KHN Morning Briefing

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Kaiser Health News provides a fresh take on health policy developments with "Political Cartoon: 'What's Left?'" by Steve Kelley.

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At a certain age
living alone is construed
as a healthy sign.

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Summaries Of The News:

Campaign 2016

Despite Democrats' Previous Pharma Criticism, Convention Is A Schoomze Extravaganza For Industry

Curbing high drug prices is a popular topic on the campaign trail, but industry lobbyists weren't feeling the heat at the Democratic National Convention this week. Meanwhile, now that the general election is officially on, The Hill looks at what to expect out of the candidates' health care policies.

Stat: At The DNC, The Debate Over Drug Prices Gives Way To Charcuterie And Cheese
The drug industry didn’t really feel the heat here at the Democratic National Convention. Once you left Wells Fargo Arena, where Bernie Sanders thundered, “The greed of the drug companies must end!” in the climatic speech of the convention’s opening night, drug lobbyists could be seen chatting with senior Democratic officials in crowded bars, picking at spreads of choice charcuterie and cheese. In between band sets at one such event, cosponsored by the drug company Astellas, Democratic congressmen lauded free trade — on the same day that streams of Sanders supporters had chanted their opposition to the Trans-Pacific Partnership agreement. (Scott, 7/28)

The Hill: What Can We Expect In Healthcare With Clinton, Trump?
Clinton would expand Obamacare by allowing a buy-in to Medicare starting at age 55, offering a public health insurance option and continuing the drive for Medicaid expansion...Mr. Trump has adopted the Republican platform, which eliminates Obamacare and replaces it with consumer-based insurance plans. (Bellefeuille, 7/28)

Administration News

Two Fla. Counties Asked To Stop Collecting Blood Due To Possible 'Home-Grown' Zika Cases

The Food and Drug Administration has asked blood centers in Miami and Fort Lauderdale to suspend blood donations during the investigation into the four cases that may not be linked to travel outside the country.

The Associated Press: FDA: No Miami-Area Blood Donations During Zika Investigation
Federal authorities have told blood centers in two Florida counties to suspend collections amid investigations into four mysterious cases of Zika infection that may be the first spread by mosquitoes on the U.S. mainland. Blood centers in the Miami and Fort Lauderdale areas were asked to immediately stop collecting blood until they can screen each unit of blood for the Zika virus with authorized tests, according to a statement on the U.S. Food and Drug Administration website. (7/28)

NPR: Fearing Zika, FDA Asks 2 Florida Counties To Halt Blood Donations
The move came after investigators ruled out travel as the cause of four cases of Zika virus in those counties. Florida health officials announced the cases last week. The people hadn't traveled to places where Zika is endemic and don't appear to have contracted it through sex, leaving a possibility that they got the virus from being bitten by infected mosquitoes in the U.S. (Bichell, 7/28)

The Washington Post: FDA Temporarily Halts Blood Donation In Two Florida Counties Over Zika Fears
The FDA is also recommending that nearby counties also put these precautions in place as soon as possible to maintain the safety of the blood supply. For blood-collection establishments outside of this region, FDA is recommending that donors who have traveled to Miami-Dade and Broward Counties during the previous four weeks defer on donating blood. The FDA alerted the Florida's surgeon general and the major blood-collection industry organization Wednesday night. On Thursday morning, the FDA also reached out to blood-collection establishments in Florida, starting with the state’s largest blood collectors, according to Tara Goodin, an FDA spokeswoman. (Sun, 7/28)

The Associated Press: F.D.A. Says 2 Florida Counties With Zika Cases Should Suspend Blood Donations
The F.D.A. had previously advised blood banks to refuse donations from people who had recently traveled to foreign countries with Zika outbreaks. The main supplier of blood in Florida, OneBlood, announced last week that it would start testing donated blood for the Zika virus on Monday. OneBlood officials have said they will halt blood collections in ZIP codes where local transmission of Zika is confirmed and bring in blood from unaffected areas to maintain local supplies. Some blood banks in Texas and Hawaii have begun testing donations for the Zika virus, and others plan to do so soon. (7/28)

PBS Newshour: 2 Florida Counties Halt Blood Donations, As Evidence Mounts For Local Zika Transmission
The U.S. Food and Drug Administration has requested that two Florida counties — Miami-Dade and Broward — postpone blood donations as officials investigate the possible local transmission of Zika virus, which is linked to birth defects. The temporary ban arrived Wednesday, the same day Florida health officials announced an investigation into two cases of the mosquito-borne disease that do not appear linked to travel. Last week, the Florida Health Department reported two other cases of suspected transmission by local mosquitoes. (Akpan, 7/28)

PBS Newshour: What You Need To Know About South Florida Zika Scare
The Food and Drug Administration asked two South Florida counties — Miami-Dade and Broward — to immediately halt blood donations as what looks like four cases of locally transmitted, mosquito-borne Zika virus are investigated. Hari Sreenivasan talks with Dr. Anthony Fauci, National Institutes of Health, about the virus, which can cause birth defects. Fauci says the FDA is taking “prudent steps.” (Sreenivasan, 7/28)

In other Zika news —

Stat: The Best Drug To Fight Zika May Already Be Approved And Out There, Study Suggests
Several teams of scientists are racing to develop a vaccine for the Zika virus. But what if a drug that already exists could stop an infection in its tracks? According to new research, it’s not a totally crazy idea. A group of researchers has identified two dozen Food and Drug Administration-approved drugs that have shown some ability to block Zika from infecting human cells in the lab, according to a paper published Thursday in the journal Cell Host & Microbe. Some of these drugs — which treat infections, cancers, and even depression— also showed potential to prevent infection in certain cells tied to fetal defects in pregnant women. (Joseph, 7/28)

Kansas Health Institute: Amid Zika Concerns, Kansas Researchers Seek Mosquitoes That Can Carry The Virus
The Centers for Disease Control and Prevention recently awarded Kansas more than $350,000 to support efforts to protect Kansans from Zika virus, a mosquito-borne disease. The money also will go toward eliminating adverse health outcomes that can result from Zika infection, including severe birth defects. Now, state agencies are working to identify and monitor the two species of mosquito that transmit the Zika virus. (Wilson, 7/28)

