Morning Briefing
Summaries of health policy coverage from major news organizations
From 吃瓜不打烊 - Latest Stories:
吃瓜不打烊 Original Stories
In California, Doctors Accused Of Sexual Misconduct Often Get Second Chances
The state medical board grants probation in more than a third of cases, a KHN analysis found. Even as other institutions adapt to lessons of the #MeToo movement, the board plans no significant changes, saying it has always prioritized discipline for sexual misconduct.
Health Insurance Costs Crushing Many People Who Don鈥檛 Get Federal Subsidies
The rising costs of premiums, deductibles and copayments have driven millions who don鈥檛 get a subsidy to drop their coverage or turn to cheaper, less comprehensive 鈥 and sometimes inadequate 鈥 insurance.
Nurse Denied Life Insurance Because She Carries Naloxone
The U.S. surgeon general has called on "bystanders" to be equipped with the opioid reversal drug to save lives. But when a nurse answered that call, her application for life insurance was denied. Why?
Podcast: KHN鈥檚 鈥榃hat The Health?鈥 Insurance Enrollment Is Lagging 鈥 And There Are Lots Of Reasons Why
Sign-ups for insurance under the Affordable Care Act are still well behind last year鈥檚 mark with just a week until the end of open enrollment in most states. The Supreme Court declines a case that could have allowed states to defund Planned Parenthood. And the Trump administration gets hundreds of thousands of comments about its proposed changes to immigration rules that could penalize people who use government-funded health care and other social service programs. Alice Ollstein of Politico, Anna Edney of Bloomberg News and Rebecca Adams of CQ Roll Call join KHN鈥檚 Julie Rovner to discuss these issues and, for 鈥渆xtra credit,鈥 provide their favorite health policy stories of the week.
Summaries Of The News:
Health Law
'I Hate To Panic, But ...': Advocates Eye Tomorrow's Health Law Enrollment Deadline With Trepidation As Numbers Lag
Former President Barack Obama released a video earlier this week urging people to hurry up and shop for health insurance on the Affordable Care Act exchange. "This year I'm giving it to you straight," Obama says in the video. "It's important to have health insurance in case, God forbid, you get really sick, or hurt yourself next year." (Kodjak, 12/14)
It's not too late yet, but time is running out to enroll in the Affordable Care Act marketplace health insurance for 2019. The marketplace sells private insurance, and those who qualify are eligible for federal subsidies to help pay for it. (Innes, 12/13)
As the deadline to sign up for insurance on Connecticut鈥檚 Affordable Care Act鈥檚 marketplace looms, officials say enrollment in the state is matching last year鈥檚 pace. The state ACA marketplace, Access Health CT, has already signed up about 100,000 individuals and families in the enrollment period that began in October. (Radelat, 12/13)
Kaiser Health News: Health Insurance Costs Crushing Many People Who Don鈥檛 Get Federal Subsidies聽
Like millions of Americans in this final week of open enrollment for the Affordable Care Act marketplaces, Diane McCabe is shopping for health insurance. 鈥淎t my age, I can鈥檛 go without it even though I鈥檓 healthy now,鈥 said McCabe, 62, a self-employed real estate agent in Luzerne County, Pa. 鈥淏ut the process is frustrating, and the expense significant.鈥 That鈥檚 because McCabe is one of the 5 million people who buy their own coverage and pay the full cost. Her income is too high to qualify for a government subsidy to help defray the premium. (Findlay, 12/14)
In other health law news聽鈥
A federal appeals court on Thursday narrowed an order that had blocked President Donald Trump's administration from enforcing new rules that undermine an Obamacare requirement for employers to provide insurance that covers women's birth control. Last year two federal judges - one in Philadelphia and one in Oakland, California - had blocked the government from enforcing a new guideline allowing businesses or nonprofits to obtain exemptions from the contraception policy on moral or religious grounds. The Justice Department appealed both rulings. (Levine, 12/13)
Thursday's ruling by a three-judge panel of the 9th U.S. Circuit Court of Appeals concerned changes to birth control coverage requirements under President Barack Obama's health care law that the U.S. Department of Health and Human Services issued in October 2017. States were likely to succeed on their claim that those changes were made without required notice and public comment, the appeals court panel said in a 2-1 decision. (Thanawala, 12/13)
Capitol Watch
