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4. Political Cartoon: 'Self-Care?'

Kaiser Health News provides a fresh take on health policy developments with "Political Cartoon: 'Self-Care?'" by Mike Twohy.

Here's today's health policy haiku:

OBAMACARE LOATHING: GETTING TO THE BOTTOM OF IT

So you don’t like it …
Actually you just hate it …
Why so much passion?

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Summaries Of The News:

Health Law

5. House Republicans Unveil Plans To Delay, Suspend Affordable Care Act Taxes

The plan would include another delay of the Cadillac tax. The legislation, if it's passed, would be a boon for some in the health industry who have been pushing for relief from the taxes for years.

Modern Healthcare: House GOP Lawmakers Look To Delay Cadillac Tax, Other ACA Taxes
Afordable Care Act taxes are all on the U.S. House of Representatives' chopping block. Republicans on the House Ways and Means Committee introduced a bundle of bills on Tuesday to delay the Cadillac tax, employer mandate and other taxes that healthcare industry groups have opposed. The employer mandate gets a retroactive repeal from 2015 and a delay through 2018; this measure is paired with a one-year delay of the Cadillac tax. (Luthi, 12/12)

The Hill: House GOP Unveils Package To Delay ObamaCare Taxes
House Ways and Means Chairman Kevin Brady (R-Texas) led the announcement for the bills to delay ObamaCare’s tax on medical devices for five years, on health insurance for two years, and the "Cadillac tax" on high-cost health plans for one year. The package would also eliminate penalties for employers who do not offer health insurance to their workers, under the employer mandate, through 2018. (Sullivan, 12/12)

6. Top Democratic Senators Ask For Open Enrollment To Be Extended Through January

The enrollment window was shortened this year and will end on Dec. 15 for the federal exchange and for some states.

The Hill: Dems Call For Trump Officials To Extend ObamaCare Deadline
Two top Senate Democrats are calling on the Trump administration to extend ObamaCare’s sign-up period, arguing it is being cut off too soon this year before people have time to enroll. The sign-up period is slated to end on Friday, after beginning Nov. 1, about half as long as it has been in previous years. Sens. Ron Wyden (Ore.) and Patty Murray (Wash.), the top Democrats on the Senate committees overseeing health care, wrote to the administration on Tuesday calling for the period to be extended to Jan. 31. (Sullivan, 12/12)

Politico Pro: Obamacare Sign-Ups Expected To Lag At The End Of Enrollment This Week
Obamacare’s open-enrollment season is headed for a disappointing ending this Friday despite its surprisingly robust start. The reasons for the expected lag include the Trump administration's decision to cut the sign-up period in half and slash outreach and marketing, skyrocketing premiums and general confusion about the status of the health law after repeated failed Republican attempts to dismantle it. (Demko, 12/12)

The Baltimore Sun: Maryland Health Exchange Extends Deadline To Enroll In Obamacare
Marylanders seeking health insurance under the federal Affordable Care Act will get an extra seven days to sign up, state officials plan to announce Wednesday. The new enrollment deadline is December 22 rather than Friday. The deadline was extended by a week to accommodate procrastinators and avoid a last-minute enrollment crush at the end of this week. (Cohn, 12/13)

Arizona Republic: 'Obamacare' Insurance Sign-Up Period For 2018 Coverage Ends Friday
Arizonans who get health insurance through the Affordable Care Act marketplace have until Friday night to sign up for 2018 coverage. ... Arizonans have signed up for ACA health insurance at a faster pace this year, but some predict overall enrollment will fall short of last year's because of the shorter enrollment period and cuts to federal funding for advertising and outreach workers who promote the law. (Alltucker, 12/12)

Kaiser Health News: Consumers Who Froze Their Credit Reports Could Hit A Glitch Enrolling In Insurance
Some Americans who froze their credit reports following the big data breach this year at the credit-rating firm Equifax may be in for a surprise if they try to purchase insurance on the federal health law’s marketplaces. That freeze could trigger a delay in the application process. Signing up for a marketplace plan online requires consumers — especially first-time enrollees — to prove their identity by answering questions linked to their credit history. It can affect both those who are seeking a subsidy and those who are not. (Appleby, 12/13)

7. House Lawmakers: Ball Is In Senate's Court On Bills Stabilizing ACA Marketplaces

Reps. Kevin Brady (R-Texas) and Greg Walden (R-Ore.) said the House is taking a wait-and-see approach to the legislation aimed at shoring up the exchanges. Meanwhile, the White House backs the measure, according to Sens. Susan Collins (R-Maine) and Lamar Alexander (R-Tenn.).

CQ HealthBeat: House Chairmen Wait for Senate Action On Health Stabilization
Two House Republican chairmen say it may be up to the Senate to act first on legislation aimed at stabilizing the individual health insurance market. The fate of two health care bills is tied into the tax overhaul and spending debates that Republicans hope to wrap up by the end of next week. But Reps. Kevin Brady, R-Texas, and Greg Walden, R-Ore., who lead the Ways and Means and the Energy and Commerce committees, respectively, both said late Monday that House Republicans will likely wait to see how the Senate acts on those bills. (McIntire, 12/12)

Politico Pro: White House Is Said To Back Obamacare Stabilization Measure In Year-End Deal
The White House supports passing stopgap legislation to stabilize Obamacare markets as part of a broader year-end spending agreement, Sens. Susan Collins and Lamar Alexander said today. The pair of GOP senators emerged from an impromptu meeting with Vice President Mike Pence confident that the administration would side with them and pressure House Republicans to drop their opposition to measures aimed at shoring up the health law. (Cancryn and Haberkorn, 12/12)

And in other health law news —

The Hill: Actuaries Warn Of Premium Increases From Repealing ObamaCare Mandate
A group of insurance experts is warning Congress against repealing ObamaCare’s individual mandate, saying the move would raise premiums and could cause insurers to drop out of the market. The American Academy of Actuaries wrote to congressional leaders on Tuesday saying that “eliminating the individual mandate would lead to premium increases.” (Sullivan, 12/12)

