Reuters: Democrats Refocus Fight Against Trump's Supreme Court Nominee On Healthcare
Democrats on Wednesday were reorienting their uphill push to block U.S. Senate confirmation of President Donald Trump's nominee to the Supreme Court, moving healthcare to the center of their strategy and putting less emphasis on abortion rights. While the two issues are closely linked, the change aligns with polling that shows healthcare is a major concern for swing-state voters ahead of November's congressional elections, with abortion rights more divisive. (Cowan, 7/11)

Politico: Dems Pitch Mixed Messages In Supreme Court Fight
As they start a Supreme Court battle with control of the Senate on the line, Democrats want to talk about Obamacare. And Roe v. Wade. And the special counsel’s investigation into President Donald Trump. That’s not to mention Democratic concerns about how Supreme Court nominee Brett Kavanaugh would rule on guns, unions, voting rights and more. While the GOP is promoting Trump’s pick with a singular message — touting Kavanaugh’s ample qualifications — Democrats are offering multiple arguments against him that each speak to multiple parts of their base and the electorate. The multi-part strategy reflects a perennial challenge for a party that has struggled to succinctly communicate its agenda to voters. (Schor and Caygle, 7/12)

The Wall Street Journal: Health Law Is An Issue In Fight Over Supreme Court Pick Brett Kavanaugh
Almost any nomination to the high court spurs debates about abortion, affirmative action, and similar social issues. In this case, Democrats see the health-care issue as a particularly effective way to galvanize opposition to the Kavanaugh nomination, while the judge’s supporters say it shows the weakness of their case against him. “They will have, if they get this nominee, a Supreme Court ready to rule against protections for people with pre-existing conditions,” said Sen. Chris Murphy (D., Conn.). Organizations supporting the ACA plan to hold rallies and events in key battleground states such as Alaska, Arizona, Nevada, and Ohio, hoping to mirror the strategy used to block the ACA repeal last year. (Armour and Peterson, 7/11)

Los Angeles Times: Supreme Court Nominee Brett Kavanaugh Lauded Late Chief Justice Rehnquist For Dissenting In Roe Vs. Wade And Supporting School Prayer
Judge Brett M. Kavanaugh, President Trump’s Supreme Court nominee, gave a revealing speech last fall in which he lauded former Chief Justice William H. Rehnquist for having dissented in Roe vs. Wade and for rejecting the notion of “a wall of separation between church and state.” He also praised the late chief justice’s unsuccessful effort to throw out the so-called “exclusionary rule,” which forbids police from using illegally obtained evidence. (Savage, 7/11)

The Hill: Conservatives, Liberals Both Agree: Nominee A Pivotal Vote On Abortion 
Conservatives and liberals alike think Trump nominee Brett Kavanaugh could shift the Supreme Court further right on abortion issues. The question, they say, is not whether Kavanaugh’s addition to the court would be a shift, but whether it will lead to a complete overturning of the Roe v. Wade decision legalizing abortion or the upholding of restrictions that would make the decision obsolete. (Hellmann, 7/11)

The New York Times: Democrats Zero In On Kavanaugh’s Defense Of Presidential Power
Democrats who once saw health care and abortion as their best lines of attack against Judge Brett M. Kavanaugh, President Trump’s Supreme Court nominee, are recalibrating their approach to go after him for his view that a sitting president should not have to answer questions in a criminal case, much less face indictment. Senator Chuck Schumer of New York, the Democratic leader, said in an interview on Wednesday that Judge Kavanaugh’s belief in broad presidential authority was “just off the deep end.” (Stolberg, 7/11)

The Associated Press: Smile! Supreme Court Nominees And The Art Of The Schmooze
Brett Kavanaugh's wooing of the Senate is part of a time-honored tradition, including awkward grip-and-grin photo ops and light conversation that skirts the contentious issues that lie ahead. Here's what to watch for as Kavanaugh makes the rounds on Capitol Hill ahead of his confirmation hearing to become the next Supreme Court justice. (Flaherty, 7/11)

The Washington Post: Every Current Supreme Court Justice Attended Harvard Or Yale. That’s A Problem, Say Decision-Making Experts.
It is not hard to see similarities between President Trump’s last two Supreme Court nominees: They are both white male conservatives who attended Ivy League law schools, clerked for retiring Justice Anthony M. Kennedy and went to the same exclusive private prep school. The elite background does not end with them. If the Senate approves Trump’s nominee, Brett Kavanaugh, every justice sitting on the Supreme Court will have attended either Yale's or Harvard’s law school. (Ruth Bader Ginsburg started at Harvard and transferred to another Ivy, Columbia.) (Wan, 7/11)

The Associated Press: 2 Supreme Court Nominations Made, Trump May Have None To Go
What would it take for President Donald Trump to get yet another Supreme Court pick? Probably the death of a justice. Trump has speculated that he could appoint a majority of the nine-member court. But it has been three decades since a president has been able to name more than two justices to their life-tenured posts, and Trump tied that number this week. The court's oldest remaining justices, two liberals and a conservative who are 85, 79 and 70, haven't suggested they're going anywhere and appear in fine health. (Gresko, 7/12)

