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KHN First Edition: August 22, 2016


First Edition

Monday, August 22, 2016
Check Kaiser Health News online for the latest headlines

Today's early morning highlights from the major news organizations.

Kaiser Health News: ‘More At Peace’: Interpreters Key To Easing Patients Final Days
KHN's Eryn Brown reports: "Interpreters routinely help people who speak limited English — close to 9 percent of the U.S. population, and growing — understand what’s happening in the hospital. They become even more indispensable during patients’ dying days. But specialists say interpreters need extra training to capture the nuances of language around death.Many doctors and nurses need the assistance of interpreters not only to overcome language barriers but also to navigate cultural differences. Opportunities for miscommunication with patients abound. Words don’t always mean the same thing in every language." (8/22)

Kaiser Health News: Doctors, Hospitals Prepare For Difficult Talks Surrounding Medical Mistakes | Kaiser Health News
KHN's Zhai Yun Tan reports: "Hospitals have traditionally been reticent to disclose to patients or their family members the specifics of how a medical procedure didn’t go as planned for fear of malpractice lawsuits. In recent years, though, many are beginning to consider a change. Instead of the usual “deny-and-defend” approach, they are revamping their policies to be more open. To help them move in this direction, the federal Agency for Healthcare Research and Quality released in May an online toolkit designed to expand the use of the agency’s “Communication and Optimal Resolution” process, which establishes guidelines for adopting more transparency in communicating adverse events." (8/22)

California Healthline: Race, Ethnicity Affect Kids’ Access To Mental Health Care, Study Finds
KHN's Shefali Luthra reports: "One in five Americans is estimated to have a mental health condition at any given time. But getting treatment remains difficult — and it’s worse for children, especially those who identify as black or Hispanic.That’s the major finding in research published last week in the International Journal of Health Services. The study examines how often young adults and children were able to get needed mental health services, based on whether they were black, Hispanic or white." (8/22)

The Wall Street Journal: Nonprofit Hospitals’ Business Relationships Can Present Conflicts
Nonprofit hospitals have extensive business ties that can pose conflicts of interests for their administrators and board members, a Wall Street Journal analysis of newly released Internal Revenue Service data shows. While having relationships with companies doing business with a nonprofit hospital isn’t necessarily improper—as long as the deals are disclosed and at market rate—administrators and board members sometimes may be forced to choose between what’s best for the hospital and what’s best for their private interests. (Fuller and Evans, 8/21)

The New York Times: U.S. Officials Move To End Duplicate Health Care Coverage
The Obama administration is moving to end duplicate coverage for tens of thousands of people who are enrolled in Medicaid and simultaneously receiving federal subsidies to help pay for private health insurance under the Affordable Care Act. In the last few days, consumers around the country have received letters warning, in big black type: “People in your household may lose financial help for their marketplace coverage.” (Pear, 8/21)

The Wall Street Journal: Some Small Businesses Restore Group Health Coverage
Some small companies that dropped group health insurance for their employees are reversing course, driven by a tightening labor market and rising costs and fewer choices for individual coverage. Laura Cottrell, owner of a seven-person home-furnishings and home-improvement products business in St. Louis, dropped group coverage in 2014, not only because of the cost but also the complexities of picking the right plan within a short deadline. Instead, she gave her employees a raise that they could use to buy their own health plans, sparing her from choosing for them. (Simon, 8/21)

The New York Times: Think Your Obamacare Plan Will Be Like Employer Coverage? Think Again
When Obamacare was developed, one goal was to allow middle-class Americans to use the new marketplaces to buy the same kind of health insurance they had at their jobs. People could retire early, or quit a corporate job and become a freelancer, and still have the great care and financial protection that come with high-end plans. But six years into the health law, the reality is that a typical Obamacare plan looks more like Medicaid, only with a high deductible. (Sanger-Katz, 8/21)

