First Edition: October 9, 2019

Kaiser Health News: They Enrolled In Medical School To Practice Rural Medicine. What Happened?
The University of Kansas School of Medicine-Salina opened in 2011 — a one-building campus in the heart of wheat country dedicated to producing the rural doctors the country needs. Now, eight years later, the school’s first graduates are settling into their chosen practices — and locales. And those choices are cause for both hope and despair. Of the eight graduates, just three chose to go where the shortages are most evident. Two went to small cities with populations of fewer than 50,000. And three chose the big cities of Topeka (estimated 2018 population: 125,904) and Wichita (389,255) instead. (Weber, 10/9)

Kaiser Health News: Congenital Syphilis Continues To Rise At An Alarming Rate
In California, cases of congenital syphilis — the term used when a mother passes the infection to her baby during pregnancy — continued a stark seven-year climb, to 332 cases, an 18.1% increase from 2017, according to the federal data. Only Texas, Nevada, Louisiana and Arizona had congenital syphilis rates higher than California’s. Those five states combined made up nearly two-thirds of total cases, although all but 17 states saw increases in their congenital syphilis rates. (Barry-Jester, 10/8)

Kaiser Health News: Medicare Fraudsters Now Tap Telemedicine In Medical Equipment Scams
Dean Ernest had been living in a nursing home about a year when his son, John, got a call last winter asking if his father was experiencing back pain and would like a free orthotic brace. The caller said he was with Medicare. John Ernest didn’t believe him, said “no” to the brace and hung up. He didn’t give out his father’s Medicare number. And yet, not just one, but 13 braces arrived soon afterward at Ernest’s house in central Pennsylvania. (Knight, 10/9)

The New York Times: Supreme Court Considers Whether Civil Rights Act Protects L.G.B.T. Workers
In a pair of exceptionally hard-fought arguments on Tuesday, the Supreme Court struggled to decide whether a landmark 1964 civil rights law bars employment discrimination based on sexual orientation and transgender status. Job discrimination against gay and transgender workers is legal in much of the nation, and the wide-ranging arguments underscored the significance of what could be a momentous ruling. If the court decides that the law, Title VII of the Civil Rights Act, applies to many millions of lesbian, gay, bisexual and transgender employees across the nation, they would gain basic protections that other groups have long taken for granted. (Liptak and Peters, 10/8)

Reuters: U.S. Supreme Court Divided On LGBT Employment Protection; Gorsuch Could Be Key
The nine justices heard two hours of high-profile arguments in three cases that could broaden LGBT rights involving three workers - two gay and one transgender - who sued after being fired by their employers, claiming unlawful discrimination. The Supreme Court has never ruled on transgender rights. The court’s four liberal justices signaled agreement toward arguments by the plaintiffs that gay and transgender workers are covered under Title VII of the Civil Rights Act of 1964, which bars employers from discriminating against employees on the basis of sex as well as race, color, national origin and religion. (Hurley and Chung, 10/8)

The Washington Post: Trump Nominees Could Play Pivotal Role As Supreme Court Decides On Protections For Gay, Transgender Workers
The Supreme Court appeared divided Tuesday about whether federal discrimination laws protect gay and transgender workers, and President Trump’s appointments to the court could play the pivotal roles in deciding the outcome. (Barnes and Marimow, 10/8)

USA Today: Gay Rights: Supreme Court Divided In LGBT Job Discrimination Case
The court's four liberal justices forcefully denounced the firings of two gay men and a transgender woman from Georgia, New York and Michigan and made clear they believe all three should be protected by the statutory ban on sex discrimination. "We can't deny that homosexuals are being fired merely for being who they are and not because of religious reasons, not because they are performing their jobs poorly," Associate Justice Sonia Sotomayor said, calling it "invidious behavior." ... Gorsuch said sex was at least "in play," an acknowledgment that the gay and transgender workers claiming sex discrimination have a reasonable argument. What he did not say: that the courts should fix it. Instead, Gorsuch said the "massive social upheaval that would be entailed in such a decision" in the fired workers' favor points more toward Congress. "It's a question of judicial modesty," he said. (Wolf, 10/8)

Detroit Free Press: Michigan Case Has US Supreme Court Justices Struggling With Transgender Issues
Hearing the case of a transgender woman from Redford on Tuesday morning, several U.S. Supreme Court justices seemed to struggle to find a way to balance precedents against using sex stereotypes while maintaining separate gender-based rules for bathrooms, dress codes and programs meant to ensure equality. "There are other women ... who would feel intruded upon if someone who still had male characteristics walked into their bathroom," Justice Sonia Sotomayor said, questioning how the rights of non-transgender women could be balanced with those of transgender women. "The hard question is, how do we deal with that?" (Spangler, 10/8)

