KHN Morning Briefing

Summaries of health policy coverage from major news organizations

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Kaiser Health News Original Stories

Political Cartoon: 'Enough Is Enough?'

Kaiser Health News provides a fresh take on health policy developments with "Political Cartoon: 'Enough Is Enough?'" by Gary McCoy.

Here's today's health policy haiku:

IS MEDICARE STEPPING BACKWARD?

Payment for Value —
New concept in medicine.
Too much for Tom Price?

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Summaries Of The News:

Health Law

'Obviously We Had A Setback': McConnell Uncertain About Next Steps On Health Care

Senate Majority Leader Mitch McConnell (R-Ky.) says after Congress returns from recess that Republicans will have to sit down with Democrats and figure out a way forward. Meanwhile, state and local groups are stepping up to preemptively counter any lack of enrollment support from the federal government.

The Hill: McConnell: Path On Healthcare ‘Murky’ 
Senate Majority Leader Mitch McConnell (R-Ky.) acknowledged Monday that Congress's next steps on healthcare are unclear after Republicans failed to repeal ObamaCare. "Obviously we had a setback on the effort to make dramatic changes on ObamaCare. The way forward now is somewhat murky," the Senate GOP leader said at a Chamber of Commerce event in Kentucky with Treasury Secretary Steven Mnuchin. (Carney, 8/21)

The Hill: Fearing Sabotage, Groups Prepare ObamaCare Blitz 
State and local groups that help support ObamaCare are springing into action ahead of an enrollment period they fear could be sabotaged by the Trump administration. Their marketing efforts are expanding, their advertisements are starting earlier, and those that fought repeal are shifting their focus to spreading the word about open enrollment, which begins Nov. 1.  (Roubein and Hellmann, 8/22)

And in other news on the health law —

Modern Healthcare: With Congress Deadlocked, Iowa And Oklahoma Seek To Reform The ACA Through Waivers
Iowa and Oklahoma are about to test the Trump administration's declared commitment to giving states greater leeway in establishing alternatives to the Affordable Care Act's insurance exchanges. Iowa officials plan to submit a sweeping state innovation waiver request to the CMS next week that would substantially revamp the ACA premium tax credit model and use some of the federal subsidy money to set up a reinsurance program to protect insurers that sign up high-cost enrollees. ... On Wednesday, Oklahoma filed a waiver request, also under the ACA's Section 1332 state innovation waiver authority, to use federal subsidy money to fund a new reinsurance program, as the first step in a broader reform of the ACA coverage system. (Meyer, 8/18)

Medicaid

Medicaid Officials Say Repeal Effort Bolsters Support Of Program And Efforts To Improve It

Matt Salo, executive director of the National Association of Medicaid Directors, says states will likely soon begin bids to bolster the program to be better coordinated. In other news, Republicans opposed to Medicaid expansion in Maine are beginning to organize to fight a referendum there and Virginia Gov. Terry McAuliffe presses lawmakers once again to expand the program there.

Bloomberg/BNA: Medicaid Directors See Boon In Newfound Public Awareness
Medicaid directors are seeing a newfound public awareness and appreciation of the safety-net health insurance program in the wake of failed Obamacare repeal-and-replace efforts. That’s critical for Medicaid’s future, Matt Salo, executive director of the National Association of Medicaid Directors, told Bloomberg BNA Aug. 18. Now the real work will move back to the states, which can push bids to bolster the program to be more value-driven, holistic, and better coordinated for the most needy beneficiaries, he said. (Pelham, 8/18)

Portland (Maine) Press Herald: Republicans Organize To Raise Concerns About Medicaid Expansion In Maine
Several Republican lawmakers are expected to announce their concerns Tuesday about expanding Medicaid, a first step toward what could become a formal campaign to oppose the question voters will face on the Nov. 7 ballot. ... Maine Equal Justice Partners, a progressive advocacy group for low-income people, gathered more than 67,000 signatures of registered Maine voters to put the Medicaid expansion question on the Nov. 7 ballot. The proposal would expand Medicaid coverage to adults under 65 who earn below $16,000 for a single person and $22,000 for a family of two. (Thistle, 8/21)

Richmond Times-Dispatch: McAuliffe Backs Devoting Full Surplus To Reserve Funds, Pitches Medicaid Expansion Again
Gov. Terry McAuliffe warned General Assembly budget leaders on Monday that Virginia needs to bolster its cash reserves to hedge against the potential threat to the state’s economy from President Donald Trump’s proposed federal budget. McAuliffe, speaking to the assembly money committees in their temporary home in the Pocahontas Building, also called on legislators for the fourth time to expand Virginia’s Medicaid program with billions of dollars in federal funds under the Affordable Care Act after its survival from attempts to repeal the law in Congress. They quickly declined the offer. (Martz, 8/21)

Public Health And Education

Johnson & Johnson Ordered To Pay $417M In Case Linking Talcum Powder, Ovarian Cancer

Eva Echeverria, 63, of East Los Angeles, is one of thousands of women who sued the consumer products giant, claiming Johnson's baby powder caused their disease.

