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Health Care

Health Insurer To Stop Covering Uterine Procedure

Kaiser Health News - Mon, 08/04/2014 - 9:19am

Highmark Inc., which sells plans in Pennsylvania, Delaware and West Virginia, will stop covering power morcellation, a technique often used in hysterectomies, after the Food and Drug Administration advised doctors against it because it may spread cancer. 

The Wall Street Journal: Health Insurer To Stop Covering Uterine Procedure
In the procedure, a bladed device is used to cut up common uterine masses called fibroids, often in hysterectomies, so the tissue can be removed through tiny incisions in minimally invasive surgery. Highmark is the first insurer known to be halting coverage of power morcellation, and the move is the latest in a series of mounting pressures on use of the tool. ... The FDA estimates the instruments were being used in 50,000 hysterectomies a year (Levitz, 8/2).

Reuters: U.S. Insurer To Stop Coverage Of Gynecological Procedure
A health insurer with 5.2 million members in three Eastern U.S. states said on Saturday it would stop providing coverage for a procedure called laparoscopic power morcellation that is used in gynecological surgery and may inadvertently spread cancer. Highmark Inc, which has customers in Pennsylvania, Delaware and West Virginia, will stop covering the procedure on Sept. 1, company spokesman Aaron Billger said in an email. It is the first insurer to halt coverage of power morcellation after the U.S. Food and Drug Administration advised doctors in April against it (Walsh, 8/3).

Categories: Health Care

The Health Law Fading From The Campaign Trail Spotlight

Kaiser Health News - Mon, 08/04/2014 - 9:18am

News outlets report that the sweeping overhaul appears to be less of a point of contention among candidates and less of a rallying point for voters.    

Los Angeles Times: Obamacare Loses Some Of Its Campaign Punch For Republicans
Six months ago, a House Republican campaign official listed the top three issues that would propel the party's candidates to victory in the midterm election: "Obamacare, Obamacare, Obamacare." It was a strategy that worked well in 2010, when GOP electoral gains were fueled primarily by a high-profile campaign to repeal the newly passed Affordable Care Act (Memoli and Mascaro, 8/3).

Modern Healthcare: Obamacare Not Seen As Flashpoint In Midterm Elections
Congress is all but done for the summer. That means attention will now pivot toward the fall elections. Four years ago during the August recess, legislators encountered voters in their home districts angry about the recent passage of the Patient Protection and Affordable Care Act. Republicans rode that backlash against the federal healthcare law to an electoral rout that resulted in a takeover of the House (Demko, 8/1).

Categories: Health Care

Newly Insured Get Schooling On How To Use Coverage

Kaiser Health News - Mon, 08/04/2014 - 9:17am

Health law advocates who had focused on enrolling people in insurance now are teaching them how to use their often-complicated policies. Meanwhile, a Hartford physician explains why he won't take Obamacare plans and thousands of inmates in a Cook County jail sign up for insurance.

The New York Times: Newly Insured, Many Now Face Learning Curve
Advocates of the Affordable Care Act, focused until now on persuading people to buy health insurance, have moved to a crucial new phase: making sure the eight million Americans who did so understand their often complicated policies and use them properly. The political stakes are high, as support for the health care law will hinge at least partly on whether people have good experiences with their new coverage. Advocates of the law also say teaching the newly insured how to be smart health care consumers could advance the law’s central goal of keeping costs down, such as by discouraging emergency room visits, while still improving care (Goodnough, 8/2).

Kaiser Health News: A Doctor's Perspective On Obamacare Plans
On a recent afternoon at his office in Hartford, Conn., Dr. Doug Gerard examines a patient complaining of joint pain. Gerard, an internist, checks her out, asks her a few questions about her symptoms and then orders a few tests before sending her on her way. For a typical quick visit like this, Gerard could get reimbursed $100 or more from a private insurer. For the same visit, Medicare pays less — about $80. And now, with the new private plans under the Affordable Care Act, Gerard says he would get something in between, but closer to the lower Medicare rates. That's not something he's willing to put up with (Cohen, 8/4).

