�鶹Ů��

Hillary Clinton said on Friday that if elected to the White House she would create an oversight panel to protect U.S. consumers from large price hikes on long-available, lifesaving drugs and to import alternative treatments if necessary, adding to her pledges to rein in overall drug prices. Clinton, the Democratic presidential candidate, would seek to give the panel an "aggressive new set of enforcement tools," including the ability to levy fines and impose penalties on manufacturers when there has been an "unjustified, outlier price increase" on a long-available or generic drug, her campaign said. (Becker and Pierson, 9/2)

Clinton's plan is carefully delineated to target "excessive, outlier" price hikes on "long-standing" treatments that haven't had any major improvements and have little or no competition. That's a clear attempt to reassure the pharmaceutical industry that government intervention won't squelch the development of new, pricey treatments. According to the campaign, the initiative will be focused on drugs without patent protection. (Johnson, 9/2)

Clinton proposed creating a federal consumer oversight body that would investigate and respond to price hikes of older drugs with limited competition, as was the case with Mylan's EpiPen. The board could wield enforcement power when it determines a price increase is unjustified. Offending companies would be fined or charged increased rebates. That money would be used to support new programs to make lower-cost alternatives available and increase approval of competing treatments. (Karlin-Smith, 9/2)

At first blush, this is scary talk for investors. Any action to curb price increases on older drugs would hurt manufacturers that rely on them to generate growth. But their share prices already have taken a beating over the past year. In addition, the plan offers familiar solutions such as enabling Medicare to negotiate drug prices and eliminating tax deductions for drug advertisements directed at patients. Those policies, if enacted, would have a more comprehensively negative effect on the industry. Yet a closer look suggests that scenario is unlikely to come to pass. For instance, Mrs. Clinton’s plan notes the need to “ensure that there are proper incentives for real innovations that bring effective products to market.” (Grant, 9/2)

On Friday, Hillary Clinton called for creation of a government commission with the power to compete with or penalize pharmaceutical companies like Mylan, Valeant and Turing that jack up the prices of lifesaving drugs that have been on the market for years. (Pianin, 9/2)

Democratic presidential candidate Hillary Clinton, acting on her pledge to curb what she has called outrageous drug costs, outlined a set of proposals to crack down on “unjustified” increases on prices for older treatments. The plan adds to a year of attacks against pharmaceutical firms that have hiked the prices of life-saving treatments, including the outcry over Mylan NV’s EpiPen emergency allergy shot. The measures, released Friday on the candidate’s website, would give the U.S. government a broader role in determining the correct price for some drugs, a task that’s typically been off limits for federal regulators. (Cordeiro and Tracer, 9/2)

At first glance, it may sound like Hillary Clinton's plan is an attempt to tackle drug prices overall. It's not. Clinton economic policy advisor Mike Shapiro said it's to go after an insidious problem where a subset of drug makers (think Turing and Mylan) crank up prices on generics, just because they can. (Gorenstein, 9/2)

Two key U.S. congressional committee members on Friday called for an investigation into whether Mylan NV, under fire for raising the price of its EpiPen device, overcharged the government's low-income healthcare program for the allergy treatment. In a letter to the secretary of the Department of Health and Human Services, Senator Ron Wyden and Representative Frank Pallone, both Democrats, seek clarification of whether EpiPen was classified as a generic, "non-innovator" drug, or a brand-name drug by the Medicaid program. (Beasley, 9/2)

Two Democratic congressmen are raising questions about whether Mylan NV, the company facing backlash for raising the price of its EpiPen device, overcharged the government's Medicaid program for the allergy treatment. Sen. Ron Wyden (D-Ore.) and Rep. Frank Pallone (D-N.J.) wrote a letter to the secretary of Department of Health and Human Services asking for clarification on whether EpiPen was considered a generic, "non-innovator" drug, or a brand-name drug by the Medicaid program, according to Reuters. (Hellmann, 9/3)

Two top Democratic lawmakers asked for information about how Mylan NV may have grossly underpaid rebates to a government health program for its EpiPen allergy shot for almost two decades, adding to the growing number of inquiries about the drugmaker’s pricing practices. (Edney, 9/2)

