Friday, January 6, 2023 – Kaiser Health News

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Kaiser Health News Original Stories
More Orthopedic Physicians Sell Out to Private Equity Firms, Raising Alarms About Costs and Quality
While some doctors seem eager for a huge payoff, others are warily watching what happens when private equity firms take charge of orthopedic practices. (Harris Meyer, )
During In-Flight Emergencies, Sometimes Airlines’ Medical Kits Fall Short
U.S. airlines have response plans for passengers who run into health issues in flight, but planes carry limited and sometimes incomplete medical supplies that can put travelers at risk. (Vignesh Ramachandran, )
KHN’s ‘What the Health?’: Year-End Bill Holds Big Health Changes
The year-end spending bill passed by Congress in late December contains a wide array of health-related provisions, including a structure for states to begin to disenroll people on Medicaid whose coverage has been maintained through the pandemic. Meanwhile, the Biden administration is taking steps to make the abortion pill more widely available. Joanne Kenen of the Johns Hopkins Bloomberg School of Public Health and Politico, Rachel Cohrs of Stat, and Rachel Roubein of The Washington Post join KHN’s chief Washington correspondent Julie Rovner to discuss these topics and more. Also this week, Rovner interviews Mark Kreidler, who reported and wrote the latest KHN-NPR “Bill of the Month” feature about a billing mix-up that took about a year to sort out. ( )
Here's today's health policy haiku:
SANE makes real-time sense —
Example of equity
for rural women
– Sharon Yee
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.
After Roe V. Wade
South Carolina's 6-Week Abortion Ban Overturned By State's Supreme Court
In a 3-2 decision, the South Carolina Supreme Court struck down a state law banning abortion when an ultrasound detects a fetal heartbeat. Justice Kaye Hearn wrote in the majority opinion: “Six weeks is, quite simply, not a reasonable period of time for these two things to occur, and therefore the act violates our constitution’s prohibition against unreasonable invasions of privacy."
CNBC: South Carolina Supreme Court Overturns State Abortion Ban
The South Carolina Supreme Court on Thursday overturned the state’s ban on abortion after around six weeks of pregnancy, ruling that the law violated the state’s constitutional right to privacy. The 3-2 decision comes nearly seven months after the U.S. Supreme Court’s bombshell ruling voiding the federal constitutional right to terminate pregnancies. (Mangan, 1/5)
The Post and Courier: SC Supreme Court Tosses Out 6-Week Abortion Ban, Leaving It Legal Through 22 Weeks
The decision means abortion remains legal in South Carolina through 5½ months into a pregnancy, as per a 2016 law signed by then-Gov. Nikki Haley. It strikes the 2021 law signed by Gov. Henry McMaster that banned abortions once an ultrasound detects cardiac activity. Since that can occur as early as the sixth week, the law is commonly referred to as a six-week ban. (Adcox, 1/5)
ABC News: South Carolina's Supreme Court Strikes Down 6-Week Abortion Ban
"We hold that the decision to terminate a pregnancy rests upon the utmost personal and private considerations imaginable, and implicates a woman's right to privacy," Justice Kaye Hearn wrote in the majority opinion. "While this right is not absolute and must be balanced against the State's interest in protecting unborn life, this Act, which severely limits — and in many instances completely forecloses — abortion, is an unreasonable restriction upon a woman's right to privacy." (Kakatos, 1/5)
The Hill: South Carolina Supreme Court Strikes Down Six-Week Abortion Ban
Under the law, abortions were banned when a fetal heartbeat was detectable, which usually occurs around six weeks; South Carolina Supreme Court Justice Kaye Hearn noted that was before many people know they are pregnant. In her opinion, Hearn rejected the argument put forth by the South Carolina state government that the constitutional rights to privacy were limited by the absence of language mentioning bodily autonomy and medical care, an argument that states with similar laws have previously made. (Choi, 1/5)
AP: South Carolina Supreme Court Strikes Down State Abortion Ban 
The decision marked a significant victory for abortion rights’ advocates suddenly forced to find safeguards at the state level after the U.S. Supreme Court overturned Roe v. Wade in June. With federal abortion protections gone, Planned Parenthood South Atlantic sued in July under the South Carolina constitution’s right to privacy. Restrictions in other states are also facing challenges, some as a matter of religious freedom. (Pollard, 1/6)
Idaho's High Court Tosses Out Lawsuits Challenging Near-Total Abortion Ban
Idaho's Supreme Court upheld three state laws that ban nearly all abortion and allow prosecution of medical providers, ruling that there is "no implicit right" to abortion in the Idaho constitution. On the heels of South Carolina's high court ruling the other way, the contradictory decisions offer a prime example of the complicated legal landscape in the U.S.