The New York Times: Trump Administration To Speed Reunions Of Families Separated At Border
Facing pressure to expedite the reunion of migrant families separated at the border, the Trump administration is expected to announce on Thursday that it will streamline the process, immigration advocates say. The government will stop requiring a litany of steps before a child can be released from a shelter, the American Civil Liberties Union confirmed. It has sued the government over the family separations. (Jordan, 7/12)

Reuters: Tech Issues Plague U.S. Web Portal Tracking Separated Children
In late June, attorney Sebastian Harley tried to log into a U.S. government web portal to check on a Guatemalan child who had been separated from his parent at the border. He got an error message saying there were too many users. “I just couldn’t get in,” he said. “The system appeared to be down.” (Levinson, Cooke and Torbati, 7/11)

The Associated Press: Lawmakers Battle Over Migrants Crossing Border Illegally
Congress' fight over President Donald Trump's abandoned policy of separating migrant families has stirred anew, drawing fresh attention to an issue that has divided Republicans and that Democrats hope will propel voters their way in the midterm elections. The battling at the House Appropriations Committee on Wednesday underscored how both parties still see vast political potency in immigration, even as congressional votes have shown that partisan differences and divisions within the GOP make it unlikely anything will reach Trump's desk soon. (7/12)

CQ: Labor-HHS-Education Bill OK'd; Family Separation Changes Added
The House Appropriations Committee late Wednesday evening approved, 30-22, a $177.1 billion fiscal 2019 bill to fund the departments of Labor, Education, and Health and Human Services. The committee has now approved 11 of its 12 fiscal 2019 spending measures, following the marathon 13-hour markup of the massive nondefense bill that left lawmakers from both parties exasperated at various points. The debate covered family separations at the U.S.-Mexico border, gun research funding, abstinence-only sex education and thorny political issues around religious adoption agencies. (Siddons and Mejdrich, 7/11)

Politico: House GOP Appropriators Block Funding For Gun Violence Research
House Republican appropriators Wednesday rejected a proposal to designate millions of dollars for the Centers for Disease Control and Prevention for gun violence research, voting 32-20 to keep the language out of a fiscal 2019 spending bill. The party-line vote marked Democrats’ latest failed bid to spur studies into preventing firearm-related injuries and deaths — and comes despite a bipartisan agreement earlier this year that the CDC is permitted to conduct such research. The agency's ability to study gun violence had been limited by a 1996 provision that prevented the CDC from collecting data to advocate for gun control. (Cancryn, 7/11)

CQ: Ways And Means Advances Four Health Savings Account Bills
The House Ways and Means Committee approved four bills on Wednesday intended to expand health savings accounts before recessing until Thursday morning, when the panel will consider seven additional measures with similar objectives. Several of the bills had bipartisan support, but Wednesday’s markup immediately took a partisan turn and the tallies fell mostly along party lines. Chairman Kevin Brady, R-Texas, said the markup was about providing patients with more choice, while ranking member Richard E. Neal, D-Mass., said the bills would not address the health care challenges Americans are facing.  (McIntire, 7/11)

Politico Pro: 4 HSA Expansion Bills Clear Ways And Means
The legislation that advanced mostly on party-line votes includes a bill, H.R. 6301 (115), written to permit wider HSA use by those who hold high-deductible health plans. It would allow insurers to offer coverage for low-cost services for chronic disease management, such as diabetes testing strips, below the deductible, for example. They also cleared another bill, H.R. 6317 (115), that would let HSA account holders use them on direct primary care services, as well as legislation, H.R. 6305 (115), to permit HSA use for employment-related services like onsite clinics and allow eligible individuals to make HSA contributions if a spouse has a flexible spending account. (Lorenzo, 7/11)

The Hill: Lawmakers Worry About Rise In Drugged Driving 
Lawmakers on the House Energy and Commerce Committee held a hearing Wednesday on the dangers of drug-impaired driving. There is growing concern in Congress over the issue as data from the Governors Highway Safety Association (GHSA) and the Foundation for Advancing Alcohol Responsibility finds that accidents from drugged driving have been on the rise over the last 10 years. (Goodman, 7/11)

The Washington Post: Companies Shipped 1.6 Billion Opioids To Missouri From 2012 To 2017, Report Says
Three companies shipped approximately 1.6 billion doses of powerful prescription opioids to Missouri pharmacies from 2012 to 2017, according to a congressional report seeking the root causes of the opioid epidemic. The report, released by Sen. Claire McCaskill (D-Mo.), shows that drug distributors Cardinal Health, McKesson Corp. and Amerisource Bergen funneled the equivalent of about 260 opioid pills for every person in Missouri in the five-year period, during which time the opioid epidemic raged there — and nationwide. (Zezima, 7/12)