Reuters: Democratic Presidential Hopeful Sanders Says He Was 'Dumb' To Ignore Health Warnings
U.S. Senator Bernie Sanders said on Tuesday he had wrongly ignored warning signs about his health before suffering a heart attack last week, but that he did not think the scare would damage his campaign for president. Sanders, one of 19 Democrats competing to take on Republican President Donald Trump in the November 2020 election, suffered chest pains on Oct. 1 while in Nevada for a campaign stop and abruptly canceled campaign events. (Lewis, 10/8)

Los Angeles Times: Bernie Sanders To Slow Campaign Pace After Heart Attack
“I should have listened to those symptoms,” he said. “If there’s any message that I hope we can get out there, is that I want people to pay attention to their symptoms. When you’re hurting, when you’re fatigued, when you have pain in your chest, listen to it.” Sanders was speaking to a room of supporters in Las Vegas one evening last week when he stopped the event and asked for a chair. He was taken to a hospital, where doctors discovered he’d had a heart attack. They inserted two stents to clear a blocked coronary artery. He spent three days in the hospital. (Finnegan, 10/8)

The New York Times: Sanders Says He Will ‘Change The Nature’ Of His Campaign After Heart Attack
Senator Bernie Sanders, in a striking concession for a leading presidential candidate, said on Tuesday that he planned to slow down his pace on the campaign trail after suffering a heart attack a week ago, and acknowledged that voters would likely consider his health when deciding whether to support him. “I think we’re going to change the nature of the campaign a bit,” Mr. Sanders told reporters after a visit with a local cardiologist. “Make sure that I have the strength to do what I have to do.” (Ember and Martin, 10/8)

The New York Times: What Apes Can Teach Us About Our Heart Health
No chimpanzees or gorillas are in training for a fall marathon — a reflection, perhaps, of the ways in which the hearts of apes and men look and function as they do, according to a major new study of the health and evolution of cardiac muscles. The study, which involved scanning the hearts of untamed primates and a wide variety of men, indicates that hearts adapt in telling ways to the needs of their owners. The findings likewise suggest that not getting enough of the right kind of exercise could mean that our hearts start to look just a little bit less human, and could impact our long-term health. (Reynolds, 10/9)

The Associated Press: Lawsuits Around US Seek To Block Trump's Public Charge Rule 
The scene is playing out in courtrooms from coast to coast — federal judges being asked to block a new Trump administration policy scheduled to take effect next week that would deny legal permanent residency to many immigrants over the use of public benefits. Almost a dozen lawsuits have been filed from New York to California with plaintiffs including states, counties, cities, service providers and immigrants to prevent the "public charge" rule from taking effect on Oct. 15. (Hajela, 10/8)

The Associated Press: 3 Sexually Transmitted Diseases Hit New Highs Again In US
U.S. infections from three sexually transmitted diseases have risen for the fifth consecutive year. More than 1.7 million cases of chlamydia were reported last year. The infection rate rose 3% from 2017. It's the most ever reported in a year, though the trend is mainly attributed to increased testing. (10/8)

Reuters: CDC Says STD Cases In U.S. Rose To Record High In 2018 As Funding Lags
The rate of infection climbed steadily between 2014 and 2018, resulting in a 71% jump in the number of syphilis cases, a 63% increase in gonorrhea and a 19% rise in chlamydia during that period. Budget cuts at the state and local level resulting in staff reductions, clinic closures, less screening and patient follow-up has accounted for the increased disease rates, in addition to decreased condom use, health officials said. (10/8)

The New York Times: Sexually Transmitted Disease Cases Rise To Record High, C.D.C. Says
It said the increase in newborn deaths was a consequence of rising syphilis rates among women of reproductive age, whom it encouraged to practice safer sex and to get tested for S.T.D.s by their health care providers. “There are tools available to prevent every case of congenital syphilis,” Gail Bolan, director of the C.D.C.’s Division of S.T.D. Prevention, said in a statement. “Testing is simple and can help women to protect their babies from syphilis — a preventable disease that can have irreversible consequences.” There were more than 1,300 cases of syphilis cases among newborns in 2018, a 40 percent increase from the previous year, the center said. The 2018 figure represented a 185 percent increase since 2014. (Stack, 10/8)

