KHN Morning Briefing

Summaries of health policy coverage from major news organizations.

Kaiser Health News Original Stories

Political Cartoon: 'Shot In The Arm?'

Kaiser Health News provides a fresh take on health policy developments with "Political Cartoon: 'Shot In The Arm?'" by Chuck Legge.

Here's today's health policy haiku:

CELEBRATING MEDICARE AND MEDICAID

Nineteen-sixty-five
Such important programs passed
Safety net strengthened.

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Administration News

Forecast: National Health Care Spending To Accelerate

Federal actuaries issued a report Tuesday detailing a reversal in the slower spending trends of recent years. Among the reasons for this change, they said, is the health law's expanded health insurance coverage, the improving economy and the aging of baby boomers.

The Associated Press: Health Care Spending To Accelerate, US Report Says
It's lasted six years. But now welcome relief from rising U.S. health care costs seems to be winding down. Health care spending will outpace the nation's overall economic growth over the next decade, the government forecast on Tuesday, highlighting a challenge for the next president, not to mention taxpayers, businesses and individual Americans. A combination of expanded insurance coverage under President Barack Obama's law, an aging population, and rising demand will be squeezing society's ability to pay. (Alonso-Zaldivar, 7/29)

The Wall Street Journal: U.S. Health-Spending Growth Jumped To 5.5% In 2014
Growth in national health spending, which had dropped to historic lows in recent years, has snapped back and is set to continue at a faster pace over the next decade, federal actuaries said Tuesday. The return to bigger growth is a result of expanded insurance coverage under the 2010 health law, a revived economy and crunchtime as Medicare’s baby-boom beneficiaries enter their 70s. (Radnofsky, 7/28)

The Washington Post's Wonkblog: By 2024, Health Spending Will Be Nearly A Fifth Of The Economy
There are several major factors behind the accelerated growth over the next decade, economist Sean P. Keehan said at a press briefing Tuesday morning. More people have gained health insurance coverage under the Affordable Care Act, the aging of the Baby Boomer generation and stronger economic growth will all contribute to the long-term trend, he said. Prescription drug spending has also increased markedly, largely due to the debut of expensive hepatitis C drugs over the last two years, Keehan said. (Johnson, 7/28)

USA Today: Health Spending Projected To Grow Modestly, But Faster
Overall, health spending is expected to rise to $5.4 trillion by 2024, surpassing growth in the Gross Domestic Product, which is expected to average 4.7%. That means health spending will account for about a fifth of the U.S. economy in 2024 — 19.6% to be exact, up from 17.4% in 2013. Chapin White, a senior policy research with the RAND Corporation, a nonprofit, non-partisan research organization, says that's not necessarily going to happen -- and, in fact, none of the projections are assured. "There's a lot of uncertainty around these projections," he says, adding that what ultimately happens depends a lot on decisions and policies yet to be made. (Unger, 7/28)

Politico: Health Care Spending Again Accelerating
But the projected hikes remain far below the historic levels of recent decades. ... Moreover, the average projected growth during the coming decade is actually down slightly from last year, when 6 percent annual increases were predicted. About 8.4 million Americans gained coverage under the ACA in 2014, according to CMS. “If you’re temporarily reaching spending growth not much above those historic lows, but in the process you’re covering millions of people, that’s a pretty good bargain,” said Paul Hughes-Cromwick, senior health economist at the Altarum Institute’s Center for Sustainable Health Spending. (Demko, 7/28)

CNN Money: Health Care Spending Expected To Grow Faster
The rapid growth of Medicare and Medicaid, however, will weigh even more heavily on the federal budget. Nearly half of total U.S. health expenses will be paid for by federal, state and local governments by 2024, according to federal projections. (Luhby, 7/28)

The Fiscal Times: US Health Spending: $3.1 Trillion A Year And Growing
To experts in the economics of health care, the findings in the new paper by a team of economists and actuaries from the Centers for Medicare and Medicaid Services are still modestly encouraging. Despite the addition of millions of people to the health care system under the Affordable Care Act, the rate of spending growth doesn’t appear to be headed back toward pre-recession rates. For the next decade and more, the annual growth rate will stay at around 5.8 percent, well below the 9 percent annual increase that was standard in the years prior to the Great Recession. (Garver, 7/29)

Take Note -- Medicare And Medicaid Mark A Big Birthday

Both federal programs were signed into law on July 30, 1965. News outlets are examining these programs, as well as their accomplishments and the growing pains they will face going forward.

