First Edition: May 2, 2019

Kaiser Health News: Even Doctors Can’t Navigate Our ‘Broken Health Care System’
Dr. Hasan Shanawani was overcome by frustration. So, last week he picked up his cellphone and began sharing on Twitter his family’s enraging experiences with the U.S. health care system. It was an act of defiance — and desperation. Like millions of people who are sick or old and the families who care for them, this physician was disheartened by the health care system’s complexity and its all-too-frequent absence of caring and compassion. (Graham, 5/2)

Kaiser Health News: CBO’s Report On Single-Payer Health Care Holds More Questions Than Answers
Notably, the single-payer report avoids a question that critics frequently surface: How much would this cost? How would you pay for it? That’s because there’s no uniform cost estimate for single-payer and no easy formula to apply. For one thing, the price tag depends on what services are covered — something like long-term care would make the idea much more expensive. (Luthra, 5/1)

Kaiser Health News: Booker’s Argument For Environmental Justice Stays Within The Lines
As part of Sen. Cory Booker’s presidential primary campaign, the New Jersey Democrat talks about “environmental justice” — which seems to mean addressing the environmental factors that disproportionately affect people who are low-income and from minority backgrounds. One issue he’s highlighting: the impact of so-called Superfund sites, hazardous waste sites that are especially prevalent in Booker’s home state, and usually located in the same neighborhoods as low-income residents, often African American or Hispanic. (Luthra, 5/2)

The New York Times: ‘Medicare For All’ Gets Much-Awaited Report. Both Sides Can Claim Victory.
The Congressional Budget Office published a much-awaited paper about the possible design of a single-payer or “Medicare for all” system in the United States. The budget office most often provides detailed estimates about the cost of legislation. But anyone looking for many numbers in Wednesday’s long report would be disappointed. Instead, the nonpartisan office noted the many ways that legislators could devise such a system, outlining the cost and policy effects of a wide range of difficult choices. It also noted that such a system would be so different from the country’s current situation that any hard estimates would be difficult, even with all the specifics laid out. (Sanger-Katz, 5/1)

The Associated Press: Budget Office: Caveats To Government-Run Health System
"The transition toward a single-payer system could be complicated, challenging and potentially disruptive," the report said. "Policymakers would need to consider how quickly people with private insurance would switch their coverage to a new public plan, what would happen to workers in the health insurance industry if private insurance was banned or its role was limited, and how quickly provider payment rates under the single-payer system would be phased in from current levels." (Alonso-Zaldivar and Fram, 5/1)

The Washington Post: Medicare-For-All Plans Get A Reality Check
The analysis, issued Wednesday by the Congressional Budget Office, offers a reality check on the campaign slogans that have characterized a growing crop of Democratic presidential aspirants who champion the idea of Medicare-for-all. The report lays out “opportunities and risks” of moving every American into a single government plan that covers all or most medical services. On the plus side, it says, such a plan would produce universal coverage and probably a more efficient health system. Among the negatives: higher government spending and taxes — and potentially longer waits for some treatments and technologies. (Goldstein, 5/1)

The Wall Street Journal: Medicare For All Could Trim Costs, Impede Care, Report Says
The report serves as a yardstick laying out possible pitfalls and advantages of instituting such a Medicare for All system, as well as the policy questions lawmakers would have to address. By consolidating administrative tasks, the report says, their costs would likely fall under the new health system. But the design of the system would determine whether it lowers overall health-care spending. A Medicare for All system would create incentives, such as access to expanded preventive care and other benefits that may improve people’s health, the report said. But it also said that extending coverage to more Americans could produce longer wait times and reduced access to care if there weren’t enough health workers. (Armour, 5/1)

The Hill: House Democrats Introduce Moderate Medicare Expansion Plan 
House Democrats on Wednesday unveiled a more moderate proposal for expanding health care coverage than "Medicare for All" legislation that has been advocated by a number of the party's 2020 presidential candidates. The Medicare for America Act, sponsored by Reps. Rosa DeLauro (D-Conn.) and Jan Schakowsky (D-Ill.), was released a day after Democrats held the first hearing about Medicare for All. (Weixel, 5/1)

