First Edition: October 25, 2019

Kaiser Health News: Los Angeles Vape District A Black-Market Gateway
A five-block section of downtown Los Angeles that used to be part of the city’s Toy District has become ground zero for the nation’s counterfeit cannabis trade. While a few remaining stores sell fidget spinners and stuffed animals, the majority are hawking vape cartridges, e-juice flavors, vaporizers and other wholesale smoking and vaping supplies — including knockoffs that originated in China. (De Marco, 10/25)

Kaiser Health News: KHN’s ‘What The Health?’: All About Medicaid
Medicaid, the joint federal-state health program for people with low incomes, serves more than 70 million people, covers 1 in every 5 births in the U.S. and foots more than half the nation’s bill for long-term care. Yet Medicaid isn’t one program, it’s 56 separate programs (one for each state plus the District of Columbia and U.S. territories). Understanding Medicaid isn’t easy, but with plans to overhaul the health system back in the news, it’s critical. (10/24)

The Hill: Warren Faces Tough Choices On Funding 'Medicare For All' 
It’s the multitrillion dollar question everyone is trying to answer, including Sen. Elizabeth Warren (D-Mass.): How do you pay for “Medicare for All,” a proposal that would dramatically reshape the entire U.S. health care system? Warren, a Democratic candidate for president, says she will soon release a plan to pay for Medicare for All after facing criticism for evading questions about the proposal's potential tax implications for the middle class. (Hellmann, 10/24)

Los Angeles Times: Can Elizabeth Warren Afford To Be All In On 'Medicare For All'?
Warren is caught between two powerful forces. On the one side, progressives expect her to stick to her pledge to pursue a far-reaching plan similar to the one proposed by Sen. Bernie Sanders of Vermont. On the other, her identity as the candidate of detailed policies means she can’t easily avoid the fine print, which is full of political peril. “She’s painted herself into a corner,” said Gerald Friedman, a University of Massachusetts economist whose research is often cited to support Medicare for all. “She wants Medicare for all, but she didn’t think through the politics.” (Halper and Hook, 10/24)

The Washington Post: Economists Rush To Help Sen. Elizabeth Warren Solve Medicare-For-All Puzzle
Internal and external economic policy advisers are trying to help Sen. Elizabeth Warren (D-Mass.) design a way to finance a single-payer Medicare-for-all health-care system that would place every American on a government insurance program. Warren has promised more details within weeks, but her team faces a challenge in crafting a plan that would bring in large amounts of revenue while not scaring off voters with big middle-class tax increases. The proposal could cost more than $30 trillion over 10 years. Complicating matters, she has already committed all of the money she would raise from a new wealth tax, close to $3 trillion over 10 years, to several other ideas, including child care and student debt cancellation. (Stein, 10/24)

The Associated Press: Sanders Plans To Release Health Records By End Of Year
Democratic presidential candidate Bernie Sanders is planning to release his health records by the end of the year. The White House hopeful addressed his health Thursday in Iowa ahead of his first appearance in an early voting state since suffering a heart attack earlier in the month. The 78-year-old Vermont senator has repeatedly promised to release his health records at some point, but he outlined a likely timeline in an interview with The Associated Press. (Peoples, 10/24)

The Hill: O'Rourke Unveils Plan To Combat Opioid Epidemic 
Former Rep. Beto O’Rourke (D-Texas) unveiled a plan Thursday to address substance use disorders and end the opioid crisis as part of his 2020 presidential campaign. The plan would, among other things, look to end the stigma of substance abuse, focus on promoting long-term recovery, target the supply chain of illegally imported fentanyl and work to improve economic stability for those recovering from substance abuse. (Axelrod, 10/24)

Politico's Pulse Check: Meet John Marty — The 'Bernie Sanders Of Minnesota'
John Marty ran for state Senate in Minnesota in the 1980s because he wanted to achieve social change. More than 30 years later, single-payer health care has become his defining mission — and Marty says that his local battle has been supercharged by Bernie Sanders and the national Medicare for All movement. POLITICO's Dan Diamond looked at the political dynamics around Medicare for All and then sat down with Sen. Marty to discuss his policy, strategy and the difficult trade-offs behind single-payer. (10/24)

