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Morning Briefing

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Thursday, Sep 29 2016

麻豆女优 Health News Original Stories 5

  • Congress Finally Approves Funding To Fight Zika 鈥 But What Does This Mean?
  • Poll Finds Majority Of Americans Want Restraints On Drug Prices
  • Specialty Drug Costs Soar 30% For California Pension Fund
  • A Practical To-Do List For Family Caregivers
  • Large Danish Study Links Contraceptive Use To Risk Of Depression

Capitol Watch 2

  • Zika Battle Finally Funded As Congress Passes Stopgap Spending Bill
  • Researchers: Zika Can Be Passed Through Sweat, Tears

Health Law 1

  • Sen. Grassley Hints At GOP's Willingness To Work With Democrats On Health Law Changes

Campaign 2016 1

  • Galas And 'Grand Benefactors': Trump's Relationship With Cancer Institute Draws Scrutiny

Administration News 1

  • Obama Administration Cracks Down On Nursing Home Arbitration Clauses

Veterans' Health Care 1

  • Over 600,000 Uninsured Veterans Fall In 'Medicaid Gap'

Marketplace 1

  • Federal Employees' Share Of Health Premiums To Increase 6.2 Percent Next Year

Health IT 1

  • New Email Scam Involves Fake Health Law Tax Bill

Public Health 3

  • 27 Overdoses In 24 Hours: Opioid Crisis Grips An Ohio City
  • Despite Tremendous Progress, America Still Lags Behind On Teen Birth Rates
  • Immunotherapy Is The Hottest Trend In Cancer Treatment -- So What Exactly Is It?

State Watch 1

  • State Highlights: Vt. Makes Progress Toward All-Payer Reimbursement System; Exploring The Reasons Behind Texas' Pregnancy-Related Death Rates

Editorials And Opinions 1

  • Viewpoints: Clinton's View Of Health; The Return Of The Public Option; Reducing EpiPen Costs

From 麻豆女优 Health News - Latest Stories:

麻豆女优 Health News Original Stories

Congress Finally Approves Funding To Fight Zika 鈥 But What Does This Mean?

Mosquito season may be ending in parts of the U.S., but public health officials say the additional resources will make a difference because the threat will not be measured in one cycle but in years. ( Shefali Luthra , 9/29 )

Poll Finds Majority Of Americans Want Restraints On Drug Prices

As the spiraling costs attract headlines, many people are looking to the government to rein in prescription drug prices, according to the Kaiser Family Foundation poll. ( Jordan Rau , 9/29 )

Specialty Drug Costs Soar 30% For California Pension Fund

Such medications account for more than a quarter of the state agency鈥檚 $2.1 billion in pharmacy costs. ( Chad Terhune , 9/28 )

A Practical To-Do List For Family Caregivers

In order to maximize the important role they play, family caregivers must be proactive in speaking up, planning and documenting their ability to meet their loved one鈥檚 health care needs. ( Judith Graham , 9/29 )

Large Danish Study Links Contraceptive Use To Risk Of Depression

The research, published in JAMA Psychiatry, finds significant increases in the use of anti-depressants and depression diagnoses for women using hormonal forms of contraceptives, such as the pill. ( Carmen Heredia Rodriguez , 9/28 )

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Summaries Of The News:

Capitol Watch

Zika Battle Finally Funded As Congress Passes Stopgap Spending Bill

After House leaders reach an agreement over the Flint water crisis funds, Congress averts a government shutdown by passing a bill that includes $1.1 billion for the fight against Zika.

Congress staved off an Oct. 1 government shutdown Wednesday, passing a stopgap spending measure after House Republicans agreed to address聽the drinking-water crisis in Flint, Mich., removing a major obstacle in negotiations. The bill extends current government funding levels until early December, giving appropriators time to negotiate 2017 spending measures. It also provides year-long funding for veterans programs, $1.1 billion to address the Zika virus and $500 million in emergency flood relief for Louisiana and other states. (DeBonis, 9/28)

Congress avoided a partial government shutdown at week鈥檚 end after both chambers passed a short-term spending bill that would keep the government running through early December. A weekslong partisan impasse over the bill broke when lawmakers agreed to provide federal assistance for residents of Flint, Mich., in separate legislation this year. That deal quickly paved the way for the Senate to pass a short-term spending bill, also known as a continuing resolution, that would keep the government funded through Dec. 9. (Peterson and Hughes, 9/28)

