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The chief executive of Valeant Pharmaceuticals International, which has been harshly criticized for its practice of raising prices on old drugs, said during a tense hearing on Capitol Hill on Wednesday that the company had made “mistakes,” while lawmakers accused him and others connected to Valeant of favoring profits over patients’ needs. “Let me state plainly that it was a mistake to pursue, and in hindsight I regret pursuing, transactions where a central premise was a planned increase in the prices of the medicines,” J. Michael Pearson, the chief executive, said at the hearing. (Thomas, 4/27)

Lawmakers accused Valeant Pharmaceuticals of gouging patients to reward Wall Street investors during a hearing Wednesday scrutinizing the embattled drugmaker's pricing tactics. The blistering criticisms from Senate Republicans and Democrats came as Valeant's outgoing CEO expressed regrets for the most egregious price increases and a billionaire hedge fund investor defended the company's business model. (4/27)

Michael Pearson, who oversaw the rise and fall of Valeant, told the committee that Valeant’s strategy of buying and increasing prices on many drugs was a mistake. The testimony, under sharp questioning, highlighted Valeant’s stark fall from Wall Street darling to Washington punching bag, and showed how much it has at stake. Its stock is​down more than 85% from its high last August, closing at $34.92 on Wednesday. Shares were up about 2.5% in after-hours trading. (Hoffman and Rapoport, 4/27)

A leading Senate Democrat is vowing to take on prescription drug price-gouging amid a deepening congressional probe into embattled drugmaker Valeant Pharmaceuticals. “Pigs get fed, hogs get slaughtered. It’s time to slaughter some hogs,” Sen. Claire McCaskill, the top Democrat of the Senate Aging Committee, said Wednesday. McCaskill’s remarks were the opening salvo of a high-drama hearing on Wednesday, which features three current or former executives from Valeant. (Ferris, 4/27)

Investor Bill Ackman, an influential Valeant board member, told the Senate Special Committee on Aging that he texted Valeant board chairman Robert Ingram during the hearing to suggest a conference call with the board this week to discuss cutting the prices of the drugs — Isuprel and Nitropress — by 30 percent. That would match the 30 percent discount that Valeant said it has been offering hospitals that need the drugs — though senators on the committee, and a hospital official, said hospitals had not yet received the price break. Ackman said he would also recommend unspecific decreases for two other drugs that treat Wilson’s disease, Cuprimine and Syprine, which were focuses for the committee. (Scott, 4/27)

Activist investor William Ackman promised U.S. lawmakers on Wednesday that he will urge the board of Valeant Pharmaceuticals to reduce the high prices of four life-saving drugs that are now at the heart of two congressional probes. Speaking before the Senate Special Committee on Aging, Ackman revealed that Valeant's board will hold a conference call on Thursday to discuss the costs of heart medications Isuprel and Nitropress, as well as Cuprimine and Syprine, two drugs that are used to treat a genetic disorder that causes copper to build up in the body's organs. (Lynch and Berkrot, 4/27)

Neither Pearson, Schiller and Ackman were were able to produce convincing answers as to how Valeant’s business model could work without price hikes. Ackman, who has invested roughly $4 billion in Valeant, said he was unaware of the extent of the company’s drug prices, even when a friend described the company’s prices for Cuprimine, a cure of Wilson’s disease. Meanwhile, CEO Pearson was unable to name a single instance in the U.S. where Valeant did not raise prices after acquiring a drug, and he noted instances where the company could only justify a deal with sharp price increases. (Gara, 4/27)

Berna Heyman told a Senate committee Wednesday that her annual co-payment for a lifesaving drug needed to treat an ailment known as Wilson disease stayed below $700, a manageable cost, until 2013. That's when Valeant Pharmaceuticals International (VRX), an embattled Canada-based drugmaker, raised the price on Heyman's medication, said the retired Virginia librarian. By 2014, her projected co-pay topped $10,000 a year, with her health insurer paying more than $260,000, she said. (McCoy, 4/27)

