Tagged States

Activists Challenge Law In Maine Allowing Physician-Only Abortions

ACLU attorney Julia Kaye says the law is a hardship on rural women because it requires them to travel several hours to receive services, but defenders of the law say there is little evidence to support that charge. Dozens of states have similar restrictions. News on abortion comes out of Georgia, as well.

When Drug Costs Get Too High, Patients Are Skipping Doses Or Just Not Taking Medication

Experts are worried this behavior could be extremely dangerous for the patients. “We have lots of treatments where if you don’t take them exactly as prescribed, you might be doing more harm than good,” said Stacie Dusetzina, a health policy researcher at Vanderbilt University. Other ways patients are trying to control costs are by asking for cheaper drugs from doctors or seeking out alternative therapies. Meanwhile, Ohio’s attorney general is suing UnitedHealth’s OptumRx unit alleging it overcharged the state for prescription drugs.

Did Your Doctor ‘Ghost’ You? An Employment Contract May Be To Blame

When Don Cue developed a bladder infection last fall, he called his longtime urologist’s office for a urine culture and antibiotics. It was a familiar routine for the two-time prostate cancer survivor; infections were not uncommon since he began using a catheter that connects to his bladder through an incision in his abdomen.

When Cue called this time, a receptionist told him that his physician, Dr. Mark Kellerman, no longer worked at the Iowa Clinic in Des Moines, a large multi-specialty group. She refused to divulge where he’d gone.

“As a patient, ‘scared’ is too strong a word, but my feeling is, ‘What do I do now?’” said Cue, 58.

Flummoxed, he solved his immediate problem by taking leftover antibiotics he had in his medicine cabinet.

It was only later that he learned his doctor had been fired by the Iowa Clinic and planned to start a urology practice with clinic colleagues. And, under the terms of their contract with their former employer, the doctors were banned for a year from practicing within 35 miles of the clinic and from recruiting former patients to follow them.

Contracts with so-called restrictive covenants are now common in medicine, although some states limit their use. Noncompete clauses — common in many commercial sectors — aim to stop physicians or other health care professionals from taking patients with them if they move to a competing practice nearby or start their own. But what may be good for business is bad for patient care — and certainly disquieting for those whose doctors simply disappear.

One survey of nearly 2,000 primary care physicians in five states found that roughly 45 percent were bound by such clauses.

Continuity of care is important, doctors say, especially for patients with ongoing medical issues. Cutting off access to a doctor is different from disrupting someone’s relationship with a favorite hairstylist or money manager, they say.

“When doctors want to move from one practice to another, if they’ve got good therapeutic relationships with their patients, you’d think that public policy would want them to continue to treat these patients that trust them,” said Judy Conti, government affairs director at the National Employment Law Project.

Charlie Wittmack, a lawyer at Hartung Schroeder in Des Moines, is representing Kellerman and the two other urologists who were also fired in a lawsuit against the Iowa Clinic. The wrongful termination suit asks the court to declare the physicians’ restrictive covenant provisions unenforceable. Wittmack said the controversy there was “tragic” for patients. “These are people who have prostate cancer or are in extreme pain because of kidney stones or have blood in their urine.”

Ed Brown, the clinic’s CEO, said the noncompete agreements are not just about business but also help ensure that the Iowa Clinic can provide reliable services.

“Noncompetes are good for the patients because they help to provide stability within a practice and ensure continuity of care,” Brown said recently in an email. Further, he added, noncompetes protect physicians by ensuring that other physicians in the practice are committed to the same agreement and can’t abandon it without proper notice.

The urologists “believe they can make more money elsewhere, and they don’t want to be held to any contractual responsibilities,” he said.

Even when longtime patients go sleuthing to find their doctors’ new offices, they may not be accepted into those practices. Hospitals and clinics say they have little choice but to respect the terms of business agreements that others have negotiated.

UW Health, the health care system for the University of Wisconsin-Madison, recently hired three primary care doctors who had worked across town, said Dr. Sandra Kamnetz, vice chairwoman of clinical care for the Department of Family Medicine and Community Health at the University of Wisconsin’s School of Medicine and Public Health. They are taking great pains not to treat any of the new doctors’ former patients because the terms of the doctors’ contracts with their old employer prohibit them from taking care of former patients for two years.

