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

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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

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

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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.

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

The Health Care Promises We Cannot Keep – Kaiser Health News

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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

Health care needs will increase as aging population grows – WKOW

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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."

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‘A fing soap opera’: The health care drama riveting the White House – POLITICO

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

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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

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

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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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Ocasio-Cortez Makes Connection Between 20% Jump in Healthcare Costs and Industry-Sponsored Spa Days for Congressional Staffers – Common Dreams

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After end-of-the-year reports showed healthcare costs for Americans rose an average of20% in 2019, Rep. Alexandria Ocasio-Cortez on Twitterhighlighted evidence of the cozy relationship between the for-profit health insurance industry and U.S.lawmakers.

The New York Democrat noteda retreat at a luxury resort in Virginia taken last April by more than 40 senior congressional staffers where they rubbed elbows with and listened to talks given by health insurance lobbyists.

"One of the sneaky and most corrupting aspects of lobbying is to court a member's staff," Ocasio-Cortez tweeted.

Health insurance costs have gone up *20%* in the past year.

This is the healthcare system of choice that so many politicians are committed to protecting with small, incremental tweaks.

Meanwhile, Big Pharma & insurance lobbyists treat Congressional staffers to spa weekends. https://t.co/58VDRPf7HY

Alexandria Ocasio-Cortez (@AOC) December 12, 2019

If you think Im joking about the spa weekend bit, Im not!

One of the sneaky and most corrupting aspects of lobbying is to court a members staff - especially their chief.

It just happened earlier this year with lobbyists fighting Medicare for All:https://t.co/Xp3rq8Y1XW

Alexandria Ocasio-Cortez (@AOC) December 12, 2019

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Staffers in attendance at the event came from both sides of the aisle and heard healthcare and pharmaceutical lobbyists' pitches for so-called "reforms" to the healthcare systemwhich did not include Medicare for All.

"This event wasn't about fixing the healthcare system," former health insurance executive-turned-Medicare for All advocate Wendell Potter told The Intercept at the time. "It was about protecting the healthcare industry, no matter the cost to patients, families, workers, or employers. The industry is the root cause of our healthcare crisis. A congressional staffer serious about finding solutions wouldnt touch that retreat with a 10-foot pole."

The federal Consumer Price Index report revealing the rise inhealthcare costswas released a day after CBS reported that more than half of American families are being forced to cut back on holiday spendingbecause of expenses includingmedical expenses specifically.

More than 70% of respondents to a survey taken by the insurance company Aflac said it was the second year in a row that they had cut holiday costs by eliminating travel, gift-giving, or other traditions.

Many of the people surveyed faced high healthcare costs this year despite having insurance; 30% of the respondents who had visited the hospital this year reported that they had been responsible for at least $1,000 in out-of-pocket costs.

"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."

Thursday's report also came two days after Gallup released a poll showing that a quarter of Americans delayed or avoided getting healthcare due to costs.

"This is the healthcare system of 'choice' that so many politicians are committed to protecting," Ocasio-Cortez said.

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Ocasio-Cortez Makes Connection Between 20% Jump in Healthcare Costs and Industry-Sponsored Spa Days for Congressional Staffers - Common Dreams

Republican Satisfaction With US Healthcare Costs Surges – Gallup

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WASHINGTON, D.C. -- Republicans' satisfaction with the costs of healthcare in the U.S. has jumped 17 percentage points in 2019, rising to 43%, up from 26% in 2018. At the same time, independents' and Democrats' levels of satisfaction show less change, at 25% and 9%, respectively.

A similar partisan-based pattern in Americans' satisfaction with their own healthcare costs was previously reported.

These results come from Gallup's annual Health and Healthcare poll, conducted Nov. 1-14. Democrats are in the midst of their presidential nomination campaign, during which healthcare has been a major focus, with most candidates proposing a publicly sponsored health plan option if not a single-payer system. Republicans recently released a new plan to replace the Affordable Care Act, which they have unsuccessfully tried to repeal in recent years.

One of the key purposes of the ACA, also known as "Obamacare," was to control healthcare costs in the U.S. After President Barack Obama signed it into law in 2010, 31% of Republicans and 19% of Democrats were satisfied with the costs of healthcare in the U.S. Six years later, at the end of Obama's second term in 2016, Democrats had become more satisfied with healthcare costs (28%) while Republican satisfaction had sunk to an all-time low (11%).

However, since then -- coincident with Donald Trump taking office -- partisan satisfaction has again flipped. In November 2017, Republican satisfaction with healthcare costs had risen to 23%. At the same time, Democrats' satisfaction with these costs had fallen modestly to 24%. Over the next two years, Republicans' satisfaction continued to rise while Democrats' continued to fall, producing the largest partisan gap in ratings to date -- 34 points in 2019.

The surge in satisfaction with U.S. healthcare costs among Republicans has been largely responsible for an uptick in satisfaction among all Americans. Twenty-six percent of U.S. adults now say they are satisfied with these costs, up from 20% last year and the highest level since 2009.

Americans have consistently registered low levels of satisfaction with healthcare costs in the U.S. No more than 28% of Americans have been satisfied with these costs since 2001, with satisfaction generally hovering near 22%.

This year, Republicans are substantially more satisfied with healthcare costs, both for themselves and the country more broadly, while Democrats are slightly less satisfied. It is possible that this partisan-based divergence may be a response to the rhetoric from both parties. Republicans have again begun beating the drum for a repeal of Obamacare and have announced a plan to replace the law, while Democratic presidential candidates have talked extensively about "Medicare for All," despite a continued majority of Americans favoring a private health system for the country.