Now that Michael Pearson, the outgoing Valeant Pharmaceuticals chief executive, has issued a mea culpa about his decision to raise drug prices sky high, where does the drug maker go from here? The prognosis is not healthy — at least as far as some Wall Street wags are concerned. (Silverman, 4/27)

Valeant Pharmaceuticals International Inc. is planning sweeping changes to its board of directors as it moves to set a new tone at the top of a company under fire from politicians and investors for its management and drug-pricing practices. The drugmaker is expected to announce as early as Friday that five of its long-standing directors have agreed to step down to make room for new nominees, according to people familiar with the matter. Four new directors are lined up to join the board, the people said. Their names couldn’t be learned, but they draw heavily from traditional pharmaceutical companies, the people said—a sign that Valeant is looking for credibility from an industry it has long criticized as bloated, slow-moving and wasteful. (McNish, Hoffman and Benoit, 4/27)

Valeant Pharmaceuticals International Inc., which came under fire after it raised dramatically drug prices, on Wednesday disclosed a multimillion-dollar pay package for its new chief executive. Under the terms of the contract, Joseph C. Papa, the chief executive of rival Perrigo Co. who is slated to take over as Valeant’s chairman and CEO next month, will receive a $1.5 million annual salary. But the 60-year-old stands to make much more thanks to restricted stock awards that would vest if Valeant’s stock reaches certain thresholds. (Armental, 4/27)

Sen. Ron Wyden (Ore.), the top Democrat on the Senate Finance Committee, on Wednesday introduced a bill aimed at protecting seniors from high drug costs, an issue that has attracted growing scrutiny. Wyden’s measure would cap drug cost-sharing for Medicare enrollees so that seniors would not have to pay out of pocket costs above a roughly $7,500 cap. In 2013, 2.9 million people in Medicare’s prescription drug program had to pay costs above that cap, Wyden’s office said. (Sullivan, 4/27)

“Escalating drug prices are increasingly straining the budgets of families in Oregon and across the country, particularly seniors in Medicare who often have to take multiple costly medications to stay healthy,” Wyden said in a statement. “It defies common sense that protection from high out-of-pocket costs exists for almost all other types of health coverage, but not for traditional Medicare.” Medicare’s program’s prescription drug benefit, or Part D, is offered by private insurance plans, whereas the hospital and medical components of the program are run by the federal government. (Owens, 4/27)

U.S. House of Representatives Speaker Paul Ryan called on Wednesday for an end to Obamacare's financial protections for people with serious medical conditions, saying these consumers should be placed in state high-risk pools. In election-year remarks that could shed light on an expected Republican healthcare alternative, Ryan said existing federal policy that prevents insurers from charging sick people higher rates for health coverage has raised costs for healthy consumers while undermining choice and competition. (Morgan, 4/27)

Expect insurers to seek significant premium increases under President Barack Obama’s health care law, in a wave of state-level requests rippling across the country ahead of the political conventions this summer. Insurers say the law’s coverage has been a financial drain for many of them, and they’re setting the stage for 2017 hikes that in some cases could reach well into the double digits. For example in Virginia, a state that reports early, nine insurers returning to the HealthCare.gov marketplace are seeking average premium increases that range from 9.4 percent to 37.1 percent. Those initial estimates filed with the state may change. (Alonso-Zaldivar and Murphy, 4/28)

Anthem Inc. said its enrollment through the Affordable Care Act’s exchanges grew more than expected in the first months of the year. The company said it is still targeting a slim positive margin on the business this year, striking a guardedly optimistic tone about the marketplaces amid questions about their sustainability. The No. 2 U.S. health insurer said it had 975,000 exchange enrollees at the end of the first quarter, up by around 184,000 since the end of the year. The increase drew sharp questions from analysts after UnitedHealth Group Inc.’s recent announcement that it would withdraw from all but a handful of the exchanges after steepening losses. (Wilde Mathews and Steele, 4/27)

