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The Nobel Prize in Physiology or Medicine has been awarded to James P. Allison and Tasuku Honjo “for their discovery of cancer therapy by inhibition of negative immune regulation.” Dr. Allison is chairman of the department of immunology at the University of Texas and has spent his career developing strategies for cancer immunotherapy. Mr. Honjo is a professor at the department of immunology and genomic medicine at Kyoto University. (Sugden and Chopping, 10/1)

Dr. Allison and Dr. Honjo, working separately, showed how certain proteins act as “brakes” on the immune system’s T-cells, limiting their ability to attack cancer cells, and that suppressing those proteins could transform the body’s ability to fight cancer. (10/1)

The discovery is transforming cancer treatments and has led to a new class of drugs that work by switching off the braking mechanism, prompting the immune cells to attack cancer cells. The drugs have significant side-effects, but have been shown to be effective – including, in some cases, against late-stage cancers that were previously untreatable. The Nobel assembly’s summary said Allison, who is professor and chair of immunology at the University of Texas’s MD Anderson Cancer Center, “studied a known protein that functions as a brake on the immune system. He realised the potential of releasing the brake and thereby unleashing our immune cells to attack tumours. He then developed this concept into a new approach for treating patients. (Devlin, 10/1)

Allison’s and Honjo’s prize-winning work started in the 1990s and was part of significant advances in cancer immunotherapy. “In some patients, this therapy is remarkably effective,” Jeremy Berg, editor-in-chief of the Science family of journals, told The Associated Press. “The number of different types of cancers for which this approach to immunotherapy is being found to be effective in at least some patients continues to grow.” (Keyton and Heintz, 10/1)

In a statement to reporters after learning of his award, Allison said he was “honored and humbled.” For many scientists, he said, a driving motivation “is simply to push the frontiers of knowledge. I didn’t set out to study cancer, but to understand the biology of T cells, these incredible cells that travel our bodies and work to protect us.” (Begley, 10/1)

When Teresa McKeown was diagnosed with breast cancer in 2006, her disease was easily treated with standard therapies. But 11 years later, the cancer returned. This time, it morphed into what’s called triple-negative disease, an aggressive and difficult-to-treat form. “I had one therapy after another,” she said, “and failed them all.” (Swartz, 9/30)

A diagnosis of cancer, even an early-stage, highly curable cancer, can prompt some people to feel as if they’ve suddenly lost control of their future and that they must do whatever they can to regain it. They may seek guidance from the internet, friends and acquaintances, some of whom may be quick to relate tales of miraculous cures from alternative remedies that claim to spare patients the challenges of established cancer treatments like surgery, radiation and chemotherapy. (Brody, 10/1)

Physician suicide has been a problem in healthcare for decades. Studies dating back to the 1920s show that physicians suffer from suicide at high rates. Physicians with mental health conditions have long been discriminated against and suicides have often been kept hidden from colleagues and the public. The difference in the past few years is that the industry is responding. Recent concerns around burnout have pushed organizations to rethink how they approach physician well-being, which has led to more action around how to deal with physician mental health concerns and suicide. (Castellucci, 9/29)

Kaiser Health News: White Coats As Superhero Capes: Med Students Swoop In To Save Health Care

Each wall of the library reading room at the New York Academy of Medicine is lined with tall wooden bookshelves holding leather-bound medical tomes. Atop the shelves perch busts — seemingly all white, all male — lit by two large brass chandeliers. Floor-to-ceiling windows overlook New York City’s Central Park and Fifth Avenue. This setting, which speaks to medicine’s staid past, recently became the backdrop for plotting medicine’s future. (Bluth, 10/1)

President Donald Trump isn't playing it straight when it comes to his campaign pledge not to undercut health coverage for people with pre-existing medical conditions. Five weeks before midterm elections, he is telling voters that those provisions "are safe," even as his Justice Department is arguing in court that those protections in the Affordable Care Act should fall. The short-term health plans Trump often promotes as a bargain alternative to "Obamacare" offer no guarantee of covering pre-existing conditions. (Yen and Woodward, 10/1)

Voters in west Houston's hotly contested Congressional race say taking away protections for pre-existing medical conditions -- or even just appearing to do so -- could spell doom for a candidate, a new survey finds. A poll of 562 voters in the district represented by Republican John Culberson found that 46 percent were less likely to vote for him because of his staunch support of efforts to repeal the Affordable Care Act. (Deam, 9/28)

Autoworkers in this blue-collar, central Indiana city have an eager helper waiting to pick up the bill at their next doctor visit. Fiat Chrysler is offering free health care for most of its employees and their families — about 22,000 people — through a clinic the carmaker opened this summer near one of five factories it operates in the area. The company pays for basic care like doctor visits and consults with a dietitian and even an exercise physiologist. Workers don’t pay a cent, not even a co-pay. (Murphy, 9/30)

