�������ýҕ�l

People with health insurance may now represent the majority of debtors American hospitals struggle to collect from, according to medical billing analysts. This marks a sea change from just a few years ago, when people with health insurance represented only about one in 10 bills hospitals considered “bad debt”, analysts said. “We always used to consider bad debt, especially bad debt write-offs from a hospital perspective, those [patients] that have the ability to pay but don’t,” said Colleen Hall, senior vice-president for Kodiak Solutions, a billing, accounting and consulting firm that works closely with hospitals and performed the analysis. (Glenza, 1/11)

Families with workplace health insurance may have missed out on $125,000 in earnings over the past three decades as a result of rising premiums eating into their pay, according to a new JAMA Network Open study. (Owens, 1/17)

Drug companies often increase prices at the start of the new year, and 2024 seems to be no exception. There have been about 600 price hikes so far in January, according to the drug price nonprofit 46Brooklyn Research. But the increases haven't been as steep as they were in some previous years. In the 2010s, drug price hikes were typically much bigger — up to 10% on average (Lupkin, 1/17)

An aide for Defense Secretary Lloyd Austin asked during a 911 call on Jan. 1 that an ambulance arrive to pick Austin up without lights or sirens, according to audio of the call. The 70-year-old’s trip to Walter Reed National Military Medical Center in Maryland, and his ensuing hospitalization, remained secret for days — with even President Biden kept in the dark. “Can the ambulance not show up with lights and sirens? We’re trying to remain a little subtle,” the aide said on the recording, which was obtained by Reuters and heard by The Washington Post. The aide’s name was redacted from the recording. (Ables, 1/17)

Under the Trump administration, the White House Medical Unit -- a joint Defense Department team that provides medical care for the president, vice president and family members and also manages health services for certain high-level officials -- sent ineligible staff members to military hospitals for specialty care and surgeries, the DoD inspector general has found. The medical unit also dispensed hundreds of free prescriptions, including controlled substances, to people in the White House, the DoD inspector general said in a report released Jan. 8. (Kime, 1/16)

Congressional leaders have made another tentative deal to keep the government open and fund key health programs into March, but hospitals and other healthcare industries continue to await action on vital matters. Congress will act this week to advance a third stopgap appropriations bill, which would prevent a partial government shutdown from commencing Friday and fund operations until March 8. The legislation offers only short-term relief for a healthcare sector that needs Congress to approve funding for the rest of fiscal 2024. (McAuliff, 1/16)

The Senate on Tuesday took the first step in advancing a stopgap spending bill to avoid a partial government shutdown at the end of the week, buying time to enact a broader bipartisan funding agreement for the remainder of the year. By a 68-to-13 vote, senators voted to take up the legislation, which would temporarily extend funding for some federal agencies until March 1 and for others through March 8. It would keep spending levels flat while lawmakers and aides hammer out the details of a $1.66 trillion deal reached between Speaker Mike Johnson, the Louisiana Republican, and Democrats. (Edmondson, 1/16)

Sen. Chuck Grassley (R-Iowa) has been admitted to a local Washington hospital to treat an infection, his office announced Tuesday. “Senator Chuck Grassley (R-Iowa) is receiving antibiotic infusions at an area hospital to treat an infection,” Grassley’s office said in a statement. “He is in good spirits and will return to work as soon as possible following doctors’ orders.” Grassley, 90, is the chamber’s oldest member. He earned that distinction after Sen. Dianne Feinstein (D-Calif.) passed away in September after health troubles that consumed her final years in office. (Weaver, 1/16)

The chairman of the Senate Special Committee on Aging is launching a review of safety lapses in the assisted-living industry, saying an investigation by The Washington Post into the deaths of dementia-care residents who have wandered from facilities had revealed “horrific” neglect and a “violation of trust.” In response to The Post’s finding that nearly 100 seniors have died over the past five years after leaving facilities unnoticed or being left unattended outside, Sen. Bob Casey (D-Pa.) sent letters Tuesday to the nation’s three largest assisted-living chain owners seeking information about their practices. The Post’s report is the first nationwide accounting of such deaths. (Rowland, 1/16)

�������ýҕ�l Health News: America’s Health System Isn’t Ready For The Surge Of Seniors With Disabilities 