Republicans have clearly staked out their position ahead of the 2020 presidential election, with their new plan to replace the ACA. What plan Democrats propose is still dependent on which candidate clinches the party's nomination -- but it likely will involve a defense of the ACA and greater government involvement in the country's healthcare system, which Democrats favor by a wide margin.

View complete question responses and trends.

Learn more about how the Gallup Poll Social Series works.

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Republican Satisfaction With US Healthcare Costs Surges - Gallup

What we learned at the HIMSS Healthcare Security Forum – Healthcare IT News

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BOSTON After two days of wide-ranging and detailed discussion about the multi-faceted challenges of healthcare cybersecurity, data privacy and patient safety, some themes have emerged from the HIMSS Healthcare Security Forum, which took place earlier this week.

Here are a few top-level takeaways.

The challenges of the CISO (and all healthcare infosec professionals) are many. Whether it's getting adequate resources from cost-conscious CFOs one speaker suggested leaders communicate the stakes in business terms, framed as the catchall term of "risk," rather than the specialized field of cybersecurity or gaining clinician buy-in, the CISO has many more jobs than just keeping ones and zeroes on lockdown.

One consistent theme was the shift in how the CISOs are perceived not just as security scolds who run phishing tests and shut down shadow IT, but as active strategic leaders, communicating regularly with other stakeholders across the enterprise to help with innovation and business transformation.

"A lot of it has to do with understanding an organization's culture," said Anahi Santiago, chief information security officer at Christiana Care Health System.

Still, there are the day-to-day challenges, such as keeping up with regulatory compliance and maintaining good vendor relationships in a world of "hyper-outsourcing." And those challenges will only get more complex in the world of myriad mobile devices, empowered consumers, artificial intelligence and more.

"Many healthcare providers aren't prepared for the new risks they will be introducing into their orgs over the next 3-5 years," said keynote speaker Dr. John Halamka, newly minted president of Mayo Clinic Platform.

But, he added: Try innovating in a zero-risk environment. You cant.

The key is to find an acceptable balance between innovation and risk management, based on mitigation, organizational benefits and strategic urgency, he said.

"Healthcare is moving forward and transforming, and it's going to do it with or without us," Santiago said. "And it's great to see more and more folks talking about the fact that not only do we have a seat at the table but we're engaged in discussions that are helping with that transformation.

"We're moving in the right direction," she added. "We're maturing. There's still a lot of work to do. But at least there are some answers out there."

"No one is going to do the hard thing to breach your organization when the easy thing is going to work every single time," said keynoter Michael Coates, CEO and cofounder of Altitude Networks, who previously served as CISO at Twitter and head of security for Mozilla.

Similarly, perhaps, some professionals who may feel overwhelmed by the dizzying array of cybersecurity threats and compliance imperatives may consider taking some cues from the KISS principle.

"It's easy for folks to get lost in the most esoteric and complicated vulnerabilities and not manage the basic stuff," says Johns Hopkins CISO Darren Lacey.

Erik Decker, chief security and privacy officer at University of Chicago Medicine, was on hand in Boston to describe the value of HHS' Health Industry Cybersecurity Practices framework, which he helped spearhead.

As Decker explained recently, the guide can be viewed as something like "a cookbook," he said, "a series of recipes that will help you mitigate and manage the most prevalent threats we face in healthcare."

In a world where basic mistakes like missing patch notifications are far, far more common than targeted cyber attacks on patient-connected infusion pumps, ensuring that attention is paid, piece by piece, to low-hanging fruit, will offer much more protection than many realize.

At the Boston conference, there was a panel discussion entitled "Security in the Cloud Era." And the fact that healthcare finds itself in a "cloud era" when security and the cloud used to not that long ago be considered mutually exclusive by many healthcare security pros, is remarkable.

Over the past 12 months, providers have doubled the share of workloads deployed to the public cloud to 25%, according to HIMSS research.

"I am all about trying to secure her information as it goes to the cloud," said John Houston, vice president, privacy and information security, and associate counsel at UPMC, who manages "hundreds" of different cloud vendors of all shapes and sizes and estimates that some 70% of his compute workload is now remote hosted.

"We all need to be concerned about that reality: We're moving very quickly to the cloud," he said. "Risk follows information. And we'd better figure out a way to get our arms around it."

That's going to be a challenge, and will depend on a fundamental rethinking of some longstanding security practices.

"Perhaps 80% of what a traditional IT or cybersecurity person knows today is irrelevant when moving to the cloud," Halamka said. "Its effectively an entirely new job."

Lee Kim, HIMSS director of privacy and security, was at the Healthcare Security Forum in part to discuss a new report on the intersection of patient safety and cybersecurity.

Dispiritingly, but perhaps unsurprisingly, "we found that patient safety and cybersecurity professionals at hospital organizations simply don't speak to each other too much," said Kim.

"What is healthcare about? At the end of the day it's about patients and patient safety," she said. In the era of IoT and networked medical devices, many without adequate logging mechanisms and forensic data to investigate the reason for aberrational events, "this should be the goal of all healthcare organizations."

But too often, whether in purchasing decisions or simply where their offices are, safety and security teams are siloed from each other.

Too often, IT security labor "deep down in the bowels of the hospital, never seeing the light of day," said Kim. "That's symbolic."

But as Dr. Saif Abded, healthcare cybersecurity expert and co-founder of AbedGraham, explained: "Cybersecurity is patient safety. If you're thinking of it in some other way, like something that sits in a back room somewhere, you're missing the point."

"I think about patients a lot," said Geisinger CISO Stephen Dunkle. "And when I stop doing that, it's probably time to retire."

