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The number of vaping-related illnesses in the U.S. could soon climb much higher, a public health official said Tuesday. Dr. Anne Schuchat, of the Centers for Disease Control and Prevention, told a congressional subcommittee that she believes “hundreds more” lung illnesses have been reported to health authorities since last Thursday, when the CDC put the tally at 530 confirmed and probable cases. “We are seeing more and more cases each day and I expect the next weekly numbers will be much higher,” Schuchat said. (Perrone, 9/24)

Dr. Schuchat called youth vaping an epidemic affecting nearly all U.S. states, with half of all cases appearing in people 25 and younger. Most of the products involved in the reported injuries or illnesses are believed to be black-market ones that include THC, a psychoactive ingredient in marijuana, though she said that chemical isn’t necessarily the culprit. She also said three out of four such patients are male. (Burton, 9/24)

A top official with the Centers for Disease Control and Prevention warned federal lawmakers Tuesday that a new generation of e-cigarettes now on the market is "even more addictive," than early versions of vapes, and the number of vaping-related lung diseases is continuing to rise. "We are seeing more and more cases each day," the CDC's Dr. Anne Schuchat told lawmakers at a hearing of the House Committee on Oversight and Reform that is looking into the recent national outbreak. (Aubrey, 9/24)

Kaiser Health News: At Raucous Hearing, No Unity On Vaping Issues

Opposing views on e-cigarettes, witnesses interrupting members of Congress and even a wink. A hearing Tuesday on the epidemic of respiratory injuries linked to vaping was one unusual show. ... Yet even these rising numbers [of lung illness cases] and stark warnings didn’t unify the often-contentious party lines at the House subcommittee hearing on vaping. Ostensibly about public health, the hearing grew tense and political at unexpected moments. (Bluth, 9/25)

“As we focus on the tragic outcomes of this lung disease outbreak, we must view is as another chance to come together to protect the public health,” said Rep. Raja Krishnamoorthi (D-Ill.), chairman of the panel’s Economic and Consumer Policy Subcommittee. (Hellmann, 9/24)

Kaiser Health News: Meet The Health Officials Who Alerted The World To The Alarming Vaping Illness

The epidemic has prompted outrage about federal oversight of vaping, but there is also a local public health success story to be told. Doctors and regional officials in Wisconsin, Illinois and elsewhere pieced together that this mysterious illness was much larger than it appeared. It’s a tale of teamwork, communication and long-serving public health officials tapping into their networks in an era of limited public health funding, diminished public health infrastructure and high turnover. It’s surprising in some ways that Wisconsin became ground zero for uncovering the link. The state has ranked near the bottom nationwide for per-person spending on public health until a huge boost of $588 million more was greenlighted for the next two years. Wisconsin is also home to Juul vaping pod manufacturing sites, and one of its U.S. senators, Republican Ron Johnson, credits his win to vaping advocates. (Weber, 9/25)

Doorways chained shut and “Members Only” signs warn casual passersby against stopping along this five-block stretch of downtown known as the “Cannabis District.” This gritty corridor is a major hub for the estimated $9 billion black market for the state’s illicit cannabis products. Products sold here, including a flood of counterfeit vape materials from China, are coming under scrutiny as federal authorities investigate the mysterious vaping-related lung illness that has sickened at least 530 people in 38 states and claimed nine lives. (Kuznia and Sun, 9/24)

A recent rash of vaping-related illnesses has sickened hundreds in the United States, sparked a sweeping public health investigation, and generated a flurry of legislative measures to curb the e-cigarette industry. But in exam rooms, the illnesses have prompted a less-noticed but equally significant shift: Doctors, particularly pulmonologists, are asking patients whether they vape, even when they’re not presenting symptoms of the mysterious illness. (Thielking, 9/24)

Outdated health surveillance infrastructure is making it more challenging to solve the mystery of lung illnesses that appear to be linked to vaping, a top Centers for Disease Control and Prevention official told a House panel Tuesday. The warning from Anne Schuchat, the deputy CDC director, came as the number of illnesses and deaths associated with vaping continues to climb. “The epidemic is moving faster than our data gathering,” she told the House Oversight and Reform Subcommittee on Economic and Consumer Policy. (Siddons, 9/24)

The chief executive of Juul Labs, the dominant e-cigarette company that has been the target of public and regulatory outrage over the soaring use of teenage vaping, stepped down on Wednesday. The executive, Kevin Burns, will be replaced by K.C. Crosthwaite, an executive from Altria, the major tobacco company that owns a 35 percent stake in Juul, the San-Francisco-based company. (Kaplan and de la Merced, 9/25)