The Associated Press: Then & Now: Medicare And Medicaid Turn 50
When President Lyndon B. Johnson signed Medicare and Medicaid into law on July 30, 1965, Americans 65 and older were the age group least likely to have health insurance. "No longer will older Americans be denied the healing miracle of modern medicine," Johnson said at the signing ceremony. "No longer will illness crush and destroy the savings that they have so carefully put away over a lifetime so that they might enjoy dignity in their later years. No longer will young families see their own incomes, and their own hopes, eaten away simply because they are carrying out their deep moral obligations to their parents, and to their uncles, and their aunts." (7/29)

The Sacramento Bee: Happy 50th, Medicare
At 50, Medicare is comfortably settled into middle age, but with some of the aches and pains that go with getting older. As the granddaddy of the U.S. health care system, it helps pay for hospitalizations, doctors’ visits and prescription drugs for 55 million Americans who might otherwise go without. (Buck, 7/28)

In related news -

CQ Healthbeat: CMS: Medicaid And CHIP Enrollment Rose In May
The number of people enrolled in Medicaid or the Children’s Health Insurance Program continued to inch upward in May, according to updated federal statistics. The total number of people who were receiving Medicaid or children’s health coverage benefits stood at 71.6 million people, about 12.8 million people on average more than in a three-month period in 2013, before the main coverage expansions in the health care law took place. (Adams, 7/28)

Capitol Hill Watch

GOP Senators Introduce Legislation To Defund Planned Parenthood

The goal of this bill is to stop federal funding for the abortion rights organization, which is in the hot seat after covert videos were released about the group's role in supplying fetal tissue for medical research. A vote is planned in the next few days and Republicans are looking to some of the women in their caucus to lead the charge.

Politico: GOP Introduces Legislation To Defund Planned Parenthood
Senate Republicans — including Majority Leader Mitch McConnell — have introduced legislation to cut off all federal funds to Planned Parenthood, the abortion rights group at the center of a political firestorm over alleged fetal tissues sales. A “working group” led by GOP Sens. Joni Ernst of Iowa, James Lankford of Oklahoma and Rand Paul of Kentucky drafted the legislation, which is expected to be voted on in the Senate next week. More than 20 other Republicans have signed on as cosponsors, including Majority Whip John Cornyn and Sen. Ted Cruz, both of Texas. Cruz and Paul are both vying for the Republican presidential nomination. (Bresnahan and Palmer, 7/28)

Reuters: After Videos, Senate Republicans Target Planned Parenthood Vote
Senate Republicans are planning a vote in coming days on legislation to cut $500 million in annual federal funding for Planned Parenthood, reigniting a fight in Congress over abortion that has long been dormant. For years a target of conservatives, Planned Parenthood has come under increasing scrutiny recently due to secretly recorded videos about its role in supplying aborted fetal tissue for medical research. (Cowan and Cassella, 7/28)

The Washington Post: GOP Leaders Want Women Leading Anti-Planned Parenthood Efforts
Congressional Republicans are launching a new effort to end federal support for Planned Parenthood amid questions over its handling of fetal tissue, and it appears GOP leaders are looking to women to lead that fight. Sen. Joni Ernst (R-Iowa) will lead a working group tasked with developing a legislative response to the spate of recently released undercover video of Planned Parenthood executives, Senate Majority Leader Mitch McConnell (R-Ky.) said Tuesday. And House Majority Leader Kevin McCarthy (R-Calif.) said Monday that House leaders are looking closely at legislation by Rep. Diane Black (R-Tenn.), a veteran antiabortion advocate, that would block funding to the group unless it stops performing abortions. (DeBonis, 7/28)

This debate is also a hot topic among GOP presidential candidates and has prompted Planned Parenthood to hire a crisis PR firm -

Politico: Carson, Cruz And Paul Rally Against Planned Parenthood
Sen. Ted Cruz called on the Department of Justice to open a criminal investigation into the people who appear in undercover videos of Planned Parenthood officials discussing fetal tissue donation. Cruz was speaking at an anti-abortion rally organized by Students for Life of America on Tuesday, just after activists released their third undercover video of Planned Parenthood officials discussing fetal body parts in graphic detail. (Collins, 7/28)

