The Washington Post: Abortion Battles Are Heating Up Ahead Of November Midterms
Mississippi’s governor just signed a law, more restrictive than in any state, banning abortions after 15 weeks. Iowa’s state Senate is trying to go even further and stop abortions at around six weeks. And 20 Ohio legislators have proposed outlawing all abortions, even if the woman’s life is in danger. In many state capitols, Republican lawmakers are backing unusually strict antiabortion laws. Many are emboldened by President Trump, who has been more supportive of their agenda than any president in decades. Conservative lawmakers also are eager to get more restrictions on the books in case November’s elections bring a surge of Democrats hostile to them. (Jordan, 4/19)

The Hill: GOP In Retreat On ObamaCare
Republicans are retreating from calls to repeal ObamaCare ahead of this year’s midterm elections. Less than a year after the GOP gave up on its legislative effort to repeal the law, Democrats are going on offense on this issue, attacking Republicans for their votes as they hope to retake the House majority. (Sullivan, 4/20)

Kaiser Health News: Podcast: KHN’s ‘What The Health?’ Nothing In Health Care Ever Goes Away
Congressional Republicans have struck a decidedly different tone when talking about the Affordable Care Act, and the Democrats have introduced a new Medicare expansion bill. Meanwhile, states are talking about Medicaid expansion, and a federal court’s ruling on Maryland’s proposal to battle drug price-gouging sends shock waves nationwide. Both chambers of Congress have been busy introducing legislative fixes for the nation’s opioid epidemic with lawmakers promising that legislation will land this spring. (4/19)

In other health law news —

Modern Healthcare: How Stakeholders In The Short-Term Medical Market Are Gearing Up To Attract More Customers 
The Trump administration's proposal to allow insurers to sell short-term medical plans that last up to 12 months, coupled with the repeal of the Affordable Care Act's individual mandate penalty in 2019, is bound to drive up enrollment in the short-term plan market next year. Some insurance companies are gearing up to capitalize on what they hope will be a flood of new customers by adding new, attractive benefits to their short-term products. At the same time, a major online brokerage is shifting gears to promote "ACA alternatives" rather than putting comprehensive major medical plans front and center for health plan shoppers. (Livingston, 4/19)

CQ: States Take Steps To Shore Up Insurance Markets
More states are moving closer this week to pouring funds into their health insurance markets, emphasizing the concern over rising premiums in 2019. Wisconsin GOP Gov. Scott Walker on Thursday submitted a waiver application to the Trump administration seeking to implement a reinsurance program, which would help cover high-cost patients in the state’s individual health insurance market. (McIntire and Clason, 4/19)

The Hill: Judge Rules Against Trump Administration In Teen Pregnancy Prevention Case 
A federal judge in D.C. ruled Thursday that the Trump administration's cuts to the Teen Pregnancy Prevention Program were unlawful. Last summer, the administration notified 81 organizations that their five-year grants through the program would end in 2018, rather than in 2020, prompting multiple lawsuits. (Hellmann, 4/19)

Reveal: Judge Rules Trump Officials Broke Law When Axing Teen Pregnancy Program
U.S. District Judge Ketanji Brown Jackson issued a summary judgment in favor of four grant holders who had filed suit. “Further ordered that HHS’s decision to shorten the project period for Plaintiffs’ projects is vacated and that HHS shall accept and process Plaintiffs’ applications as if it had not terminated” the funding, according to the judge’s ruling. The order is effective April 26. The only programs directly affected by the decision are the four operated by the plaintiffs: Policy and Research LLC, a New Orleans and Seattle consulting group; Project Vida Health Center in El Paso, Texas; Sexual Health Initiatives for Teens in North Carolina and the South Carolina Campaign to Prevent Teen Pregnancy, represented by the nonprofit Public Citizen Litigation Group. (Kay, 4/19)

