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A year and a half ago, Gavin Newsom was in the same place as Elizabeth Warren and Bernie Sanders, running in a tough Democratic primary and vowing “it’s about time” for a single-payer health care system while dismissing his critics as “can’t-do Democrats” who refuse to think big. Now he’s in a different place. ... As governor, Newsom’s health care program has been more incremental than promised, annoying some allies in the single-payer movement while winning some unexpected praise from industry groups. But he also may have found something larger than his own agenda: A health care path that builds on past successes, enacts fresh reforms and may eventually lead to a single-payer system — without the political earthquake that so many predict under Sanders’ bill or Warren’s financing plan. (Hart, 11/19)

Elizabeth Warren’s proposal to gradually move the country to a government-funded health care system has further inflamed the debate over “Medicare for All,” likely ensuring the issue will play a significant role in this week’s Democratic presidential debate. The Massachusetts senator announced Friday that her administration would immediately build on existing laws, including the Affordable Care Act, to expand access to health care while taking up to three years to fully implement Medicare for All. That attempt to thread the political needle has roiled her more moderate rivals, who say she’s waffling, while worrying some on the left, who see Warren’s commitment to a single-payer system wavering. (11/18)

[Sen. Elizabeth's] Warren’s hardline stance on [The 21st Century Cures Act] was the exclamation point on her yearslong health care transformation — a shift from a senator, sympathetic to her home state’s health care interests, to a national political figure with her sights on more sweeping policy shifts. That metamorphosis has bolstered her credentials as a progressive presidential candidate and leading advocate of “Medicare for All.” But her broadsides against drug companies have also angered Massachusetts health industry figures, who have accused her of “demonizing her constituents who work in biopharma.” (Facher and Goodwin, 11/19)

Billionaire Tom Steyer's health care plan plants him among the centrists in the 2020 Democratic primary. He promises to expand access to health care through more Obamacare funding and a public option, while still envisioning a large role for private insurers — in contrast to the "Medicare for All" plans proposed by rivals like Sens. Bernie Sanders and Elizabeth Warren. (Luthi, 11/18)

Ten candidates will be on stage Wednesday for the fifth Democratic presidential debate. That’s two fewer than were onstage for last month’s debate — one who was there, former congressman Beto O’Rourke, dropped out, and another, former HUD secretary Julián Castro, failed to hit the required polling levels. And while some candidates have left the race since the October debate, former Massachusetts governor Deval Patrick has jumped in and former New York mayor Michael Bloomberg is looking at joining the already large field. (11/18)

The Democratic Attorneys General Association (DAGA) will only back candidates who support abortion rights, becoming the first national party committee to make that pledge. Beginning in 2020, Democratic candidates for attorney general seats who oppose abortion access will no longer receive financial support or other assistance from DAGA. (Hellmann, 11/18)

A Democratic group is launching $2 million in new digital ads highlighting vulnerable House Democrats’ efforts to lower drug prices. The ads from the group Protect Our Care illustrate how Democrats are seeking to keep their momentum going on health care after they focused on the issue in winning back the House last year. (Sullivan, 11/18)

Marijuana stocks took another leg down on Monday, after The Washington Post reported that former vice president Joe Biden said that marijuana may be a “gateway drug” that can lead users to harsher substances, a sign one of the leading democratic challengers to President Trump may be at odds with much of his party when it comes to pot. (Ashraf, 11/18)

U.S. President Donald Trump's health examination on Saturday was "routine" and he was not treated for any urgent or acute issues, his physician said in a statement on Monday. Trump's unexpected trip to Walter Reed National Military Medical Center in the Washington suburb of Bethesda, Maryland, led to a variety of rumors about the health of the 73-year-old president, who generally eschews exercise and has waved away advice to lose some weight. (11/18)

Mr. Trump was taken on Saturday to Walter Reed National Military Medical Center in his motorcade in a trip that had not been listed on his public schedule. He stayed for about two hours for what White House officials said were routine tests, but since the visit had not been revealed in advance and came only nine months after his last annual physical, it touched off much discussion about whether the president had an undisclosed health issue. Mr. Trump, 73, is the oldest man ever sworn in for a first term as president, and he is not known for a healthy diet or exercise other than weekend golf. (Baker, 11/18)

Dr. Sean P. Conley, physician to the president, used a memo released by the White House late Monday night to refute speculation that Trump had suffered from chest pain or another serious issue that led him to suddenly depart the White House by motorcade on Saturday afternoon. ... Conley added in his memo that Trump also took a brief tour of the Bethesda, Md., medical center and met with staff. Trump also spoke with the family of a soldier going through surgery, then headed back to the White House. (Choi, 11/18)