Sacramento Bee: Zika Found In Sacramento County's First Reported Case
A Sacramento County man who recently traveled to an area with active Zika transmission has tested positive in a preliminary test for the virus. The 34-year-old man sought medical care after exhibiting Zika symptoms, prompting the doctor to report the case to the county, said Sacramento County Public Health Officer Dr. Olivia Kasirye. She could not specify which symptoms the man had. (Caiola, 7/28)

The Associated Press: Genetically Modified Mosquitoes Released In Cayman Islands
The first wave of genetically modified mosquitoes were released Wednesday in the Cayman Islands as part of a new effort to control the insect that spreads Zika and other viruses, officials in the British Island territory said. Genetically altered male mosquitoes, which don't bite but are expected to mate with females to produce offspring that die before reaching adulthood, were released in the West Bay area of Grand Cayman Island, according to a joint statement from the Cayman Islands Mosquito Research and Control Unit and British biotech firm Oxitec. (7/28)

U.S. Forms Trans-Atlantic Partnership In Effort To Stem Tide Of Superbugs

The Department of Health and Human Services will invest $250 million into CARB-X, the initiative to foster development of drugs that will target antibiotic-resistant bacteria.

The Washington Post: Major Global Partnership To Speed Antibiotic Development Launched
U.S. and British officials announced an ambitious collaboration Thursday designed to accelerate the discovery and development of new antibiotics in the fight against one of the modern era’s greatest health threats: antibiotic resistance. CARB-X, for Combating Antibiotic Resistant Bacteria Biopharmaceutical Accelerator, will create one of the world’s largest public-private partnerships focused on preclinical discovery and development of new antimicrobial products. (Sun, 7/28)

The Wall Street Journal: U.S. To Form International Partnership To Fight ‘Superbugs’
The U.S. Department of Health and Human Services is expected to invest $250 million over the next five years to the public-private initiative, which will be known as CARB-X, for Combating Antibiotic Resistant Bacteria Biopharmaceutical Accelerator. The venture, which has grown out of a 2015 Obama administration initiative, will focus on providing monetary help to small companies and laboratories that are in the earliest stages of developing new drugs, vaccines or medical devices to combat such microbes. (Burton, 7/28)

Capitol Hill Watch

Legislation That Could Make Deductibles For Chronic Care More Affordable Has Bipartisan Support

The bill, introduced earlier this month, comes at a time when more people have high-deductible plans. The bill would allow plan members to get coverage of all services needed for costly chronic illnesses, such as diabetes or heart disease, without having to meet the high deductible first. In other Capitol Hill news, House Democrats urge stronger regulations for nursing homes.

Modern Healthcare: A Bipartisan Bill Might Alter Deductibles For Chronic-Disease Care. Really
People in diverse corners of healthcare are hopeful new legislation will ease growing consumer anxiety over higher medical deductibles. And it might have a chance of becoming law because the cause comes from rare bipartisan ground. Earlier this month, U.S. Reps. Diane Black (R-Tenn.) and Earl Blumenauer (D-Ore.)—both of whom sit on the House Ways and Means Subcommittee on Health—introduced a bill that would change how the federal tax code treats high-deductible health plans that are paired with tax-exempt health savings accounts. (Herman, 7/28)

Morning Consult: House Dems Call For Stronger Nursing Home Standards
Nearly three dozen House Democrats are urging the Centers for Medicare and Medicaid Services to strengthen proposed regulations for nursing homes. Their urging comes as a final rule updating quality standards for nursing homes is expected to be released by CMS in September. The rule will update the standards for the first time in more than two decades. The letter, signed by 32 lawmakers, was sent last week. (McIntire, 7/27)


Justice Department Opposes Anthem's Request For A Quick Trial On Merger With Cigna

Federal lawyers say the case is too complex for a rushed trial. Also in the news, insurers in Minnesota weigh an increase in rate requests, a Texas insurer may cover sex change surgery and an insured California family struggles to care for a disabled child.

Bloomberg: U.S. Opposes Anthem Push For A Quick Trial In Cigna Merger Case
Anthem Inc. is pushing for a speedy decision on the government’s bid to block the health insurer’s planned $48 billion merger with rival Cigna Corp. The government doesn’t want that, and on Wednesday its lawyers told a federal judge the case is too complex to rush a ruling. Justice Department lawyers told U.S. District Judge John D. Bates in Washington that the antitrust case they filed last week is far more complicated than a coal company lawsuit that Anthem attorneys cited on Monday as an example of what could be done. (Harris, 7/28)

Star Tribune: Blue Cross Retreat Prompts Re-Evaluation By Insurance Competitors
The pullback by Blue Cross and Blue Shield of Minnesota from the state's individual market has prompted competing health insurers to consider if they need higher premiums for 2017. As a result, an expected release of preliminary rate requests that was planned for Monday isn't going to happen, state officials said Thursday. It's now likely the premium proposals will be posted by Sept. 1. (Snowbeck, 7/28)

The Dallas Morning News: Blue Cross May Soon Cover Sex Change Surgery; What It Means For Premiums
Blue Cross Blue Shield of Texas wants to cover gender reassignment surgery in plans sold on And the state’s largest insurer noted the change in the same filing that calls for increasing next year’s premiums by almost 60 percent on individual plans. ... Studies show that extending coverage to transgender people has a tiny impact on health costs. While surgery is expensive, up to $89,000, few people get it. And those “in transition” often receive hormone treatments or other less expensive therapies. (Schnurman, 7/28)

KQED: Even With Insurance, Family Of Medically Fragile Child Struggles To Find Home Health Care
Noah [Smart] has a feeding pump, a suction machine, and needs oxygen, his father says. These needs are highly complex, and while some members of Noah’s makeshift support system have medical skills — Brian’s mother is a retired registered nurse, the au pair has a nursing license from the Philippines — everyone agrees this care system is not sustainable. “Ideally, we would want a nurse 24 hours a day,” Brian says, although he also says they’d take even 8-hour support. But trying to access that level of care has been a months-long odyssey. (Katz, 7/28)

Theranos CEO Set To Present Technology At Prestigious Scientific Conference

Elizabeth Holmes' slated conference speech is drawing mixed reactions, with some willing to listen, but others outraged at the idea. “Would you have Al Capone come and talk about his novel accounting practices?” asked Geoff Baird, a clinical pathologist. “Is it acceptable to allow someone to talk about science if they’ve used that science so horribly inappropriately?”

