage that’s affordable,” the 60-year-old retiree tells CQ. “I’d like to see Obamacare improved, but not done away with. ”McIlvaine, who lives about 30 minutes south of Milwaukee, had insurance through her job before retiring. She has had a subsidized HealthCare.gov plan since the program started in 2014. (Mershon, 12/12)

Politico Pro: Moderate Senate Republicans Targeted In New Pro-Obamacare Ad Blitz 
A new coalition of Obamacare supporters is releasing a seven-figure ad buy Monday to rally opposition to the Republican plan to repeal the Affordable Care Act.The Alliance for Healthcare Security's print and digital ads will be running in major daily newspapers and websites in Alaska, Arizona, Maine, Nevada and Tennessee, as well as in D.C. The message is that repealing the health law without an immediate replacement is a risky move — the print ad uses an image of a person standing at the edge of an unfinished bridge over open water — that would cause a crisis. The ad says that 30 million people would lose insurance coverage, hospitals would lose $165 billion, premiums would skyrocket and states could be forced to raise taxes to cover Medicaid cuts. (Haberkorn, 12/12)

Meanwhile, President Barack Obama, liberal groups and WHO make the case for keeping the health law —

The Hill: Obama Urges Congress Not To Repeal ObamaCare
President Barack Obama on Saturday lauded the Affordable Care Act as a Republican-controlled Congress looks forward to its repeal.  During his weekly White House address, Obama encouraged Americans who don't currently have healthcare to enroll in the program, and said that he wants to "build on the progress we’ve made" with the law. (Vladimirov, 12/10)

The Hill: Liberal Groups Form Coalition To Fight ObamaCare Repeal 
Liberal groups are forming a new coalition to fight ObamaCare repeal and put pressure on congressional Republicans. The group, called the Protect Our Care Coalition, is made of groups including the Service Employees International Union, NAACP, National Council of La Raza and Families USA. The coalition is calling on Republicans to detail what their replacement for the Affordable Care Act (ACA) is before voting to repeal the law. (Sullivan, 12/9)

Reuters: WHO Urges Trump To Expand Obamacare, Ensure Healthcare For All
The World Health Organization (WHO) on Friday urged U.S. President-elect Donald Trump to expand Obamacare and ensure all Americans have access to healthcare. The real estate magnate takes office next month after promising to repeal outgoing President Barack Obama's signature healthcare policy which helped millions more Americans get medical insurance but has been a target of Republican attacks. (Nebehay, 12/9)

And from the states —

Nashville Tennessean: Trump, BCBST Loom Large As First Obamacare Deadline Approaches
Alan Hall sat with his laptop at the ready at Bellevue Public Library Sunday, prepared to help people navigate healthcare.gov as the first Health Insurance Marketplace deadline approaches this week. The deadline to sign up with a guaranteed Jan. 1 coverage start date is Dec. 15. Navigators around the state like Hall are preparing for a busy week. Listen to Hall speak for very long and it's a workshop on insurance, explaining co-insurance and the structure of plans' specialist and emergency room coverage, along with the random, odd personal fact — presumably the answer to a security question that won't be hard to remember. (Fletcher, 12/11)

St. Louis Post Dispatch: High Insurance Costs Sway Consumers To Consider Alternative Health Coverage Options
As health insurance costs climb, some consumers are turning to alternative products for coverage that can impose strict Christian-based moral expectations and are unregulated in many states including Missouri and Illinois. The alternative coverage may also lack some of the hallmark protections included in the Affordable Care Act, such as the requirement to cover individuals with pre-existing conditions. But with the alternative coverage, known as health care sharing ministries, consumers are exempt from paying a federal tax penalty for not having insurance. Consumers also can enroll in these plans any time during the year, not just during open enrollment like traditional insurance. (Liss, 12/11)

The Wall Street Journal: Insurers Step Up Lobbying With An Eye To Health-Law Changes
Health insurers are bracing for rapid changes to the Affordable Care Act, preparing contingency plans for their business and readying a full-court lobbying press as Congress looks to overturn swaths of the law as soon as January. Republican leaders in the House and Senate have promised quick action on the health law. They have said that much of the dismantling—and replacement—could take effect after a transition period of as long as a few years. (Wilde Mathews and Radnofsky, 12/11)

Boston Globe: Trump’s Insurance Idea May Have Unhealthy Side Effects 
In their quest to dismantle President Obama’s signature health care law and replace it with a new plan, President-elect Donald Trump and Republican leaders in Congress are pushing an idea long championed by conservatives: Allow health insurers to sell across state lines. It’s one of the few policy proposals Trump identified on the campaign trail, and it has the backing of House Speaker Paul Ryan, who included it in his “Better Way” health care plan. (Dayal McCluskey, 12/10)

Previous KHN coverage: Sounds Like A Good Idea? Selling Insurance Across State Lines

Bloomberg: Aetna CEO Denies Obamacare Pullout Driven By U.S. Merger Suit 
Aetna Inc. Chief Executive Officer Mark Bertolini defended the decision this year to withdraw from Obamacare markets, saying the move was driven by mounting losses and not the U.S. lawsuit against the health insurer’s planned takeover of Humana Inc. In testimony Friday in Washington, Bertolini disputed that Aetna’s pullout from the insurance exchanges was triggered by the Justice Department’s case. The insurer was projecting losses of $800 million to $900 million in 2017 from the exchanges and had to do something “to stop the bleeding,” he said. (McLaughlin, 12/9)

