First Edition: February 15, 2019

Kaiser Health News: Discharged, Dismissed: ERs Often Miss Chance To Set Overdose Survivors On ‘Better Path’
The last time heroin landed Marissa Angerer in a Midland, Texas, emergency room — naked and unconscious — was May 2016. But that wasn’t her first drug-related interaction with the health system. Doctors had treated her a number of times before, either for alcohol poisoning or for ailments related to heavy drug use. Though her immediate, acute health issues were addressed in each episode, doctors and nurses never dealt with her underlying illness: addiction. Angerer, now 36 and in recovery, had been battling substance use disorder since she started drinking alcohol at age 16. She moved onto prescription pain medication after she broke her ankle and then eventually to street opiates like heroin and fentanyl. (Bluth, 2/15)

Kaiser Health News: Two Crises In One: As Drug Use Rises, So Does Syphilis
Public health officials grappling with record-high syphilis rates around the nation have pinpointed what appears to be a major risk factor: drug use. “Two major public health issues are colliding,” said Dr. Sarah Kidd, a medical officer at the Centers for Disease Control and Prevention and lead author of a new report issued Thursday on the link between drugs and syphilis. The report shows a large intersection between drug use and syphilis among women and heterosexual men. In those groups, reported use of methamphetamine, heroin and other injection drugs more than doubled from 2013 to 2017. (Gorman, 2/14)

Kaiser Health News: Glimpsing The Future At Gargantuan Health Tech Showcase
Imagine going to the doctor and finding out before you leave the exam room how much your prescribed drug will cost, avoiding sticker shock at the pharmacy. Or what if you could wear a tiny device at the top of your back that would gently nudge you to sit up straight whenever you slump. How about not having to sign by hand a raft of hospital registration papers — instead, doing it all online — and using a laptop computer during your stay for health education purposes? (Galewitz, 2/15)

Kaiser Health News: Podcast: KHN’s ‘What The Health?’ “Medicare-For-All” For Dummies
Republicans are still in charge of the White House and the Senate, but the “Medicare-for-all” debate is in full swing. Democrats of every stripe are pledging support for a number of variations on the theme of expanding health coverage to all Americans. This week, KHN’s “What the Health?” podcast takes a deep dive into the often-confusing Medicare-for-all debate, including its history, prospects and terminology. (2/14)

Politico: Court Allows House Democrats To Join Obamacare's Defense
A federal appeals court is allowing House Democrats to defend Obamacare in a lawsuit threatening the future of the health care law. The 5th Circuit Court of Appeals today granted the House’s petition to intervene in the case challenging Obamacare's constitutionality. The court will review a federal judge's December ruling that the entire health care law is invalid after Congress eliminated the penalty for not having health insurance. (Ollstein, 2/14)

The Hill: Federal Court Agrees To Let Democrats Defend ObamaCare In Court 
The House last month asked the court if it could intervene as a defendant alongside 16 Democratic states and the District of Columbia in the lawsuit Republican states brought challenging the law. In December, a federal district court judge in Texas ruled the ACA’s individual mandate was unconstitutional and inseverable from the rest of the statute. Because the Trump administration joined the 20 GOP-led states in attacking the law, the House under Democratic control said it had a right to intervene. (Wheeler and Hellmann, 2/14)

The Hill: Democrats Seek Cosponsors For New 'Medicare For All' Bill 
Two progressive lawmakers are circulating a letter to their Democratic colleagues asking for cosponsors for a Medicare for all bill as they prepare to introduce it. Reps. Pramila Jayapal (D-Wash.) and Debbie Dingell (D-Mich.) sent the letter, which was obtained by The Hill, on Tuesday, saying they have been working with experts for months to write an updated version of the single-payer health care legislation. Jayapal says she plans to introduce the measure later this month. (Sullivan, 2/14)

