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U.S. President Donald Trump on Thursday called for a federal lawsuit against opioid companies and stiffer penalties for drug dealers, arguing that the government must take a strong approach to combat an opioid addiction epidemic. Trump said that he had urged Attorney General Jeff Sessions to take legal action."Hopefully we can do some litigation against the opioid companies," Trump said at a summit hosted by the White House on the nation's opioid crisis. (Rascoe, 3/1)

President Donald Trump said Thursday the "ultimate penalty" may be in order for drug dealers because the nation's drug problem will never be solved without a show of strength and toughness. The comments were Trump's most explicit on the matter to date. He previously has alluded to death for drug dealers by noting that some countries are "very harsh" with drug dealers. Trump also has said he knows the answer to the drug crisis, but he isn't sure the country is "ready for it yet." (Superville, 3/1)

Trump’s statements came at the end of a two-hour summit on opioid addiction, in which Cabinet secretaries talked about combating the nation’s opioid epidemic with treatment programs and law enforcement officials discussed efforts to disrupt the supply chain for heroin and fentanyl in Mexico and China. Trump’s emphasis on criminal penalties stands in contrast to the focus on treatment by some of his Cabinet secretaries and many fighting the epidemic nationwide. (Zezima, 3/1)

The remarks are likely to rankle administration critics who have urged the White House to focus on the public health component of the opioid crisis. The president's remarks did not touch on health approaches like providing additional funding for treatment. “It makes us all very nervous” that the U.S. could move back to a “penal-first approach,” said Andrew Kessler, who leads Slingshot Solutions, a consulting firm specializing in behavioral health policy that advocates for substance abuse treatment and prevention. “I have no love for high-level traffickers or cartels, but a very high percentage of people who sell drugs do it to support their own habit.” (Karlin-Smith and Ehley, 3/1)

First lady Melania Trump called for action on the opioid crisis in a speech Thursday kicking off a White House summit on the epidemic. The first lady added her voice to the discussion as the administration works to highlight steps it has taken to address the crisis. (Sullivan, 3/1)

President Trump attempted to gain some initiative in his faltering efforts to combat opioid abuse with a White House summit Thursday, but critics decried what they see as only sporadic, ineffective attention to the epidemic from this administration. (Herndon, 3/2)

Attorney General Jeff Sessions is asking the Drug Enforcement Administration (DEA) to evaluate whether changes are needed to the amount of opioids drug makers are allowed to produce. If needed, potential alterations could be made through an interim final rule, which allows an agency to issue a new regulation effective immediately without first going through the notice and comment period. (Roubein, 3/1)

House Energy and Commerce Chairman Greg Walden (R-Ore.) detailed additional pieces of opioid legislation the panel will review as it aims to get the bills passed by Memorial Day weekend. At a U.S. Chamber of Commerce event Thursday on combating the opioid epidemic, Walden specifically mentioned three bills the committee will review in its next legislative hearings slated for this month. (Roubein, 3/1)

For six years, a pharmaceutical distributor sent more than 50 million doses of prescription opioids to five eastern Kentucky counties, enough for every person there to have 417 pills each. Kentucky's attorney general has sued that company and others like it. Thursday, state lawmakers voted to tax them. (3/1)

Lawmakers in Kentucky are weighing whether to impose a new tax on opioid prescriptions, the latest effort in a string of so-far failed attempts to pull new revenue from the painkillers that helped seed a nationwide addiction crisis. The proposed tax — a 25-cent levy on drug distributors for every dose sent to the state — was approved by the Kentucky House Thursday as part of a broader budget and tax plan. But unlike in other states, where lawmakers aimed to steer the new revenue to addiction treatment and education programs, the Kentucky plan, if enacted, would direct the money to fill budget gaps elsewhere, including boosting funding for the state’s public schools. (Joseph, 3/2)

While the opioid epidemic touches people in all kinds of communities, physicians and researchers are finding out that painkiller addiction affects men and women differently. ... At Johns Hopkins All Children’s Hospital in St. Petersburg, physicians in the maternal, fetal and neonatal institute see two to four babies born every day that are addicted to opiates, said Dr. Sandra Brooks, associate medical director of the neonatal intensive care unit at the hospital. (Griffin, 2/28)

