- Kaiser Health News Original Stories 4
- Mylan’s Generic EpiPen — A Price Break Or Marketing Maneuver?
- How To Fight For Yourself At The Hospital — And Avoid Readmission
- Taxpayers Foot 70 Percent Of California’s Health Care Tab, Study Finds
- Trans And Adopted: Exploring Teen Identity
- Political Cartoon: 'Is This Legal?'
- Administration News 3
- With Tough Warning Label, FDA Aims To Curb Fatal Overdoses From Mixing Opioids, Sedatives
- 'Women Have Had To Be Strong For So Long. Opioids Are A Good Way Out. Benzos Are A Good Way Out'
- Off-Label Drug Communication Restrictions To Be Discussed At FDA Meetings
- Health Law 2
- Marketplace Insurers, Already Under Fire For Limited Networks, Double Down To Cut Costs
- Georgia Business Group Lays Out Proposals For Medicaid Expansion
- Quality 2
- Emails, Reports Show How Detroit Hospital Struggled With Dirty Or Missing Instruments
- Surgical Cap, Which Doctors See As 'Symbolic Of Profession,' Comes Under Fire
- Public Health 2
- Recovery High Schools Offer Students With Addiction Safe Space For Second Chance
- Adults' Attitudes Shifting Toward Marijuana, Analysis Shows
- State Watch 1
- State Highlights: Fla.'s Price Transparency Law; N.J. Audit Reveals Incorrect Hospital Incentive Payments
From Kaiser Health News - Latest Stories:
As news that Mylan will make available a generic version of its own brand-name product, KHN answers key questions about how this development could affect consumers. (Julie Appleby, 9/1)
This new column explains what older adults and their families can do to avoid hospital readmission. (Judith Graham, 9/1)
The public spending on health care outpaces the nation. (Ana B. Ibarra, 9/1)
A Boston health clinic that treats transgender kids and teens finds that the percentage of its young patients who are adopted is higher than expected. These kids might need extra support, doctors say. (Martha Bebinger, WBUR, 9/1)
Kaiser Health News provides a fresh take on health policy developments with "Political Cartoon: 'Is This Legal?'" by Lee Judge, Kansas City Star.
Here's today's health policy haiku:
MYLAN, EPIPEN, AN AUTHORIZED GENERIC … HOW DOES THIS WORK?
It’s their brand-name thing.
But it’s their generic, too.
Now that’s confusing!
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:
The agency will require "black box warnings" -- its strongest type -- on more than 400 products. The move comes following criticism that it has not done enough to stem the rising tide of the opioid crisis.
The New York Times:
F.D.A. Orders Stronger Warning On Common Painkiller-Sedative Mix
The Food and Drug Administration announced on Wednesday that it would require its toughest warning labels to caution patients against taking opioid painkillers together with benzodiazepines, like Xanax and Valium. The combination makes an overdose more likely and the warning is aimed at making sure people understand that. Benzodiazepines are prescribed for anxiety, insomnia and seizures, and opioids for pain. The drugs work by depressing the central nervous system. Increasingly, doctors have been prescribing them together. The number of patients who were prescribed both drugs rose by 41 percent — about 2.5 million people — from 2002 to 2014, the agency said. (Tavernise, 8/31)
The Associated Press:
FDA Warns Of Fatal Risks From Mixing Opioids And Sedatives
The Food and Drug Administration said it will add a boxed warning — the strongest type — to nearly 400 medications about the interaction, including opioid painkillers, opioid-containing cough medicines and benzodiazepines, which are used to treat anxiety, insomnia and seizure disorders. (Perrone, 8/31)
The Washington Post:
FDA Requires New Warnings On Danger Of Combining Opioids, Benzodiazepines
In a call with reporters, FDA Commissioner Robert Califf implored doctors “to heed these new warnings” and to carefully evaluate, on a patient-by-patient basis, whether the benefits of using opioids and benzodiazepines together outweigh the serious risks involved. Current labels on the drugs warn of potentially dangerous interactions. But FDA officials said the tougher warnings, sometimes called “black box warnings,” are designed to catch the attention of physicians and patients and to underscore the seriousness of the threat. (McGinley, 8/31)
Opioids And Anxiety Medications Combined Can Be Deadly
The move comes after an extensive review of scientific evidence by the FDA showing that physicians have been increasingly prescribing these drugs together. There was also a request for action in February, when health officials in cities and states across the country petitioned the agency for the change to the drug labels, citing an increase in overdoses from simultaneous use of the drugs. (Neel, 8/31)
Los Angeles Times:
FDA Orders Stronger Warnings About Risk Of Using Opioid Painkillers With Certain Antidepressants
The new FDA order calls for some 400 products to carry one of several “black box warnings.” Those aim to alert physicians and patients to the dangers of mixing opioids with benzodiazepines and other drugs — including insomnia medications, muscle relaxants, antipsychotic drugs and alcohol — that depress the central nervous system. The new warnings tell physicians and patients that the combined use of drugs that reduce the reflexive urge to breathe can cause dizziness, extreme sleepiness, slowed or difficult breathing, and unresponsiveness. (Healy, 8/31)
FDA Warns Against Combining Opioids With Anxiety Pills
Dr. Leana Wen, Baltimore’s city health commissioner and one of the public health officials who pushed the FDA to require stronger warnings, told reporters that prescribing the two drugs together had become routine clinical practice, despite there being “no scientific reason” to do so. (Scott, 8/31)
FDA Adds Toughest Warning Label To Nearly 400 Drug Products
“It is nothing short of a public health crisis when you see a substantial increase of avoidable overdose and death related to two widely used drug classes being taken together,” FDA Commissioner Robert Califf said in a statement. (Wheeler, 8/31)
Mixing Opioids And Tranquilizers Can Be Deadly, FDA Warns
The FDA has been heavily criticized for doing too little to stop overuse and abuse of opioids such as OxyContin, Vicodin and Percocet. The drugs, which are similar to morphine and heroin, are highly addictive and are easy to overdose on. (Fox, 8/31)
The Washington Post offers a series on why death rates have risen for whites in midlife, particularly women.
