The New York Times: Open, Closed Or Something In Between: What A Shutdown Looks Like
The vast machinery of the federal government began grinding to a halt on Saturday morning, hours after the Senate failed to reach a funding deal. But like an aircraft carrier after its propellers stop turning, much of the bureaucracy will stay in motion for a while, and some essential services, like the armed forces, the post office and entitlement programs, will not stop working at all. ... While roughly half of the work force at the Department of Health and Human Services will be furloughed, the department said it would continue services that involve the safety of human life or the protection of property. Those include a suicide prevention hotline, patient care at the National Institutes of Health, and product recalls and other consumer protection services run by the Food and Drug Administration. (Landler, 1/20)

CQ: HHS Would Furlough Half Its Staff In A Shutdown
Roughly half the employees at the Department of Health and Human Services would be furloughed in the case of a partial government shutdown, according to a document outlining the department’s contingency staffing plans for the current fiscal year in the case of lapsed appropriations. (McIntire and Siddons, 1/19)

The Associated Press: How Shutdown Affects Key Parts Of Federal Government
Medicare, which insures nearly 59 million seniors and disabled people, will keep going. And so will Medicaid, which covers more than 74 million low-income and disabled people, including most nursing home residents. States will continue to receive payments for the Children's Health Insurance Program, which covers about 9 million kids. However, long-term funding for the program will run out soon unless Congress acts to renew it. Deep into a tough flu season, the Centers for Disease Control and Prevention will be unable to support the government's annual seasonal flu program. And CDC's ability to respond to disease outbreaks will be significantly reduced. (1/21)

The Washington Post: This Flu Season Keeps Getting Deadlier, And A Shutdown Will Make Things Worse
A bad flu season that has hit the entire continental United States has yet to peak and already has caused the deaths of more children than what normally would be expected at this time of the year, according to officials and the latest data released Friday. During the second week of January, more people sought care for flulike illnesses than at any comparable period in nearly a decade, the Centers for Disease Control and Prevention weekly report shows. Ten children died in the week ending Jan. 13, bringing the total number of pediatric deaths this flu season to 30. More than 8,900 people have been hospitalized since the season started Oct. 1. (Sun, 1/19)

Stat: Flu Response Will Be Maintained During Shutdown, Officials Say, Contrary To Previous Plan
The Centers for Disease Control and Prevention may be able to continue its immediate response to seasonal influenza in the event the government shuts down, a senior administration official said Friday night on a call with reporters. “CDC will specifically be continuing their ongoing influenza surveillance,” the official said. “They’ll be collecting data reported by states, hospitals, [and] others and they’ll be reporting that critical information needed for state and local health authorities.” (Mershon, 1/19)

The New York Times: Shutdown Goes Into Monday As Senate Inches Toward Deal
Senators failed on Sunday to reach an agreement to end the government shutdown, ensuring that hundreds of thousands of federal employees would be furloughed Monday morning even as the outlines of a potential compromise came into focus. For much of the day, feverish work by a bipartisan group of senators offered a reason for cautious optimism that a deal could be reached soon. By Sunday night, Senator Mitch McConnell of Kentucky, the majority leader, moved to delay until noon Monday a procedural vote on a temporary spending bill — a signal that talks were progressing. (Fandos and Kaplan, 1/21)

Politico: Congress Stuck In Shutdown Stalemate
Returning to the Capitol for a rare Saturday session, Republicans accused Democrats of prioritizing “illegal immigrants" over American citizens by insisting that protections for young immigrants facing deportation be included in any spending deal. Legislation that the House passed but that the Senate blocked early Saturday included six years of funding for health care for poor children. (Bade, Kim, Bresnahan and Cheney, 1/20)

Los Angeles Times: Congress Fails To Reach Deal On Ending Federal Shutdown, Pushes Vote To Monday
Hopes for a breakthrough grew after Senate Majority Leader Mitch McConnell and Schumer, who had not spoken for a day, huddled briefly on the Senate floor and met later Sunday to consider the proposal for a three-week temporary funding bill brokered by a bipartisan group of senators. "The shutdown should stop today," McConnell said. "Let's step back from the brink, let's stop victimizing the American people and get back to work on their behalf." (Mascaro, 1/21)

The Wall Street Journal: Senate Fails To End Government Shutdown, Plans Vote On Three-Week Spending Bill
Without an agreement Sunday night, a blame game that Democrats and Republicans carried on all weekend was likely to intensify, lawmakers said. “I am really worried about where this thing goes because it’s going to get nastier in terms of rhetoric,” said Sen. Lindsey Graham (R., S.C.), predicting it would hit both parties. “First prize in a government shutdown is you get to be dumb, not dumber. That’s the best you can hope for.” (Peterson, Andrews and Hughes, 1/21)

NPR: Who Will Carry The Blame For The Shutdown? Maybe No One
While a lot of furious negotiation has been going on behind the scenes on Capitol Hill to end a partial government shutdown, to voters and cable news viewers it may look like most of the work in Washington is going into pointing fingers. As the countdown to shutdown hit zero, an official White House statement called Democrats "obstructionist losers." (Seipel, 1/21)

Kaiser Health News: How The Shutdown Might Affect Your Health
A government shutdown will have far-reaching effects for public health, including the nation’s response to the current, difficult flu season. It will also disrupt some federally supported health services, experts said Friday. In all, the Department of Health and Human Services will send home — or furlough — about half of its employees, or nearly 41,000 people, according to an HHS shutdown contingency plan released Friday. (1/19)

Politico: The Religious Activists On The Rise Inside Trump's Health Department
A small cadre of politically prominent evangelicals inside the Department of Health and Human Services have spent months quietly planning how to weaken federal protections for abortion and transgender care — a strategy that's taking shape in a series of policy moves that took even their own staff by surprise. Those officials include Roger Severino, an anti-abortion lawyer who now runs the Office of Civil Rights and last week laid out new protections allowing health care workers with religious or moral objections to abortion and other procedures to opt out. Shannon Royce, the agency's key liaison with religious and grass-roots organizations, has also emerged as a pivotal player. (Diamond, 1/22)

