- Kaiser Health News Original Stories 3
- 5 Things To Know About Medicaid Work Requirements
- That ‘Living Will’ You Signed? At The ER, It Could Be Open To Interpretation.
- Puerto Rico’s Water System Stutters Back To Normal
- Political Cartoon: 'Out Of Proportion?'
- Health Law 1
- Even If You Get Insurance Through Work, Trump Administration's Pre-Existing Conditions Decision Could Still Effect You
- Capitol Hill Watch 1
- In Midst Of Raucous Debate Over 340B Drug Discount Program, Lawmaker Introduces Bill To Address Concerns
- Opioid Crisis 1
- DEA's Crackdown On Opioids Has Led To Uptick Of Illicit Trading On Digital Black Market
- Public Health And Education 3
- Why Middle-Age Suicides Have Become A Chronic Problem In America
- The Paper Touting Benefits Of Mediterranean Diet Was Just Retracted. But That Doesn't Mean It Was Wrong.
- This Scientist's 'Reason To Live'? Helping Others Fight The Disease That Has Ravaged His Body
- State Watch 3
- Texans Want State Leaders To Lower Health Care Costs, Consider Expanding Medicaid, Poll Finds
- Puerto Rico Releases Data Showing Higher Hurricane Maria Death Toll
- State Highlights: University Of California Nabs Two Patents In Epic Battle Over CRISPR Technology; Illinois Welfare Officials Called To Explain Children Being Stuck In Psychiatric Hospitals
From Kaiser Health News - Latest Stories:
The key issues in play when a U.S. District Court takes up a legal challenge to Kentucky’s Medicaid work requirement on Friday. (Phil Galewitz, 6/14)
End-of-life documents express your preferences for care but may not be binding medical orders. Here’s how to better prepare for the unexpected — that your last wishes won’t be carried out. (Judith Graham, 6/14)
Efforts to restore tap water service has been delayed in many rural areas of Puerto Rico, but even in the cities running water can be interrupted by electrical power outages at pumping stations. (Carmen Heredia Rodriguez, 6/14)
Kaiser Health News provides a fresh take on health policy developments with "Political Cartoon: 'Out Of Proportion?'" by John Cole, The Scranton Times-Tribune.
Here's today's health policy haiku:
PURDUE PHARMA'S PAINKILLER PUSH
The whirlwind effort
To get America hooked
If you have a health policy haiku to share, please Contact Us and let us know if you want us to include your name. Keep in mind that we give extra points if you link back to a KHN original story.
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Summaries Of The News:
If the pre-existing conditions provision of the health law is stripped away by an upcoming court case -- which the Justice Department announced last week it will not defend -- it won't just affect people who buy their health care on the health law marketplace. Meanwhile, a group of Democratic lawmakers are demanding more information on the administration's decision, and candidates plan on using it as a talking point in the upcoming midterms.
The Associated Press:
Worker Protections Seen At Risk In Trump Health Care Shift
The Trump administration's latest move against "Obamacare" could jeopardize legal protections on pre-existing medical conditions for millions of people with employer coverage, particularly workers in small businesses, say law and insurance experts. At issue is Attorney General Jeff Sessions' recent decision that the Justice Department will no longer defend key parts of the Obama-era Affordable Care Act in court. That includes the law's unpopular requirement to carry health insurance, but also widely supported provisions that protect people with pre-existing medical conditions and limit what insurers can charge older, sicker customers. (Alonso-Zaldivar, 6/13)
The Wall Street Journal:
Get Health Coverage At Work? Lawsuit Against ACA Could Affect You, Too
Most of the attention surrounding a recent Justice Department request to strike down parts of the ACA has focused on the individual market, where people buy their own coverage. But the request would also rewind some protections for the vast majority of Americans—some 175 million people—who get health coverage via small and large employers, analysts said. “Anyone who just thinks this is just impacting the 12 to 15 million individuals with individual coverage is wrong,” said Timothy Jost, an emeritus law professor at Washington and Lee University. (Armour, 6/13)
The Associated Press:
Experts: Protections On Pre-Existing Conditions At Risk
The Trump administration's latest move against "Obamacare" could jeopardize legal protections on pre-existing medical conditions for millions of people with employer coverage, particularly workers in small businesses, say law and insurance experts. At issue is Attorney General Jeff Sessions' recent decision that the Justice Department will no longer defend key parts of the Obama-era Affordable Care Act in court. That includes the law's unpopular requirement to carry health insurance, but also widely supported provisions that protect people with pre-existing medical conditions and limit what insurers can charge older, sicker customers. (6/14)
The Washington Post Fact Check:
President Trump’s Flip-Flop On Coverage For Preexisting Health Conditions
In plain English, the attorney general’s letter means that the Trump administration no longer supports a provision of the Affordable Care Act, a.k.a. Obamacare, that makes it possible for people to buy insurance if they have preexisting health conditions. Sessions, in an unusual step, sided with plaintiffs who had argued the ACA was now unconstitutional because Congress, in the tax bill, eliminated the penalty for not buying insurance, known as the individual mandate. Sessions said the Justice Department would no longer defend the law in a lawsuit brought by Republican-led states, a surprise stance that led to the resignation of a senior career lawyer at the Justice Department. (Glenn Kessler and Meg Kelly, 6/14)
House Dems Demand Answers From HHS On DOJ's ObamaCare Decision
A group of House Democratic leaders are demanding answers from the Trump administration about the role the Department Health and Human Services (HHS) played in the Department of Justice’s decision not to defend key parts of ObamaCare in federal court. The lawmakers asked HHS Secretary Alex Azar and Centers for Medicare and Medicaid Services Administrator Seema Verma if their respective agencies conducted any analysis on the impact the decision will have on the country’s health-care system. (Weixel, 6/13)
Dems Seek To Leverage ObamaCare Fight For Midterms
