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2. Political Cartoon: 'Hand To Mouth'

Kaiser Health News provides a fresh take on health policy developments with "Political Cartoon: 'Hand To Mouth'" by Dave Coverly, Speed Bump.

Here's today's health policy haiku:

EXCHANGE: HOSPITAL OUTLIERS COULD BE CUT

Poor performers out?
Maybe in California …
The market reacts.

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Summaries of the News

Supreme Court

3. Contraception Case Faces Possible 4-4 Split After Scalia's Death

If at least five Supreme Court justices fail to agree on a decision on the contraception mandate, it would leave lower court's decision intact, creating different rules for different parts of the country.

The Associcated Press: Scalia's Death Could Affect Politically Tinged Cases
Challengers in two politically tinged cases before the Supreme Court this week face the seemingly insurmountable problem of being unable to count to five — as in five votes. The death of Justice Antonin Scalia has deprived conservatives of a reliable vote on a range of issues, including the design of congressional districts in Virginia and the Obama administration's effort to accommodate faith-based groups that object to paying for contraceptives as part of their health insurance plans. (Sherman, 3/18)

Pharmaceuticals

4. As Public Outcry Swells, Chances Of Lowering Drug Prices Still Remain Close To Nil

Congress would need to act to make a dent in the astronomical cost of drugs, but pressure from the pharmaceutical industry and political gridlock have stymied action. Meanwhile, a new study finds that nearly half of all Americans 75 and older took five or more prescription drugs in 2011, a trend which has significant financial ramifications.

The Associated Press: No Clear Path To Government-Lowered Drug Prices
Most Americans support it. Virtually all other developed countries already do it. And the two leading presidential candidates on both sides of the aisle agree: the federal government should lower drug prices. But experts say the chances for government action in the near-term are close to nil. The reasons are familiar: political gridlock in Washington, pharmaceutical industry influence and the structure of the U.S. health system itself, which limits government intervention. (Perrone, 3/18)

CBS News: The High Cost Of Seniors' Soaring Rx Drug Use
A recent study found that almost half (47 percent) of Americans age 75 and older took five or more prescription drugs in 2011, nearly double the 24 percent that did so in 1999, just 12 years earlier. The comparable percentage for Americans 65 to 74 also increased significantly -- from 23 percent in 1999 to 33 percent in 2011. (Vernon, 3/21)

Marketplace

5. Insurance To Cover Critical Illnesses Becoming More Popular, But May Prove Costly

As consumers find their general health plans have higher deductibles, they are increasingly turning to policies that cover specific -- and expensive -- illnesses, such as cancer. But consumer advocates question the cost. Also, a look at cancer treatment expenses and surprise bills that some people receive after getting out-of-network care.

The New York Times: Insurance For Critical Illness May Add Security, But At A Cost
It’s often pitched as an insurance policy for your health insurance policy.The product, known as critical illness insurance, promises to pay a lump sum, anywhere from $5,000 to $100,000, after someone receives some sort of dreaded diagnosis, like cancer, a heart attack or a stroke. And the coverage is not terribly expensive; if you are in your 40s, it might cost $25 to $50 a month. These policies have become increasingly popular, partly because they are being marketed as a way to provide another layer of financial support now that consumers are shouldering an ever-rising share of medical expenses out of pocket. ... But some consumer advocates and health policy analysts have questioned whether these policies are worth the expense, partly because they are so narrowly focused. (Bernard, 3/19)

The Richmond Times Dispatch: For Many, Cancer Sets Off Financial Crisis
Cancer is a health crisis that for many sets off a financial crisis. In a study done by Virginia Commonwealth University School of Pharmacy researchers, nearly one-third of cancer survivors reported that their illness had caused financial problems. The patients who reported the most financial problems also reported more physical and mental health problems. Having health insurance was not a guarantee that a person would not face money problems. (Smith, 3/18)

USA Today/The Tennessean: 'Surprise Bills' Shock Those Who Choose In-Network Care
Because patients get billed by individual providers, a patient can go in-network but still get hit with an out-of-network charge. ... The inadvertent out-of-network bills are called “balance billing” because patients pay the difference between the insurance plan's out-of-network benefits and the provider's rack-rate charge, which is often considerably higher than the negotiated amount with an insurer. Some insurance plans offer little to no out-of-network coverage. Hospitals encourage the doctors to accept the same insurance plans and networks as the hospital — but it’s not required. (Fletcher, 3/18)

6. Hospitals, Insurance Companies Acquire Urgent Care Clinics As Their Popularity Grows

More Americans are turning to urgent care clinics, and patients are finding the dual benefit of the ones that are attached to a hospital: convenience but with a safety net if their problem proves more serious than they thought.

