�鶹Ů��

Moving beyond "Obamacare," political activists are looking to state ballot questions to refocus the nation's long-running debate over government's role in health care. This fall, California voters will decide whether to lower some prescription drug prices, while Coloradans will vote on a state version of a "single-payer" government-run health system, similar to what Vermont Sen. Bernie Sanders proposed in his unsuccessful bid for the Democratic presidential nomination. (8/9)

A well-financed industry campaign trying to kill a single-payer health care measure on the ballot in Colorado in November is coalescing around a simple overarching message: Pretty much everyone, they say, hates the idea. The “Coloradans for Coloradans” campaign has received financial backing — about $3.7 million, so far — from large health insurers, Colorado hospitals and others with ties to the health care industry. But the campaign’s strategy is to build a far broader coalition — not just businesses and conservatives who are the natural foes of a bigger government role in health care, but more liberal voices such as unions, and even some abortion rights advocates who think single payer would be bad for the state, or who say the priority should be improving Obamacare. (Pradhan, 8/9)

Hillary Clinton added her voice Tuesday to the chorus calling for Congress to return to Washington as soon as possible to pass emergency funding to respond to the Zika virus. After a visit to a Miami-area health clinic, the Democratic presidential nominee said she “would very much urge the leadership of Congress to call people back for a special session and get a bill passed.” (Scott, 8/9)

"I am very disappointed that the Congress went on recess before actually agreeing what they would do to put the resources into this fight," Clinton said. "If we pass this critical funding we can develop rapid diagnostic testing and even begin the hard work of developing a vaccine." (8/9)

In response to Clinton on Tuesday, Don Stewart, a spokesman for Senate Majority Leader Mitch McConnell (R-Ky.) called on Clinton's running mate, Sen. Tim Kaine (D-Va.), and other Democrats to stop blocking the Republican-backed Zika response bill. "We would love for Sen. Kaine and others to end that filibuster and pass the bill, but it doesn’t sound like they’re prepared to do that," Stewart said. "Apparently they believe an earmark for Planned Parenthood in the future is more important that preventing the threat of Zika now." (Sullivan, 8/9)

Health and Human Services Secretary Sylvia Burwell is warning that administration funds to fight the Zika virus are quickly running out.  In a letter to congressional Republicans sent Monday, Burwell points to a range of responses that will be impaired if Congress does not provide new funding. The letter comes as Democrats and Republicans point fingers at each other over who is to blame for the lack of Zika funding. (Sullivan, 8/9)

The woman who set off the Zika scare in Florida doesn’t have a clear connection to the neighborhood where the outbreak is believed to be concentrated. She hasn’t traveled to a country where Zika is circulating and she hasn’t had sex with anyone likely to be infected. These confounding facts are also laced with potential danger. The woman in her early 20s is pregnant. The woman is one of 21 cases health officials are grappling with in their efforts to understand and contain the first known mosquito-borne Zika outbreak in the continental U.S., according to an internal report on the investigation for health officials reviewed by The Wall Street Journal. (McKay and Evans, 8/10)

Zika’s first mosquito-borne transmission in the United States has not sparked alarm for the vast majority of Americans, who do not fear infection by the disease, according to a new Washington Post-ABC News poll. Sixty-five percent of Americans say they are “not too” or “not at all" worried about being infected with Zika or about having an immediate family member become infected, which is hardly changed from 67 percent in June. Just over one-third of the public, 35 percent, is at least somewhat worried, though only 12 percent say they are “very worried” about infection. (Guskin and Clement, 8/9)

As the number of locally acquired Zika cases in Miami climbed a notch on Tuesday, county officials held an emergency meeting to blunt concerns about an epidemic and to underscore that local infections remain well contained. Gov. Rick Scott of Florida said Tuesday that four more people had been identified as likely to have acquired the Zika virus from local mosquitoes in the Wynwood neighborhood of Miami, the only place in the continental United States with active transmission. That brings the number of locally acquired cases in Florida to 21. On Monday, officials announced a Zika case in West Palm Beach, and they are investigating how the person, who recently traveled to Miami, was infected. (Alvarez, 8/9)

