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The Obama administration on Thursday said it was shifting $81 million away from biomedical research and antipoverty and health care programs to pay for the development of a Zika vaccine, resorting to extraordinary measures because Congress has failed to approve new funding to combat the virus. Sylvia Mathews Burwell, the secretary of health and human services, told members of Congress in a letter that without the diverted funds, the National Institutes of Health and the Biomedical Advanced Research and Development Authority would run out of money to confront the mosquito-borne illness by the end of the month. (Davis, 8/11)

The money will supplement the $347 million HHS transferred away from an existing fund to fight the Ebola virus. The administration is seeking $1.9 billion to fight Zika, but Congress is deadlocked over the funding. “The failure to pass a Zika emergency supplemental has forced the Administration to choose between delaying critical vaccine development work and raiding other worthy government programs to temporarily avoid these delays,” Burwell wrote. (Snell and Dennis, 8/11)

Secretary Burwell, in her letter, said the administration now has to “choose between delaying critical vaccine development work and raiding other worthy government programs to temporarily avoid” delays in vaccine research on Zika. She estimated that, even with the $34 million, NIH will need another $196 million in fiscal 2017 for vaccine and other research related to Zika. (Burton and McWhirter, 8/11)

NIAID Director Tony Fauci said at the National Press Club that funding Zika this way is not wise. "All of that is extremely damaging to the biomedical enterprise," he said. "We're taking money away from cancer, diabetes, all of those kinds of things." The new Zika funding is coming from other NIH accounts, as well as the Administration for Children and Families, CMS and the Substance Abuse and Mental Health Services Administration. Burwell said that these moves will “exhaust” the ability to provide short-term financing help for ZIka and that more funding will be needed. (Haberkorn, 8/11)

Top Democrats on Thursday said congressional inaction on Zika funding is forcing the Obama administration to take money from vital biomedical research. House Minority Leader Nancy Pelosi (D-Calif.) did not disclose how much money would be transferred to fight the Zika virus, but said an announcement from the National Institutes of Health (NIH) is forthcoming. (Lillis, 8/11)

HHS Secretary Sylvia Mathews Burwell said Thursday she will divert federal funds to support efforts to develop a Zika vaccine.In a letter sent to congressional leaders, Burwell said some $34 million that was previously committed toward researching other illnesses such as Alzheimer's disease, diabetes and cancer would be re-allocated. An additional $47 million from other agencies will go to the Biomedical Advanced Research and Development Authority, or BARDA. (Muchmore and Johnson, 8/11)

Hammering GOP leaders for tying funding for the Zika virus to restrictions on Planned Parenthood clinics, Pelosi on Thursday wondered aloud how many Republicans abstain from using contraception. "Zika … can be sexually transmitted. … And yet, they're saying, 'Well, if we have any funding for Zika it cannot include contraception,' " Pelosi said at a press briefing in the Capitol. (Lillis, 8/11)

Perhaps no one is more frustrated with Congress’s inaction on emergency Zika funding than Cindy Pellegrini. Pellegrini oversees lobbying at the March of Dimes, the nonprofit working to improve maternal and infant health. Since March, Pellegrini has been leading the charge on Capitol Hill to pass legislation funding research, vaccine development and other measures to combat the Zika virus, which causes severe brain defects in babies whose mothers are infected while pregnant. But her efforts have hit a wall. (Ho, 8/11)

Two new reports call into question advice about how long men who have been infected with the Zika virus should wait before trying to father a child. On Thursday, scientists described two cases in which the semen of men who contracted Zika in Haiti early this year continued to test positive for the virus, even though it has been six months since they were infected. (Branswell, 8/11)

Now, as the pace of new cases has slowed, Brazil is entering a new phase of the epidemic, in which families and doctors are discovering the long-term medical complications Duda and the 1,748 other infants like her nationwide will confront.Doctors have coined a new name for their disease, “congenital Zika syndrome” — a sign of how much they have to learn. Besides microcephaly, experts say some of the affected children have joint malformation or brain malformation, though their heads are normal-sized. So much is unknown: How will these babies grow? Will they ever be able to talk or walk? How long will they live? (Bailey, 8/12)

