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KHN First Edition: September 28, 2015


First Edition

Monday, September 28, 2015
Check Kaiser Health News online for the latest headlines

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

Kaiser Health News: Hospital Workers Find Solace In Pausing After A Death
Reporting for Kaiser Health News, in partnership with NPR, Kara Lofton writes: "For trauma workers like Jonathan Bartels, a nurse who has worked in emergency care and palliative care, witnessing death over and over again takes a toll. Over time, they can become numb or burned out. But about two years ago, after Bartels and his team at the University of Virginia Medical Center in Charlottesville tried and failed to resuscitate a patient, something happened." (Lofton, 9/28)

The Washington Post: Boehner: There Will Be No Government Shutdown; Select Committee Will Probe Planned Parenthood
In his first major interview since announcing his pending resignation, House Speaker John A. Boehner vowed Sunday that there will be no government shutdown at the end of the month — adding that he will impanel a select committee to investigate Planned Parenthood after "undercover" videos renewed outrage among conservatives about government funding for the women's health provider. (Lowery and DeBonis, 9/27)

The Associated Press: Senate Set To Act On Stopgap Spending Bill To Avoid Shutdown
The Senate is on track to advance legislation to prevent the government from shutting down after a midnight Wednesday deadline, but a wrinkle remains. Majority Leader Mitch McConnell has moved to strip the measure of a provision that would cancel federal funding of Planned Parenthood. McConnell's move has rankled conservatives such as Sen. Ted Cruz, R-Texas, and tea partyers in the House who want the taxpayer money withheld from the women's health care provider after the release of secret videos in which Planned Parenthood officials discussed the transfer of fetal tissue to researchers. (9/28)

Politico: Ted Cruz's Big Moment
But Cruz’s supporters see the showdown in Congress over Planned Parenthood and the budget — which kicks into high gear this week and could stretch into the winter, on the cusp of voting in early states — as a critical opening for the first-term lawmaker. With the spotlight focused on Congress, they say, it will allow Cruz to make a sustained case to tea party and evangelical voters that he’s the one candidate doing battle in the trenches for their causes, just as many of them are picking a horse in the race. The goal, he and allies stop just short of saying, is to expose his chief competitors for the outsider mantle as pretenders by comparison. (Everett and Glueck, 9/28)

Politico: Poll: 69 Percent Oppose Shutdown Over Planned Parenthood
Nearly seven in 10 Americans — 69 percent — oppose shutting down the government over funding for Planned Parenthood, according to the results of a new national Quinnipiac University poll released Monday. Just 23 percent support closing the government over the dispute. Even among Republicans, a majority of 56 percent to 36 percent opposes a shutdown due to Planned Parenthood. (Gass, 9/28)

The New York Times: Reacting to Videos, Planned Parenthood Fights to Regain Initiative
The undercover videos were made over more than two years, yet Planned Parenthood was taken by surprise when the first one was posted online in July. ... Immediately the organization was caught in a storm of internal confusion and defensiveness. There was disquiet among Democratic allies as Republicans, who control Congress and many state capitols, charged that the nonprofit organization was criminally “profiteering in baby parts.” A new video surfaced almost every Tuesday. But Planned Parenthood has fought back and managed to put some opponents on the defensive after gathering information from its affiliates; hiring lawyers, crisis managers and video experts to document deceptive edits; and working to solidify support among donors, Democrats and, according to polls, a majority of Americans. (Calmes, 9/26)

The Washington Post: Republican Hard-Liners Are ‘False Prophets,’ Boehner Says
Boehner referred, as he has in the past, to the ill-fated 2013 shutdown over funding of the Patient Protection and Affordable Care Act, a.k.a. Obamacare: "This plan never had a chance," he said, but he blamed outside forces for leading Republicans down an ill-advised path: "We got groups here in town, members of the House and Senate here in town, who whip people into a frenzy believing they can accomplish things that they know — they know! — are never going to happen." (DeBonis, 9/27)

Politico: Boehner Unloads On GOP's 'False Prophets'
In his first one-on-one interview since his resignation announcement, Speaker John Boehner blasted right-wing lawmakers and groups as “false prophets” who “whip people into a frenzy” to make legislative demands that “are never going to happen.” The Ohio Republican also declared on CBS’ Face the Nation Sunday that there won’t be a government shutdown this week, though he’s “sure” it will take Democratic votes to pass a temporary funding extension. (Zapler, 9/27)

