Politico: Can House Democrats Really Protect Obamacare?
House Democrats who swept back into power on the promise to protect people with pre-existing conditions face tough legal and political choices as they try to make good on that vow. Those promises galvanized millions of voters. But now, like the Republicans previously elected on promises to repeal and replace Obamacare, they face the formidable challenge of turning campaign rhetoric into reality. (Ollstein and Cancryn, 11/24)

Modern Healthcare: HealthCare.Gov ACA Enrollment Lower By 400,000 
A little more than 1.9 million people signed up for health insurance in the first three weeks of the Affordable Care Act open enrollment for 2019 coverage. That compares with almost 2.3 million during the first three weeks of open enrollment last year, which included an additional day. Americans are signing up for coverage through the federal marketplace at a slower rate this year, but the CMS numbers don't include enrollment in states that operate their own exchanges. It also does not include those who will be automatically enrolled in plans during the last week of open enrollment, which ends Dec. 15 in most states. (Livingston, 11/21)

Kaiser Health News: In Health Insurance Wastelands, Rosier Options Crop Up For 2019
In recent years, places such as Memphis and Phoenix had withered into health insurance wastelands as insurers fled and premiums skyrocketed in the insurance marketplaces set up by the Affordable Care Act. But today, as in many parts of the country, these two cities are experiencing something unprecedented: Premiums are sinking and choices are sprouting. In the newly competitive market in Memphis, the cheapest midlevel “silver” plan for next year will cost $498 a month for a 40-year-old, a 17 percent decrease. (Rau, 11/23)

And in news from the states —

The Baltimore Sun: Maryland Legislators Call For Health Insurance Down Payment Plan 
Marylanders without health insurance would be required to pay a state penalty that can go toward purchasing coverage, under legislation to be introduced next year by state Sen. Brian Feldman and Del. Joseline Peña-Melnyk. Proponents touted the plan Tuesday at a news conference, followed by a scheduled legislative hearing on health care in Annapolis. (Cann, 11/23)

Chicago Tribune: Is The Obamacare Exchange Losing Its Appeal For Illinois Consumers? Sign-Ups Down 26 Percent During Start Of Open Enrollment 
Illinois residents have signed up for far fewer health insurance plans through the Obamacare exchange so far this year, despite slightly lower prices for many of the most popular plans, according to numbers released Wednesday by the federal government. Three weeks into open enrollment, Illinois residents had selected 57,819 health insurance plans on the exchange, according to the Centers for Medicare & Medicaid Services. That’s a nearly 26 percent drop from the 77,960 plans that had been chosen at about the same time last year. (Schencker, 11/21)

The New York Times: Trump Administration Invites Health Care Industry To Help Rewrite Ban On Kickbacks
The Trump administration has labored zealously to cut federal regulations, but its latest move has still astonished some experts on health care: It has asked for recommendations to relax rules that prohibit kickbacks and other payments intended to influence care for people on Medicare or Medicaid. The goal is to open pathways for doctors and hospitals to work together to improve care and save money. The challenge will be to accomplish that without also increasing the risk of fraud. (Pear, 11/24)

And here's a look at what else is on the administration's health policy agenda for next year —

The Hill: Five Controversial Health Actions On Trump's Agenda 
The Trump administration is expected to push ahead with a range of controversial health policies next year despite Democrats retaking the House. Democrats captured the House majority in part on their health-care message. But despite that there are a slew of actions where the administration is moving ahead on its own agenda. (Weixel, 11/24)

The New York Times: This City’s Overdose Deaths Have Plunged. Can Others Learn From It?
Overdose deaths in Montgomery County, anchored by Dayton, have plunged this year, after a stretch so bad that the coroner’s office kept running out of space and having to rent refrigerated trailers. The county had 548 overdose deaths by Nov. 30 last year; so far this year there have been 250, a 54 percent decline. Dayton, a hollowed-out manufacturing center at the juncture of two major interstates, had one of the highest opioid overdose death rates in the nation in 2017 and the worst in Ohio. Now, it may be at the leading edge of a waning phase of an epidemic that has killed hundreds of thousands of people in the United States over the last decade, including nearly 50,000 last year. (Goodnough, 11/25)

Modern Healthcare: Addiction Treatment Interests Investors, But Quality Questions Remain 
In the midst of a nationwide epidemic of drug addiction, the U.S. has a big shortage of high-quality providers offering treatment to people with substance use disorders. So who's rushing in to fill the gap? Not many traditional health systems. It's private equity firms that see it as a way to build lucrative businesses they can sell for large profits a few years down the line, while providing an important public good. But critics say too often the companies they are building are not offering the most cost-effective services for the largest numbers of people. It's too easy to make money by repeatedly treating patients who relapse, without being held accountable for outcomes. (Meyer, 11/24)

In other news on the crisis —

The Washington Post: Homeless People Are Synthetic Drugs’ Latest Victims. This Activist Has Had Enough.
Robin McKinney wasn’t wearing the right shirt. She also didn’t have all of her supplies. But the night was warm for mid-November, and that had gotten her worried. So she went anyway, pulling up to a Southeast Washington park hit hard by synthetic drugs, trying to make a difference on an issue she believes is usually met with indifference. The District had just seen another spike in K2 overdoses, this one smashing previous levels, with 1,054 overdoses in September alone. And McKinney, whose activism represents the latest chapter in the city’s ongoing struggle against the drug, wanted to get information to the people most in peril. (McCoy, 11/24)

