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As state regulators consider rate proposals for next year, both of the carriers set to remain on Connecticut's exchange – Anthem and ConnectiCare – could eliminate their commissions for brokers in 2017, creating uncertainty as brokers and customers plan for the coming year. Anthem said earlier this year it would eliminate broker commissions while ConnectiCare has yet to decide. Many brokers have indicated they will leave the exchange if they do not receive sufficient compensation. (Constable, 8/8)

Like basketball players who are sick of losing a game, many health insurers who ventured into the new marketplaces are sending a clear message: We're taking our ball and going home.And if the government wants them to play again, they want more of the rules changed.The large publicly traded insurers wrapped up second-quarter results last week. Adverse selection continued to weigh down the finances of health plans on the Affordable Care Act marketplace. (Herman, 8/6)

Weeks after announcing a new "relationship-based" health insurance plan that would provide patients unlimited access to health coaches and primary doctors with no co-pay, Harken Health Insurance withdrew its application to open in South Florida in 2017.Harken's withdrawal further narrows the number of health insurance choices for customers who qualify for federal subsidies under the Affordable Care Act exchanges. (Hurtibise, 8/5)

Six years after President Barack Obama's health care law passed with its sweeping mandate for nearly universal coverage, Texas still leads the nation in the number of uninsured. More than 4.5 million Texans are without coverage, without consistent medical care.The story of the uninsured is told in political ideology and unmet promises - unfolding still, one town, one family, at a time.More than three-quarters of a million Texans now have no realistic entry to health insurance because of the state's vow not to expand Medicaid. (Deam, 8/6)

On the evening of March 24, 2015, Sheriff Dan McClain got an unexpected voice mail: “This is Gov. Mike Pence calling. I would welcome the opportunity to get your counsel on what’s going on in Scott County.”What was going on was unprecedented in Indiana and rare in the United States: H.I.V. was spreading with terrifying speed among intravenous drug users in this rural community near the Kentucky border. Local, state and federal health officials were urging the governor to allow clean needles to be distributed to slow the outbreak. (Twohey, 8/7)

Indiana Gov. Mike Pence signed a pledge last month, along with most of the nation’s governors, to combat the opioid crisis, calling it “one of the deadliest drug epidemics in our nation’s history.” But when confronted with a spiraling HIV outbreak in his home state as a result of opioid addicts sharing contaminated needles, Pence dragged his feet before agreeing to lift a ban on programs that distribute sterile needles. (Demko, 8/7)

Aetna and Anthem's multibillion-dollar health insurance mergers may be decided by year-end, after all. The federal judge overseeing the U.S. Justice Department's challenges to the deals has sent one case to another judge.U.S. District Judge John Bates said there was no way he could try and decide the cases against Aetna's $37 billion deal for Humana and Anthem's $53 billion acquisition of Cigna Corp. by their requested year-end deadline, returning the Anthem-Cigna case back to the federal court for reassignment. (Teichert, 8/5)

The judge overseeing two U.S. cases challenging mergers among four of the biggest health insurers gave up one, improving the odds for rulings on both tie-ups by the end of the year and reducing the chance they fall apart beforehand.U.S. District Judge John Bates in Washington said Friday he would keep the case against Aetna Inc.’s deal for Humana Inc., leaving the challenge to Anthem Inc.’s takeover of Cigna Corp. to another judge. (McLaughlin and Harris, 8/5)

Cigna Corp. Chief Executive Officer David Cordani faces a tough task: persuading investors and lawyers that the health insurer is committed to a troubled $48 billion takeover by Anthem Inc., while also talking up its prospects as an independent company.Cigna met with investors this week to discuss the merger, which Cordani says he still supports, and also talk about his Plan B -- stock buybacks or acquisitions if the deal falls apart, according to notes to investors from Wolfe Research and Goldman Sachs Group Inc. (Tracer, 8/6)

The cost of long-term health insurance for Bentley University biotechnology professor Lynn Arenella will double in the next year, to about $2,600 annually. This wasn’t supposed to happen. Legislators passed a law in 2012 aimed at protecting consumers from such steep increases. But nearly four years later, amid a tussle between industry and consumer groups, state insurance regulators still haven’t issued final rules for implementing the law, leaving insurance companies to raise certain rates at will. The delay has allowed Arenella’s insurer, Chicago-based CNA Financial Corp., to raise premiums by close to 100 percent for Massachusetts consumers who bought their policies through their employers, unions, or associations — known as group coverage — with no regulatory review. (Fernandes, 8/8)