Stat: System For Reporting Suspicious Opioid Orders Repeatedly Failed, Report Finds
A Senate report released Thursday lays out systematic failures in the reporting system for suspicious opioid orders, faulting some drug distributors and manufacturers for their roles and criticizing the Drug Enforcement Administration for a years-long lull in enforcement actions. The findings, the latest in a series of reports from Sen. Claire McCaskill (D-Mo.), the top Democrat on the Senate’s leading oversight committee, pointed in particular to disparities between two leading drug distributors: McKesson and AmerisourceBergen. (Facher, 7/12)

Kansas City Star: McCaskill Report On Opioid Distributors In Mo. Faults DEA
“What the report finds very clearly is something is wrong with the application of the law as it relates to reporting potential problematic distributions," said McCaskill. "Because clearly the law is not being applied the same way among these three major distributors and it calls into question how effective the DEA is being in terms of overseeing the distribution of opioids in this country.” (Marso, 7/12)

In other news on the crisis —

The Hill: DOJ Unveils Proposal Giving Feds More Power To Limit Opioid Production
The Department of Justice (DOJ) finalized a proposal Wednesday giving the agency more power to control how many opioids are produced annually in the U.S. Under the proposal, the Drug Enforcement Administration (DEA) could issue stricter limits on certain opioids if federal authorities believe they are being misused. (Hellmann, 7/11)

Bloomberg: Startups Look To Mainstream Medical Tourism 
About 14 million people spent $68 billion on medical tourism in 2016, according to consulting firm PwC. A growing number are Westerners headed to developing countries for cosmetic surgery or dental work, procedures that are less expensive and invasive than major operations and often aren’t covered by insurance. PwC predicts that by 2021 the medical tourism market will reach $125 billion. The growth will be built not on nose jobs and dental implants but on costlier and riskier procedures with longer recovery times, such as knee replacements and heart surgeries. Startups from Berlin to Bangkok are trying to do for medical tourists what Airbnb or Hotels.com does for the general public. Instead of searching for a place to stay, users type in a medical procedure and get a list of clinics or doctors in nations that offer the surgery—scroll and click on a link to make an appointment. (Altstedter, 7/12)

Modern Healthcare: Cost Containment Is A Top Priority Among Health System Executives
When Rob Lazerow, a managing director at the Advisory Board Co., recently met with the executive team of a large health system, he noticed a construction project had been downsized from the prior year. The organization decided to replace its aging facilities with smaller structures, which would potentially allow it to fine-tune its staffing model and reduce its inventory of excess supplies. (Kacik, 7/11)

Modern Healthcare: High Prices Test Private Equity's Ability To Close Healthcare Deals 
Now that healthcare consumerism is replacing traditional retail storefronts with dental and urgent-care clinics, the sector has drawn ravenous interest from private equity. But a new analysis finds some would-be buyers are getting discouraged by increasingly high prices. One in 4 respondents to West Monroe Partners' recent survey on 100 private equity groups and strategic healthcare buyers said their top challenge in completing healthcare mergers and acquisitions is a shortage of attractive targets. The biggest reason? They were too expensive. (Bannow, 7/11)

Bloomberg: Amazon Has Global Aspirations For Medical-Supplies Marketplace
Amazon.com Inc. has global aspirations for its medical-supplies marketplace, according to a job listing posted on its website, highlighting the e-commerce giant’s sweeping ambitions to disrupt health care by selling products to hospitals, doctors and dentists and offering prescription drugs. The world’s biggest online retailer is looking to hire someone to lead outreach to medical-products manufacturers and service providers, who will focus on building the business in the U.S. and then expanding it globally, according to a new job post. Amazon started the Amazon Business marketplace in 2015, with health care among the industries it listed as potential customers -- along with factories, offices and universities. The new job posting emphasizes that what works for most businesses isn’t working for medical-industry clients. (Soper, 7/10)

Stateline: The U.S. Targeted Breastfeeding Abroad. Here At Home, It’s Another Story. 
The Trump administration this spring tried to remove pro-breastfeeding language from a World Health Organization resolution. But here at home, breastfeeding has steadily become more accepted and accessible — culminating this year in the 49th and 50th states enacting laws to allow it in public. The World Health Organization resolution stated that breast milk is the healthiest choice for babies and encouraged countries to crack down on misleading claims from purveyors of formula. Attempts by the United States to remove language that called on governments to “protect, promote and support breastfeeding” were unsuccessful, but the move shocked researchers and health advocates who have long contended “breast is best.” (Beitsch, 7/12)

Meanwhile, a deep look at what happened with the resolution —

Reveal: Trump Team Weakened Global Efforts To Control Marketing Of Baby Formula
Changes made to an international breastfeeding resolution under pressure from the Trump administration are more extensive than previously reported and were aimed at diluting efforts to limit the marketing of baby formula. Most provisions related to stopping “inappropriate promotion” by baby formula companies were eliminated from the United Nations’ World Health Assembly resolution, according to documents and interviews with attendees by Reveal from The Center for Investigative Reporting. (Neilson, 7/11)