Consumers and Congress members pushing for cheaper alternatives to the EpiPen and other high-priced drugs are seeking answers about a stubborn backlog of generic drug applications at the Food and Drug Administration that still stretches almost four years. As of July 1, the FDA had 4,036 generic drug applications awaiting approval, and the median time it takes for the FDA to approve a generic is now 47 months, according to the Generic Pharmaceutical Association, or GPhA. The FDA has approved more generics the past few years, but a flood of new applications has steadily added to the demand. (Lupkin, 9/6)

Several House Republicans in Florida say they’re willing to concede defeat in their party’s months-long battle over Planned Parenthood if that’s what it takes to pass a $1.1 billion funding package for the Zika virus. With Zika spreading rapidly in south Florida, even some of the most conservative members of Congress say GOP leaders should strike a deal with Democrats to get emergency money to their home state. (Ferris, 9/3)

Florida Gov. Rick Scott (R), who expected to make a pitch to Congress for Zika funding on Tuesday, has cancelled his trip. In a statement Monday, the governor’s office said Scott will stay in Florida to continue monitoring response efforts to the damage caused by Hurricane Hermine, which hit Florida on Friday. The office said Scott’s previously scheduled trip to Washington, D.C., will be rescheduled for a future date. (Wheeler, 9/5)

A prominent abortion rights group is attacking Marco Rubio over his opposition to abortion rights for women infected with the Zika virus. NARAL Pro-Choice America is spending $175,000 to air a TV ad in Orlando and West Palm Beach targeting the vulnerable incumbent starting Monday, according to a source familiar with the buy. While the Republican senator has voted for every Zika funding proposal to come through the Senate, the GOP majority has failed to approve new emergency spending to combat the mosquito-borne disease. (Everett and Gass, 9/6)

As the Zika virus spreads both at home and abroad, new information is bringing to light how children — even those who at birth do not show obvious signs of impairment — are likely at a greater risk than previously believed. This possibility, experts say, is highlighting a need to better track the development and well-being of babies who may have been exposed to the virus in utero. (Luthra, 9/6)

For weeks, Florida Department of Health officials have said Zika test results will be available to patients in one to two weeks. In fact, as recently as Thursday afternoon, the department's daily Zika update gave the one- to two-week timeline. But in a town hall Thursday night, a department representative said results are actually taking much longer. (Stein, 9/5)

Key Biscayne Presbyterian Church hosted a public forum last night to inform residents about the Zika virus. Dr. Aileen Marty is a professor of infectious diseases at Florida International University. She led the discussion and answered questions about Zika prevention. (Kranz, 9/5)

While the recent arrival in the U.S. of the Zika virus is getting most of the attention, public health experts consider West Nile to be a much more potent threat in California than Zika will ever be. (Cockerham, 9/5)

Progress in reducing the number of people without health insurance in the U.S. appears to be losing momentum this year even as rising premiums and dwindling choice are reviving the political blame game over President Barack Obama's health care law. The future of the Affordable Care Act hinges on the outcome of the presidential election, and it's shaping up as a moment of truth for Republicans. (Alonso-Zaldivar, 9/6)

Blue Cross Blue Shield is lobbying Congress this summer to protect an ObamaCare insurer fund that Republicans have called a “bailout” for companies. The corporation — which insures more than 100 million people nationwide — is distributing a memo to lawmakers warning against some GOP attempts to block the money from going to insurers this fall. (Ferris, 9/2)

Iowa Insurance Commissioner Nick Gerhart can hardly believe he’s giving some consumers this advice: If you can’t find an affordable, full-fledged health insurance policy, he tells them, maybe you should consider going without one.The Affordable Care Act started requiring most Americans to have health insurance in 2014. But the law offers an exemption for people who can’t find policies that would cost them less than about 8 percent of their household incomes. With premiums on some Iowa policies set to jump by as much as 43 percent next year, more consumers could be eligible for the rarely discussed exemption, Gerhart said in an interview this week. (Leys, 9/2)

Most Connecticut health insurance plans sold through individual and small group markets will undergo steep rate hikes next year, although in some cases, the prices will not go up by as much as carriers had sought. (Phaneuf and Levin Becker, 9/2)

