Politico: Clashes Among Top HHS Officials Undermine Trump Agenda
President Donald Trump’s health secretary, Alex Azar, and his Medicare chief, Seema Verma, are increasingly at odds, and their feuding has delayed the president’s long-promised replacement proposal for Obamacare and disrupted other health care initiatives central to Trump's reelection campaign, according to administration officials. Verma spent about six months developing a Trump administration alternative to the Affordable Care Act, only to have Azar nix the proposal before it could be presented to Trump this summer, sending the administration back to the drawing board, senior officials told POLITICO. Azar believed Verma’s plan would actually strengthen Obamacare, not kill it. (Pradhan, Cancryn and Diamond, 11/26)

In other news on CMS, health insurance and enrollment —

Houston Chronicle: Risky Business: Buying Health Insurance In The New Age Of Deregulation 
While the full impact of dismantling prior rules is unknown, the Centers for Medicare and Medicaid predicted the number of people buying just one type of newly deregulated plans will rise from 86,000 last year to 1.6 million by 2022. Regulators and consumer advocates worry that unsuspecting buyers could be vulnerable to staggering medical bills because the coverage they were sold is insufficient. (Deam, 11/27)

Kaiser Health News: KHN’s ‘What The Health?’: How’s That Open Enrollment Going?
Open enrollment for 2020 health coverage under the Affordable Care Act is halfway over. So far, sign-ups appear to be lagging behind last year’s, but not dramatically. Meanwhile, President Donald Trump and Congress still say they want to do something about the teen vaping epidemic, the high cost of prescription drugs and “surprise” medical bills. But it’s Thanksgiving week, and official Washington has not much to show for any of those issues. (11/26)

Modern Healthcare: Medicare Wants Primary-Care Docs To Take On Financial Risk
The CMS on Monday announced that it's accepting applications for its Primary Care First alternative payment model. The pilot will allow providers that deliver primary-care services to take on financial risk for original, fee-for-service Medicare patients in exchange for less federal oversight and the opportunity to earn financial rewards. Under the new payment model, small primary-care practices can volunteer to accept full or partial risk for managing the care of beneficiaries of traditional Medicare who are seriously ill or have a chronic illness. The CMS will pay them a fixed monthly fee for each participating enrollee. (Brady, 11/25)

The Associated Press: Trump Order Creates Task Force On Missing American Indians
President Donald Trump signed an executive order Tuesday creating a White House task force on missing and slain American Indians and Alaska Natives. The task force will be overseen by Attorney General William Barr and Interior Secretary David Bernhardt. It will develop protocols to apply to new and unsolved case and create a multi-jurisdictional team to review cold cases. Trump called the scourge facing American Indian women and girls “sobering and heartbreaking.” (11/26)

The Star Tribune: Trump Signs Effort To Combat Problem Of Missing And Murdered Indigenous Women
The new Operation Lady Justice Task Force gets underway as states across the country are forming similar groups to address the long-standing problem. Minnesota Gov. Tim Walz signed off this year on a state-level task force to tackle the situation. Mille Lacs Band of Ojibwe Chief Executive Melanie Benjamin, who looked on as Trump signed the executive order, said having state and federal officials take up the issue at the same time creates a chance for key partnerships. The federal government, different levels of law enforcement and medical professionals need to work together, she said. (Van Berkel, 11/26)

Alaska Public Media: New Rural Alaska Law Enforcement Initiative Helps Nab Napakiak Sexual Assault Suspect
In October, Alexie Michael ran away from Napakiak after hearing that the U.S. Marshals Service had teamed up with local law enforcement to bring him into custody. First he fled into Bethel, then Anchorage and then to Palmer, where he was finally arrested on Nov. 19. Michael, age 65, faces seven counts of sexual assault in the first. A new initiative helped catch Michael. It’s called the Rural Alaska Anti-Violence Enforcement Working Group, or RAAVEN for short. Deputy U.S. Marshal Rochelle Liedike says that the group was created after U.S. Attorney General William Barr released funding earlier this year. (Shallenberger, 11/22)

Iowa Public Radio: In Absence Of Prominent Activist, Native Americans To March For Children Lost To Foster Care
Members of the Native American community will march Wednesday in Sioux City to honor Native children who have died in foster care or are lost to the system. But after a prominent local activist died earlier this year, the community is looking to fill the void he left behind. (Peikes, 11/26)

CBS News: Supreme Court Abortion Lawsuit: Opening Brief Filed By Center For Reproductive Rights In June Medical Services V. Gee Monday
The lawsuit that will decide the future of abortion access in Louisiana – and the rest of the country – is officially underway. A 63-page opening brief was filed late Monday night by the Center for Reproductive Rights (CRR) in a Supreme Court case that could leave Louisiana without access to legal abortion and provide a roadmap for other anti-abortion access states to follow. (Smith, 11/26)

The Hill: Supreme Court Sets Date For Louisiana Abortion Case 
In February, the court ruled to prevent the law from taking effect while it faces a legal challenge. Chief Justice John Roberts joined the liberal justices in this decision, but it is unclear whether he would vote to block the law permanently. A similar law in Texas was struck down 5-3 in 2016, but Roberts voted to uphold that law at the time. Justice Anthony Kennedy has retired since then. (Frazin, 11/26)

New Orleans Times-Picayune: Save The Date: U.S. Supreme Court To Hear Major Louisiana Abortion Case March 4
Reproductive rights advocates argue the 30-mile rule is not medically necessary because abortion is a low-risk procedure. They further argue the law is one of several restrictions passed with the intent of reducing abortion access. (Poche, 11/26)

The Associated Press: US Judge Bars Trump’s Health Insurance Rule For Immigrants
A U.S. judge in Oregon on Tuesday granted a preliminary injunction blocking a Trump administration proclamation that would require immigrants to show proof of health insurance to get a visa. U.S. District Court Judge Michael Simon said in a written opinion that the proclamation could not take effect while a lawsuit challenging its constitutionality makes its way through the courts. (Flaccus, 11/26)

Politico: Judge Halts Trump's Insurance Mandate For Immigrants
Simon noted that the requirement that immigrants buy unsubsidized insurance — meaning they couldn't get financial assistance through Obamacare — barred poor people from entering the country, which he said clearly infringed on the law. "The proclamation is anticipated to affect approximately 60 percent of all immigrant visa applicants," the judge wrote. "The president offers no national security or foreign relations justification for this sweeping change in immigration law." (Luthi, 11/26)

The Oregonian: Federal Judge Blocks President Trump From Restricting Visas For Immigrants Without Health Insurance 
“As the text of Article I and more than two centuries of legislative practice and judicial precedent make clear, the Constitution vests Congress, not the President, with the power to set immigration policy,’’ the judge wrote in a 48-page ruling. Simon also cited the 2018 U.S. Supreme Court ruling in Trump v. Hawaii, which said Congress may delegate certain powers to the president, but the president may not execute those powers in a way that “expressly override (s) particular provisions’’ of the immigration act. (Bernstein, 11/26)

The Hill: Judge Halts Trump Immigrant Insurance Mandate 
The judge also dismissed the government’s argument that migrants would not suffer irreparable harm because their family members’ visas will only be “delayed,” noting that the proposal could prevent some immigrants from entering the country and thus separating families. (Axelrod, 11/26)

