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3. Political Cartoon: 'Lookout?'

Kaiser Health News provides a fresh take on health policy developments with "Political Cartoon: 'Lookout?'" by Mike Luckovich, Atlanta Journal-Constitution.

Here's today's health policy haiku:


Pharma loses pal
Expects loss of influence
Who else needs to go?

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Summaries Of The News:


4. $850K Price Tag For Blindness Drug Makes It One Of Most Expensive In World -- But There's A Twist

In a novel arrangement, drugmaker Spark Therapeutics will offer discounts based on whether or not the drug, Luxturna, works initially and remains effective.

The Associated Press: Price Tag On Gene Therapy For Rare Form Of Blindness: $850K
A first-of-its kind genetic treatment for blindness will cost $850,000 per patient, making it one of the most expensive medicines in the world and raising questions about the affordability of a coming wave of similar gene-targeting therapies. The injectable treatment from Spark Therapeutics can improve the eyesight of patients with a rare genetic mutation that affects just a few thousand people in the U.S. Previously there has been no treatment for the condition, which eventually causes complete blindness by adulthood. (Perrone, 1/3)

The Washington Post: Gene Therapy For Inherited Blindness Sets Precedent: $850,000 Price Tag
The drug, called Luxturna, is the realization of a long-sought scientific dream: The one-time treatment corrects a faulty gene to improve vision, allowing patients to see the stars or their parents' faces. Only 1,000 to 2,000 people in the United States are thought to have deteriorating vision caused by this errant gene, called RPE65, but Luxturna is widely expected to be the first in a wave of cutting-edge treatments that are targeted at fixing the causes of a wide range of genetic diseases — while also raising difficult questions about how to pay for them. (Johnson, 1/3)

Stat: Spark Prices Its Gene Therapy As Most Expensive U.S. Medicine
Spark CEO Jeff Marrazzo says Luxturna’s ability to restore vision in a small number of people with a defective gene justifies the high cost, particularly because the gene therapy is only injected one time in each eye for a long-term benefit. Many investors expected Spark to charge $1 million or more for Luxturna, so the actual price will be considered a bargain by some. (Feuerstein and Garde, 1/3)

The Wall Street Journal: Drug Firm Spark Therapeutics Will Charge $850,000 For Vision-Loss Gene Therapy
To address concerns about the cost of the drug, Luxturna, Spark said it is offering alternative payment arrangements to health insurers, including partial refunds if a patient’s vision doesn’t improve significantly after treatment. The company also is seeking U.S. government clearance to allow insurers to spread out payments for Luxturna in installments. U.S. regulators approved Luxturna last month, making it the first therapy in the U.S. to deliver a functional gene to replace a faulty disease-causing one. (Loftus, 1/3)

Bloomberg: A Breakthrough Blindness Treatment Will Cost $425,000 Per Eye, If It Works 
The company’s effectiveness-based discount is sharply different from how most drugs are currently sold. Health insurers are also used to paying for medicine over the course of a disease or over a patient’s life, in the case of some chronic conditions. A one-time treatment presented a challenge, since the cost would be paid for by one insurer or government, only to have others reap the benefits when the patient changes coverage. (Cortez, 1/3)

The Hill: Price Of New Genetic Therapy For Blindness Set At $850K 
Critics, however, say Luxturna's price is still too high, adding that people without insurance and those who have high deductibles will face the brunt of the cost. “Luxturna offers hope to hundreds of patients. But … what is a fair price that will maximize affordability and accessibility and provide a reasonable return for the drug?" David Mitchell, president and founder of the advocacy group Patients For Affordable Drugs, asked. "The answer to that is certainly not the $850,000 price tag announced today." (Weixel, 1/3)

In other pharmaceutical news —

Politico: Pulse Check: FDA Commissioner Scott Gottlieb
FDA Commissioner Scott Gottlieb discusses his agency's work, why he took the job and what lies ahead in 2018. In a panel discussion, POLITICO reporters analyze Gottlieb's comments and discuss the looming issues facing FDA. (1/3)

5. Allergan To Slash Jobs In Preparation Of Generic Competition For Top-Selling Drugs

The biggest generic threat to Allergan is to its eye treatment drug Restasis. The company has taken various steps to shield Restasis from competition, notably selling its patents to an Indian tribe in New York state to avoid a U.S. Patent and Trademark Office hearing on the validity of the drug’s patents.

