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Morning Briefing

Summaries of health policy coverage from major news organizations

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Monday, Nov 21 2016

麻豆女优 Health News Original Stories 2

  • Uncertain Fate Of Health Law Giving Health Industry Heartburn
  • In Depressed Rural Kentucky, Worries Grow Over Medicaid

Health Law 1

  • Repeal Without Replace Plan Spooks Insurers, May Provoke Stampede To Exit Market

Marketplace 2

  • Anthem-Cigna Merger Goes To Trial In Final Chapter Of Obama's Antitrust Efforts
  • 25% Of Children In U.S. Don't Have Access To Essential Health Care, Study Finds

Administration News 1

  • Though Its Work Saves Countless Lives, Agency's Anonymity Threatens Its Future

Public Health 4

  • WHO Shifts Zika Classification From Emergency To Ongoing Threat
  • U.S. Attorney Wants To Treat Overdose Deaths Like Crime Scenes
  • Alleviating Loneliness Can Aid Recovery: Calif. Hospital Pairs Older Patients With Companions
  • Science Fiction Or Achievable Target?: Scientists Make Headway On Multi-Year Flu Vaccine

Women鈥檚 Health 1

  • Expectations Are High For Trump's Moves On Abortion, But Sweeping Changes Are Unlikely

State Watch 1

  • State Highlights: Mass. Executive Touts State's Affordable Care; Calif. Medical Marijuana Companies Struggle To Navigate Gray Area

Editorials And Opinions 1

  • Viewpoints: Finding Common Ground On Health Law; Surgeon General's Pivotal Stand On Opioids

From 麻豆女优 Health News - Latest Stories:

麻豆女优 Health News Original Stories

Uncertain Fate Of Health Law Giving Health Industry Heartburn

The effect of 鈥渞epeal and replace鈥 could have greatest consequences for hospitals. They accepted lower federal funding under the law because their uncompensated care was expected to fall as more people became insured. ( Julie Rovner and Chad Terhune , 11/21 )

In Depressed Rural Kentucky, Worries Grow Over Medicaid

Low-income residents in poverty-stricken Clay County worry what will happen to their health care if Gov. Matt Bevin鈥檚 ambitions to overhaul the state鈥檚 Medicaid program go forward. ( Phil Galewitz , 11/21 )

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Summaries Of The News:

Health Law

Repeal Without Replace Plan Spooks Insurers, May Provoke Stampede To Exit Market

Insurers would have little incentive to stick around if the law is dismantled without a replacement plan in place -- which would mean chaos for consumers. Meanwhile, Mike Pence says Donald Trump will take on the health law right "out of the gate," but two conservative thinkers talk with Politico about how Trump's stance on health care is more of a wild card than some may think.

Republicans warned for years that Obamacare would blow up the nation's individual insurance market. Instead, their own rush to repeal the health care law may be what triggers that death spiral. GOP lawmakers say they plan to repeal the Affordable Care Act as soon as President-elect Donald Trump takes office, including a transition period of a year or two before it takes effect. That way, they satisfy their base while giving notice to 20 million Obamacare customers that they must find other coverage options. (Cancryn and Demko, 11/21)

In the summer of 2013, as state and federal officials readied new insurance marketplaces created through the Affordable Care Act, millions of Americans started getting disquieting notices from their insurers. Health plans were being canceled because they didn鈥檛 comply with the law, often called Obamacare. Some 4 million people were ultimately told they would lose their plans. The ensuing outrage sparked a political firestorm, seriously eroded public confidence in Obamacare and forced an embarrassed President Obama to change federal regulations so people could keep their coverage. Yet that tumultuous episode could be dwarfed by what President-elect Donald Trump鈥檚 administration and its congressional allies unleash beginning next year. They plan to not only repeal the law but are contemplating changes that are significantly more far-reaching and could disrupt insurance coverage for many more Americans than did the original law. (Levey, 11/21)

