KHN Morning Briefing

Summaries of health policy coverage from major news organizations

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Kaiser Health News Original Stories

Hospital Surprise: Medicare's Observation Care

You're in a hospital and think you're admitted. Maybe not. Many Medicare beneficiaries are surprised to learn that even after spending a couple of days, they are receiving observation care, which Medicare considers an outpatient service, so the seniors' costs can be more than expected. (Francis Ying and Thu Nguyen and Lynne Shallcross, 8/29)

Teaching Medical Teamwork Right From The Start

In a joint project, the Cleveland Clinic and Case Western Reserve University are banking on a new building to kick start efforts to bring health professionals together by introducing collaboration into medical training. (Julie Rovner, 8/29)

Political Cartoon: 'Pocket Change'

Kaiser Health News provides a fresh take on health policy developments with "Political Cartoon: 'Pocket Change'" by Ann Telnaes.

Here's today's health policy haiku:

ANOTHER ONE DECIDES TO LEAVE ...

Marketplace trouble
Now Oscar's leaving two states
A recurring theme

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 Issues And Implementation

Threat Of Monopolies Looms As Insurers Withdraw From ACA Markets, Analysis Shows

More than 60 percent of counties in the United States could have only one or two options for coverage in 2017, according to a new analysis.

The Wall Street Journal: Health Insurers’ Pullback Threatens To Create Monopolies
Nearly a third of the nation’s counties look likely to have just a single insurer offering health plans on the Affordable Care Act’s exchanges next year, according to a new analysis, an industry pullback that adds to the challenges facing the law. The new study, by the nonpartisan Kaiser Family Foundation, suggests there could be just one option for coverage in 31% of counties in 2017, and there might be only two in another 31%. That would give exchange customers in large swaths of the U.S. far less choice than they had this year, when 7% of counties had one insurer and 29% had two. (Wilde Mathews and Armour, 8/28)

Reuters: More U.S. Counties To See Obamacare Marketplace Monopoly: Analysis
Nearly a third of U.S. counties will likely be served by only one insurer that participates in an Affordable Care Act (ACA) marketplace in 2017, according to an analysis published Sunday by the Kaiser Family Foundation.The 31 percent of U.S. counties that will have just a single option of insurers within the ACA's exchanges would represent an increase from 7 percent this year, the nonpartisan group found. (Hunnicutt, 8/27)

Meanwhile, enrollment numbers are significantly lower than predicted, and Tennessee Sen. Lamar Alexander rails against the health law —

The Washington Post: Health-Care Exchange Sign-Ups Fall Far Short Of Forecasts
Enrollment in the insurance exchanges for President Obama’s signature health-care law is at less than half the initial forecast, pushing several major insurance companies to stop offering health plans in certain markets because of significant financial losses. As a result, the administration’s promise of a menu of health-plan choices has been replaced by a grim, though preliminary, forecast: Next year, more than 1 in 4 counties are at risk of having a single insurer on its exchange, said Cynthia Cox, who studies health reform for the Kaiser Family Foundation. (Johnson, 8/27)

The Hill: Tenn. Senator Blasts 'Intolerable Increase' In ObamaCare Prices 
Sen. Lamar Alexander (R-Tenn.) on Saturday said his state offers living proof ObamaCare is on its last legs.“When Tennesseans woke up on Wednesday morning and opened up our state’s largest newspaper, the front page headline read, ‘Very near collapse,’” he said in the GOP’s weekly address. (Hensch, 8/27)

Administration News

FDA: All Donated Blood Should Be Screened For Zika

The agency -- in an effort to safeguard the nation's blood supply -- says even centers in states where Zika is not circulating should take precautions. Meanwhile, the Obama administration is warning that all funding will be exhausted by the end of September.

The New York Times: All Donated Blood In U.S. Should Be Tested For Zika, F.D.A. Says
The Food and Drug Administration on Friday took steps to safeguard the nation’s blood supply from the Zika virus, calling for all blood banks to screen donations for the infection even in states where the virus is not circulating. The recommendations are an acknowledgment that sexual transmission may facilitate the spread of Zika even in areas where mosquitoes carrying the virus are not present. Officials also want to prepare for the possibility that clusters of local infection will continue to pop up in parts of the United States for years to come. (Saint Louis, 8/26)

The Washington Post: FDA Takes Radical Measure Of Recommending Zika Screening For Entire U.S. Blood Supply
Peter Marks, director of the FDA’s Center for Biologics Evaluation and Research, said the advisory was put out because "there is still much uncertainty regarding the nature and extent of Zika virus transmission." In a media conference call, he noted the “rapid expansion” of the virus, which is actively spreading in more than 50 countries, mostly in the Americas and Caribbean. The United States has documented 8,000 cases of Americans who acquired the virus abroad and 2,000 infected through local transmission. Nearly all of those in the latter group are in Puerto Rico. (Cha, 8/26)

The Wall Street Journal: FDA Calls For Zika Testing Of All Blood Donations
Dr. Marks said testing of blood donations already is under way in Puerto Rico and Florida, where most of the U.S. Zika cases have occurred. The plan, he said, is to expand that testing in 11 more states over the next four weeks. They are Alabama, Arizona, California, Georgia, Hawaii, Louisiana, Mississippi, New Mexico, New York, South Carolina and Texas. Testing should begin in all states within 12 weeks, Dr. Marks said. “Given the very serious outcome of small-headed babies,” said Dr. Marks, “in order to prevent that from happening, we feel this step makes sense.” (Burton, 8/26)

NPR: FDA Says All Blood Donations Should Be Tested For Zika
Currently, Zika is being spread by mosquitoes in South Florida, Puerto Rico and the U.S. Virgin Islands, as well as most countries in the Caribbean and Central and South America. There are a total of 2,517 cases of Zika in the U.S. states and D.C., according to the Centers for Disease Control and Prevention, with 9,011 more in U.S. territories. (Neel, 8/26)

The Hill: FDA: All Blood Donations Should Be Tested For Zika 
Several members of Congress, led by Rep. Lloyd Doggett (D-Texas), first urged the FDA on July 20 — before the Zika was spreading locally in Florida — to implement mandatory screening for all blood donations. “If we wait for the first confirmed locally transmitted Zika case to begin testing, we risk serious harm to the stability of our blood supply,” Doggett wrote to FDA Commissioner Dr. Robert Califf. Implementing the additional screening will be costly, Marks acknowledged, though he declined to say how much the FDA will need to spend. (Ferris, 8/26)

