KHN Morning Briefing

Summaries of health policy coverage from major news organizations

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Political Cartoon: 'Mistaken Identity?'

Kaiser Health News provides a fresh take on health policy developments with "Political Cartoon: 'Mistaken Identity?'" by Steve Kelley, New Orleans Times-Picayune.

Here's today's health policy haiku:


Hold on now, some said.
We’re not ready to confirm
This Trump nominee.

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Summaries Of The News:

Health Law

Bipartisan Coalition Of Experts Proposes Blueprint To Shore Up Fragile Marketplaces

The group, composed of prominent advisers to former Republican and Democratic presidents, began holding monthly meetings in January to search for points of agreement. Meanwhile, a study finds that the uncertainty from the Trump administration has triggered premium hikes and community organizations that help people enroll in health care through the Affordable Care Act are on edge about their funding.

The Washington Post: Bipartisan Health Policy Coalition Urges Congress To Strengthen The ACA
An unlikely coalition of liberal and conservative health-policy leaders is calling on Congress to strengthen the existing health-care law in a variety of ways to help Americans get and keep insurance. The group is urging the government, in particular, to continuing paying all the federal subsidies provided under the Affordable Care Act and to help Americans enroll in coverage. In a five-point set of principles issued Wednesday, the coalition lays out a potential bipartisan path forward after a Republican strategy to tilt federal health policies in more conservative directions failed in the Senate last month. (Goldstein, 8/9)

The Wall Street Journal: Health Experts Push Fix For Insurance Markets Aimed At Both Parties
The plan makes five primary recommendations. It encourages lawmakers to formally authorize the ACA’s “cost-sharing reduction” payments, which help insurers subsidize costs for some low-income consumers. It recommends Congress ensure funding for the popular Children’s Health Insurance Program, which is favored by members of both parties but has been floated as a vehicle to pass more contentious health reforms. The authors also endorse two GOP-backed ideas—expanding the use of health savings accounts and broadening the ACA’s state innovation waivers, to give states additional flexibility in administering their insurance markets. In exchange, they nod to a core priority for Democrats to have a mechanism that will entice more people to sign up for health insurance. (Hackman, 8/9)

The Associated Press: Study: Trump Actions Trigger Health Premium Hikes For 2018
The Trump administration's own actions are triggering double-digit premium increases on individual health insurance policies purchased by many consumers, a nonpartisan study has found. The analysis released Thursday by the Kaiser Family Foundation found that mixed signals from President Donald Trump have created uncertainty "far outside the norm," leading insurers to seek higher premium increases for 2018 than would otherwise have been the case. (Alonso-Zaldivar, 8/10)

The Hill: Insurers Cite Uncertainty In Filing ObamaCare Rate Hikes 
Insurers’ requests for premium increases in 2018 varied widely amid uncertainty surrounding how the Trump administration will implement ObamaCare, a new analysis finds. The Kaiser Family Foundation analyzed initial premium requests from 21 major cities, and found the rate requests ran the gamut from a 5 percent decrease in Providence, R.I., to a 49 percent increase in Wilmington, Del. (Roubein, 8/10)

The Wall Street Journal: Health ‘Navigators’ Brace For Decision On Their Funding
The Trump administration must decide within weeks whether to continue funding organizations that help people enroll in health insurance through the Affordable Care Act, one of several imminent choices that could signal the administration’s larger approach to the law. The Centers for Medicare and Medicaid Services last year awarded $63 million in grants to nearly 100 community organizations that help people sign up for health plans under the 2010 law. The grants for these so-called “navigators” are set to run through September 2018, but the contracts specify that funding year-to-year would be contingent on their performance. (Hackman, 8/9)

And in other news —

The Fiscal Times: Heads Up: Healthcare Is Still In Trouble
The issue of the US health insurance system was taken off the front burner with the evident failure of the Republican effort to repeal and replace the Affordable Care Act. But while it may not be in the headlines as much as it once was, the health care system in the United States is still in need of serious attention. (Garver, 8/9)

Kansas City Star: Faith-Based Health Sharing Takes Off As Obamacare Costs Rise
As premiums and deductibles for individual health plans have increased under the Affordable Care Act — commonly called Obamacare — more people are turning to such ministries rather than buying traditional health insurance. The health sharing ministries are explicitly exempt from ACA requirements, so they can offer monthly dues that are lower than typical insurance premiums, especially for people who accept less coverage and more personal risk. (Marso, 8/9)

McConnell, Trump Bicker Over Who's To Blame For Health Care Failure

Senate Majority Leader Mitch McConnell (R-Ky.) says President Donald Trump's "early timelines" and "excessive expectations" are hindering Congress' ability to get anything done, while the president fired back that lawmakers have had seven years to work on it.

The Associated Press: Trump Hits McConnell For Senate Crash Of Obama Health Repeal
President Donald Trump scolded his own party's Senate leader on Wednesday for the crash of the Republican drive to repeal and rewrite the Obama health care law, using Twitter to demand of Majority Leader Mitch McConnell, "Why not done?" Trump fired back at the Kentucky Republican for telling a home-state audience this week that the president had "not been in this line of work before, and I think had excessive expectations about how quickly things happen in the democratic process." (8/9)

USA Today: Donald Trump Responds To McConnell: I Don't Have Excessive Expectations
In an interview this week, McConnell had blamed Trump for setting "early timelines" and "excessive expectations" as one of the reasons that people believe Congress is getting nothing done. But Trump said he didn't think he had "excessive expectations." "After 7 years of hearing Repeal & Replace, why not done?" he said on Twitter. (Collins, 8/9)

WBUR: Trump, McConnell Point Fingers Over Health Care Failure
"Our new president, of course, has not been in this line of work before. And I think he had excessive expectations about how quickly things happen in the democratic process," the Senate majority leader continued. "So part of the reason I think people feel we're underperforming is because too many artificial deadlines — unrelated to the reality of the complexity of legislating — may not have been fully understood." (Taylor, 8/9)

Politico: Trump Vs. McConnell
The tit-for-tat between Donald Trump and Senate Majority Leader Mitch McConnell over the chamber's failure to repeal Obamacare opens a politically perilous schism within a party already riven by tensions over its lack of accomplishments this year. (McCaskill and Schor, 8/9)

In other news about President Trump —

Cleveland Plain Dealer: Cleveland Clinic Facing New Pressure To Abandon Planned Gala At Donald Trump's Mar-A-Lago
The last time complaints came in, President Donald Trump was pushing to block citizens of Syria and other Muslim-majority countries from entering the United States -- a policy affecting physicians, medical students and their families. The Cleveland Clinic said sorry, plans were already set. It was not going to cancel its February, 2017 ball and fundraising gala at the elegant, Trump-owned Mar-a-Lago estate and club in Palm Beach, Florida. (Koff, 8/9)

Onus Is On Congress To Fix Or Repeal Law, Price Says Hinting At New Willingness To Keep ACA

Trump officials are moving beyond the longtime focus on repeal-and-replace only and signaling a willingness to fix aspects of the health law.

