Must-Reads Of The Week From Brianna Labuskes

Happy Friday! Have drug prices gotten so bad that patients are now turning to robbing banks to afford them? It sounds like something out of a movie script, but it’s what a Utah man told police when he was accused of just that. While it’s unverified whether he, in fact, had any prescriptions, it doesn’t seem like much of a stretch for anyone paying attention to the state of drug prices in this country.

On to what you may have missed this week (including one of the wilder health stories I can recall reading in a while).

Lawmakers were busy, busy bees this week with hearings on health care issues.

The moment that drew perhaps the biggest spotlight was almost cinematic: A furious Jon Stewart took members to task in an almost nine-minute display of pointed, nonpartisan outrage over their feet-dragging on health care funding for 9/11 first responders and victims. Why is this “so damn hard?” the comedian asked. Firefighters, police and other first responders “did their jobs with courage, grace, tenacity and humility,” Stewart said. “Eighteen years later, do yours.” A bill allocating money to the fund for 70 years passed the House panel following the hearing.

The Associated Press: Jon Stewart Lashes Out at Congress Over 9/11 Victims Fund

The New York Times: How Jon Stewart Became a Fierce Advocate for 9/11 Responders

Reuters: House Panel Approves Permanent Sept. 11 Victims’ Compensation

But it wasn’t just made-for-TV drama on Capitol Hill this week. There was a flurry of activity related to health care. Here are some of the highlights, including a hearing on universal health coverage, which was heavy on fiery political rhetoric and light on substance:

The Hill: House Democrats Vote to Overturn Trump Ban on Fetal Tissue Research

CNN: Medicare for All Hearing Turns Into a Defense of Obamacare

Modern Healthcare: Arbitration for Surprise Medical Bills Splits House Panel

The Hill: Pelosi to Change Drug-Pricing Plan After Progressive Complaints

The Hill: Democrats Scuttle Attempt to Strike Hyde Amendment From Spending Bill

The Hill: House Panel Launches Investigation Into Juul

Even if “Medicare for All” were to overcome the daunting political hurdles lying in its path, it’s likely it would face so many legal challenges it could be bled out before it’s ever implemented. “There could be a death by a thousand-lawsuits approach,” Georgetown law professor Katie Keith told Politico. Other experts note, though, that there’s a difference between forcing someone to buy a product and banning something, which makes Medicare for All less vulnerable legally than the health law.

Politico: ‘Death by a Thousand Lawsuits’: The Legal Battles That Could Dog ‘Medicare for All’

Over in Chicago at the American Medical Association’s annual meeting, a medical student-led push to get the organization to reverse its decades-long opposition to single-payer health care failed. But, there’s more to it than that! A fabulous thread on Twitter from Bob Doherty of the American College of Physicians explains how the fact that the vote percentages were so close is remarkable in and of itself. The outcome would have been “unimaginable” in years past, he says.

The Hill: Major Doctors Group Votes to Oppose Single-Payer Health Care

And read Doherty’s thread here.

When premiums shot up over the past several years, more and more people turned to health care sharing ministries — which essentially connect people of similar faiths and set up a cost-sharing arrangement among the members. Because these models are not technically insurance, they’re allowed to skirt health law regulations and aren’t regulated by state commissioners. All of that was seen as a point in their favor from supporters at the time they joined them. But now it means that when bills aren’t paid on time, or at all, consumers have little recourse and officials’ hands are tied in holding the organizations responsible for their promises.

The Wall Street Journal: As Sharing Health-Care Costs Takes Off, States Warn: It Isn’t Insurance

Meanwhile, the Trump administration continues to chip away at the health law with its latest rule on health reimbursement arrangements, which will allow small firms to use tax-free accounts to help workers pay for insurance.

The Hill: Trump Officials Issue New Rule Aimed at Expanding Health Choices for Small Businesses

If you took anything away from last week’s drama over former Vice President Joe Biden’s stance on the Hyde Amendment it was probably that it seems the parties are dead set on their positions on abortion. But a look at how the public feels about the issue reveals blurred lines and nuance that doesn’t always fit into pat sound bites and political declarations. Many Americans struggle with the moral complexities surrounding abortion and their opinions can change from one question to the next, depending on the wording.

The New York Times: Politicians Draw Clear Lines on Abortion. Their Parties Are Not So Unified.

A new poll does show, however, that despite the ever-increasing threat to Roe v. Wade a strong majority of Americans don’t want to see it overturned.

NPR: Abortion Poll: Majority Wants to Keep Abortion Legal, but With Restrictions

Actress Jessica Biel ignited a firestorm of criticism after speaking out about a controversial California bill that would give a state official the final say on medical exemptions from vaccines. Once the blaze was lit, Biel tried to clarify that her issue was not with the vaccines themselves, but rather with the legislation introducing bureaucrats into the process. California’s governor has even hinted at similar concerns. The blowback, though, highlights how inherently inflammatory the topic has become as measles cases continue to climb across the country.

The New York Times: Here Is What Jessica Biel Opposes in California’s Vaccine Bill

In New York — the state at the heart of the record-busting measles outbreak — lawmakers passed a bill banning religious exemptions to vaccines. The governor signed it minutes later.

