Politico: Trump May Finally Be Undermining Obamacare
There has been a steep drop in Obamacare insurance numbers, halfway through the sign-up season for 2019, raising concerns that the Trump administration’s controversial policy changes are undermining the marketplaces. The 9.2 percent drop to roughly 100,000 sign-ups per day has surprised close observers of the Obamacare markets, who expected the number of customers to remain fairly stable even after Republicans eliminated the unpopular individual mandate penalties for being uninsured. Premium hikes were fairly low in most states for 2019, and many parts of the country saw an increase in consumer choice as more health plans participated in what they now see as a more profitable, stabilizing market. (Demko, 11/28)

Bloomberg: Fewer People Buy Obamacare Plans As Trump Pushes Other Options 
The decline in signups follows an effort by the Trump administration to promote cheaper coverage with fewer consumer protections, which critics called an attempt to undermine Obamacare. Congress also lifted the individual-mandate penalty for going without health insurance -- a fee of 2.5 percent of income that was intended to discourage healthy people from waiting until they got sick to purchase coverage. That change takes effect in 2019. (Tozzi, 11/28)

Austin American-Statesman: Obamacare Enrollment Declines In First Four Weeks
The Trump administration has cut funding for advertising and enrollment support for the second year in a row. Meanwhile, the fate of the Affordable Care Act — commonly known as Obamacare — was heatedly debated through much of 2017, increasing its profile ahead of last year’s open enrollment period and potentially spurring sign-ups. The GOP-controlled Congress “spent the entire year trying to repeal the Affordable Care Act” in 2017, said Stacey Pogue, a senior policy analyst for the Austin-based Center for Public Policy Priorities, a left-leaning think tank. “It’s possible that a lot of the attention given to the ACA raised awareness” and fueled enrollment. (Sechler, 11/28)

The Hill: Top Dems Blame 'Sabotage' As ObamaCare Enrollment Slows 
Top House Democrats are blaming President Trump for ObamaCare signup numbers that so far are lower than last year. "While there are still two weeks remaining in Open Enrollment, these lagging numbers show that Republicans' sabotage of our nation's health care system is working,” said Reps. Richard Neal (D-Mass.), Frank Pallone Jr. (D-N.J.) and Bobby Scott (D-Va.), the incoming chairmen of the three committees overseeing the Affordable Care Act. (Sullivan, 11/28)

And in other news —

Chicago Tribune: Illinois Lawmakers Push Back Against Trump Administration's Expansion Of Short-Term Health Insurance 
Illinois consumers will only be able to use controversial, short-term health insurance plans for about six months at a time now that the state legislature has voted to override Gov. Bruce Rauner’s veto of a bill that sets that limit. Dozens of Illinois consumer advocacy groups had supported the original bill, which took aim at a recent Trump administration change to the rules surrounding short-term plans. Such plans are generally cheaper than traditional health insurance but cover fewer services. (Schencker, 11/28)

Los Angeles Times: Number Of Uninsured Children Climbs, Reversing More Than A Decade Of Progress, Report Finds
The number of children in the United States without health insurance increased last year for the first time in more than a decade, according to a new report that highlights potentially worrisome backsliding in pediatric care. The erosion in health insurance came despite a robust economy, which in the past has helped fuel expansions in coverage. It likely reflects a number of steps taken by the Trump administration and the Republican-controlled Congress that have targeted safety net programs such as Medicaid and the Children’s Health Insurance Program known as CHIP, note the authors of the new report from Georgetown University’s Center for Children and Families. (Levey, 11/28)

Kaiser Health News: Under Trump, Number Of Uninsured Kids Rose For First Time This Decade
While not a big jump statistically — the share of uninsured kids rose to 5 percent in 2017 from 4.7 percent a year earlier — it is still striking. The uninsured rate typically remains stable or drops during times of economic growth. In September, the U.S. unemployment rate hit its lowest level since 1969. “The nation is going backwards on insuring kids and it is likely to get worse,” said Joan Alker, co-author of the study and executive director of Georgetown’s Center for Children and Families. (Galewitz, 11/29)

Houston Chronicle: Texas Leads Nation In Uninsured Kids As Gains Slip Away
Texas led the nation in children without health insurance as the number without coverage jumped last year, according to a new national health care report. An estimated 835,000 Texas children went without health insurance in 2017, an increase of about 80,000, or more than 10 percent, from 2016, according to the report by Georgetown University’s Center for Children and Families. To put those numbers into perspective, one in five of the nation’s uninsured children lived in Texas. (Deam, 11/28)

Dallas Morning News: Report: Nation's Child Health Coverage Trend Turns Negative, And Texas Has A Fifth Of The Uninsured Kids 
“This is a disturbing report,” said Adriana Kohler, senior health policy associate at the nonprofit Texans Care For Children. “Texas was already doing a bad job of making sure kids had health care, and now Texas is doing even worse.” (Stone, 11/29)

Austin American-Statesman: Report: 1 In 5 Uninsured Children In Nation Live In Texas
Alker attributes the decline in children’s coverage to the increasing public perception that government-subsidized health insurance programs are no longer available. Conservative lawmakers have launched multiple efforts to scale back the Affordable Care Act, including the successful repeal of the individual mandate that had required anyone without health insurance to pay a penalty. (Chang, 11/28)

Tampa Bay Times: In One Year, The Number Of Florida Kids With No Health Insurance Went Up By 37,000. Why?
The report, released early today by the Georgetown University Center for Children and Families, found that Florida, after years of marking declines in the number of children without health insurance, is suddenly seeing a rise.It’s part of a national trend, with the number of uninsured children in the U.S. increasing last year for the first time in a decade. But Florida is one of the outliers, one of nine states that showed the largest upticks of children in that category. (Griffin, 11/29)

Arizona Republic: Arizona Among Worst States For Its Rate Of Uninsured Children, Report Says
Arizona has made improvements in reducing its rate of uninsured children but still ranked worse than most other states in 2017, a new report from Georgetown University said. The report, released Thursday, identified Arizona as one of 12 states with "significantly higher" rates of uninsured children — 7.7 percent — than the 2017 national average of 5 percent. (Innes, 11/29)

The Hill: Dem Single-Payer Fight Set To Shift To Battle Over Medicare ‘Buy-In’ 
Momentum is building among House Democrats for a more moderate alternative to single-payer health-care legislation. The legislation, which would allow people aged 50 to 65 to buy Medicare, is being championed by Rep. Brian Higgins (D-N.Y.), who supported House Minority Nancy Pelosi (D-Calif.) for Speaker in exchange for a commitment to work on his bill when Democrats take control of the House early next year. (Weixel, 11/29)