Florida health authorities have found four more people who likely contracted Zika through mosquito bites in the Miami neighborhood where an outbreak began, Gov. Rick Scott announced Tuesday.The new cases bring to 21 the total number of people in Florida who health authorities believe became infected without traveling to areas outside the U.S. where the virus is circulating. (Kamp, 8/9)

In an effort to detect any local transmission of the Zika virus, the New York City Department of Health and Mental Hygiene said on Tuesday that it had expanded the guidelines on who should be tested for the disease to include anyone with its most-common symptoms. Previously officials said only those who had traveled to a Zika-affected region or their sexual partners should be tested. The move comes on the heels of the first confirmed cases of local transmission by mosquitoes in Florida — a number that continues to rise. (Santora, 8/9)

As the number of cases of the Zika virus in the U.S. increases, so does the number of people calling local exterminators to rid their yards of the potentially dangerous mosquitoes. Although no mosquito-transferred cases of Zika have been found in Ohio, area businesses specializing in mosquito control have seen an uptick in business this summer.The phones have been ringing so much at one exterminator, Mosquito Squad in Dublin, that co-owner Leslie Wilson said she had to hire an answering service to field the influx of inquiring customers. (Husnick, 8/10)

A baby girl has died in Harris County from complications related to the Zika virus, local public health officials said Tuesday. The death is the first known fatality in Texas linked to the virus, which can cause birth defects when contracted by pregnant mothers. It is the second Zika-related death in the continental United States after an elderly man in Utah died in June. (Walters, 8/9)

The mother traveled during her pregnancy to Latin America, where it's believed she became infected, before giving birth in Harris County, according to a news release issued Tuesday by the county's public health department. She'd traveled to El Salvador and didn't know she had the virus, KHOU reports. The baby was born with birth defects, including microcephaly, a rare condition in which a baby's head is smaller than average.  (Farmer, 8/9)

Zika has claimed the life of a newborn girl in Harris County, health officials said Tuesday, the first infant death in the U.S. involving the mosquito-borne virus. The baby, whose mother traveled to Latin America during her pregnancy, died hours after being born with birth defects associated with Zika. They included but were not limited to microcephaly, a devastating but not usually fatal condition characterized by an abnormally small head and underdeveloped brain. The virus also can cause severe problems to fetuses' lungs and eyes. (Ackerman and Zaveri, 8/9)

Texas health officials reported the state’s first Zika-related death Tuesday, after an infant who died recently in Harris County was determined to have microcephaly, a birth defect linked to the virus. Officials with the Texas Department of State Health Services said the infant’s mother contracted the disease while traveling in Latin America during her pregnancy, and the baby acquired the infection while in the womb. Test results confirmed the baby’s condition and link to Zika, health officials said. (Frosch, 8/9)

Texas reported its first Zika-related death Tuesday after a baby girl whose mother traveled to El Salvador while pregnant died shortly after birth in a suburban Houston hospital. The girl, who died a few weeks ago, had microcephaly linked to the Zika virus, said Dr. Umair Shah, executive director of Harris County Public Health. (8/9)

Several other cases of babies with microcephaly have been documented in the United States in recent months — and some women with Zika have chosen to have abortions after ultrasounds showed a high likelihood of serious complications — but the Texas case appears to be the only one in which a microcephalic infant died shortly after birth. (Dennis, 8/9)

A California state court has cleared the path for nearly a dozen lawsuits to proceed that alleged that pharmaceutical company Bayer's permanent birth control device, Essure, seriously injured patients. The ruling could have major implications for device manufacturers who, like Bayer, argue that federal regulation of their products means they shouldn't be accountable for injuries. (Whitman, 8/9)

Workers at Memorial Hospital in Colorado Springs failed for years to properly disinfect vaginal ultrasound probes and other pieces of medical and surgical equipment, according to a state Health Department investigation conducted earlier this year. The investigation, completed in May, found that the hospital did not have a consistent policy for disinfecting the probes and also found problems with cleaning surgical instruments, procedure rooms and a rubber component of intravenous medication vials. (Ingold, 8/9)

