KHN Morning Briefing

Summaries of health policy coverage from major news organizations

In This Edition:

From Kaiser Health News - Latest Stories:

Kaiser Health News Original Stories

Medicaid To Fund More Addiction Treatment

Some Medicaid plans will now get federal funding for 15 days of inpatient treatment. But Pennsylvania fears the new rule will close a loophole the state has been using to pay for longer stints. (Ben Allen, WITF, 1/7)

Political Cartoon: 'Who Needs Health Insurance?'

Kaiser Health News provides a fresh take on health policy developments with "Political Cartoon: 'Who Needs Health Insurance?'" by Darrin Bell.

Here's today's health policy haiku:


Another repeal?
To show where Obama stands?
Ummm, he will veto.

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

Republicans Send Symbolic Health Law Repeal To Obama

The house passed the measure, 240-181, on Wednesday. It also includes a measure to defund Planned Parenthood. The vote highlights the partisan discord over the Affordable Care Act that hasn't faded over the last six years.

Reuters: Congress Sends Bill To Gut Obamacare, To Certain Veto
The U.S. Congress on Wednesday approved legislation dismantling President Barack Obama's signature health care plan, putting on his desk an election-year measure that faces a certain veto. ... The Republican-run House of Representatives finalized passage on Wednesday on a 240-181 vote, sending the bill to the White House. Republican leaders are expected to try to override Obama's promised veto, but they lack the two-thirds majority needed to do so. (Cornwall, 1/6)

The New York Times: House Votes To Send Bill To Repeal Health Law To Obama’s Desk
While Democrats dismissed the bill — which would also remove funding for Planned Parenthood — as another ploy in the partisan drama that has played out in the Capitol since the law was enacted in 2010, the vote proved that a Republican congressional majority could deliver a measure that repeals the health law to a Republican president, even in the face of united opposition from Democrats. It also shows that nearly six years after its enactment, the law remains a divisive political issue not only because it is associated with Mr. Obama, but also because for much of the middle class, it is at least perceived as costly and lessening consumer choice, polls show. (Steinhauer, 1/6)

Politico: Congress Sends Obamacare Repeal To President's Desk
House Speaker Paul Ryan has vowed that Republicans will offer their Obamacare alternative this year — a familiar promise Republicans have made since it became law in 2010. "The people deserve a truly patient-centered health care system. And ultimately, this is going to require a Republican president," Ryan said. (Ehley, 1/6)

Fox News: Congress Sends Health Law Repeal To Obama's Desk For First Time
House Speaker Paul Ryan's next goal is to engineer and pass a bill – also for the first time – to replace the Affordable Care Act. Doing so could help Republicans respond to Democrats’ allegations that they have no viable alternative. Ryan is tempering expectations for the GOP in this exercise. In a recent meeting with reporters, the speaker indicated that the House was practically obligated to pass a health care reform replacement bill. He was confident the House could do so this year but underscored that he didn’t say the president would sign the legislation into law. (1/6)

The Hill: House Passes ObamaCare Repeal, Sending Measure To President
Republicans say they are playing the long game with the repeal vote, hoping it will give voters a glimpse of how they would govern if they win back the White House in November. All of the GOP’s presidential hopefuls have expressed support for rolling back the law. Democrats scoff at the idea of a Republican replacement for ObamaCare. (Sullivan, 1/6)

Modern Healthcare: House Passes ACA Repeal
Republicans in Congress have achieved their longtime goal of sending a bill repealing the Affordable Care Act to President Barack Obama, who is certain to veto it. The House Wednesday evening passed the bill 240-181, with Representatives almost entirely voting along party lines. (Muchmore, 1/6)

The Huffington Post: Congress Votes Yet Again To Defund Planned Parenthood
The 114th Congress will kick off the new year on Wednesday by voting an eighth time to strip federal funds from Planned Parenthood, the nation's largest family planning provider, because its health services include abortion. The House of Representatives is expected to pass a budget reconciliation bill that guts the Affordable Care Act, pulls roughly $450 million in federal assistance from Planned Parenthood and prevents Medicaid recipients from getting reimbursed for their visits at Planned Parenthood clinics. (Bassett, 1/6)

Judge Dismisses Ohio Attorney General's Challenge To Health Law Tax

The lawsuit brought by Attorney General Mike DeWine argued that there is no precedent allowing the collection of millions of dollars from government entities. Meanwhile, the Connecticut Mirror offers consumers information about Obamacare tax forms.

