Daily Health Policy Report

Tuesday, May 29, 2012

Last updated: Tue, May 29

KHN Original Reporting & Guest Opinion

Health Reform

Campaign 2012

Capitol Hill Watch

Health Care Marketplace

Coverage & Access

Public Health & Education

State Watch

Editorials and Opinions

KHN Original Reporting & Guest Opinion

Insuring Your Health: Proposed Changes To Psychiatric Manual Could Impact Addiction Diagnosis

In her latest Kaiser Health News consumer column, Michelle Andrews writes: "What's in a name? That's a question that experts are wrestling with as they prepare to revise the diagnostic manual that spells out the criteria for addiction and other substance-use problems. ... The new guidelines would do away with the diagnostic categories of 'substance abuse,' which generally is defined by such short-term problems as driving drunk, and 'substance dependence,' which is chronic and marked by tolerance or withdrawal, in favor of a combined 'substance use and addictive disorders' category" (Andrews, 5/29). Read the column.

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Louisville’s Strategy For The Future: Stick With The Old Folks

Writing for Kaiser Health News, in collaboration with The Washington Post, Frank Browning reports: "This city of 570,000 people is generally recognized as the home of the Kentucky Derby, mint juleps and bourbon. But few outsiders know it also hosts the largest concentration of nursing-home and extended-care companies in the nation" (Browning, 5/28). Read the story.

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Political Cartoon: "Overspecialization?"

Kaiser Health News provides a fresh take on health policy developments with "Overspecialization?" By Harley Schwadron.

Meanwhile, here's today's health policy haiku:

THE WORLD'S GREATEST DELIBERATIVE BODY

The U.S. Senate
actually passes a bill.
Fix Medicare next?
- 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

House GOP Plans New Votes Repealing Parts Of Health Law

The two bills would repeal a tax on medical devices and ease restrictions on health savings accounts, both parts of the Democrats' health care reform law.

The Hill: House Plans Two Votes To Repeal Health Care Law Before Supreme Court Ruling
The House will keep voting on piecemeal bills to repeal parts of President Obama's health care law before the Supreme Court decides whether the law is unconstitutional. Majority Leader Eric Cantor (R-Va.) said in a planning memo that the House will vote on two partial repeal bills as early as June 4. One would repeal the health law's tax on medical devices, and the other would relax the law's restrictions on the use of tax-preferred health savings accounts (HSAs) (Baker, 5/25). 

CQ HealthBeat: Ways And Means To Mark Up Device Fee Repeal May 31
The House Ways and Means Committee will mark up legislation May 31 to repeal fees that medical device manufacturers will have to pay beginning next year to help cover the costs of the health care overhaul, a GOP aide said. Introduced by Rep. Erik Paulsen, R-Minn., the bill has 238 cosponsors. The committee also will mark up HR 5842, a bill introduced by Rep. Lynn Jenkins, R-Kan., according to the aide. That measure permits the use of health savings accounts and flexible spending account funds to purchase over-the-counter medications, which is now barred under the health care overhaul law (5/25).

Politico Pro: Medical Device Tax Becomes Campaign Issue
A controversial health care reform tax due to go into effect next year has become a prominent issue in a number of House and Senate races throughout the country. Beginning next year, the medical device industry will face a 2.3 percent tax on its sales. The tax is estimated to raise $2 billion each year to help pay for President Barack Obama’s health reform law, according to the Joint Committee on Taxation (Haberkorn, 5/29).

Meanwhile, other news organizations look at issues related to the health insurance exchanges also established under the 2010 law:

The Washington Post: State-Based Insurance Marketplaces Hang In Balance Of Supreme Court Health-Care Ruling
While partisan gridlock and logistical disputes have stalled preparations for the 2010 health care law in about two dozen states, more than a dozen others have moved swiftly to set up the insurance marketplaces at the statute’s core. So what will come of those efforts if the Supreme Court decides to overturn all or part of the law? Interviews with key officials in some of the states that are furthest along suggest the results could vary widely (Aizenman, 5/26).

Politico Pro: How IT Could Trip Up State Exchanges
Even states that are solidly committed to pursuing an exchange are facing major logistical challenges in building the computer systems that will be able to handle enrollment when exchanges open for business in 2014. That's largely because the system that will actually connect people to the right coverage will have to "talk" to many other systems, and they don’t use a common language. This includes a yet-to-be built federal "data hub" with tax and citizenship data, the enrollment systems of multiple private insurers selling exchange plans, and --hardest of all -- state Medicaid enrollment systems, many of which are not yet fully computerized (Feder, 5/25).

And The Associated Press tries to answer one of the biggest questions around Washington.

The Associated Press: Justices' Summer Plans Point To Late June Finish
One never knows when the Supreme Court will hand down its last, often biggest, opinions of the term. But the justices' summer travel schedules make it a pretty safe bet that blockbuster health care and immigration cases will be decided by the end of June. That's because Professor John Roberts, also known as Chief Justice of the United States, has a morning law school class to teach the first week of July. On Malta (Sherman, 5/27).

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Specialty Doctor Groups Ask Feds To Delay Managed Care Move For Dual Eligibles

Several organizations have asked the federal government to slow down implementation of a health law provision that would move people eligible for both Medicare and Medicaid into managed care.

Modern Healthcare: Specialists Push For More Time On Dual-Eligibles Demo
The Alliance of Specialty Medicine, an association of specialty medical societies, wants the CMS to delay for at least a year its implementation of a demonstration project for patients known as dual-eligibles who are eligible for both Medicare and Medicaid. In a letter to Marilyn Tavenner, acting CMS administrator, the alliance members wrote they are concerned that access to care will be disrupted because of potential problems with the demonstration resulting from a swift and relatively large implementation among the states applying to join (Barr, 5/27).

CQ HealthBeat: Specialists Urge One Year Delay In Demo Moving Duals Into Managed Care
The Alliance of Specialty Medicine, which represents about 100,000 specialty physicians, says federal officials should delay until 2014 a program expected to move a million or more of the so-called dual eligible population into managed care plans (Reichard, 5/25). 

The Hill: Medical Specialists Push Back On Initiative From Health Care Law
In a letter, the Alliance of Specialty Medicine asked the Centers for Medicare and Medicaid Services (CMS) for a one-year delay on the grounds that the current "direction and speed" of the project's implementation would jeopardize payments to medical professionals as well as the care of so-called dual eligibles -- people enrolled in both Medicare and Medicaid. "While the goal of the program is to eliminate duplication of services for these patients," the group wrote, "we are deeply concerned about unintended consequences" (Viebeck, 5/25).

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Campaign 2012

Democrat, GOP Candidates Say Rivals Would Throw Granny Off Cliff

The battle over Medicare figures large in House and Senate races across the country, with candidates and their allies trading charges over who would inflict the most damage to seniors.