Juul announced this morning that its CEO would step down and that the company would not lobby the Trump administration on its looming ban of flavored vapor products. The nation's largest e-cigarette maker also said it will suspend all broadcast, print and digital product advertising in the United States. ... The company said it will fully support and comply with the policy, which is expected in the coming weeks. (Owermohle, 9/25)

Juul Labs Inc. is preparing a staff restructuring, as the e-cigarette maker braces for slower sales following a mysterious vaping-related illness and a proposed U.S. ban on flavors that make up more than 80% of its sales. The move underscores the pressure faced by one of the country’s most valuable startups. The San Francisco company, which employs about 3,900 people, has been adding hundreds of staff as it expands in the U.S. and abroad. It had about 225 employees at the end of 2017. (Maloney, 9/24)

California public health officials on Tuesday urged people to stop vaping as the number of cases of severe lung disease associated with use of e-cigarettes and vape pens continues to rise dramatically across the state and country.The state advisory applies to all vaping devices and products, including tobacco and cannabis. Public health officials said that until investigators determine exactly what’s causing the spate of lung diseases, no vaping products should be considered safe. (Allday, 9/24)

Ninety Californians with a history of vaping have been hospitalized for breathing problems and lung damage, according to the department. Two have died. ... “We are seeing something that we have not seen before,” California’s top public health official Dr. Charity Dean said in a statement. “There are numerous unknown factors at this time, and due to the uncertainty of the exact cause, it is our recommendation that consumers refrain from vaping until the investigation has concluded.” (Bollag, 9/24)

E-cigarettes are loaded with a liquid cartridge — typically containing THC or nicotine — that when heated turns into a vapor that the user then inhales. The recent outbreak, however, suggests that something in the liquid, such as oil or another substance mixed in, has been also entering people’s lungs and causing damage, experts say. “People are getting sick and some are dying as a result of vaping,” Gov. Newsom said in a statement Tuesday. “Californians are encouraged to stop vaping until health officials fully understand what’s causing this public health crisis.” (Karlamangla, 9/24)

Facing an explosion of vaping-related illnesses, Governor Charlie Baker took aggressive action Tuesday, ordering a four-month ban on the sale of all vaping products in Massachusetts in what is the most sweeping prohibition targeting electronic cigarettes in the United States. Baker’s decision to declare a public health emergency — and apply the ban to both tobacco and marijuana vaping products — quickly reverberated through the country, drawing praise from concerned medical professionals and consternation from the fledgling legal cannabis industry. (Stout, 9/24)

There will be a four-month ban on all vaping products in Massachusetts. At the State House Tuesday, Gov. Charlie Baker declared a public health emergency and called upon the state's public health council to enact the temporary ban. The council swiftly approved the move, making Massachusetts the first U.S. state to halt sales of vaping products of all kinds. (Brown, 9/24)

Baker’s decision to declare a public health emergency — and apply the ban to both tobacco and marijuana vaping products — quickly reverberated through the country, drawing praise from concerned medical professionals and consternation from the fledgling legal cannabis industry. (Stout, 9/24)

Gov. Charlie Baker said the Massachusetts ban would cover all vaping products, whether they were flavored or unflavored, used with nicotine or with THC, or purchased online or in stores. The ban was approved by a state public health council on Tuesday afternoon. “I’m declaring this public health emergency because medical and disease control experts have been tracking a rapidly increasing number of vaping-related illnesses that in some cases have led to death,” Mr. Baker said at a news conference. (Bogel-Burroughs, Richtel and Thomas, 9/24)

Bans on sales of flavored vaping products took effect this month in New York and Michigan, and the Trump administration said it plans to enact a similar regulation at the federal level. Flavored products have attracted particular scrutiny from policymakers who say they are getting children hooked on nicotine. (Knowles, 9/24)

During the temporary ban, Baker said, the administration will work with medical experts and state and federal officials to better understand vaping illnesses and work on additional steps to address the public health crisis. That, he said, could include legislation and regulations. The administration will also work on providing more resources for a public awareness campaign and smoking cessation programs, he said. (LeBlanc, 9/24)

