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Democratic presidential front-runner Joe Biden unveiled a $750 billion healthcare plan on Monday that he said would strengthen the Affordable Care Act, drawing a contrast with rivals who back a more sweeping "Medicare for All" government-run system. Biden portrayed White House rivals led by U.S. Senator Bernie Sanders of Vermont, who back a single-payer plan that eliminates private insurance, as a threat to former President Barack Obama's signature healthcare law, known as Obamacare. (Whitesides and Stone, 7/15)

It was the singular promise that doomed the public perception of President Barack Obama’s health care law — and now former Vice President Joseph R. Biden Jr. is using it on the campaign trail. “If you like your health care plan, your employer-based plan, you can keep it,” Mr. Biden told an AARP forum on Monday. “If you like your private insurance, you can keep it.” Mr. Biden restated nearly verbatim Mr. Obama’s Affordable Care Act promise — which was named Politifact’s “Lie of the Year” in 2013 and has been ridiculed by Republicans for years — as he detailed for the first time how he would tackle health care as president. (Epstein and Goodnough, 7/15)

But the law has provided 20 million people with health insurance, and it’s now more popular than ever. Biden is running on protecting ObamaCare. He is banking the law’s popularity will convince voters that his plan of shoring up the law with more subsidies and a public option is a better approach than Medicare for All. “You get your choice, you get full coverage … I think it’s the quickest, most reasonable, rational and best way to get to universal coverage,” he said. (Weixel, 7/15)

His approach reflects a schism among Democrats that will define the party—and possibly health care—for years to come. Moderates such as Mr. Biden favor incremental policy advances like the plan laid out Monday. The more progressive wing wants to remake the system into something new. Mr. Biden risks appearing out of step. “You have Biden who is defending Obamacare, and everyone else has moved on,” said Scott Jennings, an appointee in former President George W. Bush’s administration. “Politically, Biden is trapped by his old job,” because he can’t abandon Obamacare after supporting it as vice president, Mr. Jennings said. (Armour, 7/15)

Under Biden’s plan, an estimated 4.9 million low-income Americans living in states that haven’t expanded Medicaid would have access to a no-premium public option. States that have expanded Medicaid -- typically, those governed by Republicans -- would also have the option of moving to the new public option if they continue paying their current share of the cost of covering those benefiting from the expansion. The plan also includes a string of proposals that Democrats generally support, including repealing the law that bars Medicare from negotiating lower drug prices, allowing consumers to buy prescription drugs from other countries, and eliminating “surprise billing” when a patient doesn’t have control over which provider he or she sees. Biden would also favor doubling federal funding for community health centers. (Epstein, 7/15)

Biden’s language regarding Medicare prices was also aggressive. He called the existing ban on the federal government negotiating with manufacturers an “outrageous exception.” Democrats have almost universally called for allowing Medicare to negotiate for drug prices directly, and almost succeeded in including such a provision in the Affordable Care Act, which Biden helped push through Congress as vice president. (Facher, 7/15)

A nonprofit foundation set up by Democratic presidential candidate Joe Biden that relied on health care world partnerships to speed a cure for cancer has suspended its operations, it announced Monday. The Biden Cancer Initiative's sudden move to cease its activities comes two years after it was founded in 2017 by the former vice president and his wife, Jill, as a philanthropic extension of Biden's stewardship of the White House Cancer Moonshot program. (Braun, 7/15)

Greg Simon, president of the Biden Cancer Initiative, said the organization is “suspending activities given our unique circumstances.” Simon added that “we remain personally committed to the cause, but at this time will have to pause efforts. We thank the community for their incredible response to our mission to improve the cancer journey for patients and to improve outcomes for all patients for generations to come.” (Weixel, 7/15)

Those unique circumstances: Biden is currently the top-polling Democratic candidate for the nomination of the Democratic Party in the 2020 presidential election. Last month, the Associated Press raised concerns as to whether the Biden Cancer Initiative’s connections with for-profit health care companies would pose ethical issues for a Biden administration. The AP cited concerns from Arthur Caplan, a prominent New York University bioethicist, who said that a “Biden administration would give favorable treatment for anyone who supported his foundation in the past.” (Herper and Facher, 7/15)

Biden and his wife, Jill, founded the organization in June 2017 to continue efforts begun by the Obama administration’s Cancer Moonshot, which Biden oversaw while in the White House. The couple’s son Beau died of brain cancer in 2015. The Biden Cancer Initiative did not fund cancer research. Rather, it tried to harness the Bidens’ “convening” power to prod researchers, companies and patient groups to collaborate and move faster to improve data sharing, clinical trials and cancer-care accessibility, Greg Simon, the group’s president, said in an interview. (McGinley, 7/15)

Any voter looking for a "Medicare for All" champion would have been out of luck Monday at a Democratic presidential candidate forum at Drake University. All four candidates at the forum, sponsored by AARP and the Des Moines Register, urged more gradual efforts to ensure health care for all Americans. The Democratic race's polling leader, former Vice President Joe Biden, explained his new health-care plan by saying he wouldn't force people who like their private insurance to switch. (Leys, 7/15)

The 2020 hopefuls who participated in a forum sponsored by AARP Iowa and The Des Moines Register also supported adding a public option to the Affordable Care Act to expand coverage to more Americans but three balked at eliminating private insurance for those who prefer to keep their current health care coverage. (Boshart, 7/15)

