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Senate to begin bipartisan health care push – CNN International

The Senate health committee announced Tuesday that it will hold two back-to-back hearings on health care September 6 and 7. That will be the first time that Republican and Democratic senators officially gather together to examine potential ways to stabilize the Obamacare marketplace. Witnesses are expected to include governors and state insurance commissioners.

“While there are a number of issues with the American health care system, if your house is on fire, you want to put out the fire, and the fire in this case is in the individual health insurance market,” Tennessee Sen. Lamar Alexander, the Republican chairman of the health committee, said in a statement.

Washington Sen. Patty Murray, the top Democrat on the panel, said: “It is clearer than ever that the path to continue making health care work better for patients and families isn’t through partisanship or backroom deals. It is through working across the aisle, transparency, and coming together to find common ground where we can.”

One of the panel’s main concerns — that many Americans may have no options on the Obamacare exchange in their area in 2018 — has largely abated. While several large insurers have pulled out of the individual market, others have stepped up to take their place. Only one county in rural Ohio, with fewer than 350 Obamacare enrollees, remains at risk of having no insurer on its exchange next year.

Another key problem, however, remains unresolved. One reason why many insurers are hiking premiums for 2018 and others are fleeing is because the Trump administration won’t commit to continue paying a key Obamacare subsidy. Insurers, along with governors and insurance commissioners, have been pressing the administration to guarantee these cost-sharing reduction payments will be made through 2018. It’s vital to the stability of the market, they say.

President Donald Trump agreed last week to make the August payment, despite earlier threats to end what he calls a bailout for insurers. He has not made a decision on future payments.

The hearings follow the GOP’s failed attempt last month to repeal major portions of the Affordable Care Act, widely known as Obamacare.

House Republicans had passed a bill earlier this year to gut the law, but Senate Republicans were unable to do the same. Despite months-long efforts by Senate Majority Leader Mitch McConnell to rally rank and file members, Sens. Susan Collins of Maine, Lisa Murkowski of Alaska and John McCain of Arizona ultimately voted “no” in a dramatic late-night scene on the Senate floor.

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Senate to begin bipartisan health care push – CNN International

Why is Louisiana’s Healthcare so Bad? – Healthline

The Bayou State ranks last in a recent survey of healthcare systems. Obesity, poverty, and smoking are just a few of the reasons.

How does your states healthcare system compare with the rest of the nation?

According to a new report from WalletHub, Louisiana has the worst healthcare in the country.

Meanwhile, Hawaii has claimed the best state healthcare title once again.

Last year, Healthline reported on annual healthcare rankings by the United Health Foundation, the nonprofit arm of UnitedHealth Group.

WalletHubs report is similar, but uses its own set of metrics for weighting its rankings.

Their results are similar, despite the different varying methodologies.

WalletHub assigned point values based on three primary scores:

At the top of the list, Hawaii is followed by Iowa, Minnesota, New Hampshire, and the District of Columbia for best healthcare.

On the other end of the spectrum, the worst begin with Louisiana, followed by Mississippi, Alaska, Arkansas, and North Carolina.

Mark Diana, PhD, chair of Tulane University Department of Global Health Management and Policy, told Healthline that while hes not happy with the rankings, hes not surprised by them.

I think its true that its fairly consistent that Louisiana ranks near the bottom in most efforts to evaluate the general health of states, he said. Typically we go back and forth with Mississippi for 49 and 50.

Louisiana is a poor state, and its a very rural state, said Diana. Those two things tend to go hand in hand, and they also go hand in hand with poorer health outcomes.

Recent census data indicate that Louisiana is one of the poorest states in the United States.

Median household income there is only $45,727, meanwhile the states poverty rate is 19.6 percent the third highest in the country behind New Mexico and Mississippi.

To combat this, Louisiana is one of 31 states that have expanded Medicaid coverage under the Affordable Care Act (ACA). Diana regards the expansion as a real success.

About 1.5 million people out of 4.5 million are on Medicaid in Louisiana, he noted. Thats a third of the population.

If you accept, and I do accept this, and I think that most health policy people agree, that having insurance improves access, and if you have access to a usual source of care, whether it’s a primary care physician or whatever, that tends to mean that you have better health outcomes, he said.

The state will need to fight for improved outcomes because, along with poverty, major health epidemics are also plaguing Louisiana.

Currently, the state has some of the highest rates of cancer and heart disease in the country.

Louisianas rate of heart disease is mirrored in its rates of obesity and smoking, both of which are above the national average.

I think its also poor diet, says Diana. Louisiana obviously has a reputation for really good food and really unhealthy food.

Community or behavioral elements of healthcare, such as diet and exercise, are factors that will impact a healthcare system, but tend to reside outside the medical communitys direct control, said Diana.

Delivery of medical care acute moments when healthcare is sought out by an individual due to an illness Diana believes is only a smaller element of a states health, dwarfed by many more external factors.

That connection is relevant to the states high cancer rates, which Diana attributes to industry and chemical manufacturing.

Louisiana has a stretch along the Mississippi River just west of New Orleans thats populated with lots of refineries and plants that have earned it the reputation of being called cancer alley, Diana said.

My suspicion is that if you remove those [areas] from the data, we probably would not be in the top any longer. I think thats not a statewide phenomenon, he added.

Diana is also confident that Louisiana is making strides in certain areas of healthcare, even if they arent necessarily reflected in this years rankings.

Infant mortality rates have dramatically improved over the past few years. Diana said thats thanks largely to Medicaid, which has provided insurance to single pregnant women and children.

Diana also said that through the Medicaid expansion, the state is continually looking into improving their programs.

Finally, he stressed that were some of these rankings better controlled for certain outside factors, they could perhaps look different.

In defense of Louisiana, Id argue that some of these things, like poverty and rurality, are very difficult to influence, says Diana. I suspect if we adjusted for the level of poverty or how much rural population there is, we wouldnt look quite so bad.

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Why is Louisiana’s Healthcare so Bad? – Healthline

Governors Preparing Bipartisan Health Care Plan For Congress To Consider – NPR

Colorado Gov. John Hickenlooper (left) and Ohio Gov. John Kasich will present a plan that fleshes out a set of principles they wrote about in an op-ed in The Washington Post. Carolyn Kaster/AP hide caption

In the wake of congressional Republicans’ failure to pass a health care bill, two governors from different parties are going to bring their own ideas to Washington.

Staff for Colorado Gov. John Hickenlooper, a Democrat, and Ohio Gov. John Kasich, a Republican, are working on a joint plan to stabilize the country’s health insurance markets. Kasich told Colorado Public Radio’s Colorado Matters that they expect to release it ahead of September hearings in the U.S. Senate. They also intend to get other governors from both parties to sign onto the plan, to show support at the state level.

“We’re getting very close. I just talked to my guys today, men and women who are working on this with [Hickenlooper’s] people, and we think we’ll have some specifics here, I actually think we could have it within a week,” Kasich said in a joint interview with Hickenlooper that aired Tuesday.

The plan will flesh out a set of principles the two men wrote about in an op-ed in The Washington Post, in which they said another one-party health care plan is “doomed to fail,” just like the Republican plans considered this year. In the op-ed, they asserted that the best place to start reform efforts is “to restore stability to our nation’s health insurance system.”

Bipartisan health care hearings, including the one the governors will appear at, are set to begin just after Labor Day when Congress returns from its August recess. Lawmakers will be consumed with a number of deadlines involving government funding, though sending health care to the back burner.

“I’m not going to get into specifics with you until we have it all ironed out, but it’s not going to be some pie-in-the-sky, way-up-there kind of stuff. There will be things that we will address that will have specific solutions. And one of the things we’re finding out is the states do have some power to do some things unique to them, as long as these insurance markets are going to be stabilized,” Kasich said.

One specific they agree on and would discuss: changing the Affordable Care Act mandate that employers with 50 or more employees provide insurance coverage. The governors say that number is too low, which deters hiring at small companies.

They also agree that the possibility of national single-payer coverage is not on the table in their discussions.

In recent months, Hickenlooper and Kasich have appeared on national television shows to advocate for bipartisan health care reform that includes keeping the Medicaid expansion intact, with both took advantage of in their states. The two governors have even entertained running for the White House on a split ticket.

On whether they think health care should be a “right”

John Hickenlooper: I come from the school that I think it is a right. I’m not sure how much health care is included in that right, but some basic coverage.

John Kasich: I don’t think that’s that important in this. I mean we want everybody to have health insurance. I mean that’s how I feel. Is it a right or is it a privilege or whatever? I don’t know why that declaration is important … The question is how do you do it, and that’s what we’re working on … Primary care is important. Catastrophic coverage is important. We don’t want anybody to get bankrupted because they get sick.

On what to change about the Affordable Care Act first

Hickenlooper: There are several important things, but the probably top one on our list would be this notion of having some sort of reinsurance [using public money to help insure the sickest people] to make sure the high-cost pool is not causing higher rates for all the people seeking insurance on the private markets … You use reinsurance in almost every type of insurance program to cut off those “hilltops” as we say.

On why this joint effort may gain traction

Hickenlooper: “[The Senate’s health committee] is now holding hearings [starting Sept. 5], and hopefully in those hearings we’ll get a chance to present, hopefully, what by that point a number of both Republican and Democratic governors think look like good ideas.”