Stat: Nonpartisan Congressional Report Suggests Pelosi’s Drug Pricing Bill Could Be Found Unconstitutional
House Democrats’ signature drug pricing legislation could run afoul of not one, not two, but three separate parts of the U.S. Constitution, Congress’ own legal experts write in a new report. The Oct. 21 Congressional Research Service report obtained by STAT states that H.R. 3, which would allow the government to negotiate over drug prices and levy huge fines on companies who refuse, might run afoul of the Fifth and Eighth Amendments, as well as Congress’ taxing power under the Constitution. (Florko, 10/25)

The Associated Press: Tally Of Children Split At Border Tops 5,400 In New Count
U.S. immigration authorities separated more than 1,500 children from their parents at the Mexico border early in the Trump administration, the American Civil Liberties Union said Thursday, bringing the total number of children separated since July 2017 to more than 5,400. The ACLU said the administration told its attorneys that 1,556 children were separated from July 1, 2017, to June 26, 2018, when a federal judge in San Diego ordered that children in government custody be reunited with their parents. (Spagat, 10/24)

The Wall Street Journal: Number Of Family Separations At U.S. Border Higher Than Previously Known
The watchdog report found that the government hadn’t properly accounted for the number of children separated from their parents before the same court ordered them to stop the practice in the summer of 2018. Government investigators also found that federal agencies didn’t have a system to identify children who had been taken from adults throughout the implementation of the “zero tolerance” policy. The government initially resisted calls to locate the additional children cited by the watchdog report, and told the court it would take two years to pull together a list. The court instead gave the government six months. (Hackman, 10/24)

The Washington Post: ACLU Says 1,500 More Migrant Children Were Taken From Parents By The Trump Administration
The ACLU said the Justice Department disclosed the final tally — which is in addition to the more than 2,700 children known to have been separated last year — hours before a federal court deadline to identify all children separated since mid-2017, the year President Trump took office. U.S. District Judge Dana M. Sabraw in San Diego gave the Trump administration six months in April to disclose the names to the ACLU, which is trying to track down all the families and learn whether they have been reunited. (Sacchetti, 10/24)

Politico: Top Trump Aide Suppressed VA Whistleblowers, Department Investigator Finds
A political operator who led an office created by President Donald Trump to expose wrongdoing at the Department of Veterans Affairs used his position to quash whistleblowers and retaliate against foes, according to an inspector general report released Thursday. The accusations involve Peter O’Rourke, who Trump appointed in 2017 to lead the new Office of Accountability and Whistleblower Protection, and his successor, Kirk Nicholas. (Allen, 10/24)

NPR: U.S. Travel Ban Disrupts The World's Largest Brain Science Meeting
When Sepiedeh Keshavarzi was getting her medical degree in Tehran, she often read research papers by prominent scientists in the U.S. "It was my dream at some point when I was much younger to do research in the States," she says. Not anymore. (Hamilton, 10/24)

The Washington Post: Governor: Ohio Making Plans To Divide Future Opioid Dollars
Some 100 lawyers and government officials from across Ohio have made a “positive start” on deciding how millions of dollars that communities might receive through national opioid litigation settlements should be spent, said Gov. Mike DeWine. DeWine said a meeting he convened Wednesday involving the state attorney general, lawyers for cities and counties and various state and local officials may serve as a national model. “Everyone had the same goal, which is really to be united and have a united front as we move forward in future negotiations,” the governor told The Associated Press in a phone interview. (Smyth, 10/24)

Reuters: Several States Wary Of $48 Billion Opioid Settlement Proposal
Several U.S. states that have been ravaged by the opioid epidemic are pushing back on a proposed $48 billion settlement framework that would resolve thousands of lawsuits against five drug companies accused of fueling the addiction crisis. The proposal would bring an end to all opioid litigation against AmerisourceBergen Corp, Cardinal Health Inc and McKesson Corp, drugmaker Teva Pharmaceutical Industries Inc, and Johnson & Johnson. (Hals and Raymond, 10/24)