Los Angeles Times: Trump Administration Shifts Tone On Obamacare, Signals Openness To Bipartisan 'Fix'
The Trump administration, thwarted in several attempts to repeal the Affordable Care Act, notably shifted tone Wednesday, opening the door for a bipartisan plan to "fix" the law. ... "Both folks in the House and the Senate, on both sides of the aisle frankly, have said that Obamacare doesn't work, and it needs to be either repealed or fixed," Health and Human Services Secretary Tom Price said on the Fox News program “Fox & Friends.” "So the onus is on Congress," he said.Talk of fixing the law is new for most Republicans. Price and President Trump have long focused only on repealing or replacing it. (Bierman, 8/9)

The Hill: Trump Officials Confront New ObamaCare Reality
President Trump has threatened to cancel key ObamaCare payments to insurers as part of an effort to make the health law “implode.” But he is yet to follow through on that threat, leaving insurers in a state of anxious uncertainty. The next sign-up period for enrolling in ObamaCare begins Nov. 1. The Obama administration ran advertisements to encourage enrollment, but Trump officials have signaled that promotion effort might come to an end. (Sullivan, 8/10)

The Hill: Price Booed As He Throws Out First Pitch At Nationals Game 
Health and Human Services Secretary Tom Price was booed as he threw out the first pitch at the Washington Nationals Game on Wednesday. Price was reportedly met with boos and only a few cheers when he took the mound at Nationals Park to toss the ceremonial first pitch, according to multiple people at the ball park. (Thomsen, 8/9)

Republican Senator Says Tumor May Have Affected McCain's Health Vote

Sen. Ron Johnson (R-Wis.) later walked back the statement, saying "I’m disappointed I didn’t more eloquently express my sympathy for what Sen. McCain is going through."

The Associated Press: GOP Senator Suggests Brain Tumor Affected McCain Vote
Sen. Ron Johnson suggested that fellow Republican Sen. John McCain's brain tumor and the after-midnight timing of the vote were factors in the Arizona lawmaker's decisive vote against the GOP health care bill. In a radio interview Tuesday with AM560 "Chicago's Morning Answer," Johnson answered questions about the collapse of the years-long Republican effort to repeal and replace Barack Obama's Affordable Care Act, his criticism of the process and McCain's dramatic vote. (8/9)

Arizona Republic: Wis. Senator: McCain's Health May Have Affected His 'Obamacare' Vote
“You really think that that played a factor in his judgment call?" she asked Johnson. “Again, I don’t know exactly what – we really thought that – again I don’t want to speak for any senator,” said Johnson. “I really thought John was going to vote yes to send that to conference at 10:30 at night. By about 1 or 1:30 (in the morning), he voted no. You’d really have to talk to John about what was on his mind.” (Gilbert, 8/9)

Bloomberg: GOP Senator Backtracks On Linking McCain's Tumor To Health Vote 
Senator Ron Johnson on Wednesday walked back his remarks suggesting a connection between fellow Republican Senator John McCain’s brain cancer diagnosis and his decisive vote last month against a stripped-down repeal of Obamacare. "I’m disappointed I didn’t more eloquently express my sympathy for what Sen. McCain is going through. I have nothing but respect for him and the vote came at the end of a long day for everyone," Johnson of Wisconsin said in a statement. The controversy began after Johnson told WIND-AM in Chicago, "I’m not gonna speak for John McCain -- he has a brain tumor right now -- that vote occurred at 1:30 in the morning, some of that might have factored in.” He added: "I really thought John was going to vote yes to send that to conference at 10:30 at night. By about 1, 1:30, he voted no." (Kapur, 8/9)

The Hill: McCain Aide: Brain Tumor Remark 'Bizarre And Deeply Unfortunate' 
A spokesman for Sen. John McCain (R-Ariz.) is criticizing Sen. Ron Johnson's (R-Wis.) remarks suggesting McCain's brain cancer might have been a factor in his vote against ObamaCare repeal. "It is bizarre and deeply unfortunate that Sen. Johnson would question the judgement of a colleague and friend," a McCain spokesman told NBC. (Bowden, 8/9)

Device Makers, Other Groups Pressing Congress To Use Tax Reform To Cut ACA's Taxes

Some groups are launching ad campaigns as part of their efforts. But while some senators seem to favor the idea, key members of the House say the best way to get "the Obamacare taxes out of the economy is through health care reform legislation."

The Hill: Medical Device Group Launches Ad Campaign To Repeal Tax
The trade group for medical device companies is launching a new advertising campaign to push lawmakers to repeal ObamaCare’s tax on medical devices. The effort comes on the heels of Congress’s failure to pass repeal of the healthcare law and as various industries are now looking for other avenues, besides full ObamaCare repeal, to abolish particular taxes in the law. (Sullivan, 8/9)

Roll Call: Lobbyists Push GOP To Repeal Obamacare Fees In Tax Overhaul
The Republican effort to repeal President Barack Obama’s signature health care law may have stalled, but lobbyists are pushing the GOP to continue to target the provisions the industry most despises: the law’s taxes. House and Senate Republicans hope to push forward on a tax overhaul when Congress returns in September, an item they previously delayed in favor of health care. Repealing the 2010 health care law and its corresponding taxes would have helped simplify the GOP’s upcoming work, but those hopes were deflated when the Senate did not pass a repeal bill last month. (Clason, 8/10)

Administration News

Trump Sued Over Proposed Ban On Transgender People Serving In Military

Other groups are waiting for formal action to be taken by the administration before they file suit.