Premiums for 14 Affordable Care Act plans — both eligible and ineligible for federal tax subsidies — will increase an average of 19.1 percent in 2017, the state Office of Insurance Regulation announced in a statement released shortly after noon on Friday. But how many Obamacare consumers will actually pay 19.1 percent more next year is open to interpretation. Within an hour of the state's news release came a rebuttal from the federal Department of Health and Human Services, which administers and promotes Obamacare. (Hurtibise, 9/2)

Health insurance rates in Florida are going to jump next year by an average of 19 percent. These are the rates for health insurance plans individuals can buy in Florida. The rates were released by the Florida Office of Insurance Regulation. People buying health insurance on the Obamacare exchange could be eligible for premium tax credits to make them cheaper. (Aboraya, 9/5)

Consumers don't need to use antibacterial soaps, and some of them may even be dangerous, the Food and Drug Administration says. On Friday, the FDA issued a rule banning the use of triclosan, triclocarban and 17 other chemicals in hand and body washes, which are marketed as being more effective than simple soap. Companies have a year to take these ingredients out of their products or remove the products from the market, the agency said. (Kodjak, 9/2)

The antibacterial ingredients found in many hand soaps will be banned from sale in the U.S. under a new Food and Drug Administration rule meant to curb unintended effects, such as bacterial resistance or affecting hormone levels. The 19 ingredients banned by the rule, including triclosan and triclocarban, will be prohibited from soaps, but not from hand sanitizers, wipes or products used in health-care settings such as a doctor’s office. Animal studies have show that triclosan alters the way some hormones work, the FDA said. (Armstong, 9/2)

The Food and Drug Administration is cracking down on antibacterial hand soap. The FDA on Friday announced a ban on 19 ingredients that are found in the “vast majority” of antibacterial hand soaps. Manufacturers will have one year to either remove the ingredients or stop selling the products. The ban does not apply to hand sanitizers. (Devaney, 9/2)

Hundreds of clinics around the country are offering to treat a long list of health problems with stem cells. The clinics claim that stem cells found in fat tissue, blood, bone marrow and even placentas can help people suffering from arthritic joints and torn tendons to more serious medical problems, including spinal cord injuries, Parkinson's disease and strokes. Some even claim the cells can help children with autism. But leading stem cell researchers say there's not enough evidence to support the clinics' claims. (Stein, 9/5)

Mr. Hatmaker became one of more than 200 people to overdose in the Cincinnati area in the past two weeks, leaving three people dead in what the officials here called an unprecedented spike. Similar increases in overdoses have rippled recently through Indiana, Kentucky and West Virginia, overwhelming ambulance crews and emergency rooms and stunning some antidrug advocates. ... In Cincinnati, some medical and law enforcement officials said they believed the overdoses were largely caused by a synthetic drug called carfentanil, an animal tranquilizer used on livestock and elephants with no practical uses for humans. ... Experts said an amount smaller than a snowflake could kill a person. (Healy, 9/5)

He found the woman slumped over the steering wheel, an empty syringe on the floorboard and her skin dulling to a purplish blue. Dave McClure, an EMS supervisor, counted four faint breaths per minute. Without the antidote he carried, she'd be dead in five minutes. It was 3:25 p.m. on what was, so far, an ordinary Monday. For an EMT in this struggling city, bringing an addict back from the brink of opiate-fueled death counts as routine. But as McClure searched for an unscarred vein in the young woman's arm, dozens of others were shooting or snorting the same toxic powder she'd just taken. (9/4)

Cincinnati officials on Friday announced new plans to fight heroin in the aftermath of an unprecedented spike in overdoses in the area. Mayor John Cranley says the city wants to expand efforts to keep users alive and get them into treatment. The city is working with Ohio Gov. John Kasich, and the state has shipped more overdose-reversing naloxone. (Sewell, 9/2)

Law enforcement, health professionals and addiction specialists from around the country will convene in Minnesota next week to talk about ways to address the growing number of deaths from heroin, prescription painkillers and other opioids. The two-day conference, beginning Wednesday, will also address the emerging problem of fentanyl, a powerful synthetic opioid that's blamed for a surge of deaths in some parts of the country — including the April 21 overdose death of Prince at his suburban Minneapolis home.  (9/2)

