The Hill: ObamaCare Enrollment Down Compared To Last Year
Fewer people are signing up for ObamaCare plans this year compared to a similar period last year, according to data released Wednesday by the Trump administration. About 1.2 million people signed up for ObamaCare plans in the first ten days of this year's sign up period, which began Nov. 1. In the first nine days of last year's enrollment period, 1.5 million people signed up for plans — a different of more than 300,000. (Hellmann, 11/14)

CNBC: Obamacare Early Enrollment Rate Drops In First Season Since GOP Changes
More than 901,300 existing customers renewed their coverage on the marketplace, while 274,913 new consumers chose an insurance plan on HealthCare.gov. Roughly 8.8 million people enrolled in Obamacare during last fiscal year. (Lovelace, 11/14)

CNN: Obamacare Sign-Ups For 2019 Off To A Slow Start
Last year, with the Affordable Care Act fresh off the threat of being repealed, people rushed to sign up in the early days of open enrollment. Ultimately, nearly 11.8 million people selected coverage on the federal and state-based exchanges during a shortened enrollment period. That was down only 3.8%, much less than some advocates of the health care law had feared. (Luhby, 11/14)

Modern Healthcare: ACA Health Insurance Enrollments Behind Las Year
Open enrollment in most states lasts until Dec. 15. It is unclear how a combination of lower average premiums in many states, coupled with actions by Congress and the federal administration seen as detrimental to the exchanges, will ultimately affect enrollment in the ACA marketplace in 2019. (Livingston, 11/14)

The Wall Street Journal: To Curb Wasteful Health Spending, Walmart To Send Employees Traveling For Spine Surgery
Walmart Inc. said it will require its employees to use certain hospitals for costly spine surgeries, an effort to weed out unnecessary procedures and lower its health-care spending. The retailer has been trying since 2013 to encourage employees to undergo the surgeries at hospital systems known for their quality by offering to pay the full cost of the procedures and travel. But not all workers took Walmart up on the offer, and the retailer continued to pay for surgery elsewhere. (Evans, 11/14)

Stat: A Startup For Diabetes Patients Will Only Get Paid By Insurers If Its Service Works
An ambitious startup that uses digital coaching and monitoring to try to help patients reverse type 2 diabetes, is making a big change to the way it makes money: Insurers and employers will now only pay Virta if its service works. Under Virta Health‘s new business model, announced on Wednesday, a health plan or employer will pay Virta a fee only if the patient is sufficiently engaged with its program after one month. The second payment comes after a year, only if patients lower their A1C, a measure of glucose in the blood, to a certain level determined on a case-by-case basis. (Robbins, 11/14)

The Philadelphia Inquirer: Jefferson Adds A New Employee Perk: Free Genetic Testing
One of the region's largest health employers is offering its more than 30,000 workers an unusual new benefit: free genetic tests. Jefferson, the combination of Jefferson Health and Thomas Jefferson University, told employees in mid-October that they could take a panel of genetic tests that flag people at higher risk for certain cancers and heart problems, as well as those who may metabolize medications in unusual ways that could make them candidates for different dosing or alternative drugs. (Burling, 11/13)

The Philadelphia Inquirer: Screening Or Diagnostic Mammogram? The Difference Could Cost You
It had been a few years since Deanie Gauntlett's last mammogram, so when the X-ray showed a few unusual spots, her doctor ordered a follow-up diagnostic scan. The diagnostic test had that same uncomfortable, is-this-over-yet squish, but was different in one discernible way: its price tag. Though Gauntlett's screening mammogram was covered in full by her health-insurance plan, she owed a $65 co-pay for the diagnostic version. (Gantz, 11/14)

Wyoming Public Radio: Cloud Peak Cuts Post-Retirement Health Care
One of Wyoming’s largest coal companies cut health care benefits for its retired workers. In its third quarter report released October 25, Cloud Peak Energy said the move will provide it with $19.4 million in net income. It was announced to employees in August. The report also recounted an approximately 15 percent reduction in coal shipments compared to Q3 last year. Coal has been costlier to remove from the ground due to additional overburden from digging deeper. Cloud Peak explained it will provide benefits for the remainder of 2018 and give a lump sum contribution for 2019 benefits. It maintains an unfunded medical plan to eligible employees. (McKim, 11/13)

The Wall Street Journal: Big Tobacco Warns It May Fight FDA Over A Menthol Ban
The possibility of a nationwide ban on menthol cigarettes puts the tobacco industry into an all-too-familiar spot: having to defend the minty smokes, which are popular among younger smokers and African-Americans. Menthol-flavored cigarettes account for nearly a third of the roughly 250 billion cigarettes sold annually in the U.S., and the industry has a long history of marketing them to blacks and in minority neighborhoods. More than a dozen municipalities have adopted bans on menthols but cigarette makers have so far avoided federal restrictions. (Maloney and McGinty, 11/15)

Arizona Republic: Proposed Public Charge Rule Change Could Affect 200,000 Arizonans
A Trump administration proposal is making legal immigrants in Arizona increasingly fearful of getting government help for basic needs, including health care, a statewide anti-poverty coalition says. The Department of Homeland Security's draft "public charge" rule change would allow the government to penalize immigrants who use taxpayer-funded programs such as Medicaid (in Arizona, the Arizona Health Care Cost Containment System, or AHCCCS) and subsidized housing. (Innes, 11/14)

Meanwhile, a doctor talks about what it's like being a Dreamer —

Georgia Health News: ‘Dreamer’ Raised Here — Now Med Student — Feels Shut Out
Back in 2009, Belsy Garcia Manrique was studying as an undergrad at Mercer University in Macon when her younger sister called. It was about their mother. Feeling tired and looking pale, she had paid a visit to the health clinic near the family home in Calhoun. From what she heard there, she understood that her hemoglobin levels had dropped so low that she needed a transfusion — fast. The mom, who was anemic, rushed to a local hospital, only to be told that she was fine and didn’t require a transfusion. (Blau, 11/14)

