The New York Times: Republican Candidates Soften Tone On Health Care As Their Leaders Dig In
In advertisements, in debates and on the campaign trail, Republican candidates are abandoning their promise to “repeal and replace” the Affordable Care Act and are swearing that they never voted to undo protections for people with pre-existing medical conditions — and never will. But as the candidates seek to assuage voters who say health care is their top issue, their leaders are staying the course, setting up a collision between campaign promises and the party’s agenda should Republicans emerge from the midterms in control of Congress. (Edmondson, 10/18)

Los Angeles Times: GOP Lawmakers Who Voted For Years To Repeal Obamacare Now Campaigning To Save Popular Parts Of It
Republican lawmakers and candidates across the country are suddenly telling voters they’ll protect preexisting conditions rules, brushing aside the fact that many voted to repeal the Affordable Care Act dozens of times and that GOP leaders pledge to resume that fight in 2019. The shift reflects the growing popularity of Obamacare and Democrats’ success in using the issue to make a compelling closing argument in the midterm races. (Haberkorn, 10/18)

The Hill: McConnell Defends Trump-Backed Lawsuit Against ObamaCare 
Senate Majority Leader Mitch McConnell (R-Ky.) defended the Trump administration’s decision to join a lawsuit that seeks to overturn ObamaCare and its protections for people with pre-existing conditions. “It’s no secret that we preferred to start over" to repeal and replace Obamacare, McConnell said in a newly published interview with Bloomberg. “So no, I don’t fault the administration for trying to give us an opportunity to do this differently and to go in a different direction.” (Weixel, 10/18)

Politico: House GOP Leader McMorris Rodgers Faces Obamacare Backlash
Cathy McMorris Rodgers got an earful about health care on a recent Friday afternoon knocking on doors in the suburban Balboa neighborhood of Spokane. McMorris Rodgers, the top-ranking Republican woman in the House facing the toughest reelection contest of her career, heard one resident complain his wife’s monthly insurance premiums have swelled to over $700 per month. Another agonized about affording long-term care for her elderly mother. Yet another worried whether Medicare would go bankrupt. (Demko, 10/17)

Modern Healthcare: Will Republicans Keep Their New Promises On Pre-Existing Condition Protections? 
With their increasingly ardent campaign promises to protect health coverage for people with pre-existing medical conditions, House and Senate Republican candidates will face pressure to keep those commitments if they win in November. GOP leaders, including Vice President Mike Pence, say they want to try again in 2019 to repeal the Affordable Care Act. Last year's GOP repeal bills would have significantly weakened the law's provisions, letting states re-establish the use of medical underwriting by insurers. (Meyer, 10/18)

Kaiser Health News: Podcast: KHN’s ‘What The Health?’ Republicans’ Preexisting Political Problem
Ensuring that people with preexisting health conditions can get and keep health insurance has become one of the leading issues around the country ahead of this fall’s midterm elections. And it has put Republicans in something of a bind — many either voted to repeal these coverage protections as part of the 2017 effort in Congress or have signed onto a lawsuit that would invalidate them. (10/18)

And news on the elections comes out of New York, Massachusetts, Michigan and Arizona, as well —

The Associated Press: Hip-Hop, Health Care Share Spotlight In Pivotal House Race
Hip-hop, health care and Brett Kavanaugh have emerged as issues in a tight congressional race in New York's Hudson Valley that pits a freshman Republican congressman against a rapper-turned-corporate lawyer seeking his first political office. Democrat Antonio Delgado is running on universal access to Medicare, creating good jobs and eliminating tax loopholes for the rich. But his supporters say Republicans have instead obsessed over his brief rap career more than a decade ago, portraying Delgado, who is black, as a thuggish "big-city liberal" who denigrated police, women and American values. (Esch, 10/18)

Boston Globe: Business Groups Could Prove To Be Important Allies For Hospitals In Question 1 Battle
Hospital administrators found a natural ally in their efforts to thwart mandatory nurse staffing ratios: other executives. Question 1 looms large, with the statewide vote less than three weeks away. So prominent business groups are making their final push against the ballot question that would set standards for the maximum number of hospital patients that can be assigned to a nurse at any given time. (Chesto, 10/19)

Milwaukee Journal Sentinel: Candidates For Governor Talk About Trauma Care. But Is Either On Target?
Walker's state Department of Corrections sponsored 26 workshops for 135 guards and other prison staff on a concept called "trauma-informed care" — practices meant to sensitize government workers and social agencies to the prevalence of neurological trauma that stems from childhood exposure to neglect, abuse, violence, sexual assault, addiction or chronic stress. Data collected in the last decade show an epidemic of psychological trauma all across the American population — rural, urban and suburban. (Schmid, 10/18)