The number of older adults with disabilities — difficulty with walking, seeing, hearing, memory, cognition, or performing daily tasks such as bathing or using the bathroom — will soar in the decades ahead, as baby boomers enter their 70s, 80s, and 90s. But the health care system isn’t ready to address their needs. (Graham, 1/17)

For lessons on how to age well, we could do worse than turn to Richard Morgan. At 93, the Irishman is a four-time world champion in indoor rowing, with the aerobic engine of a healthy 30- or 40-year-old and the body-fat percentage of a whippet. He’s also the subject of a new case study, published last month in the Journal of Applied Physiology, that looked at his training, diet and physiology. (Reynolds, 1/16)

House Republicans are teeing up two measures that signal their opposition to abortion ahead of the annual March for Life, but for the second year in a row are focusing not on abortion bans but on issues related to unwanted pregnancies in the wake of the Supreme Court’s 2022 decision to overturn Roe v. Wade. (Raman, 1/16)

Two attorneys have asked the Texas Medical Board to clarify what qualifies as a medical exception to the state’s abortion laws, following the Texas Supreme Court’s rejection last month of a Dallas woman’s attempt to terminate her nonviable pregnancy. (Rubin, 1/16)

The American legal system has a message for women concerned about their abortion rights: Don’t make the mistake of thinking that your pharmacist is your friend. Thanks to a gaping loophole in federal health care regulations, some of our leading drug store chains turn over customers’ most sensitive private health care information to law enforcement agencies, even without a warrant. (Hiltzik, 1/16)

An Oklahoma lawmaker wants voters to enshrine into the state Constitution that personhood begins at conception. Rep. Jim Olsen, R-Roland, said House Joint Resolution 1046 would make it more difficult for the Oklahoma Supreme Court justices to “ignore the rights of the unborn” in their rulings. “The justices have this habit of when that issue comes before them, they consider the rights of the woman, which is proper, but they do not consider that the baby also has a right to life,” Olsen said. (Stecklein, 1/16)

After coming up short at the Capitol for more than a decade, backers of a Minnesota equal rights amendment view 2024 as their moment. Ahead of the 2024 legislative session, they’re tweaking a proposed addition to Minnesota’s Constitution to address new concerns around equality. That has meant explicitly spelling out rights to pregnancy and pregnancy outcomes, though authoring groups have not formally agreed to the final draft. (Ferguson, 1/16)

Reproductive rights activists in Missouri agree they want to get a ballot measure before voters this fall to roll back one of the strictest abortion bans in the country and ensure access. The sticking point is how far they should go. The groups have been at odds over whether to include a provision that would allow the state to regulate abortions after the fetus is viable, a concession supporters of the language say will be needed to persuade voters in the conservative state. It’s a divide that’s not limited to Missouri. (Fernando and Ballentine, 1/16)

North Carolina Lt. Gov. Mark Robinson, the state’s second highest-ranking elected official and its leading Republican candidate for governor in 2024, once hailed banning abortion as his top priority, advocating for its complete ban without exceptions. “For me, there is no compromise on abortion. It makes no difference to me why or how that child ended up in that womb,” he said in July 2020 while campaigning for lieutenant governor. ... Now, as the 2024 GOP front-runner for governor, Robinson avoids mentioning abortion on the campaign trail, claiming recently that he stopped using what he calls the “a-word,” preferring instead to use the word “life.” (Kaczynski and Steck, 1/17)

The first pill for postpartum depression approved by the U.S. Food and Drug Administration is now available, but experts worry that minority and low-income people, who are disproportionately affected by the condition, won’t have easy access to the new medication. (Hassanein, 1/16)

At a time when increased abortion restrictions are stoking the demand for shared responsibility, Bill Prentice wants to reinvent the vasectomy. Prentice, 58, a Wall Street trader-turned-entrepreneur, has received regulatory clearance for his five-year-old company, Signati Medical, to test a device he says will bring “a new level of comfort, safety, and speed” to a procedure that’s seen little innovation in the past century. ... If the Food and Drug Administration green-lights Signati’s device, Prentice, the CEO, wants to broadcast the first approved use of the company’s procedure — on himself — on live television. (Weisman, 1/16)

