The New York Times: Supreme Court Opens New Term With Argument On Insanity Defense
In the first argument of its new term, the Supreme Court on Monday considered whether states may abolish the insanity defense, a question that seemed to puzzle several of the justices, who drew conflicting lessons from history, moral philosophy, constitutional law and the brutal crimes at the heart of the case. James Kahler of Kansas was sentenced to death in 2011 for killing four family members, but his lawyers said he had severe depression that made it impossible for him to understand reality or to distinguish right from wrong. (Liptak, 10/7)

CNBC: Supreme Court Weighs Insanity Defense And Split Juries In Murder Cases
[James Kraig Kahler] was convicted of murdering his wife, two children, and his wife’s grandmother in a fit of rage over Thanksgiving weekend in 2009. After his wife left him and pursued a relationship with a female co-worker, Kahler grew obsessed, turned to stalking, and was fired from his job. While in a state that one doctor described as “stress induced short-term dissociation,” he shot and killed his family members while chasing them room to room through their home in a spree that was partially recorded on the grandmother’s Life Alert system. (Higgins, 10/6)

SCOTUSblog: Argument Analysis: Justices Open New Term With Questions And Concerns About Insanity Defense
Arguing for Kahler, attorney Sarah Schrup began by emphasizing that, for centuries, a defendant’s culpability hinged on his ability to distinguish between right and wrong. The insane, she stressed, lack that capacity. Justice Ruth Bader Ginsburg asked whether a state could decide that it wanted to “rethink” the insanity defense, creating the prospect that someone could be found guilty but nonetheless insane and then committed to a psychiatric hospital instead of prison. Would that violate the Constitution, she asked? Schrup pushed back, arguing that someone who is insane historically would not have been subject to prosecution at all. And a conviction, she added, could carry a stigmatizing effect. (Howe, 10/7)

The Washington Post: Supreme Court’s New Term Opens With Arguments Over Unanimous Juries, Insanity As A Criminal Defense
Justice Stephen G. Breyer said the case raised “quite deep” questions. He wondered about one “crazy” defendant who killed someone because he believed the person was a dog, and another who killed someone he knew was a person but did it because he believed a dog had told him to do it. “Why does Kansas say one is guilty, the other is not guilty?” Breyer asked. Kagan also found the case raised deep questions but said she doubted the outcome will mean much for Kahler. In no state, Kagan told Kahler’s lawyer Sarah Schrup, “would your client be found insane.” (Barnes, 10/7)

Reuters: U.S. Supreme Court Kicks Off New Term, With Justice Thomas Absent
Justice Clarence Thomas, 71, was absent due to illness. Thomas likely has the flu, a court spokeswoman said. One of the nine-member court’s most conservative members, Thomas has served since 1991 and is its longest-serving justice. In remarks from the bench before the first argument, Chief Justice John Roberts said Thomas was “indisposed” due to illness but would still participate in deciding the three cases. (Hurley and Chung, 10/7)

The Wall Street Journal: Sanders’s Heart Attack Brings Age To 2020 Forefront
Bernie Sanders’s recent heart attack and hospitalization are bringing to the forefront an issue the Democratic party’s three leading presidential candidates have actively tried to minimize: their age. At 78, the Vermont senator is the oldest in the party’s field. Former Vice President Joe Biden is 76, and Massachusetts Sen. Elizabeth Warren is 70. All three—who have consistently occupied the trio of top slots in public polls of the Democratic contest—are much older than the median age of about 55 years for a U.S. president at inauguration. They are competing to face President Trump, who is 73. (Parti, 10/7)

Politico: Sanders Heart Attack Casts Cloud Over His Candidacy
Bernie Sanders has been sidelined for nearly a week — after failing for almost three days to disclose that he had a heart attack. It's unclear when the 78-year-old senator will return to the stump. His campaign has yet to divulge the severity of his heart attack. And that sequence of events unfolded as he's been eclipsed in the polls by the other progressive icon in the race, Elizabeth Warren. (Otterbein and Siders, 10/7)

CNN: How Bernie Sanders' Heart Attack Changes The 2020 Race
Bernie Sanders' heart attack suffered on the campaign trail last week thrusts a tough issue to the front of the 2020 presidential race: How old is too old to be president? Sanders is the obvious focus of that question, after having two stents placed into an artery following a campaign appearance in Nevada -- and being forced to pull out of a CNN-sponsored town hall on LGBT issues in California later this week. But he's not the only candidate in the Democratic field who will be affected by Sanders' heart attack in the race. (Cillizza, 10/7)

The Wall Street Journal: Trump’s Federal Hiring Emphasizes Border Control, Veterans, Military
The White House has reshaped the federal workforce to advance President Trump’s priorities, emphasizing border control, veterans and the military while shrinking the size of the education, labor and housing-and-urban-development agencies, an analysis by The Wall Street Journal shows. Compared with the political difficulties of the federal-budget process, strategic hiring is a quieter way to advance a presidential policy agenda and a practice employed by all White Houses to varying degrees. (Butchireddygari, 10/7)

Other news on the administration looks at rainbow-colored crosswalks and worker safety —

The New York Times: The Government Says Rainbow Crosswalks Could Be Unsafe. Are They Really?
Ahead of an annual L.G.B.T.Q. festival in Ames, Iowa, members of the City Council decided to liven up a pedestrian crosswalk near the downtown shopping district by painting stripes in colors evoking the gay, nonbinary and transgender pride flags. “Who would have thought, 50 years ago, that a small town in central Iowa would be saying this: We see you, we hear you, we welcome you,” Reginald Stewart, vice president for diversity and inclusion at Iowa State University, said of the kaleidoscopic markings. (Rueb, 10/7)

NPR: Lawmakers Seek Protections For Workers Against Lung Damage Tied To Making Countertops
Lawmakers in Congress are calling on the Department of Labor to do more to protect workers who may be unsafely cutting "engineered stone" used for countertops. The material contains high levels of the mineral silica, and breathing in silica dust is dangerous. While silica is found in natural stones, like granite, engineered stone made of quartz can be more than 90% silica. This type of artificial stone has become increasingly popular among Americans for kitchen and bathroom countertops in recent years. (Greenfieldboyce, 10/7)

