Daily Health Policy Report

Tuesday, April 16, 2013

Last updated: Tue, Apr 16

KHN Original Reporting & Guest Opinion

Health Reform

Health Spending And Fiscal Battles

Health Care Marketplace

Capitol Hill Watch

Medicare

Medicaid

State Watch

Editorials and Opinions

KHN Original Reporting & Guest Opinion

Insuring Your Health: Questions About Colon Screening Coverage Still Vex Consumers

In her latest Kaiser Health News consumer column, Michelle Andrews writes: "No one looks forward to screening tests for colon and rectal cancers. But under the Affordable Care Act, patients are at least supposed to save on out-of-pocket costs for them. Coverage is not always clear, however, and despite the federal government's clarifications, some consumers remain vexed and confused" (Andrews, 4/16). Read the column.

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Capsules: Auditors: Medicare Could Save Millions By Limiting Advance Payments To Insurers; Alicia Keys Shines Light On Women And HIV; Sounding An Alarm On Alarms

Now on Kaiser Health News' blog, Julie Appleby reports on the findings of a government report regarding money Medicare could save by limiting insurers' ability to retain investment earnings on funds they are paid through the prescription drug program: "That's because Medicare prepays the private insurers approximately 20 days before the insurers pay their pharmacy bills and does not require them to return any of the interest they earn while holding that money, says the report by the Office of the Inspector General for the Department of Health and Human Services" (Appleby, 4/16).

Also on Capsules, Diane Webber reports on efforts to focus attention on women and HIV: "One in 32 African American women in the United States is likely to be diagnosed with HIV in her lifetime. 'One in 32, think about that,' said singer-songwriter Alicia Keys, citing the Centers for Disease Control and Prevention statistic at an event Monday" (Webber, 4/15).

In addition, Alvin Tran reports on a sentinel event alert issued by the Joint Commission regarding alarm fatigue: "In their latest Sentinel Event Alert, issued April 8, the commission highlighted the dangers that result when doctors and other health professionals develop 'alarm fatigue' or become desensitized and immune to alarm sounds set off by medical devices used for monitoring and treating patients" (Tran, 4/15). Check out what else is on the blog.

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Political Cartoon: 'Take The Fifth?'

Kaiser Health News provides a fresh take on health policy developments with "Take The Fifth?" by John Deering.

Meanwhile, here is today's health policy haiku:

AVOIDING CONFUSION...

Colonoscopy
cost questions can be vexing.
Clear up questions first.
-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.

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Health Reform

In Rhode Island, Blue Cross Signals Rate Increase

Rhode Island Blue Cross, the state's largest insurer, indicated that it would increase its average rates for small businesses by 15 percent, according to filings released on Monday. In Georgia, the push for earlier renewal dates is billed as an effort to avoid "rate shock."

The Wall Street Journal: Rhode Island Blue Cross Filings Signal Rate Rises
The biggest health-insurance carrier in Rhode Island says its average rates for small businesses will go up about 15% next year, an increase tied to the federal health-care overhaul as well as other factors. Rhode Island on Monday became one of the first states to unveil filings that reveal how much its insurers are aiming to charge next year, though the rates still must be approved by state regulators (Mathews and Radnofsky, 4/15).

Georgia Health News: Some Renewing Insurance Early In The Face Of ACA
Health insurers in Georgia are letting smaller firms and individuals move up their policy renewal dates so they can extend their current deals into next year – and avoid possible "rate shock"’ caused by the Affordable Care Act. State insurance department officials and an industry group say the practice of trying to get around the ACA rules is occurring at least on a limited basis in Georgia. "If consumers think it's in their best interests to renew before January 1, we certainly are not going to stand in their way," said Jay Florence, assistant insurance commissioner. "There is no state or federal law that prohibits this type of agreement between customer and insurer" (Miller, 4/15).

Related KHN Coverage: Insurers’ Efforts To Delay Health Law Compliance Could Affect Premiums, Benefits For Millions (Appleby, 4/5).