Reuters: Under Trump, Congress Likely To Pull Plug On Medical Device Tax
When Donald Trump takes over as president on Jan. 20, one of the first business tax breaks he delivers is likely to go to the U.S. medical device industry and companies like Mark Throdahl's. The chief executive of OrthoPediatrics Corp, based in northern Indiana, said his company has been able to hire more workers since the temporary suspension effective last January of a federal tax on medical devices. The tax was imposed as part of outgoing President Barack Obama's signature 2010 healthcare law. (Carey and Cornwell, 12/9)

The New York Times: ‘Restaurant Recession’ From Health Care Act? Little Evidence
Of all the policy positions taken by Andrew F. Puzder, the fast-food chief executive whom Donald J. Trump has chosen to be his secretary of labor, one he returns to with regularity is his passionate disdain for the Affordable Care Act and its effect on businesses and workers. In the last few months, Mr. Puzder has spoken out multiple times — in a speech before restaurant executives, on Fox Business, on the editorial page of The Wall Street Journal — about what he calls a “government-mandated restaurant recession.” He says the law has led to rising health insurance premiums, “reducing consumer spending, resulting in a reduction in restaurant visits.” (Scheiber and Strom, 12/9)

CQ Roll Call: Donors To HHS Nominee Price Have Stakes In FDA, CMS Decisions
Companies and trade groups that have donated to Rep. Tom Price’s campaign funds have major financial stakes in the decisions that he will oversee if confirmed as the next Health and Human Services secretary. Among the contributors to Price is a maker of placenta-based wound care products that’s in open conflict with a rival over Food and Drug Administration regulations. Based about a dozen miles from the Georgia Republican’s district office, MiMedx Group Inc. stands out among Price’s contributors for giving big money relative to its size. MiMedx donated $21,800 in the 2015-2016 campaign cycle to Price's campaign funds, according to a tally by the nonpartisan Center for Responsive Politics, putting it just behind the American Medical Association’s $22,000 contribution to the lawmaker's combined political accounts. (Young, 12/9)

Kaiser Health News: Price Poised To Protect Doctors’ Interests At HHS
In picking Tom Price to be secretary of Health and Human Services, Donald Trump has chosen an orthopedic surgeon who in his congressional career, has loyally promoted the interests of the medical profession — its freedom and importantly, its financial interests. A conservative representing Georgia’s 6th District, Price sponsored a 2015 bill that would restrict efforts to reduce doctor payments for medical services. He cosponsored another 2011 bill that would have limited reports used by hospitals and regulators to perform background checks used to screen doctors before hiring them. (Jewett and Taylor, 12/12)

Kaiser Health News: Five Quick Ways A New HHS Secretary Could Change The Course Of Health Policy
Prospective Health and Human Services Secretary Tom Price, currently the chairman of the House Budget Committee, brings a distinctive to-do list to the agency.  And, if confirmed by the Senate, he will have tremendous independent power to get things done. While he will report to the president, heads of major agencies like HHS — with a budget of more than $1 trillion for the current fiscal year — can interpret laws in different ways than their predecessors, and rewrite regulations and guidance, which is how many important policies are actually carried out. (Rovner, 12/9)

In other administration news —

Stat: Bipartisan Support Rises For Scott Gottlieb As FDA Commissioner
If the Trump team wanted to win passionate support for Dr. Scott Gottlieb to serve as FDA chief, they couldn’t have devised a better strategy than to float the name of another leading candidate: Jim O’Neill. Earlier this week, sources close to the Trump transition team said they were considering O’Neill, the managing director of an investment fund run by Peter Thiel, the billionaire Trump donor. (Kaplan, 12/9)

Stat: Francis Collins Says He Would Remain NIH Director Under Trump
The director of the National Institutes of Health said Friday that it would be a “privilege” to remain in that post if asked to stay by President-elect Donald Trump. “I’m somebody who believes in public service,” Dr. Francis Collins said in an interview with STAT. “If I were asked to stay on, I would consider it a privilege to do so. We have a mission and a vision that is captivating, yeah, I want to be part of that.” Collins said he had not yet been asked to stay. He said that if that call did not come, he would would likely return to the NIH lab he previously led, not far from his current headquarters on the campus in Bethesda, Md. (Scott and Kaplan, 12/9)

The New York Times: Abortion Foes, Emboldened By Trump, Promise ‘Onslaught’ Of Tough Restrictions
Christina Hagan, the youngest woman in the Ohio Legislature, received a surprise last week. The toughest piece of abortion legislation in the country — a bill she had championed for years — suddenly passed. The measure, which would ban abortions after a heartbeat is detected, as early as six weeks, was long presumed dead. But now that Donald J. Trump is headed to the White House, the political winds have changed, and it passed with overwhelming majorities. (Tavernise and Stolberg, 12/11)

Stat: Trump Win Could Boost Push To Define Fertilized Eggs As People
The push to confer full “personhood” status on every fertilized human egg has been rejected by voters and lawmakers in state after state, including deep-red Mississippi. But activists are cautiously hopeful that their cause could get a boost from Republicans who are about to assume leadership in Washington. Georgia Representative Tom Price, who has been tapped by President-elect Donald Trump to run the Department of Health and Human Services, has twice co-sponsored federal legislation that would define fertilized human eggs as legal persons — a move that would outlaw not just abortion, but also potentially birth control pills and other common methods of contraception. (Robbins, 12/9)