The Washington Post: ‘He Knows How To Read A Room Really, Really Well’: How White House Physician Ronny L. Jackson Became Trump’s Nominee To Lead VA
As a White House physician under three presidents, Ronny L. Jackson often went to extra lengths to win over the officials he was on hand to assist. He helped George W. Bush clear brush at his Texas ranch. He supplied Barack Obama with Nicorette gum even as he urged him to quit the nicotine substitute. He once was so eager to deliver a sling to Vice President Richard B. Cheney for a sore arm that his sprint toward the presidential helicopter caught the attention of Secret Service agents, a friend said. That kind of enthusiasm drew ridicule in January, when Jackson said at a news conference that President Trump “might live to be 200 years old” if he had a more healthful diet. But his performance received lavish praise from the president, who shocked Washington a few months later by tapping the former combat surgeon to run the Department of Veterans Affairs — one of the federal government’s largest and most fraught bureaucracies. (Gardner and Crites, 4/19)

The New York Times: As Opioid Prescriptions Fall, Prescriptions For Drugs To Treat Addiction Rise
The number of new monthly prescriptions for medications that treat opioid addiction nearly doubled over the past two years, according to new data, while prescriptions for opioid painkillers continued to decline. The changing calculus reflects a stepping up of efforts among policymakers and the medical establishment to address the nation’s opioid epidemic, which is killing more than 115 people every day. But it also underscores questions about whether some pain patients are now being undertreated, and whether tightened prescribing over the last few years has contributed to the surge in overdose deaths from heroin and especially fentanyl. (Goodnough, 4/19)

Stat: In The Throes Of An Opioid Crisis, Prescriptions Fell Dramatically Last Year 
“We saw the imposition of new programs by states and a greater focus by the surgeon general and federal government in reducing opioid prescribing,” said Murray Aitken, an IQVIA senior vice president and executive director of the institute. “While we cannot attribute the decline to anything particular, in aggregate, it looks as if those measures are having a market impact.” Indeed, the data suggest that the drumbeat of alarm expressed by a plethora of government officials and policymakers is starting to sway medical practice. The White House declared a public health emergency and Congress is considering legislation that would address a mix of insurance coverage, payment issues, prescription regulations for Medicaid beneficiaries, and prevention strategies. (Silverman, 4/19)

Bloomberg: How An Opioid Deadlier Than Heroin Became Off Limits For Researchers 
A powerful illegal opioid is causing tens of thousands of deaths, but a standoff between government researchers and federal law enforcement is keeping scientists from finding a way to stop it from killing. Overdoses from synthetic opioids called fentanyl have surged more than 500 percent since 2013, killing roughly 20,000 people in the U.S. in 2016 and outpacing deaths from heroin. Worryingly, people who overdose on such designer drugs, known collectively as China White, have been said to be less responsive to antidotes now widely carried by first responders. (Edney, 4/19)

CQ: Senate Finance Kicks Off Its Opioid Debate
The Senate Finance Committee dove into tackling the opioid crisis on Thursday with its first hearing on improving Medicaid, Medicare and other programs that cope with the effects of substance abuse directly. Both parties expressed an interest in bipartisanship, though Democrats voiced strong concerns about the role of drug manufacturers and the high price of opioid overdose reversal drugs. (Raman, 4/19)

And in other news on the crisis —

The New York Times: Prince’s Overdose Death Results In No Criminal Charges
No one will be criminally charged in the 2016 death of Prince by accidental fentanyl overdose, law enforcement authorities in Minnesota announced on Thursday, saying that they could not determine who had provided the powerful drug that killed him. The musician had been struggling with a dependence on painkillers and most likely believed he was taking Vicodin, which does not contain fentanyl, the Carver County attorney, Mark Metz, said in a news conference. Prince actually took a look-alike, counterfeit version of the drug that was far more powerful and dangerous, Mr. Metz said. (Coscarelli and Eldred, 4/19)

