Morning Briefing
Summaries of health policy coverage from major news organizations
From 麻豆女优 Health News - Latest Stories:
麻豆女优 Health News Original Stories
Cost Of Diabetes Drugs Often Overlooked, But It Shouldn鈥檛 Be
Much of the recent debate about drug costs has centered on high-priced specialty drugs, such as those to cure hepatitis C. But millions more people have diabetes and their drugs are also expensive.
Bad Health Outcomes For Adults Who Don鈥檛 Get Help As Teens
Study reports adolescents鈥 unmet health care needs foreshadow problems later in life.
Medicare Says Doctors Should Get Paid To Discuss End-Of-Life Issues
The topic is complex and sometimes requires multiple visits, but right now doctors are paid for it only if they discuss end-of-life planning in their initial visit with a new Medicare patient.
Summaries Of The News:
Administration News
White House Marshals Money, Focus To Combat Heroin Epidemic
The funding 鈥 a sliver of the $25.1 billion that the government spends every year to combat drug use 鈥 will help create a new 鈥渉eroin response strategy鈥 aimed at confronting the increase in use of the drug. A recent study by the Centers for Disease Control and Prevention found that heroin-related deaths had nearly quadrupled between 2002 and 2013. 鈥淭he Heroin Response Strategy will foster a collaborative network of public health-public safety partnerships to address the heroin/opioid epidemic,鈥 said the announcement by the policy office. 鈥淭he aim will be to facilitate collaboration between public health and public safety partners within and across jurisdictions, sharing best practices, innovative pilots, and identifying new opportunities to leverage resources.鈥 (Shear, 8/17)
About $2.5 million from President Obama's anti-drug programs will target heroin abuse in New England, Appalachia and East Coast cities, and $1.3 million will go to fight trafficking on the border with Mexico, drug czar Michael Botticelli said. Public health coordinators will monitor heroin use and issue warnings regarding dangerous batches of the drug. Public safety coordinators will work with law enforcement to stem illegal imports. Botticelli emphasized the benefits that would come from cooperation between public health officials and law enforcement. (Toman-Miller, 8/17)
Other measures will include more support for recovering addicts, more education for first responders and better coordination among law enforcement agencies. In addition, other federal funds will be available to states along the U.S.-Mexico border to stem the tide of drugs flowing across that region. (Tau, 8/17)
While the grants don't provide any new money 鈥 only Congress can do that 鈥 the new heroin strategy is "targeting the resources we have already to deal with our biggest drug threats," Botticelli said. But critics of the national drug policy say the announcement is "one step forward, two steps back." 鈥淗alf of what they鈥檙e doing is right 鈥 the focus on health and overdose prevention 鈥 but the other half, the side that focuses on the failed arrest and incarceration policies of the past is destined to ruin lives and fail,鈥 said Bill Piper, director of the Drug Policy Alliance鈥檚 office of national affairs. (Korte, 8/17)
The move is a response to a sharp rise in the use of heroin and opiate-based painkillers, which the U.S. Centers for Disease Control has described as an epidemic. Heroin use has more than doubled among people aged 18-25 in the United States in the past decade, according to CDC figures, while overdose death rates have nearly quadrupled. An estimated 45 percent of U.S. heroin users are also addicted to prescription painkillers. (8/17)
The rise in heroin use has become a frequent topic in the 2016 presidential campaign. Democratic frontrunner Hillary Rodham Clinton recently held a forum in New Hampshire on drug addiction, an issue she said voters have been frequently raising as she鈥檚 campaigned in the early voting state. (8/17)
NPR's Robert Siegel speaks to Director of National Drug Control Policy Michael Botticelli about how the plan to tackle heroin abuse shifts focus from punishment to treatment. (8/17)
Campaign 2016
Walker's Health Plan Designed To Dismantle Obamacare, Give More Control To States
Republican presidential candidate Scott Walker's plan for replacing President Barack Obama's health care law would extend refundable tax credits to help pay for private health insurance based on age instead of income, restructure Medicaid and allow people to shop for insurance across state lines. The Wisconsin governor provided details of his proposal to The Associated Press in advance of a Tuesday speech in suburban Minneapolis where he was to outline his first major policy initiative of the presidential campaign. (8/18)
Wisconsin Gov. Scott Walker plans to hit a favorite Republican target, "Obamacare," in an effort to excite many of the Republican primary voters who have ignored him in the five weeks since he entered the presidential primary. ... Walker plans to travel to Minnesota on Tuesday to give a detailed plan to repeal and replace President Obama's healthcare plan. He promises to limit government interference while still 鈥渆nsuring affordable coverage for those with preexisting conditions, and removing the fear that something as simple as changing jobs could result in loss of coverage.鈥 (Bierman, 8/17)