As the number of older caregivers grows, and their need for help becomes more dire, a few states have passed laws to give older caregivers a chance to help decide where, and how, the person they care for will live. Tennessee passed a law in 2015 to ensure that anyone with an intellectual disability and a caregiver over 80 got the services they needed, and this year the state expanded the law to those with caretakers over 75. (Fifield, 8/10)

Before Josh, 36, arrived at First Place Transition Academy, he had never taken public transportation on his own, much less held down a paying job. But a new pilot program is empowering adults with autism to overcome hurdles to independence. (Donovan, 8/9)

Middle- and lower-income countries now have a higher rate of hypertension than high-income countries. Worldwide, the prevalence of hypertension is at a record high, according to a new study in the journal Circulation. From 2000 to 2010, the rate of hypertension in middle- and lower-income countries increased by nearly eight percentage points. For higher-income countries in that same time period, it decreased by nearly three percentage points. (Beachum, 8/9)

The biggest tragedy of the Flint, Michigan, drinking water scandal is that an estimated 8,000 children under the age of six may have been exposed to lead poisoning for two years before the outrageous mismanagement of the municipality’s water system was finally exposed. Many of those children may have already suffered brain damage or developmental problems from drinking tap water with lead levels ten times higher than the levels recommended by federal regulators. And given the relatively limited health care services in the economically depressed city of 95,000 mostly low-income and minority residents, some medical experts say the long-term prognosis for these kids is not encouraging. (Pianin, 8/9)

Three college-age scientists think they know how to solve a huge problem facing medicine. They think they've found a way to overcome antibiotic resistance. Many of the most powerful antibiotics have lost their efficacy against dangerous bacteria, so finding new antibiotics is a priority. It's too soon to say for sure if the young researchers are right, but if gumption and enthusiasm count for anything, they stand a fighting chance. (Palca, 8/9)

The FDA should fundamentally rethink its nutrition policy work, recommends an internal agency memo obtained by POLITICO. The FDA, under the Obama administration, has pushed to enable healthy choices by giving consumers more information, whether it be through disclosing calories on menus or mandating added sugars be listed on nutrition labels. But a yearlong review urges the agency to go a step further and make its goal to actually improve health outcomes. (Evich, 8/10)

A think tank challenging a federal ban on the use of electronic cigarettes during flights has filed its opening brief in the lawsuit. The Competitive Enterprise Institute (CEI) and the Consumer Advocates for Smoke-free Alternatives Association are suing the Department of Transportation (DOT) over the regulation, which was published in March and prohibits passengers from using e-cigarettes while onboard planes. (Zanoma, 8/9)

Dr. George Q. Daley, a prominent stem cell researcher and crimson-dyed Harvard man, will be the new dean of Harvard Medical School, the university announced Tuesday. Daley, who led dozens of international colleagues to unite around ethical guidelines for stem cell research, is taking on a new challenge: unifying the powerful hospitals that train Harvard’s medical students. The 55-year-old will take on the job effective Jan. 1. He will succeed Dr. Jeffrey Flier, who stepped down on July 31. Dr. Barbara McNeil has been filling in in the interim. (Bailey, 8/9)

Prominent stem-cell scientist George Q. Daley will assume the helm of Harvard Medical School this January, Harvard announced Tuesday. Daley, an expert on the biology of blood stem cells, is "an eminent scientist, a dedicated educator, an adept bridge-builder, a compelling advocate for scientific discovery, and a person of remarkable leadership qualities and thoughtful judgment,” Harvard president Drew Faust said in the announcement. (Goldberg, 8/9)

New York auditors say the state's Medicaid system made up to $12.1 million in inappropriate payments last year, including $2.3 million in managed care payments for dead patients. Auditors say other payments went for recipients dropped from long-term care coverage. About $2.1 million was recovered during the auditors' field work. (8/10)

Medicaid reimbursement rates for dental care have dropped steadily in Kansas for years. In 2003, reimbursements for Kansas children were among the top 10 in the nation, covering almost 70 percent of what private insurance would pay. By 2013 Kansas had dropped to the middle of the pack, with reimbursements around 47 percent of private pay. The reimbursements for treating adults are even less competitive. (Marso, 8/9)