The Associated Press: As Prince's Health Waned, Alarm Grew In Inner Circle
Some of Prince's closest confidants had grown increasingly alarmed about his health in the days before he died and tried to get him help as they realized he had an opioid addiction — yet none were able to give investigators the insight they needed to determine where the musician got the fentanyl that killed him, according to investigative documents released Thursday. Just ahead of this weekend's two-year anniversary of Prince's death, prosecutors announced they would file no criminal charges in the case and the state investigation was closed. (Forliti, 4/20)

The Associated Press: Virginia To Receive Nearly $10M To Fight Opioid Crisis
Virginia will receive nearly $10 million in federal grant money to help combat the opioid crisis.The U.S. Department of Health and Human Services announced Thursday its second year of funding through the Opioid State Targeted Response program. Virginia is getting $9.76 million. A press release says recipients used the first year’s funding to implement medication-assisted treatment, promote prevention strategies as well as the use of the antidote naloxone, and build sustainable recovery support services. (4/20)

The Star Tribune: Health Systems Trim Opioid Prescriptions 
A new HealthPartners study showed that it is possible to substantially cut opioid prescriptions, which makes sense because a new Mayo Clinic study showed that patients don’t take most of their opioid painkillers anyway. The findings this week by two influential health care providers in Minnesota offer further evidence of the overprescribing over the past two decades that has resulted in a rapid rise in opioid addictions and overdose deaths. (Olson, 4/20)

Health News Florida: Feds Give Florida Another $27M For Opioid Crisis
Florida will get another $27 million dollars this year from the federal government to combat the opioid crisis. The money is part of a two-year $54 million grant, which the state began spending last year after Gov. Rick Scott declared a state of emergency for the opioid epidemic. (Ochoa, 4/19)

CNN: Turning Points: Woman Loses 2 Sons In One Night To Opioids
"Everything just kind of seemed like a blur that day," Becky Savage said. "Your mind is not really meant to process something that extreme."The day Savage is describing is June 14, 2015. Her two oldest sons, Nick and Jack, were celebrating at high school graduation parties the night before. The boys came home about 12:30 a.m. and checked in with their mom, who had been waiting up. (Bergeron, 4/20)

Stat: Doctors May Learn Bad Habits At Teaching Hospitals With Safety Violations
Teaching hospitals like Jackson South, located in metro Miami, are where physician trainees get practice treating patients. They prepare the next generation of doctors, and they have a reputation as places of cutting-edge patient care, given their ties to academic institutions. But at some of these hospitals, residents may be learning bad habits. A STAT analysis of federal inspection data finds that there’s a wide gap in the quality of training at teaching hospitals, as shown by how frequently these hospitals are cited for deficiencies by the Centers for Medicare and Medicaid Services. While the majority of the roughly 1,200 teaching hospitals received no citations each year from 2014 to 2017, others racked up dozens of safety violations in that time period — putting patients at risk, and compromising the training that students receive. (Blau, 4/20)

The New York Times: E. Coli Outbreak Tied To Romaine Lettuce Expands To 16 States
At least 53 people have been sickened by tainted, chopped romaine lettuce in an expanding E. coli outbreak that now spans 16 states, the Centers for Disease Control and Prevention said on Wednesday. The contaminated greens have been traced to Yuma, Ariz., but investigators recommended abundant caution because they have not yet identified a specific source. (Chokshi, 4/19)

The Washington Post: E. Coli: Romaine Lettuce-Linked Outbreak Expands, CDC Says
The CDC said the exact source of the tainted lettuce hasn’t been identified, but that “information collected to date indicates that chopped romaine lettuce from the Yuma, Arizona, growing region could be contaminated ... and could make people sick.” “Consumers anywhere in the United States who have store-bought chopped romaine lettuce at home, including salads and salad mixes containing chopped romaine lettuce, should not eat it and should throw it away, even if some of it was eaten and no one has gotten sick,” the CDC said. “If you do not know if the lettuce is romaine, do not eat it and throw it away.” (McMillan and Phillips, 4/19)

