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Morning Briefing

Summaries of health policy coverage from major news organizations

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Tuesday, Aug 28 2018

吃瓜不打烊 Original Stories 3

  • Parent Alert! Your Kid May Be Vaping More Than Nicotine
  • Suicide By Opioid: New Research Suggests Overdoses Should Be Classified As Self-Harm
  • Shifting Gears: Insuring Your Health Column 鈥 Born With The ACA 鈥 Draws To A Close

Health Law 1

  • GOP's Proposed Bill To Protect Preexisting Conditions Opens Republican Candidates Up To Attack

Marketplace 2

  • Health Care Costs Among Hardships Weighing On Americans Even In Strong Economy
  • Patrick Soon-Shiong Brought Hope To Deeply Indebted California Health System. A Year Later It's Been Dashed.

Government Policy 1

  • Toddler Died After Contracting Infection At ICE Detention Center, Law Firm Claims

Quality 1

  • As America's Jails Become Warehouses For Mentally Ill, Brutal Treatment Of Inmates Leading To Grisly Deaths

Opioid Crisis 1

  • 'I Sat My Wife Down And Told Her Life Wasn鈥檛 Worth It': Opioid Crackdown Driving Pain Patients To Drastic Measures

Public Health 4

  • Suicidal Students Devastated By Universities' Responses To Crises: 'I Reached Out For Help And Now I鈥檓 Suddenly Getting Blamed For It'
  • Advocates Warn Nationwide Study On Sepsis Treatment Endangers Patients, Should Be Halted
  • As Women Put Off Motherhood Until Later, More Are Turning To Apps Or Wearable Devices To Help Conceive
  • Many Studies Fail Reproducibility Tests Again In Social Sciences And Psychology, So What's Up?

State Watch 2

  • Court Records Detail Jacksonville Shooter's History Of Mental Illness As An Adolescent
  • State Highlights: Coalition Forms To Kill Any Attempt At Single-Payer In California; Ill. Bill To Require Insurers Cover Egg, Sperm Freezing For Patients With Cancer, Other Diseases

Editorials And Opinions 2

  • Different Takes: Pros And Cons Of 'Medicare For All'; Pinpoint Smaller Tweaks That Make A Big Cost Difference
  • Viewpoints: Practice Safe Recoveries From Opioid Abuse, But Don't Legalize Safe Injection Sites; Lessons From John McCain On Dying

From 吃瓜不打烊 - Latest Stories:

吃瓜不打烊 Original Stories

Parent Alert! Your Kid May Be Vaping More Than Nicotine

Educators and researchers say that as vaping becomes more common among young people, some are putting pot in their pods. ( Ana B. Ibarra , 8/28 )

Suicide By Opioid: New Research Suggests Overdoses Should Be Classified As Self-Harm

Researchers combined the number of suicide deaths with those associated with drug overdoses in an effort to better grasp the overlap between these two public health epidemics. ( Rachel Bluth , 8/27 )

Shifting Gears: Insuring Your Health Column 鈥 Born With The ACA 鈥 Draws To A Close

The column, which began in 2010 shortly after the federal health law was signed, helps explain how that law affected Americans. Michelle Andrews, the author, will continue to report for KHN. ( Michelle Andrews , 8/28 )

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Summaries Of The News:

Health Law

GOP's Proposed Bill To Protect Preexisting Conditions Opens Republican Candidates Up To Attack

Sen. Joe Manchin (D-W.Va.) says that with the legislation Republicans are admitting that patients would be harmed by the suit currently in the courts against the health law. Meanwhile, Sen. Susan Collins (R-Maine) spoke out about the proposed bill, saying it doesn't properly address essential benefits protections.

Democratic Sen. Joe Manchin (W.Va.) is using a new bill from Senate Republicans to attack his opponent over ObamaCare鈥檚 pre-existing condition protections. Manchin, facing a tough reelection race this year against West Virginia Attorney General Patrick Morrisey (R), is pointing to a new Senate GOP bill that aims to preserve ObamaCare鈥檚 pre-existing condition protections as a rebuke to Morrisey鈥檚 position in court against those provisions. (Sullivan, 8/27)

Sen. Susan Collins on Monday criticized a new GOP health bill for failing to fully protect people with pre-existing conditions 鈥 undercutting her fellow Republicans鈥 claims that the legislation would shield vulnerable Americans if Obamacare is eliminated. (Cancryn, 8/27)

In other health law news聽鈥

Illinois consumers who buy health insurance on the state鈥檚 Obamacare exchange will get more coverage aimed at treating and preventing opioid addiction, starting in 2020. On Monday, the federal Centers for Medicare & Medicaid Services approved Illinois鈥 request to expand the list of medical services that exchange insurers in Illinois must cover. Most people in Illinois get health insurance through employers or government programs such as Medicare and Medicaid, but this year more than 300,000 Illinois residents had insurance through the Obamacare exchange. (Schencker, 8/27)

Marketplace

Health Care Costs Among Hardships Weighing On Americans Even In Strong Economy

A surprising number of Americans are unable to pay for basic needs such as health care, a new survey finds. In other news on health care costs, a few employers are offering workers a unique benefit: help paying for stem cell storage.

