First Edition: April 27, 2018
Today's early morning highlights from the major news organizations.
Kaiser Health News:
Dissecting The Rhetoric Vs. Reality Of Trump’s Tough Talk On Drug Prices
President Donald Trump has railed against the high price of prescription drugs and famously bemoaned how pharmaceutical companies are “getting away with murder.” Yet, many Americans aren’t seeing a change in what they pay out-of-pocket. Trump promised a speech on prescription drug prices, and it’s expected anytime.Here’s a look at the rhetoric thus far versus the results. (Tribble, 4/27)
Kaiser Health News:
Podcast: KHN’s ‘What The Health?’ What’s Next For The VA?
The Trump administration has withdrawn the nomination of White House physician Ronny Jackson to head the Department of Veterans Affairs after allegations surfaced about inappropriate handling of prescription drugs, issues with alcohol and difficulties working with other White House medical unit staffers. It is unclear whom the White House will turn to next to take over the helm at the VA. (4/26)
California Healthline:
Millions Eligible For Food Stamps In California Don’t Reap The Benefit
Millions of low-income Californians eligible for food stamps are not receiving the benefit, earning the state one of the lowest rankings in the nation for its participation in the program. Just three states — all much more conservative than the Golden State — have lower rates of participation, according to the latest available federal data. The poor performance stands in sharp contrast to California’s leadership on enrollment in Medi-Cal, the state’s version of Medicaid, which also serves people living in low-income households. (Gorman and Rowan, 4/26)
Kaiser Health News:
Readers Weigh In On Vitamin Use And The Big Pharma-Patient Advocacy Connection
Letters to the Editor is a periodic Kaiser Health News feature. KHN welcomes all comments and will publish a selection. We edit for length and clarity and require full names. (4/27)
Politico:
‘Veterans Are Losing 6 Different Ways Right Now’
The implosion of Ronny Jackson’s nomination to lead the Veterans Affairs Department may look like the Trump administration’s drama of the moment, but it carries big consequences for 9 million veterans in a sprawling health care system with uneven results and a precarious future. Not only does the VA have no leader, the veteran health care community is divided between conservatives inclined to privatize much of veterans’ care and those who want to invest more in fixing the current system. The impact can be seen across 170 medical centers and hundreds of clinics of varying quality that treat veterans who served in the U.S. military in every conflict since World War II. (Allen, 4/26)
The New York Times:
For Many, Life In Trump’s Orbit Ends In A Crash Landing
Another day, another casualty. Or two. By the time the sun set Thursday, Dr. Ronny L. Jackson was a failed cabinet nominee whose life had been picked apart for public consumption, and Michael D. Cohen was back in court facing possible criminal prosecution. A ride on President Trump’s bullet train can be thrilling, but it is often a brutal journey that leaves some bloodied by the side of the tracks. In only 15 months in office, Mr. Trump has burned through a record number of advisers and associates who have found themselves in legal, professional or personal trouble, or even all three. (Baker and Haberman, 4/26)
The Washington Post:
Ronny Jackson Withdraws As Trump’s Nominee To Lead Veterans Affairs, But He Remains Under Scrutiny
Ronny L. Jackson’s withdrawal from consideration to lead the Department of Veterans Affairs stanched an immediate political crisis for the Trump White House, but it sparked new questions over his future as the president’s doctor and the fate of the embattled agency. Jackson announced Thursday morning that he was pulling out of the nomination process amid a mushrooming cloud of allegations over professional misconduct, leaving in limbo a sprawling federal bureaucracy serving 9 million military veterans that President Trump has called a top domestic priority. Yet even as Jackson strongly denied the charges against him, calling them “completely false and fabricated” in a defiant statement, his position as Trump’s chief physician and a pending Navy promotion looked shaky. (Rein, Lamothe and Nakamura, 4/26)
Politico:
‘Jon Poked The Bear’: Tester Braces For Trump’s Revenge
Jon Tester didn't intend to play a central role in taking down President Donald Trump's pick to lead the Veterans Affairs Department. Yet that's exactly what the Montana Democrat ended up doing. And now, Trump is coming after him. (Everett, 4/26)
Politico:
The Cost Of Donald Trump’s Deserted Government
Job vacancies are fast becoming a singular threat to President Donald Trump’s administration, with a record number of openings that stretch from low-level appointments to the secretary’s office at the Department of Veterans Affairs. While civil servants have stepped up to fill gaps, their power and influence is limited — and many senior career government workers have quit or retired since Trump took office, taking institutional knowledge with them. (Woellert, 4/27)