Beto O'Rourke has staked his long-shot campaign to beat Sen. Ted Cruz on the idea that Obamacare should be even bigger in Texas — a state that has done more than any other to try to destroy the landmark health care law. It just might be working. (Ollstein, 9/30)

Democratic candidates for governor in red and purple states are going on the offensive on Medicaid expansion, betting the ObamaCare issue will resonate with voters. In ads and speeches in states including Wisconsin, Georgia and Florida, Democrats are seizing on the popularity of Medicaid, making it a central part of their campaigns and using it to attack their GOP opponents. (Weixel, 9/29)

House Minority Leader Nancy Pelosi is hoping six Texas Democrats will turn red U.S. House seats blue in November; wants Democratic candidates to focus on improving people’s health care rather than abolishing U.S. Immigration and Customs Enforcement; and thinks U.S. Supreme Court nominee Brett Kavanaugh lacks the “temperament” for the job. (Walters, 9/29)

Iowans say health care and education are the most important issues for the next governor to address, a new Des Moines Register/Mediacom Iowa Poll found. When asked to identify one or two top issues, 51 percent of Iowans say health care, including Medicaid and mental health, is most important. ... Health care has been a big issue for Iowans because of controversy over the state's privatization of Medicaid for low-income and disabled people, efforts to improve the state's mental health system and legislation to approve the sale of non-Obamacare health coverage in the state. (Petroski, 9/30)

Republican Gov. Greg Abbott and Democratic challenger Lupe Valdez clashed late Friday over Medicaid expansion, in-state tuition for unauthorized immigrants, who’s responsible for high property taxes and whether to arm teachers and other school officials. ... [Valdez] referred to the Affordable Care Act’s inducement for states to add more poor adults to their Medicaid programs — an offer steadfastly rebuffed by Abbott and other Texas Republicans. Abbott, though, said he’s responsibly managing Medicaid, despite its “one-size-fits-all approach.” The state recently renewed a deal with federal officials that helps fund innovative programs at safety-net hospitals such as Parkland Memorial in Dallas, he said. And he called Obamacare’s offer of wider coverage fool’s gold. (Garrett and Jeffers, 9/29)

Minnesota's two contenders for governor split Friday in their approaches to tackling the opioid overdose crisis and to expanding the availability of legal marijuana. The topics arose during and after back-to-back appearances by Republican Jeff Johnson and DFLer Tim Walz at a conference focused on substance abuse, particularly opioids. (Bakst, 9/28)

In shelters from Kansas to New York, hundreds of migrant children have been roused in the middle of the night in recent weeks and loaded onto buses with backpacks and snacks for a cross-country journey to their new home: a barren tent city on a sprawling patch of desert in West Texas. Until now, most undocumented children being held by federal immigration authorities had been housed in private foster homes or shelters, sleeping two or three to a room. They received formal schooling and regular visits with legal representatives assigned to their immigration cases. (Dickerson, 9/30)

The Trump administration is claiming broad new authority to block access to abortions sought by undocumented immigrants under age 18 who are in its custody. In a case that brings together two of the most volatile issues in American society, immigration and abortion, the Justice Department argued this past week before a federal appeals court that the government “has a strong, legitimate and profound interest in the life of the child in the womb.” (Pear, 9/29)

Kaiser Health News: Podcast: KHN’s ‘What The Health?’ (Almost) Live From Austin! 

President Donald Trump’s proposed rule that would make it more difficult for immigrants to gain permanent status if they use government aid programs could have a major impact in Texas, with its large immigrant population. Texas is also ground zero for the health debate in this year’s midterm elections. Texas Attorney General Ken Paxton is the lead plaintiff in a case filed by 20 GOP state officials arguing that the entire Affordable Care Act is now unconstitutional in light of last year’s tax bill, which canceled the penalties for people who fail to obtain health insurance. (9/28)

Anti-abortion groups — normally staunch allies of the Trump administration — have turned their fire on the health department, accusing the agency of being complicit in abortions by refusing to end research projects using fetal tissue. The simmering fight spilled into public view on Monday night, as HHS abruptly terminated one longstanding contract with a fetal tissue provider while opening an audit of all federally funded research and practices related to fetal tissue, which is mostly obtained from abortions. (Diamond, 9/28)

