Politico: GOP Obamacare Repeal Hits Procedural Speed Bump
Senate Republicans will be able to go ahead with legislation dismantling Obamacare under fast-track rules, according to a procedural ruling reached Tuesday — as long as the GOP makes some changes first. The Senate parliamentarian ruled Tuesday afternoon that some provisions of a GOP bill to repeal Obamacare and defund Planned Parenthood did not survive the so-called Byrd rule, which governs when the powerful procedural tool known as reconciliation can be used. But top GOP Senate aides also noted the parliamentarian ruled that the bill was "privileged," meaning it can avoid a filibuster. Republicans also maintained that the problem could be resolved relatively easily on the floor with a substitute amendment. (Kim, 11/10)

Reuters: U.S. Democrats Discussing Fix To Health Care 'Cadillac Tax'
U.S. Democratic lawmakers are discussing proposing changes to the "Cadillac tax," a levy on high-cost employer-based healthcare plans passed as part of President Barack Obama's 2010 Affordable Care Act, the Senate's No. 2 Democrat said on Tuesday. "I'm not proposing eliminating it at this point, I'm open to suggestions for changing it," Illinois Senator Dick Durbin told reporters. (Cornwell, 11/10)

MTN News: In First Week, 5,500 Montanans Signed Up For Expanded Medicaid Coverage
In the first week since federal health officials approved Montana’s expanded Medicaid program, 5,500 people already have signed up for the coverage, Gov. Steve Bullock said Tuesday. ... Montana’s low-cost, expanded Medicaid coverage is available to anyone earning up to 138 percent of the federal poverty level, or about $16,200 for a single person. Many of those eligible will be required to pay annual premiums equal to 2 percent of their income. They’ll also have to make small co-payments for medical care, ranging from $4 for a doctor’s visit to 10 percent of the charge. However, for most, the total out-of-pocket expense is limited to 5 percent of their annual income. (Dennison, 11/10)

Montana Public Radio: 5,500 Montanans Sign Up For Expanded Medicaid Coverage In First Week
State health officials say they’re surprised at the number of Montanans who are signing up for expanded Medicaid. Jessica Rhoades with the Department of Public Health and Human Services says more than 5,500 people have signed up in a little more than a week since enrollment began. “We are so pleased to see that strong reaction. We knew that this program would be popular, but this is more popular than we even thought. We’re thrilled that these people will be getting the health coverage that they need.” (Jess, 11/10)

The Fiscal Times: The 20 States With The Largest And Smallest Drop In Their Uninsured Rate
The nationwide uninsured rate has fallen to 13.4 percent since the Affordable Care Act, otherwise known as Obamacare, was implemented. But uninsured rates vary dramatically across states. A new WalletHub analysis breaks down the numbers at the state level between 2010 and 2014. ... All of the states that saw the largest drop in their uninsured rate have also adopted the Medicaid expansion. This relationship isn’t surprising because the states that fail to expand Medicaid leave many low-income adults in a coverage gap, where their incomes are above Medicaid eligibility requirements but below the lowest threshold for marketplace premium tax credits. (Dent, 11/10)

The New York Times: In Republican Debate, Candidates Battle Sharply On Immigration
But policy details and disagreements, for the most part, replaced nasty potshots in the early going on Tuesday night, laying bare real fissures within the Republican Party on immigration, national security, trade and the meaning of being a conservative. The candidates used the 90 seconds they were allotted for each answer to promote their tax proposals, to lament what they said were intrusive business regulations and to delve into the country’s monetary policy. Even when Mr. Kasich sought to speak at one point when he was not called on, it was because he wanted to discuss a value-added tax. (Martin and Healy, 11/10)

The Hill: Fiorina Takes Aim At Drug Companies, Health Insurers
“Every healthcare provider ought to publish its costs, its prices, its outcomes because, as patients, we don't know what we're buying,” Fiorina said to roaring applause at the GOP debate hosted by Fox Business Network in Milwaukee, Wis. Fiorina said both drug companies and insurers have been less than transparent about their practices, as they’ve increased the cost of healthcare. Her attacks on the industry came in response to a question about ObamaCare's employer mandate, which went into effect this year. Beyond repealing the full text of ObamaCare, she did not propose a specific way to alleviate the burdens of the employer mandate. (Ferris, 11/10)