Also related to the health law's implementation and insurance coverage -

Fox News: Nation's Biggest Movie Theater Chain Cuts Workweek, Blaming ObamaCare
The nation's largest movie theater chain has cut the hours of thousands of employees, saying in a company memo that ObamaCare requirements are to blame. Regal Entertainment Group, which operates more than 500 theaters in 38 states, last month rolled back shifts for non-salaried workers to 30 hours per week, putting them under the threshold at which employers are required to provide health insurance. The Nashville-based company said in a letter to managers that the move was a direct result of ObamaCare (Chiaramonte, 4/15).

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Arkansas Compromise On Medicaid Expansion Hits Roadblock

The compromise, which was viewed as a model for other states, failed to garner the necessary 75 votes in the GOP-controlled House of Representatives. Meanwhile, in Kansas, expansion advocates say they will renew their fight next year.

Reuters: Arkansas Fails To Muster Medicaid Compromise Seen As U.S. Model
Arkansas lawmakers rejected on Monday a compromise measure that would have extended health insurance to more of its low-income citizens, turning back what some saw as a possible model for other states also wrestling with opposition to U.S. government expansion plans for Medicaid. The measure failed to attract the 75 votes needed in the Republican-dominated Arkansas House of Representatives, drawing 69 votes for, 28 against and one abstention (Parker, 4/15).

Kansas Health Institute: Medicaid Expansion Advocates Setting Sights On Next Year
Advocates pushing Kansas officials to expand Medicaid acknowledge it is unlikely they will achieve their goal this year. But they said they remain hopeful they can convince Gov. Sam Brownback and legislators next year to make more Kansans eligible for the program (McLean, 4/15).

And a progress report from California -

California Healthline: Advocates Push For Expansion Compromise
The Legislature last week moved two key components of the special session bills on health care reform. SBX1-2 by Sen. Ed Hernandez (D-West Covina) and ABX1-2 by Assembly member Richard Pan (D-Sacramento) passed through committees of the opposite house. Both bills make changes to the individual health insurance market. The Assembly Committee on Health approved SBX1-2, and it's now going to Appropriations; and ABX1-2 moved through the Senate Committee on Health on its way to Senate Appropriations. Both bills were approved in floor votes in their own house so they are nearing final approval. Also last week, a Senate floor vote unanimously approved SBX1-3 by Sen. Hernandez, the bridge plan to help people move from Medi-Cal to the exchange more easily. That bill now moves to the Assembly (Gorn, 4/15).

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Health Spending And Fiscal Battles

House Panels Kick Off Hearings On Slowing Medicare, Social Security Spending

Among the proposals that will be discussed and debated are increasing Medicare premiums for higher-income seniors and raising the program's eligibility age. Meanwhile, Politico details the health industry gains and losses likely to stem from President Barack Obama's budget plan, which was released last week.

The Washington Post: Republicans Embrace Obama's Offer To Trim Social Security Benefits
This week, two House subcommittees plan to hold hearings on "reforms to protect and preserve" programs for retirees, starting with Obama's proposal to apply a less generous measure of inflation to annual increases in Social Security benefits. Also on the table are higher Medicare premiums and reduced benefits for better-off seniors, and a higher Medicare eligibility age (Montgomery, 4/15).

Politico: President Obama's Budget: Impact On Health Care
The health care sector saw some huge gains and losses in last week's White House budget presented by President Barack Obama. It will not pass the Congress or become law, but the document underscores White House priorities. And if grand bargain negotiations resume this year, the document could become the floor, exciting some health players and making others nervous (Haberkorn and Norman, 4/16).

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Health Care Marketplace

High Court Skeptical That Biotech Firm Can Patent Human Genes

Supreme Court justices seemed to express skepticism Monday that a biotech company can patent human genes isolated from the body that signal a greater likelihood of ovarian or breast cancer. The biotech industry has warned that a broad ruling against such patents could endanger billions of dollars in investment.

