The New York Times: Tax Bill Is Likely To Undo Health Insurance Mandate, Republicans Say
House and Senate negotiators thrashing out differences over a major tax bill are likely to eliminate the insurance coverage mandate at the heart of the Affordable Care Act, lawmakers say. But a deal struck by Senate Republican leaders and Senator Susan Collins of Maine to mitigate the effect of the repeal has been all but rejected by House Republicans, potentially jeopardizing Ms. Collins’s final yes vote. (Pear and Kaplan, 12/6)

The Hill: Study: ObamaCare Bills Backed By Collins Would Lower Premiums
Two bipartisan ObamaCare fixes being pushed by GOP Sen. Susan Collins (Maine) would reduce premiums by 18 percent in 2019, according to a new study. The study from Avalere, a consulting firm, finds that the two bills would more than cancel out the projected premium increase from repealing ObamaCare’s mandate that most individuals purchase health insurance. (Sullivan, 12/6)

And in other news —

CQ: Health Mandate Repeal Could Expand Medicaid
The plan to repeal the individual health insurance mandate penalty as part of the Republican tax overhaul could have long-term ramifications for state Medicaid programs. An estimated 5 million fewer people would be covered by Medicaid over the next decade if the mandate penalty is nixed, according to the Congressional Budget Office. But industry experts say the impact could be more sweeping because people forced to drop insurance exchange coverage as premiums rise may ultimately end up on Medicaid. (Williams, 12/7)

Modern Healthcare: Healthcare Lobbyists Not Optimistic On Changing GOP Tax Bill
Healthcare lobbyists are scrambling to win changes in congressional Republican tax legislation, as Senate and House GOP leaders race to merge their separate bills into something both chambers can pass on a party-line vote this month. But provider, insurer, and patient advocacy groups doubt they can convince Republicans to remove or soften the provisions they find most objectionable. They say GOP leaders are moving too fast and providing too little opportunity for healthcare stakeholders to provide input. (Meyer, 12/6)

The Hill: House Conservatives, Ryan Inch Closer Toward Spending Deal
The conservative House Freedom Caucus and Speaker Paul Ryan (R-Wis.) are inching closer toward a deal to avert a shutdown and fund the government through Dec. 22, though some sticking points still remain. Freedom Caucus Chairman Mark Meadows (R-N.C.) and the group’s former leader, Rep. Jim Jordan (R-Ohio), emerged from a meeting in Ryan’s office Wednesday morning saying they are making progress on a deal and have had productive discussions with leadership. (Zanoma and Wong, 12/6)

Reuters: Sign-Ups Pick Up In Week Five Of 2018 Obamacare Open Enrollment: U.S.
The number of people signing up for 2018 Obamacare plans picked up significantly during the fifth week of open enrollment, a U.S. government agency reported on Wednesday, but the number of participants appears to be falling short of last year's numbers with just over a week of enrollment left. For the week ended Dec. 2, the U.S. Department of Health and Human Services said 823,180 people signed up for 2018 Obamacare individual insurance in the 39 states that use the federal government website Healthcare.gov. (Abutaleb, 12/6)

The Associated Press: Health Law Sign-Ups Seen As Falling Short Though More Enroll
Americans are signing up in growing numbers for the Affordable Care Act's subsidized health insurance, the government said Wednesday. But with enrollment season cut in half and just over a week to go, experts say the final tally will likely fall short. About 3.6 million people signed up through Dec. 2 in states served by the federal HealthCare.gov website, according to the Centers for Medicare and Medicaid Services. That's about 20 percent higher than the comparable period last year. (Alonso-Zaldivar, 12/6)

The Washington Post: Enrollment In ACA Marketplaces Brisk Yet Lags Last Year’s Total As Deadline Nears
The 3.6 million figure is half of the total at the comparable point in the sign-up period for 2017 coverage, according to an analysis by the Washington-based consulting firm Avalere Health. To reach the 9.2 million enrollees that states relying on the federal marketplace had by the final deadline, a huge surge of people would need to take action by the time the season concludes on Dec. 15 or be automatically re-enrolled just afterward. (Goldstein, 12/6)

The Hill: 3.6 Million People Signed Up For ObamaCare Plans In One Month
The strong numbers so far come despite cuts the Trump administration made to ObamaCare's advertising and outreach budget. The initial surge has also put the administration, which has long claimed the health-care law is failing, in a difficult spot. (Hellmann, 12/6)

CQ: States Upbeat on Health Exchange Enrollment Outlook
Enrollment in the state health insurance exchanges is looking healthier than on the federal platform as local officials deploy targeted advertisements and allow for later deadlines. Many states embraced the flexibility that comes with running their own exchange by maintaining a longer enrollment period than the six-week window established this year by the Trump administration. State exchanges have significantly more control over enrollment than states that rely on HealthCare.gov, including the ability to set deadlines. Open enrollment on the federal HealthCare.gov website ends Dec. 15, but states have deadlines as late as Jan. 31. (Clason, 12/6)