The New York Times: For Transgender Women, An Extra Dose Of Fear
In an era in which protections allowing transgender students to use the restrooms they prefer have been rescinded and 14 transgender people have been murdered so far this year, according to the Human Rights Campaign, an L.G.B.T. rights advocacy group, many transgender people say they feel increasingly unsafe, and that “passing” is necessary for survival. So far, 19 states and the District of Columbia have put strong nondiscrimination policies in place for transgender people. But “now we’re seeing this pushback,” said Jaclyn White Hughto, a research fellow at the Yale School of Public Health who specializes in transgender health. “It’s the belief that the violence is a response to the more progressive agenda to protect transgender people.” (Ellin, 8/9)

Health Officials Denounce Trump's Decision To Cut Funding For Pregnancy Prevention Programs

The $214 million pregnancy prevention program is made up of 81 five-year grants that are now set to end in June 2018, two years early, under a highly unusual Health and Human Services Department decision outside the normal budget process.

The Washington Post: Big City Health Officials Decry Trump Administration’s Cuts To Teen Pregnancy Prevention Programs
The federal funding was curtailed last month without explanation and without warning: $214 million for teen pregnancy prevention programs across the country. The city of Baltimore lost $3.5 million, money that Health Commissioner Leana Wen said had supported classes in anatomy and physiology and counseling in social and emotional issues related to sex for 20,000 teens, plus training for 115 teachers. She worries what the loss of funds will mean for local teen pregnancy rates, which already are twice as high as the state's and much higher than the U.S. average. (Cha, 8/9)

The New York Times: Programs That Fight Teenage Pregnancy Are At Risk Of Being Cut
At age 14, Latavia Burton knows something about teenage pregnancy. Her mother gave birth to her at 18 and couldn’t attend college because of it. And Latavia’s former best friend became pregnant at 16. So a pregnancy prevention program in eighth grade and another in her neighborhood this summer hit home. Latavia hasn’t had sex yet, and said if she were asked to she’d say, “Let’s just wait a little longer.” But to be safe, she plans to get an intrauterine device at a clinic for teenagers the program introduced her to. And since she learned that it would not protect her from sexually transmitted diseases, but that condoms would, she said she would “just go to the teen clinic and get some for free” if a boyfriend claimed he couldn’t afford them. (Belluck, 8/10)

Veterans' Health Care

VA To Flex Powers Of New Law That Makes It Easier To Fire Department Employees

Brian Hawkins, the former director of the agency’s main medical center in D.C. which a report found to be plagued by the "highest levels of chaos," was fired in late July. The government’s Merit Systems Protection Board issued a stay on the decision, but now VA Secretary David Shulkin has another tool to make the firing stick.

The New York Times: V.A. Plans To Fire Its D.C. Medical Director — Again
The head of the Veterans Affairs Department told lawmakers he intends to try out a new law that makes it easier to fire — and keep fired — deficient department employees. The test case: the former director of the agency’s main medical center here. The center’s director, Brian Hawkins, oversaw an operation that the department’s inspector general said was plagued by the “highest levels of chaos.” After the inspector general findings were released in a rare interim report in April, the department immediately transferred Mr. Hawkins to a job at its nearby headquarters. It then fired him in late July, saying in a statement that he had “failed to provide effective leadership at the medical center” or live up to the department’s values. (Fandos, 8/9)

The Washington Post: Federal Panel Blocks Firing Of Head Of Troubled D.C. Veterans’ Hospital
A federal board has blocked the firing of the director of D.C.’s troubled hospital for veterans, setting up a showdown with the Trump administration as it pursues expanded authority to clean house at the U.S. Department of Veterans Affairs. Brian Hawkins, who until recently served as the head of the VA Medical Center in Washington, was removed from his post in April and fired two weeks ago for what VA officials said was a failure to “provide effective leadership.” (Jamison, 8/9)


Medicare's Observation Care Policy More Likely To Affect Low-Income Seniors

A new study finds that low-income patients are more likely to be kept in the hospital under observation, and the higher out-of-pocket spending that accompanies not being officially admitted is a bigger burden for them. Also in the news, long-term care hospitals are pressing Medicare for a change that may cut their reimbursement rates.

Reuters: Poor Medicare Patients May Spend More On Hospital Stays
Out-of-pocket spending for hospital care by people with Medicare may be higher for those with lower incomes, because they’re more likely than wealthier Medicare beneficiaries to be kept in the hospital without being officially admitted, a new study suggests. Under Medicare, the government insurance program for the elderly and disabled, people admitted to the hospital pay a fixed out-of-pocket fee that covers the majority of their care there .... But people who aren’t sick enough for an inpatient admission may be kept in the hospital for observation, which not only carries a one-time out-of-pocket fee but also requires patients to pay 20 percent of the bills for hospital services and pick up the tab for certain drugs. The poorest people on Medicare had more hospitalizations for observation, researchers found. (Rapaport, 8/9)

Modern Healthcare: Hospitals Hope Trump's Pause Of A Medicare Reimbursement Cut Will Become Permanent 
Long-term care hospitals around the country are hopeful the Trump administration will permanently abolish a proposed policy that would dramatically reduce their Medicare reimbursement. The Trump administration said Aug. 2 that it will freeze the so-called 25% rule that dings Medicare reimbursement rates for hospitals for one year while it assesses whether the policy is needed. Under proposed rule, if more than a quarter of a long-term care hospital's patients come from a single acute-care hospital, the long-term care hospital would receive a reduced Medicare reimbursement rate for patients exceeding that threshold. (Dickson, 8/9)


HHS Watchdog Says Iowa Failed To Collect $700,000 in Medicaid Drug Rebates

The inspector general for the federal Department of Health and Human Services says that between March 2012 and December 2014 Iowa's Medicaid program did not invoice drugmakers for the rebates that the state and federal government were entitled to. Also, California groups file suit to help some Medicaid patients stay out of managed care networks if the patients want to keep their doctors and specialized providers.

Des Moines Register: Feds: Iowa Failed To Collect $700,000 In Drug Rebates Owed To Medicaid
For almost three years, the Iowa Department of Human Services neglected to collect rebates on pharmaceutical drugs purchased through Medicaid, costing Iowa taxpayers more than $700,000 in lost revenue. The U.S. Department of Health and Human Services’ Office of Inspector General investigated the loss as part of a wide-ranging probe into uncollected drug rebates that the Medicaid program is entitled to receive. (Kauffman, 8/9)

California Healthline: Medi-Cal Sued For Pushing Patients Into Managed Care Despite Judges’ Orders
Like Medicaid programs in many states that want more budgeting certainty or hope to save money, Medi-Cal is shifting many patients like [Alondra] Diaz, with complex conditions, into managed care plans. The plans agree to cover enrollees for a fixed amount per month. But in doing so, they often rely on narrow networks of physicians that do not include the patients’ doctors. ... Two health consumer advocacy groups, Neighborhood Legal Services of Los Angeles County and Western Center on Law and Poverty, sued DHCS Tuesday to help Diaz and the dozens of other Medi-Cal members who’ve had similar rulings [allowing them to stay in the traditional fee-for-service Medi-Cal] overturned by the state. (Bazar, 8/10)


'Things Must Be Bad': Mylan's Stumbles Over Generic Drugs Indicative Of Larger Industry Trouble

The company is the latest to slash their forecast due to generic drugs.

