First Edition: September 10, 2019

Kaiser Health News: Hospital Giant Sutter Health Faces Legal Reckoning Over Medical Pricing
Economists and researchers long have blamed the high cost of health care in Northern California on the giant medical systems that have gobbled up hospitals and physician practices — most notably Sutter Health, a nonprofit chain with 24 hospitals, 34 surgery centers and 5,000 physicians across the region. Now, those arguments will have their day in court: A long-awaited class-action lawsuit against Sutter is set to open Sept. 23 in San Francisco Superior Court. (Gold, 9/10)

Kaiser Health News: Listen: Health Officials Warn People To Stop Vaping
As the number of patients combating mysterious lung illnesses grows, state and federal public health officials are warning people to stay away from e-cigarettes and vape pens, especially those obtained off the streets. As of Friday, public health officials were investigating more than 450 possible cases of severe pulmonary disease related to vaping, including five deaths, in 33 states, according to the Centers for Disease Control and Prevention. Investigators are looking into 60 possible cases in California, including one death. (9/9)

USA Today: Vape Maker Juul Under Fire For Safety, Teen Marketing Messages
Federal health officials warned electronic cigarette maker Juul Monday to stop saying vaping is safer than smoking because it hasn't complied with regulations that call on companies to prove that's true. The Food and Drug Administration also sent a letter to the company "expressing concern, and requesting more information" about the its outreach and marketing practices, especially to students, tribes, health insurers and employers, following congressional testimony this summer that included reported safety claims. (O'Donnell, 9/9)

The Wall Street Journal: FDA Warns Juul About Marketing Products As Safer Than Cigarettes
The FDA Monday said Juul hadn’t been forthcoming in producing the documents the agency had requested, noting that the company had turned over records to a congressional subcommittee that it hadn’t provided to the FDA. “We are reviewing the letters and will fully cooperate,” a Juul spokesman said. The House Subcommittee on Economic and Consumer Policy, in a July hearing, heard testimony from two teenagers who said that a Juul representative had given a presentation in their high school and told them that Juul’s e-cigarettes were “99% safer than cigarettes.” (Maloney, 9/9)

The Associated Press: Juul Warned Over Claims E-Cigarette Safer Than Smoking
The Food and Drug Administration also upped its scrutiny of a number of key aspects of Juul's business, telling the company to turn over documents about its marketing, educational programs and nicotine formula. The FDA action increases the pressure on the nation's best-selling vaping company, which has been besieged by scrutiny from state and federal officials since a recent surge in underage vaping. Federal law bans sales to those under 18. The FDA has been investigating Juul for months but had not previously taken action against the company. (Perrone, 9/9)

Reuters: Juul Warned By FDA Over Marketing Practices
Juul has already come under scrutiny for its marketing initiatives, including its use of social media influencers to promote its vaping devices, with the Federal Trade Commission launching an investigation last month. "The law is clear that, before marketing tobacco products for reduced risk, companies must demonstrate with scientific evidence that their specific product does in fact pose less risk or is less harmful," acting FDA Commissioner Ned Sharpless said in a statement. (9/9)

The New York Times: Juul Illegally Marketed E-Cigarettes, F.D.A. Says
In a second letter to Juul on Monday, the F.D.A. sought further documents about the company’s practices, details about some of its products, including nicotine-salt e-liquids, and any scientific evidence it has amassed to prove its claims. The agency singled out Juul’s ad campaign, “Make the Switch,” saying it may convey that its devices are less harmful than tobacco cigarettes and may also violate limits on health claims. The company’s switching campaign has also drawn fire from lawmakers and public health experts, who contend that the message implies that Juul’s products are a smoking cessation option. (Kaplan and Richtel, 9/9)

The Washington Post: FDA Warns Juul, Says It Marketed Vapes As Less Harmful Than Regular Cigarettes Without Agency Authorization
The FDA, in the letter to Burns, also said that in April 2018 it had asked the company for documents relating to marketing practices and research into marketing, effects of product design, public health impact and adverse experiences. But it said the company apparently provided Congress more documents than it gave the FDA. (McGinley, 9/9)