The Environmental Protection Agency has sent a proposal to the White House that would weaken existing curbs on power plants' emissions of mercury, a powerful neurotoxin, by changing the way it calculates the cost and benefits of curbing hazardous air pollutants. The proposed rule, according to two senior administration officials who have reviewed the document but spoke on the condition of anonymity because it has not been finalized, would reverse a 2011 Obama administration finding that the agency must factor in any additional health benefits that arise from lowering toxic pollutants from coal plants when evaluating the rule’s costs and benefits. (Eilperin and Dennis, 9/30)

President Donald Trump signed an $854 billion spending bill on Friday to keep the federal government open through Dec. 7, averting a government shutdown in the weeks leading up to November's pivotal midterm elections. Trump signed the legislation to fund the military and several civilian agencies without journalists present as the fate of his Supreme Court nominee, Brett Kavanaugh, continued to hang in the balance. The House and Senate approved the spending plan earlier this week. (Colvin and Lucey, 9/28)

Funding for the Department of Health and Human Services, as well as the labor and education departments, would grow to $178 billion, a $1 billion increase and $11 billion more than the White House originally requested. This was a major priority for Democrats. Because Republicans only narrowly control the Senate, they need support from Democrats to pass spending bills. (Paletta, 9/28)

It also includes a measure to keep the federal government open until at least Dec. 7, even though Congress has not yet passed full-year appropriations bills covering every department. (9/28)

The House passed consensus legislation, 393-8, on Friday that is intended to help combat the opioid crisis. The legislative compromise was finalized earlier this week, and now heads to the Senate for a final vote. The two chambers came to an agreement on Tuesday, but made additional changes to the bill (HR 6) after the Congressional Budget Office initially estimated that the bill would increase the deficit by $44 million over the next 10 years. (Raman, 9/28)

The legislation includes a range of measures aimed at fighting the deadly opioid crisis, which killed more than 42,000 people in 2016, according to the Centers for Disease Control and Prevention. The bill lifts some limits on Medicaid paying for care at addiction treatment facilities, addressing restrictions that lawmakers called outdated. It cracks down on illicit opioids being imported by mail and fueling the crisis across the United States. (Sullivan, 9/28)

I felt a shake and opened my eyes. The clock read 1:30 a.m. “We need to go to the hospital,” my mother whispered in my ear, clutching her stomach. She knew; it was the same pain she had experienced many times before. (DeFilippis, 9/29)

Costly and dangerous heroin-related infections have risen sharply in Minnesota since 2010, a frightening but little-noticed byproduct of the state’s opioid epidemic that is presenting local hospitals with patients who need lengthy and expensive treatment. Since 2010, for example, admissions at Minnesota hospitals for heart valve infections among drug users have more than quadrupled, from 18 to at least 81. While the full impact on Minnesota’s health care system stemming from injecting opioids is unclear, doctors report a growing number of grave infection cases — patients who require up to six weeks of intravenous antibiotic therapy. (Howatt, 9/30)

Kaiser Health News: Judges In California Losing Sway Over Court-Ordered Drug Treatment

Dressed in jailhouse orange, with hands and feet shackled, Jimi Ray Haynes stood up in a Santa Cruz County courtroom and pleaded guilty to a felony weapons charge. Haynes, then 32, had spent the previous two weeks in jail detoxing from methamphetamine and heroin. The judge told Haynes he could serve part of his yearlong jail sentence in a drug treatment program rather than locked in county jail. (Rinker, 10/1)

A vice president of Memorial Sloan Kettering Cancer Center has to turn over to the hospital nearly $1.4 million of a windfall stake in a biotech company, in light of a series of for-profit deals and industry conflicts at the cancer center that has forced it to re-examine its corporate relationships. The vice president, Dr. Gregory Raskin, oversees hospital ventures with for-profit companies. As compensation for representing the hospital on the biotech company’s board, Dr. Raskin received stock options whose value soared when the start-up went public a little over a week ago. (9/29)

A federal judge on Friday struck down a Kentucky law requiring abortion providers to sign advance agreements with hospitals and ambulance services for emergency patient care, in a ruling that keeps the state from revoking the license of its only remaining abortion clinic. U.S. District Judge Greg Stivers in Louisville sided with the EMW Women's Surgical Center and Planned Parenthood in challenging a law that threatened to make Kentucky the first U.S. state without a single legal abortion provider. (Gorman, 9/29)

The judge found the two-decades old rule to be a violation of women's constitutional right to an abortion, the AP reported. The agreements “do not advance a legitimate interest” in promoting women’s health, Stivers ruled. "On the other hand, the regulations effectively eliminate women's rights to abortions in the state,” Greg Stivers wrote in his opinion. “Therefore, the challenged regulations are unconstitutional." (Gstalter, 9/29)