The Associated Press: Spin Meter: Political Ads Stir Health Care Horror
Republicans and Democrats seem to be converging on a not-so-subtle message for their political ads on health care this election year: The other side is going to throw granny off a cliff! Expect health care ads to feature heavy doses of what each party alleges that the other party plans to do to wreck Medicare (Alonso-Zaldivar, 5/28).

The Hill: Medicare Fight Hits House, Senate Races
The battle over Social Security and Medicare has been resurrected in House and Senate races across the country, with candidates and their allies stretching the truth as they squabble with opponents about who would inflict the most damage on the nation's seniors. The scrap has worked its way into candidate debates, mailers and television ads — and prompted one senator's unsuccessful quest to have an attack ad pulled off the air (Lederman, 5/28).

Politico: GOP To Target Obamacare, Gas Prices
House Republicans this summer will take more swipes at President Barack Obama’s health care law, try to slash more regulations and take votes to highlight sky-high gas prices during the travel-heavy season. In a memo being sent to House Republican lawmakers Friday morning, Majority Leader Eric Cantor (R-Va.) also makes official a series of votes this summer on the Bush-era tax rates – a political vote meant as a contrast with Democrats, who are seeking to hike rates on high-income earners when they expire at year-end (Sherman, 5/25).

The New York Times: Redistricting Poses New Challenge For Incumbent
(Rep. Kathy Hochul) who rode a wave of anger over a Republican plan to cut Medicare a year ago must convince a primarily Republican electorate that she can represent it and offer an independent voice, regardless of party label. ... National Republicans, still smarting over the way she transformed a little-noticed House race into a closely watched referendum on the Medicare plan, have made her a top target this fall (Hernandez, 5/27).

The Associated Press: Bitter Primaries Undercut GOP Hopes In 3 States
Don't go looking for compliments and congeniality in the Republican primary to decide (Sen. Bill) Nelson's election-year challenger. It's one of the meanest races in the country. … The U.S. Chamber of Commerce recently spent $2 million on an ad criticizing Nelson for his support for Obama's health care law. "Obamacare will be a nightmare for seniors," the ad says. "Did Bill Nelson consider the consequences when he cast the deciding vote for Obamacare?" (Cassata, 5/29).

Los Angeles Times: $55 Million For Conservative Campaigns — But Where Did It Come From?
During the 2010 midterm election, the (Center to Protect Patient Rights) sent more than $55 million to 26 GOP-allied groups, tax filings show, funding opaque outfits such as American Future Fund, 60 Plus and Americans for Job Security that were behind a coordinated campaign against Democratic congressional candidates. The money from the center provided a sizable share of the war chest for those attacks, which included mailers in California, robo-calls in Florida and TV ads that inundated a pocket of northeastern Iowa. The organizations it financed poured at least $46 million into election-related communications in the 2010 cycle, among other expenditures (Gold and Tanfani, 5/27).

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Capitol Hill Watch

House To Vote On Amended FDA Bill, Hears From Docs On Pay Fix

The GOP-led House will vote on an amended version of the FDA reauthorization bill, and medical officials are urging action on Medicare payments.

HealthBeat: House To Take Up Amended FDA User Fee Reauthorization
The House is expected to vote on passage of an amended reauthorization bill for the Food and Drug Administration’s user fee programs on May 30, upon the chamber’s return from its Memorial Day recess. House Energy and Commerce Chairman Fred Upton, R-Mich., released a substitute amendment on Friday that aims to keep the bipartisan measure from adding to the deficit. A Congressional Budget Office cost estimate released Thursday found that the bill would add $247 million to the federal deficit over 10 years (Ethridge, 5/25).

Minnesota Public Radio: Consumer Groups Unhappy With Bill Easing Medical Device FDA Review Process
Congress is considering some legislation of great interest to Minnesota's medical device industry, which employs some 35,000 people in the state. Device companies say the legislation will speed up the lengthy process of federal approval required to bring the new life-saving devices to market. But some consumer groups argue that Congress is missing an opportunity to strengthen a review process for the Food and Drug Administration that they say is too lenient. … The legislation more than doubles the fees medical device and drug companies pay the Food and Drug Administration for safety reviews. These med-tech companies will pay the agency about $600 million over five years, to fund an increase in review staffing (Moylan, 5/29).

Meanwhile, medical groups are urging Congress to change the Medicare reimbursement formula.

Modern Healthcare: MGMA, AMA Repeat Call For SGR Repeal
Two organizations representing the country's doctors and practice managers reiterated their position that Congress should repeal the sustainable growth-rate formula and outlined alternative approaches to the current Medicare physician payment system. The appeals from the MGMA-ACMPE and the American Medical Association to the House Ways and Means Committee were in response to the panel's April request for comments on different approaches to the way physicians are reimbursed in the Medicare program (Zigmond, 5/26).

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Bipartisan Group Of Senators Say They'll Ratify Disability Treaty

The senators are backing a U.N. treaty that they say would protect Americans with disabilities who work or travel abroad. The Obama administration has sent the treaty to the Senate for ratification.

The Hill: Senators Back UN Disability Rights Treaty
The Convention on the Rights of Persons with Disabilities (CRPD) prescribes actions for states that want to "ensure and promote the full realization of all human rights … for all persons with disabilities without discrimination." The U.S. government has signed but not ratified the treaty, which now requires Senate approval. It contains detailed policy objectives, though a release said that ratification would require "no changes to U.S. laws or new appropriations" (Viebeck, 5/28). 

CQ HealthBeat: Disability Treaty Gets Bipartisan Support
A bipartisan group of senators Friday announced support for U.S. ratification of a treaty that, the senators say, would help protect Americans with disabilities who travel and work abroad. The Convention on the Rights of Persons with Disabilities (CRPD) is in part patterned, advocates say, after the U.S. disability law and is the first treaty to address such rights globally. An American delegation under President George W. Bush negotiated and approved the convention in 2006. The U.S. signed the accord on July 30, 2009. So far, 153 countries have signed the treaty and 112 of those have ratified it. Last week, the Obama administration sent the treaty to the Senate for ratification (Bunis, 5/25). 

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Health Care Marketplace

Insurers Make Patients Pay Hundreds More for Cancer, Arthritis Drugs

Thousands of patients taking costly drugs for ailments such as cancer and rheumatoid arthritis are being asked to shoulder a greater share of the expense. In other news, consumers are demanding access to their medical device data. Others are harnessing the internet to jumpstart medical research and share important experiences, including serious illnesses, with family and friends.

Los Angeles Times: Insurers Forcing Patients To Pay More For Costly Specialty Drugs
Thousands of patients in California and across the nation who take expensive prescription drugs every month for cancer, rheumatoid arthritis and other ailments are facing sticker shock at the pharmacy. Until recently, most of these patients typically paid modest co-pays for the advanced drugs. But increasingly, Anthem Blue Cross, Aetna and other insurers are shifting more prescriptions to a new category requiring patients to shoulder a larger share of the drug's cost. The result: Pharmacy bills are going up by hundreds of dollars a month — on top of insurance premiums (Terhune, 5/29).