The New York Times: When Is It Safe To Eat Salad Again?
For lovers of leafy greens, these are not salad days. A multistate outbreak of E. coli infections has been linked to bags of chopped romaine lettuce, and information from different sources about the risk has been confusing, making many of us scared to eat salad. This week, the Centers for Disease Control and Prevention reported the outbreak has grown to 53 cases in 16 states — that’s 18 more sick people since April 13. Fortunately nobody has died, but nearly 70 percent of those infected have been hospitalized with a nasty toxin-producing strain of E. coli, and several have developed kidney failure. (4/19)

The Associated Press: California Lawmakers Move To Limit Gay Conversion Therapy
Selling or advertising gay conversion therapy may soon be classified as a fraudulent business practice in California under a bill passed Thursday by the state Assembly. Conversion therapy, the practice of trying to change someone's sexual orientation, has been shown to be ineffective, said Assemblyman Evan Low, who wrote the bill that now heads to the state Senate. (Bollag, 4/19)

Los Angeles Times: Gay 'Conversion Therapy' Services Would Be Banned Under Measure Advancing In California
“It is harmful and it is unnecessary,” Assemblyman Evan Low (D-Campbell), the bill’s author and one of the Legislature’s most vocal LGBTQ members, said of the practice. Low, who told Assembly members that he explored conversion therapy as a teenager and suffered depression over his sexual orientation, insisted that the bill would be limited to efforts that involve the exchange of money. “There’s nothing wrong with me,” he said in an emotional speech on the Assembly floor. “There’s nothing that needs to be changed.” (Myers, 4/19)

ProPublica: Florida Moves To Shut Down For-Profit Residence After Finding Horrific Abuse And Neglect
After another patient died under suspicious circumstances and reports surfaced of more instances of abuse and neglect, Florida regulators moved this week to shutter a for-profit school and residential campus for children and adults with severe developmental disabilities. (Vogell, 4/19)

The Wall Street Journal: New York City Launches Task Force On Mentally Ill After Shootings
Two weeks after New York Police Department officers fatally shot a mentally disturbed man they thought was armed with a gun, Mayor Bill de Blasio launched a task force aimed at improving city responses to emergencies involving the mentally ill. The task force, made up of city officials, as well as New Yorkers living with mental illness, will over the course of 180 days focus on ways to prevent crises with the mentally ill and increase collaboration between the NYPD and the city’s health agencies, municipal officials said on Thursday. (Kanno-Youngs, 4/19)

Los Angeles Times: Gavin Newsom Gets Backing From Doctors Group, Despite Differences Over Single-Payer Healthcare
California’s doctors are siding with Gavin Newsom in the governor’s race, even though they don’t see eye-to-eye on a defining issue of the campaign: single-payer healthcare. The California Medical Assn., the state doctors lobby and a political heavyweight, announced its endorsement of the lieutenant governor on Thursday. “Gavin is a lifelong champion for health care in California, and we know he will continue to fight for pragmatic solutions to our most crucial health care challenges, including working to achieve universal access and tackling our state’s physician shortage,” CMA President Theodore M. Mazer said in a statement. (Mason, 4/19)

Milwaukee Journal Sentinel: The Future Of Wisconsin Caps On Malpractice Payment Goes To Wisconsin Supreme Court
The more than $9.5 million award paid to a Milwaukee woman who lost all four of her limbs as a result of medical malpractice will not be enough to cover all of her future healthcare costs, her attorney told the state Supreme Court on Thursday. (Spivak, 4/19)

KQED: San Joaquin County Should Install Independent Medical Examiner, Audit Finds
An audit of San Joaquin County’s sheriff-coroner operations, made public Wednesday, concluded that removing the sheriff from death investigations and instituting a medical examiner's office run by a physician is the best way to ensure the probes remain independent from law enforcement. (Small, 4/19)