Politico: Idaho Supreme Court Upholds Near-Total Abortion Ban 
The Idaho Supreme Court upheld multiple state laws prohibiting abortion in the state on Thursday, ruling that there is no implicit right to abortion in the state’s constitution. In a 3-2 decision, the court ruled that three state laws — prohibiting abortion at conception and after six weeks of pregnancy, as well as a Texas-style civil enforcement measure — are constitutional as the state has a “legitimate interest in protecting prenatal fetal life in all stages of development, and in protecting the health and safety of the mother.” (Messerly, 1/5)
The Hill: Idaho Supreme Court Upholds State Laws Restricting Abortion 
In Thursday’s decision, the Idaho Supreme Court echoed the U.S. Supreme Court’s reasoning for overturning Roe v. Wade last June, finding that the right to an abortion is not “deeply rooted” in the state’s traditions and history. “When we apply that test to this dispute, there simply is no support for a conclusion that a right to abortion was ‘deeply rooted’ at the time the Inalienable Rights Clause was adopted,” Justice Robyn Brody wrote in the majority opinion. (Shapero, 1/5)
In abortion updates from Minnesota —
AP: Abortion Rights Bill Fast-Tracked In Minnesota To Become Law 
A bill to strengthen abortion rights in Minnesota is on the fast track to becoming law as it passed its first test Thursday. A House health panel approved the legislation, which codifies protections into state statutes, 11-8 on just the third day of the 2023 session and sent it to its next committee stop on an expedited path to a House floor vote. Backers hope to put the bill on Democratic Gov. Tim Walz’s desk for his signature by the end of the month. (Karnowski, 1/5)
Minnesota Public Radio: Abortion Access Bill Advances As Ground Shifts On Issue At MN Capitol
After the Supreme Court last year overturned the federal right to an abortion and left a patchwork of legal abortion options around the country, Minnesota lawmakers are considering cementing the right in state law. Minnesotans have a constitutional right to abortion under a 1995 state Supreme Court case, but some say that’s not enough. (Ferguson, 1/5)
In abortion updates from Illinois, Texas, and Kansas —
Chicago Tribune: Illinois House Sends Measures On Guns, Abortion To Senate.
With Democratic Gov. J.B. Pritzker seated in the front row of the chamber, the Illinois House early Friday approved a sweeping ban on high-powered firearms about two hours after voting to shore up the state’s already expansive protections for abortion rights. Both measures were at the top of the agenda for the Democratic-controlled legislature, and now head to the Senate. (Gorner and Petrella, 1/6)
Houston Chronicle: Texas Abortion Laws Force Houston OB-GYN Residents Out Of State
“There is no question that the restrictions in place following the Dobbs decision pose a risk to the training of up to 45 percent of OB-GYN residents who are training in states where abortion care is restricted,” said Dr. AnnaMarie Connolly, chief of education and academic affairs at the American College of Obstetricians and Gynecologists. “The joint efforts of ACOG … and countless residencies in protected states are directly addressing this risk to medical education and training.” (Gill, 1/5)
Topeka Capital-Journal: Voters In Kansas Rejected An Abortion Amendment After Roe Fell, But The Debate Is Far From Over
Voters on Aug. 2 defied expectations by rejecting a measure that would have eroded constitutional abortion rights protections in Kansas. But the issue remains a live one in Kansas, as lawmakers are said to be considering running with a variety of abortion-related measures when they return to Topeka next week for the annual legislative session. (Bahl, 1/5)
FDA Steady On Abortion Pills: Rejects Pushes To Widen, Restrict Access
Media outlets report on efforts to: limit abortion pill access, from a conservative group; and to expand access, from a medical group seeking more use of mifepristone in miscarriages. Meanwhile, the Boston Globe reports on how some pharmacies may, or may not, decide to dispense the drugs.
The Hill: FDA Rejects Petitions On Abortion Pills From Left- And Right-Leaning Groups
The Food and Drug Administration (FDA) this week denied two citizen petitions from groups related to accessing mifepristone, a drug used in medication abortion. The petitions came from a conservative group seeking to restrict the use of the drug, and also from a medical group seeking to expand its use for a new indication. In denying both, the agency appears to be holding its ground on abortion pills, which have rapidly become the newest flashpoint in the fight over abortion. (Weixel, 1/5)
Politico: FDA Stays The Course On Abortion Pills, Rejecting Demands From The Left And Right 
The FDA rejected a demand from the anti-abortion group Students for Life to prohibit most prescriptions via telemedicine and revert back to the 2011 restrictions on the drug that the FDA has loosened by allowing the pill to be prescribed over the phone, sent by mail, and picked up at a local pharmacy. … The FDA also rejected a petition from the American College of Obstetricians and Gynecologists (ACOG) to make the pills easier to obtain for patients using them to treat a miscarriage rather than an elective abortion. (Ollstein, 1/5)
Also —
The Boston Globe: The FDA Allowed Pharmacies To Dispense Abortion Pills. But Will They Do It?
Mike Wilson, president of the Massachusetts Independent Pharmacists Association, said that he expects that most of the state’s approximately 80 independent community pharmacies will take on the task. “This will be a huge step toward increasing access and personal autonomy,” said Rebecca Hart Holder, president of Reproductive Equity Now, a Massachusetts-based advocacy group. “This mainstreams abortion care.” (Freyer, 1/5)
Covid-19 Crisis
NIH Launches Remote Program For Covid Testing, Consults, Treatments
The National Institutes of Health's new pilot program is designed to allow people to receive free covid-related telehealth care, and it's thought up to 8,000 people may use the "Home Test to Treat" site. Meanwhile, the latest worrisome covid variant is driving up hospitalizations on the East Coast.
The Hill: Biden Administration Launches Pilot Program For COVID-19 Telehealth Care 
The National Institutes of Health (NIH) on Thursday announced the launch of a pilot program that will allow people to receive free testing, consultation and treatment for COVID-19 from their homes. The NIH estimated up to 8,000 eligible individuals will participate in the pilot program, called the Home Test to Treat program, which will be led by local and state officials in Berks County, Pennsylvania. (Choi, 1/5)
Reuters: NIH Launches Pilot COVID Telehealth Program
EMed, a privately-owned at-home health services firm, will host the official Home Test to Treat website, where individuals can sign up to receive antiviral treatment delivery as well as to coordinate telehealth-enabled test kits. The public health agency has also engaged the UMass Chan Medical School in Worcester, Massachusetts, to collaborate with eMed on analyzing the data collected from the telehealth program such as the impact of a home-based process on testing and treatment. (1/5)
More on the spread of covid —
San Francisco Chronicle: XBB.1.5 Driving Up Hospitalizations On East Coast
The pace of new COVID-19 hospital admissions is rapidly rising in regions where XBB.1.5 has become dominant. The latest omicron offshoot has been labeled the most infectious coronavirus subvariant to date and made up about 75% of new sequenced cases on the East Coast last week, according to data published last Friday by the U.S. Centers for Disease Control and Prevention. (Vaziri, 1/5)
The Atlantic: How Worried Should We Be About The XBB.1.5 Subvariant?