The New York Times: Trump Administration Files Formal Request To Strike Down All Of Obamacare
The Trump administration formally declared its opposition to the entire Affordable Care Act on Wednesday, arguing in a federal appeals court filing that the signature Obama-era legislation was unconstitutional and should be struck down. Such a decision could end health insurance for some 21 million Americans and affect many millions more who benefit from the law’s protections for people with pre-existing medical conditions and required coverage for pregnancy, prescription drugs and mental health. (Hoffman and Goodnough, 5/1)

The Associated Press: Trump, GOP States Ask Appeals Court To Kill 'Obamacare'
The "Obamacare" opponents hope to persuade the 5th U.S. Circuit Court of Appeals in New Orleans to uphold U.S. District Court Judge Reed O'Connor's ruling late last year striking down the law. If the ruling is allowed to stand, more than 20 million Americans would be at risk of losing their health insurance, re-igniting a winning political issue for Democrats heading into the 2020 elections. President Donald Trump, who never produced a health insurance plan to replace "Obamacare," is now promising one after the elections. (McGill and Alonso-Zaldivar, 5/1)

The Wall Street Journal: Trump Administration Now Urges Court To Strike Down Entire Health Law
At earlier stages of the case, the Trump-era Justice Department argued against several central provisions of the ACA, but it didn’t ask the court to strike down the whole law. The department signaled its change of heart in a one-paragraph letter submitted to the Fifth Circuit in March, but it didn’t lay out its new position at the time. “Once those core provisions are excised, the balance of the ACA cannot continue to operate as intended,” the Justice Department said in Wednesday’s filing. “Instead of rewriting the statute by picking and choosing which provisions to invalidate, the proper course is to strike it down in its entirety.” (Kendall and Armour, 5/1)

The Hill: Sanders Criticizes Biden Health Plan: 'It Doesn't Go Anywhere Near Far Enough' 
Sen. Bernie Sanders (I-Vt.) criticized his 2020 Democratic presidential rival Joe Biden’s health care plan on Wednesday, saying it falls short of needed changes. “It doesn't go anywhere near far enough,” Sanders told reporters in the Capitol when asked about the former vice president’s plan. “It will be expensive, it will not cover a whole lot of people.” The remarks mark relatively rare direct criticism of a rival candidate in the early stages of the Democratic presidential primary. (Sullivan, 5/1)

The New York Times: Measles Outbreak: Why A Bid To End Religious Exemptions For Vaccines Has Stalled
As New York has emerged as the epicenter of a national outbreak of measles, local lawmakers and health officials have struggled to compel some ultra-Orthodox Jewish communities, where most of the cases have been found, to drop their resistance to vaccinations. Public health emergencies have been declared in New York City and Rockland County; summonses have been issued to those not abiding by vaccination requirements; and schools have been closed. (McKinley, 5/1)

Reuters: Merck Steps Up U.S. Measles Vaccine Production With Increased Demand
Merck & Co said on Wednesday it has increased production of the measles vaccine to meet an uptick in demand in the United States in the midst of the country's biggest outbreak in 25 years. Merck, the sole U.S. supplier of measles vaccines, said the increased demand was noticeable, but did not amount to a surge, and has not required a significant increase in distribution across the country. (5/1)

The New York Times: Cruise Ship Quarantined In St. Lucia After Measles Case Is Reported
The Caribbean nation of St. Lucia has quarantined a cruise ship on the island after identifying a confirmed case of measles on board, a health official said. Passengers and crew aboard the large ship were not permitted to leave, Dr. Merlene Fredericks-James, the nation’s chief medical officer, said on Tuesday. The highly infectious disease, which can be prevented by a common vaccination, is in the midst of its largest outbreak in a quarter century in the United States, with more than 700 cases reported. (Victor, 5/2)

