Three-quarters of all workplace assaults happen to health care workers, according to the Occupational Safety and Health Administration. And right now, unlike other professions, there is no federal law requiring prevention, reporting, or action if a health care worker is assaulted while on the job.

You can get into a cab or an Uber, or onto a train, and it says that assaulting an employee is a felony and you can go to prison, Michigan State University professor Judy Arnetz, an expert in workplace violence in the health care sector, told ABC News. And yet, people walk into hospitals to take care of patients every day and they are getting assaulted every day.

From 2009 to 2013, health care professionals reported more than 730,000 cases of assault, according to the Government Accountability Office. And these numbers are likely low due to an issue of underreporting, Arnetz maintains.

There have been reports of workers being bitten, shoved, kicked, shot, and even killed.

Workplace violence is in every health care institution across the country, Arnetz said. Large and small, urban, rural -- it occurs everywhere.

And the problem is growing, prompting a push for legislation to help stem the tide.

A bill passes the House

In February, Rep. Joe Courtney, D-Conn., introduced a bill that would require OSHA to issue a nationwide standard for establishing and implementing workplace violence prevention plans for health care professionals. The bill, the Workplace Violence Prevention for Health Care and Social Service Workers Act, or H.R. 1309, passed the House on Nov. 21 with bipartisan support.

H.R. 1309 would require risk assessment and identification, as well as action, tailored to each type of health care facility outlined in the bill. Each treatment center would have to establish procedures for communication, train its workers to recognize high-risk situations, record incidents using a violent incident log, and plan for future incidents by recognizing past violent incidents.

Experts like Arnetz acknowledge the bills broadness, but still believe it would be a positive step forward by simply putting prevention, in Arnetz's words, "on the dashboard.

Organizations would be required to do the bare minimum, Arnetz said. Record keeping, collecting data on incidents that occur, making sure that there is a prevention plan in place and that employees are involved in that.

Nurses celebrated the measure.

But the American Hospital Association opposed the bill, which is pending in the Senate Committee on Health, Education, Labor, and Pensions, saying hospitals "already stress workplace violence prevention."

ABC News reached out to the committee, which said it was working on its 2020 agenda.

Healthcare workers experience more workplace violence compared to any other private sector professional. A bill passed in the House that could help protect these workers.

Courtney pointed to the fact that 32 Republican representatives supported the bill, along with the Kentucky Nurses Association.

Were hoping that they are going to prevail on [Senate Majority Leader] Mitch McConnell, Courtney said, referring to the Kentucky nurses. Because, you know, saying no to nurses is not easy.

McConnell declined comment.

The rate of violence has increased

The level of violence against health care workers has increased dramatically -- 63% -- from 2006 to 2016, according to H.R. 1309.

Courtney suggests that this increase is due to the rise of heroin and opioid use, as well as an overall increase in general behavioral health issues. Regardless, he says health care professionals didnt sign up for this.

If the bill becomes law, Courtney says it could help more than just health care professionals. By saving on workers compensation costs, lost time from work, and burnout, companies could end up saving money, despite paying for training and the costs of raising standards.

But for many health care workers who have promised to "do no harm," the bill has come too late. Harm has been done to them.

Here is the original post:

'Epidemic': 75% of workplace assaults happen to health care workers - ABC News

A former health insurance executive criticized South Bend, Ind., Mayor Pete ButtigiegPeter (Pete) Paul ButtigiegBloomberg has already spent 0 million on ads in presidential race Buttigieg surrogate: Impeachment is 'literally a Washington story' Buttigieg campaign introduces contest for lowest donation MORE for his time at consulting firm McKinsey & Co. and his work with a medical care provider, accusing the top-tier presidential candidateof using health insurance industry talking points against more progressive health care policy.

Hes absolutely using the talking points that I used to create in my old job and my former colleagues are still turning out, Wendell Potter, who spent 20 years in the health insurance industry, told Hill.TV during an interview that aired on Tuesday.

Potterpointed to Buttigiegs recent jab at rivals Sens. Bernie SandersBernie SandersButtigieg surrogate: Impeachment is 'literally a Washington story' Michael Moore: Sanders can beat Trump in 2020 Buttigieg campaign introduces contest for lowest donation MORE (I-Vt.) and Elizabeth WarrenElizabeth Ann WarrenWarren in Christmas tweet slams CBP for treatment of detainees Buttigieg surrogate: Impeachment is 'literally a Washington story' Buttigieg campaign introduces contest for lowest donation MORE (D-Mass.) as a prime example. Though he didn't mention them by name,the South Bend, Ind., mayorsuggested in an MSNBC interview earlier this month thatthe twoprogressive candidates were calling for a health care policythat "would eliminate the job of every single American working at every single insurance company in the country.

In my old job in the industry, I used to play the jobs card too and I call it that because every time reform is proposed that insurance companies dont like they say, Oh, theyll have to lay people off, he said, referring to Buttigieg's claim. Its called playing the jobs card and hes doing that.

Buttigieg campaignspokesperson Sean Savettpushed back against Potter's remarks, sayinghis claim that Buttigieg is parrotingindustry talking points "doesn't hold up."

"Petes 'Medicare for All Who Want It' plan would make some of the boldest, most progressive changes to our health care system in decades in order to achieve universal coverage for all Americans," Savett said in a statement. "It has also been attacked by the health insurance industry because it would create competition and force insurers to lower costs and improve care or lose customers."

Sanders and Warren have been advocating for a "Medicare for All" planthat would ultimately do away with private insurance.

Getting rid of private insurance has beena point of contention between these progressive candidates and moderate candidates like Buttigieg and former Vice President Joe BidenJoe BidenLawyer for Giuliani associate to step down, citing client's financial 'hardship' Buttigieg surrogate: Impeachment is 'literally a Washington story' Presidential candidates should talk about animals MORE, who have both advocated for expanding existing health care coverage andadding a public option plan.

Buttigieg, meanwhile, has defended his work at the insurance company where he previously worked as a consultant, Blue Cross Blue Shield of Michigan and maintained that he wasnt involved in the decision-making process at McKinsey.His campaign has also noted that the mayor has been critical of his former employer, calling its work with U.S. Immigration and Customs Enforcement disgusting.

Buttigieg, whohas made itto the top of the polls in Iowa and New Hampshire, has faced increasing scrutiny from critics, who argue that he hasnt been forthcoming about his past work.

A feud has emerged between Buttigieg and Warren after the Massachusetts senator called on him to make his fundraisers public and disclose his past clients at McKinsey. In an effort to address this criticism, the South Bend, Ind. Mayor has since acceded to both demands.

However, Buttigiegs campaign left out more than 20 high-profile fundraisers from a list of bundlers it released earlier this month, potentially opening his campaign for more attacks over the issue of transparency.

Tess Bonn

Go here to read the rest:

Former health insurance executive: Buttigieg uses industry talking points against progressive health care policy | TheHill - The Hill

Warming up for a giant campaign rally in Venice on Dec. 21, Bernie Sanders, the three-term U.S. senator from Vermont making his second run for the Democratic presidential nomination, sat down for an hour with the Los Angeles Times editorial board to talk about the economy, healthcare, immigration, homelessness and other top issues. The following is a partial transcript, edited for clarity and brevity.

Sanders: So this is a major improvement over the old building. God, the traffic, I dont have to tell you. It wasnt bad today. We went, it must have been a mile, and it took us what, 45 minutes or something.

Nick Goldberg, editor of the editorial pages: You complain about that at the rally later, youll make some

Sanders: Thatll win me some votes. (Laughter)

Goldberg: So lets get started. Welcome. This is the editorial board only. The meeting is for the purpose of helping us make decisions about who were going to endorse in the race. Were on the record. Youre being videoed. Youre welcome, if you want, to make a very short, one minute or so intro.

Sanders: Im used to 60-second remarks.

Goldberg: And we have a couple of our [editorial board] members on the phone.

Sanders: We are at an unprecedented and dangerous moment in American history. We have a president who is a pathological liar, who is running, in my view, one of the most corrupt administrations in American history, who rightfully was impeached, was a racist and a sexist and a homophobe and a xenophobe and a religious bigot. And it gives me no pleasure to say that. But that is who the president of the United States is.

I will do everything in my power to defeat him. And in fact, I believe I am the strongest Democratic candidate to do that. We could discuss that later. But the crisis that were facing as a nation, as a world, is not just Donald Trump. And wed be wrong to think that just defeating Trump will solve all of our issues. Were dealing with massive levels of income and wealth inequality. Im deeply concerned about big money controlling the political process and undermining American democracy, not to mention all the voter suppression thats going on among Republican governors.

The more I study the issue, the more frightened I become about climate change. And the scientists now are telling us that they have underestimated the severity and the degree to which climate change is ravaging this country and the world. And there is no middle ground in terms of dealing with climate change. I wish that it was. But right now well need to throw all of the resources and intelligence that we can in leading the world, because this is not just an American issue, to literally save the planet for our kids and future generations. This is a major, major, major crisis.

So, I mean there are many, many other issues out there, obviously, but I just wanted to lay out some of the concerns that I have.

Goldberg: Let me kick it off then by asking you, do you think that the U.S. can repair the damage that Donald Trump has done? Can it be done quickly and easily? And how would you go about it?

Sanders: The answer is I think it will be difficult. I really do think it will require extraordinary leadership. I think what Trump did in the 2016 campaign is rather intelligently pick up on the fact that there are, what, tens and tens of millions of people in this country who are suffering, who are in pain, who are going nowhere in a hurry, are seeing decline in their standard of living, seeing a decline, literally, in their life expectancy, worried about their kids. And theyre looking around them and theyre saying, Who is concerned about me? Is the Democratic establishment worried about my kids? [Are they] worried that Im working for nine bucks an hour, that I dont have any healthcare? That my kid cant go to college? And he played on that.

Now he turned out to be a fraud and a liar, but he certainly exposed, I think, the weakness of the Democratic and the political establishment in general, including the Republican establishment. So what we are going to need is leadership in this country that brings people together around the issues that are of concern to all of us. So if youre a conservative Republican, you want healthcare, if you are a conservative Republican, you want to be able to send your kid to college.

And I think the issues that we have been talking about in this campaign, that I talked about four years ago when I was here, those issues have resonated with the American people. And in fact, as I think you all know, they have become kind of mainstream now in at least in the Democratic Party, when they were seen as pretty out there four years ago.

So I think when you talk about raising the minimum wage, when I think you talk about making educational opportunity available to all regardless of income, where youre talking about canceling student debt, when you talk about healthcare for all as a human right, Medicare for all, when you talk about climate change, criminal justice reform, immigration reform, sensible gun policy in this country, a womans right to control her own body and many other issues, those issues in fact do resonate with a whole lot of Americans and we bring those people together around those issues.

Goldberg: Before we move around the table, let me exercise my prerogative and ask you one other question. What do you say to voters who worry that in a general election a candidate as far to the left as you are is gonna alienate swing voters and moderates and independents?

Sanders: Excellent question, Ive heard it once or twice. (Laughter) I want you to think about this. In my view, and Ive thought about this a whole lot, anyone who underestimates Donald Trump as a candidate, for a variety of reasons, will be very mistaken.

He is going to be a very, very strong candidate. He certainly has a very strong base. He will have unlimited amounts of money to campaign on. He is a pathological liar. He will merge in an unprecedented way agencies of government with his campaign, because he doesnt particularly believe in the rule of law. So he is going to be a very, very tough opponent.

The only way that you beat Trump is by having an unprecedented campaign, an unprecedentedly large voter turnout. And well have to combat every single day the voter suppression which youve recently seen manifest itself in Wisconsin and Georgia. And we can expect that to take place all over the country. We are living in perilous times, and Republicans understand that if they can keep poor people and people of color and young people from voting, theyve got a better shot to do it. And I have zero doubt that they will do it. Theyve appointed right-wing judges who will sustain their efforts. So we have to combat that in every way we can.

