KHN Morning Briefing

Summaries of health policy coverage from major news organizations

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From Kaiser Health News - Latest Stories:

Kaiser Health News Original Stories

Election Buzz: With Pot On The Ballot, States Weigh How To Police Stoned Drivers

Blood tests for marijuana aren't an accurate measure of impairment for drivers, and there isn't an easy roadside sobriety test for pot yet. The five states where recreational marijuana is on the ballot may be looking to Colorado for its experiences with the DUI problem soon. (Stephanie O'Neill, Southern California Public Radio and Ben Markus, Colorado Public Radio, 9/27)

Political Cartoon: 'Sugar-Coated'

Kaiser Health News provides a fresh take on health policy developments with "Political Cartoon: 'Sugar-Coated'" by Steve Sack, The Minneapolis Star Tribune.

Here's today's health policy haiku:

TAPPING INTO THE WATER SUPPLY

There’s more talk – drip, drop …
As some city councils mull
Fluoride’s pros and cons.

If you have a health policy haiku to share, please Contact Us and let us know if you want us to include your name. Keep in mind that we give extra points if you link back to a KHN original story.

Summaries Of The News:

Pharmaceuticals

Mylan Misrepresented EpiPen Profits To Congress By 60 Percent

The company said it used the standard 37.5 percent corporate tax rate to get the numbers it reported to Congress. But Mylan had a 7.4 percent overall tax rate last year.

The Wall Street Journal: Mylan’s EpiPen Pretax Profits 60% Higher Than Number Told To Congress
Mylan NV on Monday clarified the profit it said it made from its lifesaving EpiPen drug, days after House members badgered the company’s CEO to justify the device’s steep price increases. Testifying before a congressional committee last week, CEO Heather Bresch said Mylan’s profit was $100 for a two-pack of the injectors, despite a $608 list price. But in response to questions from The Wall Street Journal, Mylan said Monday that the profit figure presented by Ms. Bresch included taxes, which the company didn’t clearly convey to Congress. (Maremont, 9/26)

The Fiscal Times: Mylan Admits It Makes Far More On EpiPens Than It Originally Reported To Congress 
Mylan CEO Heather Bresch tried to perform damage control during her testimony before a House committee last week, voicing regret for what many view as unconscionable price hikes on the popular EpiPen epinephrine auto-injector used to combat dangerous allergic reactions. But Mylan admitted on Monday that the EpiPen’s pre-tax profits were actually 60 percent higher than it told Congress, according to The Wall Street Journal. (Pianin, 9/26)

Reuters: Mylan Faces Scrutiny Over EpiPen Profit Data Shown To Congress
Mylan NV faced questions on Monday about the profit on its EpiPen emergency allergy treatment, following a report that the company makes 60 percent more on the injector than it had told Congress. ... Lawmakers are trying to determine whether Mylan made more money on EpiPen than warranted from state Medicaid programs by having it classified as a generic product, resulting in much smaller rebates to the government health plans. (Clarke and Grover, 9/26)

CNN Money: Outrageous EpiPen Prices Lead Some People To Make Their Own
The EpiPencil, which costs less than $35, requires just a few parts which someone can easily get themselves, including an auto injector and a syringe. The epinephrine medicine and delivery system (an epinephrine pump) are currently at the center of a debate about pharmaceutical pricing. (Larson, 9/24)

Pfizer Decides Not To Split Into Two Companies After Years Of Planning That Cost $600M

The pharmaceutical company considered the option as a way to reduce its complexity while rewarding shareholders with the stock split, but has decided to scrap the plan.

The Wall Street Journal: Pfizer Throws Out Plan To Split Into Two Companies
Pfizer Inc. said Monday it would remain a single company, deciding not to split into one business focused on patent-protected drugs and another on cash-rich older products. The decision means the New York City-based drug company would remain one of the industry’s largest. It projects at least $51 billion in revenue this year from a growing portfolio of cancer drugs and vaccines as well as a pipeline with copies of expensive big-molecule drugs. (Rockoff and Hufford, 9/26)

Bloomberg: Pfizer Opts Not To Split, Putting Focus On M&A And New Drugs
Share on Facebook Share on Twitter Pfizer Inc. decided not to split in two separate companies, opting against what could have been one of the biggest breakups in the drug industry’s history after years of what it called an “extensive evaluation.” The decision follows the collapse of Pfizer’s attempted $160 billion merger with Allergan Plc in April, a deal that would have shifted the company’s tax address overseas and bulked up one of the units before a split. In recent months, New York-based Pfizer had signaled it might stay together. (Koons and Hopkins, 9/26)

In other pharmaceutical news —

The Wall Street Journal: Kite Pharma’s Lead Cancer Candidate Shows Promising Results
Kite Pharma Inc. said more than two-thirds of patients treated with its proposed lymphoma treatment responded to the therapy, with more than 40% showing a complete remission, according to an interim analysis of a mid-stage clinical trial. Shares of the biopharmaceutical company, down 11% this year, jumped 9% to $60 in after-hours trade. (Armental, 9/26)

Health Law Issues And Implementation

House To Vote On Measure To Help Consumers Who Lost Coverage When Co-Ops Collapsed

In other news related to the health law and marketplace coverage, media outlets report on Blue Cross Blue Shield movements in Tennessee, Texas and five other states.