Sacramento Bee: Camp Fire Death Toll Increases To 56; Names Of Missing People Released
Some are missing. Some aren’t. Some, nobody knows. As the death toll from the Camp Fire increased to at least 56 Wednesday, the Butte County Sheriff’s Office released a list of 103 people who have been reported missing since the blaze erupted last week, part of an effort to determine how many area residents actually are still unaccounted for and should be the subject of law enforcement searches. (Lillis, Yoon-Hendricks, Sullivan and Stanton, 11/14)

The New York Times: A ‘Perfectly Imperfect’ Life: The Victims Of The California Wildfires
In many ways, the story of Ernie Foss runs right alongside the narrative of the state he loved, California. He was a surfer and skateboarder as a young man. He grew up in San Francisco and worked at a store in the hippie heyday of Haight-Ashbury, selling candles and crystals, a job that allowed him to pursue his passion of music. And then tech money flooded the city, his neighborhood was gentrified, and like so many others he was priced out. (Arango, 11/14)

The Washington Post: Camp Fire: Toyota Offers To Replace Burned Truck Of California Nurse Who Helped Save Lives
By the time Allyn Pierce arrived at his job last Thursday morning, the sky in Paradise, Calif., was an eerie shade of burnt orange, choked with haze. A wildfire had exploded in the area hours before, and the flames were cutting through the Butte County town at an alarming pace. Now, at 8 a.m., they were threatening the Adventist Health Feather River hospital, where Pierce worked as a registered nurse and ICU manager. Pierce and his team quickly scrambled to help the hospital’s few dozen patients evacuate by ambulance. By 9:30 a.m., he and two colleagues were among the last to evacuate. They piled into his white Toyota Tundra and headed south for less than a mile, then east on wooded Pearson Road. (Wang, 11/14)

San Jose Mercury News: Escaping The Camp Fire, They Heard The Call: 'We Have A Woman In Labor'
Separated from her husband, Anastasia Skinner had been waiting for help for nearly two hours in the panic-fueled traffic jam out of Paradise — and her labor contractions were getting worse. She had nearly been trapped by the fire. With the flames licking at her Honda Pilot, escape had seemed impossible. She had called her husband, Daniel, who was with their two sons and also stuck in the chaotic evacuation. “We said our final goodbyes,” he said. “She said to tell the kids I love them.” (Bartley, 11/14)

Sacramento Bee: Norovirus Hits Shelter For Fire Evacuees In Chico, Second Shelter May Be Affected
Norovirus has broken out at a Butte County shelter housing Camp Fire evacuees, and an outbreak is suspected at a second shelter.Fifteen to 20 people staying at Neighborhood Church of Chico have become ill, and lab tests have confirmed they have norovirus, said Lisa Almaguer, spokeswoman for the Butte County Public Health Department. (Kasler and Clift, 11/14)

San Jose Mercury News: Norovirus Outbreak Reported At Camp Fire Evacuation Center
“Norovirus is not uncommon, especially this time of year, and it’s especially not uncommon for a shelter situation where you have hundreds of people living in very close quarters,” Almaguer said. Norovirus is a very contagious virus that causes vomiting and diarrhea, according to the Centers for Disease Control and Prevention. (Green, 11/14)

Sacramento Bee: No Easy Breathing: The Smoke In Sacramento Hasn’t Been This Bad In Nearly A Decade
Air quality related to fine particulate matter was expected to hit “unhealthy” or “very unhealthy” levels for the seventh time this year in the Sacramento region on Wednesday, more “code red” or worse days than any other year since at least 2009, according to the latest data from local air districts. (Reese and Finch, 11/14)

California Healthline: For Wildfire Safety, Only Particular Masks Guard Against Toxic Particulate Matter
Toby Lewsadder stepped outside an Ace Hardware store wearing a simple one-strap dust mask. He knew it wasn’t the right defense against the wildfire smoke lingering in the air, but it was all he could find. The local hardware stores he checked Tuesday didn’t have the more substantial respirator mask that public health officials recommend to defend against the harmful wildfire smoke that is blanketing communities across the state. One pharmacy he contacted was selling surgical masks for only a quarter. (Young and Ibarra, 11/15)

Capital Public Radio: Wildfire Smoke Masks Have ‘More Risks Than Benefits,’ According To Sacramento County Health Officials
Sacramento County's top health official says the risks of wearing a mask to protect against breathing in smoke may outweigh the benefits. City officials may have been premature in handing them out to the public this weekend, the county also said. On Sunday, city of Sacramento officials announced residents could pick up free N95 model masks at fire stations to guard against the smoke settling in the valley from the Camp Fire in Butte County. (Ciaola, 11/13)

San Jose Mercury News: Non-Breathing Premature Born Boy Revived By Oakland Police Officer
An Oakland police officer is being credited with saving the life of a baby boy, who he found not breathing after being prematurely born to his homeless mother Tuesday afternoon inside her car, officials said Wednesday. Officer Gregory Palomo found the baby not breathing and turning blue about 3:22 p.m. Tuesday after police received a 911 call of a woman screaming and crying for medical aid in the street next to a car on Sixth Street near Laney College. It turned out the 22-year-old woman was living out of the car and had just given birth, police said. (Harris, 11/14)

Los Angeles Times: Third Body Found Among Wreckage Of Woolsey Fire As Residents Blast Officials About Emergency Response
As a third body was discovered among the ashes of a home in Agoura Hills, residents in nearby Malibu questioned fire officials about the division of resources and rushed evacuation notices during the Woolsey fire’s devastating march through Los Angeles and Ventura counties. (Hamilton, Fry, Winton and Panzar, 11/14)

The Washington Post: Heat Waves Caused By Climate Change Could Impair Male Fertility Across Generations, Scientists Warn
One of the ways that heat kills is by increasing pressure in the skull, constricting blood flow to the brain. Damaged tissue can also enter the bloodstream and cause kidney failure. At a certain point, an elevated internal temperature simply incinerates cells in the body. In contrast to extreme weather events so visible and violent that they hardly escape pubic notice, such as hurricanes and tornadoes, heat waves are more of a “silent killer,” as the National Weather Service has called the prolonged periods of hot weather. (Stanley-Becker, 11/15)

