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What does it sound like when a political candidate makes bashing “Big Pharma” a cornerstone of her campaign? Look no further than one of Claire McCaskill’s campaign rallies. On the trail in Missouri, the imperiled Democratic senator is talking about perceived greed within the pharmaceutical industry with an intensity largely unseen in Washington and within other political campaigns. At a recent campaign stop at a Democratic Party office here, McCaskill spent roughly half of a 15-minute stump speech ripping into drug makers and the industry at large. (Facher, 10/25)

U.S. Sen. Kirsten Gillibrand of New York and Republican challenger Chele (shehl) Farley have sparred in a televised debate over immigration, health care and whether the incumbent Democrat plans to run for her party's presidential nomination in two years. ... On health care, Gillibrand said she supports Medicare for all, while Farley opposes it as being too costly for taxpayers. (10/25)

Their 30-minute exchange was cordial, as both women outlined competing proposals on various subjects. Sen. Gillibrand said she would favor a “Medicare for All” plan that would guarantee people have “access to life-saving care.” Ms. Farley questioned the cost of such a measure, and said a single-payer health insurance system might lead to long waits for specialists or surgical procedures. (Vielkind, 10/25)

The Republican candidate in New Hampshire's 1st Congressional District Eddie Edwards says he supports the repeal of the Affordable Care Act. For people who currently rely on expanded Medicaid, he says, increasing access to insurers across the country would bring down costs. All Things Considered Host Peter Biello spoke with Edwards about healthcare policy. All Things Considered is speaking with all congressional candidates this week. (Biello and Goldstein, 10/25)

With just two weeks to go until the critical midterm elections, an overwhelming majority of Americans say the United States is greatly divided, according to an Associated Press-NORC Center for Public Affairs Research poll. Few Americans believe those stark divisions will get better anytime soon. ... Overall, top issues for Americans include health care, education, economic growth, Social Security and crime, each of which was called very important by at least three-quarters of Americans. (Summers, 10/25)

Kaiser Health News: Podcast: KHN’s ‘What The Health?’ Trump, GOP Fight Back On Health Care

With Election Day less than two weeks away, the Trump administration tried to pivot away from Democrats’ attacks that they are out to dismantle health insurance protections for people with preexisting conditions. The administration made three health care moves over the course of the week, including addressing high prices paid by the Medicare program for drugs administered in doctors’ offices and outpatient facilities. (10/25)

Under pressure to curb vaping among young people, the tobacco giant Altria announced on Thursday that it would discontinue most of its flavored e-cigarettes and stop selling some brands altogether. The company also said, for the first time, that it would support federal legislation to raise the age to 21 for the purchase of any tobacco and vaping product. (Kaplan, 10/25)

The tobacco manufacturer, which also makes Marlboro cigarettes, said it would not put the vaping products back on the market until they get federal clearance or “the youth issue is otherwise addressed.” That means a halt in sales of MarkTen Elite and MarkTen pod-based products. Those pods are essentially cartridges that hold liquids that are turned into vapor before being inhaled. Such pods have become increasingly popular because of their portability and ease of use. The vaping products currently do not need a Food and Drug Administration sign-off if they were on the market before August 2016. (McGinley, 10/25)

Altria’s e-cigarettes, sold under the MarkTen and Green Smoke brands, are just a small slice of the U.S. market. Juul is the dominant player, with devices resembling USB sticks and pods in mango, cucumber and other flavors. In a letter to the FDA, Altria Chief Executive Howard Willard said underage use of e-cigarettes is “compounded by flavors that go beyond” traditional tobacco and menthol flavors. (Maloney, 10/25)

The FDA said in a statement in response to Altria's announcement it "appreciates any voluntary steps companies can take to address the youth access and appeal of e-cigarettes." The agency added it "will be taking additional action very soon ... all policy options are on the table." (Weixel, 10/25)

Caitlyn Jenner, the transgender rights activist who has long drawn criticism from members of the L.G.B.T.Q. community for her Republican leanings, unambiguously denounced President Trump on Thursday for his stance on transgender issues. In a column published in The Washington Post, Ms. Jenner, 68, wrote that she had hoped she could work within the Republican Party to improve its position on L.G.B.T.Q. issues, but that she had evolved to see that belief as a mistake. (Jacobs, 10/25)