Columbus Dispatch: Planned Parenthood Says Support Up As Legislators Approve New Restrictions 
Support and donations to Planned Parenthood of Greater Ohio have surged in the wake of President-elect Donald Trump’s victory and the passage this week of two abortion-ban bills in the Ohio legislature, Planned Parenthood officials say. One bill would make abortions illegal in Ohio after 20 weeks of pregnancy. Another, the so-called Heartbeat Bill, would impose the nation’s strictest abortion law by outlawing the procedure once a fetal heartbeat can be detected, which is usually around six weeks. (Price, 12/10)

Politico Pro: Rhetoric Vs. Reality: The Hype Of 21st Century Cures
In a rare display of bipartisanship, a nearly 1,000 page, $6.3 billion medical research bill passed Congress this week. To hear lawmakers talk, the cure for hundreds of diseases are just around the corner. “Right now, there are 10,000 known diseases. We only have treatments for 500 of them. Cures will close that gap,” House Speaker Paul Ryan said of the 21st Century Cures Act on the House floor. “It will fundamentally transform the way that we treat and cure diseases in this country,” he added at a press conference on the bill. (Karlin-Smith, 12/9)

In other news from Capitol Hill —

CQ Roll Call: Senate Clears Water Bill And Flint Aid Package
The Senate early Saturday cleared a water resources bill that would authorize nearly $11.7 billion for water infrastructure projects and $170 million to help Flint, Mich., repair its lead-tainted drinking water system. The vote was 78-21. It followed soon after the chamber cleared a continuing resolution late Friday (HR 2028) that avoided a government shutdown at the end of the day. Senators spent most of Friday arguing over the miners' benefits that were part of the CR. (Fishler, 12/10)

Boston Globe: The San Antonio Way
This coalition in San Antonio has built a crisis center for psychiatric and substance abuse emergencies and a 22-acre campus for the homeless that resembles a community college. To date, more than 100,000 people have been diverted from jail and emergency rooms to treatment, local officials say, resulting in a savings of nearly $100 million over an eight-year period. Thousands of emergency responders in San Antonio and Bexar County have been trained to manage mental health crises. (Helman, Cramer, Russell, Rezendes and Wallack, 12/11)

Earlier KHN coverage: Wrestling With A Texas County’s Mental Health System (Gold, 8/20/2014) and San Antonio Police Have Radical Approach To Mental Illness: Treat It (Gold, 8/19/2014)

In other mental health news —

NPR: Pets Help People Manage Serious Mental Illnesses
Any pet owner will tell you that their animal companions comfort and sustain them when life gets rough. This may be especially true for people with serious mental illness, a study finds. When people with schizophrenia or bipolar disorder were asked who or what helped them manage the condition, many said it was pets that helped the most. "When I'm feeling really low they are wonderful because they won't leave my side for two days," one study participant with two dogs and two cats, "They just stay with me until I am ready to come out of it." (Ross, 12/9)

Los Angeles Times: Personality Trait Or Mental Disorder? The Same Genes May Weigh In On Both
You don’t need fancy genome-sequencing or brain-imaging equipment to know that some of the people we know and love are just a little, well, out there. We used to call these people “worriers,” “creative types,” “eccentrics” or “loners.” Like the rest of us, they seem to have come into the world with some recognizably fixed personality settings: They’re friendly or moody or dreamy or disorganized. They’re just more extremely so. (Healy, 12/9)

The Baltimore Sun: Thanksgiving Riot Shows Dangers At Maryland Mental Hospitals 
Workers in state hospitals and their union say the incident is only the most recent illustration of the dangers state employees face in Maryland health facilities. They say that many of the facilities are chronically understaffed and that staff members are ill-equipped and inadequately trained to deal with an increasingly dangerous population. The state Department of Health and Mental Hygiene, which operates Springfield and other state psychiatric facilities, says 90 percent of patients in its facilities are referred by the criminal justice system, up from 38 percent 15 years ago. (Dresser, 12/10)

The Washington Post: A Severe Birth Defect Linked To Zika Quadrupled In Colombia This Year
The number of babies born with microcephaly in Colombia during a Zika outbreak this year more than quadrupled from a year ago, dispelling earlier suggestions that the nation with the second-largest number of infections had somehow escaped the dreaded wave of fetal deformities witnessed in Brazil, the epicenter of the outbreak. In a report released Friday that provides the most detailed information about microcephaly prevalence to date in Colombia, health officials in that country and the Centers for Disease Control and Prevention said 476 cases of microcephaly were identified between February and mid-November, compared with 110 cases reported during the same period in 2015. (Sun, 12/9)

The Hill: Health Officials: Zika No Longer Actively Spreading In Florida
Florida Gov. Rick Scott (R) on Friday announced his state is officially cleared of any active zones of Zika virus transmission, ending a four-month public health threat. “Florida does not have any identified areas with active Zika transmission, which is incredible news for the Miami Beach community and our entire state,” Scott wrote in a press release. Miami Beach, a popular tourist destination, was the last remaining region of Florida considered an active zone of transmission for Zika. That final 1.5-mile stretch of the city is now cleared, which Scott said he hopes will reopen the flow of visitors. (Ferris, 12/9)

Texas Tribune: Texas Officials Confirm 4 More Locally Transmitted Zika Cases 
The Texas Department of State Health Services and the Cameron County Health Department announced Friday they've identified four more locally-transmitted cases of Zika in Cameron County. In late November, the first such case in Texas, contracted by mosquito bite, was reported out of Cameron County. (Silver, 12/9)

