First Edition: August 11, 2014
Today's headlines include reports about health exchange developments in Oregon and Massachusetts.
Kaiser Health News: Washington's $10 Billion Search For Health Care's Next Big Ideas
Kaiser Health News staff writer Jay Hancock reports: “The Affordable Care Act was supposed to mend what President Barack Obama called a broken health care system, but its best-known programs — online insurance and expanded Medicaid for the poor — affect a relatively small portion of Americans. A federal office you’ve probably never heard of is supposed to fix health care for everybody else” (Hancock, 8/11). Read the story, which also appeared in The Washington Post.
Kaiser Health News: Capsules: If You Have A Stroke, Better It Should Be In Paris
Now on Kaiser Health News’ blog, Frank Browning writes: “I had a stroke last month, oh boy. It’s just that I know it. Here’s what happened: Only after three days of flashing, floating visual squiggles — commonly known as ocular migraines that usually last 20 minutes — do I e-mail my old friend Dr. John Krakauer, who helps run stroke recovery at Johns Hopkins Hospital in Baltimore. After a few questions he told me to get an MRI scan as soon as possible. In the U.S. that could involve the emergency room (with its hours-long wait) or a complicated process of getting the referral — and then finding a radiologist who would take my coverage. Here, it is so much simpler” (Browning, 8/11). Check out what else is on the blog.
Los Angeles Times: Oracle Sues Oregon Over Botched Obamacare Exchange
The legal battle over Oregon's dysfunctional health insurance exchange officially began this week when Oracle Corp. sued the state agency operating the exchange, alleging breach of contract and accusing Gov. John Kitzhaber of attempting to systematically "vilify the company in the media." In a 21-page complaint filed Friday in federal court for the District of Oregon, Portland Division, Oracle charges that during the early months of this year, state officials privately continued to request Oracle's help to fix their system while engaging in a campaign of "constant public slander" against the tech company (Reston, 8/9).
The Associated Press: Oracle Sues Oregon Over Health Insurance Exchange
Oracle Corp. has sued the state of Oregon in a fight over the state's health insurance exchange, saying government officials are using the technology company's software despite $23 million in disputed bills. Oracle's breach-of-contract lawsuit against Cover Oregon was filed Friday in federal court in Portland. It alleges that state officials repeatedly promised to pay the company but have not done so (Cooper and Wozniacka, 8/8).
The Wall Street Journal: Massachusetts To Replace Health Exchange With Privately Run System
Massachusetts will replace its failed online health-insurance exchange with another from a private company rather than shifting to the federally run marketplace, a state health official said Friday. The state has been scrambling to replace the old system after a problem-plagued enrollment period late last year. In June, it cut ties with the system's architect, CGI Group Inc. (Kamp, 8/8).
The New York Times: Uniting To Take Congress, G.O.P. Tries To Become The Party Of ‘Yes’
With control of Congress within reach, Republicans are quietly assembling an aggressive 2015 agenda built around a push for a balanced budget and quick passage of measures, like approval of the Keystone XL pipeline and repeal of a medical equipment tax, to show they can govern. ... Republicans say they would lay the procedural groundwork within the budget for more sweeping changes on taxes and in social programs such as Medicare and Medicaid by initiating an arcane budget process known as reconciliation. The procedure can protect legislation from a filibuster and its 60-vote threshold and reduce the need for Democratic support. ... Even as they talk about pragmatic achievable solutions, though, Republicans also say they are likely to take an early symbolic vote on repeal of the health care law, which would face a certain veto by Mr. Obama. After that showdown, Republicans say, they could move on to more realistic proposals and changes in the law (Hulse, 8/9).
The New York Times: Midterms Give Parties Chance For Sweeping Control Of States
Republicans are looking to take over senates in Colorado, Iowa, Oregon, Maine and Nevada, and houses in Kentucky, New Hampshire and West Virginia. Republicans could emerge with complete control of the legislatures in New Hampshire and Kentucky, though both of those states have Democratic governors. They hope these victories will help them push through legislation that has been stymied by Democrats until now, such as pressing the kind of restrictions on labor organizing the party passed in Wisconsin, or rolling back gun laws in Colorado. In Iowa, Republicans are looking to eliminate a tax on manufacturing and enact a ban there on telemedicine abortions, where women in rural areas obtain abortion pills after videoconference consultations with faraway doctors (Nagourney, 8/10).