Three more local cases of Zika were identified on Thursday, in the same small area of the Miami-Dade County, bringing up the total of such cases to 25, according to the Florida Department of Health. There were also 21 new travel-related cases of Zika identified on Thursday, 17 of which were in Broward County. (Miller, 8/11)

Scientists at the University of Southern California discovered a key weapon used by the Zika virus to ravage the brains of infected fetuses: proteins. In an article published Thursday in the journal Cell Stem Cell, researchers identified two proteins in Zika potentially responsible for causing microcephaly. ... The proteins — called NS4A and NS4B — affect the brain by targeting a critical signaling pathway that controls cell growth and breaks down damaged cells and their elements. Initially, Zika slows cell development and reduces the variety of cells in the brain. Over time, this “rigged” system enables the virus to thrive and spread while healthy cells die. (Heredia Rodriguez, 8/11)

Dr. Karen DeSalvo, who had been wearing two hats at HHS, is stepping down from her role as the nation's top health information technology official. Effective Friday, Dr. Vindell Washington, the agency's principal deputy national coordinator, will take over as head of the Office of the National Coordinator for Health Information Technology. DeSalvo will remain at HHS as acting assistant secretary for health. (Conn, 8/11)

Karen DeSalvo stepped down as national coordinator for health IT Thursday and urged Congress to keep funding unfinished health IT work that she said was crucial for building a modern health care system. After 2 ½ years of moonlighting — she would never say whether ONC or her job as acting assistant secretary of health was her main job — DeSalvo will be replaced at ONC Friday by Vindell Washington, ONC’s second-in-command since January. She will remain at her senior HHS position. (Pittman, 8/11)

The Obama administration on Thursday issued a data analysis saying insurers’ costs for people who buy health-care coverage on their own remained essentially the same between the first and second years of the Affordable Care Act, partly because of a healthier mix of customers on exchanges created by the law. The analysis is one way the administration is seeking to counter insurers seeking substantial premium increases for 2017. Health insurers already have filed proposed rates for the year ahead with state regulators, and big plans across the country are seeking hefty premium increases because of what they say are substantial losses in the first few years of the law’s implementation. (Radnofsky, 8/11)

That trend shows that more healthy people signed up for ObamaCare between its first enrollment period and its second, according to the Centers for Medicare and Medicaid Services (CMS), which runs the federal marketplace. Still, the scope of the new report is limited: It covers only the enrollment periods ending in 2014 and 2015, when healthier people were already expected to sign up in greater numbers. (Ferris, 8/11)

Aviva Aron-Dine, senior counselor to U.S. Health and Human Services Secretary Sylvia Burwell, said the data was encouraging when many insurers have announced double-digit rate increases for 2017 and others have pulled back in some states to curtail financial losses. “What we take from this is that the marketplace is on sound footing,” she said in a phone briefing with reporters. She also said the sharp 2017 rate increases could be intended to help insurers compensate for underpricing their premiums in 2014 and 2015 and not the first in a series of large annual rate hikes. (Galewitz, 8/11)

A government report says the cost of expanding Medicaid to millions more low-income people is increasing faster than expected. That's raising questions about a vital part of President Barack Obama's health care law. The law called for the federal government to pay the entire cost of the Medicaid expansion from 2014 through the end of this year. (8/12)

The Obamacare risk pools are improving and stabilizing exactly as anticipated, HHS officials said Thursday, but insurers questioned the numbers underpinning the agency's claim. HHS's evidence: Medical costs fell 0.1 percent for exchange customers from 2014 to 2015. That was well below the medical cost growth of 3 percent in the broader insurance market. (Demko, 8.11)

Teachers, state employees and retirees on Georgia’s State Health Benefit Plan can expect a slight increase in their insurance premiums next year, although options in the program will remain relatively stable for many of the plan’s 650,000 members.The final 2017 rates for the $3 billion program were approved Thursday by the state Board of Community Health. They show that, on average, premiums will increase on average about 2.5 percent, depending on the plan and who is covered. (Torres, 8/11)