Morning Consult: House To Vote On Obamacare Individual Mandate Exemption
The House on Wednesday will consider a bill that would exempt people who lost their insurance coverage because a co-op closed from the Affordable Care Act’s individual mandate. The measure seeks to help consumers of three co-op insurance plans who have had their coverage interrupted this year because the co-op through which they purchased insurance failed mid-year. The Ways and Means Committee approved the measure by voice vote earlier this month. Republicans say people whose coverage is stopped because their insurer closes their doors shouldn’t be fined for not having coverage the rest of that year. (McIntire, 9/26)

Medicaid Expansion Advocates Look To The Election To Press Their Cause

Some people hoping to see more states expand their Medicaid programs under the health law think the opposition may be lighter after this campaign.

Politico Pro: Medicaid Expansion Backers Look To 2017 — And A New President 
Supporters of Obamacare’s Medicaid expansion want to capitalize on the first year of a post-Barack Obama presidency, hoping that a change in the White House will inject new life into efforts that have languished. Nineteen states predominantly controlled by Republicans have yet to embrace the Obamacare program, leaving roughly 3 million low-income individuals without health insurance. Yet there are some signs that opposition is splintering. (Pradhan, 9/26)

Deseret News: Gov. Herbert, Challenger Weinholtz Spar Over Economy, Medicaid Expansion, Public Lands In Debate
Democratic candidate for governor Mike Weinholtz took some tough shots at Republican Gov. Gary Herbert in what will likely be their last debate Monday, but the governor said he has Utahns on his side. ... Throughout the debate, Weinholtz called for the state to do more on a range of topics, including expanding Medicaid coverage under the Affordable Care Act and preserving public lands. The chairman of CHG Healthcare, who has pumped $2.5 million of his own money into the race, criticized the governor for what he said was a "punt" to the Legislature on Medicaid expansion. (Riley Roche, 9/26)

The (Baton Rouge, La.) Advocate: Democrats In U.S. Senate Race Say Expanding Medicaid Good, Even 'G-R-E-A-T'; Republicans Strongly Disagree
The major Republican and Democratic candidates running for the U.S. Senate divide along party lines when asked whether they support Gov. John Bel Edwards’ decision to allow the working poor to qualify for Medicaid. The four Republicans oppose the Democratic governor’s decision, while the two Democrats support it, according to a survey of the candidates by The Advocate. (Bridges, 9/26)

Campaign 2016

Health Plans From Both Trump And Clinton Would Add To Federal Deficit

However, the effect the proposals would have on the number of uninsured in the country differs dramatically.

Roll Call: Clinton, Trump Health Plans Differ In Impact On Uninsured, Cost
The health care policy proposals of Hillary Clinton and Donald Trump would have dramatically different impacts on the uninsured rate in the United States and on out-of-pocket health care costs. But they share one trait: Both would add to the federal deficit, according to a study released Friday. (Mershon, 9/27)

In other election news —

Capitol Hill Watch

As Zika Money Debate Dominates Capitol Hill, Other Health Priorities Pushed To Backburner

In other news on the virus spread, Florida officials face questions about millions in federal emergency funds it has not yet used while three more cases are reported in the Miami area. Research efforts are also in the news.

The Hill: Zika Funding Fight Throws Wrench In Health Lobbyists’ Plans
Public health groups are disappointed Congress has dragged out funding to fight the Zika virus and neglected other health priorities. But a coalition of health groups that have lobbied for Zika funding is satisfied with Senate Majority Leader Mitch McConnell’s (R-Ky.) bill extending funding for the federal government and hope lawmakers will soon address other health care priorities. (Harper, 9/27)

Miami Herald: Zika Virus: Florida Has Yet To Use Nearly $34 Million In Federal Funds Available For Zika Response 
Over the past months, as local governments strained their budgets to pay for the fight against Zika, Florida has left largely untapped a $27 million emergency preparedness fund from the Centers for Disease Control and Prevention and $8.4 million in federal grants — both of which can be used by the state to combat the virus. State officials insist nearly all of the money is simply part of Florida’s usual allocation from the CDC and doesn’t count as extra cash to help with anti-Zika efforts. (Chang, 9/26)