Kaiser Health News: Overshadowed By Opioids, Meth Is Back And Hospitalizations Surge
The number of people hospitalized because of amphetamine use is skyrocketing in the United States, but the resurgence of the drug largely has been overshadowed by the nation’s intense focus on opioids. Amphetamine-related hospitalizations jumped by about 245 percent from 2008 to 2015, according to a recent study in the Journal of the American Medical Association. That dwarfs the rise in hospitalizations from other drugs, such as opioids, which were up by about 46 percent. The most significant increases were in Western states. (Gorman, 11/26)

The New York Times: Federal Ban On Female Genital Mutilation Ruled Unconstitutional By Judge
More than two decades ago, Congress adopted a sweeping law that outlawed female genital mutilation, an ancient practice that 200 million women and girls around the world have undergone. But a federal court considering the first legal challenge to the statute found the law unconstitutional on Tuesday, greatly diminishing the chances of it being used by federal prosecutors around the country. A federal judge in Michigan issued the ruling in a case that involved two doctors and four parents, among others, who had been criminally charged last year with participating in or enabling the ritual genital cutting of girls. Their families belong to a small Shiite Muslim sect, the Dawoodi Bohra, that is originally from western India. (Belluck, 11/21)

The Associated Press: Ruling In Genital Mutilation Case Shocks Women's Advocates
Women's rights advocates said they were shocked when a federal judge in Michigan ruled this week that a law protecting girls from genital mutilation was unconstitutional. They called his decision a serious blow to girls' rights. Legal experts said the judge made clear that U.S. states have authority to ban the practice, though only about half do. Here is a look at the ruling, which dismissed several charges against a doctor accused of cutting nine girls in three states as part of a religious custom, and what could happen next. (Forliti, 11/23)

The Washington Post: Number Of Abortions In U.S. Hit Historic Low In 2015, The Most Recent Year For Which Data Is Available
Fewer U.S. women are having abortions than at any time since Roe v. Wade, according to new government figures released Wednesday. In 2015, the most recent year for which data is available, a total of 638,169 abortions were reported, a decrease of 2 percent from 652,639 abortions in 2014. The abortion rate was 11.8 abortions per 1,000 women ages 15-44 in 2015, compared with 12.1 in 2014 and 15.9 in 2006. (Cha, 11/21)

The Hill: Anti-Abortion Groups In Standoff With Trump Over Fetal Tissue Research 
The Trump administration and its anti-abortion allies have found themselves in a rare feud. The Department of Health and Human Services (HHS) is facing pressure from leading anti-abortion groups to cancel more than $100 million in federal funding for research projects that use fetal tissue. (Hellmann, 11/25)

The Associated Press: Mississippi Will Seek To Revive Law On 15-Week Abortion Ban
Mississippi's attorney general said Friday that he will appeal a federal judge's ruling that struck down one of the most restrictive abortion laws in the United States. U.S. District Judge Carlton Reeves ruled Tuesday that a Mississippi law banning most abortions after 15 weeks "unequivocally" violates women's constitutional rights. (Wagster Pettus, 11/23)

The Associated Press: Battle Over Idaho's Abortion Reporting Law Awaits Ruling
The battle over a new law that creates a list of what lawmakers deem to be complications of abortion and requires health professionals to report when they occurred now awaits a judgment from a federal appeals court. A federal lawsuit against the state of Idaho over the law, which went into effect on July 1, has been put on hold while the Ninth U.S. Circuit Court of Appeals considers a judge's ruling rejecting a preliminary injunction against the legislation. (Ridler, 11/23)

Columbus Dispatch: Failure To Deliver: Burgeoning Industry Fails To Hold Midwives Accountable
Across the country, midwives can dodge punishment for fatal mistakes, leaving empty-armed parents with few avenues for justice and a lifetime of loss. Some states let midwives practice without rules or oversight. Others regulate them but rarely revoke credentials. Even in states with rules, some midwives openly break them. Dozens of U.S. midwives practice unlawfully, including a top official at the North American Registry of Midwives, the certifying body of the largest group of non-nurse midwives in the country. (Le Coz, Salman and Sherman, 11/25)

Columbus Dispatch: Ohio Among More Than A Dozen States That Don't Regulate Non-Nurse Midwives
The United States has failed to keep pace with the rising popularity of out-of-hospital deliveries, which until a decade ago accounted for just 0.8 percent of U.S. births but have nearly doubled since then to 1.5 percent. During that time frame, more than a dozen states have passed laws recognizing, and in many cases regulating, the biggest group of out-of-hospital delivery providers — direct-entry midwives. ...Of the more than 400,000 out-of-hospital births attended by midwives in the past decade, nearly 60 percent involved those not certified as nurses, according to data from the Centers for Disease Control and Prevention. (Le Coz, Salman and Sherman, 11/26)

The CT Mirror: Midwives Could Be Key To Reversing Maternal Mortality Trends
Despite the fact that an estimated 85 percent of women are appropriate for midwife care, midwives attend about 11 percent of births in Connecticut, said Holly Kennedy, professor of midwifery at Yale School of Nursing. By contrast, about half of all babies in England are delivered by midwives, according to National Health Services statistics. Kennedy sees a direct correlation between lower use of midwives and higher maternal mortality. (Heubeck, 11/25)

NPR: Bed Rest Is Still Often Prescribed During Pregnancy, Despite Proven Risks
The couch is dark brown corduroy with lumpy cushions. There are a few telltale smears of food, maybe yogurt or a banana, and some crumbs here and there. It's a well-loved piece of furniture. Margaret Siebers plops herself down in the center and reaches out to baby daughter Frances, who climbs onto her mother's lap to breastfeed. "This is where I spent several months," says Siebers, with a shrug. Her 4-year-old, Violet, runs around nearby. "I could come downstairs and sit on the couch." (Kodjak, 11/26)