The biggest hurdle to a quick getaway was Democrats鈥 demand that money be added to the CR to help the 100,000 people in Flint who faced lead-contaminated drinking water. But Republicans wouldn鈥檛 budge, and said Flint should be dealt with in a water infrastructure bill moving through Congress. Ryan and Pelosi worked out an agreement Tuesday evening to allow a floor vote on an amendment to authorize $170 million for Flint in the water bill. (Bade, Kim and Weyl, 9/29)

It brings to an end a partisan fight that has had the unusual effect of delaying funding to deal with what all sides agree is a public health emergency. The delay came out because of disagreement over side issues like funding for Planned Parenthood and whether the money should be considered "emergency" spending. Wednesday's deal drops language barring the money from going to Planned Parenthood clinics. The Senate passed the measure Wednesday; it is pending in the House. (Kodjak, 9/28)

Congress聽late Wednesday approved federal funding that聽will provide $1.1 billion to fight the Zika virus, along with money necessary to keep the government running through Dec. 9. (Kaplan, 9/29)

House passage of a government funding bill late聽Wednesday聽night means that funding for the Zika virus has finally been approved.聽The measure included $1.1 billion in funding to fight the virus, capping a fierce months-long debate over the money that dismayed public health experts who called for speedily approving funding. (Sullivan, 9/28)

So what exactly has Congress done? And, from a public health standpoint, how much will it help? Here is a breakdown of what you need to know. (Luthra, 9/29)

In other news from Capitol Hill聽鈥

A top Democratic negotiator said Wednesday that new funding in a major medical cures bill has been cut significantly as lawmakers look for a path for passage.聽Rep. Gene Green, the top Democrat on the House Energy and Commerce health subcommittee, told The Hill that a new version of the 21st Century Cures bill will allocate about $4 billion over five years for research at the National Institutes of Health (NIH), down from the original $8.75 billion.聽(Sullivan, 9/28)

Sen. Ron Johnson tried, but failed, to have the Senate approve Right to Try legislation by unanimous consent Wednesday. Senate Minority Leader Harry Reid (D-Nev.) objected to S. 2912, legislation from the Wisconsin Republican that would provide experimental drugs to terminally ill patients. The bill would increase access to drugs that have cleared initial safety tests but are not approved by the FDA. (McIntire, 9/28)

Researchers: Zika Can Be Passed Through Sweat, Tears

The son of a man who died of the virus contracted it after sitting by his father's bedside, touching his skin and wiping his eyes. Meanwhile, the Centers for Disease Control and Prevention responds to a whistleblower's claims that it is not using the most effective test for Zika.

New details are emerging about the mysterious Zika case in Utah where a son caring for his sick father became infected with the virus. The father's death in June was the first related to Zika in the continental United States. His son's infection was unusual because, unlike all other known adult cases, he had not traveled to a Zika-infected region or had聽sex with a partner who had done so. Instead, he had remained at his father's side in the hospital. (Sun, 9/28)

A new report suggests the first person who died while infected with Zika virus in the United States actually succumbed to the infection, not a previous illness. (Branswell, 9/28)

A leading official at the Centers for Disease Control and Prevention (CDC) is rejecting claims that the agency has been knowingly promoting a less effective test for the Zika virus. The public health agency has been hit with criticism this week after one of its own top scientists alleged that CDC officials had recommended the use of a Zika test that is far less effective than another existing test. (Ferris, 9/28)

The state health department confirmed eight new travel-related Zika cases on Wednesday, two of which are in Orange County. This brings up the Orange County total to 79, and the four-county total to 132 travel-related cases since earlier this year.聽No local cases have been聽confirmed in Central Florida, and local mosquitoes haven't tested positive for聽Zika. (Miller, 9/28)

Health Law

Sen. Grassley Hints At GOP's Willingness To Work With Democrats On Health Law Changes

The change in tone by the influential Republican may signal changing battle lines on the Affordable Care Act.

