- KFF Health News Original Stories 2
- Beyond Birth Control, Women Could Pay More For Insurance Again Under TrumpCare
- Deadly Infections Linked To Heart Surgery Device Highlight Holes In FDA Monitoring
- Political Cartoon: 'Bad Actors'
- Capitol Watch 1
- Warren Says Big Pharma Has Hijacked Cures Bill: 'I Know Difference Between Compromise And Extortion'
- Marketplace 2
- Fresh Details Of Behind-The-Scenes Rift Between Anthem, Cigna Revealed
- Zenefits Slammed With $7M Fine From California Insurance Regulator
- Veterans' Health Care 1
- 'I Appreciate Your Sacrifice': Obama Makes Likely Last Visit To Walter Reed As President
- Women’s Health 1
- With GOP In Control, Planned Parenthood Defunding Becomes Question Of 'When' Not 'If'
- Public Health 5
- Texas Confirms Locally Transmitted Zika Case: 'We Knew It Was Only A Matter Of Time'
- Myriad Stokes Unfounded Fears That Competitors' BRCA Cancer Tests Are Faulty
- How One Man's Addiction Took Him To 'Rock Bottom' -- And How He Dug Himself Out
- Computer, Cell Phone Use Linked To Better Health Among Older Generation
- Scientists Shift Focus To Understanding Root Of Allergies Instead Of Treating Symptoms
- State Watch 2
- Boston Children's To Partner With GE To Improve Interpretation Of Young Patient's Brain Scans
- State Highlights: Questions Surround Top Health Officials In Oregon, Florida; Colo. Physicians Prepare For New Aid-In-Dying Law
From KFF Health News - Latest Stories:
The federal health law offered new coverage guarantees for women, and some advocates fear they could change under Republicans’ efforts to “repeal and replace” the Affordable Care Act. (Michelle Andrews, )
The federal agency took 14 months to warn the public about the potential for infections. Officials say they acted as fast as they could. (Chad Terhune and Christina Jewett, )
KFF Health News provides a fresh take on health policy developments with "Political Cartoon: 'Bad Actors'" by Joel Pett.
Here's today's health policy haiku:
WATCHING 21ST CENTURY CURES
Looking for a cure …
Or maybe a lobbyist?
Just check this bill out.
If you have a health policy haiku to share, please Contact Us and let us know if we can include your name. Haikus follow the format of 5-7-5 syllables. We give extra brownie points if you link back to an original story.
Opinions expressed in haikus and cartoons are solely the author's and do not reflect the opinions of KFF Health News or KFF.
Summaries Of The News:
Rep. Tom Price, an orthopedic surgeon from Georgia, has introduced bills offering a detailed, comprehensive replacement plan in every Congress since 2009. Donald Trump also names consultant Seema Verma to lead the Centers for Medicare and Medicaid Services.
The New York Times:
Tom Price, Obamacare Critic, Is Said To Be Trump’s Choice For Health Secretary
If President-elect Donald J. Trump wanted a cabinet secretary who could help him dismantle and replace President Obama’s health care law, he could not have found anyone more prepared than Representative Tom Price, who has been studying how to accomplish that goal for more than six years. Mr. Price, an orthopedic surgeon who represents many of the northern suburbs of Atlanta, speaks with the self-assurance of a doctor about to perform another joint-replacement procedure. He knows the task and will proceed with brisk efficiency. (Pear, 11/28)
The Associated Press:
Tom Price Tapped As HHS Head
President-elect Donald Trump has selected Georgia Rep. Tom Price, a leading critic of President Barack Obama's sweeping health care law, to head the Department of Health and Human Services, according to a person familiar with the decision. If confirmed by the Senate, Price would play a central role in Republican efforts to repeal and replace the current health care law. Trump has pledged to move quickly on overhauling the landmark measure, but has been vague about what he hopes to see in a replacement bill. (Pace, 11/29)
Trump Looks To Obamacare Critic To Overhaul Healthcare
U.S. President-elect Donald Trump named a vociferous critic of Obamacare and a policy consultant on Tuesday to help him overhaul the healthcare system that Republicans have targeted since Democrats enacted sweeping reforms in 2010. Republican Representative Tom Price, an orthopedic surgeon from Georgia, will be Trump's Health and Human Services (HHS) secretary, and consultant Seema Verma will lead the Centers for Medicare and Medicaid Services, a powerful agency that oversees government health programs and insurance standards. (Holland, 11/29)
Rep. Tom Price Is Trump's Pick For Health And Human Services Dept.
