First Edition: May 13, 2019

Kaiser Health News: How Obamacare, Medicare And ‘Medicare For All’ Muddy The Campaign Trail
The health care debate has Democrats on Capitol Hill and the presidential campaign trail facing renewed pressure to make clear where they stand: Are they for “Medicare for All”? Or will they take up the push to protect the Affordable Care Act? Obamacare advocates have found a powerful ally in House Speaker Nancy Pelosi, who in a recent “60 Minutes” appearance said that concentrating on the health law is preferable to Medicare for All. She argued that since the ACA’s “benefits are better” than those of the existing Medicare program, implementing Medicare for All would mean changing major provisions of current Medicare, which covers people 65 and up as well as those with disabilities. (Luthra, 5/13)

Kaiser Health News: ‘John Doe’ Patients Sometimes Force Hospital Staff To Play Detective
The 50-something man with a shaved head and brown eyes was unresponsive when the paramedics wheeled him into the emergency room. His pockets were empty: no wallet, no cellphone, not a single scrap of paper that might reveal his identity to the nurses and doctors working to save his life. His body lacked any distinguishing scars or tattoos. Almost two years after he was hit by a car on busy Santa Monica Boulevard in January 2017 and transported to Los Angeles County+USC Medical Center with a devastating brain injury, no one had come looking for him or reported him missing. The man died in the hospital, still a John Doe. (Abram and de Marco, 5/13)

California Healthline: Newsom Changes Course On Plan To Pay For Immigrant Health Coverage
Gov. Gavin Newsom’s administration Friday reversed course on his plan to divert public health dollars from several counties to help provide health coverage to young adults who are in the country illegally. The administration heeded the alarm sounded by Sacramento, Placer, Santa Barbara and Stanislaus counties, which had warned that the governor’s plan would compromise their ability to cope with surging rates of sexually transmitted diseases and, in some cases, measles outbreaks. (Young, 5/10)

The Associated Press: States Bring Price Fixing Suit Against Generic Drug Makers
Attorneys general from more than 40 states are alleging the nation's largest generic drug manufacturers conspired to artificially inflate and manipulate prices for more than 100 different generic drugs, including treatments for diabetes, cancer, arthritis and other medical conditions. The lawsuit, filed in federal court in Connecticut on Friday, also names 15 individual senior executives responsible for sales, marketing and pricing. (LeBlanc, 5/11)

The New York Times: Teva And Other Generic Drugmakers Inflated Prices Up To 1,000%, State Prosecutors Say
Leading drug companies including Teva, Pfizer, Novartis and Mylan conspired to inflate the prices of generic drugs by as much as 1,000 percent, according to a far-reaching lawsuit filed on Friday by 44 states. The industrywide scheme affected the prices of more than 100 generic drugs, according to the complaint, including lamivudine-zidovudine, which treats H.I.V.; budesonide, an asthma medication; fenofibrate, which treats high cholesterol; amphetamine-dextroamphetamine for A.D.H.D.; oral antibiotics; blood thinners; cancer drugs; contraceptives; and antidepressants. (Murphy, 5/11)

The Hill: 44 States Accuse Drug Companies Of Price-Fixing
Teva USA denied wrongdoing in a statement to Reuters. “The allegations in this new complaint, and in the litigation more generally, are just that – allegations,” the company said. “Teva continues to review the issue internally and has not engaged in any conduct that would lead to civil or criminal liability.” The drugs in the alleged scheme include treatments for diabetes, high cholesterol, high blood pressure, cancer, epilepsy and more, according to the news outlet. (Frazin, 5/11)

NPR: Book Exposes How Some Generic Drug Makers Ignored Safety And Committed Fraud
Generic drugs are supposed to work just as well as their name-brand counterparts. Once a patent lifts, generic drug companies find alternative ways to manufacture a drug that should work indistinguishably from the name-brand version. In a world of skyrocketing prescription drug prices, cheaper generics have acted as a crucial counterweight. (Lambert, 5/12)

