First Edition: December 9, 2019

Kaiser Health News: It’s Not Just You: Picking Health Insurance Is Hard. Here’s How To Be Smart About It.
Science has proved, no kidding around: Picking health insurance is extremely hard. Health care — and how much it costs — is scary. But you’re not alone with this stuff, and knowledge is power. “An Arm and a Leg” is a podcast about these issues, and its second season is co-produced by KHN. It’s open enrollment — time to pick next year’s insurance — for folks who buy it on their own and for many of us in our jobs. Lots of us aren’t sure we know how to pick, and research shows: We’re not wrong.A group of economists found that most people will not make the best choice among the plans in front of them. (Weissmann, 12/9)

Kaiser Health News: Obamacare Back At The High Court — With Billions For Insurers On The Line
More than $12 billion is at stake for the nation’s health insurers Tuesday when the Supreme Court hears another Affordable Care Act case. For the federal government, the potential damages could be far greater, as its reputation as a reliable partner to private businesses is on the line. Unlike earlier Obamacare cases before the high court — where the entire 2010 law and health coverage for millions of Americans was at risk — the latest case has largely flown under consumers’ radar. (Galewitz, 12/9)

Kaiser Health News: ‘Warm’ Hotlines Deliver Help Before Mental Health Crisis Heats Up
A lonely and anxious Rebecca Massie first called the Mental Health Association of San Francisco “warmline” during the 2015 winter holidays. “It was a wonderful call,” said Massie, now 38 and a mental health advocate. “I was laughing by the end, and I got in the holiday spirit.”Massie, a San Francisco resident, later used the line multiple times when she needed additional support, then began to volunteer there. (Stephens, 12/9)

Politico: House-Senate Fix Could Break Gridlock On 'Surprise' Medical Bills
Bipartisan efforts to protect patients from “surprise” medical bills are regaining momentum after stalling out over the summer. Leaders of the House Energy and Commerce Committee and the chairman of the Senate health panel announced a deal Sunday they said would rely on “a new system for independent dispute resolution often called arbitration." The lawmakers didn't elaborate. (Roubein and Luthi, 12/8)

The New York Times: Ban On Surprise Medical Bills May Pass After All
The proposal would prevent doctors from sending unexpected bills to patients when they are treated in a hospital that accepts their insurance, and would establish a system for resolving related billing disputes between those doctors and insurance companies. “It is long past time that Congress protect patients and families from the devastating financial toll of surprise medical bills, and this agreement puts an end to this egregious billing practice,” said Frank Pallone Jr., the chairman of the House Energy and Commerce Committee. “I’m hopeful that this bipartisan, bicameral agreement can be voted on quickly so that it can be signed into law before the end of the year.” (Sanger-Katz, 12/8)

Roll Call: Deal Banning Surprise Medical Bills Also Ups Tobacco Purchase Age To 21
“I do not think it is possible to write a bill that has broader agreement than this among Senate and House Democrats and Republicans on Americans’ number one financial concern: what they pay out of their own pockets for health care,” Alexander said. “Congress should pass the bill promptly and give the American people a very good Christmas present.” Senate HELP Committee ranking member Patty Murray, D-Wash., did not sign on to Sunday’s announcement, but a spokeswoman said she is working with the other lawmakers on a final agreement. (McIntire, 12/8)

The Hill: Key House And Senate Health Leaders Reach Deal To Stop Surprise Medical Bills
The deal also includes other health care measures, such as an extension of funding for community health centers, raising the purchasing age for tobacco to 21 and drug pricing transparency measures. Backers of the deal are hoping to include it in a must-pass government funding deal that faces a Dec. 20 deadline. There are still obstacles, though. Congressional leadership has not yet signed on to the deal. (Sullivan, 12/8)