Stat: Embattled Theranos Promises First-Ever Peek At Its Science — But Doubts Abound
After more than a decade of evasion, Theranos is finally stepping into the scientific spotlight. And that’s creating quite a stir. Elizabeth Holmes, the turtleneck-clad CEO of the once dazzling diagnostics startup, is slated to deliver the first comprehensive rundown of the science behind Theranos’s blood tests on Monday, in front of industry professionals at the American Association for Clinical Chemistry conference in Philadelphia. (Keshavan, 7/29)


New Hospital Star Ratings Ignite Debate About Assessing Quality Of Care

Many hospitals say the new ratings are oversimplistic, but consumer advocates contend patients need markers to help them make wise choices about where to seek treatments.

WBUR: How Many Stars For Your Hospital? The Pros And Cons Of New Medicare Hospital Ratings
The federal government is out with a five-star rating system for the hospital near you and more than 3,600 across the country. In Massachusetts, half of the hospitals earned three stars. Only one scored the top five-star rating and there is only one with a single star. The rating is based on 64 measures including patient-reported hospital cleanliness, infection rates, how often Medicare patients are readmitted for heart failure and how often those with pneumonia die. Many hospitals are not pleased with the new practice. ... Consumer groups, including Health Care For All (HCFA), applaud the federal CMS for shedding light on differences between hospitals. (Bebinger, 7/29)

The New Orleans Times-Picayune: Jefferson Parish Hospitals Top Local Providers In Medicare Ratings
Jefferson Parish's two public hospitals earned high marks from the Center for Medicare and Medicaid Services as part of the center's first Overall Hospital Quality Star Rating. West Jefferson Medical Center and East Jefferson General Hospital both scored four stars out of five, placing them among the top 20 percent of rated hospitals in the country. Well-regarded hospitals like Tulane Medical Center and Ochsner Medical Center New Orleans, by comparison, received just two out of five stars. (Lipinski, 7/28)

Kansas Health Institute: Five Kansas Hospitals Receive Five Stars In Medicare’s New Ratings
Federal health officials Wednesday released much anticipated — and controversial — quality ratings for 4,000 hospitals in the United States, and five Kansas facilities received the top rating of five stars. The hospital industry has criticized the ratings system as overly simplistic and its methodology as flawed. And hospitals that serve largely poor populations or deal with more complex cases say it unfairly penalizes them. (Margolies, 7/28)

NJ Spotlight: Some NJ Hospitals Unhappy With How They Score In The New Ranking System
None of the Garden State’s 64 acute care facilities scored five stars, but nine percent (6 facilities) got a single star – nearly three times the national rate. More than 12 percent (8) achieved four stars; nearly a third (20) scored three stars; and 47 percent (30) were assigned two stars by CMS. In general, hospitals in suburban central New Jersey and along the Shore performed well, while hospitals in urban areas or aging bedroom communities scored lower. (Stainton, 7/28)


Bristol-Myers' Bet On Cancer Drugs Pays Off In Second Quarter

In other pharmaceutical news, Sanofi's profits fall, Pfizer's takeover of Bind Therapeutics is approved by a federal bankruptcy court and Gilead comes under fire once again for its pricey hepatitis C medication.

The Wall Street Journal: Bristol-Myers Results Boosted By Cancer Drugs
Bristol-Myers Squibb Co. said its second-quarter revenue rose 17% and it raised its earnings forecast for the year as the company’s bet on cancer immunotherapies continues to pay off while other drugs show gains. The drugmaker was the first to bring to market an immunotherapy, which aims to fight cancer by unshackling the body’s immune system. Sales of its newest immunotherapy, Opdivo, rose to $840 million in the quarter, up $718 million from a year earlier and accounting for much of Bristol’s revenue gains in the quarter. (Rockoff and Stynes, 7/28)

The Wall Street Journal: Sanofi Profit Down As Diabetes Drug Sales Slip
French drugmaker Sanofi SA on Friday reported a fall in second-quarter net profit, hurt by dwindling U.S. diabetes drug sales and adverse currency moves but said it still expected to meet its profit target this year. The Paris-based drugmaker said net profit declined by 11% to €1.16 billion ($1.29 billion) for the three months through June from €1.3 billion a year earlier. (Bisserbe, 7/29)

Boston Globe: Bankruptcy Court Approves $40 Million Takeover Of Bind Therapeutics
A federal bankruptcy court Wednesday approved a $40 million takeover of cancer drug developer Bind Therapeutics Inc. by Big Pharma stalwart Pfizer Inc. The court order authorizing the sale closes the book on Bind, a 10-year-old Cambridge biotech company that pioneered a novel approach to fighting cancer but ran into financial trouble before it could bring its experimental therapies to the marketplace. (Weisman, 7/27)

Stat: Gilead Hep C Drug Prices Blamed For England’s Health Service Rationing Treatment
Faced with budgetary constraints, England’s National Health Service took several controversial steps to delay coverage of Gilead Sciences’s pricey hepatitis C treatments, but did so at the expense of patients, according to an investigation by the BMJ, the UK medical journal. Specifically, the agency’s moves caused delays in providing treatment to many of the estimated 160,000 hepatitis C patients, while others were unable to obtain the medications due to rationing. As a result, some people are now traveling out of the country to receive treatment. Meanwhile, Gilead has been blamed for igniting the problem due to its pricing practices. (Silverman, 7/28)

Veterans' Health Care

Report: VA Spent $20M On Decorative Artwork During Height Of Wait-Time Scandal

The report, which focuses on the agency's expenditures from 2004-2014, has sparked fresh anger with lawmakers and advocates. In other news, Army Secretary Eric Fanning speaks about the importance of mental health treatment, and a veteran's family seeks answers about his death at a VA facility's inpatient drug rehabilitation unit.