Stat: Allergan To Eliminate 1,400 Positions As Generic Competition Looms
Making good on a recent promise, Allergan (AGN) disclosed plans to cut 1,000 existing jobs as the company prepares to face generic competition, especially for its second-biggest medicine, the Restasis eye treatment. The job cuts, which also involve eliminating 400 open positions, are expected to reduce expenses between $300 million and $400 million this year, according to a regulatory filing made on Wednesday. Allergan employs about 18,000 people. Other steps, such as closing buildings, may also occur. (Silverman, 1/3)

In other news —

The Star Tribune: Bio-Techne Buys Atlanta Biologicals In Cash Deal 
Minneapolis-based Bio-Techne Corp., which makes biological supplies and machines used in research by the pharmaceutical industry, has acquired a small firm in Georgia called Atlanta Biologicals that makes a bovine-derived serum that promotes cell growth during biotech experiments. Bio-Techne announced late Tuesday that it has acquired all of the stock of Atlanta Biologicals and its affiliate company Scientific Ventures in a cash transaction. The deal price was not disclosed. (Carlson, 1/3)

Health Law

6. 'No Significant Deterioration' Is Expected In ACA Markets In 2018, Analysts Forecast

Since insurers have had time to adjust to "negative factors" and policy changes, analysts predict that marketplaces will remain stable for a year and maybe beyond.

The Hill: Credit Rater Predicts Stable Year For ObamaCare Markets 
The ObamaCare insurance markets will be relatively stable through 2018, analysts predicted Wednesday. Insurers have adapted to the uncertainty surrounding the Trump administration's handling of the law, A.M. Best, a global credit rating organization, wrote in a briefing released Wednesday. It said insurers should have a stable 2018. (Hellmann, 1/3)


7. Having Buyer's Remorse Over Medicare Advantage Plan? You Can Still Switch Back

Medicare Advantage Disenrollment Period, which is open until Feb. 14, allows people enrolled in an Advantage plan for 2018 to switch to original Medicare. Meanwhile, in other Medicare news, the Centers for Medicare & Medicaid Services will start reviewing Advantage networks on three-year cycles.

CNBC: If You're Tired Of Medicare Advantage, Now Is The Time To Ditch
If you missed your initial Medicare enrollment period or want to dump your Advantage Plan altogether, now's the time to do it. While early December marked the end of open enrollment — when Medicare recipients can make changes related to their Advantage Plan (Part C) and prescription drug coverage (Part D) — two separate windows opened Jan. 1 for people in certain situations. The first is the wordy Medicare Advantage Disenrollment Period, which lasts until Feb. 14. This is for people enrolled in an Advantage Plan for 2018 who want to switch to original Medicare (Part A hospital coverage and Part B outpatient coverage). The change takes effect the first day of the month after the request is received. (O'Brien, 1/3)

Modern Healthcare: White House Greenlights CMS' Crackdown On Medicare Advantage Plans 
The White House has signed off on the CMS' proposal to ensure Medicare Advantage plans have adequate provider networks. Starting next year, the CMS will start reviewing Medicare Advantage networks on three-year cycles rather than only when a company applies to be or renews their status in the program. The agency will also conduct intermediate full network reviews under certain circumstances, as when Medicare beneficiaries report access issues. (Dickson, 1/3)

In other Medicare news —

Forbes: Smaller Rite Aid Plans To Grow PBM's Medicare Prescription Business
Rite Aid executives Wednesday said the smaller pharmacy chain will focus on eight states on the West and East coasts and grow its pharmacy benefit manager following the sale of more than 2,000 stores to Walgreens Boots Alliance. The smaller Rite Aid plans to use its EnvisionRx PBM as a key “growth engine for the entire enterprise,” Rite Aid President Kermit Crawford told analysts on a 70-minute conference call Wednesday evening to discuss its fiscal third quarter earnings. Rite Aid said its PBM is growing rapidly and will add more than 100,000 customers who purchase Medicare Part D drug benefits this year, growing a business that has already “surpassed 500,000 lives.” (Japsen, 1/3)


8. ACLU Alleges In Suit That Rhode Island Medicaid Wrongly Dropped People From Rolls

The Rhode Island lawsuit centers on a Medicaid program that helps elderly and disabled enrollees pay their Medicare premiums. Elsewhere, Republican Kansas Gov. Sam Brownback names a lawyer who helped fight to block Medicaid payments to Planned Parenthood to serve as the interim head of the state agency that oversees the program.