Joe Biden grew emotional, choking on his words and tearing up during a forum here Monday as he described the value of personal care givers, relating the discussion to the tragedies in his own life. “They should be rewarded, compensated for what they do. They're desperately needed, particularly in poor and rural areas,” Biden said at a AARP presidential candidate forum here, saying that “paid care givers are not paid very much at all.” (Korecki, 7/15)

Kamala Harris on Tuesday announced a plan to reduce prescription drug costs and rein in pharmaceutical companies, including linking the price of drugs to their prices in other countries. The California senator is expected to promote the plan at an AARP forum in Davenport, Iowa. (Siders, 7/16)

Harris, a U.S. senator from California, said her proposal would dramatically lower drug costs by allowing the federal government to set fair prices for what companies can charge and forcing them to pay rebates to consumers for medicines sold at artificially high rates. “As President, I will not stand idly by as Americans pay thousands of dollars for prescription drugs while big pharmaceutical companies rake in massive profits,” Harris said in a statement ahead of speaking about the plan at a candidate forum in Iowa, the first state to hold a nominating contest. (Reid, 7/16)

Under the proposal, the Department of Health and Human Services would set a "fair price" for any drug that is sold for a cheaper price in an economically comparable county -- the plan cites the United Kingdom, France, Germany, Japan and Australia as examples -- or when a company hikes its price by more than inflation. The plan also slaps a tax of 100% on all profits drug makers earn from selling a drug above the fair price. These funds will ultimately go to consumers, either at the pharmacy counter or through rebates. And Harris would end the tax loophole pharmaceutical companies receive for direct-to-consumer advertising expenses. (Merica and Luhby, 7/16)

Before healthcare investor Joel Freedman shutters the money-losing hospital he controls in the heart of Philadelphia, he must craft a plan to remove all the street signs that direct people to its emergency room. Medical care, emergency or not, will no longer be available at Hahnemann University Hospital under a proposal being considered this month by the federal judge overseeing the bankruptcy of the 171-year-old institution and its parent company. (Church, 7/15)

Sen. Bernie Sanders (I-Vt.) on Monday attacked the pending closure of a Philadelphia hospital as an example of corporate greed taking priority over people’s health. During a rally to save the 171-year-old Hahnemann University Hospital from bankruptcy, Sanders said his “Medicare for All” plan would guarantee healthcare to every American and save them from corporations that are just seeking to make a profit. (Weixel, 7/15)

In December 2017, Sidney Canada felt dizzy and disoriented. The 52-year-old Georgia father often struggled to get a decent night’s rest, due to his sleep apnea. When he couldn’t talk clearly, his wife wondered if he had taken too many sleeping aids. He was sent to Evans Memorial Hospital, a 49-bed facility between Macon and Savannah, according to family members. After Canada was admitted, the staff attached tubes and a catheter, hoping to stabilize and monitor him. But he grew agitated. He ripped them off, splattering blood on the walls. (Blau, 7/15)

The Minnesota Hospital Association said the state's largest not-for-profit health insurer, Blue Cross Blue Shield of Minnesota, is probably breaking the law by imposing a slate of new policies designed to deny or delay access to routine colonoscopies and hundreds of other services in hospitals. The hospital trade group is asking state officials to investigate the practices of the state Blue Cross plan and stop the insurer from imposing new policies that the hospitals said make it more difficult and expensive for Minnesotans to access routine and lifesaving health care services. (Carlson, 7/15)

By year's end, Akron's two major health systems will be owned by outside entities, a reality that just a few years ago some leaders were reluctant to embrace. But now, with Akron General years into a successful integration with Cleveland Clinic, and Summa Health announcing it will become a wholly owned subsidiary of Michigan-based Beaumont Health, city and hospital leaders are ready to seize what comes alongside a loss of local ownership: stability and an infusion of outside resources. (Coutre, 7/15)

The Trump administration says it will begin immediately enforcing new rules barring federal family planning dollars to groups that provide abortions or make referrals for the procedure, ending weeks of uncertainty about the status of the overhaul. Diane Foley, the head of HHS' Office of Population Affairs, wrote to Title X grantees Monday night that the 9th U.S. Circuit Court of Appeals' recent decision not to freeze the rule while legal challenges play out means most of it can take effect. (Ollstein, 7/15)

That means clinics receiving family planning grants to provide contraception and other services to low-income women will have to stop providing abortion referrals or lose their funding. The requirement that family planning services funded by Title X be financially separate from abortion services also begins today. An additional requirement that abortion services and Title X services be performed in separate facilities won't take effect until next year. (Hellmann, 7/15)

The head of a national umbrella group representing the clinics said the administration is following "an ideological agenda" that could disrupt basic health care for many low-income women. Ahead of a planned conference Tuesday with the clinics, the Health and Human Services Department formally notified them that it will begin enforcing the ban on abortion referrals, along with a requirement that clinics maintain separate finances from facilities that provide abortions. Another requirement that both kinds of facilities cannot be under the same roof would take effect next year. (Alonso-Zaldivar, 7/15)

The sponsor of Georgia’s new anti-abortion law compares civil rights activists who oppose the measure to plantation owners, saying they are trampling on the rights of the unborn just as owners ignored the humanity of slaves. “Sadly, civil rights groups who crush the rights of unborn children remind me of 18th century plantation owners who, after winning their freedom from Britain, enslaved people of color to achieve their own economic goals,” Acworth Republican state Rep. Ed Setzler told The Atlanta Journal-Constitution. (Prabhu, 7/15)