The Wall Street Journal: Black Voters Back Medicare For All, Not So Much The Candidates Pushing It
African-American voters back Medicare for All more than other groups, polls show, but the policy’s two chief proponents in the 2020 Democratic presidential race haven’t been able to translate that into widespread black support. Instead, Sens. Bernie Sanders and Elizabeth Warren continue to lag well behind Joe Biden with black voters. The former vice president has been a chief critic among Democrats of Medicare for All and prefers a more moderate expansion of health insurance. In a recent South Carolina poll, he led Mr. Sanders and Ms. Warren by more than 30 points with black voters. (Jamerson, 12/7)

Reuters: As Poll Numbers Slide, Warren Wrestles With Medicare For All Dilemma 
With support for Elizabeth Warren's White House bid sliding since the release last month of a divisive plan to overhaul healthcare, the Democratic presidential contender has made an effort to refocus her campaign in early-voting Iowa on her signature anti-corruption message. Some supporters worry that shift could end up hurting the Massachusetts senator, however. Now that Warren has put her $20.5-trillion Medicare For All plan on the table, they want the candidate to try harder to win over doubting voters. (Becker, 12/8)

The Wall Street Journal: Elizabeth Warren Is In Excellent Health, Doctor Says
Democratic presidential candidate Elizabeth Warren released results from her annual physical examination, making her the first of the top-tier 2020 candidates to continue a tradition of U.S. presidential contenders making their health details public. “Senator Warren is in excellent health and has been throughout the 20 years I have served as her physician,” Dr. Beverly Woo of Brigham and Women’s Hospital in Boston wrote in a letter released by Ms. Warren’s campaign. Dr. Woo is also an associate professor at Harvard Medical School. (Jamerson, 12/6)

The Associated Press: Senators Urge Medicare To Allow Seniors A Drug Plan Do-Over
Leading senators are urging Medicare to allow seniors concerned about their drug plan pick for next year to switch if they received inaccurate information due to changes the agency made this sign-up season. The request from 14 Democrats and one Independent comes as open enrollment for prescription drug coverage ends at midnight Saturday. Medicare hinted Friday in a statement that it will provide such second chances. But the agency said it will post details when sign-up season is over, because a policy announcement now might create confusion. (Alonso-Zaldivar, 12/6)

Politico: Medicare Chief Asked Taxpayers To Cover Stolen Jewelry
A top Trump health appointee sought to have taxpayers reimburse her for the costs of jewelry, clothing and other possessions, including a $5,900 Ivanka Trump-brand pendant, that were stolen while in her luggage during a work-related trip, according to documents obtained by POLITICO. Seema Verma, who runs the Centers for Medicare and Medicaid Services, filed a $47,000 claim for lost property on Aug. 20, 2018, after her bags were stolen while she was giving a speech in San Francisco the prior month. The property was not insured, Verma wrote in her filing to the Health and Human Services department. (Diamond, 12/7)

Axios: Tensions Among Alex Azar, Seema Verma Led HHS To Call For Outside Probe
The Department of Health and Human Services took the extraordinary step of bringing in outside counsel earlier this year to investigate allegations of sex discrimination, Axios has learned — a sign of how badly the working relationship had deteriorated between Secretary Alex Azar and Medicare chief Seema Verma. (Swan and Owens, 12/6)

Stat: Lawmakers Ask HHS For More Oversight Of Patient Assistance Programs
Amid ongoing concern about the use of patient assistance programs by the pharmaceutical industry, two lawmakers want the Inspector General of the Department of Health and Human Services to update its oversight and require more disclosure from the foundations about their operations. In arguing their case, the lawmakers maintained that some drug makers game the system by finding ways to boost sales of their own medicines while also benefiting from tax breaks. At the same time, they contended that programs favor expensive brand-name medicines over lower-cost generics and sometimes fail to help patients with the most need. (Silverman, 12/6)