Health insurer Anthem (ANTM) aims to pull a small profit this year from the Affordable Care Act's public insurance exchanges, and its CEO said Wednesday he's "really glad" to be serving nearly 1 million people in this still-developing market. (4/27)

Anthem Inc., the No. 2 U.S. health insurer, fell in New York trading as costs tied to its Medicaid and Affordable Care Act businesses pressured margins. ... While the Affordable Care Act has helped companies like Anthem add paying customers, those new members have often had higher-than-expected medical costs. Anthem said it’s taking a cautious posture on booking profits from plans sold in the ACA’s exchanges and probably won’t reach its margin target of 3 percent to 5 percent until 2018. (Tracer, 4/27)

When Democrats fault the Affordable Care Act, it’s increasingly because it does not go far enough, a poll released Thursday shows. The results come as Democratic presidential candidate Bernie Sanders has repeatedly derided the law for including too many concessions to the private health care industry and costing consumers too much. The Kaiser Family Foundation poll found that 51 percent of Democrats want to expand the law, a 15 point increase since December. (KHN is an editorially independent program of the foundation.) (Rau, 4/28)

Need knee replacement surgery? It may be worthwhile to head for Tucson. That's because the average price for a knee replacement in the Arizona city is $21,976, about $38,000 less than it would in Sacramento, Calif. That's according to a report issued Wednesday by the Health Care Cost Institute. The report, called the National Chartbook on Health Care Prices, uses claims and payment data from three of the largest insurance companies in the U.S. to analyze how prices for procedures vary from state to state, and city to city. The takeaway? Health care prices are crazy. (Kodjak, 4/27)

Huge variations exist in the prices of some of the most common medical procedures across state lines, by according to a report major insurers released Wednesday, but some experts say the data is of little use to consumers who rarely know what they owe until the bills arrive. The insurer-funded Health Care Cost Institute (HCCI) won’t disclose which hospitals or doctors are the high-price culprits and instead are releasing how much states' average prices differ from national average. (O'Donnell, 4/27)

Why does a knee replacement cost $29,000 in Kansas but $40,000 in next-door Colorado? Health care prices are all over the map in the U.S., a new study finds. It digs deeply into the crazy pattern of health costs across the U.S. and shows there is very little consistency. (Fox, 4/27)

Prices of some medical services in Charlotte are 20 percent higher than the national average, according to a new study that contributes to the national push for transparency in health care costs. (Garloch, 4/27)

The cost of medical care for Connecticut patients with private insurance is more than 20 percent above the national average for dozens of medical services, but exactly how much higher can vary widely across the state, according to data released Wednesday and an analysis published in the journal Health Affairs. (Levin Becker, 4/28)

Hospitals and some nursing groups are lobbying state legislators across the nation to do away with requirements that nurses be licensed in each state where they work, arguing that the rules inhibit the use of new health-care methods such as telemedicine. The push to get states to join nursing licensing compacts reflects growing adoption of remote health services such as patient care and monitoring online and by the phone. Telemedicine, as it is known, is expected to soar in the U.S. to $1.9 billion in 2018 from $240 million in revenue in 2013, according to research firm IHS Technology. (Armour, 4/26)

Apple is edging its way a little further into health care with the release of new iPhone apps that patients can use to manage their own medical conditions — from diabetes to pregnancy and even depression. (Bailey, 4/27)

Arizona Sen. John McCain proposed legislation Wednesday to expand and make permanent a program allowing veterans to go anywhere for health care. McCain’s bill, borne of frustration over the slow pace of improvements in the U.S. Department of Veterans Affairs' system, would remove the current restriction that veterans must wait more than 30 days or live more than 40 miles from a VA facility in order to go outside the VA system for care. (Theobald, 4/27)

Earlier this month a report revealed that the Manchester VA Hospital, like many others around the country, had been fudging wait times for veterans’ care. But the program designed to fix the backlog by allowing vets to get care closer to home is now having its own problems. (Sutherland, 4/27)

