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Tuesday, May 29 2018

șÚÁÏłÔčÏÍű News Original Stories 2

  • Benefit Change Could Raise Costs For Patients Getting Drug Copay Assistance
  • Cameras On Preemies Let Family In, Keep Germs Out

Note To Readers

Veterans' Health Care 1

  • Veterans Groups Praise Trump's VA Pick As Safe, Stabilizing Choice In Wake Of Years Of Scandal

Coverage And Access 1

  • Single-Payer Is Becoming Litmus Test For Democrats, But Reality Is Far More Complicated Than Rhetoric

Health Law 1

  • Republicans May End Up Bearing Lion's Share Of Blame For Premium Spikes, Recent Poll Suggest

Opioid Crisis 1

  • Purdue Pharma Knew About And Concealed 'Significant' Abuse Of OxyContin In Drug's Early Years, Report Shows

Health Care Personnel 1

  • 'We Have Heard The Message That Something Is Broken': Following Gynecologist Scandal, USC President To Step Down

Women’s Health 1

  • When It Comes To Abortion, Both Sides Think They Have Upper Hand For The Midterms

Public Health 4

  • Transfusions, Bone Marrow Transplant Push Limits Of Already Daring Fetal Therapy Field
  • What Is The Definition Of Death? Some Doctors Re-Evaluate After Recent High-Profile Cases Involving Brain Death
  • Here Comes The Sun: Outdated Sunscreens Pose Dangerous Risks For Skin Cancer
  • Debate Over Bullying's Link With School Shootings Re-Emerges After Santa Fe Incident

Health IT 1

  • New Technology Is Helping Make Operating Rooms Smarter, More Effective And Less Risky For Patients

Marketplace 1

  • Screening For Anxiety, Depression Cut Number Of Orthopedic Procedures Nearly In Half For One Doctor's Practice

State Watch 2

  • N.H. Hospitals Await Governor's Signature On Compromise Bill For Underpayments That Stretched Out For Years
  • State Highlights: Diabetes Treatment Resulted In 'Zombie-Like State,' Calif. Patient Claims; Ill. Bill To Improve Care For Sexual Assault Victims Moves Forward

Editorials And Opinions 2

  • Perspectives: Trump's Anti-Abortion Policies Aside, He's Not Really A Pro-Lifer
  • Viewpoints: In Commitment To Veterans' Special Needs, Be Wary Of Using Private Doctors

From șÚÁÏłÔčÏÍű News - Latest Stories:

șÚÁÏłÔčÏÍű News Original Stories

Benefit Change Could Raise Costs For Patients Getting Drug Copay Assistance

More health plans are refusing to count the copayment assistance offered by drug makers as part of the patients’ deductibles or out-of-pocket limits. ( Michelle Andrews , 5/29 )

Cameras On Preemies Let Family In, Keep Germs Out

Virtual visitation using webcams lets anyone with a password keep their eye on the most vulnerable babies. ( Blake Farmer, Nashville Public Radio , 5/29 )

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Note To Readers

VAPING UNVEILED: Nicotine-loaded e-cig juices that spoof popular treats may be luring youths into addiction. Tune in to California Healthline’s Facebook Live on Thursday, May 31 at 11:30 a.m. PT, when columnist Emily Bazar, reporter Ana Ibarra and Yolo County health program manager Steven Jensen discuss. Please send questions and .

Summaries Of The News:

Veterans' Health Care

Veterans Groups Praise Trump's VA Pick As Safe, Stabilizing Choice In Wake Of Years Of Scandal

If confirmed, Robert Wilkie will have to tread carefully between the administration and veterans advocates who are on opposing sides when it comes to privatization. But for now, he's winning praise from Republicans and Democrats alike.

President Trump's selection of Robert Wilkie to lead the Department of Veterans Affairs (VA) is being praised by veterans groups as a safe, stabilizing move in the aftermath of the failed nomination of former White House physician Ronny Jackson. Wilkie, who is serving as acting VA secretary, is a Washington insider with years of administrative experience who has previously worked on Capitol Hill as well as in the Pentagon for two presidents. (Weixel, 5/28)

Coverage And Access

Single-Payer Is Becoming Litmus Test For Democrats, But Reality Is Far More Complicated Than Rhetoric

California's gubernatorial race is acting as a microcosm of the larger push toward universal health care. But, experts say the issue is complicated. “Voters are thinking about the fundamental values associated with single-payer,” said Kelly Hall, an independent health consultant. “Almost zero voters have thought about the policy implications.” Those implications range from funding challenges to a vocal opposition to unanswered legal questions.

If wholesale opposition to President Trump is one litmus test for progressive Democrats, another — as the governor’s race in California is proving — is health care. All the leading Democratic contenders in the June 5 primary have pledged support for a single-payer system run by the state. The front-runner, Lt. Gov. Gavin Newsom, the former mayor of San Francisco, has made it the centerpiece of his campaign. “There’s no reason to wait around on universal health care and single-payer in California,” he has declared. (Cohen and Abelson, 5/25)

In other news —

A proposal to create government price controls in California for surgeries, hospital stays, doctor visits and other health care services died Friday when it failed to clear a key committee, but the author says he plans to bring it back next year. The measure was a longshot from the beginning, but it drew national attention from health care policy observers. Hospitals, doctors and other influential health care providers lobbied intensely against the bill, which they said would lead to longer waits for medical care. (Cooper, 5/25)

Health Law

Republicans May End Up Bearing Lion's Share Of Blame For Premium Spikes, Recent Poll Suggest

GOP lawmakers continue to point fingers at Democrats for passing the health law in the first place, but polls suggest that voters are thinking more short-term as they brace for the pain of higher premiums.

