Morning Briefing
Summaries of health policy coverage from major news organizations
From KFF Health News - Latest Stories:
KFF Health News Original Stories
High Praise: Pot Churches Proliferate As States Ease Access To Marijuana
Churches that offer marijuana as a sacrament are popping up across California and the U.S., vexing state and local officials who say they’re simply pot shops in disguise.
Reverberations From War Complicate Vietnam Veterans’ End-Of-Life Care
Vietnam veterans’ wartime experiences — and their lasting psychological toll — can make it harder to treat their physical and emotional pain as they approach death.
Summaries Of The News:
Health Law
'No Significant Deterioration' Is Expected In ACA Markets In 2018, Analysts Forecast
The Hill: Credit Rater Predicts Stable Year For ObamaCare Markets
The ObamaCare insurance markets will be relatively stable through 2018, analysts predicted Wednesday. Insurers have adapted to the uncertainty surrounding the Trump administration's handling of the law, A.M. Best, a global credit rating organization, wrote in a briefing released Wednesday. It said insurers should have a stable 2018. (Hellmann, 1/3)
Administration News
Trump's Nuclear Taunt Reignites Democrats' Chatter Over 25th Amendment, State Of His Mental Health
Politico: Washington's Growing Obsession: The 25th Amendment
Lawmakers concerned about President Donald Trump’s mental state summoned Yale University psychiatry professor Dr. Bandy X. Lee to Capitol Hill last month for two days of briefings about his recent behavior. In private meetings with more than a dozen members of Congress held on Dec. 5 and 6, Lee briefed lawmakers — all Democrats except for one Republican senator, whom Lee declined to identify. Her professional warning to Capitol Hill: “He’s going to unravel, and we are seeing the signs.” (Karni, 1/3)
In other news on the president, advocates are worried Trump's decision to fire his AIDS advisory council will result in a backslide on progress that's been made, and the White House reiterates its stance on entitlement cuts —
Politico: Trump's Firing Sets Back AIDS Prevention Efforts
President Donald Trump’s decision to fire his HIV/AIDS advisory panel and refusal to fill other key policy positions puts the U.S. at risk of slipping backward on prevention just as the opioid epidemic threatens to spread the virus among intravenous drug users. The advisory panel, which has existed in some form since the Reagan years, sits empty after Trump removed all 16 of its remaining members last week. (Ehley, 1/3)
The Hill: White House: Trump Hasn't Shifted On Not Cutting Entitlements
President Trump has not changed his position on protecting entitlement programs from funding cuts, White House press secretary Sarah Huckabee Sanders said Wednesday. After last month's GOP victory on tax reform, many Republicans are calling for changes to the social safety net as a way to cut government spending. But, asked about Trump's repeated campaign pledge to protect Social Security, Medicare and Medicaid, Sanders said he doesn't support cuts to the programs. (Hellmann, 1/3)
Public Health
In Nation's First Opioid Court, Goal Shifts From Punishing Defendants To Keeping Them Alive
The New York Times: This Judge Has A Mission: Keep Defendants Alive
There are two kinds of defendants who enter Judge Craig D. Hannah’s courtroom: Those who stand on the far side of the bench to have their cases considered in the usual way, and those invited to step closer. Close enough to shake the judge’s hand or shout obscenities in his face, depending on their mood that day. Both kinds are facing criminal charges, but those in the second group have volunteered to take part in an experiment where the primary goal is to save their lives. Arrested for crimes related to addiction, they are participants in what is believed to be the nation’s first opioid court. (Williams, 1/3)
California Healthline: Drug Overdose Deaths Plateau In California, Soar Nationally
Even as the opioid crisis fueled overdose deaths across the nation, the number of Californians who succumbed to these and other drugs has remained stable, new federal data show. Deaths from opiates, cocaine and methamphetamines shot up by 35 percent in the United States between the year ending in May 2015 and that ending in May 2017, according to a Kaiser Health News analysis of statistics from the Centers for Disease Control and Prevention. (Bartolone, 1/4)
Nashville Tennessean: Williamson County Files Lawsuit Against Opioid Manufacturers, Distributors
Williamson County filed a federal lawsuit against several drug manufacturers and distributors on Wednesday, alleging the companies failed to comply with the federal Controlled Substances Act. The lawsuit, filed in Tennessee's Middle District, names five of the nation's largest prescription opioid manufacturers and their related companies, as well as three major wholesale drug distributors, as defendants. (Sauber, 1/3)
