Daily Health Policy Report

Tuesday, August 12, 2014

Last updated: Tue, Aug 12

KHN Original Reporting & Guest Opinion

Administration News

Health Reform

Capitol Hill Watch

Health Care Marketplace

Public Health & Education

State Watch

Editorials and Opinions

KHN Original Reporting & Guest Opinion

Must A Divorced Dad Cover Adult Kids; Will Medicare Pay For Infusion Therapy

Kaiser Health News consumer columnist Michelle Andrews explores questions related to a divorced mother’s efforts to get her ex-husband to keep their sons on his plan, one senior’s problems getting Medicare to cover his antibiotic infusion at home and what earnings one reader will have to count when applying for premium subsidies (Andrews, 8/12). Read her responses.

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To Beat Heroin Addiction, A Turn To Coaches

WBUR’s Martha Bebinger, working in partnership with Kaiser Health News and NPR, reports: “Two young men sit in a car outside a church or union hall where they just attended a Narcotics Anonymous meeting. Both men are addicted to heroin. But they haven’t used the drug since they finished a residential treatment program a week or so earlier. … Of patients addicted to heroin who stop, 40 to 60 percent relapse within the first year. For many it happens soon after finishing a recovery program. Wurzberg is now in a new young adult recovery program. It’s a one-year pilot project at Gosnold, which runs a network of addiction treatment services on Cape Cod” (Bebinger, 8/11). Read the story.

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Stigma Is A Side-Effect Of HIV-Prevention Medicine

WABE’s Jim Burress, working in partnership with Kaiser Health News and NPR, reports: “In order to slow the spread of HIV, certain people who do not have the virus but are at risk should take medication to prevent becoming infected. That’s the recommendation of the Centers for Disease Control and Prevention, and just recently, the World Health Organization. The preventive treatment includes a drug called Truvada, and it is known as PrEP, for pre-exposure prophylaxis” (Burress, 8/11). Read the story.

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Political Cartoon: 'Numbers Game?'

Kaiser Health News provides a fresh take on health policy developments with "Numbers Game?" by Ron Morgan.

Meanwhile, here's today's haiku:


Innovation funds
What will be the next breakthrough?
When will savings come?
-Bill Winfrey

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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Administration News

Healthcare.gov Fixer Takes Top Spot Of New 'U.S. Digital Service'

The White House says it wants to apply the approach that was used to resuscitate the federal online insurance marketplace after its disastrous launch to the government's other troubled websites and computer systems. 

The New York Times: White House Picks Engineer From Google To Fix Sites
Faced with the politically devastating collapse of HealthCare.gov last year, President Obama’s White House staff lured Mikey Dickerson away from Google to save the day. Mr. Dickerson will lead a new government team that is intended to identify and fix the government’s other failing computer systems and websites, officials said Monday (Shear, 8/11).

The Washington Post: White House Launches 'U.S. Digital Service,' With Healthcare.Gov Fixer At The Helm
The White House on Monday announced that it is formally launching a new U.S. Digital Service and that it has hired to lead it Mikey Dickerson, an engineer widely credited with playing a central role in salvaging HealthCare.gov after its disastrous launch. The idea behind the USDS, as the White House has taken to calling it, is institutionalizing the approach that saved the health care site and applying it to the work of the government even before disaster strikes (Scola, 8/11).

The Wall Street Journal’s CIO Journal: White House Proves It Can Lure Top Tech Talent
That the White House managed to land a seasoned engineer from one of the world's leading tech companies is as much a surprise as it is a coup. Top technology talent usually is reluctant to work for the government, John Challenger, CEO of professional staffing firm Challenger Gray & Christmas Inc. told CIO Journal in January. Not only is the pay often lower, but government work can be too bureaucratic and process-centric for people used to Silicon Valley’s coding culture. "We need much better tech workers in government but I just don't think you can get there from here," said Mr. Challenge (Boulton, 8/11).

McClatchy: After HealthCare.gov, White House Creates Team To Solve Tech Problems
The White House announced Monday that it will use the same digital and technology experts that helped fix HealthCare.gov to solve other government technology problems. The U.S. Digital Service, comprised of a small team of digital experts, will collaborate with federal agencies to make websites more consumer friendly, to identify and fix problems and to help upgrade the government’s technology (Kumar, 8/11).