Leaders of a new east-side Des Moines clinic say they can help patients stay healthy while saving money for the insurance company that owns the place. The CareMore clinic is the most extensive Iowa example of a new health care model: Health insurance companies that pay medical bills also employ the doctors, nurses and other professionals who provide the care. The clinic, which is on East Euclid Avenue, is part of a controversial shift in Iowa’s Medicaid program. (Leys, 8/2)

Athos Health, a start-up based in St. Paul, wants to help people review their medical bills so patients don’t wind up paying hundreds or thousands of dollars in unnecessary out-of-pocket costs. Those costs are more likely as more health insurance policies feature high deductibles where patients must spend thousands of dollars out-of-pocket before full coverages kicks-in. (Snowbeck, 8/6)

Today, according to cybersecurity specialists, criminals hoping to scoop up valuable personal data are increasingly targeting health care companies — from local doctor’s offices to major health insurers. More than 100 million health care records were compromised in 2015 alone. Federal records show that almost all of those losses came from just three attacks on health insurance providers: Anthem Inc., Premera Blue Cross, and Excellus Health Plan Inc. At the same time, data breaches in the retail industry are plummeting. Last year marked a four-year low for reported breaches of records of retailers, with just 5.7 million compromised, according to research from IBM Security. (Woodward, 8/7)

Decades of medical breakthroughs have improved the quality and length of life, but technology has done little to help people... care for older relatives. Several startups aim to ease the burden of these families by using technology to automate caregiver-family matches, post customer feedback, create schedules and make payments more convenient. (Chapman, 8/5)

Cigarette smoking among U.S. adults continues to slide among almost all racial and ethnic groups, but big disparities remain, according to a new study by the Centers for Disease Control and Prevention. Among whites and blacks, a quarter still light up. By contrast, barely one in 10 Asians uses cigarettes, while nearly four in 10 Native Americans and Alaska Natives do so. (Kelly, 8/5)

Smoking in the U.S. is down, both overall and in nearly every ethnic group, but a new analysis by the Centers for Disease Control points out big disparities within those groups.The report looks at survey respondents identifying as Hispanic and Asian who smoked in the past month. Cigarette use dropped between the three-year periods of 2002 to 2005 and 2010 to 2013, but the latest data showed Puerto Ricans smoked far more than other Hispanics. (Wagner, 8/5)

When President Obama signed a sweeping $15 billion bill to end delays at Department of Veterans Affairs hospitals two years ago, lawmakers standing with him applauded the legislation as a bold response that would finally break the logjam. It has not quite worked out that way. Although veterans say they have seen improvement under the bill, it has often fallen short of expectations. (Philipps, 8/5)

Seeking to arm themselves with new ammunition after losing a major Supreme Court battle, the anti-abortion movement is calling for a national database for abortion statistics and increased state reporting — moves likely to raise patient privacy concerns. The high court’s June decision in favor of Texas abortion providers in Whole Woman’s Health v. Hellerstedt is expected to have a chilling effect on state abortion restrictions, which had closed clinics in Texas and other parts of the country. (Haberkorn and Pradhan, 8/8)

A woman apparently high on several drugs when she had an abortion almost certainly couldn't have made a rational decision about her health care, two Ohio State University medical experts say. Dr. Brad Lander, a psychologist and clinical director of addiction medicine at the OSU Wexner Medical Center, said he could not comment specifically on the case of a 31-year-old woman who received an abortion last year at a Dayton-area abortion clinic. The case is the subject of complaint filed by the Ohio Deparment of Health and Dayton Right to Life with the State Medical Board. (Johnson, 8/6)

A group of fetal tissue researchers and laboratory employees is suing the University of Washington and anti-abortion activist David Daleiden to block the release of their names and personal information.The suit, filed in Washington state this week, comes as the University of Washington’s Birth Defects Research Laboratory was preparing to respond to a public information request filed by Daleiden and another anti-abortion activist, Zachary Freeman. (Haberkorn, 8/5)

