First Edition: April 26, 2018

Kaiser Health News: ‘Rapid Autopsy’ Programs Seek Clues To Cancer Within Hours Of Death
After Keith Beck died of bile duct cancer last year, family members said more than 900 people showed up to pay respects to the popular athletic director at the University of Findlay in northwestern Ohio. Many were former students who recalled acts of kindness during Beck’s nearly 30-year career: $20 given to a kid who was broke, textbooks bought for a student whose parents were going through bankruptcy, a spot cleared to sleep on Beck’s living room floor. (Aleccia, 4/26)

Kaiser Health News: Hospitals Lure Diabetes Patients With Self-Care Courses, But Costs Can Weigh Heavily 
When a routine physical revealed mildly elevated blood-sugar levels, Michael Phillips was strongly encouraged to sign up for a diabetes self-management class. Phillips never asked about the cost of the two half-day sessions he attended in a conference room at St. Mary’s Hospital in Athens, Ga., and doesn’t recall the instructor mentioning it. But the 64-year-old retired bank analyst was flabbergasted when he opened his bill after attending. (Appleby, 4/26)

The New York Times: New Allegations Emerge Against Ronny Jackson As White House Digs In
Dr. Ronny L. Jackson, the White House physician nominated to lead the Veterans Affairs Department, provided such “a large supply” of Percocet, a prescription opioid, to a White House Military Office staff member that he threw his own medical staff “into a panic” when it could not account for the missing drugs, according to a summary of questionable deeds compiled by the Democratic staff of the Senate Veterans’ Affairs Committee. A nurse on his staff said Dr. Jackson had written himself prescriptions, and when caught, he simply asked a physician assistant to provide him with the medication. And at a Secret Service going away party, the doctor got intoxicated and “wrecked a government vehicle,” according to the summary. (Fandos, 4/25)

The Washington Post: VA Nominee Considers Withdrawing As New Allegations Emerge Of Drinking, Wrecking Government Vehicle
White House physician Ronny L. Jackson has grown frustrated with the nomination process to lead the Department of Veterans Affairs and has told colleagues he may remove his name from consideration, according to two White House officials with knowledge of his deliberations. Jackson’s indecision was brewing even before Capitol Hill Democrats on Wednesday released new allegations of professional misconduct, including the claim that Jackson had wrecked a government vehicle after getting drunk at a Secret Service going-away party. (Gardner, Dawsey and Kim, 4/25)

Reuters: Trump Veterans' Nominee Weighing Options After New Allegations
Jackson told reporters at the White House earlier on Wednesday that he did not wreck a car, saying he did not know where the allegations were coming from. The sprawling Department of Veterans Affairs has long been under fire for the quality of healthcare it provides veterans, a group that carries considerable political clout in America. During his election campaign, Trump vowed to clean it up. (4/25)

The Wall Street Journal: VA Nominee Ronny Jackson Faces New Allegations In Democratic Report
Once, missing Percocet threw the medical staff into a panic, the report found. It was revealed later that Dr. Jackson had provided a large supply to a staffer in the White House military office, the report said. The report said Dr. Jackson also asked staffers to write prescriptions for each other so that drugs could be given to non-beneficiaries. It said physicians felt so uncomfortable that they refused to be part of the culture of loose distribution of drugs to current and former White House staffers—and, at times, their family members. The new revelations emerged as the White House was defending its nominee. Officials had asked the Senate to reschedule a confirmation hearing that lawmakers postponed amid concerns over past performance and behavior. (Hughes, Nicholas and Ballhaus, 4/25)

The Washington Post: The Lengthy List Of Allegations Against Ronny L. Jackson, Annotated
Conversations with 23 colleagues and former colleagues of Rear Admiral Jackson, most of whom are still in uniform, have raised serious concerns about Jackson’s temperament and ethics, and cast doubt on his ability to lead the second largest agency in government and one tasked with the sacred mission of fulfilling our commitment to the men and women who have served our nation in uniform and their families. Those concerns are best captured under the following three topics. (Blake, 4/25)

