The chief executives of seven pharmaceutical companies defended their pricing and business policies at a hearing of the Senate Finance Committee this week, reports USA Today . Although the CEOs agreed drugs should be more affordable for Americans, they were hesitant to commit to price reductions without additional reforms. Their argument was that other contributors, like pharmacy benefit managers who negotiate discounts and insurance coverage, play a bigger role in how much consumers pay. Merck CEO Kenneth Frazier described pricing as "complex and interdependent," and noted addressing cost, access, and affordability would require bringing "all the parties around the table." Patents grant drug companies exclusive rights to sell a drug for several years before generic companies can make competing versions. Sen. John Cornyn (R-Texas) stated, "I support drug companies recovering a profit," but "at some point, that patent has to end, that exclusivity has to end," so Americans have access to more affordable generics. Other lawmakers questioned whether Americans are subsidizing the cost of new drug development for the rest of the world, through higher list prices charged to U.S. consumers compared to other developed countries, and taxpayer-funded research grants that cover early scientific discoveries that might lead to new medications.

Glassdoor offers a strategy to spot and address employee underperformance, which is attributed to a host of issues. Issues include few growth opportunities and little job variety, a dearth of communication, work-related stress, the absence of a settling-in period, personal problems, a bad work environment, few challenges and incentives, vague goals or a lack of direction, and scarcity of on-the-job resources. Resolving such problems requires managers developing a plan with the employee, querying them on what difficulties they may be having, writing down those issues, and agreeing on a plan together. To provide the underperforming worker helpful feedback, managers are recommended to be specific and constructive, aware of any patterns that lead to underperforming behavior, to encourage and explain how making positive changes will improve employee development, and practice kindness. Should no improvement ensue, managers should first consult with their human resources department on the next step. Overall, they should invite the employee to a meeting in writing, ensuring they are given sufficient notice beforehand, stating that the employee has the right to be accompanied by a witness, and listing the reasons why the disciplinary meeting is happening. During the meeting, the employee should be offered the opportunity to defend their claim and supply evidence as to why they do not deserve a warning or dismissal. The worker should be informed that they can appeal the decision in writing if they feel it is unjust.

Illinois Gov. JB Pritzker recently approved a bill to incrementally raise the state's minimum wage to $15 per hour by 2025, reports the Littler . This makes Illinois the fifth state to pass a statewide minimum wage hike to that level, after California, New Jersey, New York, and Massachusetts. SB 1 stipulates that the minimum wage will increase with a slate of hourly rate adjustments over the next five years to achieve the $15 hourly rate. For workers at least 18 years old, hourly rates will rise from $8.25 to $9.25 per hour, starting Jan. 1, 2020. Six months later, the hourly minimum will climb to $10 per hour through the end of 2020. Afterwards, the minimum wage will go up by a dollar an hour on the first day of each year until it reaches $15 an hour on Jan. 1, 2025. Included in the bill are tax credits to help smaller businesses counter higher wages, and businesses with 50 or fewer workers will be able to claim a tax credit corresponding to 25 percent of the increased cost of wages paid from Jan. 1, 2020, through Dec. 31, 2020. This credit will then be phased out over the course of the scheduled wage increases, eventually falling to 5 percent of the increased cost of wages in 2025.

New nurses are predominantly working 12-hour shifts and nearly half work overtime, trends that have remained relatively stable over the past decade, according to a new study by researchers at NYU Rory Meyers College of Nursing. Amy Witkoski Stimpfel, PhD, RN, assistant professor at NYU Meyers, and colleagues analyzed surveys from more than 4,500 newly licensed nurses in 13 states and Washington, D.C., reports ScienceDaily . They found newly licensed nurses work an average of 39.4 hours a week, predominantly in 12-hour shifts. Twelve percent of nurses report working mandatory overtime (an average of less than an hour in a typical week), and nearly half (45.6 percent) work voluntary overtime (an average of three hours in a typical week). The study, published in the Journal of Advanced Nursing, also reveals that more than 13 percent report having a second paid job. Over the past decade, there was a decline in both mandatory and voluntary overtime during the economic recession by about an hour per week, but overtime hours rose for nurses first licensed in 2014-2015. Changes in health policy in recent years, such as the passage of the Affordable Care Act, have had implications for nurses. Stimpfel says she wanted to understand what these changes have meant for the newest generation of nurses.

If you're helping pay the expenses of your child and possibly your parent too, you may not have much cushion left for yourself. Nearly four in 10 middle-aged Americans have no emergency savings fund and a third have less than $25,000 socked away for retirement as many grapple with the financial strain of helping support children, aging parents or both, according to a survey by PNC Financial Services provided to USA Today . The results of the online survey of 36- to 60-year-olds, conducted in August, are broadly consistent with Federal Reserve findings earlier this year that 40 percent of adults can't cover a $400 emergency expense, or would have to borrow or sell something to do so. While 38 percent of those surveyed have no emergency fund, another 31 percent have a reserve that would last less than six months in case they lost a job or faced a similar unforeseen loss of income, according to the survey.