The looming threat posed by the Zika virus will reveal the vast inequalities faced by women seeking reproductive healthcare in poor and politically conservative areas, experts say. “This is not a battle-ready public health infrastructure,” said Clare Coleman, president and CEO of the National Family Planning and Reproductive Health Association. (Johnson, 8/5)

Sen. Marco Rubio said Saturday that he doesn’t believe a pregnant woman infected with the Zika virus should have the right to an abortion — even if she had reason to believe the child would be born with severe microcephaly. ... "I understand a lot of people disagree with my view – but I believe that all human life is worthy of protection of our laws. And when you present it in the context of Zika or any prenatal condition, it’s a difficult question and a hard one," Rubio told POLITICO. "But if I’m going to err, I’m going to err on the side of life." (Caputo, 8/7)

In Puerto Rico the local association of obstetricians and gynecologists has launched a new attack on Zika. Because Zika primarily is a problem for pregnant women, the doctors are trying to reduce the number of pregnant women by offering free contraception across the island to any woman who wants it. "We have had ... historical barriers to contraception in Puerto Rico for a long long time," says Dr. Nabal Bracero, the driving force behind the initiative and the head of the local chapter of the American Congress of Obstetricians and Gynecologists. (Beaubien, 8/6)

U.S. health regulators have cleared the way for a trial of genetically modified mosquitoes in Florida that can reduce mosquito populations, potentially offering a new tool to fight the local spread of Zika and other viruses. The U.S. Food and Drug Administration said on Friday that a field trial testing Intrexon Corp's genetically engineered mosquitoes would not have a significant impact on the environment. The announcement came as Florida officials grapple with the first cases of local Zika transmission in the continental United States. (Steenhuysen, Grover and Stein, 8/5)

As the Zika virus continues its spread in Florida, federal officials on Friday approved a plan to release millions of mutant mosquitoes there in hopes of suppressing the disease-carrying insect’s population. The Food and Drug Administration has issued its final environmental assessment of the plan, saying that the proposed field trial in Key Haven, a suburb of Key West, “will not have significant impacts on the environment.” (Kelkar, 8/6)

Florida Republican Governor Rick Scott on Sunday accused the federal government of lagging in providing assistance to combat the spread of the Zika virus in a Miami-area neighborhood, the site of the first U.S. transmission of the virus.Scott was speaking on NBC's "Meet the Press" about the neighborhood of Wynwood, where crews began aerial spraying on Thursday to kill virus-carrying mosquitoes. Zika can cause microcephaly, a rare but devastating birth defect. (Skinner, 8/7)

Republican Gov. Rick Scott on Sunday defended cutting some state funding in Florida to pay for mosquito control amid increasing cases of the Zika virus in his state. Under Scott, state aid to mosquito control programs was reduced 40 percent in 2011, from $2.16 million to $1.29 million. Scott also ignored pleas from fellow Republicans that year when he cut a special $500,000 appropriation for the Public Health Entomology Research and Education Lab in Panama City Beach, which was founded in 1964.Florida has documented 408 Zika infections as of Friday. (Temple-West, 8/7)

Reporter Amy Walters continues her Zika journey to one other high-risk area: Texas’ Lower Rio Grande Valley, one of the poorest regions in the country. ... The community clinics are ill-equipped to handle this crisis, and they aren’t alone – Texas is short on doctors. According to one study, Texas needs 12,000 more physicians to meet our per-capita national average. And about half the state has no OB-GYNs. It’s an ominous report. And Zika hasn’t even arrived in Texas – yet. (Center For Investigative Reporting, 8/6)

Delaware officials say Medicaid recipients can now get benefit coverage for over-the-counter mosquito repellents. Officials say the move is intended to help protect against the Zika virus. Over-the-counter insect repellents generally are not covered by Medicaid. But the federal Centers for Medicare and Medicaid Services recently allowed states to cover mosquito repellents for Medicaid recipients when prescribed by an authorized health professional. (8/6)

