First Edition: December 10, 2018

Kaiser Health News: Need Health Insurance? The Deadline Is Dec. 15
The annual open-enrollment period for people who buy their own insurance on the Affordable Care Act’s marketplaces ends Dec. 15 in most states. Enrollment in states that use the federal healthcare.gov platform has been sluggish this year compared to last. From Nov. 1 through Dec. 1, about 3.2 million people had chosen plans for 2019. Compared with the previous year, that’s about 400,000 fewer, or a drop of just over 11 percent. The wider availability of short-term plans is one big change that has set this year’s apart from past sign-up periods. (Andrews, 12/10)

Kaiser Health News: Even When Not In Rome, Eat A Mediterranean Diet To Cut Heart Disease Risk
Once again, your mother was right. You really do need to eat your vegetables. And while you are at it, put down the bacon and pick up the olive oil, because new research supports the contention that switching to a Mediterranean diet could significantly decrease the risk of heart disease. According to a study published Friday in JAMA Network Open, people who followed this type of diet had 25 percent less risk of developing cardiovascular disease over the course of 12 years. (Bluth, 12/7)

Politico: Establishment Looks To Crush Liberals On Medicare For All
The united front that helped Democrats save Obamacare just a year ago is falling apart over single-payer health care. Deep-pocketed hospital, insurance and other lobbies are plotting to crush progressives’ hopes of expanding the government's role in health care once they take control of the House. The private-sector interests, backed in some cases by key Obama administration and Hillary Clinton campaign alumni, are now focused on beating back another prospective health care overhaul, including plans that would allow people under 65 to buy into Medicare. (Cancryn, 12/10)

The Wall Street Journal: Democratic Attorneys General To Bolster Fight Against Trump’s Agenda
Democrats are building a new power base that will play an elevated role in a divided government in Washington: state attorneys general contesting President Trump’s agenda in the courts. Democrats defeated Republican incumbents in four states last month, giving the party a 27-23 edge among states’ top law-enforcement officials, a shift that will beef up its legal fights against the president. Democrats plan to build upon dozens of existing lawsuits fighting Mr. Trump’s attempt to undercut the Affordable Care Act, roll back environmental regulations and install hard-line immigration policies. (Thomas, 12/10)

The Hill: Top Dems Press Trump Officials For Answers On Pre-Existing Conditions
Four incoming House Democratic chairmen on Friday pressed the Trump administration for answers about its decision to call for overturning ObamaCare’s pre-existing condition protections in court. “In declining to defend these provisions, the Trump Administration is seeking to invalidate these critical patient protections, and once again subject millions of Americans with preexisting conditions to the discrimination they faced before the ACA,” the Democrats wrote in a letter to Secretary of Health and Human Services Alex Azar and Centers for Medicare and Medicaid Services Administrator Seema Verma. (Sullivan, 12/7)

The Hill: Trump Administration Considers Medicaid Work Requirements In Virginia
The Trump administration will consider whether to approve work requirements for Virginia's Medicaid expansion program, with the Department of Health and Human Services opening the proposal for public comment on Friday. Virginia expanded eligibility for Medicaid this year to more low-income adults but needs approval from the Trump administration to impose work requirements. (Hellmann, 12/7)

The New York Times/ProPublica: Prominent Doctors Aren’t Disclosing Their Industry Ties In Medical Journal Studies. And Journals Are Doing Little To Enforce Their Rules
One is dean of Yale’s medical school. Another is the director of a cancer center in Texas. A third is the next president of the most prominent society of cancer doctors. These leading medical figures are among dozens of doctors who have failed in recent years to report their financial relationships with pharmaceutical and health care companies when their studies are published in medical journals, according to a review by The New York Times and ProPublica and data from other recent research. (Ornstein and Thomas, 12/8)

The New York Times/ProPublica: Doctors And Disclosures
Academic journals are the way the world learns about medical breakthroughs, and companies benefit greatly when research about their products is published in them. Prestigious journals require authors to list any potential conflicts of interest. But dozens of doctors have failed to disclose significant relationships with health care and drug companies that pay them for consulting work, sitting on corporate boards and other roles. (Thomas and Ornstein, 12/8)

