Stat: Top Medicaid Official Calls GOP Reforms 'Bad Policy' 
The Biden administration’s outgoing Medicaid chief said on Wednesday that Republican ideas to overhaul Medicaid are “just plain bad policy” and will hurt the program’s low-income enrollees. (Herman, 11/20)

The New York Times: Medicaid May Face Big Cuts And Work Requirements 
With Republicans set to control Washington, conservative lawmakers and policy experts who could advise the next Trump administration are discussing long-sought cuts to Medicaid, the government health program that covers roughly a fifth of all Americans and makes up about 10 percent of the federal budget. Some of the changes are being proposed as a way to pay for a law that would extend the tax cuts from the first Trump administration, most of which benefited corporations and wealthier Americans. The policies might slash funding for Obamacare’s Medicaid expansion — which added roughly 23 million people to the program — or require that many enrollees work in order to receive benefits. (Kliff and Weiland, 11/20)

Disability Scoop: Disability Advocates Sound Alarm Over Possible Medicaid Cuts 
With Republicans set to assume control in Washington, disability advocates are warning that proposals are in the works to drastically reshape Medicaid and undermine the nation’s system of home and community-based services. (Diament, 11/21)

More on the nomination of Dr. Mehmet Oz as CMS chief —

MarketWatch: Trump’s Choice Of TV’s ‘Dr. Oz’ To Oversee Medicare And Medicaid Could Be ‘Devastating’ For Millions Of Americans 
“Nominating a person who has promoted unproven medical treatments for personal gain, opposed the Affordable Care Act and supports the further privatization of Medicare to oversee the healthcare for millions of people, including seniors, will have devastating consequences,” said Tony Carrk, executive director of government watchdog Accountable. US. “President-elect Trump is helping his friends, but the rest of us get higher costs, less coverage, and weakened protections — especially those with pre-existing conditions,” Carrk said. As of 2022, Oz and his wife owned up to $600,000 in UnitedHealth Group stock and up to $100,000 in shares of CVS Health, which owns Aetna, according to Accountable. US. Both companies are large Medicare Advantage providers. Medicare Advantage is a private-company alternative to traditional Medicare. (Hall, 11/20)

Fortune Well: How Dr. Oz Could Change Medicare Under President Trump 
When Trump made his CMS nomination announcement, he said Oz “will also cut waste and fraud within our Country’s most expensive Government Agency, which is a third of the Nation’s Healthcare spend, and a quarter of our entire National Budget.” There seems to be plenty of waste, and possibly fraud, for Oz to try eliminating from Medicare and Medicaid. (Eisenberg, 11/20)

The New York Times: Dr. Oz, Tapped to Run Medicare, Has a Record of Promoting Health Misinformation
The heart surgeon turned TV star has championed healthy lifestyle habits. But he’s also promoted sham diet pills and ineffective Covid-19 treatments. (Blum, Schmall and Agrawal, 11/20)

Politico: Dr. Oz Getting High Marks From Senate Moderates — Maybe Even Fetterman 
President-elect Donald Trump’s pick to run the Centers for Medicare and Medicaid Services, Dr. Mehmet Oz, is seemingly drawing more enthusiasm from Senate Republicans than Trump’s selection to run HHS, Robert F. Kennedy Jr. Some GOP senators have not been publicly enthusiastic about Kennedy’s selection. But Senate Republicans across the ideological spectrum — and even the Democrat who beat Oz in a bitter Pennsylvania Senate race in 2022, Sen. John Fetterman — are voicing potential support for the TV celebrity doctor. That bodes well for his confirmation: Senate Republicans can confirm Oz without Democrats, and Democratic support would give him a healthy margin. (Leonard, 11/20)

Bloomberg: Trump's Top Candidate For FDA Seen To Be Marty Makary
Surgeon and author Marty Makary is seen as the leading candidate to run the US Food and Drug Administration under President-elect Donald Trump, people familiar with the matter said. Makary, a pancreatic surgeon at Johns Hopkins Medicine, is a health researcher whose latest book focuses on questioning medical orthodoxy on topics from peanut allergies to antibiotics. (Tozzi, Muller, and Cook, 11/20)

Who might lead the NIH? —

MedPage Today: What To Know About Jay Bhattacharya, Trump's Potential NIH Pick 
Jay Bhattacharya, MD, PhD, of Stanford University in California, has emerged as President-elect Donald Trump's top pick to lead the National Institutes of Health (NIH), according to reporting from the Washington Post. Amid Trump's stated plans to "restructure federal agencies," Bhattacharya would indeed be an outsider coming in to lead the NIH. And Bhattacharya has previously said he believes top officials there hold too much influence. (Henderson, 11/20)

