- Kaiser Health News Original Stories 2
- The 'Perfect Storm': Redirecting Family Planning Funds Could Undercut STD Fight
- 'Where The Need Is:' Tackling Teen Pregnancy With A Midwife At School
- Political Cartoon: 'End Run?'
- Pharmaceuticals 1
- Advocacy Group Blasts Democratic Lawmakers For Their Support Of Pharma's 'Doughnut Hole' Battle
- Health Care Personnel 2
- USC's Handling Of Complaints Against Campus Gynecologist Comes Under Scrutiny By Federal Government
- AMA Opts To Continue Reviewing Its Opposition To Physician-Assisted Dying
- Public Health And Education 4
- Ticking Time Bombs: Cells Successfully Edited By CRISPR Technology Have Increased Risk Of Triggering Cancer
- Actress, Friend Of Anthony Bourdain's Partner Calls For 'Collective Conversation' About Depression
- Anniversary Of Pulse Nightclub Shooting Marked With Rallies For Tighter Gun Restrictions
- When 20/20 Vision Isn't The End Of The Story: Lasik Patients Suffering From Debilitating Side Effects
- Marketplace 2
- Experiments To Cut Health Care Costs Emerge As Corporations' Frustrations With High Prices Boil Over
- Private Equity Firm KKR Snaps Up Physician Provider Envision In Massive $5.57B Deal
- Medicaid 1
- Families Struggle To Find Providers Who Will Accept Low Medicaid Rates For Autism Treatment
- State Watch 1
- State Highlights: Huge Tobacco Ban Victory In San Francisco Sparks Action Elsewhere; Turmoil Over Cincinnati VA Clinic Renewed After Surgery Patients Were Turned Away
- Editorials And Opinions 3
- Perspectives: Regard Suicide As Medical Problem, Invest In Research
- Parsing Policies: Health Law Gutting Continues With Latest Move On Pre-Existing Conditions; Verdict Still Out On Measure To Improve Care For Veterans
- Viewpoints: One Quick Solution Can Save Lives During Opioid Epidemic
From Kaiser Health News - Latest Stories:
Some public health officials fear that the Trump administration’s proposals to change how Title X funding is handled may impede the effort to cut the record number of sexually transmitted diseases. (Michelle Andrews, 6/12)
While U.S. teen pregnancy rates overall have trended steadily downward in the past decade, they remain high in some communities, particularly for black and Latina teens. In one part of Washington, D.C., a high school midwife program is a novel approach that's showing promise in tackling the problem. (Selena Simmons-Duffin, NPR, 6/12)
Kaiser Health News provides a fresh take on health policy developments with "Political Cartoon: 'End Run?'" by Lisa Benson.
Here's today's health policy haiku:
THE NEXT THING TO GO?
May soon be excludable.
Buy insurance now!
- Ernest R. Smith
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Summaries Of The News:
The agency released guidelines on Monday specifically geared toward helping states use Medicaid to help infants born addicted to opioids. Meanwhile, lawmakers worry that the FDA is not doing enough to stop the flow of illegal drugs into the country.
CMS Releases Guidance To States On Using Medicaid To Address Opioid Crisis
The Centers for Medicare and Medicaid Services (CMS) on Monday released guidance aimed at helping states leverage Medicaid to combat the opioid epidemic. Specifically, the guidance focused on information related to covering services for infants born exposed to opioids and how to enhance federal funding for telemedicine and programs that keep tabs on patients’ prescriptions. (Roubein, 6/11)
Concord (N.H.) Monitor:
New Hampshire Drug And Mental Health Providers To Rally For Better Payments
Without some action, the state’s newly approved Medicaid expansion program could saddle substance abuse and mental health treatment providers with lower payouts that could force cuts to staffing and services when the law takes effect next year, providers say. ...The passage of a five-year extension of the state’s Medicaid expansion program was hailed as a boost to both health care services and drug treatment services across New Hampshire. With it came an expansive change, intended as a cost-effective improvement. (DeWitt, 6/11)
House Panel Questions FDA's Track Record Combating Illegal Opioids
U.S. lawmakers fear the Food and Drug Administration is not doing enough to stop the flow of illegal drugs into the United States as the country works to combat the opioid epidemic. Republican and Democratic members on the House Energy and Commerce Committee questioned whether the FDA's criminal investigators are effective at blocking illegal drugs at U.S. ports of entry, in a letter seen by Reuters. (Lynch, 6/11)
The lawmakers signed a letter that encouraged congressional leaders to relax a policy enacted earlier this year that put drug companies on the hook for a higher percentage of seniors’ prescription drug costs beginning in 2019. Meanwhile, HHS officials are meeting with drug companies to push for voluntary price cuts.
