First Edition: August 30, 2019

Kaiser Health News: They Got Estimates Before Surgery — And A Bill After That Was 50% More
From a planning perspective, Wolfgang Balzer is the perfect health care consumer. Balzer, an engineer, knew for several years he had a hernia that would need to be repaired, but it wasn’t an emergency, so he waited until the time was right. The opportunity came in 2018 after his wife, Farren, had given birth to their second child in February. The couple had met their deductible early in the year and figured that would minimize out-of-pocket payments for Wolfgang’s surgery. (Bluth, 8/30)

Kaiser Health News: ‘Locally Grown’ Insurance Companies Help Fortify Washington State Market
Although few states have finalized their 2020 health insurance rates yet, preliminary reports suggest that increases in premiums for plans sold on the Affordable Care Act’s marketplaces will be moderate again this year. One analysis of those early state filings, which noted some states appear poised to have lower premiums next year, found that Washington had a lower rate increase than almost half the other states. (Blankinship, 8/30)

Kaiser Health News: Shopping At The Apotheke: Compare German Pharmacies With Your Corner Drugstore
If you’re looking for bobby pins, cheap lipstick or a protein bar, well, sorry, Americans, the German pharmacy can’t help you. It’s not the CVS, Rite Aid or Walgreens of home. Die Apotheke, as a pharmacy is known here, sells medications. German drugstores might have some high-end makeup (hypoallergenic, and for sensitive skin!), lotions or baby bottles. You’ll also definitely find magnesium supplements and vitamins. But they aren’t convenience stores stocking hair dryers, cellphone chargers, toys or groceries. This is the place you go for health, and for medicine. (Luthra, 8/30)

Kaiser Health News: California Requires Suicide Prevention Phone Number On Student IDs
Denise Herrmann was only a few months into her new job as principal of a Palo Alto, Calif., high school in fall 2014 when a student took his own life. By the next day, Herrmann said, she and some of her colleagues at Henry M. Gunn High School were in conversations with experts from nearby Stanford University about how to cope with student suicides and their aftermath. She knew her school was not alone. “This was a community issue,” she said. (Kreidler, 8/30)

The Associated Press: THC Found In Wisconsin Vaping Cases That Led To Illnesses
Nearly nine out of 10 cases where vaping led to people developing a severe lung disease in Wisconsin involved the use of THC products, such as waxes or oils, Wisconsin's Department of Health Services said Thursday. Health officials said that 89% of the 27 people they interviewed who became sick reported using e-cigarettes or other vaping devices to inhale THC, the psychoactive compound in marijuana. (8/29)

The Washington Post: As Vaping-Related Lung Illnesses Spike, Investigators Eye Contaminants
Officials are narrowing the possible culprits to adulterants in vaping products purported to have THC, the component in marijuana that makes users high, as well as adulterants in nicotine vaping products. The sudden onset of these mysterious illnesses and the patients’ severe and distinctive symptoms have led investigators to focus on contaminants, rather than standard vaping products that have been in wide use for many years. (Sun and McGinley, 8/29)

The Associated Press: Probes Of E-Cigarette Giant Juul Underway In Illinois, DC
E-cigarette giant Juul Labs is facing mounting scrutiny from state law enforcement officials, with the attorneys general in Illinois and the District of Columbia investigating how the company's blockbuster vaping device became so popular with underage teens, The Associated Press has learned. The company's rapid rise to the top of the multi-billion dollar U.S. e-cigarette market has been accompanied by accusations from parents, politicians and public health advocates that Juul fueled a vaping craze among high schoolers. (Lardner and Perrone, 8/30)

The New York Times: Surgeon General Warns Pregnant Women And Teenagers Not To Smoke Or Vape Marijuana
The United States surgeon general on Thursday issued a public warning that smoking or vaping marijuana is dangerous for pregnant women and their developing babies. At a news conference with other top Trump administration health officials, the surgeon general, Dr. Jerome Adams, said he was concerned that pregnant women, teenagers and others were unaware of the health hazards posed by new, professionally grown marijuana crops. (Kaplan, 8/29)