In other news from the administration —

The Hill: Top Dem Presses Trump Health Official On Potential Ethics Violation
Sen. Ron Wyden (D-Ore.) says it appears a senior Trump administration health official has violated her ethics agreement by reviewing applications from states that employed her consulting firm. Wyden, the top Democrat on the Senate Finance Committee, sent a letter to the Department of Health and Human Services general counsel on Friday pressing for answers about the ethics agreement of Seema Verma, the administrator of the Centers for Medicare and Medicaid Services (CMS). (Sullivan, 1/19)

The Wall Street Journal: CDC To Scale Back Work In Dozens Of Foreign Countries Amid Funding Worries
The Centers for Disease Control and Prevention plans to scale back or discontinue its work to prevent infectious-disease epidemics and other health threats in 39 foreign countries because it expects funding for the work to end, the agency told employees. The CDC currently works in 49 countries as part of an initiative called the global health security agenda, to prevent, detect and respond to dangerous infectious disease threats. It helps expand surveillance for new viruses and​ ​drug-resistant bacteria, modernize laboratories to detect dangerous pathogens​and train workers who respond to epidemics. (McKay, 1/19)

Modern Healthcare: CMS' Focus On 'Meaningful Measures' Faces Hurdles
A CMS effort to turn the corner on achieving widespread use of outcomes-based quality measures is getting mixed reviews from providers and payers. Industry stakeholders support recent efforts by the CMS to focus on quality measures that are "meaningful" to clinicians and their patients. But questions remain about how effective the agency's work will be as uncertainty persists around which measures are actually the most valuable. The CMS' Meaningful Measures initiative, launched a few months ago, was a response to widespread concern across the industry that there are too many quality measures, most of which have little value to clinicians or patients. (Castellucci, 1/20)

The New York Times: Trump Tells Anti-Abortion Marchers ‘We Are With You All The Way’ And Shows It
In the daily din of scandal and turmoil that has dominated President Trump’s first year in office, it can be easily overlooked how transformative he has been in using his executive powers to curtail abortion rights. As thousands of anti-abortion marchers gathered on the National Mall in Washington in the annual March for Life on Friday, Mr. Trump ordered his administration to make it easier for states to cut off money for Planned Parenthood clinics that offer health care to low-income women. (Peters, 1/19)

The Associated Press: Trump Tells March For Life: 'We Are With You All The Way'
In an address broadcast from the White House Rose Garden, Trump said he's committed to building "a society where life is celebrated, protected and cherished. "The moment marked the president personally stepping to the forefront of the anti-abortion movement in the United States as the anniversary of his inauguration approaches. Last year, Vice President Mike Pence addressed the crowd in Trump's absence. In the year since, Trump has delivered on rules and policies he had promised in an effort to help curb abortion rights legalized 45 years ago. Chief among them is the confirmation of conservative Justice Neil Gorsuch. (1/19)

The Wall Street Journal: Trump Tells Antiabortion Marchers He Would Always Defend Right To Life
The president also touted his efforts to expand a policy to prevent federal funds from going to foreign organizations that perform or advise on abortions, spurring praise from antiabortion groups and criticism that the move would restrict women’s access to health care. Senior administration officials said last year that the ban now would apply to $8.8 billion in global health-assistance funds, expanding by almost 15 times the financial reach of an antiabortion policy first implemented by the Reagan administration in 1984. Coinciding with the march, officials at the Department of Health and Human Services said they are rescinding a federal Medicaid policy requiring states to pay for all non-abortion services performed at Planned Parenthood clinics. The move paves the way for states to exclude abortion providers from their Medicaid networks, significantly restricting the amount of money those clinics can receive. (Ballhaus and Hackman, 1/19)

Bloomberg: Trump Tells Abortion Opponents He’ll Defend ‘Right To Life’ 
The remarks, delivered in the White House Rose Garden, were shown on screens set up on the Mall. Trump is the first sitting president to address the 45-year-old march by live video. Previous Republican presidents have spoken to march participants by phone. Vice President Mike Pence spoke at last year’s event, which took place a week after Trump took the oath of office. (Epstein, 1/19)

Reuters: U.S. Health Agency Revokes Obama-Era Planned Parenthood Protection
U.S. health officials said on Friday they were revoking legal guidance issued by the Obama administration that had sought to discourage states from trying to defund organizations that provide abortion services, such as Planned Parenthood. The U.S. Department of Health and Human Services (HHS) officials also said the department was issuing a new regulation aimed at protecting healthcare workers' civil rights based on religious and conscience objections. (Humer and Abutaleb, 1/19)

In other news —

CQ: House Passes Bill To Protect Babies Born In Abortion Attempts
The House passed a bill by 241-183 Friday that would place additional precautions on late-term abortions, including the ability to prosecute health care professionals with fines and imprisonment for violations. The legislation is likely to face challenges in the Senate. The bill (HR 4712) by Rep. Marsha Blackburn, R-Tenn., would protect an infant who is born alive after an attempted abortion. A doctor would be required to administer the same level of care to such an infant as they would to any other child born at that stage. (Raman, 1/19)

Denver Post: 120 Turn Out To Protest Planned Parenthood Clinic That Organizer Calls Frontline Of Anti-Abortion Battle 
A big, steel-bar fence around the Planned Parenthood-Denver Stapleton Health Center on Saturday divided two sides of a polarizing issue: abortion. Colorado Right to Life held a March for Abolition across the street from the health center with a goal to abolish abortion in the state and the nation. Approximately 120 people turned out to the rally, most standing near huge signs, propped against cars, reading “Turn back we’re here to help you,” and “No peace with child sacrifice,” others depicted fetuses. (Hoffman, 1/20)

The Associated Press: Deportation Fears Have Legal Immigrants Avoiding Health Care
The number of legal immigrants from Latin American nations who access public health services and enroll in federally subsidized insurance plans has dipped substantially since President Donald Trump took office, many of them fearing their information could be used to identify and deport relatives living in the U.S. illegally, according to health advocates across the country. (Kennedy, 1/21)