Despite a strong economy, about 40 percent of American families struggled to meet at least one of their basic needs last year, including paying for food, health care, housing or utilities. That's according to an Urban Institute survey of nearly 7,600 adults that found that the difficulties were most prevalent among adults with lower incomes or health issues. But it also revealed that people from all walks of life were running into similar hardships. (Skidmore Sell, 8/28)

As MyCrypto mulled what benefits to offer employees, the new blockchain startup asked them what they wanted. 鈥淪urprisingly, we found that the traditional health benefits and 401(k) benefits鈥攖hey had no interest in those,鈥 said Taylor Monahan, the company鈥檚 founder and chief executive. If employees didn鈥檛 want two of the biggest reasons to be full-time, what did they want? 鈥淭hey鈥檙e early adopters and they鈥檙e tech-minded people, so the concept of living forever turns them on,鈥 said Monahan. 鈥淭hat鈥檚 how we figured Forever Labs would be a good fit.鈥 (Greenfield, 8/27)

And a heart attack leaves a patient with a massive bill聽鈥

Kaiser Health News: A Jolt To The Jugular! You鈥檙e Insured But Still Owe $109K For Your Heart Attack聽

Drew Calver took out his trash cans and then waved goodbye to his wife, Erin, as she left for the grocery store the morning that upended his picture-perfect life. Minutes later, the popular high school history teacher and swim coach in Austin, Texas, collapsed in his bedroom from a heart attack. He pounded his fist on the bed frame, violent chest pains pinning him to the floor. (Terhune, 8/27)

Patrick Soon-Shiong Brought Hope To Deeply Indebted California Health System. A Year Later It's Been Dashed.

Billionaire Patrick Soon-Shiong promised great improvements for the struggling Verity Health System when he took it over last year. Now it stands on the edge of bankruptcy.

In the year since Los Angeles billionaire Patrick Soon-Shiong took control of a deeply indebted California hospital system, it invested millions in technology that advanced his for-profit interests while cutting charity care and neglecting earthquake preparedness. Now, it stands at the brink of sale or, possibly, bankruptcy. Soon-Shiong, the Los Angeles surgeon and entrepreneur whose empire includes health technology firms and foundations, part of the L.A. Lakers and, most recently, ownership of the Los Angeles Times, bought a controlling stake in the firm that operates the struggling Verity Health System hospital chain in July 2017. Soon-Shiong saw Verity as a place to fulfill his longtime dream of advancing high-tech approaches to cancer treatment, and promised to provide 鈥渢he highest level of care with the best outcomes at lowest cost for all Californians.鈥 (Tahir, 8/28)

In other health industry news聽鈥

As tech giants start to forge paths into healthcare, they stand to put pressure on established healthcare IT firms to open up their systems and adopt data standards. But change won't happen overnight, and these outsiders will need to adjust too, gaining access to healthcare data and making it useful while potentially moving at a slower pace than they're used to. (Arndt, 8/27)

A trio of economists has a suggestion it says will save taxpayers about $4.6 billion per year with no harm to patients: get rid of higher payments to long-term care hospitals. A National Bureau of Economic Research study released Monday found that despite being reimbursed at much higher rates than skilled nursing facilities and home healthcare providers, long-term care hospitals don't produce better outcomes in three important areas: They don't reduce mortality or length of stay and they leave patients with higher out-of-pocket costs. (Bannow, 8/27)

Government Policy

Toddler Died After Contracting Infection At ICE Detention Center, Law Firm Claims

The mother and her one-year-old daughter, Mariee, were held at a facility in Dilley, Texas in March, and the girl died of viral pneumonitis about six weeks after her release. "A mother lost her little girl because ICE and those running the Dilley immigration prison failed them inexcusably," said R. Stanton Jones, a partner at the D.C. law firm representing the family.