For the first time in six years, some congressional Republicans are willing to engage in conversations about fixing 鈥 not repealing 鈥 Obamacare, should another Democrat occupy the White House. Republicans uniformly believe the next Congress must do something to address the Affordable Care Act. ... "There鈥檚 two ways鈥 that action on Obamacare could play out, said Sen. Chuck Grassley (R-Iowa) in an interview with Morning Consult. 鈥淥ne, if a Republican鈥檚 elected, we鈥檙e going to have to deliver on our promise to dramatically change the health care system. ... The second one is, if the Democrats elect a president, there鈥檚 some changes 鈥 there鈥檚 some bipartisan support 鈥 that ought to be made. But it鈥檇 have to have the White House support. So I think it鈥檚 going to be pretty much driven by what Hillary would say,鈥 Grassley said. (Owens, 9/28)

And on the debate over Medicaid expansion 鈥

Following more than two hours of impassioned public testimony, a legislative panel reviewing health care options for thousands of Idaho鈥檚 working poor acknowledged Wednesday that it does not expect to reach consensus on what if any action to recommend to the full Legislature. ... At issue before the Legislature 鈥 yet again 鈥 is how Idaho should address the needs of 78,000 lower-income residents who don鈥檛 qualify for standard Medicaid or for subsidized health coverage on the state exchange. The Legislature has been unable to reach consensus on what boils down to two options: approving a modified expansion of Medicaid, with conditions, to cover the so-called gap population, or instituting a more limited, state-financed program. (Dentzer, 9/28)

Campaign 2016

Galas And 'Grand Benefactors': Trump's Relationship With Cancer Institute Draws Scrutiny

Although he hasn't donated any of his own money to the Dana-Farber Cancer Institute, Donald Trump's business ties to it are raising some eyebrows. In other election news, Hillary Clinton reiterates her health care plan in the New England Journal of Medicine.

The annual fundraising bashes that Donald Trump hosted at his Mar-a-Lago Club for the renowned Dana-Farber Cancer Institute were showy affairs, complete with poolside champagne, flamenco dancers, and Tiffany party favors. (Swetlitz, 9/29)

Democratic presidential candidate Hillary Clinton laid out her vision for the future of health care in an editorial posted Wednesday in the New England Journal of Medicine. The three-page post reiterated her plans to strengthen the Affordable Care Act, combat rising out-of-pocket health costs, expand Medicaid, and let Americans age 55 and over buy into Medicare. (Rice, 9/29)

Administration News

Obama Administration Cracks Down On Nursing Home Arbitration Clauses

A new rule from the Centers for Medicare & Medicaid Services would bar nursing homes from turning over claims of elder abuse, sexual harassment or even wrongful death to a private system to settle disputes.

The federal agency that controls more than $1 trillion in Medicare and Medicaid funding has moved to prevent nursing homes from forcing claims of elder abuse, sexual harassment and even wrongful death into the private system of justice known as arbitration. An agency within the Health and Human Services Department on Wednesday issued a rule that bars any nursing home that receives federal funding from requiring that its residents resolve any disputes in arbitration, instead of court. (Silver-Greenberg and Corkery, 9/28)

A new CMS rule will bar nursing homes from compelling residents to settle disputes in arbitration as a condition of admission and introduces new requirements aimed at improving the quality of care and reducing unnecessary hospital readmissions. (9/28)

Veterans' Health Care

Over 600,000 Uninsured Veterans Fall In 'Medicaid Gap'

These vets who don't seek or qualify for care by the Department of Veterans Affairs are also not eligible for Medicaid coverage, especially in states that did not expand the program. Meanwhile, news outlets report about the ongoing challenges at the VA.

More than 600,000 veterans will go without health insurance next year unless 19 states stop holding out against expanding Medicaid, researchers said Wednesday. A new report from the Urban Institute finds that 604,000 veterans fall into the so-called "Medicaid gap" 鈥 they are not poor enough to qualify for Medicaid, but they make too much money to qualify for federal subsidies to buy health insurance on the Obamacare exchanges. (Fox, 9/29)

More than 600,000 military veterans are likely to be without health coverage next year unless more states expand income eligibility for the Medicaid program, researchers at the Urban Institute reported Wednesday. (Pugh, 9/28)

The Veterans Affairs Department turned over documents to Congress on Wednesday in response to a subpoena demanding information about how the cost of a Denver-area VA hospital soared more than $1 billion over budget. VA spokeswoman Linda West said the department gave the House Veterans Affairs Committee some of the documents that lawmakers wanted and that more were on the way. (Elliott, 9/28)

