First Edition: October 15, 2019

Kaiser Health News: Think ‘Medicare For All’ Is The Only Democratic Health Plan? Think Again
If you tuned in for the first five nights of the Democratic presidential debates, you might think “Medicare for All” and providing universal care are the only health care ideas Democrats have. With four months to go before the Feb. 3 Iowa caucuses, proposals on issues like the opioid epidemic have attracted less attention. That is because big-ticket policy ideas ― like enrolling all U.S. residents into a Medicare-style program and eliminating private insurance ― can help candidates stand out in the eyes of voters during a primary, said Robert Blendon, a professor of health policy and political analysis at Harvard University and director of the Harvard Opinion Research Program. (Huetteman, 10/15)

California Healthline: How Newsom’s Bill-Signing Marathon Affects Your Health Care
Gov. Gavin Newsom wrapped up his bill-signing marathon Sunday, capping the end of a legislative session that will have a big impact on Californians’ health care and coverage. Some of the most high-profile — and contentious — measures of the year were health care-related: Who hasn’t heard of the bill that spawned raucous protests at the Capitol by anti-vaccine activists? After some hesitation, Newsom signed SB-276 and an accompanying measure, which will give state public health officials authority to review and, in some cases, revoke questionable medical exemptions for childhood vaccinations. (Ibarra, 10/14)

The Wall Street Journal: Democratic Debates: What The Presidential Candidates Are (And Aren’t) Saying
A close viewer of the Democratic primary debates so far this year might come away with an informed understanding of the presidential candidates’ views on certain policy areas, such as immigration and health care. ... Everyone in the 2020 Democratic field has taken sides on Sen. Bernie Sanders’s Medicare for All plan. Sen. Elizabeth Warren has said she’s “with Bernie” on expanding government-run health insurance, while former Vice President Joe Biden and South Bend, Ind., Mayor Pete Buttigieg have argued in favor of letting Americans keep their private insurance plans. Pete Buttigieg: “I propose Medicare for all who want it. We take a version of Medicare, we make it available for the American people, and if we are right, as progressives, that that public alternative is better, then the American people will figure that out for themselves. I trust the American people to make the right choice for them. Why don’t you?” (Secada and Stephenson, 10/15)

Axios: Four Health Care Questions For Tonight's Democratic Debate
If tonight’s Democratic debate is anything like the earlier ones, it will feature an extended back-and-forth about whether to eliminate private health insurance, and then move on from health care. But there’s a whole lot more that’s also worth asking about. (Baker, 10/15)

CNN: Democratic Debate: 12 Candidates Face High Stakes On Biggest Primary Debate Stage Ever
Addressing the health care system -- perhaps the most important issue for progressive voters -- could offer an opening for Sanders, who is keen to reestablish himself as the dominant liberal in the race. He hinted at a more aggressive approach toward Warren in an interview with ABC News' "This Week on Sunday." "There are differences between Elizabeth and myself," he said. (Collinson, 10/14)

The Hill: Progressives Fume At Buttigieg, Warn Him Not To Attack Warren At Debate
Progressives are warning South Bend, Ind., Mayor Pete Buttigieg not to attack Sen. Elizabeth Warren (D-Mass.) at Tuesday night’s Democratic debate in Ohio. Buttigieg, who has emerged as a center-left contender for the Democratic presidential nomination, has drawn the ire of progressives in recent days for remarks viewed as swipes against more liberal contenders like Warren and former Rep. Beto O’Rourke (D-Texas). (Easley, 10/14)

CNN: 2020 Democratic Candidates: Voter's Guide To Where They Stand On The Issues
Democratic presidential candidates are unified in their goal of defeating President Donald Trump in 2020. But they differ on what they’d do if they reach the White House. Some are seeking to restore the country to where it was when President Barack Obama left office and build on his legacy, while others are proposing policies – the Green New Deal and "Medicare for All" chief among them – that would move the country in a new direction. (10/14)