Nashville Tennessean: Influx Of Shoppers Expected For Early Obamacare Deadline
The reality of an early deadline for individual health insurance is hitting shoppers and navigators are bracing for a busy final nine days of the Obamacare open enrollment season. Tatum Allsep, executive director at Music Health Alliance, isn't sure the team will be able to get to everyone who wants help picking a plan between now and Dec. 15. They are working on a tip sheet so people can have a resource to use on their own. (Fletcher, 12/6)

In related news —

Politico: Politico Survey: Insurers On Pace To Record Obamacare Profits For First Time
Insurers have finally figured out how to make money in the Obamacare markets: Charge more. After taking a beating for three years, health plans jacked up their rates for 2017, with the average premium on the most popular products rising more than 20 percent. That created sticker shock for many Obamacare customers while putting many insurers on pace to record profits this year for the first time, according to a POLITICO analysis of 31 regional Blue Cross Blue Shield plans, many of which dominate Obamacare markets in their states. (Demko, 12/7)

Reuters: Obamacare Insurance Options Dwindle For Neediest U.S. Patients
Josh Brookhart has four health insurers to choose from in Seattle's King County for 2018, more than many Americans like him who buy coverage on the Obamacare individual market. Yet none of the plans cover all the complex medical care needed for his seven-year-old son, Gabriel. (12/7)

Georgia Health News: When You Like Your Health Plan . . .  But It’s No Longer Available
Kathy Brooke of Smyrna is facing a major hassle at a time in her life when she wants fewer problems, not more. The recently diagnosed cancer patient is going to have to get a new doctor at the start of the new year. Many consumers — whether with work-based coverage or government insurance — face the prospect of switching physicians during benefits Open Enrollment season. It can be an emotional time for someone who’s had a longtime relationship with a trusted doctor. For many people, the stress is real, even if the change ends up working out fine. (Miller, 12/6)

Kaiser Health News: Churning, Confusion And Disruption — The Dark Side Of Marketplace Coverage
Cyndee Weston can barely remember the last time she didn’t have to switch health plans during an Affordable Care Act sign-up season. By her count, she has been on five plans in five years. Every fall, after she has spent months figuring out her insurance plan’s deductibles, doctor networks, list of covered drugs and other fine print, she receives notice that the policy will be canceled as of Dec. 31. Because her job doesn’t come with insurance, “it’s agonizing going through all the plans and trying to compare,” said Weston, 55, who has diabetes and a history of melanoma. “Every year it’s the same scenario: ‘We’re not going to renew your policy.’” (Hancock, 12/7)

Kaiser Health News: Brokers Tout Mix-And-Match Coverage To Avoid High-Cost ACA Plans
Health insurance a la carte? As the Affordable Care Act open-enrollment season moves into its final weeks, some consumers looking for lower-cost alternatives are considering a patchwork approach to health insurance. The products may secure some basic protection but leave patients on the hook for high medical bills. (Appleby, 12/7)

The Washington Post: Ryan Says Republicans To Target Welfare, Medicare, Medicaid Spending In 2018
House Speaker Paul D. Ryan (R-Wis.) said Wednesday that congressional Republicans will aim next year to reduce spending on both federal health care and anti-poverty programs, citing the need to reduce America's deficit. “We're going to have to get back next year at entitlement reform, which is how you tackle the debt and the deficit,” Ryan said during an appearance on Ross Kaminsky's talk radio show. "... Frankly, it's the health care entitlements that are the big drivers of our debt, so we spend more time on the health care entitlements — because that's really where the problem lies, fiscally speaking.” (Stein, 12/6)

CNN: GOP Will Tackle Medicare, Medicaid, Welfare In 2018, Ryan Says
The House GOP caucus plans to work on entitlement reform next year as a way to "tackle the debt and the deficit," according to House Speaker Paul Ryan. Speaking to Ross Kaminsky on his talk radio show, the Wisconsin Republican said Wednesday that the House would be working to reform health care entitlements in 2018, calling them "the big drivers of our debt," during a discussion about the Republican tax bill. (Tatum, 12/7)

The Hill: Ryan Pledges 'Entitlement Reform' In 2018
Health-care entitlements such as Medicare and Medicaid “are the big drivers of debt,” Ryan said, “so we spend more time on the health-care entitlements, because that's really where the problem lies, fiscally speaking." Ryan said he’s been speaking privately with President Trump, who is beginning to warm to the idea of slowing the spending growth in entitlements. (Weixel, 12/6)

CQ: Ryan: House GOP To Push Health and 'Welfare' Cuts in 2018
We are working with the president on entitlements that he wants to reform, that he’s supportive of,” Ryan said. “I think the president is understanding choice and competition works everywhere in health care, especially Medicare.” (Shutt, 12/6)

The Wall Street Journal: U.S. Health Spending Rose At A Slower Pace In 2016
Spending on all health care increased 4.3% in 2016, according to a report Wednesday from the Centers for Medicare and Medicaid Services. That compares with 5.1% in 2014 and 5.8% in 2015. That is still above the historic lows of 2008 through 2013, when health spending grew at an average 3.8% a year. Much of the slowdown in those years has been linked to less use of medical services during the recession and tepid economic recovery. (Armour, 12/6)