In recent elections, Democrats have faced attacks related to health-care costs, with the party being blamed for premium increases on Affordable Care Act exchanges during the Obama years. Now, as many health insurers are seeking to impose double-digit rate increases on those marketplaces, a number of recent surveys suggest Republicans may take the lion’s share of the blame, with Democrats viewed more favorably on the issue ahead of November’s midterm elections. (Armour, 5/28)

Opioid Crisis

Purdue Pharma Knew About And Concealed 'Significant' Abuse Of OxyContin In Drug's Early Years, Report Shows

The drugmaker, under fire for its role in the opioid crisis, has maintained that it was unaware of the way its drug was being abused for years. But according to recently disclosed documents, that wasn't the case. In other news on the epidemic: Philadelphia is working through the implications of closing its tent-camps; senators butt heads over an investigation into Teva; and more.

Purdue Pharma, the company that planted the seeds of the opioid epidemic through its aggressive marketing of OxyContin, has long claimed it was unaware of the powerful opioid painkiller’s growing abuse until years after it went on the market. But a copy of a confidential Justice Department report shows that federal prosecutors investigating the company found that Purdue Pharma knew about “significant” abuse of OxyContin in the first years after the drug’s introduction in 1996 and concealed that information. (Meier, 5/29)

Beneath a freight railway north of downtown, an estimated 200 people congregate in tents and atop mattresses in four dank tunnels. Many openly inject opioids into their hands, arms and necks. The drug use spills out into the city’s row-house-filled Kensington neighborhood. On a recent sunny day, a gaunt man rocked in place on a nearby street, a syringe gripped sideways in his mouth, as three children walk by. Residents frequently find used syringes and say streets have become toilets. (Kamp, 5/28)

Claire McCaskill, the Democratic senator from Missouri, has spent the past 18 months investigating drug makers and distributors to determine what role they played in furthering the opioid crisis. But her investigation into the Israeli drug company Teva — the world’s largest manufacturer of generic drugs — has largely been thwarted. For one, McCaskill said, Teva has stonewalled her efforts and refused requests to turn over documents detailing its efforts to prevent drug misuse and audits of suspicious orders for opioids. (Facher, 5/29)

In a record-breaking drug bust in Nebraska, state troopers seized 118 pounds of fentanyl — containing enough lethal doses to kill tens of millions of people. Nebraska State Patrol Col. John Bolduc announced Thursday that a massive amount of suspected opioids seized last month in the state have tested positive for fentanyl, a synthetic opioid that is 50 to 100 times more potent than morphine and 30 to 50 times more potent than heroin, according to the U.S. Drug Enforcement Administration. (Bever, 5/25)

A Delaware health official is warning people who use drugs that two people have died from suspected overdoses in a 24-hour period involving heroin packets with the same stamp. Department of Health and Social Services Secretary Kara Walker issued the warning on Monday. The department says it’s not identifying the stamp so people will not seek out the drug. (5/28)

Gov. Rick Scott and leaders of the Florida House rejected appeals to save $28 million in prison programs Friday, choosing instead to allow hundreds of layoffs at inmate transition and treatment programs throughout the state when the programs close at the end of June. The cuts offered up by the Florida Department of Corrections will reduce access to dozens of privately run programs that had a proven track record of preventing offenders from returning to crime and drugs. (Klas, 5/25)

Health Care Personnel

'We Have Heard The Message That Something Is Broken': Following Gynecologist Scandal, USC President To Step Down

The decision followed a call from students, faculty and alumni for C. L. Max Nikias' resignation after reports emerged that the university knew of allegations against campus gynecologist George Tyndall for years and failed to act on them.

The president of the University of Southern California, C. L. Max Nikias, agreed to step down Friday in the wake of a scandal over a gynecologist accused of abusing students at the campus health center. Rick J. Caruso, a member of the university board of trustees, said in a statement that the board had “agreed to begin an orderly transition and commence the process of selecting a new president.” (Medina, 5/25)

"President Nikias and the Executive Committee of the Board of Trustees have agreed to begin an orderly transition and commence the process of selecting a new president," committee chairman Rick Caruso said. Nikias could not be reached immediately for comment. His resignation comes three days after 200 faculty members demanded in an open letter he quit as USC faces a rising tide of litigation accusing Dr. George Tyndall of misconduct and the university of complicity and negligence. (5/26)

Two hundred faculty members, as well as many alums and current students, called in recent days for Dr. Nikias to resign, following a report in the Los Angeles Times about the allegations. That article included claims that for decades, the gynecologist, George Tyndall, conducted improper pelvic exams on female students and made sexually and racially inappropriate comments. (Korn, 5/25)

A prolific fundraiser during his eight years as president, Nikias pushed USC to imagine itself as an elite global research university and to dramatically expand and renovate its South Los Angeles campus. He oversaw a major construction boom that transformed parts of the campus community and extended USC's ties to China and the Pacific Rim. The departure of Nikias, an engineering professor whose ambition took him from a childhood in a Cypriot village to a post leading one of the nation's top private universities, was once considered unthinkable, and signifies the end of an era at USC. The cornerstone of Nikias' legacy is a $6-billion campaign launched in 2011, then described as the largest such drive in academic history. (Hamilton, Pringle, Ryan and Lopez, 5/25)

Tyndall routinely made crude comments, took inappropriate photographs and forced plaintiffs to strip naked and groped them under the guise of medical treatment for his “sexual gratification,” according to civil lawsuits filed this week. At least a dozen lawsuits have been filed so far and police are interviewing alleged victims to see if any crime was committed. The Los Angeles Times reported earlier this month that complaints about Tyndall weren’t properly address by USC for years and university officials never reported him to the medical board, even after he was quietly forced into retirement. (Balsamo, 5/26)

Women’s Health

When It Comes To Abortion, Both Sides Think They Have Upper Hand For The Midterms

Both anti-abortion and abortion rights groups are pouring money into campaigns for the 2018 midterms, which could prove to be a turning point for the divisive issue. In other women's health news: hospital closures leave expectant mothers scrambling to find care; midwives mean healthier babies, so why aren't they more common in the U.S.?; schizophrenia and unhealthy pregnancies; and untested rape kits.