Democrats are seizing on the Trump administration’s push in court to overturn ObamaCare’s protections for people with pre-existing conditions, hoping to leverage the issue ahead of November’s midterm elections as some Republicans rush to distance themselves from the move. The Department of Justice’s (DOJ) decision to join a legal battle arguing that one of the most popular parts of ObamaCare should be struck down is being viewed by Democrats as a political gift, with the party apparatus quickly using the issue to attack GOP candidates and rally their base. (Sullivan, 6/14)
Flipping The Script — Red State Democrats Campaign On Health Care
Democrats see the health care focus as a viable defense against the politically-unfriendly territory this year's Senate campaign is playing out on, as well as increasingly positive views voters hold about the economy and the general direction of the country. (Detrow, 6/14)
Democrats' Focus On Pre-Existing Conditions Puts GOP On Defense
Democrats capitalizing on the Trump administration’s decision not to defend the 2010 health care law in court are finding that most congressional Republicans are distancing themselves from the case.Democrats argue that Republicans are abandoning protections for patients with pre-existing conditions. Republicans, finding themselves on the defensive, are asserting their commitment to ensuring insurance coverage for sick patients. (McIntire, 6/13)
In other health law news —
Insurance Experts: ObamaCare Mandate Repeal Driving Premium Increases
Increases in health-care costs and policy changes are driving ObamaCare premium increases for the 2019 plan year, according to a new report released Wednesday. The American Academy of Actuaries says that the elimination of the individual mandate penalty and the expansion of cheaper health plans with fewer benefits will contribute to premium increases next year. (Hellmann, 6/13)
Obamacare Navigators In The Dark About 2019
The Trump administration has yet to tell Obamacare outreach workers when or how to apply for another round of federal grants to boost enrollment around the country for 2019, compounding worries that federal officials will undermine the law during the upcoming sign-up season. The delay in starting the funding process for groups working as so-called navigators is increasing anxiety that they could lose staff or be hindered as they hone their outreach tactics for 2019 enrollment. (Pradhan and Glorioso, 6/12)
Los Angeles Times:
Nonprofit Hospitals Are Being Less Charitable. They Say That Shows Obamacare Is Working
California’s nonprofit hospitals are providing sharply less free and reduced-cost medical care than they did a few years ago, raising questions about the role and obligations of those institutions in the age of Obamacare. About 170 nonprofit general acute-care hospitals provided $651 million of charity care in 2016, down from $985 million in 2011, according to a report due out this week by the California Nurses Assn. (Cosgrove, 6/12)
The measure from Rep. Doris Matsui (D-Calif.) could clarify the intent of the program and define which patients are eligible -- two bones of contention over the program, which requires pharmaceutical companies to give steep discounts to hospitals and clinics that serve high volumes of low-income patients. In other news from Capitol Hill: CHIP funding, an Indian Health Services bill, and gun control.
A Bill Would Keep Status Quo Of Contentious Hospital Drug-Discount Program
Amid ongoing debate over a drug discount program for safety-net hospitals, a lawmaker introduced a bill that would memorialize the intent of the controversial program and require the Trump administration to implement oft-delayed regulations about pricing and penalties. The bill arrives as Congress hashes out oversight of the 340B program, which was created in 1992 and requires drug makers to offer discounts of up to 50 percent on all outpatient drugs — for everything from AIDS to diabetes — to hospitals and clinics that serve indigent populations. There are currently more than 12,400 such providers, according to the Human Resources and Services Administration. (Silverman, 6/13)
House Labor-HHS-Education Bill To Grab More CHIP Cash
House Republicans are set to tap unused Children's Health Insurance Program funding once again, this time to offset spending in the draft fiscal 2019 Labor-HHS-Education bill the House Appropriations Committee plans to release Thursday, according to an aide familiar with the plans. It wasn't clear Wednesday how much of a raid on CHIP was in the offing, but appropriators have been told there is about $18 billion left in the program that is not likely to be spent. Thus even if the Senate passes the House's separate rescissions package (HR 3), which cuts $7 billion from CHIP, there appears to be plenty to go around to backfill Labor-HHS-Education accounts that otherwise might face cuts to keep the draft bill within its $177.1 billion fiscal 2019 discretionary spending allocation. (Mejdrich, 6/13)
House Panel Advances Indian Health Bill
The House Natural Resources Committee on Wednesday approved a bill that would grant the Indian Health Service greater authority to hire and fire employees. While the bill (HR 5874) is sponsored exclusively by Republicans, it was reported by voice vote and the committee’s top Democrat, Raúl M. Grijalva of Arizona, praised aspects of it, especially those aimed at recruiting medical professionals. (Siddons, 6/13)
The Associated Press:
A Year After Shooting, GOP Lawmakers Hold Firm On Gun Rights
In the year since House Majority Whip Steve Scalise and others were shot at a congressional baseball practice, mass shootings have occurred at a Texas church, a Las Vegas music festival and high schools in Parkland, Florida, and Santa Fe, Texas. Ohio Rep. Brad Wenstrup, a doctor who helped save Scalise's life last June, has watched those attacks unfold with the acute sensitivity of a mass shooting survivor. Each shooting is jarring, says Wenstrup — calling the Parkland shooting in particular sickening — but his views on gun control have not changed. (6/13)
Wanted: Doctors In Congress
Doctors want more of their own to serve in Congress. But despite near-constant national debates over Obamacare, drug costs and how Medicare reimburses physicians, they're not having much luck. (Pittman, 6/12)
As more and more states start adding work requirements to their Medicaid programs, this court will decide if they're legal. Medicaid news comes out of Kansas and Iowa, as well.