Prescription databases are playing an increasingly useful role in the battle against the U.S. opioid epidemic, federal and state officials say. A number of states are analyzing the data to probe doctors for practices that could jeopardize their medical licenses. Nationally, the number of opioid prescriptions fell by about 12% from 2012 to 2015, according to drug-research firm IMS Health, though last year’s total was still 39% higher than the total in 2000. At the same time, the abuse of heroin and other illicit street drugs has skyrocketed in the U.S. in recent years. (Calvert and Campo-Flores, 9/2)

The United States and China on Saturday agreed to work together to combat the flow of fentanyl and other related drugs coming into America from China. Fentanyl is more potent than even heroin, and its influx has led to overdoses and deaths in parts of the country already ravaged by heroin and prescription painkillers. (Scott, 9/3)

The Obama administration on Saturday announced new “enhanced measures” it will take with China to potentially stem the U.S.-bound flow of fentanyl, the powerful narcotic drug linked to the deaths of thousands of Americans in the past several years. The steps—which included a Chinese commitment to target exported substances that are controlled in the U.S., but not China—also cover drugs that are analogues of fentanyl. (Kamp, 9/3)

Jessie Quinn of Sacramento was 36 years old when loss of appetite, weight loss, some eye issues and finally pelvic pain sent her to the emergency room in 2010. Tests quickly revealed she had acute myeloid leukemia — a type of blood cancer that progresses quickly — and doctors told her that chemotherapy would probably not be enough; she would need a bone-marrow transplant. Quinn, who has a science background, knew that finding a donor would be difficult. In college, she had donated to a bone-marrow registry after learning that people like her, with a mixed racial heritage, have a much harder time than others finding a match. (Berger, 9/5)

A cancer diagnosis doesn’t automatically lead to an overhaul of unhealthy habits, says a study in the Journal of Cancer Survivorship. People who had survived various cancers had similar rates of physical inactivity, unhealthy eating habits and other risky health behaviors as people not diagnosed with cancer, the study found. Some habits, such as smoking, were more prevalent among survivors, particularly women. (Lukits, 9/5)

A new class of drugs could be a significant step forward in the treatment of ovarian cancer, one of the most lethal forms of the disease. The drugs, known as PARP inhibitors, are thought to help the body slow the disease’s progression by helping to prevent cancer cells from repairing themselves after chemotherapy treatment, thereby shrinking tumors and delaying relapses. (Walker, 9/5)

Loneliness not only feels nasty, it can also make you depressed, shatter your sleep, even kill you. Yet scientists think loneliness evolved because it was good for us. It still is — sometimes. There is plenty of evidence to suggest that being lonely ruins health. In one recent study, the risk of dying over a two-decade period was 50 percent higher for lonely men and 49 percent higher for lonely women than it was for those who did not experience feelings of isolation. According to some research, loneliness may be worse for longevity than obesity or air pollution. Yet according to scientists such as John Cacioppo, a neuroscientist at the University of Chicago, loneliness has evolved to protect us. (Zaraska, 9/4)

Researchers with the Durham Veterans Affairs Medical Center in North Carolina recently tracked the progress of 1,787 veterans who underwent gastric bypass surgery. They found that one year after surgery patients lost 98 pounds on average. Ten years later they gained back only about 7 pounds. Earlier studies have tracked gastric bypass patients for relatively short periods of time, about 1 to 3 years. That has led to the assumption that most people who have gastric bypass surgery will eventually regain the weight. (Neighmond, 9/5)

Last week, pediatricians cheered as their professional organization boldly confronted the growing problem of vaccine "hesitancy." For the first time, the American Academy of Pediatrics called on states to get rid of nonmedical exemptions for vaccines, and said it is "acceptable" for physicians to show the door to families who reject this bedrock approach to disease prevention. (McCullough, 9/5)

Nearly 5,000 nurses took to the picket lines on Monday — Labor Day — as they began an open-ended strike at five Twin Cities hospitals operated by the Allina Health system. The strike follows a 22-hour negotiation session that stretched from Friday into Saturday morning but failed to produce an agreement between the Minnesota Nurses Association and Minneapolis-based Allina. “We should be at a Labor Day picnic, and here we are at a Labor Day picket instead,” MNA executive director Rose Roach said at a Monday news conference outside Abbot Northwestern Hospital in Minneapolis. (Cooney, 9/5)

