First Edition: November 5, 2018

Kaiser Health News: Quick: What’s The Difference Between Medicare-For-All And Single-Payer?
Across the country, catchphrases such as “Medicare-for-all,” “single-payer,” “public option” and “universal health care” are sweeping state and federal political races as Democrats tap into voter anger about GOP efforts to kill the Affordable Care Act and erode protections for people with preexisting conditions. Republicans, including President Donald Trump, describe such proposals as “socialist” schemes that will cost taxpayers too much. ... Voters have become casualties as candidates toss around these catchphrases — sometimes vaguely and inaccurately. (Young, 11/5)

Kaiser Health News: Tobacco Tax Battle Could Torch Montana Medicaid Expansion
Montana legislators expanded Medicaid by a very close vote in 2015. They passed the measure with an expiration date: It would sunset in 2019, and all who went onto the rolls would lose coverage unless lawmakers voted to reapprove it. Fearing legislators might not renew funding for Medicaid’s expanded rolls, Montana’s hospitals and health advocacy groups came up with a ballot measure to keep it going — and to pay for it with a tobacco tax hike. (Whitney, 11/5)

Kaiser Health News: Like Clockwork: How Daylight Saving Time Stumps Hospital Record Keeping
Modern technology has helped medical professionals do robot-assisted surgeries and sequence whole genomes, but hospital software still can’t handle daylight saving time. One of the most popular electronic health records software systems used by hospitals, Epic Systems, can delete records or require cumbersome workarounds when clocks are set back for an hour, prompting many hospitals to opt for paper records for part of the night shift. And it happens every year. (Lupkin, 11/3)

The Washington Post: In Final Pitch To Suburban Voters, It’s GOP Talk On Economy Vs. Democrats On Health Care
Republicans are entering the final days of the campaign with a message they hope will win over wavering suburban voters — the economy is booming, don’t let Democrats ruin it — while echoing President Trump in stoking fears about undocumented immigrants to try to rile the GOP base. Democrats are focused on female and independent voters angry with Trump, minorities and young people, hoping that coalition will turn out for the midterms and propel them to victory. The party has been especially focused on health care, warning that Republicans threaten a core provision of the Affordable Care Act — the protection for Americans with preexisting medical conditions. (DeBonis, 11/4)

Politico: Would Republicans Take Another Shot At Obamacare?
Republicans who just endured months of withering attacks over health care will face an immediate high-stakes decision if, against all odds, they keep control of the House and Senate: whether to mount one more bid to kill Obamacare that's almost certain to fail. The GOP believes it can't just walk away from an eight-year pledge to repeal the law, a promise the party's base still wants Republicans to keep despite Obamacare's relative new popularity. If an election-night shocker keeps Republicans in power — rebuking the conventional wisdom that voters will punish them for their Obamacare attacks — they might be emboldened to mount another repeal push without risking reprisals at the polls next time around. (Cancryn, 11/5)

The Washington Post: Midterm Elections: Mapping Out What Issues Americans Care About
We’re left wondering what issues have an enduring impact. Health care does, it turns out. We’ll get to other issues in a moment, but after Google provided us with search data for more than a hundred politics-related issues, there was one obvious pattern. In almost every county in almost every month for the past year, health care topped the charts. Medicare and Medicaid were perennially popular, as was mental health. (Van Dam, 11/3)

The Associated Press: AP Fact Check: Trump's Fabrications On Medicare, Immigrants
In the final days before pivotal midterm elections, President Donald Trump is painting a distorted picture of immigration while exaggerating his record of achieving economic gains for non-whites and improving health care for veterans. ... Meanwhile, on health care, Trump falsely suggests that Democrats would seek to destroy Medicare if they take control of Congress and overstates improvements he made to the Department of Veterans Affairs. (Woodward and Yen, 11/5)

Roll Call: GOP Candidates Are Hearing It From Constituents With Pre-Existing Conditions
Republicans have tried to contain the damage of their “repeal and replace” push as they defend their majorities in the midterm elections. In order to pull that off, the campaigns have had to find ways to discredit the sympathetic voices of people with complex medical needs who opposed their votes. These health care advocates include people who got engaged in advocacy for the first time because of Republicans’ attempts to dismantle the law. They are patients with serious health conditions who are covered through the law’s marketplaces and patients who rely on Medicaid. They worry that without the law they could go into bankruptcy or go without care. (Kopp, 11/2)