The Washington Post: Measles On Cruise Ship: Hundreds Quarantined In St. Lucia
Authorities confirmed the case Tuesday morning, said Merlene Fredericks James, St. Lucia’s chief medical officer. The vessel was locked down later that day, an attempt to stymie any potential spread of the highly contagious disease that is sickening people in the United States at a record pace, fueled by anti-vaccination misinformation. “No one was allowed to leave the ship,” Fredericks James said in a statement. “Because of the risk of potential infection, not just from the confirmed measles case but from other persons who may be on the boat at the time, we thought it prudent to make a decision not to allow anyone to disembark.” (Thebault, 5/1)

The Hill: 'Avengers: Endgame' Crowd May Have Been Exposed To Measles, California Health Officials Warn 
Health officials in Orange County, California are warning moviegoers that they could have been exposed to measles last week after a woman who went to a viewing of “Avengers: Endgame” reported having been diagnosed with measles. According to a local NBC affiliate, the woman was diagnosed with the virus shortly after she attended a late-night showing of the blockbuster film last week at an AMC theater in Fullerton. (Foley, 5/1)

The New York Times: Guatemalan Boy Dies In U.S. Custody After Illness, Officials Say
A 16-year-old Guatemalan boy who was placed in a Texas shelter for migrant children and teenagers after entering the United States has died in federal custody, officials said on Wednesday. The boy, who died on Tuesday, was considered an unaccompanied minor who had entered the United States. Officials refused to comment on how long he had been in the country, where his parents were or whether he entered illegally. But his death is sure to highlight the risks for the surge of Central American families who have crossed the southwestern border in recent months, overwhelming federal facilities and resources. (Kanno-Youngs, 5/1)

Reuters: Teenage Guatemalan Migrant Dies In Texas While In U.S. Custody
He entered the United States near the border city of El Paso, Texas and was detained by U.S. border patrol agents on April 19, according to a statement from Guatemala's foreign ministry. The boy was then sent to a shelter nearly 700 miles away in Brownsville, the statement added, where he was "beginning the process of family reunification." (5/1)

The Washington Post: Trump Says The Border Crisis Is About Criminals And Gangs. His Administration Says It Is About Families And Children.
Faced with rising numbers of migrants at the southern border, President Trump has regaled supporters with increasingly apocalyptic warnings of an “invasion” populated by criminals with face tattoos who look fearsome enough to be “fighting for the UFC.”... But on Wednesday, in an emergency plea to Congress for $4.5 billion, his administration described the migrants as vulnerable families and children whose dire situation requires the resources “to sustain critical and lifesaving missions.” “Immediate emergency action is required . . . to safely, securely, and humanely process and care for this at-risk migrant population,” Russell T. Vought, the acting director of the Office of Management and Budget, wrote in the emergency request to lawmakers. (Nakamura, 5/1)

The Wall Street Journal: Bill Would Deny U.S. Pensions To Convicted Child Molesters
A U.S. senator is seeking to ban convicted child molesters from receiving government pensions after a U.S. Indian Health Service doctor was revealed to be drawing a six-figure retirement income following his conviction for sexually abusing patients. The Wall Street Journal and the PBS series Frontline reported in March that the doctor, longtime Indian Health Service pediatrician Stanley Patrick Weber, stood to get more than $1.8 million in U.S. pension payments during his prison sentence, which began in September. (Weaver and Frosch, 5/1)

The Hill: Dems Turn Black Maternal Deaths Into Powerful 2020 Issue 
Democratic presidential candidates led by Sens. Kamala Harris (Calif.) and Elizabeth Warren (Mass.) are talking about an issue that hasn’t historically received much attention on the campaign trail: the high rates of pregnancy-related deaths among black women. For black women — a key voting bloc in the Democratic Party — issues of maternal mortality and racial disparities in health care have particular resonance, and that hasn’t gone unnoticed by some of the top 2020 candidates, including Sens. Kirsten Gillibrand (D-N.Y.), Cory Booker (D-N.J.) and Bernie Sanders (I-Vt.) (Hellmann, 5/2)