A new model based out of Northeastern University predicts that nearly 30,000 Zika virus infections have been imported into the United States as of June. The CDC reported only 1,657 travel associated cases.But don't panic — at least, not yet.That's the message from Northeastern University professor of computational sciences Alessandro Vespignani. He and an international team of scientists have built a model to understand how the Zika epidemic will respond in the future. (Michaels, 8/4)

The Louisiana Department of Health and Hospitals has identified four new cases of Zika virus, bringing the total number of infections in the state to 19. All of the Louisiana cases reported, thus far, have been travel-related, involving patients who traveled to regions with ongoing Zika transmissions.Louisiana has not seen local transmissions, cases spread by mosquito bites. (Hunter, 8/5)

Airplanes dispersed insecticide over Miami early Thursday morning, and according to officials they’re already seeing a lot of dead mosquitos.Gov. Rick Scott and Dr. Tom Frieden—who heads the Centers for Disease Control and Prevention (CDC)—made the announcement at a press conference in Doral on Thursday afternoon. (Mack, 8/5)

For decades, the fabled Hazelden Foundation here has relied on group therapy, individual counseling and other nonmedical approaches to help tens of thousands of people recover from drug and alcohol addiction. But several years ago, Hazelden realized that too many of its opioid-addicted patients were dying of overdoses after dropping out of the traditional 12-step treatment programs. (Vestal, 8/8)

Use of the antioverdose drug Narcan has increased dramatically in Boston, with Roxbury among the hardest hit, according to new data that show which neighborhoods are bearing the brunt of the opioid scourge.Outside of downtown, a constricted area that attracts transients, Roxbury experienced the highest per-capita use of Narcan for the 12 months ending June 28, according to figures compiled by Boston Emergency Medical Services.The drug was used 268 times in Roxbury during that period, a 77 percent jump over the previous 12 months, in emergency calls in which Narcan was administered by EMS crews, civilians, and first responders such as police officers and firefighters. (MacQuarrie, 8/6)

Suboxone, a mixture of the synthetic opioid buprenorphine and the overdose reversal drug naloxone, has become the go-to drug in the U.S. for helping people to stop taking painkillers or heroin. Virginia aims its substance abuse funding toward medication-assisted treatment, which is meant to combine a drug such as Suboxone with recurring counseling sessions. Studies suggest that addicts are less likely to relapse if the drug is used as part of a complete treatment program. But recovering addicts, elected officials and law enforcement agents throughout the mountain towns near the southwestern tip of Virginia say the drug is more menace than miracle. (Ramsey, 8/6)

According to the Centers for Disease Control and Prevention, overdose deaths involving prescription opioids have quadrupled since 1999. But amid growing concern over the country’s problem with heroin and prescription opioids, a lesser-known drug in that same group is just as lethal. David Armstrong of STAT joins Hari Sreenivasan from Boston to talk more about the threat posed by fentanyl. (Armstrong and Sreenivasan, 8/6)

For a generation of commercial-watching adolescents, it was an indelible image: an egg, sizzling in a frying pan, representing “your brain on drugs.” It was a straightforward message, and the ad’s final line — “Any questions?” — asked as the egg white clouded and cooked, was strictly rhetorical.Three decades later, the Partnership for Drug-Free Kids (the group formerly known as the Partnership for a Drug-Free America) is bringing the frying pan out of retirement and firing up the stove again. But this time questions are the point. (White, 8/7)

In a big hotel conference room near New York’s Times Square, six doctors huddle around a greasy piece of raw pork. They watch as addiction medicine specialist Michael Frost delicately marks the meat, incises it and implants four match-sized rods. “If you can do it well on the pork, you can easily do it on the person,” Frost tells his audience.Frost consults for Braeburn Pharmaceuticals, the company behind the newly FDA-approved treatment Probuphine, and is teaching doctors how to use it. They are learning to implant it in pork so they can later implant it in patients’ arms. (Shakerdge, 8/8)

Gov. Wolf came to Philadelphia on Friday to tout a $20 million state program to coordinate treatment for people addicted to opioids."This is a disease we need to get our arms around," Wolf said at Thomas Jefferson University. "We're losing people every day."Wolf said 2,500 deaths in Pennsylvania were attributed to opioid overdoses last year, more than twice the 1,200 killed in traffic accidents.The funding, though modestly spread across the state, is a good start, he said. (Wood, 8/6)

