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Alex Azar, the White House’s choice to become the second health and human services secretary in less than a year, will appear for his Senate confirmation hearing Tuesday, giving Democrats a chance to probe his drug industry ties but not halt his path toward joining the president’s Cabinet. The 10 a.m. hearing before the Senate Finance Committee will give Azar’s Democratic critics a forum to contend that his role in helping to approve rising pharmaceutical prices while a top executive of Eli Lilly means he is ill-suited to carry out President Trump’s stated goal of making medicines more affordable. (Goldstein and Eilperin, 1/8)

President Donald Trump’s pick for Health and Human Services secretary is on the verge of taking control of the department with a clear mandate: Take down Obamacare from the inside. With Republicans stalled on repeal, the GOP is looking to Alex Azar to put a conservative stamp on the health care system through shrewd rulemaking and the use of expansive regulatory powers — and all without the help of a Congress that’s failed to scrap the 2010 health care law. (Cancryn, 1/9)

A group of House Democrats want the Senate Finance Committee to question President Trump’s nominee for Health and Human Services secretary about high drug prices at his former employer, Eli Lilly. In a letter to Finance Committee leaders, led by Texas Reps. Beto O'Rourke and Lloyd Doggett, the Democrats said Alex Azar should also be pressed on his commitment to uphold the Affordable Care Act, otherwise known as ObamaCare. (Weixel, 1/8)

Until about a year ago, nominee Alex Azar was an executive at drugmaker Eli Lilly & Co., a role that’s fueled lawmakers’ concerns that he might not be willing to take a tough stance against the pharmaceutical industry on drug prices. Azar told senators at a November hearing that he wants to end “gaming” by drugmakers that allows them to extend monopolies and keep prices high, an idea backed by both Republicans and Democrats. His commitment to a crackdown may receive extra scrutiny during the Senate Finance Committee hearing after Politico reported that Lilly gained extra time on its exclusive sales rights to the erection drug Cialis by studying studying its effects on a rare muscular disorder in children. (Edney, 1/8)

A leading pro-ObamaCare group is urging senators to vote "no" on President Trump’s Health and Human Services secretary nominee, saying he will continue a campaign of “sabotage” against the health law. The group, Protect Our Care, unveiled a digital ad that urges lawmakers to oppose the nominee, Alex Azar. (Sullivan, 1/8)

Republicans are scaling back their ambitions to overhaul safety-net programs and dismantle the Affordable Care Act following President Donald Trump’s weekend retreat with GOP leaders, due to concerns they can’t muster enough support ahead of the 2018 midterm elections. Instead, Republican lawmakers are likely to embrace a slimmed-down agenda focused on the basics, including funding the government, raising the government debt limit and striking a deal on immigration, according to GOP lawmakers and aides. (Peterson and Armour, 1/9)

President Donald Trump had indicated he would like to rein in spending on U.S. social welfare programs to follow up on his 2017 victory in overhauling the U.S. tax code. Some Republicans, including House of Representatives Speaker Paul Ryan, welcomed the effort. Others, including Senate Republican leader Mitch McConnell, indicated they are hesitant to tackle this politically volatile issue in a congressional election year. (Becker, 1/8)

Congress' official budget analysts have eased one stumbling block to lawmakers' fight over renewing a program that provides health insurance for nearly 9 million low-income children. The Congressional Budget Office says a Senate bill adding five years of financing to the program would cost $800 million. Previously, the analysts estimated it would cost $8.2 billion. That means lawmakers should find it much easier to agree to a way to pay for extending the program. (Fram, 1/8)