Bloomberg: Generic Drug Price Slump's Latest Victim: Mylan Profit Goal 
For the last five years, Mylan NV executives have gotten up in front of investors every year and said they could bet on one thing -- that the maker of generic drugs would hit at least $6 in earnings per share in 2018. That’s not gonna happen. On Wednesday, Mylan cut its adjusted earnings forecast for next year to $5.40 a share. It’s the latest stumble in the generic-drugs industry during a period of falling drug prices, political scrutiny and takeovers by Mylan and its competitors that either couldn’t be consummated or turned out not to work as well as hoped. (Hopkins and Melin, 8/9)

Bloomberg: Mylan Pares Losses As Path To Generic Advair Approval Smoothed 
Mylan shares briefly pulled out of an early-morning swoon after executives tempered concern about regulatory roadblocks for some of its new drugs. Approval of a highly anticipated generic version of the asthma treatment Advair, which was delayed, won’t require additional clinical or device approvals, Mylan President Rajiv Malik said on a conference call. That helped placate investors who had driven Mylan down as much as 7 percent early Wednesday after the company cut its forecast for this year and the next. The shares rose as much as 2.8 percent during the call and were down 2 percent to $31.16 at 12:05 p.m. in New York. (Hopkins, 8/9)

In other pharmaceutical news —

The Washington Post: Md. Drug Company Sues Federal Government To Fend Off Competition From Generics
One of Maryland’s largest drug manufacturers is suing the federal government to fend off competition on one of its key drugs, saying its right to exclusively sell the medication should continue an additinoal three years. The suit comes as the company, United Therapeutics, faces new competition from other firms trying to sell similar treatments on the generic market. Silver Spring-based United Therapeutics filed suit Aug. 4 in U.S. District Court for the District of Columbia, alleging the firm is entitled to a seven-year period of exclusive sale of the drug’s oral formulation. (Gregg, 8/9)

Kaiser Health News: Hospitals Slashed Use Of Two Heart Drugs After Huge Price Hikes
Even before media reports and a congressional hearing vilified Valeant Pharmaceuticals International for raising prices on a pair of lifesaving heart drugs, Dr. Umesh Khot knew something was very wrong. Khot is a cardiologist at the Cleveland Clinic, which prides itself on outstanding heart care. The health system’s pharmacists had alerted doctors about the skyrocketing cost of the drugs, nitroprusside and isoproterenol. But these two older drugs, frequently used in emergency and intensive care situations, have no direct alternatives. (Tribble, 8/9)

Bloomberg: Teva Ramps Up Sales With Medis, Respiratory Units 
Teva Pharmaceutical Industries Ltd. is ramping up asset sales as the troubled Israeli drug maker works to preserve its credit rating and cut debt, people familiar with the matter said. The company is considering a disposal of Medis, an Icelandic unit that develops generics for other companies, a representative for Teva said, confirming Bloomberg’s earlier report. The company is also weighing a sale of some of its respiratory treatment assets, the people said, asking not to be identified because deliberations are private. Teva hasn’t made a final decision about the assets and considerations are at an early stage, they said. (Baigorri, David and Bemeleh, 8/9)

Public Health And Education

One In 12 Physicians Have Accepted Payments From Opioid Drugmakers

The study comes amid a raging epidemic across the country in which physician prescribing has been identified as a key factor. Meanwhile, states are taking steps to limit the number of painkillers a doctor can prescribe, and officials tout the benefits of declaring an emergency over the crisis.

Stat: How Many Doctors Have Received Payments From Opioid Makers? Look Here
One in 12 physicians — and nearly one in five family medicine doctors — have accepted payments from drug makers that sell prescription opioid painkillers, according to a review of federal records. Although the analysis did not examine the extent to which payments may have influenced prescribing, the findings are certain to raise questions about the sway the companies may have over medical practice. Overall, the average payment was small — just $15 — and most doctors received only one payment a year for such things as speaking, meals, consulting, or travel. But of more than 375,000 payments, the top 1 percent of 68,000 physicians collectively received $38 million, which represented 82 percent of all payments. On average, the top prescribers received $2,600 per year. (Silverman, 8/9)

Modern Healthcare: One In 12 Doctors Receive Payments From Opioid Makers 
All in all, more than 68,000 physicians received more then $46 million between 2013 and 2015 in non-research payments from drugmakers that create pain-killing opioids or medciation-assisted opioid treatments like buprenorphine, according to a study published in the American Journal of Public Health on Wednesday. Although researchers found the doctors received an average payment of $15, the top 1% of physicians received 82% of all opioid drugmaker payments, or $38 million at an average of $2,600 per top physician. (Johnson, 8/9)

The Washington Post: At Least 17 States Are Enacting Strict Limits On The Length Of Painkiller Prescriptions As Drug Overdoses Soar
States are enacting strict limits on the number of powerful prescription painkillers doctors can prescribe, a move that many believe will help fight the opioid crisis but has raised alarms among some physicians. At least 17 states have enacted rules to curb the number of painkillers doctors can prescribe. Some, including Arizona, Connecticut, Delaware, Massachusetts, New Jersey and Ohio, have passed laws limiting the duration of initial opioid prescriptions to five or seven days. Others are passing dosage limits. In Kentucky, a law went into effect last month capping opioid prescriptions for acute pain to three days. (Zezima, 8/9)

NPR: Arizona Fighting Opioid Crisis With Better Data, More Funding
Health officials awaiting news from President Trump's briefing on opioids Tuesday didn't, in the end, get much about what the White House plans to do about the growing crisis. While he acknowledged the severity of the problem and the threat opioids pose to all Americans, Trump did not talk about expanding addiction treatment or access to the overdose-reversal drug naloxone, two of the recommendations his commission on opioids made in its interim report last week. (Hsu, 8/9)

And in other news —

Stat: Are People Really Falling Ill From Contact With Fentanyl?
Police officers hospitalized after incidental exposure to fentanyl. A Florida child fatally overdosed. In communities around the country, such headlines are stoking fears that a momentary brush with a tiny amount of fentanyl powder could prove fatal. The synthetic opioid, blamed for increasing numbers of overdose deaths across the U.S., is 50 to 100 times more potent than morphine. But experts consulted by STAT said many of the reported incidents appear to be false alarms that run counter to scientific fact and exaggerate the risks. (Ross, 8/9)