Even as the US-Cuba relationship changes, bringing a growing numbers of tourists, the island remains in many ways frozen in time; when (Mick) Phillips was last there in the spring, he was driven around by a cabbie in a ‘55 Buick. But a striving, modern biotech enterprise thrives in Cuba, too. It’s a legacy of the US embargo: With drugs from the US unavailable, Cuba had to develop its own pharmaceutical industry. Among its biggest accomplishments is a novel treatment for lung cancer called CimaVax. (Waters, 8/5)

Lynn Hlatky has spent her career as a scientist studying the development of cancer, hoping in some way to improve understanding of an insidious disease.She took a path common in her field: won funding, established a lab, assembled a team of colleagues, and got to work.But now, a decade of Hlatky’s work is suddenly gone. After a highly unusual chain of events, thousands of little glass tubes of cells and proteins, pieces of human tumor tissue, and other biological samples have been destroyed.The materials fell victim to the bankruptcy of Genesys Research Institute Inc., a nonprofit that in 2013 took control of Hlatky’s lab on the campus of St. Elizabeth’s Medical Center in Brighton. (McCluskey, 8/6)

Black men treated with hormone therapy for prostate cancer may have a higher risk of death than white men undergoing the same therapy, according to a new study. But the deaths aren’t actually caused by prostate cancer. Androgen deprivation therapy, or ADT, is a hormone treatment that shrinks prostate tumors. Researchers from the Brigham and Women’s Hospital in Boston found that black men undergoing the therapy had a 77 percent higher risk of death than non-black men. (Beachum, 8/5)

Through the Shelter Canine Mammary Tumor Program, breast tumors are removed from homeless dogs that would otherwise go untreated and quite likely die. The dogs are then put up for adoption.At the same time, the dogs and their tumors are contributing to research on breast cancer in humans... Shelter dogs turn out to be excellent subjects for the study of how breast cancers form. (Giordano, 8/7)

Concerns about the potential harmful effects of radiofrequency radiation have dogged mobile technology since the first brick-sized cellphones hit the market in the 1980s. Industry and federal officials have largely dismissed those fears, saying the radiation exposure is minimal and that the devices are safe. ... But the launch of super-fast 5G technology over the next several years will dramatically increase the number of transmitters sending signals to cellphones and a host of new Internet-enabled devices, including smart appliances and autonomous vehicles. (Puzzanghera, 8/8)

Advancements in immunotherapy are giving Rome oncologist Dr. Melissa Dillmon hope that even more people will survive their battles with cancer. She told the Rotary Club of Rome on Thursday immunotherapy was pioneered to treat melanoma, but is now approved to fight lung, kidney and bladder cancers. She thinks its use will continue to spread. (Walker, 8/5)

More than a decade ago, Colleen Lum was diagnosed with Stage 3 ovarian cancer. ...A few months ago, after battling the disease for 13 years, Lum, who lives with her husband and family in Hopedale, Massachusetts, decided to end treatment. Today, at age 56, her health has further declined, according to her daughter. Lum is no longer eating or drinking much. (Brewster and Meyer, 8/5)

On the evening of March 8, 2016, 30-year-old Kyle Odom was arrested in Washington, D.C., for throwing objects over the White House fence. He'd traveled from Idaho, where authorities suspected him of shooting and wounding Idaho pastor Tim Remington in a church parking lot days earlier. Shortly after his arrest, an Idaho television station released a 30-page manifesto believed to have been sent by Odom. In the letter, the writer claims his life was ruined by "an intelligent species of amphibian-humanoid from Mars" using humans as sex slaves. The manifesto included drawings of the aliens and a claim that President Obama and Remington were aware of or involved in the Martians' plot. (Jacewicz, 8/5)

People living in Flint are experiencing mental health issues caused by the ongoing water crisis, including stress, anxiety and fear over what the future holds as they continue to rely on bottled water and filters more than two years after problems first surfaced with the drinking water.A widespread concern for residents throughout the lead-poisoned city is not knowing how they, or their children and grandchildren, may be impacted because of exposure to the contaminated water. (Anderson, 8/7)

