The Associated Press: It's Time For Trump's Doctor To Be Examined, For VA Chief
Rear Adm. Ronny Jackson was tending to grievously injured military personnel in Iraq when he was summoned to Washington to interview for a job he barely knew existed. He didn't see a way to get there. "I thought this was it — this is where the road stops," he told the Lubbock Avalanche-Journal this month. Instead, Jackson managed to catch a ride on a transport plane that steered the Levelland, Texas, native toward some of the loftiest corridors of power. (Kellman, 4/23)

The Hill: Trump VA Pick Faces Challenge To Convince Senators He’s Ready For Job 
President Trump's pick to lead the Department of Veterans Affairs is hearing skepticism from senators about his ability to lead the sprawling and often-troubled agency ahead of what could be a contentious confirmation hearing next week. Ronny Jackson, who now serves as the White House physician, has no experience running a bureaucracy like the VA, which has left senators in both parties questioning whether President Trump put personal ties above qualifications in making the nomination. (Weixel, 4/21)

In other news —

The Cleveland Plain Dealer: Retiring Cleveland VA Chief Says Privatizing 'Would Result In A Huge Disservice To Veterans'
Dr. Murray Altose has developed a keen appreciation for the advantages and aggravations of veterans health care after nearly 30 years at the Northeast Ohio Veterans Affairs (VA) Healthcare System, which includes the Louis Stokes Cleveland Veterans VA Medical Center and outpatient clinics. Altose, 76, the longest-serving chief medical officer/chief of staff in the entire VA health care system, is retiring at the end of this month. (Albrecht, 4/22)

The New York Times: Trump Plan Would Cut Back Health Care Protections For Transgender People
The Trump administration says it plans to roll back a rule issued by President Barack Obama that prevents doctors, hospitals and health insurance companies from discriminating against transgender people. Advocates said the change could jeopardize the significant gains that transgender people have seen in access to medical care, including gender reassignment procedures — treatments for which many insurers denied coverage in the past. (Pear, 4/21)

The Hill: Trump Admin Announces Abstinence-Focused Overhaul Of Teen Pregnancy Program 
The Trump administration will shift federal funding aimed at reducing teen pregnancy rates to programs that teach abstinence.  The Department of Health and Human Services (HHS) announced Friday the availability of grants through the Teen Pregnancy Prevention Program, (TPPP) a grant program created under former President Obama that funds organizations and programs working to reduce teen pregnancy rates. (Hellmann, 4/20)

The Wall Street Journal: U.S. Hospital Firms, Hungry To Expand, Look To China
ProMedica , a nonprofit operating more than a dozen hospitals across Rust Belt communities in Ohio and Michigan, is looking to a new market to bolster its anemic growth: China. Executives and staff from the Toledo-based nonprofit have been touring hospitals in Shanghai, Shenzhen and Chengdu, exploring possible deals in the world’s second-largest economy that they hope will help offset weak revenue growth at home. “We have to look outside our traditional world if we’re going to survive,” said Randy Oostra, president and chief executive of the hospital group. “The economic model is tough” in ProMedica’s domestic markets, where populations are stagnant or declining and where cost pressures and competition are shifting medical care outside of hospitals, he said. (Evans, 4/22)

Modern Healthcare: Hospitals Cry Foul And Sue Anthem Over New Policies 
County courtrooms are no strangers to contract disputes between local hospitals and insurers. Lately, though, they've had some big cases dropped in their laps as hospitals owned by HCA Healthcare, Sentara Healthcare and Piedmont Healthcare take health insurance giant Anthem to court over its new policies that restrict outpatient imaging and emergency department reimbursement. Typically, state courts hear arguments pertaining to relatively minor contract disputes, such as coverage of one particular drug, for example, said David Honig, an attorney with the healthcare law firm Hall Render. These cases, by contrast, are much larger in scope. (Bannow, 4/21)

And in other hospital news —

NPR: Medicare's Observation Status Makes Inpatients Into Outpatients
A few months ago, I wrote a check for $12,000 but couldn't figure out exactly why. The payment was to secure a place for my mother at Sligo Creek Center, in Takoma Park, Md. It's a nursing home and rehab center owned by Genesis Healthcare. My mother was about to be discharged from Holy Cross Hospital, in nearby Silver Spring, after a fall. Medicare wouldn't pay for her rehabilitation care. So before the Sligo Creek Center would let her through the door, I had to prepay for a month — $12,000 — or nearly $400 a night. (Kodjak, 4/20)