The Washington Post: FDA Warns Liveyon For Selling Unapproved Umbilical Cord Blood Products
The Food and Drug Administration announced Friday it had issued a warning to a California company for making and selling unapproved umbilical cord blood products, and for “significant deviations” from safety practices that create serious risks for patients injected with the stem cell therapy. A year ago, the company, Liveyon, based in Yorba Linda, was tied to the distribution of another manufacturer’s contaminated umbilical cord blood products that sickened 12 people in three states. (McGinley, 12/6)

The New York Times: Despite Warnings, Trump Moves To Expand Migrant Family Detention
On a burning hot day last summer at the South Texas Family Residential Center, a federal detention facility for immigrant families, Kenia and her son, Michael, 11, were hunched over a foosball table in an air-conditioned recreation room when Michael dropped to the floor and started sobbing. He curled his body into a ball and writhed as if he were in pain. The other parents and children in the room looked up from their jump ropes and boomboxes as Kenia knelt down and pleaded into Michael’s ear: Would he please go back to their room before the guards noticed him? (Dickerson, 12/9)

ProPublica: House Chairman Says Trump Administration Misled Congress On Boy’s Death In Custody
The chairman of the House Homeland Security Committee accused the Trump administration of misleading Congress and the public about the death of a 16-year-old boy in Border Patrol custody, and he urged a swift completion of an internal investigation. Rep. Bennie Thompson, D-Miss., said a report by ProPublica on the May 20 death of Carlos Gregorio Hernandez Vasquez “calls into serious question the steps U.S. Customs and Border Protection claims to have taken to care for a child in its custody.” (Moore, 12/6)

Stat: House GOP To Introduce Competing Drug Pricing Legislation
Republicans on Monday are set to accelerate Capitol Hill’s drug pricing chaos with a new proposal to lower the cost of prescription medicines, according to a summary document obtained by STAT. It’s intended to compete with a Democratic package from House Speaker Nancy Pelosi that is expected to come up for a vote this week. The Republican lawmakers’ new proposal includes a collection of bipartisan proposals collectively rebranded as the “Lower Costs, More Cures Act.” The House bill, according to Republican aides, is a “good-faith effort” to overcome partisan drug pricing squabbles, and includes a number of provisions that could conceivably become law before the end of 2019. (Facher, 12/9)

The New York Times: Two New Drugs Help Relieve Sickle-Cell Disease. But Who Will Pay?
The Food and Drug Administration recently approved two transformative new treatments for sickle-cell disease, the first in 20 years. But the drugs are wildly expensive, renewing troubling questions about access to cutting-edge medicines. Adakveo, made by Novartis, can prevent episodes of nearly unbearable pain that occur when malformed blood cells get stuck in blood vessels. Approved only for patients aged 16 and over, it is delivered as an infusion once a month. (Kolata, 12/7)

Stat: Revamped Senate Drug Pricing Package Is A Little Better For Seniors
Leaders of a key Senate committee unveiled a new version of a sweeping, bipartisan drug pricing bill Friday, and they’ve devised a novel plan to get it signed into law. The bill hasn’t changed much from the version that was narrowly passed out of the Senate Finance Committee in July — though a handful of tweaks offer further benefits to seniors. Since then, however, the bill’s political prospects have grown brighter, particularly after key Trump administration officials endorsed it over a far more progressive proposal from House Speaker Nancy Pelosi. (Florko, 12/6)

Stat: More Hospital Drug Spending Going Toward Cancer Immunotherapies 
Amid intense scrutiny over prescription drug costs, a new analysis finds some hospitals are spending a larger share of their budgets for new cancer and migraine treatments, as well as for a biosimilar version of a brand-name drug that is used to prevent white-cell depletion in patients given chemotherapy. Not surprisingly, the spending reflects a growing trend among hospitals to shell out more of their dollars for outpatient infusion treatments and, in particular, costly specialty drugs, according to Bonnie Lai, vice president of product management at Lumere, a research and analytics firm that focuses on hospitals and generated the data from 26 facilities across four hospitals systems. (Silverman, 12/6)