Friday's decision is a victory for abortion-rights supporters who had clashed with the administration of (Gov.) Matt Bevin, an anti-abortion Republican, over rules they said his administration misused to try to close one clinic in Louisville and block another from offering abortions. ... Bevin spokeswoman Elizabeth Kuhn said the administration is disappointed with the ruling and plans to appeal to the 6th U.S. Circuit Court of Appeals, which she said already has upheld a similar law in Ohio. (Yetter, 9/28)

The number of abortions performed in Ohio last year slightly increased from 2016, although the overall number continues to remain among the lowest since the state started tracking it. In 2017, 20,893 abortions were performed in Ohio, up 1 percent from 2016. (Hancock, 9/28)

The heated national debate about sexual misconduct has cast a spotlight on victims’ reluctance to report assault. The issue has been at the center of some of the most high-profile cases in the #MeToo era. The National Sexual Violence Resource Center, a Harrisburg, Pa., nonprofit, reviewed studies by the U.S. Department of Justice and Centers for Disease Control and Prevention, as well as academic legal research, and found only 5% to 20% of sexual-assault victims report attacks to law enforcement. (Bernstein, 9/29)

In Thursday's testimony at Judge Brett Kavanaugh's confirmation hearings, Christine Blasey Ford alleged Kavanaugh sexually assaulted her at a party in 1982, when she was 15 years old and he was 17. Kavanaugh staunchly denied these allegations.But memory is fallible. A question on many people's minds is, how well can anyone recall something that happened over 35 years ago? (Chatterjee, 9/28)

Painful. Gut-wrenching. Heartbreaking. Unbearable. That’s how women described listening to Thursday’s Senate Judiciary Committee hearing, where Christine Blasey Ford testified that Supreme Court nominee Brett M. Kavanaugh had sexually assaulted her when they were both in high school. (Bloom, 9/28)

Not too long ago, Brian Wansink was one of the most respected food researchers in America. He founded the Food and Brand Lab at Cornell University, where he won attention for studies that showed that small behavioral changes could influence eating patterns. He found that large plates lead people to eat more food because they make portions look smaller and that children eat more vegetables when they have colorful names like “power peas.” (O'Connor, 9/29)

There are a lot of misconceptions out there about the flu shot. But following a winter in which more than 80,000 people died from flu-related illnesses in the U.S. — the highest death toll in more than 40 years — infectious disease experts are ramping up efforts to get the word out. (Aubrey, 10/1)

Every August for the past 43 years, Twinsburg, Ohio, has hosted the biggest gathering of twins in the world. Two decades ago, organizers added an attraction to the lineup of parade, talent show and hot-dog dinner that drew more than 2,000 pairs this year: the chance to participate in research. Scientists vie for tent spots to test such things as twins’ exposure to the sun, their stroke risk and their taste preferences. “Every year we get more [research] requests than we can handle,” says Sandy Miller, a Twins Day Festival organizer and mother of 54-year-old twins. “We just don’t have room for all the scientists who want to come.” (9/28)

There’s very little research on whether medications are safe and effective in pregnant and lactating women, but an expert panel has ideas for how to close that information gap — and it’s calling on the federal government to take action in a new report that could stir change. The sweeping report is the product of more than a year of public meetings by a task force formed by Congress in 2016 to study why so few women can get reliable answers on medication use while pregnant and lactating. More than 6 million women are pregnant in the U.S. each year, and it’s estimated that more than 90 percent take at least one medication while pregnant or lactating. (Thielking, 10/1)

For more than 40 years, Morningside Ministries operated a nursing home in San Antonio, caring for as many as 113 elderly residents. The facility, called Chandler Estate, added a small independent living building in the 1980s and an even smaller assisted living center in the 90s, all on the same four-acre campus. The whole complex stands empty now. Like many skilled nursing facilities in recent years, Chandler Estate had seen its occupancy rate drop. (Span, 9/28)

Russ Clark’s favorite part of the ultrasound is when the medical students go for his gallbladder. His heart might not be in precisely the right spot, but it’s there. Same with his liver. But his gallbladder? It was removed years ago, and the students can get confused searching for it. (Hafner, 9/28)

The early weeks of a school year can rattle even the most self-assured kid — the swirl of new classes, teachers and tribes, and the pressure to try out new extracurriculars, sports and even personalities. Tween and teen girls face an added challenge because their confidence is already plummeting during those years. Of course, puberty is a turbulent time for confidence in both genders. But girls experience a much more significant, dramatic drop. (Shipman, Kay and Riley, 10/1)