Retail titan Walmart uses its market dominance to inflict “ruthless,” “brutal” and “relentless” pressure on prices charged by suppliers, business writers frequently report. What if huge health insurance companies could push down prices charged by hospitals and doctors in the same way? The idea is getting new attention as already painful health costs accelerate and major medical insurers seek to merge into three enormous firms. (Hancock, 8/11)

Instead of buying a health insurance policy to cover their workers, a growing number of small and midsized companies are opting to pay their employees’ medical claims directly, a potentially riskier practice financially called self-insuring, a recent study found. Between 2013 and 2015, the proportion of midsized companies with 100 to 499 employees that were self-insured increased 19 percent, to 30.1 percent, according to the analysis published in July by the Employee Benefit Research Institute. The percentage of small firms with fewer than 100 employees that self-funded their health plans grew 7 percent, to 14.2 percent, the study found. Meanwhile, self-funding by large companies declined slightly, to 80.4 percent. (Andrews, 8/12)

She’s one of a growing number of doctors who have cut loose from what she calls the “assembly-line, volume approach” and is now using a health care delivery model called direct primary care. She has scaled back the number of patients she sees and takes longer with the ones she does. She doesn’t take insurance and deals mostly in cash; she charges each time she sees a patient, but most direct primary care doctors charge a monthly fee for unlimited visits. In her previous practice, (Lorraine) Page says, the pressure to see more patients in less time wore her down, as did the need for an army of support staff to process the copious paperwork required by insurance companies. (Gorn, 8/11)

The long and bitter fight between a struggling rural health care system and Texas' largest insurer appears over as the flagship hospital in Tyler will now be included in the carrier's in-network group plans, both parties confirmed Thursday. East Texas Medical Center captured national attention when it took the extraordinary step of suing Blue Cross and Blue Shield of Texas and its Chicago-based parent company last summer in state court alleging that the insurer had plunged it into financial ruin and put patients with specialized needs at risk by shutting the main hospital in Tyler out of the most common and popular group health insurance network. (Deam, 8/11)

The U.S. Justice Department sued Mississippi on Thursday, saying the state is violating the Americans With Disabilities Act by "unnecessarily and illegally" making mentally ill people go into state-run psychiatric hospitals. The state has failed to provide community-based services that would enable people with mental illnesses to have meaningful interaction with friends and family and to make decisions about work and daily life, says the suit filed Thursday in U.S. District Court in Jackson. It also says life in an institution leads to stigma, isolation and learned helplessness. (Pettus, 8/11)

Jenna banged her fists against a cinder-block wall at Rikers Island while two correction officers and a therapist hovered nearby. “I have the power, you do not!” screamed Jenna as she paced wildly in her cell. Jenna is actually Erin Shields, one of the actors who regularly come to the New York City jail complex, change into orange prison-uniform pants and play the role of inmate to teach correction and health staff how to defuse conflicts with the mentally ill. (Ramey, 8/11)

A state representative and a national patient rights group are calling for a federal investigation into the Secure Psychiatric Unit at the state prison in Concord. Mental health patients considered a danger to themselves or others are incarcerated in the psychiatric unit at the state prison for men, even if they have committed no crime, because New Hampshire — unlike 47 other states — has no other place to put them. (Solomon, 8/11)

Legislation that would require better transparency and tracking of mental health services for foster kids in every California county unanimously passed the Assembly Appropriations Committee on Thursday. Senate Bill 1291, by Sen. Jim Beall, D-San Jose, would institute more stringent annual oversight of county Medi-Cal mental health plans' services to foster youth. Services may include screenings, assessments, psychiatric hospitalizations, crisis interventions, case management, and psychotropic drugs, among other treatments. (Seipel, 8/11)

After decades of failing to push through reforms from Congress, advocates representing more than 30 million Americans with eating disorders are celebrating a rare moment of progress on Capitol Hill. For the first time ever, legislation specifically aimed at combating and expanding access to treatment for anorexia and bulimia among other disorders is quietly moving through Congress and has a shot at passage this fall. The Anna Westin Act, which is tucked into broader bipartisan mental health reform legislation approved by the House this summer, targets insurers who deny coverage for expensive inpatient treatments that cost tens of thousands of dollars — a common practice despite existing laws requiring equal coverage of mental health care, advocates say. It also creates first-of-their-kind federal programs for prevention and early detection activities, such as training staff at schools to spot signs of eating disorders. (Ehley, 8/11)