Stat: Gilead Will Donate Truvada For HIV Prevention, But Reaction Is Mixed 
Seeking to blunt criticism of its pricing, Gilead Sciences (GILD) is donating enough of its HIV prevention pill to cover as many as 200,000 patients over the next 11 years. The donation will cover both the existing Truvada pill, which has been the subject of battles with AIDS activists, and still another drug the company hopes will also win regulatory approval to prevent the virus. The move was hailed by the Trump administration, which announced plans to end HIV in the U.S. by 2030, but has also been criticized by activists for not taking steps to reduce the cost of Truvada. The pill, which is also sometimes referred to as PrEP, costs about $1,675 a month, or $20,000 a year, but has been climbing steadily since it was first introduced in 2004 for treating HIV. (Silverman, 5/10)

Modern Healthcare: FDA Finalizes Guidance To Spur Biosimilar Availability
The FDA has approved 19 biosimilar drugs, but it has not approved any drugs that are interchangeable with a biologic. Several providers say that the lack of interchangeability has been one of the barriers to more availability with others being physician reluctance. Catholic hospital chain Ascension recently complained at a U.S. House of Representatives hearing that physicians are reluctant to prescribe biosimilars and interchangeability is gravely needed. The guidance will be very helpful for healthcare systems that include pharmacies. (King, 5/10)

The Hill: Health Care, Climate Change Top Issues For Iowans Ahead Of Caucuses: Analysis
Iowa caucus-goers’ top concerns appear to be health care and climate change, according to data analysis by the Des Moines Register. An analysis of more than 300 questions asked by potential voters at 46 candidate events over the course of 30 days found 27 questions about climate or environmental issues. The candidate receiving the most climate-related questions was former Rep. Beto O’Rourke (D-Texas), with seven, followed by Rep. Eric Swalwell (D-Calif.) and Sen. Cory Booker (D-N.J.), each with four. (Budryk, 5/12)

The Washington Post Fact Checker: Cory Booker’s Misleading Claim That Toy Guns Are More Regulated Than Real Guns
These are three examples of a catchy talking point from the 2020 presidential hopeful — that toy guns are subject to more regulation than real guns. The Medium post is rather specific: The Consumer Product Safety Commission, because of a “loophole,” does not assess the safety of guns. But in television interviews and tweets, that nuanced point gets turned into misleading shorthand — there is “more federal regulation” of toy guns, or there are “no regulations” for guns. Booker’s point is not particularly original. Gun-control advocates have been calling for consumer safety oversight of guns for decades. But he veers off course when he compares regulatory oversight of guns and toy guns. (Kessler, 5/13)

The Hill: Health Industry To Clash Over Surprise Medical Bills
Three powerful players in the health care industry are gearing up for battle over surprise medical bills. Doctors, hospitals and insurers have all pledged to protect patients from being hit with massive, unexpected bills for out-of-network care, but no one wants to take on the added costs that come with it. That reluctance is setting the stage for a fight, with the insurance industry on one side and hospitals and doctors on the other (Weixel, 5/11)

The Hill: House Budget Committee Announces Hearing On Single-Payer Health Care
The House Budget Committee on Friday announced that it will hold a hearing on single-payer health care on May 22, marking another step forward for the progressive proposal on Capitol Hill. The hearing will be the second one on the idea of single-payer, sometimes called "Medicare for All," that House Democrats have held this year since taking back the majority. (Sullivan, 5/10)

The Associated Press: Washington To Offer First 'Public Option' Insurance In US
Washington is set to become the first state to enter the private health insurance market with a universally available public option. A set of tiered public plans will cover standard services and are expected to be up to 10% cheaper than comparable private insurance, thanks in part to savings from a cap on rates paid to providers. But unlike existing government-managed plans, Washington's public plans are set to be available to all residents regardless of income by 2021. (James, 5/12)