The Associated Press: Judge Dismisses Ohio Lawsuit Over Health Care Law Tax
A tax levied on state and local governments under President Barack Obama's federal health care overhaul is constitutional, a judge ruled, dismissing a lawsuit by Ohio Attorney General Mike DeWine. The 2015 lawsuit argued there was no precedent allowing the collection of approximately $6.4 million the previous year from government entities and nothing in the federal health care law that allowed such a tax. (Welsh-Huggins, 1/6)

Incoming La. Governor Sets Aggressive Medicaid Expansion Deadline

Democrat John Bel Edwards says he will issue an executive order within 24 hours of being sworn into office so that people can have access by July 1.

The Associated Press: Edwards Sets July 1 Date For Planned Medicaid Expansion
Gov.-elect John Bel Edwards has set an ambitious timeline for a Medicaid expansion, saying he wants to have government-funded health insurance cards in thousands more people's hands by July 1. To make that happen, his new health care leader said Louisiana will have to hire nearly 250 new health department workers to handle the enrollment and find the dollars to pay them, in a state saddled with deep budget problems. (Deslatte, 1/6)

Meanwhile, in other news about Medicaid -

Kaiser Health News: Turning To Medicaid To Insure Lowest-Paid Employees
Companies must offer affordable coverage to all employees and will be subject to a penalty if their workers instead turn to the health exchange to buy subsidized coverage. There's no penalty for companies, it turns out, if workers qualify for Medicaid — though there could be controversy. ... Wal-Mart, McDonald's and some other large companies have drawn fire for not providing employees with health insurance, instead relying on taxpayers to fund workers' health needs via Medicaid. (Mogul, 1/7)

Kaiser Health News: Medicaid To Fund More Addiction Treatment
For decades, if someone on Medicaid wanted to get treatment for drug or alcohol addiction, they almost always had to rely solely on money from state and local sources. Now, in a dramatic shift, the federal government is considering chipping in, too. The agency that governs Medicaid is proposing to cover 15 days of inpatient rehab per month for anyone enrolled in a Medicaid managed care plan. (Allen, 1/7)

Survey Shows Progress Slowing On Reducing The Number Of Americans Without Health Insurance

However, a Health Affairs report finds little evidence the health law has pushed people out of full-time employment.

Marketplace: The Effect Of Obamacare On Employment
A new report in the journal Health Affairs finds little evidence that the health care law is pushing people out of full-time work. In 2015, companies with 100 or more employees had to start offering coverage to anyone working at least 30 hours — or face fines. (Gorenstein, 1/6)

News outlets also report on the impact of shuttered health insurance co-ops in New York and Colorado —

Albany (N.Y.) Times Union/Houston Chronicle: $200 Million Tax Hike Possible After Health Co-Op Collapse
Plagued by inadequate funds to cover their claims, Health Republic was shut down by state regulators in November. Similar scenarios have played out nationwide, with 12 of 23 co-ops closing this year. Some have asserted that co-op rates might have been unrealistically low given the high cost of health care. Monthly costs under Health Republic were in some cases hundreds of dollars less than those of other plans. (Karlin, 1/6)

The Associated Press: Officials: Hospitals, Doctors Owed $200M Over Failed Insurer
Hospitals and doctors told New York senators Wednesday they've got $200 million or more in unpaid bills because of last year's financial failure of the insurance cooperative Health Republic, and they want the state to step in. Other insurers and care providers who met at the Capitol also questioned the state Department of Financial Services' methods for setting insurance rates lower than Health Republic had requested and obviously needed. (Virtanen, 1/6)

The Denver Post: Colorado Health Co-Op's Shutdown Leaving Many Uninsured
Less than half of the Colorado residents who lost their medical insurance when Colorado HealthOp folded have found new policies through the state health exchange. The numbers suggest that tens of thousands of people have decided to risk going without insurance this year instead of paying much higher prices for health coverage — although some are likely to have found policies outside the exchange. (Olinger, 1/6)