Stacey Bannerman didn't recognize her husband after he returned from his second tour in Iraq. "The man I had married was not the man that came back from war," she says. Bannerman's husband, a former National Guardsman, had been in combat and been diagnosed with post-traumatic stress disorder. He behaved in ways she had never expected, and one day, he tried to strangle her. (Lawrence, 4/27)

Recovery centers around the U.S. say they have long struggled to attract and retain workers, given the low pay, the stigma attached to addiction, and the high burnout from dealing with difficult patients. Many counselors leave the field after only a few years. Yet clinics now must not only replace those workers, but fill an expected surge of new positions in the coming years to meet rising demand for addiction treatment. The jobs range from psychiatrists to licensed addiction counselors to house aides who monitor patients. (Campo-Flores, 4/27)

Operated by Johns Hopkins Hospital and located two blocks from its main campus, the Broadway Center — or “911” as it’s called because of its address at 911 N. Broadway [in Baltimore] — has provided methadone maintenance therapy for people with opioid addiction for more than two decades. But unlike most of the roughly 1,400 methadone clinics across the country, the Broadway Center offers not only methadone, but the two other federally approved addiction medications, buprenorphine and naltrexone, and a full complement of mandatory addiction counseling and group classes. (Vestal, 4/27)

The House Judiciary Committee took an election-year swipe Wednesday at the nation's growing drug addiction problem, approving federal grants that would bolster state and local efforts against the abuse of opioid painkillers. The bipartisan measure sailed through the Judiciary panel by voice vote. Its easy approval contrasted with recent clashes between the two parties over President Barack Obama's Supreme Court nominee, Merrick Garland, and administration efforts to win quick emergency spending to combat the zika virus and fix the lead-poisoned water supply of Flint, Michigan. (4/27)

Prince’s death was a tragic loss — one that will be made even more tragic if, as reported, he was hospitalized after overdosing on Percocet days before his death, and suffered from what has been called a “substantial” problem with the opioid painkiller. (Kenneally, 4/27)

The New Hampshire Senate this afternoon will once again tackle a handful of bills geared at the state’s opioid crisis. Many of the proposals being related to illegal drug use. (Sutherland, 4/27)

Stories of the people affected by the epidemic, and MPR News hosts Cathy Wurzer and Tom Crann interview Minnesota experts. One of the most staggering aspects of the epidemic is that, for many, drug abuse starts with legal painkillers. MPR reporter Jon Collins is the reporter and producer of this special report. (4/28)

An outbreak of poisonings linked to a counterfeit prescription painkiller -- previously seen in the Sacramento region -- has reached the Bay Area, according to the U.S. Centers for Disease Control. The CDC reported Tuesday that seven patients were treated for overdoses in Bay Area hospitals in late March and early April after taking what they thought were tablets of Norco, a brand-name painkiller that combines acetaminophen and hydrocodone. (Feder Ostrov, 4/28)

The point of the voluntary certification program from the state Department of Public Health is simple: to make sure sober homes are just that, at a time when the state remains mired in a deadly opioid crisis and the need for a haven from drugs is urgent. (Freyer, 4/28)

Dr. Vivek Murthy is not only one of the youngest people ever named the U.S. Surgeon General, the 38-year-old also is the first person of Indian descent to hold the post. But there’s one more thing: he's a Floridian. (Shedden, 4/27)

Taking a stance sharply at odds with most American public health officials, a major British medical organization urged smokers to switch to electronic cigarettes, saying they are the best hope in generations for people addicted to tobacco cigarettes to quit. The recommendation, laid out in a report published Thursday by the Royal College of Physicians, summarizes the growing body of science on e-cigarettes and finds that their benefits far outweigh the potential harms. (Tavernise, 4/27)

