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POLITICO New York Health Care: Legionnaires' deaths rising; de Blasio's mental illness, homeless strategy

Dear readers: POLITICO New York Pro subscribers receive this email at 5:30 a.m. each weekday. If you'd like to receive it at that time, along with a customized real-time news feed of New York health care policy news throughout the day, please contact us at lenglander@politico.com and we'll set you up for trial access.

written by Dan Goldberg

LEGIONNAIRES’ The de Blasio administration reports that no new cases have been diagnosed since Aug. 3, which gives it reason to believe the height of the epidemic has passed. Since the outbreak began about one month ago, there have been 109 reported cases and 10 deaths.

THE POLITICS OF HEALTH On Friday, state health commissioner Dr. Howard Zucker and his city counterpart, Dr. Mary Bassett, held a press conference at the governor's New York City office. It was supposed to be a unified show of strength and collaboration. But it quickly exposed the gulf between how the city and the state see the situation, as neither Gov. Andrew Cuomo nor his health commissioner would defend how Mayor Bill de Blasio's administration handled the outbreak of Legionnaire’s amid criticism that it had been too slow to respond. "Patience is not one of Gov. Cuomo's virtues," Zucker said, as he announced a plan to deploy state employees to the Bronx. http://bit.ly/1MWfq1i

…The frosty relationship between de Blasio and Cuomo isn't new, (see Ebola, MTA, charter schools, mayoral control, rent regulations, etc.) but city officials seemed particularly irked at the notion that they had responded too slowly to this outbreak—and Cuomo, knowingly or not, pressed down hard on that nerve. Soon after the press conference ended, Cuomo was asked on NY1 if de Blasio had moved too slowly. “I don't know that I'm in a position to say or judge. I don't know exactly what they did when. I'm not a health professional. I know that from my point of view, the situation became critical," Cuomo said.

...Then things got weird: Karen Hinton, the mayor’s new press secretary, told several outlets, including POLITICO New York, she felt the mayor and Bassett were disrespected by the state’s refusal to come to their support. Further, she said, there are more than 500 cases of legionella each year in the state, so the question should be asked why hasn’t the state responded sooner. (That line of logic is particularly confounding because Bassett has spent the last week trying to explain that this is a common bacteria and only when a cluster appears can health departments really swing into action.)

...Then things got weirder: Phil Walzak, a senior adviser to the mayor, told The New York Times that Hinton’s remarks regarding the state’s performance did not reflect the views of the de Blasio administration. That means the spokeswoman for the mayor was not actually speaking for the mayor when she spoke to a group of reporters following a press conference. http://nyti.ms/1Tb4Wjx

SATURDAY — De Blasio on Saturday sought reassure New Yorkers that he was in charge even as 150 state employees—under the direction of Cuomo—were canvassing the Bronx, testing cooling towers across the borough, part of an effort the governor described as "taking matters into our own hands." De Blasio said he is happy for the state to help in that effort, but inspecting towers is a hedge against future outbreaks, not an admission that the current outbreak is ongoing, or has spread. http://politi.co/1Tb4i5Q

SUNDAY Cuomo further tweaked de Blasio, saying he would make sure to protect the residents of the South Bronx (and implying that de Blasio had not done so). Cuomo again promised to regulate cooling towers across the state so this kind of outbreak would not happen again. Other elected officials, including City Comptroller Scott Stringer thanked Cuomo for, essentially, saving the city. http://politi.co/1Tb3EVX

BLOOD IN THE WATER? — Cuomo doesn’t need any special reason to needle de Blasio, but don’t underestimate the impact of last week’s poll, which found that only 33 percent of city voters think quality of life in the city is "good" or "very good.” Weak poll numbers provide an opening, or excuse, for Democrats like Stringer, or Ruben Diaz Jr. to attack. http://politi.co/1Tb8rGX

SHARE ME: Like this newsletter? Please tell a friend to sign up. Give them this link: http://politi.co/1gMLiJV

OVERTURNED — The Affordable Care Act’s birth control exemption for religious groups goes far enough to relieve the burden on their religious freedom, a federal appeals court in New York ruled Friday, overturning a lower court’s decision. Under the ACA, employers must provide access to contraception as part of their health insurance. The law provides an exemption for religious employers, as well as an “accommodation” that applies more broadly to religious nonprofit organizations. This allows employers who object on religious grounds to providing contraception to opt out of paying for coverage, while allowing individual employees to seek coverage from a third party. The plaintiffs contended that by simply participating in the process, they were forced to compromise their belief system. A federal court in Brooklyn had agreed with the plaintiffs, but the Second Circuit reversed its ruling Friday, finding that the exemption imposed only a “de minimis burden.”

NOW WE KNOW — Researchers from Duke University and the University of Miami say you’re likely to vote for the candidate with the deepest voice. (Sorry, Hillary.) It’s a caveman thing, they said in a study published by PLOS One. "We think of ourselves as rational beings, but our research shows that we also make thin impressionistic judgments based on very subtle signals that we may or may not be aware of," study co-author Casey Klofstad, associate professor of political science at Miami, said in a press release accompanying the article. "But if it turns out that people with lower voices are actually poorer leaders, then it's bad that voters are cuing into this signal if it's not actually a reliable indicator of leadership ability." http://bit.ly/1W9ljw3

WE'D LOVE TO HEAR FROM YOU: This roundup is for you, so please tell us how we can make it even better. Send tips, news, ideas, calendar items, releases, promotions, job postings, birthdays, congratulations, criticisms and corrections to dgoldberg@politico.com.

