First Edition: August 29, 2018

Kaiser Health News: Earwax, Of All Things, Poses Unrecognized Risk In Long-Term Care
Of all the indignities that come with aging, excessive earwax may be the most insidious.Don’t laugh. That greasy, often gross, buildup occurs more often in older ears than those of the young, experts say. And when it goes unrecognized, it can pose serious problems, especially for the 2.2 million people who live in U.S. nursing homes and assisted living centers. (Aleccia, 8/29)

Kaiser Health News: Wis. Board Will Again Cover State Workers Seeking Transgender Treatment
In a surprising reversal, a Wisconsin board has voted to again offer insurance coverage to transgender state employees seeking hormone therapy and gender confirmation surgery. Members of the Group Insurance Board, which manages the insurance program for Wisconsin’s public workers and retirees, last week voted 5-4 to overturn its current policy barring treatments and procedures “related to gender reassignment or sexual transformation.” (Huetteman, 8/29)

The Washington Post: Trump Administration To Pay New York, Minnesota For Lost Health-Care Funds
The Trump administration will pay New York and Minnesota close to half a billion dollars this year after the two states sued over lost federal funding for programs that provide health care to tens of thousands of low-income residents. The two states are the only ones in the country to create “Basic Health Programs,” an option for states created by the Affordable Care Act. Under such programs, people earning between 138 percent and 200 percent of the federal poverty level -- the population earning slightly too much to be eligible for Medicaid -- receive their health coverage from the state. That is about 738,000 people in New York and 84,000 people in Minnesota. (Itkowitz, 8/28)

The Hill: GOP Eyes Another Shot At ObamaCare Repeal After McCain’s Death
Senate Republicans say they would like Arizona Gov. Doug Ducey (R) to appoint a successor to late Sen. John McCain (R-Ariz.) who, unlike McCain, would support GOP legislation to repeal ObamaCare. GOP lawmakers say they won’t have time to hold another vote to repeal the law in 2018 but vow to try again next year if they manage to keep their Senate and House majorities. (Bolton, 8/29)

Bloomberg: Fewer Americans Without Health Insurance Since Obamacare Debut 
Fewer Americans lack health insurance -- but the gap remains wide, especially in some pro-Trump states. The number of uninsured declined to 28.3 million in the first quarter, down from 29.3 last year -- and 48.6 million in 2010, the year the Affordable Care Act was signed into law by then-President Barack Obama, according to data from the federal Centers for Disease Control and Prevention.(Tanzi, 8/29)

The Hill: Why CBO Won't Estimate Cost Of Bernie Sanders's 'Medicare For All' Bill 
A recent study concluding that Sen. Bernie Sanders's “Medicare for all” bill would cost $32 trillion has set off a furious debate over the cost of the plan. But there's one estimate that would make an even bigger splash: the score from the nonpartisan Congressional Budget Office (CBO). (Sullivan, 8/29)

The Hill: California Gov Candidate Backs Universal Healthcare For Undocumented Immigrants 
California Lt. Gov. Gavin Newsom (D), who is running for governor, said in an interview released Tuesday that he would like to see the state pay for universal healthcare for all illegal immigrants. “I did universal healthcare when I was mayor — fully implemented, regardless of pre-existing condition, ability to pay, and regardless of your immigration status,” Newsom told the podcast Pod Save America, referencing his stint as San Francisco's mayor. “I’d like to see that extended to the rest of the state. (Keller, 8/28)

The New York Times: Nearly A Year After Hurricane Maria, Puerto Rico Revises Death Toll To 2,975
A long-awaited analysis of Hurricane Maria’s deadly sweep through Puerto Rico prompted the government on Tuesday to sharply increase the official death toll. The government now estimates that 2,975 people died as a result of the disaster and its effects, which unfolded over months. The new assessment is orders of magnitude greater than the previous official tally of 64, which was not revised for nearly a year despite convincing evidence that the official death certificates failed to take full account of the fatal and often long-range impacts from the storm across the island. (Fink, 8/28)

