- California Healthline Original Stories 1
- Novel Measures Test Cities’ Power — And Will — To Tame Health Care Costs
- Elections 1
- Slipped Into Prop. 11 Is Language That Could Protect Ambulance Companies From Lawsuits Over On-Call Break Times
- Health Care Personnel 1
- Powerful California Nurses Union Eyes National Audience For 'Medicare For All' Campaign
- Public Health and Education 2
- California Eviscerates Administration's Plan To Freeze Fuel-Efficiency Standards, Concluding That It Will Harm Americans' Health
- Bay Area Startup Chosen To Help With Massive NIH Project To Decode The Genomes Of 1 Million Americans
Latest From California Healthline:
California Healthline Original Stories
Novel Measures Test Cities’ Power — And Will — To Tame Health Care Costs
Union-backed initiatives in Palo Alto and Livermore, Calif., aim to cap charges by hospitals and doctors, seeking to build on national furor over rising medical bills. The measures arise in health care markets that are among the most expensive in the nation. (Rob Waters, )
More News From Across The State
The clause would define the past industry practice of on-call meal and rest breaks as legal. Critics have blasted the measure. “It is not ok to bury a liability protection clause,” said Jason Brollini, the executive director for United EMS Workers Local 4911. “And to scare the citizens of California saying that ambulances are not going to respond because we want our meal periods is intellectually dishonest.”
Capital Public Radio:
Prop. 11 Would Change Rules For Private Ambulance Workers In California
Paramedics and ambulance employees with those private companies are required to remain on call during breaks. That will continue if voters pass Proposition 11. But there is language at the tailend of the measure that could have a negative impact on pending worker liability lawsuits against ambulance companies, according to the Legislative Analyst's Office. (Soto, 10/25)
In other news —
CALmatters:
The Block That Prop. 13 Built: Too Few Homes
California, and particularly the Bay Area, hasn’t built enough housing to keep up with demand. By one estimate from the California Department of Housing and Community Development, the state needs to build 1.8 million units over the next seven years just to keep pace with population growth. Right now, California isn’t close to building that quickly. (Levin, 10/25)
USC Verdugo Hills Hospital's Exclusive Physician Contract Sparks Debate
In that type of "closed" ICU, if patients with serious chronic health conditions are admitted and request their regular doctor, that physician may visit but cannot write or change orders without approval of the intensivist on duty.
Los Angeles Times:
As USC Verdugo Hills Restricts ICU To Contracted Physician Group, Area Docs Question Move
As USC Verdugo Hills Hospital implements an exclusive physician contract for pulmonary/critical care services in its intensive care unit, a debate over the pros and cons of exclusivity is playing out locally. In January, the hospital began a pilot program in which ICU patients would be treated exclusively by on-duty or on-call intensive care doctors — also called intensivists — belonging to Pasadena-based Foothill Pulmonary and Critical Care Consultants Medical Group. (Cardine, 10/25)
In other health system news —
Ventura County Star:
Ventura-Based Identity Medical Group Joins Dignity Health
The Ventura-based Identity Medical Group is joining Dignity Health and is changing its name to the Dignity Health Medical Group. The Ventura region’s Dignity Health Medical Group includes nine medical group locations and over 25 providers. With the addition of Identity Medical Group, the newly expanded Dignity Health Medical Group footprint will include over 50 providers and 15 convenient locations. ...Identity Medical Group offers adult, pediatric, and family medicine with offices in Ventura, Oxnard, Camarillo, and Santa Paula. Dignity Health Medical Group in the Ventura Region is a multi-specialty group with locations in Camarillo, Oxnard, and Thousand Oaks. (10/25)
Powerful California Nurses Union Eyes National Audience For 'Medicare For All' Campaign
Previously, the California Nurses Association, which represents 100,000 nurses across California, focused on the state's efforts to shift to single payer health care. But the organization is rebranding its efforts to go national.
