- Kaiser Health News Original Stories 2
- Do Cell Phones Belong In The Operating Room?
- N.Y. Law Offers Model For Helping Consumers Avoid Surprise Out-Of-Network Charges
- Political Cartoon: 'Hide And Seek Counsel?'
- Administration News 1
- In Pushing States To Help Seniors Save For Retirement, Obama Lauds Medicare, Medicaid And Social Security
- Health Law 2
- Alaska Gov. To Announce Medicaid Expansion Plans Thursday
- Colorado's Exchange Board Gets New Members; Republicans Seek More Oversight Of MNsure
- Health IT 1
- Video Conferencing, Cell Phones And Novel Medical Apps -- How Technology Is Changing Medical Practice
- State Watch 2
- After A Decade Of Federal Control, Calif. Begins To Regain Responsibility For Health Care In State Prison System
- State Highlights: Kan. Official Urges Passage Of Controversial Health Compact; Poll Finds Many In Calif. Unaware Of Caregiver Program
From Kaiser Health News - Latest Stories:
A number of doctors and professional organizations are calling for clear rules on whether and how health care professionals can use cell phones while in the operating room. (Shefali Luthra, 7/14)
Under the comprehensive law, patients are generally protected from owing more than their in-network copayment, coinsurance or deductible on bills they receive for out-of-network emergency services or on surprise bills. (Michelle Andrews, 7/14)
Kaiser Health News provides a fresh take on health policy developments with "Political Cartoon: 'Hide And Seek Counsel?'" by Hilary Price.
Here's today's health policy haiku:
I told the app I
was seeing spots. Its reply?
"You have chicken pox."
- Marie Murphy
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:
President Barack Obama made these comments during a speech at the sixth White House conference on aging, an event that takes place roughly once a decade.
The New York Times:
Obama Wants More State Laws To Make Retirement Saving Easier
A handful of states have passed laws that require certain employers to automatically open retirement plans for employees when they are hired instead of waiting for workers to decide to do so on their own, and about 20 more are considering such laws. Mr. Obama said he wanted to encourage more of these laws to be passed. The president spoke during the sixth White House conference on aging, an event that takes place roughly once a decade. Mr. Obama noted that the conference was particularly well timed because it was being held almost 50 years after legislation was passed creating the Medicare and Medicaid programs, which provide health care to the elderly and the poor. (Harris,7/13)
Obama Pushes States To Help Millions More Save For Retirement
The president praised Medicare, Medicaid and Social Security and said the programs reaffirmed the greatness of the United States, allowing older Americans who had worked hard to retire independently. He used his grandmother as an example, saying Medicare and Social Security allowed her to continue to live on her own after she had retired and his grandfather died. (Kennedy, 7/13)
Los Angeles Times:
Obama Wants To Help California Create More Retirement-Savings Accounts
President Obama on Monday threw his weight behind California’s bid to provide more workers with retirement savings accounts. ... A few other states, including Illinois, Oregon and Connecticut, are pursuing similar plans. ... The goal is to provide workers with an added retirement benefit beyond Social Security and Medicare. (Peltz, 7/13)
The "surgeon scorecard," which is Web-based, free and supported by a non-profit consumers group, ranks surgeons in 14 types of major surgery including bypass, and total knee and hip replacement.
The Washington Post:
Need A New Knee? Heart Valve? Back Surgery? This Web Site Could Help You Find The Top Surgeons Near You.