The Washington Post: Surgeon General Calls Marijuana A ‘Dangerous’ Drug, Warns Against Use By Youth, Pregnant Women
Citing greater access and increased potency of what’s available on the market, Jerome M. Adams and Health and Human Services Secretary Alex Azar said the drug “carries more risk than ever” and announced that they would be starting a public awareness campaign on social media about the effect it can have on the developing brain. The initiative, they said, is funded by President Trump, who donated his full second-quarter presidential salary of $100,000 to the effort. It’s a drop in the bucket compared to his personal fortune but underscores how much of a priority addiction and substance abuse is for the administration, they said. (Cha, 8/29)

Politico: Surgeon General Advises Pregnant People, Youth Against Marijuana Use
"We need to be clear: Some states' laws on marijuana may have changed, but the science has not and federal law has not," HHS Secretary Alex Azar said. In 2017, about 9.2 million people ages 12 to 25 reported that they used marijuana in the last month, according to HHS. High school students' perception of marijuana as harmful has been declining over the past decade, the department has found. (Roubein, 8/29)

NPR: Surgeon General: Marijuana Use During Adolescence And Pregnancy Is Risky
Young people who regularly use marijuana are "more likely to show a decline in IQ and school performance [and] are more apt to miss classes," Adams said. And frequent use of the drug can also impair a child's attention, memory and decision-making.In addition, it can be habit-forming. "Nearly 1 in 5 people who begin marijuana use during adolescence become addicted," Adams said. "That's scary to me as the dad of a 15-, a 13- and a 9-year-old." (Aubrey, 8/29)

The Associated Press: Anti-Smoking Advocates Bemoan 'Faltering' Pace Of FDA Action
It seemed like a new era in the half-century battle against the deadly toll of tobacco: U.S. health officials for the first time would begin regulating cigarettes, chew and other products responsible for a half-million American deaths annually. "The decades-long effort to protect our children from the harmful effects of smoking has finally emerged victorious," then President Barack Obama said in a speech before signing the 2009 measure into law. (Perrone, 8/29)

The Associated Press: Trump Eyes Mental Institutions As Answer To Gun Violence
When shots rang out last year at a high school in Parkland, Florida, leaving 17 people dead, President Donald Trump quickly turned his thoughts to creating more mental institutions. When back-to-back mass shootings in Dayton, Ohio, and El Paso, Texas, jolted the nation earlier this month, Trump again spoke of "building new facilities" for the mentally ill as a way to reduce mass shootings. (Freking, 8/30)

Reuters: White House Hopeful Kamala Harris To Emphasize Access For Individuals With Disabilities
U.S. Democratic presidential hopeful Kamala Harris will announce a plan on Thursday aimed at ensuring individuals with disabilities have equal access to job opportunities, education, housing and healthcare. Harris, a U.S. senator from California and one of 20 Democrats vying to take on Republican President Donald Trump in the November 2020 election will emphasize how her Medicare for All healthcare proposal would cover long-term, in-home services and early screening for individuals with disabilities, according to a preview of the plan provided by her campaign. (8/29)

Reuters: Trump Administration Barring Tours Of Migrant Detention Centers, Democrats Say
Democrats in the U.S. House of Representatives on Thursday said the Trump administration is blocking investigators from touring immigrant detention facilities nationwide after recent visits revealed what they called “serious ongoing problems” concerning how detainees are being treated. Representative Elijah Cummings, chairman of the House Oversight and Reform Committee, said committee staff were barred from visiting 11 U.S. Customs and Border Protection facilities days after previous inspections found conditions that threatened the health and safety of the adult and child migrants being held, writing in a letter to Kevin McAleenan, the acting secretary for the Department of Homeland Security. (Oliphant, 8/29)