Modern Healthcare: HealthCare.gov Vet To Head New U.S. Digital Team To Improve Fed Websites
Dickerson had worked at Google for seven years before joining the effort to save HealthCare.gov. In typical tech cheekiness, his LinkedIn page notes that he had "No Fancy Title, Thanks" at that four-month stint with the federal insurance exchange site. (Tahir, 8/11).

The Associated Press: Obama Takes Step to Improve Government Technology
"I'm excited for the opportunity to shift the focus of government IT delivery from compliance to greater impact and meeting the needs of real citizens," Dickerson said in a statement. "We can make services a lot more effective and cost efficient with better use of technology." In the midst of the health care website's troubles, Obama bemoaned the limitations of government IT procurement procedures and called for changing to the system (Pace and Anderson, 8/11).

Politico Pro: W.H. Launches Fed Website Fixer
Hoping to prevent another HealthCare.gov disaster, the White House on Monday launched the U.S. Digital Service, a team of experts that aims to fix problems with government websites and help upgrade federal technology infrastructure. ... The effort is the Obama administration’s latest effort to grapple with the federal technology shortcomings exposed by HealthCare.gov. When it became clear last fall that millions of Americans were unable to log on to the health care website, the administration brought in a "tech surge" of experts to tackle the glitches (Bachman, 8/11).

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Health Reform

Tax Day 2015 May Be Another Health Law Hurdle

Some consumers are likely to face headaches sorting through new IRS forms about their health insurance coverage and whether they might be exempt from penalties. 

Politico: Consumers’ Next Obamacare Challenge: Tax Forms
If consumers thought logging on to HealthCare.gov was a headache, sorting through complex forms ahead of tax deadline day 2015 is their next big Obamacare challenge. The health care law’s benefits are rolling out, but its major math problems start next year as the IRS tries to ensure that millions of Americans are correctly calculating their benefits and that those who don’t have coverage are penalized unless they qualify for an exemption (Cunningham and Weinger, 8/11).

Also, questions continue to swirl around estimates of state uninsured rates released last week by the Gallup-Healthways Well-Being Index -

Kansas Health Institute News Service: Accuracy Of Survey Showing Spike In Kansas Uninsured Rate Questioned
Kansas Insurance Commissioner Sandy Praeger was among the doubters. She said the number appeared to be “an anomaly” because a spike of that magnitude from one year to the next “would be unprecedented.” But others seized on the numbers to score political points. Some said Kansas’ decision to join 23 other states in not expanding Medicaid contributed to the increase. Others said the number was evidence that the Affordable Care Act was failing to achieve its primary goal of reducing the number of uninsured – if only in Kansas (McLean, 8/11).

Indianapolis Star: Indiana's Uninsured Rate Is Now Above National Average
The share of Hoosier adults who lack health insurance has changed little since major parts of the Affordable Care Act began this year, according to new data. But, unlike Indiana, states that expanded Medicaid and had an active role in running the exchanges in their state to help people buy coverage on the private market saw significant drops in their uninsured rates. For example, Kentucky's uninsured rate dropped from about 20 percent last year to about 12 percent so far this year, according to the Gallup-Healthways Well-Being Index released last week. Indiana's rate stayed at around 15 percent (Grope, 8/10).

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Average Obamacare Premium Increase Estimated At 7.5 Percent

The estimate was part of an analysis done by the Health Research Institute at PricewaterhouseCoopers. Meanwhile, a separate analysis, this one by Citigroup, offers details regarding what California consumers can expect regarding premiums for coverage purchased through the state's exchange.    

The Hill: Obamacare Premiums Slated to Rise By An Average of 7.5 Percent
Premiums on Obamacare's health insurance exchanges will rise by an average of 7.5 percent next year, according to a new analysis. Data compiled by the Health Research Institute (HRI) at PricewaterhouseCoopers found modest changes in premiums for 27 states and the District of Columbia, with the increases mostly falling short of dire predictions for Obamacare’s second year. The average national increase of 7.5 percent is "well below the double-digit increases many feared," HRI Managing Director Ceci Connolly wrote in an email (Viebeck, 8/11).

Los Angeles Times: Kaiser Cuts Obamacare Rates 1.4% For 2015; Anthem Hikes Rates 4.6%
Health care giant Kaiser Permanente is lowering its rates for Obamacare coverage in California by 1.4 percent next year, according to an industry report. California's health insurance exchange recently announced that premiums were rising 4.2 percent, on average, statewide for 2015 policies. A new analysis by Citigroup health care analyst Carl McDonald offers new details on what consumers can expect by company (Terhune, 8/11).