Sacramento Bee:
CA Nurses Go National With ‘Medicare-For-All’ Campaign
The union representing 100,000 nurses across California has shifted its “Medicare-for-all” campaign from California to the national stage, perhaps relieving political pressure on Democratic gubernatorial candidate Gavin Newsom to fulfill what the union sees as his top campaign promise: Delivering a single-payer health care system in the nation’s largest state. The California Nurses Association, which led the coalition behind the high-profile 2017 push for a single-payer system, has re-branded its campaign with the slogan “Fight to Win Medicare-for-All!” Its social media feeds reflect the new national scope of their efforts. (Hart, 10/26)
Meanwhile, health care workers' three-day strike against the University of California has wrapped up —
Sacramento Bee:
Health Care Workers Claim Win In 3-Day Strike; UC Leaders Say No Deal
Roughly 39,000 unionized employees wrapped up a three-day strike Thursday at five University of California teaching hospitals, including UC Davis Medical Center, a job action that UC leaders said moved them no closer to a contract agreement. ...Union leaders, however, said that they received reports from colleagues working on the UCD hospital floor, saying that the hospital had to postpone services for patients in the gastrointestinal clinic, physical therapy and elective surgery. (Anderson, 10/26)
The Trump administration’s plan “a contrived solution to justify a predetermined outcome,” California's report reads. The criticism will join the more than 72,000 comments that the government has received on its controversial proposal.
The Washington Post:
California Blasts Trump Proposal To Freeze Fuel-Efficiency Standards As ‘Nihilistic’ And ‘Illegal’
California officials on Friday plan to submit a 400-page repudiation of the Trump administration’s proposal to freeze fuel-efficiency standards for the nation’s cars and trucks through 2026, calling it a deeply flawed, disingenuous effort that will harm the health and pocketbooks of Americans. “Finalizing this proposal would worsen air quality for the most vulnerable, waste billions of gallons of gasoline, forfeit our best chance to fight climate change, and result in years of uncertainty in the marketplace,” reads a draft of comments from the California Air Resources Board obtained by The Washington Post. It calls the Trump administration’s plan “a contrived solution to justify a predetermined outcome.” (Bennis and Laris, 10/26)
Color Genomics will analyze and report data for dozens of genes that can cause serious conditions, such as cancers and syndromes, plus provide pharmacogenomic results that show how genes affect people’s response to medication.
The Mercury News:
Color To Help NIH Decode Genomes Of 1 Million Americans
Color Genomics will be working with the prestigious Broad Institute in Massachusetts to help in the five-year effort, which the NIH calls “one of the country’s most ambitious biomedical research efforts ever undertaken.” The NIH announced in late September that it had awarded $28.6 million to establish three genome centers around the nation, including the Broad-Color team, as part of its All of Us program. (Sumagaysay, 10/25)
President Donald Trump says will he take aim at "global freeloading" with his plan, which would run essentially as a pilot program within the Medicare Part B program. "Same company. Same box. Same pill. Made in the exact same location, and you would go to some countries and it would be 20 percent of the cost of what we pay," he said. Pharma has already begun pushing back against the plan in what is likely to be a fierce battle between the companies and the administration.
The New York Times:
Trump Proposes To Lower Drug Prices By Basing Them On Other Countries’ Costs
President Trump proposed on Thursday that Medicare pay for certain prescription drugs based on the prices paid in other advanced industrial countries — a huge change that could save money for the government and for millions of Medicare beneficiaries. As part of a demonstration project covering half the country, Medicare would establish an “international pricing index” and use it as a benchmark in deciding how much to pay for drugs covered by Part B of Medicare. (Pear, 10/25)
The Associated Press:
Trump Says Goal Of Proposal Is To Lower Some US Drug Prices
"We are taking aim at the global freeloading that forces American consumers to subsidize lower prices in foreign countries through higher prices in our country," Trump said in a speech Thursday at the Department of Health and Human Services. "Same company. Same box. Same pill. Made in the exact same location, and you would go to some countries and it would be 20 percent of the cost of what we pay," said Trump, who predicted the plan will save Americans billions. "We're fixing it." (10/26)
The Wall Street Journal:
Trump Offers Test Plan To Lower Medicare Drug Costs