The Washington Post: Generic Drug Price-Fixing Investigation Expands To 300 Drugs And 16 Companies
Executives at more than a dozen generic-drug companies had a form of shorthand to describe how they conducted business, insider lingo worked out over steak dinners, cocktail receptions and rounds of golf. The “sandbox,” according to investigators, was the market for generic prescription drugs, where everyone was expected to play nice. “Fair share” described dividing up the sales pie to ensure that each company reaped continued profits. “Trashing the market” was used when a competitor ignored these unwritten rules and sold drugs for less than agreed-upon prices. (Rowland, 12/9)

The Washington Post: Shingles Vaccine: Shingrix Shortage Worsens As Demand Soars
A national shortage of a new vaccine to protect against the painful rash known as shingles is worsening, even as the manufacturer announced plans this week to boost deliveries. Demand for the two-dose Shingrix vaccine has skyrocketed since it became broadly available in the United States in the spring, say pharmacists. The new vaccine provides much greater protection than an older, single-shot vaccine from a disease that affects 1 in 3 adults and can cause debilitating nerve pain that can last months, or even years. Demand is also surging because federal health officials recommended it last year for healthy adults at age 50 – a decade earlier than previous recommendations. (Sun, 12/7)

The Hill: House Set To Vote On Bill Cracking Down On Drug Companies Overcharging Medicaid
The House is expected to vote next week on a bill to crack down on drug companies that overcharge the government, according to two House aides. The bipartisan bill is aimed at stopping a repeat of the actions from Mylan, the maker of EpiPen, which made headlines last year for overcharging the Medicaid program for its commonly used product by as much as $1.27 billion over 10 years. (Sullivan, 12/7)

The Wall Street Journal: Roche Executive Daniel O’Day Is Named Gilead CEO
Gilead Sciences Inc. has named industry veteran Daniel O’Day to take the helm and help the drug company revive sales and recover from a disappointing deal. Mr. O’Day, whose hiring was announced early Monday, will become Gilead CEO after a long career at Switzerland’s Roche Holding AG, most recently running its pharmaceuticals group. In the role, Mr. O’Day oversaw successful launches of several new cancer and other drugs and turned the business into a top industry performer. (Rockoff and Walker, 12/10)

The New York Times: Six Michigan Doctors Charged In $464 Million Insurance And Opioid Scheme
Six Michigan doctors have been charged with insurance fraud and unnecessarily prescribing opioids to patients in a $464 million scheme, according to court documents filed this week by federal prosecutors. The 56-count indictment, filed on Tuesday and made public on Thursday, named Dr. Rajendra Bothra, 77, of Bloomfield Hills, who owned and operated the Pain Center USA in Warren and Eastpointe, Mich., and the Interventional Pain Center in Warren. The other five doctors were employed by the clinics, which catered to patients with joint and spinal injuries. (Holson, 12/7)

The Associated Press: A Young Mayor, His Friend, And A Fatal Attraction To Opioids
Brandon Wentz agonized over his resignation letter. The 24-year-old mayor of Mount Carbon had just moved with his family to a nearby town, requiring him to give up the office. Normally so good with words, Wentz strained to find just the right ones to express himself. He felt like he was letting his constituents down. ... After tinkering with it for several days, Wentz finally sent a brief missive to the town secretary. Then he met up with a close friend, Ryan Fessler. They hung out in Wentz's room for a while, and Fessler left. Wentz was dead by morning. The cause: an overdose of heroin and fentanyl. (12/9)

The Associated Press: ‘I Killed My Best Friend’: Opioids’ Fatal Grip On Mayor, Pal
Brandon Wentz agonized over his resignation letter. The 24-year-old mayor of Mount Carbon had just moved with his family to a nearby town, requiring him to give up the office. He felt like he was letting his constituents down. “You could just see the stress and sadness in him,” recalled his mother, Janel Firestone. Wentz finally sent a brief missive to the town secretary. Then he met up with a close friend, Ryan Fessler. They hung out in Wentz’s room for a while, and Fessler left. Wentz was dead by morning. The cause: an overdose of heroin and fentanyl. (Rubinkam, 12/9)