San Francisco Chronicle: Effort Under Way To Make Naloxone Opioid Antidote More Accessible In State
Bay Area public health officials have begun receiving shipments of naloxone — the drug that reverses the effects of an opioid overdose — in the first state-funded effort to get the emergency antidote to local health departments across California. The distribution of the drug, funded by a one-time $3 million grant approved by state legislators in 2016, marks a ramp-up in the state’s response to deadly overdoses of prescription painkillers, heroin and the synthetic opioid fentanyl. (Ho, 1/3)
Lawsuit May Upend Local-First Mentality When It Comes To Organ Donations
Los Angeles Times: In A Turf Battle For Organs, A Policy Review Rattles The National Transplant System
Tethered to a breathing machine at a Manhattan hospital, 21-year-old Miriam Holman would die without a lung transplant. But her odds of finding a suitable organ were especially low in New York, where waiting times are among the longest in the country. Just across the Hudson River in New Jersey, patients in far better condition routinely receive lungs much more quickly. Pockets of the South and Midwest also have dramatically shorter waiting times. The disparities stem from a principle that has always guided the national transplant system: local first. Most organs stay in the areas where they are donated, even if sicker patients are waiting elsewhere. (Zarembo, 1/3)
Los Angeles Times: A Popular Sugar Additive May Have Fueled The Spread Of Not One But Two Superbugs
Two bacterial strains that have plagued hospitals around the country may have been at least partly fueled by a sugar additive in our food products, scientists say. Trehalose, a sugar that is added to a wide range of food products, could have allowed certain strains of Clostridium difficile to become far more virulent than they were before, a new study finds. The results, described in the journal Nature, highlight the unintended consequences of introducing otherwise harmless additives to the food supply. (Khan, 1/3)
Stat: He Wants To Upend The Nursing Home Industry — And Reinvent Senior Living
But here on the black-stone edge of a gloomy Cayuga Lake stood the pioneering geriatrician Dr. Bill Thomas, a few feet away from his weapon of choice in this battle: a 330-square-foot, plywood-boned home he calls a Minka. ...The idea sounds, in one sense, simple: create and market small, senior-friendly houses like this one and sell them for around $75,000, clustered like mushrooms in tight groups or tucked onto a homeowner’s existing property so caregivers or children can occupy the larger house and help when needed. (Tedeschi, 1/4)
The New York Times: The Hospital Gown Gets A Modest Makeover
As 2018 dawns and with it the new tax plan, the future of health care for many individuals remains uncertain. But there is at least one type of improvement in coverage Americans can look forward to: the end of the dreaded exposed rear end, that hospital cliché created by back-tying gowns that has been immortalized in movies including “Something’s Gotta Give” (courtesy of a medicated Jack Nicholson stumbling down the hallway) to “Yes Man” (Jim Carrey this time, spotted on the back of a motorcycle). The fashion world has woken up to a new dressing opportunity. (Safronova, 1/3)
The Washington Post: ‘Raw Water’ Is The Latest Health Craze. Here’s Why Drinking It May Be A Bad Idea.
Hold your canteen under a natural spring and you'll come away with crystal clear water, potentially brimming with beneficial bacteria as well as minerals from the earth. That's what proponents of the “raw water” movement are banking on — selling people on the idea of drinking water that contains the things they say nature intended without the chemicals, such as chlorine, often used in urban water treatment processes. In some areas of the country, including the West Coast, it has become a high-dollar commodity — water captured in glass bottles and sold straight to you. (Bever, 1/3)
PBS NewsHour: This New Treatment Could Make Your Next Trip To The Dentist More Bearable
A new method of treating tooth decay using silver nitrate may make the pain, and expense, of traditional treatments obsolete. (Wise, 1/3)
Georgia Health News: Sudden Meat Allergy May Come From Surprising Source
Researchers think the alpha-gal allergy is caused by a bite from the Lone Star tick. There’s no definitive proof of that, but there is strong circumstantial evidence. Dr. Scott Commins, an allergist and researcher at the University of North Carolina at Chapel Hill, said the thing that most alpha-gal allergy patients seem to have in common is a history of tick bites. (Knight, 1/3)
Vast Geographical, Ethnic Disparities In Infant Mortality Continue To Plague U.S.