Researchers from the University of California San Diego School of Medicine say a new method can better predict the quality of embryos used for in vitro fertilization, potentially raising the odds of a successful pregnancy for those relying on assisted reproductive technology. (Balthazar, 1/17)

One side effect of the new RSV shots for older Americans: More are winding up getting other preventative tests and services during their vaccine appointments. That tidbit came from UnitedHealth Group's year-end earnings report that showed use of medical services were up, prompting health insurer stocks to dip on Friday. (Reed, 1/16)

"While rates of infections have been coming down - visits to emergency departments and so forth - we are seeing increased hospitalization rates for influenza, as well as for COVID," said Dr. Sharon F. Welbel, an infectious disease physician with Cook County Health. Dr. Larry Kociolek, an infectious diseases physician and the medical director for infection prevention and control at Lurie Children's Hospital, said it is not time right now to let down our guard. (Gonzalez, 1/16)

California’s health department has changed its COVID-19 guidance, which could have significant implications for people of all ages statewide. The new recommendations, issued last week, reflect a more relaxed approach to isolation and testing, allowing people who test positive for COVID-19 but do not have symptoms to return to work and school. ... “Overall, I think this is reasonable given the high proportion of kids with immunity against COVID,” ... said Peter Chin-Hong, an infectious-disease expert at UCSF. (Vaziri, 1/16)

Surgeon General Dr. Joseph Ladapo has expressed concerns about the mRNA vaccine. Two Florida experts are confused by his questions, saying they don't make much sense. (Pedersen, 1/16)

A large staggered cohort study from primary care patients in the UK, Spain, and Estonia finds that COVID-19 vaccination consistently reduced the risk of long-COVID symptoms. The study is published in The Lancet Respiratory Medicine. The study used the World Health Organization’s (WHO) definition of post COVID condition, or long COVID, as new or persisting symptoms 3 months after infection that cannot be explained by alternative causes. The WHO recognizes 25 long COVID symptoms, including fatigue, shortness of breath, and cognitive dysfunction. (Soucheray, 1/12)

A new study from the US Department of Agriculture shows that elk experimentally infected with SARS-CoV-2 did not shed infectious virus but mounted low-level serologic responses, while mule deer shed and transmitted virus and mounted a more pronounced serologic response to the virus. The authors of the study, published in Emerging Infectious Diseases, said the results suggest mule deer could spread COVID-19. (Soucheray, 1/16)

Yesterday in Clinical Infectious Diseases, scientists report on three confirmed people in Michigan who contracted tuberculosis (TB) linked to wild deer and domestic cattle from 2019 to 2022, raising the total number of zoonotic cases in the state to seven since 2002. ... The three infected were a taxidermist, a woman who interacted with deer in the affected area, and a man with no obvious animal exposures and his female household contact. (Van Beusekom, 1/12)

Lifepoint Health and ScionHealth's ownership by Apollo Global Management is the focus of a report by a nonprofit formed to hold private equity buyers accountable for the impact their acquisitions have on services and communities. The report released last week by the watchdog organization Private Equity Stakeholder Project, which criticized the systems' performance and Apollo, follows a recent academic study published in JAMA that raised concerns about higher rates of adverse patient safety events at private equity facilities. (Devereaux, 1/16)

A New Jersey long-term care hospital and some of its investors have agreed to pay more than $30 million to settle claims that the hospital fraudulently overbilled Medicare, with investors pocketing the extra funds, federal prosecutors announced Tuesday. Silver Lake Hospital in Newark will pay the government $18.6 million, plus interest, while the investors will pay $12 million, plus interest, according to New Jersey U.S. Attorney Philip Sellinger. The investors' share will come from Silver Lake's principal investor, Richard Lipsky, and from Columbus Management South, an entity through which other investors received cash from the hospital. (Pierson, 1/16)

Bill Gates believes a key way to combat climate change is improving access to health care in developing countries, an area the billionaire philanthropist worries that governments are neglecting. “Global health is a little bit off the radar right now,” he said on Tuesday in an interview at the Bloomberg House in Davos. “For the next ten years, where money is going to be so limited, if you want to care about climate impact, the health spending should go up, not down.” (Lacqua and Bergen, 1/16)