Low-income individuals may have more difficulty accessing and paying for health care in states like Texas, which declined to expand Medicaid coverage, according to research published this week. Other studies link Medicaid expansion to decreases in uncompensated care and say it did not cause a spike in emergency room visits. (Rice, 8/9)

Now, with California’s new vaccination law rolling out shot by shot, the state joins Mississippi and West Virginia to become the third in the nation to adopt stringent vaccination school entrance requirements. And medical experts say disease rates are likely to fall in California as they have in those states. (Adams, 8/9)

Workers’ compensation rates could fall an average of 9 percent for policies that go into effect next year, the fifth year in a row that rates could fall for employers, the state Insurance Department said. The Insurance Department said an insurance-industry rating organization proposed the reduction earlier this month. It still must be reviewed and approved by state regulators. (Hayward, 8/9)

Combining death rates from all types of cancer, in 2013 North Carolina saw 167.7 deaths out of 100,000 people, which is about the national average. But there are pockets of the state where death rates are considerably higher than average, and one of the worst areas, not just in the state but in the country, is in northeast North Carolina, said Sam Cykert, UNC-Chapel Hill’s director of health and clinical informatics. (Nigam, 8/9)

A Long Island pharmacist and his company were convicted of charges related to illegally distributing black-market HIV medication, the state attorney general’s office said on Tuesday. A Suffolk County jury on Monday found Ira Gross, 63 years old, guilty of grand larceny, criminal diversion of prescription medication and conspiracy, among other charges. His firm, Chaparral Services Ltd., which prosecutors called a shell company, was found guilty of money laundering and commercial bribing. (Ramey, 8/9)

The doctor on a mission met the homeless heroin addict who lived under a tree last year at Jackson Health System’s special immunology clinic when both men were struggling to overcome the odds. Jose De Lemos, infected with HIV and hepatitis C from a shared needle, had gone without treatment for almost a year. He’d dropped 80 pounds, suffered from night sweats and a rash on his leg and chest. Even walking hurt. He was in no mood for conversation with a well-meaning doc. (Driscoll, 8/10)

After 42 years, the Feminist Health Center, which has long provided family planning services from its office on South Main Street, has officially changed its name. As of July, the organization became known as the Equality Health Center. This name shift has been in progress for two years, since the organization started offering more services to men and Lesbian Gay Bisexual Transgender groups. (Willingham, 8/9)

A parasitic amoeba that can cause fatal brain infections has been found in Grand Teton National Park. On Monday, the park announced the presence of the parasite in their recent water samplings taken from some of the park’s geothermal features and run-off streams. Spokeswoman Denise Germann says the infection risk for humans is low, but the amoeba Naegleria Fowleri can be fatal. (Mullen, 8/9)

Syrian and Iraqi refugees have been arriving in Buffalo with decidedly different medical and mental health needs than the previous waves of refugees from Myanmar, Bhutan, Sudan and Somalia, say local resettlement agencies and primary care physicians. Refugees from poor countries can languish for decades in refugee camps without access to medical care, and they often arrive in the U.S. with tuberculosis, malaria and childhood malnutrition. But many Syrians and Iraqis grew up in what were once middle-income countries with modern, if fragmented and imperfect, health care systems in their larger urban centers. Once engineers, teachers and other professionals, they are more likely to have diabetes and hypertension than TB or malaria. When they arrive in their adopted homeland, they suffer not from diseases of poverty, but from fresh memories of war. (Varney, 8/10)

Reed House is Georgia’s only evidence-based mental health program that follows the standards of Clubhouse International and is a part of 341 accredited Clubhouses located in 34 different countries around the world. The goal is rehabilitation and to give those people whose lives have been disrupted by serious mental illness the opportunity to recover meaningful and productive lives. This is done through reintegration into the workplace and community with the help of certified staff and volunteers. (Wade, 8/6)

Veterans struggling with chronic homelessness will soon have access to new housing as construction got underway on Tuesday on a 100-unit efficiency apartment complex on the campus of the Minneapolis VA Medical Center. With an expected completion date of summer 2017, the $14.3 million project, known as Veterans East and developed by the nonprofit Community Housing Development Corp. (CHDC), will provide on-site support services for health care, case management, life skills, financial management, VA benefits, and education and employment resources. (Brunswick, 8/10)