The Hill: Dem Senator Murray Calls For Trying Again On Bipartisan ObamaCare Fix 
Sen. Patty Murray (D-Wash.) on Wednesday called for reviving bipartisan efforts to reach a deal to fix ObamaCare after an agreement she was part of collapsed last year. “Mr. Chairman, I'm really hopeful that we can revive discussions in the new Congress and find a way past the ideological standoffs of the past,” Murray said to Sen. Lamar Alexander (R-Tenn.), her Republican partner in forging last year’s deal, at a hearing on health care costs. (Sullivan, 11/28)

CQ: Senate Fight Between Friends Slows Bipartisan Health Bills
An unusual spat between Senate GOP sponsors of two bipartisan House-passed health measures might threaten the bills’ chances of clearing Congress this year. Both bills would normally be candidates to pass the Senate by unanimous consent so they would not take up much floor time, but objections from each member on the other’s bill is preventing that. One of the sponsors hopes his bill will be added to a year-end spending package. (Siddons, 11/28)

Bloomberg: Looking Toward 2020, Democrats Shift Focus From Health Care To Mueller
Democrats built a midterm electoral wave by centering their message around health care. But since the Nov. 6 election, many Democratic ads have shifted focus from protecting health insurance to protecting special counsel Robert Mueller. ...Focusing on health care made sense during the fall campaign, when Democratic candidates were seeking support form independents and Republicans, along with their own voters. Polls consistently showed health care was a top issue for midterm voters. Having leveraged that broad-based appeal to make big midterm gains in Congress and statehouses, 2020 presidential hopefuls are now targeting grassroots activists, whose support will be critical in the upcoming presidential primaries. (Green, 11/29)

The Associated Press: Baltimore Sues Trump Administration Over Immigration Policy
Baltimore filed a federal lawsuit on Wednesday against the Trump administration alleging that "unlawful" efforts altering a State Department policy are restricting visa applicants and deterring law-abiding immigrants from claiming public assistance. In its lawsuit, Baltimore asserts the U.S. State Department earlier this year quietly expanded its definition of "public charge" — someone the United States deems likely to be primarily dependent on government aid. (McFadden, 11/28)

The Washington Post: Baltimore Sued The Trump Administration Over Efforts To Withhold Visas For Immigrants Who Use Public Benefits
“They’re giving up government-supported health care, they’re giving up free school lunches, they’re giving up food stamps, they’re not applying for housing,” said City Solicitor Andre M. Davis, a former federal judge. “It’s a noncash public benefit that people are abandoning so they don’t lose the opportunity for themselves or their family to get a visa.” (Cox, 11/28)

CNN: Baltimore Sues Trump Admin Over Immigrants' Access To Benefits
"The Trump Administration's changes to (a State Department manual) put a thumb on the scale in favor of barring immigrants from the country if they have used any of a host of federal, state or local programs -- making it much harder for immigrants to reunite with their families," the lawsuit reads. The suit names President Donald Trump, Secretary of State Mike Pompeo and the State Department as defendants, and it charges the administration with violating the Constitution's equal protection guarantees. (Watkins, 11/28)

In other immigration news —

The Associated Press Fact Check: Entire Trump Tweet On Immigrant Aid Is Wrong
President Donald Trump is spreading a false claim from supporters that people who are in the United States illegally receive more in federal assistance than the average American gets in Social Security benefits. Everything about the tweet he passed on to his 56 million listed Twitter followers Tuesday is wrong. (Woodward, 11/29)

The Associated Press: Texas Ruling May Allow Licensing Of Migrant Family Detention
A Texas appeals court's ruling Wednesday could allow state authorities to formally license two detention centers that house thousands of immigrant families, something advocates warn might lead to the unlimited detention of migrant children. Two facilities in the South Texas cities of Karnes and Dilley have the capacity to detain roughly 3,500 parents and children. Under federal court rulings, the government is required to release children from Karnes or Dilley quickly because the facilities aren't licensed by a state or local government. That effectively leads to the faster release of many parents as well. (11/28)

Reveal: At Tornillo Tent City, Shrouded In Secrecy, Few Have Access To Migrant Children
Months after the government erected a tent city in the desert, most of what happens inside the encampment remains hidden, even from curious neighbors in the nearby town of 1,600 residents. The only images of the minors in the camp, standing outside in an orderly line or playing soccer, have been released by the Department of Health and Human Services. (Morel and Michels, 11/28)

San Francisco Chronicle: Return Possible For Oakland Nurse Whose Deportation Split Family
A woman whose case drew national attention last year when immigration officials tore her from her children and her job as a nurse in Oakland and deported her to Mexico has a chance to beat the odds and return to the Bay Area, thanks to a lottery drawing and a recommendation from a U.S. consular officer. The final decision, though, is in the hands of a Trump administration immigration agency. (Egelko, 11/28)

The Associated Press: Suicide, At 50-Year Peak, Pushes Down US Life Expectancy
Suicides and drug overdoses pushed up U.S. deaths last year, and drove a continuing decline in how long Americans are expected to live. Overall, there were more than 2.8 million U.S. deaths in 2017, or nearly 70,000 more than the previous year, the Centers for Disease Control and Prevention said Thursday. It was the most deaths in a single year since the government began counting more than a century ago. (Stobbe, 11/29)

The Washington Post: U.S. Life Expectancy Declines Again, A Dismal Trend Not Seen Since World War I
The data continued the longest sustained decline in expected life span at birth in a century, an appalling performance not seen in the United States since 1915 through 1918. That four-year period included World War I and a flu pandemic that killed 675,000 people in the United States and perhaps 50 million worldwide. Public health and demographic experts reacted with alarm to the release of the Centers for Disease Control and Prevention’s annual statistics, which are considered a reliable barometer of a society’s health. In most developed nations, life expectancy has marched steadily upward for decades. (Bernstein, 11/29)

The Wall Street Journal: U.S. Life Expectancy Falls Further
“The continuation of this trend is a warning for all of us that our country has not found a way of addressing the profound needs of the people who are dying,” said Eric Caine, professor of psychiatry and director of the Injury Control Research Center for Suicide Prevention at the University of Rochester Medical Center. “While the economy may be recovering at the macro level, it’s very uncertain whether it’s affecting the lives of these people.” The U.S. has lost three-tenths of a year in life expectancy since 2014, a stunning reversal for a developed nation, and lags far behind other wealthy nations. (McKay, 11/29)

The New York Times: ‘The Numbers Are So Staggering.’ Overdose Deaths Set A Record Last Year.
A class of synthetic drugs has replaced heroin in many major American drug markets, ushering in a more deadly phase of the opioid epidemic. New numbers Thursday from the Centers for Disease Control and Prevention show that drug overdoses killed more than 70,000 Americans in 2017, a record. Overdose deaths are higher than deaths from H.I.V., car crashes or gun violence at their peaks. (Katz and Sanger-Katz, 11/29)

