WASHINGTON - Rep. Chris Collins dramatically increased his campaign fundraising in the first half of the year, and he took more money from health care and pharmaceutical companies than any other special interest at a time when he's under investigation for his ties to an Australian biotech firm.

The Clarence Republican raised $529,964 in the first six months of this year, 77 percent more than he raised in the same period two years earlier. Some $58,500 of that new campaign money came from political action committees tied to the health care industry, including $31,000 from pharmaceutical industry PACs.

Collins' newly aggressive fundraising highlighted the six-month candidate reports filed with the Federal Election Commission, which also showed Rep. Tom Reed -- long a fundraising juggernaut -- raising far more money that any other lawmaker.

Rep. Brian Higgins, a Democrat from a largely Democratic Buffalo-based district, trailed as usual despite a new uptick in contributions from the financial industry.

[Collins, Higgins, Reed campaign financing reports]

Members of Congress often get large shares of their campaign money from special interests, and the three local lawmakers are no exception.

Collins' contributions from the health care special interests -- and especially the donations from drug companies - are notable for two reasons.

He serves on the House Energy and Commerce Committee's Health Subcommittee, and last year he authored a section of important health legislation that speeds the process for new drugs to be approved through clinical trials.

In addition, Collins is the largest shareholder in Innate Immunotherapeutics, an Australian biotech firm that tried and failed to make a successful new drug for multiple sclerosis. Before that drug failed, though, Collins touted the company to his colleagues and Buffalo-area investors, prompting an Office of Congressional Ethics investigation.

Collins talks stock trades just off the House floor again

And before the drug failed, Innate said in corporate filings it was looking to possibly be taken over by a larger pharmaceutical firm. Larger pharmaceutical firms such as Amgen, Merck and Pfizer all have political committees that donated to Collins, who had a fundraiser specifically targeting the pharmaceutical industry in May.

Asked why Collins took so much money from health care interests, Collins' political adviser, Christopher M. Grant, said it's only natural for such PACs to do so.

"They want to make sure they are supporting lawmakers who support pro-growth, pro-worker policies," Grant said.

Grant also acknowledged that Collins has ramped up his fundraising in anticipation of a more substantive threat in the 2018 election. The Democratic Congressional Campaign announced early this year that it is targeting Collins, and one Democrat, Erin Cole, already announced she will challenge Collins next year.She is a military veteran and former state and federal government official.

Collins and New York Gov. Andrew M. Cuomo have clashed repeatedly over health care and other issues, and Cuomo already said he's teaming with Democratic Minority Leader Nancy Pelosi to try to defeat several New York Republicans, including Collins.

"We know what that entails, and we're prepared for the fight," Grant said.

Collins starts off well prepared, with a campaign chest of $1.1 million as of June 30.

That's considerably more than Reed, who raised significantly more than Collins in the first half of the year.

Reed finances

Reed -- whohas had to fight off serious challenges in the last three elections -- spent far more campaign money than Collins or Higgins. That's because Reed, unlike the others, maintains a year-round campaign operation, meaning he spent much of the money he raised and didn't bank his money the way Collins and Higgins did.

Just as Collins took a large share of his money from a special interest that's tied to the committee he serves on, so did Reed. A member of the tax-writing Ways and Means Committee, Reed, took more than a quarter of his PAC money from the finance and insurance industries, which are keenly interested in tax reform legislation that i set to be developed in that committee later this year.

Reed's campaign manager, Nicholas Weinstein, said there never is any connection between the money Reed takes and the positions he takes on the issues.

"It's not going to affect what his decisions are," Weinstein said. "He bases his decisions on the interests of the people of the 23rd congressional district."

Reed raised 30 percent more money in the first six months of the year than he did two years earlier, and Weinstein said it's partly because of the Corning Republican's involvement in the Problem Solvers Caucus, a bipartisan group that is trying to break through the gridlock that has gripped Congress this year.

"That has gotten us attention from across the table and across the country," Weinstein said.

Higgins finances

Meantime, Higgins has enjoyed a smaller increase in fundraising, and an unusually high share of it -- 24 percent -- came from the same kind of finance and insurance industry PACs that have funded Reed for years.

Higgins raised more from the financial industry in the first six months of the year than he did in the previous two years combined, and it's all because he just rejoined the Ways and Means Committee after six years on other panels. He also joined the House Budget Committee.

"Different committee memberships expose members of Congress to different people, and given Brian's move to the Ways and Means and Budget committees, that's likely what's happened here," said Chuck Eaton, Higgins chief of staff. "The same thing happened back in 2009 when he served on Ways and Means, so this really isn't much of a surprise."

The figures prove that Eaton is right. Higgins' fundraising from financial interests doubled in the 2010 election cycle, when he served on Ways and Means, and shrunk in half in 2012 after he left the committee.

Higgins still gets more of his PAC money from organized labor than from any other source, while Collins and Reed get far less from unions.

The three Western New York lawmakers have one thing in common in terms of their fundraising. They don't get much money from average voters. All three got more than half their money from PACs and between 37 and 44 percent from big-money individual donors.

Higgins got 8 percent of his campaign donations for the first half of the year from small donors. Collins received 3 percent of his campaign money from small individual contributors, and Reed got just 2 percent from such people.

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Collins sharply boosts fundraising, and health care interests lead the way - Buffalo News

Democrats want health care on the federal government tab and will never raise the taxes needed to actually pay for state-of-the-art health care for all.

Just look at Medicare today costing the federal government some $600 billion per year (only for 50 million Americans) but only direct revenues raised in taxation coming in around $300 billion a year or so. Democrats will never raise taxes high enough to pay for major social programs and keep raising such taxes each year as automatic benefits kick in without a vote from anyone. If it costs $600 billion for 50 million people, how much will it cost for 320 million Americans, and what level of direct taxation is needed to achieve that worthy goal of health care for all but not the high taxes?

But the GOP is just as bad coming from the opposite end of solutions. They will scale back federal benefits and let market forces prevail. They wont acknowledge that such tricks cause death, suffering, grave financial hardships, etc. They also ignore the simple fact that the majority of Americans now think health care is a right. Agree or disagree, that is what the country wants, and it is hard to resist in a democracy.

The now infamous Affordable Care Act quickly became very unpopular because it used government power to force people to buy something. There goes an important piece of freedom for sure. But it has become anything but affordable as well. No blue collar worker can afford $3,000 per year premiums and a $5,000 per year deductible.

Clearly something must be done, and bipartisan debate is the only way to get there. So thank you, Sen. John McCain, for forcing such a path down the throats of both parties. I dont believe that was particularly courageous, but it sure was the next right thing to do. The last thing we need is another single-party health care program.

Remember as well, Democrats, your own Bernie Sanders recently stated No one knows the cost when asked how much federal money would be needed to implement his very liberal health care for all legislation. He was honest for sure. That also gives him an out as if no one knows the cost then no one can demand a tax increase to pay for his utopian dreams. But know them or not, huge additional costs to our federal government are sure to come in just like the tide.

Here you go, Americans. Demand health care for all, and politicians will give it to you. But learn to put up with much higher taxes to go along with it if politicians have any sense. As health care costs continue to rise, expect annual, automatic tax increasesagain if politicians have any sense. Then vote in those who will lower taxes and try again for something less than health care for all or at least state-of-the-art health care for all.

While the ensuing debate takes place, I hope politicians can realize that only limited health care for all is possible, financially, even in the richest country in the world. Start with paying for preventive care (only) for all along with hospice care for all, not a nickel for personal expense to die with dignity and pain free. Then add in all the treatments possible as well until the taxes on all Americans go so high that the country will have reached that limit of high taxes as determined by the majority.

Remember, if you only increase taxes on some of the people, the others will call for more and more health care. To make this approach doable, all Americans must feel the pain of very high taxes and very limited or nonexistent economic growth, neither of which are part of the American Dream.

Anson Burlingame lives in Joplin.

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Anson Burlingame: Moving forward on health care - Joplin Globe

Senate Majority Leader Mitch McConnellMitch McConnellOvernight Finance: Trump signs Russia sanctions bill, rips Congress | Trump plan would cut legal immigration | Senate confirms labor board pick | House Budget chair running for governor | Regulator takes step to change 'Volcker Rule' House Dem on Statue of Liberty: 'She persisted' Senate GOP eyes end to August session MORE (R-Ky.) looked to rally Republicans on Saturday in the wake of the Senate GOP's failure to pass an ObamaCare repeal bill last week.