The second strike this summer by more than 4,000 Allina Health nurses started like the first — with a bagpiper serenading the pickets at 7 a.m. Monday at Abbott Northwestern Hospital in Minneapolis, and cheers rising as bleary-eyed nurses finishing overnight shifts emerged from the hospital. And yet this walkout felt very different to the picketing nurses. The June strike lasted seven days; this one, they say, won’t end until a deal is reached. (Olson, 9/6)

Thousands of nurses at five Minnesota hospitals went on strike today in a dispute over health insurance, workplace safety and staffing levels. Here's a look at some of the issues. (Benson and Karnowski, 9/4)

Although Truvada was approved as a preventive drug four years ago, less than one-tenth of those who could benefit from it take the drug. The need is greatest among blacks and Latinos, who are disproportionately affected by AIDS, and gay men under 30, whose rates of infection are growing. That’s why Massachusetts public health officials recently started a project with AIDS service agencies and health centers, testing ways to bring PrEP into wider use. That effort got a boost last week when the Planned Parenthood League of Massachusetts started offering PrEP to its patients, men and women. (Freyer, 9/6)

Whether you're looking at chronic conditions, sexually transmitted diseases or other maladies, Baltimore has some of the worse health outcomes in the state and the nation. City data shows 19 percent of Baltimore residents have asthma, while statewide it's 14 percent; 30 percent of children are obese, compared with 15 percent statewide; 30 percent of city kids have had at least two traumatic childhood experiences, versus 19 percent statewide. (Cohn, 9/3)

People living in Northeast Texas are more likely to die from heart disease, cancer, stroke and lower respiratory conditions than people living in other areas of the state, a recent report finds. It’s not the first study to explore the widening gap in health care outcomes between rural and urban areas of the state.  But the authors say the magnitude of the disparities suggest that limited access to clinicians and health insurance are not the sole issues spurring the differences. (Rice, 9/2)

No matter which way you count, the number of Texas women dying after they have babies or unsuccessful pregnancies is on the rise.Two new studies detailing the disturbing trend have prompted soul-searching from state policymakers and outcry from women’s health advocates, who argue that cuts by the state’s Republican-led Legislature to Planned Parenthood and other women’s health programs are at least partially responsible for the increase. (Walters, 9/4)

For more than a decade, doctors at Detroit Medical Center lodged complaints about surgical instruments. Some were dirty or broken, they said. Others were missing altogether. Now both the CMS and the state of Michigan are investigating the claims, which were aired in a newspaper account late last month. No matter what investigators find at DMC, unclean surgical instruments and other medical devices are nothing new. (Whitman, 9/3)

In the 10 years since it was formed by a $10.6 billion merger, Thermo Fisher Scientific Inc. has turned in some impressive numbers. The world’s largest supplier of laboratory products and services has bought more than a dozen smaller companies. Revenue has doubled to a projected $18 billion in 2016. Employment has grown from 30,000 to 55,000, including 1,930 in 13 offices in Massachusetts. And annual research and development outlays have increased from $300 million to more than $700 million. (Weisman, 9/5)

[Marco] Tapie’s mother, Maria Garaitonandia, asked state disability administrators two years ago for help in caring for Tapie, now 23, and too strapping for his mother to control him when his rare form of epilepsy sends him into paroxysms of unintended motion. The Agency for Persons with Disabilities refused, saying the young man failed to meet eligibility for a program that serves disabled Floridians in their homes or communities. But late last month, a Miami appeals court said the disabilities agency, or APD, cherry-picked diagnostic tests in an effort to avoid caring for Tapie, and ordered the state to enroll him into its community-based care program. (Miller and Harris, 9/3)

Mental health workers are joining Denver police on foot and in their patrol cars to help handle calls involving people in mental health crisis, a new program aimed at getting people into treatment instead of sending them to jail. The six social workers and clinicians are employees of the Mental Health Center of Denver but work at Denver police headquarters through the partnership, called the “co-responder” program. The $500,000 initiative, funded through grants and other money from Denver Human Services, is part of the city’s crisis intervention and response unit specializing in mental and behavioral health calls. (Brown, 9/2)