Kentucky's Medicaid Work Requirement Faces Reckoning In Court
In a case with major national implications, the Trump administration and advocacy groups are set to argue in federal court in Washington Friday over whether the HHS secretary has the legal authority to allow Kentucky to establish a work requirement and other tough new conditions on people receiving Medicaid coverage. U.S. District Judge James Boasberg, an Obama administration nominee, will hear oral arguments in the case, which was filed in January by the National Health Law Program, the Kentucky Equal Justice Center and the Southern Poverty Law Center. (Meyer, 6/13)
Kaiser Health News:
5 Things To Know About Medicaid Work Requirements
The Trump administration’s decision in January to give states the power to impose work requirements on Medicaid enrollees faces a federal court hearing Friday. The lawsuit before the U.S. District Court in Washington, D.C., will determine whether tens of thousands of low-income adults in Kentucky will have to find jobs or volunteer in order to retain their health coverage. (Galewitz, 6/14)
Medicaid Work Requirement Could Jeopardize Coverage Even For People Who Comply
Kansas Gov. Jeff Colyer’s proposed Medicaid work requirement would create a “catch-22” for some low-income Kansans, according to a report released Tuesday. The report, from the Center for Budget and Policy Priorities — a nonpartisan research organization that supports Medicaid expansion — said work requirements could jeopardize their coverage. Medicaid recipients who fail to meet a work requirement would “lose their coverage,” said researcher Aviva Aron-Dine. But, she said, so would some of those who followed the rules and got jobs. Particularly in states like Kansas, that haven’t expanded Medicaid eligibility. (McLean, 6/12)
Des Moines Register:
Iowa Medicaid Director Says He's Sure Privatization Is Saving Money
Iowa's Medicaid director said Wednesday that he is sure Iowa taxpayers are saving money by having private companies manage the giant health-care program, even though it's hard to say exactly how much. "I think it's important that, regardless of the methodology, there are savings," Iowa Medicaid Director Mike Randol told an advisory council. Randol gave a thumbnail description of how his staff last month came up with a $141 million estimate of the annual savings to the state from the controversial shift to private Medicaid management. He gave no explanation of why the new estimate was triple the $47 million estimate his agency released a few months ago. (Leys, 6/13)
Sales of prescription opioids on so-called cryptomarkets rose faster after 2014 in the U.S. than elsewhere. By July 2016, sales through cryptomarkets in the U.S. represented 13.7 percent of all drug sales.
The DEA Is Playing 'Whack-A-Mole' As It Tries To Stamp Out The Opioid Crisis
Four years ago, the Drug Enforcement Agency decided to make it harder to obtain the most commonly prescribed opioid painkillers — specifically, pills such as Vicodin that contain hydrocodone. The move worked: Prescriptions for hydrocodone-based opioids fell by a whopping 26 percent between June 2013 and June 2015. But the tactic appears to have created yet another problem — there has been a notable uptick in illicit trading of opioids on the “dark net,” according to a new study published in BMJ. (Silverman, 6/13)
House Holds Second Day Of Opioid Votes
The House moved into its second day of a two-week stretch focused on opioid bill votes. The chamber on Wednesday is expected to pass several more noncontroversial bills intended to combat the opioid crisis. The House passed 25 opioid bills on Tuesday sent to the chamber by the Energy and Commerce Committee. Wednesday’s opioid bills come from five different committees and have a broader focus, touching on topics from support programs to veterans issues. (Raman, 6/13)
Experts talk about the problems that arise around midlife -- such as health issues, social isolation and financial stress -- that are playing a role in the sharp uptick of suicides the country is seeing in those who are middle-age.
The Wall Street Journal:
The Mystery Around Middle-Age Suicides
The recent suicides of two well-known figures—celebrity chef Anthony Bourdain and fashion designer Kate Spade —underscore a sobering reality: Suicide rates for people in middle age are higher than almost any other age group in the U.S. and rising quickly. A report released today from the Centers for Disease Control and Prevention showed that suicide rates for women 45 to 64 increased nearly 60% between 2000 and 2016. For men of the same age the suicide rate increased almost 37% over that time. (Reddy, 6/14)
Milwaukee Journal Sentinel:
Everyday Issues — Money, Jobs — Seem To Be Propelling Rise In Suicides
Newly released data from the Centers for Disease Control and Prevention indicate a steady increase in the Wisconsin suicide rate over the past 20 years, from 13.1 per 100,000 persons in 1999 to 16.5 per 100,000 persons in 2016 — a jump of more than 25 percent. This trend parallels the national suicide rate, which has increased by 25.2 percent during that same period. (Weissmann, 6/14)
The New York Times:
6 Therapists, Psychiatrists And Counselors Talk About Treating The Suicidal
Last week provided two grim case studies in how fans, friends and family react to the suicides of beloved celebrities. It also provided a view into something far more obscure: the insights of mental health workers who are on the front line of America’s suicide crisis. As news of Kate Spade and Anthony Bourdain’s suicides emerged last week, mental health workers took to The New York Times’s comment section to describe what the crisis looks like to them. (Tessier, 6/13)
Suicide Rates In The U.S. Are Climbing Faster Among Women Than Men
The number of people dying by suicide in the United States has risen by about 30 percent in the past two decades. And while the majority of suicide-related deaths today are among boys and men, a study published Thursday by the National Center for Health Statistics finds that the number of girls and women taking their own lives is rising. "Typically there's between three and three times as many suicides among males as among females," says Dr. Holly Hedegaard, a medical epidemiologist at the NCHS and the main author of the new study. In 2016, about 21 boys or men out of 100,000 took their own lives. On the other hand, just six girls or women out of 100,000 died by suicide that year. (Chatterjee, 6/14)
There were flaws found in the way the study was conducted, as it is hard to clinically test the benefits of any specific diet, but many experts are still putting stock in the findings.
The New York Times:
That Huge Mediterranean Diet Study Was Flawed. But Was It Wrong?
The study was a landmark, one of the few attempts to rigorously evaluate a particular diet. And the results were striking: A Mediterranean diet, with abundant vegetables and fruit, can slash the risk of heart attacks and strokes. But now that trial, published in the New England Journal of Medicine in 2013, has come under fire. The authors retracted their original paper on Wednesday and published an unusual “re-analysis” of their data in the same journal. (Kolata, 6/13)
New England Journal Of Medicine Retracts And Replaces Mediterranean Diet Study
The revised paper says only that people eating the Mediterranean diet had fewer strokes and heart attacks, not, as the original paper claimed, that the diet was the direct cause of those health benefits. Of course, a change in one paper — even a high-profile one — doesn't mean that researchers have lost faith in the benefits of the Mediterranean diet. "I don't know anybody who would turn around from this and say, 'Now that this has been revealed, we should all eat cotton candy and turn away from the Mediterranean diet,' " says David Allison, dean of the School of Public Health at Indiana University in Bloomington. (McCook, 6/13)
The Associated Press:
Science Says: What Happens When Researchers Make Mistakes
A top medical journal is correcting five studies and republishing a sixth after a British doctor scrutinized thousands of reports in eight journals over more than a decade and questioned some of their methods. The editor of the New England Journal of Medicine says no conclusions changed, and that the corrections it published Wednesday should raise public trust in science, not erode it. (Marchione, 6/13)
Rahul Desikan had just begun the biggest study ever of the genetics of ALS when he himself was diagnosed with the disease. Now he's continuing his research even as the condition takes its toll on his health. In other public health news: cellular recycling, JUUL, fertility treatments, IBM's Watson, gang violence, and living wills.