The Colorado Matters website has the full transcript.

This story is part of a reporting partnership with NPR, Colorado Public Radio and Kaiser Health News.

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Governors Preparing Bipartisan Health Care Plan For Congress To Consider – NPR

Austin lands conference focused on health care innovation – MyStatesman.com

Local health care industry officials on Tuesday said they have enticed a key conference to move to Austin from Atlanta and expect at least 500 top executives to attend next spring.

The third annual Transformation in Health Conference, tentatively scheduled for April or May, relocated to Austin to tap into the regions entrepreneurial and budding health-care ecosystems, the events organizers said.

Austin is a small market, but its an up-and-coming market and has created a reputation that welcomes innovation and supporting innovation, said Fawn Lopez, publisher and vice president of Modern Healthcare magazine, which organizes the conference. We wanted to be in a market thats consistent with the goal and the objective of the transformation summit.

Lopez and her colleagues will coordinate the conference in partnership with the Austin Healthcare Council, which helped draw the event to Austin and announced the deal at a luncheon Tuesday. Gus Cardenas, president of the council, said he expects between 500 and 1,000 executives to attend the two-day event.

This shows the rest of the world we are here, Cardenas said Tuesday morning. Its a small, nascent but growing ecosystem thats looking at new ways of tackling old health problems.

Theres nothing were working on that has the same potential as health care innovation, Austin Mayor Steve Adler said at the luncheon. The possiblities are especially significant for Austin, Adler said, because the city is getting into this in such a big way as the health care industry is undergoing significant changes.

Prior summits drew executives from a broad range of health care companies, Lopez said in a phone interview last week. By bringing together physicians, administrators, suppliers and other stakeholders, the conference could identify ways individuals and organizations were transforming the health care industry.

As an example, Lopez noted the ongoing transition to a model that pays for better overall patient outcomes, rather than a fee paid every time a doctor performs a procedure. That shift is forcing the industry participants from hospitals to physicians to equipment suppliers to rethink their business interactions.

So physicians might not be able to dictate the equipment or supplies they use if those supplies cost a lot more but dont produce better results. Lopez said. That means the companies that supply those products and services now have to participate in efforts to provide greater value.

They now have to get on the same page with the administration as far as cost containment is concerned, she said. If they cant help customers save money and deliver quality care at a lower cost, theyre not going to get a seat at the table.

The conference brings all those industry officials together to discuss new ways to improve care, lower costs and increase efficiency, she said. With the move to Austin, the summit will add new matchmaking opportunities designed to bring together health care startups and investors, Lopez said.

Cardenas and other local officials said Central Texas, despite its relatively small health care industry, is a natural environment for thinking about new innovations in health care systems, operations and especially technology.

The University of Texas at Austin Dell Medical School has a stated goal to transform health care delivery and systems. An emerging innovation zone near the school is being developed to help foster startups and companies and to help bridge the innovation at the school to the Austin business and residential community.

And earlier this month, Merck, Sharpe & Dohme Corp. officially said it will build its fourth global information-technology innovation center in Austin. The global pharmaceutical company expects to create at least 600 local jobs in the coming years.

People are seeing we have the brain trust, the infrastructure thats in place and the ability to be able to move forward quickly because of an entrepreneurial type of thinking and acceptance of new ideas, Cardenas said.

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Austin lands conference focused on health care innovation – MyStatesman.com

In a swing district, a Democrat runs on (eventual) single-payer health care – Washington Post

DETROIT Andy Thorburn, a health insurance executive who is plugging $2 million into a bid to replace Rep. Edward R. Royce (R-Calif.), is the latest Democrat pushing the party to embrace single-payer health care even in swing districts. In a video announcement, Thorburn paints thecontest as a referendum on health care, between a Republican who voted for the repeal of the Affordable Care Act and a Democrat who wants to move, eventually, to Medicare for all.

First-time Democratic candidate Andy Thorburn released an ad embracing single-payer health care, in his campaign to replace Rep. Edward R. Royce (R-Calif.). (Andy Thorburn)

In an interview, Thorburn presented himself as a candidate who could debate health care from a position of total awareness. He ran Global Benefits Group, an international insurance company, until stepping back to the board this year.

The part that really bothered me, when Obama first presented his plan,was my friends and colleaguesstarting their arguments by saying: Hey, we have the best medical system in the world. Why change it? I was like, Look, I cant have a serious discussionwith you if you think that. Its the best system if youre rich. But its clearly not the best for everyone. Yeah, the shah of Iran came here for treatment once thats not the standard!

Progressives, who are stepping up their campaigns to promote single-payer legislation and baiting Republicans into attack ads have struggled with California. The states Democratic-run legislature had passed single-payer legislation during the term of Gov. Arnold Schwarzenegger (R), knowing it would be vetoed; a new single-payer bill was bottled up by legislators, kicking off months of intraparty infighting.

Thorburn suggested that the Democrats national single-payer debate could start on different terms.

Im aware of the debate, Thorburn said. Look, the tax burden has to go up, but all youre doing is shifting from one pocket to another. And the end of the day, were paying less money for health care, because thats been the experience of every country that went to this system.

Asked about the effect that universal Medicare would have on the private insurance system, Thorburn acknowledged that it would hurt.

Move as quickly as you can, he said. It would have a negative impact on my business, but it would be relatively small. Almost all the countries that have universal insurance also have competitive supplemental insurance industries. Germany has Allianz, one of the biggest insurers in the world.

On Tuesday night in Detroit, Sen. Bernie Sanders (I-Vt.) and Rep. John Conyers Jr. (D-Mich.) were holding a town hall meeting to promote specific single-payer legislation in Congress Conyerss HR 676, and Sanderss tbd bill. Thorburn said he would study the bills, suggesting he could cut his own path without undermining anything Democrats were doing.

Im not one of those people who thinks [Nancy] Pelosis terrible, he said, referring to the House minority leader, but Im too much of a novice to think I know who should be speaker.

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In a swing district, a Democrat runs on (eventual) single-payer health care – Washington Post

Dems’ New Health Care Ads Literally Follow You Online – Daily Beast

Its no secret that Democrats want to turn the 2018 midterms into a referendum on Republican efforts to overhaul the health care system. The bigger mystery is how Democrats can do so most effectively.

On Tuesday, the Democratic Senatorial Campaign Committee offered one of the more innovative attempts yet, deploying an advertising strategy that is relatively new to the digital content creators and even newer for political party apparatuses.

The spot, which will target voters in Arizona, Florida, Indiana, Missouri, Montana, North Dakota, Nevada, Ohio, Pennsylvania, and West Virginia. Instead of a traditional thirty-second clip, it optimizes viewer experiences by breaking the advertisement into six-second increments. And instead of being presented all at once on a single website, those six-second increments follow a user as he or she travels around the Internet. In other words, viewers will see the first part of the ad as they begin their day at thedailybeast.com. They will then see a second portion of the ad as they move on to a different website; and then a third portion of the ad as they go to yet another page.

This less disruptive format has been deployed by content providers seeking to grab viewer’s attention in an age of Snapchat and short attention spans. But a DSCC official says this is the first time this cycle that they or any other committee has utilized the format. Google helped the committee utilize its technology, the official said.

In the spots released on Tuesday, the committee enacts a text conversation between a child and his or her mother, as they find themselves in an emergency room needing stitches. By the second clip, its revealed that the family has no insurance. By the third clip, it is pointed out that the Republican senator being targeted in the ad cast a vote that, it is suggested, slashed their insurance.

As a factual matter, the advertisements have their holes. The Republican-authored health-care bill never became law, despite the fact that the GOP senators being targeted by the DSCC voted for their nearly passed bill. A stronger argument would be that the Trump administration has made insurance more expensive because of its sabotage of Obamacare. But the DSCC is invested in regaining control of the Senate, not in unseating the president.

Still, the GOP-authored bill was projected to swell the ranks of the uninsured in addition to elevating premiums for the elderly and sick. And that is the message that DSCC is hammering home, now in a more innovative, digitally savvy way.

The Republicans health care plan is striking Americans in their everyday lives and in their most challenging moments — spiking their costs and stripping away coverage they are depending on so that big insurance companies can get another tax break, said David Bergstein of the Democratic Senatorial Campaign Committee. This message reaches voters over a series of direct and compelling spots that tell the story of how the GOP agenda has hurt Americans and their families.

The DSCCs bumper flock ads are part of a larger, six figure, digital ad buy that has also featured six-second bumper YouTube ads and full screen Google takeover ads.

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Dems’ New Health Care Ads Literally Follow You Online – Daily Beast

Kennedy talks money, healthcare – The Capitol Fax Blog (blog)

* WCIAS Mark Maxwell interviewed Chris Kennedy the other day. Click here to watch it all, but heres an excerpt

MAXWELL: Your recent polling, your internal polling, said you were a frontrunner, but yet its a big fight. Youve got a long way to go. Seven other candidates gunning for that top spot, and theres a lot of money in this race. JB Pritzker has $21 million already that hes self-funding in his campaign. Are you going to be able to catch up there? Hows fundraising going lately? I know you brought on Bill Daley.

KENNEDY: Yeah, Bill Daleys been incredible, and well have the resources to compete. Im not worried about the money.

MAXWELL: Are you going to cut a check?