The Hill: Two GOP Lawmakers Call For End To ObamaCare Program Operating In Only Arkansas
Two Republican lawmakers are calling for the elimination of a little-known ObamaCare program that costs the federal government $10 million a year. Rep. Mark Meadows (R-N.C.), chairman of the Government Operations subcommittee, and Sen. Ron Johnson (R-Wis.), chairman of the Senate Homeland Security and Governmental Affairs Committee, introduced a bill Tuesday that would repeal ObamaCare's Multi-State Plan program. (Hellmann, 12/12)

Kaiser Health News: Why Do People Hate Obamacare, Anyway?
The Affordable Care Act, aka “Obamacare,” has roiled America since the day it was signed into law in 2010. From the start, the public was almost evenly divided between those who supported it and those who opposed it. They still are. The November monthly tracking poll from the Kaiser Family Foundation found that 50 percent of those polled had a favorable view of the health law, while 46 percent viewed it unfavorably. Partisan politics drives the split. Eighty percent of Democrats were supportive in November, while 81 percent of Republicans were strongly negative. (Rovner, 12/13)

Capitol Hill Watch

8. Orphan Drug Credit, Repatriation Top List Of Issues Pharma Is Watching As Congress Hammers Out Tax Bill

The industry is poised to win big if Republicans pass their tax legislation.

Stat: What Pharma's Watching As Congress Tries To Hammer Out A Tax Bill
As congressional leaders prepare to lock themselves away and hammer out a final tax bill, one thing is clear: Big Pharma, like the rest of corporate America, is going to get a big break. But there are devilish details the drug industry will be tracking, including the fates of an oft-used tax credit and a long-promised provision that would make it cheaper for multinational companies to bring overseas cash back to the U.S. (Garde, 12/13)

Los Angeles Times: Families Of Patients Fear GOP Tax Plan Will Scuttle Drug Development For Rare Diseases
Of all the proposals in the GOP tax plan, none may be more important to families like Jay and Amy Granzow than an obscure provision on "orphan" drug research. The Granzows, who live in Manhattan Beach, fear that the final tax bill will end up killing or drastically cutting a three-decade-old tax credit for companies developing therapies for so-called orphan or rare diseases, such as cystic fibrosis, muscular dystrophy and Angelman syndrome. The last is a debilitating genetic disorder that afflicts the Granzows' nearly 3-year-old daughter, Cora. (12/13)

9. Governors Urge Congress To Help Restore Families' 'Peace Of Mind' By Renewing CHIP

The bipartisan group highlighted the strong support the program has always received from both sides of the aisle. Funding for the Children's Health Insurance Program expired earlier in the year, and it has been overshadowed by some of the bigger health debates on Capitol Hill.

The Hill: Bipartisan Group Of Governors Calls For Swift CHIP Reauthorization
A bipartisan group of governors is urging Congress to act quickly to reauthorize funding for the Children’s Health Insurance Program. In a letter led by Ohio Gov. John Kasich (R) and Colorado Gov. John Hickenlooper (D), the governors said their states are running out of money, and urged lawmakers to find a bipartisan solution. (Weixel, 12/12)

The Baltimore Sun: Hogan Urges Congress To Reauthorize Health Insurance For Kids
Gov. Larry Hogan urged congressional leaders Tuesday to reinstate by the end of the year a federal program that provides health insurance for children. “We should all be able to agree that needy kids should never become a political football,” Hogan wrote in a letter to leaders of both parties in the Senate and House of Representatives. (Cox, 12/12)

Columbus Dispatch: With Health Insurance For 220,000 Ohio Kids On The Line, Kasich Urges Congress To Act
Ohio Gov. John Kasich joined 11 other governors from both parties Tuesday to plead with Congress to keep health coverage for nearly 220,000 Ohio children and millions more across the country. With Congress facing an end-of-the-year deadline to extend the 20-year-old setup, known as the Children’s Health Insurance Program, the governors urged Senate and House leaders to forget their differences and pass a bill “as quickly as possible.” (Torry, 12/12)  

The Washington Post: Fact-Checking Jimmy Kimmel On CHIP Funding
Late-night host Jimmy Kimmel on Dec. 11 stepped out of his comedic role and offered a commentary on the reauthorization of the Children’s Health Insurance Program, after introducing his son Billy, who has a serious heart issue. His presentation was a bit one-sided, and readers requested a fact check. It’s often difficult to describe Washington sausage-making in shorthand, and Kimmel fell short in several areas, appearing to pin most of the blame on Republicans — even though he was careful not to mention party affiliation. (Kessler, 12/13)

Administration News

10. Trump's Order To Roll Back Birth Control Mandate Gets Its Day In Court

California's lawsuit against the new rules that allow employers to cite religious or moral objections to providing workers coverage for birth control says that they violate the U.S. Constitution by overvaluing religious beliefs and discriminating against women.

The Associated Press: Lawyers Clash Over Impact Of Trump's Rules On Birth Control
Lawyers for California and the U.S. Department of Justice clashed in court Tuesday over whether new rules from President Donald Trump's administration would dramatically reduce women's access to free birth control. Deputy Assistant Attorney General Ethan Davis urged a federal judge not to grant the state's request to block the policy change to President Barack Obama's health care law, saying it was not clear any women would lose no-cost contraception coverage. (Thanawala, 12/12)

Reuters: U.S. Judge Questions Trump Administration On Birth Control Rules
New rules from the Department of Health and Human Services announced in October let businesses or non-profit organizations lodge religious or moral objections to obtain an exemption from the Obamacare law's mandate that most employers provide contraceptives coverage in health insurance with no co-payment. The move from President Donald Trump's administration kept a campaign pledge that pleased the Republican's conservative Christian supporters.California and several other states with Democratic attorneys general promptly sued and asked for the policy to be blocked while its legality is decided. (Levine, 12/12)

Medicaid

11. Idaho Weighs Plan To Improve Coverage For Some Poor Residents

It's not yet clear if the state's legislators will accept the plan, which would allow working adults to buy subsidized health insurance on the state's health care exchange and very sick adults, like those with stage-4 cancers, to be covered by Medicaid. News outlets also report on Medicaid news in Louisiana and Connecticut.