The Associated Press: Maryland Bill Aims To Help Enroll Uninsured In Health Plans
A Maryland measure that’s the first of its kind could help people without health insurance find out if they qualify for free or low-cost insurance after they file their taxes. Gov. Larry Hogan is scheduled to sign the bill Monday. It will create a box for people to check on state income tax returns. If selected, the state’s health care exchange will see if the person qualifies for low-cost insurance, based on information in their tax return. Those who qualify for Medicaid will be enrolled automatically. The exchange will reach out to people who qualify for private coverage. (Witte, 5/13)

The Washington Post: Could Miscarriages Land Women In Jail? Let’s Clarify These Georgia And Alabama Abortion Bills.
Abortion legislation in Georgia and Alabama ascended in the news cycle this week, with Georgia’s governor signing a “heartbeat bill” into law on Tuesday and Alabama’s Senate postponing until next week its vote on a near-total abortion ban. The Georgia law will ban abortions after a doctor is able to detect “a fetal heartbeat in the womb,” usually at about six weeks, before many women know they are pregnant. It was one of the nation’s most stringent proposals until the all-out ban introduced in Alabama. (Paul and Wax-Thibodeaux, 5/12)

The Washington Post: Ohio Abortion Bill Includes False Claim About Ectopic Pregnancy
An abortion bill introduced in Ohio’s legislature drew scorn this week for including misinformation about a dangerous medical condition that can affect pregnant women. Some health experts see the bill’s language as another example of politicians trying to legislate women’s health without considering the medical implications. The House bill, which was first introduced in April by Ohio state Rep. John Becker (R), seeks to limit insurance coverage for abortion procedures where the mother’s life is not endangered. It would also bar coverage for drugs or devices that prevent the implantation of a fertilized egg, which experts say could affect certain kinds of IUDs. (Epstein, 5/10)

The Associated Press: More 'Heartbeat' Abortion Bans Advancing In South, Midwest
If a new Mississippi law survives a court challenge, it will be nearly impossible for most pregnant women to get an abortion there. Or, potentially, in neighboring Louisiana. Or Alabama. Or Georgia. The Louisiana legislature is halfway toward passing a law — like the ones enacted in Mississippi and Georgia — that will ban abortions after a fetal heartbeat is detected, about six weeks into a pregnancy and before many women know they're pregnant. Alabama is on the cusp of approving an even more restrictive bill. (5/11)

The New York Times: The Race To Limit Abortion Access
This year, with the future of Roe v. Wade newly in question after the appointment of Justice Brett Kavanaugh to the Supreme Court, a rash of abortion-related bills have been making their way through statehouses. The vast majority are bills to restrict access to abortion, though a couple are efforts to shore up abortion rights. This week, Georgia and Alabama have made moves to restrict access to the procedure. Alabama’s is one of the most aggressive ever in the U.S., aiming to criminalize abortion. The vote, initially expected to take place on Thursday, was delayed until next week after chaos erupted on the Senate floor. (Salam, 5/10)

The Hill: Additional Actors, Filmmakers Boycott Georgia Over New Abortion Law
More actors and film production companies, such as Alyssa Milano and Duplass Brothers Productions, have joined a boycott of the state of Georgia after Gov. Brian Kemp (R) signed a new "heartbeat" abortion bill into law. Milano told BuzzFeed News in a statement Thursday that she will not return to Netflix's "Insatiable" for a third season if the show's filming does not move to a different state. (Frazin, 5/10)

The Associated Press Fact Check: Trump, His Baby 'Executions' And The Reality
President Donald Trump, in what's become a staple of his rallies, accuses doctors of executing babies who are born alive after a failed abortion attempt. His comments, meant to taint Democrats, have been embraced by many anti-abortion activists, and assailed as maliciously false by many medical professionals. What's clear is that he is oversimplifying a deeply complex issue. It's already a crime to kill babies, but not necessarily a crime to forgo sophisticated medical intervention in cases where severe fetal abnormalities leave a newborn with no chance of survival. (Crary, 5/13)