But the reason I believe that I am the strongest candidate, and the reason I believe our approach is right is if you want a large voter turnout, if we understand that there are tens of millions of people in this country who dont vote, whove kind of given up on the political process, that young people although were seeing some real gains there and were working really hard on this thing young people, who are by and large progressive my guess is roughly speaking for every three people under 30 who vote, two of them are going to vote progressive, okay, but many of them dont vote I think I am by far the strongest candidate to reach out to those people. I think Im the strongest candidate to bring together a multiracial coalition of African Americans, of Latinos, of Asians.

So to answer your question, I dont believe that the [way to win] this election is to just speak to Republican women in the suburbs. Thats one theory. And I think many of those women will vote for me because they are appalled, correctly so, about Trumps personal behavior and his temperament. I think we can win many of them. Not all of them. But on the other hand, the key to this election is can we get millions of young people who have never voted before into the political process, many working people who understand that Trump is a fraud, can we get them voting? That is the key to this election. So Ive heard that hypothesis, I just dont agree with it.

And let me add to that if I might, [there are] people who run the same old, same old type of campaign. And you know, [former Vice President] Joe Biden is a personal friend of mine, so Im not here to, you know, to attack him. But my God, if you are, if youre a Donald Trump and you got Biden having voted for the war in Iraq, Biden having voted for these terrible, in my view, trade agreements, Biden having voted for the bankruptcy bill. Trump will eat his lunch.

Jon Healey, deputy editorial page editor: So youve noted the widening income inequality. [But] when you look at the consumer confidence indices, they suggest that most people are feeling better about where we are, and their expectations for the future are better and better. If you look the trend lines since the [last recession], its gone steadily up. And in fact, the numbers now in both consumer confidence and expectations for the future are where they were in 99, 2000. So how do you reconcile those two things, where youve got a campaign which is trying to reach out to people who feel that theyve been left behind, but much of the country thinks things are going pretty well right now?

Sanders: I read statistics til Im blue in the face, and Ive got to tell you, I read polls til Im blue in the face. Today theres a poll that says this, and yesterday theres a poll that says that. Half of the people in this country are living paycheck to paycheck. Agreed? Thats a fact. All right?

I dont know the exact number, but theres a hell of a lot of people in this country who if their car broke down and they needed $500 to fix that car, dont have that 500 bucks. Theyll have to go to some payday lender to get to come up with the money. We got 45 million people who are dealing with student debt, and some of it is outrageous levels of student debt. In this city, you got 50,000 people who are sleeping out on the streets.

So I dont accept the premise. I mean, I think what people say is, you know what? If I want to go out and get a job today, I can get a job. Thats true. But on the other hand, and I do this all over the [country], you know, Ive held a whole lot of town meetings and you talk to people. Yeah, I can go out and get a job, but I cant find a job that pays me a wage that allows me to deal with healthcare and pay my rent or put gas in the car. So the economic crisis that were facing now is not unemployment, which is low. It is wages. And last year in the midst of the so-called booming economy the media talks about it, Trump talks about it you know what real inflation [adjusted] wages went up last year? Anyone happen to know?

Healey: Less than a percent?

Sanders: Yeah, one point exactly. 1.1%. What we are looking at is a continuation of a trend in which the very, very wealthy do phenomenally well. I mean, its a fact I keep mentioning I dont know if anyone pays any attention at all of my rallies, that in the last 30 years, the top 1% have seen a $21-trillion increase in their wealth; [the] bottom half of America has seen a decline in their wealth.

So to answer your question, unemployment is low. You want to go out, you can get a job. But by the way, whats also frightening is according to the studies, most of the new jobs being created are low-wage jobs.

And, you know, when were on the campaign trail, we go to restaurants all the time. Thats what we do. And invariably the kids, the young people who will come up to me, who are waiters and waitresses, you know, these are people who often have a college degree, and theyre waiting tables today. And Ill never forget this, I was in New Hampshire a month ago talking to teachers. And a teacher said, You know, my son just graduated college, wanted to be a music teacher. He ended up being a salesman at a liquor store in New Hampshire. He made more money doing that than being a teacher.

So to answer your question, unemployment is low but wages are terribly low in this country, and many people are struggling to get the healthcare they need to take care of their basic needs.

Kerry Cavanaugh, editorial writer: Theres been a lot of focus on a $15 minimum wage. But how does the federal government create more $30-an-hour jobs, $45-an-hour jobs?

Sanders: Thats right. If Im allowed to toot my own horn here, when I was here four years ago and I talked ... about a $15 minimum wage, everyone thought that I was kind of extreme. Since then, seven states, including this state, have passed a $15 minimum wage, as has the U.S. House of Representatives. So your point is well taken.

Nobody should think for one moment that, Ahh! We got a $15 an hour minimum wage. Weve solved our economic problems. It is a minimum. It is a minimum. And I have been to this state, Ive been to Iowa, needless to say, New Hampshire. Ill never forget a woman in Des Moines, Iowa, making $10.25 an hour trying to raise three kids. She cant. Alright, so Im not here to tout that a $15-an-hour minimum wage is the end of the world. Its not, but it is the minimum. We have to do that.

The question of how we create good paying jobs, $25-, $30-an-hour jobs, is the more important question. I think one way we do that, and obviously its going to be a combination of federal policy and the private sector, as president of the United States, what I will do is demand and do everything that I can to end the kind of corporate greed and irresponsibility that we see right now. We were just over in San Bernardino. We had a rally there yesterday, where Amazon apparently has a lot of influence. Theres a lot of pollution, and kids come down with asthma and all that stuff. And people in the warehouses are making $11 or $12 an hour while Amazon is, as you know, an enormously profitable corporation that paid $0 in federal income taxes last year.

So I think what a progressive president has got to do is say to these corporations, You know what? Make money. Thats great. Create jobs. We want you to do that. But it cannot just go to CEO compensation or your stockholders. Weve got to break this mentality, which has been prevalent for so many decades, that the only thing that a corporation has to do is make as much money as possible for its stockholders and pay it CEOs outlandish levels of compensation. And we have to do it culturally, and we have to do it legislatively to say, You know what? Make money. Thats fine. You want to be rich, thats fine. But you cannot have it all. You cant break unions or deny workers the right to join a union. You cant continue to harass women on the job. You cant pay abysmally low wages and expect, you know, to be treated respectfully by the federal government.

Youre going to have to be good corporate citizens. You cant shut down plants in America and move to low-wage countries. You have a certain responsibility. So thats the bottom line. Thats the role I think leadership plays with the private sector.

We also want to stimulate small-business growth in America. But then the role that the federal government can play is enormous. I happen to believe in a federal job-guarantee program, and Ill tell you why. Because there is an enormous amount of work to be done in this country, and I think about it differently than maybe others do. But I look at our childcare system, which is completely dysfunctional, which is so unfair to working families, and more importantly to the children. I dont know the exact number, but hundreds of thousands of good jobs with well-trained, well-paid childcare workers.

I look at our infrastructure, which there is no argument is crumbling, whether its roads, bridges, highways. God, Ive been driving around in L.A. in the last few days. What a traffic disaster you have here. You know, water systems. Everyone knows about Flint, Mich., and we were there. My wife and I were there and it was one of the most emotional and difficult meetings weve ever had, you know, behind closed doors, dealing with parents whose kids were poisoned. But it is not just Flint, Mich., it is all over this country. It is California. I dont know if you know this of course you know this, you live here but there are tens of thousands of homes where we turn on the water, you cant drink the water. So we have major infrastructural crisis. And, last but not least, if we are going to combat climate change, we need to transform our energy system away from fossil fuel to energy efficiency and sustainable energy. And in doing that, we can create up to 20 million good-paying jobs. So the federal government can be very aggressive.

Teachers. What a pathetic state of affairs when you have good teachers who are leaving the profession because theyve got to work two or three jobs. So we pay teachers. I mean, when we rebuild our country infrastructure, education, climate, environmental protection we create a whole lot of good-paying jobs. Thats the role of the federal government.

Dr. Patrick Soon-Shiong, executive chairman, Los Angeles Times: Well, first of all, thank you. I was upstairs because Im with the most inspiring 15 kids from a Jesuit high school in Compton. Senator, listen, first of all, thank you for coming. I want to talk about healthcare. Just so you know, background: I came from South Africa, apartheid. Grew up in South Africa, was the first Chinese doctor, came to this country. Its the greatest country in the world.

So During the debate, we held a focus group at the L.A. Times, with 25 undecided voters. The concern that they related to us was that your Medicare for all plan, as communicated, would not win in the swing states. Question is, what do you mean by Medicare for all?

Sanders: Look, healthcare, as everybody knows, and even the president of the United States recognizes, is a complicated issue. And we have got to do better [explaining Medicare for all]. And sometimes it is difficult, because youre on a debate when you have 75 seconds. Im not so sure as a doctor you can explain healthcare in 75 seconds. Correct? Maybe you can.

Soon-Shiong: If you give me two minutes, maybe.

Sanders: Okay. All right. Well, you dont get two minutes when youre up on the stage, by the way. Thats too much. Unless you cheat and go beyond the red light.

Soon-Shiong: But thats a problem, right?

Sanders: It is a problem.

Soon-Shiong: Because you really should have enough time to [explain it], and maybe in your rallies where you do have time.

Sanders: I do have time. And come to the rally this afternoon. As soon as we leave here were going to a good rally, and I will talk about [healthcare]. But that is one of the problems. On a complicated issue, you are often asked to explain it in 10 or 20 seconds, or 75 seconds. But we have more than that now, so let me explain what I mean. First of all, we go all over the country and we say, OK, tell me about healthcare. And the stories that you hear and we have them on tape, we video these things, we put them out there are just unbelievable. So I start off, Patrick, with the strong belief that there is something fundamentally wrong when we are spending twice as much per capita on healthcare as the people of any other country.

I live 50 miles away from Canada. Is the Canadian healthcare system perfect? No, it is not. But they guarantee healthcare to all of the people spending half as much. We spend about $11,000, theyre something around $5,000 or $6,000 a year. Meanwhile, you got 87 million people in this country who are uninsured or underinsured, and the keyword here is underinsured. Everybodys Ah, well, you dont have any health insurance, thats a problem. But you know what? You may have health insurance, but if you have a $10,000 deductible then your health insurance doesnt mean a damn thing to you because you cant go to the doctor when you need to. OK? You dont have the money to do that. You have 30,000 people who [will] die this year because they dont get to a doctor on time.

And heres what is unbelievable, and Ive been talking about this more, and this resonates with people, by the way: Some half a million people go bankrupt in this country for medically related reasons. Now, that might be the only reason. Now youre struggling financially, youre diagnosed with cancer. Just think about it. You tell me. You make $50,000 or $60,000 a year, youre diagnosed with cancer, you run up a bill for $50,000, $100,000. How do you pay that bill? I mean, its insane. So we are living in a country which says that you can suffer financial ruin for the rest of your life, for what crime did you commit? You were diagnosed with cancer or heart disease. How disgusting is that? It really is. I use that word advisedly. So this system I think is dysfunctional and its really quite indefensible. And we can argue about where we go from here.

But I think on top of everything else, I mean we dont have five hours to discuss it, is the complexity of the system. OK? And I think its not only healthcare, its everything else. People are sick and tired of filling out a million forms for every thing. My wife has a PhD, all right, and she goes crazy trying to fill out the healthcare things, choosing what healthcare program you want, you know, when youre fighting for the coverage that you think you are entitled to. We need a simple system. And the beauty of a simple system and the advantage of single payer over a system which has thousands of separate policies is that it is easier to administer.

