�鶹Ů��

Sen. Bernie Sanders' tax and spending proposals would provide new levels of health and education benefits for American families, but they'd also blow an $18-trillion hole in federal deficits, piling on so much debt they would damage the economy. That sobering assessment comes from a joint analysis released Monday by the nonpartisan Urban-Brookings Tax Policy Center and the Urban Institute Health Policy Center, well-known Washington think tanks. Democratic presidential candidate Sanders would raise taxes by more than $15 trillion over 10 years, with most of that paid by upper-income earners. But that wouldn't be enough to cover the cost of his proposed government-run health care system. (5/9)

Another analysis has found that Democratic presidential candidate Bernie Sanders' ambitious Medicare-for-all plan would not come close to raising enough revenue to pay for itself. The analysis by the Urban Institute's Health Policy Center and the Urban-Brookings Tax Policy Center found that federal expenditures under Sanders' plan would increase by $32 trillion from 2017 to 2026 while his revenue proposals would raise $15.3 trillion in the same time period. Both organizations are bipartisan. (Muchmore, 5/9)

The Tax Policy Center got it “half right,” a Sanders aide said in a statement. While the analysis found Sanders' plan would help low- and middle-income people even more than the campaign estimated, Warren Gunnels said the center “wildly exaggerated” the cost of Sanders’ health care plans. “This study significantly understates the savings in administration, paperwork, and prescription drug prices that every major country on earth has successfully achieved by adopting a universal health care program,” said Gunnells, Sanders’ policy director. “If every other major country can spend less on health care and insure all of their people, so can the U.S.” (Faler, 5/9)

At a campaign stop Monday in Northern Virginia, Hillary Clinton reiterated her support for a government-run health plan in the insurance market, possibly by letting let Americans buy into Medicare, to stem the rise of health-care costs. ... While Clinton long has supported including a public option in the insurance market, her campaign said she was floating the idea of letting Americans not yet of retirement age buy into the Medicare system as one way of accomplishing that. She's also open to creating a separate government-run option on the Obamacare exchanges. (Kapur, 5/9)

“Secretary Clinton’s proposal to let the American people buy into Medicare is a step in the right direction, but just like her support for a $12 minimum wage, it is not good enough,” Bernie Sanders says in statement to Bloomberg Politics. (Kapur, 5/9)

A Donald Trump administration is likely to prove as unorthodox as his campaign — and that extends to the health care realm. The presumptive GOP nominee has not named any advisers with notable health care policy experience, and few names have emerged as possible picks for top administration jobs — and some wouldn't want to serve a President Trump. But a few names are being floated as potential HHS secretary — particularly Ben Carson, given his medical pedigree and strong support for Trump. The other names in the ether: Florida Gov. Rick Scott, who rose to prominence as CEO of hospital chain Columbia/HCA, and former Louisiana Gov. Bobby Jindal, who held a top HHS post in the administration of George W. Bush and who was a sworn enemy of Obamacare while he was governor. All three have expressed support for Trump now that he's the presumptive nominee. (Demko, 5/9)

Demanding an end to "back room deals," former Gov. Steve Beshear is calling on Gov. Matt Bevin to include the public in his plans to reshape the state's expanded Medicaid program under the Affordable Care Act. Beshear, in a joint letter to Bevin and U.S. Health and Human Services Secretary Sylvia Burwell, also asks the federal government, which funds the majority of Kentucky's Medicaid costs, to disclose any changes sought through a "waiver" the federal agency must approve. (Yetter, 5/9)

While peaceful transitions of power are a longstanding U.S. tradition, the handoff in Kentucky from Democrat Steve Beshear to Republican Matt Bevin has been ugly. The two men have argued loudly over health care, voting rights, pensions and even the appointment of Beshear's wife to a state commission. Things were so tense recently that Bevin and Beshear both claimed the FBI was investigating the other. ... Ten days after Bevin was elected, Beshear held a news conference criticizing Bevin's plans to dismantle Kentucky's health insurance exchange and replace its expanded Medicaid program, both cornerstones of Beshear's legacy. (Beam, 5/10)