The proposal wouldn’t likely go into effect until late 2019 or 2020 and would cover only some drugs in Medicare in parts of the country. Some Democrats said the idea would do little in the short term and fall short of Mr. Trump’s more aggressive campaign promise on drug prices. Under the proposal, the Centers for Medicare and Medicaid Services would issue a proposed rule this spring to change how it pays for infused and injected drugs administered by physicians in half of the country. The changes would only apply to some drugs in Medicare’s outpatient program known as Part B, and not the most commonly used medicines sold at pharmacies. (Armour and Walker, 10/25)
NPR:
Trump Says Medicare Part B Should Pay Less For Drugs
The proposed changes are related to the Medicare Part B program that pays for medications that patients receive in hospitals or in doctor's offices. Today, Medicare reimburses doctors and hospitals the average sales prices of the drugs, plus 6 percent to cover the cost of giving medications to patients. The arrangement gives physicians an incentive to prescribe the most expensive medications, because they will collect a higher fee, Trump said. (Kodjak, 10/25)
The Washington Post:
Trump Says He’s Taking ‘Revolutionary’ Action To Lower Drug Prices
Trump’s remarks were the first as president at HHS and come at a time when health care is playing a defining role in midterm campaigns, with Democrats slamming Republicans over whether they support protecting access to health care for people with preexisting conditions. Trump argued that other countries were being “very disrespectful” by selling their prescription drugs to Americans for higher prices than their citizens are paying for them. (Winfield Cunningham and Sonmez, 10/25)
Stat:
Railing Against ‘Global Freeloading,’ Trump Offers Plan To Lower Drug Prices
Trump’s speech came as his administration has made its work on drug pricing a priority — and as that work, too, has increasingly taken direct aim at pharmaceutical companies. Last week, top officials unveiled a new proposal that would require drug makers to include the prices of their products in TV commercials. The timing, just two weeks before the midterm elections, also bolsters the administration’s argument that it is acting aggressively to curb soaring drug prices, even as Democrats around the country have made health care costs and perceived greed within the pharmaceutical industry central to their campaigns. (Swetlitz, 10/25)
Politico:
Trump's Drug Plan Falls Flat In Health Care Messaging War
President Donald Trump tried Thursday to make good on a campaign vow to lower drug prices — attacking “foreign freeloaders” and proposing significant changes to how Medicare pays for many drugs. But his populist proposal didn’t appear likely to budge the national debate around health care, just days ahead of the midterm elections. Early indications are that it won’t be an immediate game changer — it’s too wonky for Republicans playing defense in local races, it gave Democrats a fresh opportunity to slam the administration‘s attacks on patient protections and it won’t help most voters pay less for prescriptions at local pharmacies. (Diamond, 10/25)
Bloomberg:
Drug Lobby Compares Trump Drug Price Plan To ‘Socialized’ System
The lobbying groups for U.S. drugmakers aren’t happy about President Donald Trump’s plan to borrow from Europe’s system of paying for some high-cost drugs. On Thursday, Trump proposed cutting what Medicare pays for many costly drugs that are administered in hospitals and clinics, using a new index of prices that would bring U.S. government payments closer to what European countries pay. (Edney, 10/25)
Stat:
Trump’s New Drug Pricing Proposals Have Already Sparked A War With Pharma
The Trump administration’s new plan to pay for certain drugs in Medicare based on international prices quickly set off a war with the drug industry after it was unveiled Thursday — and both sides are charging ahead with aggressive statements that the other is ignoring patients. The trade group for drug makers, PhRMA, called the proposal “price controls” and said it was “disappointed the administration put the needs of patients aside with these proposals.” (Florko, 10/25)
Stat:
These Companies Have The Most To Lose Under New Trump Drug Pricing Plan
President Trump’s forthcoming proposal to lower the cost of expensive physician-administered drugs will hit three drug companies — Amgen, Genentech, and Regeneron — harder than anyone else. Trump is expected to roll out a pilot program Thursday that would tie reimbursement for certain expensive drugs to the prices paid in other similar countries, POLITICO reports. And the Department of Health and Human Services is already out with a report that names the specific drug companies that charge more for their medicines in the U.S. than in other countries. (Florko, 10/25)
The moves come amid heightened government scrutiny of the e-cigarette industry, with the FDA trying to curb an "epidemic" of vaping among young people. Altria only has a tiny slice of the market, but the decision could pressure other companies, like Juul, to follow suit.
