Monday, October 3, 2022 – Kaiser Health News

Kaiser Health News Original Stories
Severe Sleep Apnea Diagnosis Panics Reporter Until He Finds a Simple, No-Cost Solution
An industry has grown up around sleep apnea, stirring concerns about overdiagnosis and overtreatment. (Jay Hancock, 10/9 )
Mental Health Crisis Teams Aren’t Just for Cities Anymore
In many cities, social workers and counselors are responding to mental health emergencies that used to be solely handled by police. That approach is spreading to rural areas even though mental health professionals are scarcer and travel distances are longer. (Tony Leys and Arielle Zionts, 10/9 )
Listen: Grieving Families Face the Cruelest Bills
KHN Midwest correspondent Lauren Weber talks with NPR’s “Consider This” podcast about her reporting on families confronted with medical bills while grieving the loss of a baby who received expensive hospital care. ( 10/9 )
Journalists Dig In on the Fiscal Health of the Nation and Hospital Closures in Rural Missouri
KHN and California Healthline staff made the rounds on national and local media this week to discuss their stories. Here’s a collection of their appearances. ( 10/9 )
Political Cartoon: 'Best Buds?'
Kaiser Health News provides a fresh take on health policy developments with "Political Cartoon: 'Best Buds?'" by Dave Coverly.
Here's today's health policy haiku:
Hospitals losing;
Patients and millions in claims;
HAIs winning
– Bob Arnold
If you have a health policy haiku to share, please Contact Us and let us know if we can include your name. Haikus follow the format of 5-7-5 syllables. We give extra brownie points if you link back to a KHN original story.
Opinions expressed in haikus and cartoons are solely the author's and do not reflect the opinions of KHN or KFF.
Medicare
Rural Medicare Programs Extended In Short-Term Spending Bill
The congressionally-passed bill that keeps the federal government funded through mid-December included two Medicare programs. The Medicare Dependent Hospital program would have otherwise expired, while the Low-Volume Hospital program would have lost expanded eligibility criteria, Modern Healthcare reports.
Modern Healthcare: Rural Medicare Programs Get Short-Term Extensions From Congress 
Two Medicare programs that boost payments for hundreds of rural hospitals were extended through mid-December with the House’s passage of a short-term federal spending package on Friday. (Kane, 9/30)
Fierce Healthcare: Congress Passes Spending Bill That Extends Rural Programs
The House voted 230 to 201 to advance to President Joe Biden’s desk a continuing resolution that funds the federal government through Dec. 16. Biden is expected to sign the legislation. The short-term package gives providers another chance to include key end-of-the-year policy priorities such as delays to Medicare doctor payment cuts and extensions of a key quality bonus. The legislation also extends through Dec. 16 the hospital payment adjustment for certain low-volume hospitals (LVH) and the Medicare-Dependent Hospital (MDH) program. Both programs were set to expire after September. (King, 9/30)
Forbes: Big Health Insurers Will Expand Medicare Advantage To Hundreds Of New Counties For 2023
Health insurance companies that are big players in Medicare Advantage, including Humana, Cigna, CVS Health’s Aetna unit, Elevance Health and UnitedHealth Group are launching popular plans in several new states and hundreds of new counties for 2023. Aetna, which is in 1,875 counties and 46 states plus Washington, D.C. with 3.2 million Medicare Advantage enrollees today is expanding to 2,014 counties and 46 states plus Washington, D.C. (Japsen, 10/1)
Atlanta Journal-Constitution: PolitiFact: Democratic Bill Sen. Warnock Voted With Biden On Didn’t 'Slash' Medicare Spending
Although the bill is projected to reduce federal spending by almost $300 billion, that would reflect government savings and not benefit cuts. In other words, Medicare recipients would receive the same amount of medicines, just for less taxpayer money. (Jacobson, 10/3)
CNBC: Some Seniors Make This Costly Medicare Enrollment Mistake. A Bipartisan Bill Looks To Fix It
A bipartisan bill in the House aims to fix a costly enrollment mistake that some older adults make when they transition to Medicare from an employer-based health plan. (O'Brien, 10/2)
More from Capitol Hill —
Politico: The War Against Superbugs Caught In Congressional Quagmire
Lawmakers are on the brink of missing a critical window to fix America’s broken antibiotic market — and to prepare for the growing crisis of superbugs that federal officials say is a national security threat and experts warn is already a silent pandemic. Nearly 50,000 people die each year in the U.S. from drug-resistant and antibiotic-associated infections, according to the Centers for Disease Control and Prevention. The agency says the crisis grew worse during Covid-19 as doctors over-prescribed antibiotics and inundated hospitals failed to control drug-resistant infections, which spiked by at least 15 percent in 2020. (Gardner and Mahr, 10/2)
More from the Biden administration —
AP: US Outlines Plan For Long-Term Baby Formula Imports
U.S. regulators on Friday unveiled their plan to allow foreign baby formula manufacturers to stay on the market long term, an effort to diversify the nation’s tightly concentrated industry and prevent future shortages. The Food and Drug Administration said recent entrants to the U.S. market will have until October 2025 to make sure their formulas comply with federal standards for nutrition, labeling and manufacturing. The agency noted that some companies should be able to meet those requirements sooner. (Perrone, 9/30)
Stat: White House's Open-Access Directive Scrambles Long-Entrenched Models
In August, the White House’s Office of Science and Technology Policy released a memo directing all federal agencies to form plans to make all federally funded research publications and data publicly available without embargo by the end of 2025. (Trang, 10/3)
Pharmaceuticals
Newly Approved ALS Drug Priced At $158,000 Annually
Amylyx Pharmaceuticals revealed its recently FDA-approved Relyvrio drug would cost about $12,500 per 28-day prescription. The drugmaker noted it would give the drug free to certain uninsured patients. Separately, reports say the "Ice Bucket Challenge" actually helped fund Relyvrio's development.
