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KHN First Edition: December 11, 2017

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First Edition

Monday, December 11, 2017                       Visit Kaiser Health News for the latest headlines

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

Kaiser Health News: Podcast: ‘What The Health?’ Is Health Care Spending Still The Hungry, Hungry Hippo?
Congress is trying to wrap up its work for the year, but unsettled questions remain about the Children’s Health Insurance Program, the fate of the individual mandate insurance requirement from the Affordable Care Act and other health issues. Meanwhile, outside Washington, major mergers are happening within the health care system and the federal government reports that the rate of increase in health spending slowed in 2016. (12/8)

Kaiser Health News: In Era Of Increased Competition, Hospitals Fret Over Ratings
For two years, Saint Anthony Hospital here has celebrated its top-rated “A” grade from the national Leapfrog Group that evaluates hospital safety records. But this fall, when executives opened a preview of their score, they got an unwelcome surprise: a “C.” Hospitals take their ratings seriously, despite hospital industry experts’ skepticism about their scientific methodology and studies showing that scores may not have a huge influence on patient behavior. In a highly competitive market, no one wants to be a “C”-rated safety hospital any more than a “C”-rated restaurant for cleanliness. (Gold, 12/11)

Kaiser Health News: Opioids After Surgery Left Her Addicted. Is That A Medical Error?
In April this year, Katie Herzog checked into a Boston teaching hospital for what turned out to be a nine-hour-long back surgery. The 68-year-old consulting firm president left the hospital with a prescription for Dilaudid, an opioid used to treat severe pain, and instructions to take two pills every four hours as needed. Herzog took close to the full dose for about two weeks. (Bebinger, 12/11)

Kaiser Health News: Retirement’s Revolving Door: Why Some Workers Can’t Call It Quits
In his view, Tim Franson utterly failed at retirement. After 20 years as a high-ranking vice president at drugmaker Eli Lilly, Franson and his wife, Chris, a successful real estate agent, thought they were quietly retiring nearly a decade ago to Bonita Springs, Fla. For the first month or so, Franson said, he mostly slept. He wasn’t depressed, just mentally and physically exhausted. (Horovitz, 12/11)

California Healthline: Reverberations From War Complicate Vietnam Veterans’ End-Of-Life Care
Many of Ron Fleming’s fellow soldiers have spent the last five decades trying to forget what they saw — and did — in Vietnam. But Fleming, now 74, has spent most of that time trying to hold onto it. He’s never been as proud as he was when he was 21. Fleming was a door gunner in the war, hanging out of a helicopter on a strap with a machine gun in his hands. He fought in the Tet Offensive of 1968, sometimes for 40 hours straight, firing 6,000 rounds a minute. But he never gave much thought to catching a bullet himself. (Dembosky, 12/11)

The Associated Press: Deadline Week Crunch For Health Law Sign-Ups Under Trump
The Trump administration came into office looking to dismantle Barack Obama's health care law, but the Affordable Care Act survived. Now the administration is on the hook to deliver a smooth ending to sign-up season, with a crush of customers expected this week. For millions of eligible consumers time runs out on Friday. (12/11)

The Associated Press: Price Hikes Push Health Insurance Shoppers Into Hard Choices
Margaret Leatherwood has eight choices for health insurance next year but no good options. The cheapest individual coverage available in her market would eat up nearly a quarter of the income her husband brings home from the oilfields. The Bryson, Texas, couple makes too much to qualify for Affordable Care Act tax credits that help people buy coverage. But they don't make enough to comfortably afford insurance on their own, even though Paul Leatherwood works seven days a week. (12/10)

The Wall Street Journal: Obamacare’s Individual Mandate: On Its Way Out, Or Already Gone?
With Congress seemingly on the brink of repealing the Affordable Care Act’s centerpiece requirement that most people get insurance or pay a penalty, Democrats are warning such a move would be disastrous, and Republicans are anticipating a sweeping symbolic victory. Senate Republicans included a measure to repeal the mandate in their recently passed tax overhaul; the House didn’t, leaving GOP leaders to hammer out a final agreement for the compromise bill they hope to pass by year’s end. President Donald Trump on Friday night threw his weight behind the push to strike the mandate, promising a crowd in Pensacola, Fla., that it would soon be gone. (Radnofsky and Armour, 12/10)