The Star Tribune: Regions Hospital Pushes For Exception To State Law To Add More Beds 
Citing an aging population and sicker patients, Regions is pushing this spring for an exception to a state law so it can add 100 hospital beds by 2040. While the focus is long-term, Regions [Hospital] hopes to address current problems with ambulance diversions and patients backing up in the emergency room, as well. Two of the hospital’s competitors in St. Paul have raised concerns about the proposal, and sisters with the religious order that founded nearby St. Joseph’s Hospital have voiced outright opposition. (Snowbeck, 4/21)

The CT Mirror: Hospital Tax Could Complicate CT Deficit, But Income Tax Receipts Keep Rising
Some days bring good news and bad news. While Connecticut learned Friday that surging state income tax receipts now are running $1.03 billion more than anticipated — $116 million better than Thursday’s forecast — Gov. Dannel P. Malloy disclosed the state has a pretty hefty accounting problem equal to about $150 million. Technically, the current state deficit has nearly doubled, growing from $198 million to $363.5 million. (Phaneuf, 4/20)

Concord (N.H.) Monitor: Concord Hospital Plans To Build New Medical Office Building
Concord Hospital plans to build a new medical office building in the middle of its Pleasant Street campus, replacing a parking lot between two existing office buildings. The project was approved by the city planning board a month ago, but details are still being worked out, including who will occupy the building, said Jennifer Dearborn, spokeswoman for the hospital. (Brooks, 4/21)

The Washington Post: Drug Abuse Education Takes On Urgency In Ohio Opioid Crisis
Ohio, a state where 4,329 people died of drug overdoses in 2016, a death rate second only to neighboring West Virginia, is taking the fight against the opioid epidemic into the classroom with a new style of drug-abuse-prevention education. Ohio’s plan, controversial in a state that prizes local control over schools, features lessons that begin in kindergarten. Instead of relying on scare tactics about drug use or campaigns that recite facts about drugs’ toll on the body, teachers are encouraged to discuss real-life situations and ways to deal with them and to build the social and emotional skills that experts say can reduce the risk of substance abuse. (Vander Schaaff, 4/22)

In other news on the epidemic —

Health News Florida: Feds Give Florida Another $27M For Opioid Crisis
Florida will get another $27 million dollars this year from the federal government to combat the opioid crisis. The money is part of a two-year $54 million grant, which the state began spending last year after Gov. Rick Scott declared a state of emergency for the opioid epidemic. The money pays for treatments, such as methadone, medication to reverse drug overdoses and counseling services. (Ochoa, 4/19)

Arizona Republic: Arizona Medicaid Panel Rejects Opioid Drug
Arizona's largest public health insurance program, Medicaid, pays for only one type of buprenorphine drug designed to wean people from opioid addiction. Despite calls from doctors to authorize competing versions of the drug, a state Medicaid committee this week decided to stick with Suboxone as a preferred medication for opioid dependence. (Alltucker, 4/21)

Stat: How Vaccine Experts Weigh Benefits For Many Against Risks For A Few
Vaccines protect huge numbers of people, generally children, from serious diseases, but in rare cases, certain vaccines can tragically cause harm. How do those scientists figure out which to value more? This dilemma was at the center of last week’s decision by an expert committee advising the World Health Organization to sharply scale back use of a controversial vaccine called Dengvaxia, the first to protect against dengue infection. (Branswell, 4/23)

The New York Times: Ethicists Call For More Scrutiny Of ‘Human-Challenge’ Trials
Members of a government ethics panel have renewed their criticisms of a controversial study in which volunteers are to be deliberately infected with the Zika virus. In an article published this month in the journal Science, panel members called for the establishment of ethics committees to review the design of such human-challenge studies, which are sometimes used to test vaccines. (Baumgaertner, 4/20)

Los Angeles Times: Decoding Your Baby's DNA: It Can Be Done. But Should It Be?
Maverick Coltrin entered the world a seemingly healthy 8-pound boy. But within a week, he was having seizures that doctors could neither explain nor control. They warned that he would probably die within a few months.“I remember my world just came crashing down,” said his mother, Kara Coltrin, 24. In October, Coltrin and her husband, Michael, began taking hundreds of photos of their son, hooked up to tubes and his skin purplish gray. Family rushed to San Diego from across the country to meet him before he died. (Karlamangla, 4/22)

Modern Healthcare: Home Healthcare Providers' Infection Prevention Efforts Hampered By Dearth Of Data, Tools 
Bayada Home Health Care had to go it alone when it developed infection control and prevention protocols for its clinicians. Unlike the numerous infection prevention resources available to hospitals and nursing homes, there isn't much published guidance for home health providers on how to best protect patients from infections. The Centers for Disease Control and Prevention hasn't published infection control guidelines specific to the home health industry even though such resources are available for acute-care and long-term care providers. (Castellucci, 4/21)