The Associated Press: Public Offers Input On New Plan To Address Medicaid Gap
Idaho's top health officials are collecting input from residents across the state on their latest plan to provide health care to poor residents who do not have medical coverage. The proposal calls for Idaho to apply for two federal waivers that would change how the state's working poor can qualify for health insurance subsidies or Medicaid. Doing so would provide medical coverage to an estimated 38,000 Idahoans and slash premiums by up to 20 percent. (12/12)

The CT Mirror: Special Session Over Medicare Savings Plan Stars In Political Theater
Republican legislative leaders want Gov. Dannel P. Malloy to call them into special session just before Christmas to restore funds for the Medicare Savings Program, a popular social services program — that won’t face reductions until after the 2018 legislative session starts in February. ... The program uses Medicaid money to help more than 100,000 low-income people pay medical expenses that Medicare doesn’t cover, such as premiums, deductibles and co-pays. (Phaneuf, 12/12)

Medicare

12. Medicare Websites Add New Quality Ratings For Consumers

The data has been added to the sites where people can compare inpatient rehabilitation facilities and long-term care hospitals. Medicare officials also announced that they plan to continue a pilot program aimed at reducing non-emergency ambulance transports.

Modern Healthcare: CMS Adds New Quality Measures To Two Compare Sites
The CMS announced Tuesday that it added four new quality measures for healthcare consumers to view on the Inpatient Rehabilitation Facility and Long-Term Care Hospital Compare websites. The additions to the sites come as the CMS works to improve the Hospice Compare website, which fell under scrutiny shortly after it launched in August for showing patients inaccurate information about providers. The CMS' suite of Compare sites were mandated under the Affordable Care Act and designed to encourage Medicare beneficiaries to seek out high-quality healthcare. CMS Administrator Seema Verma has publicly touted her commitment to improving patients' access to information that allows them to shop for their care. (Castellucci, 12/12)

Modern Healthcare: CMS Extends Medicare Experiment To Curb Ambulance Use
The CMS will continue its multi-state initiative to reduce ambulance use in the Medicare program, citing the program's success in lowering claims. Under the initiative, Medicare beneficiaries need prior authorization for regular, non-emergency ambulance transportation in order for the rides to be covered. The CMS said Tuesday that the 4-year-old demonstration has led to fewer claims for ambulance services. (Dickson, 12/12)

Public Health And Education

13. 'This Isn't A Wave. It's A Tsunami': Opioid Epidemic Creating Flood Of Kids Into Foster System

An already strained system is being stretched even further with a new generation of children displaced from their homes in one way or another because of the addiction crisis. In other news, the head of the Drug Enforcement Administration says a 2016 law needs to be revised because it makes regulating opioids more difficult for the agency.

The Associated Press: Opioid Crisis Strains Foster System As Kids Pried From Homes
The case arrives with all the routine of a traffic citation: A baby boy, just 4 days old and exposed to heroin in his mother's womb, is shuddering through withdrawal in intensive care, his fate now here in a shabby courthouse that hosts a parade of human misery. The parents nod off as Judge Marilyn Moores explains the legal process, and tests arrive back showing both continue to use heroin. The judge briefly chastises, a grandmother sobs, and by the time the hearing is over, yet another child is left in the arms of strangers because of his parents' addiction. (Sedensky and Hoyer, 12/12)

The Associated Press: Q&A: How Is The US Opioid Crisis Affecting Children?
Public attention to the historic wave of opioid addiction gripping the U.S. has focused mostly on its effect on adults and the thousands who have died of overdoses. Missed by much of the spotlight, though, is a hidden epidemic: children who have fallen victim to opioids' wrath because a parent's drug use has left them in danger and thrust them into the foster care system. (Sedensky, 12/12)

The Washington Post: DEA Official Says 2016 Law That Undermined Enforcement Should Be Changed
The head of the Drug Enforcement Administration office that regulates pharmaceutical opioids told senators Tuesday that a 2016 law has made enforcement more difficult in urgent circumstances and should be revised. Demetra Ashley, who leads the agency’s Diversion Control Division, said Congress should choose between repealing and amending the law. But she said the DEA agrees with the Justice Department that it should be altered to help curb the ongoing opioid epidemic. (Bernstein and Higham, 12/12)

The Hill: DEA, DOJ Back Changes To Law Linked To Opioid Crisis
The Drug Enforcement Administration (DEA) and Department of Justice both support changing a controversial law that led to the withdrawal of President Trump's nominee to be the nation’s drug czar earlier this year. Rep. Tom Marino (R-Pa.) asked that his nomination be withdrawn after 60 Minutes and The Washington Post in a joint report said a law he spearheaded through Congress had weakened the enforcement of the nation’s drug policing laws, perhaps contributing to the opioid crisis. (Roubein, 12/12)

And in other news on the epidemic —

Marketplace: S02-4: The Sentence That Helped Set Off The Opioid Crisis
When OxyContin went to market in 1996, sales reps from Purdue Pharma hit one point particularly hard: Compared to other prescription opioids, this new painkiller was believed to be less likely to be addictive or abused. But recently unsealed documents in this investigative episode shed light on how the maker of OxyContin seems to have relied more on focus groups than on scientific studies to create an aggressive and misleading marketing campaign that helped fuel the national opioid crisis. (Esch and Clark, 12/13)

The Associated Press: Officer Honored For Adopting Baby From Opioid Addicted Mom
A routine call about an Albuquerque convenience store theft turned into a life-transforming moment for an officer who came across upon a pregnant woman he found using heroin. That officer later volunteered to adopt the unborn baby. Officer Ryan Holets and his wife, Rebecca, were honored Monday for adopting the baby girl they named Hope after the addicted mom agreed to let the couple raise her child. The baby is now 6-weeks-old and is recovering after being born with an opioid addiction. (Contreras, 12/12)

The Associated Press: Hard-Hit By Opioids, A City Struggles With Hardcore Homeless
This is the lesson that the working-class city of Everett has learned: It takes a community to rescue the hardcore homeless.It takes teams of outreach workers — building relationships with men and women struggling with addiction or untreated mental illness, prodding them to get help. It takes police and other agencies, working together to provide for their needs. (Le, 12/13)

The Associated Press: West Virginia Nurse Admits To Illegally Distributing Drugs
A registered nurse has admitted to illegally distributing drugs used to treat opioid addiction through her job at a clinic in West Virginia’s northern panhandle from 2008 through 2016. Sharon E. Jackson of Wellsburg pleaded guilty Monday to one conspiracy charge in federal court, agreeing to cooperate with prosecutors and forfeit $253,000 described in court papers as her proceeds from the drug offense at an addiction treatment center, Advance Healthcare Inc., in Weirton. (12/12)

14. There's No HIV Cure Yet, But With Each Promising Case, Scientists Become More Excited

There have been a few unique cases recently that have offered movement forward toward an eventual cure.