Reuters: Cracks In Purdue's Proposed Opioid Settlement As Arizona Backs Out
The U.S. state of Arizona withdrew its support for a proposed nationwide opioid settlement with Purdue Pharma LP, saying the maker of OxyContin sought to "undermine material terms of the deal," according to a court filing on Monday. Since Purdue filed for bankruptcy protection in September, Arizona is the first state to switch sides in the looming showdown over the privately-held company's proposed settlement, which it has estimated is worth more than $10 billion. (Hals, 10/8)

The Associated Press: Arizona Now Has Misgivings About Purdue Opioid Settlement
Brnovich has not gone as far as backing out of the tentative settlement. His spokesman, Ryan Anderson, said the state is “not interested in renegotiating terms that we’ve already agreed upon.” He made waves in July, when he asked the U.S. Supreme Court to find that some of the Sackler money was fraudulently transferred from Purdue and to force family members to return it to the company so it could be part of any settlement with or judgment against the company. (Mulvihill, 10/8)

The Wall Street Journal: Arizona Wavers On Purdue Pharma Opioid Settlement Terms
In a statement, Arizona Attorney General Mark Brnovich said: “It’s in everyone’s best interest to secure a just and timely settlement. Purdue and the Sackler family need to take responsibility for their role in the opioid crisis.” Uniquely among the states, Arizona has challenged Purdue in the U.S. Supreme Court, filing an unusual lawsuit in the nation’s highest forum in July seeking to force the disgorgement of billions of dollars collected by Purdue’s shareholders. (Scurria, 10/8)

Bloomberg: Addicted Babies, Blue Cross Drive Billions In New Purdue Claims
Some of the biggest names in health care, including the Blue Cross & Blue Shield Association, will serve alongside mothers of addicted babies on a committee of creditors in the bankruptcy of Purdue Pharma LP. The unusual alliance is well positioned to play an outsized role in the coming bankruptcy battles between the pharmaceutical company and its opponents. Judges often rely on such official creditor committees to test the reorganization plans of bankrupt companies. (Church and Hill, 10/7)

The Wall Street Journal: Bill Aims To Combat Overdoses At New York Homeless Shelters
Homeless shelters would have to increase the level of on-site medical care they provide opioid-addicted clients under a bill being considered by the New York City Council. The bill, introduced by Councilman Stephen Levin, would require all shelters to have buprenorphine, an addiction medication, available on-site, in addition to at least one physician or physician assistant familiar with treating opioid addiction. Mr. Levin called the bill a response to the growing opioid epidemic, which has contributed to a recent spike in overdoses among the homeless population in the city. (Blint-Welsh, 10/8)

The New York Times: Bronx Teenager’s Death Is The Youngest Vaping Fatality In U.S.
A 17-year-old Bronx boy whose death was disclosed by New York State officials on Tuesday is the first teenager in the United States to die of a vaping-related illness, according to federal and state data. The teenager died on Friday after being hospitalized twice in September with a vaping-related illness, becoming the state’s first fatality from the mysterious lung disease, according to state health officials. (Shanahan and Paybarah, 10/8)

The Wall Street Journal: New York City’s First Vaping-Related Death Is A Bronx Teen
The health department is investigating the death and exploring the possibility that the person used both THC, the psychoactive ingredient in marijuana, and nicotine products, the health department said. “This vaping is a public health crisis. It is affecting our young people,” Mr. Cuomo said Tuesday at an unrelated news conference. “Parents have to know, young people have to know, you are playing with your life when you play with this stuff.” (West, 10/8)

The Associated Press: Teens To Share Their Vaping Experiences With Melania Trump
Melania Trump will hear directly from teens and young adults about their experiences with electronic cigarettes and vaping. The White House says she has invited a group from the Truth Initiative to participate in a "listening session" Wednesday. It will be the second time this week that the first lady has highlighted e-cigarettes and vaping among youth. (Superville, 10/8)

Los Angeles Times: Los Angeles Could Ban All E-Cigarettes And Vaping Devices
Los Angeles officials are considering banning all e-cigarettes and vaping devices in the city, one of the most extreme proposals yet to curb a nationwide outbreak of lung illnesses linked to vaping. Amid reports that more than 1,000 people have been diagnosed with severe lung problems, politicians across the country have been pushing restrictions on e-cigarettes, which have soared in popularity among young people in recent years. (Karlamangla, 10/8)

The Wall Street Journal: Alibaba To Suspend Sales Of E-Cigarettes, Accessories To The U.S.
Alibaba Group Holding Ltd. said Wednesday that it will suspend sales of e-cigarettes and accessories to buyers in the U.S., following a rash of vaping-related pulmonary illnesses and several deaths in the country. The move aims to address U.S. concerns with underage e-cigarette usage and potential public-health issues related to such products, Alibaba said. (Wang, 10/8)