San Antonio Press Express: Communities Must Work Together To Prevent Zika From Spreading 
Health officials in Brownsville are knocking on every door in a neighborhood where a woman contracted the Zika virus from a mosquito bite. She hadn’t traveled to anywhere in the Caribbean or South America where the virus has exploded, nor had she been in contact with anyone who had. Since it wasn’t a travel-related case of infection, Texas became the second state to report a locally transmitted Zika case due to a mosquito bite. (Ratner, 12/11)

The Washington Post: Defeating Cancer Was Once A ‘War’; Now It’s A ‘Moonshot’
For more than a century, we have used military terms — such as wars, battles, survivors and victims — to discuss our relationship with cancer. But some critics are bothered by the implicit suggestion that those who die might not have fought heroically enough. When the Obama administration launched its anti-cancer effort earlier this year, “moonshot” rhetoric came to the fore, but that, too, drew dissent. Some say it suggests that curing cancer involves a massive engineering effort rather than a multitude of new insights into the biology of hundreds of different diseases. (McGinley, 12/9)

Los Angeles Times: Cooling Cap Helps Cancer Patients Preserve Their Hair During Chemotherapy, Clinical Trial Shows
It’s been one year since the Food and Drug Administration approved the first cooling cap system to help cancer patients in the U.S. preserve their hair during chemotherapy treatments. A new clinical trial strengthens the case that cooling caps really do reduce the risk of hair loss. Among 95 breast cancer patients who were randomly assigned to test a cooling cap, 48 — or 51% — still had a good amount of hair after four cycles of chemotherapy. Meanwhile, among 47 control patients who did not use a cooling cap, none had hair after four rounds of chemotherapy. (Kaplan, 12/9)

Los Angeles Times: Optimistic Women Are Less Likely To Die Prematurely Of Cancer Or Heart Disease, Study Says
Having an optimistic outlook on life could help you live longer, according to a new study. Researchers at Harvard University found that among a group of 70,000 female nurses, the 25% who were most optimistic had a 31% reduced risk of mortality while they were being tracked compared with the 25% who were least optimistic. (Netburn, 12/9)

The Washington Post: One-Third Of Long-Term Users Say They’re Hooked On Prescription Opioids
One-third of Americans who have taken prescription opioids for at least two months say they became addicted to, or physically dependent on, the powerful painkillers, according to a new Washington Post-Kaiser Family Foundation survey. Virtually all long-term users surveyed said that they were introduced to the drugs by a doctor’s prescription, not by friends or through illicit means. But more than 6 in 10 said doctors offered no advice on how or when to stop taking the drugs. And 1 in 5 said doctors provided insufficient information about the risk of side effects, including addiction. (Clement and Bernstein, 12/9)

The Wall Street Journal: Opioid Epidemic Is An Immediate Test For Donald Trump’s Administration
Donald Trump’s plans to tackle the opioid crisis are taking on new urgency as deaths from the drugs are rising sharply in the U.S. The number of deaths from heroin overdoses surged by 23% to 12,990 in 2015, while fatal overdoses from powerful synthetic opioids such as fentanyl rose by more than 73% to 9,580, the Centers for Disease Control and Prevention said Thursday. (Adamy, 12/9)

And in news on the epidemic from the states —

The New York Times: New Mothers Derailed By Drugs Find Support In New Hampshire Home
The young women, soon to be mothers, gathered around a big kitchen table, chatting excitedly about due dates and baby names and even morning sickness. But these were not typical expectant mothers. They had used opioids, mostly heroin and fentanyl. Many had been incarcerated. Few had families they could turn to for help, and the fathers of their babies were out of the picture. (Seelye, 12/11)

The Associated Press: Fentanyl Overdose Deaths In Delaware More Than Double
Delaware health and law enforcement officials say 90 people died from fentanyl overdoes through September, more than double the number who died in all of 2015. The Department of Health and Social Services Department of Safety and Homeland Security reported the statistics in a news release Friday. (12/10)

New Hampshire Union Leader: Remote Rehab -- Telehealth Helps Seniors Recover In Rural Areas 
Samuel Brown was laughing with co-workers when his legs suddenly gave out...A month later, the 86-year-old is rock climbing, playing soccer, and skiing - all without leaving the rehabilitation center where he is recovering. Brown is part of a program at the New Jewish Home in Manhattan's Upper West Side using a videogame console-like system outfitted with a Microsoft Kinect camera that monitors 25 points on his body. It tracks his movements and relays the data back to his health care team who can remotely watch his progress and adjust his program as necessary.(Grosky, 12/10)

The Star Tribune: Campaign Confronts Elderly Isolation, Which Carries Health Risks 
A dramatic increase in the number of elderly Americans living alone — combined with research showing the consequences of social isolation — has resulted in a new campaign to reduce social isolation among seniors. Prolonged isolation can be as big a health risk as smoking 15 cigarettes per day, according to the National Association of Area Agencies on Aging, which is encouraging adult children during the holidays to talk with their parents about remaining socially engaged. (Olson, 12/9)

Kaiser Health News: Home Caregivers Can Face A Steep Learning Curve
Dementia has been slowly stealing Ruth Perez's memory and thinking ability for 20 years. Her daughter, Angela Bobo, remembers when it was clear that her mother was never going to be the same. "She would put food together that didn't belong together — hamburger and fish in a pot. Mom never cooked like that," she says. (English, 12/12)