Shortly after Donald Trump's unexpected victory in the presidential election, leaders of the six-hospital Mission Health system decided to put large capital investments on hold. They wanted to preserve financial flexibility in case the new Republican administration pushed through 鈥渧ery harmful changes and reductions in payment,鈥 said Dr. Ronald Paulus, CEO of the Asheville, N.C.-based system. Meanwhile, Mission Health chose to continue investing in population health initiatives, its new health insurance company and its Medicare Advantage program. Paulus said those decisions flowed out of the huge uncertainty caused by Trump's and congressional Republicans' promise to rapidly repeal and replace the Affordable Care Act. (Meyer, 11/19)

Six years into building its business around the Affordable Care Act, the nation鈥檚 $3 trillion health care industry may be losing that political playbook. Industry leaders, like many voters, were stunned by the election of Donald Trump and unprepared for Republicans鈥 plans聽to 鈥渞epeal and replace鈥 Obamacare. In addition, Trump鈥檚 vague and sometimes conflicting statements on health policy have left industry officials guessing as to the details of any substitute for the federal health law. (Rovner and Terhune, 11/21)

President-elect Donald Trump will prioritize repealing President Barack Obama's landmark health care law right "out of the gate鈥 once he takes office, Vice President-elect Mike Pence said Sunday. (Temple-West, 11/20)

Repeal of the 2010 health care law is a top priority as soon as Donald Trump takes office in January, Vice President-elect Mike Pence said in a Sunday television interview. 鈥淒ecisions have been made, that, by the president-elect, that he wants to focus out of the gate on repealing Obamacare and beginning the process of replacing Obamacare with the kind of free-market solutions that he campaigned on,鈥 Pence said on 鈥淔ox News Sunday.鈥 (Mejdrich, 11/20)

The House Speaker wants Obamacare dead. The House Budget Chairman 鈥 a leading candidate for HHS secretary 鈥 wants Medicare reform. But all the focus on Republicans' health strategies is ignoring the biggest elephant in the room: Donald Trump, a president-elect who's spent more than a year bucking congressional Republicans 鈥 and may not share their priorities, two leading conservative thinkers tell POLITICO's "Pulse Check" podcast. (Diamond, 11/18)

And in other health law news聽鈥

The GOP wasn鈥檛 just focused on repealing Obamacare this week. A group of congressional Republicans also want to make sure the Obama administration doesn鈥檛 distribute additional funding to insurers as part of the Affordable Care Act鈥檚 鈥渞isk corridor鈥 program. ... Republicans raised concerns that the Obama administration could get around restrictions on using other funds for the program by simply settling with the insurers that have sued, effectively keeping the program in operation. So this new bill would prohibit the administration from using the 鈥淛udgement Fund鈥 to pay out any settlements. (McIntire, 11/18)

With Republicans taking full control in Washington, GOP governors in Wisconsin and across the nation will seek a bedrock shift in how the federal government helps states pay for health care for the needy, highway projects and worker training. Wisconsin Gov. Scott Walker, the newly elected head of the Republican Governors Association, said his group is seeking to move federal aid to states to a looser model that would come with greater flexibility and fewer rules but also the likelihood of much less money, especially over the years to come. (Stein, 11/20)

The post-election confusion over the fate of Obamacare has only complicated the already difficult choices faced by middle class consumers who are worried they聽can't afford their health insurance options聽this fall. Premiums and deductibles soared聽in many parts of the country after the departure of several large insurers from the Affordable Care Act exchanges for 2017. That's led many to fret about how to either afford insurance or how to get by without it. (O'Donnell, 11/20)

Marketplace

Anthem-Cigna Merger Goes To Trial In Final Chapter Of Obama's Antitrust Efforts

If completed, the merger between Anthem and Cigna and the deal between Aetna and Humana would leave the industry topped by three giant firms. While the decisions are expected before Donald Trump takes office, it's unclear where his administration will come down on mega-mergers like these.