Los Angeles Times: Elizabeth Warren Flaunts Fitness As Candidates' Health Becomes Issue
As hundreds of people gathered for a recent Elizabeth Warren rally in Rock Hill, S.C., the heat built so much that one woman in the crowd passed out before the event started. The 90-degree day did not appear to slow Warren: She bounded up the steps to the stage and gave a kinetic, full-body wave to the crowd. Without saying a word, the 70-year-old presidential candidate sent a message: Her physical stamina belies her age. (Hook, 10/14)

Politico: When Elizabeth Warren Ducked And Dodged On Medicare For All
Seven years before Elizabeth Warren said “I’m with Bernie on Medicare for All," she was campaigning for the Senate and didn’t want to talk about single-payer health care. Running a tough race against Republican incumbent Scott Brown, the first-time candidate repeatedly distanced herself from the idea. In one interview, she was grilled by New England Cable News host Jim Braude: He wanted to know if she’d support single-payer if she were “the tsarina” — in other words, if politics weren’t an obstacle. (Otterbein, 10/14)

The Hill: Support Drops For Medicare For All But Increases For Public Option 
Support is dropping for Sen. Bernie Sanders' (I-Vt.) "Medicare for All" health care plan, according to a poll released Tuesday. The Kaiser Family Foundation tracking poll found that 51 percent of those surveyed in October favored Medicare for All, a proposal in which all Americans would get their insurance from a single government plan, compared to the 53 percent who said they supported it last month.  (Hellmann, 10/15)

Politico: Beto O’Rourke’s Campaign Found New Meaning In The Gun Debate. But Is He Hurting The Cause?
Tom Sullivan, a Colorado state lawmaker whose son, Alex, was killed in the Aurora theater shooting in 2012, met Beto O’Rourke one cloudless morning in September and, inside a glass-and-brick office building in downtown Denver, introduced him to several other people whose friends or relatives had been killed in mass shootings. They were seated at a table in a third-floor conference room of the Colorado Trial Lawyers Association, beside a largely untouched basket of bagels and a box of Starbucks coffee. Jane Dougherty, whose sister Mary Sherlach was murdered at Sandy Hook Elementary School in Newtown, Conn., in 2012, brought up the moment, at a presidential debate in Houston the previous week, when O’Rourke had said, “Hell yes, we’re going to take your AR-15, your AK-47.” (Siders, 10/15)

NPR: Trump Is Trying Hard To Thwart Obamacare. How's That Going?
The very day President Trump was sworn in — Jan. 20, 2017 — he signed an executive order instructing administration officials "to waive, defer, grant exemptions from, or delay" implementing parts of the Affordable Care Act, while Congress got ready to repeal and replace Barack Obama's signature health law. Months later, repeal and replace didn't work, after the late Arizona Sen. John McCain's dramatic thumbs down on a crucial vote (Trump still frequently mentions this moment in his speeches and rallies, including in his recent speech on Medicare). (Simmons-Duffin, 10/14)

Reuters: Vaping Illness, Deaths Likely Very Rare Beyond U.S., Experts Say
E-cigarette or vaping-linked lung injuries that have killed 29 and sickened more than 1,000 people in the United States are likely to be rare in Britain and other countries where the suspect products are not widely used, specialists said on Monday. Experts in toxicology and addiction said they are sure that the 1,299 confirmed and probable American cases of serious lung injuries linked to vaping are "a U.S.-specific phenomenon," and there is no evidence of a similar pattern of illness in Britain or elsewhere. (Kelland, 10/14)

The New York Times: How Investigators Could Pursue A Case Against Juul
The rise of vaping-related illnesses and deaths has put Juul squarely in the government's sights. Juul has dominated the e-cigarette market in the United States through its sales of flavored nicotine products. Michigan, Massachusetts and Rhode Island have banned sales of flavored e-cigarettes, while a similar move by New York was temporarily blocked by a court. The Trump administration also has announced that it wants to keep flavored e-cigarettes away from teenagers. (Henning, 10/14)

