- Kaiser Health News Original Stories 1
- Concerned About Losing Your Marketplace Plan? ACA Repeal May Take Awhile
- Political Cartoon: 'Weight Up'
- Health Law 4
- Following Trump's Win, Americans Sign Up For Health Law Coverage In Droves
- Trump's Daunting Challenge: How Do You Actually Replace Obamacare?
- Medicaid Expansion Might Continue With Key Changes But States May Have Higher Spending
- Trump's Vague Policies Leave Key Questions On Future Of Health Coverage, Quality, Medicare
- Women’s Health 2
- Abortion-Rights Advocates Terrified Of Trump: Nobody 'Has Any Earthly Idea Of What He Is Going To Do'
- Women, In Fear Of Losing Contraception Coverage, Eye Long-Lasting IUDs
- Public Health 3
- Suicide Hotlines Fielded Unprecedented Volume Of Calls On Election Night
- Misconceptions About Methadone Undermine Opioid Treatment Efforts
- Higher Tobacco Taxes Make A Dent In Smoking Rates
- State Watch 1
- State Highlights: Mich. Must Offer Water-Bottle Delivery To Flint Residents; Kan. Program Helps People With Mental Illness Leave State Hospital
- Health Policy Research 1
- Research Roundup: ACOs And Non-Medical Needs; Library Health; Retail Clinics And ERs
From Kaiser Health News - Latest Stories:
Republican efforts to get rid of the federal health law are expected to take some time to work through Congress and leaders have promised to give consumers time to adjust to those changes. (Michelle Andrews, 11/10)
Kaiser Health News provides a fresh take on health policy developments with "Political Cartoon: 'Weight Up'" by Signe Wilkinson .
Here's today's health policy haiku:
THE BIRTH CONTROL CHOICE THAT LASTS LONGER THAN TRUMP’S FIRST TERM
Election result: there’s a
Rush on IUDs.
If you have a health policy haiku to share, please Contact Us and let us know if you want us to include your name. Keep in mind that we give extra points if you link back to a KHN original story.
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Summaries Of The News:
More than 100,000 people enrolled in coverage on Wednesday. Meanwhile, the White House says getting people signed up is its top priority.
Los Angeles Times:
More People Signed Up For Obamacare The Day After Trump Was Elected Than Any Day This Enrollment Period
Underscoring the challenge President-elect Donald Trump faces repealing the Affordable Care Act, more than 100,000 people signed up for health coverage through the law on Wednesday, the day after Trump’s election. The tally, reported Thursday by the Obama administration, marked the busiest day since the enrollment period for coverage in 2017 began Nov. 1. (Levey, 11/10)
The Wall Street Journal:
Affordable Care Act Enrollment Surges Following Trump Election
“Is it people trying to get in before something happens? I don’t know but it’s possible,” said Brian Burton, an enrollment worker in Lafayette, La. Health analysts, insurance brokers, and the navigators who help people obtain coverage said some consumers fear Republicans will take away the tax subsidies that offset premium costs. Some also said people are asking if they can forgo enrolling because they believe the Trump administration will end a requirement that most individuals have health insurance or pay a penalty. (Armour, 11/10)
Burwell: Wednesday Was Best Day Yet for 2017 Obamacare Sign-Ups
More people signed up for health insurance through HealthCare.gov Wednesday, the day after Donald Trump was elected the next U.S. president, than any other day so far of the open enrollment period. Consumers selected more than 100,000 plans Wednesday, [Health and Human Services Secretary Sylvia Burwell] said. (McIntire, 11/10)
ObamaCare Sign-Ups Surge Post-Election
More than 100,000 people selected plans through HealthCare.gov on Wednesday, the Department of Health and Human Services (HHS) announced. “Best day yet this Open Enrollment,” HHS Secretary Sylvia Mathews Burwell wrote in a tweet. Wednesday marked the first day that the Obama administration actively began marketing its healthcare signup period this year, which began Nov. 1. Officials at HHS had already planned to expand the program's outreach following the election, after the candidates' campaigns no longer clogged the airwaves. Even though the GOP's wave victory on Election Day likely dooms ObamaCare, the White House has made clear that it plans to forge on with this year's enrollment period. (Ferris, 11/10)
The New York Times:
No Affordable Care Act? Health Insurers Weren’t Expecting That
More than 100,000 Americans rushed to buy health insurance under the Affordable Care Act on Wednesday, the biggest turnout yet during this year’s sign-up period, the day after the election of Donald J. Trump, who has promised to repeal the law. The figure, announced by the Obama administration, added to a sense of whiplash about the law, and underscored the magnitude of any change. Despite all the criticisms about the law coming from President-elect Trump and his allies, millions of people now depend on it for coverage. (Abelson, 11/11)
The New York Times:
White House Says Obamacare Enrollment A Priority
Getting more Americans to enroll for health insurance under President Barack Obama's healthcare law known as Obamacare is a top priority of his administration until President-elect Donald Trump takes office on Jan. 20, the White House said on Thursday. "We would be focused on ... maximizing the opportunity that currently is available for millions of Americans to go to healthcare.gov during the open enrollment period and sign up for healthcare," White House spokesman Josh Earnest told a news briefing. (Heavey and Hummer, 11/10)
Obamacare Allies Push Enrollment Ahead Of Law's Dismantling
Obamacare may be toast by next year, but it's still here for now — and the law's supporters are doing all they can to reassure confused and worried consumers they can still get insurance. Advocates working to boost enrollment say they are focused on the current reality, two months before President-elect Donald Trump takes office. Individuals can still sign up for coverage and potentially qualify for subsidies, even as Republicans are drawing up plans to dismantle the law early next year. (Pradhan and Demko, 11/10)
The San Antonio Express News:
People In S.A. Signing Up For Obamacare Even As Trump Vows Repeal
President-elect Donald Trump has vowed to take steps to repeal and replace the Affordable Care Act within his first 100 days in office. With Republicans taking control of the presidency, House and Senate in January, the question is no longer if they will make changes to the Affordable Care Act, but when and how. (Martin, 11/10)
There are several portions of the health law Donald Trump will be able to roll back on his first day. But he, and congressional Republicans, will find it hard to strip 20 million people of health care coverage overnight.