President Trump and anti-abortion activists this week touted recent actions restricting abortion as helping to galvanize Republican voters for the midterm elections. But Democrats see it the other way around, arguing Trump’s actions to defund Planned Parenthood and roll back ObamaCare’s contraception mandate are going to hurt, not help, Republican candidates on the ballot in November. (Hellmann, 5/26)

The sudden closure of a hospital has left some expectant mothers in the Missouri Bootheel region scrambling for care in an area that already has one of the highest infant mortality rates in the U.S. St. Louis Public Radio reports that Twin Rivers Regional Medical Center in Kennett recently announced that it will close in July. The closure will leave the surrounding area in southeast Missouri without an OB-GYN. (5/27)

Midwives in the U.S. participate in less than 10 percent of births. But in Sweden, Denmark and France, they lead around three-quarters of deliveries. In Great Britain, they deliver half of all babies, including all three of Kate Middleton’s. So if the midwifery model works for royal babies, why not our own? (Chakraborty, 5/29)

Far be it from us to tell 23andMe how to run its business, but if it or any other DNA company wants to give customers a better read of disease risk they might start asking how mom’s pregnancy went. That’s the key message of a schizophrenia study published Monday, which showed that 108 regions of the genome previously identified as raising the risk of schizophrenia do so only slightly if the mother experiences no complications during pregnancy — but by some 12-fold if she does. (Begley, 5/28)

Do not tell a survivor of rape that her state’s police departments, crime labs and hospitals are holding a stash of 4,889 untested rape kits. Not on the same day that one of the two men accused of raping her, pleaded guilty in the rape of another woman, a Johnson County sheriff’s deputy. (5/25)

Public Health

Transfusions, Bone Marrow Transplant Push Limits Of Already Daring Fetal Therapy Field

Elianna Constantino and her mother Nichelle Obar were the first patients in an experiment to treat a normally fatal disorder while Elianna was still in the womb.

In the three months before she was even born, Elianna Constantino received five blood transfusions and a bone-marrow transplant. All were given with a needle passed through her mother’s abdomen and uterus, into the vein in her umbilical cord. Elianna, born Feb. 1 with a robust cry and a cap of gleaming black hair, has a genetic disease that usually kills a fetus before birth. The condition, alpha thalassemia major, leaves red blood cells unable to carry oxygen around the body, causing severe anemia, heart failure and brain damage. (Grady, 5/25)

In more news —

Few procedures in medicine present patients with a sharper double-edged sword than a bone-marrow transplant. The treatment offers a potential cure for lethal blood cancers such as leukemia or lymphoma and other blood disorders. But it is a highly toxic and sometimes fatal procedure in which patients’ immune systems typically are severely weakened or wiped out with high-dose chemotherapy or radiation. Many patients turn down the potentially lifesaving treatment, fearing that the cure is at least as bad as the disease. (Winslow, 5/28)

What Is The Definition Of Death? Some Doctors Re-Evaluate After Recent High-Profile Cases Involving Brain Death

Legally, standards for determining brain death are largely left up to the medical community. But families have begun to challenge doctors' determinations, leading to more questions around the murky topic. In other public health news: medical professionals and hand washing; Ebola; brain stimulation and diabetes; DNA testing; crowdfunding for scientific research; and much more.

What is the definition of death—and who gets to make the call? For decades, physicians have had the authority to declare a person brain-dead—defined in the U.S. as the irreversible cessation of all brain function, including the brainstem—even if heart and lung activity can be maintained with machines. The medical profession determined the acceptable tests and procedures used to make the diagnosis. (Marcus, 5/28)

Hospitals have spent considerable resources trying to reduce the number of preventable mistakes that doctors and nurses make, such as skipping hand washing. But it’s hard to ensure that caregivers take every preventive step every time. Perhaps they need to be watched all the time. (Ward, 5/28)

The World Health Organization said it was assuming 100-300 cases of Ebola in Democratic Republic of Congo over a three-month timeline, under a revised strategic response plan it published on Tuesday. The WHO, which said the figure is not a prediction, had assumed there would be 80-100 cases in an earlier version of the plan, based on information as of May 15. (5/29)

A surprising (but welcome) side effect of a therapy for obsessive-compulsive disorder may pave the way for a new approach to treating type 2 diabetes — and offer new insights into the links between obesity and the metabolic disease that afflicts close to 1 in 10 American adults. The therapy in question is deep brain stimulation of the nucleus accumbens, a structure best known for its role in motivation, reward and addiction. It now appears that deep brain stimulation also increases the liver's and muscles' ability to take up and use insulin, researchers reported this week. (Healy, 5/26)

While genetic diseases pose the single biggest source of infant mortality in the U.S., many of these disorders are so rare and little understood that an accurate diagnosis can take weeks or months. Some babies don’t have that much time. For others, the battery of tests that tend to be ordered adds to their suffering and often still ends with no diagnosis. (Linden, 5/28)

There are 89 experimental drugs currently being tested in people, according to Biomedtracker, a research unit of Informa. Some are improvements on existing drugs, others have found new ways to target the cancer cells; a few engage the body’s immune system in the fight. Not all the drugs will make it through the trial process, of course. But on the roster, there may be effective treatments for the one-quarter of patients who haven’t yet been helped by existing drugs. (Weintraub, 5/29)