“Sadly, I was wrong,” Jenner wrote. “The reality is that the trans community is being relentlessly attacked by this president. ”The New York Times reported Sunday that the Department of Health and Human Services was leading an effort to establish a legal definition of gender under Title IX, the federal civil rights law. The law states that no person can be discriminated against from participating in or receiving benefits of any education program on the basis of gender. (Morin, 10/25)

About 200 people gathered outside City Hall on Thursday to condemn an initiative by the Trump administration they said would erode the civil rights of transgender, intersex and gender nonconforming people. The move would strictly define gender as a fixed status determined by the genitalia a person is born with, reversing Obama-era policies that granted federal recognition to transgender individuals, according to a memo obtained by The New York Times. (Garza, 10/25)

As one of President Trump’s top compliance and ethics attorneys in the White House, Uttam Dhillon had urged several candidates for Drug Enforcement Administration chief to withdraw from consideration, citing concerns about their background checks. Then, he accepted the job himself. Mr. Dhillon’s rise to the top of the world’s largest drug-fighting agency—after being closely involved in the selection process—has riled police groups that had pushed the White House to choose a DEA administrator with a law-enforcement background. (Bender, 10/25)

The Food and Drug Administration is poised to approve a new form of a powerful opioid for use in hospitals and emergency rooms despite opposition from the head of the committee that reviewed the drug. The FDA is scheduled to decide by Nov. 3 whether to allow a California company to produce a 30-microgram pill form of sufentanil, a potent painkiller commonly used after surgery. An FDA advisory committee recommended approval of the drug in a 10-to-3 vote on Oct. 12. The FDA usually follows the guidance of those committees, which are comprised of experts on various drugs and medical devices. (Bernstein, 10/25)

The sharp rise in opioid abuse and fatal overdoses has overshadowed another mounting drug problem: Methamphetamine use is rising across the United States. "Usage of methamphetamine nationally is at an all-time high," says Erik Smith, assistant special agent in charge of the Drug Enforcement Administration's Kansas City office. "It is back with a vengeance." he says. "And the reasons for that are twofold." The drug's now stronger, and cheaper, than it used to be. (Morris, 10/25)

Representatives with a number of different federal agencies tasked with responding to the opioid crisis were in Nashua Thursday for a conference on the city’s Safe Station program. The event, co-sponsored by Nashua-based Harbor Homes and the federal Health Resources and Services Administration, aimed to share results and best practices of the Safe Station model. (Greene, 10/25)

A study from Boston Medical Center published Thursday estimates that 275,000 Massachusetts residents, or 4.6 percent of people older than age 11, suffered from opioid use disorder in 2015. Previous estimates based on national surveys pegged the number at just over 1 percent. (Freyer, 10/25)

The California Nurses Association, which led the coalition behind the high-profile 2017 push for a single-payer system, has re-branded its campaign with the slogan “Fight to Win Medicare-for-All!” Its social media feeds reflect the new national scope of their efforts. Until this month, the coalition, previously called “Campaign for a Healthy California,” was focused solely on passing a single-payer health care bill in California. (Hart, 10/26)

Large majorities of young Americans want to see an expansion of government services, including a single-payer health care program, according to a new poll by The Associated Press-NORC Center for Public Affairs Research and MTV. According to the poll, 69 percent of young Americans between the ages of 15 and 34 favor a national health plan, known as a single-payer program. Eighty-eight percent of young Democrats and 40 percent of young Republicans favor a government-run health insurance program, according to the poll. Roughly two-thirds of young independents are in favor. (Summers, 10/24)

In its annual report CVS said retail pharmacists are shifting from primarily filling prescriptions to providing services including vaccinations and patient counseling. And [Robert] Field said offering things like flu shots can be cheaper for the big company than for the small doctor’s office. (Olgin, 10/25)

Fewer than 4 out of 10 adults in the United States got flu shots last winter, the lowest rate in seven seasons and one likely reason that the 2017-2018 season was the deadliest in decades. Reports released Thursday by the Centers for Disease Control and Prevention provide new details outlining the severity of the past flu season, during which more people were killed by seasonal influenza than in any other since the 1970s. (Sun, 10/25)