The Associated Press: Crist Opponents Question His Political Conversion
Crist’s reputation for being a say-anything-for-a-vote politician isn’t new. …President Barack Obama’s health care overhaul: As a Republican Senate candidate in 2009, Crist said Obama’s plan was “cockamamie” and “nuts” and demanded its repeal; as a 2010 independent Senate candidate, Crist said there were positive things about the law and it should be fixed, not repealed; as a 2014 Democratic gubernatorial candidate, he says it’s “great” (8/10).
The Associated Press: Medicaid Expansion Talk Key In Fla. Governors Race
Expanding Medicaid to an additional 1 million Floridians under President Barack Obama’s new health law is turning into one of the biggest issues of this year’s gubernatorial race. Former Gov. Charlie Crist brings up the topic on most campaign stops and says one of the first things he’ll do if elected is call a special session to expand Medicaid. His opponent, incumbent Republican Gov. Rick Scott, seems to be waning in his support. Scott says he’s open to taking roughly $51 billion over the next decade from the federal government, but only as long as Florida taxpayers aren’t left with the bill (Kennedy, 8/9).
The New York Times: New V.A. Chief Promises To Mend Practices
In his first public address since taking the helm of the embattled Department of Veterans Affairs, Secretary Robert A. McDonald vowed on Saturday to restore trust in the agency by initiating an independent audit of its scheduling practices and holding poorly performing officials accountable. Speaking to about 4,000 people at the Disabled American Veterans national conference here, Mr. McDonald acknowledged systemic problems that have plagued the agency; attempts to “game the system” to hide problems; and a culture that failed to protect whistle-blowers who pointed them out (Curtis, 8/9).
The Wall Street Journal: New VA Secretary Seeks Independent Review Of Scheduling Practices
The Department of Veterans Affairs will launch an independent review of its scheduling practices beginning in the fall, the VA announced Friday. In one of his first major announcements as VA secretary, Robert McDonald said the Joint Commission, the largest health care accrediting body in the country, will a make a sweeping, independent review of the VA's scheduling practices (Kessling, 8/8).
The Associated Press: VA Chief Makes 1st Hospital Visit Amid Scandal
Veterans Affairs Secretary Robert McDonald visited a VA hospital Friday for the first time since taking over the embattled agency last month, meeting with veterans and health care providers and vowing to restore trust in the organization. Reports that dozens of people died while waiting to see a doctor and that employees covered up long wait times at the Phoenix VA hospital helped touch off a national firestorm over veteran care. The former VA secretary was forced to resign, and President Barack Obama on Thursday signed a $16.3 billion law to overhaul the department (Kashfi, 8/9).
The Texas Tribune/The New York Times: In the Valley, High Hopes For A V.A. Voucher Effort
In the [Rio Grande] Valley, where the closest veterans hospital is more than 250 miles away, veterans have long had to seek specialty care in the private sector by using vouchers. Those vouchers grant the patients access, but the providers must file invoices to get paid. In light of whistle-blower claims that staff members at agency hospitals nationwide fudged records to make it appear that veterans were experiencing shorter waiting times, the system is expanding the voucher program as part of a major overhaul to help address the massive backlog. Doctors and patients in the Valley welcomed the additional resources, but they said the voucher program must be improved to maximize its effectiveness (Rocha, 8/9).
Los Angeles Times: PTSD Continues To Afflict Vietnam Veterans 40 Years After The War
our decades after the Vietnam War, 11% of its veterans still suffer from post-traumatic stress disorder, according to new research suggesting that for some people it is a condition unlikely to ever go away. The findings, presented Friday at a meeting of the American Psychological Assn., provide a rare look at the long-term course of PTSD in veterans. The research updates a landmark study conducted in the 1980s, when researchers found that 15% of Vietnam veterans had the disorder. Despite the passage of many years and the increasing availability of effective treatments for PTSD, the picture remains much the same (Zarembo, 8/8).
The Wall Street Journal: More Workers File Family-Leave Lawsuits
The 1993 law guarantees employees as many as 12 weeks of unpaid leave a year for medical and family reasons, and bars employers from retaliating against workers for taking it. Lawsuits filed under the statute jumped to 877 in 2013 from 291 a year earlier, according to the most-recent figures from the Administrative Office of the U.S. Courts. The number of family-leave cases was dwarfed by the more than 15,000 suits filed last year accusing companies of violating laws that protect against race, sex or disability discrimination. But the FMLA was the only one among those laws to generate a sharp increase in claims. The statute requires a lower threshold of proof than most other employment laws (Palazzolo, 8/8).
