First Edition: August 2, 2019

Kaiser Health News: Infusion Treatments For Low Iron Can Deplete Patients’ Wallets
Shannon Wood Rothenberg walked into her annual physical feeling fine. But more than a year later, she’s still paying the price. Routine bloodwork from the spring 2018 visit suggested anemia, of which she has a family history. Her doctor advised pills. After two months with no change, the doctor sent Rothenberg to a hematologist who could delve into the cause and infuse iron directly into her veins. (Luthra, 8/2)

Kaiser Health News: Colorado Doctors Note The Challenges In Treating Marijuana Users Who Undergo Surgery
When Colorado legalized marijuana, it became a pioneer in creating new policies to deal with the drug. Now the state’s surgeons, nurses and anesthesiologists are becoming pioneers of a different sort in understanding what weed may do to patients who go under the knife. Their observations and initial research show that marijuana use may affect patients’ responses to anesthesia on the operating table — and, depending on the patient’s history of using the drug, either help or hinder their symptoms afterward in the recovery room. (Ruder, 8/2)

Kaiser Health News: KHN’s ‘What The Health?’: Deciphering The Democrats’ Health Debate
Twenty Democratic candidates for president debated health care at length over two nights in Detroit this week. But countless 30-second charges and countercharges from “Medicare for All” backers and those who want a more gradual approach to universal coverage may have left the audience more confused than ever about the best way to make the health system better and more affordable. (8/1)

Politico: Warren Has Lots Of Plans. But Not On Health Care.
Elizabeth Warren boasts she has a plan for everything, but there’s one glaring omission: health care. Warren, who has recently leaped into the top tier of a crowded primary field as she rolled out detailed policies for seemingly everything — from climate change to the opioid crisis to breaking up tech giants — has instead embraced “Medicare for All” legislation from Sen. Bernie Sanders, her foremost progressive rival. And for many single-payer activists thrilled the once-fringe issue has entered the party’s mainstream, that’s good enough. (Ollstein, 8/2)

The Associated Press: Health Care Comes In Focus, This Time As Risk For Democrats
With health care at the center of presidential politics, Democrats are split over eliminating employer-provided health insurance under "Medicare for All." The risk is that history has shown voters are wary of disruptions to job-based insurance, the mainstay of coverage for Americans over three generations. Divisions were on display in the two Democratic debates this week, with Sens. Bernie Sanders and Elizabeth Warren calling for a complete switch to government-run health insurance for all. (Alonso-Zaldivar, 8/1)

The Hill: Schumer Warns Democrats Against 'Circular Firing Squad' On Health Care 
Senate Minority Leader Charles Schumer (D-N.Y.) on Thursday warned Democratic presidential candidates not to become so focused on the internal differences over health care that they lose sight of fighting against President Trump. ..."If we get all focused on the differences between, say Bernie [Sanders] and Cory [Booker] and Mayor Pete [Buttigieg] and [John] Hickenlooper, we'll lose sight of the fact that it's Donald Trump who's now trying to reduce health care, destroy health care, get rid of it for everybody," Schumer said. (Weixel, 8/1)

The Washington Post: Democrats' Failure To Talk About Drug Prices Was 'A Missed Opportunity'
The soaring cost of prescription drugs is among voters’ greatest concerns, but the issue drew little attention from the Democratic candidates during this week’s presidential debates. The low wattage trained on the issue during nearly six hours of debate Tuesday and Wednesday contrasts with the attention President Trump and his top aides are showering on the issue. That partisan gap poses risks for Democrats who might forfeit the advantage they have long held when voters are asked which party they trust to fix health-care problems, according to health policy analysts and pollsters. (Goldstein, 8/1)