The March on the Capitol gathered in Cowles Commons, downtown, to march to the Iowa state Capitol building so that legislators and Gov. Terry Branstad could hear from Iowans who believe in making mental health care a priority. In 2015, Branstad closed two prominent facilities for citizens living with mental illness. The march was meant as a way to show legislators that it affects the whole world, not just Iowa — but we're far behind the rest of the world, said Susan Rowe. (Gstalter, 8/7)

To make health care more accessible and higher quality, insurers and providers are experimenting with a number of new approaches — from storing patient information in the cloud to opening clinics inside of grocery stores. Close cousins to many of these tactics, however, were implemented even earlier in the homeless health care system. Homeless patients’ unique characteristics — they frequently have multiple chronic conditions, they move around often — overlap with some of the pressures driving medicine’s evolving care model today. And the cost and time constraints of the homeless revealed the weakness of the health care system before others saw it. (Seervai, 8/5)

In particular, [ Jennifer Johnston and Andrew Joy] looked at a 2015 study that examined 57 billion tweets, of which 72 million used the word “shooting” and 2 million the words “mass murder” or “school shooting."...If, after a school shooting, at least 10 out of every million tweets mentions the incident, the likelihood that there will be another school shooting increases to 50 percent within eight days after the initial violence and to 100 percent within 35 days afterward, according to the paper. (Mohney and Feely, 8/5)

For decades, Alzheimer’s has been silently ravaging brains, stealing memories and shortening the lives of millions of Americans. Now, researchers say they may be on the brink of tantalizing treatment breakthroughs that could for the first time at least slow the disease’s deadly progression. ... Amyloid, the sticky protein that attaches to brain cells and causes Alzheimer’s, is at the forefront of new therapies. (Buck, 8/7)

Asthma sufferers who live near wells in which hydraulic fracturing is used to extract natural gas are up to four times more likely to have an asthma attack than those who live farther away, according to new research from the Johns Hopkins University.The findings are the latest in a string of studies that have linked health problems to proximity to such wells, and come as Maryland prepares to lift a moratorium next year and issue permits for the controversial method of extraction known as "fracking." (Cohn, 8/5)

All of you who wait until the day before your dental appointment to floss your teeth – which is most of you – a report this week might ease your fleeting guilt: Little clinical research exists that the practice delivers the promised benefits. But dental professionals in Greater Cincinnati say mounds of anecdotal evidence collected by dentists over decades shows daily flossing is better than not flossing to ward off gum disease, which can lead to chronic infection that affects the whole body. Plus, said Dr. Rachel Gold, a Cold Spring general dentist and president of the Northern Kentucky Dental Society, pulling off a rigorous controlled study of daily flossing would be virtually impossible. (Saker, 8/5)

(Helen) Kostelac began receiving Medicaid benefits when she was pregnant with her daughter, Keira, now 2. She had recently lost her job at a tanning salon after a car crash.Help came from an unexpected source: her health insurer. CareSource, one of several insurance companies that Medicaid applicants can choose, recently launched a program called Life Services that it says helps members find work and educational opportunities. (Rinehart, 8/7)

For the first time in years, Kansas doesn’t have anyone with physical disabilities on the waiting list to receive home-based Medicaid services, state officials said. The Kansas Department for Aging and Disability Services reported Friday that the 438 people on the physical disability waiver list had been cleared to receive home and community-based services. (Hart, 8/5)

A California bill that would allow certified nurse-midwives to practice independently is pitting the state’s doctors against its hospitals, even though both sides support the main goal of the legislation. The California Hospital Association and the California Medical Association, which represents doctors, agree that nurse-midwives have the training and qualifications to practice without physician supervision.But they differ sharply over whether hospitals should be able to employ midwives directly — a dispute the certified nurse-midwives fear could derail the proposed law. (Gorman, 8/8)

A new law to help prevent suicide by students at New Jersey colleges brings needed attention to an important campus issue, school administrators said, while also giving them support to expand services. Gov. Christie last week signed into law the Madison Holleran Suicide Prevention Act, named after a 19-year-old University of Pennsylvania student from Bergen County who killed herself in 2014 in Philadelphia. (Lai, 8/8)

