- California Healthline Original Stories 4
- Marketplace Confusion Opens Door To Questions About Skinny Plans
- University Was Tipped Off To Possible Unauthorized Trials Of Herpes Vaccine
- Doctors Make Big Money Testing Urine For Drugs, Then Ignore Abnormal Results
- The Ratcheting Price Of The Pneumococcal Vaccine: What Gives?
- Around California 3
- Marketing Push Boosts San Diego As Medical Tourism Hot Spot
- Supercomputers Can Slash Cancer Drug Development Timelines, Bay Area Researchers Say
- New San Francisco Marijuana Rules Reduce School Buffer Zone For Dispensaries
- Covered California & The Health Law 3
- HHS Nominee Alex Azar Heads To Hill To Face Questions On Pharma Ties, Health Law Views
- From Repeal Of Individual Mandate To CHIP: Health Measures At Center Of Congress’ End-Of-Year Legislative Push
- A Detailed Look At Who Benefits From Tax Bill's Repeal Of Individual Mandate
Latest From California Healthline:
Regulators are scrutinizing claims by companies that their alternative, slimmed-down health plans satisfy Obamacare coverage requirements. California Insurance Commissioner Dave Jones said his agency will investigate whether one of those companies is selling such plans in California in violation of state law. (Julie Appleby, 11/29)
Southern Illinois University has concluded its researcher violated university rules and U.S. law. (Marisa Taylor, 11/29)
Medicare and insurers struggle to oversee a booming business in testing urine samples. In some cases, pain doctors’ lack of follow-through can turn fatal. (Fred Schulte, 11/29)
The price for Pfizer’s Prevnar 13 has increased 5 to 6 percent each year since its 2010 approval by the Food and Drug Administration. (Shefali Luthra, 11/29)
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Summaries Of The News:
The effort aims to build out the infrastructure necessary to attract patients to the city for surgeries and other medical treatment.
Come For A New Hip, Stay For The Beach? San Diego Bets On Medical Touism
Among the many issues that need to be addressed: Local hotels need to be equipped appropriately to handle patients recuperating from various types of treatments. Hospitals need to train their doctors to be culturally sensitive to patients coming from different parts of the world. They may need more translators. Or special prayer rooms. Or luxury cars to ferry patients to and from the hospital. Their cafeterias need to brush up on global flavors and culinary favorites, as well as faith-based dietary restrictions. (Keshavan, 11/29)
“There’s been a revolution in machine learning,” says Jim Brase, the deputy associate director for computation at Lawrence Livermore National Laboratory. In other news impacting the California medical landscape: the benefits of a nursing Ph.D.
Bay Area Scientists Say Computers Can Develop Cancer Drugs 6 Times Faster
Since one of every four deaths in the U.S. is due to cancer, a lot of lives could be saved if that drug development time could be cut down to just a year. Cancer researchers at UCSF and computer scientists at Lawrence Livermore National Laboratory are partnering with researchers from the National Cancer Institute’s Frederick National Laboratory and pharmaceutical giant GlaxoSmithKline (GSK) in an attempt to do just that. (Snow and Venton, 11/28)
Orange County Register:
Earn A Ph.D. In Nursing? A Cal State Fullerton Assistant Professor Tells Why
Every doctoral nursing student hears the same question. Sharrica Miller explains the benefits of the ultimate degree in nursing. (Fawthrop, 11/28)
Cannabis dispensaries can now operate 600 feet from a San Francisco school, in one of several new marijuana regulations passed by the city's Board of Supervisors. In other news: the perils of pot for teenagers.
San Francisco Chronicle:
SF Supervisors Pass Recreational Marijuana Rules After Months Of Talking
Cannabis dispensaries in San Francisco will be allowed to operate closer to schools under rules the Board of Supervisors approved Tuesday. The new regulations, passed on a 10-1 vote with Ahsha Safai in dissent, will reduce the school buffer zone from 1,000 to 600 feet, the amount recommended by the state. (Swan, 11/28)
Kaiser Health News:
Teaching Teens The Perils Of Pot As Marketplace Grows
After Yarly Raygoza attended the drug prevention program at the Boys & Girls Club here last year, she used what she learned to talk a few friends out of using marijuana. The 14-year-old took the class again this year but worries that counseling her friends will become more difficult. Recreational marijuana is now legal in California, which could bring a massive boom in drug sales and advertising when stores can begin selling the drug to adults without a prescription in January. (Gorman, 11/29)
President Donald Trump's pick to lead the Department of Health and Human Services will answer senators' questions Wednesday during his first confirmation hearing. Drug pricing and Obamacare are expected to top the subject list.