Politico: Planned Parenthood Taps Crisis Communications Firm
Planned Parenthood has enlisted high-profile Washington public relations firm SKDKnickerbocker as it scrambles to deal with the ongoing scandal and release of a third undercover video Tuesday showing a clinic’s staff handling fetal tissue after an abortion. (Haberkorn and Palmer, 7/28)

Meanwhile, here's an explainer on how this tissue has long been used in medical research -

Pending Highway Bill Includes Emergency Funding For Veterans Affairs

Without congressional intervention, the agency faced a budget hole that it says would force the closure of hospitals and clinics across the country. In related health news, the Pentagon is set to award a $10.5 billion electronic health records contract.

The Associated Press: What's In Emergency Bill To Fund Veterans Affairs Department
A three-month highway spending bill scheduled for a vote Wednesday in the House includes nearly $3.4 billion to fill a budget hole that the Department of Veterans Affairs claims would force it to close hospitals and clinics nationwide. Lawmakers from both parties said the spending was needed even as they complained about the VA's failure to anticipate the problem. An amendment sponsored by Rep. Jeff Miller, R-Fla., chairman of the House Veterans Affairs Committee, would allow VA to use $3.35 billion from the new Veterans Choice program to pay for private health care for veterans from May 1 to Oct. 1. (7/28)

The Washington Post: Pentagon Gets Ready To Award Big Contract For Electronic Medical Records
The Pentagon is poised within days to award one of the most coveted health information-technology contracts in history — the first phase of a deal that could ultimately be worth more than $10.5 billon over the 18-year life of the contract. This is the first major federal IT contract since HealthCare.gov, which was so plagued by defects that hundreds of thousands of Americans were initially frustrated in trying to sign up for health insurance. The effort, designed to provide a much-needed upgrade to the current system used by 9.5 million military personnel, including active duty and retirees, is being hotly pursued by three of the heaviest hitters in private industry: Epic Systems, Cerner and Allscripts Healthcare Solutions. (Nutt and Brittain, 7/27)

Also from Capitol Hill, a status update on the Cures bill -

CQ Healthbeat: Alexander Expects Senate Action On Medical Cures Next Year
Senate Health, Education, Labor and Pensions Chairman Lamar Alexander is confident that Congress will next year clear a bill that's intended to help speed the introduction of new medical treatments. "This is a train that will actually get to the station," Alexander, a Tennessee Republican, told a Bipartisan Policy Center event on Monday. House Energy and Commerce Chairman Fred Upton, R-Mich., has been urging rapid action on any Senate companion to his so-called 21st Century Cures bill (HR 6), calling on Alexander to pass a bill addressing concerns such as making electronic health records more user-friendly and then move for a conference with the House. Waiting until next year could make it harder to pass a sweeping regulatory bill during an election. The House passed Upton's bill, 344-77, earlier this month. (Young, 7/28)

Health Law Issues And Implementation

Burwell: No Evidence Of Fraudulent Obamacare Enrollments

Health and Human Services Secretary Sylvia Mathews Burwell testified on Capitol Hill to respond to a preliminary report by the Government Accountability Office that detailed how investigators were able to sign up for coverage and qualify for subsidies with phony information. Also in the news, Wheaton College will take a stand against the health law's contraception mandate by ceasing to provide health insurance to students.

Modern Healthcare: HHS: No Evidence Of Fraudulent Healthcare.gov Enrollment
HHS is not aware of any consumers intentionally falsifying information to get subsidies for insurance exchange coverage, Secretary Sylvia Mathews Burwell testified Tuesday at a hearing. Her testimony came days after the Government Accountability Office issued a preliminary report that documented how its investigators were able to sign up for coverage, get insurance subsidies and re-enroll with made-up information. (Dickson, 7/28)

The Chicago Tribune: Wheaton College Ends Coverage Amid Fight Against Birth Control Mandate
Taking a firm stand against Obamacare's controversial contraception mandate, Wheaton College on Friday will stop providing any health insurance for students. The decision, announced to students July 10, will halt health care coverage for about a quarter of the college's 3,000 undergraduate and graduate students, forcing them to shop for other plans just weeks before their coverage ends. (Pashman, 7/28)