Los Angeles Times: Supreme Court Seems Opposed To Granting Patents On Human Genes
The Supreme Court took up a deceptively simple question in a case brought by breast cancer patients and medical researchers: Are human genes patentable? The answer appeared to be "no" during Monday's oral arguments. The justices signaled that they probably will bar any grants of exclusive and profitable patents on human genes that prevent other scientists from testing these pieces of DNA (Savage and Terhune, 4/16).

The Wall Street Journal: Justices Wary On Gene Patents
Monday arguments underscored the difficulty of distinguishing between those innovations that can be protected and scientifically significant discoveries that may not be eligible for patents -- even ones that seek to unlock the mystery of the human genome (Bravin, 4/16).

Reuters: Justices Wary Of Wide Human Gene Patent Ruling
The Supreme Court justices on Monday signaled reluctance to issue too broad a ruling about patents on human genes, and some indicated they might seek a compromise distinguishing between types of genetic material. The biotechnology industry has warned that an expansive ruling against Myriad Genetics Inc could threaten billions of dollars of investment (Hurley, 4/15).

Politico: SCOTUS Case: Can Genes Be Patented?
Several Supreme Court justices seemed sympathetic to claims that genes themselves do not warrant patent protection during arguments Monday in a landmark intellectual property case that could determine whether genes should be in the public domain. But during the arguments in Association for Molecular Pathology, et al. v. Myriad Genetics, the justices repeatedly took refuge in metaphors of baseball bats and chocolate-chip cookies rather than the hard science of DNA (Norman, 4/15).

Philadelphia Inquirer: A Patent On A Gene Stirs High-Court Musings
Molecules and chocolate-chip cookies, baseball bats, and Amazonian tree sap were all part of a spirited Supreme Court discussion Monday as the nine justices wrestled with the question of whether one should be able to get a patent for a human gene. If you slice up pieces of microscopic molecules, have you created new ones or just separated existing body parts, not unlike kidneys or livers, which are products of nature and not usually granted patents? And, more important in this matter, can you profit by preventing others from researching those molecules or providing lower-cost testing services? The justices seemed to be looking for a compromise in Association for Molecular Pathology v. Myriad Genetics Inc. AMP was part of the original group of plaintiffs that represented researchers, including two from the University of Pennsylvania, patient groups, and six women, including one from Williamsport, Pa., with breast or ovarian cancer or a family history of either (Sell, 4/16).

Medpage Today: Gene Patents Spark Debate In High Court
Supreme Court justices lobbed hard questions Monday about whether a company could patent isolated human genes in a case that looms large in the personalized medicine arena. During arguments before the court, several justices expressed doubt that Myriad Genetics could rightfully patent segments of human genes BRCA1 and BRCA2, genes in which mutations are indications of increased risk of breast and ovarian cancer. Products of nature aren't patentable. Only inventions are, but Salt Lake City-based Myriad argued that because the genes have been isolated from the body, they are no longer a product of nature and can be patented (Pittman, 4/15).

In the meantime, drugmakers are using an interpretation of safety laws to block generic versions of their drugs --

The New York Times: Drug Makers Use Safety Rule To Block Generics
For decades, pharmaceutical companies have deployed an array of tactics aimed at preventing low-cost copies of their drugs from entering the marketplace. But federal regulators contend the latest strategy -- which relies on a creative interpretation of drug safety laws -- is illegal. The Federal Trade Commission recently weighed in on a legal case over the tactic involving the drug maker Actelion, and earlier this month a federal suit was filed in another case in Florida (Thomas, 4/15).

In other drug industry news --

The Wall Street Journal: High Court Rejects Glaxo Appeal In Avandia Case
The U.S. Supreme Court on Monday cleared the way for health insurer Humana Inc. to sue GlaxoSmithKline for the recovery of health care expenses on some patients who were allegedly harmed by diabetes drug Avandia. The high court, in a short written order, said it wouldn't consider a Glaxo appeal of a lower-court ruling that allowed the Humana lawsuit to proceed (Kendall, 4/15).