Drug Pricing Advocates Take Aim At Democrats For Supporting Pharma
Fifty congressional Democrats signed on to a letter advancing the pharmaceutical industry’s talking points — and now a drug pricing advocacy group is calling them out. Patients for Affordable Drugs sent a letter this morning to Speaker Paul Ryan and House Minority Leader Nancy Pelosi, along with the 50 Democrats, condemning the members who signed on to a separate May 24 missive that supports one of the drug industry’s chief lobbying priorities: a change to their financial liability in the so-called “donut hole.” (Mershon, 6/11)
Trump Officials Meet With Drug Companies To Push For Voluntary Price Cuts
Department of Health and Human Services (HHS) officials have been meeting with pharmaceutical companies to seek voluntary cuts in drug prices, according to sources familiar with the meetings. Voluntary cuts in prices would allow the administration to immediately tout benefits of President Trump's drug pricing plan, which was announced last month, rather than having to wait for any regulatory actions to be put forward and take effect. (Sullivan, 6/11)
In other pharma news —
FDA Reprimands AbbVie For Failing To Properly Probe Death Complaints
In an unusual rebuke, AbbVie was reprimanded by the Food and Drug Administration for sloppy procedures when reviewing complaints of deaths that were reported in connection with three of its medicines, including the best-selling Humira rheumatoid arthritis treatment. Following an inspection at a North Chicago, Il., facility late last year, FDA examiners found the company failed to “thoroughly investigate” complaints over certain syringe kits for its Lupron medication that were associated with deaths, according to an inspection report that was issued by the agency last Dec. 15, and was obtained by STAT, but is not yet available on the FDA web site. Lupron is used to treat endometriosis and uterine fibroids, among other illnesses. (Silverman, 6/8)
Biotech's Soon-Shiong Hiring Bankers For Nant Cancer Drug IPO
Billionaire Patrick Soon-Shiong plans to take an experimental cancer treatment company public this year and has begun hiring bankers, the biotechnology entrepreneur told Reuters. The former surgeon said in a recent interview that the new company, to be called Nant, would use most of the money raised from the initial public offering to develop a pipeline of cancer drugs, although the amount of financing has yet to be determined. (Beasley, 6/11)
Hospitals are worried about the financial burden of the rule, and say that it's redundant because protections for employees' religious beliefs are already in place.
White Houses Taps The Brakes On HHS Religious Rule
The White House has urged HHS not to finalize a rule that will require hospitals and physician practices to create standards and procedures to protect their employees' religious and moral beliefs until it can elaborate how the policy will affect the industry. HHS received more than 72,000 comments on the rulemaking before the March deadline. The agency is still drafting a final version of the rule, but proactively asked the Office of Management and Budget to allow it to confirm that providers were both complying with the rule and notifying staff and patients of their rights. (Dickson, 6/11)
In other news from the Trump administration —
Alcohol Study Failed To Seek FDA Approval, Possibly Violating Federal Rules
The controversy surrounding a study of whether moderate drinking might prevent cardiovascular disease isn’t over: If one interpretation of federal regulations is correct, the study may be in violation of Food and Drug Administration requirements meant to protect the health of research volunteers. STAT has learned that the study’s leaders failed to seek a form of regulatory approval intended to protect study participants and ensure they understand the possible health risks of the research. By not seeking approval from the FDA, said public health researcher Dr. Michael Siegel of Boston University, the study “is in violation of federal law.” (Begley, 6/12)
The Department of Education has launched an investigation into the university's response into complaints against Dr. George Tyndall and his alleged misconduct going back decades.
U.S. Opens Inquiry Into Gynecologist Scandal At University Of Southern California
The U.S. Education Department has opened an investigation into how the University of Southern California handled complaints that a longtime campus health clinic gynecologist sexually harassed or abused his patients during pelvic examinations. The agency's Office for Civil Rights will examine USC's response to reports of such misconduct by Dr. George Tyndall that date back to 1990 but were not fully investigated by the university until the spring of 2016, the department said in a statement. (Gorman, 6/12)
The Wall Street Journal:
Education Department Launches Investigation Into University Of Southern California
USC has been dealing with fallout from allegations that the doctor, George Tyndall, had abused students as far back as the 1990s by conducting improper pelvic exams and making sexually inappropriate comments to patients during exams. By the end of May USC had received more than 410 complaints against Dr. Tyndall, via telephone and online forms, while at least a dozen women have filed lawsuits against Dr. Tyndall and the school. The Los Angeles Police Department is conducting a criminal probe, though Dr. Tyndall hasn’t been charged with any crime. (Korn, 6/11)
Los Angeles Times:
USC's Handling Of Complaints About Campus Gynecologist Is Being Investigated By Federal Government
Secretary of Education Betsy DeVos, who has been criticized for taking a less vigorous approach to examining sexual misconduct than predecessors, called for a “systemic” examination of USC and urged administrators to fully cooperate. “No student should ever endure sexual harassment or abuse while trying to pursue their education,” DeVos said in a statement. The Education Department’s action is the second high-profile investigation of a university’s handling of sexual misconduct complaints this year. The agency launched an investigation in January into Michigan State’s response to Dr. Larry Nassar, the USA Gymnastics doctor convicted of sexual misconduct toward young patients. (Hamilton and Ryan, 6/11)
The nation's leading doctors group on Monday voted 56-44 percent to keep studying its current guidance, which states that medically-assisted deaths are “fundamentally incompatible with the physician’s role as healer.”