The Hill: Murkowski Pushes Back On ObamaCare 'Scare Tactics'
Sen. Lisa Murkowski (R-Alaska) is pushing back on Democratic attacks that she is undercutting ObamaCare, saying opponents are simply using “scare tactics.” In a question-and-answer video posted on her YouTube page, Murkowski defended her vote for tax reform this month. Murkowski backed a bill that includes language repealing ObamaCare’s individual mandate. (Sullivan, 12/8)

The Wall Street Journal: Tax Overhaul Looks Set To Cut Credits For Drugs Targeting Rare Diseases
A tax overhaul bill being hammered into its final form by Senate and House Republicans is all but certain to cut tax credits designed to encourage development of “orphan drugs” meant to treat rare diseases afflicting limited numbers of patients. Since 1983, a federal law has allowed fledgling companies to write off 50% of the cost of human clinical studies to develop drugs aimed at small markets of patients who wouldn’t otherwise have access to drugs specifically designed for their ailments. The law was designed to address crippling diseases afflicting a few thousand, or fewer, adults and children. (Burton, 12/8)

The Washington Post: ‘Very, Very Scary’: 8.8 Million Americans Face Big Tax Hike If Republicans Scrap The Medical Deduction
Anne Hammer is one of millions of elderly Americans who could face a substantial tax hike in 2018 depending on the final negotiations over the Republican tax bill. In her retirement community in Chestertown, Md., it’s the big topic of conversation. Hammer is 71. Like many seniors, her medical bills are piling up. There are doctor visits, insurance premiums, drugs, a colonoscopy, a heart scan, an unexpected trip to the emergency room that lasted three days, ongoing monitoring for breast and ovarian cancer that run in her family and the costs of medical staff at her retirement community. Her out-of-pocket medical expenses vary, but she estimates they are about $20,000 a year. (Long, 12/10)

The Hill: Man With ALS Confronts Flake On Plane Over Tax Bill Vote
A progressive activist who identified himself as diagnosed with Lou Gehrig's Disease (ALS) confronted Sen. Jeff Flake (R-Ariz.) on an airplane this week over Flake's vote on the GOP tax-reform bill. Activist Ady Barkan, a staffer at the Center for Popular Democracy, questioned Flake on Thursday after the Arizona Republican voted in favor of the GOP tax-reform bill that passed the Senate in a late-night session last week. Videos of the 11-minute conversation were posted on Twitter. (Bowden, 12/8)

The New York Times: Under New Tax Plan, The Cost Of Aging Could Rise
In the coming days, a small group of Republicans will meet in Washington to try to settle a simple question: Should their revised tax bill eliminate a deduction for medical expenses and take away thousands of dollars each year from many people who are sick and, often, old? The two competing tax bills that will form the basis of an attempt at compromise over the coming weeks, one from the House of Representatives and one from the Senate, answer the question differently. The Senate bill would keep a deduction for medical expenses intact. The House bill would kill it off entirely. The more money that people had to spend this year, the more they would lose next year if the House prevails and the deduction disappears. (Lieber, 12/8)

The Washington Post: Why These Researchers Think Most Americans Could End Up Losing Under The GOP Tax Plan
If President Trump and congressional Republicans end up paying for their proposed $1.4 trillion tax cut by reducing spending or raising taxes later on, most Americans making less than $86,000 would be worse off, according to a new report by the Tax Policy Center, a nonpartisan think tank. Republicans have yet to say how they intend to pay for the tax cut. Originally, Treasury Secretary Steven Mnuchin argued the tax cut would completely pay for itself because the economy would grow substantially faster, a claim that has not been backed up by independent research. Congress's official scorekeepers estimate that the tax cut would add $1 trillion to the federal deficit, even after taking into account some additional economic growth. (Long, 12/8)

Reuters: U.S. Tax Revamp Still Incomplete As Republicans Eye Social Program Cuts
Even before completing their overhaul of the U.S. tax code, Republicans in Washington have begun turning their attention to changes and possible cuts in the social safety net of government programs for the poor, children, elderly and disabled Americans. President Donald Trump, House of Representatives Speaker Paul Ryan and other Republican officials in recent remarks have made clear that welfare or "entitlement reform," as they often call it, will be a top priority for them in 2018. (12/8)

The Hill: ObamaCare Fight Could Threaten Shutdown Deal
A fight over ObamaCare is spilling into Congress’s December agenda, threatening lawmakers’ ability to keep the government open. President Trump signed stopgap legislation Friday aimed at averting a shutdown and keeping the government funded through Dec. 22. The bill allows lawmakers to focus on the next — and seemingly more difficult — negotiating period. (Weixel, 12/9)

