The Washington Post: Infighting Between Alex Azar, Seema Verma Stymies Trump Health Agenda
Bitter infighting among President Trump’s top health officials — as well as his own shifting demands on signature policies — have undermined key planks of the president’s health-care agenda as he girds for a tough reelection campaign, according to current and former administration officials. Though polls show the issue is critically important to voters, Trump has failed to deliver on his most important health-care promises. His plan to dramatically lower the prices consumers pay for prescription drugs has been stalled by internal disputes, as well as by technical and regulatory issues, said six people with knowledge of the process. And an administration plan to replace the Affordable Care Act has not materialized even as the administration seeks to strike down the law in federal court. (Abutaleb, Dawsey, Winfield Cunningham and Goldstein, 12/11)

Politico: Azar, Verma Battle For Trump’s Favor Amid White House Showdown
Even after Donald Trump had urged them to end their feud, the president’s top two health deputies couldn’t resist competing for his attention — and undermining each other on Twitter and cable TV. Seema Verma, who runs Medicare, Medicaid and Obamacare, last Tuesday heaped praise on Trump’s recent order that requires hospitals and health insurers to post their prices. "The federal agency I lead, the Centers for Medicare and Medicaid Services, is taking swift action to implement it," Verma wrote in an accompanying Chicago Tribune op-ed that day. But on Friday, Health and Human Services Secretary Alex Azar went on “Tucker Carlson Tonight” — one of Trump’s favorite TV shows — and claimed credit for driving the same initiative. (Diamond, Cancryn and Pradhan, 12/11)

Politico: White House Moves Up Meeting With Warring Health Officials
President Donald Trump's top two health officials have been called to a White House meeting Wednesday evening with acting chief of staff Mick Mulvaney, in the latest attempt to quash their escalating feud, according to four individuals with knowledge of the gathering. HHS Secretary Alex Azar and CMS Administrator Seema Verma were originally planning to meet with Mulvaney on Thursday, and it's not clear why the meeting has been moved up or if Trump will attend. (Pradhan and Cancryn, 12/11)

In other news about the administration —

The Wall Street Journal: Confirmation Hearing Is Smooth For Nominee To Lead Indian Health Agency
President Trump’s nominee to lead the Indian Health Service breezed through a Senate confirmation hearing Wednesday, facing few tough questions from the handful of lawmakers who were present. Rear Adm. Michael Weahkee, a career IHS official who has served as the agency’s acting director since June 2017, has in recent weeks gained the support of many Native American tribes. That made him a shoo-in for senators taking signals from their constituents. (Weaver, 12/11)

Modern Healthcare: ACA Exchange Enrollment Lags As Deadline Nears
With less than a week to go before open enrollment for 2020 health insurance exchange coverage ends in most states, signups trail last year's totals by about 6%, the federal government said Wednesday. Roughly 3.9 million people enrolled in an Affordable Care Act exchange plan in the first six weeks of open enrollment, which ends on Dec. 15 for the states that use the federally operated HealthCare.gov. Plan selections have dropped about 250,000 over the same time in 2018. (Livingston, 12/11)

Mississippi Today: Despite Changes To Affordable Care Act, Mississippi Enrollment Remains Steady In Final Weeks
One of the most common questions Marian Talley gets when helping Mississippians sign up for health insurance under the Affordable Care Act is “We still have Obamacare?” In June 2017, President Donald Trump promised voters he would “very, very quickly” repeal Obamacare. Two-and-a-half years later, the law remains largely intact, but the Trump administration has successfully chipped away at many of its tenets, from ending the requirement that all Americans have coverage and allowing new short-term plans to cutting funding for the navigators who help consumers sign up for insurance. (Campbell and Hensley, 12/11)

Capital Public Radio: Californians Need Health Insurance By Jan. 1 Or Risk Paying A New Penalty
Californians must carry health insurance in 2020, or face a state-imposed penalty starting at $695 in 2021. Covered California and the California Franchise Tax Board are encouraging the state’s uninsured to enroll in a plan by Dec. 15. That’s the deadline for coverage that kicks in Jan. 1. The Covered California enrollment season lasts until Jan. 31. (Caiola, 12/11)

Azfamily.Com: Time Is Running Out To Enroll For Health Insurance In Arizona
When it comes to December, you might think of Christmas or family get-togethers. But, you should be thinking about open enrollment. (Horn and Harper, 12/10)

Seattle Times: Need Health Insurance Through The Washington Health Benefit Exchange? Enrollment Deadline Is This Sunday. 
Time is running out to sign up for health insurance through the state’s marketplace for next year. Open enrollment for the Washington Health Benefit Exchange closes at 11:59 p.m. Sunday, Dec. 15. If you select a plan by that deadline, your coverage will begin Jan. 1, 2020.For those who need help selecting a plan or navigating the enrollment process, Public Health – Seattle & King County is putting on events in Seattle, Federal Way, SeaTac, Tukwila and Vashon Island. Customers can shop for plans on the state’s Healthplanfinder website. (Blethen, 12/11)

In other insurance and health industry news —

Reuters: U.S. Watchdog Finds $6.7 Billion In Questionable Medicare Payments To Insurers
A U.S. government watchdog is raising fresh concerns that health insurers are exaggerating how sick Medicare patients are, receiving billions of dollars in improper payments as a result. Health insurers selling Medicare Advantage plans to seniors and the disabled received an estimated $6.7 billion in 2017 after adding diagnoses to patients' files that were not supported by their medical records, according to a report released on Thursday by the U.S. Health and Human Services (HHS) Inspector General's Office. (12/12)

Detroit Free Press: Hard Cost Targets Set For Blue Cross And These 7 Health Care Providers
Seeking to rein in health care costs, insurance giant Blue Cross Blue Shield of Michigan announced Wednesday that it has reached new payment contracts with seven southeast Michigan hospitals or physicians groups that must start hitting annual cost targets next year or pay penalties. The new payment model, called "Blueprint for Affordability," begins in January and will affect roughly 30% of the Blues' total Commercial PPO and Medicare Advantage products, covering $4 billion in yearly health care spending. (Reindl, 12/11)

