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Summaries of health policy coverage from major news organizations
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麻豆女优 Health News Original Stories
When Drug Reviewers Leave The FDA, They Often Work For Pharma
Researchers examine the Food and Drug Administration鈥檚 鈥渞evolving door鈥 regarding employees who worked on cancer and hematology drugs.
Election Buzz: Critics Of Legal Pot Say Addiction Becomes 'A Disease Of The Family'
As more states consider legalizing recreational marijuana, families consider what messages to present to young people about using pot. Should it be avoidance, moderation or acceptance? Differing views from Arizona and Oregon.
Deadly Opioid Overwhelms First Responders And Crime Labs in Ohio
Carfentanil, a potent variation on fentanyl, is being blamed for a wave of opioid overdoses. In Cincinnati, the coroner, crime lab and first responders are struggling to keep up.
Summaries Of The News:
Health Law
Administration Unveils Plans For Push To Enroll Young Adults In Health Plans
The Obama administration will use targeted, digital messages and online networks such as Twitter in a sweeping campaign to get young adults to sign up for health insurance during the Affordable Care Act鈥檚 fall open enrollment, appealing to a group seen as critical to the law鈥檚 success. The administration, which announced the new push on Tuesday, is betting the aggressive campaign will resonate with uninsured consumers age 35 and under. (Armour, 9/27)
The Obama administration is announcing new steps to increase ObamaCare outreach to young adults as it seeks to improve the stability of the healthcare law by bringing in more youthful, generally healthy participants. Amid concerns from insurers about financial losses due to a sicker-than-expected pool of enrollees, the administration is stepping up its efforts ahead of the signup period for next year, which begins Nov. 1. (Sullivan, 9/27)
The House on Tuesday passed a bill that would allow people enrolled in failed health insurance "co-ops" to skip this year's penalty for not having coverage. The Republican-backed bill passed on a mostly party-line vote of 258-165. Sixteen Democrats broke with their party to support the measure. ... Democrats opposed the bill, arguing it is unnecessary. They pointed out that enrollees in co-op plans that fail in the middle of the year are provided a special sign-up period in order to find a new plan. Rep. Sandy Levin (D-Mich.) said the bill is 鈥測et another attempt to undermine the Affordable Care Act, plain and simple.鈥 The White House threatened a veto on the bill, arguing that it would chip away at the individual mandate, a crucial component of the law that helps prevent people from waiting until they get sick to sign up for coverage. (Sullivan, 9/27)
Shopping for health insurance isn鈥檛 easy for most people, but for Branden Weaver, the stakes are especially high: His two young sons are on the autism spectrum, and he and his wife are determined to ensure they have a health plan that covers the practitioners who treat them. But the first time they tried signing up for coverage through the state鈥檚 health insurance exchange, Access Health CT, they ended up in Medicaid, which didn鈥檛 cover one of their older son鈥檚 providers. Weaver tried to sign his son up for a private insurance plan that did, but even with his information technology background, he found it difficult. So he turned to an insurance broker. (Levin Becker, 9/28)
BlueCross BlueShield of Tennessee sent shock waves Monday across Tennessee with the company's decision to exit the Obamacare exchange in Nashville, Memphis and Knoxville, a move that highlights persistent volatility in the young health insurance marketplace. Three years into the Affordable Care Act exchange, the state鈥檚 largest insurer is grappling with hefty losses and ongoing uncertainty on the marketplace. BCBST is open to coming fully back into the market once uncertainties about policies and the membership wane. (Fletcher, 9/27)
Iowans looking to buy individual health insurance policies now have fewer options from the state鈥檚 largest carrier. Wellmark Blue Cross & Blue Shield leaders said Tuesday that they no longer will sell standard, broad-network health policies, known as PPO plans, on the individual market in Iowa. The company will continue to sell plans that steer participants to specific hospital-and-clinic systems, such as the Mercy Health System or the University of Iowa system. It also will sell an HMO plan that has some restrictions on out-of-network care. (Leys, 9/27)
Administration News
Expert Demoted After Raising Concerns About Efficacy Of CDC's Zika Test
In the midst of the fight to control Zika, the top public health agency in the United States has been engaged in an intense internal debate about the best way to test whether someone has been infected with the mosquito-borne virus. At the center of the debate at the Centers for Disease Control and Prevention is one of the leading experts on Zika virus. Robert Lanciotti is chief of the CDC lab responsible for developing tests to diagnose viral diseases such as聽Zika that are transmitted by mosquitoes, ticks and fleas. Lanciotti was demoted in May after he raised concerns inside and outside the agency about the CDC鈥檚 decision in the聽spring to recommend a new test for Zika. (Sun, 9/27)
In other Zika news聽鈥
The results of an emergency research push for a Zika vaccine announced last week by Gov.聽Rick Scott聽likely won't come to fruition for years.聽Members of the state Biolmedical Research Advisory Council have been asked to get the grant program off the ground in the next four months with a three-year timeline for the projects that ultimately will be funded by the Department of Health. ... Last Thursday, Scott announced the grant program, a rare use of his power under a state of public health emergency declared in February as travel-related cases of Zika first arrived in Florida. He set aside $25 million primarily聽for research into a vaccine聽and more efficient Zika tests. (Auslen, 9/27)