The ban on the sale of flavored and non-flavored vaping products will take effect immediately and last through Jan. 25, according to a statement from Baker's office. It applies to all vaping products and devices, including tobacco and marijuana. The statement said that 61 cases of vaping-associated pulmonary disease have been reported to the state's Department of Public Health. (Frazin, 9/24)

Massachusetts Gov. Charlie Baker today moved to temporarily ban the sale of all vaping products amid an outbreak of mysterious vaping-related illnesses. The Republican governor's emergency declaration, which goes further than temporary flavor bans announced by Democratic governors in Michigan and New York, would prohibit the online and retail sale of all flavored and non-flavored vaping products, including those containing marijuana, which is legal in Massachusetts. (Pradhan, 9/24)

Kansas health officials have confirmed a second death in the state tied to a vaping-related lung disease, bringing the total number of U.S. deaths to nine. Kansas currently has nine probable or confirmed vaping related cases, including the two deaths, but officials still do not know what is causing people to become sick. The lung disease has sickened more than 530 people across the country. (Weixel, 9/24)

The Trump administration declared there’s no “international right to abortion” at a United Nations meeting in New York this week, calling on other countries to join a coalition pushing the elimination of what it calls “ambiguous” terms and expressions, such as sexual and reproductive health, from U.N. documents. ... Earlier this year, HHS officials began meeting with representatives from other countries, urging them to join a new international coalition that would focus on the value of the family, and which would not condone harmful sexual risks for young people, or promote abortion as a means of family planning. Other countries, civil society and women’s rights groups have expressed alarm at the efforts, and accused the United States of aligning with countries like Saudi Arabia and Sudan with poor human rights records and, also, of putting unfair pressure on poor countries that depend on U.S. aid. (Eunjung Cha, 9/24)

Monday’s oral arguments before a federal appeals court were intended to center on whether the Trump administration’s new Protect Life Rule should stay in effect while lower courts consider a legal challenge by nearly two dozen states, including California, as well as the American Medical Association, Planned Parenthood and other opponents. ... But rather than constrain discussion to the merits of reinstating a preliminary injunction on the rule while the broader case plays out, an 11-judge panel of the 9th U.S. Circuit Court of Appeals in San Francisco dove into the heart of the matter: Do the restrictions on abortion referrals for these low-income clinics constitute a lawful policy change by a conservative administration? Or, do they amount to an arbitrary disruption of medical care for millions of poor and uninsured teens and adults? (Varney, 9/25)

About a half-million students could lose access to free school meals under a Trump administration proposal to limit the number of people who qualify for food stamps, drawing protests from congressional Democrats who say it could harm needy schoolchildren. The change, proposed over the summer, would cut an estimated 3 million people from the Supplemental Nutritional Assistance Program. It is intended to eliminate eligibility for people who get food stamps because they have qualified for other forms of government aid, even though they may have savings or other assets. (Balingit, 9/24)

After years of complaints, the Federal Trade Commission has sent letters to lawyers to warn that some ads seeking clients to file lawsuits may misrepresent the risks associated with certain medicines, and possibly worry consumers that a product recall may be under way. In a statement, the agency indicated letters were sent to seven lawyers, as well as people who generate leads for potential lawsuits, saying such ads may be considered deceptive or unfair under federal law. Some of the ads may make deceptive or unsubstantiated claims about the risks of taking blood thinners and drugs for diabetes, acid reflux, and high blood pressure, among other illnesses, the FTC explained. (Silverman, 9/24)

The secretary of veterans affairs has told several members of Congress that he's evicting them from offices they've been using in VA hospitals. The House members use the offices to meet with vets and discuss everything from their eligibility for benefits to the quality of the care they receive. The VA says it wants the spaces back for clinical uses, but one of the lawmakers, Rep. Brian Mast, R-Fla., thinks it's personal. (Allen, 9/25)

The Department of Veterans Affairs (VA) is under pressure to ease restrictions on veterans’ access to medical marijuana to help treat pain and other ailments. Veterans advocacy groups want to know if marijuana can treat chronic pain, as well as help address widespread suicides among veteran communities. While 33 states and the District of Columbia have legalized marijuana for medicinal purposes, veterans are finding themselves fighting stigma and roadblocks from the federal government’s drug laws. (Weixel, 9/24)

The Trump administration has escalated its fight with California over environmental regulations. Environmental Protection Agency Administrator Andrew Wheeler sent a letter Monday to the California Air Resources Board threatening to withdraw billions of dollars in federal highway money unless the state clears a backlog of air pollution control plans. "California has the worst air quality in the United States, with 82 nonattainment areas and 34 million people living in areas that do not meet National Ambient Air Quality Standards," Wheeler wrote. (Brady, 9/24)