KQED: Frontiers Of HIV Research: The Man Who Was Nearly Cured
Now, two more patients — with the first names Luis and Clark, no less — may find themselves at least footnotes in the narrative of HIV’s trajectory from pandemic to cure, should the latter be achieved. The cases of Clark Hawley, 54, and Luis Canales, 31, have provided at least a temporary answer to a big question: Can very early treatment after exposure to HIV lead to complete eradication of the virus – an actual cure? (d'Adesky, 12/12)

Georgia Health News: HIV In America Is Increasingly A Southern Problem
Half of the new HIV diagnoses occur in the South, as well as half of the AIDS-related deaths. And the region has just one-third of the U.S. population. ...Gilead Sciences, maker of HIV medications, has cited those statistics in its launch of a $100 million, 10-year initiative to fight the disease in the region. (Miller, 12/12)

15. 'Fantastically Promising' Trial For Drug To Treat Huntington's Giving Hope To Formerly Hopeless

Patients and doctors often say Huntington's is like having Alzheimer's disease, amyotrophic lateral sclerosis and Parkinson's disease -- all at the same time. In other public health news: mental health and guns; the flu shot; a president's health; gluten in medication; and more.

The Washington Post: 'Phenomenal' Trial Results May Lead To A Treatment For Huntington's Disease, Experts Say
The discovery of a drug that may treat the fatal disease known as Huntington's is being hailed as “historic” by Louise Vetter, president and CEO of the Huntington's Disease Society of America, and “phenomenal” and “fantastically promising” by Huntington's researchers, including the woman who discovered the genetic mutation that causes the disease. “I'm ecstatic,” said Nancy Wexler, who in 1993 identified the mutation. “Huntington's is horrible, one of the worst diseases known to mankind, and certain death. . . . We know it’s a bad gene, making a bad protein, that makes people sick, that kills your brain cells. Anything that could impact that, we knew that that could be a cure.” (Nutt, 12/12)

The Associated Press: 5 Years After Sandy Hook, Mental Health Care Worries Linger
Anguished mothers with mentally ill children have sought out Liza Long for help ever since she wrote an essay, "I am Adam Lanza's Mother," comparing experiences with her son to the emotionally troubled 20-year-old who carried out the Sandy Hook Elementary School shooting. The massacre sounded alarms nationally about gaps in mental health care and led to calls for better screening and services, especially for young people showing a propensity for violence, but some key reforms enacted in the wake of the Sandy Hook shooting depend on funding that has yet to be delivered by Congress. And Long still hears almost daily from families overwhelmed by their children's behaviors and struggling to get treatment. (Haigh, 12/13)

The New York Times: Why You Need The Flu Shot Every Year
Most people know: If you got a flu shot this year, next year you’ll need it again. This is because the virus changes, usually rendering the previous year’s vaccine partly or totally useless. And it’s no secret that the flu vaccine’s effectiveness falls well short of what scientists and public health officials would like to see. Yes, it reduces the severity of influenza infections and prevents thousands of deaths and hospitalizations every year, but nowhere near other recommended vaccines. But why does the virus change so much every year? (Haelle, 12/12)

Los Angeles Times: Is 'Man Flu' Real? Medical Science Delivers Comfort To Helpless Male Snufflers
We've all seen him: The man who strides boldly into high-stakes negotiations, risks serious injury to win a pickup basketball game and fearlessly confronts things that go bump in the night, yet is brought low by a tiny virus. He snivels pitiably, wallows in his misery and tests the most forbearing caregiver with his abject helplessness. The diagnosis often comes with a roll of the eyes. It’s “man flu,” an infectious disease that renders healthy males utterly incapable of self-care. (Healy, 12/12)

The Washington Post: Trump Reportedly Drinks 12 Cans Of Diet Coke Each Day. Is That Healthy?
Those keeping tabs on President Trump's diet know that Wendy's and McDonald's are staples. While campaigning, Trump inhaled Filets-o-Fish and Big Macs and snacked on Oreos. He'd then wash it all down with a Diet Coke. Just how much diet soda the president consumes, though, was revealed Saturday by the New York Times, which reported that Trump has a button to summon household staff for one of the 12 Diet Cokes he drinks each day. (Eltagouri, 12/12)

Bloomberg: FDA Proposal Would Make Clear There's No Gluten In Your Pills
In draft guidance issued on Tuesday, the agency is pushing drugmakers to clearly label that medications taken orally don’t have ingredients from grains that include gluten like wheat, barley or rye. Currently there are no drugs marketed in the U.S. that contain gluten in a quantity that would exceed the amount in a gluten-free food product, the FDA said. The new rules are an attempt to reduce uncertainty for people with gluten sensitivities or diseases aggravated by ingesting gluten. (Koons, 12/12)

The Washington Post: Women Rate The Strongest Men As The Most Attractive, Study Finds
Heterosexual male gym rats, rejoice! Women, when asked in a study to judge photos of men's bodies, rated the strongest men as the most attractive. Height and leanness were appealing attributes, too, but strength played an outsize role in the ratings of a man's torso, per a report published Tuesday in the Proceedings of the Royal Society B. “No one will be surprised by the idea that strong men are more attractive,” said study author Aaron Lukaszewski, an evolutionary psychologist at California State University at Fullerton. “It's no secret that women like strong, muscular guys.” (Guarino, 12/12)