White House officials denied that anything was wrong with the president. “The president remains healthy and energetic without complaints, as demonstrated by his repeated vigorous rally performances in front of thousands of Americans several times a week,” White House press secretary Stephanie Grisham said in a statement Saturday. On Twitter, Ms. Grisham later called speculation about the president’s health irresponsible. In December 2014, President Obama made an unscheduled weekend trip to Walter Reed because of what the White House said was a sore throat that was determined to be caused by acid reflux. (Restuccia, 11/18)

Though the White House usually discloses the president's weight, blood pressure and other details of an annual exam, Conley provided only the president's cholesterol numbers. Conley said he would provide a more comprehensive exam early next year. The president last had his annual physical in February. (Fritze, 11/18)

“The one thing you can be absolutely sure of is this was not routine and he didn't go up there for half his physical,” tweeted Joe Lockhart, a press secretary under President Bill Clinton, who was himself impeached for perjury and obstruction. “What does it mean? It means that we just won't know what the medical issue was.” (Freking, 11/18)

"Unless the healthiest man alive is shifting to fiscal year reporting, two medicals in the same year ain’t annual, it’s biannual," tweeted Philippe Reines, who was a top aide to 2016 Democratic presidential nominee Hillary Clinton, whose health was also scrutinized during her campaign. "Perfect example of how the long history of false statements from White House has worn away any presumption of truthfulness," David Lauter, the Los Angeles Times' Washington bureau chief, tweeted. "Maybe Trump's hospital visit was routine, but burden of proof is on WH to show evidence." (Smith, 11/17)

On Monday, he remained out of public view, holding his meetings behind closed doors. He met with Federal Reserve Chair Jerome H. Powell inside the White House residence rather than the Oval Office, according to a White House official familiar with the matter who was not authorized to speak publicly and requested anonymity. A common cold would normally not be enough to prompt a visit to Walter Reed because the White House has adequate equipment and facilities to treat most minor illnesses and conduct routine tests. More comprehensive testing can be performed at Walter Reed. (Olorunnipa and Gardner, 11/18)

The questions came pouring out of Trevor Noah on Monday night as the Comedy Central host struggled to make sense of President Trump’s mysterious weekend hospital visit, an unscheduled trip that has since renewed scrutiny on his health. “Was it a health emergency or did he need to get a marble removed from his nose again?” Noah asked. “We don’t know.” (Chiu, 11/19)

President Trump’s decision to hold off on a possible ban of flavored e-cigarettes drew a harsh response from some members of Congress, who say it appears the White House is doing an about-face. Rep. Raja Krishnamoorthi (D., Ill.), whose House subcommittee held a recent hearing on youth vaping, wrote Monday to the White House Office of Management and Budget and the Food and Drug Administration to inquire into the status of the proposed regulation on flavors. “The strong promises made by the President and his Administration to address the youth vaping epidemic were incredibly encouraging,” he wrote. “Now, however, the delay in finalizing the Administration’s compliance policy raises deep concerns.” (Burton and Leary, 11/18)

The White House Office of Management and Budget completed regulatory review of a proposed rule about “electronic nicotine delivery systems” on Nov. 4, and canceled meetings with public health advocates as well as pro-vaping groups. But the rule was never published. Krishnamoorthi noted that under normal practice, when the White House regulatory agency completes its review, it sends the action back to the relevant federal agency, and the agency promptly publishes the final action. (Weixel, 11/18)

It's been more than two months since President Donald Trump announced that he would ban kid-friendly flavored e-cigarettes, and public health groups are losing patience. But the administration has taken no action yet, fueling speculation that Trump is backing away from a ban because doing so may cost him votes next November. "We are deeply troubled by reports that politics may be interfering with policy that would prevent children from the dangers of e-cigarettes," Nancy Brown, CEO of the American Heart Association, said in a statement. (Edwards and Siemaszko, 11/18)

The Trump administration’s delay of rules that would restrict flavored  e-cigarettes may look like a win for the industry right now, but it will come at a steep cost later, according to former FDA Commissioner Scott Gottlieb. “Delays on regulatory steps to combat youth vaping may be a Pyrrhic victory for outside vaping groups fighting reasonable action to stop kid use of the products; putting the entire opportunity at risk and making bipartisan legislation to impose restrictions increasingly inevitable,” Gottlieb said over Twitter Sunday night. A Pyrrhic victory is one achieved at “excessive cost,” according to the Merriam-Webster dictionary. (Lovelace, 11/18)

The state of California on Monday sued e-cigarette maker Juul Labs Inc, alleging the San Francisco company engaged in a "systematic" and "wildly successful" campaign to attract teenagers to its nicotine devices. The lawsuit draws on internal correspondence and other evidence, asserting the company did little to prevent sales to underage customers. It also claims that Juul used a "flawed" age-verification process for online sales. (Kirkham, 11/19)