House Hearing On Fetal Tissue Research Gets Heated Amid An Ever-Intensifying Debate Over The Issue
House conservatives long opposed to medical research using fetal tissue applied fresh pressure on the Trump administration to end government funding for such work at a hearing Thursday spotlighting antiabortion scientists who contend alternatives exist. The hearing before subcommittees of the House Oversight and Government Reform Committee grew testy at times over whether cells from sources other than aborted fetuses are as useful as fetal tissue in advancing therapies and possible cures for diseases from HIV to cancer. (Goldstein, 12/13)
The House Oversight and Government Reform Committee hearing, chaired by government affairs subcommittee Chairman Mark Meadows (R-N.C.), looked to add pressure this week as the Trump administration tries to reach a decision about how to move forward. Republicans argue taxpayers shouldn鈥檛 have to pay for research projects that use fetal tissue when alternatives exist, especially when their money is already going to Planned Parenthood. (Hellmann, 12/13)
The discussion by two House Oversight Committee subcommittees 鈥 Healthcare, Benefits, and Administrative Rules as well as Government Operations 鈥 fell along party lines, with Republicans expressing concerns about the source of fetal tissue. 鈥淥bviously the 800-pound gorilla in the room is that we know aborted tissue is being used,鈥 said Rep. Jody B. Hice, R-Ga. 鈥淵ou can make the arguments for or against abortion,鈥 said Mark Meadows, who is chairman of the Government Operations Subcommittee. 鈥淲hat my constituents have a problem with is buying baby brains and baby eyes to do research when they find it abhorrent.鈥 (Raman, 12/13)
Elsewhere on Capitol Hill聽鈥
Congress' newly passed farm bill has a holiday present for rural hospitals: debt refinancing. The bill headed to President Donald Trump's desk includes a provision that would allow rural hospitals to refinance substantial debt through lower-interest loans from the U.S. Department of Agriculture. Rural hospital lobbyists acknowledge the provision won't change much overnight for the 44% of rural hospitals which operate at a loss. The USDA requires applicants to show levels of financial viability that the really struggling hospitals likely can't currently meet. (Luthi, 12/13)
Government Policy
7-Year-Old Guatemalan Girl Dies Of Dehydration And Shock After Being Taken Into Border Patrol Custody
A 7-year-old girl from Guatemala died of dehydration and shock after she was taken into Border Patrol custody last week for crossing from Mexico into the United States illegally with her father and a large group of migrants along a remote span of New Mexico desert, U.S. Customs and Border Protection said Thursday. The child鈥檚 death is likely to intensify scrutiny of detention conditions at Border Patrol stations and CBP facilities that are increasingly overwhelmed by large numbers of families seeking asylum in the United States. (Miroff and Moore, 12/13)
The girl reportedly hadn鈥檛 eaten or had anything to drink for several days and began suffering seizures about eight hours after being taken into custody, according to Customs and Border Protection. The agency said emergency medical personnel discovered the girl had a fever of 105.3 degrees and she was flown to a hospital in El Paso. There she suffered cardiac arrest and was revived but died Saturday morning, the agency said. (Caldwell, 12/14)
The girl鈥檚 death raises questions about whether border agents knew she was ill and whether she was fed anything or given anything to drink during the eight-plus hours she was in custody. Immigrants, attorneys and activists have long raised issues with the conditions of Border Patrol holding cells. In Tucson, an ongoing lawsuit claims holding cells are filthy, extremely cold and lacking basic necessities such as blankets. A judge overseeing that lawsuit has ordered the agency鈥檚 Tucson Sector, which patrols much of the Arizona-Mexico border, to provide blankets and mats to sleep on and to continually turn over surveillance footage from inside the cells. (12/13)
Nearly 15,000 migrant children are being held at government聽shelters, putting the facilities nearly at capacity, NPR聽reported聽Thursday. The news outlet reported that the Department of Health and Human Services (HHS) said its network of more than 100 shelters聽is 92 percent full. The influx of migrant children in recent months has prompted the department to weigh options for how to accommodate additional bodies. (Samuels, 12/13)
Administration News
Rocked By Alcohol-Industry Ethics Scandal, NIH To Evaluate All Private Donations To Research Projects