Outreach Community Health Centers, one of the four community health centers in Milwaukee, has bought a clinic on the city's north side. The nonprofit organization bought the building, 210 W. Capitol Drive, where it has been operating a clinic. Outreach bought the two-story, 29,500-square-foot building for $4.1 million from Verkadin Capitol Drive LLC, a San Francisco-based investors group, according to state real estate records posted Tuesday. (Daykin, 8/9)

Elk Grove is the latest community where increased West Nile virus activity has raised the prospect of aerial spraying for mosquitoes. West Nile virus activity is intense and widespread in Sacramento and Yolo counties, and Elk Grove requires close monitoring, officials with the Sacramento-Yolo Mosquito and Vector Control District said Monday. If more virus activity is detected, aerial spraying to control mosquitoes infected with the virus may be necessary, they said. (Locke, 8/8)

A biotech company called Seres Therapeutics got some bad news late last month: Its all-important infectious disease drug failed in a clinical trial, sending its stock price down roughly 70 percent. Investors took a bath. But in the two days before that failure became public, three top Seres executives sold a combined $2.5 million worth of the company’s stock. They made a tidy profit. They avoided nearly $2 million in paper losses. And it was entirely legal. (Garde, 8/8)

As a rule, principal investigators for clinical trials should not be trading in the stocks of companies whose drugs they are testing. But the feds allege that Dr. Edward Kosinski ignored this dictum and now faces charges of insider trading. In two separate instances, Kosinski sold his shares in Regado Biosciences after receiving bad news about a clinical trial in which he was the principal investigator, according to a lawsuit filed on Thursday in federal court in Connecticut by the US Securities and Exchange Commission. In the first stock trade, he avoided $160,000 in losses, and in the second transaction he made more than $3,000 by exercising options. (Silverman, 8/5)

Nurses and doctors lobbied the state to help cover the cost of a cocktail of drugs that can protect sexual assault victims from contracting HIV. In 2014, they succeeded when a state law was changed to reimburse hospitals, at least in part, when they provided the medication to victims who sought treatment and had a rape kit collected. Now, more than two years later, the law still isn't being followed; the state isn't covering any medication costs. (Dissell, 8/8)

Global pressure on health spending is forcing the $1 trillion-a-year pharmaceutical industry to look for new ways to price its products: charging based on how much they improve patients' health, rather than how many pills or vials are sold. In the United States, both parties are promising fresh action on drug prices whoever wins the White House. In Europe, economies are stalled, squeezing state health budgets. And in China and other Asian markets, governments are getting tougher with suppliers. Pricing drugs based on clinical outcomes is one way to ensure that limited funds bring the most benefits to patients now and pay for the most promising medical advances in future. Some experiments in pricing have already been made. (Hirschler, 8/9)

Six former and current Novartis executives at its Korean unit were indicted Monday on charges of paying more than $2 million to doctors in return for prescribing its medicines, a company spokesman confirmed. Among those indicted was the former chief executive in the country. At the same time, six publishers of medical publications and 15 doctors who work at general hospitals were also indicted. The drug maker funded academic events that were supposedly organized by the publications, but distributed to doctors money disguised as attendance fees and for articles that the doctors contributed to the publications, the Korea Herald reported. (Silverman, 8/9)

Prescription drug prices are a mystery, but a new start up is disrupting prices for generic drugs across the country. While there's pricing transparency for most products, costs vary widely for the same medication at different drug stores. The terrain has created an opening for one enterprising start-up looking to shake up the market." Technology is sort of realigning a whole host of…industries," Geoffrey Chaiken, Blink Health CEO told CNBC's "On the Money" recently. He mentioned Uber and Groupon as disruptor examples. "It just hadn't happened yet in the pharmaceutical space." (Gillies, 8/7)

To keep doctors current on medical issues, drug makers help pay for continuing education. Until now, though, industry has not had to report the value of these sessions to a federal database created in response to mounting concerns that such payments may unduly influence medical research or practice. That is expected to change next year, however, when a new reporting requirement and kicks in. And many physicians are pushing back. (Ed Silverman, 8/9)