After another legislative session with no action on Medicaid expansion, advocates in Kansas are turning their attention to the upcoming state elections and urging voters to become more vocal on the issue. (Marso, 5/9)

A diverse group of activists gathered at the Capitol on Monday to chide Kansas lawmakers for failing to hold a hearing on Medicaid expansion before adjourning its 2016 session last week. ... “Can you imagine us turning down military funds, highway funds, some other federal funds to the tune of $1.1 billion?” asked physician Eric Voth, vice president for primary care at Stormont Vail Health in Topeka. Rep. Jim Ward, D-Wichita, who observed the event, said that unless the make-up of the Legislature significantly changes with the upcoming election, it’s unlikely efforts to expand Medicaid will gain more traction next legislative session. (Lowry, 5/9)

A coalition of business, faith and health interests convened Monday to launch an election-year campaign to build momentum for state approval of Medicaid expansion capable of delivering basic health care to 150,000 uninsured adults. Gov. Sam Brownback, House Speaker Ray Merrick and other Republican lawmakers have maintained a robust line of defense against attempts to extend a key Medicaid provision of the Affordable Care Act into Kansas. (Carpenter, 5/9)

The Utah Department of Health now is accepting public comments on a draft plan to expand Medicaid to 16,000 of the poorest Utahns. This small-scale Medicaid expansion, which targets the chronically homeless, mentally ill and those recently released from prison, takes effect Tuesday. However, the department doesn't expect to begin enrolling individuals until Jan. 1. The state's plan for expansion must be approved by the federal Centers for Medicare and Medicaid Services before it is implemented. The department plans to submit the waiver by July 1, but is accepting public comment on the draft first. (Stuckey, 5/9)

Spinal surgeons are more likely to perform surgery if they profit from the medical devices used in the treatment, according to a congressional study that recommends more safeguards to police such financial incentives. The report by Senate Finance Committee Republicans analyzes the trend in which doctors have ownership interests in commercial entities that act as intermediaries between medical-device makers and hospitals. The surgeons generally get a commission on each sale, which may lead them to perform excessive or unnecessary operations in order to steer business to themselves. (Armour, 5/9)

The House Energy and Commerce Committee Republicans can’t find most of the $200 million that the Obama administration claims it recouped from state-based health care exchanges as part of a federal grant program to help them set up shop, according to a new report obtained by Morning Consult. Centers for Medicare and Medicaid Services Acting Administrator Andy Slavitt told the committee in December that “over $200 million” had been returned to federal coffers from the state exchanges since the grant program went into effect. (Johnson, 5/10)

The National Governors Association is calling on Congress to quickly strike a deal on emergency funding to respond to the Zika virus, as the number of confirmed cases in the United States climbs to nearly 500. "The nation's governors urge the administration and Congress to work together to reach agreement on the appropriate funding levels needed to prepare for and combat the Zika virus," the governors said in a statement. (Ehley, 5/9)

Questions continue to swirl around Puerto Rico's $72 billion financial crisis as U.S. Treasury Secretary Jack Lew visited the territory Monday. Amid concerns about how the island's government can pay off the debt, officials are also worried about health implications. (Tam, 4/9)

A Connecticut teenager says she was shocked she tested positive for the Zika virus after learning she was pregnant. Sara Mujica, 17, of Danbury, said she found out she was pregnant in March while she was visiting Victor Cruz, her fiance and the baby's father, in Honduras. At the time of the pregnancy test, she said she was getting over an illness that gave her rashes, headaches and neck aches. She thought it was related to fish she had eaten, not Zika. (Collins, 5/9)

The first case of Zika has been recorded in Pinellas County, the state Department of Health said Monday. The person who contracted the virus had recently traveled to the Dominican Republic. (McGrory, 5/9)