I choose not to dwell on situations where we come up a little bit short, McConnell said during a surprise appearance ata Republican event in Kentucky, according to local radio station WFPL.

Even on the night when we came up one vote short of our dream to repeal and replace Obamacare, heres the first thing I thought about: feel better, Hillary ClintonHillary Rodham ClintonCongress wants Trump Jr. phone records related to Russia meeting Zuckerberg hires top Clinton pollster amid rumors of presidential run: report Democrats new 'Better Deal' comes up short for people of color MORE could be president," he added.

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McConnell's comments come as lawmakers have returned to their home districts for the August recess after Senate GOPefforts to fulfill their seven-year campaign promise to repeal and replaceObamaCare collapsed last week in the Senate, with a scaled-down repeal bill narrowly failing.

President Trump has recently pushed Senate Republicans to abolish the legislative filibuster and bring back efforts to repeal and replace the 2010 healthcare law, however Republicansappear poised to move onto other issues such as tax reform.

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McConnell on healthcare failure: 'Feel better, Hillary Clinton could be president' - The Hill

"My fellow conservatives, let me be clear. This ain't over. This ain't over by a long shot," Pence said. "And President Trump and I are absolutely committed to keep our promise to the American people. We were not elected to save Obamacare -- we were elected to repeal and replace it."

Pence was speaking at Young America's Foundation's annual National Conservative Student Conference a little over a week after the Republican-led Obamacare replacement proposal failed in dramatic fashion in the Senate.

Hours before Pence's speech, President Trump had left the nation's capital for a 17-day working vacation at his golf club in Bedminster, New Jersey, and the Senate had left for its August recess.

Yet the vice president assured the conservative audience that the GOP's seven-year campaign to repeal the Affordable Care Act would continue.

"Last week it was clear that the Senate wasn't quite ready to keep that promise to the American people when they fell one vote short of moving forward on a bill to repeal and replace this disastrous policy," Pence said.

Read more here:

Pence on health care: 'It ain't over' - CNN International

Aug. 5, 2017, 3:09 p.m.

Over the shouts of a lone heckler at a packed Livermore town hall, Northern California Rep. Eric Swalwell on Saturday once more called for the creation of an independent commission to investigate Russian interference in the 2016 election.

If we do anything, we should make sure that the 2018 election is more secure than the 2016 election, Swalwellsaid, drawing a round of applause from the audience.

Roughly 500 people filled the seats at a Granada High School gym, many of whomwere attending a town hall for the first time amid concerns over what they said they view asa tense and divisive political climate in Washington. The event was organized to address questions from constituents about jobs, healthcareand what Swalwellcalled efforts to protect democracy.

It came daysafter special counsel Robert S. Mueller IIIconvened a criminal grand jury to investigate the presidential election, focusing on Donald Trump Jr.s meeting with a Russian lawyer who promised damaging information about Hillary Clinton.

Questions over the Russia probeand GOP efforts to kill the Affordable Care Act dominated the discussion.

Swalwell, a Democrat from Dublin who serves on the House Intelligence Committee, hasstarted a web page detailing the alleged Russian tiesof Trump administration officials. Hesaid Mueller's investigation did not eliminate the need for an independent commission.

The congressman said there was no evidence Russian actors had changed votes. But intelligence reports had shown President Vladimir Putin influenced the election through "a multifaceted attack" that hesaid included hacked emails and the spread of fake news throughsocial media trolls.

What we know the Russians did do is that they went into a number of state election voter databases, he said. We dont know why. You could speculate that they wanted to show that they could at least get in, and that it would sow discord or sow doubt when the result came out.

The event waslargely free of the protests and rambunctious tactics that have overtaken recent townhalls in California. Oneman in the audience shouted questions at Swalwell as he spoke about Russian interference, yelling, "Get over it. He won." But he was soon silenced by the audience.

Swalwellalso fielded questions about his efforts to ease college debt and build the Future Forum, a group of young Democratic members of Congress focused on student loan debt and homeownership.

On healthcare, Swalwell called for a "Medicare for all" system, saying lawmakers needed to continue to expand access and reduce costs. Constituents quizzed him on who would pay for such a plan.

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Questions over Russia, healthcare dominate Rep. Eric Swalwell's town hall at Livermore high school - Los Angeles Times

The clock is ticking for action on the Affordable Care Act following last month's failure to repeal and replace President Obama's signature legislation.

While seated at a corner table at Garden of Eatin restaurant in Levittown on Wednesday afternoon, Congressman Brian Fitzpatrick, R-8, of Middletown, said he recognized the sense of urgency on stabilizing the individual markets.

That's why the bipartisan House Problem Solvers Caucus released earlier this week its five-point proposal to fix parts of the ACA, Fitzpatrick said.

"That was the purpose of the proposal, to inject a sense of urgency," Fitzpatrick said. "This is our temporary, bipartisan fix until we get a permanent solution."

A couple days into Congress' August recess, Fitzpatrick had just spent an hour answering questions on the air at Levittown's WBCB radio station. The Garden of Eatin is a favorite spot for Fitzpatrick, who said he regularly stops in on Sundays after church.

The post-lunch, pre-dinner Wednesday afternoon left a sparsely filled, quiet restaurant as Fitzpatrick touched on several topics between bites of his garden salad, washed down with a cup of coffee.

Millions of Americans who rely on the ACA to guarantee coverage for pre-existing conditions or expanded Medicaid payments to help cover costs were relieved when the Senate failed in its attempt to pass a repeal bill. However, President Trump has not made it clear if he will allow to go unchallenged the payment of cost-sharing reimbursements to insurance companies participating in the individual exchanges.

That uncertainty has insurance companies looking at possible rate hikes for the 2018 market, and either the White House or Congress has until the end of September to clear everything up.

Stabilizing the cost-sharing reimbursements is the top priority in the Problem Solvers Caucus' proposal, and Republican Sen. Lamar Alexander, of Tennessee, chair of the Senate Health, Education, Labor and Pensions Committee, has made it clear the reimbursements will be item number one when he convenes bipartisan committee hearings on health care the week of Sept. 4.

"The individual marketplace is what needs to be rescued right now," Fitzpatrick said. "The actuaries in these companies need to start pricing out their products. They are threatening to increase premiums, in some cases up to 30 percent. We can't allow that to happen."

Fitzpatrick seemed hopeful after months of partisan bickering on the future of the ACA that the settling dust has allowed a bipartisan solution to take shape. The people on the extreme wings of either party are never going to agree on legislation, Fitzpatrick said, but people he describes as "reasonable folks" have embraced the proposal.

"I'm a big believer in the need to fix the system," Fitzpatrick said. "We all need a health care system that works. We're all going to get old, we're all going to get sick and we're all going to get injured. We need a health care system that's low-cost, high-quality and has expanded access."

Bipartisanship was a running theme during his first congressional election campaign, and Fitzpatrick says he has tried to adhere to that during his first seven months in office. He partnered with Democratic Congressman Brendan Boyle in the neighboring 13th District, in Northeast Philadelphia and Montgomery County, to lobby for more attention paid to the issue of perfluorinated chemicals contaminating the water supply in communities in Bucks and Montgomery counties.

They have attached three amendments to the latest National Defense Authorization Act that requires the Department of Defense to partner with local governments and provide health screenings in neighborhoods close to the air bases where firefighting compounds containing PFCs were used. The amendments also call for the Department of Defense to pay for a health study into the long-term effects of PFCs and provide an update on the department's progress developing an alternative firefighting foam that does not use the perfluorinatedchemicals PFOS and PFOA.

"We passed the House version, and the Senate will pass its own version, and then we will go into conference," said Fitzpatrick. "Senators (Bob) Casey and (Pat) Toomey have been supportive, so I feel confident we'll get these in the final draft. We'll get in as many as we can."

Fitzpatrick is also looking forward to the return of regular order to Congress as the focus shifts to tax reform. The drafting of the House and Senate bills occurred mostly behind closed doors, with little time spent in committees or public hearings on the legislation.

A group of Republican legislators from Congress and the executive branch has started putting together a framework for tax reform. Last week, the group, dubbed the Big Six, ruled out a border adjustment tax from the reform package. Once completed, the legislation will go to the House for normal committee review and hearings, Fitzpatrick said.

"It will make its way through the Ways and Means committee," Fitzpatrick said. "Then we'll start the amendment process on the floor of the House. My big thing is that it should go through regular order and that there be hearings where everybody who is a stakeholder has a chance to be heard. Their input needs to be part of the legislative package."