A law firm representing the family of a toddler reported to have died after being released from an immigration detention facility issued new information Monday about what it called a "needless and devastating loss." Washington-based Arnold & Porter's statement Monday identifies the child by her first name, Mariee, and says she was 21 months old when she died in May. A Vice News story also released Monday said Mariee arrived with her mother, Yazmin Juarez, at the detention center in Dilley, Texas, in March, and died about six weeks after her release. (8/27)

Shortly after they arrived at the South Texas Family Residential Center in March, Mariee contracted a respiratory infection that her lawyers at the firm of Arnold & Porter allege "went woefully under-treated for nearly a month." Officials in Texas say they are investigating the case, and Immigrations and Customs Enforcement officials did not respond to specific allegations made by Juarez and her lawyers. (Lynch, Alsup and Park, 8/28)

"A mother lost her little girl because ICE and those running the Dilley immigration prison failed them inexcusably," said R. Stanton Jones, a partner with Arnold & Porter, a Washington, D.C. law firm representing the family pro bono. 鈥淚nstead of offering safe harbor from the life-threatening violence they were fleeing, ICE detained Yazmin and her baby Mariee in a place with unsafe conditions, neglectful medical care, and inadequate supervision. ... The medical care Mariee received in ICE detention was woefully inadequate, neglectful, and substandard." (Platoff, 8/27)

Quality

As America's Jails Become Warehouses For Mentally Ill, Brutal Treatment Of Inmates Leading To Grisly Deaths

鈥淲e are arresting people who have no idea what the laws are or the rules are because they're off their medications,鈥 said Nashville Sheriff Daron Hall, a vice president of the National Sheriffs鈥 Association. 鈥淵ou'd never arrest someone for a heart attack, but you're comfortable arresting someone who is diagnosed mentally ill. No other country in the world is doing it this way.鈥 The Virginian-Pilot investigates the issue.

David O'Quin was arrested for disturbing the peace in Louisiana. His father pleaded in vain to jail officials for him to be given his medications for severe mental disorders. Less than two weeks later, O'Quin died from a bacterial infection after his own excrement got into cuts that he received from being beaten and put in a restraint chair. Jennifer Towle was suffering from depression so severe she started eating a nail clipper, milk cartons and other objects while jailed in New Jersey. After she died, an autopsy found about three liters of such material in her stomach. People with mental illnesses in jails around the country are routinely dying in horrific ways and under preventable circumstances, a Virginian-Pilot investigation has found. The country鈥檚 3,000-plus jails are the default treatment center for many. There is often nowhere else to take them. (Harki, 8/23)

Opioid Crisis

'I Sat My Wife Down And Told Her Life Wasn鈥檛 Worth It': Opioid Crackdown Driving Pain Patients To Drastic Measures

鈥淢y pain exceeded my ability to handle it," Jon Fowlkes said after he was cut off from his opioid prescription. "We had a very frank discussion. 鈥 We even discussed what gun I would use.鈥 Fowlkes is one of many chronic pain patients who feel angry and betrayed by the recent efforts to curb the opioid epidemic.

Last August, Jon Fowlkes told his wife he planned to kill himself. The former law enforcement officer was in constant pain after his doctor had abruptly cut off the twice-a-day OxyContin that had helped him endure excruciating back pain from a motorcycle crash almost two decades ago that had left him nearly paralyzed despite multiple surgeries. (Ehley, 8/28)

America is facing what is arguably its biggest public health crisis since AIDS: the opioid epidemic. As lawmakers struggle to address the crisis, POLITICO is following the unintended consequences patients are facing, from doctors who aren鈥檛 trained to safely taper patients off opioids to non-drug alternatives that aren鈥檛 covered by insurance. We asked for your stories, and more than 500 of you responded. Many of you shared how you tapered off opioids and ideas for others to transition off their prescription painkillers and cope with withdrawal symptoms. (Yu, 8/28)

And in other news聽鈥

About 20 percent of kids in the U.S. use prescription drugs and many take more than one at a time, putting them at risk of harmful interactions, new research finds. Nearly one in five children and teenagers use prescription medicines, with 7.5 percent taking multiple medications, according to a study of 23,152 kids under the age of 19 in the journal Pediatrics. Of those taking more than one medication, 1 in 12 were at risk for a potentially major interaction. (Hopkins, 8/27)

Public Health

Suicidal Students Devastated By Universities' Responses To Crises: 'I Reached Out For Help And Now I鈥檓 Suddenly Getting Blamed For It'

A series of legal challenges against universities' policies on students' mental health highlights the way the organizations struggle to respond to the young people in need. In other mental health news, conversion therapy is getting attention because of big-screen movies as states work to limit and ban the practice.