The New York Times' The Upshot: Obamacare Options? In Many Parts Of Country, Only One Insurer Will Remain
So much for choice. In many parts of the country, Obamacare customers will be down to one insurer when they go to sign up for coverage next year on the public exchanges. A central tenet of the federal health law was to offer a range of affordable health plans through competition among private insurers. But a wave of insurer failures and the recent decision by several of the largest companies, including Aetna, to exit markets are leaving large portions of the country with functional monopolies for next year. (Abelson and Sanger-Katz, 8/21)

USA Today/Milwaukee Journal Sentinel: Health Insurers Eye Steep Increases As Enrollment Period Nears
With the fourth open-enrollment period set to begin this fall for the marketplaces set up by the Affordable Care Act, it’s becoming clear that the market for health insurance has not evolved as expected, or hoped. The market is smaller than projected. The people who have bought health plans overall are sicker than predicted. And health insurers have incurred larger losses than anticipated. (Boulton, 8/22)

The Associated Press: Repeal Or Retain? Election Opens Final Act For 'Obamacare'
Election Day 2016 will raise the curtain on the final act in the nation's long-running political drama over President Barack Obama's health care overhaul. If Republican Donald Trump wins, the unraveling begins. "We have an obligation to the people who voted for us to proceed with 'repeal and replace,'" said Sen. John Barrasso, a Wyoming Republican. If Democrat Hillary Clinton goes to the White House, it gets very difficult for Republicans to keep a straight face about repealing "Obamacare." (Alonso-Zaldivar, 8/20)

The Associated Press: Without A Subsidy, Couple Faces Higher Insurance Premiums
With a household income too high for a federal subsidy, Bruce Mainzer and Beth Shadur are bracing for higher health insurance premiums in 2017. As in other states, many insurers in Illinois have requested double-digit rate increases. Americans ineligible for the government subsidies that help cover their premiums will be hit hardest. (Johnson, 8/20)

The Associated Press: Man Who Owes Insurance To 'Obamacare' Still Voting For Trump
When Bruce Bradford was fired after nearly two decades as a federal police officer, he lost his income, his health insurance and eventually his wife and apartment as his medical problems mounted. He ended up being thrown a lifeline by the very politicians he can't stand. Bradford, a longtime Republican who dislikes big government and what he regards as handouts, obtained insurance and a monthly government subsidy under President Barack Obama's health care overhaul. (Kennedy, 8/20)

The Associated Press: Cancer Patient Could Not Get Coverage Before 'Obamacare'
Health care will be on Rebecca Esparza's mind in the voting booth this fall. The two-time cancer survivor from Corpus Christi, Texas, said repealing the Affordable Care Act, as Republicans have tried to do dozens of times, could make her uninsurable. "I realize this is something that could happen," she said. "It's a terrifying thought for me not to have any insurance at all." (Johnson, 8/20)

The Associated Press: Popular 'Obamacare' Provision Gives Young Adults Coverage
It's a popular part of the Affordable Care Act. Soon after the provision went into effect, the number of uninsured Americans ages 19 to 25 dropped by 1.6 million, according a government survey. More young adults received health insurance as the law's other provisions took effect in 2014. By last year, fewer than 5 million were uninsured, about half the number when the law passed in 2010. (Mulvihill, 8/20)

The Associated Press: Tanning Industry Blames 10,000 Salon Closings On 'Obamacare'
The tanning salon industry is feeling burned by "Obamacare." Business owners around the country say the little-noticed 10 percent tax on tanning in President Barack Obama's health care overhaul has crippled the industry, forcing the closing of nearly 10,000 of the more than 18,000 tanning salons in the U.S. Experts say the industry is overstating the effects of the "tan tax" and that it has been hurt by other factors, too, including public health warnings about the dangers of tanning and the passage of laws in dozens of states restricting the use of tanning salons by minors. (Kennedy, 8/20)

Politico: The County Obamacare Forgot
An Arizona county is poised to become an Obamacare ghost town because no insurer wants to sell exchange plans there. Aetna’s announcement that it would exit most of the states where it offers Obamacare plans leaves residents of Pinal County, Ariz., without any options to get subsidized health coverage next year, unless regulators scramble to find a carrier to fill the void between now and early October. (Pradhan, 8/21)