Obamacare Under President Trump: What Happens Next?
Trump has yet to lay out a detailed plan on how he'd replace Obamacare. But it's unlikely he and Congress will do anything that kills Obamacare for those who sign up for coverage next year, experts say. Open enrollment has already started, and the Obama administration estimated more than 11.4 million people will be insured through the exchanges in 2017. Any legislation will probably include a delayed shuttering of the exchanges -- and of the federal subsidies program that millions depend on to afford the policies -- to give enrollees time to find coverage elsewhere. The insurance industry will also need a period to adjust since any swift changes to the individual market could throw their businesses into turmoil. (Luhby, 11/10)
Los Angeles Times:
Donald Trump Wants To Replace Obamacare. But It's Not That Simple.
Republicans, who for six years have promised to repeal and replace the Affordable Care Act, will finally get their chance to do it. But even with control of the White House and Congress, it’s unclear whether the GOP can pull it off. (Levey, 11/10)
The Associated Press:
Behind The Smiles, Tough Reality For Trump And GOP Congress
The budding new alliance between Donald Trump and congressional Republicans hides a tougher reality: Even with unified GOP control of Washington, the president-elect's priorities may have trouble getting through Congress. ... Repealing President Barack Obama's health care law? That looks likely to happen in some way, shape or form, but a number of states that accepted that law's expansion of the Medicaid health program for the poor are represented by Republicans. It will take painstaking and potentially lengthy negotiations to come up with a solution. (Werner, 11/11)
The Washington Post:
12 Trump Promises And How He Could Fulfill Them
Trump benefits from the fact that House and Senate Republican leaders share his goal. Congress probably can readily rescind parts of the ACA that involve federal spending, through a method called budget reconciliation — a strategy that produced a bill early this year that President Obama vetoed but Trump would sign. This method requires 50 Senate votes — one fewer than the GOP majority in the next Senate — and could be used to eliminate federal subsidies for ACA health plans, the requirement that most Americans have insurance, and other important elements. (Gibbons-Neff and Fears, 11/10)
The Associated Press:
President-Elect Trump Means Angst For 'Obamacare' Consumers
Donald Trump's election ushers in a time of high anxiety for people with health insurance under President Barack Obama's law, which expanded coverage to millions but has struggled to find widespread public acceptance. While repeal now seems likely, that may take Congress months. A replacement for the 2010 health care law could take even longer, and may retain some of its features. (Alonso-Zaldivar, 11/10)
Kaiser Health News:
Concerned About Losing Your Marketplace Plan? ACA Repeal May Take Awhile
President-elect Donald Trump has promised that he’ll ask Congress to repeal the Affordable Care Act on Day One of his administration. If you’re shopping for coverage on the health insurance marketplace, should you even bother signing up? If everything’s going to change shortly after your new coverage starts in January anyway, what’s the point? (Andrews, 11/10)
The Wall Street Journal:
5 Questions About Affordable Care Act Coverage After Donald Trump’s Election
President-elect Donald Trump and the Republicans leading congress have said that they plan to repeal the Affordable Care Act. That’s left a lot of consumers wondering what is changing for them. Here are a few questions and answers. (Wilde Mathews, 11/10)
No Immediate Changes To Your Obamacare Coverage
To the millions of Californians who obtained health insurance as a result of the Affordable Care Act, know this: Despite the election of Donald Trump, who has promised to repeal the health law, nothing is going to happen to your coverage immediately. In fact, open enrollment for Covered California plans continues through January 31 despite the election outcome. (Bazar, 11/11)
Covered California’s Future In Peril If Federal Subsidies Dry Up
Before Election Day, California’s insurance exchange was slated to meet soon to map out its “long-term vision” for health reform. That conversation has suddenly shifted to whether the largest state-run marketplace has much of a long-term future itself. (Terhune, 11/10)
The Cleveland Plain Dealer:
Obamacare Is Like Mouse Trap. Altering It Won't Be Quick Or Simple.