The New York Times:
Altria To Stop Selling Some E-Cigarette Brands That Appeal To Youths
Under pressure to curb vaping among young people, the tobacco giant Altria announced on Thursday that it would discontinue most of its flavored e-cigarettes and stop selling some brands altogether. The company also said, for the first time, that it would support federal legislation to raise the age to 21 for the purchase of any tobacco and vaping product. (Kaplan, 10/25)
In other national health care news —
The New York Times:
Caitlyn Jenner, A Longtime Republican, Revokes Support For Trump Over Transgender Rights
Caitlyn Jenner, the transgender rights activist who has long drawn criticism from members of the L.G.B.T.Q. community for her Republican leanings, unambiguously denounced President Trump on Thursday for his stance on transgender issues. In a column published in The Washington Post, Ms. Jenner, 68, wrote that she had hoped she could work within the Republican Party to improve its position on L.G.B.T.Q. issues, but that she had evolved to see that belief as a mistake. (Jacobs, 10/25)
The Wall Street Journal:
Trump’s DEA Chief Vetted Candidates And Then Took The Job Himself, Riling Police Groups
As one of President Trump’s top compliance and ethics attorneys in the White House, Uttam Dhillon had urged several candidates for Drug Enforcement Administration chief to withdraw from consideration, citing concerns about their background checks. Then, he accepted the job himself. Mr. Dhillon’s rise to the top of the world’s largest drug-fighting agency—after being closely involved in the selection process—has riled police groups that had pushed the White House to choose a DEA administrator with a law-enforcement background. (Bender, 10/25)
Modern Healthcare:
Medicaid Will Pay Doctors, Hospitals More Next Year
Providers across the country can expect to score higher Medicaid reimbursement next year, but inpatient hospitals may see cuts or rate freezes, according to a state Medicaid survey released Thursday. Forty-seven states plan to offer at least one provider type a rate increase in fiscal 2019, Kaiser Family Foundation's survey showed. That could include primary-care doctors, specialists, home care aides or nursing homes. While at least one provider type in 31 states can expect a rate decrease, that's the smallest number of rate restrictions since fiscal 2008. (Dickson, 10/25)
USA Today:
Dementia And Alzheimer’s Leave Families Grappling With Elder Guardianship
Casey Kasem’s widow battled his children to maintain medical control of the radio legend as he faded with a form of dementia. The wife and daughter of actor and comedian Tim Conway are sparring in court over the care of the former Carol Burnett Show star. Similar disputes divided the families of country music icon Glen Campbell and R&B singer Etta James. Star Trek actress Nichelle Nichols is the subject of a court action brought by her son. (Alltucker, 10/25)
The Washington Post:
Drop In Adult Flu Vaccinations May Be Factor In Last Season’s Record-Breaking Deaths, Illnesses
Fewer than 4 out of 10 adults in the United States got flu shots last winter, the lowest rate in seven seasons and one likely reason that the 2017-2018 season was the deadliest in decades. Reports released Thursday by the Centers for Disease Control and Prevention provide new details outlining the severity of the past flu season, during which more people were killed by seasonal influenza than in any other since the 1970s. (Sun, 10/25)
Viewpoints: Trump's Proposal To Help Curb High Drug Prices Is A Promising Start
A selection of opinions on health care developments from around the state.