The Washington Post:
Opioids And Anti-Anxiety Medication Are Killing White American Women
While death rates are falling for blacks and Hispanics in middle age, whites are dying prematurely in growing numbers, particularly white women. One reason: a big increase in overdoses, primarily from opioids, but also from anti-anxiety drugs, which are often prescribed in tandem. Between 1999 and 2014, the number of middle-aged white women dying annually from opiate overdoses shot up 400 percent, according to a Washington Post analysis of data from the Centers for Disease Control and Prevention. Anti-anxiety drugs known as benzodiazepines contributed to a growing share of the 54,000 deaths over that period, reaching a third in the last several years, The Post found, though spotty reporting in death records makes it likely that the combination is even more widespread. (Kindy and Keating, 8/31)
The Washington Post:
Trolling For Drugs In A California ‘Heroin Alley’
When doctors cut off her painkillers, Samantha Burton went through withdrawal. Experts say it can feel like an extreme case of the flu, but Burton found the experience far more punishing. Opioids “make your brain’s ability to create happy chemicals completely flaccid,” she said. “It wasn’t like I felt bad. I felt like I was going to die.” So Burton, a professional illustrator who grew up in nearby Bakersfield, joined a stealthy parade of middle-aged white women trolling for drugs in Oildale, a dusty little town in central California known for its bountiful oil fields, its Appalachian-grade poverty and an open-air market for illicit drugs dubbed “Heroin Alley.” (Kindy, 8/31)
The Washington Post:
How A 'Party Girl' Confronted Her Own Death At Age 58
Life as a “party girl” caught up with Beverly Layman in March. She had gone to the doctor to receive a new treatment for hepatitis C. She was excited by the prospect of getting her energy back. But the blood tests showed it was too late. Layman, 58, was dying. “The doctor said, ‘I think you need to start looking at hospice.’ That just blew me away,” Layman said. “I thought I was invincible. I thought nothing was going to kill me.” (Kindy, 8/31)
Pharmaceutical companies want regulators to loosen strict limits currently in place on what information they can provide to doctors about unapproved uses of prescription medications.
FDA To Hold Long-Awaited Meeting To Review Off-Label Marketing
After years of anticipation, the US Food and Drug Administration will hold a public, two-day meeting in November to review the extent to which so-called off-label information about medicines may be disseminated to physicians. Off-label information is regulatory parlance for materials that describe unapproved uses of a drug. Doctors are, in fact, allowed to prescribe a medicine for an unapproved use, but drug makers have long chafed at restrictions on their ability to distribute such information — reprints of medical studies, for example — and have lobbied Congress and the FDA to loosen regulations. (Silverman, 8/31)
FDA To Hold Hearing On Updating Pharmaceutical Industry Speech Regulation
The Food and Drug Administration on Wednesday announced in the Federal Register that the agency will hold a public hearing in November to gather input about how companies communicate about their products. Specifically, the agency will focus on how companies discuss off-label uses of their products, the notice says. The FDA regulates how drug and device makers communicate about their products through approved labels, but many of those companies say there’s more information about their products worth sharing to help providers and others provide better care to patients. (McIntire, 8/31)
A McKinsey & Co. analysis of regulatory filings for 18 states and the District of Columbia found that only about 25 percent of the plans offered on those exchanges would be preferred-provider organizations or similar options that generally give consumers the ability to choose from larger selections of doctors and hospitals and include out-of-network coverage, The Wall Street Journal reports. Other health law news includes a look at a statement about insurance costs by the White House press secretary and previews of Minnesota health plan rates.
The Wall Street Journal:
Insurers Move To Limit Options In Health-Care Exchange Plans
Under intense pressure to curb costs that have led to losses on the Affordable Care Act exchanges, insurers are accelerating their move toward plans that offer limited choices of doctors and hospitals. A new McKinsey & Co. analysis of regulatory filings for 18 states and the District of Columbia found that 75% of the offerings on their exchanges in 2017 will likely be health-maintenance organizations or a similar plan design known as an exclusive provider organization, or EPO. Both typically require consumers to use an often-narrow network of health-care providers—in some cases, just one large hospital system and its affiliated facilities and doctors. (Wilde Mathews, 8/31)
The Washington Post's Fact Checker:
The White House Claim That ‘Most’ People On Obamacare Pay $75 Or Less
A number of readers asked about this tweet, which was a summary of comments made by [White House press secretary Josh] Earnest during a White House press briefing. The tweet included a video of Earnest’s remarks, in which he said: “What is clear is that the vast majority of people all across the country will have access to a plan that costs $75 a month or less.” Earnest made these comments in response to a question about a Washington Post report about how enrollment in the insurance exchanges established by the Affordable Care Act is at less than half its initial forecast. Officials say he was referring to people in the exchanges, not the population as a whole, when he referred to the $75 figure. (Kessler, 9/1)
The Star Tribune:
Minnesota Health Plan Shoppers Brace For Premium Jumps
Three years ago, premiums generated from state residents who buy health insurance on their own exceeded claims for medical care by nearly $130 million. But the market for individuals and families — about 5 percent of state residents — changed significantly in 2014 with the federal health law, which stopped insurers from denying coverage to those with preexisting health problems. In 2014, claims exceeded premiums in the market by some $9 million, state Commerce Department figures show, and the gap swelled in 2015 to more than $166 million. (Snowbeck, 8/31)
Four Things To Know About Health Insurance Premiums Expected Thursday
Minnesota’s insurance companies will unveil their proposed 2017 rates Thursday — and Minnesotans should expect some sticker shock. The new rates for the state’s individual insurance marketplace are expected to see increases of at least 25 percent and perhaps far more. Affected will be people who buy individual insurance plans — about 300,000 people today, of whom 70,000 buy through the state-run MNsure exchange and about 230,000 directly from insurers. People who get health insurance from providers or from government programs such as Medicare, Medical Assistance or MinnesotaCare won’t be directly affected. (Montgomery, 8/31)
A task force set up by the state's Chamber of Commerce offers Georgia lawmakers three conservative options to cover the state's uninsured. About 16 percent of Georgia's residents are uninsured, one of the highest rates in the nation.