The Philadelphia Inquirer/Philly.com: Joint Replacement Surgery Doesn't Work As Well For Obese Patients, Penn Study Finds
To be sure, the University of Pennsylvania study found most people who went through the pain and extended recovery of getting new hip or knee joints wound up better able to carry out everyday activities, no matter what they weighed. But 1 in 4 obese patients reported having more difficulty with bathing, walking, getting in and out of bed, or using the toilet two years after joint surgery, according to the analysis, published in the January issue of the British Journal of Anaesthesia.  In comparison, about 1 in 5 patients who were normal weight or overweight reported becoming more disabled after surgery. (McCullough, 12/12)

Kaiser Health News: These Annual Checkups Help Seniors Not Only Survive But Thrive
Bea Lipsky shuffled into her wellness coach’s office one morning this fall and parked her walker by the wall. Lipsky, 89, had had a trying year, enduring a hernia operation and two emergency room visits for heart problems. She’s losing her hearing, and recently gave up her dream of riding in a hot air balloon for her 90th birthday. (Bailey, 12/13)

KQED: Just Because You Have A ‘Mild’ Concussion Doesn’t Mean You’re OK
Each year, about 2.5 million people in the United States are admitted to emergency rooms with traumatic brain injuries, according to the Centers for Disease Control and Prevention. The difficulties of studying concussions, with their vague symptoms and hidden physical damage, have turned brain injury into a “silent epidemic,” in the words of Pratik Mukherjee, a neuroradiologist at UCSF. (Vassey, 12/12)

State Watch

16. Massachusetts Ranks As Healthiest State, While Mississippi Clocks In At The Bottom

The report from the United Health Foundation found that states in the lower rankings struggled with particularly high rates of poverty among kids, smoking and obesity.

Stat: How Healthy Is Your State? The Disparities Are Stark
Massachusetts is the healthiest state in which to live this year, according to a new report from the United Health Foundation. The report ranks states on 35 factors that impact health, from vaccination levels and infant mortality rates to environmental pollution and poverty levels. The analysis also pinpoints public health challenges nationwide. (Thielking, 12/12)

WBUR: Mass. Rises To No. 1 In National Health Rankings, But Challenges Remain
The state has more people covered by health insurance, a lower obesity rate and more mental health care than other states -- and smoking is way down in the last five years. ...But challenges remain, the report says, including a high drug death rate — up from nearly 12 to nearly 20 per 100,000 people over the last five years — and high rate of preventable hospitalizations. (Goldberg, 12/12)  

The Oregonian: Oregon Just Average On Health, Report Says
The health of Oregonians remains in the middle of the pack among states, pulled down by low rates of immunization and high school graduation, but boosted by physical activity and fewer drug deaths, according to an annual report. America’s Health Rankings found that Oregon improved by a notch, moving from 21st place in 2016 to 20th this year. (Terry, 12/12)

17. State Highlights: In Ga., Blue-Ribbon Panel Urges More Kids' Mental Health Services; Mass. Watchdog Agency Launches Review Of Planned Hospital Mega-Merger

Media outlets report on news from Georgia, Massachusetts, Washington, D.C., Minnesota, Ohio, Arizona, Texas, Kansas, Washington, Pennsylvania, Illinois, New Hampshire and California.

Georgia Health News: Blue-Ribbon Panel Urges Stronger Mental Health Services For Kids
Despite some successful funding and programs since then, the need for more and better funded mental health care has presented problems for communities and families across the state. On Tuesday, Gov. Nathan Deal released a report from a state commission created to provide recommendations for improving mental health services for kids. (Miller, 12/12)

Boston Globe: State Watchdog Launches Review Of Planned Beth Israel-Lahey Merger
The state’s health care watchdog agency on Tuesday launched a detailed review of a planned merger of Beth Israel Deaconess Medical Center, Lahey Health, and several other hospitals, in perhaps the largest and most complicated hospital transaction ever proposed in Massachusetts. The Health Policy Commission will analyze the deal’s effect on health care costs, quality, and access to care. (Dayal McCluskey, 12/12)

The Washington Post: D.C.'s Only Public Hospital Needs A $17 Million Taxpayer Bailout To Stay Afloat
A taxpayer bailout of at least $17 million will be needed if the District’s only public hospital is to stay afloat, the hospital’s finance committee has concluded, in the latest setback to afflict United Medical Center. Hospital board members plan to discuss the recommended subsidy request when they meet Wednesday. If approved by Mayor Muriel E. Bowser (D) and the D.C. Council, it would be the largest investment of District tax dollars to prop up the hospital’s operating budget since 2010, when the city took over the facility. (Jamison, 12/12)

Pioneer Press: Minnesota Elder-Care Whistleblower Was Fired, According To State Lawmaker: ‘I Want Answers’
A Minnesota lawmaker says a state manager whose bureau oversees investigations into abuse and neglect in nursing homes was fired after she blew the whistle on a “toxic culture” that was an obstacle to ensuring that officials do a better job protecting residents of senior care facilities. “I want answers,” said Sen. Karin Housley, R-Stillwater, who chairs the Senate Aging and Long-Term Care Policy Committee. (Orrick, 12/12)

NPR: Down Syndrome Families Divided Over Abortion Ban
When a pregnant woman finds out that she's likely to give birth to a baby with Down syndrome, she's often given the option to terminate the pregnancy. But families affected by the genetic disorder that causes developmental delays are conflicted over whether such abortions should be legal. Ohio could soon become the latest state to restrict abortions based on a Down syndrome diagnosis. A bill that would make it a felony for doctors to perform abortions after a Down syndrome diagnosis is moving through the state legislature and could be ready for Gov. John Kasich's signature as soon as this week. (McCammon, 12/13)

Boston Globe: State Lawmakers Try To Untangle The Intersection Of Crime And Mental Illness
Lawmakers are calling for expanded programs to divert mentally ill people from jail, stronger oversight of solitary confinement policies, and more training to help police officers deescalate confrontations with those who have mental illness. Legislators also plan to study establishing a crisis center in Middlesex County where police officers and other first responders from that region could bring people in psychiatric or drug-induced distress. (Cramer, 12/13)