One of President-elect Donald Trump's promises was to decimate Obamacare and replace it with "something terrific." Majority Leader Mitch McConnell, who will once again lead the GOP in the Senate, said this week he is eager to get working on that goal. (Koff, 11/11)
The Cleveland Plain Dealer:
Repeal of Obamacare Could Put Strain On Local ERs, Affect Contraceptive Benefits
President-elect Donald Trump's repeated campaign promises to repeal and replace the Affordable Care Act, also known as Obamacare, are causing anxiety among people who might lose their healthcare coverage, and the hospitals who treat them. (Zeltner, 11/10)
Many experts expect Republicans to seek a change from traditional Medicaid to give states more control of the program, and some say it will be hard to scale back the expansion.
Medicaid Expansion Could Continue Under Trump
[E]xperts say there could be a greater push to go away from a traditional Medicaid expansion to one that includes more conservative provisions such as a work requirement, or the ability to lockout people below the poverty level that don't pay premiums. There is already evidence of this, with Arkansas' Gov. Asa Hutchinson saying Wednesday morning that he will approach the Trump administration to impose a work or work search requirement to be eligible for Medicaid. HHS under the Obama administration had denied the request. HHS under a Trump administration is more likely to embrace conservative expansion waivers, such as the one adopted in Indiana under governor and now Vice President-elect Mike Pence. (Dickson, 11/9)
Trump Medicaid Plan Could Force Service Cuts, Higher Taxes
The new Donald Trump administration may soon force states to cut spending on services or raise taxes. That's because the president-elect wants to overhaul the way the federal government pays for state-provided Medicaid health-care coverage. ... "Trump's proposal to convert Medicaid funding into a block grant program would lead to much lower federal funding to states," according to a statement Thursday from Fitch Ratings, which tracks state finances for investors in municipal bonds. (Schoen, 11/10)
Republican Governors Who Expanded Medicaid Confront New Challenge — Obamacare Repeal
Republicans’ reinvigorated pledge to repeal Obamacare under President-elect Donald Trump is setting the stage for potential conflict in more than a dozen Republican-led states that enacted the law's Medicaid expansion. (Pradhan, 11/10)
Since the campaign offered few specifics on how Donald Trump would repeal and replace the health law, many issues are in flux. Questions include: Will Republicans continue to guarantee coverage for people with pre-existing conditions; what happens to the low-income people who have been added to the Medicaid rolls; how will the administration deal with growing Medicare costs; and will efforts continue to move health payments toward paying for quality instead of quantity.
Trump Outlines Health Plan, From Obamacare Repeal To Abortion
On his transition page Thursday, Trump hinted at softening the coverage guarantee for those with pre-existing conditions under the ACA, saying high-risk pools -- state insurance programs for individuals who are sick or otherwise unable to get coverage -- would cover those with large medical expenses who have “not maintained continuous coverage.” Repealing the ACA, a law passed in 2010 that brought insurance to about 20 million people who previously lacked it, could leave those with pre-existing conditions without insurance. (Tracer and Kapur, 11/10)
Trump’s Updated Health Proposals Still Leave Questions
President-elect Donald Trump’s most updated health care proposals don’t say whether a Trump health care policy would require insurers to cover pre-existing conditions or whether the law would continue an expanded Medicaid program. Those are two of several questions that advocates and observers are posing about how Trump plans to replace the Affordable Care Act, which bars insurers from denying covering to people with pre-existing health conditions. Then there’s this. The biggest challenge that Republicans face in attempting to advance health reform is how to continue covering the 20 million people who gained have insurance under the ACA. (McIntire, 11/10)
Five Questions About Trump And Health Care, Beyond The ACA
The post-election headline grabber is “Repeal and Replace” — when it would happen, what it would look like, what kind of transition would bridge the Affordable Care Act to whatever comes next. But there are a host of other gnawing health issues. Here are five we’re watching. (Kenen, 11/10)
Will Value-Based Payment Initiatives Continue Under Trump?
President-elect Donald Trump's promise to dismantle the Affordable Care Act is unlikely to also undo widespread efforts to nudge the U.S. healthcare system toward value-based payment, including with experiments devised by the ACA-funded CMS Innovation Center. “The concept of value in healthcare has been around a long time,” said Helen Darling, interim president and CEO of the Washington, D.C.-based National Quality Forum. Fundamental ideas like the importance of transparency and data to patients, providers and competition existed well before the Affordable Care Act, and they are as Republican as they are Democratic, she said. “Some of those things are more Republican than Democrat, frankly,” she added. (Whitman, 11/11)
The New York Times:
Trump Wants To ‘Drain The Swamp,’ But Change Will Be Complex And Costly
Within the government’s health agencies, Mr. Trump’s campaign also proposed eliminating the Food and Drug Administration’s “food police,” which it said “dictate how the federal government expects farmers to produce fruits and vegetables and even dictates the nutritional content of dog food.” But the proposal was quickly taken down from the campaign’s website. The Food Safety Modernization Act of 2011, which strengthened the F.D.A.’s oversight of food, is popular among many Republicans as well as with food manufacturers, tarnished by massive food recalls. (Shear and Harris, 11/10)
Planned Parenthood and other organizations have seen a surge of support and donations following Donald Trump's win.
