First Edition: October 12, 2018

Kaiser Health News: Dementia And Guns: When Should Doctors Broach The Topic?
Some patients refuse to answer. Many doctors don’t ask. As the number of Americans with dementia rises, health professionals are grappling with when and how to pose the question: “Do you have guns at home?” While gun violence data is scarce, a Kaiser Health News investigation with PBS NewsHour published in June uncovered over 100 cases across the U.S. since 2012  in which people with dementia used guns to kill themselves or others.  The shooters often acted during bouts of confusion, paranoia, delusion or aggression — common symptoms of dementia.  Tragically they shot spouses, children and caregivers. (Bailey, 10/12)

Kaiser Health News: Fact-Check: Who’s Right On Protections For Preexisting Conditions? It’s Complicated 
Ensuring that people with preexisting health conditions can get and keep health insurance is the most popular part of the Affordable Care Act. It has also become a flashpoint in this fall’s campaigns across the country. And not only is the ACA, which mostly protects people who buy their own coverage, at risk. Also potentially in the crosshairs are preexisting conditions protections that predate the federal health law. (Rovner, 10/11)

Kaiser Health News: ‘Grossly Unfair’? Widower Takes Ban On Military Injury Claims To Supreme Court
More than four years after Navy Lt. Rebekah Daniel bled to death within hours of childbirth at a Washington state military hospital, her husband still doesn’t know exactly how — or why — it happened. Walter Daniel, a former Coast Guard officer, demanded explanations from officials at the Naval Hospital Bremerton, where his wife, known as “Moani,” died on March 9, 2014. He says he got none. No results from a formal review of the incident, no details about how the low-risk pregnancy of a healthy 33-year-old woman — a labor and delivery nurse herself — ended in tragedy, leaving their newborn daughter, Victoria, now 4, without a mom. (Aleccia, 10/11)

Kaiser Health News: Podcast: KHN’s ‘What The Health?’ Falling Premiums And Rising Political Tensions
The Trump administration announced that, for the first time, the average premium for a key plan sold on the federal health law’s insurance marketplaces will fall slightly next year. Federal officials said that changes they have made helped facilitate the reduction, but others argue that it was because more plans are moving back into those federal exchanges and making money. (10/11)

Kaiser Health News: Obamacare Premiums Dip For First Time. Some Call It A Correction.
The analysis by federal officials looked at the price of the second-lowest silver plan for a 27-year-old nonsmoker on the marketplaces. Those silver plans are used by the ACA to set subsidies. Open enrollment for 2019 runs from Nov. 1 through Dec. 15. (Galewitz and Appleby, 10/11)

The Washington Post: Premiums For Popular ACA Health Insurance Dip For The First Time
The average price tag for the most popular level of insurance sold in the Affordable Care Act’s federal marketplaces is dropping slightly, the first time the rates have stopped going up since the health plans were created a half-dozen years ago. In the 39 states that rely on HealthCare.gov, the monthly premium is dipping by 1.5 percent for 2019 in a tier of coverage that forms the basis for the ACA’s federal insurance subsidies, according to federal figures released Tuesday. (Goldstein, 10/11)

The New York Times: Premiums For Most Popular Type Of Obamacare Plan Will Drop Next Year
“Though the average decrease is small, it is a dramatic and very positive change from the double-digit increases experienced over the past two years,” said Seema Verma, the administrator of the Centers for Medicare and Medicaid Services, which runs the online marketplace serving 39 states. From 2017 to 2018, the benchmark rose 37 percent, officials said, and in the prior year it rose 25 percent. (Pear, 10/11)

The Wall Street Journal: Price Of Obamacare Insurance Plans Takes Surprise Drop
The new dynamic could muddle both parties’ political messages. The pattern of more moderate rate increases could hold in future years if the markets remain stable, but it’s uncertain how the spread of plans that don’t comply with the ACA, and the legal challenges to the health law itself, will affect insurer pricing in years to come. The data also confirm that insurers are expanding their presence in the ACA markets, after previous industry pullbacks. (Armour and Wilde Mathews, 10/11)

The New York Times: Hospitals Pummeled By Hurricane Michael Scramble To Evacuate Patients
Bay Medical Center, a 300-bed hospital in the center of town, was a tumultuous mess. Staff members were frantically working on Thursday to evacuate patients just as new ones showed up at the door. Hurricane Michael had strafed the place, blowing out windows and stripping some of the buildings in the sprawling complex down to their metal girders. Signage was strewn in the streets. Doctors, nurses and workers wandered outside, some crying, some looking for cell service. (Fausset, Fink and Haag, 10/11)