Confused by your medical bills? Surveys say you’re not alone, and now a top federal health official wants to do something about it. Department of Health and Human Services Secretary Sylvia M. Burwell announced a challenge Monday to solicit new designs for medical bills to make them easier for patients to understand. (Levin Becker, 5/9)

There are few things as flat out baffling as a medical bill. And that matters more and more as many of us end up paying out of pocket to cover our health costs. But there’s a chance these pages of gobbledygook may soon do the unexpected and explain what we owe. (Gorenstein, 5/9)

Two years ago, when the federal government first released data on how much Medicare paid physicians, the media coverage was widespread. Doctors who earned significant sums were dubbed "Medicare millionaires" and journalists highlighted unusual patterns in how some doctors bill for services. When Medicare released its third round of data last Thursday, the coverage was practically nonexistent. In some ways, that's because data releases from the Centers for Medicare and Medicaid Services have become almost routine. (Ornstein, 5/9)

It's one more milestone in Medicare history that physicians probably don't want to celebrate. The program last week published online what individual physicians, nurse practitioners, physician assistants, and other clinicians received in fee-for-service (FFS) payments during 2014, the third annual data dump of its kind. The public-use data allow anyone to look up submitted charges and payments for Medicare Part B services and procedures by clinician. (Lowes, 5/9)

Doctors are learning valuable new lessons from past malpractice cases about mistakes that could put their patients at risk and expose them to lawsuits. Malpractice insurers and medical specialty groups are mining thousands of closed claims from suits that have been tried, dismissed or settled over the past few years. Their goal is to identify common reasons that doctors are sued and the underlying issues that threaten patient safety. They are sharing those insights with doctors and hospitals, which in turn are using them to develop new safety protocols and prevention strategies. (Landro, 5/9)

What’s healthier than a Pop-Tart? Not almonds, according to today’s regulatory rules. That could change as the Food and Drug Administration kicks off a review of the 1990s official definition of “healthy” at the urging of food companies and lawmakers. The regulator is planning to ask the public as well as food experts for comment on what should be the modern definition of healthy, setting off a process that could take years to complete. But the decision to redefine the term marks a major step in the FDA’s effort to catch up to changing ideas about health and eating habits. (Gasparro, 5/10)

A new study by researchers at the University of California at Davis Medical Center found that exercise increased the level of the neurotransmitters glutamate and GABA, both of which are depleted in the brains of patients with depression and anxiety. Neurotransmitters are chemical messengers that allow the brain to communicate with the body. Richard Maddock, a professor of psychiatry and behavioral sciences and lead author of the study, said he hopes the findings will encourage more doctors and patients to consider exercise as therapy for these two conditions. “It’s becoming more accepted, but there hasn’t been enough research in this area to make people confident.” (Loudin, 5/9)

America's opioid epidemic has had far-reaching and generally devastating consequences. Now, the impact is being seen in organ donations. Coinciding with a rise in drug-related deaths, the number of organ donors who died of drug overdoses has sharply increased in recent years — "a silver lining to what is absolutely a tragedy," Alexandra K. Glazier, president of the New England Organ Bank, recently told U.S. News & World Report. Last year, 848 organ donors died of drug intoxication, according to Organ Procurement and Transplantation Network data. And while such organ donors have become more common over the decades, the recent numbers show a staggering jump. (Izadi, 5/9)

This week, the House will vote on 15 bills related to opioid addiction, including one that will require the Centers for Disease Control and Prevention to provide educational materials to teenagers and adolescents injured while playing sports. The bills — which were introduced over several months — are being grouped together in response to the Comprehensive Addiction and Recovery Act, co-sponsored by Sen. Rob Portman, R-Ohio, which passed the Senate last month. The Senate bill offers grant programs that focus on both prevention of and recovery from opioid addiction. (Perkins, 5/10)

The center, located a half mile from the State House in Concord, does not provide treatment but rather recovery coaches to help connect people to addiction services. The non-profit has three recovery coaches on staff and expects to serve 20 to 30 people a week. Soon after Monday's ribbon-cutting ceremony, three people lined up to get help. (Sutherland, 5/9)

