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Senator Bernie Sanders does not understand Joseph R. Biden Jr.’s position on health care. To Mr. Sanders, the health care system is broken, and the only way to fix it is to replace it with his signature policy plan known as Medicare for All. “I am disappointed, I have to say, in Joe, who is a friend of mine, really distorting what Medicare for All is about,” Mr. Sanders said in an interview hours before he delivered a speech on Wednesday defending his health care proposal. “And unfortunately, he is sounding like Donald Trump. He is sounding like the health care industry in that regard.” (Ember and Glueck, 7/18)

Asked to respond, Biden spokesman Andrew Bates said: "Joe Biden was instrumental to making Affordable Care Act and its hard-won benefits a reality for millions of Americans. He disagrees with any Republican, Democrat, or Independent who wants to dismantle the ACA at a time when we should be protecting and building on it." (Sullivan, 7/18)

The tension points to a broader power struggle in Washington and on the campaign trail that pits long-dominant moderates like Biden against an insurgent wing led by Sanders and Elizabeth Warren. But a prolonged battle risks entrenching bitterness between the factions that threatens party unity heading into the general election. (Kapur, 7/19)

Politically, health care was a winning issue for Democrats in 2018, and could be again in 2020. Polls regularly show health care as a top priority, and voters say they trust Democrats on the issue more than Republicans. But centrists worry about jeopardizing that advantage. (Weixel, 7/18)

After two years of Republicans’ unsuccessful attempts to repeal the Affordable Care Act, Democrats won back the House majority in 2018 with a unified focus on health care. Now the scalpels are out, and the issue is swiftly becoming one of the clearest dividing lines in the Democratic presidential primary. (Bidgood, 7/18)

After claiming governorships from Republicans in seven states last year, including in crucial presidential battlegrounds like Wisconsin and Michigan, Democratic governors should have good reason to celebrate. But there was as much anxiety as optimism when the governors gathered for their annual fund-raising retreat on Nantucket last weekend and grappled with why a party that won with a pragmatic message in 2018 is now veering sharply to the left. A group of governors are alarmed that their party’s presidential candidates are embracing policies they see as unrealistic and politically risky. And they are especially concerned about proposals that would eliminate private health insurance. (Martin, 7/19)

Other candidates have staked out a middle ground by calling for Medicare for All while also looking to preserve private insurance. Three candidates calling for this mixed approach also co-sponsored Sanders’ bill: Sens. Cory Booker, Kamala Harris and Kirsten Gillibrand. (Sen. Elizabeth Warren also co-sponsored the bill, but she supports Sanders’ desire to end private insurance.) Other hopefuls — including former Housing and Urban Development Secretary Julian Castro, entrepreneur Andrew Yang and Rep. Tim Ryan — have said they support a Medicare for All system that preserves private insurance, but Booker, Harris and Gillibrand stand out in light of their sponsorship of Sanders’ bill. (Rod, 7/18)

Kaiser Health News: KHN’s ‘What The Health?’: Biden Doubles Down On Obamacare

Former Vice President Joe Biden has said if he’s elected president he would build on the Affordable Care Act rather than move to a whole new health care system, such as the “Medicare for All” plan supported by some of his primary opponents for the Democratic nomination. But his campaign’s new health plan would include many things Congress tried and failed to pass as part of the health law, including a government-run “public option” plan that would be widely available. (7/18)

White House hopeful Pete Buttigieg (D) vowed to implement a “fairer” and “more just” health care system if elected president after a 21-year-old man, Jesimya David Scherer-Radcliff, died in Minnesota after rationing insulin for his diabetes. ...Many of the 25 Democrats running for president have vowed to lower prescription drug costs, saying high prices force some patients to choose whether to treat their ailments. (Axelrod, 7/18)

Former Rep. John Delaney spoke to POLITICO Thursday as part of a series of interviews with Democrats seeking to challenge President Donald Trump in 2020. Here are key excerpts from the hour-long conversation. ... "My plan, which is called BetterCare, leaves Medicare alone. Medicare is not perfect, but it's probably the least broken part of our health care...But what I do is I create a new plan that everyone gets from when they're born until they're 65. So, and it's a basic federal plan that every citizen gets for free. So, every citizen in this country will be covered by health care, that they won't have to pay for it. And I get rid of Medicaid as part of that, because Medicaid is the most broken program in this country. Reimbursement rates are so insufficient, that they're inadequate provider networks all over the country. (7/19)

A Department of Veterans Affairs employee used a network of shell companies to steal millions of dollars from a VA program to provide health services to children of veterans who are suffering from a debilitating spinal condition, federal prosecutors say. The Justice Department lodged 23 federal criminal charges late last year against Joseph Prince, a former Veterans Affairs employee who prosecutors say used his position to steer almost $20 million in taxpayer money to companies run by family members and associates. Those companies then provided huge kickbacks to Prince, his wife, and other family members, the government alleges. (Markay and Hughes, 7/18)

There are a host of reasons health care costs are out-of-control and routinely top American’s list of financial worries, from unnecessary treatment and high prices to waste and fraud. Most people assume their insurance companies are tightly controlling their health care dollars. Insurers themselves boast of this on their websites.In 2017, private insurance spending hit $1.2 trillion, according to the federal government, yet no one tracks how much is lost to fraud. Some investigators and health care experts estimate that fraud eats up 10% of all health care spending, and they know schemes abound. (Allen, 7/19)

