KHN Morning Briefing

Summaries of health policy coverage from major news organizations

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From Kaiser Health News - Latest Stories:

Kaiser Health News Original Stories

Too Few Patients Follow The Adage: You Better Shop Around

Three-quarters of participants in a newly released study said they did not know of resources for comparing health care costs, while half said that if a website were available to provide such information, they would use it. (Michelle Andrews, 8/18)

Political Cartoon: 'Self-Made Men?'

Kaiser Health News provides a fresh take on health policy developments with "Political Cartoon: 'Self-Made Men?'" by Mike Smith, Las Vegas Sun.

Here's today's health policy haiku:

I’LL FOLLOW THE SUN

Careful for your eyes.
Use special glasses if you
Want to see eclipse.

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

Summaries Of The News:

Health Law

Upon Returning From Recess, Republicans Will Face Ticking Clock To Shore Up Marketplaces

Lawmakers will need to scrounge up 60 votes in 12 days to pass their bipartisan bill. Meanwhile, another plan from Sens. Lindsey Graham (R., S.C.) and Bill Cassidy (R., La.) gains traction among Republicans and three former HHS chiefs urge Republicans to stabilize the system.

The Wall Street Journal: Republicans Face Looming Deadline On Health Law
A fast-approaching deadline for insurers to commit to selling health plans next year under the Affordable Care Act is pressuring Republican lawmakers to decide quickly whether to shore up the law and ease the path for insurers or continue efforts to roll it back. Lawmakers returning to the Capitol from recess on Sept. 5 will have only 12 legislative days to decide whether to pass a bipartisan bill aimed at bolstering the ACA’s markets before insurers must commit to participating in the law’s exchanges in 2018. (Armour and Hackman, 8/20)

Modern Healthcare: Collins, McCain And Murkowski Are Modern Healthcare's Most Influential People In Healthcare
In the end, three Republican senators—Maine's Susan Collins, Alaska's Lisa Murkowski and Arizona's John McCain—decided their party's bill to repeal the Affordable Care Act would be bad for the states they represent. Resisting tremendous political pressure, the three voted against Senate Majority Leader Mitch McConnell's stripped-down ACA repeal bill. In doing so, they dramatically reshaped the epic political battle over the future of the ACA, which has been bitterly fought over by Republicans and Democrats since it was passed by Democrats on a party-line vote in March 2010. (Meyer, 8/19)

Roll Call: Will 2018 Look Like 2010 For Anti-Repeal Republicans?
When House Republicans passed their measure to repeal and replace the 2010 health care law in May, 20 members of their conference voted against it. While some of them might be able to defend themselves against criticism by saying they voted against a historically unpopular bill, they could find themselves in the same political peril as Democrats who voted against the original health care bill in 2010. (Garcia, 8/21)

The Associated Press: Past Health Chiefs: Insurance Market Stability Is The Goal
Three former U.S. health secretaries of both parties say President Donald Trump and the GOP-led Congress should make stabilizing health insurance marketplaces their immediate goal. Former Health and Human Services secretaries Kathleen Sebelius, Mike Leavitt and Tommy Thompson tell The Associated Press that calming markets should be the objective now that "Obamacare" seems here for the foreseeable future. (8/21)

And Democrats are thinking about their own blue-sky proposals for health care —

The Hill: Democrats Prep For Next Round Of Healthcare Fight
Democrats are heading toward a new phase in the battle over healthcare as they brace for a tough midterm. With the GOP ObamaCare repeal push largely on ice, Democrats are shifting their focus from defending the Affordable Care Act to pitching their own healthcare ideas. (Carney, 8/20)

The Hill: Dems Ask Trump Officials For Briefing On ObamaCare 
Top Democrats on committees overseeing healthcare are requesting a briefing on the administration’s plans for ObamaCare’s open enrollment season, which begins Nov. 1, amid uncertainty over how President Trump will administer the law. In a letter sent to Health and Human Services Secretary Tom Price and Centers for Medicare and Medicaid Services Administrator Seema Verma, the lawmakers expressed concerns over what they see as the White House’s efforts to undermine the Affordable Care Act’s marketplaces. (Roubein, 8/18)

How Typically Risk-Averse Insurers Are Helping Save Obamacare

Companies are stepping in to sell plans in the pockets of the country where other insurers left residents with no options for ACA coverage.