NPR: Pilot Project To Reduce C-Sections Put To The Test By A Twin's Difficult Birth
The tiny hand and forearm slipped out too early. Babies are not delivered shoulder first. Dr. Terri Marino, an obstetrician in the Boston area who specializes in high-risk deliveries, tucked it back inside the boy's mother. "He was trying to shake my hand and I was like, 'I'm not having this — put your hand back in there,' " Marino would say later, after all 5 pounds, 1 ounce of the baby lay wailing under a heating lamp. (Bebinger, 11/24)

The Washington Post: Supreme Court Sets High Bar For Medical Device Lawsuits
The tiny balloon was supposed to stretch open a blocked artery on Charles Riegel’s diseased heart. Instead, when the doctor inflated the balloon, it burst. The patient went on life support but survived. His lawsuit against the manufacturer of that arterial balloon did not. The U.S. Supreme Court ruled in favor of Medtronic, among the world’s largest makers of medical devices, setting a precedent that has killed lawsuits involving some of the most sophisticated devices on the market. (Pritchard, 11/25)

NPR: Hospitals Rethink Role Of Medical Device Sales Reps During Surgery
In the operating room, surgical masks and matching scrubs can make it hard to tell who's whom — at least for outsiders. Patients getting wheeled in might not realize that salespeople working on commission are frequently present and sometimes even advise the clinical team during surgery. Who are these salespeople, and why are they there? (Farmer, 11/23)

The Associated Press: Spinal-Cord Stimulators Help Some Patients, Injure Others
For years, medical device companies and doctors have touted spinal-cord stimulators as a panacea for millions of patients suffering from a wide range of pain disorders, making them one of the fastest-growing products in the $400 billion medical device industry. Companies and doctors aggressively push them as a safe antidote to the deadly opioid crisis in the U.S. and as a treatment for an aging population in need of chronic pain relief. But the stimulators — devices that use electrical currents to block pain signals before they reach the brain — are more dangerous than many patients know, an Associated Press investigation found. They account for the third-highest number of medical device injury reports to the U.S. Food and Drug Administration, with more than 80,000 incidents flagged since 2008. (Weiss and Mohr, 11/25)

Detroit Free Press: Spectrum Health Suggests Crowdfunding For Heart Transplant
A Grand Rapids-based hospital system has denied a heart transplant to an ailing 60-year-old woman, recommending that she first try to fund raise $10,000 on her own. In a Nov. 20 letter that has since gone viral on social media, a nurse with Spectrum Health's Heart & Lung Specialized Care Clinics told the patient that a heart transplant committee determined that she isn't currently eligible for the transplant because she needs more secure financing for the expensive immunosuppresive drugs necessary to keep her body from rejecting the new organ. (Reindl, 11/25)

The Wall Street Journal: Hospitals Hire Frontline Workers To Improve Care, Trim Costs
To drive down health care costs and improve outcomes for patients with chronic illnesses, New York’s Northwell Health hospital system is training health care workers who can better relate to—and help—people from underserved and largely minority communities. Less than a year old, Northwell’s program has trained nearly 30 people to become community health workers, a nonmedical, entry-level job at the front lines of serving hard-to-reach patients in vulnerable communities, many of whom use Medicaid. (West, 11/22)

Bloomberg: Mysterious $1,000 Lab Bills Leave Patients Baffled And Annoyed
As health plans with high deductibles become more prevalent, labs are increasingly being forced to seek payments from patients, rather than insurance companies. The cost-shifting is leading to unpleasant surprises. Four in 10 insured adults under age 64 said they received an unexpected medical bill in the past year, according to a poll by the Kaiser Family Foundation. Most respondents listed surprise invoices as a bigger financial concern than living expenses, prescription-drug prices and food. (Dodge, 11/21)

Boston Globe: Massachusetts Doctors Going The Startup Route 
More and more, however, executives in Massachusetts’ red-hot biotech cluster are taking a different route. After spending hundreds of thousands of dollars on elite medical schools, they decide they don’t want to wear a white coat — at least not most of the time. They believe they can do more to improve health care by being entrepreneurs. (Saltzman, 11/26)

Richmond Times-Dispatch: Long-Term Care Costs Mostly Rise In Virginia, But Assisted Living Costs Drop Slightly 
An annual cost-of-care survey conducted by Henrico County-based Genworth Financial Inc. shows that costs for care continue to increase nationwide. Costs were up an average of 3 percent from 2017 to 2018, with some care categories exceeding two to three times the 2.1 percent U.S. inflation rate. (Reid Blackwell, 11/23)

Kansas City Star: Suits: Kansas City VA Hospital Failed To Treat Hepatitis C 
VA staff members knew that Jones had hepatitis C. They’d known since at least 2006. But according to a lawsuit, from 2012 to 2015, Jones didn’t get any of the regular scans or ultrasounds that patients with the condition should get. He also didn’t get drugs approved in 2014 that are highly effective at curing it. By the time the VA staff realized Jones had fallen out of the regular treatment protocol, his condition had deteriorated into fatal liver cancer, according to the suit filed on behalf of Jones’ daughter. (Marso, 11/25)

Tampa Bay Times: Bay Pines VA Says It Got Out Front Of Mold Problem, But Workers Insist They Were Long Ignored
Dozens of workers at the Bay Pines VA Healthcare System are being moved out of their building because of an infestation of mold that can cause health problems. ...The investigation, conducted in October by the company VRG of Clearwater, identified two types of mold — aspergillus and penicillium, both known to cause health problems in people with compromised immune systems. The molds can lead to allergic reactions and infections in the lungs and other organs, according to the Centers for Disease Control. (Altman, 11/23)