Arizona Republic: Medical Group Yanks Endorsement Of Debbie Lesko Over Phony Doctor Ads
The Arizona Medical Association did not endorse Hiral Tipirneni, a former emergency-room doctor who now works as a cancer-research advocate, but it did take back an endorsement for what it said was the first time in its history. The move capped a week of unrest among its members as they saw Tipirneni attacked in yard signs as a "fake doctor" and on TV as recently as Thursday as a "phony." (Hansen, 10/18)

The Washington Post: Trump Says ‘All Republicans’ Back Protections For Preexisting Conditions, Despite Repeated Attempts To Repeal Obamacare
President Trump expressed support Thursday for one of the most popular provisions of an Obama-era law protecting people with preexisting conditions, even as he has repeatedly promised to scrap the law and his administration is waging a legal fight to overturn it. “All Republicans support people with pre-existing conditions, and if they don’t, they will after I speak to them,” Trump said in a tweet Thursday afternoon. “I am in total support. Also, Democrats will destroy your Medicare, and I will keep it healthy and well!” (Sonmez, 10/18)

The Hill: Trump: All Republicans Will Support People With Pre-Existing Conditions 'After I Speak To Them'
“Did he drop his lawsuit to eliminate protections for those with pre-existing conditions and just not tell anybody?” tweeted Matt House, a spokesman for Senate Democratic Leader Charles Schumer (N.Y.). Trump also supported ObamaCare repeal bills in the House and Senate last year that would allow states to get waivers to allow insurers to spike premiums for people with pre-existing conditions. (Sullivan, 10/18)

The Wall Street Journal: Immigrant Children Are Staying Longer In Government Custody
Migrant children who come into the U.S. without family are staying longer in crowded shelters as authorities struggle to handle their growing numbers and to screen potential sponsors, according to government data and advocates. The average stay for unaccompanied minors who crossed the U.S.-Mexico border, most illegally, is now 59 days. That is up from 56 in June and 41 last year, according to the U.S. Department of Health and Human Services’ Office of Refugee Resettlement, which is caring for about 13,000 newly arrived immigrant children. (Caldwell, 10/19)

In other news —

Texas Tribune: Federal Appeals Court Finds Texas Foster Kids Were Endangered — But Strikes Down Some Attempts At Reform
A federal appeals court on Thursday once again confirmed what advocates and lower courts have said for years: There are major, troubling flaws in Texas’ child welfare system. But the judges also struck down many specific remedies that a lower court had proposed to target those problems. (Platoff and Walters, 10/18)

Texas Tribune: Study: Family Separations Causing A Mental Health Crisis In South Texas
The study was released Wednesday by Human Impact Partners, a California-based research group, and the community organization La Unión del Pueblo Entero. ...Around 1,800 children in the Valley had a parent deported by Immigration and Customs Enforcement in 2017, leading to what the study’s authors say is increased levels of "toxic stress" in the community. (Wiley, 10/19)

The Wall Street Journal: Opioid Makers Ask Counties For Proof Of Harm
Purdue Pharma LP has a request for counties suing the drug manufacturer for allegedly causing the opioid epidemic: Show us how we are to blame. As the number of opioid lawsuits against Purdue and other drug manufacturers reaches 1,500 and counting, the companies are pushing their adversaries to offer specific details to back up their claims. (Randazzo, 10/18)

Stat: Cardinal Health Pushed To Redo Executive Pay To Reflect Opioid Settlements
As the number of lawsuits over the opioid crisis mounts, Cardinal Health (CAH) is being pushed by members of an investor coalition to overhaul the way executive pay is calculated in order to reflect the potential cost of any settlements or fines. In a recently filed shareholder proposal, the International Brotherhood of Teamsters and a Rhode Island state pension fund argue the wholesaler should change its approach to tallying profits over concerns any possible payments will be substantial, and that Cardinal executives should bear some of the costs. To add more pressure, a letter is being sent to shareholder this week in advance of an annual shareholder meeting scheduled for Nov. 7. (Silverman, 10/18)

Stat: FDA Expert Panel Chair Defies His Panel For Endorsing Opioid Painkiller
In an unusual move, the chair of a Food and Drug Administration panel is defying a recommendation that his own panel made last week to endorse a powerful opioid painkiller, because he believes the drug represents a “danger” to public health. And to make sure his views are known, Dr. Raeford Brown, the panel chair, conveyed his concerns in a letter on Thursday to FDA officials. At issue is Dsuvia, which the FDA’s Anesthetic and Analgesic Drug Products Advisory Committee last Friday voted 10-to-3 to recommend for combating moderate-to-severe acute pain, but only for adults in medically supervised settings. (Silverman, 10/18)

In other news on the epidemic —

Reuters: Roseanne Character Dies Of Opioid Overdose As 'The Conners' Take Over
One of television's best-known families returned on Tuesday without its matriarch, as the character of feisty Roseanne Conner was killed off through an accidental opioid overdose. ... Audiences had last seen Roseanne Conner hiding an opioid addiction stemming from knee pain and about to undergo long-delayed, costly surgery. (Serjeant, 10/18)