Valeant's revenue and earnings fell short of Wall Street estimates in the second quarter, which would be disastrous news for most companies.But Valeant's miserable year and a nearly 90 percent share-price decline from a peak last August have lowered the bar inches off the ground for the embattled pharma company. Its shares rose 17 percent on Tuesday after management merely reaffirmed its full-year guidance for 2016, breaking a long string of forecast cuts. Valeant also said it had sold a real asset (Ruconest) for real money ($60 million up front) instead of just talking about it. It also intends to negotiate more wiggle room on its debt covenants. After a series of shambolic, share-price-crushing conference calls from management, this one was surprisingly competent. (Max Nisen, 8/9)

A few weeks ago, though, I saw a television commercial that dealt that process a setback. It was a 90-second ad for Opdivo that began with soaring music and shots of older people in warm sunlight, gazing upward at a building on which the words “A chance to live longer” were superimposed. The voice-over said, “Opdivo significantly increased the chance of living longer versus chemotherapy.” The wording may be a little clumsy, but the velvet-voiced narrator made his point, bolstered by actors portraying lung cancer patients playing with babies and watching Little League games.It would be incredibly uplifting if it weren’t so utterly misleading and exploitive. (Matt Jablow, 8/9)

The television commercial begins simply: “This is a legal alert for the users of Xarelto.” Lawyers, the narrator says, are reviewing claims that the blood-thinning drug can cause “severe bleeding or hemorrhaging, stroke or even death.” If affected, viewers are advised to call a number on the screen. “You may have a case,” the speaker intones. In 2015, lawyers spent $128 million to air 365,000 ads like this, which seek plaintiffs for lawsuits against drug and medical-device manufactures. In the first six months of this year, that number jumped to $85 million, or about 14 percent of all lawyer advertising dollars, according to X Ante, which tracks mass tort litigation advertising. And why not? These ads drum up business for firms. They can also scare patients to death. (Lisa A. Rickard, 8/5)

A promising new drug to treat hepatitis C, a liver disease afflicting as many as 150 million people worldwide, was recently introduced by Gilead Sciences Inc., a Foster City biopharmaceutical company. That’s the good news. Unfortunately, a 12-week treatment with the drug, Epclusa costs $74,760. That’s half a lifetime’s worth of income in Africa and Central Asia, the worst-affected areas. In the United States, for those with private insurance or Medicare or Medicaid, some of the cost will be reimbursed, and the drugmaker is providing a “coupon” for “eligible” patients to cut the price by 25 percent. (Andrew L. Yarrow, 8/4)

The health care industry is undergoing dramatic transformation as we shift from fee-for-service reimbursement to a fee-for-value payment system. This will promote the value and outcome of the health care services we deliver. We’re focused on providing the best care for the people we serve, measuring the efficiency of our healthcare delivery and striving to improve outcomes at a lower cost. At St. Vincent’s HealthCare and Ascension, the nation’s leading nonprofit health care system, we have embraced this transformation because it’s the right thing to do. (Tom VanOsdol, 8/8)

Pricing of and access to medication are handled in an insane manner in the United States. It has been said that between 20 and 30 percent of prescriptions are never filled, presumably because of cost or access issues. Comparing plans is nearly impossible, because drug tiers, co-pays, deductibles and coinsurance vary from plan to plan and drug to drug. Those with high drug costs are likely to fall into the dreaded “doughnut hole,” in which all pharmacy benefits go away, until you have reached an out-of-pocket limit of thousands of dollars. (8/7)

It’s easily forgotten that Congress and the Obama administration did the health insurance industry an enormous favor in enacting the Affordable Care Act in 2010. Several favors, in fact. They placed commercial insurers at the center of Obamacare, giving them most of the responsibility for covering enrollees—and therefore access to an army of new customers. They left in place private insurers’ access to the immense Medicaid pool via Medicaid managed care. They killed the public option, which would have provided a nonprofit counterweight to private insurers, hopefully goading the latter into maintaining competitive pricing and customer service. (Michael Hiltzik, 8/9)