The Wall Street Journal: Traditional Providers Get Into The Urgent-Care Game
When it comes to health issues that need immediate attention but aren’t life-threatening, more Americans are turning to urgent-care centers—and traditional health-care providers are getting into the game. Over the past two years, hospital chains and insurance companies have snapped up urgent-care centers in a spate of mergers and acquisitions. Health systems, too, are moving into this space, striking joint ventures with independent urgent-care operators, says Tom Charland, chief executive of consulting firm Merchant Medicine. (Landro, 3/20)

7. Advocates Warn Return Of House Calls Puts Strain On Limited Physician Field

As new apps allow patients to bring a health care provider to their house with a click of a button, there are those who think the model won't scale with the current shortfall of doctors. But in other news, home visits pay off for new mothers and kids with asthma.

Los Angeles Times: The Return Of Doctor House Calls: Convenient, But At What Cost?
Dr. Sam Kim works for Heal, a Los Angeles-based start-up that allows patients in several California counties to order doctor house calls through a smartphone app. Similar companies exist in other parts of the country, including Pager in New York City and Mend in Dallas. Health advocates generally support using technology to make medical care more convenient. As these companies grow, however, some question the return of the house call. A century ago, most medical visits were in the patient's home. But cities got bigger and doctors began using more equipment, therefore it made sense for them to not travel more than 10 steps from patient room to patient room. (Karlamangla, 3/19)

PBS NewsHour: How Home Visits For Vulnerable Moms Boost Kids’ Brainpower
A rapidly expanding medical program for low-income first-time mothers combines social services with the latest in brain science. The Nurse-Family Partnership provides in-home advice on health and parenting, which can lead to improved cognitive development and language skills for their children, who are showing up to school better prepared for learning. Special correspondent Cat Wise reports. (3/18)

The Des Moines Register: Home Inspections Seek Root Of Kids' Asthma Attacks
Kevin Ochoa’s family is getting unusual help in answering a vexing riddle: Why is he having so much trouble breathing? The Des Moines sixth-grader suffers severe asthma attacks, which routinely send him to the hospital. The situation is frightening, painful and expensive. Last week, a team of experts came to his south-side home to help figure out if something there was triggering Kevin’s lung spasms. (Leys, 3/18)

8. Johnson & Johnson Seeks To Settle Cases Linking Uterine Cancer To Surgical Device

The cases involve a laparoscopic power morcellator made by J&J that doctors now fear helped spread undetected cancers. Also, the Food and Drug Administration is looking at the possible malfunctioning of devices that measure blood clotting and are commonly used in homes and doctors' offices.

The Wall Street Journal: Johnson & Johnson Settling Cases Tied To Device That Can Spread Uterine Cancer
Johnson & Johnson is settling a series of legal claims and lawsuits alleging that its now-discontinued hysterectomy device harmed women by spreading an undetected hidden cancer, according to court documents and plaintiff lawyers with knowledge of the settlements. An estimated 100 cases have either been filed—or readied for lawsuits—against J&J’s Ethicon unit related to a device known as the laparoscopic power morcellator, said Paul Pennock, a plaintiff lawyer and co-lead counsel on the steering committee for consolidated litigation under way in a Kansas City, Kan., federal court. (Levitz, 3/18)

The Wall Street Journal: FDA Weighs Danger Tied To Blood-Monitoring Devices
The Food and Drug Administration is striving to assess the scope of the danger from medical devices that sometimes produce erroneous readings of how quickly patients’ blood tends to clot when they are taking anticoagulant medicines such as warfarin. The small mobile devices, used in patients’ homes and in doctors’ offices, have malfunctioned in thousands of cases over the years, according to the FDA. (Burton, 3/18)

Public Health And Education

9. Puerto Rico's Landscape, Climate and Economy Create Perfect Storm For Zika Outbreak

One-quarter of the population is expected to be infected with the virus within a year, and up to 80 percent could be eventually affected overall. In other Zika news, if the virus starts spreading in the U.S. it could set off a political debate just in time for the presidential election, the CDC adds Cuba to its travel warning list, Connecticut confirms its first case, and Democrats are calling for Republicans to pass Zika funding.

The New York Times: Puerto Rico Braces For Its Own Zika Epidemic
On an inexorable march across the hemisphere, the Zika virus has begun spreading through Puerto Rico, now the United States’ front line in a looming epidemic. The outbreak is expected to be worse here than anywhere else in the country. The island, a warm, wet paradise veined with gritty poverty, is the ideal environment for the mosquitoes carrying the virus. The landscape is littered with abandoned houses and discarded tires that are perfect breeding grounds for the insects. Some homes and schools lack window screens and air-conditioning, exposing residents to almost constant bites. (McNeil, Jr., 3/20)

Politico: America's Summer Threat: Zika Virus
If brokered conventions and third-party insurgencies aren’t enough, consider the chaos that Zika could bring to the United States this summer. If the mosquito-borne virus linked to birth defects hits big — and that’s a big if — it could stir a panic like Ebola, set off an epidemic of finger-pointing and create new fear and acrimony over reproductive rights, global warming and immigration, all at the height of a presidential campaign. (Allen, 3/19)

