KHN Weekly Edition: Oct. 28, 2022

$38,398 for a Single Shot of a Very Old Cancer Drug
By Arthur Allen Lupron, a drug patented half a century ago, treats advanced prostate cancer. It’s sold to physicians for $260 in the U.K. and administered at no charge. Why are U.S. hospitals — which may pay nearly as little for the drug — charging so much more to administer it?

Knoxville’s Black Community Endured Deeply Rooted Racism. Now There Is Medical Debt.
By Noam N. Levey Despite the end of Jim Crow segregation, its legacy lives on in medical debt that disproportionately burdens Black communities.

Ambulance Company to Halt Some Rides in Southern California, Citing Low Medicaid Rates
By Sarah Kwon American Medical Response, the largest U.S. ambulance company, is ending nonemergency transportation for 12 hospitals in Los Angeles and Orange counties, saying the state doesn’t pay enough to transport low-income patients. The state is pushing back.

Despite Katie Couric’s Advice, Doctors Say Ultrasound Breast Exams May Not Be Needed
By Michelle Andrews When Katie Couric announced she had breast cancer, she urged women to get a mammogram — and, if they have dense breasts, to get supplemental screening by ultrasound. But medical experts point out that ultrasound and other auxiliary screenings haven’t been proven to do more than regular mammography in reducing mortality.

Employers Are Concerned About Covering Workers’ Mental Health Needs, Survey Finds
By Michelle Andrews Nearly half of large employers report that increasing numbers of their workers were using mental health services, according to a KFF annual employer survey. Yet almost a third of those employers said their health plan’s network didn’t have enough behavioral health care providers for employees to have timely access to the care they need.

When Monkeypox Reaches Rural Communities, It Collides With Strained Public Health Systems
By Jazmin Orozco Rodriguez In Nevada, local health officials are assessing the threat of monkeypox, but their response may be hampered by historically limited public health infrastructure worn thin by the covid-19 pandemic.

Drivers in Decline: A Shortage of Volunteers Complicates Access to Care in Rural America
By Christina Saint Louis Public transit is already insufficient in rural areas, leaving residents with few options as they travel greater distances to access health care. But older residents who depend on volunteer drivers to get them to appointments face another challenge: The number of those volunteers is declining.

A Billing Expert Saved Big After Finding an Incorrect Charge in Her Husband’s ER Bill
By Bram Sable-Smith A medical billing specialist investigated her husband’s ER bill. Her sleuthing took over a year but knocked thousands of dollars off the hospital’s charges — and provides a playbook for other consumers.

For the Houma People, Displacement Looms With Every Storm
By Emmarie Huetteman The Houma, an Indigenous tribe, has seen much of its Gulf Coast community washed away by rising sea levels and dangerous storms. Its leaders say the tribe’s lack of federal recognition makes it harder to keep rebuilding.

Listen: How Does Human Composting Work?
California Healthline’s Bernard J. Wolfson went on the air to explain a new California law that will allow people to have their bodies reduced to compost after death, an alternative to the traditional-but-toxic methods of cremation and burial.

An Abortion Rights Question on the California Ballot Revives the Debate Over ‘Viability’
By April Dembosky, KQED California voters will decide in November whether to amend the state constitution to explicitly protect abortion rights. But there is disagreement over whether the proposal, Proposition 1, would merely enshrine existing rights or expand them.

Hospitals Said They Lost Money on Medicare Patients. Some Made Millions, a State Report Finds.
By Fred Clasen-Kelly A North Carolina state treasurer’s report found hospitals give conflicting information about whether they profit from Medicare patients. Experts said the findings are significant because they suggest the federal government has failed to closely watch the billions of dollars in tax breaks that nonprofit hospitals have received.

How Private Equity Is Investing in Health Care: A Video Primer
By Hannah Norman and Oona Zenda Investors are putting money into everything from emergency room obstetrics units and dermatology practices to nursing homes and hospice care — from cradle to grave.

States Opting Out of a Federal Program That Tracks Teen Behavior as Youth Mental Health Worsens
By Daniel Chang Colorado, Florida, and Idaho are the latest states to opt out of a survey that tracks concerning behaviors in high school students. Officials cite low participation and state laws that require parental permission. But some advocates say dwindling state participation is an “enormous loss” that will make it harder to track signs of poor mental health — like drug and alcohol misuse and suicidal ideation — among teens.

Montana Backs Away From Innovative Hospital Payment Model. Other States Are Watching.
By Katheryn Houghton Montana has been a national model for how employers could gain control and transparency over medical bills. Upcoming changes to its model have health care price experts wondering whether the state is making improvements or losing focus.

KHN’s ‘What the Health?’: Voters Will Get Their Say on Multiple Health Issues
Abortion isn’t the only health issue voters will be asked to decide in state ballot questions next month. Proposals about medical debt, Medicaid expansion, and whether health care should be a right are on ballots in various states. Meanwhile, the latest lawsuit challenging the Affordable Care Act has expanded to cover all preventive care. Alice Miranda Ollstein of Politico, Jessie Hellmann of CQ Roll Call, and Victoria Knight of Axios join KHN’s Julie Rovner to discuss these topics and more.

Readers and Tweeters Take Positions on Sleep Apnea Treatment
KHN gives readers a chance to comment on a recent batch of stories.