�Թϲ�����

Women held in rooms without running water, sleeping bags set up on concrete and children left apart from their families: That was what Democratic lawmakers said they heard about on Monday as they toured two Texas border facilities. Their emotional, and graphic, descriptions came on a day when ProPublica reported the existence of a secret Facebook group for current and former Border Patrol agents. Posts on the group’s page included jokes about migrants’ deaths, obscene GIFs and doctored images of Hispanic lawmakers, the report said. Some of the most offensive posts were directed at Representative Alexandria Ocasio-Cortez, Democrat of New York. (Cochrane, 7/1)

Migrants held at a border patrol station in Texas were subjected to psychological abuse and told to drink out of toilets, Representative Alexandria Ocasio-Cortez said after a visit with members of the Congressional Hispanic Caucus to the main border patrol facility in El Paso. ... "After I forced myself into a cell with women and began speaking to them, one of them described their treatment at the hands of officers as "psychological warfare," Ocasio-Cortez, a first-term New York Democrat, wrote on Twitter after leaving the El Paso border patrol station. (Chavez, 7/1)

Rep. Judy Chu from California described what the delegation saw as appalling and disgusting. In addition to some immigrant women telling members of Congress they didn’t have access to running water, one epileptic woman said she been unable to obtain medication for her condition. (Flores, 7/1)

"We came today and we saw that the system is still broken," said Rep. Joaquín Castro, D-Texas, who chairs the Congressional Hispanic Caucus, at a press conference after their tour. "These are the conditions that have been created by the Trump administration. These are the inhumane conditions that folks are facing," he said, as he and the other lawmakers were trying to speak above the din of hecklers shouting, "America First!" (Aviles, 7/1)

Ocasio-Cortez was confronted by shouting Trump supporters during a televised press conference in Clint. “No woman should ever be locked up in a pen when they have done no harm to another human being,” she said. “They should be given water and basic access to human rights.” (Wasson, 7/1)

US Border Patrol Chief of Operations Brian Hastings denied the accusations that some immigrants in border detention facilities are forced to drink from toilets. "Drinking out of the toilet is completely untrue," said Hastings. He said there are "ample supplies" and that "a lot of our stations look like Costco." (Alvarez, 7/1)

The lawmakers' visit came as Immigration and Customs Enforcement confirmed in a statement that 30-year-old Yimi Alexis Balderramos-Torres from Honduras died in hospital Sunday while in the agency's custody. He was found unresponsive at the Houston Contract Detention Facility, ICE said. (Falconer, 7/1)

Cory Booker vowed to used executive authority as president to end detention for asylum seekers, shut down “inhumane” holding facilities and de-emphasize prosecutions of those in the country illegally unless they pose a safety risk. The New Jersey senator and Democratic presidential hopeful said that if elected he’d reverse most of President Donald Trump’s border policies on his first day in office without waiting for Congress to take action. (Kinery, 7/2)

Members of a secret Facebook group for current and former Border Patrol agents joked about the deaths of migrants, discussed throwing burritos at Latino members of Congress visiting a detention facility in Texas on Monday and posted a vulgar illustration depicting Rep. Alexandria Ocasio-Cortez engaged in oral sex with a detained migrant, according to screenshots of their postings. (Thompson, 7/1)

The “I’m 10-15” Facebook group, created in August 2016, has roughly 9,500 members from across the country. “10-15” is Border Patrol radio code for “aliens in custody.” The group described itself in an online introduction as a place for “funny” and “serious” discussions about work with the agency. (Finucane, 7/1)

On a post about a 16-year-old migrant who died in Border Patrol custody, group members responded with crass comments such as, “Oh well,” and “If he dies, he dies.” (Rosenberg, 7/1)

The head of the U.S. Border Patrol on Monday slammed as "completely inappropriate" sexually explicit posts about U.S. Rep. Alexandria Ocasio-Cortez and comments questioning the authenticity of a photo of a drowned man and his young daughter in a secret Facebook group for agents. (Attanasio and Long, 7/1)

A separate statement from Customs and Border Protection, the patrol’s parent agency, said the inspector general of the Department of Homeland Security would conduct an independent investigation. (Moore, DeBonis and Wagner, 7/1)

"Today, U.S. Customs and Border Protection was made aware of disturbing social media activity hosted on a private Facebook group that may include a number of CBP employees," CBP’s Matthew Klein, Assistant Commissioner, Office of Professional Responsibility noted in a statement. "CBP immediately informed DHS Office of the Inspector General and initiated an investigation." Klein added that CBP employees are expected to adhere to the agency’s standards of conduct, "both on and off duty," directing that its ranks "not make abusive, derisive, profane, or harassing statements or gestures, or engage in any other conduct evidencing hatred or invidious prejudice to or about one person or group on account of race, color, religion, national origin, sex, sexual orientation, age or disability." (Parkinson and Owen, 7/1)

The disclosure of the group’s existence and the nature of the posts raise a number of questions that remain unanswered. It’s apparent from some of the comments that agents were aware that the posts were inappropriate, and potentially actionable, for serving government employees. But it’s unclear whether CPB’s senior leadership was aware of the group or if any complaints had been made to the agency. (Thompson and Lind, 7/1)