The Associated Press: Ex-Colorado Gov. Hickenlooper Supports Universal Health Care
John Hickenlooper, the former governor of Colorado who is considering a run for president in 2020, said Thursday he supports universal health care and thinks the U.S. eventually should provide it. But as other Democrats already in the race endorse "Medicare-for-all," Hickenlooper told a crowd at a New Hampshire college that it was more important now to get behind the general idea rather than argue over a specific approach. (Casey, 2/14)

The Hill: Trump Offers Preview Of Abortion Message Ahead Of 2020
President Trump offered a preview of his message on abortion to activists and supporters in a call Thursday as he plans to make it a focus of his re-election campaign. “He clearly is ready to take this on in the coming presidential election,” said Marjorie Dannenfelser, president of the Susan B. Anthony List. Dannenfelser briefed Trump on the issue at the White House before he participated in a nationwide conference call with activist groups and 4,500 other participants. (Hellmann, 2/14)

The Associated Press: Kansas' Abortion Uncertainty Fuels Response To New York Law
Kansas abortion opponents are as eager as ever to impose new restrictions but aren't sure of their options because the state's legal climate is uncertain. So in the meantime, they're putting their energy into condemning New York's new law protecting abortion rights. The Kansas Senate adopted a resolution Thursday decrying the New York law as harmful to both "unborn children" and women, sending it to the House, where its approval also is expected. The Senate vote Thursday was 27-13 , reflecting exactly the number of sponsors for the measure, all but one of the chamber's Republicans. (2/14)

Stat: Draft Spending Deal Includes Largest Boost For FDA In Five Years 
A government funding deal released late Wednesday includes $269 million in new funding for the Food and Drug Administration, which would represent the largest increase the agency has seen in at least five years. With that new funding, the FDA would receive $3.08 billion in government funding for fiscal year 2019. Coupled with roughly $2.5 billion in fees from drug, device, and other regulated companies, FDA’s total budget would be $5.67 billion. (Swetlitz and Florko, 2/14)

Stat: Lawmakers Question FDA On Contaminants In Blood Pressure Drugs 
As recalls mount for blood pressure drugs with potential cancer risks, a congressional committee wants the Food and Drug Administration to explain steps taken to contain the issue and, more broadly, to ensure that overseas manufacturers are not jeopardizing the U.S. pharmaceutical supply chain. In a letter to the agency, the House Committee on Energy and Commerce expressed specific concerns about the ability to oversee foreign suppliers in the wake of an ongoing probe into a class of medicines known as angiotensin II receptor blockers, notably, valsartan. (Silverman, 2/14)

Reuters: U.S. Unveils Plan To Control Some Toxins In Drinking Water, Sets No Limits
The U.S. Environmental Protection Agency said on Thursday it plans to control a group of toxic chemicals found in Americans' drinking water but stopped short of setting limits until later this year. Acting EPA Administrator Andrew Wheeler on Thursday said the agency planned short- and long-term steps to help states exposed to a class of common chemicals called PFAS, used in Teflon and firefighting foam. (Valcovici, 2/14)

The Washington Post: Critics Say EPA Action Plan On Toxic ‘Forever Chemicals’ Falls Short
The manmade chemicals have long been used in consumer products, including water-repellent fabrics, nonstick cookware and grease-resistant paper products, as well as in firefighting foams. Long-term exposures have been associated with health problems that include thyroid disease, weakened immunity, infertility risks and certain cancers. Because PFAS do not break down in the environment, they have become known as “forever chemicals.” (Dennis, 2/14)

The New York Times: E.P.A. Will Study Limits On Cancer-Linked Chemicals. Critics Say The Plan Delays Action.
Environmentalists and Democratic lawmakers criticized the plan, saying it in effect delayed desperately needed regulation on a clear public health threat from chemicals that are commonly used in cookware, pizza boxes, stain repellents and fire retardants. E.P.A. officials described their proposal as the “first-ever nationwide action plan” to address the health effects of human-made chemicals known as poly- and perfluoroalkyl substances, or PFASs. There currently no federal regulations on the production or monitoring of that class of about 5,000 chemicals, which are manufactured and used in a wide variety of industries and products. Studies have shown that they can linger in the human body for years, causing harmful health impacts. (Davenport, 2/14)