Any reforms would need to include cuts to both individuals and corporations, Fitzpatrick said. The current corporate tax rate of 35 percent is one of the highest in the world and keeps the U.S. from being competitive with other countries, he said. There needs to be a "sweet spot" where the tax is low enough to be competitive, but not so low that will bleed tax revenue.

Fitzpatrick supports reducing income tax brackets from seven to three and eliminating deductions and loopholes. The Internal Revenue code is a mess, he said, weighing in at 70,000 pages of costly bureaucracy.

"CPAs like myself had a hard time navigating that," said Fitzpatrick. "Unless they have a tax attorney that can handle the complex system, the average person gets crushed. Bringing down the marginal rates and getting rid of the special interest deductions and loopholes, coupled with regulatory reform and a balanced budget amendment, are key to growing the economy."

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Fitzpatrick pushes bipartisanship for health care fix - Bucks County Courier Times

During a recent trip back to the outskirts of his hometown of Raqqa, Abu Ismail saw that life in the city, which over the past few years has become the de-facto capital of ISIS in Syria, is now nothing like it was when he left in 2013.

Abu Ismail, 54, was told by residents who had just fled the predominantly Sunni city that they had no clean water inside instead, they had to drink unsanitary water from wells. Some went without food for days, while others boiled grape leaves and had the soup for dinner. The lack of nutrition and clean water is making many civilians sick, while some sustain injuries from bullets and explosions in the beleaguered city -- and all have little or no access to healthcare, he said.

Some volunteer doctors from Raqqa have opened clinics for people inside, but there are no hospitals or medical centers or anything, and water and electricity is cut off, Abu Ismail, an activist who now lives in Turkey, told ABC News.

A few weeks ago, Abu Ismail visited the northwestern outskirts of Raqqa to see his brother for the first time in four years. During his trip, he said residents who had just left Raqqa told him that only one hospital in the northern Syrian city remains partially functioning. And ISIS fighters have first priority there.

If a child and an ISIS fighter are wounded, they will treat the ISIS fighter instead of the child, said Abu Ismail -- which, meaning "father of Ismail," is a nickname he goes by. He uses the name out of fear of potential repercussions he may face for traveling back into the Raqqa area.

The U.S.-backed Syrian Democratic Forces (SDF) -- which is dominated by Kurdish People's Protection Units militia, also known as YPG -- launched its campaign to seize Raqqa from ISIS in early June. About 45 percent of the city is now under SDF control, according to Col. Ryan Dillon, spokesman for the U.S.-led coalition fighting ISIS in Iraq and Syria. As the frontline tightens around the estimated 20,000-50,000 residents still living inside Raqqa, civilians are being injured and killed.

Given the danger on the ground and lack of access to Raqqa, its difficult to determine the state of the security and humanitarian situation. But the World Health Organization (WHO) reports that some health workers who recently fled the city say that all hospitals and health centers there are now out of service. In addition to injuries from coalition airstrikes and sniper fire, civilians in Raqqa are at risk of waterborne epidemic diseases such as cholera and hepatitis, as theyve had no access to clean drinking water for 48 days, the WHO said.

In addition, the majority of local physicians as well as the other health workers have fled the city, and the medicines are quite scarce, and their prices are excessive, a WHO spokesperson told ABC News.

Since June, the organization Doctors Without Borders, commonly known by its French acronym MSF, said it has treated more than 400 patients from Raqqa and surrounding villages. Most patients are civilians with injuries caused by improvised explosive devices, landmines, unexploded ordnance, shrapnel and gunshot wounds, MSF said.

Some of MSF's patients were civilians who sustained wounds upon returning to their old neighborhoods after fighting there ended, said Vanessa Cramond, MSFs medical coordinator in Northern Syria.

A Raqqa-based family had returned to their home and was tidying up the house after being away for a long time. The familys two teenage girls were making the bed when a device placed either in or under the bed exploded, killing one sister immediately and injuring the other critically, Cramond said. And last week, a young boy picked up an unexploded ordinance and brought it home, not knowing what it was. The device detonated, killing two of his immediate family members and injuring the whole family, she said.

I think its just the precariousness of that situation and how devastating it is for the whole family just going about their daily business, Cramond told ABC News via phone during a recent trip to Northern Syria. That is a relative norm, unfortunately, as war has become normal for so many people in Raqqa.

Cramond said she believes the level of access to healthcare inside Raqqa changes from moment to moment sometimes people have more freedom to walk around and seek care than at other times. Some of the residents MSF has treated over the past months actually seemed to have received a good level of care inside Raqqa, she said, while other times injuries were addressed too late.

We see people with shrapnel inside them from the impact of a blast so the wound is really infected, and that often means that we see people who need to be amputated because were seeing them very much after the injuries occurred and were unable to salvage them, Cramond said.

MSFs team on the ground has not seen patients with ongoing health issues such as uncontrolled asthma, diabetes, and heart disease, said Cramond, and the number of patients they do see is relatively small.

That worries us, she said, adding that this tells her that many civilians are unable to reach medical centers, or dont know where to go for necessary treatments and surgeries.

Hodeb Shahada, an activist who fled Raqqa for Turkey about a year and a half ago, said he was in touch with some of his friends who have remained in the city, until they decided to flee in mid-July. When they had access to the internet inside Raqqa, they would send him voice recordings about what life is like inside. They told him that only three to four doctors remained in the only hospital that was partially functioning. Some residents died on their way to seek treatment.

Everything that moves in the street is a target, so at the end no one dares to take people to the hospital, Shahada told ABC News.

Shahadas friends told him about an ambulance worker who had lost his wife after their home was hit by an airstrike. The worker later tried to help four boys who were injured after a different strike hit their home, but he was killed when his vehicle was also struck.

The cause of many of the issues Raqqas residents are facing, however, is the lack of clean water, Shahada said.

People drink bad water from wells and it leads to diseases. Some are killed on their way to get water, he said.

Some civilians have reportedly died because they were caught in the crossfire on their way to get water from the Euphrates river, the WHO said.

The ongoing military campaign in Raqqa means that the WHO doesnt have access to send health teams into the city. For the first time in three years, the WHO on Tuesday delivered medicine and medical supplies -- enough for 150,000 treatments to Al-Qamishli, northeast of Raqqa, where some residents displaced from Raqqa live in temporary camps.

More than 200,000 people have fled their homes around Raqqa since April 1, according to the United Nations. In 2004, Raqqa was the sixth largest city in Syria, with a population of 220,000.

But not everyone wants to flee, Cramond said. While its dangerous to live inside Raqqa, getting out is also unsafe. A number of residents have been killed while fleeing.

Abu Ismail says that his brother is one of those who want to stay. His brother had moved from the city of Raqqa to what was once the family's vacation house, about 12 miles away from the city, in an area that is now controlled by the SDF, but was ISIS-held. Abu Ismail offered to try to bring his brother, his wife and children to Turkey.

"But my brother said 'I stayed in Raqqa under ISIS for two and a half years. We endured under ISIS, so we can take it a little longer,'" Abu Ismail said.

"I would ask people I met in the area, 'why didn't you leave two months ago?' he said. They responded that they hadn't expected that the battle would last this long. People also don't like to stay in refugee camps. Some say that they'd rather die in their homes."

Excerpt from:

Civilians trapped in Raqqa with little access to urgently needed healthcare, organizations warn - ABC News

Republicans haven't stopped targeting Democrats on healthcare even after their failure to repeal Obamacare.

The National Republican Congressional Committee, the House GOP campaign arm, is running digital ads in eight states hitting Democrats for supporting the creation of what is called a single-payer healthcare system. Democrats have been adopting support for such a government-run system in the U.S. with increasing frequency, a position to the left of Obamacare and closer to the socialized medicine seen in other countries.

House Republicans believe the position could hurt Democratic candidates in 2018, despite their party's failure to replace former President Barack Obama's healthcare law after years of promising, not to mention infighting, over what to do next to address America's ailing medical system.

Republican insiders concede the oddity of running on healthcare given their paralysis on the issue. But they say internal polling has revealed Democrats are vulnerable on single-payer in targeted districts.

"We like the contrast between our bill and single-payer. The ads write themselves, pulling all these Democratic candidates in their huge primaries left and makes them unelectable in a general," a Republican operative said, referring to GOP legislation to partially repeal Obamacare that passed the House but stalled in the Senate.

The operative, who has viewed the polling but declined to disclose its findings, said surveys in July showed that in competitive House districts, "when both the GOP healthcare proposal and single-payer proposal were described to respondents, respondents disapproved of single-payer in stronger numbers."