CQ: Immigration Crackdown Raises Fears Of Seeking Health Care
With fears of arrest causing undocumented residents to recalibrate their everyday lives — including fewer trips for medical care — the consequences could cascade beyond the immigrant population. Skipped vaccinations or treatments could hasten the spread of infectious diseases. Avoiding treatment for chronic ailments invites a cascade of potential trouble, including more expensive and invasive care later. And when the patient is uninsured, those costs often are absorbed either by government health programs or by hospitals, which may cover the expense by hiking prices for insured patients. (Adams, 1/22)

And in other news —

CQ: Undocumented Kids Get Health Care In Six States, D.C.
On Jan. 1, Oregon became the sixth state, plus the District of Columbia, to offer health care coverage to undocumented children. Hospitals, doctors and other providers, as well as insurers that will administer the coverage, supported the move as a way to ensure that children stay healthy. The insurance will help families pay their medical bills, which will benefit the hospitals and doctors that care for them. (Adams, 1/22)

The New York Times: 1 Son, 4 Overdoses, 6 Hours
The torrent of people who have died in the opioid crisis has transfixed and horrified the nation, with overdose now the leading cause of death for Americans under 50. But most drug users do not die. ... In the 20 years that Patrick has been using drugs, he has lost track of how many times he has overdosed. He guesses 30, a number experts say would not be surprising for someone taking drugs off and on for that long. Patrick [Griffin] and his family allowed The New York Times to follow them for much of the past year because they said they wanted people to understand the realities of living with drug addiction. Over the months, their lives played out in an almost constant state of emergency or dread, their days dictated by whether Patrick would shoot up or not. (Seelye, 1/21)

The New York Times: How A ‘Perfect Storm’ In New Hampshire Has Fueled An Opioid Crisis
They sat on plastic chairs in a corner of the Manchester fire station, clutching each other in a desperate farewell. Justin Lerra was 26 when he turned himself in last summer to the fire department’s “safe station” program, which helps get drug users into treatment. He had been using drugs for seven years. His girlfriend, Sarah, who asked that her last name not be published, was pregnant and had told him that if he didn’t stop using, she would leave him. (Seelye, 1/21)

In other news on the crisis, the administration extends emergency public health declaration, debate continues over safe-injection sites, candidates for a congressional seat out of Maryland focus on opioids, and more —

The Hill: HHS Extends Trump's Emergency Declaration For Opioids 
The Trump administration has extended the opioid public health emergency issued by President Trump, days before that declaration was set to expire. In October, President Trump announced in the White House’s East Room that he was declaring the opioid epidemic a national public health emergency. The move was without precedent, as such declarations had in the past been reserved for natural disasters and the outbreak of infectious diseases. (Roubein, 1/19)

The Associated Press: Debate On In Massachusetts Over Safe Sites For Drug Users
The idea may seem jarring at first: Creating safe spaces where drug users can shoot up under the watchful eye of staff trained in helping counter the effect of potentially fatal overdoses — all with the approval of public health officials. But the terrible toll taken by the state’s opioid battle in recent years have prompted some lawmakers, activists and medical groups to endorse the idea of “supervised injection sites” as another way to reduce overdose deaths. (Leblanc, 1/21)

The Washington Post: Experiences With Opioid Addiction And Loss Fuel Md. Congressional Hopefuls
The candidates forum had the feel of a group-therapy session at times, as three of six Democrats running for an open congressional seat shared stories of close relatives who overdosed on opioids. A brother-in-law. A nephew. A father. “In the next 10 years with opioids, there will be probably a million people dead,” Total Wine co-founder David Trone said Wednesday night at a Hood College forum focused on health care and opioids. (Portnoy, 1/20)

The Star Tribune: Opioid Crisis Putting Strain On Minnesota's Child Protection Setup 
The opioid epidemic that has ravaged communities across Minnesota is also wreaking havoc on the lives of hundreds of children whose parents abuse drugs. New data from the Minnesota Department of Human Services (DHS) show that, as the opioid crisis tightened its grip on the Upper Midwest, the number of children being removed from their homes because of parental drug abuse has more than doubled since 2012. (Serres, 1/20)

Arizona Republic: Arizona Painkiller Laws: Ducey Seeks 5-Day Opioid Prescription Limit
Gov. Doug Ducey will seek to pass legislation next week that would limit new opioid prescriptions to five days and cap the amount of pain medication that can be prescribed for many people. ... In addition to imposing new caps on how much doctors can prescribe in many cases, the Republican governor wants to expand the availability of treatment with a $10 million fund for people who are struggling with addiction but can't afford treatment due to a lack of health-insurance coverage. (Alltucker and Nicla, 1/19)

Cincinnati Enquirer: Half Of Ohioans Favor Needle Exchange, New Poll Says
Public health officials Friday touted benefits of a newly reconstituted needle exchange in Hamilton County and Cincinnati as they disclosed a new poll that shows that just more than half of Ohioans favor the service. The poll, which also shows that about four in 10 Ohioans oppose needle exchange, was released [in] concert with Hamilton County Public Health's unveiling of the region's newest efforts to fight the heroin epidemic, the Exchange Project. (DeMio, 1/19)

Nashville Tennessean: Tennessee Gubernatorial Candidates Discuss Health Care, Opioid Crisis At Nashville Forum
Speaking at a forum centered on health care, the majority of Tennessee's top-tier gubernatorial candidates stressed the need to tackle the ongoing opioid crisis and the importance of getting the state's residents to live healthier lifestyles. The Friday forum, sponsored by the nonprofit Healthy Tennessee and Lipscomb University, featured six of the seven top-tier candidates in the race, with U.S. Rep. Diane Black, R-Gallatin, the only person to not make an appearance. (Ebert, 1/19)

Los Angeles Times: Death Toll Jumps Sharply After California Experiences Its Worst Week Of The Flu Season
The death toll from influenza in California rose sharply on Friday, amid a brutal flu season that has spread across the nation. State health officials said that 32 people under 65 died last week of the flu, making it the deadliest week this season so far. In total, 74 people under age 65 have died of the flu since October, compared with 14 at the same time last year. (Karlamangla, 1/19)