Although the state bars sales of the devices to people younger than 21, the lawsuit alleges electronic cigarette firms made products with nicotine that appealed to young smokers by marketing flavors such as mango, cool mint, crème brûlée and cucumber. “We’ve worked too hard, committed our hard-earned money for too long combating harmful tobacco use to stand idly by as we now lose Californians to vaping and nicotine addiction,” state Atty. Gen. Xavier Becerra said at a news conference in Los Angeles. “Juul adopted the tobacco industry’s infamous playbook, employing advertisements that had no regard for public health and searching out vulnerable targets.” (McGreevy, 11/18)

"Juul adopted the tobacco industry’s infamous playbook, employing advertisements that had no regard for public health and searching out vulnerable targets,” Becerra said in a statement. “We will hold JUUL and any other company that fuels a public health crisis accountable.” North Carolina was the first state to sue Juul earlier this year, and the company is also facing numerous state and federal investigations about the role it played in what public health officials have called an “epidemic” of youth vaping. (Weixel, 11/18)

Missouri Gov. Mike Parson on Monday announced the launch of the state’s new youth vaping education campaign to bring attention to the dangers of e-cigarettes and vaping products. Parson signed an executive order in November giving the departments of Health and Senior Services, Elementary and Secondary Education, and Public Safety one month to get the program running without any additional funding. (Driscoll, 11/19)

A top federal homelessness official announced Friday that he has left his post at the Trump administration’s request, an unexpected move that comes as the White House plans a sweeping crackdown aimed at homelessness in California. Matthew Doherty, executive director of the U.S. Interagency Council on Homelessness, wrote in an email to colleagues that the administration “no longer wishes to have me” in the position. Doherty also announced on Twitter that he was leaving at the administration’s request. (Stein, 11/16)

As homelessness has exploded in Los Angeles in recent years, taxpayers have been willing to spend hundreds of millions of dollars on housing, shelters and services to help get people off the streets. But a new poll shows that a broad majority of voters think the city and county have been ineffective in spending that money and that new policies are needed to address a crisis that they now equate with a natural disaster. (Smith and Oreskes, 11/18)

The number of school-age children in New York City who live in shelters or “doubled up” in apartments with family or friends has swelled by 70 percent over the past decade — a crisis without precedent in the city’s history. By day, New York’s 114,085 homeless students live in plain sight: They study on the subway and sprint through playgrounds. At night, these children sometimes sleep in squalid, unsafe rooms, often for just a few months until they move again. School is the only stable place they know. (Shapiro, 11/19)

The federal government has begun flagging nursing homes with a history of resident mistreatment, opening a new window into abuse and neglect in as many as one in 20 elder-care facilities across the U.S. The government’s database, Nursing Home Compare, has for years allowed the public to search and compare nursing homes nationwide. But last month, the government began adding a small icon—a red circle with a white hand inside—by the name of nursing facilities recently cited for abuse or neglect. (Hayashi, 11/19)

Massachusetts tops all states in the share of single people over 65 whose income doesn’t cover living expenses such as food, housing, health care, and transportation. More than six in 10 here fall short, according to the elder economic security standard index released Tuesday by the Gerontology Institute at the University of Massachusetts Boston. (Weisman, 11/19)

For years, the federal Bureau of Prisons has been plagued by systematic failures, from massive staffing shortages to chronic violence. But the largest agency in the Justice Department has largely stayed out of the public view. The death of billionaire financier Jeffrey Epstein and the revelation that he was able to kill himself while behind bars at one of the most secure jails in America has cast a spotlight on the agency, which has also been besieged by serious misconduct in recent years. (Balsamo and Sisak, 11/19)

After years of the Arizona Department of Corrections failing to comply with a legal settlement requiring better health care for inmates, the judge is sending the two sides back to the negotiating table. The state already owes $1.4 million for not complying in 2018 and could face another $1.7 million for noncompliance this year. ...In letters submitted to the court in May, lawyers detailed numerous stories in which the department failed to provide adequate treatment to inmates. One woman gave birth in her cell alone three days after she reported her water broke. (Castle, 11/18)

Jax has a rare disease called metachromatic leukodystrophy that could rob him of the ability to walk, sit and hold up his own head within the next year. Children with the disease typically die between the ages of 2 and 10. ...The insurer sent the family letters denying requests for coverage five times. The insurer said the hospital was out-of-network, and Jax should get care closer to home. Those familiar with the disease, however, say the Pittsburgh hospital is one of only three centers in the country that specialize in treating children with Jax’s condition. (Schencker, 11/18)

Colorado regulators last week unveiled their final proposal for a public health insurance option, a program that would, in theory, provide a more affordable choice for people who buy coverage on their own. ... The final proposal, along with its appendices, weighs in at several hundred pages, but there are still a few big issues that need to be decided. It will be up to the state legislature to sketch in those details .... Here’s a look at some of the questions that are still TBD. (Ingold, 11/18)

