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Morning Briefing

Summaries of health policy coverage from major news organizations

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Monday, Jun 13 2016

麻豆女优 Health News Original Stories 2

  • Women And The Zika Virus: Smart Questions And A Few Solid Answers
  • As Hospital Chains Grow, So Do Their Prices For Care

Administration News 1

  • FDA Guidelines For Gay Men Donating Blood Criticized Following Orlando Massacre

Health Law 3

  • Republicans Shift Strategy, Go Small On Latest Health Law Changes
  • California Inches Closer To Offering Coverage Under Health Law To Those In U.S. Illegally
  • Ga. State Senator Who Once Led Fight Against Medicaid Expansion Has A Change Of Heart

Campaign 2016 1

  • On Medical Initiatives, Clinton's Detailed Style Contrasts Sharply With Trump's General Views

Marketplace 1

  • In Latest Devastating Blow To Theranos, Walgreens Terminates Partnership

Public Health 3

  • When Drugs Are Everywhere, The Daily Struggle To Stay Clean Can Be A Herculean Effort
  • Federal Health Officials Prepare Plan For Responding To Possible Zika Outbreak In U.S.
  • Penicillin Still A Match For Syphillis Despite Other Bacteria's Growing Resistance

Women鈥檚 Health 1

  • Both Sides Wait With Bated Breath For Split Court To Rule On Texas Abortion Law

State Watch 3

  • Survey Offers Glimpse Of Extreme Frustration Fla. Pediatricians Feel Toward Medicaid
  • Hospital Roundup: Connecticut Approves Sale Of Two Hospitals
  • State Highlights: N.Y. Advances Requirement That Nearly All Prescriptions Be Submitted Electronically; Fla. High Court Mulls Medical Malpractice Caps

Editorials And Opinions 1

  • Viewpoints: Precautions Against Superbugs; Dying With Society's Blessing

From 麻豆女优 Health News - Latest Stories:

麻豆女优 Health News Original Stories

Women And The Zika Virus: Smart Questions And A Few Solid Answers

Here鈥檚 a breakdown of what women should know, and what is still unclear, regarding how Zika is transmitted, who is at risk and how to take precautions against it. ( Shefali Luthra , 9/30 )

As Hospital Chains Grow, So Do Their Prices For Care

The average patient stay costs $4,000 more at Sutter and Dignity hospitals than at other California medical centers, study shows. ( Chad Terhune , 6/13 )

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Summaries Of The News:

Administration News

FDA Guidelines For Gay Men Donating Blood Criticized Following Orlando Massacre

Experts say they are overly conservative and unnecessary with the testing technology available now.

The massacre at a gay nightclub in Orlando on Sunday sparked calls from leading AIDS researchers and gay-rights advocates for the federal government to rewrite guidelines that bar men who have had sex with men in the past year from donating blood. (Piller, 6/12)

Hundreds lined up to give blood Sunday in Orlando to help the victims of the massacre at a gay nightclub, but major restrictions remain for gay men wanting to give blood themselves. The response overwhelmed OneBlood donation centers, where officials asked donors to make appointments and continue donating over the next several days. Over 50 people were injured and 50 were killed when a gunman opened fire early Sunday inside the downtown Orlando club Pulse. While many Facebook and Twitter posts from individuals and at least one gay advocacy group in Florida said no one would be turned away and all blood would be screened, OneBlood denied any change in policy. (6/12)

Health Law

Republicans Shift Strategy, Go Small On Latest Health Law Changes

The move suggests that lawmakers are willing to make adjustments to the current law, despite plans to release replacement plan details. In other news, the insured who aren't getting subsidies struggle under the threat of skyrocketing premiums, health care economists gather for a conference where the Affordable Care Act will take center stage and Solicitor General Donald Verrilli, in talking about his tenure, describes the reviews of his ACA performance as "quite rough."