The Associated Press:
20 States Seek To Block Obama's Health Care Law
Twenty Republican-led states are seeking to temporarily invalidate former President Barack Obama's health care law while their larger lawsuit against it proceeds. In a February suit, Texas and Wisconsin led a coalition arguing that the Affordable Care Act is no longer constitutional after the Republican-backed tax overhaul eliminated fines for not having health care coverage. Sixteen states with Democratic governors later sought to intervene. They suggested that Democratic attorneys general will have to defend the law because President Donald Trump's administration won't. (4/26)
Modern Healthcare:
CMS Extension Of Transitional Health Plans Could Ding ACA Market
The CMS has once again allowed insurers and states to renew so-called transitional health plans that pre-dated Affordable Care Act coverage requirements and that don't have to comply with those rules. State officials have the option to end these "grandmothered" plans in the individual and small-group markets. But about three dozen states have allowed them to continue, even though experts say moving transitional plan enrollees into the ACA-regulated market likely would bring down premiums. (Meyer, 4/26)
USA Today:
Drug Copay Assistance Keeps Patients Alive And Prices, Premiums High
Copayment assistance groups, created to help patients with the increasingly higher price of drugs to treat medical conditions, are under investigation by federal authorities for possibly skewing the cost of health care to favor drug companies. The probes, noted by several drug makers in their regulatory filings, are slowing contributions to at least two of these assistance groups, charities that sometimes pay top executives salaries of $300,000 or more. Critics of these groups, such as Patients for Affordable Drugs founder David Mitchell, say they drive up the cost of health care by masking the price of drugs and forcing higher costs on the insurance companies that pass them along to consumers and employers. (O'Donnell, Robinson, Alltucker and Freeman, 4/26)
The Hill:
Experimental Drugs Bill Runs Aground Despite Trump, Pence Support
Advocates for White House–backed legislation intended to make it easier for sick patients to get access to experimental drugs are frustrated, believing that congressional momentum behind “right to try” has ground to a halt. Despite vocal support from President Trump and Vice President Pence, the House and Senate have made little if any progress on bridging differences with each other over separate bills that have passed each chamber. (Roubein, 4/26)
Stat:
New York Panel Votes To Lower The Cost Of A Pricey Vertex Drug For Cystic Fibrosis
In the first test of a new law designed to lower drug costs, a New York state panel voted unanimously to seek an additional rebate for a pricey cystic fibrosis drug for the state Medicaid program. The decision comes in response to concerns that the medicine, which is called Orkambi and has a list price of $272,000, may cause the state Medicaid program to exceed a cap on drug spending. In a 10-to-0 vote, the state Department of Health was authorized to negotiate with Vertex Pharmaceuticals (VRTX) for a rebate that would bring the cost down to about $83,200 and match cost effectiveness estimates. (Silverman, 4/26)
The Hill:
Schumer: CDC Chief 'Agreed' Agency Can Study Gun Violence
Senate Minority Leader Chuck Schumer on Thursday said President Trump's new director of the Centers for Disease Control and Prevention (CDC) believes there isn’t a prohibition on his agency researching gun violence. Robert Redfield "agreed there is no longer a prohibition on the CDC conducting research on the gun violence epidemic," Schumer said after a meeting with Redfield. "That is a good first step but we have a lot of work to do to ensure the CDC initiates this extremely important research in the near future." (Weixel, 4/26)
The New York Times:
Why A City At The Center Of The Opioid Crisis Gave Up A Tool To Fight It
To its critics here, the needle exchange was an unregulated, mismanaged nightmare — a “mini-mall for junkies and drug dealers” in the words of Danny Jones, the city’s mayor — drawing crime into the city and flooding the streets with syringes. To its supporters, it was a crucial response to an escalating crisis, and the last bulwark standing between the region and a potential outbreak of hepatitis and H.I.V. When Charleston closed the program last month after a little more than two years of operation, it was the latest casualty of a conflict playing out in a growing number of American communities. At least seven other such exchanges have closed in the past two years, even as dozens of others have opened. (Katz, 4/27)
The Wall Street Journal:
Opioid Crackdown Has Patients Struggling To Get Their Meds