The Associated Press: AP FACT CHECK: GOP Candidates Flub Some Figures In Debate
The fourth debate of the 2016 Republican presidential campaign was thick on economic policy — and with that came a variety of flubs and funny numbers. Some of the claims Tuesday night and how they compare with the facts: ... CARLY FIORINA: “Obamacare isn’t really helping anybody.” THE FACTS: President Barack Obama’s health care law may or may not be good for the country on balance. But it’s clearly helping many people. In the two years it’s been in effect, the share of Americans without health insurance has declined to 9 percent, a historic low. People with pre-existing health conditions can no longer be turned away by insurers, and everyone is required to have coverage or face fines. (Rugaber and Boak, 11/11)

The New York Times: Chris Christie Saves All His Shots For Clinton In G.O.P. Undercard Debate
When Mr. Jindal criticized Mr. Christie for “liberal” policies in New Jersey, he simply said he had no interest in contrasting himself with the Louisiana governor. “I want to talk about what’s going to happen to this country if we have another four years of Barack Obama’s policies,” Mr. Christie said, adding that his success in a blue state qualified him to run strongly nationally. “Wait a minute, records matter,” Mr. Jindal interjected. He criticized Mr. Christie for expanding food stamps and Medicaid in his state. Again, Mr. Christie refused to engage. “Who’s going to be able to beat Hillary Clinton and keep their eye on the ball,” he said. (Gabriel, 11/10)

The Wall Street Journal: In Early Republican Debate, Chris Christie Looks For An Opening
Mr. Christie was joined on stage by former Arkansas Gov. Mike Huckabee, Louisiana Gov. Bobby Jindal and former Pennsylvania Sen. Rick Santorum. Mr. Jindal took repeated swipes at Mr. Christie, arguing the New Jersey governor had expanded his state’s government. “You caved in to Obamacare, you expanded Medicaid,” Mr. Jindal said, in a reference to the government health-care program for the poor. “We need a conservative, not a big government Republican.” (Hook and Ballhaus, 11/10)

The Associated Press: Clinton Pushes Back Against GOP On Veterans’ Health Issues
Hillary Rodham Clinton outlined steps to improve the Department of Veterans Affairs on Tuesday, casting herself as a protector against proposals to privatize the sprawling health care system for those who have served in the military. In a pre-Veterans Day event, the Democratic presidential candidate said she would seek to improve veterans’ health care, modernize veterans’ benefits system and address an unwieldy bureaucracy that was exposed in a scandal involving chronic delays for those seeking medical care or to have their claims processed. (Thomas, 11/10)

The Wall Street Journal: Hillary Clinton Vows To Fight VA Privatization
Democratic presidential candidate Hillary Clinton offered her vision for veterans’ health care Tuesday, promising to fight full-fledged privatization while allowing the government to contract with private providers for a range of health services. In her proposal, Mrs. Clinton struck a balance between support for traditional government-run veterans health programs while acknowledging that many veterans want to access care from private providers as well, given the system’s failings. (Meckler and Kesling, 11/10)

The New York Times: White House Seeks To Ease Veterans’ Access To Care
The Obama administration on Wednesday will call on Congress to enact measures to help military veterans gain easier access to health care, disability and educational benefits, part of a push to spotlight its efforts to improve the way the government treats veterans after a scandal at the Department of Veterans Affairs. President Obama will urge Congress to improve a program that allows veterans to receive private medical care, speed the appeal process for disability claims and pass legislation aiming to improve the quality of schools that serve veterans. (Hirschfeld Davis, 11/11)

The Washington Post: 'Don’t Just Throw Rocks,’ VA Secretary Tells Congress
As he tries to repair a sprawling agency beset by poor morale, growing caseloads, a shortage of medical staff and a crisis last year over manipulated waiting lists to paper over delays in health care, the retired chief executive of Procter & Gamble has felt bipartisan criticism. VA may be the one corner of the government that, because there are veterans in every congressional district, Democrats and Republicans can agree on. And the public criticism of how he is leading the agency — more biting from Republicans, not surprisingly — has been unrelenting, from inaction on firing executives who engaged in misconduct to battles over funding. (Rein, 11/11)