Politico: Meningitis Deaths Fuel A Renewed FDA Debate
Food and Drug Administration Commissioner Margaret Hamburg will be on the hot seat Tuesday as she tries to defend the agency's failure to stop a fungal meningitis outbreak last year that killed more than 50 people. The episode mostly fell from the headlines as the deaths tapered off but is roaring back with the hearing on the Hill. Many Democrats in Congress want to give the FDA more authority to regulate compounding pharmacies like the one linked to this outbreak. But some Republicans question whether the agency failed to properly use the authority it already had, and the key House panel didn't put the issue on its list of legislative priorities for the year (Norman, 4/15).

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Capitol Hill Watch

Panel Expected To Give Tavenner The Nod, Send Nomination On To The Full Senate

The Hill: Health Officials Prepare Budget Defenses
This week brings a full schedule as top federal health officials head for Capitol Hill to defend their 2014 budget requests. The Senate Finance Committee is also expected to approve Marilyn Tavenner, President Obama’s choice to lead the Centers for Medicare and Medicaid Services, which would send her nomination to the full Senate (Viebeck, 4/15).

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Medicare

Medicare Auditors Say Millions Could Be Saved By Limiting Advance Payments To Insurers

According to a report by the Department of Health and Human Services Office of the Inspector General, the federal program prepays private insurers approximately 20 days before they pay their pharmacy bills but does not require them to return any of the interest earned during the time they hold that money. 

Kaiser Health News: Capsules: Auditors: Medicare Could Save Millions By Limiting Advance Payments To Insurers
That's because Medicare prepays the private insurers approximately 20 days before the insurers pay their pharmacy bills and does not require them to return any of the interest they earn while holding that money, says the report by the Office of the Inspector General for the Department of Health and Human Services. That contrasts with how the government treats insurers in the Federal Employees Benefit Program, which provides health coverage for federal workers, the report said. The report is advisory and was given to the Centers for Medicare & Medicaid Services (CMS) and to members of Congress (Appleby, 4/16).

News outlets also report on developments related to the bankruptcy filing of the Scooter Store, which has been under congressional scrutiny because some people say its marketing targets people who don't need these scooters and causes unnecessary Medicare spending. Also, the University of Maryland St. Joseph Medical Center and federal officials strike a deal for the hospital to recoup some lost Medicare billings -

The Associated Press/Washington Post: Texas-Based Scooter Stores Files For Bankruptcy Protection In Delaware
The Scooter Store, a Texas-based company that supplies power wheelchairs and scooters to people with limited mobility, has filed for Chapter 11 bankruptcy protection. Monday’s bankruptcy filing in Delaware comes after federal agents raided the company’s South Texas headquarters earlier this year, and amid congressional scrutiny of whether TV ads by The Scooter Store and a rival company target people who don’t need scooters, leading to hundreds of millions of dollars in unnecessary Medicare spending (4/15).

Baltimore Sun: St. Joseph Strikes Deal With Medicare To Recoup Some Of Lost Billings
University of Maryland St. Joseph Medical Center will be able to recoup some of the tens of millions of dollars it lost while operating without a Medicare certification under a compromise reached with federal officials. The Towson hospital will be able to bill Medicare for treatment given to patients in the federal program since Jan. 7, about six weeks before it regained what is known as a Medicare provider agreement. St. Joseph had operated without one since the University of Maryland Medical System bought the hospital and chose not to renew its existing Medicare certification. Medicare won't reimburse hospitals for treatment if they lack the certification (Dance, 4/15).

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Medicaid

Rule On Home Health Care Workers Causing Rift Between Medicaid Directors, Labor Advocates

CQ HealthBeat: Rule On Home Care Aides Divides Medicaid Directors And Worker Advocates
Directors of state Medicaid programs and disability rights groups are warring with labor advocates over a long-awaited federal regulation that would extend federal minimum wage and overtime pay to in-home health care workers. The Medicaid directors warned in an April 8 letter to the Office of Management and Budget that the proposal could disrupt complex and long-standing care arrangements for low-income people, particularly when friends or relatives are the caretakers. Matt Salo, executive director of the National Association of Medicaid Directors, said in an interview that new cost estimates need to be made because the potential impact is "just huge" (Norman, 4/15).