A six-term member of Congress and an orthopedic surgeon, Price is a frequent critic of the health care law that Obama signed in 2010. “Premiums have gone up, not down," he has said. "Many Americans lost the health coverage they were told time and time again by the president that they could keep. Choices are fewer.” Price, 62, received his doctorate from the University of Michigan and started his career as an orthopedic surgeon in Roswell, Ga. Two decades later, he ran for office as a Republican. He was elected to the State Senate in 1996. (Jackson and Solis, 11/29)
Trump Picks Tom Price To Lead Health And Human Services
“There is much work to be done to ensure we have a health care system that works for patients, families, and doctors; that leads the world in the cure and prevention of illness; and that is based on sensible rules to protect the well-being of the country while embracing its innovative spirit,” Price said in a statement. (Edney, House and Jacobs, 11/28)
Trump Chooses Rep. Tom Price, An Obamacare Foe, To Run HHS
Politically, Price is conservative. He opposes abortion rights, receiving a 2016 rating of 0 by Planned Parenthood and 100 percent by National Right to Life. He has voted against legislation aimed at prohibiting job discrimination based on sexual orientation; for a constitutional amendment to define marriage as between one man and one woman; and against the bill that would've ended the don't-ask-don't-tell policy regarding disclosure of sexual orientation in the military. (Neel, 11/28)
The Washington Post:
Trump Names Rep. Tom Price As Next HHS Secretary
One of the 18 members of the House GOP Doctors Caucus, Price also supports major changes to both Medicaid and Medicare, health insurance pillars of the Great Society programs of the 1960s. Under his vision, both programs would cease to be entitlements that require them to provide coverage to every person who qualifies. Instead, like many House Republicans, he wants to convert Medicaid into block grants to states – which would give them more latitude from federal requirements about eligibility rules and the medical services that must be covered for low-income Americans. This plan would also require “able-bodied” applicants to meet work requirements in order to receive health care benefits — an idea that the Obama administration has consistently rebuffed. (Goldstein and Rucker, 11/29)
The Wall Street Journal:
Donald Trump Chooses Tom Price as Health Secretary
[Price] has championed his own legislation, the Empowering Patients First Act, since 2009, taking a position on a number of hot-button issues for conservative health policy thinkers. In its latest iteration, the proposal includes refundable, age-adjusted tax credits for people to buy insurance if they don’t have access to coverage through an employer or government program. People in a government program, such as Medicare, Medicaid or Tricare, would also be allowed to opt out of it and get tax credits toward the cost of private coverage instead. (Radnofsky and Nicholas, 11/28)
Trump Picks Rep. Tom Price For HHS Secretary, Verma For CMS
Experts have also guessed he would concentrate on state reform efforts and noted he has worked across the aisle. Price has been a strong supporter of looking to state governments for proposals of how to spend their healthcare dollars, even if the ideas are more left-leaning than he might personally advocate. (11/28)
Los Angeles Times:
Trump Chooses Conservative Georgia Congressman, A Harsh Critic Of Obamacare, To Be Health Secretary
As a leading member of the tea party caucus in the House, Price has led calls for dramatically cutting federal programs, particularly for low- and moderate-income Americans, and for repealing and replacing Obamacare, which he has called “monstrous legislation.” “Repealing this misbegotten monstrosity is the first step toward real healthcare reforms that empower patients and actually reduce costs,” he said a few months after Obama signed the health law in 2010. (Levey, 11/28)
Price Picked To Lead HHS
An early Trump supporter, Price endorsed the president-elect in May. Price also campaigned with Trump at an Obamacare repeal rally a week before the election. "The things that we all believe about health care — we want a system that is affordable for everybody, that is accessible for everybody, that is of the highest quality and provides choices for patients — all of those things have been destroyed by Obamacare," Price said at the rally. That is "why we need Donald Trump and Mike Pence to work with us and make sure we put in place a real health solution.” (Haberkorn, 11/28)
Trump Announces Selection Of Tom Price For Health Secretary
But Price’s departure will also leave a major vacancy at the top of the budget committee at a time when GOP leaders will be pushing Congress’s budget rules to the limits. ... Price emerged as a top contender for HHS secretary earlier this month, beating out competitors such as former Louisiana Gov. Bobby Jindal and former Utah Gov. Mike Leavitt (R), who is advising Trump’s transition team. (Hensch and Ferris, 11/28)
Among aspects of the legislation that Sen. Elizabeth Warren, D-Mass., finds problematic are a provision that would roll back requirements for doctors to report some “Sunshine Act” payments from drug companies, a measure that would permit drug companies to market drugs for unapproved uses as legalized fraud and provisions designed to speed approval for stem cell therapies.
Elizabeth Warren Rips 21st Century Cures Bill, Vows To Fight It
Senator Elizabeth Warren on Monday railed against legislation that would ease standards for new drugs and medical devices, saying the bill had been “hijacked” by the pharmaceutical industry. With the legislation headed for a possible vote in the House this week, the Massachusetts senator accused Republican lawmakers of trying to extort Democrats by tying additional funds for medical research to the bill, known as the 21st Century Cures Act. “I cannot vote for this bill,’’ Warren said on the Senate floor, speaking to a largely empty chamber. “I will fight it because I know the difference between compromise and extortion.” (Kaplan, 11/28)
The Associated Press:
Sen. Warren Blasts Drug Approval Bill As 'Extortion'
Sen. Elizabeth Warren has delivered a ferocious attack on congressional Republicans and Senate Majority Leader Mitch McConnell over a medical research bill, putting fellow Democrats on the spot by pushing them to oppose a measure she said "is corrupt, and it is very, very dangerous." As Congress began the final stretch of its post-election session, Warren said the 996-page measure — a top priority for GOP leaders and backed by the biomedical industry — was riddled with provisions that she called "a bunch of special giveaways" to big pharmaceutical companies. (11/29)
Warren Slams Cures Bill As Handout To 'Big Pharma'
Sen. Elizabeth Warren (D-Mass.) on Monday slammed a bipartisan medical innovation bill as a handout to “Big Pharma,” saying on the Senate floor that she would oppose the measure. Warren, a leading progressive champion, accused Republicans of going back on their deal to balance measures to speed up the approval process for new drugs with more money for medical research. She said the funding in the latest version of the bill, $4.8 billion over 10 years, is far too little for what is needed at the National Institutes of Health and other agencies. (Sullivan, 11/28)
21st Century Cures Would Require Pharma To Post Policies On Experimental Drugs