Providence Journal: RI ACLU Again Sues State Over UHIP, Claiming Problems With Medicaid
The ACLU of Rhode Island has filed another class-action lawsuit against the state over failures of the problem plagued public-benefits computer system known as UHIP. The latest lawsuit alleges that participants in the state’s Medicaid program are not being given “proper notice” before being kicked out of the program. The lack of notice has led to loss of income for participants and put them “at risk of losing their homes and their utilities and deprives them of funds needed for their daily living expenses, including food,” the lawsuit filed in U.S. District Court states. (Bogdan, 1/3)

Rhode Island Public Radio: RI ACLU Suit: State UHIP System Dropped Residents From Medicaid Rolls
The plaintiffs include elderly residents and those with disabilities who the ACLU says are falling behind on their utility bills and having trouble paying for housing and food. The suit centers on residents enrolled in a Medicaid program that pays monthly premiums and other costs for residents enrolled in Part B of Medicare, the government insurance program for residents 65 and older. The costs of Medicare Part B – which covers expenses for doctors, outpatient services and durable medical equipment – include premiums of $134 per month. (Arditi, 1/3)

KCUR: Planned Parenthood Foe To Head Kansas Health Agency; Lawmaker Named Top Medical Officer 
A lawyer who spearheaded Republican Gov. Sam Brownback’s efforts to block Medicaid payments to Planned Parenthood will take charge of the Kansas Department of Health and Environment next week. Darian Dernovish will become interim head of the agency on Jan. 8, Brownback’s office said Wednesday. He will replace Susan Mosier, who has held the job since December 2014. Dernovish has been a KDHE attorney since 2015, serving as the agency’s chief litigator in federal and state court. In that capacity he advanced the administration’s arguments to stop reimbursing Planned Parenthood for non-abortion services. (McLean, 1/3)

Modern Healthcare: Hospitals Slam Kansas' Proposed Medicaid Overhaul 
Providers are concerned that a new waiver to overhaul Kansas' Medicaid program will impede access to care and further empower managed-care plans, which they claim lack proper oversight. For years, Kansas providers have complained the state's Medicaid program, known as KanCare, was complex to work under and that it underpaid or didn't pay at all for services. Rather than revamp KanCare's oversight of the plans, Republican Gov. Sam Brownback submitted a waiver late last month that appears to cede additional power to them, providers said. The state waiver includes a work requirement proposal for so-called able-bodied adults, which includes a three-month coverage lockout penalty if beneficiaries don't comply. (Dickson, 1/3)

Administration News

9. Trump's Nuclear Taunt Reignites Democrats' Chatter Over 25th Amendment, State Of His Mental Health

Last month lawmakers were briefed by a psychiatrist on the signs that might indicate President Donald Trump is having mental health issues. The president's latest tweet on North Korea has done nothing to soothe those concerns.

Politico: Washington's Growing Obsession: The 25th Amendment
Lawmakers concerned about President Donald Trump’s mental state summoned Yale University psychiatry professor Dr. Bandy X. Lee to Capitol Hill last month for two days of briefings about his recent behavior. In private meetings with more than a dozen members of Congress held on Dec. 5 and 6, Lee briefed lawmakers — all Democrats except for one Republican senator, whom Lee declined to identify. Her professional warning to Capitol Hill: “He’s going to unravel, and we are seeing the signs.” (Karni, 1/3)

In other news on the president, advocates are worried Trump's decision to fire his AIDS advisory council will result in a backslide on progress that's been made, and the White House reiterates its stance on entitlement cuts —

Politico: Trump's Firing Sets Back AIDS Prevention Efforts
President Donald Trump’s decision to fire his HIV/AIDS advisory panel and refusal to fill other key policy positions puts the U.S. at risk of slipping backward on prevention just as the opioid epidemic threatens to spread the virus among intravenous drug users. The advisory panel, which has existed in some form since the Reagan years, sits empty after Trump removed all 16 of its remaining members last week. (Ehley, 1/3)