Capitol Hill Watch

Doctors, Advocates Worry New Gun Rule May Exacerbate Mental Health Stigma

Some are concerned that President Barack Obama's new FBI reporting regulation, a measure that is part of his efforts to curb gun violence, has escalated tensions on Capitol Hill surrounding mental health legislation and could reinforce stigma around receiving treatment. Meanwhile, lawmakers have proposed a bipartisan bill expanding a 2014 law to create community mental health clinics.

The New York Times: Under Gun Rules, F.B.I. Will Receive Health Data
Responding to Republicans who have repeatedly tied gun violence to mental health issues, President Obama’s new gun control plan will allow state agencies and the Social Security Administration to provide certain “protected health information” to the F.B.I. to help crack down on weapons sales to people who pose a danger to themselves or others or are unable to manage their own affairs. ... The Obama administration said the final rule “balances public safety goals with important patient privacy interests.” Many mental health professionals agree. But some doctors and lawyers said the rule could add to the stigma of mental illness and deter people from seeking treatment. (Pear, 1/6)

Modern Healthcare: HIPAA Rule Change Part Of Move To Fight Gun Violence
Only a few healthcare organizations report to the federal database that conducts background searches on people who want to buy guns, but those groups will get a little more latitude through a final HHS rule that's part of a White House package announced this week aimed at combating gun violence. (Conn, 1/6)

The Washington Post: Mental Health Legislation Complicated By Gun Control Debate
For a long time, the Republican response to more gun control was to double down on calls for better mental-health services to catch disturbed shooters who shouldn’t have access to guns. But the renewed focus on gun control in the wake of President Obama’s proposals may just exacerbate existing tensions on mental-health efforts that advocates hoped would gain momentum in 2016. (Demirjian, 1/6)

The Hill: Lawmakers Propose Bipartisan Bill To Boost Mental Health Funding
Sens. Debbie Stabenow (D-Mich.) and Roy Blunt (R-Mo.) on Wednesday announced they are introducing a bipartisan bill to increase funding for community mental health clinics. The bill would expand on a 2014 law that provides funding for a trial program for eight states to create community mental health centers. The centers are to offer services such as 24-hour crisis psychiatric care. The bill announced Wednesday expands on this effort by providing funding for 24 states to have the new clinics, an increase from the eight states designated in the 2014 law. While the bill is still being finalized, Stabenow’s office said it expects the measure to provide around $1.7 billion in new funding. (Sullivan, 1/6)

In Washington state, Gov. Jay Inslee follows the president's lead —

Campaign 2016

GOP Candidates' Lack Of Unified Health Platform May Come To Define Party's Agenda

Experts warn that congressional leaders need to establish a clear health message for the Republican presidential field before front-runner Donald Trump's unorthodox ideas dominate the conversation. In Iowa, Ben Carson says he wants to replace the Affordable Care Act with "health empowerment accounts." Meanwhile, the Democratic candidates spar over health care in Nevada.

Los Angeles Times: Republicans Push Again For An Obamacare Alternative, With Donald Trump A Looming Worry
Even as congressional Republicans celebrated their latest symbolic jab at the Affordable Care Act, the GOP confronts an increasingly urgent challenge to develop a meaningful alternative in the face of Donald Trump’s enduring candidacy. More than five years after the health law was enacted, the party still has no unifying healthcare platform. And if Trump extends his run atop the Republican presidential field, his unorthodox healthcare positions may soon define the GOP. (Levey, 1/6)

Iowa Public Radio: Carson Wants To Replace Obamacare With "Health Empowerment Accounts"
Republican presidential candidate Ben Carson says he plans to repeal the Affordable Care Act, and replace it with what he calls, “health empowerment accounts.” During a town hall meeting in Panora on Wednesday, the retired neurosurgeon described health empowerment accounts as health-savings accounts, "but with no bureaucrats.” Everyone with a Social Security number would get an account, and families would be able to shift money among themselves to pay for medical care. (Boden, 1/6)