In a nod to patients clamoring for greater access to experimental medicines, the 21st Century Cures legislation would require companies to publicly disclose their policies for making such drugs available. The language in the bill, which is designed to jump start medical innovation, appeared after complaints that many drug makers make it difficult for patients and their physicians to sort out the process for gaining access to medicines that are not yet approved for use by the US Food and Drug Administration. (Silverman, 11/28)
House ’Cures’ Package Could Hit Potholes In Senate
An expansive plan to spur the development of new medical treatments that’s on the fast track in the House could encounter resistance on the other side of the Capitol over disclosure requirements and the way the legislation is funded. ... The updated package would direct $4.8 billion in funding over a decade to the National Institutes of Health. The bill would include $1.4 billion for President Barack Obama’s Precision Medicine Initiative, $1.8 billion for Vice President Joseph R. Biden Jr.’s cancer “moonshot” program and $1.6 billion for a program focused on enhanced understanding of brain-related diseases like Alzheimer’s. The bill would be paid for mostly through sales of the U.S. strategic petroleum reserve and a fund created in the 2010 health care overhaul intended to promote disease prevention and public health. While the earlier version would have provided $8.75 billion in mandatory funding for the NIH, the new text would instead create several “innovation” funds. Each year, appropriators would need to endorse any withdrawals from those accounts. The switch has caused some concern among liberals such as Democratic Sen. Elizabeth Warren of Massachusetts. (Williams, 11/29)
Grassley Threatens To Hold Up Cures If Disclosure Requirements Are Weakened
Sen. Chuck Grassley (R-Iowa) says he will object to the Senate passing a major health care bill by unanimous consent because it would weaken disclosure requirements between industry players and health care providers. The 21st Century Cures Act currently includes a provision that would exempt drug and device makers from disclosing additional payments to health care providers. Grassley says that would result in less transparency in the health care industry. (McIntire, 11/28)
The New York Times:
$6.3 Billion Measure Aims To Cure Ailing Health Care Policies
In one of the most sweeping and rare bipartisan acts of this Congress, lawmakers will move this week on a $6.3 billion bill to increase funding for research into cancer and other diseases, address problems in the nation’s mental health systems and enact potentially far-reaching regulatory changes for drugs and medical devices. The bill, known as the 21st Century Cures Act, is the product of years of debates over health care policy issues, including how to track the federal drug regulatory structure with the fast-paced world of biotechnology, streamline the unwieldy mental health care system, and stem the widespread and intractable problem of opioid drug abuse. (Steinhauer and Tavernise, 11/28)
Consumer Groups Caution Dems On ‘Cures’ Bill
Consumer groups are cautioning against approval of a medical innovation bill moving toward passage in the House and Senate, warning that it could endanger patients by lowering standards for the approval of new drugs. Groups like Public Citizen and the National Center for Health Research say the bill, known as 21st Century Cures, would unacceptably lower safety standards at the Food and Drug Administration. (Sullivan, 11/28)
Funding For Cures Bill Remains Sticking Point For Health Groups
U.S. lawmakers finally reached an agreement on legislation to fund cancer research and accelerate new drugs to market. But the plan to pay for the proposal remains a sticking point for some health groups. The $6.3 billion bill, known as the 21st Century Cures Act, gets more than half its funding by revoking $3.5 billion over 10 years that was supposed to go to a pot of money established under Obamacare to help prevent diseases such as Alzheimer’s and diabetes, increase vaccine use, and raise awareness about the harm caused by tobacco. (Tracer and Edney, 11/28)
Gallup found that 43 percent of people want to see the law change significantly, but not repealed, while thirty-seven percent want it repealed and replaced. In other news, KHN looks at how dismantling the health law will affect women's coverage beyond contraception access, environmental groups eye new health alliances as a rollback of the ACA threatens progress they've made, and an audit finds Minnesota's exchange improperly spent $1.2 million in grants.
Change That Health Care Law, Say Vast Majority Of Americans
President-elect Donald Trump is eager to change the nation’s health care law – and most Americans are eager for some changes, a new Gallup Poll released Monday found. ... Trump had pushed repeal, though recently said he’d retain the ban on barring insurers from excluding consumers with pre-existing conditions, and permitting people under 26 to remain on their parents’ policies. Gallup found that 43 percent of people want to see the law change significantly, but not repealed. Thirty-seven percent want it repealed and replaced. (Lightman, 11/28)
Kaiser Health News:
Beyond Birth Control, Women Could Pay More For Insurance Again Under TrumpCare
As the prospect began to sink in of losing access to free contraceptives if the health law is repealed or replaced, women have reportedly been racing to get IUDs or stockpile birth control pills before President Barack Obama leaves office. But birth control is just the tip of the iceberg, advocates say. There are a number of other women’s health benefits that are also at risk. (Andrews, 11/29)
Environmentalists Offer To Help Protect Health Care Under Trump
Environmental groups are laser-focused in their crusade for cleaner air and water, on curbing climate change, and preventing toxins from contaminating communities. But as they prepare for the Trump administration and Republican control of Congress, many of them say they’re rethinking their strategies and building new alliances. For Sierra Club California, that could mean working with health care advocates to prevent the rollback of the Affordable Care Act. (Bartolone, 11/29)
MNsure Should Refund $1.2 Million To Feds, Audit Says
A federal audit says MNsure improperly spent $1.2 million in federal grants, but the state-run health insurance exchange is disputing most of the findings. The audit examined part of the $86.4 million in federal grant money MNsure spent through June 30, 2014, as it was preparing to launch in late 2013. In particular, the U.S. Department of Health and Human Services’ Office of Inspector General focused on $930,000 in marketing spending and $346,000 in “establishment grants” to help build MNsure. The $346,000 was part of a broader $1.8 million expenditure divided between MNsure and public health programs such as Medicaid. The audit claims MNsure used old data to divide up the money and so improperly took $346,000 that should have gone to public programs if better data had been used. (Montgomery, 11/28)
Unsealed testimony from a court hearing on the companies' proposed merger show that Cigna officials questioned Anthem’s post-acquisition plans, while Anthem executives tried to move forward unilaterally when Cigna ceased cooperating with them on various deal-related issues.