A new batch of startup companies are trying to drive a revolutionin lab testing by letting you skip the doctor and test for food sensitivities, fertility, sleep hormones and even vitamin deficiencies — all from the privacy of your bathroom — no lab visit required. Do-it-yourself testing kits cost anywhere from about $35 for an individual test to $450 for a battery of tests. Last November on "Shark Tank," the reality show featuring budding entrepreneurs who think they have a hot idea, contestant Julia Cheek hawked her company's home-testing kits to the program's panel of investors. (McClurg, 5/28)

Scientists struggling to find funding for research may have a new source of money: crowdfunding. That’s the conclusion of a new study, which suggests that scientists who lack extensive published research may be better off gathering many modest contributions instead of pursuing large financial grants from traditional sources. (Constable, 5/28)

For people with disabilities, design can hurt more than it helps. Clothing can be hard to put on, terrain rough to navigate. Even seemingly accessible developments such as voting machines and smartphones can present obstacles. So how can design become more inclusive, and more practical, for people with differing abilities? “Access + Ability,” an exhibition at the Cooper Hewitt, Smithsonian Design Museum in New York, tackles that question head-on. (Blakemore, 5/27)

Yet health officials have been sounding the alarm over the escalating use of e-cigarettes, and especially Juuls, among young people for a few years. The products, they say, come in hundreds of fruit and candy flavors — mango, sweet tart, watermelon, caramel cappuccino — making them attractive to teens. (Tucker, 5/27)

In the past two years, outbreaks of cryptosporidiosis, a parasitic disease caused by the organism cryptosporidium, have affected hundreds of people. State health department data shows cryptosporidiosis cases tend to peak from July through September, aligning with the height of swim season. (Philip, 5/26)

Nationwide, 82 percent of nurses consider workplace stress the biggest risk to their health, according to the American Nurses Association's Health Risk Appraisal. And about 57 percent say they work extra hours - before or after work or during lunch or breaks - to handle their workload, according to the ANA survey, which was completed by 10,688 nurses and nursing students. (Christ, 5/27)

On nights that the pain became unbearable, Marion Millhouse Barker would get out of bed, head for the guest room, shut the door and scream as loud as she could. “It helped,” said Barker, recalling the strategies she devised to cope with the stabbing sensation on the right side of her rib cage that left her doubled over. “I have a high pain tolerance,” she said, but this pain proved to be more excruciating than unmedicated childbirth or acute appendicitis. (Boodman, 5/26)

Kaiser Health News: Cameras On Preemies Let Family In, Keep Germs Out

Hospitals around the country have been upgrading their neonatal intensive care units to include personal webcams for each tiny patient. It’s a convenience for parents — and reduces worries about visitors bringing in germs. The neonatal intensive care unit at St. Thomas Midtown in Nashville is the latest hospital to join the webcam wave, among facilities around the country from big cities to towns that are installing cameras over each infant. (Farmer, 5/29)

Here Comes The Sun: Outdated Sunscreens Pose Dangerous Risks For Skin Cancer

Also, a dermatologist hails skincare products sold in other countries, saying they're more effective and feel better. Plus, news on summertime dangers include protection from eye damage and the dangers of leaving children in hot cars.

Dermatologist Steve Wang treats skin-cancer patients all day at a Sloan Kettering hospital in New Jersey, so he knows better than most that U.S. sunscreens aren’t up to the job. The oily stuff Americans are slathering on before heading to the beach this summer probably won’t give them as much protection as the products sold in other countries. Europe, Japan, Australia, Canada: All have sunscreens that do a better job shielding against cancer-causing skin damage, and feel better on the skin, too. (Kaskey, 5/25)

The next time you head to the drugstore to buy sunscreen, don’t forget to pick up some sunglasses, too. That’s because both products work to protect your body from the sun’s damaging ultraviolet rays. Wearing sunglasses for protection should not be reserved for sunny summer days, says Dianna Seldomridge, spokeswoman for the American Academy of Ophthalmology and practicing eye doctor at Duke University. There’s UV light on cloudy days and during other seasons of the year — anytime it’s daytime. “It’s important to protect your eyes all year round,” she says. (Adams, 5/26)

It’s well known that a car parked outside on a hot summer’s day can turn into a scorching oven. But how much time does it take for the inside of a car to heat up to deadly temperatures? The answer can be a matter of life and death. Every year in the United States, an average of 37 children die after being left in hot cars, according to researchers of a new study, published online last week in the journal Temperature. To investigate the matter, researchers studied how long it takes different types of cars to heat up on hot days. The findings were sobering: Within one hour, the temperature inside a car parked in the sun on a day that reached 95 degrees Fahrenheit or hotter hit an average of 116 degrees. (Geggel, 5/27)

Debate Over Bullying's Link With School Shootings Re-Emerges After Santa Fe Incident

In many mass school-shooting cases in which the accused is a student, allegations have surfaced that the shooter was bullied. But whether there is a clear link between the two issues is the subject of contention.

As this grieving town searches for answers about a mass shooting by a 17-year-old student, an emotional and divisive debate has emerged over bullying at the high school where the rampage took place. The alleged shooter’s father, Antonios Pagourtzis, said his son—a quiet former football player known for wearing a trench coat to school—had faced bullying and said he believed that was part of the trigger for the May 18 attack, which left 10 dead and 13 wounded. As students return to school Tuesday for the first time after the shooting, some here say bullying has long been a problem at this rural Texas town’s lone high school, but others don’t recall the suspected shooter, Dimitrios Pagourtzis, being picked on by his peers at all. (Hobbs, Frosch and Calvert, 5/29)

In other news —

Barbara Herrington, a geriatric care manager in Polk County, Fla., was calling on a 72-year-old woman with dementia and a long history of alcoholism. Ms. Herrington knew her client would be angry that morning. Her daughter had taken the car away the day before because her mother was ignoring a neurologist’s instructions to stop driving and was heading out at night to buy liquor. (Span, 5/25)

Colorado patients, health insurers and taxpayers spent nearly $26 million in 2016, up 50 percent in just five years, to treat injuries related to firearms, according to new data that provide a unique look at gun violence in the state. The numbers also show that health insurance claims for firearm injuries are on the rise in Colorado, more than tripling between 2012 and 2016, although a change in how injuries are documented at hospitals could also have played a role in the apparent increases. (Ingold, 5/25)

Health IT

New Technology Is Helping Make Operating Rooms Smarter, More Effective And Less Risky For Patients

From surgeon-controlled robot cameras to GPS-like maps projected onto a patients' bodies, technology is bringing surgery into the new era. In other health-tech news: dementia, school nurses, blindness, and more.