The Hennepin County Sheriff's Office says first responders in cities outside of Minneapolis used an antidote to successfully counteract an opioid overdose 50 times since early 2016. (Collins, 3/1)

While the sponsor acknowledged the bill won’t solve the state’s opioid crisis, the House unanimously passed a measure Thursday that includes imposing prescription limits. (3/1)

The top lobbyist for the National Rifle Association claimed late Thursday that President Trump had retreated from his surprising support a day earlier for gun control measures after a meeting with N.R.A. officials and Vice President Mike Pence in the Oval Office. The lobbyist, Chris Cox, posted on Twitter just after 9 p.m. that he met with Mr. Trump and Mr. Pence, saying that “we all want safe schools, mental health reform and to keep guns away from dangerous people. POTUS & VPOTUS support the Second Amendment, support strong due process and don’t want gun control. #NRA #MAGA.” (Shear, Gay Stolberg and Kaplan, 3/1)

Minutes into Donald Trump’s renegade embrace of the left’s wish list for gun control, Republican Rep. Warren Davidson’s phone lines blew up. “What is Trump doing?” texted one angry constituent from his conservative southwest Ohio district, according to Davidson. “You’ve got to stop this,” demanded another. “That can’t be real,” Davidson recalled thinking as his supporters — all Trump enthusiasts — unloaded on the president. (Everett and Bade, 3/1)

A Democratic senator is calling on appropriators to include funding in the upcoming budget bill for the Centers for Disease Control and Prevention (CDC) to study gun violence. Sen. Ed Markey (D-Mass.) said he wants to provide $10 million a year for six years to conduct or support CDC research on firearms safety and gun violence prevention. (Weixel, 3/1)

An analysis published Friday confirms the state of American gun policy science is not good, overall. The nonprofit RAND Corporation analyzed thousands of studies and found only 63 that establish a causal relationship between specific gun policies and outcomes such as reductions in homicide and suicide, leaving lawmakers without clear facts about one of the most divisive issues in American politics. (Hersher, 3/2)

One of the lawmakers involved in writing the bill in 1996 was Jay Dickey, a Republican congressman from Arkansas who had the endorsement of the National Rifle Association. He says a lobbyist alerted him to the CDC’s gun-injury research. (Mack, 2/28)

The insurance broker President Trump nominated to lead the Indian Health Service, Robert Weaver, is firing back at the White House and the media after his nomination was withdrawn last week. "The allegations raised against me in the media are baseless, irrelevant, and in the most important cases simply incorrect," Weaver said in a press release Tuesday.In January, The Wall Street Journal quoted a former colleagues of Weaver alleging that he had exaggerated his prior work experience. (Whitney, 3/1)

HHS Secretary Alex Azar has picked Judy Stecker to serve as the department's top communications official, multiple sources familiar with the selection told POLITICO. (Cancryn, 3/1)

Sen. Orrin Hatch (R-Utah) on Thursday called ObamaCare supporters “the stupidest, dumbass people” he’s ever met. Orrin made the comments during a speech at the American Enterprise Institute about the GOP tax overhaul, which repealed the ObamaCare individual mandate. (Anapol, 3/1)

The favorable rating for ObamaCare has reached its highest level since the law was enacted in 2010, according to a Kaiser Family Foundation (KFF) poll. The poll finds that 54 percent of the public has a favorable view of the law, compared to 42 percent who have an unfavorable view. That is the highest favorable rating in a KFF poll since it began asking the question in 2010. (Sullivan, 3/1)

Uber is driving deeper into health care by offering to take patients in every U.S. market where it operates to their next medical appointment. The ride-hailing service said Thursday its Uber Health business will handle rides set up by doctor's offices or other health care providers and then bill that business, not the patient, for the service. The company said rides can be set up within a few hours or days in advance. Patients won't need access to a smartphone to use the service. (Murphy, 3/1)

