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5. Political Cartoon: 'Eye Of The Beholder?'

Kaiser Health News provides a fresh take on health policy developments with "Political Cartoon: 'Eye Of The Beholder?'" by Dave Coverly, Speed Bump.

Here's today's health policy haiku:

OUTPACING THE ECONOMY

Health care no bargain
At $10,000 per
U.S. resident.

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Summaries Of The News:

Spending And Fiscal Battles

6. National Health Spending Expected To Hit New High Of $10,000 Per Person

CMS estimates that the 5.5 percent increase in 2015 totals $3.2 trillion. After several years of lower growth, the acceleration is largely attributed to a stronger economy, an uptick in medical prices and an aging baby boomers, as well as specialty drug costs.

The New York Times: National Health Spending To Surpass $10,000 A Person In 2016
National health spending will average more than $10,000 a person this year for the first time, the Obama administration said Wednesday, a milestone that heralds somewhat faster growth in health spending after several years of exceptionally low growth. By 2025, the administration reported, health care will represent 20 percent of the total economy, up from 17.8 percent last year. By 2025, one of every five Americans will be on Medicare, and the program will spend an average of nearly $18,000 a year for each beneficiary. Medicare spent about $12,000 per beneficiary in 2015. (Pear, 7/13)

The Washington Post: Health Care Spending Is Projected To Grow Much Faster Than The Economy
The report, compiled by a team of government actuaries, shows overall health spending picking up after a historic slowdown, but the growth remains lower than the nearly 8 percent annual growth in the two decades before the Great Recession. The Obama administration — including the president himself in a recent essay — has credited the Affordable Care Act with keeping health expenditures in check. But economists remain uncertain whether the slowdown in spending is because of provisions of the law or might be explained by other factors. (Johnson, 7/13)

The Wall Street Journal: Pace Of U.S. Health Spending Increased In 2015, With Further Rise Expected
The pickup in the past two years follows five consecutive years in which average spending growth through 2013 was less than 4% annually, the lowest rates since the government began tracking health-care spending in the 1960s. The acceleration is largely attributed to a stronger economy, faster growth in medical prices and an aging baby boom generation. Spending growth in 2014 and 2015 was also driven by expanded coverage under the Affordable Care Act because it means more people are using health services. At the same time, the law has helped rein in spending growth, administration officials said. However, the actuaries said quantitative estimates that measure the impact of the ACA aren’t yet available. (Armour, 7/13)

The Hill: US Health Spending Rises To $3.2 Trillion
Drug spending has been a particularly scrutinized area given calls to address the rising cost of prescription medications. The report finds that drug spending grew 8.1 percent last year, a slight slowdown from the spike of 12.2 percent the year before. (Sullivan, 7/13)

Modern Healthcare: Healthcare Spending Growth Rate Rises Again In 2015
CMS actuaries wrote that higher rates of health coverage through Medicaid expansion and the ACA's public exchanges, as well as more people getting insurance through their employers, “resulted in a slight acceleration in spending growth.” Indeed, 2014 kicked off the full-scale rollout of expanded Medicaid eligibility for all people who earn up to 138% of the federal poverty level as well as the introduction of the state and federal insurance marketplaces. The exchanges have become financial headaches for many health insurers, though not all. (Herman, 7/13)

Morning Consult: Health Care Expenditures Heading Toward 20 Percent Of Economy
“The Affordable Care Act continues to help keep overall health spending growth at a modest level and at a lower growth rate than the previous two decades. This progress is occurring while also helping more Americans get coverage, often for the first time,” said CMS Acting Administrator Andy Slavitt in a statement. (Owens, 7/13)

Capitol Hill Watch

7. Despite Discord Over Funding, Congress Sends Opioid Bill To President's Desk

The legislation, which passed the Senate 92-2, focuses on treatment and recovery efforts but the authorized spending has not been appropriated. This is "the first time that we’ve treated addiction like the disease that it is," says Sen. Rob Portman, Republican of Ohio.

The New York Times: Senate Approves Bill To Combat Opioid Addiction Crisis
The Senate on Wednesday approved a bill to tackle the nation’s opioid crisis, sending to the president’s desk the most sweeping drug legislation in years in a rare instance of consensus in Congress. The measure, which passed, 92 to 2, would strengthen prevention, treatment and recovery efforts, largely by empowering medical professionals and law enforcement officials with more tools to help drug addicts. It would also expand access to a drug that emergency medical workers could use to help reverse overdoses and improve treatment for the incarcerated. (Huetteman, 7/13)

The Wall Street Journal: Congress Passes Bill To Fight Opioid Abuse, But Funding Clash Continues
The legislation will authorize almost $900 million over five years for prevention, treatment and law enforcement efforts to fight the health crisis. “This is a historic moment, the first time in decades that Congress has passed comprehensive addiction legislation, and the first time Congress has ever supported long-term addiction recovery,” said Sen. Rob Portman (R., Ohio), who along with Sen. Sheldon Whitehouse (D., R.I.) introduced the Senate version of the bill. (O'Keeffe, 7/13)

Stat: Senate Sends First Major Opioids Legislation To Obama’s Desk
The legislation would create a $100 million-per-year grant program within the US Department of Justice to support states in fighting opioid addiction. Programs that offer an alternative to jail time, overdose training for first responders, and prescription drug-monitoring programs are some of the efforts that could be funded. Other provisions include allowing nurse practitioners and physician assistants to administer medication-assisted treatment, undertaking awareness campaigns to try to deter opioid abuse, and requiring the US Department of Health and Human Services to set up a task force on pain management. (Scott, 7/13)

Politico Pro: Without Money, CARA Not Expected To Impact Opioid Crisis Soon
The catch is it doesn’t include a penny to fund them, although Republicans are pledging to provide resources to back up the bill through appropriations later this year. But when Congress returns in September, it’s expected to keep the government running with a continuing resolution, which typically keeps funding flat. “After the confetti has fallen and the champagne corks have popped, people are going to look back and say, ‘Where is this new funding? What are these new programs?’” said Daniel Raymond, policy director of the Harm Reduction Coalition and a supporter of the legislation. (Norman, 7/13)

The Hill: Congress Sends First Major Opioids Bill To Obama's Desk
The slow pace of action from Congress has, at times, drawn fierce criticism from advocates, particularly the families of people who have died of overdoses, who say national and state leaders have ignored the warning signs. Many say the Obama administration and the GOP-led Congress are not thinking big enough to tackle the problem. “I don’t think the speed at which the solutions are being adopted are even close to what they should be based on the enormity of the issue,” Gary Mendell, the founder and CEO of an anti-addiction group called Shatterproof, told The Hill earlier this year. “It’s not right, in relation to the amount of suffering that’s going on.” (Ferris, 7/13)

The Associated Press: Congress Sends Obama Compromise Drug-Abuse Bill
In a statement, the White House said Obama would sign the bill while expressing disappointment that it failed to provide significant money to deal with the epidemic. "Some action is better than none," the White House said, but Obama "won't stop fighting to secure the resources this public health crisis demands. Congressional Republicans have not done their jobs until they provide the funding for treatment that communities need to combat this epidemic." (Daly, 7/13)

Meanwhile, governors are also uniting to battle the epidemic —

The Associated Press: In Rare Show Of Unity, Governors Vow To Fight Opioid Crisis
Nearly every U.S. governor pledged Wednesday to combat the opioid crisis that is leaving a trail of overdose deaths and misery in their states. At least 45 state governors signed on to the Compact to Fight Opioid Addiction committing to fight the epidemic, fueled by the overprescribing of prescription pain relievers. The National Governors Association released the compact ahead of its summer meeting, which starts Thursday in Des Moines, Iowa. (7/13)

8. House Passes Bill To Shield Insurers From Paying For Abortions In Largely Symbolic Vote

A California order requiring health insurance companies to pay for elective abortions was upheld by the Obama administration, so it is unlikely the House-passed "Conscience Protection Act" would become law during his presidency. In other news, a Democratic lawmaker proposes a bill that would protect information about workers' birth control use.

