First Edition: Feb. 16, 2023

Linda Rider

Today’s early morning highlights from the major news organizations.

As Covid Grabbed The World’s Attention, Texas’ Efforts To Control TB Slipped 

Narciso Lopez has spent more than two decades working to control the spread of tuberculosis in South Texas. He used to think that when patient traffic into the clinics where he worked was slow, that meant the surrounding community was healthy. But when the covid-19 pandemic hit in early 2020, that changed. “I would be getting maybe three to four a month,” recalled Lopez, a TB program supervisor with Cameron County’s health department. In a matter of months, patients seeking care at the county’s two clinics dropped by half. “And then I wasn’t getting any at all,” he said. (DeGuzman, 2/16)

One State Looks To Get Kids In Crisis Out Of The ER — And Back Home 

It was around 2 a.m. when Carmen realized her 12-year-old daughter was in danger and needed help. Haley wasn’t in her room — or anywhere else in the house. Carmen tracked Haley’s phone to a main street in their central Massachusetts community. “She don’t know the danger that she was taking out there,” said Carmen, her voice choked with tears. “Walking in the middle of the night, anything can happen.” (Bebinger, 2/16)

Republican Lawmakers Shy Away From Changing Montana’s Constitutional Right To Abortion 

Republican lawmakers in Montana wield a supermajority that gives them the power to ask voters to approve a constitutional amendment that would break the link between abortion rights and the right to privacy in the state’s constitution. But so far, they haven’t sought to ask voters to make the change, a rewrite that would allow lawmakers to ban or further restrict abortion after the U.S. Supreme Court gave that power back to the states last year. (Houghton, 2/16)

She Sued A Hospital And Lost — But Felt She’d Won 

When a patient faces an outrageous medical bill, they have two choices: Pay the balance or fight. Lauren Slemenda chose to fight. After failing to reach a consensus with the hospital on a fair price, she took the case to small-claims court. (2/16)

The New York Times:
Narcan Is Safe To Sell Over The Counter, Advisers To The FDA Conclude 

Two federal panels of addiction experts on Wednesday unanimously recommended that Narcan, the overdose-reversing nasal spray, be made widely available without a prescription, a significant step in the effort to stem skyrocketing drug fatalities. Making Narcan an over-the-counter drug has been urged by doctors, patient advocacy groups and the Biden administration. (Hoffman, 2/15)

U.S. FDA Panel Backs OTC Opioid Overdose Drug, Proposes Label Changes 

Most panelists emphasized that OTC use of the nasal spray was safe and proposed ways to improve its labeling, to avoid using the drug wrong. Panelist Brian Bateman said there was room for improving the labeling, “but I think the evidence we saw today provides clear indications that the drug can be used without direction of the healthcare provider.” (Satija and Jain, 2/15)

Panel Backs Moving Opioid Antidote Narcan Over The Counter 

The positive vote, which is not binding, came despite concerns from some panel members about the drug’s instructions and packaging, which caused confusion among some people in a company study. The manufacturer, Emergent Biosolutions, said it would revise the packaging and labeling to address those concerns. The FDA will make a final decision on the drug in coming weeks. Panel members urged the FDA to move swiftly rather than waiting for Emergent to conduct a follow-up study with the easier-to-understand label. (Perrone, 2/15)

The Hill:
CBO Warns Of Sharp Uptick In Social Security, Medicare Spending 

Federal spending on Social Security and Medicare is projected to rise dramatically over the next decade, far outpacing revenues and the economy on the whole while putting new pressure on Congress to address accelerated threats of insolvency, according to new estimates from the Congressional Budget Office (CBO). The increase is driven by a variety of factors, including Social Security’s new cost-of-living adjustment, the rising cost of medical services under Medicare and greater participation rates in both programs, as the last of the baby boomers become eligible for retirement benefits. (Lillis, 2/15)

The Hill:
Social Security Set To Run Short Of Funds One Year Earlier Than Expected 

Social Security funds are set to start running a shortfall in 2032, one year earlier than previously expected, the director of the Congressional Budget Office (CBO) said on Tuesday. “The Social Security solvency date — the exhaustion date for the trust fund — is now within the budget window,” CBO Director Phillip Swagel said, referring to the 10-year period covered by the agency’s annual report. (Shapero, 2/15)

