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Political Cartoon: 'Small Frog, Big Pond?'

Kaiser Health News provides a fresh take on health policy developments with "Political Cartoon: 'Small Frog, Big Pond?'" by Mike Lester.

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iGen Kids, who knew?
Less booze, sex and rock'n'roll
Hurts your mental health!

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Summaries Of The News:

Administration News

Trump Stops Short Of Declaring National Emergency For Opioid Epidemic

President Donald Trump focused on the need for prevention and law enforcement, but offered no concrete policy ideas in a brief meeting about the crisis.

Reuters: Trump Vows To 'Win' Against Opioid Epidemic, Offers No New Steps
President Donald Trump promised to win the fight against a U.S. epidemic of opioid drug use, but offered no new steps to do so and did not act on a recommendation made by a presidential commission that he declare a national emergency. Trump spoke at an event he had billed as a "major briefing" on the opioid crisis during a two-week "working vacation" at his private golf club in New Jersey. He also used the appearance to unexpectedly issue a stern warning to North Korea over its threats to the United States. (Chiacu and Oliphant, 8/8)

USA Today: Trump Calls Opioid Deaths 'A Tremendous Problem' But Doesn't Declare National Emergency
President Trump on Tuesday stressed the importance of prevention and law enforcement in a briefing on the opioid crisis at his New Jersey golf course, but stopped short of declaring the state of national emergency that his own opioid commission has recommended. Health Secretary Tom Price told said the administration has the resources it needs to combat the epidemic without invoking the emergency powers. (Korte, 8/8)

The New York Times: Vowing Again To Tackle Opioid Crisis, Trump Faults His Predecessor
Meeting with top advisers during his working vacation in New Jersey, Mr. Trump cited statistics saying that deaths stemming from opioid overdoses had skyrocketed in recent years and had become the leading cause of accidental death in the United States. He spoke generally about better health care and law enforcement action as well as guarding the southern border. “It’s a tremendous problem in our country, and I hope we get it taken care of as well as it can be taken care of — hopefully better than any other country that also has these same problems,” he told reporters at his golf club in Bedminster, N.J. “Nobody is safe from this epidemic that threatens all — young and old, rich and poor, urban and rural communities. Everybody is threatened.” (Baker and Shear, 8/8)

The Washington Post: Trump Holds Off On Declaring Opioid Crisis A National Emergency
[Trump] said the “best way to prevent drug addiction and overdose is to prevent people from abusing drugs in the first place.” “If they don’t start, they won’t have a problem. If they do start, it’s awfully tough to get off,” Trump told reporters at the clubhouse at his private golf club. “So if we can keep them from going on — and maybe by talking to youth and telling them: ‘No good, really bad for you in every way.’ But if they don’t start, it will never be a problem.” (Johnson and Wagner, 8/8)

The Wall Street Journal: Trump Pledges Tough Law-Enforcement Response To Opioid Crisis
Mr. Trump cited a dramatic rise in opioid overdose deaths in the past two decades and a decline in federal drug prosecutions and drug offender prison sentences in recent years. “They looked at this scourge and they let it go by,” the president said, referring to the Obama administration. “We’re not letting it go by.” (Radnofsky and Campo-Flores, 8/8)

Politico: Trump Says He'll Beat Opioid Epidemic With Law-And-Order Approach
"Strong law enforcement is absolutely vital to having a drug-free society," Trump said. "I'm confident that by working with our health care and law enforcement experts we will fight this deadly epidemic and the United States will win." The remarks echoed similar comments made by Attorney General Jeff Sessions earlier this summer. (Ehley, 8/8)

Bloomberg: Trump Calls Opioids ‘No Good,’ Urges People Not To Abuse Them 
[Trump] also called for more aggressively policing U.S. borders to stop the import of heroin and synthetic opioids from abroad. “We’re also very, very tough on the southern border where much of this comes in, and we’re talking to China, where certain forms of man-made drug comes in and it is bad,” Trump said. “We have to win for a lot of other people, not necessarily young, that are totally addicted and have serious, serious problems.” (Sink and Edney, 8/8)

Los Angeles Times: Trump Emphasizes Tough Law Enforcement In Comments On Opioid Epidemic
The commission Trump appointed to study the epidemic, headed by New Jersey Gov. Chris Christie, recommended last week that Trump declare a national emergency, but its report emphasized medical solutions, not law enforcement. “We must act boldly to stop it,” the commission wrote. “The opioid epidemic we are facing is unparalleled.” The interim report, which the authors said would be updated in the fall, included several recommendations to lift restrictions on the use of federal funds. Current rules limit states’ use of Medicaid money for residential addiction treatment. (Bierman and Levey, 8/8)

The Washington Post: Here’s What Happens If Trump Declares Opioid Abuse A National Emergency
From a strictly practical standpoint any emergency declaration would have two main effects, according to Keith Humphreys, an addiction specialist at Stanford University (and frequent Wonkblog contributor) who worked in the federal Office of National Drug Control Policy under President Barack Obama. “First, it lets states and localities that are designated disaster zones to access money in the federal Disaster Relief Fund, just like they could if they had a tornado or hurricane,” Humphreys said. States and cities would be able to request disaster zone declarations from the White House, which would enable them to use federal funds for drug treatment, overdose-reversal medication and more. “Second, declaring an emergency allows temporary waivers of many rules regarding federal programs,” Humphreys said. “For example, currently Medicaid can't reimburse drug treatment in large residential facilities (16 or more beds). That could be waived in an emergency.” (Ingraham, 8/8)

Stat: How States Have Used Emergency Declarations To Fight The Opioid Epidemic
In Arizona, it allowed state officials to get daily reports on overdoses. In Alaska, it allowed officials to expand naloxone use. In Massachusetts, it led to new prescription monitoring guidelines and even a controversial ban on a specific painkiller. But at the national level, Health and Human Services Secretary Tom Price said Tuesday the Trump administration did not yet think it was necessary to declare a state of emergency regarding the opioid crisis. And it is still unclear what invoking such powers would mean for an epidemic that is touching every corner of the country and will likely endure for the foreseeable future. (Mershon and Joseph, 8/9)

The Hill: Trump Promises Intense Effort On Opioids
The president’s efforts on the opioid crisis came under criticism on Tuesday from Democrats and liberal groups. The Democratic National Committee said Trump had done nothing for communities ravaged by the opioid epidemic, while Protect Our Care, a pro-ObamaCare coalition, called the meeting a “sham.” (Roubein, 8/8)

Health Law

Sen. Carper Launched Crusade Against GOP Health Plan By Focusing On Governors

Sen. Tom Carper (D-Del.) wanted to make sure they got the message: The legislation will hurt your states. Put your opposition in writing so the Senate can pause. Meanwhile, lawmakers have headed home to face their constituents and their town halls are just as raucous as they have been the rest of the year.