ABC News: Report: VA Spent Millions On Costly Art As Veterans Waited For Care
A new report alleges that the Department of Veterans Affairs spent $20 million between 2004 and 2014 on costly artwork. The expenditures included more than $1 million for a courtyard with a large sculpture at a Palo Alto veterans facility; $330,000 for a glass-art installation; and $21,000 for an artificial Christmas tree, according to the report. (McLaughlin, 7/29)

The Associated Press: Army Secretary Touts Importance Of Mental Health
Army Secretary Eric Fanning says the Army is paying more attention to behavioral health and making sure anyone who's injured while defending the nation gets the treatment they need. The Army and other military branches are conducting research into how military deployment affects anger, and they are encouraging mental health treatment before deployment to mitigate the effects of anger after soldiers return, he said. (7/27)

Milwaukee Journal Sentinel: Family Seeks Answers In Army Vet's Overdose Death
Last fall, Cole Schuler, a 26-year-old former U.S. Army Ranger from the Fox Valley, checked himself into the inpatient drug rehabilitation unit of the Clement J. Zablocki Veterans Affairs facility in Milwaukee. He was trying to kick an addiction to opioids. Instead, 11 days into his stay, he died of a heroin overdose at the center. ...The overdose is being investigated by the VA, local law enforcement and the Milwaukee County district attorney's office, according to a letter sent last month by U.S. Sen. Tammy Baldwin to the top official at the U.S. Department of Veterans Affairs. (Bekker, 7/28)

Health IT

Digital Health Firm Targets Low-Income Patients For Diabetes Initiative

Omada offers an online tool to help those with diabetes — but it wants to take it a step further and specifically address a population that faces a higher risk of certain chronic health problems.

Stat: Can A Silicon Valley Startup Prevent Diabetes In Medicaid Patients?
Omada, which offers an online program geared to helping people who are prediabetic or obese lose weight and avoid developing type 2 diabetes, is rolling out a version of its program specifically tailored to people who rely on safety-net services like Medicaid. It is also sponsoring a clinical trial to try to demonstrate that such a program can work in low-income communities. In all of Omada’s programs, participants are given a scale that tracks their weight every day and are matched into groups based on geography and weight loss goals. The groups are paired with health coaches who provide guidance and lessons, customizing them so that a group of Louisianans, for example, can discuss how to keep up healthy habits during Mardi Gras. (Joseph, 7/29)

In other news, service dogs are being trained to help those with diabetes —

NPR: Can Dogs Help Sniff Out Low Blood Sugar In Diabetes?
For people with diabetes who take insulin, the risk of losing consciousness from low blood sugar is a constant fear. Devices called continuous glucose monitors (CGMs) can alert wearers to dropping levels, but not everyone has access to them. And even among those who do, some prefer a furrier and friendlier alert option: A service dog with special training to alert owners when their blood sugar reaches dangerously low levels. (Tucker, 7/29)

Public Health And Education

'Natural' Painkiller Used To Wean An Opioid Addiction Causing Spike In Poison Control Calls

Kratom is a highly addictive plant that can be brewed into teas, and it's causing serious side effects for patients. In other news, physicians are having to learn new skills to help deal with the opioid epidemic, and Massachusetts lawmakers are considering a bill that would require insurers to cover addiction treatment.

Stat: Poison Control Centers Are Getting A Surge Of Calls About ‘Natural’ Painkiller Kratom
The herbal supplement seemed like a miracle. Trying to kick an opioid addiction, the middle-aged man found he could soothe his cravings with a tea made from an Asian plant called kratom. It relieved his pain and made him more alert. But when he combined it with a stimulant, it also gave him a seizure that landed him in a Boston-area emergency room. Those kinds of stories are on the rise, according to a study published Thursday in a weekly report from the Centers for Disease Control and Prevention. The number of calls to poison centers about problems stemming from kratom ingestion have increased tenfold over five years, from 26 in 2010 to 263 in 2015. (Boodman, 7/28)

NPR: Doctors Need A New Skill Set For This Opioid Abuse Treatment
In a big hotel conference room near New York's Times Square, six doctors huddle around a greasy piece of raw pork. They watch as addiction medicine specialist Michael Frost delicately marks the meat, incises it and implants four match-sized rods. "If you can do it well on the pork, you can easily do it on the person," Frost tells his audience. Frost consults for Braeburn Pharmaceuticals, the company behind the newly FDA-approved treatment Probuphine, and is teaching doctors how to use it. They are learning to implant it in pork so they can later implant it in patients' arms. (Shakerdge, 7/28)

WBUR: Controversial Bill Would Require 30-Day Addiction Treatment Coverage
State lawmakers are considering a health insurance mandate that would require private health insurers to cover addiction treatment. As part of the federal Medicaid waiver the Baker administration filed this year, some public health insurance carriers would be required to cover up to 30 days of treatment. But some commercial insurers, along with several business groups, say there's no evidence that 30 days works. (Becker and McNerney, 7/28)

Alzheimer Drug Failure Deals Crushing Blow To Scientists Who Rail Over 35 Years Of Missteps

Researchers have approached a cure with the mindset that it was the expectation that amyloid plaques and tau tangles kill brain synapses and neurons, and despite clues suggesting otherwise, the field has been stuck on that for decades. A promising drug's failure has sparked anger and frustration by those who have been toiling for all that time.