NPR: Teens Cyberbully Themselves As A New Type Of Self-Harm
During the stressful teen years, most adolescents experience emotional highs and lows, but for more than 20 percent of teenagers, their worries and sad feelings turn into something more serious, like anxiety or depression. Studies show that 13 percent to 18 percent of distressed teens physically injure themselves via cutting, burning or other forms of self-harm as a way to cope with their pain. Recent research and clinical psychologists now suggest that some adolescents are engaging in a newer form of self-aggression — digital self-harm. They're anonymously posting mean and derogatory comments about themselves on social media. (Fraga, 4/21)

The New York Times: Infinitesimal Odds: A Scientist Finds Her Child’s Rare Illness Stems From The Gene She Studies
By the time her mother received the doctor’s email, Yuna Lee was already 2 years old, a child with a frightening medical mystery. Plagued with body-rattling seizures and inconsolable crying, she could not speak, walk or stand. “Why is she suffering so much?” her mother, Soo-Kyung Lee, anguished. Brain scans, genetic tests and neurological exams yielded no answers. But when an email popped up suggesting that Yuna might have a mutation on a gene called FOXG1, Soo-Kyung froze. (Belluck, 4/23)

The Washington Post: Playing Is Good For Grown-Up Brain And Body
Want to feel better, smarter and healthier? It might be time to get serious about play. TED’s list of talks about the importance of play is a good place to start. It includes nine talks that might persuade you to take a more lighthearted approach to life — and help you reap the health benefits of your new attitude. The free videos offered by TED have a reputation for tackling serious subjects — topics such as work, technology, psychology. This collection is a bit different. Each expert approaches play with TED’s signature smarts but keeps the focus on fun. (Blakemore, 4/21)

The Wall Street Journal: Philip Morris Shares Suffer Biggest Daily Fall In A Decade On Declining Cigarette Volume
Shares of tobacco companies tumbled after Philip Morris International Inc. said cigarette shipments fell more than expected and sales for its cigarette alternative started to stall in a key market—raising wider alarm about the health of the entire tobacco industry.Shares in the New York-listed, Switzerland-based tobacco giant ended down 16%. That was its biggest one-day slide since becoming a public company in March 2008. The disappointing first-quarter results dragged down shares of other giants, like Altria Group Inc., British American Tobacco PLC and Imperial Brands PLC. (Chaudhuri, 4/19)

The Washington Post: How To Understand Survival Odds
“So how long do I have to live?” A reader with cancer recently sent me a letter with this question, which on its face seems simple enough: “My oncologist told me that the five-year survival rate for my cancer is 45 percent. What does this actually mean for me? ”I am familiar with this question from my own cancer diagnosis three decades ago, when a doctor gave me 10-year survival odds that were dismal. The first two questions racing through someone’s mind after getting a cancer diagnosis are “Is this terminal?” and “How long do I have?” (Petrow, 4/21)

NPR: Cannabis Extract's Popularity Gets Ahead Of The Science
As more states legalize marijuana, there's growing interest in a cannabis extract — cannabidiol, also known as CBD. It's marketed as a compound that can help relieve anxiety — and, perhaps, help ease aches and pains, too. Part of the appeal, at least for people who don't want to get high, is that CBD doesn't have the same mind-altering effects as marijuana, since it does not contain THC, the psychoactive component of the plant. (Aubrey, 4/23)

The Wall Street Journal: Many In Middle Age Have Arthritis—They Just Don’t Know It
It may start as a stiff knee, soreness in the hips, or swelling in the fingers that makes it hard to hold a coffee cup. The joint disease arthritis is on the rise in the U.S., driven largely by the aging of the baby-boom generation and the obesity epidemic. But while the Centers for Disease Control and Prevention estimates 54 million adults have been told by a doctor they have the condition, new research suggests a much higher prevalence—especially in the 45-64 age group—totaling more than 91 million adults. (Landro, 4/22)

The Wall Street Journal: The Common Advice For Those With Thinning Bones Could Be All Wrong
Clare Tuke never considered herself athletic. But when thinning bones from osteoporosis led to a series of vertebral fractures, she searched the Web for a remedy—and found a local scientist-run clinic proposing a regimen of strenuous weight training. At first the idea of lifting heavy barbells was “absolutely terrifying” given her fragile bones, says Mrs. Tuke, a 54-year-old nurse from Brisbane, Australia. But a year after beginning a twice-a-week routine, Mrs. Tuke says a recent scan shows her bone density is “going in the right direction,” and she loves how much stronger she feels in daily tasks, such as opening jars. (Johannes, 4/22)