The New York Times: Ebola Drug Could Save A Few Lives. But Whose?
A history of controversy about drug testing in Africa is just one of the complexities facing public health authorities as they wrestle with whether and how to bring that drug and possibly other experimental ones to the countries afflicted with Ebola. Who should get such a scarce supply of medicine? Health workers? Children? The newly infected who are not yet as sick? There are virtually no remaining supplies of the drug, called ZMapp, that was used to treat the two Americans, United States officials say. And even a few months from now, according to various estimates, there may be no more than a few hundred doses (Pollack, 8/8).
The New York Times: Fighting Deadly Diseases Without Breaking A Sweat
The diversity of infectious ailments in the city was part of what drew Dr. Phillips to New York. As a young epidemiologist, he dreamed of battling tuberculosis in Eastern Europe. Then he met Dr. Marcelle Layton, a city health official. She persuaded him to instead battle communicable diseases in the city as an epidemic intelligence service officer for the Centers for Disease Control assigned to the health department in 2000. “I get to eastern Brooklyn,” Dr. Phillips said. “It’s just as good.” Over the years, he has learned to expect the unexpected (Swarns, 8/10).
The Texas Tribune/New York Times: A New Test For Texas’ Abortion Restrictions
The latest legal challenge to Texas’ sweeping abortion measures went to trial in a federal courthouse in Austin last week, as federal judges around the country grapple with the question of how far states can go in regulating abortion — a question that seems likely to end up in the United States Supreme Court. The crux of the matter is what the Supreme Court meant when it ruled in 1992 that abortion regulations may not impose an “undue burden” on women seeking an abortion. Some judges have held that as long as a law has a “rational basis” and does not prevent most women from getting an abortion, it does not impose an undue burden. But others have suggested that laws making abortions harder to get must have a good reason for doing so (Edelman, 8/9).
The New York Times: Out-of-State Clinic Is Central In Texas Abortion Law Fight
Of all the clinics and facilities at the center of a federal lawsuit challenging Texas’ sweeping abortion law passed last year, one has stuck out. It is not in Texas, but about a mile across the state line in Santa Teresa, N.M. Its role in the case gets to the heart of the legal questions swirling around the trial here this week. The law will soon force El Paso’s sole abortion clinic to shut its doors, leaving no abortion providers in all of West Texas. Opponents of the law said that would force women to embark on a lengthy drive to the nearest abortion provider in San Antonio. For women in El Paso, for example, it amounts to a nearly eight-hour, 550-mile trip one way (Fernandez, 8/8).
The Washington Post: Admitting-Privileges Laws Have Created High Hurdle For Abortion Providers To Clear
Among the raft of abortion restrictions passed by states in the past few years, one did not initially gain much notice — a requirement that doctors performing abortions obtain admitting privileges at a local hospital. But the measure, which 11 states have passed in some form, has proved an especially high hurdle for abortion providers to clear and a potent tool for antiabortion activists seeking to shut down abortion clinics (Somashekhar, 8/10).
USA Today: What Ails Appalachia Ails The Nation
Diabetes is slowly ravaging Alisha Blankenbeckler's body — stealing her eyesight, impairing her kidneys and damaging her nerves so severely she can barely walk across a parking lot without help. And she's only 48. "I try to stay upbeat no matter how bad I feel," she says, mostly so she can keep caring for a husband with dangerously high blood pressure. "It's difficult, though. Dying is something I think about every day." The couple's travails are common in this corner of Appalachia, one of the nation's unhealthiest regions, a place plagued by poor health habits and sky-high levels of chronic disease that some experts say may be a harbinger of where the country is headed if we don't rein in epidemics like obesity. This week, U.S. Centers for Disease Control and Prevention Director Tom Frieden made a "house call" to find out more about the underlying causes of the region's ills and how to treat them — and in the process gain traction against the rising burden of chronic disease that ails the nation. … Appalachia, like some blighted urban areas and Native American reservations, mixes several ingredients of poor health: doctor shortages and access-to-care problems; stressful, unhealthy lifestyles; low education levels; and insidious poverty (Ungar, 8/8).
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