California sues hospital for denying patient an emergency abortion
(NEW YORK) — California Attorney General Rob Bonta announced the state is suing a hospital in Eureka for allegedly refusing emergency abortion care to women whose lives are in danger.
The lawsuit, filed Monday in Humboldt County Superior Court, alleges Providence St. Joseph Hospital violated multiple California laws due to its refusal to provide urgent abortion care to people experiencing obstetric emergencies.
Providence St. Joseph’s is a Catholic hospital and the primary hospital services provider in Eureka, the largest coastal city between San Francisco and Oregon in northern California.
The lawsuit names one particular patient, Anna Nusslock, who had her water break when she was 15 weeks pregnant with twins in Feb. 2024.
Nusslock, a 35-year-old healthcare professional, claimed in the lawsuit that doctors at Providence St. Joseph’s told her the only option was abortion, but they could not provide her the service, based on hospital policy.
“Without abortion care, I risked infection or hemorrhage, both of which are so dangerous to my health and my life, and increased with every minute that passed,” Nusslock said during a press conference Monday.
Nusslock said she was told by doctors that they were prohibited from offering an emergency abortion if her twins still had any signs of heart tones, despite her own life being at risk and the pregnancy no longer being viable.
“I was told I could not receive emergency abortion care while at Providence because of hospital policy,” Nusslock said.
Instead, Nusslock alleges Providence staff gave her a bucket and towels “in case something happens in the car” and told her to drive 12 miles to a small community hospital where doctors were allowed to perform the procedure.
Once at that smaller hospital, Nusslock said she was actively hemorrhaging when she was placed on an operating table and the pregnancy was aborted.
In the state’s lawsuit, Attorney General Rob Bonta argues Providence has been violating multiple California laws by refusing emergency abortion care to women in need.
California is requesting a court order to force the hospital to perform prompt emergency care including abortions.
“Pregnant patients have the same rights to health care, including emergency care, that any other patient has,” said Bonta.
Bonta claims Providence is barring doctors from providing lifesaving or life-stabilizing emergency abortion treatment even when a pregnancy is not viable and when doctors have determined that immediate abortion care is necessary to save the life of the mother.
The lawsuit alleges that Providence only allows the procedure if the mother’s life is in immediate danger of death by which time intervention can be too late.
“This policy, let’s make no mistake, is draconian,” Bonta said. “It has no place in institutions that are charged with delivering accessible and equitable healthcare.”
While Bonta argues Providence must provide the care under California law, federal law on the topic is less clear.
The Emergency Medical Treatment and Labor Act requires every hospital in the United States that operates an emergency department and participates in Medicare to provide life-stabilizing treatment to all patients, but in a recent case, the U.S. Supreme Court did not confirm that the act includes abortion care.
In a statement to ABC News, a spokesperson for Providence St. Joseph Hospital said, “Providence is deeply committed to the health and wellness of women and pregnant patients and provides emergency services to all who walk through our doors in accordance with state and federal law. We are heartbroken over Dr. Nusslock’s experience earlier this year.”
“This morning was the first Providence had heard of the California attorney general’s lawsuit, and we are currently reviewing the filings to understand what is being alleged. Because this case is in active litigation and due to patient confidentiality, we cannot comment on the matter,” the spokesperson added.
“As part of our pledge to delivering safe, high-quality care, we review every event that may not have met our patient needs or expectations to understand what happened and take appropriate steps to meet those needs and expectations for every patient we encounter,” the spokesperson said.
(NEW YORK) — Newer three-dimensional imaging is more effective at detecting breast cancer and may improve long-term outcomes, according to a new study led by researchers at the Yale School of Medicine.
The study, which analyzed more than 272,000 breast cancer screenings over 13 years, showed that 3D mammography, known as digital breast tomosynthesis, or DBT, identified breast cancer at higher rates and earlier stages when compared to traditional 2D mammograms.
3D mammography also reduced the number of false positive results, leading to fewer unnecessary tests after initial screening, according to the study, published Tuesday in the medical journal Radiology.
The study builds on a growing body of research suggesting 3D mammography could offer benefits over 2D imaging.
According to lead co-author Dr. Liane Philpotts, this is the first study on 3D mammography of its scale, with 10 years’ worth of 3D screening data.