In a four-page letter to Senate Finance Chairman Orrin G. Hatch, CBO Director Keith Hall said the Senate CHIP bill would cost $800 million over 10 years. Prior to this, the CHIP bill needed to be offset by about $8 billion over 10 years. The total cost of CHIP over 10 years would be $48.4 billion, but decreases in Medicaid and health care marketplace spending would offset much of that amount. Lawmakers in both chambers and in both parties have agreed to renew CHIP for five years, but a dispute over how to pay for it has been the main issue delaying passage. House Republicans suggested a number of offsets that would change Medicaid, Medicare and the existing federal Prevention and Public Health fund established under the 2010 health care law as part of a CHIP bill that the House passed mostly along party lines. House and Senate Democrats largely opposed these offsets. (Raman, 1/8)

Virginia Medicaid Director Cindi B. Jones told legislators on Monday that the state had received additional federal money to allow the program to continue through Feb. 28 rather than end on Jan. 31, as it had warned affected families last month. Jones and her staff at the Department of Medical Assistance Services are still counting on Congress to reauthorize the program before a continuing federal budget resolution expires on Jan. 19. (Martz, 1/8)

The ObamaCare doomsday scenario that many Republicans and Democrats predicted for 2018 is unlikely to come to pass, with insurers having adapted to the uncertainty that marked President Trump’s first year in office.  Insurers who decided to stick with ObamaCare after a tumultuous 2017 are likely to have a relatively profitable year, analysts and experts predict, for reasons including higher-than-expected enrollment.  (Hellmann, 1/9)

U.S. health insurer Centene Corp said on Monday more than 1.4 million people had paid for its insurance plans via the federal Obamacare marketplace as of Jan. 7. "The growth in the exchange has been so dramatic ... We had planned on incremental growth, but not that much," Centene Chief Executive Michael Neidorff said, adding "We've had people working all weekend, playing catchup." (Mathias, 1/8)

More Connecticut residents signed up for private insurance through the state’s health insurance exchange, Access Health CT, during the open enrollment period that ended in December than signed up last year, officials said Monday. Access Health CT CEO Jim Wadleigh and Lt. Gov. Nancy Wyman viewed the enrollment results as a victory, especially in light of challenges from Washington, D.C., where the Administration and Republicans in Congress have been working to eviscerate the Affordable Care Act (ACA). (Silber, 1/8)

Maryland lawmakers are scheduled to outline a plan on how to protect and improve the federal Affordable Care Act in Maryland. Lawmakers will announce the plan Tuesday in Annapolis. State Sens. Brian Feldman and Jim Rosapepe are scheduled to attend, as well as Delegate Joseline Pena-Melnyk. (1/9)

Organizers say that more than 1,700 people enrolled in coverage from two new agricultural cooperative health plans during recently completed open enrollment periods for the Minnesota program. Starting in 2018, the health plans are an alternative to the state's troubled individual market, where farmers are among the roughly 166,000 people who have seen steep premium hikes since major changes came to coverage under the federal Affordable Care Act. (Snowbeck, 1/8)

In recent years Obamacare’s Medicaid expansion has created a financial fault line in American health care. Hospitals in states that enacted the expansion got a wave of newly insured patients, while those in states that rejected it were left with large numbers of uninsured individuals. A new study released Monday reports a crucial consequence of that divide: Nonexpansion states have suffered a significant increase in hospital closures. States that expanded benefits, on the other hand, saw their rate of closures decline. (Ross,1/8)

Hospitals in states that expanded Medicaid were about 6 times less likely to close than hospitals in non-expansion states, according to a study by researchers at the University of Colorado Anschutz Medical Campus. The study was published Monday in the January edition of the journal Health Affairs. Colorado was one of 32 states to expand Medicaid under the Affordable Care Act. That cut the state's uninsured rate in half. The biggest group that got coverage was childless adults. (Daley, 1/8)

Researchers examined CMS data on hospital closures and their financial performance between 2008 and 2016. They found hospital closure rates were the same from 2010 to 2012 among states that eventually expanded Medicaid versus states that opted not to expand. Closure rates between expansion and non-expansion states began to diverge in 2013, a year after the U.S. Supreme Court ruled states had the option to expand Medicaid to cover all adults earning up to 138% of the federal poverty level. The hospital closure rate for non-expansion states doubled from 0.45 per 100 hospitals in 2012 to 0.90 in 2013, the researchers found. (Johnson, 1/8)