Staff at the UW clinics ask prospective patients if they’ve ever been seen by one of the doctors. They then check the patient’s electronic health record to confirm there are no messages, prescription refills or other recent contact with the new UW Health doctors and that patient at the previous job, said Kamnetz.

When Don Cue called his longtime urologist in Des Moines to get an appointment, the receptionist said the doctor no longer practiced there and would not explain why or where he had gone.(Courtesy Don Cue)

“Patients get frustrated, but what they may not understand is that this is a legal thing that we have to abide by,” she said.

Whether noncompete clauses are binding in health care — especially when patient care is disrupted — is a point legal scholars debate. In general, to be enforceable, the agreements must be reasonable and narrowly drawn so that they protect an employer’s legitimate business interest but don’t unduly restrict a doctor’s ability to make a living.

Courts may weigh whether enforcing a noncompete clause would create a physician shortage in a particular region or specialty. The guiding principle is patient choice, said David J. Clark, a partner in the New York office of the law firm Epstein Becker Green who has analyzed state noncompete statutes in health care.

“No court is going to deny a patient who wants to go see a doctor of her choice,” Clark said.

Most disputes are settled before they make it to court, however.

A recent report by the Trump administration evaluating how to promote choice and competition in health care recommended that states examine noncompete agreements for their effect on patients’ access to care and the supply of providers.

Several states, including Massachusetts and Colorado, that allow noncompete clauses in employment contracts generally won’t enforce them against doctors, according to Clark’s analysis.

Other states, such as Texas and Tennessee, place limits on the agreements. In Texas, for example, a noncompete pact must allow doctors to have access to a list of their patients in the past year and access to their medical records, among other things, Clark found.

Medical board rules take it a step further. “In Texas, when a physician leaves, the practice is required to cooperate with a physician who wants to put up a notice that says this is where that physician can now be contacted,” said Kathy Poppitt, a partner in the health care and government and internal investigations practices at the Austin, Texas, office of King & Spalding.

The American Medical Association, which represents doctors, doesn’t oppose restrictive covenants outright, although its policy notes they can limit patients’ choices. “To the extent that these agreements disrupt continuity of care and disrupt patient choice, this is of great concern to the AMA,” said Dr. Patrice Harris, the organization’s president-elect.

For patients in central Iowa, the departures of longtime urologists at the Iowa Clinic is dizzying. After Kellerman and his colleagues left, five of the clinic’s remaining seven urologists submitted their resignations. They are also subject to noncompete restrictions. They left the practice in mid-February.

Brown, the clinic CEO, said the urology department has replaced four of the eight urologists and has nine nurse practitioners or physician assistants to treat patients. The clinic is continuing to recruit physicians and advanced practice providers like nurse practitioners.

Susan Murphy, 72, has seen a number of doctors in the urology department. Dr. Richard Glowacki, one of the urologists who left with Kellerman, performed surgery to remove her kidney stones more than a decade ago. Another, Dr. Stephanie Pothoven, did surgery to repair her prolapsed uterus a few years ago.

Murphy said she got a letter from Pothoven announcing her departure. It didn’t provide details about where she would be going.

“I’ve got it etched in my brain to find out where they went,” she said. She has no plans to return to the Iowa Clinic. “Somehow they lost sight of patient care and were more concerned about the bottom line,” she said.

Billionaire-Backed Health Venture ‘Haven’ May Find Itself Facing Legal Challenges Over Name

There are already dozens of companies named “Haven,” with a large handful that deliver or facilitate health services. “It seems very risky to me,” said Jonathan Bell, managing director of Want Branding, a firm that advises companies on name selection. In other health industry news: health savings accounts, hospitals’ religious policies, cost disclosures, and minimum wage increases.

Billionaire-Backed Health Venture ‘Haven’ May Find Itself Facing Legal Challenges Over Name

There are already dozens of companies named “Haven,” with a large handful that deliver or facilitate health services. “It seems very risky to me,” said Jonathan Bell, managing director of Want Branding, a firm that advises companies on name selection. In other health industry news: health savings accounts, hospitals’ religious policies, cost disclosures, and minimum wage increases.

Woman Going To Jail Sues For Access To Methadone Treatment: ‘I Will Lose Control Of My Addiction… I Will Die.’

The federal prison does not allow anti-craving medications as ongoing treatment for opioid addiction except for pregnant women, who can take methadone. Meanwhile, Massachusetts advocates want hope to revolutionize the way the criminal justice system treats people who are addicted.