The Associated Press: US Warns Of Zika Risk In Cuba Ahead Of Obama's Trip
The United States is warning of the risk of Zika virus in Cuba just as President Barack Obama heads to the country. The Centers for Disease Control and Prevention says it's adding Cuba to its travel notice for Zika. The notice warns travelers they are at risk of contracting the virus. Zika is spread though bites from a specific mosquito and is believed to carry particular risk for birth defects. The CDC advises pregnant women not to travel to places with Zika. (Lederman, 3/19)

The Connecticut Mirror: Connecticut Confirms Its First Case Of Zika Virus
The state’s first case of Zika virus was confirmed in a person who traveled to a Zika-affected area and returned earlier this month, according to the state Department of Public Health. The patient, aged 60 to 69, had a skin rash, conjunctivitis, headache, fatigue, chills and muscle aches, and is now recovering, according to the health department. (Levin Becker, 3/18)

10. How A Vermont Law Is Turning The Food Industry On Its Head

Congress failed to block Vermont's GMO labeling law, which goes into effect July 1, and because of the logistical headaches of only labeling products for one state, some companies will start labeling food across the country.

The Associated Press: Tiny Vermont Brings Food Industry To Its Knees On GMO Labels
General Mills’ announcement on Friday that it will start labeling products that contain genetically modified ingredients to comply with a Vermont law shows food companies might be throwing in the towel, even as they hold out hope Congress will find a national solution. Tiny Vermont is the first state to require such labeling, effective July 1. Its fellow New England states of Maine and Connecticut have passed laws that require such labeling if other nearby states put one into effect. The U.S. Senate voted 48-49 Wednesday against a bill that would have blocked such state laws. (Rathke, 3/19)

The Associated Press: General Mills To Label Products With GMOs Ahead Of Vt. Law
General Mills said Friday it will start labeling products across the country that contain genetically modified ingredients to comply with a law set to go into effect in Vermont. The maker of Cheerios and Yoplait said it is impractical to label its products for just one state. And with no deal yet for national legislation on GMO labeling, the company said it decided to add the disclosures required by Vermont starting in July to products throughout the U.S. (Choi and Jalonick, 3/18)

The Wall Street Journal: General Mills To Label GMOs In Products Nationwide
General Mills Inc. is changing its labels nationwide to indicate whether its foods contain genetically modified organisms, ahead of a Vermont law that will mandate it as of July. “The complexity and the cost of having one system for Vermont and one for everywhere else is untenable,” Jeff Harmening, the company’s chief operating officer of U.S. retail, said in an interview. He said he is still hopeful that Congress will pass a national law that would supersede such state laws, but the company had to move ahead to comply with Vermont. (Gasparro, 3/18)

11. Flint Just 'Tip Of Iceberg' On Lead In Schools

Most schools are not required to test for lead in their water under federal law, and even if districts do they don't have to tell parents about the results. “Right now there is a yawning gap in our lead-testing protocols,” Sen. Charles Schumer (D-N.Y.) said.

The Washington Post: A Legal Loophole Might Be Exposing Children To Lead In The Nation’s Schools
Children drinking from water fountains at the nation’s schools — especially in aging facilities with lead pipes and fixtures — might be unwittingly exposing themselves to high levels of lead, which is known to cause brain damage and developmental problems including impulsive behavior, poor language skills and trouble remembering new information. Under federal law, the vast majority of schools don’t have to test the water flowing out of their taps and drinking fountains, and many states and districts also do not mandate water testing at schools. Even when districts do test their water, they don’t always tell parents about the problems they find. (Brown, 3/18)

In other public health news —

NPR: Aspirin Both Triggers And Treats An Often-Missed Disease
A few unusual symptoms helped Allison Fite eventually figure out that she had a little-known disease shared by 1 to 1.5 million Americans. She has asthma, a loss of smell and taste, and a strong, adverse reaction to alcohol. "Before I could finish [a drink], I started to get these really bad headaches," she says. "I really am allergic to fun." And she had nasal polyps, which are benign growths in the sinus cavities. When she was 20, she had them surgically removed for the first time. At age 25, she flew back from where she was living in Thailand to the U.S. for a second operation. But this time the polyps reappeared even faster, a mere eight weeks after the surgery. ... But the doctor mentioned that aspirin can cause nasal polyps. This was Fite's first real clue about her illness. It's called aspirin-exacerbated respiratory disease, or AERD. (Chen, 3/21)

The Kansas City Star: Medical Team Studies When An Effective But Sometimes Risky Stroke Drug Should Be Used
Count RoseMary Lee among the fortunate ones. When Lee suffered a stroke a few weeks ago, she was rushed to a hospital with an advanced stroke program and she received state-of-the-art care. Two days later, Lee, 79, was back home in Gladstone, and back to normal. “It’s amazing how it worked,” Lee said. Amazing, yes. But it happens far less often than it should, many doctors say. (Bavley, 3/20)