KENNEDY: If you look at the number of donors we have, the number of volunteers, the support across the state is incredible. I know Im ahead in the polls, but Im gonna run this like, uh, like Im the underdog and I think thats an important message to people as well.

Bill Daleys arrival was announced on July 19th

It was a bad quarter, no question about it, Daley told me. There was a lot of political outreach. (But) there wasnt even a finance committee, just a committee of stakeholders.

Fixing that is the first thing on his agenda, Daley said. A full finance committee is being assembled (Daley declined to disclose any names), with an initial meeting set for next week. Lists of fundraising targets will be assembled, and regular calls and contacts made, he continued. Some of that will involve the candidate himself. Chris has to spend more time on it.

Since then, Kennedys campaign has reported just $34,700 in contributions. Now, he could be holding back his deposits in order to make a big splash at the end of the quarter. But youd think a candidate whos been under fire for not raising enough money would want to get out in front of that story by rolling out some big donors.

* On to healthcare

MAXWELL: I want to ask you about healthcare for a minute because a lot of the candidates are weighing in. There was a recent fight over single payer, public option. And I want to see if I can get you to weigh in here. What direction would you like to see the country, and what direction would you like to see the state of Illinois go in how it provides healthcare for people?

KENNEDY: I think there are, there are, there are great examples to us around the country. I dont think we need to invent it all ourselves in Illinois. I think if you at what happened under Governor Romney in Massachusetts and the expansion of Medicaid there and the ability for the state to provide great coverage to people at all economic levels.

MAXWELL: Weve expanded Medicaid in Illinois. One in four residents in this state are on Medicaid.

KENNEDY: And I think we can continue to do that, and in effect migrate towards a single payer system. I think we need to free up Medicare and Medicaid to negotiate pricing.

MAXWELL: That sounds like a slow incremental process youre describing, migrate towards single payer. How long do you think that would take?

KENNEDY: I dont know. But I think were moving, were moving in that direction. Its clear to me that thats where well end up, both as a state and as a country over time. And we ought to be on the front-burner here in Illinois.

MAXWELL: Youre describing it as inertia, something thats already on the track, and maybe a spectator. Would you push that faster?

KENNEDY: Oh, Id definitely push it faster, absolutely. And I think we should continue to expand as best we can by negotiating with the federal government what, uh, what issues and who can be covered in Illinois, then do a better job recruiting people who havent signed up to sign up for the available care in our state now. And I think thats how we get full coverage for everyone. Theres coverage, I mean, the fact is that were just handling it poorly. People are getting sick and going to emergency rooms, and it doesnt have to be like that. The problem with the state is largely we look so, we look inward and not outward, and we ought to look to other states and see what great outcomes are occurring there. We could provide better coverage and better healthcare for people in our state.

MAXWELL: So you mention Massachusetts, RomneyCare. Its a deep blue state there. Theyve had some trial balloons and things on the national healthcare scene. Any other states or any other practices that youve seen in relation to how youd lower drug prices or how you would make medicine more affordable for average Americans?

KENNEDY: I think some of the things theyve done in California are helpful. And California, places like California and Texas have massive populations, and theyve begun to negotiate. And I think we can create a consortium with other states, cooperate. I know that were competitive with the people in Indiana and Wisconsin and Iowa, but we can work with them and create regional competition, or regional buying power, that allows us to use the market to drive down pricing.

Im not sure I completely follow, but OK.

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Kennedy talks money, healthcare – The Capitol Fax Blog (blog)

McConnell: Path on healthcare ‘murky’ – The Hill (blog)

Senate Majority Leader Mitch McConnellMitch McConnellTrumps isolation grows Ellison: Trump has ‘level of sympathy’ for neo-Nazis, white supremacists Trump touts endorsement of second-place finisher in Alabama primary MORE (R-Ky.) acknowledgedMondaythat Congress’s next steps on healthcare are unclear after Republicans failed to repeal ObamaCare.

“Obviously we had a setback on the effort to make dramatic changes on ObamaCare. The way forward now is somewhat murky,” the Senate GOP leader said at a Chamber of Commerce event inKentucky with Treasury Secretary Steven MnuchinSteven Terner MnuchinLiberal coalition launches ‘Stop Trump Tax Cuts’ website Trump touts infrastructure order, but veers off message Looming debt limit fight rattles Wall Street MORE.

A GOP push to pass a “skinny repeal” of ObamaCare failedin a dramatic 49-51 vote before the August recess. A broader repeal proposal and a measure to repeal and replace theAffordable Care Actsimultaneouslyalso failed to get enoughvotes to pass inthe Senate.

McConnell added that lawmakers were “going to see” whatnegotiationsbetween Sens. Lamar AlexanderAndrew (Lamar) Lamar AlexanderTrump to make ObamaCare payments to insurers for August CBO: ObamaCare premiums could rise 20 percent if Trump ends payments CBO to release report Tuesday on ending ObamaCare insurer payments MORE (R-Tenn.) and Patty MurrayPatty MurrayCBO to release report Tuesday on ending ObamaCare insurer payments OPINION | Progressives, now’s your chance to secure healthcare for all McConnell open to bipartisan deal on health insurance payments MORE (D-Wash.), the top two members of the Senate’s healthcare committee, aimed atstabilizingthe individual health insurance market could produce.

“We have … collapsing individual insurance markets around the country. Requests to continue to subsidize the insurance companies. It’s a pretty controversial subject to subsidize insurance companies without any reforms,” the GOP senator said.

He added that Democrats “have been pretty uninterested in any reforms,” but the two parties will need to try to negotiate when they get back to Washington next month.

“So when we get back after Labor Day we’ll have to sit down and talk to themand see … what the way forward might be,” he said.

Alexander and Murray are expected to holda series of bipartisan Health Committee hearings next month.

Their goal is to craft an insurance stabilization bill by mid-Septemberthat is expected to include money for ObamaCare’s cost-sharing reduction payments, which President Trump has threatened to cut off.

McConnell has previously acknowledged that the next steps on healthcare are unclear afterRepublicans campaigned for years on repealing and replacing the Obama-era law.

If the Democrats are willing to support some real reforms, rather than just an insurance company bailout, I would be willing to take a look at it, McConnell toldreporters earlier this monthahead of the annual Fancy Farm Picnic.

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McConnell: Path on healthcare ‘murky’ – The Hill (blog)

Democrats prep for next round of healthcare fight – The Hill

Democrats are heading toward a new phase in the battle over healthcare as they brace for a tough midterm election cycle.

With the GOP’s ObamaCare repeal push largely on ice, Democrats are shifting their focus from defending the Affordable Care Act to pitching their own healthcare ideas.

The long-shot proposals have little chance of passing with Republicans in control of both chambers of Congress and the White House.

But the competing measures could feed into the ongoing fight about the partys future as Democrats search for a path out of the political wilderness.

Establishing a Medicare for All single-payer program will improve the health of the American people and provide substantial financial savings for middle class families. It is the right thing to do. It is the moral thing to do, Sanders wrote in a Guardian op-ed.

Echoing his upstart presidential campaign last year, the Vermont senator is asking supporters to sign up as a citizen co-sponsor of the forthcoming legislation, arguing that its time to wage a moral and political war against a dysfunctional healthcare system.

Sanders put universal healthcare at the center of his bid for the Democratic nomination, and the idea has gained traction amid a progressive resurgence within the party.

Many of Sanderss potential opponentsin a 2020 presidential primary including Democratic Sens. Kamala Harris (Calif.) and Cory BookerCory Anthony BookerBooker: Republicans can’t force new healthcare plan ‘down our throats’ Bill targets lead in schools drinking water Batman v Superman star pushes Cory Booker for president MORE (N.J.) have voiced some support for a government operated healthcare system. Sen. Elizabeth WarrenElizabeth WarrenWarren: Education Dept lawyer may have violated conflict-of-interest laws Congress should think twice on the Israel Anti-Boycott Act Sanders plans to introduce single-payer bill in September MORE (D-Mass.) told The Wall Street Journal that its time for the next step. And the next step is single-payer.

Marissa Barrow, a spokeswoman for the Progressive Change Campaign Committee, said Democrats should embrace a big and bold agenda heading into the next election.

Were looking to make Medicare for all one of the big issues on the campaign trail, she said. We see it as an issue that could help unite the Democratic Party.

But Sanderss Senate colleagues who are running in red states have kept the proposal at arm’s length.

Democratic Sens. Joe ManchinJoe ManchinOPINION | 5 ways Democrats can win back power in the states Trump’s Democratic tax dilemma Manchin eyed as potential pick for Energy secretary: report MORE (W.Va.), Joe DonnellyJoe DonnellyTrump’s Democratic tax dilemma FEC ‘reform’ a smokescreen to weaponize government against free speech It’s time for McConnell to fight with Trump instead of against him MORE (Ind.), Jon TesterJon TesterWhy ‘cherry-picking’ is the solution to our nations flood insurance disaster Trump signs Veterans Affairs bill at New Jersey golf club It’s time for McConnell to fight with Trump instead of against him MORE (Mont.) and Heidi HeitkampHeidi HeitkampTrump’s Democratic tax dilemma It’s time for McConnell to fight with Trump instead of against him The real litmus test is whether pro-life democrats vote for pro-life legislation MORE (N.D.), as well as Independent Sen. Angus KingAngus Stanley KingSen. King: If Trump fires Mueller, Congress would pass veto-proof special prosecutor statute Senate heading for late night ahead of ObamaCare repeal showdown Overnight Healthcare: Four GOP senators threaten to block ‘skinny’ repeal | Healthcare groups blast skinny repeal | GOP single-payer amendment fails in Senate MORE (Maine), joined with Republicans to vote against a single-payer amendment from GOP Sen. Steve Daines (Mont.) late last month.