In other fertility news —

The Wall Street Journal: Finally, A Fertility Clinic That Doesn’t Look Like A Fertility Clinic
At Trellis, nobody uses the c-word—“clinic,” that is. “We call it a fertility studio,” says Jennifer Huang. Huang is Chief Marketing Officer at Trellis, an egg freezing facility which opens today in Flatiron, with a grand opening party tomorrow that will include “fertility-friendly light bites.” (Larson, 11/14)

Stat: Obtaining Abortion Pill From Pharmacies And Online Gains Support Among Women
As debate intensifies in the U.S. over abortion, a new survey finds nearly half of all women support alternatives to visiting a medical facility in order to obtain the abortion medicine to terminate pregnancies. And the findings suggest there is potential to expand access to abortion care, if regulators can be persuaded to loosen regulations governing access to the medicine, according to the researchers. Currently, women in the U.S. must obtain mifepristone at a doctor’s office, clinic, or hospital under a risk management program required by the Food and Drug Administration. The restrictions were imposed when the drug was approved in 2000 and stipulate Mifeprex may not be sold in pharmacies and health care providers must complete a certification process. (Silverman, 11/15)

Columbus Dispatch: Ohio House GOP Comes Out Of The Gate With Gun, Abortion Legislation
After plenty of campaign ads talking about health care, education, taxes and job growth, Ohio House Republicans kicked off the post-election lame-duck session with controversial bills on guns and abortion. The House voted 64-26 on Wednesday to pass a “stand your ground” bill that would eliminate the obligation to retreat in confrontations before deciding to utilize deadly force. That margin is large enough to override a likely veto from Gov. John Kasich, if the Senate quickly approves the bill before the session ends in mid-December. (Siegel, 11/14)

Cleveland Plain Dealer: With Veto Override, Anti-Abortion Heartbeat Bill, Ohio General Assembly Faces Down Gov. John Kasich
The Ohio General Assembly mustered enough votes Wednesday afternoon to override a summertime veto by Gov. John Kasich of a bill centered on the power of the legislature over the governor’s agencies. The veto override of Senate Bill 221 is just one strike at the outgoing governor. On Thursday, the Ohio House is expected to vote on House Bill 258, which prohibits abortions if a fetal heartbeat is detected. Kasich vetoed a similar bill in 2016. (Hancock, 11/14)

And in other news —

Politico: Democratic Lawmakers Warn Pompeo Against Possible Ban On Sex Health Terminology
Several Democratic members of Congress are warning Secretary of State Mike Pompeo to not move forward with a possible ban on State Department employees using terms like “sexual and reproductive health” and “comprehensive sexuality education”. The lawmakers — Reps. Eliot Engel (D-N.Y.), Jan Schakowsky (D-Ill.), Nita Lowey (D-N.Y.), Barbara Lee (D-Calif.) and Lois Frankel (D-Fla.) — argue in a letter sent Wednesday to Pompeo that banning State Department employees from using those terms would be regressive for U.S. global health programs. The letter comes after POLITICO reported that conservative political appointees in the Trump administration were pushing for the proposal two weeks ago. (Choi, 11/14)

The Associated Press: Report Cites Weak Reporting On Missing, Killed Native Women
Numerous police departments nationwide are not adequately identifying or reporting cases of missing and murdered indigenous women and girls as concerns mount over the level of violence they often face, according to a study released by a Native American nonprofit Wednesday. The report from the Seattle-based Urban Indian Health Institute, the research arm of the Seattle Indian Health Board, was conducted over the past year amid worry in tribal communities and cities that Native American and Alaska Native women are vanishing in high numbers, despite a lack of available government data to identify the full scope of the problem. (Hudetz, 11/14)

Wyoming Public Radio: Bill Aimed At Addressing Violence Against Indigenous Women Takes First Steps In Senate
The U.S. Senate Indian Affairs Committee will discuss on Wednesday landmark legislation that aims to address the crisis of missing and murdered women in Indian Country. Indigenous women face some of the highest violence and sexual assault rates in the country. The proposed law, known as Savanna’s Act, would require the federal government to begin tracking the number of homicide victims and missing women. (Hegyi, 11/13)

The Philadelphia Inquirer: Some Pharmacies Thwart Efforts To Improve Access To The Opioid Overdose Reversal Drug
In response to the opioid crisis, all 50 states have changed their laws to make naloxone, the overdose reversal drug, easier to get and use. Many states, including Pennsylvania and New Jersey, have issued standing medication orders so pharmacists can dispense the lifesaving antidote without a prescription. Cities such as Philadelphia have campaigns encouraging family and friends of people at risk of overdose to carry naloxone. (McCullough, 11/14)

WBUR: Report: Opioid Epidemic Cost Massachusetts $15.2 Billion In 2017
The opioid epidemic cost Massachusetts $15.2 billion in 2017. That startling tally, a combination of expenses and lost labor, is explained in a report from the Massachusetts Taxpayers Foundation (MTF). It's the first to offer a thorough assessment of the economic damage caused by rising opioid use and deaths in Massachusetts. The authors say it's a conservative estimate because they couldn't find data to measure some considerable costs. (Bebinger, 11/14)

North Carolina Health News: NC Counties Putting New Federal Funding To Use In Battling Opioid Epidemic
A new grant from the U.S. Centers for Disease Control and Prevention will give funding to 22 North Carolina health departments to create strategies for fighting the state’s opioid epidemic. Thirty-four counties applied for a share of $1.8 million funds, for up to $100,000 each, according to the N.C. Department of Health and Human Services. (Monk, 11/15)