Politico: Drug Overdoses And Suicides Fuel Drop In U.S. Life Expectancy
Although the U.S. has struggled with a drug crisis for years, overdoses have only recently become a major driver of the overall mortality rate because decreases in other causes of death, like heart disease, have leveled off after long-term declines. "In those previous years, the increase in overdose deaths offset the declines in heart disease, but now those have flattened out so that's no longer the case," said Bob Anderson, chief of the Mortality Statistics Branch at the CDC's National Center for Health Statistics. (Ehley, 11/29)

USA Today: Suicide: My Mom Took Her Life At The Grand Canyon – And I Wanted A Why
I stood and looked down into the canyon, at a spot where, millions of years ago, a river cut through. Everything about that view is impossible, a landscape that seems to defy both physics and description. It is a place that magnifies the questions in your mind and keeps the answers to itself. Visitors always ask how the canyon was formed. Rangers often give the same unsatisfying answer: Wind. Water. Time. It was April 26, 2016 – four years since my mother died. Four years to the day since she stood in this same spot and looked out at this same view. I still catch my breath here, and feel dizzy and need to remind myself to breathe in through my nose out through my mouth, slower, and again. I can say it out loud now: She killed herself. She jumped from the edge of the Grand Canyon. From the edge of the earth. (Trujillo, 11/28)

USA Today: Suicide Prevention: Would More Funding, Less Stigma Save Lives?
Americans are more than twice as likely to die by their own hands, of their own will, than by someone else's. But while homicides spark vigils and protests, entering into headlines, presidential speeches and police budgets, suicides don't.Still shrouded in stigma, many suicides go unacknowledged save for the celebrities – Robin Williams, Kate Spade, Anthony Bourdain – punctuating the unrelenting rise in suicide deaths with a brief public outcry. Just since 1999, suicide rates have climbed nearly 30 percent,  according to the Centers for Disease Control and Prevention. (Godlasky and Dastagir, 11/28)

USA Today: Native American Suicides: Coping With Trauma Saved This Woman's Life
With practiced precision, Shelby Rowe uses a small needle to lift each bead, stitching it into fabric, coaxing it to become something more. Her black hair fans across hunched shoulders. A silver tree of life hangs from her neck, tethering her to the past, anchoring her in the present. For Rowe, this Native American tradition isn’t just art. Beading is part of survival.“Beads are nothing but broken glass,” she says. “I spend hours of my time mending broken things. Making something beautiful out of something broken.” (Dastagir, 11/28)

USA Today: Transgender Suicide: How This LGBT Person Copes With Suicidal Thoughts
When Shear Avory was a child, they'd look out the window and hope. For the bullying to stop. For conversion therapy to end. For Mom. Every morning, Avory would sit in bed and count down – three, two, one – before chanting, “Today I begin a new life. Today I am free. Today I start over.” A better day would take years to come. There would be new traumas and wounds from old ones that refused to heal. “I was constantly in a space of being unaccepted, unwelcomed and put down,” said Avory, who identifies as transgender and uses the personal identity pronouns they/them/theirs. “I think from those experiences, I've always held on to hope. … I had nothing else to rely on.” (Dastagir, 11/28)

USA Today: Suicide Loss Survivors: How Survivors Can Cope, Loved Ones Can Help
Loss survivors – the close family and friends left behind after a suicide – number six to 32 for each death, according to the Centers for Disease Control and Prevention, meaning that in 2016 alone, as many as 1.44 million people unwillingly became part of this group. They are forced to cope with the loss of a loved one and navigate uncertain futures, often caring for confused children as they struggle to accept they may never know "why." (Dastagir, 11/28)

KCUR: Health Experts Hope Dr. Rich Mahogany And ‘Man Therapy’ Can Reduce Suicide In Men 
Tens of thousands of Americans die by suicide each year; it is a leading cause of death among working-age men in the U.S. In Colorado, 56 percent of men who die by suicide used a firearm. Between 2004 and 2017, more people died by suicide in El Paso County, a populated area that is home to multiple military bases and Colorado Springs, than in any other county in the state. Last year, 75 percent of those people were men. That’s why county health officials are trying to reach men before their crisis point through “Man Therapy.” The slightly crass, tongue-in-cheek public health program lives largely online, in the form of a slick website that aims to first draw in men with funny videos and witty graphics — and then offer them mental health resources. (Paterson, 11/28)

The Associated Press: China Halts Work By Team On Gene-Edited Babies
China’s government ordered a halt Thursday to work by a medical team that claimed to have helped make the world’s first gene-edited babies, as a group of leading scientists declared that it’s still too soon to try to make permanent changes to DNA that can be inherited by future generations. Chinese Vice Minister of Science and Technology Xu Nanping told state broadcaster CCTV that his ministry is strongly opposed to the efforts that reportedly produced twin girls born earlier this month. Xu called the team’s actions illegal and unacceptable and said an investigation had been ordered, but made no mention of specific actions taken. (Marchione, 11/29)

The Washington Post: Scientists Call For A Halt To Genetically Editing Embryos, Rebuke Chinese Researcher
“At this summit we heard an unexpected and deeply disturbing claim that human embryos had been edited and implanted, resulting in a pregnancy and the birth of twins,” said the summit’s organizing committee, which called for independent verification of He’s claims that have so far not been published in a peer-reviewed journal. “Even if the modifications are verified, the procedure was irresponsible and failed to conform with international norms,” the organizers said in the summit’s highly anticipated consensus statement that is usually seen as setting the tone and direction for the fast-changing field. (Johnson and Shih, 11/29)

NPR: Science Summit Denounces Gene-Edited Babies Claim, But Rejects Moratorium
Much more research is needed before anyone tries to prevent diseases by editing human embryos, the organizers concluded. ... But enough scientific advances have been made since the last summit in 2015 to begin plotting a course for how that could happen some day, according to the statement. "Progress over the last three years and the discussions at the current summit, ... suggest that it is time to define a rigorous, responsible ... pathway toward such trials," said Baltimore, a Nobel-prize winning U.S. biologist. (Stein, 11/29)

The Washington Post/The Marshall Project: Federal Prisons Are Failing Inmates With Mental Health Disorders
In 2014, amid mounting criticism and legal pressure, the Federal Bureau of Prisons imposed a new policy promising better care and oversight for inmates with mental-health issues. But data obtained by the Marshall Project through a Freedom of Information Act request shows that instead of expanding treatment, the bureau has lowered the number of inmates designated for higher care levels by more than 35 percent. Increasingly, prison staff are determining that prisoners — some with long histories of psychiatric problems — don’t require any routine care at all. As of February, the Bureau of Prisons classified just 3 percent of inmates as having a mental illness serious enough to require regular treatment. (Thompson and Eldridge, 11/21)