Sen. Amy Klobuchar and state health leaders on Thursday called for mandatory national reporting of cases of acute flaccid myelitis, or AFM, the polio-like disorder that has stricken as many as seven Minnesota children this year. Mandatory reporting by doctors and hospitals could lead to improved tracking and understanding of the mysterious, paralyzing condition, according to a top Minnesota infectious disease official. It is already required for a number of diseases, including West Nile virus and influenza, but not for AFM. (Olson, 10/25)

Six or seven Minnesota children have been diagnosed this year with AFM, a polio-like disorder that attacks the spongy core of the spinal cord. The local cluster has renewed national attention to the disorder, which federal officials started tracking in 2014 after outbreaks in California and Colorado, while forcing parents to confront the realities of prevention and treatment. The U.S. Centers for Disease Control and Prevention has reported 155 suspected cases in the nation so far this year, but it hasn’t isolated the viral, genetic or environmental causes. (Olson, 10/25)

The Centers for Disease Control and Prevention recently reported it has confirmed 62 cases of AFM in 22 states so far this year. In Georgia so far this year, there have been an estimated three confirmed, or probable, cases of AFM with two possible other cases under investigation, according to the state’s Department of Public Health. In 2017, there were 33 confirmed cases in 16 states, the CDC reported. (Prince, 10/25)

Casey Kasem’s widow battled his children to maintain medical control of the radio legend as he faded with a form of dementia. The wife and daughter of actor and comedian Tim Conway are sparring in court over the care of the former Carol Burnett Show star. Similar disputes divided the families of country music icon Glen Campbell and R&B singer Etta James. Star Trek actress Nichelle Nichols is the subject of a court action brought by her son. The high-profile legal battles around celebrities incapacitated by dementia are drawing attention to a phenomenon dividing many more families across the country. (Alltucker, 10/25)

Color Genomics will be working with the prestigious Broad Institute in Massachusetts to help in the five-year effort, which the NIH calls “one of the country’s most ambitious biomedical research efforts ever undertaken.” The NIH announced in late September that it had awarded $28.6 million to establish three genome centers around the nation, including the Broad-Color team, as part of its All of Us program. (Sumagaysay, 10/25)

By now, many consumers have heard of glyphosate, the active ingredient in the herbicide known as Roundup, and warnings about its presence in many of their favorite foods. From oatmeal to granola bars, ice cream to even orange juice, trace amounts of the chemical can be found throughout your local supermarket. It’s the world’s most widely used weedkiller—a blockbuster for Monsanto Co. since it was introduced in the 1970s. The vast majority of U.S. corn and soybeans have been genetically modified to withstand it, making it a critical component of modern farming. But in 2015, the International Agency for Research on Cancer—an arm of the World Health Organization—labeled it a probable carcinogen. Since then, it’s become a legal headache for Monsanto, and now Bayer AG, which bought the company in June for $66 billion. (Shanker and Mulvany, 10/26)

The 2013 Violence Against Women Act is due for a reauthorization by Congress so it can be funded to continue lifesaving services for shelter programs and coalitions nationwide, especially on reservations. A recent bill that would have done so only received Democratic votes and is now stalled. But Republicans did step in at the last minute to keep the act funded by including it in an appropriations bill called the Continuing Resolution or CR. (Edwards, 10/25)

An ancient part of the brain long ignored by the scientific world appears to play a critical role in everything from language and emotions to daily planning. It's the cerebellum, which is found in fish and lizards as well as people. But in the human brain, this structure is wired to areas involved in higher-order thinking, a team led by researchers from Washington University in St. Louis reports Thursday in the journal Neuron. (Hamilton, 10/25)

How old were you when CRISPR got added to the dictionary? And what were your grandparents doing when DNA made its first appearance?Now you can find out. Merriam-Webster has been promoting a search tool that lets you look up the words that got added to dictionary in the year you were born, or any other year dating all the way back to 1500. ...We at STAT decided to scour Merriam-Webster’s trove for some of the most important words that have shaped science in the past century. Taken a whole, the list is a revealing lens through which to understand the history of science and biotech. (Robbins, 10/26)

