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Kaiser Health News Original Stories

2. Political Cartoon: 'Deflated?'

Kaiser Health News provides a fresh take on health policy developments with "Political Cartoon: 'Deflated?'" by Rick McKee, The Augusta Chronicle.

Here's today's health policy haiku:


A “no-brainer” bill
Caused a big lobbying scrum…
Follow the money!

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Summaries Of The News:

Capitol Hill Watch

3. Few Republicans Have Appetite To Risk Another Repeal Failure In Election Year

“We sort of tested the limits of what we can do in the Senate last year. And we’re one vote down from where we were then," said Sen. John Thune (R-S.D.), the No. 3 GOP leader.

Politico: Republicans Give Up On Obamacare Repeal
Republicans are giving up on their years-long dream of repealing Obamacare. Though the GOP still controls both chambers of Congress and maintains the ability to jam through a repeal-and-replace bill via a simple majority, there are no discussions of doing so here at House and Senate Republicans’ joint retreat at The Greenbrier resort. Republicans doubt they can even pass a budget providing for the powerful party-line “reconciliation” procedure used to pass tax reform last year, much less take on the politically perilous task of rewriting health care laws in an election year. (Everett, 2/1)

In other news from Capitol Hill —

The Hill: Bipartisan Group Of Senators Call On Trump To Boost Alzheimer's Funding 
A bipartisan group of senators is calling on President Trump to boost funding for Alzheimer’s research in his fiscal 2019 budget set to be released this month. “At a time when the United States is spending more than $200 billion a year to care for Alzheimer’s patients, we are spending less than two thirds of one percent of that amount on research,” the letter — led by Sens. Susan Collins (R-Maine) and Amy Klobuchar (D-Minn.) and signed by a dozen others — states. (Roubein, 2/1)

And community health centers are struggling as Congress sits on funding —

The CT Mirror: Community Health Centers, Facing Fund Cutoff, Get Short Reprieve
Despite congressional inaction, the federal agency that oversees community health centers has sent money to some centers in Connecticut and committed this week to send funding to more, giving them a temporary reprieve from potential layoffs and cuts to services. Like the Children’s Health Insurance Program (CHIP), despite bipartisan support, Congress missed its Sept. 30 deadline to reauthorize money for the Community Health Center Fund, which represents the largest chunk of federal grant money going to the centers. (Rigg, 2/2)


4. 'Right-To-Try' Bills Give Patients False Hope And Weaken FDA Safety Measures, Ethicists Argue

A group of more than 40 medical professionals sent a letter to Congress about the legislation after President Donald Trump mentioned it in his State of the Union address. Meanwhile, the inclusion of the topic in the speech gave advocates for the movement a jolt of momentum.

Stat: Physicians, Ethicists Urge Congress Not To Pass 'Right To Try' Legislation
Dozens of doctors, medical ethicists, and lawyers are warning Congress that legislation to allow Americans with life-threatening conditions access to unapproved, experimental drugs risks harming patients’ health. The letter was drafted by Alison Bateman-House, associate professor of medical ethics at NYU Langone Health, along with some of her colleagues. It is addressed to the leaders of the House Committee on Energy and Commerce, the committee currently considering a so-called “right-to-try” bill. The letter was circulated for online signatures on Thursday, and organizers said they planned to send the letter on Feb. 5. (Swetlitz, 2/1)

The Hill: Right To Try Act Gains Momentum After Trump Pitch 
Advocates of “right to try” legislation have been given a jolt of momentum by President Trump’s decision to tout the bill during his State of the Union address. The legislation would allow patients with a serious illness to request access to experimental medicines that the Food and Drug Administration (FDA) hasn’t yet approved. (Roubein, 2/1)

In other pharmaceutical news —

The Hill: Trump's Vows To Take On Drug Prices, Opioids Draw Skepticism 
President Trump has pledged to take action to combat the opioid epidemic and reduce drug prices, but one year into his tenure, advocates and industry have grown skeptical of his promises. During his State of the Union speech Tuesday, Trump said one of his top priorities is “fixing the injustice of high drug prices.” (Weixel, 2/1)

The Hill: New Group Plans Midterm Spending Against High Drug Prices 
A new patient group says it plans to spend seven figures this year backing candidates who support policies to lower drug prices in what it hopes will be a counter to the pharmaceutical industry. The group is called Patients for Affordable Drugs NOW, and is founded by a cancer patient named David Mitchell. (Sullivan, 2/1)


5. HHS Secretary Expected To Announce Today Work Requirement For Medicaid In Indiana

Secretary Alex Azar has announced he will be speaking about Medicaid in Indiana today. The state's Medicaid waiver is up for renewal, and officials there have proposed adding a work requirement for non-disabled adults. News outlets also report on Medicaid developments in Iowa, Montana, Virginia and Arkansas.