Modern Healthcare: Kaiser Permanente Names Gregory Adams CEO
Gregory Adams has replaced the late Bernard Tyson as chairman and CEO of Kaiser Permanente, the Oakland, Calif.-based integrated not-for-profit health system announced late Tuesday. Adams has overseen health plan and hospital operations in all eight of the system's regions since 2016 as executive vice president and group president. (Kacik, 12/11)

The Associated Press: Tips For Using Flexible Spending Dollars Before Year's End
Still have money set aside for medical expenses that you need to spend by the end of the year? There are plenty of ways to meet the deadline for flexible spending accounts, and you don't need to buy big-ticket items. You can use up the balance on everyday purchases like bandages and items you've already bought. (12/11)

Politico: How Trump And The Democrats Parted Ways On Lowering Drug Prices
It was supposed to be one place President Donald Trump and House Speaker Nancy Pelosi could strike a deal. But Pelosi and House Democrats are going it alone on drug pricing, pushing through sweeping legislation this week to bring down the cost of medicines. The White House, infuriated by impeachment, won’t be joining the victory parade, although drug prices — a major voter concern — were one of Trump’s top domestic priorities. The administration instead threw its weight behind a bipartisan Senate drug plan that — like Pelosi’s bill, after leaving the House — is probably going nowhere. (Karlin-Smith, 12/11)

NPR: How The House Prescription Drug Plan Would Try To Lower Drug Prices
Practically everyone is frustrated by high prescription drug prices. Voters have made clear they want Congress to do something about them. The House of Representatives is voting Thursday on a bill that tries to deliver on that. It's highly unlikely to get through the Senate, and the White House has announced that President Trump would veto it if it came to his desk. (Simmons-Duffin, 12/12)

Modern Healthcare: House Democrats Amend Drug-Pricing Bill To Boost Private Plans' Cost Savings
House Democratic leaders amended their signature government drug price negotiation bill on Tuesday to eventually require drugmakers to pay back private healthcare plans if they raise drug prices faster than inflation and to include more drugs in negotiations with the HHS secretary. The Congressional Progressive Caucus pushed for the changes, and some members threatened to vote against the bill if their demands were not met. (Cohrs, 12/11)

Stat: It’s A Bonanza: With Drug Pricing Bill Up For A Vote, D.C. News Outlets Are Drowning In Advocacy Ads
The almost comical onslaught of ads in Wednesday’s newspapers represents drug makers’ last stab at sinking Democrats’ signature drug pricing bill. All of them — some more explicitly than others — urge lawmakers to vote against Speaker Nancy Pelosi’s sweeping drug pricing package, which is set for a House vote this week. The bill would direct Medicare to negotiate the price of certain high cost drugs. STAT counted nearly 20 ads across the papers. (Florko, 12/11)

The Hill: Ways And Means Committee Announces Rival Surprise Medical Billing Fix 
The House Ways and Means Committee on Wednesday put out its own, rival proposal to protect patients from surprise medical bills. The proposal from Reps. Richard Neal (D-Mass.) and Kevin Brady (R-Texas), the chairman and ranking member of the panel, comes on top of the deal announced by a different panel on Sunday. That panel, the Energy and Commerce Committee, on Sunday announced a bipartisan deal on surprise medical bills that included the chairman of the Senate Health Committee, Sen. Lamar Alexander (R-Tenn.).  (Sullivan and Hellmann, 12/11)

Bloomberg: Patients, Insurers Seen As Biggest Winners In Surprise-Bill Deal 
Congress is closing in on a deal that could shield patients from surprise medical bills, eliminating a source of frustration for Americans who face unexpected charges from emergency care and other procedures. The question for the health-care industry is whether that fix might have broader implications for overall medical prices. (Court and Tozzi, 12/11)

The Hill: House Democrats To Vote On Flavored E-Cigarettes Ban Next Year 
A bill aimed at curbing youth vaping rates by banning flavored e-cigarettes will not get a vote in the House until next year, one of the measure’s co-sponsors said. Rep. Donna Shalala (D-Fla.), who co-sponsors the bill with Energy and Commerce Committee Chairman Frank Pallone Jr. (D-N.J.), told The Hill on Wednesday that she has a “promise” from House leadership for a vote on the floor “early” next year. (Hellmann, 12/11)

PBS NewsHour: Researchers Still Striving To Understand Cause Of Vaping-Related Illnesses
State governments continue to crack down on flavored e-cigarettes and other vape products, largely in response to the deaths and illnesses that began coming to light this past summer. But as lawmakers deliberate over their policy response to vaping, researchers are still trying to understand the cause of the illnesses. (O'Brien, 12/11)

Meanwhile, in the states —

The Associated Press: New York Could Try To Keep Alive Flavored E-Cigarette Ban 
New York's ban on flavored e-cigarettes is still held up in court but the state may try to keep it alive and expand it to include menthol. The state's Public Health and Health Planning Council is set to vote Thursday to keep the emergency ban on the books for another 90 days. The council had approved the ban in September but a state appeals court blocked the state from enforcing it in October. (Villenueve, 12/12)

Atlanta Journal-Constitution: Georgia Lawmakers Consider Ways To Curb E-Cigarette Use
The chairwoman of a state House health panel said she wants Georgia to pull flavored vaping liquids from stores and raise the purchase age to 21 to help keep the smoking product out of the hands of children. House Health and Human Services Chairwoman Sharon Cooper, a Marietta Republican, said she believes the General Assembly will pursue legislation to cut down on underage use of the e-cigarettes. (Prabhu, 12/11)

Politico: Impeachment Committee’s Rancor Forged By Decades Of Abortion Battles
The personal attacks, shouting matches and made-for-TV stunts on full display in the House Judiciary Committee’s impeachment proceedings this week were actually decades in the making. Tasked on paper with overseeing the federal courts, the committee — now in the midst of debating, then voting out articles of impeachment — has long been at the heart of the nation’s culture wars. Its stage draws partisans eager for star turns — and is radioactive for more moderate or vulnerable lawmakers from swing districts. (Ollstein, 12/12)

In other news from Capitol Hill —

Los Angeles Times: Congress To Halt Military Use Of Toxic Foam Contaminating Drinking Water
Congress has reached a deal on a spending bill that would require the military to stop using firefighting foam containing toxic chemicals linked to cancer, but would abandon efforts to place stronger regulations on the chemicals. The bill, called the National Defense Authorization Act, has been the focus of intense negotiations for months. (Phillips, 12/11)