Miami-Dade County on Wednesday will release the locations of mosquito traps that captured Zika-positive insects in Miami Beach, the result of a public dispute between state and local officials after the Miami Herald filed a lawsuit seeking the information. The word came Tuesday evening, an hour after Gov. Rick Scott and Surgeon General Celeste Philip agreed that Miami-Dade can release the trap locations. (Flechas, 9/27)
At least for now, Tampa Bay is considered officially Zika-free. Florida Department of Health officials announced Tuesday that they have closed the active investigation into the region's first locally transmitted case of the virus that has been linked to birth defects.The patient was a Tampa Fire Rescue firefighter who lived in Pinellas, triggering a scramble by health departments on both sides of the bay to contain a potential outbreak. (O'Donnell, 9/27)
Study Raises Concerns Over Revolving Door Between FDA, Pharma Companies It Regulates
Critics of the revolving door between government and industry cite the hundreds of lawmakers-turned-lobbyists as case studies in the art of cashing in on one鈥檚 years of public service. But less is known about the revolving door between the Food and Drug Administration and the biopharmaceutical industry. In a study published Tuesday in the journal BMJ, researchers who studied the careers of FDA medical reviewers found that more than half of the hematology-oncology assessors who reviewed drugs between 2001 and 2010 went on to work for the biopharmaceutical industry. (Kaplan, 9/27)
More than a quarter of the Food and Drug Administration employees who approved cancer and hematology drugs from 2001 through 2010 left聽the agency and now work or consult for pharmaceutical companies, according to research published by a prominent medical journal Tuesday. Dr. Vinay Prasad, a hematologist-oncologist and assistant professor at Oregon Health and Science University, sought to understand the so-called 鈥渞evolving door鈥 between the FDA and the pharmaceutical industry, which he said is often discussed but hadn鈥檛 been quantified. (Lupkin, 9/27)
What's In A Word? FDA Seeks Input On Definition Of 'Healthy'
The U.S. Food and Drug Administration聽on Tuesday聽took the first step toward redefining its decades-old definition of 鈥渉ealthy,鈥 following pressure from food companies that say the current regulations are outdated. Regulators are now seeking opinions from consumers, companies and other members of the public on how the term 鈥渉ealthy鈥 should be used on food packaging. It鈥檚 a process that will likely take years to complete. (Gasparro, 9/27)
In other news about healthful eating, nutrition and exercise聽鈥
Eating well has many known benefits. But a good diet may not be able to counteract all the ill effects of stress on our bodies. A new study, published in Molecular Psychiatry, suggests stress can override the benefits of making better food choices. To evaluate the interactions between diet and stress, researchers recruited 58 women who completed surveys to assess the kinds of stress they were experiencing. The women also participated in what researchers call a "meal challenge," where they were each given two different types of meals to eat, on different days. (Aubrey, 9/27)
It could get a bit harder for people in Prince George鈥檚 County to buy chips, cookies or soda in county facilities, if a bill to limit those choices and stock vending machines with healthier options is embraced by the County Council. Vice Chair Dannielle M. Glaros (D-Riverdale Park) introduced the bill Tuesday, saying she wanted to address the negative health impacts of sugary and fatty foods in a county with high rates of diabetes, obesity and other chronic diseases. (Hernandez, 9/27)
Stepping away from a breakout session at the First Annual Conference on Native American Nutrition, Ryan Bad Heart Bull 鈥 a tall, fit man in a dark-blue suit 鈥 said the event had been a monumental experience."It's been fascinating to learn the ways and the methods that other tribes have been using to provide better options for themselves as well as bring the community together," he said. He's part Oglala and Hunkpapa Lakota, an enrolled member of the Pine Ridge Reservation. He's also a new registered dietician, and said he's the first Native American to graduate from the University of Minnesota's Dietetic Internship program. Heart Bull said the gathering was historic because it's part of a food movement to reclaim Native American health. (Xaykaothao, 9/28)
Before you skip another workout, you might think about your brain. A provocative new study finds that some of the benefits of exercise for brain health may evaporate if we take to the couch and stop being active, even just for a week or so. (Reynolds, 9/28)
Capitol Watch
Breakthrough On Flint Could Pave Way To Spending Deal After Senate Blocks Bill
House Speaker Paul D. Ryan and Minority Leader Nancy Pelosi struck a deal late Tuesday to deliver federal aid to address the water crisis in Flint, Mich., potentially removing a major flashpoint in negotiations to keep the government fully operating past Friday. Under the deal, the House will vote Wednesday on an amendment to a pending water projects bill that would authorize up to $170 million in infrastructure funds for communities like Flint whose water systems are blighted by 鈥渃hemical, physical, or biological鈥 contaminants. (DeBonis, 9/27)
