First Edition: March 30, 2018
Today's early morning highlights from the major news organizations.
Kaiser Health News:
‘Aggressive’ New Advance Directive Would Let Dementia Patients Refuse Food
Treading into ethically and legally uncertain territory, a New York end-of-life agency has approved a new document that lets people stipulate in advance that they don’t want food or water if they develop severe dementia. The directive, finalized this month by the board for End Of Life Choices New York, aims to provide patients a way to hasten death in late-stage dementia, if they choose. (Aleccia, 3/30)
Kaiser Health News:
Podcast: KHN’s ‘What The Health?’ VA Secretary Out, Privatization In?
David Shulkin, the secretary of Veterans Affairs, was fired Wednesday night by President Donald Trump. To replace him, Trump will nominate his White House physician, naval Rear Adm. Ronny Jackson. Shulkin, however, is not going quietly. He took to The New York Times op-ed page to claim he was pushed out by those who want to privatize VA health services for profit. (3/29)
California Healthline:
A Little-Known Activist Thinks Big About Single-Payer
There’s a new guy in Sacramento-town — and he’s leading the charge to ease funding for “single-payer” health care in California.He’s not a doctor or nurse, not a lobbyist or legislator. Dale Fountain, 42, is a publicity-shy high-tech worker seeking signatures for his proposed ballot initiative, mostly through Facebook. (3/29)
The New York Times:
Veterans Affairs Shake-Up Stirs New Fears Of Privatized Care
President Trump’s dismissal of David J. Shulkin, the secretary of veterans affairs — and the nomination of a man with no known policy views to take his place — has brought renewed focus to an increasingly contentious debate over whether to give veterans the option of using the benefits they earned through military service to see private doctors rather than going to government hospitals and clinics. (Fandos, 3/29)
Politico:
White House: 'No One Is Talking About Privatizing The VA'
President Donald Trump said Thursday he fired Veterans Affairs Secretary David Shulkin because he wanted to give veterans more choices, but a spokesperson said his actions did not signal a desire to privatize veterans' health services. "No one is talking about privatizing the VA," deputy press secretary Lindsay Walters said in an email. She also told pool reporters Thursday that the selection of Dr. Ronny Jackson, the White House doctor, to be Shulkin's replacement was not an indication of a privatization plan. (Lima, 3/29)
The Washington Post:
Trump’s Pick To Head Veterans Department Faces Skepticism Over His Experience
The White House was thrown on the defensive Thursday over President Trump’s choice to lead the Department of Veterans Affairs, forcing officials to fend off mounting skepticism that Ronny L. Jackson has the experience to run the government’s second-largest agency. Trump announced by tweet late Wednesday that the White House physician would succeed ousted secretary David Shulkin, surprising veterans groups and lawmakers, who were not notified beforehand and scrambled to learn the policy views of someone whose positions on the chronic challenges facing VA are unknown. (Rein, Kim, Wax-Thibodeaux, and Dawsey, 3/29)
The Wall Street Journal:
Lawmakers Respond Cautiously To Little-Known VA Pick Ronny Jackson
Capitol Hill lawmakers reacted guardedly to President Donald Trump’s nomination of the White House physician to head the Department of Veterans Affairs, with key members noting that they know little about him. Dr. Ronny Jackson, a U.S. Navy rear admiral who has served as a White House physician during the past three administrations, is slated to succeed Secretary David Shulkin, who was ousted Wednesday. Mr. Trump indicated on Thursday that he removed Dr. Shulkin because change at the agency was coming too slowly. The secretary had also been the subject of a travel-expenses scandal. (Radnofsky and Nicholas, 3/29)
Politico:
Trump’s VA Pick Blindsides Staff, Deepens Agency Disarray
The timing of President Donald Trump’s announcement to name Rear Admiral Ronny Jackson to lead Veterans Affairs was a snap decision that surprised his own chief of staff and knocked the government's second-largest agency, already bedeviled by scandal, deeper into disarray. White House chief of staff John Kelly had spoken with David Shulkin by phone Wednesday morning, reassuring the now-former VA secretary that he wouldn’t be fired by tweet that afternoon. Hours later, Kelly had to phone Shulkin again telling him plans had changed. (Woellert, Johnson and O'Brien, 3/29)
