KHN Morning Briefing

Summaries of health policy coverage from major news organizations

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From Kaiser Health News - Latest Stories:

Kaiser Health News Original Stories

Political Cartoon: 'Change Of Heart?'

Kaiser Health News provides a fresh take on health policy developments with "Political Cartoon: 'Change Of Heart?'" by Mike Peters.

Here's today's health policy haiku:


He’d send a letter
To help smooth out the red tape.
That was the Price way.

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Summaries Of The News:

Capitol Hill Watch

McConnell: Senate To Vote On Repeal This Week, Replace Plan Will 'Rapidly' Follow

But the Senate majority leader didn't offer any specifics. Meanwhile, Donald Trump's advisers say he is still considering the speed of which to replace the health law.

The Associated Press: GOP Lawmakers Vow Quick Action To Enact New Health Care Law
Top Republicans said Sunday they’ll move quickly to enact a new health care law, but they won’t say how long that might take or what might replace President Barack Obama’s version. Questions surrounding the future GOP plan have unnerved key parts of the health care industry, including hospitals and insurers that have warned Congress against uncertainty. (1/8)

Reuters: Senate To Act This Week On Obamacare Repeal, McConnell Says
The U.S. Senate will take its first steps toward repealing President Barack Obama's signature healthcare reform act by the end of the week, Republican Senate Majority Leader Mitch McConnell said on Sunday. Speaking on CBS's "Face the Nation," McConnell said: "There ought not to be a great gap" between repealing the act and replacing it and that Republicans would be "replacing it rapidly after repealing it." (Clarke, 1/8)

The Wall Street Journal: Mitch McConnell Vows New GOP Health Plan Soon
Congress will quickly devise a new health-insurance system after moving to repeal the Obama administration’s signature health-care law in coming days, Senate Majority Leader Mitch McConnell said Sunday, despite growing questions within the Republican Party over the GOP’s strategy. (Talley, 1/8)

The Hill: Senate Braces For ObamaCare Vote-A-Rama
As ObamaCare repeal moves along, the debate is only getting more intense. The Senate is expected to take a long string of votes on Wednesday, known as a "vote-a-rama," on a budget resolution that is the first step to repealing ObamaCare. That series of votes gives Democrats an opportunity to offer a series of provisions designed to make things uncomfortable for Republicans and put them on record about popular aspects of ObamaCare. (Sullivan, 1/9)

The Wall Street Journal: Senate Looks To Move Fast On Trump Administration Hearings, Health Law
The Republican-controlled Senate, brushing aside concerns from Democrats and a government-ethics watchdog, is moving quickly this week to help President-elect Donald Trump staff his administration, scheduling multiple confirmation hearings on a single day on which the chamber also could vote on a step toward repealing much of the Affordable Care Act. (Hughes, Andrews and Peterson, 1/8)

Politico: Conway, Priebus Won't Promise Immediate Repeal-And-Replace
Kellyanne Conway and Reince Priebus, top advisers to Donald Trump, said Sunday that the president-elect is still considering his options when it comes to the speed of replacing Obamacare. Republican leaders in Congress have been discussing a repeal of Obamacare that would take effect two years or more after the vote to repeal to give them time to craft a replacement plan so that millions of Americans would not suddenly lose coverage. But some conservatives, including Kentucky Sen. Rand Paul, have said Congress should pass a replacement plan immediately. Other senators have suggested delaying repeal until a replacement plan is ready. (Robillard, 1/8)

The Hill: Conway Refuses To Commit To ObamaCare Repeal And Replacement On Same Day 
Incoming White House counselor Kellyanne Conway refused to say President-elect Donald Trump will replace the Affordable Care Act (ACA) on the same day Republicans in Congress repeal the law, also known as ObamaCare. "Well, it really depends [on] what the piece of legislation is. What does it look like?" she said Sunday on CNN’s “State of the Union” when asked if Trump agrees with Sen. Rand Paul (R-Ky.) that a replacement is needed the same day the ACA is repealed. "I can confirm that he is committed to replacing ObamaCare with something that actually is affordable and accessible and allows you to buy health insurance over state lines," she added. (Shelbourne, 1/8)

The Associated Press: Paul: Trump Backs Health Repeal, Replacement At Same Time
A Republican senator who challenged Donald Trump for the White House nomination says the president-elect "fully supports" repealing President Barack Obama's health law only when there's a viable alternative to replace it. Republican leaders in the GOP-controlled Congress are moving toward a vote on repeal legislation in coming weeks, but they anticipate a transition period of months or years to a replacement. Some Republican lawmakers are expressing reservations about scrapping the law, which now covers 20 million people, without a near-term replacement. Kentucky Sen. Rand Paul, who clashed with Trump during the GOP primary, said in a tweet late Friday that the two had a conversation and that Trump agreed with Paul's approach. (Colvin and Fram, 1/7)

Boston Globe: How Donald Trump Could Repeal Obamacare — And Why 
Changes are coming to the nation’s health care system. President-elect Donald Trump has vowed to repeal President Obama’s signature health care law, and having a Republican-led Congress boosts the odds he can make good on that promise. Republicans have yet to detail what new plan they want to implement in place of the Affordable Care Act. Here’s what we know about what’s happening to the national health care law and what it means for Massachusetts. (McCluskey, 1/9)

Don't miss: Today marks the launch of Repeal & Replace Watch, a KHN feature that tracks the efforts of the Trump administration and Congress to revamp the U.S. health care system.

Health Law

Republicans Between Rock And Hard Place When It Comes To Health Law's Taxes

Lawmakers have to decide if they should immediately cut off the taxes that would be needed to fund a transition period between repeal and replace and be left scrambling to pay for Americans' subsidies.

The Wall Street Journal: Health-Law Taxes Complicate GOP’s Repeal Strategy
Republicans eager to scrap the 2010 health-care law are wrestling with whether to immediately cut off the tax revenue it brings in. Among the thorniest issues GOP lawmakers face as they hash out how to try to dismantle the Affordable Care Act is that getting rid of the health law’s taxes now would eliminate a source of revenue they would need to fund the two- or three-year transition period until any replacement plan is in place. Repealing the taxes would throw into question how to fund the subsidies that help many people get health coverage by offsetting their premium costs, health analysts say. (Peterson and Rubin, 1/7)

CQ Roll Call: Obamacare Tax On Wealthy Sparks Battle Over Fairness
Republicans and Democrats are squaring off in a fight over tax fairness as the GOP develops a timetable for repealing the 3.8 percent surtax on investment income under the health care overhaul. GOP lawmakers have long argued for elimination of the surtax, or the net investment income tax, that applies to income such as interest, dividends and capital gains for individuals making more than $125,000 or couples earning more than $250,000. The levy was created by the health care overhaul to help pay for subsidies and has been championed by Democrats as both a pillar of support for health care coverage and a key component of President Barack Obama’s push to reduce income inequality in part by raising taxes on the wealthy. (Ota, 1/9)

Possible GOP Defectors Threaten To Undermine Repeal Strategy

Some Republican lawmakers voice concerns about dismantling the health law without having a solid replace plan in place.