Georgia Health News:
Task Force Unveils Options To Cover Uninsured In Georgia
A widely anticipated plan to reduce the number of Georgians without health coverage, unveiled Wednesday, takes a unique, conservative approach to Medicaid expansion. The plan, created by a health care task force, contains three proposals with differing eligibility standards and designs. The group’s leaders said Wednesday that they hope the options will serve as a kick start for discussion this fall and into next year’s General Assembly session. Included in the blueprint is an array of features that may please many Republican legislators, who are clearly the target of the task force effort. (Miller, 8/31)
WABE (Atlanta Public Radio):
Ga. Chamber Releases Plans For Expanding Health Care Access
None of the three plans suggest adopting conventional Medicaid expansion as called for under the Affordable Care Act, or "Obamacare." States that have taken this route simply expanded eligibility for Medicaid, the federal health program for the poor and disabled, to all individuals whose income falls at or below 138 percent of the federal poverty line, or about $16,000. Rather, all three proposals outlined by the Georgia [Chamber of Commerce’s] task force call on lawmakers to seek a 1115 Waiver, which other Republican-majority states have used to cover the same low-income population, but on their own terms. (Eloy, 8/31)
The Associated Press:
Georgia Business Group Hopes To 'Kick Start' Medicaid Change
One of the chamber's options extends Medicaid to adults without children and who are making less than the federal poverty level, $11,700. That proposal wouldn't cover people making up to 138 percent of the poverty level, a key benchmark for federal officials when evaluating other waivers. The other options include coverage for adults making 138 percent of the poverty level, totaling $16,242 annually. In one plan, everyone is covered by Medicaid. The other option requires those making more than the poverty level to find private insurance coverage through marketplaces created by the health care law rather than being covered by Medicaid. (Foody, 8/31)
Georgia Chamber Pitches Conservative-Friendly Blueprint For Medicaid Expansion
Gov. Nathan Deal has long opposed accepting more federal funds to expand Medicaid, saying it will be too costly in the long run. But a growing number of Republicans say it is past time for Georgia to begin accepting tens of billions in federal money to expand coverage to more than 600,000 low-income residents and shore up the struggling network of rural hospitals. Just how to do that promises to be a main theme of next year’s legislative session. (Bluestein, 8/31)
In Alaska, there's growing concern about costs of the state's Medicaid program —
The Associated Press:
State Analyzing Higher Claims For Expanded Alaska Medicaid
Costs for Alaska's expanded Medicaid program have exceeded first-year estimates by roughly $30 million so far, leaving some concerned about the impact the program may have on the state budget once the federal government stops covering the entire tab. Gov. Bill Walker expanded Medicaid to provide coverage to thousands more lower-income Alaskans. Enrollment began last September, and as of July 31, nearly 20,400 people had signed up. The federal government is expected to fully cover the health care expenses for the expansion enrollees through December; then, the state will start chipping in. The state share next year is expected to be 5 percent and grow to as much as 10 percent by 2020. (Bohrer, 8/31)
A new survey finds that three-quarters of Americans rank the allocation of money for Zika as an important or top priority for Congress when it is back in session.