Kaiser Health News: The Startlingly High Cost Of The ‘Free’ Flu Shot

In the Byzantine world of health care pricing, most people wouldn’t expect that the ubiquitous flu shot could be a prime example of how the system’s lack of transparency can lead to disparate costs. The Affordable Care Act requires health insurers to cover all federally recommended vaccines at no charge to patients, including flu immunizations. Although people with insurance pay nothing when they get their shot, many don’t realize that their insurers foot the bill — and that those companies will recoup their costs eventually. (Galewitz, 11/19)

For many people, turning on the tap or flushing the toilet is something we take for granted. But a report released Monday, called "Closing the Water Access Gap in the United States," shows that more than 2 million Americans live without these conveniences and that Native Americans are more likely to have trouble accessing water than any other group. The nearest water station for Darlene Yazzie is 9 miles away at the Dennehotso Chapter House — a community center — in the Four Corners region of the Navajo Nation. On Tuesday, she counted her dimes and nickels to pay for water. It costs $1.10 plus gas money to fill up two 50-gallon barrels, and she has just been told the price is going up next month. (Morales, 11/18)

The Baltimore court system is locked in a legal and political battle with a powerful Maryland lawyer who owns the Orioles baseball team over efforts to reduce one of the country’s largest backlogs of asbestos litigation. Baltimore’s courts have nearly 30,000 asbestos cases pending, a legacy of three decades of litigation during which the city became a leading venue for suing companies over illnesses tied to the dangerous fibers. (Randazzo, 11/18)

The families of young people diagnosed with a rare childhood cancer confronted Democratic Gov. Tom Wolf on Monday over what they called his administration’s insufficient response to a health crisis they blame on pollution from the shale gas industry. Dozens of children and young adults have been diagnosed with Ewing sarcoma and other forms of cancer in a four-county region of southwestern Pennsylvania where energy companies have drilled more than 3,500 wells since 2008. (Rubinkam, 11/18)

One evening in early July, a stream of people filed into a nondescript building on a bend of the Mississippi River in St. James Parish to fight over the permits to build a new chemical plant. Four years earlier, the Taiwanese plastics company Formosa had applied to build a $9.4 billion petrochemical complex about 20 miles north. If approved, it would be one of the largest and most expensive industrial projects in the state’s history. (Younes, 11/18)

For nearly two years, state regulators have required Greensboro and Reidsville to monitor monthly for the probable carcinogen 1,4 dioxane at their wastewater treatment plants. The data, which the state never made public before Friday, show alarmingly high concentrations of the chemical being released repeatedly into the Haw River from December 2017 until September 2019. (Barnes, 11/19)

A health and science watchdog group petitioned federal regulators on Monday to take enforcement action against 27 manufacturers of dietary supplements marketed as helping women become pregnant, but for which the makers provided no scientific evidence of efficacy. In letters to the Food and Drug Administration and the Federal Trade Commission, the nonprofit Center for Science in the Public Interest said its nearly yearlong investigation of 39 “fertility” supplements — pills and powders with names such as Fertile CM, Pregnitude, FertilHerb for Women, OvaBoost, and Pink Stork — found no evidence they increase a woman’s chance of conceiving. (Begley, 11/18)

In the United States, wealth buys health. Consider: In 2000, in Boston’s upscale Back Bay community, a typical resident could expect to live nearly 92 years. But just a few miles away in the South Boston and Roxbury neighborhoods, the average person could not expect to celebrate a 59th birthday. Access to health care plays a big role in this disparity, said Howard Koh, a professor at the Harvard T.H. Chan School of Public Health who was an assistant secretary for health in the Obama administration. That’s why that administration pushed so hard for the Affordable Care Act, Dr. Koh said. “Poverty is the major driver of health inequities.” (Weintraub, 11/19)

In May 2017, elite marathon runner Shalane Flanagan tweeted a very personal piece of information. In all her years of training and competing against the best in the world, she wrote, she had never missed a menstrual cycle. Five months later, she won the New York City Marathon. Flanagan’s tweet was startling because many athletes don’t even talk to their coaches about their periods—much less the world. It was also surprising because of the long-held perception that it’s normal, even preferable, for women in distance sports to be so lean that they no longer menstruate. (Bachman, 11/18)

Novel drugs may offer fresh ways to reduce heart risks beyond the usual medicines to lower cholesterol and blood pressure. One new study found that heart attack survivors benefited from a medicine long used to treat gout. Several experimental drugs also showed early promise for interfering with heart-harmful genes without modifying the genes themselves — in one case, with treatment just twice a year. (Marchione, 11/18)

Alkermes announced Monday it would acquire Rodin Therapeutics, a Boston-based biotech developing drugs intended to change brain cells’ synapses, for up to $950 million. The deal is worth $100 million upfront, but could be worth up to $850 million more based on milestone payments. The deal gives Alkermes another potential path to growth following a handful of disappointments in its research pipeline and the 2018 refusal of the Food and Drug Administration to even consider one of its drug candidates, for treatment-resistant depression. (Sheridan, 11/18)