And in military health care news —

Tampa Bay Times: For First Time Ever, Military's Tricare Will Have Open Enrollment Similiar To Civilian Health Insurance.
For the first time, those using Tricare can take part in an open enrollment season akin to civilian healthcare, allowing users to change or keep their current plan. In addition, military retirees will no longer receive dental benefits through Tricare, but will be able to obtain them through the Office of Personnel Management's Federal Employees Vision Insurance Plan. And family members of active duty personnel, as well as reservists and retirees, will also be eligible to receive greatly expanded vision coverage, according to Patrick Grady, interim chief of the Tricare health plan. (Altman, 11/23)

WBUR: White House Asks Supreme Court To Fast-Track Ruling On Transgender Military Ban
The Department of Justice asked the Supreme Court on Friday to bypass lower courts and rule quickly on its ban of most transgender military members. ...For a case to bypass lower courts, it must be of "imperative public importance" — important enough to warrant a change in the process it's reviewed by appellate courts, and important enough "to require immediate determination in this court," according to Supreme Court rules. (Lombardo, 11/24)

The Hill: Trauma Surgeon Creates Twitter Account To Organize Doctors Against Gun Violence 
A Twitter account for “Medical Professionals who care for #GunViolence Victims” has reached over 15,000 followers since it was created by a trauma surgeon earlier this month. The account @ThisIsOurLane has grown in popularity as health care professionals clash with the National Rifle Association (NRA) after the gun rights organization tweeted “Someone should tell self-important anti-gun doctors to stay in their lane.” (Axelrod, 11/21)

In other news —

NPR: Preventing Suicides Unites Some Doctors And Gun Shop Owners 
Doctors across the U.S. have become increasingly vocal in addressing gun violence as a public health crisis, a posture that recently has drawn the wrath of the National Rifle Association. Yet, in Colorado, a diverse group that includes doctors, public health researchers and gun shop owners has come together to bridge this divide. The Colorado Firearm Safety Coalition has found common ground on at least one issue: preventing firearm suicide. The group's motto: "fighting suicide, together." (Block, 11/21)

The Wall Street Journal: When Mental-Health Experts, Not Police, Are The First Responders
They are the kind of calls that roll into police departments with growing regularity: a man in mental crisis; a woman hanging out near a dumpster at an upscale apartment complex; a homeless woman in distress. In most American cities, it is police officers who respond to such calls, an approach law-enforcement experts say increases the risk of a violent encounter because they aren’t always adequately trained to deal with the mentally ill. At least one in every four people killed by police has a serious mental illness, according to the Treatment Advocacy Center, a nonprofit based in Arlington, Va. (Elinson, 11/24)

In other mental health news —

Boston Globe: Mental Health Therapy At Walmart? It’s Now A Thing
A Boston company is taking the concept of retail health care to a new level — offering mental health treatment in a Walmart. Beacon Health Options, which manages mental health care for 40 million people, has opened a small clinic in the discount department store in Carrollton, Texas. The company plans to roll out the program in other retail locations nationwide, with the goal of increasing access to mental health care. (Freyer, 11/26)

The CT Mirror: School-Based Health Centers Take Leading Role In Fighting Teen Suicide
Although the number of youth in Connecticut who have committed suicide has fluctuated in recent years, making it difficult to identify a trend, mental health professionals who work with teenagers say that depression and anxiety – the typical reasons for suicide – are definitely on the rise. Between 2012 and 2017, there was an 11 percent increase in the number of mental health visits at school-based health centers, according to the Department of Public Health (DPH). Mental health visits now make up 41 percent of total visits to the school-based centers. (Werth, 11/23)

The Associated Press: How Many Kids Have Autism? US Government Measures 3 Ways
How many American children have autism? The U.S. government answers that question at least three different ways and says the latest estimate — 1 in 40 kids — doesn't necessarily mean the numbers are rising. The new number, published Monday in Pediatrics , is from one of three periodic surveys the government uses to assess autism rates. It's higher than a different survey's estimate published earlier this year, but the surveys use different methods and measure different populations of kids so the results aren't really comparable. (11/26)

The Washington Post: In The United States, Right-Wing Violence Is On The Rise
As a Republican, Mitchell Adkins complained of feeling like an outcast at Transylvania University in Lexington, Ky. “Hardcore liberals” made fun of him, he wrote, and he faced “discrimination on a daily basis.” He soon dropped out and enrolled in trade school. But his simmering rage led him back to campus one morning in April 2017, when Adkins pulled out a machete in the campus coffee shop, demanded that patrons state their political affiliation and began slashing at Democrats. (Lowery, Kindy and Tran, 11/25)

The Washington Post: Dispelling Deadly Myths About The Flu Vaccine
Every year as flu season emerges, so too do myths and misconceptions about the flu shot. Some people avoid getting the vaccine because they don’t think it works well enough to be worth it. Some think they are too healthy to need it. And some worry it will make them sick, possibly remembering a time when they got the shot and fell ill soon after. (Sohn, 11/24)

NPR: C. Diff Infections Crop Up Outside Hospitals And Nursing Homes
Named from the Greek kloster, for spindle, a class of bacteria known as Clostridia abounds in nature. Staining deep violet under the microscope, they appear as slender rods with a bulge at one end, like a tadpole or maple seed. They thrive in soil, marine sediments and humans. They live on our skin and in our intestines. And sometimes, they can kill you. (Dalton, 11/25)

USA Today: Makeup's Maligned Ingredients: Are Goop, EWG Right About Chemicals?
Skincare sets wrapped in millennial pink and eco-green are already filling Instagram ads this season, and with their pore-refining promises these would-be stocking-stuffers also draw attention to “toxic chemicals" that’ve been canceled by clean-living proponents in the last few years. Face masks with parabens? Don’t even think about it, the gospel of Goop preaches. Body lotions with mineral oils? Definitely not on Beautycounter’s “nice” list. (Kelly and O'Donnell, 11/21)

