First Edition: July 24, 2019

Kaiser Health News: ‘An Arm And A Leg’: Real Lessons Doctors Can Learn From Fake Patients
Sometimes doctors get the “medical stuff” right while patients still get the wrong care. That’s one finding from a study that sent fake patients — actors wired with recording devices — into real doctors’ offices. When the “patients” walked into the doctor’s office to tell their story, physicians were often laser-focused on biomedical issues. But the physicians often missed the psychosocial problems that can be a barrier to good health. (Weissmann, 7/24)

Kaiser Health News: When A Doctor’s Screen Time Detracts From Face Time With Patients
Electronic health records can help reduce medical errors, but when not used well they can strain the doctor-patient relationship. But medical providers — and patients — can learn skills to keep communication flowing even when there’s a screen in the room, Lee said. Improving doctor-patient communication is the topic of this week’s episode of the podcast “An Arm and a Leg.” Kaiser Health News co-produces the podcast. (Heredia Rodriguez, 7/24)

Kaiser Health News: Why It’s So Hard To Predict How Much Funding 9/11 First Responders Need
The idea of getting cancer from searching through the rubble of Ground Zero after the 9/11 attacks — and then standing guard over it for months — didn’t occur to Kevin Zweigbaum. It did cross his mind that the swirling dust and fumes from the shattered World Trade Center might be unhealthy. Now retired, the New York City police sergeant vividly remembers raising the idea with workers from the Environmental Protection Agency who were at the site. (McAuliff, 7/23)

Kaiser Health News: Summer Setbacks: The Long Road To Lower Drug Prices Hits Some Potholes
When Washington returned from its winter holiday break in January, it seemed everyone was talking about lowering drug prices. Energized by a new class of freshmen and a few weeks away from the office, members of Congress were ready to wag their fingers at drug company executives and pitch their fixes. President Donald Trump had unveiled some of his solutions to a problem he said was a top priority, and more would follow. (Huetteman, 7/24)

The Associated Press: GOP, Dems Offer Compromise To Reduce Drug Costs For Seniors
Two veteran senators — a Republican and a Democrat — unveiled compromise legislation Tuesday to reduce prescription drug costs for millions of Medicare recipients, while saving money for federal and state health care programs serving seniors and low-income people. Iowa Republican Chuck Grassley and Oregon Democrat Ron Wyden said the bill would for the first time limit drug copays for people with Medicare's "Part D" prescription plan , by capping patients' out-of-pocket costs at $3,100 a year starting in 2022. They're hoping to have it ready soon for votes on the Senate floor. (Alonso-Zaldivar, 7/23)

Reuters: Senators Announce Bipartisan Proposal To Lower Drug Prices
It is not clear how much support this, or any other drug pricing measure proposed in Congress, will receive ahead of 2020 presidential elections. But the cost of U.S. healthcare is sure to be a top campaign issue. A spokesman said the White House was encouraged by the bipartisan package. "Today we are engaging with coalitions to help build support," spokesman Judd Deere wrote on Twitter. (7/23)

The Washington Post: Senate Releases Bipartisan Proposal To Lower Seniors’ Drug Prices
The measure would also save seniors $27 billion in out-of-pocket costs over that period and $5 billion from slightly lower premiums, according to the CBO. The White House endorsed the proposal and said it would build support among senators. President Trump has made lowering drug prices a top priority headed into his 2020 reelection campaign and is eager to strike a deal with Congress that he can tout on the campaign trail. (Abutaleb, 7/23)

Politico: Senate Finance Pushes Ahead On Plan To Address High Drug Prices
CBO also estimates that Medicare beneficiaries will save $27 billion in out-of-pocket costs and $5 billion in premium spending from the two policies. The bill would place a similar inflation cap on physician-administered drugs in Medicare Part B — pricey treatments for cancer, rheumatoid arthritis and other conditions that the Trump administration wants to buy at the sums paid in developed countries overseas. Grassley’s office worked closely with Trump's health department on the drug bill, but declined to say whether the administration ultimately supports this alternate approach. Another provision would cap seniors' out-of-pocket spending in Medicare Part D and shift more of the payments for the catastrophic phase — when prescription drugs cost patients thousands of dollars — to health plans and drugmakers rather than the government. (Cancryn and Owermohle, 7/23)