Austin American-Statesman: Austin Addiction Treatment Company To Partner With Health Insurance Carrier
Horizon Healthcare Services Inc. will deploy MAP’s telehealth “Peer Recovery Support” service, the company said. The service aims to help patients and their families identify relapse behaviors and provide communication primarily through phone and video sessions. (Cobler, 10/18)

Kansas City Star: Kansas City Doctor John Verstraete Sentenced To One Year
A popular Kansas City doctor was sentenced to a year in federal prison at an emotional hearing Thursday for his role in prescription drug fraud. John Verstraete and employees at his office at 3215 Main St. had pleaded guilty to writing unnecessary prescriptions for human growth hormone and importing illegal steroids from overseas and then selling them on the black market. (Marso, 10/18)

The New York Times: Project Baseline Aims To Ward Off Illness Before We Get Sick
One of the sobering facts about cancer treatment is that it often begins when it is already too late: Studies show that an alarming number of treatable cancers are diagnosed in the advanced stages of disease. That has long bothered Dr. Sam Gambhir, a top cancer researcher at Stanford University who lost his teenage son to brain cancer in 2015. Dr. Gambhir wondered if there were some surefire way to detect cancer long before people got sick. (O'Connor, 10/18)

The New York Times: Researchers Explore A Cancer Paradox
Cancer is a disease of mutations. Tumor cells are riddled with genetic mutations not found in healthy cells. Scientists estimate that it takes five to 10 key mutations for a healthy cell to become cancerous. Some of these mutations can be caused by assaults from the environment, such as ultraviolet rays and cigarette smoke. Others arise from harmful molecules produced by the cells themselves. In recent years, researchers have begun taking a closer look at these mutations, to try to understand how they arise in healthy cells, and what causes these cells to later erupt into full-blown cancer. (Zimmer, 10/18)

Stat: Feds Crack Down On Stem Cell Clinics That Touted Autism Treatments, Blindness Cures
For the first time, the Federal Trade Commission has cracked down on stem cell clinics for overzealous marketing claims, filing a complaint against two California clinics that promoted their treatments for everything from autism to Parkinson’s despite a lack of evidence. As part of a proposed settlement announced Thursday, the FTC is requiring the clinics — Regenerative Medical Group and Telehealth Medical Group — and their owner, Dr. Bryn Jarald Henderson, to stop making such claims and to inform past and current patients about the settlement. (Joseph, 10/18)

The Washington Post: Scientists Argue Heart Stem Cell Trial Should Be Paused
Days after Harvard Medical School said it found extensive falsified or fabricated data from the laboratory of a prominent heart researcher, doctors and scientists are urging a halt to a medical trial based in part on his work. They say that sick people should not be subjected to the risks of an experiment whose underlying science has been called into question. In the ongoing, taxpayer-funded trial, cardiac stem cells are injected into the hearts of people with heart failure, in the hopes that those cells — alone or in combination with others — will improve patients’ heart function. (Johnson, 10/18)

Bloomberg: Biohackers Are Implanting Everything From Magnets To Sex Toys
Research house Gartner Inc. identified do-it-yourself biohacking as one of five technology trends—others include artificial intelligence and blockchain—with the potential to disrupt businesses. The human augmentation market, which includes implants as well as bionic limbs and fledgling computer-brain connections, will grow more than tenfold, to $2.3 billion, by 2025, as industries as diverse as health care, defense, sports, and manufacturing adopt such technologies, researcher OG Analysis predicts. “We’re only at the beginning of this trend,” says Oliver Bendel, a professor at the University of Applied Sciences & Arts Northwestern Switzerland who specializes in machine ethics. (Nicola, 10/19)

Stat: With Genome Sequencing, Some Sick Infants Are Getting A Shot At Healthy Lives
When babies become intensely ill, it can be difficult to know what has gone wrong. But the answer, quite often, is hidden somewhere in their genes. Whole-genome sequencing — in which scientists can read the nearly 3 billion chemical letters in DNA — can help turn up that answer. And scientists, increasingly, are laying out a case for using that tool in an intensive care setting, despite the upfront costs. (Keshavan, 10/19)

The Washington Post: Parents Of Children With AFM Warn About Rare Polio-Like Condition
It started with a sinus infection. Then 4-year-old Camdyn Carr couldn’t move the right side of his face or lift his arm to scratch his nose. His parents decided to take him a couple of hours away to see doctors who might be able to figure out what had afflicted their young boy. But as they drove from their Roanoke home to the University of Virginia, Carr’s whole body seized up and he was suddenly paralyzed. (McDaniels, 10/18)

Stat: An Ebola Outbreak Presents A New Mystery Involving Children 
Epidemiologists working on the world’s latest Ebola outbreak are racing to try to solve a mystery. Why have so many children — some still infants — been infected with the virus? The disproportionate number of recent infections among children in the Democratic Republic of Congo — specifically in Beni, the outbreak’s current hot spot — has come as a surprise; typically young children don’t make up a big proportion of cases during an Ebola outbreak. (Branswell, 10/19)