Medicare says it's moving toward potentially covering acupuncture for chronic low back pain as an alternative to opioid painkillers that can become addictive. The agency announced its initial decision Monday. For now, access will be limited to seniors signed up in government-approved clinical studies. Medicare says more evidence is needed before broad approval can be considered. (7/15)

The proposal, released by the Centers for Medicare and Medicaid Services, would apply only to patients enrolled in clinical trials supported by the National Institutes of Health or those approved by CMS. In its statement, CMS acknowledged that while “the evidence base for acupuncture has grown in recent years … questions remain.” (Joseph, 7/15)

The studies will allow the government to assess whether there is enough evidence to offer Medicare coverage of the controversial treatment to a wider group of people age 65 and older who are afflicted by chronic low back pain. Currently, the giant government health insurance program does not cover acupuncture. “By focusing on older adults and addressing the limitations of previous published research, evidence derived from this initiative would assist [the Centers for Medicare and Medicaid Services] in determining future Medicare coverage for acupuncture,” according to the announcement. (Bernstein, 7/15)

As the Food and Drug Administration grapples with rising pressure to approve new medicines more quickly, a new analysis finds the agency disagreed with its expert advisory panels about one-fifth of the time. The disagreements were more likely to occur over safety issues than over approving new products or additional uses for existing products. (Silverman, 7/15)

The largest study to date of a “cancer vaccine” plus one of the immunotherapy drugs that has revolutionized cancer treatment found that they kept patients’ tumors in check longer, on average, than drugs alone, but that the benefit was still only a few months for two forms of cancer, study sponsor Neon Therapeutics reported on Monday. It was a hint that an experimental therapy often described as the next great hope for immune-based approaches to fighting cancer will not be a silver bullet. (Begley, 7/15)

Consumer products giant Johnson & Johnson was a “kingpin” company that helped fuel the most devastating public health crisis in Oklahoma history, the state attorney general argued Monday during the close of his case against the opioid drug manufacturer. Mike Hunter said the New Jersey-based company and its subsidiaries, including Janssen Pharmaceuticals, created a public nuisance by launching a “cunning, cynical and deceitful” marketing campaign that overstated the benefits of opioid drugs for treating chronic pain and understated the risk of addiction. (Murphy, 7/15)

State and company lawyers delivered spirited closing arguments that capped the landmark seven-week proceeding — the first state trial in what has become a nationwide effort to recoup money from the drug industry for the cost of the crisis. Judge Thad Balkman is expected to issue a decision near the end of August. The stakes are high for both sides and dozens of other states suing the pharmaceutical industry. A win for Oklahoma and a penalty in the billions of dollars — the state wants $17.5 billion over 30 years to “abate” the epidemic — would be a big blow to Johnson & Johnson. It might also establish a settlement threshold for future defendants. (Bernstein, 7/15)

Even after illegally promoting opioid painkillers to reap billions of dollars in profit over the past two decades, Johnson & Johnson has accepted “zero responsibility’’ for its central role in fueling a public-health crisis, Oklahoma’s top law-enforcement official told a trial judge. J&J engaged in a “cunning” scheme to dupe doctors into over-prescribing addictive medications that “wrecked thousands” of families in the state, Oklahoma Attorney General Mike Hunter said during closing arguments Monday. The trial in Oklahoma City is the first of more than 1,900 local U.S. government lawsuits against drug makers and distributors over the fallout from opioid abuse. (Feeley, 7/15)

Over a seven-week trial, attorneys for Oklahoma presented evidence and witnesses they say prove Johnson & Johnson was the kingpin of the state’s prescription opioid supply. Oklahoma has proposed a more than $17.5 billion, 30-year plan to abate the costs of opioid addiction that it says Johnson & Johnson should fund. The plan includes money for addiction treatment, education of the public and medical community, and overdose prevention programs. The state says 6,100 Oklahomans died from prescription-drug overdoses between 2000 and 2017. (Randazzo, 7/15)

Before adjourning the trial, Cleveland County District Judge Thad Balkman said he anticipates taking about a month to reach a decision in the case. The case could lay a road map for other states and municipalities seeking to hold drugmakers responsible for opioid crises in their communities. (Howard, 7/15)

In the first trial aimed at holding drug companies accountable for the opioid crisis, Oklahoma earlier this year reeled in more than $350 million in settlement payments from drugmakers Purdue Pharma and Teva. But skirmishes between the attorney general and a group including the governor, lawmakers and local governments over who gets to spend the money threaten to bog down efforts to use it for much-needed prevention, treatment and recovery services. Nationwide, similar struggles loom in opioid cases brought by attorneys general in nearly every state and in a consolidated class action lawsuit involving nearly 2,000 plaintiffs, including local, county and tribal governments, as well as some insurers and medical groups. (Vestal, 7/15)

A couple from Ohio pushed a shopping cart filled with their tattered belongings toward West 34th Street as tourists crowded beside them. An older man from Massachusetts nodded off outside Pennsylvania Station, which 600,000 people pass through daily. Nearby, a woman from North Carolina crouched next to a cardboard sign. New York’s transit hubs welcome millions of tourists and commuters every year. But in recent years, the hubs have also increasingly become a destination for people with opioid and other drug addictions, many of whom arrive from parts of the country that have seen soaring rates of drug use and fatal overdoses. (Correal, 7/16)