The Washington Post: Black Voters Hear Little In Debate To Excite Them
Some who watched said they were disappointed that in a debate held in Detroit, which is 79 percent black, there was only a passing discussion of the social and economic disparities between blacks and whites that have increased as the region recovers from the automotive industry crisis. And in Flint, which grabbed headlines five years ago when it was discovered that local officials had made decisions that resulted in lead and other toxins contaminating the water supply, those attending watch parties were disappointed that some candidates said nothing about their ongoing challenge to get safe drinking water. (Williams, 8/1)

The New York Times: Trump Treats Rally In Cincinnati As Rebuttal To Democratic Debates
After imbibing days of wall-to-wall news coverage of the 2020 Democratic debates, President Trump seemed to feel a little left out. “The Democrats spent more time attacking Barack Obama than they did attacking me, practically,” he marveled. ... Delivering a reliably red-meat, 80-minute speech, Mr. Trump singled out former Vice President Joseph R. Biden Jr. and Senator Elizabeth Warren of Massachusetts and he seized on some of the more liberal proposals advanced by Democrats, including eliminating private health insurance in favor of a government-run system and providing health care coverage even to illegal immigrants. (Baker and Rogers, 8/1)

The Associated Press: At Rally, Trump Laces Into Democrats But Avoids Race
He mocked some of the leading Democratic contenders, reviving his nickname of “Sleepy” for Joe Biden, teasing Elizabeth Warren for claiming some Native American heritage and lashing the Democrats for their health care and immigration proposals. “The Democrats have never been so far outside the mainstream,” Trump claimed. (Lemire and Sewell, 8/1)

The New York Times: Republicans Watch Fractious Democratic Debates And Like What They See
After two nights of debates between 20 presidential hopefuls that exposed a wide rift between the Democratic Party’s progressive and centrist wings, President Trump’s allies and Republican strategists said Thursday that they had gotten largely what they wanted: Five hours of a nationally televised clash where Democrats themselves questioned the practicality of prominent liberal wish-list items. ... “What the moderates were doing was pointing out that a large group of the Democrats running are simply out of sync with mainstream swing voters,” said Karl Rove, the former top political adviser to President George W. Bush’s two winning presidential campaigns. “The idea they’re going to provide illegal immigrants free health care, that’s not going to go down in union households in Michigan.” (Peters and Karni, 8/1)

The Associated Press: Canadians Worried By Plan To Let Americans Import Drugs
A Trump administration plan to let Americans legally import cheaper prescription drugs from Canada is causing concern among Canadians who that fear it could cause shortages of some medications — as well as surprise by officials who say they weren't consulted about a possible influx of U.S. drug-buyers. The plan is a "clear and present danger" to the health and well-being of Canadians who need prescription medications, said John Adams, the volunteer chairman of the Best Medicines Coalition, a non-profit organization representing 28 national patient organizations. (8/1)

The Washington Post: Trump And Sanders Want To Ease Imports Of Drugs From Canada. Canada Says Not So Fast 
The response from Canadians? Sorry, but back off. Pharmacists, patient groups, doctors and some lawmakers here worry that the large-scale importation of pharmaceuticals could deplete the drug supply for the country’s 37 million residents. “This is going to exacerbate some of the drug shortages that we’re already seeing in Canada,” said Joelle Walker, the vice president of public affairs for the Canadian Pharmacists Association. “We aren’t equipped to deal with a country that is ten times our size.” (Coletta, 8/1)

The Hill: Sanders Pledges To Allow Prescription Drug Imports On First Day In Office 
Sen. Bernie Sanders (I-Vt.) on Thursday pledged to allow the importation of cheaper prescription drugs from Canada on his first day in office. The Democratic presidential candidate's pledge comes one day after President Trump made a more incremental move toward allowing some drug importation. (Sullivan, 8/1)

Reuters: Congress Approves Trump-Backed Two-Year Spending, Debt Limit Deal
The U.S. Senate on Thursday passed and sent to President Donald Trump a two-year budget deal that would increase federal spending on defense and an array of other domestic programs, significantly adding to rapidly escalating government debt. By a vote of 67-28, the Senate ignored late-hour appeals from some conservative Republicans who support bigger military expenditures and tax cuts that constrain revenues but were angered over more spending for non-defense domestic programs. (Cowan, 8/1)

