KHN Morning Briefing

Summaries of health policy coverage from major news organizations

First Edition: May 29, 2014

Today's early morning highlights from the major news organizations, including articles on an inspector general's report on care at VA hospitals and growing pressure from some House Republicans to vote on an alternative to the Affordable Care Act.

Kaiser Health News: Georgia Looks To Reopen Some Closed Rural Hospitals As E.R.s
Reporting for Kaiser Health News, in partnership with NPR, Susanna Capelouto reports: "Four of Georgia's 65 rural hospitals have shut down over the past two years. A dozen more have cut services in response to shrinking budgets. There just wasn't enough money to keep Charlton Memorial going, says Doug Gowen, who stayed and is in charge of what's left of the defunct hospital. ... The state of Georgia just threw him a lifeline, offering a new kind of license to allow struggling hospitals and those that have closed in the past year to become rural freestanding emergency departments. 'The intent here is to have some kind of health care infrastructure in a community, as opposed to nothing at all,' says Clyde Reese, who runs the Georgia Department of Community Health" (Capelouto, 5/29).

Kaiser Health News: Capsules: ‘National Dialogue’ Urged On Cost Of New Hepatitis C Drug
Now on Kaiser Health News’ blog, Julie Appleby reports on the latest regarding Sovaldi, a $1,000-a-pill treatment for Hepatitis C: “While the drug is a significant advance over older treatments for the viral liver disease, the price set by the company 'represents an abuse of market power, said John Rother, president and CEO of the National Coalition on Health Care, which includes businesses, unions, insurers, consumers and some drugmakers, including the Generic Pharmaceutical Association. On Wednesday, the group urged a 'national dialogue' on the cost, saying Sovaldi’s price tag threatens the budgets of government run-health programs as well as the premiums for everyone who has private insurance” Appleby, 5/28). Check out what else is on the blog.

The New York Times: Severe Report Finds V.A. Hid Waiting Lists
In the first confirmation that Department of Veterans Affairs administrators manipulated medical waiting lists at one and possibly more hospitals, the department’s inspector general reported on Wednesday that 1,700 patients at the veterans medical center in Phoenix were not placed on the official waiting list for doctors’ appointments and may never have received care. The scathing report by Richard J. Griffin, the acting inspector general, validates allegations raised by whistle-blowers and others that Veterans Affairs officials in Phoenix employed artifices to cloak long waiting times for veterans seeking medical care. Mr. Griffin said the average waiting time in Phoenix for initial primary care appointments, 115 days, was nearly five times as long as what the hospital’s administrators had reported (Oppel and Shear, 5/28). 

The Wall Street Journal: 'Serious Conditions' At Phoenix Veterans Affairs Office, Watchdog Says
A watchdog's report found systemic problems at Department of Veterans Affairs health-care facilities, including improper procedures for scheduling patient appointments and efforts to hide excessive wait times, increasing the pressure on embattled VA Secretary Eric Shinseki. ... The White House said Mr. Obama found the interim report "extremely troubling" and wants the Veterans Administration to take immediate steps to improve access to care, a spokesman said Wednesday (Kesling, 5/28). 

The Washington Post: 'Troubling’ Report Sparks New Wave Of Calls For VA Chief’s Resignation
The agency has made it a goal to schedule appointments for veterans seeking medical care within 30 days. But the interim IG report found that in the 226-case sample, the average wait for a veteran seeking a first appointment was 115 days, a period officials allegedly tried to hide by placing veterans on “secret lists” until an appointment could be found in the appropriate time frame (Lowery and Hicks, 5/28).

Los Angeles Times: Pressure Grows On VA Chief Eric Shinseki To Quit After Critical Report
Shinseki "has said that VA will fully and aggressively implement the recommendations" of the inspector general, Carney said. "The president agrees with that action and reaffirms that the VA needs to do more to improve veterans' access to care. Our nation's veterans have served our country with honor and courage, and they deserve to know they will have the care and support they deserve" (Simon and Carcamo, 5/28).

NPR: Report Finds Systemic Problems With VA Wait Lists
In a new report released Wednesday, the inspector general for the Department of Veterans Affairs says that the department has frequently manipulated records to hide medical care delays. Investigators focused their probe on a hospital in Phoenix, Ariz (Lawrence, 5/28). 

The Wall Street Journal: Sens. Franken And Shaheen Join Call For Shinseki To Resign
Support for Veterans Affairs Secretary Eric Shinseki continued to erode on Capitol Hill late Wednesday as two additional Democratic senators, Jeanne Shaheen of New Hampshire and Al Franken of Minnesota, joined the chorus of lawmakers calling for him to resign (Crittenden, 5/29). 

