KHN Morning Briefing

Summaries of health policy coverage from major news organizations

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Podcast: 'What The Health?' Health Plans Busting Out All Over

In this episode of “What the Health?” Julie Rovner of Kaiser Health News, Joanne Kenen of Politico, Margot Sanger-Katz of The New York Times and Stephanie Armour of The Wall Street Journal discuss Democratic, Republican and bipartisan health proposals all being pursued in Congress, including the latest version of Sen. Bernie Sanders’ (I-Vt.) “Medicare-for-All” proposal. Plus, for “extra credit,” the panelists recommend their favorite health stories of the week. (9/13)

Political Cartoon: 'Pain In The Rear?'

Kaiser Health News provides a fresh take on health policy developments with "Political Cartoon: 'Pain In The Rear?'" by Bob and Tom Thaves.

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Health plan coverage
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Without change midstream.

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Summaries Of The News:

Capitol Hill Watch

Unveiled Health Care Bills Show Just How Far Apart Parties Are Despite Ongoing Bipartisan Efforts

As the Senate Health, Education, Labor and Pensions Committee races to find bipartisan fixes to stabilize the Affordable Care Act marketplaces, two groups of senators release controversial health care bills designed to replace the current system in very different ways. It's unlikely either will pass, but those continued efforts shine a light on how difficult it will be to get lawmakers to agree on a solution.

The New York Times: Medicare For All Or State Control: Health Care Plans Go To Extremes
In one Senate office building, some of the leading lights of the Democratic Party gathered Wednesday to embrace what was once a proposal only of the far left: a huge expansion of Medicare, large enough to open the popular, government-run health program to all Americans. In another Senate office building, a smaller but equally adamant group of Republican senators stood together to take one last stab at dismantling the Affordable Care Act. They proposed instead to send each state a lump sum of federal money, along with sweeping new discretion over how to use it. (Pear, 9/13)

The Wall Street Journal: Senate Backpedals On Bipartisan Approach To Health Law
A week after Republicans and Democrats held the first bipartisan hearing on ways to fix the 2010 health-care law, the Senate was once more divided on Wednesday, with one side continuing efforts to undo the ACA and the other pushing to expand government-sponsored health coverage. Neither plan holds any appeal to the opposite party, and they lack even full support from their respective caucuses. That leaves the question of how Congress can move ahead on health care amid a widespread perception that the ACA is flawed but that Republicans don’t have a politically viable replacement. (Hackman, 9/13)

Los Angeles Times: Bipartisan Effort To Stabilize Health Insurance Markets Is Coming Down To The Wire
Despite broad support from consumer advocates, state officials and healthcare leaders across the country, a bipartisan effort in Congress to stabilize health insurance markets and control rising premiums is being threatened by resurgent political fighting over the Affordable Care Act. With time running out before millions of Americans could be subject to major rate hikes, it is increasingly unclear if Congress will be able to come together to offer relief. (Levey, 9/13)

The Hill: Trump Is 'Open' To ObamaCare Fix, Lawmakers Say 
President Trump was "open" to the idea of a bipartisan ObamaCare stabilization bill but did not make any commitments during a meeting Wednesday with a group of House lawmakers, attendees said. The bipartisan group of lawmakers, known as the Problem Solvers, pitched Trump on their plan to stabilize ObamaCare markets. (Sullivan, 9/13)

Seattle Times: Sen. Patty Murray Is Working With Republicans On Obamacare Fix 
During her re-election campaign last fall, Sen. Patty Murray promised repeatedly to work with Republicans to break gridlock in Congress. That promise was quickly put to a stiff test after the presidential election by the partisan chasm on health care. President Trump and the GOP pushed to repeal Obamacare, and Murray’s conciliatory campaign prose turned combative. At times, Murray, who has a record of bipartisan deal-making, sounded like a partisan warrior. (Kelleher, 9/13)

Kaiser Health News: Podcast: ‘What The Health?’ Health Plans Busting Out All Over
In a busy health week for Congress, Republicans and Democrats on the Senate Finance Committee agreed on a proposal to fund the Children’s Health Insurance Program for five more years, while Republicans and Democrats at the Health, Education, Labor and Pensions Committee continued to pursue a joint plan to stabilize the individual health insurance market. (9/13)

Sanders Releases Single-Payer Proposal: 'Health Care In America Must Be A Right, Not A Privilege'

Sixteen Democratic senators support Sen. Bernie Sanders (I-Vt.) as he releases the new bill, throwing their weight behind an idea that's gaining traction with progressive voters.

The Associated Press: Sanders Would Make Government Health Care Role Even Bigger
In an animated, campaign-style rally, Sen. Bernie Sanders unwrapped his plan to remake the nation's convoluted health care system into federally run health insurance Wednesday — a costly proposal embraced by liberal activists hoping to steer the Democratic Party in upcoming elections. The Vermont independent's plan would hand government a dominant role in insuring Americans, a crucial step, he said, in guaranteeing health care for all. Census Bureau data this week showed the proportion of people lacking policies falling to 8.8 percent last year under "Obamacare," the lowest level ever recorded, but he called it an "international disgrace" that not all Americans have coverage. (Fram, 9/13)

Politico: Sanders Lays Down Marker With Ambitious Single-Payer Bid
The plan wouldn't completely wipe out private health insurance, but it would drastically shrink a system that currently covers more than 170 million Americans through their employers or on the individual market. Under Sanders' vision, health insurers would likely be relegated to covering elective procedures not covered by the government. "The average American family will be much better off financially than under the current system because you will no longer be writing checks to private insurance companies," Sanders said. (Cancryn, 9/13)

The Washington Post: Sanders Introduces Universal Health Care
“This is where the country has got to go,” Sanders said in an interview at his Senate office. “Right now, if we want to move away from a dysfunctional, wasteful, bureaucratic system into a rational health-care system that guarantees coverage to everyone in a cost-effective way, the only way to do it is Medicare for All.” Sanders’s bill, the Medicare for All Act of 2017, has no chance of passage in a Republican-run Congress. But after months of behind-the-scenes meetings and a public pressure campaign, the bill is already backed by most of the senators seen as likely 2020 Democratic candidates — if not by most senators facing tough reelection battles in 2018. (Weigel, 9/13)

Los Angeles Times: Turning Aside Risk, Democrats Rally To Bernie Sanders' Single-Payer Health Plan
In the days before Sanders’ announcement, Democrats as ideologically diverse as liberal Sen. Kamala Harris of California and conservative Sen. Joe Manchin of West Virginia expressed support for his effort. Their statements reflect a significant shift within the Democratic party, driven by multiple developments: a belief that the window has closed on Republican efforts to repeal Obamacare; a surge in support for government-run insurance among younger, more activist Democrats; and looming 2018 and 2020 contests that demand clarity on what Democrats support — not just whom they oppose. (Decker, 9/13)