At the Healthcare Security Forum, attendees were able to ask questions during the panel discussion via the online app Slido. A sampling of some of their questions suggests a trend:

They're good questions. And ones that have been asked before. (Many times, by many different stakeholders.)

What happens with regard to a wider rethink of the law is ultimately up to Congress and other federal policymakers. In the meantime, other HIPAA changes are coming.

But Houston, speaking, one presumes, for many other security and compliance pros buckling under the weight of many overlapping, often contradictory, state, federal and international laws, said a new and more streamlined approach was needed.

"We need uniformity," he said. "My organization has hospitals in three countries and four or five states. We operate in a lot of different jurisdictions. It's very difficult to operate when you really have such a disparity in how information security has to be delivered."

"If we're now dependent on machine learning and AI, what happens when the AI is corrupted?" asked Halamka. "What if an adversary wants to pollute my data set, and I end up with an algorithm that's not set for purpose? These are things we have to start to consider."

And that's just in the near term. Further out in 15-20 years, as Brian Cady, principal security architect at Providence St. Joseph Health, estimated revolutions such as quantum computing could have major and transformative implications for cyber offense and defense.

In the meantime, Greg Singleton, director of the Health Sector Cybersecurity Coordination Center at HHS, said healthcare organizations should be on guard against more quotidian cyber risks: VPN vulnerabilities, outdated Windows versions, networked PACS systems.

"Understand your environment and make sure you don't have something that's inadvertently exposed that could pose a risk," said Singleton.

Also, he highlighted the value of information sharing with groups such as HC3. "It's important that people reach out," he said. "We can do good stuff together."

More here:

What we learned at the HIMSS Healthcare Security Forum - Healthcare IT News

Podcasts About Beyonc, Arias and Health Care: Worth a Listen – The New York Times

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At the end of a year filled with more podcast debuts than ever, its sometimes easy to overlook returning shows just as worthy of your time. If you havent given them a try yet, there are plenty of past episodes for your ears to indulge during holiday travels. Below are some recent podcasts that came back for new seasons, followed by a few newcomers to check out.

Dan Weissmann kicked off his podcast last year by likening health care costs to water, arguing that Americans (the fish in this metaphor) are so surrounded by it that we cant see how it changes everyones lives in very real, very painful ways. So each episode of An Arm and a Leg sets out to show you the water, examining a different persons battle to pay for the care they need. Weissmanns charming, empathetic and occasionally expletive-laden approach makes for an entertaining but sobering bottom line: Our health care system is broken, and everyone is suffering for it. Season 3 opens with Stephanie Wittels-Wachs the sister of Harris Wittels and the creator of Last Day, the new podcast that begins with his death. But her episode isnt about addiction or opioids. This is about the battle she pursued to convince the Texas state legislature to cover her daughters hearing aids.

The shows exploration of the hidden traumas within families will undoubtedly convince you that yours isnt the only one with skeletons in its closet. While the first two seasons focused on individuals, Season 3 begins with a three-episode arc unpacking Americas own family ghost. Set in Mobile, Ala., this mini-series focuses on the descendants of the enslaved people aboard the last known slave ship to arrive illegally (50 years after importing humans was banned) on U.S. shores. The ship, the Clotilda, was dismissed by the white residents of Mobile as fantasy, and the descendants living in Africatown have fought for centuries to be believed about their origin story.

How do you make British palaces and their bygone occupants come alive without a trip to the U.K.? You listen to Outliers Stories From the Edge of History. Kings and queens are not the focus here. Instead, each episode is devoted to someone the history books rarely if ever mention: Katherine of Aragons African lady-in-waiting, King George Is Turkish valet, the mistress-turned-wife of the Duke of Gloucester (who happened to be a convicted sorceress). Following each episode is a must-listen interview with the given episodes writer, who explains the choice of narrator to reveal historys forgotten moments.

The first season of this James Beard Award-winning podcast took a deep dive into the exclusionary traditions around gender, identity and femininity in the kitchens of fine-dining restaurants. Katy Osuna, the host and former chef de partie in the three-Michelin-starred Manresa restaurant, is back with a second season that again questions the unspoken rules that keep restaurant work in a vice grip. The new season, Overhead, employs the same storytelling by professional restaurant workers to demonstrate how badly the economics of restaurant labor need disrupting.

The Metropolitan Operas podcast is back for a second season, all about one thing: desire. Hosted by the Grammy Award winner Rhiannon Giddens, each episode features a different aria, exploring how the performance embodies operas most enduring and universal theme. Guests include opera singers like Roberto Alagna, Diana Damrau and Sondra Radvanovsky, as well as fans like Dan Savage, Anna Chlumsky and Dame Judi Dench. Even for a philistine like me, who fell asleep when a date took her to the opera, Aria Code presents a mesmerizing appreciation of these powerful solo performances brimming with universal feelings.

The creators of Making Oprah and Making Obama are back for a third season, and this time theyve left Chicago city limits. The new host, Jill Hopkins, a local radio personality, singer, storyteller and self-proclaimed Beyonc superfan, takes us on a deep dive into pre-Destinys Child Beyonc. Hopkins focuses on the rigorous training that Beyoncs original group, Girls Tyme, endured to try to make it big as a preteen band with adult-grade performances. Really what Making Beyonc provides is the vision of Beyoncs father, Matthew Knowles, as a salesman who channeled his ambition through his daughters extraordinary talent, and the insane competitiveness, pain and professionalism the young girls had to shoulder as they tried to make their (and their parents) dreams come true.