The proposed health insurance mega-merger between Anthem and Cigna heads to court on Monday, as the companies face off against a Justice Department seeking to block their $48 billion deal. It will be followed in just a few weeks by the trial for another proposed insurance mega-merger, between Aetna and Humana. (Abelson, 11/20)

The trial starts Monday in the Justice Department鈥檚 challenge to health insurer Anthem Inc.鈥檚 $48 billion acquisition of reluctant partner Cigna Corp., a case that could produce unusual courtroom drama and be a last hurrah for President Barack Obama鈥檚 antitrust enforcers. The Justice Department has been aggressive in challenging mergers recently, but none of its efforts is bigger than its lawsuits challenging the Anthem-Cigna deal, the largest ever in the industry, and a $34 billion deal that would combine insurers Aetna Inc. and Humana Inc. A trial on the latter transaction begins Dec. 5. (Kendall and Wilde Mathews, 11/20)

On Monday, the U.S. Department of Justice will begin arguing its case against what it says is the largest merger in the history of the health insurance industry. The Justice Department is challenging Anthem鈥檚 $54 billion acquisition of Cigna Corp., alleging that the deal will reduce competition among insurance carriers in dozens of markets, leading to increased market power for Anthem, which could lead to increased costs for consumers. Health care economists agree this is a case area consumers should care about. (Liss, 11/19)

25% Of Children In U.S. Don't Have Access To Essential Health Care, Study Finds

But the number of children without health insurance has decreased, the study by the Children鈥檚 Health Fund found.

A new study to be released on Monday by the Children鈥檚 Health Fund, a nonprofit based in New York City that expands access to health care for disadvantaged children, found that one in four children in the United States did not have access to essential health care, though a record number of young people now have health insurance. The report found that 20.3 million people in the nation under the age of 18 lack 鈥渁ccess to care that meets modern pediatric standards.鈥 (Santora, 11/20)

Administration News

Though Its Work Saves Countless Lives, Agency's Anonymity Threatens Its Future

The Agency for Healthcare Research and Quality has instituted changes in the health care system that have saved many lives, but as the industry is about to enter a time of uncertainty under a Trump administration, the agency could lose support.

AHRQ鈥攑ronounced 鈥渁rc鈥 by wonks鈥攊s quietly lauded by fans and vocally scorned by detractors. Its mission of figuring out how to improve the healthcare system is all the more daunting for its relatively puny annual budget that for several years has hovered around $430 million. But research supported by AHRQ, sometimes solely so, has transformed the underpinnings of a sector that not only directly manages life and death but also encompasses nearly one-fifth of the U.S. economy. The HHS agency's anonymity might be inherent in the nature of its work, but its obscurity has serious implications as federal healthcare policy is thrown into tumult with the election of Donald Trump to the presidency. (Whitman, 11/19)

In other news聽鈥

The head of the National Institutes of Health (NIH) is warning that plans to pass a short-term government spending bill could deal a blow to health research. NIH Director Francis Collins on Thursday called the plan for a continuing resolution (CR), which would extend current spending levels until March, "an extremely unfortunate and painful outcome for biomedical research.鈥滳ollins said researchers needed more funding. (Chacko, 11/18)

Public Health

WHO Shifts Zika Classification From Emergency To Ongoing Threat

Experts worry the distinction 鈥 that the virus is here to stay and should have longterm resources devoted to it 鈥 will be lost on many, and could slow research and funding efforts. In other news, Florida moves forward with plans to release genetically engineered mosquitoes and a look at the race for a vaccine.

The World Health Organization declared an end to its global health emergency over the spread of the Zika virus on Friday, prompting dismay from some public health experts confronting the epidemic. An agency advisory committee said it ended the emergency 鈥 formally known as a Public Health Emergency of International Concern 鈥 because Zika is now shown to be a dangerous mosquito-borne disease, like malaria or yellow fever, and should be viewed as an ongoing threat met as other diseases are, sometimes with W.H.O. help. (McNeil, 11/18)

In a grim milestone, the World Health Organization declared Friday that Zika no longer presents a 鈥減ublic health emergency鈥 and said the virus should now be treated like other established infectious diseases. That means the United Nations health agency will establish a long-term program to fight the virus responsible for thousands of cases of microcephaly and other neurological ailments. (Kaplan, 11/18)

Peter Salama, a senior WHO official, said Zika represents a set of long-term issues, including neurological complications in children as well as adults, family planning and maternal reproductive health, that will require a comprehensive research agenda and sustained financing over many years. Yet many public health officials and experts are worried that this technical distinction may be lost and end up sending the wrong message about Zika 鈥 even as new cases seem to be emerging in Asia. (Sun, 11/18)