Anxiety disorders, the most common mental health problems in children and adolescents, often go untreated while children suffer, even though there are effective treatments available, according to a new report on anxiety in children and adolescents from the Child Mind Institute in New York. Anxiety may be missed because it doesn’t necessarily declare itself with attention-getting disruptive behaviors; in fact, symptoms may keep some children quiet and inhibited, though in other children, alternatively, anxiety may be misunderstood as oppositional behavior. (Klass, 10/1)

Seid Moradi was elated when he found out his family had been approved to resettle in America. As non-Muslims who’d fled death threats in Iran, the family barely scraped by in Turkey. His sons had trouble finding work because of discrimination toward refugees. His wife picked through trash bins for food. And the family of six crammed into a friend’s apartment. Moradi’s case had a special urgency, however. He needed life-saving surgery for a bulging blood vessel by his heart. An American doctor, he was told, could perform the operation once he arrived in the U.S. (Kaleem and Etehad, 9/30)

For years, parents of a Texas boy believed he was mostly nonverbal because of a brain aneurysm he had when he was 10 days old. The boy, Mason Motz, 6, of Katy, Tex., started going to speech therapy when he was 1. In addition to his difficulties speaking, he was given a diagnosis of Sotos syndrome, a disorder that can cause learning disabilities or delayed development, according to the National Institutes of Health. (Garcia, 9/29)

Kaiser Health News: Eat, Toke Or Vape: Teens Not Too Picky When It Comes To Pot’s Potpourri 

There is no doubt that some high school students will try to get high. However, the ways they’re doing it might be changing. A survey of more than 3,000 10th-graders from 10 high schools in Los Angeles showed that while traditional combustible marijuana is still the most popular method, kids are turning to edible and vaporized weed, according to a study published in JAMA Network Open today. (Bluth, 9/28)

Well before dawn, nearly a hundred people stood in line outside one of the capital’s top hospitals. They were hoping to get an appointment with a specialist, a chance for access to the best health care in the country. Scalpers hawked medical visits for a fee, ignoring repeated crackdowns by the government. (Wee, 9/30)

The risk of Ebola escaping from the Democratic Republic of Congo is now “very high,” and the outbreak already is nearing Uganda, the World Health Organization said on Thursday. The W.H.O. raised its official alert level because of violence by local militias, which has slowed efforts to contain the outbreak, and population movements in eastern Congo, where the latest outbreak erupted in August. (McNeil, 9/28)

California Gov. Jerry Brown rejected legislation on Sunday that would have allowed San Francisco to open what could be the nation's first supervised drug injection site under a pilot program. Advocates of "safe injection" sites say the locations would save lives by preventing drug overdoses and providing access to counseling. (Har, 10/1)

The bill by Assemblywoman Susan Eggman, D-Stockton, would have created a four-year pilot program in San Francisco aimed at reducing opioid overdoses and encouraging users to go into treatment by giving them supervised facilities to inject themselves and ride out the high under clinical supervision. (Gutierrez, 9/30)

Proponents say such sites help prevent fatal overdoses by offering access to clean needles, trained supervisors and referral to treatment programs. There are about 100 secure injection facilities around the world, according to a legislative analysis. (Mason, 9/30)

Gov. Jerry Brown broke ranks with Democrats and abortion rights advocates Sunday by refusing to require student health centers at California’s public universities to provide abortion medication by 2022. Brown, who vetoed a bill requiring the health centers to provide abortion pills during the first 10 weeks of a pregnancy, said those services are already available to University of California and California State University students. (Myers, 9/30)

Gov. Jerry Brown on Sunday vetoed a measure that would have required public university student health centers to provide abortion medication by no later than Jan. 1, 2022. Brown noted in his veto message that “the average distance to abortion providers in campus communities varies from five to seven miles, not an unreasonable distance.” (Koseff ,9/30)

California Governor Jerry Brown signed several gun control bills into law on Friday, including one measure that raises the minimum age for buying rifles and shotguns from 18 to 21. The new laws come seven months after a gunman opened fire with a semiautomatic assault-style rifle at Marjory Stoneman Douglas High School in Parkland, Florida, killing 14 students and three adults, the second-deadliest mass shooting at a public school in U.S. history. (O'Brien, 9/29)

On Thursday, Gov. Jerry Brown signed SB1045, a law giving San Francisco, San Diego and Los Angeles counties permission to create five-year pilot programs intended to reach people who can’t care for themselves. Now, lawmakers have to craft local legislation to create and implement those programs. (Fracassa, 9/28)

California Gov. Jerry Brown (D) on Saturday vetoed a proposed ban on smoking at state parks and beaches for the third year in a row. Three bills passed by state legislators would have imposed $25 fines on the use of tobacco, marijuana and e-cigarettes at parks and beaches, according to the Los Angeles Times. The measures cited wildfire concerns and public health as reasons to ban smoking in those outdoor areas. (Anapol, 9/30)

