First Edition: November 16, 2018

Kaiser Health News: Women Applaud Michelle Obama’s Decision To Share Her Trauma Of Miscarriage
Miscarriage is “lonely, painful, and demoralizing,” Michelle Obama writes in her new memoirs. Yet, by some estimates, it ends as many as 1 in 5 pregnancies before the 20-week mark. The former first lady’s disclosure that she and former President Barack Obama suffered from fertility issues, including losing a pregnancy, has sparked conversations about miscarriage, a common but also commonly misunderstood loss. (Huetteman, 11/16)

California Healthline: Gun Control Vs. Mental Health Care: Debate After Mass Shootings Obscures Murky Reality
After the recent mass shooting in Thousand Oaks, Calif., in which 11 people were killed at a country music bar, President Donald Trump struck a familiar refrain: “It’s a mental health problem,” he said of the gunman, Ian David Long. “He was a very sick puppy.” Similarly, after a school shooting in Parkland, Fla., that killed 17 students and staff members in February, Trump tweeted that there were “so many signs that the shooter was mentally disturbed.” (Waters, 11/16)

Kaiser Health News: Podcast: KHN’s ‘What The Health?’ Doctors, Guns And Lame Ducks
Election Day was Nov. 6, but results remain undetermined in some races at the state and federal levels. Nonetheless, it is already clear that the election could have major implications for health policy in 2019. The current Congress is back in Washington for a lame-duck session, and while the budget for the Department of Health and Human Services is set for the fiscal year that began Oct. 1, other health bills, including ones addressing AIDS and bioterrorism, are on the to-do list. (11/15)

Modern Healthcare: Arkansas Drops 3,815 More Medicaid Enrollees Over Work Requirement 
Nearly 4,000 Arkansans lost their Medicaid expansion coverage in October because they failed to comply with the state's new work requirement, joining 8,462 other low-income adults who lost benefits in the previous two months. State officials reported Thursday that 3,815 of the 69,041 people subject to the so-called community engagement requirement in October were noncompliant for three months and were dropped from Medicaid. They will lose coverage for the rest of 2018 and can only reapply in January. (Meyer, 11/15)

The Hill: More Than 12K People In Arkansas Have Lost Medicaid Coverage
Arkansas began phasing in work requirements for Medicaid beneficiaries in August. In the three months the requirements have been in effect, 12,128 people were removed from Medicaid and are locked out until Jan. 1. In addition, there are 6,002 people with two strikes against them who are at risk for losing coverage next month. (Weixel, 11/15) 

Politico: California's New Governor Embodies Democrats' Dilemma On Single Payer
California’s next governor Gavin Newsom is an avowed single-payer supporter in the country’s most populous state. But how much of his stand is principle and how much is policy is not totally clear. And no matter how he handles it, he'll inevitably anger part of his base. That, in a nutshell, is a preview of the Democrats' health policy dilemma heading into the 2020 election cycle. Single payer, or “Medicare for All,” has become a litmus test for the growing number of Democrats who are contemplating challenging President Donald Trump. (Colliver, 11/15)

The Hill: Left Wants A Vote On Single-Payer Bill In New Congress
Progressive Democrats are pushing for a vote on a controversial health-care bill after the party takes control of the House early next year. But the left’s push for “Medicare for all” legislation would likely divide Democrats and pose a headache for House Minority Leader Nancy Pelosi (D-Calif.), who is poised to become Speaker in the next Congress.  (Sullivan, 11/15)

The Washington Post: FDA Unveils Sweeping Anti-Tobacco Effort To Reduce Underage Vaping And Smoking
The Food and Drug Administration on Thursday launched a multipronged attack on the rising underage use of tobacco products, imposing sales restrictions on flavored e-cigarettes and announcing plans to ban menthol cigarettes and flavored cigars. The FDA says it will limit sales of many flavored e-cigarettes to bricks-and-mortar outlets that have either age-restricted entry or areas inside stores that are not accessible to people under 18. The agency also will require stepped-up age verification for online sales. (McGinley and Bernstein, 11/15)