USA Today: Sen. Tom Carper Cast As Governors' Lobbyist In Health Care Debate
When Sen. Tom Carper was shopping for votes to block GOP health care bills, he didn’t just turn to his fellow senators. He turned to their governors. A self-described “recovering governor,” himself, the Delaware Democrat carried out a communications blitz — calling, texting, emailing — and made contact with up to half of them. He skipped out on a Democratic campaign retreat to make a case at the National Governors Association summer meeting in Rhode Island. (Gaudiano, 8/8)

Roll Call: GOP Members Face Tough Town Halls At Home
As town halls replace committee meetings during this last stretch of summer, Republican congressmen find themselves facing increasingly critical and at times raucous crowds of voters. Rep. Doug LaMalfa represents a California district that he won by 15 percent and voted overwhelmingly for President Donald J. Trump in 2016, but none of that was apparent Monday as the Republican congressman heard from his harshest critics. Over the course of the hour-long town hall, LaMalfa was on the defensive as constituents booed and asked for his resignation. One man told the congressman, “May you die in pain.” (Stewart, 8/8)

Denver Post: Michael Bennet Town Hall In Greeley: Colorado Democrat Blasts Republicans
U.S. Sen. Michael Bennet on Monday said he couldn’t have designed a bill less responsive to criticisms of the Affordable Care Act than what Republicans have put forth in the past few months, and the Colorado Democrat expressed hope that a recently announced bipartisan effort to repair the individual marketplace will be met with success. “It’s crazy to me that they wrote a bill like that,” Bennet said during a town hall at the University of Northern Colorado. “Can you imagine how hard it would be to say you’re going to repeal ACA for eight years, then you find yourself on the floor of the Senate and you can’t repeal it?” (Silvy, 8/8)

Denver Post: Tom Perez, John Hickenlooper Hold Health Care Rally In Denver
Colorado Democrats on Tuesday, joined by Democratic National Committee Chairman Tom Perez, continued their rallying cry against GOP efforts to dismantle the Affordable Care Act, working to drum up support among their liberal base and proclaiming their battle is far from over. “We won, but we have not finished the victory,” Perez said outside of the Colorado Capitol building in Denver, speaking to a crowd of a few dozen people holding signs. “We have won for now. And we have succeeded for now because of all of your stories.” (Paul, 8/8)

Meanwhile, one senator is pushing forward with an idea that she sees as a "win-win" solution —

Detroit News: Stabenow: Medicare At 55 Plan A ‘Win-Win’
A proposal that would allow older Americans to buy in to Medicare at age 55 would also be a “win-win” for the government health insurance program and private insurance markets, sponsoring Sen. Debbie Stabenow said Tuesday. The third-term Michigan Democrat introduced the Medicare at 55 Act last week, as lawmakers left Washington for an August break. Her proposal follows the high-profile collapse of Republican plans to repeal a federal health care law that has not controlled premium increases as originally intended. (Oosting, 8/8)

Those With Employer-Sponsored Health Plans Won't See Outrageous Spikes, But Costs Will Rise

As prices continue to go up, employers may begin to explore different cost-saving measures such as offering at least one high-deductible health plan.

The Fiscal Times: Here’s How Much More Your Health Insurance Will Cost Next Year
Large employers estimate that the employee share of health insurance costs next year will be $4,400, up from $4,200 this year, according to a new report from the National Business Group on Health. On average, employers will continue to cover about 70 percent of the total costs, which they project will increase by 5 percent to $14,156. (Braverman, 8/8)

Modern Healthcare: Large Employers Increasingly Leaning On Value-Based Contracts
Instead of looking to reduce demand by shifting costs to employees, large employers are increasingly hoping to constrain health insurance cost growth through value-based contracts with providers, according to a survey released Tuesday by the National Business Group on Health. High performance-networks, or narrow networks, declined in popularity from 26% to 19%, though the report added: "If health care cost trend begins to increase again, this may be one of the first areas employers go in to rein in costs." (Lee, 8/8)


N.C. Releases Plan For Restructuring Medicaid, Improving Physical And Mental Health Care

The details lay out how the state will move from a fee-for-service program to managed care. Among other Medicaid developments are news accounts on the head of Oregon's program resigning at the governor's request, doctors at California's UC Davis Medical Center saying the hospital's decision to refuse to accept Medicaid payments has hurt vulnerable patients and health care providers complaining about Colorado's new billing system.

The Associated Press: North Carolina Leaders Put More Meat On Medicaid Proposal
Gov. Roy Cooper's administration wants the state's pending Medicaid overhaul to integrate physical and mental health treatment more quickly and expand coverage to more of the working poor in North Carolina, according to its plan unveiled Tuesday. The Department of Health and Human Services released a report explaining how it wants the Medicaid program to look when a 2015 state law directing the reorganization takes effect, possibly in July 2019. (Robertson, 8/8)

Oregonian: Campaign To Taint Courtroom Foe Costs Saxton Post At OHA
Lynne Saxton, director of the Oregon Health Authority, resigned Tuesday at the request of Gov. Kate Brown after a "communication plan" became public detailing how the agency intended to damage the reputation of a Portland health care provider. Saxton, who has overseen the sprawling state agency since late 2014, insisted that she never implemented the hardline tactics advocated in the plan. She also publicly apologized. ... Saxton's ouster was borne of the agency's long, bitter legal dispute with FamilyCare Health, one of 16 coordinated care organizations serving the state's Medicaid population. The two camps have been battling for years, with FamilyCare insisting the agency's ratemaking process is unfair and unsustainable. (Manning, 8/8)

East Oregonian: GOP Calls For Special Session On Health Care
Republicans in the Oregon House of Representatives are calling for a special session to address the state’s Medicaid funding plan. The Legislature approved assorted revenues, ranging from a tax on insurance premiums to assessments on hospitals, earlier this year to fund the Oregon Health Plan, the state’s Medicaid program. (Withycombe, 8/8)

Sacramento Bee: Medi-Cal Patients Left Out Of UC Davis Medical Center Primary Care
Ian Kim sees the dire effects every day of UC Davis Medical Center’s decision to stop providing basic care for some of Sacramento County’s most vulnerable patients. This past year, a boy came into the hospital’s emergency room with an infection so serious that, if not well managed, could have led to the loss of a limb or even death, said Kim, who is a resident physician at the medical center. ... UC Davis stopped accepting Medi-Cal coverage more than two years ago, saying the federally funded health program for low-income people didn’t adequately reimburse the hospital for its services. (Yoon-Hendricks, 8/8)