“We estimated,” said Richard Lindrooth, a professor at the Colorado School of Public Health who is a co-author of the new study, “that about half the closures that occurred in states that did not expand Medicaid could have been prevented if they did expand Medicaid.” (Ingold, 1/8)

Kaiser Health News: Despite Prod By ACA, Tax-Exempt Hospitals Slow To Expand Community Benefits

The federal health law’s efforts to get nonprofit hospitals to provide more community-wide benefits in exchange for their lucrative tax status has gotten off to a slow start, new research suggests. And some experts predict that a recent repeal of a key provision of the law could further strain the effort. The increased emphasis on community-wide benefits was mandated by the Affordable Care Act. The health law required hospitals that meet federal tax standards to be nonprofits to perform a community health needs assessment (CHNA) every three years, followed by implementing a strategy to deal with issues confronting the community, such as preventing violence or lowering the rates of diabetes. (Connor, 1/8)

The yearslong decline in free or discounted care that hospitals provide to patients may have reached its floor. The 20 largest U.S. health systems dedicated 1.4% of their collective operating revenue in fiscal 2016 to charity care—about the same as the previous year, a Modern Healthcare analysis of financial data shows. That's noteworthy considering the significant declines in charity care spending that followed the 2014 implementation of the Affordable Care Act, a law credited with insuring nearly 24 million people through expanded Medicaid eligibility and subsidized commercial plans. Total uncompensated care fell to a 25-year low in 2015 and held steady in 2016, according to the American Hospital Association. (Bannow 1/6)

New Hampshire social workers are all too familiar with how opioid abuse can push children into foster care. ...It’s a last resort, reflecting what appears to be a stark trend across the state: Since 2010, the number of child removals in which substance abuse was a factor has nearly quadrupled. (Duncan, 1/8)

Add another negative consequence to the opioid epidemic’s far-reaching impact: Prescription drug abuse is driving more children into Florida’s foster care system, according to a new study from the University of South Florida. The study, published in this month’s issue of Health Affairs, shows that addiction to painkillers like oxycodone or morphine has contributed to more than just a dramatic rise in overdose deaths and health care costs, said Troy Quast, a USF researcher and the study’s lead author. (Griffin, 1/8)

Massachusetts, where Ohlman lives, began recognizing that some opioid overdose deaths are suicides in May 2017. The state says confirmed suicides are only about 2 percent of all overdose deaths, but Department of Public Health Commissioner Monica Bharel says it's very difficult to determine the person's true intent. (Bebinger, 1/9)

Gov. Rick Scott is pushing legislation that would be a modest step toward combating the state’s growing opioid crisis. But it’s placing the former healthcare company CEO in an unusual spot: He’s at odds with doctors, drug companies and some fellow Republicans, who fear losing control or profits from Scott’s legislation. (Mower, 1/8)

In his final State of the State speech before his 2018 re-election campaign, Gov. Doug Ducey touted his accomplishments while presenting an agenda of tackling the opioid crisis, increasing school funding and adopting new policies for ex-prisoners and the child-welfare system. In a speech that lasted 56 minutes Monday afternoon, Arizona's Republican governor, first elected in 2014, did not identify funding sources for his many proposals. (Wingett Sanchez, Gardiner and Randazzo, 1/8)

This winter’s flu season is turning into a “moderately severe” one that might get worse because of an imperfect vaccine and steady cold weather, flu experts and public health officials said this week. The flu is now widespread across the country and the peak of transmission probably occurred during the Christmas-New Year’s holiday week, just as many people were crowded into planes, buses and cars or in large family gatherings, said Dr. Daniel B. Jernigan, director of the influenza division of the Centers for Disease Control and Prevention. (McNeil, 1/8)