USA Today: Jury Awards $417M In Lawsuit Linking Talcum Powder To Cancer
The judgment, reached after a roughly one-month long trial in Los Angeles Superior Court, includes $347 million in punitive damages against Johnson & Johnson. It was the latest among several verdicts against the consumer-products maker, with about 2,000 women having filed similar cases. In the latest verdict, plaintiff Eva Echeverria alleged that Johnson & Johnson was aware of potential dangers from consistently using its talcum-based products for personal hygiene but refused to warn the public. (Jones, 8/21)

The Associated Press: Record $417M Award In Lawsuit Linking Baby Powder To Cancer
The verdict in the lawsuit brought by the California woman, Eva Echeverria, marks the largest sum awarded in a series of talcum powder lawsuit verdicts against Johnson & Johnson in courts around the U.S. Echeverria alleged Johnson & Johnson failed to adequately warn consumers about talcum powder’s potential cancer risks. She used the company’s baby powder on a daily basis beginning in the 1950s until 2016 and was diagnosed with ovarian cancer in 2007, according to court papers. (Balsamo, 8/21)

Bloomberg: J&J Loses $417 Million Talc Verdict In First California Case 
Mark Robinson, a lawyer for plaintiff Eva Echeverria, said outside the courtroom that J&J should start warning women immediately about the risks of its talcum powder. “J&J needs to see they not only have verdicts against them in St. Louis, they now also have them in Los Angeles,” Robinson said. “There’s a problem all over the country with women using talcum powder on daily basis for 10, 20, 30, 40 years.” (Fisk and Pettersson, 8/21)

And in other news on the company —

Stat: What The J&J CEO Told Employees About The Trump Manufacturing Council
Johnson & Johnson (JNJ) chief executive officer Alex Gorsky was initially chastised last week for deciding to stay on President Trump’s manufacturing advisory council, before reversing course just as Trump announced the panel would be dissolved after a series of defections. A trio of internal memos sent to J&J employees, reviewed by STAT, offer some insight into Gorsky’s reasoning. An exodus from the council began with Merck chief executive Ken Frazier, one of the most prominent African-American business leaders in the country, two days after Trump’s initial comments on Saturday, Aug. 12. Originally, Gorsky planned to sit tight. In a memo distributed on Monday, Aug. 14, Gorsky essentially argued that J&J had an opportunity to influence the Trump administration. (Silverman, 8/21)

Did You Damage Your Eyes Looking At The Eclipse? Probably Not

But if you did, the damage takes one to two days to kick in.

USA Today: Solar Eclipse: How To Know If You Damaged Your Eyes During The Eclipse
If you, like our nation's president, looked directly into Monday's eclipse, you might wonder: Did I just damage my eyes? Whether by accident or disregard, untold masses looked at the sun with unshielded eyes during the must-see-safely event. By Monday afternoon, people were already freaking out about their eyes online. (Hafner, 8/21)

NPR: Eye Damage From The Eclipse Might Show Up The Next Day
[I]f you did steal unprotected glances skyward, and especially if your eyes felt funny or hurt a little afterward, you might be wondering how you'll know if you've done any long-term damage. To answer that question, we once again turned to Ralph Chou, a professor emeritus of optometry and vision science at the University of Waterloo, in Ontario, Canada, and a leading authority on the damage the sun's rays can do to the eye's retina. (Hsu, 8/21)

'It's Only Getting Worse': Hospitals Flooded With Opioid Patients As Crisis Rages On

There's been a 64 percent increase in inpatient stays, while emergency room visits related to opioids have doubled since 2005. Meanwhile, Health and Human Services Secretary Tom Price praises China's help in cracking down on opioids. And experts say hospices aren't doing enough to monitor family members' potential abuse of patients' drugs.