Health News Florida: 3 More Zika Cases Reported In Miami-Dade 
Three more locally transmitted cases of the mosquito-borne Zika virus were reported Friday in Miami-Dade County as the overall number of such cases climbs toward 100. The Florida Department of Health said the three new cases are linked to an investigation into the spread of the disease in Miami Beach. In all, Florida has reported 95 locally transmitted cases of the virus, which is particularly dangerous to pregnant women because it can cause severe birth defects. (9/26)

Orlando Sentinel: Zika Experts Gather In Orlando To Share Latest Research At Entomology Conference
en the International Congress of Entomology decided four years ago to hold its meeting in Orlando, the Zika virus was hardly on anyone's radar... Since early this year, there have been more than 3,300 travel-related cases of Zika infection in the United States and more than 19,700 local cases in U.S. territories. Researchers still aren't sure what catapulted the virus from obscurity to a major public health threat. Maybe the virus mutated, or maybe the area Northeast of Brazil, with large population and lack of good sanitation, provided it with an optimal environment to replicate and spread to rates that it hadn't before. (Miller, 9/26)

Reuters: Sanofi Gets $43M U.S. Funding To Spur Zika Vaccine Development
Sanofi SA said on Monday the U.S. Department of Health and Human Services (HHS) approved $43.18 million in funding to accelerate the development of a Zika vaccine, as efforts to prevent the infection gather momentum. The funding from the HHS' Biomedical Advanced Research and Development Authority (BARDA) will be used for mid-stage trials, expected to begin in the first half of 2018, and for manufacturing, the French drugmaker said. (Grover, 9/26)

Marketplace

Transgender Surgery Demand Spikes Amid Growing Support From Medical Community

The procedure was once nearly unattainable as people had to go to private-practice plastic surgeons or even out of the country.

The Wall Street Journal: With Insurers On Board, More Hospitals Offer Transgender Surgery
Surgery is becoming more available for transgender people as a growing number of academic centers and hospitals offer the procedure and insurance companies provide coverage. Stacey Parsons, a 45-year-old from Kent, Ohio, had genital surgery in August at Cleveland Clinic, which last year launched a transgender-surgery-and-medicine program. For years the procedure was unattainable for Ms. Parsons because it costs upward of $20,000 and was rarely covered by insurance. (Reddy, 9/26)

However, in Ohio, a woman is going to court because her insurer refused to cover the procedure —

Cleveland Plain-Dealer: Cincinnati Transgender Woman Sues Insurer, Public Employer For Not Covering Sex-Reassignment Surgery 
A Cincinnati woman today sued the Cincinnati public library and the corporate parent of Anthem Blue Cross and Blue Shield for refusing to cover her sex-reassignment surgery. The insurer's refusal violates the Affordable Care Act's guarantee of coverage for medically necessary treatment, and the employer's requirement under federal law to treat employees equally, regardless of gender, says Rachel Dovel's lawsuit, filed in U.S. District Court in Cincinnati. If the case proceeds, it could be the first establishing or denying an insurer's requirement to cover transgender surgery under the Affordable Care Act, better known as Obamacare. (Koff, 9/26)

Cincinnati Enquirer: Transgender Library Insurance Dispute Goes To Court
Public library employee Rachel Dovel sued her employer Monday after repeated pleas for the library to cover transgender transition surgery failed. ... She is asking the court to order the library to cover the cost of her gender reassignment surgery; prohibit Anthem from selling insurance plans that exclude coverage for transition-related care; and prohibit the library from carrying insurance that excludes coverage for transition-related care. And she is asking for damages. (Coolidge, 9/26)

Doggone It: Spiking Costs, Inefficiencies At Veterinarian's Office Mirror U.S. Health Care System

Meanwhile, KHN reports on new recommendations for the preventive services that should be free for women. And in insurance news, Kaiser Permanente ranks highest among providers in Georgia and a Washington health system comes to an agreement with Premera Blue Cross.

Kaiser Health News: Expert Panel Recommends Expansion Of Services With No Cost Sharing For Women
The list of preventive services that women can receive without paying anything out of pocket under the health law could grow if proposed recommendations by a group of mostly medical providers are adopted by federal officials later this year. The draft recommendations, which are open for public comment until Sept. 30, update the eight recommended preventive services for women. (Andrews, 9/27)

Georgia Health News: Kaiser Continues Winning Streak In Ratings Of Health Plans 
For the 12th straight year, Kaiser Permanente is Georgia’s top-rated commercial health plan, according to the National Committee for Quality Assurance... Kaiser’s 4.5 score for its HMO was followed by 3.5 for these plans: Aetna HMO/Point of Service (POS), Blue Cross and Blue Shield of Georgia HMO/POS, Cigna PPO, Connecticut General PPO, and UnitedHealthcare PPO. The Kaiser Medicare plan in Georgia was followed by an Aetna plan scoring 4.0. (Miller, 9/26)

Public Health And Education

Its People Are Dying At Alarming Rates, But This City Just Can't Make A Dent In Its Opioid Crisis

Huntington, W.Va., has taken steps to curb the epidemic that's holding the city in its grasp. But barriers prevent the residents from getting the best treatment. Meanwhile, CNN offers a look at how drug deaths are spiking across the country.