Los Angeles Times: The More Equal Women And Men Are, The Less They Want The Same Things, Study Finds
Imagine an egalitarian society that treats women and men with equal respect, where both sexes are afforded the same opportunities, and the economy is strong. What would happen to gender differences in this utopia? Would they dissolve? The answer, according to a new study, is a resounding no. The findings, published Thursday in Science, suggest that on the contrary, gender differences across six key personality traits — altruism, trust, risk, patience, and positive and negative reciprocity — increase in richer and more gender-equal societies. Meanwhile, in societies that are poorer and less egalitarian, these gender differences shrink. (Netburn, 10/18)

NPR: Letting Sunlight Indoors Kills Disease-Causing Bacteria
Even before Florence Nightingale advised that hospitals be designed to let daylight in, people observed that sunshine helps keep you healthy. But there was not much research to explain why that's the case, especially inside buildings. Researchers at the University of Oregon set up a study of dusty, dollhouse-size rooms to compare what happens in rooms exposed to daylight through regular glass, rooms exposed to only ultraviolet light and those kept dark. They used a mix of dust collected from actual homes in the Portland area and let the miniature rooms sit outdoors while keeping the insides at a normal room temperature. (O'Neil, 10/18)

The Oregonian: Facebook Bad For Your Mental Health? New OHSU Study Says In-Person Is Better
A new study says that face-to-face contact may buffer people from mental illness in a way that Facebook and other social media won't. An Oregon Health & Science University study said that a large group of veterans were found to experience mental health issues 50 percent less if they spent more time around loved ones over those who mostly socialized online. The science about whether social media is making us more anxious or depressed is mixed. Some doctors say there is a clear link between increased rates of youth mental illness and social media culture. (Harbarger, 10/18)

The Associated Press: 93 Women Accuse Former USC Doctor Of Sex Abuse
Nearly 100 women who contend that they were sexually harassed or abused by a former University of Southern California gynecologist are suing the school, contending it ignored decades of complaints. "I am part of an accidental sisterhood of hundreds of women because the university we love betrayed our trust,” said Dana Loewy, who alleged that Dr. George Tyndall assaulted her during an examination in 1993. (10/19)

Los Angeles Times: Scores More Former Patients Sue USC Over Gynecologist's Alleged Sexual Misconduct
Andy Rubenstein, whose Texas firm D. Miller & Associates is representing hundreds of Tyndall’s former patients, said in a statement that “the survivors we represent are furious, and rightfully so. They are not going away.“ Generations of Trojan women have had to endure the same emotional pain and scars because USC did nothing,” Rubenstein said. “Since this story broke nearly six months ago, there has been no significant effort by USC to come clean or enact substantive change in the way it handles allegations of sexual assaults against its staff.” (Branson-Potts and Hamilton, 10/18)

The New York Times: A Wave Of Child Sexual Abuse Accusations Against A Doctor, And Hospital Says It Knew
For almost 30 years, parents sought out Dr. Reginald Archibald when their children would not grow. They came to his clinic at The Rockefeller University Hospital, a prominent New York research institution, where he treated and studied children who were small for their age. He also may have sexually abused many of them. (Goldbaum, 10/18)

Iowa Public Radio: New York Hospital Says It Knew Of Sexual Misconduct By Pediatric Doctor
The hospital, a respected research institution in New York, says it knew since 2004 of "credible allegations" against Archibald, who died in 2007, indicating that he had engaged in "certain inappropriate conduct" with his minor patients that allegedly occurred during the doctor's physical exams. In a statement on Oct. 5, the hospital said that after the initial allegations — put forward allegedly by just one patient — it reached out to authorities, including the Manhattan district attorney and hired legal counsel from Debevoise & Plimpton to investigate the claims. (Sullivan, 10/19)

And in California —

Los Angeles Times: How A Newport Beach Doctor Fell From Reality TV Star To Suspected Serial Rapist
Authorities continue to seek potential victims after additional charges were filed this week against a prominent Newport Beach doctor, who now is accused of attacking at least seven women. Dr. Grant Robicheaux, 38, once dubbed Orange County’s most eligible bachelor, and his girlfriend, Cerissa Riley, 31, are accused of rape by drugs, kidnapping, oral copulation by anesthesia, assault with intent to commit sexual offenses and other crimes. (Winton and Sclafani, 10/18)

Modern Healthcare: Hospitals Have An Unrealized $25.4 Billion Supply Chain Opportunity 
Hospitals can save $25.4 billion if they improve their supply chain operations and harness data, according to a new report. That amounts to a 17.7% average supply chain expense reduction, or up to $11 million a year per hospital, according to a Navigant Consulting analysis of 2,300 hospitals that compared the top-tier hospitals' supply cost per adjusted patient day with their peers. That is equivalent to the annual salaries of 160 registered nurses or 42 primary care physicians, or the cost of building two outpatient surgery centers. (Kacik, 10/18)