The New York Times: Hospitals Are Clogged With Patients Struggling With Opioids
President Trump this month declared the opioid epidemic a national emergency, a move intended to direct more funding and attention toward the crisis. Recent research on hospitalizations related to opioid use depicts a problem of increasing urgency. According to a series of government briefs published this year, nearly 1.3 million hospitalizations involving opioids occurred in the United States in 2014. The figure includes hospitalizations for abuse of both prescription and illegal drugs, including heroin. (Yin, 8/21)

The Associated Press: US Health Chief Lauds China For Help With Opioid Control
China has been an "incredible partner" in cracking down on synthetic opioids seen as fueling fast-rising overdose deaths in the United States, U.S. Health and Human Services Secretary Tom Price said Monday during a visit to the country considered the source of many of the deadly substances sought by addicts. Price said China has been quick to respond when regulators identify a threat from a dangerous drug such as fentanyl, the powerful opioid blamed for thousands of fatal overdoses, including the death of entertainer Prince. (Bodeen, 8/21)

Kaiser Health News: Dying At Home In An Opioid Crisis: Hospices Grapple With Stolen Meds
Nothing seemed to help the patient — and hospice staff didn’t know why. They sent home more painkillers for weeks. But the elderly woman, who had severe dementia and incurable breast cancer, kept calling out in pain. The answer came when the woman’s daughter, who was taking care of her at home, showed up in the emergency room with a life-threatening overdose of morphine and oxycodone. It turned out she was high on her mother’s medications, stolen from the hospice-issued stash. (Bailey, 8/22)

In other news on the crisis —

New Hampshire Union Leader: Executive Council To Mull $1M In Grants To Fight Opioid Crisis 
Nearly $1 million in state grants to fight opioid addiction will go before the Executive Council for approval on Wednesday, including $200,000 for Serenity Place in Manchester and $200,000 for Harbor Homes in Nashua to keep the Safe Station programs operating in the state’s two largest cities. The Department of Health and Human Services will ask the Executive Council on Wednesday to approve no-bid contracts with the two recovery services, retroactive to June 30. (Solomon, 8/22)

Stat: FDA To Evaluate Children's Cough Medicine Containing Opioids
Afederal committee will meet in three weeks to consider whether cough medicine containing certain opioids should be prescribed to children, the Food and Drug Administration announced Monday. The agency already warned in April that drugs containing codeine, which is an opiate, “should not be used to treat pain or cough” in children under 12. The warning must appear on those drugs’ labels. At the time, the agency said that codeine, along with tramadol, an opioid found in some pain medications for children, “carry serious risks, including slowed or difficult breathing and death, which appear to be a greater risk in children younger than 12 years.” (Swetlitz, 8/21)

Administration Pumps Brakes On Study About Public Health Risks Of Coal Mining

“Mountaintop removal mining has been shown to cause lung cancer, heart disease and other medical problems,” said Rep. Raúl M. Grijalva (D-Ariz.) “Stopping this study is a ploy to stop science in its tracks and keep the public in the dark about health risks as a favor to the mining industry, pure and simple.”

The New York Times: Coal Mining Health Study Is Halted By Interior Department
The Interior Department has ordered a halt to a scientific study begun under President Obama of the public health risks of mountaintop-removal coal mining. The National Academies of Sciences, Engineering and Medicine, which was conducting the study, said in a statement Monday that they were ordered to stop work because the Interior Department is conducting an agencywide budgetary review. (Friedman and Plumer, 8/21)

The Washington Post: Trump Administration Halted A Study Of Mountaintop Coal Mining’s Health Effects
A statement by the academy said Interior’s Office of Surface Mining Reclamation and Enforcement dispatched a letter Friday telling it to cease all work by an 11-member committee undertaking the study pending a departmental review of projects costing more than $100,000. The review was prompted “largely as a result of the Department’s changing budget situation,” the statement said. (Fears, 8/21)

In other environmental health news —

Reveal: EPA Budget Cuts Threaten To Slow Uranium Cleanup At Navajo Nation
Dangerous remnants of the region’s Cold War boom, more than 500 uranium mines were abandoned on and near the Navajo reservation, now home to about 175,000 people. Thousands of families like Hood’s unwittingly used water from contaminated wells and springs to drink, bathe, hydrate their livestock and irrigate their gardens. (Spanne, 8/21)

There's No Cure For Alzheimer's But Those Who Are At High Risk Search For One Anyway

With the rise of genetic testing comes the looming knowledge that you may be at risk for a disease that has yet to be conquered by doctors. In other public health news: a possible cure for hair loss, the importance of breakfast, infections in babies, colon cancer, allergies and more.