The Wisconsin governor and GOP presidential candidate says the plan wouldn鈥檛 add to the federal deficit and would completely repeal and dismantle the Obama administration鈥檚 health-care law. Mr. Walker says his plan would give more control to the states, overhaul Medicaid and do away with tax credits based on income. It would also toss out the law鈥檚 requirement that insurers offer plans that cover essential health benefits such as maternity care and mental-health services. (Epstein and Armour, 8/18)
Walker says he would replace Obamacare with a plan that would return authority to the states and provide sliding-scale tax credits directly to consumers who don鈥檛 get coverage at work to help them buy insurance. He would also expand the role of health savings accounts and allow consumers to buy insurance across state lines 鈥 standard Republican ideas. States would also be able to set up high-risk pools with federal funds to help consumers with pre-existing health problems purchase coverage. In a nod to Republican opposition to federal control over health care, Walker would also give states greater say over Medicaid, which he would break into separate plans for different groups, such as poor families, people with disabilities and low-income seniors. (Haberkorn and Cheney, 8/18)
Wisconsin Gov. Scott Walker will roll out his first big policy proposal Tuesday in Minnesota when he unveils his plan to repeal and replace Obamacare. Walker says Obamacare's backwards approach has driven up health care costs and reduced access to medical care for too many people. (Donner, 8/18)
Meanwhile, what about "Kasich-care" -
[John Kasich] wants to ensure insurance coverage for people who have pre-existing conditions. He likes insurance exchanges. And he thinks everyone should have health insurance 鈥 even young, healthy people who need an incentive to sign up. Yet he says he鈥檇 push to repeal President Barack Obama鈥檚 health care law and replace it with something else 鈥 something better, he says 鈥 if his presidential campaign were to prove successful. ... Kasich鈥檚 ideas about health care illustrate the difficulty the Ohio governor may have distancing himself from a law that so many of his fellow Republicans detest. Because a lot of what the governor wants to do is already part of Obamacare. (Thompson, 8/17)
Jeb Bush Details Approach To Overhaul VA, Improve Veterans' Health Care
Republican presidential hopeful Jeb Bush wants to privatize more veterans care, make it easier to fire federal employees found responsible for poor treatment and overhaul the Pentagon to prioritize an increase in the number of active troops. The former Florida governor announced those and other veterans policy ideas Monday to open a two-day swing in the early voting state of South Carolina, where he visited a Veterans Affairs medical facility in Charleston and held a town hall-style meeting with veterans in Columbia. (Barrow, 8/17)
Bush鈥檚 VA reform plan, to be unveiled later Monday in advance of an appearance with Concerned Veterans for America in South Carolina on Monday night, includes expanding 鈥渃hoice鈥 options for care outside the department without cutting funding for VA hospitals and medical staff. Instead, he promises that extra funds can be found through 鈥渃utting excess administrators (not caregivers)鈥 and eliminating 鈥渂illions of dollars in waste, fraud, and abuse.鈥 That includes more competitive bidding for department contracts and firing poorly performing employees. (Shane, 8/17)
The Republican presidential candidate unveiled a new veterans health-care plan on Monday at the start of a two-day visit to South Carolina, the place with the highest percentage of active-duty and retired military personnel among the first four early primary states. ... Bush said that revamping the VA and veterans health care overall would be "a top priority" if he's elected president. His ideas mirror those advanced last year by many Republican lawmakers, who responded with outrage to revelations of widespread mistakes and delayed care for veterans seeking medical treatment or referrals. (O'Keefe, 8/17)
Jeb Bush laid out his plan to overhaul the Department of Veterans Affairs and improve health care access for veterans during a campaign swing through South Carolina on Monday. (Frasier, 8/17)
On The Campaign Trail, Planned Parenthood Offers Fodder To Candidates From Both Parties
As eager as Republicans have been to attack Planned Parenthood, a women鈥檚 health-care provider that also performs abortions, Democrats have rushed to defend the group. And, at least during the presidential primary season, the issue is working for candidates from both parties. Former Hewlett-Packard Chief Executive Carly Fiorina, who earned a spike in the polls following her recent GOP debate performance, Monday vowed to defund the organization, earning the greatest round of applause during her stint at the Iowa State Fair soapbox. (Meckler and Ballhaus, 8/18)
