| | | | | | | Presented By Blue Cross Blue Shield Association | | | | Axios Vitals | | By Tina Reed · May 18, 2022 | | Good morning, Vitals readers. Today's newsletter is 1,143 words or a 4-minute read. | | | | | | 1 big thing: How America feeds its young |  | | | Illustration: Aïda Amer/Axios | | | | America's dependence on baby formula has come under the spotlight as a national shortage sparked a nutritional crisis. Why it matters: The U.S. Dietary Guidelines for Americans and the American Academy of Pediatrics recommend infants be exclusively breastfed for about the first six months. - But, in practice, most babies get some type of formula.
"Although we're doing a better job of breastfeeding nationally, we still have most infants — or a little over half — that are requiring some type of formula within the first six months of life," James Franciosi, chief of gastroenterology, hepatology and nutrition at Nemours Children's Hospital in Florida, told Axios. The big picture: Years of public health campaigns about the nutritional benefits of breastfeeding for babies have resulted in more than four out of five infants starting out on breastmilk. - Hospitals have adopted programs to support new mothers with early skin-to-skin contact while not introducing any formula, as well as in-person lactation support to help them become comfortable with breastfeeding.
- Public support for breastfeeding has also grown, at times exposing major cultural dividing lines. Case in point: The firestorm sparked by Bette Midler's "Try breastfeeding!" tweet about the shortage, which critics said was insensitive and uninformed.
While breastmilk is considered nutritionally "best," parents ultimately switch exclusively to formula or supplement breastfeeding with formula for many reasons, Franciosi said. - In many cases, breastfeeding is simply not possible due to medical concerns, including an infant's food allergies or metabolic conditions.
- Breastfeeding can also be physically and mentally taxing, or simply incompatible "with the demands of work outside the home," the New York Times reports.
- In other words, they write: "breastfeeding isn't the answer to the formula shortage."
Go deeper. |     | | | | | | 2. Axios-Ipsos poll: 1 in 3 say the pandemic's over |  Data: Axios/Ipsos poll; Chart: Simran Parwani/Axios One in three Americans now says the pandemic is over — despite rising cases and hospitalizations — Axios' Margaret Talev writes about the latest installment of the Axios/Ipsos Coronavirus Index. The big picture: Respondents are more concerned about spreading COVID-19 to others or being inconvenienced by restrictions than getting sick or dying, the data shows. - "There appears to be a relatively small amount of Americans who are feeling any personal sense of risk," said Ipsos pollster and senior vice president Chris Jackson.
Be smart: In two new questions to the survey, 62% of respondents say they support the idea of local news broadcasts reporting daily on COVID rates in their area — and 57% support the idea of a the federal government funding a single national COVID monitoring system. - These numbers suggest majorities of Americans want to stay informed even if they aren't inclined to modify their behaviors any longer.
| | | | | | | | 3. Lawmakers eyes supplement, cosmetics oversight |  | | | Photo: Chris Hondros/Getty Images | | | | Top lawmakers on the Senate health committee are proposing to beef up FDA oversight of dietary supplements, cosmetics and lab-developed tests as part of a sweeping plan to reauthorize regulatory programs, Axios' Adriel Bettelheim writes. Why it matters: The agency has faced challenges looking out for unproven claims or companies that aren't safely manufacturing products. Where it stands: A draft plan released Tuesday by Senate HELP Committee Chair Patty Murray (D-Wash.) and Ranking Member Richard Burr (R-N.C.) would, among other things, require premarket approval of supplements and make manufacturers disclose what's in their products. - The FDA lacks authority to approve supplements, and firms generally don't have to provide evidence for the FDA to conclude the products are safe.
- Some supplement manufacturers are aggressively fighting the plan: The Natural Products Association says it would drive up consumer costs and weaken privacy protections for the industry's supply chain.
Go deeper: Murray and Burr's plan would also address the agency's oversight of lab-developed tests, which became a friction point during the Trump administration. - And it would require cosmetics manufacturers to track and report adverse events involving their products and make the FDA set good manufacturing practices.
- The proposals are wrapped in a larger package that would renew FDA user fees that help fund the agency's product evaluations.
- Any plan that emerges from the Senate would still have to be blended with a House FDA reform package.
| | | | | | | | A message from Blue Cross Blue Shield Association | | Increasing access to mental health care | | |  | | | | Too many Americans struggle silently with untreated mental illnesses. What you need to know: This Mental Health Awareness Month, see how Blue Cross and Blue Shield companies nationwide are expanding telehealth, making it easier for those in underserved communities to access the care they need. | | | | | | 4. Colorado court rules against $229K surprise bill | | The Colorado Supreme Court on Monday said that a woman isn't liable for a $229,112 medical bill, even though she signed a hospital services agreement ahead of time, because she didn't know about or agree to the facility's price, Axios' Caitlin Owens writes. Why it matters: The case revolves around what is covered by a patient-hospital contract, which the court essentially said isn't a blank check, Colorado Politics reports. Details: A patient received spinal surgery from a Centura Health hospital in Colorado in 2014. Initially, the hospital told her she'd owe around $1,300 out-of-pocket for the procedure, per the opinion. - But after the surgery, Centura determined that it had misread her insurance card and that the patient was out-of-network. It then billed her for nearly a quarter of a million dollars and sued the patient to collect it.
- Centura argued its chargemaster, or the database that lists rates for specific services and supplies, was incorporated in agreements signed by the patients.
- The court ultimately said it wasn't, and that "the hospital services agreements left the price term open."
The big picture: The case raises bigger questions of whether the federal surprise billing law would prevent something similar from happening now, or whether it has implications for the way surprise bills are ultimately hashed out between insurers and providers. - To avoid billing patients, the law sends surprise bills — which are often based on chargemasters — to arbitration to determine what rate is ultimately paid.
- "The interesting question is whether patients and/or insurers can use contract law, as it's used in the [Colorado Supreme Court] case, to resist arbitration amounts," said Barak Richman, a law professor at Duke University.
- "If an arbitration award is, say some compromise between an in-network price and a chargemaster price — and this is what the [American Hospital Association] wants — then it's possible that patients could say that that price was never agreed to," Richman added.
| | | | | | | | 5. Health tech's big rural divide |  Reproduced from Rock Health; Chart: Axios Visuals Long portrayed as a necessary convenience for health care, digital health tools are still failing to reach many of the 57 million U.S. residents in rural areas, Axios' Erin Brodwin and Sarah Pringle write about a new Rock Health report. - Details: Compared with people in suburban and urban areas, respondents in rural areas reported lower rates of live video use for telehealth, ownership of wearable tools such as rings and fitness bands and digital tracking of health metrics such as activity, weight, blood pressure and mood.
Between the lines: One big reason for the gaps includes lack of broadband access. But personal trust also influences these disparities. - Rural respondents were more likely to trust health info provided by a clinician, and a greater percentage of rural residents said they trust health data from a doctor than from a digital health tool.
- Yes but: While 20% of U.S. residents live in rural areas, only 11% of clinicians do.
| | | | | | | | A message from Blue Cross Blue Shield Association | | Increasing access to mental health care | | |  | | | | Too many Americans struggle silently with untreated mental illnesses. What you need to know: This Mental Health Awareness Month, see how Blue Cross and Blue Shield companies nationwide are expanding telehealth, making it easier for those in underserved communities to access the care they need. | | |  | It's called Smart Brevity®. Over 200 orgs use it — in a tool called Axios HQ — to drive productivity with clearer workplace communications. | | | | | | Axios thanks our partners for supporting our newsletters. If you're interested in advertising, learn more here.
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