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State Watch

Abortion Opponents Use Regulation As Weapon Against Clinics

Abortion opponents have shifted their strategies away from pursuing outright bans to using regulations to hamper the availability of the procedure, Stateline reports. In Mississippi, a judge has stopped part of a state law that would have likely forced the closure of the state's only abortion clinic.

Stateline: Fight Over Abortion Rules Could Reverberate Widely
Republicans in many states have tackled abortion head on this year with new laws that would prohibit the procedure after a pregnancy reached a certain number of weeks. A more nuanced tactic is underway in a handful of states, using regulations as an anti-abortion weapon. Mississippi has landed in court to defend a slate of tough provider requirements that advocates on both sides say could ultimately force the state’s only abortion-providing clinic to close. Alabama and North Dakota have adopted similar laws in recent weeks (Grovum, 4/16).

The Hill: States Ramping Up Push To Restrict Abortion
This year could bring an especially strong push in the states to restrict abortion access, according to a new report by the Guttmacher Institute. Several states have passed measures in the past few years requiring women to obtain ultrasounds before receiving an abortion, or imposing new restrictions on clinics (4/16).

The New York Times: Judge Prevents Closing Of Mississippi's Sole Abortion Clinic
A federal judge in Mississippi on Monday blocked part of a state law that would have forced the closing of the state’s only abortion clinic (Robertson, 4/15).

The Associated Press: Only Mississippi Abortion Clinic Gets License Reprieve
A federal judge on Monday temporarily blocked Mississippi from revoking the license of the state's only abortion clinic. U.S. District Judge Daniel P. Jordan III extended an injunction he issued several months ago, which blocks the state from closing the clinic while it tries to fulfill a 2012 state law (4/16).

In Pennsylvania, lawmakers are advancing a bill that would disallow abortion coverage from the state's health insurance exchange --

The Associated Press/USA Today: Bill To Limit Abortion Coverage In Pa. Advances
Republicans in the Pennsylvania House on Monday pushed out of committee a bill that would prevent most coverage for abortions under the health exchange in Pennsylvania being set up as part of the federal health care overhaul. The Health Committee voted 15-9 in favor of the proposal that provides exceptions only for victims of rape and incest or when the mother's life is in peril. One Democrat voted for it (4/15).

And an abortion doctor's murder trial continues --

Reuters: Media Spotlight Falls On Philadelphia Abortion Doctor On Trial For Murder
A city medical examiner described fetal body parts stored in pet food containers during his testimony on Monday at a murder trial that has drawn a national spotlight after anti-abortion groups complained that it was being ignored. The graphic testimony came in the fifth week of the murder trial of Dr. Kermit Gosnell, 72, who faces the death penalty if convicted of charges he killed seven infants and a female patient at what a grand jury described as his squalid abortion clinic in urban West Philadelphia (Warner, 4/15).

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Roundup: Ariz. Lawmakers Revive Vetoed Health Care Price Transparency Bill

A selection of health policy stories from Arizona, California and Texas.

The Associated Press: Senate Revives Vetoed Medical Care Pricing Bill 
The Arizona Senate voted Monday to revive the major provisions of a medical pricing transparency bill that was vetoed by Gov. Jan Brewer just last week. Senate Bill 1115 by Republican Sen. Nancy Barto would have required health care providers to post prices for common medical procedures (Christie, 4/15).

The Associated Press/Washington Post: Tobacco Cos. Make Payments Under Pact To Help States With Smoking-Related Health Care Costs
The nation's top cigarette companies have made their payments as part of the longstanding settlement in which some cigarette makers are paying states for smoking-related health care costs. Philip Morris USA, the nation's largest cigarette maker owned by Altria Group Inc., said Monday that it made its full annual payment of about $3.1 billion as part of the 1998 Master Settlement Agreement (4/15).