Politico: Exclusive: Top Drug Lobbyist To Depart Next Year
The CEO of a leading drug industry lobby will depart at the end of 2020, he announced Tuesday, setting up the organization for a major transition as the pharmaceutical industry faces one of its toughest political environments in years. CEO Jim Greenwood will leave the Biotech Innovation Organization after 15 years atop the trade group, which represents companies ranging from Pfizer and Merck to startups that have no approved medicines. BIO also lobbies on behalf of biotechnology innovators in agriculture and energy. (Karlin-Smith, 10/8)

Stat: ICER Says Drug Price Hikes Without Proof Of New Benefits Cost U.S. $5.1B
During 2017 and 2018, drug makers raised prices on seven widely used medicines by large amounts, but without any new clinical evidence to justify the increases, leading patients and insurers in the U.S. to spend an added $5.1 billion, according to a new analysis. For instance, AbbVie (ABBV) boosted the price on its best-selling Humira rheumatoid arthritis treatment by 15.9%, after accounting for estimated rebates and other discounts, which caused Americans to spend an extra $1.86 billion than they would have if the company had not raised the price during that two-year period. (Silverman, 10/8)

The New York Times: Johnson & Johnson Hit With $8 Billion Jury Verdict In Risperdal Suit
A Philadelphia jury on Tuesday hit Johnson & Johnson with an $8 billion verdict over its marketing of the anti-psychotic drug Risperdal, siding with a Maryland man who argued that the health care giant downplayed risks that the drug could lead to breast growth in boys. The verdict in the Philadelphia Court of Common Pleas was the first to award punitive damages against Janssen Pharmaceuticals, a Johnson & Johnson subsidiary, said Thomas R. Kline, a lawyer who is part of a legal team representing the man and more than 10,000 people in similar lawsuits. (Zaveri and Thomas, 10/8)

The Associated Press: Johnson & Johnson, Risperdal Maker Hit With $8B Verdict
A law firm for the plaintiff released a statement Tuesday saying the companies used an organized scheme to make billions of dollars while illegally marketing and promoting the drug called Risperdal. Johnson & Johnson says the award “is grossly disproportionate with the initial compensatory award in this case,” and that the company is “confident it will be overturned.” (10/8)

The Wall Street Journal: J&J Hit With $8 Billion Jury Award Over Antipsychotic Drug
It was the biggest award to date among more than 13,000 lawsuits against J&J alleging that Risperdal caused a condition called gynecomastia in boys, which involves enlargement of breast tissue. The lawsuits generally claim that J&J was aware of the risk of this side effect, but understated the risk to doctors. It is also the latest in a series of costly legal setbacks for J&J in a slew of lawsuits alleging injuries from products and other claims. In August, an Oklahoma judge ordered the company to pay $572 million for contributing to the state’s opioid-addiction crisis. (Loftus, 10/8)

CNBC: One Medical, Backed By Alphabet, Has Hired Banks Ahead Of An IPO
One Medical, a chain of primary care clinics that’s backed by Google’s parent company Alphabet and tries to bring a modern feel to the typical doctor’s office, has hired banks including J.P. Morgan and Morgan Stanley for its IPO, according to people familiar with the matter. The company, which was valued at about $1.5 billion in a financing round last year, is expected to file its prospectus publicly by the first quarter of 2020 and possibly sooner, said the people, who asked not to be named because the plans are confidential. Representatives from One Medical, J.P. Morgan and Morgan Stanley all declined to comment. (Farr and Sherman, 10/8)

The New York Times: Pregnant Women Should Get Flu And Whooping Cough Shots, C.D.C. Says
Millions of pregnant women in the United States are not getting two vital vaccines that protect not only their health, but their babies, the Centers for Disease Control and Prevention said Tuesday. The vaccines — against flu and whooping cough — are strongly recommended during every pregnancy. But only about 35 percent of pregnant women in the country are receiving both vaccines, according to a new C.D.C. report, and just over half receive one. (Belluck, 10/8)

Stat: Large Numbers Of Pregnant Women Not Getting Key Vaccines, CDC Says
Getting these vaccines protects pregnant women. But the antibodies that are passed to the developing fetus protect their babies after birth as well, when they are too young to be vaccinated. Babies get their first shot of pertussis-containing vaccine at 2 months and can’t be vaccinated against flu until they are 6 months old. “It’s incredibly important,” said Dr. Cynthia Gyamfi-Bannerman, a maternal-fetal medicine specialist at NewYork-Presbyterian/Columbia University’s Irving Medical Center. “We have all seen pregnant women in the ICU with influenza.” (Branswell, 10/8)