In the background, Planned Parenthood is trying to fight back against recent bad press -
After weeks of bad PR over videos of its executives discussing fetal tissue and organs, the group is unveiling a six-figure broadcast and cable ad buy Tuesday that will run in the states of four vulnerable Republican senators, according to details obtained by POLITICO. The lawmakers could be key to deciding whether a fight over the group鈥檚 funding triggers a federal government shutdown this fall. (Palmer, 8/17)
Planned Parenthood Federation of America appears to be gaining traction in its efforts to push back against videos targeting it and state efforts to cut its funding. The Center for Medical Progress, which released undercover videos that it says show Planned Parenthood illegally profits from the sale of fetal tissue to medical researchers, is now under investigation in two states over the videos. In addition, the Obama administration warned Alabama, Arkansas and Louisiana that they might be in violation of federal law after moving to choke off Medicaid funding to Planned Parenthood. (Armour, 8/17)
In addition, news outlets examine Ben Carson's positions related to abortion and his public statements about Planned Parenthood -
Ben Carson鈥檚 presidential campaign is surging on a wave of support from socially conservative voters inspired by his passionate talk about faith and his attacks on Planned Parenthood. But while Carson insists he鈥檚 a fierce opponent of abortion, he also defends a long series of actions on the issue that are sharply at odds with the beliefs of the very voters fueling his rise. (Glueck, 8/18)
We have delved before into the question of birth-control pioneer Margaret Sanger, eugenics and her attitude about African-Americans, during the 2012 election season when Herman Cain made similar remarks suggesting Planned Parenthood targets blacks. The 2011 fact check came under attack for allegedly sugarcoating Sanger鈥檚 record, in particular for some language on her paternalistic view of blacks that we later acknowledged was a 鈥減oor choice of words.鈥 Carson鈥檚 remarks are less inflammatory than Cain鈥檚, but the implication is similar: The claim is that Sanger (1879-1966), who founded what is now Planned Parenthood, was racist and Planned Parenthood thus has a deliberate policy of trying to 鈥渃ontrol鈥 the black population by placing 鈥渕ost of their clinics in black neighborhoods.鈥 (Kessler, 8/18)
Coverage And Access
Percentage Of Workers With Job-Based Insurance Declines, Federal Report Finds
Fewer employees worked for a firm that offers health insurance in 2014 and that insurance cost them more with higher deductibles, especially for family coverage plans, according to an annual report from the Agency for Healthcare Research and Quality. 鈥淐ontinuing a trend that began in 2008, the percentage of employees working in an establishment where insurance was offered fell from 84.9 percent in 2013 to 83.2 percent in 2014, a decline of 1.7 percentage points,鈥 said the report, the agency鈥檚 annual insurance component of its Medicare Expenditure Panel. Results are based on responses from 39,000 firms nationwide. (White, 8/17)
Also, a look at health law enrollment in Georgia -
More than 55,000 Georgians signed up for health insurance exchange coverage during a 鈥渟pecial鈥 four-month period through the end of June. This period came after regular open enrollment ended in February. (Miller, 8/17)
State Watch
Alaska Lawmakers To Consider Possible Challenge To Gov. On Medicaid Expansion
A joint Alaska House-Senate committee has scheduled a meeting Tuesday to examine whether the Legislature can challenge Gov. Bill Walker鈥檚 move to expand the Medicaid health care program. Walker announced last month that he was using his executive power to expand Medicaid after lawmakers rejected his attempts to do so during the legislative session earlier in the year. Walker, a Republican-turned-independent, made Medicaid expansion one of his key promises during his campaign for governor last year. (Herz, 8/17)
Montana is asking the federal Centers for Medicare and Medicaid Services, or CMS, to give it a waiver from regular Medicaid rules so the state can expand the government health program for children, the disabled and low income people on terms state lawmakers passed earlier this year. Representative Art Wittich, a Belgrade Republican, says the state's draft waiver application appears to leave out provisions requiring some recipients to work or look for work to continue receiving benefits. ... Wittich sits on a special oversight committee for Montana Medicaid expansion established in the new law that met Monday. Tara Veazey, the governor's health policy advisor assured Wittich the employment requirements in the bill will be part of Montana's waiver application, which it plans to submit in four weeks. (Whitney, 8/17)
In other news, Iowa is pushing forward on the governor's plan to add managed care to the state's Medicaid program.