The Hill: Republicans Put In Bind Over Preexisting Conditions
New actions from the Trump administration are complicating efforts of vulnerable Republicans to show their support for pre-existing condition protections heading into Tuesday's midterm elections. The Trump administration moved last week to allow states to waive certain ObamaCare requirements and pursue conservative health policies that were previously not allowed under the Obama administration. (Weixel, 11/3)

The Associated Press: Health Care, Trump Among Diverse Stands Of Colorado Hopefuls
Republican treasurer Walker Stapleton has attacked his opponent in the race for Colorado governor, Democratic U.S. Rep. Jared Polis, as too radical and extreme for the rapidly growing state as the GOP tries to prevent a complete Democratic takeover of the Statehouse. ... Polis and his supporters largely view the race as a referendum on President Donald Trump, whom [Republican treasurer Walker] Stapleton has embraced. Trump’s efforts to dismantle former President Barack Obama’s health care law top the list of issues. “Health care is on the ballot. Social Security and Medicare are on the ballot,” Tom Perez, chairman of the Democratic National Committee, told activists while campaigning with Polis at Servicios de la Raza, a Denver community center. “You need guardrails here in Colorado.” (Anderson, 11/3)

The New York Times: ‘Big-City Rapper’ Vs. Weak On Health Care: How A Tossup Race Captures The Forces Driving The Midterms
The Democrats thought they had the most devastating weapon: a political video showing the Republican incumbent [in New York] hugging a young mother with a brain tumor and a spinal condition, and promising to protect her coverage of pre-existing conditions — only to vote for the Republican bill to repeal Obamacare weeks later. The Republicans, in turn, believed they had the most devastating piece of political tape: the Democratic challenger rapping a decade ago, using expletives and a racial epithet common among black rap artists, as he veered into controversial topics. The question: Which clip will prove more politically potent in America in 2018? (Goldmacher, 11/4)

Los Angeles Times: This Wrestling Villain Praises Hillary And Invokes Obamacare. Meet The Progressive Liberal, Who’s Body-Slamming His Way Through Trump Country
[Daniel] Harnsberger is the Progressive Liberal, a professional wrestler whose renewable energy politics and preening arrogance have riled supporters of President Trump across the Appalachian Mountains. He praises Hillary Clinton and invokes the Affordable Care Act. Worst of all he’s an outsider, a real estate agent from Richmond, Va., who drives south on weekends and slips on “blue wave” tights and a conceit that he’s better than out-of-work coal miners and Baptists with rifle racks in their pickups. (Fleishman, 11/4)

The New York Times: Where ‘Yes! To Affordable Groceries’ Really Means No To A Soda Tax
In the run-up to Election Day, residents of Washington and Oregon have been bombarded with similar messages from groups with names like Yes! To Affordable Groceries. The organizations have spent more than $25 million on commercials that feature plain-spoken farmers and penny-pinching moms urging support of ballot measures that would prohibit municipalities from taxing food sales. But what most voters don’t know is that Coca-Cola, PepsiCo and other American beverage companies are largely financing the initiatives — not to block taxes on staples like milk and vegetables but to choke off a growing movement to tax sugary drinks. (Jacobs, 11/2)

Los Angeles Times: The Pitched Election Battle Over Healthcare Is Personal For Many Southland Voters
A few short years ago, Kim Adams couldn’t have told you the name of her representative in Congress. That changed last year, when Republican Rep. Mimi Walters voted to repeal the Affordable Care Act as Adams watched live on C-Span from her home in Tustin. News cameras showed a smiling Walters taking a celebratory selfie in the White House rose garden after the vote on the Obama-era healthcare law. That, Adams said, made things personal. After she was diagnosed with multiple sclerosis in 1999, Adams lost her small business as her health deteriorated and she eventually got to a point where she could no longer afford her health insurance premiums. For three years, the single mother was uninsured and unable to get treated for her MS — until the Affordable Care Act kicked in. And her congresswoman had voted to take it away. (Kim, 11/4)