Marshfield Clinic Health System said Tuesday it plans to furlough about 3% of its workforce. A spokesperson for the Marshfield, Wisconsin-based health system said in a statement the furloughs will occur mostly in non-patient-facing departments, including leadership roles. The spokesperson did not provide details on when the furloughs would take effect or how long they would last. (Hudson, 1/16)

The National Labor Relations Board has certified the union election of more than 130 Allina Health doctors, following its nearly yearlong investigation into objections raised by the health system. Although physicians at Mercy Hospital and its Unity campus in Fridley and Coon Rapids, Minnesota, voted to join Doctors Council SEIU in March 2023 by a margin of 2-to-1, the election was not certified until Jan. 10. (Devereaux, 1/16)

Roseman University is looking to expand and bring a medical degree program to Summerlin. The university on Tuesday unveiled a $500-$550 million three-phase plan to expand its campus in Summerlin from a few office buildings to a full-fledged medical school campus. The expansion will take place on the 32 acres of undeveloped land that Roseman University already owns. It could be completed by 2032, the university said. (Hemmersmeier, 1/16)

Detroit-based Henry Ford Health System has filed a lawsuit against the U.S. Citizenship and Immigration Services for denying two of its Canadian radiologic technologist employees U.S. work visas, according to a lawsuit obtained by Becker's. Tibor Hric, a Canadian citizen named in the lawsuit, has been with Henry Ford since 2009. ... "Their absence has created critical staffing issues that have negatively impacted Plaintiff's ability to deliver patient care," the lawsuit said. (Ashley, 1/16)

The Supreme Court let stand a lower court ruling allowing transgender students in Indiana to access school restrooms and locker rooms consistent with their gender identity Tuesday. The justices in a brief order denied a request from a central Indiana school district to hear the case, which centers around a now-teenage transgender boy, identified in court documents as A.C., who was barred from using the boys restrooms at his former middle school. (Migdon and Schonfeld, 1/16)

For the last two years, Koen has routinely self-administered weekly testosterone injections without a second thought. During that time, the trans 17-year-old said his self-image and school and family life has drastically improved. His fear of needles, too, has faded. ... At the start of the year, though, a greater worry emerged. A new law banning gender-affirming care for minors in Louisiana took effect on Jan. 1 prohibiting puberty blockers, hormone treatment, and gender-reaffirming surgery. Now, Koen isn’t sure he could continue his hormone treatment. (Chavez, 1/16)

Gov. Gavin Newsom extinguished an effort to ban youth tackle football in California on Tuesday, vowing to veto a measure that was gaining support among Democrats but emerging as a new front in the culture wars. Newsom, in a statement shared exclusively with POLITICO, said he would not sign proposed first-in-the-nation legislation to ban the sport for children 12 and under because of concerns about head injuries. “I am deeply concerned about the health and safety of our young athletes, but an outright ban is not the answer,” Newsom said. (He, Bluth and Cadelago, 1/16)

One of the first lessons Scott Brettell teaches his high school students is the importance of being last. The last person to stay with someone through their last moments — even if only over the phone. (Breunlin, 1/17)

Kelly Causey is the deputy commissioner of the BHA. "We can't just assume that they are mini-adults, and they experience our systems in that same way," Causey said. Working with several other state agencies, she says they've identified more than 100 action items to make immediate improvements. They include things like developing an early childhood mental health consultation program, enhancing school-based mental healthcare and a renewed focus on building a workforce. (Morfitt, 1/16)

�������ýҕ�l Health News: ‘I’m Not Safe Here’: Schools Ignore Federal Rules On Restraint And Seclusion 

Photos show blood splattered across a small bare-walled room in a North Carolina school where a second grader repeatedly punched himself in the face in the fall of 2019, according to the child’s mom. His mother, Michelle Staten, said her son, who has autism and other conditions, reacted as many children with disabilities would when he was confined to the seclusion room at Buckhorn Creek Elementary. “I still feel a lot of guilt about it as a parent,” said Staten, who sent the photos to the federal government in a 2022 complaint letter. “My child was traumatized.” (Clasen-Kelly, 1/17)

Two Florida lawmakers have co-sponsored a bill that would put extra safeguards in place for students with special needs at risk of running away from school, also referred to as elopement or wandering. Autistic students are nearly four times as likely as their nonautistic peers to try to leave school unattended. That’s according to the National Autism Association. (Prieur, 1/16)