In addition, news outlets track developments regarding Colorado's online insurance marketplace and new research from the Urban Institute regarding the overhaul's Medicaid expansion --

Health News Colorado: Health Exchange Under Pressure To Find New CEO, Improve Performance In Year Two
Patty Fontneau was all smiles Monday at her final board meeting as executive director and CEO of the state’s health exchange organization, Connect for Health Colorado. The board met in executive session before the open meeting to discuss the process for replacing Fontneau, who is joining Cigna as president of its private exchange business. An interim director will be announced “shortly,” Board Chair Sharon O’Hara said, and negotiations are under way to contract with an executive recruitment firm to search for a more permanent replacement (Carman, 8/11).

The Washington Post’s Wonkblog: Another Argument Against The Medicaid Expansion Just Got Weaker
We learned late last week that the decision by 24 states to reject Obamacare's Medicaid expansion comes as a startling cost -- $423.6 billion in lost federal funds from 2013 to 2022, according to researchers at the Urban Institute. So how are states justifying their decisions to leave that much federal money on the table? One of their main arguments is that the federal government will eventually renege on its generous funding commitment to the Medicaid expansion. But based on the 49-year history of the Medicaid program, that claim doesn't hold up, according to Urban Institute researchers in a finding that hasn't received as much attention (Millman, 8/11).

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If Senate Flips In November, Health Law Likely To Face More Challenges

The GOP plan includes a series of votes on legislation to roll back all or parts of the overhaul. Such measures would set up a face-off with President Barack Obama.

The Hill: GOP Eyes Obamacare Votes If Senate Flips
Republicans plan to hold a series of votes on repealing Obamacare if they win control of the Senate in November, according to a report. The votes would set the tone for a new, GOP-led Congress and create a showdown with President Obama, who would almost certainly veto any legislation rolling back parts of the health care law (Viebeck, 8/11).

Meanwhile, health care issues including the health law's Medicaid expansion are playing a role in Wisconsin's governor's race --

Reuters: Recall A Thing Of The Past In Race Against Wisconsin's Walker
[Democratic gubernatorial candidate Mary] Burke says she supports having public-sector workers contribute more to pensions and health care, while arguing they should retain collective bargaining rights. Yet she does not emphasize the issue in her stump speech and explains she wants to move Wisconsin past it. A former executive at Trek Bicycle, which her father founded, Burke declares herself a fiscal conservative. But she also takes stances -- in favor of raising the minimum wage, overturning Walker's decision to refuse federal dollars for the expansion of Medicaid and opposing cuts to education -- that make her popular with the Democratic rank-and-file (Carey, 8/11).

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Capitol Hill Watch

Retiree Health Fund Pushes Postal Service Into Red

Nearly all of the Postal Service's products produced revenue increases, but the agency is in debt because of a congressional requirement that it pay about $5 billion into a future retiree health care fund.

The New York Times: Postal Service Quarterly Loss Was $2 Billion, Despite Higher Prices
Despite an increase in revenue for nearly all of the Postal Service’s products, the agency continues to be mired in debt because of a congressional requirement to pay about $5 billion into a future retiree health care fund, post office officials said on Monday (Nixon, 8/11).

The Wall Street Journal: U.S. Postal Service Posts $1.96 Billion Loss In Third Quarter
The biggest financial hurdle is a congressional mandate that requires it to prefund about $5.5 billion annually for health benefits for future retirees. The service said Monday it will default on its required $5.7 billion payment by Sept. 30 for the fourth year in a row, unless legislative reform is passed in time. Before this charge, as well as some workers' compensation items, it would have earned $1 billion in the first three quarters (Stevens, 8/11).

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Health Care Marketplace

Silicon Valley Startup Pitches Self-Insurance Software

Collective Health says it can help employers save money with software that helps them pay workers' health costs directly. Meanwhile, Reuters reports that Apple is preparing to roll out "HealthKit," a monitoring app, as part of the iPhone 6 this fall.

Reuters:  Silicon Valley Startup Launches Self-Insurance Option For Smaller Firms
The founders of Collective Health, a Silicon Valley startup, say they can help employers save money by self-insuring rather than paying premiums to a health insurance company. Collective Health has developed software to help companies pay workers' health costs directly. Collective Health describes its "sweet spot" as companies with a few hundred or a few thousand employees, typically in the tech sector (Farr, 8/12).