The Washington Post:
Devastated By ALS, Trying To Save Others
Rahul Desikan sits at his dining room table, a large computer screen before him, and works on his latest scientific paper. He types a single letter, then another, then another. For a man in a hurry, desperately trying to rid the world of terrible diseases, it’s an excruciatingly slow process. Using a special mouse strapped to his forehead that detects his smallest movement, Desikan moves a cursor around an on-screen keyboard. When he finds the letter he wants, he clicks a button with his right thumb, and it appears in a white space to the side. Repeating the process over and over, he debates research ideas with colleagues, analyzes reams of data and competes for grants. He types so much that he occasionally wears out the clicker. (McGinley, 6/13)
Is It Time To Target Autophagy To Treat Disease?
Agrowing number of small companies and a few large drug makers are taking a serious look at co-opting cellular recycling, or autophagy, as a way to treat disease. Cells use this process, whose Greek roots mean “self-eating,” to clear damaged proteins, adapt to starvation, or fight infection, all by digesting their own contents. When autophagy’s essential genes are mutated and the process goes wrong, diseases from cancer to inflammatory bowel disease to Parkinson’s can result. (Cooney, 6/14)
Pulse Check: The Rise Of JUUL, With Tevi Troy
Tevi Troy helped lead the nation's health department under President George W. Bush. Now he's helping steer JUUL — the nation's most popular e-cigarette company — through the Washington policymaking process and public health scrutiny. "Using a JUUL is worse than doing nothing," Troy acknowledged on the podcast. But"if we can get people to switch away from [traditional] cigarettes… there's a potentially huge public health benefit." (Diamond, 6/13)
Should Insurance Companies Have To Cover Fertility Treatments For Cancer Patients?
It used to be that cancer patients gave up on having children of their own, but with technological advances in reproductive medicine, there are options now. Many younger patients go through treatments to preserve their fertility; they extract eggs, bank sperm and freeze embryos. But when cancer patients want a chance at parenthood, who pays for the expensive treatments? (Dillon, 6/13)
IBM Watson Health Hampered By Internal Rivalries And Disorganization
When IBM launched its Watson Health division three years ago, promising to revolutionize medicine, not everyone in the sprawling technology company was on board. An existing group of employees was already working with health care clients and had its own secure cloud to store data, according to two former employees. But the new Watson Health team, with headquarters in Cambridge, Mass., started promoting another cloud, creating what seemed to be duplication — even competition — between old and new guards. (Ross and Swetlitz, 6/14)
The Washington Post:
How Emoji Can Kill: As Gangs Move Online, Social Media Fuel Violence
Instead of tagging graffiti, some rival gang members now upload video of themselves chanting slurs in enemy territory. Taunts and fights that once played out over time on the street are these days hurled instantaneously on Twitter and Instagram. The online aggression can quickly translate into outbreaks of real violence — teens killing each other over emoji and virtually relayed gang signs. Social media have profoundly changed gang activity in the United States, according to a new report by a Chicago nonprofit. Of particular concern, researchers say, is how social media often appear to amplify and speed up the cycle of aggression and violence. (Wan, 6/13)
Kaiser Health News:
That ‘Living Will’ You Signed? At The ER, It Could Be Open To Interpretation.
“Don’t resuscitate this patient; he has a living will,” the nurse told Dr. Monica Williams-Murphy, handing her a document. Williams-Murphy looked at the sheet bearing the signature of the unconscious 78-year-old man, who’d been rushed from a nursing home to the emergency room. “Do everything possible,” it read, with a check approving cardiopulmonary resuscitation. (Graham, 6/14)
"It looks like costs are stabilizing, but they are still going up at a rate above inflation," said Barbara Gniewek, of PricewaterhouseCoopers. "They are still increasing at an uncontrolled level and are ultimately unsustainable."
Healthcare Costs Increasing At Unsustainable Pace
Medical costs are poised to continue their relatively flat growth in 2019, but researchers say the steady trend is unsustainable for consumers. The expected 6% growth in 2019 aligns with the 5.5% to 7% trend over the past five years—a welcome change from the double-digit spikes in the 2000s—but higher costs haven't translated to similar gains in consumers' health and productivity, said PricewaterhouseCoopers researchers who studied employer-sponsored healthcare spending. (Kacik, 6/13)
In other health industry news —
Kaiser Permanente Partners With Emory Healthcare
Kaiser Permanente and Emory Healthcare will partner to create a fully integrated healthcare experience at Emory University Hospital Midtown and Emory St. Joseph's Hospital in Atlanta, the organizations announced Wednesday. Starting in October, the two hospitals will become the primary hospitals for physicians and members of Kaiser, which provided an undisclosed capital contribution to expand both facilities. (Kacik, 6/13)
Steward Health Care Voices Opposition To Beth Israel-Lahey Merger
Steward Health Care System is joining the opposition against the big merger of two of its rivals, Beth Israel Deaconess Medical Center and Lahey Health. ...The merger, which received one approval in April and is pending others, would create a large new health system of 13 hospitals and thousands of doctors stretching across Eastern Massachusetts. (Dayal McCluskey, 6/13)
Cardinal Health Sells Majority Stake In IT Firm NaviHealth
Cardinal, Ohio’s largest public company, announced the sale Wednesday, saying it will retain a 45 percent interest in Nashville-based NaviHealth after selling a 55 percent stake to New York-based Clayton, Dubilier & Rice. Exact terms were not disclosed, but Cardinal said its after-tax proceeds should be $650 million. (Matzer Rose, 6/13)
In a state that prides itself on a less-government-is-better mantra, the findings might reflect changing values: 64 percent think Medicaid should be expanded.