Kaiser Health News: Indiana Medicaid Drops 25K From Coverage For Failing To Pay Premiums
As the Trump administration moves to give states more flexibility in running Medicaid, advocates for the poor are keeping a close eye on Indiana to see whether such conservative ideas improve or harm care. Indiana in 2015 implemented some of the most radical changes seen to the state-federal program that covers nearly 1 in 4 poor Americans — including charging some adults a monthly premium and locking out some of those who don’t pay for six months. (Galewitz, 2/1)

Roll Call: More States Jump On Medicaid Work Requirements Bandwagon
A growing number of mostly Republican-led states are rushing to follow Kentucky’s lead in requiring thousands of people on Medicaid to work or lose health coverage. The governors of South Dakota, Alabama, Louisiana and South Carolina have said in recent weeks that they plan to pursue work requirements for their Medicaid programs, following the Trump administration’s release of guidelines for the concept in January. (2/1)

Des Moines Register: Iowa Medicaid Leaders End Contract With Milliman Consulting Firm
Iowa Medicaid leaders won't renew their contract with a national consulting firm whose cost estimates were blamed for some of the turmoil the public health care program has faced under private management. The Milliman firm provided Iowa with complicated estimates of how much care 600,000 Iowans on Medicaid would use. State officials and private Medicaid management companies used those estimates to negotiate rates the state has paid the companies to cover those Iowans, starting in April 2016. The Medicaid management companies have complained that Milliman’s estimates were as much as 40 percent below the actual costs, leading to a “drastically underfunded” system and a “catastrophic experience” for the companies. The management companies complained of losing hundreds of millions of dollars. (Leys, 2/1)

Alaska Public Media: State Supplemental Budget Reaches $178 Million, Prompts Medicaid Concern
Gov. Bill Walker’s administration provided a final number on the amount of extra money it plans to spend this year beyond what the Legislature budgeted: $178 million. Most of this cost — $92 million — is from Medicaid. Roughly a third of that cost is due to the Legislature funding Medicaid at a lower level than state officials projected costs would run. On top of that, those projections were too low. Officials say more people enrolled in Medicaid due to the recession. (Kitchenman, 2/1)

The Associated Press: Little Support For Proposed Medicaid Cuts
Some of [Montana's] proposed cuts in Medicaid reimbursement will harm children and leave the state responsible for more expensive services, opponents said Thursday. The Department of Public Health and Human Services took public comment on its proposal to implement about $12.5 million of $49 million in state budget cuts it must make due to lower-than-expected state revenue and a record fire season. The $12.5 million in state cuts over the next 18 months means the loss of another $22.2 million in federal matching funds. (Hanson, 2/1)

Great Falls (Mont.) Tribune: Dozens Speak Out Against State's Program Fee Cuts
Sheila Hogan, director of the Department of Public Health and Human Services appointed to the job in late 2016 by Democratic Gov. Steve Bullock, told the audience the agency was forced to propose these changes due to decisions made at the last legislative session in which GOP leadership opposed any revenue increase proposed by Bullock. She said the Republican lawmakers did not approve a compromise. (Drake, 2/1)


6. 1.84 Percent Rate Hike Proposed For Medicare Advantage Plans In 2019

The increase in what the federal government pays the plans was near to what analysts had expected.

Modern Healthcare: Medicare Advantage Plans To Receive 1.85% Rate Hike For 2019 
The CMS Thursday proposed to bump up baseline Medicare Advantage payment rates for 2019 by 1.84% on average, up from the 0.45% plans received last year. The average Medicare Advantage payment rate will increase by 3.1% after taking into account the way health plans code their members' diagnoses, the CMS said. That's up from a 2.95% increase last year. (Dickson, 2/1)

Reuters: U.S. Government Proposes 1.84 Percent Hike In 2019 Payments To Medicare Insurers
The proposed rate, which affects how much insurers charge for monthly healthcare premiums, plan benefits and ultimately, how much they profit, was near analyst expectations, and insurer shares were largely unchanged in after-hours trading. UnitedHealth Group Inc, Humana Inc, Aetna Inc and WellCare Health Plans Inc are the largest sellers of Medicare Advantage health insurance. Under the program, they are paid a set rate by the government to cover member healthcare costs. (Humer, 2/1)

In other news —

The Wall Street Journal: Former CEO Of Lab Firm, Two Associates Found Liable For Defrauding Medicare
A federal jury found the former chief executive officer of a Virginia laboratory firm and two associates liable for defrauding Medicare and ordered them to pay more than $51 million in damages to the U.S. At issue in the civil case tried in a federal court in Charleston, S.C., was $126.5 million that defendants Tonya Mallory and her associates, Cal Dent and Brad Johnson, earned from a business arrangement the Justice Department deemed illegal. (Carreyou, 2/1)

Administration News

7. 'Palpable Relief' Sweeps CDC With Announcement Of Acting Director

Anne Schuchat, who has nearly three decades of experience at the Centers for Disease Control and Prevention, will be taking on the role again.

The Washington Post: CDC Employees Are Delighted That Their Acting Director Is Back In Charge
It took several hours Wednesday before employees at the Centers for Disease Control and Prevention heard who was going to run the nation’s leading public health agency. Brenda Fitzgerald had just resigned after barely six months in the job because of conflicts over financial interests. When the notice finally went out on the CDC’s internal announcement board that the principal deputy director, Anne Schuchat, 58, with nearly three decades of CDC experience, would be taking over (again) as acting director, employees were very happy to hear the news. (Sun, 2/1)

In other news from the CDC —

The Washington Post: CDC To Cut By 80 Percent Efforts To Prevent Global Disease Outbreak
Four years after the United States pledged to help the world fight infectious-disease epidemics such as Ebola, the Centers for Disease Control and Prevention is dramatically downsizing its epidemic prevention activities in 39 out of 49 countries because money is running out, U.S. government officials said. The CDC programs, part of a global health security initiative, train front-line workers in outbreak detection and work to strengthen laboratory and emergency response systems in countries where disease risks are greatest. The goal is to stop future outbreaks at their source. (Sun, 2/1)

Veterans' Health Care

8. Oregon VA Clinic Director Accused Of Trying To Game Ratings System Being Replaced

The Roseburg Veterans Administration Medical Center saw its ratings dramatically improve under Douglas Paxton. But doctors said that was driven largely by strategic tweaks to health care practices to boost performance measures, even when they left veterans worse off. Meanwhile, Wisconsin is setting up an alert system to locate at-risk, missing veterans.