St. Louis Public Radio: As The Opioid Backlash Grows, Sickle Cell Patients Fear They'll Lose Critical Pain Treatment
For the 100,000 mostly black people in the United States who have sickle cell disease, the combination of acute crises and chronic pain can be debilitating. Treatment guidelines allow for high levels of opioids, but many sickle cell patients are now worried where recent crackdowns on opioids will leave them, particularly after a long history of misunderstanding about the disease. Sickle cell can cut life expectancy by decades, and, until recently, treatment was mostly palliative care — treating the pain without much thought to the consequences. (Smith, 11/14)

The Washington Post: School Shootings Have Fueled A $2.7 Billion School Safety Industry. What Makes Kids Safer?
The expo had finally begun, and now hundreds of school administrators streamed into a sprawling, chandeliered ballroom where entrepreneurs awaited, each eager to explain why their product, above all others, was the one worth buying. Waiters in white button-downs poured glasses of chardonnay and served meatballs wrapped with bacon. In one corner, guests posed with colorful boas and silly hats at a photo booth as a band played Jimmy Buffett covers to the rhythm of a steel drum. For a moment, the festive summer scene, in a hotel 10 miles from Walt Disney World, masked what had brought them all there. (Woodrow Cox and Rich, 11/13)

NPR: Vicarious Trauma For Doctors And Nurses Who Treat Victims Of Gun Violence
Gun violence has become a part of everyday life in America and of the work lives of doctors, nurses and first responders, too. After the National Rifle Association told doctors to "stay in their lane" in response to a policy proposal from the American College of Physicians for reducing gun-related injuries and deaths, there was a backlash. Health care professionals shared heart-wrenching stories about treating people harmed by firearms. (Gordon, 11/14)

NPR: How Doctors And Nurses Cope With The Human Toll Of Gun Violence
Gun violence has become a part of everyday life in America and of the work lives of doctors, nurses and first responders, too. After the National Rifle Association told doctors to "stay in their lane" in response to a policy proposal from the American College of Physicians for reducing gun-related injuries and deaths, there was a backlash. Health care professionals shared heart-wrenching stories about treating people harmed by firearms. How do doctors and nurses cope with their regular encounters with the human toll of gun violence? How does exposure to trauma affect them? (Gordon, 11/14)

ProPublica: Brothers Who Were Online Friends With Pittsburgh Shooting
The morning of the synagogue massacre in Pittsburgh last month, 23-year-old Edward Clark killed himself in a Washington, D.C., park. Ever since, the authorities have been piecing together a disturbing portrait of Clark and his older brother, Jeffrey Clark, 30, who had been online friends with the suspect in the Pittsburgh attack. Online, Jeffrey Clark had called the massacre a “dry run for things to come.” (Thompson, 11/14)

And more on the Stoneman Douglas school shooting in Florida —

The Associated Press: Florida School Massacre Panel To Hear From Criticized Deputy
The then-sheriff's deputy on campus during the Florida high school massacre is scheduled to testify Thursday before a state commission investigating the shooting, a day after members called him "not a real cop" and "a coward." Former Broward County Deputy Scot Peterson is subpoenaed to appear before the Marjory Stoneman Douglas High School Public Safety Commission, where he will be asked why he did not enter the building where 14 students and three staff members died Feb. 14 and try to stop the shooter. (Spencer and Anderson, 11/15)

The Associated Press: Students Say They Reported Threats Before School Massacre
Two students told investigators they reported the Florida high school shooting suspect to an administrator for making threats but felt they were not taken seriously, a commission investigating the massacre was told Tuesday. Pinellas County sheriff's Detective Chris Lyons told the Marjory Stoneman Douglas High School Public Safety Commission that 30 people knew suspect Nikolas Cruz made threats and racist remarks, committed animal cruelty and engaged in odd behavior in the years before the February shooting that left 17 dead, but few reported it to police or school authorities. (Spencer, 11/14)

Health News Florida: Stoneman Douglas Safety Hearing Scrutinizes 911 System In Parkland, Coral Springs, Broward
A poorly organized 911 system hampered the police response to the shooting at Marjory Stoneman Douglas High School. That’s one finding discussed on Tuesday by the public safety commission investigating the shooting. (Stein, 11/14)

The New York Times: How A Low-Carb Diet Might Help You Maintain A Healthy Weight
It has been a fundamental tenet of nutrition: When it comes to weight loss, all calories are created equal. Regardless of what you eat, the key is to track your calories and burn more than you consume. But a large new study published on Wednesday in the journal BMJ challenges the conventional wisdom. It found that overweight adults who cut carbohydrates from their diets and replaced them with fat sharply increased their metabolisms. After five months on the diet, their bodies burned roughly 250 calories more per day than people who ate a high-carb, low-fat diet, suggesting that restricting carb intake could help people maintain their weight loss more easily. (O'Connor, 11/14)

Stateline: ‘On The Geaux’: How A Playground On A Truck Brings Joy
In a state with the fourth-highest rate of youth obesity in the nation, the Baton Rouge, Louisiana, parks and recreation agency wanted to lure kids away from their screens and into the parks to get moving. But the low-income youths who needed exercise the most weren’t showing up at the parks, because, officials learned, they didn’t have transportation, and their parents were too busy working to take them. So they decided to take the parks to the kids. With money donated in 2012 by corporate sponsors and a portion of their parish budget, the local parks and recreation agency, known as the Baton Rouge Recreation, or BREC, bought a box delivery truck, painted it with bright colors and filled it with scooters, hula-hoops, balls, slack lines, trampolines, sidewalk chalk and jump ropes. (Vestal, 11/14)

And in more news —

The New York Times: Diet, Not Age, May Account For Rising Blood Pressure
Cardiologists are generally convinced that blood pressure inevitably increases with age. Now a new study calls this belief into question. Researchers studied two communities in a remote area of the Venezuelan rain forest that can only be reached by air. The Yanomami are among the most isolated and least assimilated people in the world. Nearby live the Yekwana people, also quite isolated, but with an airstrip that allows for the regular delivery of Western food and medicine. (Bakalar, 11/14)