The Hill: White House: Trump Hasn't Shifted On Not Cutting Entitlements
President Trump has not changed his position on protecting entitlement programs from funding cuts, White House press secretary Sarah Huckabee Sanders said Wednesday. After last month's GOP victory on tax reform, many Republicans are calling for changes to the social safety net as a way to cut government spending. But, asked about Trump's repeated campaign pledge to protect Social Security, Medicare and Medicaid, Sanders said he doesn't support cuts to the programs. (Hellmann, 1/3)

Public Health And Education

10. In Nation's First Opioid Court, Goal Shifts From Punishing Defendants To Keeping Them Alive

Participants in the court, which recognizes failure as part of the process and not something that should be punished, are required to appear daily before Judge Craig D. Hannah. Court systems around the country are watching the Buffalo, N.Y., initiative as a potential model. Media outlets report on news from the drug crisis out of California and Tennessee as well.

The New York Times: This Judge Has A Mission: Keep Defendants Alive
There are two kinds of defendants who enter Judge Craig D. Hannah’s courtroom: Those who stand on the far side of the bench to have their cases considered in the usual way, and those invited to step closer. Close enough to shake the judge’s hand or shout obscenities in his face, depending on their mood that day. Both kinds are facing criminal charges, but those in the second group have volunteered to take part in an experiment where the primary goal is to save their lives. Arrested for crimes related to addiction, they are participants in what is believed to be the nation’s first opioid court. (Williams, 1/3)

California Healthline: Drug Overdose Deaths Plateau In California, Soar Nationally
Even as the opioid crisis fueled overdose deaths across the nation, the number of Californians who succumbed to these and other drugs has remained stable, new federal data show. Deaths from opiates, cocaine and methamphetamines shot up by 35 percent in the United States between the year ending in May 2015 and that ending in May 2017, according to a Kaiser Health News analysis of statistics from the Centers for Disease Control and Prevention. (Bartolone, 1/4)

Nashville Tennessean: Williamson County Files Lawsuit Against Opioid Manufacturers, Distributors
Williamson County filed a federal lawsuit against several drug manufacturers and distributors on Wednesday, alleging the companies failed to comply with the federal Controlled Substances Act. The lawsuit, filed in Tennessee's Middle District, names five of the nation's largest prescription opioid manufacturers and their related companies, as well as three major wholesale drug distributors, as defendants. (Sauber, 1/3)

San Francisco Chronicle: Effort Under Way To Make Naloxone Opioid Antidote More Accessible In State
Bay Area public health officials have begun receiving shipments of naloxone — the drug that reverses the effects of an opioid overdose — in the first state-funded effort to get the emergency antidote to local health departments across California. The distribution of the drug, funded by a one-time $3 million grant approved by state legislators in 2016, marks a ramp-up in the state’s response to deadly overdoses of prescription painkillers, heroin and the synthetic opioid fentanyl. (Ho, 1/3)

11. Lawsuit May Upend Local-First Mentality When It Comes To Organ Donations

There are vast geological disparities when it comes to availability of organs for donation, but a recent lawsuit may change that. In other public health news: sugar, nursing homes, hospitals gowns, "raw water," dental health and meat allergies.

Los Angeles Times: In A Turf Battle For Organs, A Policy Review Rattles The National Transplant System
Tethered to a breathing machine at a Manhattan hospital, 21-year-old Miriam Holman would die without a lung transplant. But her odds of finding a suitable organ were especially low in New York, where waiting times are among the longest in the country. Just across the Hudson River in New Jersey, patients in far better condition routinely receive lungs much more quickly. Pockets of the South and Midwest also have dramatically shorter waiting times. The disparities stem from a principle that has always guided the national transplant system: local first. Most organs stay in the areas where they are donated, even if sicker patients are waiting elsewhere. (Zarembo, 1/3)

Los Angeles Times: A Popular Sugar Additive May Have Fueled The Spread Of Not One But Two Superbugs
Two bacterial strains that have plagued hospitals around the country may have been at least partly fueled by a sugar additive in our food products, scientists say. Trehalose, a sugar that is added to a wide range of food products, could have allowed certain strains of Clostridium difficile to become far more virulent than they were before, a new study finds. The results, described in the journal Nature, highlight the unintended consequences of introducing otherwise harmless additives to the food supply. (Khan, 1/3)