Arizona Republic: DCS Investigated Parents Of Sanaa Cunningham 3 Times Before 7-Year-Old's Death
Arizona's Department of Child Safety officials investigated three reports of abuse or neglect against Sanaa Cunningham before her February death, but none produced enough evidence to remove the 7-year-old girl from her home, according to the DCS. DCS on Tuesday released a media statement detailing the allegations in each report and results of the subsequent investigations. (Cassidy and Pitzi, 12/12)

The Associated Press: Ex-Kansas Official Accused Of Misconduct Fired From New Job
A company that helps to manage the Medicaid program in Kansas has fired an employee who was accused of sexual misconduct while working as a state social services administrator. Amerigroup Kansas Inc. spokeswoman Olga Gallardo said Tuesday in an email that Brandt Haehn “was terminated.” She provided no other details about the firing or his employment. (Hanna, 12/12)

Seattle Times: Seattle’s Swedish Health Nurses Vote No Confidence In Leadership
Nurses and other caregivers at Swedish Health have voted overwhelmingly to express no confidence in the leadership of the health-care organization, saying morale and patient care continue to suffer. At a gathering Tuesday night in Seattle where nurses described a range of concerns across Swedish campuses, their union announced that 98 percent of nurses and caregivers had voted to express their opposition to the current administration at Swedish and its parent organization, Providence. (Baker, 12/12)

The Philadelphia Inquirer/Philly.com: Acadia Healthcare And Reading Hospital Building New Psychiatric Hospital In Berks County
Acadia Healthcare Co. Inc. and Reading Hospital will jointly construct a 144-bed inpatient psychiatric facility in Berks County, Reading Hospital’s parent, Tower Health, said Tuesday. Construction of the Bern Township facility, on an 80-acre parcel with room to expand, is expected to begin early next year with the opening anticipated in early 2019, Tower said. The partners did not disclose the cost of the project. A recent Tower bond offering statement said Tower will own 33 percent of the new facility, but will share equally in managing it. (Brubaker, 12/12)

Cleveland Plain Dealer: Akron Public Schools Hopes New Supplemental Health Plan, Health Care Facility Help Save Millions
Akron Public Schools will offer employees and their families supplemental health insurance that's designed to drive down costs. Health care will be offered out of a new facility established at the district's administration building near downtown Akron. The insurance will not replace the district's existing health plan but will offer free supplemental  care through Paladina Health. (Conn, 12/12)

San Jose Mercury News: As Bay Area Rent Skyrockets, More Families Go Hungry
The cost of living across Santa Clara and San Mateo Counties is so high that more than a quarter of people in the region struggle to pay for food each month, according to a new food insecurity study by Second Harvest Food Bank. Nearly 27 percent of those living in Santa Clara and San Mateo counties — an estimated 720,000 residents — are food insecure, which means they’re at risk for hunger, the study released Tuesday said. (Sanchez, 12/12)

WBUR: With New Cannabis Cafes, You Can Smoke 'Em Where You Bought 'Em
The state agency responsible for regulating legalized marijuana approved a policy on Monday that will allow for such establishments, so-called "cannabis cafes," to open — where one can buy a cannabis product and then legally consume it on the premises, just like buying a drink at a bar. (Brown, 12/12)

Prescription Drug Watch

18. A Pill To Knock Out Hookworm Costs 10,000 Times More In U.S. Than In Tanzania

News outlets report on stories related to pharmaceutical pricing.

NPR: Why A Pill That's 4 Cents In Tanzania Costs Up To $400 In The U.S.
Two pills to wipe out hookworm could cost you 4 cents. Or $400. It just depends where you live. The 4 cents is in Tanzania. That'll cover the two pills it takes to knock out the intestinal parasite. But in the United States, where hookworm has re-emerged, the price for two 200 mg tablets of albendazole can cost as much as $400. (Whitehead, 12/11)

Stat: FDA To Study Deputizing Consumers To Find Bad Ads, As Warnings To Pharma Plunge
Concerned about the veracity of some pharmaceutical marketing, the Food and Drug Administration plans to study the extent to which doctors and consumers can detect deceptive ads. In explaining its rationale, the agency reiterated ongoing worries that misleading advertising can generate unnecessary prescribing, but also indicated interest in finding new ways to identify troubling ads, since resources are tight, according to this notice. (Silverman, 12/12)

Stat: Three More Drug Makers Allegedly Used Nurses To Promote Medicines
Three more drug makers allegedly relied on schemes in which nurses were used to illegally promote its diabetes medicines to physicians, according to recently unsealed lawsuits. The documents describe how Gilead Sciences (GILD), Amgen (AMGN), and Bayer Pharmaceuticals (BAYRY) hired nurses to talk up treatments to doctors and their patients, an arrangement that purportedly violated federal kickback laws. The companies avoided concerns that sales reps might get little to no face time with doctors and simultaneously helped save physicians from the expense of providing follow-up care, according to the lawsuit. The approach is sometimes known as “white coat marketing,” which the lawsuit noted is considered problematic by authorities because it may blur trust between doctors and patients. (Silverman, 12/11)

Stat: How Alex Azar Could Try To Shake Up Drug Prices Through Medicare Part B
Alex Azar might have big plans to overhaul how Medicare pays for drugs. At a congressional hearing at the end of November, the nominee to be secretary of Health and Human Services wondered aloud about how to modify a government health insurance program that helps tens of millions of Americans over the age of 65 pay for medicines. Such changes might impact the price of the drugs across the board. (Swetlitz, 12/12)

Reuters: Merck Raises Stakes In Lung Cancer As Rivals Close In
Merck & Co Inc, maker of the only immunotherapy approved for patients newly-diagnosed with the most common type of lung cancer, could solidify its lead by playing the long game, even as rivals edge closer. Shares of Merck have fallen 10 percent since the drugmaker several weeks ago said it would make survival a main goal of a key lung cancer trial for immunotherapy Keytruda, extending the study by up to a year. (Beasley, 12/11)