“It confirms some of what we knew from earlier … and shows the sustainability of these benefits,” Philpotts told ABC News. “But the big take-home point is that the advanced cancer rate was less [with 3D mammography]. That is the most significant finding from this.”
While 2D mammography is still accepted as a gold standard for breast cancer screening, an increasing number of health centers are incorporating this 3D technology.
Here are five questions answered about 3D mammography:
1. What is 3D mammography?
While traditional mammography involves a two-dimensional X-ray image, three-dimensional mammograms use a rotating “X-ray arc” that takes X-rays from multiple angles to create a detailed 3D representation of breast tissue.
This allows radiologists to scroll through 1-millimeter slices to obtain a more comprehensive view of the tissue.
2. Practically speaking, what are the benefits of 3D mammograms compared to 2D, according to the latest research?
3D mammograms may be able to detect breast cancers more frequently and at earlier stages. Earlier detection means earlier treatment and a higher chance of a cure.
In addition, 3D mammograms were associated with fewer false positive results, reducing the burden of unnecessary follow up testing. This could mean less time, money and stress for patients.
“It gives us … a better chance of finding things, and also a reduced chance of having to call people back unnecessarily,” Philpotts said. “So, it’s kind of a win-win from that point of view.”
3. What do current guidelines say about 2D vs. 3D mammograms?
According to the U.S. Preventive Services Task Force guidelines — an influential group of experts whose guidelines help determine government insurance coverage — 2D and 3D mammography are both effective forms of breast cancer screening.
Right now, one is not recommended over the other.
4. Is it covered by insurance?
Many insurance providers, including Medicare, cover 3D mammography.
However, coverage varies depending on insurance company and state of residence, as 3D mammograms are more expensive than 2D.
In some cases, only a portion is covered, or patients must meet a deductible first. Patients may need to call their insurance provider to understand what their individual plan covers.
5. Can I request it during my next screening?
More than likely, if you are due for breast cancer screening, you could receive a 3D mammogram.
3D breast mammography is offered at 90% of certified breast imaging centers. However, 3D imaging may not be necessary for everyone. It is a good idea to speak with your provider about whether it’s right for you.
(WASHINGTON) When Congress passed the Inflation Reduction Act in 2022, there was a key provision that the Biden administration fought hard for. For years, private insurance companies negotiated with drug makers over prescription prices.
However, Medicare, representing 50 million seniors, did not have the same right to negotiate prices for its Part D coverage. This meant that Medicare basically had to accept the prices offered to them.
Health and Human Services Secretary Xavier Becerra joined “Start Here,” ABC News’ flagship daily news podcast, earlier this year to announce that negotiations were starting. They had selected 10 medications to prioritize and attempt to bargain down prices.
On Thursday, during the first public event held by President Biden and Vice President Harris since the Biden dropped out of the presidential race, they revealed that they had agreed on all issues. This is being described as a significant development for anyone on Medicare, and for anyone who pays taxes to fund the expenses of Medicare.
Secretary Becerra joined “Start Here” on Friday to discuss this further.
START HERE: Mr. Secretary, last time we spoke you had just identified the drugs…they included some diabetes drugs, some arthritis medications, treatments for blood clots and blood cancer. Where are we now?
BECERRA: We are done with the negotiation, Brad. We have completed 10 drugs. Every company joined in the negotiations. We had offers, counter offers, and we hit a sweet spot with all ten. And that sweet spot will save Americans on Medicare who need these drugs lots of money. And it will save taxpayers who help fund the Medicare program lots of money, in the billions.
START HERE: Yeah. How much of a discount are we talking about here?
BECERRA: So in some cases, the discount from the list price is up to 79%. I think the lowest discount is about 38%. And I do want to caveat that a bit. Very rarely does anybody pay list price for anything. And if you do, take it back and bargain a bit. Whether it’s that car at the dealership where you look at list price, you don’t pay that. When you go to the department store, you try to find everything you can on sale or, you know at some point it’s going to go on sale.
And so everybody makes the effort to try to get the best price for whatever the product is. In this case, it’s a very important product, it’s your prescription medication. But you should still be able to get a good price, and that’s what we did. We negotiated and got a much better price than what Medicare was getting.