Woman Going To Jail Sues For Access To Methadone Treatment: ‘I Will Lose Control Of My Addiction… I Will Die.’

The federal prison does not allow anti-craving medications as ongoing treatment for opioid addiction except for pregnant women, who can take methadone. Meanwhile, Massachusetts advocates want hope to revolutionize the way the criminal justice system treats people who are addicted.

FDA Orders European Seller Of Online Abortion Pills To Immediately Cease Delivery To U.S. Customers

The FDA says the “unapproved new drugs pose an inherent risk to consumers.” In other news on abortion: Tennessee judge rebuked for denying a women on house arrest to travel to get an abortion; Indiana takes steps toward allowing nurses and physician assistants to object to playing role in abortion procedure; and Maine governor wants to allow medical professionals besides doctors to be able to provide the service.

FDA Orders European Seller Of Online Abortion Bills To Immediately Cease Delivery To U.S. Customers

The FDA says the “unapproved new drugs pose an inherent risk to consumers.” In other news on abortion: Tennessee judge rebuked for denying a women on house arrest to travel to get an abortion; Indiana takes steps toward allowing nurses and physician assistants to object to playing role in abortion procedure; and Maine governor wants to allow medical professionals besides doctors to be able to provide the service.

Hidden Cost Of Immigration Enforcement Battle: Veterans Drug Court Could Become Casualty In Sanctuary City Standoff

The Trump administration in 2017 threatened to withhold law enforcement grants from 29 cities, counties or states it viewed as having “sanctuary” policies that limit cooperation with federal immigration agents. Today, all those jurisdictions have received or been cleared to get the money, except Oregon, which is battling for the funds in federal court. Some of that money is slated for veterans courts that help servicemen and women who are addicted to drugs get help.

Hidden Cost Of Immigration Enforcement Battle: Veterans Drug Court Could Become Casualty In Sanctuary City Standoff

The Trump administration in 2017 threatened to withhold law enforcement grants from 29 cities, counties or states it viewed as having “sanctuary” policies that limit cooperation with federal immigration agents. Today, all those jurisdictions have received or been cleared to get the money, except Oregon, which is battling for the funds in federal court. Some of that money is slated for veterans courts that help servicemen and women who are addicted to drugs get help.

Must-Reads Of The Week From Brianna Labuskes

Happy Friday! Has everyone recovered from their daylight saving time jet lag? Every year we get a whole host of articles about why changing the clocks is outdated, terrible and really quite bad for our health, and yet! Here were are, still grumpy and tired. But it’s almost the weekend, so let’s soldier on.

Here’s what you may have missed in your spring-forward daze.

President Donald Trump released his $4.75 trillion budget plan this week, which included a big increase in military funding and deep cuts to other domestic spending. Although the proposal will be dead on arrival in Congress, it still serves as a good road map for the administration’s priorities and Trump’s re-election campaign.

There were some health care wins, but there were also some blows, as well. At the heart of it all, critics say, are contradictions that undercut Trump’s talk about supporting certain public health causes. Take the $291 million budgeted for HIV, for example. Trump’s proposal allocates hundreds of millions toward the cause domestically, but then cuts global aid and chips away at programs like Medicaid, which HIV patients rely on.

Some of the health care highlights in the budget:

• Shaving $818 billion from projected spending on Medicare over 10 years and calling for belt-tightening within the popular program to combat “waste, fraud and abuse”;

• Cutting nearly $1.5 trillion from projected spending on Medicaid and transforming the program into a block grant system (a controversial idea that has received a lot of criticism in the past, even from Republican governors);

• Slashing spending on the National Institutes of Health, a longtime favorite of lawmakers of both parties, by $4.5 billion, with the National Cancer Institute absorbing the largest chunk of that cut;

• Increasing funding for pediatric cancer research by $50 million;

• Cutting HHS funding to $87.1 billion, which would be 12 percent less than in the spending plan Congress adopted for this fiscal year;

• Charging the e-cigarette industry $100 million a year in user fees that would go toward the FDA and its oversight efforts;

• And raising funding for VA medical care by nearly 10 percent.

Another interesting tidbit comes out of Politico’s reporting: HHS would be directed to steer $20 million toward a small children’s health program sought by one of Trump’s golfing buddies, Jack Nicklaus.