The Congressional Hispanic Caucus, led by Rep. Joaquin Castro (D-Texas), condemned the "derogatory and sexist comments regarding immigrants and members of Congress" and called for a full investigation by the Department of Homeland Security as well as the officers' removal. Castro and other Democrats vowed to scrutinize the agents’ Facebook posts as part of a congressional tour of border facilities in Texas, where lawmakers spoke to mothers with young children who had been detained there, and learned of what they called unacceptable conditions. (Ferris and Caygle, 7/1)

President Donald Trump signed a $4.6 billion aid package on Monday to help the federal government cope with the surge of Central American immigrants at the U.S.-Mexico border. Many Democratic lawmakers were hoping for more. They wanted to provide stronger protections for how migrants are treated at holding facilities and to make it easier for lawmakers to make snap visits. (Freking, 7/1)

Speaker Nancy Pelosi’s (D-Calif.) relationship with Senate Democratic Leader Charles Schumer (N.Y.) is being put to the test in the aftermath of an emergency border supplemental spending bill that divided congressional Democrats. The rare disunity from two leaders who have regularly issued joint statements and stood firm together during the Trump presidency raises questions about how Pelosi, Schumer and Senate Democrats will tackle other high-stakes negotiations facing them in the coming weeks and months. (Bolton and Lillis, 7/2)

California's governor vowed on Monday to continue expanding taxpayer funded health benefits to adults living in the country illegally next year, ensuring the volatile issue will get top billing in the 2020 presidential election as Democrats vying for the nomination woo voters in the country's most populous state. Democratic Gov. Gavin Newsom signed a $214.8 billion operating budget last week that includes spending to make low-income adults 25 and younger living in the country illegally eligible for the state's Medicaid program. (Beam, 7/1)

“To my friends at Fox News, I know we’re keeping you in business and getting your advertising rates and clicks going, but we believe in universal healthcare — universal healthcare is a right,” Newsom said during a budget rally in Sacramento on Monday. “We’re delivering it regardless of immigration status to everyone up to the age of 26,” Newsom added, saying the goal of universal coverage is “the right thing to do and it’s the fiscally responsible thing to do.” (White, 7/1)

“You look at what they’re doing in California, how they’re treating people. They don’t treat their people as well as they treat illegal immigrants,” the Republican president told reporters in the White House on Monday. “It’s very unfair to our citizens and we’re going to stop it, but we may need an election to stop it.” Trump did not elaborate about how he intends to stop California from expanding health care options for undocumented immigrants. (Bollag, 7/1)

A Trump administration proposal to increase the odds that immigrants will be deemed “public charges” ineligible for government health benefits may result in millions of kids becoming uninsured, a study suggests. The proposed changes are expected to cause many immigrants to disenroll their children from safety-net programs like Medicaid and the Children’s Health Insurance Program (CHIP) out of fear and confusion, even among families to whom the rule would not apply. (Rapaport, 7/1)

The Department of Health and Human Services is dramatically expanding its network of child shelters across the country in order to avoid the scandal in Clint, Texas, where scores of immigrant children were warehoused together. "There are too many kids in Border Patrol stations right now, and we're working to get them out of those stations and into HHS care," says Mark Weber, HHS deputy assistant secretary for public affairs. (Burnett, 7/2)

The U.S. government has started detaining immigrant youth at an emergency facility in South Texas. U.S. Department of Health and Human Services spokesman Mark Weber said Monday that the facility at Carrizo Springs, Texas, now has around 200 boys and girls but that number could expand to up to 1300 children. The Carrizo Springs facility is at the site of a former camp for oilfield workers. Crews were working last week to remove mold spots and make repairs. (7/1)

Senator Bernie Sanders says most people in America will have to pay more in taxes to pay for his Medicare-for-All plan. But he insists that’s a good deal -- and will save people money overall by lowering health costs. For many Americans, though, that would not be true. Households that spend a lot on health care already would be most likely to see the benefit. But for many, higher taxes would exceed any savings. (Davison, 7/2)

About half of Democrats and Democratic-leaning independents want the government to provide a national health insurance program, but don't want it to completely replace private insurance, according to a new CNN poll conducted by SSRS out Monday. Yet, the candidate who is seen as the strongest on health care is Vermont Sen. Bernie Sanders, the candidate who unapologetically backs "Medicare for All" and wants to see the end of the private insurance industry. When asked which Democratic candidate for president can best handle health care, Democrats and Democratic-leaning independents supported Sanders above the rest (26%). (Sparks, 7/1)

Some Democratic presidential candidates who say they support “Medicare for All” are walking a tightrope on whether to fully embrace a key portion of the proposal that calls for eliminating private insurance. Only a few White House hopefuls raised their hands when asked at last week’s debates if they were willing to abolish private insurers, even though others who were on the stage have publicly backed legislation from Sen. Bernie Sanders (I-Vt.) which would do just that. (Weixel, 7/2)

Managed-care investors hoping for a sustained rebound after the sector’s worst first-half performance in a nearly a decade are probably going to have to wait a bit longer. Last week’s face-off among candidates in the Democratic presidential primary have set the tone for a health-care debate that’s only expected to heat up throughout the year, weighing on insurer stocks. What’s more, an appeals court decision on the Affordable Care Act later this year promises even more volatility for a sector that’s seen nothing but steady earnings growth over years. (Darie, 7/1)