The Washington Post:
American Medical Association To Keep Reviewing Its Opposition To Assisted Death
A recommendation that the American Medical Association maintain its opposition to medically assisted death was rejected Monday, with delegates at the AMA's annual meeting in Chicago instead voting for the organization to continue reviewing its guidance on the issue. Following a debate on whether the nation’s most prominent doctors’ group should revise its Code of Medical Ethics, the House of Delegates voted by a margin of 56 to 44 percent to have the AMA’s Council on Ethical and Judicial Affairs keep studying the current guidance. That position, adopted a quarter-century ago, labels the practice “physician-assisted suicide” and calls it “fundamentally incompatible with the physician’s role as healer.” (Bever, 6/11)
AMA Could Be Reconsidering Stance On Physician-Assisted Suicide
The issue was one of the more contentious items discussed during the first day of voting for the AMA's governing body. The nation's leading physician organization was considering adopting recommendations from the AMA's Council on Ethical and Judicial Affairs that concluded the current definition of physician-assisted suicide within the body's Code of Medical Ethics should not be changed. The AMA's current policy on physician-assisted suicide is that it is "incompatible with the physician's role as healer." A study two years in the making looked at two resolutions that requested the AMA replace the term "physician-assisted suicide" with "aid in dying", and that the group should take a neutral stance on the practice of aid in dying. (Johnson, 6/11)
Although the companies' stocks took a huge hit, experts "haven't freaked out" at the findings.
CRISPR-Edited Cells Might Cause Cancer, Two Studies Find
Editing cells’ genomes with CRISPR-Cas9 might increase the risk that the altered cells, intended to treat disease, will trigger cancer, two studies published on Monday warn — a potential game-changer for the companies developing CRISPR-based therapies. In the studies, published in Nature Medicine, scientists found that cells whose genomes are successfully edited by CRISPR-Cas9 have the potential to seed tumors inside a patient. That could make some CRISPR’d cells ticking time bombs, according to researchers from Sweden’s Karolinska Institute and, separately, Novartis. (Begley, 6/11)
CRISPR Scientists Are In For The Long Haul. Wall Street Is Less Patient
Investors’ bullishness on the potential of gene-editing technologies has turned a trio of startups into multibillion-dollar enterprises. But some unforeseen scientific findings, courtesy of a pair of new scientific papers, provides a jarring reminder to the market: Until this newfangled technology is proved safe in actual humans, investing in CRISPR stocks will remain a head-spinning experience. (Garde, 6/11)
CRISPR Stocks Tank After Research Shows Edited Cells Might Cause Cancer
Shares of companies developing CRISPR-based therapies slid Monday after STAT News reported two new studies showed edited cells might cause cancer. Gene editing tool CRISPR-Cas9 has been hailed as a breakthrough that could allow scientists to treat and possibly even cure genetic diseases. In two studies published Monday in the journal Nature Medicine, researchers found editing cells' genomes with the technique might increase the risk of cancer. Those edited cells are those ones that are intended to treat diseases. (LaVito and Tirrell, 6/11)
Also, researchers examining the impact of social media on the mental health of college students report negative experiences increased symptoms of depression.
The New York Times:
Rose McGowan Calls For ‘Collective Conversation’ On Depression After Bourdain’s Death
The actress Rose McGowan echoed calls for a broad conversation about depression and mental illness in an open letter on Monday about her friend Asia Argento, an actress, and Ms. Argento’s partner, Anthony Bourdain, who killed himself last week. “To the media and to the random commenter, Anthony would never have wanted Asia to be hurt, I’d like to think he would want us to have the collective conversation that needs to be had about depression,” she wrote. (Chokshi, 6/11)
Toll Of Twitter Trolls: Study Delves Into Social Media's Link To Depression
University of Pittsburgh researchers surveyed more than 1,000 American college students ages 18 to 30 about their social media usage, as well as the valence — psychology slang for "goodness" or "badness" — of these online experiences. ...The researchers found that negative experiences on social media were “strongly and directly related” to increased symptoms of depression, as expected. However, positive experiences were not significantly protective against depression. (Kaplan, 6/11)
The death toll from Pulse ranks as the second-most lethal mass shooting in the United States, surpassed only by the 59 lives lost when a gunman opened fire in October 2017 on an outdoor country music festival from a high-rise hotel window in Las Vegas and then killed himself.
Orlando Rally Marks Second Anniversary Of Nightclub Mass Shooting
Hundreds of protesters, including survivors from two of Florida's deadliest modern mass shootings, staged a rally in Orlando on Monday to call for tougher firearms restrictions two years after a gunman killed 49 people at the Pulse nightclub. The demonstration, held on the eve of the shooting anniversary, preceded a day of events planned in Orlando commemorating the bloody rampage by a South Florida security guard who professed allegiance to Islamic State militants. (Gorman, 6/11)
The Associated Press:
2nd Anniversary Of Pulse Massacre Marked By Art, Litigation
Survivors and victims' relatives are marking the second anniversary of the Pulse nightclub shooting with a remembrance ceremony, a run, art exhibits and litigation. Ahead of Tuesday's commemoration of the massacre of 49 people at the gay nightclub, some survivors and victims' relatives have sued the Orlando Police Department and the owners of the nightclub. (Schneider, 6/10)
In other news —
The New York Times:
Illinois Prohibits Guns On Campuses. Teachers Are Training To Use Them Anyway.
Illinois is one of 40 states that prohibit concealed weapons on school campuses. That hasn’t kept teachers there from turning out in droves for firearms training, spending hours in classrooms and on shooting ranges — receiving lessons, for a change. Across the state, businesses have begun offering free concealed-carry training sessions to teachers and school staff members, a seemingly uncoordinated response to mass shootings in schools. Many of them are banking on a proposal to allow armed faculty that’s currently making the rounds in school board meetings. (Gomez, 6/12)
Patients whose vision is improved to 20/20 are considered success stories, but just because they can now see the little letters on the charts doesn't mean the procedure went off without a hitch. In other public health news: PrEP and HIV; the nationwide DNA research initiative; lobotomies; belly fat; exercise; genetic tests; hunger and irritation; 3D organs; and more.