Stat: Even As They Scold Drug Distributors, Lawmakers Take Their Campaign Cash 
In this election season, lawmakers are taking on drug distributors with abandon, and many seem to relish the role. “I just want you to feel shame,” one member of Congress said in May to five executives of major drug wholesalers, which are accused of worsening the opioid crisis by dumping thousands of addictive painkillers into small towns. ... In the run-up to next month’s midterm elections, the country’s three largest distributors alone have given nearly $3 million to congressional campaigns. Key lawmakers from both parties — including many of the ones who publicly shamed the companies for their role in the crisis — have accepted the contributions eagerly. (Facher, 10/12)

Stat: Insurance Giant Will Require Medicare Beneficiaries To Try ‘Step Therapy’ 
One of the nation’s largest health insurers will use “step therapy” in some of its private Medicare plans next year, requiring patients to try cheaper drugs before pricey biologics and other costly medicines. The decision by UnitedHealthcare is among the first signs that insurers plan to take advantage of a Trump administration initiative that policymakers argue will bring down drug costs for consumers. (Swetlitz, 10/12)

Reuters: Pfizer Settles New York Probe Into 'Deceptive' Copay Coupons
Pfizer's coupons said consumers would "PAY NO MORE THAN" $15, $20 or $25 for Estring to treat vaginal atrophy, Quillivant XR and Quillichew ER for attention deficit hyperactivity disorder, and Flector patches for acute pain from minor injuries. New York Attorney General Barbara Underwood said this was "deceptive" because Pfizer buried limits on the total savings in the small print, and that thousands of consumers ended up paying much more. (Stempel, 10/11)

The Wall Street Journal: Walgreens’s U.S. Pharmacy Sales Climb
Walgreens Boots Alliance Inc. said growth in prescription volumes helped lift pharmacy sales in its latest quarter, as the company’s integration of Rite Aid stores expanded its foothold in the U.S. prescription market. Walgreens’s share of the U.S. retail prescription market this year has grown to a company record 21.7%, compared with 20.2% in 2017, Walgreens Chief Financial Officer James Kehoe said Thursday, citing data from health-care research firm Iqvia. (Chin, 10/11)

Modern Healthcare: Texas Fines Humana For Out-Of-Network Anesthesiology Bills
In an unusual enforcement action against an insurer for out-of-network billing, Humana will pay Texas a $700,000 fine for failing to maintain an adequate number of in-network anesthesiologists at its contracted hospitals in four counties. It's the latest development in a running national battle over surprise out-of-network bills, which a bipartisan group of U.S. senators recently targeted with draft legislation. The problem is particularly pronounced in Texas, which lacks a comprehensive system for shielding patients from contract disputes between insurers and providers, unlike California and other large states. (Meyer, 10/11)

The New York Times: Prescriptions For Millions Of Opioid Pills Lead To Charges Against 5 Doctors
It was not hard to tell when the doctor was in at the Staten Island office of Carl Anderson. Noisy crowds of people, some with visible signs of drug addiction, stood in long lines at all hours of the night, seeking prescriptions for oxycodone pills, the authorities said Thursday. Sometimes, the noise outside Dr. Anderson’s office got so loud that it prompted neighbors to call the police, and more than once ambulances were called to treat pill-seeking patients, a series of new indictments show. Several patients, including two of his employees, overdosed and died, the authorities said. (Weiser, 10/11)

The Wall Street Journal: ‘Drug Dealers In White Coats’
One of the doctors, Dante Cubangbang, 50 years old of Nassau County, is accused of selling more than 6 million oxycodone pills from a Queens medical center since January 2012, the most prescriptions of the narcotic in the state, Mr. Berman said.  Dr. Cubangbang, as well as one of his nurses and clinic employees, received more than $5 million dollars in cash for their dealings, Mr. Berman said. “Instead of caring for their patients, these doctors were drug dealers in white coats,” he said. “They hid behind their medical licenses to sell addictive, dangerous narcotics.” (Kanno-Youngs, 10/11)

The Washington Post: Percentage Of Young U.S. Children Who Don’t Receive Any Vaccines Has Quadrupled Since 2001
A small but increasing number of children in the United States are not getting some or all of their recommended vaccinations. The percentage of children under 2 years old who haven’t received any vaccinations has quadrupled in the last 17 years, according to federal health data released Thursday. Overall, immunization rates remain high and haven’t changed much at the national level. But a pair of reports from the Centers for Disease Control and Prevention about immunizations for preschoolers and kindergartners highlights a growing concern among health officials and clinicians about children who aren’t getting the necessary protection against vaccine-preventable diseases, such as measles, whooping cough and other pediatric infectious diseases. (Sun, 10/11)