The Associated Press: House Bill Allows Companies To Deny Abortion Coverage
The House backed legislation designed to circumvent a California order that requires health insurance companies to pay for elective abortions. The legislation passed 245-182 on a mostly party-line vote on Wednesday. Republicans say the California order upheld by the Obama administration last month would discriminate against companies and employees that oppose abortion on ethical and moral grounds. (Jalonick, 7/13)

The Hill: House Approves Bill To Shield Anti-Abortion Healthcare Workers
The House on Wednesday approved a controversial abortion bill that supporters say would help shield healthcare providers who refuse to perform the procedure on religious grounds. Anti-abortion lawmakers, including the bill’s chief sponsor, Rep. Diane Black (R-Tenn.), say it would bar state or local governments from penalizing healthcare providers who decline to offer abortions. (Ferris, 7/13)

The Wall Street Journal: Bill Would Forbid Firms From Getting Workers’ Birth-Control Details
A Democratic congresswoman is proposing legislation that would keep employers from accessing data about individual employees’ birth-control prescriptions. The Birth Control Privacy Act, introduced in the House of Representatives on Wednesday by Rep. Suzan DelBene of Washington, would explicitly prevent workplace health vendors from sharing information about individual workers’ use of birth control. Rep. DelBene said she introduced the bill in response to a story published this year in The Wall Street Journal that described how some workplace health programs mine employee health data— such as claims for birth-control prescriptions and other information, including age and search data—to predict whether an employee might be pregnant. (Silverman, 7/13)

Meanwhile, the head of the Susan B. Anthony List talks about her top election priorities —

The Wall Street Journal: Antiabortion Group Lays Out Central Goals For 2016
A prominent antiabortion group says banning terminations after 20 weeks of pregnancy and blocking taxpayer funding of abortion and Planned Parenthood are the key issues that it will use to rally support for its congressional and White House candidates this fall, following recent setbacks in the courts. Marjorie Dannenfelser, president of the Susan B. Anthony List, said at a press conference Wednesday that she was encouraging candidates to focus on aspects of the abortion debate where they have the most support — such as getting a bar on abortions later in pregnancy, and preserving restrictions on federal dollars being used for abortion, or for any services at Planned Parenthood, the clinic network that also provides contraception and reproductive health screening. (Radnofsky, 7/13)

Health Law Issues And Implementation

9. Most Recent Closing Of Insurance Co-Op Leaves Some Customers In Illinois Facing Higher Costs

Customers switching plans may not be able to keep the same doctors and will not be credited for money that they've already paid toward their deductibles and out-of-pocket maximums.

Chicago Tribune: Obamacare Company Shutdown Leaves Customers In A Lurch, Facing Higher Costs
The Illinois Insurance Department moved Tuesday to shut down Land of Lincoln because of its unstable financial health, leaving about 49,000 policyholders in a lurch. They will lose coverage in the coming months, but neither regulators nor the company have said exactly when. Policyholders will be able to buy insurance from a different carrier to cover them for the rest of 2016, according to the state Insurance Department. But switching plans is going to cost them. The co-pays and deductibles enrollees have been paying since January will not transfer to new plans. A new plan will reset deductibles and out-of-pocket maximums paid by consumers. (Sachdev, 7/13)

Kaiser Health News: Seven Remaining Obamacare Co-Ops Prepare Survival Strategies
New failures are piling up among the member-run health insurance co-ops carrying out one of the Affordable Care Act's most idealistic goals, leaving just seven remaining when the health law's fourth enrollment season starts in the fall. There were 23 in 2014. The public knows them as co-ops. They’re officially called consumer operated and oriented plans in the health law. Eleven are still in business, but four in Oregon, Ohio, Connecticut and Illinois will disappear by fall due to financial insolvency. (Galewitz, 7/13)

Morning Consult: Top CMS Official Tries To Defend Co-Ops As Conservatives Label Program A ‘Failure’
A top Centers for Medicare and Medicaid Services official defended the health insurance co-ops created under the Affordable Care Act Wednesday, after four more of the nonprofit insurers announced they would take steps to wind down in recent weeks. Kevin Counihan, the CEO of HealthCare.Gov, told a subcommittee of the House Committee on Oversight and Government Reforms that the co-ops have spurred innovation within the health insurance marketplace and given consumers more opportunities. But Republicans on the panel railed against the program, as about two-thirds of the co-ops have now announced steps to close down. (McIntire, 7/13)

10. Ohio Hospital A Microcosm Of Health Law Implementation Successes And Struggles

University Hospitals in Cleveland have had to adjust to a new way of life under the Affordable Care Act. In other health law news, IRS issues new opt-out payment rules and a look at the difference in premiums from 2016 to 2017 in the marketplaces where information is available.

Cleveland Plain Dealer: Obamacare In Ohio: Hospitals Respond With Innovation And Efficiency, But Care Remains Costly
At Cleveland Clinic, the onset of the Affordable Care Act prompted a massive cost-cutting effort that has trimmed $600 million in expenses over the last three years. University Hospitals has responded to the law by re-engineering the way it does everything from hip replacement surgeries to appointment booking. And MetroHealth Systems is shifting its entire model of care, delivering more preventive care to outpatients to keep them, whenever possible, from becoming hospital inpatients. (Ross, 7/13)

Bloomberg BNA: IRS Proposes Rules On Opt-Out Payments Under ACA
Opt-out payments offered by employers may be used to determine affordability under the Affordable Care Act, depending on whether they are conditional or unconditional, according to IRS proposed rules. Under the proposed rules, opt-out payments, cash payments given to employees who opt-out of their employer-sponsored health insurance, will be treated as a salary reduction for the purposes of determining health insurance affordability if they are considered unconditional. (Elgatian, 7/13)

The Fiscal Times: Here’s How Big The Proposed Price Hikes Are For Key Obamacare Plans
Consumers who purchase their insurance through the public exchanges will likely see prices rise again next year, according to a new analysis of proposed premiums for next year. The Avalere Health analysis of 14 states where data is available finds that premium increases for average silver plans would go up by 11 percent. Lower-cost silver plans would increase a bit less, by 8 percent. The average price of silver premiums for a 50-year-old male non-smoker would increase 11 percent to $508, according to the report. (Braverman, 7/13)

11. Montana Officials Say 47,400 Residents Sign Up For Medicaid Expansion

The report to the legislature also notes that the program has brought in $75 million in federal funding. In North Carolina, the Democratic candidate for governor says he will push for Medicaid expansion.