Boston Globe: How Culture Shapes Your Mind — And Your Mental Illness
Culture shapes who we are, so it follows that it would also shape our manifestations of stress, mental disorder, emotion. Yet, that also implies a kind of messiness that modern psychology and psychiatry, particularly the American kind, have spent the last 100 years struggling to tidy up. (Rodriguez McRobbie, 11/28)

The New York Times: Study Warns Of Cascading Health Risks From The Changing Climate
Crop yields are declining. Tropical diseases like dengue fever are showing up in unfamiliar places, including in the United States. Tens of millions of people are exposed to extreme heat. These are the stark findings of a wide-ranging scientific report that lays out the growing risks of climate change for human health and predicts that cascading hazards could soon face millions more people in rich and poor countries around the world. (Sengupta and Pierre-Louis, 11/28)

The New York Times: Online Cancer Information Is Often Unreliable
Many YouTube videos about prostate cancer are unreliable sources of information. Researchers searched YouTube for “prostate cancer screening” and “prostate cancer treatment.” Then they scored the first 75 hits for each phrase, using validated scales to assess such measures as whether the video favored new technology, recommended unproven treatments, accurately described risks and benefits or showed commercial bias. (Bakalar, 11/28)

Stat: Study Sees Bias In Tests Used To Determine If Patients Needs Dementia Evals
It’s widely known that these quick screening tests — some of them technically copyrighted but often easily downloadable for free — aren’t always right. Some patients might pass the animal-naming test with flying colors but still have dementia; others might be sent for hours of in-depth evaluation that they don’t need. But what predisposes a patient to get a misleading result turns out to be very different form one screening method to another, according to a paper published Wednesday in Neurology. (Boodman, 11/28)

The Associated Press: HIV Cases In Children Dropping But Still Too Slowly, UN Says
The United Nations children's agency says the number of youths living with HIV could drop by about one-third to 1.9 million between now and 2030, while children dying each year from AIDS-related causes could drop by nearly half to 56,000 in 2030. Its new report says that while the projected decline in HIV cases is good news, it's still too slow. The report says 270,000 people up to age 19, the bulk of them in Africa, could be infected in 2030 alone. (11/29)

Bloomberg: Male Birth Control Closer As U.S. Tests Hormone Skin Gel 
U.S. government scientists will test an experimental birth control method for men, which would be a major advance in contraception and bring more equality to a family planning burden borne largely by women. The study is being conducted by the National Institutes of Health and will involve 420 couples. The experimental treatment is a gel, applied to the back and shoulders, that combines two types of hormones to halt the production of sperm while maintaining the energy and libido benefits of testosterone. (Cortez, 11/28)

The New York Times: You Don’t Want French Fries With That
If French fries come from potatoes, and potatoes are a vegetable, and vegetables are good for you, then what’s the harm in eating French fries? Plenty, say experts and nutritionists, including Eric Rimm, a professor in the departments of epidemiology and nutrition at the Harvard T. H. Chan School of Public Health, who called potatoes “starch bombs.” Potatoes rank near the bottom of healthful vegetables and lack the compounds and nutrients found in green leafy vegetables, he said. (Mele, 11/29)

NPR: Trauma Surgeon Joseph Sakran Talks About Gun Violence
For trauma surgeon Joseph Sakran, gun violence is a very personal issue. He has treated hundreds of gun wound victims, comforted anxious loved ones and told mothers and fathers that their children would not be coming home. But Sakran's empathy for his patients and their families extends beyond the hospital. Sakran knows the pain of gun violence because he is a survivor of it; when he was 17, he took a bullet to the throat after a high school football game. (Gross, 11/28)

Georgia Health News: Federal Report Urges Bigger Fight Against Diseases Caused By Ticks
Federal health officials are calling for a bigger effort to fight tick-borne diseases. In a report earlier this month, an advisory committee for the U.S. Department of Health and Human Services called for improved diagnosis, lab testing and treatment, as well as more funding in fighting Lyme disease and other tick-related diseases. (Miller, 11/28)

The New York Times: To Treat Eating Disorders, It Sometimes Takes Two
The issue was peanut butter. No matter what form it took — creamy, crunchy, straight from the jar or smeared between two slices of bread — it caused Sunny Gold enormous anxiety. In fact, the gooey spread posed such a threat that during her first few years of recovery from binge eating disorder, between 2006 and 2007, Ms. Gold, 42, a communications specialist in Portland, Ore., couldn’t keep it around the house. It was one of her favorite foods, and she feared she would binge on it. Just knowing it was there, lurking in her cupboard, made her feel “unsafe,” as she put it. (Ellin, 11/29)

The Associated Press: Younger School Entry Could Set Stage For ADHD Diagnosis
The youngest children in kindergarten are more likely to be diagnosed with attention deficit hyperactivity disorder in early grades, a study shows, an intriguing finding for parents on the fence about when to start their child in school. The study found younger students, especially boys, are also more likely to be started on medications for ADHD and kept on the drugs longer than the oldest children. The medications are generally safe, but can have harmful side effects. (Johnson, 11/28)

The Washington Post: Youngest Kids In Class Are More Likely To Be Diagnosed With ADHD Than Oldest Kids, Study Finds
The new analysis is likely to fuel the debate about whether there is an epidemic of ADHD in the United States or whether the problem is overdiagnosis. The number of children diagnosed with ADHD has significantly increased, from 7.8 percent in 2003 to 11.0 percent in 2011-2012 for children ages 4 to 17, according to the Centers for Disease Control and Prevention. The number among younger children, ages 2 to 5, jumped by more than 50 percent from 2007 to 2011. The most recent numbers released by the CDC — which recently changed how it counts ADHD — showed that 9.4 percent of children ages 2 to 17 had been diagnosed, the equivalent of 6.1 million children across the country. (Wan, 11/28)

NPR: ADHD Diagnosis Is More Common For Youngest Students In Class
"You could certainly imagine a scenario in which two kids who are in a class who are different in age by almost a year could be viewed very differently by a teacher, or school personnel who's evaluating them," says Dr. Anupam Jena, a physician and economist at Harvard Medical School. "A year of age difference in a 5-year-old or a 6-year-old is huge." (Harris, 11/28)