The Hill: Former Top Trump Health Official Says THC Vaping Should Be Banned
Former Food and Drug Administration (FDA) Commissioner Scott Gottlieb on Monday called for banning THC-based vaping products, as lung injuries tied to vaping have sickened more than a thousand people in the U.S. “Hardware marketed explicitly for vaping THC oils helped popularize consumption through vaping. This vaping has dangerous consequences and should be prohibited,” Gottlieb, who stepped down in April, said on Twitter. (Weixel, 10/14)

NPR: High School Vape Culture Can Be Almost As Hard To Shake As Addiction, Teens Say
When Will tried his first vape during his sophomore year, he didn't know what to expect. It was just something he had vaguely heard about at school. "I just sort of remember using it a bunch of times, like in a row," he says. "And there's this huge buzz-sensation-like head rush. And I just ... didn't really stop." Will kept vaping nicotine addictively for the next year and a half. He was part of a trend. Teens' use of e-cigarettes has doubled since 2017, according to the National Institute on Drug Abuse, with 1 in 4 high school seniors reporting use of a vape in the past month. (Yu, 10/14)

CNN: Vaping Is Increasing Among Younger People -- But Not So For Older Adults, Study Says
Vaping, often described as an "epidemic" in middle and high schools, was not significantly different among adults in the United States in 2014 vs. 2018, according to survey results published Monday. However, those numbers had been declining from 2014 to 2017, preceding an uptick largely attributable to the increasing popularity of vaping among 18- to 24-year-olds. In that age group, prevalence of e-cigarette use rose from 5.2% in 2017 to 7.6% in 2018. (Nedelman, 10/14)

The Washington Post: A Hometown Lawyer Is Suing The Nation’s Largest Drug Companies Over The Opioid Crisis
Paul Farrell, Jr. was looking through the West Virginia Code a few years ago when he came across a statute saying a county has the legal right to abate a “public nuisance.” Typically, that would mean things like trash heaps in someone’s front yard. But Farrell decided it might also describe prescription opioids. Farrell is a small-city lawyer in a place often described as the epicenter of the opioid crisis. His hometown has been flooded by pills — “a tsunami,” he says. A thousand people have died of drug overdoses here in less than two decades. (Achenbach, 10/14)

Los Angeles Times: Massive Opioid Case May End With Huge Settlement. Where Would The Money Go?
The largest civil trial in U.S. history is scheduled to begin in a matter of days, putting those who made, marketed, distributed and dispensed prescription painkillers under the legal spotlight. But those on the front lines of the opioid epidemic are already looking beyond the courtroom to the massive settlement they expect will ultimately resolve the case. Experts have little doubt it would be the most complex payout the country has ever seen. It would exact so much, from so many companies. And it would need to do so much for so many people, starting with the 2 million Americans ensnared in addiction. (Healy, 10/14)

The Hill: Almost Half Of Americans Have Dealt With Substance Abuse In Family: Gallup 
Nearly half of U.S. adults say that substance abuse problems have affected someone in their family, according to a new Gallup poll released Monday. Forty-six percent of respondents said they have experienced substance abuse in their family overall, with 18 percent reporting just alcohol problems, 10 percent reporting only drug problems and 18 percent reporting problems with both, according to Gallup. (Budryk, 10/14)

The New York Times: Faced With A Drug Shortfall, Doctors Scramble To Treat Children With Cancer
A critical drug that serves as the backbone of treatment for most childhood cancers, including leukemias, lymphomas and brain tumors, has become increasingly scarce, and doctors are warning that they may soon be forced to consider rationing doses. Persistent shortages of certain drugs and medical supplies have plagued the United States for years, but physicians say the loss of this medication, vincristine, is uniquely problematic, as there is no appropriate substitute. (Rabin, 10/14)

