Volume 403, Issue 10445
WORLD REPORT Justices did not address claims that mifepristone endangered patients and that its approval by the FDA was flawed. Opponents vow to continue the legal fight. Susan Jaffe reports [continued here].
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WORLD REPORT Health and science groups warn the Supreme Court ‘s decision threatens workforce diversity and
patient care. Susan Jaffe reports from Washington, DC.
Leading medical and scientific organisations have criticised the June 29 US Supreme Court decision severely limiting how colleges and universities consider an applicant’s race in the admissions process. A 6 to 3 majority abandoned 45 years of legal precedent protecting affirmative action, which is widely expected not only to reduce the number of Black and Latinx college students but also roll back their representation in medicine, law, science, and other postgraduate programmes, diversity advocates say. [Continued here.] …
WORLD REPORT Some medical associations support restrictions on social media use to protect adolescent’s health, while others focus on making companies provide safer platforms.
Volume 396, Number 10244
11 July 2020
WORLD REPORT The court’s decision means that Louisiana’s three abortion clinics will remain open. Susan Jaffe reports.
The US Supreme Court delivered the Trump administration’s third defeat in as many weeks when it overturned a Louisiana law requiring physicians who provide abortions to have local hospital-admitting privileges.
In an opinion written by Justice Stephen Breyer, the court declared on June 29 that “enforcing the admitting privileges requirement would drastically reduce the number and geographic distribution of abortion providers, making it impossible for many women to obtain a safe, legal abortion in the State and imposing substantial obstacles on those who could”. [Continued here.]…
Volume 395 Number 10222 8 February 2020 Volume 394 Number 10213 30 November 2019 By Susan Jaffe | Kaiser Health News | August 12, 2019 | This KHN story also ran on Salon and Next Avenue
Medicare paid for Betty Gordon’s knee replacement surgery in March, but the 72-year-old former high school teacher needed a nursing home stay and care at home to recover.
Yet Medicare wouldn’t pay for that. So Gordon is stuck with a $7,000 bill she can’t afford — and, as if that were not bad enough, she can’t appeal.
The reasons Medicare won’t pay have frustrated the Rhode Island woman and many others trapped in the maze of regulations surrounding something called “observation care.”
Patients, like Gordon, receive observation care in the hospital when their doctors think they are too sick to go home but not sick enough to be admitted. They stay overnight or longer, usually in regular hospital rooms, getting some of the same services and treatment (often for the same problems) as an admitted patient….
(Photo courtesy of Betty Gordon)
But observation care is considered an outpatient service under Medicare rules, like a doctor’s appointment or a lab test. Observation patients may have to pay a larger share of the hospital bill than if they were officially admitted to the hospital.Medicare’s nursing home benefit is available only to those admitted to the hospital for three consecutive days. Gordon spent three days in the hospital after her surgery, but because she was getting observation care, that time didn’t count.
There’s another twist: Patients might want to file an appeal, as they can with many other Medicare decisions. But that is not allowed if the dispute involves observation care.
Monday, a trial begins in federal court in Hartford, Conn., where patients who were denied Medicare’s nursing home benefit are hoping to force the government to eliminate that exception. A victory would clear the way for appeals from hundreds of thousands of people. [Continued at Kaiser Health News, Next Avenue or Salon]
…“We can send prescriptions to the pharmacy, including [for] narcotics,” says Marie Grosh, a geriatric advanced practice nurse practitioner and the owner of a medical house calls practice in a Cleveland suburb. “We can order lab work, x-rays, ultrasounds, EKGs [electrocardiagrams]; interpret them; and treat patients based on that. But we’re just not allowed to order home care—which is absurd.”
By SUSAN JAFFE | Health Affairs | June 2019 | Volume 38, Number 8
When Christine Williams began working as a nurse practitioner some forty years ago in Detroit, Michigan, older adults who couldn’t manage on their own and had no family nearby and no doctor willing to make house calls had few options besides winding up in a nursing home.
Not anymore.
Home check: Nurse practitioner Marie Grosh visits Leroy Zacharias at his home in a Cleveland suburb, He has Parkinson disease, and Grosh says he would be living in a nursing home if he couldn’t get medical care at home. (Photo by Lynn Ischay.)
“The move towards keeping seniors in their homes is a fast-galloping horse here,” says Williams, who settled in Cleveland, Ohio, more than a decade ago. “We don’t have space for them in long-term care [facilities], they don’t want to be in long-term care, and states don’t want to pay for long-term care. And everybody wants to live at home.”
But despite the growing desire for in-home medical care for older adults from nearly all quarters, seniors’ advocates and home health professionals claim that rules set by the Centers for Medicare and Medicaid Services (CMS) along with state regulations have created an obstacle course for the very providers best positioned—and sometimes the only option—to offer that care. [Continued here] …
Volume 393 Number 10191 29 June 2019 Volume 393 Number 10184 11 May 2019 “We are the department of life…from conception until natural death, through all of our programmes”, US Department of Health and Human Services (HHS) secretary Alex Azar said earlier this year…. The government’s anti-abortion efforts have ignited lawsuits from Maine to California. Eventually, one or more of these cases are expected to reach the Supreme Court. With its newest arrival—Justice Brett Kavanaugh, whose nomination by Trump was championed by abortion opponents—the Supreme Court’s ideological balance has now shifted towards a conservative majority [raising] opponents’ hopes that a sympathetic court will diminish, if not overturn, Roe v. Wade...
