�鶹Ů��

Hoping for better health in the New Year? Starting Nov. 15, Americans will have a three-month window to sign up, renew or change their insurance plan during the annual open enrollment period for Obamacare. (Firger, 11/13)

Just a few days before the re-launch of the health-care law’s marketplaces, many consumers remain confused about key aspects of the sign-up process, including the timing of the enrollment period, presenting a challenge for insurers eager for a smooth opening. The online insurance exchanges are set to go live again Saturday, when people will be able to buy new coverage taking effect on Jan. 1. Insurance companies are required to send letters explaining changes to their customers’ plans before open enrollment starts. (McCabe and Wilde Mathews, 11/13)

Here’s what you need to know about the Affordable Care Act’s second enrollment period, which starts Saturday. (Millman, 11/13)

The Golden State last year earned high marks when it sliced the uninsured rate from 22 percent to 11 percent by signing up 3.4 million residents in exchange or Medi-Cal plans -- without any of the systemic website problems that plagued the federal exchange and those of many state-run marketplaces. But unlike the first open enrollment period, which lasted 6½ months, the second will span only three months. And most health care experts considered the first year's eager applicants to be low-hanging fruit. This year, the California exchange -- like others around the country -- will have to shake a lot more trees to reach its goal of enrolling half a million more people in private insurance plans. (Seipel, 11/13)

In total, the state Health Connector expects roughly 414,000 Massachusetts residents to use its new website to sign up for health insurance between this Saturday, Nov. 15, and Feb. 15, 2015. Beginning at 8 a.m. Saturday — the first day of open enrollment — we’ll know if you can get back on track with a permanent plan, ending a year of frustrating dead-ends online, confusing calls and letters, and uncertainty about your care. (Bebinger, 11/13)

The Affordable Care Act exchange, which begins its second open enrollment period this Saturday, will offer many Georgians lower prices this time around. ... Still, people looking for a second year of coverage in the exchange – or to get a policy for the first time – need to pay attention to many factors besides premiums. (Miller, 11/13)

More than 120,000 Arizona residents who get private health insurance through the federal marketplace will find out this week how much they can expect to pay for health coverage next year. When the three-month sign-up period for Affordable Care Act health coverage begins Saturday, most individuals will be automatically enrolled in their existing marketplace plan for coverage beginning Jan. 1, 2015. (Alltucker, 11/13)

Phil Ammann, a freelance writer in St. Petersburg, was one of nearly a million Floridians who bought a plan on the federal exchange for 2014. And now, he has to shop for a new plan. In 2013, he bought a bronze plan from Coventry One, an inexpensive plan he said wasn't ideal, but it took care of some necessary medical expenses. Like 91 percent of Floridians who bought a plan on Healthcare.gov, he was eligible for federal tax credits that helped pay for part of his monthly premiums. Even more critical than the premium help, he said, was the the piece of the Affordable Care Act that says people can’t be denied coverage based on "pre-existing" conditions. (Watts, 11/12)

A majority of Americans give good reviews for insurance they recently acquired through government exchanges within the last year, a new poll shows. With the second round of Obamacare enrollment set to begin on Saturday, 71 percent said their coverage through the exchanges was good or excellent, according to a Gallup poll released Friday. Another 19 percent said the coverage was fair, while nine percent rated it poorly. (McCalmont, 11/14)

It’s been just over one week since the midterm elections and Republicans are already back in the fight to repeal Obamacare—this time, with both houses of the soon-to-be GOP-controlled Congress preparing for battle. (Ehley, 11/13)

Three months before the debut of Healthcare.gov last year, Hollywood celebrities huddled with President Obama at the White House over their plans to urge Americans to buy health coverage under the Affordable Care Act. The president took to late-night television himself to spread the word. And on the eve of the launch, an op-ed by the nation’s top health official appeared in major newspapers across the country, proclaiming that “better options for better health are just a click . . . away.” But now, as the second sign-up time arrives this weekend for Americans to buy health coverage through the law’s insurance marketplaces, the administration’s high-wattage 2013 sales campaign has given way to a 2014 strategy that is shorter, more targeted and lower-key. (Goldstein, 11/13)

Facing high political stakes and re-energized opposition, the White House is tweaking its strategy for year two of the health law’s insurance enrollment after last year’s problem-plagued launch. President Barack Obama , who appeared alongside celebrities with youth appeal during the first enrollment push, won’t be in the U.S. when the insurance exchanges reopen Saturday, though he will speak about the Affordable Care Act in his weekly radio address that morning. Top administration officials plan to fan out for an appeal that relies on customer testimonial and uses a smaller marketing budget. (McCain Nelson, 11/13)

