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4. Political Cartoon: 'Down The Drain'

Kaiser Health News provides a fresh take on health policy developments with "Political Cartoon: 'Down The Drain'" by Monte Wolverton.

Here's today's health policy haiku:

PROFITABLE NONPROFITS

Hospital profits
Are mostly in non-profits.
What happened to "non"?

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Summaries Of The News:

Quality

5. Researchers Call For Better Tracking Of Medical Errors As They Climb To No. 3 Cause Of Deaths

Only heart disease and cancer take more lives than medical errors in America, and the exact toll is unknown because the coding system used by the Centers for Disease Control and Prevention to record death certificate data doesn't capture things like communication breakdowns, diagnostic errors and poor judgment that cost lives, says a new study in the journal BMJ.

NPR/ProPublica: Medical Errors Are No. 3 Cause Of U.S Deaths, Researchers Say
A study by researchers at Johns Hopkins Medicine says medical errors should rank as the third leading cause of death in the United States — and highlights how shortcomings in tracking vital statistics may hinder research and keep the problem out of the public eye. The authors, led by Johns Hopkins surgeon Dr. Martin Makary, call for changes in death certificates to better tabulate fatal lapses in care. In an open letter, they urge the Centers for Disease Control and Prevention to immediately add medical errors to its annual list reporting the top causes of death. (Allen and Pierce, 5/3)

The New York Times: Medical Errors May Cause Over 250,000 Deaths A Year
If medical error were considered a disease, a new study has found, it would be the third leading cause of death in the United States, behind only heart disease and cancer. Medical error is not reported as a cause of death on death certificates, and the Centers for Disease Control and Prevention has no “medical error” category in its annual report on deaths and mortality. But in this study, researchers defined medical error as any health care intervention that causes a preventable death. (Bakalar, 5/3)

The Washington Post: Researchers: Medical Errors Now Third Leading Cause Of Death In United States
Martin Makary, a professor of surgery at the Johns Hopkins University School of Medicine who led the research, said in an interview that the category includes everything from bad doctors to more systemic issues such as communication breakdowns when patients are handed off from one department to another. "It boils down to people dying from the care that they receive rather than the disease for which they are seeking care," Makary said. (Cha, 5/3)

Los Angeles Times: Medical Errors Are No. 3 Cause Of Death In The U.S., After Heart Disease And Cancer
Fatal medical errors include cases in which patients received medications they were allergic to and instances in which patients died of preventable infections, among many other possibilities. Doctors and nurses are not necessarily involved, experts said — sometimes a faulty computer program may be to blame. “Medical care has become really complex,” said Dr. David Classen, an associate professor of medicine at the University of Utah who was not involved in the study. “It's no longer one single physician taking care of a single person at a hospital. It's these huge groups of people now, and mistakes get made.” (Netburn, 5/3)

CNN: Medical Errors May Be Third Leading Cause Of Death In The U.S.
The study gives an example of exactly how limited the death certificates are when it comes to recording medical errors. One example involved a patient who had a successful organ transplant and seemed healthy, but had to go back to the hospital for a non-specific complaint. During tests to determine what was wrong, a doctor accidentally cut her liver and hadn't realized it. The hospital sent her home, but she returned with internal bleeding and went into cardiac arrest and later died. It was the cut that led to her death, but her death certificate only listed a cardiovascular issue as the cause. (Christensen and Cohen, 5/3)

STAT: Medical Errors Are Third-Leading Cause Of Death In The U.S.
This paper builds upon a recent study that found that more than 210,000 deaths per year occur due to medical errors. When adjusting for 2013 hospital admission rates, Makary and his colleague found that the present number is more likely 251,454 deaths per year — surpassing the CDC’s stated third-leading cause of death, respiratory disease, which kills close to 150,000 people per year. The leading cause of death in the US is heart disease, followed by cancer. (Swetlitz, 5/3)

CBS News: Medical Errors Now 3rd Leading Cause Of Death In U.S., Study Suggests
For the study, Makary and his colleagues evaluated four separate studies that analyzed medical death rate data from 2000 to 2008, including one by the U.S. Department of Health and Human Services' Office of the Inspector General and the Agency for Healthcare Research and Quality. Based on 2013 data on hospitalization rates, they found that of 35,416,020 hospitalizations, 251,454 deaths stemmed from a medical error. They said that adds up to 9.5 percent of all deaths a year in the U.S. (Marcus, 5/4)

Health Law Issues And Implementation

6. Watchdog Finds IRS Calculated Health Law Credits Correctly On 93 Percent Of Returns

In other news, employers say in a poll that they will turn to contract workers more frequently because of the Affordable Care Act, both sides of the aisle in Minnesota's legislature know that the state's exchange needs fixing, and insurers say smokers are dodging surcharges.