The operating room is getting smarter, more effective—and a lot less risky for patients. Hospitals are investing in new devices, designs and digital technologies that promise a new era of innovation for surgery. The moves are part of a growing shift away from traditional open procedures that involve big incisions, lots of blood loss and long hospitalizations. They point toward a future where more patients can choose minimally invasive outpatient surgeries, with faster recoveries, fewer complications, and less pain and scarring. (Landro, 5/28)

Brain surgery is never going to be easy. When a surgeon is removing a tumor, even a slight miscalculation in the angle of entry can interfere with important functions of the brain. But augmented reality—blending digital imagery with the physical world—may help surgeons keep their focus at critical moments during the task. (Toy, 5/28)

Technology promises to make it easier for people with dementia to live independently for longer and stay connected with family and friends. Home sensors, communications and personal navigational devices—some of which are already commercially available—provide ways to monitor patients and loved ones from afar. Robotics, smartphone apps and some intriguing experiments with tablet computers, meanwhile, show the potential to help sufferers of dementia sustain their social and family contacts. (Wang, 5/28)

Telemedicine has grown rapidly in recent years. Now hundreds of schools are bringing it to the nurse’s office. School nurses say telemedicine helps them treat students faster right at school, reducing risk of infection, getting the students back to class faster and relieving a big burden on the students’ families. (Holland, 5/25)

Patients sitting in emergency rooms, at chiropractors' offices and at pain clinics in the Philadelphia area may start noticing on their phones the kind of messages typically seen along highway billboards and public transit: personal injury law firms looking for business by casting mobile online ads at patients. The potentially creepy part? They're only getting fed the ad because somebody knows they are in an emergency room. (Allyn, 5/25)

Since losing his vision at age 13, Erik Weihenmayer has summited Mount Everest, white-water rafted and climbed frozen waterfalls. But making soup in his kitchen presented a unique challenge. On a frozen waterfall he could tap his ax against the ice to get a feel for its density, but in the kitchen, he had no way to differentiate between cans of tomato and chicken noodle. Mr. Weihenmayer, 49 years old, found a solution in Microsoft Corp.’s Seeing AI, a free app for the visually impaired. Among other things, the app can recognize faces, identify money, read handwriting and scan bar codes to differentiate between cans of soup. (Kornelis, 5/28)

Kaiser Permanente, based in Oakland, Calif., closely manages the medical care of people enrolled in its health-insurance plan, who use Kaiser’s integrated network of hospitals and doctors. Increasingly, that network is also a digital one. (Evans, 5/28)

Marketplace

Screening For Anxiety, Depression Cut Number Of Orthopedic Procedures Nearly In Half For One Doctor's Practice

But the problem is that value-based purchasing hasn't caught on in the behavioral health sector at nearly the same level as other medical specialties. Media outlets report on other cost and quality issues, such as paying for emergency room visits and a fight over dialysis.

Value-based purchasing hasn't caught on in the behavioral health sector at nearly the same level as other medical specialties. That's partly due to the fact that most providers don't use standardized metrics to gauge outcomes and some small providers are reluctant to adopt expensive electronic health record platforms and other technology necessary to facilitate data collection and sharing. To be sure, a wealth of pilot programs are actively testing behavioral health value-based purchasing among commercial and government payers in several states. But so far, they're happening in silos. (Bannow, 5/26)

When HonorHealth leaders were looking for ways last year to decrease spending, the joint-replacement service line stuck out as a big opportunity. The procedures are one of the Scotts-dale, Ariz.-based system's most popular—and lucrative—service lines and make up a significant percentage of supply chain costs, which account for nearly 40% of its $1.7 billion in revenue, according to 2016 financial data from Ernst & Young. But HonorHealth was paying more for parts than its competitors. (Castellucci, 5/26)

Minnetonka-based UnitedHealthcare announced long-term strategic partnerships this week with two large lab testing companies to develop “value-based programs” like those the health insurer has been pushing with hospitals and clinics. With the new arrangements, New Jersey-based Quest Diagnostics will become an in-network lab for more than 48 million people enrolled in UnitedHealthcare health plans starting next year, the companies said in a news release. (Snowbeck, 5/25)

Tony Miller spent years pushing the idea that health plans with special accounts for covering deductibles might transform patients into savvy shoppers. Now Miller has moved on to a new idea for insurance. His latest startup is a Minneapolis-based company called Bind that is selling the concept of “on-demand” health insurance, which lets workers in employer plans buy coverage for certain ailments only if they need the services. (Snowbeck, 5/25)

Starting June 4, Blue Cross and Blue Shield of Texas, the state’s largest insurer, will step up its scrutiny of all out-of-network emergency room claims for patients who have health maintenance organization, or HMO, plans. If, after treatment, a company review finds patients could have reasonably gone elsewhere for care, it will pay zero. That means even insured patients could potentially be on the hook for thousands — if not tens of thousands — of dollars in medical bills if they make the wrong choice. (Deam, 5/26)

The country’s largest insurer, UnitedHealth Group, has filed a pair of lawsuits against American Renal Associates alleging that the national dialysis chain conspired to funnel patients into private insurance plans to pump up its profits. Lawmakers in California are considering tough new restrictions against third parties such as charities that pay premiums for dialysis patients. (Demko and Colliver, 5/25)

State Watch

N.H. Hospitals Await Governor's Signature On Compromise Bill For Underpayments That Stretched Out For Years

“This will not cover all of the uncompensated care costs that hospitals incur in taking care of those patients, but it will certainly help to offset the loss they will incur providing those important services,” said Steve Ahnen, president of the New Hampshire Hospital Association.