The Associated Press: New York Set to Cut Religious Exemption to Vaccine Mandates

I have kept you on tenterhooks long enough! One of the wilder health stories I’ve read in a long time comes from gruesomely fascinating Arizona Republic reporting. It’s a look into the thriving for-profit world of whole-body donations following death. Critics deem the practice as no better than “back alley grave robbing.” “There’s a price list for everything from a head to a shoulder, like they are a side of beef. They make money, absolutely, because there’s no cost in getting the bodies,” lawyer Michael Burg told The Arizona Republic. Supporters, however, see it as an affordable way to dispose of the remains of loved ones (which can actually be very expensive for low-income families).

Either way, it garnered my favorite quote of the week, asked by one potential donor: “Will I have a head in heaven?”

The Arizona Republic: Arizona Is a Hotbed for the Cadaver Industry, and Potential Donors Have Plenty of Options

The Arizona Republic: Despite 2-Year-Old State Law, Arizona’s Body Donation Industry Still Unregulated

In a move that left Flint, Mich., residents stunned and frustrated, prosecutors dropped all criminal charges against officials over the city’s water contamination crisis. Although prosecutors said the old investigation was bungled and there will be new charges, the announcement came like a fist to the jaw to people who already have had their faith in the government shattered.

Detroit Free Press: All Flint Water Crisis Criminal Charges Dismissed by AG’s Office

In the miscellaneous file this week:

• If you ever think you’re having a bad day at work, read this story about how an employee’s small photocopier mishap triggered a series of events that undermined a pair of late-stage clinical trials and ultimately scrapped a development deal between pharma companies.

Stat: How a Mishap at a Photocopier Derailed Clinical Trials and a Development Deal

• I am fascinated by the anatomy of pandemics, and this is a great tick-tock of the start of the last one. They don’t play out as they would in Hollywood, but, to me, the reality is even more interesting (I can’t be the only one, right?!).

Stat: The Last Pandemic Was a ‘Quiet Killer.’ Ten Years After Swine Flu, No One Can Predict the Next One

• World health officials have been begging farmers to stop using antibiotics on healthy farm animals in an effort to combat the ever-looming threat of resistance (which, as you know, terrifies yours truly). The farmer,s though, also have drugmakers whispering in their ears — despite a public facade from pharma of wanting to help combat the problem.

The New York Times: Warning of ‘Pig Zero’: One Drugmaker’s Push to Sell More Antibiotics

• Are you a sufferer of “white coat hypertension”? You might think it’s just because you get stressed out when you visit the doctor (join the club!), but a study shows that those anxiety-induced numbers are linked to an increased risk of a cardiac event.

Stat: Those With ‘White Coat Hypertension’ More Likely to Die From Cardiac Events

That’s it from me! Have a great and restful weekend. (Truly, insomnia can kill!)

Kaiser Health News


Must-Reads Of The Week From Brianna Labuskes

Happy Friday! This week brought us one of the most perfect click-bait stories in recent memory — each part of it adding to the what on earth? feeling you get reading it. Click here for what it was. (Just kidding!) Apparently, New York’s Medicaid program has paid nearly $ 60,000 for erectile dysfunction drugs for … wait for it … sex offenders. (The less click-bait-y part: State officials say those drugs can treat a broad range of problems, and dismissed much of the criticism.)

Now on to what else you may have missed.

2020 hopeful and former Vice President Joe Biden set off a political firestorm early in the week when his campaign clarified that he supports the Hyde Amendment, a provision that states that Medicaid cannot pay for an abortion unless the woman’s life is in danger or the pregnancy resulted from rape or incest. (Feeling hazy on the details of the amendment? The New York Times has you covered.)

Biden’s rivals were quick to condemn the comments and were joined by abortion rights groups in pointing out that it is the most vulnerable women who are affected by the amendment. Biden reversed course, citing current threats to Roe v. Wade and saying “times have changed.” But with abortion at center stage in the national conversation, his opponents are unlikely to let voters forget Biden’s original stance (which, he says, he makes no apologies for).

The New York Times: Joe Biden Denounces Hyde Amendment, Reversing His Position

The Trump administration took steps this week to restrict fetal tissue funding and research in another win for the president’s anti-abortion supporters. HHS has discontinued all internal research that involves fetal tissue. Outside projects that receive government funding will continue but require approval from an ethics board if they’re up for renewal. The behind-the-scenes decision-making was apparently somewhat heated, according to Politico’s reporting. White House officials wanted an outright ban, while HHS Secretary Alex Azar sought to allow current research to go forward.

Scientists were dismayed by the decision, saying that fetal tissue research is at the root of medical breakthroughs across a spectrum of diseases.

Politico: Pushed by Anti-Abortion Groups, HHS Restricts Fetal Tissue Research

Residents in a small Colorado town who were sick of playing David to the Goliath of health care costs banded together to become their own version of a giant — or at least a slightly bigger David. The residents formed what could be a first-of-its-kind alliance that brings businesses and individuals together to collectively negotiate prices from hospitals and doctor groups before getting any insurance company involved. The alliance went to different systems and asked, “What kind of deal will you give us?” That seemed to work. According to the group, participating members could see premium prices 20% lower. In a world where the patient often is left with almost zero leverage, this model might flip that on its head.