Los Angeles Times: Many Hospitals, Doctors Offer Cash Discount For Medical Bills
A Long Beach hospital charged Jo Ann Snyder $6,707 for a CT scan of her abdomen and pelvis after colon surgery. But because she had health insurance with Blue Shield of California, her share was much less: $2,336. Then Snyder tripped across one of the little-known secrets of healthcare: If she hadn't used her insurance, her bill would have been even lower, just $1,054. ... Unknown to most consumers, many hospitals and physicians offer steep discounts for cash-paying patients regardless of income. But there's a catch: Typically you can get the lowest price only if you don't use your health insurance (Terhune, 5/27).

The New York Times: Waking Up To Major Colonoscopy Bills
Patients who undergo colonoscopy usually receive anesthesia of some sort in order to "sleep" through the procedure. But as one Long Island couple discovered recently, it can be a very expensive nap. Both husband and wife selected gastroenterologists who participated in their insurance plan to perform their cancer screenings. ... And in both cases, the gastroenterologists were assisted in the procedure by anesthesiologists who were not covered by the couple's insurance. They billed the couple's insurance at rates far higher than any plan would reimburse — two to four times as high, experts say (Rabin, 5/28).

Los Angeles Times: Facebook Group Helped With Cancer Support, Mourning
Karen North, director of USC's Annenberg Program on Online Communities, says that the practice of using online community tools to connect deeply with friends and family is on the rise. "People are engaging their loved ones for important life events including struggling with the challenges of an illness, sharing relationships and weddings, engaging others in the upbringing of their children — showing pictures, telling stories, asking for advice or support, and more." Though Facebook has been criticized as a font of useless narcissism, this type of helpful sharing often feels very personal, especially if the creator includes pictures, videos and audio as well as text, North says (Williamson, 5/27).

NPR/KQED: Patients Crusade For Access To Their Medical Device Data
Each year, tens of thousands of Americans are implanted with tiny battery-controlled devices that regulate the beating of their hearts. Those devices transmit streams of medical data directly to doctors. But some patients, like Hugo Campos of San Francisco, fear they're being kept out of the loop. ... That's because even though Campos' ICD can wirelessly transmit data twice a day about his heart and the ICD itself, that information goes only to his doctor. Campos has to make an appointment and ask for a printout. And that, he says, just doesn't seem fair (Standen, 5/28). 

NPR: Patients Find Each Other Online To Jump-Start Medical Research
People with extremely rare diseases are often scattered across the world, and any one hospital has a hard time locating enough individuals to conduct meaningful research. But one woman with an extremely rare heart condition managed to do what many hospitals couldn't. Katherine Leon connected with enough people online to interest the Mayo Clinic in a research trial (Cuda-Kroen, 5/28). 

The New York Times: A Game To Help Doctors Ask Tough Questions
As Dr. Danielle McCarthy listens to a man beg for a prescription for painkillers, she weighs her possible responses. ... Their exchange is similar to conversations that take place on almost every shift at Northwestern Memorial Hospital here, Dr. McCarthy said. But it is fiction — part of an interactive video game designed to train doctors to identify deceptive behavior by people likely to abuse prescription painkillers. The patient is an actor whose statements and responses are generated by the program (Johnson, 5/25). 

The Wall Street Journal: Long Medical Waits Prove Hard To Cure
Efforts in the medical world to reduce the amount of time patients spend waiting for appointments can have unintended consequences. If you measure how long patients coming off a waiting list have spent on that list, a hospital has little incentive, while under evaluation, to clear those who already have been waiting longer than average. As soon as they are cleared, the hospital's numbers get worse (Bialik, 5/25). 

Meanwhile, analysts predict the low use of medical services, which has boosted insurers' stocks, is unlikely to continue.

Reuters: Analysis: HMO Stocks May Struggle Over Health Claim Costs
Americans' low use of healthcare services has proved a boon to health insurers over the past two years, reducing medical claim costs and raising profits. The growing view on Wall Street is that those days are over. A series of first-quarter earnings disappointments for health insurers in the past month has damped hopes for a repeat of the profit windfalls that led to huge stock gains in 2011 (Krauskopf, 5/25).

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Coverage & Access

Half Of New Vets Seek Disability, Obama Vows To Protect All Veterans' Benefits

Veterans returning from war are seeking disability at high rates as President Obama vows to protect their benefits in Memorial Day speeches.

The Associated Press: Almost Half Of New Vets Seek Disability
America's newest veterans are filing for disability benefits at a historic rate, claiming to be the most medically and mentally troubled generation of former troops the nation has ever seen. A staggering 45 percent of the 1.6 million veterans from the wars in Iraq and Afghanistan are now seeking compensation for injuries they say are service-related. That is more than double the estimate of 21 percent who filed such claims after the Gulf War in the early 1990s, top government officials told The Associated Press (Marchione, 5/27).

The Associated Press/ABC News: Obama Vows To Protect Benefits For Veterans
President Barack Obama honored the nation's military heroes in a pair of Memorial Day ceremonies, vowing to protect the benefits earned by veterans and their families in an election year marked by the nation's transition from war. … Obama said the nation must remain committed to providing for the families of fallen soldiers and help returning service members seeking jobs, higher education or health care benefits (Thomas, 5/29).

In the meantime, Sen. Patty Murray sounds off on vets issues --

The Hill: Sen. Murray: Lawmakers 'Weren't Prepared' To Deal With Veterans' Issues 
Sen. Patty Murray, (D-Wash), chairwoman of the Senate Veterans' Affairs committee, on Sunday said lawmakers needed to better address the long-term funding needs of Iraq and Afghan war veterans over the coming decades. ... But the Washington state senator said veterans' benefits would not be threatened by automatic spending cuts set in motion by last August’s debt-ceiling deal and set to take effect early next year (Mali, 5/27).

And the GAO outlines potential problems with a dialysis pilot program slated to begin in the VA --

Modern Healthcare: GAO Cites Risks To Goals Of VA Dialysis Pilot
The Veterans Affairs Department has not shown how it will achieve the goals of a dialysis pilot program it began to develop three years ago, nor has it created clear measures to evaluate its performance, a new federal report found. In 2009, the VA started its Dialysis Pilot, which will establish four VA-operated outpatient clinics near VA medical centers by the end of this year (Zigmond, 5/28).

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Seniors Increasingly Cared For In Multi-Generational Homes

NPR examines how families are living under the same roof to care for senior relatives -- and also, to get by.

NPR: Family Matters: Pitching In To Take Care Of Grandma
On a recent evening, the Martin family of Harrisburg, Pa., had too many places it needed to be. AnnaBelle Bowers, the 87-year-old matriarch of the family who is also known as "Snootzie," was at home — watching television and getting ready for bed. Someone needed to care for her. That fell to Chris Martin, her 14-year-old great-grandson. His willingness to stay at home meant his sister, Lauren, could play in a softball game. It also meant her parents, David and LaDonna Martin, could watch. ... More and more, multigenerational families like the Martins are living under the same roof in order to care for a loved one — and also get by (Greene, 5/29).