The Hill: Cadillac Tax Is Sticking Point For Congress
ObamaCare's "Cadillac tax" has emerged as a sticking point in bipartisan negotiations over delaying certain health-care taxes before the end of the year. Democrats are pushing to delay the “Cadillac tax” on high-cost health plans, which is despised by unions, but Republicans are pushing back and have resisted including the Cadillac tax in the package, sources say. (Sullivan, 12/10)

The Hill: Democrats Rip 'Highly Partisan' Bill To Fund Children's Insurance
Nearly 100 House Democrats are urging congressional leaders to pass a bipartisan extension of the Children’s Health Insurance Program (CHIP). In a letter sent Friday, 99 House Democrats urged leaders of the House and Senate to reject the House-passed CHIP extension and instead work on a bipartisan solution. (Weixel, 12/8)

The New York Times: Prescription Drugs May Cost More With Insurance Than Without It
Having health insurance is supposed to save you money on your prescriptions. But increasingly, consumers are finding that isn’t the case. Patrik Swanljung found this out when he went to fill a prescription for a generic cholesterol drug. In May, Mr. Swanljung handed his Medicare prescription card to the pharmacist at his local Walgreens and was told that he owed $83.94 for a three-month supply. Alarmed at that price, Mr. Swanljung went online and found Blink Health, a start-up, offering the same drug — generic Crestor — for $45.89. (Ornstein and Thomas, 12/9)

The New York Times: How To Save Money On Your Prescription Drugs
If you’re willing to do a little extra work, it is possible to lower your prescription bills. A reporter for The New York Times and a reporter for ProPublica both found instances this year in which drugs prescribed for family members could be purchased for less money without using their insurance coverage. (Ornstein and Thomas, 12/9)

The Associated Press: Drug Companies Sue To Block California Drug Price Law
Pharmaceutical companies on Friday sued to block a new California law that would require them to give advance notice before big price increases. The law was approved this year in response to consumer outrage over a rise in drug spending and high costs for some prescription treatments, including new Hepatitis C medications and EpiPens to control allergic reactions. (12/8)

Los Angeles Times: Drug Manufacturers Ask Federal Court To Block California's New Prescription Medicine Transparency Law
If successful, the lawsuit by the Pharmaceutical Research and Manufacturers of America could either delay or derail implementation of what supporters predicted would be a major improvement in the transparency of drug pricing. The industry effort argues the state law is unconstitutional. “The law creates bureaucracy, thwarts private market competition, and ignores the role of insurers, pharmacy benefit managers and hospitals in what patients pay for their medicines,” said James Stansel, the trade group’s executive vice president, in a written statement. (Myers, 12/8)

Stat: The Way Over-The-Counter Drugs Are Regulated Is A Mess
The Food and Drug Administration has, for years, limited the amount of acetaminophen in any prescription painkiller to 325 milligrams a dose. Yet walk into your local CVS and you’ll still find dozens of non-prescription painkillers containing 500, even 650, milligrams of the ingredient. The FDA also requires prescription codeine products to include a warning that they are unsafe for kids under 12. If your local drugstore carries it, you may find non-prescription codeine cough syrups that still list dosing information specifically for children. (Mershon, 12/11)

Bloomberg: The Little Blue Pill: A History Of Viagra
And what a run it was. Approved 19 years ago, Pfizer Inc.’s Viagra ushered in a pharmaceutical and cultural revolution, put the phrase “erectile dysfunction” in the medical mainstream, launched a thousand bad jokes and made friskiness a staple of prime-time television commercials. Bloomberg News spoke to people at the center of the phenomenon. Their comments have been edited for clarity. (Tozzi and Hopkins, 12/11)

The Washington Post: The Other Big Drug Problem: Older People Taking Too Many Pills
Consider it America’s other prescription drug epidemic. For decades, experts have warned that older Americans are taking too many unnecessary drugs, often prescribed by multiple doctors, for dubious or unknown reasons. Researchers estimate that 25 percent of people ages 65 to 69 take at least five prescription drugs to treat chronic conditions, a figure that jumps to nearly 46 percent for those between 70 and 79. Doctors say it is not uncommon to encounter patients taking more than 20 drugs to treat acid reflux, heart disease, depression or insomnia or other disorders. (Boodman, 12/9)