The Wall Street Journal: Republican Skepticism Grows Over Strategy On Health-Law Repeal
Republicans in both the House and Senate are expressing growing skepticism of their party’s approach to repealing the Affordable Care Act, signaling potential peril ahead for a strategy that relies on nearly complete GOP unity. In the House, some conservatives are balking at a budget document meant to serve as the vehicle to repeal the 2010 health law. Meanwhile, in the Senate, a growing number of Republicans are questioning the wisdom of repealing the law without knowing how they will replace it. (Peterson and Armour, 1/6)

The Associated Press: State GOP Wary As Republicans Push Repeal Of Health Law
Congressional Republicans' drive to repeal the 2010 health care law has financial and political repercussions for GOP leaders in the states and gives Democrats potential openings as they struggle to reclaim power lost during President Barack Obama's tenure. Some Republican governors, in particular, are wary about what their Washington colleagues might do with Obama's signature law, exposing a fissure in a party that has consolidated control in the nation's capital and dozens of statehouses around the country in accompaniment with President-elect Donald Trump's victory in November. (Barrow and Beaumont, 1/9)

Politico Pro: GOP Resistance Grows To Obamacare Repeal Without Replacement 
A growing number of Senate Republicans are resisting the idea of repealing Obamacare without a concrete replacement proposal, complicating GOP plans to move swiftly to undo the health care law. Sen. Rand Paul (R-Ky.) started the open, intra-party dissension this week when the libertarian-leaning senator urged Republicans to vote on a replacement plan at the same time they pass a repeal bill. He was followed a day later by hardline conservative Sen. Tom Cotton (R-Ark.), then by the more centrist Sen. Bob Corker (R-Tenn.). (Everett, 1/6)

The Washington Post Fact Checker: Republicans Once Again Rely On A Misleading Obamacare Factoid
With the election of Donald Trump, Republican lawmakers finally have the opportunity to repeal the Affordable Care Act, a.k.a. Obamacare. As a result, we’re hearing some talking points that were debunked long ago. We’re not sure why these old chestnuts keep coming back. There are plenty of legitimate complaints one could make about the law, particularly the functioning of the Obamacare exchanges and premium-rate increases in certain states. (Kessler, 1/9)

Obama Mounts 11th Hour Defense Of Law: 'Repeal First And Replace Later’ Is, Simply Put, Irresponsible'

The president talked with Vox and wrote a piece in the New England Journal of Medicine criticizing Republicans' plans to dismantle his signature law.

The Wall Street Journal: Obama Urges GOP Plan To Delay Its Repeal Of Health Law
Mr. Obama, in a live interview on the news website Vox, said Republicans repeatedly promised they could do better but have failed to put out a stronger plan. He said it would be hard for the GOP to craft a better, cheaper proposal that leaves everyone satisfied, but that he would publicly support it if they do. “You don’t want a situation where they make a promise they can’t keep,” Mr. Obama said. “I’ve worked on this a long time. If we have a better way to do this, we would have done it. It would have been in my interest to do it, because I knew I would be judged by how it worked.” (Armour, 1/6)

Kaiser Health News: Obama’s Challenge To GOP: Show Me Your Plan Before Repealing Mine
Trying to protect his signature Affordable Care Act from being hastily dismantled by the new GOP Congress, President Barack Obama took to the media to pressure Republicans to unveil a replacement proposal before they repeal major parts of the law. In an interview webcast by and an op-ed in the New England Journal of Medicine, the president called Republicans’ fast-track plans to rescind much of the law but wait until later to craft a replacement “reckless.” (Rovner, 1/6)

Morning Consult: Obama Urges GOP To Show Their ACA Alternative
Americans should insist their lawmakers have a replacement plan before Congress votes on whether to repeal the Affordable Care Act, President Barack Obama said in an interview Friday. ... Obama offered his own suggestions for improving health care in the United States. He called for higher subsidies to help people afford insurance, an option Republicans would be loath to advance. (McIntire, 1/6)

The Associated Press: Obama Health Care Legacy: Coverage, Conflict, And Questions
Although his signature law is in jeopardy, President Barack Obama's work reshaping health care in America is certain to endure in the broad public support for many of its underlying principles. Notwithstanding growing pains in connection securing some of the promises of the Affordable Care Act, the belief that people with medical problems should be able to get health insurance is no longer challenged. The idea that government should help those who can't afford their premiums has gained acceptance. And the question is how much, and for what kind of coverage. (1/9)

The Worst That Could Happen: Industry Braces For Repeal's Possibly 'Devastating' Consequences

It's "going to be like that slow-moving tsunami that we know is coming, and we can watch it and try to prepare for it — but in the aftermath of the tsunami, there’s devastating loss that we never could have planned for,” said Heidi Gartland, vice president for community affairs and government relations at Cleveland-based University Hospitals Health System.

Politico: Obamacare Repeal's Doomsday Scenario
Hospital and health plan leaders talk in almost apocalyptic terms about what might lie ahead if Republicans abolish Obamacare without a blueprint for its replacement. Their doomsday scenario: Millions of people could lose their health care coverage, hospitals could hemorrhage cash and shocks to the $3 trillion-a-year health system could send ripples through the entire economy. (Demko and Cancryn, 1/9)

Media outlets look at the ways repeal will affect various aspects of the health care system —

USA Today: Obamacare Repeal Jeopardizes Mental Health, Addiction Coverage
Sherri Reynolds' son Qual has been drug free for 16 months, thanks in large part to treatment he got through Medicaid under the Affordable Care Act. Reynolds knows firsthand what can happen when people can't get coverage: Her 20-year-old stepson, Jarvis, suffered from mental illness and killed himself in 2010 after he couldn't get medical treatment. He bounced in and out of foster care and the juvenile justice system. (O'Donnell and DeMio, 1/8)

The CT Mirror: Insurers: Repeal Of ACA Should Go Slowly And Keep Subsidies Awhile 
As Republicans in Congress begin work on a repeal of the Affordable Care Act, the nation’s health insurers are telling lawmakers to keep paying subsidies to the companies and to low-income Americans so they can afford coverage. Insurers also want Congress to create a long transition period before the ACA is eliminated and a GOP plan replaces the health law. (Radelat, 1/9)