Politico:
No Longer Muzzled, Shulkin Takes On Trump’s White House
Ousted Veterans Affairs Secretary David Shulkin is going down swinging. Instead of disappearing into obscurity like others who were summarily fired by President Donald Trump, Shulkin is using his dismissal as an opportunity to step into the spotlight. Freed from the constraints of serving in the Trump administration, Shulkin is publicly — and loudly — raising red flags about what he sees as a sinister plot to privatize veterans’ health care. (Restuccia and Nelson, 3/29)
The Associated Press:
Fired VA Secretary Says Privatization Advocates Doomed Him
Former Veterans Affairs Secretary David Shulkin is blaming his sudden ouster from the Trump administration on "political forces" that he says are bent on privatizing the agency and putting "companies with profits" over the care of veterans. Shulkin, the lone Obama administration holdover serving in President Donald Trump's Cabinet, blasted a "toxic" and "subversive" environment in Washington that made it impossible for him to lead. In a tweet late Wednesday, President Donald Trump fired Shulkin, who faced a mounting internal rebellion at VA and a bruising ethics scandal. (Yen and Miller, 3/29)
Politico:
Shulkin: Trump Didn’t Mention Firing In Call Hours Before He Was Fired
Hours before he was ousted, former Veterans Affairs Secretary David Shulkin discussed his progress in his position with President Donald Trump — who gave him no indication that he would later fire him. Shulkin said during an interview with MSNBC that he spoke on the phone to Trump on Wednesday about needing to focus on polices to help the VA. (Morin, 3/29)
The Associated Press:
Pentagon Silent On Transgender Policy Released Last Week
Nearly a week after the Pentagon publicly posted its new recommended policy on transgender troops, the department's chief spokeswoman refused to clarify portions of the memo or settle confusion about whether service members who have already transitioned from one gender to another would be discharged under the proposed plan. (3/29)
The Wall Street Journal:
Walmart In Early-Stage Acquisition Talks With Humana
Walmart Inc. is in preliminary talks to buy insurer Humana Inc., according to people familiar with the matter, a deal that would mark a dramatic shift for the retail behemoth and the latest in a recent flurry of big deals in health-care services. It isn’t clear what terms the companies may be discussing, and there is no guarantee they will strike a deal. If they do, the deal would be big: Humana currently has a market value of about $37 billion. (Mattioli, Nassauer and Wilde Mathews, 3/29)
Reuters:
Walmart Talking With Humana On Closer Ties; Purchase Possible: Sources
Should the talks lead to a tieup, it would be the latest deal to bring together a retail chain and a health insurer, following CVS Health Corp's $69 billion deal to acquire Aetna Inc and Cigna Corp's $54 billion deal to buy Express Scripts Holding Co. (O'Donnell and Roumeliotis, 3/29)
Bloomberg:
Walmart Is In Early Talks With Humana, WSJ Reports
An acquisition of Humana’s size -- $37 billion -- would be rare for Walmart, which has mostly been focused on buying e-commerce companies, including last year’s deals for Bonobos Inc. and ModCloth. But the company still gets plenty of shoppers in physical stores who rely on its 4,700 pharmacies in the U.S. Like drugstore chain CVS, Walmart could use a partnership with an insurer, or even a merger, to take on a more powerful role in the delivery of medications to consumers. (Tracer and Hammond, 3/29)
Stat:
FDA Charts Biosimilars' Future — But Drug Makers Aren't All On Board
In his recent public appearances, Food and Drug Administration Commissioner Scott Gottlieb has sounded a repeating note: drug prices are too high, and especially prices for complicated protein-based drugs called biologics. The answer, he says, is in part encouraging generic biologics, called biosimilars, to enter the market. And one way in which the FDA can do so, Gottlieb told an assembled crowd of insurers at an industry conference earlier this month, is to set clearer standards for what these drugs have to prove to be considered equivalent — or interchangeable — to the originals. (Swetlitz, 3/30)
The Hill:
Azar Taps Former CVS Executive To Help Lower Drug Prices