The Wall Street Journal:
Testimony Shows Anthem And Cigna At Odds Over Proposed Merger
Newly unsealed court testimony shows health insurers Anthem Inc. and Cigna Corp. have significant disagreements about their proposed merger, offering fresh details about a rift that is highly unusual for two companies seeking to press ahead with such a deal. A trial on the planned merger began last week after the Justice Department decided to challenge it on antitrust grounds. (Kendall and Wilde Mathews, 11/28)
Anthem-Cigna Deal Seen By U.S. Economist As Risk To Competition
Anthem Inc.’s proposed $48 billion merger with Cigna Corp. could give the insurer the power to raise prices for employers both in the 14 states where it does business, as well as across the country, according to a witness in the U.S. government’s lawsuit to block the deal. “The merger will harm competition in the market for national accounts” as well as in states where Anthem operates, said David Dranove, a health-care economics professor at Northwestern University’s Kellogg School of Management in Evanston, Illinois. Dranove told U.S. District Judge Amy Berman Jackson that the combined company could impose a price increase in the range of five percent to 10 percent without losing business simply because there would be one less option available. (Harris, 11/28)
California regulators called it "one of the largest penalties for licensing violations ever assessed in the department's history."
Zenefits Hit With $7 Million Fine By California Insurance Regulator
Software company Zenefits has been fined $7 million by California's insurance regulator, marking the biggest penalty yet for the startup that has faced multiple investigations for flouting insurance laws. California Insurance Commissioner Dave Jones said in a statement posted on the state insurance department's website that Zenefits was charged with allowing unlicensed employees to sell insurance and circumventing education requirements for insurance agents. (Somerville, 11/28)
The Wall Street Journal:
Zenefits Hit With $7 Million Fine By California Insurance Regulator
The settlement is the largest thus far for Zenefits, which has faced investigations from multiple states for improper sales practices by some of its staff. The San Francisco company has already settled investigations with other states, including Tennessee, Arizona and Minnesota, paying much smaller fines in the tens of thousands of dollars. (Winkler, 11/28)
Zenefits Fined $7 Million By California Insurance Regulator
California’s insurance regulator said Zenefits has agreed to pay as much as $7 million over licensing violations. The human resources startup will pay $3.5 million upfront and will be on the hook for the rest if additional violations are found or if it fails a follow-up compliance test in 2018, the insurance department said. The fine is the largest single penalty assessed against Zenefits, the regulator said. Fines from other states this year totaled about $1 million, Zenefits said. The company said it’s resolved issues in 17 states. (Newcomer, 11/28)
Aides have said the visits to wounded soldiers have taken a heavy emotional toll on the outgoing commander-in-chief.
The New York Times:
Obama’s Sacred Duty: Visiting The Wounded At Walter Reed
On Tuesday, for his 23rd and probably last time as president, Mr. Obama will helicopter to the military hospital to spend another afternoon with the wounded from Afghanistan and Iraq. ... Mr. Obama will arrive at the hospital in suburban Maryland on Marine One with a minimum of ceremony, having memorized the names of the wounded he will visit from a list he received the night before. (Harris, 11/29)
In other veterans' health care news —
The Associated Press:
Obama Signs Bill To Improve Crisis Hotline
President Barack Obama has signed into law a bill that seeks to ensure all telephone calls and other communications delivered through a Department of Veterans Affairs' crisis line get answered in a timely manner by a qualified person. The legislation signed Monday comes after federal investigators substantiated allegations that some calls went into a voicemail system and that some veterans didn't get immediate assistance. (11/28)
Congressional Republicans plan to move on legislation cutting of all federal funds to the organization early next year, according to sources.
GOP Eyes Best Chance In Years To Defund Planned Parenthood
Congressional Republicans are aiming to cut off federal funding for Planned Parenthood early next year, according to GOP sources on and off the Hill, as social conservatives press for a milestone win under Donald Trump's presidency after years of thwarted attempts to defund the health care group. (Haberkorn and Everett, 11/28)
In other news —
Texas To Implement Rules Requiring Burial Or Cremation Of Fetal Remains
Texas’ proposed rules requiring the cremation or burial of fetal remains will take effect Dec. 19, according to state health officials. Despite intense outcry from the medical community and reproductive rights advocates, the state will prohibit hospitals, abortion clinics and other health care facilities from disposing of fetal remains in sanitary landfills, instead allowing only cremation or burial of all remains — regardless of the period of gestation. (Ura, 11/28)
No travel alert suggesting that pregnant women avoid the area will be issued now because a single case does not constitute evidence of continuing local transmission.
The New York Times:
Local Transmission Of Zika Virus Is Reported In Texas
A probable case of local transmission of the Zika virus has been reported in Texas, state health officials announced on Monday, making it the second state, after Florida, in which the infection is thought to have been carried from person to person by mosquitoes. The patient is a woman who is not pregnant and lives in Brownsville, on the Gulf Coast near the Mexican border. The state’s first case of chikungunya, a virus spread by the type of mosquito that carries Zika, was confirmed this year in Brownsville. (McNeil and Fernandez, 11/28)
Texas Confirms Its First Case Of Local Zika Transmission
Health officials in Texas said Monday a woman had been infected with Zika after being bitten by a mosquito there, making Texas the second state to have documented local transmission of the virus. The woman lives in Cameron County, which sits along the Mexican border and on the Gulf Coast. The mosquitoes that are the main drivers of the virus thrive in hot, humid climates, and experts had identified South Texas as one of the most likely locations to see the virus spread by local mosquitoes. (Joseph, 11/28)
Los Angeles Times:
Texas Becomes Second State To Confirm Locally Transmitted Zika Infection
Lab tests confirmed last week that a woman who lives in Brownsville, Texas, was infected with the virus, state health officials said in a statement. The woman had not recently traveled to Mexico or any other region with an ongoing Zika outbreak. ... The virus was detected in her urine but a blood test was negative, “indicating that the virus can no longer be spread from her by a mosquito,” the statement said. (Simmons, 11/28)
Texas Officials Confirm First Case Of Zika Spread Locally
“We knew it was only a matter of time before we saw a Zika case spread by a mosquito in Texas,” John Hellerstedt, commissioner of the state health department, said in a statement. “We still don’t believe the virus will become widespread in Texas, but there could be more cases, so people need to protect themselves from mosquito bites, especially in parts of the state that stay relatively warm in the fall and winter.” (Chang, 11/28)
Texas Confirms First Locally Transmitted Case Of Zika
Florida is the only other state in the U.S. that has reported locally transmitted cases. About 4,400 people have tested positive for Zika in U.S. states and the District of Columbia, though the vast majority of cases are linked to travel abroad. (Ferris, 11/28)
Myriad Genetics pioneered breast cancer testing that has saved millions of lives. And the company was reaping the rewards for nearly 20 years before it lost its patent. Now, struggling, it's going after its competitors.