Kaiser Permanente, Centene Corp. and Molina Healthcare are among the health insurers that racked up massive charges under an Affordable Care Act program meant to steady the premiums in the individual insurance market and discourage insurers from cherry-picking healthy, less costly plan members. According to Modern Healthcare's analysis of data released by the CMS late last week, Kaiser Permanente, which is integrated with Kaiser Foundation Health Plan, must pay $891.7 million into the ACA risk-adjustment program for the individual market for 2018, which will be transferred to insurers who enrolled riskier patients. (Livingston, 7/1)

Air ambulance rates in the United States are soaring. The cost of a medical ride in a helicopter or airplane climbed about 60 percent from 2012 to 2016, to a median of $39,000, according to a study of federal data released Monday. The list charges rose to as much as 10 times what Medicare pays for the service, despite a surge of air ambulance carriers entering the market, the study said. (Rowland, 7/1)

Many air ambulance providers are not in insurance networks, leading to patients getting stuck with surprise out-of-pocket bills for thousands or tens of thousands of dollars. That has triggered public anger, prompting state and federal lawmakers to propose limits on balance billing by air ambulance companies. Last month, the Senate health committee shocked the air ambulance industry, which is made up heavily of private equity-owned companies, by including a balance-billing ban for air ambulance services in its broader legislation to regulate surprise out-of-network billing. Experts say only the federal government has the authority to address the problem of out-of-network bills from air ambulance companies. Courts have blocked states from regulating these companies due to a federal law governing air carriers, the Air Deregulation Act of 1978. (Meyer, 7/1)

As it enters its 11th year, America's economic expansion is now the longest on record — a streak that has shrunk unemployment, swelled household wealth, revived the housing market and helped fuel an explosive rise in the stock market. Yet even after a full decade of uninterrupted economic growth, the richest Americans now hold a greater share of the nation's wealth than they did before the Great Recession began in 2007. And income growth has been sluggish by historical standards, leaving many Americans feeling stuck in place. (Rugaber, 7/1)

What Aliera Healthcare was peddling was not insurance, but rather connection to a Christian health-sharing ministry, an obscure but growing type of coverage based on the biblical principle that the like-minded should help each other in times of need. Members paid monthly into an Aliera-administered fund to help pay their future medical bills. ...As similar cases have surfaced across the country, regulators in several states, including Texas, are taking action against Aliera, accusing the four-year-old company of fraudulently selling insurance without a license — a charge Aliera denies. But the story runs deeper, emerging as a tangled tale of broken deals, politics, religion, prison, and, of course, money - hundreds of millions of dollars. And it is unfolding at a time when the nation’s health insurance regulations are steadily unspooling. (Deam, 7/2)

Drugmakers initiated a new round of price increases on their products Monday, with some of them affecting generic hospital-administered injectable drugs that are in short supply. B. Braun Medical Inc. recorded the most increases, raising the price of more than a dozen drugs, many of which are used by hospitals. B. Braun increased the price of antibiotic cefazolin by 50% to more than $9 a package. That drug, which has been around for decades, is now in short supply like several other antibiotics, according to the U.S. Food and Drug Administration. (Hopkins, 7/1)

Prescription drug prices jumped 10.5 percent over the past six months, more slowly than during the same period last year but still four times faster than inflation, despite increasing pressure on drugmakers from the Trump administration and Congress. However, the top drug brands in the U.S. saw prices rise by an average of only 3.1 percent over the past six months according to Bernstein analysts, who calculated the average based on which brands — usually the top-sellers — they cover. (Owermohle, 7/1)

The price increases come at a time when lawmakers and consumers are increasingly concerned about the escalating cost of medications, which are far outpacing wage growth and the cost of living. Four of 5 Americans believe the cost of prescription drugs is unreasonable, according to a study earlier this year from the Kaiser Family Foundation. About one-third of patients say they're skipping prescription medicine because of the cost, the survey found.(Picchi, 7/1)

Amid ongoing interest among Americans to import drugs from other countries as well as continuing concern about a spate of recalled blood pressure medicines manufactured overseas, House and Senate lawmakers have asked the FDA to explain how it protects the pharmaceutical supply chain. At the same time, a bipartisan group from the House wants the Government Accountability Office to review the FDA inspection program. In separate letters sent late last week, the lawmakers cited recent news reports about ongoing manufacturing problems at companies in China and India, which account for the majority of the active pharmaceutical ingredients used in medicines that are shipped to the U.S. (Silverman, 7/1)

The Senate Finance Committee is widening a probe into tax-exempt organizations — including patient advocacy groups and medical associations — that have financial ties with opioid makers in a bid to shed light on the extent to which these relationships affected the ongoing opioid crisis afflicting the U.S. Last Friday, letters were sent by Sen. Chuck Grassley (R-Iowa), who heads the committee, and Sen. Ron Wyden (D-Ore.), the minority leader, to 10 organizations, including the Federation of State Medical Boards, which supports physician licensing and regulation; The Joint Commission, which accredits health care organizations; and such groups as the American Chronic Pain Association and the American Society of Pain Educators. (Silverman, 7/1)