Stat: The Data Are In, But Debate Rages: Are Hospital Readmission Penalties A Good Idea?
The policy, known as the Hospital Readmissions Reduction Program, created financial penalties for hospitals whose readmissions exceed the national average for patients suffering from heart failure, heart attacks, and pneumonia. In recent years it has been expanded to include other conditions. Its aim was to encourage hospitals to deliver stepped-up care to severely ill patients even after they leave the hospital, in the hope of preventing return visits that result in more anguish for patients and skyrocketing costs for everyone else. (Ross, 12/11)

The Wall Street Journal: Hospital Giants In Talks To Merge To Create Nation’s Largest Operator
Two major hospital systems are in talks about a possible merger that would create the largest U.S. owner of hospitals, as a series of deals shape up to further consolidate control of the health-care landscape. Ascension and Providence St. Joseph Health, both nonprofits, are talking about combining, according to people familiar with the discussions. A deal would create an entity of unprecedented reach, with 191 hospitals in 27 states and annual revenue of $44.8 billion, based on the most recent fiscal year. That would dethrone the nation’s largest pure hospital operator, HCA Healthcare Inc., which owns 177 hospitals and ended 2016 with $41.5 billion in revenue. (Evans and Wilde Mathews, 12/10)

Los Angeles Times: Shopping For Healthcare Online? The Odds Are Stacked Against You
The internet is great place to shop for plane tickets, laundry detergent, artisan jewelry and pretty much anything else you might ever want to buy. But a new report says there's one big exception — healthcare. If you expect the World Wide Web to help you figure out how much you'll need to pay to get your hip replaced, a painful joint isn't your only problem. And if you think Google can tell you the cheapest place to go for a cholesterol test, just type "reality check" into that rectangular search bar. (Kaplan, 12/8)

Bloomberg: McKesson Records Show Failed Opioid Oversight, Lawsuit Says
McKesson Corp.’s board failed to audit the company’s system to spot suspicious shipments of opioid-based painkillers even after agreeing to do so as part of a settlement, according to a summary of board minutes unsealed Friday in a shareholder lawsuit. The suit, filed in October, alleges that McKesson directors paid scant attention to oversight of opioid sales after a 2008 settlement centering on the company’s insufficient monitoring of such shipments. The directors also disclaimed any responsibility for the growing opioid epidemic, seeing it as a “matter of public policy to be addressed by the federal and state governments,” the investor said in another unsealed portion of the complaint. (Melin and Feeley, 12/8)

The New York Times: Supplements Claiming To Ease Opioid Addiction Come Under Scrutiny
Chris Beekman, whose company sells the dietary supplement Opiate Detox Pro, does not understand what all the fuss is about. “If it works, it works,” Mr. Beekman, the owner of NutraCore Health Products, said in an interview. “If it doesn’t, it doesn’t.” His customers, addicts trying to shake a dependence on opioids, can always get their money back, he said. (Kaplan, 12/8)

The Washington Post: States To Try New Ways Of Executing Prisoners. Their Latest Idea? Opioids.
The synthetic painkiller fentanyl has been the driving force behind the nation’s opioid epidemic, killing tens of thousands of Americans last year in overdoses. Now two states want to use the drug’s powerful properties for a new purpose: to execute prisoners on death row. As Nevada and Nebraska push for the country’s first fentanyl-assisted executions, doctors and death penalty opponents are fighting those plans. They have warned that such an untested use of fentanyl could lead to painful, botched executions, comparing the use of it and other new drugs proposed for lethal injection to human experimentation. (Wan and Berman, 12/9)

The New York Times: The Next Flu Pandemic Will Appear When You Least Expect It
If a new flu pandemic emerges, it may be easy to spot. The epidemic is most likely to appear in spring or summer, researchers have found — not in the midwinter depths of the flu season. Normally flu strikes in winter, when children are crowded into classrooms and the air is cold and dry — ideal for transmitting the influenza virus. But historically, that has not been true of the great flu epidemics. (McNeil, 12/8)

NPR: In The U.S., Flu Season Could Be Unusually Harsh This Year
Health officials are warning that the United States may have an unusually harsh flu season this year. But they stress that flu seasons are notoriously difficult to predict, and it's far too early to know for sure what may happen. The concern stems from several factors, including signs that the season started a few weeks earlier than usual. "When you have an early start with regional outbreaks, that is generally not a good sign," says Anthony Fauci, who directs the National Institute of Allergy and Infectious Diseases. "Sometimes that's the forerunner of a serious season." (Stein, 12/8)