Senate Democrats say they plan to block a governing spending bill Tuesday because they don鈥檛 trust Republicans to keep their promise to separately approve funding for the Flint, Mich., drinking water crisis. Sen. Barbara Boxer (D-Calif.), who is on the Environment and Public Works Committee, said at a press conference about two hours before the vote that Democrats are demanding a commitment to Flint aid in writing. (Ferris, 9/7)
This was not supposed to be difficult. With the election a little more than a month away and few major issues on the table, the House and Senate were going to pass a straightforward stopgap bill to fund the government through early December and then skedaddle. So much for that. (Hulse, 9/27)
Health IT
Aetna Bets On Apple Watches Amid Growing Skepticism Of Wearables' Health Benefits
Apple Watches are becoming near-ubiquitous in healthcare and the corporate world, and health insurer Aetna is now investing heavily in the wellness promises of the device. However, companies that have offered an Apple Watch with the hope of getting people to be more active and healthy have to prove wearable devices and wellness programs meaningfully change consumer behavior, which has often worked better in theory than in practice. 鈥淭hese types of technologies can really help to facilitate behavior change, but the devices themselves are not what drive behavior change,鈥 said Dr. Mitesh Patel, an assistant professor of medicine at the University of Pennsylvania. (Herman, 9/27)
Aetna Inc. will give some customers and employees discounts on Apple Inc.鈥檚 smartwatch, offering the potential that incentives from the insurance industry could boost sales of the technology giant鈥檚 wearable device. The health insurer, which covers about 23 million people in the U.S., is developing apps for Apple devices that will help consumers remember to take their medicines, get a refill on prescriptions, or contact a doctor. The applications, which will be available next year, will also help members understand their insurance benefits and use Apple鈥檚 Wallet feature to pay bills, Aetna said Tuesday in a statement with Apple. (Tracer and Webb, 9/27)
Google Glass Expands Possibilities For High-Tech Doctor Visits, But Danger Lurks At Edges
Jim Andrews is in a medical office wearing just a hospital gown, staring at his doctor of 11 years, who is staring back at him through the sleek, metallic lens of Google Glass. As the doctor examines Andrews, a new kind of medical scribe is watching the examination, transcribing everything he sees. The scribe, named Rahul, is thousands of miles away in India, and he is viewing the office visit live through the pint-size, WiFi-connected camera attached to the doctor鈥檚 glasses. (Dwoskin, 9/27)
In other health technology news聽鈥
A new startup is using Uber鈥檚 technology to help patients hail a ride to their doctors, hoping to cut down on the 3.6 million Americans who miss medical appointments each year because they don鈥檛 have transportation. The service is targeted at patients who don鈥檛 have cars and can鈥檛 afford or access public transit, and whose rides are covered by health plans such as Medicaid. The startup, Circulation, used Uber鈥檚 software to create an app that hospitals can use to request Uber vehicles for patients who need help getting to and from appointments. (McCluskey, 9/27)
Related KHN Coverage: (8/17)
Public Health
First Baby Born Using New Wave Of 'Three-Parent' IVF Technique
A few months ago, after a fertility procedure at a Mexican clinic, a healthy baby boy was born in New York to a couple from Jordan. It was the first live birth of a child who has been called 鈥 to the dismay of scientists who say the term is grossly misleading 鈥 a three-parent baby. ... The method used to help the couple is one that reproductive scientists have been itching to try, but it is enormously controversial because it uses genetic material from a donor in addition to that of the couple trying to conceive. (Kolata, 9/27)
A boy born in April with three genetic parents is the first infant born using a new technique that incorporates DNA from two women and one man, New Scientist reported Tuesday. The technique offers promise to help children avoid often-fatal genetic diseases passed down by their mothers, but has raised thorny ethical questions and is not allowed in the United States. The boy was born in Mexico to Jordanian parents who tapped researchers from the New Hope Fertility Center in New York to help them conceive a healthy child, according to New Scientist. (Joseph, 9/7)
So-called three parent babies actually have more like 2.001 parents, according to experts. And the baby boy born earlier this year isn't the first child to have a little more DNA than Mom and Dad could provide on their own:聽An IVF technique that relied on small transfers of donor DNA was pioneered in the United States during the 1990s but was banned after fewer聽than 100 babies were born. This Jordanian newborn represents the first successful birth in a new wave of "three parent" techniques 鈥 ones that are more sophisticated and that will likely stick around much longer. (Feltman, 9/27)
Mitochondrial DNA consists of just 37 genes, a tiny fraction of the genetic material inside a cell. Unlike nuclear DNA 鈥斅爓hich is bundled into 23 pairs of chromosomes and influences traits such as eye color, height and cancer risk 鈥斅爉itochondrial DNA contains instructions for the energy-producing structures inside cells. It is passed down virtually unchanged from mother to child. That was a situation the infant鈥檚 mother wanted to avoid. Her mitochondrial DNA contains mutations that cause Leigh syndrome, a neurological disorder that is usually fatal during early childhood. (Kaplan, 9/27)
The goal was to prevent the child from inheriting a fatal genetic disease from his mother, who had previously lost two children to the illness. ... The technique is not approved in the United States, but Zhang told the magazine, "To save lives is the ethical thing to do." (9/27)
The $64,000 Question: Is The Flu Shot Worth All The Bother?