The Washington Post: AP Fact Check: Ad On Bacon’s Health Care Vote Is Partly True
Democrats hope Kara Eastman will unseat first-term Republican Rep. Don Bacon Tuesday in Nebraska’s most competitive U.S. congressional race, a district centering on the Omaha area where the GOP has reigned for 22 of the last 24 years. Democratic groups and politicians across the country are attacking Republican candidates for their health care record. It’s become a central issue in the campaign, with Republicans saying Eastman’s support for “Medicare for all” is too extreme and costly for taxpayers while Democrats argue Bacon has voted to strip benefits from the Affordable Care Act. (Seitz, 11/2)

The Wall Street Journal: Midterm Elections Could Test Health-Care ETFs
Investors this year have poured almost $9 billion into exchange-traded funds focused on health care, one of the main sectors that could feel an impact from the U.S. midterm elections on Nov. 6, according to ETF analysts. “Year-to-date, health-care ETFs have gathered shy of $9 billion across the globe, compared with less than $1.5 billion of inflows in 2017,” says Antoine Lesne, head of SPDR ETF research and strategy, Europe, Middle East and Africa, at State Street Global Advisors. “Within the sector, biotech has attracted the greatest investor attention, with inflows north of $2 billion,” he says. (Akhtar, 11/4)

The Associated Press: Virginia Facing High Unexpected Medicaid Costs
Virginia is facing a huge bill for unexpected Medicaid costs that hamper proposed new spending on things like school improvements or tax breaks for the poor. State officials said Friday that Virginia has about $460 million in unforeseen Medicaid costs. The new costs, first reported by the Richmond Times-Dispatch, are unrelated to Virginia’s recent decision to expand Medicaid eligibility to low-income adults under the Affordable Care Act. (Suderman, 11/2)

The Wall Street Journal: North Carolina Faces Hospital Fight Trying New Tack To Set Health-Care Payments
North Carolina wants to reshape how it pays for its workers’ health care—and save hundreds of millions of dollars—by scrapping the secret negotiations typically used to set rates with doctors and hospitals. The fate of the plan, from the state’s treasurer, is expected to be watched closely by other employers eager to stem rising health costs. But hospitals are already fighting back. At issue is the system that employers’ health plans have long used to determine how much they will pay doctors and hospitals. The payments are typically set through negotiations, conducted in secret, between health insurers and the hospital systems and physician groups. (Wilde Mathews, 11/4)

The New York Times: Poor Disaster Oversight Imperiled Nursing Homes, Senate Report Finds
A Senate inquiry faulted state and federal oversight for fatal heat strokes and chaotic evacuations at nursing homes after last year’s hurricanes, calling for tougher disaster preparedness standards on Friday. Officials with the Centers for Medicare and Medicaid Services, a federal agency that was a subject of the inquiry, have said they would clarify expectations for how nursing homes must maintain safe temperatures in emergencies. Officials added in an interview this week that they were actively seeking lessons from recent disasters. But they defended the agency’s new preparedness requirements for health care providers, which did not come under enforcement until just after last year’s hurricane season. (Fink, 11/2)

The New York Times: F.D.A. Approves Powerful New Opioid Despite Warnings Of Likely Abuse
The Food and Drug Administration on Friday approved a new form of an extremely potent opioid to manage acute pain in adults, weeks after the chairman of the advisory committee that reviewed it asked the agency to reject it on grounds that it would likely be abused. The drug, Dsuvia, is a tablet form of sufentanil, a synthetic opioid that has been used intravenously and in epidurals since the 1980s. It is 10 times stronger than fentanyl, a parent drug that is often used in hospitals but is also produced illegally in forms that have caused tens of thousands of overdose deaths in recent years. (Goodnough, 11/2)

The Wall Street Journal: Noting Military Potential, FDA Approves Powerful Painkiller Dsuvia
The FDA also said it had signed a memorandum of understanding with the Defense Department to expedite availability of medical products, particularly those used to treat injuries in battlefield settings. Others weren’t convinced that the drug’s benefits outweighed potential risks. “It is certain that Dsuvia will worsen the opioid epidemic and kill people needlessly,” Dr. Sidney Wolfe, founder and senior adviser of Public Citizen’s Health Research Group, said in a statement. (Burton and Armental, 11/2)