Six months after halting a study of moderate drinking that was underwritten by donations from the alcohol industry, the National Institutes of Health outlined a series of steps to prevent similar conflicts of interest and to safeguard the integrity of its research and its reputation. In a report issued on Thursday, N.I.H. officials said its 27 institutes must evaluate all current research projects that receive private donor support for conflicts of interest of the kind that compromised the alcohol trial. The institute directors are to report their findings to Dr. Francis Collins, director of N.I.H., early next year. (Rabin, 12/13)
In other news on NIH聽鈥
Institutions across the U.S. may have fallen victim to a tiny fraction of foreign researchers who worked to feed American intellectual property to their home countries, an advisory committee to the National Institutes of Health found in a report issued Thursday. The report zeroed in on China鈥檚 鈥淭alents Recruitment Program,鈥 which the Pentagon has previously identified as an effort 鈥渢o facilitate the legal and illicit transfer of US technology, intellectual property and know-how鈥 to China. (Facher, 12/13)
Opioid Crisis
'I Was Supposed To Be Somebody': In Cradle Of Opioid Epidemic, One Woman's Journey Offers Snapshot Of The Crisis
People suffering from drug addiction are commonly depicted at their most vulnerable 鈥 nameless refugees from a world of misery, washed up on city sidewalks or huddling beneath an overpass. But the lives of these people, like all lives, are more than their lowest points; there is boredom, laughter, fatigue, friendship, scheming, desperation, love, loss and death. The addiction just lies beneath it all. Since 2013, Mark E. Trent has been recording this life in his native Greenbrier County in West Virginia, the state with the country鈥檚 highest death rate from opioid addiction. (Trent and Robertson, 12/14)
In other news on the epidemic聽鈥
Amid furious lobbying by opponents, the Philadelphia City Council tabled a controversial ordinance on Thursday that would prevent drug makers from giving gifts to doctors, require all sales reps to become licensed, and prohibit distribution of copay coupons for controlled substances. The delay followed recent amendments that were made by lawmakers who sponsored the legislation, which is designed to blunt the opioid crisis. But their gesture did little to assuage the concerns of local hoteliers and restaurant owners, who assembled a campaign of lobbyists and targeted emails to complain that their businesses would be irreparably damaged if the ordinance is enacted. (Silverman, 12/13)
Cigna Corp. is using artificial intelligence to predict whether patients might abuse and or overdose on prescription opioids as part of the company鈥檚 commitment to reducing the substance鈥檚 use among its consumers, said Mark Boxer, executive vice president and global chief information officer. Cigna鈥檚 proprietary algorithms are aided by the use of machine learning, a subfield of artificial intelligence that refers to the science of getting computers to act intelligently without being explicitly programmed. (Castellanos, 12/13)
As the state reviews how it involuntarily commits people to addiction treatment under a state law called Section 35, [Nick] Cocchi has opened this part of his jail for men who have been civilly committed. He's done this despite public calls from some who have been civilly committed to stop sending people into correctional institutions for drug and alcohol treatment. (Becker, 12/14)
Marketplace
Technology Is Key To Giving Consumers Better Experience Navigating Health Plans, Insurers Say
Health insurance customers generally report poor experiences with their health plans. Only utility and internet and television service providers have worse customer service scores, and that's saying something. But health insurers say investing in digital tools and other technologies can help them fix this and give their customers a personalized, frictionless healthcare experience. ..Simplifying the healthcare system and making it easier to navigate is becoming an imperative for health insurers as they face the threat of losing membership to well-funded startups who鈥攊nstead of redefining complicated terms like "deductible"鈥攁re just getting rid of them. It's also becoming more important as healthcare costs continue to squeeze employers and individuals alike. (Livingston, 12/13)
In other health industry news聽鈥