The Washington Post: Stanford’s Jay Bhattacharya Emerges As A Top Candidate To Lead NIH 
The rise of Jay Bhattacharya — from being scorned by the nation’s NIH director to possibly occupying his office four years later — reflects how the backlash to coronavirus policies has helped reshape conservative politics and elevate new voices. (Diamond, 11/16)

Newsweek: RFK Jr.'s Reforms Should Be Embraced By Doctors: Stanford Medical Professor Jay Bhattacharya
Jay Bhattacharya, a professor at Stanford University Medical School, says that American doctors should embrace the reform agenda of Robert F. Kennedy Jr., Donald Trump's controversial pick to lead the Department of Health and Human Services (HHS) in the next presidential administration. In an article for UnHerd, a nonpartisan website that aims to "test and retest assumptions, without fear or favor," Bhattacharya wrote that critics of Kennedy focus too much on his belief in conspiracy theories. (Whisnant, 11/16)

More on RFK Jr. and the FDA —

Roll Call: FDA’s Nutrition Goals Similar To Kennedy’s, Experts Say 
President-elect Donald Trump’s pick to helm the Department of Health and Human Services has said he wants sweeping changes to how the United States approaches health and food, going so far as to suggest that the Food and Drug Administration should eliminate its nutrition operations. But the agency may be more aligned with Robert F. Kennedy Jr.’s goals than he’s made it seem. (DeGroot, 11/20)

The Washington Post: RFK Jr. Wants Fluoride Out Of Water. Oregon Is Way Ahead. 
Oregon, the third-least-fluoridated state, one where the mineral has long been a contentious issue, offers a window into the fluoride fights to come. Just 26 percent of Oregonians using community water systems drink fluoridated water, according to the Centers for Disease Control and Prevention, compared to 72 percent of Americans overall. Portland is the nation’s largest city without fluoridated water, and voters have repeatedly rejected efforts to add it since 1965, most recently in a bruising 2013 ballot measure vote. In addition to conservative Lebanon, residents of Hillsboro, Oregon, a Democratic-leaning Portland suburb, voted in November against a ballot measure to fluoridate its water supply. The battles in Oregon illustrate how fear of fluoride spans partisan lines, tapping into distrust of authorities and mainstream science. (Nirappil, 11/20)

USA Today: RFK Jr., AIDS Denial, Trans Rights: Why LGBTQ+ People In Uproar
RFK Jr. has become somewhat of a persona non grata for sharing what LGBTQ+ advocates say is harmful misinformation about some of the hot-button topics that impact them the most: HIV, transgender people and their healthcare. In the days since his name was put forward, many have expressed their concern and disappointment both with Kennedy and the direction they fear the Trump administration will take overall. (Oliver, 11/20)

Politico: Bill Nye: RFK Jr. Has ‘Lost His Way’ 
Bill Nye, an engineer best known for his 1990s TV show “Bill Nye the Science Guy,” panned Robert F. Kennedy Jr.’s selection as the incoming Trump administration’s top health official. “I think he’s lost his way,” he said on Wednesday while speaking to reporters in the Capitol. Nye, an advocate for the National Ataxia Foundation, said he was in the Capitol “trying to get the FDA just a bit of a nudge” to consider data around a potential treatment for spinocerebellar ataxia, a group of inherited brain disorders that affects physical coordination and loss of fine motor skills. The genetic condition runs in Nye’s family. (Gardner, 11/20)

Also —

Roll Call: CDC Director Looks To Future Of Public Health With Worry
With two months to go before the end of the Biden administration, Centers for Disease Control and Prevention Director Mandy Cohen says she’s worried about the future of the public health agency and the people it serves. House GOP appropriators are pushing a 22 percent cut to the sprawling public health agency. President-elect Donald Trump has nominated a vaccine skeptic, Robert F. Kennedy Jr., to lead the Department of Health and Human Services. And years after the end of the COVID-19 pandemic, skepticism about public health agencies remains despite the agency’s work to restore trust in it and its efforts. (Cohen, 11/20)