No-show patients are a real problem in medicine, but it's far from clear whether ride-sharing services scheduled by providers are the solution. A study of nearly 800 Medicaid patients in West Philadelphia found that offering to schedule free Lyft rides to and from primary care appointments didn't decrease the number of missed appointments compared to a group of people not offered the service. That work, published in the journal JAMA Internal Medicine last month, calls into question whether simply expanding the availability of ride-sharing services would help solve the problem. (Johnson, 3/1)

STAT got an inside look at this $195-a-head symposium, held last month in this wealthy beachside enclave. It offered a striking view of how promoters aggressively market scientifically dubious elixirs to aging people desperate to defy their own mortality. ... Beyond the questionable science, participants have to pay big money to join the trial. Faloon, an evangelist of anti-aging research who cut a slim figure in his black suit and had the thick dark hair of a younger man, acknowledged during his talk that it would be “expensive” to sign up for the trial. (Robbins, 3/2)

The question is whether flu vaccines that are not made in eggs are more protective against the H3N2 viruses that have been causing so much illness this winter. Coming up with the answer is tricky, because the two vaccines that are not made in egg-based production lines make up only a small portion of the flu vaccine used in the United States. ...The Department of Defense purchased a substantial amount Flucelvax this year; it is one of the vaccines not made in eggs. In fact, half of the department’s beneficiaries — a population that includes guards and reserves, the families of active service personnel, and retirees — who were vaccinated got Flucelvax. (Branswell, 3/2)

Scientists have tried to muster viruses to hunt and kill tumors for almost 70 years, with limited success. That may be changing.Now, microbes are playing an important role in an emerging branch of cancer immunotherapy that’s attracting some of the world’s biggest drugmakers. Merck announced plans to buy Australia’s Viralytics Ltd. last week to gain an experimental cold virus-based treatment that may bolster the utility of Keytruda, its blockbuster cancer medicine. (Gale, 3/1)

This week, the American Academy of Pediatrics updated 10-year-old guidelines for primary-care doctors to screen all children 10 through 21 for depression once a year. Here are seven questions to consider when you talk to your child’s doctor. (Saker, 3/1)

Kaiser Health News: As Surgery Centers Boom, Patients Are Paying With Their Lives

The surgery went fine. Her doctors left for the day. Four hours later, Paulina Tam started gasping for air.Internal bleeding was cutting off her windpipe, a well-known complication of the spine surgery she had undergone.But a Medicare inspection report describing the event says that nobody who remained on duty that evening at the Northern California surgery center knew what to do. In desperation, a nurse did something that would not happen in a hospital. She dialed 911. By the time an ambulance delivered Tam to the emergency room, the 58-year-old mother of three was lifeless, according to the report. (Jewett, 3/1)

Seventeen volunteers in the Netherlands have agreed to host parasitic worms in their bodies for 12 weeks in order to help advance research toward a vaccine for schistosomiasis, a chronic disease that afflicts more than 200 million people a year, killing thousands, primarily in sub-Saharan Africa and South America. “Yes it sounds odd and crazy. The idea of having a worm grow inside you is awful,” says Meta Roestenberg, an infectious disease physician at Leiden University Medical Center, who is directing the research. But she said the risk to the student volunteers is “extremely small,” especially compared with the potential benefit to preventing a disease that burdens millions of the world’s poorest people. A Dutch ethics board agreed. (Murphy, 3/1)

IV bags filled with saline solution are one of the most common items in hospitals. But new research suggests replacing the saline with a different intravenous solution may significantly reduce risks of death and kidney damage among patients. (Lemon, 3/1)

Kaiser Health News: A Tale Of Love, Family Conflict And Battles Over Care For An Aging Mother

“Edith + Eddie,” a short documentary vying for an Academy Award Sunday, is a gripping look at a couple in their 90s caught up in an intense family conflict over caring for an aging parent. As a columnist who covers aging, I’m familiar with such stories. But as I immersed myself in the details of this case, I found myself reaching a familiar conclusion: real life is more complicated than in the movies. (Graham, 3/1)

Tucked in a corner of the MedStar Georgetown University Hospital campus is the country’s 28th proton therapy center, which is set to begin treating patients this month. It is a small but state-of-the-art system designed to attack tumors more quickly than its predecessors in proton therapy, a precise type of radiation treatment that spares healthy tissue. Twenty-four more centers are under construction or in development, including one at D.C.’s Sibley Memorial Hospital that is scheduled to open in late 2019. (Berkowitz and Steckelberg, 3/1)