The rollout of Nevada's health insurance exchange last year was a certifiable flop: Website glitches left people without coverage they paid for, enrollments were less than one-third of what state officials predicted, and complications led to a lawsuit against the state and its contractor, Xerox. But officials with Nevada Health Link, the state exchange, are optimistic things will improve now that they have scrapped a $75 million deal with Xerox and are using the infrastructure of the federal HealthCare.gov website. (Rindels, 11/13)

Minnesotans who are in the market for private health insurance can start shopping Saturday on MNsure, the state's online insurance website. The state exchange had a disastrous debut a year ago, but agency officials expect the process to go much more smoothly during the second open enrollment period. (Sepic, 11/13)

Tens of thousands of Iowans shrugged last winter when the federal government offered to help pay for their health insurance. Many gave up after spending fruitless hours trying to see their new insurance options on the government's colossally flawed website, healthcare.gov. Other folks never bothered to look. Now that the Obamacare website has been vastly improved, will more Iowans give it a spin? Starting Saturday, consumers who buy their own coverage will have three months to purchase 2015 health-insurance policies. The website, a key part of the Affordable Care Act, is the only place where moderate-income consumers can find subsidized plans. (Leys, 11/13)

Holiday shoppers at Fayette Mall [in Lexington, Ky.] can now buy some health insurance to go with their Jamba Juice. Kynect, the state's health insurance exchange, opened its first retail store on Thursday just across from the popular smoothie restaurant. Kynect has been lauded for signing up more than 521,000 people for health insurance, with most of those people added to the state's Medicaid program. Now state officials are turning their attention to the hard-to-reach groups as the second open enrollment period begins on Saturday, including the so-called "young invincibles," people in their 20s and 30s who don't think they need health insurance because they are young and healthy. (11/13)

President Barack Obama's health chief emphasized the ease of signing up for health coverage under the federal overhaul, while acknowledging Thursday that no website is perfect. Health and Human Services Secretary Sylvia M. Burwell stopped in Ohio to spread the word about subsidized private coverage through HealthCare.gov and state insurance markets. Open enrollment begins Saturday. Officials are hoping to avoid a repeat of last year's online meltdown. (Sanner, 11/13)

Connect for Health Colorado, the state health insurance marketplace, is touting its new and improved enrollment website for customers shopping for private health insurance. Open enrollment under the Affordable Care Act begins Nov. 15 and runs through Feb. 15, 2015. More than 148,000 individuals are covered through plans purchased on the Marketplace in 2014. All this week, customers could compare policies offered in their area, research eligibility for tax credits, choose coverage and begin the enrollment process. (Draper, 11/13)

Gov. Terry McAuliffe said Virginia’s government is “all in” this year as open enrollment for the second year of the Affordable Care Act marketplace begins Saturday. ... Last year more than 200,000 Virginians enrolled in Affordable Care Act marketplace health plans. McAuliffe said projections are that an additional 160,000 Virginians will sign up this year. (Smith, 11/13)

Advocates for expanded health insurance coverage are trying to sign up more minorities and rural Missouri residents during an annual enrollment period that begins Saturday for a federally run insurance marketplace. Health care organizations are spending several million dollars in Missouri to promote the insurance website and guide people through the sign-up process. Grant funding has been increased this year to groups serving urban minority populations and rural areas such as the Bootheel, where enrollment has trailed other places. In Sikeston, the Missouri Bootheel Regional Consortium plans to give away hotdogs, popcorn, cookies and soft drinks Saturday as part of its promotional kickoff for the health insurance enrollment period. The group also plans to offer blood pressure checks and free flu shots to the uninsured. (Lieb, 11/14)

Changes in health insurance premiums vary widely across Missouri but the average consumer may end up paying less for coverage, according to a report released Thursday by the St. Louis University School of Law. The study found that monthly premiums for the second-lowest cost "silver" plan sold on HealthCare.gov decreased on average by about 2 percent in Missouri for a 40-year-old nonsmoker with an annual income of $30,000. All prices in the study are based on that life scenario. (Shapiro, 11/13)