Health and Human Services Secretary Alex Azar is tapping a former CVS Caremark executive to lead the agency’s efforts to lower drug prices. According to HHS, Daniel Best will be Azar’s senior adviser for drug pricing reform. Best was most recently a vice president of industry relations for CVS’s Medicare Part D business. This included the company’s prescription drug plans, Medicare Part D plans and other clients. (Weixel, 3/29)
Stat:
Students Push UCLA To Improve Access To A Cancer Drug Developed By Its Scientists
Students at UCLA are calling on the university to ease access to a prostate cancer drug developed on campus. The drug, Xtandi, is at the center of a legal battle in India over whether generic competitors can enter the market — a battle in which, students say, the university is on the wrong side. (Cooney, 3/30)
The Washington Post:
In Emotional Speech, CDC’s New Leader Vows To Uphold Science
Robert Redfield Jr., the new director of the Centers for Disease Control and Prevention, gave a deeply personal agencywide address Thursday in which he repeatedly underscored the importance of science and data and said the CDC's most critical public health mission is to protect Americans “from that which we don't expect.” (Sun, 3/29)
Stat:
U.S. Can End AIDS Epidemic Within Seven Years, CDC Director Says
The AIDS epidemic in the United States could be ended in the next few years, the new director of the Centers for Disease Control and Protection predicted Wednesday, saying that health officials have all the tools they need to prevent its spread. Dr. Robert Redfield, a former AIDS researcher who has spent decades treating people infected with HIV, made the remark in an all-hands meeting for CDC staff on his second full day at the Atlanta-based agency. Redfield is the agency’s 18th director. (Branswell, 3/29)
The Associated Press:
CDC Director Pledges To Bring Opioid Epidemic 'To Its Knees'
He called the opioid-driven surge in drug overdose deaths "the public health crisis of our time," and he stressed the importance of getting treatment for addicts and enhancing the CDC's tracking of the epidemic. "We will help bring this epidemic to its knees," he said. He also talked about his decades working in AIDS research and treatment. "Ending the AIDS epidemic in America is possible," he said. "I think it can be done in the next three to seven years if we put our minds to it." (Stobbe, 3/29)
Los Angeles Times:
Opioid Overdose Deaths Are Still Rising In Nearly Every Segment Of The Country, CDC Says
At a time when the country seems hopelessly divided, health officials are here to remind us of something that unites Americans from all walks of life: deaths tied to opioid overdoses. A report issued Thursday by the Centers for Disease Control and Prevention presents some alarming new statistics about the opioid epidemic that claims the lives of 115 Americans each day. Researchers from the CDC’s National Center for Injury Prevention and Control examined data on fatal overdoses from the 31 states that made reliable reports of drug-related causes of death to the CDC’s National Vital Statistics System. The District of Columbia was included as well. (Kaplan, 3/29)
The Hill:
Powerful Synthetic Opioid Driving Increase In Overdose Deaths: CDC Report
The opioid epidemic is showing no signs of slowing down, as a new analysis reveals overdose deaths are rising among demographic groups and spreading geographically, and powerful synthetic opioids are largely behind the increases. “The opioid overdose epidemic in the United States continues to worsen,” according to an in-depth analysis of 2016 drug overdose data from the Centers for Disease Control and Prevention (CDC). (Roubein, 3/29)
The Associated Press:
Arkansas Sues Drugmakers It Blames For Deadly Opioid Crisis
Arkansas officials filed a lawsuit against three drug manufacturers Thursday, claiming overzealous and deceptive marketing contributed to an increase in opioid abuse that fueled a spike in overdose deaths. The lawsuit in state court names Purdue Pharma, Johnson & Johnson and Endo Pharmaceuticals. The state claims they broke laws against deceptive trade practices and the filing of false Medicaid claims. (Kissel, 3/29)
The Washington Post:
Unique ‘Emergency Room’ For Addicts To Open In Baltimore
Baltimore is trying a new way to treat people who are under the influence of drugs or alcohol, opening up a unique facility that will offer a safe, short-term place for them to recover and connect with other services. Officials call it a stabilization center, and they secured $6.2 million for it. The center will be the first of its kind in Maryland. Patients who meet the criteria will be taken to the 24/7 center instead of an emergency room. (Columbus, 3/29)
The Associated Press:
Lawmakers OK Bill To Steer More Pregnant Inmates Into Rehab
Faced with a fast-growing incarceration rate, Kentucky is moving forward with a plan to keep some pregnant women out of jail for nonviolent offenses. The House overwhelmingly passed a bill to allow women facing low-level drug or similar charges to get into rehabilitation as they wait for their cases to move through the court system. It also could apply to women already convicted of those offenses. (Schreiner, 3/29)
The Hill:
Senate Dems Say Changes To Family Planning Program Could Undercut Access To Care
Recent changes to the Title X family planning program for low-income women and men could undercut access to reproductive health care, Senate Democrats argued in a letter to the Trump administration Thursday. In a funding announcement released last month, the Department of Health and Human Services (HHS) said grantees should be able to provide primary health services, as well as reproductive health services. (Hellmann, 3/29)
Stat:
Guidelines For Abortion Pill Were Properly Eased, Report Finds
A congressional watchdog agency has concluded the Food and Drug Administration properly conducted a review of the controversial Mifeprex abortion pill before relaxing usage guidelines two years ago, a move that prompted complaints by some lawmakers and anti-abortion activists that the shift was politically motivated. (Silverman, 3/29)
The Associated Press:
California Judge: Coffee Needs Cancer Warnings
A Los Angeles judge ruled that California law requires coffee companies to carry an ominous cancer warning label because of a chemical produced in the roasting process. Superior Court Judge Elihu Berle wrote in a proposed ruling Wednesday that Starbucks and other coffee companies failed to show that the threat from the chemical was insignificant. (Malley, 3/29)
Bloomberg:
Coffee Sellers Can't Dodge California Cancer-Warning Law, Judge Says
A California state judge in Los Angeles issued a tentative ruling in a lawsuit brought against dozens of companies, including Starbucks Corp., Target Corp., 7-Eleven Inc. and Whole Foods Market for their alleged failure to comply with the state’s required warnings. The companies failed to persuade the judge that “sound considerations of public health” support an exemption from California’s Proposition 65 warning for the chemical acrylamide in coffee. (Pettersson, 3/29)
Los Angeles Times:
Judge Rules Coffee Sold In California Requires Cancer Labels
Berle said scientists who testified on behalf of the coffee companies failed to prove that there was an acceptable level of acrylamide. Earlier in the trial, he also ruled that the coffee companies failed to show the chemical was not a significant risk or that requiring them to include the warnings would violate the 1st Amendment. "While Plaintiff offered evidence that consumption of coffee increases the risk of harm to the fetus, to infants, to children and to adults, Defendants' medical and epidemiology experts testified that they had no opinion on causation," he wrote. (Kim, 3/29)
The Washington Post:
Starbucks, Other Coffee Companies Must Have Cancer Warning Label, California Judge Rules
In addition to the warning signs likely to result from the lawsuit, the Council for Education and Research on Toxics, which brought the lawsuit, has asked for fines as much as $2,500 for every person exposed to the chemical since 2002, potentially opening the door to massive settlements. Starbucks is the lead defendant in the case; others like 7-Eleven have already settled. Starbucks did not immediately respond to a request for comment. (Rosenberg, 3/29)
The Wall Street Journal:
California Judge Rules Coffee Must Carry Cancer Warning
Under Proposition 65, cancer warnings already appear in places as far-ranging as apartment-building lobbies, parking garages and restaurants. Businesses must warn about the presence of any of more than 900 chemicals on a list of those known to the state of California to cause cancer, birth defects or other reproductive harm. Acrylamide, used for industrial processes like making paper and dyes, is also created during the cooking process for many baked and fried foods, including potato chips, bread and french fries. Many of those products also contain the cancer warnings as a result of litigation. (Randazzo, 3/29)
The Washington Post:
‘Our Greatest Fear’: Highly Drug-Resistant Gonorrhea Confirmed By Health Officials