The Washington Post Fact Checker: Trump’s Claim Of ‘Amazing’ Success In Cutting Opioid Prescriptions
During a recent speech on the administration’s efforts to ease the opioid crisis, President Trump asserted that his administration had already achieved its goal of cutting nationwide opioid prescriptions by one-third. Trump’s original goal, made on March 19, 2018, was to reach this target within three years. So obviously we were curious about whether the claim about already reaching the milestone within a year was valid. (Kessler, 5/2)

Stat: State AGs Criticize A Government Task Force Over Opioid Prescribing 
As the opioid crisis continues unabated, a federal task force meets next week to review a draft report on managing pain, but dozens of attorneys general worry the final version may be used to unravel prescribing guidelines already issued by the Centers for Disease Control and Prevention. The draft from the Pain Management Best Practices Inter-Agency Task Force covers a lot of ground in attempting to find ways to address acute and chronic pain management: medicines, other medical approaches, overdose prevention, insurance coverage, and treating different patient populations, among other things. (Silverman, 5/1)

Reuters: CVS Health Raises Full-Year Profit Forecast On Aetna Strength
CVS Health Corp on Wednesday raised its full-year profit forecast and reported first-quarter earnings that topped Wall Street estimates due to growth in its Aetna health insurance business, and as drug prices fell within its expectations. Shares rose more than 5 percent to $57.35. They had fallen 17 percent this year, hurt by a weak forecast in February and a cut to rival Walgreen Boots Alliance's full-year outlook last month due to lower generic drug prices. (5/1)

The Wall Street Journal: CVS Eases Concerns About Aetna Deal
The first-quarter results mark a shift from February when the Woonsocket, R.I.-based company offered a downbeat earnings projection for 2019 that sent shares tumbling. The latest performance also distinguishes CVS from rival Walgreens Boots Alliance Inc., which reported weaker profits in the most recent quarter and lowered its forecast citing weaker profit from generic-drug sales. “Considering that expectations have been low, we see this as the first positive catalyst that restores investor confidence in this management team,” SVB Leerink analyst Ana Gupte said. (Terlep and Wilde Mathews, 5/1)

Reuters: Fitbit Results Beat Street As Demand For Wearable Devices Climb
Wearable device maker Fitbit Inc reported better-than expected first-quarter results and reaffirmed its full-year revenue forecast on Wednesday, as it sells more smartwatches and wearable devices that track health at affordable prices. Shares of the company rose 1.5 percent to $5.45 in late trade. Fitbit, which helped pioneer the wearable devices craze, posted year-over-year trackers growth for the first time in three years, getting a boost from its new Inspire line. Smartwatch sales also more than doubled in the quarter. (5/1)

The Wall Street Journal: CEOs In Health Care Discuss Challenges Of Working With Artificial Intelligence
Technology is reshaping health care, from pharmaceutical research to detecting opioid addiction, but the magnitude and pace of change isn’t always as dramatic as some had hoped a few years ago, industry leaders said at The Wall Street Journal Health Forum on Tuesday. Novartis AG Chief Executive Vas Narasimhan said that for now, the opportunities presented by artificial intelligence are on the margin. “It’s another tool in the toolbox,” he said. (Walker, Loftus and Abbott, 5/1)

Stat: Development Of New Antibiotics Will Require New Incentives, Experts Say
The market for combating superbugs, in theory, is substantial. In the U.S. alone, some 2 million people are infected with antibiotic-resistant strains of bacteria annually, and 23,000 people die. Globally, about 700,000 people die each year thanks to antimicrobial resistance, according to a UN committee report. By 2030, the authors believe superbugs may kill up to 10 million people each year. Yet companies continue to bow out of the antimicrobial field. (Keshavan, 5/2)