San Francisco Chronicle: Bernie Sanders Kicks Off Medicare For All Proposal; Harris, More On Board
With California Sen. Kamala Harris and a handful of other liberal senators often viewed as the Democratic Party’s next generation of leaders lined up in support, Sen. Bernie Sanders introduced a plan Wednesday for a government-run health care system he called Medicare for All. The proposal, which Sanders, independent-Vt., introduced to a packed audience in the Senate’s largest hearing room, comes as several Senate Republicans are attempting to revive their party’s floundering effort to repeal and replace the Affordable Care Act with a new plan that would provide states with lump sums of federal money to provide health care. (Lochhead, 9/13)

Bloomberg: Sanders Offers Medicare-For-All Plan Backed By 16 Senate Democrats
Several Democrats, including some of Sanders’s co-sponsors, made it clear that they see the bill as one of many options toward improving the Affordable Care Act, President Barack Obama’s signature domestic accomplishment. “The principle that I support is universal, accessible, affordable quality health care for all, and I think the single-payer system is a strong articulation of the principle,” said Senator Mazie Hirono of Hawaii, a co-sponsor of the bill. (John, 9/13)

Concord (N.H.) Monitor: Shaheen, Hassan Split On Single-Payer Health Care
Sen. Jeanne Shaheen threw her support behind an expansive plan for single-payer health insurance set to be introduced by Sen. Bernie Sanders – the only member of New Hampshire’s congressional delegation to do so. In a statement Tuesday, Shaheen announced that she would support the proposed bill, known as the Medicare for All Act of 2017, which would expand insurance coverage under the present Medicare plan to all Americans, creating a single government-run plan. New Hampshire’s other senator, Democrat Maggie Hassan, released her own statement declining to support Sanders’s plan, saying she would rather focus on improving the Affordable Care Act, commonly known as Obamacare. (DeWitt, 9/13)

Boston Globe: Democrats Split Over Bernie Sanders’ Single-Payer Health Care Plan
But while support for so-called single-payer insurance has grown significantly since Sanders made the issue a bedrock of his 2016 presidential campaign, the glitzy names of top-level supporters — many of whom are prospective Democratic candidates for president in 2020 — mask a real divide among rank-and-file Democrats nationwide. As the 2018 midterm elections loom, and Democrats aim to reestablish control of Congress by winning tough seats in conservative-leaning districts, many are questioning whether a gargantuan government takeover of the health care system, and the required higher taxes to pay for it, is the right policy for an already wounded Democratic Party. (Herndon, 9/13)

The Associated Press Fact Check: Single-Payer Sounds Best When It Sounds Free
Americans are not clamoring for single-payer health care, as Sen. Bernie Sanders suggests they are, in proposing a plan that would have the government foot most medical bills. He's right that support for the idea has grown and in some polls tops 50 percent. But polls suggest that the prevailing sentiment is ambivalence. Saving money on health insurance holds lots of appeal. Seeing taxes rise to cover those costs may dull the appetite. (Woodward and Swanson, 9/14)

The Hill: White House Rips Sanders's 'Horrible' Single-Payer Plan 
The White House on Wednesday slammed the push by Senate Democrats for a single-payer health-care plan at the same time Sen. Bernie Sanders (I-Vt.) announced his proposal, calling the plan "horrible." "The president as well as the majority of the country know the single-payer system the Democrats are proposing is a horrible idea," White House press secretary Sarah Huckabee Sanders said during the daily briefing. (Kamisar, 9/13)

The Hill: Insurers Rail Against Sanders Health-Care Plan 
The main insurer trade group issued a strongly worded statement against “Medicare for all” ahead of the release of Sen. Bernie Sanders’s (I-Vt.) single-payer health-care plan. “Whether it’s called single-payer or Medicare For All, government-controlled health care cannot work,” David Merritt, executive vice president of America’s Health Insurance Plans, said in a statement Wednesday. (Roubein, 9/13)

The Hill: Sanders Enjoys Big Moment With Single-Payer Unveiling
Sen. Bernie Sanders (I-Vt.) unveiled his single-payer health-care plan in a jam-packed Senate hearing room on Wednesday and to millions more watching online and on cable television, highlighting his newfound status as a Capitol Hill power player. ... In 2013, no one co-sponsored a similar Sanders single-payer bill, and in 2015, when he announced his long-shot presidential bid, a relatively small group of reporters showed up to a park outside the Capitol. At his hourlong announcement on Wednesday, Sanders spoke to a crowd of about 300, and at times shared the stage with other Democratic stars — and potential rivals if he decides to make another White House run in 2020. (Roubein and Hellmann, 9/13)

Roll Call: Bernie Sanders, The Man With Single-Payer Clout
[Sanders' plan] also provided a welcome talking point for Republicans who have long railed against government-run health care. Several GOP senators used Sanders’ legislation as a tool to warn voters of what could come if Republicans are unable to overhaul the health care system. (Williams, 9/14)

The Hill: House GOP Campaign Arm Targets Dems On Single-Payer Support 
The House GOP's campaign arm is targeting Democrats over their support of a government-run health-care system, commonly referred to as single-payer. In a new digital ad released Wednesday, the National Republican Congressional Committee instructs viewers to tell Democrats that "single-payer is not an option." (Hellmann, 9/13)

What Is Single Payer? Why Now? And More Questions About Sanders' New Bill Answered

Media outlets take a look at the ins and outs of Sen. Bernie Sanders' new "Medicare for all" plan.

The Hill: Five Things To Know About Sanders’s Single-Payer Plan 
Sen. Bernie Sanders (I-Vt.) rolled out his “Medicare for all” health-care bill to much fanfare on Wednesday. While the bill has no chance of passing in the current GOP-led Congress, it is a marker of where the Democratic Party is heading. Here are five things to know about the plan. (Sulivan, 9/13)

Bloomberg: What You Need To Know About ‘Medicare For All’ 
In most of the developed world, everybody’s health care is paid for by the government. In the U.S., for years that idea has been relegated to the far-left edge of politics under the name of single payer. Last year, Senator Bernie Sanders, an independent of Vermont called it “Medicare for All” and put it at the forefront of his campaign for the Democratic presidential nomination. Now, with liberals revved up by their so-far successful fight to protect Obamacare from President Donald Trump and a Republican Congress, Sanders’s idea is getting some support. The legislation he introduced today would build on Medicare, the hugely popular insurance program for those over 65, to provide coverage to all Americans. (Edney and Tracer, 9/13)

Graham-Cassidy Bill Proposes State-By-State Block Grants As Solution To Health Insurance Woes

The measure, crafted by Sens. Lindsey Graham (R-S.C.) and Bill Cassidy (R-La.), is a last-ditch effort to repeal and replace the Affordable Care Act. It has long odds of getting anywhere, although President Donald Trump did applaud their efforts.