Kaiser Health News: Pace Of U.S. Health Spending Slows In 2016
The analysis from the Office of the Actuary at the Centers for Medicare and Medicaid Services (CMS) showed a shift from the dramatic escalation in health spending that accompanied the coverage gains in 2014 and 2015 as millions of Americans found insurance under the Affordable Care Act. The rate at which spending grew last year was lower across many measures — including figures for Medicare, Medicaid, private insurance, prescription drugs and hospitals — than in the previous two years. (Galewitz, 12/6)

The Hill: US Health-Care Spending Hit $3.3 Trillion In 2016
"Basically, we saw two major things happening in 2014 and 2015. We had the enrollment expansion that impacted Medicaid and private health insurance with 10.2 million and 8.7 million people gaining coverage," a CMS official told reporters Wednesday. "In addition, in 2014 and 2015 we saw strong and rapid spending growth in retail prescription drugs," the official added. (Hellmann, 12/6)

The Washington Post: Out-Of-Pocket Health Spending In 2016 Increased At The Fastest Rate In A Decade
U.S. health care spending increased to $3.3 trillion in 2016, with out-of-pocket health care costs borne directly by consumers rising 3.9 percent — the fastest rate of growth since 2007. The findings, published Wednesday by Health Affairs, are considered the authoritative breakdown of American health care spending and are prepared each year by the Centers for Medicare and Medicaid Services. (Johnson, 12/6)

Modern Healthcare: CMS: Hospital, Doc Services Demand Slipped In 2016
Demand for hospital and physician services waned slightly in 2016 following intense demand in the prior year, according to a new government report released Wednesday. Spending for hospital services hit $1.1 trillion, an increase of 4.7% in 2016. However, that was slower than the rate of 5.6% between 2014 and 2015. Spending on physician and clinical services grew 5.4% to hit $664.9 billion, which was down from a prior growth rate of 6.3%, according to the analysis by CMS Actuary Micah Hartman.  (Dickson, 12/6)

The New York Times: UnitedHealth Buys Large Doctors Group As Lines Blur In Health Care
In another example of the blurring boundaries in the health care industry, UnitedHealth Group, one of the nation’s largest insurers, said on Wednesday that it is buying a large physician group to add to its existing roster of 30,000 doctors. UnitedHealth’s Optum unit will acquire the physician group from DaVita, a large for-profit chain of dialysis centers, for about $4.9 billion in cash, subject to regulatory approval. DaVita operates nearly 300 clinics across a half-dozen states, including California and Florida. (Abelson, 12/6)

The Associated Press: UnitedHealth Is Buying Hundreds Of Clinics In $5-Billion Deal As Insurers Push Into Patient Care
UnitedHealth Group Inc., the nation's biggest health insurer, is spending nearly $5 billion to buy hundreds of clinics, just three days after rival Aetna Inc. announced a tie-up with CVS Health Corp. Minnetonka, Minn.-based UnitedHealth said Wednesday that its Optum segment will buy the DaVita Medical Group from DaVita Inc. in a cash deal expected to close next year. (12/6)

Modern Healthcare: UnitedHealth's Optum To Buy DaVita Medical Group For $4.9 Billion
DaVita Medical Group's physician network provides care to approximately 1.7 million patients every year via its 300 clinics in California, Colorado, Florida, Nevada, New Mexico and Washington state. The group also runs 35 urgent-care centers and six outpatient surgery centers. "Combining DaVita Medical Group and Optum advances our shared goal of supporting physicians in delivering exceptional patient care in innovative and efficient ways while working with more than 300 healthcare payers across Optum in ways that better meet the needs of their members," Optum CEO Larry C. Renfro said in a statement. (Teichert, 12/6)

Bloomberg: UnitedHealth Buys DaVita's Doctor Groups For $4.9 Billion
“Combining DaVita Medical Group and Optum advances our shared goal of supporting physicians in delivering exceptional patient care in innovative and efficient ways,” Larry Renfro, chief executive officer of Optum, said in a statement Wednesday.(Tracer, 12/6)

Bloomberg: UnitedHealth's Splish Beats CVS-Aetna's Splash
UnitedHealth Group Inc. is that kid in school who's always doing better than you. The $214 billion company announced on Wednesday that it's buying DaVita Inc.'s physician-network business for $4.9 billion. It's just the latest step in UnitedHealth's push to diversify its revenue. Thanks to deals over the past few years, the company isn't just the largest private U.S. health insurer, it's also a pharmacy-benefit manager, a health care analytics company and increasingly a provider of medical care through physician clinics, outpatient services and urgent care centers. (Brooke Sutherland and Max Nisen, 12/6)

And about that CVS-Aetna deal -

The Hill: Democrats Sound Alarm Over CVS-Aetna Deal
Congressional Democrats are expressing alarm over the proposed merger between CVS Health and a health insurer, fearing it will lead to higher costs and less choice for consumers.CVS Health, a drug store chain, announced over the weekend that it has agreed to b uy Aetna for about $69 billion in what could be, if approved, the largest health insurance deal in U.S. history. (Hellmann, 12/7)