The uninsured rate for low-income adults (below 138 percent of the federal poverty level) has fallen since 2008-09 in nearly all states, but small towns and rural areas of states, including Connecticut, that have expanded Medicaid have seen the sharpest declines, according to the study by the Georgetown University Center for Children and Families and the North Carolina Rural Health Research Program. The study examined the status of insurance coverage for low-income adults in the 46 states with significant rural populations. (Rigg, 9/28)

The number of reported Valley fever cases set a record in California in 2016, with more than 6,000 infections. That number jumped to 8,103 in 2017, an increase of more than a third—growth many experts link to climate change. This year could be the worst yet. (Gorn, 9/29)

Twenty Kansas youth killed themselves in 2016, the most recent year for which statistics are available, up from 18 in 2015. Two thirds of the victims were boys. (Hendricks, 9/29)

Nine months after state officials said they solved a problem that was costing Iowa an estimated $224,000 annually, the problem has yet to be fixed. ... Under federal rules, Iowa’s Ombudsman for Long-Term Care can ask the federal Medicaid program to reimburse the state agency for some of the advocacy work it does on behalf of seniors who rely on Iowa's privatized Medicaid program for their long-term care. But to collect that federal money, the ombudsman’s office has to bill the federal government for the work that's performed. Last year, the agency said it expected to collect $224,000 in federal reimbursements for work performed in 2017. To date, however, the office has submitted only one invoice to the federal government, and that is for $154 worth of staff time. (Kauffman, 9/28)

The leader of the Kansas child welfare system said Friday the state’s foster care contractors will face fines if they continue to have children sleep in their offices in the aftermath of a teenager being charged with raping a 13-year-old at an Olathe welfare site. Gina Meier-Hummel, secretary of the Kansas Department for Children and Families, made the penalty public during a meeting of the state’s child welfare system task force amid questions and concerns about the earlier sexual assault. (Woodall, 9/28)

In May, though, [Stephen] King began a diabetes program through his insurer, Blue Cross and Blue Shield of Georgia. The state’s largest health insurer has launched a “virtual’’ diabetes clinic in partnership with Onduo, a Massachusetts-based diabetes management company. The program is free to most Blue Cross members who have work-based or individual insurance in Georgia, as part of a large pilot program. (Miller, 9/28)

Health care hacking is on the rise, according to a new Massachusetts General Hospital study. The researchers looked at all the reported breaches of health care information from 2010 to last year. (Goldberg, 9/28)

In 1793, New York created its first health department in hopes of staving off a yellow fever outbreak that had occurred in Philadelphia. It was too little, too late: Despite the best efforts of early public health officials, a yellow fever epidemic reached the city, killing hundreds of New Yorkers and causing others to flee. It would not be the last time the city contended with a widespread disease outbreak. “Germ City,” a new exhibition at the Museum of the City of New York, tells the story of the metropolis’s long history with microbes. (Blakemore, 9/29)

Austin has one of the highest rates of fatal police shootings of people suffering from mental health issues, and the Police Department’s mental health policies are not in line widely accepted law enforcement practices, a city audit has found. ...As a result of these lapses, the audit found that people experiencing a mental health crisis in Austin may find themselves at a higher risk of a bad encounter with officers compared with those in a city that is more closely in step with international best practices. (Wilson, 9/30)

The University of Minnesota Board of Regents on Friday unanimously approved an eight-year agreement with Fairview Health Services that will dramatically increase funding for the medical school while creating incentives to better work together. The deal replaces the original M Health agreement reached in 2013, which was seen as a precursor to a merger between the U, University of Minnesota Physicians, and Fairview, which bought the U’s East Bank hospital in 1997. No one’s talking about a merger anymore, but the agreement creates a new organizational structure with aligned incentives. (Verges, 9/28)

Like the boy needed less money for books, children with disabilities needed less expensive educational services that year, due to the "declining severity of special education needs," Texas has argued, preparing for a face-off with the U.S. Department of Education in a federal appeals court this week. But the U.S. government says Texas violated an unambiguous federal law requiring states to maintain the same amount of funding each year for special education services in order to continue to be eligible for federal special education grants. (Swaby, 10/1)

When two men visited a yard sale in Western Pennsylvania last month, they browsed under the shelter of a blue tarp through the typical wares: dishes and vases, books and DVDs, old paintings and used clothes. They spent about $10 between them. One of the men, David Dunkleberger, 27, picked up a carton of glass bottles and some newspapers from the summer of 1977, when heavy rains brought catastrophic flooding to the area. The other man, Ed Sheets, 27, bought a railroad stock certificate. (Fortin, 9/30)