The Associated Press: Opioid Case Has New Complication: Babies Born In Withdrawal
The long-running federal court case seeking to hold drugmakers responsible for the nation’s opioid crisis has a new complication: How does it deal with claims covering the thousands of babies born to addicts? Attorneys representing the children and their guardians want their claims separated from the federal case in Cleveland that involves hundreds of local governments and other entities such as hospitals. They will argue that Thursday before a federal judicial panel in New York. (Mulvihill, 11/28)

Politico: Babies Of The Opioid Crisis Seek Their Day In Court
“These kids end up being robbed of a chance because of opioids and because of big pharma,” said Kevin Thompson, one of the attorneys representing the opioid babies. Thompson is pushing for the babies’ cases — there are at least 13 class-action lawsuits — to be carved out from the sprawling lawsuit in Cleveland and transferred to a federal judge in West Virginia, one of the hardest-hit states where roughly 5 percent of all babies are born dependent on opioids. On Thursday morning, a seven-judge federal panel in New York that considers jurisdictional disputes will hear oral arguments on Thompson’s request. (Demko, 11/29)

The New York Times: Jail Ordered To Give Inmate Methadone For Opioid Addiction In Far-Reaching Ruling
In a ruling that could have tremendous consequences for the country’s correctional system, a federal judge said this week that a Massachusetts man facing a jail sentence could not be denied access to treatment for his opioid addiction. Judge Denise J. Casper of the United States District Court in Massachusetts issued a preliminary injunction on Monday, saying that Geoffrey Pesce was likely to prevail in his argument that such a refusal violated the Americans with Disabilities Act and was cruel and unusual punishment. (Taylor, 11/28)

The Wall Street Journal: New York City To Spend $8 Million Combatting Bronx Opioid Epidemic
New York City is dedicating $8 million to programs aimed at stemming drug-overdose deaths in the Bronx, Mayor Bill de Blasio said Wednesday. The announcement comes as the city and the New York State Department of Health wrangle over the opening of four safe-injection sites in the city and as rates of unintentional drug-overdose deaths rose for the seventh-straight year. In 2017, one New Yorker died every six hours from an overdose, according to city officials. (West, 11/28)

Stat: Philadelphia Is Latest City To Consider Licensing Sales Reps To Blunt Opioid Crisis
In the latest bid to blunt the opioid crisis, the Philadelphia City Council is considering an ordinance that would ban drug makers from giving gifts to doctors and also require all pharmaceutical sales reps to become licensed. Specifically, the ordinance, which will be reviewed at a city council health committee meeting on Friday, would require sales reps to provide city officials with materials that are slated for physicians and, possibly, undergo training. Reps would also have to pay an annual $250 licensing fee and would be prohibited from distributing copay coupons for any controlled substances. (Silverman, 11/28)

Boston Globe: Former Drug Exec Pleads Guilty To Pushing Painkiller Prescriptions
Alec Burlakoff, former vice president of sales of Chandler, Ariz.-based Insys Therapeutics, pleaded guilty to a count of racketeering conspiracy before US District Court Judge Allison D. Burroughs. By agreeing to cooperate with prosecutors, he could become a crucial witness at the trial in January of six former Insys executives accused of participating in the scheme. (Saltzaman, 11/28)

The Wall Street Journal: CVS Completes $70 Billion Acquisition Of Aetna
CVS Health Corp. completed its nearly $70 billion acquisition of Aetna Inc., forging a new industry giant and starting the clock ticking on ambitious goals of curbing health-care costs and improving consumers’ experience. The combined company faces significant challenges in bringing together its diverse set of health assets, including CVS’s sprawling network of pharmacies, a pharmacy-benefit manager and Aetna’s employer insurance, Medicare and Medicaid managed-care businesses. Aetna will be operated as a stand-alone unit, and CVS will continue using the brand in reference to its insurance products. (Wilde Mathews and Al-Muslim, 11/28)

Bloomberg: CVS Closes $70 Billion Aetna Deal, Ending Long Road To Takeover 
The companies announced the takeover almost a year ago in December 2017, promising to create an integrated health-care company whose pharmacy locations could be hubs for medical services while better managing patients. (Armstrong and Langreth, 11/28)

Modern Healthcare: CVS Health And Aetna Close $70 Billion Merger 
"Today marks the start of a new day in health care and a transformative moment for our company and our industry," CVS Health President and CEO Larry Merlo said in the announcement. "By delivering the combined capabilities of our two leading organizations, we will transform the consumer health experience and build healthier communities through a new innovative health care model that is local, easier to use, less expensive and puts consumers at the center of their care." (Livingston, 11/28)

The Hill: CVS, Aetna Complete $70 Billion Merger 
CVS needed final approval from state insurance regulators where Aetna sells its coverage. New York was the final state to grant approval earlier this week. To ease its approval, Aetna said it would sell its Medicare Part D business to WellCare Health Plans. The companies plan to turn CVS's 10,000 pharmacies and clinics into community-based sites of care with nurses and other health professionals available to give diagnoses or do lab work. (Weixel, 11/28)

The CT Mirror: CVS Says Purchase Of Aetna Is Done Deal
To complete the sale, Aetna was also required to agree to the Justice Department’s demand that it divest itself of its stand-alone Medicare Part D prescription drug plans, which have been sold to approximately 2.2 million customers. Aetna said it will continue to manage those plans through 2019. (Radelat, 11/28)

The Wall Street Journal: Amazon Makes Inroads Selling Medical Supplies To The Sick
Amazon.com Inc. is selling medical products to patients based on one of the most private corners of the health system: electronic medical records. A growing number of doctors around the U.S. can direct a patient to Amazon to buy blood-pressure cuffs, slings and other supplies via an app embedded in the patient’s private medical record. Hospitals that use the app say the goal is to replace the handwritten shopping lists doctors often hand people, which are easy to lose, and to spare frazzled patients lengthy searches through pharmacy shelves. (Evans, 11/29)

Bloomberg: UnitedHealth Stock Gains Amid Amazon E-Records Push Report 
While concerns about Amazon.com Inc. have weighed on medical distributors like Cardinal Health Inc., companies streamlining medical records data such as UnitedHealth Group Inc. may not face such a threat. Amazon.com Inc. plans to mine patient data to bolster medical supply sales via its online pharmacy and to help find patients for clinical trials, according to a report in the Wall Street Journal. Yet shares of UnitedHealth Group, which highlighted its machine learning platform platform at an investor day yesterday, are trading near a record high. (Flanagan, 11/28)

And in other health industry news —

The Wall Street Journal: Magellan Health Finds Itself In Well-Charted Territory
Investors don’t like to be disappointed. It is even worse when they know it is coming. Magellan Health, a small health insurer and pharmacy-benefits manager, said in a filing on Wednesday that it will replace Sam Srivastava, chief executive of the company’s health-insurance division. He joins the unenviable club of executives who saw their companies’ shares rise on their departure. (Grant, 11/28)