The Arizona Republic: TriWest Chief Touts Vets' Care Effort, But Concedes There's More To Do
David McIntyre Jr., president and chief executive officer of TriWest Healthcare Alliance, concedes he's in a challenging race to meet the needs of U.S. military veterans who have been backlogged in the Department of Veterans Affairs medical system. To date, the Tempe-based company is still running slightly behind, unable to meet the escalating demand for timely care. Still, 12 months into a rush job — and on the verge of Veterans Day — McIntyre eagerly discussed the progress that's been made. (Wagner, 11/10)

Elsewhere, media outlets write about post-traumatic stress disorder and other mental health challenges vets face --

The Philadelphia Inquirer: After Years, VA Now Considering PTSD As Factor In Discharges
Von Wiggins laughed at the small troubles he got into back in his Army days. "One time I was hanging around the female barracks [at Fort Meade] and I didn't leave when they told me to," he recalled last week over breakfast near his home in Rhawnhurst. It was around 1971. He was 23, just back from Vietnam, feeling carefree. But the memory of that bloodied old man hunched over those rocks still haunted him. So did the wave of terror he'd felt when that flapping motion outside his bunker revealed itself to be a hand in the moonlight. (O'Reilly, 11/11)

The Texas Tribune: Report: Veteran Mental Health Ignored In Capital Cases
Veterans sentenced to death in Texas murder cases — and nationwide — might have escaped the punishment if juries had been told about their military service and any ensuing mental health problems, according to a Death Penalty Information Center report released Tuesday. (Silver, 11/10)

And STAT reports on an ambitious VA project to sequence the DNA of a million veterans to uncover clues about disorders ranging from diabetes to PTSD --

STAT: The VA's Push For Big Science, One Million Genomes, And A Medical Revolution
Since its launch in 2010, the VA has spent $30 million building and running MVP. Caring for 8.76 million veterans enrolled in the Veterans Health Administration, it has a strong interest in understanding the role that genes play in the diseases they develop. The VA is also uniquely situated to carry out this kind of project, in part because veterans tend to have medical records in the system that stretch back decades. But the research being done as part of the MVP — which has already enrolled more than 420,000 participants — could have implications that reach far beyond the VA. (Zimmer, 11/11)

The Wall Street Journal: Express Scripts Cutting Off Pharmacy That Sold Drugs From Horizon Pharma
Express Scripts Holding Co. said it was cutting off a pharmacy that sold medications made by Horizon Pharma PLC and suing the drug maker, in the latest sign of tension over ties between pharmaceutical manufacturers and companies that dispense their medicines. (Wilde Mathews, 11/10)

The New York Times: Express Scripts Cuts Ties To New York Specialty Pharmacy
The nation’s largest pharmacy benefit manager has stopped doing business with a specialty pharmacy used by the drug maker Horizon Pharma, in a sign of a further crackdown on the use mail-order dispensaries to help lift sales of expensive drugs. The benefit manager, Express Scripts, sent an immediate termination letter to Linden Care, a specialty pharmacy in Woodbury, N.Y., on Monday. Linden Care in turn sued Express Scripts in Federal District Court in Albany on Tuesday, asking the court to reverse the termination. (Pollack, 11/10)

The Wall Street Journal: Biggest Valeant Holder Plumbed Philidor Ties
As shares in Valeant Pharmaceuticals International Inc. plunged in recent weeks, representatives from its largest shareholder went to great lengths to check up on its multibillion-dollar investment, including paying hundreds of dollars for information and offering thousands more to not talk with anyone else. Ruane, Cunniff & Goldfarb Inc., manager of Sequoia Fund Inc., said it reached out to former employees of the Philidor Rx Services LLC mail-order pharmacy that almost exclusively dispensed Valeant drugs and sought to speak with them about the pharmacy’s work. (Rockoff and Rothfeld, 11/10)

The Wall Street Journal: Safeway, Theranos Split After $350 Million Deal Fizzles
Safeway Inc. spent about $350 million to build clinics in more than 800 of its supermarkets to offer blood tests by startup Theranos Inc. But the tests never began, the clinics are now used largely for flu shots and travel-related vaccines, and the two companies have been negotiating to officially dissolve their partnership, according to people familiar with the matter. Current and former Safeway executives said Theranos missed deadlines for the blood-testing rollout. They also said several Safeway executives questioned the accuracy of results Theranos gave to Safeway employees tested at a clinic in the supermarket chain’s headquarters in Pleasanton, Calif. (Carreyrou, 11/10)