MTN (Montana) News: More Than 47K Montanans Signed Up For Expanded Medicaid Coverage
Montana’s Medicaid expansion is covering 47,400 low-income people so far this year and has paid for $75 million in care, with federal money, Bullock administration officials told an oversight panel Wednesday. Jessica Rhoades, policy director for the state Department of Public Health and Human Services, said as of May, the program has paid for 11,000 preventive dental exams, 2,600 wellness exams, 3,600 cholesterol screenings and 1,300 vaccinations. (Dennison, 7/13)

Montana Public Radio: Medicaid Expansion Brings $75 Million In Federal Funding To Montana
Montana’s Medicaid expansion also requires recipients with incomes greater than 100 percent of the federal poverty level to pay premiums, averaging $26 a month. Officials say 379 Montanans have been dis-enrolled from Medicaid for failing to pay. The state has collected $1.1 million in Medicaid premiums so far. And the state has saved more than $5 million by shifting some people who previously received Medicaid into the expansion population, and receiving federal reimbursement for them. (Whitney, 7/13)

The Associated Press: Roy Cooper "Jobs Plan" Includes Medicaid Expansion, HB 2 Repeal
Democratic gubernatorial nominee Roy Cooper unveiled his “jobs plan” on Wednesday, promising that if elected, he’ll expand Medicaid and broadband access, cut taxes for the middle class, pass a transportation bond and repeal the law on discrimination known as House Bill 2. ... Supporters say expanding Medicaid to cover hundreds of thousands of uninsured working people would generate health-care jobs and revitalize rural hospitals by leveraging a relatively small amount of state money. The Republican-led General Assembly voted in early 2013 to prevent any such expansion without its approval. (7/13)

In other Medicaid news —

Idaho Statesman: Can Uber-Style Rides Work For Medicaid Patients In Idaho?
The afternoon of June 30, Jeremy Ricky was shutting down his Boise transportation company. As the 14 full-time drivers at Trinity Transport parked their vehicles for the last time, Ricky said a change in a state contract had slashed payments to his business, forcing it to close. He worried the contract also will cause missed therapy or medical appointments for Idaho’s most vulnerable residents. The Idaho Department of Health and Welfare chose a new contractor to arrange transportation for Medicaid patients to go to health care-related appointments. After evaluating bids from five companies, the state hired Veyo, a San Diego startup that uses Uber-like technology in urban areas to move patients in a way it says is more efficient and less costly. (Dutton, 7/13)

Administration News

12. CDC Risk Analysis: Olympics Won't Be To Blame For Spread Of Zika

The estimated 350,000 to 500,000 people headed to Brazil for the Olympic and Paralympic Games represent less than 0.25 percent of the total who traveled to Zika-affected countries in 2015. “The relative contribution of the Olympics is really quite small,” said Martin Cetron, director of the CDC’s division of global migration and quarantine.

The Washington Post: Four Countries Face The Highest Risk Of Zika Virus >From The Olympics
Four countries face the highest risk of a Zika outbreak if a single one of their athletes or travelers becomes infected during the Summer Olympics in Rio de Janeiro, according to a risk analysis published Wednesday by U.S. health officials. The four countries -- Chad, Djibouti, Eritrea and Yemen -- have the factors that could result in a sustained spread of the mosquito-borne virus in a worst-case scenario, according to the Centers for Disease Control and Prevention. (Sun, 7/13)

The Wall Street Journal: Global Zika Risk Is Low For Rio Olympics, CDC Says
The 350,000 to 500,000 visitors expected at the Olympic and Paralympic Games in August and September represent less than 0.25% of the total estimated travel to Zika-affected countries in 2015, the CDC analysis found. Estimated travel to the U.S. from Rio for the Games is 0.11% of all 2015 U.S. travel from countries where Zika is now spreading, the CDC said. “The relative contribution of the Olympics is really quite small,” said Martin Cetron, director of the CDC’s division of global migration and quarantine, who led the analysis. (McKay, 7/13)

Stat: Olympics Pose Direct Zika Threat To Only Four Countries, CDC Says
Brazil’s hosting of the Olympics next month has prompted concern that the games could propel the spread of Zika across the globe. But the event in Rio de Janeiro is unlikely to cause the virus to spread to new places, according to a new report from the Centers for Disease Control and Prevention. The CDC’s risk assessment, published Wednesday, bolsters the case that the games should not fuel much wider spread of the mosquito-borne Zika virus, which can cause birth defects when it infects pregnant women. A key reason: Even though hundreds of thousands of people are expected to head to Rio, they represent only a small percentage of the overall travel to and from areas with Zika transmission. (Joseph, 7/13)

Meanwhile, tensions continue to roil on the Hill over the funding stalemate —

The Hill: GOP Chairman Blasts White House Over Zika Spending
A top GOP chairman is blasting the White House for what he described as millions of dollars that could be used to fight the Zika virus, as Congress is locked in a tense partisan stalemate over funding for the virus. House Appropriations Committee Chairman Hal Rogers (R-Ky.) said Wednesday that the Obama administration has spent just $90 million of the $590 million it redirected from its Ebola virus fund in April to launch efforts against Zika. (Ferris, 7/13)

Morning Consult: McConnell, Ryan Turned Down White House Meeting On Zika, Reid Says
Republican leaders in Congress declined a meeting with administration officials to work on fighting the Zika virus, Minority Leader Harry Reid (D-Nev.) revealed Wednesday on the Senate floor. Still, Majority Leader Mitch McConnell (R-Ky.) said Tuesday that he’s spoken with both President Obama and Health and Human Services Secretary Sylvia Burwell about the issue. (McIntire, 7/13)

And media outlets cover developments out of the states —

The Texas Tribune: First Baby With Zika-Related Microcephaly Born In Texas
A baby boy born with microcephaly in Harris County is the first Zika-affected infant in Texas, the Texas Department of State Health Services announced Wednesday. The baby's mother contracted Zika in Colombia, and the baby was infected in the womb, according Umair Shah, executive director of Harris County Public Health. The baby was born a few weeks ago in Harris County outside of Houston, and tests confirmed that he had Zika on Monday, Shah said. (Taft, 7/13)

Orlando Sentinel: Zika Update: 2 New Cases In Orange County; Florida Total: 293
The number of travel-related Zika cases in Florida is getting closer to 300, including 11 new cases confirmed on Wednesday by the state health department. There have been 25 cases in Orange, 12 in Osceola, nine in Seminole and one in Lake County, since the state began reporting travel-related Zika cases in eary February. (Miller, 7/13)

Richmond Times Dispatch: Virginia Will Begin Testing Mosquitoes For Zika Virus In Targeted Areas
As the number of Virginians infected with the Zika virus jumped to 38 this week, state health care leaders gathered Wednesday to educate the public and share tactics on ways to prevent the virus, which has spread rapidly through Latin America and the Caribbean, from doing so in Virginia. ... There has yet to be a local transmission of Zika — which is spread through mosquitoes and sexual activity — in the U.S. All the reported cases of the illness in Virginia are related to residents traveling outside the country. As of July 7, the number of infected Virginians stood at 33. (Demeria, 7/13)

Pharmaceuticals

13. Even As Public Fury Mounts And Scrutiny Intensifies, Drugmakers Are Still Boosting Prices

U.S. manufacturers' prices of pharmaceuticals rose 9.8 percent from May 2015 through May 2016, the second-highest increase among the 20 largest products and services tracked by the Bureau of Labor Statistics’ Producer Price Index. Meanwhile, Valeant's former CEO sells $100 million in stock, a look at how Gilead avoided paying $10 billion in U.S. taxes and Mark Cuban talks sky high drug prices.