The Associated Press: UN: Experts To Develop Oversight Standards For Gene Editing
The World Health Organization is convening an expert meeting next month to develop global standards for the governance and oversight of human gene editing, months after a Chinese researcher rocked the scientific community with his announcement that he had created the world’s first gene-edited babies. In a statement Thursday, the U.N. health agency announced it had chosen an expert panel to examine the scientific, ethical, social and legal challenges linked to gene editing. (2/14)

NPR: WHO Forms Human Gene-Editing Committee To Establish Guidelines
The 18-member committee "will examine the scientific, ethical, social and legal challenges associated with human genome editing," according to the WHO announcement. "The aim will be to advise and make recommendations on appropriate governance mechanisms for human genome editing," the WHO says. The committee's formation was prompted by the disclosure last year by Chinese scientist He Jiankui that he had created the world's first gene-edited babies, twin girls. That sparked international outrage. Scientists, bioethicists and advocates condemned the experiment as unethical and irresponsible. (Stein, 2/14)

Reuters: First Stop For Migrant Kids: For-Profit Detention Center
For a growing number of migrant children, this is their first home in America: a sprawling campus dotted with beige buildings, massive white tents and metal trailers, next door to a U.S. Air Force base. The federal government is holding nearly 1,600 migrant children here, at what it calls a “temporary influx” shelter. It has added 250 beds in the last two months and could soon house 2,350 children who crossed the nation’s southern border on their own. (Torbati and Cooke, 2/14)

The Associated Press: ICE Halts Force-Feeding Of Immigrant Detainees
The U.S. government has suddenly stopped force-feeding a group of men on a hunger strike inside an El Paso immigration detention center, U.S. Immigration and Customs Enforcement said Thursday. The dramatic reversal comes as public pressure was mounting on ICE to halt the practice, which involves feeding detainees through nasal tubes against their will. Last week, the United Nations human rights office said the force-feeding of Indian hunger strikers at the facility could violate the U.N. Convention Against Torture. (2/14)

The Associated Press: Medicare Ambulance Rides May No Longer End Up At ER
Medicare wants to change how it pays for emergency ambulance services to give seniors more options besides going to a hospital emergency department, officials said Thursday. Other options could include going to an urgent care center, a doctor's office, or even treatment at home under supervision of a doctor via telehealth links. It's just a pilot project for now, but if adopted nationwide the idea could save Medicare more than $500 million a year and allow local fire departments and ambulance services to focus the time and energy of first responders on the most serious emergencies. (Alonso-Zaldivar, 2/14)

Modern Healthcare: Ambulance Providers Will Be Paid For Trips To Alternative Sites, Telemedicine 
The Center for Medicare and Medicaid Innovation will conduct an experiment on a new payment model for Medicare to create new incentives on emergency transport and care. The model would apply to Medicare fee-for-service beneficiaries. Currently Medicare pays for ambulance services to take patients to an emergency room, which Trump administration officials say hinders creation of a value-based system. "A payment system that only pays first responders to take people to the hospital creates the wrong incentive," said Adam Boehler, director of CMMI, at an event at a Washington, D.C., fire station on Thursday. "That leads to unnecessary ER visits and hospitalizations and ultimately that harms patients." (King, 2/14)

Reuters: Trump Puts On A Few Pounds, Enters Obese Range: Medical Report
U.S. President Donald Trump has gained weight over the past year and is now in the obese range, although he remains in "very good health overall," according to results of an annual presidential physical examination conducted last week. Trump, known for his love of hamburgers and well-done steaks and an aversion to the gym, was warned by his doctor last year that he needed to change his diet and start to exercise. (2/14)

The New York Times: At 243 Pounds, Trump Tips The Scale Into Obesity
Dr. Conley, a Navy commander and the director of the White House medical unit, reported Mr. Trump’s weight without comment in a memorandum describing some results of the physical that was released by the White House. After a team of 11 specialists examined the president for four hours at Walter Reed National Military Medical Center, Dr. Conley said the president was in “very good health” and was expected to remain so “for the remainder of his presidency and beyond,” but did not release any other details. (Karni and Altman, 2/14)