As police forces across the country re-evaluate their practices regarding encounters with people with mental health problems, Minneapolis authorities are considering an approach that might seem to fly in the face of conventional policing wisdom: Stand down, and leave it to the professionals. Under a recently announced pilot program, city police officers would be paired with mental health specialists on emergency calls involving such problems. Officials hope the tactic, already in use by departments in Houston, Los Angeles and Madison, Wis., will lead to more peaceful resolutions and decrease the likelihood of jail time — or physical encounters. (Jany, 9/6)

Cleveland's public health department has asked the Ohio Department of Health (ODH) to officially close 38 percent of the city's backlog of thousands of unresolved lead poisoning cases. The request to the state, sent Wednesday, is the first of its kind in the nine months city officials have spent working through the cases, some of which date back more than a decade. (Dissell and Zeltner, 9/5)

Unlike at many hospitals, the medical team at Hospital of the University of Pennsylvania's surgical intensive care unit has embraced the idea of including families in physician rounds. That helps families form realistic expectations and helps the staff get to know patients who are often too sick to talk, said Daniel Holena, a Penn surgeon who specializes in critical care, trauma, and emergency surgery. But distance and work responsibilities can make it difficult for some family members to be physically in the hospital when teams discuss patients. (Burling, 9/5)

It’s long been a problem for the nation’s hospitals: A staggering number of medical supplies — from surgical gloves to sponges to medications — go unused and are discarded after surgeries. A recent study by researchers at the University of California, San Francisco has put a price tag on that waste: almost $1,000 per procedure examined at the academic medical center. (Ibarra, 9/6)

Counting on the growing public outrage over the soaring costs of prescription drugs -- and bolstered by the recent fury generated by huge price hikes for lifesaving EpiPens -- Proposition 61 proponents are gearing up for one of the most highly anticipated ballot measure showdowns this election season. (Seipel, 9/5)

A Kent woman with a rare genetic condition that caused her teeth to break and crumble to the gum line has a bright new smile — thanks to what one doctor likens to winning a lottery for dental care. ... Last month, her struggle ended — because she won a contest sponsored by a Renton oral-surgery practice. Coleman received about $56,000 worth of free care, including removal of her old teeth and a set of full-mouth dental implants. (Aleccia, 9/2)

Medical marijuana will be legal in Ohio on Thursday. But for most of those with debilitating conditions covered under the new law it will mean nothing – except more waiting. It could be as long as two years before medical marijuana is sold here, before doctors who want to recommend it will know how to proceed, before the state medical and pharmacy boards and the commerce department will have all of the rules in place. (DeMio, 9/2)

Minnesotans seeking pain relief have quickly become the second-largest group of patients in the state’s medical marijuana program, even though they became eligible just one month ago. One out of three patients enrolled in the program is seeking relief from chronic pain, according to figures released this week by the Office of Medical Cannabis. (Brooks, 9/5)

Over the past decade, the number of older homeless people has increased both in St. Paul and across the country. Part of that increase can be credited to the fact that baby boomers are a large portion of the population, and they are aging. And the recent recession took its toll on many people’s savings and safety nets. ... In Minnesota, the increase of homeless people older than 55 is similar to that age group’s increase in the general population, according to the Wilder Foundation, which has conducted a statewide one-night count of the homeless every three years since 1991. (Cooney, 9/2)

If you haven’t heard about EpiPen’s unconscionable price increases, you have probably been in an ashram. The price of these life-saving medical devices, which are used to quell potentially fatal allergic reactions, has quintupled over the last few years. ... The public outrage is high and growing, and Hillary Clinton has quickly moved to capitalize on it. On Friday, she released a plan to try to stop the prices of this and other generic drugs from suddenly rising to nosebleed levels. ... Is Hillary Clinton’s solution the right one? Sort of. I tend to think that it overcomplicates things. Our health care system already has too many overlapping panels of bureaucrats trying to tweak the market. (Meghan McArdle, 9/2)

When I was a kid in the late 1960s, I suffered from serious asthma attacks. About twice each summer, struggling for air, I received a shot of epinephrine drawn up in a syringe from the camp nurse. The relief was nothing short of miraculous. Today that same tiny, lifesaving bolus of epinephrine — used mostly to treat severe allergic reactions — is delivered via sometimes elaborate devices called auto-injectors. Though the medicine itself hasn’t changed, the delivery devices have been protected by patents, enabling drug makers to charge ever escalating — sometimes prohibitive — prices for one of the oldest drugs in medical use. (Elisabeth Rosenthal, 9/2)