The CT Mirror: Malloy To Congress: Obamacare Repeal Would Be ‘Disastrous’ 
Responding to a request for input from top congressional Republicans, Gov. Dannel P. Malloy warned that repealing the Affordable Care Act without a replacement would create “disastrous uncertainty for families and businesses,” threaten the stability of Connecticut’s insurance market and companies, and leave the state with no insurers willing to write policies for the next year. But the governor, a Democrat, also wrote in a letter that he would work with Congress to make improvements to the existing health care system. (Levin Becker, 1/6)

St. Louis Post Dispatch: Missourians Brace For Loss Of Health Insurance As Congress Moves To Dismantle Obamacare
In Missouri, nearly 250,000 consumers have picked a health plan on for 2017 coverage. A majority of them receive financial help to afford the coverage. In 2010, before the ACA, 13.2 percent of Missourians were uninsured. In 2015, the uninsured rate fell to 9.8 percent. Millions of Americans gained access to coverage because the Affordable Care Act provided financial help and required insurance companies to provide a certain threshold of benefits to consumers. (Liss, 1/8)

Denver Post: Colorado Prepares For Obamacare Repeal Under Trump Administration
Analysts expect that a repeal would have an outsized impact on Colorado, as the state embraced the full spectrum of President Barack Obama’s signature piece of legislation, better known as Obamacare. Under the 2010 law, policymakers expanded the number of Coloradans who receive health insurance through Medicaid, created a program for residents to buy coverage through a state exchange and reduced the cost of emergency-room visits by patients without insurance. (Matthews, 1/8)

The CT Mirror: Access Health Says 104,495 Signed Up For Insurance That Began Jan. 1 
Connecticut’s health insurance exchange reported Friday that 104,495 people have signed up for private insurance coverage that began Jan. 1. That figure represents customers who met the first coverage deadline for Obamacare plans, Dec. 15. The open enrollment period for individual-market health plans runs through Jan. 31. People who sign up by Jan. 15 will receive coverage starting Feb. 1, while those who sign up after that will start their coverage March 1. (Levin Becker, 1/6)

Administration News

Pelosi: Watchdog Group Should Investigate Price's Dealings With Health Care Stocks

Donald Trump's nominee for HHS secretary has come under fire after it was reported that he'd traded more than $300,000 in health-related stocks while pushing legislative and regulatory action that might affect the bottom lines of those same companies.

The Hill: Pelosi Calls For Ethics Probe Into HHS Pick Tom Price
House Minority Leader Nancy Pelosi (D-Calif.) on Friday called for an independent ethics probe into Donald Trump's pick to lead the Health and Human Services Department. The Democratic leader said the Office of Congressional Ethics (OCE), a non-partisan watchdog group, should examine whether Rep. Tom Price (R-Ga.) violated any rules or laws when he traded hundreds of thousands of dollars in health-related stocks while working on healthcare legislation, as reported last month by The Wall Street Journal. Several top Senate Democrats, including Minority Leader Charles Schumer (D-N.Y.), called this week for the House Ethics Committee to investigate potential violations surrounding those trades.  (Illis, 1/6)

Bloomberg: Nine Trump Nominees Who’ll Face Extreme Vetting By Democrats
A marathon of Senate confirmation hearings starting this week will give Democrats the chance to put Donald Trump’s Cabinet nominees on trial even though they have little chance of actually grabbing a scalp or two...[Tom] Price, the House Budget Committee chairman until his nomination, will face questions from Democrats on his trades in health-care stocks while handling legislation that could affect the shares. Watchdog group Public Citizen says he made 630 trades in about 40 companies starting in 2012 while he led the Budget Committee and the Ways and Means Committee’s health panel. (Dennis, 1/9)

Veterans' Health Care

Trump's Struggles To Fill VA Position Highlight Just How Difficult Job Will Be

The Cabinet position is only one of two that have yet to be filled. “Who in their right mind wants to go in and take on what seems to be insurmountable problems?” said Susan Lukas, a former high-ranking VA budget official.

The Washington Post: Why Trump Still Hasn’t Named A Leader For The Department Of Veterans Affairs
With confirmation hearings for Donald Trump’s Cabinet set to start this week, the president-elect still has not chosen a leader for the Department of Veterans Affairs, an agency he vowed on the campaign trail to significantly shake up.It is not for lack of trying. Trump has met with or considered about a dozen candidates to run the second-largest federal department. But none seems to have made the cut. (Rein, 1/9)

In other veterans' health care news —

USA Today: Fla. Shooting Raises Question About Vets' Mental-Health Care
The deadly shooting spree by a military veteran who dealt with mental health problems has reignited debate about services for vets with post-traumatic stress disorder. Esteban Santiago, 26, who is suspected of killing five people at Fort Lauderdaule-Hollywood International Airport on Friday, told FBI agents in November that the Islamic State terrorist group had gained control of his mind and commanded him to commit acts of violence on its behalf, the FBI said Friday. (Swartz and Shesgreen, 1/7)


Justice Subpoenas 2 Dialysis Chains And Charity Over Premium Assistance To Patients

The charity, the American Kidney Fund, receives money from the dialysis chains and helps patients buy insurance to cover their kidney treatments.

The New York Times: Dialysis Chains Receive Subpoenas Related To Premium Assistance
The nation’s two largest dialysis chains, Fresenius and DaVita, said on Friday that they had received subpoenas from the Justice Department for information about their relationship to a charity that provides assistance paying the insurance premiums of needy patients. A spokeswoman for the charity, the American Kidney Fund, also said it had been subpoenaed. (Abelson and Thomas, 1/6)


Some GOP Governors Press Congress To Consider Keeping Medicaid Expansion

But lawmakers appear determined to rein in Medicaid as part of the overhaul of the federal health law. News outlets also report on Medicaid developments in Georgia, North Carolina, Virginia, Missouri and New Jersey.