EPA officials added that California has 34 million residents living in areas that don’t meet national air-quality standards. They asked state officials to tell them by Oct. 10 whether the state will withdraw the old plans. California Air Resources Board Executive Officer Richard Corey disputed the sincerity of the Trump administration’s move, saying the “EPA has unclean hands: It sat on these documents for years and is now pounding the table about paperwork issues of its own creation.” He added, “The letter from the EPA contains multiple inaccuracies, omissions and misstatements.” (Stech Ferek, 9/24)

Last week, the administration launched an assault on California’s role as an environmental leader in reducing greenhouse gas emissions and improving air quality. It announced the revocation of a decades-old rule that empowers California to set tougher car emissions standards than those required by the federal government. California Atty. Gen. Xavier Becerra sued the administration the next day, arguing that the state’s stricter pollution rules were lawful and needed to improve air quality. (Díaz, Phillips and Barboza, 9/24)

A Congressional Budget Office (CBO) analysis finds that a rival approach backed by doctors groups for protecting patients from getting massive “surprise” medical bills would increase the deficit by “double digit billions” of dollars. The email from the nonpartisan CBO to a congressional office, obtained by The Hill, comes amid a raging debate over legislation to stop surprise medical bills, which is seen as a rare area of possible bipartisan accomplishment this year. (Sullivan, 9/24)

With the proposal, Mr. Sanders is embracing an idea that has been a centerpiece of the campaign of his top progressive rival, Senator Elizabeth Warren. But while Ms. Warren came first, Mr. Sanders is going bigger. His wealth tax would apply to a larger number of households, impose a higher top rate and raise more money. Mr. Sanders’s plan to tax accumulated wealth, not just income, is particularly aggressive in how it would erode the fortunes of billionaires. His tax would cut in half the wealth of the typical billionaire after 15 years, according to two economists who worked with the Sanders campaign on the plan. Mr. Sanders would use the money generated by his wealth tax to fund the housing plan he released last week and a forthcoming plan for universal child care, as well as to help pay for “Medicare for all.” (Kaplan, 9/24)

The tax rate would start at 1 percent on net worth of more than $32 million and rise with income above that, topping out at 8 percent on wealth over $10 billion. Sanders’ Democratic presidential campaign said the tax would raise $4.35 trillion over a decade and would be used to fund "Medicare for All", along with his plans for affordable housing and universal childcare. (Eckert, 9/24)

Among Democratic presidential candidates, it’s the rallying cry of the moment — tax the rich. The idea is a centerpiece of the campaigns of Senator Elizabeth Warren and Senator Bernie Sanders. A former candidate, Mayor Bill de Blasio of New York, went so far as to say the government ought to “tax the hell out of the wealthy.” The new taxes would fund a laundry list of liberal proposals — “Medicare for all,” free college, combating global warming and rebuilding roads and bridges. (Schwartz and Gates, 9/24)

CMS Administrator Seema Verma on Tuesday told insurers that they need to support the Trump administration's policies on transparency, value-based payments, interoperability and data access, cautioning them that the health insurance industry is under threat from disgruntled patients, doctors and politicians. Speaking at the America's Health Insurance Plans' 2019 National Conference on Medicare, Verma said that patients are tired of high costs, surprise bills and a system that's too complex and difficult to navigate. (Brady, 9/24)

The CMS on Tuesday said Medicare Advantage average monthly premiums are projected to hit their lowest point in 13 years in 2020. The agency also predicted that enrollment in the plans would continue its upward march as more seniors opt for Advantage over the traditional Medicare program. Average monthly premiums are expected to decrease 14.4% from $26.87 in 2019 to $23 next year—the lowest premium since 2007, according to the CMS. (Livingston, 9/24)

Blue Cross and Blue Shield of North Carolina and Cambia Health Solutions said their deal to combine is on hold following recent revelations about the arrest of the North Carolina insurer’s chief executive for an allegedly alcohol-related traffic accident. The two large insurers had planned to come together in a tie-up that would generate around $16 billion in annual revenue and cover more than six million people through Blue Cross Blue Shield plans. Patrick Conway, chief executive of Blue Cross and Blue Shield of North Carolina, had been slated to lead the combined entity. (Wilde Mathews, Scism and Bauerlein, 9/24)