Heitkamp said Congress needs realistic solutions and that Dainess maneuver which was expected to fail was a political stunt.

We need realistic solutions to help fix our healthcare system. … The decision was made in 2010 to go with a market-based system the question is how we improve the system we have, Heitkamp said in a statement.

Sen. Claire McCaskillClaire McCaskillSenators push for possible FCC enforcement over Lifeline fraud Democrat senator: Trump has elevated Kim Jong-Un to the world stage It’s time for McConnell to fight with Trump instead of against him MORE (D-Mo.), who like most Democrats voted present on the GOP amendment, also told constituents she would not support a single-payer proposal.

Im going to disappoint a lot of you. … I would say if a single-payer came up to a vote right now I would not vote for it, McCaskill, who is up for reelection next year, told constituents during a town hall earlier this year.

McCaskill added she would support allowing individuals who only have one option on the ObamaCare exchanges to buy into Medicare or Medicaid instead.

Democrats face a tough Senate map in 2018, with 10senators running for reelection in states carried by Trump. The nonpartisan Cook Political Report shifted three of those races West Virginia, Indiana and Missouri to toss up and North Dakota from likely D to lean D this week.

A spokesman for Sanders said he didnt yet have an estimate for how many members of the Democratic conferencewould support the forthcoming legislation. One hundred and sixteen House Democrats are backing a separate House bill from Rep. John Conyers (D-Mich.) the first time a majority of the House Democratic Caucus has supported the proposal.

Democratic leadership is trying to walk a fine line in the looming healthcare fight as they balance the competing interests of different wings of the party.

Senate Minority Leader CharlesSchumer (D-N.Y.) has put myriad options, including single payer, on the table.

We’re going to look at broader things single payer is one of them, he told ABC News. Medicare for people above 55 is on the table. A buy-in to Medicare is on the table. A buy-in to Medicaid is on the table.

Overall, 33 percent of Americans believe healthcare should be a single payer setup, according to a Pew Research Center poll from late June, compared to 52 percent of Democrats and 64 percent of liberals.

The poll also found that roughly 60 percent believe the government is responsible for making sure all Americans have health insurance.

The coming fight over healthcare is the latest example of a vocal progressive wing trying to flex its muscle and push the Democratic Party to the left in the wake of the 2016 presidential election.

When Sanders introduced a bill to raise the federal minimum wage to $15 a key issue between himself and primary opponent Hillary ClintonHillary Rodham ClintonAssange meets U.S. congressman, vows to prove Russia did not leak him documents High-ranking FBI official leaves Russia probe OPINION | Steve Bannon is Trump’s indispensable man don’t sacrifice him to the critics MORE 30Democratic senators signed on to the bill, compared to five supporters for a similar bill in 2015.

But red-state incumbents arent the only Democrats worried about embracing single payer.

Sen. Dianne FeinsteinDianne FeinsteinTrump’s Democratic tax dilemma Feinstein: Trump immigration policies ‘cruel and arbitrary’ The Memo: Could Trumps hard line work on North Korea? MORE (D-Calif.) received pushback at a town hall in San Francisco when she said told constituents that she wasnt there on single payer.

Asked if he could support a single-payer system, Sen. Tim KaineTim Kaine Violent white nationalist protests prompt state of emergency in Virginia Republicans will get their comeuppance in New Jersey, Virginia Spicer signs deal with top TV lawyer: report MORE (D-Va.), Clintons vice presidential pick, noted Sanders would be introducing a bill but that he has a different view about what we ought to do.

I want people to have more options, not fewer. … I would like to explore a circumstance under which there could be a public option, like a Medicare Part E for everybody that you’d have to buy into, Kaine, who is also up for reelection next year, told ABC News earlier this month.

Democratic Sens. Debbie StabenowDebbie StabenowHead of McConnell-backed PAC: We’re ‘very interested’ in Kid Rock Senate campaign Juan Williams: Trump and the new celebrity politics Senate Dems unveil trade agenda MORE (Mich.), Tammy BaldwinTammy BaldwinClub for Growth endorses Nicholson in Wisconsin GOP primary Senate Dems unveil trade agenda Group pushes FDA to act on soy milk labeling petition MORE (Wis.) and Sherrod BrownSherrod Campbell BrownOvernight Finance: House passes spending bill with border wall funds | Ryan drops border tax idea | Russia sanctions bill goes to Trump’s desk | Dems grill bank regulator picks Dems grill Trump bank regulator nominees Senate Dems launch talkathon ahead of ObamaCare repeal vote MORE (Ohio), who are each up for reelection in states carried by Trump, are offering legislation that let Americans between the ages of 55 and 64 buy into Medicare.

Barrow called the move a positive step, though the end game is either a single-payer system or a state-by-state or federal Medicare option for everyone.

Sanders has also acknowledged that with Republicans in control of Congress, his bill is unlikely to pass. He outlined three steps to take in the meantime: passing legislation to get the public option in every state, lowering Medicaid eligibility to 55 and lowering the cost of prescription drugs.

But he is also prepared to take his argument for a broader single payer bill into Trump territory. Hell hit the road with stops in Indiana, Ohio and Michigan to discuss healthcare and the economy, including a rally with Conyers where theyre expected to discuss Medicare for all.

Barrow added that the Progressive Change Campaign Committee is already reaching out Capitol Hill offices and will keep up their effort through 2018 and beyond to get Democrats to wrap themselves in the flag of Medicare.

If you go into a red state its a super, super popular program in red states, blue states and purple states, she said. Its going to be a winning issue in 2018 especially in those red and purple states.

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Democrats prep for next round of healthcare fight – The Hill

Getting People to Enroll in Health Plans While Trump Attacks Them … – New York Times

A recent sticky Friday found Ms. Barker passing out fliers about open enrollment at a back-to-school fair in East Nashville. To every parent and grandparent who strolled past, she asked, You have health insurance? Nearby was her favorite prop: a wheel that passers-by could spin with a dial that landed on terms like deductible and penalty, which she cheerfully explained to those willing to listen.

For the laws first four enrollment seasons, the Obama administration spent heavily on advertising, recruited celebrities like Katy Perry and companies like Uber to spread the word and scrutinized data to pinpoint potential customers. But this year, community-based enrollment groups, known as navigators, may be largely on their own.

This is going to be the heaviest lift we have ever tried to undertake, said Jessie Menkens, navigator program coordinator for the Alaska Primary Care Association. We will be shouting out for people to recognize this really is not over that regardless of what deliberations are happening in Washington, this is still truly the law of the land.

The approximately 100 navigator groups around the country, which received $63 million in federal grants last year, are not sure the Trump administration will renew those grants, which are supposed to be awarded next month. Matt Slonaker, executive director of the Utah Health Policy Project, said he had had encouraging conversations with officials at the Centers for Medicare and Medicaid Services (known as C.M.S.), but no one will know for sure until the grants are finalized.

Mr. Slonaker also said that at a conference that C.M.S. held for navigators in June, employees of the agency said the federal government would not run any ads to promote open enrollment this year. A spokeswoman for the agency would not confirm whether that was true or answer other questions about the administrations plans.

Other open questions include whether the Trump administration will automatically re-enroll people who did not actively cancel or change their plan, as Mr. Obamas did, and whether it will increase staffing at call centers that help people sign up, given the compressed enrollment time frame.

Insurance companies had asked for the shorter enrollment period, saying it would allow them to collect a full years worth of premiums from Obamacare customers and reduce the number of people who wait until they are sick to sign up. The Obama administration had planned to cut the enrollment period to six weeks starting in 2018, but the Trump administration moved it up to this year.

Leaders of the state-based marketplaces say they feel largely in the dark.

By this time in prior years, the states would have a really good sense of what the federal government was planning so we could plug the holes or leverage what they were doing, said Mila Kofman, executive director of the D.C. Health Benefit Exchange Authority. We just havent seen any details.

It seems clear that Mr. Trump wont be using his powerful Twitter account to encourage sign-ups. Nor are he and Tom Price, his health and human services secretary, likely to be visiting enrollment sites around the country like Mr. Obama and his health secretaries, Kathleen Sebelius and Sylvia Burwell, did.

Mr. Obama visited Nashville to promote the health law in 2015, going to the home of a breast cancer survivor who had benefited from the law, then taking her in his motorcade to an elementary school, where the two of them talked up the law to a cheering crowd.

Last year, Tennessee became a symbol of the laws growing problems. Insurers sought some of the steepest premium increases in the country after posting major losses they blamed on their Obamacare customers high medical costs. Then BlueCross BlueShield of Tennessee decided to stop offering plans in Nashville, Memphis or Knoxville. Statewide enrollment dipped to 200,401 by February 2017, from 231,705 in March 2016.