Last February, Barbara Moore switched to a new medicine to combat a rare neuromuscular disease that had plagued her for nearly a quarter of a century. She had not planned to do so, but Moore had no choice: An effective treatment she had been taking all those years was forced off the market. In late 2018, Catalyst Pharmaceuticals (CPRX) was granted exclusive marketing rights to sell its new drug, called Firdapse, after the Food and Drug Administration approved the medicine. The move precludes any competition for seven years. (Silverman, 11/15)

The spaces have gentle names: The reflection room. The cool-down room. The calming room. The quiet room. But shut inside them, in public schools across the state, children as young as 5 wail for their parents, scream in anger and beg to be let out. The students, most of them with disabilities, scratch the windows or tear at the padded walls. They throw their bodies against locked doors. They wet their pants. Some children spend hours inside these rooms, missing class time. Through it all, adults stay outside the door, writing down what happens. In Illinois, it’s legal for school employees to seclude students in a separate space — to put them in “isolated timeout” — if the students pose a safety threat to themselves or others. (Richards, Cohen and Chavis, 11/19)

In fall 2015, Glacier Ridge Elementary School in Crystal Lake first used its Blue Room, a padded space that allows school workers to place students in “isolated timeout” for safety reasons. Students were secluded in that room more than 120 times during the 2015-16 school year, according to records obtained by ProPublica Illinois and the Chicago Tribune. Yet the district, in its required reporting to the federal government, said it hadn’t used seclusion at all that school year. (Chavis, Cohen and Richards, 11/19)

Gov. Kristi Noem has a message for South Dakota: "Meth. We're On It." Noem launched her new anti-meth campaign on Monday to bring awareness to the meth epidemic in South Dakota that will include a new TV ad, billboards, posters and website. The campaign's motto features the phrase, "Meth. We're on it," over an outline of South Dakota, and the ad and posters feature people of differing in ages and races saying, "I'm on meth." ... Broadhead Co., a marketing and ad agency in Minneapolis, created the "Meth. We're On It." campaign. The state's Department of Social Services paid the agency just short of $449,000 this fall, according to the state's finances website, open.sd.gov. (Kaczke, 11/18)

In one video spot shared on YouTube on Monday, people from an elderly man to young men and women share the message “I’m on meth.” “Meth is not someone else’s problem, it’s everyone in South Dakota’s problem, and we need everyone to get on it,” a narrator says in the video.While some poked fun at the campaign for showing those who appeared to be claiming they were using the drug, others said it was a clever double play on words that got people intrigued. (Graham, 11/18)

The idea for the campaign began last year after Governor Noem took office as the first female governor in the state’s history. A Republican, she has focused on addressing what she has called an “escalating meth crisis" in the state. “She wanted to do it in a way that got the attention of the citizens,” Laurie Gill, the state’s secretary for the Department of Social Services, said in an interview on Monday night. “We are looking for a way that would cause the citizens to stop, pay attention and understand that we do have a meth issue and that there are resources available.” (Zaveri, 11/18)

“South Dakota’s meth crisis is growing at an alarming rate. It impacts every community in our state, and it threatens the success of the next generation,” Noem said in a public service announcement. “This is our problem, and together, we need to get on it.” “Let’s get meth out of South Dakota,” she added. (Brice-Saddler, 11/18)

Mailing free home HIV tests to high-risk men offers a potentially better strategy for detecting infections than usual care. That’s according to a U.S. government study that resulted in many more infections found — including among friends with whom recipients shared extra kits. (11/18)

Americans’ growing fixation on self-care has them spending billions to treat conditions from insomnia to itchy skin without doctors or prescription drugs. Now Procter & Gamble Co. is trying to seize on the trend. The maker of Pampers diapers and Gillette razors, a decade after getting out of the drug business, is making a push into wellness and self-care—growing pockets of the health-care industry—with products such as vitamins and supplements, nonprescription sleep aids and all-natural menopause treatments. (Terlep, 11/18)

Roxane Gay, Pam Belluck and Martha Wells are among the contributors to a free e-book story compilation supported by the public health philanthropy the Robert Wood Johnson Foundation. The e-book is called “Take Us to a Better Place: Stories” and is intended to create a conversation about a “culture of health.” The book is a joint project between the foundation, a public health philanthropy, and the packager Melcher Media. (11/18)

Fall-into-winter: the time of year when we come together to light a candle, carve a bird, raise a glass. It’s a season that is cherished and dreaded often in equal measure. But while attending the company holiday party or fa-la-la-ing with family might seem like a chore, social scientists and other experts make a compelling case that there is strength in numbers: Gathering is good for our body and our spirit. (Sethi, 11/18)