San Francisco Chronicle: California Flu Deaths Rise To 74, A Huge Increase Over A Year Earlier
The number of Californians who have died from the flu has risen to 74 as of the second week of January — five times the number seen at this point last year, according to figures released by state health officials Friday. Thirty-two people younger than 65 died from influenza during the second week of January, more than double the 15 deaths from the previous week, according to data from the California Department of Public Health. (Ho, 1/19)

New Orleans Times-Picayune: Flu Overwhelming Emergency Rooms In New Orleans
Emergency rooms in hospitals around New Orleans are experiencing an unprecedented volume of patients due in large part to the widespread flu outbreak that has affected most of the country. At one point last week, every single emergency room in the city was at capacity, according to Dr. Prateek 'Raj' Adhikari, the medical director of the Emergency Department at Tulane Medical Center. (Clark, 1/19)

Georgia Health News: Deaths Mount In Georgia As Flu Season Stays Severe
Seven more Georgians have died from the flu, bringing the total to 12 deaths across the state this influenza season, Public Health officials said Friday. There were 40 hospitalizations in metro Atlanta due to influenza infection during the week of Jan. 7 through Jan. 13, the state Department of Public Health said. (Miller, 1/20)

Pioneer Press: Flu Hitting Nursing Facilities In Minnesota, State Reports 
The flu bug has bitten Minnesota’s nursing care residents particularly hard this winter, a state health official said. “We’ve seen a record number of outbreaks,” said Kris Ehresmann, director of infectious disease epidemiology, prevention and control for the Minnesota Department of Health, in an interview on Thursday. “Our long-term care facility outbreaks are way up.” The health department’s weekly influenza report, released on Thursday, says 91 flu outbreaks at long-term care facilities have been reported in Minnesota so far this flu season. That includes 36 in the past week and 23 the week before that. (Lundy, 1/20)

Dallas Morning News: MedStar Sees 10-Fold Increase In Flu-Related Ambulance Calls 
This year's brutal flu season has meant more ambulance calls for MedStar: Since November, it has seen about a tenfold increase in flu-related ambulance calls. In November, before flu season ramped up, MedStar got an average of 1.8 flu-related calls per day. As of Friday, it had received 19.5 flu-related calls per day in January. (Branham, 1/21)

Marketplace: Using Smart Thermometers To Track Flu ... And Advertise
The United States is experiencing an especially bad flu season this winter. So grab your hand sanitizer, because we're taking on the topic with a look a smart thermometers, like the ones made by KinsaHealth. (Scott and Mills, 1/19)

The Wall Street Journal: What If Children Should Be Spending More Time With Screens?
Imagine someone traveling through time to the days before the internet, regaling audiences with fantastical tales of a future in which children can access devices containing the sum of all human knowledge and which gain new powers daily to instruct, create and bring people together. Now imagine this time traveler describing the reactions of most parents to these devices—not celebration, but fear, guilt and anxiety over how much time their children spend with them. That’s where we are today. Parents are frequently admonished that the most important thing to do with iPhones, iPads and computers is limit children’s access to them. (Mims, 1/22)

The Washington Post: Transgender Kids Are New Focus For Doctors And Entire Medical Field
The California wildfires were still raging last fall as Jennifer Bilstein and her 15-year-old son inched their way down Highway 101, a two-hour drive in ordinary times that took four hours through the smoke-filled air and yellow sky. She was determined to get Jacob to his doctor’s appointment on time. It was his second visit to the adolescent gender clinic, where Jacob — a shy boy with pink cheeks, a cowlick and black oversize glasses — was being medically evaluated to begin taking testosterone. (Solovitch, 1/21)

The New York Times: Yes, People Really Are Eating Tide Pods. No, It’s Not Safe.
It seems every few weeks another challenge takes social media by storm. Some, like the “Ice Bucket Challenge,” promote a cause. Others, like the bottle-flipping craze, are benign. But then there are those fads that are ill-informed or, worse, dangerous. The latest, the “Tide pod challenge,” belongs in that category. It involves biting down on a brightly colored laundry detergent packet of any brand and spitting out or ingesting its contents, an act that poses serious health risks. (Chokshi, 1/20)

The Wall Street Journal: China, Unhampered By Rules, Races Ahead In Gene-Editing Trials
In a hospital west of Shanghai, Wu Shixiu since March has been trying to treat cancer patients using a promising new gene-editing tool. U.S. scientists helped devise the tool, known as Crispr-Cas9, which has captured global attention since a 2012 report said it can be used to edit DNA. Doctors haven’t been allowed to use it in human trials in America. That isn’t the case for Dr. Wu and others in China. (Rana, Marcus and Fan, 1/21)

The New York Times: Oral Contraceptives Reduce Risk For Ovarian And Endometrial Cancers
The long-term use of oral contraceptives reduces the risk for ovarian and endometrial cancers, and the effect is especially evident in smokers, the obese and those who exercise infrequently, a new study found. Earlier studies have demonstrated an association of previous oral contraceptive use with reduced risk for these cancers in postmenopausal women. This study considered the impact of various health and lifestyle factors, including smoking, obesity and physical activity. (Bakalar, 1/19)

NPR: Cancer Patients Get Little Guidance From Doctors On Using Medical Marijuana
Even three queasy pregnancies didn't prepare Kate Murphy for the nonstop nausea that often comes with chemotherapy. In the early months of 2016, the Lexington, Mass., mother tried everything the doctors and nurses suggested. "But for the most part I felt nauseous 24/7," she said. Murphy, then 49 and fighting breast cancer, dropped 15 pounds from her already slim frame in just two months. Then, she remembered what a fellow cancer patient had advised while she was waiting for her first dose of chemo: "Make sure you get some medical marijuana." (Weintraub, 1/21)