The Associated Press: Thousands Of Young US Children Get No Vaccines, Survey Finds
"This is pretty concerning. It's something we need to understand better — and reduce," said the CDC's Dr. Amanda Cohn. Most young children — 70 percent — have had all their shots. The new estimate is based on finding that, in 2017, 1.3 percent of the children born in 2015 were completely unvaccinated. That's up from the 0.9 percent seen in an earlier similar assessment of the kids born in 2011. A 2001 survey with a different methodology suggested the proportion was in the neighborhood of 0.3 percent. (Stobbe, 10/11)

The New York Times: Most White Americans’ DNA Can Be Identified Through Genealogy Databases
The genetic genealogy industry is booming. In recent years, more than 15 million people have offered up their DNA — a cheek swab, some saliva in a test-tube — to services such as 23andMe and Ancestry.com in pursuit of answers about their heritage. In exchange for a genetic fingerprint, individuals may find a birth parent, long-lost cousins, perhaps even a link to Oprah or Alexander the Great. But as these registries of genetic identity grow, it’s becoming harder for individuals to retain any anonymity. (Murphy, 10/11)

The Associated Press: Study: DNA Websites Cast Broad Net For Identifying People
About 60 percent of the U.S. population with European heritage may be identifiable from their DNA by searching consumer websites, even if they've never made their own genetic information available, a study estimates. And that number will grow as more and more people upload their DNA profiles to websites that use genetic analysis to find relatives, said the authors of the study released Thursday by the journal Science. (Ritter, 10/11)

The Wall Street Journal: Researchers Identify Relatives From DNA Data Online
“Genetic privacy is becoming compromised over time,” said Eric Topol, a professor at the Scripps Research Institute in La Jolla, Calif., who is familiar with the researchers’ findings but wasn’t involved in the studies published Thursday. Genetic data can reveal private information that people don’t always want to share. DNA can be used to identify someone’s risk of a future medical condition, opening individuals and their children to possible discrimination or receiving information they don’t want to know. (Marcus, 10/11)

Los Angeles Times: So Many People Have Had Their DNA Sequenced That They've Put Other People's Privacy In Jeopardy
This new reality represents the convergence of two long-standing trends.One of them is the rise of direct-to-consumer genetic testing. Companies such as Ancestry.com and 23andMe can sequence anyone’s DNA for about $100. All you have to do is provide a sample of saliva and drop it in the mail. The other essential element is the proliferation of publicly searchable genealogy databases like GEDmatch. Anyone can upload a full genome to these sites and powerful computers will crunch through it, looking for stretches of matching DNA sequences that can be used to build out a family tree. (Netburn, 10/12)

NPR: Ancestry DNA Databases Can Help Police Identify Majority Of European Descendants
"It's kind of like each person in this database is a beacon that illuminates hundreds of distant relatives," Erlich says. "So it's enough to have your third cousin or your second cousin once-removed in these databases to actually identify you." And when the researchers combined their strategy with other information, such a specific geographic area or the approximate age of a person, they could quickly reduce a list of possibilities to just a few people. (Stein, 10/11)

The Washington Post: Even If You’ve Never Taken A DNA Test, A Distant Relative’s Could Reveal Your Identity
The idea that people who voluntarily spit into a tube and share their genetic data online to search for relatives could unwittingly aid law enforcement was thrust into the spotlight recently. This spring, genetic genealogy helped California police identify a suspected serial killer and rapist in a grisly, decades-old cold case. But the new study, published in the journal Science, drives home the reality that that instance was not an outlier; a majority of Americans of European descent could be matched to a third cousin or closer using an open-access genetic genealogy database. (Johnson, 10/11)

The Wall Street Journal: Can Typos Give Insight Into Your Mental Health?
The latest wearable technology can reliably track heart beats and notify users of any irregularities. Up next? Reliably tracking your brain and mental health. A team of researchers at the Center on Depression and Resilience at the University of Illinois at Chicago is working on technology that could monitor users’ mood and cognition—important indicators of mental-health stress—by tracking their typing patterns with an iPhone app called BiAffect. Initial research has found it is possible to predict episodes of mania and depression among users with bipolar and major depressive disorder based on changes in their typing habits. (Higgins, 10/11)

The New York Times: Every Older Patient Has A Story. Medical Students Need To Hear It.
Whatever the cluster of second-year students at Weill Cornell Medicine in New York expected to hear from an 82-year-old woman — this probably wasn’t it. At first, Elizabeth Shepherd, one of several seniors invited to meet with future doctors in an anti-ageism program called “Introduction to the Geriatric Patient,” largely followed the script. (Span, 10/12)