The Associated Press: Doctors End Protest To Demand Flu Vaccines For Migrants
A group of doctors on Wednesday ended a three-day protest against the U.S. government's refusal to allow the flu vaccine be administered to migrants, following the arrests of six demonstrators outside a Border Patrol regional headquarters in San Diego. Dr. Bonnie Arzuaga said Customs and Border Patrol officials met briefly with her and other protest leaders and vowed to pass her organization's request to start a pilot program to inoculate migrants in detention facilities in San Diego up their chain of command. (Watson, 12/11)

Los Angeles Times: U.S. Officials Won't Let Doctors Give Flu Shots To Migrant Children
Dr. Mario Mendoza, a retired anesthesiologist, said it would take less than half an hour to administer the vaccines to more than 100 children via the free mobile flu clinic they set up directly outside the CBP facility. “We have the team here. We have the vaccines. It would not take 72 hours to do,” said Mendoza, adding that denying children the basic healthcare being offered was intentionally cruel and inhumane. (Fry, 12/10)

The New York Times: Why Border Patrol Refuses To Offer Flu Shots To Migrants
Since last December, three migrant children have died from influenza in facilities along the southwestern border, where migrants routinely complain that cold temperatures sicken children, and where physicians have reported that crowded conditions spread illnesses. The Centers for Disease Control and Prevention, concerned that infectious respiratory illnesses were spreading in congested border facilities, this year recommended flu vaccinations “at the earliest point of entry” for migrants who are 6 months or older. (Jordan, 12/11)

CNN: Border Agency Says It's Doing All It Can To Stop Children From Dying From Flu. Others Aren't So Sure
In its 10-page report, which was issued in January, CDC experts wrote that border patrol agents lacked training to identify acutely ill migrants, and that there were "limited" options for isolating sick migrants. "Current infrastructure is not sufficient to assure rapid and adequate infection control measures," the CDC experts concluded. "With inadequate DHS medical infrastructure, illness in the border patrol facilities stresses both the border patrol staff and the community medical infrastructure." (Cohen and Bonifield, 12/12)

In other news on immigration, an investigation reveals that some doctors involved in vetting green card applicants have a history of professional misconduct, highly skilled immigrants struggle to find work in their fields, and more —

ProPublica: Despite Audit, Doctors With Checkered Records Can Still Decide Fate Of Green Card Seekers
Last year, government investigators found that the federal program for vetting the health of green card applicants included scores of doctors with histories of professional misconduct. Physicians who had been disciplined by state medical boards for abusing patients, and in some cases had faced criminal charges, had the government’s blessing to conduct screenings that can decide the fate of an immigrant’s petition for permanent residency. (Chou and Medina, 12/12)

ProPublica: Your Doctor Might Have A Disciplinary Record. Here’s How To Find Out.
Patients often select doctors based on recommendations from family and friends, distance from their house or participation in their health insurer’s network. ProPublica also provides helpful resources for researching doctors, and knowing whether a doctor has been sanctioned by a professional licensing board should be another essential part of your search. Doctors can be disciplined for criminal convictions, medical negligence, wrongly prescribing controlled substances and other wrongdoing. (Ornstein, Waldman and Ojiaku, 12/11)

KQED: ‘Brain Waste': Highly Skilled Immigrants Struggle To Fill Workforce Gaps
Burmese doctors dish sushi at a restaurant, a Jordanian computer engineer drives for Uber, and a Nepali non-profit program officer stocks shelves at a Walmart. Nearly two million college-educated immigrants labor in jobs for which they are overqualified, or cannot find work at all. The so-called “brain waste” phenomenon is costing California and other states billions of dollars per year in lost individual earnings and tax revenues, according to estimates by the Migration Policy Institute. (Romero, 12/11)

Atlanta Journal-Constitution: Marietta Leaders Reject Shelter For Immigrant Children
A proposal to open a shelter for unaccompanied migrant children seized from the U.S-Mexico border suffered a major setback, but the pastor behind the project is not ready to throw in the towel. The Marietta City Council on Wednesday unanimously voted to overturn a Zoning Board of Appeals’ decision and deny a variance to Stone Mountain Pastor Mitchell Bryant for the shelter at a building at 119 Powers Ferry Road. (Dixon, 12/12)

The New York Times: Suspect In Rampage At N.J. Kosher Market Wrote Anti-Semitic Posts
After first saying that a deadly rampage at a New Jersey kosher market was random, the authorities disclosed on Wednesday that one of the two attackers had published anti-Semitic posts online and had, in fact, targeted the site. He was also a follower of the Black Hebrew Israelite movement, a fringe religious group that has expressed hostility to Jews, officials said. A rambling religious manifesto was found inside the suspect’s rental van. (Barron, Gold and Watkins, 12/11)

Politico: Grewal Won’t Call Jersey City Attack A Hate Crime; Fulop Says ’No Other Way To Interpret It’
State Attorney General Gurbir Grewal and federal officials refused during a Wednesday afternoon press conference to say whether investigators believe the attackers — a man and woman who are also suspected of fatally shooting a police detective — were motivated by hate against the Jewish community. (Hutchins, 12/11)

The Wall Street Journal: New Jersey Shooters Targeted Kosher Grocery Store, Jersey City Mayor Says
Anderson, 47 years old, and Graham, 50, used high-powered rifles to kill three people inside the Jersey City Kosher Supermarket on Tuesday afternoon after pulling up to the store in a stolen U-Haul van, officials said. The shooters had earlier killed a police officer during a confrontation at the Bay View Cemetery about a mile away, Mr. Grewal said. Investigators also recovered a pipe bomb from the stolen van, he said, as well as digital and documentary evidence. (De Avila and Blint-Welsh, 12/11)

The New York Times: ‘I’ve Cried My Eyes Out’: Victims Of N.J. Shooting Are Mourned
For the dozens of Hasidic Jewish families who had settled in Jersey City over the past few years, the JC Kosher Supermarket served as a community hub. It was the sole kosher grocery store in the area, stocking Kedem grape juice, canned vegetables and candy. The store’s popular deli counter was run by a young couple — among the first to relocate to Jersey City from the Satmar Hasidic neighborhood of Williamsburg, Brooklyn, in search of more affordable housing and a bit of open space. (Otterman, 12/11)