The New York Times: Trump Proposes a Record $4.75 Trillion Budget

The Washington Post: Springing Forward to Daylight Saving Time Is Obsolete, Confusing and Unhealthy, Critics Say

The Washington Post: Trump Pledges Support for Health Programs but His Budget Takes ‘Legs Out From Underneath the System’

Politico: Trump’s Budget Would Steer $20M to Jack Nicklaus-Backed Hospital Project

Democrats were less than pleased with the suggested budget. Lawmakers warned HHS Secretary Alex Azar — who bore the brunt of their ire at a hearing on Tuesday — that if Medicaid were transformed into a block grant system the change would face “a firestorm” of opposition.

The New York Times: Congress Warns Against Medicaid Cuts: ‘You Just Wait for the Firestorm’

Meanwhile, the “Mediscare” game went another round with Democrats saying that the “unbelievable” cuts fulfill long-standing Republican ambitions “to make Medicare wither on the vine.” If the accusations sound familiar to ones you’ve heard in the past, you’re not mistaken. They just might have been coming from Republicans. The Washington Post Fact Checker untangles it all to show that everyone is guilty of playing this particular scare game.

The Washington Post Fact Checker: Democrats Engage in ‘Mediscare’ Spin on the Trump Budget


Following FDA Commissioner Scott Gottlieb’s surprise resignation announcement, Dr. Ned Sharpless has been named as the acting chief of the agency. Sharpless’ current work as the director of the National Cancer Institute has focused on the relationship between aging and cancer, and the development of new treatments for melanoma, lung cancer and breast cancer.

The appointment was a bit of a curveball for some agency watchers. Some Republicans had been chafing at the way Gottlieb embraced his pro-regulation side as commissioner and were hoping for a sea change. But Sharpless is a Democrat who has spoken out before about how his worries over the e-cigarette industry keep him up at night, so the direction of the agency may not be changing soon. (HHS Secretary Alex Azar has said this is a temporary appointment and the search for a permanent commissioner is underway, but there are also hints that Sharpless could step into the role.)

Colleagues were quick to praise the cancer doctor and research veteran for his breadth of experience and his “approachable, objective” demeanor.

Stat: How Ned Sharpless, Biotech Veteran, Vaulted to the Top of the FDA

No one can accuse Gottlieb of getting whatever the professional version of “senioritis” is, despite the fact that he’ll be departing in a few weeks. The FDA has issued a proposal that would sequester flavored e-cigarettes to areas off-limits to anyone under age 18. The stores can still sell tobacco, mint and menthol e-cigarettes, which the FDA says are more popular among adults than minors.

The New York Times: F.D.A. Moves to Restrict Flavored E-Cigarette Sales to Teenagers


Beto O’Rourke is the latest Democrat to throw his hat in the ring for 2020, but can the moderate Texan overcome his baggage when it comes to his past opposition to the Affordable Care Act? In terms of his current stance, he has said that he supports universal health care, but has, like other moderates in the race, taken pains not to name “Medicare-for-all” in particular.

The Wall Street Journal: Beto O’Rourke’s Past GOP Ties Could Complicate Primary Run


The Connecticut Supreme Court has now cleared the way for Sandy Hook families to sue gunmakers over wrongful marketing. In the lawsuit, the families pointed out ads with slogans like “Consider your man card reissued,” which they say is specifically targeted for troubled young men like Adam Lanza. The ruling is fairly narrow and limited to marketing — the justices dismissed other aspects of the lawsuits — but could have far-reaching ramifications because it strips away some of the blanket immunity offered to gun manufacturers by Congress.

The New York Times: Sandy Hook Massacre: Remington and Other Gun Companies Lose Major Ruling Over Liability


Lawyers are starting to warn their clients who have filed disability claims with the government to clean up their social media because Uncle Sam might start snooping for fraud. “You don’t want anything on there that shows you out playing Frisbee,” one said. Advocates for people with disabilities say using social media sites in such a way would be irresponsible, as it’s impossible to gauge just from the pictures people post if they need disability aid.

The New York Times: On Disability and on Facebook? Uncle Sam Wants to Watch What You Post


In the miscellaneous file for the week:

• Calls for a worldwide moratorium on gene-editing human embryos expose the ethical divide over the research, which has been thrust into the spotlight following a Chinese scientist’s shocking and unexpected revelation that he successfully accomplished the feat.