CNN: Infant Mortality: States With The Highest Rates
There's good and bad news when it comes to infant mortality in the United States. Infant mortality, or the death of a baby before his or her 1st birthday, has declined in recent years across the nation and around the world. Yet disparities persist across states, according to a report released by the Centers for Disease Control and Prevention's National Center for Health Statistics on Thursday. (Howard, 1/4)
Columbus Dispatch: Ohio Near Bottom In Black Infant Mortality
Ohio ranked next to last among the 50 states and the District of Columbia with 13.46 deaths for every 1,000 live births to black mothers from 2013 to 2015. That’s more than double the state’s infant-mortality rate of 5.76 for babies born to white mothers during the same period, according to data released Thursday by the National Center for Health Statistics. (Candisky, 1/4)
In other news on infant health —
Milwaukee Journal Sentinel: Navigating The Co-Sleeping Debate As A Breastfeeding Mother
The issue of sharing a bed with a baby, known as co-sleeping or bed-sharing, is hotly debated in parenting communities. While hospitals and medical providers in the United States almost uniformly discourage bed-sharing, the practice remains popular among parents. (Ledbetter, 1/3)
Health Care Personnel
Evolving Gender Roles, Shrinking Job Opportunities Are Helping Shift More Men Into Nursing
The New York Times: ‘Forget About The Stigma’: Male Nurses Explain Why Nursing Is A Job Of The Future For Men
Jake Creviston, a nurse practitioner, has been repeatedly mistaken for a doctor. Adam White says the veterans he cares for as a student nurse at the V.A. hospital feel comfortable around him because “I’m a big burly guy with a beard. ”Glenn Fletcher, after being laid off from a lumber mill during the financial crisis, found a new career in nursing. And with it, “a really good feeling putting your head on the pillow realizing you’ve helped other people.” (Miller and Fremson, 1/4)
State Watch
Depending On Where You Live In Minnesota, Medical Treatments Could Cost You 8 Times As Much
Pioneer Press: Need A Knee Replacement? It Costs $46,974 At One Minnesota Hospital And $6,186 At Another
Minnesotans could pay up to eight times more for certain medical procedures depending on the hospital they choose, but it’s hard to know which facilities offer the most affordable services. That’s the take away from a report released Wednesday by the Minnesota Department of Health aimed at making health care costs more transparent. Researchers examined the wide range of prices Minnesotans pay hospitals for four procedures — hip and knee replacements and normal and C-section births. (Magan, 1/3)
The Star Tribune: Minn. Study Shows Surgery Costs Vary Widely: $6,200 To $47,000 For Knee Replacement
Knee replacements are a standard procedure at many hospitals, but there's nothing standard about the price. Minnesota insurers paid as much as $47,000 for a patient's total knee replacement and as little as $6,200 — a nearly eight-fold price difference, according to a study released Wednesday by the Minnesota Department of Health. (Howatt, 1/3)
Minnesota Public Radio: Report Finds 'Huge Swings' In Minnesota Hospital Charges
"Employers have long suspected that there is a great deal of variation in both the quality and the cost of health care," Pare said in a statement. "But to be able to see the actual numbers provides them an opportunity to make better purchasing decisions. Employers can also help employees and their family members identify and access more affordable care." (Moylan, 1/3)
State Highlights: N.H. Hospitals Hit Hard By IV Bag Shortages Linked To Hurricane Maria; Partners HealthCare’s Plan To Acquire Hospital To Get AG Scrutiny
New Hampshire Public Radio: N.H. Hospitals Sound Alarm Over Supply Shortages Tied To Hurricane Maria
At Weeks and other hospitals across the state, pharmacy managers like Eddy have spent the last three months scrambling to deal with an unexpected fallout from the September storm that knocked out power to Puerto Rico: a backlog in the supplies they need to perform all kinds of routine medical procedures, from IV drips to surgeries. As FDA Commissioner Scott Gottlieb testified to Congress in October, Puerto Rico plays a critical role in the whole country’s supply of medical products. (McDermott, 1/3)