The New York Times: Swift Gene-Editing Method May Revolutionize Treatments For Cancer And Infectious Diseases
For the first time, scientists have found a way to efficiently and precisely remove genes from white blood cells of the immune system and to insert beneficial replacements, all in far less time than it normally takes to edit genes. If the technique can be replicated in other labs, experts said, it may open up profound new possibilities for treating an array of diseases, including cancer, infections like H.I.V. and autoimmune conditions like lupus and rheumatoid arthritis. (Kolata, 7/11)

The Washington Post: With New Genes And An Electric Shock, Scientists Turn Immune Cells Against Cancer
A promising new class of cancer treatments recruits the cells in our blood to fight tumors, using powerful gene-editing tools to transform a type of white blood cell — called a T cell — from an immune cell that normally targets bacterial or fungal infections into a living cancer drug. The genetic alterations could boost immune systems to successfully fight cancers on their own. Researchers remove T cells from patients and slip new genes into the cells. After clinicians return the modified T cells to patients, the cells, like microscopic bloodhounds, lead the immune system on the hunt for tumors. (Guarino, 7/11)

Stat: CRISPR Makes Cancer Cells Turncoats That Attack Tumor, Mouse Study Finds
As an idea for wiping out cancer, it could have been ripped from the pages of a spy thriller: Take cancer cells that have departed the original tumor and spread elsewhere in the body, genome-edit them to be stone-cold killers, then wait for the homesick cells to return and make like émigré assassins. In a study four years in the making, scientists reported on Wednesday that “rehoming” cells that had been CRISPR’d to attack cells in the original tumor improved survival in lab mice with brain cancer, as well as in mice with breast cancer that spread to the brain. (Begley, 7/11)

NPR: A Safety Plan Can Help Suicide Survivors Prevent The Next Attempt
Many people who attempt suicide end up in an emergency room for immediate treatment. But few of those suicide survivors get the follow-up care they need at a time when they are especially likely to attempt suicide again. Now, a study shows that a simple intervention conducted by staff in emergency departments can reduce the risk of future attempts. The intervention involves creating a safety plan for each patient and following up with phone calls after discharge. (Chatterjee, 7/11)

The Associated Press: Late-Life High Blood Pressure May Harm The Brain, Study Says
New research suggests that high blood pressure late in life might harm the brain. Autopsies were done on nearly 1,300 older people, including hundreds of nuns and priests who donated their brains to science. The exams revealed more signs of damage and one of the hallmarks of Alzheimer's disease in those with higher pressure than among those with pressure closer to normal. (7/11)

Los Angeles Times: If You're An Adult In America, There's About A 50-50 Chance You've Been On A Diet In The Past Year
Dieting has become the new normal in the U.S. If you doubt this is true, just ask two American adults whether they’ve tried to lose weight in the past year. Odds are, one of them will say yes, according to a new report from the Centers for Disease Control and Prevention. Between 2013 and 2016, 49.1% of Americans ages 20 and up told interviewers with the National Health and Nutrition Examination Survey that they made an effort to shed some pounds in the previous 12 months. (Kaplan, 7/12)

The New York Times: The Power Of Positive People
Are you spending time with the right people for your health and happiness? While many of us focus primarily on diet and exercise to achieve better health, science suggests that our well-being also is influenced by the company we keep. Researchers have found that certain health behaviors appear to be contagious and that our social networks — in person and online — can influence obesity, anxiety and overall happiness. A recent report found that a person’s exercise routine was strongly influenced by his or her social network. (Parker-Pope, 7/10)

McClatchy: CDC Joins Investigation Into ‘Sonic Attacks’ In Cuba And China
The Centers for Disease Control and Prevention has joined the investigation into the sonic incidents that have injured U.S. diplomats and have confounded U.S. officials and scientists since first discovered last year in Cuba. ...The addition of CDC reflects the ongoing trouble the United States is having trying to determine the cause of the incidents that have left more than 25 Americans and U.S. personnel experiencing headaches, hearing loss, and other mysterious ailments in Cuba and China. (Ordoñez, 7/11)

Kaiser Health News: A Hospital’s Human Touch: Why Taking Care In Discharging A Patient Matters 
The kidney doctor sat next to Judy Garrett’s father, looking into his face, her hand on his arm. There are things I can do for you, she told the 87-year-old man, but if I do them I’m not sure you will like me very much. The word “death” wasn’t mentioned, but the doctor’s meaning was clear: There was no hope of recovery from kidney failure. Garrett’s father listened quietly. “I want to go home,” he said. (Graham, 7/12)

NPR: Anti-Aging Drugs In Development Show Positive Early Study Results
Scientists on the hunt for anti-aging drugs say they've made an advance with tantalizing potential: Two experimental drugs appear to safely boost the immune systems of elderly humans. The researchers stress that more research is needed to confirm the findings and show the drugs are safe. And at least one researcher says the findings are based on a relatively small number of people and used methods that could produce misleading results.Still, many researchers say the findings are encouraging. (Stein, 7/11)