NPR: Citing Billions In Charity Care For Addiction, Some Hospitals Sue Drug Makers
While thousands of cities and counties have banded together to sue opioid makers and distributors in a federal court, another group of plaintiffs has started to sue on their own: hospitals. Hundreds of hospitals have joined up in a handful of lawsuits in state courts, seeing the state-based suits as their best hope for winning meaningful settlement money. (Farmer, 10/24)

NPR: What Are The Real Costs Of The Opioid Epidemic?
There's a reckoning underway in the courts about the damage wrought by the opioid crisis and who should pay for it. Thousands of cities and counties are suing drug makers and distributors in federal court. One tentative dollar amount floated earlier this week to settle with four of the companies: $48 billion. It sounds like a lot of money, but it doesn't come close to accounting for the full cost of the epidemic, according to recent estimates — let alone what it might cost to fix it. (Simmons-Duffin, 10/24)

The Associated Press: Meth Is Most Common Drug In Overdose Deaths In Chunk Of US
Fentanyl is driving drug overdose deaths in the U.S. overall, but in nearly half of the country, it's a different story. Meth is the bigger killer, a new government report shows. Nationwide, most deaths still involve opioid drugs like fentanyl and heroin. But in 2017, the stimulant meth was the drug most frequently involved in deaths in four regions that include 19 states west of the Mississippi. (Stobbe, 10/25)

Bloomberg: Trump Considers Retreat From Ban Of Mint, Menthol Vaping Flavors
The Trump administration is considering backing away from a pledge to ban popular mint and menthol vaping products -- part of an effort to stem use among kids and curb a growing health crisis -- as e-cigarette advocates press to preserve some flavors for adults. Health and Human Services Secretary Alex Azar said last month that the administration would soon ban all flavors of vaping products except tobacco-flavor. But the administration is reconsidering on mint and menthol, two people familiar with discussions said. They asked not to be identified because no decision has been made. (Wingrove, Porter and Cortez, 10/25)

The Associated Press: Vaping-Related Illnesses In US Still Rising, But More Slowly
Fewer reports of vaping illnesses are coming in, but U.S. health officials say they are not sure what to make of it. The Centers for Disease Control and Prevention said 125 additional cases were reported in the last week, bringing the total to 1,604 in this year's outbreak. That includes 34 deaths, one more than last week. The outbreak is still happening, but the count of new cases has dropped for three straight weeks. A CDC spokeswoman said reporting delays could be one explanation. (Stobbe, 10/24)

Reuters: U.S. Vaping-Related Deaths Rise To 34, Cases Of Illness To 1,604
The deaths have occurred in 24 states, as of Oct. 22, among people whose ages ranged from 17 to 75 years. Investigators have not linked the cases to any specific product or compound, but have pointed to vaping oils containing THC, the psychoactive ingredient in marijuana, as being especially risky. (10/24)

The Wall Street Journal: Vaping-Related Illnesses Rise To 1,604, CDC Says
“People five months ago were talking about these fake cartridges that were being sold,” said Yulin Hswen, a computational epidemiologist at Boston Children’s Hospital and Harvard Medical School who collected and analyzed the data. “In the comments five months ago, they were saying these oils are bad.” The number of cases grew by 125 this week, a smaller increase than the week before. (Abbott, 10/24)

The Washington Post: D.C. Reports First Vaping-Related Death
D.C. health officials on Thursday reported the city’s first death associated with vaping. In a statement, the D.C. health department confirmed the fatality, saying more than 1,600 cases of lung injury related to e-cigarettes or vaping have been reported to the Centers for Disease Control from all states but Alaska. The victim was not identified by D.C. authorities. (Moyer, 10/24)

NPR: Vaping Devices Now Being Collected On National Prescription Drug Take Back Day
In the wake of vaping-related deaths and illnesses, the Drug Enforcement Administration is expanding "National Prescription Drug Take Back Day," and this year allowing people to drop off electronic vaping devices and cartridges. The annual event lets people anonymously dispose of expired, unused, and unwanted prescription medications at collection sites across the U.S. (Treisman, 10/25)