CNN: This Is America On Drugs: A Visual Guide
Drugs are the leading cause of accidental death in this country. Fatal overdoses surpassed shooting deaths and fatal traffic accidents years ago. For perspective on how fast drug deaths have risen, Anderson said, consider the sharp rise in heart disease in the early half of the 20th century. It took about 50 years for the rate of heart disease to double. It took drug deaths a fraction of that time. (Christensen and Hernandez, 9/24)

In other news on the opioid crisis —

St. Louis Post-Dispatch: St. Charles County Joins Drug Monitoring Program
The County Council on Monday night voted unanimously to join a new regional prescription drug monitoring program aimed at reducing the abuse of OxyContin and other painkillers. The program, already set to include St. Louis County and St. Louis, will get around the Legislature’s failure to set up a statewide monitoring network. Missouri is the only state in the country without a statewide program. (Schlinkmann, 9/26)

Roll Call: Opioid Epidemic Enters Funding Debate
Senate Majority Leader Mitch McConnell's proposal to keep the government funded included one below-the-radar addition: funding to combat the opioid epidemic. While senators in both parties support addressing the issue, the move had some Democrats crying foul. The Kentucky Republican unveiled last week a draft continuing resolution to fund the government through Dec. 9, after spending talks stalled between Senate leaders. His proposal included $37 million in annual funds for implementing the Comprehensive Addiction and Recovery Act, or CARA, which became law in July. (Bowman, 9/26)

A Medical Mystery Solved: 'I Didn’t Know How To Convince Them This Is Not In My Head'

A chance meeting on a hiking trail leads to the restoration of a normal life for one woman who suffered from intense pain every time she ate. In other news, testosterone's bad rap might have a silver lining, patients' fitness levels come under scrutiny before surgery, scientists make strides toward identifying CTE in living victims and more.

The Washington Post: Pain Kept This Young Woman From Eating For 5 Years, And Doctors Didn’t Know Why
The medical team encircled Mackenzie Hild’s bed, their somber expressions reflecting the gravity of the news they were about to impart to the Harvard sophomore and her mother, newly arrived from California. “We’ve done all these tests, and they’re all normal,” Hild recalls one doctor at the renowned Boston hospital telling them. To treat Hild’s life-threatening weight loss, which the 19-year-old claimed was the result of searing abdominal pain triggered by eating, doctors were sending her to an inpatient center specializing in eating disorders. (Boodman, 9/26)

Los Angeles Times: In Addition To Fueling Aggression, Testosterone Can Also Make Men More Generous, Study Says
Testosterone, the big daddy (if you will) of male hormones, has gotten a bit of a bad reputation, what with it being linked to bluster, aggression, violent offending and a whole raft of behaviors at which men do seem to best women consistently. But in humans, new research suggests that’s not the whole picture. The testosterone findings that have shaped our common assumptions probably fail to take account of human society’s exquisite level of social evolution. (Healy, 9/26)

The Wall Street Journal: Are You Fit For Surgery?
Are you healthy enough to have surgery? More hospitals are asking that question before patients undergo elective procedures such as hip and knee replacements. They are identifying those at higher risk of infections and other complications due to diabetes, heart disease and anemia—or simply being sedentary and out of shape. And they are steering them to “pre-habilitation” programs that include medical treatments, diets and exercise regimens to improve their chances of a successful surgery. (Landro, 9/26)

The New York Times: Researchers Make Progress Toward Identifying C.T.E. In The Living
One of the frustrations of researchers who study chronic traumatic encephalopathy, the degenerative brain disease linked to repeated head hits, is that it can be detected only in autopsies, and not in the living. Researchers, though, have been trying to solve this problem in two primary ways: by identifying biomarkers linked to the disease that show up on imaging tests in certain locations in the brain, and by trying to locate in the blood the protein that is the hallmark of the disease. (Belson, 9/26)

NPR: Doctors Encouraged To Use Medications To Treat Alcohol Abuse
Two often-overlooked medications might help millions of Americans who abuse alcohol to quit drinking or cut back. Public health officials, building on a push to treat people who abuse opioids with medications, want physicians to consider using medications to treat alcohol addiction. The drugs can be used in addition to or sometimes in place of peer-support programs, they say. (Yasinski, 9/26)

The Washington Post: That Horrible Morning Sickness You’re Having? It’s Actually A Good Sign For The Baby.
The first three months of pregnancy, a time that parenting magazines and Hallmark cards often portray as magnificent and carefree, can actually be a wretched experience for many women. As many as 90 percent of mothers-to-be experience some degree of nausea and vomiting, and scientists have long speculated about what, from an evolutionary standpoint, the function of all that unpleasantness might be. The leading theory has to do with food. (Cha, 9/26)