House Republicans are considering small-bore changes to ObamaCare even as they prepare to release an outline for replacing the entire law. The House Energy and Commerce Committee on Friday held a hearing on five bills that would make relatively small changes to the health law, such as changing the documentation required to enroll in coverage or changing how insurers can use someone's age in setting premiums. The moves indicate that Republicans have not ruled out making adjustments to the existing law despite preperations to tout their long-awaited replacement plan for all of ObamaCare, coming from Speaker Paul Ryan鈥檚 (R-Wis.) task force later this month. (Sullivan, 6/10)

Millions of people who pay the full cost of their health insurance will face the sting of rising premiums next year, with no financial help from government subsidies. Renewal notices bearing the bad news will go out this fall, just as the presidential election is in the homestretch. "I don't know if I could swallow another 30 or 40 percent without severely cutting into other things I'm trying to do, like retirement savings or reducing debt," said Bob Byrnes, of Blaine, Minnesota, a Twin Cities suburb. His monthly premium of $524 is already about 50 percent more than he was paying in 2015, and he has a higher deductible. (6/13)

Six years after President Obama signed the Affordable Care Act, the health reform law has gained acceptance from a majority of California voters, but the cost of getting healthcare remains a major concern, eclipsing worries about having insurance, according to a new USC Dornsife/Los Angeles Times poll. The widespread worry about costs indicates a potential shift in the debate over healthcare, at least in this heavily Democratic state. (Lauter, 6/10)

About 1,000 health care economists from around the country descend on Philadelphia this week for the biennial conference of the American Society of Health Economists. (Gorenstein, 6/10)

鈥淚 really felt like the roof had caved in on me,鈥 Solicitor General Donald B. Verrilli Jr. said the other day, recalling the low point of his five years as the Obama administration鈥檚 top appellate lawyer. Mr. Verrilli, 58, is preparing to step down from the job this month after a tenure that included 37 Supreme Court arguments and a string of major victories on behalf of a Democratic president facing a court dominated by conservative justices. But the scathing reviews of his most important Supreme Court argument, in the 2012 case challenging the constitutionality of President Obama鈥檚 health care law, still sting. (Liptak, 6/11)

California Inches Closer To Offering Coverage Under Health Law To Those In U.S. Illegally

Gov. Jerry Brown signed legislation that would require the state to seek a waiver from the federal government to allow immigrants in the country illegally to buy insurance from Covered California exchanges. They would not be eligible for subsidies.

California Governor Jerry Brown signed a bill into law allowing unauthorized immigrants to buy health insurance on a state exchange created under the U.S. Affordable Care Act, making the state the first in the country to offer that kind of coverage. The law lets the state request a waiver from the federal government that will be needed to allow unauthorized immigrants to purchase unsubsidized insurance through Covered California, the state's healthcare exchange. (O'Brien, 6/11)

The new law is the latest immigrant-friendly policy recently passed in California. Over the last few years, immigrants here illegally have gained the ability to apply for professional licenses, such as for practicing law or medicine, and also for drivers licenses. Opponents of these policies say they encourage illegal immigration and take away resources from those here legally. But immigrant advocates have praised California鈥檚 efforts, especially those around expanding healthcare. (Karlamangla, 6/10)

Under the terms of California鈥檚 request to the federal government, immigrants without legal standing would not qualify for government assistance to help pay for the coverage 鈥 unlike the vast majority of Covered California enrollees. Many experts and advocates concede that this makes the measure a largely symbolic gesture, since few would be able to afford policies on their own. They are allowed to buy coverage in the private market, but many decline to do so for financial reasons, insurance industry experts say. (Ibarra, 6/10)

鈥淭oday we ask the federal government to remove barriers to health insurance access that discriminates against some of our residents on the basis of their documentation status,鈥 Sen. Ricardo Lara, D-Bell Gardens, said in a statement. 鈥淭he current policy disallowing immigrants from purchasing care with their own money is both discriminatory and outdated.鈥 (White, 6/10)

Ga. State Senator Who Once Led Fight Against Medicaid Expansion Has A Change Of Heart

Renee Unterman, who heads the Georgia Senate's health committee, said last week, "Times have changed, and we've seen the effect of the health crisis we're in." Also, federal plans for a survey of Indiana's Medicaid expansion is raising some concerns in the state.