Reuters: U.S. Prosecutors Open Criminal Probe Of Opioid Makers, Distributors
Federal prosecutors are investigating six pharmaceutical companies for potential criminal charges in connection with shipping big quantities of opioid painkillers that contributed to a healthcare crisis, according to regulatory filings. Five companies have received subpoenas from the U.S. Attorney's office in the Eastern District of New York as part of the investigation: drugmakers Teva Pharmaceutical Industries Ltd, Mallinckrodt Plc, Johnson & Johnson and Amneal Pharmaceuticals Inc, and distributor McKesson Corp, regulatory filings showed. (11/26)

The Wall Street Journal: Federal Prosecutors Launch Criminal Probe Of Opioid Makers, Distributors
The investigation, if it results in criminal charges, could become the largest prosecution yet of drug companies alleged to have contributed to the opioid epidemic, escalating the legal troubles of businesses that already face complex, multibillion-dollar civil litigation in courts across the country. Prosecutors are examining whether the companies violated the federal Controlled Substances Act, a statute that federal prosecutors have begun using against opioid makers and distributors this year. (Ramey, 11/26)

Bloomberg: Opioid Makers, Distributors Investigated By U.S. Prosecutors 
U.S. prosecutors in Brooklyn are looking into whether companies violated the Controlled Substances Act, which regulates how companies manufacture, import, possess and distribute certain substances that have the potential for abuse, including opioid painkillers, according to the filings. (Griffin and Flanagan, 11/26)

In other news on the opioid epidemic —

Reuters: Judge Partly Vacates Convictions Of Opioid Maker Insys' Founder, Executives
A federal judge on Tuesday partially overturned the convictions of Insys Therapeutics Inc's founder and three former executives accused of bribing doctors to prescribe an addictive opioid, but declined to disturb the remainder of the jury's verdict. U.S. District Judge Allison Burroughs in Boston ruled the evidence prosecutors presented at trial did not support finding that John Kapoor and the others intended for doctors to prescribe the drug, Subsys, to patients who did not need it. (Raymond, 11/26)

Los Angeles Times: Are Drug-Addicted Mothers Liable For Babies’ Deaths?
[Chelsea] Becker is at the center of a legal and ethical debate over the criminalization of drug abuse and pregnancy that’s playing out across the country. Legal experts have raised questions about how the justice system is policing women’s bodies and treating mothers who struggle with addiction. California’s penal code defines murder as the unlawful killing of a human being or unborn child. The statute was amended to include the word “fetus” in 1970. Legislators made the change after the state Supreme Court overturned the conviction of a Stockton man charged with murder for beating his estranged pregnant wife and causing her to lose the baby. (Wigglesworth, 11/26)

The Associated Press: Trump Donates 3rd-Quarter Salary To Help Fight Opioid Crisis
President Donald Trump is donating his third-quarter salary to help tackle the nation’s opioid epidemic. A White House official says Trump has given the $100,000 he would be paid in the quarter to the Office of the Assistant Secretary of Health, which oversees federal public health offices and programs, including the surgeon general’s office. (Miller, 11/26)

The Washington Post: The Post Released The DEA’s Data On Pain Pills. Here’s What Local Journalists Are Using It For.
On July 18, The Washington Post made publicly accessible part of a Drug Enforcement Administration database that tracked the path of every pain pill sold in the United States between 2006 and 2012. Since then, we have registered more than 38,000 downloads of the data, in whole or in part, and over 550 messages from local journalists, educators, researchers, federal and local government workers, health-care professionals, volunteers, advocates and citizens. Our hope in releasing the data was that local reporters, in particular, would use it to tell stories about the impact of the opioid crisis in their communities. (Sanchez Diez, 11/26)

Stat: How Difficult Is A $1 Billion Health-Tech Fraud? 
Building a health-technology startup on nothing but hot air may be easier than you’d think — at least, according to a federal indictment unsealed Monday and related civil charges brought by the Securities and Exchange Commission. Federal prosecutors charge that executives at Outcome Health, a high-flying startup, are guilty of defrauding their clients, lenders, and investors, leading to nearly $1 billion in fraudulently obtained investments and debt. The SEC made its own complaint, alleging that Outcome raised $487 million by falsely portraying itself as a success to its investors, which included Goldman Sachs, Google-affiliated CapitalG, and the Pritzker Group. (Herper, 11/26)

In other health industry news —

Bloomberg: MiMedx’s Petit Charged With Fraud Exposed By Short-Sellers 
MiMedx Group Inc. was going to be Parker H. Petit’s last act -- the final chapter of a long career building and selling health care companies. For years, the maker of skin grafts repeatedly beat its quarterly revenue targets. Its market value briefly touched $2 billion. At its headquarters in Marietta, Georgia, rumors swirled about an eventual sale to a bigger rival. (Melin, Van Voris and Dolmetsch, 11/26)

Bloomberg: J&J Fails To Get $70 Million Risperdal Award Tossed On Appeal 
A Pennsylvania appeals court upheld a $70 million verdict against Johnson & Johnson in a lawsuit charging its Risperdal anti-psychotic drug caused a man to grow female breasts and also ruled that punitive damages may be available in the case. In addition to upholding the verdict for Tennessee resident Andrew Yount, the Pennsylvania Superior Court Tuesday sent back to the Philadelphia trial judge the issue of punitive damages in the case, potentially raising the stakes for J&J. The company was hit last month with $8 billion in punitive damages in another Philadelphia Risperdal case. (Feeley, 11/26)

Stateline: More Kids On Medicaid To Get Health Care In School 
Children who have high blood pressure or are obese perform worse academically than others. Children with asthma miss far more school. Students who have healthy diets, who are physically active, who abstain from alcohol and illicit drugs, get better grades. With that in mind, more than a dozen states are finally taking advantage of a five-year-old federal policy change that would make it easier for schools to provide health care to millions of children across the country. (Ollove, 11/27)

Modern Healthcare: 46,000 Kicked Off Louisiana Medicaid Rolls For Ineligibility
More than 46,000 people lost their Medicaid coverage this month, because they didn't respond to letters warning they didn't appear eligible for the government-financed insurance. The removals came as the state health department resumed a process that automatically kicks people off Medicaid if they don't respond to annual renewal information requests. Enrollees had until Oct. 31 to maintain coverage if they could prove eligibility. (11/26)

New Hampshire Public Radio: N.H. Will Apply For Waiver To Loosen Restrictions On Medicaid Mental Health Spending
State health officials say they are planning to apply for a waiver from the federal government that would loosen restrictions on how Medicaid dollars could be spent on mental health treatment in New Hampshire. Federal law currently prohibits the use of Medicaid dollars to pay for mental health care at facilities with more than 16 beds, to prevent the so-called “warehousing” of mental health patients with public funds. (Moon, 11/26)

The Post Register: Student Activists Express Gratitude For BYU-Idaho Medicaid Reversal
Brigham Young University-Idaho’s decision to accept Medicaid as acceptable insurance to waive to student health plan came as a relief to the students who had been pushing their university to do just that. “I’m excited, and ... I’m super grateful,” said Amanda Emerson, a senior who helped to organize her fellow students’ push back against BYU-Idaho’s decision earlier this month to no longer accept Medicaid. “A lot of other students are still upset and still want to know the truth, but I think for me, I’m just glad they made the right decision. It took a lot of pride to swallow.” (Brown, 11/26)

Modern Healthcare: Telemedicine Sees 17% Growth In Veteran Population
More than 900,000 veterans used telemedicine services from the U.S. Department of Veterans Affairs in fiscal 2019, up 17% from the previous year, the agency announced Friday. The VA has been bolstering its telemedicine services in recent years, introducing new avenues for virtual care and proposing a federal rule to ease licensing restrictions for providers. (Cohen, 11/25)