The New York Times: Director Of Veterans Hospital Accused Of Manipulating Ratings Is Replaced
The Department of Veterans Affairs announced on Thursday it would replace the director of its medical center in Roseburg, Ore., Douglas Paxton. He had come under fire in recent weeks for limiting the number of patients the center admitted in an effort to improve its dismal performance rating, according to doctors at the hospital. “There are times that facility leadership needs to change in order to usher in a new approach that will demonstrate we are committed to delivering results for veterans,” Dr. Carolyn Clancy, executive in charge of the Veterans Health Administration, said in a statement. (Philipps, 2/1)

The Washington Post: Wisconsin Expected To Set Up ‘Green Alerts’ For Missing At-Risk Veterans
Wisconsin is expected to become the first state to set up a “Green Alert” system to help families and law enforcement officials locate missing at-risk veterans. Advocates say they hope other states soon adopt Green Alerts, which are similar to the Amber and Silver alerts for missing children and older adults. The legislation unanimously passed the Wisconsin state Senate and is likely to pass the state Assembly in February, as first reported by The Milwaukee Journal Sentinel. (Wax-Thibodeaux, 2/1)

Milwaukee Journal Sentinel: Death Of Milwaukee Air Force Veteran With PTSD Inspires 'Green Alert' Movement
Gwen Adams called the next day and was told the officer who took their missing person's report was off for two days and they would have to wait until she returned. They did. They told police their son suffered from PTSD, they told police the medications he was taking and that he had missed an appointment at the VA. But because he was an adult, the family was told he didn't meet the criteria for a critical missing person. (Jones, 1/30)

And in other news —

Nashville Tennessean: Veterans Suddenly Die After Leaving Murfreesboro VA Hospital
The veterans' families — and others who have spent time at the Murfreesboro VA hospital — paint a bleak picture about how some are treated, leveling accusations that patients are force-fed medications, treated like jail inmates and given dozens of prescriptions when discharged. ... The surviving family members say their loved ones were not the same when they left treatment, overly medicated and with the underlying conditions they developed serving the country in combat the same or worse. In multiple cases reviewed by the USA TODAY NETWORK - Tennessee, they relapsed and were found dead within days or weeks after their release, each by self-inflicted means. (Lowary, 2/2)


9. Bickering In Congress Created Vacuum That Tech Billionaires Decided To Fill With Health Initiative

The idea of businesses stepping in where they see government failing is nothing new. But will the initiative from Amazon, Berkshkire Hathaway and JPMorgan actually succeed with the odds stacked against it?

The New York Times: Businesses Look At Washington And Say, ‘Never Mind, We’ll Do It’
Can private businesses solve public policy problems better than the government? It’s a question that has persisted for decades and taken on new resonance now that a career businessman is in the White House. There has never been a clear answer. For every sign of success — a smooth privatized toll road or a gleaming charter school — there have been obstacles revealing just how difficult public works can be. But companies haven’t stopped trying. (Gelles, 2/1)

Politico Pro: How Amazon — Against All Odds — Could Succeed At Using Tech To Save Health Care Dollars
While health care analysts are skeptical of the ability of Amazon, Berkshire Hathaway and JPMorgan Chase to transform the industry, tech futurists think it could at least lead to patients shopping for insurance plans the way they compare products on Amazon’s online retail platform. The key question, they say, is whether Jeff Bezos and his partners are thinking about the middle- or longterm. (Ravindranath, 2/1)

Modern Healthcare: Cigna CEO Sees Opportunity In Amazon's New Venture 
Cigna Corp., which reported higher 2017 fourth-quarter and full-year revenue on Thursday, isn't worried about the potential threat posed by the Amazon-JPMorgan Chase-Warren Buffett mashup unveiled earlier this week, even though the announcement sent insurance stocks spiraling down. Instead, Bloomfield, Conn.-based Cigna sees the new employer coalition, built to tackle rising healthcare costs, as another opportunity to leverage its expertise in value-based funding arrangements, medical management and ability to keep cost trends low, according to CEO David Cordani. (Livingston, 2/1)

Public Health And Education

10. Effectiveness Of Flu Vaccine Looks Like It Will Be Even Lower Than CDC Experts Expected

Canadian researchers offer the first study on the vaccination's effectiveness in North America this year. Their midseason estimate suggested that the H3N2 component of the vaccine is 17 percent effective at preventing infection.