Chicago Tribune: Dart: Up To 9.000 Inmates Signed Up For Obamacare To Help With Mental Health Treatment
Cook County Sheriff Tom Dart, attempting to cope with what he says is a growing mental health crisis among inmates at the county jail, said up to 9,000 people who have been incarcerated have signed up for health insurance under the Affordable Care Act in an attempt to get the care they need. “Systemically, over the course of decades, we’ve sort of carved back all the mental health services to the point where there is this question, we’ve carved it back to next to nothing,” Dart said on “The Sunday Spin” on WGN AM-720. The sheriff said that the process of closing mental health institutions under the goal of putting the mentally ill into community-based treatment has led to 3,000 of the jail’s 10,000 inmates requiring treatment. As a result, he said, costs have increased and jail staff has undergone greater training (Peterson, 8/4).

Categories: Health Care

State Highlights: Federal Trial Testing Texas Abortion Law Begins Today

Kaiser Health News - Mon, 08/04/2014 - 9:17am

A selection of health policy stories from California, Texas, New Jersey, Pennsylvania, D.C. and Minnesota.  

The New York Times: California Asks: Should Doctors Face Drug Tests?
At a time when random drug testing is part of the job for pilots, train operators, police officers and firefighters — to name a few — one high-profile line of work has managed to remain exempt: doctors. That may be about to change. California would become the first state to require doctors to submit to random drug and alcohol tests under a measure to appear on the ballot this November. The proposal, which drew approval in early focus groups, was inserted as a sweetener in a broad initiative pushed by trial lawyers (Nagourney, 8/1).

The Wall Street Journal: Texas Trial To Test Higher Standard For State's Abortion Clinics
In a federal trial set to begin here on Monday, abortion-rights supporters are seeking to strike down a new provision of a state law that will require abortion clinics to qualify as "ambulatory surgical centers" starting next month, saying it will force even more of the state's facilities to close. Since Texas Gov. Rick Perry signed a hotly contested law in July 2013 requiring abortion doctors to have admitting privileges at nearby hospitals, the number of licensed Texas clinics providing abortions has declined by half over the past year, to 18 from 36. Many abortion doctors have been unable to obtain admitting privileges from neighboring hospitals, leaving swaths of the sprawling state without any clinics at all (Koppel, 8/3). 

Houston Chronicle: Whole Women’s Health Closes Austin Clinic Due To New Abortion Law
Whole Woman’s Health will close its flagship clinic in Austin, its operators said Thursday, due to strict abortion restrictions state lawmakers passed last year. The announcement comes just days before Whole Woman’s Health and the Center for Reproductive Rights again take the state to court over the rules, which among other new restrictions requires abortion clinics to upgrade their facilities to meet the standards of an outpatient surgery clinic. A trial starting Monday in Austin federal court will focus, in part, on this portion of the law, which is set to take effect on Sept. 1.According to a study released last week, abortion rates in the Lone Star State have dropped 13 percent since the law was passed (McGaughy, 7/31).

The New York Times: In New Jersey, Workers’ Advocates Aim To Put Paid Sick Time On Ballot
Frustrated in their efforts to make paid sick leave mandatory for businesses throughout New Jersey, workers’ advocates are now pressing their campaign city by city, emboldened by laws recently passed in Newark and Jersey City, as well as in New York City (McGeehan, 8/3). 

The Wall Street Journal: Christie Pushes For Smaller Pension Benefits
Gov. Chris Christie on Friday stepped up his push to scale back the state pension and health benefit system, creating a commission to study the perks of public workers. The five-member New Jersey Pension and Health Benefit Study Commission will be charged with figuring out how to reap savings that will make the underfunded benefits system sustainable, Mr. Christie said (8/1).

The Associated Press: Hospital Killing Shows Safety Gap In Mental Health
When a man opened fire at a hospital outside Philadelphia, fatally shooting his caseworker and wounding his psychiatrist, the doctor saved his own life and probably the lives of others by pulling out a gun and shooting the patient. If Dr. Lee Silverman's decision to arm himself at the office was unusual, the violence that erupted at Mercy Fitzgerald Hospital served as yet another illustration of the hazards mental health professionals face on the job — and, experts say, the need for hospitals to do more to protect them (Rubinkam, 8/3).

The Washington Post: D.C.’s United Medical Center Is On Financial Upswing, But Its Future Is Mired In Politics
Shortly after David R. Small took over as chief executive of D.C.’s United Medical Center last year, a woman at a community meeting gave him some unwelcome news about the facility he’d been hired to run. “It was,” Small recalls being told, “the hospital where you go to die.” The 354-bed hospital on Southern Avenue SE has long suffered from a dismal reputation as a hospital of last resort, an image buttressed by long-standing and well-publicized financial woes and its location, in one of the region’s most concentrated pockets of poverty (DeBonis, 8/3).