WBUR: Department Of Veterans Affairs Thinks Telehealth Clinics May Help Vets In Rural Areas
About 5 million vets live in rural America and when it comes to health-care, there can be both literal and logistical obstacles. The Department of Veterans Affairs thinks telehealth clinics may help. (Price, 11/25)

Kansas City Star: VA Secretary Says Veterans Exposed To Toxins Might Get Help
A new study into whether military toxic exposures cause cancer and other illnesses could make it easier for veterans to get their medical expenses covered, the U.S. Department of Veterans Affairs secretary said Monday in Kansas City. (Gutierrez, 11/25)

The Associated Press: Navy Veteran May Have Been Dead In Apartment For 3 Years
Doris Stevens’ son, a Navy veteran who traveled the world for work and pleasure, suddenly stopped answering her phone calls in 2016. Stevens said she spent years trying to find out what happened, appealing to authorities to no avail. Earlier this month, Stevens received a grim answer when maintenance workers found Ronald Wayne White dead on the floor of his apartment in a Dallas suburb. (11/25)

Stat: New CDC Report Offers A Possible Clue About Why Vaping Illnesses Sprang Up In 2019
A new report adds to the evidence that vitamin E acetate might play a role in a spate of vaping-related illnesses that have sickened thousands. It could also offer an early clue about why the illnesses appeared seemingly suddenly this year — though experts caution it’s too soon to rule out other potential culprits. The chemical — used as an additive or thickener in some vaping products — was found in vaping products used by 11 of 12 patients sickened with vaping-related illness in Minnesota, the Centers for Disease Control and Prevention reported Tuesday. (Thielking, 11/26)

The Associated Press: More Clues Point To Chemical Compound In US Vaping Illnesses
Health officials said Tuesday they have more evidence that a certain chemical compound is a culprit in a national outbreak of vaping illnesses. Researchers analyzed black market vaping cartridges seized in Minnesota during the outbreak this year, and vaping liquid seized in that state last year. The newer cartridges contained the compound vitamin E acetate, but none of the older samples did. (Stobbe, 11/26)

The Wall Street Journal: Researchers Say FDA Has Fallen Down On E-Cigarette Testing
The Food and Drug Administration has come under fire for not moving quickly to address the health risks of e-cigarettes, but outside the public spotlight it is also under attack for not prioritizing study of whether those vaping products may well be an important way to reduce deaths from traditional smoking. More than 480,000 Americans die each year from causes related to cigarette smoking. Some leading academic researchers believe e-cigarettes may be an effective and safer alternative. (Burton, 11/27)

The Star Tribune: Minnesota Investigation Points To Vitamin E's Role In Vaping Lung Injuries 
Lab tests performed in Minnesota on illicit THC vaping products have solidified the role of vitamin E acetate in an outbreak of severe lung injuries among e-cigarette users across the nation this year. The tests found vitamin E in illicit vaping products that were seized by Minnesota law enforcement agencies in 2019, at the height of the outbreak, but not in products seized in 2018, before the outbreak, the Minnesota Department of Health reported on Tuesday. (Olson, 11/26)

The Associated Press: New York City Lawmakers Vote To Ban Flavored Vaping Products
New York City lawmakers voted Tuesday to ban flavored electronic cigarettes after a lawsuit halted a statewide ban. “We are acting to protect our kids by banning the e-cigarette flavors that have been hooking them for years,” Democratic City Council member Mark Levine said before the Council voted 42-2 to adopt the ban on flavored vaping products. (11/26)

The Wall Street Journal: New York City Bans Flavored E-Cigarettes
The council’s proceedings were briefly interrupted by pro-vaping protesters who shouted and threw $1 bills at council members, accusing them of bending to tobacco companies that the protesters have said will benefit from the ban. Councilman Mark Levine, the bill’s primary sponsor and chairman of the committee on health, said at a news conference, that the nation has been “woefully slow” in responding to the teen vaping epidemic. Mr. Levine acknowledged that underage people are already prohibited from buying e-cigarette products, but those age restrictions haven’t kept children from vaping. (West, 11/26)

Bloomberg: NYC Lawmakers Ban Flavored E-Cigarettes After Trump Wavers 
The Council’s action came after President Donald Trump reversed an earlier vow to ban flavored vapes, saying that doing so would encourage a black market with unregulated and unsafe products. Also this month, the Massachusetts legislature approved a law that would make it the first state to ban all flavored tobacco products, including menthol, and imposing a 75% tax on the wholesale price of all nicotine vaping products. (Goldman, 11/26)

The Associated Press: DC Government Sues E-Cigarette Maker Juul Over Teen Use
The District of Columbia is joining several states in suing the nation’s largest e-cigarette maker Juul Labs, saying the company’s online ads and promotions illegally targeted minors. Washington, D.C., Attorney General Karl Racine announced the lawsuit Tuesday, alleging that Juul’s viral marketing contributed to the surge in underage vaping by teens in the district and across the U.S. (Perrone, 11/26)

The Washington Post: D.C. Sues Juul, Alleging E-Cigarette Maker Marketed To Teens
Vaping has exploded in popularity in recent years, including among teenagers, and has raised alarms in schools and among anti-tobacco advocates. “There is a teenage vaping epidemic, and usage levels are spiking at an unprecedented rate, which importantly is reversing a decades-long decline in smoking rates among young people,” Racine said in an interview. (Nirappil, 11/26)

The Hill: District Of Columbia Sues Juul Over Alleged Underage Marketing 
Under pressure from Congress and federal and state investigators, Juul has halted its advertising and removed most of its flavors from the market. It recently removed its CEO, and replaced him with a former executive from Altria, the tobacco company that owns a 35 percent stake in Juul. (Weixel, 11/26)

The CT Mirror: As Federal Effort To Ban Flavored Vaping Products Stalls, Advocates Look To State
Frustrated by the Trump administration’s retreat from a pledge to ban flavored vaping products at the federal level, anti-tobacco advocates are doubling down on a push to enact a statewide prohibition in Connecticut. (Carlesso, 11/27)

The New York Times: It’s Not Just Poor White People Driving A Decline In Life Expectancy
As the life expectancy of Americans has declined over a period of three years — a drop driven by higher death rates among people in the prime of life — the focus has been on the plight of white Americans in rural areas who were dying from so-called deaths of despair: drug overdoses, alcoholism and suicide. But a new analysis of more than a half-century of federal mortality data, published on Tuesday in JAMA, found that the increased death rates among people in midlife extended to all racial and ethnic groups, and to suburbs and cities. (Kolata and Tavernise, 11/26)

The Washington Post: U.S. Life Expectancy: Americans Are Dying Young At Alarming Rates
Despite spending more on health care than any other country, the United States has seen increasing mortality and falling life expectancy for people age 25 to 64, who should be in the prime of their lives. In contrast, other wealthy nations have generally experienced continued progress in extending longevity. Although earlier research emphasized rising mortality among non-Hispanic whites in the United States, the broad trend detailed in this study cuts across gender, racial and ethnic lines. By age group, the highest relative jump in death rates from 2010 to 2017 — 29 percent — has been among people age 25 to 34. (Achenbach, 11/26)

Los Angeles Times: Suicides, Overdoses, Other 'Deaths Of Despair' Fuel Drop In U.S. Life Expectancy
In an editorial accompanying the new report, a trio of public health leaders said the study’s insight into years of cumulative threats to the nation’s health “represents a call to action.” If medical professionals and public health experts fail to forge partnerships with social, political, religious and economic leaders to reverse the current trends, “the nation risks life expectancy continuing downward in future years to become a troubling new norm,” wrote Harvard public health professors Dr. Howard K. Koh, John J. Park and Dr. Anand K. Parekh of the Bipartisan Policy Center in Washington, D.C. (Healy, 11/26)