Earhustle isnt the only show made within the walls of San Quentin State Prison. Thanks to the California Arts in Corrections Program and audio classes from KALW, incarcerated men at San Quentin and Solano State Prison have joined forces to produce this moving new show. They take turns interviewing each other stories run the gamut from forgiving abusive fathers to finding peace through yoga. Then following each story is a collective reflection on it, as the men challenge each others ideas of masculinity and offer reassurances that their childhood traumas are not their fault.

In this new podcast, the religion reporter Michael OLoughlin complicates the conventional wisdom that views the AIDS crisis in the 1980s and 90s as a clash between a community dying from an epidemic and the religious institution that turned its back. With survivor testimony and interviews with religious leaders, OLoughlin, himself a gay Catholic man, shares the stories of those who found God in their care for the sick.

If you love hearing authors read their own work, and appreciate well-written prose enhanced with moving soundscapes, youll enjoy this new podcast from Lit Hub, the literary website. Writers like Matt Gallagher, Lidia Yuknavitch and Caitlin Doughty read original works that explore ideas of family, history and the power of a good story. Each episode matches a different sound designer and composer with a writer, and the result is a private reading just for you. The first episode, with Mitch Albom reading from his forthcoming memoir, Finding Chika, is a moving story of adopted fatherhood.

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Podcasts About Beyonc, Arias and Health Care: Worth a Listen - The New York Times

Private health insurance premiums should be based on age and health status – The Conversation AU

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Private health insurance has come under intense scrutiny in recent months, as it becomes clear health insurers are failing to stop the exodus of young people dropping their cover.

Legislated age-based discounts began in April 2019 but havent achieved their aim of keeping young people in private health insurance. In July to September, the largest decreases in coverage were for people aged between 25 and 34, and in particular 25- to 29 year-olds, with more than 7,000 people in that age group dropping their private health insurance cover in that period.

This trend should come as no surprise. Weve known since the 1970s that young people drop out of private health in voluntary insurance markets, especially those with an underlying universal public system such as Medicare. If too many young people exit the system, premiums go up for everyone.

This was also confirmed by last weeks Grattan report, which argued private health insurance premiums should be made cheaper for Australians aged under 55.

Read more: How do you stop the youth exodus from private health insurance? Cut premiums for under-55s

Its time to change the way insurers are allowed to charge premiums. These should be based on the persons likelihood of using their private health insurance determined not just by their age, but also their health status or risks rather than charging everyone the same.

This could lead to unaffordable premiums for the elderly or the sick. But this potential problem can be addressed through other measures.

In Australia, private health insurance operates under a legislated community rating system. Insurers are forced to charge everyone the same premium for the same cover, irrespective of their age, gender or health status.

This means the young and healthy subsidise older, sicker Australians. Young people end up paying high premiums, relative to their underlying health risk and, as weve seen, this encourages the young and healthy to drop their cover.

Read more: Youth discounts fail to keep young people in private health insurance

The alternative is to establish a risk rating system, where premiums are based on the persons underlying risks.

Risk-based insurance schemes operate successfully in many countries including the United States, New Zealand, Germany, China and Switzerland.

This would mean those who are at low risk (based on their age and other risk factors) pay lower premiums, and those who are at high risk (older people who are more likely to have health problems) pay higher premiums than they currently do.

Risk ratings for private health insurance would challenge the principle of solidarity and affordable access to coverage. These are the reasons community ratings were established in the first place.

Responding to last weeks Grattan Institute proposal to move towards age-based premiums, Private Healthcare Australia chief executive Rachel David told Nine newspapers the community rating rule was critical to keeping health care affordable for our ageing population.

To solve the problem of older and higher-risk members being priced out of private health insurance, private health insurance rebates would need to be redirected.

Rebates are currently a means-tested percentage off the price of your insurance premiums. These discounts are based on income/age and are irrespective of your health needs.

Under a risk-rating scheme, the rebates would need to become risk-based rebates. The rebates would be provided based on a persons health status, such as their age and health conditions, to discount their insurance premiums.

Risk-based rebates would help tackle equity, as those who face higher premiums would get greater rebates.

An additional rebate would apply to people whose expenses are above a certain threshold, to provide additional financial support for those who face the higher premiums. This would help ensure higher premiums dont become prohibitive.

Such a move would require redistributing the A$9 billion in taxpayer subsidies that currently flow to the private health insurance system.

Read more: Do you really need private health insurance? Here's what you need to know before deciding

Risk-based payments are often criticised because of the extensive data requirements consumers would need to disclose, including more personal details, information about the persons past claims and the illness for which theyve been diagnosed.

Risk-based systems are also criticised because of the sophistication of the techniques needed to calculate (and subsidise) individuals risk correctly.

These challenges can be addressed with modern computer-based techniques, meaning this is no longer an unsurmountable task.

It is possible to make Australias private insurance system more sustainable and stop young people leaving the system by relaxing the community rating restrictions and adjusting the rebate system.

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Private health insurance premiums should be based on age and health status - The Conversation AU

4 Healthcare Stocks With FDA Approvals on the Horizon – The Motley Fool

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In 1992, Congress passed the Prescription Drug User Fee Act (PDUFA) allowing the U.S. Food and Drug Administration (FDA) to collect fees from drug manufacturers to fund the drug review and approval process. To promote getting novel medicines to patients expeditiously, the act requires the FDA to make its decisions within certain deadlines.

These PDUFA dates provide crucial timing information for biotech investors since FDA approval or lack thereof can create tremendous swings in stock price. Let's explore four companies with PDUFA dates lined up in the first quarter of 2020.

Image source: Getty Images.