And a JAMA study offers positive news about the health law's impact to date -

USA Today: Obamacare Reduces Uninsured Rates, Improves Access To Care, Study Finds
Since the Affordable Care Act took effect, fewer Americans lack health insurance or have trouble getting the care and medicines they need, a study released Tuesday says. The research, published in the Journal of the American Medical Association, says the number of Americans who reported being uninsured dropped 7.9 percentage points by the first quarter of this year. Minorities saw the biggest reductions — with uninsured rates among Latinos, for example, dropping by 11.9 percentage points. (Ungar, 7/28)

Reuters: Americans Report Improved Health, Better Healthcare: Study
Americans are reporting improved health and better healthcare two years after health insurance became available under the Affordable Care Act, according to a new study published on Tuesday in the Journal of the American Medical Association. The study of more than 500,000 Americans found improvements in insurance coverage, access to primary care and prescription medicine, affordable healthcare and overall health since late 2013. (Seaman, 7/29)

Medicare

Study: Deaths, Hospital Stays And Costs Decrease Among Americans On Medicare

USA Today says the findings are "jaw-dropping," and experts quoted in other news stories say the results reported in this JAMA study indicate "remarkable progress."

USA Today: 'Jaw-Dropping': Medicare Deaths, Hospitalizations AND Costs Reduced
The U.S. health care system has scored a medical hat trick, reducing deaths, hospitalizations and costs, a new study shows. Mortality rates among Medicare patients fell 16% from 1999 to 2013. That’s equal to more than 300,000 fewer deaths a year in 2013 than in 1999, said cardiologist Harlan Krumholz, lead author of a new study in the Journal of the American Medical Association (JAMA) and a professor at the Yale School of Medicine. (Szabo, 7/28)

Reuters: Health Care Improving For Older Americans
The number of deaths, hospital stays and healthcare costs decreased among older Americans on Medicare over the past 15 years, according to a new study. "Although our health care system has its failings, we are making remarkable progress," said Dr. Harlan Krumholz, the study's lead author from Yale University in New Haven, Connecticut. (Seaman, 7/28)

NPR: Happy 50th Birthday, Medicare. Your Patients Are Getting Healthier
Here's a bit of good news for Medicare, the popular government program that's turning 50 this week. Older Americans on Medicare are spending less time in the hospital; they're living longer; and the cost of a typical hospital stay has actually come down over the past 15 years, according to a study in the Journal of the American Medical Association. (Harris, 7/28)

Marketplace

Gilead's Blockbuster Hepatitis C Drug Propelled Second-Quarter Profits

The Associated Press reports that the company's hepatitis C franchise was responsible for 59 percent of the revenue. Meanwhile, Merck reported better-than-expected financial news because of increased demand for its diabetes and cancer drugs.

The Associated Press: Gilead Beats Street 2Q Forecasts On Surge In Sales, Profit
Blockbuster hepatitis C medicine Harvoni propelled Gilead Sciences Inc.’s second-quarter profit up 23 percent as total revenue for the biotech drugmaker jumped 26 percent and it raised its 2015 sales forecast for the second time. Its shares jumped in after-hours trading. Harvoni and a second hepatitis C drug, Sovaldi, together posted sales about $500 million above expectations and HIV medicine sales were higher-than-expected across all products, noted Edward Jones analyst Ashtyn Evans. (Johnson, 7/28)

Reuters: Merck Raises Forecast On Strong Sales Of Diabetes, Cancer Drugs
Merck & Co Inc reported a better-than-expected quarterly profit and boosted its full-year earnings forecast as demand for its diabetes and cancer drugs increased. The company also said it expects to reap benefits from its $8.4 billion purchase of Cubist Pharmaceuticals, the maker of blockbuster antibiotic Cubicin. Cubicin sales for the second quarter were $293 million. (7/28)

In other marketplace news -

Reuters: Centene Considers Snapping Up Medicare Advantage Plans From Rivals
Health insurer Centene Corp reported a better-than-expected quarterly profit and said it would consider buying the Medicare Advantage plans its rivals are likely to divest during the current phase of consolidation in the managed care industry. U.S. health insurers are consolidating in an attempt to cut costs and improve their bargaining power with doctors and hospitals. Anthem Inc said last week that it would buy Cigna Corp for about $54.2 billion, creating the largest U.S. health insurer, while Aetna Inc agreed to buy Humana Inc for $37 billion this month. (Penumudi, 7/28)

State Watch

State Highlights: Feds Extend Ban On New South Fla. Home Health Agencies; Seattle Hospitals Fall Short In Preventing Infections

Health care stories are reported from Florida, Washington, Minnesota, Kansas, Illinois, New York and Massachusetts.