Medicare Politics Are On A Crash Course With Reality

There’s an inconvenient truth underneath the politics of Medicare — its finances are simply unsustainable. Medicare is one of the largest line items in the U.S. budget, and as the population ages, it’s expected to only get more expensive. (Owens, 2/16)

Insurers Balk At Proposed Changes To MA Marketing Rules

Medicare Advantage and Medicare drug plans told the Centers for Medicaid and Medicare Services that too much regulation at once could drive up costs and result in increased premiums or fewer benefits. Public comment closed this week on on a proposal to crack down on Medicare Advantage marketing practices, impose other standards on Medicare drug plans and create requirements to increase access to behavioral health and culturally competent care. (Dreher and Goldman, 2/16)

The New York Times:
What We’ve Learned From Presidential Physicals Of Biden, Trump And Obama 

When Barack Obama underwent a routine physical exam as president, his doctor noted that he had moved on from cigarettes to nicotine gum. Bill Clinton’s doctor included details about his fluctuating weight. Richard Nixon’s doctor complained that he didn’t exercise enough. There is no legal requirement to follow when it comes to the president’s checkups, and the amount of information released has always been up to the man himself. But President Biden’s exam on Thursday will get extra scrutiny because, at 80, he is America’s oldest president. (Kanno-Youngs, 2/15)

Moderna Says Covid Vaccines Will Remain Available At No Cost

In an unexpected shift, Moderna has decided not to ask Americans to pay for its Covid-19 vaccine, a move that follows intense criticism over initial plans to charge $110 to $130 per dose after the company pivots from government contracts to commercial distribution. (Silverman and Owermohle, 2/15)

Moderna CEO To Testify In Senate On Proposed Vaccine Price Hike

Senator Bernie Sanders said on Wednesday Moderna Inc’s chief executive officer Stéphane Bancel will testify next month in front of the senate on the drugmaker’s plans to raise the price of its coronavirus vaccine. In January, Sanders had written to Bancel to refrain from quadrupling the price of COVID-19 vaccine, after Moderna said it was considering pricing its vaccine at $110 to $130 per dose in the United States, when it shifts from government contracting to commercial distribution. (2/15)

U.S. NIH Starts Trial For Shionogi’s COVID-19 Pill 

The U.S. National Institutes of Health (NIH) said on Wednesday that it had started a clinical trial to evaluate Japan’s Shionogi & Co Ltd’s experimental oral antiviral drug to treat COVID-19. The drug, S-217622 or ensitrelvir, will be tested in adult patients hospitalized with COVID-19. It is already approved for emergency use in Japan. (2/16)

S. Carolina House Passes Abortion Ban; No Sign Of Budging

For the second time since the U.S. Supreme Court ended federal abortion protections, the South Carolina House has passed a near-total abortion ban — and shows no sign of budging. The lower chamber’s Republican supermajority on Wednesday continued its efforts to make South Carolina the 13th state with a ban from conception. By a 83-31 vote largely along party lines, the House advanced a bill including exceptions for rape, incest, fatal fetal anomaly and the patient’s health and life. (Pollard, 2/16)

Bill Raising Abortion To Homicide Draws Republican Pushback

Newly filed legislation allowing illegal abortions to be prosecuted as homicides drew a quick pushback Wednesday from the state’s anti-abortion attorney general, who warned it would wrongly subject Kentucky women to charges for terminating pregnancies. Republican state Rep. Emily Callaway raised the stakes in the state’s bitter abortion debates when she introduced the measure Tuesday in a state where most abortions are currently banned. (Schreiner, 2/15)

The Wall Street Journal:
Shooting Rattles El Paso Mall Next To Scene Of 2019 Rampage 

One person was killed and three were wounded in a shooting at El Paso’s Cielo Vista Mall Wednesday evening—steps away from the Walmart where an attacker killed 23 people in 2019. Police in the West Texas border city said reports of an active shooter near the mall’s food court came in at 5:05 p.m. local time. An off-duty officer at the mall was at the scene of the shooting within three minutes and detained one suspect, interim police Chief Peter Pacillas said. A second suspect was later taken into custody as well. (Findell, 2/15)

White Supremacist Gets Life In Prison For Buffalo Massacre

A white supremacist who killed 10 Black people at a Buffalo supermarket was sentenced to life in prison without parole Wednesday after relatives of his victims confronted him with pain and rage caused by his racist attack. Anger briefly turned physical at Payton Gendron’s sentencing when a victim’s family member rushed at him from the audience. The man was quickly restrained; prosecutors later said he wouldn’t be charged. The proceeding then resumed with an emotional outpouring from people who lost loved ones or were themselves wounded in the attack. (Thompson and Peltz, 2/15)

The Washington Post:
MSU Students Grew Up On Lockdown Drills. The Shooting Is A Call To Action.