The New York Times: F.D.A. Seeks Restrictions On Teens’ Access To Flavored E-Cigarettes And A Ban On Menthol Cigarettes
The proposed menthol ban would be the most aggressive action the F.D.A. has taken against the tobacco industry in nearly a decade, and it was notable given the Trump administration’s business-friendly approach to regulatory issues. But the proposal is likely to face a protracted legal battle, so it could be years in the making. The effort to cut off access to flavored e-cigarettes stopped short of a ban that the F.D.A. had threatened in recent months as it sought to persuade e-cigarette makers like Juul Labs to drop marketing strategies that might appeal to minors. The agency said it would allow stores to continue selling such flavored products, but only from closed off-areas that would be inaccessible to teenagers. (Kaplan and Hoffman, 11/15)

NPR: FDA Moves To Ban Menthol Cigarettes, Flavored Cigars
In a statement, FDA Commissioner Scott Gottlieb says the moves are aimed at fighting smoking among young people. Flavored e-cigarettes, menthol-flavored tobacco cigarettes and flavored cigars are all popular among teenagers. "Today, I'm pursuing actions aimed at addressing the disturbing trend of youth nicotine use and continuing to advance the historic declines we've achieved in recent years in the rates of combustible cigarette use among kids," Gottlieb says. (Stein, 11/15)

The Wall Street Journal: FDA Seeks Ban On Menthol Cigarettes
The FDA concluded in 2013 that menthols are harder to quit and likely pose a greater health risk than regular cigarettes. But it wasn’t until last year that the agency signaled it was considering a ban on menthol and other flavored tobacco products. (Maloney and McGinty, 11/15)

The Associated Press: FDA To Crack Down On Menthol Cigarettes, Flavored Vapes
Battery-powered e-cigarettes are more popular among teens than regular smokes and are considered safer. But many versions contain potentially addictive nicotine, and health officials believe they set kids who try them on a path toward regular cigarettes. Gottlieb called for additional steps to prevent the marketing of e-cigarettes directly to kids and online sales to minors. He also proposed beefing up measures to ensure that convenience stores and some other retailers do not sell e-cigarettes in kid-friendly flavors such as cherry and vanilla. They could still be sold in vape shops or other businesses that do not admit minors. (Stobbe, 11/15)

The Wall Street Journal: Youth Use Of E-Cigarettes Jumped 78%, Government Study Shows
Youth use of e-cigarettes soared between 2017 and 2018, thanks largely to the popularity of the Juul and similar thumb-drive shaped vaporizers, according to a federal survey released Thursday. The number of U.S. high-school students who used e-cigarettes rose 78% between the spring of 2017 and the spring of 2018 to 3.05 million, according to data from the National Youth Tobacco Survey. That is 20.8%, or one out of every five high-school students. (McKay, 11/15)

The New York Times: The Price Of Cool: A Teen, A Juul And Nicotine Addiction
He was supposed to inhale on something that looked like a flash drive and threw off just a wisp of a cloud? What was the point? A skeptical Matt Murphy saw his first Juul at a high school party in the summer of 2016, in a suburban basement crowded with kids shouting over hip-hop and swigging from Poland Spring water bottles filled with bottom-shelf vodka, followed by Diet Coke chasers. (Hoffman, 11/16)

The New York Times: She Couldn’t Quit Smoking. Then She Tried Juul.
Try as she might, Brittany Kligman couldn’t free herself of a pack-a-day cigarette habit, eight years in duration. And she ached to. She was mortified the time that a taxi driver sniffed as she entered his cab and remarked, “You’re a smoker, huh?” (And she had just showered!) She was getting more sinus infections. Because her chest felt uncomfortably tight when she exercised, she stopped high intensity interval training. Then SoulCycle classes. Finally, she quit working out. (Hoffman, 11/16)

The New York Times: Q&A: The ABCs Of E-Cigarettes
The term “electronic cigarette” refers to a battery-powered device that heats a tank or cartridge of liquid usually containing nicotine, flavorings and other chemicals, but not the cancer-causing tar found in tobacco cigarettes. Users inhale and exhale the vapor. The devices come in numerous shapes, including ones that look like pens, flash drives and hookahs. Many consumers are confused about the health implications of e-cigarettes. This is a primer about what research so far shows about these devices. (Hoffman, 11/15)

The New York Times: Gun Control Groups Eclipse N.R.A. In Election Spending
Amid a numbing succession of mass shootings, gun control groups outspent the National Rifle Association in the midterm election cycle, federal filings and additional reporting indicate, upending the usual order in the partisan battle over gun use. Two groups that are focused on gun control, Giffords and Everytown for Gun Safety, spent at least $37 million at the state and federal level in the midterms, compared with at least $20 million by the N.R.A. (Hakim and Shorey, 11/16)