The Hill: Report: IRS Correctly Calculated ObamaCare Tax Credit On Most Returns
The Internal Revenue Service correctly determined the allowable amount of the ObamaCare-related premium tax credit on most tax returns, a report made public Tuesday found. The tax credit, created by the Affordable Care Act, is designed to help offset the costs of health insurance for low- and moderate-income people. ... The Treasury Inspector General for Tax Administration (TIGTA) analyzed more than 2.6 million tax returns filed from January to May 2015 that claimed the credit. The watchdog said in its report that it determined that the IRS accurately calculated the allowable credit on 93 percent of the returns. (Jagoda, 5/3)

The Fiscal Times: How Obamacare Is Fueling The Gig Economy
The desire for autonomy and work-life balance is driving more workers into freelance roles, but at the same time there are growing incentives for companies to employ workers via contracts rather than hire them full-time. Chief among those incentives is the cost of providing (or not providing) health care to workers under the Affordable Care Act. Nearly three-quarters of companies said that they would contract with more freelancers this year because of Obamacare, according to a new survey by online work platform Field Nation and executive development firm Future Workplace. (Braverman, 5/3)

Minnesota Public Radio: Lawmakers split on MNsure changes as campaign fight looms
For as much as Minnesota Republicans despise MNsure, they love to talk about it. They've written letters, legislation and plenty of campaign literature since even before the insurance marketplace went live in a problem-plagued 2013 rollout. This legislative session, they are again taking aim. Republicans have passed measures to slice MNsure's operating allowances, alter its leadership structure and phase out the state exchange altogether. Their goal is to put Minnesota into a federally run marketplace beginning in 2018. (Bakst, 5/4)

Kaiser Health News: Smokers’ Ranks Look Conspicuously Sparse In Obamacare
Barred from restaurants, banned on airplanes and unwelcome in workplaces across America, smokers have become accustomed to hiding their habits. So it’s no surprise many may now also be denying their habit when they buy health coverage from the federal health law’s insurance exchanges. Insurers -- who can charge higher rates in most states to admitted smokers -- are steamed. (Galewitz, 5/4)

Meanwhile, the man who played a crucial role in the Affordable Care Act's passage is stepping down —

The Washington Post: Leader Of Families USA, Pivotal In Passing Affordable Care Act, Will Step Down
After 33 years as [executive director of Families USA, Ron] Pollack will announce Wednesday that he plans to step down next March. ... Under his direction, Families USA became a major player in almost every big health-care battle of the past several decades. It was at the forefront of pushing for the creation of the Children’s Health Insurance Program in 1997 and in opposing changing Medicaid into a block-grant program. (McGinley, 5/4)

7. Aide To S.D. Gov. Says Federal Policy Changes Could Make It Easier To Expand Medicaid

State officials are checking whether changes in federal policy for covering Native Americans' Medicaid costs could free up funding for Medicaid expansion. Also in the news, Louisiana's governor says his plan to expand Medicaid will help hospitals, and Arkansas political leaders applaud the legislative effort there to keep the state's program.

The Associated Press: Funding Could Make SD Medicaid Expansion Easier
South Dakota's ability to expand Medicaid under Gov. Dennis Daugaard's conditions got a boost from federal policy changes that could help the state cover the costs of expansion, a top adviser to the governor said. Officials examining expansion hope to have a better idea next month whether a federal move to take on more Medicaid costs for Native American enrollees will allow South Dakota to cut spending enough to offset broadening eligibility for the public health coverage program. Daugaard has proposed expanding Medicaid as long as the state's share of the cost is covered by savings contingent on the federal policy changes. (5/3)