Stat: Bluesky Sees Influx Of New Users From 'MedTwitter,' Scientists On X
Ten years ago, science was entering its extremely online era. On Twitter, some academics, traditionally siloed in their niche fields, were growing unprecedented public profiles. Neil Hall, a genome scientist in the United Kingdom, responded by creating what he called the “Kardashian index,” a satirical measure comparing a scientist’s publishing record with their following on Twitter. The K-index — and countless lists of scientists to follow — sparked intense debate over scientists’ role in communicating their work (and more) to the public. (Palmer, 11/21)

Stat: The Health Care Industry Is Girding For Trump’s Tariffs —And Pushing Hard For Carveouts
President-elect Trump campaigned on imposing broad, steep tariffs to create more jobs in the U.S. and combat China. If enacted, these taxes would send the U.S. health care industry scrambling and could eventually force patients and insurers to shell out more for medical care. But no one in the industry is in a tizzy just yet, at least not publicly. There are two reasons for that. One: No one knows what Trump is actually going to do. Two: They’re pushing hard for carve-outs behind the scenes. (Bannow and Silverman, 11/21)

Modern Healthcare: Underinsured Patients At Risk If ACA Subsidies Lapse
More people may face gaps in insurance coverage, have trouble affording medical care or not be able to pay for coverage if certain Affordable Care Act subsidies aren't renewed next year, the Commonwealth Fund said Thursday. The independent healthcare research organization's 2024 report on health insurance found 44% of Americans are underinsured, face coverage gaps or are uninsured, despite improvements in lowering the number of uninsured citizens. In its 2022 report, the group pegged the percentage at 43%. (DeSilva, 11/20)

KFF Health News: Washington Power Has Shifted. Here’s How The ACA May Shift, Too
President-elect Donald Trump’s return to the White House could embolden Republicans who want to weaken or repeal the Affordable Care Act, but implementing such sweeping changes would still require overcoming procedural and political hurdles. Trump, long an ACA opponent, expressed interest during the campaign in retooling the health law. In addition, some high-ranking Republican lawmakers — who will now have control over both the House and the Senate — have said revamping the landmark 2010 legislation known as Obamacare would be a priority. They say the law is too expensive and represents government overreach. (Armour, Whitehead and Rovner, 11/21)

Modern Healthcare: Prior Authorization Policies Need More Changes, Providers Say
The Biden administration sought to tackle one of the most contentious policies in healthcare: prior authorization. Providers and insurers say there’s still room for improvement. Provider groups have complained misuse of prior authorizations is responsible for care delays, increased hospitalizations and a reduced likelihood that patients follow their care plans, along with the administrative burden providers face in trying to secure coverage for patients. (Early, 11/20)

AP: Open Enrollment: How To Shop For Health Insurance
Everyone likes a good deal, and health insurance bargains abound this time of year. But buyers should look beyond price when searching for a plan. Shoppers also should consider doctor networks and coverage limits to avoid getting stuck with big bills after care. Millions of Americans are looking for 2025 coverage now during annual enrollment windows for Medicare Advantage plans and individual insurance. Plus, many employers are telling their workers about their coverage plans for next year too. (Murphy, 11/20)

More on the high cost of health care —

MedPage Today: Health Prices Are Getting More Transparent, But It's Still Not Enough, Experts Say 
Health transparency rules have helped researchers gain more insight into hospital pricing practices, Ge Bai, PhD, CPA, said here Wednesday at an event sponsored by Georgetown University's Center on Health Insurance Reforms. The price transparency regulations that were part of the Affordable Care Act (ACA) "gave us unprecedented insight into what's really going on in the commercial market," said Bai, who is professor of health policy and management at Johns Hopkins Bloomberg School of Public Health in Baltimore. (Frieden, 11/20)

North Carolina Health News and Charlotte Ledger: Trapped In The Medical Billing Maze
When Mary Katherine Snow of Cornelius was diagnosed with leukemia in 2017, she was prepared to fight for her life. But she didn’t expect that in addition to fighting cancer, she would also have to fight a cascade of medical billing errors that tanked her credit score, required hours of back-and-forth with her hospital and her health insurer, and piled on stress at a time when she could least afford it. (Crouch, 11/21)

Bloomberg: New York Aims To Lower Drug Prices With PBM Rules For CVS, Cigna, UnitedHealth
New York state regulators are setting new rules to rein in the behavior of prescription drug middlemen — including units of CVS Health Corp., Cigna Group and UnitedHealth Group Inc. — in a step the state’s top financial regulator said will boost competition and transparency. Regulations taking effect this month will make pharmacy benefit managers, or PBMs, publish their lists of covered drugs and directories of pharmacies in their networks. The state will also bar PBMs from steering patients to their affiliated pharmacies and allow local pharmacies to offer mail-order and home delivery. (Tozzi, 11/20)