Stat: Alzheimer’s Researchers Seethe Over Years Of Missteps After Latest Drug Failure
In the wake of disappointing results this week for yet another experimental Alzheimer’s drug, scientists who have toiled for decades to understand the devastating disease expressed frustration and even anger that their field has not made more progress toward a cure. ... To a growing number of scientists, the problem isn’t that there’s been too little time to make meaningful progress against a hugely complicated disease that strikes an organ unrivaled for its complexity. It’s that the field has made many missteps, that its leaders stifled research that deviated from the dominant theory of what caused Alzheimer’s, and that it was too easy to count as progress journal papers rather than advances that help patients. (Begley, 7/28)

In other public health news, a new organ donation technique offers hope to patients, experts caution against a new trend of injecting gas into the areas around the eye and a study puts a price tag on the world's growing sedentary lifestyle —

The Philadelphia Inquirer: For Organs Kept Alive Before Transplant, Tantalizing Possibilities
The process is called perfusion... it means the delivery of oxygenated blood to the tissues of the body. Normally, they are inside. But donor kidneys have been perfused before transplant since the 1960s. Surgeons started experimenting with small numbers of other organs about a decade ago. Pumping blood or a synthetic solution through them for several hours allows time to run tests rather than discarding an organ because of the mere possibility of a problem. It also opens up all sorts of futuristic medical ideas. (Jablow, 7/29)

Stat: Trend Watch: People Are Injecting Gas Into Their Eyelids To Fix Dark Circles
Forget all those creams that promise to reduce eye puffiness. A new beauty trend makes your eyes swell up on purpose — with the goal of making you look less tired. Fans of the procedure, called carboxytherapy, can spend thousands of dollars to have carbon dioxide injected both above and below the eye, hoping to stimulate blood flow and erase dark circles. But experts caution there isn’t any evidence to back up the procedure. It’s likely not even targeting the real root of the skin blemishes. “I would be very skeptical of its use for dark circles,” said Dr. Molly Wanner, a cosmetic dermatologist at Massachusetts General Hospital. (Thielking, 7/29)

CBS News: How Much Are Couch Potatoes Costing The World?
Obesity, heart disease, and even an early death are some of the risks of physical inactivity. But what if we could put a dollar amount on the financial burden of an increasingly sedentary world? Researchers from the University of Sydney in Australia attempted to do just that in the first study to estimate the global cost of physical inactivity. The results are startling. The report, published in The Lancet, found that physical inactivity cost the world $67.5 billion in direct and indirect costs in 2013. (Welch, 7/28)

3 Apollo Astronauts Have Died Of Heart Problems, And New Study Tries To Figure Out Why

While radiation is one of the big concerns when monitoring the health of those who have traveled in deep space, some researchers are questioning if there's also a connection to cardiovascular problems.

The Washington Post: Studying Heart Disease In Astronauts Yields Clues But Not Conclusive Evidence
When James Irwin suffered his first heart attack at age 43 — just two years after walking on the moon — NASA doctors dismissed any connection with his trip to space, during which he had experienced short spells of irregular heart rhythm. "They noted that pre-flight testing had shown Mr. Irwin to be prone to slight uneven heartbeats on occasion after exercise," according to the New York Times. But then Irwin died of a heart attack in 1991, when he was just 61. A year earlier, fellow Apollo astronaut Ron Evans died of a heart attack in his sleep at age 56. And Neil Armstrong died after complications from cardiovascular surgery in 2012. He was 82. (Kaplan, 7/28)

The New York Times: Study Asks If Moon Astronauts Got Increased Heart Risks
Only 24 people have ever gone to deep space, or to the area beyond the Earth’s magnetic shield. These are the Apollo astronauts who flew to the moon, the last of whom did so in 1972. Today, dreams of deep space exploration are surfacing again. Government space programs and private corporations alike have their eyes set on returning to the moon for longer visits and venturing beyond, to Mars, in the coming decades. Michael Delp, a professor of human sciences at Florida State University, said researchers need to better understand and study the effects of deep space travel on the human body. (Yin, 7/28)

Repercussions Of Hinckley's Insanity Plea Reverberate To This Day

John Hinckley Jr., the man who tried to assassinate Ronald Reagan, was released this week, resurrecting the fierce debate over a defense tactic that is used much less frequently than the general population believes. NPR reports on the "not guilty for reasons of insanity" plea as well as the gun violence relationship to mental health.

NPR: After Hinckley, States Tightened Use Of The Insanity Plea
The insanity ruling that sent President Ronald Reagan's would-be assassin, John Hinckley Jr., to a government psychiatric hospital rather than prison was handed down 34 years ago, but its repercussions still affect hundreds, if not thousands, of people who commit a crime and also have mental illness. These consequences and the insanity defense itself were forced into the national spotlight again on Wednesday, when a federal judge said Hinckley would be released to live with his elderly mother in Williamsburg, Va. (Jacewicz, 7/28)

NPR: Gun Violence And Mental Health Laws, 50 Years After Texas Tower Sniper
For some people, the attack on police officers by a gunman in Dallas this summer brought to mind another attack by a sniper in Austin 50 years ago – on Aug. 1, 1966. That's when student Charles Whitman stuck his rifle over the edge of the clock tower at the University of Texas at Austin and started shooting. Ultimately, he killed 16 people — and wounded more than 30 others. For decades, people have struggled to figure out why. There have been theories about abuse, a brain tumor and, of course, mental illness. (Silverman, 7/29)

State Watch

Parents Of Disabled Children Press N.C. Officials To Reconsider Cuts To Medicaid Services

The state had recommended cutting a program that provides help to families with children who are medically fragile. Also, Colorado officials are challenged on their policy to provide Medicaid coverage for expensive hepatitis C medications only to the sickest patients.