The Associated Press: House Dems Say Trump Admin Blocking Visits To Border Sites
The department's inspector general has warned that some sites pose "an immediate risk to the health and safety of DHS agents and officers, and to those detained." Cummings says in a letter to McAleenan that it appears the administration "expects Congress to be satisfied with receiving agency tours of facilities" without questioning the department's policies or decisions. He says "that is not the way effective oversight works." (8/29)

The New York Times: Poor Conditions Persist For Migrant Children Detained At The Border, Democrats Say
Migrant children detained at the border continue to sleep in cold cells without proper clothing or adequate food, a top Democratic lawmaker said on Thursday, accusing the Department of Homeland Security of blocking members of Congress from visiting the facilities. Parents were not provided enough diapers for their children, toddlers were fed “burritos rather than age-appropriate foods” and one child was told by an immigration agent to eat food off the floor, according to interviews that House Democrats conducted with detainees during earlier visits. (Kanno-Youngs, 8/29)

The Associated Press: Mumps Sickens Hundreds Of Detained Migrants In 19 States
Mumps has swept through 57 immigration detention facilities in 19 states since September, according to the first U.S. government report on the outbreaks in the overloaded immigration system. The virus sickened 898 adult migrants and 33 detention center staffers, the Centers for Disease Control and Prevention said in its report Thursday. New cases continue as migrants are taken into custody or transferred between facilities, the report said. As of last week, outbreaks were happening in 15 facilities in seven states. (8/29)

The Hill: CDC Reports 900 Mumps Cases In Migrant Detention Facilities Over Past Year
Most of the facilities that saw mumps outbreaks were run by private companies, while 19 were county jails and four were operated by ICE. Almost 400 of the cases were reported from facilities that house ICE detainees in Texas. The CDC said most detainees caught the virus while in the custody of ICE or another U.S. agency. (Hellmann, 8/29)

BuzzFeed: Mumps Outbreaks In Detention Centers Included Over 900 Cases
Those numbers are “striking” and “noteworthy,” said Marc Stern, an affiliate assistant professor in public health at the University of Washington. Based on the CDC’s data, an ICE detainee had roughly at least a 4,000-fold greater risk of getting mumps than a nondetainee in the United States at large, Stern told BuzzFeed News. “That’s an incredibly huge risk,” he said by email. (Lee, 8/29)

The New York Times: Sick Migrants Undergoing Lifesaving Care Can Now Be Deported
Maria Isabel Bueso was 7 years old when she came to the United States from Guatemala at the invitation of doctors who were conducting a clinical trial for the treatment of her rare, disfiguring genetic disease. The trial was short on participants, and thanks to her enrollment, it eventually led the Food and Drug Administration to approve a medication for the condition that has increased survival by more than a decade. Now 24, Ms. Bueso, who had been told she likely would not live past adolescence, has participated in several medical studies. (Jordan and Dickerson, 8/29)

The Associated Press: US: 6-Month-Old Migrant Girl Recovering In Hospital
Authorities say a 6-month-old migrant girl who was hospitalized after being taken across the U.S.-Mexico border illegally has improved to stable condition. The baby was airlifted Saturday to a hospital in Corpus Christi, Texas, and listed in critical condition. U.S. Customs and Border Protection said Thursday that the infant had been upgraded and transferred to a hospital in Houston. (8/29)

The Associated Press: Report: US Native American Health Agency At Crossroads
Emergency rooms shut down for months. Hospitals put patients at risk for opioid abuse and overdoses. A longtime pediatrician was charged with sexually abusing children. The federal agency that administers health care for more than 2.5 million Native Americans has long been plagued with problems that have kept it from improving health care delivery. Money, staffing, infrastructure, health disparities and a general lack of accountability all have played a part. (Fonseca, 8/29)