New Hampshire’s hospitals and top state officials have brokered a seven-year deal over uncompensated care payments, ending for now a yearslong dispute from hospitals who said they were underpaid. The agreement, negotiated by Senate President Chuck Morse, R-Salem, and others, halts a period of uncertainty for the state after a key federal court ruling in March. (DeWitt, 5/28)

And in other hospital news —

Three patients at Boston Children’s Hospital suffered from medication errors in 2017, including one who waited hours for an antibiotic and later died, according to a state and federal inspection report. The mistakes, which occurred between January and November and involved two drugs, prompted regulators to threaten the hospital with potential termination from the federal Medicare program. (Kowalczyk, 5/27)

The city home to Washington’s main psychiatric hospital is fighting to stop patients from being discharged to residential treatment centers within its borders. Lakewood approved a moratorium last week on city business licenses for new adult family homes and authorized a lawsuit against the state to end what it calls the unsafe release of people with histories of violence or sexual offenses into its city. (Orenstein, 5/28)

Froedtert Health plans to test a new model of providing care by building what it calls a “neighborhood” hospital in Mequon that would have eight overnight beds and an emergency department. The hospital, which would not provide surgical services, would be built across the street from a clinic at 11430 N. Port Washington Road opened last year by the Froedtert & Medical College of Wisconsin Health network. (Boulton, 5/25)

State Highlights: Diabetes Treatment Resulted In 'Zombie-Like State,' Calif. Patient Claims; Ill. Bill To Improve Care For Sexual Assault Victims Moves Forward

Media outlets report on news from California, Illinois, Minnesota, Connecticut, South Carolina, Florida, Ohio and Texas.

A San Diego woman says she was put at risk of hospitalization last year after receiving a series of insulin infusions at Dr. James Novak’s Trina Health clinic in Pacific Beach. The woman and her endocrinologist said the infusions spiked her blood sugar to dangerously high levels. The nation has a limited supply of healthcare dollars to spend on drugs and services, which is why the government and health plans require scientific evidence of patient benefit. This is especially important for the 30.3 million people in the U.S. with diabetes, whose medical costs in 2012 totaled $245 billion.Leadership at Scripps Health started an investigation of Novak’s practice when they learned about the incident, the endocrinologist said. And the founder of the Trina infusion procedure, Sacramento lawyer G. Ford Gilbert, faces federal criminal charges related to his network of clinics. (Clark, 5/25)

The Illinois Senate passed legislation Friday to ensure that rape and sexual assault victims in emergency rooms are seen by someone trained to treat them. The legislation, which passed the Illinois House in a similar form in April, was approved 49-0 by the Senate. It would require that, by 2022, hospitals in the state that treat sexual assault victims have a specially trained provider present within 90 minutes of a patient’s arrival in an emergency room. (Bowen, 5/25)

Here in Illinois, 220,000 people are living with Alzheimer’s disease, which gradually, irreversibly degrades cognitive functions, according to the Alzheimer’s Association. By 2025, an estimated 40,000 others are expected to develop the condition, a more than 18 percent increase in this state alone. And though diagnoses of Alzheimer’s are expected to increase as the senior population continues to grow nationally, Latinos like Salvador Campos are 50 percent more likely to develop the disease than their white counterparts, researchers from the University of Southern California say. Between 2012 and 2060, the number of Latinos in the United States living with Alzheimer’s disease is projected to increase 832 percent — from 379,000 to more than 3.5 million, this research indicates. (Olumnhense, 5/29)

California’s historic aid-in-dying law is suspended, for now, after a Riverside Superior Court issued a final ruling on Thursday night that called it unconstitutional. The action follows a May 15 ruling by the same judge that the law was passed illegally, and the 4th District Court of Appeal’s refusal Wednesday to grant an emergency stay requested by California Attorney General Xavier Becerra. (Krieger, 5/25)

A major tobacco company is pumping millions of dollars into a campaign to persuade San Francisco voters to reject a ban on selling flavored tobacco products, including menthol cigarettes, certain chewing tobaccos and vaping liquids with flavors like cotton candy, mango and cool cucumber. R.J. Reynolds Tobacco Co. has contributed nearly $12 million to the "No on Proposition E" campaign, filling television and radio airwaves and mailboxes with ads urging voters to reject a law supervisors approved last year that is now on the June 5 ballot. (5/28)

The city ordinance to restrict tobacco sales, including vaping products, to those who can legally buy alcohol goes into effect Oct. 1. Minneapolis is joining seven other Minnesota cities and 300 nationwide that have raised the tobacco-buying age in an effort to discourage young people from picking up the habit. (Ibrahim, 5/25)

When adequate investment in human capital — higher education, adequate health care and decent housing — are impossible because of debt or under-employment, inequality becomes a significant drag on economic growth. Further complicating Connecticut’s struggle with accelerating inequality, the state is divvying up responsibility for paying a historic bill brought on by its own fiscal imprudence over decades: unprecedented pension and other debt costs that already are placing extreme pressure on services and taxpayers. (Phaneuf, 5/29)

A 9-year-old South Carolina boy selling lemonade to help his sick baby brother has raised nearly $6,000 in two hours. Andrew Emery wants to help his parents pay for the medical bills for his little brother Dylan. The infant suffers from Krabbe disease, a rare and often lethal neurological condition. So on Saturday, Emery spent two hours at used truck dealership Southern Wheels in Greenwood, selling lemonade and #TeamDylan t-shirts. He raised $5,860 to be added to $1,300 raised at a Friday benefit concert and $5,600 from a GoFundMe site for his brother, currently in a Pittsburgh hospital. (5/28)