Users hail kratom — which is sold at gas stations, smoke shops and online —as a miracle cure for pain, fatigue, anxiety and even opioid addiction. But many doctors say kratom (pronounced KRAY-tum or KRAH-tum) is dangerous because it works like an opioid, can make users high and can also be habit-forming. Plus, experts say, there's no real scientific proof it can cure anything. The federal government agrees. In May, a federal judge sentenced a Royal Oak man to two years in prison for illegally importing kratom — he claimed it was incense — and selling it as a medical treatment. (Kovanis, 7/2)

Kaiser Health News: Florida Is The Latest Republican-Led State To Adopt Clean Needle Exchanges

A green van was parked on the edge of downtown Miami, on a corner shadowed by overpasses. The vehicle serves as a mobile health clinic and syringe exchange, where people who inject drugs like heroin and fentanyl could swap dirty needles for fresh ones. One of the clinic’s regular visitors, a man with heavy black arrows tattooed on his arms, waited on the sidewalk to get clean needles.“I’m Arrow,” he said, introducing himself. “Pleasure.” (Mack, 7/2)

Nursing home staffing levels are often lower than what facilities report, which could compromise care quality, new research shows. Self-reported direct staffing time per resident was higher than the CMS' payroll-based metrics 70% of the time, according to a new study published in Health Affairs. Staffing levels were significantly lower during the weekends, particularly for registered nurses. (Kacik, 7/1)

Unreported falls. Unexplained bruises. Untreated bedsores. An overdose of insulin — 25 times the prescribed amount. A resident discharged to a hotel without meds, money, food, a phone — or a long-term care plan. These were violations at some of Tennessee's 11 most poorly performing nursing homes. (Nelson, 6/30)

The expansion of the CMS' long-standing readmissions penalty program to hip and knee replacement procedures didn't lead to significant reductions in 30-day return rates to hospitals, a new study finds. While readmission rates have declined for total hip and knee replacement surgeries, the most dramatic improvements happened before providers even knew the procedures were included in the Hospital Readmissions Reduction Program, according to the analysis published Monday in Health Affairs. (Castellucci, 7/1)

Ten U.S. states and Washington, D.C. sued the Environmental Protection Agency to begin working on rules to tighten oversight of asbestos, and reduce the health risks that the substance poses to the public. The attorneys general from California and Massachusetts, Xavier Becerra and Maura Healey, said on Monday they are leading the case, after the EPA denied the states' petition that it collect more data on asbestos. (Stempel, 7/1)

“It is widely acknowledged that asbestos is one of the most harmful and toxic chemicals known to humankind,” California Attorney General Xavier Becerra said in a release about the lawsuit. “While it’s troubling that we must once again take the EPA to court to force the agency to do its job, we won’t pull any punches. There’s too much at stake to let the EPA ignore the danger that deadly asbestos poses to our communities.” (Beitsch, 7/1)

The power plants, factories, vehicles and appliances in use today could make it all but impossible to meet the goals of the Paris climate accord unless some are retired ahead of schedule, according to an exhaustive new analysis of the world's energy infrastructure. If allowed to operate for the rest of their expected lifetimes, the greenhouse gases they would produce by continuing to burn fossil fuels will raise global temperatures more than 1.5 degrees Celsius above preindustrial levels, the study found. (Rosen, 7/1)

More restrictive smoking laws took effect Monday in Virginia, Illinois, Florida and Vermont — the latest in a line of legislative efforts designed to combat what some say is a teen vaping epidemic. Virginia and Illinois joined six other states, the District of Columbia and hundreds of municipalities in implementing “Tobacco 21” policies, raising the buying age from 18 to 21. Eight more states are expected to enact similar laws by 2021, and a Senate bill introduced in May aims to do the same at the federal level. (Denham, 7/1)

A 92% tax on e-cigarettes went into effect in Vermont Monday as part of an effort to curb youth vaping in the Green Mountain State. State Rep. George Till, who sponsored the tax increase bill, said the measure will help keep tobacco products out of the hands of kids, who are most affected by price hikes. "We know the group that is most sensitive to price is teenager," he told CBS MoneyWatch. "And we know that these companies are going out of their way to get kids addicted." (Cerullo, 7/1)

The Atlanta City Council voted Monday to institute a broad-reaching ban on smoking and vaping in restaurants, bars, workplaces and many other public places in the city, as well as at Hartsfield-Jackson International Airport. Council members voted 13-2 in favor of the ordinance, which if signed by Atlanta Mayor Keisha Lance Bottoms would prohibit smoking and vaping in bars, restaurants, places of employment, hotel and motel rooms and other enclosed public areas starting Jan. 2, 2020. (Yamanouchi, 7/1)

Cumberland Farms is suing six Massachusetts towns over new regulations blocking the sale of flavored tobacco products and Sen. John Keenan said the suit is proof of the need for a state law banning products like some of the most popular Juul pods and more. Cumberland Farms, the local convenience store chain with more than 200 stores in Massachusetts, last week sued the boards of health in Barnstable, Billerica, Framingham, Sharon, Somerville and Walpole in an attempt to block the prohibition on flavored tobacco at convenience stores. (Young, 7/1)

In a move that reflects a growing acceptance of transgender individuals in the U.S., the American College of Physicians on Monday issued its first guidelines on caring for transgender patients. This isn’t the first set of such guidelines. They go back at least 10 years, initially aimed at endocrinologists, the medical specialty to which transgender individuals were often referred. What is newsworthy about the new guidelines is the audience, “your critical mass of general internal medicine people who are primary care providers and also people who are family medicine doctors,” said Dr. Joshua Safer, professor of endocrinology and executive director of the Mount Sinai Center for Transgender Medicine and Surgery in New York City. (Joseph, 7/1)