Stateline: Polio-Like Illness AFM Tests An Overstretched Public Health System
The mysterious, polio-like disease that has struck 414 people — mostly young children — across the United States since 2014 comes at a time when the public health system already is overstretched. Reported in 39 states and Washington, D.C., acute flaccid myelitis, known as AFM, causes muscle weakness and in some cases paralysis in the arms or legs, terrifying parents and puzzling medical researchers. (Ollove, 11/15)

The New York Times: What To Know About Getting A Flu Shot This Year, No Matter Who’s Paying
When I went to a pharmacy in Brooklyn to get a flu shot last year, I was presented with a choice: one vaccine with three different strains of the flu virus for about $30 or, for just $10 more, four strains. It sounded vaguely like a late-night television infomercial. I stood at the counter, confused. Didn’t I want every strain? I thought that one new vaccine was developed each year and that it was more effective some years than others. What was I missing? (Bernard, 11/15)

The Star Tribune: Salmonella Outbreak In Raw Turkey Expands Nationwide
With Thanksgiving and turkey dinners just around the corner, food-safety investigators are still trying to pinpoint the source of drug-resistant salmonella that has shown up in some raw turkey around the country over the past year. While more than 1 million Americans get sick from salmonella each year, this particular outbreak of drug-resistant salmonella has vexed experts because it is so diffuse, appearing in a variety of products and in most of the country. (Painter, 11/14)

PBS NewsHour: Nearly 1 In 5 Teens Seriously Considers Suicide. Can Schools Offer Relief? 
The statistics are sobering: according to the Centers for Disease Control and Prevention, suicide is now the second-leading cause of death for ages 10 to 18, and the number of teens reporting feeling sad, hopeless or suicidal has risen. But experts say suicide is preventable. (Stark, 11/13)

The Washington Post: As Ebola Outbreak Worsens In Congo, U.S. Stays Out Of War Zone
The United States has no plans to redeploy personnel to fight the growing Ebola outbreak on the ground in Congo because of worsening security concerns, administration officials said Wednesday. The outbreak in northeastern Congo is taking place in an active war zone and has now become the country’s largest in more than four decades. Attacks on government outposts and civilians by dozens of armed militias have complicated the work of Ebola response teams, who have often had to suspend crucial work tracking cases and isolating people infected with the deadly virus. Violence has escalated in recent weeks, including attacks by armed groups this weekend near the operations center in Beni, the urban epicenter in North Kivu province. (Sun, 11/14)

Fox News: US Officials Report A Record Number Of Tick Diseases
U.S. health officials say a record number of tick-borne diseases were reported last year. The 2017 tally of more than 59,000 cases is a 22 percent increase from the previous year. The Centers for Disease Control and Prevention released the numbers Wednesday. Lyme disease accounted for nearly three-quarters of the illnesses. That's about 43,000 cases. (11/14)

Stat: Nebula Genomics, With Free DNA Sequencing, Opens For Business 
Information wants to be free, says the old internet meme, and a genomics company will now apply that to DNA: Starting on Thursday, the startup Nebula Genomics is giving customers the option of having their full genome sequenced at no cost, a first for direct-to-consumer genetics. There is, naturally, an itsy-bitsy little catch. Customers will have to answer a handful of questions about their health and other traits — from whether they have ever been diagnosed with cancer to their history of cardiovascular disease, diabetes, and other common ills to what medications they take, how physically active they are, and whether they smoke — in order to earn credits toward free sequencing. Answering the questions will earn enough credits, or “tokens” as the company calls them, to score free DNA sequencing. (Begley, 11/15)

Stat: Scientists Hope To Translate Paralyzed Patients' Thoughts Into Speech 
Dr. Ashesh Mehta, a neurosurgeon at the Feinstein Institute for Medical Research on Long Island, was operating on his epilepsy patient to determine the source of seizures. But the patient agreed to something more: to be part of an audacious experiment whose ultimate goal is to translate thoughts into speech. While he was in there, Mehta carefully placed a flat array of microelectrodes on the left side of the brain’s surface, over areas involved in both listening to and formulating speech. By eavesdropping on the electrical impulses that crackle through the gray matter when a person hears in the “mind’s ear” what words he intends to articulate (often so quickly it’s barely conscious), then transmitting those signals wirelessly to a computer that decodes them, the electrodes and the rest of the system hold the promise of being the first “brain-computer interface” to go beyond movement and sensation. (Begley, 11/15)

The New York Times: Data-Driven Medicine Will Help People — But Can It Do So Equally?
The promise of data-driven medicine is clear. Using the latest analytical techniques can lead to better health outcomes and — over time as data technology inevitably becomes cheaper and more widely available — help many more people. But as medicine moves from the kind of clinical practice that has informed centuries of treatment to the data-driven practices that have already transformed commerce, finance and the media, it will also find itself facing some of the same social challenges. In particular, big-data technology might seem like a social neutralizer or even a leveling force, but it can have a way of increasing divisions. One hint at why this is comes from what communications theorists describe as a knowledge gap. (Tufekci, 11/15)

Modern Healthcare: Hospitals Are Ill-Equipped To Treat Behavioral Health, ECRI Finds
Many hospitals aren't equipped to treat patients with behavioral health needs, but they could do better if they develop a clear vision for caring for those patients, according to a new report released Wednesday. The not-for-profit ECRI Institute Patient Safety Organization found that about half of the 2,400 behavioral health events at hospitals they studied involved patient violence against others, while 81 incidents involved temporary or minor patient harm. (Castellucci, 11/14)

The New York Times: Proteomics Might Have Saved My Mother’s Life. And It May Yet Save Mine.
The sergeant with the Mount Crested Butte Police Department in Colorado appeared and I was with my wife and our two young children, ages 2 and 7, at Lake Irwin, a remote campsite at 10,200 feet in the Rocky Mountains. When the officer stepped out of his S.U.V. cruiser, its blue and red emergency strobes piercing the darkness, I thought that perhaps a neighboring camper had summoned him to silence my dissonant guitar strumming beside the campfire. “I’m looking for Mr. Behar,” the sergeant announced. My cousin, who knew our whereabouts, had called the county sheriff, who dispatched the sergeant. His name was Brad Phelps, and he had navigated a dirt road at night through rugged alpine terrain to our location, because there was no cell reception where we were. After I identified myself, Phelps read from a palm-size paper notepad: “I’m sorry to have to tell you that your mother has passed away.” (Behar, 11/15)