Trump Election Emboldens Opponents Of Abortion
Amy Hagstrom Miller of Whole Women's Health had been having a banner year. Her organization, based in Charlottesville, Va., operates several abortion clinics around the country and brought a legal challenge that led the Supreme Court to issue a landmark ruling this past summer. The court struck down abortion restrictions in Texas, setting a precedent that abortion rights groups believe could help turn back a wave of restrictions passed by legislatures across the country in recent years. But now that Donald Trump is the president-elect? "I'm devastated," Miller says. "I feel stunned. I'm numb." (Ludden, 11/10)
‘I Just Feel Terrified’: Women Pour Support Toward Planned Parenthood After Trump’s Victory
Women fearful that the Trump administration will limit reproductive rights are showing the first signs of channeling their frustration into action. Planned Parenthood confirmed to STAT that it saw an increase in donations, emails, and phone calls on Wednesday. And the advocacy group NARAL Pro-Choice America received so many unsolicited donations — many designated in honor of Hillary Clinton or sardonically honoring Donald Trump — that a spokesperson called it “just unlike anything we’ve ever seen.” (Robbins, 11/10)
For Planned Parenthood, Trump Era Starts With Worried Calls And Defiant Donations
Planned Parenthood hasn’t yet tallied up the amount of donations it received after Trump's victory, but the outcome of the election looks likely to become a sizable source of contributions. In Atlanta, to cite just one example, Elizabeth Hartman, 33, raised $1,900 for her local affiliate through Facebook. The group has seen this kind of politically motivated rush to donate before. In 2012, after 19 states passed an unprecedented number of abortion restrictions, such as mandatory waiting periods or ultrasounds, individual supporters gave $98 million—$25 million more than they had the year before. (Suddath, 11/10)
One of Donald Trump's top priorities is dismantling the Affordable Care Act, which currently requires insurers to cover the cost of women's contraception.
The Washington Post:
Women Consider Long-Term Birth Control Now That Trump Victory Looms Over Reproductive Health
As protesters burned a giant papier-mâché Trump head outside City Hall in Los Angeles and their East Coast counterparts torched an American flag in front of the Trump Tower in New York, America’s social media feeds lit up, too. Among those concerned were women who, worried about what the next four years could bode for reproductive health, pondered a lasting prophylactic measure. In the months before President-elect Donald Trump takes office, some advocates answered, consider long-term intrauterine devices or implanted contraceptive rods. (Guarino, 11/10)
Women Seek Birth Control That Will Outlast The Trump Presidency
Women across the country are rushing to get IUDs. Or at least, they're tweeting about rushing to get long-term birth control, according to a surge of messages on social media. They're concerned that the Trump administration might end Obamacare provisions that require insurers to cover intrauterine devices (IUDs) and other contraception, and cut funding for abortion and reproductive health overall. So women are looking for long-term solutions like IUDs: ones that will outlast a presidency. But they may have a bit more time than they think. (Ross, 11/11)
“This was an extraordinary year by any stretch of the imagination," says National Suicide Prevention Lifeline Director John Draper.
The Washington Post:
At Suicide Hotlines, The First 24 Hours Of Trump’s America Have Been Full Of Fear
The outcome wasn’t certain, but in the 60 minutes that seemed to stretch for much longer between 1 and 2 a.m. Wednesday, while the swing states deciding our next president flipped between red and blue, the phone at the National Suicide Prevention Lifeline rang 660 times. People were scared — for their rights, for their safety, for their children. They were thinking about taking their lives. (Mettler, 11/10)
Child Psychiatrists: If Kids Are Feeling Anxious After Election, How To Help
Elections are, above all, political moments, but each one offers parenting moments as well. That's certainly the case with this one. One Boston-area mother told me Wednesday morning: "My son has been very worried about Donald Trump, who he calls 'the bully.' I've been telling him not to worry. The bully wouldn't win." (Goldberg, 11/10)
Despite research that proves how effective methadone can be in treating addiction, there are still some who believe using it amounts to "trading one addiction for another."