Roll Call: Trump's First Week In Office May Set Tone On Abortion Policy 
President-elect Donald Trump’s first actions upon taking office in January could set the tone for how much he plans to leave the issue of regulating abortion to the states. Presidents typically make two key global family planning decisions during their first week in office: whether to fund the United Nations Population Fund, known as UNFPA, and whether to fund foreign nongovernmental organizations that perform, refer for or provide counseling for abortion abroad. (Raman, 11/20)

NPR: Anti-Abortion Groups Have A To-Do List For Trump In His Second Term
During his first term in office, President-elect Donald Trump delivered on many goals of the anti-abortion-rights movement: appointing conservative Supreme Court justices and restricting federal funding for groups like Planned Parenthood, among other things. Now, those activists hope a second Trump term will be a chance to take their agenda further. "All of that is good, what we saw in the first Trump administration. But we can do better," said Kristan Hawkins, president of Students for Life of America. (McCammon, 11/21)

Politico: Anti-Abortion Groups Have 2 Asks. RFK Jr. Is Listening. 
Abortion opponents — concerned about Kennedy’s past comments supporting abortion access — have two major asks: that he appoint an anti-abortion stalwart to a senior position in HHS and that he promise privately to them and publicly during his confirmation hearing to restore anti-abortion policies from the first Trump administration, according to four anti-abortion advocates granted anonymity to discuss private conversations. And Kennedy, according to a fifth person close to the Trump transition, is open to their entreaties. (Messerly, Ollstein and Cancryn, 11/20)

Updates from Idaho, Illinois, and Massachusetts —

ABC News: Miscarrying Patient Was Passed Around 'Like A Hot Potato' Due To Idaho Abortion Ban, Doctor Testifies
A woman experiencing dangerous bleeding was not admitted by doctors at an Idaho hospital until her fourth emergency room visit in one week, due to fear and confusion over the state's abortion ban, an Idaho doctor said in testimony on Tuesday. "My colleagues are so scared and confused to even mention the word, it's like a hot potato -- pass the patient around and hopefully something will happen and declare itself," Dr. Julie Lyons, a family physician in Idaho and plaintiff in a lawsuit over the state's abortion bans, said on the stand. (El-Bawab, 11/20)

Chicago Tribune: Anti-Abortion Groups, Employers Sue Pritzker Over Abortion Law
Half a dozen groups and employers who oppose abortion are suing Gov. JB Pritzker and other state officials, aiming to stop them from enforcing a law that requires health insurers in Illinois to cover abortions and abortion medications at no cost to patients. (Schencker, 11/20)

Axios: Patients Rush To Replace IUDs, Renew Birth Control After Trump's Win
Patients with contraceptive implants and IUDs, which can remain in the body for three to 10 years, are asking Boston-area clinics if they can replace the devices early because they don't know if they will be covered by insurance or available under Trump, doctors say. Some patients are asking to get their IUDs replaced as early as two to three years before they're due to be switched out, says Deborah Bartz, a gynecologist for Mass General Brigham. (Solis, 11/21)

In other reproductive health news —

The Hill: Biden Awards The Medal Of Freedom To Cecile Richards, Former Planned Parenthood President
President Biden awarded on Wednesday the Presidential Medal of Freedom to Cecile Richards, an abortion rights activist and former president of Planned Parenthood. During a private ceremony, Biden said Richards has “led some of our Nation’s most important civil rights causes — to lift up the dignity of workers, defend and advance women’s reproductive rights and equality, and mobilize Americans to exercise their power to vote.”  (Weixel, 11/20)

ABC News: Why Rates Of Postpartum Depression Have Doubled In The Last Decade
Rates of postpartum depression -- a serious mood disorder affecting new moms within the first 12 months after childbirth -- have doubled over the last decade, according to a new study of more than 440,000 people from Kaiser Permanente Southern California. The rate of diagnosis jumped from about 9% in 2010 to 19% in 2021. This is part of a larger trend. Mental health conditions are now the leading cause of pregnancy-related deaths in the U.S., according to the Centers for Disease Control and Prevention. (Zusstone, 11/20)