Going back to the 1940s, radioactive iodine has been among the treatments for an overactive thyroid. It's absorbed mostly by the thyroid gland, destroying those cells. But it has also been linked to cancers in other parts of the body down the line, especially when it's used in higher doses as a treatment for primary thyroid cancer. New research published Monday sheds new light on the association, following up with patients in the United States and the UK for nearly 70 years. Most had an autoimmune disorder that causes hyperthyroidism called Graves' disease. (Nedelman, 7/1)

You might assume that standard medical advice was supported by mounds of scientific research. But researchers recently discovered that nearly 400 routine practices were flatly contradicted by studies published in leading journals. Of more than 3,000 studies published from 2003 through 2017 in JAMA and the Lancet, and from 2011 through 2017 in the New England Journal of Medicine, more than one of 10 amounted to a “medical reversal”: a conclusion opposite of what had been conventional wisdom among doctors. (Kolata, 7/1)

A few years ago, a scientist named Nenad Sestan began throwing around an idea for an experiment so obviously insane, so “wild” and “totally out there,” as he put it to me recently, that at first he told almost no one about it: not his wife or kids, not his bosses in Yale’s neuroscience department, not the dean of the university’s medical school. Like everything Sestan studies, the idea centered on the mammalian brain. More specific, it centered on the tree-shaped neurons that govern speech, motor function and thought — the cells, in short, that make us who we are. (Shaer, 7/2)

As our devices get smaller and more sophisticated, so do the materials we use to make them. That means we have to get up close to engineer new materials. Really close. Different microscopy techniques allow scientists to see the nucleotide-by-nucleotide genetic sequences in cells down to the resolution of a couple atoms as seen in an atomic force microscopy image. But scientists at the IBM Almaden Research Center in San Jose, Calif. and the Institute for Basic Sciences in Seoul, have taken imaging a step further, developing a new magnetic resonance imaging technique that provides unprecedented detail, right down to the individual atoms of a sample. (Sheikh, 7/1)

Scientists have created living entities that resemble very primitive human embryos, the most advanced example of these structures yet created in a lab. The researchers hope these creations, made from human embryonic stem cells, will provide crucial new insights into human development and lead to new ways to treat infertility and prevent miscarriages, birth defects and many diseases. The researchers say this is the first time scientists have created living models of human embryos with three-dimensional structures. (Stein, 7/1)

Kaylee Patterson woke with a sharp pain in her right eye the morning after she had Lasik surgery. She felt a dull ache on one side of her face. Worried, Ms. Patterson visited her surgeon and her regular eye doctor several times over the next few weeks. They repeatedly told her that everything looked normal, she says. Yet the slightest thing—a draft of air, a ray of light—would cause excruciating pain in her head. “I was in pain and nobody was helping me,” the 33-year-old mental-health counselor said. (McKay, 7/1)

In 2015, Jessica Price, a 29-year-old Air Force veteran in Illinois, started experiencing urinary tract infection symptoms, including an unrelenting urge to urinate and bladder pain. But standard dipstick testing, where a doctor dips a plastic stick into a urine sample to check it for signs of bacteria, kept coming back negative. Based on her symptoms and the negative tests, doctors told Price she had interstitial cystitis (IC), an incurable syndrome of unknown cause and suggested several invasive procedures that only worsened her pain. (Weiss, 7/1)

Scientists believe that bedbugs have developed resistance to some insecticides, and travel is helping to spread the resistant insects worldwide. Another major contributor is the failure of many hotels and residential landlords to identify infestations promptly, and to dispose of or treat infested bedding and carpeting. It has been known since the 1950s that bed bugs can develop resistance to commonly used insecticides, like pyrethrin. Resistance has emerged to more products over the years. (Ray, 7/1)

A new clinical report on organized sports for children, preadolescents and adolescents from the American Academy of Pediatrics keeps coming back to the question of fun. The report summarizes evidence on the many benefits of sports participation for children, from acquiring motor skills to developing positive self-image, from strong social interactions to higher levels of physical activity and good weight management. But especially in younger children, all of this should spring from the child’s desire to get out there and play, and kids who participate in organized sports should also have lots of time for less formal activities with friends. (Klass, 7/1)

When Sylvia Groth steps through the doors of the Vanderbilt Eye Institute in Nashville, she knows she has a tough day ahead. Before she goes home, she’ll likely have at least one hard talk with a person whose sight has been ravaged by glaucoma. “When I make a diagnosis of advanced glaucoma, I do it with a heavy heart,” the ophthalmologist says. “It’s such an empty feeling to not be able to do anything.” (Woolston, 7/1)

People with obesity-related disorders may benefit from supplements of a common gut bacterium, a small pilot study suggests. Researchers tested the bacterium, Akkermansia muciniphila, in 32 men and women who met the criteria for metabolic syndrome by having at least three of five conditions: high fasting blood sugar, high blood pressure, high triglycerides, low HDL (the “good” cholesterol) or excessive waist circumference. (Bakalar, 7/1)