Youre asking me what Medicare for all is. It is no more premiums, not for you as an employer. You must spend a fortune, I imagine, right now on healthcare. All right, no more premiums for the worker, for the employer. No more co-payments, no more deductibles, no more out-of-pocket expenses. All gone. Medicare for all expands Medicare to cover dental care, which last I heard is healthcare, hearing aids, eyeglasses and home healthcare. And we do that.

How we do fund it? We fund it through a progressive tax system such that, I suspect your company, by the way, will save money. Youll be paying more in taxes but less in your overall healthcare costs, and the savings will go to the workers. Youll be better off on the Medicare for all. And one of the things that we have not succeeded at, I think, is getting large corporations to understand that. Because we are the only major country on earth not to guarantee healthcare, theyre competing against international concerns who dont have to worry about paying their workers healthcare. Because its government sponsored.

Goldberg: Do you think theres a problem with the way [Medicare for all] is being sold?

Sanders: Yep. The answer is yes. I think there is enormous ignorance about the nature of healthcare, why we spend so much, why our outcomes are not particularly good. Yes. Life expectancy, childbirth, infant mortality. So Im not arguing. I think youre right. But please understand, which I think you do know, that there are people who are benefiting big time from this dysfunctional healthcare system.

Robert Greene, editorial writer: Senator, youve made your position on President Trump quite clear. I want to ask you, is there anything that hes done, any policy that he has, any actions hes taken that you think are worthy and worth building on?

Sanders: I have such contempt for somebody who is trying intentionally to divide this country up based on the color of peoples skins or where they came from or their religion or their sexual orientation. That disgusts me so much. So were in the midst of that. And somebody who was a, you know, is a pathological liar. And a corrupt person.

I mean, he has talked about the need for infrastructure repair. Yes, thats true. Has he done anything? No. Hes talked about the need to lower the cost of the prescription drugs. Has he taken on the pharmaceutical industry? No, he has not.

He has talked about trade policy and, in fairness, probably what has recently happened is probably modestly better than the previous NAFTA. So you want to give him credit and, and the Democrats in the House credit for that? Fine. But I think the overwhelming result of his administration is contemptible.

Mariel Garza, editorial writer: So theres been a lot of talk about electability in this race what is electability, whos electable. There are a fair amount of women who believe that when we talk about electability, when we use that word, its really code for, a woman cant beat Trump. And I wonder if you, if you believe that thats true.

Sanders: I surely do not. I mean, it 100% has to do with the candidate. But I will say that whether youre a man or a woman, Trump is going to be harder to beat than many people think. They think, this guy is a buffoon, of course hes going to be beaten. Not so easy. But it gets back to the question, the original question is, its not a woman or a man or whatever. Its a question of the kind of campaign that you run. And I think in this unprecedented moment in American history, you need an unprecedented campaign. And I think you need ideas that are going to excite and energize millions of people who right now are not particularly active in politics, and who may not vote at all. So I think the question that we want to ask is, which candidate out there is capable of growing voter turnout? Thats the real question. And if youre not dealing with that, I think Trump is going to be hard to defeat, thats true whether youre a man or a woman. But if the question is can a woman beat Trump? Of course.

Carla Hall, editorial writer: You mentioned the thousands of people sleeping on the streets here in the city, and in the county. President Trumps approach to homelessness has been pretty much to scapegoat homeless people and vaguely hint that he would move them all into a big empty federal building somewhere. How would you address homelessness?

Sanders: You know, we started talking about the economy, and what I suggested is that there is so much work to be done in this country. I mean starting with childcare, starting with healthcare. We need more doctors, we need more nurses, we need people who are not pushing paper but providing care to older people. We have a proposal that would build 10 million units of housing. In terms of low-income housing, Im proud to tell you that I co-sponsored successfully with Barbara Lee of Oakland what was called low-income, I think, I forget the name, the low income housing trust fund or something, which Obamas people put, I think, several hundred million dollars into. Nowhere near enough. But it was the first piece of legislation to actually address low-income housing.

But to answer your question, and Ive learned as you travel around the country, boy you do learn this, the housing crisis is not just in L.A.. Its not just in San Francisco or Seattle. It is virtually in almost every part of the country. And it has to do not only with homelessness, which is a disgrace a half a million people homeless in America. It has to do with the fact that 18 million families are spending 50% of their income on housing. It has to do with gentrification all over this country, which is driving rents up to levels that, that working families just cannot afford. We have a proposal that would build some 10 million units of housing and put a hell of a lot of people back to work at good wages, union wages, and it would, in fact, end homelessness as we know it.

We were down in, what do you call it here?

Greene: Skid row.

Sanders: Skid row not a highly technical term (laughter), I thought you had a more sophisticated name for it where, for example, instead of arresting people, you bring them into a shelter, which seemed to me a pretty sensible thing. But the problem with homelessness is not just providing a home. Often, youve got to deal with addiction. Youve got to deal with counseling, you need wraparound services, etc.

Soon-Shiong: Correct. Can I follow up on that? And two, maybe three different topics. Really, the homelessness issue here is really mental health issues.

Sanders: Right.

Soon-Shiong: So the mental health issue is really

Sanders: And addiction is part of it.

Soon-Shiong: And being thrown out of the jails theres a real issue.

The other question I really want to ask you about, and it relates to privacy, it relates to tech, it relates to Facebook, Google, etc. It relates actually to our democracy because it leads now to local news. Newspapers completely being destroyed. In California we have, its a largest incidence of small, local town newspapers being destroyed because frankly the [concept of] fair use is not being fairly used, where these platforms can take this data, say theyre not media, and use them. Whats your feeling about that? How do we save, across this nation, local newspapers that can speak truth to power?

Sanders: Its a huge issue. And youre absolutely right. I can tell you from personal experience, when I was mayor of Burlington, which was a larger city in Vermont of 40,000 people, I cant remember how many radio stations we had. We had newspapers, we had small weekly newspapers all over, right?

Newspapers are in trouble. I would say that what we want to do and by the way, this is not just media, this is many other sectors of our society is have an attorney general who understands antitrust law. And thats true in agribusiness. Its true in many parts of our economy. Start breaking up these huge conglomerates, which have just an unbelievable influence over our general economy.

Media is something different. Because without a free media, you dont have a democracy. So it raises another issue, and we have some ideas out there about and its a tricky thing. You dont want government control over media. You dont want a handful of giant conglomerates to control the media. But were going to have to sit down and have a conversation about how we support local independent media. I dont have a magical answer

Soon-Shiong: But Facebook and Google hide behind the fact that they can give fake news because theyre not media.

Sanders: And also I may add in terms of, you tell me if Im wrong, you know more about this than I do. They gobble up a huge amount of the advertising revenue.

Soon-Shiong: They gobble up everything, in fact, thats exactly why papers are being destroyed.

Sanders: Thats right.

Soon-Shiong: So one of the ideas is, datas now the next oil, basically equal to a utility. Why is there not a data tax on these organizations? That is where that should actually be.

Sanders: Well, I think the idea is that a handful, what have we got, Google, Facebook, who else is out there? Twitter, right? Twitter controlling what percentage of the advertising revenue?

Healey: Google and Facebook together are north of 80%, I think. [Editors note: Analysts put the figure at close to 60%.]

Sanders: Wow, is that right? This is an issue that cannot be ignored, I agree with you.

Michael McGough, senior editorial writer: Senator, when you were here last time, four years ago, we had a discussion about whether you were maybe too averse to military intervention. You thought Hillary Clinton was the opposite. And one of the things you said when we were talking was, as proof that you werent pacifist, was that you had voted for the war in Afghanistan after 9/11. You had some second thoughts about that in the debate. And Im wondering, are you more averse to intervention now than you were when you were running in 2016, and what sort of standards would guide you as president in deciding whether to send U.S. forces abroad?

Sanders: Well, its not a question of more or less. Obviously you have to look at the particular circumstances. No. 1, I think unlike Trump, who has exploded military spending while cutting back on diplomacy and our State Department, I would do exactly the opposite. I think you need and Ive been around the world and met with some of our diplomats. Youve got some really strong and good people who know the language, who know the culture. So we had got, I mean the bottom line is that war has got to be the last response, not the first response. It is very easy for politicians, because its almost always very popular to say, You know what? The only thing that fill-in-the-blank understands is force and were going to go to war.

Its a good speech. It polls very well but it ends up in some cases with horrible circumstances, i.e. the war in Iraq. So I voted against the first war in the gulf. Literally, its one of the first votes that I cast that I thought I would be unelected two years later because that war was popular. I voted against it, led the effort against the war in Iraq. God, I wish check out what I said then, it turned out to be a pretty prescient, and I wish that wasnt the case, but it was. I helped lead the effort to end U.S. intervention in Yemen following the dictatorship in Saudi Arabias lead. So No. 1, youve got to do everything you can to bring people together diplomatically without the use of military force.

Are there some circumstances where genocide is going to be committed where you may have to use military force or other reasons? Yeah, I suspect there will be. But also you want to be mindful that you need, to the degree you can get it, to use international support. Strengthen the United Nations. People say the U.N. is ineffective. Yeah. Compared to what? Nuclear war? You know, so weve got to strengthen the United Nations, and see where we can resolve international conflict.

The other thing that I would say on this is that, in issues like Israel-Palestine, issues like, Saudi Arabia-Iran, the United States for many years has had a kind of one-sided policy. We have loved the brutal dictatorship in Saudi Arabia. We have been very 100% pro-Israel. And I say this as somebody whos proudly Jewish who spent time as a kid, on a kibbutz in Israel. But we need to have an evenhanded foreign policy which brings people together.

And I wont deny for one second, this is complicated stuff. It is not easily resolved. But we throw all of the resources that we can to bring people together. And you gotta do things like rethinking this war on terror, which has cost us some $5 trillion. And I guess people can argue the situation is worse than it was before we got into it. So theres a lot of rethinking. Got to deal with authoritarianism all over the world.

Scott Martelle, editorial writer: Hi, good morning. Thank you. Senator, you call for comprehensive immigration reform, and thats been tried multiple times before and its been failing for decades. As president, what can you do to get a comprehensive immigration reform package through Congress?

Sanders: Yeah, I dont want to tell you Ive been one of the leaders of that in terms of the discussions or the negotiations in Congress, but I have been involved in it. And the truth is, I do believe it can be done. I absolutely do believe it. Trump, of course, because of his xenophobia and his obsession with building a wall, has exacerbated the situation. I think despite Trumps xenophobia, the American people do want comprehensive immigration reform. And I think when you have a president who can speak and Im the son of an immigrant, as a matter of fact, who came to this country with nothing when you can speak to the contributions of the immigrant community, the fact that so many immigrants are working so hard, raising their families, abiding by the law, are so important to our economy, when you can explain that to the American people rather than demonize immigrants, I think we could strengthen the support that exists at the grass-roots level for immigration reform.

Now as you also know, a president has certain authority regarding executive orders. So on day one, what I have promised and will fulfill, is to reinstate the legal status of the 1.8 million young people and their parents in the DACA program. That we can do. And we can stop the very ugly practices at the border in which, you know, babies are literally snatched from the arms of their mothers or children thrown into cages. We can do that as well. But to answer your question, I think there is broad support among the American people. I think theres more Republican support, which I think would be able to play out without having a xenophobe as president of the United States.

Garza: I have a pretty quick question. And that is, normally I wouldnt ask somebody about their health, because you know, we all know that 80 is the new 60

Sanders: 50! 40! 30! (Laughter)

Garza: But the truth is you have had a heart attack fairly recently. And I wonder, you know, convince us that, that you are hale and hearty enough for whats going to be a brutal campaign and probably a pretty, well, we know its a tough job.