While the flu is a common illness, that hardly means the science around it is static. Some recent studies have suggested that getting a yearly shot may actually diminish the benefit of successive vaccinations. Others have raised the possibility that statins 鈥 the commonly used cholesterol-lowering drugs 鈥 may actually interfere with your immune system鈥檚 response to influenza vaccine. Meanwhile, the Centers for Disease Control and Prevention recently recommended against the use of the nasal mist vaccine that many kids prefer over injected vaccine. (Branswell, 9/27)
Read KHN's past coverage on the flu shot: .
After the recent discovery that the popular nasal spray performed poorly against the flu virus over the past three flu seasons, doctors and public health officials are recommending only the flu shot this year. That has left many parents scrambling to calm needle-phobic children. (Shah, 9/27)
Viral Images Of Parents' Overdoses Show Toll Opioid Epidemic Is Taking On Children
It was a horrific video 鈥 a young mother who had overdosed was lying unconscious on the floor of a Family Dollar store in Lawrence, Mass. Adding a gut-wrenching kick to the scene was that the woman鈥檚 2-year-old daughter, wearing purple footie pajamas, was tugging at her mother鈥檚 limp arm, trying to wake her up. The girl was wailing. The mother looked lifeless. (Seelye, 9/27)
Police in small towns in Ohio and Massachusetts may have started a trend: releasing photos of unconscious drug addicts, to dramatically show the public what officers encounter on a daily basis as opioid abuse explodes across America. The photos of a man and woman passed out in the front seat of an SUV in East Liverpool, Ohio, and video of a woman lying on the floor of a discount聽store in Lawrence, Mass., being prodded by a terrified child, have gone viral and brought the hard reality of addiction home to millions who鈥檝e never imagined its real life impact. (Jackman, 9/27)
In other news on the opioid crisis聽鈥
In the fight against the opioid epidemic, authorities are increasingly relying on computers 鈥 state-run drug databases that can turn up evidence of abuse, like doctors who shovel prescriptions out the door indiscriminately or patients who doctor shop for pills. But while the prescription drug monitoring programs (PDMPs) help police and prosecutors, they haven鈥檛 necessarily helped address addiction as disease. (Allen, 9/27)
California doctors will be required to check a database of prescription narcotics before writing scripts for addictive drugs under legislation Gov. Jerry Brown signed Tuesday that aims to address the scourge of opioid abuse. The measure attempts to crack down on a practice known as "doctor-shopping," in which addicts visit multiple providers to obtain prescriptions for addictive drugs. (9/27)
Pennsylvania hospitals have seen soaring rates of babies born addicted to opioids over the last 15 years, a reflection of the national epidemic of pain pill and heroin abuse, according to a new state analysis. The Pennsylvania Health Care Cost Containment Council used hospital records from 2000 through 2015 to figure out how often mothers and newborns were hospitalized because of addiction issues. In 2015, 2,691 newborns were hospitalized in Pennsylvania for substance-related problems, or almost 2 percent of the 138,000 infant hospitalizations. (McCullough and Sapatkin, 9/27)
Jamie Landrum has been a police officer for two years in District 3 on the west side of Cincinnati. In late August, the city was hit by 174 overdoses in six days. Landrum says officers were scarce. 鈥淲e were literally going from one heroin overdose, and then being on that one, and hearing someone come over [the radio] and say, 鈥業 have no more officers left,鈥 鈥 Landrum said. Three more people overdosed soon after that. (Harper, 9/28)
States Scramble To Act As Youth Suicide Rates Climb
Between 2006 and 2014, the suicide rate among Americans 19 and under rose from 2.18 to 2.72 per 100,000 people. At least 36 states have experienced an increase, but the problem is especially dire in Utah, where the suicide rate rose from 2.87 to 6.83 during that period. Among the possible causes cited by suicide experts is a decline in the use of psychiatric medicines and the rise of cyberbullying. Whatever the reasons, a number of states, over the last five years, have adopted measures to try to reverse the trend. (Ollove, 9/28)
The World Health Organization said Tuesday that 92 percent of people breathe what it classifies as unhealthy air, in another sign that atmospheric pollution is a significant threat to global public health. A new report, the W.H.O.鈥檚 most comprehensive analysis so far of outdoor air quality worldwide, also said about three million deaths a year 鈥 mostly from cardiovascular, pulmonary and other noncommunicable diseases 鈥 were linked to outdoor air pollution. (Ives, 9/27)
Global health authorities on Tuesday declared the Americas free of endemic measles, the first region to be so certified. The hemisphere鈥檚 last case of endemic measles 鈥 meaning one that did not spring from an imported strain 鈥 was in 2002. Normally, it takes three years without cases to declare a disease eradicated from a region, but in this instance it took 14 years. (McNeil, 9/27)
In theory, clostridium difficile (aka C. diff) does not seem like a tough problem to solve. Yes, it鈥檚 a deadly bacterial infection that sickens almost a half-million people and contributes to some 29,000 deaths every year, the vast majority in hospitals and other healthcare settings. And yes, it has recently become both more common and more deadly. But the weapons needed to defeat this bug are inexpensive and straightforward: soap, gloves, disinfectants, and the proper use of antibiotics. (Interlandi, 9/27)
Judy Maggiore remembers looking in the mirror in college, perplexed by her body's disproportion. "I was skinny. I was a stick. The upper part of my body was really, really thin. You could see my ribs!" exclaims Maggiore. "But from the waist down, it was like there were two of me or something." (McClurg, 9/27)