Politico: FDA Warns Juul For Marketing With Unproven Safety Claims
The agency has been under pressure to tighten restrictions on the e-cigarette industry. Sen. Dick Durbin (D-Ill.) has called on Sharpless to take such actions or resign. FDA inspected Juul offices late last year and seized documents tied to an earlier ad campaign. FTC has also launched a probe into Juul marketing practices, as has the House Oversight and Reform subcommittee on Economic and Consumer Policy. (Owermohle, 9/9)

Reuters: U.S. Doctors' Group Says Just Stop Vaping As Deaths, Illnesses Rise
The American Medical Association on Monday urged Americans to stop using electronic cigarettes of any sort until scientists have a better handle on the cause of 450 lung illnesses and at least five deaths related to the use of the products. The AMA, one of the nation's most influential physician groups, also called on doctors to inform patients about the dangers of e-cigarettes, including toxins and carcinogens, and swiftly report any suspected cases of lung illness associated with e-cigarette use to their state or local health department. (Steenhuysen, 9/9)

The Washington Post: Bloomberg To Spend $160 Million To Ban Flavored E-Cigarettes
Michael Bloomberg, the billionaire businessman and philanthropist who has financed efforts to combat tobacco use around the world for years, has a new target: e-cigarettes in the United States. Bloomberg Philanthropies announced Tuesday it would spend $160 million over three years to try to ban flavored e-cigarettes, which, it said, are specifically designed to entice kids to vape. (McGinley, 9/10)

The Associated Press: Delaware Probes 3 Possible Cases Of Vape-Related Lung Issues
Delaware health officials are investigating three possible cases of severe lung disease related to the use of electronic cigarettes and vaping. News outlets report the state health department is urging residents to stop vaping as cases of lung disease possibly linked to e-cigarettes pop up across the country. The Centers for Disease Control and Prevention says there have been 450 possible cases of lung disease related to vaping reported in 33 states. As many as five cases have ended in death. (9/10)

The Associated Press: Alabama Investigates 5 Cases Of Lung Disease Tied To Vaping
The Alabama Department of Public Health says it's investigating five reports of potentially severe lung disease associated with electronic cigarettes or vaping. The department told news outlets that it's evaluating the reports and will release information as it becomes available. A department statement says the group is joining other state health departments in requesting information from health care providers on any cases of suspected respiratory illness among patients who vape. (9/10)

Reuters: New York Governor Proposes Ban On Flavored E-Cigarettes
New York Governor Andrew Cuomo proposed legislation on Monday to ban flavored e-cigarettes statewide in an effort to protect young people from the unknown consequences of vaping. "Common sense says if you don’t know what you’re smoking, don’t smoke it," Cuomo told reporters at a news conference. "And right now, we don’t know what you’re smoking in a lot of these vaping substances," he said. (9/9)

The Washington Post: Firms Selling Vitamin E Acetate For Vaping Products Face New York Subpoenas
The companies are marketing and selling “thickening agents” that can be used in black market vaping products that contain THC, the active ingredient in marijuana that produces the high. Dealers have been using thickening agents to dilute THC oil in street and illicit products, industry experts said. These thickeners are being marketed and readily available on the Internet “as a cheaper, safer alternative that does not negatively impact flavoring or odor of existing products and can be used to cut vape products to any level of THC,” the governor’s office said in a news release. (Sun, 9/9)

The Washington Post: White House Weighs Controversial Plan On Mental Illness And Mass Shootings
The White House is considering a controversial proposal to study whether mass shootings could be prevented by monitoring mentally ill people for small changes that might foretell violence. Former NBC chairman Bob Wright, a longtime friend and associate of President Trump’s, has briefed top officials, including the president, the vice president and Ivanka Trump, on a proposal to create a new research arm called the Health Advanced Research Projects Agency (HARPA) to come up with out-of-the-box ways to tackle health problems, much like the Defense Advanced Research Projects Agency (DARPA) does for the military, according to several people who have been briefed. (Wan, 9/9)