The state became something of a poster child for the repeal-and-replace effort this year, when Humana announced it was pulling out of the Obamacare markets nationally. That left 16 Tennessee counties with no insurers for next year, a situation Mr. Trump seized on at a rally here in March. (BlueCross BlueShield has since agreed to offer coverage in those counties.)

The Health and Human Services department has produced a series of videos featuring Americans burdened by Obamacare, which Mr. Price has posted on Twitter. In response to a request from Senate Democrats, the Government Accountability Office is investigating the videos as part of a broader look at whether some of the anti-Obamacare actions by H.H.S. have violated restrictions on how federal funds can be spent.

Congressional Democrats said they would be sending a letter to Mr. Price on Friday, demanding detailed information about his plans for marketing and outreach during open enrollment. In the letter, the ranking Democrats on House and Senate committees with jurisdiction over health care said they were concerned the administration was intent on depressing sign-ups.

Its pretty powerful, Ms. Barker said of the administrations frequent attacks on the law, and thats what were up against.

Ms. Barkers salary is paid out of the $1.6 million grant that her nonprofit agency, Family and Childrens Services, receives under the law and shares with three other groups around the state. For now she remains upbeat, especially since Senator Lamar Alexander of Tennessee, the Republican who leads the Senate health committee, recently announced the committee would try to create bipartisan legislation next month to shore up the law.

Im thinking yes, thats great! Ms. Barker said. I use that when I talk to people who are concerned theres a possibility that things will get better, that premiums will go down and this will all get worked out.

At the back-to-school fair, she buttonholed an uninsured father who said he was moving to Memphis, telling him he might be eligible for a special enrollment period and pressing a phone number into his hand. He gave her a thumbs-up as he walked away.

As the event wound down, she made plans to stop on her way home at a TJ Maxx that was going out of business. Its employees, she reasoned, might need new insurance soon.

An earlier version of this article misspelled the surname of the executive director of the D.C. Health Benefit Exchange Authority. She is Mila Kofman, not Mila Kaufman.

A version of this article appears in print on August 21, 2017, on Page A11 of the New York edition with the headline: The Heavy Lift of Recruiting for Tenuous Health Insurance Plans.

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Getting People to Enroll in Health Plans While Trump Attacks Them … – New York Times

Study says Aurora tops in country for pediatric health care – Chicago Tribune

Aurora has been named tops in the country for pediatric health care.

The ranking comes from Vitals, a national health care incentive and engagement program. It researched the 200 largest American cities to find out which have access to the best and worst pediatric care, according to a press release from the city of Aurora.

Aurora was number one in the study. The other top cities were Madison, Wis, second place; Grand Rapids, Mich., third place; Minneapolis, Minn., fourth place; Rochester, N.Y., fifth place; St. Paul, Minn., sixth place; Cleveland, Ohio, seventh place; Salt Lake City, Utah, eighth place; Cincinnati, Ohio, ninth place; and Akron, Ohio, 10th place.

When creating the list of America’s Top Cities for Access to Pediatric Care, Vitals analyzed the number of pediatricians available in each city on a per-capita basis for their under-18 population, according to the press release. Patient-reported information such as ease of getting an appointment, pediatrician ratings and wait times were also factored into the final rankings.

“When a child is ill, the primary concern for parents is getting quick access to quality care,” said Mitch Rothschild, founder and executive chairman of Vitals, in the release. “Vitals not only helps consumers find top-rated pediatricians near their homes, but also make informed decisions, relying on the wisdom of others who’ve contributed to the nine million patient ratings and reviews on the site.”

Pediatric services in Aurora are provided by a range of medical professionals including Rush Copley Medical Center and its connection with Rush University Children’s Hospital; Presence Health and its collaboration with the Lurie Children’s Hospital of Chicago; and the multiple locations of VNA Healthcare in Aurora, according to the release.

“Pediatric health care is a primary building block for lifelong success,” said Trish Rooney, executive director of Strong Prepared and Ready for Kindergarten, in the release. “We have a strong network of early childhood providers in Aurora, and our health care providers are integral members of the community. It is great to know they are leading the way and setting the standard for pediatric health care for the entire country.”

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Study says Aurora tops in country for pediatric health care – Chicago Tribune

Why Tenet Healthcare Shares Are Rallying 14.2% Today – Motley Fool

What happened

After a sell-off that’s seen its shares drop from over $20 in July to below $13 earlier this month, news that a hedge fund has acquired a 5.7% stake sentshares ofTenet Healthcare(NYSE:THC)soaring 14.2% at 2:00 p.m. EDT today.

On Aug. 7, Tenet Healthcare reported second-quarter financial results that were anything but encouraging. In the quarter,the company’s net revenue declined 1.4% to $4.8 billion, and its net loss expanded 19.6%, to $55 million, or $0.55 per share. On an adjusted basis, the company’s net loss per share was $0.17. These figures were worse than investors were looking for, and shares were punished as a result.

IMAGE SOURCE: GETTY IMAGES.

Last week, two members of Tenet Healthcare’s board of directors resigned, citing “irreconcilable differences.” The two members are employees of Glenview Capital Management, a major Tenet Healthcare investor, and their departure triggers the expiration of a standstill agreement later this month. After the standstill agreement expires, Glenview can evaluate other options that could unlock shareholder value in the company, and according to Glenview’s press release on that matter, they are committed to remaining a Tenet Healthcare investor. Perhaps this suggests that a proxy fight for control of the board is in the making. As of June 30, Glenview is Tenet Healthcare’s largest shareholder, with holdings of 17.9 million shares.

Tenet Healthcare’s shares moved up significantly after Glenview’s announcement, and Camber Capital Management today revealed in a Securities and Exchange Commission filing that it’s amassed a 5.7% position in Tenet Healthcare, adding conviction to the thinking that a management shake-up can unlock shareholder value. As of June 30, Camber Capital reported $1.4 billion in assets invested in 37 positions, including a 4 million share stake in Tenet Healthcare. Currently, Camber Capital owns 5.75 million shares.

After its lackluster performance last quarter, Tenet Healthcare ratcheted back its outlook for the full year. In addition to its operating headwinds, Tenet Healthcare also faces uncertainty regarding the future of Obamacare. Because Obamacare has decreased the uninsured rate, it has had a positive impact on hospital write-offs that are associated with charity care that’s provided to patients.

Clearly, Glenview and Camber Capital believe there’s value in Tenet Healthcare that can be unlocked. However, it’s unclear exactly how that might happen. Until we get greater insight into how Glenview will proceed, or see signs that Tenet Healthcare’s business is improving, the volatility that’s likely in this stock has me thinking there are better stocks for investors to focus on.

Todd Campbell has no position in any stocks mentioned. His clients may have positions in the companies mentioned. The Motley Fool has no position in any of the stocks mentioned. The Motley Fool has a disclosure policy.

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Why Tenet Healthcare Shares Are Rallying 14.2% Today – Motley Fool

A Health-Care Fix That Works, Now Being Rolled Back – Wall Street Journal (subscription)


Wall Street Journal (subscription)
A HealthCare Fix That Works, Now Being Rolled Back
Wall Street Journal (subscription)
President Trump is correct: Health care is complicated. If you've ever received a hospital bill, you've seen it for yourself. America's healthcare system is a tangle of providers, all paid separately for each and every thing they do. One emergency

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A Health-Care Fix That Works, Now Being Rolled Back – Wall Street Journal (subscription)

Hospitals must band together to beat hackers – Healthcare IT News

Consider this a rallying cry: Hospitals, health systems and networks need to join forces, organize, come together as a community, to proactively fend off hackers, hacktivists, organized criminals and other emerging threats all trying to penetrate healthcare entities to either steal patient data or, worse, destroy it altogether.

Its not just WannaCry, Petya, NotPetya, ransomware in coffee makers (yes, that appears to have really happened) or the newest malware strain, either. Yes, they all startled the industry, if not the world, for a flash. And theyre legitimate threats.

But the greater danger is that CISOs, CIOs and their shops regardless of how tech-savviness, how many specialists they boast or even the number of attacks their ace security team has detected, blocked or survived every single healthcare organization must protect against the next big attack even though there is literally no way to know what it will look like or from where it will come.

[Register Now: Upcoming HIMSS Healthcare Security Forum]

To be fair, this is happening. Some hospitals are working together just not nearly enough. Security frameworks, information sharing centers, industry trade groups already exist.

Its time to start operating as a healthcare infosec community because security is only going to get harder.

Embed from Getty Images

Tom Ridge, the first U.S. Secretary of Homeland Security and former Pennsylvania Governor, said that a community approach has worked in other industries.

Can it succeed in healthcare?

Yes, yes, Ridge said. Yes and the information sharing and analysis centers proved to be very helpful in financial services and energy-related industries. That is a great platform within which to share best practices, to share threat information.

Healthcare has an ISAC of its own, too, the NH-ISAC and Denise Anderson is its President.

Obviously we’d love to see as many people situationally aware as is possible, Anderson said.

In response to Petya, for instance, Anderson said NH-ISAC had a core team of subject matter experts working to collaboratively determine what the problem was and then craft a mitigation strategy. Members, in turn, can take that strategy and put it, or parts thereof, into action.

Thats just one recent example, of course. And Penn Medicine Associate CIO John Donohue said the opportunities to collaborate with other healthcare organizations to improve Penns own security posture are significant.