A proposal to release genetically engineered mosquitoes聽for the first time in the United States cleared an important threshold Saturday, with mosquito control officials in the Florida Keys giving their nod of approval to a hotly debated field trial. The board of the Florida Keys Mosquito Control District voted 3-2 to move forward with the trial, with commissioners Stephen Smith and William Shaw opposing the measure, a spokeswoman for the mosquito control district said. (Joseph, 11/19)

In the Florida Keys on Election Day, along with the presidential race, one of the most controversial items on the ballot dealt with Zika. In a nonbinding vote countywide, residents in the Florida Keys approved a measure allowing a British company to begin a trial release of genetically modified mosquitoes. Armed with that approval, local officials voted Saturday to try out what they hope will be a new tool in the fight against Zika. (Allen, 11/20)

Zika is no longer a global health emergency spreading across borders and requiring a coordinated international response, the World Health Organization declared on Friday, while emphasizing that managing the infectious disease remains a significant challenge for the long-term. (Chang, 11/18)

The Zika virus thrives in tropical climates. But it is also growing in this cold-weather city 鈥 up a flight of stairs, past a flier for lunchtime yoga and behind a locked door. That is where scientists working in a lab for Takeda, the Japanese drug company, inspect and test vials of the virus. They are engaged in an all-out race to halt Zika, a disease that has set off worldwide alarm because of its links to severe birth defects. Day and night, these researchers are trying to crack the code to the virus. (Thomas, 11/19)

U.S. Attorney Wants To Treat Overdose Deaths Like Crime Scenes

A U.S. attorney in New York wants to go after dealers in an effort to curb the opioid epidemic ravaging the country. Meanwhile, reducing the amount of potent synthetic drug fentanyl on the street is proving to be complicated for enforcement agents.

Preet Bharara, the U.S. attorney known for cracking down on insider trading and public corruption in New York, is tackling a new challenge: the growing opioid epidemic. In a recent initiative, Mr. Bharara has asked local police departments to begin systematically reporting drug overdoses to his office of federal prosecutors in the Southern District of New York, which includes Manhattan, the Bronx and Westchester County. The goal is to treat every overdose like a potential crime scene, including stringent evidence collection, and bring federal charges against any dealer whose drugs can be linked to an overdose death. (Hong, 11/20)

In mid-August, an affable, 40-year-old man from Everett, Mass., overdosed at his mom's home after almost 25 years of heroin use. Joe Salemi had overdosed before, but this time couldn't be revived. Salemi's brother, Anthony, says he was pretty sure when his brother died that there must have been something besides heroin in the syringe. The medical examiner later confirmed it. (Bebinger, 11/18)

And media outlets report on the crisis from the states聽鈥

Arizona has joined a growing list of states that have adopted a dose of tough love for patients seeking prescription pain pills, but some medical experts question the policy's wisdom. Gov. Doug Ducey聽signed an order last month to limit initial painkiller prescriptions to seven days for Arizona adults insured by Medicaid or the state鈥檚 health-insurance plan. (Alltucker, 11/18)

Faced with a聽rising death toll from opioid abuse, Texas public health officials in May聽decided to apply for a $1 million federal聽grant to purchase Naloxone, a drug that, if administered during an overdose, can save the life of a person addicted to heroin or pain pills. (Walters and Taft, 11/20)

New Hampshire is joining 40 other states in a lawsuit against the maker of Suboxone, a drug widely promoted to help opioid addicts. The Attorney General says Reckitt Benckiser Pharmaceuticals conspired to monopolize the U.S. Suboxone market, inflating the company's profits. (Rodolico, 11/17)

What to many is known as the opioid epidemic raging through most of the country is, to some, considered a chronic pain epidemic. While illicit drugs like heroin are a major problem, what is becoming an even bigger issue is the improper use of prescription opioids, such as percocet or oxycontin. (Demeria, 11/19)

Alleviating Loneliness Can Aid Recovery: Calif. Hospital Pairs Older Patients With Companions

In other news on care for the aging population, Californians debate if people with Alzheimer's should be excluded from the state's new aid-in-dying law. And opinions about surgery for older lung cancer patients is changing.