Poll: Most Americans Want Congress To Make Zika Funding A High Priority
Summer is winding down, but when members of Congress return to Washington from their vacations next week, many of their constituents want them to do something about the mosquitoes — the ones carrying Zika virus, to be specific. A new survey shows that three quarters of Americans say Congress should make the allocation of more money to deal with the Zika outbreaks in Florida and Puerto Rico an "important" or "top priority" when they return to Washington. (Kodjak, 9/1)
House GOP Leaders Unveil September Agenda
House Republican leaders next month will seek a short-term spending patch to keep the government running in the fall, in addition to finding a way forward on Zika funding and other priorities outlined in a memo sent Wednesday to the GOP conference. “Once we return, Conference discussions will continue on overall government funding, including a Continuing Resolution and a path forward for the $1.1 billion supplemental funding package to address the Zika crisis that the House passed on June 23, 2016,” House Majority Leader Kevin McCarthy (R-Calif.) said in the memo. ... The memo said there could also be action on the annual defense authorization, “reauthorization of career and technical education programs, and protecting seniors from a harmful Obamacare tax.” (Reid, 8/31)
In other Zika news —
The New York Times:
Study Finds Increase In Temporary Paralysis Accompanied Zika Outbreaks
In seven countries that recently experienced Zika outbreaks, there were also sharp increases in the numbers of people suffering from a form of temporary paralysis, researchers reported Wednesday. The analysis, published online in The New England Journal of Medicine, adds to substantial evidence that Zika infections — even asymptomatic ones — may bring on a paralysis called Guillain-Barré syndrome. (Saint Louis, 8/31)
Zika Hits Singapore, Raising Fears Of Epidemics In Asia, Africa
The Zika virus appears to be spreading rapidly in Singapore, with 115 confirmed cases as of Wednesday, according to government officials. At least one pregnant woman is among them. The virus’s emergence in the Asian city-state is raising lots of questions that will likely preoccupy experts on the World Health Organization’s Zika Emergency Committee, which meets Thursday. The most pressing: Is this a sign the epidemic virus racing through the Americas will do the same in Asia and Africa? (Branswell, 9/1)
Health News Florida:
Officials Investigating 3 New Local Zika Cases In Miami-Dade
The Florida Department of Health reported three new, non-travel related cases of Zika in Miami-Dade County on Tuesday. One of the cases is reportedly associated with the Miami Beach investigation, but the other two are being investigated to determine where the exposure happened. There have now been 46 non-travel-related cases of Zika reported in Florida. (8/31)
But, still, most said neither candidate would improve access to affordable care.
The Associated Press:
Poll: More Voters Trust Clinton On Health Care
A new poll finds that more voters trust Democratic presidential candidate Hillary Clinton to do a better job on health care issues, from Medicare to medical costs. But they're not holding out hope for big improvements. The survey from the nonpartisan Kaiser Family Foundation found that Clinton leads Republican opponent Donald Trump when it comes to the future of Medicare, Medicaid, the federal health care law, and the cost of medications. (9/1)
Poll: More Voters Trust Clinton On Key Health Issues
The majority of voters say they trust Hillary Clinton over Donald Trump to address top health care issues, according to a new Kaiser Family Foundation poll released Thursday. Sixty-six percent listed the future of Medicare and access to affordable care as the most important health care issues they want the candidates to discuss on the campaign trail, the poll found. About half of survey respondents said the future of Medicaid, the rising cost of prescription drugs and the future of Obamacare were top health issues the candidates should address. Further down the list were the opioid epidemic, women's access to reproductive care, and the Zika virus. (Ehley, 9/1)
In other 2016 election news —
The Fiscal Times:
Clinton Wants To Spend Billions On Mental Health, And The GOP May Just Agree
On Monday, Clinton unveiled her latest major policy initiative: an overhaul and reform of the nation’s troubled mental health system. Although the two parties are far apart on Obamacare and health care reform more generally, they have been trying for months to find common ground on mental health issues in the wake of numerous mass shootings and terrorists attacks in recent years. (Pianin, 8/31)
Can Clinton Global Health Charity Survive Loss Of Bill Clinton?
Bill Clinton has promised to leave the Clinton Foundation board if Hillary Clinton is elected president, but his potential departure from another Clinton charity could have far greater consequences for global health. Though it’s less well-known than the foundation, the Clinton Health Access Initiative has played a central role in bringing down drug prices in the developing world and helping governments in Africa and Asia build health care delivery systems. Known as CHAI, it relies so heavily on the former president, say global health experts, that his exit would raise a fundamental dilemma for the influential organization: Can it operate in any meaningful way without the Clinton clout? (Piller and Kaplan, 8/31)
A series of articles in the Detroit News used internal reports and emails to explore problems over 11 years at the Detroit Medical Center to keep surgical instruments cleaned. “We are putting patients at risk frequently," the chief surgeon at Children’s Hospital, Joseph Lelli, wrote in an email in 2015.
Dirty, Missing Instruments Plague DMC Surgeries
The Midtown hospitals of the Detroit Medical Center have struggled for years to properly clean surgical instruments, stoking doctors’ fears about patient safety, a Detroit News investigation has found. The News has obtained more than 200 pages of internal emails and reports indicating that surgeons and staffers have complained for at least 11 years about improperly cleaned, broken and missing instruments. The complaints have continued under the tenure of the for-profit Tenet Healthcare of Dallas, Texas, which acquired the DMC in 2013, the documents show. (Bouffard and Kurth, 8/26)
Hospital Oversight Lacking, Experts Say
No state requires that hospitals report exposures to dirty instruments, which may or may not lead to infection. As a result, it can be difficult to track whether patients become sick or die as a result. State reporting requirements, if they exist, typically are based on the National Quality Forum’s list of reportable events. That list includes contamination by drugs, devices or biologics, but only if the exposure results in serious injury or death. “It’s a resource issue and it’s also a politically tense issue,” said Jill Rosenthal, senior program director at the National Academy for State Health Policy. (Bouffard and Kurth, 8/25)
Other stories included in the Detroit News special report:
Detroit News: Hospital Records Kept From Public (Kurth and Bouffard)
Low-Paid Workers Do A High-Stakes Job (Bouffard and Kurth)
Feds Join On-Site Probe Over Dirty DMC Instruments (Kurth)
There are concerns the traditional cap worn by surgeons is creating situations that promote infection.