Stat: Mass. Lawmakers OK Compromise To Lower Medicaid Drug Spending 
Bowing to industry pressure, Massachusetts lawmakers on Monday approved a compromise measure that is designed to lower prescription drug spending for the state Medicaid program, although consumer advocates maintain the diluted effort may still achieve its goals. The initial proposal from Gov. Charlie Baker sought to negotiate supplemental rebates for Medicaid and potentially cite drug makers for violating consumer protection laws for failing to cooperate, a step that generated significant interest from other states seeking solutions to high drug costs. But the final version contains language that notably softens the original approach. (Silverman, 7/23)

The New York Times: 9/11 First Responders Fund Clears Senate And Heads To Trump
Thousands of emergency workers who rushed to the rubble of the World Trade Center after the Sept. 11 attacks will be granted health care and other compensation for the rest of their lives. The Senate on Tuesday gave final approval to legislation that would care permanently for those who have grown deathly ill from the toxins of ground zero. White House officials said President Trump was expected to sign it. Even before the Senate’s 97-to-2 vote was gaveled to a close, retired New York firefighters and police officers, advocates and Jon Stewart, the comedian who championed the legislation, had leapt to their feet in the usually hushed chamber to lead a standing ovation. (Cochrane, 7/23)

The Associated Press: Senate Approves Bill To Extend 9/11 Victims Fund
The bill would extend through 2092 a fund created after the 2001 terrorist attacks, essentially making it permanent. The $7.4 billion fund is rapidly being depleted, and administrators recently cut benefit payments by up to 70%. The Congressional Budget Office estimates the House-passed bill would result in about $10.2 billion in additional compensation payments over 10 years, including more than $4 billion for claims already filed. Senate Democratic Leader Chuck Schumer of New York said the bill guarantees "once and for all that the heroes who rushed to the towers 18 years ago will no longer have to worry about compensation for their families when they're gone." (7/23)

The Washington Post: Senate Votes To Extend 9/11 Victims Fund For First Responders Who’ve Become Sick Since 2001 Attacks
Wearing a blue firefighter T-shirt, Stewart said Feal and other advocates “lifted this 9/11 community on their shoulders, and they carried them home, and I will always be so proud to be associated with it. . . . There have been too many funerals, too many hospices. These families deserve better. ”The moment was bittersweet, Feal said. “We’re not celebrating, we’re not spiking a football,” he said. “Too many people are dying or have died.” (Barrett and Epstein, 7/23)

The Wall Street Journal: Senate Passes Bill Securing 9/11 Compensation Fund
Sen. Kirsten Gillibrand, a New York Democrat who pushed to get the legislation passed in the Senate, said the bill was “for every person who spent days, weeks and months on the pile, and has had to suffer physical and mental scars for years because of that heroic work.” The bill had been approved overwhelmingly in the House of Representatives this month, and Mr. Trump is expected to sign it. “This was a tremendous victory today, but it’s bittersweet,” said Rep. Peter King (R., N.Y.), a co-sponsor of the bill who noted the unknown number of people who could become sick in the future and the many first responders who died or are sick because of their work. (Naranjo, 7/23)

The Washington Post Fact Checker: Trump Cuts Medicare For Tax Cuts?
The ad purports to show a couple who have been farmers for 42 years — “Bill A.” and “Mona A.” At first, it seems the ad would delve into the impact that President Trump’s policy of putting tariffs on Chinese goods has had on U.S. farmers, but then it veers into familiar territory for a Democratic attack ad. “I paid into Medicare my whole life. Trump wants to cut it just to pay for tax breaks to billionaires,” Bill says. “It’s just the rich wanting to be richer, and the rest of us are just going to have to deal with it,” Mona adds. The ad closes with this line: “Trump’s economy isn’t working for us.” (Kessler, 7/24)