Stat: Some Drug Makers Are Considered Good Corporate Citizens
Seeking to remake corporate America, a nonprofit has released a ranking of the largest publicly traded companies in the U.S. It is based on issues that its own polling finds are important to the public, such as worker pay and treatment, customer respect, and product quality, among many other things. And while drug makers did not rate in the very highest positions, seven of these companies did fall within the Top 100, starting with Eli Lilly (LLY) at number 28. The others are Biogen (BIIB), Bristol-Myers Squibb (BMY), Johnson & Johnson (JNJ), Celgene (CELG), Merck (MRK), and AbbVie (ABBV). All totaled, 1,000 companies were ranked, and 42 drug companies made the list. (Silverman, 12/12)

Detroit Free Press: New Generic Viagra Is Here, Cutting Pharmacy Bills For Michigan Men In Search Of Erections
America's favorite little blue pill has gotten a fairly big price tag over the past 19 years. Now the costs of drugs like Viagra for treating male erectile dysfunction are finally coming down. Pfizer, the maker of Viagra, on Monday introduced the first official generic version of its blockbuster impotence pill. The drug costs $30 to $35 per pill, about half the price of brand-name Viagra. Generic maker Teva Pharmaceuticals can also introduce its own Viagra generic beginning this week, although the company hasn't announced whether it will. (Reindl, 12/11)

Stat: Wall Street Loves Sage's Experimental Antidepressant. Will Patients?
Although Sage Therapeutics’ (SAGE) experimental antidepressant has been great for its stock price — it soared 70 percent on Thursday after the company announced mostly positive results from a Phase 2 clinical trial of the compound it calls Sage-217, and kept climbing on Friday — the jury is very much out on whether it will ever be good for patients suffering from major depression. (Begley, 12/8)

The Associated Press: Philippines Wants Money Back From Sanofi For Dengue Vaccine
The Philippine government will demand a refund of 3.5 billion pesos ($69.5 million) from vaccine maker Sanofi Pasteur and look at possible legal action after a study showed the vaccine used in a dengue immunization program could expose some people to severe illness, the health chief said Friday. Health Secretary Francisco Duque III said the government will also seek compensation for treatment of children who may develop severe dengue. No deaths have been confirmed, but at least one immunized child has developed dengue. (Gomez, 12/8)

Bloomberg: Opioid Maker Tries To Kick Dependence On $36,000 Autoimmune Drug
Three years of gains in a key earnings gauge are being overshadowed by weak prices for generic drugs and doubts about Acthar, Mallinckrodt’s $36,000-a-vial prescription drug for autoimmune and rare diseases that accounts for more than a third of sales. Multiple government probes of opioid makers including Mallinckrodt have added to the unease, leaving some of the company’s $5.7 billion of junk-rated debt hovering below 82 cents on the dollar and the shares down more than 55 percent this year. (McNeely, 12/5)

19. Perspectives: With Federal Government Stalled Over Drug Prices, States Should Be Allowed To Act

Read recent commentaries about drug-cost issues.

Bloomberg: Let States Lower Drug Prices
Drug prices are too high, and Congress lacks the political will to do anything about it. These are two of the most uncontroversial assertions in the contentious debate about U.S. health care policy -- and they explain why states should be allowed to act on their own. (12/11)

The Hill: Other Countries Control Drug Prices The US Could, Too
Public opinion surveys show that most Americans are deeply concerned about rising drug prices. That’s not surprising: Overall, we spend twice as much on drugs as our counterparts in other developed countries. For example, in 2015, the most recent year for which data are available, an American patient and insurer could expect to pay about $2,670 for a month’s supply of adalimumab, a drug commonly used to treat rheumatoid arthritis. A patient and insurer in the United Kingdom would pay about $1,360 for the same supply of the same drug; in Switzerland, about $820. (Allan Coukell, 12/7)

Bloomberg: A Cancer-Drug Pricing Experiment Just Got More Interesting
It's one of those good news/bad news situations.The good news is that Pfizer Inc.'s cancer drug talazoparib -- which came with its $14 billion acquisition of Medivation Inc. in 2016 -- helps breast-cancer patients, according to late-stage trial data released Friday. The bad news? Though comparing trials is tricky, the results look similar to those produced by AstraZeneca PLC's drug Lynparza, which is already on the market. If approved by the FDA, Pfizer's drug will be the fourth in a class of potentially interchangeable drugs called PARP inhibitors to hit the market. (Max Nisen, 12/8)

Forbes: Biopharma Schizophrenia: High Demand For Innovation Vs. Pleas For 'Me-Too' Drugs
In a session called “Five Fixes For Healthcare” at the recent Forbes Healthcare Summit, concerns were raised about how innovative the biopharmaceutical industry really is. Dr. Laurie Glimcher, CEO of the Dana-Farber Cancer Institute, chided the industry saying that, when it comes to productivity, we “need to make a distinction between drugs that are transformative and drugs that are ‘me-too’.” Dr. George Yancopoulos, President and Chief Scientific Officer of Regeneron, was even more strident in his remarks, criticizing the industry’s 2016 new drug output noting that of the 22 FDA approvals only seven compounds were novel breakthroughs. (John LaMattina, 12/11)

The Hill: Keep Big Government Out Of Medicare Drug Pricing Negotiations
[On Tuesday], the Senate Health, Education, Labor & Pensions Committee (HELP) will discuss a proposed alteration to Medicare. The proposal comes from a report released in late November by the National Academies of Sciences, Engineering, and Medicine. NASEM urges Congress to allow federal bureaucrats to negotiate Medicare drug prices directly with pharmaceutical companies. Currently, private insurance companies conduct these negotiations. The academies believe the federal government could use its bulk purchasing power to obtain lower drug prices for Medicare beneficiaries. (Sally Pipes, 12/11)

Newsweek: How To Reduce Medical Drug Prices At A Stroke
From penicillin to vaccines to biologics, pharmaceutical innovation has blessed us with better ways to treat, prevent and even cure disease. But some of the pharmaceutical industry’s most recent “innovations” have nothing to do with health, other than their own financial health. Drug companies are coming up with imaginative – and I would argue “unscrupulous” – ways to circumvent competition and the free market. All in an effort to keep their prices and profits high. (Scott Knoer, 12/6)