Meanwhile —

The New York Times: Fertility Rate In U.S. Hit A Record Low In 2018
The fertility rate in the United States fell in 2018 for the fourth straight year, extending a steep decline in births that began in 2008 with the Great Recession, the federal government said on Wednesday. There were 59.1 births for every 1,000 women of childbearing age in the country last year, a record low, according to the National Center for Health Statistics. The rate was down by 2 percent from the previous year, and has fallen by about 15 percent since 2007. (Tavernise, 11/27)

The Washington Post: Why Romaine Lettuce Keeps Getting Recalled For E. Coli Contamination
Once again, just in time for Thanksgiving, millions of people have been told their romaine lettuce might be contaminated with a toxic strain of E. coli bacteria, that it’s potentially deadly, and that they should throw it away immediately and sanitize the fresh-produce drawer of their refrigerator. No one knows why this is happening, exactly. There are inferences, speculation and intriguing clues, but the best minds of the U.S. government, the lettuce-growing states of California and Arizona, and the leafy greens industry have failed to figure out why romaine keeps getting contaminated — or how they can stop it from happening again and again. (Kindy and Achenbach, 11/26)

The New York Times: C.D.C. Reports More E. Coli Illnesses Linked To Romaine Lettuce
The Centers for Disease Control and Prevention said Tuesday that it had identified 27 more people who were ill from the recent outbreak of E. coli infection linked to romaine lettuce from Salinas, Calif., bringing the total number of reported cases to 67. The C.D.C. reported no fatalities but said the outbreak affected 19 states, up from 16 on Friday, and resulted in a total of 39 people being hospitalized, up from 28. Six people also had developed hemolytic uremic syndrome, a type of kidney failure, according to the agency. (Dahir, 11/26)

CNN: Romaine Lettuce Recall: 67 E. Coli Infections Across 19 States Are Linked To Romaine Lettuce, CDC Says
"Look for a label showing where the romaine lettuce was grown. It may be printed on the package or on a sticker," the CDC said. "If the label says 'grown in Salinas' (whether alone or with the name of another location), don't eat it. Throw it away." And if the lettuce doesn't have labeling information on it, don't eat it, said Frank Yiannas, FDA's deputy commissioner for food policy and response. "Restaurants and retailers should not serve or sell romaine lettuce if they cannot confirm it is from outside Salinas," he said. (Maxouris, 11/27)

The Oregonian: E. Coli Outbreak Spreads To Oregon; Beware Bloody Diarrhea, Officials Say 
Oregon Health Authority spokesman Jonathan Modie declined to provide any details about the Oregon case, citing the fact that the investigation is ongoing. Generally, he said, the state works with county health departments and the Centers for Disease Control to interview victims and try to figure out what made them sick. (Zarkhin, 11/26)

The New York Times: Holiday Eating Got You Anxious?
The holiday season is typically an indulgent time, especially when it comes to food and drink consumption. For people who struggle with body-image issues, food and weight-related health problems, including and especially eating disorders, this time of year can be stressful. We spoke with experts to offer tips that can help you navigate the season and its attendant anxieties: the meals, the parties and the people. (Kerr, 11/27)

NPR: How To Keep Stress Over Food Allergies Off The Menu At Thanksgiving
Out of all the Thanksgiving dishes Kim Yates has helped prepare for her large family over the years, one batch of mashed potatoes stands out clearly in her memory. About 30 guests were gathered that year, at her sister's home in Palo Alto, Calif., and Yates had made a point of taking on responsibility for the mashed potatoes so that her young daughter Tessa (who was dealing with extreme food allergies to eggs, dairy, wheat, peanuts, tree nuts and shellfish) would have at least one safe side dish to eat. (Vaughn, 11/27)

The New York Times: Don’t Get Mad, But ‘Hangry’ Isn’t Really Angry
The morning walk before a holiday meal can feel like an act of advance penance: a show of restraint before the feast, best performed under a pale sun, amid a lonely scatter of leaves and with a determination to keep the campfire in sight. March off too slowly — or too far — and you’ll only annoy the other pilgrims, who likewise skipped breakfast to save room for the banquet. Scientists have only recently begun to explore the emotional and social effects of acute hunger. (Carey, 11/27)

The New York Times: Eating After You Exercise May Provide Added Fat-Burning Benefits
Working out on an empty stomach could amplify the health benefits of the activity, according to a well-timed new study of the interplay of meal timing, metabolic health and moving. The study, which involved sedentary men and moderate cycling, suggests that whether and when we eat may affect how exercise affects us. In general, any exercise improves our health. But a wealth of recent science and personal experience indicate that different people can respond to similar exercise routines in different ways. (Reynolds, 11/27)

The New York Times: Fresh-Food Vending Machines Will Be Graded Like Restaurants
On Oct. 30, an inspector from the New York City Department of Health and Mental Hygiene was making her rounds when she came across a vending machine unlike any she seen before. Called Farmer’s Fridge, it was made of washed white wood, with a giant touch screen and a built-in recycling bin. Inside was not the usual candy and soda, but tall jars packed with salad greens, Thai noodle and falafel bowls, and yogurt parfaits. What might look like a convenient healthy-eating option to many people looked to the inspector like a food-safety time bomb waiting to blow. (Black, 11/26)

Stat: With Ketamine, Researchers Rewrite Memories In Bid To Curb Drinking
Our memories are immensely powerful. For a person with alcohol use disorder, a memory triggered by a simple cue — like walking by a favorite bar or spotting a beer billboard — can drive a desire for a drink. But they’re also surprisingly pliable. And scientists are trying to curb harmful drinking by dredging up memories and rewriting them — with the help of a dose of ketamine, a longtime anesthetic which is also used recreationally and to treat certain mental health conditions. (Thielking, 11/26)

Stat: Why The Surge In EEE Cases? Rules On Samples Mean We May Never Know
A massive surge in human cases of Eastern equine encephalitis this autumn has raised urgent questions about whether the dangerous virus has changed. But federal regulations that are leading most states to quickly destroy any positive EEE samples they find will stymie future efforts to come up with any answers, worried arbovirus experts warned. The World Reference Center for Emerging Viruses and Arboviruses has been trying to amass specimens from this year’s EEE outbreak to place in its repository, the world’s largest and a resource from which researchers worldwide draw. (Branswell, 11/27)

The Associated Press: 1 Year Later, Mystery Surrounds China’s Gene-Edited Babies
Chinese scientist He Jiankui shocked the world by claiming he had helped make the first gene-edited babies. One year later, mystery surrounds his fate as well as theirs. He has not been seen publicly since January, his work has not been published and nothing is known about the health of the babies. "That's the story — it's all cloaked in secrecy, which is not productive for the advance of understanding," said Stanford bioethicist Dr. William Hurlbut. (11/26)

The New York Times: Does Who You Are At 7 Determine Who You Are At 63?
On a brisk Saturday morning, one uncommonly cloudless and bright for late autumn on England’s moody North Sea coast, the filmmaker Michael Apted paced a sloping headland of mud and stubble with an air of fretful preoccupation. Though the day’s shoot would amount, in the end, to an additional five-minute increment of the documentary project that had intermittently consumed the entirety of his working life, these occasions never ceased to surprise and unnerve him. He had known Jackie, whose arrival was imminent, for 56 years, but her interviews could be volatile, and this one was particularly important, he felt, to get right. (Lewis-Kraus, 11/27)