Atlanta Journal-Constitution: Doctor Burnout Can Cause Major Medical Errors, Study Says
Researchers from Stanford University School of Medicine recently conducted a study, published in the Mayo Clinic Proceedings, to evaluate doctor burnout and work safety in relation to medical errors. Previous studies estimate that medical errors are responsible for 100,000 to 200,000 deaths each year in the United States. (Parker, 7/11)

The New York Times: Running After A Heart Attack
John Quinn, a retired newspaper editor, likes to wear the teal cotton T-shirt he got from the 2012 Broad Street Run, a 10-mile race in Philadelphia. It was his first 10-mile event, and he’d come a long way to get to that 2012 starting line: losing more than 60 pounds and going from calling himself “John 316,” a reference to his previous weight, to being a dedicated runner. “Getting into shape, it’s not glamorous,” he said. “It’s hard. You can’t fake it.” (Miller, 7/12)

The Washington Post: These Louisiana Physicians Can Monitor Your Blood Pressure — And You Don’t Even Have To Leave Your Living Room
There were termites in the garage and a $2,100 bill to get rid of them. The mechanic had called to say he didn’t know when the car would be fixed. So after a summer day full of aggravations, 73-year-old Ann R. Ware wasn’t surprised to see the result when she sat down on her sofa, wrapped a blood pressure cuff around her arm and pressed a button on her iPhone screen to trigger the cuff to take a reading. It was too high. At 8:30 a.m. the next day, she got a call from someone worried about the result. It was Megan McKenzie, a clinical pharmacist at Ochsner Medical Center. (Johnson, 7/11)

ProPublica: Undercooked: An Expensive Push To Save Lives And Protect The Planet Falls Short
An array of studies, including some financed by the Alliance itself, have shown that the millions of biomass cookstoves of the kind sold or distributed in the effort do not perform well enough in the field to reduce users’ risk of deadly illnesses like heart disease and pneumonia. The stoves also have not delivered much in the way of climate benefits. (Morrison, 7/12)

The Washington Post: New York Organ Collection Agency, Nation’s Second-Largest, Threatened With Closure
The government is threatening to close one of the country’s largest “organ procurement organizations” for poor performance, a rare move against a nonprofit that collects kidneys, livers, hearts and other organs used in transplantation. In a letter last month to Live­OnNY, which recovers organs in the New York City area, the Centers for Medicare and Medicaid Services (CMS) said it “will not renew its agreement with LiveOnNY” when the contract is set to expire Jan. 31. The CMS rejected LiveOnNY’s request for reconsideration Monday. (Bernstein and Kindy, 7/11)

Houston Chronicle: Texans Missing Or Delaying Needed Treatment Because Health Costs Too High 
Six in 10 Texans say someone in their household has recently skipped or postponed needed health care and medication because the cost is now out of reach, according to a new national study. Rising costs also mean Texans, even those with insurance, struggle significantly to pay the medical bills when they do seek care, the Houston Episcopal Health Foundation and the national Kaiser Family Foundation’s joint study found. The survey of 1,367 adults in the state was conducted between March and May and is part of an ongoing partnership between the two foundations examining health care issues in the state. (Deam, 7/11)

The Star Tribune: DFL Candidates In Race For Governor Highlight Health Care Plans 
Minnesota DFLers running for governor are focusing on health care plans this week, seeking to help address rising medical and prescription drug costs as two of the three leading candidates get behind a single-payer approach. While Republicans have pushed for the dissolution of MNsure and a shift to health care policies where customers pick and choose what’s covered, DFL candidates Erin Murphy and U.S. Rep. Tim Walz have lined up behind single-payer health care. That would have the state take a greater role in providing more expansive coverage and decreasing drug costs by tapping into the state’s purchasing power. (Smith, 7/11)

Des Moines Register: Iowa Nursing Homes Get Relief On Fines Via Trump's Regulatory Rollbacks
Lobbyists for Iowa’s nursing home industry called federal regulators last month and thanked them for lowering fines imposed on facilities that deliver substandard patient care. Iowa Health Care Association President Brent Willett told the regulators that "2016 cannot happen again," referring to the record $4.6 million in federal fines that Iowa homes paid two years ago under the Obama administration. (Kauffman, 7/11)

Kansas City Star: Missouri Auditor Gives Putnam County Hospital Poor Marks
Putnam County Memorial Hospital in Unionville, Mo., is showing signs of progress after a blistering audit last year prompted a Missouri attorney general investigation, but remains in poor financial condition, according to a new report. Missouri Auditor Nicole Galloway on Wednesday released a follow-up audit to one her office issued last year that found the rural hospital was involved in $90 million in questionable billings. (Vockrodt, 7/11)

Milwaukee Journal Sentinel: 7th Circuit Reinstates Transgender Inmate's Lawsuit Over Treatment
The U.S. Court of Appeals has ruled a transgender former Wisconsin inmate can sue Wisconsin Department of Corrections officials for denying her hormone treatment, both in prison and while on supervised release. The 7th U.S. Circuit Court of Appeals reinstated most of a lawsuit by Lisa Mitchell against Kevin Kallas, the Department of Corrections' mental health director, and three probation officers. (Vielmetti, 7/11)