The Washington Post: Selling Opioids In This Rural Maryland County Could Get You A Murder Charge
A rural Maryland county is bringing murder charges against suspected opioid drug dealers as part of an aggressive campaign to combat the epidemic, becoming the first in the state to file some of the toughest charges against distributors who they say are responsible for carnage, officials said. St. Mary’s County law enforcement officials on Wednesday announced eight second-degree murder indictments so rare that they attracted a visit from Gov. Larry Hogan (R), who traveled to Southern Maryland to support the stepped-up effort to identify and arrest drug dealers. (Hernandez, 8/9)

The Philadelphia Inquirer/ Third Of Philadelphians Used Prescription Opioids In The Last Year, Survey Finds
About 469,000 adults in Philadelphia — a third of the city’s population — used a prescription opioid like Percocet or OxyContin in the last year, the city has estimated, based on a new survey, and more than 81 percent of them received the prescriptions from their health-care providers. Of particular concern, the city Public Health Department said Wednesday, is that 13 percent of all adults reported taking a prescription opioid in the last seven days, and more than a third of those were also on anti-anxiety medications like Xanax. The combination of opioids and those drugs, known as benzodiazepines, significantly increases the odds of an overdose. (Sapatkin, 8/9)

KCUR: 'Superhuman Strength:' When Drugs Shorten The Fuse, An Argument Can Turn Deadly 
Drug use often spins simple arguments out of control, law enforcement officials say. But instances, like this one, that led to Sha [Tate's] death last year, also point to larger underlying issues — like history of trauma, and an inability to resolve conflict. The same issues that may lead someone to solve their disputes with a gun, often lead someone to self-medicate with drugs. (Tudhope, 8/10)

Columbus Dispatch: Massage Gloves, Pain Blockers: Ohio Turns To Tech To Battle Opioid Crisis
The Ohio Third Frontier Commission Tuesday chose NineSigma of Cleveland to manage a competition to award about $7 million in grants to develop ideas largely aimed at preventing prescription overdoses, treating addiction and producing alternatives to opioids in the treatment of pain. Gov. John Kasich called during his State of the State speech for awarding $20 million from a voter-approved bond fund to bring technology to bear against the opioid crisis responsible for the vast majority of Ohio’s more than 4,100 drug-overdose deaths last year. (Ludlow, 8/9)

Minnesota Public Radio: The Legal Opioid Dilemma
There has been much coverage of the growing opioid epidemic in the U.S. But if legislators and health care providers move to crack down on addiction, how will that affect people who legitimately need and have come to rely on prescription drugs to treat their chronic illnesses? (Miller and Shockman, 8/9)

'Alcohol Is Our Number One Drug Problem': Experts Hope Drinking Study Serves As Wake-Up Call

The study finds that a "startling" number of adults in America are binge drinking at least once a week. In other public health news: stroke, Glenn Campbell's struggle with Alzheimer's, gallstones and pregnancy, exercise, video games, asthma, and more.

Bloomberg: America’s Drinking Problem Is Much Worse This Century 
Americans are drinking more than they used to, a troubling trend with potentially dire implications for the country’s future health-care costs. The number of adults who binge drink at least once a week could be as high as 30 million, greater than the population of every state save California, according to a study published on Wednesday in JAMA Psychiatry. A similar number reported alcohol abuse or dependency. Between the genders, women showed the larger increase in alcohol abuse, according to the report. (Tozzi, 8/9)

The New York Times: Stroke Risk Declining In Men But Not Women
The incidence of stroke has declined in recent years, but only in men. Researchers studied stroke incidence in four periods from 1993 to 2010 in five counties in Ohio and Kentucky. There were 7,710 strokes all together, 57.2 percent of them in women. (Bakalar, 8/9)

Stat: Glen Campbell's Doctor Discusses His Public Struggle With Alzheimer's
Glen Campbell’s decades-long musical career came to an end Tuesday, when the 81-year-old country music superstar died after a six-year struggle with Alzheimer’s disease. He leaves behind a sprawling songbook and one candid documentary, 2014’s “Glen Campbell … I’ll Be Me,” which follows the singer as he deals with his diagnosis and embarks upon a farewell tour, performing the final renditions of “Rhinestone Cowboy” and “By the Time I Get to Phoenix” in the presence of his family, his band, and his thousands of fans, crisscrossing the country before his disease forces him off the stage and into an around-the-clock treatment facility. (Garde, 8/9)

The Baltimore Sun: Gallstones Can Cause Complications During Pregnancy 
Hormonal changes during pregnancy can make expectant mothers more prone to developing gallstones. While gallstones won’t hurt the fetus or complicate pregnancy, in some cases they may cause pain and discomfort for the mom, said Dr. Marcie Feinman, director of the surgical intensive care unit at Sinai Hospital. Sometimes the gall bladder has to be removed, she said. (McDaniels, 8/9)

The New York Times: Exercise As A Weight-Loss Strategy
Some types of exercise may be better than others at blunting appetite and potentially aiding in weight management, according to an interesting new study of workouts and hunger. It finds that pushing yourself during exercise affects appetite, sometimes in surprising ways. As anyone who has begun an exercise program knows, the relationships between exercise, appetite, weight control and hunger are complex and often counterintuitive. (Reynolds, 8/9)

Los Angeles Times: Can A Hormone Called Klotho Enhance Cognition And Hold Off Dementia? Yes, In Mice, At Least
If ever there were a hormone to spark intellectual excitement, it’s klotho. At the dawn of our lives, our blood brims with klotho. But as age and disease stiffen our joints and cloud our minds, klotho ebbs. People who exercise and remain spry into old age have more of the stuff. Those suffering chronic stress or degenerative brain diseases such Parkinson’s and Alzheimer’s see theirs depleted. (Healy, 8/9)

NPR: Action Video Games May Affect The Brain Differently
People who played action video games that involve first-person shooters, such as Call of Duty and Medal of Honor, experienced shrinkage in a brain region called the hippocampus, according to a study published Tuesday in Molecular Psychiatry. That part of the brain is associated with spatial navigation, stress regulation and memory. Playing Super Mario games, in which the noble plumber strives to rescue a princess, had the opposite effect on the hippocampus, causing growth in it. (Columbus, 8/9)

PBS NewsHour: How Industrial Farming Techniques Can Breed Superbugs
As high-density, industrial-scale livestock farms have become fertile breeding grounds for disease, they’ve also become a major source of drug-resistant superbugs. Science correspondent Miles O’Brien and economics correspondent Paul Solman team up to report on how scientists are studying how superbugs can get into the food supply. (O'Brien and Solman, 8/9)

Women’s Health

Democrat Uses Ultrasound Bill Against Opponent For Va. Lieutenant Governor Race

Republican Jill Holtzman Vogel sponsored the 2012 bill that would have required most women who get abortions to first undergo a vaginal ultrasound.