When Harrison Fowler heard about the counseling center at Stanford, where he enrolled as a freshman last fall, he decided to finally do something about the angst he had been struggling with for a long time. The results were not what he had expected. Asked if he had ever considered suicide, he said yes. The center advised him to check himself into the hospital. From there, he was sent to a private outpatient treatment center, where he was prescribed an antidepressant that he said triggered horrible suicidal fantasies. It wasn鈥檛 long before he was back in the hospital, being urged to go home to Texas. (Hartocollis, 8/28)

A therapist forbade 16-year-old Mathew Shurka from speaking to his mother and sisters for three years. The youngest child and only son in a tight-knit Long Island family, Shurka said that his mom wasn't physically or emotionally abusive. Instead, the therapist told the teen to give the women the silent treatment because it would help make him straight. "When I first came out to my dad when I was 16, I was looking for his acceptance and approval about being gay. He was loving in that moment and said he cared and he'd be there for me, but he thought it was a phase, and he wanted to get me help," said Shurka, now 30. "He didn't raise us religious or anything. He just didn't think I'd be successful if I was a gay man." (Christensen, 8/27)

And from the states聽鈥

Religious people tend to turn to clergy聽for help and support in times of trouble.聽But when that trouble manifests as a聽mental health issue, odds are their pastor or rabbi聽is not well-equipped to respond effectively, said Jared Pingleton, a licensed clinical psychologist. ...Mental health and relational issues can be complicated, costly and labor intensive, Pingleton said. And clergy members do not have the training nor do they have the time to give these types of crises the attention they need, he said. (Meyer, 8/27)

When a sick kid steps into the pediatrician鈥檚 office, it could be for just about anything: an ear infection, a twisted ankle聽or an upset stomach. And sometimes, behind all those outward symptoms, there is something deeper that needs attention. Pediatricians and family doctors have long served a crucial but largely undefined role in American mental health care, diagnosing and treating depression and anxiety in addition to everyday physical injuries and common diseases. (Kelman, 8/27)

The Austin school board Monday night approved an agreement with Integral Care to keep 16 campus mental health centers open this school year. The campus centers were in jeopardy of closure after the school district in June approved a $7.1 million student health services plan with Seton Healthcare Family that discontinued funding for 16 of 40 campus-based mental health centers with an on-site therapist. (Taboada, 8/27)

Advocates Warn Nationwide Study On Sepsis Treatment Endangers Patients, Should Be Halted

Doctors currently struggle to find the "sweet spot" in treating patients who contract the life-threatening infection. But Public Citizen says the massive study's benefits won't outweigh its risks.

A consumer advocacy organization is asking federal health officials Tuesday to halt a large medical study being conducted at major universities nationwide. Public Citizen says that the study, involving treatment for sepsis, puts patients at risk and will at best produce confusing results. (Harris, 8/28)

The problems with the 鈥淐LOVERS鈥 study are so serious that 鈥渋t is difficult to imagine any reasonable person agreeing to enroll 鈥 if he or she were fully informed of [its] true nature and risks,鈥 wrote Dr. Sidney Wolfe and Dr. Michael Carome of Public Citizen鈥檚 Health Research Group. They contended that patients in the trial are 鈥渦nwitting guinea pigs in a physiology experiment that will not advance medical care for sepsis,鈥 and that other lapses are 鈥渟tunning in their breadth and scope.鈥 (Begley, 8/28)

As Women Put Off Motherhood Until Later, More Are Turning To Apps Or Wearable Devices To Help Conceive

New technology is helping women pinpoint their fertility window with more accuracy. In other public health news: evolution, video games, the flu, "rose hip" neurons, Advil, and more.

When Nicole and Christopher Roberts of North Stonington, Conn., decided to start a family in 2016, Nicole quickly became pregnant, but then miscarried three months later. Getting pregnant a second time became far tougher than they expected. Mrs. Roberts, 32, started taking neonatal vitamins, tracking her menstrual cycle carefully, taking over-the-counterovulation tests, and even trying a few wacky internet suggestions, such as putting her legs up in the air after sex and not moving for half an hour. (Morrissey, 8/27)

No one is questioning whether leaving the couch to go for a walk or run or to lift heavy objects would personally do you some good 鈥 accelerating your heart rate, burning some calories, maybe even adding a few years to your life. But consider this: All that exercise may be a selfish act, a shortsighted game of checkers in an evolutionary chess match that鈥檚 been going on for eons. And by not stepping, you may have already taken the first step toward saving the species. (Wootson, 8/27)

Doctors who played the game [Tobi] Saulnier designed did a better job on a separate virtual simulation designed to test their clinical judgement about trauma transfers than those who used a text-based app or nothing at all, according to new research published Monday in the Proceedings of the National Academy of Sciences.聽The study found a similar result for doctors who played a story-based adventure game from Schell Games, also for the iPad. (Seridan, 8/27)

For over a year, the Chinese government has withheld lab samples of a rapidly evolving influenza virus from the United States 鈥 specimens needed to develop vaccines and treatments, according to federal health officials. Despite persistent requests from government officials and research institutions, China has not provided samples of the dangerous virus, a type of bird flu called H7N9. In the past, such exchanges have been mostly routine under rules established by the World Health Organization. (Baumgaertner, 8/27)