At 21, Zoe Beers has already survived two school shootings. The first was in California when she was 8. The second was this week, as a gunman stormed the Michigan State campus, killing three students and wounding five more. Now, she said, she’s had enough. “No one I know understands what it is like for me, what it is like for us,” she said. “Things needed to change 20 years ago, and they absolutely need to now.” (Rosenzweig-Ziff, Thebault and Khan, 2/15)

The New York Times:
At Michigan State, Balancing Freedom And Safety In The Wake Of Tragedy 

While elementary, middle and high schools in the United States have been transformed in the last generation — with only moderate success — by metal detectors, new security systems, increased screening for visitors and the installation of locks on classroom doors to evade mass shooters, the same changes have not come to colleges and universities. “What we do and what is acceptable from K through 12 is not necessarily acceptable when you get to the college level,” said Anthony Gentile, a professor at John Jay College of Criminal Justice and security adviser to the Newtown Public School District, where the Sandy Hook Elementary School massacre occurred in 2012. “Frankly, anybody can drift onto one of the campuses and do what happened the other day.” (Bosman, Jimenez and McKinley Jr. 2/15)

NBC News:
Roaches In The Operating Room: Doctors At HCA Hospital In Florida Say Patient Care Has Suffered From Cost Cutting

On Dec. 7, 2021, more than a dozen surgeons convened a meeting at their hospital, HCA Florida Bayonet Point in Hudson, Florida. Their concerns about patient safety at the 290-bed acute care facility owned by HCA Healthcare Inc. had been intensifying for months and the doctors had requested the meeting to push management to address their complaints. (Morgenson, Schecter and McFadden, 2/15)

The Washington Post:
St. Elizabeths Hospital Settles Lawsuit Over Water Crisis, Covid 

St. Elizabeths Hospital patients settled a lawsuit with the District-owned psychiatric hospital and the city over allegations that the facility failed to provide needed care during an extended water outage in 2019 and the coronavirus pandemic. As part of the settlement with the three patients, filed Tuesday in federal court, the District agreed to provide a water remediation plan as well as the process for regular testing. (Silverman, 2/15)

Modern Healthcare:
Community Health Systems’ Profits Soar While Operating Income Drops

The Franklin, Tennessee-based for-profit system on Wednesday reported fourth-quarter net income of $414 million, or $3.18 per share, compared with $178 million, or $1.34 per share, a year ago. The results included a $180 million gain from early debt extinguishment and $119 million from HealthTrust Purchasing Group’s sale of CoreTrust Holdings, which closed on Oct. 1. Community Health Systems is a noncontrolling partner in HealthTrust. (Hudson, 2/15)

Modern Healthcare:
CommonSpirit To Purchase 5 Steward Health Care Hospitals

CommonSpirit said on Wednesday it will acquire Steward Health Care’s Utah locations, which include more than 35 clinics and five hospitals—Davis Hospital and Medical Center in Layton; Jordan Valley Medical Center in West Jordan; Jordan Valley Medical Center-West Valley Campus; Mountain Point Medical Center in Lehi; and Salt Lake Regional Medical Center in Salt Lake City—for an undisclosed amount. (Hudson, 2/15)

The Wall Street Journal:
More Women With Breast Cancer Could Skip Harsh Radiation, Study Says 

More older women with low-risk breast cancer could forgo radiation after surgery to avoid further side effects and costs, research showed, as some doctors work to limit tough treatments without hurting survival. Women in the study published Wednesday by the New England Journal of Medicine were 65 and older with early stage breast cancers that could respond to hormone therapy. The women all had surgery and hormone therapy and were divided into a group that underwent radiation and a group that went without it. Ten years after surgery, survival rates in the two groups were almost equal, suggesting more women could skip radiation without affecting their survival. (Abbott, 2/15)

CBS News:
New Method Revolutionizes Heart Transplants

It was moments with his kids that made Jason Banner decide to take a chance on a new method of heart transplantation. The single father of two discovered in 2005 he had a genetic heart condition. Last year, he was hospitalized with an irregular heartbeat that causes poor blood flow. (Lapook, 2/15)