Pioneer Of BRCA Cancer Gene Testing Slams Rivals With Overblown Claims
The pioneering genetic test, introduced in 1996, was also good for Myriad, which won a patent on the “BRCA” cancer genes and has collected more than $2 billion from its BRCA tests. But its fortunes changed in 2013, when the US Supreme Court invalidated the company’s key patents and Myriad lost its monopoly on BRCA testing. Other labs began offering the tests for as little as a few hundred dollars, a small fraction of Myriad’s $4,000. Revenue slid — even after Angelina Jolie raised awareness of Myriad’s BRCA tests by publicizing her results and her decision to therefore undergo a double mastectomy...Desperate to protect its business, Myriad embarked on an aggressive strategy to undermine its new competitors, STAT has found. In interviews, genetic counselors, physicians, and competitors said the company deployed its national sales force to stoke fears that other companies’ BRCA tests are so faulty they miss potentially deadly mutations. (Begley, 11/29)
In other news —
The New York Times:
Summer Project Turns Into Leukemia Testing Breakthrough
A rare but treatable form of cancer can now be diagnosed cheaply and easily with dried blood spots instead of whole blood, scientists in Seattle announced last week. The new test for chronic myeloid leukemia can be run with a few dime-size spots on a paper card that can be mailed to a center for diagnosis. (McNeil, 11/28)
Health News Florida:
Promising New Treatments Providing Hope For Cancer Patients
Promising new treatments are providing hope that a cure for some forms of cancer may be within reach. Researchers at Moffitt Cancer Center are using one form of immunotherapy and awaiting FDA approval for another. (Ochoa, 11/28)
For Ken DeCesare it took a bigamist second marriage he didn't even remember before he realized he needed help.
Surviving The Long Trip To Addiction 'Rock Bottom'
In late 2015, with a variety of legal problems pending, [Ken] DeCesare entered the Orange County Adult Drug Court Program. At the outset, he was no longer using drugs but continued to drink. Then his turnaround began, with the presence of a counselor who "changed my life" and his first group therapy session. (Candelaria, 11/28)
In other news from the opioid epidemic —
Ohio Leads Nation In Overdose Deaths
In a grim statistic that surprises no one close to the problem, Ohio leads the nation in opioid overdose deaths, a new report shows. Along with the overall category, Ohio also had the country's most deaths related to heroin: One in 9 heroin deaths across the U.S. happened in Ohio. The Buckeye State also recorded the most deaths from synthetic opioids: About 1 in 14 U.S. deaths. (Candisky and Johnson, 11/29)
In other news on aging, the Atlanta Journal Constitution reports on the challenges that face the 5.5 million Americans with Alzheimer’s.
San Jose Mercury News:
Elders Who Use Tech Tools Feel Less Lonely, More Physically Fit, Stanford Study Finds
Forget bingo and shuffleboard. Use of computers and cellphones is linked to higher levels of mental and physical well-being among those over age 80, according to new Stanford research. And these elders — dubbed “the oldest old,” a generation typically ignored by the youth-obsessed tech industry — are motivated for the same reasons as digital-savvy millennials: to stay connected. (Krieger, 11/28)
Atlanta Journal Constitution:
Living With Alzheimer’s And The Fight To Combat It
For millions of Americans, this is their everyday reality. These people typically have some form of Alzheimer’s disease, a type of dementia that affects cognitive functions such as memory, judgment and perception. Alzheimer’s disease has been rising since 1983, the year President Ronald Reagan named November as National Alzheimer’s Disease Awareness Month. Fewer than 2 million Americans had the disease then, but today over 5 and a half million Americans live with Alzheimer’s. (Hansen, 11/29)
The experimental treatment that may be closest to market uses desensitization to wean patients away from an allergy. In other public health news, a study finds getting flu shots while pregnant does not increase the child's chance of being diagnosed with autism, doctors suggest behavioral therapy over drugs when it comes to insomnia, just one season of playing football affects brain health, and more.
Allergy Treatments Enter New Era As Money Pours Into Field
Allergy treatments haven’t advanced much in decades, even as hundreds of millions around the world suffer from wheezing, itches, and rashes — and in severe cases, risk death — from exposure to allergens ranging from eggs to pollen to dog dander. But hope may be on the way. Scientists who study the immune system are beginning to understand the root cause of allergies — and are starting to work on next-generation therapies that could stop allergies in their tracks, rather than simply treating symptoms. Private investors and corporations are pouring money into the field. (Keshavan, 11/29)
Flu Shots Don't Increase Autism Risk In Pregnancy
Getting the flu while pregnant doesn't appear to increase the child's risk of being diagnosed with autism later on, a study finds, and neither does getting a flu shot while pregnant. The study, published Tuesday in JAMA Pediatrics, tries to tease apart subtle questions of risk and risk avoidance. (Shute, 11/28)
The Wall Street Journal:
Can’t Get To Sleep? Lay Off The Drugs
It’s easy to get into the habit of popping a pill to have a good night’s sleep. Insomnia, which affects a third of adults, becomes more common as we age. But as evidence has mounted about the risks of drugging the brain to induce or maintain slumber, more doctors are steering patients away from sleep aids, including over-the-counter medications, and are offering innovative behavioral-change solutions. (Landro, 11/28)
Los Angeles Times:
For High School Football Players, Just A Season Of Play Brings Brain Changes
Without sustaining a single concussion, a North Carolina high school football team showed worrisome brain changes after a single season of play, a new study has shown. A detailed effort to capture the on-field experiences of 24 high school football players showed that, at the end of a single season of play, teammates whose heads sustained the most frequent contact with other moving bodies had the most pronounced changes in several measures of brain health. (Healy, 11/28)
The Philadelphia Inquirer:
Preventative Antibiotics May Prevent C. Diff Infection For Some Blood-Cancer Patients
Hospital patients who undergo a stem cell transplant to treat blood cancers must take immune-suppressing drugs to prevent rejection of the donor cells. But along with that comes an increased risk of infections, such as a dangerous bacteria called C. difficile. A new University of Pennsylvania study identified a possible solution: administering preventative antibiotics. At Penn's Abramson Cancer Center, physicians gave an oral antibiotic called vancomycin twice a day to 73 of these blood cancer patients undergoing an allogeneic stem cell transplant — in which patients receive stem cells from a healthy donor. (Avril, 11/28)
Big Data Projects Surpass Biomedical Scientists' Ability To Analyze Them
Biomedical research is going big-time: Megaprojects that collect vast stores of data are proliferating rapidly. But scientists' ability to make sense of all that information isn't keeping up. This conundrum took center stage at a meeting of patient advocates, called Partnering For Cures, in New York City on Nov. 15. (Harris, 11/28)
In other hospital news, Catholic Health Initiatives is bringing an operating loss to merger talks with Dignity Health.