The Washington Post: GOP Tries One More Time To Undo ACA With Bill Offering Huge Block Grants To States
With just 17 days left for Republicans to repeal the Affordable Care Act on a party-line vote, a quartet of GOP senators on Wednesday rolled out a plan to devolve federal health care spending into state-by-state block grants — legislation that South Carolina Sen. Lindsey O. Graham described as conservatives’ last shot at reform. “It should have been our first bill to repeal and replace Obamacare, but it is now our last,” Graham said at a morning news conference. “To those in the Republican Party who feel like we have not fought as hard as we could, you’re right.” (Weigel and Goldstein, 9/13)

Politico: Graham, Cassidy Unveil Last-Ditch Obamacare Repeal Bill
Sens. Lindsey Graham, Bill Cassidy, Dean Heller and Ron Johnson on Wednesday released an Obamacare repeal bill, framing it as the last, best hope to fulfill the GOP's promise to undo the health law. "There's a lot of fight left in the Republican Party" on repeal, Graham said. The bill faces long odds: Even some of its GOP backers say it would be almost impossible to get a massive rewrite of the health care system through the Senate within 17 days, or before the expiration of fast-track procedural powers Republicans hope to use to bypass the threat of a Democratic filibuster. (Haberkorn, 9/13)

The Hill: GOP Senators Make Last ObamaCare Repeal Pitch
Sens. Bill Cassidy (R-La.), Lindsey Graham (R-S.C.), Ron Johnson (R-Wis.) and Dean Heller (R-Nev.) argued at a press conference that their party should not give up on repealing the health law. But they face extremely long odds in trying to win 51 votes before a fast-approaching procedural deadline on Sept. 30. “This is our last shot,” Johnson said. (Sullivan, 9/13)

Modern Healthcare: Hospitals Fear New GOP Block-Grant Bill Would Slash Medicaid Funding
Four Republican senators unveiled a radical proposal Wednesday to repeal and replace the Affordable Care Act by handing states $1.2 trillion in ACA subsidies through 2026 and letting them design their own coverage systems with few limitations on what they could do. Sens. Lindsay Graham, Bill Cassidy, Dean Heller, and Ron Johnson acknowledged that their bill probably represents Republicans' last chance to undo Obamacare. ... And they warned that if their bill isn't passed, it's likely that the country will get a government single-payer health insurance system. (Meyer, 9/13)

Bloomberg: Trump Says He Applauds Last-Ditch Obamacare Repeal Proposal
President Donald Trump let Republican senators working on an eleventh-hour effort to repeal Obamacare know he is rooting for them, without explicitly supporting the legislation.GOP senators Lindsey Graham, of South Carolina, and Bill Cassidy, of Louisiana, introduced a bill Wednesday to repeal the Affordable Care Act and replace it with block grants to states, who would determine how to help people pay for health care. Their effort comes as Tennessee Republican Senator Lamar Alexander is working with Washington Democratic Senator Patty Murray to craft a bipartisan, short-term Obamacare fix. (Edney and Litvan, 9/13)

The Hill: Trump Applauds Republican Senators For Latest ObamaCare Repeal Effort 
President Trump on Wednesday applauded the Republican senators who introduced a last-ditch effort to repeal and replace ObamaCare, though he stopped short of a full-throated endorsement. “I applaud the Senate for continuing to work toward a solution to relieve the disastrous Obamacare burden on the American people. My Administration has consistently worked to enact legislation that repeals and replaces Obamacare, and that can pass the Senate and make it to my desk,” Trump said in a statement. (Shelbourne, 9/13)

Bloomberg: Greenspan Backs Bid To Replace Obamacare With Grants To States 
The latest long-shot bid to undo Obamacare got a boost from Alan Greenspan, a former Federal Reserve chairman who served under presidents from both parties. Greenspan, who held office from 1987 until 2006, said in a statement that a measure proposed by four Senate Republicans on Wednesday represents a “giant step forward” because it provides grants to states to provide health coverage. The measure -- sponsored by Bill Cassidy of Louisiana, Lindsey Graham of South Carolina, Dean Heller of Nevada and Ron Johnson of Wisconsin -- “as best I can judge, will make health care more affordable, more accessible, and I believe it will lead to better outcomes for patients,” Greenspan said in a statement. (Litvan, 9/13)

Senators May Have Reached Deal On CHIP Funding, But Its Path Forward Is Still Uncertain

It is unlikely, though, that Republicans will hold up the funding for the widely popular program.

The Associated Press: Will Senate Bargainers' Deal On Children's Health Pass?
Senate bargainers have reached agreement to extend financing for the children's health insurance program for five years, and approval of the deal would avert an end-of-month cash crunch for the popular initiative. In a concession to Republicans, the agreement late Tuesday would phase out extra federal dollars that have gone to states since the additional money was mandated as part of former President Barack Obama's 2010 health care law. (9/13)

Columbus Dispatch: 210,000 Ohio Children Will Keep Health Coverage, Sherrod Brown Predicts
Sen. Sherrod Brown predicted the Senate will approve a compromise bill that will finance a federal children’s health program for the next five years that provides coverage to nearly 210,000 low-income Ohio children. Both the Senate and House will have to re-authorize the program, which expires at the end of this month, to prevent nine million children across the country from losing their health coverage. (Torry, 9/13)

Health Law

Forget Congress -- Administration Is Quietly Gutting Health Law By Itself

In rolling back Obama-era regulations, the administration has become the chief weapon against the Affordable Care Act.

Politico: How The Trump Administration Is Reshaping Health Care — Without Congress
While Congress tussles over Obamacare, the Trump administration is quietly pressing ahead with plans to gut major Obama-era rules and relax federal oversight of swaths of the health care industry. Top health officials have already signaled their intention to end mandatory programs making hospitals more accountable for their patients’ health, slowed the transition to a system that pays doctors based on quality rather than quantity, and indicated they will reverse a high-profile rule blocking nursing homes from forcing residents to sign away their right to sue. (Cancryn, 9/13)

In other news on the health law and marketplaces —

KCUR: Uncertainty Over The Future Of Healthcare Plagues Entrepreneurs Helped By ACA 
Like many Americans, Stinson Dean has nervously watched this year’s national healthcare debate, but his interest doesn’t stem from a serious health condition. He says the Affordable Care Act made it possible for him to start his business, but now uncertainty about the ACA’s future is affecting his business’s ability to grow.  ...Encouraged by the availability of affordable insurance through the Affordable Care Act, the family took the plunge. Stinson Dean quit his quit and started his company. The move paid off, as new construction here and elsewhere around the country boosted Dean’s business far beyond what he imagined.He’s now ready to expand and bring on 3 or 4 new people, but there’s a problem. (Smith, 9/13)

The CT Mirror: Anthem, ConnectiCare Say They Will Continue On Access Health CT
Anthem and ConnectiCare said on Wednesday they will continue to sell policies on the Access Health CT exchange next year, but charge a lot more for most policies. The Connecticut Insurance Department said it had approved an average 31.7 percent rate increase on the policies Anthem offers individuals next year, both on and off the Access Health CT exchange. (Radelat, 9/13)


8 Dead At Nursing Home Where Air Conditioner Failed In Wake Of Hurricane Irma

Dozens more patients were found in distress, as well. The deaths have prompted a criminal investigation.