The Wall Street Journal: Research Finds Volunteering Can Be Good For Your Health
If it is Monday, you’ll find Phil Diamond in New York teaching photography to seniors. On Tuesdays he’s coaching small-business owners through a nonprofit. Other days, he helps in a photography class, mentors teens, visits homebound seniors and volunteers at a Harlem jazz museum. Mr. Diamond, 73, worked six days a week in the bridal-gown business before retiring in 2009. He sees the 15 to 20 hours he now volunteers each week as necessary. “You have to interact with people,” he says, “or your brain really dries up.” (Gallegos, 4/22)

The Associated Press: '60 Minutes' Report Details Progression Of Alzheimer's
Filmed over 10 years, a "60 Minutes" report this weekend shows in startling detail the progression that Alzheimer's disease takes on a patient. CBS medical correspondent Dr. Jon LaPook began interviewing Mike and Carol Daly of Staten Island, New York, in 2008, shortly after Carol learned of her diagnosis. She was mildly forgetful but functional, although upset at how it had affected her ability to cook, or enjoy books and movies. (4/19)

The Baltimore Sun: Training Can Help People Stop Bleeding From Traumatic Injuries, Experts Say 
These mannequins are mostly used by the military and other government agencies, but the small Maryland company near the Delaware border is getting more attention lately from police forces, hospitals and others that are increasingly training their own staffs and the public how to apply pressure, pack wounds and use a tourniquet. The “Stop the Bleed” movement arose after the 2012 mass shooting at Sandy Hook Elementary School in Connecticut but gained steam with more recent mass casualty events in Las Vegas and Parkland, Fla. Organizers say bystanders need to know how to stop bleeding from gunshot wounds and other injuries because they are on the scene already. Emergency services could be minutes away, enough time for the most grievously wounded victims to bleed to death. (Cohn, 4/21)

KCUR: Health Workers Say 'Battlefield Medicine' Can Keep Kansas City Gun Violence Victims Alive
Tourniquets may be an old concept; they may also be the key to keeping gunshot victims from bleeding to death. Health professionals at Truman Medical Center in Kansas City, Missouri, have been training Kansas City police officers and school administrators how to "Stop the Bleed." It's a campaign out of the White House to raise awareness and train first responders and civilians on basic practices to stop life-threatening bleeding. At a summit on gun violence held by the Jackson County Prosecutor's office on Friday, Truman trauma nurse Andrea Hawk demonstrated how to use tourniquets. (Tudhope, 4/20)

And in other news on guns and public safety —

St. Louis Public Radio: Students Call For Stronger Gun Control In Latest School Walkout
High school students from across the St. Louis region took part in another day of action Friday to call for improved school safety and tighter gun control measures. The protest fell on the 19th anniversary of the school shooting at Columbine High School in Littleton, Colorado, where 13 people were killed. Many consider that event the moment when mass school shootings entered Americans’ consciousness. The Feb. 14 shooting in Parkland, Florida, has rocketed student activists to the center of the debate over guns. (Delaney, 4/20)

Kaiser Health News: Texas Disability Groups Want A Voice At The Table In Gun Debate
A disability rights group in Texas sent out a survey last month, trying to figure out how many of its members became disabled due to gun violence. The group, ADAPT of Texas, said it’s an effort to collect data that will help inform Texas lawmakers on how they legislate guns. Bob Kafka is an organizer with ADAPT and said that when gun violence happens, particularly mass shootings, the public tends to have a pretty limited discussion about what happens to the victims. (Lopez, 4/23)

New Hampshire Public Radio: At One N.H. High School, Students Find Their Own Way To Remember Victims Of Gun Violence
Students from across New Hampshire walked out of their schools -- and some gathered at the State House -- to call for stricter gun control on Friday. But as NHPR’s Jason Moon reports, at a Catholic high school in Manchester, students took part in the national movement in their own way. On the front lawn of Trinity High School, a few students set up folding chairs in a circle near the flag pole. Senior Emily Gagne made her way around the circle taping a sheet of paper onto the back of each chair. (Moon, 4/20)

The New York Times: New York To Expand Use Of Doulas To Reduce Childbirth Deaths
Gov. Andrew M. Cuomo announced on Sunday a series of initiatives aimed at addressing a disturbingly high rate of maternal mortality among black women, who are four times more likely to die in childbirth than white women in New York State, according to a study released last year. The plan includes a pilot program that will expand Medicaid coverage for doulas, birth coaches who provide women with physical and emotional support during pregnancy and childbirth. (Ferre-Sadurni, 4/22)