Among the report’s conclusions are that e-cigarettes aren’t a gateway to smoking tobacco for current nonsmokers and that they likely lead tobacco smokers to try to quit regular cigarettes when they otherwise wouldn’t. “This report lays to rest almost all of the concerns over these products, and concludes that, with sensible regulation, electronic cigarettes have the potential to make a major contribution towards preventing the premature death, disease and social inequalities in health that smoking currently causes in the U.K.,” said John Britton, director of the U.K. Center for Tobacco & Alcohol Studies at the University of Nottingham, who chaired the panel responsible for the report. (Mickle and Chaudhuri, 4/27)

Oklahoma has received $76 million in the latest annual payment from the tobacco industry as part of a 1999 settlement of a lawsuit against tobacco companies. State Treasurer Ken Miller said Wednesday that $57 million goes to the Tobacco Settlement Endowment Trust Fund and the remainder to a fund for health care-related projects and to the state attorney general's evidence fund. (4/27)

The budget committee in the Alabama House of Representatives today approved a plan to split money from a $1 billion BP oil spill settlement between debt payments and road projects in Mobile and Baldwin counties. The plan would also free up $55 million in one-time funding for the Alabama Medicaid Agency, said the sponsor, Rep. Steve Clouse, R-Ozark. (Cason, 4/27)

Under the proposal, the state would securitize its scheduled payments from BP, leading to a single payment of roughly $639 million. ... The repayments could also free up $55 million in the General Fund. Clouse said that would go to help Medicaid. The program, which covers more than 20 percent of the state’s population, mainly children, says it needs $85 million more than what it is currently budgeted to maintain services. (Lyman, 4/27)

Round 2 of hearings on Medicaid operations Wednesday focused on hospitals’ involvement in the program. The main thrust of Medicaid officials' argument: Hospitals self-fund their costs, but reductions to other parts of Medicaid could drive more patients to emergency rooms and straining hospitals’ already stressed budgets. (Lyman, 4/27)

Federal officials have reversed position on a long-standing ban on paying for some inpatient psychiatric care, giving a possible boost to Kansas crisis centers. The Centers for Medicare and Medicaid Services released a rule Monday that will place new requirements on managed care organizations administering Medicaid, such as the three insurance companies that operate KanCare, the state’s privatized $3 billion program. (Hart, 4/27)

North Carolina's improved Medicaid financial picture is one big reason why Gov. Pat McCrory can offer significant pay raises and bonuses and avoid significant budget cuts. State budget director Drew Heath gave House and Senate budget writers Wednesday more details of McCrory's $22.3 billion plan. He's making adjustments to the second year of the two-year state budget approved last fall. The budget lowers projected Medicaid spending growth by $318 million. That's because Heath says Medicaid enrollment and use of services are coming in lower than anticipated. (4/27)

Southeastern Pennsylvania will have two new companies offering managed Medicaid benefits in 2017, the Pennsylvania Department of Human Services said Wednesday. Entering the market are publicly-traded Centene Corp., of St. Louis, and UPMC For You, part of the giant University of Pittsburgh Medical Center, which dominates the managed Medicaid market in western Pennsylvania. (Brubaker, 4/27)

An appeals court will hear arguments June 7 in a long-running dispute between the state Agency for Health Care Administration and more than two-dozen hospitals about Medicaid payments for providing emergency care to undocumented immigrants. ... Hospitals are required to treat patients who show up for emergency care, but the legal dispute has focused on the extent of care for undocumented immigrants that should be covered through the Medicaid program. (4/27)

Missouri lawmakers on Tuesday passed legislation to change how medical expenses are handled in court, sending the measure to Gov. Jay Nixon. House members voted 95-57 in favor of the bill, which would allow only the actual costs and not the value of medical expenses to be considered as evidence in civil lawsuits. (4/27)

Texas lawmakers will meet Thursday to examine policies on how human fetal tissue can be used for scientific research. It will be the first hearing on the subject since a Harris County grand jury in January indicted two undercover videographers who circulated videos about how fetal tissue was procured at Planned Parenthood clinics. (Walters, 4/28)