Scientists have taken another step toward understanding what makes the human brain unique. An international team has identified a kind of brain cell that exists in people but not mice, the team reported Monday in the journal Nature Neuroscience. "This particular type of cell had properties that had never actually been described in another species," says Ed Lein, one of the study's authors and an investigator at the Allen Institute for Brain Science in Seattle. (Hamilton, 8/27)

Pfizer Consumer Healthcare says they are voluntarily recalling one specific lot of Children's Advil Suspension Bubble Gum flavor. According to the alert, the dosage cup provided in the package is marked in teaspoons, while the instructions on the label are described in milliliters. (King, 8/27)

After a day of mainlining coffee and staring at the computer, 鈥渞elaxing鈥 at happy hour then staying up late glued to the television, getting in bed only to consume the infinite scroll of news and takes on your mobile instead of sleeping like you know you should, an eye twitch begins. You go to sleep, thinking by the time you wake up the twitch will be gone. But it's not. It's there for days, maybe even weeks. (Furby, 8/27)

Having spent a quarter of her life in the hospital, she knows how to sleep through noise. She's so good at it that she worried the phone call wouldn't wake her. But when her cell rang at about 5:30 a.m. Sunday, she was ready. On the other end was the news Claire Wineland had been waiting for: Doctors had found a pair of donor lungs. She'd been on the transplant list for just over two weeks after months of uncertainty. Now she was getting her chance at an extended life. (Ravitz, 8/28)

Everybody loves a winner 鈥 even toddlers, according to a study published Monday. But even though kiddos tend to like high-status individuals, they don't like those who win conflicts by using force. "It seems like toddlers care about who wins, but they also care about how they win," says Ashley Thomas, now a researcher in cognitive development at the Massachusetts Institute of Technology and Harvard. (Greenfieldboyce, 8/27)

Kaiser Health News: Parent Alert! Your Kid May Be Vaping More Than Tobacco

By now, many parents know kids are vaping sweet-smelling tobacco 鈥 often using devices that look deceptively like pens or flash drives. And most parents are hip to the prevalence of underage marijuana use. Now comes a combo of the two: vaping pot. Experts and educators say young people are 鈥 once again 鈥 one step ahead of the adults in their lives, experimenting with this new and more heady way to consume weed. (Ibarra, 8/28)

Is it really possible to find healthy food at an airport? When it comes to airports in the United States, at least, the answer is yes, increasingly so. In recent years, airports around the country have amped up their availability of healthy snacks, meals and drinks to cater travelers who want to follow a balanced diet when they are away from home. (Vora, 8/28)

Many Studies Fail Reproducibility Tests Again In Social Sciences And Psychology, So What's Up?

Rather than view the studies that aren't able to be replicated as troublesome, scientists say they can predict the losers and regard the flawed research as a way to help accelerate the process of science.

The 鈥渞eproducibility crisis鈥 in science is erupting again. A聽research project attempted to replicate 21 social science experiments published between 2010 and 2015 in the prestigious journals Science and Nature. Only 13 replication attempts succeeded. The other eight were duds, with no observed effects consistent with the original findings. The failures do not necessarily mean the original results were erroneous, as the authors of this latest replication effort note. (Achenbach, 8/27)

As part of the reproducibility study, about 200 social scientists were surveyed and asked to predict which results would stand up to the re-test and which would not. Scientists filled out a survey in which they predicted the winners and losers. They also took part in a "prediction market," where they could buy or sell tokens that represented their views. "They're taking bets with each other, against us," says Anna Dreber, an economics professor at the Stockholm School of Economics, and coauthor of the new study. It turns out, "these researchers were very good at predicting which studies would replicate," she says. "I think that's great news for science." (Harris, 8/27)

State Watch

Court Records Detail Jacksonville Shooter's History Of Mental Illness As An Adolescent

Divorce records show David Katz played video games obsessively, often refusing to go to school or to bathe. His mother reported when she took his game controllers away, she'd find him walking in circles in early morning hours. In other news, lawmakers in California approve new gun restrictions and bans, including to those involuntarily placed in psychiatric hospitals.

The suspect in a deadly shooting at a Florida video game tournament had previously been hospitalized for mental illness, according to court records in his home state of Maryland reviewed by The Associated Press. Divorce filings from the parents of 24-year-old David Katz of Baltimore say that as an adolescent he was twice hospitalized in psychiatric facilities and was prescribed antipsychotic and antidepressant medications. (8/28)

California lawmakers on Monday approved a trio of bills that would reduce the number of people with access to firearms, including lifetime bans on owning guns for people convicted of domestic violence聽and individuals placed on involuntary psychiatric holds twice in a year by the courts. The three bills now head to the desk of Gov. Jerry Brown for consideration. (McGreevy, 8/28)

State Highlights: Coalition Forms To Kill Any Attempt At Single-Payer In California; Ill. Bill To Require Insurers Cover Egg, Sperm Freezing For Patients With Cancer, Other Diseases

Media outlets report on news from California, Illinois, Oregon, Massachusetts, New Hampshire, Iowa and Wyoming.