Jan. 17 marks the PDUFA date forAimmune Therapeutics (NASDAQ:AIMT) and Palforzia, its immunotherapy for peanut allergy in children and teens. The Palforzia powder is mixed into the patient's food to deliver a small daily dose of peanut protein. Submission of the Biologics License Application (BLA) to the FDA occurred in March, while the FDA convened an advisory committee panel in September to weigh in on the drug's data. The Allergenic Products Advisory Panel voted seven-to-two that the efficacy data supported approval. The panel voted eight-to-one in favor of Palforzia based on its safety profile.

Palforzia addresses a market of more than 1.6 million children and teens in the U.S. with peanut allergies. Combine what appears to be favorable data and a large potential need, and Aimmune's stock could be off to the races. The stock has consistently trended upward since summer.

Epizyme (NASDAQ:EPZM) develops novel treatments for cancers with known genetic causes. Tazemetostat, the company's lead compound, targets the protein EZH2 found in a variety of blood and solid tumors. Epizyme faces a PDUFA date of Jan. 23 for tazemetostat as a treatment for epithelioid sarcoma, a rare subtype of soft tissue sarcomas (STS). First, though, the FDA scheduled an advisory panel to be held on Dec. 18. The outcome of this event will greatly influence its subsequent decision.

From a commercial point of view, seeking a subtype of a subtype with a known genetic marker means the company is seeking very specific patients. This personalized approach can be quite successful as an intervention but challenging to educate oncologists to identify the appropriate patients. Unfortunately, STS, the broader group of cancers this falls into, does not have many good treatment options so physicians likely will embrace new tools for treatment.

After reviewing phase 2 clinical trial data presented at the European Society of Medical Oncology Annual Meeting in October 2018, I'm not excited. Tazemetostat works better in patients who did not receive prior treatment, which seems logical. Those with more advanced disease fared worse. The response rates measuring tumor shrinkage were low, but that is common in STS. The benefit is that this oral treatment seems to work in line with other infused chemotherapy products and thus offers a convenient, potentially less toxic way to combat cancer. I await the views of the panel later this month.

Esperion Therapeutics (NASDAQ:ESPR) holds the distinction of having two PDUFA dates just days apart on Feb. 21 and Feb. 26. First up is bempedoic acid, a once-a-day oral treatment to reduce low-density lipoprotein cholesterol (LDL-C) when added to other lipid-lowering medications. The second PDUFA date will see the FDA weigh in on a combination pill of bempedoic acid and ezetimibe to lower LDL-C in patients with primary hyperlipidemia.

According to Esperion, bempedoic acid works in the liver to prevent cholesterol biosynthesis. Phase 3 clinical trials enrolled more than 4,000 patients with over 2,600 receiving bemedoic acid. This gives the FDA quite a bit of data to mine for both efficacy and safety. Keep in mind that this non-statin alternative could potentially address high cholesterol in 96 million Americans using Esperion's estimate. Therefore, the FDA will not take this decision lightly.

Esperion's current $1.4 billion market cap looks cheap should bempedoic acid get approved. However, because of the size of the potential market, the product launch will require substantial investment. I imagine a pharma suitor will emerge to acquire the company following approval.

March 8 is the PDUFA date for Horizon Therapeutics' (NASDAQ:HZNP) teprotumumab as a treatment for active thyroid eye disease (TED). TED, a serious and progressive eye disease, causes a protrusion on the eye called proptosis. This leads to vision impairment including double vision and vision loss. Teprotumumab, potentially the first-ever FDA approved treatment for TED, successfully demonstrated in phases 2 and 3 clinical trials that it improved proptosis, double vision, and quality of life.

The data looks compelling for the FDA to approve teprotumumab for this autoimmune disease. Horizon also boasts a multidrug product portfolio that generated $936.5 million in net sales so far this year. It expects to achieve between $1.28 billion to $1.3 billion in net sales for all of 2019. An approval for Horizon will add yet another product to its stable. However, for investors, any positive share-price reaction will likely be muted compared to other companies where the approval is the first or only product to get approved.

FDA advisory committee reviews and the approval decisions can propel the stocks of drug developers dramatically. Correct predictions of the outcomes can generate substantial returns for biotech investors. Aimmune and Esperion seem to have the greatest chance for success and commensurate stock appreciation.

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4 Healthcare Stocks With FDA Approvals on the Horizon - The Motley Fool

Dozens of health-care providers oppose potential insurance regulation changes in open letter – Calgary Herald

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Repair planner Gary Ferguson writes an estimate to front end damage to a pickup at Herbers on Parsons Road.File photo

Almost 90 doctors and medical professionals opposed potential unfair changes to insurance regulations they said could cause those injured in motor vehicle accidents to pay more for medical care in a Thursday open letter to Premier Jason Kenney and Finance Minister Travis Toews.

Released by insurance fairness advocacy organization Fair Alberta Injury Regulations, the letter signed by 87 medical practitioners expressed concern that the insurance industry is now advocating for concussions and some other chronic conditions to be classified as minor injuries alongside sprains and strains.

Open Letter Re FAIR Insurance Regulations by Moira Wyton on Scribd

Patients with more expensive, complex and long-lasting injuries would have to pay more, the signatories said, because insurance payments for minor injuries have been capped since 2004.

Concussions, PTSD and chronic pain are not minor injuries and should not be categorically described or treated as such, said the letter. Expansion of the regulation is unfair to innocent Albertans who have been victimized in vehicle accidents.

Those are conditions that can haunt people for life, said Fair Alberta spokesman Mark Feehan in a previous interview.

Jerrica Goodwin, press secretary to Toews, said in an emailed statement to Postmedia that the government has not yet made any decisions on the regulation in question or other further changes to the insurance industry.

Government is currently reviewing the challenges associated with Albertas automobile insurance system, she said. This is a complex issue and our government will be looking at reforms to Albertas insurance system and will be considering a wide range of options.