Politico: VA Cuts Program For Homeless Vets After Touting Trump's Commitment
Four days after Veterans Affairs Secretary David Shulkin held a big Washington event to tout the Trump administration’s promise to house all homeless vets, the agency did an about-face, telling advocates it was pulling resources from a major housing program. The VA said it was essentially ending a special $460 million program that has dramatically reduced homelessness among chronically sick and vulnerable veterans. Instead, the money would go to local VA hospitals that can use it as they like, as long as they show evidence of dealing with homelessness. (Allen and Woellert, 12/6)

In other veterans' health care news —

The Associated Press: Veterans Are Key As Surge Of States OK Medical Marijuana For PTSD
It was a telling setting for a decision on whether post-traumatic stress disorder patients could use medical marijuana. Against the backdrop of the nation’s largest Veterans Day parade, Democratic Gov. Andrew Cuomo announced this month he’d sign legislation making New York the latest in a fast-rising tide of states to OK therapeutic pot as a PTSD treatment, though it’s illegal under federal law and doesn’t boast extensive, conclusive medical research. (12/6)

The New York Times: Birth Control Pills Still Linked To Breast Cancer, Study Finds
Women who rely on birth control pills or contraceptive devices that release hormones face a small but significant increase in the risk for breast cancer, according to a large study published on Wednesday. The study, which followed 1.8 million Danish women for more than a decade, upends widely held assumptions about modern contraceptives for younger generations of women. Many women have believed that newer hormonal contraceptives are much safer than those taken by their mothers or grandmothers, which had higher doses of estrogen. (Rabin, 12/6)

NPR: Even Low-Dose Contraceptives Slightly Increase Breast Cancer Risk
In the research published Wednesday in the New England Journal of Medicine, a team of scientists studied 1.8 million women between the ages of 15 and 49. They were looking to see what happened over a stretch of nearly 11 years among women who used hormonal birth control — usually a combination of estrogen and progestin — versus women who relied on non-hormonal contraceptive methods, such as a condom, diaphragm or copper IUD. Unlike most previous research, this study didn't just track the effect of birth control pills. Because their set of data was very large, scientists this time were also able to get a good sense of the impact of various other hormonal methods — including the birth control patch, the ring, and implants as well as hormone-releasing IUDs. (Neighmond, 12/6)

Bloomberg: Those Newer Birth Control Pills Don’t Lower Cancer Risk
While contraceptive drugs that contain estrogen have long been suspected of increasing the likelihood of breast cancer, researchers had expected smaller doses of the hormone, often combined with the drug progestin, would be safer, said Lina Morch, an epidemiologist at Copenhagen University Hospital who led a study analyzing the records of 1.8 million women in Denmark. (Lauerman, 12/6)

The Philadelphia Inquirer/Philly.com: The Pill Comes With A Small Risk Of Breast Cancer: How Worried Should Women Be?
“It’s almost a default, putting young women on the pill, without too much thought,” said Weiss, who is a breast cancer survivor. “While the increased breast cancer risk is not that huge, it has a significant public health impact” because so many young women use hormonal birth control. “I think [the new study] is a wake-up call for the ob-gyn world.” (McCullough, 12/6)

Stat: The Surgeon General And His Brother: A Family’s Reckoning With Addiction
The path that Dr. Jerome Adams took to the office of U.S. surgeon general begins in this southern Maryland town, where crab restaurants dot the rural landscape, where signs warn drivers to watch out for Amish horse-drawn buggies, and where he grew up on a rolling road with three siblings, including a brother five years his junior. Phillip. But as Jerome’s career has taken flight — he’s won scholarships for college and medical school, taken charge of a state health department, and ascended to become “the nation’s doctor,” as his job is nicknamed — Phillip’s has been diverted. (Joseph, 12/7)

In other news on the opioid crisis —

The New York Times: Fewer Pain Pills May Be Best Bet After Surgery
Surgical patients can get as good or better pain relief with a fraction of the amount of opioids typically prescribed, a group of doctors reports. In 170 gallbladder operations from January 2015 to June 2016, they found that patients left the hospital with an average of 250 milligrams of opioids in 40 pills. Within a year, patients had taken an average of 30 milligrams of opioids, sometimes along with Tylenol or ibuprofen. Their median score on a 10-point pain scale was 5. (Bakalar, 12/7)

KCUR: Amid Opioid Crisis, Some Doctors Offer Another Strategy To Deal With Chronic Pain
The first step, [Dr. Muhammad] Farhan explains, is getting them over the idea that they can eliminate pain entirely. He says this expectation can be especially dangerous for people who rely on increasing doses of opioids. ... Farhan says opioids have their place – right after surgery or an injury, say, or for cancer pain. But for patients with issues like back pain or other long-term problems, he favors non-opioid drugs and treatments. Many of these treatments by themselves don’t have the same pain-reducing effects as high-voltage opioids. So he pairs them with mind-body techniques like meditation, hypnosis, biofeedback and yoga to help patients control stress, which can make pain worse. (Smith, 12/6)