North Carolina Health News: Parents Of Disabled Kids Weigh In On Proposed Medicaid Changes
About 2,200 to 2,300 kids in North Carolina are medically fragile, like Lydia Nell, and qualify for [Community Alternatives Program for Children]. Usually, Medicaid caps the amount of money a family can make to qualify for the program. But for families like the Nells, the federal government allows a waiver to the usual Medicaid rules. Last year, North Carolina’s federal waiver needed to be renewed. But the plan DHHS unveiled in April set off alarm bells: Service hours for families were slashed, among other changes. ... The outcry forced DHHS to announce in May that they would rework the waiver application. (Hoban, 7/28)

The Denver Post: Only The Sickest Coloradans On Medicaid Get Breakthrough Treatment For Hepatitis C
It’s not until the final two stages of liver damage that needy Coloradans with the blood-borne hepatitis C virus get access to a life-saving drug with a 90-percent cure rate and an exorbitant price tag. “You’ve got to be on death’s door before they will treat you,” said David Higginbotham, a Colorado Medicaid beneficiary who contracted the virus 35 years ago while working as a hospital surgical tech. ... Now pressure for change is increasing against the state Department of Health Care Policy and Financing, which has restricted access to the breakthrough drug due to its cost. (Brown, 7/29)

State Highlights: Fla. Health Officials Appoint Telehealth Advisory Council; S.C. Hospital To Pay $17M In Physician Referral Whistleblower Case

Outlets report on health news from Florida, South Carolina, Texas, Kansas, California and Tennessee.

Health News Florida: Florida Health Regulators Announce Telemedicine Board Appointments
Florida’s health regulators announced the appointment of 13 health care professionals to a board tasked with assessing the viability of telemedicine. The taskforce will recommend solutions for reimbursing doctors who use distance medicine technology to treat patients. The 15-member panel will be chaired by Agency for Health Care Administration Secretary Elizabeth Dudek or her stand-in. Florida Surgeon General Celeste Philip was also appointed to the committee and can also select a stand-in. (Benk, 7/28)

Modern Healthcare: South Carolina Hospital To Pay $17 Million Over Physician Pay Allegations
South Carolina's Lexington Medical Center will pay the government $17 million over allegations that it paid 28 physicians unreasonably high amounts in exchange for referrals. A whistle-blower and the government alleged that Lexington bought access to patients by acquiring physician practices and then paid the doctors “commercially unreasonable compensation” with the expectation that they would make referrals to Lexington. (Schencker, 7/28)

Stateline: In Aging America, New Efforts To Connect Young And Old
[As] the country grows older, more colleges and communities are trying such programs to build kinship and improve quality of life for people of all ages. The programs can take many forms. Some are housed at universities; and several localities, including San Diego County and New York City, run programs that bring seniors and other adults together with teens and children for games and community projects. (Fifield, 7/28)

Houston Chronicle: Thousands Of Kelsey-Seybold Patients To Lose In-Network Coverage From Blue Cross
As many as 100,000 Kelsey-Seybold Clinic patients across Houston will soon lose in-network coverage when Blue Cross and Blue Shield of Texas drops the medical provider's vast network of doctors and treatment options from some of its plans. The insurer, Texas' largest health insurance carrier, confirmed Thursday that as of Oct. 1 Kelsey-Seybold's 470 doctors at 20 locations across the region will become out of network and therefore more costly for patients to see. (Deam, 7/28)

Kansas Health Institute: Wyandot Inc. To Cut Mental Health Services For More Than 800 Clients
One of the Kansas City area’s leading mental health organizations is cutting services for more than 800 adults and children. Wyandot Inc., an umbrella organization for four nonprofit agencies in Kansas City, Kan., said Wednesday that it would need to cut services due to revenue losses and Gov. Sam Brownback’s decision earlier this year to reduce Medicaid reimbursements by 4 percent. (Smith, 7/28)

KQED: California Adds Atrazine To List Of Toxic Chemicals, But No Ban
Atrazine has been a dirty word among environmentalists for decades. Now state and federal agencies are coming down on the weed killer, amid troubling evidence that it disrupts hormones and contributes to birth defects. This month, California added atrazine to the Prop 65 list of toxic chemicals since it’s known to cause reproductive harm. And in June, the U.S. Environmental Protection Agency declared, “there are risk concerns for mammals, birds, reptiles, plants and plant communities across the country for many atrazine uses.” The agency opened a public comment period for its atrazine draft ecological risk assessment, which is based on new studies. By the end of the year it will issue a separate report on atrazine’s human impact. (Hoshaw, 7/28)

The Tennessean: Saint Thomas Health, NHC Partner To Coordinate Care After Discharge
A new partnership between Saint Thomas Health and National HealthCare Corporation will help coordinate and transition patients from the hospital to other facilities, such as skilled nursing, in an effort to improve care. Starting Aug. 1, the pair will begin to work on integrating their systems and teams to make sure patients who can't be discharged home get the continuous care they need to prevent readmission to the hospital and reach the expected level of recovery. (Fletcher, 7/28)

Tampa Bay Times: A Six-Figure Grant, A New Project, A Simple Idea: Welcome Babies To The Neighborhood
The Foundation for a Healthy St. Petersburg awarded $327,511 to the center and the Lake Maggiore Shores neighborhood to put a focus on area children's mental health. The money comes from the sale of the former nonprofit Bayfront Medical Center, which this year is funding 19 projects in Pinellas County totaling $4 million. The kids' welcome baskets are a small part of what neighbors hope will blossom into a broader initiative spanning some 40 blocks, home to 170 children under 5 years old. (Jeffrey, 7/29)

Orlando Sentinel: New West Boca Nonprofit Offers Home Health Care To Seniors
Senior citizens who need help with daily tasks but want to remain independent can get help from a new nonprofit service that supports their goal of staying out of a nursing home. JFS At Home was created by the Ruth & Norman Rales Jewish Family Services, a social service agency. It brings certified nursing assistants and home health care aides into seniors' apartments and houses to help them with bathing, toileting, feeding and other daily requirements. (Solomon, 7/29)

Orlando Sentinel: Middletown's Community Health Center Participating In Ambitious U.S. Health Study
A massive federal project to study the health habits of 1 million or more Americans over a decade has chosen the Community Health Center to be one of 11 organizations in the country to participate in the first phase. The National Institutes of Health said the Precision Medicine Initiative is "one of the most ambitious research projects in history" that will use data and health information to find better ways to treat and prevent disease. (Beals, 7/28)

San Francisco Chronicle: Danbury Psychiatrist Settles Medicare Fraud Allegations
According to a statement released from the U.S. Justice Department, Dr. Anton Fry and CPC Associates, which has offices on Hospital Avenue and North Street, were being investigated for Medicare fraud for providing services to patients over the telephone instead of treating the patients in person. The practice, however, said in a statement there was no criminal intent and the telephone services were provided on a limited basis to accommodate patients with other health issues. While some “telehealth” services are allowed by Medicare in rural areas with shortages in health care professionals, Danbury is not considered one of those areas. (Perrefort, 7/28)

Health Policy Research

Research Roundup: Teens And Nighttime Car Crashes; Self-Insured Plans; Virtual Violence

Each week, KHN compiles a selection of recently released health policy studies and briefs.