Stat: Flu Vaccine Provided Low Protection Against This Winter's Virus, Data Suggest
As the country battles an especially fierce flu season, experts have struggled to explain why one family of virus — the influenza A virus H3N2 — that has infected a lot of people in recent years is causing so much damage again this winter. Now, new data from north of the border sheds some light on the question. Canadian influenza researchers reported Thursday in the online journal Eurosurveillance that the first reckoning of how well the flu vaccine is protecting against H3N2 viruses this year in North America has a dismal answer: not very. (Branswell, 2/1)

And in the states —

The Hill: New York Governor: Flu Season Worsens Each Week
New York's historic flu season is continuing to worsen every week, Gov. Andrew Cuomo (D) said Thursday. Cuomo said the state confirmed more than 11,600 cases of influenza reported to the health department over the past week, with more than 2,200 people hospitalized. (Weixel, 2/1)

Kansas City Star: Flu Now Worse In Kansas Than Missouri According To Kinsa
Kinsa, one of several companies that make thermometers that connect to smartphones, has produced data on flu-like symptoms for the last two years that has been similar to the information from the Centers for Disease Control, but with less lag time. The company reported this week that Kansas had surpassed Missouri to take the nation’s top spot in percentage of people showing flu-like symptoms like fever, cough, sore throat and chills. (Marso, 2/1)

Arizona Republic: Arizona Health Officials: Flu Numbers Rival Pandemic Of 2009-10
The number of confirmed flu cases in Arizona this season rivals the total seen during the H1N1 flu pandemic of 2009-10, with 19,279 cases of influenza reported this season as of last Saturday, state officials said. The number of reported cases is a sharp increase from the 2,175 total cases confirmed in the state last season. (Fish, 2/1)

11. Judge Overseeing 200 Suits Against Painkiller Makers Holds Summit To Get To Root Of Crisis

Taking Purdue Pharma's most powerful pill off the market was one suggestion at the gathering held by U.S. District Judge Dan Polster. Meanwhile, those on the front lines of the epidemic are struggling to deal with the crisis without extra funding from the federal government.

Bloomberg: Purdue’s Oxycontin Targeted At Judge’s Opioid Summit 
Local governments pressing lawsuits to hold pharmaceutical companies responsible for the opioid epidemic told a judge that taking the strongest version of Purdue Pharma Inc.’s Oxycontin painkiller off the market would have immediate results in addressing the crisis, according to people at the meeting. Purdue’s 80-milligram version of Oxycontin is snorted by thousands of abusers, so removing it would be a good first step, experts for cities and counties and state attorneys general told U.S. District Judge Dan Polster, according to three people in attendance at the Wednesday meeting. They spoke on the condition of anonymity because they weren’t authorized to speak publicly about the closed-door summit. (Feeley, 2/2)

Reuters: New York Accuses Insys Of Deceptively Marketing Opioid
Insys Therapeutics Inc's legal woes deepened on Thursday as New York's attorney general filed a lawsuit seeking at least $75 million from the company, which he said deceptively promoted a fentanyl-based cancer pain medicine for unsafe uses. New York Attorney General Eric Schneiderman alleged that the Chandler, Arizona-based drugmaker recklessly marketed its product Subsys for wider uses than the U.S. Food and Drug Administration approved and bribed doctors to prescribe it. (2/1)

Modern Healthcare: Trump's Opioid Priority Still Lacks Congressional Funding 
Every 25 minutes an infant is born to an opioid-addicted mother, and that's when the intense care starts. The average hospital bill to Medicaid in Missouri is about $63,000 per birth of a child with so-called neonatal abstinence syndrome. These babies may experience difficulty eating and breathing, rapid weight loss and sometimes seizures; on average, they stay in the hospital for three weeks after birth. From 2009 to 2012, hospital billing for care of these infants soared from $732 million to $1.5 billion, according to the last comprehensive analysis by Journal of Perinatology. Since that study, addiction rates have only climbed but there has been no more recent estimate of the costs incurred. (Luthi, 2/1)

And in California —

Los Angeles Times: Orange County’s Only Needle Exchange Shuts Down After Santa Ana Denies Permit
Orange County's first and only needle exchange program has shut down after Santa Ana city officials denied its permit application, a move some local advocacy groups and the state's leading public health agency say could negatively affect public welfare. However, the city contends the move was necessary because of an increased number of discarded syringes in the Santa Ana Civic Center, for which it says the needle exchange was at fault. (Brazil, 2/1)

12. 'It’s Just So Scary': Brett Favre Cringes Over Physical Toll Football Takes On Little Kids

The veteran National Football League star says that with all the new information out about brain damage and concussions that can result from the sport, it's hard to watch kids play it. In other public health news: gut microbes, seizures, tainted baby formula, Alzheimer's and heart failure.

The Washington Post: When Brett Favre Sees Little Kids Playing Football, ‘I Cringe.’
Sometime on Saturday morning, Brett Favre will do a small favor for an old friend and former backup, stepping up to deliver a pep talk to Doug Pederson’s Eagles before Super Bowl LII. But it’s the dangerous side of football that preoccupies Favre the most these days. “I cringe,” he said, “when I see video, or I’m driving and I see little kids out playing, and they’re all decked out in their football gear and the helmet looks like it’s three times bigger than they are. It’s kind of funny, but it’s not as funny now as it was years ago, because of what we know now. I just cringe seeing a fragile little boy get tackled and the people ooh and ahh and they just don’t know. Or they don’t care. It’s just so scary.” (Boren, 2/1)

The New York Times: Gut Microbes Combine To Cause Colon Cancer, Study Suggests
Two types of bacteria commonly found in the gut work together to fuel the growth of colon tumors, researchers reported on Thursday. Their study, published in the journal Science, describes what may be a hidden cause of colon cancer, the third most common cancer in the United States. The research also adds to growing evidence that gut bacteria modify the body’s immune system in unexpected and sometimes deadly ways. (Kolata, 2/1)