Two years ago, state Sen. Renee Unterman helped lead an effort to shut down Medicaid expansion in Georgia. But now the prominent Republican wants her colleagues to reconsider years of opposition to any form of Medicaid expansion. ... Unterman's shift is the latest crack in Republican opposition to a key component of President Barack Obama's signature health care law. Unterman and others argue that increasing Medicaid eligibility is the only way to quickly affect Georgia's health care system, which has seen a rash of rural hospitals shutting down or cutting services in recent years. (Foody, 6/11)

Indiana officials say the CMS is planning to use a biased survey to evaluate the state's conservative approach to Medicaid expansion. In April, the federal Office of Management and Budget approved an emergency request by the CMS to let it examine whether Indiana's conservative-friendly, alternative Medicaid expansion model known as Healthy Indiana Plan 2.0, or HIP 2.0, has hurt beneficiaries' access to care. ... Indiana Gov. Mike Pence, a Republican, has argued there is no need for the CMS to perform its own evaluation of his plan because the state already hired the Lewin Group, an independent consultancy, to do so. (Dickinson, 6/11)

Campaign 2016

On Medical Initiatives, Clinton's Detailed Style Contrasts Sharply With Trump's General Views

Donald Trump typically announces his thoughts on medical research only when asked directly about it -- and so many in the field aren't sure where exactly he stands on the issues. Meanwhile, Hillary Clinton calls the Republican presidential candidate out on his views about women's health care at a Planned Parenthood Action Fund gala.

When Hillary Clinton announced in December that she wanted a big increase in Alzheimer鈥檚 research, she did it in typical Clinton fashion 鈥 with a major speech and a six-point plan, led by a specific commitment of $2 billion a year in federal funds to find a cure by 2025. When Donald Trump announced his own support for Alzheimer鈥檚 research last summer, he did it because someone asked him a question at a town hall. And his response was typical Trump. He assured the New Hampshire audience that Alzheimer鈥檚 was a 鈥渢otal top priority鈥 for him 鈥 a bold promise with no specifics and no follow-up. These are the two paths that US medical research could take now that the lineup for the November presidential election is settled. (Nather, 6/13)

Hillary Clinton continued her move into the general election Friday by framing Donald Trump鈥檚 campaign as one of a war on women. ... She spoke for the first time since clinching the Democratic presidential nomination, acknowledging the milestone of becoming the first woman to earn the nomination of one of the nation鈥檚 major political parties. She also discussed some of the women鈥檚 health and family policies that she would prioritize in the White House, such as paid family leave and access to birth control and safe abortion. But mostly, Clinton hammered on the idea that Trump puts women鈥檚 reproductive rights at risk. (Owens, 6/10)

Marketplace

In Latest Devastating Blow To Theranos, Walgreens Terminates Partnership

The 40 Theranos blood-draw sites inside Walgreens stores in Arizona, which the company calls 鈥渨ellness centers,鈥 have been the primary source of revenue for Theranos and its conduit to consumers.

Drugstore operator Walgreen Co. formally ended a strained alliance with Theranos Inc. as regulators near a decision on whether to impose sanctions against the embattled Silicon Valley firm. Some officials at the Walgreens Boots Alliance Inc. unit had grown frustrated at not getting more details and documentation from Theranos after learning it had corrected tens of thousands of blood tests, including many performed on samples collected from patients at Walgreens pharmacies, according to people familiar with the partnership. (Siconolfi, Weaver and Carreyrou, 6/12)

Walgreens said on Sunday that it was terminating its relationship with Theranos, dealing a severe blow to the embattled blood-testing company. Walgreens said it would immediately close all 40 of the Theranos testing centers in its Arizona drugstores, the source of most of Theranos鈥檚 customers. The giant retailer, a part of the Walgreens Boots Alliance, played a critical role in Theranos鈥檚 early success. Founded by Elizabeth Holmes, a Stanford University dropout, the company promised to revolutionize the lab industry by being able to offer blood tests through a simple finger prick at a fraction of the cost of conventional testing. (Abelson and Pollack, 6/12)

Theranos spokesperson Brooke Buchanan said that the firm is working closely with the government to exceed all federal regulations. "We are disappointed that Walgreens has chosen to terminate our relationship and remain fully committed to our mission to provide patients access to affordable health information and look forward to continuing to serve customers in Arizona and California through our retail locations," Buchanan said. (Mclean, 6/12)

Theranos still lists five locations where consumers can get their blood tested, four in Arizona and one in California. The Walgreens web page that used to list the locations of Theranos centers now redirects to the drugstore chain鈥檚 home page. (Brooks, 6/12)

Public Health

When Drugs Are Everywhere, The Daily Struggle To Stay Clean Can Be A Herculean Effort

Prescription painkillers have become so ubiquitous in America's rural towns, those trying to stay sober are facing a constant uphill battle. Meanwhile, a New Jersey ER has embraced a culture shift in how it treats pain, federal prosecutors have gone after a drugmaker's former employees saying they were inappropriately marketing fentanyl, and investors and businesses are seeing a big opportunity in addiction treatment.