The VA for years has bought private care for veterans at its own discretion. But the Veterans Access, Choice, and Accountability Act made getting that care a right for a significant number of veterans. And, after a slow start, top VA officials last year told local health care systems that they had to use it. That wreaked havoc on local VA facilities that already were relying heavily on the private sector to treat veterans 鈥 without the complications of going through a middleman. (Romney, 9/28)

Marketplace

Federal Employees' Share Of Health Premiums To Increase 6.2 Percent Next Year

Federal officials attributed the rise largely to increasing prescription drug costs, which make up about a quarter of the total costs in the program, general inflation and the aging of the covered population, The Washington Post reports. Meanwhile, Bloomberg examines how the U.S. health care system compares to other countries.

The enrollee share of premiums in the health-care program for federal employees and聽retirees will rise 6.2 percent on average in 2017, an increase about in line with the general聽trend for employer-sponsored health insurance, the government announced Wednesday. The announcement of premium聽rates in the Federal Employees Health Benefits Program comes in advance of an annual open season, which this year will run Nov. 14-Dec. 12, during which聽enrollees may change plans or change types of enrollment for the following year. Also, employees who are not currently enrolled may join the program, although retirees generally may not newly join. (Yoder, 9/28)

The U.S. health-care system remains among the least-efficient in the world. America was 50th out of 55 countries in 2014, according to a Bloomberg index that assesses life expectancy, health-care spending per capita and relative spending as a share of gross domestic product. Expenditures averaged $9,403 per person, about 17.1 percent of GDP, that year 鈥 the most recent for which data are available 鈥 and life expectancy was 78.9. Only Jordan, Colombia, Azerbaijan, Brazil and Russia ranked lower. (Du and Lu, 9/28)

Health IT

New Email Scam Involves Fake Health Law Tax Bill

In other health information technology news, researchers work on flexible bone grafts using a 3D printer.

Americans, beware: the Internal Revenue Service isn鈥檛 emailing you. Just recently, a new scam has started involving fake tax bills tied to the Affordable Care Act. In one sure sign the notices are fake, many are arriving by email鈥攁nd the IRS doesn鈥檛 initiate taxpayer contact by email. Even so, some of the fakes are paper notices sent by regular mail and taxpayers should watch out. (Saunders, 9/29)

Scientists have 3-D-printed splints for babies鈥 airways, faux brains to study cortical folding 鈥斅燼nd now they鈥檝e done it with bone. A team of researchers at Northwestern University has created a highly flexible artificial bone that helps speed up recovery and that can be easily manipulated by surgeons in the operating room. (Khan, 9/28)

Public Health

27 Overdoses In 24 Hours: Opioid Crisis Grips An Ohio City

The wave of overdoses overwhelmed first responders in Columbus. Police officers are scrambling to determine the source of the heroin.

In a 24-hour span that lasted into early Wednesday dealers across the city released a crushing dose of heroin into the city, choking the city鈥檚 safety forces. Authorities say 27 people had overdosed on heroin across the city on Tuesday into early Wednesday. (Sullivan, 9/29)

As Ohio continues to endure unprecedented waves of heroin overdoses, including 27 in Columbus in a 24-hour period this week, legislative Democrats again urged Gov. John Kasich to declare a state of emergency on Tuesday. ... Democrats want the governor to declare a state of emergency on the heroin epidemic, allowing for the release of at least $300 million from the state鈥檚 $2 billion-plus rainy day fund to help communities deal with the crisis. (Siegel, 9/28)

And in Pennsylvania and Florida聽鈥

Gov. Wolf has called it a public health crisis and an epidemic, crisscrossing Pennsylvania for more than a year to participate in roundtables and work sessions on how to combat prescription drug and heroin addiction. On Wednesday, he used his office's bully pulpit to address a joint session of the legislature and urge lawmakers to swiftly pass bills aimed at fighting the problem - his boldest public move yet to focus attention on opioid abuse. (Couloumbis, 9/29)

Florida Attorney General Pam Bondi聽on Tuesday聽announced an emergency rule to ban a type of synthetic drug that she said has caused multiple deaths in Florida. The rule targets a drug known as U-47700, which Bondi's office said is usually found in powder or granular form but also can be made into a pill that appears like a prescription drug. It also can be found in liquid form and as a nasal spray. (9/28)

Despite Tremendous Progress, America Still Lags Behind On Teen Birth Rates

For the seventh straight year, U.S. teen birth rates drop. But other industrialized countries are far ahead of America. In other public health news, high blood pressure could affect children's cognitive skills, biological age trumps actual age when it comes to lifespan and a study finds a link between contraception use and depression in women.