The number of cases of children entering the foster care system due to parental drug use has more than doubled since 2000, according to research published this week in JAMA Pediatrics. Researchers analyzed data from the Adoption and Foster Care Analysis and Reporting System (AFCARS), a federally mandated data collection system that includes information on children in foster care in the United States. (Neilson, 7/15)

A Maryland state agency failed to adequately monitor groups to which it provided funding to treat opioid and gambling addictions and care for severely disabled children, according to a state audit released last week, raising questions about whether clients received proper treatment and how millions of taxpayer dollars were spent. The Behavioral Health Administration could not prove that it reviewed reports submitted by groups it paid to provide treatment for substance abuse disorder, the audit said. (Chason, 7/15)

While the opioid crisis has not hit California as hard as some of the Eastern states, roughly 2,000 Californians die each year of an opioid overdose. In a bid to combat this, California's Department of Health Care Services (DHCS) has invested $265 million since 2017 to increase access to medication-assisted treatment throughout the state. Tomás' story offers a window into what America's opioid crisis may look like in the future: people on medication to treat their addiction for years, or even for the rest of their lives. (Klivans, 7/15)

A man demanding methadone opened fire at a Baltimore addiction clinic Monday, killing one person and wounding a police sergeant before he was fatally shot by police, authorities said. Baltimore Police Commissioner Michael Harrison said at a news conference that the gunman had gone into the clinic seeking the drug that helps control opioid cravings and withdrawal symptoms. It can be given only at government-regulated clinics. (7/15)

On the last day of March, Kirstjen Nielsen set off for what was supposed to be a weeklong trip to Europe with a packed itinerary. In London, she would meet with British officials on counterterrorism matters, then travel on to Stockholm to discuss election security with her Swedish counterparts and finally head to Paris, where she would represent the United States at a meeting of Group of 7 interior ministers. These are some of the far-flung obligations of the secretary of homeland security, who bears responsibility for not only thwarting terrorist attacks and preventing foreign interference in American elections but also cleaning up after hurricanes and ensuring that the United States doesn’t cede control of the Arctic to Russia and China. (Zengerle, 7/16)

Sixty-two U.S. Customs and Border Protection employees and eight former employees have come under investigation for possible misconduct for their alleged participation in a secret Facebook group, where members shared racist and sexist memes, cracked jokes about migrant deaths and made derogatory remarks about Latina members of Congress. (Hauslohner, 7/15)

On Monday, officials for the first time provided details of the recently launched federal investigation into the 9,500-member group, known as “I’m 10-15,” the code used by Border Patrol for migrants in custody. The probe was spurred by a ProPublica report that revealed the existence of the group and its vulgar posts, including an illustration of Democratic New York Rep. Alexandria Ocasio-Cortez being sexually assaulted by President Trump. Other posts mocked migrants who drowned in the Rio Grande. (O'Toole, 7/15)

The leader of the nation’s largest provider of migrant shelters for children was paid $3.6 million during the charity’s most recent tax year, even as the nonprofit organization came under intense scrutiny for its high compensation packages for executives and for its decision to accept children separated from their families by the Trump administration. Juan Sanchez, the chief executive of Southwest Key Programs, received that income, which included life insurance and retirement benefits, between September 2017 and August 2018. (Barker, Kulish and Ruiz, 7/15)

The record number of families entering the U.S. and requesting asylum has overloaded a border enforcement system not designed to safely and quickly process them. Here is a step-by-step look at the process families go through and where the system is straining. (Wang, Caldwell and Wang, 7/16)

Dr. Sally Goza of Fayetteville, president-elect of the American Academy of Pediatrics, said Monday that the visit by herself and other pediatricians underscored the organization’s position that the Border Patrol facilities are not a good place for children, and that kids should be there for as short a time as possible. (Miller, 7/15)

Rep. Rosa DeLauro and a group of fellow Democrats toured a facility that holds migrant youth in southern Florida on Monday and said they are both dissatisfied with conditions at the center and information they received about the children’s care. DeLauro , D-3rd District, said the lawmakers left the Homestead Temporary Shelter for Unaccompanied Children with questions about the standard of care at the center and about how long it takes for children to be placed with family in the United States. (Radelat, 7/15)

Hospital executives, with some support in Congress, are lobbying for more regulation to protect health information from unscrupulous data mongers. But HHS is pushing forward with rules that leave that responsibility in patients’ hands. As federal rule-makers grapple with making patient data more easily shareable, some health leaders fear that their actions could lead to a proliferation of apps selling or exploiting medical data. They worry that patients are likely to sign away their rights to data — perhaps including detailed family histories — without realizing what they're doing. (Ravindranath, 7/15)

Companies that provide business support to dentists are starting to use artificial intelligence to analyze X-ray images and automate certain steps in common procedures, pointing to the technology’s cost-cutting potential. Dental support organizations don’t get involved in patient care but they can take care of everything from accounting to tax preparation for dental practices that fall under their umbrella. DSOs hope that providing AI services will help standardize care across member clinics. And while AI itself might not lead clinics to join a DSO, the better treatment and savings the technology promises could factor into the decision. (Shah, 7/16)

In New Hampshire, this explosion of telemedicine is being heralded by some as a solution to health care problems like long wait times, rural access, and workforce shortages. But questions remain whether telemedicine will be able to deliver. (Moon, 7/16)