Now a nonprofit consumers group has come out with a free surgeon rating tool that allows consumers to type in a Zip code and search for the top-performing surgeons in 14 types of major surgery. They include: heart valve and bypass surgery, total knee and hip replacement, gastric (stomach), hernia, and spine fusion surgery. The ratings are based on an analysis of federal government records of more than 4 million surgeries performed by more than 50,000 doctors. Using star ratings (5 stars being the best), the group identified surgeons who have better-than-average performances based on three criteria: Death rates; Other bad outcomes, such as infections, falls or other complications that resulted in longer hospital stays; or re-admissions. (Sun, 7/14)
'Surgeon Scorecard' Measures Docs By Complications
Surgeons around the country are now scored against their peers in a new statistic developed by a non-profit news organization that goes beyond hospital-level data, providing a never-before-available tool for consumers and generating debate and some angst in the surgical community. (Penzenstadler, 7/14)
In related news, Bloomberg takes a look at the geographic cost disparity -- sometimes within the same city or region -- that exists for surgical procedures -
Thirty Cities Where The Price Of A New Hip Can Double Across Town
In Dallas, a 15-mile trip can save a patient $12,000 on joint replacement surgery. Coloradans who come down from the mountains for treatment in Denver can save $19,000. And in Maryland, a 9-mile drive from Baltimore to the suburbs can save $36,000. Hospitals sometimes just a few miles apart get paid wildly different prices for hip or knee replacements in much of the U.S., according to an analysis of Medicare data. The public health insurance program for Americans over 65 spends $7 billion on more than 400,000 joint replacements each year. (Tozzi, 7/13)
The Wall Street Journal notes that changes in the insurance market could lead to new pressures as doctors likely face stingier reimbursements, with cancer treatments a possible target. Meanwhile, Bloomberg reports that insurers, which have been hesitant to cover costly hepatitis C drugs, will also feel a push from a report that finds these therapies cost effective.
The Wall Street Journal's Pharmalot:
Health Insurer Mergers Will Pressure Pharma Over High-Cost Drugs
As the nation’s biggest health insurers jockey for supremacy, drug makers should brace for added pressure because doctors are likely to face stingier reimbursement over the next few years. And cancer treatments, in particular, are expected to be targeted, according to a report from Moody’s Investor Service. (Silverman, 7/13)
Gilead Pills Priced At $1,000 A Day Are Found Cost-Effective
Health insurers that have been reluctant to cover hepatitis C drugs with list prices of $1,000 a daily dose will face more pressure after a report concluding the medications are “cost-effective” given their benefits. The report, still in draft form, is by an influential panel of doctors and medical experts that helps insurers set policies. While insurance companies already cover the sickest patients for treatments by Gilead Sciences Inc. and AbbVie Inc., they’ve resisted extending coverage to people who aren’t yet showing damage from the disease. Even with negotiated discounts, the pills can cost hundreds of dollars a day and are taken for eight to 12 weeks. (Bloomfield, 7/13)
Meanwhile, on the biotech front -
CMS Pay Proposal On Copycat Biotech Drugs Draws Criticism
Novartis AG, the first company to win United States approval to sell a copycat biotechnology drug, and Amgen Inc., a competitor in the emerging field, are questioning how Medicare officials plan to pay for these products. The Centers for Medicare and Medicaid Services last week said it plans to put products that are approved to deliver the same therapeutic protein in the body into a common group calculation. The approach, known as blended J codes, would make it more difficult to track cases where one manufacturer's version of a biotech medicine may have variations that cause complications, Kimberly Greco, director of research and development policy at Amgen, told reporters Monday after a Capitol Hill briefing. Having distinguishable codes in setting payments would make it easier to track the cause of potential adverse events for patients, she said. (Young, 7/13)
A spokesman for Gov. Bill Walker said the announcement won't mark the beginning of the program but will explain how the governor will roll it out. News outlets also report on some Medicaid developments in Arkansas and Indiana.
Alaska Dispatch News:
Alaska Gov. Walker To Announce Plans For Medicaid Expansion Thursday
Gov. Bill Walker will announce his plans to expand Medicaid in Alaska on Thursday, bringing him closer to fulfilling one of this top campaign promises, his spokeswoman said Monday. The scheduled announcement Thursday morning won’t mark the initiation of the program, but will explain how Walker intends to go forward on expansion without a mandate from the Republican-controlled Legislature, said Grace Jang, Walker's spokeswoman. The Legislature, with opponents of expansion in key leadership roles, failed to hold a vote on Walker's expansion bills. (7/13)
The Associated Press:
Walker To Announce Plans For Medicaid Expansion
Walker campaigned on expanding Medicaid coverage. ... In May, during the first special session, an administration bill to expand and make changes to the Medicaid program was tabled in the House Finance Committee for further review. Senate Finance did not take up the bill during this year's two special sessions. (/7/12)
The Associated Press:
Governor: More Help Allowed For Medicaid Check
Concerned about disruptions in health coverage for private-option enrollees and children from low-income families, Gov. Asa Hutchinson said in a letter to state lawmakers Monday that he has instructed the state Department of Human Services to "bring in additional resources as necessary" to help with the annual check of eligibility for Medicaid benefits. Hutchinson sent the letter to update lawmakers on an annual check of the incomes of about 600,000 Medicaid recipients, including tens of thousands of enrollees on the private option, that began a month ago using an electronic eligibility and enrollment system that has been under construction for more than two years. (Davis, 7/14)
Medicaid Director Lauds Lake County HIP Response
Lake County is one of the leading counties in [Indiana] when it comes to previously uninsured residents signing up for the Healthy Indiana Plan 2.0. In a Monday speech before the Gary Chamber of Commerce, Indiana Medicaid Director Joe Moser spotlighted the fact that 20,309 of 25,557 of Lake County enrollees were purchasing insurance for the first time through HIP 2.0 — and not rolled over from the previous version of HIP or other Medicaid programs. ... But Moser said that census data reveals that there are almost 7,000 Lake County residents who may qualify for HIP 2.0, but haven't enrolled yet. (Lazerus, 7/14)
News outlets report on developments related to the state health exchanges in Colorado and Minnesota.