Middle Tennessee residents will soon have a new option for an innovative cancer treatment. Knoxville-headquartered Provision Healthcare is opening its second proton therapy center in the state, across from the Williamson County Medical Center in Franklin. The center will feature the ProNova system, the company's newest iteration of proton beam therapy that treats several types of cancers. (Sauber, 3/1)

Gov. Mark Dayton and several DFL lawmakers are proposing a dramatic expansion of the state’s MinnesotaCare program, hoping to create a “public option” that would offer health insurance for any Minnesotan struggling to find and afford coverage. Announcing the plan Thursday, Dayton said the buy-in option — removing Minnesota­Care’s income restrictions and allowing anyone to purchase coverage — is “the single most significant step that Minnesota can take” to shore up its unstable insurance market for individuals. (Olson, 3/1)

Most greater Minnesota residents have one or two choices for health insurers, which Gov. Mark Dayton said shows a need to expand a state health insurance program to everyone. The MinnesotaCare insurance program especially could help farmers, who often struggle with finding and affording health care coverage, Dayton said Thursday. The expansion plan is not new; the DFL governor unsuccessfully pushed it last year, but the Republican-controlled Legislature did not consider it. There is no sign that the GOP has changed position, but Dayton said the Nov. 6 election could influence Republicans to reconsider their votes. (Davis, 3/1)

"People say that you shouldn't have government competing with the private sector. Well competition's good for everybody," Dayton said. "It may not be what the providers like because nobody wants new competition, but it gives the consumers choice." (Zdechlik, 3/1)

Facing the possibility that voters could change laws on several hot-button issues, Utah lawmakers are considering giving themselves the option to change any voter-approved measure before it goes into effect, a move that comes as lawmakers around the country work to limit the effects of ballot initiatives. Utah voters could have the opportunity to consider an unusually high six ballot initiatives, ranging from medical marijuana, school funding and Medicaid expansion, making at least one lawmaker uneasy. (3/1)

A Florida bill to assist first responders suffering from post-traumatic stress disorder has found new life in the aftermath of the Marjory Stoneman Douglas High School shooting. (Aboraya, 3/1)

The highest-cost providers in Massachusetts spent nearly a third more per patient than their lowest-cost peers, mirroring the widespread cost variation found in markets throughout the country. Massachusetts' largest and highest-cost organization, Boston-based Partners HealthCare, spent 32% more per patient annually than Reliant Medical Group, after adjusting for treatment severity, according to a new report from the Massachusetts Health Policy Commission that analyzed the 14 largest providers in the state. That variation amounted to more than $1,500 per patient. (Kacik, 3/1)

After weeks of intensive triage, state regulators have virtually eliminated a giant backlog of unresolved complaints alleging abuse and neglect at Minnesota senior care facilities, while also modernizing the state's complaint-intake system. (Serres, 3/1)

Blue Cross Blue Shield of Michigan's top executive saw his annual bonus surge last year as the state's largest health insurance company reported a strong overall financial picture. Total compensation for Daniel Loepp, CEO of Blue Cross since 2006, reached $13.4 million in 2017, a new record for him. That was up from his $10.9 million payday in 2016 and $9 million in 2015. (Reindl, 3/1)

The House on Wednesday took a step supporters said would improve patient privacy, voting 139-14 to pass a bill that would require insurers to send explanation of benefit forms directly to adult patients instead of to the plan subscriber. (Lannan, 3/1)

Johns Hopkins Health System plans a $469 million expansion and modernization of its Bayview Medical Center in Southeast Baltimore.It plans to build a new inpatient building there as well as renovate two existing buildings to modernize the outdated facilities. All patients will have private rooms once the project is completed. (3/1)

As Dallas-based Tenet Healthcare aims to dramatically turn around its financial outlook by refocusing attention from hospitals to ambulatory care, there is uncertainty about what could come next for its profitable subsidiary Conifer Health Solutions, Frisco’s second largest employer. Conifer bills itself as a revenue cycle management and patient communications firm. What that means is it helps hospitals connect with patients at the front end of care, to properly code those medical visits, and ultimately, to collect reimbursements for the care that was provided. (Rice, 3/1)