Orlando Sentinel: Chain Of Mental Health Clinics Declares Bankruptcy
Sanford-based Coastal Mental Health, which has eight locations across the region, filed for Chapter 11 bankruptcy Monday declaring more than $500,000 in debt. But it was the interest rate on the debt that made it unusual — much of it was at 30 percent to 50 percent. (Brinkman, 4/19)

California Healthline: Calif. Leads Nation In Pushing Back Against Trump Administration Health Policies
These days, when the federal government turns in one direction, California veers in the other — and in the case of health care, it’s a sharp swerve.In the nation’s most populous state, lawmakers and other policymakers seemingly are not content simply to resist Republican efforts to dismantle the Affordable Care Act. They are fighting to expand health coverage with a series of steps they hope will culminate in universal coverage for all Californians — regardless of immigration status and despite potentially monumental price tags. (Ibarra, 4/19)

New Orleans Times-Picayune: Louisiana House Passes Budget That Would Shutter Hospitals, Reduce TOPS
The Louisiana House voted 55-47 for a state operating budget Thursday (April 19) with $648 million worth of cuts that state officials said would result in the closing of hospitals, nursing homes and medical residency programs for doctors throughout the state as early as July. More than 46,000 people who are elderly and disabled are expected to lose their nursing home slots and 24-hour home health care services in a little over two months if the House budget plan becomes law. (O'Donoghue, 4/19)

Pioneer Press: MN Legislature Tax Fight Muddied Over Health Care Funding
Minnesota Republicans say Gov. Mark Dayton needs to drop a proposal to continue a tax that pays for health care for the working poor if he wants any chance at an agreement to rewrite the state’s tax code. “If the provider tax is not part of the conversation, tax conformity is a lot easier,” Rep. Pat Garofalo said Thursday, moments after finishing a news conference where he accused the Democratic governor of supporting what amounts to a $1.4 billion tax hike. (Magan, 4/19)

San Francisco Chronicle: State Can Label Widely Used Herbicide As Possible Carcinogen
A state appeals court on Thursday backed California’s listing of the widely used herbicide glyphosate as a possible cause of cancer and the state’s prohibition against discharging it into public waterways. ...Citing new findings by the International Agency for Research on Cancer, state health officials added glyphosate to their list of potential carcinogens in July 2017 under Proposition 65, a 1986 initiative that requires warnings of exposure to products that pose a risk of cancer or reproductive harm. (Egelko, 4/19)

San Francisco Chronicle: SF’s St. Mary’s Hospital Finally Gets OK To Open Beds For Mentally Ill
The 54 beds for severely mentally ill patients have opened at St. Mary’s Medical Center in the Richmond District, six weeks after Mayor Mark Farrell announced the city’s plans to add them. Forty of the beds are reserved for patients in San Francisco’s public health system, including some that may be homeless. (Swan, 4/19)

The San Diego Union-Tribune: Mounting Toll Of Alzheimer's In Lives, Dollars In San Diego Spelled Out In Reports 
More than 84,000 people in San Diego County are living with Alzheimer’s and related dementias, a figure that will reach 115,000 by 2030, according to two reports released by the county Friday. The lifetime cost of care for San Diegans with these dementias now exceeds $38 billion and is expected to surpass $52 billion by 2030. The reports update a 2015 report on an ambitious county program to cope with the rising toll of dementia. One report focuses on the prevalence of these diseases. The other examines the cost. (Fikes, 4/20)

The Baltimore Sun: State Health Body Approves Anne Arundel Medical Center Mental Health Hospital 
A new Annapolis mental health hospital could be opening its doors in 2020 after the Maryland Health Care Commission on Thursday approved the center’s certificate of need. The Anne Arundel Medical Center Mental Health hospital will include 16 beds and provide in- and out-patient services for a number of mental health conditions. It will be the second hospital providing in-patient mental health care in the county. (Ohl, 4/19)