The Washington Post: Clinton, Sanders Make Competing Cases For Electability In Nevada
[At the Nevada Democratic Party’s “Battle Born Battleground” dinner] Hillary Clinton cited progress made on health care under President Obama and warned against “tearing up the Affordable Care Act.” That was a not-so-subtle jab at Sanders, who has proposed moving to a single-payer system. During his remarks, Bernie Sanders credited Obama for making progress in reducing the number of uninsured but said “we must do better.” “The time is long overdue for this great country to join to the rest of the industrialized world and pass a Medicare for all single-payer program,” Sanders said. (Phillip and Wagner, 1/7)

Elsewhere, following the president's executive action on gun control, Ohio Gov. John Kasich is left to defend how he expanded Medicaid in the state —


High Drug Costs Make Some Cures, Precision Medicine Unaffordable For Many Patients

In other news, Bloomberg reports that Valeant's ailing CEO faces contractual and payout issues if he resigns for medical reasons.

USA Today: Skyrocketing Drug Prices Leave Cures Out Of Reach For Some Patients
Sophisticated drugs are opening the door, scientists say, to an era of "precision medicine." They're also ushering in an age of astronomical prices. Even with insurance, patients might pay thousands of dollars a month out of pocket. But patients aren't the only ones paying. Taxpayers underwrite the cost of prescription drugs provided by Medicare, Medicaid and other public insurance programs. (Szabo, 1/6)

Bloomberg: For Valeant's Ailing Chief Executive, It Wouldn't Pay To Leave
If Michael Pearson leaves Valeant Pharmaceuticals International Inc. now, it would be without a parachute. Two potential payouts would disappear should the drug company’s ailing chief executive resign for medical reasons. At the moment, he appears unlikely to return to work quickly, and on Wednesday the company appointed an interim leader. Pearson’s employment contract states that if he steps down for “good reason,” such as a demotion, he would be entitled to a $9 million cash severance. An exit for medical causes wouldn’t trigger the payout, according to the contract. (Melby and Weinberg, 1/7)

And the Dementia Discovery Fund invests $100 million in a new avenue of Alzheimer’s research —

The Wall Street Journal: Dementia Discovery Fund Chooses Alector For First Investment
A promising new avenue in Alzheimer’s research that focuses on the eradication of brain plaque by the immune system has become the first investment for a $100 million fund dedicated to delivering new dementia drugs within a decade. The Dementia Discovery Fund, set up last year with backing from the U.K. government and several of the world’s biggest pharmaceutical companies, has led a $29.5 million investment round to back research under way at San Francisco-based Alector LLC. (Roland, 1/7)

Public Health And Education

Research Finds Link Between Sleep Apnea And Cholesterol

The findings suggest that cholesterol-lowering statins could limit the cardiovascular damage sleep apnea causes. In other news, the Obama administration's new dietary guidelines back off earlier sodium rules, say lean meats are OK and still recommend cutting out added sugars.

NPR: Cholesterol Provides A Clue About Heart Risks From Sleep Apnea
Soon after many people fall asleep, they have trouble breathing. Their upper airway constricts and chokes them. They wake, startled, take a deep breath, and fall back to sleep. This condition, obstructive sleep apnea, affects about a fifth of American adults and triples the risk for cardiovascular disease. How exactly has been unclear. Research published Wednesday suggests that cholesterol, a common culprit in heart disease, plays a special role in raising risk for people with sleep apnea. (Chen, 1/6)

The Associated Press: New Dietary Guidelines: Lean Meat OK, Cut the Added Sugars
Some Americans may not have to cut back on eggs and salt as much as they once thought. And eating lean meat is still OK. But watch the added sugars — especially the sugary drinks. The Obama administration's new dietary guidelines, released Thursday, back off the strictest sodium rules included in the last version, while still asserting that Americans consume too much salt. The guidelines reverse previous guidance on the dangers of dietary cholesterol and add strict new advice on sugars. (Jalonick, 1/7)