Sanders: Yes, its a tough job. Look, all I can say is youre quite right. I did have a heart attack two and a half months ago in Las Vegas. I had two stents put in. I was in the hospital for 2 days and got quite good healthcare. Thank God. I had an artery that was blocked and I think that was dealt with. As I understand it, and (to Soon-Shiong) doctor, you can tell me if Im wrong, but I think that procedures done about a million times a year, roughly speaking in the United States. Its not an unusual procedure. I have been blessed with good health my entire life. I think you can ask my staff the last time other than the heart attack, that I missed work. Im in just, I was a kid, a long-distance runner, so I have a lot of endurance. Since the heart attack we have been running a pretty vigorous campaign.

These guys had me working, what did we do, four rallies in the last couple of you know, I work hard. And youre right. I mean it is, needless to say, president of the United States might be slightly stressful job (laughter) and a difficult job. But I suspect Ill be on the golf course a lot less than Donald Trump is. I dont play golf. But, I mean, thats a fair question. All that I can say is, in some respects, I feel better than I did before the heart attack. I guess having three arteries that work is better than having two, right?

See the article here:

Opinion: Bernie Sanders on healthcare, homelessness and Trump - Los Angeles Times

As healthcare becomes more technology-driven, digital health and IT leaders will be the key executives to watch.

Some of these influential technology leaders are pushing forward withartificial intelligence, data analytics and telehealth capabilities to improve patient care. Others are bringing in technology expertise from outside healthcare to help make the industry more consumer-centric ortacklethecomplex issue of interoperability.

And everyone is keeping an eye on the big tech giants and their next moves in healthcare.Haven, the technology-driven healthcare venture lead by Amazon, JPMorgan and Berkshire Hathaway, has built a team withsome of the brightest in healthcare technology including Zocdocs Serkan Kutan and Blue Cross Blue Shield IT leader Dana Safran Gelb.

Top health industry issues of 2020: Will digital start to show an ROI?

Each year, PwC's Health Research Institute (HRI) names the top issues for the health industry in the coming year. What made the list for 2020? Join HRI for a discussion of the most important trends for providers, insurers, pharma/life sciences and employers.

Here are five healthcare technology leaders were keeping an eye on in 2020. Think we missed someone? Find me on Twitter at @HeatherLandi.

John Halamka, M.D.,president of Mayo Clinic Platform

Health IT pioneer and digital health leader John Halamka is leaving his post at Beth Israel Lahey Health after 23 years to move over to Mayo Clinic starting Jan. 1. He will be leading digital health strategy at the Rochester, Minnesota-based academic medical center as president of Mayo Clinic Platform.

Halamka refers to the Mayo Clinic Platform as an innovation factory for collaboration. Hell lead initiatives that encompass artificial intelligence, the internet of things and an ecosystem of partners to advance Mayos digital health efforts. Mayo is in the midst of a digital transformation supported by a new10-year partnership with Google to move patient data over to the tech giant's cloud platform.

Halamka will play a key role in this partnership to advanced cloud computing, AI and data analytics toadvance the diagnosis and treatment of disease.

Angela Yochem, executive vice president and chief digital and technology officer, Novant Health

Angela Yochem came to Novant Health in 2018 with deep technology roots at Fortune 500 companies. As executive vice president and chief digital and technology officer, she has been tapping into that tech expertise as she redefines the North Carolina health systems approach to technology.

In June, the health system launched theNovant Health Institute of Innovation & Artificial Intelligence (AI), which will use AI to enhance personalized patient care.

That institute, which Yochem co-leads, has already produced AI-based solutions to improve care, such as a tool that helps treat stroke patients more rapidly.

Novant Health also is working with healthcare AI company Jvion to use predictive analytics to reduce readmissions for congestive heart failurepatients. A project with KenScis AI platform is focused on improving the patient experience in its hospitals.

Natalie Pageler, M.D., chief medical information officer at Stanford Childrens Health

Stanford Childrens Health is pioneering cool technology to improve care for pediatric patients. From using virtual reality to help distract and entertain children who are preparing for procedures to diabetes digital health tools, the organization focused on using technology to address the needs of children and their families.

As CMIO, Natalie Pageler, M.D., a board-certified pediatric intensivist, leads the hospitals digital health program with a focus on meeting the needs of tech-savvy patients and families in the Silicon Valley area. Shes focused on expanding virtual visits to enable patients and their families better access to pediatric experts. From 2017 to 2018, Stanford Childrens grew virtual visits by more than six times, from less than 200 visits a year to 1,100 annual visits.

The hospital is on track to double that to 2,500 telehealth visits in 2019. The virtual visits save hundreds of miles in travel for patients who need specialty care.

Vivian Lee, M.D., president of health platforms, Verily

Vivian Lee, M.D. is leading Verily Life Sciences' expanding footprint in healthcare. The life sciences arm of Googles parent company Alphabet has been shifting from research into clinical care and gaining big-name partners.

Verily partners with health insurers like Blue Cross Blue Shield as well as Walgreens and life insurance company John Hancock to provide chronic care management through its Onduo virtual diabetes clinic. Its also developing machine learning tools to help detect diabetic eye disease.

Under Lees leadership, Verily also is moving into population health and supporting the shift to value-based care. The company is working with Atrius Health and the Palo Alto Veterans Affairs healthcare system to improve patient outcomes through population health projects. Verily also is taking on aging by teaming up with Wake Forest Baptist Health to test technologies to help older people stay healthy and independent at home.

Mariann Yeager, CEO of The Sequoia Project

Mariann Yeager is a 20-year health IT veteran taking on the complex problem of healthcare interoperability. She leads the Sequoia Project, apublic-private partnership that advocates for nationwide health IT exchange.

The organization was tapped by the governments IT agency, the Office of the National Coordinator for Health IT, to oversee the implementation of a big data exchange project called the Trusted Exchange Framework and Common Agreement.

Under Yeagers leadership, The Sequoia Project will create baseline technical and legal requirements for different health IT systems, companies and groups to communicate with each other and share electronic information.

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5 health IT executives to watch in 2020 | FierceHealthcare - FierceHealthcare

The Americans for Prosperity-Missouri and the AARP argue that allowing nurse practitioners to treat patients without physician supervision would help ease a health care shortage in Missouri, particularly in underserved areas.However, the editorial failed to mention several important facts. First, like most of the states in the Union, Missouri is not only short of physicians, but also of nurses.By encouraging more nurses to move into a provider role, nurse practitioner independence would have a negative impact on the supply of bedside nurses.

Secondly, while advocates claim that allowing nurses to practice independently will fill the need for primary care in underserved areas, studies have consistently shown that states with independent practice have not this promised increase in rural health shortage areas. Instead, independent nurse practitioners end up working in the exact same places as physicians. Additionally, less nurse practitioners are entering into primary care. More and more, nurse practitioners are forgoing primary care to work in specialty offices.In fact, in areas with independent practice, it is not uncommon to see nurse practitioners opening cosmetic practices offering botox and fillers rather than bread-and-butter primary care medicine.

The opinion piece argues that nurse practitioners are already trained and qualified, and that research has shown that nurse practitioner care is equivalent to that of physicians.Unfortunately, the authors neglect to mention that every single study that has ever claimed to show nurse practitioner safety and efficacy has been performed in a setting in which nurses were supervised by a physician.There are absolutely no studies that show nurse practitioner safety and efficacy when practicing independently.

Moreover, most of the studies that purport to show nurse practitioner safety have been of low quality, often following healthy patients over very short time frames, with one often-cited study having a time frame of only two weeks.These studies are not appropriately designed to show whether nurse practitioners, especially practicing independently, can safely and effectively care for patients over the course of a lifetime in a primary care role.

Additional concerns have been raised regarding the quality of training and education of newer nurse practitioners.While physicians are required to have 15,000 hours of training and experience before being permitted to treat patients independently, nurse practitioners are required to complete just 500 hours.Unlike medical school, many nurse practitioner programs are 100% online, and clinical experience lacks the standardization required of physician trainees. Many nurse practitioner programs no longer require nursing experience, allowing students with any bachelors degree to become a nurse practitioner.

There is no doubt that Missouri needs more physicians and nurses.Legislators would be better off focusing their efforts on ways to increase the supply of both critically important professions, rather than trying to pass off one as the other.

For example, Missouri has led the way in enacting legislation to create a new profession called Assistant Physicians which become effective in late 2014.Assistant physicians are physicians who have completed medical school but not a residency program.They work under the supervision of a fully licensed physician.Since 2015, approximately 300 Assistant Physicians have obtained a license.

Rebekah Bernard MD, Carmen Kavali MD, Purvi Parikh MD, Ainel Sewell MD, Amy Townsend MD, and Roy Stoller DO are Board Members of Physicians for Patient Protection. Physicians for Patient Protection is a grassroots organization of practicing and retired physicians, residents, and medical students. Our mission is to ensure physician-led care for all patients and to advocate for truth and transparency regarding healthcare practitioners. We advance our mission by educating our colleagues, by influencing policy and legislation, and by educating our patients and the public.

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Opinion: Response to 'Expand access to health care by expanding the role of Missourians deserve physician-led care' - The Missouri Times

Family Healthcare of Hagerstown recently received a jointly funded grant for $235,000 from the Maryland Community Health Resources Commission and Aetna Better Health of Maryland.

Money from the grant will help serve high-risk patients, those with chronic diseases and those who are frequent users of the hospital and/or emergency room.

The program,called "Integrating Pre-Provider Welcome Visits for Better Outcomes," welcomes and supports patients as they transition to individualized care at the clinic.

Along with capital and workflow improvements, the program has allowed Family Healthcare of Hagerstown to hire two additional licensed practical nurses to provide more support for patients, thereby decreasing patient no-shows.

The pre-visit nurse coordinators support patients in person and by telephone. They work with patients before their scheduled clinic appointment to address barriers to care so patients can achieve better health outcomes.

Before the initiative, staff members were noting that some patients weren't keeping clinic appointments and frequently were using hospital or emergency room services.

To address both, the nurses are spending more time working directly with patients so appointments are kept, medications lists are reconciled, full medical records and histories are gathered, and barriers are addressed.

In turn, patients are better prepared for their clinical appointments and health care providers are fully equipped with necessary information. That allows more time during the visit for the patient and provider to focus on health issues.

Implementation began in May. In just four months, more than 400 patients received care.

"We have an excellent staff caring for very complex patients, so having staff and patients working closely alongside one another maximizes time and effort,"Kim Murdaugh, executive director of Family Healthcare of Hagerstown, said in a news release.

We are especially excited to support the grant for Family Healthcare of Hagerstown" said Angelo Edge, chief executive officer of Aetna Better Health of Maryland. "Their work with high-risk patients is an essential to helping close the gaps in patient care."

"The Community Health Resources Commission is thrilled to support Family HealthCare of Hagerstown," said Mark Luckner, the commission's executive director. "This program will help create a medical home at Family Healthcare of Hagerstown for individuals with chronic conditions."

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Family Healthcare of Hagerstown receives grant - Herald-Mail Media

PARKERSBURG, W. Va. (WTAP) - The Ohio Valley Health Care is a senior facility that has many amenities to help seniors live a comfortable life.

But the organization felt like something was missing.

They found that most activities have more women participating than men.

"We have a couple residents that worked for the railroads, so we thought lets do a model train," said Jay Miller, administrator, Ohio Valley Health Care.

Jay says, they shared the idea with Joe Stephens who builds trains and train stations and they werent expecting it to be this big.

For some seniors, the trains are therapeutic as they sit in front of the window. The train station turned out to be a treat that both men and women enjoy.

"Its great for me to see the smiles on their faces and to me its not just a job, its not about the money, these people mean a lot," said Joe Stephens, owner of Stephens Outdoor Railways.