Jessica Kilpatrick was in the middle of a 10-hour shift at Burger King when she checked her phone messages. Right away she knew. It was the canned voice of the community corrections office ordering her in for a random drug test. Jessica put her headset back on and tried to stay calm. She looked into a mirror. She was hot and greasy and smelled like a Croissan鈥檞ich, but her eyes were clear and her mind was straight, unglazed by opioid painkillers. She had not missed a single day of work in 11 months. Above: Jessica Kilpatrick and Jeremy Horton have tried to get their lives in order after years of drug abuse. But with Jeremy now having to serve a prison sentence, Jessica must enter a new chapter while fighting her addiction to painkillers. 鈥淗ave a blessed one,鈥 a customer shouted from the drive-through, and Jessica, who was 33, hollered back in her raspy twang, 鈥淵ou do the same.鈥 She had learned in recovery to focus on the positive and not let the old voices get too loud, so on the drive to the courthouse later she thought of the calendar she kept at home on her nightstand. For every day she stayed clean, she marked another X. (Hull, 6/11)

Since Jan. 4, St. Joseph鈥檚 Regional Medical Center鈥檚 emergency department, one of the country鈥檚 busiest, has been using opioids only as a last resort. For patients with common types of acute pain 鈥 migraines, kidney stones, sciatica, fractures 鈥 doctors first try alternative regimens that include nonnarcotic infusions and injections, ultrasound guided nerve blocks, laughing gas, even 鈥渆nergy healing鈥 and a wandering harpist. Scattered E.R.s around the country have been working to reduce opioids as a first-line treatment, but St. Joe鈥檚, as it is known locally, has taken the efforts to a new level. (Hoffman, 6/10)

Jonathan Roper, once a sales manager at Insys Therapeutics, a small pharmaceutical company, had a problem. The end of the quarter was near, and for the first time, Insys was in danger of missing sales goals for its only product, a spray called Subsys that contains the powerful painkiller fentanyl. So Mr. Roper sent out a blistering email to his staff members at the time, in March 2014, urging them to make a final push. 鈥淭here is no excuse for any of your docs to not take care of you at this crucial time of the quarter,鈥 he wrote. It鈥檚 time, he said, for the top-prescribing doctors 鈥渢o give back for all of the hard work, long days and late nights you have spoiled them with.鈥 Mr. Roper and a former sales representative, Fernando Serrano, were arrested on Thursday on federal anti-kickback charges. (Thomas, 6/10)

The first time Ray Tamasi got hit up by an investor, it was kind of out of the blue. "This guy called me up," says Tamasi, president of Gosnold on Cape Cod, an addiction treatment center with seven sites in Massachusetts. "The guy" represented a group of investors; Tamasi declines to say whom. But they were looking to buy addiction treatment centers like Gosnold. "He had checked around and learned that we were one of the more reputable programs. We had a good reputations in the community 鈥 nice array of services," Tamasi recalls. "He wanted to know if we were interested in becoming part of his company." (Kodjak, 6/10)

Meanwhile, in other news on the opioid epidemic聽鈥

Drug addiction is not restricted to the young. Donna Weber, now 53, turned to painkillers after undergoing simple surgery. Then a long, tortured path to divorce made her anxious and depressed. Soon, she found herself on a candy-colored pill roller coaster. Unlike street drugs, the pharmaceutical pills were easy to obtain legally. She got them from emergency rooms, dentists, psychiatrists, even plastic surgeons. 鈥淚 went to doctors with exaggerated truths,鈥 explained Ms. Weber, who once had four doctors. 鈥淚 said I hurt more and more.鈥 (Gustke, 6/10)

...(As) early as next year, Baltimore's health commissioner, Dr. Leana Wen, hopes to open a "stabilization" center where addicts can be taken to sober up and get referrals to treatment and other services. The addicts 鈥 many of whom now end up in hospital emergency rooms or jail 鈥 also would receive food, clothing and a shower. (Marbella and Cohn, 6/11)

As physicians face increased scrutiny over prescribing painkillers, the nation's largest medical group meets this week with delegates resolved to eliminate barriers to alternative treatments. (Johnson 6,11)

Ohio鈥檚 largest county is asking the federal government to waive rules that would make more publicly funded beds available for long-term drug treatment as it battles a growing epidemic of heroin and fentanyl abuse that has killed 200 people so far this year. (Gillispie, 6/13)

Federal Health Officials Prepare Plan For Responding To Possible Zika Outbreak In U.S.