Los Angeles Times: California Adopts New Policies On Treatment Of Mentally Ill Inmates
California prison officials adopted sweeping new policies intended to protect mentally ill prisoners from abusive force and punishment, including use of pepper spray and deep isolation in solitary confinement cells (St. John, 8/2).

Minnesota Public Radio: Hennepin Co. First Responders Now Carry Drug To Reverse Opiate Overdose
Twenty-four Hennepin County Sheriff's deputies hit the streets Friday with a new tool they hope will save lives. Hennepin is the first county in the state to take advantage of a law that went into effect Aug. 1 that allows law enforcement personnel and first responders to carry and administer a drug that can reverse opiate overdoses. The brand name version of the drug is called Narcan. It also goes by the generic name naloxone. The antidote can overpower the opiates in an overdose victim's body and restart their respiratory system (Collins, 8/2).

Minnesota Public Radio: State To Resume Indefinite Storage Of Newborn Health Data
Minnesota's newborn screening program is again storing newborn screening data indefinitely. A law passed during the legislative session removes a restriction that required the Minnesota Department of Health to destroy dried blood spot cards after 71 days and test results after two years. To prepare for the change, the Minnesota Department of Health has sent more than 1,600 letters to prenatal providers informing them of the law (Benson, 8/1). 

Categories: Health Care

Medicaid Roundup: Fla. Gets 3-Year Renewal For Managed Care Program

Kaiser Health News - Mon, 08/04/2014 - 9:17am

About 3 million Floridians are enrolled in the privatized program. Meanwhile, Illinois Medicaid puts limits on who is eligible for Sovaldi, an expensive hepatitis C drug, and Kansas recoups more than $28 million in Medicaid fraud.

The Associated Press: Feds Grant Fla. 3-Year Medicaid Managed-Care Renewal
The federal government has granted a three-year renewal of Florida's Medicaid managed-care program. About 3 million Floridians — more than half are children — are enrolled in the program, which has been rolling out statewide over the past few months. Under Medicaid privatization, the state gives insurance companies a set amount of money each month for patient care, giving the insurer broad authority to decide which doctors they can see and what treatments can be prescribed (8/3).

The Wall Street Journal: How Illinois Allocates $84,000 Drug For Hepatitis C
The $84,000-a-patient cost of the Sovaldi hepatitis C treatment has intensified a national debate among lawmakers, insurers and economists about the value of expensive medicines to society at large. The dilemma sparked by Sovaldi, which is made by Gilead Sciences, is also presenting hard choices to state Medicaid programs. In Illinois, for instance, officials recently instituted a new set of 25 stringent criteria for using Sovaldi that includes treating only those patients with the most advanced stage of liver disease and limiting treatment for those with a history of drug use and alcohol abuse (Silverman, 8/3).

Kansas Health Institute  News Service: State Medicaid Fraud Unit Recovers More Than $28M
The state recovered more than $28 million in taxpayer funds through its Medicaid fraud enforcement during the recently ended state fiscal year, Kansas Attorney General Derek Schmidt said Friday. During fiscal 2014, which ended June 30, the Medicaid Fraud and Abuse Division of the Kansas attorney general's office recovered more than $28.7 million. The recoveries were reported in the division’s annual report to the U.S. Department of Health and Human Services. This was the second-highest year of recoveries, following last fiscal year’s record $33.7 million (8/1).

Categories: Health Care

Viewpoints: Ignagni On Prices Of New Drugs; Sen. Johnson On The Difficulty Of Suing A President

Kaiser Health News - Mon, 08/04/2014 - 9:16am

The Wall Street Journal: Paying For The Thousand-Dollar Pill 
Lately, there has been considerable debate about the soaring prices of specialty drugs, which are aimed at difficult-to-treat diseases. The good news is that more of these breakthrough drugs are now coming onto the market, giving people new hope and a chance to live longer, healthier lives. But along with the drugs have come prices so high—some more than six figures for a course of treatment—that they threaten the sustainability of the health-care system. This isn't a debate about medical advancement, but rather a larger systemic question of whether the prices being charged for some new drugs are rational and allow people access to the innovation we all want. Do the prices reflect the cost of investment, or are we entering a new phase where monopolies approved under patent law are producing prices entirely untethered to the cost of developing drugs? (Karen Ignagni, 8/3). 