The Washington Post: Tester’s Scrutiny Of Trump’s VA Choice Offers Political Peril And Opportunity
The firestorm over President Trump’s nominee to lead the Department of Veterans Affairs has thrust a vulnerable Democratic senator into a moment of political peril and opportunity. Sen. Jon Tester (Mont.), the top Democrat on the Veterans’ Affairs Committee, is leading the effort to dig deeper into the background of Ronny L. Jackson, who has faced accusations that he improperly dispensed drugs, created a hostile workplace and became intoxicated on duty. Ensuring capable stewardship of the sprawling Veterans Affairs is an issue certain to resonate with Tester’s constituents; nearly 1 in 10 Montana residents is a veteran. Only Alaska has a higher percentage of veterans living in-state. (Sullivan, 4/25)

Politico: Jackson Troubles Shine Light On A Fact Of Washington Life: Sleeping Pills
Ronny Jackson, the White House physician who is battling to save his nomination to be the secretary of veterans affairs, regularly handed out the sleep drug Ambien and the alertness drug Provigil to West Wing officials traveling on overseas flights. Jackson’s nomination has inadvertently exposed the widespread use of sleep and alertness drugs among government officials from the White House and State Department to the Pentagon and Congress itself. (Johnson, Everett, Bender and Karlin-Smith, 4/25)

The Washington Post: Are Ambien And Provigil Allegedly Given By Ronny Jackson On White House Trips Dangerous?
White House physician Ronny L. Jackson allegedly provided travelers on White House trips with Ambien, a prescription sedative that is widely regarded as a safe drug that poses little risk of addiction. Nearly 30 million Americans take it for it insomnia — the vast majority of them in its generic form, zolpidem — for a single night or for longer periods of sleeplessness. But that doesn't mean a physician can hand out the drug “like candy,” as Sen. Jon Tester (D-Mont.) said Jackson did, without inquiring about other medications a patient might be taking, drug history or other medical issues, experts said. (Bernstein, 4/25)

The Washington Post: Here Are 5 Urgent Problems A New VA Secretary Would Need To Tackle
With White House physician Ronny L. Jackson’s nomination to lead the Department of Veterans Affairs in serious doubt, here are five things that veterans advocates and experts say are the most urgent needs a new VA secretary must address to successfully run the $200 billion agency that serves 9 million. (Wax-Thibodeaux, 4/25)

The Wall Street Journal: Health Care’s New ‘Skinny Plans’: Winners And Losers
New, more-limited health plans may draw consumers away from Affordable Care Act coverage and drive up prices on insurance sold in the health law’s marketplaces. These “skinny” plans offer lower premiums, making them an attractive alternative for young, healthy buyers. But the plans can be loaded with restrictions. Often, people who aren’t healthy are blocked from buying them. Many don’t cover prescription drugs or pre-existing conditions, and some cap coverage, doing away with ACA requirements and potentially leaving buyers with big bills if they get sick. (Macnaughton and Wilde Mathews, 4/25)

The Wall Street Journal: Are New Bare-Bones Health Care Plans Worth The Risk?
Last year, President Donald Trump signed an executive order that promised to cut back some of the rules in the Affordable Care Act. The new "skinny plans," expected out this year, are poised to benefit some and hurt others. WSJ's Spencer Macnaughton explains. (4/25)

The Associated Press: Insurer Anthem's Earnings Jump 30 Pct As Medical Costs Fall
Anthem's first-quarter earnings shot up 30 percent, and the Blue Cross-Blue Shield insurer hiked its 2018 forecast, as a drop in medical expenses bolstered its performance. The nation's second-largest health insurer joined rival UnitedHealth Group Inc. in topping analyst expectations for the quarter and hiking its 2018 forecast. Anthem said Wednesday that it now expects 2018 adjusted earnings to be greater than $15.30 per share after saying in January that they would exceed $15 per share. (4/25)