NPR: Walk Now To Stay On Your Feet As You Grow Older
People who have reached their later years may think it's primarily a time to relax, not to increase their physical activity. Not so. Previous research has suggested that exercise can improve memory and reverse muscle loss in older adults, among other benefits. And a study out Monday finds that a regular program of physical activity reduces the time spent with mobility-limiting disability. (Hobson, 9/26)

Despite $127M Lawsuits, Scientists Say Still No True Link Between Talc, Ovarian Cancer

Two plaintiffs who sued Johnson & Johnson were awarded millions each, but research finds little evidence to back up the decisions. “Lord knows, with the amount of powder that’s been applied to babies’ bottoms, we would’ve seen something” if talc caused cancer, says Dr. Hal C. Lawrence III.

The Associated Press: Research Finds Talc Doesn’t Cause Cancer; Juries Disagree
Two lawsuits ended in jury verdicts worth $127 million. Two others were tossed out by a judge who said there wasn’t reliable evidence that the talc in Johnson & Johnson’s iconic baby powder causes ovarian cancer. So who’s right? And is baby powder safe? Most research finds no link or a weak one between ovarian cancer and using baby powder for feminine hygiene, a practice generations of American mothers have passed on to their daughters. Most major health groups have declared talc harmless. (Johnson, 9/26)

In other news —

The New York Times: Some Good News On Ovarian Cancer
The death rate from ovarian cancer declined in the United States by 16 percent from 2002 to 2012, among the largest reductions in the world. The rate in the United States, 4.85 per 100,000, puts it roughly in the middle of a list of 47 countries whose rates and trends were described recently in a study in Annals of Oncology. (Bakalar, 9/26)

In Training To Handle Calls Involving Mentally Ill, Atlanta Police Learn To See Bigger Picture

At first, many officers had to be ordered to attend. But they say they walked away with a better understanding of how to de-escalate situations involving someone with a mental illness. Advocates say there's still more work to do.

Atlanta Journal Constitution: How Atlanta Police Handle Calls Involving The Mentally Ill 
Agencies continue to work with the Georgia Bureau of Investigation and the National Alliance of Mental Illness to train officers how to recognize those suffering from mental illness, problems of addiction and diseases such as Alzheimer’s and autism. In 2004, a group from NAMI approached the GBI about bringing a national program to agencies across Georgia, Director Vernon Keenan said. He talked about the course during a recent event at Brookhaven police headquarters for NAMIWalks, a nationwide fundraising and mental health awareness program. (Eldridge, 9/25)

Meanwhile, Congress passes a measure to fund training for first responders —

Morning Consult: House Approves Bill For Mental Health First Aid Training
The House on Monday approved a bill that would require the Substance Abuse and Mental Health Services Administration to reauthorize mental health first aid training programs. The chamber approved H.R. 1877, the Mental Health First Aid Act of 2015, by voice vote. The bill would reauthorize a grant program that trains individuals who are likely to be a first responder to a patient experiencing mental illness, such as teachers of police officers. (McIntire, 9/26)

State Watch

Medicaid Managed Care Official Sees Growing Role For Plans On Health Law Marketplaces

Jeff Myers tells The Hill, "It seems to me that the exchange products that work best are ones that, rather than just open up a giant network and provide lots of services, really look at, are there services that we can open up and drive that will improve health outcomes and reduce cost?” News outlets also report on Medicaid developments in Kansas and Nebraska.

The Hill: Advocating For More Managed Care
[Jeff] Myers is the top advocate for insurers under Medicaid managed care, where states will contract with a private company to run their Medicaid programs. ... And the model is growing: Nearly 55 million people — about three-fourths of all Medicaid enrollees — are now covered under managed care, a sharp increase even in the past three years, according to a new report from PricewaterhouseCoopers. ... The [health law] marketplaces, also called exchanges, have been plagued this year by insurers dropping out or hiking premiums due to financial losses. But some insurers with experience in the Medicaid business are faring better. And that’s no coincidence, Myers says. One point helping those insurers is having a narrower network, i.e., fewer doctors to choose from. But more important, Myers said, are other programs to help low-income sick people make the most of their insurance. (Sullivan, 9/27)

Kansas Health Institute: National Meeting On Medicaid Managed Care To Include Focus On KanCare
Several Kansans are scheduled to meet Tuesday with federal officials and counterparts from across the country to discuss issues related to the privatization of state Medicaid programs. Two Kansas legislators — Democratic Sen. Laura Kelly of Topeka and Republican Rep. Chuck Weber of Wichita — are expected to attend the meeting in Baltimore, along with Rocky Nichols, a former legislator who now heads the Disability Rights Center of Kansas, Janet Williams, the chief executive of Communityworks Inc., a home health agency based in Overland Park, and Mike Oxford, director of the Topeka Independent Living Resource Center. (McClean, 9/26)

State Highlights: In Wash., Fifth Patient Diagnosed With Legionnaires; Former Ohio State Doctor Scores Age Discrimination Settlement

Outlets report on health news from Washington, Ohio, Minnesota, Connecticut, California, New York and Massachusetts.