Reuters: U.S. Agencies Investigate Merck, Lilly Drug Pricing
U.S. drugmakers Merck & Co and Eli Lilly & Co are being investigated by federal prosecutors over their drug-pricing practices, the companies disclosed. The exact nature of the investigations and where they might lead was not immediately clear. Lilly, in an Oct. 30 regulatory filing, said the Philadelphia U.S. Attorney's Office and the civil division of the U.S. Department of Justice are investigating its distribution agreements with wholesalers. The agreements are used to determine Average Manufacturer Prices that are the basis of required rebates to the Medicaid healthcare program. (Pierson, 11/19)

Bloomberg: Mallinckrodt's $35,000 Drug Is Back In The Spotlight
A decades-old drug whose price surged after its maker was acquired is back in the spotlight thanks to a notorious short-seller’s scrutiny. H.P. Acthar Gel, extracted from the pituitary glands of pigs and used for patients with lupus, multiple sclerosis and other conditions, rose from $1,235 a vial in 2005 to $29,086 a vial in 2008, according to Red Book, a directory of drug prices. The increase caused an uproar, long before such price hikes became so common that they’re now an issue in the presidential campaign. A vial now costs about $35,000, according to price comparison site GoodRx. (Koons and Langreth, 11/10)

Bloomberg: Pfizer, Allergen Said To Discuss Making Saunders CEO In Deal
Pfizer Inc. and Allergan Plc are moving toward a plan to make Brent Saunders chief executive officer if the two drug giants reach a takeover agreement, according to people familiar with the matter. A combined Pfizer and Allergan would probably split into two companies eventually, with Allergan CEO Saunders taking the helm of the faster-growing business of new brand-name drugs, said the people, who asked not to be identified because negotiations are private. The other unit would contain older products at or near the end of their patent lives. (Campbell, David and Koons, 11/10)

Elsewhere, President Barack Obama expresses concern about drug-pricing issues but also talks about the important role the U.S. plays in the development of new medicines -

Health News Florida: Obama: U.S. Drug Development, Costs At Odds
President Barack Obama says he’s worried about rising prescription drug prices, but consumers need to take into account the United States’ role in the development of new medications, he told WUSF in a one-on-one interview. Lawmakers are pointing to prescription drugs costs as a main culprit in rising health care costs, from Florida to the U.S. Capitol, where new hearings on price gouging were announced last week. The President said part of the problem is that the U.S. doesn’t negotiate drug prices, even for programs like Medicare. And it’s also the world leader in developing new drugs. (Shedden, 11/8)

The Wall Street Journal: Millennium Health Files For Chapter 11 Bankruptcy
Millennium Health LLC, one of the nation’s largest drug-testing laboratories, has filed for chapter 11 bankruptcy protection, a month after agreeing to pay $256 million to settle allegations that it billed the federal government for unnecessary tests. The San Diego-based company filed for bankruptcy with a lender-backed plan that will slash $1.15 billion in debt off its books. Under the terms of the so-called prepackaged plan, Millennium’s lenders, owed $1.75 billion, will swap their debt for 100% of the equity in a reorganized company plus $600 million in new debt. (Fitzgerald and Brickley, 11/10)

Reuters: Millennium Health Seeks Bankruptcy After Overbilling Statement
Millennium Health, one of the largest urine drug testing laboratories in the United States, filed for Chapter 11 bankruptcy on Tuesday, a month after agreeing [to] a $256 million settlement to resolve federal allegations of health care fraud. The company, formerly Millennium Laboratories, allegedly billed Medicare, Medicaid and other federal healthcare programs for medically unnecessary testing. (Hals and Rucinski, 11/10)

Bloomberg: Millennium Lab Files Bankruptcy After Settling With U.S.
Millennium Health LLC filed for bankruptcy after settling federal claims that it improperly billed the government for running urine tests on dead people and checking senior citizens for angel dust. The prepackaged reorganization plan filed Tuesday in Delaware already has the support of key lenders. Under the proposal, Millennium, the largest U.S. drug-testing lab, will pay $256 million to settle the government claims while eliminating $1.2 billion in debt from its balance sheet. (Keller, Kary and McCarty, 11/10)

