First Edition: August 29, 2019

Kaiser Health News: In India’s Slums, ‘Painkillers Are Part Of The Daily Routine’
In the crowded waiting room of Dr. Sunil Sagar’s clinic, in the working-class neighborhood of Bhagwanpur Khera, a toddler breathes from a nebulizer. Fever is widespread, and the air quality in Delhi has reached “severe-plus emergency.” The patients sit, motionless, but there is somehow tremendous noise. The clinic is a squat cement building draped in wires, a red cross on the door. Sagar sits behind a desk in a small, open room, as a squad of assistants escort patients to him. He seems utterly unflappable. A father with a troubled look sits down next to the doctor, holding a baby. Sagar listens to the baby’s chest with a stethoscope, pulls out scrap paper and writes a prescription. The father hands over a few rupees, and Sagar places the bills into a money drawer under his desk. The entire exchange takes perhaps two minutes. (Varney, 8/29)

California Healthline: Governor’s ‘Mental Health Czar’ Seeks New Blueprint For Care In California
In a career full of twists, turns and high-powered assignments, Thomas Insel may now be embarking on one of his most daunting tasks yet — helping California find its way out of a worrisome mental health care crisis. This year, he assumed a new role to help Gov. Gavin Newsom revamp mental health care in the state. Newsom called Insel his “mental health czar,” though his position is unpaid and Insel says it grants him “no authority.” Even so, he is zigzagging across California this summer, visiting mental health facilities to try to understand what works and what doesn’t. (Waters, 8/28)

The Associated Press: US Agency: Hospital Forced Nurse To Participate In Abortion
Vermont's largest hospital forced a nurse to participate in an abortion procedure over her moral objections in violation of federal law, a government civil rights agency said Wednesday. The University of Vermont Medical Center in Burlington could lose some federal funding if the two parties cannot agree within 30 days on the hospital's policies on employee participation in abortions, the Office for Civil Rights of the U.S. Department of Health and Human Services announced. (Ring, 8/28)

The Washington Post: Trump Administration Accuses Vermont Hospital Of Forcing Nurse To Participate In Abortion
The notice of violation, sent Wednesday to the University of Vermont Medical Center, is the latest example of the Trump administration’s focus on protecting “religious freedom” — a core value for antiabortion activists and other social conservatives key to the president’s political base. The action against UVM medical center is the third enforcement action taken in the 1 1/2 years since the Department of Health and Human Services created a conscience and religious freedom division within its civil rights office. It is the first that deals specifically with a health-care worker’s objection to participating in an abortion. (Goldstein, 8/28)

The Associated Press: Doctors Don't Always Know What Patients Will Owe For Meds
It's the No. 1 reason patients don't fill their prescriptions: sticker shock. While the price of almost any good or service can be found online, most Americans don't know what they'll owe for a prescription medication until they get it. Unexpected costs contribute to the estimated 20 to 30 percent of prescriptions that are never filled, which can lead to health problems from untreated medical conditions. (Perrone, 8/28)

Stat: Medicare Paid Millions For Drugs Already Covered By Hospice Benefits
Despite a previous warning, the Center for Medicare and Medicaid Services failed to take steps to ensure the Medicare Part D program does not also pay for medicines that should be covered under the Medicare Part A hospice benefit, resulting in an estimated $161 million in duplicate payments  in 2016, according to a new federal government analysis. Specifically, Medicare, Part D paid $422.7 million for 6.7 million prescriptions for beneficiaries who received hospice care. (Silverman, 8/28)

The Wall Street Journal: Juul Introduces Checkout System To Combat Underage Purchases
E-cigarette startup Juul Labs Inc., facing blame for a surge in teenage vaping, is offering more than $100 million in incentives to retailers to install a new electronic age-verification system intended to curb illegal sales to minors. The modification to point-of-sale software blocks each Juul purchase until the shopper’s driver’s license or other government identification has been scanned. It also limits each purchase to a maximum of one vaporizer and four refill packs. So far, Juul said, Cumberland Farms Inc., QuikTrip Corp. and other chains representing 40,000 outlets have agreed to adopt the system. (Maloney, 8/28)