NPR: Her Seizures Looked Like Epilepsy, But Her Brain Looked Fine
When Sarah Jay had her first seizure, she was in her mid-20s and working a high-stress job at a call center in Springfield, Mo. "I was going to go on break," she says. "I was heading towards the bathroom and then I fell and passed out." An ambulance took Jay to the hospital but doctors there couldn't find anything wrong. Jay figured it was a one-time thing. Then a week later, she had another seizure. And that kept happening once or twice a week. "So I was put on short-term disability for my work to try to figure out what was going on," says Jay, who's now 29. (Hamilton, 2/1)

The New York Times: ‘My Baby Almost Died’: Formula Scandal Sends Shudders Through France
When the French dairy giant Lactalis began recalling baby formula, Ségolène Noviant thought she was safe. The milk she had been feeding her 5-month-old son wasn’t on the list. Then her son, Noan, was rushed to the emergency room with a fever, diarrhea and internal bleeding. His formula was tainted with salmonella — and a broad range of other Lactalis powdered milk products still on the shelves were at risk, too. (Alderman, 2/1)

WBUR: Can Cooking Classes Keep Chronic Heart Failure Patients Out Of The Hospital?
Shirline Burbanks is one of the 6.5 million Americans suffering from congestive heart failure (CHF). Recently, she checked herself in to the Tulane Medical Center in New Orleans, complaining of shortness of breath. But unlike most other CHF patients in the U.S., within hours of her admittance, Burbanks was met at her bedside with an offer: to sign up for cooking classes. (Nargi, 2/1)

State Watch

13. Texas Lawmakers Aim To Reduce Maternity Mortality; Nurse Practitioner Bill Makes Headway In Va.

State legislatures also focus on telemedicine practices and medical marijuana.

Houston Chronicle: Lawmakers Urge More Action To Grapple With Texas' Maternal Health Problems 
It's no secret that Texas has a serious health crisis on its hands with the alarming number of women dying due to issues related to pregnancy within a year after giving birth, and state leaders haven't yet come to a consensus on finding the best policy path forward. But some women's health experts and state legislators agree one of the first steps is making sure Texas mothers have continuous access to health care before, during and after childbirth. (Milburn, 2/1)

Richmond Times-Dispatch: Nurse Practitioner Bill Squeezes Through First Committee, With Amendments
A bill that would provide an avenue for nurse practitioners to practice independently without the supervision of a physician edged through its first committee hearing Thursday after being saddled with an amendment requiring them to receive far more training. The House Health, Welfare and Institutions Subcommittee was standing-room-only as nurse practitioners and physicians — many wearing white medical coats — showed their support or opposition for House Bill 793, sponsored by Del. Roxann Robinson, R-Chesterfield. (O'Connor, 2/1)

KCUR: Kansas Telemedicine Push Dragged Into Abortion Debate 
A telemedicine bill aimed at improving health care access for Kansans, particularly in rural areas, may get bogged down in abortion politics. The legislation would mean insurance companies can’t refuse to pay for services provided long-distance that they would cover at an in-person office visit. More controversially, the bill would not allow drug-induced abortion or other abortion procedures through telemedicine. (Fox, 2/1)

The Washington Post: Virginia General Assembly Likely To Legalize Broad Medical Use Of Cannabis Oil 
A bill that would allow physicians to broadly prescribe a form of medical marijuana received preliminary approval in the Virginia House of Delegates on Thursday and seems likely to become law, its sponsors say, after years of failed attempts. The legislation, HB 1251, would permit the use of non-hallucinogenic marijuana or cannabis extracts known as cannabidiol oil or THC-A oil to treat any diagnosed condition or disease. Scientific studies indicate that the oils can reduce nausea and alleviate pain, and also may slow the growth of and kill some cancer cells. (Sullivan, 2/1)

14. State Highlights: Calif. Struggles To Expand Care For Mentally Ill Inmates; New Ore. State Hospital Chief Pledges To Raise Level Of Care

Media outlets report on news from California, Oregon, Colorado, Pennsylvania, Washington, Illinois, Texas, Maryland and Florida.

Los Angeles Times: California's Mentally Ill Inmate Population Keeps Growing. And State Money Isn't Enough To Meet Needs, Lawmaker Says
Gov. Jerry Brown has earmarked $117 million in his new state budget to expand the number of treatment beds and mental health programs for more than 800 mentally ill inmates found incompetent to stand trial. State officials said they have struggled to keep up with the needs of a population that has jumped in size by 33% over the last three years, as judges are increasingly referring defendants to treatment. But one state lawmaker says additional funds are not enough. (Ulloa, 2/2)

The Oregonian: Oregon State Hospital Hires New Superintendent 
Officials with the Oregon Health Authority announced Thursday that Dolly Matteucci has been hired to lead the Oregon State Hospital, filling a void atop the state psychiatric institution that has gone without a permanent superintendent for a year. Matteucci, who will take the helm in mid-March, will arrive from California, where she has served as executive director of Napa State Hospital since 2010. That hospital serves more than 1,200 patients with an annual budget of $305 million, compared to Oregon's 600-some patients and $250 million annual budget. (Friedman, 2/1)