Loneliness can be a problem for older people, especially when they're in the hospital. Their children may have moved away. Spouses and friends may themselves be too frail to visit. So a California hospital is providing volunteer companions in the geriatric unit. One of the volunteers at the UCLA Medical Center in Santa Monica is 24-year-old Julia Torrano. She hopes to go to medical school. Meanwhile, her twice-weekly volunteer shifts give her a lot of practice working with patients. (Jaffe, 11/21)

Since California鈥檚 controversial new law went into effect in the late spring, it has allowed approximately 150 state residents suffering from terminal illnesses to get physicians to prescribe a lethal prescription drug. But for many Californians who fear wasting away slowly over years, the law falls short. The reason: The law requires someone to make a competent decision to die, which patients with dementia clearly can鈥檛 do. (Wessel and Seipel, 11/18)

Every year when Morton Pollner had his checkup, he worried that doctors would find something on his lung. For years, they didn't. Then his luck ran out. "My reaction was, 'Well, you smoked for 30 years. You got away with it for another 30 years and this is it.' I thought it was a death sentence," he says. (Neighmond, 11/21)

Science Fiction Or Achievable Target?: Scientists Make Headway On Multi-Year Flu Vaccine

In other public health news: young adults that were part of the surge in autism diagnoses head to college; research on female head trauma lags behind because of a dearth of donors; the election continues to effect Americans' health; chronic pain isn't just a problem for adults; and more.

If you鈥檙e one of the hundreds of millions of people worldwide who get an annual flu shot, Sanofi Pasteur may have some good news. Scientists at a local lab the drug company acquired eight years ago from vaccine maker Acambis PLC are working on a next-generation vaccine that could reengineer hemagglutinin 鈥 the most significant viral protein 鈥 to offer years of protection against multiple flu strains. (Weisman, 11/19)

Crosby J. Gardner has never had a girlfriend. Now 20 and living for the first time in a dorm here at Western Kentucky University, he has designed a fast-track experiment to find her. He ticks off the math. Two meals a day at the student dining hall, three courses per meal. Girls make up 57 percent of the 20,068 students. And so, he sums up, gray-blue eyes triumphant, if he sits at a table with at least four new girls for every course, he should be able to meet all 11,439 by graduation. (Hoffman, 11/19)

There鈥檚 something wrong with the brain banks created to study the dangers of repeated trauma to the head: Almost all the brains donated so far belonged to men. 聽It鈥檚 just one example of how the study of brain trauma in women lags behind 鈥 even though women get concussions at higher rates than men in many sports and may suffer more severe and persistent symptoms. (McFarling, 11/21)

Normally, politics doesn't come up in the exam room, but in recent days, Roth says, whether patients come in for a check-up, a sore throat or knee pain, many need to talk about how they're feeling about the election results. And many in this deep blue state are not feeling good. (Goldberg, 11/18)

It鈥檚 common to think of pain as an adult burden, the product of time-beaten joints and aged tissues, but pain also hobbles children. When that happens, youngsters鈥 suffering is often overlooked or dismissed. Or it gets chalked up to psychological issues 鈥 an approach especially troubling to some parents. (Freyer, 11/19)

There's new evidence that excessive screen time early in life can change the circuits in a growing brain. Scientists disagree, though, about whether those changes are helpful, or just cause problems. Both views emerged during the Society for Neuroscience meeting in San Diego this week. (Hamilton, 11/19)

Drinking colas and other sugary drinks is tied to an increased risk of pre-diabetes, but diet soda is not, a recent study suggests. Previous studies on the link between diet sodas and diabetes have been mixed; some research pointing to a potential connection has suggested this relationship may be explained at least in part by soda drinkers being overweight or obese. (11/18)

Every year, workers on both sides of the camera are maimed, burned, break bones and even die striving to deliver entertainment that packs multiplexes and commands top TV ratings. Injuries come not just from obvious risks such as stunts and explosives, but from falls off ladders, toppled equipment and machines without safety guards. Yet in an industry where virtually everything is tallied and every success is touted, set accidents remain largely hidden and the consequences usually amount to mere thousands of dollars in fines paid out of multimillion-dollar budgets. (McCartney, 11/21)

Women鈥檚 Health

Expectations Are High For Trump's Moves On Abortion, But Sweeping Changes Are Unlikely

Smaller state-level skirmishes are expected to continue, but any major nationwide changes won't happen overnight 鈥 if at all.