Most physicians learn how to measure blood pressure while in medical school, but they never revisit that training during their professional life, which could lead to misdiagnoses, according to two major associations. The American Medical Association and the American Heart Association on Monday launched a 30-minute online course to train healthcare professionals on measuring blood pressure based on 2017 clinical guidelines for preventing, detecting, evaluating and managing adult hypertension. (Johnson, 11/18)

As the chill of the Scottish autumn set in, a 43-year-old man went to see a family doctor in 2016. For about the last three months, he was constantly tired and out of breath. The physician at the Aberdeen Royal Infirmary in Scotland thought the patient — who worked a desk job and didn’t smoke cigarettes — had an infection in his lower respiratory tract. At first the man got better. But then it got so bad that the patient had to take 14 days off work. The doctor looked at the man’s blood count, kidney and liver function, and took a chest radiograph — all of which seemed normal. (Yan, 11/18)

As soon as James Griffin gets off the school bus he tells his mom, “Go dance, go dance.” James is 14 and has autism, and his speech is limited. He’s a participant in a program for children on the autism spectrum at the University of Delaware that is studying how dance affects behavior and verbal, social and motor skills. One afternoon while dancing, he spun around, looked at his mother, smiled and shouted, “I love you.” (Hollow, 11/19)

In 2014, when Ebola was raging across West Africa and terrifying the world, Sheila Davis had a comfortable desk job in Boston. But Dr. Davis, who holds a Ph.D. in nursing, could not sit and watch from afar. So, she headed to Liberia. She then used her experience in the Ebola wards to help the nonprofit she worked for, Partners in Health, figure out how to rebuild the region’s devastated health care system. (Weintraub, 11/19)

Kaiser Health News: For Newborns With Hearing Loss, Screening Opens Window To A World Of Sound

Four-year-old Betty Schottler starts each morning with the same six sounds: [m], [ah], [oo], [ee], [sh], and [s]. Her mom makes the sounds first, then Betty repeats them to check that her cochlear implant is working. Betty was born profoundly deaf and got her first set of glittery rainbow hearing aids at 6 weeks old. (Bluth, 11/19)

Fewer doctors would have to wait for permission to prescribe addiction treatment drugs under new, bipartisan legislation being unveiled this week by two lawmakers on the House Energy and Commerce Committee. Under a new bill authored by Reps. Paul Tonko (D-N.Y.) and David McKinley (R-W.Va.), the practice of “prior authorization,” in which insurers require doctors to seek approval before they can proceed with a prescription or procedure, would be banned in state Medicaid programs for addiction treatment medicines like buprenorphine. (Facher, 11/18)

In 2004, Purdue Pharma was facing a threat to sales of its blockbuster opioid painkiller OxyContin, which were approaching $2 billion a year. With abuse of the drug on the rise, prosecutors were bringing criminal charges against some doctors for prescribing massive amounts of OxyContin. That October, an essay ran across the top of The New York Times’ health section under the headline “Doctors Behind Bars: Treating Pain is Now Risky Business.” Its author, Sally Satel, a psychiatrist, argued that law enforcement was overzealous, and that some patients needed large doses of opioids to relieve pain. (Armstrong, 11/19)

The 20 Xanax pills that Rachel Bandman’s friend had sold her were not enough, she wrote in a text message. The University of South Carolina student said she wanted to die and the medication hadn’t killed her. “I need more for it to happen,” Bandman texted Anthony “A.J.” Hunt in 2016, BuzzFeed News reported, citing court transcripts. Hunt, a drug dealer who had dropped out of the university, sold Bandman more of the sedatives, federal prosecutors said. (Iati, 11/18)

Democratic lawmakers rushed to file bills Monday as the legislative window opened for next year’s General Assembly session, setting out voting rights, gun control, LGBTQ protections and the Equal Rights Amendment as priorities for their newfound power in the majority. It was bad timing for Republican leaders, who traveled to Richmond Monday to officially shut down the special legislative session on gun control that they had cut short over the summer. (Schneider, 11/18)

Washington University has put big money behind its support of Medicaid expansion in Missouri, contributing $250,000 on Friday to an effort that would place a question on next year’s November ballot. The check to Missourians for Healthcare came after Chancellor Andrew Martin and Dr. David Perlmutter, dean of the School of Medicine, on Nov. 4 issued a joint letter endorsing the ballot initiative. (Suntrup, 11/18)

Children’s Wisconsin on Tuesday will announce an ambitious five-year plan to significantly improve access to behavioral health care for children and adolescents. The plan is projected to cost $150 million over five years and includes an array of initiatives to address the severe shortage of psychiatrists, psychologists and therapists. Children’s Wisconsin, the new name of Children’s Hospital of Wisconsin, hopes to roughly double the number of professionals who provide behavioral health care in its system. It now has 137 psychiatrists, psychologists, psychiatric nurse practitioners and therapists. (Boulton, 11/19)