GE, Children's Hospital Form Medical Software Venture
Boston Children’s Hospital is teaming up with General Electric Co. to produce software that will help doctors more accurately interpret brain scans of young patients. Under a deal set to be announced Monday, Children’s and Boston-based GE’s health care division will develop the system over the next 18 months, then market it to hospitals around the world. (Dayal McCluskey, 11/28)
CHI Takes $483 Million Operating Loss Into Dignity Merger Talks
Catholic Health Initiatives is bringing an operating loss of $483 million from its fiscal 2016 to its merger talks with Dignity Health, CHI reported in its year-end earnings statement Monday. The operating loss in fiscal 2016, which ended June 30, compared with an operating surplus of $24 million in fiscal 2015. CHI, the nation's third-largest not-for-profit hospital company by revenue, attributed the losses to “lower patient volumes, higher labor costs, increased pharmacy prices and reduced reimbursement in Medicare and Medicaid.” The Englewood, Colo.-based health system also struggled to manage the red ink from its health insurance business, which CHI plans to sell. (Barkholz, 11/28)
Outlets report on health news from Oregon, Florida, Colorado, Massachusetts, Kansas, Maryland and California.
State Claims Raussen, Head Of Insurance Board, Accepted Meals, Gifts
In eight months on the job as executive director of the Oregon Educators Benefits Board, James Raussen allegedly accepted a handful of spendy meals and, on one occasion, tickets to a Blazers game courtesy of insurers and consulting firms. He went out of his way in state vehicles to attend wine tastings in Hood River and Walla Walla, the state alleges. And when confronted about some of these events, Raussen inaccurately told state officials he had paid his own way, according to newly released state documents. The benefits board put Raussen on paid leave in September and asked the Department of Justice to investigate. Board members refused to explain why at the time. Raussen resigned earlier this month before state investigators could conclude their inquiry. (Manning, 11/28)
Tampa Bay Times:
Eight Months After Losing Confirmation Fight, Armstrong Leaves DOH
Since March, when it was clear the Senate would not confirm him as state surgeon general, Dr. John Armstrong has continued to cash a paycheck while on medical leave as deputy secretary of health. On Nov. 21, he finally left the Department of Health. The state announced Monday that Michele Tallent will officially take over the role of deputy secretary of health for administration after holding the job on an acting basis since January. (Auslen, 11/28)
Colorado Physicians Contend With New Aid-In-Dying Law, Whether Or Not They Approve
Physicians across Colorado are preparing to work under the new law, whether or not they approve of it. The constitutional amendment, approved by a two-thirds, one-third margin Nov. 8, makes clear that doctors do not have to participate — they are required only to transfer a patient’s medical records to a new physician. According to a Colorado Medical Society survey of its membership earlier this year, 56 percent of doctors are in favor of medical aid in dying, while 35 percent are opposed (including 25 percent “strongly” opposed). Doctors in Denver were more likely to approve, at 62 percent, compared with 48 percent approval in rural parts of the state. (Brown, 11/28)
Haunted By A Word, A Family Does Battle With The Medical Examiner’s Office
The medical examiner’s office has drawn controversy several times in the past two years over how it decides the manner of death in cases, especially those involving infants. A Globe report in August found it gives extraordinary power to its 12 medical examiners to rule how people died, with little oversight by the chief medical examiner and virtually no legal mechanism for critics to appeal. The Globe has also found there are no standards dictating the level of certainty medical examiners must have before ruling on a manner of death. (Wen, 11/29)
Kansas Health Institute:
Study Delves Into Wyandotte County Health Divide
To the east of Seventh Street, the average resident dies around age 72, according to a new study of health disparities in Wyandotte County. Cross the street, however, and that average drops to 59. The next-closest community where most people live into their 70s is west of Interstate 635, about four miles away. Wyandotte County consistently ranks near the bottom of Kansas counties on health outcomes, despite sharing a border with Johnson County, which usually comes in first or second. Even within Wyandotte County, however, a person’s address can have a serious effect on his health. (Wingerter, 11/29)
The Baltimore Sun:
Harford Health Department To Offer Free Flu Shot Clinics Next Month For School-Age Children K-12
With the arrival of cold weather comes flu season and the need to be vaccinated. This year, there are some key changes about influenza vaccination programs in Harford County, according to local health officials, and free flu shot clinics will be offered next month for school-age children only. The Harford County Health Department urges everyone in the county ages six months or older to be vaccinated against the flu. The first reported case of flu in Maryland was on Oct. 7, which is about a month earlier than last year, Harford Health Office Susan Kelly said during her six-month Board of Health update to the Harford County Council on Oct. 18. The council also sits as the county's Board of Health. (Vought, 11/28)
Pot Doctors Who Thrived Under CA Medical Marijuana Law Adapt Business Model For Recreational Era
In the weeks since Californians voted to legalize marijuana for recreational use, the phones have been ringing more intensely and the flow of walk-in patients has picked up at 420 Med Evaluations, a midtown Sacramento clinic specializing in medicinal pot referrals. The passage of Proposition 64 on Nov. 8 instantly allowed adults 21 and older to consume marijuana, regardless of medical need. Along with that, went the thinking, people seeking pot for pleasurable pursuit no longer had to endure the inconvenience of going to a doctor and citing a physical ailment to get a medical recommendation to legally light up a joint. (Hecht, 11/28)
Marijuana Legalization Advocates Furious At Lawmakers’ Proposed Changes
Secretary of State William F. Galvin said Monday that the results of the Massachusetts marijuana legalization measure passed by voters may not be certified in time for it to go into effect Dec. 15, when the drug is slated to become legal for possession and use. A successful ballot initiative does not officially become law until it is certified by the eight-member Governor’s Council, a Colonial-era body that meets every Wednesday. (Miller and Phillips, 11/28)
Editorial and opinion writers offer different takes on what's ahead in health policy as leaders grapple with what comes next.