The New York Times: For Millennials Making Their Way, A Detour: To Caregiving
In the summer of 2017, soon after starting a new job, Ariel Brandt Lautman took her two young children to Denver to visit her mother. This wasn’t purely a social call. Her mother’s memory had been deteriorating for several years, and Ms. Brandt Lautman, who lives in Silver Spring, Md., needed to plan for her care. Ms. Brandt Lautman was 35 at the time, considerably younger than the typical caregiver. Each day was a juggling act. She worked from sunrise to 2 p.m., taking a break to drive her 5-year-old son and 3-year-old daughter to camp. (Garland, 11/27)

The New York Times: What Are The Benefits Of Probiotics?
Walk into a health food store, or even a drugstore, and you’re likely to find an entire aisle, maybe two, dedicated to probiotics. Probiotics are live micro-organisms, usually bacteria, that provide health benefits when consumed at appropriate doses. According to some surveys, approximately four million Americans take probiotics, which are available as pills, powders, foods and drinks. Probiotics are a huge industry — at least a $40 billion dollar one, according to Zion Market Research — and popular brands sell for 35 cents to $1 a dose, with a shelf life of several months. (Moyer, 11/27)

The Washington Post: A German Man Died From Bacteria In His Dog’s Saliva
The 63-year-old man showed up in the hospital with a burning sensation in his left leg and muscle pain in both. His flulike symptoms were severe, with labored breathing for three days. He had petechiae, or rounds spots on the skin that look like rashes as a result of bleeding capillaries, which made his legs look discolored. The patient’s heartbeat was stable, doctors said, even though he was running a temperature of 102. His labored breathing caused an inadequate supply of oxygen to his tissue. His failing kidneys were not producing urine, researchers wrote. (Beachum, 11/26)

The Associated Press: Hospital: Kidney Went To Wrong Transplant Patient
A New Jersey hospital says a kidney meant for one patient was mistakenly transplanted into another with the same name who was farther down the priority list. Virtua Health says the Nov. 18 operation on a 51-year-old patient at Virtua Our Lady of Lourdes Hospital in Camden was successful. But officials then discovered the patient was given the kidney out of priority order because “unusually, the individual who should have received the organ has the same name and is of similar age.” (11/27)

The Baltimore Sun: Legislators Concerned About Auditor’s Complaints That University Of Maryland Medical System Is ‘Hindering’ His Probe 
Maryland lawmakers say they’re concerned and closely monitoring the University of Maryland Medical System’s behavior after the state’s top legislative auditor said the hospital network was “hindering” his work. Some legislative leaders, including the sponsors of sweeping reform legislation passed this year after a self-dealing scandal at UMMS, say more bills could be needed if the hospital network refuses to comply with the state audit. (Broadwater and Rector, 11/27)

The CT Mirror: Watchdog Organization Calls For 'Drastic Change' At Whiting Forensic Hospital
A report released Tuesday morning by a disability rights advocacy group found “widespread systemic deficiencies” at Whiting Forensic Hospital and called on state lawmakers to “enact immediate reforms” to protect the safety and rights of patients at Whiting and Connecticut Valley Hospital. It isn’t the first investigation of the state-run maximum security psychiatric hospital to conclude there’s a need for systemic improvements. (Lyons, 11/26)

Boston Globe: Brigham And Women’s To Launch Center For Research On Rare Liver Disease
Brigham and Women’s Hospital said that it is launching a first-in-the-nation center to undertake research into primary sclerosing cholangitis, a rare chronic liver disease that can only be treated effectively by a liver transplant. The new center, under the direction of Dr. Joshua Korzenik, will take a multipronged approach to finding new treatments for the disease, which affects about 30,000 people in the United States, most of them young men, hospital officials said in a statement. (Finucane, 11/26)

Seattle Times: Before Mea Culpa, Children’s Was Confident Its Air Systems Weren’t Source Of Infection 
Children’s repeated struggles to eradicate mold from its operating rooms have forced it to reschedule or delay surgeries, opened it to new litigation and put a cloud over the reputation of the esteemed pediatric hospital. But the hospital’s disclosures raise questions that executives so far have declined to answer in detail. After infections spanning 18 years and allegations implicating its air-handling system, why has the hospital only now reached this conclusion? Why didn’t the hospital install the superior quality air filters – currently used for three of its operating rooms – for all of them before now? (Gilbert and Gutman, 11/26)

California Healthline: Coping With (Power) Loss: California’s Hospitals, Clinics, Patients Face New Reality
We all know that when the power goes out, refrigerators, heaters and air conditioners stop running. Homes go dark, and desktop computers shut down. But those are mere inconveniences. If you need regular dialysis or chemotherapy at a clinic, or you have an infant in a neonatal intensive care unit or a loved one on a hospital ventilator, a loss of power carries far more dire implications. (Kreidler, 11/26)

The New York Times: FEMA’s Hurricane Aid To Puerto Rico And The Virgin Islands Has Stalled
More than two years after back-to-back hurricanes ravaged this tropical island, medical workers are still treating gunshot wounds in hallways and kidney failure in a trailer. They ignore their own inflamed rashes that they say are caused by the mold that has shut down an entire hospital floor below a still-porous roof. At least they have a hospital. The lone medical center on Vieques, an idyllic island that is part of Puerto Rico, was severely damaged by Hurricanes Maria and Irma, then abandoned to wandering roosters and grazing horses. Ailing people wait at the ferry dock to catch a boat to the mainland. (Walker and Kanno-Youngs, 11/27)

The Baltimore Sun: Long-Serving Chief Of Maryland Medical Examiner’s Office Steps Aside Amid High Death Toll 
As homicides and drug-related deaths continue their years-long rampage, Maryland’s long-serving and well-regarded chief medical examiner said he plans to leave his post. Dr. David Fowler has led the Office of the Chief Medical Examiner for the past 17 years, and confirmed to The Baltimore Sun that he will step down by the end of the year. Fowler said resource challenges related to the opioid epidemic was a factor in his decision. (Cohn and Fenton, 11/26)

NH Times Union: Manchester Resident Asks Questions After Seeing VA Employee, Homeless Man Near Her Home
A resident in a Manchester neighborhood said she was shocked last week to see a Veterans Affairs worker drop off a homeless man and allegedly try to help him set up camp in nearby woods. Officials said they later took the man to an emergency shelter. The homeowner said the two discontinued their effort once she started asking questions and pointing out they were on private property. The incident took place last Wednesday on the portion of Smyth Road east of Mammoth Road, about a quarter-mile from the Manchester VA Medical Center. (Hayward, 11/26)

MPR: Shortage Of Home Care Workers In Minn. Affecting People With Disabilities
The Americans with Disabilities Act of 1990 gives people with disabilities the right to live in a community if that is where they want to live. However, high turnover rates and a large percentage of unfilled home care jobs are forcing people into institutions such as nursing or group homes. (Scheffler, 11/26)

The Washington Post: About One Out Of Every Three Washingtonians Say They Or Someone They Know Have Experienced Gun Violence, Poll Finds
Nearly half of Washingtonians in the city’s poorest neighborhoods say they or someone they know has been threatened with a gun or shot in the past five years, a Washington Post poll finds. Across the city, about a third of District residents say they or someone they know has been menaced or been the victim of gun violence since 2014, even as a large majority of Washingtonians say they feel safe in their neighborhoods. (Schwartzman and Guskin, 11/26)