Meanwhile, the Baltimore Sun looks at how health bills factor into seniors' debts.

Baltimore Sun: Seniors Grow Old Under Debt
Health care bills are a leading factor contributing to the indebtedness of graying Americans.
Workers are paying more for employer-sponsored health insurance, while costs for medical care are skyrocketing. Eligibility for Medicare doesn't begin until age 65, and it does not cover such expenses as hearing aids, dental care and long-term nursing care (Cho, 5/27).

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Patients With Mental Health Issues Overwhelm ERs

Patients suffering from schizophrenia, psychotic tendencies and suicidal behaviors are burdening hospital ERs, reports Modern Healthcare.

Modern Healthcare: Out Of The ER
Borderline personality disorder. Schizophrenia. Psychotic tendencies. Suicidal behaviors. Typically found in the caseload of an inpatient psychiatric facility, these conditions have become prevalent in another area of the U.S. healthcare system: the acute-care hospital emergency department. In 2006, an Institute of Medicine report concluded hospital emergency rooms are overwhelmed, citing increases in lengths of stay for patients seeking care, crowding of existing ER space and boarding of patients who need an inpatient bed as the reasons (Zigmond, 5/26).

Meanwhile, Kaiser Health News columnist Michelle Andrews explores how the diagnosis for addiction could change as a result of revisions to the diagnostic manual for mental illnesses.

Kaiser Health News: Insuring Your Health: Proposed Changes To Psychiatric Manual Could Impact Addiction Diagnosis
"What's in a name? That's a question that experts are wrestling with as they prepare to revise the diagnostic manual that spells out the criteria for addiction and other substance-use problems. ... The new guidelines would do away with the diagnostic categories of "substance abuse," which generally is defined by such short-term problems as driving drunk, and "substance dependence," which is chronic and marked by tolerance or withdrawal, in favor of a combined "substance use and addictive disorders" category (Andrews, 5/29).

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Public Health & Education

Studies Outline Dilemmas On New Generic Heart Drugs, HRT

One heart drug's move to generic status has complicated treatment options for some patients and doctors, the Wall Street Journal reports. Also, another study raises concerns about hormone replacement therapy in women.

The Wall Street Journal: Heart Patients May Face a New Drug Dilemma 
The newly low cost of Plavix, one of the biggest-selling drugs, is intensifying debate among cardiologists over how to make sure patients get optimal benefit from any blood-thinning medication. A generic version of Plavix became available this month so there is an incentive to switch patients to it. But, nearly a third of patients prescribed a blood thinner to prevent heart attack or stroke have a genetic variation that limits their response to Plavix. For these patients, some doctors prescribe Effient or Brilinta, two rival drugs used by far fewer patients (Winslow, 5/28).

Los Angeles Times: New Study Sounds Warning On Hormone Replacement Therapy
Women who are past menopause and healthy should not use hormone replacement therapy in hopes of warding off dementia, bone fractures or heart disease, says a new analysis by the government task force that weighs the risks and benefits of screening and other therapies aimed at preventing illness. The recommendation by the U.S. Preventive Services Task Force does not necessarily apply to women who use hormone replacement therapy to reduce menopausal symptoms such as hot flashes, night sweats and vaginal dryness. ... The recommendation ... comes a decade after the study first linked hormone replacement therapy with higher rates of invasive breast cancer. Those initial findings prompted droves of women to abandon or avoid hormone therapy (Healy, 5/29).

Other stories look at a medical marijuana movement in Florida, drugs for adults being used to treat children and a new method to treat hypertension --

The Wall Street Journal: Joint Effort: Reefer Roadshow Asks Seniors to Support Medical Pot
Selma Yeshion, an 83-year-old retiree here, says she long considered marijuana a menace. ... Then she attended a presentation at the local L'Dor Va-Dor synagogue in April put on by a group called the Silver Tour. The group aims to persuade seniors to support legislation to legalize marijuana for medicinal purposes in Florida. ... The group was founded in 2010 by an unlikely activist: Robert Platshorn, who served nearly 30 years in federal prison for his role in what drug-enforcement officials call one of the biggest marijuana-smuggling rings of the 1970s (Campo-Flores, 5/28).

The New York Times: Drug For Adults Is Popular As Children’s Remedy 
Since it was first introduced 13 years ago, a drug called Miralax -- an odorless, tasteless laxative that can be easily diluted in orange juice or water -- has become a staple in many American households. But the way many families use Miralax and its many generic equivalents has strayed far from its original intent. The Food and Drug Administration approved the drug for use only by adults, and for only seven days at a time. Instead, Miralax has become a long-term solution for childhood constipation (Saint Louis, 5/25). 

The Associated Press/MSNBC: Drastic Method Targets Hard-To-Treat Hypertension 
Hypertension may be the nation's sneakiest epidemic, a time bomb that's a leading cause of heart attacks, strokes and kidney failure, and one that's growing worse as the population rapidly grows older. Despite an arsenal of drugs, millions of people in the United States can't get their blood pressure down to safe levels. Now, in a high-stakes experiment at dozens of hospitals, scientists are testing a dramatically different approach for the toughest to treat patients, by burning away some overactive nerves deep in the body that can fuel rising blood pressure (Neergaard and Perrone, 5/28).

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For Many Prostate Cancer Patients, New Guidance Is Confusing

The recommendation that fewer men get screened for the disease goes against what many people believe should be appropriate, NPR reports.

NPR: With PSA Testing, The Power Of Anecdote Often Trumps Statistics
Millions of men and their doctors are trying to understand a federal task force's recommendation against routine use of a prostate cancer test called the PSA. The guidance, which came out last week, raises basic questions about how to interpret medical evidence. And what role expert panels should play in how doctors practice. About 70 percent of men over 50 have gotten a PSA blood test. Some are convinced it was a lifesaver (Knox, 5/28).

Reuters: Doctors Disagree On When To Stop PSA Screening
In the new study, researchers at Johns Hopkins School of Medicine in Baltimore looked at how primary care doctors in their university network typically handle the age question. They found, not surprisingly, that practices varied. Of 125 doctors, about one-third said they had no particular age when they stopped recommending PSA screening (Norton, 5/28).

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One Third Of Homeless Are Obese

Amid some signs that America's obesity rates may be flattening out, media outlets report that one in three homeless people is obese and that bariatric surgery, which reduces stomach size, is becoming more common for patients as young as 12 or 13.

Des Moines Register: U.S. Sees Progress In Battle Against Obesity, Former Surgeon General Says
America finally appears to be making progress on fighting obesity, which could help the country gain control of its medical costs, the nation’s former top doctor says. Former Surgeon General David Satcher, who was in Iowa to give the commencement address for Des Moines University over the weekend, noted that some studies suggest America’s obesity rates are starting to flatten out or even drop a bit after climbing for many years (Leys, 5/27).