Denver Post: 69 Coloradans Got Aid-In-Dying Prescriptions During Law’s First Year, Report Says
Sixty-nine Colorado patients were prescribed aid-in-dying medication during 2017, the first year of the law approved by voters, and 50 of those patients filled the prescription, according to a report by the Colorado Department of Public Health and Environment released Thursday. Although 56 of those 69 patients died, the data don’t reveal which ones died as a result of the drugs, or even if the deceased had filled their prescription. (Simpson and Brown, 2/1)

The Associated Press: Feds To Pay $42M To Parents Of Boy Hurt By Forceps Delivery
The federal government has withdrawn its appeal and agreed to pay $42 million to the parents of a young Pennsylvania boy left disabled from brain injuries apparently caused by the use of forceps during his birth, the parents' lawyers and the government announced Thursday. "The government recognized that their issues on appeal were without merit and that the verdict was just and appropriate," said Regan Safier, of Kline & Specter, a Philadelphia law firm. "The judge recognized the catastrophic injuries suffered by this child and awarded the money necessary to care for him over his lifetime." (2/1)

Modern Healthcare: Washington Residents' Tab For Unnecessary Care In A Year: $280 Million-Plus
Roughly 622,000 Washington state residents received low-value services over one year, which collectively cost about $282 million, a new report found. The not-for-profit Washington Health Alliance's study found that 45.7% of the 1.5 million total services it analyzed from July 2015 to June 2016 were unnecessary and wasteful according to recommendations from the Choosing Wisely campaign. (Castellucci, 2/1)

The Associated Press: Nurses With A Mission: Send Older ER Patients Home With Help
When 86-year-old Carol Wittwer took a taxi to the emergency room, she expected to be admitted to the hospital. She didn't anticipate being asked if she cooks for herself. If she has friends in her high-rise. Or if she could spell lunch backward. "H-C-N-U-L," she said, ruling out a type of confusion called delirium for the geriatrics-trained nurse who was posing the questions in a special wing of Northwestern Memorial Hospital's emergency department. Wittwer's care is part of a new approach to older patients as U.S. emergency rooms adapt to serve the complex needs of a graying population. (2/2)

KCUR: Planned Parenthood Great Plains Names New President And CEO 
The regional office of Planned Parenthood has selected a new president and CEO. Brandon Hill, formerly executive director of the Center for Interdisciplinary Inquiry and Innovation in Sexual and Reproductive Health at the University of Chicago, assumed the role on Thursday. Hill says he's eager to move from reproductive research to advocacy. (Smith, 2/2)

The Associated Press: UAE Gives Johns Hopkins $50M For New Stroke Care Institute
The United Arab Emirates says it’s making a $50 million gift to Johns Hopkins University for a new institute for stroke research in Baltimore and in Abu Dhabi. The UAE ambassador to the U.S., Yousef Al Otaiba, released a statement in partnership with Johns Hopkins on Thursday ahead of a planned announcement in New York. The statement says the Sheikh Khalifa Stroke Institute in Baltimore and Abu Dhabi will focus efforts by Johns Hopkins’ to develop new tools for stroke diagnosis, treatment and patient recovery. (2/1)

The Baltimore Sun: Johns Hopkins Gets $50 Million From UAE For Global Stroke Center 
The United Arab Emirates has donated $50 million to Johns Hopkins Medicine to create an institute to transform treatment for stroke patients across the globe. Officials from the Baltimore health system and the Middle Eastern nation gathered in New York City Thursday, at the United Arab Emirates’ permanent mission to the United Nations, to announce plans for the Sheikh Khalifa Stroke Institute. (McDaniels, 2/1)

San Jose Mercury News: California Failing Youngest And Poorest Children, Study Says
Among findings in the 2018 California Children’s Report Card, only half of California’s 3- and 4-year-olds attend preschool — now considered a critical launchpad for a child’s learning — and just one-quarter of infants and toddlers have access to licensed child care. Only 14 percent of low-income children are in publicly funded child care. (Noguchi, 2/1)

Los Angeles Times: L.A.'s Homelessness Surged 75% In Six Years. Here's Why The Crisis Has Been Decades In The Making
Some of the poorest people in the city spend their days in the shadow of Los Angeles City Hall, napping on flattened cardboard boxes. On any given day, as many as 20 people take to the City Hall lawn, across the street from LAPD headquarters. They're there to "escape the madness" in downtown streets, a 53-year-old homeless man named Lazarus said last week. At night, they fan out to doorways or deserted plazas to wait for daybreak. (Holland, 2/1)

Sacramento Bee: CA Marijuana Crimes Easier To Clear From Records Under Bill
When California voters legalized recreational weed in 2016, they made the law retroactive, allowing residents to petition to overturn or reduce old convictions for possession, cultivation and distribution of marijuana. But it is a difficult and expensive legal procedure, advocates say, and many people are not even aware they are now eligible to clean up their records. (Koseff, 2/2)

Health Policy Research

15. Research Roundup: Microcephaly; Insurance Coverage; And Child Mortality

Each week, KHN compiles a selection of recently released health policy studies and briefs.