Do-it-yourself DNA tests have taken off across the United States in recent years, but now officials are warning of scammers who promise free kits to steal victims’ private information and defraud health plans in California, Kentucky, Nebraska and beyond. Oregon Attorney General Ellen Rosenblum was the latest to warn the public of the scam on Thursday, saying multiple Medicare beneficiaries in the state have reported scammers victimizing them through telemarketing, health fairs and door-to-door pitches. (Gilmour, 7/18)

A decade-old experiment to put a dent in Massachusetts health care costs by changing the way doctors are paid appears to be working — offering a potential strategy to combat one of the most vexing problems in today’s economy. In a new study, researchers at Harvard Medical School found that a payment plan from Blue Cross Blue Shield of Massachusetts that rewards doctors who control costs is linked to smaller increases in health care spending and better-quality care. (Dayal McCluskey, 7/18)

The program, called the Alternative Quality Contract, works in two key ways. First, health care providers like Atrius Health, which joined in 2009, received bonuses to pay for upgrades at their medical practices like additional staff and improved electronic medical records. “That allows us to invest in infrastructure and connect better with our patients and do a better job,” Strongwater says. “The goal [of that] is to keep patients healthier through prevention and early intervention.” The idea, he says, is that healthier patients cost the system less overall. (Chen, 7/18)

The Trump administration took a major step to weaken the regulation of toxic chemicals on Thursday when the Environmental Protection Agency announced that it would not ban a widely used pesticide that its own experts have linked to serious health problems in children. The decision by Andrew R. Wheeler, the E.P.A. administrator, represents a victory for the chemical industry and for farmers who have lobbied to continue using the substance, chlorpyrifos, arguing it is necessary to protect crops. (Friedman, 7/18)

The agency denied the petition by a dozen environmental groups, led by Earthjustice, to ban the pesticide. They said studies show that exposures to the pesticide is liked to low birth weight, reduced IQ, attention disorders and other issues in infants and children. The Obama administration's EPA had banned the use of chlorpyrifos in 2015 after it decided it could not be certain whether exposure to the chemical in food and water would be harmful. But Trump's first EPA administrator, Scott Pruitt, reversed that decision in 2017, prompting an ongoing legal battle. (7/18)

The EPA, in a notice that will be posted to the Federal Register, said further examination of epidemiological studies of health risks associated with chlorpyrifos is necessary before the agency can make a final decision on its safety. The agency said “there is good reason” to continue allowing farmers to use chlorpyrifos, “given the importance of this matter and the fact that critical questions remained regarding the significance of the data addressing neurodevelopmental effects.” (Crampton, 7/18)

"By allowing chlorpyrifos to stay in our fruits and vegetables, Trump's EPA is breaking the law and neglecting the overwhelming scientific evidence that this pesticide harms children's brains," said attorney Patti Goldman of Earthjustice, who represents the groups that took the issue to court. (Wallace and Kaufman, 7/18)

New Hampshire has voted to put into place some of the country's toughest drinking water standards for a class of toxic chemicals that were once used in everything from firefighting foam to nonstick cookware but are now raising health concerns. A joint legislative committee Thursday approved three measures allowing standards for compounds known as per- and polyfluoroalkyl substances, collectively called PFAS, to go into effect. (7/18)

Wildfire smoke isn’t great for anybody, but a new rule California regulators vote on today recognizes that it’s particularly dangerous for workers while they’re on the job. The state’s Occupational Safety and Health Standards Board will decide whether to require employers to offer workers additional protections under specific circumstances when air quality is poor. The move comes after especially active fire seasons in 2017 and 2018. (Peterson, 7/18)

Democratic lawmakers accused Kevin K. McAleenan, the acting secretary of homeland security, of leading an agency with an “empathy deficit” during a hearing on Thursday that focused on the separation of migrant children from their parents and reports of poor conditions at holding facilities near the border. “What does that mean when a child is sitting in their own feces? Can’t take a shower?” said Representative Elijah E. Cummings, Democrat of Maryland, the chairman of the House Oversight and Reform Committee. “What’s that about? None of us would have our children in that position. They are human beings.” (Kanno-Youngs, 7/18)

A top Trump administration official said Thursday the number of family separations at the border has fallen since last summer's zero tolerance policy, and they are done only for compelling reasons. Acting Homeland Security Secretary Kevin McAleenan said fewer than 1,000 children have been separated from families out of 450,000 family groups that have crossed the border since October. He said they are separated because of health and safety concerns, among other reasons. "The vast majority" of families are kept together, he said. (7/18)

The young migrants often arrived at night. They were teenagers from Central and South America, brought by border agents to the Tornillo Detention Facility and led to rows of metal bunk beds in military tents ringed by barbed wire. Human touch, even a simple hug, was rare inside this secured temporary city, where nearly 3,000 unaccompanied minors at a time were confined between June 2018 and January 2019. In this harsh environment, the Chihuahuan Desert, imagination and faith helped them make it through. The Rev. Rafael Garcia, a Jesuit priest from South El Paso, got his first inkling of the creativity within the camp when he noticed a cross with a red Sacred Heart entwined in yarn, handmade by incarcerated youngsters. (Brown, 7/19)

Unaccompanied migrant children apprehended at the two busiest sectors along the U.S.-Mexico border are spending almost twice as long in U.S. Customs and Border Protection custody than the maximum 72 hours mandated by a court ruling. During the month of June, agents held 19,352 children in the Rio Grande Valley in Texas. (Carranza, 7/18)