Los Angeles Times: California Panel Advances Bills Targeting Prescription Drug Abuse
A broad package of bills aimed at reducing prescription drug abuse and overdose deaths won approval from a key state Senate committee Monday. The bills, including a measure that would require coroners to report prescription-involved deaths to the Medical Board of California, followed a series of Times articles linking doctors to patient overdose deaths (Girion and Glover, 4/15).

The Texas Tribune: Senate Approves Bill That Targets Medicaid Fraud
The Texas Senate on Monday approved legislation that aims to tackle Medicaid fraud. …Thirty senators voted in favor of the bill, while Sen. Kirk Watson, D-Austin, abstained from the vote. The bill now moves to the House (Aaronson, 4/15).

California Healthline: Telehealth Project Brings ‘Virtual Dental Home’ To Patients
The "virtual dental home" -- a collapsible dental chair, laptop computer, digital camera on the end of a dental probe and a handheld X-ray machine -- was put through its paces last week in a portable classroom of Magnolia Head Start Preschool in the parking lot behind St. Francis of Assisi Church in this less-than-affluent community in the middle of affluent Silicon Valley. The event was a sort of coming out party for the dental telehealth project created by the University of the Pacific Arthur A. Dugoni School of Dentistry (Lauer, 4/15).

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Editorials and Opinions

Viewpoints: 9 'Brilliant Legal Minds' Wrestle With Tough Biological Questions In Gene Case; Drug Overdoses Take Surprising Toll In Calif.; VA Case Raises Privacy Questions

Los Angeles Times: The Supreme Court Looks At Gene Patents, Worries About Biotech
When the Supreme Court took up the question Monday of whether genes could be patented, the justices were clearly concerned about preserving innovation in medicine and biotechnology. But the issue presented by Myriad Genetics' patents on the BRCA genes cuts both ways, leading to a potential split among the justices (Jon Healey, 4/15). 

Los Angeles Times: Why Genetic Patents Are Good For Patients [Blowback]
As we said in our Supreme Court brief, these molecules were "never available to the world until Myriad's scientists applied their inventive faculties to a previously undistinguished mass of genetic matter. This was the product of creative, human ingenuity." The government has issued thousands of patents over many years involving isolated genetic material. Many more patents protect products derived from natural material, such as ours. Laboratories routinely turn elements found in nature into innovative remedies and medical prescriptions that are patented (Peter D. Meldrum, 4/15). 

The Washington Post: At Supreme Court, Cookies And Baseball Bats
The Supreme Court on Monday took up the unusual question of whether corporations control our genetic material — specifically, whether a Utah-based company called Myriad Genetics has valid patents on the human genes BRCA1 and BRCA2, which are related to breast and ovarian cancers. That a company most people have never heard of could have the exclusive rights to pieces of our DNA is a bit unnerving. More than a bit unnerving: The ownership of our genes is being decided by nine justices who, although brilliant legal minds, are not exactly biotechnologists (Dana Milbank, 4/15). 

The Associated Press: Compromise Key To Legacy Obama Desires
He wants to take on the expensive Democratic sacred cows of Social Security and Medicare. He doesn't agree with a judge and women's rights groups that girls of any age should have easy access to emergency contraception. He has hinted that he may disappoint environmentalists by letting the proposed Keystone XL oil pipeline be built. ... There's a paradox for the White House to worry about, though. By spurning the party's left wing on issues like entitlement programs, Obama runs might be sabotaging exactly what he's trying to achieve. Congressional Democrats who side with him risk inviting liberal primary challenges and could end up losing their re-election bids, squandering Obama's chance at absolute Democratic power in the final two years of his presidency (Liz Sidoti, 4/15).

Los Angeles Times: Drug Overdose Prevention Could Be Right At Our Fingertips
What do you think is the leading cause of accidental death in California? If you said car accidents, you were wrong. In 2009, the most recent year for which statistics are available, 3,200 people in the state died in automobile crashes, while 3,561 people died of drug overdoses, the bulk of them involving prescription pills. That high number of deaths is particularly tragic because we have a powerful weapon against drug overdoses, and it isn't used nearly as often as it could be (Lynne Lyman, 4/16).