Politico Pro: 'Virtually All' Zika Funding Will Run Out Next Month, HHS Warns 
The Obama administration has spent nearly all of the funding it had reallocated from Ebola to fight the Zika virus, HHS Secretary Sylvia Mathews Burwell told lawmakers in a letter obtained by POLITICO. "Our nation's ability to mount the type of Zika response that the American people deserve sits squarely with Congress," Burwell wrote. The $374 million the administration took from efforts to fight Ebola “will be virtually exhausted by the end of the fiscal year” on Sept. 30, she said. The dire warning comes a week before lawmakers are due to return to Congress following a seven-week break. (Haberkorn, 8/27)

The Hill: Obama Calls For Quick Zika Action From Congress After Recess 
President Obama is urging Republicans to make funding for fighting the Zika virus their top priority once Congress comes back into session. “Every day that Republican leaders in Congress wait to do their job, every day our experts have to wait to get the resources they need — that has real-life consequences,” Obama said. “Weaker mosquito-control efforts. Longer wait times to get accurate diagnostic results. Delayed vaccines. It puts more Americans at risk. (Hensch, 8/27)

And in other Zika news —

Health News Florida/News Service Of Florida: Florida Picks Up 15 Travel-Related Zika Cases
Fifteen new cases of the mosquito-borne Zika virus were reported Friday in Florida, all tied to people who brought the disease into the state after getting infected elsewhere. The state Department of Health announced that the new travel-related cases included five pregnant women. The agency didn't report where the pregnant women reside or where they had traveled. (8/29)

Kaiser Health News: As Aerial Spraying Winds Down In Miami’s Zika Fight, Effectiveness Up In Air
Miami-Dade County’s aerial spraying campaign against Zika-carrying mosquitoes is scheduled to end this month, and the blitz could be one for the record books if the Centers for Disease Control and Prevention records it as a success. Scant published research exists to prove aerial spraying works against the adult Aedes aegypti mosquitoes that carry Zika. Many experts in tropical diseases dismiss insecticide spraying from low-flying planes because they say the urban dwelling species may escape the killer spray by living indoors. (Kopp, 8/29)

NBC News: Tropical System Could Make Florida's Zika Fight Even Harder
A tropical system brewing in the Caribbean could make Florida's fight against the spread of the Zika virus even more challenging. Forecasters have pegged the tropical wave as only having a 40 percent chance of strengthening into a tropical storm over the coming days, and some models see it hitting the Gulf Coast states west of Florida. But whether it makes landfall in Florida or not, one thing is certain: the system will bring heavy rains to the Sunshine State, and that could create breeding grounds for Zika-carrying mosquitoes. (Chuck, 8/27)

Health News Florida: Survey Finds Most Floridians Support GMO Mosquitoes 
While Florida Keys residents debate the use of genetically modified mosquitoes ahead of a November referendum, a new survey finds that a majority of Floridians supports the concept. And a group of Pinellas County elected officials has written to the U.S. health and human services secretary asking for emergency approval to use the GMO mosquitoes in their region. Pinellas had its first case of locally acquired Zika confirmed earlier this week.A survey released Friday by the University of Pennsylvania's Annenberg Public Policy Center finds that most Floridians support the release of genetically modified mosquitoes. The phone survey was conducted between Aug. 18 and 22. (Klingener, 8/28)

The New York Times: A Guide To Help Pregnant Women Reduce Their Zika Risk
Zika has a foothold in the continental United States now that mosquitoes in parts of Miami-Dade County, Fla., have infected people with the virus. Zika can cause harrowing brain damage in the developing fetus of a woman who is infected during pregnancy, so it is vital that pregnant women minimize that risk. Here’s some advice on how to do that. (Belluck, 8/26)

Health News Florida: Guess How Many Zika Cases Showed Up At The Olympics? 
Now, no cases doesn't mean no one caught Zika at the Summer Games. About 80 percent of people who get infected don't know it. They don't have any symptoms. And those who do get sick often have only mild symptoms. So the vast majority of cases go unreported. But so far, it's looking like predictions from computer models were pretty much spot on: Zika wasn't a big threat in Rio de Janeiro during the Olympics. (Doucleff, 8/26)

Bloomberg: Singapore Steps Up Zika Fight After 41 Local Cases Confirmed
Singapore has stepped up its fight against the Zika virus after confirming 41 locally transmitted cases one day after reporting its first infection. The Ministry of Health said it will continue to screen people who had close contact with those infected. Of the 41 people who contracted the virus in Singapore, 34 have fully recovered, the ministry said, with the majority of cases occurring among foreign construction workers. (Chanjaroen and Khan, 8/28)

Campaign 2016

Clinton Introduces Mental Health Plan Focusing On Early Diagnosis, Intervention

Hillary Clinton also is promising to create a national initiative for suicide prevention, hold a mental health conference within her first year in office, enforce mental health parity laws and prioritize training for law enforcement officers.

The Associated Press: Clinton Proposes Plan To Address Mental Health Treatment
Hillary Clinton is rolling out a comprehensive plan to address millions of Americans coping with mental illness, pointing to the need to fully integrate mental health services into the nation's health care system. Clinton's campaign released a multi-pronged approach to mental health care on Monday, aimed at ensuring that Americans would no longer separate mental health from physical health in terms of access, care and quality of treatment. (Thomas, 8/29)

In other 2016 election news, Clinton is facing turbulent waters in terms of the health law if she's elected —

The Associated Press: Clinton Could Face Mounting Problem With Health Overhaul
With the hourglass running out for his administration, President Barack Obama's health care law is struggling in many parts of the country. Double-digit premium increases and exits by big-name insurers have caused some to wonder whether "Obamacare" will go down as a failed experiment. If Democrat Hillary Clinton wins the White House, expect her to mount a rescue effort. But how much Clinton could do depends on finding willing partners in Congress and among Republican governors, a real political challenge. "There are turbulent waters," said Kathleen Sebelius, Obama's first secretary of Health and Human Services. "But do I see this as a death knell? No." (8/29)

Capitol Hill Watch

Documents Reveal Congressional Advocacy On Behalf Of Controversial Cancer Doctor

From 2011 to 2016, 37 members of Congress wrote to the Food and Drug Administration asking the agency to grant constituents access to Stanislaw Burzynski's cancer treatment. Critics say that congressional advocacy is giving the doctor unearned legitimacy and the patients a false sense of hope for a treatment that has been cited as potentially fatal to those who partake in the treatment.