In Opioid Epidemic, Prejudice Persists Against Methadone
Despite the nation’s decadelong surge in opioid addiction, large swaths of the U.S. still lack specialized opioid treatment centers that can dispense methadone, one of three medications available to treat addiction to heroin and prescription pain pills. The other two medications, buprenorphine (approved by the Food and Drug Administration in 2002) and Vivitrol (approved in 2010), can be prescribed by doctors. But for some patients, particularly those who have built up a high tolerance for opioids through prolonged use or high doses, methadone can be the only addiction medication that works. (Vestal, 11/10)
In other news on the opioid epidemic —
'Pink,' Synthetic Opioid Linked To Nearly 50 Deaths, To Be Banned
The Drug Enforcement Administration is poised to ban a little-known drug called U-47700, also known colloquially as “pink.” The agency, which has the power to ban drugs for two or three years “to avoid an imminent hazard to the public safety,” said Thursday the new regulation will take effect Monday. The DEA has cited 46 deaths in the United States over the last two years in which U-47700 is a confirmed cause. That doesn’t include the widely reported deaths of two 13-year-olds in Utah, which were purportedly linked to the drug. (Boodman, 11/10)
Saving Heroin Users With A Nasal Spray Is An $80 Million Business
In recent years, as drug overdoses have overtaken car accidents as the leading cause of accidental death in the U.S., sales of naloxone products have soared, from $21.3 million in 2011 to $81.9 million in 2015, according to QuintilesIMS. Within this market, Adapt Pharma’s Narcan nasal spray is the fastest-growing product. Part of its appeal is that, in theory, anybody can use it to save a life. You don’t need to be a doctor or have any medical training. (Gillette, 11/11)
A further drop in the number of smokers is expected with California's new $2-a-pack tax. In other cancer-related news, immunotherapy is making some progress against lung cancer, Vietnam veterans fight to raise awareness about the connection of a rare form of cancer to military service and a patient advocate group works to reduce chemotherapy errors.
Smoking Declines As Cigarette Taxes Rise
The number of cigarette smokers in the United States has dropped by 8.6 million since 2005 — and that fall could be accelerated by a tobacco tax just passed in California. The Centers for Disease Control and Prevention says smoking rates have fallen from 21 percent of the adult population in 2005 to 15 percent in 2015, when the agency conducted its latest survey. The smoking rate fell by 1.7 percentage points between 2014 and 2015 alone — a substantial decline, according to a report Thursday in Morbidity and Mortality Weekly Report. (Harris, 11/10)
The Washington Post:
Immunotherapy Moves To The Front Lines In Fight Against Lung Cancer
Lung cancer, which kills almost 160,000 Americans a year, is among the cruelest of foes. Most patients are diagnosed at an advanced staged after punishing chemotherapy still have a bleak prognosis. More than half die within a year. (McGinley, 11/10)
The Associated Press:
Still Fighting: Vietnam Vets Seek Help For Rare Cancer
Mike Baughman considered himself one of the lucky ones, returning from Vietnam without any major injuries or psychological scars. But after falling ill nearly a half-century later, he found out he did not escape the war after all. The 64-year-old is among hundreds of veterans who have been diagnosed with a rare bile duct cancer that may be linked to their time in the service and an unexpected source: parasites in raw or poorly cooked river fish. (McDowell and Mason, 11/11)
The Philadelphia Inquirer:
Cancer Network Campaigns To Prevent Deadly Chemotherapy Error
Vincristine, widely used to treat leukemia and lymphoma, powerfully blocks the growth of cancer cells. Safeguards exist to make sure it is not injected into the spinal fluid. Among other things, the U.S. Food and Drug Administration requires syringes of vincristine to be sealed with a sticker reading “For intravenous use only — fatal if given by other routes.” Still, the FDA allows vincristine to be dispensed in a syringe because some clinicians prefer giving it by intravenous injection, called “IV push,” than by dripping it from an intravenous bag. (McCullough, 11/10)
Outlets report on health news from Michigan, Kansas, Georgia, Pennsylvania, New York, Minnesota and Florida.