Health News Colorado:
New Board Members Join Veterans On Exchange Board
A heath insurance broker and an insurance industry expert have joined Colorado’s health exchange board. Senate Republicans appointed Marc Reece of Aetna to the board while House Democrats picked Jay Norris, a health insurance broker from Northern Colorado. Both will serve four-year terms. (Kerwin McCrimmon, 7/13)
The Minneapolis Star-Tribune:
Citing Renewal Backlog, Republicans Call For MNsure Oversight Hearing
After word last week of a big backlog in public health insurance renewals in MNsure, Republicans want a legislative oversight committee to begin talking about fundamental changes for the state’s health insurance exchange. (Snowbeck, 7/13)
The Department of Veterans Affairs may have to take this step if Congress does not address the agency's $2.5 billion, current-year budget shortfall. This news comes as the Huffington Post reports more than 238,000 of the 847,000 veterans in the backlog awaiting care may have already died.
The Associated Press:
VA Says It May Shut Down Hospitals To Close $2.5B Budget Gap
The Department of Veterans Affairs may have to shut down some hospitals next month if Congress does not address a $2.5 billion shortfall for the current budget year, VA officials warned Monday. (Daly, 7/13)
The Huffington Post:
Nearly One-Third Of 847,000 Veterans In Backlog For VA Health Care Already Died
More than 238,000 of the 847,000 veterans in the pending backlog for health care through the Department of Veterans Affairs have already died, according to an internal VA document provided to The Huffington Post. Scott Davis, a program specialist at the VA's Health Eligibility Center in Atlanta and a past whistleblower on the VA's failings, provided HuffPost with an April 2015 report titled "Analysis of Death Services," which reviews the accuracy of the VA's veteran death records. The report was conducted by staffers in the VA Health Eligibility Center and the VA Office of Analytics. (Grim and Bendery, 7/13)
And in Missouri -
St. Louis Public Radio:
As More Women Enlist In Military, VA Health Care System Sees Changes
More than 38,000 veterans who live in Missouri are women, and that number continues to grow rapidly. That means changes are in store for the Veterans Health Administration, a network of hospitals and clinics that provide care to active duty service members and discharged veterans. Serving more women means expanding the VA’s capacity to offer gynecological exams, services surrounding childbirth, and counseling related to military sexual trauma. (Bouscaren, 7/13)
In his announcement, Walker said Washington leaders are out of touch with the nation, over-regulating businesses and forcing mandates such as President Obama’s health-care law. Meanwhile, Hillary Clinton, a Democratic presidential hopeful, offered a policy speech.
