CALIFORNIA WATCH FEBRUARY 26, 2018 Ventura County Star

CALIFORNIA WATCH FEBRUARY 26, 2018

Ventura County Star: Ventura County HIV Increase Triggers Concerns about Hookup Apps The front lines of the increase in Ventura County HIV diagnoses include Grindr and other apps men use to hook up with other men, said health officials and advocates. Provisional data shows 70 new local cases of HIV were diagnosed in 2017, public health officials said at a Thursday meeting of an HIV/AIDS Coalition of Ventura County. In 14 additional cases, the condition had progressed to AIDS by the time the HIV was diagnosed. While the numbers could change when a final report is released in March, the tentative figures suggest a twofold leap. (Kisken, 2/25)

KPCC: Critically Ill Medi-Cal Patients Just Got an Important New Benefit About 300 health care providers from around the Los Angeles region gathered for a day-long conference Saturday to learn more about palliative care and end-of-life planning. L.A.'s largest Medi-Cal plan brought them together to learn more about a new state regulation that took effect in early 2018. In 2014, California passed a law requiring Medi-Cal Managed Care patients get access to palliative care. Now, patients with congestive heart failure, advanced cancer, liver disease, and chronic obstructive pulmonary disease can get more services to address suffering associated with their illness. (Faust, 2/24)

KQED: California Nurses Warn That Losing Supreme Court Case Could Gut Unions Nurses protested outside San Mateo Medical Center in front of a sign that read “Patient safety comes from union strength” last week. They wore the characteristic bright red shirts of their own union: the California Nurses Association (CNA). They were calling attention to the U.S. Supreme Court case Janus vs. American Federation of State, County and Municipal Employees. The outcome of the case could dramatically weaken public sector unions if the court overturns a rule that requires non-union employees at union-affiliated workplaces to pay “fair share” fees. (Klivans, 2/23)

Capital Public Radio: Only 7 Percent of Californians Lack Health Insurance, National Study Says A new study indicates that almost 29 million Americans lack health insurance — a big improvement compared to nearly 49 million in 2010. Californians are better covered than most of the nation. Texas comes in last, with 20 percent having no health insurance, according to the latest findings by the National Center for Health Statistics. In California, that number is 7 percent. (Ibarra, 2/23)

CAPITOL HILL WATCH

The New York Times: Is This the Moment for Gun Control? A Gridlocked Congress is Under Pressure Lawmakers will return to Washington on Monday facing intense public pressure to break their decades- long gridlock on gun control, a demand fortified by a bipartisan group of governors calling for Congress to take action to protect against mass shootings. But even as members of both parties said it might be difficult for Congress to remain on the sidelines after the school massacre this month in Parkland, Fla., lawmakers have no clear consensus on even incremental changes to gun restrictions, let alone more sweeping legislation. (Gay Stolberg, Martin and Kaplan, 2/25)

Modern Healthcare: Week Ahead: House Launching 'Aggressive' Legislative Agenda on Opioids Months after President Donald Trump first designated the opioid epidemic as a public health emergency and weeks after Congress announced $6 billion in new funding for states to battle the problem, the House of Representatives will kick off its first big policy effort to manage the crisis. On Wednesday in the first of three scheduled hearings, the House Energy and Commerce Committee's Health Subcommittee will examine a packet of bills that focus more on enforcement than treatment. The legislation emerging from these hearings will likely be this Congress' final substantive health policy push before the 2018 midterm elections. (Luthi, 2/24)

The Associated Press: Governors Push Bipartisan National Health Care Compromise A bipartisan group of governors working to strike compromise on hot-button policy issues took on the question of health care on Friday. Republican Ohio Gov. John Kasich, in presenting the group's blueprint for policy changes at the National Press Club, lamented that one of the country's largest challenges seems to have been set aside by policymakers. "It's like health care doesn't even matter anymore down here," he said. (2/23)

ADMINISTRATION NEWS

The Hill: Planned Parenthood Won't be Barred from Applying for Family Planning Funds Planned Parenthood and other abortion providers will not be barred from applying for funding under a federal family planning grant program, an official at the Department of Health and Human Services (HHS) said Friday. The HHS Office of Population Affairs released a long-awaited funding announcement Friday for $260 million in funding for Title X grants. (Hellmann, 2/23)

Stat: CDC Requests Funds to Build New Maximum-Security Laboratory The request, which is currently in the proposed budget for fiscal year 2018, is for $350 million. But more will be needed later; the new high containment continuity laboratory, as it is called, would be built on the site of one of only a few parking facilities on the CDC’s main campus. (Branswell, 2/23)