Politico: Obamacare Survives Its Latest Threat — Bare Counties
President Donald Trump contends the health care law is “dead,” but residents of all but one county in America will be able to get an Obamacare health plan next year. Poised for their fifth enrollment cycle this fall, the Obamacare insurance markets are proving more resilient than many anticipated, with insurers jumping in to cover regions other companies fled, undercutting GOP predictions of widespread market collapses. (Demko, 8/20)

California Healthline: Anthem’s Exit Leaves Thousands With No Choice Of Health Plans
For about 60,000 Covered California customers, choosing a health plan next year will be easier, and possibly more painful, than ever: There will be only one insurer left in their communities after Anthem Blue Cross of California pulls out of much of the state’s individual market. That means they could lose doctors they trust, or pay higher premiums. (Ibarra, 8/18)

Meanwhile, in Tennessee —

The New York Times: In Tennessee, Promoting Enrollment In Tenuous Health Care Plans
Sharon Barker isn’t used to recruiting new health insurance customers in deepest summer, long before the enrollment season for the Affordable Care Act. But this year, everything is different. Despite surviving Republican efforts to repeal it, the law known as Obamacare remains vulnerable. President Trump has repeatedly threatened to end billions of dollars in payments to insurance companies, but his administration decided this week to continue them for another month. (Goodnough, 8/20)

Nashville Tennessean: TennCare: Family Regains Coverage, Issues Remain
The Tennessee Comptroller's office is launching an investigation into TennCare's paperwork problem. Tennessee House Speaker Beth Harwell reached out to the comptroller's office after she was made aware of the issue by the USATODAY NETWORK-Tennessee. ... Harwell was made aware of the rising number of Tennesseans facing unclear coverage status through TennCare when she visited the Murfreesboro Daily News Journal offices Aug. 7. (Timms, 8/18)

Nashville Tennessean: Congressional Clarity Over CSRs 'A Herculean Task' Before ACA Deadline
Questions over the 2018 individual health insurance market are swirling as insurers get a federal extension to file rates and month-by-month decisions from the White House on whether to make an insurance payment. The Tennessee Department of Commerce and Insurance was on track to approve insurers' premium requests for 2018 on Aug. 16 but an unexpected move from the U.S. Centers for Medicare and Medicaid Services pushed the timeline back into early September. (Fletcher, 8/20)

Administration News

To Cut 'Regulatory Costs,' Administration Wants To Roll Back Obama-Era Rule On Nursing Homes Lawsuits

The Obama administration rule tried to ban nursing homes from requiring residents to sign an arbitration agreement before being admitted to the facility -- a standard practice in the industry.

The New York Times: Trump Moves To Impede Consumer Lawsuits Against Nursing Homes
The Trump administration is pushing to scrap a rule that would have made it easier for nursing home residents to sue nursing homes for injuries caused by substandard care, abuse or neglect, bringing its campaign to relax federal regulations to the delicate business of care for older Americans. The push would undo a rule issued by the Obama administration that would have prevented nursing homes from requiring that consumers agree to resolve any disputes through arbitration rather than litigation. (Pear, 8/18)

In other news about President Donald Trump —

Stat: Trump Quietly Signs New FDA User Fee Agreement Into Law
President Trump on Friday quietly signed into law a sweeping measure that will help ensure the Food and Drug Administration can continue to oversee drug and device approvals. It’s a victory for the pharmaceutical industry, which, together with the FDA, fought to ensure the package would become law before existing agreements expire at the end of September. The industry will pay more than $1 billion toward the agency’s oversight efforts, per an agreement hammered out with lawmakers and the FDA. Both industry and the agency say the so-called user fees are critical to keeping the lights on at the FDA. (Mershon, 8/18)

The Hill: House Dem Introduces Measure Urging Trump Undergo Mental Exam 
A House Democrat introduced a resolution on Friday suggesting that President Trump undergo a physical and mental health exam to help determine whether he is fit for office. Rep. Zoe Lofgren’s (D-Calif.) resolution specifically calls on Vice President Pence and Trump’s Cabinet members to “quickly secure the services of medical and psychiatric professionals” to “assist in their deliberations” invoking the 25th Amendment, which outlines presidential removal procedures. (Marcos, 8/17)

White House's Vaccine Safety Commission Has Mostly Fallen Off Radar

Stat talks with Robert Kennedy Jr., who had been approached by President Donald Trump to chair such a panel.