The blueprint for federal and state action if the virus begins to be transmitted in this country could be released this week. Meanwhile, Florida officials are looking for more leadership and funding from the federal government. And Kaiser Health News has an FAQ about concerns for women of child-bearing age.

The federal government, preparing for homegrown cases of the Zika virus, is planning to release a proposal for responding to them, health officials said Friday. The 60-page document, a blueprint for action when the first cases of locally transmitted Zika occur in the continental United States, could be released early next week, officials at the Centers for Disease Control and Prevention said. They emphasized that it was a working draft that could change based on advice from state officials. Sylvia Mathews Burwell, the secretary of health and human services, and Dr. Thomas R. Frieden, the director of the C.D.C., spoke by videoconference with state governors Thursday about the plan. On Friday, experts with the C.D.C. talked with state health departments. (Tavernise, 6/10)

Governor Rick Scott says Florida is doing its part to fight the spread of the Zika virus in the state. But he鈥檚 continuing the complaint that he鈥檇 like to see the Federal government do more. Scott spoke with a group of reporters Friday. (McCarthy, 6/12)

Hoping for the best but preparing for the worst, Leon County officials are asking the state for nearly $470,000 for a Zika emergency plan. (Ash, 6/10)

Mosquitoes may be one of summer鈥檚 nuisances. But the ones carrying Zika, a virus that has spread through Latin America and could be transmitted in the United States this summer, are triggering public health warnings -- especially among women of childbearing age -- because of Zika's propensity to cause birth defects. ... What鈥檚 the danger? A lot is up in the air, since there鈥檚 not a ton of research on the virus. Here鈥檚 a quick breakdown of the smart questions to ask and what we do actually know. (Luthra, 6/13)

Penicillin Still A Match For Syphillis Despite Other Bacteria's Growing Resistance

News outlets report on other public health stories about unregulated chemicals found in drinking water, America's least healthy cities and the mental and financial toll Alzheimer's takes on families.

Lola Stamm fell in love with the bacterium that causes syphilis when she was in grad school. Other bacteria are rod-shaped or blobby. Treponema pallidum, the syphilis culprit, is a long, skinny corkscrew 鈥 and it slithers. "Under the dark-field microscope they look like little snakes," says Lola Stamm, a microbiologist at the University of North Carolina, Chapel Hill. "It's really rather creepy, but they're just fascinating organisms." The bacterium is bizarre for another reason 鈥 penicillin still obliterates it. (Bichell, 6/10)

For all the pathogens and chemicals monitored by the federal government to protect drinking water, a far broader universe of 鈥渆merging contaminants鈥 is going unregulated. The Environmental Protection Agency keeps tabs on scores of substances that have surfaced in water systems around the country, with the aim of restricting those that endanger public health. But partly because the rules that the agency must follow are complicated and contentious, officials have failed to successfully regulate any new contaminant in two decades. Only once since the 1990s has the EPA come close to imposing a new standard 鈥 for perchlorate, a chemical found in explosives, road flares, rocket fuel and, it turns out, the drinking water of over 16 million people. (Dennis, 6/10)

Thanks to continued improvement in public health care, Americans today are healthier than ever. The average American is expected to live 79 years, about six years longer than in 1975. The improvement, however, has not been uniform across the United States, and some cities are stuck in the past. In some of the least healthy cities, life expectancy is as low as it was 40 years ago. To determine the least healthy cities in the country, 24/7 Wall St. compiled an index of various health factors and outcomes. Health factors in an area, including eating and exercise habits of residents, the availability of clinical care, social and economic conditions, and the physical environment, tend to be accurate predictors of an area鈥檚 health outcomes 鈥 its residents鈥 length and quality of life. (Comen, 6/11)

More than 5 million Americans now have Alzheimer's disease, the most common form of elderly dementia, and the prevalence of Alzheimer's among baby boomers is expected to explode by midcentury. The Alzheimer's Association projects that 10 million baby boomers will develop the disease. While studies and media stories that explore the emotional toll the disease extracts from family and friends are all but legion, the financial toll, which can also be devastating, is less understood. (Stephenson, 6/11)

Women鈥檚 Health

Both Sides Wait With Bated Breath For Split Court To Rule On Texas Abortion Law

With an unpredictable 4-4 Supreme Court, abortion providers and opponents are planning for any situation. In other news, a look at the Indiana abortion law going in front of a federal judge on Tuesday, and Arizona's Department of Health Services reports that there's been no violations to a 10-month-old fetal tissue rule.