HEALTH LAW

The Hill: Trump: ObamaCare Being Wiped Out 'Piece by Piece' President Trump argued Friday that ObamaCare is being “wiped out” in a “piece-by-piece” way despite the failure of the GOP Congress to repeal the law. Trump, speaking to the Conservative Political Action Conference Friday, pointed to a number of actions that Republicans have taken against the law, including repealing the individual mandate to buy health insurance as part of the tax-cut bill. (Sullivan, 2/23)

California Healthline: Ding Dong! The Obamacare Tax Penalty Is(n’t) Dead Rick, Patrick and Michael recently commented on Covered California’s Facebook page, urging others to ditch health insurance because: “No more fines or penalties!!! Trump took care of that!! Saved me 700 bucks this year!!!” “Trump removed the penalty for not having insurance.” “I’m pretty sure Trump abolished the illegal penalty.” They’re right — and wrong. (Bazar, 2/23)

PUBLIC HEALTH AND EDUCATION

NPR: Kids Still Plagued by Obesity in U.S., Report Finds Hopes were dashed this week that the United States was finally making progress in the fight against childhood obesity. Contrary to previous reports, the epidemic of fat has not abated. In fact, there's been a big jump in obesity among the nation's youngest children, according to the latest analysis of federal data, published Monday in the journal Pediatrics. (Stein, 2/26)

NPR: Screen All Teens for Depression, Pediatricians Urge Only about 50 percent of adolescents with depression get diagnosed before reaching adulthood. And as many as 2 in 3 depressed teens don't get the care that could help them. "It's a huge problem," says Dr. Rachel Zuckerbrot, a board-certified child and adolescent psychiatrist and associate professor at Columbia University. (Aubrey, 2/26)

The New York Times: F.D.A. to Expand Medication-Assisted Therapy for Opioid Addicts In an effort to encourage new treatments for opioid addiction, the Food and Drug Administration plans to begin permitting pharmaceutical companies to sell medications that help temper cravings, even if they don’t fully stop addiction. The change is part of a wider effort to expand access to so-called medication- assisted treatment, or MAT. The agency will issue draft guidelines in the next few weeks. A senior agency official provided details of the proposal to The New York Times. (Kaplan, 2/25)

The Washington Post: Flu Cases Fall for the First Time This Awful Influenza Season Flu activity is on the decrease for the first time in this fierce flu season, suggesting that the worst may be over, according to a federal health report released Friday. But the intensity of illness caused by the respiratory virus, the worst since the swine flu pandemic of 2009-2010, continues to take its toll. Another 13 child deaths were reported for the week ending last Saturday, according to the Centers for Disease Control and Prevention. That brings the total to at least 97 pediatric deaths since October. (Sun, 2/23)

EDITORIALS AND OPINIONS

The New York Times: Guns and Opioids are American Scourges Fueled by Availability The United States is in the midst of at least two plagues with much in common. One is gun-fueled mass murder; the other is addiction to opioids — pain pills, heroin, fentanyl. Both are uniquely American afflictions, killing in alarming numbers. Both are revved in part by commercial interests and in part by the collapse of community in American culture. Both persist because of the erroneous belief that there’s an easy answer to these complicated problems. (Sam Guinone, 2/24)

DHNR is a daily compilation of news stories from GCHP’s Communications Department. Certain news organizations are protected via a paywall requiring the purchase of a subscription to view their content.

CALIFORNIA WATCH FEBRUARY 27, 2018

California Healthline: At Some California Hospitals, Fewer Than Half of Workers Get the Flu Shot How well are doctors, nurses and other workers at your local hospital vaccinated against the flu? That depends on the hospital. According to data from the California Department of Public Health, flu vaccination rates among health care staffers at the state’s acute care hospitals range from a low of 37 percent to 100 percent. (Wiener, 2/27)

Ventura County Star: Gold Coast Health Plan: Organ Donor Awareness: Registration is Vital In the 25-year period from 1991 to 2015, the number of organ donors in the United States more than doubled, from 6,953 to 15,947. The same trend held true for organ transplants, which rose from 15,756 to 33,612. Good news? Yes. But in the same period, the number of people awaiting transplants quintupled, from 23,198 to 119,262 as demand far out-distanced supply. The shortage of available organs has become more severe since 2001, as the number of people needing transplants has jumped 50 percent, while the number of organ donors has increased only marginally. (Nelson, 2/26)

LA Times: Judge Orders California Agricultural Officials to Cease Pesticide Use A judge has ordered California agricultural officials to stop spraying pesticides on public and private property to control insects that threaten the state's $45-billion agriculture industry. The injunction by a Sacramento County Superior Court judge, issued late last week, could throw a substantial hurdle in front of efforts by the state Department of Food and Agriculture to control dozens of crop-damaging pests such as the Asian citrus psyllid, which carries bacteria that have decimated the citrus industry in Brazil and Florida. (Mohan, 2/26)