The Washington Post:
Scott Walker Vows To ‘Fight And Win’ With A Conservative Message For 2016
In a 33-minute speech, delivered extemporaneously, Walker had a sharp and ideological pitch focused on his victories over liberals in this blue-leaning state on issues including abortion, school vouchers and voter-ID requirements. ... On Monday evening, Walker, 47 — a Ronald Reagan devotee who was married on the Gipper’s birthday — said Washington leaders are out of touch with the nation, over-regulating businesses, weakening families and forcing mandates such as President Obama’s health-care law. (Johnson, 7/13)
The Associated Press:
Where They Stand: Scott Walker On Issues Of 2016 Campaign
Where two-term Wisconsin Gov. Scott Walker stands on various issues that will be debated in the Republican presidential campaign, a race he's joining. ... Walker, the son of a Baptist minister, opposes abortion rights, including in cases of rape and incest. As governor, he signed into law a bill requiring women to have an ultrasound before having an abortion. He's also set to sign a bill into law that would ban abortions after 20 weeks of pregnancy, with no exceptions for cases of rape or incest. ... Walker proposed, just six weeks after taking office in 2011, that public employees except for police and firefighters pay more for pension and health care benefits, and only be allowed to bargain collectively over base wage increases no greater than inflation. (7/13)
The Wall Street Journal:
Hillary Takes Aim At Republicans In Policy Speech
While liberals are keenly focused on economic inequality, much of Mrs. Clinton’s address centered on ways to boost growth, albeit growth that she said should be spread widely. That satisfied some centrist Democrats. Jonathan Cowan, president of Third Way, a think tank that has tangled with the party’s populist activists, was pleased that Mrs. Clinton didn’t call for a single-payer health-care system, where the government replaces private insurance companies, or a $15 federal minimum wage. (Meckler, 7/13)
A range of news stories detail how new technology is touching medicine in positive and negative ways.
Telemedicine Puts A Doctor Virtually At Your Bedside
Video conferencing technology can now connect patients and physicians almost instantaneously, offering convenience, efficiency and savings. But what happens to the doctor-patient relationship if you're never in the same room? (7/13)
Kaiser Health News:
Do Cell Phones Belong In The Operating Room?
Next time you’re on the operating table and you have one last look around as the anesthesiologist approaches, don’t be too sure that that person in scrubs looking at a smartphone is pulling up vital health data. He or she might be texting a friend, or ordering a new carpet. Cellphone use is not generally restricted in the operating room, but some experts say the time for rules has come. In interviews, many described co-workers’ texting friends and relatives from the surgical suite. Some spoke of colleagues who hide a phone in a drawer and check it when they think no one is watching. (Luthra, 7/14)
The Sacramento Bee:
What’s That? Figure 1 Lets Health Care Professionals Crowdsource Patient Cases
It’s been dubbed “Instagram for doctors.” With a tap on their smartphones, medical professionals are using a novel app, called Figure 1, to upload photos, X-rays and other images of their patients’ maladies. Like Facebook for health care, Figure 1 lets colleagues chime in with comments, questions and potential diagnoses. The mobile app, one of thousands populating the health care industry, gives physicians and other health care providers instant, pull-it-from-their-pocket access to unusual clinical cases seen by colleagues around the world. It’s part of a wave of social media and technology tools that are continually changing the way doctors interact with patients – and each other. (Buck, 7/13)
The California Department of Corrections and Rehabilitation took over medical responsibilities at Folsom State Prison -- the first of many steps in ending a long-standing lawsuit.
Los Angeles Times:
California Regains Control Over Healthcare At Folsom Prison
The state has regained full control of one of its prisons for the first time since 2006, when a federal court stripped California of control over its sprawling inmate healthcare system. J. Clark Kelso, the overseer of prison medical care and spending, returned responsibility for the health of some 2,400 inmates at Folsom State Prison to California’s corrections department on Monday. (St. John, 7/13)
The Associated Press:
California Begins To Regain Control Of Prison Health Care
California on Monday began regaining responsibility for its prison health care system after nearly a decade of federal control and billions of dollars in improvements. A court-appointed receiver returned medical care at Folsom State Prison to the California Department of Corrections and Rehabilitation, the first of many steps toward ending a long-running lawsuit. The decision comes a decade after a federal judge found that conditions in the state's prisons were so poor that an average of an inmate each week was dying of medical malpractice or neglect. A receiver was appointed to run the system in 2006. Since then, the state has spent $2 billion for new prison medical facilities, doubled its annual prison health care budget to nearly $1.7 billion and reduced its prison population by more than 40,000 inmates. (Thompson, 7/13)
Health care stories are reported from Kansas, California, Oregon, New York, Florida, Kentucky, Missouri and North Carolina.