In other news on gun violence —

The Associated Press: As Newtown Students Grow Up, Some Turn To Activism
They were children themselves when they lost siblings, friends, and schoolmates in the Sandy Hook Elementary School shooting. Too young to comprehend the massacre, they spent years in shock and denial. Seven years later, some young people in Newtown, still struggling with the trauma, are emerging as new voices for school safety and gun violence prevention. The activism, they say, has been a way to turn something horrific into something positive. (Collins, 12/11)

Kaiser Health News: Battling The Bullets From The Operating Room To The Community
Dr. Laurie Punch plunged her gloved hands into Sidney Taylor’s open chest in a hospital’s operating room here, pushing on his heart to make it pump again after a bullet had torn through his flesh, collarbone and lung. His pulse had faded to nothing. She needed to get his heart beating. She couldn’t let the bullet win. (Ungar, 12/12)

The Washington Post: FDA Warns Company Over Ad That Leaves Out Information On Risk Of Overdose
The Food and Drug Administration has warned the manufacturer of a long-acting anti-addiction medication that its printed advertisement does not include one of the most serious risks of using the product: the increased chance of an opioid overdose. In a Dec. 2 letter to Alkermes that was posted to the FDA’s website Wednesday, the agency said a company ad for Vivitrol does not warn users that they are more vulnerable to a “potentially fatal” overdose if they resume use of opioids after the medication wears off. (Bernstein, 12/11)

Stat: FDA Blasts Alkermes For Underselling Risks Of Vivitrol 
The company failed to sufficiently communicate the risk of overdose associated with Vivitrol, which is one of three FDA-approved medications used to treat opioid use disorder. While Vivitrol guards against opioid cravings and relapse for people in recovery from opioid addiction, it reduces opioid tolerance and leaves its users more vulnerable to opioid overdose for patients who relapse, even at comparatively low doses. (Facher, 12/11)

In other news on the opioid crisis —

San Francisco Chronicle: New Online Tracking System Shows How Many SF Addiction Treatment Beds Sit Empty
San Francisco is hoping to better match the swelling population of those struggling with addiction to its vacant drug treatment beds. The Department of Public Health launched a new tool this month, findtreatmentsf.org, to track empty treatment beds in San Francisco after officials realized that desperately needed spots were sitting unused despite a tsunami of need on the streets. (Thadani, 12/11)

The Washington Post: Planned Parenthood To Open Centers At 50 Los Angeles High Schools
Planned Parenthood is pioneering a new model of reproductive health services for Los Angeles County teens by opening 50 clinics at area high schools. The program — announced Wednesday and launched in partnership with the school district and county health department — is believed to be the most ambitious effort in the country to bring these types of services to at-risk students in public schools. The program, funded by an initial investment of $10 million from Los Angeles County and $6 million from Planned Parenthood over three years, will offer a full range of birth control options, testing and treatment for sexually transmitted infections, and pregnancy counseling, but not abortion, for an estimated 75,000 teens. (Cha, 12/11)

KCUR: Funding For Missouri Planned Parenthood Clinics In Hands Of State Supreme Court 
The Missouri Supreme Court heard oral arguments on Tuesday to decide whether the state’s 12 Planned Parenthood clinics should receive federal funding. John Sauer argued on behalf of the state, asking the court to back the Republican-led Legislature’s 2018 decision to deny funding to all Planned Parenthood facilities but not other providers that care for the state’s Medicaid population. (Driscoll, 12/11)

Iowa Public Radio: Questions Remain Over Decline In Use Of Iowa's Family Planning Program
Public officials say they're not sure why there has been a sharp decline in the number of people in Iowa using a state family planning program. According to a Department of Human Services report presented at a council meeting on Wednesday, 1,502 people used the program in 2018, a sharp drop from nearly 5,857 in 2017. (Krebs, 12/11)

Health News Florida: Senate Health Panel Clears Parental Consent Abortion Bill
Religious, political and social beliefs are key to the debate over whether to require parental consent for abortions in Florida. After an initial stall, the Senate’s Health Policy Committee voted Tuesday along party lines to approve the measure. Senate Health Policy Committee Chairwoman Gayle Harrell split her hearing room in two—those for and against the bill. People were called up to speak in groups of 10. (Hatter, 12/11)

Columbus Dispatch: Where Did This Ohio Lawmaker Get His Ideas About Implanting Ectopic Pregnancies? 
No one was talking about the notion of reimplanting ectopic pregnancies until two conservative Ohio men plopped the idea into their proposal to ban insurance coverage of abortions. Clermont County Rep. John Becker, R-Union Township, didn’t consult doctors about the medical procedure. Instead, he received regular input from Barry Sheets, a lobbyist for the Right to Life Action Coalition of Ohio, according to emails obtained through a Cincinnati Enquirer public records request. (Balmert, 12/11)

The Associated Press: More Americans Are Dying At Home Rather Than In Hospitals
For the first time since the early 1900s, more Americans are dying at home rather than in hospitals, a trend that reflects more hospice care and progress toward the kind of end that most people say they want. Deaths in nursing homes also have declined, according to Wednesday's report in the New England Journal of Medicine. (Marchione, 12/11)

The New York Times: More Americans Are Dying At Home Than In Hospitals
The gap may be small, but it had been narrowing for years, and the researchers believe dying at home will continue to become more common. The last time Americans died at home at the current rate was the middle of the last century, according Dr. Haider J. Warraich, a cardiologist at the Veterans Affairs Boston Healthcare System and a co-author of the new research. (Kolata, 12/11)

NBC News: More People Are Choosing To Die At Home, Instead Of In A Hospital
The flip-flop may be attributed in part to growth in home hospice care, which is covered by Medicare, said study co-author Dr. Haider Warraich, associate director of the heart failure program at the VA Boston Healthcare System. Hospice provides pain management, along with emotional support and care to terminally ill patients nearing the end of their lives, as well as their families. The number of Medicare beneficiaries receiving hospice care has steadily grown over the past decade. The National Hospice and Palliative Care Organization reports there were 1.49 million such recipients in 2017, a 4.5 percent increase from the year before. (Edwards, 12/11)