When officials try to explain why Missouri, alone among 50 states, has failed to create a monitoring program that tells doctors when patients are abusing narcotics, they point to a right-wing state senator who has repeatedly filibustered the program. The effort to block the program is championed by Rob Schaaf, a Republican family doctor who has intense worries about privacy — even going so far as to suggest the Pentagon is using health care databases to find out who has guns. (Tahir, 8/11)

The number of babies being born in the United States addicted to opioids has tripled in a 15-year stretch, according to a government report published Thursday. The Centers for Disease Control and Prevention said in its most recent Morbidity and Mortality Weekly Report that the findings, based on hospital data, are likely underestimates of the true problem and point to an urgent need for public health efforts to help pregnant women deal with addiction. The CDC found that the incidence of neonatal abstinence syndrome jumped to 6 per 1,000 hospital births in 2013, up from 1.5 per 1,000 in 1999. The data came from 28 states with publicly available data on opioid addiction. (Ross, 8/11)

Legislative leaders and Attorney General Mike DeWine today began pushing for more effective ways to educate Ohio students about drug abuse amid an ongoing epidemic. The 22-member Ohio Joint Study Committee on Drug Use Prevention Education will have 90 days to study the issue and recommend solutions to DeWine and state lawmakers. The focus will be on "comprehensive, age-appropriate drug use prevention education" for students in kindergarten through 12th grade. Calling the current wave of abuse "the worst drug epidemic that I've seen in my lifetime," DeWine said the state needs to enhance education and prevention or "we will continue to face this problem decade after decade." (Johnson, 8/11)

In addition to medications and surgical procedures, veterans can receive physical and occupational therapy as well as a type of cognitive behavioral therapy developed specifically for pain patients. There's a pain school, a program that helps veterans understand and manage their pain. There's exercise, massage, weight-loss counseling, help with sleep, meditation, acupuncture, chiropractic care, and more. (Burling, 8/12)

Since the bombings [on Hiroshima and Nagasaki], which occurred 71 years ago this week, many survivors and their children participated in studies that helped scientists understand the long-term effects of radiation exposure. About 120,000 survivors of the 1945 attacks, and 77,000 of their children, have taken part in the ongoing work since the 1940s. The research was conducted by the U.S. from 1947 to  1975, when Japan set up the Radiation Effects Research Foundation, in partnership with the U.S. This work helped inform the empirical basis for modern radiation exposure standards. (Roston, 8/11)

So the hypothesis is that intestinal worms could possibly reverse these problems, by damping down the immune system. The idea was so promising, that back in 2011 a pharmaceutical company decided to test it in clinical trials. Coronado Biosciences put together about six large studies. The first study to finish was a big one in Europe, which looked to see if pig whipworms helped with Crohn's disease. (Doucleff, 8/12)

It's standard medical care: Newborn babies get a shot of Vitamin K. It helps their blood clot, and prevents potentially dangerous bleeds. But a few new parents decline the shots for their babies, and their numbers seem to be rising — an apparent trend that’s deeply troubling to doctors from Nashville to New Zealand.American health authorities do not track Vitamin K refusals. But in recent years, anecdotal reports from hospitals and the CDC have described clusters of several babies who had brain bleeds and whose parents had declined the Vitamin K shot. (Goldberg, 8/12)

Paraplegics who learned to control an Iron Man-like exoskeleton with their thoughts appeared to regain some feeling and function in their legs as a result of the training regimen, according to a new study. The study, published Thursday in the journal Scientific Reports, describes how a year of training enabled participants with spinal cord injuries to recover some sensation, voluntary muscle contraction, and control over bowel function — evidence of neurological recovery that the authors were not expecting. Four of the eight participants had their paralysis reclassified to a less severe level, although they still do not have control over most of their leg muscles. (Joseph, 8/11)