Stat: Inside A Stanford Study On Virtual Reality Aimed At Helping Pediatric Patients
Virtual reality is often confined to the usual Silicon Valley crowd — mostly white and mostly wealthy. But at Stanford University, a new clinical trial is testing the technology in an underserved population: Spanish speakers with limited proficiency in English. The idea for the trial was dreamed up by a 24-year-old researcher who noticed that Spanish-speaking parents of pediatric patients undergoing medical procedures were showing more anxiety than is typical in those cases, often because of language and cultural barriers. That parental anxiety could sometimes trickle down to their kids, making them more anxious about their own procedure. (Robbins, 11/21)

Columbus Dispatch: To Their Detriment, Millions Falsely Think They're Allergic To Penicillin
Did you know that more than 29 million people in the United States — a little more than the population of Texas — unnecessarily avoid taking penicillin antibiotics? ...Earlier this year I learned the following statistic: 10 percent of people in the U.S. report penicillin allergy, but 90 percent of them aren’t truly allergic. (Roth 11/25)

Stat: Purported Birth Of First Gene-Edited Babies Proclaimed On YouTube 
In a promotional video posted on YouTube on Sunday, the Chinese researcher He Jiankui revealed new details about the two babies that he claims to have genetically modified as embryos using the gene-editing technology known as CRISPR. He said in the video that the twin girls — named Lulu and Nana — were born a few weeks ago after a normal pregnancy. They are now at home with their mother, a woman named Grace, and their father, Mark, a man who is HIV-positive and did not want to pass along his infection to his offspring, He said. (Robbins, 11/26)

The Washington Post: Teenage Sleep And Brain Health May Improve With A Better Pillow
Healthy sleep leads to healthy brains. Neuroscientists have gotten that message out. But parents, doctors and educators alike have struggled to identify what to do to improve sleep for teenagers. Some have called for delaying school start times or limiting screen time before bed to achieve academic, health and even economic gains. Still, recent estimates suggest that about half of adolescents in the United States are sleep-deprived. These numbers are alarming because sleep is particularly important during adolescence, a time of significant brain changes that affect learning, self-control and emotional systems. (Galvan, 11/24)

The Washington Post: Why You Should Carefully Read Medical Consent Forms You're Given Before Surgery And Other Treatment
Do you think you own your own medical data? Your hospital and doctor records, lab and radiology tests, genetic information, even the actual tissue removed during a biopsy or other surgical procedure? Well, you don’t. It’s a good bet that the fine print of the consent form you signed before your latest test or operation said that all the data or tissue samples belong to the doctor or institution performing it. They can study it, sell it or do whatever they want with it, without notifying or compensating you, although the data must be depersonalized in their best effort to make sure you are anonymous. (Petrow, 11/25)

San Francisco Chronicle: DNA Testing Companies Get Into The Black Friday Game 
If you’ve noticed a flood of ads on TV and social media for DNA test kits featuring smiling families gathered around a dinner table, you’re not alone. Consumer genetic testing companies like Burlingame’s Color Genomics and Mountain View’s 23andMe are trying their hand at Black Friday and Cyber Monday promotions, adopting marketing tactics of more traditional retailers and playing up a familiar theme that resonates with many during this time of year. (Ho, 11/23)

The New York Times: Excess Weight Increases Asthma Risk
Children who are overweight or obese are at increased risk for asthma, researchers report. A retrospective study, published in Pediatrics, included 507,496 children followed for an average of four years. None of the children had incidents of asthma before the start of the study. The researchers divided the children into three groups: overweight, defined as the 85th to 94th percentile for weight; obese, the 95th percentile or higher; and normal weight, the 25th to 64th percentile. (Bakalar, 11/26)

The Washington Post: How An ‘Outbreak Culture’ Worsened The 2014-2016 Ebola Epidemic In West Africa
When Ebola broke out in West Africa in 2014, it spread with dizzying speed — and outwitted responders. By the time the epidemic ended in 2016, more than 28,000 people had been infected and 11,325 had died. It didn’t have to be that way, write Pardis Sabeti and Lara Salahi. In “Outbreak Culture: The Ebola Crisis and the Next Epidemic,” they uncover the chaos behind the world’s response to the 2014-2016 Ebola outbreak, and posit how it could have been avoided. Sabeti, a genetic researcher, was on a team that determined when and where Ebola first jumped from animals to humans. (Blakemore, 11/25)

The Washington Post: Camp Fire, California’s Deadliest Wildfire In History, Has Been Contained
The Camp Fire — the deadliest, most destructive blaze in California history, which has killed 85 people, destroyed 14,000 residences and charred an area the size of Chicago — has been fully contained, authorities announced Sunday. Cal Fire, the state’s forestry and fire protection agency, made the announcement after spending 17 days beating back a blaze that has roared through 153,000 acres of Butte County, which is north of Sacramento. Three straight days of rain helped more than 1,000 firefighters get a foothold. (Wootson, 11/25)

The Wall Street Journal: Deadliest Fire In California History Deemed Contained
“We’re confident that it’s not going to move out of the containment lines,” said Jennifer Erickson, a spokeswoman for the U.S. Forest Service. The fire was contained, but it wasn’t completely out, with sections still smoldering. “There definitely are areas of smoke that probably will be going for a while,” Ms. Erickson said. (McWhirter, 11/25)

The Associated Press: What Makes A California Wildfire The Worst? Deaths And Size
The so-called Camp Fire in Northern California in many ways has become the worst wildfire in the history of a state whose topography and climate have long made it ripe for devastating blazes. With terrain ranging from steep, tree-topped mountains to dry, brush-covered hillsides, and matched with a climate that frequently varies from light rainy seasons to drought years, California has been home to deadly, destructive wildfires since record-keeping began in the early 20th century. (Rogers, 11/23)