The New York Times: Eight Dead From Sweltering Nursing Home As Florida Struggles After Irma
The first patient was rushed into the emergency room of Memorial Regional Hospital around 3 a.m. on Wednesday, escaping a nursing home that had lost air-conditioning in the muggy days after Hurricane Irma splintered power lines across the state. Another arrived at 4 a.m. After a third rescue call, around 5 a.m., the hospital’s staff was concerned enough to walk down the street to check the building themselves. What they found was an oven. (Reisner, Fink and Yee, 9/13)

The Associated Press: Manager Of Nursing Home Where 8 Died Has Been Charged Before
The manager of a Florida nursing home where eight people died following Hurricane Irma has a history of health-care fraud accusations. Federal court records show the U.S. Attorney's Office in Miami filed civil charges in 2004 against Dr. Jack Michel and Larkin Health Systems, among others. That company owns The Rehabilitation Center at Hollywood Hills, which had eight patients pronounced dead Wednesday. (Fischer, 9/13)

The Washington Post: Eight Dead After South Florida Nursing Home's Air Conditioning Fails Following Hurricane Irma
"We believe at this time it may be related to the loss of power in the storm," Tomas Sanchez, the Hollywood police chief, said at a news briefing Wednesday. "It's a sad event." Police later said they are working to determine what caused the tragedy, but early indications pointed at the air conditioning in the facility. "The initial investigation has determined that the facility's air conditioning system was not fully functional," Hollywood city officials said in a statement Wednesday evening. "Portable [air-conditioning] units were being used in the facility, but the facility was excessively hot." (Berman, Zezima and Davis, 9/13)

Stat: Florida Nursing Home Where 8 Deaths Occurred Had Repeat Safety Violations
The Florida nursing home where overheating may have caused eight deaths and led to a mass evacuation of over 100 residents has a checkered history of safety inspections, including repeated problems with its generator, STAT has found. Around 6 a.m. Wednesday morning local police officers responded to Rehabilitation Center at Hollywood Hills, a 152-bed facility located 30 minutes north of Miami, where they found patients in “varying degrees of medical distress,” three of them deceased, according to a police report. (Blau, 9/13)

The Associated Press: Oldest Residents' Safety More Vulnerable During Disasters
Like clockwork, stories of suffering by the oldest residents in the line of hurricanes, floods, tornadoes and other natural disasters seem to follow. Regulations dictate nursing homes and other facilities must have preparation plans in place, but the realities of how older Americans cope with a storm go beyond any piece of paper. The issue burst to the forefront again Wednesday with news of eight deaths at the Rehabilitation Center at Hollywood Hills in Florida, where workers say Hurricane Irma caused the air conditioning to fail, and they struggled to keep residents cool with fans, cold towels and ice. A look at the issues at play in keeping the oldest safe in the line of disaster. (Sedensky, 9/14)

Health News Florida: Hurricane Irma Causes Sewage Spills Around The State
Rain and power outages from Hurricane Irma led to sewage spills across Florida, according to the Department of Environmental Protection. St. Petersburg again reported spills but the wastewater plant that caused the city to release more than 100 million gallons of partially treated sewage into Tampa Bay last year didn’t have any problems. (Ochoa, 9/13)

Meanwhile, fallout continues from Harvey —

NPR: Harvey Spawns Air Pollution Problems In Houston
On the first sunny day in Houston after about 50 inches of rain, residents in the east Houston community of Manchester emerged from their homes and gave thanks that their neighborhood had been spared in the floods. "Mama, yeah, I just feel blessed," said 73-year-old Maria Julia Rodriguez, standing in her driveway in late August and marveling at her luck. "God was looking out for us, I guess." And yet, something was wrong. The air was heavy with the smell of gasoline and other harder-to-place odors. The neighborhood is ringed by industrial sites, the biggest of which is the Valero oil refinery. (Hersher and Schaper, 9/14)

Houston Chronicle: Midtown's San José Clinic Offering Affordable Medical Care For Uninsured Harvey Victims 
As displaced residents struggle to rebuild their lives and homes, many are facing heightened financial burdens in post-Harvey Houston. Some locals are struggling to afford even basic healthcare. San José Clinic, a 95-year-old institution that offers affordable healthcare for low-income uninsured patients, is seeking support from the public to help those affected by Harvey. (Guillen, 9/13)

And in Montana —

NPR: Filtering Wildfire Smoke From Classrooms Takes A Village
More than a million acres of Montana forests and rangeland have burned this year, so far, causing unhealthy air across the state since mid-July. In August the Missoula County health department took the unprecedented step of advising the entire town of Seeley Lake to evacuate due to smoke; air there has been classified as "hazardous" levels for 35 days in August 1. (Saks, 9/13)

Reproductive Services May Become Harder To Access As More Hospitals Affiliate With Catholic Church

“This alone represents a substantial cost to women, who must subsequently rely on other, more inconvenient suboptimal forms of contraception,” finds a study of the trend toward hospital consolidation. In other industry news: Tenet considers selling, troubles at a D.C. hospital, an infection pattern at a Wisconsin facility, and more.

Stat: Catholic Hospitals Are Multiplying, Impacting Reproductive Health Care
The rapid growth of Catholic-affiliated hospitals in the U.S. could significantly reduce access to inpatient sterilization procedures, according to a new study that examines the rising influence of religion on reproductive health services. The study, published by the National Bureau of Economic Research, estimates that Catholic hospitals reduce the per-bed annual rates of inpatient abortions by 30 percent, and tubal ligations, or sterilization, by 31 percent. (Ross, 9/14)

Modern Healthcare: Tenet Shares Jump In After-Hours Trading Amid Reports It's Considering Sale
Shares of Tenet Healthcare Corp. rose sharply in after-hours trading Wednesday amid reports that the troubled hospital chain is exploring strategic options, including the possible sale of the company. The Wall Street Journal reported Wednesday afternoon that Tenet had hired bank advisers to review its strategic options. Tenet spokesman Dan Waldmann said the company does not comment on market speculation. (Barkholz, 9/13)

USA Today: Hospital's Patients Range From D.C.'s Poorest To Its Most Powerful
Sewage that leaks down the walls and on the operating room floors is among the many problems at the go-to hospital for Congress and the White House, according to interviews and documents obtained by USA TODAY. The D.C. health department is now investigating the leaks at MedStar Washington Hospital Center only after the department received a complaint, not because it was alerted by the hospital. The problems included the room in which Louisiana Rep. Steve Scalise had his last surgery after being shot at a congressional baseball practice in June. (O'Donnell, 9/13)

Stat: Why Five Patients In The Same Hospital Contracted A Rare Blood Infection
As an infectious disease doctor, Nasia Safdar is a detective of sorts at the University of Wisconsin Hospital in Madison. She tracks the patterns of infections, from the type of illness to the organism at its root, and in spring 2014, she noticed something odd: A cluster of bloodstream infections caused by an uncommon, and potentially deadly, bacteria. The microbe, Serratia marcescens, can infect the lungs, bladder, blood, and skin, and usually causes a few infections per year at Safdar’s hospital; some studies estimate that about 1 out of 100,000 people fall prey to a blood infection from the bacteria annually. So it was strange that five cases had occurred in just five weeks, and Safdar did a double take. (Bond, 9/14)

The Washington Post: ‘That Will Kill You’: GW Hospital Chief Of Trauma Says Helipad Needed To Save Lives
The morning a gunman opened fire on a Republican congressional baseball practice in Alexandria, Babak Sarani cleared three operating rooms and readied his team. But the shooting victims, which included House Majority Whip Steve Scalise, needed to be airlifted from the open field. That meant they couldn’t be taken to George Washington University Hospital.For Sarani, chief of the hospital’s trauma and acute care surgery, that was frustrating. (Itkowitz, 9/13)


Arizona High Court To Hear GOP Lawmakers' Suit Challenging Expansion Of Medicaid

The legislators filed suit in 2013 seeking to stop then Gov. Jan Brewer's decision to expand Medicaid under the federal health law. In other Medicaid news, Iowa officials are considering moving people with serious disabilities out of the state's new managed care plan and a federal judge dismissed a lawsuit seeking to move more people out of nursing homes in Washington, D.C.