The Hill: Anthem Sees Profits Rise After Scaling Back Participation In ObamaCare 
The company announced last year it would sell fewer ObamaCare plans in 2018, citing uncertainty and instability in the markets. Instead, Anthem has focused on growing its Medicare Advantage business. Enrollment in these plans grew by 237,000 during the first quarter. Overall, however, enrollment dropped by 2.5 percent, driven mostly by the insurer's decision to sell fewer ObamaCare plans. (Hellmann, 4/25)

The Hill: California ObamaCare Official Urges Trump To Restore Outreach Funding 
The head of the California ObamaCare marketplace is urging the Trump administration to restore outreach funding to encourage people to sign up, warning of higher premiums if the step is not taken. Peter Lee, the executive director of Covered California, wrote a letter to Health and Human Services Secretary Alex Azar on Wednesday calling on him to increase ObamaCare outreach funding. (Sullivan, 4/25)

Reuters: U.S. Congress Girds For Fight Over Expected Trump Spending Cuts
The Trump administration is preparing to submit to the U.S. Congress up to $25 billion in immediate spending cuts, including possible reductions to social safety net programs, lawmakers said on Wednesday, in a move that could upend a budget deal enacted last month. The White House plan, which has not yet been unveiled, would call on Congress to rescind funding already enacted into law. It likely would be submitted next month, sometime after a recess that ends on May 7. (Cowan, 4/25)

The Associated Press: Judge Prevents Trump From Cutting Planned Parenthood Grants
A federal judge has issued a permanent injunction blocking the Trump administration from cutting grants to Planned Parenthood that pay for a teen pregnancy prevention program in numerous states. U.S. District Court Judge Thomas Rice of Spokane issued his ruling late Tuesday, after listening to arguments from attorneys for Planned Parenthood and the U.S. Department of Health and Human Services. (Geranios, 4/25)

The Hill: Federal Judge Blocks Trump Cuts To Planned Parenthood Teen Pregnancy Program
U.S. District Judge Thomas Rice on Tuesday issued a permanent injunction preventing the administration from ending the grants two years earlier than originally planned, saying that doing so would cause public harm. "The Court determines that the public interest weighs in favor of Plaintiffs, as it would prevent harm to the community ... and prevent loss of data regarding the effectiveness of teen pregnancy prevention," Rice wrote. (Hellmann, 4/25)

The Hill: Top Dems On Energy And Commerce Panel Concerned House Opioid Push Moving Too Quickly
Top Democrats on the House Energy and Commerce Committee voiced concerns over the speed at which the Republican chairman is aiming to put opioid legislation on the House floor. Chairman Greg Walden (R-Ore.) has repeatedly said he hopes the House can take up the committee’s legislation to combat the opioid epidemic by Memorial Day weekend. (Roubein, 4/25)

Stat: McKesson Board Exonerates Execs In Opioid Crisis, But Teamsters Cry Foul
Following an internal investigation, the McKesson (MCK) board absolved senior management of any failures to oversee the distribution of opioid painkillers, an issue that has haunted several wholesalers as the opioid crisis in the U.S. worsens. Notably, the probe found that senior managers “worked in earnest” to meet Drug Enforcement Agency requirements, such as reporting suspicious orders to pharmacies, and had oversight procedures in place for a monitoring program and distribution facilities. (Silverman, 44/25)

NPR: Celebrex As Safe As Ibuprofen And Naproxen, FDA Advisers Say
A prescription painkiller that has been under a cloud for more than a decade is apparently safer than previously believed, a Food and Drug Administration panel concluded Wednesday. The drug celecoxib, which is sold by Pfizer under the brand name Celebrex, poses no greater risk for causing heart attacks and strokes than two other widely used pain relievers, the committee voted at the end of a two-day hearing. The vote was 15-5. One member abstained. (Stein, 4/25)