UnitedHealth Group Inc. will make a much bigger play on the nation’s health insurance exchanges this fall, but the Minnetonka-based insurer still won’t be competing close to its corporate home. On Friday, UnitedHealth is announcing the 23 states where it plans to compete for health exchange business starting Saturday — a roster that’s up significantly from the four states where the insurer was competing this year. Even with the expansion, Minnesota isn’t on the list because of a noncompete agreement with Minnetonka-based Medica, which hires United for claims processing and certain back-office functions. (Snowbeck, 11/14)

Many Americans with low incomes now have health coverage they couldn’t have gotten before this year under the act, widely called Obamacare. But their sheer numbers are straining some health-care systems that already don’t have enough doctors and staff. And the new Medicaid enrollees can challenge medical practices’ bottom lines in ways that lead them to turn some away. Almost nine million additional Americans now have coverage through Medicaid as a result of changes that took effect this year under the 2010 act. (Radnofsky, 11/13)

Millions of low-income Americans are expected to join Medicaid after the second sign-up drive begins on Saturday for coverage under the Affordable Care Act, widely called Obamacare. That will further expand Medicaid–already the nation’s largest health plan–which lawmakers chose as the vehicle for covering around a third of the nation’s uninsured. (11/13)

Former HHS Secretary Kathleen Sebelius is optimistic that with midterm elections now over, more states will consider Medicaid expansion in 2015. (Villacorta, 11/13)

Next month, Gov. Gary Herbert will present the details of his alternative Medicaid plan to skeptical members of Utah’s Republican-controlled Legislature. After consulting with legislative leaders this week, Herbert said Thursday that he’s decided to roll out the plan in December to lawmakers on a health committee meeting shortly before the full Legislature returns for business in 2015. (Price, 11/13)

Gov.-elect Greg Abbott’s pick for Texas secretary of state voted for a local resolution last year endorsing the expansion of Medicaid — a central tenet of the federal Affordable Care Act that Abbott fiercely campaigned against. In a phone interview, Carlos Cascos, a Republican judge from Cameron County, said that as secretary of state he was “not just going to go along to get along” with Abbott, and that on health care issues there would be “policy disagreement” among Republican officials. (Walters, 11/13)

On Saturday, the Affordable Care Act's health exchanges will begin a three-month open-enrollment period for 2015. The flurry of information that will be sent and received to enroll provides criminals with an open season for added opportunities to steal data and trick consumers and businesses into sharing their personal information. (Pribish, 11/13)

Two Kansas City-area companies that challenged the Affordable Care Act’s so-called contraception mandate won’t be required to cover birth control as part of their employees’ health care plans. Citing the U.S. Supreme Court’s Hobby Lobby decision, Senior U.S. District Judge Ortrie Smith on Wednesday barred federal officials from enforcing the requirement against Randy Reed Automotive Inc. and Sioux Chief Manufacturing Co. Smith issued separate – and except for the names of the companies – identically worded orders in the cases. The outcomes were expected in the wake of the Hobby Lobby decision. (Margolies, 11/13)

Among the tools: penalties for admitting patients too soon after they were discharged and a focus on reducing hospital-acquired infections. KHN’s Mary Agnes Carey and Jordan Rau discuss what you need to know before open enrollment in the health law’s marketplaces begins again on November 15th. (11/14)

Small-business enrollment on new insurance marketplaces set up under the president’s health-care law has fallen well short of the administration’s expectations, according to government report released Thursday. The Government Accountability Office examined enrollment totals for the online small-business exchanges, commonly called SHOP exchanges, in states that built their own health insurance portals. Most states defaulted to a federally operated small-business marketplace — a complementary site to the more widely known individual exchange. Both exchanges are slated to relaunch this weekend. (Harrison, 11/13)

Early enrollment for the health overhaul's small business insurance exchanges fell far short of the 2 million workers who were expected to sign up this year. The shortfall calls into question the future of the exchanges as they begin accepting enrollment for 2015. About 76,000 people had purchased coverage on 18 exchanges through June 1, according to a report released Thursday by the U.S. Government Accountability Office. Enrollment figures from 33 state exchanges that are run through the federal government are not yet available, but researchers expect those totals to be low as well. (Murphy, 11/13)

Where you live in many ways determines what you get from Obamacare — and some insurance agents say that may not change much in the second year of the program, which begins open enrollment Saturday. Cincinnati insurance agent Kevin Schlotman describes a neighborhood on the Ohio-Indiana border where Affordable Care Act options are vastly different depending upon which side of the street you live on. (Unger, 11/13)