In 2000, the Broward County Public Schools in Florida received an alarming report. Like many affluent school districts at the time, Broward was considering laptops and wireless networks for its classrooms and 250,000 students. Were there any health risks to worry about? The district asked Bill P. Curry, a consultant and physicist, to study the matter. The technology, he reported back, was “likely to be a serious health hazard.” He summarized his most troubling evidence in a large graph labeled “Microwave Absorption in Brain Tissue (Grey Matter).” (Broad, 7/16)

Livongo Health on Monday revealed details of its proposed initial public offering, including information on how many shares it plans to offer and at what price. Livongo, a digital health company founded by former Allscripts Healthcare Solutions CEO Glen Tullman in 2014, filed its registration statement for the proposed IPO with the U.S. Securities and Exchange Commission in June. At the time, the company had not determined the number of shares to be offered or their price range. (Cohen, 7/15)

New research shows that the extreme weather and fires of recent years, similar to the flooding that has struck Louisiana and the Midwest, may be making Americans sick in ways researchers are only beginning to understand. By knocking chemicals loose from soil, homes, industrial-waste sites or other sources, and spreading them into the air, water and ground, disasters like these — often intensified by climate change — appear to be exposing people to an array of physical ailments including respiratory disease and cancer. (Flavelle, 7/15)

The Trump administration failed to follow ethics rules last year when it dismissed academic members of Environmental Protection Agency advisory boards and replaced them with appointees connected to industry, a federal watchdog agency concluded Monday. The agency, the Government Accountability Office, found that the administration “did not consistently ensure” that appointees to E.P.A. advisory panels met federal ethics requirements. It also concluded that Trump administration officials violated E.P.A. guidelines by not basing the appointments on recommendations made by career staff members. (Friedman, 7/15)

An arm of the Veterans Affairs Department in Atlanta eliminated 208,272 applications from across the country for health care early this year amid efforts to shrink a massive backlog of requests, saying they were missing signatures or information about military service and income, according to records reviewed by The Atlanta Journal-Constitution. Veterans groups say the VA should have done more to communicate with the veterans before closing their applications, some of which date back to 1998. (Redmon, 7/15)

Though nurses have traditionally been employed in inpatient acute-care settings, more and more nurses are now playing a larger role in providing and coordinating care across the continuum of care. As services move from inpatient to outpatient services, Case Western Reserve University's Frances Payne Bolton School of Nursing and the Louis Stokes Cleveland VA Medical Center are teaming up to help address that shift. (Coutre, 7/15)

The Department of Veterans Affairs last week named Harvard Medical School professor Gil Alterovitz as its first director of artificial intelligence, putting him in charge of coordinating and building capacity for the agency’s AI research-and-development activities. (McCormick, 7/16)

Scientists are closing in on a long-sought goal — a blood test to screen people for possible signs of Alzheimer's disease and other forms of dementia. On Monday at the Alzheimer's Association International Conference, half a dozen research groups gave new results on various experimental tests, including one that seems 88% accurate at indicating Alzheimer's risk. (7/15)

Doctors are hoping for something to use during routine exams, where most dementia symptoms are evaluated, to gauge who needs more extensive testing. Current tools such as brain scans and spinal fluid tests are too expensive or impractical for regular checkups. "We need something quicker and dirtier. It doesn't have to be perfect" to be useful for screening, said Maria Carrillo, the Alzheimer's Assn.'s chief science officer. Dr. Richard Hodes, director of the National Institute on Aging, called the new results "very promising" and said blood tests soon will be used to choose and monitor people for federally funded studies. It will take a little longer to establish their value in routine medical care, he said. (Marchione, 7/15)

Everyone has two copies of the apolipoprotein E, or APOE, gene—one inherited from each parent. There are three variants of the gene. The e4 variant is associated with a heightened Alzheimer’s risk. About 20% of the population has one or two copies of the e4 variant, said Rudy Tanzi, professor of neurology at Massachusetts General Hospital and Harvard Medical School and co-director of the McCance Center for Brain Health. One copy increases your risk of developing Alzheimer’s disease three- to four-fold, according to studies. About 2% of the world’s population has two copies of the e4 variant, which can increase the risk by as much as 14-fold, Dr. Tanzi said. (Reddy, 7/15)

Netflix Inc. is removing a controversial graphic scene depicting a youth suicide from its popular young adult drama "13 Reasons Why", following advice from medical experts, the company said on its Twitter account early on Tuesday. The show, based on a book of the same name, depicts the suicide of the protagonist in the last episode of season 1, with a scene of the youth Hannah slitting her wrists in a bathtub. (McKay, 7/16)

“It was our hope, in making ’13 Reasons Why’ into a television show, to tell a story that would help young viewers feel seen and heard, and encourage empathy in all who viewed it, much as the bestselling book did before us,” showrunner Brian Yorkey said in a statement. “Our creative intent in portraying the ugly, painful reality of suicide in such graphic detail in season one was to tell the truth about the horror of such an act, and make sure no one would ever wish to emulate it. But as we ready to launch season three, we have heard concerns about the scene from Dr. Christine Moutier at the American Foundation for Suicide Prevention and others, and have agreed with Netflix to re-edit it." (Nicholai, 7/15)

A study funded by the National Institutes of Health suggested that “13 Reasons Why” was a factor in a rise in teen suicides. The study found that the suicide rate among people 10 to 17 went up by nearly a third in April 2017, the month after the show launched on Netflix. Some school officials issued warnings and guidance to parents about the show. At the time of the study, a Netflix spokesman said, “It’s a critically important topic, and we have worked hard to ensure that we handle this sensitive issue responsibly.” (Flint, 7/16)