Florida's ban that prevents medical marijuana patients from smoking their cannabis has gone up in smoke. Leon County Circuit Court Judge Karen Gievers on Friday ruled that a state's ban on smokable cannabis is unconstitutional. Florida's Department of Health said in a statement it has appealed the ruling, which will impose an automatic stay. (5/25)

A Florida judge on Friday ruled that the state’s ban on smokable medical marijuana is unconstitutional. Leon County Circuit Court Judge Karen Gievers wrote in her ruling that residents “have the right to use the form of medical marijuana for treatment of their debilitating medical conditions as recommended by their certified physicians.” (Anapol, 5/26)

The new Centers for Disease Control and Prevention study found students living in Health Zone 2, encompassing the Greater Arlington area, had the highest rate of suicide attempts. And more female students than male said they’ve made a suicide plan. (Kilbride, 5/25)

Ignition interlocks, which keep drunken drivers from starting their cars, are proven to reduce alcohol-related fatal crashes. But in central Ohio, the majority of first-time offenders aren’t using them, attorneys say. (Cooley, 5/27)

A 54-year-old man who called himself "Dr. Dave" has been convicted of swindling health care insurers through millions in bogus claims. David Roy Williams was convicted this week in federal court of four counts of health care fraud for falsely billing insurance companies. Each count carries a 10-year sentence in federal prison and a $250,000 fine. Williams is scheduled to be sentenced Aug. 27. (Tsiaperas, 5/26)

Mayor Darrell Steinberg, who has made curbing homelessness a centerpiece of his administration, announced earlier this week plans to place pop-up structures resembling giant tents in at least three neighborhoods he has yet to identify. Known as "Sprung" shelters, they would each have beds for as many as 200 clients, as well as paid "navigators" who would help connect people to insurance, health care, social services and ultimately permanent housing. (Hubert, 5/27)

Editorials And Opinions

Perspectives: Trump's Anti-Abortion Policies Aside, He's Not Really A Pro-Lifer

Opinion writers express views on President Donald Trump's recent announcements about withholding funds for organizations that perform abortions or make referrals.

Whenever I hear Donald Trump described as the most pro-life president ever, I think well then, I would not want to meet the runner-up. Pro-lifers, and yes, I am one, do not debate which people are people. Or think of even the most remorseless criminals as less than human. “These are not people,” Trump has said of some of the immigrants being deported. “These are animals." He’s frequently called gang members and school shooters and terrorists animals. (And he reportedly has no patience with animals.) ...You cannot really value life and speak this way. (Melinda Henneberger, 5/29)

President Donald Trump’s plan to withhold federal funds for organizations that perform abortions or make referrals for them will endanger women’s access to a wide range of health care, such as birth control, Pap tests for cervical cancer and testing for breast cancer and sexually transmitted infections. Trump’s effort is designed to placate a group of social conservatives who are determined to crush Planned Parenthood, damn the consequences. They view the women’s health organization as evil because some of its clinics perform legal abortions. They constitute a small fraction of Planned Parenthood services, and no federal funds are used for the procedures. Trump opts to put women’s health at risk just so he can pander to a group that can’t seem to see anything beyond the abortion issue. (5/28)

President Trump is trying to turn family planning — what most of us consider good for mothers, fathers, children, and families — into something bad, even shameful. He’s also trying to make abortion – part of women’s health care for 45 years – into an abomination so nasty that clinicians dare not speak its name. (Margery Eagan, 5/28)

I had hoped the political conversation around abortion would fade. I had hoped that people who were firmly against abortion could take comfort in knowing that they would never be forced to have one. But our politicians have never let it fade. And yet women still want and need abortions. In a perfect world, no one would need one. Birth control would be perfect, finances would be perfect. But that’s not how it is. (Joan Finn-McCracken, 5/25)

Viewpoints: In Commitment To Veterans' Special Needs, Be Wary Of Using Private Doctors

Editorial pages focus on these and other health care issues.

Veterans like me need managed, culturally competent medical care, in a safe community that respects them. Private doctors do not understand the complexity of service-related health problems. (Howard L. Hibbard and Marcela Davison Avilés, 5/25)

In the course of my active military career, I had troops under my command on three deployments to Iraq and Afghanistan. I have lost more of my soldiers to suicide than I lost in combat. That may sound shocking to you — it is shocking to me. But I have yet to meet a veteran of Iraq or Afghanistan who doesn’t know someone who took their own life. That is staggering. I can recite the numbers. An estimated 20 veterans commit suicide every day, losses that are piled upon the nearly 7,000 US troops that have been killed in our ongoing conflicts in Iraq and Afghanistan. (Jack Hammond, 5/28)

America’s veterans have served our country and protected our freedoms, sometimes at the expense of their own well-being and health. They have sacrificed while fighting our adversaries, and that sacrifice continues beyond their active duty status. Adversaries are still pursuing veterans and their personal information in cyberspace. The area where veterans are perhaps the most vulnerable is the health care sector. Nation-states, criminals, and hacktivists go after their personally identifiable information (PII), and some of the most robust and sensitive PII are medical records and insurance information. (Sarah Geary, 5/27)

In 2009, my husband had an emergency spinal-fusion operation to prevent permanent nerve damage caused by a ruptured disk. I was rolling the I.V. pole while he pushed a walker around the hospital corridor when I got an urgent call from a friend: “Don’t let them give him pain pills,” she said. I told her the nurses were giving him oxycodone on a schedule because the drug works better to prevent pain than to knock it back once it’s out of control. She was insistent: “Well, get him off it as fast as you can when you get home. Mom was addicted within a week of her back surgery, and she’s been addicted ever since. We can’t get her off it.” (Margaret Renkl, 5/28)