The Colorado Sun: How Summit County Residents, Fed Up With High Health Care Prices, Banded Together and Negotiated a Better Deal

As this and countless other stories about our unsustainable system show, health care will be a potent topic in the 2020 elections with the potential to woo single-issue voters. Have any of the candidates struck on a winning formula to do so?

“No one’s found the magic fairy dust yet,” said Rep. Greg Walden (R-Ore.), which seems to sum up the current state of affairs fairly well. Health care is complicated, after all.

The Wall Street Journal: American Voters Have a Simple Health-Care Message for 2020: Just Fix It!

Meanwhile, the first proposed rate hikes for health law plans rolled in this week and they are … not terrible. Not the world’s most ringing endorsement, but experts took heart that it’s just one more sign the marketplace is stabilizing. To be fair, those increases are likely moderate because of how much insurers overcompensated in years past. But they do offer hope that last year’s numbers weren’t a fluke and the era of eye-popping hikes is history.

Politico: Obamacare Rate Hikes Appear Modest for 2020

And a quick note: KHN launched its new partnership with the podcast “An Arm and a Leg,” which, as you can probably work out from the title, explores painful high health care costs.

Kaiser Health News: ‘An Arm And A Leg’: They Thought They Had ‘Adulted’ Properly

A new report released by Pennsylvania’s senators shows that the federal government has been keeping a hidden list of the names of hundreds of nursing homes around the country found by inspectors to have serious ongoing health, safety or sanitary problems. CMS does disclose a smaller list of about 80 nursing homes that are getting special scrutiny, but they seem indistinguishable from the ones on the long roster. In response to the criticism, CMS announced it will start posting the extended version publicly.

The Associated Press: Government to Start Posting List of Troubled Nursing Homes

Skeptical lawmakers and veterans’ advocates looked on as the VA implemented its expanded privatized care program Thursday. Although veterans were warned there could be “a few hiccups,” VA Secretary Robert Wilkie said he was confident in his team to handle the rollout.

The New York Times: V.A. Prepares for Major Shift in Veterans’ Health Care VA Secretary Confident June 6 Rollout of Private-Care Options Will Be Smooth

In 2015, Pfizer realized that its rheumatoid arthritis drug appeared to cut the risk of Alzheimer’s in those who took it by 64% — an astounding and startling discovery in a field riddled with heartbreaking disappointments. But the world was never told about it because the company opted out of running a clinical trial, calling it a dead end. Critics say the decision had more to do with the fact the drug’s patent is expiring and Pfizer wants to put its market muscle behind a new drug rather than an old one. Wagering money on a clinical trial that the company’s leaders had doubts about anyway did not show good business sense.

The Washington Post: Why Pfizer Didn’t Report That Its Rheumatoid Arthritis Medication Might Prevent Alzheimer’s

And read the story of the man behind one of those legions of disappointments in Alzheimer’s research, including an engrossing tick-tock of the day he was told about the results of his promising study.

Stat: A Celebrated Drug Hunter Went After Alzheimer’s. Here’s How He Lost

The opioid crisis has created a “Generation O” — kids who consider it normal to be dealing with their parents’ debilitating addiction as that’s all they’ve known. They’re trapped in a life of begging parents not to use drugs, finding them passed out or worse, dealing with days-long disappearances, all at the mercy of the financial insecurity that comes with opioid abuse. The psychological ramifications for these kids growing up in the heart of an epidemic are likely to be wide-reaching.

The New York Times: ‘Become My Mom Again’: What It’s Like to Grow Up Amid the Opioid Crisis

In the miscellaneous file this week:

• In a check on human hubris, a study finds that people with the genetic mutation to protect against HIV — which the Chinese scientist who edited embryos was trying to mimic — actually leads to a shorter life span overall. (It’s almost as if there are best practices on ethics in place to protect against that.)

NPR: Chinese CRISPR Experiment May Increase Twins’ Risk of Early Death, Study Finds

• At its worst, the booming stem cell industry can be a Wild, Wild West of unscrupulous snake oil salesmen luring patients into trying untested treatments. But the lawless landscape might have some sheriffs to contend with soon. A federal judge just granted FDA authority to regulate one of the more dangerous of the popular procedures performed by the clinics.

The New York Times: F.D.A. Can Act Against Stem Cell Clinic, Judge Rules

• A study finds that states that expanded Medicaid under the health law were able to chip away at some of the racial disparities surrounding cancer care.

The Associated Press: Study: More Blacks Got Timely Cancer Care After ‘Obamacare’

• As genetic testing becomes more widespread, parents are learning that the sperm donor they spent a long time deliberating over is not necessarily the one they got. The anecdotes piling up raise questions about whether the sperm bank industry should be tighter regulated.

The New York Times: Their Children Were Conceived With Donated Sperm. It Was the Wrong Sperm.

• Do political threats amount to anything or are they all bluster? A look at how the Republicans who voted to expand Medicaid tell a story of the latter.

The Washington Post: Medicaid Expanders in Virginia Mostly Escape Primary Challenges

Have a great weekend!