Nashville Tennessean: Nashville Contracting Dispute Delays Potential Lawsuit Against Opioid Industry
Nashville Mayor Megan Barry's administration lined up a a law firm to explore a potential lawsuit against manufacturers and distributors of prescription opioids, but members of the Metro Council's Minority Caucus delayed the hiring at Tuesday's council meeting. They contend that the procurement was not transparent and have raised questions about the selection, including whether Metro reached out to minority-led firms about the request for proposals. (Garrison and Reicher, 12/6)

Milwaukee Journal Sentinel: Better Angels: For A Family Who Lost A Daughter To A Heroin Overdose, 'A Small Kindness Can Mean So Much'
What do you say to people like Jeff and Sue Shesto? What do you say to neighbors you've known for years, whose daughter has died of a heroin overdose? A girl who grew up right in front of your eyes, a girl who might have watched your cat while you were out of town, who might have babysat for your kids, who might have waved at you just the other day as you drove by her house. What do you say to that pretty young woman's devastated mom and dad? (Stephenson, 12/6)

Milwaukee Journal Sentinel: Three Probable Drug Overdose Deaths Reported Wednesday In Milwaukee Area
The Milwaukee County medical examiner's office responded to three probable drug overdose deaths Wednesday, two in Milwaukee and one in Racine County, an official at the office said. (Garza, 12/6)

Stat: Spark Gene Therapy Nearly Eliminates Bleeding Episodes In Hemophilia B
With longer follow-up out to one year, bleeding episodes have been almost completely eliminated for a small group of hemophilia B patients infused once with an experimental gene therapy from Spark Therapeutics (ONCE). The updated results from Spark’s Phase 1/2 clinical trial, published Wednesday night in the New England Journal of Medicine, provide further evidence to support a groundbreaking change in the way the inherited blood-clotting disorder is treated — and potentially cured. (Feuerstein, 12/6)

The Washington Post: Gene Therapy Makes A Big Advance Treating Hemophilia B Blood Disorder
Jay Konduros used to rush home several times a year after accidentally cutting or bumping himself. There he would inject himself with refrigerated blood-clotting factor to prevent internal bleeding and extensive bruising and swelling. “I was walking on eggshells all the time,” said the former aerospace engineer who has a blood disorder called hemophilia B. Then, last year, Konduros enrolled in a clinical trial, receiving an experimental gene therapy at Children's Hospital of Philadelphia. Almost immediately, he began producing the missing clotting factor. Several weeks later, after he dropped a heavy box on his shin, he watched a bruise develop and shrink within hours. “Are you kidding me?” he thought. “Life's easy if this is what happens.” (McGinley, 12/6)

The New York Times: How Exercise Can Make For Healthier Fat
Exercise could help to make your fat tissue healthier, which, hear me out, is a good thing. According to a timely new study, a single session of exercise may change the molecular workings of fat tissue in ways that, over time, should improve metabolic health. (Reynolds, 12/6)

NPR: Looking Below The Locks: Teaching Hairdressers To Spot Melanoma
Of all types of skin cancer, melanoma causes the majority of deaths. When on the scalp it can be especially difficult to catch in a self-examination — when was the last time you examined the top of your head? One person who might be able to help: your hairdresser. While cutting your hair, they've got a great view for a scalp inspection. And they can learn how to spot scary changes, researchers say. (Jochem, 12/6)

KQED: Before You Try The Ketogenic Diet, Read This
Louison Labeaume believes a ketogenic diet has done him a lot of good. Not only has he lost 25 pounds on the popular low carb/high fat regimen, he even wonders if it helped push his prostate cancer into remission. While some research has been conducted into the diet’s ability to starve cancer cells, there has been little evidence to date that this could be the case. (Smith, 12/6)

Kaiser Health News: Health Risks To Farmworkers Increase As Workforce Ages
That bag of frozen cauliflower sitting inside your freezer likely sprang to life in a vast field north of Salinas, Calif. A crew of men and women here use a machine to drop seedlings into the black soil. Another group follows behind, stooped over, tapping each new plant. It is backbreaking, repetitive work. Ten-hour days start in the cold, dark mornings and end in the searing afternoon heat. (Varney, 12/7)

Kansas City Star: What Australia’s Nasty Flu Outbreak Tells Us About What To Expect In Kansas City
A flu outbreak that rocked Australia this fall could be headed to the United States next, experts fear. Flu season comes earlier in the southern hemisphere, so U.S. health officials watch Australia closely to gauge the effectiveness of the annual flu vaccine. The shot was only about 10 percent effective this year in preventing the dominant virus, influenza A H3N2, leaving Australia with an epidemic that caused about twice as many hospitalizations as usual. Across all the strains for which it was produced, the vaccine was about 33 percent effective in Australia. (Marso, 12/6)

Orange County Register: Asian American Women Have Tough Time Seeking Help For Eating Disorders, Says Study
Young Asian American women tend to have cultural and family influences that discourage them from seeking help for eating disorders, according to new research led by Yuying Tsong, Cal State Fullerton associate professor in human services. Compared with a general population with eating disorders, young Asian American women displayed some common themes, the study found. (Fawthrope, 12/6)