LA Daily News: LA County Offers to Pay Off Student Debt for New Doctors — If They Work in its Jails On the outside, Richard Brent was a thief and a user. He stole and used meth and heroin, acted tough and aggressive, all of which got him a 90-day sentence to Los Angeles County’s Men’s Central Jail. But for Dr. Lauren Wolchok, his physician on the inside, Brent is neither criminal nor inmate. For her, he is a person in need of medical care like anyone else. (Abram, 2/26)

Sacramento Bee: Rent Control and Health Care: Liberals Fight for the Soul of the California Democratic Party As her primetime speech at the California Democratic Party convention ran long Saturday, an orchestral recording drowned out Sen. Dianne Feinstein. ... And at one point, angry over Assembly Speaker Anthony Rendon's decision to hold a proposed single-payer universal health care bill in committee, a person in the crowded room at the Progressive Caucus Friday night yelled that Rendon was a "DINO," or "Democrat-in-name-only." (Hart and Kosseff, 2/26)

ADMINISTRATION NEWS

The Associated Press: Administration Considers Expanding Mental Health Treatment Amid the outcry over the Florida school shootings, the Trump administration says it is "actively exploring" ways to help states expand inpatient mental health treatment using Medicaid funds. President Donald Trump again brought up the issue of mental hospitals in a meeting with governors on Monday, invoking a time when states maintained facilities for mentally ill and developmentally disabled people. "In the old days, you would put him into a mental institution," Trump said, apparently referring to alleged shooter Nikolas Cruz, whose troubling behavior prompted people close to him to plead for help from authorities, without success. (Alonso-Zaldivar, 2/27)

NPR: Trump Echoes NRA More, After Bipartisan Tone Started the Gun Discussion Lawmakers in Washington and Tallahassee have discussed a lot of ideas to reduce school shootings, but on the hardest questions — like what to do about guns — there is just no clear consensus. There are few signs of clarity from President Trump, who has taken a leading role in the debate without providing strong direction to solve the problem. (Liasson, 2/27)

HEALTH LAW

Politico: 20 States Sue Over Obamacare Mandate — Again The GOP tax law "eliminated the tax penalty of the ACA, without eliminating the mandate itself,” the states argue in a complaint filed today in U.S. District Court in the Northern District of Texas. “What remains, then, is the individual mandate, without any accompanying exercise of Congress’s taxing power, which the Supreme Court already held that Congress has no authority to enact." The Supreme Court in 2012 upheld Obamacare’s individual mandate in one of the highest-profile court cases in years. The justices did not agree then with the Obama administration’s main argument that the mandate penalty was valid under the Commerce Clause. But the justices did say that the mandate was a constitutional tax. (Haberkorn, 2/26)

MEDICAID

Kaiser Health News: Refusing to Work for Medicaid May Not Translate to Subsidies for ACA Plan In general, people who are eligible for Medicaid — the federal-state health program for low-income people — or employer coverage can’t qualify for federal tax credits that help pay for premiums on plans sold on the health insurance exchanges. This year, Kentucky and Indiana became the first states to receive federal approval to require some Medicaid recipients to put in 80 hours each month at a paid job, school or volunteer work, among other activities, to receive benefits. Nearly a dozen other states have made similar requests. (Andrews, 2/27)

MARKETPLACE

Bloomberg: Buffett-Dimon Health Venture to go Beyond Just Squeezing the Middlemen Health-care spending is taking up an increasing proportion of the U.S. economy, and a goal of the venture is to “at least” halt that, [Warren] Buffett said, adding that he hopes “we could find a way where perhaps better care could be delivered even at somewhat lesser cost.” (Tracer and Chiglinsky, 2/26)

PUBLIC HEALTH AND EDUCATION

The Hill: FDA Advisory Committee to Analyze Changing Flu Vaccine for Next Year A Food and Drug Administration (FDA) advisory committee will consider whether to change the flu vaccine for next year as the country faces a worse-than-expected flu season. The FDA convenes a panel annually to analyze what will make up next flu season’s vaccine. The panel examines the World Health Organization’s recommendations to help decide the composition of the next year’s shots. (Roubein, 2/26)

The Washington Post: Autism Connection to Ultrasound Seems Unlikely, Study Says Ultrasounds during pregnancy can be lots of fun, offering peeks at the baby-to-be. But ultrasounds aren’t just a way to get Facebook fodder. They are medical procedures that involve sound waves, technology that could, in theory, affect a growing fetus. With that concern in mind, some researchers have wondered if the rising rates of autism diagnoses could have anything to do with the increasing number of ultrasound scans that women receive during pregnancy. (Sanders, 2/26)

San Jose Mercury News: Standing Desks May Be Hazardous to Your Health You might want to sit down before you hear the latest research on standing desks. We all know that sitting at a desk for too long can lead to long-term health problems, which has led to many workers switching to standing desks to lose weight, reduce back pain and generally stay more alert. Sitting is the new smoking, right? (D'Souza, 2/26)