The Wall Street Journal: Americans Say Marijuana Is Less Of Health Risk Than Tobacco, Poll Finds
Americans are polarized on many issues, but they tend to be on the same page when it comes to assessing the health risks from marijuana, compared with alcoholic beverages, tobacco or sugar. Far more people say a cigarette, an alcoholic drink or a candy bar are more harmful to a person’s overall health than pot, a new Wall Street Journal/NBC News survey finds. (Jamerson, 1/19)

NPR: What's The Science Behind Personalized Diets Based On Your DNA?
The idea that each of us has a unique nutrition blueprint within our genes is a delicious concept. Perhaps, this helps explain the growth in personalized nutrition testing and services such as Habit, Profile Precise and Nutrigenomix.So, what exactly can these tests tell you? (Aubrey, 1/22)

PBS NewsHour: Remembering AIDS Activist Mathilde Krim, ‘Mother Of The Movement’
The co-founder of amFAR (the American Foundation for AIDS Research), Dr. Krim died at the age of 91 this week. Her legacy was that of a most unusual triple threat: She easily bridged the worlds of science and public health; fundraising, Hollywood and activism; and pushing for changes to public policy in the halls of Washington, D.C. (Jacobson, 1/19)

The New York Times: One Day Your Mind May Fade. At Least You’ll Have A Plan.
When Ann Vandervelde visited her primary care doctor in August, he had something new to show her. Dr. Barak Gaster, an internist at the University of Washington School of Medicine, had spent three years working with specialists in geriatrics, neurology, palliative care and psychiatry to come up with a five-page document that he calls a dementia-specific advance directive. (Span, 1/19)

NPR: When A Tattoo Literally Means Life Or Death
The man was unconscious and alone when he arrived at University of Miami Hospital last summer. He was 70 years old and gravely ill. "Originally, we were told he was intoxicated," remembers Dr. Gregory Holt, an emergency room doctor, "but he didn't wake up." "He wasn't breathing well. He had COPD. These would all make us start to resuscitate someone," says Holt. "But the tattoo made it complicated." (Hersher, 1/21)

The Wall Street Journal: How Hospitals’ Woes Are Making Health Lines Blur
Hospital chains are responding to continued health-care consolidation with some vertical integration of their own. It is the latest sign that traditional industry borders are starting to break down. Four large systems, comprising about 300 hospitals in total, said this week that they are banding together to create a nonprofit generic-drug company. The goal is to curb shortages of commonly used medicines in hospitals as well as to pre-empt financial damage from sudden price increases on them. (Grant, 1/19)

The Star Tribune: UnitedHealth And Walgreens Are Mixing Urgent Care With Pharmacy 
The tiny suburb of Hilltop, located just north of Minneapolis, is hosting an experimental mash-up of health care services that’s helping to generate buzz on Wall Street. Hilltop is one of more than a dozen locations across the country where pharmacy giant Walgreens has carved out space in its stores for urgent care clinics from MedExpress, a company that Minnetonka-based UnitedHealth Group acquired in 2015. (Snowbeck, 1/20)

San Jose Mercury News: California May Buck Congress With Its Own Health Insurance Requirement
With Congress ending the requirement that all Americans have health insurance, California leaders are preparing to counter that move by securing health care for as many residents as possible in a fortified state insurance exchange. State lawmakers say they will present a package of health-related proposals in the coming weeks, before a Feb. 16 deadline for new bill introductions. (Aguilera, 1/21)

Milwaukee Journal Sentinel: Wisconsin Gov. Scott Walker Wants $200 Million To Stabilize Obamacare
Stepping toward the political center in a difficult election year, Gov. Scott Walker proposed using $200 million in state and federal money to stabilize the state's Obamacare market and hold down rising insurance premiums. While Republicans nationally talk about tax cuts, Wisconsin's GOP governor has mixed in proposals on health care, the overhaul of a troubled youth prison and funding schools at levels proposed by a leading Democratic challenger. (Stein and Marley, 1/21)

And a look at why fewer Americans have health insurance —

Marketplace: Here’s Why More Americans Now Lack Health Insurance
This week the Gallup-Sharecare Well-Being Index reported that more than 3 million fewer Americans had health insurance at the end of 2017 compared to the previous year. It's the first time since key provisions of Obamacare went into effect in 2014 that the uninsured rate went up. (Gorenstein, 1/19)

Chicago Tribune: 'Pharmacy Deserts' A Growing Health Concern In Chicago, Experts, Residents Say 
Growing portions of Chatham and more than a dozen other poor Chicago neighborhoods, mostly on the city’s South and West sides, are becoming “pharmacy deserts,” say some public health experts. The term describes a community with limited access to a pharmacy, whether retail or independent. Hospital inpatient pharmacies are not typically included in these counts, as they dispense medicine only to hospitalized patients. In Chicago, research has shown most of these neighborhoods share a mix of characteristics: Their residents tend to be low-income, immigrants, and/or black and Latino. And, experts argue, given the widening scope of services many pharmacies are providing, including physicals, immunizations, drug counseling, sexually transmitted infection screening and other laboratory testing — even access to naloxone, the medication used to reverse opioid overdose — pharmacies are increasingly important pieces of the national conversation around health care, especially where health inequity already exists. (Olumhense and Husain, 1/22)

KCUR: Kansas Nursing Home Operators Say Regulation Putting Them In Crisis 
Nursing homes in Kansas find themselves in crisis, say the people who run them. Where to fix blame or how to remedy things remain matters of debate. A parade of nursing home operators and their lobbyists pleaded with members of a Kansas House health committee Thursday to fully restore cuts in Medicaid reimbursement rates. They also called for pressure on Gov. Sam Brownback’s administration to repair a long-broken Medicaid enrollment system. (McLean, 1/19)

Houston Chronicle: Rape Allegations Embroil Kingwood Pines Psychiatric Hospital In Houston 
A Houston Chronicle review of medical records, court filings, hospital accreditation reports and records from state and federal regulators, and interviews with parents, portray an understaffed facility that has failed to watch over patients, leaving the most vulnerable among them open to further victimization. The parents of the two girls agreed to talk to the Chronicle on the condition they be identified by first names only, to protect the privacy of their daughters. The Chronicle does not typically identify the victims of alleged sexual assault. (Barned-Smith, 1/19)