It’s a sunny spring day in Judge Alan Lemons’s courtroom, but it is hard to feel optimistic. A screen next to his bench shows a set of slides, each with a picture of a young mother and a brief description of why she will be appearing this morning. Two numbers on each slide tell the real story: the ages of her children and the number of days she has been sober. Sometimes the numbers are quite low. “Child age: 3 months; days sober: 81.” Several of these women were using drugs while pregnant and lost custody after giving birth. Judge Lemons runs what’s called a “family drug court” here in Scioto County, where the rate of opioid overdose is among the nation’s highest. He is hoping that this unconventional model of justice will help parents kick their habit, allowing them to reunite sooner with their children. (Naomi Schaefer Riley, 5/25)

As part of the mental health division of one of the largest safety-net health care systems in the Midwest, we come face to face with the opioid crisis and the lives it claims every day. One important lesson we have learned in treating people with substance use disorders is that we can’t just rely on an excellent clinical team — we also need lawyers to help address critical social issues that arise for our patients during recovery. (Gregory M. Singleton and Jay Chaudhary, 5/29)

Alex Azar will soon make his most consequential decision as health and human services secretary. President Trump has asked HHS to expand health-insurance protections in a way that could make coverage more affordable and improve the outlook for Obama Care’s risk pools. Whether Mr. Azar will oblige is uncertain. Some officials don’t understand that Mr. Trump’s request would expand consumer protections, or mistakenly believe HHS lacks the authority to grant it. The need for action is clear, as ObamaCare premiums keep skyrocketing. Rate hikes as high as 91% will hit many consumers just before Election Day. Maryland insurance commissioner Al Redmer warns ObamaCare is in “a death spiral. So-called short-term health plans, exempt from ObamaCare’s extensive regulations, are providing relief. Such plans often cost 70% less, offer a broader choice of providers, and free consumers to enroll anytime and purchase only the coverage they need. (Michael Cannon, 5/28)

Not only have many public health interventions in the United States been hugely successful, but they’ve also saved more money than they’ve cost. And yet Americans spend relatively little money in that domain and far more on medical care that returns less value for its costs. Instead of continually complaining about how much is being spent on health care with little to show for it, maybe we should direct more of that money to public health. (Aaron E. Carroll and Austin Frakt, 5/28)

In a victory for patient rights, the House passed the ‘‘Trickett Wendler, Frank Mongiello, Jordan McLinn, and Matthew Bellina Right to Try Act.” The bill removes the Food and Drug Administration (FDA) as an obstacle for incurable, dying patients who want to try promising experimental medicines that have passed initial safety testing. The bill has been forwarded to President Trump for signature. The president, who has been a strong supporter of the legislation, will soon sign it into law. (Roger D. Kelin, 5/26)

With the usual ballyhoo, the White House said on May 11 that President Donald Trump would announce his long-delayed plans to reduce the costs of prescription drugs. When Trump began speaking at 2:08 p.m., stock prices on Standard & Poor’s pharmaceutical sector dropped. By the time he finished speaking, the sector was soaring. Big Pharma was very happy with Trump’s speech. It contained nothing that will threaten its enormous profits nor anything that will slow down relentless price increases. As president-elect, Trump accused drug companies of “getting away with murder.” As president, Trump has become an accessory to that murder. It was yet another broken populist campaign promise, joining “great health care,” putting coal miners back to work, a trillion-dollar infrastructure plan and more. Trump has kept his promise to crack down on immigrants and move the U.S. Embassy to Jerusalem, but his economic populism has proved to be a mirage. (5/27)

Nearly 40 years ago, when prophylactic double mastectomies did not generate the reassuring headlines they do today, I had both of my breasts removed. It was a decision that began in tragedy and fear but unfolded into health and healing. It was the right decision, and I want to explain why. Today genetic testing offers information indispensable to making informed medical decisions about treatments and risk reducing options. Not all breast cancers are hereditary (10 percent or less). But for patients at high risk because of family history or genetic make up, such information can be lifesaving. (Ruth O. Selig, 5/28)

Of the afflictions routinely visiting the tropics, Zika virus is surely one of the most alarming. A contagion known mostly for fever and chills took on a deadly new face in Brazil in 2015, when it was linked to severe brain deformities in newborns, including a spike in infant microcephaly, or babies with undersized craniums. And all of this was unfolding amid Brazil’s gathering fiscal chaos, which undercut funding for science even as public health authorities were scrambling to contain other mosquito-borne illnesses such as dengue fever, chikungunya and a resurgent centuries-old menace, yellow fever. So who would have thought that such a scourge could be turned into a treatment? Yet Zika’s destructive powers were precisely what caught the attention of geneticists and biological researchers at the University of Sao Paulo, known as USP. (Mac Margolis, 5/25)

Last month, Governor Charlie Baker reluctantly signed a sweeping criminal justice overhaul into law. Now he’s trying to weaken a key provision, a “compassionate release” measure allowing some of the sickest and most incapacitated inmates to leave prison before they die.Lawmakers should reject the governor’s efforts. Compassionate release is the right thing to do, and it could save Massachusetts taxpayers millions of dollars to boot. (Christopher Burrell, 5/27)

If Arizona wants to keep children out of the child welfare system, it should make alleviating poverty a public policy priority. The evidence is in the areas of Maricopa County with the highest number of children being removed from their homes. (Linda Valdez, 5/27)

The Arizona Supreme Court struck down a 2012 law that allowed the state to criminally charge students with medical marijuana cards if they had or used pot on campus. The law didn't "further the purpose" of the medical marijuana law voters approved in 2010, the court ruled, and that made it unconstitutional. (5/26)

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