The New York Times: Many Genes Influence Same-Sex Sexuality, Not A Single ‘Gay Gene’
How do genes influence our sexuality? The question has long been fraught with controversy. An ambitious new study — the largest ever to analyze the genetics of same-sex sexual behavior — found that genetics does play a role, responsible for perhaps a third of the influence on whether someone has same-sex sex. The influence comes not from one gene but many, each with a tiny effect — and the rest of the explanation includes social or environmental factors — making it impossible to use genes to predict someone’s sexuality. (Belluck, 8/29)

The Associated Press: New Genetic Links To Same-Sex Sexuality Found In Huge Study
The genome-wide research on DNA from nearly half a million U.S. and U.K. adults identified five genetic variants not previously linked with gay or lesbian sexuality. The variants were more common in people who reported ever having had a same-sex sexual partner. That includes people whose partners were exclusively of the same sex and those who mostly reported heterosexual behavior. The researchers said thousands more genetic variants likely are involved and interact with factors that aren't inherited, but that none of them cause the behavior nor can predict whether someone will be gay. (8/29)

The Washington Post: There’s No ‘Gay Gene,’ But Genetics Are Linked To Same-Sex Behavior, New Study Says
Andrea Ganna, lead author and European Molecular Biology Laboratory group leader at the Institute of Molecular Medicine in Finland, said the research reinforces the understanding that same-sex sexual behavior is simply “a natural part of our diversity as a species. ”The new study, published Thursday in the journal Science, is not the first to explore the link between genetics and same-sex behavior, but it is the largest of its kind, and experts say it provides one of the clearest pictures of genes and sexuality. (Bever, 8/29)

NPR: Search For 'Gay Genes' Comes Up Short In Large New Study
Using another technique to analyze the data, the authors say genes could still influence 8% to 25% of the behavior they studied. But the effect of any individual genetic variant is so faint that, even in a sample of half a million people, it's impossible to tease out anything about them. One obvious conclusion from these results is that nobody is going to come up with a blood test to predict these sexual behaviors. (Harris, 8/29)

Los Angeles Times: Is There A 'Gay Gene'? DNA Analysis On Behavioral Link Says No
Though estimates of same-sex experiences vary, a 2016 CDC study of U.S. adults found that 6.2% of men and 17.4% of women between the ages of 18 and 44 reported at least one same-sex experience in their lifetimes. A smaller portion, 1.3% of women and 1.9% of men, described themselves as lesbian or gay, and 5.5% of women and 2.0% of men said they were bisexual — underscoring the difference between sexual behavior and sexual identity. Scientists have long probed the nature of same-sex behavior, finding some evidence in twin studies that genetics plays a role. But such research has typically involved small numbers of people and hasn’t used modern methods of genomic analysis, scientists said. (Khan, 8/29)

The Associated Press: Where Did The Sacklers Move Cash From Their Opioid Maker?
Ninety minutes outside London, a turn down a narrow lane leads past fields of grazing cattle to a sign warning “Private Keep Off.” Around an elbow bend, a great stone manor, its formal gardens and tennis court hidden behind thick hedges, commands a 5,000-acre estate. The estate is a pastoral prize — proof of the great wealth belonging to the family accused of playing a key role in triggering the U.S. opioid epidemic. But there’s little evidence of that connection. On paper, the land is owned by a handful of companies, most based in distant Bermuda, all controlled by an offshore trust. (Geller, 8/30)

The Wall Street Journal: Proposed Opioid Deal With Purdue Drawing Pushback From States
A proposed deal for Purdue Pharma LP to resolve more than 2,000 lawsuits over its role in the opioid crisis is facing pushback from a vocal group of state attorneys general who say it doesn’t bring in enough cash to satisfy their demands, according to people familiar with the matter. Virtually every state, in addition to thousands of cities and counties across the U.S., sued Purdue, claiming the company’s aggressive promotion of its painkiller OxyContin helped trigger an addiction epidemic. (Hopkins and Randazzo, 8/29)