Sacramento Rep. Doris Matsui confirmed some of the worst accounts of the border patrol centers housing migrant men, women and children who’ve crossed over the southern border, after visiting two facilities in Texas last weekend. ...Matsui and a delegation of 19 other Democratic House members traveled to McAllen and Brownsville, Texas to visit Customs and Border Patrol processing centers as well as humanitarian organizations working with migrants seeking asylum in the United States. (Cadei, 7/18)

Images of overcrowded border facilities have prompted public outcry and congressional hearings. The acting secretary of the Department of Homeland Security answered questions Thursday on the immigration crisis along the U.S.-Mexico border. Massachusetts Congresswoman Ayanna Pressley also recently testified at a federal oversight hearing about her visit to a U.S. Customs and Border Protection (CBP) center in Texas. (Dooling, 7/18)

Inside the nation’s latest holding facility for migrant children, about 200 unaccompanied teenagers live under the care of the U.S. Department of Health and Human Services in Carrizo Springs. Mayor Wayne Seipel said he hasn’t heard of any residents opposing the shelter. In fact, he's hopeful the facility will mean a boost for the town’s economy. But some are skeptical of the optimistic outlook for the shelter, given reports of the deteriorating conditions inside Border Patrol facilities. (Vazquez, Dehn and Wiseman, 7/18)

The Senate will vote next week on a House-passed bill to extend the September 11th Victim Compensation Fund. Senate Majority Leader Mitch McConnell (R-Ky.) locked in votes for Tuesday afternoon after senators announced a deal to take up the bill on the Senate floor earlier Thursday. As part of the agreement they are expected to also vote on two amendments to the bill, one from Sen. Mike Lee (R-Utah) and one from Sen. Rand Paul (R-Ky.). (Carney, 7/18)

Sen. Rand Paul escalated a fight with Jon Stewart Thursday, saying the former TV show host didn’t have his facts straight when he lambasted the Kentucky Republican for blocking speedy passage on a bill to provide health care to 9/11 first responders. The blast at Stewart — calling him a “guttersnipe” on Fox News — came hours after supporters of the legislation announced that the legislation will come to the floor for a vote on Tuesday — along with a proposal by Paul to slash federal funding to pay for the measure. (Clark, 7/18)

Pills by the tens of thousands, then by the hundreds of thousands and ultimately by the millions found their way to this remote city tucked amid rugged, lush mountains in southwestern Virginia’s coal country. They were opioids, manufactured in bulk, prescribed by doctors promiscuously, prosecutors say. They were sold liberally to pharmacies. Over the course of seven years, from 2006 through 2012, the big Walmart on the four-lane road at the edge of this city received more than 3.5 million opioids. The CVS at the end of the main street through town received more than 1.3 million. (Achenbach, 7/18)

The numbers are staggering: An average yearly total of 107 opioid pills per resident were distributed over a seven-year period in this rural Appalachian county. The newly released federal data is shocking even to people who live here in Jackson County, where nearly everyone seems to have known someone who died from drug-related causes. Five children in one elementary school class were said to have lost a parent to an overdose death this past academic year. (7/18)

Charleston County has distributed the highest concentration of opioid pain pills of any county in the nation, a Washington Post analysis of federal drug enforcement data over a span of recent years shows. A federal judge’s ruling Monday freed secret Drug Enforcement Administration data showing the path of opioid pills from manufacturers to community pharmacies and finally to the public. It offers a glimpse into the severity of the epidemic in Charleston County. (Wildeman, 7/17)

A specialty Massachusetts pharmacy that delivers medication to patients' doorsteps received more than 34 million opioid pain pills in recent years, federal data show. Injured Workers Pharmacy (IWP), of Andover, is a home delivery pharmacy, set up to work with attorneys on worker’s compensation claims and personal injury lawsuits across the country. It was established in 2001. (Willmsen, 7/18)

Over the past two decades, hundreds of thousands of Americans have died during a national opioid addiction crisis. As the drug manufacturers face a possible legal reckoning from multiple lawsuits, a newly uncovered database sheds more light on the scope of the disaster. (Brangham, 7/18)

Federal prosecutors in Cincinnati filed criminal charges Thursday against an opioid distributor and two of its former executives, accusing them of conspiring with doctors and pharmacies to pour millions of addictive pain pills into Ohio, West Virginia and Kentucky. The indictment of Miami-Luken, its former president and its former compliance officer was the second time in three months that federal prosecutors have used criminal laws against a drug distributor in their efforts to stem the prescription opioid epidemic. (Bernstein, 7/18)

The indictment says the distribution of oxycodone and hydrocodone was "outside the scope of professional practice and not for a legitimate medical purpose," Benjamin C. Glassman, the US Attorney for the Southern District of Ohio, said in the indictment. Miami-Luken, a drug distributor based in Springboro, Ohio, allegedly failed to report suspicious orders and exercise the care needed to prevent the drugs from being diverted from proper use. (Almasy and Riess, 7/19)

Good news came out from the Centers for Disease Control and Prevention Wednesday: Preliminary data shows reported drug overdoses declined 4.2% in 2018, after rising precipitously for decades. "It looks like this is the first turnaround since the opioid crisis began," says Bertha Madras who served on President Trump's opioid commission, and is a professor of psychobiology at Harvard Medical School. She says it won't be entirely clear until the CDC finalizes the numbers but, "I think the tide could be turning." (Simmons-Duffin, 7/18)