To reach enrollment goals in the coming round of insurance sign-ups, health-care officials are changing their strategies. While Washington boasted a big reduction in the number of uninsured residents in the first enrollment wave, those gains came, in large part, from a surge in Medicaid participants — and less because people bought coverage. So when enrollment in 2015 private insurance plans starts again Saturday, insurance brokers — the folks licensed to help people choose among dozens of insurance plans — will play a more prominent role. (Stiffler, 11/13)

Nobody much cared how much credit Jonathan Gruber took for Obamacare — until now. Once videos surfaced in which the MIT economist talked about the public’s “stupidity,” his claims suddenly matter a lot. (Winfield Cunningham, 11/13)

Republicans are demanding hearings into videos that have emerged in recent days of MIT professor Jonathan Gruber making impolitic remarks about the Affordable Care Act. Why should Gruber’s comments matter? Because Gruber is well-known in health-care circles as one of the intellectual godfathers of Obamacare and the very similar law in Massachusetts (sometimes called Romneycare), though people involved in ACA deny he was “an architect” of the ACA. (Kessler, 11/14)

As Congress voted on the Affordable Care Act, or Obamacare, in 2010, one of the bill's architects, MIT economist Jonathan Gruber, told a college audience that those pushing the legislation pitched it as a bill that would control spiraling health care costs even though most of the bill was focused on something else and there was no guarantee the bill would actually bend the cost curve. (Tapper, 11/13)

The White House looked to distance itself Thursday from critical remarks made by one of the architects of President Barack Obama’s health care law, who suggested the law benefited from a lack of transparency and the ignorance of the American voter. (Clark, 11/13)

Nancy Pelosi claimed Thursday she didn’t know who ObamaCare architect Jonathan Gruber is, after several tapes surfaced showing him gloating about how the law was written to take advantage of the stupidity of the American voter. Problem is, Gruber’s analysis of the law was cited extensively by her office back in 2009. (11/13)

It's been the comments of economist Jonathan Gruber that has vaulted talk of repealing Obamacare back into the news. Republicans have seized on Gruber's remarks as suggesting that the development of President Obama's eponymous health-care policy was tainted from the outset, reinvigorating calls to scale it back. (Bump, 11/3)

The Justice Department is investigating whether a cancer-care giant improperly billed Medicare for a procedure when it administered radiation therapy to patients—the second time the company has faced federal scrutiny this year. Federal prosecutors have requested an array of documents from 21st Century Oncology Holdings Inc. “concerning allegations” that it “knowingly billed for services that were not medically necessary and for services not rendered,” the company disclosed in a regulatory filing. (Carreyrou, 11/13)

The federal agency that oversees the 340B drug discount program is abandoning an attempt to create a sweeping set of rules for the effort and instead will try to resolve disputes about the program through a guidance document. Krista Pedley, director of the Office of Pharmacy Affairs at the Health Resources and Services Administration, said the Department of Health and Human Services will at midnight withdraw a proposed regulation that had advanced to the final clearance step before public release, submission to the Office of Management and Budget. HRSA intends to issue guidance early next year to address many of the same issues. (Young, 11/13)

Three products among the most expensive equipment tracked in the Modern Healthcare/ECRI Institute Technology Price Index saw double-digit increases in the prices that hospitals were paying. The Technology Price Index provides a monthly snapshot of prices based on three-month rolling averages. The average price paid for radiosurgery equipment such as stereotactic systems was $2.4 million, up 49.1% from the previous month's data but down 38.7% from a year earlier. (11/13)

Andre Wilson lived as a woman for the first 43 years of his life. It was excruciating, he said. When Wilson began hormone therapy to transition into becoming a man, everything changed. “The third day on testosterone for me was the first un-depressed day of my life,” Wilson said. That feeling of severe discomfort with one’s biological sex is called "gender dysphoria" by physicians. The treatment is often gender reassignment therapies or surgeries. But in many cases, the treatments are not considered medically necessary by health insurance plans and are therefore not covered, leaving people to pay the bills out-of-pocket. (Bouscaren, 11/13)

But the CBO is forecasting the deficits will start rising for the rest of the decade as baby boomers retire and Social Security and Medicare costs rise. The CBO and other budget experts have warned that the current trajectory for the deficit is unsustainable and eventually could lead to a fiscal crisis. ... The improved deficit picture for 2014 reflected slower growth in spending due to lower-than-expected health care costs as well as a 2011 budget pact with Republicans that sharply curbed agencies’ operating budgets. (11/13)