Young health care companies around Nashville received more than $940 million from 2005 to 2015, an explosion of venture capital investment that aligns with both the city’s rise to national prominence and the implementation of the Affordable Care Act.Health care investments accounted for about 60 percent of the $1.6 billion in Nashville-area venture capital investments over 11 years, according to a report from the Nashville Capital Network and Nashville Health Care Council. (Fletcher, 8/7)

CCHI is an "accountable care organization," health care speak for an emerging model designed to let physicians efficiently manage care and engage with patients to get healthier outcomes. Physicians can work with insurance companies and Medicare in contracts that reward better savings....But what it is, is a band of primary care doctors in about 50 counties across Tennessee who want to collaborate as a way to sustain their independence in changing the health care system — and as a path to making their patients, and communities, healthier. (Fletcher, 8/6)

Despite choosing an in-network hospital, the emergency room doctor who treated (Ed) Hagan wasn't in-network. Neither was the anesthesiologist who worked on Hagan’s bone marrow sampling. Combined, their bills totaled $2,000. ... State lawmakers have long sought a solution to surprise medical bills — also known as balance bills — as doctors, insurance companies and patients argue over who is responsible for the phenomenon. (Walters, 8/6)

Three decades of wear have taken their toll on Harris County's only public psychiatric hospital, built in 1986 just east of the Texas Medical Center...Now, hospital officials are renovating the units. They're fixing the bathrooms, replacing portions of concrete walls with tempered glass and installing surfaces with wood finish to create a brighter atmosphere that they hope will improve patient outcomes and lift the spirits of staffers.  (Zaveri, 8/5)

Montgomery County is poised to become the latest Texas jurisdiction to launch a mental health court, joining a national trend aimed at sending nonviolent offenders with serious mental illnesses to treatment rather than prison...These courts help address a massive national problem: 1 in 5 people in local jails has a recent history of mental illness, according to a 2006 Bureau of Justice Statistics report, and mentally ill inmates with prior convictions were more likely to end up in jail again. (Kragie, 8/7)

A Janesville pharmacist billed the federal government about $1 million for fraudulent prescriptions over several years, a federal indictment charges. Mark Johnson, 55, was arrested at his office Friday morning without incident, according to U.S. Attorney John Vaudreuil of Wisconsin's Western District in Madison.  Johnson faces 46 felony counts, including fraud, identity theft and lying during a health care audit. (Vielmetti, 8/5)

Alameda County will sever ties with its longtime jail health care contractor after grappling with allegations that the company provided inadequate care that may have led to inmate deaths.The Alameda County Board of Supervisors on Friday voted 4-0 to award the three-year, $135 million contract to California Forensic Medical Group instead of Corizon Health Inc., following a vigorous debate among nurses, former inmates and representatives from the two companies — both of which are giants in prison health care. Supervisor Keith Carson abstained from the vote. (Swan, 8/5)

A doctors group has filed a complaint against the emergency medicine training program at the UNC School of Medicine, saying the program violates federal law by using live animals. The complaint, filed by the Physicians Committee for Responsible Medicine with the U.S. Department of Agriculture, says the program instructs trainees to cut into various parts of a pig to insert needles and tubes, and to spread the ribs to access the heart. After the training session, the animals are killed. (8/5)

A man fatally shot by a Loudoun County sheriff’s deputy Friday morning was experiencing a mental-health crisis, his family said Saturday. Johannes Melvin Wood, 58, was shot and killed by a deputy who had responded to a call at Wood’s residence in Aldie after Wood refused to drop two knives he was holding, police said. Deputies had visited the home a day earlier when Wood called 911 because he was hearing voices and felt afraid, Gary Byler, the family’s attorney, said in an interview Saturday. (Schmelzer, 8/6)

Janus Pawlowicz was having root canal surgery at an Illinois dental clinic when his dentist told him that she had dropped an instrument somewhere and couldn’t find it. A couple of days later, Pawlowicz’s stomach began hurting, and he started feeling nauseous. He went to his doctor, who ordered an X-ray. And there it was: The nearly 2-inch-long barbed broach, a razor-sharp metal file used during root canals, was lodged in the middle of Pawlowicz’s stomach. (Guerra, 8/5)