More:

Ohio Valley Health Care model train station lit for the holidays - WTAP-TV

The Zacks Medical - Outpatient And Home Healthcare industry comprises companies that provide ambulatory care in an outpatient setting or at home. These companies utilize advanced medical technologies for diagnosis, observation, consultation, treatment and rehabilitation services.

The industry participants also include operators of HMO medical centers, kidney dialysis centers, freestanding ambulatory surgical units, emergency centers and other outpatient care centers.

Here are the three major industry themes:

Zacks Industry Rank Indicates Encouraging Prospects

The Zacks Medical - Outpatient and Home Healthcare industry falls within the broader Zacks Medical sector. It carries a Zacks Industry Rank #92, which places it in the top 37% of more than 250 Zacks industries.

The groups Zacks Industry Rank, which is basically the average of the Zacks Rank of all the member stocks, indicates solid near-term prospects. Our research shows that the top 50% of the Zacks-ranked industries outperforms the bottom 50% by a factor of more than 2 to 1.

We will present a few stocks that have the potential to outperform the market based on a strong earnings outlook. But its worth taking a look at the industrys shareholder returns and current valuation first.

Industrys Stock Market Performance

The industry has underperformed both its sector and the Zacks S&P 500 composite in the past year.

The industry has lost 14.9% over this period against the S&P 500s rally of 29.3% and the broader sectors increase of 10% in the same timeframe.

One Year Price Performance

Industrys Current Valuation

On the basis of the forward 12-month price-to-earnings (P/E), which is commonly used for valuing medical stocks, the industry is currently trading at 19.65X compared with the S&P 500s 18.67X and the sectors 21.66X.

Over the last five years, the industry has traded as high as 20.26X and as low as 14.67X, with the median being at 17.87X, as the charts below show.

Price-to-Earnings Forward Twelve Months (F12M)

Price-to-Earnings Forward Twelve Months (F12M)

Story continues

Bottom Line

Technological advancement has led to simplification of procedures related to outpatient services and also made them less time consuming. Participation in alternative payment models also plays a major role.

Here are three stocks that either have a Zacks Rank #1 (Strong Buy) or 2 (Buy), which investors can take a look at. These stocks are also well positioned to grow in the near term. You can seethe complete list of todays Zacks #1 Rank stocks here.

Amedisys, Inc. (AMED): Amedisys provides home health and hospice services throughout the United States to the growing chronic, co-morbid, and aging American population. The stock sports a Zacks Rank of 1.

For this Baton Rouge, LA-based company, the Zacks Consensus Estimate for 2019 revenues indicates an improvement of 18.5%. It has an average positive earnings surprise of 21.1% in the trailing four quarters.

Price and Consensus: AMED

DaVita Inc. (DVA): DaVita is a leading provider of dialysis services in the United States to patients suffering from chronic kidney failure, also known as end stage renal disease (ESRD). Its services include outpatient dialysis services, hospital inpatient dialysis services and ancillary services such as ESRD laboratory services and disease management services. The stock sports a Zacks Rank #1.

For this Denver, CO-based company, the Zacks Consensus Estimate for 2019 earnings suggests growth of 48.7%. It has an average positive earnings surprise of 8.1% in the trailing four quarters.

Price and Consensus: DVA

Hanger, Inc. (HNGR): The company delivers orthotic and prosthetic (O&P) patient care, and distributes O&P products and rehabilitative solutions. The company manages O&P networks, and provides therapeutic solutions to patients and businesses in acute, post-acute, and clinic settings in the United States. The stock carries a Zacks Rank of 2.

For this Austin, TX-based based company, the Zacks Consensus Estimate for 2019 revenues indicates an improvement of 4.7%. The consensus mark for 2019 earnings indicates an increase of 15.4%.

Price and Consensus: HNGR

5 Stocks Set to Double

Each was hand-picked by a Zacks expert as the #1 favorite stock to gain +100% or more in 2020. Each comes from a different sector and has unique qualities and catalysts that could fuel exceptional growth.

Most of the stocks in this report are flying under Wall Street radar, which provides a great opportunity to get in on the ground floor.

Today, See These 5 Potential Home Runs >>

Click to get this free report

Hanger Inc. (HNGR) : Free Stock Analysis Report

DaVita Inc. (DVA) : Free Stock Analysis Report

Quest Diagnostics Incorporated (DGX) : Free Stock Analysis Report

Amedisys, Inc. (AMED) : Free Stock Analysis Report

To read this article on Zacks.com click here.

Zacks Investment Research

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Rosy Outlook for Outpatient and Home Healthcare Industry - Yahoo Finance

Every fall, another somber seasonal marker arrives: the flu. The CDC estimated that in the winter of 201819, about 42 million people got sick from the flu, causing 647,000 hospitalizations and 61,000 deaths. These numbers would be lower if more adults heeded medical advice to obtain a flu shot, yet only about one-third of prime-aged adults do so.

Enter the retail clinic. Retail clinics arrived on the healthcare scene in the early 2000s as a convenient and affordable alternative to doctors offices, urgent care centers, and emergency rooms (ERs). Because they are usually in big box stores or pharmacies such as Walmart and CVS, retail clinics are conveniently located. And because they serve customers on a walk-in basis, they are convenient to access. Their services include basic primary care for minor illnesses and injuries, such as sore throats, bug bites, and minor burns as well as preventive primary care, such as vaccines and diabetes glucose monitoring.

Providing these medical servicesat convenient times and locationsmay affect how many people end up in the ER for minor conditions. A recent study found that the prices in retail clinics are around 80% lower than ER prices for the same service. Retail clinics thus have the potential to not only expand medical services but to do so while saving money. But do they live up to this potential?

This question animates a recent research article by Diane Alexander, economist, Federal Reserve Bank of Chicago; Janet Currie, Henry Putnam Professor of Economics and Public Affairs, Princeton University; and Molly Schnell, assistant professor of economics, Northwestern University. Economics writer Lisa Camner McKay summarizes their research.

While ideally researchers assess how a populations health changes when a retail clinic opens, such extensive health data is difficult to assemble. To gain traction on the impact of retail clinics, then, Alexander, Currie, and Schnell analyzed how the numbers of ER visits for different categories of illness are affected by the presence of retail clinics in the state of New Jersey.

They found that people who live within two miles of a retail clinic after it opens do indeed have fewer visits to the ER for the minor illnesses and injuries that retail clinics treat than do people who live farther away. Retail clinics also reduce ER visits for illnesses that can be prevented via appropriate primary caremost notably, visits for the flu decline by 13%. This suggests that retail clinics, with their low, transparent prices and convenient hours, make an important contribution to the healthcare landscape.

A theory of retail clinic usage

Before diving into the data, Alexander, Currie, and Schnell developed a theory as to how the presence of retail clinics affects the healthcare setting in which patients receive treatment. This theory provides concrete predictions that they then test with data. The authors assumed that patients select a venue based on the severity of their condition and the cost of the treatment, making retail clinics best suited for low-severity conditions, doctors offices best suited for mid-severity conditions, and ERs best suited for high-severity conditions. The arrival of a retail clinic, then, will affect how many people visit the ER via two mechanisms: substitution and prevention.

First, the authors theorize that patients with low-severity, treatable conditions will substitute the ER for a retail clinic when a retail clinic is convenient. These conditions include minor illnesses and injuries that can be treated by a nurse practitioner or general medical practitioner, such as ear infections, eye infections, upper respiratory tract infections, sore throats, urinary tract infections, sprains, and strains. The authors call this class of condition primary care treatable.

Because these conditions require treatment relatively quickly, these patients may end up in the ER if they cant get a doctors appointment. If a retail clinic opens nearby, however, some of these patients should switch to the clinic because of its convenience and low cost. In particular, patients with the least-severe conditions in these categories should be more likely to switch venues, leaving the ER to handle fewer but more severe visits in the primary care treatable category.

Related: Walmart Launches Digital Healthcare Site

Second, the authors theorize that ER visits will be prevented when a retail clinic opens because more people will receive preventive primary care. In this class of conditions, dubbed emergent, preventable, the authors focus on influenza and diabetes. These are illnesses that can be avoided or controlled in an outpatient setting if they are treated properly (with flu shots and glucose monitoring), but if they go untreated, they will land some patients in the ER.

More here:

Retail Clinics Make Important Contribution to Healthcare - Managed Healthcare Executive

When John Rockhold drew a low number, No. 12, in the 1971 draft lottery, his adolescence in the San Fernando Valley forever changed. Seeking to avoid the Army, he signed up for the Navy just after graduating from Granada Hills High School. As an enlisted petty officer, he spent months operating boats that dropped off SEALs at night along long and humid Vietnamese shorelines where American troops were trying to stop the communist north from taking over the south.

More than 58,000 U.S. service members died in the war, and since it ended in 1975, innumerable American veterans have returned to Vietnam, seeking understanding, forgiveness or reconciliation. Now some are coming for more mundane reasons: inexpensive housing, cheap healthcare and a rising standard of living.

After his military career, Rockhold worked as a defense contractor, operating mostly in Africa. He first returned to Vietnam in 1992 to work on a program to help economic refugees. He settled in Vietnam in 1995, the same year the United States and Vietnam normalized relations. He married a Vietnamese woman in 2009.

In fact, he liked it so much that he persuaded his mother to move to Vietnam from Santa Maria, Calif., also in 2009.

She came for the wedding, and decided to stay, he said with a laugh. She lived in Vietnam until her death in 2015 at 94.

Rockhold, now 66, sits on several boards and is raising two children, 10 and 9, with his wife, Tu Viet Nga. The children were born via caesareansection; the procedure, including a four-day hospital stay, cost about $1,200, far less than it would have in the United States. The family lives in a 20th-floor condominium overlooking the Saigon River and the sprawling city beyond. They bought the four-bedroom, 3-bathroom unit, measuring about 1,840 square feet along with a separate veranda, for about $250,000 in 2011.

Rapid growth in Vietnam and its Southeast Asian neighbors has created a situation that would have been unthinkable in the past: Aging American boomers are living a lifestyle reminiscent of Florida, Nevada and Arizona, but in Vietnam. Monthly expenses here rarely exceed $2,000, even to live in a large unit like Rockholds, including the help of a cook and a cleaner. The neighbors are friendly: A majority of Vietnamese were born well after the war ended in 1975, and Rockhold says he has rarely encountered resentment, even when he talks about his service as a combat veteran.

The vast majority of the owners in his apartment building are members of Vietnams burgeoning urban middle class; many work in government or in education, and can afford to take vacations abroad. He estimates that no more than 1 in 5 residents in the 25-floor complex are foreigners.

The Vietnamese were extremely nice to me, especially compared to my own country after I came back from the war, Rockhold said at a coffee shop recently inside a polished, air-conditioned office tower that also houses a restaurant and cinema.

In semi-retirement, Rockhold keeps busy: He helps Vietnam import liquefied natural gas, and is involved with a charity that provides solar energy to low-income households. His wifes family farm is about a 45-minute drive from where he once saw combat. It didnt ever pass my mind that 30 years later I was going to own some of Vietnam, Rockhold said with a chuckle.

Vietnam has relaxed visa rules to lure American retirees like Rockhold, along with their savings. Geopolitics are a factor; Vietnam has seen spillover benefits from the economic boom in China but also has an ambivalent relationship with its far larger and more powerful neighbor, with which it fought a brief war in 1979. Expatriates tend to consider Vietnam more hospitable than China; Ho Chi Minh City, formerly Saigon, retains a cosmopolitan character.

The government wont say precisely how many American retirees live in Vietnam. Interviews with about a dozen such retirees suggest that some are here on one-year tourist visas; others are here just for a season or two; and still others have qualified for long residence by marrying Vietnamese citizens, as Rockhold did.