The Snohomish County Council on Monday voted to send a 0.2 percent sales-tax increase to voters in August to address what leaders called “an unprecedented heroin epidemic.” (Thompson, 5/9)

When Al Piazza learned he had prostate cancer, his first thought was, “Let’s get this out and be done with it,” he says. But his urologist, Jeremy Lieb, said the side effects of treatment could be more harmful than the cancer itself. Dr. Lieb ran a genetic test on the patient’s biopsy sample, which calculated that Mr. Piazza, then 70 years old, had only a 3% chance of dying from prostate cancer over the next 10 years if he left the tumor untreated. ... The procedure done on Mr. Piazza’s tumor sample, called Prolaris by Myriad Genetics, is one of several new prostate-cancer tests that aim to reduce detection and treatment of tumors that are likely to be harmless while still spotting those that are lethal. (Beck, 5/9)

African American lung cancer patients who live in low-income, segregated neighborhoods are less likely than their peers in more-affluent communities to get surgery that can add years to their lives, a study suggests. Compared with black patients living in the least-segregated areas, residents of the most-segregated communities were at least 60 percent less likely to receive surgery for what’s known as non-small-cell lung cancer, the most common form of the disease. A greater proportion of black patients than whites died during the study, and African Americans typically had fewer months of survival after their diagnosis, the study also found. (Rapaport, 5/9)

New Mexico officials are predicting they can shrink a state budget shortfall for Medicaid health care to $24 million if proposals go forward to reduce reimbursement rates to hospitals and physicians along with other accounting measures. (Lee, 5/9)

Medicaid managed by corporations has failed in two states, leaving advocates for the poor and disabled to warn Iowa: Don’t get hooked by flashy promises, unverifiable data and staunch ideologies. Their advice surrounding Iowa’s new Medicaid management system is for public and state officials to aggressively monitor results, insist on transparency and don’t be afraid to fire the for-profit networks if standards aren’t met. (Clayworth, 5/9)

Memorial Hospital and BJC HealthCare are seeking approval to build a $22 million medical office building next to the new Memorial Hospital East in Shiloh. (Liss, 5/9)

In a rare loss for the Federal Trade Commission in a hospital merger case, a federal judge declined Monday to temporarily block a union between Penn State Hershey Medical Center and PinnacleHealth System. The ruling is an unusual setback for the FTC, which has otherwise prevailed in a string of cases against hospital mergers in recent years. Hospitals and insurers across the country have been watching the Pennsylvania case and several others as mergers continue to proliferate. The loss comes as the FTC pursues an injunction in a hospital merger case in the Chicago area between Advocate HealthCare and NorthShore University HealthSystem. (Schenker, 5/9)

Florida Hospital is opening a multidisciplinary practice for heart failure patients to reduce their odds of returning to the hospital and to improve their care. (Miller, 5/9)

A labor dispute involving doctors at New Hampshire Hospital could jeopardize whether the state-run psychiatric facility in Concord has a complete medical staff in place this summer. (Morris, 5/9)

A judge on Monday allowed Boston Children’s Hospital to move ahead with a controversial project to construct a new clinical building over a healing garden beloved by many patients, their families, and hospital employees. (Dayal McCluskey, 5/9)

Little Davette, now 2 and still a bit small for her age, spent the the first two months of her life in a hospital with a rare set of birth defects that, among other things, caused her to be born without thumbs. (Benoit, 5/9)

All things considered, Erika and Tony Kuzera spent a comfortable night together in their suite at NorthShore Highland Park Hospital. It was their first one together as a family following the arrival of son Cameron Anthony at 3:26 a.m. on May 3. (Berkowitiz, 5/9)