The birth rate for U.S. teenagers hit an all-time low in 2015, the seventh straight year a new record has been set.聽Overall, there were 22.3 births for every 1,000 young women between 15 and 19, according to a report released Wednesday by the Centers for Disease Control and Prevention. That represents an 8% drop in just one year. (Kaplan, 9/28)

Increasing numbers of children have high blood pressure, largely as a consequence of their obesity. A growing body of evidence suggests that high blood pressure may impair children鈥檚 cognitive skills, reducing their ability to remember, pay attention and organize facts. (Saint Louis, 9/29)

UCLA geneticist Steve Horvath led a team of 65 scientists in seven countries to record age-related changes to human DNA, calculate biological age and estimate a person鈥檚 lifespan. A higher biological age 鈥 regardless of chronological age 鈥 consistently predicted an earlier death. The findings are published in today鈥檚 edition of the journal Aging. (Goldberg, 9/28)

Aside from pesky side effects like nausea and headaches, hormonal contraceptives are generally considered quite safe and effective. But researchers Wednesday identified a heightened risk of an unintended consequence: depression. A study published in JAMA Psychiatry聽found women using hormonal contraception faced a higher rate of developing depression and using antidepressants than women who did not use the drugs. Oral contraceptives that combine two key hormones, a type widely used by Americans, increased women鈥檚 rate of taking antidepressants by 23 percent. Among teens using these contraceptives, the rate nearly doubled. (Heredia Rodriguez, 9/28)

Immunotherapy Is The Hottest Trend In Cancer Treatment -- So What Exactly Is It?

The Washington Post offers a look at the basics of the treatment that has everyone from patients to investors to pharmaceutical companies paying attention.

The idea of using the body's immune system to fight cancer has been around for a century, but only in the past half a dozen years have dramatic breakthroughs begun rocking the medical world. "That's when the tsunami came," says Drew Pardoll, director of the Bloomberg-Kimmel Institute for Cancer Immunology at Johns Hopkins University, and those advances聽are spawning hundreds of clinical trials nationwide, plus generating intense interest from patients, physicians and investors. (McGinley, 9/28)

In other news, sometimes, when it comes to the technology to diagnose cancer, cheaper is actually better聽鈥

What鈥檚 the best way to bring cutting-edge healthcare to the world鈥檚 poorest places? It can be tempting to export money and equipment to solve the problem. But when bioengineer Rebecca Richards-Kortum visits hospitals in places such as Malawi and El Salvador, she sees the unintended consequence of that charitable impulse. 鈥淚ronically, if you walk down the hall or into the basement of a hospital, there鈥檚 always a big room that is just for broken, donated equipment,鈥 she says. (Blakemore, 9/28)

State Watch

State Highlights: Vt. Makes Progress Toward All-Payer Reimbursement System; Exploring The Reasons Behind Texas' Pregnancy-Related Death Rates

Outlets report on health news from Vermont, Texas, California, Indiana, Ohio, Illinois, Washington, Wisconsin, Maine and Florida.

Vermont has received tentative approval from the Obama administration to establish an all-payer reimbursement system for healthcare providers in the state starting in January. Maryland long has had an all-payer system, but it covers only hospitals. Vermont plans to use an accountable care organization-type structure that would cover all providers. (Dickson, 9/28)

The rate of pregnancy-related deaths among Texas women has nearly doubled in recent years, a national study found this month, while a separate state-commissioned study found that black women are especially vulnerable. (McSwane and Langford, 9/28)

The national fight over sugary soda is bubbling up in the San Francisco Bay Area, where voters in November will consider a tax on the drinks that many health experts say contribute to diabetes, obesity and tooth decay. Backers of the campaign say a penny-per-ounce tax is needed in San Francisco, Oakland and tiny Albany to curb consumption of sweetened cola, sports drinks and canned teas that people gulp without thinking, adding empty calories. (9/28)