Reuters: Experts Call for Halt to Gene Editing That Results in ‘Designer Babies’

• An entrenched culture of sexism at VA facilities has led female veterans to forgo needed care in order to avoid harassment. “It’s like a construction site,” said Rep. John Carter (R-Texas).

The New York Times: Treated Like a ‘Piece Of Meat’: Female Veterans Endure Harassment at the V.A.

• Court filings detail Johnson & Johnson’s role in the opioid epidemic, including accusations that the company operated like a drug “kingpin … profiting at every stage.’’

Bloomberg: US Opioid Drug Epidemic: J&J Called ‘Kingpin’ by Oklahoma

• The cost of this Oregon child not getting vaccinations? $800,000 in medical bills and 57 days in the hospital. The terrifying ordeal shows how quickly a small cut can spiral into a devastating emergency.

The New York Times: An Unvaccinated Boy Got Tetanus. His Oregon Hospital Stay: 57 Days and $800,000.

• Medical ethicists were given a lot to think about this week: In this case, it’s examining the tough decisions that come from deciding to extract sperm from a deceased loved one. While some support the choice if it’s a spouse, what happens if it’s the parents who are making the call?

Stat: Efforts to Save the Sperm of the Dead Bring Heartache and Tough Questions

• Is there a chilling effect on disease research when social media activists engage in thought-policing? Scientists say yes, and that, ultimately, the patients are the ones getting hurt.

Reuters: Special Report: Online Activists Are Silencing Us, Scientists Say


Doctors say our oversanitized culture does no favors to our immune system. (I have been pounding this drum for years, so I had to include this story.) The next time you drop some food on the floor, apparently the right move is to embrace the three-second rule and eat it. Have a great weekend!

Must-Reads Of The Week From Brianna Labuskes

Happy Friday! Has everyone recovered from their daylight saving time jet lag? Every year we get a whole host of articles about why changing the clocks is outdated, terrible and really quite bad for our health, and yet! Here were are, still grumpy and tired. But it’s almost the weekend, so let’s soldier on.

Here’s what you may have missed in your spring-forward daze.

President Donald Trump released his $4.75 trillion budget plan this week, which included a big increase in military funding and deep cuts to other domestic spending. Although the proposal will be dead on arrival in Congress, it still serves as a good road map for the administration’s priorities and Trump’s re-election campaign.

There were some health care wins, but there were also some blows, as well. At the heart of it all, critics say, are contradictions that undercut Trump’s talk about supporting certain public health causes. Take the $291 million budgeted for HIV, for example. Trump’s proposal allocates hundreds of millions toward the cause domestically, but then cuts global aid and chips away at programs like Medicaid, which HIV patients rely on.

Some of the health care highlights in the budget:

• Shaving $818 billion from projected spending on Medicare over 10 years and calling for belt-tightening within the popular program to combat “waste, fraud and abuse”;

• Cutting nearly $1.5 trillion from projected spending on Medicaid and transforming the program into a block grant system (a controversial idea that has received a lot of criticism in the past, even from Republican governors);

• Slashing spending on the National Institutes of Health, a longtime favorite of lawmakers of both parties, by $4.5 billion, with the National Cancer Institute absorbing the largest chunk of that cut;

• Increasing funding for pediatric cancer research by $50 million;

• Cutting HHS funding to $87.1 billion, which would be 12 percent less than in the spending plan Congress adopted for this fiscal year;

• Charging the e-cigarette industry $100 million a year in user fees that would go toward the FDA and its oversight efforts;

• And raising funding for VA medical care by nearly 10 percent.

Another interesting tidbit comes out of Politico’s reporting: HHS would be directed to steer $20 million toward a small children’s health program sought by one of Trump’s golfing buddies, Jack Nicklaus.

The New York Times: Trump Proposes a Record $4.75 Trillion Budget

The Washington Post: Springing Forward to Daylight Saving Time Is Obsolete, Confusing and Unhealthy, Critics Say

The Washington Post: Trump Pledges Support for Health Programs but His Budget Takes ‘Legs Out From Underneath the System’

Politico: Trump’s Budget Would Steer $20M to Jack Nicklaus-Backed Hospital Project

Democrats were less than pleased with the suggested budget. Lawmakers warned HHS Secretary Alex Azar — who bore the brunt of their ire at a hearing on Tuesday — that if Medicaid were transformed into a block grant system the change would face “a firestorm” of opposition.