California and New York regulators approved health insurer Cigna Corp.'s acquisition of pharmacy benefit manager Express Scripts on Thursday, bringing the $67 billion deal a step nearer to closing. The California Department of Managed Health Care approved the deal with conditions, including that the combined company not raise premiums to pay for the merger for five years and keep premium increases "to a minimum." (Livingston, 12/13)
Public Health
A Step Toward Unraveling The Notoriously Tricky Mystery Of The Genetic Roots Of Psychiatric Diseases
For the past two decades, scientists have been exploring the genetics of schizophrenia, autism and other brain disorders, looking for a path toward causation. If the biological roots of such ailments could be identified, treatments might follow, or at least tests that could reveal a person鈥檚 risk level. In the 1990s, researchers focused on genes that might possibly be responsible for mental distress, but then hit a wall. Choosing so-called candidate genes up front proved to be fruitless. In the 2000s, using new techniques to sample the entire genome, scientists hit many walls: Hundreds of common gene variants seemed to contribute some risk, but no subset stood out. (Carey, 12/13)
But a sweeping set of studies published Thursday make a dent in that mystery, and shows the potential of big data and teamwork among many labs to unlock valuable clues. The 10 papers 鈥 appearing in Science, Science Translational Medicine, and Science Advances 鈥 are part of a unique, nationwide collaboration among more than a dozen research sites known as the PsychENCODE Consortium. (Thielking, 12/13)
Genetic Tests That Use Multiple Variants To Predict Disease Risk Are Gaining Popularity. But Are They Reliable?
The commercial landscape for genetic testing has come a long way from testing only for certain inherited genes directly linked to disease, such as BRCA genes whose mutations heighten risk for breast cancer. Myriad Genetics made its name with BRCA testing, but in 2017 the company also began marketing a different type of test, one that turns up multiple genetic variants found throughout a woman鈥檚 genome that together may point toward her risk of breast cancer. Earlier this year Ambry Genetics began marketing a similar test to estimate a man鈥檚 risk of prostate cancer. (Robbins, Garde and Feuerstein, 12/14)
Access to abortion services is a contentious issue in the United States. Clinics in many states are at risk of shutting down and operate with heightened security. Doctors can be hard to find in states with restrictive laws around abortion clinics, so some doctors travel in from out of state to provide care. (12/11)
Three of the most influential scientific organizations in the world are calling for an urgent international effort to prevent scientists from creating any more gene-edited babies without proper approval and supervision. Global standards are needed quickly to ensure gene-editing of human embryos moves ahead safely and ethically, according to the presidents of the U.S. National Academy of Medicine, U.S. National Academy of Sciences and the Chinese Academy of Sciences. (Stein, 12/13)
Target Corp, Walmart Inc and toy importer LaRose Industries were sued on Thursday over the sale of lead-contaminated children's toys, New York Attorney General Barbara Underwood said. The lawsuit, filed in New York state court in Albany, is over "Cra-Z-Jewelz" jewelry-making kits that were imported by LaRose and sold by Target and Walmart. Tests conducted by the attorney general's office found that the kits contained levels of lead that were up to 10 times higher than the federal limit, according to the complaint. (12/13)
Melania Trump spread her anti-bullying message on an annual Christmas season visit to a Washington children's hospital on Thursday, reading a story about a Christmas ornament named Oliver who is bullied by other ornaments in a family's collection. "Wishing you a Merry Christmas and a happy and healthy new year," the first lady said after she finished reading "Oliver the Ornament" at Children's National Health System. The author, Todd Zimmerman, sat a few feet away. (Superville, 12/13)
U.S. Gun Deaths Rise To Highest Level In Nearly 40 Years, CDC Data Shows
Gun deaths in America have reached a record high. Nearly 40,000 people in the United States died by guns last year, marking the highest number of gun deaths in decades, according to a new analysis of data from the Centers for Disease Control and Prevention's WONDER database. A similar analysis was first conducted by the Educational Fund to Stop Gun Violence, a non-profit gun policy advocacy group. (Howard, 12/13)