Four national companies will take over management of Iowa's $4.2 billion Medicaid program under an overhaul that will affect how nearly one in five Iowans receives health care, state officials announced Monday. The Iowa Department of Human Services on Monday released the selection of Amerigroup Corp., AmeriHealth Caritas, UnitedHealthcare Plan of the River Valley and WellCare Health Plans. They are expected to administer services beginning Jan. 1 for the 560,000 children, low-income residents and disabled who are on Medicaid. (Foley, 8/17)
The Iowa Department of Human Services said Monday that four private firms will be awarded contracts to manage the state鈥檚 Medicaid health insurance program for 560,000 poor and disabled Iowans. ... State officials have not yet negotiated the contracts, said DHS spokeswoman Amy McCoy. But Gov. Terry Branstad鈥檚 administration has projected the use of private managed care will save $51.3 million from January through June 2016, its first six months. (Petroski, 8/17)
Planned Parenthood Seeks Emergency Injunction In Clash With Florida Regulators
With Congress in summer recess into September, anti-abortion officials in a number of Republican-controlled states are rushing to halt public funding for Planned Parenthood or to investigate it in reaction to hidden-camera videos claiming that it profits from fetal tissue sales. On Monday, Planned Parenthood of Southwest and Central Florida sought a judge鈥檚 emergency injunction against the state health agency, which did inspections ordered by the governor and cited three clinics 鈥 in St. Petersburg, Naples and Fort Myers 鈥 as illegally performing second-trimester abortions when they are licensed only for first-trimester procedures. The state used a new definition of gestational age, one that differs from that of medical societies. (Calmes, 8/17)
Planned Parenthood on Monday asked a judge to intervene in its ongoing dispute with Gov. Rick Scott and state health regulators over alleged violations of its licenses to perform abortions. The organization filed a lawsuit against the state Agency for Health Care Administration in response to citations it was issued Aug. 5 at three of its 16 Florida clinics. AHCA alleges that Planned Parenthood was illegally performing abortions in the second trimester of pregnancy when it was only licensed to serve first-trimester patients at its facilities in St. Petersburg, Fort Myers and Naples. (Auslen and Bousquet, 8/17)
Planned Parenthood sought an emergency legal injunction on Monday against Florida health officials to block the use of what it says are new and unpublished standards to define pregnancy gestation periods. The legal move filed in circuit court in Tallahassee came after Florida Republican Governor Rick Scott ordered a probe last month of the state's 16 Planned Parenthood locations, resulting in three clinics being cited on Aug. 5 for illegally performing abortions in the second trimester. (Adams, 8/17)
Planned Parenthood in Florida asked a judge Monday for an emergency ruling to allow them to continue performing abortions at 12 and 13 weeks after a discrepancy with the state about what constitutes first and second-trimester abortions. The request comes after state health officials recently inspected 16 Planned Parenthood facilities and said three were performing second-trimester abortions when they licensed to perform first-trimester abortions. (8/17)
State Highlights: Calif. Lawmakers Mull New Tax On Health Plans; Meeting Postponed Between Minn. Gov. And UCare
The debate over new taxes and fees 鈥 a dominant theme in the final weeks of the legislative session 鈥 kicked off Monday, with some Democratic lawmakers calling for a new tax on health insurance plans to pay for Medi-Cal and other social services. Assemblyman Marc Levine (D-San Rafael) touted his proposal to impose a flat tax on managed care organizations at a news conference, arguing that it would avert a plunge in funding from Washington for state-subsidized healthcare. (Mason, 8/17)
A meeting scheduled between Gov. Mark Dayton and the chief executive of Minneapolis-based UCare was postponed on Monday. UCare had sought the meeting to discuss ways the health insurer might be able retain a portion of business it stands to lose due to competitive bidding results announced in July. (Snowbeck, 8/17)
The compensation of chief executives at many of Massachusetts鈥 biggest teaching hospitals rose faster than overall health care spending in the state, boosted in some instances by payouts to retiring chief executives, according to filings submitted Monday with the Internal Revenue Service. (Dayal McCluskey, 8/18)