Los Angeles Times: Kermit Gosnell And Abortion's Darkest Side
So, obviously this is a story about the mainstream media. My fellow Fox News contributor Kirsten Powers wrote a USA Today column last week shaming the media for not covering the Gosnell case enough or, in many cases, at all. She got results. Suddenly everyone was talking about the case. Though a dismaying amount of the coverage is about why there was a lack of coverage (Jonah Goldberg, 4/16).

Tampa Bay Times: VA Report Dodges Invasion Of Privacy
Most health care providers respect their obligation to respect the privacy of their patients. Then there is the Department of Veterans Affairs. That agency's inspector general played team ball recently by clearing Tampa's James A. Haley VA Medical Center of wrongdoing for placing a camera disguised as a smoke detector in the room of a brain-damaged veteran without telling his family. This is a clear violation of ethics even for an obtuse bureaucracy with no real sense of accountability. Congress should demand some answers (4/15).

Bloomberg: Doctors Should Welcome A Nudge To Wash Their Hands
As a physician, I am glad for the mobile health-monitoring applications that allow me to help my patients sleep better, exercise better and eat better. Yet I was a little offended when I learned of a new wristband monitor that prods doctors to wash their hands when they enter a patient’s room. ... But such measures are necessary, however demeaning they seem. In the average U.S. hospital, hand-washing compliance rates vary from just one-third of patient encounters to half at best. And hand hygiene is the single-largest contributor -- and the most fixable -- to the almost 2 million hospital-acquired infections each year that kill 100,000 people in the U.S. (Ford Vox, 4/15).

Politico: Open Access Aids Science Research
No one likes paying for the same thing twice. This holds true for federally funded scientific research. For years, scholarly journals have relied on taxpayers paying for research on the front end and access to the results on the back. It is past time to embrace an open access policy for scientific research (Rep. Jim Sensenbrenner, R-Wis., 4/15).

Boston Globe: A Doctor Ponders Her Reaction To A Cancer Diagnosis
There's this weird feeling I get when I hear bad news, or even not-that-bad news, or even the possibility of bad news: a tingling that spreads across my forehead, down my face, into my jaw, and then to my chest, where it settles like a . . . no, not a lump . . . a void. I get the feeling every time I go for my annual mammogram or any other medical test, I wonder how I would react to a bad outcome. Would I be brave and noble, as so many of my patients are? Or would I be like Woody Allen in the classic scene from "Hannah and Her Sisters," one of the "weaker ones," panicked, swallowed up in the void of my own fear? At my Literature and Medicine discussion group, I had a chance to reconsider this question (Dr. Suzanne Koven, 4/15). 

San Jose Mercury News: Curing California's Acute Doctor Shortage
California doesn't have enough primary care physicians. Forty-two of its 58 counties fall short of the federal government's most basic standard. The state needs another 2,000 doctors, and the situation will get dramatically worse next year -- even in Silicon Valley -- when 2-4 million Californians obtain health insurance under Obamacare and go looking for a doctor. The California Medical Association wants to build more medical schools and expand opportunities for young doctors. Good plan -- but thinking it will solve the immediate problem is like expecting a Band-Aid to heal a bullet wound. Training a doctor takes a decade. That's a long time for a patient to sit in a waiting room (4/12).

HealthyCal: Will Reform Of Care For Aging Help Or Hurt? 
Amid all the recent worry about people lacking health insurance, one vulnerable group of Californians appears to be suffering from too much, not too little coverage. Low-income older adults qualify for both Medicare and Medi-Cal. That might sound like a good thing. But the lack of coordination between the federal program for seniors and the state-federal program for the poor may be hurting their health. It is also costing the taxpayers a ton of money (Daniel Weintraub, 4/15).

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The Kaiser Daily Health Policy Report is published by Kaiser Health News, an editorially independent program of the Kaiser Family Foundation. (c) 2014 Kaiser Health News. All rights reserved.