In other women's health care news —

Chicago Tribune: Women Fighting Cancer Ask, 'Why Won't Illinois Insurers Cover Egg, Embryo Freezing?' 
State law requires insurers to cover infertility treatments, such as in vitro fertilization, for those who’ve tried and failed for a year to conceive. But insurers are not required to cover fertility preservation — freezing of eggs, sperm and embryos — for patients facing medical treatments that might leave them unable to have children. Some insurers cover the procedures but many don’t. A bill under consideration in the Illinois legislature aims to change that — one in a string of such measures across the nation. Connecticut and Rhode Island passed bills last year requiring insurers to cover fertility preservation, and a similar bill is before Maryland’s governor. (Schencker, 4/22)

The Associated Press: NY Lawmakers To Hold Hearing On Physician-Assisted Suicide
State lawmakers in New York are examining a legislative proposal to give terminally ill people the right to seek life-ending medication from their physician. The Assembly's Health Committee is scheduled to hold a public hearing on the measure Monday in Albany. A second hearing is planned for May 3 in New York City. A proposal now before lawmakers would require two doctors to sign off on the use of life-ending medication. It has been proposed for years but has yet to receive a vote in the Legislature. (4/21)

Denver Post: Watch Your Paychecks: Colorado Employers Are Pushing Higher Health Care Costs To Workers, Report Says
A new report released this week reveals that the cost of health insurance for employers in Colorado is increasing faster than the national average — and that employers are often pushing that added cost onto their workers. Meanwhile, an annual study released last year found, for the first time in its history, that the percentage of Coloradans covered by an employer-based plan had dropped below 50 percent. Taken together, the two reports paint a worrisome picture for employer-based insurance, the workhorse of Colorado’s health coverage system. (Ingold, 4/20)

Dallas Morning News: Fifth Official In Texas Health And Human Services Commission Departs Amid Contracting Problems
Another top official is leaving the Texas Health and Human Services Commission in the wake of contract mismanagement — the fifth since the contracting problems came to light. Ron Pigott, the agency's deputy executive commissioner for procurement and contracting services since 2015,  has resigned, agency spokeswoman Carrie Williams confirmed in an email. He previously was over procurement at the Texas Comptroller's office. ...Pigott's departure comes just two days after Gov. Greg Abbott's top appointee over social services profusely apologized to legislators for his agency's failure to take care of the basics as it awards lucrative health insurance and other contracts to private companies. (Nix, 4/21)

The Associated Press: Office Helping Granite Staters With Disabilities Has Deficit
A New Hampshire state agency that helps people with disabilities find and keep jobs for years spent millions more than it took in, prompting an office restructuring and plan to prioritize services for those with the most significant impairments. The Department of Education said Friday that the problem in its vocational rehabilitation bureau dates back to at least 2012 and was discovered during a recent review of grant spending. As a result, the bureau is being overhauled to save money, and will use a process to serve people with the most significant disabilities first. It also will work with community partners and charitable groups to ensure other clients get help, officials said. (4/22)

The Associated Press: Admissions Ban On Florida Nursing Home Tied To Irma Deaths
Florida health officials will not allow new patients to be admitted to an assisted living facility associated with a nursing home where a dozen residents died after the facility lost power in a hurricane. The Agency for Health Care Administration banned Floridian Gardens Assisted Living Facility from taking new patients Friday, citing "an immediate serious danger to the public health, safety or welfare" at the Miami facility. The Miami Herald reports a survey uncovered at least two deaths and multiple falls due to "deficient practices." (4/23)

Des Moines Register: 16,000 UnityPoint Health Patients May Have Been Affected By Phishing Attack
About 16,000 UnityPoint Health patients could have had their health and personal information compromised after the health care provider was affected by a phishing attack, a spokeswoman says. On Feb. 15, UnityPoint Health discovered a phishing attack that had affected some employee email accounts, according to a letter sent to patients April 16. The accounts may have been accessed between Nov. 1, 2017, and Feb. 7, 2018. (Tendall, 4/20)

The Star Tribune: Growth Of Nurse Practitioner Field Changing Patient Care In Minn.
Nurse practitioners, or NPs, are becoming vital to Minnesota’s medical system, which is seeing the demands of an aging patient population outpace the existing supply of doctors. Since the state Legislature in 2014 enacted the first state licensing standards for advanced practice registered nurses, the number of licensed NPs has increased by more than a third from 3,864 to 5,619. The Minnesota Department of Employment and Economic Development lists nurse practitioner as the seventh fastest growing profession in the state — based on a 10-year projection that the supply of NPs will increase 26 percent. (Olson, 4/21)