Kaiser Health News


Must-Reads Of The Week From Brianna Labuskes

[UPDATED at 2:55 p.m. ET]

Happy Friday! I come bearing a medical ethical quandary for you to mull as you head into your weekend. Stumped mid-surgery, a renowned doctor turned to old anatomical drawings that had been created by Nazis (and are, to this day, considered unsurpassed in comprehensiveness and precision). She was left with the question: Were they OK to use?

Now on to what you may have missed this week.

If you thought the topic of abortion was going anywhere anytime soon, you’d be very wrong! (Although, let’s be honest, were any of us expecting an end to the debate?) In terms of health care, it dominated this week’s news cycle.

Let’s start with 2020 hopeful Sen. Kamala Harris’ plan to protect abortion rights. Borrowing logic from the Voting Rights Act, the plan from Harris (D-Calif.) would require states with a history of unconstitutionally restricting abortion rights to obtain federal approval from the Department of Justice before such laws could take effect. Where it gets tricky is determining which states would fall under the requirements: the formula used in the VRA was ruled unconstitutional by the Supreme Court in 2013.

The New York Times: Kamala Harris Wants to Require States to Clear Abortion Laws With Justice Dept.

Meanwhile, the Supreme Court performed a delicate dance on a tightrope when it ruled on an Indiana abortion ban. The justices upheld parts of the law, which dictate that fetal remains need to be buried or cremated, but they went ahead and sidestepped ruling on the constitutionality of the right to an abortion. The move signals that they might not be super eager to move aggressively on the issue, despite the way states keep trying to send them cases.

The New York Times: Supreme Court Sidesteps Abortion Question in Ruling on Indiana Law

Speaking of … Louisiana’s Democratic governor broke with his party this week to sign “heartbeat” legislation. Though it wasn’t a surprise (Gov. John Bel Edwards has been vocal about his support of the bill), it’s notable in a political landscape where many are left wondering if there’s any room left in the Democratic Party for anti-abortion politicians.

The Associated Press: Louisiana’s Democratic Governor Signs Abortion Ban Into Law

Although many people do have their eyes on the cases that are designed to challenge Roe v. Wade, an argument can be made that abortion opponents have already won the ground game. Even if Roe is upheld, opponents have taken enough bites of the apple over the past several years that the landscape looks a lot different than it once did. Considering mandatory waiting periods, clinic deserts, the missed wages and work that comes with traveling to get the procedure done, and the hostility that doctors and clinic staff face from protesters, for a lot of women — low-income women, especially —getting an abortion is already a monumental task.

Politico: Even If Roe Is Upheld, Abortion Opponents Are Winning

Hours before Missouri’s last remaining abortion clinic would have had to shutter, a judge issued a temporary order Friday ensuring that the St. Louis Planned Parenthood facility could continue to provide abortions, for now. Another hearing is set for Tuesday.

The Associated Press: Judge’s Order Means Missouri Clinic Can Keep Doing Abortions

As President Donald Trump prepares an executive order geared toward increasing transparency across the health industry, some parties are making such a ruckus over a particular element that it might get dropped in the final version. At issue is a requirement that insurers and hospitals disclose for the first time the discounted rates they negotiate for services. “There is good transparency and bad transparency,” Kristine Grow, spokeswoman for America’s Health Insurance Plans, told The Washington Post. “This is bad transparency, because it is highly likely to cause prices to go up for everyone.”

The Washington Post: White House Runs Into Health-Care Industry Hostility as It Plans Executive Order

And elsewhere on the unhappy insurers front: Connecticut lawmakers have pressed pause on their push for a public option. The reason? Blowback from insurers. While I’m sure it’s more complicated than I’m making it, I was left wondering if the lawmakers had thought insurers were going to like it.

The Wall Street Journal: Connecticut’s Public Health Bill Stalls on Industry Concerns

HHS is proposing to roll back protections for transgender patients by mandating that “gender identity” is not protected under federal laws that prohibit sex discrimination in health care. A court challenge is almost certain, and patients are unlikely to feel any immediate impact from the proposal. But advocates see it as another move in the administration’s attempts to chip away at transgender rights.

The Associated Press: Administration Moves to Revoke Transgender Health Protection

A major opioid trial kicked off this week in Oklahoma with some fighting words thrown out by state Attorney General Mike Hunter. Hunter accused Johnson & Johnson — which is the sole remaining plaintiff in the case after the other companies settled — of using a “deceitful, multibillion-dollar brainwashing campaign’’ to dupe doctors into prescribing the opioids. The tricky part of the case is that painkillers are regulated and approved medication, and pinning the crisis on one company might be an uphill battle for the attorney general’s office. Still, the eyes of the nation are on the trial as a precursor to larger ones that are coming up.

Bloomberg: Oklahoma Opioid Trial Against Johnson & Johnson Begins

On Memorial Day (yes, it was this week, doesn’t it feel like ages ago?), the Army sent out a tweet asking veterans about how their service has affected them. The responses may not have been what officials were anticipating, though. Many vets wrote in about their mental health struggles with PTSD, creating a conversation about some of the darker aspects of returning home.

The New York Times: U.S. Army’s Tweet Prompts Stories of Harmful Effects of Military Service

Separately,  2020 hopeful Rep. Seth Moulton, a military veteran, shared his experiences with PTSD as he released a plan that would require mandatory mental health care checkups for returning military personnel.