The New York Times: Were U.S. Diplomats Attacked In Cuba? Brain Study Deepens Mystery
In late 2016, dozens of United States diplomats working in Cuba and China began reporting odd mental symptoms: persistent headaches, vertigo, blurred vision, hearing phantom sounds. Since then, scientists and commentators have groped for plausible explanations. Deliberate physical attacks, involving microwaves or other such technology? Or were psychological factors, subconscious yet mind-altering, the more likely cause? The strangeness of the symptoms, and the spookiness of the proposed causes, have given the story a life of its own in the diplomatic corps, the Pentagon and in assorted pockets of the internet where conspiracy theories thrive. (Carey, 7/23)

Reuters: Scans Show Changes To Brains Of Havana U.S. Embassy Workers Who Reported Illness
Advanced brain scans of U.S. Embassy employees who reported falling ill while serving in Havana revealed significant differences from a control group, according to a new study published on Tuesday. The finding does little, however, to resolve the cause of a string of mysterious health incidents that led the administration of U.S. President Donald Trump to withdraw many personnel from Cuba. (7/23)

NPR: Brain Scans Find Differences But No Injury In U.S. Diplomats Who Fell Ill In Cuba
But those differences "do not reflect the imaging differences that we see in [traumatic brain injury] or concussion," Verma says. "All you can say is something happened, which caused their brain to change," she says. And even that conclusion was challenged by brain scientists who have been skeptical that any diplomat was attacked or injured from what became known as "Havana syndrome." (Hamilton, 7/23)

The Associated Press: New US Facility To Hold Immigrant Children Already Closing
The U.S. government's new holding facility for migrant youth will close as early as this week, less than one month after it was opened in response to the squalid conditions in which children were being detained by the Border Patrol, according to the nonprofit operating the facility. The last children at the camp at Carrizo Springs, Texas, are on track to leave by Thursday, said Kevin Dinnin, the CEO of the nonprofit BCFS. The U.S. Department of Health and Human Services opened the facility in late June. An HHS spokeswoman declined to comment Tuesday. (7/23)

The Washington Post: ICE Detained U.S. Citizen For Nearly A Month Over Paperwork Problem, Attorney Says
An 18-year-old U.S. citizen who was detained in federal immigration custody for nearly a month has been released, his mother confirmed to The Washington Post Tuesday night. Francisco Erwin Galicia, a rising high school senior in Edinburg, Tex., had set off on a Texas road trip on June 27 to attend a college soccer team tryout only to end up accused of lying about his citizenship as authorities questioned the authenticity of his documents, according to his attorney, Claudia Galan. (Flynn, 7/23)

Politico: Crackdown On Food Stamps Could Worsen Hunger, USDA Acknowledges
The Agriculture Department acknowledged Tuesday that its latest push to cut back on who is eligible for food stamp benefits may worsen food insecurity in the U.S. The Trump administration has just released a proposed rule seeking to rein in what's known as broad-based categorical eligibility. That policy has allowed 43 states to expand the number of low-income people who qualify for the Supplemental Nutrition Assistance Program, formerly known as food stamps. (Bottemiller Evich, 7/23)

The Washington Post: Newly Unsealed Exhibits In Opioid Case Reveal Inner Workings Of The Drug Industry
Newly unsealed documents in a landmark lawsuit Tuesday in Cleveland show the pressure within drug companies to sell opioids in the face of numerous red flags during the height of the epidemic. The release of the exhibits — sworn depositions of executives, internal corporate emails and experts’ reports — also reveals the ignored concerns of some employees about the huge volume of pain pills streaming across the nation. In one exhibit, emails show that a Purdue Pharma executive received an order from a distributor for 115,200 oxycodone pills, which was nearly twice as large as that distributor’s average order over the previous three months. (Horwitz, Higham, Davis and Rich, 7/23)

The Washington Post: Internal Documents Show What Drug Companies Knew About The Spread Of Opioids In America
A cache of previously undisclosed internal drug company documents and other records are being released as the result of the largest civil action in U.S. history. About two dozen drug companies are being sued in federal court by nearly 2,000 cities, towns and counties, alleging they conspired to flood the nation with opioids. Below are portions of some of the documents in the case, entered by the plaintiffs as exhibits and selected by The Post. (7/23)