Stat: At High Risk For Alzheimer's, They're Experimenting — On Themselves
Everyone at the meeting had one thing in common: a ticking time bomb buried in their DNA. The engineers, physicians, financiers, and farmers gathered here this month all had learned through genetic testing that they carry a copy or two of APOE4, an allele that substantially increases their risk of developing Alzheimer’s. It’s a disease with no good treatment, and no good prevention strategy. So carriers scour the internet to devise their own tactics for keeping their brains healthy: a high-fat diet. Episodic fasting. Oils. Supplements. Regular blood tests to monitor a specific type of cholesterol. Exercise, exercise, exercise — even including barefoot cartwheels across the conference room floor. (Keshavan, 8/22)

The New York Times: Is This Treatment The Cure For Hair Loss?
When Heidi Imhof started losing her hair at 42, she also started losing sleep. Ms. Imhof, a lawyer, was afraid that blow-drying her straight dark hair would hasten the shedding, so she got up two hours early to shower and apply mousse and volumizers. When her hair finally air-dried, she’d pull it back, hoping to hide the bald patches on her scalp.“I was desperate,” she said. (Rubin, 8/21)

The New York Times: The Case For A Breakfast Feast
Many of us grab coffee and a quick bite in the morning and eat more as the day goes on, with a medium-size lunch and the largest meal of the day in the evening. But a growing body of research on weight and health suggests we may be doing it all backward. (Rabin, 8/21)

The New York Times: How To Prevent Deadly Infection In Babies? Good Bacteria
It may be possible, scientists say, to save many thousands of newborns in poor countries by giving them a simple probiotic — a strain of bacteria originally scooped out of the diaper of a healthy baby. A large clinical trial in rural India has found that babies fed a special strain of Lactobacillus bacteria for just one week were 40 percent less likely to develop sepsis, a life-threatening bloodstream infection. (McNeil, 8/21)

The New York Times: More Young People Are Dying Of Colon Cancer
When researchers reported earlier this year that colorectal cancer rates were rising in adults as young as their 20s and 30s, some scientists were skeptical. The spike in figures, they suggested, might not reflect a real increase in disease incidence but earlier detection, which can be a good thing. (Rabin, 8/22)

The Wall Street Journal: A Striking Rise In Serious Allergy Cases
The rate of reports of severe allergic reactions to foods like peanuts has increased by nearly five times over the past decade, according to a new analysis of private insurance claims. The analysis looked at private insurance claims with a diagnosis of an anaphylactic food reaction from 2007 to 2016. Anaphylaxis is a systemic allergic reaction in which the immune system affects multiple parts of the body at the same time, often leading to trouble breathing. It can be fatal if not treated promptly and requires an injection of epinephrine and a trip to the emergency room. (Reddy, 8/21)

Stat: Ironwood Wins FDA Approval For Combination Gout Treatment
It’s the most common form of inflammatory arthritis in adults, often first appears as a painfully swollen big toe, and used to be called the “rich man’s disease” because sufferers frequently consumed lots of meat, seafood, and alcohol: gout. Now, Cambridge, Mass.-based drug maker Ironwood Pharmaceuticals Inc., has won approval from the Food and Drug Administration for a pill that can be taken once a day by patients who have not been able to control gout with other treatments. (Saltzman, 8/21)

Stat: Astronauts Could One Day Use Their Urine To Make Vitamins For Long Flights
Chemical engineers at Clemson University are bioengineering yeast to use human urine and breath to make omega-3 fatty acids, the vitamins humans need for heart, eye, and brain health that are found in fish such as salmon. It’s still in the early stages — and there are some significant hurdles to clear — but the process could one day be used to simultaneously recycle waste and keep astronauts healthy on multiyear space missions. The researchers will present their results Tuesday at the American Chemical Society’s annual meeting. (Caruso, 8/22)

The New York Times: Marijuana Tied To Hypertension Risk
Marijuana use may be a cause of high blood pressure, a new study reports. Researchers studied 332 deaths among 1,213 people participating in a larger health study, of whom 57 percent were marijuana users. They had used marijuana for an average of 12 years, and the longer they used it, the more likely they were to have hypertension. The study is in the European Journal of Preventive Cardiology. (Bakalar, 8/21)

Veterans' Health Care

Rural Areas Often Overlooked For VA Nursing Home Funding, And The Agency Wants To Change That

The Department of Veterans Affairs now sets its priority list by looking at demographics and the need for beds, making it difficult for some rural areas to compete, but officials say they want to make it easier for them to get funding.