Most women know breast-feeding is good for their babies’ health. But doctors and midwives rarely tell moms-to-be that it’s also good for nursing mothers. Nursing mothers reduce their relative risk of breast cancer by 4.3 percent for every 12 months they breast-feed, in addition to a relative decrease of 7 percent for each birth. Breast-feeding is particularly protective against some of the most aggressive tumors, called hormone receptor-negative or triple-negative tumors, which are more common among African-American women, studies show. It also lowers the risk by one-third for women who are prone to cancer because of an inherited BRCA1 mutation. (Rabin, 10/26)

I’d always thought that our need for sleep, like our appetite for food, drink or social contact, was a personal matter: Some people need more, some need less. Age, lifestyle, work and metabolism combine to determine how much sleep a person needs to function, and if some people thrive on five hours a night and others require seven, chalk it up to different strokes for different folks, right? Wrong. A new study of the sleep habits of more than 10,000 people around the world suggests that the amount of sleep adults need is universal. The massive survey, published in the journal Sleep, demonstrates that adults everywhere need 7-8 hours a night—no more and no less—in order to be mentally limber. (Pinker, 10/25)

California officials on Friday plan to submit a 400-page repudiation of the Trump administration’s proposal to freeze fuel-efficiency standards for the nation’s cars and trucks through 2026, calling it a deeply flawed, disingenuous effort that will harm the health and pocketbooks of Americans. “Finalizing this proposal would worsen air quality for the most vulnerable, waste billions of gallons of gasoline, forfeit our best chance to fight climate change, and result in years of uncertainty in the marketplace,” reads a draft of comments from the California Air Resources Board obtained by The Washington Post. It calls the Trump administration’s plan “a contrived solution to justify a predetermined outcome.” (Bennis and Laris, 10/26)

New Jersey health officials said Thursday tests confirmed a 19th patient has been infected in a viral outbreak at a pediatric rehabilitation center that has killed seven people. The unidentified person had already been ill so the diagnosis does not necessarily mean the virus is still spreading, according to Health Department spokeswoman Donna Leusner. (10/25)

The case last month of an allegedly mentally-ill Asian woman charged with stabbing several people has highlighted what advocates say is a troubling insufficiency in mental health care services for New York City’s growing Asian population. The system is hampered by a shortage of culturally fluent providers, wait times that can stretch to weeks and a lack of adequate governmental funding, the advocates say. (West, 10/25)

State and county investigators have launched criminal probes into the troubled Milwaukee Health Department, although officials are tight-lipped on details of the investigations. Asked about a criminal investigation into the Health Department, Milwaukee Mayor Tom Barrett said he could not comment — but added that city staffers have been instructed to cooperate with any investigations. (Spicuzza, 10/25)

The Texas Higher Education Coordinating Board swiftly signed off on opening two new medical schools Thursday, months after a similar proposal from Sam Houston State University was subject to extensive debate and nearly shot down by the nine-member body. In back-to-back votes, the University of Houston and the University of North Texas Health Science Center were given the go-ahead to launch doctorate of medicine programs in the next few years, with respective tuition and fee rates ranging from $22,500 to around $60,000. (Najmabadi, 10/25)

The state higher education regulatory agency gave its stamp of approval Thursday to the University of Houston's plan to create the city's first new medical school in nearly half a century. The Texas Higher Education Coordinating Board unanimously approved the UH proposal, which calls for a focus on training primary-care doctors to practice in underserved areas. (Ackerman, 10/25)

A police task force is preparing to investigate a Detroit funeral home where 36 fetuses were found in boxes and 27 others in freezers, the city's police chief said Thursday. Chief James Craig told reporters at a news conference that the task force will include his officers, state police and the FBI. On Monday, the task force will start looking into operations at the Perry Funeral Home , where the fetuses were found last week. (10/25)

The Planning Commission on Wednesday unanimously approved University Hospitals Parma Medical Center's $27.5 million surgery department renovation and expansion. The proposed multiphase construction, scheduled to begin this winter and last two years, is the largest project at the main hospital in 33 years. (Benson, 10/25)