The San Jose Mercury News: High-Tech Startup Challenges Insurance Industry
As transformational health care laws take root in California and across the country, one Silicon Valley startup is trying to change the broken industry by becoming what may be the first high-tech health insurance provider. San Mateo company CollectiveHealth launches Tuesday with a new way to deliver health insurance -- tossing the complicated explanation of benefits and indecipherable bills, and replacing insurance paperwork and administrative red tape with software. CollectiveHealth joins a vibrant health tech scene, which has exploded in the last year and benefitted from millions in venture capital money, but the startup isn't another Fitbit or doctor-recommendation app (Somerville, 8/12).

Also in the headlines -

Reuters: Apple Prepares Healthkit Rollout Amid Tangled Regulatory Web
Apple Inc. has been discussing how its "HealthKit" service will work with health providers at Mount Sinai, the Cleveland Clinic and Johns Hopkins as well as with Allscripts, a competitor to electronic health records provider Epic Systems, people familiar with the discussions said. While the talks may not amount to anything concrete, they underscore how Apple is intent on making health data, such as blood pressure, pulse and weight, available for consumers and health providers to view in one place. ... Apple has not divulged much specific detail on HealthKit, which is expected to be incorporated into the iPhone 6 come September (Farr, 8/12). 

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Public Health & Education

Screening Test For Colon Cancer Wins FDA Approval

The test, called Cologuard, can detect genetic mutations in patients' stool samples that are associated with cancerous and precancerous growths. 

The Wall Street Journal: FDA Approves DNA Test For Colon Cancer
The Food and Drug Administration on Monday approved a DNA test to screen for colon cancer in people with a lower risk of developing the disease, the first such test of its kind to be cleared by U.S. regulators. The test, called Cologuard, is used to detect genetic mutations in patients' stool associated with cancerous and precancerous growths in the colon. Doctors must prescribe the test, but patients collect stool samples at home and ship the samples to laboratories for analysis (Walker, 8/11).

Pioneer Press:  Mayo-Backed Colon Screening Tests Gets FDA Approval
The Food and Drug Administration on Monday announced approval for Cologuard, a new test kit developed in part at the Mayo Clinic for screening patients to assess their risk for colorectal cancer. In a related announcement Monday, the federal Centers for Medicare and Medicaid Services proposed that the federal Medicare cover costs for the new test. Colorectal cancer primarily affects people age 50 and older and is one of the most common causes of cancer-related death (Snowbeck, 8/11).

Bloomberg: Exact Sciences Wins U.S. Approval For Colon Cancer Test
The Food and Drug Administration cleared Cologuard, which screens stool samples for the presence of red blood cells and DNA mutations that may indicate the presence of cancer. Patients use Madison, Wisconsin-based Exact Sciences’ test at home and those who have positive results are advised to get a colonoscopy, which uses a small video camera on the end of a thin tube to view the colon, the FDA said yesterday in a statement (Edney, 8/12).

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State Watch

Feds Say Texas Responsible For Unnecessary Medicaid Spending

Elsewhere, a report says Kansas improperly claimed $10.7 million in Medicaid reimbursements for school-based services.

Texas Tribune: Feds: Texas Responsible For Misspent Medicaid Dollars
Texas is "ultimately responsible" for millions of misspent Medicaid dollars, according to a new federal audit, because a state agency failed to properly oversee the contractor that reviewed the medical necessity of Medicaid claims. For nearly five years, the Texas Medicaid and Healthcare Partnership (TMHP), a subsidiary of Xerox, allowed workers with limited expertise to approve dental claims for Texas' Medicaid program, the joint state-federal insurer. State spending on orthodontic services spiraled out of control: Between 2003 and 2010, Texas Medicaid payments for orthodontic services grew by more than 3,000 percent — from $6.5 million to $220.5 million — while program enrollment only grew 33 percent. By 2012, federal and state auditors found that the contractor's actions had opened the door to a "massive Medicaid fraud scheme" that cost taxpayers hundreds of millions of dollars (Aaronson, 8/11).