The Boston Globe:
For Surgeons Working In The OR, A Flap Over Headwear
Surgeons for years have stepped into operating rooms wearing their surgical cap — a snug covering that ties in back and comes in standard-issue blue or hundreds of personalized designs. But a crackdown appears to be underway on that almost sacred piece of headgear. Inspectors in January reprimanded operating room staff at Brigham and Women’s Hospital in Boston for having the hair around their ears uncovered during surgery — and for sporting visible facial hair. And a New York surgeon was written up for showing 3 inches of hair at the nape of his neck. (Kowalczyk, 9/1)
In other news concerning doctors —
Trudging Through Gettysburg, Doctors Learn Leadership
On the first day of battle at Gettysburg, a moment of hesitation cost the Confederacy a chance at an early advantage. On a steamy morning 153 years later, a group of hospital employees walked the meadows of this famous battlefield to ask themselves how that misstep happened. The 50 staff members from Florida Hospital Waterman, a full-service medical center in suburban Lake County, did not travel to Gettysburg last week for a history lesson, or for a casual respite. They made the trek as part of a leadership program designed to train doctors, nurses, and administrators to think strategically in the face of the bureaucratic and logistical challenges — and the personality clashes — that can undermine medical care. (Ross, 9/1)
For The Head Of Doctors Without Borders, Impatience Is A Virtue
With little fanfare earlier this summer the humanitarian group Doctors Without Borders did something it had never done before. It reelected its international president. Dr. Joanne Liu, a 50-year-old French-Canadian who practices pediatric emergency medicine, had seen her first three-year term whiz by, subsumed by the civil war in Syria and the West African Ebola outbreak. (Branswell, 8/31)
A new analysis finds that the sickest Americans pay about four times the amount on health care than does the average patient.
The Fiscal Times:
Sickest Americans Paying More For Care, Getting Less
American adults with chronic illnesses that limit their ability to care for themselves spend more than $21,000 per person for health care, about four times the average for all adults. Despite that higher spending, however, a new analysis from the Commonwealth Fund finds that those with the greatest medical need — defined as people with at least three chronic diseases and a limited ability to care for themselves — were more likely than other patients to have delayed or done without medical care or a prescription, and they’re more likely to say that their doctors were disrespectful, didn’t spend enough time with them, or didn’t listen or explain things carefully. (Braverman, 8/31)
In other news about health care costs —
UCLA Study: Taxpayers Foot 70 Percent Of California’s Health Care Tab
This year, taxpayers will cover about 70 percent of what is spent on health care in California, according to a new analysis released Wednesday by the UCLA Center for Health Policy Research. Many people assume that the U.S. health care system is primarily supported by private dollars, such as insurance premiums from employer-based coverage, said Gerald Kominski, director of the UCLA Center for Health Policy Research and the study’s lead author. (Ibarra, 8/31)
In other news, a medical patch -- or "electronic tattoo" -- could help monitor pregnant women's health.
The New York Times:
Moderate Drinking Does Not Affect Fertility
A new study has found that moderate alcohol consumption does not affect a woman’s ability to get pregnant, although higher amounts might. Danish researchers studied 6,120 women trying to conceive in stable relationships with male partners. The women reported their drinking habits in questionnaires. By the end of the study, 4,210 of the women had gotten pregnant. Women who drank the alcoholic equivalent of one to 13 four-ounce glasses of wine a week were no less likely to conceive than those who abstained completely. (Bakalar, 8/31)
‘Electronic Tattoos’ Could Monitor Pregnant Moms At Home
The “electronic tattoo” may sound like an attempt by Silicon Valley to encroach on one of the last few activities still requiring an actual human being. But what the term actually refers to is a sensor that adheres like a Band-Aid to parts of your body in order to monitor vital signs like heart rate, blood pressure and breathing. Another term for the devices– equally evocative–is “smart skin.” Researchers around the country are designing electronic tattoos, which look a bit like a child’s sticker but come outfitted with wireless antennae. (McClurg, 8/31)
Right now there are 27 public or charter recovery high schools in 11 states, with more slated to open. Meanwhile, in Louisville, Kentucky, doctors see an overdose outbreak as a clear sign of a public health emergency, New Hampshire gets $1 million to expand access to medication-assisted treatment and Denver cracks down on drug use in parks.
Amid Opioid Epidemic, States Experiment With Recovery High Schools
As the nation struggles with an opioid-addiction epidemic, states increasingly have experimented with recovery high schools that enroll only kids who have drug and alcohol addiction problems as a way to help treat and support them. Today, there are 27 public or charter recovery high schools in 11 states, including Texas, Minnesota and New Jersey. This month, Florida will open its first public recovery high school, in Jacksonville. In July, Pennsylvania Gov. Tom Wolf, a Democrat, signed a bill to create a four-year pilot program to allow public school students to attend the state’s lone recovery high school, which is private. (Wiltz, 9/1)
The Associated Press:
Heroin Overdoses Surge In Louisville
During a recent shift spent treating numerous overdoses, Dr. Robert Couch heard a similar refrain from patients: they couldn't believe that the small amounts of heroin they took nearly killed them. On Tuesday, at Norton Hospital in Louisville, Couch treated eight overdose patients in five hours — an unprecedented number for the emergency physician. He sees it as a clear sign of a public health emergency. (Schreiner, 8/31)
New Hampshire Public Radio:
N.H. Wins Grant To Expand Access To Substance Abuse Medication
New Hampshire is one of nearly a dozen states getting a one million dollar federal grant to expand access to medication-assisted treatment for drug addiction. New Hampshire currently has the fewest number of physicians in New England who are certified to prescribe Suboxone, a drug used to reduce opioid cravings and ease withdrawals. Recently the federal government raised the number of patients doctors are allowed to treat with Suboxone from 100 to 275. (Sutherland, 8/31)
3,500 Needles Collected In 2016 At Denver Parks Prompt Drug-User Ban
More than 3,500 needles have been collected on the Cherry Creek trail and in other downtown Denver parks this year, an official said Wednesday, and that uptick in open drug use has spurred a new crackdown. Beginning Friday, Denver police will issue 90-day park or trail suspension notices to people they observe involved in illegal drug activity, whether it’s use, possession, selling or buying. (Murray, 8/31)
More people are using the drug, while fewer are reporting that they think it is harmful.