Poll: Texans Say Legislators Need To Make Health Care A Priority
Texans think the Legislature needs to step up its efforts to increase health care spending, lower costs and help more people access services, according to a poll released Thursday. Respondents to the poll, conducted by the Episcopal Health Foundation and the Kaiser Family Foundation, said the Legislature’s top three priorities should be lowering the cost of health care, reducing the number of women dying after childbirth and lowering the cost of prescription drugs. (Evans, 6/14)
Texans Want State Leaders To Do More To Solve State’s Health Care Crisis
About two-thirds of Texans think state lawmakers are not doing enough to help low-income adults get the health care they need, including tackling skyrocketing costs, reducing the number of maternal deaths and boosting access to health insurance, a new national survey found. And by the exact same percentage, Texans think the solution is expanding Medicaid — a position current state leaders and conservative forces have steadfastly opposed. (Deam, 6/14)
The information supports other research finding the death toll from last September's hurricane far exceeds 64, the official number. In other news, water service on the U.S. island remains spotty.
The Wall Street Journal:
Puerto Rico Data Suggests Hurricane Maria Death Toll Is Much Higher
Newly released data from Puerto Rico’s government bolsters a conclusion reached by several studies that the death toll from last September’s Hurricane Maria vastly exceeds the official figure of 64. The number of deaths on the island from September to December 2017 surpassed the average for the same period over the previous four years by more than 1,400, according to mortality data released by the government Tuesday. The figures show the numbers of fatalities in September and October last year—2,928 and 3,040, respectively—are greater than the tally for any month going back to January 2013. (Campo-Flores, 6/13)
Kaiser Health News:
Puerto Rico’s Water System Stutters Back To Normal
Carmen Rodríguez Santiago counts herself lucky to have any water service at home. But eight months after Hurricane Maria, the 52-year-old security guard said the faucets in her cream-and-pink-colored house still run dry every two to three days, and the water, when it returns, is flecked with sediment. Puerto Rican officials claim that water service on the U.S. island has been restored to more than 96 percent of customers as of June 6, but the report of progress masks underlying problems. Outside of cities, service has been slower to be reconnect. Flow is often intermittent and the water quality is uncertain. (Heredia Rodriguez, 6/14)
Media outlets report on news from California, Illinois, Tennessee, Minnesota, Idaho, Colorado, Texas, Ohio, Maryland and Arizona.
The University Of California Will Finally Be Granted Two CRISPR Patents
In the never-ending saga of CRISPR patents, the University of California has finally put some points on the board, with the U.S. Patent and Trademark Office granting it two genome-editing patents. One, granted on Tuesday, was first applied for in 2014. The other and more significant patent, applied for in 2015 but based on a 2012 discovery, will be granted next week. The granted patent, number 9,994.831, covers “methods and compositions for modifying a single stranded target nucleic acid.” Next week’s, which is to be issued on June 19, covers the use of CRISPR-Cas9 for genome-editing in anything other than a bacterial cell and, specifically, where the targeted region on the genome is 10 to 15 nucleotides, or base pairs, long — the “letters” that constitute DNA and its cousin RNA. Next week’s patent is considered more foundational and therefore significant. (Begley, 6/13)
Illinois Lawmakers Demand Explanation On Children Stuck In Psychiatric Hospitals
Illinois lawmakers have asked state child welfare officials to explain why they routinely fail to find better homes for hundreds of children in psychiatric hospitals, leaving them trapped for weeks and sometimes months. State Sen. Julie Morrison, a Democrat from Deerfield, called for a public hearing after a ProPublica Illinois investigation last week revealed that children in the care of the Illinois Department of Children and Family Services are confined to psychiatric hospitals after physicians have cleared them for release. (Eldeib, 6/14)
Tennessee Governor's Race: Phil Bredesen Talks Trump, Tariffs And Health Care In Williamson County
In his third brown bag lunch across the state, U.S. Senate candidate Phil Bredesen lightly drummed his fingers on the table while he listened to a table of Williamson County women talk health care. The Democrat and former Tennessee governor and Nashville mayor asked the 16 women — 12 of whom identified as Republican or conservative — what their experiences had been like with their families. (West, 6/13)
The Star Tribune:
Blue Cross Mental Health Cuts Leave Some Minn. Clinics Struggling
After the state’s largest health insurer cut her pay nearly in half, mental health therapist Kristy Brecke reluctantly stopped taking new clients who are covered by Blue Cross and Blue Shield of Minnesota. The Eagan-based insurer cut mental health therapy reimbursement rates to control what it said were “unusually high claims trends,” a move that has left thousands of mental health clinics scrambling to pay salaries and overhead costs with lower revenue. (Howatt, 6/13)
Here's What A New California Law Says About Teaching Abortion In Class
The law, enacted in 2016, requires school districts to ensure that all students in grades seven through twelve receive "comprehensive sexual health education," including information about abortion. Information presented in class must be "medically accurate and objective," according to the law. Parents must be notified of the curriculum in advance, and have the option of excusing their children from all or part of the classes. (Hubert, 6/14)
The Star Tribune:
Federal Agency Faults Minnesota For Inadequate Oversight Of Adult Day Centers