Reuters: Amylyx Prices Newly Approved ALS Drug At $158,000 Per Year 
Amylyx Pharmaceuticals Inc on Friday set the list price of its newly approved drug to treat amyotrophic lateral sclerosis (ALS) at about $158,000 per year in the United States, a discount to its most recently approved competitor. The drug Relyvrio was approved by the U.S. Food and Drug Administration on Thursday, making it the third ALS treatment to get the regulator's nod after Japanese firm Mitsubishi Tanabe's Radicava, priced at around $170,000 per year, and the generic drug riluzole. (Leo, 9/30)
Axios: New ALS Treatment Sparks Yet Another Drug Pricing Debate
The FDA's expedited approval of a new ALS treatment priced at $158,000 a year, has touched off another debate over balancing regulation with patient access. (Owens, 10/3)
AP: NIH To Fund Unproven ALS Drugs Under Patient-Backed Law
When patients with a deadly diagnosis and few treatment options have tried to get unapproved, experimental drugs, they have long faced a dilemma: Who will pay? Responsibility for funding so-called compassionate use has always fallen to drugmakers, though many are unwilling or unable to make their drugs available for free to dying patients. After years of lobbying Congress, patients with the debilitating illness known as Lou Gehrig’s disease have found an unprecedented solution: make the federal government pay. (Perrone, 10/1)
NPR: ALS Ice Bucket Challenge Helped Fund The Development Of A New Drug For Treatment
The ALS Association said that $2.2 million of funds that were raised from the Ice Bucket Challenge went into funding the development and trial of the new drug that the Food and Drug Administration approved this week for treatment of ALS, which is also known as Lou Gehrig's disease. (Davis, 10/1)
In other pharmaceutical and biotech news —
Stat: Epic Overhauls Popular Sepsis Algorithm Criticized For Faulty Alarms
Epic Systems has revamped its widely criticized sepsis prediction model in a bid to improve its accuracy and make its alerts more meaningful to clinicians trying to snuff out the deadly condition. (Ross, 10/3)
Stat: Scientists Train An AI Model To Predict Breast Cancer Risk From MRI Scans
A biopsy that turns out to have benign results can be a relief. But in some cases, it could also mean a patient whose risk of cancer was low from the start has gone through an unnecessarily invasive procedure. (Williamson-Lee, 10/3)
Reuters: Walmart, CVS Must Face Lawsuit Over Placement Of Homeopathic Products 
The District of Columbia’s highest court revived two lawsuits that claim CVS and Walmart are misleading consumers by selling unproven homeopathic products alongside FDA-approved over-the-counter medicines on their store shelves and websites. (Grzincic, 9/30)
Supreme Court
New Supreme Court Term Opens On Heels Of Far-Reaching Abortion Ruling
The conservative-majority court is back in session starting Monday. Environmental protections, election law, and gay rights are already on the justices' docket, and other health-related cases are expected.
The Wall Street Journal: Supreme Court Term Opens With New Justice And Weighty Cases 
The Supreme Court opens its new term Monday with a new member, Justice Ketanji Brown Jackson, and a docket that could reshape features of American society ranging from college admissions to political redistricting. Monday’s first case, Sackett v. Environmental Protection Agency, could offer an early sign of whether the court’s 6-3 conservative majority will continue the refashioning of federal law they pursued last term, with opinions that eliminated the constitutional right to an abortion and expanded religion’s place in public education. (Bravin and Wolfe, 10/2)
The New York Times: As New Term Starts, Supreme Court Is Poised To Resume Rightward Push 
The last Supreme Court term ended with a series of judicial bombshells in June that eliminated the right to abortion, established a right to carry guns outside the home and limited efforts to address climate change. As the justices return to the bench on Monday, there are few signs that the court’s race to the right is slowing. The new term will feature major disputes on affirmative action, voting, religion, free speech and gay rights. And the court’s six-justice conservative supermajority seems poised to dominate the new term as it did the earlier one. “On things that matter most,” said Irv Gornstein, the executive director of the Supreme Court Institute at Georgetown Law, “get ready for a lot of 6-3s.” (Liptak, 10/2)
Politico: A Shaken Supreme Court Returns To Chambers 
Speaking at a judges’ conference in Colorado last month, Chief Justice John Roberts sounded exhausted by it all. “The last year was an unusual one and difficult in many respects. It was gut-wrenching every morning to drive into a Supreme Court with barricades around it,” Roberts said. “I think, with my colleagues, we’re all working to move beyond it.” (Gerstein, 10/2)
AP: Supreme Court Poised To Keep Marching To Right In New Term
Last term’s epic decisions might have produced bruised feelings among the justices anyway. But the leak of the abortion decision in early May, seven weeks before it was released, exacerbated tensions on the court, several justices have said. The court has apparently not identified the source of the leak, Justice Stephen Breyer said in a recent interview on CNN. Justice Elena Kagan delivered a series of talks over the summer in which she said the public’s view of the court can be damaged especially when changes in its membership lead to big changes in the law. “It just doesn’t look like law when some new judges appointed by a new president come in and start just tossing out the old stuff,” Kagan said in an appearance last month at Salve Regina University in Newport, Rhode Island. (Sherman and Gresko, 10/1)
After Roe V. Wade
Arizona Judge Declines To Suspend Ruling Blocking All Abortions
Pima County Superior Court Judge Kellie Johnson said abortion providers would likely fail in their appeal that challenges her ruling that a Civil War-era law should be enforced. Meanwhile, Reuters reports how Vice President Kamala Harris is encouraging female Democrats to fight for abortion rights.