Health News Florida: Multimillion-Dollar Tobacco Verdict Upheld
A divided state appeals court this week upheld a nearly $6.4 million verdict in a case filed against cigarette-maker Philip Morris USA by the widow of a Jacksonville man who died of smoking-related illnesses. A panel of the 1st District Court of Appeal, in a 2-1 decision, ruled Wednesday in favor of Mary Brown, who was awarded $6.375 million in 2015 after a trial in Duval County, according to state and county court records. (4/20)

St. Louis Post Dispatch: More Missourians Facing Hefty Air Ambulance Bills
The attorney general’s office has logged and investigated 10 consumer complaints from consumers since 2016, according to a records request submitted by the Post-Dispatch. The attorney general’s office did not have a comment about overall findings, which include allegations against multiple air ambulances including Arch Air Medical Services, Air Evac Lifeteam and Survival Flight. ...Because of the way private health insurance operates, there’s no marketplace solution to the problem of excess billing if air-ambulance companies are unwilling or unable to negotiate rates with insurers and insurers refuse to pay for out-of-network services. That points to a need for legislation, say some health care policy experts. (Liss, 4/23)

Health News Florida: Judge Backs Nursing Home On Death Records
Ruling against the Florida Department of Health, a circuit judge Friday said an embattled Broward County nursing home is entitled to receive copies of death certificates for people who died across the state around the time of Hurricane Irma. Leon County Circuit Judge Terry Lewis ruled that the death certificates are public records under a state open-government law. In doing so, he sided with arguments made by The Rehabilitation Center at Hollywood Hills, a Broward County nursing where residents died in sweltering conditions after the September hurricane. (4/23)

The Associated Press: N.H. Prison Told To Turn Over Records On Inmate's Death
New Hampshire prison officials have begun providing records to a disabilities rights organizations investigating suspected abuse or neglect in the death of an inmate with mental illness. According to the Department of Corrections, Phillip Borcuk, 34, died in the state prison's residential treatment unit in December after he was heard "engaging in self-injurious behavior." The Disabilities Rights Center, a federally mandated protection and advocacy agency, sued corrections officials in February after they failed to turn over records related to the death. (4/22)

The Associated Press: Family Says Surgeons Left Needle In Baby's Heart
A family says surgeons at a Florida children's hospital left a needle in their baby's heart. A doctor made the discovery about Amara Le's baby during a follow-up appointment. Le and her fiance rushed baby Katelynn back to Johns Hopkins All Children's Hospital in St. Petersburg but the surgeons said there was no needle. Ten days later, the couple says a different hospital found the needle in Katelynn's aorta. (4/23)

Sacramento Bee: E. Coli Levels Drop In Sacramento Rivers
New tests taken at one of Sacramento’s most popular public beaches recorded the lowest levels of E. coli in the water all year. The bacteria is typically found in fecal matter and can enter local waterways through domestic or wild animal waste, sewage overflows, illegal trash dumping and storm water systems. Most strains don’t pose a threat to humans, but high levels of E. coli found in Sacramento’s rivers and streams have concerned officials enough to warn swimmers about potential health risks. (Luna, 4/21)

The New York Times: Easing The Dangers Of Childbirth For Black Women
The rate of maternal mortality in the United States, already higher than in other wealthy countries, has risen by more than half since 1990. The grim increase is largely because of alarmingly high rates among black women, who nationally are three times as likely to die in pregnancy or childbirth as white women. (4/20)

The Washington Post: D.C.’s Maternal Mortality Rate Is At Crisis Proportions
At 29, she was pregnant with twins. She had no health insurance. Though she’d had complications with a previous pregnancy, she received no prenatal care until late in her second trimester. Diagnosed with gestational diabetes, she had a Caesarean section at 34 weeks but after giving birth suffered a seizure and died. Another woman, 20, tested positive on a home pregnancy kit but didn’t seek care. When she began to experience severe abdominal pain, she went to a clinic and was found to have an ectopic pregnancy. While arrangements were being made for surgery, her blood pressure dropped and she lost consciousness. She also died. The cases, recounted by a Planned Parenthood doctor at a D.C. Council hearing, highlight the national problem of maternal mortality, which has taken on crisis proportions in the District. About 41 women in the District die for every 100,000 live births, according to a 2016 analysis by the United Health Foundation. (4/21)