Des Moines Register: Disabled Iowans Could Be Exempted From Private Medicaid Management
Iowa might resume direct oversight of care for people with serious disabilities instead of having private Medicaid-management companies continue doing it, the state’s human-services director said Wednesday. Many of the most serious complaints about Iowa’s privatized Medicaid system have come from disabled Iowans and their families. Numerous families have reported having their services cut and their hassles multiplied by the management companies. Their plight has sparked a federal lawsuit against the state. (Leys, 9/13)

The Washington Post: Nursing Home Residents Lose Class-Action Suit To Secure Community-Based Services
A U.S. district court judge on Wednesday dismissed a class-action lawsuit that alleged that the District failed to comply with a federal mandate to move eligible and interested Medicaid recipients out of nursing homes and into the community. U.S. District Judge Ellen Segal Huvelle ruled that a single injunction could not remedy the problems experienced by the elderly and disabled nursing home residents because barriers to moving them back into the community extended beyond the system’s shortfalls with transition services. (Chandler, 9/13)


Advocates Pressing Medicare To Promote Advance Directives Among Beneficiaries

Some lawmakers and organizations want the government to help get the word out about advance directives and to encourage people to create them. Also, a look at some of the experimental programs being run by Medicare to change how doctors are reimbursed.

Modern Healthcare: Healthcare Groups, Lawmakers Push Medicare To Promote Advance Directives
Although the CMS reimburses clinicians for advance care planning during Medicare patients' yearly wellness visits, the agency has yet to encourage patients to set up these plans. It shows: Two-thirds of American adults do not have advance directives to guide their healthcare if they become unable to communicate. ... But even if a person has an advance directive, it may be hard to use. (Amdt, 9/13)

Modern Healthcare: Providers Find Success In CMS' Multipayer Model
Dr. Katherine Clark was tired of the fee-for-service status quo. Every day, she would go through the same motions: see patients, treat their ailment and not see them again until they had a new health issue. But those patients weren't getting better in the long run, and she wanted the cycle to end. That required a change in how she and other members in her practice were paid. ... When the practice was accepted into the CMS' Comprehensive Primary Care Initiative, it moved from the standard care pattern to one that put more emphasis on preventive screenings and follow-ups. Not only did she notice an overall improvement in quality of care, her practice also achieved notable savings under the model. (Dickson, 9/13)


To Circumvent Patent Challenges, This Pharma Company Made A Deal With A Native American Tribe

Now that the deal has been made public, other drugmakers are taking interest. In other pharmaceutical news, the struggle to create a Zika vaccine highlights a broader public health problem, the Food and Drug Administration is changing the way it approves orphan drugs, the House has begun work on a bill that would boost the agency's oversight of over-the-counter drugs, and more.

Stat: Allergan Patent Deal With Mohawk Tribe Prompts Interest From Other Drug Makers
In the wake of a startling deal in which Allergan (AGN) is selling some patents to a Native American tribe, an attorney for the tribe indicated other drug makers have asked about such arrangements. “I can’t provide specific information, but your assumptions are pretty correct” that representatives for other pharmaceutical companies have made inquiries since the deal was announced last Friday, said Chris Evans of the Shore Chan DePumpo law firm, which brought the deal to the tribe. (Silverman, 9/13)

Stat: Race For A Zika Vaccine Slows, A Setback For Efforts To Head Off Outbreaks
The development of a type of Zika vaccine that authorities had hoped to usher to the market has proven more challenging than some scientists and pharmaceutical companies had expected, people involved in the research have told STAT, posing a setback for efforts to avoid future outbreaks of the disease. Although vaccines typically take years to produce, test, and license, U.S. health officials had voiced confidence that Zika would not be a difficult target, and some predicted that a vaccine could be made and fully tested, ready for Food and Drug Administration assessment, within two to three years. Others predicted a licensed Zika vaccine could be available sometime in 2020. (Branswell, 9/13)

Kaiser Health News: FDA Moves To Guard Against Abuse Of ‘Orphan Drug’ Program
The Food and Drug Administration is changing the way it approves medicines known as “orphan drugs” after revelations that drugmakers may be abusing a law intended to help patients with rare diseases. In a blog post Tuesday, FDA Commissioner Scott Gottlieb said he wants to ensure financial incentives are granted “in a way that’s consistent with the manner Congress intended” when the Orphan Drug Act was passed in 1983. That legislation gave drugmakers a package of incentives, including tax credits, user fee waivers and seven years of market exclusivity if they developed medicines for rare diseases. (Tribble, 9/13)

Roll Call: House Begins Work On Over-The-Counter Drug Fees
The House began public deliberations Wednesday on a bill that would boost the Food and Drug Administration’s oversight of over-the-counter drugs in exchange for industry-paid fees. A bipartisan draft bill released earlier this week has support from the FDA and the over-the-counter drug industry. Under the new proposal, drug manufacturers would pay an annual fee for their facilities and an extra fee each time they submit a request to review proposed changes related to their product. (Siddons, 9/13)

Los Angeles Times: Bill To Shed More Light On Prescription Drug Prices Heads To Gov. Jerry Brown's Desk
Powered by increasing scrutiny of costly prescription drugs, a measure that would require sweeping new disclosure on how medicines are priced cleared its final legislative hurdle Wednesday. The state Senate approved the bill with no debate, belying the fierce behind-the-scenes jockeying that pit pharmaceutical companies against health insurers, labor unions and liberal activists. (Mason, 9/13)

San Jose Mercury News: California Drug Price Transparency Bill Heads To Gov. Brown
The nation’s most comprehensive legislation aimed at shining a light on prescription drug prices is heading to California Gov. Jerry Brown’s desk. ... It would do so by requiring pharmaceutical companies to notify health insurers and government health plans like Medi-Cal at least 60 days before scheduled prescription drug price hikes that would exceed 16 percent over a two-year period. (Seipel, 9/13)

The Associated Press: Pharma Bro Martin Shkreli Has Bail Revoked, Heads To Jail
Defense attorneys had argued at a hearing in federal court in Brooklyn that the post by Shkreli, offering a $5,000 bounty to anyone who could grab him one of Clinton’s hairs while she’s on a book tour, was political satire. But U.S. District Judge Kiyo Matsumoto didn’t see the humor, saying the offer could be taken seriously by fellow Clinton detractors. (Hay, 9/13)

Public Health And Education

One Ohio County Makes Anti-Overdose Drug Widely Available, While Another Rejects That Approach

Bloomberg profiles Hamilton County, Ohio, where officials think the best way to tackle the opioid epidemic is to get Narcan in as many hands as possible, and Butler County, where the sheriff refuses to allow officers to carry the medication. In today's other public health news: a $25,000 "life-extension test"; anti-smoking efforts; miscarriage risks from flu shot studied; and more.