The Hill: New Obama Guidelines: Lean Meat Has Role In Healthy Diet
New federal dietary guidelines, which dropped early Thursday morning, tell Americans to follow a healthy eating pattern that includes a variety of vegetables, fruit, grains, fat-free dairy, oils and a variety of proteins, including lean meats. The recommendations for what Americans should and shouldn't be eating, which the U.S. Department of Agriculture and the Department of Health and Human Services update together every five years, created unprecedented controversy in 2015 when the federally appointed panel of nutritionists that helps draft them considered sustainability in recommending in its report that people should eat less meat because it’s better for the environment. (Wheeler, 1/7)

News outlets report other public health developments related to the Chipotle contaminations, birth defects, brain injuries and cancer screenings —

The Chicago Tribune: Feds Probing Norovirus Outbreak At Chipotle
Chipotle's bad winter is getting worse. A series of high profile foodborne illness outbreaks at the Mexican restaurant chain has meant a slew of lawsuits and a 43 percent drop in its stock price in less than three months— and now the company has been served with a federal grand jury subpoena as part of a criminal investigation of an outbreak of norovirus in California. (Janssen and Channick, 1/6)

NPR: Study Finds Birth Control Pill Use Isn't Associated With Birth Defects
Pregnant women worry about all kinds of things. Now there's one less thing to fret about: harm to the baby when the mother takes birth control pill right before conceiving, or during the first few months of pregnancy. According to a study covering more than 880,000 births in Denmark, the overall rate of birth defects was consistent for women who had never taken the pill at all, for those who had used it before getting pregnant and for those who continued on the pill in early pregnancy. (Hobson, 16)

NPR: How A Simple Bump Can Cause An Insidious Brain Injury
It's not just football players or troops who fought in the wars who suffer from brain injuries. Researchers estimate that hundreds of thousands of ordinary people in the U.S. get potentially serious brain injuries every year, too. Yet they and even their doctors often don't know it. One such doctor is Bryan Arling, an internist in Washington, D.C. His peers often vote to put him on those lists of "top doctors," published by glossy magazines. So it's ironic that the brain injury he failed to diagnose was his own. And he could have died from it. (Zwerdling, 1/6)

Reuters: Does Cancer Screening Saves Lives? Unclear, Researchers Say
Bigger studies are needed to tell whether cancer screening really saves lives, according to a new analysis. While cancer screening may be linked to fewer deaths from tumors, finding cancers doesn't necessarily save lives when fatalities from all causes are taken into account, the authors point out. (Rapaport, 1/6)

State Watch

California Governor's Budget Will Revamp Health Plan Tax

The tax would replace California’s current tax on health plans that participate in Medi-Cal, which provides state-subsidized health care to the poor. The Obama administration has said the tax must be overhauled to include all health plans.

Los Angeles Times: Gov. Jerry Brown's State Budget Is Set To Include A Revised Healthcare Tax
In an effort to break a political and policy logjam, Gov. Jerry Brown will unveil a state budget that revamps a controversial tax on health plans to avoid jeopardizing federal healthcare dollars. Sources who spoke on the condition that they not be identified prior to Brown's scheduled Thursday announcement said the reworked tax plan reflects intense behind-the-scenes negotiations with California's biggest insurance companies. (Myers and Mason, 1/6)

California Healthline: MCO Tax A Looming Question In Governor's Upcoming Budget Proposal
When Gov. Jerry Brown (D) unveils his fiscal year 2016-2017 budget proposal on Thursday, one of the big unknowns may be answered -- what he plans to do about the pending loss of the MCO tax and the $1.1 billion hole it leaves in the budget. The managed care organization tax is due to expire June 30, 2016. The state imposed a 3.9% tax on revenue generated by health plans through Medi-Cal managed care and received federal matching funds for the MCO tax. The state then reimbursed the MCOs. (Gorn, 1/6)

UnitedHealth Fined $100,000 After N.Y. Investigation Reveals Anti-Competitive Practices

Meanwhile, the insurer warns that its rates in New York may be too low because of the failure of a competing company.