Stateline: How Disease Rates Vary By State — And What States Can Do About It
Health disparities based on race, income and gender tend to draw more notice, but variations related to where people live are attracting the attention of public health officials, who are using the information to craft more-targeted policies. As the data become more precise, health policy experts believe interventions to combat geographic disparities will become even more effective. The increasing interest comes amid a growing recognition that people’s health depends as much on geographic factors such as recreation, transportation, crime and unemployment as it does on what takes place in doctor’s offices or hospitals. (Ollove, 12/12)

The Associated Press: New CDC Data Understate Accidental Shooting Deaths Of Kids
Government statistics released this week claiming that 77 minors in the U.S. were killed by unintentional gun discharges last year significantly understate the scope of an enduring public health problem. A review of shootings nationwide by The Associated Press and USA TODAY Network found that at least 141 deaths of minors were attributed to unintentional or accidental shootings in 2015 — 83 percent higher than what the Centers for Disease Control reported. (Foley, 12/9)

Modern Healthcare: Back To Abstinence-Only Education For Teens? 
In 2008, the United Way of Greater Milwaukee & Waukesha County launched an initiative to lower Milwaukee's high rate of teen childbirths. That year, more than 5% of Milwaukee teens between 15 and 17 gave birth—double the national average. The campaign involved building communitywide awareness through the Milwaukee Health Department, local businesses, healthcare providers, schools and community groups. The goal was to cut the rate of teen pregnancies in half by 2015. Related Content More pregnancy stats: Data Points The centerpiece of the campaign was an eight-hour, evidence-based, sex education curriculum aimed at middle-school youth called “Making Proud Choices! A Safer Sex Approach to STDs, Teen Pregnancy, and HIV.” (Johnson, 12/10)

The Wall Street Journal: PepsiCo Wants To Sell Healthy Food, Consumers Want Chips
An array of new products at a trade show in Atlanta this fall told the story of two PepsiCos. Anchoring one part of the display was a fiber-filled nut and fruit bar called Init and a sparkling lemonade with real lemon juice called Lemon Lemon. Nearby sat an assemblage of bright bags of Mac N’ Cheetos, new frozen cheese sticks resembling Cheetos, and Top N Go Doritos, a portable meal designed to be eaten with a fork and high in salt and fat. (Esterl, 12/11)

The Baltimore Sun: Effects Of Traumatic Accident Last Long After Physical Wounds Heal 
Trauma from car accidents, falls, and sports and work injuries accounts for 41 million emergency room visits and 2 million hospital admissions a year, according to the National Trauma Institute. Trauma costs the U.S. economy more than $671 billion annually in health care costs and lost productivity.After enduring often long hospital stays and rehabilitation programs to recover physically, trauma patients return to lives very different from those they lived before their injuries. Many find it hard to cope. (McDaniels, 12/11)

Cleveland Plain Dealer: Preschools Should Start Young, Include Health Care And "Motherly Love," Study Finds
Preschool programs have greater effects the earlier they start, when they include some health care and when they encourage "motherly love," economist James Heckman said last week as he announced a new study of the benefits of early childhood programs. The analysis of the long-term gains from the so-called "Abecedarian" preschool experiment and a related program in North Carolina in the 1970s shows the programs brought more than a $6 return for every $1 spent. (O'Donnell, 12/12)

Chicago Tribune: 'Nightmare' Superbug Cases Rise In Illinois Health-Care Facilities - Chicago Tribune
Cases of a dangerous superbug increased 27 percent last year in a region surrounding Chicago, a new survey shows, but incidents were down in the city, and officials say they are making strides in containing the contagion. The state survey counted medical patients who tested positive for a germ known as CRE, short for carbapenem-resistant Enterobacteriaceae, which withstands many of the strongest antibiotics. It generally strikes at health-care facilities, often among the elderly and people who have serious illnesses or have had invasive medical procedures. (McCoppin, 12/10)

Cleveland Plain Dealer: Ohio Autism Insurance Coverage Mandate Approved By State Lawmakers 
Private insurers must cover Ohioans with autism spectrum disorders under a bill passed late Thursday by the Ohio General Assembly. The bill mandates any health insurance plan must provide coverage for the screening, diagnosis and treatment of autism spectrum disorder. It sets minimum coverage standards such as covering at least 20 speech or occupational therapy sessions a year. (Borchardt, 12/9)

Denver Post: Only One Staff Member Convicted After Thousands Of Incident Complaints At Pueblo Center For Disabled
Residents at a state-run center in Pueblo for the severely intellectually disabled were subjected to sexual assaults and ongoing physical abuse and neglect from 2012 to early 2016. Incidents ranging from patient discomfort to more severe allegations of abuse were reported at a rate of about 150 each month to the center’s staff during that time, according to federal records. In the end, just two staff members were charged criminally and only one was convicted. That was for the petty offense of making too much noise. At least 12 cases were investigated by the Pueblo County Sheriff’s Office. Eight employees were fired. (Osher, 12/9)

Boston Globe: Partners HealthCare Posts Record Operating Loss 
Partners HealthCare posted the biggest annual operating loss in its 22-year history, driven by red ink at Neighborhood Health Plan, a Medicaid insurer whose finances have deteriorated since Partners acquired it in 2012. The state’s largest health network said Friday that it lost $108 million on operations in the year that ended Sept. 30, reversing a profit of $106 million a year earlier. Revenue at the parent company of Massachusetts General and Brigham and Women’s hospitals rose 7 percent to $12.5 billion, but expenses grew at a faster clip. (Dayal McCluskey, 12/9)