Aja C. Holmes planned to go to work last week, but her flu symptoms — a cough, fever and severe body aches that worsened overnight — had other ideas. “It felt like somebody took a bat and beat my body up and down,” said Holmes, 39, who works as a residential life director at California State University-Sacramento. “I couldn’t get out of bed.” The nation is having a Terrible, Horrible, No Good, Very Bad flu season. (Ostrov, 1/8)

The recent spike in flu cases around the Bay Area and California is not only crowding hospital emergency rooms with flu patients, it’s also leading to more demand for flu shots and antiviral medications to treat the virus. That means some drug stores around the region, such as Walgreens, are reporting a limited supply of Tamiflu, said company spokesman Scott Goldberg. (Seipel, 1/8)

A high numbers of patients with flu-like symptoms had Methodist Dallas Medical Center rerouting some ambulance patients so it can care for those in emergency situations. "This measure is so we can still take care of emergency patients such as trauma, stroke and sexual assault," the hospital said in a written statement Monday, noting that it is at critical capacity but not turning away patients.  (Cardona, 1/9)

When President Trump has his physical exam on Friday, there is little chance he will repeat the same story within a span of 10 minutes or fail to recognize old friends, as the explosive new book “Fire and Fury” by Michael Wolff asserts he has done in the past. But the mental deterioration that causes such memory lapses would be detectable on standard cognitive tests. The White House told reporters on Monday that psychiatric tests would not be conducted as part of the president’s physical, but did not explicitly rule out cognitive assessments. (Begley, 1/9)

The White House is struggling to contain the national discussion about President Trump’s mental acuity and fitness for the job, which has overshadowed the administration’s agenda for the past week. Trump publicly waded into the debate spawned by a new book, “Fire and Fury” — Michael Wolff’s inside account of the presidency — over the weekend by claiming on Twitter that he is “like, really smart” and “a very stable genius.” In doing so, the president underscored his administration’s response strategy — by being forceful and combative — while also undermining it by gleefully entering a debate his aides have tried to avoid. (Rucker and Parker, 1/8)

If President Donald Trump were any other 71-year-old — covered by Medicare and having his annual wellness visit — he'd be checked on his cognitive functions and possible safety risks. But when the president goes for his physical exam Friday, the White House said his mental fitness won't be tested. And there's no guarantee that the public would find out the results of cognitive tests if Trump were to take them. White House deputy press secretary Hogan Gidley said such tests are not part of the president’s planned physical. "He's sharp as a tack. He's a workhorse, and he demands his staff be the same way," he told reporters aboard Air Force One. (Diamond and Cancryn, 1/8)

To millions of Americans, Bob Harper was the picture of health, a celebrity fitness trainer who whipped people into shape each week on the hit TV show “The Biggest Loser.” But last February, Mr. Harper, 52, suffered a massive heart attack at a New York City gym and went into cardiac arrest. He was saved by a bystander who administered CPR and a team of paramedics who rushed him to a hospital, where he spent two days in a coma. (O'Connor, 1/9)

With the booze-filled December behind us, many Americans will try to make up for their eggnogs, wines and other holiday spirits with Dry January, a 31-day break from all alcohol. The practice gained popularity after a British nonprofit promoted it in 2013, becoming a government-backed public health campaign the next year aimed at improving health, trimming waistlines and fattening wallets. But will putting down the bottles for a month make up for the recent weeks' revelry? Yes and no, according to a smattering of data and experts on the subject. It might depend on your goal. (Hafner, 1/8)

"It's a beautiful thing, the destruction of words," George Orwell writes in the fifth chapter of his dystopian novel, "1984." Four public health experts from Emory University in Atlanta, just a stone's throw from the Centers for Disease Control and Prevention, beg to differ. In an editorial published Monday in the Annals of Internal Medicine, they said it would be "damning, immoral and unacceptable" for CDC officials to act on reported admonitions from the Trump administration to avoid the use of seven words and phrases in the agency's official budget documents. (Healy, 1/8)