One Army veteran, Michael Gormalley, a former platoon sergeant, returned to Vietnam as a volunteer English teacher for rural high schools in 2008. In 2014 he started teaching at a Vietnamese university.

He arrives at school at 7 a.m., before it gets too hot in the classrooms, which are not air-conditioned. He leads groups of blue-uniformed, necktie-wearing, exam-wary teenagers who might have classes six days a week. The 71-year-old former school principal in Pittsfield, Mass., said he had added teaching hours to show respect for the Americans and Vietnamese people who lost their lives during the Vietnam War.

Frederick R. Burke, a lawyer with the law firm Baker McKenzie who is well-connected in the American expatriate community here, remarked on the number of veterans living in Vietnam. They want to come back and want to reconcile, he said. Often theyve married a Vietnamese woman, and their Social Security and veteran benefits go a lot further here than they do in Los Angeles.

Vietnam has joined other Southeast Asian countries to lure retirees from wealthier parts of the world.

Cambodia, another nation that struggles with the legacy of United States military intervention, is also attempting to attract American retirees. The countrys per capita GDP is about $1,400, and for that sum, an expatriate can easily pay a months rent, energy costs and a housekeepers wages.

Sri Lanka, where a brutal civil war ended in 2009, is issuing renewable two-year visas to retirees 55 and older if they can support themselves and have at least $15,000 in a local bank account. A typical expatriate cost of living is $1,000 to $2,000 per month.

Historically, the Philippines, Thailand and Malaysia were more common destinations for American retirees. But a higher cost of living, especially in coastal areas like California and New York, has pushed many farther afield.

Rockhold, the Navy veteran, said that healthcare had vastly improved in Vietnam. He added, This is one of the safest cities in the world; petty pickpocketing is almost unheard of.

Remarkably, he said, some of his friends are Americans who never served in Vietnam. The cost of living is so low, he said. Its a communist country, but if I blindfolded you and put you in downtown Saigon, you wouldnt know it.

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Americans are retiring to Vietnam. Here's why - Los Angeles Times

The global Internet of Things (IoT) in healthcare market size to grow at a CAGR of 27.6% during the forecast period

NEW YORK, Dec. 26, 2019 /PRNewswire/ --

Read the full report: https://www.reportlinker.com/p05184178/?utm_source=PRN

The IoT in healthcare market size is projected to grow from USD 55.5 billion in 2019 to USD 188.0 billion by 2024, at a Compound Annual Growth Rate (CAGR) of 27.6% during the forecast period. The IoT in healthcare market is driven by factors, such as advancement in technology coupled with rising demand for self-health management service and rise of digitalization and increase in the overall level of connectivity and innovations taking place in the modern healthcare ecosystem. However, lack of skilled digital workforce, and challenge for organizations due to security concerns related to the violation of crucial patient information are expected to retrict thre growth of the IoT in healthcare market.

Systems and Software segment to grow at the highest CAGR during the forecast periodThe IoT in healthcare market by component is segmented into medical devices, systems and software, services, and connectivity technology.The systems and software segment is expected to grow at a rapid pace during the forecast period.

Systems and software are the most promising components in the IoT in healthcare market as they create a high degree of smart characteristics and autonomy in the IoT ecosystem. They are designed to meet interoperability challenges that occur due to varied heterogeneous devices, along with managing large volumes of data and offering them security and privacy.Hospitals, surgical centers, and clinics segment to hold the largest market size during 2019The IoT in healthcare market by end user has been segmented into hospitals, surgical centers, and clinics; clinical research organizations; government and defense institutions; and research and diagnostic laboratories. IoT solutions in the healthcare sector are majorly catered by this segment that consists of hospitals, surgical centers, and clinics, as they are the most approached care centers by patients.

APAC to grow at the highest CAGR during the forecast periodAsia Pacific (APAC) is expected to grow at the highest CAGR during the forecast period. Factors, such as flexible economic conditions, industrialization- and globalization-motivated policies of the governments, as well as expanding digitalization, would support the growth of the IoT in healthcare market in the region.

In-depth interviews were conducted with Chief Executive Officers (CEOs), innovation and technology directors, system integrators, and executives from various key organizations operating in the IoT in healthcare market. By Company: Tier I: 45%, Tier II: 40%, and Tier III: 15% By Designation: C-Level Executives: 40%, Directors: 35%, Managers: 15% and Others: 10% By Region: North America: 15%, APAC: 35%, Europe: 40%, and RoW: 10%

The report includes the study of key players offering IoT in healthcare solutions and services.It profiles major vendors in the global IoT in healthcare market.

Major vendors in the IoT in healthcare market are Agamatrix (US), Armis (US), Capsule Technologies (US), Comarch SA (Poland), Cisco Systems (US), GE Healthcare (US), IBM Corporation (US), Intel (US), KORE Wireless (US), Medtronic (Ireland), Microsoft Corporation (US), OSP Labs (US), Resideo Technologies (US), Royal Philips (Netherlands), SAP SE (Germany), Sciencesoft (US), Softweb Solutions (US), STANLEY Healthcare (US), Telit (UK), and Welch Allyn (US). It further includes an in-depth competitive analysis of key players in the IoT in healthcare market, along with their company profiles, business overviews, product offerings, recent developments, and market strategies.

Research CoverageThe market study covers the IoT in healthcare market across segments.It aims at estimating the market size and the growth potential of this market, across different segments, such as component, application, end user, and region.

The study further includes an in-depth competitive analysis of key players in the market, along with their company profiles, key observations related to product and business offerings, recent developments, and key market strategies.

Key Benefits of Buying the ReportThe report will help the market leaders/new entrants in this market with information on the closest approximations of the revenue numbers for the overall IoT in healthcare market and the subsegments.This report will help stakeholders understand the competitive landscape and gain more insights to position their businesses better and to plan suitable go-to-market strategies.

The report further helps stakeholders understand the pulse of the market and provides them with information on key market drivers, restraints, challenges, and opportunities.

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The global Internet of Things (IoT) in healthcare market size to grow at a CAGR of 27.6% - PRNewswire

The longer a language is spoken and written, the more it changes. When two-word phrases are used frequently, they often become hyphenated or compounded.

Such is the case with health care. In Western society, health care is one of the primary concerns of day-to-day life for many people. The policies surrounding health care service delivery, and their associated costs, are a large part of the national discourse in many countries.

Some countries have different spelling conventions for these words, depending on how they are used in a sentence. Continue reading to learn about these spelling differences.

In this post, I will compare health care vs. healthcare. I will use each variation in at least one example sentence, so you can see it in its proper context. Plus, I will give you a mnemonic device that will help you choose either healthcare or health care in your own writing.

Is healthcare one word or two? Lets find out.

What does health care mean? Health care (two words) is a noun. It refers to maintenance of ones wellbeing, either by medical means or otherwise.

Here are some examples,

When this term is used as an adjective, it is hyphenated to form health-care, like in the below examples,

For anyone using AP Style, The AP Stylebook requires health care to be spelled as such: health care.

What does healthcare mean? Healthcare (one word) is a variant of the same term. It is not yet considered standard, but it is being used more and more often as time progresses.

See the below charts,

This next graph isolates the use of healthcare as an adjective, where it is actually surpasses health-care in popularity,

These data are not exhaustive, and the charts should not be considered scientifically accurate. Still, they illustrate clear usage trends, and healthcare is clearly becoming more popular with each passing year.

Heres a helpful trick to remember health care vs. healthcare.

For now, healthcare is still not accepted as standard in American English, despite its increasing popularity. At least in formal writing, you will want to stick with health care as a noun and health-care as an adjective for American audiences. As I mentioned above, place like The AP Stylebook still require the two-word health care.

For British audiences, healthcare is an accepted adjective, but health care is still more common as a noun.

Remember that healthcare is a compound adjective in British English, much like another British English adjective, gobsmacked. This memorable term, which is spelled as a single word, should help you remember to spell healthcare as a single-word adjective in British English.

Is it healthcare or health care? Health care is an incredibly important subject, so its best to know how to write about it.

Healthcare and gobsmacked are two British English compound adjectives that are spelled as a single word. Remembering the similarities between these two words will help you remember when to use healthcare, and as what part of speech.

English can be confusing, so dont forget to check this site any time you have questions. If you are ever stuck choosing health care or healthcare, you can revisit this page for guidance.

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Healthcare or Health Care Whats the Difference? - Writing ...

Very real health care costs not a fictional Grinch are taking away holiday cheer from more than half of Americans.

Fifty-three percent of individuals say health care bills have eaten into money they would have otherwise spent celebrating the season, according to a survey from insurer Aflac. Sacrifices they've made include cutting back on or forgoing altogether traditions like gift-giving and travel. They also say they're borrowing money from friends or relatives and working extra hours, just to keep themselves healthy.

"Health care costs are affecting Americans' financial security, particularly around the holidays," said Aflac's Stephanie Shields.

The share of families with kids whose medical costs have led them to make a "sacrifice or hard decision" is even higher. Seventy-one percent said doctor's office visits and other medical expenses have hamstrung their holiday spending during the past two years.

Shields attributes the financial burden to high out-of-pocket expenses. Nearly 30% of families with kids who visited a hospital in the past two years said they spent $1,000 or more in out-of-pocket costs, according to Aflac.

"One of the themes is medical expenses outpacing the amount of insurance people have," Shields said. "They are beyond what co-payments or deductibles will cover and that results in greater out-of-pocket costs."

Some of those families that are struggling to keep up are opting for health care rather than holiday gifts. Nearly 1 in 4 families said they spent less on gifts during the past two years, and 1 in 5 decided against purchasing a gift for a loved one altogether, according to the survey.

Medical costs also affect how people finance their pared-down spending. Nearly one in five families chose to finance paying for holiday events, travel and gifts with credit cards, and more than one in four say they borrowed money from a friend or family member. Twelve percent of families with kids said they took out a loan in order to finance the holidays because of medical costs.

Also sobering: Medical costs are influencing when and how individuals access healthcare, all throughout the year. Thirty-five percent of families said they postponed their own medical appointments due to cost concerns, the survey found.

A recent Gallup poll found a record 25% of Americans said they or a family member delayed treatment for a serious medial condition because of cost, up 19% from a year ago. Another 8% put off treatment for a less serious medical condition.

Shields stressed the importance of families paying close attention to the details of their insurance plans and to select a plan with benefits that fulfills their needs. After all, 42% of families with children say they've made mistakes in choosing coverage or seeking out care.

She encourages families to review their plans' benefits annually and adjust selections based on evolving needs, as well as to make the most of flexible spending accounts and other services available through insurance plans like telemedicine, which can help lower costs.

"Health care costs are a continuing financial burden to families and they need to decide how to spend their dollars. Ultimately, we don't want to see Americans go further into debt over this," she said.

Originally posted here:

High health care costs limit Americans' Christmas and holiday spending - CBS News

Partners HealthCare on Thursday announced a new five-year technology initiative designed to drive digital innovation, improve clinical care and enhance the patient experience.

WHY IT MATTERSPartners officials say the program as part of its five-year systemwide strategy and rebranding designed to position it as "health care system of the future" will focus on digital innovations for diagnostics, therapeutics, medical devices, analytics and population health.

Patient engagement through leading-edge digital tools will be a key component of the effort, which will include advancements in online scheduling, telehealth and virtual care, access to clinical records through OpenNotes and easier options to see cost estimates for procedures and imaging.

The initiative will also work to improve interoperability and aggregation of medical records for Partners and non-Partners health care sites; lower wait times for all Partners Emergency Departments and Urgent Care centers and customize patient communication options, including text, email, call or direct mail, according to Partners officials.