Researchers in Brazil who are trying to help people with spine injuries gain mobility have made a surprising discovery: Injured people doing brain training while interacting with robot-like machines were able to regain some sensation and movement. The findings, published in Scientific Reports (one of the Nature journals), suggest that damaged spinal tissue in some people with paraplegia can be retrained to a certain extent — somewhat the way certain people can regain some brain function following stroke though repetition and practice. In fact, this isn't a new idea for treating injuries of the spinal cord. Even people with severe injuries can regain some sensation and function through physical therapy if some nerve fibers remain. (Harris, 8/11)

Lead problems with the water in Flint, Mich., have prompted people across the country to ask whether they or their families have been exposed to the toxic metal in their drinking water, too. When it comes to assessing the risk, it's important to look in the right places.Even when municipal water systems' lead levels are considered perfectly fine by federal standards, the metal can leach into tap water from lead plumbing. (Pupovac, 8/12)

Water cooler and paper cup stations will greet some students and teachers returning to older Cleveland Metropolitan School District buildings after summer break. The district in June started testing the water for the toxin lead in 69 buildings constructed before 2002, according to spokeswoman Roseann Canfora. Testing for lead will continue in water fountains, classroom sinks and faucets in common areas like nurse's offices and bathrooms until finished. A few buildings constructed after 2002 will also be tested. (Dissell and Zeltner, 8/11)

In a stunning twist in the debate over how well state officials are handling potential contamination of drinking wells near coal ash waste dumps, State Epidemiologist Megan Davies resigned on Wednesday evening. In her resignation letter, she accused leaders in the administration of Gov. Pat McCrory and the Department of Health and Human Services of intentionally misinforming the public about the matter. (Hoban, 8/12)

Scientists carefully probe a placenta donated after birth, bluish umbilical cord still attached. This is the body's most mysterious organ, and inside lie clues about how it gives life — and how it can go awry, leading to stillbirth, preterm birth, even infections like the Zika virus, that somehow sneak past its protective barrier. In labs around the country, major research is underway to finally understand and monitor this floppy, bloody tissue that's often dismissed as the "afterbirth," the organ that lives about nine months and then gets thrown away. (Neergaard, 8/12)

A Round Rock-based nonprofit has received one of the state’s largest grants to provide women’s health care even though it doesn’t offer direct health services. The grant, announced Wednesday, has drawn fire from liberal groups who have questioned the Heidi Group’s qualifications and the anti-abortion advocacy of founder Carol Everett. (Chang, 8/11)

A new bill signed by Mayor Bill de Blasio on Thursday will require certain city offices and service centers to provide a lactation room for nursing mothers to use at their choosing. In a news conference on Thursday, Mr. de Blasio — surrounded by several women holding babies — trumpeted New York as “one of the first cities in the country” to pass such a bill. Other cities with similar legislation include Philadelphia, Pittsburgh and Madison, Wis. (Schmidt, 8/11)

The 70-page report into the deaths of that patient, in April, and another in March, paints a picture of a nursing home in chaos, with scant staff training in basic life-support care, machines needed to deliver life-saving oxygen standing empty, defective equipment used to restore a regular cardiac rhythm during a sudden heart attack, and missing alarms needed to protect dementia patients from wandering out of the building. (Lazar, 8/12)

In early July, Betsy Davis emailed her closest friends and relatives to invite them to a two-day party, telling them: “These circumstances are unlike any party you have attended before, requiring emotional stamina, centeredness and openness.” And just one rule: No crying in front of her.The 41-year-old artist with ALS, or Lou Gehrig’s disease, held the gathering to say goodbye before becoming one of the first Californians to take a lethal dose of drugs under the state’s new doctor-assisted suicide law for the terminally ill. (Watson, 8/11)

Ivana Russo submitted her application for a California nursing license on April 22, nearly a month before she graduated from a nursing program at Brightwood College in San Diego. She expected it to take 10 to 12 weeks for the state to process her paperwork and authorize her to take the licensing exam. As of early August, 15 weeks later, the licensing board still had not reviewed her file and could not tell her when it would. Russo called the agency, often, to ask about the status of her application. It was hard to get a staff member on the phone. When she did, she said, “Every time I got a different story.” (Brown, 8/11)