CNN: More People Are Dying At Home Than At The Hospital
Patients with cancer had the greatest odds of dying at home or in hospice, the report said. People with dementia died more often at a nursing home, and stroke patients had the lowest odds of dying at home. While an increasing number of people use hospice, other studies have shown that kind of care is underutilized. Medicare covers up to six months of hospice care, yet, most people only turn to hospice days, instead of months, before death, earlier studies found. (Christensen, 12/11)

The Associated Press: New Drugs Show Rare Promise Against Advanced Breast Cancer
Doctors on Wednesday reported unusually good results from tests of two experimental drugs in women with an aggressive form of breast cancer that had spread widely and resisted many previous treatments. One drug showed particular ability to reach tumors in the brain, which are notoriously tough to treat. (Marchione, 12/11)

Stat: AstraZeneca Breast Cancer Drug Shrinks Tumors In Majority Of Women
In March, AstraZeneca (AZN) signed a deal with Japanese drug maker Daiichi Sankyo that would pay up to $6.9 billion — $1.35 billion up front and $5.55 billion if sales and regulatory targets are hit — for a single experimental cancer drug. On Wednesday, data from that drug are being presented at the San Antonio Breast Cancer Symposium and published in the New England Journal of Medicine. The new drug, trastuzumab deruxtecan, was tested in a clinical trial of 184 breast cancer patients whose tumors tested positive for a marker called HER2 and who had previously received cancer treatments including Roche’s Kadcyla. (Herper, 12/11)

Columbus Dispatch: Beatty Wants Congress To Cut Insulin Prices 
U.S. Rep. Joyce Beatty says her new bill would reduce the financial burden for the 7.4 million Americans who use insulin to manage their diabetes. ... A working group at the American Diabetes Association said in March that the list price of insulin has nearly tripled since 2002. The group blamed pharmacy benefit managers — middlemen in the drug-supply chain — for much of the increase. (Rowland, 12/11)

Stat: These Four Startups Got Venture Funding A Year Ago. Did It Help?
Early-stage biotech companies are almost always raising money. That cash, CEOs say, fuels their amazing science and potentially amazing drugs. But early-stage companies are private; only their investors can count on regular updates on their progress. For everyone else, sporadic press releases are usually the only opportunity to hear from a company’s leadership. (Sheridan, 12/12)

Stat: In Largest Fundraising Effort To Date, Omega Funds Pulls In Over $400 Million
Boston-based biotech investor Omega Funds now has $438 million more to spend. The company announced Wednesday that it completed its sixth and largest-ever venture capital investment fundraising effort. The firm’s previous investments include Gossamer Bio (GOSS), Juno Therapeutics, and Editas Medicine (EDIT). (Sheridan, 12/11)

Modern Healthcare: November-Reported Healthcare Breaches Exposed 570,000 Patients' Data
More than half a million people had data exposed in healthcare breaches reported to the federal government last month. Providers, health plans and their business associates in November reported 29 data breaches affecting 570,565 patients to HHS' Office for Civil Rights, the agency that maintains the government's database of healthcare breaches. That's the lowest number of breaches reported in a single month this year. (Cohen, 12/11)

Modern Healthcare: Google Health Hires AliveCor's Chief Medical Officer
Google Health continues to build out its health team, scooping up Dr. Jacqueline Shreibati, chief medical officer for wearables start-up AliveCor, as its latest hire. Shreibati will work on the tech giant's clinical team and report to Dr. Karen DeSalvo, Google Health's chief health officer and a former HHS official, a Google spokesperson confirmed. Google added DeSalvo to its health team in October, just weeks after confirming it had tapped former Food and Drug Administration Commissioner Dr. Robert Califf to lead health strategy. (Cohen, 12/11)

The New York Times: This Helmet Will Save Football. Actually, Probably Not.
Walk between a colonnade of palm trees and push through a door at Stanford University and find a sorcerer’s apprentice lab where prospective Ph.D. sorts beaver away at bioengineering programs. This is CamLab, where David Camarillo, a nationally respected bioengineer and former college football tight end, and his students are in pursuit of that American El Dorado: They seek a helmet that will make it safe to play tackle football. Dr. Camarillo, 40, insisted they could soon crack the case. (Powell, 12/12)

The Wall Street Journal: E. Coli Outbreaks In Lettuce Point To Gaps In Food Safety
E. coli illnesses linked to romaine lettuce show how U.S. regulators continue to struggle with identifying which farms spark an outbreak and stopping it from spreading. An outbreak involving a romaine-based salad kit has sickened at least eight people in three states, health officials said this week. Those cases could be connected to an outbreak in romaine last month that sickened more than 100 people in 23 states even though the strains of E. coli are different, according to the Centers for Disease Control and Prevention. (Gasparro, 12/11)

Stat: Surgeons Test-Drive The Amputation Of The Future
More than 20 patients have now undergone the new leg operation — named the Ewing amputation after the first patient — and the early results have been “much better than we ever thought it would be,” [plastic surgeon Dr. Matthew Carty of Brigham and Women’s Hospital] said in an interview. Based on that experience, the Pentagon has awarded the Brigham, the Massachusetts Institute of Technology, and Walter Reed almost $3 million to come up with something similar for the arm, with 10 procedures planned at the Boston and Washington hospitals. (Gil, 12/12)

The Associated Press: Fewer Kids Report Sex Abuse In US Juvenile Detention Centers
A new federal report has found the number of kids who say they have been sexually victimized in juvenile detention centers has dropped across the U.S. compared with past years. But remarkably high rates of sexual abuse persist in 12 facilities stretching from Oregon to Florida, according to the Bureau of Justice Statistics report released Wednesday. The report analyzed data collected during more than 6,000 anonymous interviews last year at nearly 330 juvenile detention facilities. (12/11)

The New York Times: Why Women On The Pill Still ‘Need’ To Have Their Periods
In the 1960s, manufacturers of the new birth-control pill imagined their ideal user as feminine, maternal and forgetful. She wanted discretion. She was married. And she wanted visible proof that her monthly cycle was normal and that she wasn’t pregnant. In 2019, the user of the pill is perceived as an altogether different person. She’s unwed, probably would prefer to skip her period and is more forthright about when it’s that time of the month. As such, many birth-control brands now come in brightly colored rectangular packs that make no effort to be concealed. (Gross, 12/11)