Stat: Lawmakers Pushed Access To A Controversial Doctor
The call to Congressman Ted Yoho’s office was a matter of life and death: A constituent was seeking help for a 5-year-old great-nephew who was suffering from a terrible brain tumor. Could the Florida Republican push the Food and Drug Administration to give the boy access to an unapproved drug treatment that the caller had heard would help? ... The treatment, developed by a controversial Texas doctor named Stanislaw Burzynski to treat a rare form of cancer, has never been shown to be successful. Yet, for years, patients have continued to seek Burzynski out, and to ask their representatives in Congress to intervene on their behalf.  (Kaplan, 8/29)

Pharmaceuticals

How Unbranded Ad Campaigns Helped EpiPen Maker Skirt Regulations

The ad campaigns are a stealthy way for pharmaceutical companies to raise consumer awareness of a need for a drug without explicitly mentioning the drug itself, which allows them to avoid disclosing side effects. Meanwhile, a generic for the pricey EpiPen could be coming out as soon as next year.

Stat: Behind The Stealth Ad Campaigns For The EpiPen And Other Drugs
Mylan Pharmaceuticals has spent millions this year on television ads and celebrity testimonials that implicitly promote the EpiPen — without ever mentioning it by name. ... Welcome to the world of unbranded ads, a stealthy and lightly regulated form of drug marketing focused on educating the public about a health condition — which the pharma company just happens to sell a product to treat. The ads aren’t required to disclose side effects. Instead, they often direct patients to a website about the disease. Click on a few links and you’ll likely land on a page promoting the branded treatment. (Robbins, 8/29)

CNN Money: EpiPen Outrage May Fuel Cheap Generic In 2017
A generic alternative for the lifesaving allergy treatment is being developed by Teva Pharmaceuticals (TEVA). The company has indicated the generic treatment may arrive as early as next year, creating a cheaper alternative to EpiPen, which has cornered an estimated 94% of the market.In fact, some Wall Street analysts believe the national outcry over the 400% increase in EpiPen prices may ultimately speed up the FDA approval process for an affordable replacement. (Egan, 8/26)

Marketplace

More Employers Moving Toward High-Deductible Plans And Prescription Drug Limits

A survey of D.C.-area employers shows that they are following the same health care cost-sharing trends as other businesses nationwide.

The Washington Post: Healthcare Costs Are Still Going Up. Here’s How D.C.-Area Employers Are Compensating.
Seven years after the passage of the federal Affordable Care Act, health care costs are still going up at a robust rate for many in the region, according to a new survey of Washington area companies. Health insurance costs at a broad sample of local companies are projected to increase by 7.3 percent in 2016, the Human Resource Association of the National Capital Area reported. The association, which represents area human resource executives, said the survey found more local employers are offering higher-deductible plans and putting new restrictions on expensive prescription drugs. (Gregg, 8/26)

And the long-term health costs for Pulse victims could be in the millions —

Orlando Sentinel/Tampa Bay Tribune: Pulse Victims Could Need More Than Millions Collected So Far, Analysts Say 
An insurance underwriter from Jacksonville, [Frederick] Johnson was shot twice during the Pulse nightclub attack that left 49 people dead. He no longer has sensation in his left arm and can't move his fingers on that hand. And while he was relieved last week to learn Orlando hospitals won't bill the victims, he still faces ongoing physical therapy — currently at $700 a week — and potentially long-term mental-health counseling. (Hayes and Santich, 8/28)

Medicare

Medicare Advantage Audit Uncovers Rampant Overcharging

All but two of the 37 health plans audited for 2007 were overpaid — typically several hundred thousand dollars too much.

NPR/Center For Public Integrity: Audits Of Some Medicare Advantage Plans Reveal Pervasive Overcharging
More than three dozen just-released audits reveal how some private Medicare plans overcharged the government for the majority of elderly patients they treated, often by overstating the severity of certain medical conditions, such as diabetes and depression. The Center for Public Integrity recently obtained, through a Freedom of Information Act lawsuit, the federal audits of 37 Medicare Advantage programs. These audits have never before been made public, and though they reveal overpayments from 2007 — money that has since been paid back — many plans are still appealing the findings. (Schulte, 8/29)

Meanwhile, Kaiser Health News and California Healthline offer a look on what exactly observation care is —

California Healthline: Protecting California’s Seniors From Surprise Hospital, Nursing Home Bills
Californians with Medicare coverage would no longer be surprised by huge medical bills stemming from “observation care” in hospitals under legislation that state lawmakers approved overwhelmingly last week and sent to Gov. Jerry Brown to sign into law.The sticker-shock can happen when people go to the hospital but health care providers are not sure what’s wrong. If the patient is not sick enough to be formally admitted, but still not healthy enough to go home, they can stay in the hospital for “observation care,” which Medicare considers an outpatient service. That can mean higher out-of-pocket expenses for the patient. (Jaffe, 8/29)

Kaiser Health News: Hospital Surprise: Medicare’s Observation Care
Hospitals provide observation care for patients who are not well enough to go home but not sick enough to be admitted. The care may seem just like what an admitted patient receives — they are in a hospital room, nurses check on them and doctors  order treatments. But surprises can arise over billing because Medicare considers this outpatient care. So instead of Medicare picking up most of the bill, patients usually also have copayments for doctors’ fees and each hospital service, and they have to pay whatever the hospital charges for any routine drugs the hospital provides that they take at home for chronic conditions. (Ying, Nguyen and Shallcross, 8/29)

Medicaid

Ala. Legislature Kills Lottery Plan That Would Have Boosted Medicaid Funding

The state's Medicaid program faces a deficit of at least $85 million in the budget beginning Oct. 1. Legislators may try to patch that hole with money from an oil spill payout. Outlets also reported Medicaid news from Iowa, Virginia, Puerto Rico and Maryland.

Montgomery (Ala.) Advertiser: Alabama Lottery Dies Amid Dog Track Concerns
Needing just one final vote to go on a future election ballot, a proposal to establish a statewide lottery collapsed in the Alabama Senate Friday when Democrats, key to the bill’s success, withdrew their support amid concerns language in the bill ... could give the Poarch Band of Creek Indians a gaming monopoly at the expense of the state’s existing dog tracks. ... The end result was the death of the centerpiece of the special session called by Gov. Robert Bentley and renewed uncertainty about the future of the state’s Medicaid program, which covers 1 million Alabamians, more than half under the age of 17. (Lyman, 8/26)

AL.com: Alabama Lottery Bill Dead For Special Session
At a press conference after the bill died, the governor said today's vote rejecting the bill was a vote against the children and others who depend on Medicaid, about one million Alabamians overall. "I can't accept that as a doctor and I can't accept it as the governor of this state," Bentley said. "Because one of the things we have to do as a government is this: There are people in this state who cannot take care of themselves. And there are people who depend on government and the government is us." The lottery proposal, if approved by voters, would have sent almost 90 percent of net lottery revenue to the state General Fund, with the first $100 million of that going to Medicaid. (Cason, 8/26)