A top budget writer said Wednesday she doesn’t expect a conference committee to settle all the differences between the House and Senate on health-care spending, leaving the issues to be decided by legislative leaders. (3/1)

The number of laboratory-confirmed cases of influenza has dropped across New York state, the first decline since the flu was deemed widespread in December. Gov. Andrew Cuomo announced Thursday that about 13,700 flu cases were reported last week to the state Department of Health, down from 18,250 the previous week. The Democrat continues to encourage New Yorkers to get a flu shot. (3/1)

City Manager Zach Walker announced the news Wednesday and said the department’s functions would be transferred to other city departments. Independence is facing a projected $3 million budget shortfall for the upcoming fiscal year. Walker said the move would save about $375,00 a year for the city’s general fund. (Margolies, 3/1)

Officials with the Kansas Department for Aging and Disability Services said Thursday that a staff member improperly disclosed personal information for 11,000 people in an email sent to multiple addresses. Angela de Rocha, a KDADS spokeswoman, said the disclosure includes Social Security numbers, birth dates and other personal details of Medicaid recipients and potential recipients of the health care program. (Koranda, 3/1)

The brother of the man repeatedly abused at the Whiting Forensic Division has filed two lawsuits on his behalf — one against the state and the other against 12 of the forensic nurses and treatment specialists who the suit charges carried out the abuse. (Rigg, 3/1)

Michael Callahan, an outgoing 43-year-old carpenter, landed in a Los Angeles County jail last September because of what he said were “bad decisions and selling drugs. ”He had uncontrolled diabetes and high blood pressure when he arrived, but his health was the last thing on his mind. Consumed by a meth addiction, he hadn’t taken his medications for months. “When I got here, I was a wreck,” said Callahan, who is stocky and covered in tattoos. “My legs were so swollen that if I bumped them they would break open.” (Gorman, 3/1)

Executives from the Texas Medical Center and Houston's biggest energy companies could launch a data science consortium that would bring together two of the city's top industries to develop groundbreaking research, a move that could make the city more competitive in the field of technology and big data. Generally speaking, the proposal picks up from the University of Texas System's scuttled plan to create a data science center on 300 acres south of downtown. (Sarnoff, 3/1)

U.S. Sen. Claire McCaskill took aim at a variety of targets Thursday, as she reinforced her views on guns and drug companies – and offered up advice to some of the players involved in Gov. Eric Greitens’ legal fight. (Jo Mannies, 3/1)

University of Maryland St. Joseph Medical Center plans a $100 million upgrade to its facilities, which will include modernizing its operating rooms and cardiac catheterization laboratories. The Towson hospital filed a application with the Maryland Health Care Commission for $60 million of the renovations, which must get state approval because they involve medical space. (McDaniels, 3/1)

Piedmont Healthcare announced Thursday that it has formally added Columbus Regional Health to its burgeoning hospital system. (Miller, 3/1)

A large share of Minnesotans using medical marijuana for chronic pain say they’re experiencing less discomfort and have reduced their reliance on potentially addictive opioid drugs. In the state’s first report card on cannabis and chronic pain, more than 60 percent of patients responding to a state survey said they benefited greatly from using pot in inhaled or pill forms, and 43 percent of their doctors concurred. (Olson, 3/1)

People with depression, substance abuse problems, or other behavioral health issues also often have chronic medical conditions like obesity, hypertension, or diabetes. This “co-occurring” of conditions is far more likely to befall people with low incomes than those with higher incomes. When people have both behavioral and chronic health conditions, those with low incomes spend more on their care than people with higher incomes. This disparity may reflect greater severity of disease as well as poorer access to care. (Cunningham, Green and Braun, 2/26)

Participants ... reported cost as the major barrier to initiating therapy. Despite anticipating this barrier, they rarely brought up costs with physicians during the initial visit and generally did not expect their physician to be knowledgeable in this area. Although patients experienced inconvenience and frustration when unable to fill their prescriptions, this experience did not appear to negatively affect their satisfaction with the prescribing physician. Nevertheless, warning patients that the preferred medication may be expensive, having a plan of action if patients were unable to fill the prescription, and securing the patient’s commitment to the plan were described as actions that the physicians could take to improve primary adherence. (Ryskina, Goldberg, Lott et al, 2/28)