Politico: House Plans Special Committee To Probe Planned Parenthood
The House is considering a vote this week to create a special panel to investigate Planned Parenthood — the most direct move by congressional Republicans to probe allegations of improper fetal tissue sales by the group. The subcommittee would fall under the jurisdiction of the influential Energy and Commerce Committee. It was announced over the weekend by Rep. Marsha Blackburn (R-Tenn.), who would serve as the panel’s chairwoman. (French, 9/28)

The New York Times: Chief Justice John Roberts Amasses Conservative Record, And The Right’s Ire
And so the right’s case against the chief justice is thin, said Steven R. Shapiro, the legal director of the American Civil Liberties Union. “The reaction is almost entirely due to the two health care decisions,” he said, “and there is nothing else in his record that should be disappointing.” In 2012, Chief Justice Roberts wrote the majority opinion rejecting a constitutional challenge to a central feature of President Obama’s health care law, the Affordable Care Act. In June, he wrote the majority opinion allowing nationwide tax subsidies under the law. Those rulings were unpopular with the right, but they do not provide much evidence that Chief Justice Roberts has turned into a liberal, said Brianne Gorod, a lawyer with the Constitutional Accountability Center, a liberal group that has issued a series of reports assessing the chief justice’s decade on the court. (Liptak, 9/28)

Los Angeles Times: Chief Justice Roberts' Record Isn't Conservative Enough For Some Activists
When a divided Supreme Court handed down six major rulings in the last week of June, Chief Justice John G. Roberts Jr. came down firmly on the conservative side in five of them. ... as Roberts this week marks the 10th anniversary of becoming chief justice, he finds himself in the crosshairs of right-leaning pundits and GOP presidential hopefuls who brand him a disappointment and openly question his conservative credentials because of the one case of the six in which he voted with the court’s liberals. The decision marked the second time Roberts had voted to uphold President Obama’s healthcare law. ... Heading into an election year, the attacks on Roberts appear to reflect shifting views on the right about the court and the proper role for the justices. (Savage, 9/25)

The Associated Press: Justices Could Review Nonprofits' Contraceptives Objection
Religion, birth control and President Barack Obama's health care overhaul are about to collide at the Supreme Court yet again. Faith-affiliated charities, colleges and hospitals that oppose some or all contraception as immoral are battling the administration over rules that allow them to opt out of covering the contraceptives for women that are among a range of preventive services required to be in health plans at no extra cost. (9/27)

Politico: Supreme Court May Hear Texas Abortion Case
Supreme Court justices will meet behind closed doors Monday to start the process of deciding which cases to take up this term, with all eyes on a challenge to a Texas abortion law that could roil the presidential race just months before voters go to the polls. The case, Whole Woman’s Health v. Cole, centers on a series of far-reaching restrictions on Texas abortion providers and clinics, which led to the closure of about half of the state’s abortion facilities. It promises to be the most significant abortion case in at least two decades, and could inject divisive social issues into the presidential race at a key moment. (Haberkorn, 9/27)

The Associated Press: Late Slump In Healthcare Pushes Stocks To Weekly Loss
A late slump in health care stocks pushed the market to its third weekly loss this month. ... Shares of drug makers began their slide Monday when Democratic presidential front-runner Hillary Rodham Clinton pledged to stop "price gouging" in the industry. The healthcare sector, a longtime favorite of investors, ended Friday with its worst weekly performance in more than four years. Biotechnology shares in the S&P 500 plunged during the week, pushing the overall healthcare index down 5.8%, its worst week since August 2011. Vertex Pharmaceuticals, which focuses on developing drugs for cystic fibrosis and viral infections, was the biggest decliner in the index Friday, dropping $7.83, or 7%, to $103.20. (9/25)

The Wall Street Journal: A Health-Care Model In Coal Country
A hospital system in Pennsylvania’s coal country has become a national poster child for the kind of carefully coordinated, data-driven health care that experts say one day could right the nation’s troubled medical system, providing better care at lower costs. Geisinger Health System, whose decades of investment in technology and integration have made it a pioneer in the use of electronic medical records and other data, dominates most of the rural markets it serves. The system focuses to an unusual degree on avoiding unnecessary procedures, in part because it also runs an insurance company that covers many of its patients. (Weaver, 9/27)