The New York Times: There’s A Stress Gap Between Men And Women. Here’s Why It’s Important.
I was a workaholic. I love to create things, grow them and solve problems,” said Meng Li, a successful app developer in San Francisco. “I didn’t really care about my mind and my body until they decided to go on strike.” Ms. Li said her stress led to insomnia. When she did sleep, she experienced “problem-solving dreams,” which left her feeling unrested when she woke up. “After I became a first-time mother, I quickly realized between work and family, I was so busy caring for other people and work that I felt like I’d lost myself,” she said. “I’d put my own physical and mental needs on the back burner.” (Wong, 11/14)

The Associated Press: Skulls Reveal Neanderthals, Humans Had Similarly Harsh Lives
Life as a Neanderthal was no picnic, but a new analysis says it was no more dangerous than what our own species faced in ancient times. That challenges what the authors call the prevailing view of our evolutionary cousins, that they lived risky, stressful lives. Some studies have suggested they had high injury rates, which have been blamed on things like social violence, attacks by carnivores, a hunting style that required getting close to large prey, and the hazards of extensive travel in environments full of snow and ice. (Ritter, 11/14)

The CT Mirror: State Is Spending More, Not Less, On Inmate Health Care
A reorganization in how the state provides medical care to thousands of inmates will not save the state money this year as promised. Instead, it will cost millions more. The Connecticut Department of Correction took over managing health care for the 14,000 inmates in its custody last July after UConn Health informed the state it couldn’t sustain any more budget cuts without further sacrificing care. (Thomas, 11/13)

KQED: Judge Orders Investigation Of Possible Fraud In Prisoner Psychiatric Care Case
A federal judge overseeing improvements to psychiatric care in California’s prisons plans to appoint an experienced fraud investigator to look into allegations that state officials gave her inaccurate or misleading data in a long-running civil lawsuit. In an eight-page order issued late Tuesday, U.S. District Judge Kimberly Mueller said the investigation would focus first on whether prison leaders committed fraud upon the court. (Small, 11/14)

Cleveland Plain Dealer: Top Cuyahoga County Jail Official Resigns Ahead Of Expected U.S. Marshals Report Sparked By Six Inmate Deaths
Cuyahoga County’s top jail official resigned late Wednesday, just months after six inmates died in a four-month span and days ahead of an expected report by the U.S. Marshals about how the jail is run. Ken Mills’ resignation also came days after a strong rebuke from all 34 Cuyahoga County Common Pleas judges who said Mills’ jail was unsafe and inmates were not getting proper medical or mental health care. (Astolfi, 11/14)

New Hampshire Public Radio: Manchester Police Investigate Apparent Suicide In Manchester Jail
Police are investigating the death of a woman last weekend in a Manchester jail. Deatrah Reilly, 32, was found dead in her jail cell on Saturday after an apparent suicide. Her mother, Lorri Moore, says Reilly struggled with drug addiction and depression. (Gibson, 11/14)

The New York Times: Not Far From Flint, Contamination Has Left Detroit School Taps Dry
For a year now, Marcel Clark, a Detroit police officer and father of three, has been filling a 50-gallon drum each week with purified water for his family to drink. Ever since he heard about the water contamination crisis in Flint, Mich., an hour’s drive away, he hasn’t trusted the aging copper and steel pipes in his house. He’s been talking to contractors about replacing them, and hopes to get the work done in the next few months. (Nir, 11/15)

The Associated Press: Accusers: 20-Plus Ohio State Staff Knew Concerns Over Doctor
Alumni who say they're victims of sexual misconduct by an Ohio State University team doctor allege more than 20 school officials and staff, including two athletic directors, knew of concerns about how the physician treated young men but didn't stop him. The list of such employees grew Tuesday as 29 plaintiffs were added to one of the two pending lawsuits alleging Ohio State didn't deal appropriately with the now-deceased doctor, Richard Strauss. (11/14)

The Associated Press: Case Reveals Shame, Trauma Of Male Sex Trafficking Victims
Like many victims of a Connecticut sex trafficking ring that preyed on troubled young men and teenage boys for more than 20 years, Samuel Marino never told his family or police about being coerced into having sexual relations with much older men. Marino ended up carjacking vehicles from two different women in 2009 and leading police on a chase that left him dead at just 26 years old. (11/15)

The Associated Press: Report: Health Department Wasted $170K On Gifts, Travel
An investigative report by the Baltimore city Office of the Inspector General says the city’s health department wasted $170,000 on unused promotional goods, excessive manager travel, snacks and staff gifts. The Baltimore Sun reports the report released Wednesday focuses on the department’s Office of Chronic Disease Prevention, which fights illnesses such as lead poisoning and asthma. The report says the department raised the money by fining landlords for lead paint violations and charging attorneys for records in lead lawsuits. (11/15)

New Orleans Times-Picayune: High Demand For Shingles Vaccine Creates Shortages In New Orleans
A popular new vaccine against shingles is in such high demand that healthcare providers across the U.S. are having trouble keeping it in stock. The vaccine, Shingrix, was approved last year to prevent shingles for adults ages 50 and older. Shingles is a painful condition that causes a rash that can be severely itchy and debilitating, sometimes leaving nerve damage that causes pain for months or even years. People over 50 who had the chicken pox are 99 percent more likely to develop shingles, which occurs when the chickenpox virus is reactivated. People who are vaccinated reduce their risk of getting shingles by 50 percent, according to the U.S. Centers for Disease Control and Prevention. (Clark, 11/14)

