Happy Friday! I don鈥檛 know about you, but I have been absolutely riveted by the that has sent the scientific community into a shocked-and-appalled, pearl-clutching frenzy this week. I鈥檒l get to that in a second. First, another too-frequent example of the current pitfalls in our health system: A hospital turned down a woman鈥檚 heart transplant request because she lacked a secure source of financing for the drugs necessary for the procedure. The for her? Use crowdfunding to raise the $10,000.
Now here鈥檚 what you may have missed as we enter that strange lull between holidays (though there certainly wasn鈥檛 a dearth of health news).
New guidelines released by the administration on Thursday, among other things, encourage states to flex their creative muscles on how to spend the subsidy money they get under the health law.
Currently, the subsidies are tied to income, and can be used only for insurance that meets federal standards and is purchased through public marketplaces. But the Centers for Medicare & Medicaid Services wants to lift those restrictions and let states do what they will with the pot of money. That could include: allowing the use of subsidies for short-term 鈥渏unk insurance鈥� plans; offering subsidies as incentive to woo in younger consumers; setting different income limitations; letting people with employer-based plans set up accounts to use the money, etc., etc.
If states acted on these options, that could steer the marketplace toward the geographical disparity that ran rampant before the health law. But it鈥檚 doubtful any state would want to take advantage of this offer in the first place. For one, it would be expensive for states to manage the pot of money. Secondly, even if a state received a waiver for the regulations, court challenges likely would follow. That could be more of a headache than it鈥檚 worth.
The lagging numbers for this open-enrollment season are a bit at odds with what experts had seen as a stabilizing, if not quite聽flourishing, marketplace.聽While no one is Chicken Little-ing yet (there is still time left to see a boost, and the early weeks of November were busy ones for Americans), health law supporters are concerned that what they see as the administration鈥檚 attempts to 鈥渟abotage鈥� the Affordable Care Act are coming to fruition.
One statistic from the week that experts found 鈥渧ery troubling鈥� was that for the first time in a decade the number of uninsured children rose, despite the improving economy and the low unemployment rate. Rural areas were particularly affected.
In what is certain to draw fierce pushback from patient advocacy groups and pharma alike, President Donald Trump is expanding Medicare鈥檚 negotiating power when certain drug prices聽rise faster than inflation. The idea has been kicking around for a while as both parties have been trying to come up with the silver bullet for high costs, but the political ramifications are unappetizing. Potentially cutting seniors off from needed drugs 鈥� whether it would play out that way or not 鈥� has always kept the idea on the back burner.
File this under 鈥淚鈥檓 not sure that鈥檚 how it鈥檚 supposed to work鈥�: A generic EpiPen is now available. The catch? It鈥檚 the exact same price as the one already out there.
FBI background checks were waived for caregivers and mental health workers who were in charge of caring for teens at an immigration detention center in Texas. The revelation ignited outrage, and the Department of Health and Human Services was quick to promise it would fingerprint the employees (officials warned it could take a while, though).
The government also allowed the company who is overseeing the operation of the facility to sidestep mental health requirements 鈥� youth shelters generally must have one mental health clinician for every 12 kids, but the contractor was allowed to staff the Texas facility with just one clinician for every 100 children.
Very quietly, family separations at the border have resumed.
Also, Baltimore is suing the Trump administration over its 鈥減ublic charge鈥� policy that lets immigration officials use the acceptance of government aid, such as Medicaid, against those seeking green cards. The lawsuit might be the first of its kind, but it鈥檚 doubtful it will be the last.
It is indicative of just how busy this week was that I haven鈥檛 gotten to the (aforementioned) ethics scandal rocking the scientific community yet, but we got here eventually. Chinese scientist He Jiankui dropped a bombshell (unverified and un-peer reviewed) on everyone that he gene-edited human embryos to make designer babies resistant to HIV infections.
This practice crosses an ethical line that many researchers had dug deep, deep, deep in the sand. 鈥淒eeply unethical,鈥� 鈥渃razy,鈥� 鈥渄riven by hubris,鈥� were just a few of the reactions from fellow scientists at the shocking news. One consensus that has come out of it, though, seems to be that there鈥檚 a crucial need for binding and international guidance on editing human genes. (Oh, and this isn鈥檛 over. He says there鈥檚 another pregnancy with gene-edited embryos underway.)
Medical device policy usually flies a bit under the radar, but it was a hot topic this week. Following a damning report on spinal implants causing severe injury to some patients, the Food and Drug Administration announced that it wants to revamp its (long-criticized and decades-old) approval system.
And a look at聽whether the agency鈥檚 鈥渇irst in the world鈥� ambition contributed to a series of high-profile malfunctions.
In the miscellaneous file this week:
鈥� The combined suicide and opioid crises are taking a particularly grim toll on the country, sending us into our longest period of generally declining life expectancy since the slice of time that includes a little thing called World War I and the worst flu pandemic in modern history. I鈥檓 not going to lie, that鈥檚 not a great comparison.
鈥� A gut-wrenching personal story offers insight into the loved ones left behind in cases of suicides, and how they鈥檙e plagued with a forever-unanswerable question of 鈥渨hy鈥�? The entire series is worth a deep read.
鈥� An epidemic of extensive backlog of rape kits languishing on shelves in police departments recently drew a lot of attention. But an even more fundamental and low-profile issue? Those departments that trash them completely before the statute of limitations is up.
鈥� Johns Hopkins vowed to transform a Florida hospital鈥檚聽heart surgery unit. Then patients started dying at an alarming rate.
鈥� Despite changes in policy, federal prisons are still failing to offer inmates proper mental health care.
As you can tell, it鈥檚 a good thing I started drinking coffee (for the first time ever, cue shocked faces) this week! No, I have not been spending my time Googling its health benefits. (OK, I ) Have a lovely, possibly caffeine-fueled weekend!