Politico: Seth Moulton Discloses PTSD, Unveils Military Mental Health Proposal

And, not everyone comes home with PTSD. Can the ones who don’t teach us about caring for the ones who do?

The New York Times: I’m a Veteran Without PTSD. I Used to Think Something Was Wrong With Me.

How much is a miracle worth? That’s the question on the front burner once again now that the FDA has approved the world’s more expensive drug (with a price tag of over $ 2 million). Experts say it’s not so much the drug itself that’s the problem, but that it sets a new, higher benchmark for what people will end up paying for lifesaving drugs. Because there are plenty more coming behind it.

The Associated Press: At $ 2M, Priciest Ever Medicine Treats Fatal Genetic Disease

In the miscellaneous file for the week:

• Check out this fascinating and terrifying story about a children’s hospital where even low-risk patients were dying after surgeries. Audio obtained by The New York Times gives an unfiltered look at conversations between the doctors, which can boil down to: “Oh, my God … this is beyond horrifying.”

The New York Times: Doctors Were Alarmed: ‘Would I Have My Children Have Surgery Here?’

• A Chicago nursing home’s debacle shines a light on the vulnerabilities of a HUD program that has become a linchpin in the nation’s elder care system. It’s a program that most people don’t even realize exists but could be an Achilles’ heel for the government.

The New York Times: A Nursing Home Chain’s Collapse Leaves the Government on The Hook

• In a world where “Oh no, females are so complicated, so we just don’t study them” is a normal and expected thing to say, some researchers are trying to fight for more representation in clinical trials. But just saying there should be X number of women isn’t enough. Scientists need to go further, some say.

The New York Times: Fighting the Gender Stereotypes That Warp Biomedical Research

• Why is it Republicans who are gravitating toward the anti-vaccination movement? In the past, the party viewed it as a civic responsibility to get kids vaccinated, while resistance more often came from liberal enclaves. Today, the debate is becoming entangled with the idea of freedom from the government — and is wooing some Republicans.

Politico: How the Anti-Vaccine Movement Crept Into the GOP Mainstream

That’s it from me! Have a great weekend.



Kaiser Health News


Must-Reads Of The Week From Brianna Labuskes

Happy Friday! I think women huddled in blankets across the nation felt vindicated by a new study that found those gender-based battles over the thermostat that seem commonplace in every office aren’t just about comfort. As rooms warm, so do women’s math and verbal test scores. Will this be the end of the temperature wars? Unlikely, but one can hope!

Now on to what you may have missed this week as you get ready to head off into your Memorial Day (traffic).

Sens. Lamar Alexander (R-Tenn.) and Patty Murray (D-Wash.) — famously known for their ability to produce bipartisan legislation together — released a wide-ranging (and when I say wide-ranging, I mean it) package of bills aimed at curbing health care costs. Their plans for surprise medical bills stole the spotlight because it’s the issue du jour on Capitol Hill, but there’s plenty else in there as well. Here are the highlights:

• The draft doesn’t settle on the best way to handle surprise medical bills, but rather gives three options that have been circulating since the debate started: using an arbitrator, price-setting for out-of-network doctors and having hospitals considered “in-network” for a health plan promise that everyone working there is also in-network.

• According to our friends from STAT, the package is “unexpectedly ambitious” and “surprisingly weighty” when it comes to lowering drug prices, including a measure to ban “spread pricing” — which is an industry practice that allows PBMs to pocket the difference between a pharmacy price and wholesale price from a drugmaker. The measures would also make it easier for generics to get to market and harder for brand-name drugs to maintain exclusive patents for lengthy periods.

• Other consumer protections included: a requirement that patients receive their bill within 30 business days, a ban on hospitals’ “gag clauses,” an order that hospitals could no longer hide certain anti-competitive contract features from the employer plans and a provision requiring health plans and providers to give patients estimates of out-of-pocket-costs for a service within 48 hours of a request.

Will some or any of it get done? It’s unclear, but those in the know say that people should be taking the package seriously.

Modern Healthcare: Healthcare Bill With Sweeping Fixes Unveiled in Senate

Stat: A New Senate Health Package Includes Surprisingly Aggressive Drug Pricing Reforms

Kaiser Health News: Sen. Alexander Releases Bipartisan Plan to Lower Health Costs, End Surprise Bills

The New York Times: Surprise Medical Bills Give Both Parties an Unexpected Opportunity to Agree

Is there room in the Democratic Party for a lawmaker who holds an anti-abortion stance? The Democratic Congressional Campaign Committee chief’s decision to back out of a fundraiser for Rep. Daniel Lipinski of Illinois threw a spotlight on that very question this week as tensions run high around the hot-button issue.

The New York Times: Canceled Fund-Raiser Prompts Question: Can a Democrat Oppose Abortion?

The wave of anti-abortion legislation across the country may seem like a united, well-coordinated effort from a “master planner,” but people inside the movement said it’s less about one person’s strategy and more about feeding off one another’s momentum. The New York Times takes a look at the network of disparate activists who have brought the country the closest it has been to overturning Roe v. Wade.