After the mass shooting in Parkland, Fla., in February, Congress did not act. But state legislatures did, passing 69 gun control measures this year 鈥 more than any other year since the Newtown, Conn., massacre in 2012, and more than three times the number passed in 2017. (Astor and Russell, 12/14)
The commission investigating a Florida high school massacre heavily criticized the responding sheriff office's active shooter policy Thursday, saying it contributed to the failure of some deputies to run into the building and confront the gunman. The Marjory Stoneman Douglas High School Public Safety Commission found Thursday that Broward County Sheriff Scott Israel's policy that deputies "may" confront active shooters rather than "shall" gave some an excuse for not entering the building during the Feb. 14 massacre that left 17 dead. (12/13)
Andrew Black was a blond-haired and wide-grinning 23-year-old from Vermont. He loved hiking the Green Mountain Trails, the NHL鈥檚 Montreal Canadiens and brewing his own beer. He had been stirring together ingredients for his own brews since before he was old enough to legally drink. On Dec. 6, Black walked into a gun shop at 11:02 a.m. Twenty-eight minutes later, he left with a firearm. Somewhere between 3:00 and 3:30 p.m., Black fatally shot himself, according to the Burlington Free Press. (Swenson, 12/14)
Class Action Lawsuit Filed Over Children Who Were Held In Psychiatric Hospitals After They'd Been Cleared By Doctors For Release
The Acting Cook County Public Guardian filed a class-action lawsuit Thursday on behalf of hundreds of children and teenagers in state care who have been held in psychiatric hospitals after they had been cleared by doctors for release, calling the practice inhumane and unconstitutional. The Illinois Department of Children and Family Services has a constitutional responsibility to ensure that children in the department鈥檚 care, whose lives are already marked by trauma, are not unnecessarily held in psychiatric hospitals, according to the lawsuit, which was filed in federal court in Chicago. (Eldeib, 12/13)
There was no way she could have seen him, the boy on the bridge. Marisa Harris was driving her Ford Escape down a Northern Virginia highway, heading home after a peaceful afternoon hike at Burke Lake. Her boyfriend, Perry Muth, was stretched out in the passenger seat as they cruised east on Interstate 66 toward the bridge, an overpass suspended across the busy highway. (Contrera, 12/13)
A Chicago psychiatric hospital just two days from losing federal funding, potentially forcing it to shut down, will remain open for now, following a judge鈥檚 ruling Thursday. Federal officials had told Aurora Chicago Lakeshore Hospital they would terminate its Medicare agreement on Saturday after a November inspection found the hospital could not ensure its patients were free from sexual and physical abuse and did not have adequate policies and procedures in place to investigate abuse allegations. (Eldeib, 12/13)
New York City has agreed to a $2 million settlement with the family of a mentally ill woman who was fatally shot by a New York City police sergeant two years ago as she wielded a bat in the bedroom of her Bronx apartment, city officials said Thursday. The agreement, which was reached this week, is the latest development in a highly contentious and at times racially charged debate surrounding the death of the woman, Deborah Danner. The case became a flash point in national discussions over whether police officers are too quick to shoot people and whether they are adequately trained to work with people suffering from severe mental illness. (Stevens and Goldstein, 12/13)
Some 476 Iowans died by suicide in 2017, per the latest data from the Iowa Department of Health and the Center for Disease Control. That number has聽increased by more than 66 percent since 2000, including nearly doubling in the last decade. Suicide is the 10th leading cause of death both in Iowa and the nation. ...Suicides by Iowans tied or surpassed 17-year highs in 10 of 16 age groups tracked by the state. Iowans between 55-74 amounted for nearly a quarter of all suicides in 2017. (Finney, 12/13)
A man accused of threatening violence at the New Hampshire Police Academy graduation has been sent to Concord Hospital for a mental health evaluation. According to court documents, fellow classmates say 24-year-old Laconia Police Department recruit Noah Beaulieu talked about bringing 30-round magazines of ammunition and shooting those attending the academy graduation scheduled for Friday. (Garrova, 12/13)
State Watch
State Highlights: 60% Of California Wildfire Victims Reported To Be Elderly, Many Found In Or Near Their Homes; Romaine Lettuce E. Coli Outbreak Linked To One California Farm So Far