About 25,000 Minnesotans who used to be enrolled in MinnesotaCare will receive refunds in the coming weeks, because the automatic payments they set as members were not turned off after their accounts closed. The state Department of Human Services (DHS) discovered that some former MinnesotaCare members were still paying their premiums online even though they were no longer enrolled in the health care program. DHS will issue about $1.8 million in refunds to approximately 24,800 people, officials said Tuesday, with most refunds totaling $250 or less. (Faircloth, 9/24)

Amazon has launched a virtual health clinic with in-home follow-ups for employees in Seattle, dubbed Amazon Care. The company announced the program on a web site, Amazon.care, that is currently publicly accessible but did not formally announce the news outside the company. “Amazon Care is a benefit being piloted for Amazon employees and their families in the Seattle area,” the website reads. (Farr, 9/24)

Amazon has launched a virtual health clinic, dubbed Amazon Care, for employees and their families living in Seattle. The pilot program, which offers a combination of telemedicine and home visits, marks the most recent step the Seattle-based tech giant has taken into the healthcare sector. Amazon Care is marketed as a benefit being piloted for company employees enrolled in an Amazon health insurance plan, according to a company website. Employees will be able to reach physicians or nurses for urgent care, preventive health consults and sexual health services, such as testing for sexually transmitted infections. (Cohen, 9/24)

Walmart said Tuesday that it has added seven bachelor's degrees and two career diplomas in health care fields to its education benefits. Last year, Walmart created a program that would allow its employees to earn a college degree without taking on student debt. (Halkias, 9/24)

Best Buy Co. is well-known for bringing computers and other gadgets back to life. Now, it wants to take care of its shoppers’ health as well. The retailer’s strategy to beef up its fledgling health-care business will be a key focus of its investor meeting Wednesday in New York. The plan includes selling everything from fancy fitness machines to health-monitoring services for seniors. It could help Best Buy grab some of the $3.5 trillion market for health spending in the U.S. -- while offsetting sluggishness in its main business of selling laptops, TVs and phones. (Boyle, 9/24)

Hospital groups are beginning to push back on the CMS' plan to cut Medicaid disproportionate-share hospital funds. DSH funds are meant to help hospitals with uncompensated-care costs, an area that could grow with a recent increase in the uninsured rate. ...The CMS on Monday published a final rule for calculating $4 billion in state Medicaid disproportionate-share hospital cuts for fiscal 2020 and $8 billion for each subsequent year through 2025. (Brady and Cohen, 9/24)

The city’s largest nonprofit hospital system has erased the debts owed by more than 6,500 patients it sued for unpaid hospital bills, less than two months after announcing an overhaul of its debt collection processes. The dramatic shift was prompted by an MLK50-ProPublica investigation that revealed that Methodist Le Bonheur Healthcare filed more than 8,300 debt lawsuits from 2014 through 2018, including against its own employees. (Thomas, 9/24)

Trinity Health, based in Livonia, Mich., is considering the refinancing of $1.7 billion in debt, with $1.4 billion of that amount likely to take the form of taxable bonds. The debt under consideration for refinancing represents about 22% of the system's $6.3 billion in total long-term debt. The remaining $300 million in debt may or may not be issued as a tax-exempt security, but would be issued to cover the cost of the acquisition, construction, renovation and equipping of new and existing Trinity Health facilities or the refinancing of such expenditures, according to a municipal bond filing. (Barr, 9/24)

A group of major payers and providers said its member organizations shifted more than half their business to value-based payment arrangements in 2018, while aiming to hit the 75% mark by the end of next year. The Health Care Transformation Task Force announced on Tuesday that 42 member organizations had 52% of their business in payment arrangements involving global budgets, bundled payment or shared savings deals by the end of 2018, up to 47% the year before. (Meyer, 9/24)

Novartis AG said that an internal probe of data manipulation at one of its drug-development units was hindered by two brothers, both senior researchers whom it later fired. The Swiss drug giant said in a newly disclosed letter to the U.S. Food and Drug Administration that its months-long investigation into the issue was “significantly drawn out” due to a “lack of cooperation and categorical denial of the allegations” by the brothers. Novartis and the FDA disclosed in August they had identified data manipulation in testing of a gene-therapy treatment that was conducted by AveXis, a Chicago-based company Novartis bought in 2018 for $8.7 billion. The treatment, developed by AveXis and later dubbed Zolgensma, is now the world’s most expensive drug. (Roland, 9/24)