The Lawrence Journal-World:
Kansas Secretary Of State Seeks Approval Of Health Compact
Kansas Secretary of State Kris Kobach is urging Congress to ratify a mechanism that he says would give states an avenue to exempt themselves from the Affordable Care Act. But critics of the plan have said the plan could jeopardize the health care of people who receive other forms of federal health care benefits, including more than 450,000 seniors in Kansas on Medicare, the federal health insurance program for the elderly. (Hancock, 7/13)
The Kansas Health Institute News Service:
Kobach Urges Congress To Ratify Controversial Health Compact
Kansas Secretary of State Kris Kobach is urging members of Congress to ratify a controversial health compact that would give Kansas and eight other states control over Medicare and other federal health care programs within their borders. Kobach, a Republican whose positions on voter fraud and immigration have made him a controversial figure both in Kansas and nationally, said in a letter to Republican members of Congress that the compact is “the only legal path that we have left to end Obamacare,” referring to the federal Affordable Care Act which was spearheaded by President Barack Obama. (McLean, 7/13)
The Associated Press:
AP-NORC Poll: Many Californians Unaware Of Caregiver Program
Christine McCormack quit her job as a restaurant manager two years ago to care for her 88-year-old mother-in-law. While it doesn’t make up for all of her lost income, she’s getting some financial help through an innovative program that allows many of California’s low-income senior citizens and disabled residents to remain in their home. ... A poll by the Associated Press-NORC Center for Public Affairs Research shows that less than one-third of Californians age 40 and over have heard of the program, which dates back to the 1950s. (Freking, 7/14)
Oregon Governor Signs Paid Sick Leave, Retirement Legislation
Oregon Governor Kate Brown signed legislation on Monday mandating paid sick leave for nearly all workers and establishing a first-of-its kind state-run retirement program for private sector employees. (7/13)
Kaiser Health News:
N.Y. Law Offers Model For Helping Consumers Avoid Surprise Out-Of-Network Charges
It’s a situation that occurs all too often: Someone goes to the emergency room and doesn’t learn until he gets a hefty bill that one of the doctors who treated him wasn’t in his insurance network. Or a diligent consumer checks before scheduling surgery to make sure that the hospital she plans to use and the doctors that will perform it are all in network. Then she learns later that an assistant surgeon who she didn’t know and who wasn’t in her network scrubbed in on her operation. (Andrews, 7/14)
The Kansas Health Institute News Service:
Amerigroup Leads MCOs In Kansas Campaign Donations
The three companies that administer KanCare have donated more than $50,000 to the campaigns of current Kansas legislators since the $3 billion Medicaid program began in 2013. Amerigroup leads the trio with $27,750 in donations, as of the most recent filings, which include donations through Dec. 31, 2014. Centene Management Corporation, the parent company of Sunflower State Health Plan, gave $17,250 in that time period. United for Health, the political action committee of United HealthCare, came in a distant third with $6,200 in campaign cash. Amerigroup donated to 20 current senators and 37 current House members, Centene gave to five senators and 26 House members, and United HealthCare donated to nine senators and four House members. (Marso, 7/13)
New Law Expands List Of Vaccines Available In Pharmacies
You can go to your local pharmacy to get a tetanus shot or get vaccinated for foreign travel, thanks to a new law that took effect July 1. So far, Florida pharmacists could only administer vaccines for flu, pneumonia and shingles. The new law allows them to administer all adult vaccines that are recommended by the Centers for Disease Control and Prevention, such as measles, mumps, rubella (MMR); the tetanus, diphtheria and pertussis (Tdap) vaccine; human-papillomavirus vaccines; hepatitis A and B vaccines; and vaccines needed for travel or in case of an emergency. (Miller, 7/13)
Floyd Memorial Hospital Weighs Options
Struggling against stiff headwinds, Floyd Memorial Hospital is looking for a financial lifeline. Executives at the 236-bed facility in New Albany, [Ind.] said they intend to hire a consultant to help weigh options for securing the institution's survival — through a merger, an affiliation with a larger hospital group or another deal. The nonprofit, county-owned hospital with 2,200 employees, including 100 doctors, isn't for sale, Dr. Daniel Eichenberger, Floyd's interim CEO, said Thursday in response to a burst of recent rumors about moves executives are contemplating. (Schneider, 7/13)
St. Louis Public Radio:
Lack Of State Budget Puts East St. Louis Health Care Facility Into Jeopardy
Illinois has yet to pass a state budget, and an East St. Louis healthcare facility is facing layoffs and other tough decisions as a result. The East Side Health District, which provides health services to area residents, could lay off up to 30 workers, (an amount totaling up to two-thirds of the work staff) and may end up closing altogether if it does not receive state funding soon. (Kellogg, 7/13)