Modern Healthcare: GOP Governors Fight Uphill Battle To Save Medicaid Expansion
An effort by Republican governors in Medicaid expansion states to show the expansion is worth keeping is unlikely to influence congressional Republicans in their drive to repeal the Affordable Care Act and its expansion of coverage to low-income adults, Republican experts say. Instead, congressional Republicans are expected to push ahead to repeal the Medicaid expansion and convert Medicaid from an entitlement to a capped program of federal contributions to the states, said Jon Gilmore, a Republican strategist in Arkansas. ... But Medicaid expansion advocates hope the governors' lobbying will cause congressional Republicans to think twice before wiping out the coverage extension that has brought billions of federal dollars into their states. (Dickson, 1/7)

Atlanta Journal-Constitution: Georgians Overwhelmingly Support Medicaid Expansion
A majority of Georgians support expanding Medicaid to hundreds of thousands of poor, uninsured residents, a new poll by The Atlanta Journal-Constitution shows. Seventy-five percent of people surveyed -- including 57 percent of Republicans -- said they support growing the health program for the poor, according to poll data. (Williams, 1/7)

Richmond Times Dispatch: New, Old Health Care Issues To Be Taken Up By Lawmakers 
House of Delegates Republicans have put forward a series of legislative proposals they see as more efficient alternatives to expanding Medicaid in Virginia under the Affordable Care Act. The legislation includes a provision to reform the state’s existing Medicaid program by mitigating the risk of improper payments, improving the state’s cap on managed care organizations’ profits, and incentivize those organizations to serve more patients in lower- cost settings. (Demeria, 1/7)

KCUR: Nixon Pardons Ministers Who Protested Missouri’s Decision Not To Expand Medicaid 
Missouri Gov. Jay Nixon today granted pardons to 18 individuals, including 16 clergy members and activists who were convicted of trespassing after they staged a protest in the Missouri Senate gallery over Missouri’s decision not to expand Medicaid. The so-called Medicaid 23 – several of them well-known African-American ministers from Kansas City – refused to leave the gallery during their protest in May 2014 after they were ordered to do so by Capitol police. (Margolies, 1/6)

The Press of Atlantic City: Program Aims To Bring Specialized Care To More Patients 
Physicians and other medical experts in New Jersey are teaming up to bring more specialized care to people living in rural areas, on Medicaid and who lack comprehensive health insurance coverage. Robert Wood Johnson Partners launched the New Jersey Project ECHO Academic Medical Center Hub in fall 2016 with three remote-access "tele-mentoring" clinics. The program has picked up speed as participating primary care physicians and specialists work in hepatitis C treatment, pediatric mental health and endocrinology. (Leonard, 1/7)


Eager To Get Into U.S. Market, Ipsen Buys Cancer Drug In $575M Deal With Merrimack

In other pharmaceutical news, a GAO report finds regulation of drug compounding in small settings is weak.

Boston Globe: Merrimack To Sell Pancreatic Cancer Drug To Ipsen In $575M Deal 
Merrimack Pharmaceuticals Inc. of Cambridge agreed to sell its pancreatic cancer drug and other assets to Ipsen SA for $575 million, striking a deal less than a month after another treatment failed in clinical trials. Ipsen SA, a French drug maker eager to expand its US business, could additionally pay as much as $450 million more under the deal if the drug is eventually approved to treat other cancers. (Weisman, 1/9)

CQ Roll Call: GAO Questions Implementation Of Drug Compounding Law
A new Government Accountability Office report examining the Food and Drug Administration’s implementation of a 2013 drug-compounding law says that while the agency has taken steps to regulate large drug-compounding firms, state regulation of drug compounding in smaller settings remains weak. Drug compounding is a process in which a drug is altered to meet the needs of an individual patient by combining, mixing or switching out ingredients. The process is useful for patients who might be allergic to commercial drugs. (Ferguson, 1/9)

Health IT

Providers Could Tap Decades Of Electronic Health Records To Help Patients Make Choices Now

"Patients are always saying, don't just give me the averages, tell me what happened to others who look like me and made the same treatment decisions I did," says Dr. Tracy Lieu, who heads Kaiser Permanente's research division that is exploring how it might use years worth of health records to inform current patients.

NPR: Other People's Electronic Medical Records May Improve Your Health Care
Chances are your doctor has stopped taking notes with pen and paper and moved to computer records. That is supposed to help coordinate your care. Increasingly, researchers are also exploring these computerized records for medical studies – and gleaning facts that help individual patients get better care. (Harris, 1/9)

In other news on electronic health records —

Boston Globe: Patient Power Through Records 
Today, electronic medical records are ubiquitous — 87 percent of US office-based physicians were using them by the end of 2015, up from 42 percent in 2008. Yet the rapid adoption of the technology, spurred by $35 billion in federal government incentives, hasn’t proved the cure-all that tech evangelists promised. Electronic records are still difficult for patients to access, difficult for doctors to share among themselves, and difficult to standardize. (Tanner, 1/7)

The Associated Press: Officials: Foreign Government May Have Breached Health Data
A foreign government may have been behind a cyber breach of health insurance company Anthem Inc. that compromised the records of more than 78 million consumers, investigators said Friday. They declined to identify the hackers or the foreign government. Social Security numbers, birthdates and employment details of customers were accessed in the breach, officials said. Cybersecurity experts say the data could help a foreign government build a profile of people they're targeting for espionage. (Cooper, 1/6)

Public Health And Education

Despite Efforts To Curb Epidemic, Overdose Deaths Hitting New Peaks

Fentanyl continues to play a major role in the crisis.

The Wall Street Journal: Overdose Fatalities From Opioids Hit New Peaks
The U.S. opioid crisis shows no sign of receding as a new year begins, with the latest data from several hard-hit cities and states showing overdose fatalities reaching new peaks as authorities scramble to stem the tide. The synthetic opioid fentanyl, which has up to 50 times the potency of heroin, remains the chief culprit driving the increase in fatalities, according to medical examiners and health and law-enforcement authorities in abuse hot spots, such as Ohio, Maryland and New England. (Kamp, 1/6)

The Baltimore Sun: Opioid Users Filling Maryland Hospital Beds And Emergency Rooms 
Maryland has the nation's highest rate of hospitalizations for opioid use, according to newly released federal data that illustrates the depth of the addiction problem in a state where many people have died from overdoses of the drugs. Tens of thousands of people are admitted to state hospitals or visit an emergency room each year related to opioid withdrawal, overdose or complication, according a decade's worth of statistics provided by the U.S. Agency for Healthcare Research and Quality. (Cohn, 1/6)

Hospital Encounters Conflict When Traditional Medicine Clashes With Alternative Views

A doctor's anti-vaccine controversy at Cleveland Clinic illustrates the challenges many facilities may face. Other public health news stories include developments on the flu, cancer death rates, a morning sickness pill, fasting, the post-holiday blood supply shortage and Zika worries in Puerto Rico.