The Associated Press: Florida School Massacre: Panel To Look At Medical Response
For months, members of the panel investigating Florida’s high school massacre have called the sheriff’s deputy assigned to guard the campus “a coward” for hiding and not rushing inside in an attempt to stop the shooter. Given an opportunity to confront his critics Thursday, now-retired Broward Sheriff’s Deputy Scot Peterson sent his attorney instead before the Marjory Stoneman Douglas High School Public Safety Commission. (Spencer and Fischer, 11/16)

ProPublica: Trump Administration Plots Costly Private-Care Expansion For Veterans
The administration is working on a plan to shift millions more veterans to private doctors and is aiming to unveil the proposal during Trump’s State of Union address in January, according to four people briefed on the proposal. The people spoke on the condition of anonymity because they weren’t authorized to disclose information about the administration’s plans. The cost of expanding private care is hard to predict, but VA officials have told Congress and veterans groups that it will range from $13.9 billion to $32.1 billion over five years, the four people said. Since the administration opposes lifting overall government spending, Democrats say the increased cost of private care will come at the expense of the VA’s own health system. Some lawmakers said the administration’s plan defies the purpose of the law they passed. (Arnsdorf, 11/15)

The Associated Press: Meditation Helps Vets With Post-Traumatic Stress Disorder
Meditation worked as well as traditional therapy for military veterans with post-traumatic stress disorder in a small experiment sponsored by the Department of Defense. One method preferred by the Department of Veterans Affairs is exposure therapy, but it doesn't work for everyone and many can't handle what it requires: purposely recalling traumatic events and confronting emotions. (Johnson, 11/15)

The Washington Post: GI Bill: Veterans Wait Months For Payments Because Of VA Technology Failures
Daniel Gorman knows what it’s like to return from war, and he wants to help fellow veterans come home, too: The former sailor turned New York National Guardsman is finishing a graduate degree in social work at Fordham University. But the Department of Veterans Affairs has thrown his fall semester into chaos by underpaying him without notice or explanation — making him one veteran among potentially tens of thousands on the GI Bill who have watched their bank accounts dwindle because of the agency’s ongoing technology failures. (Horton, 11/15)

Stat: An Industry Outsider Tries To Salvage Pharma's Bruised Reputation 
Patrick O’Connor wants to emphasize that he’s not running a shadowy pharma front group. That’s why he’s attached his name to the group, the Alliance to Protect Medical Innovation, even as most of its donors have remained in the dark. It’s why he keeps repeating that the industry trade group PhRMA is not involved. And it’s why he agreed to sit down with STAT for this story, even though he cast himself as uninteresting. O’Connor is the executive director of APMI, a coalition that aims to “help educate policymakers and the public about medical breakthroughs developed by the biopharmaceutical industry.” (Swetlitz, 11/16)

Stat: A Veteran Of Pharma And Biotech Reflects On A Startup, Drug Prices, And Politics
Tony Coles has degrees from Johns Hopkins, Harvard, and Duke. He’s a cardiologist by training and practiced medicine at Massachusetts General Hospital. He’s a Big Pharma veteran, having spent time in executive positions at Merck and Bristol-Myers Squibb.But Coles is probably best known for his work in the biotech world. He led NPS Pharmaceuticals for a time, and then in early 2008, he was named CEO of Onyx Pharmaceuticals. It’s in this role that Coles really left his mark. He took over as CEO of the cancer drug maker when it was on some shaky ground with investors and its partner, the German pharma giant Bayer. ...Now CEO of Yumanity Therapeutics, Coles stopped by STAT’s Boston headquarters for a chat. This interview has been condensed and edited for clarity. (Feuerstein, Garde and Robbins, 11/16)

Stat: As New Therapies Arrive, Pressure Builds To Figure Out How To Pay For Them
The launch of a handful of inventive cell and gene therapies is already testing players in the health care system to figure out how to pay for them. But the real strain could be five years away, when a wave of these pioneering treatments could enter the market and overwhelm the system. That explains the growing pressure on drug companies, insurers, and others to develop value-based pricing — a mechanism to determine how much value any given therapy will provide over time. (Joseph, 11/15)

Stat: This Biotech Wants To Make Daily Pills Last For A Week 
It’s still very early, but if the company succeeds, its product may tackle a perpetual problem: medication adherence. Many people don’t take their pills as prescribed for a variety of reasons — because they’re nervous about side effects or it’s too expensive or it’s too difficult to keep track of a given regime, for example. But some researchers have found that more people stick to the program when they only have to take a drug once a week rather than every day. (Sheridan, 11/15)