San Jose Mercury News: Does Your Dog Lick Your Face? Could Be Deadly As Well As Icky
Beware of dog! Generations of dog owners have cherished the licks of their canine companion as if they were kisses, but now medical experts warn that letting a dog lick your face may well be a bacteria bomb. Think about it. How do doggies greet each other? It’s not with a handshake, is it? They spend a whole lot of time sniffing posteriors, among other rather germ-ridden locations. Some of the bacteria lurking in that adorable doggy mouth may even be lethal. (D'Souza, 12/6)

Boston Globe: BU Biolab Gets Final Approval To Begin Research On Deadly Microbes
The Boston Public Health Commission on Wednesday gave the final approval for Boston University’s high-security laboratory to start research on the world’s deadliest microbes, ending a decade and a half of controversy. The commission’s OK was the final step allowing the study of Biosafety Level 4 pathogens — those that have no treatment or vaccine, such as Ebola. Level 4 research could begin in a month or two at the facility, called the National Emerging Infectious Disease Laboratories. (Freyer and McDonald, 12/6)

WBUR: Boston University To Begin Researching World's Deadliest Infectious Diseases At 'Biolab'
The Boston Public Health Commission gave that approval Wednesday. The Centers for Disease Control had given approval late last year. The lab has been open but awaiting the final go-ahead for the highest-tier infectious disease research. Ronald Corley, director of BU's National Emerging Infectious Diseases Laboratory, joined WBUR to discuss. (Mullins, 12/6)

New Hampshire Public Radio: Exeter Hospital Adopts Suicide Prevention Model
Suicide is the second leading cause of death among adolescents and young adults in New Hampshire, according to the National Alliance on Mental Illness. Exeter Hospital recently endorsed an initiative for suicide prevention as a part of a five-year strategy to address the on-going issue in the state. (Ganley and McIntyre, 12/6)

Cleveland.com: Summa Health Reports $100 Million In Community Benefits For 2016
Summa Health has released its 2016 community benefit report, which gives an annual overview of the hospital system's expenses for services, programs and charges that directly affect the community. The hospital system reports $100.3 million in community benefit in 2016, up from $95.9 million in 2015. (Conn, 12/6)

Health News Florida: Senators Back Overnight Stays At Surgery Centers
Ambulatory surgical centers could treat patients overnight under a bill approved unanimously Tuesday by the Senate Health Policy Committee. Bill sponsor Sen. Greg Steube, R-Sarasota, told the committee that ambulatory surgical centers are already “performing surgeries all day, every day” but patients usually have to schedule surgeries very early because they are required under current law to leave the same day. (12/6)

Arizona Republic: Phoenix Children's Hospital Battles Irish Hospital Over Similar Name
Phoenix Children's Hospital has threatened legal action against a new Irish hospital with an almost identical name, saying the similarities will confuse patients and jeopardize their health. "Phoenix Children's Hospital Ireland," under construction in Dublin, was named after the mythical bird symbolizing renewal, hope and optimism. It will combine three medical centers into one national children's hospital when it opens in 2022. (Morse, 12/6)

The Washington Post: Maryland Medical Marijuana Dispensaries Are Already Running Out Of Pot
Marylanders interested in buying medical marijuana days after the launch of a state-sanctioned program may already be out of luck. Five of seven licensed dispensaries that have opened since Friday said they have completely or almost run out of flower — the raw part of the marijuana plant that is smoked or vaporized — and have limited supplies of other cannabis products. The other two stores are limiting sales to a small group of preregistered patients. (Nirappil, Gregg and Siegel, 12/6)  

Cleveland Plain Dealer: Ohio Medical Marijuana Program Moves Forward Despite Calls To Freeze Awarding Growing Licenses
The Ohio Department of Commerce didn't know it hired a consultant with a felony marijuana conviction to help score medical marijuana grow license applications but says the past offense didn't undermine the agency's process for awarding the highly sought-after licenses. The department plans to go ahead and award 24 cultivator licenses despite calls from state officials to freeze the program until the scoring process can be examined after it was revealed a scoring consultant had a felony drug conviction on his record. (Borchardt, 12/6)

The Associated Press: Home Health Agency Agrees To Pay Massachusetts $14 Million
A national home health care agency with six locations in Massachusetts has agreed to pay $14 million to settle allegations that it improperly billed the state's Medicaid program. Attorney General Maura Healey said in a statement Tuesday that Centrus Premier Home Care Inc., which does business in the state as Maxim Healthcare Services Inc., billed MassHealth for services that were not eligible for reimbursement under state regulations. (12/6)

Health News Florida: As Worker's Comp PTSD Bill Clears Hurdle, Pulse Responder Could Be Fired
Call it a mixed day for advocates of expanding treatment for post-traumatic stress disorder in first responders. In Tallahassee, a bill to expand workers’ compensation benefits to first responders with PTSD cleared its first committee Tuesday. But the city of Eatonville could vote tonight to fire Omar Delgado, a police officer who developed PTSD responding to the Pulse nightclub shooting. (Aboraya, 12/6)