It's no surprise that the United States ranks absolutely last in child mortality among the world's wealthiest countries — that's been true for years. A new study examines how this sad situation came to be. According to data from the World Health Organization and the global Human Mortality Database, the problems go all the way back to the 1960s. It was during that decade that the U.S. infant mortality rate (for babies less than a year old) and the U.S. childhood mortality rate (for those between the ages of 1 and 19) began to exceed the combined rates for the other 19 richest nations. (Kaplan, 1/8)

The Bill & Melinda Gates Foundation wants corporations to join its efforts in advancing public health, not just because it’s the right thing to do -- but because it can be lucrative too. Bill Gates, co-founder of Microsoft Corp. and the second-richest person in the world, told private sector companies on Monday that he needs their help to solve pressing issues in global health. Drugmakers stand to benefit financially from joining the combined efforts, Gates said in prepared remarks at the J.P. Morgan Healthcare conference in San Francisco. (Levingston, 1/8)

Top executives for genome-editing companies on Monday pushed back against a new unpublished paper that raised concerns about preexisting immune responses to CRISPR-based therapies, insisting the issues outlined in the study were either already being addressed or were not relevant to the medicines being developed. The paper, which was posted Friday on the preprint site bioRxiv, sent shares of Intellia Therapeutics and Editas Medicine down sharply Monday morning. Shares of CRISPR Therapeutics also declined. (Joseph, 1/8)

On Wednesday mornings, Stephen Fealy, an orthopedic surgeon in New York, heads downtown to see his patients. But instead of going to his office, Dr. Fealy sees patients in theirs—at Goldman Sachs Group Inc. He examines a couple of dozen Goldman employees, from managing directors to junior analysts and administrative assistants. Dr. Fealy, a sports-medicine specialist with the Hospital for Special Surgery in New York, works alongside several other physicians at the Goldman Sachs clinic on the 10th floor of the firm’s headquarters, near Wall Street. (Lagnado, 1/8)

Hairy skin may not seem like a desirable thing — until you don't have it. Burn and blast victims who require skin reconstruction often do not develop hair follicles or sweat glands on their new skin, which can have a physiological as well as cosmetic impact. Sweat glands aid with thermoregulation and hair can help mediate the sense of touch. So researchers have long sought a way to develop better replacement skin that would allow its wearer to sweat and sport hair, just like those who have not undergone such procedures. (Rudavsky, 1/9)

During three emotional days of divorce talks, Drake and Mandy Rooks managed to agree on how to divide up almost every aspect of their old lives down to the last piece of furniture. Only one thing remained: the frozen embryos. There were six of them, created from his sperm and her eggs, and they had been left over from when the couple had gone through in vitro fertilization some years earlier. The couple had had three children using the technology, and Drake was done. He didn’t want any more children in general, and certainly not with Mandy. She felt differently. (Cha, 1/9)

According to the Atlanta-based Centers for Disease Control and Prevention, approximately 70 percent of U.S. adults are considered to be overweight or obese. ...But now, researchers from the University of Texas Medical Branch at Galveston say they’ve discovered a drug that could significantly reduce body weight without reducing food intake. (Pirani, 1/8)

Ibuprofen is a common over-the-counter drug that helps with pain and inflammation. However, for men, it could compromise their ability to procreate, a new study suggests. (Harris, 1/8)

If you've somehow missed the huge warnings so far, we beg of you: Do not eat romaine lettuce. There's no official government recall in the United States - yet. But with two dead and many more sickened in the United States and Canada, major health organizations are advising you avoid the stuff. This all began in December, when the Canadian Government warned consumers to avoid romaine due to potential contamination with E. coli. (van Hare, 1/8)

Kaiser Health News: Her Sister’s Keeper: Caring For A Sibling With Mental Illness