As she waits for the U.S. Supreme Court to rule on a challenge to a restrictive Texas abortion law, Amy Hagstrom-Miller said she hopes she will not have to close up to three of the clinics she operates in the state, but is planning for it just in case. Hagstrom-Miller founded Whole Woman's Health, which runs four facilities in Texas that provide abortions and led the legal challenge to the law. She said she has spreadsheets listing staffers who would be laid off if the court allows the law to survive, and is thinking about selling buildings and medical equipment as well as shutting her clinics in Fort Worth, San Antonio and McAllen. "I would be irresponsible if I didn't plan," Hagstrom-Miller said in an interview. (Hurley, 6/12)

A federal judge will hold a hearing this week to consider a bid to block Indiana鈥檚 new abortion law from taking effect on July 1. The law, which conservative Republican Gov. Mike Pence signed off on in March, includes a provision banning abortions sought because of a fetus鈥 genetic abnormalities. Here is a look at the law鈥檚 provisions and the arguments that are likely to come up during the hearing Tuesday. (Callahan, 6/12)

Ten months after Arizona began forcing state health officials to report what happens to the remains of aborted fetuses, no violations regarding the handling of the tissue have been reported to the state Department of Health Services. (Wingett Sanchez, 6/11)

State Watch

Survey Offers Glimpse Of Extreme Frustration Fla. Pediatricians Feel Toward Medicaid

Two of the bigger problems they reported were having patients who were reassigned to a different insurance company or pediatrician without the parents' knowledge and insurance plan limitations impeding care. In other news, advocates say a federal change to Medicaid funding will greatly help Native Americans in Wisconsin.

Children are consistently switched from one Medicaid insurance company to another without their parents' consent, and pediatricians continue to have trouble getting their patients the medication and treatment they desperately need, a new survey of Florida pediatricians covering their experiences with the state's Medicaid program shows. ... More than 80 percent said that that they had experienced either some or many cases in which insurance plan limits, or authorizations for needed treatments, such as prescription drugs, had prevented them from providing children with needed care. (Clark, 6/12)

A federal change to Medicaid funding for services at tribal clinics could help close significant health gaps for Native Americans in Wisconsin, advocates say. The federal government said in February that it would offer full federal funding for transportation, long-term care and other services provided indirectly by the clinics, as it does for services within clinics. The change also applies to specialty care by providers outside of the clinics, as long as the clinics still coordinate the patients鈥 care. Until now, the federal government has paid for about 60 percent of such care, as it does for other Medicaid services, with the state picking up the other 40 percent. (Wahlberg, 6/13)

Hospital Roundup: Connecticut Approves Sale Of Two Hospitals

In other news, New Hampshire's need for a psychiatric facility to treat prison inmates continues to be pushed off and Nationwide Children's Hospital in Ohio plans a mental health center. Also, California Healthline reports on the growing gap in the cost of services at California's top two health systems versus the rest of the state.

State regulators gave final approval Friday to the $105 million purchase of Manchester Memorial and Rockville General hospitals by Prospect Medical Holdings, a for-profit company based in Los Angeles. (Pazniokas, 6/10)

New Hampshire has become the first state to launch a campaign solely aimed at breaking down the stigma around mental illness and improving treatment and prevention. But left unaddressed has been a population of mentally ill people at the state prison who are incredibly violent and have no place else to go. (Sutherland, 6/13)

Nationwide Children's Hospital is hoping to close some of that gap with its planned Behavioral Health Pavilion, a project announced Friday as part of a massive, $730 million campuswide expansion. (Kurtzman, 6/12)