The Wall Street Journal: In California, Last Year’s Wildfire Victims Struggle To Recover
Wendy Haynes lives 150 miles from the Camp Fire that has killed more than 80 people, but the smell of smoke and reports of devastation have rekindled memories of when flames raced toward her a year ago. “There’s a sense of reliving everything,” said the 63-year-old physical therapist. Ms. Haynes’s home was one of the few left standing after the 36,807-acre Tubbs Fire roared through Santa Rosa’s Coffey Park neighborhood on Oct. 8, 2017. But she suffered emotional trauma from running for her life as fist-sized embers rained around her. By the time it was all over, more than 5,100 homes in this bedroom city north of San Francisco were lost and 22 people were killed. (Carlton, 11/25)

The Associated Press: Adenovirus Cases Rise To 12 At Southern New Jersey Facility
Health officials say they've identified two new cases of children infected with adenovirus at a New Jersey pediatric health care facility. The Voorhees Pediatric Facility near Philadelphia tells WPVI-TV Friday that brings the total number of infected patients to 12. Facility officials say there have been no related deaths and none of the patients are in critical condition. (11/23)

The Washington Post: Overdoses, Bedsores, Broken Bones: What Happened When A Private-Equity Firm Sought To Care For Society’s Most Vulnerable
To the state inspectors visiting the HCR Manor­Care nursing home here last year, the signs of neglect were conspicuous. A disabled man who had long, dirty fingernails told them he was tended to “once in a blue moon.” The bedside “call buttons” were so poorly staffed that some residents regularly soiled themselves while waiting for help to the bathroom. A woman dying of uterine cancer was left on a bedpan for so long that she bruised. The lack of care had devastating consequences. One man had been dosed with so many opioids that he had to be rushed to a hospital, according to the inspection reports. During an undersupervised bus trip to church — one staff member was escorting six patients who could not walk without help — a resident flipped backward on a wheelchair ramp and suffered a brain hemorrhage. (Whoriskey and Keating, 11/25)

ProPublica: A Hog Waste Agreement Lacked Teeth, And Some North Carolinians Say They’re Left to Suffer
Today, many North Carolina hog farmers continue to store hog waste in open pits despite the millions of dollars in private investment spent and years of research and political promises. Little has changed, storms are intensifying and the clock is ticking on the Smithfield agreement, which expires in 2025. The state has yet to come up a viable replacement system, and the momentum — and money — behind the research ran out years ago, leaving in place a crude practice that grows more hazardous with each hurricane that pounds North Carolina. (Buford, 11/23)

Health News Florida: House Speaker: Florida Health Care 'Behind The Curve' 
Have no doubt: new House Speaker Jose Oliva wants to expand access to health care by expanding the scope of practice for Florida nurses. He also wants less government regulation in Florida’s health-care delivery system and  more free-market principles. (Sexton, 11/26)

The Associated Press: Report: $15M Sought After Body Used For Medical Practice
Relatives of a man whose body was used by the Bellingham Fire Department for intubation practice have filed claims against the city totaling more than $15 million, a newspaper reported. Eleven fire department employees — including two office workers — acknowledged practicing inserting and removing breathing tubes on the body of Bradley Ginn Sr. while waiting for it to be transported to a funeral home on July 31, The Bellingham Herald reported. (11/25)

The Associated Press: Scathing Report On Cleveland County Jail Spurs Vow Of Change
The short-staffed county jail in Cleveland keeps inmates in inhumane conditions, sometimes failing to provide proper food, health care and basics like toilet paper, and locks up juveniles in the same unit as adults, according to a scathing new report released by the U.S. Marshals Service. The Cuyahoga County jail was reviewed following at least six inmate deaths in a four-month span from early June to early October, including some that were considered suicides. Jail officials didn't investigate or document what led to the deaths, according to the report made public this week. (11/23)

Cleveland Plain Dealer: What’s The Story Behind How The Cuyahoga County Jail Became One Of The Worst In The Nation? A Drive For Money, A Cleveland.Com Investigation Finds 
While crowding overwhelmed the understaffed jail, while conditions throughout the facility worsened – while seven inmates died in four months -- the chief conversation by county officials about the jail was about how much revenue could result from a game-changing consolidation of jails throughout the county. The deaths, between June 10 and Oct. 2, happened as Cuyahoga County Executive Armond Budish commenced his long planned merging of many city and township jails – including Cleveland’s -- into the system operated by the county. (Astolfi and Ferrise, 11/23)

Los Angeles Times: Hidden In L.A. Suburbia, Wrenching Poverty Preys On Children And Destroys Dreams
Los Angeles Unified, the second-largest public school system in the country, is more than a sprawling collection of campuses — it’s one of the nation’s largest depositories of child poverty. About 80% of the more than 600,000 students qualify for free or reduced-price meals. When I heard from Supt. Austin Beutner that nearly a quarter of the students at Telfair last year were classified as homeless, I began visiting the school and the neighborhood, hoping to give some human shape to the numbers. You don’t see sprawling tent villages on the streets around Telfair, and there’s little of the squalor so starkly evident on skid row and elsewhere. Poverty is quieter here. It lives indoors for the most part. To an extent, it’s hidden in the fabric of the suburban design, and for all the focus on homeless encampments in Los Angeles, far more people cope with cramped, inadequate, barely affordable housing. (Lopez, 11/25)

The Associated Press: Maryland Medical Marijuana Sales Surpassing Forecast
Medical marijuana sales in Maryland are surpassing a previous forecast and could reach $100 million this year. The Baltimore Sun reports that medical marijuana sales totaled $67 million for the first nine months of 2018. A market research firm predicted last year that the state’s sales in 2018 would be about $46 million. New Frontier Data Senior Economist Beau Whitney said sales could now hit $100 million in December. (11/25)