The Associated Press: Opioid Settlement Would Divide Money Based On Local Impact
The multibillion-dollar settlement that the maker of OxyContin is negotiating to settle a crush of lawsuits over the nation's opioid crisis contains formulas for dividing up the money among state and local governments across the country, The Associated Press has learned. The formulas would take into account several factors, including opioid distribution in a given jurisdiction, the number of people who misuse opioids and the number of overdose deaths. (8/29)

The Washington Post: Feds: Drug Ring Had Enough Cheap Fentanyl To Kill 14 Million
Law enforcement officials in Virginia said Thursday that they’ve taken down a multi-state drug ring and seized enough cheap fentanyl from China to kill 14 million people. The bust was announced in the wake of growing efforts to stem the flow of fentanyl from Chinese labs to the United States. The synthetic opioid often comes through the mail or across the Mexico border. It can be stronger and more lethal than heroin and is responsible for tens of thousands of American drug deaths each year. (Finley, 8/29)

The Hill: Dozens Charged In Opioid Network Accused Of Distributing 23 Million Pills 
The Department of Justice (DOJ) has charged 41 people in nine indictments for their alleged involvement in “pill mill” clinics and pharmacies that have distributed more than 23 million oxycodone, hydrocodone and carisoprodol pills across the country, according to a statement from the DOJ. The alleged trafficking network was composed of medical providers, clinic owners, pharmacists, drug dealers and traffickers, who have been apprehended and shut down by the government, and who allegedly knew "the prescriptions had no legitimate medical purpose and were outside the usual course of professional practice." (Pitofsky, 8/29)

Reuters: Novartis Takes Aim At Roche's Star MS Drug
Swiss drugmaker Novartis on Friday stepped up its challenge to Roche's multiple sclerosis franchise, highlighting study results for its MS hopeful ofatumumab that could compete with its cross-town rival's drug Ocrevus. Novartis said ofatumumab, already approved as Arzerra to treat leukaemia, reduced annual relapses better than Sanofi's Aubagio in two head-to-head late-stage studies against relapsing forms of MS (RMS). Detailed study results are due at an MS conference in Sweden next month. (8/30)

Stat: Cerebral Organoids Produce Brain Waves Similar To Newborns' 
The Lilliputian versions of human brains that scientists have grown in lab dishes have developed distinct structures such as the hippocampus, grown glia and other cells like those in actual brains, and produced a diverse menagerie of neurons that connect with each other and carry electrical signals. Now scientists have grown hundreds of cerebral organoids with the most complex, human-like activity yet: Though only one-fifth of an inch across, or about the size of a pea, the organoids have developed functional neural networks that generate brain waves resembling those of newborns. (Begley, 8/29)

The New York Times: Hospitals Should Replace Infection-Prone Scopes With Safer Models, F.D.A. Says
Companies that make reusable, snakelike cameras to examine patients internally should begin making disposable versions, because the current models cannot be properly sterilized and have spread infections from one patient to another, the Food and Drug Administration said on Thursday. In the meantime, hospitals that use the instruments, called duodenoscopes, should start to transition to models with disposable components to reduce the risk of infection to patients, the agency said. (Rabin, 8/29)

The New York Times: Babies Display ‘Werewolf Syndrome’ After Getting Anti-Baldness Drug By Mistake
At least 17 children in Spain developed a form of “werewolf syndrome” after they were given medication intended to treat heartburn that was actually used to stop hair loss. The children who took the mislabeled medicine, some of them babies, began growing hair all over their bodies, a rare condition known as hypertrichosis, Spain’s health minister said on Wednesday. The minister, María Luisa Carcedo, said that a Spanish laboratory, Farmaquimica Sur, had erroneously distributed to pharmacists minoxidil, a drug that helps fight baldness, that was labeled omeprazole, a drug that treats acid reflux. (Minder, 8/29)