Health News Florida: State Fights Cities, Counties On Gun Law
Pointing to a “hierarchical relationship” with local governments, the state late Friday asked an appeals court to uphold a 2011 law that has threatened tough penalties if city and county officials approve gun regulations. Lawyers in the offices of Attorney General Ashley Moody and Gov. Ron DeSantis filed a 42-page brief arguing that the 1st District Court of Appeal should overturn a circuit judge’s ruling that said parts of the law were unconstitutional. (Saunders, 11/22)

Milwaukee Journal Sentinel: Student Suicides In Greenfield Raise Issues Of Bullying, Mental Health
Research shows there are effective programs school districts can use to reduce bullying and offer mental health support — not all of which have been tried in Greenfield. Superintendent Lisa Elliott said staff "diligently work to be proactive" and are considering at least one such program. School leaders called a community meeting Monday night, closed to media, to discuss next steps. (Linnane, 11/26)

Kansas City Star: Over 6,000 Untested Sexual Assault Kits Found In Missouri
Jackson County has the highest number of untested sexual assault kits in the state, with more than 2,300 kits stored at area police departments and health facilities, a report from the Missouri attorney general’s office said. The report identified a total of 6,157 kits across the state that were collected before April 30, 2018, but had never been tested. (Moore, 11/27)

Atlanta Journal-Constitution: Critics: Reforms Not Enough To Ensure Better Ambulance Service
Some of Georgia’s most influential leaders in emergency medical services, as well as patient advocates, are pushing for more dramatic reforms to a state proposal affecting the hiring of ambulance providers. The proposal, expected to take effect Dec. 9, is a first step to EMS reforms that are long overdue, said Bud Owens, chairman of an advisory committee of state EMS leaders that makes recommendations to the state. (Berard, 11/27)

Cleveland Plain Dealer: Summit County Public Health Awarded $2.48 Million To Address Infant Mortality Rates Among African-American Families In Akron Area
Summit County Public Health has been awarded $2.48 million to support programs to reduce infant mortality rates in the Akron area, particularly among African-American families. The Ohio Department of Medicaid and the Ohio Medicaid Managed Care Plans awarded the grant for health officials to continue initiatives to eliminate poor birth outcomes and infant deaths in Akron and Summit County for two years beginning Jan. 1, 2020. (Goist, 11/26)

Los Angeles Times: Trump Has Limited Options To Combat Homelessness In Los Angeles
Although the White House has vowed to take action to combat homelessness in Los Angeles and other cities, President Trump’s options are limited without cooperation from the courts, Congress and local and state governments. Administration officials have floated a range of potential plans — including using police to clear skid row and other encampments, reducing regulations for building new housing, and increasing temporary shelter space by making federal facilities available or erecting temporary structures. (Bierman, 11/26)

Cleveland Plain Dealer: Grants To Ohio Crime Victim Assistance Programs Cut By More Than $10 Million As Federal Fund Shrinks
More than $10 million in cuts to programs that serve victims of crime in Ohio means some local domestic violence survivors won’t have an advocate by their side in court next year and newly-created centers to address trauma will be able to offer fewer supports. Deposits to a federal fund to help crime victims, established 35 years ago by the Victims of Crime Act, commonly referred to as VOCA, have plummeted in recent years, meaning less money is being passed down to states, which distribute grants to local agencies that provide advocacy, therapy and other support. (Dissell, 11/26)

The Washington Post: Maryland Records Lowest Number Of New HIV Cases In More Than 30 Years
For the first time in more than three decades, the state of Maryland recorded fewer than 1,000 new cases of HIV infection in 2018. The state Department of Health announced on Tuesday that 997 new cases of HIV were reported in Maryland last year. That’s the lowest since 947 people learned they’d contracted the virus in 1986, just five years after the state’s first reported HIV case. (Zauzmer, 11/26)

Miami Herald: Eye Specialist Sued Again Over Retinoblastoma Treatment
Last week, Alvarenga filed suit against Murray, Nicklaus Children’s and neuro-oncologist Ziad Khatib, alleging malpractice in the treatment of her son, Jayden, 6, whose treatment for metastasized cancer continues as he struggles to complete the first grade. It was the third such suit filed by parents in similar cases. The previous lawsuits were filed last year and have not yet been resolved. All of the families share the same attorney. (Conarck, 11/27)

Milwaukee Journal Sentinel: Student Suicides In Greenfield Raise Issues Of Bullying, Mental Health
Research shows there are effective programs school districts can use to reduce bullying and offer mental health support — not all of which have been tried in Greenfield. Superintendent Lisa Elliott said staff "diligently work to be proactive" and are considering at least one such program. School leaders called a community meeting Monday night, closed to media, to discuss next steps.Hernandez and two other Greenfield families had their own meeting Monday afternoon at Generations Against Bullying, a Milwaukee-based nonprofit with a mission to raise awareness about bullying. (Linnane, 11/26)

Health News Florida: Group Ready To Fight Recreational Pot Efforts
With recreational marijuana advocates working to get two separate initiatives on the November 2020 ballot, opponents have formed a political committee focused on defeating the legalization efforts. Organizers of Floridians Against Recreational Marijuana, or FARM, issued a news release Friday announcing the formation of the political committee, aimed at combating “the mega-marijuana, out-of-state corporate interests” behind legalization. (Kam, 11/27)

Milwaukee Journal Sentinel: Wisconsin Boy With XLA Saved By Father's WebMD Research And Doctors
Jack had a rare, life-threatening immune deficiency, later confirmed as Bruton’s X-linked agammaglobulinemia, also known as XLA. The condition afflicts about one in every 250,000 people and can be treated by infusing patients with antibodies. Jack received his first infusion that day and stayed overnight for observation. (Johnson, 11/26)

Stat: Our Drug Policy Prioritizes Eliminating Rare Disease. Is That The Right Goal?
Dr. Peter Bach wants to turn the entire philosophical underpinnings of America’s health care system upside down. In a new argument — first laid out in a zippy 10-minute speech at last week’s STAT Summit in Cambridge, Mass. — Bach suggests the incentives created by policymakers to improve public health aren’t actually the best ideas for achieving that overarching goal. It centers on a seemingly heretical question: Is Washington’s obsession with eliminating rare diseases really the best use of taxpayer resources? (Florko, 11/26)

Stat: Pharma Execs Say MS Drug Pricing Is Based On Competition, Not R&D Costs
Despite claims that prices for new medicines are generally shaped by R&D costs, initial pricing decisions in the U.S. for multiple sclerosis drugs have been driven by other factors, especially what competitors are doing, according to four executives whose insights were described in a new paper. Besides competition, the executives also cited overall corporate growth objectives, the ability to set U.S. prices higher than in other countries, and distortions caused by the complicated rebate system used to establish insurance reimbursement, the researchers reported in Neurology. (Silverman, 11/25)

Axios: Trump Administration Is Still Focused On Lower Drug Prices, Despite Impeachment
The Trump administration is pushing ahead with its drug pricing agenda even as impeachment sucks up all the political oxygen, with plans to advance some of its most ambitious regulations and to work with Congress on legislation. Why it matters: Drug pricing remains a huge issue that both parties want to run on in 2020. For Trump, there's a lot of pressure: His most ambitious proposals have either been tabled, are tied up in the courts or have yet to be implemented. Owens, 11/25)