The state agency responsible for protecting vulnerable adults failed to provide adequate oversight over 20 adult day centers, which contributed to numerous health and safety violations. The problems were disclosed in a federal audit released this week by the Office of Inspector General for the federal Department of Health and Human Services. Federal inspectors made unannounced visits to the adult day centers in early 2017 and found that all 20 of the centers reviewed failed to comply with state licensing requirements. (Serres, 6/13)
The Washington Post:
Bubonic Plague: Child In Idaho Has First Human Case In The State In 26 Years
A boy in Idaho is recovering after contracting plague — the first human case in the state in more than two decades, health officials say. Christine Myron, a spokeswoman for the Central District Health Department, said Wednesday that the child, who has not been publicly identified, is back home in Elmore County and “doing well” after being treated with antibiotics in the hospital. The child became ill late last month and, earlier this week, health authorities received laboratory confirmation that he had bubonic plague, Myron said. (Bever, 6/13)
UCHealth Will Open Innovation Lab In Denver's Catalyst Health Tech Innovation Building
UCHealth announced Wednesday it is opening a lab and development space dedicated to health care innovation inside the River North neighborhood’s Cataylst HTI building. The Aurora-based health care provider will be an anchor tenant at the soon-to-open, health-tech innovation project, according to Catalyst HTI co-founder Mike Biselli. The nonprofit will occupy 17,500 feet there — the entire seventh floor — and have a sign on the front of the building. (Rubino, 6/13)
Homelessness, Limited Access To Medical Care Among Top Issues Affecting LGBT Communities In Texas, Study Finds
A recent statewide study identified homelessness and limited access to clinically competent medical care as some of the main issues affecting members of the LGBTQ community in Texas. Texas Pride Impact Funds funded the statewide study on the broad scope of needs for members of LGBTQ communities. (Quilantan, 6/13)
Kansas City Star:
Pregnant Honduran Awaits Deportation In Platte County Jail
In late March, Immigration and Customs Enforcement issued a directive that "ended the presumption of release of pregnant detainees." And just earlier this week, U.S. Attorney General Jeff Sessions signaled that domestic violence will no longer be grounds for undocumented persons to seek asylum. (Montgomery, 6/13)
Cleveland Plain Dealer:
Money To Relocate Should Now Be Easier To Access For Families Affected By Lead Poisoning
Families forced to move because of lead hazards may now have an easier time getting money to help relocate. Changes made this month clarify and streamline the eligibility requirements for the temporary assistance grants distributed by the county. (Dissell, 6/14)
The Baltimore Sun:
State Investigating After Man Jumps From Window To His Death At Baltimore Hospital
Police and state health regulators are investigating after a man broke a window on the 10th floor of the University of Maryland Medical Center and jumped to his death last week. The Baltimore Police Department responded to a call from the hospital at 22 S. Greene St. at about 9:35 p.m. June 4, according to a police report. Officers found the victim, a 47-year-old man, lying unconscious with a faint pulse, several cuts and broken bones on a third-floor ledge at the hospital building, according to the report. (Meehan and McDaniels, 6/13)
Phoenix Is One Of The Top 15 U.S. Cities In Kids Not Vaccinated
A rise in non-medical exemptions by families to opt out of vaccinations for their kids have created hotspots in the U.S. where the risk of contracting diseases like measles are growing, a study finds. The study, published in the Public Library of Science journal PLOS Medicine, found 12 of 18 states allowing exemptions to vaccines for religious or philosophical reasons have shown an increase in the number of kindergarten-age children enrolled in school with NMEs since 2009. (Molina, 6/13)
Cleveland Plain Dealer:
Cleveland Advocates For The Poor Lead Fight Against Possible Farm Bill Cuts
Local advocates for feeding the poor in Northeast Ohio fear that proposed cuts to food subsidy programs in a new federal Farm Bill could cause widespread hunger, economic and health consequences here. About 50 of those advocates gathered on Wednesday in a mobilization meeting organized by the Cleveland Cuyahoga County Food Policy Coalition, a nonprofit group currently led by officials from Ohio State University Extension and Case Western Reserve University. (Snook, 6/13)
Correction: A previous headline on this file said that USC was the recipient of the patents. It was the University of California.
Each week, KHN's Shefali Luthra finds interesting reads from around the Web.
Being Black In America Can Be Hazardous To Your Health
One morning this past September, Kiarra Boulware boarded the 26 bus to Baltimore’s Bon Secours Hospital, where she would seek help for the most urgent problem in her life: the 200-some excess pounds she carried on her 5-foot-2-inch frame. (Olga Khazan, 6/11)
Why Didn't My Drug-Affected Family Get Any Sympathy?
Today, the white face of the opioid epidemic has garnered a sympathetic response throughout the country. During the 2016 election, candidates tripped over themselves to be seen as the most sympathetic candidate toward heroin addicts and their families. Candidate Donald Trump, now known for his failure to muster appropriate levels of sympathy—like when he tossed out paper towels at a post-hurricane appearance in Puerto Rico or forgot the name of a fallen service member during a condolence call, according to the man’s widow—had no such problems when it came to the subject of heroin addiction. (Isaac J. Bailey, 6/10)
The New York Times:
Scientists Can Design ‘Better’ Babies. Should They?
For nine frustrating years, Lesley and John Brown tried to conceive a child but failed because of her blocked fallopian tubes. Then in late 1977, this English couple put their hopes in the hands of two men of science. Thus began their leap into the unknown, and into history. (Clyde Haberman, 6/10)
'She Absolutely Has Sociopathic Tendencies': Elizabeth Holmes, Somehow, Is Trying To Start A New Company!