From November 2016 to November 2017, a special task force that battles human trafficking in Northeast Ohio recovered more than 130 victims and placed them in a myriad of recovery services, from shelters to substance abuse counseling. That task force is on track to pull even more victims out of traffickers' clutches, and on the road to improved lives. (Washington, 9/28)

A 2017 survey of the homeless population in San Francisco found 13 percent of respondents reporting part or full-time employment. That's in a city with an estimated 7,499 people experiencing homelessness. This year, an estimated 10 percent of the 4,990 people living unsheltered in San Diego said they were currently working. (Wagner, 9/30)

Though MDLive is headquartered in Florida, it has about 20 employees in Chicago and plans to open a local office early next year, likely in the West Loop. Berner, 47 and a Chicago-area native, said the company he leads as CEO is continually hiring in Chicago. MDLive has more than 27 million members, and partnerships with major health care systems and organizations, including Deerfield-based Walgreens, which directs customers to MDLive’s services via its new digital platform. (Schencker, 10/1)

Ten Kansas nurses and nurse aides have been charged with Medicaid fraud, stealing narcotic medications and mistreating vulnerable adults after an enforcement sweep by the state’s attorney general. At least eight are still licensed to work in the state, according to the Kansas State Board of Nursing and Kansas Department for Aging and Disability Services online search tools. (Marso and Rizzo, 9/28)

After my double mastectomy two years ago, I had to read two terrifying things: my pathology report and my hospital bill. The pathology report made me sink to the floor with despair; it noted multiple large tumors that had invaded my skin, and 15 underarm lymph nodes bursting with rapidly dividing cancer cells. I would require months of aggressive treatment. The bill for my hospital stay and surgery was $173,000. But there was some good news: My insurance plan paid for all of it. For this, I thanked the Affordable Care Act, because it mandated that hospitalization — and everything else I needed, including lab tests, medication and physical therapy — be covered as part of a set of essential benefits. (Sascha Cohen, 10/1)

Republicans do not care whether anyone has health insurance—which is to say they effectively do not care whether lower-income Americans die or fall into crippling debt. If they did, they would have used their time in power to move the country toward universal healthcare, not away from it. When they try to tell you they care about this stuff, they are lying, every time. (Harry Cheadle, 9/26)

The Trump administration wants to change how the government defines who is or is likely to become a “public charge.” The Department of Homeland Security released a draft regulation on Sept. 22, in which it proposed that any immigrant who is likely to use or who has already used Medicaid, public housing or a rent voucher, cash assistance or food stamps could be barred from the country or kept from getting permanent resident status. ...This redefinition of self-sufficiency ignores the way that most people use these programs. Even people with jobs often cycle on and off assistance as work comes and goes, or to plug the gaps when it just doesn’t pay enough. These programs allow people to remain healthy and solvent — supporting their independence. This rule therefore hurts everyone, not just immigrants, by stigmatizing the safety net funded by all of us to help people survive when they fall on hard times. (Bryce Covert, 10/1)

The Trump administration recently announced a draft regulation that would penalize legal immigrants applying for green cards if they use public benefits — what’s referred to as being a “public charge.” ...The result is that our foreign-born patients would have to make life-and-death decisions between seeking care, food or shelter, and the risk of deportation. (Sarah Kimball, Nicolette Oleng and Elisabeth Poorman, 9/28)

Almost 10 years have passed since Congress required that insurers offering mental-health services for illnesses of the brain, such as depression or addiction, do so no more restrictively than illnesses of the body, such as diabetes or cancer. And yet most insurers today still do not comply with the law. Mental-health parity is more important now than ever before, considering the rising numbers of overdoses and suicides nationwide. But state and federal investigations have shown that mental-health and addiction treatment are frequently far more onerous to manage. (Rosalynn Carter and Patrick J. Kennedy, 9/28)

Medicaid expansion has made an overwhelmingly positive impact on rural Kentucky. Our state was among the top three leaders in lowering our uninsured rate for low-income adults in rural areas and small towns. (Emily Beauregard, 9/28)

The FDA is ostensibly committed to protecting Americans from harmful substances. However, the commissioner should also consider whether the FDA is interested in protecting poor Americans from regressive regulation. Evidence suggests e-cigarettes are an easy way for poor American smokers to improve their health. Unfortunately, future restrictions may change that. (Vanessa Brown Calder, 9/27)

I suppose you can excuse the ignorance of those who keep asking why Supreme Court nominee Brett Kavanaugh’s teenage accusers waited so long to speak up about his alleged sexual misconduct. But you can’t in Boston, ground zero of the Catholic sex abuse scandal. We know better. Not telling for decades is typical — not rare, not suspicious, not disqualifying. (Margery Eagan, 10/1)