New Diagnostic Tool May Identify Living Patients That Have Disease Caused By Repeated Concussions
The diagnosis begins with the brain being pulled out of the skull. Then, to determine whether someone had a condition associated with repeated concussions, the pathologist preserves the tissue in formalin, slices it thin enough for light to shine through, washes it with chemicals, and peers at it through a microscope. If some areas remain blotched with reddish brown, then the pathologist can definitively diagnose the person with chronic traumatic encephalopathy, or CTE. (Boodman, 9/27)
Concussion diagnoses have spiked in recent years as publicity about long-term brain damage has made head injuries more frightening, and Pennsylvania and New Jersey have among the highest rates in the nation, a new analysis of claims data by the Blue Cross Blue Shield Association has found. The report, released Tuesday morning, found that the increase was particularly pronounced among 10-to-19-year-olds. In that age group, concussion diagnoses increased by 71 percent from 2010 through 2015. The growth in concussion rates for girls and young women was 118 percent, while it was 48 percent for boys and young men. (Burling, 9/7)
The percentage of Illinois children diagnosed with concussions climbed by a whopping 83 percent between 2010 and 2015 as awareness of head injuries grew, according to new data released by Blue Cross and Blue Shield of Illinois. Concussions for Blue Cross members ages 10 through 19 jumped from a rate of 7.6 per 1,000 members in 2010 to 14 per 1,000 members in 2015. (Schencker, 9/27)
State Watch
Appeals Court Sides With FTC To Pause Proposed Penn State-Pinnacle Health Merger
The U.S. Court of Appeals for the 3rd Circuit reversed the FTC's May loss in the Penn State-PinnacleHealth case, temporarily pausing the proposed merger while the agency takes on administrative review of the case. The 3rd Circuit judges said the lower court ignored the impact of the proposed merger on insurers when it ruled against the FTC, saying its analysis of the FTC's and Pennsylvania state regulators' proposed geographic market for the challenge was 鈥渆conomically unsound鈥 and ignored commercial realities in the healthcare market. (Teichert, 9/27)
Since the beginning of 2013, five rural hospitals in the state have closed, and many others are struggling financially, such as Phoebe Worth and Southwest Georgia Regional. Gilman鈥檚 remarks illustrated how small hospitals often feel caught between forces they can鈥檛 control. Each of her hospitals, she said, has had聽to sink more than $1 million into an electronic medical records system to comply with federal regulations. Meanwhile, 鈥渨e are unable to improve our facility infrastructure.鈥 (Miller, 9/27)
A state health care watchdog agency on Tuesday warned that medical costs in Massachusetts are likely to rise if Boston Children鈥檚 Hospital moves ahead with a controversial $1 billion expansion plan. The Health Policy Commission cannot block the project, but its views will be considered by the state Department of Public Health, which has the final say. The commission鈥檚 warning comes on top of opposition from competing hospitals and activist groups and may complicate the chances of swift approval for facilities that Children鈥檚 says are urgently needed. (Dayal McCluskey, 9/27)
St. Christopher's Hospital for Children did not do enough to determine why nine of its patients died after heart surgery, according to a sweeping report by state investigators. The findings stem from a surprise three-day inspection of the North Philadelphia hospital one month after the Inquirer reported in February that the death rate among newborn heart-surgery patients there was nearly triple the national average. (Avril, Purcell and Fazlollah, 9/24)
And in New York, a man searches for answers on why his wife died聽鈥
After Amy Lam prematurely went into labor and gave birth to their baby at home, her husband, Gilbert Kwok, thought the worst was over. Once emergency responders had arrived and loaded Ms. Lam, 34, into an ambulance, the couple took photos with the newborn and called family members, smiling and elated that 鈥 despite the unexpected circumstances 鈥 their son had arrived. Less than 12 hours later, on Aug. 1, Ms. Lam was pronounced dead. She had bled to death after a series of surgical procedures at Harlem Hospital Center. (Schmidt, 9/28)
In Election, Trend-Setting States Could Determine National Conversation On Marijuana
From California, with its counterculture heritage, to the fishing ports and mill towns of Maine, millions of Americans in nine states have a chance to vote Nov. 8 on expanding legal access to marijuana. Collectively, the ballot measures amount to the closest the U.S. has come to a national referendum on the drug. (Elias and Crary, 9/28)
The California Nurses Association, which last year offered an unusually early endorsement for Lt. Gov. Gavin Newsom鈥檚 2018 gubernatorial bid, on Tuesday announced support for Newsom鈥檚 high-stakes fall initiative to legalize recreational marijuana. ...聽The formal endorsement puts the nurses on the side of the California Medical Association and at odds with the California Hospital Association, which opposes the Proposition 64 legalization proposal on the Nov. 8 ballot. Proposition 64 was proposed by Donald Lyman, a retired physician and former member of the California Medical Association who in 2011 wrote a white paper for the 40,000-member organization calling for the legalization of marijuana and declaring the federal ban on the drug 鈥渁 failed public health policy.鈥 (Cadelago, 9/27)
If pot laws were colors, a map of the U.S. map would resemble a tie-dye T-shirt.聽In some states, marijuana is illegal. In others, it鈥檚 legal for medical purposes. And still in others, it is even legal for recreational use. Five more states could come into that last category this fall, as voters decide whether to legalize it in California, Nevada, Maine, Massachusetts and Arizona. (Foden-Vencil and Sieg, 9/28)
Read KHN's past on the on聽state ballots.