The Associated Press: VA Seeks To Funnel More Nursing Home Money To Rural Areas
Veterans Affairs Secretary David Shulkin said Monday during a visit to Montana that his agency will propose changes to make it easier for rural areas to receive funding to build nursing homes for veterans. Rural areas are often bypassed under the agency’s existing guidelines for awarding grants for veterans’ homes, Shulkin told reporters after touring VA facilities and meeting with veterans in Helena. (Volz, 8/21)

In other veterans' health care news —

Modern Healthcare: Veterans Choice Funding Strikes A Temporary Compromise 
Although the Veterans Choice program received a six-month reprieve thanks to new emergency funding, it will take more than an influx of cash for the program to thrive, according to veterans groups. As it currently runs, VA Choice has problems, according to veterans organizations and experts. Though the program was supposed to cut down on wait times for veterans seeking care, some still wait weeks for appointments and provider shortages are exacerbating the program's troubles. VA Choice keeps running low on money, and the VA's healthcare infrastructure is hurting. Meanwhile, the population of veterans is changing, growing smaller but also older and more spread out across the country. (Arndt, 8/18)

Marketplace

Hedge Fund Scoops Up Tenet Healthcare Shares

The disclosure by Camber Capital Management drove up Tenet's stock price.

Modern Healthcare: Tenet In Crosshairs Of Activist Shareholder Camber Capital
Camber Capital Management, a hedge fund with an activist history, has purchased 5.7 million shares of Tenet Healthcare Corp., or a 5.7% stake in the money-losing hospital chain. The emergence of Camber was disclosed Monday, just three days after Tenet's largest shareholder, Glenview Capital Management, resigned two Tenet board seats, citing irreconcilable differences with management and the board. (Barkholz, 8/21)

In other health industry news —

Modern Healthcare: CHS Investor Calls For CEO Wayne Smith's Ouster
An institutional investor in Community Health Systems is calling for the ouster of CHS CEO Wayne Smith. In an open letter to CHS Monday, ASL Strategic Value Fund managing director Steven Braverman said management has failed to return his phone calls, and the company's operational turnaround has not gotten traction. (Barkholz, 8/21)

Women’s Health

Texas To Cut Funds To Anti-Abortion Group That Failed To Meet Service Goals

The group originally projected it would serve nearly 18,000 women, but it as fallen well short of that.

The Associated Press: Texas Slashes Underperforming Anti-Abortion Group's Contract
An anti-abortion group awarded nearly $7 million to boost women's health and family planning after the state cut off Planned Parenthood and other abortion providers is falling short and will receive far less money as a result, Texas officials said Monday. The decision comes a year after Texas hired the Heidi Group to help strengthen small clinics that specialize in women's health like Planned Parenthood but don't offer abortions. In March, The Associated Press found the Heidi Group had little to show for its work and had not performed promised outreach. (Weber, 8/21)

In other news —

State Watch

State Highlights: Public Hospitals Care For Large Share Of New York City's Mental Health Patients; Calif. Bills Seek To Curb Kids' Lead Exposure

Media outlets report on news from New York, California, Minnesota, New Hampshire, Illinois, Texas, Iowa and Maryland.

The New York Times: Public Hospitals Treat Greater Share Of Mental Health Patients
It has grown into a grim ritual of late in New York City: a burst of violence in which a person with mental illness is the victim or aggressor, followed by the city mapping out breakdowns in care and pledging to stitch the safety net tighter. But the late stages of a sick person’s struggle — medications missed, doctors’ declining last-minute appointments, hospitals that discharge patients with little follow-up care — are often only a coda to years of moving between home and a hospital bed. (Mueller, 8/22)

San Francisco Chronicle: State Bills Seek To Cut Children’s Exposure To Lead
Tests have turned up harmful levels of lead in water fountains and taps at other schools in San Diego and Los Angeles, where the district long ago decided to identify, flush and fix or seal hundreds of contaminated fountains. And in the wake of the much-publicized toxic lead contamination of water in Flint, Mich., a Reuters report revealed dozens of California neighborhoods in which tested children showed elevated levels of lead — a neurotoxin that causes developmental disorders and brain damage. (Aguilera, 8/21)