Stat: Even Many Who Support Trump’s Drug Rebate Plan Don’t Support It In Medicaid
Medicaid advocates have a lot of opinions about the Trump administration’s rebate rule. Namely, that it makes no sense. The Trump administration’s controversial proposal to eliminate the drug rebates that pharmacy middlemen and insurers use to negotiate down the price of certain drugs doesn’t stop with that massive change — it proposes eliminating some of the rebates in Medicaid, too. The administration argues that in both programs, the policy will force pharmacies to pass rebates directly to the consumer, meaning lower prices at the pharmacy counter. (Florko, 5/2)

Stat: FDA Approves The First Vaccine For Dengue Fever, But With Major Restrictions
The Food and Drug Administration on Wednesday approved the first vaccine against dengue fever, one that protects against a common disease but has generated significant controversy due to evidence it can increase the risk of severe infection in some people. The agency ruled that Dengvaxia, manufactured by Sanofi Pasteur, can only be used in individuals aged 9 to 16 living in parts of the United States where the dengue virus is endemic — in other words, where it circulates on an ongoing basis. Dengue is found only in Puerto Rico and a few other U.S. offshore territories and protectorates. (Branswell, 5/1)

The New York Times: Saving The Teeth Of Patients With Special Needs
Many dentists can’t — or won’t — treat patients with disabilities. Some cannot physically accommodate a large wheelchair, “or they don’t feel comfortable treating the patients,” said Dr. Rita Bilello, the dental director at Metro Community Health Centers in Brooklyn, Staten Island and the Bronx. Historically, pediatric dentists were taught how to treat patients with special needs, but general dentists weren’t. That means a child with autism might get regular checkups, but not necessarily an adult. However, in 2006, a new standard for dental programs went into effect. The Commission on Dental Accreditation mandated all students had to be able to competently assess the treatment needs of special-needs patients. But as of 2012, less than three-quarters of dental schools have predoctoral students actively involved in their treatment, according to a study in the Journal of Dental Education. (Saint Louis, 5/2)

The Associated Press: School Safety At Forefront Of Teacher Rally After Shooting
North Carolina's public school teachers and their supporters showed up in force Wednesday to demand an overhaul of the state's education priorities, bringing thousands to a march and rally in the state's capital. Chanting "Whose schools? Our schools! Whose voice? Our voice," they rallied in Raleigh for the second year in a row. They want more money for student support staff, such as counselors and nurses — features now included in the state House budget written by Republican legislators. (5/1)

The Wall Street Journal: Fossil Points To A Vanished Human Species In Himalayas
A fossil jaw found in the Himalayan highlands of Tibet belongs to a vanished human species called Denisovans, deepening the mystery of human evolution in Asia, scientists said Wednesday in a new study probing the roots of humankind. Discovered by a local Buddhist monk, the fossil shows these archaic human relatives lived on the roof of the world in the rarefied air at almost 11,000 feet—an altitude that would leave many people today starved for oxygen. They settled at these frigid heights at least 160,000 years ago, more than 120,000 years before modern humankind arrived, said the scientists, who published their work on the fossil in the journal Nature. (Hotz, 5/1)

NPR: In 'Mind Fixers,' Anne Harrington Explores Role Of Drug Marketing In Mental Illness
Historian and Harvard professor Anne Harrington believes that pharmaceutical companies have played an oversized role in determining how mental illness is treated in the United States — leading to a rise in the use of antidepressant drugs. Harrington's new book, Mind Fixers: Psychiatry's Troubled Search for the Biology of Mental Illness, chronicles the history of psycho-pharmaceuticals, such as Prozac and Xanax, which have been used to treat depression and anxiety, as well as lithium, the first drug to treat what is now called bipolar disorder. (Gross, 5/2)

The New York Times: Anti-Infective Drugs Tied To Eating Disorders
Girls who have serious or repeated infections in childhood are at higher risk for developing eating disorders in adolescence, a new study has found. The study, in JAMA Psychiatry, tracked 525,643 girls — every girl born in Denmark from 1989 through 2006. The researchers recorded all prescriptions that were filled for antibiotics and other anti-infective medications, as well as hospitalizations for infection, through 2012. There were 4,240 diagnoses of eating disorders during that time. (Bakalar, 5/2)