A group of influential, deep-pocketed business and health care organizations that have long helped shape the legislative agenda in California have joined forces to oppose any future effort to craft a universal, single-payer health care system for the nation鈥檚 largest state. The main focus of the coalition, called 鈥淐alifornians against the costly disruption of our health care,鈥 is to kill any single-payer health care bill in the state Legislature, said Ned Wigglesworth, a political strategist for the coalition. (Hart, 8/28)

Gov. Bruce Rauner signed a bill into law Monday that will require health insurance companies in Illinois to cover the preservation of eggs, sperm and embryos for patients with cancer and certain other diseases. Those patients often have to undergo treatments that can leave them sterile. Yet, until now, not all insurers have covered the costs of preserving their fertility. (Schencker, 8/27)

The state's only heart transplant program is now temporarily suspended after at least three cardiologists on the transplant team left or announced plans to leave Oregon Health & Science University. The medical center will no longer evaluate new patients for a transplant, accept donor hearts or perform any transplant surgeries for 14 days. Renee Edwards, chief medical officer for OHSU Healthcare, said the transplant team is adequately staffed to follow up with anyone who's recently received a new heart. (Harbarger, 8/27)

Family members of former USC fullback Douglas MacKenzie and former UCLA running back Rodney Stensrud have filed wrongful death lawsuits against the NCAA in Los Angeles County Superior Court. The complaints are among the first in a wave of suits expected to be filed against the NCAA and its conferences and universities in the coming months, that allege the sport鈥檚 governing body did not properly inform college football players of the risks of head injuries and the impact that traumatic brain injury could have on their long-term quality of life. (McCollough, 8/27)

Children鈥檚, the region鈥檚 largest pediatric medical center, is spending $11 million over the next three years on programs designed to help families affected by racial, ethnic, and socioeconomic inequities, and 鈥 indirectly 鈥 improve their health. Among the projects: an effort to help tenants avoid eviction, an initiative to help babies develop social and cognitive skills, and a program to educate parents about nutritious foods. (Dayal McCluskey, 8/28)

After she was injured in a car accident allegedly caused by a driver impaired by pot, state Controller Betty Yee is backing a bill approved Monday by the Legislature that aims to begin addressing the problem of drugged driving on California roads. The measure sent to Gov. Jerry Brown would require the California Highway Patrol to report on how many motorists stopped for impaired driving are allegedly under the influence of marijuana. (McGreevy, 8/28)

UC Davis Health employees are contending that a manager installed a video camera in a supply room where employees changed into their scrubs. But UCD officials said Monday that the camera had not been hooked up to record anything. (Anderson, 8/27)

The number of towns in New Hampshire at risk for West Nile virus is growing. Last week, the Department of Health and Human Services elevated Manchester鈥檚 level of risk for West Nile to high, automatically elevating the surrounding towns to medium risk. Manchester discovered the first positive batch of West Nile virus mosquitoes in late July. Since then, it has identified five more batches of mosquitoes with the virus. (Gibson, 8/27)

Leave it to California to combine high-end cuisine with the kind of ingredients that might actually get you high. It's an increasingly lucrative niche for chefs in San Francisco and Los Angeles 鈥 cities already well known for trendy food culture. (Ulaby, 8/28)

Albany County struggles more than others in the state with hunger and access to healthy food. That鈥檚 why a group of AmeriCorps volunteers came to Laramie, to help grow vegetables and deliver them to food banks and soup kitchens in the community. (Edwards, 8/27)

Editorials And Opinions

Different Takes: Pros And Cons Of 'Medicare For All'; Pinpoint Smaller Tweaks That Make A Big Cost Difference

Opinion writers express views about how to lower health care costs and provide quality care.

