Veterans Affairs Secretary David Shulkin, MD, is out and will be replaced by the White House personal physician; Iowa's governor will sign a bill allowing insurers to sell plans that don't comply with the Affordable Care Act; death certificates missing data lead to an undercounting of opioid overdose deaths.
Veterans Affairs (VA) Secretary David Shulkin, MD, has been removed from his position with the VA after weeks of speculation. CNN reported that President Donald Trump has nominated Rear Admiral Ronny Jackson, MD, to replace Shulkin. Jackson has served on the White House medical team since 2006 and was appointed as physician to the president by President Barack Obama. Shulkin was a holdover from the Obama administration who had initially been held in high regard by Trump. However, recently, Shulkin was the subject of a review that found ethical lapses during a trip to Europe. The day he was fired, Shulkin published an opinion piece in The New York Times on why he believes privatizing the VA is a mistake.
Although the Trump administration rejected a request from Idaho to allow insurers to sell plans that don’t comply with the Affordable Care Act (ACA), Iowa is planning to sign legislation that would do the same thing. Republican Governor Kim Reynolds plans to sign a bill approved by the state Senate, reported The Hill. The bill would allow small business and self-employed individuals to buy coverage through an association health plan that doesn’t comply with ACA requirements. It is unclear at this time how the Trump administration will respond to the law.
Opioid overdoses aren’t always captured in the data in death certificates, which can lead to an undercounting of opioid overdose deaths. According to Kaiser Health News, opioid-related overdose deaths may be undercounted by as much as 35%. The problem is that there is no baseline standard for reporting overdoses—standards can vary across states and counties. Coroners and medical examiners often leave out drugs that contribute to a death, and in some places, toxicology reports are optional.