The University of Maryland Medical Center has received a $25 million gift — the largest donation in the hospital’s history — from Baltimore auto dealer Len Stoler and his wife, Roslyn, that will help fund a new cancer building. The money from the owner of car dealerships will allow the University of Maryland Greenebaum Comprehensive Cancer Center to better accommodate a patient population that has tripled in the last 14 years, hospitals officials said. (McDaniels, 10/25)

Nearly 1 in 5 Georgia youths from ages 10 to 17 are obese, according to a new report. The 18.4 percent figure gives Georgia the eighth-highest rate among states. The analysis, released this week, also showed racial and ethnic disparities in the obesity figures. In Georgia, the Hispanic youth obesity rate is highest, at 32.8 percent, while black youths were at 23.4 percent and whites at 13.5 percent. (Miller, 10/25)

At least seven Texas school districts have sent students with special needs to Shiloh Treatment Center in recent years, despite the facility’s trail of deaths and abuse of children in its care, a Reveal investigation has found. Among the troubled past of Shiloh and its affiliated facilities are the deaths of four teenagers and allegations that children were injured or sexually abused. (Morel, 10/25)

According to an American-Statesman analysis of what the DPS considers border arrests, nearly 30 percent occurred more than 100 miles from the border — in Hill Country cities like Brady and Mason, as well as Panhandle towns like Seminole and Denver City. Included in the numbers are thousands of arrests in the West Texas cities of Odessa, Midland and San Angelo, nearly 200 miles from Mexico. Many of those far-flung arrests lack a nexus to cartel activity or smuggling offenses. (Keemahill and Schwartz, 10/25)

Immigration and Customs Enforcement on Thursday confirmed 10 detainees at an Aurora immigration detention facility have been quarantined for chickenpox, drawing accusations by immigration activists of medical negligence and due-process violations. Spokesmen from ICE and the GEO Group, the private company contracted to run the facility, disputed the allegations. Immigration groups contend the quarantine is preventing detainees from being able to speak face-to-face with their lawyers, visit with family and attend hearings. They also allege that ICE has not followed its medical protocols when it comes to caring for detainees. (Tabachnik, 10/25)

Another nurse is scheduled to plead guilty in a $60 million health care fraud scheme involving Novus hospice companies. Patricia B. Armstrong, 34, has reached an agreement with federal prosecutors to plead guilty to one count of conspiracy to commit health care fraud. As part of the deal, the registered nurse has agreed to cooperate with the federal investigation. Armstrong is the fifth of 16 defendants connected with Novus to reach a deal in the criminal case, which is tentatively scheduled to go to trial in January. (Wigglesworth, 10/25)

Iowa lawmakers approved new rules Thursday for handling sexual harassment complaints in state government a month after an investigation found a former state agency director harassed employees. The emergency rules, which were fast-tracked without public input, clarified that the Department of Administrative Services will investigate harassment and discrimination complaints from state employees. (Sostaric, 10/25)

Adding a new administrative hurdle in the form of work requirements in Kentucky would double the number of enrollees who disenroll from the program over a two-year period. We estimate that as many as 118,000 adults enrolled in Medicaid would either become uninsured for an extended period of time or experience a gap in insurance over a two-year period. These findings should be of concern to policymakers: research has found that adults who experience coverage gaps report problems getting health care or paying medical bills at rates nearly as high as those who are uninsured continuously. (Collins, Glied and Jackson, 10/22)

If commercial insurers retrospectively deny coverage for emergency department (ED) visits based on diagnoses determined to be nonemergent, what visits will be denied coverage? Findings: This cross-sectional study found that 1 insurer’s list of nonemergent diagnoses would classify 15.7% of commercially insured adult ED visits for possible coverage denial. However, these visits shared the same presenting symptoms as 87.9% of ED visits, of which 65.1% received emergency-level services. Meaning: A retrospective diagnosis-based policy is not associated with accurate identification of unnecessary ED visits and could put many commercially insured patients at risk of coverage denial. (Chou et al., 10/19)

What is it like to sleep squeezed in the backseat of a car? What is it like for a 4-year-old? Darlene, a mom who has spent many months homeless, told me about her experience living in a car with her 4-year-old son. Each night, they would drive around San Francisco looking for places to park—places where they would go unnoticed but that weren’t so isolated that they would be at risk of harm. Sometimes, when they could afford to, they stayed in cheap motels. But most nights, they had to sleep in the car. (Cunningham, 10/16)