After months and months of SARS-CoV-2 subvariant soup, one ingredient has emerged in the United States with a flavor pungent enough to overwhelm the rest: XBB.1.5, an Omicron offshoot that now accounts for an estimated 75 percent of cases in the Northeast. A crafty dodger of antibodies that is able to grip extra tightly onto the surface of our cells, XBB.1.5 is now officially the country’s fastest-spreading coronavirus subvariant. (Wu, 1/5)
The Boston Globe: With Cold And Flu Medicine Shortages, Not Enough Relief For Sick Kids — And Some Adults
With cases of COVID-19, the flu, and RSV surging this winter, children’s cold and flu medicines are growing sparse on drugstore shelves. And even some adult varieties are proving harder than usual to find. An “unprecedented level of respiratory need” — as over-the-counter drugmaker Procter & Gamble put it in a statement — has local pharmacies struggling to keep pediatric products like liquid Motrin or Tylenol on shelves. (Gerber, 1/5)
On testing travelers from China —
AP: As COVID Surges In China, US Begins Testing More Travelers
Shubham Chandra knows how dangerous the coronavirus can be: He lost his dad during the pandemic. So when he cleared customs at Newark Liberty International Airport and saw people offering anonymous COVID-19 testing, he was happy to volunteer. “It’s a minimum amount of effort to help a lot of people,” said the 27-year-old New York City man, who had just stepped off a plane from Cancun, Mexico. (Ungar and Lum, 1/5)
Reuters: Greece To Require Negative COVID Tests For Travellers From China 
Air travelers to Greece from China must show they have tested negative for COVID-19 48 hours before arrival, a new requirement that will be announced shortly, two government officials said on Thursday. (1/5)
In other pandemic news —
AP: Judge: Tennessee Must Release Consultant COVID Response Docs 
A Tennessee judge has ordered Gov. Bill Lee’s administration to release consultant reports that recommend how to respond to the COVID-19 pandemic — documents the state argued should remain secret under public records law. (Mattise, 1/6)
CNBC: What Long Covid Patients Need To Know About Health Insurance
Navigating the health insurance system is often difficult and overwhelming, even in the best of times. For patients with long Covid, a relatively new condition that frequently leaves patients with a lengthy and unpredictable list of debilitating symptoms, it can be especially nightmarish. (Nova, 1/5)
CIDRAP: Study Notes Racial Disparities In Kids' COVID Vaccine Uptake 
COVID-19 vaccination rates among US children aged 5 to 17 years varied widely by race as of August 2022, with the highest coverage among Asian youth and the lowest in Black children, underscoring the need for culturally relevant information, according to a study published today in Morbidity and Mortality Weekly Report. (Van Beusekom, 1/5)
Administration News
Biden Will Use Title 42 Health Policy To Expel Migrants From 4 Nations
President Joe Biden has repeatedly decried use of the pandemic-era border measure and even declared Thursday, "I don't like Title 42" — just moments after making a speech saying he would rapidly expel migrants from Cuba, Haiti, Nicaragua, and Venezuela entering the U.S. illegally.
The Wall Street Journal: Biden Administration Leans On Trump-Era Policies To Combat Migrant Wave 
Beginning on Thursday, the administration will use a pandemic-era border measure known as Title 42 to rapidly expel migrants from Cuba, Haiti, Nicaragua and Venezuela, the countries that have posed the greatest challenge to the administration in the past year. The administration is taking the step even as the Supreme Court prepares to hear oral arguments in the case and the administration has argued that the measure is no longer justified on public-health grounds and must end. (Hackman and Parti, 1/5)
CNN: The Biden Administration Keeps Shifting Its Stance On A Controversial Policy
President Joe Biden just made a point that’s surprising to those of us who’ve been closely following his administration’s approach to migration at the southern border. “I don’t like Title 42,” Biden told reporters following a speech at the White House Thursday afternoon. That comment was startling because it came minutes after his administration announced a program that effectively expands the controversial public health restrictions yet again. (Shoichet, 1/5)
In related news about immigration —
The Texas Tribune: Texas AG Ken Paxton Sues Biden Over “Public Charge” Enforcement 
Texas Attorney General Ken Paxton filed a lawsuit on Thursday against President Joe Biden, accusing his administration of nullifying a federal law that prevents immigrants from obtaining a green card if they are likely to depend on government social services. … In 2019, the Trump administration expanded a rule that would allow immigration officials to deny permanent resident status — also known as a green card — to immigrants if they previously received or in the future expected to receive food assistance, Medicaid, housing assistance or other public benefits. (Garcia, 1/5)
In other administrative health updates —
Bloomberg: Biden EPA Backs Off Plan To Crack Down On Smog From Permian Oil Drillers 
The Biden administration is deferring a plan to crack down on smog in the drilling hotbed of the Permian Basin, handing a win to oil producers along with their allies in Texas and New Mexico. The Environmental Protection Agency had been considering formally labeling parts of the region as violating federal air quality standards for ozone — a designation that would have spurred new pollution curbs and potentially deterred drilling in the world’s biggest oil field. (Dlouhy, 1/5)
KHN: KHN’s ‘What The Health?’: Year-End Bill Holds Big Health Changes 
The year-end government spending bill includes a lot of changes to federal health programs, including changes to Medicare payments and some structure for states to begin to disenroll people on Medicaid whose eligibility has been maintained through the pandemic. Separately, the Biden administration took several steps to expand the availability of the abortion pill, which in combination with another drug can end a pregnancy within about 10 weeks of gestation. Anti-abortion forces have launched their own campaign to limit the reach of the abortion pill. (1/5)
Lifestyle and Health
First-Of-Its-Kind Autism Test Could Help With Earlier Diagnosis
LinusBio researchers say they've developed a test using a single strain of hair that could be used by clinicians as a diagnostic tool before symptoms of autism manifest. Other news reports on mpox, polio, Parkinson's, and others.