NPR: To Treat Addiction In Rural America, Start With Hiring Specialists
Lindsay Bunker woke up from a nightmare. The 32-year-old lives with her sixth-month-old daughter on the Lac Courte Oreilles Indian Reservation in northern Wisconsin. She's struggled with addiction for over 10 years, mostly to heroin. Then came the nightmare: She dreamt two men were attacking her baby while she could think only about drugs. (Sable-Smith, 12/9)

The Washington Post: Trump Administration Halts Study That Would Use Fetal Tissue ‘To Discover A Cure For HIV’
The Trump administration has shut down at least one government-run study that uses fetal tissue implanted into mice even before federal health officials reach a decision on whether to continue such research, which is opposed by antiabortion groups. A senior scientist at a National Institutes of Health laboratory in Montana told colleagues that the Health and Human Services Department “has directed me to discontinue procuring fetal tissue” from a firm that is the only available source, according to an email he sent to a collaborator in late September. (Goldstein and Bernstein, 12/9)

Stat: HIV Research Halted After NIH Freezes Acquisition Of Fetal Tissue
The NIH confirmed the suspension on Friday to Science, which reported it affected two NIH labs, including halting an HIV research project. Spokespeople for the Department of Health and Human Services and and the NIH institutes with affected labs did not respond to STAT’s request for comment on Sunday. Researchers use fetal tissue to create mice with human-like immune systems — which is useful for biologists like Dr. Warner Greene who do HIV research. (Sheridan, 12/9)

The New York Times: U.N. AIDS Agency Is In ‘State Of Crisis’ And Needs New Leader, Report Says
Independent experts investigating allegations of sexual abuse at the United Nations agency fighting AIDS have called for the appointment of new leadership, saying in a damning report that its executive director tolerated harassment and bullying in a toxic organizational culture. The agency, U.N.AIDS, was “in a state of crisis that threatens its vital work,” the expert panel said in its report, which was released Friday after a four-month investigation. The evidence of “a broken organizational culture is overwhelming,” it said. (Cumming-Bruce, 12/7)

The Associated Press: Caregivers For 3600 Migrant Teens Lack Complete Abuse Checks
Nearly every adult working with children in the U.S. — from nannies to teachers to coaches — has undergone state screenings to ensure they have no proven history of abusing or neglecting kids. One exception: thousands of workers at two federal detention facilities holding 3,600 migrant teens in the government’s care, The Associated Press has learned. The staff isn’t being screened for child abuse and neglect at a Miami-based emergency detention center because Florida law bans any outside employer from reviewing information in its child welfare system. Until recently at another facility holding migrant teens in Tornillo, Texas, staff hadn’t even undergone FBI fingerprint checks, let alone child welfare screenings, a government report found. (Mendoza and Burke, 12/7)

The Washington Post: Emergency Care For Elderly Can Be Dangerous
In 2005, when physician Kevin Biese was a medical resident in Boston, a 92-year-old woman with a urinary tract infection arrived by ambulance at a hospital emergency room. Her behavior — confusion and lethargy — suggested she also was suffering from hypoactive delirium, a cognitive disorder. She was alone, without family or friends. The doctors decided to admit her, but a bed wasn’t yet available. So she had to wait. “She spent 24 hours on a cot in the hallway,” Biese recalls. “She came in during the day on a Thursday and was still there Friday morning. I got mad.” (Cimons, 12/8)

The Wall Street Journal: At Senior Centers, Holiday Cheer Is Targeted To Particular Age Issues
On a recent afternoon, Olga Calderon stretched her arms and practiced breathing exercises with a strand of sparkly holiday garland twirled around her fingers. The 73-year-old was at Sunnyside Community Services in Queens with about a dozen other older New Yorkers to take part in a regular group session that, during the holidays, is attuned to the unique pressures that some older people feel during this season: loneliness over loved ones who have died, worries about money and travel, and fears of icy sidewalks. (West, 12/9)