The program will connect data and analytics professionals from across Partners sites, including Massachusetts General Hospital and Brigham and Women's, building an enterprise data ecosystem to boost data management and use.

In addition to clinical applications, new analytics tools will be developed to focus on hospital operations, bed capacity management, human resources, active asset management, supply chain, revenue cycle and more.

THE LARGER TRENDPartners HealthCare which earlier this month announced that it would rebrand, becoming Mass General Brigham also includes several community and specialty hospitals in addition to its two flagship facilities. It also comprises an insurance plan, physician network, community health centers and long-term care services.

As principal teaching affiliate of Harvard Medical School, Partners is one of the nations leading biomedical research organizations and has long been on the forefront of healthcare technology and data innovation.

ON THE RECORD"As a health care system with two leading academic medical centers and the nations largest research enterprise, our clinicians and researchers are developing digital tools and care programs that are transforming medicine," said Dr. Alistair Erskine, chief digital health officer for Partners HealthCare. "This initiative will fuel early stage projects, provide the resources to test those projects and then more importantly, provide a structure to scale projects that allows us to expand access for patients across our health care system and beyond."

"Our patients want health care to operate like every other sector of our economy, and this initiative will help us to engage patients and ensure that they are getting the attention they need, when they need it," added Dr. Gregg Meyer, chief clinical officer at Partners HealthCare. "By leveraging data and technology, we can ensure that wherever patients are in our system, they can benefit from the expertise of our clinicians and access world-class care."

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Partners launches expansive 5-year digital health innovation plan - Healthcare IT News

Democratic presidential candidates (L-R) former tech executive Andrew Yang, South Bend, Indiana Mayor Pete Buttigieg, former Vice President Joe Biden, Sen. Bernie Sanders (I-VT), Sen. Kamala Harris (D-CA) and Sen. Kirsten Gillibrand (D-NY) take part in the second night of the first Democratic presidential debate on June 27, 2019 in Miami, Florida.

Drew Angerer | Getty Images

Skyrocketing prescription drug costs and health care continue to dominate both Democratic and Republican agendas, increasing uncertainty in the industry heading into the 2020 elections.

There are 11th-hour efforts in both the House and Senate to try win passage of bills to combat escalating drug prices and surprise medical billing before year-end. The House is expected to vote as early as Thursday on a sweeping plan to curb prescription drug prices. But the chances of a bill making it to the president's desk for signature seem slim.

If history is any guide, the odds of finding agreement on major legislation and regulations that don't get passed before the new year will fall off dramatically in 2020 and not just because of the rancor over impeachment proceedings.

"In the last several elections, one thing that we've tracked is how much policy change happened in the year of election. What we found is, typically, the number of policy changes drops by half," said Gurpreet Singh, PwC partner and health services sector leader.

The PwC Health Research Institute found that major health-care reforms slowed significantly during the reelection bid of President George W. Bush in 2004 the year after Congress passed Medicare legislation that ushered in Part D drug coverage for seniors. Reforms slowed again during President Barack Obama's reelection campaign in 2012, two years after the Affordable Care Act had been passed.

PwC says the presidential election poses the biggest uncertainty for health insurers and hospitals in 2020, due to the potential shifts in policies over the next four years.

If President Donald Trump is reelected, the researchers expect the administration will to continue its efforts to restructure the Medicaid program, the federal health program for the poor. The White House has stood behind Republican states that push work requirements for recipients, which could curb the growth of Medicaid enrollment. Medicaid expansion under Obamacare has been a growth driver for health insurers over the last decade.

If a Democrat wins the White House, the Trump administration's Medicaid measures would be off the table, including efforts to move to block grant funding for states.

PwC sees little chance of "Medicare for All" proposals, which would put private health insurers out of business, becoming law even if a Democrat wins.

"That's overrated it's not necessarily going to be something that is going to happen," said Singh, adding "we're not quite there yet."

For pharmaceutical firms, the Trump administration's tariffs on Chinese imports pose a risk if there's no resolution to the trade dispute with Beijing. PwC researchers note that tariffs on essential chemicals sourced in China already "have complicated supply chains for drug companies." The industry could continue to face uncertainty over trade no matter who wins the White House.

Regardless of the presidential election, high health-care costs will continue to be the top issue in the U.S. next year. With dozens of new lifesaving gene therapies in the pipeline for approval, PwC researchers say the next decade could bring a tsunami of high prices.

"We expect to go from about four new drugs applications [this year] to about 200 in 2020. By its nature, that's going to increase costs" Singh said. "Those tend to be very costly million-dollar treatments."

Novartis' Zolgensma, one of the break-through therapies approved by the FDA this year to treat a rare muscular disorder in children, is priced at more than $2 million.

The FDA is expected to approve between 10 and 20 new drugs per year over the next decade. By 2030, gene therapies could target diseases that impact 500,000 people in the U.S. alone.

Health care was a top issue for voters in the 2018 midterm elections, which allowed the Democrats to regain control of the House.

The impact of eye-popping drug prices in an election year could play a big role at the ballot box in 2020.

More than 70% of voters surveyed by PwC in September said they will likely vote for a candidate based on his or her health-care policies.

See the article here:

Drug prices and health care are wild cards in the 2020 election - CNBC

Use Our ContentThis story can be republished for free (details).

It was a promise Matt Perrin wasnt able to keep.

Ill never take away your independence, hed told his mother, Rosemary, then 71, who lived alone on Cape Cod, Mass., in a much-loved cottage.

That was before Rosemary started calling Perrin and her brother, confused and disoriented, when she was out driving. Her Alzheimers disease was progressing.

Worried about the potential for a dangerous accident, Perrin took away his mothers car keys, then got rid of her car. She was furious.

For family caregivers, this is a common, anxiety-provoking dilemma. Theyll promise Mom or Dad that they can stay at home through the end of their lives and never go to assisted living or a nursing home. Or theyll commit to taking care of a spouses needs and not bringing paid help into the home. Or theyll vow to pursue every possible medical intervention in a medical crisis.

Eventually, though, the unforeseen will arise after a devastating stroke or a heart attack, for instance, or a diagnosis of advanced cancer or dementia and these promises will be broken.

Mom or Dad will need more care than can be arranged at home. A husband or wife wont be able to handle mounting responsibilities and will need to bring in help. A judgment call this will only prolong suffering, theres no point in doing more will be made at the bedside of someone who is dying.

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We want to give loved ones who are sick or dying everything we think they want but we cant, said Barbara Karnes, 78, an end-of-life educator and hospice nurse based in Vancouver, Wash. And then, we feel weve failed them and guilt can stay with us for the rest of our lives.

She hasnt forgotten an experience with her mother-in-law, Vi, who moved in with Karnes, her husband and two children after becoming a widow 30 years ago. At the time, Vi was in her 70s, weak and frail. Karnes was working full time and keeping the household going.

My mother-in-law and I got into a disagreement, I dont remember what it was about. But I remember her saying to me, You promised you would take care of me, and making it clear that she felt Id let her down. And I said, I know, I was wrong I cant do it all, she remembered. I still feel bad about that.

No caregiver I know sets out to deceive another person: Its just that none of us have a crystal ball or can predict what the future will hold, she said. And the best we can do isnt always as much as we thought was possible. We have to figure out a way to forgive ourselves.

Richard Narad, 64, a professor of health services administration at California State University, spent months after his wifes death in December 2011 mentally reviewing the last hours of her life before achieving a measure of peace.

His wife, April, was diagnosed with Type 1 diabetes at age 5 and was legally blind when the couple married in 1994. A year later, she had the first of a series of strokes. Eventually, April was diagnosed with congestive heart failure. In the last 18 months of her life, she was hospitalized 13 times.

April Narad had told her husband she wanted full code status in the event of an emergency in other words, do everything possible to keep me alive. But she was nervous about his willingness to honor her wishes because his own end-of-life views differed from hers.

I think certain care is futile and you need to give up earlier, he explained.

In the end, April was rushed to the hospital one night after dinner, gasping for breath. There, Narad directed medical staff to pursue full code interventions. But when a physician came out to tell him that death appeared inevitable, Narad remembers saying, Well, if thats the case, just call it.

Had he broken a promise to insist that other treatments be tried? Narad spent months wondering but eventually accepted that he acted in good faith and couldnt have saved Aprils life.

With illness, older couples can end up re-evaluating commitments theyve made. Kathy Bell, 66, of Silver Spring, Md., promised her husband, Bruce Riggs, 82, that shed stay with him through all the changes in our lives when they married in 1987. Then in August 2011, he received a diagnosis of Alzheimers.

The couple moved into a senior living facility, but as Riggs condition worsened he had to go to a memory care facility in 2014. The following year, Bell had lunch with a man whose wife lived at the same facility. He told her his therapist had recommended he start dating.

That planted the idea of possibly doing this myself at some point, Bell said, and two years ago she met a man who has become a regular companion.

Does she feel shes broken her promise to her husband, who was committed to a monogamous marriage? No, I dont, Bell said, adding that its not clear whether he knows me at this point. He doesnt talk. The way I view it: I still love him. I still go to see him. Im still taking care of him.

Promises can be explicit spoken aloud or implicit, understood without direct communication. Both kinds can inspire regret.

Debra Hallisey, 62, a caregiver consultant based in Lawrenceville, N.J., describes making an unspoken promise to her father, Don, when he was diagnosed with congestive heart failure in 2014. Their agreement, which was never voiced: Neither would tell Halliseys mother, Doris who has diabetes, mobility issues and is legally blind how sick he was.

Debra Hallisey and her parents, Don and Doris, celebrating their 60th wedding anniversary.(Courtesy of Debra Hallisey)

I knew he was shielding [Mom] from knowing the truth. When she would ask questions, he wouldnt say anything, Hallisey said. Because her mother was disabled, Hallisey accompanied her father to doctors appointments.

When Halliseys father died in February 2015, Doris was profoundly shocked and Hallisey was overcome by remorse. It was then, I said to my mother, Mommy, there are no more secrets. If something is wrong, I am going to tell you, and together were going to determine the best thing to do, she said.

In line with that promise, Hallisey has been direct with her mother, who uses a walker to get around her home in Somerset, N.J., and has round-the-clock home care. If and when Doris becomes unable to walk, shell have to move, Hallisey has said.

Ive told her, Mommy, Ill do everything to keep you in this house, but you have to use your walker and work at staying strong. A wheelchair wont work in your house, Hallisey said. I know that keeping her at home is a promise I may not be able to keep.

Matt Perrin made the decision to move his mother, Rosemary, to assisted living in 2017, after realizing he couldnt coordinate care for her escalating needs at a distance. (Rosemary lived on Cape Cod; Perrin lived in New Hampshire.) Because hed vowed to protect her independence, I felt so guilty a guilt that I had never felt before, he admitted.

Rosemary resisted the move passionately, but after a few months settled into her new home.

I felt relief then, and I still do, Perrin said. I wish I didnt make that promise to my mom, and I wish she werent living with Alzheimers. But Im thankful that shes in a place thats really good for her, all things considered.

Judith Graham: khn.navigatingaging@gmail.com,@judith_graham

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The Health Care Promises We Cannot Keep - Kaiser Health News

MADISON (WKOW) -- Within the next ten years, health care needs will grow dramatically.

The so-called silver tsunami, or the aging baby boomer population, is expected to put more strains on the health care industry.

According to the Association of American Medical Colleges, the nation's population of people over 75 will increase by 75 percent between 2017 and 2032. The Wisconsin Department of Health Services has predicted that by 2040, there could be more than 1.5 million Wisconsin residents over the age of 65.

In 2010, there were 780,000. That would be an increase of 100 percent.

"That's just staggering," said the Wisconsin Hospital Association's vice president Ann Zenk.

The WHA is also tracking the impact baby boomers will have on health care in its latest health care workforce report.