In other hospital news —

Modern Healthcare: Fear Of Denials Could Be Pushing More Joint Procedures Into Outpatient Setting
Hospital administrators are shifting patients who need knee replacement surgery into the outpatient setting rather than risk audits by Medicare contractors, surgeons warn, adding that the practice could be jeopardizing more frail patients. The fear of audits comes despite the CMS banning Medicare contractors from reviewing inpatient total knee arthroplasty procedures after regulators last year began paying for procedures performed in the less expensive outpatient setting. (Dickson, 10/18)

Politico: Senior Energy Dept. Aide Moving To Veterans Affairs
John Mashburn, a former Trump White House official, is leaving the Energy Department for a senior position at the Department of Veterans Affairs, according to three people familiar with the move. Mashburn, a senior adviser to Energy Secretary Rick Perry, is stepping down after six months on the job. One of the people said he’s joining the VA in a high-level role advising the head of the department, Robert Wilkie. (Restuccia and Hesson, 10/18)

In other personnel news from the administration —

Politico Pro: Walmart Executive To Replace Ostroff In Foods Post At FDA
Stephen Ostroff will retire as FDA deputy commissioner for foods and veterinary medicine, a significant food safety and nutrition post at the agency. Frank Yiannas, a well known food safety executive from Walmart, will join FDA to fill a similar deputy commissioner role. (Bottemiller Evich, 10/18)

Bloomberg: New York State Considers Blocking Segments Of CVS-Aetna Merger 
New York state officials are considering blocking parts of the $68 billion merger of drugstore store chain CVS Health Corp. and Aetna Inc., jeopardizing billions of dollars in insurance premiums for Aetna. CVS and Aetna won approval from the U.S. Justice Department on Oct. 10, contingent on Aetna divesting its Medicare Part D business, which covers prescription drugs for seniors. But the deal still needs to pass through state regulatory bodies. (Dodge, 10/18)

Dallas Morning News: Court Says Texas Must Hire More State Workers To Protect Foster Kids, A 'Huge Victory For Children'
A federal appeals court has upheld a lower court's ruling that Texas must hire more of two types of protective-services employees who check on foster kids who are lingering in the state's custody after being removed from their birth families. But U.S. District Judge Janis Graham Jack of Corpus Christi went too far in prescribing how quickly the state must build up a better quantity and geographic dispersal of foster homes and treatment beds for kids in long-term foster care, the appellate judges ruled Thursday. (Garrett, 10/18)

Austin American-Statesman: Appeals Court Rejects Many Fixes Ordered For Texas Foster Care
The state of Texas has failed to adequately address severely overburdened caseworkers, routinely exposing children in foster care to physical and psychological harm, a federal appeals court determined Thursday. Even so, the 5th U.S. Circuit Court of Appeals said a federal judge went too far when she ordered Texas to make sweeping changes to its foster care system in January, including a cap on the number of children overseen by each caseworker and a ban on foster children sleeping in state offices. (Lindell, 10/18)

Atlanta Journal-Constitution: Blue Cross To Exit Obamacare Market In Some Georgia Counties
With open enrollment for Obamacare weeks away, Blue Cross customers across several Georgia counties have received letters from the insurance giant saying their health plan will no longer exist there next year. (Hart, 10/18)

The Wall Street Journal: NYC Health Department To Lead National Charge To Cut Sugar Intake
In an effort to decrease the amount of sugar in the food supply and stem a rise in obesity, the New York City Health Department will roll out on Friday a new effort pushing companies to significantly cut the sugar in packaged foods and drinks by 2025. The National Salt and Sugar Reduction Initiative, as it is being called, comprises a coalition of health departments across the country and other non-profits. Though voluntary for companies, the program builds on the work of a similar effort begun in 2009 aimed at reducing salt in foods. (West, 10/19)

Atlanta Journal-Constitution: Atlanta VA Temporarily Moves Key Staff After Hospital’s Downgrade
The Atlanta VA Medical Center shuffled some of its top leaders Thursday after it was designated one of the worst in the nation. The changes, which are mostly temporary, took place as internal watchdogs with the U.S. Department of Veterans Affairs look into why the hospital’s quality rating dropped to one star out of a possible five. (Mariano, 10/18)

The Associated Press: Hospital Says $2M Robot Enhances Surgery, Saves Money
A Delaware hospital says its new $2.1 million robot has performed more than 50 surgeries since it was introduced. The Beebe Medical Center’s Lewes Center for Robotic Surgery opened this summer. Robotic program head Dr. Kurt Wehberg tells The News Journal robot-assisted surgeries are less invasive than traditional procedures. And he says that translates into benefits for patients and practitioners alike. (10/18)