Progressive lawmakers in the U.S. House will today propose a Medicare for all bill, sponsored by Reps. Pramila Jayapal (D-Wash.) and Debbie Dingell (D-Mich.), and backed by more than 100 others, reports CNN . The legislation is similar to a prior Senate measure from Sen. Bernie Sanders (I-Vt.) and a House bill sponsored by former Rep. John Conyers (D-Mich.). The new House bill would retool the U.S. healthcare system by establishing a federal plan to insure all Americans, delivering generous coverage at no cost to beneficiaries while possibly cutting payments to many hospitals and doctors. "There are some things that should not be provided through the for-profit marketplace," said Jayapal. "Healthcare is one of them." More moderate Democrats suggest the plan is too costly and politically noxious, and prefer bills allowing Americans to buy into Medicare at age 50 or to purchase Medicaid coverage, which currently insures low-income people in all age brackets. House Budget Committee Chairman Rep. John Yarmuth (D-Ky.) doubts a Medicare for all vote will be held by this Congress, given the low probability of sufficient consensus in the Democratic caucus on a specific measure.

Democratic presidential hopefuls over the last several weeks have been struggling to explain their various healthcare proposals to voters without turning them off as the details become clarified, reports National Public Radio . Sen. Cory Booker (D-N.J.) has emphasized that he backs Medicare-for-all, with private insurers expected to contribute. Sen. Amy Klobuchar (D-Minn.) supports a public option, in the form of allowing people to buy into Medicaid, while deigning single-payer healthcare a long-term possibility. "Health reform is always more popular as a bumper sticker than as a piece of legislation," notes Larry Levitt at the Kaiser Family Foundation. He adds that when the details of Medicare-for-all start getting specified, voters' enthusiasm tends to slip. A January Kaiser survey showed nearly 70 percent of Americans favor Medicare-for-all if they are told it will eliminate premiums and out-of-pocket costs, but this support declines to about 40 percent if they hear it will entail higher taxes. Progressive healthcare overhauls also will likely inflate Republicans' derogatory labeling of Democrats as "socialists" as a way of depicting them as extremists.

Scientists at Northwestern University's Kellogg School of Management explored the constituent elements of successful teams, and found shared success to be a key factor, reports the Wall Street Journal . "Shared success is a distinguishing factor above and beyond skill," says Northwestern Professor Brian Uzzi. The researchers analyzed statistical data from professional sports leagues and a multiplayer online game, and Uzzi suggests a similar relationship may exist in the business domain, especially in fields such as technology, where the talent level is high and top performers are spread pretty evenly across organizations. Shared success lets teammates better understand each other's strengths and weaknesses, while a negative experience is less likely to be remembered and discussed, making valuable lessons harder to discern. Boosting the rate of shared success between team members from an average level to above average was linked to higher team scoring, and greater odds of winning. From these observations, Uzzi recommends managers use positive outcomes as teachable moments. If team performance is poor, managers should stress the positive aspects of the experience or even sponsor an activity outside of work, where the team can experience success together, understand each other's competencies, and better learn to share information.

Doctors at Weill Cornell Medicine in May will start testing a novel gene therapy in which people with the APOE gene variant that makes carriers highly susceptible to Alzheimer's will receive infusions of the variant with the lowest risk, reports Technology Review . Should this procedure retard disease progression in people who already have Alzheimer's, it could eventually lead to prevention therapy. Gene replacement efforts typically use viruses to carry DNA instructions into a person's cells, in attempts to correct rare diseases by replacing a single dysfunctional gene. Weill Cornell Medicine's Ronald Crystal said the project avoids the debate over the actual cause of Alzheimer's. "The approach we took is to ignore all that and think about it from a genetic point of view," he noted. Weill Cornell Medicine is currently seeking persons with two copies of the high-risk APOE gene who already are suffering memory loss, or even have an Alzheimer's diagnosis. The initial volunteers will receive an infusion into their spinal cords of billions of viruses carrying the low-risk APOE variant.

A study published in the Journal of Clinical Nursing said family caregivers and professional care assistants can retrospectively flag signs of dementia in those who go on to develop the condition, which could lead to earlier diagnosis, reports Medical Xpress . The research involved four hour-long focus groups. During the sessions, family caregivers and professional care assistants answered questions about their experiences of someone they cared for developing dementia. People who later developed dementia exhibited pre-clinical symptoms, including becoming annoyed more easily and being less able to cope if things went wrong, and becoming more isolated long before they received a diagnosis. Also emphasized was scope for earlier identification of possible dementia, which could enable individuals to take health advice and delay symptom onset, as well as make plans for their healthcare and finances before they become too unwell. "These pre-clinical signs could allow people to receive a diagnosis sooner, giving persons vital time to plan ahead and share their probable diagnosis with loved-ones," said Birmingham City University's Catharine Jenkins.