Columbus Dispatch: Former Ohio State Doctor Gets $100,000 In Age Discrimination Settlement
Ohio State University Wexner Medical Center will pay $100,000 as part of a settlement unveiled Monday to a former doctor who alleged age discrimination in a 2015 lawsuit filed in the Ohio Court of Claims. In 2004, Dr. Nathan C. Hall became an assistant professor in the OSU College of Medicine's radiology department. Within two years, he was promoted to division chief of nuclear medicine and molecular imaging. In his lawsuit, Hall states that he met or exceeded the productivity expectations outlined in his employment agreement as well as received positive performance reviews until Dr. Richard D. White was appointed to department chair in 2010. (Forchesato, 9/26)

Minnesota Public Radio News: 3 Weeks Into Strike, Nurses Union And Allina Resume Contract Talks 
Negotiators for Allina Health and the nurses union resume contract talks today — three weeks after more than 4,000 hospital nurses went on strike over health benefits. A federal mediator called negotiators back to the bargaining table last week, but that doesn't mean the two sides are ready to cut a deal. Both Allina and the Minnesota Nurses Association have been loathe to make the first move in resuming contract negotiations after a 22-hour bargaining session in early September. (Benson, 9/27)

Mercury News: Drugging Our Kids: Legislators Call On Governor Brown To Sign Bills To Protect Foster Youth
Foster youth advocates and Bay Area legislators on Monday told a panel of state officials that the alarming conclusions of a recent state audit highlighting California’s weak oversight of psychiatric drugs for foster kids could be solved if Gov. Jerry Brown signs three pieces of key legislation into law this week... The audit, released Aug. 23, mirrored many findings of this newspaper’s series “Drugging Our Kids” that disclosed the state’s dependence on psychotropic medications to control troubled children in the state’s foster care system and the failure to track how the drugs are prescribed. Beall said that one solution is his own Senate Bill 1291, which would require better transparency and tracking of mental health services for foster kids in every California county. (Seipel, 9/26)

The Associated Press: Psychiatrist: Hospital Provokes Patients To Enrich Itself
A doctor who trained for two years at the psychiatric unit of a New York hospital said in a lawsuit Monday that poor adolescent patients were routinely provoked into acting out, then restrained and drugged, extending their hospitalization and Medicaid payments. Dr. Alfred Robenzadeh said that supervisors at Westchester Medical Center in Valhalla retaliated against him when he tried to address what he says was chronic patient abuse that increased the severity of diagnoses, with usual two-week inpatient stays often extended days or weeks. He alleges the practice defrauded Medicaid. (9/26)

Boston Globe: Steward Gets $1.25B To Fund Expansion, Repay Cerberus 
Medical Properties Trust will buy Steward Health Care’s hospital properties for $1.2 billion and take a $50 million stake in the company... Steward, the largest for-profit hospital operator in Massachusetts, was created in 2010 when Cerberus Capital Management bought the former Caritas Christi network of Catholic hospitals. It said it will return the New York-based firm’s original investment, though Cerberus will continue to hold a majority stake. (Dayal McCluskey, 9/26)

Cleveland Plain-Dealer: Cleveland Will Post Signs Warning Of Lead Hazards; Old Dangers Still Linger
For the past 11 months, Cleveland officials say they've been at work rebuilding a beleaguered program meant to respond to children poisoned by lead. Yet homes that city health workers knew contained hazardous levels of the toxin still linger in neighborhoods, posing a potential threat to young children and pregnant women. Right now, the city knows about more than 300 properties that it should have evacuated and posted signs warning of lead hazards. (Dissell and Zeltner, 9/26)

Mercury News: California Ballot Measures: Tobacco Tax Tight; Voters Favor Parole Reforms, Poll Finds
California voters favor reforming the state parole system, but are more closely divided about slapping a two-buck-a-pack tax on cigarettes, a new Field Poll shows. And voters also favor extending a tax on the wealthy that they first approved in 2012, the poll shows. The new poll shows what could be a softening of voters’ appetite for a new tobacco tax to fund health care and tobacco prevention efforts, as the deep-pocketed opposition rolls out a heavy ad campaign attacking the measure as a tax grab for special interests. (Peele, 9/26)

Kaiser Health News: Election Buzz: With Pot On The Ballot, States Weigh How To Police Stoned Drivers
In five states this fall — California, Arizona, Nevada, Maine and Massachusetts — voters will be deciding whether marijuana should be legal for recreational use. And any of those states that do legalize marijuana will have to wrestle with the question of how to enforce laws against stoned drivers. It has been legal to smoke pot for fun in Colorado since January 2014, and the state modeled its marijuana driving-under-the-influence law on the one for alcohol. If a blood test shows a certain level of THC, the mind-altering compound in marijuana, the law says you shouldn’t be driving." (O'Neill and Markus, 9/27)