The Affordable Care Act: Moving Forward In The Coming Years
Social welfare legislation is inherently political, and the absence of bipartisan support during passage of the ACA hardened party-line opinions. The Senate also used reconciliation to adopt the ACA, further fueling Republican discontent. Although the public approves of individual provisions in the ACA, the law as a whole generally remains unpopular. If “repeal and replace” passed on a party-line basis, it could generate the same dynamic that undermined the ACA. There are also legal impediments to using the reconciliation tool for nonbudgetary aspects of the reform package. Moreover, if Congress were to remove subsidies or benefits that individuals now enjoy, it could provoke a political backlash. (Lawrence O. Gostin, David A. Hyman and Peter D. Jacobson, 11/28)
The Future Of The ACA And Health Care Policy In The United States
On November 8, 2016, Republicans won the presidency and retained control of the US House and Senate in Congress. The composition of the Senate shift will profoundly affect the passage of new legislation. With only 52 Republicans in the Senate, the Republican Senate leadership will have to ensure that all Republicans support any legislation because a few defections on an issue could push them into a minority position. More challenging is that except for budget-related legislation, which can pass with only a simple majority, other legislation, including much of an Affordable Care Act (ACA) replacement bill, will require the support of 60 votes in the Senate to circumvent a filibuster. (Gail R. Wilensky, 11/28)
A Bipartisan Approach To Amending The Affordable Care Act
To his credit, the president-elect has said he intends to keep the popular provisions of the ACA, while amending the law to reduce the cost of the program to those who are participating as well as to taxpayers. But as most health policy experts agree, this will be nearly impossible to achieve without a mandate to ensure a balance risk pool. As the incoming administration seeks solutions, it is critical that they and members of Congress avoid the “cut and shift” tendency that has often been employed in similar circumstances in the past. Rather than shifting federal health costs on to the states, to businesses, to health stakeholders or to beneficiaries, policymakers must look for ways to redesign and improve the individual market place to ensure longer-term improvements in both quality and lower cost. (Tom Daschle, 11/29)
Replacing Obamacare Will Be A Slog, Not A Race
In the days since the election, Republicans have realized that they are in a tight spot on Obamacare. They seem to be lurching toward a strategy that will make it tighter. Republicans have vowed over and over again to repeal and replace the health-care law, but they do not yet have a detailed plan or the votes to enact it. Democrats, meanwhile, remain committed to the law, and there will be at least 48 of them in the new Senate. Unless eight of them defect, they have enough votes to filibuster Republican bills to undo it. Republicans probably do not have the votes to abolish the filibuster. (Ramesh Ponnuru, 11/28)
The New York Times:
The G.O.P. And Health Care Chaos
Republicans have said that Congress could vote early next year to repeal the Affordable Care Act but delay the actual end of the law for a year or two. In theory, that would allow lawmakers to come up with a workable replacement while putting off the consequences of repeal. But any vote to repeal the law would almost certainly cause insurers — which know they won’t be able to depend on the federal government in the future — to start pulling their plans from the online marketplaces for 2018 coverage, kicking millions off coverage. State and local governments will have to start planning to increase spending on public hospitals and charity medical care. Consider this: Uncompensated care at hospitals declined by $7.4 billion in 2014 after most major provisions of the law kicked in, according to the Department of Health and Human Services. Those costs would most likely go right back up. (11/28)
The New York Times:
When Having Insurance Still Leaves You Dangerously Uncovered
As I’ve written before, while more Americans are insured, many are still underinsured — meaning that they are exposed to significant financial risk from out-of-pocket payments. Reducing out-of-pocket spending, however, will require some trade-offs. No easy solution exists, but there are examples out there worthy of consideration. (Aaron E. Carroll, 11/28)
The Enrollees Who Actually Didn't Even Need Obamacare
We’ve always known that there was some “woodwork effect,” in which people who were already eligible signed up because of some combination of easier signup procedures and the heightened publicity that surrounded Obamacare’s passage and implementation. But these are huge numbers; the woodwork effect is more than twice as large as the number of people who became eligible for Medicaid thanks to Obamacare’s more generous criteria. This suggests the possibility that the plurality of people who gained insurance thanks to the law technically didn’t need a new program to become insured; all they needed to do was to sign up for public insurance they already qualified for. (Megan McArdle, 11/28)
The Fiscal Times:
Replacing Obamacare: Here's How Republicans Can Fix Medicaid
To encourage states to properly manage Medicaid spending, Congress should replace the federal matching scheme with a different funding mechanism. Earlier this year, House Republicans suggested moving to either block grants or per capita allotments. A block grant is a fixed sum of money allocated to each state to support its Medicaid spending, while a per capita allotment would provide states a fixed amount of funding per Medicaid beneficiary. In either case, annual federal funding would grow at a slower rate than it does now, but states would have much more flexibility in the way they use federal Medicaid grants, enabling them to provide services in a more cost-effective manner. (Marc Joffe, 11/28)
The Washington Post:
Pennsylvania Obamacare Fan Remained Loyal To Fox News Till The End