START HERE: But just so we can we can be clear about that caveat. You’re saying it’s 68%, say it’s like 79% less than the list price. But you guys weren’t paying the list price earlier. Can you tell us how much you were paying on these drugs beforehand, and how much the new discount you’ve gotten is?
BECERRA: Yeah. And that’s where it gets a little dicey because there are lots of nooks and crannies in the health care system. Some of them include what are, what is considered proprietary information of the companies, the drug companies, that they don’t want disclosed. And so the net price that Medicare pays is lower than the list price, but still high.
START HERE: So there’s some contract somewhere being like “You guys, no one can disclose what you guys had originally been paying.”
BECERRA: Yeah. We can’t, we can’t take you behind the curtain unless the drug companies tell us it’s okay to do so.
START HERE: Were you able to actually push back against these drug companies, or was it kind of like “We’ll ask once and then we’ll have to take what we get. We’re not going to risk not giving Americans these, these drugs.”
BECERRA: Well, let’s just say that when they came in with their offer or counteroffer, the final price was neither our initial offer nor their official offer. But here’s what I will tell you. The Congressional Budget Office, which is Congress’ budget estimator, they’re the ones that keep tabs of what legislation will cost — will it save money or will it cost taxpayers money? And they are very stingy when it comes to saying “Oh, taxpayers will save money.” Right?
Well, the Congressional Budget Office said with regard to the Inflation Reduction Act and prescription drug negotiation, they said, we believe in the first year of negotiation — which we just finished — in that first year, and they’re projecting because they didn’t know which drugs it would be, etc.. They said, we believe the Department of Health Human Services will save $3.7 billion. Well, we’ve saved $6 billion.
And on top of that, we’re saving people out of pocket another billion and a half. But here’s the kicker. They said over 10 years, they assume that this new law, over 10 years of negotiating, will save $100 billion. So if we’re already almost double their first estimate for their first year, I guarantee you we’re going to do better than the 100 billion, over 10 years.
START HERE: Okay. When do the new prices go into effect, then I guess?
BECERRA: Jan. 1, 2026.
START HERE: Okay, so when that kicks in, how much of a discount will average Medicare patients actually see? Because, like, if you guys scored a 68% discount on Farxiga, like the diabetes kidney medication, does that mean that the person using that drug is going to pay, it doesn’t mean they’re going to pay 68% less. I mean, how much less would it be?
BECERRA: Yeah. So remember, and that’s also a difficult question because seniors don’t typically pay very much for their prescription medication. Medicare the program, that’s the beauty of Medicare, it covers the lion’s share of the cost of those drugs. Some Americans still have to pay some out-of-pocket costs for their drugs, especially the higher cost drugs. So we’re going to save folks quite a bit of money.
Let’s put it this way: I can talk to you in total aggregate terms. We can now look at the price that we negotiated and say “Okay, if we had this price back in 2023, what would our cost have been?” And the result is we would have saved $6 billion to the health care program, and Americans will be able to save about a billion and a half dollars collectively in their out-of-pocket costs.
START HERE: The trade group that represents companies like Pfizer, Lilly, Merck, they’ve said we might not see as much innovation because we’re not getting as much money. That’s, that’s constantly been sort of a critique of this. They also say that your math makes assumptions about how many people truly save money on this. They say a very small amount of people actually get this Part D plan in the way that would actually save the money here. What is your response to to to these pharmaceutical groups?
BECERRA: Well, remember, they’re more than 50 million Americans who have prescription coverage under Medicare, the Part D program. There are about 9 million people in the Medicare program who use one of these 10 drugs. It’s not a small universe of people. And these are very expensive drugs. When you can bring the price down of a drug that’s listed for, say, $10,000, $12,000 to $3,000. That’s a pretty good deal. It’s still $3,000, but it sure saved you a ton of money. If you were paid $12,000 or 13,000 before that.
And so this will save not just the Medicare program money, but it will save Medicare beneficiaries money. And it certainly will pay taxpayers who today, when they work, have some of their money from their paycheck taken out so they could cover their Medicare investment into the future so that when they get turned 65, they can qualify. They will get to benefit from a strengthened Medicare program that will have those new resources available, because we didn’t have to spend it at, for overcharging us for the prescription medication.
START HERE: Well, so now, I mean, the idea is that you’ll negotiate more drug prices, right? So you got these 10 out of the way. What are the next 10 or the next 20, or do you guys have a sense of what types of drugs you’re looking to target?