Bloomberg: Welcome To The Narcan Capital Of America
In neighboring Hamilton County, which includes Cincinnati, officials are taking the opposite approach. They want to create the Narcan capital of America, putting more than 30,000 doses of the opioid-overdose reversal spray in the hands of Ohioans ready to use it. That’s about one for every 27 residents. In addition to police, firefighters, and medics who already carry the drug, Hamilton County plans to distribute Narcan to syringe exchanges, houses of worship—and maybe even employers. People discharged from hospitals or jails after opioid incidents should leave with “Narcan on the belt,” says Tim Ingram, Hamilton County’s health commissioner. (Tozzi and Hopkins, 9/14)

Bloomberg: This $25,000 Life-Extension Test Is Impressing Investors But Not Doctors
Craig Venter has got a deal for you. For $25,000, he’ll sell you a complete genome sequence, a full-body MRI scan, a cardio CT scan, bone densitometry, cognitive testing and more, all in the hope of discovering a lurking tumor or brain abnormality -- and nipping it in the bud. ... The problem is Venter’s promises are ringing hollow for a growing chorus of critics. Conversations with more than a dozen current and former employees, customers and medical professionals depict a company that may prove unable to keep up with its founder’s ambitions. Some doctors contend that such comprehensive testing isn’t particularly useful, and even those who do think so say rivals may outpace Venter. Competing government-backed efforts in the U.S. and the U.K., for instance, threaten to overtake HLI in the race to collect massive amounts of the population’s genetic and clinical data, a key proposition for the company’s business success. (Chen, 9/13)

Bloomberg: Philip Morris Pledges $1 Billion To Fight Smoking 
Philip Morris International Inc. said it will spend about $1 billion setting up a foundation to reduce the prevalence of smoking as the maker of Marlboro cigarettes aims to convert smokers into consumers of devices that don’t burn tobacco. Derek Yach, a former World Health Organization official who worked on a global tobacco treaty, will lead the group, according to a statement Wednesday. The cigarette maker said it plans to spend about $80 million annually over 12 years on the project, starting in 2018. (Pfanner and Mulier, 9/13)

Stat: Where Does The March For Science Go From Here?
The hundreds of thousands of people who rallied on the National Mall and in cities worldwide for the March for Science in April came to be noticed. It was a march meant to demonstrate enthusiasm and political clout, and by those measures, organizers believe they succeeded. But as two dozen of them met in New York the following month for a debrief, they faced an obvious reality: A grass-roots organization that was quickly formed to plan a singular event was not, at least immediately, equipped for far-reaching and long-term science advocacy. (Facher, 9/14)

Stat: Study Shows Miscarriage Risk May Have Increased After Flu Shots
Sometimes when scientists study things, they come up with results they didn’t expect, can’t explain, and may secretly wish they’d never sought. A new journal article looking at whether getting a flu shot during pregnancy increases a woman’s risk of miscarrying may be one such case. The article reports that at least in the 2010-11 and 2011-12 influenza seasons, pregnant women who were vaccinated against flu may have been at a higher risk of suffering a miscarriage — but only if they had also received a flu shot in the previous year as well. (Branswell, 9/13)

As Death Toll Climbs In Hepatitis A Outbreak, San Diego Begins Washing Streets With Bleach

San Diego is also giving free vaccinations and installing hand-washing stations to combat the crisis.

The Washington Post: Hepatitis Outbreak: San Diego Power-Washing Streets As Death Toll Rises
San Diego has started sanitizing its streets and sidewalks to try to combat a hepatitis A outbreak spreading among the city’s homeless population. Amid an outbreak across several cities in San Diego County that county health officials say has led to 16 deaths and nearly 300 hospitalizations, workers hosed down areas in San Diego earlier this week with chlorine and bleach, according to the San Diego Union-Tribune. Mayor Kevin Faulconer (R) recently announced that measures to try to curb the spread of the deadly disease would include giving free vaccinations, installing hand-washing stations and power-washing streets in the Southern California city. (Bever, 9/13)

KQED: San Diego Washing Streets With Bleach To Combat Hepatitis A Outbreak
The infectious disease has largely infected homeless people in the city, and part of the issue is an apparent shortage of public restrooms in areas where the population congregates. Hepatitis A was first identified in the area in early March, according to the county, and was declared a public health emergency earlier this month. (Kennedy, 9/13)

Los Angeles Times: Death Toll From San Diego Hepatitis Outbreak Rises To 16, With 292 People Hospitalized
San Diego County’s hepatitis A outbreak shows no signs of slowing, according to the latest update released Tuesday by the county Health and Human Services Agency. The outbreak’s death total rose to 16 — one more than last week’s total. The number of confirmed cases reached 421, up 23 from last week. The number of hospitalizations also pushed higher, rising to 292 from 279 the week before. (Sisson, 9/13)

State Watch

State Highlights: Mass. Successful In Reining In Health Costs; Ohio Lawmakers Tap Brakes Over Flu Vaccine Bill

Media outlets report on news from Massachusetts, Ohio, Georgia, Louisiana, New Jersey and Tennessee.

Boston Globe: State Makes Headway In Limiting Health Care Spending, Report Shows
Massachusetts made progress in controlling health spending last year, according to a state report issued amid a swirling debate over how best to rein in costs. Total spending on health care grew an estimated 2.8 percent in 2016, more quickly than inflation and wages but well below the state’s goal, set in law, of holding spending increases below 3.6 percent a year. (Dayal McCluskey, 9/13)

The Associated Press: 5 In Health Care Fraud Case Face Charges In Witness’ Death
A Louisiana man convicted in a multi-million dollar health care fraud scheme in 2013 now faces federal charges — along with four other men — in the 2012 slaying of a witness in the case, federal prosecutors said Wednesday. Louis Age Jr., 68, his son Louis Age III, 47, and three others face multiple charges that include conspiracy to obstruct justice by murder and conspiracy to commit murder for hire. They were charged by a grand jury last month in an indictment that was unsealed Tuesday. (McGill, 9/13)

The Associated Press: A New Jersey Medicaid Fraud Amnesty Program Is Criticized
About three dozen people accused New Jersey officials of going soft on crime after a program was introduced to allow residents who received unwarranted Medicaid benefits to withdraw without prosecution. Authorities had planned a seminar Tuesday night in Toms River for Ocean County residents who would benefit from the program. (9/13)

Nashville Tennessean: VUMC, Bayer Partner On Kidney Disease Research Initiative
Vanderbilt University Medical Center is partnering with Bayer, the life science and pharmaceutical giant, on a five-year project to find two potential treatments for kidney disease, which has few treatment options. Kidney diseases impact more than 30 million Americans, and is more prevalent due to a variety of factors including obesity, hypertension and Type 2 diabetes, said Dr. Ray Harris, director of the Vanderbilt Center for Kidney Disease. Some populations, such as those from Southeast Asia, China and Pacific Islands, are at higher risk. (Fletcher, 9/13)