Arkansas Online: State Medicaid Reviews Restart
After a hiatus of more than two months, the Arkansas Department of Human Services has resumed its review of the eligibility of hundreds of thousands of Arkansans who have been enrolled in the private option or traditional Medicaid for at least a year. Human Services Department spokesman Kate Luck said Tuesday that the department used electronic records Monday evening to verify the eligibility of 3,334 recipients. Twenty-two recipients were found to be ineligible. (Davis, 11/11)

The Kansas Health Institute News Service: Federal Budget Deal Yields Medicaid Savings
A budget deal in Washington, D.C., is helping Kansas balance its own books temporarily with an infusion of Medicaid cash. But a Democratic senator says the savings should be used to provide home and community-based services to Kansans with disabilities. Gov. Sam Brownback’s budget director, Shawn Sullivan, answered lawmaker questions Monday about the administration’s plan to shift about $125 million to the state general fund. (Marso, 11/10)

The Philadelphia Inquirer: Pa. Wants Universal Health To Return $4M In Medicaid Payments
Universal Health Services Inc., of King of Prussia, said Friday that Pennsylvania officials had demanded that seven of its mental hospitals return $4 million to the state in fiscal 2011 payments made to the hospitals to compensate for losses on Medicaid and uninsured patients. The demand was made in a late September letter from the Pennsylvania Department of Human Services, UHS said in its quarterly filing with the Securities and Exchange Commisssion. State officials on Friday said the letters went to about 40 of roughly 200 hospitals eligible for the payments, but did not say how much money was demanded back overall. (Brubaker, 11/7)

The Wall Street Journal: Prime Healthcare Wins Saint Michael’s Medical Center Auction
The Saint Michael’s Medical Center, a 357-bed hospital in Newark, N.J., may become the latest facility to be taken over by California-based Prime Healthcare after it made a $62.2 million purchase offer. In court papers, Saint Michael’s Medical Center lawyers declared a Prime Healthcare affiliate to be the winner at Thursday’s bankruptcy auction for the hospital. (Stech, 11/10)

The Detroit Free Press: Allegiance Health In Jackson To Join Henry Ford System
Allegiance Health in Jackson plans next year to join the much larger Detroit-based Henry Ford Health System. The two nonprofit health systems announced Tuesday a letter of intent for an affiliation arrangement that would make Henry Ford the parent organization. The merger is still subject to regulatory approvals but expected to finalize in the first quarter of 2016, officials said. (Reindl, 11/10)

Heartland Health Monitor: Rural Hospitals In Kansas, Nebraska To Acquire Cerner Technology
About two dozen community hospitals in Kansas and Nebraska have signed up to use Cerner Corp.’s electronic health technology. The hospitals are members of the Great Plains Health Alliance, which provides management services to critical access hospitals in both states. Critical access hospitals focus on outpatient care and are limited to no more than 25 inpatient beds. Under federal Medicare guidelines, they are required to be at least 35 miles from any other hospital. (Margolies, 11/10)

Georgia Health News: 'Relationship-Based' Health Plan Debuts In Atlanta
Minneapolis-based Harken Health is launching in Atlanta and Chicago with some deep pockets behind it. Its main investor is health insurance giant UnitedHealth Group. Harken is opening six primary care centers in metro Atlanta, getting ready for its Jan. 1 start-up. The centers are located in Austell, Brookhaven, Decatur, Duluth, east Cobb County and Roswell. (Miller, 11/10)

The Associated Press: Md. Panel To Hold Seminar On Handling Mental Health Crisis
A Maryland panel is holding a seminar on how to de-escalate confrontations with people experiencing a mental health crisis. The Maryland Police and Correctional Training Commissions is holding a session on Wednesday afternoon to demonstrate what works and what doesn’t in a mental health crisis that will include participants who will role play. (11/11)

Los Angeles Times: Team Of Sleuths Stalks Cancer In L.A. County
Three men hunch over a table, scrutinizing a document. Maps paper the walls around them. The moment, captured in a black-and-white photograph, marks the beginning of a quest to catch a villain. For more than four decades, this team has been stalking the killer's every move, trying to identify patterns of attack. They collect and store evidence, filling drawers and file cabinets. The detectives: researchers at USC. The bad guy: cancer. (Karlamangla, 11/11)