Stat: He Wants To Upend The Nursing Home Industry — And Reinvent Senior Living
But here on the black-stone edge of a gloomy Cayuga Lake stood the pioneering geriatrician Dr. Bill Thomas, a few feet away from his weapon of choice in this battle: a 330-square-foot, plywood-boned home he calls a Minka. ...The idea sounds, in one sense, simple: create and market small, senior-friendly houses like this one and sell them for around $75,000, clustered like mushrooms in tight groups or tucked onto a homeowner’s existing property so caregivers or children can occupy the larger house and help when needed. (Tedeschi, 1/4)

The New York Times: The Hospital Gown Gets A Modest Makeover
As 2018 dawns and with it the new tax plan, the future of health care for many individuals remains uncertain. But there is at least one type of improvement in coverage Americans can look forward to: the end of the dreaded exposed rear end, that hospital cliché created by back-tying gowns that has been immortalized in movies including “Something’s Gotta Give” (courtesy of a medicated Jack Nicholson stumbling down the hallway) to “Yes Man” (Jim Carrey this time, spotted on the back of a motorcycle). The fashion world has woken up to a new dressing opportunity. (Safronova, 1/3)

The Washington Post: ‘Raw Water’ Is The Latest Health Craze. Here’s Why Drinking It May Be A Bad Idea.
Hold your canteen under a natural spring and you'll come away with crystal clear water, potentially brimming with beneficial bacteria as well as minerals from the earth. That's what proponents of the “raw water” movement are banking on — selling people on the idea of drinking water that contains the things they say nature intended without the chemicals, such as chlorine, often used in urban water treatment processes. In some areas of the country, including the West Coast, it has become a high-dollar commodity — water captured in glass bottles and sold straight to you. (Bever, 1/3)

Georgia Health News: Sudden Meat Allergy May Come From Surprising Source
Researchers think the alpha-gal allergy is caused by a bite from the Lone Star tick. There’s no definitive proof of that, but there is strong circumstantial evidence. Dr. Scott Commins, an allergist and researcher at the University of North Carolina at Chapel Hill, said the thing that most alpha-gal allergy patients seem to have in common is a history of tick bites. (Knight, 1/3)

12. Vast Geographical, Ethnic Disparities In Infant Mortality Continue To Plague U.S.

But a recent study found that, overall, infant mortality declined in recent years.

CNN: Infant Mortality: States With The Highest Rates
There's good and bad news when it comes to infant mortality in the United States. Infant mortality, or the death of a baby before his or her 1st birthday, has declined in recent years across the nation and around the world. Yet disparities persist across states, according to a report released by the Centers for Disease Control and Prevention's National Center for Health Statistics on Thursday. (Howard, 1/4)

Columbus Dispatch: Ohio Near Bottom In Black Infant Mortality
Ohio ranked next to last among the 50 states and the District of Columbia with 13.46 deaths for every 1,000 live births to black mothers from 2013 to 2015. That’s more than double the state’s infant-mortality rate of 5.76 for babies born to white mothers during the same period, according to data released Thursday by the National Center for Health Statistics. (Candisky, 1/4)

In other news on infant health —

Health Care Personnel

13. Evolving Gender Roles, Shrinking Job Opportunities Are Helping Shift More Men Into Nursing

Where there was once a stigma for men to enter the female-dominated field of nursing, the changing economical and social landscape is changing that. “This narrative that men can’t provide care in the way that women can is part of that broad cultural narrative that misunderstands what nursing’s about,” said Adam White, a nursing student.

The New York Times: ‘Forget About The Stigma’: Male Nurses Explain Why Nursing Is A Job Of The Future For Men
Jake Creviston, a nurse practitioner, has been repeatedly mistaken for a doctor. Adam White says the veterans he cares for as a student nurse at the V.A. hospital feel comfortable around him because “I’m a big burly guy with a beard. ”Glenn Fletcher, after being laid off from a lumber mill during the financial crisis, found a new career in nursing. And with it, “a really good feeling putting your head on the pillow realizing you’ve helped other people.” (Miller and Fremson, 1/4)

State Watch

14. Depending On Where You Live In Minnesota, Medical Treatments Could Cost You 8 Times As Much

An "eye-opening" study finds vast disparities in cost within just one state. But some say that the study shows only one piece of the complex puzzle behind rising health care costs in Minnesota and across the nation.