Importantly, this change would be implemented on top of an array of other significant policy changes made since the beginning of 2017. We analyze the implications of the 2017 policy changes relative to the ACA as originally designed and implemented, in addition to the potential consequences of the proposed expansion to short-term limited-duration policies. In estimating the effects of these changes on insurance coverage, premiums, and federal spending, we take into account the variations in state circumstances and state-specific laws on short-term plans. (Blumberg, Buettgens and Wang, 2/26)

The Affordable Care Act’s 2018 open enrollment period came at the end of a turbulent year in health care. The Trump administration took several steps to weaken the ACA’s insurance marketplaces. Meanwhile, congressional Republicans engaged in a nine-month effort to repeal and replace the law’s coverage expansions and roll back Medicaid. Nevertheless, 11.8 million people had selected plans through the marketplaces by the end of January, about 3.7 percent fewer than the prior year.  There was an overall increase in enrollment this year in states that run their own marketplaces and a decrease in those states that rely on the federal marketplace. (Collins, Gunja, Doty et al, 3/1)

The flu has been devastating this year. By the end of the season in May, an estimated 34 million Americans will have been infected. Each week there are up to 4,000 flu-related deaths. So far, 97 of the dead have been children. Public health authorities are urging people to get vaccinated. The goal is to get 80 percent of all Americans and 90 percent of at-risk populations (the elderly and children, in particular) vaccinated every year. That would ensure “herd immunity,” meaning it would provide enough protection to stop the spread of the virus. Yet less than 60 percent of children and only 43 percent of adults were vaccinated last flu season. The result is lots of unnecessary illness. (Ezekiel J. Emanuel and Justin Bernstein, 3/1)

Homelessness affects the lives of all Angelenos, not just those forced to live on the streets. And it does so almost daily, in ways large and small. Consider the pairs of thick gloves that George Abou-Daoud has stashed inside the nine restaurants he owns on the east side of Hollywood. When a homeless person accosts his customers, Abou-Daoud says, he can no longer count on the police for help; unless there’s an imminent threat to safety, he contends, they don’t respond quickly and can’t just haul the person away. So he’s had to take matters into his own hands, literally, by physically ejecting problematic homeless people himself. That’s why he has the gloves — to keep his hands clean. (3/1)

I have enjoyed using Jefferson County's parks and green spaces all my life. I regularly take long hikes along the Beargrass Creek drainage, through the Cherokee, Highlands, Phoenix Hill and Ohio River neighborhoods. Now a regular feature of these jaunts is coming across the garbage-strewn encampments of homeless men. I am astonished that the community would even waste much debate about whether to create a program to improve this situation. In Los Angeles, ongoing struggles with a booming homeless population has included taking note of the social cost of leaving destitute people to struggle in hillside and railway corridor encampments. Some of the recent West Coast fires that cost millions in property damage originated in homeless camps. Bacterial and other disease outbreaks arise rapidly in homeless camps that lack basic sanitary facilities. ... It just makes good sense for everyone to protect community health and reduce emergency room costs while helping the desperately poor have a better quality of life. (Bud Hixson, 3/1)

The One Planet Coalition established at the recent climate summit is working to ensure that the 174 nations that have ratified the Paris Agreement follow through on their commitments to battle global warming. The agreement is widely seen as an effort to counteract the ecological and economic impact of rising global temperatures: melting glaciers and ice sheets, rising water levels, and increasing frequency of extreme weather, from severe storms to extended drought, that have had crushing economic consequences.But global warming is doing far more than changing topography and weather. It is also having a series of devastating, detrimental effects on human health. (Philip Landrigan and Robert Wright, 3/1)

Since last month’s high school massacre in Parkland, Fla., attention has focused on lapses by the FBI, which failed to act on tips that the alleged shooter, Nikolas Cruz, posed an imminent danger. It’s also the case that neighbors, teachers, classmates, acquaintances and local authorities were aware that Mr. Cruz was armed and potentially dangerous, a fact that President Trump noted the day after the killing spree. “Must always report such instances to authorities, again and again!” he tweeted. (3/1)