A Colorado father, driven by grief, is pushing to make Colorado among the first states in the country to regulate the sale of sodium nitrate. The preservative, used to cure meat, is deadly in its concentrated form, which is widely available online and in some sporting goods stores. Bruce Brown's son is among a growing number of people who have used it to end their lives. ... The 17-year-old suffered from long-term COVID and it exacted a toll, not only on his physical health but his mental health too. (Boyd, 1/16)

An advisory group formed to help Michigan tackle high rates of opioid  overdoses in communities of color has been disbanded by Gov. Gretchen Whitmer’s administration, leading to hard feelings among some members who say their work is being buried. The Whitmer administration is “trying to…silence in a systematic way the voices of the Racial Equity Workgroup,” said Native American activist Banashee “Joe” Cadreau, a workgroup member. “For two years, we put our blood, sweat, tears, thoughts, time, to …. (come) up with these recommendations.” (Erb and French, 1/16)

Two cities are trying to become digital health hubs and create their own Silicon Valley. Economic development leaders in Kansas City, Missouri, and Fort Worth, Texas, want to foster an environment that will attract digital health entrepreneurs and investors, adding their municipalities to the list of cities building healthcare tech ecosystems. (Perna, 1/16)

The shooter who killed five people and injured 19 others at an LGBTQ nightclub in Colorado Springs in 2022 intends to plead guilty to 74 federal counts, including 50 federal hate crimes, according to court documents unsealed Tuesday. Anderson Lee Aldrich, 23, reached a plea agreement with federal prosecutors to plead guilty to 50 hate crime charges and 24 firearm violations, according to court documents filed in a U.S. District Court in Colorado. (Nazzaro, 1/16)

"If you see something, say something." ...A concept embraced by the Say Something Anonymous Reporting System, started by the non-profit Sandy Hook Promise Foundation. ... A new study, published in the journal Pediatrics Wednesday, evaluated the tip line as it was used by one southeastern state — North Carolina — to see how successful it was at catching firearm-related threats. Researchers found there were more than 18,000 tips submitted during the four years studied, from 2019 to 2023. "What we found is that 10% of tips contain reference to a firearm." (Chatterjee, 1/17)

ResMed said its respiratory masks containing magnets will remain on the market even though the U.S. Food and Drug Administration classified a recall of the product as most serious as their use could cause major injuries or death. The California-based medical device maker, which started the recall process on Nov. 20, said the classification was due to a correction in the labeling and is not a product removal. (1/16)

A therapy based on CRISPR gene-editing technology that the Food and Drug Administration approved in December for sickle cell disease can be used for a second inherited blood disorder, the agency said on Tuesday. (Bettelheim, 1/17)

When Kelsey Brown met Mohammed, the 15-year-old Ugandan boy looked terribly worried. He was in the late stages of rheumatic heart disease, which kills about 400,000 people a year worldwide. His scheduled heart surgery to address the illness had been postponed a day. By this point, fluid that backed up from Mohammed’s heart into his lungs made it so hard to breathe that he had to sleep sitting upright. Brown, a cardiology fellow at Children’s National Hospital in Washington, assumed that he was anxious about undergoing the surgery. But Mohammed told her that he was not scared to face the procedure. (Johnson, 1/16)

The chemotherapy Christine Ko was prescribed for her breast cancer is pretty much a guarantee for losing your hair. The intervention her doctors offered to prevent the hair loss was a cold cap that, cooled to 32 degrees Fahrenheit, would turn her scalp into an icy crown. But, to her, it wasn’t much of an option. (Chen, 1/17)

Washington University has joined up with a New York investment firm to launch a new drug research and development business, the school announced Tuesday. Deerfield Management Co. has committed up to $130 million over the next decade. The new company will be called VeritaScience, a nod to the university’s motto, “Per Veritatem Vis,” or “Strength Through Truth.” (Merrilees, 1/16)

More than half of those responsible for registering clinical trials and reporting results fail to do so over confusion about key requirements, according to a new survey that highlighted ongoing difficulties in achieving transparency surrounding study data. (Silverman, 1/16)

�������ýҕ�l Health News: Listen To The Latest '�������ýҕ�l Health News Minute' 