Roll Call: Two-Year Budget Pact Clears Senate, Ending Fiscal 2020 Impasse
Trump has embraced the deal, however, because it would uncork the higher military spending he wants — $738 billion in fiscal 2020, just shy of his initial budget request — while freeing up nondefense dollars that could be used for his priorities like border security and veterans health care. Spending cuts, the president says, can come later. “Budget Deal is phenomenal for our Great Military, our Vets, and Jobs, Jobs, Jobs!” Trump tweeted before the vote Thursday. “Two year deal gets us past the Election. Go for it Republicans, there is always plenty of time to CUT!“ Aides say he also has been making calls to on-the-fence GOP senators. (Shutt, 8/1)

The Washington Post: Trump Administration To Stall Billions In Puerto Rico Funds Amid Island’s Political Crisis
The Trump administration will place new restrictions on billions of dollars in federal disaster aid for Puerto Rico, according to two senior government officials briefed on the plan, as the island struggles to recover from a weeks-long political crisis that has forced the governor to announce his resignation. The decision will impose new safeguards on about $8.3 billion in Housing and Urban Development disaster mitigation funding to Puerto Rico, as well as about $770 million in similar funding for the U.S. Virgin Islands, according to the senior officials, who spoke on the condition of anonymity because they were not authorized to discuss the matter publicly. (Stein and Dawsey, 8/1)

The Wall Street Journal: Bill Would Let Cash-Strapped Injured Veterans Keep Disability Money During Bankruptcy
Congress passed a bill that would extend a lifeline to financially struggling injured veterans, enabling them to spend disability payments instead of using them to pay down debt in bankruptcy protection. The Senate on Thursday passed a bill sponsored by Sen. Tammy Baldwin (D., Wis.) that consumer advocates say fixes a mistake written into a 2005 overhaul of the country’s bankruptcy rules. The House passed the bill last week. It now goes to the White House for President Trump’s signature. (Ferek, 8/1)

The Associated Press: 300,000 Virginians Newly Covered Through Medicaid Expansion
Just over 300,000 low-income Virginia adults have enrolled in the state’s expanded Medicaid program. Gov. Ralph Northam made the announcement Wednesday at a health center in Alexandria. State officials have previously estimated that roughly 400,000 adults would be newly eligible for Medicaid under the expansion lawmakers approved last year. (8/1)

The Washington Post: Harvard, Johns Hopkins Doctors Urge Probe Of Child Migrant Deaths: ‘Poor Conditions’ At Border Increase Risk Of Spreading Flu
A group of doctors from Harvard and Johns Hopkins has urged Congress to investigate the deaths of six migrant children who were held in government custody after crossing the southern border in the past year, warning that “poor conditions” at U.S. facilities are increasing the risk of spreading deadly infectious diseases, especially the flu. The doctors, who wrote to Congress on Thursday, said autopsy reports show that at least three of the children — ages 2, 6 and 16 — died in part as a result of having the flu, a far higher incidence of such deaths than across the general population. Child flu deaths are rare, the doctors said, and should be preventable. (Moore, 8/1)

The Associated Press: Cities Now See More Overdose Deaths Than Rural Areas 
U.S. drug overdose deaths, which have been concentrated in Appalachia and other rural areas for more than a dozen years, are back to being most common in big cities again, according to a government report issued Friday. The report by the Centers for Disease Control and Prevention said the urban overdose death rate surpassed the rural rate in 2016 and 2017. Rates for last year and this year are not yet available. But experts, citing available data, say the urban rate is likely to stay higher in the near future. (Stobbe, 8/2)