The New York Times' The Upshot: $1,000 Hepatitis Pill Shows Why Fixing Health Costs Is So Hard
A new drug for the liver disease hepatitis C is scaring people. Not because the drug is dangerous — it's generally heralded as a genuine medical breakthrough — but because it costs $1,000 a pill and about $84,000 for a typical person's total treatment. A Washington advocacy effort has sprung up overnight, largely devoted to objecting to the cost of this one medication, Sovaldi. ... But maybe we are looking at the costs of Sovaldi in the wrong way. One reason it is causing such angst among insurers and state Medicaid officials is that treatment costs are coming all at once (Sanger-Katz, 8/2).

The New York Times: Adventures In Prior Authorization
"Dear Doctor,” the letter from the insurance company began. "We are writing to inform you that a prior authorization is required for the medication you prescribed." That’s usually where I stop reading. Thousands of these letters arrive daily in doctors’ offices across the country. They are attempts by insurance companies to prod doctors away from more expensive treatments and toward less expensive alternatives. To use the pricier option, you need to provide a compelling clinical reason (Danielle Ofri, 8/3).

The Milwaukee Journal Sentinel: Why I Took President Barack Obama To Court
During the week of July 4, as we celebrated our country's independence from the rule of kings and renewed our commitment to the rule of law, President Barack Obama explained his own unique conception of the separation of powers: If Congress wants to prevent unlawful administrative action, it should either pass a bill he likes ... or, "sue me." Well, I tried to sue him and discovered why the president was confident he could offer such an arrogant challenge to a supposedly co-equal branch of government (Sen. Ron Johnson, R-Wis., 8/2).

The Washington Post's Post Partisan: The Insiders: The Boehner Lawsuit And Our Bored Icon President
Rather than responding to the House's lawsuit by showing leadership, it appears this is just one more instance in which President Obama can't seem to rise to the occasion. If handled correctly, the former constitutional law professor could use this as a teachable moment. But that would require the president to talk about his view of the separation of powers and how he sees the stakes involved. Instead, the bored icon currently stuck in the presidency chooses to be flippant. He says snarky things to partisan crowds and gets attaboys from the sycophants around him (Ed Rogers, 7/31). 

The Washington Post: Five Myths About Impeachment
Some 40 years after Richard Nixon resigned to avoid his likely impeachment by the House of Representatives, Washington is again talking impeachment. ... House Republicans on Wednesday voted to sue Obama for exceeding his constitutional authority when implementing the Affordable Care Act. ... House Speaker John Boehner has done everything short of hiring blimps to say that there will be no impeachment. Obama is as likely to be impeached as he is to be installed as the next pontiff. And I say that as someone who has testified in Congress that this president has violated federal laws (Joanthan Turley, 8/1).

Los Angeles Times: What Happens When A State Tries To Make Obamacare Work -- Or Not Work
There were signs almost from the start that the great unknown about the Affordable Care Act was how effectively individual states would implement the law. ... Some of [Kentucky's] poorest counties, including the infamous Harlan County, went from recording the highest levels of uninsured residents to the lowest. ... So that's how the ACA works when state officials fulfill their responsibilities. On the other side of the coin is Mississippi, which apparently wishes to turn itself into a laboratory for making its residents miserable (Michael Hiltzik, 8/1).

The Tennessean: Wake Up, Tennessee: Your Health Care Is In Jeopardy
No matter where you live in Tennessee, your health care is in jeopardy. The jeopardy begins with TennCare. Designed to ensure access to health care for the poorest and most vulnerable among us — children, pregnant mothers, patients with cervical and breast cancer — it has faltered seriously. ...  Thousands of TennCare-eligible Tennesseans have been denied access to care. Some, including newborns, have waited more than six months and gone without treatment. On June 27, in a serious rebuke to state officials, the federal Centers for Medicaid & Medicare Services cited TennCare for failure to comply with six out of seven benchmarks. No other state falls so short of the law. ... It is time to raise our voices for the health of us all (Nancy F. O'Hara and Sharon H. Cox, 8/2).