Politico: House Members Rip Into VA
House members lashed out at Veterans Affairs officials Wednesday evening over a broadening VA medical scandal that has increasingly prompted calls for VA Secretary Eric Shinseki to resign. Lawmakers on both sides of the aisle criticized the Department of Veterans Affairs, aggressively cutting off the VA officials sent to testify and promising stepped-up oversight. The House Veterans Affairs Committee hearing, which began without opening statements for the three VA officials, stretched past 10 p.m. with a second round of questioning for members (Herb, 5/28).

The Wall Street Journal: House Conservatives Push For GOP Health-Care Bill
After years of bashing the Affordable Care Act, conservative House Republicans are pushing for a vote on a GOP health-care plan to show they have a policy position beyond repealing the current law. Majority Leader Eric Cantor (R., Va.) said in January the House would vote this year on a health-care alternative. Four months later, Republican leaders are working with committee chairmen, as well as with GOP lawmakers who are also physicians, to reach a consensus on what that plan should include. Now, some lawmakers are asking to speed up the process (Peterson and Meckler, 5/28).

Politico: Steve Scalise To Push GOP Leaders On Obamacare Alternative
Rep. Steve Scalise is gearing up to put new pressure on Speaker John Boehner and other top Republican leaders to repeal Obamacare in favor of a conservative-backed health care package. Scalise (R-La.) will push for a House vote on an alternative health care plan crafted by the GOP Conference’s more hard-line members during a closed-door meeting of the Republican Study Committee on Thursday (French and Bresnahan, 5/29).

NPR: Study Questions Need For Employer Health Care Requirement
When the Affordable Care Act was unveiled, business groups railed against the provision that requires companies with 50 or more employees to provide health insurance for their full-time workers. The Obama administration responded by pushing back the deadline for the coverage, so it hasn't yet taken effect. Now support for this so-called employer mandate is eroding in some surprising quarters. A study called "Why Not Just Eliminate the Employer Mandate?" has been published by the Urban Institute, a center-left think tank based in Washington, D.C. It lists a number of reasons why dropping the mandate might be a good idea (Ydstie, 5/28).

The New York Times: Democrats, To Counter G.O.P., Turn Their Focus To Local Issues For Midterms
If Republicans are trying to nationalize the 2014 midterms, tying Democrats to President Obama and his signature health care law, Democrats considered vulnerable are countering by going local, doubling down on state-specific issues that are more typically the province of Republicans. Facing a hostile national climate — with Mr. Obama’s approval rating stalled below 50 percent and that of Congress barely in double digits — Democrats say they believe their path to victory hinges on a series of individual contests rather than a referendum on the president and his policies (Parker, 5/28).

The Wall Street Journal: Isla Vista Rampage Reanimates Debate Over Mental-Health Bill
The bill from Rep. Tim Murphy (R., Pa.) is drawing attention in light of Friday's rampage near Santa Barbara, Calif., as the failure of gun-control proposals has left mental-health legislation as the most likely response from lawmakers to a string of mass shootings in recent years. Mr. Murphy, a psychologist by training, is working with the encouragement of the House Republican leadership, who have yet to schedule it for a floor vote. But his bill is giving some lawmakers pause because it revives a long-standing question about the rights of the mentally ill to determine their own treatment. Mr. Murphy would make it easier for family members or authorities to force people to be treated even if they haven't shown themselves to be a danger to themselves or others (Hughes, 5/28).

Los Angeles Times: Senate Democrats Propose More Spending On Mentally Ill Criminals
State Senate Democrats on Wednesday offered a $165-million package of proposals aimed at reducing the number of mentally ill people locked up in prisons and jails in California. The proposals, offered just days after a disturbed student killed six people in Isla Vista, Calif., also would provide $12 million in additional funds to train law enforcement officers to recognize and handle people who may be a threat to themselves and others (McGreevy, 5/28).

NPR: The Divide Over Involuntary Mental Health Treatment
The attack near the University of California, Santa Barbara, is renewing focus on mental health and intervention programs in general — and raising questions about whether enough is being done to prevent mass shootings and other violence. In California, a 2002 law allows authorities to mandate outpatient mental health care for people who have been refusing it. Proponents argue this kind of intervention could prevent violent acts. But counties within the state have been slow to adopt the legislation, and mental health professionals are divided over its effects (Siegler, 5/29).