Oklahoma County has joined over 50 other cities and counties in the state to prosecute drug companies for damages caused by the opioid epidemic. All three county commissioners voted Wednesday to approve a contract with the Fulmer Sill law firm to sue opioid manufacturers, The Oklahoman reported. The decision comes at the end of the state's trial against consumer products giant Johnson & Johnson, which alleges the New Jersey-based company and its subsidiaries created a public nuisance by aggressively promoting the highly addictive drugs. (7/18)

The opioid epidemic in the United States has largely centered on white Americans, who account for roughly 80 percent of opioid overdose victims. But the national attention on white victims has pushed minorities to the sidelines, even as the number of opioid-related deaths among non-whites is on the rise. Non-whites make up 20 percent of deaths involving prescription and non-prescription opioids in the U.S. According to recent government figures, the number is growing. (Addison, 7/18)

As the nation battles an opioid epidemic, the Los Angeles Police Department is expanding a program to supply officers with thousands of doses of a nasal spray to treat overdose victims. Last year, the LAPD launched a pilot program to train and equip officers to administer naloxone, which blocks the effects of an opioid overdose. More than 6,100 officers now carry the drug sold under the brand name Narcan. Other officers are expected to receive training. (Puente, 7/18)

At a recent conference outside Los Angeles, a national women’s rights lawyer stood before a select group of Hollywood heavyweights to issue a demand and a plea. With a woman’s right to choose in jeopardy, the lawyer, Fatima Goss Graves, said, more abortions should be portrayed in narratives onscreen. “The stories on abortion do not match our reality,” she said. The attendees — agents, celebrities and producers at an invitation-only diversity summit held by the talent agency CAA — took Goss Graves’s message in stride. As it turns out, the industry has already begun shedding one of its longest-held taboos. In recent years, abortions are taking place or being talked about on television at record levels, often on shows created or written by women. (Buckley, 7/18)

Illinois will defy enforcement of the Trump administration's rule barring federally subsidized family planning clinics from making abortion referrals, the governor said on Thursday, vowing the state would step in to fund most of those clinics itself. Illinois' action comes a week after a federal appeals court cleared the way for the administration to cut off Title X grants for reproductive healthcare and family planning for low-income women at clinics that refer patients to abortion providers. (7/18)

Two families of children with a rare and debilitating disease celebrated Thursday after UnitedHealthcare reversed previous denials and approved coverage for a $2.1 million gene therapy. The giant insurance company said it has now approved all six coverage requests it received for the new gene drug, four on the basis of initial claims and now two more after the families appealed. Zolgensma, which is marketed by Novartis, is intended as a one-time treatment for spinal muscular atrophy. The families’ fight for coverage highlights the coming insurance battles over advanced gene treatments. (Rowland, 7/18)

Getting closer to the patient seems to be paying off at UnitedHealth Group. Financial results released Thursday show the Minnetonka-based health care company surpassed the $3 billion mark in profit for the fourth consecutive quarter, prompting the company to boost earnings guidance for the year. Second-quarter results beat expectations and were aided by better expense control within the company’s UnitedHealthcare business, which is the nation’s largest health insurer. (Snowbeck, 7/18)

UnitedHealth raised profit expectations for the year after second-quarter earnings climbed almost 13%, and the nation's largest health insurer continued expanding beyond its core business and into care delivery. A nearly 12% jump in revenue from the company's pharmacy benefit management operation helped UnitedHealth beat Wall Street expectations for the recently completed quarter. UnitedHealth's OptumRx business added more customers and moved deeper into specialty services like the infusion of drugs at patient homes. (7/18)

"You can expect us not to change our stance on rebates," Chief Executive Officer David Wichmann said on a conference call with analysts to discuss the earnings. UnitedHealth shares were down $5.65, or 2%, at $260.94 in morning trading, after earlier rising about 1% in premarket trading on news the company beat estimates for quarterly profit and boosted its forecast for 2019 earnings. (7/18)

The medical loss ratio for UnitedHealthcare, the insurance arm, was 83.1%, which analysts said was in line with projections but also benefited from prior period reserve development, essentially the difference between money set aside for claims and the actual costs. UnitedHealth executives said medical expenses had matched their expectations, and the company said the number was increased by the impact of a deferred health-insurance tax. The medical loss ratio represents the share of premiums paid out in claims. (Wilde Mathews and Chin, 7/18)

Novartis AG set aside $700 million to settle a long-running lawsuit alleging the drugmaker treated U.S. doctors to lavish dinners and other events in return for boosting prescriptions. The case centers on 80,000 events Novartis held between 2002 and 2011 that federal prosecutors allege amounted to kickbacks masquerading as educational meetings. Those included fishing trips off the Florida coast, expensive meals at high-end restaurants like Nobu in Manhattan, and trips to Hooters locations across the country, according to court documents. (Roland, 7/18)

A trial had been scheduled to start in federal court in New York this past May. At the time, however, STAT reported the trial was delayed as the company began negotiating with federal prosecutors and Novartis might pay close to $1 billion in order to settle the case. A settlement would give Novartis a much-needed opportunity to dispense with a string of well-publicized cases involving bribes paid to doctors or public health employees in the U.S. and elsewhere that have tarnished its reputation. The issue has vexed Novartis chief executive Vas Narasimhan, who has made restoring the company’s corporate image a key priority since being promoted early last year.(Silverman, 7/18)