The NRCC is investing six figures to run the digital ad "Control" in California, New York, Pennsylvania, Nebraska, Colorado, Florida, Minnesota, and Virginia. The attack features House Minority Leader Nancy Pelosi, D-Calif., and the perils of putting healthcare under government control. The spot includes news clips of Charlie Gard, a since-deceased baby born with severe birth defects, whose parents fought with the British government over whether the country's government health service would allow the child access to potentially life-saving treatment.

"Big government has destroyed the American healthcare system as we know it. But it gets worse," the spot's voiceover says. "A new plan brought to you by the same Democrats who gave us Obamacare."

"Tell Nancy Pelosi and California Democrats we can't afford single-payer healthcare," the voiceover says, upon the ad's conclusion. Democrats say the spot is laughable given the Republicans recent healthcare stumbles. However, they're quick to point out that not all Democratic candidates will embrace single-payer healthcare. Some will and some won't, depending on the district they're running in.

"Republicans have lost all credibility on healthcare with this repeal disaster," said Tyler Law, spokesman for the Democratic Congressional Campaign Committee, the party's House campaign organization. "To think they can keep talking about healthcare and have that be a winning issue heading into the midterms, they're sorely mistaken."

Democrats need to win a net of 24 seats to win back the House majority.

The American Health Care Act cleared the House in late spring, but the GOP's' Obamacare repeal effort is on the fritz indefinitely after legislation pushed by Senate Republicans fell one vote short of passage in late July. That comes as President Trump's job approval numbers have hit record lows.

The effort unfolded over seven months, during which the Affordable Care Act's low approval numbers improved to the point where the law is now more popular than unpopular for the first time since it was enacted in 2010. Plus, the public has given a resounding thumbs down to the Republican alternatives.

That could give Democrats the advantage on healthcare, after losing big to the GOP in three of the last four elections partly because of public dissatisfaction with Obamacare.

But Republicans are staying on offense, arguing that the Democrats' leftward lurch on the issue to embrace a government-run system opens a new line of attack for the GOP. Republicans hope they can force the issue to be one that Democrats fight over in party primaries next year.

"European-style single-payer healthcare is the new litmus test in the Democratic Party," NRCC spokesman Matt Gorman said in a statement. "Every day from today until Election Day, Democrats will be forced to answer whether they support this disastrous plan..."

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Republicans attack Democrats on government-run healthcare after Obamacare repeal failure - Washington Examiner

Ransomware and hacking incidents plagued2016, and this year is no different, with the latest Protenus Breach Barometer midyear report finding that 2017 is on pace to exceed last years rate of one breach per day.

So far this year, the healthcare sector has reported 233 breach incidents to the U.S. Department of Health and Human Services, state attorney generals and media. More than 3.16 million patient records have been breached.

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Compiled in collaboration with Dissent from DataBreaches, the report analyzed 193 of the incidents for which it had data. Breaches have remained steady in the last six months outside of June, which saw a spike with 52 incidents. And March saw the most patients affected, with 1,360,961 records breached.

The healthcare sector will only stop being so vulnerable when the advances in data collection, sharing and analytics are matched with similar advances in our understanding of how to protect patient data, said Protenus Cofounder and President Robert Lord.

Healthcare has invested tens of billions of dollars in deploying systems to leverage data to improve patient outcomes - and appropriately so, he continued. But we still have massive problems with the abuse of that data and those systems.

So what are the biggest threats plaguing healthcare in 2017? Insiders and hackers.

Hacking accounted for 75 breaches this year, with 1,684,904 patient records impacted. Malware and ransomware were specifically mentioned in 29 of these incidents, but the report found there were many additional incidents where malware was reported as hacking or an IT incident.

Officials expect more organizations to report ransomware attacks this year, as HHS updated its ransomware reporting requirements in Aug. 2016. The update places the burden of proof on the provider to demonstrate data remained inaccessible or werent exfiltrated.

Insiders are also remaining a constant challenge for healthcare, accounting for 96 incidents or 41 percent of data breaches this year so far. More than 1.17 million patient records were breached by insider error or wrongdoing.

Wrongdoing is rife to cause significant damage, as its rarely detected immediately. For example, Anthem reported this week an employee of its Medicare insurance coordination services vendor was stealing and misusing Medicaid member data from as early as July 2016. The breach wasnt found until April.

Another issue plaguing the healthcare sector is that other types of external attacks have been underreported or unreported. Thousands of databases in all sectors have been wiped or the data were exfiltrated. The report found that only few of these were reported to HHS.

The FBI has also reported that these ransacking incidents or targeted databases arent being reported.

Healthcare executives, at a fundamental level, should stop thinking about security and privacy as a cost center and more as a strategic pillar of their organization, said Lord. We've continued to see increased awareness and incremental improvements, but not the needed dramatic leap forward.

To Lord, the leap will be driven by CISOs and Chief Privacy Officers, dramatically increasing investment in these areas to match other industries and leveraging the use of advanced analytics to detect inappropriate uses of patient data.

A culture of trust, comprised of dual pillars of privacy and security, must come from the highest levels of the organization.

Twitter:@JessieFDavis Email the writer: jessica.davis@himssmedia.com

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Insiders, hackers causing bulk of 2017 healthcare data breaches - Healthcare IT News

Tom Brenner New York Times Sen. John Thune, R-S.D., the Senates third-ranking Republican, spoke out this week about continuing to provide cost-sharing reductions (CSRs), that is, financial assistance to consumers struggling with high health insurance deductibles and other expenses.

A powerful South Dakota Republican senator merits credit for throwing his support behind a key effort to stabilize the Affordable Care Act after the failed but disruptive congressional push to repeal it.

Early this week, South Dakotas John Thune, the Senates third-ranking Republican, spoke out publicly in favor of funding a critical component of former President Barack Obamas health care law: its financial assistance to consumers struggling with high health insurance deductibles and other expenses. While Thune didnt sound overly enthusiastic, his pragmatic call to fund this consumer-friendly aid known as cost-sharing reductions, or CSRs clearly warns the Trump administration against taking action to undermine the insurance marketplace.

Its a particularly timely message one that Minnesotas three influential GOP House members should echo as Republican efforts to replace the ACA stall indefinitely. The inaction has stoked the ire of President Donald Trump, who campaigned on swiftly repealing Obamacare. There are understandable concerns that Trump appointees could pursue measures to sabotage the law to placate the angry Oval Office occupant.

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Put consumers first by stabilizing, not sabotaging, health care law - Minneapolis Star Tribune

A temporary replacement has been appointed for the top executive job at Nash UNC Health Care.

Dr. Ian B. Buchanan will serve as interim CEO for the hospital, stepping in for Larry Chewning, who was asked to leave by the hospitals Board of Commissioners in July and allowed to announce his retirement.

Our team is looking forward to working with Dr. Buchanan and our partners at UNC Health Care to continue improving the care and service we provide to the people of Nash County and the region, said hospital board Chairman Jim Lilley.

A national search is underway to find a replacement for Chewning, who will officially begin his retirement in September. He has served as CEO for the past decade. Chewning became an employee of UNC Health Care System after spearheading the partnership with UNC Health Care in 2014.

As part of the agreement, UNC provides Nash with a CEO, Alan Wolf, spokesman for UNC Health Care Systems, previously told the Telegram.

Chewning presided over a period of great expansion at the hospital with several new treatment centers built. In recent months, however, the hospital has lost money and received poor patient safety ratings.

The search process is being led by a CEO Search Committee composed of members of the local hospital board, said Jeff Hedgepeth, the hospital's director of public relations and marketing.

Buchanan will continue to serve as chief research officer for the UNC Health Care System and as senior vice president of operations at UNC Medical Center in Chapel Hill. He also serves the state as a member of the N.C. Advisory Committee on Cancer Coordination and Control.

Buchanan has worked with the Nash hospital leadership team in recent years on several initiatives related to UNC Cancer Care at Nash.

In addition to the Cancer Care programs, I am excited to begin working more closely with the larger team at Nash and in getting to know both our patients and the community, Buchanan said.

Buchanan is a graduate of the UNC School of Medicine and earned a masters degree from the UNC Gillings School of Global Public Health. He joined UNC Health Care in 2006, working in the Performance Improvement Department at UNC Medical Center, where he was responsible for the Core Measures reporting initiative.

Since then, Buchanan has served as the associate vice president for Oncology Services, as vice president for Cancer and Childrens Services, and as vice chairman for Clinical Integration within the UNC Department of Pediatrics.