Boston Globe: AG Maura Healey To Review Partners’ Plan To Buy Mass. Eye And Ear
A state health care watchdog agency Wednesday asked Attorney General Maura Healey to review Partners HealthCare’s plan to acquire a specialty eye and ear hospital, saying the deal would raise medical costs substantially. The Health Policy Commission said Partners’ takeover of Massachusetts Eye and Ear would boost health spending by as much as $61 million a year — expenses that ultimately would be borne by consumers and businesses. (Dayal McCluskey, 1/3)
Marketplace: Inpatient Care Could End At Nashville's Safety Net Hospital
Public hospitals are often cash-strapped. And in Nashville, the city's safety net facility is seen by many as an unnecessary money pit. Now the mayor has proposed ending the inpatient part of the hospital and rethinking the city's role in caring for the uninsured. (Farmer, 1/3)
The Associated Press: Lawyers Seek To Ease Doctor’s Sentence For Medicare Fraud
Even though a politically prominent Florida eye doctor was convicted of Medicare fraud, that doesn’t mean the federal government lost more than $100 million as prosecutors contend, his attorneys argued Wednesday as they tried to save him from a lengthy prison sentence. Dr. Salomon Melgen may have told Medicare he was treating patients for diseases they didn’t have but they did have other eye diseases and benefited from the treatment they received, attorneys Matthew Menchel and Josh Sheptow told U.S. District Judge Kenneth A. Marra. (Spencer, 1/3)
Houston Chronicle: Central Care's 6 Clinics Could Close Next Week After Funding Loss
A network of Houston health centers serving vulnerable residents has sued the federal government to prevent the loss of funding that local officials say would close six clinics as early as next week. Central Care Integrated Health Services obtained a temporary restraining order in late December against the U.S. Department of Health and Human Services' acting secretary to extend the terms of an operating grant until Monday. A hearing is set before Chief U.S. District Judge Lee Rosenthal in Houston Monday, and an amended lawsuit filed Jan. 1 seeks to continue federal funding beyond that point. (George, 1/3)
Modern Healthcare: Hackensack Meridian And JFK Cement Merger
Hackensack Meridian Health and JFK Health finalized their merger to create a combined entity with 16 hospitals throughout New Jersey, the companies announced Wednesday. Executives of the Edison, N.J.-based systems said the marriage would allow them to expand patient access and better deliver preventive healthcare. The merger will bolster a combined ambulatory network of 160 facilities, reflecting the importance of more convenient outpatient settings where patients can get more affordable and efficient treatment. (Kacik, 1/3)
Texas Tribune: Relatives Report Inadequate Heating At More Than 30 Texas Prisons
More than 30 Texas prisons had heating issues during a cold snap that brought freezing temperatures to much of the state this week, according to reports by inmates’ family members. The Texas Inmate Families Association, a support and advocacy group, compiled reports by inmates' relatives that blamed poor insulation, broken windows and nonfunctioning heaters for the cold conditions in the facilities. (McCullough, 1/3)
Editorials And Opinions
Thoughts On Curbing The Opioid Epidemic: Not All 'Well-Intentioned' Battle Plans Are 'Good Ideas'
JAMA Forum: A New Year’s Wish On Opioids
As overdose deaths mount, leading to a decline in US life expectancy 2 years in a row, my New Year’s wish is for more people to appreciate this statement: Not all well-intentioned approaches to addressing the opioid epidemic are good ideas. Some are based on evidence and experience, others on misunderstanding, blame, fear, or frustration. What’s needed in 2018 is the wisdom—and the courage—to tell the difference. (Joshua M. Sharfstein, 1/3)
USA Today: We Mobilized Against Flu, Cancer And Heart Attacks. Where's The Urgency On Opioids?