When sisters Jean and Ruby were growing up in Harlem, they invented a game of make-believe called “Eartha.” The little girls would put on their prettiest dresses and shiniest shoes and sit down to tea as grown-up ladies. They discussed details of their hoped-for husbands and children, and all the exciting things they would do together. But 45 years later, the sisters’ lives are nothing like they imagined. Ruby Wilson, 54, has paranoid schizophrenia and lives in an assisted living facility in North Carolina. Her sister Jean Moore, 57, is her legal guardian. (Gold, 1/9)

One blue surgical drape at a time, the patient disappeared, until all that showed was a triangle of her shaved scalp. “Ten seconds of quiet in the room, please,” said Dr. David J. Langer, the chairman of neurosurgery at Lenox Hill Hospital in Manhattan, part of Northwell Health. Silence fell, until he said, “O.K., I’ll take the scissors.” His patient, Anita Roy, 66, had impaired blood flow to the left side of her brain, and Dr. Langer was about to perform bypass surgery on slender, delicate arteries to restore the circulation and prevent a stroke. (Grady, 1/8)

Apple Inc. defended its record of providing parental controls and other protections for children who use its iPhones and other devices, after a pair of prominent investors called on the tech giant to take more steps to curb the ill effects of smartphones. In a statement late Monday, Apple said that its mobile software includes extensive parental controls governing different types of content and applications, noting that it started offering some of them as early as 2008. (Mickle, 1/8)

To study the human gut and the microbes that live within it, scientists have a couple of options. They can grab a small piece of tissue from the gastrointestinal tract or collect a sample of fecal matter. Neither way is ideal, says Jack Gilbert, a microbiologist and director of the Microbiome Center at the University of Chicago. "By studying [the sample], you're changing it, just by observing it, because you have to cut it out and analyze it," he says. (Chen, 1/8)

Federal health officials have authorized Maryland to continue its unique “all payer” health-care model for hospitals through 2019, while the state seeks approval to apply a similar plan to outpatient service providers such as doctors, skilled nurses and rehabilitation centers. Officials say expanding the program, which regulates how much hospitals can charge in exchange for having the federal government cover a larger share of Medicare costs than it does in other states, is one of the strongest steps Maryland can take to fulfill a federal requirement to lower its annual Medicare costs by $330 million. (Hicks, 1/8)

State and federal health officials delayed the potential expansion of Maryland’s experimental health care cost control program by another year to give them more time to evaluate data from 2017. Maryland is negotiating with the federal Centers for Medicare and Medicaid Services to establish a 10-year program that would encourage doctors, skilled-nursing facilities and rehabilitation centers to work with hospitals to improve patient health and save Medicare money. (Gantz, 1/8)

New Hampshire’s medical marijuana program has more than doubled in size since 2016, according to the latest available data from the Department of Health and Human Services. About 4,700 patients were enrolled as of Dec. 20, up from just over 2,000 patients the same time last year. (McDermott, 1/8)

Acting on the first day of the 2018 Georgia General Assembly session, a task force of state lawmakers approved recommendations Monday to create two centers that its leaders say will develop data and solutions to improve health care in Georgia. Led by Lt. Gov. Casey Cagle, the Georgia Health Care Reform Task Force proposed a Health Coordination and Innovation Council and a Health System Innovation Center to boost collaboration and help create a more efficient delivery of care. (Miller, 1/8)

Eden Prairie-based Metavention, which is designing a machine to treat type 2 diabetes by burning away nerves thought to drive glucose dysfunction, has raised $65 million in venture capital. Metavention announced Monday that Menlo Park, Calif.-based New Enterprise Associates led the series C funding round that includes several new investors. (Carlson, 1/8)

Adfinitas Health has acquired a majority stake in Advanced Inpatient Medicine, continuing the expansion of the Hanover-based hospitalist group. The acquisition adds four regional hospitals in Northeast Pennsylvania to Adfinitas portfolio, which already provides health care professionals to 14 hospitals and more than 40 post-acute facilities in Maryland, Virginia and Michigan. (Cohn, 1/8)