The Tampa Bay Times: Prediabetes Can Be The Wake-Up Call That Prevents Type 2 Diabetes, But Patients Need To Act
Dianne Muncey's doctor first talked with her about prediabetes in 2013. With a family history of Type 2 diabetes and blood glucose levels that had been creeping up for years, the doctor explained that Muncey was at high risk for diabetes herself. She was told to lose some weight, exercise and change her diet, but was given no specific instructions on exactly how to do that. She was on her own. "And, I just didn't do it," said Muncey, a retired teacher's assistant from Tampa, whose parents and four siblings had Type 2 diabetes. "They didn't give me any guide or a plan to follow, just general recommendations." (Maher, 3/17)

The Baltimore Sun: Nutritional Value Of Fish Might Be Reduced By Farming, Study Finds
About half the seafood that people eat around the world now comes from farms, but efforts to make fish a sustainable food source by raising it in a tank could be reducing its main nutritional selling point. Omega-3 fatty acids found naturally in fish have been shown to improve cardiovascular health and possibly stave off other maladies such as cancer. However, levels of those fats likely are being altered by a shift from feed made from fish meal and oil to plant-based feed, according to an analysis by researchers at the Johns Hopkins Bloomberg School of Public Health. (3/19)

12. Latest N. H. Opioid Death Numbers Show No Relief From Epidemic

The state is third in the country, behind West Virginia and New Mexico, for per capita drug deaths. In other news, a woman faces struggles with insurance and finding available treatment when she tries to find help for her son, who is addicted to pain killers.

NPR: A Family Engulfed By Heroin Fights To Keep A Son Alive
Here's how I knew I liked Patti Trabosh. It goes back to the very first time I called her out of the blue to ask whether I might profile her family for a story on opioid addiction. The very first words out of her mouth were, "I'm pissed off!" Trabosh went on to explain why she was angry. First, it was the struggle to find a bed in a drug treatment program for her 22-year-old son Nikko Adam. He had become addicted to prescription painkillers and then heroin when he was still in high school. He'd been in rehab twice before, and relapsed both times. Once she found an available treatment slot, it was the seemingly endless and maddening battles with her insurance company, trying to get them to cover Nikko's treatment. (Block, 3/19)

Women’s Health

13. Texas Women Face Booked Appointment Calendars, Crowded Waiting Rooms After Abortion Law Shuttered Clinics

The Supreme Court is considering whether the Texas law puts undue burdens on women seeking abortions. In other news, out-of-state women flock to New Mexico, a state that has few abortion restrictions, and an Oklahoma bill that would require schools to add an anti-abortion curriculum to their classes may be too expensive to implement.

The New York Times: Texas Abortion Law Has Women Waiting Longer, And Paying More
When Amy found out that she was pregnant, she wasted no time seeking an abortion. Her husband had just lost his job and the couple had been kicked out of their house, forcing their family of five to move in with his parents. But she found that getting an appointment for an abortion proved almost as stressful as the unwanted pregnancy. The number of abortion clinics in Texas has shrunk by half since a 2013 state law imposed new regulations that many said they found impossible to meet. The United States Supreme Court is considering the constitutionality of that law and whether it creates too much of a burden on women seeking an abortion. (Goodnough, 3/18)

The Albuquerque Journal: New Mexico Becomes Abortion Magnet
To some, New Mexico is a Wild West haven for abortions. For others, the state is a refuge from a wave of legal assaults nationwide on a woman’s right to choose. Abortions among New Mexico residents, especially women ages 19 and younger, are down dramatically since 2010, but the number of out-of-state women coming here for abortions has doubled in the past three years, according to newly compiled state data. (Heild, 3/20)

The Associated Press: Costs May Scuttle Oklahoma Anti-Abortion Curriculum Bill
Legislation that would mandate Oklahoma’s public schools to teach that life begins at conception may fail not because of its controversial nature but because the suddenly financially strapped state could have trouble paying for the course materials. The National Right to Life Committee backs the Oklahoma bill and calls it the first of its kind in the nation. Under it, public high schools would be required to provide the information “for the purpose of achieving an abortion-free society.” Parents would be able to pull their children from the classes, and none of the state funding could be used for abortion counseling or sex education. (Talley, 3/19)

State Watch

14. Once Secure Funding For Alabama Medicaid Is Now Imperiled

Lawmakers moving forward with budget that does not give officials their full request for the health program for low-income residents. News outlets also report on Medicaid issues in Connecticut and New Mexico.