Rose Farrell is the oldest victim of the devastating Camp fire to be identified so far. She was 99, and she died inside her home on Herman Road in Paradise. Evva Holt, 85, died inside a pickup truck after she was evacuated from Feather Canyon Gracious Retirement Living. She made it only a mile. (Ganga, Newberry, St. John and Lin, 12/13)
U.S. health officials have traced a food poisoning outbreak from romaine lettuce to at least one farm in California. But they cautioned Thursday that other farms are likely involved in the E. coli outbreak and consumers should continue checking the label before purchasing romaine lettuce. (12/13)
Adams Bros. Farms, the producer linked to the pre-Thanksgiving outbreak, has not shipped lettuce since Nov. 20 and has cooperated with the investigation, the FDA said in a statement. While this positive sample is a significant development in helping investigators explain the outbreak in part, the FDA said, 鈥淭he outbreak may not be explained by a single farm, grower, harvester, or distributor.鈥 In other words, the probe continues. (Santhanam, 12/13)
The announcement that came over the intercom on Southwest Flight 3606 from Seattle to Dallas on Sunday had nothing to do with turbulence. It was not about connecting flights, troubling weather, or delays. This one was highly unusual: A human heart had been left behind on the airplane, the announcement said, and was presumably needed by someone right away. With that, the airplane turned around in midair 鈥 and headed back to Seattle where it had started. (Johnson, 12/13)
The doctor instructed his patient to stand in front of him. He cupped her crotch and inserted his fingers into her vagina through her clothes, moving his hand repeatedly to her rectal area. Then he squeezed her breasts, according to a聽formal accusation聽filed by the Medical Board of California. The patient, accompanied to the appointment by her 4-year-old granddaughter, asked why that was necessary to diagnose a urinary tract infection, according to the documents. He told her to let him do his job. (Ostrov and Rowan, 12/13)
A majority of Tennesseans have a favorable view of Gov.-elect Bill Lee as he heads into office while health care remains a key issue among registered voters, according to a new poll from Vanderbilt University.聽Vanderbilt's latest poll, released Thursday, found 57 percent of respondents had a favorable view of Lee, who last month was elected Tennessee's聽50th governor. ...Although Lee remains popular among registered voters, the top issue for Tennesseans is health care.聽聽Thirty percent of respondents said health care was the state's top priority, followed by education. (Ebert, 12/13)
The police chief in Springfield, Missouri, on Thursday told a rape victim advocacy group that the department will review sex crimes cases in which the agency destroyed rape kits. Chief Paul Williams' pledge to Me Too Springfield came two weeks after he apologized to sexual assault victims and invited them to contact him if they felt their cases were mishandled. (Fantz, 12/13)
Cleveland Clinic Akron General is training prospective chaplains in the use of "spiritual-care skills" to enhance the healing of patients in hospitals and other health-care settings. The hospital's Clinical Pastoral Education program is offered through the Association of Clinical Pastoral Education, which is accredited by the U.S. Department of Education. Students learn to counsel patients' families, including children, as well as caregivers and clinical staff. (Conn, 12/13)
Social services advocates warned Thursday that a series of new caps in the state budget could dramatically drain resources away from education, other services for children, and local aid over the next decade. Analysts for Connecticut Voices for Children, a New Haven-based policy research group, also cautioned that these caps could promote a shift in tax burdens from the wealthy to the middle class and poor. (Phaneuf, 12/13)
More than 30 above-ground hog lagoons overflowed in North Carolina after Hurricane Florence, sending pig waste into water inundating surrounding communities. Floodwater from Florence and Michael also contained agricultural runoff, fuel and other contaminants that can seep into the aquifer or flow into man-made wells through their ground-level ventilation systems. Without data, though, scientists and public health officials won鈥檛 know the full impact of the flooding on private wells. (Beitsch, 12/14)