Modern Healthcare: Nursing Home Abuse To Be Flagged On Medicare Quality Website
The CMS on Monday announced that it would make it easier for consumers to find out about nursing homes that have violated rules about abuse, neglect or exploitation. The agency's Nursing Home Compare website will add an icon next to nursing homes with reported violations starting on Oct. 23. The website provides detailed information about each Medicare- and Medicaid-certified nursing home in the U.S. (Brady, 10/7)

Kaiser Health News: Trump’s New Order For Medicare Packs Potential Rise In Patients’ Costs
Vowing to protect Medicare with “every ounce of strength,” President Donald Trump last week spoke to a cheering crowd in Florida. But his executive order released shortly afterward includes provisions that could significantly alter key pillars of the program by making it easier for beneficiaries and doctors to opt out. The bottom line: The proposed changes might make it a bit simpler to find a doctor who takes new Medicare patients, but it could lead to higher costs for seniors and potentially expose some to surprise medical bills, a problem from which Medicare has traditionally protected consumers. (Appleby, 10/7)

Kaiser Health News: As Medicare Enrollment Nears, Popular Price Comparison Tool Is Missing
Millions of older adults can start signing up next week for private policies offering Medicare drug and medical coverage for 2020. But many risk wasting money and even jeopardizing their health care due to changes in Medicare’s plan finder, its most popular website. For more than a decade, beneficiaries used the plan finder to compare dozens of Medicare policies offered by competing insurance companies and get a list of their options. Yet after a website redesign six weeks ago, the search results are missing crucial details: How much will you pay out-of-pocket? And which plan offers the best value? (Jaffe, 10/8)

Meanwhile, in news on Medicaid —

Modern Healthcare: Illinois Sends People To Lowest-Rated Medicaid Managed-Care Plan
Illinois is funneling more people into the Medicaid managed-care plan with the highest turnover and lowest scores on state quality measures. The Illinois Department of Healthcare & Family Services sends 35 percent of new Medicaid enrollees who didn't request a particular plan to NextLevel Health. That ties CountyCare for the highest percentage assigned to any of the state's Medicaid managed-care providers. (Goldberg, 10/7)

The Associated Press: US Official: Research Finds Uranium In Navajo Women, Babies
About a quarter of Navajo women and some infants who were part of a federally funded study on uranium exposure had high levels of the radioactive metal in their systems, decades after mining for Cold War weaponry ended on their reservation, a U.S. health official Monday. The early findings from the University of New Mexico study were shared during a congressional field hearing in Albuquerque. Dr. Loretta Christensen — the chief medical officer on the Navajo Nation for Indian Health Service, a partner in the research — said 781 women were screened during an initial phase of the study that ended last year. (Hudetz, 10/7)

Stat: Buttigieg Wants Lower Drug Prices — Even As He Hopes Drug Makers ‘Thrive’
Just hours after he released an aggressive plan to lower prescription drug prices, South Bend, Ind., Mayor Pete Buttigieg shared his counterintuitive message for drug makers: “We want you to thrive. ”Thrive, that is, in a way that is “compatible with a decent life for Americans,” he explained during a Monday interview with STAT. Buttigieg, long seen as one of the most moderate candidates vying for the Democratic presidential nomination, released a sweeping plan Monday that included ideas once seen as radical, even among Democrats, like levying heavy fines against drug makers and seizing patents. (Florko, 10/7)

CQ: Trump Aide Calls Drug Price Deal Possible If Impeachment Fades
President Donald Trump's top domestic policy adviser on Monday predicted that the White House could strike a deal with House Democrats on drug prices — if the impeachment inquiry into the president ultimately doesn't go anywhere. Domestic Policy Council Director Joe Grogan said House Democrats deserve credit for proposing a drug price bill, which he called ambitious. He said he met last week with Speaker Nancy Pelosi's health care adviser, Wendell Primus, as well as House committee staff, and the two sides had a "great" conversation about the legislation. (Siddons, 10/7)

And in other pharmaceutical news —

Stat: Public Citizen Urges FDA To Withdraw Drug For Preventing Premature Birth
As an Oct. 29 regulatory meeting nears to review the Makena treatment for preventing premature births, a consumer advocacy group is urging the Food and Drug Administration to immediately withdraw the controversial drug because it failed a confirmatory study. In a citizen’s petition being filed with the FDA on Tuesday, Public Citizen pointed to a required followup effectiveness study that was released in March, showing Makena is no better than a placebo in preventing preterm birth or major complications from preterm birth. (Silverman, 10/8)

Stat: With A New Lobbying Group And A Day At The White House, Synthetic Biology Looks For Footing In Washington
Synthetic biology, the industry built around using back-end technologies to engineer the life sciences, has long prided itself on having a quirky, countercultural ethos — and having more fun than those stuffy suits in biotech and pharma. It was just two years ago, after all, that a biohacker CRISPR’d himself on stage at the industry’s big annual conference. Now, though, the industry is trying to establish its footing here in a town with a culture utterly unlike its own. (Florko and Robbins, 10/8)

The Associated Press: California OKs Pharmacists To Dispense HIV Prevention Meds
Pharmacists in California will be able to dispense HIV prevention pills to patients without a doctor's prescription after Gov. Gavin Newsom signed legislation Monday that supporters say will greatly reduce the spread of infection. Advocates of Senate Bill 159 say California is the first state to authorize pre-exposure prophylaxis, also called PrEP, and post-exposure prophylaxis, known as PEP, without prescriptions. California is already considered a leader in AIDS prevention, they say. (10/7)