The Associated Press: Texas Urges Reversal In Planned Parenthood Medicaid Case
Texas' attorney general is urging a federal appeals court to overturn an order halting the state from cutting Medicaid dollars to Planned Parenthood over videos anti-abortion activists secretly recorded in 2015. In a 5th Circuit Court brief, Ken Paxton accused Planned Parenthood of "breaches of medical and ethical standards." (8/8)

Colorado Public Radio: Colorado’s Glitchy New Medicaid Payment System Has Some Doctors Declaring 'Crisis'
The trouble started in March. That’s when Colorado’s Medicaid agency launched a new computer billing system, with a new vendor called DXC Technology. The rollout did not go as planned. “It's been a nightmare, to say the least,” said Annie Walter, office manager at Hanson Clinic, an orthopedic surgery in Pueblo. ... State officials say they expected some problems with the Colorado interChange, but say the pain now will be worth it in the end. “It's a lot more complex than the old system,” said Chris Underwood, office director of the health information office for the state’s Department of Health Care Policy and Financing. (Daley, 8/8)

Capitol Hill Watch

Health Care PACs Pump Millions Into Political Spending

But despite all the movement on health care, there was no sharp uptick in spending this year.

Roll Call: How The Health Care Industry Has Been Giving To Congress
As health care came to the forefront this year in Washington, groups focused on the issue continued using their political action committees to attempt to influence the debate. Though there was no sharp pickup in spending this year, these PACs have already spent millions of dollars in 2017, according to reports filed with the Federal Elections Commission at the end of last month. During the first half of the year, the 34 health-care related political action committees that contributed at least $500,000 in the previous two-year election cycle have spent a combined $69 million. (McMinn and Kelly, 8/8)

In other news concerning Congress —

Roll Call: CBO Would Disclose Research Models, Data Under Lee Measure
The hits keep coming for the Congressional Budget Office, as Republicans in Congress continue to lash out against the nonpartisan scorekeeper following its unflattering analysis of recent GOP health care proposals. Republican lawmakers and White House officials in recent months have accused the CBO of partisan bias; called for slashing its budget; singled out individual employees; and suggested the agency is now obsolete. The latest jab comes from Sen. Mike Lee, who has introduced a bill that would require the CBO to make publicly available the models and data used in its legislative scores. (McCrimmon, 8/9)


KKR Bulks Up On Health Care Holdings With $2.4 Billion Ambulance Deal

The move is just the latest in a string of health care deals for the company.

Modern Healthcare: Envision Sells Its Ambulance Business To KKR For $2.4 Billion 
Envision Healthcare's long journey to sell its giant ambulance business has culminated in a $2.4 billion deal with a Kohlberg Kravis Roberts & Co. operating company, the companies announced Tuesday. Under the deal, Envision's American Medical Response will be combined with KKR's Air Medical Group Holdings to create a medical transportation behemoth serving more than 5 million patients annually across 46 states and the District of Columbia. (Barkholz, 8/8)

Bloomberg: KKR Extends Health Flurry With $2.4 Billion Ambulance Deal 
The combined businesses will transport more than 5 million patients a year through air and ground ambulances in 46 U.S. states and Washington D.C., the companies said. The deal is expected to close in the fourth quarter pending the approval of regulators, they said in a statement on Tuesday. Shares of Nashville, Tennessee-based Envision climbed about 5.7 percent to $58.17 before the start of regular trading. (Thomson, 8/8)

In other health industry news —

The Wall Street Journal: CVS Moves Deeper Into Doctors’ Turf
CVS Health Corp. hit by slower store sales and the defection of some big insurance providers, is moving ever more onto doctors’ turf in a bid to win back business. The company said Tuesday that it intends to expand a program in which it marshals pharmacists, hundreds of on-site medical clinics and its vast data network to help people manage chronic diseases including asthma and high blood pressure. (Terlep, 8/8)

Bloomberg: CVS Health Is Sued Over ‘Clawbacks’ Of Prescription Drug Co-Pays 
CVS Health Corp. was sued by a California woman who accused the drugstore operator of charging customers co-payments for certain prescription drugs that exceed the cost of medicines. CVS, the largest U.S. pharmacy chain, overbilled consumers who used insurance to pay for some generic drugs and wrongfully hid the fact that the medicines’ cash price was cheaper, Megan Schultz said in her Aug. 7 lawsuit. Schultz said in one case she paid $166 for a generic drug that would have cost only $92 if she’d known to pay cash.  (Feeley and Hopkins, 8/8)

Public Health And Education

N.H., 'Ground Zero' Of Opioid Epidemic, Sues OxyContin-Maker Over Its Marketing Tactics

Suing the companies that make the painkillers is a new trend in states' efforts to combat the crisis. The New Hampshire case comes less than two months after Missouri's attorney general sued Purdue and two other pharmaceutical companies. In other news, a study finds that abuse-deterrent opioids aren't effective and investors are flocking to a company that makes a medication that treats addiction.

The Associated Press: New Hampshire Is Latest State To Sue OxyContin Manufacturer
The attorney general's office sued Purdue Pharma on Tuesday, alleging that the drug manufacturer has continued its deceptive marketing of OxyContin in a state that has been called the "ground zero" of the opioid epidemic. In a civil complaint, the state alleges that Purdue Pharma has downplayed the drug's risk of addiction, overstated its effectiveness, claimed it is nearly impossible to abuse and failed to report suspicious prescribers. It's the latest in a string of lawsuits by state, county and local governments accusing prescription opioid manufacturers of fraud and deceptive marketing. (8/8)

New Hampshire Public Radio: N.H. Files Suit Against Purdue Pharma For Alleged Role In Opioid Crisis
New Hampshire’s lawsuit against Purdue Pharma is being brought under the state’s consumer protection act. The head of that unit, Senior Assistant Attorney General Jim Boffetti, says investigators spoke with local doctors who claimed Purdue reps visited them as often as two or three times a week. The company, he says, downplayed the addictive risks of OxyContin and other opioids, particularly in patients being treated for chronic pain. (McDermott, 8/8)

New Hampshire Union Leader: State Sues Maker Of OxyContin 
The deputy chief of the U.S. Drug Enforcement Administration has called New Hampshire “ground zero” of the opioid epidemic and the Centers for Disease Control reports four of five heroin users started with prescription opioids. “To defeat the epidemic, we must stop creating new users, and part of that is making sure these highly addictive and dangerous drugs are marketed truthfully and without deception and in such a way as not to minimize addiction risks or overstate benefits to patients,” Rice said. (Landrigan, 8/8)