Georgia Health News: Georgia Rates Better In Emergency Preparedness, But Still Has Room For Improvement
Georgia’s preparedness for managing health emergencies is improving but still lags behind the national average, according to a newly released report. The state scored a 6.8 on a 10-point scale for preparedness, in an index that shows the ability to protect Americans’ health from incidents such as newly emerging infectious diseases; an increase in resistance to antibiotics; terrorism; and extreme weather conditions. (Miller, 4/19)

Boston Globe: For Those Who Receive — And Deliver — Meals On Wheels, More Than Nutrition Is On The Menu
The federally funded Meals on Wheels program provides a daily visit for about 75,000 people over age 60 in Massachusetts. Many are hungry, isolated, and living in or near poverty. It’s a human connection to an outside world that can recede from view in later years. (Weisman, 4/20)

JAMA Psychiatry: Physician Prescribing Of Opioids To Patients At Increased Risk Of Overdose From Benzodiazepine Use In The United States
In 2010, new opioid prescriptions for US adults stopped increasing and began to decrease among higher-risk patients who used benzodiazepines. These patterns suggest that the recent increase in opioid-related deaths may be associated with factors other than physicians writing new opioid prescriptions. Nevertheless, prescribing among higher-risk patients still occurred at rates higher than rates in the general population, representing an important opportunity to improve quality of care for patients experiencing pain. (Ladapo, Larochelle, Chen et. al., 4/12)

New England Journal of Medicine: Relationship Between Clinic And Ambulatory Blood-Pressure Measurements And Mortality 
This study examined the associations of blood pressure measured in the clinic (clinic blood pressure) and 24-hour ambulatory blood pressure with all-cause and cardiovascular mortality in a large cohort of patients in primary care. ...Ambulatory blood-pressure measurements were a stronger predictor of all-cause and cardiovascular mortality than clinic blood-pressure measurements. (Banegas, Ruilope, de la Sierra et. al., 4/19)

RAND: Facilitators And Barriers To Pre-Exposure Prophylaxis (PrEP) Use Among Black Individuals In The United States: Results From The National Survey On HIV In The Black Community
This study explores willingness to use PrEP among Black individuals in the US. From February to April 2016, an online survey was administered to a nationally representative sample of Black individuals. ...Among a nationally representative sample of Black individuals, few high risk individuals were willing to use PrEP. (Ojikutu, Bogart, Higgins-Biddle et. al., 4/17)

Annals Of Internal Medicine: National Drug Overdose Epidemic And Deceased-Donor Transplantation
In the United States, transplantation with ODD organs has increased dramatically, with noninferior outcomes in transplant recipients. Concerns about IRD behaviors and hepatitis C among donors lead to excess discard that should be minimized given the current organ shortage. (Durand, Bowring, Thomas et. al., 4/17)

The New York Times: The Problem With Miracle Cancer Cures
Much has been written about the promise of these treatments, as well as their staggering costs — many cost several hundred thousand dollars a year. But what strikes me most about them is that, by blurring the line between cure and comfort — and between hope and hopelessness — they have disrupted the fragile equilibrium that we doctors have long taken for granted. ... Sadly, for some patients, a cure will prove elusive. As we continue to chase progress in cancer, let’s be sure that we don’t rob dying patients of a smaller, more subtle miracle: a death with dignity and grace, relatively free from pain and discomfort. (Robert M. Wachter, 4/19)

The Washington Post: The Ground Is Shifting On Gun Control. Vermont Is A Sign.
The day after the Parkland school shooting focused renewed attention on the issue of gun violence, Vermont Gov. Phil Scott (R) reiterated his opposition to any new restrictions on gun ownership. But just 24 hours later, Mr. Scott announced a change of heart. Now he has signed major gun violence prevention legislation. It is a notable step for a state that historically has had some of the weakest gun laws in the country, and another encouraging sign of how the ground is shifting on gun control. (4/19)

Boston Globe: Gun Safety Takes A Step Forward On Beacon Hill
Here’s some good news for the mothers and students who have been working the State House halls and phones — and indeed, for anyone who cares about effective gun laws. A key legislative committee recently gave its stamp of approval to legislation to allow guns to be taken temporarily from owners deemed at risk of harming themselves or others. (4/20)