Stat: FDA Bid To Bolster Generics, Combat Shortages Isn't Working — Yet 
Although the Food and Drug Administration has maintained that additional generic approvals should promote competition and alleviate shortages, the proportion of approvals for drugs that could address those concerns has actually remained steady, according to a new report. From July 2016 to December 2018, the total number of generic drug applications approved by the agency gradually increased during most quarters, from 133 to 262. Of the 1,832 generics approved during that time, 20.4% faced limited competition at the time of the approval, and 39.1% had experienced a shortage in the previous five years. (Silverman, 10/14)

The Wall Street Journal: Drugmaker To Test Machine Learning To Prevent Drug Shortages
Merck KGaA plans to use analytics and machine learning to predict and prevent drug shortages, a move that could also save it money. Currently, the Germany-based pharmaceuticals company needs to stockpile medications to make sure it has enough on hand, meaning some of them expire before they can be used. Merck said its supply-and-demand forecasts are about 85% accurate today. (Castellanos, 10/14)

The Wall Street Journal: A Lot Of Women Work In Health Care. But Not At The Top. Why Is That?
Every year for the past four years, Harvard Medical School’s three-day workshop on career advancement and leadership skills for women in health care has sold out. More than 700 women will attend next month in Boston. For women in health, the ambition is there. The numbers are not. The health-care services industry has the highest share of women working in entry-level roles, according to new data from LeanIn.Org and McKinsey& Co. (Weber, 10/15)

The Wall Street Journal: What ‘Women’s Work’ Looks Like
A half-century after women began streaming into the workforce in large numbers, they have made significant gains in some fields once the domain of men, such as law and science. But the blurring of gender lines has been uneven, and many jobs continue to be done overwhelmingly by one sex or the other. To see which occupations have experienced the most change — and the least — The Wall Street Journal analyzed nearly five decades of data from IPUMS-CPS, a project by the University of Minnesota to enable analysis of Census and Labor Department data. (Bentley and Oh, 10/14)

The Wall Street Journal: Amazon Joins Trend Of Sending Workers Away For Health Care
Employers are increasingly going the distance to control health spending, paying to send workers across the country to get medical care and bypassing local health-care providers. One of the latest is Amazon.com Inc., AMZN 0.26% which will pay travel costs for workers diagnosed with cancer who choose to see doctors at City of Hope, a Los Angeles-area health system. More than 380,000 of the Seattle-based company’s employees and families across the U.S. are eligible for the travel benefit. (Evans, 10/15)

The Wall Street Journal: Johnson & Johnson’s Legal Challenges Mount
Johnson & Johnson, JNJ -0.46% facing lawsuits from more than 100,000 plaintiffs over its product safety and marketing tactics, has taken the aggressive strategy of battling many of the cases in court. And it is losing. A lot. Juries and judges have ordered the health-products giant to pay billions of dollars in several recent trials over claims that J&J’s signature baby powder and certain drugs and medical devices injured people, and that its marketing practices fueled the opioid-addiction epidemic. (Loftus, 10/14)

The Wall Street Journal: The Ethical Dilemmas AI Poses For Health Care
Could a machine-learning algorithm diagnose your next illness? Artificial intelligence can make diagnoses from digitized images such as mammograms and diabetic retinal scans. More sophisticated interventions might also be possible someday: algorithms that guide robots through surgery, for example, or even help restore motor control in paralyzed patients. (Ward, 10/14)

The Washington Post: Video Games Help People With Disabilities Find Friends And Transcend Real-World Limitations
When Jackson Reece lost his arms and legs to sepsis after already being paralyzed, he thought his life was over. It was video games that brought him back. “I don’t think about being disabled when I’m in my gaming setup and talking to everyone,” Reece, 33, said. “Just Jackson ‘pitbullreece,’ just sitting here playing, and that’s what makes me me.” In the United States, one in four people have a disability, according to Centers for Disease Control and Prevention. (Miller, 10/14)