A state-funded report released Thursday underscores the challenges that Gov. Brian Kemp faces in crafting a plan to provide more health care coverage to uninsured Georgians without expanding Medicaid, which he has long opposed. The report by consulting giant Deloitte found that an estimated 1.5 million residents lack health insurance and that Georgia trails other states, even those that also have not expanded Medicaid, in covering low-income residents. (Bluestein, 7/18)

The advisory group convened in Atlanta to hear Deloitte consultants describe the waiver effort. The federal government can waive certain health system regulations in response to a state proposal, and Georgia has hired Deloitte to help devise its waiver proposals. As outlined by state legislation enacted this year, the two central waiver categories involve possibly adding members to the state’s Medicaid program, and identifying possible changes to the health insurance exchange rules in Georgia. (Miller, 7/18)

The ACLU of Iowa lodged another challenge in the yearslong battle over transgender Iowans’ right to use Medicaid funds for transition-related care by suing Friday to block an Iowa law that specifically denies that coverage. The suit is in response to legislation passed in the waning days of the session that allows government entities to opt out of using public insurance dollars, including Medicaid, to pay for transition-related surgeries. It was filed on behalf of two transgender Iowans — Mika Covington of central Iowa and Aiden Vasquez of southeast Iowa — and LGBTQ advocacy group One Iowa. (Crowder, 7/18)

Lawmakers ordered Florida disability administrators this year to restructure its community-based Medicaid program that delivers healthcare to tens of thousands of people with disabilities. But as two state agencies begin to devise the new structure of the program, clients, caregivers and service providers worry that the coming changes to lower the agency’s budget might cut critical services to people who need them. (Koh, 7/18)

The Alaska State Hospital and Nursing Home Association (ASHNA) has sued the State of Alaska over cuts made to Medicaid reimbursement rates through emergency regulations. The lawsuit, filed in Anchorage Superior Court on June 12, alleges that the emergency regulations used by the Department of Health and Social Services are arbitrary and violate due process. Former Alaska Attorney General Jahna Lindemuth, who served under Gov. Bill Walker, is representing ASHNA in the suit as a private attorney along with Scott Kendall, Walker’s chief of staff. (Maguire, 7/17)

As a heat wave clamps down on much of the nation, cities are scurrying to provide shelter and assistance to the most vulnerable: the homeless and the elderly. Temperatures are expected to rise to dangerous levels along the Eastern seaboard and in the Midwest, with heat indexes expected to top 100 degrees and nightly lows in some places failing to fall below 80. Extreme heat can be deadly for anyone. But people living on the streets and seniors living on their own without air conditioning are particularly susceptible. (Wiltz, 7/19)

Public housing officials in Chicago were planning wellbeing checks on residents as the heat and humidity are expected to mount to dangerous levels as part of a wave of sweltering weather covering a substantial portion of the U.S. Routine checks also will be done to make sure the temperature in housing units are at safe levels. Window air conditioners are available for emergency situations, Chicago's Housing Authority said Thursday. (7/18)

Kaiser Health News: Has Your Doctor Asked You About Climate Change?

When Michael Howard arrived for a checkup with his lung specialist, he was worried about how his body would cope with the heat and humidity of a Boston summer. “I lived in Florida for 14 years, and I moved back because the humidity was just too much,” Howard told pulmonologist Dr. Mary Rice as he settled into an exam room chair at a Beth Israel Deaconess HealthCare clinic. Howard, 57, has chronic obstructive pulmonary disease (COPD), a progressive lung disease that can be exacerbated by heat and humidity. Even inside a comfortable, climate-controlled room, his oxygen levels worried Rice. (Bebinger, 7/19)

Scientists who study Alzheimer’s disease have mostly ignored the role of seizures, but that is beginning to change, and new research suggests they may provide insight into the progression of the disease and pave the way for treatments. It’s no surprise to neurologists that some people experience convulsive seizures in the later stages of the disease. In fact, the second patient ever to receive an Alzheimer’s diagnosis more than a century ago suffered from them. But because brain damage can cause seizures, they were long thought to be just one more casualty of a deteriorating brain. (Aguirre, 7/19)

Researchers are prescribing exercise as if it were a drug in a study that aims to see if it can prevent Alzheimer's disease. "We are testing if exercise is medicine for people with a mild memory problem," says Laura Baker, principal investigator of the nationwide EXERT study and associate director of the Alzheimer's Disease Research Center at Wake Forest School of Medicine. The study, funded by the National Institute on Aging, could help determine whether exercise can protect people from the memory and thinking problems associated with Alzheimer's. (Hamilton, 7/18)

Is there an infectious link to Alzheimer's disease?That's a question of debate, and opinion was divided at the 2019 Alzheimer's Association International Conference (AAIC) now underway here. "Ideas in this area of research are still evolving; there is now growing evidence that microbes such as bacteria and viruses may play a role in degenerative brain diseases such as Alzheimer's," said Maria Carillo, PhD, chief science officer of the Alzheimer's Association. (George, 7/17)

Two prominent vaping researchers are facing off over claims that electronic cigarettes double the risk of heart attacks in adults, muddying the science over how best to stop smoking. Brad Rodu, a University of Louisville professor, asked the Journal of the American Heart Association to retract a study out last month by University of California, San Francisco professor Stanton Glantz. (O'Donnell, 7/17)