As we begin to shift more to a proactive cybersecurity stance, timely and accurate intelligence becomes the name of the game, Donohue said.

Penn, for its part, taps into what Donohue described as a network of peers for real-time intelligence on zero-day malware and other trending threats.

That practice is going to become increasingly important as hospitals have more and more apps and devices to protect.

Embed from Getty Images

Depending upon which estimate you prefer, somewhere between 5 and 10 million new devices hook up to the internet every day.

Cyber Threat Alliance President Michael Daniel, who served as the White House Cybersecurity Coordinator for President Obama, said that cyberspace is the only environment expanding on a daily basis and that, in turn, makes the security problem both harder and bigger.

As the number of devices grows, so does peoples reliance on them, and the potential damage that can be done when they are attacked expands as well.

They are much more heterogeneous than we saw in the past, Daniel added. Its not just desktops or laptops, but now its mobile devices and Fitbits, refrigerators, and cars, light bulbs and all the so-called internet of things.

Lets calculate for a minute. A greater variety and number of apps and devices, more new types of cyberattacks, even more adversaries than ever before, and no suggestion that any of those will let up in the near future.

Heres one more to add.

I’m not sure anyone has a true handle on all of the organizations involved in healthcare out there, said NH-ISACs Anderson. Hospitals are not the only organizations that are vulnerable. Dentists, small physician practices, labs, radiological and therapy providers are all very rich targets because they are small and don’t have many resources.

The sum of those realities is a pretty grim picture: Healthcare information security is difficult today and its only going to get harder from here.

Not only hospital management but the boards of directors need to embrace the fact that the industry is vulnerable and they really have to prioritize securing IT systems.

Ridge pointed out that hospital IT and security executives should be aware that the world is in a digital war and its not just nation-state against nation-state. Organized cybercriminal groups, hackers and hacktivists, lone wolf attackers are all dangerous.

Corporate leadership, Ridge said, not only hospital management but the boards of directors need to embrace the fact that the industry is vulnerable and they really have to prioritize securing IT systems.

Ridge said a security framework, such as the one National Institute of Standards and Technologys offers, is a baseline. NIST is one option, HITRUST is another.

In addition to the frameworks, the Department of Health and Human Services Health Cybersecurity Communications and Integration Center, the InfraGard cyber health working group and industry trade groups including Healthcare IT News owner HIMSS, as well as the Medical Group Management Association and the American Medical Association, all make certain resources available.

Lee Kim, Director of Privacy and Security at HIMSS, said the combination of frameworks, associations, government groups could be the virtual glue binding together the infosec community healthcare needs.

Penns Donohue said as threats continue accelerating, he finds himself participating more and more in the intelligence sharing community.

As a result of this collaboration Penn Medicine has been able better prepare for vulnerability exploits and minimize the impact of malware attacks, Donohue said.

Healthcare needs to do with its IT systems what financial services, telecom and energy have already done. Be preemptive, not reactive.

The frameworks and sharing tools exist but, of course, so do challenges.

Picking one among the various resources itself can be confusing, if not inhibitive, HIMSS Kim said. Cost is another issue.

But the biggest obstacle is simply not knowing what information to seek and share or how to make that happen and the same goes for what not to share.

Ridge, who is now chairman of consultancy Ridge Global, added that healthcare should emulate other industries.

Healthcare needs to do with its IT systems what financial services, telecom and energy have already done, Ridge said. Be preemptive, not reactive.

Indeed, it has become a necessity for the healthcare industry to overcome those barriers to participation on the way to safeguarding patient information and care delivery for the patients and their families that infosec, IT and medical professionals serve.

We need to be more coordinated as a sector, HIMSS Kim said. Otherwise, we, too, will be pwned!

Twitter:SullyHIT Email the writer: tom.sullivan@himssmedia.com

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Hospitals must band together to beat hackers – Healthcare IT News

Rx for Federal Healthcare Transformation through IT – FederalNewsRadio.com

Segment 1:How Technology Improves Healthcare

The Defense Department treats about 9 million service members and their families per year. The Veterans Affairs Department provides medical services to about 6 million veterans annually.

Add to this 15 million, the citizens served by the Indian Health Service, the National Institutes of Health, the Centers for Disease Control and Prevention and a host of other agencies, giving the federal government a timely opportunity to change the way through technology and innovation healthcare is delivered to all citizens.

Market research firm Deltek estimates agencies will increase their spending on commercial health IT products and services to $6.4 billion by 2021 up from $6 billion in 2016.

Deltek says DoD and VA are driving the spending increases through new electronic health care systems as well as the broader digitization of processes and integration of data across the federal healthcare sector.

The move to the cloud and the rise of better and faster data analytics will drive the broader adoption of telehealth and mobile applications for healthcare providers, Deltek says.

These technologies can help hospitals and clinics gain a complete view of any one patient to ensure the service member or veteran or citizen more generally receives unique health plan that makes the most of the existing data, systems and processes.

The challenge many health care organizations face, however, both in the public and private sectors, is the tangled mess of systems and databases that have grown up over the last 20 years. This makes data integration and sharing much more difficult.

Right behind that challenge is the amount of data health care produces each day. IDC Health Insights estimates more than 25,000 petabytes of health data will be created by 2020. How can patients and health practitioners manage, understand and make best use of all that information?

These challenges must be overcome to reach the end goals of these efforts, which like most IT transformation efforts center around lowering the cost of care, improving patient outcomes and improving the patient experience.

Moderator

Jason Miller is a reporter whose work focuses mainly on technology and procurement issues, including cybersecurity, e-government and acquisition policies and programs.

Panelists

Andrew Jacobs, Technology Strategy Branch Chief, Architecture, Advanced Concepts & Engineering Division, Defense Health Agency

Andrew Jake Jacobsis the branch chief for the Technology Strategy Branch and the acting branch chief for the Engineering Branch, two branches of the Architecture, Advanced Concepts & Engineering (AACE) Division of the Defense Health Agency (DHA). Jacobs has more than 20 years of federal, industry, and military experience, leading IT operations and initiatives across large-scale complex organizations, including 10 years as a Navy Corpsman. Before his time as a branch chief, Jacobs was a key leader within the MHS infrastructure office, where he rose through the ranks as a network engineer and liaison to the MHS CTO. Today, Jacobs continues to provide guidance on all facets of emerging technologies, industry trends, and IT planning for military health.

Col. William Baez, Chief Medical Information Officer, Office of the Air Force Surgeon General

Col William Bez is the Chief Medical Information Officer and Chief Clinical Information Branch for the Air Force Medical Support Agency, Office of the Air Force Surgeon General, Defense Health Headquarters, Falls Church, Virginia. Col Bez is responsible for a team of six active duty members and eight civilian employees who provide medical modernization support in the arena of health information management and technology for more than 42 thousand medics, 2.6 million Air Force beneficiaries, and 76 military treatment facilities worldwide. His offices mission is to provide medical information management and technology guidance and policy in support of medical expeditionary capabilities and the provision of cost-effective, patient-centered, and prevention-based health care. They also direct the implementation of legacy and future health care information systems and collaborate with Department of Defense and Veterans Administration organizations.

Wayne Bobby, Vice President, Infor Federal

Wayne Bobby joined Infor in October of 2013 to establish a Federal sales team and grow the business throughout the Civilian, Department of Defense, and the Intelligence Community. Prior to joining Infor, Mr. Bobby was the Vice President of Oracles Public Sector Industry Solutions for North America. He draws from over thirty years of work experience in public sector program operations and technology software solutions. Prior to joining Oracle in 1996, Mr. Bobby spent seventeen years in the Federal government where he was the Director of Financial Management Services for the U.S. Department of State. He holds a Masters Degree in Business Administration with a concentration in Management Information Systems from George Washington University in Washington, D.C.

Beth Meyers, RN, PhD, CPHIM, Chief Nurse Executive, Analytics Strategy Director, Infor

Prior to joining Infor, Beth led the Fairview Health System, Minneapolis, supply chains business intelligence team, responsible for converting data into actionable information for decision making. Beth also worked as a perioperative nurse in the U.S. Army and held positions in surgery and clinical management with Baldwin Area Medical Center, Baldwin, Wisc. Beth earned a bachelors degree in nursing from the University of Minnesota and a masters degree in technology management from the University of Wisconsin. She is currently pursuing her PhD in healthcare informatics with the University of Minnesota.

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Rx for Federal Healthcare Transformation through IT – FederalNewsRadio.com

POINT OF VIEW: Don’t quit, refocus on healthcare reform wins – Palm Beach Post

Many Americans were disappointed when recent healthcare overhaul efforts failed. Whether they supported the proposed fix or not, many Floridians are now left wondering if they are stuck with all of the downsides of the Affordable Care Act.

They dont have to be, if Congress can regroup and refocus on more modest, achievable changes. One of those should be to stop the health insurance tax from going back into effect in 2018.

Emerging from a divisive healthcare fight has been broad agreement about the need to reduce healthcare premiums, especially on working families, senior citizens, minority communities and small businesses. The HIT tax, which would raise healthcare costs, can play no part in such a solution.

If allowed to return as scheduled, the Health Insurance Tax (HIT) will reach 100 million consumers and business owners in their health insurance bills, taking $156 billion from them over 10 years.