THIS WEEKEND’S LONG READ If you haven’t yet, check out Daniel DiSalvo’s and Stephen Eide’s piece on this history of 1199 SEIU. It shows how the union has worked with management and politicians to become one of the most powerful forces in New York politics. The piece mostly serves as a critique on the corrosive effects of money in politics. http://thebea.st/1Tbhfwn

CAUTIOUS OPTIMISM ON HOMELESS Mayor Bill de Blasio’s new $22.4 million plan to serve the violent and severely mentally ill, some of them homeless, drew a tentatively positive response from homeless advocates hoping the city would offer more detailed plans and funds for housing. POLITICO New York’s Laura Nahmias has more: http://politi.co/1Tb7ezg

THE BIG IDEA — The Syracuse Post Standard explains why Syracuse University is considering a medical school. http://bit.ly/1Tbe4oz

MAKING ROUNDS Dr. R. Shay Bass, spine surgeon has been appointed the new chief of the Adult Spinal Deformity Service for the Division of Spine Surgery in the Department of Orthopaedic Surgery at NYU Langone Medical Center’s Hospital for Joint Diseases. He has also been named associate professor of orthopaedic surgery at NYU School of Medicine. Bess had served as director of the pediatric scoliosis services at Rocky Mountain Hospital for Children/Presbyterian St. Luke’s Medical Center in Denver. Bess earned his medical degree from Johns Hopkins University School of Medicine in Baltimore. He completed his residency at Case Western Reserve University in Cleveland and his postdoctoral spine fellowship in pediatric and adult scoliosis and spinal deformity at Washington University in St. Louis.

COMING SOON NYU Langone’s Perlmutter Cancer Center is partnering with Tri-State College of Acupuncture to train acupuncture students to treat cancer patients.

PHARMA REPORT:
The New York Times reports: “The Obama administration has decided that Medicare will pay for one of the newest, most expensive cancer medications, which costs about $178,000 for a standard course of treatment.” Amgen’s Blincyto is for patients with a particularly aggressive form of leukemia. http://nyti.ms/1IRUNNB


WHAT WE’RE READING:

-LINGERING EFFECTS — The New York Times asks what happens to the thousands of Africans who survived Ebola? “More than 13,000 people survived the virus, and many have lingering health problems, psychological troubles like depression and post-traumatic stress disorder, and worries about returning to work to feed themselves and what is left of their families.” http://nyti.ms/1Kag2LB

-WHERE ARE THE ACA NONDISCRIMINATION RULES? — POLITICO’s Paul Demko reports on how the Obama administration has yet to release rules on how it will enforce a key section of the Affordable Care Act that prohibits discrimination in health care delivery. “Obamacare’s section 1557 specifically prohibits health plans and providers from discriminating against patients on the basis of race, sex, color, age, disability and national origin. It’s the first time such protections for the health care system have been explicitly laid out in federal law. But there’s been no explanation for the holdup on releasing the proposed rule, which has been sitting at the Office of Management and Budget since April.” The story: http://politico.pro/1K7UrDD [PRO]

-OSCAR’S PLANS — Dan Diamond asks if Oscar health insurance, the company founded in New York, is ready for California where it plans to expand. He notes that the company’s valuation resembles a tech company more than an insurer. “After officially launching in New York two years ago, Oscar is already valued at $1.5 billion—despite having just 40,000 members. (In comparison, UnitedHealthcare is valued at $115 billion and has about 45 million members. A smaller rival insurer, Health Net, is valued at about $5 billion—and has more than 3 million members.)” http://bit.ly/1IRTGNZ

-SHOCKED, SHOCKED TO DISCOVER — The New York Times reports on Coca-Cola’s “science-based” solution to the obesity crisis. The beverage maker says people should focus on exercise and concern themselves less with calorie counting. http://nyti.ms/1OZQ01q

TODAY'S TIP — Comes from the Cleveland Clinic: “Newsflash, dads. A spoonful of sugar isn't your best option for getting kids to take medicine.” /cle.clinic/1IpgFRi

STUDY THIS:


-RESISTANCE IS FUTILE Newsday reports: “A researcher at Stony Brook University's School of Medicine has developed a novel strategy she hopes will prevent cancer-drug resistance, a major problem that largely afflicts patients whose disease has recurred and spread.” http://nwsdy.li/1IRVcQd

-PROS AND CONS Treating maternal psychiatric disorder with commonly used antidepressants is associated with a lower risk of certain pregnancy complications including preterm birth and delivery by Caesarean section, according to researchers at Columbia University's Mailman School of Public Health, Columbia University Medical Center, and the New York State Psychiatric Institute. The problem is the medication also resulted in an increased risk of neonatal problems, according to a study published in the American Journal of Psychiatry. "To our knowledge, the association between taking antidepressants in pregnancy and a lower risk of preterm birth is a novel finding," Dr. Alan Brown, professor of Psychiatry and Epidemiology and senior author, said in a press release. "Given these divergent findings, the decision whether to prescribe these medications during pregnancy should be individualized to the mother's medical and psychiatric history." http://bit.ly/1IRVEhq

-OPIOID EPIDEMIC Researchers from New York University's Center for Drug Use and HIV Research examined the role opioid abuse plays in sexual violence in New York City. The researchers found 41 percent of women and 11 percent of men reported being forced to have sex without their consent while they were using drugs. "Many participants described negative sexual perceptions ascribed to opioid users and their own internalized stigma,” Dr. Pedro Mateu-Gelabert, said in a press release. “They also reported exchanges of sex for drugs or money that increased their risk for sexual violence. We found that the drug-using context facilitated victimization of users who were unconscious or semi-conscious as a result of using drugs." http://bit.ly/1IRWcnw


MISSED A ROUNDUP? Get caught up here: 8/7, 8/6, 8/5, 8/4, 8/3

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