Cleveland Plain Dealer: Ohio's Rainy Day Fund Grows To Nearly $2.7 Billion
Ohio budget officials stashed away more than $657.5 million in the state's savings account on Wednesday, boosting the total to nearly $2.7 billion. The deposit comes just 13 months after Ohio lawmakers slashed the state budget by $1 billion and follows two years without adding to the state's budget stabilization fund, informally called the rainy day fund. (Borchardt, 7/11)

The Associated Press: Report: Cancer Mortality Rates On Decline In Delaware
A recent report by the Delaware Department of Health and Social Services says there has been a decline in cancer mortality rates in the state. Citing a Monday agency release, news outlets report there was a 12 percent drop in all-site cancer deaths from the periods of 2000 through 2004 to 2010 through 2014. The release says the nation saw an overall decline of 14 percent when comparing those same periods. Delaware’s national ranking for all-site cancer mortality remains unchanged from last year, with Delaware coming in 16th. The state was ranked second in the 1990s. (7/11)

California Healthline: California Clinic Screens Asylum Seekers For Honesty
Dr. Nick Nelson walks through busy Highland Hospital to a sixth-floor exam room, where he sees patients from around the world who say they have fled torture and violence. Nelson, who practices internal medicine, is the medical director of the Highland Human Rights Clinic, part of the Alameda Health System. A few times each week, he and his team conduct medical evaluations of people who are seeking asylum in the United States. The doctors listen to the patients’ stories. They search for signs of trauma. They scrutinize injuries, including electrocution scars, bullet wounds and unset broken bones. (Gorman, 7/10)

Miami Herald: Former Employees Describe Life Inside Homestead Shelter
The last time the Homestead Temporary Shelter for Unaccompanied Children was open in 2017, 60 children would arrive some nights on a charter bus. ... From the moment they arrived until the moment they left to live with family members or sponsors, typically about a month later, the children would see an array of case workers, doctors and therapists and receive medication, testing and counseling. (Leibowitz, 7/12)

KCUR: A Year After Audit, Tiny Rural Hospital In Missouri Still Facing Financial Woes 
Nearly a year after Missouri state Auditor Nicole Galloway released a scathing audit of Putnam County Memorial Hospital in Unionville, Missouri, the tiny hospital is still struggling to recover from a lab billing scheme that's now the subject of criminal investigations. That’s one of the takeaways from a follow-up report released Wednesday on the hospital, which was in dire financial straits when the audit was conducted and remains in poor financial condition today. (Margolies and Sable-Smith, 7/11)

Miami Herald: One More Threat From Nikolas Cruz Went Unreported
The summer before he killed 17 people at Marjory Stoneman Douglas High School in Parkland, Nikolas Cruz once talked openly at his job about shooting up his former campus — yet another warning sign that went unheeded. The encounter happened at Cruz's cashiering job at a Coral Springs Dollar Tree store. (Nehamas and Ovalle, 7/11)

Concord (N.H.) Monitor: Facing $19M Accreditation Threat, N.H. Hospital Gets Funding To Fix Doors
New Hampshire’s state-run mental hospital is set to move ahead on a $647,000 upgrade for its doors after the Executive Council passed an emergency motion to head off a mounting threat to its accreditation. Now the hospital is racing against the clock to install the doors ahead of a crucial site review by inspectors from the Centers for Medicare and Medicaid Services this September. Failure to pass that CMS review could cost the hospital $19 million in federal funding, officials said. (DeWitt, 7/11)

Cincinnati Enquirer: Cincinnati Hospitals Reluctantly Realize That Medical Marijuana Is Coming To Town
Will patients with state permits, including children, be allowed to use medical marijuana when hospitalized? The Enquirer asked officials of the region’s hospitals how they plan to work with a new drug-delivery system set to open in September and expected to draw at least 200,000 Ohioans under 21 qualifying conditions. (Saker, 7/11)

USA Today: Don't Deny Insurance To Sick People, Find Other Ways To Reduce Costs
It's hard to think of a law that's been more controversial in the last decade than the Affordable Care Act, also known as Obamacare. Yet as the country continues to endure bitter division over the ACA, one provision remains extraordinarily popular: the requirement that insurers cover those who are sick. Even in the thick of the Obamacare debates a decade ago, 80 percent of Americans agreed the federal government should require insurance companies to offer coverage to everyone, regardless of their pre-existing illnesses and conditions. As Americans prepare to vote in a midterm election where polls show health care is a top issue, they will need to decide whether they want to choose candidates who would permit discriminating against sick people and support undoing the progress we've made on one of the few policy issues where the country has managed to find consensus. (Arthur Tim Garson, 7/12)