The Star Tribune: Success Stories Like Rod Carew's Credited For Boost In Upper Midwest Organ Donors 
Organ donations reached record levels in Minnesota and neighboring states in 2017 — as did the number of people willing to donate in the future, according to the LifeSource organ procurement agency. Decisions last year by 184 grieving families to donate the organs of dying loved ones resulted in 586 transplants, mostly to replace failing kidneys, livers, and hearts, the agency reported. (Olson, 1/20)

Austin American-Statesman: Texas Foster System ‘Still Broken,’ Federal Judge Rules
The Texas foster care system remains broken and continues to place children at risk, a federal judge ruled Friday, adding that state officials have shown a “troubling unwillingness” to fix problems the court had identified in a similar 2015 order. Overruling numerous objections raised by lawyers for Texas, U.S. District Judge Janis Graham Jack of Corpus Christi ordered Texas officials to adopt almost 100 changes, including reduced workloads for caseworkers, a ban on children sleeping in state offices and steps to better monitor, and reduce, sexual abuse. (Lindell, 1/19)

The Hill: Nurse Claims She Was Fired For Supporting Trump
A Denver nurse has filed a lawsuit claiming she was fired from her former hospital for supporting President Trump in the 2016 election. The nurse reportedly discussed her support of Trump with a patient. Lizzy Mathews, who had worked at Denver Health Medical Center for 27 years, filed the lawsuit on Jan. 11 with Denver's U.S. District Court against Kelly Torres and Marc Fedo, the hospital's nursing manager and director of acute nursing. (Delk, 1/20)

Miami Herald: House Hurricane Report Is Vague On Oversight Of Emergency Plans
This week, amid pressure to improve the state’s hurricane response and prevent similar tragedies, a House committee released post-Irma recommendations, including new criteria for such emergency management plans. But the recommendations say little about how to increase oversight that might have flagged problems in the Hollywood facility’s plan. (Koh, 1/21)

San Francisco Chronicle: CPMC To Shut Down Alzheimer’s Program; Residents Scramble For Alternatives
One of San Francisco’s only subsidized residential care centers for Alzheimer’s patients will shut down by the end of 2018, prompting worry among family members, caregivers and officials about the dwindling availability of affordable care for dementia patients in an aging city. (Ho, 1/21)

Milwaukee Journal Sentinel: Milwaukee City Expert Raised Lead Concerns Nearly 3 Years Ago
Nearly three years ago, a city expert alerted Mayor Tom Barrett's top health official of the looming threat facing thousands of Milwaukee children who get their drinking water from antiquated lead pipes. The memo with its warning — that replacing water mains would disturb the pipes and significantly raise lead levels — went nowhere. (Johnson, Spicuzza and Bice, 1/19)

Columbus Dispatch: Shortage Of IV Bags Forces Central Ohio Hospitals To Get Creative
Health-care providers are reviewing whether such bags are a must-have on a patient-by-patient basis and using different ways to deliver drugs, such as pushing them into an IV line with a syringe or switching to oral or skin-injected medications. Available bags are reserved for the most critically ill or for patients for whom there are no other viable options. (Viviano, 1/22)

Texas Tribune: Drinking Water Contamination Pronounced In Texas' Rural Areas
The latest, published earlier this month by the Washington D.C.-based Environmental Working Group, identified 37 water utilities serving nearly 25,000 Texans in violation of federal standards for radium — a known carcinogen that the U.S. Environmental Protection Agency says isn't safe for human consumption at any level. All of the utilities are in small towns or rural areas, with a majority serving populations under 300. (Cobler, 1/22)

Kansas City Star: Corizon Health Has $2 Billion In Contracts With Kansas, Missouri. But There's Little Accountability
Corizon’s contracts with the corrections departments of Kansas and Missouri are worth almost $2 billion combined over 10 years — yet there’s little transparency about how that money is being spent. ...As the largest for-profit prison health care provider in the country, Corizon is a lightning-rod for criticism from prisoners, their family members, the American Civil Liberties Union and others who say it takes public money and provides little care. (Marso, 1/21)

Nashville Tennessean: Meharry To Hold "Listening Session" Amid Uncertainty About Nashville General's Future
Meharry Medical College will hold a community meeting to discuss the future of healthcare amid uncertainty over the fate of the city's public hospital. The "listening session" will be held Tuesday, Jan. 23 at First Baptist Church, Capitol Hill from 5 - 6:30 p.m.The plan for a community meeting comes after medical school officials weathered criticism for excluding the public from "stakeholder" meetings convened in the aftermath of Mayor Megan Barry's plans to end inpatient care at Nashville General Hospital this year. (Wadhwani, 1/19)

Tampa Bay Times: Free Clinics Respond As More People Head To The ER With Dental Problems
Most adults who don’t have dental insurance end up in emergency rooms because of tooth or gum problems. The number of patients who go to the ER with dental-related issues surged from 1.1 million in 2000 to 2.1 million in 2010, and continues to rise, according to the American Dental Association. (Griffin, 1/22)

The CT Mirror: West Hartford Teenager Hopes To Bring Dental Exams To Schools
Connecticut has made huge strides in improving access to dental care and reducing disparities over the years, but health care advocates and providers are concerned about what will happen going forward given the state’s financial challenges and potential Medicaid cuts at the federal level. One teenager from West Hartford hopes to help more school-aged kids receive dental exams during these uncertain times. (Rigg, 1/21)

Chicago Tribune: Measles Case Prompts Vaccine Reminder
With the first measles case confirmed in the state since 2016, health officials and physicians are reminding people to check their vaccination records and vaccinate their children. The case involved an international student who arrived at Indiana University in Bloomington for orientation on Jan. 2 and became ill on Jan. 3, according to Chuck Carney, director of media relations and spokesperson. "Measles is one of those interesting viruses that is quite contagious," Stamp said. "Our vaccine works well, but it doesn't work forever, and so sometimes, we do anti-body testing to see if people are immune still or not and we can re-vaccinate if that's the case. " (Webster, 1/22)