EDITORIALS AND OPINIONS

The Hill: Sugary Drinks Are Causing Chronic Illnesses — We Need Policy Changes to Combat Them When we think of the major killers of Americans, we naturally gravitate towards drugs and violence as the major culprits. These are often graphic deaths that occur abruptly. Too often we neglect chronic diseases, which silently claim far more lives. Heart disease is the leading killer in the United States, followed closely by other related illnesses such as stroke. As a physician, I am used to treating conditions that contribute to heart disease and stroke in adults — high blood pressure, diabetes, and obesity. Now, I am seeing children sickened by the same diseases. (Dr. Leana S. Wen, 2/26)

CALIFORNIA WATCH FEBRUARY 28, 2018

Sacramento Bee: Counties Slow to Spend Millionaires' Money on Mental Health California counties are sitting on money from a special tax on millionaires that should be spent on mental health programs, but the state isn’t moving fast enough to reclaim the funds, according to a state audit released on Tuesday. California State Auditor Elaine Howle found that county mental health programs had stashed $231 million from the tax that should have been returned to the state by the end of the 2015- 16 budget year. (Ashton, 2/28)

Ventura County Star: Gold Coast Health Plan: Raising Awareness of African American Health Issues National Black HIV/AIDS Awareness Day, a national community education and mobilization initiative that advocates HIV testing and treatment for African Americans, marked its 18th year Feb. 7. While HIV/AIDS awareness and testing are critical for all groups of individuals, the Centers for Disease Control notes that three of the five groups in which most new HIV infections occur are black men who have sex with men, second; black heterosexual women, fourth; and black heterosexual men, fifth. The highest incidence is white men having sex with men and the third is Hispanic men having sex with men. (Nelson, 2/27)

Ventura County Star: Drama Over Pharmacy Medi-Cal Rates Keeps Churning In a drama playing out monthly at a Medi-Cal commission’s meetings, independent pharmacists complained Monday about alleged “underwater” reimbursement rates and “clawbacks.” And as happened in January, they went home frustrated because their complaints that reimbursements for prescriptions often don’t cover their costs and could push them out of business are still being studied. A consultant hired by the Ventura County Medi-Cal Managed Care Commission said data is being collected and a report will likely be completed next month. (Kisken, 2/27)

Ventura County Star: Consultant Hired to Help VCMC Overhaul Business Operations A Chicago-based consultant has been hired to advise officials on how to overhaul business operations at Ventura County Medical Center, where estimated net income is off by $10 million. Huron Consulting Services will be paid up to $750,000 under the 12-month contract approved Tuesday by the Ventura County Board of Supervisors. The firm has been assessing the county system of hospitals and clinics under three separate agreements of about $30,000 each, but this one required board approval because it exceeds $100,000. More contracts with the global consultant will likely be approved in the future, Ventura County Health Care Agency Director Johnson Gill said. (Wilson, 2/27)

CAPITOL HILL WATCH

Stat: New Opioid Bill Would Impose Limits on Some Prescriptions, Boost Funding The CARA 2.0 Act, billed as the sequel to the Comprehensive Addiction and Recovery Act of late 2016, would be the most substantive action Congress has taken to address the opioid crisis since President Trump took office. The legislation’s unveiling comes as Republicans in both chambers of Congress are ramping up their legislative efforts to address the opioids crisis. The two-year budget deal Congress passed earlier this year included $6 billion in extra funding to address the crisis in 2018 and 2019, but offered only broad outlines of how the funds would be used. Now, legislators, lobbyists, and policy advocates are hurrying to identify policies that could fit into that funding framework. (Facher, 2/27)

Politico: Ryan Throws Cold Water on Gun Control Push House GOP leaders downplayed the need for Congress to pass expansive new gun control measures on Tuesday, instead turning their ire on the FBI and local law enforcement for failing to prevent the Parkland, Fla. school shooting. Speaker Paul Ryan told reporters at a press conference that “we shouldn’t be banning guns for law-abiding citizens” but “focusing on making sure that citizens who shouldn’t get guns in the first place, don’t get those guns.” Ryan — who said arming teachers was a “good idea” but a local issue that Congress should not infringe upon — touted a House-passed bill to reinforce background checks under current law. (Bade, 2/27)

ADMINISTRATION NEWS

The Associated Press: DOJ to Support Lawsuits Against Companies Selling Opioids The move is part of a broader effort to more aggressively target prescription drugmakers for their role in the epidemic, Sessions said. The Justice Department will file a statement of interest in the multidistrict lawsuit, arguing the federal government has borne substantial costs as a result of the crisis that claimed more than 64,000 lives in 2016. The Trump administration has said it is focusing intensely on fighting drug addiction, but critics say its efforts fall short of what is needed. (Gurman and Mulvihill, 2/27)