Los Angeles Times: HIV Prevention Drugs Will Be Available Without A Prescription In California
Senate Bill 159 by Sen. Scott Wiener (D-San Francisco) and Assemblyman Todd Gloria (D-San Diego) allows pharmacists to dispense pre-exposure prophylaxis, known as PrEP, and post-exposure prophylaxis, known as PEP, in a way similar to birth control and emergency contraceptives. The law will also bar insurance companies from requiring prior authorization before the HIV prevention drugs are provided. “Recent breakthroughs in the prevention and treatment of HIV can literally save lives,” Newsom said in a statement. “All Californians deserve access to PrEP and PEP, two treatments that have transformed our fight against HIV and AIDS. I applaud the Legislature for taking action to expand access to these treatments and getting us close to ending HIV and AIDS for good.” (Gutierrez, 10/7)

WOSU Radio: Gov. DeWine Introduces 'STRONG Ohio' Bill To Reduce Gun Violence
Two months after the mass shooting in Dayton spurred Gov. Mike DeWine to take action against gun violence, the governor has released details about the official bill he's presenting to lawmakers. The legislation won't include two significant gun control measures DeWine previously supported, however. DeWine in August said he wanted two major elements in his gun violence bill: a version of a “red flag” gun seizure law, and enhanced background checks for private gun purchases. Neither element appears in the version DeWine unveiled Monday. (Kasler and Ingeles, 10/7)

Cincinnati Enquirer: Dayton Shooting: Ohio Governor Decides Against 'Red Flag' Gun Law
Instead of a red flag or extreme risk protection order law that would remove guns from people deemed dangerous, DeWine proposed expanding the state's "pink slip" system, which places mentally ill Ohioans in hospitals for up to 72 hours. Under DeWine's proposed changes, those dealing with chronic alcoholism or drug dependency could be "pink-slipped," too. After a hearing in probate court, a judge or magistrate could determine that the person should be separated from his or her firearms. The person could give guns to someone who doesn't live with him or her, sell them or give them to law enforcement. (Balmert and Borchardt, 10/7)

Dayton Daily News: Gov. Mike DeWine Lays Out Gun Plan
DeWine is also wants a clear path for police to enforce existing laws that allow seizure of firearms from people under a “weapons disability” because of mental illness, drug use or alcoholism. Additionally, the governor wants people with drug dependency or chronic alcoholism and are deemed to be dangerous to be held in hospitals for up to 72 hours — as is the process for people with mental illnesses who exhibit signs they’re a danger to themselves or others. “The STRONG Ohio bill will give hospitals and courts a better ability to help those who are legally declared to be a danger to themselves or others due to drug dependency or chronic alcoholism,” the DeWine administration said. (Bischoff, 10/7)

In other news on gun violence —

Modern Healthcare: Gun Control Could Reduce Suicide More Than Boosting Mental Health Staffing
Gun control measures may be more effective at reducing firearms suicides in the U.S. than increasing behavioral health capacity, a new study suggests. The study, published in Health Affairs, found that a 10% increase in behavioral health workers per state was associated with a modest 1.2% reduction in the gun suicide rate from 2005 to 2015. (Meyer, 10/7)

The New York Times: Juul Is Sued By School Districts That Say Vaping Is A Dangerous Drain On Their Resources
With school districts across the United States scrambling to reverse the rise of vaping among teenagers, three of them on Monday filed suit against Juul, the e-cigarette manufacturer, accusing it of endangering students and forcing educators to divert time and money to fight an epidemic of nicotine addiction. The school systems in St. Charles, Mo., Olathe, Kan., and on Long Island were believed to be the first in the United States to sue Juul, which dominates the e-cigarette market with devices that look like thumb drives and that have become wildly popular with American teenagers. (Hassan, 10/7)

Reuters: Two School Districts Sue Juul Over Vaping 'Epidemic'
As a result of "youth-targeted product design and marketing, and years of misstatements and omissions regarding its products, Juul succeeded in addicting a generation of youth to nicotine," the St. Charles district said in its lawsuit, which was filed in federal court in St. Louis. The Olathe district, which sued Juul in federal court in Kansas City, Kansas, similarly accused the company of creating a nationwide "epidemic of vaping" and said it had been "forced to expend significant resources combating this public nuisance." (Pierson, 10/7)

KCUR: Olathe School District Says Leading E-Cigarette Maker Addicted A Generation Of Youth To Nicotine 
The Olathe School District on Monday filed suit against the nation’s leading maker of e-cigarettes, charging it deliberately markets its products to school-age children and misleads them about their dangers. The lawsuit, filed in federal court in Kansas City, Kansas, says that Juul Labs Inc. has “succeeded in addicting a generation of youth to nicotine” by adopting the marketing tactics of the tobacco industry. (Margolies, 10/7)

Bloomberg: Juul Accused By School Districts of Creating Vaping ‘Nuisance’
Juul is a defendant in almost a dozen federal-court suits consolidated in San Francisco for pre-trial information exchanges. Some of those complaints also name Altria as a defendant. The company also faces more than 40 suits in state courts. Some plaintiffs include parents claiming their children have become nicotine addicts as a result of using e-cigarettes. Altria spokesman Steven Callahan says those suits are “meritless” and that the conduct alleged in them occurred before it had an economic interest in Juul. (Kary and Feeley, 10/7)

The Washington Post: E-Cigarettes Add To Fire Dangers On Planes, And FAA Has Little Direction
When an e-cigarette battery started smoldering on a flight to Los Angeles in July 2017, a SkyWest flight attendant threw it into an ice bucket before shoving it into a fire containment bag. In Denver, two months later, a carry-on bag with four vaping batteries “caught fire on the boarding bridge,” and firefighters were called to put it out, according to the Federal Aviation Administration. In March, Southwest Airlines employees had to pull a smoking suitcase containing e-cigarette batteries from a plane’s cargo hold in San Diego. Adjacent bags were damaged, as was the plane, which was temporarily taken out of service, according to the FAA. (Laris, 10/7)

