News Headlines for January 23, 2017

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What Does Trump’s Executive Order Against Obamacare Actually Do?
New York Times

Donald J. Trump ran on a campaign promise to dismantle the Affordable Care Act. So it should not come as a surprise that he has signed an executive order urging his administration to fight it as much as possible.

But that order, alone, won’t allow President Trump to unwind the sprawling health law known as Obamacare.

Mr. Trump and Republican leaders in Congress are engaged in negotiations about legislation that might substantially undo or replace the health law. Even before the inauguration, Congress took a first step toward gutting major provisions.

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Cervical cancer death rates are much higher than thought, study says
KSBW

Black women are dying from cervical cancer at a rate 77% higher than previously thought and white women are dying at a rate 47% higher, according to a new study that published in the journal Cancer on Monday.

The study found that previous estimates of cervical cancer death rates didn’t account for women who had their cervixes removed in hysterectomy procedures, which eliminates the risk of developing the cancer.

“Prior calculations did not account for hysterectomy because the same general method is used across all cancer statistics,” said Anne Rositch, assistant professor of epidemiology at Johns Hopkins Bloomberg School of Public Health in Baltimore and lead author of the study.

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Blame Technology, Not Longer Life Spans, for Health Spending Increases
The New York Times

American life spans are rising, and as they are, health care spending is, too. But longevity is not contributing to the spending increase as much as you might think.

The median age in the United States will rise to about 40 by 2040, up from 37.7 today. That’s partly because the average American lives three years longer today — reaching nearly 79 years old — than in 1995. The Congressional Budget Office credits population aging for a substantial portion of its projected increase in health care spending — from 5.5 percent of the economy today to almost 9 percent by 2046.

But research suggests that living longer, by itself, isn’t a big driver of rising health care spending. Because the baby boom generation is so large — members of which are now in their 50s to late 60s — the average age of Americans would rise even if life expectancy didn’t. For every 100 working-age American today, there are about 25 Americans over 65. By 2040 there will be 37.

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Watch Out for Bird Flu, WHO Says
NBC News

The World Health Organization called on all countries to closely monitor outbreaks of deadly avian influenza in birds and to report promptly any human cases that could signal the start of a flu pandemic.

Different strains of bird flu have been spreading across Europe and Asia since late last year, leading to large-scale slaughters of poultry in affected countries and some human deaths in China.

Nearly 40 countries have reported new outbreaks of highly pathogenic avian influenza in poultry or wild birds since November, according to the WHO.

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Meet The Republican Governors Who Don’t Want To Repeal All Of Obamacare
National Public Radio

As Congressional Republicans begin work on repealing the Affordable Care Act, many of the nation’s governors want to make sure that their state budgets don’t take a hit during the dismantling process.

They’re most concerned about Medicaid, the health insurance program for the poor that’s run jointly by the states and federal government. As a result of a Supreme Court decision, states were allowed to decide whether they would expand Medicaid under the ACA. 14 million people have gained health insurance coverage through Medicaid since eligibility for the program was expanded.

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Trump Issues Executive Order Scaling Back Parts of Obamacare
New York Times

In his first executive order, President Trump on Friday directed government agencies to scale back as many aspects of the Affordable Care Act as possible, moving within hours of being sworn in to fulfill his pledge to eviscerate Barack Obama’s signature health care law.

The one-page order, which Mr. Trump signed in a hastily arranged Oval Office ceremony shortly before departing for the inaugural balls, gave no specifics about which aspects of the law it was targeting.

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WhiteHouse.gov drops mention of healthcare, climate change after Trump takes office
Modern Healthcare

In an inauguration speech with heavy populist and religious tones, President Donald Trump said nothing about healthcare or the pending repeal of his predecessor’s signature law, the Affordable Care Act. As the official White House website transitioned, the section on healthcare was removed, along with sections of climate change and LGBT rights.

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Republicans race to find ACA repeal compromise
Sacramento Bee

President Donald Trump wants Congress to move quickly this week to dismantle the Affordable Care Act, but congressional Republicans are far from consensus on a repeal-and-replace effort that won’t leave millions of their constituents without insurance.

On Monday, two senators who have cautioned colleagues to delay repeal until they’ve settled on a replacement will unveil an alternative plan to give states the choice to retain Obamacare or be granted flexibility to expand Medicaid and other coverage options.

That alternative, from Sens. Susan Collins, R-Maine, and Bill Cassidy, R-La, runs counter to the plans on the table, including one from Trump’s health secretary nominee Tom Price, known as the “Empowering Patients First Act,” which would offer tax credits, encourage the use of health savings accounts and urge states to develop high-risk pools.

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Trump Executive Order: Minimizing the Economic Burden of the Affordable Care Act Pending Repeal
The Health Care Blog

My quick take [edited to be slightly less quick]:

Section 1 is warming up the idea that administrative actions will be taken without waiting for any new legislation to reduce the application of ACA penalties and take the teeth out of regulations. This could include freely offering “hardship” exemptions from the individual mandate, though that would frighten insurers and would tend to reduce the number participating on the Exchanges.