Juul Labs, the nation’s leading manufacturer of e-cigarettes, has hired as its medical director a prominent University of California researcher known for his work on the dangers nicotine poses for the adolescent brain. The company said the hire will support its efforts to stem a teen vaping craze the Food and Drug Administration has labeled an epidemic. But critics see a cynical tactic taken straight from the Big Tobacco playbook. (Barry-Jester, 7/19)

In late 2017, the Food and Drug Administration approved the first so-called smart pill, ushering in a new era of medical care. The inaugural effort involved embedding a sensor in Abilify, an old drug for treating schizophrenia and bipolar disorder, which can make it easier to track whether patients take their medicine, an especially thorny issue for people suffering from mental illness. But in a new study, several researchers claim the regulatory endorsement was misguided. (Silverman, 7/18)

In a laboratory at the Stanford University School of Medicine, the mice are seeing things. And it’s not because they’ve been given drugs. With new laser technology, scientists have triggered specific hallucinations in mice by switching on a few neurons with beams of light. The researchers reported the results on Thursday in the journal Science. The technique promises to provide clues to how the billions of neurons in the brain make sense of the environment. (Zimmer, 7/18)

Most drug trials take place in sterile hospital labs, universities or clinics. Vanda Pharmaceuticals Inc. decided a boat in the Pacific Ocean would be better. It wasn’t for relaxation; actually quite the opposite. Vanda wanted to try to make the participants in the trial seasick. Vanda, a small biopharmaceutical company based in Washington, has completed the second phase of clinical trials of a motion-sickness drug it hopes will compete with industry leader Dramamine. In a double-blind test, the company sent 126 participants with a prior history of motion sickness on ships off the coast of Los Angeles, with some receiving the company’s motion-sickness drug tradipitant and others getting a placebo. (Ward, 7/18)

Lodestone, a naturally-occurring iron oxide, was the first persistently magnetic material known to humans. The Han Chinese used it for divining boards 2,200 years ago; ancient Greeks puzzled over why iron was attracted to it; and, Arab merchants placed it in bowls of water to watch the magnet point the way to Mecca. In modern times, scientists have used magnets to read and record data on hard drives and form detailed images of bones, cells and even atoms. Throughout this history, one thing has remained constant: Our magnets have been made from solid materials. But what if scientists could make magnetic devices out of liquids? (Sheikh, 7/18)

So your doctor has told you some of the scariest words you can possibly hear: You need surgery. What do you do next? If you need an emergency surgery, like an appendectomy or a procedure after an accident, you usually don't have much choice in the matter. You'll likely get it done in the hospital where you went to the emergency room, unless the hospital isn't equipped to do it. If that's the case, you'll get transferred. (Gordon, 7/19)

Wherever electric scooters have appeared around the globe, severe injuries have followed. Now the United Kingdom — where motorized scooters are banned from public roads and sidewalks — is seeking to publicize the danger associated the devices. The Department of Transport, which oversees British transportation networks, has persuaded Amazon, the global e-commerce giant, to pressure electronic scooter manufacturers to make clear in their online listings that their devices cannot be used on public roads. (Holley, 7/18)

What could cancer have in common with broken heart? These researchers are working to find out. Broken heart syndrome is a real thing, though it's also called stress-induced cardiomyopathy or Takotsubo cardiomyopathy. It's triggered by intensely stressful situations, like losing a loved one. You know how some couples die within just a few days of each other? That's an example of the syndrome. Symptoms include sudden chest pain, caused by the surge of stress hormones. (Asmelash and Ries, 7/18)

The drugs are known as biologic medicines, or biologics. Made from living organisms, such as animal cells, instead of chemicals, they have flooded the market over the past two decades — bringing with them promise and pitfalls. By tamping down overactive immune systems, the drugs can lead to substantial improvement, even remission. But in doing so, they leave patients more susceptible to sometimes-deadly infections and other serious side effects. (Fauber, 7/18)

Sharon Stone is back. And after famously serving as amfAR’s Global Campaign Chair for 15 years, she’s taken on a new role as advocate for brain-aging diseases that disproportionally affect women. Only one third of Alzheimers patients are men, for instance. And don’t even get Stone started on strokes. “This is why I do it: My mother had a stroke. My grandmother had a stroke. I had a massive stroke — and a nine-day brain bleed,” she told Variety at an event she hosted to raise awareness for the Women’s Brain Health Initiative in West Hollywood on Wednesday night. (Herman, 7/18)

Over the last several years, light-emitting therapy masks intended to treat acne have streamed into the marketplace and onto Instagram, filling feeds with pictures of people that resemble space-age hockey goalies. Neutrogena’s version of the product, which the company said would kill acne bacteria and fight “inflammation,” cost between $30 and $40, making it one of the more affordable masks on the market. But earlier this month Neutrogena issued a recall of its masks, citing a “theoretical risk of eye injury” to a subset of people who had underlying eye conditions or were taking medicine that made them sensitive to light. (Bromwich, 7/18)

The Dutch airline KLM has found itself in the middle of a heated debate over breastfeeding in public, after the company said it might ask women to cover themselves while breastfeeding onboard if other passengers said they were offended. The issue came to light after Shelby Angel, a woman from Sacramento, Calif., wrote about her experience on a KLM flight this summer in a post on Facebook on Sunday. (Karasz, 7/18)

Kaiser Health News: Employers Urged To Find New Ways To Address Workers’ Mental Health