Chewning is only the third CEO of the hospital since it opened nearly 50 years ago. He replaced Rick Toomey, who replaced long-time CEO Bryant Aldridge.

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Nash UNC Health Care board names interim CEO - Rocky Mount Telegram

Trumps let Obamacare implode is a cruel, nihilistic policy that does nothing to solve the real problems in health care.

PRESIDENT Donald Trumps let Obamacare implode strategy should come with a flashing red warning: If you break it, you own it.

Of course, it is not a political strategy. Its a talking point aimed at the hardest base of the GOP. As a policy, it is a prescription for escalating health-care costs and devastation to already fragile rural economies as a legion of newly uninsured people, many of them in Trump-voting counties, demand care from hospitals that cannot afford a spike in charity care.

The U.S. Senates failure to repeal Obamacare last week does not end the debate about the Affordable Care Act. Nor should it. The ACA has obvious flaws acknowledged by its own supporters. Fixing them, with a bipartisan and deliberative approach, would be a priority if the Republican caucus had more sensible minds like Sens. Susan Collins of Maine and Lisa Murkowski of Alaska. They joined Sen. John McCain to rebuke the repeal strategy.

A glimmer of hope comes from U.S. Sen. Lamar Alexander, R-Tenn., chairman of the Senate Health, Education, Labor and Pensions Committee, who said he will work with Washingtons Sen. Patty Murray on a bipartisan, if temporary, solution. The ranking member of the committee, Murray welcomed the overture, which includes hearings and a proposal to extend payments to insurers through 2018.

Trump, nonetheless, acts like a cruel nihilist in threatening the foundations of the Affordable Care Act. Through executive power, he could stop payment on the estimated $7 billion in cost-sharing subsidies for low- and moderate-income buyers of health insurance. That could effectively make health insurance unaffordable for up to 10 million people.

He has other levers, including monkeying around with the Medicaid expansion, which helped drop Washington states uninsured rate to 7 percent, with the steepest drops in counties in this state that Trump won. He should stop threatening to harm his base, and his base should demand rational governance.

In the absence of constructive action from the White House, Washington states health-care leadership must buckle down for a bumpy ride. Insurance Commissioner Mike Kreidler said he is most concerned that rural counties will be left with no insurer for individual plans, a scenario barely avoided this year. Several counties have only one provider.

Kreidler is working on several contingency options, including expanded use of a high-risk insurance pool that could step in for unusually high-cost illnesses and for individuals. He is also exploring opening a public option if counties were left with no private insurer, using the insurance pool for state employees.

This intriguing idea deserves a full vetting, because Kreidler sees the current trajectory on health insurance on the individual market ending with a crash. Washington has seen that before, nearly two decades ago, and it was chaos.

Trumps disinterest in solving the big problems of health care including cost and access is remarkable because it is so callous. Instead of merely working to score political points off the Obama legacy, Trump and the GOP-led Congress need to work with Democrats and fix, not toss, the Affordable Care Act.

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Glimmers of hope amid president's health-care callousness - The Seattle Times

Senate Majority Leader Mitch McConnell, R-Ky., joined by fellow Senate Republicans, holds a news conference on Capitol Hill on Tuesday, Aug. 1, 2017. J. Scott Applewhite/AP hide caption

Senate Majority Leader Mitch McConnell, R-Ky., joined by fellow Senate Republicans, holds a news conference on Capitol Hill on Tuesday, Aug. 1, 2017.

The White House says the fight over health care is not over, but on Capitol Hill, Republicans are ready to move on.

"The president isn't giving up on health care and neither should the Senate," Office of Management and Budget Director Mick Mulvaney declared on CNN on Wednesday.

On the Senate floor that same morning, Senate Majority Leader Mitch McConnell, of Kentucky, was already focused elsewhere.

"Comprehensive tax reform represents the single most important action we can take now to grow the economy and help middle-class families get ahead," McConnell said. He added that the Republican Party has a "once-in-a-generation opportunity" to redesign the nation's tax laws.

McConnell has not publicly declared the Republican effort to "repeal and replace" the Affordable Care Act over, but the mood on Capitol Hill has decidedly shifted to the next legislative battle: cutting taxes.

The same day the health care bill collapsed last week, the "Big Six" negotiators announced a very broad outline of what Republicans hope to achieve with a tax overhaul.

"The goal is a plan that reduces tax rates as much as possible," read a statement by McConnell, House Speaker Paul Ryan, House Ways and Means Committee Chairman Kevin Brady, R-Texas, Senate Finance Committee Chairman Orrin Hatch, R-Utah, Treasury Secretary Steven Mnuchin, and National Economic Council Director Gary Cohn.

The group has been meeting privately for months to sketch out a game plan on tax legislation. Those meetings also ultimately scuttled Ryan's original hopes of including a controversial new tax on imports that he had hoped would raise new revenue to pay for cuts elsewhere.

Republicans are hopeful that a tax bill will be an easier lift than health care, and lawmakers say the pressure to deliver tax legislation has intensified after failing on long-promised health care legislation.

While the party never really coalesced around an alternative to the Affordable Care Act, every Republican in Congress supports tax cuts.

Some of the broad proposals include reducing the number of personal income tax brackets, and lowering the corporate rate as low as 15 percent which the president has called for in the past.

The tough questions about what those rates will be, if or how tax cuts will be paid for and what process Republicans will use to get the legislation through Congress remain unanswered.

The last major federal tax overhaul of this scale was in 1986, under President Reagan, who signed a bipartisan bill that has become a tale of Washington folklore featuring, for example, a final deal worked out over two pitchers of beer at a Capitol Hill pub.

But, the prospect of a bipartisan bill this time fizzled quickly earlier this week.

Forty-five Senate Democrats sent a letter to McConnell outlining the conditions that needed to be met for them to work with Republicans on a tax bill: no tax cuts for the wealthiest Americans and no cuts to entitlement programs to pay for tax cuts.

McConnell quickly declared that offer a non-starter, and indicated Republicans will use the same budget reconciliation process they deployed on health care to skirt the Senate filibuster and try to pass a bill with 51 votes.

Democrats are skeptical Republicans can pull that off with a tax overhaul.

"The question will be: Are they going to repeat the mistake of health care where they said they want to try to do tax reform just with Republicans?" said Sen. Mark Warner, D-Va., "If they use reconciliation they're not going to have a very easy path. If they think health care is hard, they have not seen anything in terms of how you deal with the complexity of tax reform."

The White House is demanding an aggressive schedule. Mnuchin this week said Trump would like to sign a bill by Thanksgiving.

Congressional Republicans are using the August recess to drum up support for their ideas, including an event at the Reagan Ranch in California on Aug. 16.

The Senate wrapped up its pre-recess business Thursday. So both chambers are on August recess until after Labor Day.

Already, staff is working on draft legislation. House and Senate lawmakers say they hope to release those drafts in September and start having open committee hearings.

Under this timeline, the House would vote in October, and the Senate would follow suit in November and send the bill to the president.

"This won't be an easy process, but the people we represent are depending on us for help. Now is the time to deliver tax reform, and I look forward to working with my colleagues to accomplish it," McConnell said.

Whether or not Republicans can pass a tax bill and whether or not their voters will forgive them for not passing a health care bill are two questions that will hang over the GOP majority for the rest of 2017.

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After Health Care Collapse, GOP Seeks Redemption With Tax Cuts - NPR

But as Republican Sens. Susan Collins and Lisa Murkowski sat side-by-side in an exclusive joint interview with CNN's Dana Bash on Thursday, they steadfastly stood by their decisions to buck their own party's recent push on health care.

The two women reflected on last week's turbulent series of events and their votes that ultimately led to the suspenseful downfall of Republican efforts to repeal and replace the Affordable Care Act.

"It's always hard not to be a member of the team. There's lots of pressure to do that," said Collins, a four-term senator from Maine. "But in the end, I have to do what I think is right. And that's what I did in this case."

Ticking off a list of the pressures senators face -- "repercussion from party, a tweet from the President, backlash from your leadership" -- Murkowski, a three-term senator from Alaska, argued that she and her colleagues shouldn't have to feel "motivated or discouraged" from doing what they feel is right for their respective states.

Murkowski knows firsthand the impact of a tweet from the President. A day after she and Collins were the only two senators to oppose a procedural vote on health care last week, President Donald Trump fired off a tweet singling out Murkowski, saying she "really let the Republicans, and our country, down."