The Washington Post: Despite Measles Outbreak, Anti-Vaccine Activists In Minnesota Refuse To Back Down
Minnesota’s worst measles outbreak in decades has un­expectedly energized anti-vaccine forces, who have stepped up their work in recent months to challenge efforts by public health officials and clinicians to prevent the spread of the highly infectious disease. In Facebook group discussions, local activists have asked about holding “measles parties” to expose unvaccinated children to others infected with the virus so they can contract the disease and acquire immunity. Health officials say they are aware of the message posts but haven’t seen evidence that such parties are taking place. (Sun, 8/21)

Los Angeles Times: There's An Unforeseen Benefit To California's Physician-Assisted Death Law
Some doctors in California felt uncomfortable last year when a new law began allowing terminally ill patients to request lethal medicines, saying their careers had been dedicated to saving lives, not ending them. Many healthcare systems designed protocols for screening people who say they’re interested in physician-assisted death, including some that were meant to dissuade patients from taking up the option. (Karlamangla, 8/21)

New Hampshire Union Leader: Patients Injure 5 State Health Care Workers
Five state health care workers were injured by patients in late June and early July — one at the Sununu Youth Services Center and four at New Hampshire Hospital — in the worst spate of violence at state-run health care facilities since late 2016, the last time such work-related injuries were reported. A youth counselor who tried to break up a July 8 fight at the Sununu Center, and a nurse who was attacked at New Hampshire Hospital on June 26, have still not been able to return to work. (Solomon, 8/22)

Los Angeles Times: USC's Dean Drug Scandal Could Take A Costly Toll On The School's Legal Battle With The UC System
Six months after Dr. Carmen Puliafito stepped down as dean of USC’s medical school, he was called by the university to give sworn testimony as a witness in a lawsuit the institution was facing. It was a sensitive matter with hundreds of millions of dollars potentially at stake, and two attorneys for the university sat with him as he answered questions. Almost immediately, the opposing lawyer hit on a topic that was a closely guarded secret at USC: The circumstances of Puliafito’s abrupt resignation in March 2016. (Ryan, 8/21)

Chicago Tribune: Study Says Aurora Tops In Country For Pediatric Health Care 
Aurora has been named tops in the country for pediatric health care.The ranking comes from Vitals, a national health care incentive and engagement program. It researched the 200 largest American cities to find out which have access to the best and worst pediatric care, according to a press release from the city of Aurora. ... When creating the list of America's Top Cities for Access to Pediatric Care, Vitals analyzed the number of pediatricians available in each city on a per-capita basis for their under-18 population, according to the press release. Patient-reported information such as ease of getting an appointment, pediatrician ratings and wait times were also factored into the final rankings. (8/22)

New Hampshire Union Leader: Telemedicine Technology Enables Former NH Surgeon To Treat Patients From Alaska 
The Last Frontier may be 4,000 miles away from New Hampshire, but a former Bedford surgeon who recently relocated to Alaska is utilizing telemedicine technology to continue treating patients here. “The technology has existed and the infrastructure seems to be applicable to this kind of utilization for medical purposes,” said Dr. Thomas Kleeman, an orthopedic spine surgeon and founder of the New Hampshire NeuroSpine Institute in Bedford. Thanks to telemedicine, Kleeman, 69, is still treating patients in New Hampshire, despite his recent move to Alaska with his wife, Anne. (Houghton, 8/22)

Des Moines Register: Wellmark Accused Of Breaching Hemophiliac Teen's Privacy
A leading Iowa health insurance executive violated a teenager’s privacy rights when she told a Des Moines business group the young man’s hemophilia was costing more than $1 million per month to treat, patient rights groups allege. The patient advocacy groups also say the teen was no longer even covered by the insurer, Wellmark Blue Cross & Blue Shield, when the executive talked publicly about his case in March. (Leys, 8/21)

Baltimore Sun: Paralyzed Patients Benefit From Scuba-Diving Lessons
Tylena [Fisher] is one of about 20 patients being treated at the Kennedy Krieger Institute’s International Center for Spinal Cord Injury who took part in an introductory scuba class sponsored by the Cody Unser First Step Foundation. ... Part of Unser’s project involves training physical and occupational therapists as certified scuba divers so they can develop these skills in their patients. (McCauley, 8/21)