The Wall Street Journal: Drugmakers’ Pricing Power Remains Strong
Pharmaceutical companies’ power to raise prices is firmly intact despite pushback from health insurers, scrutiny by U.S. lawmakers and anxiety about rising prescription drug spending. More than two-thirds of the 20 largest pharmaceutical companies said price increases boosted sales of some or most of their biggest products in the first quarter, according to a Wall Street Journal review of corporate filings and conference-call transcripts. (Walker, 7/14)

The Wall Street Journal: Valeant’s Ex-CEO Michael Pearson Sells Nearly $100 Million In Company Stock
Michael Pearson has sold nearly $100 million of his stock in Valeant Pharmaceuticals International Inc. in the past two weeks, according to securities filings, following his firing as the troubled drugmaker’s chief executive in March. Mr. Pearson sold 288,441 shares on June 30 for $5.8 million, and sold another 411,601 shares for $8.2 million on July 5, according to Securities and Exchange Commission filings. One filing also indicates Mr. Pearson sold another 4,144,687 shares—a large portion of his remaining Valeant stake—for $82.9 million on July 1. (McNish and Grant, 7/13)

The Fiscal Times: Take The Money And Run: How Gilead Sciences Dodged $10 Billion In US Taxes
It was bad enough that Gilead Sciences, the California-based pharmaceutical giant, has been charging seriously ill Americans and government health providers -- including Medicare, Medicaid and the Department of Veterans Affairs – sky-high prices for its drugs that treat the potentially fatal hepatitis C virus. ... In recent years, the company has grown to become one of the largest drug manufacturers in the world, with revenues last year of $32.6 billion. ... Now comes a new report asserting that Gilead has moved a substantial portion of its assets to a tax shelter in Ireland, allowing income from some of its U.S. drug sales to be shifted abroad and taxed at a much lower rate than the top corporate rate of 35 percent in this country. (Pianin, 7/13)

Stat: Billionaire Businessman Mark Cuban Has Something To Say About Drug Prices
Mark Cuban has something to say about prescription drug prices. The billionaire entrepreneur and Dallas Mavericks owner might not seem like an obvious participant in the pharmaceutical debate. But he is a prolific businessman with an established interest in health care and a reputation for blunt talk. ... This week, the star of “Shark Tank” tweeted a link to a Harvard Business Review article that examined price-gouging by some drug companies, particularly with treatments for rare diseases, and what could be done to stop it. (Scott, 7/13)

Meanwhile, drugmakers are fighting hard against legalized marijuana —

The Washington Post: One Striking Chart Shows Why Pharma Companies Are Fighting Legal Marijuana
There's a body of research showing that painkiller abuse and overdose are lower in states with medical marijuana laws. These studies have generally assumed that when medical marijuana is available, pain patients are increasingly choosing pot over powerful and deadly prescription narcotics. But that's always been just an assumption. Now a new study, released in the journal Health Affairs, validates these findings by providing clear evidence of a missing link in the causal chain running from medical marijuana to falling overdoses. (Ingraham, 7/13)

Medicare

14. Medicare Official Suggests New Doctor Payment Formula Could Be Delayed

CMS Acting Administrator Andy Slavitt tells a Senate hearing that administration officials are concerned the needs of small physician practices may not have been addressed yet. In other Medicare news: a study on what age groups spend more on end-of-life care, Sen. Orrin Hatch wants changes to the Stark Law and a hospice agrees to a penalty.

Modern Healthcare: Slavitt Suggests MACRA Could Be Delayed
CMS Acting Administrator Andy Slavitt told lawmakers Wednesday that the agency is considering delaying the start date for Medicare payment reform, which is set to go into effect Jan 1. Testifying before the Senate Finance Committee, Slavitt said the CMS is concerned that some physicians, particularly at small practices, may not be ready for the changes under the Medicare Access and CHIP Reauthorization Act that replaced the much-maligned sustainable growth-rate formula. (Muchmore, 7/13)

Morning Consult: CMS Still Tweaking New Medicare, Children’s Health Reimbursement System
CMS issued a rule with guidelines for implementation of the Medicare payment reform law in April. [CMS Acting Administrator Andy] Slavitt said the agency is listening to stakeholders and considering ways to improve the final rule. “There are a variety of ideas that have been coming to us, and they’re really all on the table at this point,” Slavitt said. (Owens, 7/13)

Morning Consult: Hatch Eyes Movement On Stark Law Changes By Year’s End
The Senate Finance Committee could take action before the end of the year on updating a health care fraud law that physicians say complicates the health care delivery system. Committee Chairman Sen. Orrin Hatch (R-Utah) said at the end of a hearing on the topic Tuesday that the committee would “try to do something about this before the end of the year.” ... While legislative time is limited this year, there’s bipartisan interest in addressing the issue. The Stark law restricts medical referrals of designated health services for Medicare or Medicaid patients if the physician or one of their immediate family members has a financial relationship with the entity they are referring to. (McIntire, 7/12)

The Denver Post: Hospice Care Provider To Pay $18 Million For Making False Claims To Medicare Hospice Funds
A Minnesota-based company that operates in Colorado will pay $18 million after falsely claiming Medicare reimbursement for patients who were not eligible for hospice care. Evercare, now known as Optum Palliative and Hospice Care, settled a lawsuit brought by the Justice Department alleging that the provider knowingly submitted or caused false claims to be submitted to Medicare for hospice care from Jan. 1, 2007, through Dec. 31, 2013. (Cleveland, 7/13)

Public Health And Education

15. Gene Linked To Alzheimer's Affects Brain Development In Children, Study Finds

The findings, published Wednesday by the journal Neurology, suggest that it may be useful to think of Alzheimer's as a developmental disorder. In other news, drugmakers are teaming up to more quickly develop treatments for the disease.

Los Angeles Times: Brain Changes Wrought By Gene Linked To Alzheimer’s May Begin In Childhood, Scientists Say
The gene that makes some people more vulnerable to Alzheimer’s disease as adults also affects the brain development and mental abilities of children, a new study shows. Researchers who examined brain scans of 1,187 kids and teens found distinct patterns in the size and structure of the cortex, hippocampus and other important structures. These patterns were linked with different versions of a gene known as APOE, which may play a role in up to 25% of Alzheimer’s cases. (Kaplan, 7/13)

Boston Globe: New Research Consortium To Focus On Alzheimer’s
Five drug makers, including Cambridge-based Biogen Inc., are banding together with academic scientists to form a research consortium aimed at speeding development of therapies for Alzheimer’s, a neurological disorder that has stubbornly eluded treatments. The new group, which will be formally launched Thursday night at an event at Massachusetts General Hospital, is called the Massachusetts Center for Alzheimer Therapeutic Science, or MassCATS. It will be based at a Mass. General research center. (Weisman, 7/14)

16. AIDS Activist Brings Initiatives On Condoms, Drug Prices To Calif. Ballot

Michael Weinstein, the president of the Los Angeles-based AIDS Healthcare Foundation, is pouring millions into the campaigns to require actors in adult films to use condoms and cap the price state health programs pay for prescription drugs. In other news, New York is trying to bring innovative ideas to the effort to bring HIV under control.