As health care consolidation accelerates nationwide, a new study shows that hospital prices in two of California鈥檚 largest health systems were 25 percent higher than at other hospitals around the state. Researchers said this gap of nearly $4,000 per patient admission was not due to regional wage differences or hospitals treating sicker patients. Rather, they said California鈥檚 two biggest hospital chains, Dignity Health and Sutter Health, had used their market power to win higher rates. "California experienced its wave of consolidation much earlier than the rest of the country and our findings may provide some insight into what may happen across the U.S. from hospital consolidation," said the study鈥檚 lead author, Glenn Melnick, a health care economist at the University of Southern California. (Terhune, 6/13)

State Highlights: N.Y. Advances Requirement That Nearly All Prescriptions Be Submitted Electronically; Fla. High Court Mulls Medical Malpractice Caps

Outlets report on health news from New York, Florida, Connecticut, California, Ohio, Minnesota, Missouri and North Carolina.

The New York Legislature has approved an amendment to the recently enacted law that requires doctors to submit virtually all medication prescriptions electronically to a pharmacy. If signed by Gov. Andrew Cuomo, the legislation would authorize the physician, dentist or other prescriber to electronically send it to a secure site from which it can be downloaded by the pharmacy of the patient's choice. (6/13)

More than a dozen years after a fierce political fight about the state's medical-malpractice laws, the Florida Supreme Court on Thursday heard arguments about the constitutionality of limits on damages in malpractice lawsuits. (6/10)

House Speaker J. Brendan Sharkey became the first Democratic leader Friday to call on Insurance Commissioner Katharine L. Wade to recuse herself from ruling on Anthem鈥檚 merger with Bloomfield-based Cigna, the commissioner鈥檚 last private-sector employer before joining the administration of Gov. Dannel P. Malloy. (Pazniokas, 6/10)

Families and advocates who pressed for a law that clarifies the authority of Ohio judges to order outpatient treatment for people with severe mental illness say their hard-won victory has meant little in Franklin County. (Price, 6/11)

Amelia is among more than 1,400 Minnesotans being treated with medical cannabis since the drug became legal in the state last July 1. She is one of about 300 being treated for epileptic seizures. And she is among more than 150 children in Minnesota certified to receive medical cannabis. (Lundy, 6/12)

Today, tens of thousands of Kansas City area homes still contain lead paint so dangerous that a tiny amount of paint dust can damage a young child鈥檚 brain. As many as 1,500 children in Kansas City have lead poisoning, health officials estimate. (Cummings, 6/11)

The Centers for Disease Control and Prevention has confirmed Salmonella cases in 35 states linked to exposures in backyard poultry flocks. North Carolina, with 26 known cases reported, ranks among the five states with most infections during this outbreak. (Clabby, 6/13)

Editorials And Opinions

Viewpoints: Precautions Against Superbugs; Dying With Society's Blessing

A selection of opinions on health care from around the country.

The so-called superbug recently discovered for the first time in a woman in Pennsylvania hasn鈥檛 reached the Midwest, but the fact that the bacteria is resistant to antibiotics of last resort is a super-cause for concern. (6/12)

It was inevitable that we would one day seek ways to kill ourselves with society鈥檚 blessing. California recently joined four other states 鈥 Oregon, Washington, Vermont and Montana 鈥 that allow terminally ill patients to commit suicide using doctor-prescribed drugs. Criteria under the California law include that the patient has a terminal disease, would likely die within six months, is of sound mind and can self-administer the 鈥渕edicine.鈥 Thanks to medical advances that can extend life beyond what some find acceptable, resulting in unnecessary suffering, many think it鈥檚 their right to die with dignity using medications legally prescribed. (Kathleen Parker, 6/10)

The world has made so much progress in reducing the spread of AIDS and treating people with H.I.V. that the epidemic has receded from the public spotlight. Yet by any measure the disease remains a major threat 鈥 1.1 million people died last year from AIDS-related causes, and 2.1 million people were infected with the virus. And while deaths are down over the last five years, the number of new infections has essentially reached a plateau. The United Nations announced a goal last week of ending the spread of the disease by 2030. That鈥檚 a laudable and ambitious goal, reachable only if individual nations vigorously campaign to treat everyone who has the virus and to limit new infections. (6/13)