Boston Globe: The Red-State War On Abortion Rights
A bill passed by the Iowa state Senate last month marks the latest skirmish in the right-wing war on abortion rights in this country. The Republican-controlled body approved legislation that would ban abortions after a fetal heartbeat is detected — as early as six weeks into a pregnancy. ... Iowa isn’t alone in this red-state march to block a woman’s right to choose a safe and legal abortion. GOP lawmakers have also passed heartbeat bans in Arkansas and North Dakota — fortunately, federal courts blocked the laws in both states, and the US Supreme Court declined to hear appeals. (It’s also worth noting the alarming shortage of available clinics. One of the plaintiffs in the 2015 case in North Dakota, the Red River Women’s Clinic, was the sole abortion provider in the entire state.) Earlier this year, Mississippi passed a 15-week ban. (4/23)

Seattle Times: Keep Fighting For Health Insurance For All
The Trump Administration has found yet another way to undermine the Affordable Care Act and the individual health insurance market. Lucky for Washington consumers, Insurance Commissioner Mike Kreidler has their backs. Kreidler is protecting consumers against the Trump Administration’s ill-conceived attempt to allow Americans to sidestep the requirements of the ACA and sign up for short-term medical plans without the protections codified in Obamacare. (4/22)

The Wall Street Journal: Killing An ObamaCare Alternative
The Trump Administration has been looking for lifeboats for Americans trapped in ObamaCare exchanges, and one project is to expand “association health plans,” or AHPs, that let employers team up to offer coverage. But the fine print in the proposed Labor Department rule is causing concern and needs to be cleaned up. The issue is whether the Trump rule will let association health plans set prices based on risk, which is how insurance is supposed to work. The point of the rule is to let businesses enjoy the flexibility that large employers have under a law known as Erisa. Under the Affordable Care Act bigger businesses have fared much better than those stuck in the small group market, which is heavily regulated. (4/22)

The Washington Post: Doctors Are Scrambling To Deal With A New World Of Telemedicine
For years, doctors have been told to look at the patient — not the computer — when providing medical care. What we haven’t been told is what to do when there’s only a computer. Telemedicine is perhaps the most rapidly evolving area in health care. About 15 million Americans receive some form of remote medical care every year. Investment in on-demand health-care services is estimated at $1 billion annually, according to Accenture Consulting. Kaiser Permanente, the nation’s largest integrated delivery system, provides more visits virtually than it does in person. (Dhruv Khullar, 4/22)

The New York Times: An Opioid Crisis Foretold
One of the more distressing truths of America’s opioid epidemic, which now kills tens of thousands of people every year, is that it isn’t the first such crisis. Across the 19th and 20th centuries, the United States, China and other countries saw drug abuse surge as opium and morphine were used widely as recreational drugs and medicine. In the West, doctors administered morphine liberally to their patients, while families used laudanum, an opium tincture, as a cure-all, including for pacifying colicky children. In China, many millions of people were hooked on smoking opium. In the mid-1800s, the British went into battle twice — bombing forts and killing thousands of civilians and soldiers alike — to keep the Chinese market open to drug imports in what would become known as the Opium Wars. (4/21)

Modern Healthcare: A Strategy For Combating Opioid Addiction
Everyone in Washington agrees bold action to combat the opioid epidemic is long overdue. Yet the legislation advancing in Congress barely qualifies as a start. The bipartisan Opioid Crisis Response Act, sponsored by Sens. Lamar Alexander (R-Tenn.) and Patty Murray (D-Wash.), would spend a paltry $6 billion over two years in more than two dozen programs. They include more support for research on non-addictive pain relievers; better FDA oversight of pain pill prescribing; and the creation of comprehensive opioid abuse recovery centers in targeted communities. Most are worthy projects. But therein lies the problem. Entirely absent from the bill, besides enough money, is a comprehensive strategy for combating substance abuse. (Merrill Goozner, 4/21)

Bloomberg: Pot Legalization Picking Up Steam, Just in Time
OK, I was wrong. Back in November, I wrote an item explaining all the reasons it wasn't surprising that marijuana legalization wasn't a popular policy position despite polls showing a massive voter shift in favor of it. About five minutes after I wrote that one, Democrats started aligning themselves more and more with legalization. It's even bipartisan: Former Republican Speaker John Boehner joined in, and Colorado Republican Senator Cory Gardner successfully pushed the Donald Trump administration to leave his state and other legalization states alone. And Thursday, Senate Democratic Minority Leader Chuck Schumer joined them. (Jonathan Bernstein, 4/20)