The New York Times: Congress Warns Against Medicaid Cuts: ‘You Just Wait for the Firestorm’

Meanwhile, the “Mediscare” game went another round with Democrats saying that the “unbelievable” cuts fulfill long-standing Republican ambitions “to make Medicare wither on the vine.” If the accusations sound familiar to ones you’ve heard in the past, you’re not mistaken. They just might have been coming from Republicans. The Washington Post Fact Checker untangles it all to show that everyone is guilty of playing this particular scare game.

The Washington Post Fact Checker: Democrats Engage in ‘Mediscare’ Spin on the Trump Budget


Following FDA Commissioner Scott Gottlieb’s surprise resignation announcement, Dr. Ned Sharpless has been named as the acting chief of the agency. Sharpless’ current work as the director of the National Cancer Institute has focused on the relationship between aging and cancer, and the development of new treatments for melanoma, lung cancer and breast cancer.

The appointment was a bit of a curveball for some agency watchers. Some Republicans had been chafing at the way Gottlieb embraced his pro-regulation side as commissioner and were hoping for a sea change. But Sharpless is a Democrat who has spoken out before about how his worries over the e-cigarette industry keep him up at night, so the direction of the agency may not be changing soon. (HHS Secretary Alex Azar has said this is a temporary appointment and the search for a permanent commissioner is underway, but there are also hints that Sharpless could step into the role.)

Colleagues were quick to praise the cancer doctor and research veteran for his breadth of experience and his “approachable, objective” demeanor.

Stat: How Ned Sharpless, Biotech Veteran, Vaulted to the Top of the FDA

No one can accuse Gottlieb of getting whatever the professional version of “senioritis” is, despite the fact that he’ll be departing in a few weeks. The FDA has issued a proposal that would sequester flavored e-cigarettes to areas off-limits to anyone under age 18. The stores can still sell tobacco, mint and menthol e-cigarettes, which the FDA says are more popular among adults than minors.

The New York Times: F.D.A. Moves to Restrict Flavored E-Cigarette Sales to Teenagers


Beto O’Rourke is the latest Democrat to throw his hat in the ring for 2020, but can the moderate Texan overcome his baggage when it comes to his past opposition to the Affordable Care Act? In terms of his current stance, he has said that he supports universal health care, but has, like other moderates in the race, taken pains not to name “Medicare-for-all” in particular.

The Wall Street Journal: Beto O’Rourke’s Past GOP Ties Could Complicate Primary Run


The Connecticut Supreme Court has now cleared the way for Sandy Hook families to sue gunmakers over wrongful marketing. In the lawsuit, the families pointed out ads with slogans like “Consider your man card reissued,” which they say is specifically targeted for troubled young men like Adam Lanza. The ruling is fairly narrow and limited to marketing — the justices dismissed other aspects of the lawsuits — but could have far-reaching ramifications because it strips away some of the blanket immunity offered to gun manufacturers by Congress.

The New York Times: Sandy Hook Massacre: Remington and Other Gun Companies Lose Major Ruling Over Liability


Lawyers are starting to warn their clients who have filed disability claims with the government to clean up their social media because Uncle Sam might start snooping for fraud. “You don’t want anything on there that shows you out playing Frisbee,” one said. Advocates for people with disabilities say using social media sites in such a way would be irresponsible, as it’s impossible to gauge just from the pictures people post if they need disability aid.

The New York Times: On Disability and on Facebook? Uncle Sam Wants to Watch What You Post


In the miscellaneous file for the week:

• Calls for a worldwide moratorium on gene-editing human embryos expose the ethical divide over the research, which has been thrust into the spotlight following a Chinese scientist’s shocking and unexpected revelation that he successfully accomplished the feat.

Reuters: Experts Call for Halt to Gene Editing That Results in ‘Designer Babies’

• An entrenched culture of sexism at VA facilities has led female veterans to forgo needed care in order to avoid harassment. “It’s like a construction site,” said Rep. John Carter (R-Texas).

The New York Times: Treated Like a ‘Piece Of Meat’: Female Veterans Endure Harassment at the V.A.

• Court filings detail Johnson & Johnson’s role in the opioid epidemic, including accusations that the company operated like a drug “kingpin … profiting at every stage.’’