NBC News: A New Test For Autism Hopes To Help Doctors Diagnose Before Symptoms Show
Researchers have developed a first-of-its-kind test for autism that they say can find markers of risk in a single strand of hair, an innovation that might help clinicians identify it in young children before they miss developmental milestones. (Bush, 1/5)
In updates on mpox and polio —
CIDRAP: Study Finds Few Mpox Infections After One Vaccine Dose
A large study of patients seen at sexual health clinics in London found low numbers of mpox cases after vaccination with one dose of modified vaccinia Ankara (MVA-BN) vaccine. … In the early months of the mpox outbreak, health officials embraced a one-dose vaccine strategy to stretch limited supplies of the vaccine while acknowledging that the immune boost following one dose of the two-dose vaccine might not be enough. (Schnirring, 1/5)
CIDRAP: Canada Detects Poliovirus In Wastewater Samples 
Two days before Christmas, Canada reported vaccine-derived poliovirus type 2 (VDPV2) from two wastewater samples to the World Health Organization (WHO), the WHO's Pan American Health Organization (PAHO) said in a Dec 30 epidemiologic update. The Canadian samples that tested positive for the virus were collected in August as part of sampling targeted to areas with close connections to communities in New York where similar wastewater positive samples were found earlier. A third positive environmental sample from Canada, also collected in August, is pending confirmation by virus isolation. (Schnirring, 1/5)
On aging —
CBS News: Why Doctors Say Playing Ping-Pong Could Help Manage Parkinson's Disease Symptoms
When 67-year-old Roben Seltzer was diagnosed with Parkinson's disease three years ago, his symptoms were so bad he could barely get out of bed. He was treated with physical therapy and medication to manage symptoms like tremors, stiffness and slowness. His doctor also offered him a surprising treatment option: ping-pong. (Oliver and Novak, 1/5)
Fox News: Healthy Aging And Drinking Water: Fascinating Findings From A New Study
Nearly half of people worldwide do not get the recommended daily total water intake, a new report indicates. Yet drinking enough water may help to delay the aging process for many. A recent study by the National Institutes of Health (NIH) published in eBioMedicine suggests as much — though there are caveats to know. (McGorry, 1/5)
Des Moines Register: America's Oldest Person, Bessie Hendricks, Dies At 115 In Lake City
Bessie Hendricks of Iowa lived through the roaring '20s, the Great Depression, two World Wars, the dawn of the internet age and a global pandemic. At age 115, she was believed to be the oldest person in America when she died Tuesday at the Shady Oaks Care Center in Lake City. (Block, 1/4)
Annual Price Of New US Drugs In 2022 Hit Median Of $200K
An analysis by Reuters found the price of novel drugs approved by the Food and Drug Administration during 2022 had a median annual value of $222,003. Separately, reports say the ADHD drug shortage has now spread to affect generic Ritalin and Concerta, as Adderall supplies remain limited.
Reuters: U.S. New Drug Price Exceeds $200,000 Median In 2022
After setting record-high U.S. prices in the first half of 2022, drugmakers continued to launch medicines at high prices in the second half, a Reuters analysis has found, highlighting their power despite new legislation to lower costs for older prescription products. The median annual price of the 17 novel drugs the U.S. Food and Drug Administration (FDA) approved since July 2022 is $193,900, down from $257,000 in the first half of 2022, Reuters found. For full year 2022, the median was $222,003. (Beasley, 1/5)
In other pharmaceutical news —
Bloomberg: ADHD Drug Shortages Affect Generic Ritalin, Concerta Amid Adderall Supply Issues
For the past two months, patients have had a hard time finding methylphenidate drugs, a class that includes Novartis AG’s Ritalin and Johnson & Johnson’s Concerta. A drug manufacturer and a major pharmacy told Bloomberg News there are issues with the supply of the drugs, though it’s unclear what’s causing the shortage. (Swetlitz, 1/5)
Axios: 2023 Could Be A Banner Year For New Prescription Drugs
A group of pricey breakthrough prescription drugs are poised to shake up the market this year — including an Alzheimer's treatment that could be approved today by the FDA. Though the drugs offer hope to patients with hard-to-treat conditions like Alzheimer's or sickle cell disease, or who struggle with obesity, their potentially eye-popping prices are sure to create dilemmas for insurers, government programs and patients themselves. (Owens, 1/6)
Axios: The Bad Business Of Developing New Antibiotics
Everyone agrees that the world needs new antibiotics, as the number of drug-resistant infections continues to soar. But there's little agreement on how to finance their development, and the situation is deteriorating. (Primack, 1/5)
Axios: Johnson & Johnson Sets Up Mega-IPO For Consumer Health Unit
Johnson & Johnson on Wednesday filed IPO registration papers for its consumer health products business, which is being spun out under the name Kenvue. This could be the largest U.S. IPO since Rivian went public in late 2021, with Renaissance Capital estimating that Kenvue could raise up to $5 billion. It also encompasses a slew of household brands, including Tylenol, Band-Aid, Johnson's Baby Powder, Listerine, Neutrogena and Nicorette. (Primack, 1/5)
Stat: Biogen Shakes Up R&D Role, Splitting It Into Two
More than a year after Al Sandrock was pushed out as Biogen’s R&D chief, the company has set permanent plans to replace him into motion. Biogen announced Thursday that it will be splitting the head of R&D role into two, with Priya Singhal being named as the new head of development. The company has initiated a search for a new research chief, it said in a press release. (DeAngelis, 1/5)
On cancer research —
Reuters: Moderna Signs $35 Million Deal With Cancer Drug Developer CytomX 
Moderna Inc on Thursday announced a $35 million licensing deal with cancer-focused drug developer CytomX Therapeutics to work on messenger RNA-based therapies for a wide range of diseases. Shares of California-based CytomX rose more than 50% in extended trading. (1/5)
Bloomberg: UK Signs BioNTech Deal To Treat 10,000 With Custom Cancer Drugs
The UK government agreed to work with BioNTech SE to treat as many as 10,000 cancer patients with personalized therapies by 2030, a research partnership that will give the German company quicker access to patients it needs to test its drugs. (Kresge and Ashton, 1/6)
Stat: Fate Therapeutics Plans Mass Layoffs, After Early End To Cell Therapy Deal
Fate Therapeutics, a biotech upstart with big ambitions to use cell-based therapies to treat autoimmune diseases and cancer, is now planning to cut back on both jobs and experimental drugs after an early end to a deal with Janssen. (Wosen, 1/5)
Health Care Personnel
Thousands Of NYC Nurses May Strike Next Week
Though some progress has been made toward averting a large Jan. 9 strike of nursing staff at several New York City hospitals, negotiations are still underway. Separately, Modern Healthcare covers how the FTC's proposed noncompete hiring clause ban may impact physician salaries.