Stat: Anti-Vaccine Rant Exposes Conflict Over Hospitals' Embrace Of Alternative Medicine
In the span of a few days, the anti-vaccine screed of a Cleveland Clinic doctor prompted a social media firestorm, an apparent retraction from the physician, and promises of disciplinary action by administrators of his prestigious hospital system. But those reactions will not entirely contain the damage caused by the rant, which has already been picked up by anti-vaccine organizations, or address a more fundamental question: Why do hospitals that espouse evidence-based medical care operate alternative medicine institutes that offer treatments with little foundation in science? (Ross and Boodman, 1/9)

The Washington Post: There May Someday Be A Way To Avoid The Yearly Flu Shot 
The most vexing thing about the annual flu vaccination is that it’s annual.You have to get it every year, and many people don’t do so. In fact, the Centers for Disease Control and Prevention recently reported that only 2 out of 5 Americans have received the shot so far this flu season. Wouldn’t it be easier if a flu shot were a once-in-a-lifetime event, or even once or twice in a decade? Public health officials see that as a potential game-changer. (Cimons, 1/7)

Bloomberg News: Cancer Death Rate In US Drops 25 Percent From Peak In 1991 
The cancer death rate in the United States has dropped by 25 percent since its 1991 peak, resulting in 2 million fewer cancer deaths than if the rate had stayed the same, the American Cancer Society said Thursday in a new report. The group attributed the decrease largely to reductions in smoking and improvements in the early detection and treatment of cancer. But there remains a significant gender gap: The cancer death rate is 40 percent higher for men than women, and the incidence of cancer is 20 percent higher in men. (McGinley, 1/6)

NPR: Diclegis, A Morning Sickness Pill, Back In Spotlight
A Canadian doctor who is opposed to a widely used drug for morning sickness has fired another volley. Writing in the journal PLOS ONE, Dr. Navindra Persaud in the department of family and community medicine at St. Michael's Hospital in Toronto, notes that an unpublished study that supported use of the drug, conducted in the 1970s, is seriously flawed. (Harris, 1/6)

NPR: Can Fasting Change The Microbiome And Tame MS Symptoms?
When I told my coworker that I was participating in a study that involved fasting, she laughed until she nearly cried. My boyfriend, ever supportive, asked hesitantly, "Are you sure you want to try this?" Note the use of "try" instead of "do." When I told my father over the phone, the line went silent for a moment. Then he let out a long, "Welllllll," wished me luck, and chuckled. Turns out, luck might not be enough. (Jefferson, 1/8)

Columbus Dispatch: Post-Holidays Blood Shortage Spurs Urgent Red Cross Call For Donors 
Because of a severe shortage caused by a slump in donations over the holidays, the American Red Cross has issued a nationwide emergency call for blood and platelet donors. In November and December, 37,000 fewer donations than expected were given nationwide because of busy holiday schedules, fewer blood drives, severe weather and donors coming down with colds and flu, said Rodney J. Wilson, a Red Cross spokesman in Columbus. Contributing to the number was the cancellation of about 100 December blood drives that would have collected 3,100 pints of blood. (Viviano, 1/8)

Kaiser Health News: In Puerto Rico, The Joy Of Pregnancy Is Tempered By Fear Of Zika
Before the virus overwhelmed Puerto Rico, Zika already lurked in Keishla Mojica’s home. First her partner, John Rodríguez, 23, became infected. His face swelled and a red, itchy rash covered his body. Doctors at the time diagnosed it as an allergy. Two months later, Mojica, 23, had the same symptoms. Medics administered shots of Benadryl to soothe the rash and inflammation. She didn’t give it much more thought. (Heredia Rodriguez, 1/9)

Women’s Health

Planned Parenthood Chapter Gears Up For Defunding Battle

Planned Parenthood of the Heartland plans to launch an extensive lobbying campaign against Republicans' attempts to block funding from the organization. Meanwhile, advocates in Texas are concerned state lawmakers will continue to chip away at abortion rights.

Des Moines Register: Planned Parenthood Plots Strategy To Avert Defunding In Iowa
As Republican lawmakers make plans to block government funding of Planned Parenthood, Iowa leaders of the family-planning organization are pledging a statewide lobbying initiative and are warning that women's health care is in jeopardy. Abortion opponents across the United States are calling for an end to state and federal funding for Planned Parenthood, saying the private agency's involvement in abortion should make it ineligible for public financing. Planned Parenthood of the Heartland has said about one-fourth of its Iowa financing, or nearly $2.7 million per year, comes from public sources. Most of that money comes from programs under Medicaid, which is jointly financed by federal and state governments. No public money is used for abortions, the organization says. (Petroski, 1/6)

Texas Tribune: Texas Reproductive Rights Groups Brace For Legislative Session 
Reproductive rights advocates have expressed concern that Lone Star State lawmakers will take bolder steps in the upcoming session to defund abortion providers and dismantle access to abortion, birth control and other sexual health services. They're also worried President-elect Donald Trump and the Republican-controlled Congress could take similar actions at the federal level, such as this week's announcement by U.S. House Speaker Paul Ryan that federal lawmakers would look at defunding Planned Parenthood. (Evans, 1/6)

And in other news —

Milwaukee Journal Sentinel: Abortion Foes Seek Ban After 12 Weeks
Abortion opponents in Wisconsin are seeking to outlaw the main set of procedures used to end pregnancies after the 12th week, the latest in a series of moves aimed at limiting the practice in this state. Wisconsin Right to Life has made banning the procedures its top priority, calling them particularly cruel because they can lead to a fetus being removed from a uterus in pieces during an abortion. Opponents of the ban say doctors rely on the procedure when a pregnant women or fetus experiences medical challenges in the second trimester. (Stein, 1/7)

CQ Roll Call: Under Obama, Abortion Rate Falls To 45-Year Low
The abortion rate in 2013 was lower than in any year since 1971, two years before the Supreme Court legalized abortion in its Roe v. Wade decision, according to the latest findings of the Centers for Disease Control and Prevention.  Its November report pegged the rate at 12.5 per 1,000 women, aged 15-44. The rate, which was 15.8 per 1,000 women in 2008, has declined in each year of the Obama administration. The rate dropped 5 percent between 2012 and 2013. (Zeller, 1/9)

State Watch

State Highlights: Calif. Prisoner First To Receive State-Funded Sex-Reassignment Surgery; Ga. Hospitals Dinged On Quality Of Patient Care

Outlets report on health news from California, Georgia, Illinois, Louisiana, Minnesota, Kentucky, Kansas, Pennsylvania, Ohio, Florida and New Hampshire.