The Associated Press: Fewer US Children In Foster Care; First Drop Since 2012
The number of children in the U.S. foster care system has dropped for the first time since 2012, stemming a surge that was linked to substance abuse by parents, according to new federal data released on Thursday. The annual report from the Department of Health and Human Services counted 437,283 children in foster care as of Sept. 30, 2018, down from about 441,000 a year earlier. (10/24)

Stat: An Alzheimer's Patient On The 'Roller Coaster' Of Biogen's Clinical Trial
Biogen’s decision to revisit a once-failed treatment for Alzheimer’s disease came as a shock to scientists, doctors, and investors alike. For Debby Rosenkrantz, the surprise came with a bit of hope. Rosenkrantz, 66, was a volunteer in one of Biogen’s studies on the treatment aducanumab, the studies it terminated in March after concluding the drug had no hope of working. (Garde and Feuerstein, 10/25)

Reuters: FDA Investigating Whether Zantac Causes Carcinogens To Form In Users
The U.S. Food and Drug Administration is investigating whether the popular heartburn drug Zantac causes carcinogens to form in the bodies of users, in an effort to fully understand the risks posed by the already recalled drug, the agency's spokesman said on Thursday. The issue of whether ranitidine, commonly known as Zantac, causes levels of the probable carcinogen N-nitrosodimethylamine (NDMA) to rise in users' bodies has been raised previously by Valisure, an online pharmacy that originally flagged the potential contamination of ranitidine to the FDA. (Erman, 10/24)

The Associated Press: FTC Sues To Block Promoters Of Bogus Diabetes 'Cure'
Federal regulators are suing to block pamphlet and newsletter publishers from marketing a purported cure for diabetes and advertising claims that consumers can collect $1 trillion in "Congressional Checks" or "Republican Checks." In a lawsuit filed Thursday in Maryland, the Federal Trade Commission says publishers of "The Doctor's Guide to Reversing Diabetes in 28 Days" are falsely promising a cure for the disease without dietary changes or exercise. (Kunzelman, 10/24)

Reuters: Walmart, CVS And Rite Aid Pull 22-Ounce J&J Baby Powder Off Shelves
Three major U.S. retailers, including Walmart, are removing all 22-ounce bottles of Johnson & Johnson's baby powder from their stores, following the healthcare conglomerate's recall last week of some bottles due to possible asbestos contamination. CVS Health Corp said on Thursday it would remove the bottles from its online store as well, out of caution and to prevent customer confusion. The pharmacy chain said all other sizes of the talc would remain on its shelves. (10/24)

The Wall Street Journal: CVS To Halt Sales Of Some J&J Talcum Powder After Recall
Last week, J&J recalled about 33,000 bottles of Johnson’s Baby Powder because the U.S. Food and Drug Administration found a small amount of asbestos in a single bottle, a discovery that fueled existing concerns about the safety of the famous product. Asbestos can cause disease including a rare cancer called mesothelioma. A J&J spokesman said Thursday CVS informed the company it is temporarily removing the 22 oz. bottles of Johnson’s Baby Powder in response to the recall. Other Johnson’s Baby Powder products will remain in CVS stores, the J&J spokesman said. (Loftus, 10/24)

The Washington Post: Scientists Detected Racial Bias In A Product Sold By Optum, But The Problem Likely Extends To Algorithms Used By Major Health Systems And Insurers
A widely used algorithm that predicts which patients will benefit from extra medical care dramatically underestimates the health needs of the sickest black patients, amplifying long-standing racial disparities in medicine, researchers have found. The problem was caught in an algorithm sold by a leading health services company, called Optum, to guide care decision-making for millions of people. (Johnson, 10/24)

The Wall Street Journal: Researchers Find Racial Bias In Hospital Algorithm
Hospitals use the algorithm—from Optum, UnitedHealth Group Inc. health-services arm—to find patients with diabetes, heart disease and other chronic ailments who could benefit from having health-care workers monitor their overall health, manage their prescriptions and juggle doctor visits, according to the study published Thursday in the journal Science. Yet the algorithm gave healthier white patients the same ranking as black patients who had one more chronic illness as well as poorer laboratory results and vital signs. (Evans and Wilde Mathews, 10/24)