That health-care costs are out of control is hardly a surprise. All we have to do is look at our co-pays, out-of-pockets, and insurance premiums. But the recent uproar about the huge spike in the price of the lifesaving device EpiPen shined a light on one of the major reasons medical expenses are surging: the often incredible jumps in drug prices. And that is not going to change anytime soon. (Joel L. Naroff, 9/4)

When I entered the hotel restaurant, I saw a long table covered in china, flatware and wine glasses. So many wine glasses. This was my first experience being courted by a large company. It was early 2013, and because I wrote a blog on food allergies back then, I had been invited to an exclusive, all-expenses-paid trip to New York City. The large company was Mylan and the event at the Strand Hotel was dubbed the Mylan Summit. (Ruth LovettSmith, 9/2)

Congress and the public turned their attention to inflated drug prices. Responding to sudden mass protest and media outrage over this 9-year brewing scandal. Mylan has made moves to assuage the upset by expanding its EpiPen4Schools program. It will increase its discount card from a $100 discount to a $300 discount, expanding its assistance program for families making less than 400 percent of the federal poverty level, and announcing a generic to be released in the next few weeks at $300, or half price. (Amy Faith Ho, 9/2)

In the complicated world of medicine and money, the federal government relies on a handful of privately run directories to determine which cancer medicines it should pay for, and under which circumstances. Unfortunately, there are some disturbing problems with these compendia, and they need to be fixed — because they’re costing taxpayers and run the risk of harming patients. (Ed Silverman, 9/6)

On Labor Day, we offer our annual tribute to America’s working men and women, who put in more time on the job than their counterparts in the world’s largest economies and generally are more productive. And as we salute those who are working hard, we’ll also offer a Bronx cheer (pfffft!) to those who are hardly working: our members of Congress. They went on vacation without bothering to act on President Obama’s request for money to fight Zika and refused entreaties to come back to work when the viral infection expanded across South Florida. (9/4)

During the debate over Obamacare, both supporters and opponents assumed the giant law would transform the American health care system. The supporters argued that the system would help Americans purchase health insurance through carefully regulated state exchanges. President Obama envisioned a day when consumers could shop for health coverage “the same way you’d shop for a plane ticket on Kayak or a TV on Amazon.” In 2010, the Congressional Budget Office estimated there would be 21 million Americans using the exchanges by now. Many supporters argued that the exchanges would eventually replace the current dominant employer-based system. (David Brooks, 9/6)

After a while, it becomes white noise; just big insurance company names in the news scrolling across our TV screens, phones and tablets, all void of the true impact these seemingly small but ever-piling-up events will ultimately have on so many. The premiums that were promised to decrease have skyrocketed, the plans we were promised we could keep have or will be canceled and the "competition" that was promised to drive the exchanges has ended. We are rapidly approaching a healthcare apocalypse. (Bryan Rotella, 9/2)

Hillary Clinton made one of the most consequential announcements of her campaign on last week — and hardly anyone is talking about it. The Democratic presidential nominee released a wide-ranging mental-health strategy — and, unlike much of what she has proposed this election season, it has a real chance of becoming law. (9/5)

More than 40 million American adults — almost 20 percent of the adult American population — will deal with mental illness this year. Yet mental health (of the citizens, not the candidates) has not been an issue in the presidential campaign. Hillary Clinton tried to change that last week, announcing a plan that offers hope for improving mental health research, diagnosis and treatment. Central to Mrs. Clinton’s plan is the integration of physical and mental health care and reducing the stigma attached to mental health treatment. (9/5)

As Hillary Clinton rolled out her mental health policy proposals this week, the nation is confronting a mystery regarding access to care. The past decade has witnessed a flurry of federal legislation intended to improve coverage of mental health treatment within private and public sector insurance plans. Why then do research studies continue to document that even people with health insurance often have difficulty finding a psychiatrist? Two new studies of the state of the psychiatric profession help explain this frustrating situation. (Keith Humphreys, 9/2)