Stat: Plans For White House Vaccine Commission Appear To Have Stalled
Robert Kennedy Jr., the environmental activist and leading vaccine skeptic, says that it has been months since he has talked with White House officials about chairing a vaccine safety commission — and that the idea of such a panel may no longer be under consideration. ...Kennedy said, however, he has met with a series of top administration officials about vaccine safety since Trump took office, including agency heads at the Food and Drug Administration and National Institutes of Health. He said those meetings took place at the request of the White House. (Branswell, 8/21)

Stat: An Interview With Robert F. Kennedy Jr. On Vaccines
In the early days of 2017, proponents of vaccination were deeply concerned. Donald Trump, who has long espoused a debunked link between vaccines and autism, was set to enter the White House. He met with environmental activist Robert Kennedy Jr., who has for years argued that vaccines can cause a range of developmental and other health conditions. Kennedy emerged to report he’d been asked to chair a commission into vaccine safety. But seven months later, no such commission has been appointed and the crisis-mired White House has declined to say whether the plan has been shelved. (Branswell, 8/21)

Medicare

Business Groups Bemoan Medicare's 'Step Backward' On Payments Based On Value

The Trump administration's decision last week to slow down efforts to move to bundled payments for some surgeries has raised concerns. Also, Stat looks at the new Medicare information on hospices

Forbes: How Trump's Shift From Value Depletes Medicare's Trust Fund
News that the Donald Trump White House is curtailing value-based care initiatives for Medicare could cost taxpayers billions of dollars. The Centers for Medicare & Medicaid Services (CMS) last week announced plans to slow the move away from fee-for-service medicine when it comes to paying for knee and hip replacements and eliminate other value-based care initiatives. ... the business community and those worried about Medicare’s solvency say hospitals and doctors have had plenty of time to prepare for bundled payment and other value-based initiatives started under the Obama administration. Slowing them will merely cost taxpayers money and more quickly deplete Medicare’s Hospital Trust Fund, which is projected to run out of money in 2029. (Japsen, 8/20)

Stat: Most Hospices Fare Well In First Public Release Of Medicare Quality Scores
For the first time, Medicare officials Wednesday posted quality scores for some 3,800 hospice providers on its new website, Hospice Compare, aimed at helping people select hospice facilities for themselves or others. In a press briefing Wednesday, Kate Goodrich of the Centers for Medicare & Medicaid Services said the effort will provide a “snapshot on the quality of care delivered by each provider” that will “help consumers make informed decisions.” (Clark, 8/18)

Public Health And Education

Trump Looked Like An Answer To Prayers In Counties Suffering Most From 'Deaths Of Despair'

But residents are now losing hope that the president will be able to change the cycle of alcohol, drugs and suicide that has hit these places so hard.

The Associated Press: Battling Demons In A Community Looking To Trump For Change
In Grays Harbor County, a rural community on the coast of Washington state, the rate at which people die from despair — from drugs, alcohol and suicide — is nearly twice the national average. The county embraced Donald Trump’s call to America’s forgotten corners, and flipped Republican in a presidential election for the first time in 90 years. Many of those caught in the cycle of addiction did not vote; they are either felons or too consumed by the turmoil of trying to claw their way out to be engaged in society. But they, too, hope for a better tomorrow. (Galofaro, 8/18)

The Associated Press: Trump Won Places Drowning In Despair. Can He Save Them?
Penn State sociologist Shannon Monnat spent last fall plotting places on a map experiencing a rise in “deaths of despair” — from drugs, alcohol and suicide wrought by the decimation of jobs that used to bring dignity. On Election Day, she glanced up at the television. The map of Trump’s victory looked eerily similar to hers documenting death, from New England through the Rust Belt all the way here, to the rural coast of Washington, a county of 71,000 so out-of-the-way some say it feels like the end of the earth. (Galofaro, 8/18)

Uptick In Teen Overdose Deaths 'A Red Flag' Mirroring A Trend Seen In Adults

But experts say the increase might just be statistical noise and not indicative of a crisis quite yet. Meanwhile, a look at the company behind the software that links prescription drug monitoring databases.