Stat: Activists Seek To Block Gilead Patent Extension On Lucrative HIV Drug
In an unusual move, an advocacy group asked federal authorities to reject a request by Gilead Sciences (GILD) for a three-year patent extension on an HIV drug because the company allegedly lied about important information in its application. The group argued in an emergency petition with the U.S. Patent and Trade Office that Gilead concealed a decision to delay development of the drug, called TAF, in order to thwart generic competition and “game” the patent system. In the process, the company reaped billions of dollars in additional sales while knowingly marketing an older drug that the company believed was not as safe. (Silverman, 12/6)

ProPublica: Federally Funded Health Researchers Disclose At Least $188 Million In Conflicts Of Interest. Can You Trust Their Findings?
Federally funded health researchers reported more than 8,000 “significant” financial conflicts of interest worth at least $188 million since 2012, according to filings in a government database obtained by ProPublica. The database of disclosures reported to the National Institutes of Health, which has not been made public before, details the financial relationships of researchers at universities, hospitals and nonprofit organizations. These outside interests range from stock holdings in companies that may benefit from the outcome of research to payments for royalties, consulting work and speaking engagements. The total value of the conflicts is likely much higher than $188 million, in part because 44% of the disclosures did not place a dollar value on the investigator’s financial relationship. (Armstrong and Waldman, 12/6)

ProPublica: Medical Professors Are Supposed To Share Their Outside Income With The University Of California. But Many Don’t.
For nearly two decades, Dr. Neal Hermanowicz has led the movement disorders program at the University of California’s Irvine campus, where he earns more than $380,000 a year in salary and bonuses. The widely respected expert on Parkinson’s and Huntington’s diseases adds to his income by consulting for drug companies. Since 2014, 11 pharmaceutical companies have paid him a total of at least $588,000 for consulting, speaking and honoraria, according to federal data. For example, he has received more than $225,000 in speaking and consulting fees from San Diego-based Acadia Pharmaceuticals, manufacturer of a controversial drug for Parkinson’s-related psychosis. (Waldman, 12/6)

The Wall Street Journal: Vaping-Related Lung Illnesses Appear To Have Peaked
The rate of new hospital admissions for vaping-related illnesses has dropped in the past several weeks, according to data from the Centers for Disease Control and Prevention, suggesting that the outbreak is on the decline. Doctors, cannabis-industry analysts and other experts say the trend is most likely explained by wider awareness, changing consumer habits and a potential shift in the illicit market. (Abbott, 12/6)

The New York Times: New Therapies Help Patients With Dementia Cope With Depression
Ms. Firmender, who has a history of mental health problems, was in therapy for depression. But she also has mild cognitive impairment and can have trouble remembering what day it is. So Dr. Kiosses was treating her with a novel approach called Problem Adaptation Therapy, or PATH. The therapy, developed at Weill Cornell Medicine in New York City and White Plains, N.Y., focuses on solving tangible problems that fuel feelings of sadness and hopelessness. It incorporates tools, like checklists, calendars, signs and videos, to make it accessible for people with memory issues. A caregiver is often involved. The approach is one of several new psychotherapies to treat anxiety and depression in people with cognitive impairments, including early to moderate dementia. (Petersen, 12/8)

ProPublica/South Bend Tribune: Why Are Cops Around The World Using This Outlandish Mind-Reading Tool?
SCAN, a product sold by a company called the Laboratory for Scientific Interrogation (LSI), has, in the words of four scholars in a 2016 study, “no empirical support” — meaning, there’s no dependable research showing that it works. Scientific Content Analysis is akin to other investigative tools scrutinized by ProPublica, including bloodstain-pattern analysis and photo analysis. These analytical techniques promise a degree of certainty — about how blood came to spray across a wall, or whether a particular plaid shirt was worn by a robber — that can guide an investigator or shore up a case. The trial evidence presented against Joyner included yet another example: a prosecution expert testified that two plastic garbage bags — one found in Joyner’s apartment, the other around Hernandez’s head — had “definitely” once been connected. (Armstrong and Sheckler, 12/7)