Reuters: Puerto Rico Death Toll Official Estimate From Hurricane Maria Rises To 2,975
The updated figure came from an academic study commissioned by Rossello from George Washington University's Milken Institute School of Public health. It calculated the number of deaths that could be attributed directly or indirectly to Maria from the time it struck in September 2017 to mid-February of this year, based on comparisons between predicted mortality under normal circumstances and deaths documented after the storm. (Gorman and Borter, 8/28)

The Washington Post: Study: Hurricane Maria And Its Aftermath Caused A Spike In Puerto Rico Deaths, With Nearly 3,000 More Than Normal
The government of Puerto Rico on Tuesday embraced the GWU estimate as the official death toll, ranking Maria among the deadliest natural disasters in U.S. history. For much of the past year, the government had formally acknowledged just 64 deaths from the hurricane, which ravaged much of the territory and destroyed critical infrastructure. The spike in mortality came as the territory dealt with widespread and lengthy power outages, a lack of access to adequate health care, water insecurity and diseases related to the crisis. (Hernandez, Schmidt and Achenbach, 8/28)

The Wall Street Journal: Puerto Rico Governor Raises Hurricane Maria Death Toll To Nearly 3,000
Puerto Rico’s government has faced criticism for nearly a year that it drastically undercounted the number of fatalities caused by Maria. Earlier this month, it acknowledged in a document filed to Congress that the death toll from Maria was much higher than the official total. Gov. Ricardo Rosselló said at a news conference Tuesday that he would sign an executive order updating the official death toll, with the caveat that the number was an estimate. And he said he took responsibility as the island’s governor for mishandling the fatality-count issue. “Yes, I made mistakes. Yes, in hindsight, things could have been handled differently,” Mr. Rosselló said. “My commitment as governor is accepting that criticism, but also building on it.” (Campo-Flores, 8/28)

Stat: Watchdog Asks Ethics Officials To Probe Azar Over Industry Ties And Rebates
Awatchdog group has asked ethics officials at the Department of Health and Human Services to investigate the relationship between Alex Azar, who heads the department, and Eli Lilly (LLY), his former employer, over a recently proposed rule that would benefit drug makers. The request by the Campaign for Accountability, a nonprofit, comes in response to a proposal the Trump administration is considering to reduce or restrict rebates, which are essentially a type of discount that drug makers provide pharmacy benefit managers off the wholesale, or list, price for their medicines in order to receive favorable placement on formularies, which are lists of insured drugs. (Silverman, 8/28)

The Associated Press: Worldwide Gun Deaths Reach 250,000 Yearly; US Ranks High
Gun deaths worldwide total about 250,000 yearly and the United States is among just six countries that make up half of those fatalities, a study found. The results from one of the most comprehensive analyses of firearm deaths reveal "a major public health problem for humanity," according to an editorial published with the study Tuesday in the Journal of the American Medical Association. (Tanner, 8/28)

Los Angeles Times: In Some Countries, The Odds Of Getting Shot Are 1 In A Million. In The U.S., It's 100 Times Higher
Imagine that, in the course of a single year, a ubiquitous household item was implicated in the death of every man, woman and child in the city of Glendale, Ariz., America’s 87th largest city with a population of 251,269. The world would almost certainly take notice of such a loss. That, in essence, was the global toll of humanity’s obsession with firearms. (Healy, 8/29)

The Washington Post: A Heart Attack Left Him With A $109,000 Bill. His Story Aired, And Now He Owes $782.
First, Drew Calver had an unexpected heart attack, collapsing in his bedroom on a spring morning in 2017. Then came the bill: $164,941 for his four-day hospital stay, which included the cost of having four stents put in a clogged artery. As a teacher and swim coach at a public high school in Austin, where he lives with his wife and two daughters, Calver is luckier than some, with health insurance provided to him by Aetna. But even after the insurance kicked in and covered $56,000, Calver was left with nearly $109,000 in unpaid fees billed to him by the hospital. (Rosenberg, 8/28)