The Washington Post: Speaker Johnson Restricts Use Of Capitol Bathrooms By Transgender People
House Speaker Mike Johnson (R-Louisiana) said Wednesday that transgender individuals would not be allowed into restroom facilities in the Capitol and House office buildings that do not correspond with their sex assigned at birth, announcing the rule change about two weeks after Democrat Sarah McBride of Delaware became the first openly transgender individual elected to Congress. “All single-sex facilities in the Capitol and House Office Buildings — such as restrooms, changing rooms, and locker rooms — are reserved for individuals of that biological sex,” Johnson said in a statement. “It is important to note that each Member office has its own private restroom, and unisex restrooms are available throughout the Capitol. Women deserve women’s only spaces.” (Vazquez and Alfaro, 11/20)

The Guardian: Trans Congresswoman Sarah McBride Responds To Capitol Hill Bathroom Ban 
McBride is due to be sworn in in January to represent Delaware after handily winning the seat in the election earlier this month, having been the first openly trans person elected to the state senate seat there in 2020. But on Wednesday, after Johnson’s announcement, McBride responded with a post on X: “I’m not here to fight about bathrooms, I’m here to fight for Delawareans and to bring down costs facing families. Like all members, I will follow the rules as outlined by Speaker Johnson, even if I disagree with them. This effort to distract from the real issues facing this country hasn’t distracted me over the last several days.” (Chao-Fong, 11/20)

In other news from Capitol Hill —

St. Louis Public Radio: Hawley Unveils New Radiation Fund Bill With Price Cap 
U.S. Sen. Josh Hawley is making a new push to pass funding for St. Louisans sick from exposure to radioactive waste. The Radiation Exposure Compensation Act is a federal program that gives money to people with illnesses that were likely caused by exposure to U.S. nuclear tests or uranium enrichment. The U.S. Senate passed two bills to renew the program, but Congress ultimately allowed the original funding to expire in June. (Grumke, 11/20)

The 19th: Climate Change Is Disrupting Access To HIV Treatment
Half of people with HIV in the United States are living in places that are vulnerable to extreme weather and climate disasters, according to a new analysis from the left-leaning Center for American Progress (CAP). The report from CAP released Wednesday finds that the areas of the country where HIV is being diagnosed at disproportionately high rates are also places most at risk of disasters. (Kutz, 11/20)

CIDRAP: Climate Change May Drive Migratory Birds Farther North, Introducing Exotic Tick-Borne Diseases 
Rising temperatures fueled by climate change may allow pathogen-infected ticks attached to birds migrating from tropical to cooler locations to survive at their destinations, researchers reported this week in Frontiers in Cellular and Infection Microbiology. (Van Beusekom, 11/20)

In other pharma and tech developments —

CIDRAP: Novel Genomic Test Shows Promise To Streamline Diagnosis Of Multiple Infectious Diseases
After a decade in development, a new genomic test developed at the University of California–San Francisco (UCSF) promises to rapidly and accurately diagnosis infections caused by almost any pathogen—whether a virus, bacterium, fungus, or parasite. The tool uses a genomic sequencing technique, called metagenomic next-generation sequencing (mNGS), to quickly decipher if a bacterium, fungus, virus, or parasite is causing an infection. Instead of ruling out each pathogen in a process of elimination, mNGS analyzes all the nucleic acids, RNA and DNA, present in a sample simultaneously. (Soucheray, 11/20)

MedPage Today: 'A Watershed Moment': GLP-1 Drug Succeeds In Late-Stage MASH Trial 
Semaglutide (Wegovy) improved liver fibrosis in patients with metabolic dysfunction-associated steatohepatitis (MASH) and led to greater rates of MASH resolution, an interim analysis of a phase III trial showed. (Bassett, 11/20)

Stat: A Needle Shot Alternative? Researchers Turn To Squids, Cuttlefish
Doctors have been using needles as a way to inject people with drugs since the 1600s. Today they’re often used for biologic drugs, which are too large to deliver via pills because they would be dissolved by stomach acid. Now a group of bioengineers is hoping to give drug delivery an update with a device that draws inspiration from cuttlefish and other sea creatures. (Oza, 11/20)   

Stat: New Details On A Risky Medical Device Show Need For More FDA Transparency, Researchers Say
Tonya Brand was horrified to find a piece of metal poking out of her inner thigh while relaxing at her house in Georgia in 2011. She had no idea what it could be. It was only after extensive imaging that her doctors realized what had happened: A medical device that had been implanted in her two years earlier to catch blood clots had broken and was now migrating to different parts of her body. (Lawrence, 11/20)