The Washington Post: On Obamacare, Opinion Is Locked In For A Long, Long Time
The latest Kaiser Health Tracking Poll is out, and among other things it shows an uptick in the number of Americans who say they disapprove of the Affordable Care Act, from 45 percent in June to 53 percent in July. This is a curious finding, given all the good news we've had in recent months about the law's performance. At the same time, we've had a blizzard of anti-Obamacare ads around the country, nonstop Republican rhetoric against the law, and the lawsuit against the president over a part of it — all of which has probably helped stoke general disapproval of the ACA (Paul Waldman, 8/1). 

The New York Times: Censorship In Your Doctor's Office
According to a recent decision by the United States Court of Appeals for the 11th Circuit, everything a doctor says to a patient is "treatment," not speech, and the government has broad authority to prohibit doctors from asking questions on particular topics without any First Amendment scrutiny at all. The case, Wollschlaeger v. Governor of Florida, concerned the constitutionality of the Florida Firearm Owners Privacy Act. ... While some of our fellow Second Amendment advocates may be tempted to celebrate this ruling, it is, at most, a symbolic victory for gun rights. And it comes at the cost of a serious and dangerous defeat for the First Amendment (Aul Sherman and Robert McNamara, 8/1).

The Wall Street Journal: Scandal Pays Off For The VA
There's nothing like an imminent August recess to focus Congressional minds, usually in expensive directions. This summer's example is the $17 billion that purports to fix the Department of Veteran's Affairs, Congress's parting gift last week to that failed bureaucracy (8/3). 

USA Today: Social Security, Medicare Coffers Fine
The annual Social Security and Medicare trustees report was just released, and it will presumably inspire the predictable scaremongering about those programs by many in the media and in politics. We'll be told that those programs are running out of money, that they're going to go bankrupt, and that they'll be insolvent. But the programs won't really run out of money (Duncan Black, 8/1). 

Categories: Health Care

Political Cartoon: 'Suit Yourself?'

Kaiser Health News - Mon, 08/04/2014 - 9:16am

Kaiser Health News provides a fresh take on health policy developments with "Suit Yourself?" by Bob Englehart.

Meanwhile, here's today's haiku:

CHECKING THE HEADLINES

An August Monday...
Does that mean health news slows down?
Hmm... You be the judge.
-Anonymous 

If you have a health policy haiku to share, please send it to us at http://www.kaiserhealthnews.org/ContactUs.aspx and let us know if you want to include your name. Keep in mind that we give extra points if you link back to a KHN original story.

Categories: Health Care

First Edition: August 4, 2014

Kaiser Health News - Mon, 08/04/2014 - 6:43am

Today's headlines include a variety of health policy stories reflecting developments on the state level.  

Kaiser Health News: Hospital, Insurer Earnings Show Mixed Messages About Health Spending
Kaiser Health News staff writer Jay Hancock reports: “Analysts who fear health spending is accelerating got plenty of evidence in Wall Street's second-quarter results to support their thesis. But so did folks who hope spending is still under control. Now everybody's trying to sort out the mixed message. The answer matters because deficit debates and affordability concerns revolve around forecasts that health spending will speed up as the economy revives. If it doesn't, the future looks better for consumers, employers and taxpayers” (Hancock, 8/4). Read the story.

Kaiser Health News: A Doctor's Perspective On Obamacare Plans
WNPR’s Jeffrey Cohen, working in partnership with Kaiser Health News and NPR, reports: “On a recent afternoon at his office in Hartford, Connecticut, Dr. Doug Gerard examines a patient complaining of joint pain. Gerard, an internist, checks her out, asks her a few questions about her symptoms and then orders a few tests before sending her on her way. For a typical quick visit like this, Gerard could get reimbursed $100 or more from a private insurer. For the same visit, Medicare pays less — about $80. And now, with the new private plans under the Affordable Care Act, Gerard says he would get something in between, but closer to the lower Medicare rates. That's not something he's willing to put up with” (Cohen, 8/4). Read the story

The New York Times: Newly Insured, Many Now Face Learning Curve
Advocates of the Affordable Care Act, focused until now on persuading people to buy health insurance, have moved to a crucial new phase: making sure the eight million Americans who did so understand their often complicated policies and use them properly. The political stakes are high, as support for the health care law will hinge at least partly on whether people have good experiences with their new coverage. Advocates of the law also say teaching the newly insured how to be smart health care consumers could advance the law’s central goal of keeping costs down, such as by discouraging emergency room visits, while still improving care (Goodnough, 8/2).