Reuters: Trump Says He Will Allow States To Import Prescription Drugs To Lower Costs
U.S. President Donald Trump said on Friday he will soon release a plan to let Florida and other states import prescription medicines to combat high drug prices, and he blasted the Democrat-led House for not going far enough in a drug-pricing bill. "We will soon be putting more options on the table," Trump wrote in a series of tweets, adding that House Speaker Nancy Pelosi "and her Do Nothing Democrats drug pricing bill doesn’t do the trick." (11/22)

Modern Healthcare: States Prepare Drug-Importing Plans After Trump Assures They Can
State officials are moving forward with prescription drug importation programs on President Donald Trump's repeated assurances that he wants to allow states to import drugs from Canada, though HHS has not approved any such program. Vermont on Tuesday will become the second state to submit an importation plan to HHS behind Florida. Facilitating drug imports is one of Trump's favorite healthcare talking points and he reiterated his support for approving state plans on Friday. Republican Florida Gov. Ron DeSantis and Trump talked about drug imports on a phone call the day before. (Cohrs, 11/26)

NJ.Com: Booker’s Bill To Curb Drug Prices Would Kill Innovation – And N.J. Jobs, Trade Group Says
For the first time in human history, we have cured hepatitis C – the days of liver transplants and life-long treatments are fast disappearing. We now have a simple vaccine that prevents cervical cancer, something unheard of only a few short years ago. HIV/AIDS has become a chronic, manageable condition instead of the death sentence it once was. And just last week, the first-ever Ebola vaccine was approved in Europe – a lifesaver for millions of people in Africa and around the world. (Paranicas, 11/26)

Bloomberg Law: Gilead’s HIV Patent Spat With HHS Could Keep Drug Prices High
The Trump administration’s lawsuit against Gilead Sciences Inc. over the company’s alleged infringement of government-owned patents for the HIV-prevention drug PrEP could unintentionally lead to higher drug prices, according to attorneys watching the case. The issue is that the government’s patents don’t cover the drug itself but the regimen that has patients take one pill daily. (Bauman, 11/25)

Modern Healthcare: Amazon Taps First Pharmacy For Alexa Medication Management
Amazon on Tuesday unveiled what the company hopes will be the first step in a broader effort to let patients manage their medications using Alexa. The company's voice assistant is a cornerstone of the tech giant's push into the healthcare sector. This past spring Seattle-based Amazon launched an invite-only program for healthcare companies—including hospitals and health insurers—to develop skills that transmit protected health information through the voice assistant while meeting HIPAA compliance. (Cohen, 11/26)

Bloomberg: Video: The Math Behind Drug Prices In The U.S.
Gerard Anderson, professor of health policy and management at the Johns Hopkins Bloomberg School of Public Health, discusses drug prices in the U.S.. He also makes the case for Medicare for All on "Bloomberg Markets." The Bloomberg School of Public Health is supported by Michael R. Bloomberg, founder and majority owner of Bloomberg LP, the parent company of Bloomberg News. (11/26)

Stat: Three CEOs Own Up To Biopharma’s Bad Reputation 
Biopharma’s reputation is, objectively speaking, the worst. And on Thursday, several biotech CEOs said in no uncertain terms that they believed that negative reputation was earned — particularly because of some drug pricing decisions. “Unfortunately, I think the industry has earned it. I think there has been and continues to be bad behaviors,” said Nick Leschly, the chief executive of Bluebird Bio, speaking at the STAT Summit on Thursday. (Sheridan, 11/21)

Stat: With $9.7 Billion Acquisition, Novartis Bets That Heart Drugs Are Coming Back
Novartis’ $9.7 billion acquisition of The Medicines Company (MDCO), which the companies announced Sunday after days of rumors, is a story of second acts. It represents a new chance for a type of cholesterol-lowering drug that was once predicted to generate many billions of dollars in annual sales, but has so far disappointed drug makers and investors, to dominate the landscape for heart medicines. (Herper, 11/24)

The Oregonian: Pharma Execs: Thirst For Profit Drives High Drug Prices 
Oregon State University pharmacy professor Daniel Hartung has long suspected that corporate greed is behind skyrocketing prescription drug costs, not pharmaceutical companies’ investment in research as company executives regularly claim. Now, Hartung and his research team have the evidence straight from some of those responsible for growing drug costs, revealed in anonymous interviews with four pharmaceutical executives and published Monday in the journal Neurology. (Zarkhin, 11/25)

Stat: Enlight Biosciences Highlights Struggles For ‘Precompetitive’ Biotechs
Unlike most biotech startups, Enlight Biosciences was never expected to make any drugs. Instead, the company intended to develop a whole host of promising, biotech-adjacent ideas. One would help connect clinical researchers with interested companies. Another would figure out how to use ultrasounds to diagnose a common liver disease. Yet another would transform a class of injectable drugs into pills. ...But Enlight appears to have failed. The three companies it spun out are either shuttered, struggling to operate, or stuck in preclinical development. (Sheridan, 11/27)

Washington Examiner: Trump Drug Pricing Proposal Would Doom Future Cures
President Trump wants to make a deal on drug prices. But his latest proposal could grind medical innovation to a halt. Health and Human Services Secretary Alex Azar said last week that the president was looking for "most favored nation status," whereby the United States got "the best deal among developed countries" for prescription drugs. That may sound like the art of the deal. But it would result in the development of far fewer new drugs — and would thus snuff out hope for millions of Americans currently suffering from incurable diseases. (Sally Pipes, 11/25)

Lincoln Journal Star: Pelosi Plan Wrong On Drug Prices
There are several significant concerns with House Speaker Nancy Pelosi’s new drug proposal, H.R. 3 or the Lower Drug Costs Now Act of 2019. While this legislation aims to reduce the price of prescription drugs, the reality is that H.R. 3 would bring far more disruptions that we can’t afford. Above all, H.R. 3 is the beginning of a socialized health care system masked in the name of progress. (Lisa May, 11/26)

Stat: In Pricing Our Gene Therapy, Bluebird Weighed Value, Shared Risk, And A Lifetime Cap
It is hard to not get emotional when you witness the unfair reality of terrible diseases and personal stories of struggle, triumph, perseverance, and loss. So I cried — no surprise for anyone who knows me well — for joy not long ago when the company I work for, Bluebird Bio, received regulatory approval in Europe for Zynteglo, our first gene therapy. It marked a turning point not only for people with transfusion-dependent beta thalassemia, who could see potentially curative benefits, but also for the researchers who, against the odds, poured in blood, sweat, and tears to make hope a reality. (Nick Leschly, 11/26)

The Gazette: Bipartisan Solution To Prescription Drug Costs
Politicians rarely get much right. I should know. I have done a few things well and, honestly, a lot of things wrong. “Government Ruins Nearly Everything”, as one Colorado writer explains clearly in her important book. But every now and then, there is an exception to the rule. Today that exception is a bipartisan proposal by Republican Sen. Chuck Grassley and Democratic Sen. Ron Wyden to lower prescription drug costs. (Owen Hill, 11/24)

Pennlive.Com: Pharmacy Benefit Managers Profit From High Drug Prices
Pharmacy benefit managers (PBMs) were created to control prescription drug prices. Since they arrived on the scene in 1987, however, prescription drug benefit costs have risen by 1,129 percent and patients’ actual out-of-pocket costs have increased by almost 200 percent. Here in Pennsylvania, a 2018 report from Auditor General Eugene DePasquale found that as prescription drug costs in the commonwealth went from $1.41 billion in 2013 to $2.86 billion in 2017 (an increase of more than 100 percent!), the average price of a prescription at a community pharmacy actually went down slightly, and prescription volume was flat. (Darrin Silbaugh, 11/25)