The Washington Post: Zika Virus Now Actively Spreading In Miami Beach, CDC Expands Travel Advisory
Florida Gov. Rick Scott confirmed Friday that the Zika virus is being spread locally by mosquitoes in Miami Beach, a development that marks an expansion of the outbreak in South Florida and immediately prompted a new travel advisory by federal officials. "We believe we have a new area where local transmissions are occurring in Miami Beach,” Scott said at a noon press conference. The suspect zone covers about 1.5 square miles between 8th and 28th streets, and between the beach and the intracoastal waterway -- a stretch that encompasses the city's central tourist area. (Dennis, 8/19)

Politico: Worried Florida Republicans Push Ryan For Zika Action
When Republicans left town this summer, they abandoned a billion-dollar Zika rescue package that had become mired in partisan infighting. But now some rank-and-file Florida Republicans — who represent scared constituents clamoring for Washington to do something — are pressuring their leaders to get a deal done, no matter what it takes. Rep. Ileana Ros-Lehtinen asked Speaker Paul Ryan (R-Wis.) to convene an emergency session of Congress to pass a Zika bill immediately. Rep. Carlos Curbelo is worrying that Congress’ lack of action could cripple him in an already tough reelection battle. And a number of Florida Republicans, including Rep. Dennis Ross, want their party to fully fund President Barack Obama's larger $1.9 billion Zika request. (Bade, 8/19)

The New York Times: The Beat, And The Bug Spray, Go On In South Beach Despite Zika Threat
As local government and tourism officials emphasized that the safety of residents, workers and guests came first, it was hard to sidestep the obvious: Would tourists stay away from the island’s alluring beaches, hip hotels and just-about-anything-goes clubs? And if they did, what would it mean for the economy of Miami Beach — the superstar of the county’s $36 billion tourism industry? (Alvarez and Madigan, 8/20)

The Wall Street Journal: Zika Virus Spread Renews Focus On Abortion Debate
The continued increase in the number of pregnant women possibly infected with Zika—which reached 529 in the states and the District of Columbia as of Aug. 11, according to the Centers for Disease Control and Prevention—is focusing renewed attention on the controversial issue of late-term abortions. It comes as many state legislatures are tightening restrictions on such procedures. Some of the most active efforts are in the South, one of the regions most vulnerable to the spread of Zika by mosquitoes. (Campo-Flores and Frosch, 8/21)

The New York Times: In Florida, Pregnant Women Cover Up And Stay Inside Amid Zika Fears
Amanda Paradiz is 16 weeks pregnant, and she has a mission: to get through her entire pregnancy without a single mosquito bite.It hasn’t been easy. Ever since health officials in July announced four cases of Zika transmission by local mosquitoes detected in a Miami-area neighborhood, Mrs. Paradiz and her husband, Alex, have largely secluded themselves in their Broward County home. (Rabin, 8/19)

NPR: New Zika Outbreak Hits Popular Tourist Destination Of Miami Beach
That decision to issue a warning about the entire city was prompted by the agency's concern that there may be other outbreaks in other parts of Miami-Dade that haven't been identified yet, CDC Director Thomas Frieden told reporters during a briefing. "What we are doing is stepping back and saying, 'There have now been multiple instances of local transmission,'" Frieden said. "We will always err on providing more information to the public." (Stein, 8/19)

USA Today: CDC: Pregnant Women Should Avoid Part Of Miami Beach Affected By Zika
The affected area of Miami Beach includes South Beach and stretches from the beach to the Intracoastal Waterway, from 8th Street to 28th Street. The neighborhood is several miles away and on the other side of Biscayne Bay from Wynwood, the first Miami neighborhood to experience a Zika outbreak.People who live in or who have traveled to this part of South Beach since July 14 should be "aware of active Zika virus transmission," the CDC said. (Szabo and Freeman, 8/19)