The Associated Press:
400 Employees Of Novant Health To Lose Their Jobs
Novant Health Inc. says it plans to lay off up to 400 employees across the Winston-Salem-based system as part of a reorganization that began last fall. Multiple media outlets report that Novant is recruiting for 1,000 open positions. After deciding which employees can be transferred to new positions, Novant officials say about 400 people will lose their jobs. (7/13)
The Charlotte Observer:
Up To 400 Workers To Be Laid Off In Novant Health Reorganization
Up to 400 Novant Health employees – or 2 percent of the hospital system’s workforce – will be laid off in coming days as part of a reorganization that began last fall. The changes became public Monday as officials of the Winston-Salem-based system began talking with Charlotte-area employees about potential reassignments as some positions are eliminated. Some changes are effective immediately, but others will be made in the next 45 days. The changes were necessary because of “declining reimbursements and many other challenges facing the healthcare industry today,” the statement said. “Teams across the organization have worked together to standardize processes which will improve patient quality and safety outcomes, patient satisfaction and achieve financial savings to ensure Novant Health’s long-term financial stability.” (Garloch and Chaney, 7/13)
Health News Florida:
Growers, Docs File Low-THC Pot Applications
The Florida Department of Health has 90 days to decide which five nurseries will be allowed to grow low-THC medical marijuana in Florida. As of last week, 24 nurseries had submitted 28 applications. Also, 36 Florida doctors have signed up to dispense the low-THC medical marijuana. It's been more than a year since lawmakers approved a non-euphoric strain of medical marijuana. But its implementation has been slowed by lawsuits. (Aboraya, 7/13)
A selection of opinions on health care from around the country.
A Better Way to Die
Americans spend a fortune on end-of-life care -- including on aggressive treatments with little prospect of success and every prospect of making patients' last months miserable. Choosing to forgo such interventions would save money, which rightly arouses suspicion that economy is the motive. It shouldn't be. Rethinking end-of-life care should be about improving quality-of-life care. That would be desirable even if it made health care more expensive. (7/12)
The Philadelphia Inquirer:
Death Panels Are Back -- Just Ask Sarah Palin
Why has the cry of death panels not been as widespread this time? Perhaps because most politicians recognize that encouraging physicians to discuss end-of-life planning with patients is a good idea. It empowers patients to take control of important decisions. Without prompting from their physician, patients may be reluctant to initiate discussion of such a sensitive subject or may even be unaware that there are decisions to discuss. But when patients do engage in advance planning, wrenching decisions can be avoided later on, sparing many families from emotional turmoil. (Robert I. Field, 7/13)
Silence Isn't Golden: The Case For Expanding Medicare
Throughout its history Medicare has always been a dynamic program. Unfortunately, today it seems the only time Congress talks about Medicare is to cut benefits, shift costs or find ways to take money from the program to fund other federal priorities. Last year's vote to extend the Medicare sequester cuts to cover a reversal of cost-of-living cuts to veterans' pension benefits was followed just last month by a proposal to use Medicare to pay for part of the training assistance for workers who lose jobs due to the trade deal. Using Medicare to fund unrelated programs is a relatively new yet growing trend that Congress must stop. Medicare isn't Washington's ATM. (Max Richtman, 7/13)
Save Medicare, Starting With Your Hips
In January, [Health and Human Services Secretary Sylvia M.] Burwell set goals for Medicare: By the end of 2016, 30 percent of payments are to be based on value, and 50 percent by the end of 2018. To get there, we won't be able to rely exclusively on voluntary programs, in which providers choose whether or not to shift to value-based payment. Instead, Burwell needs to use her statutory authority to introduce mandatory, and preferably national, programs. Hip and knee replacements are a great place to start. (Peter R. Orszag, 7/9)
The Philadelphia Inquirer:
Pharma Weakens FDA Oversight As Price Of Letting Congress Increase Funding
More funding for NIH is all to the good, but other provisions of the [21st Century Cures Act] could easily compromise the health of Americans that use prescription medications or devices. Lobbyists for the pharmaceutical and device companies responsible for drafting the bill promoted it to Congress as a necessary step for speeding the approval of new products. But the record shows that approvals of new drugs and devices in the U.S. are already efficient and swift. (Daniel R. Hoffman, 7/13)