A Tennessee physician recently elected to Congress received criticism Thursday from top state leaders for alleging without evidence that vaccines may cause autism. "Let me say this about autism," said Republican U.S. Rep.-elect Mark Green of Ashland City in a Tuesday town hall. "I have committed to people in my community, up in Montgomery County, to stand on the (Centers for Disease Control) desk and get the real data on vaccines. Because there is some concern that the rise in autism is the result of the preservatives that are in our vaccines." (12/13)
An administrative law judge has recommended that regulators grant a statewide license to Children鈥檚 Minnesota to operate a new quad-cab ambulance for transporting patients between hospitals across Minnesota. The state鈥檚 Emergency Medical Services Regulatory Board (EMSRB) is expected to make a final decision next week on the controversial proposal from Children鈥檚, which has been opposed by other EMS providers including the ambulance service at the Mayo Clinic. (Snowbeck, 12/13)
The Milwaukee County Board on Thursday put up a unanimous front in support of hiring county employees instead of a private contractor to provide inmate medical services at the jail and House of Correction. Board approval of a proposal by Board Chairman Theodore Lipscomb Sr. to study the feasibility of making the switch was a vote of no confidence in the current contractor to do the job. (Behm, 12/13)
The founder of a home health care company has given about $20 million of his person funds to the company鈥檚 workers. The News Journal of Wilmington, Delaware, reports BAYADA Home Health Care founder Mark Baiada gifted the money this month to the company鈥檚 more than 20,000 workers. The amount gifted to each worker was based on the worker鈥檚 lifetime earnings with the company. The amounts ranged from $50 for new hires to tens of thousands for those who have been with BAYADA for decades. (12/14)
Four former employees and an owner of the Massachusetts facility responsible for a nationwide fungal meningitis outbreak that has killed more than 100 people and sickened hundreds were convicted Thursday of fraud and other offenses. A Boston jury acquitted another employee, pharmacist Joseph Evanosky, of all charges after several days of deliberations. (12/13)
Does a marijuana dispensary belong downstairs from a counseling agency that helps families cope with addiction? Is an outlet that sells pot any more dangerous than a convenience store that sells beer or wine or a Mexican restaurant known for its Margaritas? In Rowley, 16 miles north of Salem, the answers to those questions depend on zoning laws and how much tax money could flow into the town treasury. (Greenstein, 12/13)
Health Policy Research
Research Roundup: ACOs; Diabetes; Food Allergies; And Medicaid
With an incentive to provide high-quality care while controlling costs, accountable care organizations (ACOs) may focus on patients who require the most resources and are most at risk for encountering serious problems with their care. Understanding how ACOs approach care for complex patients requires examination of their organizational strategies, contracting details, and leadership structures. (Peck, 12/11)
Low-value care worsens patient-centered outcomes and imparts a negative economic effect, which has prompted the Choosing Wisely campaign to promote a national dialogue on the judicious use of services that are deemed to be nonbeneficial. One recommendation is 鈥渁void routine multiple daily self-glucose monitoring in adults with stable type 2 diabetes on agents that do not cause hypoglycemia.鈥 (Platt et al, 12/10)
Childhood food allergy (FA) is a life-threatening chronic condition that substantially impairs quality of life. This large, population-based survey estimates childhood FA prevalence and severity of all major allergenic foods. Detailed allergen-specific information was also collected regarding FA management and health care use. (Gupta et al, 12/1)
With thousands in Arkansas losing their Medicaid benefits under the state鈥檚 work-requirement demonstration, the importance of evaluating such experiments could not be clearer. In Stewart v. Azar, the court concluded that the purpose of Section 1115 demonstrations such as Arkansas鈥檚 is to promote Medicaid鈥檚 objective of insuring the poor; evaluations of these demonstrations, as required by law, inform policymakers whether this objective is being achieved. (Rosenbaum et al, 12/12)
Parents of an estimated 1.5 million US children aged 3 to 17 years (2.50%) reported that their child had ever received an ASD diagnosis and currently had the condition. Children with parent-reported ASD diagnosis were more likely to have greater health care needs and difficulties accessing health care than children with other emotional or behavioral disorders (attention-deficit/hyperactivity disorder, anxiety, behavioral or conduct problems, depression, developmental delay, Down syndrome, intellectual disability, learning disability, Tourette syndrome) and children without these conditions. (Kogan et al, 12/1)