Pioneer Press: Need A Knee Replacement? It Costs $46,974 At One Minnesota Hospital And $6,186 At Another 
Minnesotans could pay up to eight times more for certain medical procedures depending on the hospital they choose, but it’s hard to know which facilities offer the most affordable services. That’s the take away from a report released Wednesday by the Minnesota Department of Health aimed at making health care costs more transparent. Researchers examined the wide range of prices Minnesotans pay hospitals for four procedures — hip and knee replacements and normal and C-section births. (Magan, 1/3)

Minnesota Public Radio: Report Finds 'Huge Swings' In Minnesota Hospital Charges
"Employers have long suspected that there is a great deal of variation in both the quality and the cost of health care," Pare said in a statement. "But to be able to see the actual numbers provides them an opportunity to make better purchasing decisions. Employers can also help employees and their family members identify and access more affordable care." (Moylan, 1/3)

15. State Highlights: N.H. Hospitals Hit Hard By IV Bag Shortages Linked To Hurricane Maria; Partners HealthCare’s Plan To Acquire Hospital To Get AG Scrutiny

Media outlets report on news from New Hampshire, Massachusetts, Tennessee, Florida, Texas and New Jersey.

New Hampshire Public Radio: N.H. Hospitals Sound Alarm Over Supply Shortages Tied To Hurricane Maria
At Weeks and other hospitals across the state, pharmacy managers like Eddy have spent the last three months scrambling to deal with an unexpected fallout from the September storm that knocked out power to Puerto Rico: a backlog in the supplies they need to perform all kinds of routine medical procedures, from IV drips to surgeries. As FDA Commissioner Scott Gottlieb testified to Congress in October, Puerto Rico plays a critical role in the whole country’s supply of medical products. (McDermott, 1/3)

Boston Globe: AG Maura Healey To Review Partners’ Plan To Buy Mass. Eye And Ear
A state health care watchdog agency Wednesday asked Attorney General Maura Healey to review Partners HealthCare’s plan to acquire a specialty eye and ear hospital, saying the deal would raise medical costs substantially. The Health Policy Commission said Partners’ takeover of Massachusetts Eye and Ear would boost health spending by as much as $61 million a year — expenses that ultimately would be borne by consumers and businesses. (Dayal McCluskey, 1/3)

The Associated Press: Lawyers Seek To Ease Doctor’s Sentence For Medicare Fraud
Even though a politically prominent Florida eye doctor was convicted of Medicare fraud, that doesn’t mean the federal government lost more than $100 million as prosecutors contend, his attorneys argued Wednesday as they tried to save him from a lengthy prison sentence. Dr. Salomon Melgen may have told Medicare he was treating patients for diseases they didn’t have but they did have other eye diseases and benefited from the treatment they received, attorneys Matthew Menchel and Josh Sheptow told U.S. District Judge Kenneth A. Marra. (Spencer, 1/3)

Houston Chronicle: Central Care's 6 Clinics Could Close Next Week After Funding Loss 
A network of Houston health centers serving vulnerable residents has sued the federal government to prevent the loss of funding that local officials say would close six clinics as early as next week. Central Care Integrated Health Services obtained a temporary restraining order in late December against the U.S. Department of Health and Human Services' acting secretary to extend the terms of an operating grant until Monday. A hearing is set before Chief U.S. District Judge Lee Rosenthal in Houston Monday, and an amended lawsuit filed Jan. 1 seeks to continue federal funding beyond that point. (George, 1/3)

Modern Healthcare: Hackensack Meridian And JFK Cement Merger 
Hackensack Meridian Health and JFK Health finalized their merger to create a combined entity with 16 hospitals throughout New Jersey, the companies announced Wednesday. Executives of the Edison, N.J.-based systems said the marriage would allow them to expand patient access and better deliver preventive healthcare. The merger will bolster a combined ambulatory network of 160 facilities, reflecting the importance of more convenient outpatient settings where patients can get more affordable and efficient treatment. (Kacik, 1/3)

Texas Tribune: Relatives Report Inadequate Heating At More Than 30 Texas Prisons
More than 30 Texas prisons had heating issues during a cold snap that brought freezing temperatures to much of the state this week, according to reports by inmates’ family members. The Texas Inmate Families Association, a support and advocacy group, compiled reports by inmates' relatives that blamed poor insulation, broken windows and nonfunctioning heaters for the cold conditions in the facilities. (McCullough, 1/3)

Weekend Reading

16. Longer Looks: Crowdfunding Health Care; Why Humans Sleep; And Pseudoscience In Health

Each week, KHN's Shefali Luthra finds interesting reads from around the Web.