AP: Arizona Judge Won’t Suspend Ruling That Halted All Abortions
An Arizona judge on Friday declined to put her order that allowed enforcement of a pre-statehood law making it a crime to provide an abortion on hold, saying abortion rights groups that asked her to block the order are not likely to prevail on appeal. The ruling from Pima County Superior Court Judge Kellie Johnson means the state’s abortion providers will not be able to restart procedures. Abortions were halted on Sept. 23 when Johnson ruled that a 1973 injunction must be lifted so that the Civil War-era law could be enforced. (Christie, 10/1)
Reuters: U.S. VP Harris, Actress Priyanka Chopra Discuss Mansplaining, Abortion Rights
U.S. Vice President Kamala Harris on Friday reminded top female Democrats of their duty to fight for reproductive rights and how electing two more Democratic senators in the upcoming midterm elections is critical to that fight. "If there were ever any reason for this group to exist in recent memory, the moment is now," Harris said during the Democratic National Committee's Women's Leadership Forum on Friday in Washington. (9/30)
From Ohio, Puerto Rico, and Texas —
Columbus Dispatch: Ohio Governor Mike DeWine Pitches Sales Tax Break For Baby Items
Against the backdrop of a looming abortion ban, Republican Gov. Mike DeWine is asking lawmakers to eliminate sales taxes on baby items and expand insurance coverage for lower-income mothers. (Balmert, 10/2)
NPR: Abortion Debate In Puerto Rico Follows U.S. Supreme Court Reversal Of Roe
The day after the Supreme Court overturned Roe v. Wade, a representative in the Puerto Rican legislature introduced a bill punishing "the crime of abortion" with 99 years in jail. The bill was withdrawn the same day it was introduced, but it represents renewed interest in greatly restricting abortion in Puerto Rico after the Supreme Court threw out its 1973 Roe v. Wade decision that protected abortion rights. (Rosenberg, 10/3)
Houston Chronicle: Would-Be Parents Postpone Pregnancies As Texas Abortion Ban Impacts Emergency Care
Dr. Patrick Ramsey, professor and chief of maternal-fetal medicine at UT Health San Antonio, said he has heard from many patients, especially those older than 35 who are statistically at higher risk of complications or who have had miscarriages, who worry that it may not be safe for them to get pregnant in Texas anymore. (Goldenstein, 10/2)
Also —
Axios: Post-Dobbs Birth Control Fight Heads To College Campuses
Fallout from the demise of Roe v. Wade is forcing college administrators to weigh how reproductive health services offered on campus may conflict with state abortion bans and if their employees could face prosecution. (Gonzalez, 10/2)
Undark: EDS And The Importance Of Abortion Access 
It took a long time and numerous instances of nearly fainting for Renee Schmidt to figure out what was going on. Three years after her symptoms emerged, Schmidt was diagnosed with Ehlers-Danlos Syndrome. (Johnson, 10/1)
Covid-19 Crisis
Newer Covid Strains Lurking In US; Coronavirus Cases Swell In Europe
Health experts worry that another winter wave might be on its way. Meanwhile, a new study found that more than 16,000 Americans who died in the first 10 months of the pandemic had suffered from a combination of covid and cancer.