Stat: A Big Indian Generics Maker Failed An FDA Inspection, But How Bad Was It?
Two weeks ago, Dr. Reddy’s Laboratories released a very brief statement that the Food and Drug Administration had found some problems with a key plant where the drug maker hopes to produce several generic cancer medications. At the time, though, there were no details, but now the inspection report is available and the infractions do not appear to bode well for the company. During their visit last month to the facility in Visakhapatnam, India, FDA inspectors found what are called multiple repeat observations of various problems, which is regulatory parlance for manufacturing gaffes that were noted during previous inspections. In fact, half of the quality control problems that were seen had been spotted when FDA staff visited more than a year earlier. (Silverman, 11/15)

Stat: United Therapeutics Licenses Arena Hypertension Drug For Up To $1.2B
Arena Pharmaceuticals is handing off one of its drug candidates to United Therapeutics in exchange for an eye-popping $800 million upfront payment, the company announced Thursday. The deal could ultimately be worth up to $1.2 billion. United will receive most of the rights to ralinepag, which Arena has been testing for pulmonary arterial hypertension. The drug is currently in Phase 3 clinical trials. (Sheridan, 11/15)

The Associated Press: Smoke Spreading From California Fires Sparks Health Concerns
Smoke masks. Eye drops. No outdoor exercise. This is how Californians are trying to cope with wildfires choking the state, but experts say an increase in serious health problems may be almost inevitable for vulnerable residents as the disasters become more commonplace. Research suggests children, the elderly and those with existing health problems are most at risk. (Tanner, 11/15)

Los Angeles Times: Paradise Vows To Rebuild Even As Death Toll And Number Of Missing Rises
The number of people unaccounted for soared to 631 — up from 130 on Wednesday evening — after authorities combed through additional 911 calls and other reports generated at the peak of the chaotic evacuation. Honea said that number may include some people who are counted twice or others who may not know they were reported missing. (Tchekmedyian, Santa Cruz and Panzar, 11/15)

The Washington Post: Norovirus Sickens Camp Fire Evacuees In Chico California Shelter
Nearly two dozen people who evacuated to escape the devastating Camp Fire in Northern California have been sickened by a contagious virus that has spread through an emergency shelter, officials say. Lisa Almaguer, a spokeswoman for the Butte County Public Health Department, said Thursday in a statement that 21 people being housed at the Chico Neighborhood Church Shelter have tested positive for norovirus, an extremely contagious virus known to spread easily, causing vomiting and diarrhea. (Bever, 11/15)

Los Angeles Times: Made Homeless By Flames, Camp Fire Evacuees Face Hardship, Disease And Desperation
Don Hardin burrowed between blankets in his SUV, and switched on the heater whenever the shivers returned. Even during the day Thursday, the 81-year-old Camp fire evacuee, who has arthritis, struggled to stay warm. When temperatures dropped near freezing Wednesday night, Hardin popped a sleeping pill. (Santa Cruz, La Ganga and Gerber, 11/15)

The Washington Post: Camp Fire’s Destruction In Northern California Leaves Rescue Teams Sifting Through Debris For Human Remains
Wendy Bailey, a widow and retired stay-at-home mother, hunched over a charred bathtub, surrounded by ash, looking for any trace of human remains. It was her second day searching for victims of the ferocious wildfire that destroyed this city of about 26,000 residents last week, an effort that authorities say has become the largest search operation in California history. (Craig, 11/15)

The Hill: CDC: Suicide Rates Increasing Among American Workers
The suicide rate among Americans of working age increased 34 percent from 2000 to 2016, according to a report released Thursday by the Centers for Disease Control and Prevention. “Increasing suicide rates in the U.S. are a concerning trend that represent a tragedy for families and communities and impact the American workforce,” said Dr. Debra Houry, director of the CDC National Center for Injury Prevention and Control.  (Hellmann, 11/15)

CNN: These Jobs Have Highest Suicide Rates In The United States, According To The CDC
Men who work in construction and extraction had the highest rates of suicide in the United States, according to a report published Thursday by the US Centers for Disease Control and Prevention. For women, suicide rates were highest among those who work in arts, design, entertainment, sports and media. From 2000 to 2016, the suicide rate among the US working-age population -- people 16 to 64 -- increased 34%, the report says. (Thomas, 11/15)