Bloomberg: Sex, Drugs And That Little Blue Pill
On Monday, a generic drug company is going to begin selling sildenafil in the U.S., and to tell you the truth, I’m surprised the news hasn’t gotten more attention. You see, sildenafil is the compound that goes by the brand name Viagra. Introduced by Pfizer Inc. in March 1998, Viagra has generated over $17 billion in the U.S. alone. Although the Viagra patent doesn’t expire until 2020, Pfizer agreed about four years ago to allow Teva Pharmaceutical Industries Ltd. to sell a generic version starting in December 2017, settling a legal battle between the two companies. (Joe Nocera, 12/6)

Editorials And Opinions

20. Parsing The Policies: Undoing The Individual Mandate; Medicare, Medicaid Cuts Are On The Horizon

Opinion writers offer their thoughts on a range of health policy issues.

The Washington Post: We Are Even More Convinced That Thousands Will Die Prematurely If The ACA Is Repealed
But there is universal consensus that these tax cuts will cause a massive increase in the nation's deficit — which ultimately will lead to offsetting tax increases, or, more likely, spending cuts. These cuts in spending will probably be focused on the very programs that save lives and provide valuable financial protection to our nation’s poorest and oldest. It seems implausible to argue that a tax break where 60 percent of the benefits go to the 1 percent of Americans, paid for by broad cuts to public spending focused on the needy, will improve public health. (Lawrence H. Summers and Jonathan Gruber, 12/12)

Forbes/Next Avenue: Why Big Medicare And Medicaid Cuts Are Likely
The widely expected passage of the tax reform bill will almost undoubtedly cause significant harm to Medicare. And provocative statements by President Trump and House Speaker Paul Ryan declaring that “entitlement reform” will be next threatens Medicaid. Put these two together and, I think, one thing is clear: Big Medicare and Medicaid cuts are coming. (Bob Blancato, 12/12)

The Wall Street Journal: Canada’s Health-Care Queues
American Democrats are following Bernie Sanders in embracing single-payer health care on the Canadian model. But when they get sick, our neighbors to the north increasingly find that the only way to get “free” medical care is to wait for weeks or months. (12/12)

RealClear Health: It's Time To Revamp Medicare ACOs
Medicare Accountable Care Organizations (ACOs) were created by the Affordable Care Act (ACA) to improve the efficiency of the networks of hospitals and doctors that deliver services to Medicare patients and thereby lower the government’s costs. So far, however, ACOs haven’t produced any savings for the federal government. ACOs would become more efficient and innovative if they were forced to compete with the other options beneficiaries have for getting their Medicare-covered benefits. (James C. Capretta, 12/13)

21. Viewpoints: Congress Helped Create Opioid Crisis; Thoughts On Assisted Suicide

A selection of opinions on health care from news outlets around the country.

Milwaukee Journal Sentinel: Congress Gave Birth To The Opioid Crisis
This bill encouraged physicians to treat pain aggressively, even when the treatment may increase the risk of death. In fact, the government made it a criminal offense to under-treat pain. Furthermore, the Joint Commission on Accreditation of Healthcare Organizations, which accredits more than 21,000 health care facilities in the U.S., adopted the tenet that every patient has a right to have his or her pain assessed, treated, and monitored without being influenced by that individual’s social, economic, or cultural background. ... A hospital’s revenue is greatly affected without the commission’s seal of approval, and thus committees were formed by healthcare facilities to penalize doctors who would not prescribe narcotics for pain. (Bhupendra O. Khatri, 12/12)

RealClear Policy: Assisted Suicide Is No Choice At All
Assisted suicide laws in the United States have all passed based on the assumption that a terminally ill person has less than six months to live. But the experience of many diagnosed with terminal illnesses force us to ask: What if this assumption is wrong? (Lawrence Carter-Long, 12/13)

USA Today: Doug Jones Won, But Abortion Is Still Perverting Our Politics On Both Sides
Alabama, we warmly welcome you back to the United States of America. All is forgiven, and on a personal note, I want to thank you for rewarding my optimism, which these days is mostly a lifestyle choice. True, you almost rejected a civil rights hero, Doug Jones, in the special election to fill Jeff Sessions’ old seat in the U.S. Senate. And you almost elected Roy Moore, an alleged molester of teenagers who claims we were better off before the Civil War. But as President Trump admitted Tuesday night, a win is a win. (Melinda Henneberger, 12/13)

Stat: Aetna CEO Should Ensure That CVS Deal Boosts Patient Power
Rather than pursuing the typical path of trying to corral patients within its own information silo, CVS-Aetna could instead empower new consumer relationships that deliberately dissolve the old boundaries. Those relationships should be based on three principles: shared information, shared engagement, and shared accountability. (Michael L. Millenson, 12/12)

Stat: Bankers, Doctors Collaborating To Detect ‘Early Warnings’ Of Alzheimer’s
A representative from EverSafe, a financial technology company, demonstrated how financial data across accounts can be aggregated and analyzed, and how the company can send out automated alerts when an account has an unusual transaction suggesting fraud or error. With such a system, Renee could have learned about her husband’s problem the first time he forgot to pay a bill. Joseph could continue to manage his accounts knowing that a mistake would be detected and that would be alerted — along with his doctor and other trusted advocates. (Jason Karlawish, 12/12)

St. Louis Post-Dispatch: I'm Standing With Striking Nursing Home Workers — And You Should, Too
On Dec. 1, 100 workers at Christian Care Home in Ferguson got tired of asking to be treated decently. They got tired of asking for the nursing home ownership to follow labor law. They got tired of waiting for wages they can actually live on. So they did what you do when you’ve been asking and asking and asking for something that is your basic God-given right and getting nowhere — they decided to stop asking and start demanding. So they went on strike. An unfair labor practice strike to be precise, because they were sick of having their rights trampled on. (Bruce Franks Jr. 12/12)