New Hampshire Union Leader: Verdict Awards Couple $5M After Procedures Leave Woman Legally Blind 
A Derry couple won a $5 million verdict Friday after a jury found a Londonderry opthalmologist was found liable of committing medical malpractice for failed procedures that left a 67-year-old woman legally blind. Nancy Knox had been treated for the so-called wet form of age-related, macular degeneration, which can worsen someone’s vision, but often does not lead to blindness and can be treated. Dr. Adam Beck at New England Eye & Facial Specialists in Londonderry had Knox as a patient for eight years. First, Knox lost much of her vision in her left eye. She then not only lost the vision in her right eye, it had to be removed surgically because it had shrunk so badly following treatments that did not work. (Landrigan, 12/9)

Boston Globe: A Nursing Home Giant Stumbles Amid Expansion 
At the Maplewood Center in Amesbury, administrators in May acknowledged to inspectors that they were so short of certified nursing assistants, they had to use an activities director and an admissions executive to help feed patients. (Lazar, 12/11)

Arizona Republic: Smiles Everywhere: Free Dental Care In Phoenix Draws Thousands
In his second year at the event, [Dr. Kevin] Ortale focused on providing dentures for some of the thousands of patients who waited in line for hours Friday and Saturday in the hopes of relieving pain and infection they've suffered. (Mitchell, 12/10)

New Hampshire Union Leader: 2nd Class-Action Lawsuit Filed In NH Against Saint-Gobain 
A second class-action lawsuit has been filed against Saint-Gobain Performance Plastics here in New Hampshire — this time on behalf of several Merrimack residents who say they have been exposed to high levels of perfluorinated chemicals (PFC). The complaint filed on Monday includes about 15 adults and seven children, including a couple whose child has developed leukemia, and on behalf of other local residents dealing with contaminants in their water. All of the plaintiffs argue that they have a legitimate fear of developing cancer or other diseases as a result of the PFC contamination allegedly caused when Saint-Gobain released perfluorooctanoic acid (PFOA) into the environment. The chemical was ultimately detected in local water sources earlier this year. (Houghton, 12/9)

San Jose Mercury News: Experts: California's Marijuana Legalization Could Be Delayed
Right when it seems like “The Great Pot Moment” is upon us, it turns out there are a lot of really tough regulatory issues to resolve first, according to government and industry experts who sketched out all the thorny challenges at the two-day conference, competition and harvest celebration at the Sonoma County Fairgrounds. (Krieger, 12/11)

Sacramento Bee: Father Of Sick Nevada County Boy Works To Build California Network For Medical Marijuana Using Families 
Silas’ story, chronicled last spring in a Sacramento Bee series, The Silas Project, involved a controversial alternative medical experiment that began in mid-2014. Nevada County cannabis growers grew special strains for the child and crafted tinctures rich in a marijuana ingredient, CBD, or cannabidiol, a nonpsychoactive ingredient that, according to limited studies, may have medicinal benefits. (Hecht, 12/10)

The New York Times: Room For Debate: Can Donald Trump And His Team Fix Obamacare?
With President-elect Donald Trump’s decision to appoint Representative Tom Price as his secretary of health and human services, plans to repeal and replace the Affordable Care Act are no longer a matter of if, but when. There is no question that Obamacare could use some fixing, but are the Republican plans that Price and his colleague Speaker Paul Ryan have in mind the best approach to health care? (Tom Miller and Timothy Jost, 12/12)

Forbes: For Obamacare, 'Repeal & Delay' Isn't Just Republicans' Best Choice -- It's Their Only Choice
Republican leaders in Congress have announced their intention to repeal key parts of Obamacare in early 2017, but delay the implementation of that repeal until 2019 or 2020. Some conservatives are complaining about this delay, arguing that the GOP should replace Obamacare immediately. But GOP leadership is right—and here’s why. Republicans don’t have a shovel-ready replace plan. The fundamental problem is that in order to fully replace Obamacare, Republicans need to come up with a bipartisan plan that can attract the 60 votes necessary to overcome a Democratic filibuster. Given that Republicans don’t even agree among themselves as to how to replace Obamacare, it’s going to take them some time—at least a year or two—to figure out how to do that. (Avik Roy, 12/11)

The Washington Post: The GOP Could Wreck The Health-Care System, And Soon
The GOP’s emerging plan is to vote immediately to repeal much of the Affordable Care Act but not have the repeal take effect for a few years, giving Congress time to deal with the complexities of crafting and passing a replacement. This “repeal and delay” strategy may appear to be a reasonable way to minimize the negative effects of transitioning off Obamacare. It is not. The plan would represent a reckless act of congressional malpractice , threatening the well-being of millions of Americans. (12/10)

Los Angeles Times: The Coming Obamacare ‘Death Spiral,’ Brought To You By The GOP
Ever since the Affordable Care Act became law, critics have warned that it would cause a “death spiral” in the individual health insurance market. Those fears were unfounded, but if Republicans in Congress repeal the ACA without immediately replacing it, they might just cause one. ... But there are ways to avoid this potential chaos. One approach would be to hold off on voting to repeal the ACA until the Republicans settle on a replacement. That could put Republicans in a difficult position because they have promised to repeal the ACA quickly and have not yet reached consensus on an alternative. Another approach would be to leave the individual mandate in place and extend temporary mechanisms included in the ACA to stabilize the insurance market, providing subsidies to insurance companies that enroll high-cost patients and those that experience financial losses. (Larry Leavitt, 12/12)