More US Adults Using Marijuana As Concerns About Risk Decline
Marijuana use is losing some of its taboo among US adults, according to a new analysis of government survey data. In a report published in the journal Lancet Psychiatry Thursday, federal researchers conclude that pot use began increasing in about 2007, coinciding with a drop in the number of Americans who see the drug as harmful. (Samuel, 8/31)
More U.S. Adults Use Pot As Laws, Attitudes Shift
An increasing number of U.S. adults are using marijuana, and attitudes about the drug are shifting – fewer people perceive pot as harmful, according to a new study published in The Lancet Psychiatry. Though the study cannot answer the question of why more Americans are using marijuana, the researchers say the data is consistent with other, similar research. The trend comes as a growing number of states are changing laws to legalize medical, and to a lesser extent, recreational marijuana, which may be playing a role in public perception of the drug. (Welch, 8/31)
Outlets report on health news from Florida, New Jersey, California, Illinois, Texas, New York and Ohio.
Health News Florida:
PriceCheck: Not All Health Care Transparency Tools Are Alike
A Google search for the term “medical prices” turns up several tools you can use to look up healthcare costs. If you have insurance, you may have seen a similar tool on your provider's website. Florida lawmakers even passed a price transparency law this year that will create a database of prices for medical procedures. But how do you know what the price comparison tools are really telling you?...On one side are for-profit sites that contract with health care providers. The sites list cash prices of common procedures that consumers can pay for up-front. (Ochoa, 8/31)
The Philadelphia Inquirer:
New Jersey Made Incorrect Incentive Payments To Hospitals
The New Jersey Department of Human Services made inaccurate incentive payments to 15 hospitals, according to an audit released Wednesday of a federal program designed to encourage the health care industry to adopt electronic health records. The agency overpaid 10 hospitals by $2.4 million and underpaid five hospitals by $137,329, according to the audit of Medicaid incentive payments by the U.S. Department of Health and Human Services' Office of Inspector General. (Brubaker, 8/31)
Update: Lawmakers Pass Measure To End Surprise Out-Of-Network Medical Bills
The California Assembly passed AB 72 late this afternoon. The bill heads next to Gov. Jerry Brown’s desk. It passed by a huge margin with bipartisan support, unlike a similar bill last year which stalled by three votes on the last day of the 2015 legislative session. (Klivans, 8/31)
Researchers Question Report Alleging Vulnerabilities In St. Jude Devices
A report published Aug. 25 by short-selling investment firm Muddy Waters and cybersecurity company MedSec Holdings claims that St. Jude's cardiac devices, particularly its Merlin@Home Transmitter, “lack even the most basic forms of security.” The analysis states that its devices lack hardware identify protection, encrypted software and anti-debugging mechanisms. St. Jude officials have consistently denied the allegations since the report published. (Castellucci, 8/31)
Health News Florida:
Supreme Court Turns Down Appeal In Tobacco Case
The Florida Supreme Court on Tuesday declined to take up an appeal by a woman who sued tobacco companies after her husband died of cancer following decades of smoking. The 4th District Court of Appeal in March overturned a multimillion-dollar verdict against R.J. Reynolds Tobacco Co. and Lorillard Tobacco Co. and ordered a new trial in the case filed by Kathleen Gafney. The appeals court found that Gafney's attorneys during a trial in Palm Beach County circuit court made improper comments aimed, in part, at getting jurors to "send a message" to tobacco companies. (8/31)
South Holland Woman Convicted In Health Care Referral Scheme
A federal jury on Tuesday found a South Holland woman guilty of pocketing kickbacks in exchange for referring patients to home health care agencies while she was running a Homewood -based business, according to the FBI...The jury convicted Williams on one count of conspiracy to solicit and receive remuneration in return for the referral of Medicare patients, and six counts of soliciting and receiving remuneration in return for the referral of Medicare patients, according to the FBI. Each count carries a sentence of up to five years in prison. (Swedberg, 8/31)
San Antonio Press Express:
Bexar Co. DA Nico LaHood Goes On Anti-Vaccination Rant On Facebook, 'I've Done My Own Research'
Bexar County District Attorney Nico LaHood continued his anti-vaccination crusade Tuesday night on his official Facebook page where he engaged in discussions, arguments and advocated for parents' rights to not immunize their children against diseases. (Bradshaw, 8/31)
The New York Times:
Lead Tests On New York City Schools’ Water May Have Masked Scope Of Risk
When the results of tests for lead in the water at more than 1,500 New York City school buildings were announced in July, officials said that fewer than 1 percent of all the samples taken showed lead concentrations that exceeded Environmental Protection Agency guidelines. Given other safety measures in place, officials assured parents, the water was safe to drink. But a review of how the testing was conducted suggests that the amount of lead in the water that students consume could be greater than the results indicate. (Taylor, 8/31)
Report Says Oil And Gas Production Will Exacerbate Asthma In Children
About 30,000 children in Ohio, including 7,000 in the Columbus area, will suffer asthma attacks each year by 2025 because of smog created by oil and gas operations, according to a new report. The report, released Wednesday by the Boston-based Clean Air Task Force, also quantified the average days of school missed and hours spent inside due to air pollution. The report should serve as a wake-up call for U.S. and Ohio residents, said Melanie Houston, director of oil and gas for the Ohio Environmental Council. (Tate, 8/31)
Cleveland Plain Dealer:
City Aiming To Register More Rental Properties As Part Of Plan To Reduce Lead Poisoning
Cleveland's Building & Housing department says it has a plan it hopes will increase landlords who currently register their rental properties with the city and revenue from that registration. The work started with the city's ongoing effort to reduce childhood lead poisoning cases, because children are more often lead poisoned in rental properties. Having more rentals registered would help the city perform planned health and safety inspections for city rentals, according to Ron O'Leary, director of the Building & Housing department. (Dissell, 9/1)
Opinion writers offer their thoughts on issues related to the federal health law's marketplaces.