The Associated Press: California Is First To Pay For Prisoner’s Sex-Reassignment Surgery
A 57-year-old convicted killer serving a life sentence in California is the first inmate in the United States to receive state-financed sex-reassignment surgery, the prisoner’s lawyers said. California prison officials agreed in August 2015 to pay for the surgery for the inmate, Shiloh Heavenly Quine, who was convicted of first-degree murder, kidnapping and robbery for ransom and has no possibility of parole. (1/7)

Savannah Morning News: Savannah’s Three Major Hospitals Hit With Federal Penalties For Patient-Care Issues 
Savannah’s three major hospitals are among 13 hospitals in Georgia to be hit with federal penalties for high rates of patient care complications, according to federal health officials. Memorial University Medical Center, Candler Hospital and St. Joseph’s Hospital were cited for high levels of complications including infections, blood clots, bedsores and falls, officials with the U.S. Center for Medicare and Medicaid Services reported in an annual survey. There were 31 of 134 hospitals — 23 percent — penalized in the state. (Skutch, 1/7)

Chicago Tribune: Should Illinois Hospitals Have To Pay Property Taxes? Court Will Weigh Question
A case set to go before the state Supreme Court on Thursday is challenging the law that allows Illinois' not-for-profit hospitals to skip paying property taxes. Those challenging the law say many not-for-profit hospitals enjoy hefty profits and should have to contribute to their communities, just like any other business. Hospitals, however, argue they provide valuable charitable care and use the exemptions to fulfill their communities' health care needs.Hundreds of millions of dollars — for hospitals, communities and taxpayers — are at stake. (Schencker, 1/8)

San Jose Mercury News: Troubled Theranos To Lay Off 41 Percent Of Employees
Beleaguered blood-testing startup Theranos is laying off nearly half of its remaining workforce, the company said Friday, as it reels from federal sanctions and lawsuits brought on by its underperforming product. The Palo Alto startup will lay off 155 employees — about 41 percent of its workforce — as part of an ongoing restructuring effort. Theranos has shuffled its management, closed its labs and voided two years of test results as it tries to backpedal from the failure of its signature Edison machine, which promised to perform a variety of blood tests using a pin prick’s worth of blood. (Kendall, 1/6)

The Washington Post: This Louisiana Town Has A Serious Problem With Lead In Its Water. It Won’t Be The Only One This Year.
In the tiny town of St. Joseph, La., a local preacher has temporarily suspended baptisms, figuring that if officials don’t want people drinking the tainted water, he ought not to be plunging them into it, either. “I just don’t feel comfortable immersing people in that water,” Pastor Donald Scott told the Advocate, a Baton Rouge newspaper, recently. “I’m pretty sure God understands.” (Dennis, 1/6)

Minnesota Public Radio: As Flu Cases Surge In Minnesota, Vaccinations Stall
Minnesota and neighboring states are seeing an increase in the number of flu cases. It'll likely be several more weeks before flu season peaks in Minnesota. There's still time to get a flu shot, but federal data show that most people haven't bothered. Public health officials are publicizing the increase in flu cases with hopes that the information will spur people to rush out for a flu shot. But if recent trends hold, it may not. (Benson, 1/6)

The Courier-Journal: Child Abuse Findings Voided Secretly In Kentucky
Using a secret process that not even victims may know about, [Kevin] Watson, exercising his right to a confidential appeal, was able to overturn the cabinet's child abuse finding against him. That kept his name from being added to an official list — also confidential — known as the state Child Abuse and Neglect Registry that can restrict adults from some occupations or activities, such as child care, working or volunteering with youths or serving as foster parents. (Yetter, 1/7)

KCUR: Kansas Gov. Brownback Unveils Plan To Increase State's Doctors 
Kansas Gov. Sam Brownback unveiled a two-part plan Friday to bring more doctors to the state and quell health care shortages that he said threaten to kill rural communities. Brownback, flanked by Lt. Gov. Jeff Colyer, a hospital executive and the head of the Kansas Farm Bureau, harkened back to his days growing up in Parker — population 250 — to personalize the push for more rural doctors. (Marso, 1/6)

KCUR: Kansas Community Mental Health Centers See Lottery As Potential Funding Source 
In tight budget times, Kansas mental health advocates are turning to the lottery for some financial help. Kyle Kessler, executive director of the Association of Community Mental Health Centers of Kansas, said the association will ask the Legislature to commit an additional $31 million over the next two fiscal years for the centers. That $31 million — pulled from Kansas lottery proceeds — would return funding for the 26 centers across the state to the 2007 fiscal year level. (Wingerter, 1/6)

WABE : Ga. GOP To Prioritize Health Care, Avoid Religious Exemptions 
State Republican leaders indicated Thursday they are not prioritizing religious exemption bills that have headlined legislative sessions in years past.Republican House and Senate leaders spoke about their legislative agendas Thursday for this year’s General Assembly which starts Monday. The Senate GOP Caucus’s priorities included topics ranging from health care to education funding, but did not include religious exemptions bills.  (Yu, 1/6)

The Philadelphia Inquirer: Study Suggests Prevention Efforts Are Having An Effect On Melanoma In Pa., N.J.
Free skin cancer screenings on Jersey Shore beaches. Laws cracking down on indoor tanning. Melanoma prevention programs for children as young as 3. Efforts such as these may explain why a new analysis has found a small but heartening decline in melanoma cases and deaths in most Northeastern states, in contrast to trends for the deadliest skin cancer in the rest of the country. The new study, led by dermatologist Robert Dellavalle of the Denver Veterans Affairs Medical Center and published recently in JAMA Dermatology, compared melanoma deaths and incidence by region for 2003 and 2013. (McCullough, 1/7)

Cleveland Plain Dealer: Summa Doctors Say Leadership Needs Replacing After ER Staffing Shakeup 
Doctors at Akron's Summa Health System are divided over the hospital's decision to terminate the contract of its emergency physicians on New Year's Eve. After a week of turmoil, about 250 Summa physicians on Thursday evening gave their President and CEO, Dr. Thomas Malone, a vote of "no confidence" at an unscheduled medical staff meeting, according to doctors who attended. More than 200 staffers later signed a letter to the health system's board of directors seeking Malone's resignation. (Zeltner, 1/7)

Health News Florida: Report: Florida Ranks 47 In Country In Child Health Care
The quality of health care among Florida's children has improved since 2008, but the state still lags far behind much of the nation. That's according to a report released today by Florida Kids Count. Florida made strides in crucial health care factors, including the number of children born with low birth weights and the number of deaths among children and teens. (Ochoa, 1/9)

Editorials And Opinions

Perspectives On The Evolving Partisan Plans For Obamacare

Opinion writers offer their thoughts, advice and warnings on how to shape the repeal and replace effort.