State employees, teachers and other people in Georgia’s employee benefit plan will face an average increase of 2.5 percent in their health insurance premiums starting in January.  “We think that’s a very reasonable’ average increase, considering the expected premium hikes in the general marketplace," said Commissioner Clyde Reese of the Department of Community Health on Thursday. The rates will vary depending on health plan choices, with some members of the State Health Benefit Plan (SHBP) actually seeing their premiums decrease in 2017, agency officials said. (Miller, 8/11)

Dignity Health has answered a federal discrimination lawsuit filed by a transgender nurse by arguing that civil rights law does not require its self-insured employer health plan to cover gender reassignment-related care. It says Title VII of the Civil Rights Act does not cover transgender status as a protected classification. The San Francisco-based hospital chain also argued last month in response to the closely watched suit—one of the first of its kind in the country—that HHS' May rule barring categorical exclusion of coverage for gender transition services does not take effect until Jan. 1, 2017. (Meyer, 8/10)

Public-health officials are imploring area residents to obey a simple but crucial rule: If you're sick, stay out of the pool. Apparently, someone didn't get the memo. A diarrheal disease linked to swimming pools, splash pads and a water park is rapidly spreading across central Ohio, prompting public health officials Thursday to declare a community outbreak. (Neese, 8/11)

Each year in Philadelphia, an estimated 126 lives are cut short and 284 people are hospitalized due to excess air pollution, according to a report by the American Thoracic Society and New York University.The study attributed an additional 75 deaths in the Pennsylvania suburbs and 40 in Camden County to airborne contaminants. (Wood, 8/11)

Experts speculate there could be several motives behind the arrangement, although it's hard to know for sure. For one, Medicare is undergoing some changes that impacts how it pays doctors. However, the new provision won't have as much of an impact on Medicare Advantage, "so it's possible that they wanted to get out of some [of those] provisions," said Dr. Joseph Newhouse, John D. MacArthur professor of health policy and management at Harvard University. (Miller, 8/12)

The owner of a New Orleans medical supply company was sentenced Thursday (Aug. 11) to more than six and a half years in prison for running a scheme to bilk Medicaid out of $3.3 million, U.S. Attorney Ken Polite has announced. Tracy Richardson Brown, 46...was convicted in April on 18 counts of health care fraud, conspiracy and other charges. Evidence showed Brown paid people to hunt down Medicare beneficiaries whose information she then used to bill the federal program for wheelchairs, knee and back braces and other medical devices they didn't want or need. (Rainey, 8/11)

It’s one step forward and two steps back for the proposed Newnan Behavioral Hospital. The needed zoning approvals are now in place for the mental health facility, which would be located in the old Piedmont Newnan Hospital building on Hospital Road.But objections have been filed over the OK that the state recently granted to the hospital’s developers, Vest Newnan LLC/U.S. HealthVest. (Campbell, 8/10)

It’s amazing what someone might consider a monumental reward. For Mark Mastroianni, 61, it was 4 minutes. That was the time he gained running a mile right after his kidney/pancreas transplant last year. “I had been running a 16 minute mile, and the first time I ran after the surgery, it was 12 minutes,” he said. “Now I’m down to 9 minutes.” Mastroianni got his transplant in July of last year. More than 30 years earlier, he was diagnosed with type 1 diabetes. (Jackson, 8/11)

The horses at Butterfly Dreams Farm, a nonprofit therapeutic horseback-riding center, provide life-changing therapy to individuals as young as 2 years old with serious health needs and disabilities, including autism, cerebral palsy, Down syndrome and mental illnesses. Military veterans and older adults also frequent the center. ...Vereen began practicing hippotherapy, a form of physical, occupational and speech therapy that uses a horse’s movements, in 1994 when she helped build a riding center to supplement traditional therapy services at St. Mary’s Hospital in Athens. (Fite, 8/11)

For many years, adults adopted as children who wanted to find out who their birth parents were ran up against a brick wall because they had no legal right to simply get a copy of their original birth certificate in most states. But that’s been changing, as a growing number of states have been giving adult adoptees more — and in some cases, unrestricted — access to those records. (8/12)