The letter isnt the first time Fair Alberta has opposed insurance changes by the current UCP government.

In November, the province decided to end the five per cent auto insurance cap introduced by the former NDP government because they were hearing from companies that they were losing money by paying out morein benefits than they were making in premiums.

Premier Jason Kenney said recently that personal injury claims have been growing massively, contributing to higher premium costs.

Our goal is to ensure affordable and accessible insurance for Albertans, while ensuring the long-term sustainability of Albertas insurance system, said Goodwin, noting that they are engaging with key stakeholders throughout the process.

With files from Anna Junker

mwyton@postmedia.com

twitter.com/moirawyton

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Dozens of health-care providers oppose potential insurance regulation changes in open letter - Calgary Herald

Overwhelming illustrations put the internet in your eyeballs – Fast Company

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I dont know what I just looked at. It involved a Nintendo 64 controller, that much is for certain. But then, what else? I believe there were dinosaurs? Gadgets? Disembodied breasts? I cant say for certain. I just remember a psychedelic fever dream, one seen through a 13-year-old male gaze. Or perhaps a glimpse into the id of the internet itself.

This is what its like to explore the work of Daniel Keogh, a 22-year-old self-taught illustrator out of Bendigo, Australia. His pieces are visual onslaughts of internet memes, famous cartoon characters, and a whole lot of other free-association 1990s kid junk piled in, too.

I suppose Im just going for a sensory overload, whether its by color or sheer volume of content, says Keogh. I just want my art to make people stop and look, to be so full of information its undeniable.

In another frame, I see a portrait of Jesus next to an AR15, next to a coconut drink, next to the Facebook Like button, next to a pink sprinkled donut. Its like piles and piles of the familiar references of pop artists, told through the lens of social media sensibilities. Its like the piece visualizes the daily online struggle of caring about gun control, someone elses beach photos, and a grammable dessert all in split-second scrolling succession.

At first glance, the pieces appear to be pure chaos, but while the content is certainly random at times, the way Keogh actually constructs his layouts is akin to making a mandala. Over three days of drawing with a pen, Keogh works from a center focal point outward, carefully balancing each side with column shapes to ensure a sense of structure and symmetry. (Color is added digitally once the ink is scanned into a computer.)

His most striking montage may be an overwhelming pile of heads called Meme Supreme.It shows every animated and cartoon personality from the past decade in one gigantic frame, from Arthur, to Naruto, to Bart Simpson, to Piccolo, to Pepe the Frog, to Yoshi. Across the frame, Keogh effortlessly mocks anime and PBS cartoons alike. A lot of my earliest memories are sitting at kitchen tables trying to replicate images from Mad Magazine, so I think thats where the ability to draw cartoons has come from, says Keogh.

You can find more of Keoghs work on Instagram. He also sells prints starting at $135 apiece.

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Overwhelming illustrations put the internet in your eyeballs - Fast Company

Decade list: Top trends and memes – UNR The Nevada Sagebrush

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Jayme Sileo / Nevada Sagebrush

Doge: The Decades Dog

The man, the myth, the meme. The dog we all know and love, and the subject of thousands of internet jokes. The meme uses a photo of a Shiba Inu dog with short, two-word phrases starting with modifiers like so, much, such, many, and very, to emphasize the subject as well as colorful text in Comic Sans font. First introduced to the internet in 2013, Kabuso the Shiba Inu was adopted in 2008 by a kindergarten teacher in Japan. The original image was posted in a blog post in 2010. It quickly took off over the next few years, peaking in 2013 and then resurging again in 2019.

Doge was not only a meme, as the dogs photo was used to communicate through a very specific medium. Kabuso was used by politicians and advertisers, and became a weather app, a cryptocurrency and an adaption of the popular puzzle game at the time, 2048. Kabusos story, like many other dogs and humans, invites questions about the moral consequences of making a meme.

Memes have become an important part of communication and culture. Essentially, a meme is an inside joke that anyone with internet access can be a part of. The flip side of easy and fun communication, is the lack of consent from many meme subjects to have their photos portrayed in certain ways. While most content is lighthearted, in the past decade popular memes have often been used by those full of hatred to spread that hate. Many may remember racist and antisemetic Pepe the Frog memes which surfaced during the 2016 election. Although the original artists interpretation had nothing to do with race or ethnicity, the photo was used to suit others own cruel intentions.

Does one bad apple ruin the whole bunch, or will cruel people continue to be cruel regardless of the mediums provided? In the end, no one can control the churning beast of information called the internet, so be mindful and meme on.

Jayme Sileo

Baby Yoda

An icon, a star on the rise and to some a glorified gremlin. The recent streaming service, Disney+, has blessed its audiences with a beloved new character to the Star Wars franchise. Making his first debut on the Disney+ original series, The Mandalorian, stealing the hearts of the internet. Baby Yoda is by far the best thing to come out of Disney+ for a number of reasons. Aside from dramatic fight scenes, the real star of the show has been baby Yoda. Though the character has little to say, he has gained love and admiration from fans through his simple actions including silent sips and portrayal of his taste in music. Disney has been praised for its decision in revamping the character itself and the franchise that has grossed millions of fans worldwide.

-Laura Rivas

The Natural Hair Movement

In this decade, more black women began to wear their hair natural. Going natural is a process where an individual will stop using certain chemicals and remedies that straighten their hair. The Los Angeles Times reported 71 percent of black adults in the U.S. wore their hair naturally at least once in 2016. In the natural hair movement, the idea of good hair is all hair types. Although one in five black women feel social pressure to straighten their hair for work, Mintel reported that hair relaxer, a product which chemically straightens textured hair, sales dropped from $206million in 2008 to $152million in 2013. They also found an 11 percent increase in the number of black women who wear their hair natural, without using hair products that chemically straighten naturally curly hair.