The Wall Street Journal: For Treating Severe Strokes, All Hospitals Aren’t Equal
People who suffer severe strokes here can avoid the worst if stricken within a 30-minute ambulance ride to Rhode Island Hospital, the region’s only comprehensive stroke-treatment facility. Just across the Taunton River in Massachusetts, patients even closer to Rhode Island Hospital aren’t so lucky. There, state emergency-medicine rules decree that stroke victims are taken to local hospitals offering more routine treatment. Typically, those patients have to wait an hour or more before being transferred to RIH in Providence, doctors say. (Burton, 11/28)

Modern Healthcare: Medicare Wage Index Overhaul Could Help Rural Hospitals 
Providers, hospital associations and policy experts believe revamping the tool the CMS uses to set hospital payments could be a lifeline for rural hospitals. HHS' Office of Inspector General suggested changes to the wage index in a new report that found holes in the system that has resulted in millions of dollars of improper payments to hospitals across the country. The flawed calculations have created a series of winners and losers whose reimbursement levels are minimally tied to wages, labor costs and cost of living, as the index initially intended. (Kacik, 11/27)

Modern Healthcare: Revenue-Cycle EHR Improvements Challenging For Hospitals 
Providers are still struggling to optimize revenue cycle-related electronic health record functions and manage the increase in self-pay consumers, according to a new survey. More than half of 107 hospital and health system executives surveyed said they struggle to keep up with EHR upgrades or underuse EHR functions, according to a Navigant analysis based on a survey by the Healthcare Financial Management Association. The share of executives who relayed that sentiment increased from 51% in 2017 to 56% in 2018. (Kacik, 11/28)

Boston Globe: To Patients’ Surprise, A Visit To Urgent Care Brings Steep Hospital Bill
The complaints submitted to Attorney General Maura Healey’s office all described a similar scenario: Patients sought treatment in an ordinary physician office or urgent care center. But to their shock, they were billed for an expensive outpatient hospital visit instead. (Kowalczyk, 11/28)

New Orleans Times-Picayune: How Safe Are New Orleans' Hospitals? See How They Ranked In A National Survey
Seven hospitals in the New Orleans-metropolitan area received an 'A' rating from a national watchdog group recognizing their efforts in providing high safety standards for their patients. The Leapfrog Group's Fall 2018 Hospital Safety Grade uses 28 measures of publicly available hospital safety data to assign grades to more than 2,600 hospitals across the U.S. looking at their performance in preventing medical errors, infections and other harms among patients in their care. The survey is released twice a year by the Leapfrog Group, a national independent, nonprofit organization founded in the year 2000 to act as a watchdog collecting and reporting hospital performance data. (Clark, 11/28)

Health News Florida: Hospitals Square Off Over Bone Marrow Transplants
Florida hospitals are battling about cancer treatment and the appropriate level of state regulation of bone-marrow transplants. In one corner is Cleveland Clinic Florida Health Systems, which has tried unsuccessfully to get approval from the state to offer bone-marrow transplants and is throwing its support behind proposed changes to eliminate a key type of regulation. And in the other corner are six Florida hospitals that argue bone-marrow transplant programs are services so complex and expensive that they rise to the level of requiring the blessing of state regulators. (Sexton, 11/28)

The Baltimore Sun: Hopkins Hospital In Florida Recorded High Rate Of Death, Complications In Young Heart Patients, Report Finds
The Heart Institute at All Children’s was dedicated to children with heart defects and had been working in recent years to grow in size and prestige, according to the hospital, which announced it would integrate into the Johns Hopkins Health System in 2010. But through extensive interviews with current and former employees and family members of those treated there and a decade’s worth of billing records, the newspaper probe, published online Wednesday, identified many instances of treatment gone horribly wrong. (Cohn, 11/28)

Houston Chronicle: Pearland Medical Center Adds Beds, Services
Pearland Medical Center, which became the first hospital in Pearland when it opened three years ago, has expanded to add 19 licensed beds in a second-floor medical-surgical area that includes an observation unit. ...The HCA Healthcare-affiliated hospital opened in 2015 and debuted the $8.5 million expansion on Nov. 29, according to a news release from the company. Completed after six months of construction, the addition adds 14,380 square feet to the hospital, bringing the total size to 158,380 square feet, and increases its total capacity to 53 licensed beds. (Jones, 11/28)

KQED: S.F. Supervisor Pushes To Wipe Zuckerberg's Name From City Hospital
San Francisco Supervisor Aaron Peskin wants Mark Zuckerberg's name removed from the city's public hospital.In an impassioned speech at the Board of Supervisors meeting on Tuesday, Peskin railed against the Facebook founder over allegations that the company mishandled user data. Keeping Zuckerberg's name on the building, he argued, sends the wrong message, regardless of how much money he has contributed. (Coral and Green, 11/28)

The Washington Post: Scabies Outbreak: Kona Community Hospital Battles Highly Contagious Skin Infection
A hospital in Hawaii is battling a scabies outbreak after “a number of people” reported symptoms of the highly contagious skin condition, a spokeswoman said. A spokeswoman for Kona Community Hospital said Wednesday that the outbreak was confirmed Nov. 19, although she declined to say how many people had been infected, citing employee and patient privacy. Those who may have been exposed at the hospital, which is in Kealakekua, were contacted and treated for infection, and staff members were given instruction on scabies, according to a statement from the hospital. (Bever, 11/28)

Modern Healthcare: Vanderbilt University Medical Center Could Lose Medicare Funding 
The CMS is threatening to strip Vanderbilt University Medical Center in Nashville, of its ability to care for Medicare patients because a patient died after receiving a large dose of the wrong medication. Termination from Medicare would take place Dec. 9 if Vanderbilt doesn't implement specific efforts to ensure patients receive the right medication at the right doses. (Dickson, 11/28)

The Associated Press: Panel Rules Against Proposed South Bend Abortion Clinic
A nonprofit group that wants to open an abortion clinic in South Bend was dealt a setback Wednesday after an Indiana health department administrative panel ruled that the agency acted properly when it denied the group a license. "We're obviously disappointed and it's really indicative of the unfair licensing process that we've had to go through that doesn't really apply to any other health care providers," said Sharon Lau, Midwest advocacy director for Texas-based Whole Women's Health Alliance. "We're going to continue. We're not giving up. And we will be pursuing all of our legal options." (11/28)