Reuters: NY Orders UnitedHealth To Pay $100,000 To Settle Antitrust Probe
The New York Attorney General has ordered UnitedHealth Group to pay a $100,000 fine after an investigation found the insurance provider engaged in anti-competitive practices involving elder and long-term care products, according to a person familiar with the matter. The settlement, which was signed late Wednesday, centers on efforts by UnitedHealth to force nursing homes to purchase other additional unwanted insurance services in order to participate in the insurance carrier's broader network, the person added. (Lynch, 1/7)

Bloomberg: UnitedHealth Says N.Y. Obamacare Plans Could Be In Trouble
UnitedHealth Group Inc., the largest U.S. health insurer, said its rates for Obamacare plans in New York may be too low because the failure of a competing insurer last year might lead to shortfalls in payments designed to stabilize Obamacare markets. In states like New York, health insurers participating in the Patient Protection and Affordable Care Act negotiate annually with regulators to set prices for coverage. UnitedHealth’s rates were set anticipating risk-sharing payments designed to stabilize the new insurance markets, William Golden, the company’s northeast region chief executive officer, said Wednesday at a state Senate round table in Albany. If the loss of a participant reduces the funds available to UnitedHealth, the company’s rates in New York’s Obamacare market may be insufficient, Golden said. (Tracer, 1/6)

Sutter Health To Issue Bonds To Finance Construction Of 3 Replacement Hospitals

Meanwhile, three Connecticut hospitals are joining in a lawsuit challenging a 2013 Medicare payment decision, and an Indiana hospital is missing a USB drive that includes patient information.

The Associated Press: USB Drive With Patient Info Missing From Lafayette Hospital
Officials with Indiana University Health Arnett in Lafayette say a USB flash drive containing information from more than 29,000 patients has gone missing. The hospital says the unencrypted drive disappeared Nov. 20 from its emergency department. Norma Gilbert, the hospital's director of quality and clinical excellence, said the hospital system hadn't received any patient reports of fraudulent activity as of Tuesday. (1/6)

Weekend Reading

Longer Looks: Brain Surgery; Reunited Brothers; Singing In The Hospital

Each week, KHN's Shefali Luthra finds interesting reads from around the Web.

The New York Times: The Terrible Beauty Of Brain Surgery
That book was the reason I had come. It was called “Do No Harm,” and it was written by the British neurosurgeon Henry Marsh. His job is to slice into the brain, the most complex structure we know of in the universe, where everything that makes us human is contained, and the contrast between the extremely sophisticated and the extremely primitive — all of that work with knives, drills and saws — fascinated me deeply. I had sent Marsh an email, asking if I might meet him in London to watch him operate. He wrote a cordial reply saying that he seldom worked there now, but he was sure something could be arranged. In passing, he mentioned that he would be operating in Albania in August .... The procedure is used to remove a kind of brain tumor that looks just like the brain itself. Such tumors are most common in young people, and there is no cure for them. Without surgery, 50 percent of patients die within five years; 80 percent within 10 years. An operation prolongs their lives by 10 to 20 years, sometimes more. In order for the surgeon to be able to distinguish between tumor and healthy brain tissue, the patient is kept awake throughout the operation, and during the procedure the brain is stimulated with an electric probe, so that the surgeon can see if and how the patient reacts. (Karl Ove Knausgaard, 12/30)

STAT: In Stressful Hospital Corridors, A Singing Staffer Eases Patient Anxiety
Nervous patients heading into surgery at one Boston hospital may get an extra dose of pre-op medicine: a serenade from transport worker Lindon Beckford. That is, if he can just calm his own nerves first. Beckford spends his days wheeling patients around Beth Israel Deaconess Medical Center, a 672-bed hospital in the Longwood Medical Area. Over the past three decades, he has become known for filling the hallways with song. His melodies have caught the attention of hospital staff, who have featured his performances in an employee orientation video and even called on him to sing to a patient who was about to die. (Melissa Bailey, 1/4)

USA Today: Heart Transplants Unite Long-Lost Brothers
Aaron Arnold lay in a hospital bed, tethered to machines and gripped by fear, waiting for a new heart. Heart Transplant Coordinator Donna Dennis hoped to allay his concerns by having a former patient talk to him, and heart recipient Kenneth Arnold Catlett was happy to oblige. But as soon as Catlett opened the door, the recognition on Arnold's face was immediate, and everyone realized this was no ordinary meeting between patients. “Hey, I know this guy," Arnold exclaimed. "It’s my brother!” The two men hadn’t seen each other in about 20 years, having grown up apart, met as young adults and lost touch. (Laura Ungar, 12/29)