The war on opioids is making it tough for Evelyn Lopez to get narcotic pain medication. A doctor recently stopped prescribing an opioid she had taken for years, saying it wasn’t worth possible federal scrutiny. Ms. Lopez, a 53-year-old cancer survivor, also must travel 45 minutes to pick up another opioid prescription because her doctor isn’t allowed to call a pharmacy for a refill. “I have to jump through more and more hurdles,” said Ms. Lopez, of Hazlet, N.J., who has chronic pain from treatment for her non-Hodgkin lymphoma, which is in remission. “For people like me who depend on this medication, what they’re doing is a huge injustice.” (Armour, 4/26)
NPR:
Valium, Xanax And Ativan: More Popular, Still Risky
Drew was in his early 30s. His medical history included alcohol abuse, but he had been sober for several months when he became my patient. His previous doctor had given him a prescription for Ativan, or lorazepam, which is frequently used to allay tremors and seizures from alcohol withdrawal. My first inclination was to wean him off the medication by lowering the dose and telling him to take it less frequently. But inertia is strong in medical care, and Drew prevailed upon me to continue providing lorazepam at his regular dose for another month while he solidified his situation with a new job. (Schumann, 4/26)
The Wall Street Journal:
The Million-Dollar Cancer Treatment: Who Will Pay?
The emergence of genetics-based medicines is pushing the cost of treating certain diseases to new levels, forcing hospitals and health insurers to reckon with how to cover total costs per patient approaching a million dollars. The therapies deliver new genes or genetically altered cells to tackle some of the hardest-to-treat diseases, including in children. They come at a high price: Novartis AG listed its newly approved cell therapy for cancer at $475,000, while Gilead Sciences Inc. priced its rival drug at $373,000. (Rockoff, 4/26)
The Associated Press:
More Kids Have Autism, Better Diagnosis May Be The Reason
The government estimates that autism is becoming more common, but it's only a small increase and some experts think it can be largely explained by better diagnosing of minority children. About 1 in 59 U.S. children were identified as having autism in 2014, according to a Thursday report from the Centers for Disease Control and Prevention that focused on 8-year-old children. That's up from 1 in 68 children in both 2010 and 2012. (Stobbe, 4/26)
Los Angeles Times:
Here's Why The Apparent Increase In Autism Spectrum Disorders May Be Good For U.S. Children
Normally, health officials would prefer to see less of a disease, not more of it. But in this case, the higher number is probably a sign that more children of color who are on the autism spectrum are being recognized as such and getting services to help them, according to a report published Thursday by the Centers for Disease Control and Prevention. The data come from the CDC's Autism and Developmental Disabilities Monitoring Network. ADDM researchers pore over medical reports from pediatric clinics, neurologists, child psychologists, speech pathologists and physical therapists, as well as records of special education services provided through public schools. (Kaplan, 4/26)
The New York Times:
E. Coli Flare-Up Is Largest Multistate Outbreak Since 2006
A recent spate of infections linked to romaine lettuce is now the largest multistate food-borne E. coli outbreak since 2006, according to data from the Centers for Disease Control and Prevention. At least 84 people were infected in 19 states between mid-March and mid-April, the C.D.C. announced Wednesday, adding more than two dozen cases to its previous count. Because of the time it takes for an illness to reach the agency’s attention, illnesses contracted after April 5 may not yet have been reported, the agency said. (Chokshi, 4/26)
Los Angeles Times:
For Firefighters Who Worked In World Trade Center Rubble, The Future Includes A Heightened Risk Of Cancer
It's been nearly 16 years since cleanup work officially ended at New York City's ground zero, but the health effects for rescue and recovery workers are still making themselves known. Two studies published Thursday in the journal JAMA Oncology suggest that the firefighters who came to lower Manhattan after the Sept. 11, 2001, attacks on the World Trade Center face a heightened risk of cancer — and will continue to do so for years to come. (Kaplan, 4/26)
The Washington Post:
Why Surgeons Amputated A 7-Year-Old’s Leg And Reattached It The Wrong Way
Not long before her seventh birthday, Amelia Eldred, a small dancer with big dreams of performing on stage, received a devastating diagnosis. Doctors discovered a 10-centimeter tumor in the femur in her left leg — and it had broken the bone, according to Birmingham Live. When the tumor did not respond to chemotherapy, doctors told her parents that the limb would need to be amputated, but they had a solution to help the active child maintain her mobility, according to the British news site. (Bever, 4/26)
Stat:
He Was A Tuskegee Study Architect. Should A College Expunge His Name?