Houston Chronicle: Feds: Texas 'Ultimately Responsible' For Medicaid Waste
In what may amount to a warning shot ahead of a demand for money, the federal government is making clear that it holds Texas officials responsible for hundreds of millions of dollars in Medicaid spending wasted on unnecessary braces and other orthodontic work for the state's poorest residents. A federal audit report released this month concluded that even though a private contractor tasked with reviewing and pre-approving dental Medicaid claims did not follow state and federal protocols, the Texas Health and Human Services Commission was "ultimately responsible" for the inappropriate spending because it is its job to monitor compliance (Rosenthal, 8/11).

Kansas Health Institute News Service:  Kansas Improperly Claimed $10.7M In Medicaid Reimbursements
Kansas improperly billed Medicaid for nearly $11 million in school-based health services, a government watchdog has found. In a report released Monday, the inspector general for the U.S. Department of Health and Human Services determined that Kansas received $10.75 million in unallowable reimbursements for services provided during the one-year period from July 1, 2009, through June 30, 2010. The overcharges occurred because the Kansas Department of Health and Environment's Division of Health Care Finance "did not have adequate policies and procedures" to monitor the program and to ensure it complied with state and federal requirements, the report stated (Margolies, 8/11).

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State Highlights: Aging Inmate Care Outside Prison; Colo.'s Teen Birth Rate Drop; Minn. Rural Doc Shortage

A selection of health policy stories from Colorado, Minnesota, Virginia, Massachusetts and California.

Stateline: For Aging Inmates, Care Outside Prison Walls 
Providing health care to an aging prison population is a large and growing cost for states. Not only do inmates develop debilitating conditions at a younger age than people who are not incarcerated, but caring for them in the harsh environment of prisons is far more expensive than it is on the outside. Of the 2.3 million adults in state and federal prisons, about 246,000 are 50 or older, according to the National Institute of Corrections. The U.S. currently spends more than $16 billion annually caring for these aging inmates, and their numbers are projected to grow dramatically in the next 15 years (Vestal, 8/12).

The Washington Post’s Morning Mix: How Colorado’s Teen Birthrate Dropped 40% In Four Years
Since 2009, the state has provided 30,000 contraceptive implants or intrauterine devices (IUDs) at low or no cost to low-income women at 68 family-planning clinics across Colorado through the Colorado Family Planning Initiative. The effort was funded by a five-year commitment of $23 million from an anonymous donor (Sullivan, 8/12).

MinnPost: Minnesota Responds To Rural Doctor Shortage With Teams, Training, Telemedicine
The health care provider landscape of Greater Minnesota is one where primary-care physicians are becoming older and fewer, while their patients also are older but growing in number, said Mark Schoenbaum, director of the Minnesota Department of Health's Office of Rural Health and Primary Care. Medical schools, health-care systems and legislators alike know of the problems and are doing their best to solve them. The Minnesota Hospital Association released a report last month warning that the state faces a shortfall of about 850 primary-care physicians by 2024 due, in part, to “a lack of annual growth” in state residency or clinical training positions. “Funding and the number of ‘slots’ for residency programs have been frozen since 1996,” according to the study (Cronin, 8/11).

The Washington Post: McAuliffe Sets Up Boards To Address Children’s Issues In Virginia.
A program of the cabinet called the Commonwealth Council on Childhood Success will have a more narrow mission: improving access to pre-kindergarten, education, nutrition and health care from birth to third grade. It will be led by Lt. Gov. Ralph Northam (D), who is a full-time pediatric neurologist in Norfolk (Portnoy, 8/11). 

Kaiser Health News: To Beat Heroin Addiction, A Turn To Coaches
Two young men sit in a car outside a church or union hall where they just attended a Narcotics Anonymous meeting. Both men are addicted to heroin. But they haven’t used the drug since they finished a residential treatment program a week or so earlier. … Of patients addicted to heroin who stop, 40 to 60 percent relapse within the first year. For many it happens soon after finishing a recovery program. Wurzberg is now in a new young adult recovery program. It’s a one-year pilot project at Gosnold, which runs a network of addiction treatment services on Cape Cod (Bebinger, 8/11).

The San Francisco Chronicle: Two California Catholic Universities Limit Employees' Abortion Coverage
California has some of the nation's strongest protections for abortion rights. But the recent decisions by two Catholic universities, Santa Clara and Loyola Marymount, to eliminate most abortion insurance coverage for their employees were cleared in advance by state agencies. Now Gov. Jerry Brown's administration is taking another look (Egelko, 8/11).