In the middle of a work project at a global corporate consulting firm, Katherine Switz was gripped with a debilitating bout of anxiety. Her body froze, her heart raced, her chest tightened, and her mind went blank, which made it nearly impossible for her to concentrate on a computer screen and do her work. The anxiety lasted three months, likely related to her bipolar disorder. During that time, she felt unable to ask for help from her employers or co-workers, afraid that her poor performance would get her fired or passed over for promotion. (Rinker, 7/19)

When Nimeron Mike applied to be a city police officer here last New Year’s Eve, he didn’t really expect to get the job. Mike was a registered sex offender and had served six years behind bars in Alaska jails and prisons. He’d been convicted of assault, domestic violence, vehicle theft, groping a woman, hindering prosecution, reckless driving, drunken driving and choking a woman unconscious in an attempted sexual assault. Among other crimes. “My record, I thought I had no chance of being a cop,” Mike, 43, said on a recent weekday evening, standing at his doorway in this Bering Strait village of 646 people. He was wrong. (Hopkins, 7/18)

Kansas schools will require two new vaccines come August, including one against a virus that’s hospitalized 13,000 people and killed 200 across the country since 2016. The new rules, which apply to public and private schools, will be phased in over the next several years. ...Nationally, 25 states have seen more than 20,000 cases of hepatitis A in widespread outbreaks since 2016. The liver infection often spreads through contamination in water, raw or undercooked foods or through sex. (Llopis-Jepsen, 7/18)

Gov. Mike DeWine has signed a two-year budget bill, his first since taking office in January, with both a tax cut and new money for his education, children’s health and Lake Erie priorities. In signing the budget Thursday morning, DeWine also issued 25 line-item vetoes, most of which were health-care related. Among the items he nixed were “price transparency” measures requiring hospitals to provide patients with billing estimates in advance, and “surprise billing” language that required insurers to cover to reimburse out-of-network medical services when performed at an in-network facility. (Tobias, 7/18)

The University of Maryland School of Medicine will receive $750,000 in federal funds to train more doctors for posts in rural areas, where the growing nationwide shortage of doctors is most acute. The money, announced Thursday at the Baltimore school, comes from the U.S. Health Resources and Services Administration. It’s part of a $20 million award that will be made over a three-year period to develop rural residency programs across the country. (Cohn, 7/18)

Federal law requires California to act against nursing homes that practice “patient dumping,” the act of sending low-income patients to medical or mental hospitals and refusing to take them back, a federal appeals court ruled Thursday. The Ninth U.S. Circuit Court of Appeals in San Francisco reinstated lawsuits by three patients — one of whom has died — and an advocacy group against state health officials. (Egelko, 7/18)

Memorial Hermann Health System appointed Dr. David Callender as its new president and CEO, the not-for-profit integrated health system announced Thursday. Callender, who is the current president of the University of Texas Medical Branch, will officially take the helm from Chuck Stokes Sept. 1. Stokes succeeded Dr. Benjamin Chu in June 2017 after Chu's brief tenure. (Kacik, 7/18)

A former prisoner who alleged that faulty treatment at the Lunenburg Correctional Center may cost him a finger was awarded a total of $1,058,671 in compensatory and punitive damages in federal court Thursday from the company providing medical care at the facility. John Kinlaw, 32, filed suit against a physician and two nurses and their employer, Florida-based Armor Correctional Health Services Inc., in November 2017, several months after his release from Lunenburg and almost a year after he injured his right hand during a fall in the prison recreation yard. (Green, 7/18)

In the latest twist in an ongoing legal battle between the Department of Correction and a woman who gave birth in her prison cell last year, lawyers for the state have opened a line of inquiry that is raising concern among her advocates. The request for admissions, a standard filing in a federal court case, began with a series of conventional, yes-or-no-style questions. (Carlesso, 7/18)

Crossover Health, a one-stop comprehensive health and wellness center for employees at nearby companies, said Thursday it will open in Spring next week. Already in 20 locations across the country, including four in Texas, the Crossover centers create a health care hub where employers can pay a direct membership fee to provide easy access for primary care, behavioral health and other services for workers and skip traditional insurance claims for such visits. (Deam, 7/18)

Florida can limit who gets to give dietary advice, a federal court ruled. The ruling came in a lawsuit filed by a health coach who was fined for practicing without a dietary license. Heather Del Castillo had argued Florida's law violated her First Amendment right to free speech, noting dietary advice is ubiquitous online, in books and on TV. (7/18)

The songs have been weaponized before to annoy parents, babysitters and other formerly sane adults in proximity to children. Now, “Baby Shark” and “Raining Tacos” are being used by city officials in West Palm Beach, Fla., as a property management tool. To deter people experiencing homelessness from sleeping overnight at the city’s Lake Pavilion and Great Lawn, venues that offer “million-dollar views” for special events, West Palm Beach officials began playing the catchy, obnoxious tunes three weeks ago from strategically situated speakers. (Mettler, 7/18)

Sen. Bernie Sanders (I-VT) took the stage at George Washington University Wednesday to reclaim an idea he’s made central to Democrats’ health care debate: Medicare-for-all. (Tara Golshan, 7/17)

It matters that the first patients were identical twins. Nancy and Barbara Lowry were six years old, dark-eyed and dark-haired, with eyebrow-skimming bangs. (Siddhartha Mukherjee, 7/15)

For all but the luckiest Americans, there will come a time when you realize that the health-care system as it stands — the most expensive in the world — isn’t working the way we were told it would, or the way we may have expected it to, when we were young. (Katie Heaney, 7/12)