NPR: Pitching Health Care In Baltimore's Red Light District
Every Thursday night you can find Nathan Fields making the rounds of Baltimore's red light district, known to locals as The Block. An outreach worker with the Baltimore City Health Department, Fields, 55, is a welcome sight outside strip clubs like Circus, Club Harem and Jewel Box. In the early evening before the clubs get busy, he talks with dancers, bouncers and anyone else passing by about preventing drug overdoses and how to stop the spread of HIV and other sexually transmitted diseases. Later on, he'll drop into the clubs to check on the dancers who aren't able to come outside, finding out what they might need. (Cornish, 11/10)

The Associated Press: Maine Sues Planned Parenthood Foe, Says He Yelled Too Loudly
Maine's attorney general is suing a protester who she says yelled so loudly outside a Planned Parenthood facility that he disrupted health care services there. Attorney General Janet Mills filed a complaint under the state's civil rights act against 26-year-old Brian Ingalls, of Lisbon. She says he violated the rights of patients at the Portland facility Oct. 23 when the sound of his voice directed to the second floor disrupted counseling sessions between staff and patients. (11/10)

Reuters: Maine Sues Anti-Abortion Protester, Claiming He Shouts Too Loud
Maine's top attorney on Tuesday filed a civil rights lawsuit against an anti-abortion protester, contending that his yelling outside a Portland Planned Parenthood clinic was so loud that it disrupted the staff's ability to counsel patients inside. The lawsuit, filed in Maine's Superior Court by Attorney General Janet Mills, alleges that Brian Ingalls, 26, who shouts about "murdering babies, aborted babies' blood and Jesus," violated the state's Civil Rights Act because he was audible inside the facility. (11/10)

Los Angeles Times: L.A. County To Pay $1.3 Million Over Doctor Who Molested Patients
Los Angeles County supervisors agreed Tuesday to pay $1.3 million to settle a lawsuit brought by a patient who alleged she was groped and sexually harassed by a doctor at a county clinic. They also took county health officials to task and called on them to put in place stricter protocols requiring that medical examinations be chaperoned and policies be developed to encourage nurses and staff to report doctors suspected of misconduct. (Sewell, 11/10)

Bloomberg: Texas Home Health Agency Indicted In $13M Medicare Fraud: U.S. Justice Dept.
Federal agents arrested and indicted the owners and administrators of a Texas-based home-health agency on Tuesday for defrauding Medicare of around $13 million through billing for unnecessary or non-existent services, the U.S. Justice Department said on Tuesday. The agency owned by Ebong Tilong and Marie Neba allegedly devised a web of kickbacks where physicians authorized home-health services and patients in on the scheme received a share of the payments, the department said. (11/10)

The Washington Post: How I Would Replace Obamacare
As gridlock persists in our nation’s capital and good legislation continues to die in the Senate, it is clear the next president will play a key role in determining the future of Obamacare. That means candidates’ positions on the issue will be among the most important when ballots are cast next year. Obamacare’s “three-legged stool” — the subsidies, guaranteed-issue rules and individual mandate — is already collapsing under its own weight. ... I recently proposed the most substantive conservative plan to repeal and replace Obamacare presented to date. My Obamacare alternative addresses the root causes of high health-care costs, offers patients more options and strengthens the safety net for the most vulnerable Americans. (Jeb Bush, 11/10)

The Wall Street Journal's Washington Wire: Health Care And The 2016 Debates
Until Carly Fiorina criticized Obamacare during Tuesday’s prime-time Republican debate, there hadn’t been much attention to health care in the GOP debates. During last week’s Democratic candidate forum in South Carolina, I didn’t detect a single question about health care or the Affordable Care Act. This is not a knock on hosts and moderators; debates and forums such as the Democratic meeting last week are not the best vehicles for drawing out presidential candidates on the intricacies of health policy. The result, however, is that the public is not learning much from these widely viewed events about what candidates would do regarding one of the country’s most divisive issues should he or she be elected president. (Drew Altman, 11/11)