Financial concerns such as high vaccine purchase costs and inadequate insurance reimbursement are cited as a key barrier to human papillomavirus (HPV) vaccination of adolescents who are covered by private health insurance. Statistical evidence on the relationship between payments to providers for HPV vaccination and HPV vaccine uptake is limited. This study used data for 2008–14 from the MarketScan Commercial Claims and Encounters database and included adolescents ages 11–17 who had been continuously enrolled in the same noncapitated private insurance plan. Our estimates showed that a $1 increase in median provider payments in a state was associated with a 0.48-percentage-point increase in the probability of initiating the HPV vaccine series and a 0.25-percentage-point increase in the probability of receiving two or more doses. These numbers translated to an average increase of 49,435 adolescents initiating the series and 25,314 adolescents receiving two or more doses. The association between provider payments and HPV vaccine uptake was stronger among adolescents ages 11–12 than among older adolescents, and among adolescents who lived in a Metropolitan Statistical Area than those who did not. (Tsai et al, 10/1)

Question: Is a standardized intervention delivered by community health workers effective for improving clinical outcomes across a Veterans Affairs medical center, a federally qualified health center, and an academic family practice clinic? Findings: In this multicenter randomized clinical trial of 592 adults, self-rated health was similar among the intervention and control groups, but the patients in the intervention group were more likely to report high-quality primary care and a reduction in total hospital days. (Kangovi et al, 10/22)

In a population-based cohort study of 68 946 French adults, a significant reduction in the risk of cancer was observed among high consumers of organic food. ... A higher frequency of organic food consumption was associated with a reduced risk of cancer; if the findings are confirmed, promoting organic food consumption in the general population could be a promising preventive strategy against cancer. (Baudry et al, 10/22)

A stronger economy was a primary factor driving lower Medicaid enrollment growth and relatively steady spending growth as states finished state fiscal year (FY) 2018 and adopted budgets for FY 2019. This brief analyzes Medicaid enrollment and spending trends for FY 2018 and FY 2019 based on interviews and data provided by state Medicaid directors as part of the 18th annual survey of Medicaid directors in all 50 states and the District of Columbia. The methodology used to calculate enrollment and spending growth as well as additional information about Medicaid financing can be found at the end of the brief. Key findings are described below and in a companion report. (Rudowitz, Hinton and Antonisse, 10/25)

One thing President Trump hasn’t changed about the GOP: Republicans still say any increase in government redistribution would be tantamount to communism. That was the case in the 1930s when Republican leaders lambasted the New Deal as Bolshevism-lite. It was in the 1960s when Ronald Reagan warned that Medicare would lead to a socialist dystopia. And it is today when the Trump administration tries to scare voters about the supposed dangers of Medicare-for-all. The only difference is they’re now willing to be more offensive about how they put it. (Matt O'Brien, 10/25)

Those of us with employment-related health insurance should care about policies affecting the few million people stuck between a rock and a hard place when buying health insurance because they use the same hospitals we do.By law, hospitals must treat uninsured or underinsured patients. The cost of this “uncompensated care” reached $38.3 billion in 2016. That’s a huge drain on hospital resources. A recent report estimated that each uninsured patient costs a hospital $800 in uncompensated costs. People with short-term insurance function as uninsured when they seek treatment for conditions their policies don’t cover, such as childbirth, heart attack, or emergency psychiatric care. (Vivian Ho, 10/26)

“Medicare for All” is now a political campaign talking point. Polls on Medicare for Alland single-payer health care have shown that public support varies depending on what the proposal is called and the arguments for or against it. Misconceptions abound about these proposals and their likely effects. (Jodi L. Liu and Christine Eibner, 10/26)

Until recently, it looked as if the midterm elections might be defined largely by an argument about health care. Over the past few days, however, the headlines have been dominated instead by hatred — hysteria over a caravan of migrants a thousand miles from the U.S. border, and now the attempted assassination of multiple prominent Democrats. But whoever sent the bombs and why, the caravan hysteria is no accident: creating a climate of hatred is how Republicans avoid talking about health care. What we’re seeing in this election is a kind of culmination of the strategy the right has been using for decades: distract working-class voters from policies that hurt them by promoting culture war and, above all, racial antagonism. (Paul Krugman, 10/25)