Today, the University of Kansas announced a $25 million grant from the National Institutes of Health to fund the KU Medical Center's program, Frontiers: University of Kansas Clinical and Translational Science Institute (KU CTSI). Frontiers began five years ago. It's a clinical science institute dedicated to connecting scientists at the KU Med Center to resources and innovative research tools. It's one of just 57 institutes of its kind in the country. The university has become known for this program, along with its cancer center, and Alzheimer's disease center. (Tudhope, 1/8)

For the man who killed a Douglas County sheriff’s deputy and wounded six other people, the warning signs were abundant. At various points over the past three years, Matthew Riehl’s parents, friends who served with him in the Wyoming National Guard, professors at his former law school and law enforcement officers in two states all expressed concern about his mental health, according to official documents and interviews. His mother told police last year that he had stopped taking medication for bipolar and post-traumatic stress disorders. A sheriff’s deputy and a mental health professional went to his apartment last month and had the door slammed in their faces.But, despite those concerns, Riehl was not placed on an emergency mental health hold in recent years and was not apparently receiving treatment of any kind when deputies arrived at his doorstep on New Year’s Eve morning. (Ingold and Phillips, 1/8)

L.A. County has opened more than a dozen temporary winter shelters, with about 1,500 beds. Hinderliter says the shelters give LAHSA outreach workers a chance to offer services to people who can otherwise be hard to reach and track at a time when there isn’t enough supportive housing to shelter the county’s surging homeless population. (Cuevas, 1/8)

While [former Health and Human Services Secretary Tom] Price distinguished himself as a zealous opponent of the ACA, [nominee Alex] Azar has the opportunity to enact a proactive agenda to improve America's health care. But first he has to decide whether he's going to be an agent for the future or a captive of his past as an executive for a top U.S. drug company. Azar can revive HHS's mission to "enhance the health and well-being of Americans," or follow the profit-driven path he plowed at Eli Lilly which jacked up the price of insulin by 225 percent since 2011. (Margarida Jorge and Ethan Rome, 1/8)

After passing a lavish tax cut for corporations and wealthy families, Congress hastily left town last month without reauthorizing the federal-state health insurance program, which benefits nearly nine million children. Authorization expired in September, and so far states have kept CHIP going with unspent funds carried over from previous appropriations. Before Christmas, Congress allocated $2.85 billion to the program, saying that the money would take care of the children’s needs until the end of March. But that appears to have been a gross miscalculation, because the Trump administration said on Friday that some states would start running out of money after Friday, Jan. 19. (1/8)

Can a relatively low-tax country run a high-quality, taxpayer-funded health service that's free to all? Britain's National Health Service suggests the answer is no.The NHS is good at some things but bad, bordering on disastrous, at others. Its great virtue is truly universal coverage, no questions asked -- and by international standards, the system is also cheap to run. As a result, though, it's perpetually short of money, and the service is erratic. Today the NHS is yet again dealing with a financial crisis and a surge of complaints about standards. (1/8)

In North Carolina the ACA remains popular indeed. Despite Trump’s administration having shortened the signup period for 2018 – the mandate requiring signup or a penalty also has been nixed in the GOP budget – some 523,989 North Carolinians signed up for health insurance through the ACA. That’s the third highest enrollment in the country, behind Florida and Texas. (1/7)

The influenza season is just getting started in the United States, and it already promises to be more severe than usual. Hospital emergency rooms are filling up with flu sufferers, and pharmacies have reported medicine shortages. Twelve children had died as of last month. ... Yet as bad as this winter’s epidemic is, it won’t compare with the flu pandemic that is almost certainly on the horizon if we don’t dedicate energy and resources to a universal vaccine. (Michael T. Osterholm and Mark Olshaker, 1/8)