Bloomberg: US Opioid Drug Epidemic: J&J Called ‘Kingpin’ by Oklahoma

• The cost of this Oregon child not getting vaccinations? $800,000 in medical bills and 57 days in the hospital. The terrifying ordeal shows how quickly a small cut can spiral into a devastating emergency.

The New York Times: An Unvaccinated Boy Got Tetanus. His Oregon Hospital Stay: 57 Days and $800,000.

• Medical ethicists were given a lot to think about this week: In this case, it’s examining the tough decisions that come from deciding to extract sperm from a deceased loved one. While some support the choice if it’s a spouse, what happens if it’s the parents who are making the call?

Stat: Efforts to Save the Sperm of the Dead Bring Heartache and Tough Questions

• Is there a chilling effect on disease research when social media activists engage in thought-policing? Scientists say yes, and that, ultimately, the patients are the ones getting hurt.

Reuters: Special Report: Online Activists Are Silencing Us, Scientists Say


Doctors say our oversanitized culture does no favors to our immune system. (I have been pounding this drum for years, so I had to include this story.) The next time you drop some food on the floor, apparently the right move is to embrace the three-second rule and eat it. Have a great weekend!

Podcast: KHN’s ‘What The Health?’ The Karma Of Cutting Medicare

Like those of his recent predecessors, President Donald Trump’s proposed budget for the fiscal year that starts in October will not be adopted by Congress. Still, a presidential budget plan is an important indicator of the administration’s priorities.

The Trump administration’s priority for health is for the federal government to spend less. In some cases much less, as evidenced by its proposed funding for the National Institutes of Health and Centers for Disease Control and Prevention.

Also this week, a federal district judge in Washington, D.C., heard arguments in a case challenging work requirements for some Medicaid enrollees in Arkansas and Kentucky. This is the same judge who struck down an earlier version of Kentucky’s proposal.

Meanwhile, Food and Drug Administration chief Scott Gottlieb is stepping down, but this week he issued more rules intended to prevent minors from purchasing flavored e-cigarette products.

This week’s panelists are Julie Rovner of Kaiser Health News, Stephanie Armour of The Wall Street Journal, Alice Ollstein of Politico and Rebecca Adams of CQ Roll Call.

Among the takeaways from this week’s podcast:

  • Trump’s budget may turn the tables on the Republican Party. It calls for more than $500 billion in reductions to Medicare, much of that in payments to providers. That is similar to what Democrats proposed to help fund the Affordable Care Act — a tactic that Republicans used to whip up widespread opposition to the law and gain control of the House of Representatives. Count on Democrats to return the favor in coming campaigns.
  • Some Republicans, including Rep. Tom Cole of Oklahoma, a key Republican on the House Appropriations Committee, signaled concerns about budget cuts recommended by the administration, especially for NIH.
  • On Medicaid, the budget suggests that states be allowed to administer many parts of the program as they see fit. But opponents are likely to ask courts to stop any efforts to weaken federal requirements for coverage.
  • House Democrats have begun an investigation of the marketing and benefits of short-term insurance plans to see if they are denying promised coverage to consumers. The lawmakers are concerned that what they call “junk plans” are confusing consumers who would be better off with policies from the ACA’s marketplace. But any efforts to rein in the plans — which have the blessing of the Trump administration — could run into opposition from Republicans.
  • A federal appeals court this week ruled that Ohio may exclude Planned Parenthood from participating in several small federal health programs that provide money to the state to distribute. The case does not involve either Medicaid or the federal family planning program, but the participation of four judges appointed by Trump could signal a judicial trend.

Plus, for extra credit, the panelists recommend their favorite health policy stories of the week they think you should read too:

Julie Rovner: Buzz Feed News’ “Military Doctors Told Them It Was Just ‘Female Problems.’ Weeks Later, They Were In The Hospital,” by Ema O’Connor and Vera Bergengruen.

AND

The New York Times’ “Treated Like a ‘Piece of Meat’: Female Veterans Endure Harassment at the V.A.,” by Jennifer Steinhauer.

Rebecca Adams: Kaiser Health News’ “’Medicare-For-All Gets Buzzy In Unexpected Locales,” by Shefali Luthra.

Stephanie Armour: Kaiser Health News’ “Understanding Loneliness In Older Adults – And Tailoring A Solution,” by Judith Graham.