BECERRA: Yeah. And here I have to be careful, because everything we say about a drug can move the price on the market. Right? And I don’t want to be accused of trying to influence the price up or down. And so what I can tell you is the statute, the new law, the Inflation Reduction Act, gave a pretty clear prescription of how to select these, set of drugs that will be negotiated. That’s a, it’s a good thing in the way, in a sense that it doesn’t let politics enter into this. It was pretty clear which drugs count. In this case, the first 10, they had to be the most expensive drugs in the Medicare system.
START HERE: All right. So then we’ll see what happens next. All right. Secretary Xavier Becerra, thank you so much.
(NEW YORK) — Deaths from dementia have tripled in just 21 years, according to a new study published in The Primary Care Companion for CNS Disorders.
In 1999, about 150,000 Americans died from dementia, according to the study. By 2020, that number had tripled to over 450,000.
The chances of dying from dementia increased among every demographic group studied, according to study author Mohsan Ali, a physician with the King Edward Medical University in Pakistan.
Tripling of dementia deaths
Dementia is defined by the National Institute on Aging as “the loss of cognitive functioning — thinking, remembering, and reasoning — and behavioral abilities to such an extent that it interferes with a person’s daily life and activities.” The reason it is increasingly the cause of death could be because people are living longer or getting diagnosed earlier, according to Ali.
“Age is the most significant risk factor for dementia,” Ali said. However, the increased prevalence of chronic conditions such as heart disease, diabetes, and obesity may also be contributing factors, he added.
Women, Black adults, and people living in rural communities showed the greatest increase in dementia deaths, the study found.
“While the increased rates in women may be because women live longer than men, there may be biological and genetic factors that make women more susceptible to dementia,” Ali noted. “Rural areas face a higher burden of dementia-related mortality due to several factors. These include limited access to healthcare services, fewer specialists in dementia care, and reduced availability of support services.”
Black adults had the highest death rate, followed by non-Hispanic white adults, and then Hispanic adults.
Fresh insights on dementia prevention
By 2050, the number of people with dementia will double in the U.S. to over 10.5 million and triple globally to over 150 million, the British medical journal The Lancet forecast in 2022. Yet despite these alarming statistics, experts say the average person has some control over their cognitive health.
“I am most excited about advances in dementia prevention, because we are learning about a number of lifestyle modifications that are both accessible to most of us and effective,” Leah Croll, MD, neurologist at Maimonides Health in New York, told ABC News.
Up to 45% of dementia cases may be preventable by addressing 14 modifiable risk factors, according to the Lancet Commission on Dementia.
Lifestyle factors that increased the chances of a dementia diagnosis include less education, head injury, physical inactivity, smoking, excessive alcohol consumption, high blood pressure, obesity, diabetes, high cholesterol, hearing loss, depression, social isolation, vision loss, and exposure to air pollution in older life.
“Staying up-to-date with your primary care visits, being diligent about your medications pays dividends over and over for your brain health,” Croll emphasized.
Dementia diagnosis and treatment today
Early detection and diagnosis is key to addressing dementia, according to experts.
Dementia is generally diagnosed with a combination of cognitive testing, brain imaging, and sampling the cerebrospinal fluid (CSF) that surrounds the brain and spinal cord and checking it for levels of dementia-related proteins.
Because some of these tests may not be readily available in some areas and can be expensive, researchers have been working on more accessible screening methods. For example, a recent study found that a blood test for Alzheimer’s disease, which is the most common type of dementia, may be as accurate at detecting Alzheimer disease as CSF sampling. However, the blood test is still in early phases of study.
In addition to ongoing research for diagnostics, there are new FDA-approved treatments for early Alzheimer’s dementia, when the symptoms are still relatively mild.
“Right now, it seems that these drugs modestly slow down the progression of disease, but they do not stop it, so it’s unclear how they will impact morbidity and mortality,” Croll cautions.
Overall, Croll believes that patients and families affected by dementia should feel hopeful about the future: “In many ways, dementia is one of the final frontiers in medicine, and we are finally starting to crack the code,” she said.
Noor Shaik, MD, PhD, is a neurology resident physician and a member of the ABC News Medical Unit.