The Washington Post: Trump’s Doctor Says He Is In Good Health, Despite Gaining Weight
Mariell Jessup, chief science and medical officer of the American Heart Association, said the data released by Trump’s physician show a “lucky” older man with relatively low risk for cardiovascular disease. Jessup plugged the data released by Trump’s physician into the American Heart Association’s risk calculator and found that Trump has a 17 percent chance of developing cardiovascular disease in the next decade. (Olorunnipa and Johnson, 2/14)

Politico: Trump Technically Obese, Despite Doctor's Clean Bill Of Health
Some Trump critics wondered why it took so long, but it often takes days to receive medical test results. The White House nonetheless released the memo on a busy day, shortly after news broke that the president planned to sign a government funding deal and issue a national emergency to ensure the construction of his border wall along the U.S.-Mexico border. (Restuccia, 2/14)

The Wall Street Journal: Trump Has Gained Weight Since Last Year, White House Physician Says
The report by Dr. Conley was less comprehensive than the three-page memo Dr. Jackson issued last year, which in addition to the president’s vital statistics described each of the exams Dr. Jackson had performed and detailed Mr. Trump’s lab results. Dr. Jackson also held a briefing with reporters, in which he said he had administered an extensive cognitive assessment at the president’s request. The assessment yielded a perfect score, Dr. Jackson said. Dr. Conley’s memo said he administered a neurological exam but didn’t say if he administered a cognitive assessment. Dr. Conley didn’t have a briefing with reporters. (Ballhaus, 2/14)

The New York Times: The Instant, Custom, Connected Future Of Medical Devices
When Jeff Dachis suddenly and unexpectedly learned he had Type 1 diabetes at the age of 46 in September 2013, he was stunned. After all, he ran marathons, followed a healthy diet and never had an inkling of any medical troubles during previous annual physicals. “I went to the doctor, got about six minutes with a nurse practitioner, an insulin pen, a prescription and a pat on the back, and I was out the door,” Mr. Dachis said. “I was terrified. I had no idea what this condition was about or how to address it.” Feeling confused and scared, he decided to leverage his expertise in digital marketing, technology and big data analytics to create a company, One Drop, that helps diabetics understand and manage their disease. (Morrissey, 2/14)

The New York Times: They’ve Taken America’s Temperature — And It’s Running High
Americans are suffering through a very bad cold season — but not a terrible flu season, which would be far more threatening, according to the makers of a smart thermometer that accurately tracked last year’s highly lethal flu season. Nearly 1 million American households use Kinsa Health’s internet-connected thermometers and they submit about 40,000 readings a day. This week, about 10 percent more Americans have fevers than did even at the peak of last year, the company said. (McNeil, 2/14)

The Associated Press: Flu Vaccine Doing A Relatively Good Job This Season
The flu vaccine is doing a relatively good job this season, protecting about half the people who got it, U.S. health officials said Thursday. Preliminary figures suggest the vaccine is 47 percent effective in preventing flu illness severe enough to send someone to the doctor's office. Health officials are generally pleased if a flu vaccine works in 40 to 60 percent of people. (2/14)

The Washington Post: This Year’s Flu Vaccine Is Doing Well, But Deaths Are Still High
Unlike last winter, when flu killed and hospitalized more people in the United States than any seasonal influenza in decades, this season’s flu is considered significantly less harsh, according to officials at the Centers for Disease Control and Prevention. The vaccine also works better overall than last year and is even more effective — about 61 percent — in children, who are among the groups most vulnerable to flu-related complications. But the vaccine has not provided any measurable protection for older adults, with only an 8 percent reduction in the need for medical attention for flu, according to preliminary estimates. (Sun, 2/14)