The Washington Post: A Recent College Graduate Helps Nursing-Home Residents See The World — Without Leaving Home
Jim Halsey, 83, has traveled in his life to Japan and South Korea, through Europe and Central America. One recent day, he squatted in a narrow, wooden boat and watched as an elephant trudged through a swamp in Botswana. Halsey, who was an intellectual-property lawyer before he retired, didn’t have to leave his wheelchair at Powhatan Nursing Home in Falls Church, Va., to make the trip. He and about a half-dozen other residents at the retirement facility strapped on virtual-reality goggles and journeyed to the country in southern Africa, as well as to Antarctica. (Lumpkin, 10/14)

The New York Times: Air Pollution Is Linked To Miscarriages In China, Study Finds
Researchers in China have found a significant link between air pollution and the risk of miscarriage, according to a new scientific paper released on Monday. While air pollution is connected to a greater risk of respiratory diseases, strokes and heart attacks, the new findings could add more urgency to Beijing’s efforts to curb the problem, which has long plagued Chinese cities. Faced with a rapidly aging population, the government has been trying to increase the national birthrate, which dropped last year to the lowest level since 1949. (Qin, 10/14)

The Associated Press: Where You Die Can Affect Your Chance Of Being An Organ Donor
If Roland Henry had died in a different part of the country, his organs might have been recovered. And lives could have been saved. But the local organ collection agency said no. It gave no reason, no explanation to his family, though the Connecticut man appeared to be a well-qualified donor despite advancing age: He died in a hospital, on a ventilator, previously healthy until a car crash that led to a stroke. (10/14)

The New York Times: The New Makers Of Plant-Based Meat? Big Meat Companies
Beyond Meat and Impossible Foods, scrappy start-ups that share a penchant for superlatives and a commitment to protecting the environment, have dominated the relatively new market for vegetarian food that looks and tastes like meat. But with plant-based burgers, sausages and chicken increasingly popular and available in fast-food restaurants and grocery stores across the United States, a new group of companies has started making meatless meat: the food conglomerates and meat producers that Beyond Meat and Impossible Foods originally set out to disrupt. (Yaffe-Bellany, 10/14)

The Wall Street Journal: A New Way To Treat Hot Flashes—With Talk Therapy
A promising new treatment for menopause symptoms is using psychological techniques to change how women experience hot flashes. In a 12-week program at St. Joseph’s Healthcare Hamilton here, women learn to challenge the thoughts that can make hot flashes feel worse (everyone can see I’m having one) and replace them with more helpful ones (most likely no one will notice and they usually pass within a few minutes). They learn behavioral strategies like deep breathing to quell anxiety that can make hot flashes more distressing. (Petersen, 10/14)

The New York Times: Rx For Doctors: Stop With The Urine Tests
It’s such a common routine in a doctor’s office or clinic or hospital that patients tend to comply without thinking: Step on the scale, roll up your sleeve for the blood pressure cuff, urinate into a cup. But that last request should prompt questions, at the least. The urine test is the first step into what’s sometimes called “the culture of culturing.” (Span, 10/14)

The New York Times: CBD Or THC? Common Drug Test Can’t Tell The Difference
In June of 2018, Mark Pennington received troubling news from his ex-girlfriend, with whom he shared custody of their 2-year-old son. She had taken a hair follicle from the boy, she said, and had it analyzed at a lab. A drug test had returned positive for THC, the intoxicating compound in marijuana; evidently their son had been exposed to it, presumably in Mr. Pennington’s presence. He was told that, from then on, he would be permitted to see the child only once a week, and under supervision. (Lewis, 10/15)