The Washington Post: Trump Has To Rescue Obamacare Or Admit He’s A Liar
It didn’t take long. During the first week of 2017, the new Republican Congress has begun efforts to dismantle America’s health-care system. Their long-standing goal, consistent with their right-wing ideology, is to take away health insurance from tens of millions of Americans, privatize Medicare, make massive cuts to Medicaid and defund Planned Parenthood. At the same time, in the midst of grotesque and growing income and wealth inequality, they’re preparing to allow pharmaceutical companies to increase drug prices and to hand out obscene tax breaks for the top one-tenth of 1 percent. (Sen. Bernie Sanders, I-Vt., 1/9)

The Washington Post: Republicans Have No Clue How To Keep Their Promises On Obamacare
Republicans last week kicked off their dominance of Washington by vowing to push through an unpopular and unwise unraveling of the Affordable Care Act, an imperfect law that nevertheless has done much good. Scaling back the policy is “the first order of business,” Vice President-elect Mike Pence promised after a strategy meeting on Capitol Hill. At the same time, House Speaker Paul D. Ryan (R-Wis.) pledged that Republicans would not pull the rug out from under people currently benefiting from the plan. (1/7)

The Washington Post: Republicans Don’t Want To Hurt ‘Real America.’ By Repealing Obamacare, They Will.
Let’s try to get this straight. Donald Trump campaigned as the champion of lower-paid working people who deserve better than they have. Republicans have spent the Obama presidency complaining about high deficits and promising to cut them. And whenever liberals put forward major reforms, conservatives say: No, no, you can’t make radical changes on the basis of narrow partisan majorities. Let’s take it slow and be very careful. They love to cite Thomas Jefferson’s dictum, “Great innovations should not be forced on slender majorities.” (E.J. Dionne, 1/8)

Cleveland Plain Dealer: Republicans, Please Have The Guts To Gut Obamacare
This week, Republicans were all set to gut the House of Representatives' ethics rules. Now, they're supposedly gearing up to gut Net neutrality. They're expected to gut executive department rules related to global warming. They've always wanted to rethink/privatize/fix Medicare, but "gut" fits so much easier in post-Trump election headlines. They've been itching to "gut" the Consumer Financial Protection Bureau since the day it was misbegotten. (Kevin O'Brien, 1/6)

Modern Healthcare: GOP Obamacare Replacement Plan Could Prove 'Disastrous'
Republicans seem intent on pursuing a disastrous Obamacare replacement plan that couples catastrophic coverage with subsidized health savings accounts. Such high-deductible plans will make achieving good health much harder for patients. They will raise uncompensated-care costs and thus everyone’s rates. And they will undermine the system’s efforts at delivering better, more cost-effective care. (Merrill Goozner, 1/7)

The Washington Post: Republicans Reach Staggering New Heights Of Hypocrisy
It’s never all that hard to find examples of politicians in either party being hypocrites, accusing their opponents of things they themselves are guilty of or flipping 180 degrees on supposedly heartfelt positions when it looks to be to their momentary advantage. But the Republicans now taking power in Washington are bringing hypocrisy to spectacular new heights. (Paul Waldman, 1/6)

The Washington Post: More Republicans Are Going Wobbly On Obamacare Repeal. Here’s One Possible Reason Why.
Bloomberg Politics reports today that “growing GOP doubts” could “jeopardize swift Obamacare repeal in the Senate.” That’s because more GOP Senators are suddenly going wobbly on the GOP plan to repeal the law on a delayed schedule with no guarantee of any replacement later. As of today, six GOP Senators have signaled real reservations. There are 52 GOP senators, so if they lose only three, repeal-and-delay would go down to defeat — meaning, in Bloomberg words, that right now, there are “more than enough” senators expressing doubt to “scuttle efforts to deliver swiftly on a central promise from President-elect Donald Trump.” (Greg Sargent, 1/6)

Milwaukee Journal Sentinel: Time For Common Sense On Obamacare
Americans woke up Thursday morning to learn that the president-elect of the United States had referred to his rivals in the debate over health care policy as “clowns.” His comments, tweeted, of course, were as classless as they were unhelpful, and they left me wishing the soon-to-be leader of the free world would take two minutes to watch and learn from a video Sen. Joe Donnelly (D-Ind.) posted this week (Matthew Tully, 1/7)

Stat: ACA Successor Must Have Affordable Insurance For Preexisting Conditions
Republicans in Congress have started the process of repealing the Affordable Care Act despite great uncertainty about what might come next. As cancer survivors in our 30s, we are all too familiar with life’s uncertainties. That is why we are especially attuned to policies that would adversely affect the 22 million Americans who gained coverage under Obamacare, and specifically the 27 percent of the non-elderly adult population with preexisting conditions who would have been excluded from receiving health coverage before the ACA. (Jen Campisano and Ben Fisman, 1/6)

USA Today: Medicare For All Should Replace Obamacare: Column
Even before the election of Donald Trump, Obamacare was in trouble. Premiums on the government exchanges for individual policies are projected to increase an average of 11% next year, nearly four times the increase for employer-based family policies. And some large insurers are pulling out of that market altogether in parts of the country. ... The problem is that the underlying causes of the cost inflation were left largely untouched by Obamacare. The system remains in the hands of investor-owned insurance companies, drug companies, and profit-oriented providers that can charge whatever the market will bear — and in health care, the market will bear much more than in most sectors of the economy. (Marcia Angell, 1/6)

The Philadelphia Inquirer: Kill Obamacare? Might As Well Kill Patients
[Donna] Torrisi is a nurse practitioner who heads Philly-based Family Practice & Counseling Network (FPCN, for short). Through six gleaming nurse-managed health centers, FPCN provides primary health care for 23,000 low-income patients, most of them the working poor...Before the Affordable Care Act, known as Obamacare, was passed, 25 percent of FPCN's patients were uninsured. Because the network treats everyone regardless of ability to pay (it offers a sliding-fee scale), it had to eat a lot of the cost of providing primary, behavioral, dental and preventive care. (Ronnie Polaneczky, 1/9)