The New York Times:
Lasik’s Risks Are Coming Into Sharper Focus
Ever since he had Lasik surgery two years ago, Geobanni Ramirez sees everything in triplicate. The surgery he hoped would improve his vision left the 33-year-old graphic artist struggling with extreme light sensitivity, double vision and visual distortions that create halos around bright objects and turn headlights into blinding starbursts. His eyes are so dry and sore that he puts drops in every half-hour; sometimes they burn “like when you’re chopping onions.” His night vision is so poor that going out after dark is treacherous. (Rabin, 6/11)
The New York Times:
As An H.I.V. Prevention Drug Surged In Australia, Condom Use Fell
The rollout of a drug that prevents H.I.V. infection was followed by a reduction in condom use among gay and bisexual men in Australia, according to a study published in the journal Lancet H.I.V. But so effective was the drug that H.I.V. infection rates in the study region declined anyway, the researchers concluded. During the rapid distribution of a drug that prevents infection — a strategy called pre-exposure prophylaxis, or PrEP — among gay and bisexual men in Australia, researchers found that unprotected sex increased even among those not on PrEP, suggesting that perceptions of risk had declined in communities where the drug was widely available. (Baumgaertner, 6/11)
Nationwide Program Seeks 1 Million Volunteers For Medical Research. Here's Why.
It’s an ambitious goal: Recruit 1 million people to contribute their time and, in some cases, DNA toward a research project aimed at learning how to better treat diseases based on genetics, lifestyle and environment. Northwestern University research assistant professor Joyce Ho says she’s up for the challenge. Health care institutions across the country are taking part in the All of Us Research Program, and Ho is Northwestern’s lead investigator on the project. The Illinois Precision Medicine Consortium, which includes Northwestern, University of Illinois at Chicago, University of Chicago, Rush University Medical Center and NorthShore University HealthSystem, has received $51 million from the National Institutes of Health to gather data and samples from 93,000 volunteers over the next five years. (Schencker, 6/11)
A Shameful Medical History: Using Lobotomies To Treat Ulcerative Colitis
The radical idea of using lobotomy to treat ulcerative colitis arose from a theory in vogue at the time: The disease was psychosomatic, meaning it originated from mental or emotional causes. This concept evolved from ancient observations that emotions can cause physical changes. Think sweating under stress, stomachaches before marriage, battlefield diarrhea, and the like.”Emotions and Bodily Changes,” a persuasive collection of anecdotes published in 1935 by psychiatrist Helen Flanders Dunbar, helped set the stage for viewing many illnesses as psychosomatic. (Carrier, 6/12)
The New York Times:
The Dangers Of Belly Fat
If you do nothing else today to protect your health, consider taking an honest measurement of your waist. Stand up straight, exhale (no sucking in that gut!) and with a soft tape measure record your girth an inch or two above your hip bones. The result has far greater implications than any concerns you might have about how you look or how your clothes fit. In general, if your waist measures 35 or more inches for women or 40 or more inches for men, chances are you’re harboring a potentially dangerous amount of abdominal fat. (Brody, 6/11)
Young Women Get Exercise Less Than Men Do
Young women, especially young women of color, tend to get less exercise than their male counterparts, and the disparities worsen after high school ends. This is the finding of a study published Monday in the journal JAMA Pediatrics. As teens, 88 percent of boys report being physically active, compared to 78 percent of girls. Once the high school days of soccer games, track practices and physical education classes have ended, around 73 percent of young men stay active, but only 62 percent of women do. (Watson, 6/11)
Genetic Tests And Research Get Personal In 'She Has Her Mother's Laugh'
As a science columnist for The New York Times, Carl Zimmer had reported extensively about genetics and the role gene mutations play in various ailments. After a while, he got to wondering about what secrets his own genetic code holds. "I wanted to know if there was anything I needed to worry about," Zimmer says. "We all think back to our relatives who got sick and then wonder, 'Is that in me?' " (Gross, 6/11)
How Hunger Pangs Can Make Nice People 'Hangry'
Hunger can trigger cruel words from kind people. A starved dog lover might fantasize about punting the neighbor's Chihuahua that just will not shut up. A puckish but otherwise nice person might snap at a friend, "Bring me the freaking cheesesteak before I flip this TABLE!" They are, in a word, "hangry," or irrationally irritable, upset or angry because of hunger. But how hunger turns into hangriness is a mystery, says Jennifer MacCormack, a doctoral candidate at the University of North Carolina, Chapel Hill in psychology and neuroscience, who wanted to understand the phenomenon. "The mechanism isn't clear on how [hunger] affects your emotions or the exact emotional processes," she says. (Chen, 6/11)
The Washington Post:
3D Organs Help Surgeons Figure Out Out To Operate
Bernice Belcher couldn’t get out of bed. It wasn’t that she was tired — she’d had a good night’s sleep. But every time the 77-year-old from Columbus, Ohio, tried to get up, she became so dizzy she had to lie down again. That’s how she eventually found herself in consultations with surgeons who told her she needed an artificial heart valve, to be done by open-heart surgery. They had abandoned the thought of less-invasive surgery — transcatheter aortic valve replacement, or TAVR, because Belcher’s aortic root, where the body’s main artery meets the heart, wasn’t long enough to have an artificial valve implanted using a catheter. (Blakemore, 6/11)
The New York Times:
Secrets Of The Y Chromosome
In advance of Father’s Day, let’s take a moment to sort out the differences and similarities between “Dad jeans” and “Dad genes.” Dad jeans are articles of sex-specific leisure clothing, long mocked for being comfy, dumpy and elastic-waisted but lately reinvented as a fashion trend, suitable for male bodies of all shapes and ages. Dad genes are particles on the sex-specific Y chromosome, long mocked for being a stunted clump of mostly useless nucleic waste but lately revealed as man’s fastest friend, essential to the health of male bodies and brains no matter the age. (Angier, 6/11)
The Washington Post:
Tick Paralysis: 5-Year-Old Kailyn Griffin Paralyzed By Feeding Tick
As soon as Kailyn Griffin's feet hit the floor Wednesday morning, she collapsed in a heap. The 5-year-old kept trying to stand but fell every time. She was also struggling to speak, said her mother, Jessica Griffin. Her daughter had been fine when the family went out to a T-ball game the night before, NBC-affiliate WLBT in Jackson, Miss., reported. Maybe Kailyn was having a hard time waking up Wednesday morning, or perhaps her legs were asleep. (Wootson, 6/11)
From on-campus doctors to plans that are negotiated directly with nearby medical systems, which can earn bonuses for keeping employees healthy, big companies are looking for ways to drive down the huge line item on their budget.