Meanwhile, in Alabama —

The Associated Press: Alabama Wants To Reinstate Hearings For Pregnant Girls
Alabama’s top prosecutor said the state is going to appeal a federal judge’s ruling that struck down a one-of-a-kind law in which minors seeking court permission for an abortion could be put through a hearing where the fetus could get a lawyer and a district attorney could question the pregnant girl’s maturity. (Chandler, 8/9)

State Watch

State Highlights: Calif. Ballot Initiatives To Impose Stricter Rules At Dialysis Centers Filed; Ariz. Faces Millions In Fines Over Prisoners' Medical Care

Media outlets report on news from California, Arizona, New York, Massachusetts, Oregon, Pennsylvania, Florida, Tennessee, Maryland, Texas, Missouri, Kansas, New Hampshire and Georgia.

Los Angeles Times: While Dialysis Clinic Battle Brews At State Capitol, Healthcare Workers Look To The Ballot
Cracking down on clinics treating Californians with chronic kidney disease has been a top legislative priority this year for unions representing healthcare workers. Now they’re opening a new front in their crusade against the dialysis industry: the ballot box. Service Employees International Union-United Healthcare Workers filed two initiatives with the state attorney general on Wednesday that, if they qualify, would appear on the November 2018 ballot. The union is seeking to impose stricter rules at dialysis centers for the staffing levels and how much they charge. (Mason, 8/9)

Sacramento Bee: Backers Of Dialysis Measure File Ballot Measure Proposals
SEIU-United Healthcare Workers West filed a pair of proposed November 2018 ballot measures Wednesday that would set staffing ratios at dialysis clinics and contain other provisions similar to pending union-backed legislation that faces an uncertain outcome in the Legislature. ...Besides setting rules on staffing levels, they would require annual inspections of dialysis clinics, require more recovery time for patients, and restrict how much patients can be charged. (Miller, 8/9)

The Associated Press: Maggot Case Gives Rare Look At Neglect Probes
In his bed at a New York state group home for the severely disabled, Steven Wenger lay helpless against a silent invader. A slimy, wriggling clump was growing around the hole in his throat near his breathing tube. Nurses peered closer and made a discovery almost unheard of in modern American health care: maggots. For Wenger, unable to walk, speak, or breathe without a ventilator since a car accident 26 years ago, it was the first of two infestations of the larval flies in his throat over successive days last summer, resulting in repeated trips to an emergency room and a state investigation that found days of neglect by caretakers. (Klepper, 8/10)

Boston Globe: Health Care Company Will Pay More Than $750,000 For Improper Billing, AG Says
Apria Healthcare LLC, a company that provides home health care services and medical devices, will pay more than $750,000 for directly billing state residents for services that are already covered by MassHealth, the state’s Medicaid program. Under the settlement announced Wednesday, Apria has agreed to pay $99,008 in restitution and $665,934 in penalties to resolve the allegations that the firm improperly billed consumers, Attorney General Maura Healey’s office said in a statement. (McDonald, 8/9)

Reuters: Oregon Bans Tobacco Sales To Under 21s, Matching Rules On Marijuana
Oregon is raising the minimum age for buying tobacco and e-cigarettes in the state to 21, bringing its regulations into line with sales of marijuana products. The new law, signed by Governor Kate Brown on Wednesday and taking effect on Jan. 1, bans under-21s from buying tobacco products and vaping devices, and makes vendors liable for fines for under-age sales. (O'Brien, 8/10)

The Philadelphia Inquirer/ Penn Joins Program To Train Doctors To Make House Calls
The University of Pennsylvania’s Perelman School of Medicine has teamed with an Illinois-based nonprofit organization to expand the number of medical professionals trained to provide house calls to elderly and medically complex patients. The Home Centered Care Institute in Schaumburg is working with eight health organizations to train 5,000 doctors, physician assistants, and nurse-practitioners, as well as practice managers, over the next five years. Currently, the organization estimates that about 1,000 professionals are providing the bulk of in-home primary care in the United States. (Burling, 8/10)

Miami Herald: Drug Violations Costs 2 South Florida Nurses Their Licenses
Florida has stripped two health professionals of their licenses over involvement with drugs, according to the state Department of Health. Guillermo Delgado of South Miami-Dade, already stripped of his pharmacy technician license, also has lost his practical nurse license. Both actions follow his incarceration in federal prison in Miami. (Neal, 8/9)

The Baltimore Sun: 'Stop The Bleed' Campaign Comes To Baltimore Amid Record Violence 
Amid a violent year in Baltimore, the University of Maryland Shock Trauma Center is spearheading a local initiative to teach health care workers and members of the public how to use critical care skills to stop life-threatening bleeding. The “Stop The Bleed” campaign began in 2015 as a national effort to provide bystanders with training for emergency situations, said Thomas Scalea, physician-in-chief at Shock Trauma. It was partly a response to an autopsy review of the 2012 mass shooting at Sandy Hook Elementary School, which revealed about 30 percent of the children who died during the attack may have survived if pressure had been applied to their wounds. (Brice-Saddler, 8/9)

Houston Chronicle: Texas Begins Transfer Of 1,000+ Heat-Sensitive Inmates
A plain, white school bus left the Wallace Pack Unit under moonlit skies Wednesday morning, transporting the first group of more than 1,000 heat-sensitive inmates to cooler climes under federal court order. ...The predawn transit marked a major turning point in a legal battle over inmates’ living conditions at the Pack Unit that has played out in a 3-year-old civil rights lawsuit that has drawn national attention. (Banks, 8/9)

San Antonio Press-Express: San Antonio’s HVHC Selling Eye Division, Could Make Billions
San Antonio-based vision company HVHC is selling one of its business units and a minority stake in its second to private investment firm Centerbridge Partners in a deal that could be worth billions of dollars. HVHC, a wholly owned subsidiary of Pittsburgh-based Highmark Inc., will sell its managed vision care division Davis Vision Inc. to Centerbridge, a private investment management firm with offices in New York and London, according to a news release. (Druzin, 8/9)