Stat: Abuse-Deterrent Opioids Aren't Effective Enough And Are Too Expensive, ICER Report Says
As the opioid crisis rages across the United States, a new analysis contends there is a lack of evidence that pills designed to deter abuse are truly effective in reducing overall opioid abuse and, moreover, the cost to prevent a single case of abuse or an overdose death may appear prohibitive. After reviewing available studies, a panel of experts concluded data to support most of the so-called abuse deterrent formulations is “promising, but inconclusive,” given that some pills are new to the market or not yet available. And while studies indicated OxyContin, specifically, is harder to abuse, all of the drugs may shift people to other forms of opioids, notably heroin or fentanyl. (Silverman, 8/8)

Bloomberg: Investors Are Hooked On This Drugmaker Battling Opioid Abuse
As opioid addiction reaches epidemic proportions in American communities, investors are getting hooked on a U.K. company trying to wean them off. Indivior Plc makes Suboxone Film, a prescription medicine to treat dependence on illegal or prescription opioids, a class of drugs including heroin that act on the nervous system to relieve pain. Patients place the small, rectangular piece of film containing an active ingredient known as buprenorphine under their tongue or inside their cheek once a day to reduce cravings and suppress withdrawal symptoms. (Wiggins, 8/8)

NPR: Naloxone Prices Are Up As Demand Has Increased
In Prince George's County, Md., every first responder carries naloxone, the drug that can reverse an opioid overdose. "We carry it in our first-in bags," says Bryan Spies, the county's battalion chief in charge of emergency services. "So whenever we arrive at a patient's side, it's in the bag, along with things like glucose, aspirin and oxygen." (Kodjak, 8/8)

And outlets report on news from the crisis out of the states —

The Associated Press: High-Tech Ideas To Fix Opioid Crisis Compete For Ohio Grants
A call by Republican Gov. John Kasich for scientific breakthroughs to help solve the opioid crisis is drawing interest from dozens of groups with ideas including remote controlled medication dispensers, monitoring devices for addicts, mobile apps and pain-relieving massage gloves. The state has received project ideas from 44 hospitals, universities and various medical device, software and pharmaceutical developers that plan to apply for up to $12 million in competitive research-and-development grants. The grant money is being combined with $8 million for an Ohio Opioid Technology Challenge, a competition similar to one spearheaded by the NFL to address concussions. (8/8)

KCUR: Johnson County Opioid Usage Appears Steady, But Red Flags Remain 
While communities across the country deal with dramatic increases in illegal opioid use, statistics in Johnson County suggest rates of death and addiction closer to home are relatively more stable. Court filings involving opioid offenses have remained relatively flat in recent years, and illegal use has decreased for hydrocodone and oxycodone, two of the most popular opiates, according to a report from public health and crime experts presented to the Johnson County Commission in June. Heroin use remains steady. (Martin, 8/8)

The Washington Post: A Secret, Supervised Place Where Users Can Inject Drugs Has Been Operating In The U.S. For Three Years
Somewhere in a U.S. city, a small nonprofit organization has been hosting a secret site where users can inject drugs under the supervision of trained staff who provide clean needles and guard against overdoses, researchers said Tuesday. The site, which is illegal under federal law, has been operating for three years, according to a paper published in the American Journal of Preventive Medicine. It is part of the “harm reduction” strategy adopted by 98 facilities in 10 other countries where supervised injection sites operate legally. (Bernstein, 8/8)

Seattle Times: Bellevue Bans Safe-Injection Sites For Heroin Users 
Bellevue banned safe-injection sites for heroin users Monday although none has been proposed for King County’s second-largest city and it’s highly unlikely one would be. The controversial sites endorsed by Seattle Mayor Ed Murray and King County Executive Dow Constantine appear to have stalled, even as they ripple through local politics. (Young, 8/8)

In Era Where Almost Every Ailment Is Treated With A Pill, A Simple Diet Change May Save Lives

Researchers are trying to introduce a clean diet to children with a rare kidney disorder called focal segmental glomerulosclerosis because treatment with medication doesn't help them. In other public health news: colon cancer, sleeping and memories, workers' health, tai chi and more.

Stat: Can A Simple Diet Help Change These Children's Lives?
Like every other meal Cecily would be sharing with 19 other children and their parents this month, this one was freshly cooked and served by the crack staff of kitchen professionals who were working under strict orders: Give the kids anything they want, as long as it’s all organic, and free of gluten, dairy, salt, and processed sugar. It was a grand medical — and, in ways, social — experiment. The children are all living with a rare kidney disorder called focal segmental glomerulosclerosis, or FSGS, in which their kidneys leak proteins into the bloodstream. The disease strikes 5,000 people in the United States each year, and for a subset of pediatric patients, like most of those here, treatments like steroids and immunosuppresants don’t help. They face painful symptoms and, eventually, the prospect of kidney failure. (Tedeschi, 8/9)

The Washington Post: Death Rates From Colon Cancer Are Increasing For White Americans Under 55
Earlier this year, researcher Rebecca Siegel of the American Cancer Society published a startling report showing that colon and rectal cancer incidence is rising among Gen X and millennials while falling in older generations. On Tuesday, after delving further into the data, she and her co-authors identified “a true and perplexing escalation in disease occurrence.” In a paper in JAMA, the Journal of the American Medical Association, they report that deaths from colorectal cancer are increasing for young and middle-aged Americans — though the increase appears, at least so far, to be confined to white men and women. (Cha, 8/8)

The Washington Post: Your Brain Can Form New Memories While You Are Asleep, Neuroscientists Show
A sleeping brain can form fresh memories, according to a team of neuroscientists. The researchers played complex sounds to people while they were sleeping, and afterward the sleepers could recognize those sounds when they were awake. The idea that humans can learn while asleep, a concept sometimes called hypnopedia, has a long and odd history. It hit a particularly strange note in 1927, when New York inventor A. B. Saliger debuted the Psycho-phone. (Guarino, 8/8)

The Wall Street Journal: Healthier Workers Are More Productive, Study Finds
Healthy employees are more productive employees, according to new research bolstering the case for corporate wellness programs. While that might seem like an obvious conclusion, the connection has been tough to establish with data to link workers’ job performance and their personal health information. (Weber, 8/8)

The New York Times: Tai Chi May Help Prevent Falls
Practicing tai chi helps older people improve their balance and avoid falls, a review of studies has found. Tai chi is a form of Chinese martial arts now practiced as exercise. It involves a specific program of graceful movements, accompanied by deep breathing and mental focus, that slowly move the center of balance from one leg to the other. (Bakalar, 8/8)