Los Angeles Times: New Coronavirus Subvariant BA.2.75.2 Tops Concerns As Officials Gear Up For Potential Winter Wave
It’s too soon to say whether any of the newer variants will rise to prominence in the ways Omicron and Delta did. None have been documented in significant numbers in California or the nation. Still, experts say another super-spreading subvariant — combined with more people being indoors when the weather gets cold — could bring new challenges. (Lin II and Money, 10/1)
CIDRAP: COVID-19 Continues Upward Trend In Europe
Europe's COVID cases showed more signs of rising last week, marking the first regionwide spike since the most recent BA.5 wave, the European Centre for Disease Prevention and Control (ECDC) said today in a weekly update. In the past, increasing cases in Europe have come ahead of similar rises in other regions, so trends in Europe are a closely watched global indicator. (Schnirring, 9/30)
CIDRAP: More Than 16,000 Americans Died Of Combination Cancer, COVID In 2020
In the first 10 months of the pandemic, COVID-19 was an underlying cause of 3,142 US cancer deaths, and cancer contributed to 13,419 COVID-19 deaths, according to a study published yesterday in JAMA Oncology. (9/30)
In updates on the vaccine rollout —
Fox News: Two-Thirds Of U.S. Adults Do Not Plan On Getting COVID Boosters
Around two-thirds of adults in the United States are not planning to get the updated COVID-19 booster shots soon, according to a survey conducted by the Kaiser Family Foundation (KFF), a health policy nonprofit organization. (Rumpf, 9/30)
The New York Times: Anti-Vaccine Parents Go From Welcome To Ostracized In Marin County
For more than a decade, few places in the nation were associated with anti-vaccine movements as much as Marin County, the bluff-lined peninsula of coastal redwoods and stunning views just north of San Francisco. This corner of the Bay Area had become a prime example of a highly educated, affluent community with low childhood vaccination rates, driven by a contingent of liberal parents skeptical of traditional medicine. Marin was something of a paradox to mainstream Democrats, and often a punching bag. In 2015, during a measles outbreak in California, the comedian Jon Stewart blamed Marin parents for being guilty of a “mindful stupidity.” But Marin is the anti-vaccine capital no more. (Karlamangla, 10/2)
The Boston Globe: New Nasal Spray Vaccines Might Reduce COVID Infections, But The Money Is Still Missing
“None of these vaccines have been tested to prove that they can prevent transmission or infection,” said Karin Bok, deputy director of the Vaccine Research Center at the National Institute of Allergy and Infectious Diseases. “It’s not clear how we’re going to get that done, and at the very least, it is going to take a couple of years to get there.” (Cross, 10/1)
In other news about covid —
Bay Area News Group: COVID Misinformation: Gov. Newsom Signs Bill To Police California Doctors
Gov. Gavin Newsom signed a bill that will subject doctors to discipline and possible suspension of their licenses to practice for spreading misinformation about the COVID-19 pandemic to patients, one of the most controversial pieces of pandemic legislation lawmakers sent to his desk. (Woolfolk, 10/2)
CIDRAP: COVID Study Spotlights Unsafe Wait Times For Hospital Beds
A research letter today in JAMA Network Open shows that, in the first year of the COVID-19 pandemic, US hospitals dealing with patient surges held emergency-department (ED) patients in places like hallways while awaiting an inpatient bed for a median of 6.6 hours, far longer than the Joint Commission's 4-hour standard. The Joint Commission, a US-based healthcare accreditation organization that sets standards for hospitals and other medical settings, has deemed ED boarding—or holding admitted patients in the ED, often in hallways, as they wait for a bed to open up—a patient safety risk. (Van Beusekom, 9/30)
CIDRAP: Kids With Shortness Of Breath After Covid-19 May Have Airway Obstruction
Yesterday in the Journal of Allergy and Clinical Immunology, researchers from National Jewish Health published a study showing children who experienced shortness of breath after COVID-19 infection had evidence of peripheral airway obstruction. (9/30)
San Francisco Chronicle: COVID Can Infect Fat Cells. May Explain Why Some Get Much Sicker
The virus that causes COVID-19 can infect and replicate in fat cells, and cause inflammation in fat tissue, Stanford University researchers found in a new study that could help explain why obese people are at higher risk for severe COVID. (Ho, 9/30)
The New York Times: What to Do if You’re Experiencing Hair Loss After Covid
If you recovered from Covid-19 in the past few months, such an increase in shedding may not be a coincidence. Some research estimates that 22 percent of those who were hospitalized with Covid-19 experienced temporary hair loss. It is harder to evaluate how common the condition is in people who had milder forms of the disease, but studies suggest hair loss is also among the more than 60 persistent symptoms often associated with long Covid — some of which are more well-known, such as the loss of smell, cognitive impairment and sexual dysfunction. Doctors say they too have noticed a surge in patients seeking help for the phenomenon. “I have never seen anything like it in my life,” said Dr. Michele Green, a New York City-based dermatologist affiliated with Northwell Health’s Lenox Hill Hospital who specializes in hair loss. “I’m seeing more male and female patients, from every age group, every working profession. It’s really been across the board.” (Sheikh, 9/30)
Mental Health
New $314M Mental Health Funding Targeted At Schools, Emergency Depts.
The new $314 million funding through the Health Resources and Services Administration is aimed at mental health professionals in schools and in emergency departments. Separately, Boise State Public Radio News reports that roughly $1 billion in federal grants will go to support student mental health.