The senator said that tweet also came a day after the President personally spoke to her over the phone. Asked if she felt intimidated by their conversations, Murkowski declined to get specific. "I will just say that the President and I had a very direct call."

She also received a call from Interior Secretary Ryan Zinke, a person who holds enormous sway in a state like Alaska, to urge Murkowski to support the President on health care.

Zinke is now being investigated by the department's inspector general over whether the secretary threatened Alaska's economic development in the phone call. Responding to news of the preliminary probe, Murkowski told Bash that she did not interpret the phone call as a "threat" but that "he was merely delivering a message."

Pressed on whether Zinke mentioned economic development in the call, Murkowski simply stated the focus was on health care. "What he mentioned was that the President was very -- that the health care bill was very important to the President," she said.

Before last week's health care votes, Murkowski had been warning Trump that she was not going to vote by party line on the issue. Earlier last month at the White House, at a meeting between Republican senators and Trump on health care, Murkowski said she told the President in front her colleagues that she wasn't necessarily going to back whatever Republicans ended up proposing. "I am voting for the people of Alaska," she said.

"Lisa gave a wonderful speech that day at the White House," Collins added, with her colleague sitting next to her. "And I remembered being so proud of you for saying directly to the President what your obligations were."

Both women felt that one of those obligations was protecting federal funds for Planned Parenthood during the health care battle, saying too many women in their states relied on it for health care needs like cancer screenings. Collins said she felt it was "inconsistent with our Republican ideals" to advocate for people to choose their own health care providers -- but not if it was Planned Parenthood.

Just three days after Murkowski and Collins were the only two Republicans to oppose a procedural vote to move on to a health care measure -- resulting in Vice President Mike Pence having to make the tie-breaking vote -- the two were back in the "no" column again, but this time they had company.

Sen. John McCain joined the two women to vote against what was dubbed the "skinny repeal" bill to strip away key aspects of the Affordable Care Act -- essentially a last-resort option for Senate Republicans after other measures failed to advance. While very few senators were particularly thrilled about the legislation, they were hoping to at least pass it, then work with the House to improve it in a conference committee.

But it wasn't good enough for Collins and Murkowski, and in a dramatic twist, McCain became the third Republican senator to vote no, effectively sinking the bill. They said they didn't know for sure how he was going to vote until he walked up to them on the floor after midnight at the late-night vote.

"I so remember when both Lisa and I were talking with John McCain on the Senate floor and he pointed to both of us and he said, you two are right on this issue," she said. "And that's when I knew for sure."

Murkowski said she'll never forget a conversation the three had after the vote.

"He said people might not appreciate what has happened right now as being a positive," she recalled. "But time will prove that having a pause, having time out for us to do better is going to be good for the country. And it was a good, good, strong John McCain message."

Just a few days later, Republican Sen. Jeff Flake of Arizona, a longtime critic of Trump's, released a scathing critique of the President in his book, arguing that his party was in "denial" and urging others to stand up to the White House.

Asked by Bash if there was a noticeable shift in the way Republicans were starting to handle Trump, Collins said that many in her party are still interested in the President's agenda but are not so tolerant of his style.

"I don't think that the caucus is ignoring the President," Collins said. "But there may be some ignoring of his rhetoric, which, at times, is over the top."

Murkowski agreed, saying that when the rhetoric from the Oval Office "is not constructive to governing," it's "important to speak up."

"And I think you are starting to see a little bit of that," she added. "I think we're all still getting to know this new administration and how this President operates."

Read more from the original source:

Collins, Murkowski take CNN behind the scenes of the health care battle - CNN

THE PROGNOSIS

John McCains surprise, middle-of-the-night thumb down that sunk his partys Obamacare repeal bill last week made for perfect political showbiz. But signals the Arizona Republican would be the final GOP defector were there all along. After all, McCains a mostly free spirit from a state that deeply benefited from the Affordable Care Act. And he likes some drama now and again.

McCains never really belonged to the brand of tea party-style Republicans who loved to rail against Obamacare. He criticized the ACA when he needed to, like when he was running for reelection in 2010 and again last year. But McCain didnt share many of his colleagues perspective that virtually anything would be better than President Obamas health-care law.

Besides, McCain is used to ducking the party line on other issues, too, like campaign finance reform and climate change.

Theres a certain impulsiveness about McCain, and every once in a while he tends to stray from orthodoxy, David Berman, a political science professor at Arizona State University, told me.

If there were ever a time for McCain to stray from orthodoxy and do whatever he wants, its now. Just a few days before the Senatevote on its "skinny repeal" bill, the 80-year-oldannounced he has glioblastoma, a common but aggressive form of brain cancer.

So while McCain sees the same realities back home as Arizonas other senator, Republican Jeff Flake, the two parted ways on Obamacare partly because they are facing far different political situations. McCain, in all likelihood, never has to worry about another election, while Flake is facing a potentially tough reelection race next year.

Speaking of those realities back home, theyre harsh.

Arizona is among the handful of Republican-led states that expanded Medicaid to cover low-income, childless adults. That program, along with new opportunities for coverage through federally subsidized marketplace plans, has provided coverage tohalf a million Arizonansover the past few years. Arizonas uninsured rate fell from 17.3 percent in 2009 to 10.8 in 2015 the 13th-largest drop in the nation during that time.

Arizona, with its expanding retiree population, has also seen its health-care sector explode in recent years. Since 2010 it has experienced the fifth-highest health-care job growth of any state, according to the U.S. Bureau of Labor Statistics.

So it was a no-go for McCain when Senate leadership pressured him to support skinny repeal that would have destabilized insurance markets without fixing Obamacares deepest problems and could have led to a return of deep Medicaid cuts proposed in the Senates replacement bill known as the Better Care Reconciliation Act. State officials had estimated that the BCRA would have cost Arizonas Medicaid program $7.1 billion by the end of 2026.

Arizona was about to get screwed, if I may, under this plan,"McCain toldPhoenix-based radio host Mike Broomhead yesterday.

Thats exactly what Arizona Gov. Doug Ducey was privately worried about, although as a Republican hed also publicly criticized Obamacare, at times calling it "ground zero" for problems with the law. Three amendments McCain offered to protect Arizona, including one to phase out Medicaid expansion over a decade instead of the seven years envisioned by the BCRA, were at the behest of Ducey. McCain said all along he would center his health-care vote on Ducey's wishes:

McCains no vote has won him praise among health-care advocates in Arizona. I think people are pretty pleased with him in the world I work in, Greg Vigdor, president of the Arizona Hospital and Healthcare Association, told The Health 202.

But McCain wasnt just frustrated by the GOP legislation itself hed also expressed annoyance all along at the Senate GOP leaderships secretive process in writing it, at times even mocking the lack of transparency.

Damned if I know,McCain responded in May when I asked whether he expects a health-care vote this summer.

Look at the concernsMcCaintweeted over the past several weeks:

Business Insiders Bob Bryan noted McCain's skepticism at the Senate's initial repeal-and-replace bill, the Better Care Reconciliation Act (BCRA):

Ultimately, I think a lot of it comes down to the unique nature of Sen. McCain as a person and a legislator, Vigdor said. He really believes in the Senate as the great bastion of debate and deliberate consideration.

McCain displayed that love for Senate procedure and regular order in a floor speech he gave on July 25, his first time in the chamber since announcing his cancer diagnosis. In that speech, which Democrats being cut out of the health-care process especially hailed, McCain in strong terms blasted GOP leadership for trying to cram through an unpopular Obamacare repeal measure and called in his party to start reaching across the aisle.

Weve tried to do this by coming up with a proposal behind closed doors in consultation with the administration, then springing it on skeptical members, trying to convince them its better than nothing, asking us to swallow our doubts and force it past a unified opposition," McCain said."I dont think that is going to work in the end."

Boston Globe's Matt Visernoted Democratic leader Chuck Schumer's response to McCain's speech:

Of course McCain, who lost to President Obama in 2008, doesnt eschew the limelight, either. Reporters hounded him last week afterhe emerged as one of the chief GOP skeptics of the repeal effort. As he walked into the Senate chamber around 1 a.m. on July 28for the skinny repeal vote, he played coy amid the flood of questions about which way he leaned.

Watch the show, McCain told reporters.

He'd warned he'd vote against a repeal-replace bill if it wasn't improved....and then he did, noted HuffPost's Matt Fuller:

MSNBC's Lawrence O'Donnell:

Programming note:The Health 202 will not publish on Monday, Aug.7 and on Friday, Aug.11 next week. Well be back in your inbox on Tuesday. In the meantime, be sure to read our colleague Tory Newmyers The Finance 202 every day next week.