Politico: Trump Administration Warns California Against 'Safe' Opioid Injection Sites
The Justice Department is threatening to shut down San Francisco's proposed test of supervised injection sites amid the opioid crisis even before the governor has a chance to sign the pilot program into law. The looming showdown could affect similar efforts in New York, Philadelphia and Seattle, where officials have grappled with the ramifications of setting up spaces where drug users could shoot up while gaining access to clean syringes, medical professionals and treatment services as an approach to curb opioid addiction and overdose deaths. (Colliver, Goldberg and Roubein, 8/28)

Bay City News Service: Mayor: Safe Injection Sites Are 'One Step Away' After Legislature Passes Bill
The California Legislature on Monday passed Assembly Bill 186, which would give the green light for safe injection sites in San Francisco under a three-year pilot. Amid a visible drug crisis happening in the city, safe injection sites would allow for people suffering from addiction to use drugs at facilities under the supervision of trained staff. The bill now heads to Gov. Jerry Brown for his signature. (8/28)

NPR: Does The 'Club Drug' Ketamine Ease Depression By Acting Like An Opioid?
A new study suggests that ketamine, an increasingly popular treatment for depression, has something in common with drugs like fentanyl and oxycodone. The small study found evidence that ketamine's effectiveness with depression, demonstrated in many small studies over the past decade, comes from its interaction with the brain's opioid system. A Stanford University team reported their findings Wednesday in The American Journal of Psychiatry. (Hamilton, 8/29)

Bloomberg: Narcan Maker Adapt To Be Acquired By Emergent BioSolutions
The maker of Narcan, the opioid-overdose antidote that’s been widely used across the U.S. to combat the nation’s addiction crisis, will be acquired by Emergent BioSolutions Inc. Emergent said the $735 million deal for Adapt Pharma, which includes a $635 million upfront payment and as much as $100 million in potential sales-based milestones, will expand the use of the nasal spray while maintaining its affordability and raising awareness of naloxone, the generic name for Narcan. The deal is expected to generate annual revenue of as much as $220 million in 2019, the company said. (Hopkins, 8/28)

The New York Times: Boy, 9, Killed Himself After Being Tormented By Bullies, His Mom Says
Leia Pierce shuffled out the front door on Tuesday. Her son, Jamel Myles, 9, had killed himself last week, and she was still struggling with the basics. Eating. Sleeping. “I took a shower, but I put the same clothes back on,” she said, staring at the ground. “I need him back.” Jamel, a fourth grader at Joe Shoemaker Elementary School in Denver, hanged himself in his bedroom last Thursday, according to the county coroner, and his death has plunged a mother into despair and a community into disbelief. (Turkewitz, 8/28)

USA Today: Preteen Suicides Are Rare, But Numbers Are On The Rise
The Centers for Disease Control and Prevention reports that the teen suicide rate rose by more than 70 percent between 2006 and 2016. Suicide was the 10th leading cause of death for elementary school-aged children in 2014, the CDC reported. The death rate among 10- to 14-year-olds more than doubled from 0.9 per 100,000 in 2007 to 2.1 per 100,000 in 2014. Suicide is a particular concern among LGBTQ youth. Pierce told KUSA-TV that her son was bullied because he was gay. (O'Donnell, 8/28)

The New York Times: S.T.D. Diagnoses Reach Record 2.3 Million New Cases In U.S.
New cases of chlamydia, gonorrhea and syphilis rose sharply for the fourth consecutive year in 2017, to a record high of nearly 2.3 million, according to new data from the Centers for Disease Control and Prevention. That number surpassed the previous record, which was set in 2016, by more than 200,000 cases. The statistics are an alarming sign that the systems to prevent and treat sexually transmitted diseases are “strained to near-breaking point,” said Dr. Jonathan Mermin, a top C.D.C. official. (Zraick, 8/28)