The Associated Press: Accused Man Cites State Abortion Law In Sexual Assault Case
A man accused of sexually assaulting a 15-year-old girl unsuccessfully argued that he should not be charged with taking advantage of a child because she was actually 16 under a Kansas law that says life begins at fertilization. Defense attorney Cooper Overstreet argued in a motion that Jordan Ross, 21, of Topeka, could not be convicted of aggravated indecent liberties with a child because, under the state's definition of life, the alleged victim would be 16, rather than 15. The age of consent in Kansas is 16. (11/28)

Columbus Dispatch: Doctor Who Performed Ohio's First Abortion Surrenders License Over Prescription Allegations
An obstetrician/gynecologist known as the first physician to perform a legal abortion in Ohio has agreed to a permanent revocation of his medical license, based in part on allegations that he improperly prescribed drugs to men without keeping patient records, state records show. Dr. Harley Blank, 79, who helped establish Founder’s Women’s Health Center, Columbus’ first abortion clinic, signed an agreement Oct. 25 to surrender his license. The State Medical Board of Ohio revoked his license on Nov. 14. (Viviano, 11/28)

Sacramento Bee: No New Dead Found In Camp Fire; Paradise Residents May Be Allowed To Return In Coming Days
For the third day in a row, Butte County searchers reported Wednesday they found no new human remains in areas burned by the Camp Fire, prompting the county’s sheriff to say he is hoping the death toll has reached its peak. That number, 88, is the highest by far in California history from a wildfire. (Bizjak, 11/28)

Reveal: The Smoke’s Gone, But Hearts And Lungs Still May Be In Danger Months After Wildfires
Three to five months after the 37,000-acre Tubbs Fire in Napa and Sonoma valleys in October 2017, the region’s emergency rooms treated about 20 percent more patients for respiratory and cardiac ailments compared with previous years, according to the analysis, which used state data. At the time, the Tubbs Fire was the most destructive in California history, killing 22 people and destroying nearly 6,000 structures. (Glantz and Neilson, 11/28)

Politico Pro: Texas Family Planning Clinics Brace For Upheaval From Reduced Aid, Health Program Overhaul
Dozens of Texas family planning clinics may face a serious financial squeeze as state lawmakers consider overhauling a scandal-tainted women’s health program and cope with less federal family planning aid from the Trump administration. The unexpected convergence of events could result in the loss of tens of millions of dollars for some 40 clinics around the state that have been through multiple rounds of budget cuts and program restructurings and bear the brunt of treating low-income and uninsured Texas women. (Rayasam, 11/28)

The Associated Press: Illinois House Expunges Lawmaker's Tainted Water Threat
The Illinois House took the rare step Wednesday of erasing from its record a Democratic legislator's remark suggesting she'd like to infect the water supply of a GOP colleague's loved ones with "a broth of Legionella." Rep. Stephanie Kifowit apologized for the indelicate comment she made about Lombard Republican Peter Breen Tuesday during floor debate on legislation involving the deadly Legionnaire's disease crisis at a Quincy veterans' home. (11/28)

Nashville Tennessean: Nashville Officials: Tuberculosis Case At Cane Ridge High In Antioch
A single student at Cane Ridge High School in Antioch has been diagnosed with tuberculosis, prompting Nashville health officials to offer free screenings to teachers and classmates who have been in close contact with the student. The infected student, who is not being publicly identified, is currently being kept out of school, according to a news release from the Metro Public Health Department. The release also states that the agency’s investigation into the school has determined that the risk of tuberculous spreading to others is low. (Kelman, 11/28)

The Associated Press: Sisters Charged In Medicaid Fraud Scheme
Two sisters who ran multiple home health care companies in Pittsburgh were indicted by a federal grand jury for their alleged role in a multi-million dollar health care fraud scheme. Court documents unsealed Tuesday show Arlinda Moriarty and Danyelle Dickens were charged in the scheme, along with 10 of their employees or former employees. (11/28)

St. Louis Public Radio: Southern Missouri Town Stops Adding Fluoride To Water; Dentists Predict Tooth Decay
Nearly two thirds of voters in the Texas County town of Houston decided to stop adding fluoride to the city’s water, but dentists serving the area are saying the change will lead to an increase in tooth decay. Opponents of water fluoridation call it government overreach, and cited studies that question the long-term health effects adding fluoride. (Ahl, 11/28)

Columbus Dispatch: Atrium Health Breach Could Affect Up To 6,000 Ohioans
About 6,000 Ohioans might have been affected by a data breach involving the billing information of Atrium Health, a health-care system that operates in the Carolinas.Atrium and AccuDoc Solutions Inc., its billing-service provider, announced Tuesday that an Atrium database was compromised when the billing service was hacked between Sept. 22 and 29. (Viviano, 11/29)

Iowa Public Radio: Foxhoven: Counties Can Move Mental Health Regions As Long As Core Services Stay Intact
The head of Iowa’s Department of Human Services says the state’s regional mental health system is working, despite some counties leaving their regions and joining others. In Iowa, counties group together to manage and deliver their own mental health and disability services.Before July 2014, each county was in charge of its own mental health services. (Peikes, 11/28)

Wyoming Public Radio: EPA Denies Petition To Immediately Ban 'Cyanide Bombs' On Public Lands
Cyanide bombs largely targeting nuisance predators like coyotes can stay on public lands – for now. The EPA calls them M-44’s and denied a petition by several wildlife groups to ban their use. The devices lure carnivores with bait and eject deadly cyanide when triggered. ...The bombs have also killed household pets and last year injured a boy and killed his dog when he was hiking in Idaho. (Dawson, 11/28)

Miami Herald: Minnesota Mom Made 9-Month Baby Sick With Laxatives: Police
When Megan Lee Kafer was in the hospital with her ailing 9-month-old son in July, police say, medical staff saw something shocking. Now, newly-released documents from the St. Paul Police Department in Minnesota say she purposefully tried to get her son sick by, among other things, sneaking an over-the-counter laxative into his feeding tube.And, police say, the woman from Lewiston, Minnesota, has a harrowing internet search history related to the crime. (Magness, 11/28)

St. Louis Post Dispatch: Mercy South Is Right To Insist Its Medical Staffers Get Flu Vaccinations
Medical professionals have an obligation not just to their patients, but to the defense of medical science against pseudoscience. That principle apparently was lost on demonstrators outside Mercy South on Tuesday as they protested the reported firing of a nurse for refusing to be vaccinated for flu under hospital policy. Adults have the right to refuse vaccinations, but a hospital employee doesn’t have the right to put patients’ fragile health at further risk. It’s bad enough that a portion of the public buys into anti-vaccination hysteria. For anyone in a medical field to embrace that dangerous movement is especially disturbing. (11/28)