On health data and privacy —

Modern Healthcare: Dexcom Invests $75M Into Oura Smart Rings
Smart ring company Oura announced it received $75 million in funding from glucose monitoring and diagnostics company Dexcom. The strategic investment brings Oura’s valuation to more than $5 billion and allows the companies to begin integrating data between Dexcom’s continuous glucose monitoring products and Oura’s smart ring and application. (Turner, 11/19)

Los Angeles Times: Tracking Your Health With A Device? Here's Where The Data Could Go
Wearable technology — smartwatches, smart rings, fitness trackers and the like — monitors body-centric data such as your heart rate, steps taken and calories burned, and may record where you go along the way. ... But the lack of oversight into how body-centric data are used and shared with third parties has prompted concerns from privacy experts, who warn that the data could be sold or lost through data breaches, then used to raise insurance premiums, discriminate surreptitiously against applicants for jobs or housing, and even perform surveillance. (Fry, 11/20)

San Francisco Chronicle: Kaiser Poised To Downsize At Oakland HQ In Another Blow To Downtown
Kaiser Permanente, one of Oakland’s largest employers, plans to downsize its headquarters office space in another blow to the city’s downtown. The health care giant “will significantly reduce its space” at the Ordway Building, where it has been headquartered since 1970, according to a building loan servicer note. As a result, the 530,000-square-foot tower faces “imminent monetary default” due to “insufficient cash flow” and was transferred to special servicing earlier this year. (Li, 11/20)

More health news from California —

Los Angeles Times: Union Representing UC Service Workers Launches Two-Day Strike
Nearly 40,000 University of California workers began a two-day strike Wednesday to protest what they claim is bad faith bargaining by university negotiators as the two sides try to hammer out new labor agreements. The work stoppage, which affects service and patient care workers at all UC campuses and medical facilities, will continue until 11:59 p.m. Thursday. AFSCME Local 3299, the union representing the workers, and the university system have been in talks over new contracts for nearly a year. (Petrow-Cohen, 11/20)

The Mercury News: Good Samaritan Hospital Clears Rezoning Hurdle At San Jose City Council
Despite criticism from some city leaders over the past few weeks about HCA Healthcare’s previous service cuts, the San Jose City Council will not stand in the way of the health provider’s plans to build a new facility at Good Samaritan Hospital. Instead, the City Council unanimously approved rezoning the hospital’s campus Tuesday — allowing it to move forward with the permitting process to build new facilities that comply with state seismic law — amid overwhelming support for the project from patients, labor groups and medical professionals. (Patel, 11/20)

Los Angeles Times: Feds Raise Concern About Maternal Care For Black Cedars-Sinai Patients
Federal investigators looking into the treatment of Black pregnant patients at Cedars-Sinai Health System have found evidence that federal laws against discrimination may not have been followed, according to a “letter of concern.” “Our investigation has uncovered evidence that Cedars-Sinai may have engaged in a pattern of inaction and/or neglect concerning the health risks associated with Black maternity patients,” the U.S. Department of Health and Human Services Office for Civil Rights said in its Nov. 12 letter to Cedars-Sinai officials. (Alpert Reyes, 11/20)

KFF Health News: California Sets 15% Target For Primary Care Spending Over Next Decade
A California agency charged with slowing health costs has set a lofty goal for insurers to direct 15% of their spending to primary care by 2034, part of the state’s effort to expand the primary care workforce and give more people access to preventive care services. The board of the state Office of Health Care Affordability in October set its benchmark well above the industry’s current 7% primary care spending rate, in hopes of improving Californians’ health and reducing the need for costlier care down the road. (Sánchez, 11/21)

From Texas —

Houston Chronicle: Montgomery County Launches New Medical Examiner's Office
Montgomery County is now the 14th county in Texas to become a medical examiner’s office after commissioners unanimously approved the decision without discussion. The Tuesday action comes after commissioners approved the department’s $3.2 million budget in September. Dr. Kathryn Pinneri, who became director of forensic services in 2016, will be the county's first chief medical examiner. (Dominguez, 11/20)

The Texas Tribune: What To Know About Texas Hospitals' Citizenship Question 
On Nov. 1, Texas hospitals that accept Medicaid or Children’s Health Insurance Plan coverage started asking all patients about their immigration status and whether they are lawfully present in the United States. The requirement is part of an executive order Gov. Greg Abbott issued this summer. The information is statistical only. No identifying information about the patient is passed along to the governor’s office. (Langford, 11/21)