The state says it inadvertently released the protected health information of thousands of Ohioans who received mental health services. Ohio's Department of Mental Health and Addiction Services says the breach happened in February when the agency mailed postcards inviting patients to participate in a satisfaction survey. The information included patients' full names and addresses — not mental health conditions, any services received or information that could lead to identity theft. However, by requesting participation in the survey, the postcards disclosed that recipients had received mental health or addiction treatment. (5/9)

Enrique Camacho says his 22-year-old autistic son “looks practically normal,” but functions at the mental level of a two- or three-year–old. ... As a result, Camacho must watch his son, Francisco, full-time, and gets paid $10 per hour through In-Home Supportive Services (IHSS), a publicly financed program that helps some low-income elderly and disabled people receive care at home. Starting next year, Camacho’s pay will rise because of a new California law that gradually increases the minimum wage. It will be $15 an hour by 2022 for businesses with more than 25 employees, and the same amount by 2023 for smaller workplaces. The current minimum wage of $10 per hour took effect in January. ... The roughly 400,000 IHSS caregivers in California, like Camacho, are among a larger number of home care workers who will benefit from the law. (Bazar and Gorn, 5/10)

KidsCare, the health-care safety net for children, found its own safety net in the final days of the legislative session. Its prospects were promising early in the year, when lawmakers returned to the Capitol full of ambition for great accomplishments in an election year. The federal government was offering the program at no cost to the state, with full funding assured through 2017 and the prospect of another two years after that. With the state entering its sixth year of a freeze in KidsCare enrollment, and the label as the only state without an active children's health-insurance program, the time seemed ripe to bring the program back. (Pitzl, 5/9)

Which standards should state government use to alert people that their drinking water is unsafe? In the wake of increased scrutiny to coal ash ponds, this question has gone from affecting some North Carolinians to affecting us all. (Clabby, 5/9)

Kansas parents do a better-than-average job at getting vaccinations for their young children but don’t fare as well once those children reach their teen years. (Hart, 5/9)

After Justin Richard sustained a spinal cord injury in 2003, he spent three months in a rehabilitation facility, re-learning how to do the basics. ... During that process, Richard said occupational therapy was perhaps the most important part of his rehabilitation. (Hoban, 5/9)

The Food and Drug Administration will decide this month whether to approve an innovative drug for a fatal form of muscular dystrophy, and one question is whether the agency’s management will rebuke the dubious science propagated by its staff reviewers. Here’s another: Will FDA defy a law that directs the agency to pick up the pace on treatments for rare diseases? Eteplirsen by Sarepta Therapeutics produces dystrophin, the protein missing in boys with Duchenne muscular dystrophy, a condition that destroys every muscle in a decline from walking to wheelchair to death. Eteplirsen shows zero safety risks and four years of striking results in a clinical trial of 12 boys. FDA reviewers assert that the study is too small and maybe the drug doesn’t work, though Duchenne experts world-wide say otherwise. (5/9)

This FDA advisory panel ... heard from an entire community of parents whose kids have Duchenne, who are seeing them improve, who know these kids better than any scientist, any doctor, any panelist at the FDA — and who begged for the drug to be approved. The committee, sadly, ruled against the drug. It did so because it essentially applied the same standard to this drug as it would to one designed to treat a much more common disease. (Marco Rubio, 5/9)

Recent headlines telling us that medical errors are now the third leading cause of death deliver as much “news” as headlines telling us that Bill Clinton was the 42nd president of the United States. While the report in the BMJ — and the press release promoting it — sounded like researchers were on to something new, they were merely reminding us of old data. (Vinay Prasad, 5/9)

An estimated 20 million people have gained insurance since health care reform was signed into law in 2010, but in the six years since, a significant group of Americans remain uninsured. (Lara Cooper, 5/10)

You might think that people enrolled in the Affordable Care Act’s marketplace plans would like their coverage more or less depending on whether they have a high or low deductible, or receive a subsidy to help them pay their premium. Those factors and other elements of their coverage matter, but by far the biggest difference between those in marketplace plans who say they have benefited from the ACA or been negatively affected by it is whether they are a Republican or a Democrat. That’s one finding from an analysis of a Kaiser Family Foundation survey of people covered in the non-group insurance market, which provides the clearest illustration I have seen yet of how partisanship colors people’s views of the ACA. (Drew Altman, 5/10)