Montgomery Advertiser: Alabama Medicaid, Once Protected, Sees Funding Questioned
It used to be that whatever else happened with the General Fund, legislators would give the Alabama Medicaid Agency the funding it requested. But legislators are discussing the possibility of passing a budget without the full amount of Medicaid’s requested funding, a move that could doom regional care organizations (RCOs) which the Legislature approved in 2013 in the hopes of slowing the growth in health care costs. That has Medicaid and health care groups concerned about major consequences for Alabama’s health care system, which depends on the program, and the loss of hundreds of millions of dollars from the federal government to implement RCOs. (Lyman, 3/18)

The Wall Street Journal: Connecticut Moves Away From Private Insurers To Administer Medicaid Program
At a time when most states are paying private insurers to provide health care for their Medicaid recipients, Connecticut says it has saved money and improved care by going the opposite way. In 2012, Connecticut fired the companies that were running Husky, as its Medicaid system is known, and returned to a more traditional “fee-for-service” arrangement where the state reimburses doctors and hospitals directly. (Beck, 3/18)

Albuquerque Journal: Democrats Propose Protections For Accused Medicaid Providers
The Democratic members of New Mexico’s congressional delegation have introduced legislation containing safeguards for Medicaid consumers and providers when fraud is alleged. The bill was prompted by the 2013 shakeup in New Mexico’s behavioral health system, which the Democrats in a news release called “reckless” and “a manufactured crisis.” Republican Gov. Susana Martinez’s administration abruptly halted Medicaid funding to 15 providers in June 2013, alleging they overbilled and may have committed fraud. Arizona companies were brought in to replace them, and many of the New Mexico nonprofits were driven out of the behavioral health business. (Baker, 3/20)

The Associated Press: US Lawmakers Want Guidelines For State Mental Health Funding
The 2013 audit alleged providers mishandled $36 million in Medicaid funding. An investigation by the state attorney general found some regulatory violations but no pattern of fraud. Investigations into two of the nonprofits are ongoing. State officials have vowed to recoup what they classify as millions of dollars in misspent funds. They have pointed to accusations that one of the companies lent public money to its CEO to buy a private plane. Some nonprofits have fired back with lawsuits, saying the state failed to give them a chance to answer concerns about the use of Medicaid money. (Montoya Bryan, 3/18)

15. Christie Proposes Moratorium On Nonprofit Hospitals' Property Taxes

The plan faces an uphill battle in the state's legislature though. Media outlets report on other hospital developments in Florida; Washington, D.C., and Illinois.

The Wall Street Journal: Christie Urges Hospital Tax Freeze
New Jersey Gov. Chris Christie proposed a two-year moratorium Friday to stop local governments from collecting property taxes from nonprofit hospitals. Mr. Christie’s proposal comes nearly nine months after a court ruling paved the way for localities to pursue these taxes. The hospitals have maintained that their nonprofit status exempts them from paying property taxes. The governor said he would advance legislation to put on hold municipalities’ legal efforts to recover the property taxes from the hospitals. (Haddon, 3/18)

The Washington Post: Bowser’s Pick To Lead St. Elizabeths Came From Troubled Hospital In S.D.
D.C. Mayor Muriel E. Bowser’s choice to lead the District’s public psychiatric institution had only one other hospital stint on his résumé: chief executive of a hospital on an Indian reservation where emergency services were halted because they posed a risk to patients, according to federal and tribal officials. James Edward Kyle, 50, who took over as chief executive of St. Elizabeths Hospital in Southeast Washington on March 2, also was found unqualified for a job at the University of the District of Columbia after regulators discovered he lacked the proper credentials, according to records kept by the District’s Board of Nursing. (Nirappil, 3/18)

The Chicago Sun-Times: Presence Health Sizing Up Layoffs After 2015 Losses
Presence Health is likely to lay off workers and leave hundreds of job openings unfilled after posting a bigger-than-expected operating loss in 2015. “Although our liquidity is secure and we have a strong balance sheet, we are committed to improving our operations in 2016,” Michael Englehart, Presence Health president and chief executive, said in a statement Thursday. (3/19)

16. State Highlights: Feds Examine Calif. Health Plan Tax; New York's Paperless Prescribing Requirement Takes Effect This Month

News outlets report on health issues in California, New York, Ohio, Illinois, Florida, Connecticut, Iowa and Massachusetts.

The Associated Press: As NY Demands Paperless Prescribing, Doctors Are Mixed
The scribbled, cryptic doctor's prescription is headed toward eradication in New York, where the nation's toughest paperless-prescribing requirement takes effect this month. Instead of handing patients slips of paper, physicians soon must electronically send orders directly to pharmacies for everything from antibiotics to cholesterol pills to painkillers, with some exceptions. Otherwise, prescribers face the possibility of fines, license loss or even jail. The requirement is meant to fight painkiller abuse, reduce errors and expand a practice that doctors and patients often find convenient. But physicians say digital scripts can present roadblocks for some patients and doctors shouldn't have to fear punishment over a prescription format. (3/19)