The Texas Tribune: Texas Senate To Prioritize Creating Dementia Research Fund
Two decades ago, state Rep. Tom Craddick could ask a room of his West Texas constituents what illness they feared the most and the answer, unfailingly, was always cancer. A few weeks ago, about the time Lt. Gov. Dan Patrick contacted him about a new blockbuster medical research fund idea, Craddick asked a group of his constituents the question again and no one mentioned cancer. “It was unanimous in the room,” Craddick said. “Alzheimer’s and dementia.” (Langford, 11/21)

From New York, Alabama, and Iowa —

The New York Times: Urologist Who Sexually Abused Patients Is Sentenced To Life In Prison
A urologist convicted of sexually abusing seven patients, including five who were minors, was sentenced to life in prison on Wednesday, prosecutors said. The doctor, Darius A. Paduch, a fertility specialist, molested boys and young men for years at two prominent New York hospitals, prosecutors said. Hundreds of other young men and boys have also accused Dr. Paduch, 57, of abuse spanning more than 15 years in scores of civil suits. (McFadden, 11/20)

AP: Alabama To Use Nitrogen Gas To Execute Man For 1994 Slaying Of Hitchhiker 
An Alabama prisoner convicted of the 1994 murder of a female hitchhiker is slated Thursday to become the third person executed by nitrogen gas. Alabama this year began using nitrogen gas to carry out some death sentences, the first use of a new execution method in the United States since lethal injection was introduced in 1982. The method involves placing a respirator gas mask over the person’s face to replace breathable air with pure nitrogen gas, causing death by lack of oxygen. Alabama maintains the method is constitutional. (Chandler, 11/21)

KFF Health News: After Institutions For People With Disabilities Close, Graves Are At Risk Of Being Forgotten
Hundreds of people who were separated from society because they had disabilities are buried in a nondescript field at the former state institution here. Disability rights advocates hope Iowa will honor them by preventing the kind of neglect that has plagued similar cemeteries at other shuttered facilities around the U.S. (Leys, 11/21)

The Washington Post: CDC Warns Of Body-Lice Transmitted Infections Among Homeless Populations 
A rare disease spread by body lice poses a danger to people experiencing homelessness and others who have received organ transplants from the infected, according to three papers released Wednesday by investigators at the Centers for Disease Control and Prevention. The bacterial infection, known as Bartonella quintana, or trench fever as it was called during World War I, lives in the feces of body lice and can cause skin lesions, fever and bone pain. However, severe cases can lead to a potentially fatal infection of the heart valves. (Johnson and Malhi, 11/20)

Also —

NBC News: Georgia Woman Sues In Response To E. Coli Outbreak Linked To Carrots
Melinda Pratt had been buying the same brand of organic carrots for years: Bunny Luv by Grimmway Farms. ... After she ate them, she said, she began experiencing bloody diarrhea and stomach pain that felt like “somebody getting stabbed in the stomach repeatedly and not stopping.” Her symptoms also included nausea and vomiting, Pratt said, adding that she was the only one in her household who ate the carrots. “I genuinely thought at some point that I was slowly dying,” she said. (Richardson, 11/20)

CBS News: Are Food Recalls And Outbreaks On The Rise? FDA Says U.S. Food Supply Still "One Of The Safest In The World"
The Food and Drug Administration said Wednesday that the U.S. food supply is still "one of the safest in the world," in the wake of a number of foodborne disease outbreaks affecting items ranging from organic carrots to deli meats to McDonald's Quarter Pounders. E. coli, listeria and other contaminants have sickened thousands of people and forced a number of recalls in recent months. But despite those high-profile examples, data cited by the FDA suggest recalls were not unusually high this past year. (Tin, 11/20)

Axios: A Quarter Of Americans Suffer From Chronic Pain
Roughly a quarter of Americans say they suffer from chronic pain and nearly 1 in 10 say it's bad enough to regularly limit their life or work, according to new data from the Centers for Disease Control and Prevention. (Reed, 11/21)

AP: American And Australian Tourists Die, Raising Toll To 4 In Laos Alcohol Poisoning Incident
An Australian teenager has died after drinking tainted alcohol in Vang Vieng, Laos, in what Australia’s prime minister on Thursday called every parent’s nightmare, and the U.S. State Department confirmed an American also died in the same party town, bringing the death toll to four. (Rising and Saksornchai, 11/21)