While Parkland satisfied many of the issues that threatened its federal funding, it remains under continued scrutiny by the federal government. The Dallas County public hospital is two years into a five-year corporate integrity agreement that has focused on billing problems and patient-safety concerns. (Jacobson, 8/17)
Graduate students employed by the University of Missouri will have a harder time paying for health insurance after MU told students Friday it is taking away subsidies that help with premium costs. MU Associate Vice Chancellor for Graduate Studies Leona Rubin said the change is the result of a recent IRS interpretation of a section of the Affordable Care Act. The law, which requires adults to have health insurance or face tax penalties, 鈥減rohibits businesses from providing employees subsidies specifically for the purpose of purchasing health insurance from individual market plans,鈥 the university said in a letter sent to students Friday. (Favignano, 8/16)
In this new role, paramedics augment existing programs like visiting nurse services and home care. They also treat patients who don鈥檛 meet home-nursing criteria or don鈥檛 want someone in their home all the time but still have complex needs, says David Schoenwetter, an emergency physician and head of the mobile health paramedic pilot program at Geisinger Wyoming Valley Medical Center in Wilkes-Barre, Pa., part of Danville, Pa.-based Geisinger Health System. (Landro, 8/17)
Sixteen years ago, Texas passed a new law that would be copied across the nation. The Safe Haven law, also known as the Baby Moses law, gives parents a safe and legal way to abandon a newborn and avoid prosecution if they drop the baby off at a fire station or a hospital emergency room. Since the original law was passed, a new breed of health provider known as freestanding emergency centers has emerged and quickly spread. In Texas, there are now more than 150 such centers, which provide emergency care but are separate from traditional hospitals. In a handful of instances in recent years, a person abandoned a baby at one of the centers, according to Brad Shields, executive director of the Texas Association of Freestanding Emergency Centers. In each case, Shields said the center alerted the proper authorities and gave the newborn proper medical attention. Still, the centers were uncomfortable with people assuming they were part of the Safe Haven program when they technically weren鈥檛. Since 2004, 79 newborns have been left with emergency providers under the state's Baby Moses law. (Batheja, 8/16)
Robert Brummel鈥檚 troubles began even before he left the Army in 2010. Then things went downhill when he became a civilian. And the 30-year-old Fenton resident can quickly rattle off the offenses that landed him in the criminal justice system: a third DWI, child endangerment, possession of a chemical substance with intent to alter and manufacture crystal meth. Then, his public defender referred Brummel to the new veterans treatment court in Jefferson County, and he says what had been a growing nightmare became 鈥渁mazing. I couldn鈥檛 ask for anything better. (Singer, 8/16)
Editorials And Opinions
Viewpoints: Rubio's Health Plan; Drop In Uninsured Levels Linked To Economy
[W]hen I am president, repealing and replacing ObamaCare will be an urgent priority of my administration. ... First, I will work with Congress to create an advanceable, refundable tax credit that all Americans can use to purchase health insurance. ... Second, I will reform insurance regulations .... Those with pre-existing conditions should have access to affordable care through mechanisms such as federally-supported, actuarially-sound and state-based high risk pools. Americans should be able to purchase coverage across state lines so they can seek out affordable coverage regardless of where they live. ... Third, I will take up the difficult work of saving and strengthening Medicare and Medicaid by placing them on fiscally-sustainable paths. ... We must move Medicaid into a per-capita block grant system .... While current seniors on Medicare, like my mother, should see no changes to the program, future generations should be transitioned into a premium support system. (Sen. Marco Rubio, R-Fla., 8/17)
Recent reports have touted a significant drop in the number of uninsured and generally credited Obamacare for it. ... As one headline put it, 鈥淎fter Obamacare Number of Uninsured Hits Five Year-Low.鈥 Now, this headline might be technically correct but it hardly gives us the proper impression for why the uninsured rate has dropped so low. ... more than half of the reduction in the number of people who are uninsured is coming from an old fashioned increase in the number of people being covered in employer health plans. You will recall that the Obamacare employer mandate was delayed during 2014 so we can hardly credit the big employer gains to that part of Obamacare. ... I will suggest those employer coverage gains could just as easily have more to do with a recovering economy and employment improvement. (Robert Laszewski, 8/17)