St. Louis Public Radio: Medication Denied: St. Louis Inmates Claim Medical Neglect In Local Jails
Shirletta Chambly has lost two family members in St. Louis jails: First her brother, and then her 21-year-old son. Maleek Coleman-Chambly died after a seizure in his bed at the St. Louis City Justice Center on Jan. 31, 2017. Family members claim he told them over the phone that jail personnel had refused to give him his epilepsy medication the night before. (Bouscaren, 12/6)

Texas Tribune: Three Women Indicted In Death Of Impaired Woman In State Facility
Three employees of the Brenham State Supported Living Center have been indicted on felony murder charges in the July death of a severely disabled resident of the facility. Amy Parrish, a mentally impaired woman in her late 40s, was left in the back of a hot van parked on the center’s east Central Texas campus for several hours on July 11, The Eagle reported. She was missing for several hours; when she was eventually found, she was taken to the hospital and pronounced dead. (Platoff, 12/6)

Health News Florida: Reporting Proposed For Out-Of-Hospital Birth Problems
A [Florida] Senate committee unanimously approved a bill on Tuesday that would require physicians, certified advanced registered nurse midwives and licensed midwives to report to the state “adverse” medical incidents that occur during planned births outside of hospitals. The bill (SB 510), filed by Sen. Dana Young, R-Tampa, defines adverse incidents and would require reporting within 15 days after incidents occur. It also would require the Florida Department of Health to review each incident report and determine whether disciplinary action is appropriate. (12/6)

Columbus Dispatch: Down Syndrome Abortion Ban Now One Step From Kasich
A bill that would ban abortions sought because the fetus might have Down syndrome is one step closer to being signed into law. Senate Bill 164 was approved by the House Health Committee on a 12-6 party-line vote on Wednesday, advancing it to a full House vote. The bill would prevent anyone from performing or attempting to perform or induce an abortion because the fetus has or might have Down syndrome. Violators would face a fourth-degree felony, and the State Medical Board would be required to take away a convicted physician’s license to practice medicine in Ohio. (Henry, 12/6)

Dallas Morning News: Dallas Medical Real Estate Firm Buys $167 Million In Buildings
Dallas-based health care real estate developer, Caddis Partners LLC, which recently purchased a dozen properites, plans to add at least three more to its portfolio by the end of the year.  Together, the 15 properties including one in Plano, are valued at about $167 million. Last month, Caddis launched a new investment fund that purchased 12 buildings from affiliates for $111 million. The three medical office buildings currently under contract are valued at $56 million. (Brown, 12/6)

Nashville Tennessean: Funding Approved To Cover Inmate Medical Expenses
Overcrowding of the Cheatham County Jail, detoxification of arrested drug addicts and other factors contributing to unanticipated inmate medical bills all add up to the necessity of a budget amendment to account for payments for the remainder of the fiscal year.  The Cheatham County Commission unanimously OKed the transfer of an additional $400,000 to be allocated toward medical and dental services to cover any of the inmate medical bills incurred. (Fisher, 12/6)

Seattle Times: Costco Co-Founder And Boyhood Friend Give $50 Million For Precision Medicine At UW
Costco co-founder Jeff Brotman and Dan Baty met as kids on a playground in Tacoma and remained lifelong friends. Before Brotman’s death in August, the two businessmen and their wives decided to share some of their wealth and pursue a common interest in health care. The result is a $50 million gift to create the Brotman Baty Institute for Precision Medicine in Seattle and pursue one of the most sought-after and elusive goals in science: Treatments tailored to individual patients. (Doughton, 12/6)

Denver Post: Denver’s DaVita Selling Its Physician Network For $4.9 Billion
Denver-based DaVita Inc. is selling its physician network arm for $4.9 billion, with aims to use some of that cash to buy back stock. The sale, to multifaceted health services company Optum, was announced early Wednesday. It will be completed next year after regulatory approval, according to a joint news release from the companies. Optum is part of UnitedHealth Group, one of the largest health insurers in the United States. (Rubino, 12/6)

WBUR: So Tired Teens Can Sleep In, Boston School Committee Votes To Make Classes Start Later
The Boston School Committee voted unanimously Wednesday night to approve a new systemwide schedule that will allow most teenagers in the district to sleep in a bit next year. Under the new framework, most high schools will start at or after 8 a.m. Presently, about half of the district's public schools start class at or before 7:30 a.m. And whenever possible, younger children will be dismissed before 4 p.m., in part to prevent them from running out of steam late in the day — or walking home in the dark. (Larkin, 12/6)

The San Jose Mercury News: Alternatives Submitted For Sheltering Berkeley Homeless
Attorneys representing a group of homeless people have submitted a plan for sheltering the city’s homeless population that calls for short-term suspension of regulations they say criminalize homelessness, including limitations on lying on commercial sidewalks and spreading belongings, and on sleeping in vehicles. Other short-term remedies proposed by Dan Siegel of Oakland-based Siegel, Yee & Brunner in a Nov. 27 filing in U.S. District Court for the Northern District of California include suspending enforcement of city rules prohibiting camping in city parks, at the Berkeley Marina, other open space, and city-owned lots. (Lochner, 12/6)