In this industrial northwest Indiana city, hundreds of families who live in a gated public housing community with prim lawns and a new elementary school next door are searching for new homes. Their own places have been marked for demolition.The school, temporarily closed, has been taken over by the Environmental Protection Agency and health officials who offer free blood tests to check residents for lead poisoning. (Schneyer, Pell 9/28)

Just about every time City Council meets to discuss lead poisoning, the names of large area paint companies headquartered here are on their lips. City administrators, too, say they'd like to have corporate partners like Sherwin-Williams or RPM or PPG helping to tackle the "legacy" problem 鈥 one the city says it can't afford to address on its own. (Dissell and Zeltner, 9/28)

Gov. Bruce Rauner鈥檚 administration said on Wednesday that the state鈥檚 deficit is $2.4 billion less than what a bipartisan聽legislative commission projected in a July report.The Commission on Government Forecasting and Accountability 鈥 the Illinois General Assembly鈥檚 independent budget analysts 鈥 estimated total state spending for the 2017 fiscal year that began on July 1 at $39.5 billion, compared with revenues of $31.8 billion 鈥 leaving nearly a $7.8 billion deficit. ... Illinois Budget Director Tim Nuding said the commission didn鈥檛 factor in several key levels of revenue, including federal reimbursements to the state for Medicaid spending. The commission used Medicaid spending numbers from February, $8.2 billion, which Nuding called outdated. (Sfondeles, 9/28)

A Bay Area federal judge is suggesting she intends to rule that a transgender employee can sue his employer under sex-discrimination law for denying insurance coverage for sex-reassignment surgery. 鈥淭his is a sex-based procedure. It couldn鈥檛 be more sex-based,鈥 U.S. District Judge Yvonne Gonzalez Rogers of Oakland said Tuesday to a lawyer defending the refusal of Dignity Health of San Francisco and one of its out-of-state hospitals to cover the employee鈥檚 operation. The lawyer, Barry Landsberg, replied that the hospital鈥檚 policy was gender-neutral because 鈥渋t applies equally to men and women.鈥 Federal law, he argued, prohibits discrimination against males or females, 鈥渂ut there is not a third sex.鈥 (Egelko, 9/28)

A 32-year-old Vancouver, Wash., woman who struggled with heart failure for more than a decade received a lifesaving transplant this summer 鈥 only to contract Legionnaires鈥 disease during a deadly outbreak at the University of Washington Medical Center (UWMC). Victoria Martin planned to file a claim Tuesday notifying UW Medicine that she intends to sue the hospital for failing to prevent the infection that also has sickened four other people, including two who died. (Aleccia, 9/27)

Integrated Health Network of Wisconsin gave itself the ambitious goal of clinically integrating eight health systems throughout the state to prepare for the expected changes in the way hospitals and doctors are paid. The network would require the health systems to work toward聽lessening the variation in how care was provided. It would track their performance on an array of quality and cost measures. And it would build the complex computer systems to collect and analyze information from medical claims and electronic health records. Its plans may have proven too ambitious. (Boulton, 9/28)

California Gov. Jerry Brown has signed a bill that ends a statute of limitations on prosecuting rape cases. The bill is widely believed to be inspired by allegations against comedian Bill Cosby, after some of his accusers came forward long after the alleged sexual assaults took place. (Kennedy, 9/28)

Maine is one of 25 states, plus the District of Columbia, that permit the use of marijuana for medical purposes. It is a competitive market with thousands of growers, known as caregivers under state law. But Ms. Haywood now claims a distinction that sets her apart. She is among the first five farmers whose weed is labeled Certified Clean Cannabis by the Maine Organic Farmers and Gardeners Association. Branded MC3, the marijuana is grown following organic standards, but it cannot be labeled 鈥渙rganic鈥 under federal guidelines. (Carpenter, 9/28)

South Florida seniors may help prove that a walk in the park is just what the doctor ordered. Patients at Humana's MetCare clinic in Plantation are testing a new initiative aimed at encouraging older adults to exercise outdoors.Called Park Rx, the program is part of the growing nationwide "park prescription" movement. Its mission: to harness nature's potential medical and mental health benefits by steering people of all ages to public parks and green spaces for their exercise. (Lade, 9/28)