Dean Angstadt required a lot of convincing to sign up for Obamacare. The Pennsylvania logger had heard a lot of bad things about the president’s signature domestic initiative. Over a period of months, however, a friend of Angstadt’s — Bob Leinhauser, who’d worked for 27 years at Montgomery County’s fire and rescue department — prevailed upon him to sign up, given the stakes and all. “I was going to die,” he told this blog back in April 2014. “I was preparing myself.” He desperately needed heart-valve replacement surgery, a procedure he’d been putting off because of his finances. Thanks to Leinhauser’s prodding, he paid a minimal amount for a policy that covered a surgery he never could have paid for. (Eric Wemple, 11/28)
St. Louis Post-Dispatch:
Insurers Are Charging More For Less Coverage
Now that the elections are over, it’s just the beginning of what could be a troubling reform process to the Affordable Care Act, particularly for those with pre-existing conditions. Whether significant changes to the Affordable Care Act are on the horizon in the very near future remains to be seen, but people with pre-existing conditions will be paying close attention in the coming weeks as a new administration takes over governing entities. (Paul Gileno, 11/29)
How Obamacare Ruling Could Shield Sanctuary Cities
While sanctuary policies vary, these cities generally limit how much local law enforcement cooperates with federal immigration officials. Leaders in Sacramento, San Francisco and other cities have vowed to fight federal attempts to deport undocumented immigrants. Ironically, the Republican assault on Obamacare may prove to be the basis that courts use to reject efforts to defund sanctuary cities. (Bill Ong Hing, 11/28)
A selection of opinions on health care from around the country.
The Wall Street Journal:
Three Ways To Find More Disease Cures
The triumph of science over disease in the past century is astounding. Since 1900, a host of maladies—diphtheria, measles, whooping cough, polio, tetanus, typhoid and smallpox, among others—have been mostly controlled. These victories helped more than double human lifespans over the 20th century, according to the World Health Organization. ... Yet out of more than 10,000 known disorders, the National Center for Advancing Translational Sciences says that fewer than 1,000 have truly effective treatments. Without research breakthroughs, Alzheimer’s disease could cost $1.1 trillion a year for treatment and care by 2050, estimates the Alzheimer’s Association. That’s nearly twice the annual Defense Department budget. (Michael Milken, 11/28)
Medical Advances Offer Hope – With Precautions
Biosimilars are designed to work like the brand biologics they imitate, but they are not the same as “generics.” A generic is an exact chemical copy of the original drug. A biosimilar can be slightly different from the brand biologic due to the complexity of the manufacturing process, transportation or handling. These slight differences mean either product could produce adverse reactions in some patients. (Marcia Horn, 11/28)
The Washington Post:
The Cost Of Caring For A Child With Microcephaly For 53 Years
So far, the financial cost of the Zika virus and the birth defects caused by it is unclear. The care for one child with birth defects can cost $10 million or more, Tom Frieden, the director of the Centers for Disease Control and Prevention, said at a press briefing in April. When our son Andy was born with microcephaly 53 years ago, a doctor advised me and my husband to put him in an institution. We were determined to keep him at home, but if we had put him in an institution at 2 months of age, I estimate his care would have cost Medicaid almost $21 million (in 2013 dollars) over the past 53 years. That’s $1,084 a day, or $395,660 a year. (Barbara Altman, 11/28)
Rebates To Pharmacy Benefit Managers Are Contributing To High Drug Prices
In the furor over high drug prices, both Congress and the media have largely focused on the role played by drug companies such as Turing Pharmaceuticals, Valeant, and Mylan. Another contributor — pharmacy benefit managers and the rebates they get from drug companies — is only now getting the attention it deserves. Pharmacy benefit managers serve as intermediaries between the plan sponsor, such as an insurance company, and pharmacies. They determine which pharmacies will be in the plan’s network, develop the formulary (list of covered medications), and negotiate price rebates with drug manufacturers. Manufacturers provide these rebates in exchange for having specific medications listed on the formulary. It’s all perfectly legal. Yet the non-transparent nature of these arrangements makes it difficult to know what percentage of these rebates are passed on as savings to plan sponsors and how much is kept by the pharmacy benefit manager. (B. Douglas Hoey, 11/28)
Will Donald Trump's Rejection Of Conflict Rules Set Tone For Healthcare Leaders?
Would it be ethical if a healthcare CEO took time during an official meeting or phone call with an elected official or executive of another organization to promote or discuss issues related to his or her separate private business? “That would be a breach, or potential breach, of the fiduciary duty of loyalty,” said Douglas Chia, executive director of the Conference Board's Governance Center. Yet that is exactly what President-elect Donald Trump allegedly did in post-election conversations with a British political leader, the president of Argentina, and Trump Organization business partners from India. Healthcare governance experts fear that Trump's behavior could send a signal to leaders in healthcare and other industries that it's OK to mix their official activities with private economic interests. (Harris Meyer, 11/27)
Des Moines Register:
More Medicaid Money Promotes Better Outcomes For Patients
As expected, the governor’s decision to appropriate additional government funds to facilitate the Medicaid Modernization transition has come under fire from opponents eager to downplay the success of managed care. A few weeks ago, Gov. Terry Branstad approved an increase in per-patient rates paid to managed care organizations. The extra expenditure will not interfere with the projected goal of $110 million in Medicaid cost savings. The additional funding will be used to cover costs associated with the Iowa Health and Wellness Program and significant increases in prescription drugs. In short, the additional funds promote better outcomes for patients. (State Sen. Jack Whitver, 11/27)