Alice Ollstein: HuffPost’s “These Citizen Activists Fought Hard to Expand Health Care. Then Their Lawmakers Rebuked Them,” by Jeffrey Young.

To hear all our podcasts, click here.

And subscribe to What the Health? on iTunesStitcher or Google Play.

Podcast: KHN’s ‘What The Health?’ The Karma Of Cutting Medicare

Like those of his recent predecessors, President Donald Trump’s proposed budget for the fiscal year that starts in October will not be adopted by Congress. Still, a presidential budget plan is an important indicator of the administration’s priorities.

The Trump administration’s priority for health is for the federal government to spend less. In some cases much less, as evidenced by its proposed funding for the National Institutes of Health and Centers for Disease Control and Prevention.

Also this week, a federal district judge in Washington, D.C., heard arguments in a case challenging work requirements for some Medicaid enrollees in Arkansas and Kentucky. This is the same judge who struck down an earlier version of Kentucky’s proposal.

Meanwhile, Food and Drug Administration chief Scott Gottlieb is stepping down, but this week he issued more rules intended to prevent minors from purchasing flavored e-cigarette products.

This week’s panelists are Julie Rovner of Kaiser Health News, Stephanie Armour of The Wall Street Journal, Alice Ollstein of Politico and Rebecca Adams of CQ Roll Call.

Among the takeaways from this week’s podcast:

  • Trump’s budget may turn the tables on the Republican Party. It calls for more than $500 billion in reductions to Medicare, much of that in payments to providers. That is similar to what Democrats proposed to help fund the Affordable Care Act — a tactic that Republicans used to whip up widespread opposition to the law and gain control of the House of Representatives. Count on Democrats to return the favor in coming campaigns.
  • Some Republicans, including Rep. Tom Cole of Oklahoma, a key Republican on the House Appropriations Committee, signaled concerns about budget cuts recommended by the administration, especially for NIH.
  • On Medicaid, the budget suggests that states be allowed to administer many parts of the program as they see fit. But opponents are likely to ask courts to stop any efforts to weaken federal requirements for coverage.
  • House Democrats have begun an investigation of the marketing and benefits of short-term insurance plans to see if they are denying promised coverage to consumers. The lawmakers are concerned that what they call “junk plans” are confusing consumers who would be better off with policies from the ACA’s marketplace. But any efforts to rein in the plans — which have the blessing of the Trump administration — could run into opposition from Republicans.
  • A federal appeals court this week ruled that Ohio may exclude Planned Parenthood from participating in several small federal health programs that provide money to the state to distribute. The case does not involve either Medicaid or the federal family planning program, but the participation of four judges appointed by Trump could signal a judicial trend.

Plus, for extra credit, the panelists recommend their favorite health policy stories of the week they think you should read too:

Julie Rovner: Buzz Feed News’ “Military Doctors Told Them It Was Just ‘Female Problems.’ Weeks Later, They Were In The Hospital,” by Ema O’Connor and Vera Bergengruen.

AND

The New York Times’ “Treated Like a ‘Piece of Meat’: Female Veterans Endure Harassment at the V.A.,” by Jennifer Steinhauer.

Rebecca Adams: Kaiser Health News’ “’Medicare-For-All Gets Buzzy In Unexpected Locales,” by Shefali Luthra.

Stephanie Armour: Kaiser Health News’ “Understanding Loneliness In Older Adults – And Tailoring A Solution,” by Judith Graham.

Alice Ollstein: HuffPost’s “These Citizen Activists Fought Hard to Expand Health Care. Then Their Lawmakers Rebuked Them,” by Jeffrey Young.

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Well-Known Transgender Surgeon Resigns Following Furor Over Instagram Pictures Of Patients’ Genitals

Dr. Christopher Salgado, 50, worked at the L.G.B.T.Q. Center for Wellness, Gender and Sexual Health at the University of Miami Health System. “The purpose really was to be educational with it, but it went awry,” he said. However, critics were not only upset about the pictures but the captions that appeared to be mocking, as well.

Well-Known Transgender Surgeon Resigns Following Furor Over Instagram Pictures Of Patients’ Genitals

Dr. Christopher Salgado, 50, worked at the L.G.B.T.Q. Center for Wellness, Gender and Sexual Health at the University of Miami Health System. “The purpose really was to be educational with it, but it went awry,” he said. However, critics were not only upset about the pictures but the captions that appeared to be mocking, as well.