Kaiser Health News: California Insurance Marketplace Wants To Kick Out Poor-Performing Hospitals
California’s insurance exchange is threatening to cut hospitals from its networks for poor performance or high costs, a novel proposal that is drawing heavy fire from medical providers and insurers. The goal is to boost the overall quality of patient care and make coverage more affordable, said Peter Lee, executive director of the Covered California exchange. “The first few years were about getting people in the door for coverage,” said Lee, a key figure in the rollout of the federal health law. “We are now shifting our attention to changing the underlying delivery system to make it more cost effective and higher quality. We don’t want to throw anyone out, but we don’t want to pay for bad quality care either.” (Chad Terhune, 3/21)

Cleveland Plain Dealer: HealthSpan Strikes Deal With Lake Health To Preserve Access For Members East Of Cleveland
HealthSpan has struck an agreement with Lake Health Inc. to provide medical services to communities east of Cleveland where many of the insurer's medical offices are due to close at the end of the month. The agreement allows HealthSpan members to immediately make appointments at all Lake Health facilities and with more than 250 physicians who work for the health system in Northeast Ohio. (Ross, 3/18)

The Associated Press: Illinois Lawmaker Wants To Legalize Midwives Statewide
Mishra Keller skirted a state law when she chose to deliver her second child at home with the help of a midwife, given that the trained birthing professionals have been barred from practicing since 1987 in Illinois. Keller, a holistic health coach in Evanston, disagrees with the state's stance, saying that midwives are a "good resource." ''With the right training, they can help people have positive outcomes," Keller said. (Lisenby, 3/20)

The Washington Post's Wonkblog: In A Fight Between Nurses And Doctors, The Nurses Are Slowly Winning
Amid a flurry of legislation to pass in the final days of spring state legislative sessions last week, nurses won two more victories in a long war for independence. For decades, most of the country has required physician oversight for nurses to conduct certain procedures, and especially to prescribe drugs. But that’s slowly changing, as the nation’s health-care needs rise, and nurses fight for the right to practice everything they learned in school. (DePillis, 3/18)

The Associated Press: CSEA Challenge Increase In Thruway Retiree Health Payments
A union has sued [New York's] Thruway Authority challenging increased health care costs for about 1,500 retirees. CSEA says the authority told retirees in December that effective April 1 they would have to pay 6 percent more in personal contributions to their health care premiums. The union says that fails to honor the obligations to retirees covered by contracts between CSEA and the Thruway. (3/19)

The Orlando Sentinel: Scripps Receives $1.4M Grant To Study Breast Cancer
Scripps Florida scientists in Jupiter have received a $1.4 million grant from the U.S. Department of Defense to study new ways to block breast cancer. Donald G. Phinney, Scripps scientist and acting chairman of the Department of Molecular Therapeutics, is the principal investigator on the new three-year grant. He said Scripps will be targeting a class of molecules known as microRNA that play a pivotal role in breast cancer. (Pounds, 3/18)

The Wall Street Journal: Connecticut Studies ‘Yes Means Yes’ Sexual Consent Policy
Connecticut is weighing whether to join a growing number of states that have required universities to adopt policies for sexual interactions known as affirmative-consent. A proposal before state legislators would create a so-called “yes-means-yes” standard that would be used when investigating sexual-assault complaints. The push comes as an alleged sexual-misconduct case has shaken up Yale University, in New Haven, with the captain of the men’s basketball team expelled after a campus committee ruled he had violated the school’s policies on sexual conduct. (De Avila, 3/18)

The Associated Press: Study Finds High Drug Abuse Rates For Kids Who Were Jailed
A study has found high rates of drug and alcohol abuse and dependency among some who went through Cook County's juvenile detention center. The Northwestern Medicine study found more than 90 percent of males and nearly 80 percent of females in the study were diagnosed with a "substance abuse disorder" at some point in their lives. The study was published Thursday in the American Journal of Public Health. (3/20)

The California Health Report: Crowding On Skid Row Creates A Breeding Ground For Illnesses
A downtown development boom has brought pricey lofts, condos, nightspots and galleries to the center of the city and pushed homeless people into skid row, an area of some 40 city blocks where tents, cardboard boxes and people sleeping in the open air still line the sidewalks. Even though shelters, soup kitchens and social service agencies dominate the neighborhood, there are more people than shelter beds, and many people who simply refuse to go inside. People live their lives on the street in close quarters where sanitation is spotty. (Urevich, 3/21)

The Sioux City Journal: Nun Returns To Sioux City To Carry Out Medical Mission
Sister Theresa Keller clicks the heels of her gray suede shoes together. "There's no place like home. There's no place like home," she says chuckling as she sits in her office tucked away at Siouxland Community Health Center. Plastered above a diploma on a wall are two posters featuring Glinda the Good Witch and Dorothy from the American film classic "The Wizard of Oz." After nearly 40 years away from home, Keller, an advanced registered nurse practitioner, returned last fall to Sioux City to live and work. (Butz, 3/20)

The Boston Globe: Marijuana Study Leader Is Against Legalization Push
For a year, state Senator Jason M. Lewis maintained strict neutrality as he studied marijuana legalization — interviewing 50-plus experts, scouring the research, and observing firsthand a state where it is legal. But now he is speaking out against the expected November referendum in Massachusetts. (Miller, 3/20)

Editorials And Opinions

17. Viewpoints: Medicare Advantage And The Bigger Issue Of Entitlements; Little Sisters Of The Poor At The Supreme Court

A selection of opinions from around the country.