Idaho Legislative Panel To Hear Public Comments Today On Medicaid Expansion
The legislative committee reviewing health care options for Idaho鈥檚 working poor convenes a daylong session in the Capitol Wednesday, including a two-hour period of public testimony. Wednesday鈥檚 agenda features morning testimony from advocates on both sides of the debate over whether Idaho should expand Medicaid to cover the estimate 78,000 residents caught in a health coverage gap. Those residents earn too much to qualify for standard Medicaid health benefits, but not enough to qualify for subsidized coverage available on the state health insurance exchange. (Dentzer, 9/27)
The Alaska Department of Health and Social Services has settled its complaints with Xerox over management of Medicaid claims, resetting its health-care contract with the business giant for an agreed-upon series of performance standards. The state's claim against Xerox State Healthcare LLC followed the company's start of a multimillion-dollar Medicaid payment system about three years ago. The state said Xerox failed to issue timely and accurate payments to Alaska health care providers, among other problems. (Hanlon, 9/28)
State Highlights: New Calif. Law Requires All High Schoolers To Learn CPR; Still No Agreement Between Striking Minn. Nurses, Allina
Now a new law in California will require high schoolers to learn those skills in hopes they might one day save a life. Gov. Jerry Brown signed a bill into law Saturday that now mandates a CPR component in high schools where health classes are required to graduate, starting with the 2018-2019 school year. The previous law had given schools the choice to substitute a first aid component in those classes instead. According to the American Heart Association, only 30 percent of Americans are trained to administer CPR in an emergency and about 32 percent of heart attack victims get CPR when a cardiac emergency occurs. (Koh, 9/27)
Allina Health and the Minnesota Nurses Association negotiated throughout the day Tuesday at the behest of a federal mediator without reaching an agreement. The two sides met from morning until 11 p.m. before agreeing to take a break, according to an Allina spokesman. They planned to pick up the discussions again in the morning. Union and Allina spokespeople both declined to provide details about the talks while they were ongoing. (Cooney, 9/27)
The only Planned Parenthood location in the nation鈥檚 capital marked its grand opening this week in a booming, semi-industrial area of Northeast Washington 鈥 an area in the center of the city that the health-care provider hopes will be accessible to people from all corners of the District. ... 鈥淭here was a tremendous unmet need,鈥 said Laura Meyers, president of Planned Parenthood of Metropolitan Washington. 鈥淲ith almost no advertising, patients are finding us.鈥 (Stein, 9/27)
A new law could be in the works to regulate so-called 鈥渟ober homes鈥 in Florida.聽At a meeting attended by hundreds of residents in Lake Worth, Assistant State Attorney Al Johnson said that he is part of a task force created to crack down on 聽unscrupulous addiction recovery residences in Florida. The facilities are not currently required to be certified or licensed and the task force will propose legislation to change that. (9/27)
The former CEO of Tuomey Healthcare will personally pay $1 million to resolve his involvement in entering physician compensation arrangements that led to one of the largest-ever Stark law cases. Ralph "Jay" Cox III will also be excluded for four years from participating in any federal programs, the U.S. Department of Justice said on Tuesday. In October, Sumter, S.C.-based Tuomey agreed to pay $72.4 million to settle allegations of illegal compensation arrangements with doctors. As part of the settlement, Tuomey was sold to Palmetto Health. (Teichert, 9/27)
Tim Wendler聽doesn't give up easily. More than聽a year after his wife, Trickett Wendler, died from amyotrophic lateral sclerosis (ALS), he is giving voice to a congressional bill in her name. The Trickett Wendler Right to Try Act, authored by Republican U.S. Sen. Ron Johnson, would聽allow terminally ill patients to receive experimental drugs聽鈥 which have not been聽approved by the Food and Drug Administration 鈥斅燼nd聽where no alternative exists. There is聽a companion bill in the House. (Glauber, 9/27)
New York City has agreed to pay $5.75 million to settle a lawsuit stemming from the 2013 death of a mentally ill inmate who was found naked and covered in urine and feces after being locked in a cell at Rikers Island for six days. The settlement in Bradley Ballard鈥檚 death is apparently the largest the city has ever paid to settle a lawsuit over the death of an inmate in city custody. (Weiser, 9/27)
Medical-devices company Boston Scientific Corp. on Tuesday said it agreed to buy EndoChoice Holdings Inc. for roughly $210 million, expanding its endoscopy business as sales of some products have slowed. Boston Scientific said it would pay $8 a share in cash for EndoChoice, a 90% premium to its closing price of $4.22 a share on Monday. Boston Scientific, based in Marlborough, Mass., has diversified its product offerings in recent years to help pad softening sales in some bread-and-butter areas, such as pacemakers and implanted defibrillators. (Jamerson, 9/27)
Starting next month, transgender individuals or those who want to start their transition process will be able to go to Planned Parenthood clinics in Central Florida to get hormone therapy services... This adds Florida to the list of 15 other states under the umbrella of the national Planned Parenthood to offer hormone therapy. LGBT advocates say the service brings another trusted source of care to the transgender community, which has been historically discriminated against and faced barriers to care. It is also a positive sign that the Central Florida community is embracing diversity, they say. (Miller. 9/27)