WBUR: Endangering Children In God’s Name
Hundreds of protesters threw a tantrum recently as a Garden State legislative panel approved a bill making it harder to get religious exemptions from student vaccinations. The bill, which must be passed by the full legislature, would require notarized documentation of how vaccination "would violate, contradict, or otherwise be inconsistent with [a] tenet or practice” of a family’s faith. (Rich Barlow, 4/20)

The Washington Post: The Next Big Thing For Democrats: Medicare For All
When the Affordable Care Act was being created in 2009, many liberals who weren’t too excited about the form it was taking hoped that eventually it could evolve into something more to their liking. They told themselves that the ACA’s reforms may have kept private health insurance central, but over time it could be modified to inch closer to the kind of universal system enjoyed by citizens of every other industrialized country. Ironically, precisely because Republicans took over the government eight years later and began an attack on the ACA, we may get to that point a lot quicker than liberals anticipated. (Paul Waldman, 4/19)

The Hill: Medicaid Is Crucial To Seniors And Awareness Is Crucial To The Program's Survival
April is Medicaid Awareness Month, but many Americans are truly unaware of what the program does for seniors. Medicaid is typically viewed as a health insurance program for the poor, which, of course, it is. But it also provides crucial supports for older Americans. Medicaid covers nearly 7 million seniors and more than 8.5 million “near seniors” aged 50-64. One in five Medicare beneficiaries (known as “dual eligibles”) also have Medicaid coverage to help pay premiums and co-pays. ...Unfortunately, Medicaid has been under siege in Congress ever since the ACA was enacted. When the majority party took control of all branches of government in 2017, they tried relentlessly to gut the program — starting with Obamacare repeal legislation all the way through President Trump’s first two budgets and various House GOP budget proposals. (Max Richtman, 4/19)

USA Today: Ask Ronny Jackson How To Ensure Veterans Get Good Private Health Care
President Trump this week officially nominated Rear Adm. Ronny Jackson, the White House physician, to be secretary of Veterans Affairs. Before they vote on whether to confirm him, senators need to focus on what should be at the center of any discussion surrounding the Department of Veterans Affairs: veterans. Right now, a top priority at VA is reforming its Veterans Choice Program, which allows veterans to get care from private providers in their communities rather than from the VA. In some ways, this option makes sense — half of all vets report that they want or need to use providers in their community. But a vital first step is to make sure health care providers are ready for the job. Right now, the overwhelming majority are not. (Derek Coy, 4/19)

The Hill: Personalized Interactions Are The Future Of Health Care
The Senate Committee on Veterans’ Affairs is deciding next week whether to confirm President Donald Trump’s nominee for the Secretary of the Department of Veterans Affairs (VA), Navy Rear Adm. Ronny Jackson. The confirmation vote comes amid major efforts to reform the department to better serve our nation’s veterans. ... As we look to the future and for ways to improve healthcare for all Americans, including our veterans, technology will play a significant part in bridging these gaps. But technological advances alone are not enough; we must also invest in solutions that are personalized and patient-centered to improve the health of millions. (Mazi Rasulniam, 4/19)

The Detroit News: Deal Should Lead To State Rights On Pot
President Donald Trump is apparently overriding his attorney general on interfering with state marijuana laws, and in doing so provided some clarity for Michigan voters who may be considering a recreational pot measure on the November ballot.In a deal reached with Colorado Sen. Cory Gardner, Trump pledged to stop Attorney General Jeff Sessions from voiding an Obama-era policy to not meddle with states that had legalized marijuana use.Gardner, a Republican member of the Judiciary Committee, had for three months been blocking Trump’s judicial nominees to protest Session’s intentions. Recreational use of pot is legal under Colorado state law. Trump also said he would back a federal bill that would establish a state’s right to set its own laws on marijuana use. (4/19)