Montana officials will seek help from the Legislature to address concerns among Boulder residents about the impending closure of a residential facility for the developmentally disabled. The Montana Developmental Center Transition Advisory Committee convened in Boulder on Wednesday and considered proposals offered by the governor's office, including the possibility of asking legislators for $500,000 for a development fund to help keep Boulder's economy afloat. (Calvan, 4/27)

The Senate passed a proposal Wednesday to limit non-compete clauses in physician contracts and broaden the types of organizations that can employ doctors, a measure intended to address concerns among Senate leaders about doctors’ ability to remain in independent practice or return to it after joining a hospital system. (Levin Becker, 4/27)

Tennessee's Republican governor said Wednesday that he signed a bill into law that allows mental health counselors to refuse to treat patients based on the therapist's religious or personal beliefs. "As a professional I should have the right to decide if my clients end goals don't match with my beliefs — I should have the right to say somebody else can better serve them," Gov. Bill Haslam said in a phone interview with The Associated Press. "Lawyers can do that, doctors can do that. Why would we take this one class of professionals and say you can't do that?" (4/27)

An attempt to revive talks on legislation that would expand medical marijuana access in Iowa has failed in the state House. The Republican-majority chamber voted down a motion Wednesday aimed at bringing up a bill that would create a system for manufacturing and distributing cannabis oil. Certain epilepsy patients can possess the oil under a 2014 state law that critics say doesn't provide legal access to the drug. (4/27)

A bill to legalize hemp oil at the state level has drawn the ire of Kansas medical marijuana advocates who say it’s too watered down to do any good. Members of Bleeding Kansas, one of the state’s largest medical marijuana advocacy groups, rallied Wednesday at the Capitol to urge legislators to ditch Senate Bill 489. (Marso, 4/27)

Gov. Mark Dayton has created a task force on mental health in Minnesota. Dayton issued an executive order Wednesday creating the task force. It will include Minnesotans who have experienced mental illness, state and local government officials, mental health and other health care providers, and judicial and law enforcement officials. (4/27)

Speakers at a health-care "summit" said Tuesday that expanding access to care for more Floridians could save the state money. The two-day Florida Health Care Affordability Summit, sponsored by the business group Associated Industries of Florida, included lawmakers and experts addressing topics ranging from controlling drug costs to expanding treatment options through technology. (Menzel, 4/27)

New York medical schools and their competitors offshore are clashing over a precious resource: the opportunity for students to watch and learn from doctors in hospitals. Students in their third and fourth year of medical school need clinical clerkships so they can see how doctors diagnose patients, perform surgeries and deliver babies. Officials at New York medical schools say it is becoming harder to find sites for these rotations, partly because for-profit offshore medical schools, often in the Caribbean, have bought slots from New York hospitals at prices topping $400 a week per student. (Brody, 4/26)

California’s doctors are joining a legal challenge to the state’s largest owner of private hospitals over its refusal to allow women to have tubal ligations in its Catholic hospitals because of the church’s objections to sterilization. (Egelko, 4/27)

The Maryland Insurance Administration wants to hear your views on long-term care insurance. The agency is holding a public hearing at 10 a.m. Thursday at the Community College of Baltimore County in Catonsville. Commissioner Al Redmer says the agency wants to hear about the state of long-term care insurance and appropriate regulatory guidelines. He says he’s particularly interested in issues surrounding premium rate increases and policyholder protection. (4/28)

Chicago residents can now call 311 to have their tap water tested for lead, and 28 city schools are being tested under a new pilot program to evaluate potential health risks posed by lead water pipes. (Armentrout, 4/27)

Vermont's Health Commissioner Dr. Harry Chen will be on hand at the first blood draw clinic for Bennington residents who have been exposed to the chemical PFOA in their drinking water. The Health Department is teaming up with the Southwestern Vermont Medical Center to offer blood tests. The first clinic is set for Friday at the Health Department's Bennington regional office. (4/27)

Harvard University researchers are projecting major health benefits if Mayor Kenney's proposed tax on sugar-sweetened beverages is enacted. (Sapatkin, 4/27)