Some C.E.O.s told taradiddles, exaggerating the number of users on their platforms (ahem, Twitter); some in Congress say Mark Zuckerberg lied when he told Congress that people on Facebook have “complete control” over their personal data. (They don’t.) But all of these, all these made-up numbers, concocted valuations, and apocryphal stories of how a company was realized in a garage, are nothing—nothing!—compared to the audacious lies of Elizabeth Holmes, the founder and C.E.O. of Theranos. (Nick Bilton, 6/8)
Sean Curtis. Alex Foster. Kevin Sullivan. They grew up together in Somerville, Mass., at the same time OxyContin first hit the streets. They each became addicted to the new prescription drug before switching to heroin and overdosing. "Runnin'" takes an intimate look at a group of friends who came of age as an epidemic took hold and morphed into a national nightmare. The film goes inside a tight-knit community just outside Boston grappling with the crisis. It retraces the lives of friends lost, and one last member of the group struggling to avoid the fate of his boyhood pals. (6/14)
Why Doctors Are So Bad At Predicting Pregnancy Due Dates
A pregnant friend of mine is due to give birth on Saturday, but as she told me this week, she really has no idea if the baby will come on time, or two weeks from now. Only 4 percent of women give birth on their estimated delivery date. That’s because of the natural variation in how long it takes a baby to grow and because of our limited ability to predict due dates. (Julia Belluz, 6/11)
Inside A Chemist’s Quest To Hack Evolution And Cure Genetic Disease
David Liu's office on the third floor of the Broad Institute in Cambridge, Massachusetts is designed to quiet the mind. A museum-grade gemstone collection lines the walls, interspersed with blue-tinged photos Liu has taken of inspiring science-on-location scenes—the concrete corners of the Salk Institute, a sunset through the Scripps pier, the lights of Durango, Colorado where Darpa often meets. (Liu is a member of Jason, an elite group of scientists that advises the US government on next-generation technologies.) The only thing out of place in the 45-year-old’s chemist’s office is a three-foot-high perfect replica of Iron Man standing atop his Hulkbuster armored suit. (Megan Molteni, 6/12)
Suicide Prevention: How Scientists Are Using Artificial Intelligence To Help People At Risk
When horrible news — like the deaths by suicide of chef, author, and TV star Anthony Bourdain and fashion designer Kate Spade, or the 2015 Paris attacks — breaks, crisis counseling services often get deluged with calls from people in despair. Deciding whom to help first can be a life-or-death decision. At the Crisis Text Line, a text messaging-based crisis counseling hotline, these deluges have the potential to overwhelm the human staff. (Brian Resnick, 6/8)
The New York Times:
The Wounds Of The Drone Warrior
In the spring of 2006, Christopher Aaron started working 12-hour shifts in a windowless room at the Counterterrorism Airborne Analysis Center in Langley, Va. He sat before a wall of flat-screen monitors that beamed live, classified video feeds from drones hovering in distant war zones. On some days, Aaron discovered, little of interest appeared on the screens, either because a blanket of clouds obscured visibility or because what was visible — goats grazing on an Afghan hillside, for instance — was mundane, even serene. Other times, what unspooled before Aaron’s eyes was jarringly intimate: coffins being carried through the streets after drone strikes; a man squatting in a field to defecate after a meal (the excrement generated a heat signature that glowed on infrared); an imam speaking to a group of 15 young boys in the courtyard of his madrasa. If a Hellfire missile killed the target, it occurred to Aaron as he stared at the screen, everything the imam might have told his pupils about America’s war with their faith would be confirmed. (6/13)
Opinion pages focus on the latest efforts to undermine the health law.
The Wall Street Journal:
Strike Down ObamaCare, Says Justice Department
Twenty states have filed a lawsuit against the federal government arguing that the Affordable Care Act is unconstitutional—and this time the federal government agrees. When the Justice Department filed a brief last week taking the states’ side, critics furiously insisted that the failure to defend ObamaCare is a threat to the rule of law. Don’t be moved by selective outrage. This refusal to defend is actually more restrained than President Obama’s. And, as before, the courts will decide the ultimate questions. (Sai Prakash and Neal Devins, 6/13)
The Washington Post:
Republicans Are Still Trying To Repeal Obamacare. Here’s Why They Are Not Likely To Succeed
Conservatives are still trying to repeal the Affordable Care Act (ACA) — even after the Republican-majority Congress failed to overturn the law in 2017. A coalition of conservative groups intends to release a new plan this summer. The groups will reportedly propose ending the law’s expansion of Medicaid (the federal program that helps fund health care for low-income Americans) and convert Medicaid funding into block grants to the states. And just last week the Trump administration’s Justice Department argued in a legal filing that key provisions of the law — its protections for persons with preexisting conditions — are unconstitutional. (Eric Patashnik and Jonathan Oberlander, 6/13)
Trump Gives Democrats A Political Gift On Obamacare
For what appears to be largely ideological reasons, Attorney General Jeff Sessions and the Justice Department have given Democrats a political gift — a reminder that Republicans remain intent on repealing Obamacare and taking health care away from millions of Americans. (Michael Cohen, 6/13)
New Jersey’s Disastrous Decision To Resurrect ObamaCare’s Individual Mandate
New Jersey Gov. Phil Murphy signed legislation on May 30 that will reimpose the mandate all residents enroll in a “qualifying” health insurance plan or else pay a penalty. The national individual mandate penalty was effectively eliminated in December when the Republican-led Congress passed the Tax Cuts and Jobs Act. When the law goes into effect on January 1, 2019, any New Jerseyan without insurance will be required to pay a $695 penalty or 2.5 percent of his or her household income, whichever is higher. (Justin Haskins and Arianna Wilkerson, 6/13)
Editorial pages focus on the shrinking of funding for Medicare and Social Security.
The Philadelphia Inquirer:
Get Ready For The Great Depression If We Don't Fix Social Security, Medicare
According to the Social Security Administration, the Medicare trust fund will run dry in 2026 and Social Security funds in 2034. They will still be supported by payroll taxes, but those taxes will not cover full benefits, and recipients will likely experience severe benefit cuts if the funds aren’t replenished. The implications are dire. (6/14)
Des Moines Register:
Iowans Should Demand Solvency In Medicare And Social Security
About 600,000 Iowans are enrolled in Medicare health insurance. Almost one in five of us receives monthly Social Security benefits, the only source of income for many seniors. These Iowans should contact their members of Congress and ask them exactly what they are doing to shore up these safety net programs. Because the latest annual report from the Social Security and Medicare trustees is bleak. Social Security’s trust funds (one for retirement and one for disability) are shrinking, with tax revenues and interest no longer covering the annual cost of benefits. The trustees estimate depletion by 2034. (6/13)
Opinion writers focus on mental health and other health issues.
The Wall Street Journal:
My Mom’s Suicide Was Preventable
I didn’t know Kate Spade or Anthony Bourdain but saw familiar threads in their suicides, as my mother took her own life at age 51. Spade had spoken to her father the night before and was looking forward to a trip to California. Bourdain was in one of his favorite countries, France, working on his television show. My mother, struggling through her third and failing marriage, had arrived at a plan to get back on her feet, supported by friends and family. (Karl Rove, 6/13)
The New York Times:
What Is Sadness, And What Is Depression?