KCUR: Audit Finds Tiny Missouri Hospital Served As ‘Shell’ For $90 Million Billing Scheme 
What began as a routine audit of Putnam County took an extraordinary turn when Missouri state auditors uncovered what appears to be a massive, fraudulent billing scheme in tiny Unionville, Missouri’s lone hospital. A report released Wednesday by Missouri State Auditor Nicole Galloway says that a private company hired to take over the financially strapped Putnam County Memorial Hospital arranged for more than $90 million in questionable lab billings by the hospital. (Margolies, 8/9)

The Associated Press: Texas Doctor Gets 35 Years In Prison For $375M Medical Fraud
A 60-year-old Dallas-area doctor has been sentenced to 35 years in prison for helping defraud Medicare and Medicaid out of almost $375 million. A federal judge also ordered Dr. Jacques Roy on Wednesday to pay more than $268 million in restitution. A jury in April 2016 convicted the Rockwall physician of nine of 10 counts of defrauding a health care benefit program. (8/9)

San Francisco Chronicle: SF Gets Federal Lot On Mission, To Build Units For Formerly Homeless
A surface parking lot behind the federal courthouse at Seventh and Mission streets in San Francisco will become the site of the city’s largest housing development for formerly homeless people, thanks to a deal struck this week between city officials and the federal government. The city will lease the parking lot for three years while it pulls together the funding and irons out construction logistics for the development, which will house 250 units in two separate buildings. (Fracassa, 8/9)

KCUR: Kansas City Physician Daphne Bascom Takes On YMCA Community Health Position 
Dr. Daphne Bascom is the first physician on staff at a YMCA anywhere in the country. As senior vice president for community integrated health, she's leading the YMCA of Greater Kansas City into a new future. "What we can do at the Y is help focus on prevention and help engage all of the services that are a part of our community," Bascom said in an interview with Gina Kaufmann on KCUR's Central Standard. (Tufts, 8/10)

Concord Monitor: Study Gives N.H. Poor Score On Policies To Ensure Athletes’ Safety In High Schools
New Hampshire was among the 10 worst states in a national ranking of policies to prevent death and catastrophic injury among high school athletes, partly because many programs, equipment and training are not required statewide. The ranking, released this week by the Korey Stringer Institute at the University of Connecticut, puts New Hampshire 44th out of the 50 states and the District of Colombia. (Brooks, 8/10)

Atlanta Journal-Constitution: Student Mental Health Key For School Success
DeKalb County schools officials realize that returning to classes often means the return of anxiety and stress for students that can lead to problems as serious as depression and suicide, which is the second-leading cause of death for teenagers. That’s why the district hosted a mental wellness rally before school started for students and parents helped put some tools in their hands to make it through the school year. (Eldridge, 8/9)

Weekend Reading

Longer Looks: Andy Slavitt; Medicaid Explained; Genetic Testing And The Insurance Industry

Each week, KHN's Shefali Luthra finds interesting reads from around the Web.

The New York Times: Andy Slavitt Wants To Unite America On Health Care
In 2015, Barack Obama nominated you to run the Centers for Medicare and Medicaid Services. Are you surprised that health care isn’t more of a uniting issue? If you give me 15 minutes, I can create a common bond around a story of the health care system with almost any American. (Cox, 8/9)

Vox: Medicaid, Explained: Why It's Worse To Be Sick In Some States Than Others
Medicaid works, even if it works better in some states than others. But how did we arrive at this complicated system in the first place? Many countries around the world offer single-payer health care or tightly regulate private insurers to make sure every person can get coverage for what they need. So why didn’t that system catch on in the US? Video. (Liam Brooks, Liz Scheltens and Mallory Brangan, 8/4)

The Economist: Genetic Testing Threatens The Insurance Industry
If a genetic test could tell whether you are at increased risk of getting cancer or Alzheimer’s, would you take it? As such tests become more accessible, more and more people are saying “yes.” The insurance industry faces a few headaches as a result. (8/3)

The Cut: Why I Hid My Second Pregnancy From The Internet
About two months before our first baby died, I announced to the internet I was pregnant with her. I had no idea she’d die when I posted what I’ll reluctantly refer to as a “bumpie” on Facebook — meticulously art-directed in my living room; wearing a soft gray-and-white striped maternity shirt, my favorite; cradling a four-month belly that seemed almost to glow in the morning sun. It’s hard to look at this photo now, at the satisfied smile of the woman posing for it, the woman taking it. She exudes calm and bliss, and in about eight weeks, she’s going to have to print a retraction. (Katie Coyle, 8/8)

Vox: Why It's So Much Easier To Get An Opioid Prescription In The US Than In Europe Or Japan
When Dr. Eriko Onishi came to the United States from her home country of Japan, she ended up with culture shock on the number of opioids being prescribed.Onishi got her medical training in Japan and spent about a year there practicing medicine before coming to the United States. She was used to that country’s strict attitudes around opioid painkillers like Vicodin or Oxycontin, which are generally only prescribed in cases where a patient is in severe pain, as with cancer. In Japan, opioids for acute pain aren’t typically covered by insurance. (Ella Nilsen, 8/8)

Editorials And Opinions

Perspectives On Policies And Politics: Medicaid's Value; Who Now Owns Obamacare?

Opinion writers also offer their thoughts on the Affordable Care Act's stability, the negative systemic possibilities of Medicare for all and a range of other topics.