Taylor Johnson

Old Town Road and all of its remixes

Youve heard it at some point. It was unavoidable. Old Town Road, and its four remixed versions, topped the charts for weeks on end. The song itself was a meme to some and a bop to others. Every time you scrolled on Twitter for a moment or two, youd be met with at least one video of someone dancing to it, or my personal favorite, Lil Nas X performing the song to a room full of elementary school children absolutely losing their minds as they sang along. The tune was genre bending and left the internet and the world a better place.

-Olivia Ali

The Nevada Sagebrush end of the decade lists are made from staff contributions. Any of the writers can be reached at vrendon@sagebrush.unr.edu or on Twitter @VinceSagebrush.

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Decade list: Top trends and memes - UNR The Nevada Sagebrush

Our Top 5 Fav Memes From The Decade – 5Why

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Ah, memes, these somehow irrelevant but crucial lil companions in our lives.

With the imminent arrival of 2020, this decade has a lot of to reminisce on including the memes it produced (Donald Trump, and a frog at the most). As the internet boomed after 2010, the OG meme-sphere of Reddit & 4Chan welcomed memes all over Twitter to now every single social media platform you can think of.

If you werent surviving on memes in your teens through this decade, then what were you even doing?

So, what better way to celebrate the end of 2019 than to go back in time and allow you peeps to ride through the meme wave of this decade. Some of these bad boys were way over-used on your social feeds, and others you probably forgot about lets get some awesome nostalgia.

Pepe is the best from r/memes

Sad Pepe from r/memes

I mean there you have it, a frog that boomed into a meme icon. Pepe is cute, sad, relatable and definitely a top 5 contender no doubt.

Not only is this meme a classic, but it merges a bunch of other memes.

Distracted boyfriend Jesus/Santa from r/dankchristianmemes

So. goddamn. accurate.

AKA the birth of Karen.

After the release of this movie earlier in 2019, Im positive I saw a new joker meme every goddamn day, mark my words, this one will be forever historic.

Joker and mini joker dancing from r/MemeTemplatesOfficial

Joker gets hit by a car from r/MemeTemplatesOfficial

AKA WHeN EvERyoNe sTaRteD TaLkiNg LiKe ThIS.

Spongebob memes always have high returns. BUY!

Although these were our top 5, we couldnt leave you without some iconic memes that surfed the 2010s up until now.

Here are some honourable mentions that we wanted to include.

Success Kid from r/memes

Willy Wonka on Facebook from r/memes

me irl from r/me_irl

Confused math lady actually knows what shes doing from r/memes

If youre still looking to satisfy your meme fix, scroll through our meme tag the best memes of the decades are all documented and reporting for duty.

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Our Top 5 Fav Memes From The Decade - 5Why

Worst tweet of the decade was the Vita Coco urine tweet – Business Insider

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It's been a long, long decade. And, there have been a lot of wild tweets.

Remember when Wendy's tweeted and then hastily deleted a Pepe meme, unaware the frog had become a hate symbol? Or when SpaghettiOs tweeted its mascot cheerfully holding the American flag to commemorate Pearl Harbor? Or oh God that time back in 2014 when US Airways tweeted an incredibly pornographic photo of a woman with a toy plane in her vagina?

Twitter

Clearly, Twitter does not always bring out the best in brands. But, many of these have been accidents. Brands have apologized and tweets have been swiftly deleted.

Recently, however, there has been a rise of bad tweets that go un-deleted. As brands push what is acceptable behavior to its limits, there has been a recent wave of tweets that, a few years earlier, would have been seen as a massive lapse in judgement.

Netflix's prompt earlier in December asking followers for things "you can say during sex but also when you manage a brand twitter account" resulted in Kettle Brand Chips tweeting: "You can go elbow deep in me." Planter's Mr. Peanut won't stop tweeting about nutting, including a reference to #NoNutNovember. But, the worst purposefully disgusting tweet was by the Vita Coco community manager who peed in a jar.

In May, writer Tony Posnanski tweetedthat Vita Coco's product "is nasty like all coconut water."

Vita Coco initially offered to send Posnanski some coconut water.

"F--- that. Save that nasty s--- for someone else. I would rather drink your social media persons piss than coconut water," Posnanski responded.

Vita Coco then responded with an image of its community coordinator, Lane Rawlings. in a bathroomholding a Vita Coco-branded jug full of what appears to be urine. The photo is accompanied by one word: "Address?"

The worst tweet of the decade. Vita Coco/Twitter

The worst part about this incident was that it was not just a single employee who went rogue. Allison Finazzo, Vita Coco's brand director, told Business Insider at the time that the tweet was part of the company's "Impossible to Hate" campaign.

"We just launched a new campaign called Impossible to Hate, and to prove this claim, we created an algorithm to find the most negative people on the internet, and then had them try it live," Finazzo said. "Because if they don't hate it, no one will."

"We were going to try and impress Tony with Vita Coco Pressed, because he had previously written about how disgusting coconut water was," Finazzo continued. "But, he said he would rather drink our social media person's piss. And at Vita Coco, we'll go to great lengths to prove a hater wrong."

I do not think of myself as a prude. But, this is the moment brand Twitter officially went too far. And, as seen by Netflix's sex tweets and Mr. Peanut's willingness to regularly reference ejaculation, it is clear there is no going back now.