HEALTH LAW

The New York Times: A Big Divergence is Coming in Health Care Among States Little by little, the Trump administration is dismantling elements of the ACA and creating a health care system that looks more like the one that preceded it. But some states don’t want to go back and are working to build it back up. Congress and the Trump administration have reduced Obamacare outreach, weakened benefit requirements, repealed the unpopular individual insurance mandate and broadened opportunities for insurers to offer inexpensive but skimpy plans to more customers. (Sanger-Katz, 2/28)

Los Angeles Times: Democrats Considering a New Strategy to Expand Health Coverage as Frustrations Build with Obamacare After spending most of 2017 defending the Affordable Care Act from GOP attacks, a growing number of Democrats believe the law's reliance on private insurance markets won't be enough and the party should focus instead on expanding popular government programs like Medicare and Medicaid. The emerging strategy — which is gaining traction among liberal policy experts, activists and Democratic politicians — is less sweeping than the "single-payer" government-run system that Sen. Bernie Sanders (I-Vt.) made a cornerstone of his 2016 presidential campaign. (Levey, 2/27)

PUBLIC HEALTH AND EDUCATION

CNN: 1 in 14 Women Still Smokes While Pregnant, CDC Says About one in 14 pregnant women who gave birth in the U.S. in 2016 smoked cigarettes during her pregnancy, according to a report released Wednesday. The findings, gathered by the CDC's National Center for Health Statistics, revealed that 7.2% of all expectant mothers smoked -- but that the percentage of pregnant smokers varied widely from state to state. (Howard, 2/28)

The Associated Press: Unclaimed Bodies Pile Up as Payments Wither, Overdoses Rise Who takes care of the unclaimed dead, the people who were homeless or estranged from family members, or who outlived all their kin, and left no assets behind? The answer is usually funeral homes that get reimbursed by state or local governments for the cost of cremation or burial. But payments are not keeping up with ever-rising expenses in some places, like Massachusetts, meaning the number of funeral homes willing to shoulder the burden is dwindling. In at least one state, West Virginia, drug overdose victims have used up nearly all the money set aside for the unclaimed dead. (Richer, 2/28)

The Associated Press: What's in the IV Bag? Studies Show Safer Option than Saline New research calls into question what's in those IV bags that nearly every hospitalized patient gets. Using a different intravenous fluid instead of the usual saline greatly reduced the risk of death or kidney damage, two large studies found. The difference could mean 50,000 to 70,000 fewer deaths and 100,000 fewer cases of kidney failure each year in the U.S., researchers estimate. Some doctors are hoping the results will persuade more hospitals to switch. (Marchione, 2/27)

The New York Times: Sneeze Into Your Elbow, Not Your Hand. Please. When you feel a sneeze or a cough coming on, covering your mouth prevents the spread of infectious germs. You probably knew that. But the way you cover up also matters, and there are plenty of people who haven’t yet heard the consensus guidance of health officials: If no tissue is available, you should aim into your elbow, not your hand. Even if that means breaking a long-held habit. (Victor, 2/27)

WOMEN’S HEALTH

The Hill: Pence: Abortion Will End in U.S. 'In Our Time' Vice President Pence predicted Tuesday that legal abortion would end in the U.S. "in our time." "I know in my heart of hearts this will be the generation that restores life in America," Pence said at a luncheon in Nashville, Tenn., hosted by the Susan B. Anthony List & Life Institute, an anti-abortion organization. (Hellmann, 2/27)

EDITORIALS AND OPINIONS

Los Angeles Times: Finally, A Universal Healthcare Proposal that Would Work for Everyone Up to now, single-payer and universal health coverage proposals in the U.S. have foundered on one shoal or another: They're ungodly expensive; they replace plans that people like; they're too sudden; they're not sudden enough; they're politically impossible, etc., etc., etc. But now take a look at "Medicare Extra for All." It's a universal coverage proposal released last week by the Center for American Progress, a progressive think tank associated with the Democratic Party. (Michael Hiltzik, 2/27)

CALIFORNIA WATCH MARCH 1, 2018

San Jose Mercury News: California Has the Worst Quality of Life, New Study Says Flying in the face of traditional wisdom that we live on the best coast comes a stinging new study that says we have the worst quality of life in the nation. The coveted Best States ranking is part of an annual study that scores all 50 states on eight categories — health care, education, economy, opportunity, infrastructure, crime and corrections, fiscal stability and the most important of all for most of us, quality of life. (D'Souza, 2/28)