AHH, OOF and OUCH

Interior SecretaryRyan Zinke testifies during aSenate Energy and Natural Resources Committee hearing. (EPA/MICHAEL REYNOLDS)

AHH: What better way to mend fences than over a couple of beers? Interior Secretary Ryan Zinkesays he's patched things up withAlaska Sen. Lisa Murkowski (R) after a widely reported dispute over hervote last week against starting the health-care debate, according to the AP.

Zinke had reportedly called Murkowskito threaten repercussions for Alaskaif she failed to toe the administration's line on health care. But yesterday Zinketweeted to his nearly 50,000 followers a photo of himself and Murkowskienjoying Alaskan beers at his Washington home:

Murkowski, who leads the Senate Energy and Natural Resources Committee, was one of two Republicans to vote against starting health-care debate (along with Sen. Susan Collins of Maine) and joined both Colins and McCain to ultimately vote against the "skinny repeal" bill.

OOF: Maybe the Senate's embarrassing failure to pass Obamacare repeal was a blessing in disguise for Republicans. A new poll taken in the days just after the Senate failed to pass a series of different optionsfinds staggering oppositiontoward the GOP effort. Eighty percent of registered voters in a Quinnipiac University poll -- including 60 percent of self-identified Republicans -- said they disapproved of the way Republicans were handling health care. Just one-fourth of respondents said they were in favor of alternative health-care legislation presented by the Senate.

House Speaker Paul Ryanspeaks about health-care at hisweekly press conference. REUTERS/Yuri Gripas TPX IMAGES OF THE DAY

OUCH: Wait for it, wait for it. Here it is: The House GOP health-care defense is "maybe the Senate didn't manage to pass Obamacare repeal but thank goodness we did." That's essentially how Speaker Paul D. Ryan (R-Wis.P) responded to constituents yesterday, when they blasted congressional Republicans for getting little done this year even though they control both houses of Congressand the White House.

For eight horrible years I heard we dont have control of the House, we dont have control of the Senate, we dont have the presidency, Banker Wire employee Keith Ketzler, 62, said to Ryan, according to the AP. Ill tell you what, youre in there now and all I see is in-fighting. Its very dysfunctional. I dont see any plans for anything.

Ryan said he's worried too -- and noted that the House did pass a health-care bill in May.

I can make sure that the House delivers," Ryan said. I dont run the Senate, I run the House.

TRUMP TEMPERATURE

President Trumplistens as West Virginia Gov. Jim Justice speaks at a campaign-style rally at Big Sandy Superstore Arena in Huntington.(AP Photo/Susan Walsh)

--New Hampshire is notorious for its drug-abuse problems. But Trumpdidn't do himself any political favors by depicting the entire state as one big "drugden" in s phone call withMexican PresidentEnrique Pea Nietosix days after his inauguration. I won New Hampshire because New Hampshire is a drug-infested den, Trump told Nieto in a phone callon Jan. 27. The call was private, but The Post's Greg Millerobtained the transcript plus an equally eyebrow-raising one of a call with Australian Prime Minister Malcolm Turnbull.

There area few things that could come back to haunt Trumppolitically based on that one sentence, The Post's Amber Phillips writes. For one thing, Trump ticked off New Hampshire's two senators and its Democratic organization:

From New Hampshire Maggie Hassan (D):

From the New Hampshire Democratic Party:

The state's Republican governor, Chris Sununu, also denounced the drug commentdespite previously standing by Trump in sticky campaign situations. PerMSNBCs Shirley Zilberstein:

Some pushback to the criticism from New Hampshire Republicans:

HEALTH ON THE HILL

Senate Majority Leader Mitch McConnelltalks with reporters.(Photo by Chip Somodevilla/Getty Images)

--August recess has officially commenced, and The Health 202 couldn't be happier. But this is not how Senate Majority Leader MItch McConnell (R-Ky.) wanted to head into the long summer break, which has turnedinto the perfect storm against hisbest-laid plans. My colleague Paul Kane has the must-read take:

"Soon after Memorial Day, McConnell drew up a game plan around approving a rewrite of the Affordable Care Act by the end of June. The benefits were twofold, providing House Republicans a few weeks to approve the Senate version and send it to President Trump," Paul writes. "Also, McConnell wanted to create separation between the conclusion of the health-care debate and the start of the annual August recess, providing the month of July to rack up victories on other legislative matters. Such wins would give some Senate Republicans, wary of tackling the health-care issue back home, something else to tout with their voters."

Instead, everything got consumed by the health-care storm, which culminated in the bill failing by a single vote last week. Then yesterday, the Senate left town for a five-week breakwith no major legislative accomplishments to show for the first seven months of unified Republican control of Congress and the White House.

"When they return after Labor Day, Republicans have to tackle several must-pass bills to fund federal agencies and to increase the Treasurys borrowing authority. Those are perfunctory tasks, but without the proper tending, failure would result in government shutdowns or worse. That leaves October, maybe, for the point to legislative offense, particularly on the bid to overhaul the tax code....This is the scenario McConnell was trying to avoid back in early June."

A few more good reads from The Post and beyond:

Without fanfare or controversy, the Senate approved legislation that will keep many FDAoperations running and deliver a win to the pharmaceutical industry.

The measure is broader than some state laws, because it covers patients with serious but not imminently deadly conditions, such as muscular dystrophy.

President Donald Trump announced new efforts Thursday to use technology to improve veterans health care, saying the programs will greatly expand access, especially for mental health care and suicide prevention. Veterans living in rural areas will also benefit, he said.

Darlene Superville|AP

Dr. Jerome Adams, Trumps nominee for surgeon general, tried to make a distinction between guns and gun violence during his confirmation hearing.

STAT News

SECOND OPINION

We're not the same as antiabortion Republicans. Really.

Kristen Day

DAYBOOK

(AP Photo/Pablo Martinez Monsivais)

SUGAR RUSH

President Trump introduces new telehealth initiative for veterans:

Trump: 'Veterans means so much for me and this administration':

What Trumps golfing habits say about him:

Stephen Colbert wants to serve on Robert Muellers grand jury:

Here is the original post:

The Health 202: Here's why John McCain voted 'no' on health care - Washington Post

Our plan would stabilize markets by making the cost-sharing payments mandatory and thereby prevent rates from rising sharply.

Second, we provide a relief valve to help states deal with the high cost of pre-existing and chronic conditions. The costliest 5 percent of patients account for nearly half of all health care spending in the country. We propose a dedicated stability fund essentially a form of reinsurance that states could use to reduce premiums and limit losses for providing coverage for these high-cost patients.

Third, our proposal provides relief to certain businesses from the mandate that they provide insurance to full-time employees. It also defines full time as a 40-hour workweek to discourage businesses from manipulating employees weekly hours to skirt the mandate. More than 90 percent of large businesses offered health care before the Affordable Care Act, and studies show that they would continue to do so under this change; others would move to find employee coverage in the individual marketplace.

Fourth, our plan eliminates the Medical Device Tax, an excise charge of 2.3 percent that is often passed onto consumers and reduces funds for research and development. And finally, we provide states with additional flexibility to enter into agreements such as enabling the sale of insurance across state lines that would provide more choice and lower costs.

This proposal would not increase the federal deficit, offering several options to offset the new spending.

Our plan isnt intended to rectify everything thats wrong with American health care. We aim to solve an immediate problem and move past a seven-year stalemate in Washington that has featured Republicans trying to repeal the current health care law, Democrats trying to preserve it and neither side willing to discuss anything in between.

That approach has led us to our current moment, in which no one is happy with the status quo, least of all the American people, whose trust and confidence in Washington weakens every day that we spend fighting instead of solving real problems.

Health care is one of those problems and a textbook example of why we formed the Problem Solvers Caucus this year. We all knew the partisanship in Washington had gotten out of control and felt the need to create a bipartisan group committed to getting to yes on important issues. We have agreed to vote together for any policy proposal that garners the support of 75 percent of the entire Problem Solvers Caucus, as well as 51 percent of both the Democrats and Republicans in the caucus.

If Washington does not act to stabilize the insurance exchanges, many families we represent will lose coverage or be hit with premiums they cant afford. This isnt conjecture.

If that does happen, people will be justifiably livid that Republicans and Democrats in Congress did nothing to stop a train wreck we all saw coming.