Health care has achieved top billing in the midterms. It’s the top issue for Democrats and independents, not Republicans, but that’s been more than enough to propel health to the top of  the issue list in national polls, even ahead of the economy and jobs, a rare status for health care. Democrats have jumped on the salience health care has for their base, using it as a tool to energize voters and bludgeon Republicans — making 2018 almost the reverse of 2016. (Drew Altman, 10/25)

Are firearms injuries rising, falling or holding steady in the U.S.? It’s hard to tell, and that’s an enormous obstacle to understanding and preventing them.There is no reliable national database for firearm injuries. The Centers for Disease Control and Prevention collect data from multiple sources. But they rely significantly on a system designed to monitor injuries from consumer products, using data from surveys of a relatively small sample of hospitals. (10/25)

In his most aggressive response to date to high prescription drug prices, President Trump wants Medicare to obtain better deals by negotiating with pharmaceutical companies — just not directly. The proposal would affect only a limited number of drugs and would come with some potentially harmful side effects, but it’s a promising start. (10/26)

Two sexes have never been enough to describe human variety. Not in biblical times and not now. Before we knew much about biology, we made social rules to administer sexual diversity. The ancient Jewish rabbinical code known as the Tosefta, for example, sometimes treated people who had male and female parts (such as testes and a vagina) as women — they could not inherit property or serve as priests; at other times, as men — forbidding them from shaving or being secluded with women. More brutally, the Romans, seeing people of mixed sex as a bad omen, might kill a person whose body and mind did not conform to a binary sexual classification. (Anne Fausto-Sterling, 10/25)

These past two years under President Trump have given me the opportunity to reflect on a lot of topics that have come up in the LGBTQ community and in our nation. Some of these are thorny issues still worth discussing; many should have been settled long ago. As I’ve watched and pondered, my outlook has changed significantly from what it was during my highly publicized and glamorized early Caitlyn days, when my life as an out trans woman was just beginning. (Caitlyn Jenner, 10/25)

Not only does 23andMe not provide counseling, their results are incomplete. For instance, they report only on BRCA1 and BRCA2 and restrict their findings to the three mutations common among Jewish women. (They do explain this in their printed materials.)While the most common three mutations in the BRCA1 and BRCA2 genes are typically found in women of Ashkenazi Jewish heritage, there are more than 1,000 other mutations that can be just as deadly. Women with Ashkenazi heritage can also have a mutation not associated with being Ashkenazi.There are other genes that can have mutations that substantially increase one’s risk for breast cancer, including PALB2, CHEK2, PTEN, CDH1, TP53 and STK11. 23andMe doesn’t provide test results for any of these mutations. (Sarah C. Hopkins, 10/26)

Intimate partner violence (IPV) (defined as physical and sexual violence, emotional abuse, and stalking) and abuse of older or vulnerable adults are common in the United States and globally. Recent estimates of prevalence in the United States from the National Intimate Partner and Sexual Violence Survey, a nationally representative random-digit-dial telephone survey, indicate that 1 in 4 women and 1 in 10 men have experienced contact sexual violence, physical violence, and/or stalking by an intimate partner resulting in consequences such as injury, need for medical care, or posttraumatic stress symptoms. The prevalence of elder abuse varies depending on the population and ascertainment methods, but 1 national survey reports a 10% past year prevalence for abuse or neglect. (Elizabeth Miller, Scott R. Beach and Rebecca C. Thurston, 10/23)

Nurses put Question 1 on the ballot to protect patients. The truth about Question 1 is that it ensures when your loved one hits the call button, there will be a nurse ready to respond when they are most critically needed. (Donna Kelly-Williams and Judith Shindul-Rothschild, 10/25)

The top psychiatrist in the California Department of Corrections and Rehabilitation has accused his prison bosses of misleading the federal court — and opposing lawyers — in a long-running inmate lawsuit about appropriate levels of psychiatric treatment. The judge is weighing whether she should make the psychiatrist’s whistle-blower report public. (10/25)