The Miami Herald: Feds Extend Ban On New Home Health Agencies In South Florida
South Florida continues to be ripe for potential fraud, waste and abuse of Medicare and Medicaid through companies that provide nurses, therapists and other medical workers to patients in their homes, federal officials said this week in extending a moratorium on the licensing of new home health agencies in Miami-Dade, Monroe and Broward counties. The six-month moratorium, allowed under the Affordable Care Act, extends a ban that started in Miami-Dade and Monroe in July 2013 and Broward in January 2014. The moratorium also applies to home health agencies in Detroit, Dallas, Houston and Chicago. (Chang, 7/28)

The Seattle Times: Seattle-Area Hospitals Get Low Marks For Stopping Infections
Many of the Seattle area’s largest and best-known hospitals may fall short when it comes to preventing patients from acquiring potentially deadly infections during their stays, a new analysis shows. Of the region’s five biggest hospitals — including the University of Washington (UWMC) and Harborview medical centers — none achieved top ratings in Consumer Reports’ latest rankings, released Wednesday. All received low or middling scores both overall and for halting two newly added infections: C. diff and MRSA. (Aleccia, 7/28)

Health News Florida: Univita Health Losing Medicaid Contracts
Univita Health, which gained control of the entire Florida Medicaid home-care market a year ago, has suddenly lost all of its HMO contracts. The Florida Agency for Health Care Administration made the announcement in an e-mail blast late Tuesday afternoon. AHCA offered no explanation. Univita, based in Miramar, stopped processing requests for home health-care services, durable medical equipment such as wheelchairs, and intravenous therapy “effective immediately,” AHCA said. (Gentry, 7/28)

The Kansas Health Institute News Service: Data Breach May Affect Thousands Of Kansans
Thousands of Kansans soon will be receiving letters notifying them that their electronic health records may have been compromised. The letters are from a Fort Wayne, Ind., company that provides an online patient portal called NoMoreClipboard used by 18 Kansas hospitals and at least half a dozen clinics. Most are small-town hospitals in western and southeastern Kansas. The largest is in Hutchinson. (Thompson, 7/28)

The Associated Press: Appeals Court: Kansas Abortion Opponent Must Stand Trial
A Kansas abortion opponent must stand trial over a letter she sent to a Wichita doctor saying someone might place an explosive under the doctor’s car, a federal appeals court ruled Tuesday. The 10th U.S. Circuit Court of Appeals overturned late Tuesday a lower court’s summary decision that anti-abortion activist Angel Dillard’s letter was constitutionally protected speech. (Hegeman, 7/29)

The Chicago Tribune: Hospital Owner Faces Sentencing Wednesday For Massive Fraud Scheme
As the leader of a hospital in one of Chicago's most impoverished neighborhoods, Edward Novak often championed himself as a down-to-earth businessman who brought access to health care to those otherwise ignored. But federal prosecutors say Novak, the fabulously wealthy owner and CEO of Sacred Heart Hospital, in reality had a very different view of the residents of the Garfield Park area he supposedly served. (Meisner, 7/29)

The Kansas Health Institute News Service: KVC Hospital Agrees To Admit Would-Be Osawatomie Patients
A children’s psychiatric facility in Kansas City, Kan., has agreed to set aside 12 inpatient beds for adults who have been referred to Osawatomie State Hospital but haven’t been admitted due to overcrowding there. “This will definitely help with the situation at Osawatomie,” said Kyle Kessler, executive director with the Association of Community Mental Health Centers of Kansas. (Ranney, 7/28)

News Service Of Florida: Auto Insurer Pushes For Hospital Contracts
State Farm Mutual Automobile Insurance is asking the Florida Supreme Court to take up a dispute about whether a Jacksonville hospital needs to turn over information about contracts with health insurers. A three-judge panel of the 1st District Court of Appeal last month ruled in favor of Shands Jacksonville Medical Center, which now is known as UF Health Jacksonville, in the dispute stemming from personal-injury protection auto-insurance claims. (7/28)