Los Angeles Times:
The Trump Administration Takes On Drug Prices
In his most aggressive response to date to high prescription drug prices, President Trump wants Medicare to obtain better deals by negotiating with pharmaceutical companies — just not directly. The proposal would affect only a limited number of drugs and would come with some potentially harmful side effects, but it’s a promising start. (10/26)
San Francisco Chronicle:
A California Prison Whistle Blower Exposes The State’s Weakness On Mental Health Care
The top psychiatrist in the California Department of Corrections and Rehabilitation has accused his prison bosses of misleading the federal court — and opposing lawyers — in a long-running inmate lawsuit about appropriate levels of psychiatric treatment. The judge is weighing whether she should make the psychiatrist’s whistle-blower report public. Meanwhile, the stakes for this surprising court fight include inmate health and safety, taxpayer dollars, and the public’s trust in prison reforms that are already years in the making. (10/26)
Sacramento Bee:
Sacramento Can Protect Kids, Save Vape Bars, Too
One side says the health of Sacramento’s children is at risk. The other side says the survival of small businesses is at stake. Both sides have dug in their heels, so it’s difficult to find a common ground. But it’s still the City Council’s duty to try, as it debates new limits on tobacco retailers, including a ban on all sales of flavored tobacco to adults, in addition to children. (10/25)
Los Angeles Times:
Jeering Mayor Garcetti Won't Fix Homelessness In Venice
It was billed as a town hall for Venice residents to hear about the shelter for homeless people that city officials had proposed for an unused Metropolitan Transportation Authority bus yard in that coastal community. Mostly, however, it was a three-hour flogging of Los Angeles Mayor Eric Garcetti, City Councilman Mike Bonin — whose district includes Venice — and Police Chief Michel Moore. People packed into the auditorium of the Westminster Elementary School last Wednesday didn’t want to hear that the project would move at least 154 homeless people off the surrounding sidewalks and into ”bridge,” or interim, housing. (Carla Hall, 10/24)
Sacramento Bee:
Helping Sacramento’s Homeless Is Up To NIMBYs
The day Melanie Gamboa showed up on the campus of Loaves & Fishes — her sister, her boyfriend and their four cats in tow — the staff of Maryhouse women’s shelter didn’t have anywhere to put them. As is typically the case in Sacramento, all of the emergency beds had already been filled by other homeless people. So, having nowhere else to go, the trio and their pets joined the huddled masses across the street. They pitched a tent and that’s where they stayed for weeks, until the night Gamboa fell out of her wheelchair and couldn’t get up. She died right there on the sidewalk, tucked in with a blanket, in the shadow of multiple of shelters, all of them full. She was 39. (Erika D. Smith, 10/22)
San Francisco Chronicle:
LA Is Handing Out Flea Collars To Stem Typhus Among Homeless
The typhus outbreak in Los Angeles County is traced to disease-ridden fleas in areas with concentrated homeless populations, and the Los Angeles County Board of Supervisors actually approved a plan Tuesday for mobile health teams to distribute flea collars in the Skid Row area. Dogs often have flea collars, too. (Ian McCuaig, 10/21)
San Francisco Chronicle:
Vote 'Yes' On Prop. 11 To Ensure Ambulances Come Quickly
For the past 50 years, private emergency medical technicians and paramedics have been paid to be reachable during their work breaks in case there is a nearby emergency. It is the same way that other essential public safety personnel operate, including police officers, firefighters and public EMTs and paramedics. It is the heart of emergency response. But trial attorneys are trying to end this long-standing practice and require private, but not public, EMTs and paramedics to be completely unreachable during work breaks, putting patient care at risk. (Adam Dougherty, 10/20)
Los Angeles Times:
Take It From A Genetic Counselor: 23andMe's Health Reports Are Dangerously Incomplete
Not only does 23andMe not provide counseling, their results are incomplete. For instance, they report only on BRCA1 and BRCA2 and restrict their findings to the three mutations common among Jewish women. (They do explain this in their printed materials.) While the most common three mutations in the BRCA1 and BRCA2 genes are typically found in women of Ashkenazi Jewish heritage, there are more than 1,000 other mutations that can be just as deadly.
Women with Ashkenazi heritage can also have a mutation not associated with being Ashkenazi. There are other genes that can have mutations that substantially increase one’s risk for breast cancer, including PALB2, CHEK2, PTEN, CDH1, TP53 and STK11. 23andMe doesn’t provide test results for any of these mutations. (Sarah C. Hopkins, 10/26)
Los Angeles Times:
Here's Why Trump Thinks It's Still 'Acceptable' To Target Transgender People For Discrimination And Abuse
Back in 2010, I had an emotional conversation with a woman I am proud to call my closest transgender friend. She’s Lynn Conway, one of the most important pioneers in the history of electrical engineering and computer science, whose distinguished career spans industry and academia. She’s also a pioneer and a leader in transgender advocacy, having started her gender transition in the 1960s. (Michael Hiltzik, 10/23)