NPR: In Construction, Suicide Prevention Becomes Part Of The Toolbox
It has been five years, but the memory still haunts construction superintendent Michelle Brown. A co-worker ended his workday by giving away his personal cache of hand tools to his colleagues. It was a generous but odd gesture; no one intending to return to work would do such a thing. The man went home and killed himself. He was found shortly afterward by co-workers who belatedly realized the significance of his gifts. (Noguchi, 12/12)

The Washington Post: A Genetic Mutation Is Associated With Increased Risk Of Heart Failure In Black People, Study Finds
An underdiagnosed genetic mutation in people of African descent carries an increased risk for heart failure, according to a study. When present in those patients, a genetic variant, TTR V122I, could lead to a higher risk of hereditary transthyretin amyloid cardiomyopathy — a potentially fatal disease caused by a protein buildup in the heart. (Beachum, 12/11)

The New York Times: Sleeping 9 Hours A Night May Raise Stroke Risk
Sleeping a lot may increase the risk for stroke, a new study has found. Chinese researchers followed 31,750 men and women whose average age was 62 for an average of six years, using physical examinations and self-reported data on sleep. They found that compared with sleeping (or being in bed trying to sleep) seven to eight hours a night, sleeping nine or more hours increased the relative risk for stroke by 23 percent. Sleeping less than six hours a night had no effect on stroke incidence. (Bakalar, 12/11)

The New York Times: Questioning ‘The Newer The Better’ For Blood Transfusions
For critically ill children, fresh blood transfusions may be no better than blood that has been stored for several weeks. Transfusions in seriously ill children are usually given to improve oxygen delivery and prevent organ failure, and some studies have suggested that newer blood is better. Now a blinded, randomized trial has found it is not. (Bakalar, 12/11)

Kaiser Health News: The Health Care Promises We Cannot Keep
It was a promise Matt Perrin wasn’t able to keep. “I’ll never take away your independence,” he’d told his mother, Rosemary, then 71, who lived alone on Cape Cod, Mass., in a much-loved cottage. That was before Rosemary started calling Perrin and his brother, confused and disoriented, when she was out driving. Her Alzheimer’s disease was progressing. (Graham, 12/12)

The Washington Post: Season’s First Cold-Related Death Reported In Baltimore
Maryland health officials said Wednesday that a man in Baltimore died of “cold-related illness,” the first such recorded death of this winter season. State health officials released few details about the circumstances of the death, only describing the man as being in the “45-64 age range,” according to a statement released Wednesday. No information was provided about when or where in the city he died. (Williams, 12/11)

The Baltimore Sun: Cold Temperatures Claim First Fatality Of Season, Maryland Health Officials Say 
“As temperatures continue to drop, Marylanders are urged to take every precaution to help prevent cold-related illnesses,” Deputy Secretary for Public Health Fran Phillips said in the release. “Take care to limit your exposure to the cold. Wear layers if you go outside and contact your local health department if you need access to a warming center in your area.” (Reed, 12/11)

MPR: Minnesota Cops Rethink How To Respond To Suicide Calls
Law enforcement leaders from across the state gathered in Bloomington Wednesday to talk about how best to respond to people threatening to kill themselves. Some police departments around the country have shifted how they respond to suicide calls, said Andy Skoogman, executive director of the Minnesota Chiefs of Police Association. (Collins, 12/11)

The New York Times: ‘They Saw Him Hanging And Did Nothing’: A Teen’s Agony In Rikers
Nicholas Feliciano was hauled into a holding pen at Rikers Island on the night before Thanksgiving, after a brawl broke out among detainees at the jail. His lip had been gashed and his friend, Alfonso Martinez, had been stabbed. As Mr. Martinez was being taken to an infirmary, he recalled his friend saying, “If they separate us, I’m going to kill myself.” It was no idle threat. Mr. Feliciano, 18, had tried to take his own life several times before, most recently at a juvenile detention center, his grandmother, Madeline Feliciano, said. (Ransom and Sandoval, 12/12)

The Advocate: At Acadia Jail: No Mental Health Care, Botched Watch Logs And Two Suicides In Six Weeks 
The jail has no mental health program, which is required under voluntary accreditation standards issued by the American Correctional Association and the National Commission on Correctional Health Care. The jail does not seek accreditation. Nor is there any record of either suicide resulting in a review of policies and procedures aimed at preventing another one. (Myers, 12/11)

Atlanta Journal-Constitution: Audit Finds Problems With Aid Program For Rural Georgia Hospitals
A politically popular program that has diverted millions of state tax dollars to struggling rural hospitals has not always benefited the most needy facilities, a state audit of the program found. And a vendor that administers the $60 million-a-year program has reaped far more money than it cost to do the work and won’t let the state see where the money has gone, the report said. (Hart, 12/11)

Cincinnati Enquirer: Ohio Is The Only State Without Standards On Teaching Health. Here's Why.
Forty-nine states set standards on how to educate students on everything from childhood diabetes prevention and exercise to addressing bullies and avoiding tobacco. Ohio does not. It stands alone, largely because of state lawmakers' trepidation about comprehensive sex education. (Balmert, 12/11)

The Associated Press: Arkansas Judge Denies Students' Appeal To Vaccination Policy
A judge has denied two University of Arkansas students' request to block a public health decree that has barred them from attending classes during a mumps outbreak because they don't have the proper vaccinations. The Arkansas Department of Health issued the public health directive in a Nov. 22 letter that stated students without at least two doses of measles, mumps and rubella vaccine either be vaccinated immediately or be barred from classrooms and school activities for at least 26 days. (12/11)

ProPublica/Chicago Tribune: 'None Of The Children At The School Are Safe'
Since mid-May, DCFS has opened a total of 21 abuse investigations involving students at Gages Lake. Citing evidence from surveillance video, agency reports describe workers grabbing children by the wrists, shoving them into walls and throwing them to the ground in a cluster of four seclusion spaces — some with lockable doors, others open — that the school calls “the office.” Two aides at the center of the investigations resigned from the school. One of them is facing criminal charges; Lake County prosecutors allege he used excessive force on students. (Cohen and Richards, 12/12)