Cincinnati Enquirer: U.S. Lab Seeking Possible Links Between Vaping And Lung Disease Is In Cincinnati
The search for answers to the mysterious lung disease apparently related to vaping goes through a low-slung building in an industrial park in a northern Cincinnati neighborhood. The Forensic Chemistry Center in Cincinnati operates under the authority of the U.S. Food and Drug Administration. As a result, it’s a secretive place, and FDA officials declined repeated requests to tour the lab or speak with its leadership. An agency spokeswoman answered questions that The Enquirer submitted by email. In the vaping investigation, the laboratory has received more than 400 samples of vaping products from 18 states, “and those numbers continue to increase,” the FDA said. (Saker, 10/7)

Politico Pro: Scientists Urge FDA To Be Tough On Vaping
The evidence that vaping is safer than smoking is so thin that FDA officials preparing to regulate the products don't even know whether it makes sense for people to switch. Yet millions of youths are already hooked on e-cigarettes, despite initial evidence suggesting they could cause long-term lung problems or even cancer. (Allen, 10/7)

Reuters: Democrat Lawmaker Introduces Bill To Cap Nicotine Content In Vapes
A U.S. lawmaker on Monday introduced a bill that seeks to regulate e-cigarette makers by capping the amount of nicotine in the vapes they manufacture to make them less addictive. The bill, introduced by Illinois Congressman Raja Krishnamoorthi, is the latest effort by lawmakers to clamp down on e-cigarette use, given a spike in underage vaping. (10/7)

The Associated Press: First Lady Calls For End Of E-Cigarette Marketing To Youth
Melania Trump said Monday that companies "must stop" marketing e-cigarettes to children, saying they are addictive and dangerous. Marketing tobacco products to kids is already prohibited in the United States, and Juul Labs Inc., the nation's largest maker of electronic cigarettes, has said it will cease advertising them in the U.S. Still, some believe Juul's early online marketing of e-cigarettes contributed to an explosion in vaping among youth. (Superville, 10/7)

The Hill: First Lady Calls For End Of Marketing E-Cigarettes To Youth 
"It is important to me that we all work to educate children and families about the dangers associated with this habit," she said. "Marketing this addictive product to children must stop." Melania Trump was one of the driving forces behind President Trump's crackdown on flavored vaping products. (Weixel, 10/7)

The Associated Press: Kroger, Walgreens To Stop Selling E-Cigarettes In US
Two major retailers say they will no longer sell e-cigarettes in the U.S. amid mounting health questions surrounding vaping. Supermarket chain Kroger and drugstore chain Walgreens announced Monday they would discontinue sales of e-cigarettes at their stores nationwide, citing an uncertain regulatory environment. (10/7)

USA Today: Walgreens, Kroger End E-Cigarette Sales As Vaping Crisis Continues
Walgreens, the nation's largest drugstore chain by total locations, will stop selling e-cigarettes permanently, spokesman Phil Caruso said in an email. "This decision is also reflective of developing regulations in a growing number of states and municipalities," Walgreens said in a statement. Caruso said Walgreens had not determined a timeline for the phaseout, but "we plan to exit in an orderly manner." (Bomey, 10/7)

Los Angeles Times: Mice Who ‘Vaped’ Nicotine For A Year Had Big Spike In Tumor Growth
New research in mice suggests that long-term exposure to vaping liquids that contain nicotine greatly increases the risk of cancer. After breathing in the vapor for 20 hours a week for more than a year, 22.5% of the mice had cancerous tumors in the lining of the lungs, and 57.5% developed growths in their bladder tissue that can be precursors to cancer. Meanwhile, only 5.6% of mice in a control group that breathed only filtered air wound up with lung tumors, and none of them had growths in their bladders. (Baumgaertner, 10/7)

CNBC: E-Cigarettes Cause Lung Cancer In Mice, Finds First Study Tying Vaping To Cancer
“It’s foreseeable that if you smoke e-cigarettes, all kinds of disease comes out” over time, Moon-Shong Tang, the study’s lead researcher, said in an interview. “Long term, some cancer will come out, probably. E-cigarettes are bad news.” How carcinogenic e-cigarette use is for humans “may not be known for a decade to come,” but the study is the first to definitively link vaping nicotine to cancer. Funded by the National Institutes of Health, the study was published Monday in the Proceedings of the National Academy of Sciences. (Bursztynsky, 10/7)

Meanwhile, in the states —

The Wall Street Journal: Majority Of New Yorkers Support Ban On Sale Of E-Cigarettes
New Yorkers think the use of e-cigarettes is a serious public health problem and support a ban on flavored e-cigarette products, according to a poll released Monday. The Siena College Research Institute found that 78% of the 589 New Yorkers surveyed in late September believe that vaping is a somewhat serious or very serious public health problem. Sixty-one percent of those polled supported a temporary ban on the sale of flavored e-cigarette and vaping products, while 52% said they supported banning the sale of all e-cigarettes and vaping devices in New York. (West, 10/7)

Arkansas Democrat Gazette: Attorney General Tackles Youth Vaping, Warns Retailers
Arkansas Attorney General Leslie Rutledge launched an offensive against youth vaping on Monday -- the same day researchers in New York published the first study linking e-cigarette vapor to cancer in mice. The Republican attorney general issued an "enforcement advisory," warning online retailers that they stand to be fined up to $10,000 under the Arkansas Deceptive Trade Practices Act for selling or shipping e-cigarette products to minors. (Field, 10/8)

New Hampshire Union Leader: NH Reports First Case Of Vaping-Related Lung Injury 
A Sullivan County adult is the first person in New Hampshire to suffer a “lung injury” from vaping, state health officials reported on Monday. The unnamed patient had vaped nicotine products and was hospitalized at one point with symptoms and chest imaging that showed unspecified lung injury, the state Department of Health and Human Services said. The person was later discharged from the hospital. (10/7)

Fresno Bee: Death Due To Vaping In Kings County, California
A person has died in Kings County due to vaping, the county department of public health reported Monday. The person was not identified. It’s the second death related to the use of electronic cigarettes in the region. Last month, a resident in Tulare County died of similar complications. (Tehee, 10/7)