The Washington Post: Maryland, Virginia Among 22 States Reporting Incidents Of Vaping-Related Illness
Maryland and Virginia are among 22 states that are reporting cases of vaping-related illness. At least one death has been reported, in Illinois. Maryland announced Wednesday that the Department of Health and the Maryland Poison Center at the University of Maryland School of Pharmacy have identified five individuals who have developed severe lung illness after using e-cigarettes. All required hospitalization, according to a news release. (Demkovich, 8/28)

Stateline: New Trump Rule On Medical Interpreters Could Leave Immigrants Behind 
Nevertheless, the Trump administration intends to relax an Obama-era federal rule requiring that medical providers let patients know about their right to language interpretation services — and for people with disabilities, communication assistance such as qualified sign language interpreters or written information in alternative formats for the visually impaired. The administration insists that the current requirements are onerous and costly for providers. The change could have far-reaching effects: More than 27 million U.S. residents speak English less than “very well” or not at all, according to the U.S. Census Bureau.

The Wall Street Journal: Local Leaders Criticize Plans For New Child-Migrant Shelters
The Trump administration aims to build new permanent shelters for unaccompanied child migrants in California, Virginia and Florida, drawing criticism from local officials opposed to the president’s immigration detention policies. The federal government is planning shelter space for as many as 1,370 unaccompanied children in the three states, according to documents made public earlier this month and recently highlighted by some irate Democrats. (Lazo, 8/28)

Reuters: U.S. To Pay For Thousands Of Doses Of HIV Drugs For Venezuelan Migrants
The United States said on Wednesday it will provide thousands of doses of HIV medication to treat Venezuelans in Colombia as part of regional efforts to manage care for millions of migrants fleeing the crisis-hit nation. U.S. Health and Human Services (HHS) Secretary Alex Azar told Reuters about the decision in a phone interview following a meeting this week of health officials from 10 countries in the Colombian border city of Cucuta. (8/29)

The Wall Street Journal: New Concerns Emerge About Long-Term Antidepressant Use
How long is too long to be on antidepressants? More Americans are taking antidepressant medications like Prozac and Zoloft for extended periods of time: One-quarter of people on the drugs have used them for a decade or more, according to data from the National Center for Health Statistics. But even the longest rigorous studies of antidepressants’ safety and efficacy have followed patients for only a couple of years. (Petersen, 8/28)

The Associated Press: US Agency Sees Low Risk In Contaminated Blood Pressure Drugs
U.S. health officials on Wednesday tried to reassure patients that they face very low risks from ongoing contamination problems with widely prescribed blood pressure drugs. Drugmakers have issued more than 50 recalls since last July linked to low levels of a probable cancer-causing chemical found in generic drugs taken by millions of Americans. The contamination underscores the Food and Drug Administration's struggle to police an industry that increasingly relies on overseas manufacturing plants in China and India. (8/28)

The Associated Press: Pinterest To Direct Vaccine-Related Searches To Health Orgs
Pinterest said Wednesday it will try to combat misinformation about vaccines by showing only information from health organizations when people search. Social media sites have been tryingto combat the spread of misinformation about vaccines. Pinterest previously tried blocking all searches for vaccines with mixed results. (8/28)

Stat: A Heretical Approach To Chemotherapy Is Extending Patients' Lives
No scientist with even a rudimentary moral compass and an ounce of intellectual humility takes human experiments lightly, given how much can go wrong. But Dr. Robert Gatenby was especially aware of the stakes. An oncologist at Moffitt Cancer Center in Tampa, Fla., he has spent years studying how tumor cells respond to chemotherapy, especially in patients whose cancer has metastasized well beyond the original tumor, as when malignant prostate cells invade bones like gang members expanding their turf. Now Gatenby was ready to put his theories to a real-world test by treating men with advanced prostate cancer in a way that broke all the rules. (Begley, 8/29)

The New York Times: Why Aren’t More Women Working? They’re Caring For Parents
Aisha Adkins would rather have her own place, instead of living with her parents. She would also like a job, a car, a master’s degree and savings. But at 35, a decade after graduating from Georgia Southern University in Statesboro with a specialty in social services, she has had to put off those goals. Her mother, Rose, received a diagnosis of dementia six years ago, at 57, and cannot be left alone. Since then, Ms. Adkins has been consumed with her care. “I’ve gone on three dates in the last three or so years,” she said. (Porter, 8/29)

