Kaiser Health News Original Stories

2. New Health Plans Offer Discounts For Diabetes Care

Aetna is rolling out a special gold-level plan for 2016 that is aimed at providing better care for people with diabetes in the hopes of keeping them healthier—and their costs down. But it’s not clear the plans are a good buy. (Michelle Andrews, 11/17)

4. Political Cartoon: 'Heal The Deal'

Kaiser Health News provides a fresh take on health policy developments with "Political Cartoon: 'Heal The Deal'" by Chris Wildt .

Here's today's health policy haiku:


The court says no way
To Right-to-Life Group's bid to
See contract's fine print.

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Capitol Hill Watch

5. GOP Looks For Way To Get Senate To Pass Obamacare Repeal

Republicans are considering making big changes to their proposal to repeal the health law and defund Planned Parenthood -- even perhaps scrapping the idea to deny the clinics money. Elsewhere, a court rules Congress must cooperate to find the source of a possible leak of government health-care policy in an insider-trading probe.

Politico: Senate GOP Reassesses Plan On Obamacare Repeal
Senate Republicans are considering significant changes to their proposal to repeal Obamacare and defund Planned Parenthood and will temporarily delay consideration of the measure to ensure it can pass the Senate. GOP leaders are even mulling removing the Planned Parenthood provision if it gets them closer to putting Obamacare repeal on the president’s desk. They need just a majority of votes to pass the legislation, but Senate Majority Leader Mitch McConnell (R-Ky.) and his team are being squeezed between moderates balking at the Planned Parenthood language and a trio of conservatives that say the Obamacare repeal language doesn’t go far enough. (Everett, 11/16)

The Washington Post: Senate GOP Could Drop Attempt To Defund Planned Parenthood
Senate Republicans may abandon a plan to cut off funding for Planned Parenthood in hopes of maintaining the votes needed to force a veto fight with President Obama over repealing his signature health care law. GOP leaders are mulling what to do with a House passed reconciliation bill that would both defund the women’s health group and gut Obamacare by repealing both the employer mandate and a tax on high-end employer-sponsored health plans. The House passed the bill on a 240 to 189 vote in October. (Snell, 11/16)

The Wall Street Journal: Court Says Congress Must Comply With Federal Insider-Trading Investigation
Federal law-enforcement officials can resume a high-profile insider-trading investigation after a New York judge said Congress must cooperate with investigators looking into a possible leak of government health-care policy. In a decision announced Monday, U.S. District Judge Paul Gardephe sided with the Securities and Exchange Commission in much of the case and said a House committee and a former top aide must comply with many parts of a subpoena. (Mullins, 11/16)

Campaign 2016

6. Sanders Challenges Clinton On Paid Family Leave

The Vermont senator has thrown his support behind a bill that would help reimburse workers who take time off work for some family issues. Hillary Clinton, who supports paid family leave, has not yet put out a similar plan. Also in the news, a fact checker disputes statements by Republicans Donald Trump and Carly Fiorina about the number of veterans who have died while awaiting treatment.

The Wall Street Journal's Washington Wire: Bernie Sanders Aims To Put Hillary Clinton On Defensive On Family Leave
Sen. Bernie Sanders is trying to put rival Hillary Clinton on the defense over one of her signature issues: paid family leave. Mr. Sanders backs legislation in Congress that would create a federal fund to reimburse a portion of lost wages when workers take up to 12 weeks off after the birth or adoption of a child, to care for a family member’s serious health condition or for a serious health problem of their own. The proposal is funded by new payroll tax of two-tenths of a 1% paid by both employers and employees. ... Mrs. Clinton talks frequently about the need for paid family leave, but she has not put out a plan. On Friday, her campaign said she would not raise taxes on families earning less than $250,000 a year, a promise that rules out the pending legislation, known as the Family Act. (Meckler, 11/16)

The Washington Post's Fact Checker: Donald Trump Repeats Inaccurate Figure That ‘Over 300,000 Veterans Died Waiting For Care’
A reader pointed us to Trump’s proposal on his campaign Web site, which repeated an inaccurate figure The Fact Checker wrote about in September 2015. Carly Fiorina had inaccurately claimed twice during the GOP debate on CNN that 307,000 veterans had died waiting for health care. ... This is a widely misreported statistic that first began circulating after a Department of Veterans Affairs’ Office of Inspector General report released Sept. 2, 2015, and subsequent news coverage. Concerned Veterans for America, a conservative veterans advocacy group, cited an article quoting this figure in a political ad released this month. But the difference is that the group’s ad quotes a headline that says 307,000 “may” have died waiting for care, versus Trump’s statement (and Fiorina’s references, for that matter) that states the figure as a direct fact. (Lee, 11/17)


7. Medicare Enacts Major Reimbursement Change For Knee And Hip Replacements

To try to bring down costs and improve quality, payments and rewards will be tied to the results of the surgical procedure. Elsewhere, South Carolina ambulance owners complain that a Medicare experiment requiring patients to obtain prior authorization for non-emergency ambulance transportation is not being administered properly.