California Healthline: Vapers Accuse Officials Of Overreach As Investigation Into Deadly Lung Illness Lags
On Sept. 16, Tulare County in California announced the nation’s seventh death from vaping-related illness. Its advisory warned about “the dangerous effects of using electronic cigarettes, or e-cigarettes.” Like so many of the official warnings coming out around the country, it lacked details about the specific products involved in the vaping death. But by the time of the announcement, the family of the man who died had been in touch with Gregory Conley, president of the American Vaping Association, which advocates for vaping products. (Barry-Jester and Gold, 10/7)

The New York Times: Players With C.T.E. Doubled Their Risk With Every 5.3 Years In Football
Former tackle football players with chronic traumatic encephalopathy, the degenerative brain disease linked to repeated head hits, doubled their risk of developing the worst forms of the disease for each 5.3 years they played, according to a new study. Scientists have known that more years playing tackle football is associated with thinking and memory deficits later in life. This study builds on that research and, for the first time, calculated the number of years played with levels of measurable disease in the brain. (Belson, 10/7)

NPR: Acute Flaccid Myelitis May Be Caused By A Virus, Research Shows
The condition strikes young children. It can start with run-of-the-mill virus symptoms, like fever or sniffles. But, then the kids lose control of their limbs, may have trouble swallowing or breathing, or even end up paralyzed. This terrifying experience happened to more than 570 families since 2014, whose children were struck with an illness called acute flaccid myelitis, or AFM. "It was really scary," says Susan Coyne, the mother of a son, Evan Mazanec, who developed AFM back in 2014 when he was 7 years old. "When this first started, no one really knew what it was," she says. (Aubrey, 10/7)

NPR: Smartphone App Can Help Detect Leukocoria, A Sign Of Eye Cancer
It's hard for doctors to do a thorough eye exam on infants. They tend to wiggle around — the babies, that is, not the doctors. But a new smart phone app takes advantage of parents' fondness for snapping pictures of their children to look for signs that a child might be developing a serious eye disease. The app is the culmination of one father's the five-year quest to find a way to catch the earliest signs of eye disease, and prevent devastating loss of vision. (Palca, 10/7)

The New York Times: Stress Can Make You Sick. Take Steps To Reduce It.
Not long ago Dr. Rangan Chatterjee had a patient with Type 2 diabetes who was struggling to lower his blood sugar levels despite following an intense diet and exercise program. Dr. Chatterjee counseled him to focus on the root cause of his problem: Chronic stress. The patient, a 53-year-old businessman, had been putting in long hours at the office, working late into the night and skimping on sleep. (O'Connor, 10/8)

The New York Times: Pregnant? Try Not To Sleep On Your Back
During pregnancy, sleeping on your back may be a bad idea. Previous studies have found that sleeping in a supine position causes compression of veins and arteries that can lead to a reduction in blood flow to the placenta severe enough to double the risk for stillbirth after 28 weeks of gestation. (Bakalar, 10/8)

Kansas City Star: Lawsuit: Epic Games Made Fortnite Addictive ‘Like Cocaine’
Does the popular video game Fortnite have the same affect on children’s brains as cocaine? A Canadian law firm says the game releases the same pleasure chemicals in the brain as the illicit drug in a new lawsuit, according to Canadian reports. (Duncan, 10/7)

The Wall Street Journal: Sleepovers Have Parents Worried About Midnight Gadget Use
Kids’ sleepovers have gotten complicated. The days of flashlights, Ouija boards and prank calls are over. Now, some parents are worried their children could be exposed to porn, violent videogames or the pressure to post inappropriate photos in the wee hours. (Jargon, 10/8)

Boston Globe: Massachusetts Contains Health Care Costs, But Consumers Keep Paying More
Massachusetts met its self-imposed goal of controlling the growth in health spending last year, according to a new state report — but the cost burden on consumers continued to rise at a worrying pace. Statewide health care spending grew to an estimated $60.9 billion in 2018, or $8,827 per person, according to the study from the state Center for Health Information and Analysis. That’s a 3.1 percent increase from the previous year and in line with the state benchmark for controlling spending. (Dayal McCluskey, 10/8)

WBUR: Mass. Meets Goal To Curb Health Care Spending, But Insurance Premiums Continue To Rise
In 2018, the preliminary numbers show, Massachusetts spent $60.9 billion on health care, or about $8,827 per person. That's a 3.1% increase over what the state spent in 2017, exactly the target ceiling, which is based on the state’s projected economic growth. “The largest contributors to increases in health care spending were hospital services, physician services and prescription drugs,” says Ray Campbell, CHIA's executive director. (Chen, 10/8)

In other health spending and industry news —

Modern Healthcare: Waste Accounts For One-Quarter Of Healthcare Spending
A new study found waste accounts for roughly one-quarter of all U.S. healthcare spending, an estimate that's in the same ballpark as its predecessors. The cost of waste in the U.S. healthcare system ranges from $760 billion to $935 billion annually, according to a JAMA review of 54 peer-reviewed studies, government reports and other information, released Monday. The study found one-quarter of that could be cut using interventions found to reduce waste. (Bannow, 10/7)

Modern Healthcare: Strong September Healthcare Hiring Behind Low Unemployment Rate
Strong healthcare hiring helped push the overall unemployment rate to a historic low in September. Healthcare added 38,800 jobs last month, making up nearly 30% of overall hiring and contributing to a lower, 3.5% unemployment rate. The U.S. unemployment rate hasn't been this low since December 1969, according to preliminary data from the U.S. Bureau of Labor Statistics' September jobs report, released Friday. (Bannow, 10/4)

The Associated Press: Hospital Where 3 Preemies Died Seeking Source Of Bacteria
A Pennsylvania hospital is racing to determine the source of a waterborne germ that appears to have infected at least eight infants in the neonatal intensive care unit, three of whom have died, officials said Monday. Geisinger Medical Center in Danville has begun sending very premature newborns and some expectant mothers to other facilities while officials investigate, the hospital said. (10/7)