Reuters: Hip Implant Maker Claims Surgical Funder Inflated Patients’ Bills
A unit of Johnson & Johnson that makes artificial hips has accused a surgical funding company of seeking excessive profits from financing surgery for patients suing over the devices. The claim by DePuy Orthopaedics marks the first time that a device maker in the multibillion-dollar litigation over faulty hip replacements has publicly raised concerns about the controversial business of surgical funding, which has increasingly become a part of mass litigation over medical devices. (9/28)

The Associated Press: Multiple Factors Cause High Prescription Drug Prices In US
From 2008 through 2014, average prices for the most widely used brand-name drugs jumped 128 percent, according to prescription benefit manager Express Scripts Holding Co. In 2014, it estimated that total U.S. prescription drug spending increased 13 percent. Reasons include increasing research costs, insufficient competition and drug shortages. ... While it's clear drug prices are rising, many patients don't understand why. Here are six of the top reasons. (Johnson, 9/25)

The New York Times: Drug Companies Hire New Lobbyist To Answer Critics
The drug industry chose a new top lobbyist Friday to help pharmaceutical companies defend themselves against criticism from patients, doctors and government officials who say they are charging exorbitant prices for many medicines. The lobbyist, Stephen J. Ubl, will become president and chief executive of Pharmaceutical Research and Manufacturers of America, a trade group that represents companies like Amgen, Eli Lilly, Johnson & Johnson, Merck and Pfizer. For the last 10 years, Mr. Ubl has been the top lobbyist for medical device makers. He has led efforts to persuade Congress to repeal a tax on medical devices imposed by the Affordable Care Act. Mr. Ubl, 46, is well known in Washington for his deep knowledge of health policy, shrewd political instincts and low-key manner that sets him apart from many lobbyists. (Pear, 9/25)

The Washington Post: The Drug Industry Wants Us To Think Martin Shkreli Is A Rogue CEO. He Isn’t.
This week, a roiling controversy was ignited after Turing Pharmaceuticals chief executive Martin Shkreli hiked the price for his drug Daraprim by a mind-boggling 4,000 percent. The major pharmaceutical and biotech industry groups have portrayed Shkreli's actions as totally repugnant and the work of just one company, acting alone, with a flippant young chief executive who doesn't reflect the broader values, practices, or trends of other companies. But it's not .... while Shkreli's price increase was over-the-top extravagant, the overall trend for other brand name drugs is in the same direction: up. (Johnson, 9/25)

The Wall Street Journal: 70,000 Ways To Classify Ailments
Doctors, hospitals and insurers are bracing for possible disruptions on Oct. 1 when the U.S. health-care system switches to a massive new set of codes for describing illnesses and injuries. Under the new system, cardiologists will have not one but 845 codes for angioplasty. Dermatologists will need to specify which of eight kinds of acne a patient has. Gastroenterologists who don’t know what’s causing a patient’s stomachache will be asked to specify where the pain is and what other symptoms are present—gas? eructation (belching)?—since there is a separate code for each. (Beck, 9/27)

The Wall Street Journal: A Medical Detective Story: Why Doctors Make Diagnostic Errors
Physician and researcher Hardeep Singh probes one of the most vexing issues in medicine: diagnostic errors. As chief of health policy, quality and informatics at Houston’s Michael E. DeBakey VA Medical Center and an associate professor of medicine at Baylor College of Medicine, Dr. Singh measures the human toll of such mistakes and investigates how technology can help clinicians avoid making them. ... He answered questions from The Wall Street Journal about what doctors and patients can do to make sure they get to the bottom of the diagnostic puzzle. (Landro, 9/26)

The Wall Street Journal: How Doctors Can Approach End-Of-Life Conversations
In 2016, after years of controversy, Medicare plans to begin reimbursing doctors for having discussions with patients about what type of medical care they want and don’t want near the end of their lives. Private insurers are likely to follow, some experts say, meaning voluntary end-of-life counseling could soon become a part of standard medical care. (Sadick, 9/27)