Every day during the evening commute, my classical music station runs a segment with the memorable tagline, “reminding you that all music was once new.” The same holds true for infectious diseases: They, too, without exception, were once new. A scan of the headlines might make it feel like we are surrounded by novel dangers. Unfamiliar germs with unsettling names such as monkeypox virus and Marburg virus, Zika and Ebola regularly stir sensational news reports and raise genuine alarm in the global health community. But even our truly ancient enemies — bacteria and viruses that cause colds and diarrhea, opportunistic stomach bugs, crafty microbes such as herpes and so on — were once newcomers on the scene. (Kyle Harper, 1/8)

Two big shareholders of Apple Inc. are right to add their influential voices to those concerned with smartphone addiction. If they are serious about finding a solution, however, they’ll start looking elsewhere for progress on the issue. Like tobacco companies before them, tech companies are incapable of studying their products dispassionately and then regulating themselves for the common good. (Leonid Bershidsky, 1/9)

Human papillomavirus (HPV) is a common sexually transmitted infection with more than 100 different strands in existence. ... Often, it has no apparent symptoms, which makes it difficult to know when someone is infected. At least two strands of the virus have been shown to cause cervical, vaginal and vulva cancers in women, penile cancer in men, and head and neck cancers in both men and women. ... In the past decade, HPV vaccination for adolescents has been shown to protect against at least five types of cancer, including some that can cause infertility, or worse. This vaccine is now recommended for all preteens, boys and girls, during their annual checkups. ... Unfortunately, Missouri falls well below the national average rate for HPV vaccinations. (Dr. Lindsay Kuroki, 1/8)

According to a report released in November by the Florida Medical Examiner’s Commission, there were 5,725 opiate-related deaths in Florida in 2016. My brother-in-law and good friend, David Abrams, was one of them. But my family’s loss, unfortunately, is all too common in Florida. Opiate addiction and death are approaching the ubiquity of diseases like cancer — where none among us are left untouched by its impact on ourselves and our loved ones. In 2016, there was a 35 percent increase in opiate-related deaths from the previous year. Nearly 1,500 more lives were lost. Complete data for 2017 isn’t available yet, but preliminary and anecdotal reports suggest the problem is only getting worse. (Florida Rep. Nicolas X. Duran, 1/8)

Kentucky has the highest rate of smoking in the nation and, not surprisingly, the highest rate of cancer in the nation. And, according to the recently released Louisville Health Equity report, the top three causes of death in Louisville over the past five years – cancer, heart disease and COPD – are directly linked to smoking. We also have one of the lowest tobacco tax rates in the nation, which works against efforts to curb smoking and deaths related to smoking. (Drs. Sarah Moyer and Karen M. Cost, 1/8)

Each state decides how best to protect the health and safety of its citizens, and professional licensure plays an important role. No one wants to be operated on by an unlicensed doctor or share the road with an unlicensed truck driver. But too often, overly burdensome licensure requirements weaken competition without benefiting the public. ... Consider telemedicine. It has helped many Americans, especially in rural and other underserved areas, receive treatment based on phone consultations rather than driving hundreds of miles to a clinic. Allowing licensed medical professionals to serve patients via telemedicine may be a solution for struggling hospitals that need to extend their reach into rural communities. (Secretary of Labor Alexander Acosta and South Dakota Gov. Dennis Daugaard, 1/8)

Dear Lieutenant Gov. Jeff Colyer, It seems that you may be the face of Kansas soon. Gov. Sam Brownback might be leaving to become ambassador-at-large for international religious freedom, to the jubilation of some. But I don’t take pleasure in the failure of others. I don’t know the governor personally, but there is no denying his decisions have had consequences. I have seen the damage to my uninsured patients when the governor chose political ideology over pragmatic decision making. You supported the governor in his vision. But soon your own vision might need defining. (Taimur Safder, 1/8)