The New York Times: Stores Could Just Ban Guns, But Open-Carry Foes Back Requests As A Step
David Amad, a gun rights activist and the vice president of Open Carry Texas, is not especially bothered by Walmart’s recent announcement that it is “respectfully requesting” that customers not openly carry guns into its stores. Mr. Amad said many of his group’s 38,000 members had carried their guns openly into Walmart stores since the retailer made the policy public last Tuesday. None have been asked to leave. “They are ducking the issue,” Mr. Amad said of Walmart. “They are trying to get the gun haters to leave them alone, while at the same time leave us alone when we carry in their stores.” (Corkery, 9/9)

The New York Times: Republicans Want Stricter Gun Laws. Republican Voters, That Is.
Vast majorities of Americans — Democrats and Republicans, men and women — support stricter gun laws, the polls found. They’re even open to the kinds of programs once considered dead on arrival in political circles, including banning sales of military-style assault weapons and creating a mandatory federal buyback program for those weapons. Perhaps most significantly, the issue is starting to scare people. (Lerer, 9/9)

Reuters: Democrats Press For Stricter U.S. Gun-Sale Checks, Trump Non-Committal
Democrats in the U.S. Congress pledged on Monday to intensify pressure for stricter gun-sale background check legislation, citing strong public backing for the measure, but received no sign of support yet from President Donald Trump. With Congress returning from a long summer recess, Senate Minority Leader Chuck Schumer and House of Representatives Speaker Nancy Pelosi again urged the Republican-controlled Senate to promptly approve a bill clamping down on unregulated gun sales through the internet and at gun shows. (9/9)

The Associated Press: NRA Sues San Francisco Over Terrorist Declaration
The National Rifle Association sued San Francisco on Monday over the city's recent declaration that the gun-rights lobby is a "domestic terrorist organization." The lawsuit, filed in U.S. District Court for the Northern District of California, accuses city officials of violating the gun lobby's free speech rights for political reasons and says the city is seeking to blacklist anyone associated with the NRA. It asks the court to step in "to instruct elected officials that freedom of speech means you cannot silence or punish those with whom you disagree." (Pane, 9/9)

The Washington Post: Pelosi Bill Aims To Negotiate Medicare Prices On Top 250 Drugs, Penalize Manufacturers That Don’t Comply
House Speaker Nancy Pelosi is expected to release an ambitious drug-pricing bill as early as this week that would allow the federal government to negotiate drug prices on hundreds of drugs in Medicare that do not have competitors and would offer those prices to all consumers, according to a summary of the bill obtained by The Washington Post. The House bill is a political marker for Democrats eager to show ahead of the 2020 presidential and congressional elections that they are willing to take significant measures to lower skyrocketing drug prices, which consistently poll as a top voter concern. (Abutaleb, 9/9)

Stat: Pelosi’s Drug Pricing Plan Is More Aggressive Than Expected
The plan is sure to please House progressives who have agitated for bold policy on drug prices but, at least as drafted, has almost no chance of winning conservative support. The plan allows the federal government to negotiate the price of 250 medicines and forces drug makers to offer those prices commercially. It appears to abandon a controversial proposal to use third-party arbitration for negotiating leverage. It would also dramatically alter the way Medicare divides responsibility for drug costs between pharmaceutical companies, insurers, and taxpayers. (Florko and Facher, 9/9)

The New York Times: Bernie Sanders Went To Canada, And A Dream Of ‘Medicare For All’ Flourished
In July 1987, Bernie Sanders, then the mayor of Burlington, Vt., arrived in Ottawa convinced he was about to see the future of health care. Years earlier, as his mother’s health declined and his family struggled to pay for medical treatment, he was spending more time attending to her than in classes at Brooklyn College, suffering through what his brother called “a wrecked year’’ leading to her death. Over time, he had come to believe that the American health care system was flawed and inherently unfair. In Canada, he wanted to observe firsthand the government-backed, universal model that he strongly suspected was better. (Ember, 9/9)