The New York Times: When A DNA Test Says You’re A Younger Man, Who Lives 5,000 Miles Away
Three months after his bone marrow transplant, Chris Long of Reno, Nev., learned that the DNA in his blood had changed. It had all been replaced by the DNA of his donor, a German man he had exchanged just a handful of messages with. He’d been encouraged to test his blood by a colleague at the Sheriff’s Office, where he worked. She had an inkling this might happen. It’s the goal of the procedure, after all: Weak blood is replaced by healthy blood, and with it, the DNA it contains. (Murphy, 12/7)

The Washington Post: Rare Diseases Lack Data But This Website Aims To Help
Achondrogenesis, Noonan syndrome and sialadenitis aren’t household names. They have something else in common: Each is a rare disease. The term applies to any disease, disorder, illness or condition that affects fewer than 200,000 people in the United States. More people have a rare disease than you might think. According to the National Institutes of Health, up to 30 million people in the United States — nearly 1 in 10 — live with rare diseases, and there could be as many as 7,000 of the conditions. (Blakemore, 12/7)

The Wall Street Journal: New Approach Needed To Combat Drunken Driving, Report Says
Nearly 30% of all vehicular-crash deaths in the U.S. last year were alcohol-related, and a group representing state highway-safety offices says focusing on repeat offenders is needed to tackle the problem. Last year, 10,511 people died in crashes involving at least one driver with a blood-alcohol concentration of at least .08%, the legal cutoff in every state except Utah, federal figures show. While that represented a 3.6% drop from 2017, alcohol-related fatality levels have largely stagnated for the past decade. (Calvert, 12/9)

The New York Times: Cold Stopped A Woman’s Heart For 6 Hours, Then Helped Save Her Life
Audrey Mash arrived at a Spanish hospital cold to the touch and all but dead: Her heart had stopped beating hours earlier, as she clung to her husband in a mountain snowstorm and her body temperature collapsed. But the cold that nearly killed her also helped to save her life. After six hours in cardiac arrest she began to breathe again, rescued by doctors who said that her hypothermic condition — almost 35 degrees below normal — protected her brain from fatal damage. (Schaverien, 12/6)

The New York Times: Surgeons Transplant A Testicle From One Brother To His Twin
A 36-year-old man born without testicles received one transplanted from his identical twin brother in a six-hour operation performed on Tuesday in Belgrade, Serbia, by an international team of surgeons. The surgery was intended to give the recipient more stable levels of the male hormone testosterone than injections could provide, to make his genitals more natural and more comfortable, and to enable him to father children, said Dr. Dicken Ko, a transplant surgeon and urology professor at Tufts University School of Medicine in Boston, who flew to Belgrade to help with the procedure. (Grady, 12/6)

The Washington Post: Terrible Itchiness During Pregnancy May Be A Sign Of ICP, A Condition That Can Lead To Stillbirths
Ashley Sicher had an invisible itch. It had begun in early spring 2017, in the third trimester of her first pregnancy. During the day, the itch was noticeable, but concentrated on her palms and feet. At night, the itch became unbearable, spreading up her arms and torso. She furiously scratched at the subterranean itch with the bristles of a hairbrush, until she broke the skin. Sicher had no rash, and her obstetrician at the time assured her that itching was a normal symptom of pregnancy. Yet this didn’t feel like a normal itch. It was a penetrating, psychologically infuriating itch. (Porter, 12/8)

The Washington Post: Is Your Stomach Killing You, With Gas, Constipation, Diarrhea? It Could Be SIBO.
Your gastrointestinal system contains about a hundred trillion bacteria. That may sound scary, but it’s actually beneficial because these bacteria help with digestion, immunity and other important functions. Even though they are basically helpful, the bacteria can go astray in disagreeable ways. (Rosenbloom, 12/7)