Nearly half of all Americans know someone addicted to prescription painkillers. State lawmakers have responded forcefully, passing dozens of laws to tackle the problem. Unfortunately, there has been little evidence that the laws work. In fact, in the most comprehensive study to date, we found that they have given little relief to especially vulnerable patients. (Jill Horwitz and Ellen Meara, 8/7)

It’s hard to exaggerate the alchemy of distortions that are turning ObamaCare into such a pending disaster that big insurers like Aetna, Anthem, Humana and UnitedHealth Group, once supporters, can’t cut back their participation fast enough. ObamaCare was always going to be a questionable deal for taxpayers if the only people who signed up were poorer people whose premiums were largely paid by taxpayers. That was fine as far as insurers were concerned. They can make a profit even if taxpayers are the only ones paying. (Holman W. Jenkins, Jr., 8/5)

Of all the big health-insurance companies, Aetna may have been the last anyone expected to pour cold water on Obamacare. The company has over the past several years enthusiastically participated in the marketplaces the law created. Now, Aetna just announced, it is canceling plans to expand its Affordable Care Act (ACA) business and reviewing its existing products. Aetna is not alone. UnitedHealth Group and Humana have recently made announcements in a similar vein. Among other things, many big insurers complain that their Obamacare divisions are losing money, requiring them to pay out more in medical bills than they collect in premiums. The law’s critics have seized on the news, using it as fresh evidence that Obamacare is deeply, perhaps fatally, flawed. (8/7)

Is Donald Trump experiencing a mental illness? That’s the question making the rounds these days. The answer is: I don’t know. And neither do the commentators, tweeters and psychiatrists — both licensed and armchair — who’ve diagnosed him from afar as “crazy,” a “psychopath,” not “sane,” having “narcissistic personality disorder” and a “screw loose.”What I do know is that we ought to stop casually throwing around terms like “crazy” in this campaign and our daily lives. The president of the American Psychiatric Association has said that even for professionals, these sorts of diagnoses, made from afar, are “unethical” and “irresponsible.” And they only serve to demean and undercut people. (Patrick Kennedy, 8/8)

Don't hold your breath waiting for members of Congress to return to Washington to deal with the immediate public health threat posed by the Zika virus. That would require putting the public interest over politics, an approach gone missing in action during this poisonous election year. (Merrill Goozner, 8/5)

I teach a medical school course on homeostasis: how organ systems work together to maintain physiological balance. For example, when blood pressure drops acutely, the heart speeds up and the kidneys retain sodium and water, propelling blood pressure back to normal. If body temperature falls, we shiver to generate heat, blood vessels constrict to conserve heat, and we warm up. Homeostasis is about preserving constancy in the face of changing conditions. As a model for explaining human physiology, it does remarkably well.However, there are aspects of the human condition that homeostasis cannot explain. For instance, blood pressure often fluctuates minute to minute. (Sandeep Jauhar, 8/6)

Medical marijuana has been legal in California since 1996 — but employees who use the drug, with their doctors’ approval, can still lose their jobs, a federal judge has ruled. This week’s decision by U.S. District Judge Dale Drozd of Fresno was actually a partial victory for the former employee, Justin Shepherd. ...But on the larger issue in the case — an employer’s authority to discipline employees whose drug use was recommended by their doctors and allowed by state law — the judge said workers have no legal protection. (Bob Egelko, 8/5)

Heroin and opioid addiction presents American society with the conundrum to beat all conundrums. We feed it while we fight it. And sometimes we fight it by feeding it. Missouri is the only state that tends to fight it by ignoring it.Addiction has reached epidemic proportions nationwide because doctors, for years, have over-prescribed powerful opioid painkillers such as Vicodin and OxyContin. Feeding the addiction, in other words. Patients who get hooked increasingly find their access to prescriptions blocked because all states but Missouri maintain registries specifically designed to help doctors and pharmacists fight opioid abuse. (8/7)

This August marks the first school year that children starting school must have required vaccines unless they have a medical exemption from a physician. The number of children without the required vaccines at school enrollment had skyrocketed by 337 percent since 2000, raising the risk of outbreaks of preventable serious diseases such as measles. ...Thanks to greater public awareness, the rate of unvaccinated children in our state is already changing for the better. (Richard Pan, 8/5)