Chicago Tribune: Medicare's Big Drug Test
Federal officials poked a medical hornet's nest recently with an ambitious attempt to do what many American taxpayers — and patients — demand: tame rising prescription drug costs in Medicare. Officials at the Centers for Medicare and Medicaid Services rolled out a proposal to test new ways of reimbursing doctors who administer drugs in their offices and in hospital outpatient departments. These drugs include cancer medications, antibiotics and certain eye care treatments — about $19 billion a year in Medicare spending. (3/18)

The Wall Street Journal: ObamaCare Vs. Little Sisters Of The Poor
On Wednesday the Supreme Court will hear oral arguments in Little Sisters of the Poor v. Burwell, a landmark case challenging the Department of Health and Human Services contraceptive mandate under the Affordable Care Act. In addition to the Little Sisters of the Poor, an order of Catholic nuns whose mission is to “offer the neediest elderly of every race and religion a home where they will be welcomed as Christ,” the objecting parties include the university I head, the Catholic University of America, the Archdiocese of Washington, and a host of other religious institutions. (John Garvey, 3/20)

The Washington Post: How The Little Sisters Of The Poor Case Puts Religious Liberty At Risk
Zubik v. Burwell is the Supreme Court’s name for the set of cases more often identified with the Little Sisters of the Poor, a religious order that is also a party to the case. I filed an amicus brief in Zubik on behalf of the Baptist Joint Committee for Religious Liberty. I had never before filed a brief in support of the government in a case about the free exercise of religion. (Douglas Laycock, 3/20)

The New York Times: Religion And Birth Control At The Supreme Court
If the harm that Senate Republicans are inflicting on the nation by refusing to consider filling the Supreme Court vacancy were not already self-evident, a case that the remaining eight justices are hearing on Wednesday drives the point home. The case, Zubik v. Burwell, is a consolidation of seven lawsuits involving women’s access to birth control under the Affordable Care Act. It is the fourth time in four years that the justices have taken up a challenge to the law. (3/21)

The New York Times: What Planned Parenthood Really Does
State budget cuts to Planned Parenthood, signed into law last month by Gov. John Kasich, won’t affect the organization’s ability to provide birth control to women like Ms. Thurman. But they could put a stop to a Planned Parenthood program that provides free testing and treatment for sexually transmitted infections. And the organization might have to stop offering sex education to teenagers in the juvenile justice system and foster care, and home visits to new moms to help prevent infant mortality. (Anna North, 3/18)

The Wall Street Journal: Valeant’s Unnatural Natural Death
A company with a diverse line of consumer products that are in strong demand nevertheless sees its stock price unravel by 90%. That’s the story of Valeant, the standout corporate drama of the past six months. Most accounts trace the drug company’s problems to an October report by a short seller questioning its accounting for sales through a drug distributor called Philidor, but the stock had already lost more than $100 off its peak $262 share price in the two months before these allegations surfaced. (Holman W. Jenkins Jr., 3/18)

The Washington Post: The Next Step For Fixing Flint
The HouseOversight and Government Reform Committee met last week to witness one of the most common of Washington exercises: buck-passing. Michigan Gov. Rick Snyder (R) testified that “career bureaucrats” were responsible for the disastrous lead poisoning in Flint’s tap water, and he placed another heap of blame on the federal Environmental Protection Agency for failing to act sooner. EPA Administrator Gina McCarthy shot back that the state created the problem and dragged its feet when the EPA started to ask questions. (3/20)

The Washington Post: The Poisonous Conservative Thinking That Caused The Flint Crisis
In a hearing this week about the poisonous water in Flint, Mich., Rep. Earl L. “Buddy” Carter (R-Ga.) tried to blame the lead-tainted water on the Obama administration’s Environmental Protection Agency. EPA Administrator Gina McCarthy explained that, under the law Congress passed, states are in charge of enforcing drinking-water standards. (Dana Milbank, 3/18)

The Washington Post: Democrats Could Destroy The GOP — If Only They Would Welcome Antiabortion Liberals
The GOP was in serious trouble well before the great crackup of 2016. The Tea Party insurgency exposed serious fault lines on everything from immigration to military spending. The antiabortion wing continues to demand that the party defy its central emphasis on limited government by passing legislation that overrides the autonomy of the individual. Today, only 26 percent of Americans identify as Republicans, and with their inability to reach Latinos and Millennials, things don’t look good for the GOP’s future. If Democrats are paying attention, they could easily capitalize on the dissolution of longstanding coalitions to fatten their own. (Charles Camosy, 3/21)