CNN: 1 In 3 Is Obese—Even The Homeless
Obesity is a widespread epidemic, even among the homeless. While the popularized image of a homeless individual is one of skin and bones, a new study shows the reality is not so. One in three (32.3%) homeless individuals in the United States is obese, highlighting a hunger-obesity paradox. The paradox is that hunger and obesity can exist in the same person. And although a person may be overweight or obese, he or she can lack proper nutrition (Park, 5/25).

Kansas City Star: Weight Loss Surgery For Teens Becomes More Common
With obesity in America at epidemic levels and the rate among children at 17 percent, triple what it was 30 years ago — the practice of bariatric, or weight loss, surgery for teens is also growing, with some patients as young as 12 or 13. At root is a growing but cautious recognition among physicians that for some obese children, the surgery — which reduces the size of the stomach to a tiny pouch — not only improves their physical and emotional lives, but also may be the most effective way to change their size. Doctors across the county now report they are seeing children who, by age 10, are already too fat to lose weight in any lasting way through nutrition or exercise alone (Adler, 5/26).

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State Watch

Ill. House Passes $1.6 Billion In Medicaid Cuts, New Cigarette Tax To Help Close Budget Gap

Illinois House lawmakers approved $1.6 billion in Medicaid cuts and a new $1 per pack cigarette tax Friday to help plug one of the nation's biggest budget holes. The bill would help fill the gap by reducing eligibility and lowering provider payments.

Chicago Tribune: Medicaid Cuts Threaten Nursing Home Reforms, Advocates Say
The $1.6 billion in Medicaid cuts passed by [Illinois] state lawmakers angered a key legislator and some advocates who contend the legislation will undercut nursing home reforms enacted two years ago and delay improved care in the facilities. But state officials said the 2010 reforms remain intact and added that they are pressing forward on measures to reduce violence and lift the quality of care for indigent patients (Jackson and Marx, 5/28).

Reuters: Clock Ticking On Illinois Medicaid, Pension Reforms
Facing a May 31 deadline, the Illinois General Assembly on Friday raced to pass legislation to stop the state from sinking under pension and Medicaid payments, which account for 39 percent of general fund spending. The Democratic-controlled legislature on Thursday sent Governor Pat Quinn a bill that would slice spending on Medicaid, the joint federal-state health care program for the poor, by $1.6 billion by reducing eligibility and provider rates and cutting or eliminating programs (5/25).

The Wall Street Journal: $1.6 Billion Budget Cut Passed For Illinois Gap 
Illinois is taking steps toward plugging one of the nation's worst fiscal gaps, with state lawmakers passing deep cuts to Medicaid and considering a tax increase for cigarettes to cover a $2.7 billion shortfall in the state and federal health program for the needy, disabled and elderly. The Democrat-controlled legislature passed $1.6 billion in cuts, including eliminating prescription-drug assistance for 180,000 senior citizens. Gov. Pat Quinn, a Democrat, plans to sign the bill. ... The country's fifth-largest state has struggled with economic weakness, mismanagement and corruption that have earned it one of the nation's worst credit ratings (Nicas and Peters, 5/25). 

Chicago Sun-Times: State House Votes To Add $1 To Pack Of Cigarettes To Help Medicaid
Another major reform to the state’s Medicaid program fell into place for Springfield lawmakers Friday with House passage of a $1-per-pack cigarette tax increase to help plug a $2.7 billion hole in the state’s health-care program for the poor. The bill needed 60 votes to advance through the chamber and just reached that number, passing by a tally of 60-52. It now moves to the Senate, which passed a $1-a-pack cigarette tax hike in 2009 (McKinney and Maloney, 5/25).

Modern Healthcare: Legislation On Tax Exemption Clears Illinois House
The Illinois House approved new legislation today that attempts to better define what makes a not-for-profit hospital eligible for a property-tax exemption. The legislation, introduced today, is an amendment to a larger tax bill brought to the state Senate in February. The bill also includes provisions for the $1 per pack of cigarette tax first floated last month by Gov. Patrick Quinn as a solution to generate $700 million for the state's sputtering Medicaid program (Selvam, 5/25).

Chicago Tribune: Tinley Mental Health Center Closing Plan Needs More Funds, Advocates Say 
Just five weeks before the scheduled closing of the Tinley Park Mental Health Center, service providers and advocates say the transition plan comes with too little funding to safely serve residents of the south suburbs. Gov. Pat Quinn announced the closing this year as part of a "rebalancing plan" that will transition those with mental illnesses and developmental disabilities out of institutions and into community-based settings. The center has also been lumped into the governor's cost-cutting plan to close and consolidate state facilities (Rueff, 5/27).

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Mass. Business Groups Differ On How To Control Costs

Meanwhile, news outlets look at a new approach on malpractice disputes in Mass., an expansion by the Baylor Health Care System in Texas and health care providers go beyond checklists in Conn.

Boston Globe: Health Cost Issue Divides Former Allies In Mass.
The state’s largest business groups, which came together to play a key role in passage of the 2006 law that expanded health insurance coverage, are now divided over how aggressively to slow the growth of health costs. Associated Industries of Massachusetts, a business trade group, has called for tighter controls on spending than the House or Senate has proposed. Its regular allies -- including the Massachusetts Taxpayers Foundation, a research organization for employers -- warn against over-regulation (Conaboy, 5/29).

Boston Globe: Mass. Hospitals Urged To Apologize, Settle
The Brigham and CRICO, which insures Harvard-affiliated hospitals and doctors, have been early adopters of the "disclosure, apology, and offer" approach, which is the cornerstone of a new initiative to improve the state's cumbersome and costly malpractice system. A coalition of Massachusetts physician, hospital, and patient groups announced last month that they will use a $1 million grant to educate the industry about the practice, develop standards for implementing it, and collect data on how the approach works at seven hospitals before pushing for its adoption statewide (Kowalczyk, 5/27).

The Dallas Morning News: Baylor Health Care System Plunges Into Free-Standing ER Business
After sitting on the sideline as competitors established stand-alone emergency hospitals, Baylor Health Care System is now making a major move into that fast-growing medical business segment. Baylor, in a joint venture with The Woodlands-based Emerus, will have eight free-standing emergency hospitals up and running in North Texas by June of next year, chief operating officer Gary Brock said. More will follow, he added. Brock called the effort part of Baylor’s growth strategy into rapidly expanding communities (Jacobson, 5/29).

The CT Mirror: Checklists, Teamwork Minimizing Mistakes In Medicine
The use of checklists to ensure that the proper steps are taken before and after surgery has become commonplace, inspired in part by the use of similar methods in fields like aviation. But Dr. Alison Hong, interim vice president of quality and patient safety at the Connecticut Hospital Association, said researchers have found that even with checklists, preventable errors like leaving foreign objects in a patient or operating on the wrong body part were still happening. Now, she said, experts are increasingly focusing on going beyond the checklist itself, making sure the steps necessary for safety are being done "with intent" -- a harder-to-measure shift in operating room culture that emphasizes the patient, teamwork and minimizing interruptions (Levin Becker, 5/28).