The Wall Street Journal: U.S. Drug Epidemic Becoming More Urban
For years, death rates from drug overdoses rose faster in rural America, as supply chains of opioids and other drugs expanded and abuse took off. But urban overdose death rates overtook those of rural counties in 2016, the analysis by the Centers for Disease Control and Prevention showed. The findings reflect the effects of bootleg synthetic opioids such as fentanyl on a large, older cohort of longtime drug users in urban areas, some experts said. Fentanyl, a potent opioid with 50 times the strength of heroin, is a major culprit in a skyrocketing number of deaths from drug use since 2014, according to the CDC. (McKay and Kamp, 8/2)

The Associated Press: E-Cigarette Giant Juul's Campaign Donations Favor Democrats
E-cigarette giant Juul Labs gave nearly $100,000 to members of Congress during the first half of 2019 as the company faced the bulk of the blame for a surge of underage vaping and calls for tighter government regulation of the industry. The donations from Juul's political action committee represent a sharp increase over last year's total, according to a Federal Election Commission report released Thursday that shows most of the money went to Democrats. (Lardner and Perrone, 8/1)

The Hill: Almost Three-Quarters Say Minimum Age To Buy Tobacco Should Be 21: Gallup
Nearly three-quarters of respondents in a new poll said they support raising the minimum age to purchase tobacco products from 18 to 21. Gallup found that 73 percent of Americans said they backed raising the minimum tobacco purchase age to 21. Support for the move was higher among older respondents, the survey giant added. (Klar, 8/1)

The Associated Press: Health Insurers Experience July Heatwave
Health insurer stocks heated up in July. UnitedHealth Group, Anthem and several other insurers outpaced the broader market in what has been an otherwise choppy year for the industry. The industry is also holding up surprisingly well during the most recent round of corporate earnings. It is showing solid profit growth while companies within the broader S&P 500 are expected to report an overall contraction. (Troise, 8/1)

Reuters: Higher Medical Costs Take Shine Off Cigna Second-Quarter Profit Beat
Health insurer Cigna Corp raised its 2019 profit forecast on Thursday, helped by last year's acquisition of pharmacy benefit manager Express Scripts, but medical costs in the second quarter were higher than expected and its shares fell slightly. As health insurers face regulatory uncertainty amid political efforts to lower U.S. healthcare costs ahead of the 2020 presidential election, Cigna is hoping the $52 billion acquisition will help rein in its own costs. (Mathias and Humer, 8/1)

Stat: Pharma Lawsuit Against California Transparency Law Can Proceed
A federal judge breathed new life into a long-running effort by the pharmaceutical industry to thwart a controversial California law that requires drug makers to not only provide advance notice of price hikes, but also give the reasons for any increases. In a ruling on Wednesday, U.S. District Court Judge Morrison England Jr. allowed the PhRMA trade group to proceed with an amended lawsuit that argues the law is unconstitutional because it violates interstate commerce and free speech principles, unfairly holds drug makers largely accountable for prices, and purportedly has fuzzy language about the timeframe for providing notice of a price hike. (Silverman, 8/1)

Stat: PhRMA’s Top Lobbyist Will Leave At The End Of August 
Rodger Currie, the top lobbyist for the drug industry trade group PhRMA, is leaving the organization at the end of August, three sources confirmed to STAT. The news was announced internally by the association’s president, Steve Ubl, in an internal email sent late Thursday afternoon. Currie has chosen to “pursue new opportunities,” according to the internal email. (Florko, 8/1)

The New York Times: A Blood Test For Alzheimer’s? It’s Coming, Scientists Report
For decades, researchers have sought a blood test for beta amyloid, the protein that is a hallmark of Alzheimer’s disease. Several groups and companies have made progress, and on Thursday, scientists at Washington University in St. Louis reported that they had devised the most sensitive blood test yet. The test will not be available for clinical use for years, and in any event, amyloid is not a perfect predictor of Alzheimer’s disease: Most symptomless older people with amyloid deposits in their brains will not develop dementia. (Kolata, 8/1)