It is especially harmful because the HIT disproportionately affects small businesses and their employees. Family health insurance for a worker employed by a Main Street company, startup or family-owned business will be $500 more expensive each year. For a corner deli or a niche manufacturer, this can add up to many thousands of dollars in extra expenses, and maybe a red number on the bottom line by years end.

We have to consider the consequences of putting government pressure to these companies. Florida is home to nearly 2.2 million small businesses, including 600,000 Hispanic-owned enterprises. They comprise 98.9 percent of our employers and provide jobs for 3 million people.

Small businesses are also growing at a faster clip than the rest of the economy. And U.S. Commerce Department data shows that the minority-owned business sector is becoming a larger share of our economic base, rising from 22 percent to 29 percent of U.S. firms between 2007 and 2012. Florida is even more dependent on minority entrepreneurship. For example, in Miami, 69.2 percent of businesses are Hispanic-owned.

These powerful job creators are especially vulnerable to disruption. More than a third of Florida businesses are less than five years old, according to the U.S. Census Bureaus Annual Survey of Entrepreneurs. And they generally have less capital on hand to absorb unexpected costs.

This is a big part of the reason that of the 152,000 to 286,000 job losses Oliver Wyman predicts will occur due to the HIT tax, the majority will fall on small businesses. In Florida, that is synonymous with a large, negative impact on Hispanic communities.

These are among the many reasons that 400 Democrats and Republicans came together to suspend the HIT for 2017. Their plan was to allow time to craft a lasting solution to get rid of this tax.

Without congressional intervention, the HIT will return Jan. 1. Health insurance companies are already adding the costs to their 2018 premium calculations, so there is only a short window of opportunity before businesses and consumers pay for lawmakers inaction.

JULIO FUENTES, TALLAHASSEE

Editors note: Fuentes is president of the Florida State Hispanic Chamber of Commerce.

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POINT OF VIEW: Don’t quit, refocus on healthcare reform wins – Palm Beach Post

Health care repeal in Iowa: By the numbers – Ames Tribune

By Clara Janzen Staff Writer

Sarah Ashby is afraid of what may happen if the Affordable Care Act (ACA) would disappear, saying the effects on her would be devastating.

The 25-year old Iowa State University student suffers from mental illness that requires medication and therapy. Being under the age of 26, shes still on her parents health insurance because of the ACA. If that were to be taken away, her monthly costs would jump from $56 to $1,200.

The thought that my insurance could be stripped, well, thats terrifying, Ashby said.

Ashby is one of more than 51,000 people in Iowa who would lose their health insurance if the ACA, commonly called Obamacare, would be completely repealed. The burden for their care would then fall on unpaid emergency room visits at local hospitals, and free clinics, officials at those facilities say.

There is no way the clinic could handle such a huge increase, said Dr. Eric Peterson, a physician at the Boone County Hospital who runs the countys free clinic.

In Boone County, 1,530 people are covered by the ACA, a proportionately large number considering the county accounts for 3 percent of the states residents on the ACA, but for less than 1 percent of the overall population.

The first six months of President Donald Trumps term have revolved around repeated and narrowly failed attempts to repeal Obamacare.

The Republican-controlled Senates most recent attempt to repeal smaller sections of the ACA, dubbed a skinny repeal, in late July was just three votes shy of passing, leaving Obamacare supporters without much to celebrate as the fear of repeal is still real.

We are not celebrating, we are relieved, that millions and millions of people will at least retain their healthcare, said a tearful Senate Minority Leader Chuck Schumer following that vote.

The millions and millions of people number Schumer referred to is found within reports from the Centers for Medicare and Medicaid Services (CMS), the federal agency within the United States Department of Health and Human Services, that administers the Medicare and Medicaid programs and oversees HealthCare.gov, the health insurance exchange website created under the ACA. The numbers indicate that around 24 million people in the U.S. would lose health insurance if the ACA were to be completely repealed.

In Iowa, Polk County stands to take the biggest hit because it makes up half of the people in Iowa enrolled under the ACA at nearly 26,000 people. However, Polk County also makes up 14 percent of the states total population, meaning services such as free clinics are more accessible.

If the Affordable Care Act was repealed, taking on the role of caring for those who would lose insurance would be incredibly hard, said Tess Young, the manager of St. Lukes free clinic in Polk City. They (the federal government) cant just take it away. How do they expect people to just be fine?

When asked if Polk County would be able to handle an extra 26,000 people in need of healthcare, Young said, Well, well give it our best shot.

Handling an influx of people would be even more difficult for many other, smaller Iowa counties where services may not be as accessible. Polk County has eight free clinics. The only other county with more than one is Marion County, southeast of Des Moines, which has two. Only 20 of the 99 counties in the state even have a free clinic.

It would really hit smaller hospitals like here in Boone harder than bigger areas, and our hospital is relatively well managed comparatively to other similarly sized hospitals, Peterson said Peterson.

Free Clinics of Iowa Director Wendy Gray said before the ACA went into effect, 10 percent of Iowans were uninsured.

We had 40-plus free clinics that had lines outside of the doors before the clinic even opened, and the reality is we may be there again, Gray said.

Gray and other free clinic directors around the state agreed the ACA hasnt done as much as they had hoped, but that it hasnt been without benefit.

Certainly, it wasnt the drop-off (of people using free clinics) we had hoped for. We learned quickly that having an insurance card doesnt equate to access, Gray said. Health insurance is still unaffordable for many, and reform is a necessity.

Young, the manager of the free clinic in Polk City, agreed the clinic saw a decrease of free clinic users, and added that a lot of the services provided by the clinic changed.

We tried to become more of a way to guide people on how to get insurance after the ACA was passed, Young said.

Peterson, echoed a similar sentiment.

Our numbers decreased after the ACA was passed, but weve seen a gradual increase in people who have been returning, he said.

Much of the problem lies with those who have a serious illness, Peterson said.

One of the proposals (the Senate recently proposed) would be to introduce policies that would be less expensive; however, those exclude pre-existing conditions, he said. So all the healthy people would gravitate towards cheaper plans, but eventually people with pre-existing conditions couldnt afford what they needed.

Free clinics are not set up to handle serious illnesses, leaving a lot of that burden on emergency rooms, Peterson said.

So then hospitals are losing money, and they have to jack up the rates on everyone else, because sick people will wait until the last minute to get treated because they didnt have insurance to deal with the problem when it was simple he said. Its just going to end up with higher payments and taxes for everyone regardless of insurance status.

Ashby said she anticipates having to go on Medicare once she turns 26, because her illness prevents her from working full time, which could allow her to obtain insurance through an employer.

I need the Medicare expansion from the ACA to stay, because otherwise in order to get it, I would have to have a kid, and thats just crazy, Ashby said.

The Medicare expansion under the ACA removed the requirement a woman have a child before she could receive the benefits from Medicare.

The free clinic directors and doctors agreed the ACA needs to be improved, but said they are not seeing that in the proposals put forward by the government.

Obviously, it wouldnt be an issue if it (the ACA) was replaced with something better, but were not seeing that in what the Senate is trying to do, Young said.

Peterson said the repeal of Obamacare without a better option would do more harm than good, and he would like to see Democrats and Republicans work together to address the real issues within the bill.

To a certain degree, (the way the government is handling the healthcare debate) it says a lot about the way we treat the less fortunate, Peterson said. It says a lot about what kind of society we are and what kind of society we want to be.

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Health care repeal in Iowa: By the numbers – Ames Tribune

Healthcare bills aim to remedy racial disparities in the shadow of Charlottesville – Washington Examiner

Members of the Congressional Black Caucus have for years sought to add to Obamacare through healthcare provisions targeting racial disparities, but they are now focused on more narrow efforts for passage, even as lawmakers are seeking solutions for addressing racial tensions.

The group that studies and advances legislation on health disparities in the House, known as the Health Braintrust, was focused early in the year on staving off Republican efforts to repeal and replace portions of Obamacare, formally known as the Affordable Care Act. House members narrowly passed a bill, but the effort failed to advance in the Senate.

“We know we are not going to get a comprehensive bill passed,” said James Lewis, spokesman for Rep. Robin Kelly, D-Ill., chairwoman for the Braintrust. “We know there is no appetite for that. We are focusing on trying to tweak around the edges and on finding partners.”

A previous version, introduced by Kelly in 2016, would collect more data on disparities, increase the diversity of the healthcare workforce, extend healthcare technology, and address mental health disparities, among other measures. It would focus on diseases that disproportionately affect people of color, like cancer, heart disease, hepatitis, diabetes, and HIV/AIDS.

Members of the Braintrust believe that Obamacare was a key step in achieving their efforts because it increased the number of people who health insurance.

“People of color, especially African Americans, continue to be sicker, have less access to care and die sooner than their white counterparts,” Kelly said in an email. “Lower rates of insurance coverage, a lack of doctors and services of these communities, food insecurities, historic distrust of medical professionals and poisoned air and water all contribute to these real and shocking disparities.”

Overall efforts to reduce disparities should be even broader, say public health experts who have focused on urging policymakers to consider the “social determinants of health.” These factors, like work, education, and neighborhoods contribute to how healthy people are and how long they can expect to live, they say.