KQED: Sex, Drugs And The Controversial AIDS Activist
As an AIDS activist 30 years ago, Michael Weinstein helped defeat an inflammatory ballot measure that could have quarantined Californians with the disease. Today, Weinstein has turned to the ballot to advance his own controversial vision for public health. President of the Los Angeles-based AIDS Healthcare Foundation, which has clinics around the world, Weinstein is the architect of two initiatives Californians will vote on in November: Proposition 60, which would require actors in adult films to use condoms, and Proposition 61, which would cap the price state health programs pay for prescription drugs. (Rosenhall, 7/13)

In other California ballot measure news —

California Healthline: Hospital Finance Measure On State Ballot May Stump Voters
California voters will be asked to weigh in this November on a hospital financing measure so politically and financially complicated that they might be tempted to avoid it altogether. The initiative, Proposition 52, would make permanent the “Hospital Quality Assurance Fee,” which the state collects from private hospitals to bring in additional federal dollars for Medi-Cal, California’s version of the federal Medicaid health care program for the poor. The federal government matches money that California puts up to fund Medi-Cal services. (Bartolone, 7/13)

17. Public Health Roundup: Why Do Cancer Immunotherapies Fail After Success?; Next-Gen Prosthetics Leverage Brain Power

Public health developments related to skin cancer, superbugs, a link between kids' sleep patterns and obesity, America's lower birth rates and the risks of medical tourism also make the news.

The Washington Post: Here Are Some Ways Cancer Can Thwart The New Immunotherapy Drugs
A new type of cancer drug designed to unleash the immune system is revolutionizing treatment for advanced melanoma, lung cancer and other malignancies. But some patients who initially respond to the therapy relapse, and researchers are anxious to figure out how and why the delayed resistance occurs. "Does the immune system stop working, or does the cancer change so that it's no longer responding to the immune system?" said Antoni Ribas, director of the Jonsson Comprehensive Cancer Center Tumor Immunology Program at the University of California at Los Angeles. (McGinley, 7/13)

Stat: Next-Generation Prosthetics Aim To Rewire The Brain And The Body
As program manager and chief engineer for the Johns Hopkins University’s Applied Physics Laboratory, (Michael) McLoughlin helped lead the development of “modular prosthetic limb” technologies, which have helped amputees experience lifelike movement of prosthetic limbs. The initiative has been backed by roughly $120 million from the Defense Advanced Research Projects Agency, or DARPA, and leverages new neurological sensor technology and robotics. (Tedeschi, 7/13)

Los Angeles Times: A Genetic Link Between Red Hair, Freckles And Skin Cancer
Whether you call them gingers, the devil’s spawn or just-plain sexy, be sure to call redheads out of the sun because along with their fiery tresses comes a powerful propensity to develop melanoma, a particularly deadly form of skin cancer. And now, scientists are beginning to uncover why redheads — and probably the non-gingers who carry a genetic variant common to redheads — may be so vulnerable: For those who carry an allele, or gene variant, associated with red hair and freckles, cancer-causing genetic mutations occur at a rate 42% greater than they do for people who don’t carry that gene variant. (Healy, 7/12)

Stat: The Superbugs Are Winning The Battle Against Us
This is totally sleeper phase right now … you want to get your arms around it before it really wakes up.” That’s Anthony Fauci, head of the National Institute of Allergy and Infectious Diseases. He’s talking about the scariest new threat in one of the biggest public health problems of our time. The threat: a deadly new superbug that’s just starting to surface. The problem: the rise of antibiotic resistance. Public health officials are warning we could be headed toward a post-antibiotics world, unless we do something, and fast. So where do we start? Inside a cave. (Tirrell and Timmerman, 7/14)

The Columbus Dispatch: Preschoolers Late For Bed May End Up Obese Teens
Here’s another reason to tuck your young children into bed early: It might help lower their risk of obesity during their teenage years. Ohio State University College of Public Health researchers say early bedtimes are an integral part of developing healthy behaviors that can last a lifetime. Sarah Anderson, an associate professor of epidemiology and lead author of the study, said poor sleep, especially not getting enough, is a known risk for obesity. (Fochesato, 7/14)

Graphiq: America's Decreasing Fertility Rate Could Spell Economic Trouble
In the late 1950s, American women could expect to have 3.7 children, on average. By 2014, that number had dropped to 1.9. Women around the world are having fewer children than ever, and this decline in fertility rates could spell trouble for some countries. While those who believe that the world is already overpopulated consider this trend a good thing, countries in which the fertility rate is lower than the replacement rate might struggle economically in the future. (Perrym, 7/13)

Stat: Cut-Rate Tummy Tucks Blamed For An Outbreak Of Nasty Skin Infections
The Centers for Disease Control and Prevention is warning Americans about the risks of “medical tourism” after nearly two dozen US residents contracted serious infections related to cosmetic surgery in the Dominican Republic.The 21 people affected were all women who underwent surgeries including liposuction, tummy tucks, butt implants, and breast reduction at one of five clinics in the Dominican Republic in 2013. In the process, they were infected with rapidly growing mycobacteria, organisms that thrive in dirty water and may enter the body during a procedure in an unsterile environment. (Seervai, 7/13)

State Watch

18. Report: Health Care Has Vastly Improved Across U.S., But Progress Remains Uneven

The Commonwealth Fund has released a new scorecard on health systems across the U.S. Nationally, health care systems in Hawaii, the upper Midwest, New England and the San Francisco area generally performed better than systems in the South and West.

The Baltimore Sun: New Scorecard Ranks Baltimore In Top Third Of Cities For Health
Health care improved across the U.S. in the three years ending in 2014, though progress was uneven around the country, according to a new scorecard released by the Commonwealth Fund. The nonprofit health research group looked at three dozen indicators in 306 localities nationwide that were grouped into categories, including access and affordability of care, prevention and treatment, potentially avoidable hospital use and cost, and health behaviors and outcomes. (Cohn, 7/14)

Georgia Health News: Ga. Health Care Markets Show Improvements, But Also Big Gaps
Seven Georgia urban markets saw general improvement in their health care systems from 2011 through 2014, according to a new national study released Thursday. But each of the seven metropolitan areas was ranked in the bottom half of the 306 U.S. communities evaluated in the Commonwealth Fund’s health system ‘’scorecard.” Atlanta received the highest ranking among the Georgia markets, at 189. It was followed by Columbus, at 207; Augusta, 229; Savannah, 247; Albany, 256; Macon, 294; and Rome, 298. (Miller, 7/14)