Lexington Herald: Managed-Care Firms Strangle Ky. Medicaid
More than half of all Medicaid beneficiaries nationally receive most or all of their care from managed-care organizations that contract with state Medicaid programs to deliver comprehensive services. Kentucky leads the way, providing some of highest profits to MCOs. This is suffocating the health-care system. Kentucky HEALTH, the state’s Medicaid reform, clearly decreases access to health-care services to Medicaid beneficiaries. This would have included new requirements for co-pays and work. Currently blocked by federal courts, the plan not only shifts more costs upon the population health-care providers serve, but also ensures greater profit to MCOs. (Larry Suess, 7/11)

The Topeka Capital-Journal: Stop Posturing About Medicaid Work Requirements
Last week, a Kentucky court blocked the state’s proposal to impose Medicaid work requirements, citing they “never adequately considered whether Kentucky HEALTH (the state’s Medicaid program) would in fact help the state furnish medical assistance to its citizens, a central objective of Medicaid.” Yet Gov. Colyer, who was stripped by the Legislature this past session of the ability to implement work requirements without legislative approval, still stands in favor of pursuing work requirements in Kansas even though it will lead to another expensive legal battle the state isn’t likely to win. It’s another example of shortsighted policy-making that satisfies political talking points but fails to meet the needs of Kansans and ends up costing the state more in a multitude of ways. (7/11)

Apalachicola Times: Medicaid Expansion Is Saving Lives 
Louisiana expanded its Medicaid program just over two years ago. In that time, the number of people who were able to obtain health insurance has ballooned. When Gov. John Be Edwards approved the expansion, about 25 percent of the people in Louisiana lacked basic medical coverage. Since that time, the number is down to around 10 percent. That is a huge difference in numbers, of course, but the real difference is measured in the lives the expansion will be able to save. Consider these numbers, which tell just part of the story: 400 women on Medicaid have been diagnosed with breast cancer and begun treatment; 8,000 have had precancerous colon polyps removed; and 57,000 people are receiving mental-health care. Those are staggering figures that are making a real impact on the quality of people’s lives – and likely saving a good number of lives themselves. (7/11)

New England Journal of Medicine: Medicaid’s Path To Value-Based Reform
Prominent Medicare value-based payment models are influencing the ways in which clinicians deliver care. CMS and states have also started transforming reimbursement and care for Medicaid beneficiaries, but sustained success may be harder to achieve than in Medicare. (Joshua Liao, Benjamin D. Sommers and Amol S. Navathe, 7/12)

The Hill: AHA Medicare Appeals Reform Recommendations Miss The Mark
Last week, the American Hospital Association (AHA) filed a brief with the federal court in response to U.S. District Judge James Boasberg’s request for ideas to address the current Medicare appeals backlog. Instead of making substantive administrative recommendations to improve the Medicare appeals process, the AHA makes suggestions that are not only redundant based on existing Centers for Medicare and Medicaid Services (CMS) rules. It also clearly demonstrate that the AHA is more interested in sidelining the Recovery Audit Contractor (RAC) program than fixing the Medicare appeals backlog. (Kristin Walter, 7/11)

WBUR: Don't Expect Brett Kavanaugh To Protect The Affordable Care Act
In his health law decisions, [Brett] Kavanaugh found that Congress explicitly authorized the challenged portions of the ACA. It's likely he would uphold health law regulations, as long as there is explicit Congressional authorization to do so. (Carmel Shachar, 7/12)

The Washington Post: Where The Real Fight Over Abortion Will Take Place
In Rhode Island, Gov. Gina Raimondo, a Democrat running for a second term, has called for a special legislative session to codify abortion rights into state law. In Wisconsin, former state representative Kelda Roys, battling in a crowded Democratic gubernatorial primary, has declared that if federal protection of abortion rights is eliminated, she would pardon anyone charged with violating the state’s 169-year-old law criminalizing the procedure. ...With the coming shift in power on the Supreme Court, abortion-rights forces across the country are about to learn two things the other side figured out a long time ago: This is a battle that must be waged over the long haul. And it is one where the fight begins at home. (Karen Tumulty, 7/11)

Bloomberg: New Weapons Against Antibiotic-Resistant Bacteria
It’s frustrating enough when progress in medicine plods along slowly, but downright alarming when it starts to backslide. Bacterial infections were considered essentially conquered in the 20th century, and now resistant strains are projected to kill more people than cancer by 2050. While some people dispute the projected death rate, it’s agreed that bacteria are evolving resistance to antibiotics faster than the drug pipeline can produce new ones. (Faye Flam, 7/11)

The New York Times: For Gays, The Worst Is Yet To Come. Again.
I was recently honored for my birthday with an all-star reading of my play “The Destiny of Me.” It was obviously a very emotional experience for me. I’m supposed to be dead by now. Most of the guys who got infected with H.I.V. in the 1980s are long dead. The play is about a middle-aged man infected with H.I.V. undergoing an experimental treatment at the National Institutes of Health. In his hospital room he finds himself remembering his life since childhood. He realizes his entire life has been one long battle to be accepted as a homosexual. (Larry Kramer, 7/11)