Stat: California Cites AmerisourceBergen For Not Flagging Big Opioid Sales 
The state of California wants to revoke or suspend the wholesale license for a facility run by AmerisourceBergen (ABC), one of the nation’s largest pharmaceutical distributors, for failing to note patterns of unusual sales of opioid painkillers and other controlled substances shipped to different pharmacies over a number of years. Between 2008 and 2014, the facility based in Sacramento, Calif., sold large quantities of such medicines as Norco, which is a mixture of acetaminophen and hydrocodone; oxycodone; and promethazine with codeine syrup to four different pharmacies, according to a May 30 complaint filed by the state Board of Pharmacy. The complaint was made public on the agency website last week. (Silverman, 7/23)

Stateline: Overdose Prevention Efforts Reach Bars And Clubs
“Just Say No” — the 1980s anti-drug slogan — doesn’t cut it here at the Brooklyn cabaret House of Yes. Starting this month, House of Yes and dozens of other bars and nightclubs in the vibrant Williamsburg and Bushwick neighborhoods are handing out coasters and pinning up posters to warn people that the deadly opioid fentanyl might be mixed with their cocaine, and if it is, they could overdose and die. (Vestal, 7/23)

The New York Times: Your Data Were ‘Anonymized’? These Scientists Can Still Identify You
Your medical records might be used for scientific research. But don’t worry, you’re told — personally identifying data were removed.Information about you gathered by the Census Bureau might be made public. But don’t worry — it, too, has been “anonymized.” On Tuesday, scientists showed that all this information may not be as anonymous as promised. The investigators developed a method to re-identify individuals from just bits of what were supposed to be anonymous data. (Kolata, 7/23)

The New York Times: Someday, An Arm Implant May Prevent H.I.V. Infection For A Year
In what could eventually become a milestone for H.I.V. prevention, very preliminary tests of an implant containing a new drug suggest that it may protect against infection for a full year. The new implant, by the drug company Merck, was tested in just a dozen subjects for 12 weeks. But experts were quite excited at its potential to revolutionize the long battle against H.I.V. The research was described on Tuesday at an international AIDS conference in Mexico City. (McNeil, 7/23)

The Washington Post: Implanted Drug Could Someday Prevent HIV Infection
The approach uses a small implant the size of a matchstick, inserted in the upper arm, to slowly release a new medication that appears to block the virus for a year or more. If it is proven safe and successful in larger studies, the method could be a major improvement for people at high risk of contracting HIV who have trouble adhering to the once-a-day pill regimen and other methods used now. The new drug, islatravir, and the implant were developed by the drug company Merck and described at a news conference at an international gathering of HIV researchers in Mexico City. (Bernstein, 7/23)

Stat: Merck Unveils Early Data On HIV Drug It Says Could Be ‘A Game Changer’
At an all-day meeting for investors last month in a posh Manhattan event space, executives at Merck couldn’t have been more excited about a new HIV drug, MK-8591. They mentioned it 25 times, calling it “a game changer” and talking up its “remarkable properties.” Why? If effective, it could be used in a new drug combination that might have fewer side effects, the company says. More excitingly, it might be fashioned into an implant that could be given only once a year to prevent patients at high risk from contracting HIV, a boon to public health. (Herper, 7/23)

The Associated Press: Sex With HIV Still A Crime? Updated Laws Divide Advocates
As Sanjay Johnson describes it, his sexual encounter with James Booth on Oct. 2, 2015, was a one-night stand. But it would bind the men inextricably two years later, when Booth walked into an Arkansas police station and accused Johnson of exposing him to HIV. Little Rock prosecutors pursued a criminal charge against Johnson even though a doctor said he couldn't have transmitted HIV to Booth because he was on medication that suppressed his virus. (7/23)

The Associated Press: FDA Warns Top Marijuana Company For Making CBD Health Claims 
U.S. regulators warned a leading marijuana company for making unproven health claims about CBD, the trendy ingredient that's turning up in lotions, foods and pet treats. The Food and Drug Administration announced Tuesday it warned Curaleaf Inc., of Wakefield, Massachusetts, for illegally selling unapproved products. Curaleaf's claims could lead people to delay medical care for serious conditions like cancer, the agency said. (7/23)