Arizona Republic: Arizona Course On Vaccines Canceled After Parental Backlash
The pilot online course, modeled after programs in Oregon and Michigan, was created in response to the rising number of Arizona schoolchildren skipping school-required immunizations against diseases like measles, mumps and whooping cough because of their parents' beliefs. But some parents, who were worried the optional course was going to become mandatory, complained to the Governor's Regulatory Review Council, which reviews regulations to ensure they are necessary and do not adversely affect the public. (Innes, 10/18)

Nashville Tennessean: Tennessee Home Hid Elderly Resident In Caring Estates 'Storage' Room
An elder care home in a Memphis suburb has been ordered to stop accepting new patients after employees stashed an off-the-books resident in what was described as a storage closet in an attempt to hide her from police and state inspectors. Inspection records also say employees failed to elevate the legs of another resident, which led to her developing an ulcer due to lack of blood circulation. That resident died within a month of being transferred out of the facility. (Kelman, 10/18)

Detroit Free Press: Pharmacist Who Denied Miscarriage Meds Not Working For Meijer
Meijer issued a statement Thursday about a Petoskey pharmacist accused of denying medication in July to a miscarrying woman because of his religious beliefs. He also  refused to transfer the prescription to another drugstore, the woman says. While the company didn't go as far as to say that it fired the pharmacist, it did say he is no longer an employee. (Shamus, 10/18)

Chicago Tribune: Lake Forest Drugmaker Akorn Appeals Ruling Against $4.75 Billion Merger With German Firm 
Akorn is appealing a Delaware judge’s ruling earlier this month allowing a German health care company to abandon plans to acquire the drugmaker in a deal worth $4.75 billion. The Delaware Chancery Court judge sided in his ruling with Fresenius Kabi, which announced in April that it would terminate its agreement to acquire Akorn, headquartered in Lake Forest. The day of that ruling, shares of Akorn dropped by more than 50 percent. (Schencker, 10/18)

WBUR: There Are Now 2 Cannabis Labs With The State's Official OK To Test Marijuana For Sale
The state's Cannabis Control Commission has granted final licenses to a pair of independent testing laboratories. The move is seen as the clearing of one of the final hurdles standing in the way of the state's first marijuana retail sales. (Brown, 10/18)

Boston Globe: State Will Consider Allowing Pot Delivery
Massachusetts cannabis regulators are considering a plan to permit home delivery of marijuana across the state — but only by small, locally-owned companies. At the Thursday meeting of the Cannabis Control Commission, commissioner Britte McBride proposed allowing so-called “microbusinesses” — firms owned by Massachusetts residents that grow and process limited quantities of marijuana — to deliver marijuana and marijuana-infused products to consumers’ homes. (Adams, 10/18)

JAMA Neurology: Association Of Unintended Pregnancy With Spontaneous Fetal Loss In Women With Epilepsy: Findings Of The Epilepsy Birth Control Registry
In the Epilepsy Birth Control Registry survey study, results indicated that unplanned pregnancy may double the risk of spontaneous fetal loss in women with epilepsy. Interpregnacy interval less than 1 year and conception age younger than 18 years or older than 37 years were also factors. (Herzong, Mandle and MacEachern, 10/15)

The Commonwealth Fund: Health Care In America: The Experience Of People With Serious Illness
Most Americans expect the health care system will deliver effective treatment and support them through trying times when they get sick. But in reality, health care in America sometimes hurts even as it helps. Appointments can be difficult to get. Clinics and emergency rooms are often overcrowded. Doctors’ recommendations can be confusing and difficult to follow. And when the bills arrive, the costs can be unexpected and devastating. More than 40 million adults in the United States experienced serious illness in the past three years. More than 41 million provided unpaid care to elderly adults during the past year. (Schneider et al, 10/17)

Urban Institute: Six Things We Learned From Young Adults Experiencing Gun Violence In Chicago
In 2017, Chicago experienced more homicides than New York City and Los Angeles combined, and many of these deaths came at the hands of gun violence. Chicago had 3,475 shooting victims in 2017. While violence affects everyone in these communities, Chicago’s youth are often both the victims and the perpetrators of gun violence. New research by the Urban Institute sought to learn more about young adults in Chicago neighborhoods experiencing high rates of gun violence: whether they currently or have carried firearms and why and what they view as the best strategies to reduce gun violence and promote safe communities. (Robertson, 10/17)

Health Affairs: Prices For Cardiac Implant Devices May Be Up To Six Times Higher In The US Than In Some European Countries
Medical devices are estimated to account for 6 percent of health expenditures in the US and 7 percent in European Union (EU) countries. Cardiac implants are a large segment of the market, but little is known about their prices. Using 2006–14 data from a large hospital panel survey, this article provides a systematic comparison of prices of cardiac implants between the US and four EU countries. (Wenzl and Mossialos, 10/1)