The New York Times: Premature Birth Raises Risk Of Kidney Disease
Premature birth increases the risk for chronic kidney disease later in life, a new study reports. Researchers used a database of 4,186,615 singleton live births in Sweden from 1973 to 2014, following the people into mid-adulthood. The analysis, in BMJ, found 4,305 cases of chronic kidney disease. (Bakalar, 5/1)

The New York Times: Pay Tuition Or Eat Dinner? Nearly Half Of All State College Students Go Hungry
In the coming weeks, thousands of college students will walk across a stage and proudly accept their diplomas. Many of them will be hungry. A senior at Lehman College in the Bronx dreams of starting her day with breakfast. An undergraduate at New York University said he has been so delirious from hunger, he’s caught himself walking down the street not realizing where he’s going. A health sciences student at Stony Brook University on Long Island describes “poverty naps,” where she decides to go to sleep rather than deal with her hunger pangs. (Laterman, 5/2)

The Associated Press: Kansas Lawmakers Fail To Override Abortion 'Reversal' Veto
Republican lawmakers in Kansas narrowly failed Wednesday to override Democratic Gov. Laura Kelly's veto of a bill requiring abortion providers to tell patients about a disputed treatment to stop a medication abortion after it's been started. It was a second major loss in less than a week for abortion opponents in a state where they became accustomed to enacting new restrictions easily under Kelly's conservative GOP predecessors before she took office in January. (5/1)

The Associated Press: Ohio State Wants Info On '96 Doc Investigation Made Public
Ohio State University asked a judge Wednesday for permission to publicly share information about a confidential state medical board investigation involving the team doctor accused of decades-old sexual misconduct against more than 150 former students. The Perkins Coie law firm has spent a year investigating the men's allegations against Richard Strauss for Ohio State, and its findings are expected soon. The school plans to release that report, which it said will reference information provided by former OSU employees during the 1996 medical board investigation. (5/1)

The Associated Press: Conflict In Michigan AG's Office Over Flint Water Records
A civil war of sorts is developing in the Michigan attorney general's office over 23 boxes of records found in a state basement and what role — if any — they have in the Flint water criminal investigation. Prosecutors led by Fadwa Hammoud, a senior official in the office, want a six-month delay in the involuntary manslaughter case of former state health director Nick Lyon in order to conduct a review of the boxes. But another lawyer in the office took an extraordinary step Wednesday, telling a judge there's "no indication" that the boxes were connected to Lyon and that prosecutors last week had made a series of statements in a court filing that were "not true." (5/1)

CNN: 'Vampire Facial' At New Mexico Spa Tied To 2 HIV Cases, Health Officials Say
Health officials are investigating two cases of human immunodeficiency virus, or HIV, among clients who received injection-related procedures, including "vampire facials," at an Albuquerque spa. The New Mexico Department of Health announced on Monday that laboratory tests indicated that the two clients were infected with the same virus, increasing the likelihood that the infections may have resulted from a procedure at the spa. (Howard, 4/30)

The Washington Post: Homelessness Drops For Third Straight Year In D.C., City Officials Say
The number of homeless people counted on the streets and in the shelters of the nation’s capital has dropped for the third straight year, D.C. officials announced Wednesday. There were 6,521 homeless people in the District, a 5.5 percent decline from last year, according to the annual count performed by the city. The trend was driven by a 15.6 percent reduction in family homelessness, while the number of homeless, single adults increased by 2.8 percent. (Jamison, 5/1)

Los Angeles Times: O.C. Doctor Told Deputies He Found His Wife Dead At The Bottom Of The Stairs. Now He’s Charged With Murder
Dr. Eric Scott Sills, a successful Orange County fertility specialist, told investigators he awoke early on a November morning in 2016 to find his wife dead at the bottom of the stairs of their $1-million San Clemente home. Initially, it appeared that 45-year-old Susann Sills had fallen to her death, but prosecutors say an investigation that has spanned more than two years suggests more sinister circumstances. (Fry, 5/1)