Georgia Health News: There’s Lead In That?!
[Tamara] Rubin has made it her mission to point out how widespread a poison lead can be and how easily it can be found. Two of her four boys were lead-poisoned when a contractor used an unsafe way to remove lead paint on the outside of their house. (Goodman and Miller, 9/13)

Cincinnati Enquirer: P&G Cuts Health Care Jobs
Procter & Gamble is cutting jobs in its health care division based in Greater Cincinnati. The consumer products giant is "adjusting" jobs in its North American health care business based at the Mason Business Center. (Coolidge, 9/13)

Nashville Tennessean: Neighborhood Health's Bufwack To Be Succeeded By Brian Haile
Brian Haile, a former TennCare official, will be the CEO of Neighborhood Health starting Oct. 1. He succeeds longtime leader Mary Bufwack, who is retiring. Neighborhood Health treats about 30,000, 17,000 of whom have no insurance, and is a leading source of primary care for Nashville's homeless residents. The private, non-profit clinic system has expanded into counties surrounding Davidson County in the last few years as the population has shifted and grown. (Fletcher, 9/13)

Weekend Reading

Longer Looks: Seven Days Of Heroin; Goop; And Medicare-For-All

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

The Cincinnati Enquirer: Seven Days Of Heroin
It’s a little after sunrise on the first day of another week, and Cincinnati is waking up again with a heroin problem. So is Covington. And Middletown. And Norwood. And Hamilton. And West Chester Township. And countless other cities and towns across Ohio and Kentucky.This particular week, July 10 through 16, will turn out to be unexceptional by the dreary standards of what has become the region’s greatest health crisis. (9/10)

The Atlantic: Why Gwyneth Paltrow's Goop Is Still So Popular
How to explain Goop’s popularity? In many ways, it exemplifies—and has capitalized on—several recent trends in health media. Fact-checking often doesn’t fit into increasingly tight media budgets, or isn’t much of a priority, so dubious health claims about prolonged fasting or avoiding gluten ricochet around the internet. The rich are already more likely than the poor to be healthy, so they shell out for alternative treatments and supplements in hopes of achieving even greater vitality. (Olga Khazan, 9/12)

Vox: Bernie Sanders's New Medicare-For-All Plan, Explained
The Sanders plan envisions a future in which all Americans have health coverage and pay nothing out of pocket when they visit the doctor. His plan, the Medicare for All Act, describes a benefit package that is more generous than what other single-payer countries, like Canada, currently offer their residents.The Sanders plan goes into great detail about the type of coverage Americans would receive. But it provides no information on how it would finance such a generous health care system. (Sarah Kliff, 9/13)

The New Yorker: The Cost Of The Opioid Crisis
In September, 2016, Donald Trump delivered a speech at the Economic Club of New York. “Today, I’m going to outline a plan for American economic revival,” he said. “It is a bold, ambitious, forward-looking plan to massively increase jobs, wages, incomes, and opportunities for the people of our country.” He went on to talk about lowering taxes and removing regulations, renegotiating trade deals and building a border wall. But he overlooked one of the most pressing issues facing the American economy today: the opioid crisis. (Sheelah Kolhatkar, 9/11)

FiveThirtyEight: Surviving A Big Storm Doesn’t Mean The Trauma Is Over
The hurricanes in the Gulf and Florida over the last few weeks have left people displaced — and from more than just their homes. Places of worship, community centers, parks and schools are underwater, missing roofs or windows. And those losses can set the social infrastructure of a person’s life adrift. Years after the family is safe and the home is rebuilt, disaster victims could still be struggling with health problems that got a start because of the way a stressful, terrifying situation disrupted their lives. It’s even possible, some researchers say, that the stress and fear alone could create health problems later. (Maggie Koerth-Baker, 9/12)

Editorials And Opinions

Single-Payer Perspectives: An Opening Bid Or A Way To Change The Subject

Editorial writers offer their thoughts on the single-payer approach to health care that appears to be gaining traction in the ongoing policy debate.

The Washington Post: Bernie Sanders’ Single Payer Plan Is Here. Think Of It As An Opening Bid.
Bernie Sanders is releasing his latest single payer health care plan today, and while there are some small differences between this one and what he has proposed in the past, the biggest difference is that this time, he’s got lots of company. Fifteen Democratic senators are co-sponsoring his bill, including most of those considering running for president in 2020. Support for some kind of universal coverage is now the consensus position among Democrats. And Sanders’ single payer plan is the one that has gotten the most attention, so it’s going to be the one against which other plans are measured. (Paul Waldman, 9/13)

The New York Times: How The Bernie Sanders Plan Would Both Beef Up And Slim Down Medicare
In his big new single-payer health care bill, Senator Bernie Sanders says he wants to turn the country’s health system into “Medicare for all.” But his bill actually outlines a system very different from the current Medicare program. The Sanders plan envisions changing Medicare in two important ways. First, it would make it more generous than it has ever been, expanding it to cover new types of benefits and to erase most direct health care costs for consumers. Those changes would tend to make it more expensive. (Margot Sanger-Katz, 9/13)

Axios: How Single Payer Helps Republicans Change The Subject
Since the collapse of the GOP effort to repeal and replace the Affordable Care Act, single payer has gained new life on the left. Sen. Bernie Sanders released his “Medicare for all" plan yesterday, and a majority of House Democrats have signed on to another version proposed by Rep. John Conyers. (Drew Altman, 9/14)

Richmond Times-Dispatch: And Now, The Push For Single-Payer
Apparently, the thinking in Democratic Party circles goes something like this: Since Obamacare has been such a smashing success, let’s inject even more government into health care. ... Several leading contenders for the party’s presidential nomination have come out in favor of single-payer health care, and some Democratic skeptics are now coming around. (9/13)

Fortune: What It Would Take To Make Bernie Sanders’ Single Payer Health Care Plan Work
Senate Democrats, including nearly all of the party's potential 2020 presidential candidates, haven't so much been jumping on Bernie Sanders' single payer, "Medicare for all" health care bandwagon as they have been elbowing past each other to snatch a prominent political seat on it. But the increasingly popular idea, unveiled by Sanders and at least 16 Democratic co-sponsors in the Senate Wednesday, is already brushing up against scrutiny from the medical industry and some health care analysts who question how the proposal would be paid for and implemented in practicality. (Sy Mukherjee, 9/13)

The Wall Street Journal: Bernie’s Socialism Goes Mainstream
Hillary Clinton’s memoir of her presidential campaign is getting most of the media attention this week, but that’s the politics of progressive nostalgia. If you want to know where the Democratic Party is going, Bernie Sanders showed the way Wednesday with his proposal for a complete government takeover of health care. (9/13)

Policy Points: Three GOP Senators 'Bedside Miracle;' Immigration As A Public Health Issue

Columnists offer their opinions on a range of health policy topics, including the Obamacare alternative being advanced by Sens. Lindsay Graham (R-S.C.), Bill Cassidy (R-La.) and Dean Heller (R-Nev.), the impact of immigration policy and how to make sense of issues during the upcoming open enrollment period.