The Associated Press: Woman Accidentally Calls DA Investigator, Gets Needed Walker
An 84-year-old New Mexico woman's misdial meant for a medical supply store went to an investigator in a district attorney's office — and led to a new walker. KOB-TV reports Bernice Weems mistakenly called Kyle Hartsock with the Bernalillo County District Attorney’s Office in Albuquerque, New Mexico, seeking a new walker. She left a voicemail. It turns out Hartsock's number is just one digit off from the medical supply store she was trying to call. (12/12)

The Associated Press: Company To Pay $245M Toward Cleanup Of Kalamazoo River PCBs
One of the companies responsible for polluting an 80-mile stretch of river and floodplains in southwestern Michigan with toxic chemicals will pay at least $245.2 million to advance a cleanup effort that began more than 20 years ago, federal officials said Wednesday. NCR Corp. will fund the dredging of contaminated sediments and removal of an aging dam in the Kalamazoo River under an agreement with the U.S. Environmental Protection Agency, the U.S. Department of Justice and the state of Michigan, officials told The Associated Press ahead of an official announcement. (12/11)

Iowa Public Radio: Reynolds: University Of Iowa Doctors Will Review Treatment At Glenwood Center
Physicians from the University of Iowa will go to the Glenwood Resource Center to review residents’ health and their treatment charts, according to Iowa Gov. Kim Reynolds. The U.S. Department of Justice is investigating allegations of mistreatment at the center operated by the Department of Human Services, which cares for Iowans with intellectual disabilities. (Gerlock, 12/11)

KCUR: 18 Years After Mysterious Deaths In A Chillicothe Hospital, Court Dashes Families' Hope For Answers 
After nearly 18 years, the families of five patients who died under mysterious circumstances at a Chillicothe, Missouri, hospital have reached the end of the road. In a unanimous decision Tuesday, the Missouri Supreme Court ruled their lawsuits accusing the hospital of fraudulently concealing the true cause of their loved ones’ deaths were filed too late. (Margolies, 12/11)

Health News Florida: DeSantis Administration Fights Tampa Company Over Pot Ruling
The Florida Department of Health is challenging a July appellate decision that found a state law requiring medical marijuana operators to grow, process and sell cannabis and derivative products --- a system known as “vertical integration” --- runs afoul of a constitutional amendment that broadly legalized medical marijuana. The department went to the Supreme Court in a lawsuit filed by Florigrown, a company owned in part by strip-club operator Joe Redner. (Kam, 12/11)

Milwaukee Journal Sentinel: GOP Medical Marijuana Proposal Snuffed Out By Senate Leader Fitzgerald
Two Republican lawmakers tried Wednesday to breathe new life into a proposal to legalize marijuana for medicinal use, but it was blocked within an hour by the leader of the state Senate. The proposal from Rep. Mary Felzkowski of Irma and Sen. Kathy Bernier of Chippewa Falls would create a new state program to license dispensaries of marijuana for anyone with a serious medical condition, like cancer, AIDS or post-traumatic stress disorder. (Beck, 12/11)

Health News Florida: ‘Green Rush’ Investors Turn Skittish On Medical Marijuana Licenses
In what was jokingly called a “green rush,” investors not long ago stampeded into Florida to gain entry to what was expected to be one of the nation’s most lucrative marijuana markets. The competition swelled after Florida voters three years ago broadly legalized medical marijuana. But even as the possibility of legal recreational pot looms on the horizon, the bidding war for medical-marijuana licenses in the Sunshine State has fizzled. (Kam, 12/11)

Urban Institute: New Data Show About 1 In 10 Adults Turns To Charitable Food Assistance
This holiday season, many people will donate money, food, or time to a local food bank or soup kitchen. Yet how much do we know about the individuals and families who use charitable food assistance? New data from the Urban Institute’s Well-Being and Basic Needs Survey (WBNS) reveal that more Americans than previously estimated turn to charitable food services to feed their families. As we discuss in our new brief, about 1 in 10 adults (10.3 percent) who were surveyed as part of the December 2018 WBNS said they or someone in their household received charitable food assistance in the 30 days before being surveyed. (Waxman, Joo and Gonzalez, 12/11)

JAMA Internal Medicine: Underappreciated Bias Created By Measurement Error In Risk Factor Assessment—A Case Study Of No Safe Level Of Alcohol Consumption
It is well appreciated that systematic measurement error can bias estimates of the population mean (eg, biased estimates of average alcohol use), but the consequences of systematic measurement error on the associations between risk factors and outcomes are often overlooked. A recent example is a study that led to widely publicized reports of no safe level of alcohol consumption. The study did not account for potential misclassification owing to underreporting of alcohol use. Systematic underreporting of alcohol use could result in overestimating the association between a low amount of alcohol consumption and the risk of adverse health outcomes, especially given evidence that heavy drinkers underreport their true levels of alcohol consumption by up to 40% to 65%. (Vance, Caverly and Hayward, 12/9)

American Academy Of Pediatrics: Establishing New Norms For Developmental Milestones
A contemporary resource of normative data for developmental milestone attainment was established. Lower developmental status was associated with child age in the presence of positive behavioral screening scores (P < .01), social determinants of health (P < .01), Medicaid (P < .01), male sex (P < .01), and child race (P < .01). Comparisons between Survey of Well-being of Young Children developmental questions and CDC guidelines reveal that a high percentage of children are reported to pass milestones by the age at which the CDC states that “most children pass” and that an even higher percentage of children are reported to pass milestones by the age at which the CDC states that parents should “act early.” (Sheldrick et al, 12/1)

The Henry J. Kaiser Family Foundation: How Many Of The Uninsured Can Purchase A Marketplace Plan For Free In 2020?
While the percent of the population without health coverage has decreased since the major coverage expansion in the ACA, at least 10% of the non-elderly population is still uninsured. This analysis looks at how many of the remaining uninsured are eligible for premium subsidies large enough to cover the entire cost of a bronze plan, which is the minimum level of coverage available on the Marketplaces. The premium tax credits that subsidize Marketplace coverage are calculated using the second-lowest cost silver plan in each rating area as a benchmark. (Fehr, Cox and Rae, 12/10)