Fed Up With Rising Costs, Big U.S. Firms Dig Into Healthcare
At its Silicon Valley headquarters, network gear maker Cisco Systems Inc is going to unusual lengths to take control of the relentless increase in its U.S. healthcare costs. The company is among a handful of large American employers who are getting more deeply involved in managing their workers' health instead of looking to insurers to do it. Cisco last year began offering its employees a plan it negotiated directly with nearby Stanford Health medical system. Under the plan, physicians are supposed to keep costs down by closely tracking about a dozen health indicators to prevent expensive emergencies, and keep Cisco workers happy with their care. If they meet these goals, Stanford gets a bonus. If they fail, Stanford pays Cisco a penalty. (Humer, 6/11)
In other industry news —
The Wall Street Journal:
Stryker Makes Takeover Approach To Boston Scientific
Stryker Corp. has made a takeover approach to rival Boston Scientific Corp., a move to create a medical-device giant and the latest effort to consolidate a corner of the health-care industry that has produced a raft of large deals lately. Boston Scientific has a market value approaching $50 billion, so a deal would be one of the largest in a year that is shaping up to be one of the busiest ever for mergers and acquisitions. (Mattioli, Dummett and Cimilluca, 6/11)
Envision contracts with hospitals and health systems to provide doctors and clinicians for emergency medicine, anesthesiology and radiology, among other specialties. It also owns 261 surgery centers and a surgical hospital.
KKR To Take Envision Private For $5.57 Billion In Healthcare Push
KKR & Co said on Monday it will buy Envision Healthcare Corp, one of biggest U.S. providers of physicians to hospitals, in a deal valued at $5.57 billion as it builds up its healthcare portfolio. The private equity firm beat peers Carlyle Group, TPG Global and others as it sealed the deal for $46 per share - a premium of 5.4 percent to Envision's last close on Friday. (Saxena, 6/11)
The Associated Press:
KKR Is Buying Envision Healthcare In A Nearly $10B Deal
Nashville, Tennessee-based Envision announced last fall that it would review its strategic options. Envision said Monday that its board and financial advisers looked at acquisitions, contacted 25 potential buyers and considered keeping Envision as a stand-alone business. They determined that the KKR deal offered the best chance to maximize shareholder value. The companies said the share price in this deal is a 32-percent premium to the volume-weighted average price the day after the company said it would review strategic options. (6/11)
Envision Healthcare To Be Acquired By KKR
Envision's national footprint makes it an attractive asset for a private equity firm. Physician services firms are usually not capital intensive and they generate cash flow, analysts said. Envision also owns more than 250 outpatient surgery centers. Many companies are looking to invest in ambulatory care as health insurers encourage patients to seek care away from expensive inpatient settings. (Livingston, 6/11)
KKR Will Buy Envision Healthcare For $5.57 Billion Plus Debt
Last year, KKR finished raising money for a $1.45 billion health-care fund dedicated to growth stage companies. Health insurance and services giant UnitedHealth has acquired a string of medical practices, and drugstore chain CVS Health Corp. is buying insurer Aetna Inc., with the goal of making CVS’s retail locations hubs for health services. In 2016 Blackstone ended its three-year public-to-private buyout drought with an agreement to buy Team Health Holdings Inc, another health-care staffing company. “Envision is a leading provider of physician-led services in a health-care system in which physician-patient interactions have a pronounced impact on nearly all health-care decisions,” Jim Momtazee, KKR’s head of health-care investing, said in the statement. “We are excited to partner with the outstanding team.” (Mittelman, 6/11)
Children end up having to wait years to get help. Families have filed a class action lawsuit against South Carolina asserting that the state is violating the law by not providing medically necessary treatment. Medicaid news comes out of Iowa and Ohio, as well.