The company also promised in a letter to FDA made public today that it will share with the agency any "credible allegation" concerning the data integrity of a new drug within five days of receiving it. The Swiss drugmaker was responding to FDA’s questions about data errors that the company and its subsidiary AveXis submitted in the application for spinal muscular atrophy treatment Zolgensma, which the agency approved in May. The manufacturers were aware of the data problem before FDA approved Zolgensma, but did not inform the agency until June 28, FDA said. (Owermohle, 9/24)

After running tests, the Sandoz unit of Novartis (NVS) has expanded its recall of heartburn medicines containing ranitidine and is now pulling the products from the U.S. The move comes one week after the drug maker halted worldwide distribution of heartburn medicines and regulators in the U.S and Europe disclosed the capsules may contain high levels of a carcinogen. At the time, Sandoz also issued a recall in some European countries and Canada, but did not take the same step in the U.S. while testing was underway. (Silverman, 9/24)

Patrick Boyle recalls that by the time he got his Ph.D. in biology in 2012, he had worked with just a few other people and managed to manufacture six genes, the basic units of heredity. "Today, we are synthesizing more than 10,000 genes every month," he says, showing off a lab at a Boston biotech company called Ginkgo Bioworks. Making genes from scratch used to be laborious and time consuming, but not anymore. That's why federal officials are now considering new measures to prevent this rapidly advancing technology from being misused to create dangerous viruses or bioweapons. (Greenfieldboyce, 9/24)

Instead of waiting for lawmakers to hash out a federal privacy bill that might not even address health data, some tech companies are taking rulemaking into their own hands. Several industry groups, with input from companies such as IBM, 23andMe, Apple and Microsoft, have drawn up voluntary codes of conduct and guidelines for keeping patients' data safe. (Ravindranath, 9/24)

Milwaukee is trying to prevent violence before it happens. The city's 414LIFE team follows a public health model known as Cure Violence, which has been used national and internationally. The model grabbed headlines in 2011 when it was the subject of a documentary that followed three "violence interrupters" in their Chicago neighborhoods. (Luthern, 9/25)

Austin has the highest per capita rate of police shootings during mental health calls among the 15 largest U.S. cities, a violation of international human rights standards, according to a report by University of Texas researchers and a local law advocacy group released Tuesday. The Human Rights Clinic of the University of Texas School of Law and the nonprofit Austin Community Law Center found that of the 24 people killed in Austin police shootings from 2010 through 2016, at least a third of those had confirmed mental health conditions. (Osbourne, 9/24)

The Acton Police Department recently completed several initiatives to enhance its ability to assist people with mental illness. The department in 2017 agreed to join the One Mind Campaign, a program started by the International Association of Chiefs of Police to improve interactions between law enforcement agencies and individuals with mental illness, according to Acton Police Chief Richard Burrows. (Laidler, 9/24)

Regional approaches to marijuana legalization and transportation will be the focus Wednesday morning when New York Gov. Andrew Cuomo visits Gov. Ned Lamont at the Executive Residence in Hartford, the second time in a month the gubernatorial neighbors have met face to face. Cuomo’s visit comes a day after he called for a “regional symmetry” with Connecticut and New Jersey on marijuana legalization and vaping regulations and a week after the Metropolitan Transportation Authority released a five-year capital plan that favors the Long Island Rail Road over Metro-North, the commuter rail that connects New York City to Connecticut. (Pazniokas, 9/24)

Home delivery of marijuana and the idea of establishments where adults could use marijuana together in a social setting cleared their final regulatory hurdles Tuesday, though it will be months or more until either activity gets underway in Massachusetts. (Young, 9/24)

Legal marijuana deliveries are set to begin next year in Massachusetts, after the Cannabis Control Commission voted 4-1 Tuesday to grant final approval to a tightly regulated system of store-to-door pot commerce that initially gives priority to smaller, local businesses.Commissioner Jen Flanagan cast the lone “nay,” citing public health and safety concerns. (Adams, 9/24)

“The most dangerous of wealthy nations for a child to be born into.” That’s how global health researchers characterized the United States in a January 2018 report published in Health Affairs that sounded alarm bells about the country’s high infant mortality rate. U.S. babies, they found, were three times as likely to die of premature birth and 2.3 times as likely to die of sudden infant death syndrome than infants in comparably rich countries. Anne Driscoll, a demographer and statistician at the Centers for Diseases Control and Prevention’s National Center for Health Statistics, has been analyzing possible causes for years and has previously looked at maternal age, the rural-urban divide and other factors. Driscoll and her colleague Danielle Ely teamed up in a report released Wednesday to delve into infant mortality in two of the country’s most impoverished regions: Appalachia and the Mississippi River Delta region. (Eunjung Cha, 9/25)