The Washington Post's Wonkblog: There's A Way Around Healthcare.gov, But It's Still Not That Great
Some of the behind-the-scenes functions that consumers don't see, like the systems allowing federal subsidy payments to insurers, still need to be built. But there's another part of the enrollment system that isn't quite ready, and it doesn't sound as if it will be by the time the Affordable Care Act's second enrollment period rolls around. It's known as "direct enrollment," in which a consumer can go to a private online Web broker who provides a similar function that HealthCare.gov does — the brokers can sell a range of ACA health plans and offer insurance subsidies to those who qualify. The federal government reached agreements with several such entities last summer, with the idea that they would provide more opportunities for people to enroll in ACA plans  (Millman, 7/31).

The Associated Press: Oregon Releases 2015 Health Insurance Plan Rates
Oregon will see a much tighter range of premium prices in 2015 for individual and small employer health insurance plans, according to new rates announced Friday by state regulators. The Oregon Insurance Division says Moda, the company that captured nearly two-thirds of the individual market share with some of the lowest prices in 2014, will see a 10.6 percent rate hike on average. ... Some of the smaller carriers will see rate decreases in 2015. Plans from Providence Health and Trillium Community Health will both drop by about 14 percent on average (Wozniacka, 8/1).

Los Angeles Times: Obamacare Loses Some Of Its Campaign Punch For Republicans
Six months ago, a House Republican campaign official listed the top three issues that would propel the party's candidates to victory in the midterm election: "Obamacare, Obamacare, Obamacare." It was a strategy that worked well in 2010, when GOP electoral gains were fueled primarily by a high-profile campaign to repeal the newly passed Affordable Care Act (Memoli and Mascaro, 8/3).

Politico: White House Appeals Obamacare Subsidy Case
The Obama administration Friday asked a federal appeals court to grant another hearing in a case challenging Obamacare subsidies, and hours later, the court gave the subsidies opponents 15 days to respond to that request. The Justice Department filed the petition with the U.S. Court of Appeals for the D.C. Circuit in the case Halbig v. Burwell. In a blow to the Affordable Care Act, a three-judge panel ruled last month that the subsidies can’t flow through the federal exchange, HealthCare.gov, but only through state markets (Winfield Cunningham, 8/1).

Kaiser Health News tracked the news coverage related to the Obama administration's Friday filing (8/2).

The Wall Street Journal: Health Insurer To Stop Covering Uterine Procedure
In the procedure, a bladed device is used to cut up common uterine masses called fibroids, often in hysterectomies, so the tissue can be removed through tiny incisions in minimally invasive surgery. Highmark is the first insurer known to be halting coverage of power morcellation, and the move is the latest in a series of mounting pressures on use of the tool. ... The FDA estimates the instruments were being used in 50,000 hysterectomies a year (Levitz, 8/2).

NPR: Obama Moves To Overhaul VA With Compromise Measure
Two months after VA Secretary Eric Shinseki resigned, President Obama looks set to sign legislation to overhaul the Department of Veterans Affairs, to the tune of nearly $17 billion (8/3).

Los Angeles Times: As Disability Awards Grow, So Do Concerns With Veracity Of PTSD Claims
As disability awards for PTSD have grown nearly fivefold over the last 13 years, so have concerns that many veterans might be exaggerating or lying to win benefits. Moering, a former Marine, estimates that roughly half of the veterans he evaluates for the disorder exaggerate or fabricate symptoms. Depending on severity, veterans with PTSD can receive up to $3,000 a month tax-free, making the disorder the biggest contributor to the growth of a disability system in which payments have more than doubled to $49 billion since 2002 (Zarambo, 8/3).

The New York Times: The Drawn-Out Medical Degree
Should medical education be shorter? The answer is yes, at least according to administrators at many of America’s leading medical schools. The idea may conjure up images of clueless residents Googling symptoms on their smartphones at the patient’s bedside, but advocates insist that time spent in school can be trimmed without shortchanging education or compromising quality of care. And they say there are compelling reasons to speed up the process: to reduce the crushing debt many face by eliminating a year’s tuition and allowing doctors to start careers, and earn money, earlier (Grady, 8/1).