The Washington Post: Elder Abuse Happens More Than You Think. How To Spot The Signs.
Scams. Shady caregivers. Poor care. Elder mistreatment has many faces — from financial exploitation to physical and emotional abuse. About 10 percent of those 60 and older are reportedly affected by it in the United States. The chances of being abused rise for people who are in poor physical health, have experienced previous traumatic events or have dementia. Can you spot the signs of elder abuse? (Blakemore, 12/9)

The Washington Post: Speaking Two Languages May Help The Aging Brain
Even when you’re fluent in two languages, it can be a challenge to switch back and forth smoothly between them. It’s common to mangle a split verb in Spanish, use the wrong preposition in English or lose sight of the connection between the beginning and end of a long German sentence. So, does mastering a second language hone our multitasking skills or merely muddle us up? (Skibba, 12/8)

NPR: Seniors Who Exercise Regularly May Have Younger Hearts, Muscles
We know we need to exercise for our health, but a lifelong exercise habit may also help us feel younger and stay stronger well into our senior years. In fact, people in their 70s who have been exercising regularly for decades seem to have put a brake on the aging process, maintaining the heart, lung, and muscle fitness of healthy people at least 30 years younger. (Neighmond, 12/10)

The Washington Post: Geriatricians Treat The Elderly But It's Not Easy To Know When You Need One
Once, turning 65 typically meant retirement, Medicare and the inevitable onset of physical decline. It also often signaled the need to search for a geriatrician, a doctor who specializes in caring for the complex medical problems of the elderly. But many of today’s older Americans are healthy, vigorous and mentally sound, with no urgent need to change doctors. They aren’t afflicted with age-related diseases or functional impairments. This raises interesting questions about when — and whether — those 65 and older need to make that switch. (Cimons, 12/8)

The Washington Post: Many Alzheimer's Patients Experience Strong Mood Swings Late In The Day. Scientists Aren't Sure Why.
Linda is one of millions worldwide who experience a clinical phenomenon called sundowning, typically seen in people suffering from dementia or cognitive impairment. Also known as sundown syndrome, sundowning refers to the emergence or worsening of neuropsychiatric symptoms such as agitation, aggression and disorientation in the late afternoon or early evening. Like some sort of spell has been cast, their behavior can switch from normal to highly erratic come nightfall. (Kim, 12/8)

The Washington Post: Alzheimer’s Leaves Marine With New Mission: Saving His Daughter
Andres Martin was on the couch in his Maryland home, surrounded by his family, when he started talking about how people view Alzheimer’s. They think of 70-year-olds and 80-year-olds, he said. They think of people who have already lived full lives. People who have already had children and maybe grandchildren. “That is not what it is,” Martin said. “This,” he said, gesturing toward his toddler daughter, who moments earlier had been blowing kisses, “is Alzheimer’s right here.” (Vargas, 12/8)

The New York Times: Hospital-Acquired Infections Are Declining
The risk of getting a hospital-acquired infection is decreasing. In a study published in The New England Journal of Medicine, researchers surveyed almost 200 hospitals caring for about 12,000 patients across the country in 2011 and again in 2015, reviewing medical records to find cases of health care-associated infection. They found that in 2015, hospital-acquired infections had declined to 3.2 percent of patients, from 4 percent in 2011. They calculate that a patient’s risk of getting infected during a hospital stay was 16 percent lower in 2015 than in 2011. (Bakalar, 12/10)

The Wall Street Journal: Hospital Beds Get Digital Upgrade
A major manufacturer of hospital beds is seeking to transform the ubiquitous furniture into a source of medical data, the latest sign of hospitals’ digital transformation. Hill-Rom Holdings Inc. HRC -3.12% said its newest hospital-bed model will include sensors to monitor patients’ heart and respiratory rates. The sensors will check a patient’s vital signs 100 times a minute and alert nurses when signs suggest the patient’s condition may worsen, said Hill-Rom Chief Executive John Groetelaars. (Evans, 12/9)