Despite improvements, black Americans have long had worse health outcomes than whites. Research for the Centers for Disease Control and Prevention has shown that adults who are black are more likely to have or die from heart disease, stroke, or diabetes. Blacks are nine times more likely to be diagnosed with HIV, 2.5 times more likely to die during pregnancy and 40 percent more likely to die from breast cancer.

Jason Purnell, associate dean for social work at the Brown School at the Washington University in St. Louis, has examined social and economic factors on these health outcomes in his research.

“You can’t have the ACA in isolation and expect it to solve problems that really have to do with the very poor nature of our safety net,” he said. “Even with the ACA completely intact, unless you’re dealing with upstream social determinants of health, you’re going to see similar disparities.”

The national conversation on the media is centered on race following violence that erupted in Charlottesville, Va., involving white supremacist and nationalist protesters clashing with counter-protesters. At the protest, a man reported to have Nazi sympathies allegedly drove a car into counter-protesters, wounding 19 people and killing 32-year-old Heather Heyer.

Since then, state and federal lawmakers have called for the removal of national monuments and symbols across the country. Purnell said he agrees with their removal, but cautions that more work is needed at the policy level.

“It’s much more difficult to try to dismantle some of these other monuments that have been built over several decades that precluded generations of people from having the same opportunities to thrive and build wealth and live long and productive lives,” he said.

Lewis said House members are working on addressing some of these issues. Rather than pass a larger bill, he said, he said, they are looking for more targeted areas of agreement, such as addressing dental health or food deserts, which refers to the absence of healthful food options in certain communities.

Several individual pieces of legislation introduced this year aim to do that. For instance, Rep. Danny Davis and Sen. Dick Durbin, both Democrats from Illinois, earlier this year introduced the Trauma-Informed Care for Children and Families Act, which would create a federal task force, expand Medicaid coverage to child trauma services and implement mental health programs in schools. The bill aims to tackle toxic stress, which medical experts use to describe repeated stress after exposure to a traumatic event, such as violence, which impacts mental wellness and can impede learning or lead to high-risk behaviors.

Davis said some Republicans have expressed interest in the legislation.

“It’s not a race bill, it’s not an ethnic bill and it’s not a geographic bill,” he said. “It’s an American bill. It is a bill that will assist individuals and much of the trauma they have with terrorism being what it is and with the number of terrorist threats and acts.”

He also introduced the Sickle Cell Disease Research, Surveillance, Prevention and Treatment Act, which reauthorizes grants for educating people about the disease, a red blood cell disorder that particularly affects people of African descent. Davis credited Rep. Michael Burgess, a Republican from Texas and chairman of the subcommittee on health, for showing his support for the legislation and said he believed it had enough support to guarantee re-authorization.

A bill by Jaime Herrera Beutler, D-Wash., would allow federal health officials to study maternal mortality and would provide grants to states that identify and implement programs that identify areas in which to improve.

“While there is still an obvious need to fix the problems caused or left unaddressed by the ACA, the Preventing Maternal Deaths Act is a good example of Jaime’s effort to make progress and not let all efforts to improve healthcare stall in Congress,” a spokeswoman for Beutler said. “Rather than having Congress and Washington, D.C. prescribe specific directives, this bill helps create teams of experts to identify and begin to solve these problems at the state level. There’s no disputing the data that this troubling trend is hitting some ethnicities — particularly African American women — harder than others, and these committees will be well aware of the facts and be ready to take whatever action will be effective in improving survival of moms.”

Despite concerns about health outcomes, data show improvements have been made. Though blacks aren’t living as long as people in other races, they are still living longer than they used to, according to CDC data. The suicide rate for black men has declined since the 1990s, the only group to experience a drop, and infant mortality dropped by a fifth.

Lawmakers also have noticed that the patterns they have seen haven’t necessarily hit every community. While these improvements occurred, mortality rates among whites moved in the opposite direction. Health economists have concluded that this reversal is caused by deaths among whites from opioid overdoses, alcohol poisoning, chronic liver disease, and cirrhosis.

Death rates among blacks are still higher, but nevertheless showed a decline of 25 percent from 1999 to 2015.

For Kelly, these patterns by race are apparent in her district, her spokesman said, as it includes parts of Chicago as well as suburban and rural areas.

“As much as race is a factor in this, more and more we’re seeing the same disparities and lack of access to care between the urban communities that are brown and black and the rural communities that are white,” Lewis said. “You’re seeing these rural communities have problems that urban communities had in the 1980s: commercial blight, unemployment, drug use and overdoses, people moving into criminal behavior.”

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Healthcare bills aim to remedy racial disparities in the shadow of Charlottesville – Washington Examiner

Local governments face health care crunch this budget season – The Decatur Daily

Local governments, which historically have offered generous health-care benefits to their workers, are facing tough decisions this budget cycle as health-care costs continue to rise.

To be honest with you, I think its pretty disturbing about what we have run into over the past few years. Its just increased by large numbers, said Athens Mayor Ronnie Marks.

Most local governments project further increases in health-care spending for fiscal 2018, which starts Oct. 1, and most still have not determined how they will pay for the projected increases in their budgets.

In Decatur, Mayor Tab Bowling said city officials have been advised by the Local Government Health Insurance Board, a joint-risk pool that includes several other government entities, to plan on a 6.5 percent increase in premiums next fiscal year.

In Limestone County, officials said they have been advised to expect a 7 percent increase in premiums from their Blue Cross Blue Shield Local Government provider.

Were just like everybody else across the county. Its a struggle, Limestone County Commission Chairman Mark Yarbrough said.

Prior years also have brought spending increases for local governments. Decatur Human Resources Director Richelle Sandlin said insurance rates climbed 4 percent last year and 8 percent the year before that. Limestone County saw identical percentage increases over the same period.

Self-insured governments, which pay their own medical expenses, gambling health-care spending by their employees will be cheaper than paying non-refundable insurance premiums, saw even greater spending hikes.

In Athens, health-care spending climbed 15 percent between fiscal 2015 and 2016, jumping from $4.6 million to $5.3 million. Over the same time period, Morgan County saw an 18 percent increase as health-care claims climbed from $3.02 million to $3.58 million.

The year before, Morgan Countys claims climbed 21 percent, and the county is on track to close fiscal 2017, which ends Sept. 30, about $880,000 over budget on health care.

The rising costs raise the possibility that local governments could pass more of the expenses along to employees, and self-insured governments could end that practice to join risk pools in hopes of stabilizing rapidly climbing expenses.

Asked if Athens would continue to operate as a self-insured government, Marks said all options are on the table. In past years, being self insured has worked to the citys advantage, allowing it to add cash to its reserves in years when health spending was low, but that has not been the case the past few years, Marks said.

These are tough decisions, particularly when youre talking about the possibility of having to cut benefits and things like that, Marks said.

Athens pays 85 percent of employee premiums and 50 percent of retiree premiums.

Self-insured governments typically still pay premiums to insurance companies.

At the end of each quarter, they get whatever remains back in the form of a rebate. If spending exceeds what was paid in, they must pay the difference.

In Decatur, Bowling said it would be up to the City Council to decide whether it will pass any additional expenses along to its 498 covered employees and 225 retirees.

The city pays about 92 percent of premiums, well above the typical 80 percent that most private companies pay, Sandlin said.

In Limestone County, employees with single coverage don’t pay any of the $444 monthly premium covered by the county, and the county covers 70 percent of the $1,082 premium for family coverage.

Yarbrough said county officials were still crunching the numbers when asked last week where they would get the money to cover their projected 7 percent increase.

In Morgan County, Commission Chairman Ray Long has ruled out the possibility of a premium increase, at least temporarily. Long said he wont propose increasing what employees pay, but the numbers will be tracked closely.

He was warned that deep cuts, including possible layoffs, likely will be necessary if trends in health-care spending dont reverse.

Morgan County and Decatur both offer web-based tele-medicine services to their employees in bids to reduce health care spending for minor illnesses that can be handled over the phone.

If the governments cut health-care benefits in the effort to cut costs, they could become less competitive with the private sector, which often offers higher salaries for similar positions.

Sandlin said many Decatur workers who came from the private sector accepted pay cuts in return for robust benefits.

Its not apples to apples when youre talking about salaries. Youve got to look at the whole package, she said.

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Local governments face health care crunch this budget season – The Decatur Daily

Prisoners deserve proper legal, health care – Albany Times Union

The editorial regarding the quality of health care at the Albany County Correctional Facility could apply to many of the county facilities in New York (“Conscience and our jails,” Aug. 14). The Correction Medical Review Board of the state Commission of Correction has been advocating since its inception in the early 1970s for major improvements in the quality of health and mental health care for prisoners.

In the criminal justice industry, medical care has a comparable value as legal services for the indigent. Money is the usual factor cited when the quantity and quality of the care is deemed inadequate or grossly inept. Sheriffs, county executives and the legislative leadership at the state and local levels should strengthen the requirements for accreditation-level health care for prisoners.

Political support from the Medical Society of the State of New York and New York State Bar Association could facilitate the extension of the urgent and emergent care initiatives of the medical centers to the jails and prisons. It should be expected as part of their overall mission and charter to operate.

Health care should not be administered by the lowest bidder. Legal services should have the same level of support. It’s time for the legal and medical professions to assert their pro bono standards for equal protection and care for all persons in the community.

Karl H. Gohlke

Albany

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Prisoners deserve proper legal, health care – Albany Times Union


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