The New York Times: Colorectal Cancer Rises Among Younger Adults
Colorectal cancer is typically considered a disease of aging — most new cases are diagnosed in people over age 50. But even as the rates decrease in older adults, scientists have documented a worrisome trend in the opposite direction among patients in their 20s and 30s. Now, data from national cancer registries in Canada add to the evidence that colorectal cancer rates are rising in younger adults. The increases may even be accelerating. (Sheikh, 7/31)

CNN: Massachusetts Towns Are At 'High Risk' For A Mosquito-Borne Virus That Can Cause Brain Swelling
Health officials are warning that seven towns in southeastern Massachusetts are at "high risk" for a potentially fatal mosquito-borne virus known as Eastern equine encephalitis or EEE. The virus has been found in 92 mosquito samples this year, the Massachusetts Department of Public Health said Wednesday, and one-third of them are from a species that can spread the virus to people. "We're raising the risk level because there is more activity than we typically see and it is happening early in the season," Public Health Commissioner Monica Bharel said in a statement. (Lou, 8/1)

The New York Times: Got Impossible Milk? The Quest For Lab-Made Dairy
In recent years, the alternatives to conventional cows’ milk have proliferated. The local grocery store is likely to offer any number of plant-based options: milks made from soy, almonds, oats, rice, hemp, coconuts, cashews, pea plants and more. But most nondairy milks pale in comparison to cows’ milk. Plant-based milks are made by breaking down plants and reconstituting their proteins in water to resemble the fluid from a lactating bovine. (Sheikh, 8/2)

The Wall Street Journal: Meatless Burgers Stoke Sales And Questions About Nutrition
Plant-based burger makers say their products are better for the planet than beef. Whether they are better for consumers’ health is a different question. Debate over the nutritional merits of patties made from soy, peas, coconut and other plants is growing as meatless products stampede into tens of thousands of supermarkets and restaurants, and their manufacturers rush to ramp up production. (Bunge and Haddon, 8/1)

Los Angeles Times: These Six Things Can Stave Off Weight Gain, Even If Your Genes Boost Your Risk Of Obesity
You can run away from your fat genes, and you can waltz right on by a hereditary risk of gaining weight. But it’s a little less clear that mimicking funky moves in front of a video game console will protect you from a genetic vulnerability to becoming obese. So finds a new study that identifies six ways people with unlucky bits of DNA can stave off the accumulation of excess pounds. (Healy, 8/1)

The Washington Post: Allyson Felix Became A Mother, And Now She Wants To Be An Activist
A fundamental tenet of being a sprinter is staying in your lane, and for years, Allyson Felix applied it to every portion of her career. Obsessive focus helped make her the most decorated American woman in Olympic history. By age 30, she had won nine Olympic medals — six gold, three silver — and nine of her 11 world championships. She ran for an apparel company, endorsed products and stayed silent on issues outside of her performance. The thought of using her platform for other purposes scared her. She viewed herself, first and only, as an athlete. (Kilgore, 8/1)

The New York Times: North Carolina Hospital Found Compliant But ‘Significantly Different’ After Complaints
Regulators have determined that North Carolina Children’s Hospital is in compliance with federal rules but markedly changed since doctors, department heads and a top administrator expressed concerns three years ago about patients undergoing heart surgery there. Inspection records released on Thursday cited no deficiencies with the hospital’s operations. But a spokesman for the Centers for Medicare and Medicaid Services, which oversaw an investigation with the state health agency, said the institution’s heart surgery program “is significantly different than it was during 2016-17.” (Gabler, 8/1)

The Wall Street Journal: 938 New York City Classrooms Tested Positive For Lead
New York City principals will notify thousands of parents of young children that their classrooms had cracked, chipped or peeling paint that tested positive for lead this summer, city officials said Thursday. In a round of inspections starting in June, contractors found lead in deteriorating paint in 938 public-school classrooms for children under 6 years old in 302 buildings, according to new Department of Education data. Its officials said these trouble spots will be fixed, typically by repainting, before school opens in September. (Brody, 8/1)