Kaiser Health News: Lag In Brain Donation Hampers Understanding Of Dementia In Blacks
The question came as a shock to Dorothy Reeves: Would she be willing to donate her husband’s brain for research? She knew dementia would steadily take Levi Reeves’ memories of their 57-year marriage, his remaining lucidity and, eventually, his life. But to let scientists take his brain after he died? That seemed too much to ask. “I didn’t want to deal with the idea of his death,” said Reeves, 79. “I certainly didn’t want to deal with brain donation.” (Hancock, 8/9)

The Philadelphia Inquirer/ Penn Study: Insurance Policies Should Be Revised To Cover Costly Proton Therapy For Pediatric Cancer
Health insurers almost always agree to pay for proton therapy for pediatric cancer patients, either initially or on appeal, suggesting that policies should be revised to explicitly allow the expensive treatment, a University of Pennsylvania study concludes. Because protons stop within a target, the particles can kill a tumor while sparing healthy tissue. That’s particularly important for growing children. But proton therapy is more expensive than conventional radiation and has not been proven superior by definitive studies, so insurance policies generally reject or restrict it for pediatric cancer. (McCullough, 8/8)

The Washington Post: A Woman Had Stomach Pains. Doctors Discovered It Was Something She Swallowed — A Decade Ago.
Doctors at a hospital in Australia were bewildered when a 30-year-old woman showed up with intense stomach pains. Her heart rate was faster than normal, and the membrane lining her abdominal wall was inflamed, one of her doctors wrote in a medical article published Monday by BMJ Case Reports. But her vital signs, laboratory tests, ultrasound and a scan of her liver, gallbladder and bile ducts were all normal. (Phillips, 8/8)

State Watch

Bill Requiring Women To Purchase Separate Insurance For Abortions Advances In Texas House

Democratic opponents have decried the bill as forcing women to buy “rape insurance” because exceptions weren’t made for rape and incest, while supporters say it provides "economic freedom" for Texans opposed to the procedure.

The Associated Press: Texas House Votes To Require Separate Insurance For Abortions
The Texas House has given preliminary approval to a bill requiring women to purchase separate insurance policies for coverage of abortions, except during medical emergencies. Amarillo Republican Rep. John Smithee’s proposal passed 95-51 after hours of tense debate Tuesday. A final House vote Wednesday sends it to the Texas Senate, which already approved similar rules. (8/8)

Houston Chronicle: Texas Inches Closer To Banning Most Insurance Coverage For Abortion 
Texas is closer than ever to joining 10 other states that bar private insurance plans and those offered through the Affordable Care Act from covering abortions, except through supplemental plans. The Texas House -- over strong objections from Democrats -- gave preliminary approval to House Bill 214, which prohibits health plans from providing coverage for abortion except in the cases where the life of the mother is in danger. The House voted 95-51 to send the bill to a third and final reading. (Wallace, 8/8)

D.C. Health Department Orders Hospital To Stop Baby Deliveries; Bay Area ACO To Expand Its Network

In other hospital-related news, it's proven more difficult than expected to find patients to fill Massachusetts' increase in psychiatric beds and what city health inspectors found at Houston-area health facilities.

The Washington Post: D.C. Shuts Down Obstetrics Ward At United Medical Center For 90 Days
The D.C. Health Department is restricting United Medical Center’s license that allowed it to perform obstetrics and nursery care while the hospital implements a plan to improve those services, a spokeswoman for the agency said Tuesday. Regulators could lift the restrictions before the 90-day mark if the hospital makes the required improvements and passes an inspection. Other services at the long-troubled public hospital, which serves some of the city’s poorest residents, are unaffected by the move. (Nirappil, 8/8)

The Associated Press: DC Orders Hospital To Suspend Baby Deliveries, Prenatal Care
The Department of Health in Washington, D.C., has ordered a hospital to stop delivering babies and offering prenatal care for the next 90 days. The Washington Post reported Tuesday that district officials declined to say what prompted the suspension at United Medical Center. But the hospital is implementing a plan to improve those services. (8/8)

San Francisco Chronicle: UCSF, Dignity To Expand Bay Area Accountable Care Network
Canopy Health, the Bay Area accountable care organization co-founded by UCSF in 2015, is adding three Dignity Health hospitals to its growing list of in-network providers. With the new Dignity additions — St. Mary’s Medical Center and St. Francis Memorial Hospital in San Francisco, and Sequoia Hospital in Redwood City — the Canopy network will have 4,000 physicians, 16 hospitals and about 15,000 patients, or “members.” (Ho, 8/8)

There's also more coverage of the U.S. News hospital rankings —

New Hampshire Union Leader: Dartmouth-Hitchcock Tops In NH In U.S. News Rankings 
Dr. Joanne Conroy’s second day as CEO and president of Dartmouth-Hitchcock Medical Center started with news that her hospital was named best in the state by U.S. News & World Report. ...No New Hampshire hospital made the national rankings, but Dartmouth-Hitchcock received high marks for abdominal aortic repair surgery, hip replacement surgery, as well as colon cancer and lung cancer surgeries. (Grosky, 8/9)

KCUR: KU Hospital, Saint Luke’s Get Top Honors In U.S. News Hospital Rankings
Two area hospitals earned spots on U.S. News & World Report’s “Best Hospitals” list. U.S. News ranked Saint Luke's Hospital in four medical specialty areas. The University of Kansas Hospital was deemed to be the best hospital in Kansas and in metro Kansas City, while Saint Luke’s was ranked the second best hospital in Missouri, behind Barnes-Jewish Hospital in St. Louis. Stormont Vail Hospital in Topeka was deemed the second best hospital in Kansas, the only other hospital in the state to earn top honors. (Margolies, 8/8)

State Highlights: Analysis Details Diabetes' Hefty Price Tag In Minn.; In Pa., Back-To-School List Includes Vaccines

Media outlets report on news from Minnesota, Pennsylvania, Delaware, Florida, Texas, Arizona, Kansas, California, Colorado and Hawaii.