Bloomberg: NYC Nurses Strike: Action Set For Next Week Over Hospital Staffing Levels
Five institutions, including units of the massive Mount Sinai Health System Inc., are still in talks toward a resolution with about 10,000 members of the New York State Nurses Association. Three others have reached tentative agreements.  (Coleman-Lochner, 1/5)
Crain's New York Business: Mount Sinai's Nurse Strike Preparation Affects Surgeries, Patients 
Staff at Mount Sinai Hospital, Mount Sinai Morningside and Mount Sinai West have begun preparations ahead of a potential New York State Nurses Association strike Jan. 9, according to a memo reviewed by Crain’s. (Neber, 1/5)
In other news about health care personnel —
Modern Healthcare: FTC’s Proposed Noncompete Clause Ban Could Raise Physician Wages
Absent a federal policy, noncompete agreements have been governed by a patchwork of state laws. Physician noncompete clauses are generally unenforceable in California, North Dakota and Oklahoma. Twenty-one states have either prohibited most restrictive covenants or instituted time limits, payout requirements or other conditions, according to a 2020 report from the University of California, Hastings and the University of California, Berkeley. (Kacik, 1/5)
KHN: More Orthopedic Physicians Sell Out To Private Equity Firms, Raising Alarms About Costs And Quality 
Dr. Paul Jeffords and his colleagues at Atlanta-based Resurgens Orthopaedics were worried about their ability to survive financially, even though their independent orthopedic practice was the largest in Georgia, with nearly 100 physicians. They nervously watched other physician practices sell out entirely to large hospital systems and health insurers. They refused to consider doing that. “It was an arms race,” Jeffords said, “and we knew we had to do something different if we wanted to remain independent and strong and offer good quality of care.” (Meyer, 1/6)
Stat: A Year After A Nurse’s Loss To Suicide, A Peer Support Network Grows
When Michael Odell, an intensive care nurse, died by suicide a year ago this month, it thrust attention on all that nurses had endured during the pandemic. Odell’s death also motivated his friends in the field as well as other nurses to build on that attention and his legacy. In the year since, they’ve been advocating for health care worker well-being and calling for health systems to offer more support for nurses, historically a group that’s received less consideration than doctors. They also started an organization called Don’t Clock Out. (Joseph, 1/6)
In corporate news —
Billings Gazette: Firm Recommends Closing, Moving Geriatric Unit From State Hospital
A consulting firm that eyed the state's health care facilities over the last nine months recommended on Thursday winding down a troubled geriatric unit at the Montana State Hospital and building two new facilities that would support the hospital's services. "I know (building two new facilities) is a very large conversation, but it is one of our recommendations," Diane Rafferty of Alvarez & Marsal told a budget subcommittee on Thursday. (Larson, 1/5)
Dallas Morning News: HCA’s Medical City Healthcare In Talks To Acquire Wise Health System
Dallas-based Medical City Healthcare, a division of HCA Healthcare, is in exclusive talks to acquire Wise Health System, the Decatur, Texas-based hospital system’s board of directors announced Tuesday. (Wolf, 1/5)
Modern Healthcare: VillageMD’s CEO 5 Priorities Following Summit Health-CityMD Deal
Walgreens Boots Alliance subsidiary VillageMD has acquired Summit Health-CityMD in an $8.9 billion deal, the company announced Thursday. The deal, which closed Jan. 3, creates a combined company with roughly 20,000 employees in more than 680 locations across 26 markets that provides primary, specialty and urgent care. (Hudson, 1/5)
Opioid Crisis
Alleged Fentanyl-Trafficking Son Of El Chapo Arrested Ahead Of Biden's Visit To Mexico
News outlets report that Mexican security forces have arrested an alleged fentanyl trafficker wanted by the U.S. — one of the sons of former Sinaloa cartel boss El Chapo. In other news, two doctors' "pill mill" opioid convictions are partly overturned, and more.