The Washington Post:
Michigan Must Deliver Bottled Water To Flint Residents, Judge Rules
A federal judge in Michigan has ordered state officials to offer bottled-water delivery to Flint residents who can’t easily pick up their own from distribution sites in the city. “A safe water supply has always been critical to civilization,” U.S. District Judge David M. Lawson wrote Thursday in his decision. “The Flint water crisis has in effect turned back the clock to a time when people traveled to central water sources to fill their buckets and carry the water home.” (Dennis, 11/10)
Kansas Health Institute:
Pilot Program Helps Disabled Kansans Leave State Hospital
The program is targeted at an underserved population: Kansans with intellectual and developmental disabilities who also have severe and persistent mental illnesses. It is one of several initiatives Keck has launched to reintegrate some Osawatomie State Hospital residents into their communities. The idea was to do a comprehensive review of patients with intellectual and developmental disabilities at Osawatomie State Hospital and determine if their mental illness was controlled enough that they could be discharged to organizations that could provide home and community-based services to support their disabilities. (Marso, 11/10)
Minnesota Public Radio:
Health Officials Weigh Testing Newborns For Disability-Causing Virus
CMV is transmitted by contact with fluids, and is generally a non-event, unless a women is infected during pregnancy, and passes the virus to her fetus. There are nearly 500 newborns infected with congenital CMV in Minnesota each year. Eighty percent will be completely unaffected. Ten percent will have symptoms that are evident and treated in the hospital. The remaining ten percent need treatment but don't get it. They go home without anyone knowing they're sick. Eventually they develop serious disabilities, most often hearing loss. (Benson, 11/11)
Georgia Health News:
Most In State Health Plan Sign Up With Blue Cross
More than half of the members in the state employee and teacher health plan signed up with Blue Cross and Blue Shield of Georgia plans for coverage next year. (Miller, 11/10)
The Philadelphia Inquirer/Philly.com:
Physician, Congressman Say Hospital Beds Accumulate Debris
A Philadelphia-area physician and U.S. Rep. Mike Fitzpatrick say a commonly used model of hospital bed has a design flaw that allows the accumulation of unsanitary material, posing a risk of disease transmission for patients. The pair say the hinges on the railings of TotalCare beds, made by Chicago-based Hill-Rom Inc., are housed in a recessed "alcove" that can trap debris in such a way that is very difficult to clean. The physician, Hooman Noorchashm, said he saw grayish debris around the railing hinges on intensive-care beds in October at the Hospital of the University of Pennsylvania. He said he first saw debris in the hinges of a bed occupied by his wife, Amy Reed, who was being treated for an advanced cancer. Then he went into unoccupied rooms and saw other bed hinges in a similar state. (Avril, 11/10)
The New York Times:
New Charges For 2 Flophouse Operators Accused In Medicaid Fraud Scheme
The New York State attorney general filed Medicaid fraud and money laundering charges on Thursday against a lawyer who runs two outpatient substance-abuse programs in New York City and a couple who ran flophouses that forced residents to seek help from those programs. Their arrangement was detailed in an investigation by The New York Times last year. (Barker, 11/10)
UMN To Close Dental Clinic Serving Low-Income Neighborhood
A University of Minnesota-run dental clinic in Minneapolis’ Cedar-Riverside neighborhood is closing next summer because it’s losing too much money serving low-income people. The clinic, operated by eight general-practice residents under faculty supervision, lost $800,000 last year, according to Todd Thierer, the dental school’s acting dean. Thierer said about 75 percent of the clinic’s 7,500 visits last year were with patients on Medical Assistance. Those patients generate only about 45 percent the revenue that other patients pay, he said, because of low state reimbursement rates. (Verges, 11/10)
Health News Florida:
6 More Local Zika Cases Confirmed In Florida
State health officials Wednesday reported six more local cases of the mosquito-borne Zika virus, bringing to 217 the number of transmissions of the disease in Florida. Five of the new cases involved Miami-Dade County residents, while one involved a person from out of state. The Florida Department of Health said it was investigating to determine where exposure to the virus occurred. (11/10)
The Philadelphia Inquirer/Philly.com:
Black Patients' Readmission Rates Are Higher. Could Nursing Help?
Older black patients are much more likely than whites to be readmitted to the hospital after a hip or knee replacement. The reasons are complex, but more attention from nurses may help address the problem, a new study from the University of Pennsylvania School of Nursing’s Center for Health Outcomes and Policy Research suggests. Readmission rates matter both because no one wants to go back into the hospital and because the rates are a Medicare quality measure. Hospitals are penalized financially when too many of their patients return after they’re sent home. (Burling, 11/10)
Health News Florida:
What's Next For Medical Marijuana In Florida?
Now that Florida voters have passed a medical marijuana constitutional amendment, some are already asking: Is recreational marijuana next? (Aboraya, 11/10)
Each week, KHN compiles a selection of recently released health policy studies and briefs.
Housing, Transportation, And Food: How ACOs Seek To Improve Population Health By Addressing Nonmedical Needs Of Patients
Addressing nonmedical needs—such as the need for housing—is critical to advancing population health, improving the quality of care, and lowering the costs of care. Accountable care organizations (ACOs) are well positioned to address these needs. We used qualitative interviews with ACO leaders and site visits to examine how these organizations addressed the nonmedical needs of their patients .... We found that the nonmedical needs most commonly addressed by ACOs were the need for transportation and housing and food insecurity. ACOs identified nonmedical needs through processes that were part of the primary care visit or care transformation programs. (Fraze et al., 11/9)
Beyond Books: Public Libraries As Partners For Population Health
Public libraries are ... well positioned to be partners in building a culture of health through programming that addresses the social determinants of health. The Healthy Library Initiative, a partnership between the University of Pennsylvania and the Free Library of Philadelphia (the public library system that serves the city), has undertaken such efforts .... we report findings from an assessment of how ten highly subscribed programs address the social determinants of health, as well as results of interviews with community residents and library staff. Of the 5.8 million in-person Free Library visits in 2015, 500,000 included attendance at specialized programs that addressed multiple health determinants, such as housing and literacy. (Morgan et al., 11/9)
Annals of Emergency Medicine:
Association Between The Opening Of Retail Clinics And Low-Acuity Emergency Department Visits
We assess whether the opening of retail clinics near emergency departments (ED) is associated with decreased ED utilization for low-acuity conditions. We used data from the Healthcare Cost and Utilization Project State Emergency Department Databases for 2,053 EDs in 23 states from 2007 to 2012. ... Among all patients, retail clinic penetration was not associated with a reduced rate of low-acuity ED visits .... Among patients with private insurance, there was a slight decrease in low-acuity ED visits .... For the average ED in a given quarter, this would equal a 0.3% reduction ... in low-acuity ED visits among the privately insured if retail clinic penetration rate increased by 10 percentage points per quarter. (Martsolf et al., 11/10)
Preventing Chronic Disease/CDC:
Disparities In Who Receives Weight-Loss Advice From A Health Care Provider: Does Income Make A Difference?