At a hearing before the U.S. Senate Judiciary Committee yesterday, psychologist Christine Blasey Ford described her alleged sexual assault 36 years ago by Donald Trump’s Supreme Court nominee, Brett Kavanaugh. Some skeptics wondered why she hadn’t come forward years earlier. Other doubters called her “mixed up” and questioned the veracity of her memories.But some of us were very impressed by Dr. Ford, a research psychologist at Stanford University of Medicine and a psychology professor at Palo Alto University. Dr. Ford’s ability to speak about her memory — not just in terms of recollection, but in terms of the actual mechanisms that make memory function within our brains — was inspiring. (Joan Cook, 9/28)

The conventional wisdom is that corporate America has a renewed, almost crisis-level concern about rising health costs. But, in a puzzle I am struggling to solve, the data don’t suggest a basis for a new level of urgency about health costs in corporate America. Why it matters: In fact, just the opposite is true. There's just not that much change — so any solution that's designed for a crisis will probably miss the mark or could unnecessarily harm workers. (Drew Altman, 10/1)

If the U.S. wants to lower our dismal maternal mortality rate, we cannot continue a model in which the status quo is acceptable. The traditional model of labor and delivery (and postpartum care) can — and must — be improved upon by policymakers and hospitals. First, U.S. health policymakers should follow Texas’ lead in promoting implementation of safety protocols developed through the Alliance for Innovation on Maternal Health (AIM), a national data-driven maternal safety and quality improvement initiative. (Mark Simon and Rakhi Dimino, 9/29)

Like most of the boys in his San Salvador neighborhood, Gabriel Alessandro Mayorga Hernandez — Gabo, to his family and friends — loves soccer. But in 2014, just before he turned 12, he found himself exhausted by even a short game. Eventually he became too tired to play at all and started having headaches so severe they made him vomit. When he developed chest pains and difficulty breathing, his grandmother took him to the doctor, where X-rays and blood work indicated that he had acute lymphoblastic leukemia, or A.L.L., a blood cancer that develops most often in young children. (9/29)

Monday’s results from Amarin Corp.’s test of purified fish oil Vascepa in people at risk for heart diseases are an exception — and one more likely than any recent drug outcome to affect the average person reading this column. Vascepa was shown to reduce the risk of cardiovascular events like heart attack or stroke by 25 percent in high-risk patients, much more than analysts hoped for, and without side effects. Add to that its relative cheapness, and it’s a result that could affect millions, change how heart disease is approached, and justify the more than tripling of Amarin’s share price Monday morning.In fact, it may be the rarest success of all: a breakthrough that cost-conscious, health-care gatekeepers don’t hamper, but embrace. (Mark Gongloff, 9/29)

It is a good thing that Philadelphia stores are carrying fewer sugary beverages and more bottled water; it is a good thing consumers are changing behaviors; and it's a good thing jobs have not been impacted. (Paul Mather, 10/1)

Some of us are more vulnerable than others. Older adults with lower incomes are at higher risk, as are those who may be acting as unpaid caregivers to a loved one. And, perhaps surprisingly, the LGBTQ community is now facing a higher rate of loneliness among its aging population. Yet reaching out to those in need can be as simple as connecting a person with a community activity or simply chatting across a fence. (Lisa Marsh Ryerson, 9/28)

For a small state, Vermont has a way of getting noticed. It was the first state to recognize same-sex civil unions and the first to experiment with a single-payer health-care system. Two Vermont politicians—Sen. Bernie Sanders and former Gov. Howard Dean—have sought the White House in recent years. This year, Vermont Democrats made Christine Hallquist the first transgender candidate for governor in any state. Ms. Hallquist’s Republican opponent, Gov. Phil Scott, has gone from being one of the nation’s most popular governors to one of its least liked. The reason? Guns. (Norman, 9/28)

A year after the Oct. 1 shooting, bump stocks remain legal in Nevada. So do high-capacity magazines. So do assault-style weapons and tracer bullets. And all can still be purchased without a background check if the transaction doesn’t involve a licensed gun dealer but instead is between unlicensed individuals. In other words, not much has changed in terms of gun policy in Nevada one year after the worst mass shooting in modern history. That’s shameful. (10/1)

An ambulance ride of just a few miles can cost thousands of dollars, and a lot of it may not be covered by insurance. With ride-hailing services like Uber or Lyft far cheaper and now available within minutes in many areas, would using one instead be a good idea? Perhaps surprisingly, the answer in many cases is yes. (Austin Frakt, 10/1)