On a bright spring morning in late May, I force myself to sit down and make the dreaded call. It is to a national health plan that covers the psychotherapy benefit for many of my patients. Let's call it Community Allied Services For Health, for the fitting acronym "CASH." (Ellen Holtzman, 9/5)

The rate at which women die during pregnancy or shortly after childbirth has fallen sharply in many nations as maternal care has improved. The United States — and particularly Texas — is a glaring exception. In Texas, for instance, according to a study in the journal Obstetrics & Gynecology, the maternal mortality rate doubled from 17.7 per 100,000 live births in 2000 to 35.8 in 2014. Compare that with Germany, which had 4.1 deaths per 100,000 live births in 2014. (9/3)

For decades, public health experts have known that syringe exchange programs reduce the spread of certain viral infections — like H.I.V., hepatitis B and hepatitis C — by removing contaminated syringes from circulation. They have known that programs using sterile injection equipment are both safe and save money. And yet they are rarely seen in the United States. (Austin Frakt, 9/5)

There was no mistaking the diagnostic significance of that little red stick inside a deep blue cell: The Auer rod meant the mystery patient had acute myelogenous leukemia. As slide after slide went by, her bone marrow told a story: treatment, remission, relapse, treatment, remission, remission, remission. I was reading these marrows in 1987, but the samples had been drawn in 1978 and 1979. Median survival of that lethal disease with treatment was about 18 months; however, given that she had already relapsed once, I knew that she had to be dead. Probably someone was being sued, and that was why my hematology colleagues had asked for a blind reading. ... After the work was submitted, I asked the treating physician what was going on. She smiled and said that my report had been sent to the Vatican. This leukemia case was being considered as the final miracle in the dossier of Marie-Marguerite d’Youville. (Jacalyn Duffin, 9/5)

Jan Kern was bitten by a stray dog while traveling abroad and ended up with a jaw-dropping illustration of why the U.S. healthcare industry is completely sick. That’s because she underwent a series of rabies shots in three countries at four medical facilities. What that revealed, and which will surprise no one, is that Americans pay way more for the exact same treatment than people in other nations. Moreover, her experience highlights the lack of uniformity for drug prices, including commonly used medications. One facility might charge a few bucks for the same drug that costs thousands of dollars at a U.S. hospital. (David Lazarus, 9/6)

A funny thing happened on the way to the ballot box this year. Though grassroots referendums and initiatives have been on the wane for two decades, 73 have been approved for ballots so far in the 26 states that allow them. That’s still well below the 1996 peak of 92 measures, but it’s the highest number since 2006 and almost 50 percent more than in 2012. ... Nine states have measures that would legalize or decriminalize marijuana use. Five states would raise the minimum wage. Four would tighten gun controls. One, Colorado, would create an additional 10 percent income tax to finance a universal health-care system. (Paula Dwyer, 9/5)

So it’s time for [Gov. Terry] Branstad to schedule a series of his own public meetings to hear from constituents on Medicaid. Because it’s not clear where he is getting information about how things are going. As low-income Iowans reported confusion and loss of health services, this governor characterized the transition to privatization as “smooth.” When providers reported not being paid, he said the new system is “stopping significant fraud and abuse.” Instead of responding to a question here or there at a news conference, the governor should be publicly hearing and addressing the concerns being reported to lawmakers who didn’t craft or directly approve his privatization project. (9/3)

Efforts to make Iowans healthier feel like going backwards on an endless treadmill. The state has the 12th highest obesity rate in the nation, according to a report released last week by the Trust for America’s Health and the Robert Wood Johnson Foundation. Iowa’s percentage of obese adults was 32.1 percent in 2015, up from 20.9 percent in 2000 and from 12.2 percent in 1990. Iowa shouldn’t be discouraged. In fact, we should look north to see what we can learn. Minnesota was one of only four states in the nation to see a drop in adult obesity rates last year. (9/5)

As an emergency physician, I have seen how often patients are prescribed opioids and benzodiazepines together. This is not based on any scientific efficacy, but common clinical practice. This is not done out of bad intention, but routine and habit. Either one of these medications, when used in excess, can cause slowed breathing and sleepiness, leading to loss of consciousness and death. When used together, opioids and benzodiazepines are an especially deadly combination, increasing the likelihood of a fatal overdose. (Leana S. Wen, 9/2)