USA Today: Opioid Deaths Are Preventable. We Need To Fight It Like A Disease.
News about the opioid crisis keeps getting worse. Simple solutions haven’t changed the epidemic’s course.The number of deaths has continued to increase, driven by an influx of illicit fentanyl that is laced into counterfeit pain pills, heroin and other illegal drugs. To effectively treat this evolving public health crisis, we must recognize opioid addiction for what it is. Opioid addiction is an emergency. Just as providing first aid for cardiac arrest requires a defibrillator and first aid for severe bleeding requires a tourniquet, first aid for an opioid overdose requires naloxone. Last year, Alaska Governor Bill Walker declared the state’s opioid epidemic a public health emergency and made naloxone more readily available to all Alaskans. The U.S. Surgeon General’s recent Health Advisory calls for increasing the drug’s public availability: Too often, it is not available when needed. And just as other emergencies follow first aid with immediate medical care, the same strategy should be used for opioid addiction. (Jay C. Butler, 4/19)

The New York Times: Standing Up At Your Desk Could Make You Smarter
This is an odd admission for a psychiatrist to make, but I’ve never been very good at sitting still. I’m antsy in my chair and jump at any opportunity to escape it. When I’m trying to work out a difficult problem, I often stand and move about the office. We’ve known for a while that sitting for long stretches of every day has myriad health consequences, like a higher risk of heart disease and diabetes, that culminate in a higher mortality rate. But now a new study has found that sitting is also bad for your brain. And it might be the case that lots of exercise is not enough to save you if you’re a couch potato the rest of the time. (Richard A. Friedman, 4/19)

Detroit News: No Free Water For Nestlé. Water For Flint.
Two recent water-related decisions from our state government highlight a clear and concerning disconnect between the way in which our state treats its residents and how it rewards giant corporate business. In the same week that the state granted Nestlé the right to profit off our most valuable natural resource, it announced that the people of Flint would no longer receive free bottled water. While the outcome and timing of these decisions is absurd, it’s even more troubling that the majority of Republicans in Lansing and the Republican caucus in D.C. don’t seem to care. (Dan Haberman, 4/19)

New England Journal of Medicine: Gene Therapy In Patients With Transfusion-Dependent β-Thalassemia
Donor availability and transplantation-related risks limit the broad use of allogeneic hematopoietic-cell transplantation in patients with transfusion-dependent β-thalassemia. After previously establishing that lentiviral transfer of a marked β-globin (βA-T87Q) gene could substitute for long-term red-cell transfusions in a patient with β-thalassemia, we wanted to evaluate the safety and efficacy of such gene therapy in patients with transfusion-dependent β-thalassemia. ...Gene therapy with autologous CD34+ cells transduced with the BB305 vector reduced or eliminated the need for long-term red-cell transfusions in 22 patients with severe β-thalassemia without serious adverse events related to the drug product. (Alexis A. Thompson, Mark C. Walters, Janet Kwiatkowski, John E.J. Rasko, Jean-Antoine Ribeil, Suradej Hongeng, Elisa Magrin, Gary J. Schiller, Emmanuel Payen, Michaela Semeraro, Despina Moshous and Francois Lefrere, 4/19)

JAMA: New Prevention Guidelines For Falls And Fractures—Looking Beyond The Letters
In this week’s issue of JAMA are the updated US Preventive Services Task Force (USPSTF) recommendations on vitamin D, calcium, or combined supplementation for the primary prevention of fractures in community-dwelling adults and for falls prevention in community-dwelling adults, as well as accompanying evidence reports. Overall, the summary recommendations have not changed much compared with previous recommendations released in 2013 and 2012. The major change is the downgrade of the vitamin D supplementation recommendation for preventing falls from being a B grade (recommended based on high certainty of moderate benefit or on moderate certainty of moderate to substantial benefit) to a D grade (recommended against based on moderate or high certainty of no benefit or that harms outweigh the benefit). (David Reuben, 4/19 )