CIDRAP: Trial Supports Shorter Antibiotic Treatment For Bloodstream Infections
A randomized controlled trial involving more than 3,600 patients hospitalized with bloodstream infections found that 7 days of antibiotic treatment was noninferior to 14 days, an international team of researchers reported today in the New England Journal of Medicine. (Dall, 11/20)

CIDRAP: Study Finds No Birth Defect Risk From Tetracycline Use During First Trimester Of Pregnancy
Exposure to tetracycline antibiotics during the first trimester of pregnancy is not tied to increased risks of major congenital malformations (MCMs), researchers reported yesterday in JAMA Network Open. (Dall, 11/15)

MedPage Today: Laryngeal Dystonia Symptoms Improve With Novel Treatment 
Sodium oxybate (Xyrem), a drug approved to treat people with narcolepsy, provided temporary relief for laryngeal dystonia patients whose symptoms were alcohol-responsive, a phase IIb, double-blind, crossover trial showed. Laryngeal dystonia causes involuntary spasms in laryngeal muscles, leading to a strained, hoarse voice and a chronically impaired ability to communicate. Some 50,000 people in the U.S. and Canada have laryngeal dystonia, sometimes referred to as spasmodic dysphonia. Public figures like Robert F. Kennedy Jr. have been open about their diagnoses. (George, 11/20)

Bloomberg: Elon Musk’s Neuralink Cleared To Start Brain Chip Trial In Canada 
Canada’s University Health Network said its Toronto Western Hospital would be the first non-US site of a trial for a device created by Neuralink Corp., Elon Musk’s brain-implant company. “We are incredibly proud to be at the forefront of this research advancement in neurosurgery,” UHN Chief Executive Officer Kevin Smith said in an announcement. He also said UHN would be the “first and exclusive” site for the trial in Canada, but did not say when it would begin. (McBride, 11/21)

Research on covid and flu —

CIDRAP: Cardiac Inflammation Markers Show Role Of Long-COVID Symptoms 
A study in Nature Microbiology suggests trace-level cytokines, a marker of cardiac inflammation, may play a key role in long-COVID cardiac symptoms, including chest pains and shortness of breath. (Soucheray, 11/12)

CIDRAP: Report: 1 In 5 Animals At Zoo Tested Positive For SARS-CoV-2, Perhaps From People 
Of 47 animals tested at a zoo in Brazil, 9 were positive for SARS-CoV-2 RNA on reverse transcription-polymerase chain reaction (RT-PCR), with phylogenetic analysis suggesting they may have been infected by people, according to a report published yesterday in Virology Journal. (Van Beusekom, 11/20)

CIDRAP: Study Shows Varied Impact Of Flu In US, With Up To 29,000 Hospital Cases In A Season 
The study, published today in Morbidity and Mortality Weekly Report, shows significant illness and hospitalization rates for influenza each season and a trend to less prescribing of antiviral drugs. (Soucheray, 10/30)

Stat: Medicine Often Fails Black Cystic Fibrosis Patients Like My Sons 
Twenty years ago, cystic fibrosis wasn’t a household term for me. Today, cystic fibrosis — a genetic disorder that causes a buildup of thick, sticky mucus that can damage organs, especially the lungs — has become a centerpiece of my family’s lives, sending me on an advocacy mission to improve diagnosis and care for all families, regardless of their racial or ethnic background. (Rena Barrow, 11/21)

Also —

Stat: RFK Jr., Dr. Oz Face Tougher Opposition On Wellness Than Vaccines
While many critics of Robert F. Kennedy Jr. and Mehmet Oz are focused on their criticisms of vaccines, that focus is somewhat misplaced. The data supporting the safety and efficacy of recommended vaccines is far beyond dispute. But the reality is that the damage to getting Americans to vaccinate has already been done. The soon-to-be nominees for Health and Human Services secretary and leader of the Centers for Medicare and Medicaid Services will be focused on another battle: over wellness and prevention. (Arthur L. Caplan, 11/21)

East Bay Times: How RFK Jr. Could Destroy One Of Civilization’s Best Achievements
Even among the chaos generated by Donald Trump’s recent Cabinet picks, one stands out for the extensive suffering and lasting institutional damage it may cause: his choice of Robert F. Kennedy Jr. to lead the Health and Human Services Department. (Zeynep Tufekci, 11/20)