The New York Times: Common Pain Relievers Beat Opioids For Dental Pain Relief
Over-the-counter pain pills are safer and more effective than prescription opioids for controlling the pain following dental procedures, a review of the evidence has found. Researchers analyzed five reviews of studies of medication and medication combinations for pain relief. They included only reviews of high or moderate methodological quality. (Bakalar, 4/25)

The Hill: Medical Marijuana Legislation Gets Support Of Key House Republican 
House Judiciary Committee Chairman Bob Goodlatte (R-Va.) has signed on to co-sponsor bipartisan legislation to simplify the medical marijuana research process. Goodlatte's spokeswoman, Kathryn Rexrode, told Bloomberg that Goodlatte would co-sponsor the bill with Rep. Matt Gaetz (R-Fla.).  (Manchester, 4/25)

Stat: Koch-Backed Group Launches National Ad Push To Advance 'Right To Try'
The Koch-backed group Americans for Prosperity is pouring hundreds of thousands of dollars into a renewed push for federal “right-to-try” legislation that aims to give terminally ill patients a new way to access experimental therapies. The six-figure ad campaign will include both targeted digital ads and a new national television ad that pulls seemingly supportive sound bites from Senate Majority Leader Chuck Schumer (D-N.Y.) as well as longtime proponent Sen. Ron Johnson (R-Wis.) and President Trump. The latter will air on both broadcast and cable channels. (Mershon, 4/26)

The Hill: FDA Re-Examining Parkinson's Drug After Reports Of Deaths 
The Food and Drug Administration (FDA) is re-examining the safety of a new drug after reports that it has potentially caused serious side effects and numerous deaths. The agency confirmed to The Hill it is “conducting an evaluation of available information” about Nuplazid, a drug approved in 2016 to treat delusions and hallucinations associated with Parkinson’s disease psychosis. (Weixel, 4/25)

Politico: 7 Governors Launch ‘Unprecedented’ Effort To Study Gun Violence
More than half a dozen governors — most of them Democrats from the Northeast — announced plans Wednesday to launch an “unprecedented” multistate consortium that will study gun violence as a public health issue. The governors said they were upset at the lack of action from Washington and are looking to fill a void left by the Centers for Disease Control and Prevention, which has been restricted in its ability to collect data to advocate for gun control. (Hutchins, 4/25)

The Washington Post: Fla. Officials Who Try To Strengthen Gun Laws Can Be Personally Fined, Kicked Out Of Office
After a shooting that killed 17 people at a Parkland, Fla., high school, the mayor of nearby Weston wanted to prohibit people from carrying guns in public buildings and parks — a move that could lead to him being kicked out of office and on the hook for thousands of dollars in fines and attorney’s fees. Florida law prohibits local municipalities from passing ordinances that regulate firearms or ammunition, and if one is passed that violates the state statue, it will be declared void. Elected or appointed officials involved in the drafting or passage of such local rules face fines of up to $5,000, will be unable to use a city attorney and could be held responsible for footing up to $100,000 of the legal bills for anyone who challenges the local rule in court. The governor is also given the power to kick them out of office. (Zezima, 4/25)

Stat: Can Telemedicine Startup Lemonaid Be The Warby Parker Of Health Care?
The first thing you see when you enter Lemonaid Health’s offices is a dazzling bright yellow accent wall. Doctors work at desks clustered together in an open-plan office, ducking into smaller offices to conduct video visits with patients. The engineering, design, and data science teams sit just steps away. Hanging from a standing coat rack is a king’s crown, like the kind found in a child’s dress-up drawer, that employees wear proudly on their work anniversary. (Robbins, 4/26)

Stat: The Most — And Least — Friendly States For Telemedicine Startups
In 2016, executives at the buzzy telemedicine startup Nurx spoke openly about their ambitions. By the following year, the company’s online services for birth control and the HIV prevention pill would be available in all 50 states. That never happened. Today, Nurx operates in just 17 states and Washington D.C. Nurx is part of a new wave of businesses that have attracted lots of excitement and investment for an idea that seems intuitive: Allowing patients to use online forms and chat messages to quickly get prescription drugs to treat simple conditions like urinary tract infections, erectile dysfunction, and hair loss. (Robbins, 4/26)