Suicide prevention groups are now voicing their support in Netflix’s decision to edit the scene. “We support the decision to edit the scene in which Hannah takes her own life from 13 Reasons Why,” the groups — which included the American Foundation for Suicide Prevention and the Trevor Project — say in a joint statement to PEOPLE. “There has been much debate about the series in the medical community. But this positive change will ensure that 13 Reasons Why continues to encourage open conversation about mental health and suicide prevention – while also mitigating the risk for the most vulnerable teenage viewers.” (Boucher, 7/16)

For more than 50 years, the DNA remained hidden in a lymph node that had been snipped out of a 38-year-old man in what is now the Democratic Republic of the Congo. That nub of tissue, the size of a nail on a pinky finger, had been sealed up in a protective block of paraffin. Once freed from its wax casing, scientists at the University of Arizona were able to extract from the tissue a nearly complete genetic sequence of an HIV virus — the oldest nearly full-length genetic code for an HIV-1 virus recovered thus far, and one that supports the theory that the virus that causes AIDS began to transmit among people within the first decade or two of the 20th century. (Branswell, 7/16)

A bipartisan trio of senators on Monday introduced a resolution underscoring their opposition to the experiments last year in China that led to the birth of the world’s first genome-edited babies. The resolution from Sens. Dianne Feinstein (D-Calif.), Marco Rubio (R-Fla.), and Jack Reed (D-R.I.) also reiterated support for international groups working to produce guidelines for the clinical use of germline editing — meaning changes to the DNA in sperm, eggs, or early embryos that would be passed down to future generations. (Joseph, 7/15)

Children are more likely to die of firearm-related injuries in states with looser gun laws, according to a study published by The American Academy of Pediatrics on Monday. Firearm injuries are one of the leading causes of death among children in the United States. More than 21,200 children died of firearm-related injuries between 2011-2015. They died at a higher rate in states with lax gun laws, the study found. (Wise, 7/15)

On Monday’s St. Louis on the Air, guest host Jim Kirchherr of the Nine Network discussed ongoing violence in the region, as well as solutions which aim to address it as a public health issue. Poli Rijos of Washington University’s Gun Violence Initiative and Jessica Meyers of the St. Louis Area Violence Prevention Commission joined the conversation. (Moore, 7/15)

[Garon] Mosby spoke with guest host Jim Kirchherr of the Nine Network, alongside Helen Sandkuhl of SSM Health Saint Louis University Hospital, who has been working in emergency medicine for more than 45 years. They talked about the impact of violence in the area and the toll it takes on the morale and the mental health of those providing emergency care. (Woodburyn, 7/15)

Health care workers face a host of injury threats, from needle sticks and disease exposure to assault. But shootings like the one Monday in a Baltimore drug treatment center remain uncommon, research suggests. The shooting, however, might draw attention to such clinics and others offering urgent care, surgery and other outpatient services that are expanding outside large hospital settings that tend to have more security. (Cohn and Mirabella, 7/16)

About 34% of medical malpractice claims over a 10-year period that resulted in permanent injury or death to a patient were caused by diagnostic errors, according to a new study. The findings, published Thursday and conducted by researchers at Johns Hopkins University School of Medicine, highlight the serious injuries that may result from diagnostic errors, among of the most common mistakes in medicine. (Castellucci, 7/11)

More than one in 10 children - or 20 million worldwide - missed out last year on vaccines against life-threatening diseases such as measles, diphtheria and tetanus, the World Health Organization and the UNICEF children's fund said on Monday. In a report on global immunization coverage, the U.N. agencies found that vaccination levels are stagnating, notably in poor countries or areas of conflict. (7/15)

Scientists have long known a fairly reliable way to extend life span in rodents and other lab animals: Reduce the amount of calories they eat by 10 percent to 40 percent. This strategy, known as caloric restriction, has been shown to increase the life span of various organisms and reduce their rate of cancer and other age-related ailments. Whether it can do the same in people has been an open question. But an intriguing new study suggests that in young and middle-aged adults, chronically restricting calorie intake can have an impact on their health. (O'Connor, 7/16)

Kaiser Health News: As Temperatures Climb, A New Push To Keep Workers Safe

Last month, on a day that was sweltering even by Phoenix standards, Filiberto Lares knew he wasn’t well. An airline caterer, he said he had spent hours moving between the scalding tarmac and a truck with no air conditioning. Lares, 51, was dehydrated and fell ill with a fever that would keep him out of work for four unpaid days. It wasn’t the first time this had happened. “Honestly, I never imagined I would live a situation like this in the United States, especially not in an industry as valued as the airlines,” he said in Spanish. (Barry-Jester, 7/16)

A U.S. judge lowered a jury’s damage award from $80 million to $25 million for a California cancer victim who used Monsanto’s Roundup weed-killer. The San Francisco Chronicle reports Monday that U.S. District Judge Vince Chhabria said he was required to reduce the punitive damage award because it went beyond constitutional limits set by the U.S. Supreme Court. In March, a jury found that glyphosate was a likely cause of 70-year-old Edwin Hardeman’s diagnosis of non-Hodgkin’s lymphoma. (7/15)