In the frenetic U.S. health-care system, one thing has generally been constant—a generic drug is a low-cost alternative to brand-name medicines. But over the past year, this reliable view of the world has begun to change as reports emerged of consumers encountering substantial increases for some drugs. One notable example is a heart drug known as digoxin, which used to sell for pennies a pill, but a month’s supply can now fetch up to $1,200—although the average cost is closer to $50, according to GoodRx.com, a website that tracks prices. (Silverman, 11/13)

Market forces are dramatically driving up the cost of some generic drugs, prompting U.S. investigations into the pricing of what should be cheap alternatives to brand-name medications. Generics that should cost pennies per dose have undergone radical increases in price in recent years, said Dr. Aaron Kesselheim, author of a new commentary in the New England Journal of Medicine, and director of the Program on Regulation, Therapeutics and Law at Brigham and Women's Hospital in Boston. (Thompson, 11/13)

For years, patient advocates and families have lobbied Congress for more funds to combat rare diseases. But to what extent does lobbying make a difference when Congress sets appropriations and the National Institutes of Health makes funding decisions? A new study suggests lobbying by private groups does, indeed, influence federal funding for rare disease research. Every dollar spent on lobbying generated congressional support in the form of soft earmarks, which are passages in an appropriations bill that urge or encourage spending but do not carry the rule of law. In this instance, the term refers to providing funding for NIH research into particular diseases. (Silverman, 11/13)

Vice President Joe Biden urged lawmakers on Thursday to take up the administration’s request for more than $6 billion in emergency aid to deal with the worldwide Ebola outbreak. Speaking to activists and leaders from humanitarian, non-governmental and religious organizations, Mr. Biden called for members of those groups to go to Capitol Hill and make their voices heard in the forthcoming congressional debate over the funding request. (Tau, 11/13)

The New Jersey Assembly narrowly passed a bill Thursday that would allow terminally ill patients to end their lives by obtaining and self-administering lethal doses of medication prescribed by a doctor. The 41-31 vote - the minimum required to achieve a majority - came amid a national debate over physician-assisted suicide, also referred to as aid in dying. A similar version of the bill has not advanced in the Senate, and Gov. Christie has said he opposes it. (Seidman, 1/14)

[Virginia House Speaker William J.] Howell led Republican opposition to Medicaid expansion and denied any secret effort to let it pass. But [his likely opponent Susan] Stimpson and others objected to the creation of a 10-member commission that they feared would bolster the case for expansion. They also mistrusted budget language that they believed would have given Gov. Terry McAuliffe (D) the legal power to expand Medicaid unilaterally. (Portnoy, 11/13)

A Maryland commission approved regulations on Thursday to implement a medical marijuana program after a drawn-out process in a state that has struggled to make marijuana available to sick patients. While the regulations still need approval from a legislative panel and the state’s health secretary, advocates say the vote marked a significant step forward. (11/13)

The head of the troubled New York City jail system said Thursday it's critical to send mentally ill inmates to treatment programs instead of a lockup. Department of Corrections Commissioner Joseph Ponte told state lawmakers that Rikers Island is poorly equipped to be a mental health treatment center. The primary goal, one he shares with the medical staff, is to keep staff and inmates safe, he said. Dr. Homer Venters, head of the jail's health services, testified and said admission medical screenings done on every incoming inmate show about 25 percent have mental illnesses, though that diagnosis applies to about 38 percent of the daily population of about 11,500. Those inmates tend to stay twice as long. (11/13)

Health officials in the central Massachusetts town of Westminster say they will not hold another public hearing on their proposed first-in-the-nation town-wide ban on tobacco sales, after a rowdy crowd of hundreds forced Wednesday night’s meeting to end in just 20 minutes. (Kaufman, 11/13)

Many of Mr. Hogan’s policy views remain largely a mystery. Since election night, he has been steadfast in refusing to articulate positions until he takes office on other major state issues — like plans for the state’s troubled infrastructure or the expansion of Medicaid. ... Further, he attacked Mr. Brown, who was in charge of the disastrous and costly rollout of the state health care exchange. Maryland’s site crashed at the start of open enrollment, delaying the ability of many residents to sign up and costing the state tens of millions of lost dollars. (Steinhauer, 11/13)

The Affordable Care Act's (ACA's) "family glitch" ... refers to how some low-to-moderate-income families may be locked out of receiving financial assistance to purchase health coverage through the new health insurance Marketplaces. Eligibility ... is also subject to whether a family has access to affordable employer-sponsored insurance. The problem is that the definition of "affordable"--for both an individual employee and a family--is based only on the cost of individual-only coverage and does not take into consideration the often significantly higher cost of a family plan. ... Families caught up in this glitch, however, cannot qualify for premium tax credits to reduce the cost of a Marketplace plan or for cost-sharing reductions to lower their out-of-pocket payments for health services, even if the family cannot afford coverage otherwise. ... Estimates of the number of dependents (spouses and children) affected vary widely from two to four million. (Brooks, 11/10)