USA Today: On Medicaid Work Requirements, Who Will Judge The Character Judges?
Meet some of the people who benefited from the Obamacare expansion of Medicaid: A bedridden woman with a severe hernia who had the surgery she needed and went back to work. A person now getting treatment for bronchitis and asthma so “I'm able to be healthier and be more functional at work and able not to miss work.” People who said “I had a lot of health problems before. … Now I am able to work more.” And “I am finally getting everything that was wrong with me fixed so that I can go back to work.” . ... No doubt there are malingerers and cheaters on Medicaid, just like there are people and companies that “game the system” to get tax breaks, subsidies or government contracts. But I don’t want my country to make medical care contingent on some politician’s view of what constitutes a deserving person. (Jill Lawrence, 1/22)

Charlotte Observer: Medicaid Expansion Compromise Would Be Good For North Carolina
Republicans have stripped Gov. Roy Cooper of some of his power and Cooper has tried to block their excesses wherever he could. All of which makes what’s happening in the capital now especially noteworthy. Specifically: Cooper’s administration is seeking permission from the Trump administration to require Medicaid recipients to work, if the legislature expands Medicaid to some 400,000 North Carolinians who don’t currently qualify. (1/19)

Modern Healthcare: Medicaid Work Requirements, End Of Individual Mandate Raise Responsibility Questions
Less than one-third of the 80 million people on Medicaid are working-age adults. Of that group, 60% are already working full- or part-time and qualify for Medicaid because they make so little money. Among the remaining 10 million, over 90% are disabled, in school or taking care of someone at home. That leaves less than 1 million people nationwide who are unemployed, able to work and on Medicaid. It's shocking the number is that low. (Merrill Goozner, 1/20)

Chicago Tribune: Is A Medicaid Work Requirement Fair?
Illinois has moved many Medicaid beneficiaries to managed care in the past few years to cut costs and improve quality. Imposing a work requirement wouldn’t knock the neediest off the rolls. But it could prompt many to get jobs — and thus health coverage via employers. There are potential pitfalls. Medicaid was designed to help people gain routine health coverage. The Obamacare Medicaid expansion was supposed to help keep people out of the emergency room for such routine care. If many of these recipients lose that coverage because of the work requirement, they could wind up using the emergency room for basic care. That’s hugely expensive and wasteful. That said, we’re reminded of dire predictions that accompanied welfare reform — predictions that didn’t come true. (1/21)

Roll Call: Now More Than Ever, Medicare Needs Its Public Trustees
Lost in Washington’s political cacophony is the alarming erosion of the financial foundations of Social Security and Medicare. Focused on more immediate crises and reluctant to touch this “third rail” of politics, today’s lawmakers, like many before them, have avoided even discussing the inevitable painful adjustments they will be forced to make. Whenever Congress shakes off its inertia and begins to take action, it will look to independent analysis of the programs’ finances. That analysis is currently provided by the boards overseeing Social Security and Medicare, but unfortunately, the seats of their two public trustees — who are essential to maintaining public confidence in the findings — have been empty for more than two years. (Charles P. Blahous III and Robert Reischauer, 1/22)

Columbus Dispatch: Number Of Uninsured Isn't Only Thing Going Up
In what might be the most predictable trend of the Trump era, the uninsured rate appears to be increasing. Because young people (along with African-Americans and Hispanics) saw the biggest declines in coverage, health-care premiums will likely rise for most Americans faster than they otherwise would. (1/19)

The Wall Street Journal: A Dose Of Accountability For The FDA
One welcome development last year was a productive Food and Drug Administration, which approved more than 1,000 generic drugs and dozens of novel therapies. But FDA rejections can also be important for patients and innovation, and Commissioner Scott Gottlieb can prioritize a project that would add more public accountability to the approval process. Mr. Gottlieb said in a speech last week that the agency is looking into releasing more information in “complete response letters,” the euphemism for FDA rejection notices. Under current practice FDA doesn’t release details of why the agency is withholding approval, and the agency’s justification is that this protects the proprietary information of drug sponsors. ... Yet this can leave the public with little understanding of why a therapy wasn’t approved. Especially with treatments for rare or deadly diseases, patients deserve to know why a promising therapy will be delayed or isn’t going to pan out. (1/21)

Los Angeles Times: We're Underfunding Research On Vaccines That May Be Able To Prevent Another Terrible Flu Season
Seasonal influenza — the flu — sickens and kills many Americans in a good year, and this is already a bad one. According to the Centers for Disease Control and Prevention, since 2010, flu has annually caused "between 9.2 million and 35.6 million illnesses, between 140,000 and 710,000 hospitalizations and between 12,000 and 56,000 deaths." In this season, which began in November and won't end until March, hospital emergency rooms are overflowing, deaths are running ahead of recent years and pharmacies are low on the anti-flu drug Tamiflu and intravenous solutions needed to keep patients hydrated. (Henry I. Miller, 1/19)

Los Angeles Times: The Trump Administration Just Found Another Way To Deny Women Their Right To An Abortion
Doctors who don't want to assist with abortions, sterilizations or suicides can now turn to a new office within the federal Department of Health and Human Services for help — a "Conscience and Religious Freedom Division," part of the HHS office tasked with stopping discrimination and privacy violations by federally funded agencies, hospitals and universities. But what about people who need one of those procedures but can't find a doctor willing to help? That particular bit of fallout appears to have escaped HHS' notice. (Jon Healey, 1/19)

Boston Globe: A New Rule Allows Discrimination Against Transgender Individuals For Medical Care
It seems too cruel, even by the standards of the Trump administration: This week, officials said they would allow medical professionals and institutions who claim religious objections to deny coverage to transgender people and other individuals. ...Under the administration’s new regulations, a new federal agency will be responsible for fielding and investigating complaints from doctors, nurses, and other health care providers who feel they have been coerced into serving transgender individuals or women seeking abortions or sterilizations. (1/20)