Enthusiasm for expanding the government health-insurance program for the elderly to cover all U.S. citizens is growing among Democratic political hopefuls. According to Dylan Scott at Vox.com, 鈥淣early every single rumored 2020 candidate in the Senate has backed Senator Bernie Sanders鈥檚 Medicare-for-all bill.鈥 The idea polls well and the vast majority of seniors are satisfied with their current care under Medicare. The financing for such an ambitious program may derail these hopes. (Karl W. Smith, 8/27)

When a libertarian think-tank published a study of Sen. Bernie Sanders鈥檚 (I-Vt.) Medicare for All plan last month, it said that Sanders鈥檚 plan would cut payments to providers such as hospitals and doctors by 40 percent. The number suggested Sanders鈥檚 plan was wildly unrealistic, and that his plan for achieving universal health care relied on either massive cuts to doctors and hospitals or would prove far more expensive than he was otherwise saying. But Sanders鈥檚 supporters say the figure is misleading, and that doctors and hospitals could absorb cuts to their payments under the plan, which also would extend free government health insurance to every American in the country. (Jeff Stein, 8/27)

We asked Influencers what Florida鈥檚 next governor and Legislature should make their top priorities when it comes to healthcare. (8/27)

The health care system in the United States costs nearly double that of its peer countries, without much better outcomes. Many scholars and policymakers have looked at this state of affairs and dreamed big. Maybe there鈥檚 some broad fix 鈥 high deductibles, improvements in end-of-life care, a single-payer system 鈥 that can make United States health care less expensive. But what if the most workable answer isn鈥檛 something big, but hosts of small tweaks? A group of about a dozen health economists has begun trying to identify policy adjustments, sometimes in tiny slices of the health care system, that could produce savings worth around 1 percent of the country鈥檚 $3.3 trillion annual health spending. If you put together enough such fixes, the group points out, they could add up to something more substantial. (Margot Sanger-Katz, 8/27)

Throughout his presidential bid, Donald Trump promised not to cut Medicaid 鈥 a source of public health insurance for millions of people 鈥 including his own supporters. But the president became the most prominent booster of the congressional effort to repeal and replace the Affordable Care Act, which included a virtual end to Medicaid as it has existed for over 50 years, despite the fact that the program covers over 70 million children and adults. (Sara Rosenbaum, 8/27)

The problems inherent in the American medical industry are well-known, but solutions are rarely applied, thanks to lobbyists and the politicians they support with their campaign dollars. It鈥檚 enough to make a person sick. (Cal Thomas, 8/27)

Viewpoints: Practice Safe Recoveries From Opioid Abuse, But Don't Legalize Safe Injection Sites; Lessons From John McCain On Dying

Editorial pages focus on these health issues and others.

Almost 64,000 Americans died of drug overdoses in 2016, a shocking 54 percent increase since 2012. Dangerous opioids such as heroin and fentanyl contributed to two-thirds of the deaths. This killer knows no geographic, socioeconomic or age limits. It strikes city dwellers and Midwestern farmers, Hollywood celebrities and homeless veterans, grandparents and teenagers. Remarkably, law enforcement efforts actually declined while deaths were on the rise. Federal drug prosecutions fell by 23 percent from 2011 to 2016, and the median drug sentence doled out to drug traffickers decreased by 20 percent from 2009 to 2016. The Trump administration is working to reverse those trends. Prosecutions of drug traffickers are on the rise, and the surge in overdose deaths is slowing. Unfortunately, some cities and counties are considering sponsoring centers where drug users can abuse dangerous illegal drugs with government help. Advocates euphemistically call them 鈥渟afe injection sites,鈥 but they are very dangerous and would only make the opioid crisis worse. (Deputy Attorney General Rod J. Rosenstein, 8/27)

Americans are often a disputatious sort, earnestly quarreling over virtually anything from abortion to what body posture is patriotic. So, it鈥檚 a valuable reminder and encouraging as a nation now and then to take note when we do succeed in quietly working out serious issues together without searing political struggles. Progress may be erratic. And it may take some time to sort out our ethics and what鈥檚 right to forge a lasting social consensus. But in the end, it鈥檚 worth it and our society is better and stronger for it. Such is the case now with what used to be called the right to die. We saw dramatic evidence in recent days when 81-year-old John McCain鈥檚 family announced that after more than a year of battling an aggressive brain cancer, he was stopping treatment and letting nature take its course. He died the next day. (Andrew Malcolm, 8/27)

聽In his posthumously published bestseller, 鈥淔actfulness鈥, author Hans Rosling warns, 鈥淭here鈥檚 no room for facts when our minds are occupied by fear.鈥澛燘efore the passing of Sen. John McCain (R-Ariz.) on Saturday, he made a choice. On Friday evening 鈥 as I read the reports that he had chosen to forego aggressive treatment for his brain tumor 鈥 I was reminded of how emotions often drive the facts of a situation. Commentators and pundits were quick to point out that John McCain will 鈥渘o longer receive treatment.鈥 Reading many of these headlines, some readers 鈥 who are not familiar with the medical system 鈥 assumed that McCain鈥檚 caregivers are abandoning him. The danger with this is that such confusion can distort the quality of end of life care discussions physicians can have with patients and their loved ones. (Junaid Nabi, 8/27)