The Kentucky Court of Appeals ruled that state health officials were within their power to ban a chickenpox-afflicted student from school, even at private institutions. A three-judge panel upheld a lower-court ruling that involved the Northern Kentucky Health Department and two Catholic schools in Boone County, about 25 miles south of Cincinnati. (Li, 7/1)

The health agency canceled extracurricular activities and later imposed a temporary ban on school attendance for unvaccinated students as the chickenpox outbreak spread. "The commonwealth has a compelling interest in taking limited and temporary steps to control an outbreak of a vaccine-preventable disease," the appeals court panel said last Friday. (Schreiner, 7/1)

More than one in 10 kindergartners in Kansas in the 2017-2018 school year lacked at least some of the shots that the state requires to shield students against outbreaks of measles, whooping cough and more. The state’s most recent annual report pegged the figure at 15%. On paper at least, Kansas law requires children to get such vaccines to attend school. Yet school boards get to decide whether to enforce that, and some balk at turning children away. (Llopis-Jepsen, 7/1)

The New York Police Department is looking to outside law-enforcement agencies for help amid a crisis of officers dying by suicide. Six NYPD officers have killed themselves since Jan. 1, placing 2019 on track to be the most in a year since 2012, when there were eight officer suicides. Four of the six deaths in 2019 occurred in June, a cluster that has prompted police officials to ask departments in other cities for advice on how they are working to prevent officer suicides. (Chapman, 7/1)

The city of Chicago has also grappled with a cluster of police suicides, with at least three this year and four last year, officials said. O'Neill said his department reached out to Chicago's police superintendent, Eddie Johnson, who recommended New York look at expanding its peer-to-peer resources and evaluate its policy for when an officer's firearm should be taken away. "One of the biggest challenges — and why it takes courage to get help — is as someone's becoming anxious, depressed, jumpy, maybe starting to self-medicate with alcohol, get burnt out, it becomes tougher for that person to believe they can get help and that help will work," Dowling said. (Ortiz, 6/30)

Gov. Ralph Northam marked the 50th anniversary of Virginia’s Medicaid program Monday by touting the program’s successful expansion and outlining plans for improving maternal and infant health. The strategies announced Monday are aimed at realizing a goal Northam set in early June to eliminate racial disparities in maternal mortality by 2025. (Balch, 7/1)

Virginia’s Medicaid agency has announced a new outreach program and other steps to help lower the maternal mortality rate of black women. Virginia Department of Medical Assistance Services said Monday it has launched technology upgrades and other efforts to eliminate delays in health care treatment for pregnant women on Medicaid. DMAS said it’s also trying to increase treatment for pregnant women with substance use disorders. (7/2)

Not long after she finished her medical residency at Stanford University about a decade ago, Nadine Burke Harris got to work as a pediatrician in the Bayview-Hunters Point neighborhood of San Francisco. She founded and became CEO of a clinic there, focused on addressing health disparities in the community. It was in talking with those children and their families, she says, that she first realized how many of her patients experiencing the worst health outcomes — those with the highest levels of chronic asthma, for example — were also living with significant adversity, such as growing up in a household where a parent was mentally ill, abusive or substance dependent. (Stallings, 7/2)

A federal judge should intervene in Mississippi's mental health care system, a U.S. Justice Department lawyer argued Monday, saying the state has moved far too slowly to provide community alternatives to mental hospitals. "They could be living in more integrated settings, but they never get the chance, because the state does not make the necessary services available, lawyer Patrick Holkins said in closing arguments following a monthlong trial. "That is not just a policy failure, but a civil rights violation." (7/1)

Minnesota health care providers performed fewer abortions last year even as more women came here from other states for the procedure, a new Department of Health report shows. There were 9,910 abortions in 2018, a 2 percent decrease from 2017. The number of abortions in the state dipped below 10,000 for just the third time since 1975, according to the report released Monday. The Minnesota branch of Planned Parenthood performed more than 60 percent of the abortions at its clinics in St. Paul and Rochester. (Faircloth, 7/1)

The name Partners HealthCare is emblazoned on buildings and vehicles, medical bills and patient records, e-mail addresses and websites. But is it the right moniker for the state’s largest health care provider? As part of a corporate soul-searching process, executives at Boston-based Partners are considering ditching the name the system has used for 25 years and choosing one that they believe would better reflect the company’s greatest assets — its renowned academic medical centers. (McCluskey, 7/1)

California's new ammunition background check law began Monday not with a bang but with a whimper from dealers who reported delays and glitches with the state's online system. But they said few customers were affected because most had stockpiled bullets or shotgun shells in the weeks before the new law took effect. Voters in 2016 approved requiring criminal background checks for every ammunition purchase. But the state's latest attempt to deter gun violence only took effect Monday. (7/1)

California has some of the strictest gun laws in the country — and one of the lowest gun death rates. Public health experts believe one leads to the other. But even with strong laws, 3,184 people died in gun-related incidents in California in 2017, up from 2,942 in 2014, according to data from the Centers for Disease Control and Prevention. Roughly half of suicides nationwide are gun-related. (Ibarra, 7/1)

Georgia has a state insurance commissioner again, seven weeks after the elected one, Jim Beck, was accused in a 38-count indictment of scheming to steal $2 million from his former employer, in part to fund his election campaign. John King, the longtime Doraville police chief, was sworn in as Beck’s at-least-temporary replacement by Gov. Brian Kemp on Monday at a Statehouse ceremony. (Salzer, 7/1)