ABC News: Biden Admin Announces More Than $300M In Mental Health Funding In Part From Bipartisan Gun Bill
The Biden administration on Monday announced more than $300 million in new mental health funding, via awards and grants, with much of the money coming from the bipartisan anti-gun violence law passed this summer by Congress. (Jones II, 10/3)
Boise State Public Radio News: Nearly $1 Billion Going To Help Student Mental, Emotional Health After Uvalde Shooting
Nearly $1 billion in new federal grants is poised to go to high-need schools to support students and their mental health. The grants come via the U.S. Department of Education's Stronger Connections program, funded by the Bipartisan Safer Communities Act, which was passed in the wake of the deadly school shooting in Uvalde, Texas. (Beck, 9/30)
In other mental health news —
Los Angeles Times: Ketamine May Help Severely Depressed, Study Shows
Patients arriving at Dr. Philip O’Carroll’s Newport Beach office for their first ketamine treatment are in pain and often lost. They have visited other doctors, tried other solutions and are ready for what is considered a last resort. (Curwen, 10/2)
The Washington Post: More States Are Allowing Children To Take Mental Health Days
With child mental health problems on the rise in the past few years, a growing number of states have adopted laws that let students take an excused absence if they feel anxious, depressed or need a day to “recharge.” A dozen states already have measures in place that allow kids to take off for mental health and not just physical health reasons. A handful of others are considering making similar changes to school absentee rules. (Atkins, 10/2)
The Baltimore Sun: The Changing Landscape Of Mental Health Services In Baltimore: Diverting More Police Calls To Suicide Hotline 
The man had a gun in one hand and his dog at his feet. He made one last call, dialing the National Suicide Prevention Lifeline to relay his final messages. To his girlfriend, just a goodbye. To his brother, a request to look after the dog. Two hours later, the man was still on the line — and starting to reconsider pulling the trigger. (Skene, 9/30)
KHN: Mental Health Crisis Teams Aren’t Just For Cities Anymore 
Jeff White knows what can happen when 911 dispatchers receive a call about someone who feels despondent or agitated. He experienced it repeatedly: The 911 operators dispatched police, who often took him to a hospital or jail. “They don’t know how to handle people like me,” said White, who struggles with depression and schizophrenia. “They just don’t. They’re just guessing.” (Leys and Zionts, 10/3)
Health Industry
Spotlight Shines On Texas Health Hospitals' High Prices
The Dallas Morning News reports the region's largest health system charges roughly a third higher than the average for the state, and over three times Medicare rates. And it wants to raise prices still more. Separately, a Michigan-based hospital system lays off hundreds amid the worker crisis.
Dallas Morning News: Texas Health Hospitals Charge Over Three Times Medicare Rates — And Want A Big Increase
The region’s largest health system, controlling nearly a quarter of the hospital market, already has the highest health care charges in North Texas — roughly a third higher than the average for the state and nation. (Schnurman, 9/30)
More on health care costs and medical bills —
Crain's Detroit Business: Michigan-Based Hospital System Lays Off 'Hundreds' As Losses Mount
Sparrow Health System plans to lay off hundreds of workers after recording a $90 million loss during the first six months of the year, even as it struggles with worker shortages. (Walsh, 9/30)
Charlotte Ledger and North Carolina Health News: Tryon Drops Medical Plan, Panicking Patients
As tensions escalate nationally over health care costs, insurers and health care providers are increasingly playing hardball in their contract negotiations, creating stress and confusion for patients. That phenomenon was on display this past week in Charlotte, where Tryon Medical Partners – the largest independent primary care practice in the Charlotte region – told patients it would no longer accept the Humana Medicare Advantage insurance plan. (Crouch, 10/3)
Des Moines Register: How To Navigate Hospital Prices To Get A Better Deal
So how can patients know they're getting the best price for their care? "It’s a rocky road right now, and it's really the assertive consumers that are winning the game," said PatientRightsAdvocate.org founder and chairperson Cynthia Fisher. (Ramm, 10/2)
KHN: Listen: Grieving Families Face The Cruelest Bills
NPR’s “Consider This” podcast tells the stories of the Markow, Shickel, and Raspe familes. All had very sick infants who died after needing highly technical, very expensive treatment in neonatal intensive care units. Medical bills lived on for each family even after their babies died. “All Things Considered” host Juana Summers spoke to KHN Midwest correspondent Lauren Weber about her reporting on The Cruelest Bills. (9/30)
In other health care industry news —
Stat: Threats Prompt Hospitals To Strip Websites Of Info On Gender-Affirming Care
Children’s hospitals that have been targeted on social media for providing gender-affirming care — and even some that haven’t — are stripping information about those services from their websites. Advocates fear the changes could make it even harder for transgender adolescents to get care. (Bannow and Sheridan, 10/3)
NBC News: There's A Big Disparity In The Number Of Latino Doctors And Surgeons. Advocates Are Working To Change That
"For the last 40 years, the number of Latino physicians has not changed. That's a failure," Dr. Cesar Padilla, one of the organizers of the campaign and a clinical assistant professor at Stanford's University School of Medicine, told NBC News. (Flores, 9/30)
Milwaukee Journal Sentinel: Milwaukee Hospital Launches Study Into Water Births As Safe Option
For more than four hours, as first-time mother Sarah Hisamoto labored to bring her son, Gavin, into the world, the scene around her was one that would be hard to find in a hospital setting — certainly in southeastern Wisconsin. In a hospital room at Milwaukee's Aurora Sinai Medical Center, Hisamoto was moving freely in a small inflatable pool. (Shastri, 9/30)
KHN: Journalists Dig In On The Fiscal Health Of The Nation And Hospital Closures In Rural Missouri 
KHN chief Washington correspondent Julie Rovner discussed health care costs and the fiscal health of Medicare and Social Security on C-SPAN’s “Washington Journal” on Sept. 28. She also discussed President Joe Biden’s comments about the covid-19 pandemic being “over,” as well as health inflation, the government funding bill, and other domestic news on WAMU/NPR’s “1A” on Sept. 23. (10/1)
In global news —
Reuters: Ebola Kills Doctor In Uganda, First Health Worker Killed In Latest Outbreak
A Tanzanian doctor working in Uganda who contracted Ebola has died, the first health worker killed by the disease in the latest outbreak in the country, Uganda's health minister said on Saturday. "I regret to announce that we have lost our first doctor, Dr. Mohammed Ali, a Tanzanian national, 37-year-old Male," the health minister, Jane Ruth Aceng, tweeted. (10/1)
State Watch
'Shock To The Body': Mental Health Damage Left In Ian's Wake In Florida
A doctor explains how a hurricane can be an emotionally traumatizing event. Other news from around the nation includes transgender youth in California; paramedic home visits in Missouri; public health crises in New York; and more.