AP: Mexico Nabs Son Of Drug Lord 'El Chapo' Before Biden Visit 
Mexican security forces captured Ovidio Guzmán, an alleged drug trafficker wanted by the United States and one of the sons of former Sinaloa cartel boss Joaquín “El Chapo” Guzmán, in a pre-dawn operation Thursday that set off gunfights and roadblocks across the western state’s capital. … “This is a significant blow to the Sinaloa cartel and major victory for the rule of law. It will not, however, impede the flow of drugs into the U.S. Hopefully, Mexico will extradite him to the U.S.,” Mike Vigil, the DEA’s former Chief of International Operations, said Thursday. (Verza and Sherman, 1/6)
The Washington Post: Mexico Captures Son Of El Chapo, Alleged Fentanyl Trafficker, Ahead Of Biden Visit 
Analysts and former U.S. officials said the latest arrest appeared timed to appease Biden in advance of the summit — part of a pattern of the Mexican government nabbing major narcos or announcing big busts before key bilateral meetings. “It’s like the AMLO administration is saying, ‘We have to show Biden that we’re doing something,’ ” said Carlos Bravo Regidor, a Mexican political analyst, referring to the president by his initials. (Sheridan and Sieff, 1/5)
More on the opioid crisis —
Reuters: Doctors' 'Pill Mill' Convictions Partially Tossed After U.S. Supreme Court Ruling
A federal appeals court on Thursday overturned key parts of the convictions of two Alabama doctors accused of running a massive "pill mill" after the U.S. Supreme Court in June made it harder to prosecute physicians for illegally prescribing addictive drugs like opioids. (Raymond, 1/5)
Vice News: The DEA Shut Down A Pain Doctor. Now 3 People Are Dead
First, there was the double suicide—a husband and wife from Georgia who took their lives one week after the Drug Enforcement Administration (DEA) suspended the license of their doctor, David Bockoff, a pain specialist in Beverly Hills. After Bockoff lost his ability to prescribe fentanyl and other powerful painkillers on Nov. 1, dozens of his patients became “opioid refugees” with nowhere to turn. The third death came barely a month later. … Exclusive interviews with Bockoff patients and court documents reviewed by VICE News make it appear as though the devastation came only after the DEA intervened against Bockoff, sending his patients into desperate spirals to stave off withdrawals and manage their pain. (Hamilton, 1/5)
AP: Man Gets Record 20 Years In Prison For Teen's Fentanyl Death 
A man was sentenced Thursday to a record 20 years in prison for selling fentanyl pills that killed a Colorado teenager. Federal prosecutors say Nathaniel Corser, 23, sold two blue pills with the imprints “M” and “30” to 19-year-old Kaeden Norlander at a park in Colorado Springs on July 4, 2021. The drugs appeared to be prescription oxycodone pills but actually contained fentanyl. (1/6)
AP: Opioid Legal Charge Pushes Walgreens To $3.7B Fiscal 1Q Loss 
A huge opioid settlement dragged Walgreens to a $3.7 billion loss for the first quarter, but the drugstore chain still beat Wall Street forecasts. (Murphy, 1/5)
Public Health
Damar Hamlin Now Alert And On Path To Neurological Recovery
Media outlets report on the health of Buffalo Bills player Damar Hamlin, whose collapse on the field drew attention to heart health. Hamlin is alert, but experts worry over his organ health. Other reports cover issues relating to sports, cardiac health, and airline medical kits for in-flight emergencies.
NBC News: Damar Hamlin Is Alert And Asking Questions, Doctors Say
During a news briefing Thursday, Hamlin's doctors said his recovery includes other promising signs that his brain is functioning, such as moving his feet and squeezing the hands of his doctors and family members. (Edwards, 1/5)
The New York Times: Damar Hamlin’s Neurological Recovery Reaches A ‘Turning Point’ 
While experts have reasons to anticipate that Mr. Hamlin may be on a good path for neurological recovery, questions remain about the health of his other organs, including his lungs. In a news conference on Thursday, Dr. Knight and Dr. Timothy A. Pritts said that Mr. Hamlin was still critically ill, was in intensive care and was still lightly sedated and on a ventilator, and so unable to talk. But he can now communicate by shaking his head and nodding. He even wrote a question on a pad of paper, asking his nurse who had won the game. (Kolata, 1/5)
On the response of major-league sports teams —
The New York Times: ‘We’re Going to Need Everybody’: Recordings Captured Response to N.F.L. Crisis
The radio traffic moments after Buffalo Bills defensive back Damar Hamlin collapsed on the field Monday night in Cincinnati crackled with urgency. “I don’t like how he went down,” one person said on a channel that appears to have included medical personnel on the sidelines. Seconds later, as the gravity of Hamlin’s condition became clearer, another person was more emphatic. (Belson, Blinder and Stein, 1/5)
AP: NHL Evolves Its Plan, Prep For Terrifying Cardiac Events 
The horror that swept across the NFL when Buffalo Bills defensive back Damar Hamlin collapsed and went into cardiac arrest during a game this week in Cincinnati was all too familiar to members of the hockey community. Five players in the NHL over the past 25 years who collapsed during a game — terrifying scenes that stopped play while people scrambled to help — were diagnosed with a heart-related issue of some kind. (Whyno, 1/5)
Also —
USA Today: What Damar Hamlin's Cardiac Arrest Can Teach Parents About Kids Sports
Every year, sudden cardiac arrest claims the lives of over 2,000 children and teens in the U.S., according to Children’s Hospital of Philadelphia. This accounts for about 3% to 5% of all deaths in children aged 5 to 19. “Everyone’s at some potential risk," said Dr. Gul H. Dadlani, division chief of cardiology at Nemours Children’s Health in Orlando, Florida. “The same thing could happen to a high school student or the non-athlete who’s just at home.” (Rodriguez, 1/5)
CNN: How To Protect Your Kids When They Play Sports, According To Doctors
Every time there is a head trauma, cardiac arrest, or other major injury among professional sports, parents take a deep breath. “That athlete is someone’s child. Could that be my child?” Cardiac events during sports are uncommon for anyone, said Dr. Stuart Berger, division head of cardiology at Northwestern University Feinberg School of Medicine. While they can also occur in kids and teens, these injuries can happen whether or not people play sports. (Holcombe, 1/5)
NPR: Damar Hamlin, Cardiac Arrest And What It Takes To Boost The Odds Of Survival 