Roll Call: There’s Danger For Democrats, Too, In Obamacare Repeal
The reality is that Republicans will need a rescue from Democrats to keep their “repeal and replace” campaign promise. Even though they’ll need just 50 votes in the Senate to strike much of the law, they’ll need 60 votes, including eight Democrats, to put anything else in its place. As of now, it doesn’t look like that’s going to happen. “They need 60 votes to replace the ACA and Democrats won’t help with replacement,” a Democratic leadership aide told me. ... But as precarious as the situation is for Republicans, there is danger here for Democrats, too. At some point, they will have to decide whether voting for relief for Americans displaced from Obamacare is rescuing Republicans from their political shortsightedness or if it’s rescuing Americans from what Republicans have put into motion. (Patricia Murphy, 1/6)

Chicago Tribune: The Obamacare Endgame: Republicans Risk Chaos If They Repeal Before They Replace The Health Law
Republicans are gearing up to repeal Obamacare — what House Speaker Paul Ryan calls "the first order of business" for the new Congress and the Trump administration. House and Senate committees will be under intense deadline pressure to write legislation before the end of the month that would undercut major pillars of Obamacare as part of a budget bill. Yes, the GOP is in a hurry to rid the nation of Obamacare. (1/8)

St. Louis Post-Dispatch: Replacing Obamacare With Job-Killing Chaoscare
Like most of the charges that Republicans threw at the Affordable Care Act over the past six years, the accusation that it was a “job-killer” didn’t hold water. In fact, it was just the opposite. But if killing jobs is what opponents want, they can make it happen by eliminating key provisions of the health care law, which studies say could force an estimated 3 million people out of work. (1/8)

The Charlotte Observer: Obamacare Repeal Would Destroy Key Mental Health Protections
This was a pivotal week for healthcare with Congress starting to repeal the Affordable Care Act (also known as Obamacare) and North Carolina Governor Roy Cooper moving to expand Medicaid in our state. Regardless of your opinion on these changes, it is true that key parts of the ACA were landmark achievements for people with mental illnesses. These portions of the law are not only working, but they are commonsense, bipartisan solutions to one of our country’s greatest challenges. (Samuel Joshua Dotson, 1/7)

Viewpoints: Dr. Price And Medicare; The Impact Of New York's Medicaid Program On New Jersey

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

Forbes: Questions On Medicare For Dr. Tom Price, Our Next Health Secretary
The approach to premium support advocated by Dr. Price is a better version of the increasingly popular Medicare Advantage program, whereby seniors’ Medicare Part A (hospital), Part B (physician), and (often) Part D (drugs) are rolled into one package offered by a commercial insurer. Although the Affordable Care Act partially financed Obamacare by reducing the amounts the federal government pays insurers to participate in Medicare Advantage, the opportunity to get out of traditional Medicare had become increasingly popular among seniors. (John Graham, 1/6)

Forbes: How New York's Bloated Medicaid Program Punishes New Jersey And Other States
Tony Soprano would be outraged; Governor Chris Christie and New Jersey’s congressional delegation should be. Every year, the state of New Jersey loses enormous wealth through the Medicaid program. As it happens, its neighbor to the north is gaining almost exactly that amount through its enormous Medicaid program—one full of waste and bloat. It’s fair to think of this Medicaid financing scheme as one that simply takes dollars out of New Jersey and gives them to New York. (Brian Blase, 1/8)

Sacramento Bee: Congress Should Stop The War On Planned Parenthood 
The 15-month, $1.6 million congressional “investigation” into Planned Parenthood is finally over, with the chilling announcement that Republicans in charge plan now to eviscerate the nonprofit most associated with reproductive rights. ... Baseless as the proposals were, House Speaker Paul Ryan swiftly announced that at least one – senselessly stripping Planned Parenthood of hundreds of millions of dollars in federal funds – will be among the first orders of business. (1/6)

Los Angeles Times: Defunding Planned Parenthood Hurts The Healthcare System
Way up high on the list of priorities of the newly empowered Republican-controlled Congress is the defunding of Planned Parenthood, the well-known and highly competent not-for-profit organization that provides a broad array of reproductive healthcare services to women throughout the country. Undermining or destroying Planned Parenthood has been a GOP obsession for years, but repeated efforts to cut the federal funding the organization receives have been unsuccessful. Last year, for instance, the House and Senate tried again to do so, but President Obama vetoed the bill. This year, however, Obama will no longer be there to do what needs to be done. (1/7)

Bloomberg: A New Attack On Women's Right To Choose
So far the new Republican Congress has proved better at identifying things it doesn't like -- Obamacare, for example, or an independent ethics office -- than actually getting rid of them. On one issue, however, Congress may yet get its way: abortion. (1/9) Reducing Cleveland's High Infant Mortality Rate The Boston Way
Just like in Cleveland, far too many of Boston's black babies, many of them impoverished, were dying in the 2000s despite the city's top-notch hospitals. Nearly 14 of every 1,000 of Boston black babies didn't live to see their first birthday in 2000, because of prematurity, congenital defects or dangerous sleeping habits, such as being put to bed on their stomachs or with blankets. And they were the main victims of the city and state's once high infant mortality rate. (Sharon Broussard, 1/7)

Boston Globe: Naturopathic Medicine Is Good For Massachusetts
It is time for Massachusetts consumers who seek out complementary therapies to be protected from unscrupulous practitioners, who can now falsely present themselves as naturopathic doctors. Licensure will set standards for training, education, and practice. This legislation has been vetted for 24 years by policymakers in the Legislature and in the executive branch, and by the other stakeholders, including the public. As we move to a system of more integrated health care, state licensure of NDs is a good idea. (Amy Rothenberg, 1/8)

The Des Moines Register: Iowa Has Medical Examiner Problems, Again
The State Medical Examiner's Office is reporting delays in autopsies. As a person once involved in this office, I find the failure to meet performance goals troubling. ... Now, with Dr. Julia Goodin's move to Tennessee, the staff is at three forensic pathologists. (We had zero in 1998.) NAME's standard of 200 cases per pathologist per year is now being exceeded by about 30 percent. (Dr. John C. O'Connor, 1/8)

The New York Times: The Hidden Gun Epidemic: Suicides
Ralph Demicco, a gun shop owner in Hooksett, N.H., was shocked in 2009 when three of his customers bought handguns and committed suicide over five days in separate shootings. He encountered firsthand the stark, barely noticed fact that more than 60 percent of the nation’s 30,000-plus gun deaths each year are acts of suicide, not accidents or homicidal attacks. In New Hampshire, where the suicide rate is 31 percent higher than the national average, over 85 percent of firearm deaths are suicides. The dealer reviewed the shop’s surveillance tapes. There were no giveaway signs of the troubles driving these customers to shoot themselves. “It’s just an ugly, ugly thing,” Mr. Demicco later told researchers for Harvard University’s School of Public Health. “I decided I must become involved.” (1/9)