The Milwaukee Journal-Sentinel: Danger Brewing For Coffee Roasters
A system that tracked patients by occupation could have helped doctors spot and prevent — decades ago — what the Journal Sentinel has now uncovered: Workers from multiple coffee plants with signs of respiratory illness that medical experts suspect could be linked to their jobs roasting and grinding coffee. The discovery is part of an ongoing investigation, Gasping for Action, that has exposed how diacetyl — a chemical known for destroying lungs of microwave popcorn workers in the early 2000s — also poses risks to coffee workers and e-cigarette users across the country. (Raquel Rutledge, 12/30)

The Atlantic: How Doctors Are Experimenting With Cutting Health-Care Costs
Being pregnant on Obamacare has given me a close-up look at the potholes of America’s health-care system: high deductibles, redundant or unnecessary procedures that get charged against those high deductibles, and the lack of listed prices for procedures (which makes shopping for the best deal difficult), to name a few. But my pregnancy has also made me fascinated with the details of how providers, patients, and insurance companies navigate this terrain. Better still, it has exposed me to inventive ideas that are being experimented with in different parts of the country. (Ester Bloom, 12/30)

NPR's Fresh Air: Paramedic Shares His Wild Ride Treating 'A Thousand Naked Strangers'
In the 10 years he spent driving an ambulance in Atlanta, former paramedic Kevin Hazzard rescued people from choking, overdoses, cardiac arrest, gunshot wounds and a host of other medical emergencies. He frequently found himself practicing medicine in unsafe settings, either along the side of a highway as cars whipped past, or at the scene of an assault, where either the patient or the spectators might have weapons. Podcast. (1/5)

Pacific Standard: The Little Pink Pill That Sparked A Feminist War
Last October, the first medication designed to treat low sexual desire in women hit the market. Depending on who you believe, flibanserin (sold under the brand name Addyi) is either a safe and effective treatment for the most common form of female sexual dysfunction, or “a mediocre aphrodisiac with scary side effects.” To some, its approval by the Food and Drug Administration represented a long-overdue feminist victory for equality in sexual health; to others, it seemed like the product of a clever faux-feminist con carefully orchestrated by Big Pharma. (Maya Dusenberry, 1/5)

Vox: The Zika Virus May Cause Birth Defects — And Experts Think It's Coming To The US
The Zika virus, a rare tropical disease that's causing a panic in Brazil — because it may lead to babies being born with abnormally small heads — has now made its way to Puerto Rico. And experts fear the mainland United States could be next. Until last year, the Zika virus, which is spread by mosquitoes, was mainly confined to Africa and Asia. But in 2015 the disease made the leap to the Western Hemisphere, affecting more than a million people in Brazil. It's since spread to Colombia, Venezuela, Mexico, and nine other countries. Last week, the first confirmed case in Puerto Rico was reported. (Julia Belluz, 1/5)

Editorials And Opinions

Viewpoints: Jeb Bush On His Family's Addiction Crisis; Don't Penalize Doctors For Prostate Tests

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

The Chicago Tribune: Jeb Bush Op-Ed: A Father's View Of Drug Addiction
As a father, I have felt the heartbreak of drug abuse. My daughter, Noelle, suffered from addiction, and like many parents facing similar situations, her mom and I struggled to help. I have so many friends and know so many families who have faced this terrible challenge. Addiction crosses all barriers, all lines, all races and all incomes. It creates real hardship and heartbreak in families. And, it places substantial demands on government at every level. (Jeb Bush, 1/6)

The New York Times: Why Doctors Shouldn’t Be Punished For Giving Prostate Tests
Both of us have raised serious questions about prostate cancer screening. Nevertheless, we hope Medicare chooses not to pursue a strategy of penalizing doctors for ordering prostate-specific antigen, or PSA, tests. ... Screening is really good at finding [nonlethal] cancers, and the prostate gland is full of them. Over half of men age 60 and older have small, indolent, nonlethal prostate cancers — many more than those who have harmful ones. That’s why men are much more likely to die with prostate cancer than from it. (H. Gilbert Welch and Peter C. Albersen, 1/7)