Centers for Disease Control and Prevention/Mobidity and Mortality Report: Graduated Driver Licensing Night Driving Restrictions And Drivers Aged 16 Or 17 Years Involved In Fatal Night Crashes — United States, 2009–2014
To help address the increased crash risk for beginner teen drivers, 49 states and the District of Columbia include a night driving restriction (NDR) in their Graduated Driver Licensing (GDL) system. ... in 23 states and the District of Columbia, NDRs begin at 12:00 a.m. or later .... CDC analyzed 2009–2014 national and state-level data from the Fatality Analysis Reporting System (FARS) to determine the proportion of drivers aged 16 or 17 years involved in fatal crashes who crashed at night .... Nationwide, among 6,104 drivers aged 16 or 17 years involved in fatal crashes ..., 1,865 (31%) were involved in night crashes. Among drivers involved in night crashes, 1,054 (57%) crashed before 12:00 a.m. ... Because nearly all of the night driving trips taken by drivers aged 16 or 17 years end before 12:00 a.m., NDRs beginning at 12:00 a.m. or later provide minimal protection. (Shults and Williams, 7/28)

Health and Human Services Office of Inspector General: Adverse Events In Rehabilitation Hospitals: National Incidence Among Medicare Beneficiaries
This report is part of a series on adverse events in health care settings .... An estimated 29 percent of Medicare beneficiaries experienced adverse or temporary harm events during their rehab hospital stays, resulting in temporary harm; prolonged stays or transfers to other hospitals; permanent harm; life-sustaining intervention; or death. This harm rate is in line with what we found in hospitals (27 percent) and in SNFs (33 percent). Physician reviewers determined that 46 percent of these adverse and temporary harm events were clearly or likely preventable. Physicians attributed much of the preventable harm to substandard treatment, inadequate patient monitoring, and failure to provide needed treatment. (7/19)

Pediatrics: Virtual Violence
In the United States, exposure to media violence is becoming an inescapable component of children’s lives. With the rise in new technologies, such as tablets and new gaming platforms, children and adolescents increasingly are exposed to what is known as “virtual violence.” This form of violence is not experienced physically; rather, it is experienced in realistic ways via new technology and ever more intense and realistic games. The American Academy of Pediatrics continues to be concerned about children’s exposure to virtual violence and the effect it has on their overall health and well-being. This policy statement aims to summarize the current state of scientific knowledge regarding the effects of virtual violence on children’s attitudes and behaviors and to make specific recommendations for pediatricians, parents, industry, and policy makers. (Christakis, 7/18)

Employee Benefits Research Institute: Self-Insured Health Plans: Recent Trends By Firm Size, 1996-2015
This Notes article examines 1996‒2015 trends in self-insured health plans among private-sector establishments .... The data come from the Medical Expenditure Panel Survey Insurance Component (MEPS-IC). ... The percentage of private-sector establishments offering health plans at least one of which is self-insured has increased from 28.5 percent in 1996 to 39 percent in 2015 (36.8 percent increase). Between 2013 and 2015, the percentages of establishments offering health plans with at least one self-insured plan has increased for midsized establishments from 25.3 percent to 30.1 percent (a 19 percent increase); for small establishments from 13.3 percent to 14.2 percent (a 7 percent increase); and has decreased from 83.9 percent to 80.4 percent for large establishments (a 4 percent decrease). (Fronstin, 7/27)

Health Affairs: Off-Label Drug Promotion
In recent years there has been renewed debate over whether and how the FDA should regulate the pharmaceutical industry's communication to physicians around off-label uses .... The FDA has released multiple guidance documents detailing its current thinking about manufacturer communication and promotion, including updates -- in 2011 and 2014, respectively .... Nevertheless, it is not always clear what behavior falls into one of these safe harbors, and manufacturers have substantial incentives to push the boundaries of the law. The FDA also has limited capacity to review and monitor all forms and avenues of communication. Violations are common, and many of these violations have led to serious and costly patient harm. (Richardson, 6/30)

The Kaiser Family Foundation: Turning Medicare Into A Premium Support System: Frequently Asked Questions
Premium support is a general term used to describe an approach ... to reduce the growth in Medicare spending by increasing competition among health plans and providing a stronger incentive for beneficiaries to be cost-conscious .... Many proposals advance the concept of premium support without providing all of the details needed to assess the possible effects of the proposal on key stakeholders. Other proposals are more detailed, although they differ markedly in their specific policy features, and these differences have important implications for Medicare beneficiaries, the federal budget, health care providers, and private health plans. This issue brief is intended to highlight some of the key questions that could be considered once proposals’ details emerge. (Jacobson and Neuman, 7/19)

The Kaiser Family Foundation: Medicaid's Most Costly Outpatient Drugs
With over 70 million beneficiaries, many of whom have complicated health needs, Medicaid is one of the largest providers of prescription drugs in the United States. State Medicaid agencies have a variety of mechanisms to help control outpatient drug spending that they have been using widely for the past decade. However, new prescription drugs are always coming to market, and the health needs of the Medicaid population change over time, especially as enrollment grows because of ACA Medicaid expansion. As a result, it is helpful for policy makers to understand which drugs used by the Medicaid program are most expensive. In this issue brief, we determine the 50 most costly drugs before rebates used by the Medicaid program from January 2014 through June 2015. (Young et al., 7/15)