Sacramento Bee: California Collects First Royalty Check From $3 Billion in Stem Cell Spending After more than 13 years, the first stem cell royalty check has finally found its way to the state. The sum: $190,345.87. The stem cell agency has hailed the $190,345.87 payment as historic, but has also declared it is “only a piece of the intended return.” Others described the payment as a “less than a drop in the bucket” and warned of excessive exuberance. (Jensen, 2/27)

ADMINISTRATION NEWS

The Associated Press: Trump Says Some Lawmakers Too Fearful of NRA to Take Action "We can't wait and play games and nothing gets done," Trump said as he opened the session with 17 House and Senate lawmakers. "We want to stop the problems." Trump also raised eyebrows by suggesting that law enforcement officials should be able to confiscate people's firearms without a court order to prevent potential tragedies. (Mascaro, Daly and Lucey, 3/1)

HEALTH LAW

Kaiser Health News: ACA’s Popularity Grows, Even as GOP Lauds Change to Requirement to Have Coverage Despite Trump’s boasting that “we have essentially repealed Obamacare,” a new poll shows the ACA is more popular than ever. In fact, many people don’t know Congress repealed the ACA’s penalty for not having insurance. The poll from the Kaiser Family Foundation found 54 percent of Americans had a favorable view of the 2010 health law that expanded health coverage to millions. That was up four points from January, and it’s highest point since the monthly survey began in 2010. (Galewitz, 3/1)

Modern Healthcare: Association Health Plans Could Spark 4.3 Million People to Drop ACA Coverage As many as 4.3 million people are projected to leave the individual and small group insurance markets to enroll in association health plans over the next five years if the Trump administration's recent proposal to expand those plans is approved. As healthy, young people switch to association plans, premiums in the ACA individual and small group would rise as much as 4% between 2018 and 2022. Because of those premium increases, Avalere projected that another 130,000 to 140,000 people would become uninsured in five years, compared to current law. The study was funded by insurance industry lobbying group America's Health Insurance Plans, but Avalere said it maintained full editorial control. (Livingston, 2/28)

PUBLIC HEALTH AND EDUCATION

NPR: State Opioid Efforts Falter without Federal Funding Support Opioids are on the White House agenda Thursday — President Trump plans to talk with members of his administration about the crisis. Meanwhile, all around the United States, state legislators, treatment providers, families and many others will be listening. The administration's other opioid efforts have, so far, yielded no new money. Congress authorized funds in its recent budget deal — but those dollars aren't flowing yet, and states say they are struggling. (Daley and Fortier, 3/1)

The New York Times: Walmart and Dick’s Raise Minimum Age for Gun Buyers to 21 Two of the nation’s leading gun sellers, Walmart and Dick’s Sporting Goods, took steps on Wednesday to limit their sales of firearms, thrusting themselves into the middle of the polarizing national debate over gun control. Walmart, the biggest gun seller, announced late in the afternoon that it would not sell any gun to anyone under 21 years of age. It also said it would no longer sell items resembling assault-style rifles, including toys and air guns. (Creswell and Corkery, 2/28)

The Washington Post: Transgender Surgeries on the Rise, Says First Study of its Kind In the first broad demographic study of trends in gender-affirming surgeries in the United States, researchers found that the number of operations increased fourfold from 2000 to 2014. Some of the significant rise, according to a study published Wednesday in the journal JAMA Surgery, may be related to an increase in insurance coverage for the procedures. “Early on we recognized there’s been a lot of work on health disparities having to do with age, race and so on that get collected in health-care settings,” said Brandyn Lau, an assistant professor of surgery and health sciences informatics at the Johns Hopkins University School of Medicine. “One of the things we need to know is whether [lesbian, gay and transgender] patients are getting the same care.” (Nutt, 2/28)

Bloomberg: Scientists Want to Completely Rethink How They Make the Flu Vaccine The only thing worse than getting the flu is catching it after you’ve gotten a flu shot. It’s been a terrible year for outbreaks — the worst in almost a decade. Contributing to that is the high failure rate of this year’s vaccine. The current shot is just 25 percent effective against the H3N2 virus, this season’s most- often-identified strain by the Centers for Disease Control and Prevention. The experts say, with enough time and money, they can do a lot better. “There has to be a wholesale change to how we make the flu vaccine,” said Amesh Adalja, senior scholar at Johns Hopkins Center for Health Security. “We’re always setting ourselves up for vaccine mismatch and failures and the like because of the lead time in how long it takes the vaccines to be made.” (Koons and Levingston, 2/28)

The New York Times: You Get Thirsty and Drink. How Does Your Brain Signal You’ve Had Enough? If you think about being thirsty at all, it seems like a fairly simple thought process: Find water. Drink it. Move on. But in fact there is something rather profound going on as you take that long, refreshing drink after a run or a hot day in the garden. As you become dehydrated, there is less water in your blood, and neurons in your brain send out the word that it’s time to look for water. (Greenwood, 2/28)