Trump's Pick For Health Secretary Messages He's No Tom Price
To Republicans, President Donald Trump’s pick for Health and Human Services secretary is competence personified — an able manager who can get the agency back on track after the tumult of Tom Price’s brief tenure and forced resignation. To Democrats, Alex Azar is a pharmaceutical industry shill who knows a lot more about raising drug prices than lowering them. (Cancryn, 11/29)
The Associated Press:
Skeptical Democrats To Quiz Trump Health Pick On Drug Prices
Skeptical Democratic senators are getting a chance to question President Donald Trump’s pick for health secretary about what he’ll do about rising drug prices and the future of “Obamacare.” Alex Azar’s first confirmation hearing — before the Senate Health Education, Labor and Pensions Committee — was scheduled for Wednesday. The former drug company and government executive has the support of committee Republicans. He’s signaling that he wants to shift away from partisanship, and some prominent Democrats seem to be willing to give him a chance. (Alonso-Zaldivar and Kellman, 11/29)
Trump Health Nominee Steps Into The ObamaCare Wars
Alex Azar on Wednesday will make his first public appearance since being nominated by President Trump to lead the Department of Health and Human Services (HHS), the agency tasked with managing ObamaCare. Democrats on the Senate Health Committee are certain to bombard Azar with questions about how he plans to implement ObamaCare, his tenure as a pharmaceutical executive and how he’d lower the rising price of prescription drugs. (Roubein, 11/29)
In other HHS news —
HHS Proposes Ending Direct Notification for Health Tax Credits
Some Americans may unexpectedly find themselves cut off from tax credits to help buy health insurance under a new proposal by the Trump administration. Currently, the government cannot terminate a consumer’s tax credits, used to get coverage through the 2010 health care law’s exchanges, unless it first notifies the person of the exact reason why and how to appeal the decision. (Williams, 11/28)
As a Senate panel advances the Republicans' tax plan, Sen. Lamar Alexander (R-Tenn.) says support for eliminating the Affordable Care Act's individual mandate is solidifying. And President Donald Trump signals openness to a series of Obamacare fixes that could sway key GOP lawmakers. Meanwhile, other health items still on the agenda are stacking up.
The Wall Street Journal:
Health-Care Clashes Loom Over Republican Legislative Agenda
Congress is headed for a showdown on whether to insert several pressing health measures in year-end bills, reviving partisan fights that threaten to derail Republicans’ goal to close out the year with a raft of legislative successes. The looming health-care issues include funding for a children’s health program, the possible delay of certain taxes by the Affordable Care Act and the fate of a bipartisan plan to bolster fragile insurance markets. (Armour and Peterson 11/29)
The New York Times:
Republicans Clear Major Hurdle As Tax Bill Advances
Senate Republicans took a significant step toward passing a sweeping tax overhaul on Tuesday, with a key panel giving its approval and several wavering senators indicating they would support the tax package, helping clear the way for full Senate consideration later this week. ... Senator Lamar Alexander, Republican of Tennessee, said that Senate Republicans were increasingly united about repealing the requirement that most people have health insurance or pay a penalty. (Rappeport and Kaplan, 11/28)
Trump Backs Bipartisan Obamacare Market Bill, Boosting Tax Plan
President Donald Trump told Republican senators on Tuesday he supports an Obamacare market stabilization bill offered by Republican Lamar Alexander and Democrat Patty Murray, which may help bolster support for the tax-cut legislation headed for a vote this week. Senator Mike Rounds of South Dakota quoted Trump as telling Republican senators, “I support the Alexander-Murray bill.” (Kapur and Edney, 11/28)
The Washington Post:
Senate Republican Tax Plan Clears Hurdle With Help From Two Key GOP Holdouts
In a private meeting with [Sen. Susan] Collins before lunch, and again in front of the larger group of Republicans, Trump signaled openness to Collins’s demands, which include paying federal subsidies to help lower-income Americans afford health coverage and allowing Americans to continue deducting up to $10,000 in property taxes from their taxable income. “It’s certainly progress,” said Collins, who played a central role in derailing GOP health-care bills this year. (DeBonis, Werner and Paletta, 11/28)