I stood onstage as an audience of over a thousand people applauded and cheered. My hosts placed an award in my hands. I nodded to the crowd, and they all rose to their feet. Hooray for you, the strangers shouted. Hooray! Less than a week later, I sat up in bed in my house in Maine. A voice said: “You’re nothing. You’re a joke. They’d never have given you that award if they knew the truth.” It was hard to argue. After all, who knew me better than the voice inside my head? (Jennifer Finney Boylan, 6/13)
Current Efforts To Fight Sepsis Aren't Working. We Need A Bolder Approach
If pharmaceutical and biotech companies gave up trying to find better treatments for stroke and Alzheimer’s disease, there would be public outrage. Yet that is essentially what has happened to sepsis, an infection that kills as many Americans each year — about 250,000 — as stroke and Alzheimer’s combined — with barely a whimper. If we can strive to fight a new scourge like opioids, we should be able to do the same for a much older killer. Thanks to antibiotics, vaccinations, and public health advances like modern sanitation, it’s easy to think that Americans live largely free of the infectious diseases that once took such a toll. That’s partially right: We effectively prevent many infectious disease threats. Cholera and typhoid, which once killed one percent of Americans each year, are now virtually unheard of in the U.S. Yet nearly 1.5 million Americans are hospitalized for sepsis each year, and it accounts for 1 in 3 deaths that occur in hospitals. (Derek Angus, 6/14)
A School Shooter Game? We Don't Need Real-Life Horror On Our Kids' Screens, Too
The human race is incredibly self-destructive these days. Last week, the controversial school shooting video game “Active Shooter” scheduled to be released to the market June 6 was pulled due to parental and general public outcry. Just as quickly, though, USA Today reported that the content provider Valve will take a hands-off approach and allow almost everything on its software distribution platform, Steam. The “Active Shooter” game allows the player to act in the role of a school shooter, and keeps score based on the number of children and SWAT officers killed. As a parent and a citizen, I am concerned about the negative influence technology run amok can have on our kids' mental health. (Carolyn McGrath, 6/13)
Red Flag Gun Laws Will Let Authorities Seize Firearms From People Deemed A Violent Threat. Congress Should Pass Legislation.
It might seem cynical to put the issue of gun safety in the context of election-year politics. But here we are. There are at least two ideas floating around Congress that could make “red flag” laws a reality in all 50 states. These laws allow authorities to temporarily take guns away from a person who has shown a pattern of violence or the threat of violence. In those cases, court-approved restraining orders would let relatives or law enforcement ask a court to bar a dangerous person from having guns. Petitioners could seek an emergency order, then a permanent one. (6/13)
Lexington Herald Leader:
Child Abuse Now Official U.S. Border Policy
Anyone with a shred of empathy must be sickened by what our country is doing at the border. Science tells us that childhood trauma causes lifelong physical and emotional harm, even alters human DNA. When U.S. authorities strip children from their immigrant parents and house them in settings that resemble dog kennels, we are inflicting a harsh and lasting punishment on innocents. Families that are refugees from violence are being separated, while in the past they were first given a chance to make their case for asylum. (6/13)
New England Journal of Medicine:
The Consequences Of Gender Discrimination In Medicine
Ongoing media exposés of sexual harassment have catalyzed important public discussions about the way women are treated both in and outside the workplace. Medicine has not been immune to the problems of gender-based harassment and discrimination that have surfaced in other industries, despite efforts in recent decades to increase the field’s diversity and inclusiveness. Aside from the obvious moral issues associated with mistreatment of and job discrimination against women physicians, we believe that greater focus is needed on the potential consequences for patients and biomedical science of the loss of talent and worse outcomes that result when women in medicine are slighted, overlooked, or explicitly wronged. (Lisa S. Rotenstein and Anupam B. Jena, 6/13)
The New York Times:
When The Bully Is A Doctor
Years ago, when I was a medical student trying my hand at a variety of specialties, I spent two months on the surgery service. The days were rigorous, starting before 5 a.m., when I was expected at the hospital to round on patients who had recently undergone surgery. I then scrubbed in to the first operating room case of the day, at 7 a.m. Depending on the complexity of the procedure, we wouldn’t emerge from the O.R. for hours, biologic needs such as going to the bathroom or eating be damned. Another case, more rounding, and I typically surfaced from the hospital at dusk, completely exhausted. (Mikkael A. Sekeres, 6/14)
The New York Times:
The Digital Sex Lives Of Young Gay Teenagers
Last summer in Wisconsin, a mother came home to find her 15-year-old son running up the stairs from their basement. He yelled that a man had broken into the house and raped him. A police officer apprehended Eugene Gross, who was 51 years old and H.I.V. positive, in a nearby backyard. Authorities later learned that the teenager had met Mr. Gross on the gay hookup app Grindr and that they had met for sex before. Last month, Mr. Gross was sentenced to 15 years. The victim’s father broke down in court, saying, “The man sitting here, he destroyed my life, my kid’s life, my family life.” It’s common for gay, bisexual or questioning minors to go online to meet other gay people. It’s normal for these kids to want to explore intimacy. But most online social networks for gay men are geared toward adults and focused on sex. (Jack Turban, 6/13)
Do We Keep Waiting For The Next Pandemic Or Try To Prevent It?
News of the latest Ebola outbreak in the Democratic Republic of the Congo is an urgent reminder that we need to change the way we fight disease, and we need to do so now. Over the last few decades, the number of disease outbreaks has more than tripled, culminating in three major epidemics in recent years — Ebola, yellow fever, and Zika. Despite this, governments often respond to outbreaks only once they occur, rather than investing in ways to stop them in the first place. If this continues, there will be a growing risk that we will not only undermine the great progress that has been made in fighting infectious disease, but we could even see a resurgence of highly preventable diseases that were previously in decline. Global trends are steadily altering the global health landscape, making it easier for disease to spread. (Seth Berkley, 6/14)
San Jose Mercury News:
Low's Legislation Will Help Reduce Opioid Abuse
We are hopeful that efforts at the state level, such as the legislation authored by Assemblyman Low, will help physicians ensure that patients who truly need opioids are able to obtain them, while identifying the few physicians who persistently overprescribe and the patients who are doctor-shopping or otherwise misusing these powerful drugs. These policies must be based on evidence-based guidelines for opioid prescribing, non-opioid alternatives, compassionate pain medicine, and humane treatment of dependence and addiction. (Karen Sibert, 6/13)