For the more than 350,000 Americans each year who suffer cardiac arrest outside of a hospital, the prognosis is not always an optimistic one. Most studies suggest that no more than 10% of these patients survive until hospital discharge. As grim as that would seem, medical experts say the statistics mask much better individual outcomes for patients who receive rapid and appropriate care before they reach a hospital. (Neuman, 1/6)
In related news about emergency medical kits on airlines —
KHN: During In-Flight Emergencies, Sometimes Airlines’ Medical Kits Fall Short 
In March, a Frontier Airlines flight was headed from Phoenix to Las Vegas when a female passenger stopped breathing. The flight attendant yelled in the cabin for help. A passenger who was trained as a wilderness first responder, Seth Coley, jumped into action and found the woman was unresponsive and had a weak pulse. Coley dug through the plane’s medical kit but couldn’t find an oropharyngeal airway, a tool that was supposed to be there and that he needed to help the woman breathe. Instead, he cleared the airway by manipulating her neck. (Ramachandran, 1/6)
State Watch
Pushback Undoes Cutbacks In California's Medi-Cal Insurance Plans
The California Department of Health Care Services announced it has now negotiated with five commercial health plans for 2024 Medi-Cal services, undoing a process that had cut the number to three. Also: Medicaid expansion, flavored tobacco in Ohio, marijuana use in Maryland, transgender health laws and more.
CalMatters: Medi-Cal Will Keep More Insurance Plans After Pushback
In a significant course change, the California Department of Health Care Services announced that it has negotiated with five commercial health plans to provide Medi-Cal services in 2024, scratching a two-year-long bidding process for the coveted state contracts. (Hwang and Ibarra, 1/5)
On Medicaid expansion in New Hampshire and North Carolina —
New Hampshire Bulletin: Coalition Urges NH Lawmakers To Renew Medicaid Expansion
Expanding Medicaid insurance to more low-income Granite Staters was a tough sell before it passed the Legislature nine years ago. Fiscal conservatives urged lawmakers to reject predictions that more access to free or subsidized health insurance would lower medical costs and improve health outcomes. They warned it would instead discourage people from seeking jobs that offer benefits or high enough wages to buy insurance. (Timmins, 1/5)
Stateline: This State Could Be The Last One (For A While, Anyway) To Expand Medicaid 
For years, state Sen. Phil Berger says, there was nobody in North Carolina who opposed Medicaid expansion under the Affordable Care Act more vehemently than he did. “If there was somebody in the state of North Carolina that had spoken out publicly in opposition to Medicaid expansion more than me, I’d like to talk to that person,” Berger said in an interview last month. From the time the ACA passed in 2010 until last spring, “my attitude was Medicaid expansion was wrong for North Carolina,” he said. (Ollove, 1/4)
On tobacco use in Ohio and marijuana use in Maryland —
Columbus Dispatch: Mike DeWine Vetoes Bill Over Who Regulates Flavored Tobacco, Vapes
Sticking with his decades-long push against kids smoking, Gov. Mike DeWine vetoed a bill on Thursday that would've blocked cities from banning the sale of menthol cigarettes and vapes flavored like candy. Rather than quietly use his veto pen, DeWine called a press conference with health officials to sound the alarm over a youth smoking and vaping "epidemic" exacerbated by flavored products. (Bischoff and BeMiller, 1/5)
The Washington Post: Maryland Residents Consume More Marijuana Than Other States, Study Finds 
Maryland lawmakers working to create a system for the legalized sale of recreational marijuana had a question for researchers: What does demand look like for cannabis in Maryland? The answer: it’s high. While adult residents use marijuana in rates similar to other states, Marylanders who do use consume about five grams more per month on average than their counterparts, a survey of thousands of Maryland residents found. (Wiggins, 1/5)
On transgender health —
The Hill: Federal Judge Rules West Virginia Law Restricting Transgender Athletes Is Constitutional 
A federal judge on Thursday ruled that a West Virginia law prohibiting transgender female athletes from playing on women’s sports teams in public middle schools, high schools and universities is constitutional. (Scully, 1/5)
Oklahoman: Oklahoma Bill Would Ban Gender Surgery For Young Transgender Adults
A top Republican in the Oklahoma Senate wants to ban all gender reassignment surgeries for people under 26 years old. Calling it "a permanent solution to a temporary problem," state Sen. David Bullard, R-Durant, claimed that most medical intervention for transgender people violates the Hippocratic Oath, which requires doctors to do no harm. (Denwalt, 1/5)
The 19th: These Anti-Trans Bills Are Being Prepped For 2023 State Legislative Sessions
Lawmakers in at least eight states used the last two months of 2022 to prefile anti-transgender bills ahead of state legislative sessions convening this month — setting up another year of statehouse battles over trans rights, while targeting health care for trans adults in new ways. (Rummler, 1/5)
In other health news from Pennsylvania and North Carolina —
CNN: Pennsylvania Sen. Bob Casey Announces Prostate Cancer Diagnosis
Pennsylvania Sen. Bob Casey said Thursday he has been diagnosed with prostate cancer and has an “excellent prognosis.” “Last month, I was diagnosed with prostate cancer. While this news came as a shock, I can report that I have an excellent prognosis, as well as the benefit of exceptional medical care and the unwavering support of my family,” Casey, a Democrat who is 62, said in a statement. “In the coming months I will undergo surgery, after which I am expected to make a full recovery.” (Duster, 1/5)
North Carolina Health News: HIV Advocates Call Plans From Insurer Blue Cross NC ‘Discriminatory’ 
More than 35,000 North Carolinians are living with HIV, according to the latest available data from the North Carolina Department of Health and Human Services. Those folks are living longer, healthier lives, thanks to medicines that treat HIV infection. For many, however, cost is a barrier to getting that treatment. (Crumpler, 1/6)
Weekend Reading
Longer Looks: Interesting Reads You Might Have Missed
Each week, KHN finds longer stories for you to enjoy. This week's selections include stories on "damp" January, new health tech for 2023, antibody drugs, and more.