Sarasota Herald-Tribune: Sarasota Health Market Strongest In State, Report Finds
Sarasota had Florida's strongest local health system in 2014 in terms of access and affordability of care, prevention and treatments, avoidable hospital use and healthy lifestyles, according to a nationwide report from The Commonwealth Fund, a nonprofit research group focused on promoting a health system that improves access and quality for all people. (7/14)

Greenville News: Greenville Area Drops In National Ranking Of Health
The greater Greenville County area fell six places on a national scorecard ranking the health status of communities between 2012 and 2016, a new report shows. But that has more to do with greater rates of improvement in other communities than declines here, a scientist involved in the rankings said. The region dropped from 178 to 184 in a ranking of 306 communities by The Commonwealth Fund, a private foundation that advocates for a better health care system. (Osby, 7/14)

Arizona Daily Star: Tucson Could Improve Its Health, New Report Says
When it comes to health, a new report says that where you live matters — and that in Tucson there’s room for improvement. Data from a New York-based nonprofit, The Commonwealth Fund, ranks Tucson 163rd out of 306 metropolitan areas in a score based on 36 indicators of health care and health quality. Phoenix ranked below Tucson, at 180th. Honolulu, Hawaii, was ranked first and Hattiesburg, Mississippi, was ranked last. (Innes, 7/14)

19. State Highlights: Calif. Considers Injured-Worker Protections Against Banned Medical Providers; Catastrophic Claims On The Rise In Tenn.

Outlets report on health news from California, Tennessee, Missouri, Ohio, Minnesota, Texas and Florida.

The Center For Investigative Reporting: California Bill Could Protect Injured Workers From Convicted Providers
California lawmakers are advancing a bill that would bar medical providers who’ve been convicted of felonies from treating injured workers. The bill would require the state Department of Industrial Relations to ban medical providers who have also been stripped of a medical license or excluded from Medicare or Medi-Cal for a fraud-related offense. Citing a recent investigation by Reveal from The Center for Investigative Reporting, bill author Assemblyman Adam Gray, a Merced Democrat, told the Senate labor committee on June 29 that the state needs to stop letting people care for injured workers after they are locked out of other government health programs. (Jewett, 7/13)

The Tennessean: Report: Catastrophic Health Insurance Claims Rise For Businesses
Tennessee is among the most expensive states in the country for high-cost medical, or "catastrophic," claims, according to a report from SunLife Financial that analyzed its stop-loss insurance data. The state, along with Alabama, Kentucky and Mississippi, had the highest claim charges associated with what are called catastrophic claims – 27 percent higher than the national average. It was the most expensive region analyzed in the 2016 Catastrophic Claims Conditions report. (Fletcher, 7/13)

Cincinnati Enquirer: Kasich Signs Bills Addressing Developmental Disabilities
In a room lined people with developmental disabilities, Gov. John Kasich signed into law two bills Wednesday he believes will alleviate some of the burden they and their families face. ... Kasich signed two different bills at the St. Joseph Home in Sharonville: House Bill 483, which is aimed to allow more direct nursing from health care staff among other provisions and House Bill 158, which replaces all phrasing of “mental retardation” in the Ohio Revised Code with “intellectual disability.” (Samarghandi, 7/13)

Star Tribune: Minnesota's Health Tech Firms Saw Big Funding Increase In First Half
Minnesota health technology firms saw another sharp increase in investment capital in the first half of the year, according to an industry survey. Through June 30, 64 companies raised $227 million, about $174 million of which came in the second quarter alone, according to research published Wednesday by trade group Medical Alley Association. (Son, 7/13)

The Texas Tribune: See Which Texas Schools Have High Vaccine Exemption Rates
In Travis County, where residents are among the best educated in Texas, efforts by national medical groups to debunk concerns about vaccines appear to be meeting some of the strongest resistance. Parents of school-aged children there are choosing to avoid vaccine requirements at among the highest rates in the state, according to state data. (Smith and Daniel, 7/14)

Health News Florida: Want To Watch A Surgery? Just Log Into Facebook
Dr. Castellano, a plastic surgeon working out of his offices in a retirement community about two hours north of Tampa... has been broadcasting surgeries live for just over a year now, and has posted more than 400 videos. He started with wearable tech, like Google Glass, but found it too limiting, so he moved on to streaming straight from his smartphone. (Miller, 7/14)

Star Tribune: Feds Taking A Close Look At Abbott's Proposed Purchase Of St. Jude Medical
Federal antitrust regulators are closely scrutinizing the proposed $25 billion tie-up of local medical device-maker St. Jude Medical and its much larger acquirer, Chicago-based health care products maker Abbott Laboratories. After market-close Tuesday, the companies alerted investors that they had received a “second request” for information about their proposed deal from the Federal Trade Commission, which regulates anticompetitive mergers and acquisitions. (Carlson, 7/13)

San Antonio Express-News: Marathon Oil Sued Over Use Of Workers’ Health Care Funds
Marathon Oil Co. is accused in a lawsuit of teaming up with an insurance company to embezzle Marathon employee health care funds. The suit, filed by Redoak Hospital in U.S. District Court in Houston, alleges that Marathon entered into “an unlawful agreement” with United Healthcare that allows the Minneapolis-based insurer to use money set aside by Marathon and its workers to cover the health care expenses incurred by employees and dependents of unrelated companies, according to the case filed last month. (Sixel, 7/13)

Weekend Reading

20. Longer Looks: Skip The Pain, Take The Epidural; What's For Breakfast? Might As Well Be Dessert

Each week, KHN finds interesting reads from around the Web.

The New York Times: Get The Epidural
It’s interesting that no one cares very much about women doing anything “naturally” until it involves their being in excruciating pain. No one ever asks a man if he’s having a “natural root canal.” No one ever asks if a man is having a “natural vasectomy.” This is why I generally believe, and of course I know there are exceptions, but I’m just saying, usually, you should get the epidural. (Jessi Klein, 7/9)

Vox: We Need To Call American Breakfast What It Often Is: Dessert
In America, breakfast is often nothing more than disguised dessert .... Look no further than the menu at IHOP, where dessert for breakfast reigns. You can find such items as New York cheesecake pancakes or raspberry white chocolate chip pancakes, which come with a whopping 83 grams (nearly 21 teaspoons) of sugar. Remember that the government recommends no more than 12 teaspoons of sugar per person per day (though the average American consumes 23.) ... And yogurt? The fermented dairy product has the patina of a health food, thanks to its protein and beneficial bacteria. Yet companies like Yoplait and Chobani have built yogurt empires in America by saturating their products with sugar. (Julia Belluz and Javier Zarracina, 7/11)

Stat: A Black Psychiatrist Reflects On Race In Medicine, And Being Mistaken For A Fix-It Man
Dr. Damon Tweedy was one of the first African-Americans to earn a scholarship to Duke Medical School, back in 1996, when the school was trying to encourage more diversity in its ranks. The son of a grocery store worker, Tweedy grew up in an all-black neighborhood where his older brother was the only person he knew who went to college without a sports scholarship. Now a psychiatrist at Duke, Tweedy says he has been frustrated about the quality of medical care he can provide for patients who are uninsured, many of whom are African-American. He has also written, in a New York Times best-selling book, “Black Man in a White Coat,” about the racially charged experiences he had as a student and young doctor. (Karen Weintraub, 7/12)