Late last week, lawyers for the HHS appealed decisions by two federal court judges in Oregon and Washington state to temporarily halt new administration rules that would limit the information about abortion services that federally funded health-care providers can tell their patients.
“We are fighting back in the courts, we are fighting back in Congress and in state legislatures all across the country”, said Planned Parenthood president Leana Wen, noting that one in four women in the USA will have an abortion in their lifetime. “The public is with us when it comes to defending access to safe legal abortion, which people understand is part of the full spectrum of reproductive health care, which is health care.” [Continued here.]…
Volume 391, Number 10139
23 June 2018
WORLD REPORT Months after the Trump Administration said that there is no ban on gun violence studies, the CDC still lacks the funding to proceed. Susan Jaffe, The Lancet‘s Washington correspondent, reports.
…Appeals for immediate federal action to make schools and communities safer have so far largely gone unanswered. And legislative efforts languish in Congress, as the chairman of a key congressional committee that oversees federal health programmes has so far resisted requests by its Democratic members to hold hearings on preventing gun violence [continued here].…
Volume 391, Number 10131
28 April 2018
WORLD REPORT Frustrated by what they say is the US Government’s disregard for science, more scientists and physicians are entering politics. Susan Jaffe, The Lancet’s Washington correspondent, reports.
Nuclear engineer Elaine Luria running for Congress in southeast Virginia (photo/elaineforcongress.com)
Scientists, physicians, engineers, and their supporters surprised many people—and maybe themselves—when they assembled in cities across the USA a year ago demanding an end to President Donald Trump’s Administration’s so-called war on science, which has attacked climate change, environmental protection laws, and funds for biomedical research, among other targets.
But, for some critics, protests are not enough. Instead of appealing to elected officials, now they want to take their place.
“…More and more scientists realise that they have… an obligation to see that the idea of science is defended, that evidence is respected, and that the conditions for science to thrive are respected”, said Rush Holt, chief executive officer of the American Association for the Advancement of Science. [Continued here.] …
Susan Jaffe | Washington Correspondent for The Lancet | 27th December 2017
But critics say Azar has the wrong kind of experience. When he appeared before Senate Committee on Health, Education, Labor and Pensions (HELP) last month, the committee’s senior Democrat Patty Murray of Washington said if Azar runs HHS then “the fox is guarding the hen house.” [Continued here] …
Volume 390, Number 10108
WORLD REPORT As the Presidential Commission releases its recommendations, Trump moves closer to defining his policies against the opioid epidemic Susan Jaffe, The Lancet’s Washington correspondent, reports.
“Having failed to recognise how this epidemic was going to grow in proportion and take vigorous enough action, we need to be willing to be far more vigorous so we don’t continue with that mistake,” said Food and Drug Administration Commissioner Scott Gottlieb. [full story here]
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WORLD REPORT After the latest repeal bill was withdrawn and the budget reconciliation has expired, what does the future hold for the ACA? Susan Jaffe, The Lancet’s Washington correspondent, reports.
Republicans claim the ACA isn’t working and point to the rising cost of monthly premiums and the various counties across the USA where only one or two insurers offer coverage through the ACA’s online insurance marketplaces.… “[But] they’re not letting it fail, they’re making it fail,” said Stan Dorn, a senior fellow at Families USA, a consumer advocacy group that worked to help pass the ACA. [Continued here]…
Volume 389, Number 10071 25 February 2017
WORLD REPORT Few details have emerged regarding a replacement for the US health law. Susan Jaffe, The Lancet’s Washington correspondent, speaks to stakeholders about the problems they foresee.
Less than 8 hours after Donald Trump took the oath of office as the 45th President of the USA, he signed an executive order reiterating a popular campaign promise: “It is the policy of my Administration to seek the prompt repeal of the Patient Protection and Affordable Care Act [ACA].”
Californians march against the repeal and replacement of the ACA, Feb 4, 2017 / Getty Images
Yet 5 weeks later, the Trump Administration and the Republican controlled Congress cannot agree on whether to repeal and replace it simultaneously—as the president desires—and what the replacement will be. Tom Price, Trump’s new Health and Human Services Secretary, assured senators during his nomination hearing last month that “nobody’s interested in pulling the rug out from under anybody. We believe that it’s absolutely imperative that individuals that have health coverage be able to keep health coverage…”
…The ACA’s uncertain future has rattled health insurers—initial 2018 policies are due as soon as April—and rippled through the health-care system to worried providers and patients. “Like everyone else, we are waiting for more information to be released by the Administration and Congress”, said Jan Emerson-Shea, a spokeswoman for the California Hospital Association, a state with more than 1·5 million patients enrolled in ACA insurance plans. [Continued here] …
By May 3, 2013 | KAISER HEALTH NEWS in collaboration with 
“This trend concerns us because of the potential financial impact on Medicare beneficiaries,” officials wrote in an announcement April 26. Patients must spend three consecutive inpatient days in the hospital before Medicare will cover nursing home care ordered by a doctor.
…The reaction from patient advocates, doctors and hospitals has been swift and surprisingly unanimous: it’s a bad idea. MORE
coordinate and improve patient care and — in the process—reduce unnecessary health care spending. But convincing everyone to use electronic health records has not been easy. …Neither reward nor punishment has 
The Jan. 25 ruling, which came in response to a 2011 class-action lawsuit eventually joined by 14 beneficiaries against the Department of Health and Human Services, will guarantee p