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State Roundup: The Effects Of Proposed Calif. Budget Cuts; Fewer Free Vaccinations In Texas

California Watch: Kids’ Access To Health Care A Concern Under Brown’s Budget
Low-income children in rural California communities are in jeopardy of losing their doctors and health care plans under Gov. Jerry Brown's budget proposal, state lawmakers, doctors and health advocates say. The governor is proposing to transfer nearly 900,000 children enrolled in Healthy Families, the state’s Children’s Health Insurance Program, to Medi-Cal – a program aimed at serving the state’s poorest families, seniors and disabled residents. While combining the two programs might be a painless transition for children in urban areas with doctors who typically provide care to both Healthy Families and Medi-Cal patients, the transfer could severely limit access to health care for those on the outskirts (Snyder, 5/29).

San Francisco Chronicle: Calif. Children's Medical Therapy Facing Cuts
Nicolas Ayer is, in many ways, a typical 3-year-old boy. ... Nico suffered a stroke shortly before or after he was born and was diagnosed with cerebral palsy within 36 hours of his birth. That early diagnosis resulted in his nearly immediate entrance into a state-funded program that provides medical therapy to children with special needs. ... But the California Children's Services' Medical Therapy Program will soon be out of reach for Nico's family and thousands of other Californians if lawmakers approve a budget proposal by Gov. Jerry Brown, who is trying to close a $15.7 billion shortfall in the state's general fund (Lagos, 5/28).

Reuters: California Tobacco Tax Measure Risks Going Up In Smoke
Health-conscious Californians may mostly oppose smoking for its costs to public health and the economy but an aggressive tobacco industry campaign and general anti-tax sentiment may block a measure to raise taxes on smokers. Airwaves in the most populous U.S. state are filling up with advertising for and against Proposition 29, a June 5 ballot measure that would add a $1 tax to a pack of cigarettes, taking the tax to $1.87, mainly to fund medical research on tobacco usage and programs to prevent and control it (Christie, 5/25).

Kaiser Health News: Louisville's Strategy: Stick With The Old Folks
Writing for Kaiser Health News, in collaboration with The Washington Post, Frank Browning reports: "This city of 570,000 people is generally recognized as the home of the Kentucky Derby, mint juleps and bourbon. But few outsiders know it also hosts the largest concentration of nursing-home and extended-care companies in the nation" (Browning, 5/28). 

The Dallas Morning News: State Rule Change Means Most Insured Kids Won’t Get Free School Vaccinations This Year
A change in the rules on free childhood vaccinations has some local school districts uneasy about the start of school this fall. The Texas Vaccines for Children Program will now be basically available only to kids with no insurance. The state figures that will mean about 500,000 doses given out under the old rules won’t be available for free this year (Weiss, 5/28). 

Baltimore Sun: Safety-Net Funds Are Cut As Number Of Needy Marylanders Hits Record Levels
Demand has been so high that the Department of Human Resources, which helps Maryland families with child care, cash and food assistance, and medical services, was forced to request an additional $30 million in state funding in fiscal 2012. The shortfall occurred even though federal funding for the department has doubled from about $1 billion to nearly $2 billion each year since before the recession began (Johnston, Straumsheim and McGonigle, 5/27).

The New York Times: Logistics Hang Over A Ruling On 9/11 Cancer
(Patricia) Workman and others who believe their cancers were caused by toxic substances released by the fall of the World Trade Center are due to learn this week whether they may be treated and compensated from a $4.3 billion fund set aside by Congress. An advisory committee in March found justification for covering 14 broad categories of cancer, raising expectations that the fund would cover at least some of them. But such a decision would create a logistical quagmire, advocates for patients and government officials conceded, and could strain the fund’s resources (Hartocollis, 5/28).

The Washington Post: Reedville Country Doctor Just Wants To Have Fun
(Dr. Emory) Lewis is one of five doctors, by his count, in Northumberland County. He doesn’t embody the trends in medicine so much as he defies them. He’s a doctor who still makes house calls. His patients are mostly Medicare-eligible, and they supplement the doctor’s reimbursements with gifts of home-canned relish and menhaden roe. Lewis has no interest in assembly-line medicine. “A lot of times that’s therapeutic, just to talk to people,” he says. He knows his patients and their parents and their parents’ parents, and remembers which families have a history of diabetes (Achenbach, 5/27).

Baltimore Sun: University of Maryland, Baltimore To Revamp Teaching On Pain
As part of a federal project aimed at better treating pain, the University of Maryland, Baltimore will begin revamping the way it teaches future doctors, dentists, nurses and pharmacists. ... A pain consortium of two dozen NIH agencies received 56 proposals and picked 11 universities to be Centers of Excellence in Pain Education. Over the next three years, they are expected to develop courses in assessing, diagnosing and treating pain, and avoiding abuse of prescription painkillers (Cohn, 5/26).

HealthyCal: Project Focuses On Keeping Patients Well
The image of a harried doctor dashing among patients and issuing brusque orders is familiar to almost anyone who has set foot in a physician’s office. But that default model of care is rife with opportunities for missed maladies, garbled instructions and disillusion with the patient-caregiver relationship. … [One] group is part of a pilot program to implement the “medical home” model of care for about 2,400 participants in the Fresno Unified School District’s health insurance plan. The patient-centered approach dates to the late ’60s, when pediatricians started formally recommending that children get a central home for their medical records to guard against “fragmented care” (Brown, 5/29).

Kansas Health Institute: Kansas Breaks Ground On Statewide Digital Health Network
Developers of a new statewide digital health records exchange say the needed secure network is coming to Kansas this summer. They call it a groundbreaking event that is expected to improve patient care and help cut medical costs by avoiding redundant and ineffective treatments. It’s also expected to reduce errors (Cauthon, 5/28).

Kansas Health Institute: Health Information Exchange: An Interview With Dr. Joe Davidson
An interview with Dr. Joe Davison, chair of the Kansas Health Information Exchange board and a Wichita family physician. Davison provides some background and insight on the health information exchange set to go live in July in Kansas (McLean, 5/28).

Minnesota Public Radio: Minn. Doctors Seek Streamlined Drug Prescriptions
The Minnesota Medical Association, the state's largest doctors' group, says it wants to work with health plans and their drug benefit decision-makers in developing a more streamlined approval process. Janet Silversmith of the medical association says physicians often find the process burdensome because the list of approved drugs varies from plan to plan and changes frequently (Stawicki, 5/27).

St. Louis Beacon: CDC’S New Threshold For Lead Poisoning Means More Children In Missouri Are At Risk
The number of Missouri children facing risks from lead poisoning has risen sharply because a federal agency has lowered the threshold, saying youngsters can be harmed by ingesting even tiny amounts of lead. Until recently, children were thought to be harmed if the level of lead in their bodies was as low as 10 micrograms for each deciliter of blood. About two weeks ago, the Centers for Disease Control and Prevention (CDC) reduced the threshold to five micrograms (Joiner, 5/29).