The New York Times: C-Section Is Not Tied To Obesity In Children
Some recent reports have suggested that women who give birth by cesarean section are more likely to have obese children. But a large new study found no link between the method of birth and obesity. Swedish researchers tracked medical records of 97,291 men born between 1982 and 1987, following them to age 18. The study is in PLOS Medicine. (Bakalar, 12/10)

Modern Healthcare: Lacking Specialist Access Drives Health Disparities
Primary care is not sufficient for residents in rural communities with complex chronic conditions, according to new research that revealed a lack of access to specialists has driven up mortality rates and preventable hospitalizations. Medicare beneficiaries who lived in rural areas had a 40% higher preventable hospitalization rate and a 23% higher mortality rate compared with their urban peers, according to a new study published in Health Affairs. (Kacik, 12/3)

Los Angeles Times: The Supreme Court Just Let A Dangerous Abortion Law Stand
This week, the Supreme Court announced, without explanation, that it would not hear a challenge to Kentucky’s so-called Ultrasound Informed Consent Act, which requires women to submit to a narrated ultrasound before receiving an abortion.The court’s inaction leaves a dangerous law on the books, one that endangers not only women’s rights but also medical ethics. The Kentucky statute compels any doctor performing an abortion to first do an ultrasound on the patient and describe aloud the physical features of the fetus on the screen. The doctor must also play the sound of the fetal heartbeat. (Ruth Faden, 12/11)

The Washington Post: The Supreme Court Gives Free Speech To Fake Doctors, But Not Real Ones
The Supreme Court this week declined to review the U.S. Court of Appeals for the 6th Circuit’s decision in EMW Women’s Surgical Center v. Meier; this had the practical effect of upholding a Kentucky law requiring abortion service providers to, among other things, perform an ultrasound and play a fetal heartbeat recording to a woman seeking an abortion. (Ronald J. Krotoszynsk, 12/11)

Boston Globe: End The ‘Global Gag Rule’
In a move that played out at the United Nations General Assembly in September, US Department of Health and Human Services Secretary Alex Azar announced that the United States and 18 other states, including Saudi Arabia, Hungary, Iraq, Mali, the Democratic Republic of the Congo, and Yemen jointly condemned policies that promoted sexual and reproductive rights of women in the UN’s newly adopted Universal Health Coverage Political Declaration.A joint statement read, in part, “We do not support references to ambiguous terms and expressions, such as sexual and reproductive health and rights in U.N. documents, because they can undermine the critical role of the family and promote practices, like abortion, in circumstances that do not enjoy international consensus and which can be misinterpreted by U.N. agencies.” (Shola Lawal, 12/10)

New England Journal of Medicine: Double Environmental Injustice — Climate Change, Hurricane Dorian, And The Bahamas
Climate change has been linked to changes in Atlantic hurricane behavior, making storms more destructive to the built environment and vital infrastructure, more harmful to the physical and mental health of island-based and coastal populations, and more deadly in their aftermath. These escalating effects on population health represent a double environmental injustice: socioeconomically disadvantaged and marginalized populations sustain disproportionate harm and loss, with more hazardous storms exacerbating the inequity; and while the populations most vulnerable to Atlantic hurricanes, especially those in small-island states, contribute virtually nothing to climate change, they are among those most exposed to risks that are worsened by the carbon emissions from higher-income countries. (James M. Shultz, Duane E. Sands, James P. Kossin, and Sandro Galea, 12/11)

The Wall Street Journal: The Zombie Medical Device Tax
Republicans and Democrats are trying to cobble together an end-of-year spending bill. But even if Members can’t agree on extending most special-interest subsidies—and we hope they don’t—they should stop a return of the destructive ObamaCare medical device tax in January. Large bipartisan majorities have suspended the 2.3% excise tax on medical devices such as imaging machines and stents since 2015. The tax was intended to raise spare change to pay for ObamaCare—an estimated $25 billion over 10 years—but even Democrats don’t believe the economic damage is worth the revenue. (12/11)

Stat: Half Of Americans Now Die At Home With Hospice Care
How Americans die has fundamentally changed with advances in medical technology and the ways diseases are treated. For centuries, death commonly occurred in one’s home with care provided by relatives and community members. Yet since the 1960s, the hospital and intensive care unit have become places of passage as people approach the end.In this week’s New England Journal of Medicine, we report that home has become the most common place of death among Americans dying of natural causes for the first time since the early 20th century, while deaths in hospitals and nursing facilities have declined. (Sarah H. Cross and Haider J. Warraich, 12/11)

Nashville Tennessean: Organ Donation Reform Could Save Thousands Of Lives, Billions In Taxes
Inefficiencies in our health care system have let down patients and families across the nation. Unfortunately, the American system of organ donation has been especially susceptible to waste when it comes to taxpayer resources. While 95% of Americans support organ donation, the number of people on organ waiting lists continues to outpace the number of organs available for transplant. (Andy Slavitt and Adam Brandon, 12/11)

Los Angeles Times: Anti-Vaxxers Can’t Compete With Cold, Hard Facts 
Anti-vaccination activists gave up on their misguided effort to repeal an important new state law — Senate Bill 276 — that will make it harder for parents to get their children bogus medical exemptions from mandatory vaccinations for measles and other dangerous infectious diseases. The proponents failed to gather the 623,212 signatures required to place the repeal measure on the November 2020 ballot, and that’s a good thing. (12/12)

The Washington Post: The Hidden Financial Toll Of Having A Miscarriage
At the beginning of each month, I check off the bills my husband and I are expecting: mortgage, water, electricity. Automobile and health insurance. Our cellphones. All normal, somewhat boring expenses. Then I get to the medical debt from my miscarriage, and I need to take deep breaths to center myself. I have survived this. (Ayana Lage, 12/11)

Nashville Tennessean: Alternatives To Current Opioids Could Reduce Drug Addiction
When considering the most pressing matter that is threatening the great state of Tennessee, I would be willing to bet that more apparent matters come to your mind such as our education system, the statewide job market, or maybe even the depressing but improving University of Tennessee football program. The opioid crisis, which was declared a national public health crisis by President Trump, should be at least near the top of your list. (Joe Butler, 12/11)