The Associated Press: New Jersey's Medically Assisted Suicide Law Takes Effect
A New Jersey law allowing terminally ill patients to seek life-ending drugs went into effect Thursday. Democratic Gov. Phil Murphy had signed the bill in April, making New Jersey the seventh state with such a measure. Maine enacted a similar law in June, becoming the eighth. The Medical Aid in Dying for the Terminally Ill Act in New Jersey allows only patients who are terminally ill and have a prognosis of six months or less to live to acquire medication to end their lives. (8/1)

Los Angeles Times: California Has The Most Homeless People Of Any State. But L.A. Is Still A National Model
With tens of thousands of homeless people living on the streets, Los Angeles officials have increasingly found themselves as the subject of criticism for what many Angelenos see as a failure to keep up with a problem that seems to be getting worse. But across the country, L.A. isn’t considered to be a failure. To the contrary, at last week’s National Conference on Ending Homelessness in Washington, D.C., attendees repeatedly held up the city, the county and the state as models of political will for getting people into housing. (Oreskes, 8/1)

The Associated Press: San Francisco Public Toilets Help Homeless, Cost $200,000
The sidewalks surrounding Ahmed Al Barak’s corner market in one of San Francisco’s roughest neighborhoods are filled with cardboard, used syringes and homeless people who have nowhere safe to go at night. But Al Barak says it’s an improvement from a year ago, before the city posted a portable toilet across the street from his business in the city’s Tenderloin district. He no longer regularly sees people relieve themselves in broad daylight, and he doesn’t see as much feces and urine on the streets. In his opinion, it’s the one bright spot in a city where taxes are too high. (Har, 8/2)

The Associated Press: Medical Marijuana Cleared For Release To Louisiana Patients 
Medical marijuana is expected to start reaching select dispensaries in Louisiana on Tuesday, after the state agriculture department completed final testing and cleared therapeutic cannabis for release to patients. Agriculture Commissioner Mike Strain announced Thursday evening that GB Sciences, one of two state-sanctioned growers, can begin shipping out the product to Louisiana’s registered dispensaries. Strain thanked “everyone who has worked tirelessly from inception through production and testing to make this a reality.” (Deslatte, 8/1)

Los Angeles Times: This California Town Wants To Be A 2nd Amendment 'Sanctuary City' For Guns And Ammo
The blistering sun hung high above the barren landscape, 118 degrees of scatter-the-critters hot, as Tim Terral loaded a magazine into his 9-millimeter pistol. He narrowed his eyes, fixing his gaze on a target before a succession of pops cut through the silence. Bull’s-eye. Satisfied, Terral wiped a bead of sweat off his brow and cocked his head to the side, a coy smile spreading across his slender face. “I don’t miss much,” he crowed. (Fry, 8/1)

Los Angeles Times: Cedars-Sinai Division Director And UCLA Instructor Pleads Not Guilty To Felony Child Porn Charges
A UCLA instructor and division director at Cedars-Sinai Medical Center pleaded not guilty Thursday to charges of distributing and possessing child pornography. Guido Germano of Santa Monica is charged with one felony count each of distribution of obscene matter and possession of child or youth pornography, the Los Angeles County district attorney’s office said in a release. Germano, 59, is suspected of distributing child pornography videos using peer-to-peer software and downloading them onto his personal computer at his home. (Diaz, 8/1)

Los Angeles Times: After Boy's Death, Family Sues L.A. County’s Child Welfare Agency For $50 Million
Even years later, tears still flow easily for Maria Barron when she describes her efforts to rescue her nephew, Anthony Avalos, from his abusive Antelope Valley home. She had been a constant presence in Anthony’s life — potty training, consulting with his teachers in preschool, hearing his boyhood dreams about being a fireman. Before his death at age 10, the boy confided in her and her husband about the abuse, too. (Stiles, 8/1)