KCUR: Lenexa Teenager Makes Forbes '30 Under 30' For An App She Created To Detect Parkinson's 
An 18-year-old Shawnee Mission West graduate has been named to the 2019 Forbes '30 Under 30' health care list for an app she created to detect early symptoms of Parkinson's disease. Lenexa native Erin Smith is the youngest in a decade to make the list. She spent most of her junior year of high school designing the app, FacePrint, which she came up with while watching a video of Michael J. Fox. (Tudhope, 11/23)

Seattle Times: ‘There’s Hope Out There’: Wellspring — And A Young Mother’s Will — Lifted A Family 
Founded in 1892, Wellspring Family Services, on Seattle’s Rainier Avenue South, works to end the cycle of family homelessness. It focuses, in part, on children’s early learning, mental health, preventing domestic violence, helping clients connect to housing and, in general, providing a variety of services that can stabilize the family. It is one of 12 organizations that benefit from The Seattle Times’ annual Fund For The Needy donation drive. (Davila, 11/22)

New Orleans Times-Picayune: 1 Percent Of Adults Have His Form Of Leukemia. This Is How An LSU Student Could Beat Cancer. | Nola.Com
Further testing showed that [Lee] Montgomery was suffering from a form of leukemia that is so rare it affects only 1 percent of adults. He had been diagnosed with a form of Acute Myeloid Leukemia, which typically is only seen in infants. ...He had originally been diagnosed at Our Lady of the Lake Regional Medical Center in Baton Rouge but was referred to Ochsner in New Orleans. It was fortuitous, Finn said, that Montgomery’s case matched with a clinical trial for a targeted therapy being researched at the Precision Cancer Therapy Program for treating his form of leukemia. (Clark, 11/25)

California Healthline: Nonprofit Bets Asian-American Students Can Learn To Avoid Unhealthy Gambling
The students listened attentively as Ryan Wong explained how casinos keep customers chasing that elusive jackpot. Labyrinthine layouts force guests to walk past card tables and slot machines in search of well-concealed restrooms and exits, said Wong, an intern at the nonprofit NICOS Chinese Health Coalition, a San Francisco partnership of health and social service organizations. Casinos ply customers with free alcohol to loosen inhibitions, and clocks are nowhere to be found. (Kam, 11/26)

Kansas City Star: Missouri’s Medical Marijuana Law Could Affect Guns, Truckers 
When Colorado legalized recreational marijuana in 2014, the state saw a spike in drug screening failures by truckers, with as many as 60 percent flunking tests required by the U.S. Department of Transportation.Missouri hasn’t legalized marjiuana for recreational use, but Overland Park attorney Jason Roth said he still thinks truckers and those who work in other “safety-sensitive” industries could be in for a shock when the state rolls out its new medical marijuana program next year. (Marso, 11/26)

Los Angeles Times: Americans May Be Ready For Medicare For All, But Congress Isn’t 
Now that the 2018 election has swung control of the U.S. House of Representatives from right to left, some progressive Democrats are pushing for a vote in the new Congress on Medicare for all, a national health insurance program covering all Americans without charging premiums, deductibles or co-pays. ...Some moderate Democrats have pushed back, noting that such a vast expansion of Medicare doesn’t stand a chance of passing the Republican-controlled Senate, let alone being signed into law by a president who campaigned against it (with characteristic hyperbole) in the weeks leading up to the November election. There could be political consequences too: Forcing newly elected House members from formerly Republican-held districts in the Midwest to take a tough vote on a government-run health insurance system could usher Democrats back into the House minority. (11/24)

The New York Times: How Democrats Can Deliver On Health Care
“Democrats need to have a positive agenda, not just be against Donald Trump.” How many times did you hear pundits say something like that during the midterm campaigns? In fact, you’re still hearing it from people like Seth Moulton, who’s leading the (apparently failing) effort to block Nancy Pelosi from returning as House speaker. What makes this lazy accusation so annoying is that it’s demonstrably, arithmetically wrong. Yes, Trump was on everyone’s mind, but he was remarkably absent from Democratic messaging. A tally by the Wesleyan Media Project found that the 2018 elections stand out not for how much Democrats talked about the tweeter in chief, but for how little: Not since 2002 has an opposition party run so few ads attacking the occupant of the White House. (Paul Krugman, 11/22)

The Detroit News: Insurance Flip-Flop Hurts Seniors
Open enrollment for Medicare's prescription drug benefit is underway. From now until December 7, millions of seniors will search for and select a drug plan that best fits their medical needs and budgetary constraints. The vast majority of seniors have at least one chronic condition, and more than two-thirds have two or more chronic conditions -- so choosing the right coverage is important.Fortunately, premium prices are expected to remain stable. But out-of-pocket pharmacy costs are expected to rise, thanks almost entirely to the benefit design set by many insurance plans. To keep premiums low, insurers are saddling sick enrollees with higher out-of-pocket bills.Increasing out-of-pocket expenses for patients with multiple chronic conditions is counterproductive. (Kenneth E. Thorpe, 11/25)

The Wall Street Journal: Imagine What We Could Cure
The discovery that cigarettes cause cancer greatly improved human health. But that discovery didn’t happen in a lab or spring from clinical trials. It came from careful analysis of mounds of data. Imagine what we could learn today from big-data analysis of everyone’s health records: our conditions, treatments and outcomes. Then throw in genetic data, information on local environmental conditions, exercise and lifestyle habits and even the treasure troves accumulated by Google and Facebook. (J.J. Plecs and John H. Cochrane, 11/25)