Stat: Frontrunner To Lead FDA, Dogged By Controversies, Has Developed Knack For Confronting Them
Before he interviewed with President Trump last week to become Food and Drug Administration commissioner, Dr. Stephen Hahn had only been here once in a formal capacity: to apologize to Congress. The veteran cancer researcher came to Capitol Hill in 2009 to take responsibility for years of botched care by a doctor under his supervision. Ninety-two U.S. military veterans had been implanted with radioactive “seeds,” meant to fight prostate cancer, at the wrong dose — or in the wrong organ entirely. (Facher and Florko, 9/10)

The Washington Post: NIH Opens Inquiry Into Management, Workplace Issues At Troubled Pharmacy
The National Institutes of Health has temporarily removed four senior officials at the pharmacy that serves its world-renowned hospital and launched an inquiry into management and personnel issues in the often-troubled department. Unlike a leadership shake-up at the 200-bed Clinical Center that followed reports of contaminated drugs in 2015, this investigation does not appear to involve patient safety problems in the pharmacy, which prepares drugs for patients treated at the hospital. Rather, it focuses on complaints against managers and a difficult workplace culture. (Bernstein, 9/9)

NPR: Federal Watchdog Warns EPA Is Failing To Enforce Lead Paint Abatement Rules
Lead-based paint was extremely popular in the early and mid-20th century — used in an estimated 38 million homes across the U.S. before it was banned for residential use in 1978. The risk didn't stop with the ban. Today, when older homes are renovated or repaired, contractors are required to take special precautions to avoid exposing residents to lead-laden dust and paint chips that are dangerous, especially to children and pregnant women. It's part of a broader set of environmental regulations meant to protect young people from lead exposure. (Hersher, 9/9)

Reuters: U.S. Judge Allows Public Nuisance Claim In Opioid Trial
The U.S. judge overseeing nationwide litigation concerning the opioid epidemic on Monday rejected Purdue Pharma LP's effort to dismiss claims that its activities caused a public nuisance. U.S. District Judge Dan Polster in Cleveland ruled six weeks before the first scheduled federal trial over the epidemic, in a case brought by Cuyahoga and Summit counties in Ohio. (9/9)

The Associated Press: Texas Shows Possible Future If Abortion Bans Take Effect
After seven states passed sweeping abortion bans this year, speculation soon arose about the potentially onerous travel burdens the laws could someday impose on women seeking to end unwanted pregnancies. Across a huge swath of West Texas and the Panhandle, there's no need for speculation. The nearest abortion clinics are more than 250 miles away, despite the region having several midsize cities and a population of more than 1 million people. (Crary, 9/9)

The Hill: Two Planned Parenthood Clinics To Close In Ohio After Funding Cuts 
Planned Parenthood on Monday announced that two of its clinics in Ohio will close later this month after losing state and federal funding. The organization blamed the closures on politicians who moved to "defund" Planned Parenthood for performing abortions. Neither of the two clinics performed the procedure, Planned Parenthood said. (Hellmann, 9/9)

NPR: Spravato May Ease Depression In Suicidal Patients
The depression drug esketamine, marketed as Spravato, appears to offer quick relief to people who are actively considering suicide. Esketamine, a chemical cousin of the anesthetic and party drug ketamine, reduced depression symptoms within hours in two large studies of suicidal patients, the drug's maker announced Monday. (Hamilton, 9/9)

The New York Times: Who’s Missing From Breast Cancer Trials? Men, Says The F.D.A.
In recent years, health officials have pushed aggressively to include more women in clinical trials of new drugs. Gone is the ban that once excluded women of childbearing age from participating in studies. Even scientists who work with animals are now encouraged to include mice and rats of both sexes. But when it comes to breast cancer, it is men who get short shrift. They are often excluded from clinical trials of new treatments. (Rabin, 9/9)