Bloomberg: Medicare Should Start At 50
Yet again, the U.S. has come in last in a survey measuring the state of health in developed countries. This latest piece of disheartening news put the spotlight on people over 65 -- the age when Americans become eligible for Medicare. The survey, produced by the Commonwealth Fund, included more than 23,000 people from 11 developed countries, and revealed that American seniors were sicker than their counterparts in other countries and are more likely to go without needed health care because of costs. (Faye Flam, 12/6)

The New York Times: Living With The Republican Tax Plan
The [tax] bill’s repeal of the individual mandate will create additional challenges for the struggling Obamacare exchanges. But the mandate has never worked as its creators intended, it remains more unpopular than Obamacare as a whole, and it penalizes a narrow class of middle-class individual market buyers instead of spreading the burden of the system’s costs more widely. In the long run any universal health insurance system will be on a firmer political footing if it finds a way to work without requiring people to buy a product they don’t want. (Ross Douthat, 12/6)

The New York Times: The Republic Will Survive The Tax Bill
The tax bill is not a backdoor repeal of Obamacare. Yes, the bill would damage the quality of health insurance. And, yes, several Republican senators — starting with Susan Collins — would be violating their own stated principles if they vote for the tax bill. But damage to Obamacare isn’t the same thing as a slippery slope toward the program’s demise. The two core pieces of Obamacare are the subsidies that help middle-class families afford private insurance and the expansion of Medicaid for working-class families. The tax bill doesn’t get rid of either. Instead, it will likely repeal the individual mandate — the requirement that people buy health insurance. As a result, health-insurance markets will suffer some turmoil, and costs for some families will rise. (David Leonhardt, 12/6)

RealClear Health: Tax Reform’s Unhealthy Omission
The House and Senate recently passed tax reform bills because they successfully made the case that reform is a “once-in-a-generation” opportunity that is long overdue. It’s a compelling argument. When the last tax reform bill passed in 1986 the Internet was in its infancy and cell phones were the size of a briefcase. The world has changed, the argument goes, but our tax code has not. What’s curious, however, is that the largest deduction in the tax code – the exclusion from income tax of employer-sponsored insurance, which dates back to the 1940s – is untouched by the reform bills. This omission is an enormous missed opportunity for American consumers and both political parties. (Scott Flanders, 12/7)

Cleveland Plain Dealer: FDA Needs To Deal With Shortages Of Critically Needed Drugs
The world's attention has been rightly focused on the havoc wrought by Hurricane Maria on Puerto Rico and the suffering of the people of the island. But it's also worth paying attention to the storm's impact on the drug manufacturing plants that constitute a major component of Puerto Rico's economy. (Philip M. Rosoff, 12/6)

JAMA Forum: A Path To Health Care For All?
Health care coverage for every single person in the United States is coming. You may not be able to see it from the brutal politics of the moment. But if we step back from the health care battles in Congress and look instead at the social and economic forces brewing, as well as the new frontier of medical science, there is a path that eventually will prevail in ensuring that everyone has access to the affordable care they need. (Andy Slavitt, 12/5)

Topeka Capital Journal: Medicaid Backlog Hurts Our Seniors
For more than two years, Kansas has been struggling to eliminate its backlog of Medicaid applications. After the state activated the Kansas Eligibility Enforcement System (which was designed to make application processing more efficient) in June 2015, the backlog exploded. ... This has had a particularly harmful impact on our seniors, who are disproportionately likely to rely on Medicaid. When patients in need of hospice care are discharged from hospitals, many nursing homes refuse to admit them because they’re still waiting for Medicaid coverage. (12/6)

The Washington Post: Our Medicare Policy For Kidney Transplants Is Totally Irrational
Since 1972, Medicare has provided coverage to patients with kidney failure, regardless of age or disability status. However, while there is no time limit for dialysis patients, kidney transplant recipients who are not otherwise eligible for Medicare lose their coverage 36 months after they receive their transplant — leaving many unable to pay for immunosuppressive medications. Without access to these medications, patients eventually lose their transplants and require dialysis treatment instead. This policy is irrational, since Medicare has already paid for the kidney transplant and will pay to treat the patient with dialysis — despite its markedly higher cost — when the transplanted kidney fails. (Marcello Tonelli and John Gill, 12/6)

JAMA: Moral Choices For Today’s Physician
The work of a physician as healer cannot stop at the door of an office, the threshold of an operating room, or the front gate of a hospital. The rescue of a society and the restoration of a political ethos that remembers to heal have become the physician’s jobs, too. Professional silence in the face of social injustice is wrong. It is chilling to see the great institutions of health care, hospitals, physician groups, scientific bodies assume that the seat of bystander is available. That seat is gone. To try to avoid the political fray through silence is impossible, because silence is now political. Either engage, or assist the harm. There is no third choice. (Donald M. Berwick, 12/5)