Vox: When My Dog Died, I Didn’t Understand Why It Felt Like A Human Had Died. Then I Read The Research.
No one ever tells you that when your dog is dying, it feels like a human is dying. At first, I tried to suppress the grief. But so many other dog owners said things like, "It felt like a family member had died." As a data person, all I could see was a growing sample size. So instead of mourning — or maybe this was my mourning — I sat next to Rainbow during her final days, and I read research papers and books about humans' relationship with dogs. As it turns out, we really are two species with an odd, symbiotic relationship. (Alvin Chang, 7/11)

Health Affairs: Beating A Cancer Death Sentence
Several months ago, my wife, Françoise, and I attended something novel for melanoma patients: a survivors’ dinner. People said they wanted to make it an annual gathering. Planning anything that far in advance had been pointless for me. Two years ago, I was about to accept hospice care. When I was first diagnosed in 1996, early surgery was the only reliably successful treatment. Anything more advanced was essentially a death sentence. Over the past five years, a series of revolutionary drugs have given me and many other people a surprisingly hopeful prospect. Nevertheless, the drugs’ development process has often been excruciating for clinical trial participants, and their remarkably high costs limit their value. (Jonathan Friedlaender, 7/6)

JAMA: National Academies Hit The Brakes On Gene Drive–Modified Organisms
Despite their potential for fighting Zika, malaria, and other public health scourges, organisms that have been engineered to quickly spread genetic modifications through a population—and possibly an entire species—are not ready for release into the wild, a committee of interdisciplinary experts concluded in a recent report by the National Academies of Sciences, Engineering, and Medicine. So-called gene drive–modified organisms “require more research in laboratories and highly controlled field trials,” the committee said in a statement. (Jennifer Abbasi, 7/13)

Meanwhile, Politico takes an in-depth look at issues surrounding the health law —

Politico: Obamacare’s Sinking Safety Net
If you’re looking to find a smashing Obamacare success story—a place where the nation’s biggest and most controversial new law in a generation has truly lived up to its promise—you might stick a pin directly in North Carolina. The central pledge of the Affordable Care Act was to make insurance available to people who didn’t have it, creating a new safety net for millions nationwide. And in North Carolina that's exactly what happened. ... But if you’re looking for a quintessential Obamacare failure story, you might also stick that pin directly in North Carolina. (Paul Demko, 7/13)

Politico: Obamacare, The Secret Jobs Program
It was the first week of March 2009, and inside the White House, the grand policy aspirations of the young Obama administration were colliding with stark economic reality. On Thursday, March 5, President Barack Obama hosted a summit to kick off his health reform push. On Friday, the S&P 500 hit its lowest point in a decade. But in the Eisenhower Executive Office Building next door, for all the talk of expanding health coverage and striking bipartisan deals, aides wrestled over a deeper question: Should they push harder to control America’s runaway health spending, even if it killed jobs in the short term? (Dan Diamond, 7/13)

Politico: The War Of The Charts
In 2009, Rep. Kevin Brady made the rounds at Fox TV, ABC News and The Drudge Report as a newly minted internet star. The source of the Texas Republican's fame was a stunningly impenetrable graphic created by his staff—65 boxes in six garish colors, interlinked in uncountable ways. The title: “Organizational Chart of the House Democrats' Health Plan.” Within hours, it was available for purchase on a T-shirt with the caption, “Where is MY doctor?” (Nicole Narea, 7/13)

Politico: The Wrong State To Have An Accident
In December 2014, Donnie Gene Rippy fell off a roof while shooing away ducks, breaking his back and too many bones to count. He underwent four surgeries to fix his shoulder, wrists and vocal cords. Rippy, a brick mason, had the misfortune to be uninsured. But his bad luck was compounded by where his accident happened. If he had lived about 50 miles north—that is, anywhere over the Kentucky border—he wouldn't have to rely on ibuprofen and occasional cortisone shots from a local health department for his persistent back and knee pain. Chances are good he would also have gotten treatment for the memory and mood issues that developed after the fall. And he wouldn't be mired in more than $60,000 in medical debt. (Rachana Pradhan, 7/13)

Politico: Survey: Time To Stop Fighting, Start Fixing
As Barack Obama nears the end of his presidency, the legacy and future of his health care program is very much in play. Where are the fights going break out? What should happen next? POLITICO surveyed a wide range of health care thinkers to project the law’s future and offer their suggestions. (Danny Vinik, 7/13)

Politico: Repeal. Defund. Repeat.
Ever since the Affordable Care Act passed in 2010 without a single Republican vote, the GOP has mounted a steady stream of attempts to repeal it, defund it, or dismantle crucial pieces of the law—no fewer than 80 times so far in the House of Representatives alone. A few were reforms that President Barack Obama signed into law. The rest were veto bait—everything from defunding abortion services (a frequent move) to all-out nuclear attacks that would blow the entire 900-page bill to pieces. While nearly all these moves were doomed from the start, they’ve made for some impressive political theater over the past five years—and speak to the focus with which Obama’s opponents in Congress have seized on the law as a political weapon. (Nicole Narea, 7/13)

Politico: ‘Affordable Care’? Not So Fast.
The word is right there in the name of the law: “Affordable.” The ACA promised to bring health insurance down to earth, letting uninsured people buy policies that didn't break the bank, and bringing the astonishing cost of medical care into reach for all Americans. What's becoming clear, three years in, is that “affordable” depends where you look. Twenty million more people are covered and tens of millions of others have broader benefits because of Obamacare. But many insurers, faced with new coverage requirements and competition on premiums, have shifted costs onto consumers. (Nancy Cook, 7/13)

Politico: How LBJ Pulled Off The Biggest Government Maneuver Since D-Day
It was the largest expansion of the American welfare state since 1935. It imposed the federal government between patients and their doctors. Conservatives hated it; liberals loved it. And no one knew whether it would work. When Medicare launched in July 1966, almost 50 years ago today, nothing like it had ever been attempted in the United States: a new national health care plan, financed by payroll taxes and voluntary contributions, offering roughly 20 million seniors automatic hospital coverage and an affordable, government-subsidized insurance program for doctors’ visits. Logistically it was an utterly unclimbed mountain. In a day when “communications technology” meant snail mail and the rotary telephone, the new Medicare administration would have to find those seniors, tell them about the program and get them to sign up. (Josh Zeitz, 7/13)

Editorials And Opinions

21. Viewpoints: Obama's Assessment Of The Health Law; GOP And Drug Prices; Better Medicare

A selection of opinions on health care from around the country.