This handsome north Alabama town, population 40,428, boasts two nationally acclaimed fashion designers of luxury togs, two boutique hotels, two hipster coffee shops, a regional state university, a Frank Lloyd Wright house, a sustainably sourced restaurant with a celebrated bourbon program, and an annual Shindig cultural festival in late August drawing Jack White and other artistic and artisanal talents near the verdant banks of the Tennessee River. Florence voted for Hillary Clinton in 2016 and Democrat Sen. Doug Jones in the 2017 special election, in a county that went Republican both times. (Heller, 7/1)

A former University of Southern California gynecologist accused by hundreds of patients of molestation and other misconduct over the past three decades pleaded not guilty on Monday to charges of sexually assaulting 16 students who were under his care. George Tyndall, 72, was also ordered to remain in custody in lieu of nearly $2.1 million bond, but Los Angeles Superior Court Judge Theresa Sullivan said she would review a defense request to slash his bail at another hearing set for Wednesday. (7/1)

Florida’s record $90.98 billion spending plan for next fiscal year and more than 100 new laws will hit the books Monday. The new laws, passed by the Legislature this spring and signed by Gov. Ron DeSantis, deal with issues ranging from bans on vaping to a repeal of the state’s “certificate of need” process. (Turner, 7/1)

A New York program requiring acute-care hospitals to develop sepsis protocols has improved detection and treatment, but the results weren't as pronounced in hospitals that serve higher proportions of black patients, according to a new study. Since the program started in 2014, the proportion of patients who underwent the sepsis protocol increased from 61% in 2014 to 72% in 2016, and in-hospital mortality fell from 25% to 21%, according to research published Monday in Health Affairs. (Johnson, 7/1)

Houston' Episcopal Health Foundation announced $17 million in grants to help the state's community-based clinics offer more services, increase access, and go beyond just medical care to address underlying issues that can affect health for low-income and under-served Texans. More than 40 clinics and organizations will receive individual grants ranging from $100,000 to over $1 million. Twenty groups in the Houston area are among the recipients. (Deam, 7/1)

The owners of Hahnemann University Hospital, a historic, money-losing teaching hospital in Philadelphia, filed for bankruptcy late Sunday night after failed efforts to find a buyer and a closure announcement that triggered street protests and warnings from state health regulators. (Brickley, 7/1)

A year has passed since lofty promises were made to repair the financially struggling and volatile health care system that serves inmates at Connecticut’s 14 prisons, but Department of Correction staff say little has improved.Records show medical employees are working shifts that have stretched as long as 24 hours. State lawmakers recently pumped an extra $22 million into the system. And DOC leaders can’t say how services compare to the care offered in the private sector. (Carlesso and Lyons, 7/2)

The investigation, confirmed by a spokesperson for the U.S. Department of Education, comes less than a month after students mounted a public campaign against the university's Title IX office in May. Students said the school failed to address complaints that game design professor Joshua Yates had sexually harassed a student. (Petrin, 7/1)

Virtua, a not-for-profit health system in southern New Jersey, has purchased Camden, N.J.-based Lourdes Health System. Virtua on Monday assumed ownership of Lourdes Health System, closing out a yearlong process to acquire the not-for-profit health system from Pennsylvania-based Maxis Health System, part of national Catholic health system Trinity Health. Virtua signed a definitive agreement with Maxis Health to acquire Lourdes Health System in June of last year. (Cohen, 7/1)

When Gov. Gavin Newsom took office in January, armed with big promises and bold ideas to fix the state’s drastic shortage of homes, housing advocates were so hopeful they were almost giddy. ...But reversing a housing crisis years in the making is a daunting task. And without new legislation to dramatically boost production, Newsom will have a hard time meeting his ambitious campaign pledge — to build 3.5 million homes by 2025. (Kendall, 7/1)

While redevelopment has maybe made homelessness more visible to the urban core's new residents, the numbers show a 53% decrease in the Houston area's homeless population since 2011. ...In the meantime, other Texas cities, like San Antonio, Fort Worth and Austin – which recently passed an ordinance that allows sitting and camping in public – are experiencing increases in the number of residents who don't have a home. And such an increase is especially dramatic in Dallas, which according the 2019 Point-in-Time count, saw its homeless population surpass Houston's. (Garnham, 7/2)

Ohio appears to be on the verge of allowing patients to buy medicinal marijuana to treat autism, even as researchers who conducted the studies cited by those promoting approval urge caution. The State Medical Board of Ohio is scheduled to vote on the issue July 10. The Medical Board’s expert review committee recommended in June adding autism to the list of qualifying conditions to get medical marijuana. (Cooley, 7/1)

Across Massachusetts, customers can find CBD everywhere, from the small shops selling CBD up and down Newbury Street to the products lining the shelves at national stores like Bed Bath & Beyond and Sephora. CBD has become so common that you can even buy gummies in the small corner store in the lobby of the office building that houses the Boston Globe. (Gans, 7/1)

Last week, the world learned the chilling news that Marshae Jones, a 28-year-old woman who was five months pregnant when shot in the stomach, has been charged with manslaughter. When a grand jury failed to indict Ebony Jemison, the woman who fired the gun, the police in Pleasant Grove, Ala., sought someone else — and landed on Ms. Jones, whom they now blame for the altercation that lead to the termination of her pregnancy. To the police, if Ms. Jones had not picked a fight, her fetus would have survived. (Michele Goodwin, 7/1)