Kansas City Star: A Totally Different Idea For U.S. Health Care System 
Our national health care “system” is a shambles. The problem isn’t just money — our annual per capita expenses already exceed every other Western country. According to 2014 data, we spent about $9,024 per person, while the next nine countries spent between $3,207 (Italy) and $6,787 (Switzerland). The money is there — it just isn’t in the right places at the right time. And still we have our uninsured millions going to hospital emergency rooms with a cold or the flu. ... We need to put the law of large numbers to work by not asking insurance companies to underwrite a smaller group with a disproportionate number of older and sick people in the pool. If the underwriting companies can’t make any money, they’ll exit the business — which is exactly what’s happening to the Affordable Care Act right now. (Michael Pandzik, 12/9)

Modern Healthcare: New Healthcare Reform Agenda Must Build On Gains Already Achieved
With the transition to a new administration well underway, the fate of the Affordable Care Act is weighing on everyone's mind. We've all heard the rhetoric of repeal and replace, but what will a new system look like? One thing remains clear: The challenges haven't changed. Healthcare costs continue to soak up budgets in families, states and the federal government. (Susan DeVore, 12/10)

The Wall Street Journal: Preexisting Conditions And Republican Plans To Replace Obamacare
Across the U.S., people who have cancer, heart disease, diabetes, or other serious conditions will want to know whether they or their sick family members will be able to get and afford coverage in the future. Their partisan views about Obamacare are likely to quickly be supplanted by these more practical concerns. And a substantial number of people could be affected. A Kaiser Family Foundation analysis to be released next week found that almost 30% of U.S. adults younger than 65 have health conditions that would have left them uninsurable in a pre-ACA world. (Drew Altman, 12/9)

Modern Healthcare: Making 'More Skin In The Game' For Patients Work
Asking patients to have “more skin in the game” can work, but not through high-deductible plans. Nearly 30% of the 150 million people in employer-based health insurance plans are now responsible for the first $1,000 or more of their healthcare costs. Most individual plans sold on the Obamacare exchanges have high deductibles. ... The economists' logic for making patients price-sensitive is that they will introduce market discipline to the delivery of healthcare services. Over time, as demand inevitably falls, it will force down the price of care. Unfortunately, the logic doesn't apply to healthcare that is not discretionary, i.e., most of healthcare. (Merrill Goozner, 12/10)

Forbes: Did Obamacare Cost Hillary The Election?
To be sure, national exit polls showed that the most important issues in this campaign were the economy (52%), terrorism (18%), immigration (13%) and foreign policy (13%). However, according to David Wasserman's definitive vote tallies at Cook Political Report, a swing of only 38,595 votes in 3 states (MI, PA, WI) would have given the election to Hillary Clinton. ... Voters in these states certainly had a reason to be upset. The 2017 premium increase for the second lowest-cost Silver plan facing 27-year-olds on the Obamacare exchanges was 7% in MI, 53% in PA and 16% in WI, averaging 22% nationally. ... the bottom line is that in the aggregate, Clinton's margin among those who accepted Obamacare as is or wanted it to go farther (923,270) was smaller than Trump's margin among those who thought Obamacare went too far (976,903). (Chris Conover, 12/10)

The New York Times: The Mental Health Crisis In Trump’s America
A few days after Donald J. Trump was elected president, I started getting anxious phone calls from some of my patients. They were not just worried about the direction President-elect Trump might take the nation, but about how they were going to fare, given their longstanding and serious mental illnesses. “Will I still have insurance and have my medications covered?” one depressed patient asked me. (Richard A. Friedman, 12/12)

The Washington Post: Medicaid Has Made A Huge Difference In My Patients’ Lives. Here’s How.
Over the past few weeks, there has been talk both of funding infrastructure projects and defunding Medicaid, at least in part. I recently saw a patient who reminded me that Medicaid itself provides an essential kind of infrastructure. His black beard pointed stiffly down his chest. At the middle of his sternum, it flowered out into plastic beads, strung on the dozens of rosaries he wore about his neck. Red, yellow and green beads flashed as he yelled, “Go, go, go on, and get me out of here.” (Abraham M. Nussbaum, 12/9)

The New York Times: Should I Lie About My Beliefs To Get Health Insurance?
Here's an ethical dilemma. If you could save your family more than $8,000 next year simply by signing a statement affirming belief in principles you find repugnant, would you? It sounds absurd. But in fact that’s the position I’m in this week, thanks to a loophole in the Patient Protection and Affordable Care Act, otherwise known as Obamacare. My health insurance poses a financial hardship to my family. All I have to do to lower my yearly bills by thousands of dollars is use my John Hancock to denounce gay marriage and a woman’s right to control her reproductive destiny. (Hillary Rosner, 12/10)

Forbes: New Evidence: Obamacare Is Not Saving Lives
Now, new data shows that a U.S. life expectancy dropped in 2015 – a year after the major provisions of the ACA went into effect – and for the first time since 1993, when the drop was attributed to the AIDS epidemic, a flu outbreak, and an spike in homicide rates. While the relationship between health insurance and mortality might still be debated – and it is certainly too early to say that the ACA is as bad as the AIDS epidemic – one thing is clear: There is no evidence that the ACA is, on net, saving lives. (Robert Book, 12/11)