The New York Times: Where Will Measles Break Out Next? Chicago, Los Angeles Or Miami, Scientists Predict
Chicago, Los Angeles and Miami are the cities most likely to see the next measles outbreaks, according to an unusual new study. Researchers at the University of Texas at Austin and Johns Hopkins University mapped the 25 American counties most at risk of measles because of their vaccine-exemption rates and proximity to airports. A similar map published last year proved surprisingly accurate at forecasting many of this year’s cases. But both groups of scientists failed to predict the measles outbreak that began in Brooklyn, currently the nation’s largest. (McNeil, 5/10)

Stateline: Amid Measles Outbreak, Little Effort To Kill Vaccine Exemptions
Despite the worst measles outbreak in decades, few state legislatures this year have reconsidered the exemptions that families use to avoid inoculating their children. As many legislative sessions wind down, only Washington state, which has had one of the highest numbers of measles cases, has sent a measure to the governor’s desk. (Ollove, 5/10)

The Hill: Instagram Blocks #VaccinesKill, Reviewing Other Anti-Vaccine Hashtags
Instagram this week blocked the hashtag #VaccinesKill amid its crackdown on vaccine-related misinformation, and it says it is looking into other hashtags typically used to promote false information about vaccines. The Facebook-owned social media network had previously declined to block the #VaccinesKill hashtag, a popular gathering place for anti-vaccine activists on Instagram, arguing that the phrase "vaccines kill" did not count as medical misinformation. An Instagram spokesperson in an email to The Hill last month claimed there have been rare instances in which vaccine side effects have caused death. (Birnbaum, 5/10)

Reuters: What You Need To Know About The U.S. Measles Outbreak
The United States so far this year has recorded 704 cases of measles in 22 states, its largest outbreak since public health officials in 2000 declared the disease eradicated, according to the Centers for Disease Control and Prevention. The CDC on Monday released updated figures on the number of cases recorded so far this year, which have hit a 25-year-high. Here are key facts about the outbreak. (5/10)

Reuters: Following Opioid Suits, Family Behind Deadly OxyContin Squabbles
A united front among members of the billionaire Sackler family behind painkiller OxyContin is showing signs of strain from litigation over who bears responsibility for the deadly U.S. opioid epidemic. At least twice in recent months, eight members of the Sackler family who own OxyContin maker Purdue Pharma LP have been at odds over how to respond to allegations implicating them in deceptive marketing of prescription painkillers that led to widespread fatal overdoses, said people familiar with the matter. (5/10)

The Washington Post: ‘Who’s Going To Take Care Of These People?’
The hospital had already transferred out most of its patients and lost half its staff when the CEO called a meeting to take inventory of what was left. Employees crammed into Tina Steele’s office at Fairfax Community Hospital, where the air conditioning was no longer working and the computer software had just been shut off for nonpayment. “I want to start with good news,” Steele said, and she told them a food bank would make deliveries to the hospital and Dollar General would donate office supplies. “So how desperate are we?” one employee asked. “How much money do we have in the bank?” (Saslow, 5/11)

Stat: Hospitals Look To Computers To Predict Patient Emergencies 
Hospital command centers have proliferated across the country in recent years, with medical centers from Oregon to Florida deploying them to tackle a range of data-monitoring tasks, such as maximizing bed capacity, calibrating staffing levels, and detecting the onset of sepsis, a life-threatening response to infection that is a common killer in hospitals. Recent advances in artificial intelligence promise to help hospitals identify new warning signs of patient deterioration and intervene earlier in the process. Administrators of command centers at Johns Hopkins and Yale New Haven Hospital both said they are exploring the use of machine learning to deliver more timely care. (Ross, 5/13)

The Wall Street Journal: Rattled By Cyberattacks, Hospitals Push Device Makers To Improve Security
Hospitals are pushing medical-device makers to improve cyber defenses of their internet-connected infusion pumps, biopsy imaging tables and other health-care products as reports of attacks rise. Rattled by recent global cyberattacks, U.S. hospitals are conducting tests to detect weaknesses in specific devices, and asking manufacturers to reveal the proprietary software running the products in order to identify vulnerabilities. In some cases, hospitals have canceled orders and rejected bids for devices that lacked safety features. (Evans and Loftus, 5/12)