The New York Times: Can We Really Inherit Trauma?
In mid-October, researchers in California published a study of Civil War prisoners that came to a remarkable conclusion. Male children of abused war prisoners were about 10 percent more likely to die than their peers were in any given year after middle age, the study reported. The findings, the authors concluded, supported an “epigenetic explanation.” The idea is that trauma can leave a chemical mark on a person’s genes, which then is passed down to subsequent generations. The mark doesn’t directly damage the gene; there’s no mutation. Instead it alters the mechanism by which the gene is converted into functioning proteins, or expressed. The alteration isn’t genetic. It’s epigenetic. (Carey, 12/10)

The Hill: Ahead Of Holidays, CDC Issues Warning Against Eating Raw Cookie Dough
Ahead of the holiday season, the Centers for Disease Control and Prevention (CDC) is urging consumers not to eat raw cookie dough, cake mix or bread. "When you prepare homemade cookie dough, cake mixes, or even bread, you may be tempted to taste a bite before it is fully cooked," the CDC wrote in a message on its website. (Burke, 12/9)

The New York Times: The Planet Has Seen Sudden Warming Before. It Wiped Out Almost Everything.
Some 252 million years ago, Earth almost died. In the oceans, 96 percent of all species became extinct. It’s harder to determine how many terrestrial species vanished, but the loss was comparable. This mass extinction, at the end of the Permian Period, was the worst in the planet’s history, and it happened over a few thousand years at most — the blink of a geological eye. (Zimmer, 12/7)

The New York Times: The Genes That Make Parrots Into The Humans Of The Bird World
A macaw named Poncho starred in movies like “102 Dalmatians,” “Dr. Doolittle” and “Ace Ventura: Pet Detective” before retiring in England. She recently celebrated her 90th birthday. Alex, an African grey parrot who lived to 31, knew colors, shapes and numbers, and communicated using basic expressions. He could do what toddlers only do after a certain stage of development — know when something is hidden from view. And they’re just two of the many parrots in the world who have surprised us with their intelligence, skills and longevity. (Klein, 12/7)

The New York Times: Seeking Clues To Longevity In Lonesome George’s Genes
When Lonesome George, the only survivor of the Pinta Island tortoises of the Galápagos, died in 2012, the news landed with a blow. Rationally, people had time to prepare for the reality that George would one day fade away, and with him, an entire lineage. He had lived for a century or more, a common life expectancy for giant tortoises, and all attempts to mate him during his last few decades were unsuccessful. (Yin, 12/8)

The Washington Post: Right Bronchial Tree Cast: Man Coughs Up Clot In Shape Of His Lung Passage
The patient had come in with heart failure, and physicians at the University of California at San Francisco had an aggressive plan to help. Doctors there inserted a heart pump through his leg artery to flood his organs with blood. But there is a downside to the strategy — clots can form through its use. So doctors gave the unidentified man anticoagulants to thin his blood. But his airways began to seep. (Horton, 12/8)

The Hill: Unannounced Active Shooter Drill Sparks Chaos, Stampedes At Florida High School 
Students and parents are outraged after an unannounced active-shooter drill resulted in chaos at a Florida high school. Video and images from inside Lake Brantley High School in Altamonte Springs have gone viral after the incident. On Thursday morning, officials announced a “code red" over the school's intercom, saying that it was not a drill, according to BuzzFeed News. (Anapol, 12/9)

Los Angeles Times: #ThisIsOurLane: Doctors Tell The NRA Why They Are Experts On The Effects Of Gun Violence
It was the kind of imperious broadside that would strike fear into the hearts of most politicians. In a contemptuous tweet, the National Rifle Assn. admonished a medical group for speaking out about gun injuries and dismissed their concern by saying that physicians should mind their own business. “Someone should tell self-important anti-gun doctors to stay in their lane,” the NRA tweeted on Nov. 7. In drafting a policy statement that “reflects every anti-gunner’s public policy wish list,” the American College of Physicians “seems to have consulted NO ONE but themselves,” the NRA complained. (Healy, 12/7)