Our nation is not yet succeeding in addressing the opioid crisis, as exemplified by the latest drug overdose numbers just released by the Centers for Disease Control and Prevention (CDC). In 2016, we lost more than 63,000 Americans to drug overdoses broadly, an increase of 21% over the previous year. The relentless devastation is being felt by far too many families and communities. The country’s response to this problem has been hampered by our failure to recognize addiction as a disease that requires comprehensive health solutions. (Barry McCaffrey and Jessica Hulsey Nickel, 1/4)
The Wall Street Journal: The Opioid Crisis Has Plaintiff Lawyers Smelling Cash
America’s unrivaled pharmaceutical industry develops and manufactures more than half of the world’s new medicines and treatments. Its global dominance is due in part to the largely unregulated prices and uncapped profit margins that make America the world’s most lucrative market. Yet Big Pharma has an image problem: The industry has been tainted by the opioid crisis. (Dennis Kneale, 1/3)
Viewpoints: The Medical Device Tax's Comeback; 2018 Brings Fresh Health Policy Choices, Controversies
The Wall Street Journal: Happy New Year’s Tax
The medical device tax apparently has more comebacks than Mariah Carey. In the first minutes of 2018, while the pop star was redeeming herself on ABC for her widely panned New Year’s Eve performance the year before, the 2.3% excise tax had its own comeback after Congress had suspended implementation for two years. The tax was originally imposed in 2013 to fund Obama Care. But it proved unpopular, and not only among Republicans. Democrats from states with medical device companies squawked too. Even Al Franken, the unlamented former Senator from Minnesota, had vowed to fight this “unfair burden on the medical device industry.” (1/3)
USA Today: Your Health Care And GOP Majority Are At Stake In Congress Starting Now
This new year brings brings fresh choices and fresh controversies in health care. President Trump and Republicans tried last year to repeal the Affordable Care Act and, when that failed, to chip away at the law in other ways. But in the end, with no legislation passed, the principal result was to galvanize a once ambivalent public. Now we enter 2018 with health care as a top concern of American voters and the ACA as popular as ever. More importantly, Americans recognize the ACA’s flaws and by large margins just want them to be fixed. Take it from me, the backlash is coming. Serious proposals from both sides should be listened to. (Andy Slavitt, 1/3)
NorthJersey.com: Medicare Penalties And Improving Patient Safety
Often lost in the heated rhetoric toward the Affordable Care Act -- whipped into high flame by President Donald Trump and his hard-line Republican allies in Congress -- are the lesser known accountability measures the original act contained. Among them is a mechanism aimed at prodding hospitals into taking steps to improve patient care. (1/3)
Axios: Don’t Read Too Much Into Health Care’s High Poll Rankings
An AP/NORC poll published late in December found that health care ranked number one on the list of the public's priorities for government. It's a well done and well reported poll, and as the head of a health policy and journalism organization, I suppose I should be happy that health ranked number one. Yes, but: Having conducted and watched health care polling for decades, I'd caution readers not to over-interpret health care's first place finish, which may not mean very much for upcoming elections. They are unlikely to be about health care and are much more likely to be about the candidates and President Trump. (Drew Altman, 1/4)
The Kansas City Star: Are Missouri Prisons Prepared For Mass Nicotine Withdrawal When Smoking Ban Takes Effect?
Our first reaction to the news that the Missouri Department of Corrections will soon ban smoking in the state’s prisons was: Wait, you can smoke in prison? Yes, making Missouri one of only a few states where the official view on prisoners lighting up has been smoke ‘em if you got ‘em, boys. And they do got ‘em, because they’re sold in all the prison canteens. (1/3)
JAMA: A Piece of My Mind: The Envelope
When I move to shake hands with Jack, a 70-year-old new patient and my last of the morning, I see the large white envelope. Records, most likely. Perhaps because of noticing the way he clings to it, or perceiving his urgency, I interrupt my usual routine of logging on to the computer and preparing the history template. “Is that something you would like me to see?” I ask, eyeing the envelope. He hands it to me, looking relieved. ... I write a brief synopsis of our discussion in the chart after Jack leaves and recall being taught that the most important clues to the diagnosis usually come from the history. “Just listen to your patient, and he will tell you what the diagnosis is” was the proverbial teaching wisdom. But there is something missing in that statement: the patient must feel that I am interested. (Jeffrey H. Millstein, 1/2)
Bloomberg: A 2018 Pharma Deal Revival Is No Sure Thing
Last year was the sector's third straight year of sequential deal-volume decline and the slowest since 2013. And the $95 billion deal total for the year is a little flattering -- 31 percent of that came from Johnson & Johnson's purchase of Actelion. The good news is that most of the potential M&A drivers I mentioned last year are still intact. There's a lot of money sitting around -- cash stashes have grown for just about everyone but Johnson & Johnson and Gilead Sciences Inc., which both made sizable acquisitions last year. Limited patent lives and the high and growing rate of R&D failure mean big pharma is constantly hungry for new drugs and drug candidates. And debt is cheap. (Max Nisen, 1/3)
Los Angeles Times: Writer Laurie Kilmartin Shows Americans How Badly They 'Suck' At Handling Death
Do you know what we’re bad at in this country? Death. Not the act of dying, but dealing with it. The Victorians were horrified by sex but practically fetishized death, and we do just the opposite. Sex is one of our major cultural food groups, but death? Death, we treat like it’s some embarrassing lifestyle choice. Maybe Laurie Kilmartin can help. She’s a TV comedy writer, and in 2014, as her father was dying, she tweeted about it, from bedside to graveside. From that comes her new book, “Dead People Suck: A Guide for Survivors of the Newly Departed.” (Patt Morrison, 1/3)