Liberal and conservative groups are girding for battle over abortion rights under President-elect Donald Trump, after nearly a decade in which the Obama administration backstopped the rollback of those rights on the federal level. Mr. Trump has adopted the antiabortion rights movement鈥檚 top priorities, vowing to nominate socially conservative Supreme Court justices, withhold federal funding from Planned Parenthood, and sign legislation banning abortion after 20 weeks of pregnancy. (Reinhard, 11/20)

In other news聽鈥

The Arizona abortion doctor at the center of a legal battle over fetal tissue collection and patient rights聽said she is the target of a 鈥渂izarre鈥 state investigation that seeks unprecedented information about the identities of women who got abortions and donated remains for science. Gabrielle Goodrick, owner of Camelback Family Planning, an east Phoenix clinic that provides abortions and other medical care, has asked a judge to block state investigators from inspecting names and聽records of 鈥減atients who have had abortions and donated fetal tissue.鈥 (Wingett Sanchez, Anglen, Cassidy and Beard Rau, 11/18)

State Watch

State Highlights: Mass. Executive Touts State's Affordable Care; Calif. Medical Marijuana Companies Struggle To Navigate Gray Area

Outlets report on health news from Massachusetts, California, Idaho, Florida, Louisiana, New Hampshire, Texas, Pennsylvania and Ohio.

In the debate over how to tackle rising medical spending in Massachusetts, the head of the state鈥檚 largest hospital network has staked out a contentious position: arguing that health care in Massachusetts is relatively affordable. Dr. David Torchiana, chief executive of Partners HealthCare, acknowledged that his assessment may fall on deaf ears, but he stressed it during a meeting at The Boston Globe on Friday. (Dayal McCluskey, 11/18)

In what may be a sign of things to come after the drug鈥檚 broader legalization, medical cannabis companies like CannaCraft 鈥 which have operated in a quasi-legal, unregulated market, or gray market, for the past two decades in California 鈥 continue to be whipsawed by the glaring contradiction between a federal ban on marijuana and still-evolving state laws that should, in theory, shelter the companies from prosecution. Cannabis enterprises deal almost exclusively in cash because banks, fearing federal consequences, will not take their business. (Fuller, 11/21)

The largest health insurance company in Idaho is fighting one federal lawsuit and recently lost a second after refusing to pay medical bills for two men who were seriously injured in motorcycle crashes. Blue Cross of Idaho denied those claims based on a little-known exception: Insurers may refuse coverage when a patient is found to have committed 鈥渋llegal acts.鈥 (Dutton, 11/20)

This mix-up at UMass Memorial Medical Center is one of at least 14 instances since 2011 in which caregivers at Massachusetts facilities performed a procedure on the wrong patient, state records show. The Globe requested the records after health inspectors disclosed that a surgeon at Saint Vincent Hospital unnecessarily removed a patient鈥檚 kidney in July 鈥 an operation also mistakenly based on another patient鈥檚 computed tomography scan, which showed a large tumor. (Kowalczyk, 11/20)

The rate of babies born premature in Florida and around the nation increased in 2015 according to the recently released March of Dimes Premature Birth Report Card.聽Florida鈥檚 rate of premature births rose slightly from 9.9 percent in 2014 to 10 percent in 2015. (Davis, 11/20)

This time he [Darius Irvin] was shot with nine bullets, again by someone he did not know. He was rushed to San Francisco General Hospital. It was there something unexpected happened. ... That鈥檚 because the Wraparound Project had stepped in to help. It鈥檚 a program based at San Francisco General Hospital. Wraparound鈥檚 goal is to reduce re-injury for young people who have been violently hurt, through either a shooting or stabbing. (Klivans, 11/20)

City, state and federal officials cut the ribbon Friday (Nov. 18) on the long-planned聽Veterans Affairs hospital on Canal Street that聽Gov. John Bel Edwards said took "a little longer than it maybe should have."... Originally projected to cost about $625 million,聽a U.S. Government Accountability Office report pegged the dollar amount at closer to $1 billion. And although the hospital was scheduled to be completed in December 2014, officials were forced to push that date to nearly two years later because of construction delays. (Litten, 11/18)