The New York Times: 3 Babies Die At Pennsylvania Hospital After Bacterial Infection
The bacterium — Pseudomonas aeruginosa — is very common, likes moist environments and grows in water. Pseudomonas infections have been a particular problem for neonatal intensive care units because underdeveloped babies have compromised immune systems. “It’s often very harmless,” Dr. Frank A. Maffei, Geisinger’s chief of pediatrics, said at the news conference. “However, it can cause diseases, and it can cause diseases in very fragile patients. Certainly, premature and tiny babies are among our most fragile and vulnerable patients we care for here.” (Zaveri, 10/7)

Times Leader: Geisinger Releases Statement On Danville Infant Deaths
Geisinger officials said a hotline has been established for any community members who may have questions regarding theannouncement. The hotline numbers are 570-214-9087 and 570-214-9088. (10/7)

Miami Herald: Leaked Videos Show Florida Prison In All Its Squalor, Violence
Scott Whitney, inmate No. U21924, filmed a documentary on the Florida prison system and nobody knew. At least the guards didn’t. Over a period of years, the convicted drug trafficker used specially rigged, almost cartoonishly oversize eyeglasses fitted with hidden cameras and a hollowed-out Bible with a lens peeking through the O in HOLY to capture the gritty, ugly, violent world inside Martin Correctional Institution, one of Florida’s more notoriously dangerous prisons. (Ellenbogen, 10/4)

The Washington Post: Secretly-Recorded Prison Film Shows The Gruesome Reality Of Life Inside
With a camera hidden in a hollowed-out Bible, peeking through the “O” of the word “Holy,” and a pair of rigged reading glasses, Scott Whitney secretly filmed the world behind bars, inside one of Florida’s notoriously dangerous prisons. For four years, the 34-year-old convicted drug trafficker captured daily life on contraband cameras at the Martin Correctional Institution. He smuggled footage dating back to 2017 out of the prison and titled the documentary “Behind Tha Barb Wire.” The video — given to the Miami Herald — allows the public to see with their own eyes the violence, rampant drug use and appalling conditions inside the prison. (Paul, 10/7)

Cleveland Plain Dealer: Family Of Cleveland City Jail Inmate Says Officers’ Indifference Led To Preventable Suicide
The family of a Cleveland man who took his own life in the now-shuttered City Jail in 2017 said in a lawsuit that corrections officers failed to properly screen him for mental-health issues. Jesus Malave Morales, 33, died on Oct. 11, 2017, six days after he hanged himself with a blanket in his cell. The lawsuit, filed in federal court in Cleveland on Friday, said corrections officers failed to screen him for mental health issues or suicide risks. (Heisig, 10/7)

Cleveland Plain Dealer: Parma Heights Man Says Cuyahoga County Jail Medical Staff Ignored Worsening Back Problem
A Parma Heights man said in a lawsuit Monday that medical personnel in the Cuyahoga County Jail ignored his cries of severe back pain and would not send him to the hospital for a condition that later required surgery. David Frunza, 24, said in a suit he filed in federal court in Cleveland that MetroHealth emergency doctors treated him in August 2018 for worsening mid-back pain. (Heisig, 10/7)

North Carolina Health News: Mecklenburg Opens NC's First Jail Psych Unit 
The jail psychiatric unit in downtown Charlotte — known as “McP” — looks like a school, but it’s actually North Carolina’s first behavioral health unit located in a county jail. Inmates, or residents as the sheriff calls them, take daily medications, attend group classes, and participate in therapy with the aim of getting better before returning to the general population in the Mecklenburg County Central Detention Center or being released to the outside world. (Duong, 10/8)

The Wall Street Journal: New York City Boosts Homeless Outreach After Four Men Are Killed
New York City will increase its mental-health outreach to the homeless in Manhattan’s Chinatown after four homeless men were bludgeoned to death in the neighborhood, Mayor Bill de Blasio said Monday. Psychiatrists and clinicians from the city’s Department of Health and its Thrive mental-health program will perform street evaluations and provide substance-abuse resources to the homeless as part of the new push, officials said. (Honan and Blint-Welsh, 10/7)

The Washington Post: D.C. May Approve One Of The Highest Soda Taxes In The Country.
A majority of the D.C. Council wants to impose one of the highest taxes on sugary drinks in the nation, driving up the cost of a soda in the capital city. A bill announced Monday would levy a 1.5 cent-per-ounce excise tax on sweetened beverages, adding one dollar to the price of a two-liter bottle. The tax applies to sugary drinks with any “natural common sweeteners,” sweeping up beverages such as Ga­tor­ade, sweetened iced coffee and orange juice with added sugar. (Nirappil, 10/7)

Wyoming Public Radio: How Changes To Title X Are Affecting Wyoming's Family Planning Clinics
Gillette Reproductive Health is like any other doctor's office. There are people waiting, a TV is playing, and there are stacks of magazines. But this clinic is a Title X clinic, and Julie Price is its executive director. She said Title X clinics provide reproductive health care for low-income and uninsured people, though people with insurance can also go there. (Wheeler, 10/4)

Los Angeles Times: $600,000 For Homeless Housing? Audit Suggests Spending Money On Shelters Instead
With the costs of building housing on the rise, Los Angeles City Controller Ron Galperin is recommending that some projects be reevaluated to see if their budgets can be cut to use less of the city’s $1.2-billion homeless housing bond. In an audit that will be released Tuesday, Galperin found that more than 1,000 units of housing approved for funding through Proposition HHH could top $600,000 apiece. (Smith, 10/7)

Georgia Health News: Rebate Time: Thousands Of Ambetter Clients To Get Money Back
About 190,000 Georgians with health care policies from Ambetter of Peach State are getting rebates of $314 each. The payouts are required under a rule in the Affordable Care Act. The insurer owes a total of $59.8 million to its individual policyholders in Georgia, according to newly released federal figures. That’s a large chunk of the more than $65 million that must be paid by Georgia insurers. (Miller, 10/7)