California Healthline: Community Dental Beneficiaries Go to Liberty
Community Dental Services health plan, plagued with financial troubles and quality-of-care problems, has shut down its managed care dental plan in Sacramento and Los Angeles counties. On Friday, the state announced that all 16,000 Medi-Cal beneficiaries at CDS, the bulk of them in Sacramento County, would switch to Liberty Dental Plan of California. Also making the change will be 4,000 non-Medi-Cal patients (Gorn, 5/29).

Chicago Sun-Times: House Democrats Unveiling Pension Reform Plan
Opposed by labor unions, the plan aims to steer current employees and retirees away from automatic, 3 percent, post-retirement cost-of-living increases by limiting access to state-subsidized health care (McKinney, 5/29).

Georgia Health News: Federal Rule Change Rocks HIV Programs
HIV/AIDS service programs say a rule change by a federal agency would squeeze their budgets to the point that they may not be able to serve as many patients. The Health Resources and Services Administration is now requiring that rent, utilities and insurance costs be classified as administrative expenses under parts of the federal Ryan White HIV/AIDS program. As such, these costs will be charged to the administrative cap of 10 percent of the total amount awarded. That means many HIV service programs will have to seek other ways to cover those expenses (Miller 5/28).

Modern Healthcare: Prevention Attention
Earlier this year, Partners HealthCare awarded nearly $1 million to support health prevention programs in four eastern Massachusetts cities served by the system's hospitals. While Boston-based Partners has funded some local prevention programs for years, the financial commitment reflects a greater focus by the health system to look at the role prevention can play in lowering costs, notably as Partners moves forward as one of the participants in the CMS' Pioneer model for accountable care organizations (Lee, 5/26).

Detroit Free Press: Union Dues Can No Longer Be Withheld From Michigan Home Health Care Workers
Union dues will no longer be withheld from state payments to about 60,000 Michigan home health care workers after Attorney General Bill Schuette's office said Friday the payments are illegal under a law enacted last month. Angela Minicuci, spokeswoman for the Department of Community Health, said Friday that dues withholding will stop "immediately" based on the statement from Schuette's office upholding legislation that declared that employees hired to provide personal care services to Medicaid recipients are not government employees subject to union organizing (Bell, 5/26).

Los Angeles Times: Target Of Maryland Abortion Protesters Turns Tables On Them
(Todd) Stave, 44, son of a doctor who performed abortions and whose office was once firebombed, decided to fight back. Targeted because he rents an office to one of the nation's best-known abortion practitioners, he turned the tables, gathering volunteers to call abortion protesters at home (Knezevich, 5/27).

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Editorials and Opinions

Health Law Opinions: 'Improvised Explosive' Device Tax; Iowa Legislators Force Role For Brokers On Insurance Exchanges

The Wall Street Journal: Improvised Explosive Device Tax
"Taxmageddon" isn't only about the half-trillion-dollar blow to the economy that arrives in 2013 on the end of the Bush-Obama tax rates. Several of the Affordable Care Act's worst tax increases kick in too, such as the new excise tax on medical devices. The 2.3 percent levy applies to the sale of everything from cardiac defibrillators to artificial joints to MRI scanners. The device tax is supposed to raise $28.5 billion from 2013 to 2022, and it is especially harmful because it applies to gross sales, not profits (5/28).

Des Moines Register: Don't Force Consumers To Use Insurance Brokers
If all goes according to plan, Iowans will be able to purchase health insurance through a new "exchange" in 2014. The cornerstone of the health reform law, these state-based marketplaces will be where uninsured Americans go to buy coverage. … Although many in the Republican Party have tried to torpedo the entire law, they are working overtime to manipulate how an exchange will eventually work. The goal of some Iowa lawmakers is to use it to provide a little help to their insurance agent friends. Before it adjourned this month, the Legislature passed a bill requiring navigators to be licensed agents (5/26).

The New York Times: In Medicine, Falling For Fake Innovation 
Health care reform may quash pseudo-innovations, but that simply directs capital and creativity away from technologies that don't improve outcomes or lower costs and toward ones that do. That should not be confused with killing innovation (Ezekiel J. Emanuel, 5/27).

The Wall Street Journal: Four More Years?
A second Obama term would guarantee no repeal or significant repair of ObamaCare for at least four more years, allowing it to push its tentacles into every aspect of our health care. It will give the health and human services secretary free rein in her decisions about new mandates and about which organizations or entities can be granted exemptions from them. This would give her and the president a new way to reward favored special interests (Pete Du Pont, 5/28).

The New York Times: Obama Should Seize The High Ground 
Barack Obama is a great orator, but he is the worst president I've ever seen when it comes to explaining his achievements, putting them in context, connecting with people on a gut level through repetition and thereby defining how the public views an issue. Think about this: Is there anyone in America today who doesn’t either have a pre-existing medical condition or know someone who does and can’t get health insurance as a result? Yet two years after Obama’s health care bill became law, how many Americans understand that once it is fully implemented no American with a pre-existing condition will ever again be denied coverage (Thomas Friedman, 5/26).

Philadelphia Daily News/Philadelphia Inquirer: Supreme Court Tipping Scales Of Partisanship
Just a few weeks before the U.S. Supreme Court's hearings in March on the constitutionality of several parts of the Affordable Care Act -- a/k/a Obamacare -- an overwhelming majority of the nation's legal scholars predicted that the law would be upheld. … Silly them: They were looking at the law and how easily it fit in with eight decades of legal precedent, and figured that members of the U.S. Supreme Court would do the same. … But during the three days of legal arguments, it became clear (and alarming) that the questions of several of the conservative justices simply parroted Republican "talking points" about the legislation (5/29).

Philadelphia Inquirer: Your Coverage May Get Much Better Under Health Reform
A recent study financed by the nonprofit Commonwealth Fund revealed just how big the difference is between individual and employment-based coverage. … It found that over half of all individual policies cover less than 60 percent of medical costs. (This percentage is known as the policy’s actuarial value.) Another third covers only between 60 and 69 percent. … This situation will change under health reform. Starting in 2014, policies that are sold directly to individuals must cover at least 60 percent of medical costs. They must also include a broader range of benefits, including treatment for pre-existing illnesses (Robert Field, 5/25).

iWatch News: Could Nonprofit Health Insurance Plans Be The Real Reformers?
When members of Congress who led the effort to overhaul the U.S. health care system saw the public option slipping away, some of them suggested that a viable alternative would be the fostering of nonprofit health insurance CO-OPs (Consumer Oriented and Operated Plans) throughout the country. I was among the many who belittled the idea. Having spent two decades in the health insurance industry, I knew how difficult it is for even the biggest insurers to establish a presence in markets where one or two other insurance firms dominate. And there are hardly any markets left where that is not the case (Wendell Potter, 5/29).