Boston Globe: Massachusetts Marijuana Doctor Should Not Have Lost License, Judge Says 
A Massachusetts physician should not have had his medical license suspended for allowing nurse practitioners in his office to certify patients for medical marijuana use, according to a state administrative law judge. Regulators in May suspended the license of Dr. John C. Nadolny, medical director of Canna Care Docs, a practice with eight Massachusetts locations that specialize in screening and approving patients for marijuana use. The Board of Registration in Medicine had ruled that Nadolny was an immediate threat to public safety, saying his office improperly used nurse practitioners to certify that thousands of patients were eligible to receive medical marijuana. (Lazar, 9/26)

Editorials And Opinions

Viewpoints: House Calls -- A Better Idea Than Ever; Is The FDA Tightening Hold On Generics?

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

The New York Times: Reviving House Calls By Doctors
Surah Grumet used to be a family doctor at a clinic in the Bronx. “It always felt like I was trying to catch up,” she said. “I was always falling behind, and it was so stressful. And it was really hard to bring up my two girls, to be there for them, and still be able to practice medicine the way that I wanted to.” Now, she lives in a suburb of Raleigh, N.C. She still practices medicine, but has no office or clinic. Instead, she works with a Durham-based practice called Doctors Making House Calls. (Rosenberg, 9/27)

The Wall Street Journal: A Drug Cartel At The FDA
The anaphylactic political shock over EpiPen prices continues, and last week a House committee dragged in the company CEO. But some outrage should land on the Food and Drug Administration, which won’t approve a generic stinger that would end Mylan’s monopoly power. Instead, the agency is finishing regulation that will restrict competition precisely as patients are demanding cheaper medicines. (9/26)

Milwaukee Journal Sentinel: CMS Should Revamp Star Rating System
These [hospital star] ratings were designed by the federal government to help individuals, family members and caregivers compare hospitals in what they believed to be an easily understandable manner. We respect the efforts of agencies such as CMS to create transparency and accessibility around hospital ratings, and we believe strongly that individuals deserve to have information about the quality and safety of an institution. But the data that drive ratings — and the manner in which the data are reported — must be meaningful and fairly reflect the performance of the institution and quality of care. (Joseph Kerschner and Janis Orlowski, 9/26)

Real Clear Health: Congress: Act to Fix Shortsighted Home Respiratory Therapy Cuts
Although healthcare and payment policies aimed at improving the strength and longevity of the Medicare program are easy for providers, taxpayers, and lawmakers to stand behind, when those policies fall short – disrupting the care of patients who need it the most – there’s no time to delay in finding a solution. (Dan Stark, 9/26)

Stat: Fixing Electronic Health Records Is Good. Adding Scribes Is Even Better
The bold admission by athenahealth CEO Jonathan Bush that electronic health records (EHRs) “inflict enormous pain on our nation’s providers and care teams, turning caregivers into box-checkers and inadvertently limiting the private sector from innovating” caught my attention. Those are strong words from the head of a company that makes a widely used EHR. ... While Bush’s company is trying to design ways to decrease the amount of time that clinicians spend working on the EHR, here’s a more immediate and practical solution: medical scribes. Let these trained professionals interact with the EHR while doctors interact with their patients. (Jared Pelo, 9/27)

Cincinnati Enquirer: Drug Addiction Isn't What Most People Think
The drug war has shaped the thought that addicts and users need to spend time in jail and learn a lesson. Trauma, life crisis or isolation is what leads to an unhealthy bond with behaviors that become addictive (like gambling, sex, checking your phone) – and with drugs. ... Time to redirect the legacy of this shameful drug war and mandate public health and law enforcement tax dollars are effective, transparent and about improving outcomes. (Barbara Boylan, 9/26)

The Philadelphia Inquirer: Talking To Your Doctor About Prescription Pain Medications
At some point, most of us have been prescribed an opioid-based pain medication such as hydrocodone (Vicodin) or oxycodone (OxyContin, Percocet). Doctors and dentists often prescribe these painkillers after major surgery or dental work, or a bad fall or other accident. With all the talk about the opioid crisis, should we view these medications with newfound fear and suspicion? The short answer is “no”—as long as you use them responsibly, as your doctor directs. (Andy Carter, 9/27)

Lexington Herald Leader: 12-Step Programs Do Help Break Addictions
In the Sept. 4 Herald Leader, Dr. Rae Brown of the University of Kentucky beautifully describes the inadequate treatment of the current opioid epidemic in Kentucky. I agree completely that there is “no safe opioid dose, no safe opioid agent and no safe patient.” However, he makes some very strong statements like “medical treatment is the only treatment demonstrated to be effective,” implying that there are no others, and that medical manipulation with other addicting substances is the best treatment. There are a few long-term studies suggesting medical treatment may be helpful, just like there are few long-term studies documenting that 12-step programs work. (Dr. Gordon Hyde, 9/25)