News organizations examine how specific tax bill proposals could impact the health industry —
GOP Tax Overhaul Could Diminish Research Institutions
Both versions of the Republican-led Congress' tax overhaul levy a new tax on the endowments of major private health-research institutions, and critics say it could have a lasting impact on these facilities and the broader U.S. health research landscape. Republicans have proposed a 1.4% "excise" tax on the net investment income from large endowments of private institutions. Endowments at public universities—including any privately funded endowments for certain research centers at those public universities—will not be affected by the bill. (Luthi, 11/28)
Patient Groups Urge Senate To Reject ObamaCare Mandate Repeal
A coalition of 19 patient groups warned Republican senators on Tuesday against repealing ObamaCare’s individual mandate as part of tax reform. The coalition's letter, signed by groups including the American Cancer Society Cancer Action Network, the American Diabetes Association and the American Heart Association, warns of “coverage losses and higher premiums” from repealing the mandate.(Sullivan, 11/28)
The New York Times provides a statistical guide to the people who opt to forego insurance and pay a penalty instead. Also in news about insurance coverage, one paper explores how sometimes an income drop can help make coverage more affordable and save money, and another insurer moves into the venture capital market.
The New York Times:
Millions Pay The Obamacare Penalty Instead Of Buying Insurance. Who Are They?
The Senate Republican tax bill includes the repeal of the Affordable Care Act’s individual mandate, the requirement that all Americans purchase qualifying health insurance or pay a penalty. The move could deal a serious blow to the health law. The repeal of the mandate could result in an estimated 13 million more people without insurance within 10 years, but may potentially lead to federal savings of $338 billion, money that would be used to help pay for broad tax cuts for individuals and businesses. Here’s who pays the mandate’s penalty and how much it costs. (Lai and Parlapiano, 11/28)
USA Today/Milwaukee Journal Sentinel:
Earning A Little More Than Threshold Could Boost Cost Of Health Insurance
In a health care system teeming with fine print, here’s an oddity that middle-class people who buy insurance on their own, rather than through an employer, need to know: You might want to take a pay cut next year. (Boulton, 11/24)
UnitedHealth Goes The Venture Capital Route
The health insurance industry has long been a target for private equity firms looking for places to stash their cash. Some major health insurers have turned the tables and are pumping money into innovative healthcare startups. Cambia Health Solutions, Blue Cross and Blue Shield companies and Humana are just a few with VC arms that are injecting millions into early stage companies promising to disrupt the industry. Now UnitedHealth's Optum business unit is branching into venture capital with a $250 million fund focused on investing in startups that improve the healthcare delivery and payment systems, along with consumers' access to care. (Livingston, 11/28)
ProPublica continues its investigation of unnecessary medical treatments and their role in driving up the cost of health care. And Stat looks at how the "value" movement is reshaping the health industry, and a New Hampshire doctor raises questions around electronic record keeping.
A Hospital Charged $1,877 To Pierce A 5-Year-Old’s Ears. This Is Why Health Care Costs So Much.
Two years ago, Margaret O’Neill brought her 5-year-old daughter to Children’s Hospital Colorado because the band of tissue that connected her tongue to the floor of her mouth was too tight. ... During a pre-operative visit, the surgeon offered to throw in a surprising perk. Should we pierce her ears while she’s under? O’Neill’s first thought was that her daughter seemed a bit young to have her ears pierced. Her second: Why was a surgeon offering to do this? ... Only months later did O’Neill discover her cost for this extracurricular work: $1,877.86 for “operating room services” related to the ear piercing — a fee her insurer was unwilling to pay. (Allen, 11/28)
Seven Ways Patients Can Protect Themselves From Outrageous Medical Bills
Experts in reducing charges for medical services say patients need to push for detailed answers up front about the true costs of their care. (Allen, 11/28)
'Value' Is Medicine's Favorite Buzzword. But Whose Definition Are We Using?