The Star Tribune: Mpls. Eye Surgery Company Will Pay $12M To Settle Kickbacks Case
A Minneapolis mobile ophthalmic company and its former CEO have agreed to pay $12 million to resolve allegations that it lured physicians with illegal kickbacks in exchange for their business for nearly a decade, the U.S. attorney’s office announced Monday. The settlement comes after a whistleblower sued Sightpath Medical, Inc., and a Bloomington surgical equipment provider over allegations that Sightpath took prospective clients on luxury skiing vacations and high-end fishing, golfing and hunting trips to persuade them to use its services. (Montemayor, 8/21)

Editorials And Opinions

Thinking About Policy: Mapping The 'Supposed' Obamacare 'Implosion'; Modernizing Medicaid Waiver Process

Opinion writers offer their takes on a variety of health policy topics, from the continuing analysis of where the Affordable Care Act stands to issues related to Medicare for all and single-payer health systems.

Boston Globe: The GOP’s Downward Spiral
In its relentless efforts to delegitimize Barack Obama, the GOP further divided the country and eroded its own capacity to govern. ... Inevitably, this nihilism bred the fiasco of the party’s fake crusade against Obamacare — seven years of propaganda bereft of program. (Richard North Patterson, 8/22)

Morning Consult: Time to Modernize Medicaid’s Broken Waiver Process
For all the attention on various ways to improve Medicaid’s finances and sustainability in recent months, another key area of Medicaid policy that deserves focus is improving the state waiver process. With all the recent calls for bipartisanship, this should be an area where Democrats and Republicans can work together to improve the program. ... Despite the prevalence and normalcy of Medicaid waivers, the process for states obtaining waivers is needlessly long, cumbersome, and uncertain. (Rep. Brett Guthrie (R-Ky.), 8/22)

The Des Moines Register: Iowans' Health Insurance Is In Trump's Hands
When it comes to the fate of the Affordable Care Act, Iowans have been watching Congress. They should also be watching the Trump administration. Unlike President Barack Obama, who wanted the law to succeed, the current president said he would “let Obamacare fail.” He and Health and Human Services Secretary Tom Price can do much to ensure it does. And Iowans are positioned to feel disproportionate pain. (8/21)

Fortune: Why Medicare-For-All Is Good For Business
The ongoing failure of our health care system is directly attributable to the fact that it is largely designed not to provide quality care in a cost-effective way, but to make maximum profits for health insurance companies, the pharmaceutical industry, and medical equipment suppliers. That has got to change. We need to guarantee health care for all. We need to do it in a cost-effective way. We need a Medicare-for-all health care system in the U.S. Let’s be clear. Not only is our dysfunctional health care system causing unnecessary suffering and financial stress for millions of low- and middle-income families, it is also having a very negative impact on our economy and the business community—especially small- and medium-sized companies. (Sen. Bernie Sanders (I-Vt.), 8/21)

The Atlantic: Are You Sure You Want Single Payer?
French women supposedly don’t get fat, and in the minds of many Americans, they also don’t get stuck with très gros medical bills. There’s long been a dream among some American progressives to truly live as the “Europeans” do and have single-payer health care. Republicans’ failure—so far—to repeal and replace Obamacare has breathed new life into the single-payer dream. In June, the majority of Americans told Pew that the government has the responsibility to ensure health coverage for everyone, and 33 percent say this should take the form of a single government program. The majority of Democrats, in that poll, supported single payer. A June poll from the Kaiser Family Foundation even found that a slim majority of all Americans favor single payer. (Olga Khazan, 8/21)

Forbes: The False Promise Of 'Medicaid For All'
"Medicaid for All" has suddenly become the darling of the health reform crowd. Nevada almost became the first state in the nation to adopt Medicaid for All this year -- until Gov. Brian Sandoval vetoed the plan in June. Other states, including Massachusetts and Minnesota, are looking into it. ... This argument for "Medicaid for All" might sound compelling. But Medicaid provides low-quality care to its current beneficiaries, who are generally poor and among the most vulnerable in society, at extremely high cost to taxpayers. Expanding it would only exacerbate its problems. (Sally Pipes, 8/21)

The Health Care Blog: Tackle The Next Wave Of Healthcare Consumerism
Value-based healthcare initiatives are great, but on their own won’t be enough to bend the healthcare cost curve. The focus must move—and move quickly—from treating people who are sick to helping them get and stay healthy. The only way that’s going to happen is by getting patients and populations motivated to do the right things early instead of desperate things late. The New Consumer World of Tools and Health Models Health plans, in particular, have shifted responsibility onto consumers. (8/21)

Los Angeles Times: Lawmakers, Activists Say Nursing-Home Residents Must Have Right To Sue
Healthcare, tax reform and the debt ceiling probably will be among the highest-profile issues when Congress returns from a monthlong recess Sept. 5. But Democratic lawmakers and consumer advocates already have served notice that they’re also going to keep a spotlight on protecting people’s right to sue nursing homes for neglect or abuse of elderly patients. (David Lazarus, 8/22)

Viewpoints: Living Free But Addicted To Opioids; The Challenges Women In Medicine Face

A selection of opinions on public health issues from around the country.