New Hampshire hospitals last year reported 64 serious 鈥渁dverse events鈥 鈥 sometimes called 鈥渘ever events鈥 because they鈥檙e never supposed to happen. That鈥檚 a 12 percent drop from the 73 events reported the year before. And officials say it reflects ongoing efforts statewide to improve quality and patient safety. Since 2010, New Hampshire has required hospitals and ambulatory surgery centers to report any of 29 serious events identified by the National Quality Forum as 鈥渟erious reportable events.鈥 (Wickham, 11/20)

In a first for Dallas, a聽federal judge has ordered the release of two men accused of health care fraud, provided they remain in a high-rise condo until trial and pay for around-the-clock armed security guards... The Dallas men聽were arrested last month along with eight others, including聽doctors, pharmacy owners and marketers, and charged in an updated 35-count indictment. In all, 12 defendants聽are accused of conspiring to sell to soldiers expensive compounded products like pain and scar creams, which bilked the government out of $100 million. (Krause, 11/19)

An eye clinic that has enabled generations of kids and adults to see more clearly may soon go dark. The South Jersey Eye Center, founded in Camden in 1961 to provide affordable vision care and eyewear to city residents, is running short of operating funds. "We should have closed" already, manager Denise Baker says, adding, "The other day I burst into tears." Jobs have been eliminated, hours cut, the annual budget slashed by more than half, and the third floor at the main office on Chambers Street shuttered to save on utilities. (Riordan, 11/20)

As a rule, physicians don't try to save babies born as early as Willow. It's rare that they live for long, and if they do, there are significant problems, including deafness, blindess, cerebral palsy and developmental delays. Parents often have to fight for resuscitation. (Viviano, 11/20)

Editorials And Opinions

Viewpoints: Finding Common Ground On Health Law; Surgeon General's Pivotal Stand On Opioids

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

Since the election, I, among others, have pointed out that Donald Trump would not be able to keep his promise of repealing the rest of Obamacare while protecting people with 鈥減reexisting conditions.鈥 To do so would still require everyone to buy insurance 鈥 the controversial 鈥渋ndividual mandate鈥濃 while still requiring insurers to offer policies to anyone who wants to buy one at the standard 鈥渃ommunity鈥 rate. It would be wrong, however, for Democrats to jump from that observation to the conclusion that there aren鈥檛 other ways to structure a health insurance market to achieve near-universal coverage at affordable prices. Republicans have proposed a number of credible reform ideas that could preserve most of the gains from the Affordable Care Act while restructuring the system to better conform to conservative, market-oriented principles. A few would even make the system more efficient and more progressive. (Steven Pearlstein, 11/20)

The reality is that Republicans on Capitol Hill and the Trump team see that their own heads could roll. Republican voters, having been told that ObamaCare is a disaster, expect quick action. They wonder how hard is it to throw dirt on the grave and accept the cheers of a grateful nation. The problem for the GOP executioner in Washington is that, once the deed is done, Trump will have to take responsibility for creating a better plan for American healthcare 鈥 especially for the more than 20 million people who will lose health insurance once ObamaCare is buried. (Juan Williams, 11/21)

With Obamacare repeal-and-replace on the table, a favorite healthcare 鈥渞eform鈥 of Republicans and conservatives is about to have another day in the sun: health savings accounts.聽They sound good 鈥 tax-exempt personal slush funds that can be used to pay聽out-of-pocket medical expenses 鈥 but for the average person they鈥檙e almost useless and for the healthcare system they鈥檙e potentially disastrous. (Michael Hiltzik, 11/18)

It seems reports of Obamacare鈥檚 impending death may have been greatly exaggerated. In a wonderful irony, that good news comes from the mouth of our president-elect. (Rich Barlow, 11/18)

No one knows exactly what Donald Trump鈥檚 pledge聽to 鈥渞epeal and replace鈥 the Affordable Care Act means. The hints, however, are troubling. No state has embraced the ACA 鈥斅燨bamacare 鈥斅爉ore enthusiastically聽and successfully聽than California. And no state has more to lose with Trumpcare. (Gerald F. Kominski, 11/18)