The Hill: FDA Warns Company Against Making 'Unsubstantiated Claims' About CBD 
The FDA also said the promises of some products, like helping treat cancer, could lead people to delay medical care for serious conditions. "Selling unapproved products with unsubstantiated therapeutic claims — such as claims that CBD products can treat serious diseases and conditions — can put patients and consumers at risk by leading them to put off important medical care," acting FDA Commissioner Ned Sharpless said in a statement. (Rodrigo, 7/23)

The New York Times: How Weight Training Changes The Brain
Weight training may have benefits for brain health, at least in rats. When rats lift weights, they gain strength and also change the cellular environment inside their brains, improving their ability to think, according to a notable new study of resistance training, rodents and the workings of their minds. The study finds that weight training, accomplished in rodents with ladders and tiny, taped-on weights, can reduce or even reverse aspects of age-related memory loss. The finding may have important brain-health implications for those of us who are not literal gym rats. (Reynolds, 7/24)

NPR: How To Help Your Anxious Partner — And Yourself
Living with anxiety can be tough — your thoughts might race, you might dread tasks others find simple (like driving to work) and your worries might feel inescapable. But loving someone with anxiety can be hard too. You might feel powerless to help or overwhelmed by how your partner's feelings affect your daily life. If so, you're not alone: Multiple studies have shown that anxiety disorders may contribute to marital dissatisfaction. (Neilson, 7/24)

The Wall Street Journal: Are Oreos Part Of A Mindful Diet? Snack Makers Promote Chewing Thoughtfully
Earlier this month, about two dozen employees from Mondelez International ’s headquarters sat facing a wall emblazoned with the company’s snack brands including Oreo cookies, Triscuit crackers, Swedish Fish candy, Cadbury chocolate and Nilla wafers. They gathered to learn how to eat these foods in a new way. After breathing and meditation exercises, the group was told to slowly reach for a cracker, take one bite, and then set it down. “Close your eyes and chew slowly,” said Claire Mark, a local meditation instructor who led the class. “Try to bring in a deeper level of awareness to the muscles that it takes to chew, to the physical experience of having food in your mouth, to recognize how it feels to swallow.” After a pause, the group repeated the process for each of the remaining bites needed to eat two crackers. (Byron, 7/23)

NPR: Neurologist Unlocks A 'Secret World' Of Sleep — And Sleep Disorders
We tend to think of being asleep or awake as an either-or prospect: If you're not asleep, then you must be awake. But sleep disorder specialist and neurologist Guy Leschziner says it's not that simple. "If one looks at the brain during sleep, we now know that actually sleep is not a static state," Leschziner says. "There are a number of different brain states that occur while we sleep." As head of the sleep disorders center at Guy's Hospital in London, Leschziner has treated patients with a host of nocturnal problems, including insomnia, night terrors, narcolepsy, sleep walking, sleep eating and sexsomnia, a condition in which a person pursues sexual acts while asleep. (Davies, 7/23)

The Washington Post: Deadly Fungal Disease May Be Linked To Climate Change, Study Suggests
Three years ago, U.S. health officials warned hundreds of thousands of clinicians in hospitals around the country to be on the lookout for a new, quickly spreading and highly drug-resistant type of yeast that was causing potentially fatal infections in hospitalized patients around the world. Candida auris has become a serious global health threat since it was identified a decade ago, especially for patients with compromised immune systems. (Sun, 7/23)

The Associated Press: Judge Temporarily Blocks New Arkansas Anti-Abortion Laws
A federal judge blocked three new abortion restrictions from taking effect Wednesday in Arkansas, including a measure that opponents say would likely force the state’s only surgical abortion clinic to close. U.S. District Judge Kristine Baker granted a 14-day temporary restraining order shortly before midnight Tuesday. The 159-page order blocks the state from enforcing the new laws, including a measure prohibiting the procedure 18 weeks into a woman’s pregnancy. (Demillo, 7/24)