The Washington Times: Drug-Pricing Proposals Threaten To Derail The Pace Of Biomedical Advances
Americans are the envy of the world when it comes to accessing the medicines that save, extend and improve lives. Consider that 90 percent of the new drugs approved in the United States, Europe and Japan and launched in any country between 2011 and 2017 are available in the United States. Yet only half of those treatments are available in France, by contrast, and barely more than a third of them are accessible to Australians. (Barbara Kolm, 11/26)

Green Bay Press Gazette: Door County Medical Center CEO Aims To Lower Drug Prices With State Task Force
Prescription drug are expected to cost Wisconsinites more than $1.9 billion in 2019, according to a Gov. Tony Evers-signed executive order. This statistic drove home the reason Evers put together the Governor's Task Force on Reducing Prescription Drug Prices. People from various fields related to the issue comprise the group, from insurance to medical center leaders — including Door County's own Brian Stephens. (Sammy Gibbons, 11/26)

Stat: Concussions, Broken Bones, And More: A Week Of U.S. Football 
News about concussions and other injuries to young football players appears with alarming frequency, as do reports of the long-term damage to NFL players.Young pro players are leaving the game for fear of permanent harm to their brains and bodies. Last month, Joshua Perry discussed his retirement at age 24 after suffering six concussions. He’s following in the footsteps of A.J. Tarpley, who retired at age 23, also because of concussion concerns. In March, USA Today called for a ban on tackle football for kids under 14, and one month later the journal Pediatrics reported results from a survey in which a majority of parents who responded supported age restrictions on tackling. (Kathleen Bachynski, Lisa Kearns, and Arthur Caplan, 11/27)

Los Angeles Times: Thanksgiving: A Time For Family, Fun And Food-Borne Illness
For the third year in a row, public health officials are warning people not to eat romaine lettuce. In this current outbreak, lettuce traced to the Salinas Valley was found to contain a dangerous strain of the E. coli bacteria that has made at least 67 people sick in California and 18 other states. And everyone should heed this warning because the strain, 0157:H7, is a particularly nasty one that can cause kidney failure and even death. It’s also the same strain that was making people sick in 2017 and 2018, a worrisome trend that underscores the danger in the FDA’s decision to put off rules requiring microbial testing of the water that farmers use to irrigate their produce. But tossing out suspected greens won’t guarantee that everything else in the Thanksgiving meal is safe. Indeed, even in the absence of any current turkey recalls, all birds should be treated as if they are armed — with salmonella, campylobacter or E. coli — and dangerous to your health. (11/27)

The Washington Post: I Was A Drug Rep. I Know How Pharma Companies Pushed Opioids.
For every dollar the pharmaceutical industry spends on research and development, it spends two on marketing. When I worked as a pharmaceutical sales representative in the neuroscience division of Eli Lilly, I was the living embodiment of this investment. I took doctors out to so many fancy Manhattan restaurants that the maitre d’s greeted me by name. The company hosted them at catered “speaking programs” and gave away tickets to baseball games and Broadway musicals. We even sent doctors and their families to sponsored academic conferences at tony resorts in Florida and California. During the day, if doctors didn’t have time to see me, I chatted up their receptionists, plying them with food and gifts (stress balls, umbrellas, clocks) and asking, breezily, which medications their bosses preferred prescribing, and why. (Shahram Ahari, 11/26)

Stat: Changing ED Doctors' Behavior Boosts Opioid Use Disorder Treatment
Emergency departments have become the front line in the battle against the epidemic of opioid use disorder, in part because they are the place individuals are brought after overdosing or during withdrawal. In addition, individuals with addiction are often marginalized from traditional sources of primary care, and so often default to using what is available to them: emergency departments. Our nation’s emergency departments have seen a nearly 100% increase since 2005 in visits by patients seeking help related to opioid addiction. The rates of hospitalizations related to opioid addiction rose 64% over the same period. Fortunately, there is an effective treatment for opioid addiction that emergency doctors can begin. Called medication for opioid use disorder (MOUD), it uses buprenorphine to reduce cravings for opioids. This treatment increases the likelihood that a patient will enter a recovery program and stick with it, yet the vast majority of patients with opioid addiction are discharged from emergency departments with inadequate or no treatment at all. (Alister Martin and Ted Robertson, 11/27)

The Washington Post: My Friend And I Both Took Heroin. He Overdosed. Why Was I Charged With His Death?
We gathered along the banks of the Columbia River at sunset. In front of the assembled crowd, a volunteer read the names of more than 40 people in our Oregon community who had died from overdoses. Four of those names belonged to people I loved, including my mom and my best friend, Justin. I attended this vigil with Justin’s mother, Ember. She had watched us struggle with addiction throughout our young adulthood. Now she and I stood arm in arm. We lit candles and thought of Justin, who in 2014 fatally overdosed from heroin I had sold to him — an act that resulted in my conviction and imprisonment for five years. (Morgan Godvin, 11/26)

USA Today: Trump Would Restrict Science, Weaken Life-Saving Air & Water Standards
In a proposed rule published over a year ago, the Environmental Protection Agency indicated that in the future, when computing how pollution causes health damages, EPA would only be willing to use scientific results from studies where all the underlying data could be made public. Hundreds of leading scientists sent comments explaining in technical detail why doing that would be a very bad idea — and would preclude the use of some of the best science in setting environmental standards. This month it began to look like the EPA may be blowing off all that scientific advice. (M. Granger Morgan, 11/25)

The Washington Post: Our Flawed Health-Insurance System Depends On Self-Defeating Decisions By Consumers
The “moderates” in the Democratic presidential primary hope to build on the Affordable Care Act, rather than make the more dramatic shift to Medicare-for-all — and even Sen. Elizabeth Warren (D-Mass.) has changed course to embrace a plan that would move to Medicare-for-all more slowly. But if they want to build on the ACA, they need to confront a serious perversity of the private insurance system underlying it: The system’s financial health depends on people choosing the wrong plans. (Peter A. Ubel, 11/26)

The Hill: Congress Should Follow Cities' Lead On Mental Health 
President John F. Kennedy died 56 years ago last week. The inspiring young president’s last piece of legislation, the Community Mental Health Act, called for states to close mental hospitals and open community health care centers in their place. The bold new idea was that people could get humane and comprehensive treatment for mental health and substance disorders while bolstered by the support of families and communities.Kennedy’s vision never became reality. Without needed federal dollars, many states closed their institutions without replacing them with community-based supports. More than half of the Act’s proposed centers never opened. Far too many people ended up getting no treatment or services at all, living on the streets, in shelters, or detained in jails and prisons. Some of the nation’s key providers of psychiatric care are not hospitals or clinics, but jails in Los Angeles, Chicago, and New York City. (Chirlane McCray, 11/25)

Boston Globe: Improving Access To Behavioral Health
As primary care providers who have been working on the front lines of health care for a combined 60 years, we find this bill to be, in many ways, music to our ears. Experience and research show that in communities that have access to primary care, populations are healthier and the cost of spending is lowered. (Katherine Gergen Barnet and Barry Zuckerman, 11/27)

Nashville Tennessean: Reducing Prison Recidivism Calls For Quality Reentry Programs
Gov. Bill Lee’s Criminal Justice Investment Task Force recently met to review new data on Tennessee’s incarcerated population.Among other findings, the data revealed 47% of those released from custody are rearrested within three years. And while Tennessee’s recidivism rate is lower than the national average for state prisoners at 68%, much more must be done to help these individuals successfully reenter society. (Damon Hininger, 11/27)