The Associated Press: Doctors Turn To Thumbs For Diagnosis And Treatment By Text
Dr. Anna Nguyen spoke with none of the five patients she treated on a recent weekday morning. She didn't even leave her dining room. The emergency physician nevertheless helped a pregnant Ohio woman handle hip pain, examined a Michigan man's sore throat and texted a mom whose son became sick during a family trip to Mexico. Welcome to the latest wrinkle in health care convenience: the chat diagnosis. (10/8)

ProPublica: Feds To Investigate Hospital Alleged To Have Kept Vegetative Patient Alive To Game Transplant Survival Rates
The federal agency that oversees transplant programs said it would investigate Newark Beth Israel Medical Center after ProPublica reported that the hospital was keeping a vegetative patient on life support for the sake of boosting its survival rate. The U.S. Centers for Medicare and Medicaid Services “takes allegations of abuse and mistreatment seriously,” spokeswoman Maria LoPiccolo said in an email on Monday. “CMS is actively monitoring the situation and is in close communication with” New Jersey’s Department of Health, she added. The department said Friday that it was reviewing the allegations. (Chen, 10/8)

The Associated Press: California Eases Mandatory Sentences, Restricts Body Cameras
California will soon end some mandatory sentences, make it easier to expunge old criminal records, bar charging inmates for medical care and ban police from using facial recognition software on body cameras under more than two dozen criminal justice bills that freshman Gov. Gavin Newsom announced signing into law late Tuesday. The measures continue the state's march away from get-tough measures that once clogged California prisons, prompting a federal court-ordered population cap. (10/9)

The Associated Press: Assessor Of Biggest Arizona County Indicted On Fraud Charges
The assessor of Arizona's largest county has been indicted in connection with 11 felony offenses, including human smuggling, sale of a child and communications fraud in an adoption fraud scheme, authorities said. The Arizona Attorney General's Office confirmed the 32-count federal indictment Tuesday against Maricopa County Assessor Paul Petersen for conspiracy, theft, forgery, and 29 counts of fraudulent schemes, The Arizona Republic reported Tuesday. (10/9)

The Washington Post: D.C. Elementary School Student Diagnosed With Bacterial Meningitis
A student at a D.C. elementary school has been diagnosed with bacterial meningitis, prompting officials to alert parents of the diagnosis and urge them to have their children evaluated for the disease. An epidemiologist at the District’s Department of Health sent a letter Friday to parents whose children attend Burrville Elementary School in Northeast Washington and had been in contact with the infected student. Bacterial meningitis is a contagious and potentially deadly bacterial infection that leads to inflammation of the tissue that covers the brain and spinal cord. (Stein, 10/8)

The Wall Street Journal: PG&E Starts To Cut Power For Nearly 800,000 California Customers On Wildfire Risk
PG&E Corp. has begun to shut off power to hundreds of thousands of people in California as it seeks to prevent its electric lines from sparking more deadly wildfires, in what is believed to be the largest such pre-emptive blackout ever. The outages are poised to hit areas across the northern and central parts of the state, including the famous wine country region, the rural Sierra Nevada foothills and portions of Oakland and San Jose. (Blunt, Carlton and Ailworth, 10/9)

Los Angeles Times: Unprecedented Power Outages Begin In California As Winds Bring Critical Fire Danger
The blackouts will impact 34 counties in Central and Northern California. It would be the biggest power shutdown so far as utilities across the state attempt to reduce wildfire risk due to heavy wind. Utilities malfunctions have been tied to some of the state’s most destructive fires, including last year’s Camp fire, which devastated Paradise, Calif., and the 2017 wine country blazes. “It is a very blunt way of approaching the situation, but at the same time, there’s an understanding of why it’s being undertaken,” said Sonoma County Supervisor David Rabbitt, who noted PG&E’s announcement came on the second anniversary of the 2017 firestorm. “We have vulnerable populations, our elderly and young children. We’re mostly concerned about them.” (Serna, Cosgrove and McGreevy, 10/9)

The Wall Street Journal: Man Accused Of Killing Homeless Men In New York Investigated For Separate Attack
The 24-year-old man accused of killing four homeless men as they slept in lower Manhattan is being investigated for an assault on another sleeping homeless man a week earlier, New York Police Department officials said Tuesday. Investigators believe Randy Santos, who is accused of bludgeoning the four men to death early Saturday, used a stick in a separate incident on Sept. 27 to strike a man sleeping near the waterfront on Manhattan’s West Side, officials said. Mr. Santos is believed to have also tried to throw the man into the Hudson River, according to officials. (Chapman and Honan, 10/8)