The Associated Press: California Rampage Shows Gaps In Mental Health Law
 Elliot Rodger's murderous rampage near Santa Barbara has tragically exposed the limitations of involuntary-commitment laws that allow authorities to temporarily confine people who are deemed a danger to themselves or others. ... Like many other states, California has a law intended to identify and confine dangerously unstable people before they can do harm. It allows authorities to hold people in a mental hospital for up to 72 hours for observation. To trigger it, there must be evidence a person is suicidal, intent on hurting others or so "gravely disabled" as to be unable to care for himself (Blood and Abdollah, 5/28).

The New York Times: Obama To Host Concussions Summit
President Obama on Thursday will seek to elevate a national conversation about the dangers of sports-related concussions, especially among children and other young athletes, by pushing for more medical research and more money spent on public awareness campaigns. The president will host a daylong summit at the White House that will include researchers, professional athletes, parents, coaches, league officials and sportscasters. Officials said the goal was to use the power of the presidency to accelerate progress on one of the most serious health issues to confront sports in a decade (Shear and Belson, 5/28).

The Wall Street Journal: White House To Focus On Sports Concussions At Summit
President Barack Obama on Thursday will host a sports summit as the White House looks to raise awareness of sports-related concussions among young athletes and start to fill in gaps in scientific research into brain injuries. Research has suggested a link between concussions and dementia, depression and other brain-related illnesses, sparking lawsuits and raising concerns for athletes. The National Football League last year reached a settlement with a group of 4,500 former players who sued it over concussion-related issues (Sparshott, 5/28).

The Washington Post: Obama To Host A White House Summit On Growing Concerns Over Sports Head Injuries
The threat of brain damage from America’s most popular sport has become a widespread cultural concern, with profound implications for professional sports, the health of athletes and worried parents across the country. Now Obama is taking the unusual step of joining the discussion, both as president and as an avid sports fan and sympathetic parent of two teenage daughters (Eilperin, 5/28).

Los Angeles Times: Private Donors Commit $65 Million To Studying Youth Concussions
Readying for a White House event Thursday focusing on youth sports and brain safety, officials announced a fresh commitment of $65 million in private funds to boost clinical and scientific work. In addition to $30 million from the NCAA and a new pledge of $25 million from the NFL for separate endeavors, a $10-million gift to UCLA from Hollywood executive and New York Giants co-owner Steve Tisch will help get a national tracking system for concussions off the ground (Healy, 5/28).

The New York Times: With Special Clinics, Hospitals Vie For Hesitant Patients: Men
NYU Langone and other medical institutions have long had services devoted to women, an outgrowth of the belief that the male-dominated medical establishment had not paid enough attention to their particular needs. Now men are beginning to get equal treatment as hospitals try to take advantage of an enormous untapped market: men who, studies show, avoid doctors for virtually anything short of a bullet wound. The new clinics offer one-stop shopping for services ranging from heart monitoring to hair removal to hormone therapy, from the life-prolonging to the life-enhancing, if medically debatable (Hartocollis, 5/28).

The New York Times: Cool And Calm At Center Of An E.R. Maelstrom In The Bronx
Dr. Jara has become an expert at juggling patients while running what may be the single busiest emergency room in New York City. As chairman of the emergency medicine department at Lincoln Medical and Mental Health Center, he and his staff handled a staggering 173,000 visits in 2013, from patients who showed up with everything including gunshot wounds and chronic conditions like asthma, diabetes and hypertension. Many of them had no health insurance, no access to regular checkups and nowhere else to turn (Hu, 5/28).

The Associated Press: Abortion Doctors Restrictions Take Root In South
From Texas to Alabama, laws are being enacted that would greatly restrict access to abortion, forcing many women to travel hundreds of miles to find a clinic. The laws, requiring abortion doctors to have privileges to admit patients to local hospitals, could have a profound impact on women in poor and rural sections of the Bible Belt (Pettus, 5/28).

The Washington Post: School Cafeteria Food Fight Becomes An All-Out Food War
The nation’s school cafeteria food fight escalated Wednesday as lobbying groups, the Secretary of Agriculture and even a group of retired generals weighed in on whether the new federal school lunch program is working effectively --  or needs to be put on hold. The House Appropriations Committee is expected to vote Thursday on legislation that would grant waivers to school districts that report they are having financial problems as they comply with the dietary requirements of the Healthy Hunger-free Kids Act, which passed in 2010. First Lady Michelle Obama came out swinging against the waiver idea on Tuesday (Hamburger, 5/28).

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