Using data from the American Medical Association鈥檚 2016 Physician Practice Benchmark Survey, we provide the first nationally representative estimates of physicians鈥 use of telemedicine. In 2016, 15.4聽percent of physicians worked in practices that used telemedicine for a wide spectrum of patient interactions, including e-visits as well as diagnoses made by radiologists who used telemedicine to store and forward data. In the same year, 11.2聽percent of physicians worked in practices that used telemedicine for interactions between physicians and health care professionals. We found that in addition to specialty, larger practice size was an important correlate of telemedicine use. This suggests that despite regulatory and legislative changes to encourage the use of telemedicine, the financial burden of implementing it may be a continuing barrier for small practices. (Kane and Gillis, 12/3)
Editorials And Opinions
Viewpoints: Voters Weighed In With 'Hands-Off' Message About Medicare, Medicaid; Small Tweaks Won't Help Health Care System
The results of November鈥檚 U.S. House elections were 鈥 among other things 鈥 a seemingly loud rebuke of right-wing economic policies.聽 Yet, scarcely a month after the Democrats flipped at least 40 congressional seats, some right-wing groups disingenuously draw the opposite conclusion.聽FreedomWorks, a conservative nonprofit, which supported Tea Party candidates, contends that House Republicans lost because their economic policies were not draconian聽enough.聽(Max Richtman, 12/14)
Democrats have the chance to be the champions of that reform if they don鈥檛 waste their energy on half-measures. Instead of thinking about how they can make small tweaks to the health聽care system, they should start thinking about how to enact dramatic reforms that will assure universal coverage while reducing costs and encouraging economic growth. Voters and taxpayers are asking for Medicare for All. It鈥檚 time to listen. (Wendell Potter, 12/14)
There are more of these self-tests than I can keep track of, but of the ones I know, at least some are not scientifically valid; flipping a coin may be more accurate. There are food 鈥渟ensitivity鈥 tests that do not test for IgE, the antibody typically used to identify allergens. Also, direct-to-consumer companies increasingly request blood through a capillary sample 鈥 obtained by pricking your finger. (Amitha Kalaichandran, 12/13)
In the U.S., about 1 in 75 couples is at risk for passing on a serious, detectable, single-gene disorder. If every couple in the U.S. 鈥 not just those who know they are at high risk of passing on a genetic disease 鈥 opted into pre-conception genetic screening, followed by IVF+PGT when appropriate, we would sidestep thousands of cases of potentially lethal diseases for around $3.5 billion a year. That鈥檚 the cost of two or three Novartis-like gene therapies. (Lee D. Cooper, 12/14)
Unfortunately, in a recent attempt to focus on the opioid epidemic, state lawmakers targeted legal opioid prescriptions. A bill that聽was considered last legislative session聽would have added a 25-cent-per-pill tax on doctor-prescribed opioid medications. While I understand the idea behind the bill, I can鈥檛 seem to figure out why lawmakers sought to tax the healthcare system and honest patients rather than grabbing hold of the criminal activity surrounding illegal drugs. (Danny Glidewell, 12/13)
I am very worried for women in Ohio. The Ohio Legislature appears ready to enact into law Senate Bill 145. This law would ban the medical procedure known as dilation and evacuation (D&E) to end a pregnancy, except to save a woman鈥檚 life or prevent serious risk of substantial and irreversible physical impairment of a major bodily function. A doctor who used the D&E procedure in other circumstances would commit a felony and could be sued civilly. (David B. Schwartz, 12/13)
So while we should rightfully celebrate the recent court decision protecting California鈥檚 EOLOA, we should also remember that Californians are still a long way from achieving the right to die with dignity now solidly embraced in countries like Switzerland, Denmark and our neighbor to the north, Canada.The easiest way to see the gap between these countries and California with regard to End of Life options is to think of a patient with advanced stage Huntington鈥檚 disease. (Barry L. Price, 12/12)