Zenk said that the rapidly aging population isn't exactly good news for the health care industry, which is already strained.

"We're seeing patients having to spend unnecessary days in the hospital, waiting for a place to be discharged to," she said. "Some of those gaps are due to the shortage of nursing assistants and other entry level workers."

Health care needs will grow by 30 percent in the next ten years, Zenk said, which will increase the need for even more nurses, doctors, physician assistants, and other specialized providers.

It's not a lost cause. Plenty of people in the state are catching on to the fact that it's about growing the workforce efficiently as well as quickly.

Madison College has a new, year-long program for licensed practical nurses, or LPNs.

Dr. Ernise Williams, the associate dean of the nursing program, told 27 News that job is becoming more vital as patient care gets more intense.

"The patients may not be able to receive the level of care that they need to get out of the hospital on time," she said.

Williams encourages her students to diversify their options so they can fill in where there are gaps in health care. LPNs can fill in where needs are crucial, like in patients' homes. With more nurses available for home visits, it can free up hospital beds.

Advanced practice clinicians can also step in to provide care when there are physician shortages.

But despite the gaps, the WHA's report said that healthcare workforce is, in fact, growing.

The Wisconsin Center for Nursing reported that in 2016, 3,000 people graduated from nursing schools. In each year since, they've been able to graduate 3,500.

"That's huge," said Zenk. "But we're going to need even more."

Since 2009, hospitals in Wisconsin have been able to double the number of advanced practice clinicians working. That includes nurse practitioners and physician assistants.

"The APC workforce is expected to double again in the next decade," she said.

Zenk said they work at the state and federal levels to make sure lawmakers are passing laws that don't make things harder for the workforce to efficiently grow.

Growing, but not fast enough.

"I think we have to be creative," said Williams. "We have to be creative because we do need to grow, grow, grow, so it woul dbe the process by which the grow, grow, grow is implemented."

See the article here:

Health care needs will increase as aging population grows - WKOW

Acting White House chief of staff Mick Mulvaney has called both Azar and Verma to the White House for a meeting on Thursday in an attempt to mediate the duos months-long personality and policy clashes. Already, Trump told Azar and Verma to knock it off and get along to no avail, said two senior administration officials.

The White House press office declined to comment. A HHS spokesperson said Secretary Azars and Administrator Vermas top priority is to advance the presidents health care agenda through lowering drug costs, advancing competition in the marketplace, and ensuring Americans have access to high quality, affordable healthcare.

A CMS spokesperson echoed the same sentiment: The Administrators number one priority is continuing to deliver on the presidents bold health care agenda to ensure Americans have access to high quality, affordable healthcare.

Get the latest on the health care fight, every weekday morning in your inbox.

Its unclear where Trump stands this week after POLITICO reported over the weekend that Verma tried to have taxpayers reimburse her for $47,000 worth of property stolen during a work trip. Verma also has come under fire for spending millions of dollars on contracts for Republican communications consultants, whose jobs entailed boosting her public profile.

A person familiar with the presidents thinking said he would like both the Secretary and the Administrator to stop the friendly fire and work together.

In interviews, nine current and former senior administration officials and Republicans close to the White House detailed how the rift between the two turned toxic on numerous fronts.

Azar and Vermas fighting has persisted for months, leaving officials from the Office of Management and Budget and the White Houses two policy councils as frustrated bystanders, and the tension between the two has only escalated in recent weeks.

The deteriorating drama has formed battle lines among White House aides with camps split between Verma and Azar, contributing to the stalemate. Azar has the backing of two of the administrations most powerful lawyers, while Verma has known Vice President Mike Pence for years and had a direct line to the president during talk of unveiling an Obamacare replacement.

But the constant bickering now threatens to blow back on both of them, as allies allege one is smearing the other. The risk is that one looks so consumed by this conflict that he or she appears unable to carry out the duties of the job.

The two have clashed over matters small and large, including policy issues such as the presidents desire to lower drug prices seen as a key talking point for his reelection campaign.

What a fucking soap opera, said one person familiar with the dynamics. This does not help either of them.

Throughout the Trump presidency, health care has been one of the administrations chief tripwires. The White House and Republican lawmakers failed to repeal Obamacare after years of conservative outrage over the sweeping health care law. The first Secretary of Health and Human Services Tom Price resigned after facing multiple investigations into his use of private aircraft for taxpayer-funded work trips. Policy-wise, other high-profile health care efforts have either been stalled in the courts or over disagreements including Vermas push to institute the first-ever Medicaid work requirements and her efforts to develop an Obamacare replacement plan.

Meanwhile, Azar has come under fire for cutting Verma out of the departments decision-making and attempting to block her access to the president and a high-profile event related to a Medicare executive order. The health secretary blocked Verma from traveling with Trump on Air Force One in October for the unveiling of a Medicare executive order in Florida, according to a half-dozen officials with knowledge of the multi-day episode. Verma was only allowed aboard the plane after the White House intervened. An HHS spokesperson denied that Azar or anyone at the agency blocked Verma from boarding the flight.

Within the White House, both Azar and Verma have their defenders as well as serious detractors.

As an attorney, Azar remains close to White House counsel Pat Cipollone and Attorney General Bill Barr, powerful allies in the Trump orbit. Azar has a reputation throughout the administration as a fierce bureaucratic infighter, who does not hesitate to create a paper trail to inoculate himself against potential criticism.

Secretary of Health and Human Services Alex Azar. | Zach Gibson/Getty Images

Hes also known for his fierce temper, dubbed by several senior administration officials as the purple rage because of his face color when he becomes angry.

Verma is close with Vice President Mike Pence, with whom she worked in Indiana when he served as governor. White House aides have spotted her dining in the Navy mess with Jared Kushner, with whom she worked on health care-related information technology initiatives. She also has a direct line to the president, speaking to him with some frequency when the White House was contemplating unveiling a potential Obamacare replacement plan.

On Verma, the criticism is that she is a micromanager who only trusts people inside her very inner circle and refuses to share information more broadly inside HHS, said a former senior administration official. Although the president knows and likes her, he once accidentally called her Reema in an Oval Office meeting.

The president likes them both, said a Republican close to the White House. There is a reason Alex has earned his stripes on drug pricing, but Seema has also been very effective. That is why this is annoying. Very senior people involved in policy are just wondering why they cant just figure this out.

When asked if their ongoing fights were restraining the administrations health care policy, a former senior administration official called that a no-brainer.

Your two highest health care officials feuding will be damaging to policy wins, the official added.

Rachana Pradhan contributed to this report.

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'A fing soap opera': The health care drama riveting the White House - POLITICO

Acting White House chief of staff Mick Mulvaney summoned the administration's two top health policy officials to meet with him at the White House in an effort to cool down a months-long feud that is reaching a boiling point. Health and Human Services Secretary Alex Azar and Centers for Medicare and Medicaid Services administrator Seema Verma could met with Mulvaney Wednesday, several senior administration officials confirm to CBS News.

A White House official confirmed that the two have fought over the administration's efforts to come up with a replacement to the nation's health care law, the Affordable Care Act. Politico first reported their battles over an Obamacare alternative, stating that Verma spent six months developing a proposal, only to have Azar scuttle it before President Trump could see it. According to Politico, Azar thought Verma's plan would end up strengthening the ACA, rather than replacing it.

The two have also been at "each other's throats" on several other issues, too, ranging from the administration's work on lowering drug prices to who gets credit for any perceived victories involving health care, according to multiple White House sources.

President Trump did not attend Mulvaney's meeting with the two. White House officials maintain that Verma continues to have the support of the president, but Mr. Trump has made it clear that he wants the bickering between Azar and Verma to stop. Mr. Trump "doesn't care if they like each other, but they have a job to do," one official said. Their jobs are not in jeopardy, the source said.

"Secretary Azar's and Administrator Verma's top priority is to advance the president's health care agenda through lowering drug costs, advancing competition in the marketplace, and ensuring Americans have access to high quality, affordable healthcare," an HHS spokesperson said in a statement to CBS News.

But some White House officials say the dispute has become an obstacle to working relations between the two.

"I would not want to be in between those two," a senior White House official said of the battle between Azar and Verma.

White House officials claim that the situation has unraveled to a point where the two sides are now spilling or "leaking" unfavorable stories about each other to news outlets.

One story initially broken by Politicoand confirmed by CBS News involves a claim Verma filed in 2018 for $47,000 with the government for stolen property, including jewelry, after her luggage was stolen from a rental car while she delivered a work-related speech in San Francisco. The claim was for about $43,000 for jewelry and $4,000 for clothes. She received just $2,852.40.

Some Democrats attacked the claim as a waste of taxpayer money. Congressman Joe Kennedy, of Massachusetts, called it a "bailout for stolen goods she chose not to insure," according to USA Today.

Verma's claim has become an annoyance for many in the West Wing, but CMS considered the story to be part of a smear campaign against her.

"These recent leaks are part of a targeted campaign to smear the Administrator and undermine the accomplishments of CMS," a CMS spokesperson told CBS News in a statement. "The Administrator's number one priority is continuing to deliver on the President's bold healthcare agenda to ensure Americans have access to high quality, affordable healthcare."

Both Azar and Verma have powerful allies in the administration. Azar is close to White House counsel Pat Cipollone and Attorney General Bill Barr, while Verma, who oversaw Indiana's Medicaid program, has close ties to Vice President Pence.

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Mick Mulvaney summons feuding top health care officials Alex Azar and Seema Verma to White House for cool-off meeting - CBS News

GREENEVILLE, Tenn. A Morristown woman, who fraudulently claimed to be a nurse at eight employers over a six-year period, now faces up to 45 years in federal prison and fines up to $750,000.

Misty Dawn Bacon, 44, of Morristown entered a guilty plea in U.S. District Court in Greeneville on Thursday to wire fraud, health care fraud, and identity theft.

She will be sentenced on April 3.

This defendant created a substantial danger to public health through her lengthy criminal scheme. Anyone who fraudulently poses as a licensed professional will be vigorously prosecuted by this office and an appropriate punishment will be sought, U.S. Attorney J. Douglas Overbey said in a news release.

Our office will bring the full measure of the law against those who attempt to take this sort of dangerous and unlawful advantage of persons needing appropriate medical treatment from duly licensed health care professionals, Overbey said.

As part of the plea agreement, Bacon, a convicted felon, admitted to providing fraudulent information on job applications by using the registered nurse license numbers of others to gain employment.

Bacon posed as a registered nurse, despite not having a nursing degree or a nursing license and having no nursing experience, according to the news release from the U.S. Attorneys Office.

She was hired by at least eight health care providers between September 2012 and November 2018.

Over the six-year period, she worked in a variety of medical settings, including nursing homes, rehabilitation and assisted living facilities, a doctors office, and home health agencies, the U.S. Attorneys Office said.

While posing as a nurse, Bacon had access and rendered medical care to numerous patients, dispensing medications, obtaining invasive access to patients bodies, and gaining access to patients sensitive and private medical information, the U.S. Attorneys Office noted in the news release.

Bacon made numerous false entries in patients medical records and submitted false claims to public and private health care benefit programs.

Two of her employers voluntarily repaid health care benefit programs over $500,000 for claims submitted upon learning of Bacons imposter status.

Posing as a medical professional and putting the lives of innocent patients at risk is not acceptable, said TBI Director David Rausch. Our Medicaid Fraud Control Division remains committed to working with our federal partners to ensure healthcare fraud and identity theft cases like this one are addressed and investigated thoroughly.

The case resulted from an ongoing investigation by the Tennessee Bureau of Investigation, the Tennessee Department of Health, and the Jefferson City Police Department.

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Morristown woman posed as nurse for 6 years at 8 health care providers - WATE 6 On Your Side