Nashville Tennessean: Tennessee Hepatitis A Outbreak Claims Its First Casualty
Tennessee's growing hepatitis A outbreak has caused its first fatality and more deaths are possible as the virus continues to spread throughout Nashville and surrounding counties, state officials announced Wednesday. Elizabeth Hart, a spokeswoman for Tennessee Department of Health, said the fatality occurred in East Tennessee but that she could not release any other information about the victim. The Hepatitis A outbreak has now spread to 449 cases statewide, including 134 cases in Nashville and another 201 in the surrounding 12 counties. Another 40 cases have been documented in Chattanooga, which is the state’s second most impacted city, according to state data. Local officials have listed the Nashville count as even higher — 150 cases as of Wednesday. (Kelman, 11/14)

KQED: Rising Heat Is Making Workers Sick, Even Indoors
Excessive heat is already a health risk for millions of Californians at work, and it’s only getting worse. Over the last 30 years, warming nights and longer heat waves have become more frequent in the state. Four of the last five years were the hottest on record; 2018 could soon make it five out of six. This July and August, in Southern California, several daily and overnight temperature records toppled. One day this summer, the temperature hit 98 degrees at the coast. As [Jose] Rodriguez worked inside containers, a sensor measuring temperature and humidity found that the heat index – what it felt like to his body – was 115 degrees. (Peterson, 11/14)

Health News Florida: Department Of Health Gets Win In Trauma Case
A state appeals court Tuesday sided with the Florida Department of Health in a long-running dispute about proposed rules for determining whether trauma centers should be allowed to open --- though a law passed this year largely made the issue moot. A three-judge panel of the 1st District Court of Appeal overturned a 2017 decision by Administrative Law Judge Garnett Chisenhall, who tossed out the proposed rules. (11/14)

Dallas Morning News: Listeria Concerns Prompt Recall Of Ready-To-Eat Chicken Salad Sold In Texas
A Houston company that makes ready-to-eat chicken salad is recalling nearly 7,000 pounds of products that could be contaminated with listeria. Ron's Home Style Foods produced and packaged the chicken salad on Oct. 22 but the problem wasn't discovered until a Nov. 13 inspection, according to the U.S. Department of Agriculture's Food Safety and Inspection Service. The chicken salad was shipped to institutional and retail locations in Texas under two brand names. (O'Donnell, 11/14)

Columbus Dispatch: Ohio State's Wexner Medical Center Announces Affiliation With Cincinnati's Mercy Health
Ohio State University’s Wexner Medical Center has announced an affiliation agreement with Cincinnati-based Mercy Health, part of Bon Secours Mercy Health, aimed at tackling Ohio’s most-critical health issues. David McQuaid, chief executive officer for the Ohio State Health System, announced the new Healthy State Alliance at the Wexner Medical Center’s board meeting Wednesday. (Smola, 11/14)

Health News Florida: UCF, Nemours Team Up To Educate Youngest Patients
A new partnership between Nemours Children’s Hospital and the University of Central Florida is aimed at bringing the classroom to hospitalized children. Sixty children take classes through PedsAcademy, which brings math and science instruction to their bedside so they’re not behind when they return to school. (Prieur, 11/14)

Cleveland Plain Dealer: Cleveland Clinic, UH, MetroHealth Staff Docs Prohibited From Recommending Medical Marijuana
There are over 300 doctors throughout Ohio the state has cleared to recommend the drug, and more are being approved each month. Many of them are in private practice since many large health care systems don’t want doctors they directly employ to seek certificates from Ohio to recommend medical marijuana, said Columbus oncology, palliative care and hospice physician Jerry Mitchell at an Ohio medical marijuana meeting last week. (Hancock, 11/14)

St. Louis Public Radio: Jackson County Will Stop Prosecuting Most Pot Cases After Missouri Passes Medical Marijuana
A week after voters approved a measure to legalize medical marijuana in Missouri, the Jackson County Prosecutor’s Office announced today that it will stop processing some marijuana possession cases. Amendment 2, which legalizes medical marijuana with a 4 percent sales tax for veterans programs and job training, passed with 66 percent approval from Missouri voters and even more support from those in Jackson County. Two other medical marijuana proposals were on the state ballot but failed. (Calacal, 11/13)

The Washington Post: The Midterms Prove It: Progressive Ideas Are Now Mainstream 
Researchers from the Progressive Change Institute analyzed how every winning Democratic candidate for the House campaigned in 2018 — including their campaign ads, websites, social media and many debate performances. The resulting data shows that 65 percent of the incoming House freshman class embraced some version of Medicare-for-all or expanding Social Security benefits. Almost 80 percent embraced lowering prescription drug costs by challenging Big Pharma. And 82 percent favored challenging corporate power in our political system by rejecting corporate PAC money, passing a constitutional amendment to overturn Citizens United or passing campaign finance reform such as public financing of elections. (Adam Green, 11/14)

The Hill: The Health Care Repeal Effort Is Dead
On Tuesday night, it was clear: voters see past the Republican’s wolf in sheep’s clothing: voter turnout broke records as Americans marched to the polls to defend their health care.Health care dominated competitive races; from Rep.-elect Elaine Luria’s (D-Va.) win to Rep.-elect Debbie Mucarsel-Powell’s (D-Fla.) win.Health care also won resoundingly in referendums: Americans in the historically red states of Utah, Nebraska, and Idaho expanded health care access by a combined half-million people after they voted to expand Medicaid in their states. Thanks to voter turnout, Kansas, Maine and Wisconsin could soon follow suit. (Topher Spiro, 11/14)

The Hill: GOP Failed To Fight Dem's Health-Care Scare Tactics In Midterms
Exit polls showed that health care was the top factor in motivating voters in the 2018 election. Democrat candidates successfully stoked fears that the Republicans would end coverage of pre-existing conditions. Despite repeated assurances from President Trump that pre-existing conditions were safe, almost 60 percent of voters said they trusted the Democrats on this issue. This likely provided part of the margin that switched the House from Republican to Democrat control. (Paul Roderick, 11/14)