Among older home health care patients, depression is highly prevalent, is often inadequately treated, and contributes to hospitalization and other poor outcomes. ... Objective [of the study is to] determine whether, among older Medicare Home Health recipients who screen positive for depression, patients of nurses receiving randomization to an intervention have greater improvement in depressive symptoms during 1 year than patients receiving enhanced usual care. ... The principal finding in this study is that, among medical home health care patients who screen positive for depression, a home health nursing intervention did not improve depression scores overall. However, among the subgroup with more significant depression, the intervention was associated with greater decrease in depressive symptoms than enhanced usual care. (Bruce et al., 11/10)

This report analyzes two pairs of states that achieved very different enrollment rates in the federally facilitated Marketplace (FFM) during the 2014 open enrollment period. We compare North Carolina with South Carolina and Wisconsin with Ohio. ... All four states were also home to significant anti-Affordable Care Act (ACA) political activity. ... Demographic factors do not appear to explain the different enrollment outcomes in the four states, nor does the amount of federal funding. We find, however, that development of a strong collaborative infrastructure between and among diverse groups engaging in outreach and enrollment assistance was an important factor in both North Carolina and Wisconsin, the states with the higher enrollment rates of the pairs. (Wishner, Spencer and Wengle, 11/13)

This Visualizing Health Policy infographic takes a look at recent trends in employer-sponsored insurance, including average premium increases for workers with family coverage, the average yearly cost of premiums for single and family coverage and how those costs have increased in the past decade, along with the prevalence of health promotion programs (such as wellness programs) offered by large firms. It also looks at differences in premium and worker contributions at firms with many lower-wage workers and firms with many higher-wage workers; the average general annual deductible for workers who face a deductible for single coverage; and the percentage of workers covered by employers’ health benefits at offering and non-offering firms, from 2000 to 2014. (11/11)

[T]he Kaiser Family Foundation conducted a nationally representative survey of 1,292 U.S. adults to shed light on Americans’ understanding of basic health insurance terms and concepts .... When asked a series of questions about health insurance terms and concepts, including some that require calculating out-of-pocket costs, over half of the public (52 percent) scored an impressive grade of at least 7 out of 10 right answers, but only 4 percent answered all 10 questions correctly. On the other side of the spectrum, nearly three in ten (28 percent) gave correct answers to 4 or fewer questions, with 8 percent giving no correct answers at all. (Norton, Hamel and Brodie, 11/11)

Under the Affordable Care Act (ACA), in 2018, an excise tax on high-cost health plans, the so-called “Cadillac tax,” takes effect. The potential impact of this tax is driving employers to fundamentally reassess their health care plans and reconsider what their role and approach to providing health care benefits should be in the future. At the moment, the tax is acting as a catalyst for change. In the future, however, continued medical inflation and regional differences in health care costs will make it very difficult for employers to continue reducing benefit costs to avoid the tax. (Troy and Wilson, 11/10)

Cancer patients from an ethnic minority don't use high-volume hospitals in the United States as much as white patients, even though they live just as close, a new study shows. Socioeconomic factors, such as poverty and education level, could contribute to this difference. This is important because ethnic minorities fare worse after diagnosis with many diseases, said first author Lyen Huang, MD, a research fellow at Stanford University in California. For example, 65.6% of white patients live 5 years after a diagnosis of colorectal cancer, compared with 55.5% of black patients. "We know that high-volume hospitals are associated with decreased mortality rates after cancer, but minorities are less likely to use these hospitals," Dr Huang said here at the American College of Surgeons 2014 Clinical Congress. (Harrison, 11/11)

A new "risk algorithm" may help identify US soldiers at highest risk for suicide following psychiatric hospitalization and offer an effective opportunity to curb this growing problem in the US military, new research suggests. The latest results from the Army Study to Assess Risk and Resilience in Servicemembers (Army STARRS) showed that 5% of the soldiers classified as being at highest risk for suicide accounted for 53% of all suicides that occurred within 12 months of inpatient discharge. (Brauser, 11/13)