Des Moines Register: Report: Medicaid Managers' Spending On Iowans Varies Greatly
The three private companies managing Iowa’s Medicaid program are spending significantly different amounts on care for the hundreds of thousands of poor or disabled people they cover, a new report suggests. Amerigroup is spending an average of $402 per adult member per month, 13 percent more than the $357 spent by UnitedHealthcare and 47 percent more than the $273 spent by AmeriHealth Caritas, the report shows. Amerigroup spent $198 per child member per month, 112 percent more than the $93 AmeriHealth spent and 78 percent more than the $111 UnitedHealthcare spent. (Leys, 8/26)

Des Moines Register: Late Medicaid Payments Spark An Eviction Threat To One Newton Mom And Her Disabled Daughter
Anita Kacmarynski’s landlord is running out of patience as the Newton woman struggles to gain full payment from the private companies running Iowa’s Medicaid program. The landlord sent an eviction notice this week to Kacmarynski, whose main source of income is Medicaid payments for care of her disabled adult daughter, Heather. Like many other care providers, Kacmarynski says she’s had a devil of a time wringing payment out of the national companies the state recently hired to run the giant public health insurance program for the poor and disabled. (Leys, 8/26)

The Washington Post: McAuliffe Sees Medicaid Expansion, Rainy-Day Fund As Fix For $1.5 Billion Budget Hole
Gov. Terry McAuliffe suggested tapping the state’s rainy day fund and accepting more federal Medicaid money on Friday as a way to patch the state’s $1.5 billion budget hole. McAuliffe (D) formally informed legislators of the budget shortfall, the result of lower-than-expected revenue from payroll and sales taxes, at a meeting of House and Senate money committees on Capitol Square. (Vozzella, 8/26)

The Hill: Obama Officials Call To Boost Healthcare Funds To Puerto Rico 
The Obama administration is pushing Congress to reform Puerto Rico’s healthcare programs to help fight the Zika virus and remove limits on health funding that officials call harmful. Health and Human Services Secretary Sylvia Mathews Burwell and Treasury Secretary Jack Lew wrote to Congress on Friday calling for the cap on Puerto Rico’s Medicaid funding to be lifted and for the federal contribution to the program to be raised so it is more in line with the assistance given to the 50 states. (Sullivan, 8/26)

The Baltimore Sun: Former Priority Partners Employee Pleads Guilty To Medicaid Fraud
A former employee of Priority Partners, a Medicaid Managed Care Organization owned by Johns Hopkins HealthCare, [pleaded] guilty to felony Medicaid fraud for altering medical records that caused the Medicaid to improperly pay the company more than $875,000. Inca Elfriede Schultz, 61, of Cudjoe Key, Fla., was sentenced to five years incarceration by Anne Arundel County Circuit Court Judge Michael Wachs. He suspended all but 18 months of her sentence to be served in home detention. (Gantz, 8/26)

Public Health And Education

Pediatricians Push Back Against Rising Tide Of 'Vaccination Hesitancy'

The American Academy of Pediatrics has released guidelines for doctors facing parents who are resistant to getting their children vaccinated. A new survey shows that 87 percent of pediatricians have encountered issues with a parent refusing to vaccinate his or her child.

Los Angeles Times: Pediatricians Urge States To Get Tough On Parents Who Don’t Want To Vaccinate Their Kids
The nation’s pediatricians are pushing back against parents who resist having their children vaccinated against a broad range of dangerous diseases by calling on states to stop offering waivers to those with non-medical objections to the practice. In a policy statement issued Monday, the American Academy of Pediatrics also said that if parents continue to refuse vaccinations despite exhaustive efforts to change their minds, it would be “acceptable” for doctors to exclude these families from their practices. (Healy, 8/29)

Stat: Most Pediatricians Say Parents Have Refused Vaccines For Their Kids
More doctors are reporting encounters with parents refusing to vaccinate their kids than a decade ago, but parents’ reasons for skipping immunizations have shifted in the past decade. A new survey published in Pediatrics on Monday reports that 87 percent of pediatricians in the United States say they encountered parents refusing to vaccinate their children in 2013. A decade earlier, 75 percent of doctors reported they had experienced vaccine refusals. The most common reason parents gave, according to doctors? The vaccines weren’t necessary. (Thielking, 8/29)

Seattle Times: More Doctors Asked About Delaying Or Refusing Childhood Vaccines, Study Says 
Reports of vaccine refusals were highest in the West, with 94 percent of doctors saying they had parents opt out in 2013, up from 85 percent in 2006. Interestingly, the reasons parents refused vaccines shifted slightly during the study period. In 2013, about 64 percent opted out because of concerns about the disproved link between vaccines and autism, down from 74 percent in 2006. Nearly 67 percent of parents in 2013 refused shots because of worries about safety, also down from nearly 74 percent. At the same time, those who refused shots because they thought they were unnecessary jumped from about 63 percent in 2006 to 73 percent in 2013. (Aleccia, 8/28)

Meanwhile, in California —

The Associated Press: Judge Won't Block California's Strict Child Vaccination Law
A federal judge will not immediately block a California law that requires all schoolchildren to be vaccinated and is one of the strictest in the nation for eliminating exemptions based on religious and personal beliefs. The ruling Friday by U.S. District Judge Dana Sabraw in San Diego comes as the law faces its first test with the end of summer break. A lawsuit filed by 17 families and two foundations sought an injunction while the lawsuit works its way through the courts. The law went into effect July 1 and eliminated religious and personal beliefs as reasons for opting out of the state's mandatory immunizations. (Watson, 8/26)

Experts: 'Exceptional Responders' To Cancer Treatments Shouldn't Be Dismissed As Just Outliers

Often categorized as statistically insignificant, patients who see dramatic results from treatments that don't work on others could hold a key to better understanding cancer. In other public health news are stories on sleep apnea treatment, brain-eating amoeba, super lice and colonoscopies.