Bloomberg: The Latest (Dim, Distant) Hope For Health-Care Reform
Health-care reform is like one of those ill people in a Victorian novel. They are pronounced close to death, with no possibility of a cure … and then they linger on for hundreds of pages of breathless plotting, while the reader wonders: “Is this it? Could they possibly live after all that suffering?” The latest bedside miracle is the Graham-Cassidy-Heller proposal, which would cut spending, cap spending, and shift spending away from states that expanded Medicaid to those that haven’t. (Megan McArdle, 9/13)

WBUR: Trump's Aggressive Immigration Policies Have Created A Public Health Disaster
We are seeing only the tip of the iceberg of public health disasters stemming from the Trump administration’s aggressive detention and deportation policies. Lower birth weights have been reported in Latina mothers affected by immigration raids, and a spike in adverse mental health symptoms has been reported in many immigrant communities. (Dr. Sondra S. Crosby, Gilbert E. Benavidez and J. Astrian Horsburgh, 9/14)  

Los Angeles Times: Making Sense Of Covered California And Medicare During Open Enrollment
It’s that time of year when we all have to start thinking about health insurance plans and options. Not only do I need to figure out if my current plan will be offered again next year, and with what changes, but my husband is over 65, so I also have to research the latest Medicare plans as well. As a columnist, research is my thing, but this insurance stuff makes my head spin. (Barbara Venezia, 9/13)

Viewpoints: Cancer Drug Revolution; When The Cause Of Death Is 'Inequality'

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

The Columbus Dispatch: New Cancer Drug Revolutionary?
The Food and Drug Administration approved a new treatment last month for acute lymphoblastic leukemia, an aggressive disorder of the blood and bone marrow that is the most common childhood cancer in the United States. On its face, this may not seem like big news. The government is approving it for use only on young people, only 3,100 of whom are diagnosed with the disease every year. So a relatively small number of Americans stands to benefit. (9/14)

Los Angeles Times: Prostate Cancer: Patience And Prevention
For more than a decade, we’ve known that prostate cancer is over-diagnosed and over-treated, putting men at risk of incontinence and sexual dysfunction to remove what might have been a slow-growing, non-lethal cancer. When active surveillance of prostate cancer was first proposed over a decade ago, men weren’t racing to be the first to try it. Active surveillance is the careful monitoring of cancer for signs of progression. Unlike lung, breast and colon cancer, there are indolent forms of prostate cancer that do not require surgery or radiation. (Jeffrey Yoshida, 9/13)

JAMA Forum: Long-Term Care: Investing In Models That Work
President Trump and the US Congress have promised to reduce federal spending, through tactics that include cutting Medicaid and Medicare. What they fail to take into account is that sometimes investing in programs that work well can reduce spending while improving the health and well-being of people. A case in point: programs that help older adults and those who are disabled remain in their homes and out of long-term care facilities. (Diana Mason, 9/13)

The Des Moines Register: In A Medical Emergency, WHERE You Live May Determine IF You Live
Did you know the majority of urban ambulance services are paid, while rural ambulance services are mostly volunteers? Sixty-seven percent of all ambulance services in Iowa are staffed by volunteers who receive no compensation. The majority of our higher level care hospitals are in urban areas served by paid ambulance services, most of which are at a paramedic level. In contrast, Iowa’s rural areas have community hospitals, accounting for 79 percent of the hospitals in our state. These hospitals can only stabilize and transfer critical patients to higher level care hospitals, typically located a significant distance away. Nine counties in Iowa have no hospital. (Sandy Heick, 9/12)

JAMA: What Should I Do When I Hear The Call For Medical Assistance In A Plane?
If there is a doctor on board, would you please make yourself known to a member of the cabin crew?” Reflexively, my hand shoots up to press the button. Seven times I have responded to such requests. Mostly it has worked out well. Twice I thought the passenger had had too much alcohol. Once I comforted an anxious woman. Another time a young army recruit heading for basic training had unexplained arm pain. Sometimes it was more serious. A man with abdominal pain told me he had cancer and he needed my attention and reassurances. A woman had a cardiac emergency, and I had to request an unscheduled landing. Another emergency on a trans-Pacific flight required the extended care of several physicians. (Gregory L. Eastwood, 9/12)

Stat: It's Time To Give Those With Severe Brain Injuries The Civil Rights They Deserve
Several colleagues and I had proposed a project to study the legal rights of people with severe brain injury. Their plight is terrible: They are often dispatched from the hospitals where their lives had been saved to nursing homes where they receive what is euphemistically called custodial care rather than skilled medical care. (Joseph J. Fins, 9/13)

RealClear Health: It’s Time To Tackle Suicide Rates Smartly
September is Suicide Prevention Month and well-meaning suicide advocates are out in force calling for a greater effort to reduce it. But can we reduce suicide? While researching, “Insane Consequences: How the Mental Health Industry Fails the Mentally Ill,” I learned that mortality from strokes, AIDS, heart disease, and leukemia have decreased dramatically since the 1960s, but in spite of all we’ve spent on suicide, suicide mortality has remained the same. (DJ Jaffe, 9/14)

The Wall Street Journal: The Campus Left Vs. The Mentally Ill
Conservative commentator Ben Shapiro is scheduled to speak Thursday at the University of California, Berkeley, and school officials are prepared. A campuswide announcement promised “support and counseling services for students, staff and faculty” who feel Mr. Shapiro’s presence threatens their “sense of safety and belonging.” (Clay Routledge, 9/13)

The Kansas City Star: Josh Svaty May Be Pro-Lifeish. Will Kansas Democrats Allow Such A Thing?
Democratic gubernatorial candidate Josh Svaty got the question of the night, and of the year, from a man in suspenders in the third row: “For a lot of Democrats, particularly Democratic women, choice is a threshold issue. Can you say why, as a pro-choice Democrat, I should get enthusiastic about you?” Svaty, a 37-year-old farmer, former EPA official and ag secretary who successfully ran for the Kansas statehouse out of his college dorm room, voted with his heavily Republican, rural district on the abortion issue. He began the answer that will matter most to his candidacy this way: “That was part of being responsive to constituents. (Melinda Henneberger, 9/13)

The New York Times: The Economic Case For Letting Teenagers Sleep A Little Later
Many high-school-agechildren across the United States now find themselves waking up much earlier than they’d prefer as they return to school. They set their alarms, and their parents force them out of bed in the morning, convinced that this is a necessary part of youth and good preparation for the rest of their lives. It’s not. It’s arbitrary, forced on them against their nature, and a poor economic decision as well. (Aaron E. Carroll, 9/13)

Stat: Study On Flu Shot-Miscarriage Link Shows Science Prioritizes Vaccine Safety
[T]here is a scientific reason to think that the new findings may be a true signal we need to take seriously. While multiple studies in the past have found that women who received flu vaccine during pregnancy did not have a higher rate of miscarriage than women not vaccinated, this is the first study to focus on three important variables: 1) vaccines that contained the 2009 H1N1 flu virus strain, the virus that caused the 2009 influenza pandemic; 2) the 28 days after vaccination; and 3) the impact of repeat flu vaccination over two flu seasons. (Michael T. Osterholm, 9/13)