Children With Autism Left Behind By Low Medicaid Rates
A similar class action federal lawsuit was filed late last month in Northern California on behalf of young, severely disabled children who, the suit alleges, were not receiving the approved in-home nursing care that the lawsuit contends would keep them from institutionalization. That case also alleges a shortage of available nurses willing to accept low Medicaid reimbursement rates. Both cases assert that the states are violating the law by not providing medically necessary treatment and, as the South Carolina suit alleges, are causing “irreparable injury” to children in need of those services. Neither case specifically asks the states to pay providers more, but legal and health policy analysts say that could be the eventual result. Medicaid, which provides health care coverage to low-income people, is a joint federal-state program. (Ollove, 6/12)
Des Moines Register:
How Do Voters Feel About Iowa's Health Care, Medicaid And Abortion Policy?
A February Des Moines Register/Mediacom Iowa Poll found that nearly three-quarters of Iowans believe the state’s mental-health system is in crisis or is a big problem. Reynolds signed legislation that expands mental health services, including the addition of six regional “access centers.” Though it gained unanimous support, Democrats say it did not go far enough and lacks the funding to be fully effective. ... Former Republican Gov. Terry Branstad moved to privatize the state’s Medicaid system, which has since been fraught with challenges. Reynolds, in her first Condition of the State address, acknowledged that “mistakes have been made,” and legislation advanced making small changes to the system. But there has not been widespread reform, and Hubbell throughout the primary advocated for returning the system to state control. (Pfannenstiel, 6/11)
Cleveland Plain Dealer:
Ohio Cancels $1.1 Billion Medicaid Cut To Hospitals
The state has canceled a planned $1.1 billion Ohio Medicaid cut to hospitals, saying an uptick in the economy and reshuffling money in the health care program has prevented the reduction. The cut would have represented 5 percent of what Ohio Medicaid pays hospitals to treat some 3 million program recipients who qualify based on their incomes, health conditions and disabilities, among other factors. (Hancock, 6/11)
Media outlets report on news from California, Ohio, Massachusetts, Missouri and Kansas.
Will San Francisco's Ban On Flavored Tobacco Spark A National Trend?
The same week voters passed San Francisco's ban, the Board of Supervisors in San Mateo County unanimously passed a similar comprehensive ban that will also remove traditional tobacco products from pharmacies. ...City officials like [Carole] Groom say local initiatives are necessary because there is very little regulation of e-products at the federal level, even though use is increasing. (McClurg, 6/11)
Patients Diverted As Cincinnati VA Surgery Closed Without Approval
At least three patients needing surgery came to the Cincinnati VA Medical Center over a four-day period last month, only to be turned away because the surgery department had taken a long weekend. When the hospital’s chief of staff questioned the unexcused absence of the department, VA officials reassigned her and imposed a gag order on her. (Saker, 6/11)
In Bridging Cultures, Beth Israel And Lahey Learn From Missteps In Another Merger
It was a risky idea hatched in a hurry: two historic Boston hospitals would join and form a streamlined health care system. But the 1996 merger of Beth Israel and New England Deaconess hospitals immediately ran into problems: Rivalries lingered, doctors left, donations fell, and financial losses grew. ...More than two decades later, the result of that rocky union, Beth Israel Deaconess Medical Center, is trying to heed the lessons learned from that experience as it plans a new merger, this time with Lahey Health. (Dayal McCluskey, 6/11)
St. Louis Post Dispatch:
This Midtown Clinic For Uninsured Immigrants Adds Mental Health Services To The Treatment
The mental health services are part of a collaborative, bringing six agencies under one roof to treat patients referred by the clinic’s primary care physicians. It eliminates the long wait time — the average is 18 months — to see a specialist and alleviates the anxieties that often come with going to a new health care facility. ...The new mental health center has four consultation rooms used by the Casa partners and three more for professionals starting out and not affiliated with a practice or agency. The rooms are connected by small observation areas to help with training, especially for medical students. (Moore, 6/11)
Medical Debt Is 'Financially Crippling' Families In Kansas And Missouri
A quarter of Kansas working-age adults and a third of the state’s children live in households dealing with medical debt. That’s one of the takeaways from a new report commissioned by five Kansas and Missouri health foundations, believed to be the largest survey to date of health consumers in the two states. In Kansas, about 2,600 adults and minors were included. The survey answers point to problems with access to dental and mental health care, among other services. (Llopis-Jepsen, 6/11)
Tesla Fired Safety Official For Reporting Unsafe Conditions, Lawsuit Says
A former high-level safety official at Tesla Inc. has sued the company for failing to treat injured employees and misclassifying work injuries to avoid reporting them as required by law. Carlos Ramirez, a director of environmental, health, safety and sustainability at Tesla until June 2017, alleges he was fired in retaliation for reporting unsafe working conditions, such as chemical exposures and fires, and for refusing to go along with what he believed to be illegal practices. (Evans, 6/11)
Kansas City Star:
Health Survey Finds Medical Debt In Kansas, Missouri
While traveling through Kansas talking about health care, David Jordan has heard story after story about people drowning in a sea of medical bills they can't pay. So Jordan, the president of the United Methodist Health Ministry Fund, said he wasn't surprised when one of the largest surveys of Missouri and Kansas health care consumers ever conducted showed that medical debt was one of their top concerns. (Marso, 6/11)
Kansas City Star:
The Cost Of Kansas City's Two Measles Outbreaks
What is known at this point is that more than $170,000 in taxpayer resources was spent to hold the outbreaks to 35 total cases — 22 in Kansas and 13 in Missouri. Some of the $170,000 is federal money, some of it came out of redirected state and local resources and none of it includes other costs that are difficult or even impossible to quantify. (Marso, 6/11)
Overland Park Weight-Loss Hospital Loses Bid To Regain Its Medicare Funding
Blue Valley Hospital, an Overland Park facility specializing in bariatric surgery, has lost its bid to retain its Medicare certification, throwing its future in doubt. A federal judge last week ruled she did not have jurisdiction to hear the hospital’s legal challenge and dismissed Blue Valley’s lawsuit. The hospital promptly appealed her decision to the 10th U.S. Circuit Court of Appeals, which it hopes will take up the case on an expedited basis. (Margolies, 6/11)
State House News Service:
Calling For Higher Minimum Wage, Anti-Poverty Protesters Block Traffic In Downtown Boston
Calling for a higher minimum wage and other priorities, activists with the Poor People's Campaign shut down an intersection in Boston's Post Office Square on Monday afternoon, sitting down in the middle of Congress and Franklin Streets. The protest came during week five of a six-week movement to revive the equality campaign that the Rev. Martin Luther King, Jr. launched before his death 50 years ago. (Metzger, 6/11)
Following the deaths of Kate Spade and Anthony Bourdain, conversation continues around suicide and depression.