Here is a selection of news coverage of other recent research:

Forbes: 43 States Fail To Make Health Price Information Available
There are 43 states that fail to adequately make healthcare price information available to consumers despite pressure from employers and policymakers for greater transparency, a new analysis shows. Just six states earn a passing grade of a C or better and a seventh state gets a D when it comes to price transparency, according to the latest analysis from the nonprofit Health Care Incentives Improvement Institute and Catalyst for Payment Reform. (Japsen, 7/26)

Reuters: With Reference Pricing, Patients Spend Less On Diagnostic Testing
When employers and insurers use reference pricing for diagnostic tests, the average price paid for those tests dips by almost a third, according to a new U.S. study. Under reference pricing, which is commonly used in Europe for medications, insurers reimburse up to a certain limit, depending on the medication or service, and the patient must pay the rest out of pocket if the price charged is higher. Patients have an incentive to choose medications or services as close to the reference price as possible to reduce their own spending. “There’s no reason to believe the quality of the tests varies across labs,” said lead author James C. Robinson of the University of California, Berkeley. (Doyle, 7/26)

Editorials And Opinions

Viewpoints: Misconceptions About Patient Privacy; DOJ's Suit Against Insurers' Mega-Mergers Makes Case Against Single-Payer

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

The Washington Post: Five Myths About Patient Privacy
Shortly after the recent massacre at an Orlando nightclub, the city’s mayor declared that the White House had agreed to waive federal privacy rules to allow doctors to update victims’ families. News of the waiver was widely reported, but as the Obama administration later clarified, both the mayor and the media were “simply mistaken.” No waiver was granted because none was needed. The confusion amid the tragedy in Orlando underscores widespread misconceptions about the Health Insurance Portability and Accountability Act (HIPAA) Privacy Rule. Here we shed light on a handful of myths that bedevil doctors and patients alike. (Charles G. Kels, 7/28)

The Hill: Obama Justice Department Makes Case Against Single-Payer Healthcare
They didn’t mean to, but officials at the Obama Justice Department have laid out the case against government-run healthcare. In filing suit against mammoth health insurance mergers, they’ve explained that reduced competition limits options for consumers, raises costs, and threatens access to care. That’s exactly why a single-payer system would be a disaster for America. (Hadley Heath Manning, 7/28)

Boston Globe: Wider Access To Hepatitis C Drugs Is Humane And Pragmatic
When Gilead Sciences Inc.’s Sovaldi became the first of the more effective medicines to hit the market, in 2013, its $84,000 list price — $1,000 a pill — caused sticker shock for payers nationwide. Fearing their budgets would be drained by a rush of people who wanted to get well instead of living with uncertainty, many insurers limited access to Sovaldi. Even from a cold-blooded accountant’s perspective, it was a foolish policy — providing months or years of medical care for someone suffering from cirrhosis costs much more. (7/29)

The Hill: Do You Know Who’s In Charge Of Your Health Care Decisions?
When it comes to Medicare, most seniors rightfully assume that the representatives they elect to Congress are the ones making critical decisions that affect their health care. After all, it’s one of the largest government programs in our country accounting for more than $500 billion in federal outlays and responsible for the health of America’s seniors. What many patients and voters don’t realize, however, is that there is another body in Washington whose power and influence over the future of this program is growing: The Medicare Payment Advisory Commission (MedPAC). (David Williams, 7/28)

Lexington Herald Leader: Reject Medicaid Changes That Will Deny Care
Having no health insurance, or inadequate basic coverage, means premature death. The Medicaid expansion and Kynect significantly reduced the number of uninsured coming to our institutions. This allowed for more attention to preventative medicine, education for staying healthy, and continued contact with patients so that they did not need to return to hospitals or emergency rooms. Kentucky should not take a step backwards. (Rev. John Stowe, 7/28)

Louisville Courier-Journal: Increasing Awareness Of HIV Prevention Drug
It’s been called a game changer, this little blue pill that when taken daily can decrease the risk of contracting HIV by as much as 92 percent. But why aren’t more people in Louisville aware of it? Groups around Kentuckiana are answering just that as they strive to bring PrEP to the forefront of HIV prevention efforts while trying to save lives in the process. (Amanda Beam, 7/29)

Des Moines Register: Your Tax Dollars At Work ... Spreading Diseases
This country's federal government requires anyone seeking legal, permanent residence here to be vaccinated against 14 diseases, including measles, polio and seasonal flu. Because immunizations protect public health, the mandate for newcomers makes sense. What does not make sense: The same government fails to require workers at Immigration and Customs Enforcement facilities to be vaccinated. These individuals have extensive contact with the public and are at higher risk for contracting contagious diseases, yet may not be protected against any of them. (7/28)

The Hill: Marijuana Legalization Might Be Fix To Nation’s Opioid Problems
Proponents of marijuana prohibition have long alleged that experimentation with pot acts as a “gateway” to the use and eventual abuse of other illicit substances. But the results of a just released national poll finds that most Americans no longer believe this claim to be true. According to survey data compiled by, fewer than one in three US citizens agree with the statement, “the use of marijuana leads to the use of hard drugs.” Among those respondents under the age of 65, fewer than one in four agree. (Paul Armentano, 7/28)

Georgia Health News: Georgia Needs To Put Its Foot Down On ‘Step Therapy’ For Diabetics
More than 1 million people in Georgia live with diabetes and are at risk for developing chronic, debilitating and potentially permanent nerve pain, known as diabetic peripheral neuropathy (DPN). Currently, the American Diabetes Association estimates that more than 60 percent of Americans with diabetes also suffer from diabetic peripheral neuropathy. ... Left untreated or uncontrolled, DPN can cause irreversible damage, including complete loss of lower extremity sensation that can result in amputation. Fortunately, Georgia lawmakers are recognizing the seriousness of DPN. Last month, the General Assembly held Diabetic Peripheral Neuropathy Alert Day in order to raise awareness of this dangerous condition. (Jonathan Ownby, 7/28)