Counties and some tribes will have to foot the bill for costly mistakes made by the Minnesota Department of Human Services (DHS), as embarrassing revelations of financial mismanagement continue to emerge. The state social services agency sent letters to counties and tribes Monday saying they will be responsible for paying back more than $9 million to the federal government that was improperly spent. (Howatt and Serres, 11/18)

To paraphrase Connecticut’s private, nonprofit social service agencies: Gov. Ned Lamont just doesn’t get it. Frustration with Lamont, who rebuffed a request from nonprofits for $100 million of the state’s $2.5 billion reserve, recently surged after the governor urged the agencies to ask more from wealthy donors. (Phaneuf, 11/19)

A deadly superbug fungus continues to spread around the world and has now been reported in 14 states, including Georgia. Candida auris is often resistant to multiple antifungal drugs commonly used to treat Candida infections and is difficult to recognize with standard laboratory methods, according to the Centers for Disease Control and Prevention in Atlanta. (Clanton, 11/18)

When a fast-moving wildfire marched toward the town of Paradise more than a year ago, few who lived there were aware of it. Even though the community used the CodeRED automated emergency warning system, less than 40% of residents subscribed to the alerts. Only 7,000 of the 52,000 residents who eventually evacuated received the emergency alert to leave.The fire incinerated cell towers and communications equipment, revealing a vulnerability of the telephone-based disaster alert system. “The only notification systems left were emergency vehicle sirens and bull horns… word-of-mouth with families and neighbors… and immediate action,” the Butte County Grand Jury reported to the Superior Court earlier this year. (Cart, 11/15)

With the threat of another power outage looming, state lawmakers hammered Pacific Gas & Electric at the state Capitol on Monday for botching shut-offs that left millions of Californians in the dark this fall and blamed the company for failing to upgrade its system over time. During an all-day hearing that included testimony from California’s investor-owned utilities, state officials and representatives of communities affected by outages, state senators vented their frustrations as they tried to identify legislative solutions to problems caused by this year’s wildfire-prevention blackouts. (Luna, 11/18)

Sutter Health and a group of physicians agreed to pay the federal government $46.1 million to settle allegations that it violated the Stark law by billing Medicare for services by physicians with whom it had improper financial relationships, the Justice Department announced Friday. A 2014 whistleblower suit filed by former Sutter compliance officer Laurie Hanvey claimed Sutter Memorial Center Sacramento billed Medicare for services referred by Sacramento Cardiovascular Surgeons Medical Group physicians to whom it made payments that exceeded fair market value from 2002 through at least 2012. (Meyer, 11/18)

Oregon's new law designed to direct suspects with a mental illness to a state hospital is leaving some behind. Those charged with misdemeanors don't always qualify. That's raised some alarms. (Wilson, 11/18)

Cuyahoga County Council proposes spending an additional $5.4 million-plus over the next two years for health and human services programs that largely serve seniors, children and the mentally ill. Included in the proposal is a one-year increase for the Alcohol, Drug Addiction and Mental Health Services Board for those who need non-opioid-related mental health services, council’s legislative budget advisor, Trevor McAleer, told council members on Monday. (Astolfi, 11/18)

When Citrus Heights police pinned a shirtless James Bradford Nelson III to the pavement at a KFC restaurant on June 23, 2017, the temperature of the asphalt was estimated to be 170 degrees, eight degrees higher than what it takes to instantly destroy human skin. Nelson, who was 27 at the time and had lived with schizophrenia for years, was detained after a day of mental episodes that ended with him in the parking lot, where he was accused of trying to take a restaurant employee’s wallet, a charge that later was dropped. (Stanton, 11/18)

Metro Atlanta is often characterized as the epicenter of Georgia’s HIV crisis. Earlier this year, in fact, President Trump announced an anti-HIV plan targeting four populous counties in greater Atlanta — Fulton, DeKalb, Gwinnett and Cobb — among 48 counties in the nation. (Miller, 11/18)

BayCare Health Systems is going back to plan A for its hospital in Wesley Chapel.The health care chain is abandoning plans for a hospital in a developing area next to Interstate 75 and now wants to build a new 60-bed hospital on land it bought more than a dozen years ago along the west side of Bruce B. Downs Boulevard, south of State Road 54 in central Pasco County. The move comes almost a year after BayCare won preliminary state approval to build a new hospital farther north on 111 acres adjacent to the still-to-be constructed interchange of Interstate 75 and Overpass Road. (Bowen, 11/18)

Health department officials are investigating a possible cluster of E. coli in Maryland after seven people who had contracted the bacteria all reported buying and eating the same prepackaged Caesar salad from Sam’s Club. In a news release, the department wrote that people should not eat any Ready Pac Bistro Bowl Chicken Caesar Salads with a “best by” date of Oct. 31, 2019, as tests of one of the affected people’s salad “identified the presence of E. coli O157 in the romaine lettuce.” (Davis, 11/18)