The US Preventive Services Task Force recommends that all patients be screened for obesity .... However, the prevalence of such advice is low .... This study aimed to describe the determinants of receiving weight-loss advice among a sample with a high proportion of low-income, racial/ethnic minority individuals. Data were collected from a telephone survey of 1,708 households in 2009 and 2010 in 5 cities in New Jersey. ... Of all overweight or obese respondents, 35% reported receiving advice to lose weight. Receiving advice was significantly associated with income in multivariate analysis. Compared with those with an income at or below 100% of the federal poverty level (FPL), those within 200% to 399% of the FPL had 1.60 higher odds of receiving advice ... and those with an income of 400% or more of the FPL had 1.73 higher odds of receiving advice. (Lorts and Ohri-Vachaspati, 10/6)
Survival Rates Following Pediatric In-Hospital Cardiac Arrests During Nights And Weekends
In this national registry-based cohort study of hospitalized children younger than 18 years of age receiving cardiopulmonary resuscitation (CPR), the rate of survival to hospital discharge was 36.2% (4488 of 12 404 children) overall. After adjusting for important potential confounders, we found that the rate of survival to hospital discharge was significantly lower during nights than during days/evenings, but there was no difference between weekends and weekdays. (Bhanji et al., 11/7)
The Kaiser Family Foundation:
Access To Employer-Sponsored Health Coverage For Same-Sex Spouses
Using data collected through the most recent Kaiser Family Foundation and the Health Research & Educational Trust (HRET) Employer Health Benefits Survey, we provide the first national estimates of same-sex spousal health coverage, looking at both the share of firms offering such coverage as well as the share of covered workers with access to spousal benefits. ... In 2016, less than half (43%) of firms offering health insurance coverage to opposite-sex spouses, also provided coverage to same-sex spouses and 16% did not provide this coverage. Another 41% reported they had not encountered this as a benefits issue. ... While the majority of firms in the United States are small, and most do not offer same-sex spousal ESI, the majority of workers are employed by large firms (200 or more workers) (70%), most of whom do offer this benefit. (Dawson, Kates and Rae, 11/2)
The Kaiser Family Foundation:
Health Coverage By Race And Ethnicity: Examining Changes Under The ACA And The Remaining Uninsured
This brief examines changes in health coverage by race and ethnicity under the ACA and reviews characteristics of the remaining uninsured by race and ethnicity and their eligibility for ACA coverage. It is based on Kaiser Family Foundation analysis of Current Population Survey data for the nonelderly population. It finds: People of color have had larger gains in coverage compared to Whites since implementation of the ACA. ... Despite these gains, nonelderly Hispanics, Blacks, and American Indian and Alaska Natives (AIANs) remained more likely than Whites to be uninsured as of 2015. (Artiga et al., 11/4)
A selection of opinions and editorials from around the country.
Repealing Obamacare May Be Easy. Replacing It Won't Be.
Trump's pitch to motivate insurers to compete against one another on price and quality of service sounds great in theory. In fact, all insurers already can sell plans in every state. There's a good reason why they don't. Insurance is regulated by the states, not the federal government. Each state writes its own minimum requirements for health coverage; for reserves and other solvency guarantees; for dispute settlements; and for how much plans can discriminate by charging older, sicker people more and younger, healthier people less. To sell plans in, say, Oklahoma, UnitedHealthcare, the U.S.'s largest health insurer, must follow Oklahoma's regulations. No single product would conform with Oklahoma's regulations and those of neighboring states. So UnitedHealthcare must tailor products for each. (Paula Dwyer, 11/10)
Los Angeles Times:
Defending Obamacare: 'Don't Agonize. Organize'
Day 1. That’s when President-elect Donald Trump says he expects Congress to send him a bill repealing Obamacare, which he says he’ll sign. And more than 20 million Americans will lose health coverage. “There’s no way to sugarcoat any of this,” said Gerald Kominski, director of the UCLA Center for Health Policy Research. “We’re about to throw 20 million people under a bus.” (David Lazarus, 11/10)
Los Angeles Times:
Despite Republican Pledges, 'Repealing Obamacare' Will Be Almost Impossible — But It Could Be Vandalized
President-elect Donald Trump picked up the theme in his campaign, promising “on Day One of the Trump administration” to “ask Congress to immediately deliver a full repeal of Obamacare.” He pledged to supplant it with “something terrific.” This promise is about to come face-to-face with reality. Repealing many Obamacare provisions isn’t possible without the assent of congressional Democrats. Perhaps more important, dismantling key elements of the law risks leaving the U.S. healthcare system in chaos — certainly in worse shape than it was even before the Affordable Care Act was passed. (Michael Hiltzik, 11/10)
Basic Economic Thinking Would Fix the Broken US Health Care System
In the realm of public policy, a bit of economic thinking can go a long way. Obamacare is seemingly grinding to a [halt] as a result of being fundamentally at odds with basic economic principles. Today, real, acting human beings are much less the object of economics than are complex mathematical models, abstracted away from reality and setting aside the most central ideas of traditional political economy. And that’s unfortunate, because economics as the study of human beings, their wants, and their means of acquiring them has much to teach about health care policy in general and the failures of Obamacare in particular. (David S. D'Amato, 11/10)
Will Consumers Be Winners In Merger Trials?