Pediatrics: Prevalence And Risk Factors For Microcephaly At Birth In Brazil In 2010
According to the International Fetal and Newborn Growth Consortium for the 21st Century definition, the prevalence of microcephaly (>2 SDs below the mean for gestational age and sex) was higher in SL (3.5%) than in RP (2.5%). The prevalence of severe microcephaly (>3 SDs below the mean) was higher in SL (0.7%) than in RP (0.5%). Low maternal schooling, living in consensual union or without a companion, maternal smoking during pregnancy, primiparity, vaginal delivery, and intrauterine growth restriction were consistently associated with microcephaly. The number of cases of microcephaly is grossly underestimated, with an underreporting rate of ∼90%. (Silva et al., 2/1)

Urban Institute: Health Insurance Coverage Among Children Ages 3 And Younger And Their Parents In 2016
Using the 2016 American Community Survey (ACS), this brief updates a previous analysis that examined health insurance coverage among children ages 3 and younger and their parents in 2015. High rates of coverage through Medicaid and the Children’s Health Insurance Program (CHIP) continued among young children and their parents in 2016, the third year after implementation of the major coverage provisions of the Affordable Care Act. Uninsurance among both young children and their parents continued to decline, and coverage levels varied across states and metropolitan areas. Estimates for children ages 2 and younger nationally and across states are also presented. (Haley et al., 1/30)

Pediatrics: Injury And Mortality Among Children Identified As At High Risk Of Maltreatment
Models that predict risk of maltreatment as defined by child protective services substantiation also identify children who are at heightened risk of injury and mortality outcomes. If deployed at birth, these models could help medical providers identify children in families who would benefit from more intensive supports. (Vaithianathan, Rouland, Putnam-Hornstein, 2/1)

Urban Institute: Delayed Retirement And The Growth In Income Inequality At Older Ages
As concerns about retirement savings have intensified, many older adults have begun working beyond traditional retirement age. By working longer, they can improve their retirement security by increasing their future monthly Social Security payments and shortening the time they must rely on their savings. But does delaying retirement deepen income inequality for older adults by leaving those with health problems behind? (Johnson, 2/1)

New England Journal of Medicine: Catheter Ablation For Atrial Fibrillation With Heart Failure
Mortality and morbidity are higher among patients with atrial fibrillation and heart failure than among those with heart failure alone. Catheter ablation for atrial fibrillation has been proposed as a means of improving outcomes among patients with heart failure who are otherwise receiving appropriate treatment. ... Catheter ablation for atrial fibrillation in patients with heart failure was associated with a significantly lower rate of a composite end point of death from any cause or hospitalization for worsening heart failure than was medical therapy. (Marrouche, et al., 2/1)

JAMA Surgery: Association Of The Affordable Care Act Medicaid Expansion With Access To And Quality Of Care For Surgical Conditions
Findings: In this study of patients with 1 of 5 common surgical conditions, Medicaid expansion was associated with a 7.5–percentage point increase in insurance coverage at the time of hospital admission. The policy was also associated with patients obtaining care earlier in their disease course and with an increased probability of receiving optimal care for those conditions. Meaning: The Patient Protection and Affordable Care Act’s Medicaid expansion was associated with increased coverage of patients, earlier presentation with common diagnoses, and improved surgical care. (Loehrer et al., 1/24)

Editorials And Opinions

16. Perspectives: 5 Questions for Trump About The Opioid Crisis; Pros And Cons Of Amazon's Health Care Plan

Editorial pages highlight these important health care issues.

Stat: Trump's 49 Seconds On The Opioid Crisis: 5 Questions From The Front Lines
President Trump’s State of the Union address was 80 minutes long. He spent just 49 seconds on the opioid epidemic, something he has declared to be a public health emergency. The brevity of his remarks on opioids is indicative of the lack of action taken by the federal government in the three months since the emergency declaration. For us on the front lines of the epidemic in Baltimore, as elsewhere around the country, the declaration has had no impact at all. The federal government continues to delay committing new funding to treating addiction as the disease that it is, while hundreds of people die every day from overdoses. (Leana S. Wen, 2/1)

The New York Times: A Good Health Care Deal, But Only For Some
Here’s the good news about the announcement this week that Amazon, Berkshire Hathaway and JPMorgan Chase are forming a new company to cover health care for their employees: If you’re one of the million-plus people who work at these companies, or a family member of one, you’re likely to get cheaper, better health care pretty soon. Here’s the bad news: If you’re one of the approximately 300 million other Americans, you might not see savings for a long time, if ever. And in the short term at least, you could be hit by bigger medical bills. (Elisabeth Rosenthal, 2/1)

Bloomberg: Some Jobs Are Best Left To The Nonprofits Inc., Berkshire Hathaway Inc. and JPMorgan Chase & Co. are publicly traded, profit-oriented corporations. So it is interesting that when they announced their new joint health-care venture this week they made a point of saying it would be "an independent company that is free from profit-making incentives and constraints."Interesting but maybe not all that surprising: Around the world, health, life and property insurance, as well as various other financial services, have long been provided by nonprofit organizations, mostly in the form of customer-owned mutuals. (Justin Fox, 2/1)

Modern Healthcare: Rising Healthcare Costs Are A Cancer, Not A Tapeworm
"The ballooning costs of healthcare act as a hungry tapeworm on the American economy," said Berkshire Hathaway's Warren Buffett. ... Are the nearly 16 million people laboring in healthcare parasites? Of course not. The healthcare system is a vital cog in our society and a healthy workforce is crucial to its economy. That's why cancer is the better comparison for the system's unsustainable costs. The system is growing too quickly, like a tumor. To restore health, you have to eliminate the cancer, not the vital organ on which the tumor grows. (Merrill Goozner, 1/31)