Bloomberg: Getting The Pill Without A Doctor: The Revolution Begins
Oregon is making hormonal birth control legally available without a doctor's prescription, and California is set to follow suit. This is great policy, and the rest of the country should follow this example. Before I explain why they should, we should dispense with the policy hopes that easier access to birth control won’t fulfill. (Megan McArdle, 1/6)

The Huffington Post: The Latest Obamacare Repeal Vote Is The Most Pointless Yet
A mere 2,116 days after Obama signed the Affordable Care Act, the House voted 240-181 Wednesday on a Senate-passed measure to eliminate the most important parts of Obamacare. ... The next thing that will happen is the repeal bill will speed its way to Obama's desk, where he will promptly veto it and carry on with whatever else he was doing. Self-congratulatory press conferences won't change the fact that Republicans haven't actually repealed anything and are nowhere near proposing their long-awaited "replacement" plan, despite new pledges from House Speaker Paul Ryan (R-Wis.) and other leaders. (Jeffrey Young, 1/6)

The Washington Post: Paul Ryan’s Tricky Balancing Act Is Working. So Far, Anyway.
The president will of course veto the bill, but as Majority Leader Kevin McCarthy puts it, that’s the goal: “With this bill, we will force President Obama to show the American people where he stands.” At last, the American public will finally learn whether Barack Obama supports Obamacare. Your days of keeping the public in the dark about this are over, Mr. President! Meanwhile, a spokesperson for Heritage Action, which exists to enforce conservative purity, has this to say about Congressional Republicans: “Now, we have some reason to believe they will actually deliver on that promise” to repeal the law. Because the first 61 votes left things in doubt. (Paul Waldman, 1/6)

JAMA: JAMA Forum: Choices In Health Care Are Important And Hard To Get Right
There are few certainties in life, but you can count on these: death, taxes, and having to make a lot of choices about your health care. From selecting a health plan to choosing a physician to deciding among various treatments, health care in the United States is all about choice. Studies show that in making these choices, mistakes are common, as is overconfidence. (Austin Frakt, 1/6)

Seattle Times: Raise Medicaid Reimbursement Rate So All Children Can Access Quality Health Care
Imagine a world where kids on Medicaid with symptoms ... could find care at their local pediatrician’s office, instead of landing in the emergency department where an evaluation costs four times as much and the physicians are strangers. Taxpayers would save money by preventing illness, decreasing unnecessary emergency-room visits and reducing hospital admissions. How might we make this vision a reality? The answer lies in providing all children, rich or poor, equal access to medical care by raising Medicaid reimbursement rates. (Andrea Posa and Michael Dudas. 1/6)

Raleigh News & Observer: Sensible Medicaid Reform For North Carolina
The North Carolina General Assembly made a bold decision at the end of its uncommonly long session last fall. Legislators decided to invite managed care organizations as well as provider-led entities to administer our state’s Medicaid program, which provides health care for the approximately 2 million North Carolinians who have no other option to get the care they often desperately need. ... This massive shift in how Medicaid is run requires an enormous amount of planning, analysis and expertise to ensure that patients have access to and receive proper care and that those providing the care are treated fairly. (Docia Hickey, 1/6)

The New England Journal of Medicine: Accountable Health Communities — Addressing Social Needs Through Medicare And Medicaid
For decades, experts have described a profound imbalance between public funding of acute medical care and investments in upstream social and environmental determinants of health. By some estimates, more than 95% of the trillion dollars spent on health care in the United States each year funds direct medical services, even though 60% of preventable deaths are rooted in modifiable behaviors and exposures that occur in the community. ... As health systems are increasingly being held accountable for health outcomes and reducing the cost of care, they need tools and interventions that address patient and community factors contributing to excess utilization. (Dawn E. Alley, Chisara N. Asomugha, Patrick H. Conway and Darshak M. Sanghavi, 1/5)