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Editorials and Opinions

Viewpoints: Robin Williams' 'Wakeup Call'; Surprise In Medicaid Growth; Tools To Stop Ebola In U.S.

The New Republic: Robin Williams' Death Is A Wakeup Call For Mental Illness
Earlier this year, [Robin] Williams checked himself into a rehabilitation facility. And whether he needed help with addiction or mental illness—or, as is so often the case, with both—it's safe to assume he got it. He had the money to afford the best and the sad truth is that, in some cases, even the best isn't enough to save people. But Williams' access to such assistance would have been the exception. The majority of Americans struggle to get decent mental health care, or any mental health care at all. Expansions of insurance, including those in the Affordable Care Act, are enabling more people to pay for treatments. And halting investments in facilities and programs, some the result of highly publicized tragedies, have helped countless others. But the mismatch between what people need and what they can actually get remains stark (Jonathan Cohn, 8/12).

The New York Times’ The Upshot: Medicaid Rolls Are Growing Even In States That Rejected Federal Funds
Call it a side effect of the Affordable Care Act: Even in states that haven’t changed their Medicaid programs, nearly a million people signed up for Medicaid this year. ... But Medicaid enrollment has also increased this year in many states that chose not to accept federal funds. Data from Medicaid released Friday show that enrollment jumped in most states that did not expand their programs, including Georgia (16 percent), Montana (10 percent), Idaho (9 percent) and Florida (7 percent) (Margo Sanger-Katz, 8/11). 

Forbes: If Ebola Arrives In The U.S., Stopping It May Rely On Controversial Tools
Considering the nature of the Ebola virus, and the medical infrastructure we have to combat its spread, the diagnosis of some cases on American soil shouldn’t be reason to panic. We have a plethora of tools and public health practices to readily combat its spread. ... For most Americans, it may be the first time they glimpse the tools that our government has staked out over the last decade, as preparation for public health emergencies like a pandemic flu, or even bioterrorism. Some of these authorities are wholly necessary. Others will prove controversial and worthy of closer scrutiny. Chief among them are authority maintained by the Centers for Disease Control to quarantine Americans suspected of having a dangerous, communicable disease (Scott Gottlieb, 8/12).

The Wall Street Journal's The Experts: The Biggest Misconceptions People Have About The Medical Profession
Few people know what it's really like to be on the other side of the stethoscope. With this issue in mind, we asked The Experts: What is the biggest misconception the public has about the medical profession? (8/11).

The Wall Street Journal’s Washington Wire: A Better Option Than Impeachment To Check Executive Overreach
With Republicans in charge of Congress, they would be able to provide a true check on executive overreach. They would be able to stop Attorney General Eric Holder's politicization of the Justice Department. They would be able to hold the president accountable to his own health-care law. They would be able to exercise the oversight power that comes with having the appropriations process controlled by the opposition party (John Feehery, 8/11). 

Reuters: What Should We Eat To Stay Healthy? Why Experts Actually Have No Idea.
Have you ever wondered why nutrition experts so often change their minds about what constitutes a healthy diet? In the last six months, a variety of experts and nutrition organizations have issued at least as many major dietary guidelines proclaiming the next set of instructions on what to eat to prevent cancer, whether processed foods are really food, whether the type of fat you eat has any effect on developing heart disease, and how to control diabetes with diet. ... These new guidelines have, like most dietary guidelines in the past, done little to solidify our understanding of the cause and effect relationship between diet and disease. Even worse, they're likely to discredit nutritional science (David Seres, 8/11). 

Journal of the American Medical Association: Hospital Relationships With Direct-To-Consumer Screening Companies
In an increasingly competitive health care environment, one [hospital] strategy to bring in new "customers" is to sponsor outreach programs that can be marketed to the general public as "lifesaving." The screening tests offered by HealthFair and other [direct to consumer] DTC screening companies, which primarily focus on the early detection of atherosclerotic disease and prevention of catastrophic vascular events, are advertised and supported by evidence of early disease detection and emotional consumer testimonials rather than quality, outcomes-based evidence demonstrating reductions in morbidity and mortality. ... Given the controversy over the values and ethics of DTC screening companies and the services they offer, hospitals should clearly and publicly explain their relationships with DTC screening companies, given the lack of evidence to support mass vascular screenings (Drs. Erik A. Wallace, John H. Schumann and Steven E. Weinberger, 8/11).

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Stephanie Stapleton

Andrew Villegas

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.