Kaiser Health News: Never Too Late to Operate? Surgery Near End of Life is Common, Costly At 87, Maxine Stanich cared more about improving the quality of her life than prolonging it. She suffered from a long list of health problems, including heart failure and chronic lung disease that could leave her gasping for breath. When her time came, she wanted to die a natural death, Stanich told her daughter, and signed a “do not resuscitate” directive, or DNR, ordering doctors not to revive her should her heart stop. (Szabo, 2/28)

WOMEN’S HEALTH

Politico: Trump's Abortion Policy Sheds Light on Ad Hoc Decision-Making The Trump administration’s policy of halting abortions among undocumented minors was established by email through an ad hoc process without formal legal vetting, according to new documents released Tuesday by the American Civil Liberties Union. The ACLU, which is suing the administration over the policy, made public the December depositions of the director and the deputy director of the Office of Refugee Resettlement, the HHS office responsible for the care of undocumented minors who enter the country without their parents. (Rayasam, 2/28)

QUALITY

Milwaukee Journal Sentinel and MedPage Today: Is Your Doctor Banned from Practicing in Other States? State Licensing Systems Keep Patients in the Dark Like traveling medicine hucksters of old, doctors who run into trouble today can hopscotch from state to state, staying ahead of regulators. Instead of snake oil, some peddle opioids. Others have sex with patients, bungle surgeries, misdiagnose conditions or are implicated in patient deaths. Even after being caught in one state, they can practice free and clear in another; many hold a fistful of medical licenses. (Fauber, Wynn and Fiore, 2/28)

EDITORIALS AND OPINIONS

Los Angeles Times: Treating and Housing the Mentally Ill is Harder than Jailing Them. But it Might Actually Work If only we could make Les Jones’ story more commonplace. As the 62-year-old Texas native leans back from his desktop computer in his small apartment, he details his journey from a successful radio career to a mental breakdown, to the streets, to shelter and finally to treatment and a healthy, happy life in this tidy complex at perhaps the most enviable corner of Santa Monica, steps from the Third Street Promenade, a short walk to the beach. “I am one verse,” Jones says of the composition of the American population of the mentally ill. “There are others. Modern treatment of mental illness produces miracles. It literally saved my life.” (2/28)

CALIFORNIA WATCH MARCH 2, 2018

California Healthline: State Pay Cut for Dental Hygienists Who Serve the Poor was Illegal, Court Finds California officials should have obtained federal approval before they cut reimbursement rates for dental hygienists who serve frail Californians living in nursing homes and board-and-care facilities, a judge has ruled. (Ibarra, 3/2)

The Sacramento Bee: ‘Not Experimental Anymore’: UCD Med Center Expands Free Testing for Medi-Cal Families Families on Medi-Cal can now receive free genomic testing to diagnose rare genetic disorders at UC Davis Medical Center, according to an announcement Thursday. “Children with rare genetic disorders that come to our clinic and many times they don’t have an answer,” said Dr. Suma Shankar, associate professor of pediatrics and director of the Precision Genomics Clinic at UC Davis. (The genomic testing) helps us come to a definite diagnosis.” (Sullivan, 3/1)

California Healthline: Health Care Revamp at the L.A. County Jails Michael Callahan, an outgoing 43-year-old carpenter, landed in a Los Angeles County jail last September because of what he said were “bad decisions and selling drugs.” He had uncontrolled diabetes and high blood pressure when he arrived, but his health was the last thing on his mind. Consumed by a meth addiction, he hadn’t taken his medications for months. “When I got here, I was a wreck,” said Callahan, who is stocky and covered in tattoos. “My legs were so swollen that if I bumped them they would break open.” (Gorman, 3/1)

The Modesto Bee: Fewer Californians Will Be Insured Next Year, and Those Who are Could Feel the Impact Almost 20 percent of people with health insurance on the independent market in California will drop coverage next year because they won't face a tax penalty, a survey predicted. The study by Harvard Medical School researchers suggested that 378,000 fewer consumers in California will have insurance in 2019 when the Internal Revenue Service will no longer assess a tax penalty on the uninsured. The random survey of 3,010 adults was conducted in California last year to measure the impact of the federal tax reform law that does away with the Affordable Care Act's individual mandate. The survey results were reported Thursday in an online blog of the journal Health Affairs. (Carlson, 3/1)

ADMINISTRATION NEWS

Politico: Trump Suggests Death Penalty to Stop Opioid Epidemic The remarks are likely to rankle administration critics who have urged the White House to focus on the public health component of the opioid crisis. The president's remarks did not touch on health approaches like providing additional funding for treatment. “It makes us all very nervous” that the U.S. could move back to a “penal-first approach,” said Andrew Kessler, who leads Slingshot Solutions, a consulting firm specializing in behavioral health policy that advocates for substance abuse treatment and prevention. “I have no love for high-level traffickers or cartels, but a very high percentage of people who sell drugs do it to support their own habit.” (Karlin-Smith and Ehley, 3/1)