The California Health Care Foundation, working with researchers at the University of California, San Francisco, urged state legislators in a report released Wednesday to take bold steps to improve the quality of Medi-Cal managed care plans. ...Researchers and the foundation leaders pointed out that quality measures for for-profit health insurers paled, on average, when compared with those of nonprofit and public carriers, so the foundation advised lawmakers to “reconsider the role” that for-profit insurers play in the Medi-Cal arena. (Anderson, 9/25)

A joint public health initiative led by a drug-maker association, law enforcement and public health officials will make 800 prevention kits available to homes to reduce youth access to prescription drugs. The Capital Area Public Health Network made the announcement Tuesday that a $38,000 grant from the Rx Abuse Leadership Initiative (RALI) gives it enough money to buy the kits and market their availability. (Landrigan, 9/24)

State officials are urging residents to be cautious after a second Connecticut resident died of Eastern Equine Encephalitis, a rare but serious illness caused by mosquito bites. The second patient, who lived in Old Lyme, was described as an elderly person. Officials did not release the resident’s name or age. (Carlesso, 9/24)

Virginia is rolling out a new initiative intended to reduce the need for law enforcement agencies to transport people for treatment of a mental health crisis. Local newsoutlets report the Virginia Department of Behavioral Health and Developmental Services gave lawmakers a new look at the new transportation service that will be available soon. Under the program, some people under temporary detention orders who otherwise would be transported in the back of a police car, possibly handcuffed, will ride unrestrained apart from a seat belt in an unmarked Dodge Durango. (9/24)

Four southern Ohio doctors, including one from Green Township, were charged Tuesday in connection to several alleged "pill mills" and health care fraud schemes, according to a news release from the U.S. Department of Justice. George Griffin, 70, Thomas Romano, 69, Troy Balgo, 53, and Freeda Flynn, 66, were four of 13 individuals charged in the second coordinated law enforcement action of the Appalachian Region Prescription Opioid strike force. (Mitchell, 9/24)

The city spent four hours in federal court on Tuesday defending its 2017 law banning so-called conversion therapy from a legal challenge mounted by a Christian evangelical legal advocacy group.U.S. District Judge William Jung said he’ll issue a ruling by Oct. 4 on whether Tampa’s ban is legal. (O'Donnell, 9/24)

The New York City Council is going to repeal its a ban on gay conversion therapy over concern the Supreme Court could end up reversing the law. Gay conversion therapy is the practice of trying to change a person's sexual orientation from gay to straight. It’s been discredited by the American Psychiatric Association, among other organizations, but it’s still legal in more than 30 states. (Hobson and Hagan, 9/24)

Democratic Senate and House leaders have reached a budget agreement with Gov. Chris Sununu, capping three months of partisan jockeying and weeks of intensive meetings, officials announced Tuesday. With hours to spare ahead of a session of the full House and Senate on Wednesday, top officials released a blueprint of a budget agreement they say they’ll bring before lawmakers tomorrow. (DeWitt, 9/24)

In a rare criminal action against a senior care facility, the state’s top prosecutor has filed dozens of criminal charges against the staff and former owner of a northern Minnesota senior home where residents were allegedly beaten, robbed and denied vital medical care. The assisted-living facility, Chappy’s Golden Shores of Hill City, Minn., had its license revoked early this year after an investigation by the Minnesota Department of Health found multiple violations of state care regulations. (Serres, 9/24)

A cluster of three suicides in less than a week among one ship’s crew has shocked the United States Navy, raising questions about why the suicide rate in the service has climbed sharply in recent years, despite sustained efforts at prevention. The three deaths were all sailors assigned to the aircraft carrier George H.W. Bush, which is in dry dock in Norfolk, Va., for extensive repairs. (Philipps, 9/24)

It never fails to astonish when some Americans say they prefer paying the highest healthcare prices in the world and having millions of people uninsured rather than adopt effective approaches to affordable universal coverage found in nearly all other developed countries. My recent column on a Valley Village woman who was charged $200 for a cloth sling for her dislocated shoulder — a price tag about 900% more than similar slings found on Amazon — touched a nerve with many readers. (David Lazarus, 9/24)