Lincoln Journal Star: Nebraska Health Insurance Deductibles Going Up
What good is health insurance coverage if you can’t afford to actually use it? Unfortunately, that’s not a rhetorical question. It’s one facing thousands of Nebraskans who are required to purchase health insurance on the Affordable Care Act’s exchanges. As if rising premiums — which increased by an average of 18 percent in Nebraska this year — weren’t already hard enough, skyrocketing deductibles have rendered many plans “all but useless,” according to a recent report in The New York Times. (Nathan Nascimento, 3/21)

Lincoln Journal Star: A New Option For Health Care
An intriguing and potentially significant piece of health care reform legislation appears to have a clear trajectory to enactment. That’s a credit to its merits and the groundwork done by Sen. Merv Riepe of Ralston, a former hospital and health care manager. The bill clears the way for a new health care model in Nebraska under which patients could contract directly with a physician to pay a monthly retainer fee in exchange for unlimited office visits and an annual physical. (3/19)

The Chicago Sun-Times: Drug Companies Should Help Dispose Of Unneeded Medicines
Drugs that collect in medicine cabinets are damaging public health and tainting our environment. We need a better way to dispose of them. A proposal before the Cook County Board to require pharmaceutical companies to play a bigger role in the proper disposal of their products would be a significant step forward. On Thursday, the Metropolitan Water Reclamation District went on record in favor of the concept, which is patterned after similar programs set up by counties in California and Washington state. The County Board should follow that recommendation and enact the ordinance when it comes up for a vote next week. (3/20)

The Washington Post: Doctors Should Pause Before Dismissing The ‘12 Steps’ Approach To Addiction
Addiction has long been medicine’s unwanted stepchild. Doctors didn’t understand it, didn’t know how to treat it and felt helpless in the face of the wreckage it brought to their patients’ lives. As a result, while providers addressed the consequences of addiction — endocarditis, liver failure, seizures, overdose — they rarely treated the disease itself. That mysterious task has been left to others: counselors, peers in recovery and 12-step programs. (Jessica Gregg, 3/18)

The Courier-Journal: Doctors Need Every Tool To Aid Patients
Health care providers fight on numerous fronts every single day. Disease and illness, infections and accidents, short-term care and long-term treatment are all demands on the time and skill of physicians fighting for their patients. Then there are larger battles – the fight for greater patient access, better treatments and the ongoing effort to reduce health disparities for minority populations in America. Fighting on all these fronts takes time, energy and creativity. We believe they are all fights worth fighting. In the United States today, black males are expected to live, on average, nearly 10 years less than white females. This is because of a number of causes. According to U.S. News and World Report, “Health inequality is part of American life, so deeply entangled with other social problems — disparities in income, education, housing, race, gender and even geography — that analysts have trouble saying which factors are cause and which are effect.” (Sean L. Francis, 3/17)

The Columbus Dispatch: Pediatric Research: Funding For Child Health Studies Must Be Increased
I attended a meeting last week in Savannah, Geogia, along with about 100 pediatrics leaders in North America. The annual conference of the Association of Medical School Pediatric Department Chairs was attended by experts with each accredited medical school in the United States and Canada. The meetings are fascinating, and the agenda usually focuses on the latest developments in pediatric medicine and research. The plight of national funding for child health research is a perennial topic of dinner conversation. (Dr. John Barnard, 3/20)

The Tennessean: Going To Extremes: Disorder Addresses Obsession To Eat Clean
Everyone knows that eating healthy foods and limiting unhealthy ones is best for optimum health, but what if you cross the line and it becomes an obsession? If someone’s desire to eat clean gets to the point that they develop an actual fear of unhealthy foods it can lead to an eating disorder known as orthorexia. According to the Eating Recovery Center, the national health care system dedicated to the treatment of serious eating disorders, there are more than 30 million people in the Unites States struggling with controlled eating habits including anorexia, bulimia, binge eating and orthorexia. (Hollie Deese, 3/14)

USA Today: Public Health 'Monster Spray' Won't Stop Zika
The explosive spread of the Zika virus has captured our attention and dominated headlines. Of particular concern is the possible link between Zika virus infection and microcephaly. Meanwhile, worries about Ebola have diminished, with the World Health Organization declaring an end to the Ebola outbreak in West Africa. The frenzy that the Ebola virus generated in the United States during the fall of 2014 has become a distant memory. What lessons can we learn from our reaction to the Ebola threat, and how can we apply these lessons to Zika and future epidemics? (Puneet Opal and Ameet R. Kini, 3/20)

The New York Times: The World’s Modern-Day Lepers: Women With Fistulas
One of the worst things that can happen to a woman or girl around the world is a fistula, an internal injury caused by childbirth (or occasionally by rape) that leaves her incontinent, humiliated and sometimes stinking. Victims are the lepers of the 21st century, and although the condition is almost entirely preventable, it is suffered by hundreds of thousands of women worldwide. (Nicholas Kristof, 3/19)