The New York Times: Inside the Network of Anti-Abortion Activists Winning Across the U.S.

Meanwhile, a coalition of states is suing over an expanded Trump administration rule that allows health care personnel to refuse to perform certain procedures, such as abortions, for religious or moral reasons.

The Associated Press: States Sue Over Rule Allowing Clinicians to Refuse Abortions

2020 hopefuls Sens. Kamala Harris (D-Calif.) and Kirsten Gillibrand (D-N.Y.) both offered up legislation this week aimed at improving maternal care, a topic that has gotten more attention recently following a bevy of high-profile statistics on the grim reality for U.S. women. Harris’ bill would target racial disparities — black women are three to four times more likely than white women to die during childbirth — while Gillibrand’s would make adoption and in vitro fertilization more affordable and provide government-sponsored “baby bundles” to new parents.

The Associated Press: Harris, Gillibrand Offer Plans to Bolster Maternal Care

On that note, an analysis by USA Today has found that despite more than a decade of guidance that has called for performing episiotomies (a procedure that cuts the vagina to create more room for the baby) only in cases of emergencies, they’re still being done at startlingly high rates.

USA Today: Episiotomies Are Painful, Risky and Not Routinely Recommended. Dozens of Hospitals Are Doing Too Many.

Vice President Mike Pence might fly a little under the radar in an administration dominated by big personalities and scandals, but, if you look closely, you can see his fingerprints all over the Department of Health and Human Services. Politico has an excellent story about the sphere of influence that Pence has created at the agency and how he has directed its course to address some of his top priorities.

Politico: How Mike Pence Took Over HHS

Over at the Department of Housing and Urban Development, officials are working to roll back protections for homeless transgender people. The new proposal would allow HUD-funded providers of shelters to consider a person’s sex or gender identification in determining whether they can be admitted.

Politico: HUD Moves to Allow Discrimination Against Homeless Transgender People

How do you erase thousands of pollution-related deaths a year? Change the math. The Environmental Protection Agency plans to alter the way it calculates the health risks of air pollution, which means the death rate will look better on paper but not in reality.

The New York Times: E.P.A. Could Make Thousands of Pollution Deaths Vanish by Changing Its Math

The Oklahoma opioid trial kicks off next week and is likely to draw the attention of a lot of interested parties. The hearing is the first public trial to emerge from roughly 2,000 lawsuits aimed at holding drugmakers accountable for their alleged role in the nation’s raging opioid crisis. To borrow a phrase from former Vice President Joe Biden: It’s a big … deal.

Stateline: Nation’s First Opioid Trial Promises Long Odds, High Drama

Speaking of Biden, the former vice president and 2020 presidential hopeful’s complicated history with the “War on Drugs” is likely to haunt his campaign trail as he tries to win over the areas in the country hit hardest by the opioid epidemic.

Politico: How Joe Biden’s Drug Policies Supercharged the Opioid Crisis

Which highlights the fact that even though the Trump administration has faltered and taken missteps while handling the epidemic, we didn’t get into this problem overnight. President Barack Obama’s administration made critical mistakes as the fentanyl-driven crisis was in its infancy.

The Washington Post: Trump Administration Struggles to Confront Fentanyl Crisis

It might surprise you that the second congressional hearing on “Medicare for All” this year is this far down in the newsletter, but it demonstrates how little came out of it. Congressional Budget Office officials once again equivocated about costs, reiterating that “Medicare for All” would probably cover more people and also be disruptive. (Revolutionary, I know.) And lawmakers on both sides stuck to their talking points.

The Hill: CBO: Medicare For All Gives ‘Many More’ Coverage but ‘Potentially Disruptive’

On the same day officials confirmed the death of a sixth immigrant child in U.S. custody, lawmakers were on the Hill trading barbs with Kevin McAleenan, the head of U.S. Customs and Border Protection, over the fatalities.

The Associated Press: House Hearing Grows Heated Over Migrant Children’s Deaths

In the miscellaneous file for the week:

• A NYT story that looks at a quiet public health crisis in California and includes one of my favorite quotes for the week: “Clean water flows toward power and money.”

The New York Times: They Grow the Nation’s Food, but They Can’t Drink the Water

• A new study presented some depressing statistics about rural Americans’ financial security, including that: 40% struggle with routine health, housing and food bills; about half could not afford an unexpected $ 1,000 expense of any type; and a quarter of respondents had trouble accessing needed health care in the past several years.

NPR: Day-to-Day Financial Insecurity a Burden for People in Rural Communities

• Although much of the conversation around the measles outbreak revolves around the vocal anti-vaccination movement, there’s another reason kids aren’t getting their shots: poverty.

NPR: The Other Reasons Kids Aren’t Getting Vaccinations: Poverty and Health Care Access

• Board-and-care homes for older Americans are making their owners into multimillionaires while the workers are being paid a shamefully low wage.

Reveal/The Associated Press: Elder Care Homes Rake in Profits as Workers Earn a Pittance

• Heroin’s presence is disappearing from East Coast enclaves, where it used to thrive. But that’s not necessarily a good thing (at least for some people).

The New York Times: In Cities Where It Once Reigned, Heroin Is Disappearing

Have a great and restful holiday weekend!