JAMA Internal Medicine: Combustible And Electronic Tobacco And Marijuana Products In Hip-Hop Music Videos, 2013-2017
In this content analysis of 796 hip-hop music videos from 2013 to 2017, the appearance of combustible or electronic product use or exhaled smoke or vapor ranged from 40.2% to 50.7%. The appearance of branded combustible and electronic products increased over time. (Knutzen, Moran and Soneji, 10/15)

The Hill: When My Former Colleagues In Congress Attack Health Care, They Attack Me
Like many Members of Congress, I thought I knew health care. Until I got sick. Just over a year ago, I shared my story about my personal fight for my right to health care while my former Republican colleagues were doing everything in their power to take it away. It’s not a secret: I have multiple sclerosis, an autoimmune disease that attacks the central nervous system. It is a chronic and expensive disease. Every time the GOP attacks the health care of working families, I hear them loudly and clearly because they put my life at risk. (Former Rep. Donna Edwards, 10/18)

Boston Globe: Looking To The Future Of Patient-Centered Cancer Research And Treatment
Over the past 40 years, cancer research has seen revolutionary discoveries — about genes, targeted drugs, and immune therapies — that have already had dramatic effects for some patients.But to speed progress toward better therapies, we need another kind of revolution: We need to enable cancer patients to become active partners in research. (Reed Jobs and Eric S. Lander, 10/18)

The Hill: We Should Give Long-Term Care Residents The Quality Care They Need And Deserve
Nursing homes face constant criticism. Most recently, nursing homes have been consistently questioned and scrutinized for the amount of therapy provided to the people for whom we provide care. Some say it is too much therapy, others too little. Now critics are using a recent study in the, “Journal of the American Medical Directors Association (JAMDA)” to go one step further by accusing nursing homes of inappropriately providing increasingly intense levels of rehabilitation to long-stay residents nearing the end of life. (Mark Parkinson, 10/18)

JAMA: Clinician-Patient Discussions Of Successful CPR—The Vegetable Clause 
“Well, I wouldn’t want to be a vegetable.” This statement, which a colleague has termed the vegetable clause, is one that I have heard countless times from patients when the topic of cardiopulmonary resuscitation (CPR) is raised. Often made to an admitting resident during an overnight encounter, the vegetable clause is interpreted to mean that the patient would not want life-sustaining treatment, specifically CPR. This results in the placement of a do-not-resuscitate (DNR) order. However, when I meet these patients soon after admission, it sometimes becomes clear that attempting CPR is consistent with their values and goals but that they would not desire prolongation of life were they to sustain severe neurologic deficits. (Anthony C. Breu, 10/18)

JAMA: Cervical Cancer Screening—Moving From The Value Of Evidence To The Evidence Of Value
Widespread implementation of cytology-based screening programs has resulted in marked declines in cervical cancer incidence and mortality in the United States. Nonetheless, an estimated 13 240 women will be diagnosed with cervical cancer in 2018, and 4170 will die from the disease. It is likely that a sizable proportion of these women will not have been appropriately screened. (George F. Sawaya, 10/18)

New England Journal of Medicine: The Supreme Court’s Crisis Pregnancy Center Case — Implications For Health Law
States frequently compel health professionals and commercial entities to disclose information relevant to patient or consumer decision making. For many years, such laws were presumed to be constitutional, despite the First Amendment’s protection of free speech. But after the Supreme Court’s decision in National Institute of Family and Life Advocates v. Becerra (NIFLA) in late June 2018,1 the status of such laws is an open question. (Wendy E. Parmet, Micah L. Berman, and Jason A. Smith, 10/18)

New England Journal of Medicine: Abortion 'Reversal' — Legislating Without Evidence 
Women up to 10 weeks pregnant who are having a medication abortion generally take one dose of mifepristone, which blocks the progesterone receptor, followed within 48 hours by a dose of misoprostol, a prostaglandin that causes cervical dilation and uterine contractions, leading to expulsion of the pregnancy tissue. Four states (Arkansas, Idaho, South Dakota, and Utah) require abortion providers to tell their patients about treatment that may reverse the effect of mifepristone if they change their mind after starting a medication abortion. So-called abortion reversal involves administering repeated doses of progesterone. Since 2017, other states have proposed similar bills and the California Board of Registered Nursing approved a course on medication-abortion reversal for continuing-education credit. This trend is troubling because of the lack of medical evidence demonstrating the safety and efficacy of the treatment; laws promoting it essentially encourage women to participate in an unmonitored research experiment. (Daniel Grossman and Kari White, 10/18)

New England Journal of Medicine: 'Transparency' As Mask? The EPA’s Proposed Rule On Scientific Data
The Environmental Protection Agency proposes excluding from consideration in setting environmental standards any studies whose raw, individual-level data are not publicly available. Its actions seem to be an attack on the use of science in environmental policy. (Joel Schwartz, 10/18)