The Wall Street Journal: This Common Flu Virus Is A Growing Threat
Still, H1N1 isn’t benign. The CDC estimates that as many as 186,000 people were hospitalized with the flu from the beginning of October to Feb. 2, and as many as 15,900 died. The flu kills between 12,000 and 56,000 people in the U.S. a year, according to the CDC.Most of the people hospitalized this year had H1N1 flu, the CDC said. “The number of deaths we’re seeing is a little bit surprising,” said CDC epidemiologist Brendan Flannery. “It’s a reminder that flu can be severe.” (McKay and Umlauf, 2/14)

Bloomberg: Facebook Says It May Remove Anti-Vaccine Recommendations 
Facebook Inc., under pressure to reduce harmful, misleading and fake content, said it is exploring removing anti-vaccine information from software systems that recommend other things to read on its social network. Information discouraging people from getting vaccines for their children, which has gone viral on Facebook, especially in its Groups product, may have contributed to an increase in outbreaks of measles. The crisis drew attention on Thursday from Representative Adam Schiff, who sent a letter to Facebook Chief Executive Officer Mark Zuckerberg and Google boss Sundar Pichai, asking them to address the problem. (Frier, 2/14)

The Washington Post: Darla Shine Tweets False Claims That Childhood Diseases 'Keep You Healthy & Fight Cancer'
Darla Shine, the wife of White House communications director Bill Shine, appears to be tweeting about childhood diseases, claiming that illnesses such as measles, mumps and chickenpox “keep you healthy & fight cancer.” Health experts warn that the claim is not true and adds to misinformation that could cause harm. Darla Shine, who has been known to tweet out stories with anti-vaccination claims, wrote Wednesday on Twitter that “The entire Baby Boom population alive today had the #Measles as kids." (Bever, 2/14)

The New York Times: Do You Want To Be Pregnant? It’s Not Always A Yes Or No Answer
For decades, researchers and physicians tended to think about pregnancies as either planned or unplanned. But new data reveals that for a significant group of women, their feelings don’t neatly fit into one category or another. As many as one-fifth of women who become pregnant aren’t sure whether they want a baby. This fact may reshape how doctors and policymakers think about family planning. For women who are unsure, it doesn’t seem enough for physicians to counsel them on pregnancy prevention or prenatal care. “In the past we thought of it as binary, you want to be pregnant or not, so you need contraception or a prenatal vitamin,” said Maria Isabel Rodriguez, an obstetrician-gynecologist at Oregon Health and Science University whose research focuses on family planning and contraceptive policy. “But it’s more of a continuum.” (Sanger-Katz and Miller, 2/15)

The Associated Press: Researchers Find Clues That Depression May Speed Brain Aging
Memory and thinking skills naturally slow with age but now scientists are peeking inside living brains to tell if depression might worsen that decline — and finding some worrisome clues. Depression has long been linked to certain cognitive problems, and depression late in life even may be a risk factor for the development of Alzheimer's. Yet how depression might harm cognition isn't clear. (2/14)

The New York Times: Searching Tardigrades For Lifesaving Secrets
There are many instances in medicine when it would be helpful to stop, or greatly slow down, time. Doing so could spare a limb from amputation, prevent paralysis after a stroke or save your life following a heart attack. Across the tree of life, there are many organisms that can essentially cheat time by decelerating their biology. Chief among them is the tardigrade, a creature no bigger than a speck of sand that can survive severe temperatures and pressures, outer space and all sorts of apocalyptic scenarios by entering a dormant state called anhydrobiosis. (Yin, 2/15)

The Associated Press: Cancer Death Racial Gap Narrows, But Still Higher For Blacks
For a long time, blacks have died of cancer at higher rates than other Americans. But a new report says the gap is narrowing. Nearly 30 years ago, black men had a 47 higher cancer death rate than white men. Now it's 19 percent higher. Black women had a 19 percent greater cancer death rate. Now it's 13 percent greater. (2/14)

The Washington Post: Black-White Cancer Disparities Narrow Sharply Amid Progress Against Common Malignancies
African Americans still have the highest death rate and the lowest survival rate of any racial or ethnic group for most cancers. But the report noted the overall cancer death rate has been dropping faster in blacks than in whites because of bigger declines for three of the four most common cancers — lung, prostate and colorectal. The result: The “excess risk” of cancer death in blacks, compared with whites, fell from 47 percent in 1990 to 19 percent in 2016 for men and from 19 percent to 13 percent for women, according to the study. (McGinley, 2/14)

