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The ideas and innovators shaping health care | | | | |  | | By Evan Peng, Carmen Paun, Daniel Payne and Erin Schumaker | | | | |  Police across the nation are struggling to respond to the fentanyl crisis. | Getty Images | Drugmakers, distributors and pharmacies are paying New Jersey $1.1 billion to settle allegations they acted negligently in selling opioid pain relievers in the state, sparking an addiction crisis. A chunk of the money is going to law enforcement.
| | $19,440 The amount of its opioid settlement money Ramsey, N.J., is spending to acquire a drug-sniffing dog named Jack
| | POLITICO’s Daniel Han reviewed planning documents cities and towns have filed with the state explaining how they use their cut. The reports are incomplete, but they still provide insight into what local elected officials are thinking: — Mantua said funds would be used for increasing the number of police officers seeking to prevent overdoses among teenagers and young adults. The town didn’t explain what the police would do other than respond to emergency calls. — In addition to sniffing for drugs, Ramsey’s Jack will visit farmer’s markets and schools to attract kids to discussions of illegal drugs’ dangers. Another town, Mahwah, is also setting aside $20,000 for a K-9 program that two officials said would last for more than five years. — Verona, Holmdel, Ocean, Pennsville and Manville have already spent money on a one-day “National Night Out” community event with police, including $3,528 to distribute “Manville PD” branded items. — Manville also used $651 on a “Murder Mystery Summer Camp” for middle-school students. The “murder” involved opioids. Even so: New Jersey towns are allocating larger sums to treat people with substance use disorder than they’re alloting to law enforcement. Why it matters: The states are divvying up more than $50 billion in settlement funds, with most of the money earmarked for opioid remediation. But they have broad latitude to define what that means.
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Prince Edward Island, Canada | Shawn Zeller | This is where we explore the ideas and innovators shaping health care. Free will is circumscribed by biology, hormones, childhood and life circumstances, Stanford University’s Robert Sapolsky argues. The biologist and neurologist suggests that abandoning the concept could be “liberating” for most people, for whom “life has been about being blamed and punished and deprived and ignored for things they have no control over,” the New York Times reports. Share any thoughts, news, tips and feedback with Carmen Paun at cpaun@politico.com, Daniel Payne at dpayne@politico.com, Evan Peng at epeng@politico.com or Erin Schumaker at eschumaker@politico.com. Send tips securely through SecureDrop, Signal, Telegram or WhatsApp. Today on our Pulse Check podcast, host Lauren Gardner talks with POLITICO health care reporter Kelly Hooper about why new Biden administration rules requiring health insurers to detail their pricing are not helping employers shop around for better deals. | | | | | | | 
| The disparity in new HIV infections in the U.S. last year reflects the struggle in reaching people of color with effective treatments. How so? Of the nearly 38,000 new HIV infections in 2022, almost 40 percent were in Black individuals and more than 30 percent were in Latino individuals, according to the latest Centers for Disease Control and Prevention data. While use of PrEP drugs that protect against infection are rising – 36 percent of people who could benefit from PrEP had a prescription last year, up from 22.7 percent in 2019 – use is highest, by far, among white people. While 94 percent of white individuals who could benefit have a PrEP prescription, that number is under 13 percent for Black individuals and under 25 percent for Latino individuals. Plea for funding: Public health advocates say the government could do more to get the drugs to the people who need them. “The low usage of PrEP among the communities most impacted by HIV points to the need for increased and targeted federal resources,” said Carl Schmid, executive director of the HIV+Hepatitis Policy Institute. Even so: Budget cutters on Capitol Hill are targeting what outreach funding there is. House Appropriations Committee Republicans have proposed slashing millions in HIV funding and eliminating the CDC’s portion of the Department of Health and Human Services’ Ending the HIV Epidemic program, which then-President Donald Trump started with the goal of reducing new infections by 90 percent by 2030. Those cuts are unlikely to survive the Democratic-controlled Senate, but advocates are still pessimistic about the prospect for a funding increase.
| | | | DOWNLOAD THE POLITICO APP: Stay in the know with the POLITICO mobile app, featuring timely political news, insights and analysis from the best journalists in the business. The sleek and navigable design offers a convenient way to access POLITICO's scoops and groundbreaking reporting. Don’t miss out on the app you can rely on for the news you need. DOWNLOAD FOR iOS – DOWNLOAD FOR ANDROID. | | | | | | | | |  British doctors on strike in July | AFP via Getty Images | Public health leaders across the pond are dreading the unimaginable: a shift in Europe toward a U.S.-style health care system in which market forces play a major role. How so? A series of shockwaves to European economies — from the Covid-19 pandemic to the war in Ukraine, soaring inflation and an energy crisis — have European governments struggling to maintain their socialized systems. Citizens dissatisfied with their care are paying for treatment. That’s reducing support for so-called “solidarity systems” that prioritize equity. “I’m just back from the U.S., where I see a system I don’t want,” said Sandra Gallina, head of the EU’s health division.
| | “When public health systems fail, the private sector will fill in the gap — of course because that’s business.” Clemens Martin Auer, special envoy of health in the Austrian health ministry | | And yet: Despite widespread loathing of American-style health care in Europe, leaders there see the private sector creeping into their systems where the public sector has failed. Workers disheartened by low pay and burnout are quitting the public systems for jobs in the private sector, reports POLITICO’s Helen Collis. Today, there are around 1.8 million health worker vacancies in Europe. “That’s not a gap, it’s a gulf,” said Hans Kluge, head of the World Health Organization’s European division, at Europe’s leading public health conference, the European Health Forum Gastein, last month. Some rural areas of Europe are now becoming medical deserts. Other areas, particularly Eastern and Southern Europe, are losing their trained staff to countries that pay better. In Austria, the fastest growing health sector is the private sector, said Clemens Martin Auer, special envoy of health in the Austrian health ministry. Twist of fate: Health care experts long presumed it was the U.S. on the way to a single-payer system, with Obamacare a weigh station en route. Instead, Europe’s struggle to fund its public systems has prompted more of its citizens to seek private care. | | | | Follow us on Twitter | | | | Follow us | | | | |  |