The chief advocate for America's medical group administrators says the Obama administration's plans to overhaul Part B drug payments will devastate smaller specialty practices. Medicare now pays 6% on top of the average sales price of drugs administered by infusion or injection in outpatient settings. That incentivizes providers to choose more expensive medications. The mandatory program beginning in late 2016 would test how prescribing patterns are affected by reducing the bonus to 2.5% and substituting a flat payment of $16.80 per drug per day. (Adam Robenfire, 6/10)

Thanks to competitive tax policy, smart regulations and a well-educated workforce, Texas has become a hot spot for pharmaceutical investment. Today, the drug industry employs more than 36,000 Texas workers. However, the jobs supported by our state鈥檚 drug business are in jeopardy. Federal officials have proposed major changes to Medicare that ultimately would stifle drug innovation. If enacted, these 鈥渞eforms鈥 will drive away investment in local drug research and the jobs that go with it. (Tony Bennett, 6/12)

The specter of drug pricing can鈥檛 seem to disappear from public discourse. On the one hand, this isn鈥檛 a bad thing 鈥 wanting to tie drug prices (and healthcare prices overall) to some measure of value is a noble goal. But the devil is in the details 鈥 and Vermont鈥檚 attempt to 鈥渄o something鈥 on drug pricing moves the needle in the wrong direction. (Yevgeniy Feyman, 6/10)

The Texas Health and Human Services Commission recently negotiated with the federal government a 15-month waiver for Medicaid funding, which would produce more than $4 billion toward health care coverage for uninsured Texans. This is a crucial step to achieving health care for millions of the state鈥檚 uninsured, with 13 percent of the allocation contributing to the total income of private state hospitals. (Michele A. Rountree and Tonia Wu, 6/11)

Gov. Matt Bevin recently made a 2-percent mid-year budget cut to Kentucky鈥檚 public universities, which led to a lawsuit by Attorney General Andy Beshear. That lawsuit is now the subject of an appeal after Franklin Circuit Court Judge Thomas Wingate issued his opinion stating that Bevin had the authority to make those cuts. (Lachin Hatemi, 6/10)

A punitive measure that would fine Medicaid patients who miss doctor鈥檚 appointments is unnecessarily harsh and deserves to be vetoed by Gov. Jay Nixon, who has it under review. There are better and less mean-spirited ways to achieve the worthy goals of trying to get patients to take more control of their health care, and helping doctors avoid the time and money lost to missed appointments. (6/12)

California鈥檚 death penalty system has been broken for so long, you could forgive people for thinking that it no longer exists. The last person executed at San Quentin was Clarence Ray Allen, who arranged the murders of three people in Fresno 鈥 one who revealed details of a burglary Allen had planned, and two others who testified against him. His January 2006 execution came 23 years after his conviction. Since then, legal challenges have left California without a constitutional method of executing prisoners. The state has proposed a new lethal-injection protocol, but more lawsuits will likely stall the resumption of executions for the foreseeable future, and an initiative headed for the fall ballot would ban it outright. It鈥檚 unclear how many executions have been forestalled by the freeze. (6/11)

The task force found that what happened in Flint is the culmination of years of government failure, with the Michigan Department of Environmental Quality and state-appointed emergency managers chiefly to blame. It is cruelly ironic that the Flint crisis 鈥 which continues to deprive the community of clean, safe drinking water 鈥 happened in the state surrounded by the Great Lakes, the world鈥檚 greatest freshwater resource. But don鈥檛 think for a minute that Iowa or any other state is immune to what we鈥檙e facing in Michigan. I鈥檝e come to the conclusion that what happened in Flint can happen anywhere policymakers take clean water for granted and neglect to make appropriate investments to preserve and support safe drinking and recreational waters. Unfortunately, that describes too many communities nationwide; the American Society of Civil Engineers in its most recent report card gave the nation鈥檚 drinking water infrastructure a D grade. (Charles Kolb, 6/10)

Aspiring physicians enter the profession with an idealism that blinds us to the fact that our field exists as a fleeting reaction to the inevitability of suffering. (Jennifer Adaeze Okwerekeu, 6/12)

The Top 25 Minority Executives in Healthcare recognition program, along with the woman leaders program we hold every other year, are the two most important recognition programs we have. We get more attention for our 100 Most Influential awards. But these awards are more important because they have a broader social purpose. They are designed to highlight the importance of maintaining and increasing the diversity of the top ranks of the healthcare industry. (Merrill Goozner, 6/11)

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