The Star Tribune: Minnesota Pays Huge Price For Diabetes, Blue Cross Study Finds
One in 16 privately insured Minnesotans suffer a “loss of good health” due to diabetes, according to a new analysis by Blue Cross and Blue Shield of Minnesota, which adds up to thousands of people who will never reach their full life expectancies or will suffer chronic disabilities. The analysis, released Tuesday, is based on a new national Blue Cross “health index” tool that estimates the prevalence and cost of diseases in states and counties based on the private insurance claims of 40 million Americans. (Olson, 8/8)

The Philadelphia Inquirer/ New Pa. Health Rule: Get Your Kids Vaccinated Or They Can't Go To School
Parents, before you snap up those discounted notebooks, pencil-and-pen multi-packs, and that new hot-character backpack, do this first: Get your kids immunized. Now. Under new Pennsylvania state health rules, parents must see to it that their children have the required vaccinations by the first day of school. “If you don’t do that, your child may not be able to start school. And more importantly, your child may not be protected against serious diseases,” said Philadelphia Health Commissioner Thomas A. Farley in a Tuesday joint news conference with city school Superintendent William R. Hite Jr. (Giordano, 8/9)

The Associated Press: Judge: Board Erred In Punishing Doctor For Retrieving Pills
A judge has overturned a Delaware medical licensing board’s disciplinary decision regarding a doctor accused of misconduct after allegedly allowing prison medical workers to give an inmate expensive pills that had been thrown into a syringe-filled “biohazard” medical waste box. The board last year ordered 90 days of probation and a $1,000 fine for Dr. Laurie Ann Spraga after an incident in which 12 prescription hepatitis pills — costing $1,000 each — were discarded in a “biohazard” medical waste box after being spilled onto the floor. The pills were later retrieved and given to an inmate at the maximum-security prison in Smyrna. (Chase, 8/8)

Houston Chronicle: Area Colleges Get Students Ready For Health Care Roles 
The number of health care jobs continues to grow. The Texas Workforce Commission expects jobs in the health care sector in Texas to increase by more than 32 percent from 2014 to 2024. Of those, the top five are nurse practitioners, registered and licensed nurses, physical therapists, dental assistants and heath information technicians. "Five of Lone Star College's six campuses offer nursing programs to meet the high demand for nurses in Houston," said Linda Luehrs-Wolfe, dean of sciences and health occupations, LSC-Kingwood. "Lone Star College also is developing a Bachelor of Science in Nursing program to meet the area's growing demand." (Benton, 8/8)

Stat: Lawmaker On A Personal Quest To Address Texas's Maternal Death Rate
Recent reports show that African-American women in Texas have disproportionately high rates of maternal death, which has, in turn, given Texas the highest maternal mortality rate not only in the U.S. but in the developed world. By 2014, the state’s maternal death rate reached 35.8 per 100,000 live births, according to a study in Obstetrics and Gynecology. That’s significantly higher than any other country in the Organization for Economic Cooperation and Development group of wealthy nations with the exception of Mexico, the study reports. (Samuel, 8/9)

Arizona Republic: Judge Upbraids Arizona Prisons Chief Over Criticism Of Courts In Memo
Last month, after testifying in U.S. District Court in Phoenix about inadequate health care at Arizona prisons, two inmate-witnesses claimed that they were retaliated against by prison staff by having belongings removed from their cells, being publicly scolded and having a cellmate transferred. In response, on July 25, Duncan issued an order that the department take no actions that harass or intimidate, or do anything "which could reasonably be viewed as having a chilling effect on witness testimony by utilizing group punishments, or actions against other prisoners who could in turn blame or target the witnesses." (Kiefer, 8/8)

KCUR: Death Linked To Bourbon Virus Raises Questions About Tick-Borne Diseases 
After a week, as her fatigue and rash worsened, [Tammy] Wilson checked into a hospital in St. Louis. Doctors there were stumped. But Wilson stayed in good spirits and joked with co-workers who drove up from the park to visit. ...But more than two weeks later, after test results came back from the Centers for Disease Control and Prevention, her mother was told she had contracted the Bourbon virus. Before, there had been only two confirmed cases of the Bourbon virus and one of the patients died. May says her mother started getting nervous. (Smith, 8/9)

California Healthline: California Funds Nonprofits To Serve Food As Medicine
Federico Guzmán moved from Mexico to San Francisco in 1992, fleeing anti-gay sentiment and searching for AIDS treatment. He couldn’t find a job and sometimes went hungry until friends introduced him to Project Open Hand, a nonprofit organization that began serving free, nutritious meals to HIV patients in 1985. (Browning, 8/9)

Denver Post: CHSAA Disputes Colorado's Last-Place Ranking In High School Sports Safety Guidelines Study
A study released by the Korey Stringer Institute on Tuesday ranked Colorado last among the 50 states and the District of Columbia in its High School Sports Safety Policy Rankings, with scores based on state associations meeting evidence-based best practice guidelines addressing the four major causes of sudden death. CHSAA’s overall score across the study’s five equally weighted sub-sections — sudden cardiac arrest, exertional heat stroke, traumatic head injury, appropriate health care coverage and emergency preparedness — was 23 percent, far behind leader North Carolina’s 78.75 percent and the mean of 47.1 percent. (Newman, 8/8)

Prescription Drug Watch

'It’s Alice-In-Wonderland Time In The Drug World': A Look At Why Brand-Name Drugs Are Pushed Over Generics

News outlets report on stories related to pharmaceutical pricing.

The New York Times: Generic Drug Prices Are Falling, But Are Consumers Benefiting?
Not all drug prices are going up. Amid the public fury over the escalating costs of brand-name medications, the prices of generic drugs have been falling, raising fears about the profitability of major generic manufacturers. Last week, Teva Pharmaceuticals reported that it had missed analysts’ earnings estimates in the second quarter and planned to lay off 7,000 workers. Its share price plummeted 24 percent in one day as investors worried there was no end in sight. (Ornstein and Thomas, 8/8)

The New York Times: Take The Generic, Patients Are Told. Until They Are Not.
It’s standard advice for consumers: If you are prescribed a medicine, always ask if there is a cheaper generic. Nathan Taylor, a 3-D animator who lives outside Houston, has tried to do that with all his medications. But when he fills his monthly prescription for Adderall XR to treat his attention-deficit disorder, his insurance company refuses to cover the generic. Instead, he must make a co-payment of $90 a month for the brand-name version. By comparison, he pays $10 or less each month for the five generic medications he also takes. (Ornstein and Thomas, 8/6)

The Wall Street Journal: Falling U.S. Generic Drug Prices Hurt Manufacturers, Wholesalers
U.S. generic-drug prices are falling at the fastest rate in years, eating into the profits of pharmaceutical wholesalers and manufacturers alike and erasing billions of dollars of their market value in recent days. The three largest U.S. drug wholesalers, which warehouse and distribute some $400 billion of pharmaceuticals annually, have been competing aggressively to win business among independently owned pharmacies, largely by agreeing to cut prices on generics. In turn, the wholesalers are squeezing drugmakers for better prices. (Walker, 8/4)

The Wall Street Journal: Behind The Push To Keep Higher-Priced EpiPen In Consumers’ Hands
Something strange happened when Alice Bers went to the pharmacy earlier this year to fill her son’s EpiPen prescription: The doctor had prescribed the generic, but it would have cost her more out-of-pocket than the branded version. So the pharmacy asked her son’s doctor for a prescription for the brand-name EpiPen, and her health plan got a bill for $438.53, or $227.52 more than the generic would have cost it. Many EpiPen customers, from a range of different health plans, have wound up getting the more expensive brand. (Rockoff, 8/6)