The New York Times: New York City Wages War On The Zika Virus
The droplets would awaken any insects in the area, cause them to take flight and then kill them. The spraying is called adulticide — as opposed to larvicide, or killing insects before they hatch — and it was the first time that such a truck had ever rolled through the neighborhood. (Santora, 8/21)

The New York Times: Private Equity Pursues Profits In Keeping The Elderly At Home
With the support of private equity money, InnovAge aims to aggressively expand a little-known Medicare program that will pay to keep older and disabled Americans out of nursing homes.Until recently, only nonprofits were allowed to run programs like these. But a year ago, the government flipped the switch, opening the program to for-profit companies as well, ending one of the last remaining holdouts to commercialism in health care. The hope is that the profit motive will expand the services faster. (Varney, 8/22)

The Associated Press: As The Number Of Freestanding ERs Grows, So Does Scrutiny
Freestanding emergency centers have sprouted in recent years across the suburban landscape, taking root in affluent neighborhoods and directly challenging nearby medical clinics and hospitals. ... As these centers offer another choice for people tired of deflating wait times at hospital emergency rooms, their escalating numbers are sending ripples across the health-care field. Critics say they do little to help those in rural America with dire medical needs, siphon away skilled emergency physicians and too often stick patients with overinflated bills. (Warren, 8/21)

The New York Times: The Life-Changing Magic Of Choosing The Right Hospital
There’s an exceedingly simple way to get better health care: Choose a better hospital. A recent study shows that many patients have already done so, driving up the market shares of higher-quality hospitals. A great deal of the decrease in deaths from heart attacks over the past two decades can be attributed to specific medical technologies like stents and drugs that break open arterial blood clots. But a study by health economists at Harvard, M.I.T., Columbia and the University of Chicago showed that heart attack survival gains from patients selecting better hospitals were half as large as those from breakthrough technologies. (Frakt, 8/22)

The New York Times: Whose Lives Should Be Saved? To Help Shape Policy, Researchers In Maryland Ask The Public
For the past several years, Dr. Lee Daugherty Biddison, a critical care physician at Johns Hopkins, and colleagues have led an unusual public debate around Maryland, from Zion Baptist Church in East Baltimore to a wellness center in wealthy Howard County to a hospital on the rural Eastern Shore. Preparing to make recommendations for state officials that could serve as a national model, the researchers heard hundreds of citizens discuss whether a doctor could remove one patient from lifesaving equipment, like a ventilator, to make way for another who might have a better chance of recovering, or take age into consideration in setting priorities. (Fink, 8/21)

The Wall Street Journal: Pfizer Nears Agreement To Buy Medivation
Pfizer Inc. is nearing agreement to buy biotech firm Medivation Inc. in a move that would add one of the crown jewels of the multibillion-dollar market for cancer drugs to Pfizer’s portfolio, according to people familiar with the matter. The $14 billion all-cash deal could be announced as early as Monday, one of the people said. It would end months of bidding for San Francisco’s Medivation, one of the most desired independent biotech companies because it sells a leading prostate-cancer drug. (Rockoff, 8/22)

USA Today: Pediatric Group Says Doctors Should Treat Teen Opioid Addicts With Medicine
Jennifer Weiss-Burke knew there was a potentially life-saving medication for her 15-year-old son, who became addicted to painkillers and heroin after a sports injury. Yet she had to call dozens of doctors before finding one to prescribe it. ... The medication, buprenorphine, is used to treat addiction to opioids, such as heroin or prescription painkillers. It can suppress withdrawal symptoms, decrease cravings and cut the risk of relapse. (Shedrofsky, 8/22)

USA Today: Reports: Pills Found At Prince Estate Were Mislabeled
Drugs collected from Prince's Paisley Park estate after his body was discovered April 21 were counterfeit pills that contained fentanyl, the powerful painkiller that an autopsy report said caused his death. Nearly two dozen pills found in one Aleve bottle were falsely labeled "Watson 385," an official told the Associated Press, speaking on condition of anonymity because of the ongoing investigation. (Blas, 8/21)

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