The New York Times:
Suicide Rates Are Rising. What Should We Do About It?
The rate of suicide in the United States increased 28 percent from 1999 to 2016, according to a report last week from the Centers for Disease Control and Prevention. In 2016 alone, 45,000 Americans took their own lives. You would think that we were in the midst of a suicide epidemic, an alarming prospect that was underscored by the deaths last week of both Kate Spade and Anthony Bourdain. (Richard A. Friedman, 6/11)
The Washington Post:
Will We Finally End The Silence Around Suicide?
About 123 people die of it every day, but we still don’t want to talk about it. Those left behind often don’t receive casseroles or cards, flowers or fundraisers, hugs or visits. The obituaries, too, are evasive, resorting to euphemisms such as “died in his home” or “died suddenly.” Unless it’s Kate Spade or Anthony Bourdain. Finally, an opening to talk about suicide. (Petula Dvorak, 6/11)
There Is Help And Hope: Recognize Suicide Warning Signs, Reach Out
The deaths of fashion designer Kate Spade and celebrity chef and TV host Anthony Bourdain shocked the world. Suicide is an all too common problem and even affects those who seem to have it all together. Suicide does not discriminate — even for those with wealth, power, success, loving families and a seemingly perfect life. Struggles are faced by everyone. It is how individuals choose to cope that changes the outcome.From what we know of Spade’s particular story, and many like it, there are warning signs — signs that are evident in hindsight but at the time can seem fleeting. (Prakash Masand, 6/11)
The New York Times:
Suicide Survivor Guilt
When I was growing up, my father thought about ways to kill himself as regularly as I outgrew my shoes. There were pills to my penny loafers, carbon monoxide to my jelly sandals, razors to my Doc Martens. I was 4, 10 and 28 when he made his most damaging attempts. We found him: on the side of the road, on the side of the bed, in my grandmother’s garage where he’d tried to make a tomb of the giant powder-blue Oldsmobile we called Orca. (Amanda Avutu, 6/12)
Hiding My Depression Almost Destroyed My Job
If you spent any time on social media this past weekend, you no doubt saw hundreds — nay, thousands — of people reflecting on the recent suicides of Kate Spade and Anthony Bourdain. Some wondered what could have motivated these two wildly successful people to take their own lives. Others noted that we can never know someone else’s pain — and that, in any case, just because someone leads a seemingly blessed life doesn’t mean she or he can’t suffer from depression. The New York Times tweeted out helpful recommendations of books that explored depression, including Andrew Solomon’s classic, “The Noonday Demon.” (Joe Nocera, 6/11)
Editorial pages examine these health care issues.
The New York Times:
The Health Care Stalkers
Democrats hoping to make health care a centerpiece of midterm election campaigns just got a gift from the Trump administration. Not only has the Justice Department declined to defend the Affordable Care Act against a lawsuit filed by 20 Republican-led states, but it’s also arguing for the repeal of enormously popular consumer protections, including coverage of pre-existing conditions. These benighted moves come at a time when voters everywhere rank health care as their chief concern, and a majority say they favor fixing the current law over repealing it, after years of futile Republican efforts to do the latter. (6/11)
The Wall Street Journal:
The Autumn Of ObamaCare
Republicans are in a predictable spot as they head to the midterm election: The party failed to repeal ObamaCare, and the press is waving around double-digit premium increases for 2019. Democrats are pinning the blame on Republicans, though the basic problem is still the structure of the Affordable Care Act. Minority Leader Chuck Schumer declared the other day that Democrats will be “relentless in making sure the American people exactly understand who is to blame for the rates.” Some insurers have been requesting large premium increases for next year as they have every year: 19% on average in Washington, 24% in New York. The Congressional Budget Office said in May that “benchmark” or midlevel plans on the exchanges would absorb a 15% increase. (6/11)
The Washington Post:
Pass A Health-Care Law, GOP. I Dare You.