In a series of speeches, Biden finally did what he needed to do weeks ago: He attacked his rivals on health care. He defended the Affordable Care Act, and argued that Democrats should build on it—presumably with some form of public option—rather than embrace a Medicare for All system that bans private insurance. (Peter Beinart, 7/15)

One of the central questions of the 2020 Presidential campaign was posed last week before the Court of Appeals for the Fifth Circuit, in New Orleans, to a lawyer for the Trump Administration, who didn’t even pretend to have an answer. (Amy Davidson Sorkin, 7/14)

It says something about the state of the two major political parties that, while Washington was focused on President Trump’s racist tweets and his strategy to divide for political advantage, Democratic presidential candidates were engaged in an increasingly substantive debate about the future of health care. No matter how you feel about former vice president Joe Biden’s plan to build on Obamacare, which he released Monday, or Vermont Sen. Bernie Sanders’s Medicare-for-all proposal, which he defended in a speech Wednesday, the Democratic field has already far surpassed Mr. Trump in seriousness. His “plan” to this day has not progressed beyond a promise to destroy Obamacare. (7/18)

There’s a high-profile debate over health care playing out in the presidential race, and a lower-profile one taking place in Congress. Several Democratic presidential candidates are telling us that they are going to provide health care that is free at the point of service to all comers. In little-noticed congressional mark-ups, members of both parties are demonstrating why these promises will not be met.The legislation under consideration is aimed at so-called surprise medical bills” – charges a patient assumes were covered by insurance but turn out not to have been. My family got one last year: The hospital where my wife delivered our son was in our insurer’s network, but an anesthesiologist outside the network assisted. The bill had four digits. (Ramesh Ponnuru, 7/19)

At the top of his Wednesday night program, Fox News host Tucker Carlson apprised viewers that the usual script was getting tossed. “The President is speaking to supporters in Greenville, North Carolina. We will be taking portions of it live, especially the newsworthy moments,” said Carlson, as if the network’s producers could predict newsworthiness. “Right now, he is talking about the four radical freshman Democrats, Antifa, and more broadly, the direction the Democrats are moving. We are going to go back and listen in. It’s interesting.”The “listen in” strategy sure did vacuum up a newsworthy utterance from President Trump: “Better health care. And we’ll also always protect . . . you have to remember this. Are you ready? Because they give us a bum rap,” said Trump. “Patients with preexisting conditions are protected by Republicans much more so than protected by Democrats who will never be able to pull it off.” (Erik Wemple, 7/18)

I regret to inform you that a death may be in the offing. Obamacare’s “Cadillac tax” is facing a bipartisan congressional firing squad. The House voted on Wednesday to repeal it, and the Senate may follow suit. Someday soon, the tax may slip into the political boneyard without ever taking effect.In case you aren’t steeped in the Affordable Care Act’s wonky details, the Cadillac tax is a 40 percent excise on expensive health-care plans. The policy was unlovable, opaque and oddly structured. Yet it earned grudging wonk respect, even from ideological opponents, because it was the first serious attempt to curtail the tax break for employer-sponsored health insurance. (Megan McArdle, 7/18)

Liberal comedian Jon Stewart is no fan of Rand Paul. After the Kentucky senator's decision to object to a unanimous consent authorization of healthcare funding for 9/11 first responders on Wednesday, Stewart blasted him as “absolutely outrageous” and lamented his decision as “fiscal responsibility virtue signaling.” Democratic Sen. Kirsten Gillibrand of New York accused Paul of “turning his back on our first responders.”Meanwhile, coverage from news outlets across the political spectrum made it seem as if Paul single-handedly denied our heroes healthcare, and #RandPaulHatesAmerica started trending on Twitter. The outrage is completely unwarranted, and in fact it amounts to a vicious smear against the senator. (Brad Polumbo, 7/18)

For individuals suffering with end-stage liver disease, liver transplants — true miracles of modern medicine — can save their lives. Yet every day in the U.S., seven people die while waiting for a liver transplant. Many more die awaiting hearts, kidneys, and other organs.We have the technology, the high-tech operating rooms, the highly skilled clinical and surgical teams, all standing by. What we don’t have is enough organs. (Yuri Genyk, 7/19)

I managed to get through college in the 1980s without smoking marijuana. It wasn’t until I was diagnosed with cancer in the 1990s that I decided to give it a try.The anti-nausea medicine I was taking to combat the side effects of chemotherapy made me feel like I was going to jump out of my skin and it didn’t banish my queasiness. So I took matters into my own hands and asked a friend for some marijuana. At the time, possessing it or using it was illegal, and there was a stigma around its use. It felt like I had a dirty little secret.That said, when I smoked it, I felt great. My nausea disappeared, my appetite came back, and I slept like a baby. My two biggest regrets were that I didn’t use it more consistently during my illness and that I hadn’t tried it the first time I had cancer, eight years earlier. (Shari Berman, 7/19)

Our bungalow was still dark when my cellphone rang at 5 a.m. My husband and I had escaped for a much needed yoga retreat on the remote island of Koh Phangan, Thailand, when I got the phone call no parent ever expects to get — a call that four years of medical school, three years of pediatric residency training and 15 years of practicing pediatrics hadn’t prepared me for. At the sound of the middle school principal’s voice, my heart started racing. “We know you are away and it is early, but we had to call you.” They had called my parents to pick up my middle child from school. “He told us he has been hurting himself because he has a secret that he doesn’t know how to tell you. He thinks he is a girl.” (Paria Hassouri, 7/19)