Donald Trump, the new presumptive Republican nominee for President, has been vocal about his issues with the Affordable Care Act (ACA). He has specifically pointed to the increasing price of premiums as a huge problem facing exchange customers. To anyone following news surrounding the ACA marketplaces, Mr. Trump’s words are not breaking news. While his claims may sometimes be exaggerated, it’s impossible to deny the cost of plans is on the rise. (Robert Harrow, 5/9)

Sen. Bernie Sanders has proposed paying for his proposals to transform large sectors of the government and the economy mainly through increased taxes on wealthy Americans. A pair of new studies published Monday suggests Sanders would not come up with enough money using this approach, and that the poor and the middle class would have to pay more than Sanders has projected in order to fund his ideas. The studies, published jointly by the nonpartisan Tax Policy Center and the Urban Institute in Washington, concludes that Sanders's plans are short a total of more than $18 trillion over a decade. (Max Ehrenfreund, 5/9)

The nation could have saved an estimated $73 billion from 2010 to 2012 if clinicians had more frequently prescribed alternatives to brand-name drugs, a JAMA Internal Medicine study finds. The total out-of pocket savings for patients would have been about $25 billion. Researchers aimed to put a price tag on how much money could be saved overall and out-of-pocket through the use of generic drugs and “therapeutic substitutes.” The latter term describes prescription drugs for which no generic equivalent exists, but for which there is an equally effective alternative within the same drug class. (Sabriya Rice, 5/9)

Over the past 60 years, since the first kidney transplant was performed in Boston in 1954, there have been astonishing advances in the field. ... But there is a problem: Demand for organ transplants vastly outstrips supply. ...What could be done to harness people’s generous impulses more effectively to save lives? One group attacking the question is Organize, which was founded in 2014 by Rick Segal’s son Greg, and Jenna Arnold, a media producer and educator who has worked with MTV and the United Nations un engaging audiences in social issues. Organize uses technology, open data and insights from behavioral economics to simplify becoming an organ donor. This approach is shaking up longstanding assumptions. (David Bornstein, 5/10)

Gov. John Kasich’s expansion of Medicaid through Obamacare provided health-care coverage to about 640,000 poor Ohioans. Now, an estimated 130,000 people stand to lose that coverage through the legislature’s misguided “Healthy Ohio Program.” (5/10)

It's a question that grows in importance with each new report of a data breach: How much responsibility should companies take for protecting people's privacy? The most common response when a corporate database gets hacked is for the business to offer a year of free credit monitoring -- a better-than-nothing measure that will alert people to suspicious activity involving their credit files but will do nothing to prevent fraud, identity theft or other mischief. West Los Angeles resident Jairo Angulo and his wife were among nearly 80 million current and former Anthem health insurance policyholders whose personal information was reported hacked last February. (David Lazarus, 5/10)

Adherents to a broad spectrum of ideologies can find encouraging statistics in the latest round of reports on teen births and teen pregnancies. The Centers for Disease Control reported last month that the national teen birth rate hit an all-time low in 2013-14. Teen pregnancies – the sum of teen births, miscarriages and abortions – are also at historic lows. (5/10)

As a physician who retired early for health reasons, I heard echoes of those same voices complaining from all 35 years of my active practice. I remembered all the talk of physician burnout and threatened early retirement when I, too, first excitedly started my practice in 1982; at that time, it was HMOs and malpractice insurance premiums that were the chief complaints.Being a physician is an emotionally taxing job, one that demands personal management of the stresses of illness and death every day. But the work-life balance of a primary care physician has never been better, especially for a physician working for a large corporation such as Carolinas Healthcare System. (Dr. John Scherr, 5/9)