As the decade comes to a close, I am predicting that a fast-food brand will tweet its mascot in an explicit, sexual position in the next decade. It will make everyone uncomfortable, but also go viral. And, there will not be an apology.

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Worst tweet of the decade was the Vita Coco urine tweet - Business Insider

Hong Kongers mark half year protest anniversary with huge rally – Capital FM Kenya

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Sundays march was given rare permission to go ahead AFP / Anthony WALLACE

By AGENCE FRANCE PRESSE, Hong Kong, China, Dec 8 Vast crowds of democracy protesters thronged Hong Kongs streets on Sunday in a forceful display of support for the movement on its six-month anniversary, as organisers warned the citys pro-Beijing leaders they had a last chance to end the political crisis.

Tens of thousands snaked their way through the financial hubs main island under crisp winter skies in what looked set to be the biggest turnout in months.

The rally, which received rare police permission, comes two weeks after pro-establishment parties got a drubbing in local elections, shattering government claims that a silent majority opposed the protests.

Many of those attending voiced anger that chief executive Carrie Lam and Beijing have ruled out any further concessions despite the landslide election defeat.

No matter how we express our views, through peacefully marching, through civilised elections, the government wont listen, said a 50-year-old protester, who gave his surname Wong. It only follows orders from the Chinese Communist Party.

What has been stirred up in society the past few months wont simply fade away if the government refuses to solve the problem of systematic injustice, added Sirius Tam, 21, who donned a giant mask of Pepe the Frog, a cartoon character who has become an irreverent symbol of the protests.

Rare permission

Semi-autonomous Hong Kong has been battered by increasingly violent demonstrations in the starkest challenge the city has presented to Beijing since its 1997 handover from Britain.

Millions have hit the streets in protests fuelled by years of growing fears that authoritarian China is stamping out the citys liberties.

The last fortnight has seen a marked drop in street battles and protester vandalism after the landslide win by pro-democracy candidates.

Police took the unusual step of allowing the Civil Human Rights Front (CHRF) to hold Sundays march the first time the group has been granted permission since mid-August but they warned they would have zero tolerance for violence by radicals.

The movements demands include an independent inquiry into the polices handling of the protests, an amnesty for those arrested, and fully free elections.

This is the last chance given by the people to Carrie Lam, CHRF leader Jimmy Sham said.

The protests are largely leaderless and organised online. They were initially sparked by a now-abandoned attempt to allow extraditions to the mainland but have since morphed into a popular revolt against Beijings rule.

The CHRF, which advocates non-violence, has been the main umbrella group behind record-breaking rallies earlier in the summer that saw huge crowds regularly march in searing heat.

Authorities have repeatedly banned major rallies in recent months citing the risk of violence from hardcore protesters.

Large crowds have simply ignored the bans, sparking near-weekly tear gas and petrol bomb clashes that have upended Hong Kongs reputation for stability and helped tip the city into recession.

Police seize weapons

But fears of violence remain.

Hours before the march was due to kick off, police displayed weapons, including a pistol and knives, they said had been found during overnight raids where eleven people were arrested.

We believe the group planned to use the weapons to incite chaos during the march later today and impugn the police, senior superintendent Lee Kwai-Wa, from the citys organised crime bureau, told reporters.

Monday marks the six-month anniversary of the protests during which some 6,000 people have been arrested and hundreds injured, including police.

Online forums used to organise the movements more radical wing have vowed to target the morning commute on Monday if there is no response from Lam.

Years of huge, peaceful democracy marches have made little headway, leading to increased radicalisation among some Hong Kong protesters and a greater willingness to embrace violent tactics.

But there is little sign Lam is willing to budge, leading to fears the lull in street clashes will be temporary.

Since the local elections the citys chief executive has remained steadfast in her opposition to further concessions and Beijing has stuck by her even as she languishes with record low approval ratings.

The police forces reputation has also taken a hammering.

Police have defended their handling of the protests and say their force has matched rising violence from hardcore protesters.

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Hong Kongers mark half year protest anniversary with huge rally - Capital FM Kenya

Turkey reveals path to boost defense and aerospace exports by $10.2B in 2023 – DefenseNews.com

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ANKARA, Turkey Turkey plans to boost its defense and aerospace exports to $10.2 billion by 2023, from $2 billion in 2018, according to a government document.

The Strategic Plan 2019-2023, released by the countrys procurement agency, SSB, is also aiming for the annual revenue of the defense and aerospace industry to rise to $26.9 billion in 2023, from $6.7 billion in 2018.

Also by 2023, domestic industry will meet 75 percent of military requirements, up from 65 percent in 2018, according to the plan.

To his these targets, the government plans to restructure its defense export incentive system. In addition, Turkey is to launch a government-to-government sales scheme, whereas SSB will open defense export promotion agencies in 20 countries.

Other critical targets detailed in the document include switching to a new procurement model; prioritizing programs that minimize dependency on foreign-made systems; and supporting models that bolster Turkeys ability to compete in high-tech markets internationally.

Since coming to power in 2002, President Recep Tayyip Erdoan has sharply increased local input in defense procurement. The governments strong priority to drop off-the-shelf procurement options and instead go for indigenous design and production has produced scores of local programs including drones, naval vessels, armored vehicles, helicopters, trainer aircraft, a new-generation main battle tank and an ambitious program to locally build a fighter jet.

But an Ankara-based defense analyst warned that some of the governments targets do not look feasible.

Take the export target, for instance, the analyst told Defense News. The original export target for 2023 was $25 billion. Now they have come down to a still-difficult $10.2 billion. Thats a long way from the current level of around $2 billion.

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Turkey reveals path to boost defense and aerospace exports by $10.2B in 2023 - DefenseNews.com