U.S. District Judge Vince Chhabria said the $75 million in punitive damages awarded to Mr. Hardeman by the six-person jury was excessive compared with the $5.3 million in other damages. The judge said $20 million in punitive damages, or roughly four times the compensatory damages, was more appropriate under U.S. Supreme Court guidelines. “Based on the evidence that came in at trial, Monsanto deserves to be punished,” Judge Chhabria wrote in his Monday ruling. The judge concluded that while the science is still mixed on whether glyphosate, the active ingredient in Roundup, causes non-Hodgkin lymphoma, the company didn’t seem to care about investigating whether its product may be carcinogenic. (Randazzo, 7/15)

Chhabria nonetheless reduced punitive damages to $20 million from $75 million, saying that while Monsanto “deserves to be punished” the higher award was “constitutionally impermissible” because it was nearly 15 times the compensatory damages award. “Monsanto’s conduct, while reprehensible, does not warrant a ratio of that magnitude, particularly in the absence of evidence showing intentional concealment of a known or obvious safety risk,” Chhabria wrote. (Stempel, 7/15)

Bayer’s future growth is clouded by thousands of legal cases filed by people who argue Roundup is to blame for their cancer, leading shareholders to question its decision to buy U.S. seed and pesticide giant Monsanto for $63 billion last year. The company hired a high-profile mediator to lead settlement talks last month, though it continues to defend the herbicide as safe. (Rosenblatt, 7/15)

Rhode Island is one of about a dozen states that prohibit the release of 911 recordings or transcripts without the written consent of the caller or by court order. The goal generally is to protect the privacy of callers in what may be one of the most stressful moments of their lives. But Rhode Island’s restrictive law also keeps families in the dark about how the state’s 911 system has responded to calls involving their loved ones, and it has left the public oblivious to troubling gaps in how the system is performing, according to an investigation by The Public’s Radio and ProPublica. (Arditi, 7/16)

A system created to prevent tips about child abuse and neglect from slipping through the cracks instead created a big one: Scores of messages sent to Colorado’s statewide hotline piled up unread for four years because of a mistake in an email address. The problem started in 2015, not long after Colorado created a statewide telephone and email hotline for reporting suspected cases. The Department of Human Services set up an email account, and then made a seemingly minor change, adding an underscore and the department’s initials to the email address to bring it in line with department standards, according to the Denver station KCNC-TV, which first reported the problem. (Philipps and Stockman, 7/15)

Innovative mental health centers in eight states will lose enhanced federal funding on Sunday for a Medicaid demonstration that enables them to offer a broad array of coordinated services for people with serious mental illness and substance use disorders. The two-year, $1 billion certified community behavioral health clinic program (CCBHC), which enjoys bipartisan support, will end unless Congress quickly agrees to at least temporarily extend the funding. (Meyer, 7/12)

A federal judge on Monday gave preliminary approval to a settlement agreement for a lawsuit alleging that Missouri overmedicated children in foster care with psychotropic drugs. The agreement, which still needs final approval, calls for the state to make systemic changes to how it oversees prescriptions given to children in its care, including additional staff training and regular check-ups for kids on psychotropic medications. (7/15)

Sixteen people alleged to live in Georgia are under investigation by Tennessee authorities who say they received coverage under TennCare, Tennessee’s Medicaid program, possibly trying to get health coverage there that they couldn’t get here. It’s currently the largest number of such cases originating from any state, Tennessee’s Office of the Inspector General said. (Hart, 7/15)

Minnesota Human Services Commissioner Tony Lourey resigned abruptly on Monday, leaving his post at the state’s largest agency after only six months on the job. In his resignation letter to Gov. Tim Walz, Lourey said he believed “a new leader is necessary to best execute your vision for human services.” He did not clearly state why he was resigning. His sudden departure comes just days after his two top deputies announced they would resign. (Faircloth, 7/15)

Cara Pavalock-D’Amato, the ranking House Republican on the legislature’s Insurance and Real Estate Committee, has agreed to represent a Bristol couple suing to block the state from releasing data that show what percentage of children at each Connecticut school are unvaccinated. The legislator, who has a law degree from St. Thomas University in Miami, said she heard about the case from Brian Festa, who is her constituent and a plaintiff in the lawsuit. (Carlesso, 7/15)

The wide-ranging health care bill requires insurance companies to cover physical therapy, occupational therapy and speech therapy for all children 18 and under with disabilities. [Robyn] Schelp, the president of Missouri Disability Empowerment, said Missouri is one of just three states (the others are New Jersey and Maryland) with the disability coverage mandate. (marso, 7/16)

PG&E Corp. said it is working to repair nearly 10,000 problems it discovered throughout its electrical system as it steps up efforts to prevent its equipment from sparking more wildfires. The company posted to its website the results of an accelerated inspection process that began late last year. The company said it discovered more than 1,000 immediate safety risks and has repaired nearly all of them, as well as thousands of other lower-priority ones. But it is still working through more than 3,700 repairs as California’s wildfire season proceeds. (Blunt and Gold, 7/15)

The family’s story is not uncommon in Santa Cruz County, which has the second-highest child poverty rate in the state, according to the Public Policy Institute of California. Los Angeles County has the highest rate. Experts say the statistics can largely be traced to high housing costs. But Santa Cruz County’s median household income of $79,704 is much lower than Silicon Valley’s and San Francisco’s, partly because the area’s dominant industries are hospitality and agriculture. (Hellerstein, 7/15)