The Boston Globe:
‘It’s Night And Day’: Biogen’s New Alzheimer’s Drug May Spur More Investment In Fighting The Disease

“It’s night and day,” said Dr. Martin Tolar, who has been chief executive of Alzheon for 10 years. The Framingham-based company is in the advanced stages of testing a drug in people whose genes increase their risk of developing Alzheimer’s. “Even a couple years ago it was like the stupidest idea to do something in Alzheimer’s because everything has been failing.” (Cross, 2/15)

Longtime Drug Shortage Leads To Substandard Care For Thousands Of US Bladder Cancer Patients

The End Drug Shortages Alliance (EDSA) is urging pharmaceutical manufacturers to boost manufacturing of Bacillus Calmette-Guerin (BCG), an essential drug for bladder cancer that has been in shortage since 2019. Because of the shortage, an estimated 8,333 US patients with moderate to advanced bladder cancer aren’t receiving optimal care, EDSA said in a white paper based on a November 2022 survey of academic health centers, health systems, and physician practices. (Van Beusekom, 2/15)

Longer, Riskier: Ohio Derailment Exposes Concerns About Train Length

The toxic train derailment in East Palestine, Ohio, is drawing new attention to the dangers of increasingly long freight trains — part of a series of cost-savings efforts by freight railroads that have drawn scrutiny from the industry’s critics. The sheer bulk of the 150-car train that went off the rails Feb. 3 is just one factor investigators are expected to consider amid the unfolding ecological disaster near the Ohio-Pennsylvania border, which caused a massive fireball, forced an evacuation and has left a lingering odor, fears of lasting contamination and thousands of dead fish. But union officials, regulators and congressional researchers say the industry’s trend toward ever-growing train lengths is causing a host of safety concerns that regulators need to address. (Snyder, 2/16)

North Carolina Could Expand Medicaid For As Many As 600,000

With North Carolina’s two legislative chambers at odds over details of a comprehensive plan for health care access, the House gave tentative approval on Wednesday to a linchpin of any agreement with the Senate by voting to expand Medicaid to more low-income adults. With robust bipartisan support, the chamber voted 96-23 to accept more Medicaid coverage available under the 2010 Affordable Care Act. It could cover potentially 600,000 people who usually make too much to qualify for conventional Medicaid but too little to benefit from subsidized private health insurance. The bill still faces one more House vote on Thursday before going to the Senate. (Robertson, 2/15)

Substances Fuel Record Homeless Deaths In Portland, Oregon 

A record 193 homeless people died in Oregon’s Multnomah County, home to Portland, in 2021, a 53% increase compared with the previous year, according to a new county report released Wednesday. Substances contributed to about 60% of those deaths, the report found, mirroring trends seen across the country. (Rush, 2/15)

The Texas Tribune:
Lubbock Has The Highest Rate Of Attempted Suicides Among Texas Children

Adam Hernandez was volunteering at a local middle school in mid-January when a student he mentors asked about his daughter, Jacquelyn. Jacquelyn was three weeks shy of her 18th birthday when she died by suicide in 2018. She left no note, and the unrelenting question was, “Why?” There were exciting moments on her horizon — she had just graduated from high school and wanted to be an EMT, and her sister’s birthday was coming up. (Lozano, 2/16)

Twitter Becomes First Major Social Platform To Allow Weed Ads 

Elon Musk is backing up all his 420 tweets. The owner of Twitter, who sparked a media firestorm after he puffed on a spliff during an appearance on Joe Rogan’s podcast, is making good on speculation that his acquisition of the platform might make it more cannabis-friendly. The company changed its policy to allow U.S. cannabis companies to advertise on its platform Tuesday — although with numerous restrictions. (Zhang, 2/15)

Can Food Be Medicine? And Other Questions About A New Push

After nearly forty years of obscurity, the “food is medicine” movement is having a moment. Multiple federal agencies are working on food is medicine projects, major organizations have pledged hundreds of millions in research funding, and billions more are being invested in food-focused startups. Even the White House has publicly announced its support for the movement, which focuses on the use of healthy food as a medical intervention for certain chronic and diet-related diseases. (Florko, 2/16)

This is part of the KHN Morning Briefing, a summary of health policy coverage from major news organizations. Sign up for an email subscription.

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