Los Angeles Times: Supreme Court Should Reject This Religious Liberty Argument
In implementing the Affordable Care Act, the Obama administration has offered religious schools and charities that object to some birth control methods a reasonable and respectful accommodation: They need not provide or pay for contraceptive coverage for their female employees, but they must inform the government of their objections so coverage can be offered directly by an insurance company. But that compromise isn't good enough for the leaders of some of the organizations, who believe that merely signing a paper expressing their objections makes them complicit in sin because it "triggers" actions by others. (11/10)

The Washington Post: Signs Of Hope, But Also Heartbreak In The Fight Against Opioid Addiction
Republican presidential candidates have spent much of their time on the campaign trail lately pledging more treatment and less punishment to deal with epidemic drug abuse, most dramatically in a viral video featuring an emotional New Jersey Gov. Chris Christie. This is a welcome development — even if the GOPers, like their Democratic counterparts, exaggerate the degree to which arrests for simple possession of drugs, as opposed to trafficking, have swollen the prison population. The more attention leaders focus on the heartbreaking rise in prescription opioid and heroin addiction, and overdose deaths the better. (11/10)

The New York Times' Room For Debate: Should Drug Addicts Be Forced Into Treatment?
Opiate addiction is on the rise in the United States. Death rates, partly stemming from substance abuse, are increasing among middle-age white Americans. In response to what is being called a heroin epidemic, Massachusetts Gov. Charlie Baker has proposed legislation that would give hospitals the power to force treatment on drug addicts. Is this an effective approach to the problem? (11/11)

The New York Times' Opinionator: Lessons In End-Of-Life Care From The V.A.
Hospitals are increasingly using so-called patient experience surveys to see how they can improve, and to establish their national rankings. .... It was those questions about the hospital’s food, parking and cleanliness that prompted Roy to call me. Those things might be important to someone else, he said, who was hospitalized briefly for a knee replacement. But not for someone like [his wife] Sheila, who was facing advanced cancer and death within a year. Roy and Sheila wanted to tell us about the adequacy of the information they received from our doctors about Sheila’s prognosis and treatment options. And they wanted to compliment the emotional and spiritual support they received from our staff. Most important, Roy said, they wanted to thank the palliative care team, which was especially helpful. (David Casarett, 11/11)

The Philadelphia Inquirer: Study On Dietary Supplements Provides Perspective On Costly ER Visits
Although the percentage of adverse events associated with the use of dietary supplements is small, there are still an estimated 23,000 emergency department visits per year associated with their use. Considering the costs of emergency department visits, these types of adverse events can put a financial burden on patients, insurance companies, hospitals, and the health care system as a whole. It is unlikely that all of these emergency department visits could be prevented, but reducing the frequency of adverse events caused by dietary supplements could help to reduce the number of visits and could help to cut health care costs, as well. (Marcelo Fernandez-Vina, 11/10)

Health Affairs: To Understand Climbing Death Rates Among Whites, Look To Women Of Childbearing Age
The news that mortality is increasing among middle-aged white Americans spread like wildfire last week .... Unfortunately, there are a couple of pieces of the puzzle that we think the ... study missed. By not looking at men and women separately, [the study] failed to see that rising mortality is especially pronounced among women. ... Two studies from the National Academy of Sciences (NAS) and the Institute of Medicine (one of which was directed by the first author of this post) have shown that Americans are slipping behind other high-income countries when it comes to mortality and survival, and that this “US health disadvantage” has been growing particularly among women. Another study by researchers at the University of Wisconsin–Madison shows that in the decade between 1992-96 and 2002-06, female mortality rates increased in 42.8 percent of US counties. ... By lumping women and men together, the study also missed the important point that the increases in mortality are affecting women of reproductive and childrearing ages, a finding that has huge implications for children, families, and communities. (Laudan Aron, Lisa Dubay, Elaine Waxman, and Steven Martin, 11/10)

Bloomberg: Big Pharma's Shoes Don't Fit Amgen
The road to every blockbuster drug is a minefield. Drugs can end up being approved for smaller populations than expected, have nasty side effects, or run into increasingly penny pinching payers and governments, all of which can lop chunks off of rosy sales forecasts. For biotech firms with highly concentrated income streams, a big, failed acquisition is truly frightening. That's why the sort of company Amgen is reportedly seeking -- one with a late-stage drug that it can get on the market rapidly -- is in high demand. (Max Nisen, 11/10)