The Wall Street Journal: Autism Researchers Seek More Brains to Study
One reason autism research hasn’t made more progress is a shortage of brains available for study. Brain scans can only take researchers so far—they need to work with donated brains to gain a deeper understanding of the condition. That’s why four research institutions have formed the Autism BrainNet to reach out to potential donors. (Sadak, 9/26)

The Wall Street Journal: Gene Test Helps Some Breast-Cancer Patients Skip Chemo, Study Says
A gene test used to guide treatment for early-stage breast cancer proved effective in enabling certain women to safely forgo chemotherapy, in a study that illustrates how genomic information is reshaping cancer care. Researchers said the findings provide validation for the test, called Oncotype DX, which is already in use helping women decide whether chemotherapy should be part of their treatment. The test provides a score based on a tumor’s genetic signature that describes the risk that the cancer will recur. (Winslow, 9/27)

The New York Times: The Fragile Patchwork of Care for New York’s Oldest Old
The story of America's aging population is to a great extent the story of people like Ms. Kornblum, one in which friends or family members step in to provide informal care, usually without training, and at great expense in terms of personal time and money. According to the Institute of Medicine, a division of the National Academies of Sciences, Engineering and Medicine, unpaid caregivers provide 90 percent of long-term care for the old or disabled. Like old age itself, the job arrives unbidden and with little in the way of guidance, to be managed more than mastered. Mr. Sorensen’s fall and the events leading up to it show how tenuous such care can be. (Leland, 9/25)

The Wall Street Journal: Communities Struggle to Care for Elderly, Alone at Home
More elderly across the nation are aging at home for a variety of reasons: they prefer to and are healthy enough to stay; they can’t afford other options such as assisted living; and states in some cases have imposed policies to limit nursing home stays paid for by Medicaid, which is a major funder of long-term institutional health care for older Americans. But aging in place is proving difficult in places where the population is growing older, supportive services are scarce, houses are in disrepair and younger people who can assist have moved away. As a result, elderly people who live at home are having to rely more on neighbors—who sometimes are elderly, too—and local nonprofits and public agencies are starting to feel the strain from increasing requests for help. (Levitz, 9/25)

The Washington Post: Carly Fiorina Greeted By A Woman Dressed As Birth Control Pills At Iowa Tailgate
Carly Fiorina was shaking hands and snapping photos with people tailgating outside the University of Iowa football stadium when a woman dressed as a pack of birth control pills approached her. The woman was part of a group of about 15 protesters from Planned Parenthood who came to voice their objections to Fiorina. The Republican presidential candidate has come under fire for what she has said about undercover videos showing Planned Parenthood officials discussing the donation of fetal tissue. (Zezima, 9/26)

The Wall Street Journal: Regulators To Shut Down Health Republic Insurance Of New York
The insurer lost about $52.7 million in the first six months of this year, on top of a $77.5 million loss in 2014, according to regulatory filings. ... The shuttering of Health Republic, at least the fourth to falter among the ACA’s original 23 co-ops around the country, reflects the losses many insurers are seeing in their business related to the health law’s exchanges, which are particularly acute for small plans without deep pockets or diversified lines of business. (Wilde Mathews, 9/25)

The Washington Post: New York Health Co-Op Ordered To Close Down
The nation’s biggest nonprofit health insurer spawned by the Affordable Care Act has been ordered to shut down as it reels toward insolvency, disrupting coverage for more than 200,000 New York state residents and becoming the fourth such co-op to collapse in recent months. The action Friday to force Health Republic Insurance of New York out of business was a coordinated maneuver by state regulators and by federal health officials, who have been trying to nurture fledgling co-ops while dealing with the reality that most are hemorrhaging red ink. (Goldstein, 9/25)

The Associated Press: NY Orders Insurer Health Republic To Stop Writing Policies
The Department of Financial Services said Friday that current individual coverage should continue through Dec. 31 for 108,000 people, most of whom signed up through the New York Health Exchange. DFS and the state Health Department said existing small group plans also remain in effect, covering another 101,500 people. Most of those policies were bought outside the exchange established under the federal Affordable Care Act. The agencies said they will evaluate how to proceed with those policies based on Health Republic's ongoing financial results. (Virtanen, 9/25)

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