The Washington Post: Cancer Researchers: It’s Time To Pay More Attention To ‘Miracle’ Patients
Call it luck — or a medical miracle. During clinical trials for experimental cancer drugs, some patients simply respond better than others. And a tiny fraction of patients see dramatic results, responding so well to treatment that they survive forms of cancers that quickly kill their counterparts. Stories about people like Emily Whitehead, the then-6-year-old who was enrolled in a clinical trial that saved her life, make headlines. But statistically speaking, they’re insignificant, mere outliers. Because they deviate so far from the norm, these “exceptional responders” are often overlooked by researchers. Not so fast, says Eric Perakslis. (Blakemore, 8/26)

The Washington Post: CPAP Machines Don’t Prevent Heart Attacks, Strokes In Some Sleep Apnea Sufferers
More than 25 million Americans have obstructive sleep apnea, a dangerous disorder that causes sufferers to briefly stop breathing while they sleep, sometimes many times each night. ... The standard treatment, the continuous positive airway pressure, or CPAP, machine, keeps the airway open by pumping a stream of air through a patient's nostrils as he or she sleeps. The biggest problem with the therapy is non-compliance; many people find the air mask and hose uncomfortable and give up on the machine. But a large new sleep study published Sunday raises a serious new issue: For people with existing cardiovascular disease and moderate to severe sleep apnea, CPAP doesn't prevent heart attacks, strokes, hospitalizations or deaths any better than sleeping without the machine. (Bernstein, 8/28)

NPR: A Young Woman Dies, A Teen Is Saved After Amoebas Infect The Brain
Doctors describe 16-year-old Sebastian DeLeon as a walking miracle — he is only the fourth person in the U.S. to survive an infection from the so-called brain-eating amoeba. Infection from Naegleria fowleri is extremely rare but almost always fatal. Between 1962 and 2015, there were only 138 known infections due to the organism, according to the Centers for Disease Control and Prevention. Just three people survived. This summer, two young people, one in Florida and one in North Carolina, became infected after water recreation. Only one had a happy ending. (Aboraya and Tomsic, 8/28)

The Philadelphia Inquirer/Philly.com: 'Super Lice' Are Really A Thing. Here's How To Cope, Parents
Super lice are among us, and that's not just a back-to-school ploy to get parents running to the pharmacy aisles. A recent study published in the Journal of Medical Entomology has found that head lice resistant to the most common over-the-counter remedies appear to be dominant in 42 out of 48 states tested. Every Pennsylvania sample taken for the study turned up with all-resistant lice. New Jersey was a mix of old-school lice and the newer nasties. (Giordano, 8/28)

The Baltimore Sun: Some Hope Virtual Colonoscopies Lead To More Cancer Screenings 
Screening via a colonoscopy helps reduce cases of the disease and lower death rates. While strides have been made in getting more people tested, many still avoid getting screened. The American College of Radiology and several cancer prevention groups think that more people like [Cynthia] Bledsoe, who are turned off by the thought of getting a colonoscopy, could be persuaded to get tested if given the choice of a virtual colonoscopy. (McDaniels, 8/27)

N.H. Attorney General Accuses Purdue Pharma Of Stonewalling OxyContin Probe

In its refusal to comply with a New Hampshire subpoena, Purdue cites objections to the state’s use of a private law firm in an ongoing investigation of the company and other opioid makers. In other news, a recent heroin deaths spike in several states leaves officials scrambling.

Los Angeles Times: Purdue Pharma Rejects Request From New Hampshire Attorney General For Information On Suspected Diversion Of OxyContin
The top law enforcement official in New Hampshire, a state ravaged by the opioid epidemic, accused the manufacturer of OxyContin on Friday of stonewalling demands for information the company collects about suspected criminal trafficking of its painkiller. “They are just refusing to turn over documents,” state Atty. Gen. Joseph Foster said of drugmaker Purdue Pharma in an interview. “On one hand, they tell us they have nothing to hide and they are doing everything appropriately, but then why are they fighting so hard not to turn over this information?” (Ryan, 8/26)

The Associated Press: Dozens Treated As Heroin Overdose Spikes Hit Several States
Officials in several states are scrambling to deal with a series of heroin overdose outbreaks affecting dozens of people and involving at least six deaths. The spikes in Indiana, Kentucky, Ohio and West Virginia over the past few days have seen rescue workers rushing from scene to scene to provide overdose antidote drugs. While it's unclear if one dealer or batch is responsible for the multistate outbreak, the spikes reflect the potency of heroin flooding the Midwest. (8/26)

Cincinnati Enquirer: NKY Sees OD Spike Not As Severe As Cincinnati's
Northern Kentucky is seeing a surge in overdoses that is similar, but not nearly as great, as the barrage seen in Cincinnati this week. Cincinnati and Hamilton County endured an estimated 174 overdoses and three deaths in six days beginning Aug. 19. Northern Kentucky's St. Elizabeth Healthcare hospitals remained on alert, said aid Ashel Kruetzkamp, nurse manager for St. Elizabeth Healthcare Emergency Department. (DeMio, 8/26)

Cincinnati Enquirer: OD Crisis: Flying Blind In Search Of Killer Heroin's Source
An overdose crisis in Cincinnati for the past six days has left police and emergency responders drained, and for now, without clues. It has also underscored that the region does not have the resources to treat all of the addicted. Police are asking for the public's help in identifying the source of purported heroin sold to people in Cincinnati, mostly on the West Side, that caused scores of overdoses, including at least three deaths. (DeMio, 8/26)

In other news about the opioid crisis —

St. Louis Post Dispatch: Rapid Rise In Newborns Dependent On Opioids Has Hospitals Scrambling 
The number of babies born dependent on opioids such as prescription painkillers and heroin has increased fivefold since 2000, according to research led by neonatologist Stephen Patrick at Vanderbilt University. In 2012, nearly 28,000 newborns in the U.S. were treated for opioid withdrawal, the study showed. That is one infant every 19 minutes. The babies suffer what is called neonatal abstinence syndrome. They are more likely to be small and have respiratory complications, feeding problems, jaundice and seizures. They may shake, sweat, cry excessively, have diarrhea and be difficult to console.  (Munz, 8/27)

St. Louis Public Radio: Despite New Laws, Access To Overdose Antidote Remains Limited Without A Prescription In Mo. And Ill. 
It will likely be months before members of the public can get the opioid overdose antidote naloxone at Missouri pharmacies without a prescription. A new state law expanding access to the live-saving drug went into effect Sunday, but according to Missouri Pharmacy Association CEO Ron Fitzwater the state’s pharmacy board still has to create rules based on the law. (Phillips, 8/29)

State Watch

Damage To Vermont Hospital In 2011 Hurricane Helped Revitalize Mental Health Care

Rising flood waters forced the evacuation of the troubled state mental hospital, and eventually it was demolished. The state instead implemented a regional system of care for those with severe mental health problems. Also in the news, a look at Kansas' effort to get people into mental health treatment and efforts to recruit volunteers for a suicide prevention project in Ohio.