She’ll only get halfway. That’s the consensus on Elizabeth Warren: If the senator becomes president, Congress will wear down her ideological edge and stymie much of her radical agenda. The result won’t be something free-marketeers can love, but it will be something they can live with and then undo at a later date. Maybe not. The lesson of the 1960s is that political compromises with progressives can be much more consequential than they look—and preclude future reform. (Amity Shlaes, 11/18)

Recent state elections — the Democratic landslide in Virginia, followed by Democratic gubernatorial victories in Kentucky and Louisiana — have been bad news for Donald Trump. Among other things, the election results vindicate polls indicating that Trump is historically unpopular. All of these races were in part referendums on Trump, who put a lot of effort into backing his preferred candidates. And in each case voters gave him a clear thumbs down. (Paul Krugman, 11/18)

New polling from the Kaiser Family Foundation and the Cook Political Report confirms that while Democratic voters like the idea of “Medicare for All,” it would be a risk in a general election. Between the lines: This poll was conducted in the formerly “blue wall” states of Pennsylvania, Minnesota, Michigan, and Wisconsin. By the numbers: 62% of Democratic voters in those states say a Medicare for All plan that eliminates private insurance is a good idea — while 62% of swing voters in these battleground states say it’s a bad idea. Yes, but: Our poll suggests that 2020 is a referendum on President Trump, not on health policy. (Drew Altman, 11/19)

It’s hunting season for health insurers, commonly referred to as “open enrollment.” People over 65 who turn on their TV or open their mailbox from late October through November can’t escape advertisements from private health insurers offering so-called Medicare Advantage plans on behalf of the federal government. The process may be mildly annoying, but it is a sign of vitality in a public-private partnership that is delivering high-quality health care at comparatively low cost. Over one-third of all Medicare beneficiaries now enroll in these plans. Politicians of both parties, take note: maybe what we should be debating is not Medicare for All, but Medicare Advantage for All. (Geoffrey Joyce, 11/18)

While Oregon generally prides itself on being progressive when it comes to health care, residents are struggling to access affordable care as insurers increasingly shift costs onto consumers. The need to expand access and decrease health care disparities for communities of color is greater than ever.And so, it’s unclear why Oregon lawmakers are poised to consider legislation that would reduce access for some of the most vulnerable chronic disease patients and disproportionately affect people of color. Senate Bill 900, being revived after it died in the last legislative session, would line the pockets of insurance companies at the expense of low-income Oregonians suffering from kidney failure. (E.D. Mondaine, 11/18)

Medicaid expansion was a key component of ObamaCare. In 2014 when the expansion started, the feds stopped doing audits of states’ Medicaid eligibility determinations. The Obama administration’s goal was to build public support for the new law by signing up as many people as possible. Now, after a four-year hiatus, the Centers for Medicare and Medicaid Services have begun auditing program eligibility again. According to a report released Monday, the audits found “high levels of observed eligibility errors,” meaning a significant number of people are enrolled in Medicaid who shouldn’t be. (Brian Blase and Aaron Yelowitz, 11/18)

It is one of the most effective ways to protect our health: herd immunity. By vaccinating the vast majority of people in a population, we can guard against the spread of potentially deadly infections. When we allow this collective immunity to dissipate, the results can be devastating — sometimes even for people who have been vaccinated. Just ask my patient J.J.’s ordeal began with a routine dinner at an Italian restaurant in Culver City in October. A few days later, his wife called me with the news of a possible measles case at the restaurant the same day. I wasn’t worried because J. had attended Los Angeles public schools, which require vaccinations, and a key vaccine such as MMR (measles/mumps/rubella) would not have slipped through the cracks. A few days later, J.’s wife called again. (Daniel J. Stone, 11/19)

Nine-year-old Mpilo (this is a pseudonym) had been sick for months, suffering from fever, loss of appetite and persistent cough. His mother made the long journey with him and his sister to the nearest rural health clinic in South Africa to seek treatment as his sister also had a leg wound. Through a U.S. Centers for Disease Control and Prevention (CDC) program with health facilities, as part of the U.S. President’s Emergency Plan for AIDS Relief (PEPFAR), doctors discovered that both children were HIV-positive. They also found that Mpilo had tuberculosis (TB) — a potentially deadly combination. Doctors started Mpilo and his sister on a daily regimen of HIV antiretrovirals and immediately began TB treatment for Mpilo. (Rebecca Martin, 11/18)

The president of the United States had some free time on his hands Saturday, so he decided to go to Walter Reed Hospital for some routine medical tests as part of his annual checkup — next year’s annual checkup. That’s the explanation from the White House about President Trump’s apparently impromptu hospital visit. Uh-huh. Or, more politely: The explanation raises several questions. Wasn’t his last checkup in February? When did his annual physical become a phased affair? Why was Saturday’s visit, unlike previous checkups, not announced or listed on his public schedule? (11/18)