Fox News: Hurricane Ian Causing ‘Emotional Trauma’ On Top Of Physical Devastation, Says Doctor 
While hurricanes are known for causing swift and often devastating physical destruction, they can also cause equally serious emotional damage, said Dr. Janette Nesheiwat on Saturday, Oct. 1. "It's a traumatizing experience," said Nesheiwat, a board-certified family and emergency medical professional and a Fox News medical contributor, during a "Fox & Friends Weekend" segment. (Rousselle, 10/1)
NBC News: Florida Hospital Without Running Water Faces Crisis After Hurricane Ian
Staff members at the Health Park Medical Center in Fort Myers told NBC News that the facility's running water went out Wednesday and hasn't yet been restored. If water service isn't back soon, the workers said, they fear disease outbreaks and infections in the wake of the storm. (Hampton, Rosenblatt, Bendix and Siemaszko, 10/1)
In other health news from across the U.S. —
Los Angeles Times: Newsom Signs Bill Protecting Transgender Youths Fleeing Red-State Laws
Again heralding California as a refuge from discriminatory policies in conservative states, Gov. Gavin Newsom signed a bill into law on Thursday that aims to protect transgender youths and their families from bans against gender-affirming care. Senate Bill 107 by state Sen. Scott Wiener (D-San Francisco) provides for a range of safeguards meant to block out-of-state attempts to penalize families that come to California seeking medical treatment for transgender children and teens or move to the state to avoid consequences for already seeking that treatment elsewhere. (Mays, 9/29)
St. Louis Post-Dispatch: Paramedics Without The Ambulance: Missouri Tries To Reach Patients At Home, Avoid Hospital Visits
In an effort to smooth out barriers to health care and keep people from getting sick enough to need 911 in the first place, more and more agencies are creating a new class of paramedic, one that regularly visits people’s homes. The house calls bring routine care to patients, connect them with services and prevent emergencies before they hit. (Merrilees, 9/30)
Bloomberg: Urban Heat Officers Fight Rising Temps And Slow Bureaucracy
The first-ever gathering of chief heat officers from cities around the globe brought civic leaders from countries as diverse as Chile, Greece and Sierra Leone to Washington, D.C., recently. The all-female group of urban policymakers shared the challenging role of adapting to the harsh realities of climate change today. (Sisson, 10/3)
Politico: ‘4-Alarm Blaze’: New York’s Public Health Crises Converge
This past winter, as Covid cases were beginning to decline, state health officials in New York were expecting a respite after two exhausting years and a chance to refocus on run-of-the-mill public health duties. Almost a year later, they are still waiting. (Banco, 10/2)
Kansas City Star: Social Security Disability Exam Group Accused Of Fraud
Michael Begnaud of Liberty felt confident that the medical exam he needed to help prove he was disabled would go his way. His swollen hands, inflamed with gout, so pained him he wore braces on his wrists. The decay of his retinas from incurable retinitis pigmentosa was slowly robbing him of sight. (Adler, 10/2)
Harvest Public Media: SNAP-Ed Pays Workers So Little That Some Qualify For Food Benefits Themselves
Del Jacobs likes almost everything about her job. As a SNAP-Ed community worker in Illinois, she likes getting to know the regulars at local food pantries and teaching them about healthy eating on a budget. She likes working with children, especially since she doesn’t have any kids of her own. (Cronin, 10/3)
Lifestyle and Health
Studies Examine Monkeypox Virus Prevalence On Skin, Body Parts
A study reported by CIDRAP examined where the monkeypox virus concentrates in the body, finding lower levels in blood and urine than elsewhere. Other research looked at transmission risks in health care settings. Listeria, sleep apnea, and smartphone detection of car crashes are also in the news.