Stat: Is Pharma Hiding 'Dark Money' To Fight An Ohio Measure To Lower Drug Prices?
The skirmish in Ohio over a ballot measure for lowering drug prices took a twist as a consumer advocate filed a complaint with state authorities alleging the pharmaceutical industry is illegally masking “dark money” from individual drug makers that oppose the initiative. Known as the Ohio Drug Price Relief Act, the ballot measure would require state agencies to pay no more for medicines than the Department of Veterans Affairs. The agency currently gets a 24 percent federally mandated discount off average manufacturer prices. Supporters say the measure would save state residents $400 million annually. (Silverman, 8/3)

Cincinnati Enquirer: Who Is Paying To Oppose Issue 2? A Nonprofit Shields Pharma Donors
All $15.8 million donated this year to the campaign against Issue 2 came from "Ohioans Against the Deceptive Rx Ballot Issue LLC (A wholly-owned subsidiary of PhRMA)." ...Issue 2, which is on Ohio's Nov. 7 ballot, would prevent Ohio from paying more for prescription drugs than the U.S. Veterans Administration pays, such as for Medicaid members. (Balmert, 8/1)

Columbus Dispatch: Drug Companies Find Way To Dodge Ohio Campaign Disclosure Rules
Millions in financial contributions from pharmaceutical companies opposing an Ohio ballot proposal to cap prescription drug prices are being shielded from disclosure because they are being funneled through a nonprofit, limited liability company. Watchdogs say the tactic, being used for the first time in an Ohio election, threatens the transparency of campaign contributors in future statewide issue campaigns. (Johnson, 8/2)

Bloomberg: Medicare Projects Slight Drop In 2018 Drug Premiums
Medicare projects 2018 base premiums for its Part D drug benefit will be 61 cents cheaper than this year, despite the rising cost of drugs, particularly specialty drugs. It is the first decrease in five years. The base premium will drop from $35.63 to $35.02 as of Jan. 1, the Centers for Medicare & Medicaid Services announced last week. (Yochelson, 8/7)

Stat: Importing Drugs From Canada Could Save U.S. $6.8 Billion Over A Decade
Acontroversial bill to allow Americans to import prescription drugs from Canada would save the federal government more than $6.8 billion over the next 10 years, according to a preliminary estimate by the Congressional Budget Office. The initial findings may further debate over whether importing medicines from Canada and certain other countries can be safely done. The pharmaceutical industry and former Food and Drug Administration commissioners, among others, argue this would expose Americans to counterfeits. (Silverman, 8/1)

Stat: Is The FDA Telegraphing A Rejection For PTC Therapeutics' DMD Drug?
The FDA’s once-raging internal debate over Sarepta Therapeutics has cooled, but a recently unearthed document might portend failure for the next company angling to win an approval in Duchenne muscular dystrophy. PTC Therapeutics is seeking approval for its treatment, ataluren, despite the drug’s repeated clinical failures and the FDA’s 2016 refusal to even consider the drug. Approval would seem unlikely, and it looks to be even more of a reach in light of a memo written by Dr. John Jenkins, an FDA official, back in the heat of the Sarepta saga. (Garde, 8/1)

Perspectives: Maryland's Law To Curb Price Gouging Gives Brand-Name Drugs A Pass

Read recent commentaries about drug-cost issues.

The Washington Post: Maryland’s Price-Gouging Law Targets The Wrong Prescription Drugs
Most people who work in health-care policy agree that rising prescription drug prices pose a serious threat to efforts to make health care affordable. Prescription drug prices account for 17 percent of the nation’s health-care costs, up from 7 percent in the 1990s. According to data from the Medicare Payment Advisory Commission, prescription drug spending accounts for nearly 20 percent of total program spending for Medicare, the largest of the governmental health-care programs. With backing from powerful lobbying organizations, the brand-name pharmaceutical companies avoided price controls. (William B. Schultz, 8/4)

Columbus Dispatch: Reveal Issue 2 Donors' Names
The Dispatch strongly opposes Issue 2, a simplistic ballot measure to impose an unworkable cap on what the state can pay for prescription drugs, but the campaign to defeat the issue took a wrong turn by hiding the identity of its financial backers. They did so by taking advantage of permissive federal and state laws that allow deep pockets to heavily influence elections from behind a curtain of anonymity. (8/8)

Detroit News: GOP Should Tackle High Drug Costs
Republicans not only hold the White House, but both chambers of Congress as well, thanks in no small part to rural voters. If they want to hold on to that power into 2018 and beyond, they’d be wise not to ignore the base that gave it to them. Republicans promised these voters time and again that they would take on big pharma and work to take on high drug prices but now, given the chance, they’re wavering. (Amelia Hamilton, 8/3)

The News-Examiner: Debate's Guaranteed With Drug Costs Like These
Years ago, when my daughter was in the first stages of treatment for a brain tumor (thankfully not a glioblastoma), I went with her to the pharmacy to get 11 pills that were part of a partially filled prescription she had received earlier. When the pharmacist returned with the medication, I asked, out of curiosity, how much they’d cost if not covered by insurance. He looked up at the line behind us and said very quietly, $7,000. I gasped but not as audibly as the woman who was next up. “For 11 pills? Did I hear that correctly?” “Welcome to the world of modern medicine,” the druggist said. (Thomasson, 8/8)

Bloomberg: Valeant's Guidance Gymnastics Point To A Cut
Valeant Pharmaceuticals International Inc. on Tuesday cut its revenue guidance for 2017. It reported an 8 percent drop in revenue in the second quarter from a year ago, with declines in nearly all lines of business. It divested its second-best-selling drug as part of its effort to chip away at more than $28 billion in debt. More divestitures are set to close in the second half of the year. The company posted its sixth GAAP loss in seven quarters. (Max Nisen, 8/8)

Bloomberg: AbbVie Wages HCV Drug-Price War On Gilead
Pharma already leads the business world in unpredictability, with billions in sales potentially riding on a few points of statistical significance in a clinical trial. But even within that context, a series of blockbuster medicines for Hepatitis C (HCV) have made for a roller-coaster ride for companies and investors. AbbVie Inc. last week threw another big curve at this market by pricing its newly FDA-approved drug Mavyret -- which might be the most effective HCV medicine approved yet -- at a massive discount. (Max Nisen, 8/7)

Bloomberg: Shire's ADHD Spinoff Idea Is Shaky
Shire PLC's ADHD business has been at its core for years and helped it afford last year's transformative, $35 billion dollar purchase of Baxalta Inc. As thanks, Shire on Thursday announced, along with its second-quarter results, that it will decide whether to spin off or sell its ADHD business by the end of this year. The firm thinks it has two very different businesses, which "could be better off managed separately," according to CEO Flemming Ornskov on the firm's earnings call. (Max Nisen, 8/3)

Editorials And Opinions

Different Takes On Health Policy Debates: Bipartisan Possibilities; Medicaid And The American Dream

Opinion writers examine areas in which the next step for lawmakers regarding Obamacare might involve bipartisanship. They also take on issues related to Medicaid and the outlook for the Affordable Care Act's insurance marketplaces.