The New York Times: Obama On Obamacare’s Flaws: An Assessment
President Obama has published an essay on Obamacare in The Journal of the American Medical Association. While it hit a lot of the Affordable Care Act’s high points, it was also pretty frank that the health law has some weaknesses that need to be fixed. Margot Sanger-Katz and Reed Abelson, two New York Times reporters who have been covering Obamacare, discuss the policy changes that the president wants. (Reed Abelson and Margot Sanger-Katz, 7/13)

Forbes: The GOP Needs To Tackle The High Price Of Prescription Drugs
Last month, House Speaker Paul Ryan unveiled the GOP’s comprehensive plan for health reform. It included 30-odd pages of constructive proposals for replacing Obamacare, reforming entitlements, and promoting innovation. But the plan was also notable for what it didn’t contain: a clear plan to tackle the high and rising price of branded prescription drugs. Like objects in the rear-view mirror, drug prices are a bigger problem than they seem. (Avik Roy, 7/12)

Cincinnati Enquirer: Close The Generic Drug Safety Loophole
In April 2009, my daughter Kira’s supervisor called me one morning to say she hadn’t shown up to work. I went to her apartment and found her lying on her couch, turning blue. ... Her biggest health problem was a torn ACL, not exactly a life-threatening condition. Her doctor prescribed her propoxyphene, the generic form of the painkiller Darvon, while she awaited ACL surgery. My husband and I didn’t think it was a big deal. Kira died just a few days after she started taking the drug. (Tammy Gilbert, 7/13)

Forbes: A New Vision For Medicare: Breaking Down Barriers Between Medical Treatment And Personal Care
Medicare needs to better serve a population of older adults who live longer and with more chronic conditions than they did in the 1960s. Medicare’s fee-for-service acute care model may have worked well in the days when treating heart attacks and strokes were a primary focus of health care. But in the past half-century, medical science has turned heart disease and even some cancers into chronic conditions. Unfortunately, these advances have also made it possible for more of us to live long enough to show symptoms of dementia. Roughly 90 percent of Medicare dollars are spent on seniors with chronic conditions. Those profound changes require a model of care that fully integrates medical treatment with personal assistance and social supports. (Howard Gleckman, 7/13)

Stat: What The Fading Ebola Epidemic Can Teach Us About The Looming Zika Crisis
As the world’s worst Ebola epidemic fades in the rearview mirror of history, it’s worth remembering what happened and the key lessons learned. ... Quick action taken by Congress to provide desperately needed funding and other resources was critical to CDC’s ability to stop Ebola and build safeguards needed to prevent an Ebola resurgence. Yet no such action has yet been taken on Zika, despite the dire threat the virus poses to pregnant women and their developing fetuses. (Thomas R. Frieden, 7/13)

Stat: Stop Using The Zika Virus To Attack Planned Parenthood
Imagine a virus for which there is no vaccine that can be sexually transmitted and lead to devastating birth defects. Imagine also that a powerful tool is available to combat it. You would expect — even demand — that policymakers immediately make that tool as widely available as possible. That virus, the Zika virus, is here today. But Republicans in Congress are ignoring medical science by trying to restrict access to family planning, a proven form of protection from Zika’s harms, as part of their ongoing and dangerous crusade against women’s health care providers. (Dawn Laguens, 7/14)

Bloomberg: Utah's Ban On Planned Parenthood Funding Deserved To Be Reversed
A federal appeals court has ordered Utah Governor Gary Herbert to reinstate contracts with the state's Planned Parenthood chapter. Herbert had unilaterally suspended the funds after the release last summer of misleading videos that purported to show unrelated Planned Parenthood officers discussing the sale of fetal tissue. The court said Herbert had likely violated the Utah chapter’s free association rights and the right to abortion itself. The decision, reversing a federal district court judge based in Utah, is a useful reminder of why regional appeals courts are so valuable. (Noah Feldman, 7/13)

The New England Journal of Medicine: Beyond Bathrooms — Meeting The Health Needs Of Transgender People
Visibility of transgender people and support for transgender rights have increased dramatically in recent years. ... Despite these shifts, transgender people still face substantial discrimination. ... The 2008–2009 U.S. National Transgender Discrimination Survey revealed that 28% of transgender adults experienced harassment in medical settings, 19% reported being refused care, and 28% postponed care because of discrimination; 50% of those who received care reported having to teach their clinicians about transgender care. Transgender people need clinicians who can provide proper health care. (Mark A. Schuster, Sari L. Reisner and Sarah E. Onorato, 7/14)

JAMA Psychiatry: Mental Illness And Firearms Background Checks—Combatting Violence Without Inhibiting Care
[T]he US Department of Health and Human Services (HHS) recently published a final regulation that amends the Health Insurance Portability and Accountability Act (HIPAA) Privacy Rule to enable disclosures to the federal background check system under specified circumstances .... [It authorizes] certain disclosures [but] tailored the permission in recognition of the importance of encouraging individuals to seek psychiatric care. Notably, the rule limits: (1) who can make such disclosures ... (2) to whom the disclosures may be made ... and (3) what may be disclosed .... The rule balances important values, including the public safety function of the NICS and the confidentiality of care, on which patients’ willingness to undergo psychiatric treatment often hinges. (Charles G. Kels, Jennifer A. Bernstein and Y. Tony Yang, 7/13)

The Dallas Morning News: Mental Health Bill Could Help Millions Receive Help
Faced with an issue as important as revamping the nation's mental health system, Congress has largely failed to get those struggling with mental health issues the help they require. Last week marked a sea change in our nation's mental health debate. In one of those rare moments when bipartisanship defeats political inertia, the House voted 422-2 for HR 2646, the Helping Families in Mental Health Crisis Act. (7/13)

The Witchita Eagle: Kansas Mental Health Centers Take Hits
Some legislative incumbents and candidates act as if the governor’s budget-balancing is just responsible fiscal management, without pain or other consequences. Those on the front line of community mental health in Kansas have a different view ... The Brownback administration’s 4 percent cut to Medicaid reimbursements as of July 1 is among the causes for concern. But the state also ended a short-lived “health homes” pilot program that had coordinated care for some mentally ill people with chronic medical problems, and a Medicaid mental health screening program (objected to by federal officials) that aimed to guide some patients into community-based rather than inpatient treatment. (Rhonda Holman, 7/13)

Deseret News: Why Not Expanding Medicaid Was The Right Choice For Utah
For those of us in the Utah Legislature who have opposed Medicaid expansion, the biggest stumbling block has always been the potential burden it places on our state and our taxpayers. There is no budget certainty with such an arrangement, and the danger becomes even greater when we realize that once we commit, we are obligated to pay whatever the costs may be, but the federal government can, at any time, change the rules as it has done over and over since the implementation of the ACA. (Utah House Speaker Greg Hughes, 7/13)

Sacramento Bee: Shady Union-Hospital Deal Is Double-Crossing Voters
California voters have been duped, defrauded and double-crossed twice, and now they’re being fed an outrageously disingenuous lie to cover it up. Earlier this month, a judge blocked an attempt by Oakland-based Service Employees International Union-United Healthcare Workers West to place on the November ballot an initiative to limit the pay of nonprofit hospital executives. Why did the judge block it? (Sal Rosselli, 7/13)

Georgia Health News: Summer Is Not A Time Off For ADHD Treatment
It is a common misperception that once school is out for the summer, psychiatrists who treat attention-deficit/ hyperactivity disorder can slow down a bit. In fact, the summer months are a critically important time for ADHD treatment and shouldn’t be overlooked. We all believe that summer for kids should be filled with time at the beach, camping and other fun activities. But for a child coping with ADHD, the symptoms don’t just disappear when the last bell of the school year rings. These kids continue to have problems paying attention and controlling their behavior. (Mary Burns, 7/13)