When Paul DeWolfe needed back surgery, he was careful to make sure his hospital in St. Cloud, Minnesota, was in his insurer's network. He figured his portion of the bill would run to about $3,000, he told KARE 11 TV of Minneapolis. So you can imagine DeWolfe's surprise when his actual bill came to $18,590.83. While his hospital was in-network, some of the doctors who treated him were not. Surprise medical bills are not new. (9/23)

Juul Labs, the leading e-cigarette maker, says it has long been upfront about its determination to keep young people away from its vaping products. That’s what the San Francisco company says, anyway. But its advertising strategy has assiduously cultivated young consumers, with great success. That’s the finding in a series of studies from Stanford University that have turned a spotlight on how Juul exploited social media and the tastes of young adults to target a youth market. (Michael Hiltzik, 9/24)

Cancer therapeutics have become a big business for the pharmaceutical industry. Since 2013, cancer drug expenditures in the United States as a percentage of total U.S. prescription spending has increased by almost 60 percent, and the number of cancer drugs in late-stage trials increased more than 60 percent during the same time frame. Major pharmaceutical houses such as Pfizer, GlaxoSmithKline and AstraZeneca are reportedly “pivoting to cancer.” As well as big business, it is a saga full of celebrities and drama, framed by truly heart-wrenching stories and featuring calls for what then-Vice President Joe Biden called a cancer “moonshot” after his son Beau passed away in 2015. Although efforts to declare “war on cancer” go back to the Nixon administration, they have yielded less than one might expect. (Robin Feldman, 9/24)

By some measures, this was a thrilling year of accomplishments for the cancer field. From Aug. 1, 2018, to July 31, 2019, the U.S. Food and Drug Administration (FDA) approved 27 cancer treatments. This is the highest number ever reported in the nine editions of the annual Cancer Progress Report. ...But overall figures show that we still have work to do. Today in America, the overall cancer mortality rate is 161 per 100,000 people per year. For whites, the rate is 161.5 per 100,000, and for blacks, the death rate is 185.6 per 100,000. A look beneath the surface shows that cancer health disparities cut across racial, ethnic, socioeconomic, gender, sexual, and geographic lines, and they influence every element of cancer risk, diagnosis, and treatment. (Elaine Mardis, 9/23)

Many industries have been affected by the Trump administration’s escalating trade war, from agriculture to technology. Few people are talking about the problems faced by small biotech companies and researchers who are unable to move forward with their research due to restrictions on foreign investments. (Mahesh Narayanan, 9/25)

In a recent profile, Jonathan Van Ness of “Queer Eye” courageously shared his story as an “out-and-proud ‘member of the beautiful H.I.V.-positive community’” who has remade his life after experiencing childhood sexual abuse, drug addiction and shame. As a sociologist who has spent more than a decade interviewing women who are living with H.I.V., I saw in Mr. Van Ness’s story the larger social and political urgencies of the epidemic. (Celeste Watkins-Hayes, 9/24)

Humankind knows no greater tragedy than the death of a small child. Thanks to quiet but powerful progress in public health, that tragedy is far less common than it once was — including in the planet’s developing regions. As recently as 1990, the global annual rate of death for children under the age of 5 was 82 for every 1,000 live births. Last year, that rate was 37 per 1,000 live births. If the present trend continues, the rate could reach 28 by 2030. And with additional effort from private agencies and governments, it could fall even further, hitting the target, 25 per 1,000, set under the United Nations’ Sustainable Development Goals. (9/24)

With medical marijuana about to be legalized, Missouri doctors are issuing certifications that will allow patients to fill their prescriptions starting next year. We still think Missouri voters made the right decision to legalize medical marijuana, but it’s also important that the letter of the law still applies.The temptation will be high (no pun intended) for people to obtain prescriptions even if they have no valid medical reason to use marijuana. (9/24)

The businesses that lobbied the state Legislature over measures that would help or harm them know their work isn’t done just because the lawmakers have cast their votes and gone home for the year. There’s still Gov. Gavin Newsom’s signature or veto to be won. Among the players stepping forward is the American Kidney Fund, which paints itself as a charity devoted impartially to helping patients facing the torment and expense of dialysis. The fund’s target is a bill passed Sept. 10 that would cap the profits enjoyed by corporate dialysis providers and impose disclosure requirements on third parties, like the fund, that help dialysis patients afford their insurance. (Michael Hiltzik, 9/24)