Editorials And Opinions

Viewpoints: Clinton's View Of Health; The Return Of The Public Option; Reducing EpiPen Costs

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

Because of the Affordable Care Act (ACA), 20 million more Americans have health insurance and more than 8 million kids receive health coverage each year as a result of the Children鈥檚 Health Insurance Program. ... What鈥檚 more, expanded consumer protections and access to free preventive services 鈥 like vaccinations and cancer screenings 鈥 mean all Americans now have stronger, better health coverage. Despite this progress, we still have real challenges ahead. Americans face rising out-of-pocket costs and a health care system that is too fragmented. We need to make health coverage affordable so people can access the care they need. We need to do more to break down barriers and achieve health equity across our communities. We need to expand Medicaid in every state so that everyone has access to care, regardless of their income and where they reside. And we need to devote more resources to the necessary scientific research into the diseases of our time. (Hillary Clinton, 9/28)

On the campaign trail and in the halls of policy wonks, the health care term of the moment is 鈥渢he public option.鈥 The idea is to create a government-run health care plan that would be an alternative to the private insurance plans offered under the Affordable Care Act, or provide a fallback in markets where insurers have been pulling out. In an article in The New England Journal of Medicine published on Wednesday, Hillary Clinton reiterated her support for such a measure. (Reed Abelson and Margot Sanger-Katz, 9/29)

While Clinton has yet to release any specifics, her 2008 healthcare platform, the American Health Choices Plan, gives us a glimpse. The AHCP stipulated a public option 鈥渨hich could be modeled on the traditional Medicare program, but would cover the same benefits as guaranteed in private plan options 鈥 [to] compete on a level playing field with traditional private insurance plans 鈥 [and] provide a more affordable option. That assumes insurers are price gouging by not offering affordable options. But the problem isn鈥檛 that there鈥檚 too much profit being made on the exchanges, it鈥檚 that there鈥檚 too little. (Paul Howard and Stephen Parente, 9/28)

Health care shows up on the political agenda in 2 very different ways, as a social issue and a budget issue. These 2 views prompt very different sets of questions and also shape how the 2 major political parties focus their respective efforts in the health care arena. (David Cutler, 9/28)

Polls show that most Americans disparage Congress for its inability to agree on even simple issues. Now Obamacare gives a new meaning to "reaching across the aisle" because it has caused Democrats to adopt a traditional Republican principle while the GOP advances a position more often associated with Democrats.聽(Daniel Hoffman, 9/28)

Banning 鈥減ay-for-delay鈥 deals that postpone the production of less-expensive generic drugs is a key action point in Hillary Clinton鈥檚 comprehensive plan to lower prescription drug costs. Eliminating these deals, she says, could save Americans billions of dollars on medications.聽But an even more productive strategy would be to stop drug makers from producing so-called聽authorized generics. (Farasat Bokhari, 9/28)

Devon Herrick of the National Center for Policy Analysis recommends EpiPens be made available over-the counter (OTC). Herrick explains that about one billion dollars鈥 worth of EpiPens are thrown out unused in the United States, because they need to be immediately at hand but expire after about a year.聽 Pharmacies have evolved into very consumer-friendly retail environments 鈥 almost more like supermarkets or department stores than old-chemists鈥 shops. If patients knew they could walk in and pick up EpiPens from the pharmacy, they would not need to stockpile as many injectors as they do when they have to go to a physician for a prescription. (John Graham, 9/28)

Why is this controversy erupting now? Certainly the size and timing of the price hikes played a role. But less discussed is a change in how insurance covers access to prescription medications. In less than a decade, average health care deductibles have risen from approximately $300 to more than $1,000, with some families now facing annual deductibles of almost $5,000. In that same time period, the percentage of individuals enrolled in high-deductible insurance plans has gone from less than 5 percent to potentially approaching 40 percent in the coming year. This means that a family whose fixed copay a few years ago was $25 or $50 per prescription for their twin pack of EpiPens could get the recommended multiple sets for school, home, and to carry around for about $75 to $150. Today, many are now required to pay list price 鈥 upwards of $600 鈥 for each set, or almost $2,000 to satisfy their deductibles. (James R. Baker Jr., 9/28)