The New York Times: Improve Your Bedtime Routine With These Five Luxurious Tips
When my better angels are in charge of my schedule — instead of the insatiable gremlin that won’t get off Instagram — I end the day by starting my bedtime routine: lighting candles; eating early, (three-ish hours before going to sleep, in a knockoff version of intermittent fasting, it makes for better digestion and for me, fewer nightmares); molting daytime clothes and obligations (no screens, so no social media, no texting, no email), and then floating around for 20 minutes of Vedic meditation; some at-home hypnotherapy; a little journaling; reading a book that asks nothing of me; and listing five “happinesses,” just some small things that I want to keep close. (Carraway, 10/15)

The Washington Post: Regularly Working Long Hours Is Linked To Increase Stroke Risk
For people who regularly work long hours — defined as more than 10 hours a day for at least 50 days a year — a recent study suggests an increased risk of stroke. According to research published in the American Heart Association journal Stroke, working such long hours is associated with 29 percent greater risk stroke than are those who work less. (Searing, 10/14)

The Washington Post: Three N.C. Elderly Care Employees Charged With Assault For Encouraging Dementia Patients To Fight
Three women have been charged with creating their own makeshift fight club in North Carolina. Their fighters were the dementia patients under their care at an assisted living facility, police say. Marilyn Latish McKey, 32, Tonacia Yvonne Tyson, 20, and Taneshia Deshawn Jordan, 26, were arrested and charged with assault on an individual with a disability in early October, according to authorities. (Beachum, 10/14)

Los Angeles Times: California Finds Widespread PFAS Contamination In Water Sources
Nearly 300 drinking water wells and other water sources in California have traces of toxic chemicals linked to cancer, new state testing has found. Testing conducted this year of more than 600 wells across the state revealed pockets of contamination, where chemicals widely used for decades in manufacturing and household goods have seeped into the public’s water supply. An analysis by the Los Angeles Times found that within this class of chemicals, called perfluoroalkyl and polyfluoroalkyl substances, the two most common compounds were detected in 86 water systems that serve up to 9 million Californians. (Phillips and Pesce, 10/14)

The New York Times: Indiana Mother Faces 6 Felony Charges After Son Attempted A School Shooting
An Indiana woman who called the police in December and told them that her 14-year-old son had threatened to shoot up his former school will face criminal charges if prosecutors have their way. Prosecutors in Wayne County filed an affidavit on Friday recommending six felony charges against the woman, Mary York, 43, in the episode, which ended when her son killed himself at David W. Dennis Intermediate School in Richmond, Ind. The police did not release the boy’s name because of his age. (Padilla, 10/15)

The Associated Press: Suit Challenges Speech Rules At Mississippi Abortion Clinic
Abortion opponents in Mississippi have filed a lawsuit challenging a local ordinance that will restrict noise levels and require protesters to remain a certain distance from the entrance of health care facilities. The lawsuit says the Jackson ordinance unconstitutionally limits free-speech rights as people try to persuade women not to end pregnancies. (10/14)

Los Angeles Times: Will Later School Start Times Mean More Sleep Or More Hassles For California?
Atussa Kian, 17, a senior at Arcadia High School, said she and many classmates are short on sleep because of schoolwork — an extra half hour of shut-eye would be welcomed. “It is quite common to hear others complain about their lack of sleep or the all-nighter they had to pull the night before,” Atussa said. “Students are encouraged to take up time-consuming extracurriculars and challenging schedules, which is decent advice. However, the physical and mental health of students is rarely factored into the discussion.” (Blume, Agrawal and Kohli, 10/14)

The Wall Street Journal: New York Nail-Salon Workers Say Poor Conditions Persist
New York City nail-salon employees are protesting what they say are poor working conditions, despite stricter state regulations aimed at improving safety. Yanelia Ramirez, a 38-year-old manicurist at Envy Nails in the Bronx, said she puts in long hours, gets paid only on commission and doesn’t get breaks to rest or eat lunch. “Basically, we just want to be treated like human beings,” she said through an interpreter. She said she gets headaches and skin irritation from the chemicals she handles. (King, 10/14)