CIDRAP: Studies Detail Monkeypox Transmission Risks 
A study of almost 400 samples taken from men with monkeypox reveals a high prevalence of the virus on skin, throat, and anus swabs compared to in blood or urine—with detections in semen in the midrange—and high viral loads in skin and anal swabs. Two other new studies detail transmission risk in a tattoo parlor and in healthcare settings, and in US news, officials report a monkeypox-related death in Ohio. (Soucheray, 9/30)
CNN: US Monkeypox Deaths Are Rare, But Here's Why They Can Be Difficult To Confirm 
There have been more than 25,000 monkeypox cases in the United States during the current outbreak, and deaths among monkeypox patients are rare. Among the few reported, it has sometimes been difficult to determine the role monkeypox played in the deaths. “It’s sort of the old situation we had with Covid: Did you die of Covid, or did you die with Covid? And so this is the same scenario: Did you die with monkeypox, or did you die of monkeypox?” said Lori Tremmel Freeman, chief executive officer of the National Association of County and City Health Officials. (Howard, 10/3)
In other health and wellness news —
CBS News: Listeria Outbreak Linked To Cheese Sold By Safeway, Whole Foods And Other Grocery Chains
Friday's recall by Benton Harbor, Michigan-based Old Europe Cheese involves all of its Brie and Camembert products with "best by" dates through December 14, 2022, the company stated in a notice posted by the U.S. Food and Drug Administration. (See here for a detailed list of the recalled products, which involve more than 20 brands.) (Gibson, 9/30)
KHN: Severe Sleep Apnea Diagnosis Panics Reporter Until He Finds A Simple, No-Cost Solution 
I woke up in a strange bedroom with 24 electrodes glued all over my body and a plastic mask attached to a hose covering my face. The lab technician who watched me all night via video feed told me that I had “wicked sleep apnea” and that it was “central sleep apnea” — a type that originates in the brain and fails to tell the muscles to inhale. As a journalist — and one terrified by the diagnosis — I set out to do my own research. After a few weeks of sleuthing and interviewing experts, I reached two important conclusions. (Hancock, 10/3)
AP: Occupant's Phone Alerts Responders To Car Crash That Killed 6 In Their 20s
A passenger's cellphone automatically alerted responders after a car hit a tree early Sunday in a Nebraska crash that killed all six of the car's young occupants, authorities said. (10/3)
Worries Over Biden's Reluctance To Reform Federal Marijuana Laws
Politico reports that since the president seemingly has "no interest" in loosening federal drug laws, despite progress in some states, courts may ultimately have to force the issue. Other news on legal and illegal drugs is from Ohio, Colorado, Texas, and elsewhere.
Politico: Courts Could Throw State Marijuana Markets Into Disarray 
President Joe Biden is showing no interest in loosening federal restrictions that have left states in charge of developing how the multibillion-dollar U.S. cannabis industry grows. The nation’s courts may ultimately force the issue — in a chaotic fashion that could undermine efforts to diversify the industry and protect public health. (Zhang, 10/2)
Columbus Dispatch: Ohio Medical Marijuana Patients Say Prices Too High, But Program Improving
Ohio medical marijuana patients are happier with the state's program than they once were, but they continue to face high prices and a shortage of doctors who can recommend cannabis, according to a new study. The report from Ohio State University's Drug Enforcement and Policy Center found more than half of survey respondents reported some level of satisfaction with the medical cannabis program, including 15.3% who were "extremely satisfied." About 35% of people were dissatisfied with the program, an improvement from 55% last year. (BeMiller, 10/29)
The Gazette: New Hurdles In Obtaining Medical Marijuana Reignite Policy Debate 
Julie Richardson moved to Colorado from Louisiana in 2015, specifically to get the quality of cannabis-derived medicines available here — which were illegal or too expensive back home. Now Richardson, who suffered a spinal injury when she was 6 months old and who has gone through repeated reconstructive surgeries and a cancer battle, thinks she may need to move again. (Samuelson, 10/2)
The Courier-Journal: 3 Takeaways From Report By Andy Beshear's Medical Marijuana Committee
Gov. Andy Beshear announced Friday that an overwhelming majority of Kentuckians apparently support legalizing medical marijuana in their state, based on feedback his weed-focused advisory committee received. The Democratic governor set up the Team Kentucky Medical Cannabis Advisory Committee in June, a couple of months after he said he'll explore what executive actions he might be able to take since bipartisan efforts to pass a law legalizing medical marijuana stalled in the Republican-led Kentucky Senate. (Watkins, 10/1)
The New York Times: Elias Theodorou, Pioneer Of Medical Marijuana In Sports, Dies At 34 
Elias Theodorou, a cerebral, charismatic mixed martial arts fighter who campaigned to change his sport’s drug rules and is widely believed to be the first professional athlete to receive a therapeutic exemption to use marijuana, died on Sept. 11 at his home in Woodbridge, Ontario, a suburb of Toronto. He was 34.His brother, Michael, said the cause was colon cancer that had metastasized to his liver. (Risen, 10/2)
On the fentanyl crisis —
The New York Times: Fentanyl Test Strips Highlight Rift In Nation’s Struggle To Combat Drug Deaths 
“You smoke weed?” Eufamia Lopez asked the half-dozen young men lounging on benches in a public housing courtyard in the South Bronx. The soft September air reeked of the obvious answer. Ms. Lopez, who works for a New York University health support program, plunged into her spiel. Street drugs — meth, coke, molly, Xanax, heroin and even marijuana — are being cut with fentanyl these days, she said, which can kill you. But you can test your supply before using it to see whether there’s any fentanyl in it. She was giving out free kits. (Hoffman, 10/1)
The Wall Street Journal: Fentanyl’s Ubiquity Inflames America’s Drug Crisis 
Fentanyl, the potent opioid driving U.S. drug deaths to record highs, has infiltrated virtually every channel of the illicit drug supply and turned it more toxic than ever. In this city and across the U.S., traffickers are making fentanyl, primarily produced in Mexico, the dominant substance for opioid users craving a fix. The synthetic drug is killing users who fear its strength but can’t easily find alternatives, as well as those seeking it out to feed their rising tolerance to prescription painkillers or heroin. It also is claiming the lives of people who didn’t know they were taking it. (Campo-Flores and Kamp, 9/30)
KXAN: Texas Families Share Emotional Fentanyl Stories
Family after family has lost loved ones to fentanyl overdoses in Hays County. Some of them shared their stories Sunday. It was part of a fentanyl awareness meeting led by the Hays County Sheriff’s Office. … Janet Zarate’s nephew was a Hays County teenager who died of a fentanyl overdose. “He took a Percocet … a fake Percocet and that was it. It was just one pill, and he was gone,” Zarate said. (Al-Shaikh, 10/3)
Science And Innovations
Nobel Prize In Medicine Goes To Scientist For Evolution Discoveries
Swedish scientist Svante Pääbo won this year's Nobel Prize in physiology or medicine for accomplishing "something seemingly impossible: sequencing the genome of the Neanderthal," the Nobel committee announced.