One year after vetoing a similar measure, Gov. Jerry Brown signed a bill Tuesday that will allow pharmaceutical companies to offer experimental drugs to terminally ill Californians. A national 鈥渞ight to try鈥 movement, which seeks to expand access to not-yet-approved treatments for people who fail to get into clinical trials, yielded bills in California last year but Brown deferred to federal regulators in vetoing a measure on his desk. The governor signed this year鈥檚 similar version, Assembly Bill 1668, after it won broad support in the Legislature. It would allow drug manufacturers to offer treatments not yet approved by the U.S. Food and Drug Administration if a patient has exhausted other FDA-sanctioned treatment options and has approval from two physicians. (White, 9/27)
Abuses at a Pueblo center for people with severe intellectual disabilities included a resident performing a sexual act in exchange for a soda and another burned with a blow dryer in an attempt to raise her body temperature, according to a federal report obtained by The Denver Post. A group of men, some who are nonverbal, had words scratched into their skin, including 鈥渄ie,鈥 鈥渒ill,鈥 and 鈥淚鈥檓 back,鈥 federal investigators found. When questioned, three staffers said they believed the markings were the result of 鈥減aranormal activity.鈥 Staffers had posted photos of the etchings on social media, the report said. (Osher and Brown, 9/27)
State health officials have confirmed three new cases of Legionnaires鈥 disease linked to the ongoing Hopkins outbreak, bringing the total number to 20, including one death. In all the cases, including the three announced Tuesday, patients were exposed to the bacteria in the Hopkins area before Sep. 9. Since then, health officials have taken steps to eliminate possible infection sources; cooling towers on several local businesses were disinfected and a decorative fountain was shut down. (Howatt, 9/27)
Prescription Drug Watch
The Odd Silence From Patient Advocacy Groups On Drug Prices
Public anger over the cost of drugs has burned hot for a year, coursing through social media, popping up on the presidential campaign, and erupting in a series of congressional hearings, including one last week over the rising price of the allergy treatment EpiPen. But one set of voices has been oddly muted 鈥 the nation鈥檚 biggest patient advocacy groups. The groups wield multimillion-dollar budgets and influence on Capitol Hill, but they have been largely absent in the public debate over pricing. (Thomas, 9/27)
Even in an age when prescription drugs are increasingly expensive, a $9,500 tube of gel to combat scaly skin can gain notice 鈥 especially when the price spikes 128 percent overnight. That鈥檚 what happened earlier this month when a little-known company called Novum Pharma suddenly hiked wholesale prices for all three of its dermatology products by whopping amounts. (Silverman, 9/23)
A Chicago-based pharmaceutical company that's selling skin medications for thousands of dollars is the latest to take heat in the nationwide furor over drug pricing. (Schencker, 9/26)
With EpiPens and other prescription drugs rising in cost, families who desperately need them but do not have health insurance are bearing a huge financial burden, according to community advocates. The Maryland Citizens鈥 Health Initiative, a coalition of more than 1,200 religious, labor, business and policy groups seeking quality and affordable health care, wants the state legislature to address that financial burden by overhauling some of the laws governing drug pricing. (Escobar, 9/27)
The California Drug Price Relief Act would require the state to pay no more for prescription drugs than the Department of Veterans Affairs pays聽for the same medication. The federal agency negotiates drug prices with pharmaceutical companies, paying on average one-quarter less for drugs than other government agencies. The poll shows support for Proposition 61 is broad-based. Subgroups of likely voters most in favor include Democrats, liberals, voters in the nine-county Bay Area and Los Angeles County, college graduates, those under age 30 and Latinos. (Seipel, 9/24)
Does having your medication mailed to your door sound appealing? The discounts are often significant, especially for drugs that people take regularly, such as those for diabetes and high blood pressure. You might be able to order a three-month supply for a co-payment of just a few dollars. In some cases, you might be eligible to get generic medications with no co-pay at all, and free shipping. In addition, of course, there鈥檚 no need for you to go to a drugstore. (9/23)
Sen. Amy Klobuchar (D-Minn.) on Monday laid out several paths forward for drug price legislation, though she said any movement could be dependent on a 鈥渢rigger moment.鈥 Possible vehicles, she said, include the prescription drug user fee agreement that must be passed next year, the 21st Century Cures Act, tax reform and reforms to the Affordable Care Act. Legislation could also pass as a package of pharmaceutical price reforms. (Owens, 9/26)
Mylan raised EpiPen鈥檚 鈥渢o get filthy rich at the expense of our constituents,鈥 [Maryland Representative Elijah] Cummings said. Their strategy was to 鈥渇ind an old cheap drug that has virtually no competition and raise the price over and over and over again as high as you can.鈥 (Rood, 9/21)
Perspectives: Mylan CEO's Hearing, Though Dreadful, Could Have Positive Results