Like many Americans, I have a story about hospice care for a loved one. When my father was dying from complications of dementia and diabetes, hospice caregivers sat with him, provided pain relief, and helped him be comfortable. They also gave my mother peace of mind that her beloved husband was receiving kind attention in his final weeks. To this day, she refers to those hospice workers as angels. Sadly, not every family鈥檚 story is a positive one. ...The Department of Health and Human Services鈥 Office of Inspector General, for which I work, recently published a report examining hospice practices over a decade. It showed that hospices do not always provide the services that patients need and sometimes provide poor-quality care. We also found that patients and their families often do not receive crucial information to make informed decisions about hospice care. (Joanne M. Chiedi, 8/28)

鈥淣o one deserves to die over playing a video game, you know.鈥 That was the comment of one of the people who managed to escape from a gunman who shot up a gaming tournament in Jacksonville, Fla. The same thing also should be said about sitting in a classroom, praying in church, listening to country music, dancing at a nightclub, retrieving luggage, going to work. Sadly, though, in the United States, these and other routines of everyday life carry the risk of tragedy from gun violence. And so, once again, the question must be posed of what it will take to get Congress to confront this problem. (8/27)

After every national shooting tragedy, gun lobbyists and the lawmakers beholden to them say it's politicizing tragedy to talk about gun laws. But for the victims in Jacksonville and the nearly 100聽Americans who die from gun violence every day, it鈥檚 too late. We need stronger gun laws 鈥 solutions such as a background check on every gun sale, keeping guns out of the hands of domestic abusers, and passing red-flag laws across the nation. Many of these聽solutions are proven by data to save lives, and some are also popular with voters 鈥 gun owners and non-gun owners alike. (8/27)

Hawaii rarely encounters hurricanes; none have made landfall since 1992. Yet within three weeks this month, Hurricane Hector sideswiped the islands and Hurricane Lane flooded them. Homeowners who lack sufficient insurance will now expect the Federal Emergency Management Agency to make their houses habitable again. But if recent history is any guide, Hawaiians should brace themselves. When FEMA rules conflict with local ones, the agency鈥檚 legalistic argle-bargle sometimes requires a decade to sort out.Hurricane Harvey shows what can go wrong. It lumbered through Texas, unloading 5 feet of rain, one year ago. Yet 8% of survivors have not returned to their homes, as per a recent Kaiser Family Foundation study. Some low-income families had their aid requests denied by FEMA because of 鈥渋nsufficient damage鈥 to their homes. But FEMA also denied aid to homes with roofs blown off or mold creeping up the walls. (Parker Abt, 8/27)

After Hurricane Harvey lashed its way through Houston, everyday people got to work to rebuild. This is a "can do" city, Mayor Sylvester Turner reported in CBS鈥檚 鈥淔ace the Nation鈥 last September. 鈥淲e're not going to engage in a pity party. We are going to take care of each other. Neighbors are taking care of each other.鈥 ...But what about our mental health? Post-traumatic symptoms often appear months to years following disasters, according to the National Institute of Mental Health. Clearly then, only one year out, our communities have only begun to mentally process the effects of Harvey. But while physical rebuild efforts have now been handed over to skilled laborers, we should not expect the same for our city鈥檚 mental health. (Joy Vonk, 6/28)

Last week a paper was published in The Lancet that claimed to be the definitive study on the benefits and dangers of drinking. The news was apparently not good for those who enjoy alcoholic beverages. It was covered in the news media with headlines like 鈥淭here鈥檚 No Safe Amount of Alcohol.鈥 The truth is much less newsy and much more measured. (Aaron E. Carroll, 8/28)

The announcement that New York University is abolishing tuition for its medical students elicited surprise and joy from the incoming class of 2022 (and pangs of jealousy from students like us who had chosen to go elsewhere for medical school). Some pundits see this as the first of many tuition dominoes to fall. Given the financial investment that a school needs in order to forego tuition as a source of revenue, an analysis we performed suggests that many schools won鈥檛 be able to pull that off. (Daniel Thomas, 8/28)

[T]here is a bipartisan bill in Congress, supported by nearly half of the Senate already, that would strengthen our response to Alzheimer鈥檚. The Building Our Largest Dementia (BOLD) Infrastructure for Alzheimer鈥檚 Act (S. 2076/H.R. 4256) would provide state, local, and tribal public health officials with the funding and resources necessary to increase early detection, diagnosis, and improve data collection around Alzheimer鈥檚 disease. ... As the most expensive disease in America, Alzheimer鈥檚 will cost the country $277 billion in 2018, but it also imposes shattering financial and emotional costs on unpaid caregivers. If passed, the BOLD Infrastructure for Alzheimer鈥檚 Act would also support the needs of caregivers and support care planning for people living with Alzheimer鈥檚. (Leah Acuff-White, 8/24)

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