The Associated Press: After Irene Forces Reckoning, Mental Health Care Rebuilt
For most Vermonters, Tropical Storm Irene was a disaster that tore roads, communities and lives apart. But for many of the state's neediest mental health patients, it was a blessing in disguise. The small state had struggled for years with its mental health system. ... Most of the state office complex in Waterbury, of which the hospital was a part, had to be abandoned and temporary work spaces found for the employees. The $130 million repair to the complex was the largest state construction project in history. Patients who had been at the state hospital were moved to temporary locations while state officials and the Legislature looked for permanent fixes to the state's mental health system. The original state hospital was demolished. (Ring, 8/27)

Kansas Health Institute: Homeless Outreach: Mental Health Centers Strive To Get More Kansans Into Treatment
Kristen Whitney is service coordinator for the Cooperative Agreements to Benefit Homeless Individuals grant at Wyandot Center in Kansas City. She said Wyandot Center employees can reach out to people who are homeless, encourage them to accept treatment and emergency shelter, assist them with applying for benefits, help them locate a permanent apartment and meet with them weekly to smooth issues that may arise.  But that still isn’t enough to meet everyone’s needs, she said. Some clients require daily check-ins, particularly if they have lived on the street for years and aren’t accustomed to caring for an apartment, Whitney said, while others need someone to bring them groceries or teach them how to use the bus system. In Kansas, Medicaid doesn’t cover those kinds of supports, she said. (Hart, 8/26)

Columbus Dispatch: Amid Push To Reduce Suicides, Local Hotline Needs Volunteers
Doctors, psychologists, counselors, social workers and others connected to the mental-health system are working to reduce suicide rates that continue to rise nationwide and in Ohio. The nation’s largest suicide-prevention organization has set a goal to reduce the annual suicide rate by 20 percent over the next 10 years. But it’s volunteers such as [Steve] LeVert who are on the front lines of a crisis that has taken 20,000 people in Ohio since 2000. Those volunteers often are the difference between people receiving the help they need or sliding back into despair. (Wagner, 8/29)

State Highlights: Calif. Judge Denies Challenge To Aid-In-Dying Law; Rise In Pregnancy-Related Deaths Worries Texas Lawmakers

Outlets report on health news from California, Texas, New York, Minnesota, Iowa, Virginia, Arkansas and Ohio.

The Associated Press: California Judge Rejects Request To Suspend Assisted Suicide Law
A California judge has rejected a request by physicians to immediately suspend a new state law allowing terminally ill people to end their lives. Judge Daniel A. Ottolia of Riverside County Superior Court ruled on Friday that the law would remain in effect for now. But he agreed to allow the physicians to pursue their lawsuit claiming that the law lacks safeguards against abuse. (8/27)

Houston Chronicle: Texas Lawmakers Troubled By Spike In Pregnancy-Related Deaths, Committed To Tackling Problem
Key Texas lawmakers expressed alarm about the state's disturbingly high rate of pregnancy-related deaths, but hope the problem can be solved through the additional investment of $150 million the legislature made in women's health programs beginning in 2013. The Republican leaders last week downplayed the state's funding cuts in 2011 to women's health and family planning services that a national study earlier this month said might have been a factor in a dramatic spike in the maternal mortality rate the last five years. (Ackerman, 8/27)

Modern Healthcare: How One Safety Net Hospital Lowered Its Readmission Penalties 
Bellevue is a safety net hospital, the kind charged with taking care of everyone no matter how poor or sick. Such hospitals tend to see disproportionate numbers of patients who are homeless, uninsured or simply sicker because they can't afford regular medical care. As a result, safety net hospitals say, they are handicapped in not only healing these patients, but in keeping them from returning to the hospital after the initial discharge. (Whitman, 8/27)

Oakland Tribune: Danville's Bob Pack Nears Victory For California Prescription Drug Law
For more than a decade, Bob Pack has been haunting the hallways in and around the state Capitol, knocking on doors of California lawmakers, lobbyists and doctors' groups -- in the hopes that his family's tragic tale would persuade them to pass legislation that might prevent others from having to live through his nightmare. ... Now, Pack is on the verge of victory: Senate Bill 482, which would require doctors to check a database for a patient's prescription history before prescribing opioids and other potentially dangerous drugs, unanimously passed the California Assembly last week and is expected to get final clearance from the state Senate early this week before heading to Gov. Jerry Brown's desk. (Seipel, 8/26)

The Star Tribune: Allina Health Nurses Set Open-Ended Hospital Strike That Begins On Labor Day 
Nurses at five Allina Health hospitals will go on strike starting at 7 a.m. on Labor Day, their union said Friday in a mandatory 10-day notice sent to the health system. The walkout would be the second by the Allina nurses since negotiations started in February over a new three-year contract. Following a one-week strike in June, the nurses rejected a contract offer from Allina and authorized strike planning in voting last week. But negotiators with the Minnesota Nurses Association (MNA) opted to wait to set a date pending the outcome of talks that occurred Tuesday. (Olson, 8/26)

Des Moines Register: Cardinal Health Buys Iowa Telepharmacy Startup
Cardinal Health, a large provider of health care services, has purchased a four-year old Iowa startup that has focused on setting up telepharmacies across rural parts of the state. Ohio-based Cardinal health acquired TelePharm, based in Iowa City, in a deal that closed last month, representatives from both companies confirmed to the Register Friday. (Patane, 8/26)

Houston Chronicle: Merger Of Hermann And Memorial Systems Expanded Options For Patients 
A medical marriage expanded the health care options for Houstonians in 1997, when the historic Hermann Hospital merged with Memorial Healthcare System, a network of nonprofit suburban hospitals. Hermann Hospital, Houston's flagship provider of charity care, was a standalone institution in the Texas Medical Center that served as the hands-on classroom for aspiring physicians, nurses and other health professionals through its partnership with the University of Texas Medical School. (George, 8/28)

Richmond Times Dispatch: Virginia's Free Clinics 'Really Struggling' In The Face Of Growing Hurdles
The transgender community is considered an underserved population, meaning available health services are few and far between. It is just one of the many underserved communities that seek care at the dozens of free clinics across Virginia, such as Health Brigade. But the landscape for the free clinic is rapidly changing. The needs of the low-income populations they serve are becoming more demanding, and many, such as Health Brigade, see themselves as much more than clinics. (Demeria, 8/27)

NPR: Arkansas Schools College Students In Avoiding Pregnancy
Orientation at Arkansas Tech University this year included a surprising topic for a Bible Belt state that pushes abstinence-only in high school. Every freshman was shown a newly produced video in which real students talk about the struggle of an unplanned pregnancy, and the challenge of staying in school as a parent. "I lost a lot of friends," says one young woman in the video who had dreamed of becoming a surgeon. A young man says he "went from not having any responsibility to having a full-time responsibility," while another laments that Friday nights are no longer spent with friends but at home "watching Dora. A lot of Dora." (Ludden, 8/26)

Cleveland Plain Dealer: Cleveland, Like Toledo, Looks For Ways To Prevent Lead Poisoning In Kids
Toledo recently became the first city in Ohio to require rental property inspections for lead hazards in order to prevent childhood lead poisoning. Cleveland city officials say they're similarly committed to that goal, but may go about it in a different way. Toledo's City Council, encouraged by a broad community coalition, unanimously passed a "lead safe" rental inspection law that requires both visual inspections for peeling paint and tests for lead. (Dissell and Zeltner, 8/27)