Kaiser Health News


Must-Reads Of The Week From Brianna Labuskes

Happy Friday! This week was so busy that I am going to take the unprecedented step and highly recommend you check out our Morning Briefings for the past few days. So many compelling, interesting stories didn’t make the cut for the Breeze, but they’re worth reading.

On to what you may have missed!

Well, this one you probably didn’t miss unless you were in the middle of the woods sans cellphone service: Alabama Gov. Kay Ivey signed legislation that effectively bans all abortions and criminalizes the procedure. The uproar that followed was immediate and ferocious — especially from 2020 Democrats who all but tripped over each other to denounce it as “shameless” and “outrageous” — but is the bill actually the threat to Roe v. Wade that it so dearly wants to be?

The measure is destined for the courts, certainly, but that doesn’t mean it will make it to SCOTUS. One likely outcome: The justices can simply refuse to take it up, leaving in place the lower courts’ decision (which will probably be that the law is unconstitutional). Chief Justice John Roberts is known for favoring incrementalism over sweeping decisions that would overturn nearly 50 years of precedent on a hot-button social issue.

But you need only four votes to get a case on the docket, which has court-watchers eyeing newbie Justice Brett Kavanaugh. His appointment helped galvanize the anti-abortion movement in the first place, but in the past he’s talked seriously about needing a compelling reason to overturn precedent. So far, he has disagreed with the hard conservatives more than people expected. So, the future for Alabama’s law remains uncertain.

What seems more likely is that the high court will instead look to less extreme, but still restrictive state laws (such as bills dictating the disposal of fetal remains and an 18-hour waiting period after state-mandated ultrasound examinations) that are heading toward them even as we speak.

No matter how it plays out, you can pretty much guarantee this is going to be a Big Deal on the campaign trail.

The New York Times: Alabama Aims Squarely at Roe, but the Supreme Court May Prefer Glancing Blows

The Associated Press: Alabama Law Moves Abortion to the Center of 2020 Campaign

The Wall Street Journal: States’ Abortion Curbs Put Supreme Court to the Test

A smattering of the other (dozens and dozens) of thoughtful stories from the past few days:

• What is it like living in a liberal city in the Deep South during times like this?

The New York Times: Abortion and the Future of the New South

• Missouri wants in on the action this week.

KCUR: How Missouri’s Senate Passed a Restrictive Abortion Bill Overnight

• A vote in deep-blue (and very Catholic) Rhode Island was overshadowed by Alabama’s news, but it highlights how nuanced and complicated the issue can be.

Boston Globe: In Rhode Island, Vote on Abortion-Rights Bill Reveals a Complicated State

• A lot of Senate Republicans are trying their best to nope out of this conversation, like “no thank you, not touching that with a 10-foot pole.”

The Hill: Senate Republicans Running Away From Alabama Abortion Law

• And a really handy look at what’s going on at the state level.

The Washington Post: The Widening Gap in Abortion Laws in This Country

House Democrats took advantage of their newfound power by tying a vote on reining in high drug prices to legislation shoring up the health law. The bill is destined to die, of course, but the move forced their Republican colleagues to go on record voting against something that voters care very, very deeply about.

The New York Times: House Passes Legislation Aiming to Shore Up Health Law and Lower Drug Costs

They also foreshadowed a potential subpoena with letters to Attorney General William Barr. Five powerful committee chairmen said that they’ve been asking since April 8 for documents connected to the Justice Department’s decision to stop defending the health law but haven’t received a sufficient response. They’re giving DOJ two more weeks before they consider “alternative means of obtaining compliance.”

Politico: Dems Tee Up New Document Fight With DOJ Over Obamacare

Meanwhile, a new Sunlight Foundation report found that the Trump administration has been systematically altering and eliminating information on the health law that’s on government websites.

Wired: The Trump Admin Is Scrubbing Obamacare From Government Sites

Surprise medical billing is truly the darling of Capitol Hill recently with all the attention it’s getting. Multiple variations of bipartisan duos and groups are working on introducing legislation to combat the issue. The most recent bill unveiled would protect patients from the surprise costs, and let an outside arbitrator settle any disputes between hospitals and insurers. Other proposals have instead favored a rate-setting method to solve payment issues.

The Hill: Bipartisan Senators Unveil Measure to End Surprise Medical Bills

The Hill: Dem House Chairman, Top Republican Release Measure to End Surprise Medical Bills

Attorneys general from 44 states have filed suit against pharma companies over allegations that “the generic drug industry perpetrated a multibillion-dollar fraud on the American people.” The lawsuit implicates 20 pharma firms following an investigation into allegations that the companies sought not only to maintain their “fair share” of the generic drug market through agreements with one another but also to “significantly raise prices on as many drugs as possible.”

The Associated Press: States Bring Price Fixing Suit Against Generic Drug Makers

Washington state took a big step this week in approving the creation of a public option — which would essentially look like a state-sponsored health plan. But now comes the hard part: making it work.

And don’t call it a game changer quite yet, experts say. Even sponsors of the legislation acknowledge the state plans may save consumers only 5-10% on their premiums. Still, the rollout will likely be watched closely as the progressive universal health care push grows stronger.