A super-resistant strain of gonorrhea has been reported in the United Kingdom following warnings from global public health officials that the common sexually transmitted disease is becoming more difficult to treat. Health officials in England said it is the first time that a case of gonorrhea could not be treated successfully with antibiotics that are commonly used to cure it. (Bever, 3/29)
The Washington Post:
Mass Violence In The U.S. Usually Follows Warning Signs From Attackers, Report Finds
The attacks have taken on a numbing familiarity in recent years: five shot to death at an airport in South Florida. Twenty-six slain at a church in Texas. Five killed by a gunman rampaging through Northern California. These violent outbursts last year, and others like them, had key things in common. Chief among them: Long before the violence, the people identified as attackers had elicited concerns from those who had encountered them, red flags that littered their paths to wreaking havoc on unsuspecting strangers. (Berman, 3/29)
The Washington Post:
One Year After Delaying Obama’s Nutrition Rules, Trump’s FDA Says It Will Embrace Them
The Trump administration will encourage the food industry to reduce the salt in processed foods and will take steps to overhaul some food labels to make them easier to understand, Food and Drug Administration Commissioner Scott Gottlieb announced Thursday. The FDA will also move forward with Obama-era plans to require calorie labeling on restaurant menus and new “Nutrition Facts” panels on food products, two rules the agency had delayed. (Dewey, 3/29)
The New York Times:
Why Do Cracking Knuckles Make That Noise? You Might Need A Calculator
In some households, cracking your knuckles is a declaration of war. Whether you’re in the camp that can’t stand the sound or the one that can’t see what the fuss is about, you might be surprised to learn that where exactly the sound is coming from — what precisely in the knuckle produces it — is still a subject of scientific research. (Greenwood, 3/29)
The New York Times:
Many Americans Try Retirement, Then Change Their Minds
Sue Ellen King had circled her retirement date on the calendar: March 8, 2015. She had worked as a critical care nurse and nursing educator at University of Florida Health (UF Health) in Jacksonville, Fla., for 38 years; co-workers joked that she was there when the hospital’s foundation was laid, which happened to be true. So the send-offs went on for days — parties in the units where she had worked, a dinner in her honor, gifts including a framed photo signed by colleagues. (Span, 3/30)
The Washington Post:
Republican Medicaid Expanders In Va. Say Backlash Is Milder Than Expected
Del. Terry Kilgore did an about-face on Obamacare this year, voting to add up to 400,000 poor, uninsured Virginians to the state’s Medicaid rolls after years of steadfast opposition. When the Southwest Virginia Republican returned home from Richmond after the General Assembly adjourned, ads on his local radio station were blasting him — and broadcasting his office phone number. Bankrolled by conservative powerhouse Americans for Prosperity, the ads urged voters to call and let Kilgore have it. (Vozzella, 3/29)
The Associated Press:
CDC Get $480 Million To Replace Lab For Deadliest Germs
The nation's top public health agency has its money for a new lab to handle dangerous germs. Last month, the Centers for Disease Control and Prevention asked Congress for funds to build a new state-of-the art laboratory building. CDC officials got $480 million for the endeavor. Money for the project was tucked inside a $1.3 trillion, 2,232-page government spending bill passed by Congress last week. (Stobbe, 3/29)
The Associated Press:
Hawaii Lawmakers Legalize Medically Assisted Suicide
Hawaii lawmakers approved legislation Thursday that would make it the latest liberal-leaning state to legalize medically assisted suicide. The state Senate voted 23-2 to pass the measure that has already cleared the House. It allows doctors to fulfill requests from terminally ill patients for prescription medication that will allow them to die. The governor has said he will sign the bill, which would make Hawaii the sixth state to legalize the practice, plus Washington, D.C. (3/29)
The Associated Press:
University Recovers Money It Paid To Doctor After His Death
The University of Connecticut announced Thursday that it has recovered more than $50,000 it paid to a slain researcher while it believed he was working from home. Police checking on the welfare of Dr. Pierluigi Bigazzi, a professor of laboratory science and pathology at UConn Health, found his body on Feb. 5 wrapped in plastic inside the house he shared with his wife. (3/29)