States with tight regulations on the purchase and control of guns have fewer injuries and deaths from firearms, a new study shows. "Strict firearm legislation may help to reduce firearm-related injuries and mortalities, and help to reduce the years of life lost," Viraj Pandit, MD, a researcher at the University of Arizona in Tucson, said here at the American College of Surgeons 2014 Clinical Congress. (Harrison, 11/13)

Talking through treatment choices and what will happen in the future with health providers is important for elderly patients with chronic kidney disease, a new study finds. Based on interviews with older late-stage kidney patients, researchers found differences in their understanding of what conservative management means, and of the pros and cons of choosing that route over dialysis. (Lehman, 11/12)

Hospice care at the end of life can significantly lower rates of hospitalization, intensive care unit (ICU) admission, and invasive procedures for cancer patients, according to a new study. Not surprisingly, it can also significantly lower healthcare costs. The study, which was published in the November 12 issue of JAMA, adds further evidence to research that has shown that hospice care can reduce aggressive medical interventions and healthcare costs. (Nelson, 11/11)

Millions of blood sugar testing strips may be unneeded by the U.S. veterans who receive the strips through two government insurance programs each year, suggests a new study. There was potential waste in the two insurance programs, researchers found, but the most waste occurred among veterans who received strips through both programs. “There’s nothing illegal going on,” said Dr. Walid Gellad, the study’s lead author from the Pittsburgh VA Medical Center. “These individuals have benefits from both, but when you look at overall health spending it’s a matter of what’s efficient.” (Seaman, 11/10)

Although their health depends on working technology, many kidney-failure patients on dialysis are not prepared for natural disasters or other emergencies, new research finds. But the study from Mount Sinai Beth Israel Hospital in New York City found that giving dialysis patients detailed information about their medical history and treatment schedule could help improve their emergency preparedness. (11/13)

How long patients survive after surgery to remove lung cancer may depend on factors like insurance, income and education, according to a new study. While the stage of the cancer is a more important influence on patient outcomes, the study’s senior author said understanding all of the factors tied to survival can identify groups of people who need more attention for quality improvement. (Doyle, 11/7)

The cost of Medicare-funded breast cancer screenings jumped 44 percent from $666 million to $962 million from 2001 to 2009, yet those added millions did not improve early detection rates among the 65 and older Medicare population, according to a Yale School of Medicine study published recently in the Journal of the National Cancer Institute. The increase was due mostly to the use of costlier digital mammography ($115 per screening) compared to film mammography ($73 per screening), along with newer and expensive screening and adjunct technologies, including breast ultrasound, magnetic resonance imaging — or MRI — and biopsy. The study is the second from Yale since January 2013 to conclude that increased Medicare spending for breast cancer screening does not necessarily translate into better outcomes. (Olivero, 11/9)

Cervical cancer screening is one of the great medical success stories of the 20th century. Since the Pap test (which can detect changes in cells in the cervix that may indicate early signs of cancer) was developed in the 1940s, the U.S. death rate from cervical cancer has plummeted by more than 70 percent. Yet, as a new study published last week by the Centers for Disease Control and Prevention (CDC) makes clear, a substantial number of women continue to develop — and die from — cervical cancer in the United States. Each year, according to the latest CDC statistics, about 12,000 women are diagnosed with the disease and 4,100 die from it. (Perry, 11/10)

Here’s some disquieting news to keep in the mind the next time you or someone you know is hospitalized: Nurses, physicians and other hospital workers who interact closely with patients tend to wash their hands less frequently as their work shift progresses, according to a study published earlier this week in the Journal of Applied Psychology. Specifically, the study found that the hospital workers’ compliance rate with hand-washing protocols fell almost 9 percent from the beginning to the end of a normal 12-hour shift. (Perry, 11/13)

It’s not exactly the Ems Dispatch (the diplomatic cable Bismarck doctored to provoke the 1870 Franco-Prussian War). But what the just-resurfaced Gruber Confession lacks in world-historical consequence, it makes up for in world-class cynicism. This October 2013 video shows MIT Professor Jonathan Gruber, a principal architect of Obamacare, admitting that, in order to get it passed, the law was made deliberately obscure and deceptive. It constitutes the ultimate vindication of the charge that Obamacare was sold on a pack of lies. (Charles Krauthammer, 11/13)

Everyone is writing about GruberGate. Ugh. For those who don’t follow every tempest in a teapot that obsesses political yakkers, this is about old comments that surfaced in which Jonathan Gruber, who helped design the Affordable Care Act, said things that ranged from being stupid (calling voters stupid) to simply impolitic. ... What Gruber’s comments do is give Republicans new language to make the same points they were going to make anyway in the speeches they were going to give anyway in support of the repeal they were going to advocate for anyway. It will change nobody’s mind about a law that is now almost five years old. ( Jonathan Bernstein, 11/13)