Los Angeles Times: After Court Rules Against Parents, Toddler Is Taken Off Life Support
Two-year-old Israel Stinson, the curly-haired, angelic-looking toddler whose fight for life gained international attention, died Thursday after he was removed from a breathing ventilator against his parents wishes. Now, supporters of the family are questioning why a Los Angeles hospital moved so quickly to remove him from life support immediately after a judge upheld the decision. Israel’s parents, Jonee Fonseca and Nathaniel Stinson, sought an injunction Aug. 18 to prevent Children’s Hospital of Los Angeles from taking action while they rushed to make arrangements to put him in home care. (Evans, 8/26)

Des Moines Register: Students, Accreditor See Improvement At ISU Health Center
Iowa State University’s student health center saw a record number of visits during the last school year, even as officials addressed a staff shortage and a scathing review of the center by an outside consultant. “Students are a lot happier with the health center than they were years ago, or even at this point last year,” said Cole Staudt, ISU student body president. “Now that the focus on our physical health is catching up, we can focus more on mental health.” (Charis-Carlson, 8/28)

Kaiser Health News: Teaching Medical Teamwork Right From The Start
There’s a new building going up on the campus of the Cleveland Clinic. A very big building. The structure will house the new Case Western Reserve University Health Education campus, eventually including Case Western’s medical, dental and nursing schools, as well as Cleveland Clinic’s in-house medical school. “The idea is to create a ‘mini campus’ that gives each school its own identity but fosters collaboration,” said Chris Connell, one of the architects. (Rovner, 8/29)

Editorials And Opinions

Editorializing About EpiPens

News outlets offer a variety of perspectives on the ongoing EpiPen pricing flap.

Los Angeles Times: EpiPen Price Gouging Demonstrates Need For More Competition In Generic Drugs
Healthcare reformers are pushing insurers and government health programs to tie payments for drugs based on the value they provide to a patient and the healthcare system as a whole. That shift could generate competition between different drugs, rather than just different manufacturers of the same compound. ... Those efforts could prove crucial in the struggle to slow the growth in healthcare costs. Some critics of the pharmaceutical industry have called for more dramatic — and potentially more disruptive — steps, including government price controls and taxes on windfall profits. Before lawmakers even consider going that far, however, they should do more to bring market forces to bear on drug monopolists. Huge price increases should be sending an irresistible invitation to entrepreneurial companies to come in with a competing product. (8/26)

Stat: To Prevent Another EpiPen Controversy, The Government Should Step In
Mylan Pharmaceuticals is at the center of a firestorm of criticism over dramatic price hikes for its lifesaving EpiPen. The problem, says Mylan CEO Heather Bresch, is a broken health system that has let deductibles and copays skyrocket on many insurance policies. ...The real problem isn’t with insurance design. It is lax regulatory oversight that doesn’t ensure an adequate supply of drugs critical to population health and opens the door to shocking price increases. (Dana Goldman, 8/26)

Houston Chronicle: Of Course EpiPens Cost $300 
Charging $300 for an EpiPen makes perfect sense in the health care world we live in. In our free-market system, you can charge whatever you want for your product. A hospital can charge $50 for an aspirin, or $53 for a pair of latex gloves. You can even charge a family $15,000 a year for health insurance. If you don't have insurance and need emergency care, however, don't be surprised if the hospital charges you 10 times the actual cost of treating you. That's because you didn't negotiate the prices in advance the way insurance companies do. (Chris Tomlinson, 8/26)

The Wall Street Journal: Dear EpiPen Customers . . . 
To whom it may concern: As the CEO of Mylan, maker of the world-famous EpiPen, it gives me great pleasure to address you, via email from an undisclosed location, concerning the pricing of our product. As you may know, my father is a U.S. senator from West Virginia, where the state motto is “Montani semper liberi.” It means “mountaineers are always free.” Indeed, they are. But pharmaceuticals aren’t—especially EpiPen. (Holman W. Jenkins, 8/26)

Thoughts On Zika: Undercounting The Public Health Threat

Some columnists offer thoughts on the Zika response and public health strategies to combat the virus.

The Wall Street Journal: The Zika Undercount And The Virus’s Growing Threat To Public Health
When I was coordinating the U.S. response to Ebola in the fall of 2014, one frequent problem was false reports of Ebola cases in this country. Early symptoms of Ebola resemble flu. Even when we screened out the 99% of flu patients who had not been to Liberia, Sierra Leone, and Guinea (and therefore did not have Ebola), there were still many more suspected or feared cases than actual instances of Ebola in the U.S. Many sleepless nights in the winter of 2014-2015 ended, fortunately, with negative Ebola tests. But among the many reasons policy makers and citizens are not taking seriously enough the potential threat and consequences of Zika is that just the opposite is true for this virus. (Ron Klain, 8/28)

Miami Herald: Rick Scott’s List Of How To Fight Zika In 14 Easy Steps
Gov. Rick Scott’s War on Zika: 1. Whenever a new Zika case is confirmed in Florida, I will immediately rush to that county and stage a “round-table” discussion. This will calm fears in the local community, and lead tourists to believe that it’s still safe to visit. (Carl Hiaasen, 8/27)

Miami Herald: In Zika Fight, ‘Don’t Get Pregnant’ Is Lousy Advice
Don’t get pregnant.” Not now. Maybe not for two years. This was the advice governments gave women in a number of South American countries when the connection was established between the Zika virus and microcephaly, a serious birth defect that can result in seizures and developmental delays. But details on how they were supposed to accomplish this in countries with limited access to contraception and strict abortion restrictions weren’t provided. (Alice Pettway, 8/26)

Los Angeles Times: Disability Rights And Reproductive Rights Don't Have To Be In Conflict
Earlier this month, Florida Sen. Marco Rubio stated that women infected with the Zika virus, which can cause congenital disabilities such as microcephaly, should not be permitted to have legal abortions. In March, Indiana Gov. Mike Pence, now the Republican nominee for vice president, signed a bill banning abortions following a prenatal diagnosis of Down syndrome or related conditions. Similar bills have passed or are pending in other states. (David Perry and Elizabeth Picciuto, 8/29)

Viewpoints: Medical Websites ... Helpful? Healthful?; Local Takes On The Current State Of Obamacare

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

The New York Times' Room For Debate: Are Medical Websites, Like WebMD, Healthful?
The internet has democratized medical knowledge, allowing people to learn about their symptoms and conditions without leaving their couch. But have medical websites let people draw conclusions about their health without really understanding what they’re reading? Do they inform patients so they can have better expectations when they see a doctor, or do they do more harm than good? (8/29)