More than 600,000 people [in Washington] also gained coverage through an expansion of Medicaid 鈥 more than double the amount predicted. The money spent on uncompensated care in our state has plummeted from $2.3 billion to $1.2 billion. And our friends and neighbors struggling with an illness can no longer be denied health insurance. Since its passage, Congress has voted more than 60 times to repeal the entire law. It has never voted to amend or repair it nor proposed a replacement. For years, we鈥檝e heard the Republican mantra 鈥渞epeal and replace.鈥 Now, with the recent election, they get their chance. (Washington Insurance Commissioner Mike Kreidler, 11/18)

If you are one of the more than 50,000 Nashvillians not on Medicare who has non-group BlueCross BlueShield of Tennessee health coverage, you have probably received a termination letter indicating your coverage will lapse at the end of this year. That letter should have told you that BlueCross鈥 individual plan members have had more health needs than anticipated, leading to financial losses. Based on this and other uncertainties, the company has decided to pull out of the Nashville, Memphis and Knoxville regions. (Alex Tolbert, 11/20)

With the publication Thursday of a comprehensive 428-page report on drug and alcohol misuse, Surgeon General Vivek H. Murthy has added his voice to those calling for a more vigorous, better informed approach to addiction in the United States. Dr. Murthy emphasizes the need for a public-health-based approach to the problem, one that offers sufferers less moralizing and more medically based treatment options; fortunately, that seems already to be the emerging consensus, one of the few things Republicans and Democrats agree on. Backed by the authority of Dr. Murthy鈥檚 office, the document is likely to become a standard reference; a 1964 report on smoking and health by an earlier surgeon general, Dr. Luther Terry, became a cultural milestone. (11/19)

An investigation was launched back in 2012 to determine the nature of the relationship between medical organizations setting guidelines for prescribing opioids and the manufacturers who sell them. The members of the Senate Finance Committee initiating the investigation included Max Baucus (D-Mont.) and Chuck Grassley (R-Iowa), who astutely pointed out the disturbing epidemic and wanted to understand who was behind it. ... Sens. Baucus and Grassley left the Senate Finance Committee before the investigation report was released. They were replaced by Orrin Hatch (R-Utah) and Ron Wyden (D-Ore.) who still have not released the report despite pressure from public health advocacy groups. (Dana Connolly, 11/17)

Indeed, the plight of mental health patients held behind bars is a growing, national calamity. Thanks to the shuttering of state psychiatric hospitals and a collective failure to fund community mental health programs, the percentage of state prisoners with a mental illness has soared to more than half, according to the Urban Institute. (Michael Rezendes, 11/19)

Gov. Matt Bevin and Kentucky lawmakers face significant challenges as they weigh competing priorities for state funding. Education. Underfunded pensions. Roads. All important 鈥 and all deserving of attention for the impact they have on Kentuckians. But there鈥檚 another serious problem that state leaders simply can鈥檛 ignore: the mounting crisis of diabetes. Nearly half a million adults in Kentucky have diabetes. There are thousands not yet diagnosed. (11/20)

Just like the various systems of the body are interconnected, integrated care approaches also help manage diabetes by managing disease in other areas of the body. Diabetics face an increased risk for periodontal disease, an infection and inflammation of the gums which can lead to tenderness and tooth loss. Inflammation in the mouth can then make blood sugar management more challenging, leading to a cycle of patient health concerns and potential escalating cost. (Collette Manning, 11/18)

If successful, Ms. Wetzel鈥檚 lawsuit could set a legal precedent establishing the responsibility of housing providers to actively address discrimination based on gender orientation and sexual identity under the federal Fair Housing Act. The law states 鈥 vaguely 鈥 that discrimination based on 鈥渟ex鈥 is prohibited. 鈥淚t鈥檚 one of the first opportunities for a court to apply the Fair Housing Act to the kinds of harassment that L.G.B.T. people experience,鈥 said Karen L. Loewy, a senior lawyer at Lambda Legal, which brought the case. (Mark Miller, 11/18)

On a walk in the park, she fell face first and broke her nose. In the middle of the night, she tried to get to the bathroom but fell and crashed through closet doors. Multiple infections, along with heart and kidney disease, landed her in the hospital, where her dementia raged and she didn鈥檛 always recognize loved ones. She got better and they sent her home, but in her mind, something is wrong. (Steve Lopez, 11/19)

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