RealClear Health: Why Medicaid Matters To You
Efforts to repeal and replace Obamacare have been suspended for the time being, and many Americans are breathing a sigh of relief. But Obamacare is far from safe, and the same is true for one of the key programs – Medicaid – that the law used to expand health care coverage for millions of Americans. (Sharona Hoffman, 8/9)

JAMA Forum: Has Obamacare Become Trumpcare?
With the failure of several bills in the Senate to repeal or replace the Affordable Care Act (ACA), the effort to significantly remake the 2010 health law is apparently on hold, if not dead. This is a dramatic turn of events that few anticipated when Republicans took control of the White House and Congress after 7 years of vowing to repeal the ACA. So, now what? (Larry Levitt, 8/8)

Louisville Courier-Journal: We're Ready To Work With McConnell To Improve Health Care
We represent a coalition of faith leaders, economists, health care providers, health advocates, and concerned Kentuckians working to reduce poverty, support working families and improve health outcomes in our Commonwealth. With the recent failure of the Senate’s attempt to repeal the Affordable Care Act, we write to ask you to take this opportunity to recognize the merits of the ACA and find ways to build on it. (Emily Beauregard, 8/7)

Axios: The ACA Stability "Crisis" In Perspective
The big questions about the stability of the Affordable Care Act marketplaces have focused on how fast premiums will rise, and how many plans will participate. But an equally important question, and the heart of the matter politically, is: How many people will be affected by the sharp premium increases? (Drew Altman, 8/10)

JAMA: Challenges In International Comparison Of Health Care Systems
International comparisons of health system performance exert major influence on the public and on policy makers. These comparisons allow for reflection on and evaluation of national performance, provide empirical bases to drive reform, and serve as a way to promote accountability. Most international comparisons seek to identify high performers, often conceptualized as health systems with the best outcomes or most value for money. Even though these notions seem relatively straightforward, operationalizing them is difficult. There are at least 3 key challenges of conducting international comparisons: drawing the boundaries of the health system, managing limitations of data, and accounting for different values inherent in national systems. Without understanding and addressing these challenges, cross-national comparisons will fail to improve health policy and may lead to misinterpretations and poor policy making. (Irene Papanicolas and Ashish K. Jha, 8/8)

Sacramento Bee: So Few Docs Take Medi-Cal That It Violates Civil Rights
Fully one-third of our population, including seniors, people with disabilities and children, depend on Medi-Cal, the Medicaid health insurance program for low-income Californians. While there is wide coverage, Medi-Cal recipients have worse access to healthcare than Medicaid recipients in almost every other state, judged by the percentage of physicians who accept Medicaid patients. (Lann Lee, 8/9)

Los Angeles Times: Does State Funding For Medi-Cal Discriminate Against The Latinos It Serves?
No question, it would be great if a safety net program could offer healthcare as extensive as private insurance or Medicare. But that may not be possible or practical, and it can’t reasonably be guaranteed by law. The fiscal pressures on the state force lawmakers to balance competing demands, so increasing Medi-Cal provider fees could require cuts in benefits, a reduction in the number of people eligible for coverage, or sacrifices in other state programs. How to strike that balance is a policy judgment, not a legal one. (8/9)

Viewpoints: Trump Undercuts His Commission's Advice On Opioids; The Bieb, Mental Health And The Power Of Celebrity

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

The Washington Post: Trump Ignores His Own Commission’s Advice On Opioids
Credit President Trump with appropriate timing. On the day that updated government statistics confirmed that deaths from opioid overdoses continued to set records in 2016, he convened a meeting on the issue at his New Jersey vacation spot. Whatever welcome sense of urgency might have been demonstrated by that decision, though, was quickly undercut by what the president said during the public portion of the gathering. (8/9)

Stat: Thank You, Justin Bieber. Your Honesty About Mental Health Helps All Of Us
This “celebrity effect” may be especially true for adolescents, who may be more influenced by these media figures. Bieber’s announcement made me think of a teen in Northern Canada I had interviewed for a story on youth mental health. When I asked about who inspired her, she quickly named Kendall Jenner, a social media celebrity and supermodel a few years older than her. Describing the things they had in common, like their height and hair color, the teen also mentioned their shared mental health challenges. “Another thing I have in common with Kendall is that she talks about her anxiety, and I have anxiety too.” Perhaps Jenner’s openness about her anxiety made it less shameful for others to talk about. (Amitha Kalaichandran, 8/9)

JAMA: Health And Spirituality
For centuries, physicians and other healers have witnessed how illness focuses attention on “ultimate meaning, purpose, and transcendence, and … relationship to self, family, others, community, society, nature, and the significant or sacred.”1 Patients often discover strength and solace in their spirituality, both informally through deeper connections with family and friends, and formally through religious communities and practices. However, modern day clinicians regularly overlook dimensions of spirituality when considering the health of others—or even themselves. (Tyler J. VanderWeele, Tracy A. Balboni and Howard K. Koh, 8/8)

Stat: When There Aren't Enough Surgeons, Other Health Care Workers Can Fill In
In districts where there are no surgeons, we are investing in nonspecialist surgical care providers — health care workers like nurses, clinical officers, general practitioners, and midwives who are already on the job. They aren’t surgeons but can be trained to work as teams to perform certain emergency procedures in their community facilities. This would relieve the burden from the limited number of surgeons who work primarily in larger urban hospitals. The thinking is that teams in the trenches are well positioned to identify medical problems that require surgery and take the lead on delivering uniquely creative solutions. (Tigistu Adamu Ashengo, 8/9)

JAMA: Prisoner Of My Preconceptions
It was an unusually tranquil day in our medical intensive care unit (MICU). Ventilator alarms were not blaring, intravenous drips were not urgently beeping, and vital sign monitors were not alerting us to any unstable patients. Certainly this calm could not last for long—and it didn’t. I soon overheard our charge nurse mention that a prisoner from a regional correctional facility was in the emergency department (ED) with “really bad sepsis.” “Ugh,” I muttered in quiet annoyance. In my experience, these patients never fared well. Moreover, my cynical side suspected that more wasteful use of limited health care resources was on the horizon. Perhaps I would have felt differently if the patient were not a prisoner; I have no doubt a large part of my reaction was that part of me assumed that anyone who winds up in prison probably is a “bad person.” (Jason Chertoff, 8/8)

The Kansas City Star: In Kansas And Missouri, Sometimes Government Actually Does Good Stuff
One of the problems with the cut-taxes-first approach to governing in Kansas and Missouri is that sometimes basic, block-and-tackle functions of government get slashed in the process and left by the side of the road. Case in point: the lack of inspectors in Kansas to certify new kidney dialysis centers, which The Star reported on last week. The result is a state with eight nearly new dialysis clinics that can’t be heavily used because Kansas is so far behind on inspections. Ask Martha Voss of Olathe, who’s legally blind and uses a motorized wheelchair, what that means. She’ll tell you that it translates to multiple trips to a center in Lenexa each week instead of the new dialysis center in her neighborhood. The ridiculous inconvenience costs her 1 1/2 hours per trip. (8/9)

Chicago Tribune: Madam President, Abolish The Soda Tax
Cook County's soda tax turned one week old on Wednesday. Happy birthday! Not exactly. County officials knew the penny-per-ounce tax on sweetened beverages was unpopular, but we suspect they underestimated the public wrath it would provoke once shoppers saw how much it added to the cost of their daily purchases. (8/9)