NPR: STD Cases Reach Record High In U.S., As Prevention Funding Declines
Chlamydia, a bacterial infection, remained the most common sexually transmitted disease, with more than 1.7 million reported cases. But health officials are concerned that gonorrhea cases increased a startling 67 percent between 2013 and 2017, and syphilis climbed even faster — 76 percent over those four years. After many years of success in controlling sexually transmitted diseases, "We've been sliding backwards," says Dr. Gail Bolan, director of the CDC's Division of STD Prevention. She spoke at a news conference in Washington Tuesday. (Harris, 8/28)

The New York Times: Pollution May Dim Thinking Skills, Study In China Suggests
A large study in China suggests a link between air pollution and negative effects on people’s language and math skills. The link between pollution and respiratory diseases is well known, and most experts now believe that small particulates may also raise the risk for strokes and heart attacks. Whether this form of air pollution impairs cognition is not yet certain, but several studies have hinted at a connection. (Ives, 8/29)

The Wall Street Journal: As Wildfires Burn Miles Away, Smog Blankets The Northwest
On a recent morning in this city bred on the great outdoors, the halls of Mt. Spokane High School were filled with some 600 football players throwing spirals, cross-country runners doing laps, and marching band members twirling batons. The air outside was too smoky to breathe. The Pacific Northwest, sandwiched between Canada’s smoldering British Columbia to the north and six fire-wracked Western U.S. states, is feeling the side effects of one of the worst fire seasons on record. For much of the past several weeks, clouds of choking smog have upended daily life and posed a health hazard for millions here. (Carlton and Malas, 8/29)

Stat: At 83, AIDS Activist Larry Kramer Isn’t Done Ripping Into His Foes 
Over the course of three decades, the name Larry Kramer has become synonymous with the gay rights movement, patient rights — and savage attacks on public officials and drug companies. Today, with controversy over drug prices and concern over public health funding, we were curious what Kramer had on his mind. We also wondered whether at the age of 83 he has mellowed. He has not. (Berke, 8/29)

Stat: Officials Look To Update Federal Guidelines For Mail-Order DNA Companies
The Trump administration wants to modernize the federal guidelines for companies that sell made-to-order DNA in hopes of keeping dangerous genetic material — like smallpox or the Ebola virus — out of the hands of malicious potential customers, federal officials confirmed to STAT this week. The administration’s work is still in early stages, and it’s too soon to tell whether or how the government will make the guidelines more stringent, as companies and experts in the space have called for. (Swetlitz, 8/29)

The New York Times: Exercise Now, Sit In Front Of The TV Later
If we spend an hour working out, that’s one hour less during our day that we can potentially spend being sedentary. But we may, consciously or not, find other opportunities during the day to move less, undermining our best intentions and the potential health benefits of the exercise, according to an interesting new study of how people use their time, minute by minute, on days when they exercise and when they do not. Time management is always tricky, involving constant trade-offs, not all of which are voluntary or even conscious. (Reynolds, 8/29)

The Associated Press: Toxic Pesticides Found At Most Illegal California Pot Farms
Nine of every 10 illegal marijuana farms raided in California this year contained traces of powerful and potentially lethal pesticides that are poisoning wildlife and could endanger water supplies, researchers and federal authorities said Tuesday. That’s a jump from chemicals found at about 75 percent of illegal growing operations discovered on public land last year, and it’s six times as high as in 2012. (Thompson, 8/28)

The Associated Press: Legal Marijuana Industry Tries To Shake 'Stoner' Stereotypes
Michelle Janikian, who writes about marijuana for publications like Herb, Playboy and Rolling Stone, says after she tells someone what she does for a living, she usually spends the rest of the conversation "trying to act so friendly and mainstream" so they don't think she's stoned. Adam Salcido relates that after he went to work a couple of years ago for a Southern California company that helps organize weed-infused events like Hempfest and Cannabis Cup, he had to reassure his family he wouldn't turn into a drug addict. (Rogers and Fauria, 8/29)