The Hill: The E. Coli Outbreak Doesn't Surprise Me
The news has been flooded recently with stories about contaminated food items, recalls and a host of infections we’re all at risk of getting. Two million eggs were pulled from shelves last week because of a salmonella outbreak, putting the country on edge over their favorite breakfast staple. Then this week an E. coli outbreak tied to romaine lettuce made headlines. As of now, this infectious outbreak has been isolated to 16 states across the country. Close to 60 people have become ill according to the Centers for Disease Control and Prevention. Thankfully, as of today, there have been no fatalities. (Joseph Galati, 4/21)

The Wall Street Journal: In The War On Cancer, Truth Becomes A Casualty
If you live in a major U.S. media market, you’ve probably seen the cocksure television spots from Houston-based MD Anderson Cancer Center. From the marquee ad in the series, which premiered in 2015: Patient (addressing cancer): “You try to take everyone.” Doctor: “But I wont let you.” Second doctor: “We will stop you . . .”Patient: “My dad will survive you.” Several doctors: “We’re an army, thousands strong . . . and cancer, you’re going to lose.'' No asterisks. No cleverly parsed disclaimers. The Anderson advertisement says, simply: Come to us and you will beat cancer. The word “cancer” in the company’s logo is even rendered in red strike-through to reinforce the triumphant aura. (Steve Salerno, 4/20)

Stat: Combination Immunotherapy May Have Failed In A Trial, But It's Here To Stay
The failure of Incyte’s Phase 3 clinical trial of epacadostat combined with Keytruda, Merck’s breakthrough checkpoint inhibitor, for people newly diagnosed with melanoma was a big disappointment to the companies, the pharmaceutical industry, and patients. This negative trial prompted some to question whether combination immunotherapies have a future. Not me. I believe that immunotherapy and combination therapy are here to stay. (Raymond J. Tesi, 4/23)

The New York Times: What Hospitals Can Teach The Police
When a police officer in Cambridge, Mass., punched a black male Harvard student in the stomach multiple times while subduing him this month, the nation was reminded yet again of how quickly confrontations between the police and civilians can intensify beyond what the situation seems to call for. (The student was naked in public and apparently behaving erratically.) Much of the recent conversation about police violence in the United States has focused — quite rightly — on concerns about racism and the flagrant abuse of power. (Douglas Starr, 4/21)

The Detroit News: House Should Ease Medicaid Work Rules
Michigan needs more workers to fill the jobs now vacant in its expanding economy. And it needs fewer residents collecting Medicaid benefits, if it is to keep that program solvent for those truly in need. Both goals can be accomplished with a reasonable version of the Medicaid work requirement bill moving through the Legislature. But it must be the right version, and the bill passed by the Senate last week is not the one. (4/21)

Columbus Dispatch: Ballot Can Cure Legislative Inaction On Guns
Among nations, only the United States makes it easy for criminals and the deranged to buy all types of weapons with practically unlimited firepower. Ohio is not among the 19 states (and the District of Columbia) that require universal background checks. The Ohio General Assembly shows no interest in the subject. That being the case, gun-safety advocates should take the steps necessary to qualify such an issue for the statewide ballot, either in November 2018 or November 2020. If carefully crafted, it almost certainly would win approval. In November 2016, voters in California, Nevada and Washington approved initiatives to prohibit any transfer of a firearm without a background check. A similar initiative failed narrowly in Maine. (4/23)

The New York Times: California, Coffee And Cancer: One Of These Doesn’t Belong
About two-thirds of smokers will die early from cigarette-based illnesses. Cigarettes are also very addictive. Because of this, it seems reasonable to place warnings on their labels. If a Los Angeles Superior Court judge has his way, California businesses will have to put similar warnings on something else that can be addictive, coffee. His ruling, which is being challenged by coffee producers, is harder to justify in terms of health — if it can be justified at all. (Aaron E. Carroll, 4/23)

Arizona Republic: NRA Support Proves Ducey’s School Safety Plan Is A Joke
Sometimes, an endorsement of a political proposal is the best evidence that the proposal is a joke.Case in point:The National Rifle Association has endorsed Gov. Doug Ducey’s plan to improve school safety.Republican lawmakers gleefully announced the NRA’s support.As I’ve said before, Ducey’s plan is not nothing.Not nothing. But next to nothing. But it is next to nothing. That is not enough to deal with our gun violence problem but is plenty enough to satisfy the NRA. It adds officers to schools and a few other things, but it doesn’t deal with Arizona’s gun-show loophole, which allows any private citizen to sell a weapon to another private citizen without a background check. If there is no universal background check there is no real protection. (EJ Montini, 4/21)