Heather Bresch was beaten up by Congress last week 鈥 and rightfully so. The Mylan Pharmaceuticals chief executive testified before a House committee investigating EpiPen price hikes, and her performance was largely dreadful. Although soft-spoken and respectful, she often dodged questions, and too many of the answers she did give were vague or hard to follow. Nonetheless, the hearing may yet prove beneficial. (Ed Silverman, 9/27)
Here鈥檚 why the drugmaker should apologize to consumers. As the CEO of the drug maker that sells the EpiPen allergy-reaction injector defended the company鈥檚 six-fold price increases before Congress last week, it鈥檚 appalling to see that Heather Bresch took no fault. The company鈥檚 price hikes on a life-saving drug is clearly unethical if we take a closer look. EpiPen has gone from $100 for a two-pack in 2009 to $608 today. Usually, companies would be applauded for the ability to create revenue through such pricing power. But when it comes to life-saving drugs, consumers interpret these significant increases as the producer profiteering off a person鈥檚 life or death need. (Daniel Kozarich, 9/27)
The disregard for children's health that Mylan CEO Heather Bresch demonstrated in her testimony to the House Oversight and Government Reform Committee directly harms consumers. Less directly, Mylan's exceptionally high price increases erode public confidence in all medical companies, including those investing billions in research to help people suffering from life-threatening diseases. (Bill George, 9/27)
Profiteering in the drug business has been generating outrage for months now. Gilead Sciences and Mylan have been taking the heat for huge increases in the prices, respectively, for聽their hepatitis-C cures and injectors to fend off life-threatening allergic reactions. But at least we can say this about them: Their products work. (Michael Hiltzik, 9/26)
I carry an EpiPen for my grandson鈥檚 peanut allergy whenever he is with me. This device can mean the difference between life and death. Millions of Americans have shouldered the skyrocketing price of the EpiPen, more than 400 percent since 2007, because the cost of going without this life-saving product would simply be too high. (Doris Matsui, 9/24)
One of the most unsatisfying aspects of the Mylan hearing 鈥 and a February verbal takedown of Turing Pharmaceuticals鈥 Martin Shkreli by the same committee 鈥 is that they were postmortems, not preemptive strikes. By the time fingers started pointing at the unrepentant CEOs, their companies already had made many millions of dollars from selling grossly overpriced products. A bipartisan bill just filed on Capitol Hill won鈥檛 stop such profiteering. It might, however, do away with some of the mystery surrounding pricing, and allow consumers and elected officials to weigh in before a hike takes effect. The proposal calls for requiring companies to provide the Department of Health and Human Services with a report explaining any price increase of 10 percent or more in an 鈥渦nderstandable online format鈥 鈥 30 days in advance of its implementation. (9/23)
It has been three years since the Centers for Disease Control and Prevention effectively declared victory in the fight against Methicillin-resistant Staphylococcus aureus or MRSA and reported a decrease by over 50 percent in hospital-acquired MRSA infections. Now the United States is refocusing its efforts on antibiotic development and antibiotic stewardship, designed to both treat and prevent the emergence of infectious superbugs. (Devin Kavanagh, 9/23)
Editorials And Opinions
Viewpoints: Recognizing The Superbug Danger; Confronting Mental Health Stigma
Tuberculosis. Malaria. Syphilis. Gonorrhea. The microbes that cause these diseases are increasingly resistant, and sometimes even impervious, to antibiotics that worked in the past. Last week, amid other pressing business, 193 nations at the United Nations General Assembly signed a declaration summoning each of them to a war against a powerful and resourceful enemy: superbugs that have learned to evade science鈥檚 last remaining defenses. (9/28)
It鈥檚 no secret that there鈥檚 a veil of shame surrounding mental illness. Nearly one in five American adults will experience a mental health disorder in a given year. Yet only 25 percent of people with a psychological condition feel that others are understanding or compassionate about their illness, according to the U.S. Centers of Disease Control and Prevention. (Lindsay Holmes, 9/27)
Mental illness does not target one demographic or group, nor does it avoid others. It is an equal opportunity disease. Whether it impacts the life of a school teacher, a business executive, a stay at home mom, or a young college student 鈥 mental illness and its unfortunate societal stigma can have a devastating impact on a person and their loved ones. When they realize they can no longer manage the emotional pain and other consequences of the illness, one of the first questions asked is, 鈥淲here do I turn for help?鈥 (Ramona Johnson, 9/27)
In anticipation of Halloween, the folks who run Knott鈥檚 Berry Farm did a lousy thing, and mental health advocates were outraged. Then on Tuesday afternoon, park managers聽reversed course and shut down an attraction. But did they聽do so for the right reasons? Here鈥檚 the story; you be the judge. (Steve Lopez, 9/27)
Like 35 other states, Virginia requires health-care providers to get the state鈥檚 permission before they can spend their own money on capital investments such as new buildings and new equipment. Big players 鈥 hospital chains especially 鈥 routinely try to game the system to thwart competition from one another and from upstart entrepreneurs who bring new ideas and approaches to the delivery of medicine. Defenders of the system claim it helps hold down costs. But as the Department of Justice and the Federal Trade Commission have long pointed out, it doesn鈥檛. (9/27)