Florida Chief Financial Officer Jeff Atwater refused to go along with Gov. Rick Scott's nominee for state insurance commissioner on Tuesday, maintaining an impasse over a high-profile appointment that they must jointly support. (Turner, 4/27)

The five health systems in the Milwaukee area have roughly 4,000 job openings combined, and the shortage of workers is projected to become even more severe as a large chunk of the health care workforce retires. On Wednesday, the health systems announced an alliance to help lessen the current and projected shortage. (Boulton, 4/27)

State regulators are investigating whether nurses falsified patient records, and then lied about their actions, at a troubled Wilmington nursing home where two residents died, according to the Massachusetts Department of Public Health. (Lazar, 4/28)

Forida Hospital leaders want to build a 24-room free standing emergency department in east Orange County off Lake Underhill Road. The plan, originally submitted to Orange County leaders in February, went before the county's Development Review Committee Wednesday for preliminary approval, which would allow the project to move forward. (Dineen, 4/27)

When 31-year-old Shannon Lawley died at a Brevard County hospital four years ago, her parents wanted to file a medical malpractice suit. But only spouses or children can sue under Florida law, and Shannon Lawley had neither. Michael Lawley felt the law was so unfair that he protested to the legislature the year after she died, as Health News Florida reported at the time. (Gentry, 4/27)

HIV infections rose in some groups in Minnesota last year, while total numbers fell slightly, according to a new report. The state had 26 new HIV cases among intravenous drug users in 2015 — an 86 percent jump compared with the 14 cases the previous year. New HIV cases also rose among people ages 20 to 29, with 108 cases in 2015 — a 24 percent rise from the 87 cases reported the previous year, according to a Minnesota Department of Health report released Wednesday. (Rathbun, 4/27)

The New Mexico Supreme Court is expecting a full house for oral arguments today on a hotly disputed question: Is the exclusion of farm and ranch workers from the Workers Compensation Act unconstitutional? The Court of Appeals and a District Court judge in Albuquerque both have ruled that is unconstitutional because it treats similar groups in different ways. (Sandlin, 4/27)

The pending departure of the big insurance company UnitedHealth from most of the Affordable Care Act exchanges that it serves has prompted critics of Obamacare proclaiming the coming "death spiral" of the insurance reform. The critics aren't talking so much about the insurers who are reporting profits from the program. Their experience shows how the ACA can be made to work for customers and insurers alike. (Michael Hiltzik, 4/27)

As you have probably heard by now, the stakes in November’s presidential election could not be higher. Control of the Supreme Court hangs in the balance. Ditto the fate of millions of undocumented immigrants. U.S. foreign policy could be in for its biggest shake-up since the Cold War. Yet in one crucial respect the election might make no difference at all. Seventy-five percent of planned federal spending between now and the end of the next two presidential terms is mandatory: Social Security, Medicare and other entitlement programs, plus interest on the national debt, according to Congressional Budget Office forecasts. That money is going out the door no matter who’s president. (Charles Lane, 4/27)

What if we talked about gun violence, and discussed only bullet size? To me, that seems akin to the presidential campaign discussion of women’s health. Somehow in nine Democratic debates, not a single question was asked about women’s health, and when the issue came up elsewhere it was often in the narrowest form, about abortion: Democrats proclaim a woman’s right to choose, and Republicans thunder about the sanctity of human life. (Nicholas Kristof, 4/28)

In very succinct terms, here's the issue. Health care now consumes 16.5% of GDP. The rising costs of Medicare represent the single biggest contributor to America's growing national debt and, even now, serious illness is the most common factor in personal bankruptcy. Among the health care sectors, drug costs are the fastest growing component of overall spending. (Daniel Hoffman, 4/27)

Now that Donald Trump looks increasingly certain to become the Republican presidential nominee after his big primary victories Tuesday in five Northeastern states, we in the healthcare business press will be spending a lot of time poring over his healthcare policy pronouncements and proposals. (Harris Meyer, 4/27)