The New York Times: Going Professional: The Ins And Outs
The nation needs doctors, and students and schools are heeding the call. Last year the number of applicants to medical schools surpassed 48,000, for 20,055 slots, according to the Association of American Medical Colleges. Both numbers were a record.  ... The good news: The number of spots is growing. ... Meanwhile, colleges of osteopathic medicine more than doubled their capacity from 2002 to 2013. ... [But] enrollments are expanding faster than entry-level residency positions are increasing (Hoover, 8/1).

The Wall Street Journal: How Illinois Allocates $84,000 Drug For Hepatitis C
The $84,000-a-patient cost of the Sovaldi hepatitis C treatment has intensified a national debate among lawmakers, insurers and economists about the value of expensive medicines to society at large. The dilemma sparked by Sovaldi, which is made by Gilead Sciences, is also presenting hard choices to state Medicaid programs. In Illinois, for instance, officials recently instituted a new set of 25 stringent criteria for using Sovaldi that includes treating only those patients with the most advanced stage of liver disease and limiting treatment for those with a history of drug use and alcohol abuse (Silverman, 8/3).

The New York Times: California Asks: Should Doctors Face Drug Tests?
At a time when random drug testing is part of the job for pilots, train operators, police officers and firefighters — to name a few — one high-profile line of work has managed to remain exempt: doctors. That may be about to change. California would become the first state to require doctors to submit to random drug and alcohol tests under a measure to appear on the ballot this November. The proposal, which drew approval in early focus groups, was inserted as a sweetener in a broad initiative pushed by trial lawyers (Nagourney, 8/1).

The Wall Street Journal: Texas Trial To Test Higher Standard For State's Abortion Clinics
In a federal trial set to begin here on Monday, abortion-rights supporters are seeking to strike down a new provision of a state law that will require abortion clinics to qualify as "ambulatory surgical centers" starting next month, saying it will force even more of the state's facilities to close. Since Texas Gov. Rick Perry signed a hotly contested law in July 2013 requiring abortion doctors to have admitting privileges at nearby hospitals, the number of licensed Texas clinics providing abortions has declined by half over the past year, to 18 from 36. Many abortion doctors have been unable to obtain admitting privileges from neighboring hospitals, leaving swaths of the sprawling state without any clinics at all (Koppel, 8/3). 

The New York Times: In New Jersey, Workers’ Advocates Aim To Put Paid Sick Time On Ballot
Frustrated in their efforts to make paid sick leave mandatory for businesses throughout New Jersey, workers’ advocates are now pressing their campaign city by city, emboldened by laws recently passed in Newark and Jersey City, as well as in New York City (McGeehan, 8/3). 

The Wall Street Journal: Christie Pushes For Smaller Pension Benefits
Gov. Chris Christie on Friday stepped up his push to scale back the state pension and health benefit system, creating a commission to study the perks of public workers. The five-member New Jersey Pension and Health Benefit Study Commission will be charged with figuring out how to reap savings that will make the underfunded benefits system sustainable, Mr. Christie said (8/1).

The Associated Press: Hospital Killing Shows Safety Gap In Mental Health
When a man opened fire at a hospital outside Philadelphia, fatally shooting his caseworker and wounding his psychiatrist, the doctor saved his own life and probably the lives of others by pulling out a gun and shooting the patient. If Dr. Lee Silverman's decision to arm himself at the office was unusual, the violence that erupted at Mercy Fitzgerald Hospital served as yet another illustration of the hazards mental health professionals face on the job — and, experts say, the need for hospitals to do more to protect them (Rubinkam, 8/3).

The Washington Post: D.C.’s United Medical Center Is On Financial Upswing, But Its Future Is Mired In Politics
Shortly after David R. Small took over as chief executive of D.C.’s United Medical Center last year, a woman at a community meeting gave him some unwelcome news about the facility he’d been hired to run. “It was,” Small recalls being told, “the hospital where you go to die.” The 354-bed hospital on Southern Avenue SE has long suffered from a dismal reputation as a hospital of last resort, an image buttressed by long-standing and well-publicized financial woes and its location, in one of the region’s most concentrated pockets of poverty (DeBonis, 8/3).

Los Angeles Times: California Adopts New Policies On Treatment Of Mentally Ill Inmates
California prison officials adopted sweeping new policies intended to protect mentally ill prisoners from abusive force and punishment, including use of pepper spray and deep isolation in solitary confinement cells (St. John, 8/2).

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