The Washington Post: Ohio’s New Abortion Law Is An Assault On Roe. Here’s Why It Won’t Work.
Last June, abortion rights supporters groups celebrated what many viewed as the movement’s most important victory in decades. The Supreme Court’s decision in Whole Women’s Health v. Hellerstedt rejected a carefully crafted argument about the harm done to women by abortion. ... But before anyone had time to close the books on 2016, the opposing movements appear to have switched places. Antiabortion activists are now the ones with ambitious plans, as news from Ohio this Tuesday made clear. Energized by Trump’s election, the Ohio legislature passed a measure outlawing abortion when physicians could detect a fetal heartbeat — at roughly six weeks. (Mary Ziegler, 12/9)

Stat: Asking A Single Question Can Help Reduce Teen Pregnancy
"Would you like to become pregnant in the next year?” Asking teenage girls that question is one simple way to prevent unplanned pregnancies. The remarkable drop in birth rates among teenagers hides a large gap between urban and rural teens. Between 2007 and 2015, teen birth rates dropped 50 percent in large urban counties and just 37 percent in rural counties. We can do better. Most teen pregnancies are unplanned and unwanted. Increased use of birth control is the primary driver of fewer teenage pregnancies in urban and rural areas. So what explains the demographic difference? Formal sex education for teen boys and girls has fallen off since 2006, more in rural than urban areas. (Elise DeVore Berlan, 12/9)

Forbes: Watch Out Hospitals: Medicare's Planning To Punish You If You Misbehave
Soon, a significant chunk of hospital revenue will be at risk, under a series of Medicare pay-for-performance programs. The idea behind P4P (as the cool kids call it) is simple. ... High quality providers will receive more money than low quality ones, thereby giving providers an incentive to improve the quality of care they provide. ... Some people might think these programs should be abandoned, for being too flawed for prime time. For example, the programs hit a small percent of hospitals pretty hard. ... But it is too soon to abandon Medicare’s pay-for-performance programs. ... P4P seems to be doing what it expected – it’s motivating hospitals to improve the quality of care they provide. Rather than abandon these programs, we should improve them. (Peter Ubel, 12/9)

The Hill: E-Cigarettes Aren’t Safe For Our Kids 
Contrary to the belief of many, the aerosol produced by e-cigarettes is not harmless water vapor — it often contains nicotine and other chemical compounds that can have harmful effects on the user as well as those who inhale it secondhand. We know that nicotine can cross the placenta and have toxic effects on the developing fetus. Additionally, some say that use of e-cigarettes might protect young people from becoming cigarette smokers. But there is no evidence to support this claim.  Instead, there is evidence that millions more children are being exposed to nicotine through e-cigarettes. (Surgeon General Vivek H. Murthy, 12/9)

Jackson (Miss.) Clarion-Ledger: Keep People Healthy, Out Of Hospital To Cut Costs
The Legislative Budget Recommendations are out with a planned cut for Mississippi Medicaid for fiscal 2018 of 2.5 percent or almost $100 million. State leaders say they want to rein in state health care costs, or at least cost increases. However, since Mississippi gets 74.17 percent of our Medicaid dollars from the federal government, a full $1 billion state allocation would bring down $3 billion in matching federal funds to support the Mississippi health care system. It is hard to see how our state could pay our health care bills without those federal dollars, or reimburse the sorely needed new physicians going into practice around the state. (Lynn Evans, 12/11)

WBUR: Ethicist Dad: Passage Of 21st Century Cures Act Fills Me With Both Hope And Dread
But in 2008, after my daughter was officially declared cured and we’d used heparin for the last time, contamination in the supply from China killed 19 Americans and harmed many others. ... That heparin contamination was in part due to lax oversight of the drug supply chain. It reminds me why I do not want to see the work of the Food and Drug Administration compromised by overeager drug companies taking advantage of the hopes of desperate patients, and taking shortcuts on safety. The “giant piñata” of a bill, as science blogger Derek Lowe aptly described the 21st Century Cures Act, is destined to explode in unexpected ways. (Paul McLean, 12/9)

Richmond Times Dispatch: Why Care About Palliative Care?
Like any new physician, when I first became an Internal Medicine specialist about 20 years ago, I sometimes experienced mixed emotions. My enthusiasm for taking care of patients with complex medical problems was tempered by apprehension. Had I made the right diagnosis? Had I prescribed the right drugs? ... But with the support of colleagues and the encouragement of my many wonderful and loyal patients, these concerns seemed to fade over time. Yet even as my confidence increased, I realized there was one distinct gap in training and experience I needed to bridge: Helping to manage the pain and symptoms of patients with serious illnesses, and at times, caring for those under my care who were nearing the end of their lives. (Egidio Del Fabbro, 12/10)

Cleveland Plain Dealer: Heroin Addiction Continues To Drive Record Demand For Needles In Cuyahoga County
Last year, I wrote about another statistic to gauge the opiate problem in the county: The number of clean needles distributed by Circle Health Services, which has been operating Ohio's first syringe-exchange program since 1995. (Circle Health Services was formally known as the Free Clinic of Greater Cleveland, and changed its name recently to reflect changes to its health care offerings.) Circle Health Services' needle program allows drug users to trade used syringes for new ones. Cutting down on addicts' need to share dirty needles reduces the potential spread of blood-borne diseases such as hepatitis C and HIV. (Mark Naymik, 12/9)