RealClear Health: 10 Bipartisan Ideas For Affordable, Quality Health Care
The Senate’s failed vote on the Health Care Freedom Act, otherwise known as the “skinny bill,” confirms that quick fixes and hasty repeal measures without a solid plan in place for health care kicks the problem down the road and creates uncertainty for millions of Americans. This latest round of votes treated the symptoms but not the malady of excessive health care costs. (Gary Shapiro, 8/9)

Roll Call: Why HELP Could Be On The Way For Obamacare Recipients
Sen. Lamar Alexander had barely announced his plans to hold hearings next month on the Health, Education, Labor and Pensions Committee on stabilizing the insurance markets for Obamacare when the idea started getting panned. ... just the idea of preventing the exchanges around the country from collapsing for the 11 million people who get their health insurance through them has been enough to set people in Washington off. (Patricia Murphy, 8/9)

Stat: How Medicaid Made The American Dream Possible For Me
My older brother, Anmol, and I were born in the United States. Because of a congenital defect, my brother’s kidneys failed in infancy and he needed a kidney transplant before his first birthday. Complications from this illness caused a stroke on Christmas Eve before Anmol’s second birthday that left him blind, epileptic, and intellectually disabled. As I grew up, my family was on Medicaid and other public assistance like food stamps. Despite our financial struggles, we never had to worry about health care, especially for my brother. Medicaid and Medicare took care of him. His childhood transplant lasted 19 years before he had to go back on dialysis. About 10 years ago, Anmol received another kidney transplant. Thanks to many specialists over the years, and the grace of God, he has done well. (Hemal N. Sampat, 8/8)

The Columbus Dispatch: Ohio Shows What’s Possible
The Ohio Department of Medicaid has reached another remarkable milestone in its ongoing drive to help more elderly, disabled and mentally ill clients live safely at home — where many are happier and healthier — instead of in nursing homes. Home Choice was started in 2008 with a goal of moving 2,000 people from nursing homes back into their homes. The program provides up to $2,000 for one-time expenses such as moving costs, utilities deposits and basic furnishings. Recently, the number of folks transitioned out of nursing homes reached 10,000. (8/8)

Stat: Health Insurance Exchanges Are On Shaky Ground. Here's How To Fix Them
At least for now, the Affordable Care Act is here to stay. This means that the health insurance exchanges — which make it possible for people who do not get health insurance through work or government programs to buy it — will continue to function. Right now they are on shaky ground. There are three ways to shore up and improve the exchanges to increase choice and ensure that they operate smoothly. (David Anderson, 8/8)

The Des Moines Register: UI Med Students Oppose Efforts To Repeal Affordable Care Act
At the University of Iowa Carver College of Medicine, medical students and physician assistant students learn about health policy and healthcare delivery systems. As Iowa’s future health care providers, we have a responsibility to weigh in on public policy that will impact the health of Iowans. We have an obligation to speak out against any policy that would harm the public. (Ron Humble, 8/8)

Viewpoints: DrugTo Treat Opioid Addiction Hard To Get; What Did 'Dr. Google' Say?

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

RealClear Health: How Big Pharma Is Hindering Treatment Of The Opioid Addiction Epidemic
Drugs do exist to reverse opioid overdoses or treat long-term opioid addiction. But while opioids have become easier and easier to obtain through illicit markets and sellers on the dark web, a drug that could save countless lives has become increasingly out of reach. Consider the addiction treatment drug, Suboxone. Patents and other exclusivities on the basic version of Suboxone expired some time ago, yet the price remains sky-high, and access problems persist. (Robin Feldman, 8/9)

Stat: There's Little Evidence Abuse-Deterrent Opioids Work. Why Use Them?
The term “abuse-deterrent opioid” is a misnomer. These products do not prevent the most common form of opioid abuse — ingesting pills orally in a way that isn’t consistent with the actual prescription. These products do make it more difficult to crush, snort, or inject the underlying opioid. Because of this, some have suggested that these products be referred to as “tamper-resistant.” Yet these products aren’t truly tamper-resistant, either, because they are subject to manipulation, with instructions easily found in internet forums. (C. Bernie Good, Chronis Manolis and William Shrank, 8/8)

KevinMD: We Can No Longer Ignore Dr. Google
In a world of cyberchondria and a web polluted with unlimited medical data, patients are searching their symptoms, diagnoses and treatment options even before going to a physician. Nowadays, at least one third of patients go on the Internet for self-diagnosis — or, often, self-misdiagnosis. After searching for a symptom, understanding e-medical facts is not as simple as reading hotel amenities or reviewing a pizza place. This paradigm introduces new patient behaviors that physicians are not prepared to deal with in medical school, nor during training years. (Homere Al Moutran, 8/8)

PBS NewsHour: The Never-Ending Debate Over Finishing Your Antibiotics
Recently, a group of British health professionals penned a compelling analysis in The BMJ, advocating for shorter antibiotics courses — even going so far as to say that maybe patients should stop taking antibiotics once they feel better. ... But there’s a flip side: Overusing antibiotics can cause usually nice bugs, with which we coexist, to gain resistance. (Fedor Kossakovski, 8/8)

The Washington Post: Maryland Is Mired In A Medical-Marijuana Morass
Maryland's medical marijuana program has been so sluggish to take flight, so dazed in setting rules for applicants and so muddled in evaluating them that one might fairly wonder if the entire undertaking were conducted under the influence. Three years after it was approved, the state’s legal pot program is still earthbound. While licenses are scheduled at last to be awarded to grow, process and dispense cannabis this month, few of the nearly 30 states that have legalized the drug for medical purposes have been so slow to get their programs up and running. (8/8)

Raleigh News & Observer: NC Health Care, Among Worst In Nation, Is Feeling Poorly
It is sad that with every new report ranking states in terms of the quality of their health care, including expense and accessibility and the health of citizens, North Carolina continues to fare poorly. A new report by the personal finance website WalletHub ranks the state the fifth-worst in the country for health care. ... This state, home to nationally-respected university medical schools, should have much higher rankings in terms of the quality of health of residents. But to accomplish that, more people have to be covered and getting access to the kind of steady, preventative care that good insurance can provide. (8/8)