Stat: Why Aren't Gay Teens Taking A Daily PrEP Pill To Prevent HIV?
Every 30 hours, a gay or bisexual adolescent boy under 18 in the U.S. is diagnosed with HIV. Gay and bisexual teen boys are disproportionately affected by HIV, accounting for almost two-thirds of new infections among adolescents. Young gay and bisexual men of color are hit especially hard, accounting for over three-quarters of these infections. HIV rates are rising among Latino adolescent boys , and 1 in 2 black men who have sex with men are expected to become HIV positive in their lifetimes. Given these alarming numbers, you might expect that substantial efforts are aimed at HIV prevention in these groups of boys. But that’s just not the case — out of 61 HIV prevention programs endorsed by the Centers for Disease Control and Prevention that focus on changing HIV risk behavior, zero are for gay or bisexual teen boys. (Kathryn Macapagal, 11/26)

The New York Times: Abortion Pills Are No Post-Roe Panacea
As abortion rights have come under increasing attack in the United States, commentators have held up self-administered abortion pills as a backup plan for a post-Roe world. They point to the millions of pregnant women worldwide who are using pills to self-manage abortion, citing them as an example of what reproductive health care might look like should in-clinic abortions be made illegal. There’s no question that abortion pills are revolutionary. In the hands of women, the pills have transformed self-induced abortion from a once-dangerous endeavor into a safe procedure. Abortion help lines have walked women through the process of self-management, sometimes remotely or even over the internet. Where abortion is illegal, black market access to the drugs has resulted in significant decreases in complications and deaths. (Francoise Girard, 11/25)

The Hill: Why Romaine Lettuce Won’t Kill You 
FDA and CDC are putting public health first and emphasizing science. They are staying ahead of an emerging health risk, as they should. They also are developing a new system of tracking and labeling food, which makes perfect sense. Unfortunately, we live in a world where the news media quickly fans the flames of fear. By being so diligent and accountable, our health agencies (via the media) also unintentionally send the message that a particular food product — in this case, Romaine lettuce — is unsafe when, in fact, if you ate Romaine, the chances that you would become sick remains astronomically small. (Marc Siegel, 11/24)

The New York Times: How Loneliness Is Tearing America Apart
America is suffering an epidemic of loneliness. According to a recent large-scale survey from the health care provider Cigna, most Americans suffer from strong feelings of loneliness and a lack of significance in their relationships. Nearly half say they sometimes or always feel alone or “left out.” Thirteen percent of Americans say that zero people know them well. The survey, which charts social isolation using a common measure known as the U.C.L.A. Loneliness Scale, shows that loneliness is worse in each successive generation. (Arthur C. Brooks, 11/23)

The New York Times: My New Vagina Won’t Make Me Happy
Next Thursday, I will get a vagina. The procedure will last around six hours, and I will be in recovery for at least three months. Until the day I die, my body will regard the vagina as a wound; as a result, it will require regular, painful attention to maintain. This is what I want, but there is no guarantee it will make me happier. In fact, I don’t expect it to. That shouldn’t disqualify me from getting it. (Andrea Long Chu, 11/24)

Boston Globe: How Do We Solve The Health Care Problems That Drove Question 1?
Hospital care is increasingly complex and specialized, and the demands on staff, especially nurses, are significant. Hospital leaders must redouble efforts to find alternative ways of collaborating with nurses to ease their burden and improve care to our patients. One innovative model might show us the way. (Douglas Brown, 11/23)

St. Louis Post Dispatch: Fighting The Myths Behind The No-Vaccination Movement
According to a recent report by the Centers for Disease Control and Prevention, the number of children without vaccines is on the rise, and has been since at least 2001. The report finds that 1.3 percent of children born in 2015 were completely unvaccinated, compared to 0.9 percent of children born in 2011 and 0.3 percent of children born in 2001. How worried should we be? Not that worried, at least not yet. Vaccinations protect not just the children who receive the shots, but everyone else as well. When enough of a given community gets vaccinated, diseases can’t spread because there aren’t enough unvaccinated people to catch the disease, creating what’s often called “herd immunity.” (11/25)

Austin American-Statesman: Texas Must Seize Opportunity To Prevent Child Maltreatment
A federal appeals court ruled that Texas must hire more state workers to protect foster kids, yet the court overruled a lower court’s mandate that Texas increase the number of much-needed foster care homes. Hank Whitman, the commissioner of Child Protective Services, testified to the Texas House this month that the Legislature’s approval last session to significantly increase salaries and hire more caseworkers succeeded in reducing turnover. This is partial progress. But instead of only asking “How do we house and care for abused children?”, we must follow up with asking “How can we stop children from being abused?” (Madeline McClure, 11/23)

Boston Globe: Working Together, We Can End The Opioid Epidemic In Massachusetts
When we want to make our Commonwealth stronger, the private, public, and nonprofit sectors come together and get it done. We did this with education reform, health care reform, marriage equality, and pay equity, just to name a few. Today, with Massachusetts in the grip of an opioid overdose epidemic as evidenced by two reports funded by the RIZE Massachusetts Foundation, we must once again unite and focus our combined strengths on this crisis that is weakening our Commonwealth and hurting people and families. (Andrew Dreyfus, David Torchiana and Kate Walsh, 11/23)

Austin American-Statesman: Family Caregivers Save Texas Billions. They Need Our Support
More than 3.35 million unpaid family caregivers in Texas are providing an estimated 3.2 billion hours of care each year. This silent army is the backbone of elder care in our state, providing unpaid care valued at approximately $35 billion annually. The value provided by these unpaid family caregivers is greater than the entire Texas Medicaid program — federal and state spending combined. Texas can’t afford for these caregivers to stop providing such valuable assistance. (Bob Jackson, 11/23)