The Associated Press: Newtown Shooter Described 'Scorn For Humanity'
Documents from the investigation into the massacre at Sandy Hook Elementary School in Connecticut are shedding light on the gunman's anger, scorn for other people, and deep social isolation in the years leading up to the shooting. The documents that a court ordered Connecticut State Police to release include several writings by Adam Lanza, who gunned down 20 children and six educators on Dec. 14, 2012. He fatally shot his mother before driving to the school and ultimately killed himself. (12/9)

The New York Times: The Wildfire May Be Over, But Those It Burned ‘Live That Nightmare Every Day'
Bill Blevins had pulled himself out of homelessness and addiction with a job as an alarm systems repairman, dexterous work with tiny electrical components that he enjoyed. But last week he was forced to confront a new hurdle: His left pinkie finger was amputated. It was his third surgery since his hands were ravaged by the wildfire that devastated the town of Paradise, Calif., last month. And now he’s not sure if he will be able to work again. (Nir, 12/8)

Reuters: Michigan Medical Officer Ordered To Trial Over Flint Water Deaths
A Michigan judge on Friday ordered the state's chief medical officer to stand trial on charges of involuntary manslaughter in connection to the contamination of the city of Flint's water supply, a crisis that resulted in 12 deaths. Eden Wells, a physician who serves as the state medical executive, faces the manslaughter charge for her alleged failure to stop an outbreak of Legionnaires' disease while the city was taking its water from the Flint River. The charge carries a possible prison sentence of 15 years. (12/7)

Los Angeles Times: More Than 20 Women Accused A Prominent Pasadena Obstetrician Of Mistreating Them. He Denied Claims And Was Able To Continue Practicing
A Times investigation identified more than 20 women who claim [Dr. Patrick] Sutton mistreated them during his medical care. Their allegations date to 1989, his first year at Huntington, and include unwanted sexual advances, medical incompetence, the maiming of women’s genitals and the preventable death of an infant. Sutton denied each allegation in an interview with The Times. Top Huntington administrators were warned repeatedly about Sutton over the decades, according to interviews with current and former administrators and other hospital employees. One obstetrician at the hospital told The Times she complained to Huntington’s chief medical officer and its compliance department on several occasions about what she saw as his poor clinical judgment and misogynistic remarks. (Ryan and Hamilton, 12/9)

The Hill: 4,000 Mental Health Professionals To Go On Strike In California
Four thousand Kaiser Permanente mental health professionals will begin a five-day strike Monday demanding the HMO address their concerns about what they called understaffing problems. The workers claimed that shortages of clinicians has limited patients' access to appropriate treatment, according to a statement from National Union of Healthcare Workers (NUHW). (Rodrigo, 12/7)

The Associated Press: Jury Deliberations To Resume Latest Meningitis Outbreak Case
Jury deliberations are continuing in the case of six former employees of the Massachusetts facility responsible for the 2012 fungal meningitis outbreak that killed 76 people and sickened hundreds. Jurors in the latest case stemming from the outbreak linked to the now-closed New England Compounding Center are scheduled to return to federal court on Monday after failing to reach a verdict Friday. (12/9)

The Associated Press: Baltimore Officials Consider New Laws To Curb Smoking
Elected officials in Baltimore are considering new laws to cut down on smoking and vaping. The Baltimore Sun reports the city council has introduced a package of anti-smoking legislation. One of the measures would ban the sale of flavored vaping liquids. (12/8)

The Associated Press: Maryland’s Medical Marijuana Sales Hit $96 Million
Maryland’s medical marijuana industry brought in $96.3 million during its first year of operation. The Baltimore Sun reports that between 250 and 350 people a day are applying to be certified by the state to buy medical marijuana. There were nearly 52,000 patients who bought 730,000 individual products from dozens of licensed stores across Maryland since sales became legal last December. (12/9)