Section 2 further sets the stage for the non-enforcement or the creatively flexible enforcement of the individual mandate, employer mandate, and any other requirement/tax/penalty in the ACA.

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Is Trump Headed Into His Own “If You Like Your Health Plan You Can Keep It” Quagmire??
The Health Care Blog

On Friday night the administration issued an executive order giving Trump administration appointees enormous flexibility in modifying how the Obamacare individual health insurance market works.

Specifically, President Trump has given his administration the power “to waive, defer, grant exemptions from or delay the implementation of any provision or requirement of [Obamacare].”

The administration has not been clear about just exactly what it is they now want to do.

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Obamacare repeal would also affect your employer health insurance
Los Angeles Times

Stephanie Blythe isn’t due to give birth until April, but she already ordered a breast pump through her insurance company because she’s worried about the future of the Affordable Care Act.

“Once I have it, they can’t take it away from me,” said Blythe, 31. Approximately 4.6 million Californians gained health coverage because of Obamacare, either through Medi-Cal, the state’s low-income health program, or the insurance exchange Covered California.

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Obamacare costs way more than it should: Column
USA Today

When President Trump mentioned extending health insurance to everyone this month, it sounded like it could be pie in the sky — until you consider that the insurance he plans on replacing, Obamacare, is struggling under the weight of its own subsidies, regulations and restrictions. On his first day in office, Trump showed he recognized that with an executive order addressing just those issues.

It will certainly be easier to extend a catastrophic-plus style of insurance to more people if that is what the new president has in mind, especially when it is connected to fully tax deductible health savings accounts that will be used by the consumer to negotiate lower prices. Consider that of the 20 million or so who currently receive insurance under Obamacare, 11 million or so are actually the new Medicaid enrollees in states which have expanded the program. Not a pure success for the private Obamacare plans by any measure.

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Trump’s HHS Pick Favored Drugmakers, Device Makers And Doctors
Kaiser Health News

As Cabinet nominee Tom Price faces a Senate confirmation hearing Tuesday, a newly released trove of documents sheds further light on how he interacted as a congressman with the Centers for Medicare and Medicaid, the massive agency he may soon oversee.

Letters provided by CMS after an open records request show that the Health and Human Services pick has repeatedly stepped up in favor of drug firms, device manufacturers and higher physician payments, leading some experts to question whether he would be a reliable advocate for the public’s health.

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Bill aims to track number of CA ’superbug’ infections and deaths
Southern California Public Radio

A bill pending in the state legislature would require California hospitals to start reporting all infections and deaths from antibiotic-resistant “superbugs.” The measure would also require doctors to report some of these infections on death certificates.

California currently requires hospitals to report on three types of antibiotic-resistant infections, but only if the infections are acquired in the hospital. There are another 15 serious superbug infections that hospitals don’t have to report.

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Doctors prescribed me pain meds but couldn’t help me get off them
Washington Post

On May 23, 2015, my motorcycle was struck by a careless driver in a large van. My left foot was crushed, the great toe and first metatarsal shattered, while pieces of the first, second, and third metatarsals exploded out through the top and bottom of my foot.

My first hospital stay lasted eight days. There, the orthopedic trauma surgeon saved my foot from the immediate threat of amputation and sent me home with a vacuum-assisted closure device for the wound, while the plastic surgeons figured out how to close the large hole on the bottom of my foot.

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The search for a painkiller that works without danger of addiction
Washington Post

When did our nation’s opioid crisis begin? Pretty much as soon as a German pharmacist isolated morphine from opium in 1805. Within the century, “addiction among soldiers was reportedly prevalent enough to earn the moniker, ‘the soldier’s disease,’ ” writes Jon Kelvey on Smithsonian.com.

But after more than 200 years of increased dependency and deaths, his article declares that “America’s Long-Overdue Opioid Revolution Is Finally Here.”

Here’s the tantalizing prospect of the piece: New compounds may provide patients with opioid-level pain relief without the awful side effects.

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Online Rankings For Hospital Executives?
The Health Care Blog

This week’s NEJM features an article on hospital-sponsored online rating sites for docs. The author, Vivian S. Lee, M.D., Ph.D., MBA, a prominent health services researcher discusses the adoption and success of her program at the University of Utah and how the system uses a portal open to patients to evaluate staff.

In the piece, she covers familiar ground. Early renunciation and eventual acceptance by faculty in a manner you can predict: initial fears of reputation and prestige loss give way to a stable system allowing docs to obtain feedback in real time to improve their game. It is not all wine and roses in her telling, but like all things, the apocalypse never materializes, and the once unthinkable becomes business as usual. Docs adjust.  Life moves on.

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St. Joseph Health receives Joint Commission’s gold seal
Times-Standard

St. Joseph Health in Humboldt County earned the Joint Commission’s Gold Seal of Approval for hospital, home infusion and laboratory services accreditation by demonstrating continuous compliance with its performance standards, according to a news release.

The Gold Seal of Approval is a symbol of quality that reflects an organization’s commitment to providing safe and effective patient care.

St. Joseph underwent rigorous, unannounced on-site surveys in April 2016. Redwood Memorial received the same treatment in September of last year.

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