The Associated Press: Medicare Launches Payment Overhaul For Hip, Knee Replacement Surgery
Striving for better quality and more predictable costs, Medicare on Monday launched a major payment change for hip and knee replacements, the most common inpatient surgery for its 55 million beneficiaries. Starting April 1, hospitals in 67 metropolitan areas — from Akron, Ohio, to Wichita, Kansas — will be held responsible for the results of hip and knee replacements. The aim is better coordination that starts with the surgery itself, and continues through recovery and rehabilitation. (Alonso-Zaldivar, 11/16)

The (Charleston, S.C.) Post and Courier: Medicare Rule Draws Sharp Criticism From Ambulance Industry
Private ambulance company owners in South Carolina have become increasingly critical of a Medicare experiment designed to eliminate insurance fraud and save the federal government money. ... Medicare implemented the new rule in South Carolina almost a year ago. It requires patients to obtain prior authorization before the government pays for routine, non-emergency ambulance transportation. In theory, the rule makes sure only the sickest patients who can’t transport themselves qualify for the expensive service. But ambulance owners have complained that the company designated to administer Medicare in South Carolina seems to approve and deny transportation requests at whim. (Sausser, 11/16)


8. Health Care Leaders Overwhelmingly Support Government Action To Curb Drug Costs: Survey

According to Modern Healthcare's latest survey of executives, 90 percent of CEOs polled say that the fast rise of prescription drug prices was undermining their company's finances. In related news, The Philadelphia Inquirer reports on cancer treatment costs that can reach $30,000 a month.

Modern Healthcare: CEO Power Panel: Healthcare Leaders Back Feds Stepping In To Restrain Drug Prices
Nearly seven-eighths of the country's top healthcare leaders favor the government taking a bigger role in curbing the rising cost of prescription drugs, while nearly all say that the two-year runup in drug prices has hurt their bottom lines. A whopping 90% of CEOs responding to Modern Healthcare's latest CEO Power Panel survey said rising drug costs were undermining their finances. Nearly half (45%) said the impact was “very negative.” (Johnson, 11/14)

The Philadelphia Inquirer: Examining The Cost Of Cancer Treatment
In addition to the medical and emotional toll, the financial cost of cancer can be overwhelming. On average, some of the newer drugs run to $10,000 a month, with some exceeding $30,000 a month, according to the American Society of Clinical Oncology, a group of about 35,000 cancer professionals. ASCO and another group, the National Comprehensive Cancer Network (NCCN), have begun developing guidelines and tools to help physicians, patients, and their families assess efficacy, toxicity, and costs of the various treatment options. (Bauers, 11/15)

Public Health And Education

9. Blood Cancer Drug Treatment Wins FDA Accelerated Approval

The drug treats multiple myeloma and is made by Johnson & Johnson. Also, new tools to fight antibiotic resistant "superbugs" emerge and the FDA readies more regulation on laboratory testing that sometimes produces incorrect results.

The Associated Press: Johnson & Johnson Multiple Myeloma Drug Wins Accelerated OK
A Johnson & Johnson drug won Food and Drug Administration approval Monday for treating the incurable blood cancer multiple myeloma in patients who’ve failed prior therapies and have few options left. Darzalex is the first biologic drug and first monoclonal antibody — a genetically engineered drug designed to target diseased tissue and spare healthy cells — approved for multiple myeloma. (Johnson, 11/16)

The Wall Street Journal: New Diagnostic Tools Emerge In War Against Superbugs
A new front is emerging in the fight against antibiotic-resistant superbugs—one that doesn’t involve the development of new drugs. Companies are racing to develop diagnostic technologies that can be used by hospitals and clinics to pinpoint the cause of common infections quickly. That should cut down on the unnecessary prescription of antibiotics, a major driver of drug-resistance in bacteria. (Roland, 11/16)

The Wall Street Journal: FDA Says More Regulation Needed On Lab Tests
The Food and Drug Administration, in a report released on the eve of a congressional hearing Tuesday, said that certain laboratory tests “may have caused or have caused” actual harm to patients by producing erroneous results. At issue are so-called lab-developed tests, or LDTs, which are produced and performed within a single hospital or corporate laboratory. Such tests are often done on tissue samples sent in from outside doctors and hospitals. They are distinct from standard diagnostic equipment and products that are sold to doctors’ offices, hospitals or other labs. (Burton, 11/16)