Los Angeles Times: How Computer Algorithms Help Spread Racial Bias In U.S. Healthcare
“We shouldn’t be blaming the algorithm,” said study leader Dr. Ziad Obermeyer, a machine learning and health researcher at UC Berkeley. “We should be blaming ourselves, because the algorithm is just learning from the data we give it.” An algorithm is a set of instructions that describe how to perform a certain task. A recipe for brownies is an algorithm. So is the list of turns to make to drive to your friend’s party. (Khan, 10/24)

The Washington Post: Countries’ Preparedness For A Pandemic Ranked In New Report
After an Ebola epidemic devastated West Africa in 2014, many countries took steps to boost their preparedness. But even as the risk of such outbreaks increases, no country — the United States included — is fully prepared to respond to a deliberate or accidental threat with the potential to wipe out humanity, according to a report assessing the efforts of 195 countries. The report, released Thursday, is the first comprehensive assessment of global health capabilities, giving countries an overall score based on several measures. (Sun, 10/24)

The New York Times: Scientists Were Hunting For The Next Ebola. Now The U.S. Has Cut Off Their Funding.
In a move that worries many public health experts, the federal government is quietly shutting down a surveillance program for dangerous animal viruses that someday may infect humans. The United Nations Environment Program estimates that a new animal disease that can also infect humans is discovered every four months. Ending the program, experts fear, will leave the world more vulnerable to lethal pathogens like Ebola and MERS that emerge from unexpected places, such as bat-filled trees, gorilla carcasses and camel barns. (McNeil, 10/25)

The Washington Post: Man With ‘Auto-Brewery Syndrome’ Acted Drunk Because His Stomach Made Alcohol
Police and doctors didn’t believe the 46-year-old man when he swore that he hadn’t had alcohol before he was arrested on suspicion of drunken driving. His blood alcohol level was 0.2, more than twice the legal limit for operating a car. He refused a breathalyzer test, was hospitalized and later released. But the facts remained in contention. Then researchers discovered the unusual truth: Fungi in the man’s digestive system were turning carbohydrates into alcohol — a rarely diagnosed condition known as “auto-brewery syndrome.” (Iati, 10/24)

Stat: A Serial Entrepreneur Wants His Portable MRI To Transform Medicine
In a nondescript building in this seaside town sits a prototype that could change the way that doctors use magnetic resonance imaging. Usually an MRI machine requires a giant, powerful magnet and must be encased in its own copper-shielded room. It is why the behemoths cost hundreds of thousands or even millions of dollars. But this device, from a startup called Hyperfine, is about the size of a luggage cart. It could be wheeled from one bed to another. (Herper, 10/25)

The Associated Press: Police Face Dilemma Over When To Take Suicidal Officer’s Gun
A law enforcement think tank wants police departments dealing with a suicide crisis in their ranks to rethink how they make one of their toughest decisions: when to take guns away from troubled officers. The recommendation to review gun-removal policies is contained in a new report by the Washington-based Police Executive Research Forum released in anticipation of a gathering of police chiefs this weekend in Chicago. (Hays, 10/24)

The New York Times: Fiber And Yogurt Tied To Lower Lung Cancer Risk
Eating yogurt and fiber may lower the risk for lung cancer. Fiber is the main source of prebiotics, the nondigestible foods that promote the growth of probiotics, and yogurt is a probiotic food. Scientists suspect that a healthy microbiome may explain the link. The study, in JAMA Oncology, pooled data from 10 studies of diet and lung cancer incidence involving more than 1.4 million adults. Over an average follow-up of eight years, they found 18,882 cases of lung cancer. (Bakalar, 10/24)

The New York Times: A Forecast For A Warming World: Learn To Live With Fire
Facing down 600 wildfires in the past three days alone, emergency workers rushed to evacuate tens of thousands of people in Southern California on Thursday as a state utility said one of its major transmission lines broke near the source of the out-of-control Kincade blaze in Northern California. The Kincade fire, the largest this week, tore through steep canyons in the wine country of northern Sonoma County, racing across 16,000 acres within hours of igniting. (Fuller and Pierre-Louis, 10/24)