Critics of Medicaid expansion in Virginia who reference Kentucky鈥檚 experience with federal health care reform should beware: Our success undercuts your whole opposition. Having proved from the beginning that health care reform is both the right thing and the smart thing do, Kentucky has become the poster child for why states should expand Medicaid. ... Kentuckians鈥 collective health has long been among the worst in the nation, ranking at the bottom in almost every health category. That鈥檚 had a negative impact on our quality of life, workforce, economy and state government finances. Poor access to care is partly to blame. Back in 2013, we had about 640,000 people without health insurance. But health care reform has given us a transformative opportunity to attack this weakness. (Ky. Gov. Steve Beshear, 8/17)
[B]efore the ACA went into effect the very same people loudly insisted that expanding Medicaid was worthless, because instead of insuring more people it would mainly crowd out private insurance, making only a small dent in the number of uninsured Americans. ... maybe the Medicaid expansion has in some cases led people to drop the private coverage they would have had otherwise. But the number of uninsured has dropped sharply, especially in Medicaid expansion states. So if there was crowding out, it was more than offset by the expansion in private coverage due to the other features of Obamacare. (Paul Krugman, 8/17)
Obamacare is an important advancement in meeting our country鈥檚 moral and economic obligations to provide health insurance to all Americans and address our unbridled and unsustainable health-care system. It is simply inhumane in a wealthy industrialized country to deny individuals health coverage on any basis. Congress needs to stop the political rhetoric and start working together to fix the ACA鈥檚 flaws and the inequities experienced by its losers. (Richard Feldman, 8/17)
Since the voters of Oregon narrowly legalized physician-assisted suicide 20 years ago, there has been a profound shift in attitude toward medical care鈥攏ew fear and secrecy, and a fixation on death. Well over 850 people have taken their lives by ingesting massive overdoses of barbiturates prescribed under the law. Proponents claim the system is working well with no problems. This is not true. As a professor of family medicine at Oregon Health & Science University in Portland, as well as a licensed physician for 35 years, I have seen firsthand how the law has changed the relationship between doctors and patients, some of whom now fear that they are being steered toward assisted suicide. (William L. Toffler, 8/17)
Every day, new health care research findings are reported. Many of them suggest that if we do something 鈥 drink more coffee, take this drug, get that surgery or put in this policy 鈥 we will have better (or worse) health, or longer (or shorter) lives. And every time you read such news, you are undoubtedly left asking: Should I believe this? Often the answer is no, but we may not know how to distinguish the research duds from the results we should heed. (Austin Frakt, 8/17)
Recent news from West Africa that the number of new Ebola cases continues to fall and that an Ebola vaccine appears to provide protection against infection is heartening. But focusing only on these positive developments overlooks the huge challenges that remain. The West African epidemic, which has caused at least 11,298 deaths since it was first reported in Guinea in March 2014, is incredibly stubborn and has proved hard to control. With a grave shortage of health professionals in the region, the international community needs to remain committed to rebuilding health care systems in the wake of Ebola鈥檚 destruction. (Craig A. Spencer, 8/17)
The United States leads the world in creating new drugs, diagnostics, and other health care technologies. Some advances, such as oral rehydration therapy and the Haemophilus influenzae type B vaccine, have substantially improved health at modest cost. However, other technologies, such as prostate-specific antigen testing and robotic surgery, have increased spending without producing commensurate gains in health. Realigning incentives to encourage inventors and their investors to develop cost-lowering products could transform technology, which is currently one of the most potent drivers of health care spending in the United States, into a powerful creator of value. Once that is done, ingenuity will take care of the rest. (Arthur L. Kellermann and Nihar R. Desai, 8/17)