Reuters: C-Section Births Rise Rapidly To More Than 20 Percent Worldwide
Rates of caesarean section births almost doubled between 2000 and 2015 – from 12 to 21 percent worldwide - new research has found, with the life-saving surgery unavailable to many women in poor countries while often over-used in richer ones. The research, published in The Lancet medical journal on Thursday, found that 60 percent of countries overuse C-sections and 25 percent under-use them, suggesting that recommendations for their use in cases of medical need are widely ignored. (Kelland, 10/11)

The Washington Post: Scientists Grow Tiny Human Retinas In A Dish
Kiara Eldred sometimes compares her nine-month-long scientific experiments, growing tiny human retinas in a laboratory dish, to raising children. Eldred, a graduate student at Johns Hopkins University, starts by growing thousands of stem cells and feeding them nutrients and chemicals that will steer them to develop into the retina, the part of the eye that translates light into the signals that lead to vision. After two weeks of painstaking cultivation, those cells typically generate 20 to 60 tiny balls of cells, called retinal organoids. As they mature, these nascent retinas get dirty and slough off lots of cells, so they also need to be washed off when they’re fed every other day — at least for the first month and a half. (Johnson, 10/11)

NPR: Secrets Of Color Vision Emerge From Lab-Grown Human Retinas
The discovery, published Thursday in the journal Science, could help accelerate current efforts to cure colorblindness. It could also lead to new treatments for diseases including macular degeneration, the leading cause of vision loss. "It's important that we understand how nature controls the development of the retina so we can understand better why things go wrong in disease and how we can treat them," says Steven Becker, a scientist at the National Eye Institute. The newly published findings are a step in that direction, says Becker, who has no connection to the research. (Hamilton, 10/11)

The New York Times: Omega-3 Supplements May Ease Anxiety
Omega-3 supplements may help reduce anxiety symptoms, a review of studies has concluded. The analysis, in JAMA Network Open, concluded that people with clinically diagnosed anxiety disorders who took large doses of the supplement — up to 2,000 milligrams a day — benefited most. (Bakalar, 10/11)

The New York Times: Obesity Tied To Colon Cancer Risk In Younger Women
Obesity is linked to an increased risk for colorectal cancer in younger women, new research has found. Colorectal cancer rates have been increasing in people under 50 while declining in older people. No one knows why. In an observational study published in JAMA Oncology, researchers prospectively tracked the health of more than 85,000 women for 22 years, beginning when they were 25 to 42 years old. They found 114 cases of colorectal cancer in women under 45. (Bakalar, 10/11)

The New York Times: E.P.A. To Disband A Key Scientific Review Panel On Air Pollution
An Environmental Protection Agency panel that advises the agency’s leadership on the latest scientific information about soot in the atmosphere is not listed as continuing its work next year, an E.P.A. official said. The 20-person Particulate Matter Review Panel, made up of experts in microscopic airborne pollutants known to cause respiratory disease, is responsible for helping the agency decide what levels of pollutants are safe to breathe. Agency officials declined to say why the E.P.A. intends to stop convening the panel next year, particularly as the agency considers whether to revise air quality standards. (Friedman, 10/11)

The Associated Press: Abortion Clinic, Other Groups Seeking $1.5M From Kentucky
Kentucky’s only abortion clinic and two groups are asking for almost $1.5 million in legal costs from the state after winning a federal case over the clinic’s existence. The Courier Journal reports that lawyers for EMW Women’s Surgical Center of Louisville, Planned Parenthood of Indiana and Kentucky and the American Civil Liberties Union filed motions Thursday seeking legal expenses. (10/11)

The Associated Press: Michigan Doctor Charged In Legionnaires' Death Gets Accolade
A senior Michigan medical executive who is charged in the death of a man due to a Legionnaires' outbreak linked to Flint's lead-tainted water crisis has been recognized for her eminent career in health care. The Flint Journal reports that Dr. Eden Wells has been awarded the Roy R. Manty Distinguished Service Award. (10/11)

The Associated Press: Judge Issues Injunction Of Maryland Retiree Drug Dispute
A federal judge has ruled the state of Maryland can’t force state retirees onto a federal prescription drug plan until a lawsuit is decided. U.S. District Judge Peter Messitte issued the ruling this week. Four Maryland state retirees filed the lawsuit last month. They contend Maryland can’t force them to enroll in Medicare Part D when open enrollment begins Oct. 15. (10/11)

Los Angeles Times: L.A. Typhus Outbreak Adds Fuel To The Debates Over Homelessness And Housing
A man hospitalized for dehydration a few months ago at Los Angeles County-USC Medical Center started suffering a severe fever, and doctors weren’t sure why. The patient was homeless, a clue to doctors that he might have typhus. Every year people contract flea-borne typhus in Southern California, mostly in Los Angeles County. Doctors did a blood test. (Karlamangla, 10/11)