WBUR: Ageism Ignores And Insults The Competence Of Adults
Familiar though I have long been with an array of ageisms that include unrelenting Congressional attempts to unravel the safety nets of Social Security, Medicare and Medicaid, I’ve been hearing personal stories that shock and upset me. They report everything from real violence to casual insults. (Margaret Morganroth Gllette, 7/12)

USA Today: Trump Administration Missed Deadline, Families Aren't Reunited
President Donald Trump's suggestion Tuesday that the solution to the humanitarian crisis of family separation is that families should stop seeking entry to the U.S. is nonsensical. The administration has manufactured this crisis itself by adopting inhumane, unlawful and fiscally unsound policies. Its failure to reunite children under 5 years of age — toddlers — with their parents by a federal judge’s deadline shows the incredible toll this policy is taking on families, as well as the costly logistical nightmare it has created. (7/11)

New England Journal of Medicine: The Suffering Of Children
Every pediatrician has his or her own tips for putting young patients at ease in the exam room. Mine include referring to even the tiniest Spanish-speaking patients as usted rather than tú, as a sign of respect, and sitting at or below their level to avoid looming over them. Most important, I examine children in a parent’s lap whenever possible. I will even vaccinate them in that position if the parent feels comfortable holding the child. For most children, there is no safer, more comforting place in the world than a parent’s embrace. That is why the American Academy of Pediatrics (AAP) and the American Medical Association, along with hundreds of other national organizations, have decried the U.S. government’s recent policy of tearing undocumented immigrant children from the arms of the people who would carry them to safety. (Fiona Danaher, 7/12)

New England Journal of Medicine: Housing Immigrant Children — The Inhumanity Of Constant Illumination 
On the Wednesday before the summer solstice in the United States, President Donald Trump ended his administration’s policy of forced separation of immigrant children from their parents at the U.S.–Mexico border — a practice characterized by the president of the American Academy of Pediatrics (AAP) as a form of child abuse with long-lasting adverse effects on the developing brains of the 2300 children already subjected to this trauma. Nonetheless, there are still 1100 immigrants being held by the Department of Homeland Security (DHS) at a warehouse on Ursula Ave. in McAllen, Texas. The Ursula facility, as it’s called, is reportedly the area’s first central processing center for immigrant children and families. Alarmingly, according to press accounts, its “overhead lighting stays on around the clock.” It is critical for their health and safety that children be allowed to sleep in the dark at night and be exposed to bright outdoor light during the day. (Charles A. Czeisler, 7/12)

New England Journal of Medicine: The Calorie-Labeling Saga — Federal Preemption And Delayed Implementation Of Public Health Law
Eight years after passage of the Affordable Care Act, its provisions for calorie labeling in food-establishment chains have finally been implemented. The long delay has exposed a broken regulatory system that is often unaccountable to the public. (Jason P. Block, 7/12)

Stat: Facing Deaths Of Despair From The Depths Of Despair In West Virginia
I left my home state of West Virginia 30 years ago to embark on a career in internal medicine. What drew me back in 2015 was the opioid crisis — and the even bigger health crisis it is part of. Opioid addiction takes a greater toll in West Virginia than in any other state. In 2016, the last year with complete statistics, a West Virginian was dying of a drug overdose every 10 hours. As a physician who helps manage the largest medical system in West Virginia, I’ve learned that as big as the opioid addiction crisis is in our state, it is not the root problem. Instead, it is a symptom of a much larger problem, one of hopelessness, isolation, and despair. (Clay Marsh, 7/12)

The New York Times: A Doctor’s Responsibility
As a physician, do I or don’t I? I‘m walking home from the subway with my 12-year-old daughter when we pass a man sitting on the sidewalk, head hanging down over his knees. Living in New York City, we see a lot of people, sadly, like this. Their numbers are increasing, as the surge of opiate addiction meets the surge in housing prices. Everyone has to make a personal decision about if, when or how one should do something, or just walk on. If you’re a parent, there’s the additional challenge of navigating these heartbreaking dilemmas with your child. For doctors, it’s a little different. The American Medical Association code of ethics says that doctors have “an ethical obligation to provide care in cases of medical emergency.” (Danielle Ofri, 7/10)

The New York Times: How To Have A Better Conversation About Mental Illness
SYDNEY, Australia — As public conversation about mental health has grown louder and busier in recent years, mental illness has become more than a category of disease with social and psychological dimensions. Especially in the case of depression and anxiety, mental illness has come to be seen as a proxy for what is wrong with the modern Western world. (Lisa Pryor, 7/11)

Stat: Everyone Deserves A Holistic, Patient-Centric Health Care System
As health care evolves to become more consumer-centric, it’s crucial that providers and care advocates evolve with it. For the first time, we’re seeing a noticeable shift in the way providers care for patients, from providing mostly episodic acute care to being focused more on their patients’ health outcomes and overall well-being. While this is certainly a step in the right direction, I believe that transforming care delivery involves understanding patients more holistically and tailoring care to effectively meet their needs. (Karen Lynch, 7/12)