Boston Globe: Charlie Baker Pushes Bill That Would Target Stoned Driving
Governor Charlie Baker ramped up his push for a proposal targeting stoned drivers Monday, framing it as change that should go “hand-in-hand” with marijuana cafes potentially entering the state’s nascent legalized landscape. The Republican’s latest pitch comes less than two weeks after state marijuana regulators cleared the way for marijuana deliveries to begin in Massachusetts, and, pending a change in state law, for a pilot program allowing for so-called social consumption sites. (Stout and Martin, 10/7)

Arizona Republic: Doctor Of Incapacitated Patient Who Gave Birth Won't Be Disciplined
The Arizona Medical Board on Monday dismissed a complaint case against the doctor who cared for a woman with severe disabilities who was raped and gave birth at Hacienda HealthCare in Phoenix. The board voted 5-4 to dismiss the case against Dr. Thanh Nguyen, who was named in a $45 million notice of claim against the state as the doctor who had cared for the 29-year-old patient for four months before she gave birth to a boy. The patient is non-verbal and cannot walk on her own. (Innes, 10/7)

The Associated Press: Iowa Board Approves Payment For Student Suicide Jury Verdict
A state panel that signs off on legal settlements for the state of Iowa has approved payment of $315,000 to the parents of an Iowa State University student who died by suicide in November 2015. A jury in August found the state partially liable for the death of Dane Schussler. (10/7)

Houston Chronicle: Houston Doctor Convicted Of Fraudulently Billing Medicare $16 Million 
A Houston physician who owned and ran a local clinic was convicted Monday by a federal jury of falsely billing Medicare $16 million for home health care services that were not medically necessary or provided, according to a Justice Department news release. After a five-day trial and roughly one day of deliberations, the jury found Dr. Yolanda Hamilton, M.D., 56, guilty of conspiracy to commit health care fraud, conspiracy to solicit and receive health care kickbacks and two counts of making false statements related to health care matters. (Banks, 10/7)

The Baltimore Sun: Baltimore County To Sue Monsanto For Alleged Water Contamination 
Baltimore County is going to ask a federal judge to force agriculture chemical company Monsanto to pay for the cleanup of environmental toxins submerged in the county’s water bodies. The County Council on Monday night approved the county’s contract with three law firms to represent the county in a lawsuit to be filed against the company. ...The county alleges residents “have and will” experience a “health impact” from PCB exposure by eating PCB-contaminated fish and shellfish. County Councilwoman Cathy Bevins, a Middle River Democrat, said she was never told to warn her constituents to avoid eating the fish or crabs from the waterways they live on. (Nobles, 10/7)

Boston Globe: State Health Officials Urge People To Get Flu Vaccine
State health officials are urging Massachusetts residents to get a flu vaccine as soon as possible and there are already confirmed cases in the state, the Massachusetts Department of Public Health said. The department has confirmed 82 cases of the flu since Sept. 1, which is a normal amount for this time of year, the department said in a statement. (Lukpat, 10/7)

The Baltimore Sun: Jordan McNair Family, Baltimore City Council President Scott Tout Legislation To Improve Youth Sports Safety 
The family of the University of Maryland football player who died of heatstroke in June 2018 joined city officials in touting newly passed legislation they say will help protect children enrolled in youth sports programs throughout Baltimore. Passed during Monday night’s City Council meeting, the legislation will require anyone applying for a permit to run a youth sports league at one of the city’s youth recreation centers to receive training in six areas — concussion, heat exhaustion, heatstroke, using a defibrillator, cardiac arrest and child abuse — to identify medical conditions as well as signs of abuse. (Davis, 10/7)

The Washington Post: ‘A Way To Find The Peace I Lost’: This Maryland Nonprofit Is Teaching People With Disabilities How To Sail Boats
[April] Schrock is one of more than 600 people with disabilities (and hundreds of their family members and friends) who have benefited from CRAB’s programming this year, said Paul Bollinger Jr., the group’s executive director. In the roughly 30 years since CRAB’s founding, that number probably stretches “easily” into the tens of thousands, though 2019 will set an annual record, he said. Plus, Bollinger added, the group is poised to significantly expand and diversify its fleet of sailboats (currently around a half-dozen, with a bonus canoe). (Natanson, 10/4)

Boston Globe: Finger-Pointing As Marijuana Producers Pressure CCC To Loosen Lab Testing Rules
Good old-fashioned weed — or flower, in industry parlance — is the backbone of practically every regulated marijuana market on Earth. Going to a dispensary and discovering it’s out of flower would be like arriving at a restaurant hungry for dinner, only to realize it’s one of those weird sit-down, dessert-only places that everyone went to that one time in 2008. (Adams, 10/7)

USA Today: 2020 Democrats Must Tell Us How They'd Reverse US Health Care Decline
The health care discussion in the 2020 Democratic primary race isn’t doing justice to the health care issues that will face Americans and their next president. At a time when U.S. life expectancy has declined for three years in a row, opioids and mental health crises are nearly ubiquitous, and access to affordable care is increasingly dependent on your race, your employer or where you live, these candidates are well-positioned to provide a different vision for the future.Yet they are fixated a single question — and it’s not the very important question of whether every American should have guaranteed access to affordable care. On that, they all agree. No, they are arguing endlessly about the subsidiary question of “how” universal coverage would be achieved: with or without the availability of private employer-based insurance. (Andy Slavitt, 10/8)

The Washington Post: Trump Found A Way To Simultaneously Sabotage Our Health-Care And Immigration Systems
President Trump sabotaged the health-care system. Separately, he’s sabotaged the immigration system. And now, in a presidential twofer, on Friday night the administration found a way to sabotage both simultaneously. Unable to repeal Obamacare, the Trump administration has worked to make it less functional and more expensive. It has done this by zeroing out the individual mandate, expanding the availability of cheap but worthless junk insurance and curtailing the annual open-enrollment period, among other actions. (Catherine Rampell, 10/7)

The New York Times: The Huge Waste In The U.S. Health System
Even a divided America can agree on this goal: a health system that is cheaper but doesn’t sacrifice quality. In other words, just get rid of the waste. A new study, published Monday in JAMA, finds that roughly 20 percent to 25 percent of American health care spending is wasteful. It’s a startling number but not a new finding. What is surprising is how little we know about how to prevent it. (Austin Frakt, 10/7)