AP: Nobel Prize In Medicine Awarded For Research On Evolution
This year’s Nobel Prize in physiology or medicine has been awarded to Swedish scientist Svante Paabo for his discoveries on human evolution. Thomas Perlmann, secretary of the Nobel Committee, announced the winner Monday at the Karolinska Institute in Stockholm, Sweden. Paabo has spearheaded research comparing the genome of modern humans and our closest extinct relatives, the Neanderthals and Denisovans, showing that there was mixing between the species. (10/3)
The New York Times: Nobel Prize In Physiology Or Medicine Is Awarded To Svante Pääbo
“Through his pioneering research, Svante Pääbo — this year’s Nobel Prize laureate in physiology or medicine — accomplished something seemingly impossible: sequencing the genome of the Neanderthal, an extinct relative of present-day humans,” the Nobel committee said in a statement. “Pääbo’s discoveries have generated new understanding of our evolutionary history,” the statement said, adding that this research had helped establish the burgeoning science of “paleogenomics,” or the study of genetic material from ancient pathogens. (Mueller, 10/3)
Reuters: Sweden's Svante Paabo Wins 2022 Nobel Prize In Medicine
Paabo, son of the Nobel Prize-winning biochemist Sune Bergström, has been credited with transforming the study of human origins after developing approaches to allow for the examination of DNA sequences from archaeological and paleontological remains. His key achievements include sequencing an entire Neanderthal genome to reveal the link between extinct people and modern humans. (Pollard, Johnson and Grover, 10/3)
Read the Nobel Assembly’s description —
Press release: The Nobel Prize in Physiology or Medicine 2022
Editorials And Opinions
Viewpoints: Why Have So Few Gotten The Bivalent Booster?; Overturning Roe Is Having Broad Consequences
Editorial writers examine these public health topics.
The Washington Post: Don't Skip Your Covid Bivalent Booster Shot 
The new bivalent boosters are off to a slow start. In Minnesota, vaccine uptake is running way behind that of the first booster doses, with fewer than 4 percent of those 12 and older up to date on their shots. (10/1)
USA Today: Dumping Roe May Backfire On Abortion Opponents. Republicans Should Have Been Ready
Opponents of abortion who were thrilled to see the U.S. Supreme Court overturn Roe v. Wade in June may find their celebration short-lived. At least in some states. (Ingrid Jacques, 9/30)
New England Journal of Medicine: A Grim New Reality — Intimate-Partner Violence After Dobbs And Bruen 
The Supreme Court’s recent decision in Dobbs v. Jackson Women’s Health Organization, which allows states to ban or restrict access to abortion, will have many implications for the health, economic stability, and equal opportunity of people who can become pregnant. (Elizabeth Tobin-Tyler, J.D., 10/1)
Stat: Will There Be A Supreme Court Assault On Public Health This Term?
In just seven days last June, the U.S. Supreme Court set back public health by 50 years. The court’s conservative majority rolled back efforts to address the pressing threat of climate change, expanded access to deadly firearms, and eliminated the right to abortion by overturning Roe v. Wade. Earlier, it had eviscerated public health powers to curb the Covid-19 pandemic. We fear this is just the start. (Michelle A. Williams and Lawrence O. Gostin, 10/3)
The Washington Post: Behind Newsom’s Move On California’s Chronic Problem With The Mentally Ill 
Like virtually every California governor before him, Newsom has ambitions that go beyond Sacramento. Unlike his predecessors, he is confronting the daunting issue of untreated mental illness. His success or failure could determine his future. (Dan Morain, 10/3)
Modern Healthcare: Health Systems Can Play Critical Role In Future Of The Workforce 
As we emerge from the most significant public health challenge of the last century, the critical role of health systems and their caregivers has never been more apparent. While COVID-19 has become more of an endemic disease, we continue to process the important lessons learned regarding the needs and challenges of educating our future healthcare workforce. (Dr. Kavitha Bhatia and Dr. Paul Lyons, 9/30)
Stat: Better Use Of Health Savings Accounts: Lessons From Singapore
The insurance system in the U.S. is broken. Rather than continuing to plow money into insurance and expensive care, families should be stowing that cash away for future health care needs. That’s what they do in Singapore. There, people save toward their own health care needs via mandatory individual health savings accounts — with the government serving as the safety net. (Elise Amez-Droz and Phillip Phan, 10/3)
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