Real, or inflation-adjusted, compensation has risen 61 percent since 1970; wages, on the other hand, have increased less than 3 percent in real terms in that period. This is a tale that has gotten short shrift in this political season. Much of the narrative of the 2016 election is about middle-class anger over the lack of economic progress in an era of increasing financial inequality. Residual frustration with the financial crisis and bank bailouts isn't making voters feel any better either. (Barry Ritholtz, 9/28)

The United States is in the midst of a bold experiment. Medicare is moving rapidly away from traditional fee-for-service payment. Various alternative payment models (APMs) intended to improve quality and reduce costs are being implemented or tested. The stakes are high. If an evaluation finds that a new model meets the statutory requirements for expansion, the US Secretary of Health and Human Services is authorized to expand the models across the country. Whether these new programs work and how effectively they are evaluated should matter to physicians, patients, and taxpayers. (Elliott S. Fisher, 9/27)

Healthcare wasn't entirely absent from last night's debate. When asked about the economy, both Republican candidate Donald Trump and Democratic candidate Hillary Clinton called for more infrastructure spending. But in his reply, Trump said: 鈥淲e have a country that needs new roads, new tunnels, new bridges, new airports, new schools, new hospitals,鈥 he said. (Merrill Goozner, 9/27)

This year marks the 20th anniversary of the Health Insurance Portability and Accountability Act, better known as HIPAA. Since it took effect, doctors鈥 offices, hospitals and other health-care providers have been very careful about releasing information. Sometimes frustratingly so. I鈥檝e had providers refuse to send my information to me by email, because that form of communication is considered less secure than the now-ancient practice of faxing. (Joe Davidson, 9/28)

A few years ago at a large teaching hospital in Texas, a medical resident asked a nurse how to order an autopsy for a patient they were currently treating. It was a reasonable request. Autopsies help further the understanding of disease. There was just one problem: their patient, who was very much alive, was lying nearby. He鈥檇 overhead the request, and that鈥檚 how he found out he was soon going to die. (Wolfgang Gilliar, 9/29)

In an unprecedented move, Surgeon General Vivek Murthy sent a letter to every doctor in America last month. It did not congratulate us on a job well done; instead, it said we need an urgent change in how we manage pain and opioids. The gesture, launching the TurnTheTideRx campaign, was praiseworthy but unfortunately misses point. (Robert Bonakdar, 9/26)

You don鈥檛 have to flip through many TV channels or pick up many magazines before seeing news related to the opioid epidemic in our country. The focus of these stories is often on heroin, but that鈥檚 only part of the picture. Prescription drug abuse and misuse is the other part. (Deb Moessner, 9/28)

Ideally, adult film performers would use condoms when they engage in on-screen intercourse. It鈥檚 the most reliable way to keep them safe from contracting or聽spreading sexually transmitted diseases, including HIV. But the adult film industry has doggedly refused to adopt this simple protective measure, even though state labor code requires workers be protected from blood-borne pathogens. ... however ... we part philosophical company with Proposition 60, a heavy-handed measure on the Nov. 8 ballot backed by the AIDS Healthcare Foundation and its president, Michael Weinstein. The proposition would, in effect, make聽every Californian a potential condom cop by both mandating condom use and creating a private right of action so that any resident who spots a violation in a pornographic film shot in the state could sue and collect cash from the producers and purveyors if they prevail in court. (9/28)

The critical mental health needs of those in treatment at New Hampshire Hospital and the hopes of those who love them should be a priority for our state, regardless of party or political persuasion. Real progress has been made at the hospital in the aftermath of a federal lawsuit, but more needs to happen and I am optimistic it will. (John T. Broderick, Jr., 9/29)

When it comes to dealing with abuses of the most developmentally disabled adults in Colorado, a population that is unable to speak for itself, it鈥檚 critical that state officials who work with them be as transparent as possible. For the better half of a year in 2014 and 2015, residents at the Pueblo Regional Center suffered abuse and neglect. ... Now a federal report has been released detailing and documenting the horrors. In addition to rehashing past abuses that the Department of Human Services (DHS) made public in April 2015, the report called for additional safeguards that we hope the state makes serious a commitment to following. (9/28)

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