There is a growing recognition on Capitol Hill that something must be done, as evidenced by this weeks announcement from Senator Lamar Alexander the Tennessee Republican who is chairman of the Senate Health, Education, Labor and Pensions Committee that he will soon hold hearings focused on repairing the individual insurance market.

Our proposal isnt perfect, but it represents the first and only serious bipartisan health care proposal released in this Congress. We hope our colleagues in the House and Senate, as well as the White House, will use our plan as the foundation for the health care solution that America desperately needs and deserves.

Josh Gottheimer is a Democratic representative from New Jersey. Tom Reed is a Republican representative from New York.

Follow The New York Times Opinion section on Facebook and Twitter (@NYTopinion), and sign up for the Opinion Today newsletter.

A version of this op-ed appears in print on August 4, 2017, on Page A23 of the New York edition with the headline: A Bipartisan Fix for Health Care.

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Let's Stop the Bickering and Fix the Health Care System - New York Times

LONDON, OH (WCMH) The Ohio National Guard along with the Ohio Department of Health and Madison County Public Health is hosting a free healthcare event Saturday.

GuardCare offers free healthcare services to anyone who attends, regardless of income and insurance is not needed or considered.

No appointment is necessary to attend and care provided will include immunizations, sports physicals, womens health services, and hearing and vision testing.

GuardCare is hosted each year in a different medically-underserved Ohio community.

The event is being held Saturday from 8am to 5pm at London High School, 336 Elm Street.

Through GuardCare, Ohio National Guard medical personnel support and assist local health care providers. The event also enhances the medical skills of Ohio National Guard medical personnel, many of whom work as health care professionals in their civilian occupations as well.

NBC4i.com provides commenting to allow for constructive discussion on the stories we cover. In order to comment here, you acknowledge you have read and agreed to our Terms of Service. Commenters who violate these terms, including use of vulgar language or racial slurs, will be banned. Please be respectful of the opinions of others and keep the conversation on topic and civil. If you see an inappropriate comment, please flag it for our moderators to review.

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Ohio National Guard, health departments hosting free healthcare event in Madison Co. - NBC4i.com

In partnership with the White House Office of American Innovation, the Veterans Affairs Department announced anexpansion of its telehealth services or anywhere to anywhere health care.

The departmentwill issue a joint regulation with the Office of American Innovation and Justice Department to allow all VA providers to administer telehealth services to veterans anywhere in the country.

Existing telehealth programs provided care to more than 700,000 veterans last year and covered at least 50 different specialties, from dentistry to dermatology.

Were removing regulations that have prevented us from doing this, VA Secretary David Shulkin said during aAug. 3 White House announcement. Were removing geography as a barrier so that we can speed up access to veterans and really honor our commitment to them.

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President Donald Trump, who watched Shulkin and other VA doctors demonstratea live interaction with a veteran patient using video,said the program will help VA expand access to care across the country, particularly in rural locations and for veterans who need mental health care.

That means were going to be able to use VA providers in cities where there are a lot of doctors, and be able to use those doctors to help our veterans in rural areas where there arent many health care professionals, Shulkin said. And you talked about mental health and suicide prevention; this is one of those areas that we can really use that expertise.

Shulkin this year named suicide prevention as his top clinical priority. He also recently announced an expansion of VA mental health services to veterans who received a less than honorable discharge from service.

To help them administer the telehealth program, the department will roll out VA Video Connect to providers nationwide. Currently, about 300 VA providers use it at 67 hospitals and clinics.

Video Connect lets VA providers use their mobile devices to see and speak with veterans on their own mobile devices or home computers.

Shulkin, a doctor himself who still sees veterans, spoke with one of his patients in Grants Pass, Oregon, through the video screen.

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The department will also roll outits Veterans Appointment Request (VAR) application nationwide. The app lets veterans schedule, change or cancel their own appointments with VA providers on their own time. VA currently has the app working in 18 regions but plans to expand it to the rest of the country.

The VAR app is different from the departments attempts to update its own, in-house appointment scheduling system.

The department is evaluating a commercial scheduling solution, theMedical Appointment Scheduling System (MASS) to replace the aging system VA has now.

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VA announces expansion of 'anywhere to anywhere' health care services - FederalNewsRadio.com

With the Republican Senate failing to repeal the Affordable Care Act last week, the administration and Congress should consider paying greater attention to the healthcare problems of 2009.

When I graduated medical school in 2009, as the nation debated healthcare reform and the future of our healthcare system, the main challenges impeding doctors and patients were obvious to me. They included a rigid and perverse physician reimbursement system, a labyrinth of increasingly complicated, costly, and sometimes contradictory mandates and priorities, and a runaway malpractice system.

Medicare and Medicaid have historically reimbursed physicians via price controls, and their main cost control mechanism is to pay physicians less. This reimbursement system creates a dangerous lack of time and resources in the trenches, which facilitate myriad unintended consequences that can jeopardize care and ironically increase costs.

The price controls limit access for these patients, particularly those on Medicaid, which can lead to harmful delays or produce a heavy reliance on costly and overcrowded emergency rooms. Ultimately, the poorest patients with the greatest needs are hurt the most and have the hardest time getting help. A recent review in the Journal of General Internal Medicine found an association between hospital strain and mortality. As such, this unnecessary strain this reimbursement system produces also has the potential to harm the care of all patients.

Studies have shown that primary care can improve quality and lower healthcare costs. But the physician reimbursement system is skewed against primary care. This contributes to enormous time pressures on primary care doctors. Research in the Journal of General Internal Medicine found that the average primary care physician addresses on average 7.1 clinical problems in an on average 20.9 minute visit, leaving just 3.8 minutes per item. This time crunch hinders the ability of patients to understand their disease, treatment course, and follow up. It also impedes prevention and counseling that could facilitate healthy lifestyles and detect serious diseases earlier. This compromises care.

Consequently, fewer medical students are pursuing primary care as a career. This limits the accessibility of patients to our healthcare system. When patients are sick and don't have a primary care doctor to turn to, they must either suffer and see their condition worsen or go to expensive emergency rooms. The primary care physician shortage also limits the availability of counseling, prevention, and other services that primary care physicians offer.

The physician reimbursement system has also historically not reimbursed physicians for non-face-to-face care. In addition to impeding innovation, this unintentionally pushes healthcare services to more intensive and costly sites than necessary. This too limits access to care and contributes to rising healthcare costs.

The regulatory climate of medical practice has become increasingly complex. One-size-fits-all regulations work well for inanimate cars moving down an assembly line. Yet they fail to capture the varied backgrounds, experiences and preferences of living human beings, as well as the possible different responses to different interventions. While a certain degree of oversight is needed to ensure quality and safety, doctors have been spending more and more time on charting, paperwork, and checking off boxes and less time with their patients. Over time, healthcare systems have been forced to devote more time and resources to the administration of medicine, which takes valuable resources away from the practice of medicine.

At the same time, the unpredictability of the malpractice system has led to a constant fear of costly lawsuits, encouraging doctors to order unnecessary tests, consults, and admissions to avoid being second-guessed later in court. This practice known as defensive medicine has been estimated to cost our healthcare system between $100 billion and $200 billion annually.

Years later, now as a practicing physician, I know that the problems of our 2009 healthcare system still exist today. Few, if any, are arguing that these challenges have been resolved. In fact, in many ways they have gotten worse. The problems of our 2009 healthcare system need to be addressed now more than ever, and would go a long toward lowering costs and producing a higher-quality, more accessible healthcare system.

Jason D. Fodeman, MD, MBA is a practicing physician. He specializes in delivery systems and health policy.

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The healthcare problems of 2009 have not been fixed - Washington Examiner

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The White House wants to keep pushing on health care. The Senate has other ideas.

5:46 PM, Aug 02, 2017 | By Andrew Egger

Andrew Egger Reporter The Weekly Standard

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Gage Skidmore

Finance Committee chairman Orrin Hatch has insisted repeatedly that the window for health care has closed, and that the Senates time is better spent on other issues for now.

Theres too much animosity and were too divided on health care, Hatch told Reuters on Monday. I think we ought to acknowledge that we can come back to health care afterwards, but we need to move ahead on tax reform.

Not every senator is convinced. Health Committee chairman Lamar Alexander announced Wednesday that his committee would hold bipartisan meetings looking at Obamacare repair, which would look at ways to prevent a collapse of the health insurance market.

Asked about these meetings Wednesday, Hatch was unimpressed.

Why are they having hearings on health care? he told reporters. Were onto taxation now. Health care, as far as Im concerned, is over.

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Hatch: 'Health care, as far as I'm concerned, is over' - The Weekly Standard