The Washington Post: More Pro Athletes Are Using CBD And Cannabis Products For Aches, Pains And Stress
There was a notable face missing at last fall’s Ironman 70.3 World Championships in France. Instead of racing as expected, American Lauren Goss, 31, who had a string of wins at the distance and was feeling fit and ready to compete, was stuck on the sidelines. She’d been banned from competition for six months, lost her main sponsor and is mulling retirement. (Loudin, 12/7)

NPR: Performing CPR On A Woman Is No Harder, Trainers Say. And It Can Save Lives
When students in wilderness EMT Alice Henshaw's training courses grab practice dummies for CPR drills, they have their choice of a traditional, flat-chested training manikin or one that looks a little different: a manikin zipped into a neoprene vest with silicone breasts. That's the Womanikin, a universal attachment for CPR dummies created by New York-based ad agency Joan Creative in partnership with The United State of Women. The idea behind this breasted vest — and the related awareness campaign — is to address gender disparities in training and performance of CPR, which is vital for anyone experiencing cardiac arrest. (Treisman, 12/7)

The New York Times: Even A Little Alcohol May Raise Cancer Risk
Even moderate alcohol consumption may increase the risk for cancer. Japanese scientists compared the drinking habits of 63,232 cancer patients in Japan with those of an equal number of healthy controls. All reported their average daily alcohol intake and the number of years they had been drinking. (Bakalar, 12/9)

Los Angeles Times: Should Psychotherapists Be Required To Report Patients Who Look At Child Porn?
For years, California law required psychotherapists to report any patient who admitted developing, duplicating, printing or exchanging material depicting an obscene act involving a child. The therapists accepted that requirement. They regarded it as an obligation to report producers and distributors of child pornography. (Dolan, 12/8)

NPR: Appalachian Musical Tradition Helps People Recovering From Drug Addiction
People have been playing music together in the small Appalachian town of Hindman, Ky., since it was founded in the late 1800s. Today, one of the few businesses still open in the town is the Appalachian School of Luthiery, which teaches people how to build wooden stringed instruments. Now that school is playing a role in helping the local community overcome drug addiction. (Tan, 12/6)

The New York Times: Denmark Raises Antibiotic-Free Pigs. Why Can’t The U.S.?
How many rounds of antibiotics does it take to raise a Danish pig? If it is one of the 35,000 piglets raised each year on Soren Sondergaard’s sprawling farm, odds are the animal will get just a single course before it goes to slaughter. At times, a quarter or more of his swine arrive at the abattoir without ever having received any antimicrobial drugs at all. (Jacobs, 12/6)

The Wall Street Journal: ‘Safety Is Not A Glamorous Thing’: How PG&E Regulators Failed To Stop Wildfire Crisis
In 2015, the California regulator overseeing PG&E Corp. opened an inquiry into whether the state’s largest utility put enough priority on safety. Since then, a federal jury has found PG&E guilty of violating safety regulations for natural-gas pipelines and a federal judge later placed it on criminal probation. Its electrical equipment has sparked more than a fire a day on average since 2014—more than 400 last year—including wildfires that killed more than 100 people. It filed for bankruptcy protection this year, citing $30 billion in fire-related liabilities, and started blacking out millions of customers to try to avoid sparking blazes during strong winds. On Friday, it agreed to pay $13.5 billion to wildfire victims in a settlement deal. (Blunt and Gold, 12/8)

The Associated Press: Prosecutors Say Alaska Dentist Rode Hoverboard At Procedure
An Alaska dentist accused of fraud and unnecessarily sedating patients also performed a procedure while riding a wheeled, motorized vehicle known as a hoverboard, authorities said. Prosecutors charged 34-year-old Seth Lookhart with felony Medicaid fraud and reckless endangerment. A former patient testified Wednesday at his trial that she was angered when an investigator showed her an unauthorized 2016 video of Lookhart extracting one of her teeth while she was sedated and he was riding the hoverboard. (12/6)