Humana recently announced that next year it is withdrawing from 88% of the counties where it sold Affordable Care Act (ACA) exchange plans this year. United Healthcare forecasts higher earnings in 2017, stemming in part from its decision to shut down most of its exchange business. Aetna has cancelled plans to expand its ACA market footprint and is instead reevaluating its current participation. At least four states, Alaska, Alabama, Oklahoma and Wyoming will likely have only one exchange insurer this coming year. Sixteen of the 23 co-ops initiated with ACA funding have collapsed. And researchers supportive of the ACA estimate that insurers are requesting average gross premium increases of 23% next year. These data points suggest the ACA’s individual market changes are faring poorly thus far. (Doug Badger, Brian Blase, Seth Chandler and Ed Haislmaier, 8/9)

“I’m thinking of decamping to Maine for the rest of my pregnancy,” a pregnant patient told me last week. Her comment came days after the news of at least 17 confirmed cases of Zika in Florida. My patient worried that it was only a matter of time before the disease made its way to Virginia. Experts say Zika will probably remain farther south, but I could not argue with my patient’s logic. The pregnant women I care for do everything in their power to keep their unborn children healthy. They give up alcohol, quit smoking and see their doctor regularly. They even forgo deli meats and soft cheeses to decrease the minute risk of contracting a rare bacteria. (Emily Binkley Huffstetler, 8/9)

Data sharing is one of the “next big things” in cancer research. This essential extension of laboratory and clinical research will rely on cancer patients voluntarily sharing their private health information. Unfortunately, we aren’t making it easy or attractive for them to do this. Researchers seek patients’ DNA samples, detailed medical histories, and honest assessments of daily lifestyle habits to advance the study of disease. These data are already being collected when individuals are diagnosed with cancer and treated for it, but largely aren’t being shared with researchers. The National Institutes of Health has announced plans to dole out $55 million in grants over five years to enlist 1 million volunteers to allow access to their clinical data from electronic health records, use mobile health devices and apps to track activity in real time, and submit their genetic and biological information through blood and urine tests. (Maurie Markman, 8/9)

Kentucky is known nationally for reducing the percentage of people without health insurance — from 20.4 percent uninsured in December 2013 to 7.5 percent in December 2015. What is needed to sustain these gains? Making insurance — and health care — harder to access is not the answer. Making health care delivery more cost-effective is a better path. (Susan Zepeda, 8/9)

In Missouri and across the country, opioid addiction is a fast-growing problem that disproportionately affects rural communities. New data from the Centers for Disease Control and Prevention show opioids were involved in 28,648 deaths in 2014. As a predominately rural state, Missouri has been hit hard by this epidemic. (Tom Vilsack and Claire McCaskill, 8/9)

The law allows exemptions to school vaccine requirements for medical reasons such as life-threatening allergies to vaccine components or immune deficiencies. No one would disagree that waivers should be allowed for these children. But these make up a tiny portion of the unvaccinated school children. The much larger share are the "exemptions of conscience" for parents who don't want their children vaccinated because they simply don't like vaccines. Let's be clear: There is nothing conscientious about rejecting vaccines for non-medical reasons. (Anna C. Dragsbaek, 8/9)

Last year, I became a mom. During my pregnancy, I read all the books and all the articles, and my husband and I mentally crafted a framework to use to raise our baby. I would breast-feed. We would use cloth diapers. We would eschew television and electronic devices for her first two years. And we would vaccinate on time, following the Centers for Disease Control and Prevention’s recommended immunization schedule. (Jenn Kauffman, 8/9)

A case in which a doctor performed an abortion on a woman who was known to be high on drugs raises an important question about medical ethics. But any disciplinary action that might be taken could be muddied by abortion politics. In the spring of 2015, an abortion was performed at Women’s Med Center in Dayton on a patient who was so high on drugs that, after the abortion, she had to be hospitalized and treated for a suspected overdose. (8/10)

Cannabis. Hash. Weed. Locoweed. Pot. Grass. Mary Jane. Bud. Reefer. Hemp. Dope. Acapulco Gold. As you know, these are all synonyms for marijuana (there are many more), and they are especially helpful if one is writing a column about the stuff and doesn't want to type "marijuana" 37 times. So with that out of the way: Ohio is less than a month away from joining the 25 other states that have legalized at least some uses of marijuana. (Ted Diadiun, 8/10)