The New York Times: Surfing With A Disability
Dylan Hronec has been in a wheelchair since he was 2 years old. Surfing is his favorite activity. “When you’re surfing you don’t really think about anything else — it’s the closest thing to an out of body experience,” said Mr. Hronec, 27, who has cerebral palsy and uses a special surf board retrofitted with handles to help him grab on. “I’m more in control of my body and my muscles in the water. So I’m not limited in any way.” (Ellin, 8/29)

The New York Times: Tattoo Needles May Trigger Allergic Reactions
Tattoos can cause allergic reactions, and tattoo needles, even clean ones, may be partly to blame, a new study found. Previous studies have shown that tattoo inks contain high amounts of nickel, chromium, cobalt and mercury, which are transported to the lymph nodes and can cause allergic reactions. But now researchers have found that an additional source of metal is the needles themselves. (Bakalar, 8/28)

The Associated Press: Deaths Caused By Drivers Running Red Lights At 10-Year High
The number of people killed by drivers running red lights has hit a 10-year high, and AAA is urging drivers and pedestrians to use caution at traffic signals. In 2017, the latest figures available, 939 people were killed by vehicles blowing through red lights, according to a AAA study of government crash data. It’s the highest death toll since 2008 and 28% higher than in 2012. AAA says two people are killed every day in the U.S. by drivers who don’t stop for the signals. (8/29)

The New York Times: Peloton Is A Phenomenon. Can It Last?
As far as indoor cycling machines go, the $2,245 Peloton bike is nothing special. It has a sleek black and red frame. It has a big screen. It’s on Wi-Fi. But a combination of aspirational infomercials (“This … is fitness evolved.”) and streaming classes taught by glamorous instructors has led Peloton to sell 577,000 of its bikes and treadmills in five years. Richard Branson is a fan. So are Jimmy Fallon, Kate Hudson and the Obamas. (Griffith, 8/28)

Reuters: Let It Burn: U.S. Fights Wildfires With Fire, Backed By Trump
It was the kind of fire that has terrified communities across the drought-ridden U.S. West in the past few years: a ponderosa pine forest ablaze in the mountains of New Mexico filling the air with thick, aromatic smoke. Except this fire was deliberately set by state penitentiary prisoners, dressed in red flame-resistant clothing and dripping a mix of gasoline and diesel around trees and scrub. (8/28)

The Washington Post: ‘Cold, Callous Letter’ Critical Of D.C. Homeless Encampments Stirs Controversy
An organization that promotes development in a fast-gentrifying District neighborhood is defending a letter critical of homeless encampments that some advocates called insensitive. NoMa Business Improvement District President Robin-Eve Jasper wrote in the public letter that “conditions are worsening” for pedestrians who use underpasses beneath railroad tracks that bisect the neighborhood. The letter notes increasing reports of harassment and aggressive panhandling by those living in the encampments. (Moyer, 8/28)

The Washington Post: Austin's Homeless Crisis Is Latest Target In National Debate Over Right To Sleep On The Streets
Christopher Paul hasn’t felt a police officer tapping at his foot in more than a month — the tap, tap, tap that usually meant he was about to get another citation that he was never going to pay. Living on the streets for five years after he lost his graphic design job, Paul has been having undisturbed nights since the Austin City Council and mayor eased restrictions on “public camping” this summer, a move that liberal lawmakers billed as a humane and pragmatic reform of the criminal justice system. But the change has drawn the ire of Republicans and local business owners who decry it as a threat to public safety and the local economy, exposing a partisan clash over how to manage poverty and affordable housing in America’s cities. (Craig, 8/28)

The Washington Post: Florida Caretakers Charged With Abuse Of Woman In Attain Incorporated Group Home After Review Of Video
The caretaker who called authorities said the disabled woman had been acting out and ended up with minor injuries. But surveillance video would reveal the full story of a patient “willfully tortur[ed] and maliciously punished,” police said. The footage shows four employees at a Florida group home shoving and hitting the woman. One staffer steps with her full weight on the patient’s head as she struggles on the ground — force that “could have easily caused great bodily harm or even death,” a Mount Dora police detective wrote in an affidavit. (Knowles, 8/28)