The Washington Post: Teen Overdose Deaths Inched Up In 2015 After Declining For Several Years Before Then.
Drug overdose deaths among U.S. teens edged upward in 2015 after declining for several years, according a new report. The report, from the Centers for Disease Control and Prevention, looked at drug overdose deaths among Americans ages 15 to 19 over a 16-year period. The report showed that from 1999 to the mid-2000s, drug overdose deaths in this age group more than doubled, from 1.6 deaths per 100,000 people in 1999 to 4.2 deaths in 2007. (Rettner, 8/19)

Bloomberg: The Company Quietly Making Opioid Addiction Searchable 
Appriss, a 600-employee company in Louisville, is working to mitigate a U.S. opioid crisis blamed for more than 20,000 fatal overdoses a year—33,000 when heroin-related deaths are included—and $79 billion in annual response costs and lost productivity. President Trump said on Aug. 10 that opioid addiction represents a national emergency. While privacy advocates worry about misuse of data as sensitive as a person’s ­prescription history, states are pushing to link the information ever more quickly to simplify diagnoses for doctors, who hand out 259 million opioid prescriptions each year and often have little time to question patients. (Green, 8/21)

And in other news from the crisis —

The Washington Post: Community Health Leaders Say D.C. Isn’t Doing Enough To Curb Opioid Overdoses
James Washington has used naloxone to reverse six overdoses in the past six months.Six times, he has watched the drug stop addicts from dying in parts of the District hit hardest by the city’s growing opioid epidemic. “It’s a dream, a best-kept secret,” said Washington, who super­vises peer educators at Family and Medical Counseling Services in Southeast Washington. “And we don’t have enough.” (Chason, 8/20)

Columbus Dispatch: Could This Back-Pain Device End Need For Opioids?
A new pain pellet that scientists are developing in Columbus is about half the size of a grain of rice, but researchers say it delivers a big dose of relief that could one day help fight the opioid epidemic. The tiny rod holds a nonaddictive painkiller that doctors could insert in the lower back, much like an epidural, to give a patient a break from chronic or acute pain, said Dr. Ali Rezai, director of the Neurological Institute at Ohio State University’s Wexner Medical Center. (Viviano, 8/20)

Arizona Republic: Arizona Has High Buy-In From Police Of Using Naloxone, Records Show
Despite lingering consternation in some law-enforcement circles nationally about officers carrying naloxone to reverse opioid overdoses, Arizona has seen overwhelming buy-in from police groups, records show. Law-enforcement officers across the state administered naloxone 63 times in the past 60 days — about once a day on average, according to data The Arizona Republic reviewed after filing a records request with the state health department. (Pohl, 8/19)

Lessons Were Learned From Recent Epidemics, But We're Still Not Prepared Enough, Expert Says

Dr. Raj Panjabi talks about what experts have learned since Ebola, and the devastating effects cuts to foreign aid would have on the health of Americans. In other public health news: regulating beauty products, stem cells, a "miraculous" oxygen treatment and more.

The Star Tribune: Mayo, U Develop 'Robocop' Stem Cells To Fight Cancer
Researchers at the Mayo Clinic and the University of Minnesota say they’re on the brink of a new era in cancer care — one in which doctors extract a patient’s white blood cells, have them genetically engineered in a lab, and put them back to become personalized cancer-fighting machines. The so-called CAR T cellular therapies are expected to receive federal approval this fall for certain rare blood cancers — B-cell forms of lymphoma and leukemia. (Olson, 8/19)

New Orleans Times-Picayune: 'Miraculous' Oxygen Treatment In New Orleans Saves Toddler Who Nearly Drowned
Kristal Carlson, of Fayetteville, Ark., was taking a shower Feb. 29, 2016, as Eden slipped through her baby gate and fell into their backyard swimming pool. Eden nearly drowned and was technically deceased for two hours. Doctors at Arkansas Children's Hospital were certain the brain-damaged toddler would never walk, talk or react to the world again. ...It was not long until her husband came across a medical treatment called hyperbaric oxygen therapy, which involves inhaling pure oxygen in a tube or room with air pressure three times higher than normal. With this newfound knowledge at hand, the Carlsons reached out to researchers at the LSU Health New Orleans School of Medicine and the University of North Dakota School of Medicine to save Eden. (Nobles, 8/18)