The issue of opioids will be center stage in Washington D.C., where a series of events will take place at the White House, on Capitol Hill, and at a variety of venues across town. The timing for these meetings is critical and U.S. government collaboration with the right partners is key to combat the growing threat of opioids. ...As state and local resources have been depleted, and President Trump declared the opioid crisis a public health emergency last year, freeing up federal resources for the response. But tackling this problem is not simply a matter of unlocking U.S. resources, it’s about continuing to support and partner with the United Nations, specifically agencies like the UN Office on Drugs and Crime (UNODC) and the World Health Organization. (Jordie Hannum, 3/1)

Kentucky is dying. Black lung, COPD, emphysema. This month’s Journal of the American Medical Association reports “the largest cluster ever reported of advanced black lung, also known as progressive massive fibrosis, was confirmed in an area that includes southeastern Kentucky.”  ...Then there is our opioid crisis where 1,471 Kentuckians died in 2016 trying to tamp down their pain, with even higher numbers expected for 2017.  ...Though Kentucky rates well for quality of life at No. 27 out of the 50 states, according to U.S. News and World Report, we rank No. 49 for quality of health care, No. 38 in higher education, No. 45 in economic opportunity and No. 46 in fiscal stability. Which begs the question: How does our senior senator — the man who has represented Kentucky for more than three decades — explain numbers like these? (Teri Carter, 2/28)

Raegan McDonald-Mosley, MD, MPH, served as chief medical officer of the Planned Parenthood Federation of America (PPFA) during a particularly tumultuous time in its history. “We were battling this crazy smear campaign, and then the [presidential] election happened,” said McDonald-Mosley, who became PPFA’s chief medical officer in July 2015, only days after an antiabortion group released a heavily edited video that suggested Planned Parenthood violated federal law by selling fetal tissue. The ensuing state and US House committee investigations found no evidence of wrongdoing by PPFA. However, in January 2017, another House panel called for de-funding the organization. Meanwhile, in September 2017, just months after the call to defund PPFA, the organization was awarded the prestigious Lasker-Bloomberg Public Service Award “for providing essential health services and reproductive care to millions of women for more than a century.” (Rita Rubin, 2/28)

Since hormonal contraception became available in 1960—in the form of a combined estrogen-progestin pill—researchers have evaluated its risks and benefits. Though widely recognized as a breakthrough in medicine and the first effective long-term, reversible method of birth control, hormonal contraception, which is used by an estimated 140 million women worldwide, has never been free of adverse effects. Studies have long found an association between hormonal contraception (now available in other forms, including intrauterine devices [IUDs], the transdermal patch, the vaginal ring, and injectables) and adverse outcomes, such as an increased risk of breast cancer, depression, thrombosis, and other cardiovascular events. Therefore, clinicians have needed to weigh these risks carefully when counseling patients about birth control options—taking into consideration a woman’s family medical history, individual risk factors, and the benefits of hormonal contraception. (Rachel Rabkin Peachman, 3/1)

In the past, I have argued that Medicare needed to move away from its reliance on the Resource-Based Relative Value Scale (RBRVS) and the Sustainable Growth Rate formula (SGR) for physician reimbursement if it was serious about supporting value-based health care delivery. Indeed, the RBRVS–SGR combination represented the opposite of a value-based system: reimbursement reflecting the average effort and expenses of a physician providing a given service, in a system that assumed the “collective guilt” of physicians, in that all physicians’ Medicare fee-for-service reimbursements were adjusted according to whether aggregate Medicare fee-for-service spending for physicians grew faster or slower than the overall economy. With a level of bipartisan support that has become rare, Congress passed the Medicare Access and CHIP Reauthorization Act (MACRA) in 2015, eliminating the SGR. The purpose of the legislation was to move Medicare toward reimbursement based more on outcomes and value. The Medicare Payment Advisory Commission (MedPAC) has now questioned whether the current version of MACRA accomplishes these goals or even moves the system in a better direction. (Gail R. Wilensky, 3/1)