The Associated Press: Virginia Medicaid Boss Stepping Down
The head of Virginia’s Medicaid agency is stepping down. Gov. Ralph Northam announced Thursday that Dr. Jennifer Lee is resigning as director of the Virginia Department of Medical Assistance. She led DMAS through a massive expansion of Medicaid in Virginia that saw about 300,000 newly eligible Virginians sign up. Lawmakers voted in 2018 to expand Medicaid to low-income adults, a key part of former President Barack Obama’s health care overhaul. (8/30)

The Wall Street Journal: Connecticut’s Measles Vaccination Rates Keep Falling
The percentage of unvaccinated children in Connecticut continues to grow, according to figures released by the state’s public-health agency. Connecticut’s statewide immunization rate for measles, mumps and rubella vaccinations of kindergartners fell to 95.9% for the 2018-19 school year, compared with 96.5% for the prior year, according to data released Thursday by the state Department of Public Health. The Centers for Disease Control and Prevention recommends that at least 95% of kindergarten students in schools should be vaccinated. (De Avila, 8/29)

The Hill: Health Officials Warn New Jersey, Michigan, Massachusetts Residents Over Mosquito-Borne Virus 
Health officials in New Jersey, Michigan and Massachusetts are warning residents of mosquitos carrying a potentially deadly virus. Cases of Eastern equine encephalitis (EEE), a rare virus that causes brain inflammation, have been recorded in each of the three states. The New Jersey Department of Health confirmed a case earlier this month where a man was hospitalized. The department is urging residents to take extra precautions to avoid being bitten. (Rodrigo, 8/29)

The Washington Post: Diana Sanchez Gave Birth In Denver Jail Cell Alone, Lawsuit Says
Diana Sanchez screamed as she writhed on the small bed inside her cell at the Denver County Jail. Gripping the thin mattress with one hand, she tried to use the other to take off her white cloth pants, only managing to free her left leg. Her face glistened with sweat. She had been in labor for hours, and now her baby was coming. At 10:44 a.m. on July 31, 2018, in a moment captured on surveillance video, Sanchez gave birth to her son alone in her cell without medical supervision or treatment, despite repeatedly telling the jail’s staff that she was having contractions, according to a federal lawsuit filed in the U.S. District Court in Colorado on Wednesday. (Chiu, 8/29)

ProPublica: In A Disputed Custody Case, The Children Of A Spanish-Speaking Father Will Remain With Their Slovak-Speaking Foster Parents
A Cook County Juvenile Court judge on Thursday took a step toward awarding guardianship of two young children to their foster parents in a case that has raised concerns about how Illinois child welfare officials serve Spanish-speaking, Latino families. Judge Peter Vilkelis determined that the foster parents should become the permanent guardians of the two older children of Jorge Matias, who was deported last fall to his native Guatemala. (Sanchez and Eldeib, 8/29)

Los Angeles Times: Many UC Berkeley Buildings Pose Deadly Risk In A Major Earthquake, Report Says
Dozens of buildings at UCLA and UC Berkeley pose a serious risk to life in a strong earthquake, with at least 68 seismically deficient structures at UC Berkeley and 18 at UCLA, according to new university studies. Although no campus buildings were deemed to be in the worst category, “dangerous,” six at UC Berkeley and three at UCLA were found to have a “severe” risk to life. The remaining 62 at UC Berkeley and 15 at UCLA were said to have a “serious” risk to life, according to the first reports released this week in response to a UC Board of Regents 2017 directive calling on every campus to undertake a seismic risk assessment. (Lin and Reyes-Velarde, 8/29)

Los Angeles Times: California Housing Crisis Traps Seniors With High Rents, Evictions
Mario Canel met his wife inside the apartment where he’s lived for the last 33 years. Canel, a house painter, was at the Silver Lake complex off of Sunset Boulevard on a job, but he and his customer quickly connected over their shared Guatemalan roots. It wasn’t long before Mario and Sabina married, and her home became his. For years, they basked in such comforts as plucking chayote from a vine outside their front window. (Khouri and Shalby, 8/29)