The New York Times:
Obamacare Premiums Set To Rise, Even For Savvy Shoppers
In the last few years, even though premiums in the Affordable Care Act’s health insurance marketplaces were rising, most customers could avoid a big price rise by shopping for a cheaper plan. Next year, according to a preliminary analysis, that is going to be a lot harder. (Margot Sanger-Katz, 9/1)
Why Obamacare Can't Be What Its Supporters Want
In 2010, the problem with the U.S. health-care system was that we had a fragmented market that created regulatory headaches and all sorts of inefficiencies regarding the provision of care. We had four major government health care systems — Medicare, Medicaid/SCHIP, the Veterans Administration, and the military’s Tricare program — along with a bevy of smaller ones...Unfortunately, while basically everyone in the country thought that the U.S. health care system was as messed up as a party-school group house on graduation day, most people actually liked whatever coverage they had. (Megan McArdle, 8/31)
How To Fix The Exchanges: Focus On Health, Not Income
Now that United Healthcare, Humana, and Aetna are dropping out of or have already left the vast majority of the ACA (Affordable Care Act) Exchanges they were previously serving, and almost three-fourths of the non-profit CO-OP insurers established by the ACA with taxpayer start-up funds have gone bankrupt or otherwise out of business, it should be clear to anyone without a political ax to grind that something about the ACA Exchange system is not just flawed, but fatally flawed. (Robert Book, 8/31)
The Fiscal Times:
Obamacare’s Death Spiral Of Consumer Choice
The term “pro-choice” has a politically charged meaning, one that Democrats proudly assert when it comes to defending abortion. They also claimed that mantle for Obamacare. As we approach the fourth year of the exchanges, however, it’s clear that Democrats and Barack Obama have been as anti-choice in practice as it’s possible to be. (Edward Morrissey, 9/1)
Editorial pages across the country continue to offer perspectives on aspects of the EpiPen pricing news.
The EpiPen Drama Shows What’s Wrong With How Drugs Are Priced
The EpiPen pricing controversy is enough to trigger mental anaphylactic shock. First, Mylan raised the list price of EpiPens to more than $600 a pair. When protests predictably erupted, Chief Executive Officer Heather Bresch went on TV to say that if she cut the price of EpiPens, some people wouldn’t be able to get them anymore. Which is weird, because usually a lower price makes things easier to get. Then, on Aug. 29, Mylan announced it will sell a generic version of EpiPens at half the price—but keep selling the identical brand-name version at full price. ... None of this, including the original price hike, makes sense if you think of brand-name pharmaceuticals as normal products whose prices are set by the forces of supply and demand. (Peter Coy, 9/1)
Mylan's Sudden Plans For A Generic EpiPen
Mylan made a somewhat surprising announcement Monday that it would launch a generic version of its EpiPen and sell it for half the list price of its branded product. The company said it would launch the generic version in several weeks, pending label revisions. So, if the company can launch a generic product in a matter of weeks, where have these generic plans been all along? (Adam Rubenfire, 8/31)
EpiPen Debate And Out-Of-Control Drug Prices
It’s official. Mylan has gone too far. When the drug company raised the price of the EpiPen by 400 percent and boosted the CEO’s salary to $18 million, it definitely went beyond what the public will accept. In less than 10 years, the price for a two-pack of EpiPen Auto Injectors for life-threatening allergy relief has risen from approximately $100 to over $600. Some analysts have estimated that the tiny amount of epinephrine in an EpiPen is worth barely $1, and the auto injectors might cost as little as $5. (Twila Brase, 8/31)
EpiPen 'A Microcosm Of Broader Failures'
Epinephrine is a naturally-occurring substance, made by the adrenal gland. It was discovered more than 100 years ago. It is readily available in glass ampules for less than five bucks. By coupling with a syringe and a needle, which cost pennies, one can make a cheap EpiPen. Mylan sells its product for more than $600. So what happened? The EpiPen story is the story of crony capitalism, government meddling in medical care, and the lack of price discovery and competition in the medical markets. It is a microcosm of the broader failures of Obamacare. (Dr. Cameron S. Schaeffer, 8/29)
St. Louis Post-Dispatch:
EpiPen Price Scandal Reveals Larger Problem Of Runaway Drug Prices
It’s bizarre that Mylan NV, the same company that owns EpiPen, would commission an identical generic version of the same product and sell it for half the price. After all, Anheuser-Busch InBev wouldn’t make half-price generic Budweiser at its Pestalozzi Street plant. But the pharmaceutical business plays by different rules. It ruthlessly eliminates competition. It often collaborates with insurance companies and pharmacy benefits managers, the entities that are supposed to restrain it. It has co-opted much of the scientific research community and Congress. (8/31)
The Charlotte Observer:
Big Pharma Just Poked The Wrong Group: Moms
Big pharmaceutical companies may have finally crossed the line this time. The outrageous increase in the cost of the EpiPen – 32 percent this year alone – is certain to enrage and engage the country’s Number One voting bloc: moms. When Turing Pharmaceuticals increased the price of Daraprim, a drug used to treat an infection in HIV patients, from $13.50 to $750, there was outrage in the press followed by hearings in Congress. Although Turing promised to reduce the price of the drug, the company still hasn’t. And there is nothing – aside from public relations pressure – that can force Turing to keep its promise. (Dr. John M Scherr, 8/31)
Protecting Generic Pharma Competition Is Necessary Now
American brand and specialty drug prices are among the highest anywhere despite the fact that the U.S. pharmaceutical market is the largest in the world. Some of that problem may stem from public healthcare program fraud and an inefficient medical insurance system, but much more is the result of a long pattern of anticompetitive tactics in this highly concentrated industry. (Glenn B. Manishin, 8/31)
A selection of opinions on health care from around the country.