Boston Globe: How To Fight The Opioid Epidemic
On some levels, 2017 was a year of progress for addiction treatment, prevention, and management. ...Yet none of these initiatives reduced the number of overdose deaths, which exceeded 60,000 in 2016 and is sure to be higher when the 2017 data are released. (Raymond V. Tamasi, 1/22)

Stat: Taking A Grassroots Approach To Fighting The Opioid Epidemic
A group of organizations including the Washington state chapter of the American College of Emergency Physicians, the Washington State Medical Association, and the Washington State Hospital Association — as well as the state’s hospitals — were given the responsibility of finding their own way to lower emergency care for the highest users of emergency room care, 48 percent of whom had substance abuse problems. We launched the ER is for Emergencies program in the summer of 2012. Within just 12 months it had reduced emergency department visits by nearly 11 percent. (Hamad Husainy, 1/19)

Bloomberg: Why Hospitals Aren't In The Drug Business
Companies tend to pursue vertical integration for the same reasons that these hospitals are: because they are fed up with high prices and short supplies of some key input. They figure that if they got into the business, they’d produce as much as was needed, and eliminate all the grotesque profits their suppliers are enjoying -- or better yet, capture those profits for themselves. Rarely do they seem to stop to ask the reasons for the high prices and the scarcity, or to wonder whether those reasons will magically go away once they own their suppliers ... It’s understandable if hospitals and patients don’t really care why the prices are going up. But it does matter, because the reasons for the price increase tell us a lot about how successful this hospital-led effort is apt to be. (Megan McArdle, 1/19)

Chicago Tribune: How To Win Friends And Not Give Influenza To People
Every boss, every co-worker, every sane person should deliver the same message to flu sufferers: You aren’t that important. We can get along for a few days without you. Or consider this: If you infect your office mates, you’ll be the one doing their work when you’re back and they’re still home in bed, suffering and blaming you. (1/20)

Stat: AIDS Activist Mathilde Krim Saved My Life
Mathilde Krim, an indefatigable fighter against the virus that causes AIDS and a stalwart champion of those infected with it, died this week at age 91. Her death is a loss for the HIV/AIDS community, and for me personally. Krim saved my life — although not exactly in a way I could have imagined — and it was more than a decade before I could tell her my story and thank her on behalf of so many others. (Steven Petrow, 1/19)

Lexington Herald Leader: Get Insurers Out Of Doctor-Patient Relationship
Patrick T. Padgett, executive vice president of the Kentucky Medical Association, made several valid points in his commentary, “Patients shouldn’t have to pay for Anthem’s poor business decisions.”Another way to say this is, “Patients and their physicians should have more control over their health-care decisions.” (Molly Rutherford, 1/19)

The Washington Post: The Bad Flu Season Has Revealed A Dangerous Problem With Our Medical Supply Chain
Flu season in the United States typically peaks in February, but this year’s outbreak is already one of the worst on record. As of Jan. 6, 20 children have died of influenza, and overall mortality caused by the flu is already double that of last year’s. One reason the flu is so severe this season is that the dominant strain is H3N2, which has an impressive ability to mutate and is particularly aggressive against Americans over 50. (Morten Wendelbo and Christine Crudo Blackburn, 1/21)

Los Angeles Times: Fearing A Rebuff In Court, Lead Paint Companies Are Trying To Stick Taxpayers With Their Cleanup Bill
Three big paint companies must be terrified that they are going to be thrown for a big loss by the California Supreme Court — a loss worth hundreds of millions of dollars to them. We know this because the companies are spending millions to push a ballot measure that would nullify, as though by the back door, the judgment being considered by the court. You wouldn't know it by reading the text of the proposed initiative; you have to read between the lines. To grasp the true intent of the measure, you'd have to know that in 2014, in a lawsuit brought by 10 California cities and counties, a state judge ordered the three former manufacturers of lead paint — Conagra, NL Industries and Sherwin-Williams — to spend $1.15 billion to abate the dangers from that paint still in California homes. (Michael Hiltzik, 1/18)

Cleveland Plain Dealer: Fentanyl-Laced Cocaine Is Ohio's Newest Killer - But We Can Combat This Scourge
Fentanyl has started killing cocaine users in Ohio at a faster pace than the death toll for heroin. ...The shift in who's dying and what drug is carrying fentanyl or one of its many variants has gone unnoticed in Ohio's massive response to drug overdoses, which erroneously treats fentanyl as super-strong heroin. It is not. (Dennis Cauchon, 1/19)

The Wall Street Journal: Single-Payer Health Care Isn’t Worth Waiting
When Brian Day opened the Cambie Surgery Centre in 1996, he had a simple goal. Dr. Day, an orthopedic surgeon from Vancouver, British Columbia, wanted to provide timely, state-of-the-art medical care to Canadians who were unwilling to wait months—even years—for surgery they needed. Canada’s single-payer health-care system, known as Medicare, is notoriously sluggish. But private clinics like Cambie are prohibited from charging most patients for operations that public hospitals provide free. Dr. Day is challenging that prohibition before the provincial Supreme Court. If it rules in his favor, it could alter the future of Canadian health care. (Sally Pipes, 1/21)

The Wall Street Journal: How To Save Football Players’ Brains
Football is entertaining to watch, but it’s a violent collision sport that causes the majority of traumatic brain injuries in athletes. During a high-school season, one study finds, nearly 1 in 5 players on any given team will suffer a concussion. Many will suffer more than one. ... If opposing linemen simply started each play upright, in a knees-bent “ready” position, with their hands in front of them, it would nearly guarantee that their hands and arms, rather than their heads, would be the first body parts in contact. (Paul S. Auerbach, 1/19)

San Antonio Press-Express: Flawed Data Undermining Efforts To Reduce Pregnancy Related Deaths
Texas has a big problem with a high number of pregnancy-related deaths and that problem just got bigger. Researchers have concluded the data being used to document cases of women dying during pregnancy, in childbirth or in the six weeks following a child’s birth is so bad it undermines efforts to develop an effective prevention program. (1/19)