Denver Post: Denver Foster Clinic Trains Doctors, Nurses To Care For Abused, Neglected Children
The extra time it took to start the boy’s exam is standard at the foster kid clinic inside Denver Health’s Eastside Family Health Center, in Five Points northeast of downtown. Unique in Colorado, the clinic was created because medical staff who examined kids during abuse and neglect investigations were concerned that children were shuffled between doctors’ offices as they bounced through the foster-care system. Clinic director [Lora] Melnicoe sees kids who won’t let her touch them. Some refuse to speak. (Brown, 8/18)

Coverage And Access

Rural America Needs More Doctors, But Young Physicians Tend To Flock To Cities

Primary care physicians are in particular demand, but the pay discrepancy to other specialties is doing little to help the problem.

East Oregonian: Rural America Seeks More Doctors
The shortage, especially of primary care physicians, continues to worsen. That is partially due to an imbalance in pay between primary care doctors and specialists. According to Medscape’s 2017 Physician Compensation Report, orthopedists, cardiologists, plastic surgeons and urologists all earn $400,000 or more on average. But pediatricians, internists and family medicine doctors make $225,000 or less. ...Based on Oregon Medical Board licensures and the OHSU Office of Rural Health, 10,247 of Oregon doctors practice in urban/non-rural areas and 2,362 work in rural areas (defined as 10 miles or more away from a population center of at least 40,000). The national shortage could grow to 45,000 by the year 2020, according to the NRHA. Since 2010, more than 80 rural hospitals have closed, including Walla Walla General Hospital. (Aney, 8/18)

State Watch

Massachusetts' Largest Health Care System To Spend Up To $90M In Buy-Outs For Hospital Workers

Outlets report on hospital news out of Massachusetts, Illinois, Georgia, Missouri and Florida.

Boston Globe: Brigham And Women’s Buyouts Will Cost As Much As $90M
Partners HealthCare expects to spend up to $90 million on severance packages for employees at one of its biggest hospitals, Boston’s Brigham and Women’s. Partners, the state’s largest health care system, said Friday that it has already booked $19 million of those costs. (Dayal McCluskey, 8/18)

Chicago Tribune: Centegra's Woodstock Hospital To Stop Admitting Most Overnight Patients 
Centegra Hospital-Woodstock has stopped admitting most overnight patients as part of a slew of changes meant to save cash and become more efficient. The hospital discontinued medical-surgical and intensive care services Aug. 12, and this week it filed applications with the state's Health Facilities and Services Review Board to make those changes permanent. Previously, it had 60 medical-surgical beds and 12 intensive care beds. It will still provide emergency room care and mental health crisis stabilization as well as inpatient behavioral health services and outpatient imaging and lab services. (Schencker, 8/18)

Georgia Health News: DeKalb Medical Says Several Health Systems Open To A Partnership
Three months after sending out invitations for potential partnerships, DeKalb Medical Center says it has received bids from several suitors. ... The partnership proposals have occurred amid the continued consolidation of hospital systems, both here and nationally. This week, two big metro Atlanta players — Gwinnett Health System and Northside Hospital — announced they had completed the details of their long-awaited merger agreement and submitted it to the state attorney general for approval. And rural Stephens County Hospital in Toccoa said it, too, is looking for a hospital partner. (Miller, 8/20)

St. Louis Public Radio: St. Louis-Area Hospitals Expect Influx Of Patients To Coincide With Eclipse
Saint Louis University Hospital's emergency services director, Helen Sandkuhl, has spent the last couple of weeks reviewing emergency plans, checking equipment and preparing a crisis communications center in a hospital conference room. Visitors are descending on the St. Louis region to view the total solar eclipse on Monday, so Sandkuhl and other emergency room officials expect to be busier than usual. (Bouscaren, 8/20)

State Highlights: Committee To Handle Iowa’s Medicaid System Hasn't Met This Year; N.H. Takes Steps To Improve Mental Health Services

Media outlets report on news from Iowa, New Hampshire, Texas, Georgia, Maryland, California, Washington, Florida and Ohio.