Backers of the value movement believe the entire medical system — and every transaction within it — must be based on this seminally important five-letter word. But a survey released Wednesday by the University of Utah shows that, in health care, value has no universal meaning — 88 percent of doctors equated value with quality care, while patients and employers provided a more nuanced definition, mixing in measures of cost, customer service, and worker productivity. (Ross, 11/29)
Do Doctors Need To Use Computers? One Physician's Case Highlights The Quandary
Do you need computer skills to be a competent doctor? That's one of the central questions surrounding a difficult case unfolding in New Hampshire this month: Anna Konopka, an octogenarian doctor who eschews computers and has been practicing medicine for the better part of six decades, surrendered her license under a September agreement with the state's board of medicine — partly because of multiple complaints related to her record keeping, Merrimack Superior Court Judge John Kissinger said. (Dwyer, 11/28)
“This bill basically tore the heart out of the diversion program,” one official told senators Tuesday. In other opioid-related news, the expanding profession of opioid recovery coaches raises questions.
The Washington Post:
Former DEA Officials Call For Repeal Of Law That Weakened Enforcement
Three former Drug Enforcement Administration officials urged Democratic lawmakers Tuesday to repeal a 2016 law that effectively took away the agency’s most potent weapon against distributors and manufacturers of prescription opioids. The trio said the authority to instantly freeze shipments of powerful painkillers was the DEA’s most effective tool against giant companies that ignored legal requirements to report suspicious orders of the pills by pharmacies, doctors and others who diverted them for illegal use. Those “immediate suspension orders” not only protected the public from the most egregious abuse but deterred other companies as well, they said at a session held by Senate Democrats. (Bernstein and Higham, 11/28)
Questions Arise Over Profession Spawned By Opioid Crisis: Recovery Coaches
[Katie] O’Leary, who works for the North Suffolk Mental Health Association, belongs to a new profession whose role is expanding amid the opioid crisis. But as the use of recovery coaches grows, so do the questions: Who are they exactly? What qualifies them to do this work? What are the boundaries of their practice? (Freyer, 11/28)
In other public health news, many Americans still live with the AIDS virus for years without realizing they have it; running doesn't necessarily help the heart; what happens when clinical trials fail; and abortion doulas.
Los Angeles Times:
The World Is Off Track In Its Goal To Eliminate Malaria. Here's Why.
Progress toward the global elimination of malaria has stalled, according to a report to be published Wednesday by the World Health Organization. The world made big gains against malaria from 2000 to 2015, with annual infections falling 18% and annual deaths dropping 48%. The WHO was so encouraged by the declines that in 2015 it announced a goal of cutting malaria infections and deaths worldwide by at least 40% by 2020. (Simmons, 11/28)
Los Angeles Times:
About 15% Of Americans With HIV Don't Know They're Infected, CDC Report Says
Half of the Americans recently diagnosed with HIV had been living with the virus for at least three years without realizing it, missing out on opportunities for early treatment and in some cases spreading it to others, according to a new report by the Centers for Disease Control and Prevention. (Healy, 11/28)
The New York Times:
How Running May Or May Not Help The Heart
If 50 men run 3,510 marathons over the course of three decades, will their heart health suffer or improve? A new study delving into precisely that question concludes that the answer is simultaneously reassuring and complicated, with long years of endurance training seeming not to harm runners’ hearts, but also not necessarily to benefit them in the ways that the runners themselves probably expected. (Reynolds, 11/29)
The New York Times:
A Failure To Heal
What happens when a clinical trial fails? This year, the Food and Drug Administration approved some 40 new medicines to treat human illnesses, including 13 for cancer, three for heart and blood diseases and one for Parkinson’s. We can argue about which of these drugs represent transformative advances (a new medicine for breast cancer, tested on women with relapsed or refractory disease, increased survival by just a few months; a drug for a type of leukemia had a more lasting impact), but we know, roughly, the chain of events that unfolds when a trial is positive. ... Yet the vastly more common experience in the life of a clinical scientist is failure: A pivotal trial does not meet its expected outcome. What happens then? (Mukherjee, 11/28)
The Washington Post:
The Long Five Minutes: Abortion Doulas Bring Comfort During A Complicated Time
“Do you support reproductive choices of all shapes and sizes?” the flier had read, posted online in early April. “Become an abortion doula.” More than 50 women had seen the flier on Facebook or Twitter and responded to the email address at the bottom, not entirely sure what an abortion doula was. Twenty-five had been selected for a weekend-long training at a Virginia abortion clinic, and now, one Saturday morning in May, they’d arrived to see whether they were right for the work. (Hesse, 11/28)