Hillary Clinton and Donald Trump agree that Medicare bureaucrats should be unleashed to negotiate lower prices with drug companies, and predict billions of dollars in savings as a result. In this political era when any common ground between these two adversaries should be venerated, it is a shame that we must point out that they are both wrong. (Geoffrey F. Joyce and Neeraj Sood, 8/12)

As a leader in the Republican Party for the past 40 years, I’ve been involved in the development of 10 party platforms. Party platforms are important because they are more than a list of policies. Instead, they are a statement of the very different world views that explain those policies. This year’s Democratic and Republican Party platforms provide a useful example of differing world views on an issue that will dramatically impact the health and well-being of every U.S. citizen: biomedical research. (Newt Gingrich, 8/11)

Of all the hundreds of questions I have asked patients over the years, there was one I never asked: Are any firearms kept in or around your home? The Health and Public Policy Committee of the American College of Physicians has recommended that this question be added to the litany of queries doctors ask our patients during routine visits. Do you smoke? Do you practice protected sex? Have you had your flu vaccination? Are any firearms kept in or around your home? (Jerald Winakur, 8/11)

The FDA’s website explains that the agency “has performed extensive research and reviewed hundreds of studies about BPA’s safety,” which has led to the conclusion that “current approved uses of BPA in food containers and packaging are safe.”   Yet despite nearly 50 years of determinations that the chemical is safe, the agency and companies that use BPA continue to come under fire from environmental groups, food activists and other critics. (Henry I. Miller and Jeff Stier, 8/11)

Because I am a doctor, my friend Sophia told me the following story. “I go to a walk-in clinic with neck pain and a low-grade fever. I never go to the doctor. I know something is seriously off. ‘Would you test me for strep?’ I ask. ‘You’re overreacting. You just have a cold,’ this young doctor says. Would he have liked to hear me make a bigger deal about how badly I felt? I almost had to beg for a strep test. When it comes back positive, I’m so angry, I can barely speak to him. He was incompetent. Or trying to save money. Or maybe he was just lazy. He was certainly unkind.” Her doctor, apparently, was a lousy diagnostician. But more than that, she was put off by his attitude. What stuck in my mind weeks later was her choice of the word “unkind.” (Michael Stein, 8/11)

Twenty years ago, we described the emergence of a new type of specialist that we called a “hospitalist.”1 Since then, the number of hospitalists has grown from a few hundred to more than 50,000 — making this new field substantially larger than any subspecialty of internal medicine (the largest of which is cardiology, with 22,000 physicians), about the same size as pediatrics (55,000), and in fact larger than any specialty except general internal medicine (109,000) and family medicine (107,000). Approximately 75% of U.S. hospitals, including all highly ranked academic health centers, now have hospitalists. The field’s rapid growth has both reflected and contributed to the evolution of clinical practice over the past two decades. (Robert M. Wachter and Lee Goldman, 8/10)

Medical specialization dates back at least to the time of Galen. For most of medicine’s history, however, the boundaries of medical fields have been based on factors such as patient age (pediatrics and geriatrics), anatomical and physiological systems (ophthalmology and gastroenterology), and the physician’s toolset (radiology and surgery). Hospital medicine, by contrast, is defined by the location in which care is delivered. Whether such delineation is a good or bad sign for physicians, patients, hospitals, and society hinges on how we understand the interests and aspirations of each of these groups. (Richard Gunderman, 8/10)

Precision medicine aims to be a transformative paradigm that moves away from the “one-size-fits-all” approach in which treatments work for some people but not others. To the average American, especially one who has cancer, precision medicine sets a high expectation of a more targeted, and so more effective, treatment. But all too often the science underpinning these targeted therapies has not been up to snuff and the result has been greater uncertainty about optimal treatment — just the opposite of what precision medicine intends to do. (Spencer Phillips Hey, 8/11)

The federal Drug Enforcement Administration has just issued a helpful reminder to all Americans. In denying a petition to loosen restrictions on marijuana, the agency repeated that the drug has “no currently accepted medical use” in the U.S. This may come as a surprise, given that 25 states already allow doctors to prescribe marijuana to treat maladies from PTSD to Alzheimer’s disease. Yet the truth is, research has yet to find firm evidence that marijuana can alleviate physical suffering. (8/12)