Dr. Thomas Parran Jr., whose name graces the main building of the University of Pittsburgh Graduate School of Public Health, has also been called an architect of the syphilis experiments on black men and women in Tuskegee, Ala. While he was surgeon general, he was also aware that U.S. public health researchers were intentionally infecting with syphilis Guatemalan people who were mentally ill or in prison, in the name of research. Now, under pressure from students who say Parran’s role in these experiments shows his disregard for human lives, the university is grappling with whether to strip his name from the building, and by default, the school he helped found after decades of public service. (Satyanarayana, 4/27)
Los Angeles Times:
The Shape, Not Size, Of Our Ancestors' Brains May Have Helped Them Outlast Neanderthals
For more than 200,000 years, Neanderthals successfully occupied the cold, dark forests and shores of Europe. Then early humans came along. Archaeological evidence suggests that human migrants from Africa arrived on the European continent around 40,000 years ago. About that same time, the Neanderthals all died off. (Netburn, 4/27)
The New York Times:
Caffeine During Pregnancy Tied To Overweight Offspring
Consuming caffeine during pregnancy may increase the risk for obesity in childhood, researchers report. A Norwegian study, in BMJ Open, involved 50,943 mother-infant pairs. The mothers reported their caffeine intake at 22 weeks of pregnancy, and the researchers followed their children over the next eight years. After adjusting for other variables, the scientists found that compared with the children of women who consumed less than 50 milligrams of caffeine a day, those whose mothers had 50 to 199 milligrams were only slightly more likely to be overweight at ages 3 through 8 years. (A cup of brewed coffee contains about 100 to 150 milligrams of caffeine.) (Bakalar, 4/26)
Stat:
What Does The Golden State Killer Arrest Mean For Genetic Privacy?
The identity of one of California’s most notorious serial killers had been a mystery for decades — until this week, when law enforcement arrested a suspect. Investigators revealed on Thursday that they made the breakthrough using a remarkable tool: a commercial genealogy website. The unusual manner in which the Golden State Killer case was cracked has sparked wonderment — as well as privacy concerns about how law enforcement can and does use the genetic information that consumers give up to genetic testing companies. That’s because companies generally say on their websites that a customer’s genetic information can be shared with law enforcement if demanded with a warrant. (Robbins, 4/26)
The Associated Press:
A Look At DNA Testing That ID’d A Suspected Serial Killer
Joseph James DeAngelo, who authorities suspect is the so-called Golden State Killer responsible for at least a dozen murders and 50 rapes in the 1970s and 80s, was arrested more than three decades after the last killing with the help of information from an online genealogical site. Investigators haven’t disclosed many key elements about how and why they took this very unusual step to find a suspect. Here’s a look at the case and some of the questions surrounding it. (Balsamo, 4/27)
The New York Times:
Do Serial Killers Just Stop? Yes, Sometimes
The Golden State Killer’s barrage of rapes and murders began in a gold mining area east of Sacramento in 1976. By 1986, it seemed to have stopped.Why? With the arrest Tuesday of Joseph James DeAngelo, 72, who has been charged so far with eight counts of murder, more than 30 years had passed since the last episode in the series. That long period of quiescence seems to fly in the face of the popular belief that serial rapists and killers are incapable of stopping. (Hoffman, 4/26)
The Washington Post:
Smoke From Wisconsin Refinery Explosion Poses Health Risk
An explosion and asphalt fire at a Wisconsin oil refinery on Thursday sent huge plumes of smoke into the air that pollution experts said almost certainly contained large amounts of toxins, posing a serious health risk to those living downwind. Asphalt is a petroleum product that when burned emits chemicals in gaseous form and small particles that can linger long after the smoke dissipates, said Wilma Subra, a chemist with the Louisiana Environmental Action Network who has examined past refinery accidents. (Brown, 4/27)