The Philadelphia Inquirer: Vaping Bans Like Massachusetts’ Will Not Stop Illness Outbreak
Vaping-related illnesses have captured the attention of public officials and news media alike, and the evidence is alarming. According to the Centers for Disease Control and Prevention as of last Thursday, over 1,000 cases of lung injury associated with vaping products have been reported in the last few months, with most patients reporting that they used THC-containing products. Many cases are gruesome; one Mayo Clinic pathologist likened the injuries to those seen in people exposed to poisons like mustard gas. Though documented injuries and deaths have been climbing, the cause is not clear because the cases to date have not linked to a single product or substance. Though the CDC has cautioned those purchasing vaping products to avoid getting them from informal sources (or “off the street”), it is also possible that legal, regulated products are partly to blame. Simply put, we need more evidence. (Shaleen Title and Michael S. Sinha, 10/7)

Boston Globe: Governor Baker, Lift The Ban So Adults Can Vape
Two weeks ago, Governor Charlie Baker pushed through a ban on vaping. Although it applies only to those who sell e-cigarette supplies, and it’s for only four months, the net effect for most who vape is that they can no longer engage in the practice. Some are heading to New Hampshire for their supplies, and others might turn to the black market. But for the rest, vaping is no longer an option. (Tom Keane, 10/7)

Stat: Free-Trade Policies Contributed To The Opioid Overdose Epidemic 
To examine the connection between trade policies and opioid deaths, we analyzed county-level data from both the Department of Labor and the Centers for Disease Control and Prevention. As we wrote in the journal SSM ‑ Population Health, for every 1,000 people who lost their jobs in a county there was a 2.7% rise in opioid-related overdose deaths. After fentanyl entered regional heroin supplies in 2013, the same 1,000 trade-related job losses led to an 11.3% spike in overdose deaths.Statistics are complicated. We can’t say for sure that job losses are killing people. Yet it seems likely that there’s a relationship. Economists at Yale and the Federal Reserve Board showed a similar relationship between imports from China and overdose deaths. There is growing evidence that economic and social upheaval fundamentally fuel the opioid crisis. (Adam Dean and Simeon Kimmel, 10/8)

The Washington Post: I’m A Transgender Attorney Fighting For My Community. Will That Make A Difference To The Supreme Court?
The Supreme Court will hear arguments in three cases on Tuesday, each of which asks the court to decide whether it is legal under Title VII of the Civil Rights Act’s prohibition on discrimination because of sex to fire a worker because of the worker’s transgender status or sexual orientation. The case of Aimee Stephens, one of the three workers who were fired just because of their LGBTQ identity, is deeply personal to me. Like Aimee, I am transgender. And in the five months since the court agreed to hear R.G. and G.R. Harris Funeral Homes Inc. v. EEOC, I have lived and breathed this case. (Chase Strangio, 10/6)

The New York Times: It’s 2040. We Need To Keep Abortion Legal In New York.
As the New York legislature convenes this week to begin debate on S9764, I would like to offer my thoughts as a gynecologist who still provides that rarest of services, abortion. Our legal status is under threat, as our lives have been for decades. More important, the legislators pressing for the passage of this bill are dishonest in their motives and willfully blind to the consequences of its probable passage. (Lucy Ferriss, 10/7)

Stat: Time In Range: A New Blood Sugar Metric For People With Diabetes
With nearly 300 blood sugar measurements a day, CGMs offer a new way to evaluate how well an individual is controlling his or her diabetes: time in range. This is expressed as a percentage of the time an individual’s blood sugar is within the target values. This metric, recently endorsed by the American Diabetes Association and by an international consensus committee, correlates nicely with control of diabetes and the implied development of complications such as vision loss, kidney problems, and low blood sugar excursions. Greater time in range has been linked to more stable glucose control, which should lead to fewer complications. (Lorena Alarcon-Casas Wright, 10/8)

The Wall Street Journal: Got Oxygen?
Why do elite athletes get better by training at high altitudes and how do cancer tumors develop their own blood supply? The Nobel Prize in Physiology or Medicine on Monday was awarded to Americans William Kaelin Jr. and Gregg Semenza and Sir Peter Ratcliffe of Britain for their groundbreaking research that helps answer these and other questions behind many medical breakthroughs. ...We live in a great age of biological discovery that promises medical advances for decades if governments have the wit to allow it. This year’s Nobel is another illustration of how a better understanding of human physiology is improving medicine and lives. (10/7)

The Hill: Urgent Action Needed To Stop Preventable Deaths Of Children Around The World
Around the world, more children are surviving than ever before, according to a new report from an inter-agency group led by UNICEF and the World Health Organization (WHO). Deaths of children under the age of five have been nearly halved since 2000. Yet we still lost 5.3 million children under the age of five last year. More than 290,000 mothers also lost their lives during pregnancy or childbirth according to the latest estimates, which greatly increases the risk of their children dying. Let me take a moment to put that into perspective: 5.3 million is greater than the entire population of South Carolina. Put another way, 5.3 million children dying each year is equivalent to an airplane carrying 300 children crashing every 30 minutes, every day last year. Imagine if that happened?  (Cyril Engmann, 10/7)

The Washington Post: D.C. Is Awash In Illegal Guns. How Do You Think They Get There?
So far this bloody year, about 450 people have been hit by gunfire in the nation’s capital. They were executed, injured or they killed themselves, according to the incidents gathered by the Gun Violence Archive. Among the victims: 11-year-old Karon Brown, who was shot dead in Southeast Washington in July. Brothers Roy’Ale and Roy’Nal Hill, 12 and 13, who were injured in separate attacks; Roy’Nal was left paralyzed. Just this past weekend, a 14-year-old girl was wounded by bullets when she bent over to tie her shoe outside a grocery store in Shaw. (Petula Dvorak, 10/7)