The New York Times: Sugary Diet During Pregnancy May Increase Asthma Risk In Children
Women who consume lots of sugar during pregnancy may increase the risk for asthma in their children, researchers report. Previous studies have suggested that poor diet and obesity are linked to the current increases in childhood asthma. This new study, in the Annals of the American Thoracic Society, implicates sugary drinks and fructose, or fruit sugar. (Bakalar, 12/8)

The New York Times: Some Older Smokers Turn To Vaping. That May Not Be A Bad Idea.
Jeannie Cox currently enjoys a flavor called Coffee & Cream when she vapes. She’s also fond of White Lotus, which tastes “kind of fruity.” She buys those nicotine-containing liquids, along with her other e-cigarette supplies, at Mountain Oak Vapors in Chattanooga, Tenn., where she lives. A retired secretary in her 70s, she’s often the oldest customer in the shop. Not that she cares. What matters is that after ignoring decades of doctors’ warnings and smoking two packs a day, she hasn’t lit up a conventional cigarette in four years and four months. (Span, 12/8)

NPR: Could Probiotics Protect Kids From A Downside Of Antibiotics?
It's a typical hectic morning at Michele Comisky's house in Vienna, Va., when she gets a knock on her front door. "Hi, how are you?" Comisky says as she greets Keisha Herbin Smith, a research assistant at Georgetown University. "Come on in." Comisky, 39, leads Herbin Smith into her kitchen. (Stein, 12/11)

NPR: Window Blind Cords Still Pose A Deadly Risk To Children
Andrea Sutton, a mom in Firestone, Colo., was trying to put her 3-year-old son Daniel down for a nap, but he wasn't having it. It was January, too cold for him to burn off much energy outside, and he was restless. She read him some books to settle him down and then left him to fall asleep. She returned with her 4-year-old daughter a little while later to check on him. They found him hanging from the cord of the window blinds, wearing like a necklace the V-shaped strings above a wooden knob that lowers when the blinds go up. (Haelle, 12/11)

The Washington Post: Tour The Magnificent Ins And Outs Of The Human Brain
Your brain may be the most miraculous thing about you. Think about it: Its processing power would put the most powerful computer to shame.It’s the control center for a dizzying number of physical tasks. And it makes you you — not bad for a big lump of grayish matter. So why not feed your brain by learning more about it? It’s easy, thanks to the Harvard Brain Tour, a virtual journey through brains’ innate capacities and the discoveries they’ve prompted throughout the century. (Blakemore, 12/10)

The Washington Post: More Older People Are Doing Yoga, But They Are Also Racking Up Injuries
Yoga may hold a key to aging well, suggests a growing body of research into its potential benefits for body and mind — benefits that include reducing heart rate and blood pressure, relieving anxiety and depression, and easing back pain. One recent study even raised the possibility of positive changes in biological markers of aging and stress in people who do yoga. So it’s no surprise that the number of yoga practitioners in the United States has more than doubled to 36.7 million over the last decade, with health benefits the main reason people practice, according to the Yoga in America Study conducted last year on behalf of Yoga Journal and the Yoga Alliance. (Krucoff, 12/10)

NPR: This Year, Consider Giving Presence Instead Of Presents
During the holiday season, many of us feel pressure to find our loved ones the "perfect" gift. Why? Because gift-giving has long been considered a prime way to express love. However, recent research suggests that gestures don't need to be large or have a hefty price tag to feel meaningful. The study, published this summer in The Journal of Social and Personal Relationships, suggests that small acts of kindness, not grand overtures, make people feel most loved and supported. (Fraga, 12/9)

Los Angeles Times: Southern California's Hospitals Prepare For The Worst As Embers Ignite Throughout The Region
Hospitals across Southern California reported that high numbers of patients with breathing problems caused by this week's wildfires visited emergency rooms. Health officials in Ventura, Los Angeles and Santa Barbara counties warned of high pollution levels caused by smoke. The microscopic particles in smoke can penetrate deep into the lungs, creating a hazard for those who already have heart or lung problems such as asthma, emphysema or COPD. (Karlamangla, 12/8)

Los Angeles Times: Polluted Air, Health Problems Brought By Southern California Fires Are Expected To Linger
A week of major wind-whipped fires across Southern California has caused significant air pollution and health problems. The air quality is worst in and around fires burning from Ventura County to San Diego County, but the smoke has traveled to places not threatened by the flames. And with the Santa Ana winds dying down, officials say the smoke could stick around for a while. (Karlamangla and Vives, 12/9)

Kaiser Health News is an editorially independent operating program of the Kaiser Family Foundation. (c) 2017 Kaiser Health News. All rights reserved.

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