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3. Political Cartoon: 'Keep Me Posted'

Kaiser Health News provides a fresh take on health policy developments with "Political Cartoon: 'Keep Me Posted'" by Dave Coverly, Speed Bump.

Here's today's health policy haiku:


Broad warning: No need …
At least that’s what execs said.
Doesn’t look good now.

If you have a health policy haiku to share, please Contact Us and let us know if you want us to include your name. Keep in mind that we give extra points if you link back to a KHN original story.

Summaries Of The News:

Campaign 2016

4. 'Traditional Catholic' Kaine's Personal Qualms About Abortion A Contrast To Clinton

Although Hillary Clinton's running mate Tim Kaine says "the right role for government is to let women make their own decisions," he has some history with supporting anti-abortion programs that could make the topic a vulnerable spot for the Democrat in his debates with Republican vice presidential nominee Mike Pence.

The Associated Press: Kaine Liberal Appeal Muted By Energy Ties, Abortion Concerns
Hillary Clinton and running mate Tim Kaine are closely aligned on many issues, but Kaine's cautious, left-leaning political profile in a closely contested state is blurred by his ties to energy industry interests and his personal qualms over abortion. ... Clinton and Kaine are avowed champions of women's reproductive rights. But as a self-described "traditional Catholic," Kaine has long said he personally opposes abortion, a stance that drew criticism from women's groups. His personal qualms could cause complications later in the campaign when he debates Republican rival Mike Pence, an anti-abortion crusader. (7/23)

The New York Times: How Tim Kaine And Hillary Clinton Compare On The Issues
As governor of Virginia, Mr. Kaine supported some restrictions on abortion and said as a “traditional Catholic” that he was personally against abortion but supported abortion rights. As a senator, Mr. Kaine has voted in favor of funding Planned Parenthood and against attempts to restrict access to legal abortions. But he has also sought to reduce the number of abortions through education programs advocating adoption and abstinence. (Shepherd and Rappeport, 7/22)

Meanwhile, Kaine's views do align with Clinton's over improving the health law and expanding Medicaid —

Modern Healthcare: Clinton's VP Pick Kaine Is A Strong Backer Of Improving And Expanding The ACA
The man selected by presumptive Democratic presidential nominee Hillary Clinton as her vice presidential running mate is a strong ally of Clinton's in her push for improving the Affordable Care Act and expanding Medicaid to more states.Virginia Sen. Tim Kaine, whom Clinton named Friday as her running mate, has sponsored several bills to fix gaps and glitches in the ACA and to encourage more states to extend Medicaid to low-income adults. (Meyer, 7/22)

5. Clinton Likely To Make Health Care A Major Theme At Convention

Stat raises five questions about how the issue will play at this week's Democratic National Convention. Other media outlets look at what health care will look like under a new president and how Hillary Clinton's Medicare buy-in plan might appeal to insurers and employers.

Stat: 5 Health And Medicine Issues To Watch For At The Democratic Convention
Hillary Clinton led a health care reform effort in the 1990s, promoted medical research as a senator, and has been bashing price-hiking drug companies on the campaign trail and in TV ads. So there’s every reason to expect her to make health care a major theme when she accepts the Democratic presidential nomination in Philadelphia on Thursday night. (Nather, 7/25)

Roll Call: Clinton Medicare Buy-In Plan May Appeal To Insurers, Employers
Employers and insurers might benefit if Democrat Hillary Clinton were to win the presidency and persuade Congress to expand Medicare, policy experts say. Clinton supports allowing people to buy into the federal health program for senior citizens and those with disabilities at age 55, a decade earlier than usual. The potential for corporate backing for a Medicare expansion likely would depend on how a future president and Congress shaped such a proposal. Clinton’s platform doesn’t spell out the details. America’s Health Insurance Plans, a trade group for the health insurance industry, declined to comment, saying officials are waiting for more information. (Young, 7/22)


6. $1B Fraud Case Shines Light On Lucrative Medicare Black Market

Three people have been charged in the largest single criminal health care fraud case ever brought against individuals by the Department of Justice. “Medicare fraud has infected every facet of our health care system,” Wifredo A. Ferrer, the United States attorney in Miami, said Friday in announcing the indictments.