This week on the �������ýҕ�l Health News Minute: A national shortage of Adderall leaves people with narcolepsy struggling to live normal lives. and researchers find little evidence that mental health courts are keeping those who need them most out of lockup. (1/16)

A study led by Centers for Disease Control and Prevention (CDC) researchers suggests the high volume of topical antifungal prescribing could be feeding the emergence and spread of antifungal-resistant infections. Published yesterday in Morbidity and Mortality Weekly Report, the study found that 6.5 million topical antifungal prescriptions valued at $231 million were filled for Medicare Part D beneficiaries in 2021, nearly half of which were written by high-volume prescribers. And many of these prescriptions could be inappropriate. (Dall, 1/12)

CARB-X announced today that it is awarding Dutch contract development and manufacturing organization Intravacc $633,000 to develop a vaccine for gonorrhea. The money will help support early-stage development of Intravacc's meningococcal outer membrane vesical (OMV) vaccine, which carries tailored gonococcal antigens designed to prevent infections caused by the Neisseria gonorrhoeae bacterium. (Dall, 1/16)

Predicting how molecules will react is vital for the discovery and manufacture of new pharmaceuticals, but historically this has been a trial-and-error process, and the reactions often fail. To predict how molecules will react, chemists usually simulate electrons and atoms in simplified models, a process which is computationally expensive and often inaccurate. (University of Cambridge, 1/15)

The use of the antipsychotic drugs quetiapine and haloperidol is associated with an increased risk of ventricular arrhythmias and sudden cardiac death (SCD) caused by drug-induced QT prolongation, reports a new study. Caution is advised to manage cardiac risks in patients prescribed these medications, the authors of the study and an accompanying editorial say. (Elsevier, 1/15)

The US pays 50% more per capita for prescription drugs than Canada. Frustrated by this discrepancy, a handful of states in recent years have developed plans to import cheaper medications from across the border. Florida recently became the first state to get approval from the Food and Drug Administration to do so. (1/16)

Canada too has a powerful pharmaceutical lobby. According to news reports, it has stifled the review board’s most recent price-control undertakings. The director and two board members resigned, with one of them blaming the Canadian government for surrendering to industry pressure. The important difference is still that Canada has comprehensive price controls, however effective they may be, and the U.S. does not. Our consumers will continue to be stiffed until we have them too. (1/15)

In this Double Take video from the New England Journal of Medicine and NEJM Knowledge+, L.J. Punch (the T St. Louis, a harm-reduction program), Sarah Bagley (Boston Medical Center), Jennifer Foreman (Randolph Health Medical Group), and Scott Hadland (Massachusetts General Hospital for Children) review how primary care providers can best care for patients with opioid use disorder. They guide clinicians on how to diagnose the disorder, build trust with patients, offer counseling on harm reduction, and use medications to treat addiction and withdrawal symptoms. (Sarah Bagley, M.D., et al, 1/11)

The American legal system has a message for women concerned about their abortion rights: Don’t make the mistake of thinking that your pharmacist is your friend. Thanks to a gaping loophole in federal health care regulations, some of our leading drug store chains turn over customers’ most sensitive private health care information to law enforcement agencies, even without a warrant. (Michael Hiltzik, 1/16)

IVF has the potential to realize the dreams of many would-be parents, but thousands of women of reproductive age in the U.S. may face barriers to accessing treatment — sometimes, even before setting foot in a fertility clinic. These women all have something in common: They have a body mass index that categorizes them as obese or severely obese. (Becca Muir, 1/14)

A cluster of measles cases in the Northeast is putting a spotlight on how easily the highly contagious disease can spread — and how dangerous any further slip in childhood vaccination rates could be. (Lisa Jarvis, 1/16)

The failure of Geisinger Health System, which lost $842 million in 2022 and disappeared into a new Kaiser subsidiary called Risant, sent shockwaves through the health care community in the spring of 2023. (Jeff Goldsmith, 1/17)

When Pamela Daly got new wheelchair brakes, they rattled and didn’t work. She complained to the manufacturer but after a month was still waiting for replacements. Daly, a disability rights advocate, was late to an event at the State House because the chair slipped while she was getting into it and she fell to the floor and had to call paramedics. (1/17)