The Washington Post: Pacific Gas And Electric Power Line Broke Before Kincade Fire Ignited In Sonoma County
A fast-moving wildfire, spurred by powerful winds, burned through Northern California on Thursday and forced thousands of people to evacuate parts of Sonoma County — the rural wine country 75 miles north of San Francisco that is still recovering from a deadly 2017 blaze. Pacific Gas & Electric, the state’s largest utility, told state regulators Thursday that a jumper on one of its transmission towers broke close to where officials say the Kincade Fire started, near Geyserville. (Thebault, Bellware and Freedman, 10/25)

Los Angeles Times: Fires Explode Across California, From Wine Country Vineyards To Southern California Subdivisions
Fueled by violent winds from the northeast, fires erupted on dry hills across California, tearing through oaks and vineyards in Sonoma County and burning homes hundreds of miles away in subdivisions near Santa Clarita. The extreme weather conditions will continue into this weekend, heightening both the fire threat and the likelihood of more widespread power outages as utilities try to prevent electrical lines from sparking more blazes. (Willon, Luna, Fry and Reyes-Velarde, 10/24)

Los Angeles Times: California Wildfires Map
The most recent fire is the Mines fire, which started today. It is 0% contained and has burned 35 acres so far. (10/24)

Reuters: Number Of Social Workers A Key Sticking Point In Chicago Teachers Strike
As the Chicago teachers strike enters a sixth school day on Thursday, negotiations are hung up in part on the question of how many social workers the third-largest U.S. school system can afford for its 300,000 students. Mayor Lori Lightfoot's administration has proposed doubling the current number of school social workers from about 400 over the next five years, while the Chicago Teachers Union wants the number tripled. (10/24)

The New York Times: It’s More Than Pay: Striking Teachers Demand Counselors And Nurses
In Chicago, it has become clear that teacher pay is not the primary sticking point in the negotiations; after all, the city has already agreed to a raise. The Chicago Teachers Union is asking that the district enshrine in its contract a promise to hire more counselors, health workers and librarians, and to free them from tasks outside of their core duties. Those professionals are also members of the union. (Goldstein, 10/24)

Los Angeles Times: Three Doctors Face Medical Discipline For Vaccine Exemptions, And More Could Be On The Way
A San Diego doctor is among three California physicians accused by the Medical Board of California of granting inappropriate childhood vaccination exemptions, but many more doctors across the state may be in for similar scrutiny. Earlier this week, the board released a formal charge of negligence against Dr. Tara Zandvliet for writing a vaccination exemption for a local girl based on inadequate documentation of an adverse medical history that would make inoculation too risky. (Sisson, 10/24)

The Associated Press: Idaho Makes It Harder To Change Gender On Birth Certificates
Idaho officials have made it more difficult for young transgender people to change the sex listed on their birth certificates despite a U.S. court ruling that appears to ban such obstacles. The Idaho Department of Health and Welfare released comments from the public Wednesday on a temporary rule requiring people younger than 18 to get approval from medical or mental health professionals before requesting the change. (10/24)

The Wall Street Journal: Lenox Hill Hospital’s Development Plan Opposed By Manhattan Neighbors
A $2 billion hospital redevelopment plan by Lenox Hill Hospital was dealt a blow Wednesday night as an Upper East Side neighborhood advisory body voted overwhelmingly against a proposed rezoning of the site. The development plan by the hospital, part of Northwell Health, would dramatically upgrade the hospital but also create two large towers in a tony residential area. The site occupies a city block stretching from Park to Lexington avenues, and from 76th to 77th streets. (West, 10/24)

The Wall Street Journal: Homeless Become More Visible In Austin, Sparking Political Clash
In 10 years of off-and-on homelessness, Rebecca Wallace has lived in the shadows of Texas’ capital city. Once, while living behind a shopping mall, she said a beating by a group of men put her in intensive care for weeks. Now, Ms. Wallace sleeps on an inflatable mattress under a freeway in the city’s busy tourist district, along with a growing number of other homeless people. (Findell, 10/24)