The Washington Post: The Once-Boring Treadmill Is Becoming A Hip New Fitness Trend
On a recent evening, Elizabeth Ewens was in the middle of an intense run workout. Her coach told her to kick it up, so she did and received encouragement from a fellow runner. She finished the workout feeling good. While Ewens’s evening workout sounds like what running groups around the world do several nights a week, she was actually in her home, live-streaming a treadmill class, complete with motivational instructor, music and leader board, to a monitor on her screen. (Yu, 5/12)

The New York Times: Many Americans Will Need Long-Term Care. Most Won’t Be Able To Afford It.
Gretchen Harris likes the small brick house she bought in Norman, Okla., 36 years ago. She’s fond of her neighbors and the magnolia tree she planted in the front yard. And having a single-story residence proved helpful after knee replacement surgery last summer. “It’s always been a good size for me,” she said. But Ms. Harris, 72, a retired attorney, has grappled with assorted health problems — heart disease, non-Hodgkin’s lymphoma, osteoporosis, rheumatoid arthritis — and takes a long list of prescription drugs. (Span, 5/10)

NPR: Can Racial Disparities In Maternal Deaths Be Reduced?
Medicine continues to advance on many fronts, yet basic health care fails hundreds of women a year who die during or after pregnancy, especially women of color. Black mothers die at a rate that's 3.3 times greater than whites, and Native American or Alaskan Native women die at a rate 2.5 times greater than whites, according to a report out this week from the Centers for Disease Control and Prevention. Yet, the report concluded, roughly 3 in 5 pregnancy-related deaths are preventable. The racial disparity in maternal death rates is a dramatic argument for prevention efforts that address diverse populations, says Dr. Wanda Barfield, director of the Division of Reproductive Health and assistant surgeon general in the U.S. Public Health Service. (Neighmond, 5/10)

The New York Times: The Impact Of Early Sexual Initiation On Boys
Every couple of years, the Centers for Disease Control and Prevention asks middle and high school students to fill out surveys in class for the Youth Risk Behavior Surveillance System. If students are sexually active, it asks for the age of first sexual intercourse, which is an important milestone. From a public health point of view, sexual intercourse initiates young people into certain kinds of risk, notably pregnancy and sexually transmitted infection. In those terms, what is called early sexual initiation — that is, intercourse before the age of 13 — is well-known as a marker for other kinds of risk, in both girls and boys, including binge drinking and having multiple sexual partners. (Klass, 5/13)

The New York Times: A Little-Known Skin Disease That Can Disrupt People’s Sex Lives
You’ve probably heard of lichens, complex organisms consisting of a fungus and an alga (and sometimes a bacterium) that break down rocks to create soil. Though lichens vary widely in color and form, most often seen are the white crusty varieties that colonize the surface of trees, rocks and barren soil. This type has lent its name to a little-known skin disease — lichen sclerosus — that typically manifests as white crusts on genital tissues and is often undiagnosed or misdiagnosed before it wreaks havoc on people’s lives. (Brody, 5/12)

NPR: How You (And Your Dog) Can Avoid Snake Bites And What To Do If You Get One
It was a warm, wet winter this year across much of the United States. In most states, this means more greenery, more rabbits, more rodents and more snakes — which raises the risk of snake bites for humans and their canine companions. Biologist Gerad Fox is standing next to a loud rattlesnake. "Right now he's in a classic strike posture, very defensive," says Fox. "The rattle is a warning, saying, 'Back off. I'm dangerous. You should leave me alone.' " Fox teaches biology classes at Loma Linda University in California and also runs rattlesnake avoidance training classes for dogs. (Neighmond, 5/12)