Reuters: Suicide Kills One Person Every 40 Seconds, Says WHO
Across the world, one person takes their own life every 40 seconds, and more people die by suicide every year than in war, the World Health Organization said on Monday. Hanging, poisoning and shooting are the most common suicide methods, the WHO said as it urged governments to adopt suicide prevention plans to help people cope with stress and to reduce access to suicide means. (9/9)

NPR: Telemedicine Aids Recruiting Of Psychiatrists And Access To Care
It used to take at least nine months for a patient to schedule an initial appointment with a psychiatrist at Meridian Health Services in Indiana. Now, it takes days, thanks to a program that allows doctors to connect over the Internet with patients, reaching those even in remotest corners of the state. That has also helped with recruitment. Over the last several years, Meridian's staff of psychiatric specialists, including nurse practitioners, tripled from four to 12. (Noguchi, 9/9)

The New York Times: Seeking An Obesity Cure, Researchers Turn To The Gut Microbiome
Dr. Elaine Yu, an endocrinologist at Massachusetts General Hospital in Boston, was inundated with volunteers when she put out a call a few years ago for overweight people who were willing to take part in a study of obesity and the microbiome. People as far away as Alaska and Hawaii were eager to enroll. But the most surprising part was what they were willing to do. The study required them to swallow capsules containing stool to test whether gut bacteria from lean donors could improve their metabolic health. (O'Connor, 9/10)

Reuters: Malaria Can Be Eradicated By 2050, Say Global Experts
Malaria can be eradicated within a generation, global health experts have said. In a major report on Sunday, 41 specialists said a future free of malaria - one of the world's oldest and deadliest diseases - can be achieved as early as 2050. (9/9)

NPR: Positive Relationships In Childhood Can Prevent Depression Later In Life
Plenty of research shows that adverse childhood experiences can lead to depression and other health problems later in life. But researcher Christina Bethell wondered whether positive experiences in childhood could counter that. Her research comes from a personal place. In the 1970s, in a low-income housing complex in Los Angeles, Bethell had a tough childhood. Sometimes she didn't have money for lunch. (Simmons-Duffin, 9/9)

The Associated Press: Americans Love Snacks. What Does That Mean For Their Health?
Americans are addicted to snacks, and food experts are paying closer attention to what that might mean for health and obesity. Eating habits in the U.S. have changed significantly in recent decades, and packaged bars, chips and sweets have spread into every corner of life. In the late 1970s, about 40 percent of American adults said they didn't have any snacks during the day. By 2007, that figure was just 10 percent. (9/9)

The Washington Post: New Survey Shows Heavy Psychological Toll For Virginia’s First Responders
A first-of-its-kind mental health survey of police, firefighters and 911 call dispatchers in Virginia finds that they experience suicidal thoughts at a rate of more than double the general population and that nearly a quarter suffer from work-related depression. The survey of nearly 4,900 first responders also found that nearly half couldn’t stop looking for threats even in their own homes, a common symptom for those who have been exposed to trauma. (Jouvenal, 9/10)

The Associated Press: California Governor Signs Vaccine Bills He Demanded
California Gov. Gavin Newsom signed bills Monday to crack down on doctors who write fraudulent medical exemptions for school children's vaccinations. The Democratic governor quietly acted less than an hour after lawmakers sent him changes he demanded as a condition of approving the bills, even as protesters outside his office chanted for him to veto the measures. (Thompson, 9/9)

The New York Times: Ex-USC Doctor Charged With Sex Abuse Surrenders License
George Tyndall, a former University of Southern California gynecologist charged with sexually assaulting patients, has surrendered his medical license, the state medical board announced Monday. Tyndall surrendered the license effective last Thursday, the board announced. His license would have expired next Jan. 31. (9/9)