New Hampshire Times Union: Dave Solomon's State House Dome: DHHS Chief Says Progress Is Made On Mental Health 
The first step in creating more mental health beds to ease the shortage across the state was the easy part. The Legislature approved a $20 million investment and the Department of Health and Human Services issued a request for proposals from health care providers. Now comes the hard part - getting those health care providers to respond. The request for proposals was issued by June 30 and the initial deadline came and went without adequate responses. (Solomon, 8/20)

Politico Pro: Texas Effort To Replace Planned Parenthood Falls Short Of Goal
Texas last year embarked on a risky experiment as part of an effort to increase access to family planning services without Planned Parenthood and other high-volume clinics that perform abortions. The state handed anti-abortion activist Carol Everett nearly $7 million in contracts to rebuild a network of clinics and medical practices decimated by budget cuts and a ban on state funds for abortion providers.Earlier this year, the state concluded the experiment didn’t work. (Rayasam, 8/18)

Georgia Health News: Single Mom ‘Fighting So Hard’ For Medically Fragile Child
Sarah Allen, a single mom, spends her days and nights caring for her son, Aidan. Born premature with a malformed brain, Aidan, now 3, has multiple health conditions. They include cerebral palsy, epilepsy, obstructive sleep apnea and cortical visual impairment. He also has enlarged ventricles, scarring on his brain, and a mild form of microcephaly. ... Her son is covered by Medicaid. Though the program has covered the frequent hospital and doctor visits, Allen is fighting Medicaid over the number of hours that it will pay to cover a nurse’s visits to the home to help with caregiving. But Allen, 31, has other worries. She’s facing the prospect of being homeless this fall. And not for the first time. (Miller, 8/17)

The Baltimore Sun: State Health Officials Monitor Uptick In Whooping Cough Cases, Encourage Continued Immunization 
Maryland public health officials, monitoring an uptick in the number of whooping cough cases, are urging parents to make sure children are immunized against the highly contagious respiratory infection as the school year draws near. The number of confirmed or probable whooping cough cases increased 15 percent in the first six months of this year, compared to 2016, according to the Maryland Department of Health. (Richman, 8/18)

San Francisco Chronicle: Reforms Lagging At Troubled San Joaquin County Foster Care Shelter
Questionable arrests and poor supervision of traumatized children have continued at a foster care shelter in San Joaquin County, months after county leaders pledged new training and policies would fix conditions that led to hundreds of youth being booked at the local juvenile hall for minor misbehavior. In June, state officials found mental health services lacking for a boy who attempted to hang himself twice in one week at the Mary Graham Children’s Shelter outside Stockton. (de Sa, Dizikes and Palomino, 8/20)

Los Angeles Times: L.A. Warns Homebuilders, But Not Residents, Of Traffic Pollution Health Risks
For five years, Los Angeles has been issuing health advisories to housing developers, warning of the dangers of building near freeways. But when the city moved to alert residents as well, officials rejected it. Planning commissioners axed a provision to require traffic pollution signs on some new, multifamily developments from an environmental ordinance on the grounds that it would burden developers and hurt market values. (Barboza, 8/20)

Seattle Times: Pivot Health Works As Matchmaker With Health Care Job Board 
Pivot Health’s online job board, which helps health-care companies find suitable employees, has one big thing in common with dating apps. The downtown Seattle startup designed its technology to get a sense of both job seekers’ and companies’ values and characteristics, to try to make the perfect match. (Lerman, 8/20)

Miami Herald: Debauchery, Abuse At Florida Youth Program Leads To 3 Arrests
Some of the youth workers were having sex with the underage boys in their care. ... But if conditions at the Highlands Youth Academy in Avon Park were not exactly conducive to the rehabilitation of delinquent youths, state juvenile justice administrators were doing little to turn things around. (Marbin Miller, 8/18)

Cleveland Plain Dealer: Styx Concert To Stream Over Internet-Ready Hearing Aids Via Cellphone Technology
On Tuesday night, the lights will go down when Tommy Shaw and the rest of Styx step out onto the stage at the PNC Bank Arts Center in Holmdel, New Jersey, as a few thousand fans will rise to their collective feet, cellphone lights ablaze in lieu of the outdated cigarette lighters. At the same time, hundreds of thousands across the United States - likely many who wielded those lighters in the 1970s - will turn up their internet-capable hearing aids to tune in from their own living rooms.For the first time, using internet connectivity and their iPhones, those who wear the new Oticon Opn hearing aid will be able to stream the show . . . through those hearing aids. (Yarborough, 8/20)