The Hill: Sessions to DEA: Evaluate Opioid Production Quota Attorney General Jeff Sessions is asking the Drug Enforcement Administration (DEA) to evaluate whether changes are needed to the amount of opioids drug makers are allowed to produce. If needed, potential alterations could be made through an interim final rule, which allows an agency to issue a new regulation effective immediately without first going through the notice and comment period. (Roubein, 3/1)

The New York Times: N.R.A. Suggests Trump May Retreat from Gun Control The top lobbyist for the National Rifle Association claimed late Thursday that President Trump had retreated from his surprising support a day earlier for gun control measures after a meeting with N.R.A. officials and Vice President Mike Pence in the Oval Office. The lobbyist, Chris Cox, posted on Twitter just after 9 p.m. that he met with Mr. Trump and Mr. Pence, saying that “we all want safe schools, mental health reform and to keep guns away from dangerous people. POTUS & VPOTUS support the Second Amendment, support strong due process and don’t want gun control. #NRA #MAGA.” (Shear, Gay Stolberg and Kaplan, 3/1)

HEALTH LAW

The Hill: Hatch: ObamaCare Supporters are 'The Stupidest, Dumbass People I've Ever Met' Sen. Orrin Hatch (R-Utah) on Thursday called ObamaCare supporters “the stupidest, dumbass people” he’s ever met. Orrin made the comments during a speech at the American Enterprise Institute about the GOP tax overhaul, which repealed the ObamaCare individual mandate. (Anapol, 3/1)

MARKETPLACE

The Associated Press: Uber Starts Offering Rides to the Doctor Uber is driving deeper into health care by offering to take patients in every U.S. market where it operates to their next medical appointment. The ride-hailing service said Thursday its Uber Health business will handle rides set up by doctor's offices or other health care providers and then bill that business, not the patient, for the service. The company said rides can be set up within a few hours or days in advance. Patients won't need access to a smartphone to use the service. (Murphy, 3/1)

PUBLIC HEALTH AND EDUCATION

Kaiser Health News: As Surgery Centers Boom, Patients are Paying with Their Lives The surgery went fine. Her doctors left for the day. Four hours later, Paulina Tam started gasping for air. Internal bleeding was cutting off her windpipe, a well-known complication of the spine surgery she had undergone. But a Medicare inspection report describing the event says that nobody who remained on duty that evening at the Northern California surgery center knew what to do. In desperation, a nurse did something that would not happen in a hospital. She dialed 911. By the time an ambulance delivered Tam to the emergency room, the 58-year-old mother of three was lifeless, according to the report. (Jewett, 3/1)

The New York Times: They’re Hosting Parasitic Worms in Their Bodies to Help Treat a Neglected Disease Seventeen volunteers in the Netherlands have agreed to host parasitic worms in their bodies for 12 weeks in order to help advance research toward a vaccine for schistosomiasis, a chronic disease that afflicts more than 200 million people a year, killing thousands, primarily in sub-Saharan Africa and South America. “Yes it sounds odd and crazy. The idea of having a worm grow inside you is awful,” says Meta Roestenberg, an infectious disease physician at Leiden University Medical Center, who is directing the research. But she said the risk to the student volunteers is “extremely small,” especially compared with the potential benefit to preventing a disease that burdens millions of the world’s poorest people. A Dutch ethics board agreed. (Murphy, 3/1)

Kaiser Health News: A Tale of Love, Family Conflict and Battles Over Care for an Aging Mother “Edith + Eddie,” a short documentary vying for an Academy Award Sunday, is a gripping look at a couple in their 90s caught up in an intense family conflict over caring for an aging parent. As a columnist who covers aging, I’m familiar with such stories. But as I immersed myself in the details of this case, I found myself reaching a familiar conclusion: real life is more complicated than in the movies. (Graham, 3/1)

EDITORIALS AND OPINIONS

The New York Times: All Children Should Have to Get the Flu Shot The flu has been devastating this year. By the end of the season in May, an estimated 34 million Americans will have been infected. Each week there are up to 4,000 flu-related deaths. So far, 97 of the dead have been children. Public health authorities are urging people to get vaccinated. The goal is to get 80 percent of all Americans and 90 percent of at-risk populations (the elderly and children, in particular) vaccinated every year. That would ensure “herd immunity,” meaning it would provide enough protection to stop the spread of the virus. Yet less than 60 percent of children and only 43 percent of adults were vaccinated last flu season. The result is lots of unnecessary illness. (Ezekiel J. Emanuel and Justin Bernstein, 3/1)