The Tennessean: Tennessee Official Not Chicken Little On Obamacare 'Near Collapse'
On Tuesday, Commissioner Julie Mix McPeak, who runs Tennessee’s Department of Commerce and Insurance, announced that her department was approving massive premium increases for insurers providing individual health insurance policies through the Patient Protection and Affordable Care Act exchange in the state. The percentage increases are stunning and prompted the commissioner to put them in context. Her context was more stunning than the increases themselves. “I would characterize the exchange market in Tennessee as very near collapse,” McPeak said. (Frank Daniels III, 8/27)

Lincoln Journal-Star: Aetna Pullout Shows Need To Fix ACA
Nebraskans can heave a sigh of relief that Aetna will continue to sell individual health insurance policies in Nebraska through the government marketplace created by the Affordable Care Act. Aetna is pulling out of 11 other states, leaving their health insurance marketplaces in tatters. In fact for the first time ever the people in one Arizona county won’t be able to purchase any insurance at all through the ACA government marketplace; no insurers are offering coverage there. (8/27)

Louisville Courier-Journal: Negotiating With Feds Is Next For Bevin
When Gov. Matt Bevin sent federal officials his formal plan for changing Medicaid, he kept a chilling line from his draft: saying it "represents the terms under which the Commonwealth will continue Medicaid expansion," the move made by his Democratic predecessor, Steve Beshear. The line made people wonder if Bevin would really take health care away from more than 400,000 Kentuckians, a draconian option he favored during his campaign, until other Republicans persuaded him that might be unwise, at least politically. (Al Cross, 8/26)

Marketwatch: We Must Replace Obamacare With A Moral, Workable System
As one of the lawyers in the vanguard of litigating against Obamacare in the courts back in 2010, I have long maintained that it sounded the death knell for private insurance in the health-care industry. That’s because insurance only works when coverage is bought before your car crashes, or your home floods, or you get really sick. If we can wait until disaster strikes and then purchase that coverage at the same price anyway, why would anyone in his or her right mind buy it in advance? (Blaine Winship, 8/27)

Miami Herald: Hillary Clinton Is In Ill Health? That’s Sick
Eight years ago, at a campaign town hall meeting in Minnesota, a woman told Republican nominee John McCain that she was troubled by the prospect of a Barack Obama presidency. “I can’t trust Obama,” the woman said into a wireless microphone Sen. McCain had handed her. “I have read about him and he’s not, he’s not, uh — he’s an Arab.” It was a sentiment Republicans had expressed frequently at events that week in 2008. It was, for Sen. McCain, a moment that candidates regularly face — a decision about which thresholds they’ll allow their campaigns to cross. (8/28)

The Wichita Eagle: Hospital Tax Plan Exacerbates Problem
I need to set the record straight regarding Gov. Sam Brownback’s plan to tax hospitals (Aug. 18 Eagle). The governor has stated that he wants to increase the current hospital provider tax to replace his 4 percent Medicaid provider reimbursement cut and to help struggling rural hospitals. The governor seems to be saying that in order to reverse the 4 percent rate cuts, he is going to increase a tax on the very entities those cuts are hurting. That is at best inconsistent. More likely, it would exacerbate the problems being faced by health care providers. (Tom Bell, 8/28)

The Hill: What Is Going On At The CDC? Health Agency Ethics Need Scrutiny 
Officials at the Centers for Disease Control and Prevention have their hands full these days. An epidemic of obesity has hit Americans hard, raising the risks for heart disease, stroke, type 2 diabetes and certain types of cancer. Childhood obesity is a particular prevalent problem...But behind the scenes, mounting evidence suggests that rather than cracking down on the soda industry, high-ranking officials within the CDC’s National Center for Chronic Disease Prevention and Health Promotion are instead cozying up to beverage giant Coca-Cola and its industry allies, even in some cases aiding the industry as it argues that sodas are not to blame. (Carey Gillam, 8/27)

Forbes: The Food We Eat Daily That Leads To Poor Heart Health For Our Children
Earlier this year, I called attention to the dangers added sugars pose to cardiovascular health and other health outcomes.  In the months since, many people have told me how surprised they’ve been to learn about the sugar hidden in their healthy morning yogurt or afternoon energy bar.  Frankly, I was too.  And this lack of food literacy is a driving factor behind our nation’s growing health crisis and obesity epidemic. Some health-conscious organizations are trying to bridge that information gap.  This week, the American Heart Association (AHA) came out with its first ever scientific statement on added sugar for children.  A team of scientists conducted an extensive review of the available evidence published in peer-reviewed studies examining the cardiovascular health effects of added sugars on children, and came to a powerful conclusion. (Bill Frist, 8/27)

Lexington Herald Leader: Drugs Devastating Lives Of Appalachian Women
The alarming increase in deaths of rural, middle-aged white women reported in the Aug. 22 Washington Post article “White women are dying younger: an undertaker’s sad lesson,” should be an urgent call to action for regional leaders and non-profit organizations like ours to work together to reverse the tide of tragically young deaths like those of Lois A. Maxwell and Betty West. (Lori Sliwa and Sister Robbie Pentecost, 8/27)

Daily Pilot: Bill Would Help Social Workers Better Care For The Elderly
Out of sight, out of mind, a phrase we have heard sporadically thrown about, in this instance rings true. When pain, isolation, depression and dementia are locked away behind hospital walls, we fail to see the problem. Our society, somewhere down the line, has shifted. It went from rendering respect to the wisdom of the elderly and compassion to the wounded, to creating concrete walls to house those who no longer hold the ability to physically produce. This, combined with other naturally caused conditions, has led to what we are now witnessing: a high prevalence of mental illness among our elders and disabled. (Jennifer Nava, 8/25)

The Hill: Marijuana Legalization Not Tied To Increased Use Among Youth 
According to a June 2016 analysis by the U.S. Centers for Disease Control, the percentage of all high school students who have ever used cannabis fell from an estimated 43 percent in 1995 (one year prior to the passage of the nation’s first medical pot law) to 39 percent in 2015. The percentage of teens currently using pot (defined as at least once in the past 30 days) also declined during this same period, from 25 percent in 1995 to 22 percent in 2015. (Paul Armentano, 8/26)

Lexington Hrald Leader: Foundation Enables Doctors To Help Others
Since arriving in Lexington for medical school 16 years ago, I have seen a lot of change at the University of Kentucky. Buildings have come and gone and so have faculty and staff. What I have seen has made me into an internist and pediatrician but also a member of a team of doctors, nurses and others who work hard for the patients we serve. (Dr. L. Curtis Cary, 8/28)