The Washington Post:
CDC And NIH Officials: Congress Is Showing How Not To Fight The Zika Virus
The potential cost of a funding shortfall will be measured in human misery and even death. Every child born with microcephaly as a result of the Zika infection of the mother during pregnancy could require care that costs the family and our health-care system anywhere between $1 million and $10 million over the lifetime of the child. Every child born with microcephaly faces a difficult future, filled with intensive therapy and support. It is a price that no child — no mother, no father, no family — should have to pay, especially given that it can be avoided. ... Congress returns next week. In the past, it has shown that it understands the importance of safeguarding Americans’ health and has supported biomedical research and vital public health priorities. It has proved that it can act in moments of crisis and in our nation’s hours of need. We’re asking Congress to do so again. (Tom Frieden and Anthony S. Fauci, 8/31)
The Washington Post:
Clinton Just Made A Very Important Announcement — And Hardly Anyone Is Talking About It
Hillary Clinton made one of the most consequential announcements of her campaign on Monday — and hardly anyone is talking about it. The Democratic presidential nominee released a wide-ranging mental-health strategy — and, unlike much of what she has proposed this election season, it has a real chance of becoming law. Congress has over the past several years put serious effort into reforming the federal government’s mental-health efforts, producing — but not yet passing — a slew of bills with bipartisan backing. This is one of the few issues on which lawmakers may be able to agree, even in a severely divided Washington, over the coming months. (8/31)
Time To Hit The Pause Button On Medicare’s Payment Demonstration Projects?
After a slow start in 2011, the Center for Medicare & Medicaid Innovation (CMMI) at the Centers of Medicare & Medicaid Services (CMS) seems to have gone into overdrive. As part of the Department of Health and Human Services’ pledge to move the majority of Medicare payments away from undifferentiated fee-for-service payments to some type of value-based care, CMMI has been sponsoring a wide variety of models. These include models that feature fee-for-service payments with incentives added, bundled or episode-based payments, and population-based payments. (Gail Wilensky, 8/31)
The Pill, The Condom, And The American Dream
Condoms alone will not restore the American Dream for today’s low-income families. The lesson here is not that IUDs obviate income transfers to the poor or inclusive housing policy in rich metros. The lesson, instead, is that improvements in early childhood achievement (and, with luck, those children’s adult outcomes) can come from surprising places. Perhaps birth control doesn’t just give women power over their own future; it empowers their future children, as well. (Derek Thompson, 8/31)
Bevin Ignored Concerns About Medicaid Plan
In spite of massive public outcry which included testimony from medical professionals, warnings from vision and dental experts, fact-driven data from advocates and pleas from Kentuckians who will be devastated by the loss of health care, Gov. Matt Bevin has submitted a harsh, draconian expanded Medicaid waiver proposal to the U.S. Department of Health and Human Services for consideration. In doing so, the governor has made good on his campaign promise to strip health care away from 440,000 Kentuckians. (State Rep. Darryl T. Owens, D-Louisville, 8/31)
Make Vaccinations Part Of Back-To-School Prep
Child care facilities, preschool programs and schools are particularly prone to outbreaks of infectious diseases. Kids in these settings can easily spread illnesses to one another and staff due to typical child behavior — poor hand washing, not covering their coughs, and other factors. Infants and toddlers in child care and preschool settings are also more vulnerable to vaccine-preventable diseases and their complications. In fact, children under the age of 5 are five times more likely than older children to be hospitalized with a serious vaccine-preventable disease. (Stephanie Wasserman, 8/31)
The Cleveland Plain Dealer:
Toledo Offers Lead-Poisoning-Prevention Guidepost For Cleveland
Cleveland, which has struggled to reduce the number of lead-poisoned children, ought to become the state's second city to do so. It's that important. The problem is horrendous. John Sobolewski, who supervises Cuyahoga County's lead poisoning program, told The Plain Dealer that 40,000 children living in the county over the last 15 years have tested positive for lead. About 80 percent of them live in Cleveland. (8/30)
The Boston Globe:
Hospital CEO Salaries Are More Than Optics
The economics of health care aren’t working for the poor and disabled. But somehow, they work just fine for hospital CEOs. As the Globe’s Robert Weisman recently reported, pay increases for top Massachusetts hospital CEOs outpaced the growth of state health spending, according to the most recent filings of compensation data by nonprofits with the IRS. (Joan Vennochi, 9/1)