Harvard Public Health: If Dry January Feels, Well, Dry, Try "Damp" January Instead
A ”drier” or “damp” January might be the right approach for many people, says Aaron E. Carroll, a pediatrician, researcher, and chief health officer at Indiana University. Carroll has written extensively about the medical literature on alcohol’s health effects, especially where alcohol’s risks might be overstated by officials and news headlines. Moderation may be trite, but it’s still key. (Mehta, 1/5)
The Washington Post: The Best (And Strangest) Tech We Found At CES 2023 
CES is like a kaleidoscope of the new and strange. Among some of the health products unveiled: a toilet sensor that analyzes your urine; a wearable that adds scent to virtual experiences for gamers, retailers and health-care providers; an anxiety pillow that breathes; and more.
Barron's: Health And Wellness Gets Scientific At Swiss Medical Practices And Spas
The Kusnacht Practice started as an über-exclusive, ultra-expensive alcohol and drug rehabilitation program for those requiring the utmost privacy while undergoing treatment. The practice operates about a dozen lavishly appointed villas and apartments staffed by a hospitality team, including a personal chef, plus a live-in counselor who provides support and companionship throughout the stay, which typically ranges from four to eight weeks. The chef and counselor can even return home with the client to establish healthy practices in their normal lives, and a continuous care team works to ensure they stay on track. “We are not an institutionalized kind of place, you don’t feel like you are in treatment at all,” Greghi says. … While addiction treatment remains a specialty, 80% of clients today are not addicts, as the practice has evolved to treat myriad physical and mental health issues with a full-time staff of dedicated medical and psychiatric experts who work closely as a team to optimize results. (Kahle, 1/5)
The Washington Post: Antibody Drugs Could Target Infectious Diseases — If Costs Come Down
At a malaria research conference five years ago in Senegal, scientist Timothy Wells presented an overview of medicines on the horizon, ending with a few slides focused on an outlandish idea. Wells proposed that monoclonal antibody drugs — a class of high-price medicines that has transformed the treatment of cancer and autoimmune diseases — had a role in preventing malaria, a mosquito-borne disease that kills more than a half-million people each year, mostly children in Africa. Scientifically, it was plausible. Practically speaking, it seemed ludicrous. (Johnson, 1/3)
MarketWatch: ‘I Can No Longer Be An Executive At A High Level’: Workers With Disabilities, Including Long COVID, Are Finding Their Place As Companies Become More Flexible 
Many people with disabilities face serious difficulties finding work. The unemployment rate for people with a disability was 6% in November — down from 10.8% in 2021, but still higher than the rate of 3.3% for those who do not have a disability, according to government data. (Han, 1/5)
Editorials And Opinions
Viewpoints: MRNA Cancer Vaccine Looks Promising; What We Should Know About Variant XBB.1.5
Editorial writers delve into these public health topics.
East Bay Times: Drug Companies' Cancer Vaccine Hunt Is Making Progress, Finally
The long-awaited cancer vaccine revolution is getting a little closer to reality. New data from Moderna Inc. and Merck & Co. suggest that after decades of failures, researchers are finally figuring out the right way to design a vaccine that can teach immune cells how to recognize and combat tumors. (Lisa Jarvis, 1/5)
Bloomberg: Are Vaccines Fueling New Covid Variants Like XBB.1.5? No
A new Covid variant called XBB.1.5 is driving a new wave of infections. But susceptibility to it is not, as some contend, being fueled by vaccines. (Faye Flam, 1/5)
Bloomberg: China’s Covid Surge Will Test The US And Its Allies 
China’s abrupt reversal of its zero-Covid strategy has triggered an unprecedented surge in cases. According to one estimate, as many as 37 million people were infected in a single day; experts think China could see as many as 25,000 daily deaths over the next month. (1/5)
The New York Times: It Shouldn’t Be This Hard To Get Mentally Ill People The Help They Need 
A few weeks before Mayor Eric Adams announced that New York would begin a big push to involuntarily hospitalize severely mentally ill homeless people even if they posed no risk of harm to others, my sister was involuntarily admitted to a psychiatric unit in a city hospital. My sister is not homeless; she had been living in a studio apartment in Queens. But she has a serious mental illness and in November a neighbor called 911 after seeing her on the street carrying a chef’s knife. (Hilary de Vries, 1/6)
The CT Mirror: Solving The College Mental Health Crisis
College is supposed to be the best four years of your life.  Yet during my freshman year I had to attend the funeral of one of my best friends.  Understandably, this put a dark cloud over my first year of college. (Morgan Rogers, 1/5)
Modesto Bee: Accessibility Laws For Disabled Are Just Feel-Good Gestures
My life dramatically declined the last week of September 2021 when I felt excruciating pain throughout my neck and back. Days later, I was paralyzed by a spinal cord infection that had gone undetected. I quickly went from being fully functional to quadriplegic. Fortunately, my paralysis is incomplete — meaning that walking again might be possible. So, I exercise daily and attend weekly physical therapy, though I still use a wheelchair. (Jim Sahlman, 1/4)
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