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Viewpoints: Contraception Indignation 'Built On Air'; Frustration With VA's Backlog

The New York Times: The Politics Of Religion
Thirteen Roman Catholic dioceses and some Catholic-related groups scattered lawsuits across a dozen federal courts last week claiming that President Obama was violating their religious freedom by including contraceptives in basic health care coverage for female employees. It was a dramatic stunt, full of indignation but built on air (5/27).

The Wall Street Journal: Cheer, Cheer For Old Notre Dame
Does the Indiana Democrat running for the U.S. Senate support Notre Dame's lawsuit against the Obama administration's contraceptive mandate? After all, the Democrat in question, Joe Donnelly, is a double Domer, boasting both undergraduate and law degrees from Notre Dame. He represents South Bend in Congress. ... Mr. Donnelly has President Obama to thank for this predicament. The Indiana congressman was among the pro-life Democrats who folded on the health care bill after a last-minute phone call from a former Notre Dame president, the Rev. Ted Hesburgh -- a call made at the urging of then-House Speaker Nancy Pelosi (William McGurn, 5/28).

Los Angeles Times: Tobacco Taxes Are Great, But Proposition 29 Stinks 
The vehicle is Proposition 29, which would jack up the state tax on cigarettes by $1 a pack, generating some $800 million a year mostly for cancer research, with some going to related health and anti-smoking programs. The weighing of intention vs. result here is fairly straightforward. Raising $800 million a year for the state: Good. Discouraging smoking via a harsh tax: Great. Sequestering the money for a limited purpose: Bad. Really bad (Michael Hiltzik, 5/27).

Chicago Sun-Times: State Needs Long-Term Investments In Students
Without major changes, health care for our neediest residents and retirement benefits for faithful public employees will eat 50 percent of the state’s spending plan in 2014. Each dollar added to that total takes away a dollar from human services, law enforcement or other expenses. … We need a dollar cigarette tax to fund health-care coverage that no one has the heart to cut (Lt. Gov. Shelia Simon, 5/28).

The New York Times: The V.A.’s Shameful Betrayal
The Department of Veterans Affairs, already under enormous strain from the aging of the Vietnam generation, the end of the Iraq war and the continuing return of combat troops from Afghanistan, announced in April that it would increase its mental health staff by about 10 percent. But too many veterans waging a lonely and emotional struggle to resume a normal life continue to find the agency a source of disappointment rather than healing (Mike Scotti, 5/27).

Houston Chronicle: Backlogs At The VA Are Inexcusable
More than two years ago, in response to an enormous backlog of unprocessed veterans' disability claims, Eric Shinseki, Secretary of the U.S. Department of Veterans Affairs, vowed to "break the back of the backlog'' within a year. That didn't happen. … We do well to honor those we have lost in war, but we can, and we must, do a better job of honoring those who have fought our wars for us and returned home less than whole (5/25).

The New York Times: When Costly Medical Care Just Adds To The Pain
Why, many people ask, shouldn't the richest country in the world spend whatever is necessary to protect and preserve its citizens' health? This is the philosophy under which our health care system operates, and it promises to bankrupt us without necessarily improving our health. In more instances than many people realize, doing more medically can be worse than doing less. Too often, costly, overly aggressive medical care causes more pain and suffering than if nothing had been done at all (Jane Brody, 5/27). 

Boston Globe: For-Profit Cancer Hospitals Deserve Full Review In N.H.
The proposed lineup of for-profit "specialty" hospitals along the Massachusetts border in New Hampshire, like the existing state stores that offer cheaper alcohol and cigarettes, is an extension of New Hampshire’s longstanding efforts to serve the Massachusetts market with lower-taxed and less-regulated products and services. ... While greater competition to provide basic health care services is needed to drive down prices, government still bears a responsibility for maintaining standards of quality care (5/27).

Boston Globe: 'Haves' And 'Have-Nots' In Mass. Health Care
In what has become an annual rite, Massachusetts will hold public hearings on health care costs in early June. This year if you listen closely, you will already hear some providers and insurers warming their engines and arguments to proclaim "cost control is working, just give us time and don’t interfere with the market through government intervention or regulation." For the well-heeled, the system is working. The reality is that for most providers, and more importantly, for most consumers, it is not (Ellen Zane, 5/25).

Arizona Republic: Ariz. Prison Health Care Needs Overhaul
A walk down the windowless, concrete hallways in any of Arizona's prison complexes reveals conditions a lawsuit says puts thousands of inmates at substantial risk of abuse and neglect, the kind that results in amputation, disfigurement and even death. … The lawsuit filed in March by the American Civil Liberties Union and the Prison Law Office documented numerous examples of extreme indifference on the part of prison officials (Doris Marie Provine, 5/27).

Arizona Republic: Immunization Is Everyone's Duty
Let's be clear: Getting your child immunized is not just a personal choice. It can be a matter of life and death for others. The decision not to immunize your child against infectious diseases can endanger other children, especially infants, people who have Down syndrome -- their immune systems may be weakened -- and those who take medication that compromises the immune systems. These people can be at increased risk even if they have been immunized. Their best protection is if those around them have been vaccinated (5/26).

Des Moines Register: President And Congress Must Stop The Blame Game
Both parties and previous administrations and Congresses are responsible for the red ink, which spiked during the recession. Both parties must reach consensus on turning that around. That means increasing federal tax revenues and reducing spending. Taxes are not evil; they pay for things people expect from the federal government. Spending cuts, likewise, are not necessarily designed to destroy an essential program, whether it be the military or Medicare (5/26).

Minneapolis Star Tribune: A Health Care Model We Can't Build Alone
At Courage Center, we know that by focusing on the most complex and toughest-to-serve individuals, we can save even more money. … But we need to be very honest. Our health care home model produces fabulous results for people with complex lives and is performing groundbreaking work. But unless we fundamentally change how we pay for services like this, our model is not financially viable (Jan Malcolm, 5/28).

Minneapolis Star Tribune: Congress Sharpens Medicaid Questions
Minnesota won't start its new, independent audits of the state's controversial $4 billion-a-year Medicaid contracting until 2014 at the earliest. … Given that the state's Medicaid program is the focus of three federal investigations, the new audits should start now -- not in two years, as the recently passed HMO audit legislation provides for…. As painful as it is to see Minnesota health care in congressional crosshairs, the scrutiny is needed and has broader implications as Medicaid is expanded under the 2010 Affordable Care Act (5/26). 

Chicago Sun-Times: Legislators Must Reform Medicaid, Pensions, Pass A Budget
What state legislators do -- or don't do -- this week will shape the future of Illinois for generations to come. The state faces an unfunded pension liability of $83 billion and about $8.5 billion in unpaid bills, giving legislators no choice but to cut two of the state’s biggest-ticket items: public employee pensions and Medicaid (5/25).

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EDITOR:
Stephanie Stapleton

ASSOCIATE EDITOR:
Andrew Villegas

WRITERS:
Marissa Evans
Lisa Gillespie
Shefali Luthra

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.