The New York Times: ‘Desperation Oncology’: When Patients Are Dying, Some Cancer Doctors Turn To Immunotherapy
Dr. Oliver Sartor has a provocative question for patients who are running out of time. Most are dying of prostate cancer. They have tried every standard treatment, to no avail. New immunotherapy drugs, which can work miracles against a few types of cancer, are not known to work for this kind. Still, Dr. Sartor, assistant dean for oncology at Tulane Medical School, asks a diplomatic version of this: Do you want to try an immunotherapy drug before you die? (Kolata, 4/26)

The New York Times: A Lifesaving Pump For Cancer Patients Is Being Phased Out
A medical device that can add years to the lives of cancer patients is about to become unavailable, because its manufacturer has decided to stop producing it. The device, the size of a hockey puck, is implanted in the abdomen to pump high doses of chemotherapy directly into the liver for cancer that has spread there, usually from colon or rectal tumors. The treatment can help prevent tumors from recurring after they are removed from the liver, and can shrink inoperable growths in the liver so that they can be cut out. (Grady and Kaplan, 4/25)

NPR: As Minibrains Get Larger, So Do Bioethical Quandaries
Bits of human brain tissue no larger than a pea are forcing scientists to think about questions as large as the nature of consciousness. These clusters of living brain cells are popularly known as minibrains, though scientists prefer to call them cerebral organoids. At the moment, they remain extremely rudimentary versions of an actual human brain and are used primarily to study brain development and disorders like autism. (Hamilton, 4/25)

Los Angeles Times: Scientists Have A Promising New Approach For Treating Drug-Resistant Tuberculosis
In research that promises a new approach to treating an age-old human scourge, scientists have found a way to weaken the bacterium that causes tuberculosis and boost its vulnerability to drugs that are rapidly losing their power to cure. A study published Wednesday in the journal Science and Translational Medicine outlines a new assault against TB by a team led by researchers from Weill Cornell Medical College in New York. (Healy, 4/25)

The Wall Street Journal: Prophylactic Antibiotic Use Could Reduce Childhood Death Rate
Researchers have identified a low-cost medication that they say could protect millions of young children in poor nations from dying of pneumonia, malaria and other preventable diseases. But they and other experts acknowledge they will have to decide carefully how best to deploy the new tool—an antibiotic widely prescribed in the U.S. for bacterial infections—because heavy use could fuel antibiotic resistance. Taking antibiotics at a young age may also increase the risk of other health problems later on, some experts say. (McKay, 4/25)

Stat: Shoebox-Sized Lab Can Diagnose Infectious Diseases From A Drop Of Blood
Researchers from the University of Toronto have created a shoebox-sized laboratory that can do blood testing in remote, low-resource settings, quickly determining from a drop of blood whether a person has antibodies to specific infectious diseases. The device, which they called the MR Box — short for measles and rubella, the first diseases for which they tested — is still being fine-tuned. But their hope is that eventually it could be used to test for a variety of diseases, for both outbreak control and research purposes, in parts of the world where conventional lab support is hours — or farther — away, the scientists reported Wednesday. (Branswell, 4/25)

The New York Times: How Strenuous Exercise Affects Our Immune System
If you have ever run a marathon, you know that the effort can cause elation, exhaustion, achy legs, blackened toenails and an overwhelming urge to eat. But it is unlikely to have made you vulnerable to colds or other illnesses afterward, according to a myth-busting new review of the latest science about immunity and endurance exercise. The review concludes that, contrary to widespread belief, a long, tiring workout or race can amplify immune responses, not suppress them. (Reynolds, 4/25)