The Washington Post: FDA Approves Powerful Opioid Despite Fears Of More Overdose Deaths
FDA Commissioner Scott Gottlieb issued an unusual statement saying he would seek more authority for the agency to consider whether there are too many similar drugs on the market, which might allow the agency to turn down future applications for new opioid approvals. “We need to address the question that I believe underlies the criticism raised in advance of this approval,” Gottlieb wrote. “To what extent should we evaluate each opioid solely on its own merits, and to what extent should we also consider . . . the epidemic of opioid misuse and abuse that’s gripping our nation?” (Bernstein, 11/2)

The Associated Press: FDA OKs Powerful Opioid Pill As Alternative To IV Painkiller
The tiny pill was developed as an option for patients who pose difficulties for the use of IVs, including soldiers on the battlefield. The pill from AcelRx Pharmaceuticals contains the same decades-old painkiller often given in IV form or injection to surgical patients and women in labor. (Johnson, 11/2)

NPR: FDA Approves Potent New Opioid, Despite Abuse Concerns
In approving the drug, the agency skirted its normal vetting process, these critics say. Dsuvia is an unnecessary opioid, they say, and its size and potency will appeal to people looking to sell or misuse it. (Harper, 11/2)

Stat: The FDA, But With Guns: A Little-Known Team Tracks Down Counterfeit Drugs 
But this wasn’t an FBI sting or DEA operation. The lead agent in that hotel room was Spencer Morrison, of the Food and Drug Administration’s Office of Criminal Investigations. The OCI, it turns out, is staffed by 300 gun-toting officers, all of them employees of the same bureaucracy that issues food recall notices and verifies that medicines are safe and effective. But it is little-known in Washington or beyond. (Florko, 11/5)

The Associated Press: Feds Say Heroin, Fentanyl Remain Biggest Drug Threat To US
Drug overdose deaths hit the highest level ever recorded in the United States last year, with an estimated 200 people dying per day, according to a report by the U.S. Drug Enforcement Administration. Most of that was the result of a record number of opioid-related deaths. Preliminary figures show more than 72,000 people died in 2017 from drug overdoses across the country. About a week ago, U.S. Health and Human Services Secretary Alex Azar said overdose deaths, while still slowly rising, were beginning to level off, citing figures from late last year and early this year. (Balsamo, 11/2)

The Wall Street Journal: Therapy For Pregnant Women With Anxiety Offers Alternative To Medication
The group is part of Dr. Green and her colleagues’ treatment program for perinatal anxiety at St. Joseph’s Healthcare Hamilton. It is one of a small but growing number of psychological therapy programs that are specifically designed for pregnant and postpartum women who struggle with anxiety and depression. They address a critical need. While scientific studies have generally found that antidepressant medications are safe to use during pregnancy and breast-feeding, there are still some concerns about their impact on babies. Some doctors encourage women to avoid the drugs during the perinatal period, especially those patients with mild illness. And many women, even some with severe depression and anxiety disorders, simply refuse to take them while pregnant or breast-feeding. (Petersen, 11/3)

ProPublica: Illinois Child Welfare Agency Agrees To Stop Sending Children To Psychiatric Hospital Where Children Reported Abuse But Balks At Full Investigation
The state’s child welfare agency Friday agreed to stop sending children in its care to a Chicago psychiatric hospital where children have reported being sexually abused and assaulted, but said it would not seek the full independent investigation advocates had requested, setting up a possible court fight. The decision by the Illinois Department of Children and Family Services came one day after state lawmakers and the American Civil Liberties Union of Illinois demanded the agency allow an outside expert to conduct a comprehensive investigation of Aurora Chicago Lakeshore Hospital on the city’s North Side. (Eldeib, 11/2)

The Associated Press: Home Care Aide Claims Union Won't Let Her Cancel Membership
A California mother who cares for her disabled daughter sued a union representing home health care workers, claiming the group won’t let her cancel her membership. Delores Polk said in the lawsuit filed Thursday in Sacramento federal court that a telemarketer with the Service Employees International Union pressured her to join and failed to properly inform her that she could decline membership. The suit is the latest in a string of cases nationwide filed since the U.S. Supreme Court ruled that government workers can’t be forced to contribute to labor unions that represent them in collective bargaining. (Melley, 11/2)