The New York Times: U.S. Says Florida Network Defrauded Medicare And Medicaid Of Over $1 Billion
In the biggest health care fraud case the Justice Department has ever brought, prosecutors charged on Friday that the owner of a network of Florida nursing facilities orchestrated an elaborate scheme to defraud Medicare and Medicaid of more than $1 billion over the last 14 years. The case, featuring allegations of bribes to Miami doctors, hush money to witnesses, and laundering of huge profits through shell companies, shone a light on a lucrative Medicare black market that has surfaced in the last decade. (Lichtblau, 7/22)

The Associated Press: Authorities: $1B Medicare Fraud Nursing Home Scam, 3 Charged
"This is the largest single criminal health care fraud case ever brought against individuals by the Department of Justice," Assistant Attorney General of the Justice Department's Criminal Division Leslie Caldwell announced in a statement. Authorities said Philip Esformes, who ran 30 nursing homes and assisted living facilities, joined with two conspirators and a complex network of corrupt doctors and hospitals to refer thousands of patients to their facilities even though the patients did not qualify for the services. Some of the treatments were harmful, they added. (Kennedy, 7/22)

The Wall Street Journal: Justice Department Charges Three In $1 Billion Medicare Fraud Scheme In Florida
The case was brought as part of an interagency Medicare Fraud Strike Force, which operates in nine locations across the country, officials said. Since its creation in March 2007, the task force has charged nearly 2,900 defendants who have collectively billed the Medicare program for more than $10 billion, they said. Fraud continues to plague the roughly $600 billion Medicare program, though new criminal cases have slowed in recent years. (O'Keeffe, 7/22)

Bloomberg: U.S. Charges 3 In $1 Billion Miami-Based Medicare Fraud Case
The Justice Department charged three Florida health care executives for allegedly carrying out a $1 billion Medicare scam involving numerous Miami-based medical providers. ... Philip Esformes, owner of a chain of more than 30 Miami-area skilled nursing and assisted living facilities, allegedly conspired with two other people to defraud Medicare by providing medically unnecessary services to people, according to a 34-page indictment released Friday. (Strohm and Harris, 7/22)

7. Medicare Safeguard Leaves Taxpayers Pouring Billions Into Pharma's Pockets

Medicare's catastrophic coverage was originally designed to protect seniors with multiple chronic conditions from the cumulatively high costs of taking many different pills, with the government paying 80 percent of the cost of drugs above a catastrophic threshold. But pricey drugs are stressing the system to its limits.

The Associated Press: Pricey Drugs Overwhelm Medicare Safeguard
A safeguard for Medicare beneficiaries has become a way for drugmakers to get paid billions of dollars for pricey medications at taxpayer expense, government numbers show. The cost of Medicare's "catastrophic" prescription coverage jumped by 85 percent in three years, from $27.7 billion in 2013 to $51.3 billion in 2015, according to the program's number-crunching Office of the Actuary. Out of some 2,750 drugs covered by Medicare's Part D benefit, two pills for hepatitis C infection — Harvoni and Sovaldi — accounted for nearly $7.5 billion in catastrophic drug costs in 2015. (Alonso-Zaldivar, 7/25)

The Associated Press: What Are The Top 20 Priciest Medicare Prescription Drugs?
A look at Medicare's top 20 priciest prescription drugs in 2015, ranked by their cost above the program's "catastrophic" coverage threshold. Medicare's catastrophic protection kicks in after a beneficiary has spent a given amount of their own money, $4,850 this year. The beneficiary pays only 5 percent, while their insurer pays 15 percent, and taxpayers cover 80 percent. Catastrophic spending is a large and growing share of total costs, threatening to make Medicare's popular prescription plan financially unsustainable. (7/25)

Health Law Issues And Implementation