Mother Jones: Go Fund Yourself
Health care in America is the wedge of inequality: It’s the luxury everyone has to have and millions can’t afford. Sites like YouCaring have stepped in to fill the gap. The total amount in donations generated by crowdfunding sites has increased eleven­fold since the appearance of Obamacare. In 2011, sites like GoFundMe and YouCaring were generating a total of $837 million. Three years later, that number had climbed to $9.5 billion. Under the Trump administration, YouCaring expects donations to jump even higher, and the company has already seen an estimated 25 percent spike since the election, which company representatives believe is partly a response to the administration’s threats to Obamacare. (Stephen Marche, 1/2)

The Atlantic: Why Do We Need To Sleep?
The precise benefits of sleep are still mysterious, and for many biologists, the unknowns are transfixing. One rainy evening in Tsukuba, a group of institute scientists gathered at an izakaya bar manage to hold off only half an hour before sleep is once again the focus of their conversation. (Veronique Greenwood, 1/3)

FiveThirtyEight: Tom Brady Is Drowning In His Own Pseudoscience
I’ve spent the last year and a half reporting and writing a book about exercise recovery, and what I’ve learned is that advice from elite athletes is often cluttered with pseudoscientific explanations for their stupendous results. The problem is that gifted athletes don’t necessarily know how they got that way. Or, in the words of David Epstein, author of “The Sports Gene,” “Just because you’re a bird doesn’t mean you’re an ornithologist.” (Christie Aschwanden, 1/3)

The New Yorker: My Father’s Body, At Rest And In Motion
My father, eighty-three, had been declining for several weeks. The late-night phone calls had tightened in frequency and enlarged in amplitude, like waves ahead of a gathering storm: accidents were becoming more common, and their consequences more severe. This was not his first fall that year. (Siddhartha Mukherjee, 1/1)

WIRED: The Future Of Weed Science Is A Van In Colorado
The lab is mobile because it has to be. Researchers at CU Boulder’s Change Lab built it to study marijuana’s effects on human test subjects. But even in states like Colorado, where recreational marijuana has been legal since 2014, federal law prohibits scientists from experimenting with anything but government-grown pot.And Uncle Sam’s weed is weak. (Robbie Gonzalez, 12/31)

Editorials And Opinions

17. Thoughts On Curbing The Opioid Epidemic: Not All 'Well-Intentioned' Battle Plans Are 'Good Ideas'

Opinion writers offer their thoughts on the current status of the nation's attempts to address the opioid crisis and the areas in which they are watching for action.

JAMA Forum: A New Year’s Wish On Opioids
As overdose deaths mount, leading to a decline in US life expectancy 2 years in a row, my New Year’s wish is for more people to appreciate this statement: Not all well-intentioned approaches to addressing the opioid epidemic are good ideas. Some are based on evidence and experience, others on misunderstanding, blame, fear, or frustration. What’s needed in 2018 is the wisdom—and the courage—to tell the difference. (Joshua M. Sharfstein, 1/3)

USA Today: We Mobilized Against Flu, Cancer And Heart Attacks. Where's The Urgency On Opioids?
Our nation is not yet succeeding in addressing the opioid crisis, as exemplified by the latest drug overdose numbers just released by the Centers for Disease Control and Prevention (CDC). In 2016, we lost more than 63,000 Americans to drug overdoses broadly, an increase of 21% over the previous year. The relentless devastation is being felt by far too many families and communities. The country’s response to this problem has been hampered by our failure to recognize addiction as a disease that requires comprehensive health solutions. (Barry McCaffrey and Jessica Hulsey Nickel, 1/4)

The Wall Street Journal: The Opioid Crisis Has Plaintiff Lawyers Smelling Cash
America’s unrivaled pharmaceutical industry develops and manufactures more than half of the world’s new medicines and treatments. Its global dominance is due in part to the largely unregulated prices and uncapped profit margins that make America the world’s most lucrative market. Yet Big Pharma has an image problem: The industry has been tainted by the opioid crisis. (Dennis Kneale, 1/3)