Los Angeles Times: Burbank Unified Renews Contract For Mental Health And Wellness Centers
The mental health and wellness program in the Burbank Unified School District will continue at least another year after the school board renewed the district’s contract with the Family Service Agency of Burbank, a local nonprofit agency, on Thursday. Wellness centers at John Burroughs and Burbank high schools provide a supportive environment, where students can walk in to share their thoughts and feelings with counselors from the Family Service Agency. (Vega, 8/18)

The Baltimore Sun: Baltimore Day Care Remains Closed Following Death Of 8-Month-Old 
Following the death of an infant in May, the Rocket Tiers Learning Center in Baltimore remains under emergency suspension as the Maryland State Department of Education investigates whether the facility is safe for children. The center had appealed the suspension, but it was recently upheld after Administrative Law Judge David Hofstetter determined that further investigation was necessary to “ensure the health, safety, or welfare of children in the Center,” according to appeal documents from the Department of Education obtained by The Baltimore Sun. (Brice-Saddler, 8/18)

Editorials And Opinions

Policy Perspectives: Undoing A Health-System Fix That Works; Stabilizing Obamacare Requires Bipartisanship

Editorial writers address a range of health policy issues -- including some that touch on topics related to the Affordable Care Act and others that address politics, state-level Medicaid issues and efforts to expand the Medicare program.

The Wall Street Journal: A Health-Care Fix That Works, Now Being Rolled Back
President Trump is correct: Health care is “complicated.” If you’ve ever received a hospital bill, you’ve seen it for yourself. America’s health-care system is a tangle of providers, all paid separately for each and every thing they do. One emergency-room visit can result in a dozen different bills. This fee-for-service model, which has dominated American health care for decades, is hardly efficient. Paying for inputs — tests, procedures, hospital stays and the like — creates incentives for overtreatment, with little regard for coordinating care or improving patient outcomes. ... Unfortunately, the Trump administration is halting the shift to advanced payment models. (Jason Furman and Bob Kocher, 8/20)

Louisville (Ky.) Courier-Journal: Rand Paul Should Get On Board With GOP Or Get Out
In short, he is not really a member of any established political party but is himself a political party of one. This is rather embarrassing given the fact that Kentucky’s other Republican senator is one Mitch McConnell, the Senate's majority leader. The ultimate challenge of any majority leader is to be an accurate vote counter. With only 52 Republican votes available in the 100-member Senate, in the recent effort to repeal Obamacare, Sen. McConnell was surely frustrated to find that not only could he not depend on the all-out support of his fellow Kentucky senator, but that that senator was actually opposed to the “repeal and replace” legislation stitched together at great effort by a coalition of conservative and moderate Republican senators. (Bob Heleringer, 8/16)

Louisville (Ky.) Courier-Journal: I Didn’t Give That 'team' My Soul Or My Ideology
Apparently, there is a new source of fake news that the Courier-Journal's recent columnist frequently reads. Because the accuracy of his account of what happened last month during our efforts to repeal Obamacare is laughable at best, and egregiously misleading at worst. For the record, yes, I do belong to a “team” in politics. I ran as a Republican. I caucus as a Republican. I vote for people sometimes because, while I have misgivings, in general, they believe similar things. But I didn’t give that “team” my soul or myideology. I join with them when I agree, or when I don’t have a strong opinion. I go against them plenty of times, such as on privacy and civil liberties, and, all too often, unconstitutional war. (Sen. Rand Paul, 8/18)

RealClear Health: Is Obamacare Fueling The Opioid Overdose Death Rate?
The ACA requires insurance companies to charge the same insurance premiums to individuals regardless of whether they already have expensive health conditions. This policy, known as community rating, has had the effect of causing premiums to skyrocket across the board, as was shown in a recent study by McKinsey and Company. The ACA’s “risk-adjustment” program, meanwhile, was intended to compensate insurers for the cost of taking on enrollees who are already sick, but the program systematically underpays. It amounts to an effective penalty on networks that are seen as having the most appealing benefits for insurance enrollees who are already sick. (Jeffrey A. Singer, 8/21)