NPR: The Hidden Upside To Gossip
Almost everyone gossips. And a new study finds that people spend about 52 minutes per day, on average, talking to someone about someone else who is not present. But here's the surprise: Despite the assumption that most gossip is trash talk, the study finds that the vast majority of gossip is nonjudgmental chitchat. (Aubrey, 5/13)

The Washington Post: A Daughter’s Gift To Her Mother Saves Two Lives
Just 42 years old, Erosalyn Deveza was drifting toward death. Her kidneys were barely functioning. She was constantly exhausted. She had vertigo and vomited frequently. She was tethered to a home dialysis machine for eight hours each night as she slept. A kidney transplant was the only thing that could save her, but it was unlikely to happen in time. There is a severe shortage of kidneys from deceased donors in the United States. No one on Deveza’s side of the family could provide an organ through a living donation, doctors said, because all were at risk for the same kidney disease. It was too dangerous to leave any of them with a single kidney. Other family and friends were not a match. (Bernstein, 5/11)

The Washington Post: Tick Information Site Can Answer Your Questions
Summertime is almost here, and impending camps, cookouts and vacations mean more time spent outdoors. That comes with the risk of tick bites — and tick-borne diseases. Those diseases have been on the rise in recent years, with steady increases in both frequency and distribution. Lyme disease, anaplasmosis and other diseases can be passed along by these ectoparasites, and different critters carry different pathogens. (Blakemore, 5/11)

The Associated Press: 5 More Ex-Students Sue Ohio State Claiming Abuse By Doctor
Five more former Ohio State University students who claim they were abused by a former university physician and team doctor have sued the school. The Columbus Dispatch reports the plaintiffs in the federal lawsuit filed Friday are identified as "John Does" to protect their identities. Three of the men say they were wrestlers and two sought treatment at a university health center. (5/11)

The Associated Press: CDC Plans Door-To-Door Survey Near Illinois Ammonia Leak
Officials with the Centers for Disease Control and Prevention plan a door-to-door survey this weekend in northern Illinois near where an anhydrous ammonia leak sickened dozens last month. The Lake County Health Department says CDC staff will start interviews Saturday at home within a 1-mile radius of the spill in Beach Park, about 40 miles north of downtown Chicago. The CDC also will interview first responders and nearly 40 people hospitalized after the April 25 leak. (5/10)

The Associated Press: States Seek Explicit Patient Consent For Pelvic Exams
Savanah Harshbarger estimates she performed as many as 10 pelvic exams last year on patients before gynecologic surgeries, feeling for fibroid tumors or other abnormalities. The Duke University medical student said the experience was a revelation. “It’s pretty empowering to know this is something you can detect with a gloved hand instead of needing an MRI or some more expensive procedure,” Harshbarger said. (McDermott and Johnson, 5/12)

The Associated Press: Arkansas' First Medical Marijuana Dispensary Opens Its Doors
Two and a half years after Arkansans voted to legalize medical marijuana, qualifying patients could begin buying the product Saturday morning when the state's first dispensary opened, though the celebratory mood was dampened by confusion about operating hours and fears the dispensary wouldn't be able to serve all the patients by closing time. (5/11)

The Associated Press: Delaware Doc Accused Of Trading Drugs For Sex Loses License
Delaware has permanently revoked the license of a doctor accused of prescribing opioids in exchange for sexual favors from a female patient undergoing treatment for long-term drug addiction. The News Journal of Wilmington reports the state Board of Medical Licensure and Discipline this week revoked the license of Nihar B. Gala, who oversaw the pain management and addiction treatment center Alpha Care Medical. (5/10)

The Associated Press: Minnesota GOP Leader Has Family Stake In Gay Conversion Vote
The top Republican in the Minnesota Senate, who helped defeat a proposed ban on so-called gay conversion therapy for minors, sent his daughter to a therapist opposed to gay relationships after suspecting she had a same-sex attraction when she was a teenager, the Star Tribune reported Friday. Senate Majority Leader Paul Gazelka, a conservative Christian from Nisswa, led his caucus in voting down a Democratic proposal May 1 against the practice of trying to turn gay people straight. (5/10)