18. Viewpoints: The Medical Device Tax's Comeback; 2018 Brings Fresh Health Policy Choices, Controversies

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

The Wall Street Journal: Happy New Year’s Tax
The medical device tax apparently has more comebacks than Mariah Carey. In the first minutes of 2018, while the pop star was redeeming herself on ABC for her widely panned New Year’s Eve performance the year before, the 2.3% excise tax had its own comeback after Congress had suspended implementation for two years. The tax was originally imposed in 2013 to fund Obama Care. But it proved unpopular, and not only among Republicans. Democrats from states with medical device companies squawked too. Even Al Franken, the unlamented former Senator from Minnesota, had vowed to fight this “unfair burden on the medical device industry.” (1/3)

USA Today: Your Health Care And GOP Majority Are At Stake In Congress Starting Now
This new year brings brings fresh choices and fresh controversies in health care. President Trump and Republicans tried last year to repeal the Affordable Care Act and, when that failed, to chip away at the law in other ways. But in the end, with no legislation passed, the principal result was to galvanize a once ambivalent public. Now we enter 2018 with health care as a top concern of American voters and the ACA as popular as ever. More importantly, Americans recognize the ACA’s flaws and by large margins just want them to be fixed. Take it from me, the backlash is coming. Serious proposals from both sides should be listened to.  (Andy Slavitt, 1/3) Medicare Penalties And Improving Patient Safety
Often lost in the heated rhetoric toward the Affordable Care Act -- whipped into high flame by President Donald Trump and his hard-line Republican allies in Congress -- are the lesser known accountability measures the original act contained. Among them is a mechanism aimed at prodding hospitals into taking steps to improve patient care. (1/3)

Axios: Don’t Read Too Much Into Health Care’s High Poll Rankings
An AP/NORC poll published late in December found that health care ranked number one on the list of the public's priorities for government. It's a well done and well reported poll, and as the head of a health policy and journalism organization, I suppose I should be happy that health ranked number one. Yes, but: Having conducted and watched health care polling for decades, I'd caution readers not to over-interpret health care's first place finish, which may not mean very much for upcoming elections. They are unlikely to be about health care and are much more likely to be about the candidates and President Trump. (Drew Altman, 1/4)

JAMA: A Piece of My Mind: The Envelope
When I move to shake hands with Jack, a 70-year-old new patient and my last of the morning, I see the large white envelope. Records, most likely. Perhaps because of noticing the way he clings to it, or perceiving his urgency, I interrupt my usual routine of logging on to the computer and preparing the history template. “Is that something you would like me to see?” I ask, eyeing the envelope. He hands it to me, looking relieved. ... I write a brief synopsis of our discussion in the chart after Jack leaves and recall being taught that the most important clues to the diagnosis usually come from the history. “Just listen to your patient, and he will tell you what the diagnosis is” was the proverbial teaching wisdom. But there is something missing in that statement: the patient must feel that I am interested. (Jeffrey H. Millstein, 1/2)

Bloomberg: A 2018 Pharma Deal Revival Is No Sure Thing 
Last year was the sector's third straight year of sequential deal-volume decline and the slowest since 2013. And the $95 billion deal total for the year is a little flattering -- 31 percent of that came from Johnson & Johnson's purchase of Actelion. The good news is that most of the potential M&A drivers I mentioned last year are still intact. There's a lot of money sitting around -- cash stashes have grown for just about everyone but Johnson & Johnson and Gilead Sciences Inc., which both made sizable acquisitions last year. Limited patent lives and the high and growing rate of R&D failure mean big pharma is constantly hungry for new drugs and drug candidates. And debt is cheap.  (Max Nisen, 1/3)

Los Angeles Times: Writer Laurie Kilmartin Shows Americans How Badly They 'Suck' At Handling Death
Do you know what we’re bad at in this country? Death. Not the act of dying, but dealing with it. The Victorians were horrified by sex but practically fetishized death, and we do just the opposite. Sex is one of our major cultural food groups, but death? Death, we treat like it’s some embarrassing lifestyle choice. Maybe Laurie Kilmartin can help. She’s a TV comedy writer, and in 2014, as her father was dying, she tweeted about it, from bedside to graveside. From that comes her new book, “Dead People Suck: A Guide for Survivors of the Newly Departed.” (Patt Morrison, 1/3)