In the next few months, the U.S. Department of Justice will square off with lawyers from Anthem and Cigna and then from Aetna and Humana, seeking to block these four giant health insurers from merging into two mega-health insurers. Though these court cases may seem a little less exciting than the Fall classic, many of the tools used to predict the result of the World Series can help observers see why the DOJ should prevail in these important consumer protection cases. (David Balto, 11/10)
TrumpCare: In The Beginning ...
Yesterday Americans woke up to news of a new president-elect: Donald J. Trump. The immediate question for those whose lives focus around lifting the health of individual Americans is, “What does this mean for health care in America?” At the heart of the answer is uncertainty. Trump is an “unknown unknown” when it comes to deep, thoughtful health policy. He has excelled in many fields, but at best he personally has only dabbled in the field of health care, which accounts for a fifth of our overall economy and affects literally every American. (Bill Frist, 11/10)
Two Cases Where Trump Could Rewrite The Rules
Vice President-elect Mike Pence has told evangelical leader James Dobson that the next administration will reverse President Barack Obama’s contraceptive mandate rules and transgender bathroom guidance -- both of which it can do without Congress. If Pence speaks for President-elect Donald Trump, both decisions would have major implications for cases now before the U.S. Supreme Court. In both cases, the effects of unilateral executive action are tricky, because liberal appellate decisions remain on the books, and because conservatives would like to see those decisions reversed. Trump doesn’t yet have an attorney general or a solicitor general, but his Department of Justice will soon have to figure out how to proceed. (Noah Feldman, 11/10)
An Abortion Doctor On Trump’s Win: ‘I Fear For My Life. I Fear For My Patients.’
As I’ve headed to work in recent days to see abortion patients in my office, I have felt bereft: All the premises of my life, work, education, and future were gone. Something very profound in the meaning of the America I know has been destroyed with the election of Donald J. Trump as president. (Warren M. Hern, 11/11)
The New England Journal Of Medicine:
Meaning And The Nature Of Physicians’ Work
In a past era, the work of the hospital physician was done primarily at the bedside or in the adjacent wet laboratory. Residents had the opportunity to witness the unfolding of diseases (for which we may now have cures) and to come to know their patients over the course of lengthy hospitalizations. The life was grueling and all-consuming — and those who took it up were almost invariably unmarried white men, with teaching hospitals actively discouraging marriage. Medicine was a fraternal order. Doctors’ lounges were central locations where community internists, specialists, and surgeons ate together, socialized, and “curbsided” each other for patient consultations. Charts were kept on paper and were often indecipherable. (David I. Rosenthal and Abraham Verghese, 11/10)
St. Louis Post-Dispatch:
Lawyers' TV Ads Can Be Hazardous To Our Health
Does it seem like every time you turn on the TV these days, there seems to be only two kinds of advertising — political ads and ads from personal injury law firms? Not a day goes by that I don’t see one of these ads from personal injury law firms, which usually make scary claims about the dangers of a medicine or other product and urge people to sue. (Mary Gray, 11/11)
The New England Journal Of Medicine:
Personal Health Budgets For Patients With Complex Needs
Care for people with multiple medical conditions accounts for the majority of U.S. health care spending. Some of the highest-cost patients have functional impairments and social needs that necessitate long-term services and supports, and there is much debate about designing higher-value, more patient-centered services for them. One approach from England entails the creation of “personal health budgets,” a model for self-directed support that may be worth considering in the United States. (Luke O’Shea and Andrew B. Bindman, 11/10)
The New England Journal Of Medicine:
Ending The Opioid Epidemic — A Call To Action
On August 24, 2016, I mailed a letter and pocket card to 2.3 million doctors, nurses, dentists, and other clinicians asking them to help address America’s escalating opioid epidemic. It was the first time in the 145-year history of the Office of the Surgeon General that such a letter was issued specifically to medical professionals calling them to action. (Vivek H. Murthy, 11/9)