The Wall Street Journal: Arkansas Antiabortion Bills Temporarily Blocked
U.S. District Judge Kristine Baker issued a temporary restraining order lasting two weeks, expiring Aug. 6, in a 159-page order at 11:45 p.m. local time. The legislation was expected to take effect Wednesday at 12:01 a.m. The laws, part of a raft of new antiabortion legislation pushed by Republican lawmakers around the country, would have required physicians providing abortions to be board-certified or board-eligible in obstetrics and gynecology—a mandate that would have led to the closure of Little Rock Family Planning Services, the only clinic providing surgical abortions in the state. They also would have banned abortions after 18 weeks and prohibited abortions sought because of fetal diagnoses of Down syndrome. (Calfas, 7/24)

The Associated Press: Georgia Abortion Law Foes Seek To Keep It From Taking Effect
Opponents of a Georgia law that bans most abortions on Tuesday asked a judge to keep it from taking effect while their legal challenge plays out. The law is set to become enforceable Jan. 1. Lawyers with the American Civil Liberties Union, Planned Parenthood and the Center for Reproductive Rights sued on behalf of Georgia advocacy groups and abortion providers last month to challenge the measure. (7/23)

ProPublica: Boston Hospital Reports Disciplining Of Renowned Child Abuse Skeptic
A Boston hospital has notified the Massachusetts medical board that it has restricted the work of a world-renowned endocrinologist criticized for espousing controversial theories as an expert witness for people accused of child abuse. The action against Dr. Michael Holick is cited on his profile page on the board’s website under “health care facility discipline.” The listing is intended to alert members of the public who visit the site that Boston Medical Center, where Holick practices, has restricted his rights or privileges. (Armstrong, 7/24)

The New York Times: The Crisis Lurking In Californians’ Taps: How 1,000 Water Systems May Be At Risk
It was bath time and Rosalba Moralez heard a cry. She rushed to the bathroom and found her 7-year-old daughter, Alexxa, being doused with brown, putrid water. “We kept running the tub, we turned on the sink, we flushed the toilet. All the water was coming out dirty,” Ms. Moralez said. For more than a year, discolored water has regularly gushed from faucets in the family’s bathroom and kitchen, as in hundreds of other households here in Willowbrook, Calif., an unincorporated community near Compton in South Los Angeles. (Del Real, 7/24)

The Associated Press: Gun Group Wants Judge To Block Ammunition Background Checks
A California affiliate of the National Rifle Association has asked a U.S. judge to block a new law requiring background checks for anyone buying ammunition. The California Rifle & Pistol Association asked San Diego-based U.S. District Judge Roger Benitez to halt the checks and related restrictions on ammunition sales.Voters approved tightening California's already strict firearms laws in 2016. The restrictions took effect July 1. (7/23)

The Associated Press: Judge Orders Improvements At County Jail In Georgia
A U.S. judge ordered officials in a metro Atlanta county Tuesday to improve conditions at a local jail where women with mental health problems said in a lawsuit that they were subject to prolonged solitary confinement and dirty cells. Fulton County Sheriff Theodore Jackson must permit the women at South Fulton jail to have one hour of recreation time and two hours of free time each day and come up with a plan to provide clean cells and "therapeutic activities," Judge William Ray said. (7/23)

Los Angeles Times: Peak Fire Season Is Near And The Federal Government Is Short Hundreds Of Firefighters
Heading into the hottest and driest months of the wildfire season, the Department of the Interior is short hundreds of firefighters, a result of recruitment problems and the longest federal government shutdown in history. Based on interviews and internal agency memos obtained through a public records request, The Times found that the agency has about 500 fewer firefighters available than expected — a roughly 10% shortfall. (Phillips, 7/23)

The Washington Post: Northern Virginia Health Officials Investigating Foodborne Illness Outbreaks
Virginia health officials are investigating an increase in cases of a foodborne intestinal illness and dozens of suspected cases involving two large employers. The Virginia Department of Health reported Tuesday on a recent increase of cyclosporiasis, an intestinal illness caused by the foodborne parasite cyclospora, since mid-June in Northern Virginia. The source of the outbreak has not been identified. (Moyer, 7/23)