Now that failed inspections, government sanctions and a criminal investigation have shadowed the once stellar expectations surrounding the blood-testing company Theranos, the big question is turning from whether the company will eventually prevail to why so many people were so enamored of it in the first place. (Faye Flam, 4/27)

Unlike screening for breast or prostate cancer, screening for colorectal cancer promises not only to find cancer early, but also to prevent it from occurring. In the 1960s, Gilbertsen first suggested that polypectomy could turn colorectal cancer into a preventable disease.1 Two decades later, Vogelstein envisioned the polyp-to-cancer progression as a stepwise process and detailed the genetic alterations that occur at each step.2 Colorectal cancer became widely viewed as having a long latency period — providing ample time for both early detection and prevention. Conditions were thus considered ideal for screening to reduce related mortality. (H. Gilbert Welch and Douglas J. Robertson, 4/28)

In his 2016 State of the Union address, President Barack Obama called for a “moonshot” to cure cancer. The announcement energized the cancer community to continue building on the remarkable collective progress made in recent years. The pace of that progress has been dizzying: we already diagnose and treat many cancers differently than we did when I began my medical oncology fellowship in 2010. Cancers for which there had been no treatment advances for decades have seen a surge in new medicines. Drug-approval times have been shrinking, and the embarrassment of riches has renewed the focus on defining the proper sequence and combination of therapies in this field. In some instances, in fact, we have so many established or promising agents that we really don’t know what to do with them all. (Satish Gopal, 4/28)

Should trustees, including those serving on boards of nonprofit hospitals, physician organizations, and nonprofit health care organizations, consider every opportunity to transition from fee-for-service reimbursement to population health management and accept financial risk related to possible decreases in the volume of care patients seek at their institutions? For the purposes of this Viewpoint, population health management is a set of activities focused on a defined population that improves quality and outcomes while lowering the total costs of care and is substantially incentivized through contracts that accept financial risk and gain. From 2013 to 2014, health care expenditures increased 5.3%, substantially above the rate of inflation, and equaled 17.5% of all goods and services produced in the United States.1 Fee-for-service reimbursement results in cost increases by encouraging patient use of medical services. The majority of trustees appreciate that the revenue from fee-for-service is essential to keeping their institution financially sustainable. (Michael Jellinek, 4/26)

Although it looks like hospitals are being targeted, this is probably an illusion. These opportunistic attacks are spread across many sectors — if the door is open, these criminals will come in no matter what kind of business or organization it is. (Denise Anderson, 4/27)

There is a pressing need to optimize performance of the US health care system. This need coincides with a substantial and ongoing remarkable increase in technological innovations with implications for digital health, most notably the advent of mobile computing and communications. Currently, the adoption of digital health—which, in this Viewpoint, refers to the use of advanced electronic communication and monitoring technologies to exchange health information—by clinicians, health care organizations, and patients is increasing. (Stephen O. Agboola, David W. Bates and Joseph C. Kvedar, 4/26)

Medicine is in an era of necessary process improvement and cost cutting — the confluence of two goals that aren’t always as synergistic as administrators would suggest. In academic medical centers, there is a third goal that is equally critical: preserving and enhancing the academic mission in this challenging context. Teaching hospitals, together with medical schools in our universities, are places where medicine moves ahead. They are the envy of the world, and rightly so. For discovery happens there, whether in translational biomedical science or in systems and outcomes improvement. And extraordinary care is given there, combining the science and art of medicine, while training the next generation of pioneers and caregivers. (David Silbersweig, 4/27)

The state’s youngest citizens deserve far better than the help they are receiving from Texas’ overwhelmed child welfare services. Houston-based Katherine Barillas is among the child advocacy experts battling amid the cycles of damning reports and big reform plans that leave the rest of us throwing up our hands in bewildered dismay. Editorial writer Sharon Grigsby interviewed Barillas, who, with more than 15 years experience, serves as director of child welfare policy at One Voice Texas. (Sharon Grigsby, 4/27)