Austin (Texas) American-Statesman: Rural Hospitals Are Vanishing; Keep Medicaid In Texas
As for Medicaid, cutting funds and limiting program expansion would most certainly be devastating for families, rural hospitals and the communities they serve. In Texas, for example, 46 percent of children in rural areas and small towns are enrolled in Medicaid or the Children’s Health Insurance Program compared with 41 percent in urban areas, according to a report by the Georgetown University Center for Children and Families. (Michael D. Williams, 8/21)

The Columbus Dispatch: Don’t Override Budget Vetoes
The budget battle between Gov. John Kasich and his fellow Republicans in the General Assembly is about to resume, with the Senate poised to take a crack at reinstating some of the provisions Kasich struck from the two-year spending plan. ... The House already voted to override 11 of the vetoes. If the Senate, which could take action as early as Tuesday, does likewise, the ill effects could include destabilizing the state’s efforts to manage Medicaid and foolishly jeopardizing state parks and other lands for a short-term paycheck. Thankfully, the House refrained from overriding the most important of Kasich’s vetoes: the one with which he nixed a freeze on enrolling Ohioans in Medicaid via the Affordable Care Act’s expansion. (8/21)

Los Angeles Times: Here's How Expanding Medicare Could Set Us On The Path To Universal Health Coverage
With the near-complete collapse of the Republican attack on the Affordable Care Act having locked away the GOP’s traditional repeal-or-nothing stance, the path to a clear-eyed assessment of how to improve American health coverage.That has given the idea of single-payer a jump-start. But it hasn’t done much to clarify the most important question: How do we get there from here? (Michael Hiltzik, 8/18)

Viewpoints: 'Artificial Intelligence' And The Practice Of Medicine; Exploring The Nation's Opioid Emergency

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

Stat: Artificial Intelligence Is Coming To Medicine — Don't Be Afraid
Across all industries, an estimated 60 percent of jobs will have 30 percent of their activities automated; about 5 percent of jobs will be 100 percent automated. What this means for health care is murky right now. Does that 5 percent include doctors? After all, medicine is a series of data points of a knowable nature with clear treatment pathways that could be automated. That premise, though, fantastically overstates and misjudges the capabilities of AI and dangerously oversimplifies the complexity underpinning what physicians do. Realistically, AI will perform many discrete tasks better than humans can which, in turn, will free physicians to focus on accomplishing higher-order tasks. (Jack Stockert, 8/18)

The New York Times: The Real Opioid Emergency
On Aug. 10, driven largely by public perception that many white Americans are experiencing problems and even dying from opioid use, Donald Trump proclaimed the opioid problem a national emergency. The president’s announcement appeared to consolidate a shift in the way we view certain drug users. They are now patients in need of our help and understanding, rather than criminals deserving scorn and incarceration. ... What looks like a radical shift to a more enlightened drug policy — one that favors treatment over incarceration — has encouraged many to hope that there will be far fewer drug-related arrests than there were in previous decades. I don’t count myself among the optimists. (Carl L. Hart, 8/18)

Los Angeles Times: How Many Nurses Does It Take To Change A Patient's Blood?
The rising demand for dialysis has led to a boom in outpatient clinics that specialize in it. Two companies in particular — DaVita, which operates 286 dialysis centers in California, and Fresenius Medical Care, which operates 127 — have captured 70% of the market nationally, turning the decline in kidney health into billions of dollars in annual profits. Those centers and their profits are now the subject of a pitched battle in Sacramento over proposals to supplement federal regulations on the centers with new state requirements. Unfortunately, the proposals would raise the cost of dialysis without necessarily improving it. (8/21)

Chicago Tribune: A Chance For A Do-Over On Cook County's Soda Tax
The Illinois Department of Revenue has settled the question of whether the tax can be applied to purchases made with food stamps. The answer is no. That means 872,000 people are exempt from the tax. That’s 872,000 people whose consumption of sugary beverages is beyond your overreaching grasp; 872,000 people who won’t be contributing to the $224 million you were counting on collecting next year. When you voted for the tax, you thought you could hide it from consumers by instructing retailers to include it in the shelf price of the drinks. But the Department of Revenue says you can’t do that, either. It would require merchants to charge sales tax on top of the soda tax — an illegal double taxation. The tax has to be added at the point of sale. (8/18)