A 57-year-old man was arrested Friday after authorities say he fatally choked a woman at a Southeast Portland mental health treatment facility in May while they both were patients there. Multnomah County prosecutors allege in court documents that surveillance video shows Roger J. Jones twice go into the room of Huyen Cao on May 17, where he at some point strangled her off camera. He goes into her room once around 3:40 a.m., stays for 17 minutes, leaves and returns briefly about 10 minutes later, according to a probable cause affidavit. (Bailey, 7/15)

Pinnacle Home Healthcare Services Inc. and its owner Pauline Mwangi will pay 233 home health care aides for late and missed wages, Healey said in a statement. A Pinnacle employee alleged the company was issuing checks that were missing pay, leading to an investigation, Healey said. (Saric, 7/15)

When Massachusetts lawmakers approved a program to release prisoners who are incapacitated or terminally ill, proponents hailed it as a compassionate, practical measure that could save taxpayers millions in health care costs. But only four inmates have received medical parole since it was enacted in April 2018 and advocates say prison officials are undercutting the law by preventing inmates from even applying, placing one administrative barrier after another in their path. (Lotan, 7/15)

The 2020 Democratic presidential primary campaign is in many ways an argument between liberals and moderates over the path the Democratic Party should take, and on no issue has that argument been more intense than health care. Joe Biden has now released his health care plan, and while he’s presenting it as a rebuke of the more liberal candidates, in fact it represents a significant move to the left. (Paul Waldman, 7/15)

Despite the fact that Medicare for All has gained traction in large part due to our country’s most famous democratic-socialist, Sen. Bernie Sanders, I’m about as far from a socialist as you can be. But I know that if we’re going to grow, expand and improve our market-based economy, it’s time to drastically overhaul the way we finance health care. (David Steil, 7/16)

Last week, the BBC published a piece entitled, “The benefits of spending time alone.” Many, who read the article, scratched their heads, wondering “Wait, we were told that loneliness was detrimental to our health. What gives, and why are you changing course?” As a psychologist, I think it’s important for everyone to understand the differences between loneliness and aloneness. In addition, we should all know the tremendous benefits one can receive from some quality time to tune out and turn in. (Joan Cook, 7/15)

Replicability is one of the key tenets of scientific research, and for good reason. If a study shows that a new drug, for example, treats a specific condition in a specific population, the same result should emerge when a different team conducts the same test. Replicability validates results, assuring that the outcome is real and not the result of some unforeseen variable or the play of chance. It ensures that the information we think we’re getting is, in fact, accurate. The ultimate issue of the replication crisis is simple: We can’t make informed decisions without the correct information, and we’re getting a lot of incorrect information. (Sanjay Basu, 7/16)

More than 1.25 million Americans live with type 1 diabetes (T1D) and 40,000 are diagnosed each year. As an autoimmune response that damages the body’s cells that make insulin, it requires constant management to avoid dangerously high or low blood sugar levels. I too live with type 1 diabetes, and have since the age of 13. Diabetes impacts every aspect of life — 24 hours a day, 7 days a week — but today we can better manage this disease and we’re steps closer to cures, thanks to federal funding for T1D research provided through the Special Diabetes Program (SDP). (Aaron J. Kowalski, 7/15)

I went to a play date the other day at a new preschool-friend’s house, wrestling my 5- and 3-year-old boys through the big doors of a strange new home. Almost the moment I stepped through the front door, the mom giggled “mimosa time!” and my body froze up. I wasn’t prepared for this. As a relative newbie to sobriety, I’ve learned that preparation is key. Most times, when I’m heading to a social gathering, I have time to prepare mentally, physically (I always bring a drink with me) and emotionally. (Celeste Yvonne, 7/15)

Today, any health-care provider with a license from the U.S. Drug Enforcement Administration (DEA) to prescribe controlled substances can write a prescription for an opioid painkiller. But that same health-care professional cannot prescribe one of the three main drugs used to manage opioid dependence without first undergoing hours of training and receiving approval from the DEA. As opioid overdoses kill approximately 48,000 Americans a year — 130 each day — Congress has an opportunity to eliminate these outdated requirements and help expand access to lifesaving care.  (Allan Coukell, 7/15)

Mental health care is a national failure that is more visible and visceral in San Francisco, where too many struggles with mental illness take place on the streets among the city’s disproportionate and rapidly growing population of homeless people. That is in large part due to the persistent housing shortage that is forcing more and more vulnerable San Franciscans out of their homes — and on which the Board of Supervisors has a nearly perfect record of dithering and denial. (7/13)

A federal inspector general’s report has identified appalling conditions at hospice centers around the country, including particularly bad conditions at one unidentified Missouri center operated by Vitas Healthcare. The kinds of abuse and neglect described in the report would be condemnable under any circumstances, but it’s particularly galling that hospice centers collect taxpayer money for their services with far too little oversight to ensure abuses don’t happen. The Washington Post, citing a state inspector in Missouri, identified Vitas as one of the hospice providers with the most severe service deficiencies. (7/15)

What’s the state Department of Correction so afraid of? Its new rules on the use of solitary confinement and a gag rule for an oversight committee charged with playing watchdog over its implementation are embarrassing for a state that was once a leader in prison reform.If these “emergency regulations” are actually allowed to remain in effect, the Baker administration will have solidified its reputation as the least transparent since Calvin “Silent Cal” Coolidge occupied the Corner Office. (7/14)