The Associated Press: Skin Doctors Urge Under-18 Ban On Tanning Beds
Dermatologists who treat skin cancer patients urged [Massachusetts] lawmakers on Tuesday to approve a bill that would bar anyone under age 18 from using tanning beds, but salon owners accused critics of overstating the risks. Current Massachusetts law allows 14- to 17-year-olds to visit tanning salons with written consent from a parent or legal guardian. Children under 14 can only use a tanning bed if accompanied by a parent or guardian. (Salsberg, 7/28)

Editorials And Opinions

Viewpoints: The Role Of High-Priced Drugs In The Nation's Health Care Spending; Ushering In A New Age Of Preventive Health Care

A selection of opinions on health care from around the country.

The New York Times' The Upshot: Health Spending Forecast: No Drastic Rise, But Slowdown Seems Over
New projections by federal government actuaries suggest that the nation’s five-year run of tiny increases in health care spending is coming to an end. The projections released on Tuesday estimate that health spending will average 5.8 percent a year through 2024, higher than the 4 percent annual growth measured between 2007 and 2013. That means health spending will be growing faster than is expected for the overall economy, but it isn’t expected to grow as fast as it did in the years before the Great Recession. (Margot Sanger-Katz, 7/29)

The Wall Street Journal: How To Usher In A New Era Of Preventive Health Care
Laboratory tests drive 70% of all clinical decisions in health care. They’re used to determine whether a patient should start taking medication and, if so, which one. They help doctors decide whether a patient should undergo medical procedures or be admitted to the hospital. And they’re used to identify an individual’s risk of developing health conditions such as diabetes or heart disease. (Elizabeth Holmes, 7/28)

The Washington Post's Plum Line: Here’s Some More Good News About Obamacare. Too Bad It Won’t Dent The Debate.
Whenever a health insurer announces that it will be requesting significant premium increases in the coming year, it’s guaranteed to generate news stories that are waved triumphantly by conservatives as proof that the Affordable Care Act is a failure and, just as they predicted, premiums are skyrocketing because the government is messing around in health care. (Paul Waldman, 7/28)

Los Angeles Times: Covered California's Good News On Premium Hikes Comes With Trade-Offs
The 2010 federal healthcare reform law made it easier for millions of Americans to obtain insurance coverage, but it didn't stop the cost of that coverage from rising considerably faster than inflation. So it was a welcome surprise Monday when officials at Covered California, the state's health insurance exchange, announced that the average premiums for individual policies in 2016 would be only about 4% higher than they are this year, and only about 2% higher in Los Angeles County. Mixed in with the good news for consumers, though, were some trade-offs that won't make everyone happy. The announcement offers lessons for consumers and policymakers, not all of which are easy to stomach. (7/28)

The Kansas City Star: How Do We Prepare For The Realities Of Dying?
Why is it that Americans seem to be the only people on the planet who live their lives as though death were an optional event? For many of us who have worked for years helping families and clinicians grapple with difficult choices in “shared decision making,” we’ve been challenged by that convention despite the evidence that 75 percent of us claim that preparing a living will and appointing a health care proxy are critically important. Yet fewer than one-third of us do anything to make it happen. Perhaps it’s our willing adherence to myths, most notably our believing that when the time comes, we’ll know, and we’ll have time to get our affairs in order, making our wishes known. This “just in time” approach may be comforting but, in reality, it’s magical thinking. For most of us, the “right time” never comes, but the crisis does. Believing in a scenario that we’ll luck into a peaceful passing without ever having so much as an uncomfortable conversation with anyone doesn’t support the reality that 80 percent of us will eventually rely on a proxy to make decisions for us. (John G. Carney, 7/29)

The Detroit Free Press: A Look At ADA's Lasting Impact In Metro Detroit
Twenty-five years ago, America took a bold leap toward becoming a more perfect union when we rejected the old prejudices that restricted people with disabilities to institutions, isolation and exclusion from American life. In enacting the Americans with Disabilities Act in 1990, our nation embraced the idea that all Americans should be able to participate fully in our society. The ADA guarantees equal access for Americans with disabilities to education, jobs, health care, transportation, housing, polling places and other public places such as restaurants, hotels and entertainment venues. (Barbara McQuade, 7/28)