Des Moines Register: Focus Should Be On Preventing, Not Outlawing, Abortions In Iowa.
Newly elected Gov. Kim Reynolds says she hopes to work across the aisle with Democrats to accomplish her next agenda. That’s good news. What's bad news is that outside groups are now planning to push for a complete abortion ban in Iowa. And the hard-core ideologues who lead the Statehouse Republican majority seldom meet an abortion restriction they don't like. (Rekha Basu, 11/14)

Lexington Herald Leader: Kentucky’s Ban On Most Second-Trimester Abortions Would Harm Even Women Who Planned Their Pregnancies
Six weeks after that fateful ultrasound, my baby’s heart stopped, despite my hope for a miracle. Now I had another decision to make: deliver the baby or have a dilation and evacuation, the procedure that Kentucky is trying to outlaw. I wouldn’t judge another person for making either choice. Delivering my baby in the hospital was the worst day of my life and sometimes I wonder if it would have been easier to have been put under anesthesia and forgone the trauma. This was my third failed pregnancy — they never got any easier. Each time I left the hospital without a baby. ...This issue, with all its complexities, all its gut-wrenching decisions, all its heartbreak, is not black and white. It is our right — the right to have a choice, to have some control over ourselves and our bodies in an otherwise uncontrollable situation. (Katie Vandegrift, 11/13)

The Hill: Congress Is Going To Make Marijuana Moves
Despite majority public support in favor of marijuana legalization, and super-majority support in favor of medical cannabis access, members of Congress have nonetheless been reticent to move forward with any significant changes to federal pot policy. That is, until now. Following last week’s midterm election results, legislative leaders in both the House and Senate appear ready to take on the cannabis issue. (Paul Armentano, 11/15)

Stat: Hey, NRA: I Treat Gunshot Victims. Advocating About Firearms Is 'My Lane'
I’ll be the first to admit, National Rifle Association, that your “stay in your lane” tweet about doctors not consulting you is correct. I did not stop to consult you the last time I had someone bleeding out from gunshot wounds on the stretcher in front of me. Before his arrival, I’d been far too preoccupied listening to the overhead alert from the emergency medical service: “Young male. Unknown age. Multiple gunshot wounds. Heavy bleeding. Becoming less responsive. Other victim on scene already pronounced dead. ETA, 3 minutes.” (Christopher Lee Bennett, 11/14)

Los Angeles Times: To Stop Mass Shootings, Put Tighter Restrictions On Semiautomatic Guns
Recent history shows that mass killings in the U.S. don’t follow a single script. But there is one common element shared by many of these tragedies: legal access to semiautomatic guns.Domestic terrorists such as the mass shooters in Thousand Oaks, Pittsburgh and Parkland, Fla., come from different demographic backgrounds and have different characteristics. Few reforms are likely to stop them all.i But all three killers used semiautomatic guns, which research has shown are more lethal on average in terrorist attacks than explosives or other weapons. And all three managed to kill and injure more people than the terrorist who mailed homemade pipe bombs to high-profile targets in October. (Benjamin Bahney, 11/15)

Stat: Viewing The Opioid Crisis As An Ecological Disaster Could Help With 'Cleanup'
Perhaps the most important effect of viewing the opioid crisis as a multigenerational ecological disaster is that it offers a series of useful guidelines. In the litigation against BP after the Deepwater Horizon oil spill, for example, we saw corporate accountability. Although steps toward corporate accountability for the opioid disaster are now underway in some states, where litigation is being pursued against opioid manufacturers, we should support a broader understanding of accountability, one that holds drug makers responsible for developing new, non-opioid treatments for acute and chronic pain. (Maia Dolphin-Krute, 11/15)

New England Journal of Medicine: The SUPPORT For Patients And Communities Act — What Will It Mean For The Opioid-Overdose Crisis?
Although SUPPORT is a step in the right direction, substantially altering the trajectory of the opioid epidemic requires a comprehensive, integrated, and public health–oriented response coordinated throughout all branches and levels of government. Every dollar spent on incarcerating a person who uses drugs is a dollar that is not spent on prevention or treatment, and every person removed from the Medicaid rolls is a person who is unable to receive evidence-based care. We have the tools and knowledge to reverse the unprecedented, and largely preventable, avalanche of overdose-related morbidity and mortality. The question is not how to end the crisis of opioid-related harm but whether we will choose to mount an effective, evidence-based, and equity-focused response. The lives of thousands of people depend on the answer. (Corey S. Davis, 11/14)

Los Angeles Times: The Case Against Carbohydrates Gets Stronger
As anyone who’s gone on a diet knows, once you lose some weight, it gets harder to lose more. The “eat less, move more” mantra, as simple as it sounds, doesn’t help us deal with our bodies’ metabolic reality: As we shed pounds, we get even hungrier and our metabolism slows down. But findings from a new study I led with my colleague Cara Ebbeling suggests that what we eat — not just how much — has a substantial effect on our metabolism and thus how much weight we gain or lose. (David S. Ludwig, 11/14)

New England Journal of Medicine: Looking Beyond Mortality In Transplantation Outcomes
Despite an increasing emphasis on patient-centered outcomes in medicine, transplant centers do not systematically report information on health-related quality of life, nor are such measures incorporated into algorithms for organ allocation or program assessment. (Daniela J. Lamas, M.D., Joshua R. Lakin, M.D., Anil J. Trindade, Andrew Courtwright and Hilary Goldberg, 11/14)

Boston Globe: Cracking Down On Abusers Of The Disabled
A society is — or should be — judged by how well it protects its most vulnerable citizens. But when it comes to protections for those with intellectual and developmental disabilities, Massachusetts still has a long way to go. And by every statistic available, the problem of physical and sexual abuse is growing worse with every passing year. (11/14)

New England Journal of Medicine: Medicalization And Demedicalization — A Gravely Disabled Homeless Man With Psychiatric Illness
In our first Case Study in Social Medicine, a man presents to the emergency department reporting auditory hallucinations and suicidal thoughts. His case hinges on interpretations of whether his problems are medical in nature and within medical institutions’ scope of practice. (Joel T. Braslow and Luke Messac, 11/14)