In short, this new rule means that Medicaid will incentivize health care providers for diagnosing Alzheimer’s disease earlier and recommending community-based services and support. Most importantly, the proposed rule allows the person receiving the diagnosis to access community resources, plan for his or her future and ultimately maintain independence by staying in home longer. (Brandon Geib, 8/11)

While many of us need help as we get older, care options for those afflicted with Alzheimer's or other forms of dementia are much more limited and constrained even further by health insurance rules that favor medicalized care over supportive programs that might actually lessen the need for medical intervention. This was the situation my family and I faced when my beloved wife Nancy was diagnosed with Alzheimer's disease. (John Ottoboni, 8/11)

Scientists at NewLink Genetics, a biopharmaceutical company located in the Iowa State University Research Park, as well as researchers at the Nanovaccine Initiative, coordinated by Iowa State University, are working to develop vaccines and nanovaccines — particles that are 23 times smaller than a red blood cell. This research has the potential to save thousands of lives. If some within the federal government have their way, however, their innovative findings and products may never even make it out of the lab. (Dan Culhane, 8/11)

In America and across the globe, about 7,000 new medicines are in development. There's no question that many of them will save lives. Unfortunately, the United Nations is working to degrade the innovation ecosystem that makes such breakthroughs possible. In 2015, UN officials convened a powerful new panel to study ways to improve impoverished countries' access to lifesaving medicines. By all indications, that panel will soon push to weaken intellectual property protections on medicines. (Paul R. Michel, 8/12)

African Americans and particularly African-American men continue to be perceived as being violent when they are not. This phenomenon is not simply a belief system but also appears to be an overriding perceptual reality that directs the behavior of caretakers and law enforcement officers. (William Lawson, 8/11)

Tennessee is part of the "stroke belt,” a collection of 11 states that is notorious for its high stroke mortality rates. In the Volunteer State, stroke accounts for thousands of deaths every year.The good news is that a new stroke surgery has emerged in recent years as an effective, minimally invasive treatment for many people who have experienced a severe ischemic stroke — a stroke caused by a blood clot in the brain. (Blaise Baxter, 8/11)

Facts about women’s health won out over fiction in June, when the Supreme Court, even without examining the Texas legislature’s motives, struck down its regulations aimed at closing abortion clinics. Now the question is whether facts about human development will be adequate on their own to overcome fiction in what will probably be the next front in the abortion wars: fetal pain. Whole Woman’s Health v. Hellerstedt is a turning point in Supreme Court jurisprudence, not just because it turned the tide in the face of 300-plus abortion restrictions passed by state legislatures in the past 5 years alone.1 It also signaled a refreshing willingness to test a law’s justifications against its actual effects. In the context of women’s reproductive rights, and abortion rights in particular, such willingness has potentially far-reaching effects for measures that interfere with physician judgment and the doctor–patient relationship, including waiting periods, prohibitions on the use of necessary techniques, and requirements for medically unnecessary procedures. (R. Alta Charo, 8/10)

For decades, University of Washington has operated the federally-sponsored Birth Defects Research Lab (BDRL)— a taxpayer-funded fetal organ and tissue procurement service. The BDRL operates similarly to companies like StemExpress, Advanced Bioscience Resources, and Da Vinci Biologics: as a middleman go-between for abortion clinics and end-users of aborted baby parts. (David Daleiden, 8/11)

Visualize a long line, more than 500,000 people long. Look closer. They are all female. You’ll see lots of girls, some new born. What you can’t see is the many who have had their genitalia mutilated. Those who haven’t are in danger. This imaginary queue represents real people, the number of women and girls in the United States who were “at risk of or had been subjected to female genital mutilation/cutting (FGM/C) in 2012.” (Joe Davidson, 8/11)

Fear and death. That’s what I remember most, though not necessarily in that order, from the nightmare when Ebola struck my hometown.Two years ago this week, the World Health Organization declared that the Ebola epidemic ravaging Liberia was a “public health emergency of international concern.” By then it had already overwhelmed Redemption Hospital in Monrovia, where I was the outpatient supervisor. (Emmanuel Lasanah, 8/11)