The Wall Street Journal: Live Free Or High In The Granite State
New Hampshire residents enjoy the national spotlight that shines on them every four years during their first-in-the-nation presidential primary. They are less fond of the attention generated by their state’s reputation as an epicenter of the opioid epidemic. “It’s in every corner of the country, but I have to tell you, I think the Northeast, in particular New Hampshire, is ground zero,” Jack Riley, the Drug Enforcement Administration’s deputy administrator, said last fall. Only West Virginia has more opioid-related deaths per capita. (Matthew Hennessey, 8/21)

St. Louis Post-Dispatch: The Conundrum In Treating Opioid Addiction
The treatment of opioid addiction remains outside the realm of mainstream medicine and further segregated from the treatment of other addictions including to alcohol, methamphetamine or cocaine. The two dominant medications used in the treatment of opioid addiction, methadone and buprenorphine, are subject to considerable restrictions and best suited for patients who are actively using opioids. Methadone can only be administered in a clinic, and doctors need to obtain a DEA waiver to prescribe buprenorphine. Less than 5 percent of physicians in the U.S. have obtained the required waiver. (Percy Menzies, 8/22)

Stat: I Wish Someone Had Told Me About The Challenges Of Being A Female Doctor
Last week, I spent 75 minutes with a new patient and, after we had discussed his assessment and treatment plan, he asked to “speak with a physician.” Last month, a different patient told me he preferred male physicians because he felt he could “trust them more.” Each time I’m not recognized as a doctor, or a patient dismisses my advice in favor of a male physician’s, I question myself. (Julia M. Reilly, 8/21)

The Washington Post: It’s Time To Talk About Trump’s Mental Health
How unstable and divorced from reality is President Trump? We’ve reached the point where the nation has the right and the need to know. We’re not accustomed to asking such questions about our presidents. We don’t know how to even begin inquiring into a president’s mental health, so we rationalize aberrant behavior as being part of some subtle strategy. We say that Trump is cleverly playing to his base, or employing the “madman theory” of foreign relations, or simply being unpredictable to gain an advantage by keeping everyone off balance. (Eugene Robinson, 8/21)

Lincoln Journal-Star: Jails Not Fit To House Mentally Ill For Months
With long wait times to get into the limited number of beds at the Lincoln Regional Center, men and women with mental illnesses often end up in the Lancaster County jail. Briefly holding someone at the jail isn’t new, as people have long been booked before being transported to the regional center later that day. But the length of time those committed spend in jails statewide awaiting a bed to open up has grown significantly in recent years. (8/22)

The New York Times: Live In A Poor Neighborhood? Better Be A Perfect Parent.
Eline’s children feared going to sleep in the closet of their studio apartment, but it was the only place they would be safe from the rats. Covered in blankets from neck to toe, Eline would keep an eye on the kitchen entrance and followed the sounds of the rodents rummaging in the cupboards. I represented Eline (I can’t disclose her real name), a mother of two, in Bronx Family Court when she was charged with neglect. Her younger son had been deemed undernourished because of faltering weight. Eline had struggled to keep up the feeding regimen prescribed by the kids’ pediatrician. Doctors are required by law to report suspected neglect, so the pediatrician reported her to the Administration for Children’s Services. The agency filed a case in family court, and the children went into foster care for three years. (Emma S. Ketteringham, 8/22)

The New York Times: Sex Education Based On Abstinence? There’s A Real Absence Of Evidence
Sex education has long occupied an ideological fault line in American life. Religious conservatives worry that teaching teenagers about birth control will encourage premarital sex. Liberals argue that failing to teach about it ensures more unwanted pregnancies and sexually transmitted diseases. So it was a welcome development when, a few years ago, Congress began to shift funding for sex education to focus on evidence-based outcomes, letting effectiveness determine which programs would get money. But a recent move by the Trump administration seems set to undo this progress. (Aaron E. Carroll, 8/22)