It was only a matter of time before the national debate over fetal rights and abortion would lead to this: A woman in Alabama has been charged with manslaughter for allegedly being involved in an argument in December that ended when another woman shot her in the stomach. The victim was five months pregnant and lost her baby. The shooter has walked free. (7/1)

A pregnant woman gets in a fight. She is shot. She goes to the hospital. She loses the baby. The shooter goes free and the wounded woman – Jones – goes to jail. She is charged with killing her own baby, with manslaughter because she initiated the fight that provoked the other woman to shoot her. Whoa. Right up there with giving rapists parental rights, Alabama. (John Archibald, 6/27)

Approximately 350 minors become regular smokers every day, with 1 in 3 eventually dying as a result, according to the advocacy group Campaign for Tobacco-Free Kids. After the Food and Drug Administration cracked down on underage tobacco use over the past few years, lawmakers are finally listening. Last week, the Senate Health, Education, Labor and Pensions Committee approved the Tobacco-Free Youth Act, a bipartisan bill co-sponsored by Senate Majority Leader Mitch McConnell (R-Ky.) and Sen. Tim Kaine (D-Va.). (7/1)

We Americans are becoming ever better at vilifying people who disagree with us. This taste for hate seems perverse, an intentional pursuit of displeasure. Hate disturbs one’s inner peace, as does being hated.But the compensatory pleasures of hatred—in particular its enhancement of self-esteem—are underrated. Hatred is self-congratulatory. It involves expressing superiority to its objects, and patting yourself on the back for not being them. (Crispin Sartwell, 7/1)

Last year, as part of an effort to carry out President Trump’s promise of “extreme vetting” of visitors to the United States, the Department of Homeland Security began collecting social media account information from millions of people seeking to cross the border. After all, a radical online could be a radical offline. That’s why the stream of posts ricocheting around a 9,500-member Facebook group, comprising current and former Border Patrol agents as well as some people with no apparent connection to the Border Patrol, is so troubling. (7/1)

By the left’s account you’d think the Trump Administration’s only ambition on health care is to rip insurance from the poor and sick. So note that a Health and Human Services rule finalized last month represents a dramatic expansion in health-care choices for those who may have limited insurance options.The Trump Administration finished regulations expanding health reimbursement arrangements, often known as HRAs. The arrangements will allow an employer to give a worker tax-exempt dollars to buy a health-insurance plan in the individual market. Such arrangements have existed in some form since the early 2000s, but the Obama Administration used the Affordable Care Act to limit them. (7/1)

I have been meditating lately about death as I continue to see it on a regular basis. What continues to amaze me is the fact that, under the most obvious circumstances, patients and families seem to be skeptical about it and it is never a natural occurrence; and we are never ever ready for it.I was thinking about Jahi McMath who “died again” just about a year ago. She was the most remarkable case in our lifetime in terms of creating controversy about what death really means, after she had been pronounced brain dead, which is legal death. All of this mediated by the family resisting death itself.  (Sebastian Sepulveda, 7/1)

Among the endless metrics for assessing the quality of health care, one that is exceedingly important for measuring physician quality is on the chopping block. I’m talking about turning the U.S. Medical Licensing Exam Step 1, which all medical students take at the end of their second year of studies, into a pass/fail test. This proposed change was quietly announced by the owners of the test and has received almost no media coverage. Such a pivotal change, which I find troubling, merits greater attention and debate. If you, too, think it is an unwise move, make your voice heard before comments on the proposal are closed on July 26. (Kim Lien Nguyen, 7/1)

Clinical diagnostic laboratory tests range from routine chemical measurements like blood glucose or sodium to complex examinations for cancer, infectious diseases, or rare inherited disorders. The information they provide is among the most important data doctors use to diagnose and treat patients. Medicare spent over $7 billion on laboratory services for beneficiaries in 2017, making it the country’s largest purchaser. The program should act now to eliminate excessive payments for some lab tests. (Roger D. Klein, 7/1)

Here’s the bottom line: Psychiatric patients in the emergency department can end up being treated as less than human. All too often, I’ve seen the standard approach to care escalate what is already a tenuous, scary, and traumatic situation for everyone. And we’re up against some frightening numbers. Emergency visits for suicidal thoughts and suicide attempts have increased by more than 40% since 2006, while behavioral health visits to emergency departments have increased by nearly 57% for children and 41% for adults. And every emergency department across the country has witnessed an explosion of opioid overdoses — another tragic manifestation of untreated mental illness. (Denise Brown, 7/2)

Anyone who wants to create a medical innovation for his or her own use is free to do so. This activity is protected by the right to privacy in the Fourth Amendment of the U.S. Constitution — even if others deem the innovation to be risky or downright unsafe. And this activity is beyond the reach of federal agencies like the FDA, which cannot regulate noncommercial activity. That said, safety is important — and not guaranteed. A coding error in an artificial pancreas could lead to dangerous miscalculations of an individual’s insulin dose. But we don’t believe that concerns about safety should be a reason for governments to limit patient innovation. On the contrary, we believe that governments should encourage it. (Harold Demonaco and Eric Von Hippel, 7/1)