Los Angeles Times: Trump Once Again Vows To Lower Drug Prices, And Once Again You Shouldn't Believe Him
President Trump told some whoppers in this week's State of the Union speech: His tax cuts were the biggest ever (they weren't), he has added 2.4 million new jobs (only if you count former President Obama's last few months in office), wages are finally rising (they've been slowly but steadily climbing for years). But the one that really got my attention was Trump's declaration that he's committed to addressing "the injustice of high drug prices." (David Lazarus, 2/1)

Forbes: A New Public/Private Long-Term Care Financing Plan
Two years ago, the Long-Term Care Financing Collaborative proposed a public catastrophic long-term care insurance program. In effect, people would use private insurance, savings, or home equity to pay for the first few years of their care needs, then the government would pick up costs for people with true catastrophic needs. Today, two highly-respected long-term care experts offered an important refinement to that basic structure: A plan that ties the time period before insurance benefits are available to a person’s income. As a result, lower-income people could access new benefits sooner than higher-income people. (Howard Gleckman, 1/31)

Los Angeles Times: Banning Tackle Football For Kids? There's Nothing 'Nanny State' About It If The Science Is Sound
As the sports-loving part of the population looks forward to the National Football League's annual Super Bowl on Sunday, legislatures in New York and Illinois are zeroing in on a different aspect of the nation's most popular sport: brain injuries among young players. Lawmakers in both states have introduced measures that would ban tackle football for children under age 12. Making kids wait longer to don pads and helmets is not a bad idea, nor would it be a bad choice to extend such limits to other sports, such as hockey, lacrosse and boxing, where children as young as 8 strap on gloves and protective gear and punch each other in the head. (2/2)

Bloomberg: Why We're Still So Unprepared For Flu And Other Crises
It’s surprising how easy it is to brush off dire existential threats. We remain, for example, unprepared for the next pandemic flu, though experts warn it’s only a matter of time before a new strain capable of killing millions will emerge. ...One problem is that we citizens of the 21st century have also been warned about our “woeful” lack of preparedness for Ebola and similar disease outbreaks, a major earthquake, sea level rise, nuclear war, and a massive asteroid striking the earth. And if that isn’t enough, experts at MIT and Cambridge University are discussing how unprepared we are for threats of technology run amok, such as intelligent machines taking over the world. (Faye Flam, 2/1)

Miami Herald: Don’t Overlook Autistic Girls -- Their Symptoms Might Be Different From Boys' 
Close your eyes, and conjure up an image of an autistic kid. What springs to mind? If I had to guess, I’d say it’s probably a socially awkward boy who’s obsessed with gaming.But the time has come to challenge that assumption. A new study in the Journal of Autism and Developmental Disorders, released Jan. 4, reinforces something I’ve known innately for years, having myself been an undiagnosed autistic girl: It is easy to overlook us. According to the Centers for Disease Control and Prevention, autism affects one in 68 children but is four and a half times more prevalent in boys than girls. But that still means there are an awful lot of autistic girls. (Sally J. Pla, 2/1)

Stat: I'm The Ideal Person To Support Right To Try. But It's A Disaster In The Making
Put simply, under the right-to-try bill, a death caused by the use of an experimental drug could not be considered by the FDA in deciding whether to approve or reject the therapy. While this may help address pharmaceutical and biotechnology industry concerns that expanded access programs could jeopardize ongoing studies, it is simply unethical at its core. I’m also worried about the financial, legal, and medical protection afforded to patients and their families under the proposed right-to-try bill. Do patients undergoing right-to-try therapies lose their coverage for hospice? Would insurers be absolved of any responsibility for covering further medical expenses once a patient starts a drug under right-to-try? What if the experimental drug causes hospitalization or leads to additional treatments — who would pay for that? (Michael D. Becker, 2/1)

Boston Globe: Charlie Baker Escapes A Health Care Mess
Bureaucrats botch the rollout of big changes to health care coverage that affect hundreds of thousands of state employees and could have resulted in layoffs at a local insurer. Yet the governor manages to escape much of the blame, as if the agency making the decision went rogue, as if he didn’t appoint half of the board overseeing the agency, as if he doesn’t know how health care works. (Shirley Leung, 1/31)

Kansas City Star: What Does It Cost To Keep Kansas And Missouri Prisoners Healthy?
On Monday, a Kansas legislative committee on corrections got answers to questions they should have been asking all along. Rep. J. Russell Jennings, Chairman of the Committee on Corrections and Juvenile Justice Oversight, called the hearing after The Star detailed the nearly $2 billion Missouri and Kansas will pay to Corizon Health over a decade to provide health care to inmates. Despite the cost to taxpayers, legislative oversight has been lax, particularly in Missouri. That needs to change. (2/1)

Sacramento Bee: Don’t Turn Campus Health Centers Into Abortion Clinics
Women are strong and empowered, capable of achieving our goals without abortion. Our Legislature prides itself on caring about women, but SB 320 does nothing to address the real needs of pregnant students, such as housing, child care, lactation stations, diaper changing tables, flexible exam schedules, counseling and pre-natal care. (Wynette Sills, 2/1)

Sacramento Bee: Doctors Don’t Just Heal The Sick. They Create Jobs
According to the American Medical Association’s 2018 economic impact study, California’s 90,000 physicians generate $232 billion in direct and indirect economic activity, an average of $2.6 million each. U.S. physicians produced $2.3 trillion in economic activity, more than the total economic output for the entire country of Brazil. (Theodore Mazer, 2/1)