The Wall Street Journal: Hit-And-Run Fatalities Soar As More People Bike To Work
Hit-and-run crash deaths are rising nationwide, and pedestrians and bicyclists account for close to 70% of the victims, according to a new report, as more people cycle to work and motor-vehicle fatalities are at a near-decade-high level. The number of hit-and-run fatalities jumped 61% from 2009 to 2016, the most recent year for which data are available, according to the report from the AAA Foundation for Traffic Safety. (Calvert, 4/26)

The New York Times: There’s No Smoking In Disney Films. What About When It Owns Fox?
Add cigarettes to the list of things that the family-friendly Walt Disney Company has to figure out as it prepares to integrate the sharper-edged 20th Century Fox movie and television studio. Robert A. Iger, Disney’s chief executive, announced at a shareholder meeting in 2015 that Walt Disney Studios would “prohibit smoking in movies across the board: Marvel, Lucas, Pixar and Disney films.” He said the policy, which put Disney at the forefront of antismoking efforts in Hollywood, “was the right thing for us to do.” The decision brought cheers from activists concerned about the power of movies to promote tobacco use. (Barnes, 4/25)

The Associated Press: Genetic Sleuthing Bolsters Food Poisoning Searches
Disease hunters are using genetic sequencing in their investigation of the ongoing food poisoning outbreak linked to romaine lettuce, a technique that is revolutionizing the detection of germs in food. The genetic analysis is being used to bolster investigations and — in some cases — connect the dots between what were once seemingly unrelated illnesses. It also is uncovering previously unfathomed sources of food poisoning, including one outbreak from apples dipped in caramel. (4/26)

The Associated Press: E. Coli Outbreak Linked To Romaine Lettuce Grows To 84 Cases
U.S. health officials say the E. coli outbreak linked to tainted romaine lettuce has grown and sickened 84 people from 19 states. The U.S. Centers for Disease Control said Wednesday that at least another 31 cases are believed to be tied to romaine lettuce grown in Yuma, Arizona. The agency says those infected range in age from 1 to 88. More than half are female. Forty-two people have been hospitalized, including nine battling kidney failure. (4/25)

The Washington Post: Dangerous Outbreak Of E. Coli Illness From Romaine Lettuce Expands, With 19 States Affected
The search for the source of the outbreak is ongoing. The CDC and the Food and Drug Administration say the Yuma, Ariz., growing region is the source, but no farm has been identified. The Yuma area grows most of the lettuce harvested in the United States during the winter months, but officials say that lettuce now in stores or at restaurants is probably from California's Central Valley or Salinas Valley and has not been implicated in the outbreak. (Sun and Alchenbach, 4/25)

The Associated Press: Parents Spared Jail In Death Of Girl Who Didn't See Doctor
The parents of a 2-year-old Pennsylvania girl have been spared jail time in the pneumonia death of their daughter after vowing to seek medical care in the future for their other children. Jonathan Foster, 35, and Grace Foster, 34, were sentenced Wednesday to five years' probation on involuntary manslaughter and child endangerment convictions in the November 2016 death of daughter Ella Grace in Upper Tulpehocken Township, about 45 miles northeast of Harrisburg. (4/25)

The Associated Press: NY Advocates Renew Push For Law Banning 'Conversion Therapy'
Advocates are making another push for a New York law banning therapy that attempts to change the sexual orientation or gender identity of minors. Dozens of social workers joined students, LGBT activists and lawmakers Wednesday at the state Capitol to call on the Republican-led Senate to take up the legislation banning gay conversion therapy. The measure has passed the Democrat-controlled Assembly several years in a row. (4/25)

The Associated Press: Legionnaires' Cases Linked To Co-Op City In The Bronx
Health officials have confirmed three cases of Legionnaires' disease, one of them fatal, at an apartment complex in the Bronx. The New York City Health Department says the three cases occurred within the past year and center on three connected buildings at Co-op City. Investigators are looking into the building's internal plumbing. The building does not have a cooling tower. (4/25)