If the GOP really thinks gutting protections for people with preexisting health conditions is good policy, they should pass a damn law. I dare them to try. For eight years, on and off, they did. And they failed. The House passed literally dozens of repeal bills, none of which had the chance of becoming law while Barack Obama was still president. Then Donald Trump won the White House. Republicans had unified control of government — and they chickened out. (Catherine Rampell, 6/11)
Trump Bid To Gut The Affordable Care Act Puts Health Care On The Ballot
Donald Trump and the Republican Party just put America’s health care squarely on the November ballot. After a year of trying and failing to repeal the Affordable Care Act, the Trump administration, in cahoots with 20 conservative states, has asked the courts to strike down several pillars of the ACA — including its protections for Americans with pre-existing health conditions. These protections are a guarantee to as many as 130 million Americans that no insurance company can deny them coverage just because they (or one of their family members) had a prior illness or medical problem. (Andy Slavitt and Nicholas Bagley, 6/11)
The New York Times:
Would A Single-Payer System Require Painful Sacrifices From Doctors?
Single-payer health care systems deliver better outcomes at much lower cost than those that rely primarily on private insurance, as we do in the United States. Considerable evidence supports this claim. And because of these cost savings, I said in a recent column, the United States could switch to a single-payer system without requiring painful sacrifices from anyone. Several readers pointed out an apparent flaw in my argument. Since the biggest savings result from lower payments to service providers, wouldn’t the transition be painful for physicians and other health care professionals? (Robert H. Frank, 6/8)
The New York Times:
Can Low-Intensity Care Solve High Health Care Costs?
How much you spend on medical care depends on what you get, but also where you get it. Confoundingly to many, the cost of the same procedure on the same patient by the same physician can vary by thousands of dollars depending on whether it’s performed in a hospital, a hospital’s outpatient department, an ambulatory surgical center or a doctor’s office. It can also vary by who’s paying the bill — which insurer or public program. (Dhruv Khullar and Austin Frakt, 6/11)
The Washington Post:
Trump Rejects Parts Of VA Law He Was ‘Very Happy’ To Sign
It was the kind of ceremony presidents love. Spring weather was lovely in the White House Rose Garden on Wednesday as President Trump was surrounded by supporters at a signing ceremony for the Mission Act, a measure designed to improve health care for veterans. “This is a very big day,” Trump said. “Choice. We’ve been looking for choice for a long time, and today is the day. So, it’s very important. Very happy.” Very happy, but not totally satisfied. (Joe Davidson, 6/11)
Let's Make Good On Our Promise To Veterans
The department must clearly define eligibility and access standards for veterans seeking community care. We don’t need a repeat of what happened with the Veterans Choice Program, so the VA must take special care to clearly expand access beyond the original criteria and lay out a detailed plan for how it plans to implement all changes. (Dan Caldwell, 6/11)
Ohioans Need Consistent Health Care, Not New Rules
Access to health insurance through the Medicaid program has been critical in helping Ohioans to enter the workforce and supporting them in their work. Ohio should be focused on strengthening residents’ connection to the preventive care and treatment that keeps them healthy and connected to the workforce. (Charles Wallner, 6/11)
Opinion writers focus on these and other health issues.
The Washington Post:
One Easy, Cost-Free Thing Trump Can Do To Ease The Opioid Crisis
President Trump declared the opioid addiction epidemic a public-health emergency in October, but more than seven months later, he and his administration have yet to take the steps that would help those fighting the epidemic on the front lines. Addressing a crisis that is devastating communities across the country and killing more Americans than gun violence or car crashes requires the federal government to take difficult actions — including providing robust resources and aggressively challenging the stigma associated with addiction. (Robert Weissman and Leana Wen, 6/11)
Don't Block Experienced Drug Counselors
Just read the headlines and it’s clear we have a problem: “Michigan falls short in frontline treatment for opioid crisis”; “The rise of deadly street opioid leads to more overdoses”; or “Michigan Roulette: The rise of a deadly street opioid.” So, you would think our state government would be encouraging more treatment professionals to enter the field. Instead, it is dissuading them. Often, people who are best at helping those with addictions find recovery are those who have been there themselves. People like myself, a recovery support specialist and transitional house manager with Dawn Farm in Ypsilanti. For people like me growing up in the 90s, an altered state of mind was the norm. Stints in the Michigan Department of Corrections and boot camp for larceny and drunken driving never did the trick. It wasn’t until I was guided by experienced and dedicated social workers that I was shown a different way. (Michael Meza, 6/11)
Parkland Students’ Summer Tour Will Fight Gun Violence At The Voting Booth
On Thursday, a large group of Stoneman Douglas graduates will set out on a nationwide summer bus tour to bring about change in America. Half a century ago, it was students protesting the Vietnam War. Today, the students’ mission is to end a domestic war, one we’re waging on ourselves through gun violence. (6/12)
The New York Times:
On An Average Day, 96 Americans Die By Firearms
In the two years since the Pulse nightclub shooting in Orlando, Fla., there have been at least 700 mass shootings — defined as involving four or more victims — across the United States. Yet mass shootings represent just a fraction of the nation’s gun violence. On an average day, 96 Americans die by firearms, according to the Centers for Disease Control and Prevention. About two in every three of those are suicides. (6/10)
Playing With Crispr, Investors Get Burned
It may seem obvious, but it’s a lesson that never seems to stick with biotech investors: Assigning billions of dollars in value to a medical innovation that’s barely been tested in humans isn’t the greatest idea. For those who need to learn the hard way, a fresh reminder came Monday. Shares of companies tied to a heavily hyped, but unproven, gene-editing technology called Crispr were sent reeling after two studies published in Nature found a potential cancer risk. (Max Nisen, 6/11)