Nashville Tennessean: Why Vaccines Are Important For All Ages, Especially, Seniors 
As temperatures drop and fall is upon us, this is the perfect time of year to take an inventory of our health and make sure we’re protecting ourselves. One thing we can do is as simple as getting vaccinated.According to the National Foundation for Infectious Diseases, pneumococcal disease is the number one cause of serious illness, not only in Tennessee and across the country, but around the world. There are nearly one million cases of pneumococcal disease among adults in the United States each year, which result in thousands of people ending up in the hospital. A recent study from the University of North Carolina found that adults that haven’t been vaccinated cost the U.S. economy more than $7 billion. (I. Michele Williams, 11/29)

The Washington Post: Why Small Groups Of Vaccine Refusers Can Make Large Groups Of People Sick
Infectious diseases such as chickenpox and measles — once a rite of passage for American children — have been made uncommon due to vaccines. However, in recent years, an increasing number of parents are refusing vaccines, resulting in outbreaks.The overall vaccination rate in the United States is still high, fortunately, and despite this worrisome trend. For example, according to the CDC, more than 90 percent of 19- to 35-month-old American children are adequately vaccinated against measles and chickenpox. Why, then, do we continue to see outbreaks of diseases preventable in the United States? (Saad B. Omer, 11/29)

Houston Chronicle: What Happens When A Cancer Researcher Gets Cancer?
As someone who has devoted most of my adult life to cancer research, I’ve long known exactly the kind of lifestyle I need to live to cultivate a body that is inhospitable to cancer growth and to prevent cancer from forming. But just knowing this wasn’t enough. In March, as my wife Alison and I were finishing up the final draft of our book “Anticancer Living,” I was diagnosed with advanced melanoma. (Lorenzo Cohen, 11/27)

The Wall Street Journal: Stopping The Socialist Resurgence 
Consider the arguments against “Medicare for All.” Do voters really want to abolish private insurance? After watching the Department of Veterans Affairs bungle the treatment of the nation’s warriors, do Americans want their personal health decisions made by the unwieldy, unresponsive federal government? Do they want the wait times, the decline in quality, and the slowing of innovation that would come with a takeover by a new federal bureaucracy? And how will the country pay the $32 trillion cost of the Medicare expansion? The average working couple already pay $158,000 in Medicare taxes over their careers. How would they like to see their taxes skyrocket and their care cut? Democrats should be forced to answer for their radicals’ wild ideas. (Karl Rove, 11/28)

The New York Times: The Link Between August Birthdays And A.D.H.D.
The rate of diagnosis of Attention Deficit Hyperactivity Disorder among children has nearly doubled in the past two decades. Rates of A.D.H.D. diagnoses also vary considerably across states, with nearly three times as many children getting the diagnosis in Kentucky (where one in five children are said to have the condition) as in Nevada. More than 5 percent of all children in the United States now take an A.D.H.D. medication. These facts raise the question of whether the disease is being overdiagnosed. (Jena, Barnett and Layton, 11/28)

USA Today: Suicide: We Need To Talk About It, And The Media Needs To Cover It
We all know someone touched by suicide. Myself included.Nicole Carroll was raised by her paternal grandparents until about age 2. They remained close. Her grandfather, J.E. Carroll Jr., died by suicide in 2001.  (Photo: Nicole Carroll)I lived with my grandparents until I was 2. I stayed close to my grandfather; he never stopped looking out for me, even as I started college, work, a family. Then, in 2001, he killed himself. It wasn’t a secret, but no one ever talked about it. That was 17 years ago. And still today, we just don’t talk about suicide.The media rarely share stories of suicide, in part because we don’t want to make things worse. The practice in newspapers for decades was not to write about suicide at all unless it was done in public or was a public figure. (Nicole Carroll, 11/28)

The Washington Post: A Stunning Claim In China Highlights The Perils And Promise Of Gene Editing
The claim on Monday by a Chinese scientist that he successfully edited the genetic makeup of a human embryo followed by live births is a moment for serious worry. Rapid advances in gene editing have been pointing toward this for a few years. If confirmed, the research must trigger a fresh reexamination of the procedures for research that could alter the basic blueprint of humankind. Vigilance, transparency and oversight are vital bulwarks against dangerous research, and this experiment appears to have skirted them all. (11/28)

The Hill: Veterans Have Been Deprived Of Their Earned Benefits For Two Decades
A volunteer grassroots effort educated Congress on the need to extend the presumption of agent orange exposure to those ships who serve in the bays, harbors and territorial sea of the Republic of Vietnam. Tens of thousands of sick and dying Navy veterans and their survivors, cheered the House vote and thought that they would finally receive their earned compensation and medical benefits. The tragedy of the so-called Blue Water Navy veterans began in 2002 when the VA Secretary, with a stroke of a pen, rescinded the presumption of exposure authorized by Congress in the 1991. (John B. Wells, 11/28)

New England Journal of Medicine: Trauma-Informed Care — Reflections Of A Primary Care Doctor In The Week Of The Kavanaugh Hearing
In this time of increased awareness of the prevalence and impact of trauma, and as we are inundated with news about abuse, health care providers have an opportunity and responsibility to dig deep into ourselves and commit to actively resisting retraumatization, to develop the resources to support survivors, and to support each other as we do this work. We can strive to make our organizations trauma-informed places of healing. (Eve Rittenberg, 11/29)

New England Journal of Medicine: Sit Back And Listen — The Relevance Of Patients’ Stories To Trauma-Informed Care
If there is one thing I have learned over 22 years of practicing pediatrics in an underresourced urban environment, it is that patients reveal their most personal and painful life experiences when we build trusting relationships and encourage open dialogue. The more we understand about the long-term effects of toxic stress due to adverse childhood experiences, the more important it becomes for us to absorb these stories. They form the crux of trauma-informed care. But how can we encourage open dialogue in today’s health care climate? (Dorothy R. Novick, 11/29)

Los Angeles Times: California's Right-To-Die Law Needs High Court Intervention 
A Riverside County appeals court upheld California’s right-to-die law this week, ending months of legal limbo after a Superior Court judge invalidated the law in May because he believed it had been improperly enacted.That’s great news for the state’s terminally ill patients whose doctors may have been reluctant to write a life-ending prescription while the law was being contested in the courts. The law is now officially valid again — at least until the plaintiffs file a new challenge. (11/29)

San Francisco Chronicle: California Will Pay For Congress’ Health Care Failures
A new report by the UC Berkeley Labor Center and the UCLA Center for Health Policy Research projects a substantial increase in the statewide uninsured rate by 2020 and an even larger increase by 2023. Specifically, the researchers are projecting that 11.7 percent of Californians under 65 will lack insurance by 2020 — about 4.02 million people — and about 12.9 percent will lack it in 2023 — about 4.4 million people. (11/28)