The New York Times: Want To Make Ethical Purchases? Stop Buying Illegal Drugs
Many of my friends and classmates here in the United States care about making the world a better place, and they try to make purchases that reflect their values. Some have become vegetarians to save animals or fight climate change. Others buy cruelty-free cosmetics, fair-trade coffee or conflict-free diamonds. Yet I’ve noticed at parties and festivals that some of these same people pop Ecstasy or snort cocaine. They think this drug use is a victimless crime. It’s not. Follow the supply chain and you’ll find a trail of horrific violence. (Mario Berlanga, 9/27)

The Des Moines Register: Anonymous Medicaid Happy Tales Not Enough
Gov. Terry Branstad is desperate for good publicity about his privatization of Medicaid management. The problem: Iowans are not contacting the media to share positive experiences. Instead, numerous people have come forward with horror stories since the governor handed over administration of the government program to three for-profit insurers on April 1. (9/26)

Los Angeles Times: This Drug Company Placed A Nearly $10,000 Price Tag On Drugs That May Not Even Work
Profiteering in the drug business has been generating outrage for months now. Gilead Sciences and Mylan have been taking the heat for huge increases in the prices, respectively, for their hepatitis-C cures and injectors to fend off life-threatening allergic reactions. But at least we can say this about them: Their products work. That may not necessarily be true about some of the drugs for which Chicago-based Novum Pharma has raised prices as much as 40-fold. Two of the three topical gels for dermatological conditions distributed by Novum are listed by the Food and Drug Administration as only “possibly effective.” That’s one of the lower classifications in the FDA’s roster, coming below “effective” and “probably effective.” (Michael Hiltzik, 9/26)

Stat: Veterans' PTSD And Brain Injury Deserve Focused Research On New Treatments
Suppose that a million or more members of the US Armed Forces and veterans were suffering from an epidemic that could not be prevented, treated or cured — and 20 of them were dying from it every day. Would we address it as a national emergency, mobilizing resources, coordinating research, and insisting on answers? They are — but we aren’t. It’s time for that to change. Nearly 350,000 service member and veterans have been diagnosed with traumatic brain injury (TBI) since 2001. Even more have post-traumatic stress disorder (PTSD). Twenty veterans commit suicide every day, most of them as a direct result of these conditions. PTSD, TBI, and suicide represent an all-out epidemic. (Magali Haas, 9/26)

The Hill: When Tracking Steps Is The Wrong Step To Take
The latest research to shake up the fitness and health industry shows that wearing a fitness tracker to monitor your level of activity does not contribute to weight loss. With obesity rates affecting a third of the United States population, this comes as dismal news to those hoping that this billion-dollar industry would begin to make a dent in those statistics. ... Using fitness trackers can be an excellent source of data for many people and this study shouldn’t dissuade those finding it helpful to stop using them but the missing piece that many need to succeed is a connection between what those numbers mean and how they can affect the bigger picture of their overall health. Learning how daily nutrition fits in with step count and how stress or travel can derail a routine are important components that are individualized for each person. A health coach can stitch together a picture of health and work with an individual to find the right pieces and materials to achieve it. (Jennifer Gibson, 9/23)

Cleveland Plain Dealer: Your Right To Smoke Ends When It Harms Children
When it comes to passive smoking the old saying "Your rights end where mine begin" is uncomfortably relevant. Yes, you have the right to smoke. What you do to your body is your choice. You know how lethal it is. You know the health risks, the financial costs, and all the other 1,001 negative consequences of your addiction. (Scott Stevens, 9/25)

San Antonio Press Express: Freestanding Emergency Centers Offer Real Value 
That new freestanding emergency center in your neighborhood might look like just an urgent care facility, but it is not. Freestanding emergency centers are equipped for full emergency care, and they offer patients an alternative to crowded hospital emergency rooms. There is no evidence that freestanding emergency centers produce poorer patient outcomes than hospital-based ERs. Nor is there any data suggesting patients are more at risk by seeking treatment at a freestanding facility. (Nick Peters, 9/26)

Los Angeles Times: Don't Scapegoat Big Sugar. Lots Of Food Producers Profited From The Demonization Of Fat
The recent revelation that Harvard scientists were paid off to downplay sugar’s harms in the 1960s shows how the food industry shockingly manipulated nutrition science for decades. Yet the news media has given the sugar industry too much credit. The real story about how sugar got a pass — while dietary fat and cholesterol were blamed for heart disease — reveals that other industries played a role, as did, surprisingly, many of the country’s leading scientists. (Nina Teicholz, 9/26)