NPR: Racial Disparities In Cancer Deaths Is Narrowing Between Blacks And Whites
"In 2019, approximately 202,260 new cases of cancer and 73,030 cancer deaths are expected to occur among blacks in the United States," the analysis by ACS investigators notes. But their report also shows that the gap between blacks and whites has closed considerably over the past few decades when it comes to lung, prostate and colorectal cancers. In fact, during the period from 2006 to 2015, overall death rates from cancer declined 2.6 percent per year among black men, compared to 1.6 percent per year among white men. Among women, for that same time period, death rates from cancer declined 1.5 percent per year among blacks compared to 1.3 percent per year among whites. (Neighmond, 2/14)

The Washington Post: Breast Surgeons Say All Breast Cancer Patients Should Be Offered Genetic Testing
The nation’s breast surgeons are advising that all patients diagnosed with breast cancer be offered genetic testing to check for inherited mutations, fueling an intense debate about how such tests should be used to prevent and treat disease. The American Society of Breast Surgeons, which sent its recommendations Thursday to its 3,400 members, said it developed the recommendation because current guidelines are too restrictive. (McGinley, 2/14)

The New York Times: Transgender Man Awarded $120,000 In Discrimination Case At Iowa Prison
In 2015, Jesse Vroegh, a registered nurse working in an Iowa prison, asked his employers at the state Department of Corrections to allow him to use the men’s restrooms and locker rooms at work because he was transitioning from female to male. But the department denied his requests, citing its concerns about the “rights of the male officers” and saying that transgender issues were “too controversial,” according to a lawsuit. (Hauser, 2/14)

The Associated Press: Youth Programs Left Wanting By California Marijuana Law
When California voters legalized marijuana, they were promised that part of the tax revenue from pot sales and cultivation would be devoted to programs to teach youth how to avoid substance abuse. But more than a year after the start of sales, there's no money for those programs and questions are looming about how they might operate in the future. (2/14)

CALmatters: Frustrated With The Slow Response Of Government, Californians Are Serving Their Homeless Neighbors Themselves
Sidewalk shantytowns are as iconic as palm trees in California these days. Though state and local governments are finally spending big on the homelessness, they’re not moving fast enough. That’s the case argued by a new generation of homeless advocates in California, despite billions of dollars earmarked to address homelessness by state and local governments. (Tinoco, 2/13)

The Washington Post: Safety At St. Elizabeths Psychiatric Hospital Questioned After Brutal Attack On Nurse
A patient’s brutal attack on a nurse at a D.C. government psychiatric hospital has renewed calls for increased security at the facility, with staff and union representatives saying hospital managers have been slow to respond to repeated requests for safer working conditions. The Jan. 13 incident at St. Elizabeths Hospital in Southeast Washington — disclosed this week at a routine oversight hearing by the D.C. Council’s Health Committee — left a 71-year-old nurse with a badly beaten face and two fractured ribs after a male patient escaped from his restraints and clubbed her repeatedly with a telephone. (Jamison, 2/14)

The Associated Press: 100 Days After Paradise Burned, The Stories Of The Victims
On that frantic morning, TK Huff was calm. The 71-year-old amputee sat in his wheelchair, pointing a garden hose at what quickly became the deadliest wildfire in California history. Nobody knew at the time, early on Nov. 8, how bad it would be. When his family called at 7:15 a.m., Huff said he would leave. But he never made it out. All around, fires were breaking out, and men and women — most of them elderly, many of them disabled — were doomed: Flames soon overtook 74-year-old Richard Brown’s beloved log cabin in the Sierra Nevada foothills. On the edge of neighboring Paradise, a blaze prompted the Feather Canyon Retirement Community to evacuate its residents — all except 88-year-old Julian Binstock, overlooked in the chaos. (Gecker and Har, 2/15)