NPR: Fish Oil And Vitamin D: Your Questions Answered
Nearly 19 million Americans take fish oil supplements and some 37 percent of us take vitamin D. Many may be motivated by research that has suggested these pills can protect heart health and prevent cancer. On Saturday, NPR published a story on long-awaited research on both supplements that called those claims into question. (Neighmond, 11/15)

The New York Times: Blacks Are Twice As Likely As Whites To Experience Sudden Cardiac Death
The rate of sudden cardiac death in African-Americans is twice as high as in whites, and no one knows why. Sudden cardiac death is an unexpected fatality from cardiac causes that happens within an hour of the onset of symptoms, usually with no known cause. (Bakalar, 11/15)

NPR: Nebula Genomics Aims To Speed Research And Lower Cost Of Genome Sequencing
A startup genetics company says it's now offering to sequence your entire genome at no cost to you. In fact, you would own the data and may even be able to make money off it. Nebula Genomics, created by the prominent Harvard geneticist George Church and his lab colleagues, seeks to upend the usual way genomic information is owned. (Harris, 11/15)

The New York Times: The ‘Geno-Economists’ Say DNA Can Predict Our Chances Of Success
In 1999, a trio of economists emerged from a conference at the University of California, Los Angeles, squinting without sunglasses in the unfamiliar sun, and began a slow walk through the hills overlooking the city. The three of them — a Harvard economist-in-training, Daniel Benjamin, and the Harvard economists Edward Glaeser and David Laibson — were reeling. They had just learned about a new field, neuroeconomics, which applies economic analysis to brain science in an effort to understand human choices. Now they were strolling through the taxonomy of midday joggers and dog-walkers in Los Angeles, talking all the while about how people become what they are. Benjamin recalls feeling very out of place. “Everyone was so beautiful,” he says. (Ward, 11/16)

Los Angeles Times: A Gut Bacterium As A Fountain Of Youth? Well, Let’s Start With Reversing Insulin Resistance
Move over Bifidobacterium and Lactobacillus. There’s a new health-promoting gut bacterium in town, and it’s called Akkermansia muciniphila. You will not find its benefits at the bottom of a yogurt cup. But a new study has identified more than one way to nurture its growth in the gut, and offered evidence that it may maintain — and even restore — health as we age. Published this week in the journal Science Translational Medicine, the new research found that in mice and monkeys whose metabolisms had grown cranky with age, taking steps to boost A. muciniphila in the gut reduced the animals’ insulin resistance. (Healy, 11/15)

Reuters: California Judge Orders Next Monsanto Weed-Killer Cancer Trial For March
A California judge on Thursday granted an expedited trial in the case of a California couple suffering from cancer who sued Bayer AG's Monsanto unit, alleging the company's glyphosate-containing weed killer Roundup caused their disease. The order by Superior Court Judge Ioana Petrou in Oakland, California, comes on the heels of a $289 million verdict in the first glyphosate trial in San Francisco, in which a jury found Monsanto liable for causing a school groundskeeper's cancer. (11/15)

The Associated Press: California Recommends Ending Use Of Chlorpyrifos On Most Crops
California regulators recommended new restrictions Thursday on a widely used pesticide blamed for harming the brains of babies. The Department of Pesticide Regulation issued temporary guidelines for chlorpyrifos that include banning it from crop dusting, discontinuing its use on most crops and increasing perimeters around where it's applied. (Melley, 11/15)

The Associated Press: Nurse’s Kidney Donation Triggers Bi-State Transplant Chain
A nurse’s decision to donate a kidney to a patient triggered a series of events that led to three people getting new organs at two Kansas City-area hospitals. Christa Jordan, a nurse at Children’s Mercy Hospital in Kansas City, Missouri, wanted to donate to her friend and patient, Dayshanae Hosman, who has a genetic condition called Alagille syndrome and went on dialysis in April, the Kansas City Star reported. (11/15)

The Associated Press: 150 Victims Detail Sexual Abuse By Ex-Doctor At Ohio State
A law firm hired by Ohio State University to investigate a former team doctor accused of sexual misconduct against athletes and students hopes to wrap up its fact finding by the end of the year. The investigators told the university’s governing board Thursday about 150 former students have given firsthand accounts of alleged sexual misconduct by the now-deceased doctor. The law firm says the allegations against Richard Strauss cover a time from 1979 through 1997. (11/15)