The Washington Post: What Mitch McConnell Is Up To Is Even Worse Than Democrats Say
Mitch McConnell may be one of the most cynical politicians in the history of this great land, but at times he can be remarkably candid, as he was in a recent interview with Bloomberg News. Asked about the fact that the deficit is now projected to be $779 billion this year and $1 trillion by 2020, McConnell said, “It’s disappointing, but it’s not a Republican problem.” The real cause of debt is Social Security, Medicare and Medicaid, he argued, saying that imposing cuts to those programs “may well be difficult if not impossible to achieve when you have unified government.” (Paul Waldman, 10/18)

The Wall Street Journal: Trump’s Drug Price Bust
One thing Americans rightly hate about health care is that no one knows the true price of a service. How much did your last X-ray cost? Why are you suddenly paying more for a statin? The Trump Administration tried to address this frustration this week with a new rule requiring price disclosure on prescription drugs, but its cure is worse than the problem. (10/18)

The New York Times: Does Anyone Really Know What ‘Medicare For All’ Means?
After decades in the political wilderness, “Medicare for all” and single-payer health care are suddenly popular. The words appear in political advertisements and are cheered at campaign rallies — even in deep-red states. They are promoted by a growing number of high-profile Democratic candidates, like Alexandria Ocasio-Cortez in New York and Representative Beto O’Rourke in Texas. Republicans are concerned enough that this month President Trump wrote a scathing op-ed essay that portrayed Medicare for all as a threat to older people and to American freedom. It is not that. But what exactly these proposals mean to many of the people who say they support them remains unclear. (Elisabeth Rosenthal and Shefali Luthra, 10/19)

The Washington Post: The Trump Administration’s Latest Plan To Lower Drug Prices Is Hollow — And Maybe Counterproductive
Everyone — well, maybe everyone but pharmaceutical manufacturers — thinks that drug prices in the United States are way too high. The big question is how to bring them down. On the campaign trail, Donald Trump vigorously advocated for Medicare price negotiations. But so far, his biggest policy proposal, which arrived Monday, merely suggests that the government require pharmaceutical companies (many of which, for disclosure, I have personally invested in) to show list prices in their TV advertisements. For some reason, it does not require such pricing information for radio, newspaper or magazine advertisements. (Ezekiel Emanuel, 10/18)

The Washington Post: The Trump Administration Is Also Punishing Legal Immigrants. Here’s How.
Many people assume that the Trump administration’s immigration agenda is about punishing the undocumented. But for a taste of how it is punishing legal immigrants — and their U.S.-citizen families — consider the case of Maria, a doctor who came to California legally from Mexico. The first thing you need to know is that when her first child was born, five years ago, Maria had trouble breastfeeding. (Catherine Rampell, 10/18)

Georgia Health News: There’s More To Vaping Than You Think — And It’s Not Good
The bottom line is that vaping is not a safe alternative to cigarettes, and carries increased risks for young people, including addiction. It’s also illegal for people under age 18. So talk to your children about the dangers of vaping, and if they want to quit but feel they can’t, talk to your doctor or an addiction counselor. (Melanie Dallas, 10/18)

Stat: Consolidation Is Hurting Hospitals' Supply Costs, Not Helping Them 
When health systems merge, one of the goals is to gain economies of scale, lowering costs through the bargaining power that comes from being a bigger player. Yet despite a consolidation wave in hospitals, it appears that they are paying more for supplies than they did a year ago.In the past three years, two-thirds of the country’s leading hospital systems saw declining operating income, resulting in nearly $7 billion in lost earnings. It’s a dire situation that looks even worse when you consider the relative strength of the overall economy. Supply chain costs are second only to labor and represent 30 percent of hospitals’ expenses. That cost could rise to the top of the list by 2020. (Rob Austin, 10/19)

San Jose Mercury News: Humane Society Initiative Will Drive Up Food Costs
California’s egg farmers support cage-free production. But Proposition 12 will result in fewer eggs produced in California and fewer egg farmers, and that will lead to higher prices, just as happened the last time voters approved a poorly written initiative drafted by the Humane Society of the United States. (Debbie Murdock, 10/18)

Boston Globe: Fact, Not Fear, Should Guide Voters To A Yes On Question 3
All residents of the Commonwealth should be able to use and access our public spaces without experiencing discrimination based on who they are. For that reason, the BBA is an active supporter of Yes on 3: Freedom for All Massachusetts, a broad, bipartisan coalition working to defend these nondiscrimination protections at the ballot box this November. (Jonathan M. Albano, 10/18)

San Antonio Press Express: Marketers Are Overcoming Unique Challenges To Build Campaigns For The Nascent Cannabis Industry
Though the concept of “marijuana marketing” still intimidates, building marketing campaigns for cannabis brands, retailers, products and services requires no new methodology. Learning a little bit about the plant always helps, but any skilled marketer can analyze and solve problems in this industry. (Rosie Mattio, 10/18)