The Washington Post: Ramon Vazquez: Woman Sues Surgeon For Removing Her Kidney During Back Surgery
Maureen Pacheco had expected to have a spinal procedure. It was April 2016, and she was told a surgeon would fuse together a couple of vertebrae in her lower back to help relieve pain believed to be from an injury she sustained in a car accident the previous year. However, when she woke up from surgery at Wellington Regional Medical Center in Wellington, Fla., she learned that the surgeon had done something else, according to court records. (Bever, 11/2)

USA Today: Daylight Saving Time: How 'Fall Back' Could Be Bad For Your Health
Daylight Saving Time ends and clocks will "fall back" an hour this weekend, giving Americans the feeling of an extra hour in the morning, which could negatively affect their health. "Ever since the institution of Daylight Saving Time, there has been controversy regarding whether it accomplishes its goals or not, and if so — at what cost," Timothy Morgenthaler, Mayo Clinic's co-director of the Center for Sleep Medicine, said in an email. Morgenthaler has reviewed about 100 medical papers related to how the time change could affect health. (May, 11/2)

NPR: We Just 'Fell Back' An Hour. Here Are Tips To Stay Healthy During Dark Days Ahead
When it comes to turning back the clocks on our devices, technology has us covered. Our smartphones automatically adjust. But our internal clocks aren't as easy to re-program. And this means that the time shift in the fall and again in the spring can influence our health in unexpected ways. "You might not think that a one hour change is a lot," says Fred Turek, who directs the Center for Sleep & Circadian Biology at Northwestern University. "But it turns out that the master clock in our brain is pretty hard-wired, " Turek explains. It's synchronized to the 24 hour light/dark cycle. (Aubrey, 11/3)

The Washington Post: Tracking People With Dementia Who Wander And Get Lost.
L.A. Found, which launched in this sprawling county in September, equips potential wanderers with trackable bracelets that, when activated by search crews, transmit a radio signal to handheld receivers placed in several Sheriff’s Department cruisers and helicopters. The battery-operated bracelets are available to anyone with Alzheimer’s disease, dementia or autism. The bracelets are nothing new. They are distributed by Project Lifesaver, a nearly 20-year-old nonprofit group based in Florida that has issued the white, watch-sized wristbands — each equipped with a radio transmitter — to hundreds of municipal public-safety agencies around the country. (Kuznia, 11/3)

The Washington Post: Yes Exercise Really Does Play A Role In Weight Loss
“Exercise isn’t really important for weight loss” has become a popular sentiment in the weight-loss community. “It’s all about diet,” many say. “Don’t worry about exercise so much.” This idea crept out amid infinite theories about dieting and weight loss, and it quickly gained popularity, with one article alone citing 60 studies to support and spread this notion like wildfire. The truth is that you absolutely can — and should — exercise your way to weight loss. So why is anyone saying otherwise? (Prologo, 11/4)

NPR: Why Scientists Are Teaching Dogs To ID Malaria From Sniffing Socks
So [British entomologist Steve Lindsay] set out to create the ultimate disease watchdogs — canines that can smell parasites living inside people. Then, as people hop off international flights, these watchdogs could take a few sniffs at each person's skin and paw at the people who might be carrying a parasite. "The person can be taken aside and possibly tested for the disease with a blood test," Lindsay explains. Sound far-fetched? Well, it might not be as far from reality as you would think. (Doucleff, 11/2)

Politico: The Diabetes Epidemic: Opportunities And Missed Opportunities
One in 3 adults in the United States, about 100 million people, are living with diabetes or prediabetes, according to the CDC. Another case is diagnosed every 21 seconds. The American Diabetes Association estimates the total cost of diagnosed diabetes, including lost productivity, reached $327 billion in 2017, a big jump from $245 billion just five years earlier. That’s roughly one-tenth of the astronomical $3.5 trillion in annual U.S. health expenditures. People with diabetes are at risk for other chronic conditions such as heart disease, as well as dangerous conditions including stroke, amputation, kidney failure and blindness. The challenge is finding ways of preventing diabetes when possible and managing it optimally when prevention fails. (11/2)