Mr. Gruber was not, as many claim, the architect of the health-care law. He is an MIT economist who, as a consultant to the Department of Health and Human Services, modeled the impact of various subsidy levels and rules. He did not make policy, nor did he work for the White House, HHS, or any congressional committee. Earlier, he advised the Massachusetts legislature when it created the health-care reforms that were a model for the ACA. And Mr. Gruber’s comments in 2013 that the law passed only because of “the stupidity of the American voter” and a “lack of transparency” by the Obama administration are simply incorrect. (Neera Tanden, 11/13)

Americans are frustrated, and rightly so, by Washington’s lack of progress in spurring job creation and economic growth. While the economy is slowly climbing back from the 2008 recession, the president and Democratic-controlled Senate have failed to get our economy moving again .... Republicans now have a chance to show Americans that the party has ideas and can get things done. Here’s a great way to start: Repeal ObamaCare’s medical-device tax. (Erik Paulsen, 11/13)

Several million Americans could find their health insurance becoming vastly more expensive if the Supreme Court rules against the Obama administration in a pending case. That's what the court should do -- see here for a longer argument on that point -- but the elected branches of government need to develop contingency plans to deal with the affected people. (Ramesh Ponnuru, 11/13)

I did have an alternative plan for the Affordable Care Act, one that I was very fond of. It preserved the basic market mechanisms in health care while protecting people from catastrophic risks. It was so simple it could be explained in a couple of sentences. And it wouldn't cost that much. Ready? Here we go: The government picks up 100 percent of health-care costs above 15 to 20 percent of adjusted gross income. For people below 150 percent of the poverty line, there's Medicaid, which picks up basically all your costs. Hard to game, preserves consumer incentives to shop for prices and keeps people out of bankruptcy. (Megan McArdle, 11/13)

ObamaCare is a failure. For anyone who thinks this is a misprint because no Democratic activist would make such a comment, let me add that it is too big, too complicated and too expensive. Without a public option within its network of exchanges, ObamaCare is a giant blank check to the insurance companies that pushed it through Congress. It punishes responsible consumers like me and treats younger individuals as fools who are expected to pay the bills while not paying attention. (Burke Beu, 11/13)

Gary Wood, of Glenview, had a heart attack when he was 37. His insurance would not pay for his care because he told the ER doctors that he’d had chest pains for a month. The insurance company called that a pre-existing condition. ... This year, at age 55, Gary was again up against it, in desperate need of a quintuple bypass. However, he was uninsured and unable to access the care he needed. My office was able to direct him toward coverage through Obamacare’s Medicaid expansion, which enabled him to get the surgery he needed. Obamacare literally saved his life. ... In my congressional district alone, more than 20,000 people who were uninsured now have coverage, and seniors and people with disabilities have saved $13.8 million in drug costs. (Rep. Jan Schakowsky, D-Ill., 11/13)

For House Republicans, their guiding fiscal and economic lodestar remains — and will forever remain — the hallowed Paul Ryan budget. In its various iterations, it would repeal Obamacare, radically restructure Medicare to the detriment of beneficiaries, block-grant Medicaid, and aim most of its draconian budget cuts at programs benefiting people with lower incomes. Robert Greenstein of the Center on Budget and Policy Priorities has said earlier versions would result in “the largest redistribution of income from bottom to top in modern U.S. history.” (Greg Sargent, 11/13)

Terminally ill brain cancer patient Brittany Maynard's death by prescribed lethal overdose — legal in Oregon — made headlines. Her campaign to legalize assisted suicide — or as some prefer, "aid in dying" — sparked increased debate of the best ways to care for the terminally ill. ... Rather than shout at each other, both sides of the assisted suicide divide should get enthusiastically behind this health care change: Allow the terminally ill to enter hospice care without having to give up life-extending or curative treatments.(Arthur Caplan and Wesley J. Smith, 11/13)

Many women report losing their desire for sex, some temporarily, some permanently. Is this a relationship problem, a normal aspect of life changes or, as the pharmaceutical industry maintains, an “unmet medical need”? That was the question under consideration for two days of meetings in late October, during which the Food and Drug Administration heard from sexual medicine experts and women with sexual complaints. (Ellen Laan and Leonore Tiefer, 11/13)