Politico: 5 Key Questions About the Country’s First Public Option

NPR: Washington State to Create ‘Public Option’ Health Care Plans

(If you feel like you need a refresher on all these terms — join the crowd, amiright? this one from NYT’s Margot Sanger-Katz is great.)

Rural hospitals, which sometimes fight literally hour by hour to afford to stay open, are in a crisis in this country, as evidenced by two amazing pieces this week on what happens to a town when one dies.

“If we aren’t open, where do these people go?” asked one hospital worker in The Washington Post’s coverage.

“They’ll go to the cemetery,” another employee answered. “If we’re not here, these people don’t have time. They’ll die along with this hospital.”

The Washington Post: ‘Who’s Going to Take Care of These People?’

Kaiser Health News: Dealing With Hospital Closure, Pioneer Kansas Town Asks: What Comes Next?

But I found a flicker of hope in a lovely story about how a one-room clinic in North Carolina just marked its 100th year.

North Carolina Health News: One Hundred Years in a Rural Clinic

Think this measles outbreak is big? (It is, by the way!) How about the one in 1990, which had more than 27,000 cases? In the past few months, I’ve read and written about the record 963 cases from 1994 more times than you can count but had no idea that just four years earlier it was that much higher. If you’re as intrigued as I was about how that changed, dive into NPR’s historical look at what exactly was going on at the time, and how public officials made so much progress so quickly.

NPR: How a Measles Outbreak Was Halted in the 1990s

In the miscellaneous file for the week:

• There’s a pretty serious debate going on right now about fair distribution of donated livers. A new rule that went into effect this week and then was immediately blocked by a judge would give the organ to the sickest patient within 500 nautical miles. But advocates in the Midwest and South say that’s unfair.

The Washington Post: Liver Transplant Rules Spark Open Conflict Among Transplant Centers

• The U.S. birth rate has fallen again to the lowest in three decades. Some say that means the sky is falling; others are unconcerned.

The Associated Press: US Births Lowest in 3 Decades Despite Improving Economy

• Despite there being thousands of children in the country with a terminal diagnosis, only three hospice facilities in the U.S. are designed specifically for them.

The New York Times: Where Should a Child Die? Hospice Homes Help Families With the Unimaginable

• Can we learn about trauma from an island of monkeys that was devastated by Hurricane Maria?

The New York Times: Primal Fear: Can Monkeys Help Unlock the Secrets of Trauma?

• Many of our gun safety discussions focus on buying the weapons, but teaching about proper storage can make a bigger difference than you’d necessarily expect.

The New York Times: The Potentially Lifesaving Difference in How a Gun Is Stored

Whew! You made it both through this hefty Breeze and the week itself. Take it easy this weekend as a reward!

Kaiser Health News


Must-Reads Of The Week From Brianna Labuskes

Happy Friday! As if those sky-high medical bills weren’t bad enough, apparently California teachers also must pay substitutes to cover for them — even while undergoing treatment for breast cancer.

Which is the perfect segue into what you may have missed this week (almost like I planned it).

President Donald Trump waded into the turf wars among doctors, hospitals and insurers Thursday when he called for an end to surprise medical bills. The issue has been gaining attention across the country as stories about $ 48,512 cat bites and $ 109,000 heart attacks resonate with voters who are sick of paying an arm, a leg and a mortgage for health care even when they have insurance.

It’s not exactly a controversial issue — it’s listed as a top concern among voters, and lawmakers are lining up in droves to sign their names to any potential legislation. But, as is often the case with health care costs, the devil’s in the details. The costs don’t just disappear because the president doesn’t want patients to have to pay them. Physician groups tend to favor arbitration, while insurers argue that method is flawed because it still relies on bill charges. Instead, the industry wants set prices, with rates in line with what they would consider reasonable for the procedures. Each side hates the other’s opinion. So … good luck to the lawmakers who have to balance those two big interest groups!

The New York Times: Trump Said He Wanted to Work With Democrats on Surprise Medical Bills. Then He Attacked Democrats.

(FWIW: Two stories of the patients who were featured at the White House event were previously highlighted in KHN and NPR’s “Bill of the Month” series. Check them out here.)

Kicking off a veritable blitz of bills, House Democrats voted on legislation that would ban the Trump administration from granting states waivers for health law regulations. Over the next couple of weeks, Dems are expected to go hard on their campaign promises to shore up the bruised and battered health law. Some of the topics of those bills: short-term “junk insurance” plans, outreach funding, “reinsurance” payments, drug rebates and more.

The New York Times: With Insurance Bill Passage, House Democrats Begin Health Care Blitz

Speaking of waivers, Tennessee is set to ask for one to shift its Medicaid program into a block grant model. Block grants — aka Republicans’ longtime dream system — as an idea have a long history riddled with controversy and criticism, and the request, if granted, is all but certain to draw a court challenge. Now the question is: How far is CMS ready to go in pushing the envelope on Medicaid changes? Especially when other waivers are getting knocked down left and right in court?

Modern Healthcare: Tennessee Will Test CMS’ Willingness to Block-Grant Medicaid

Meanwhile, the Trump administration is proposing a change to the formula to calculate poverty. That may seem fairly dry, but since government assistance (like Medicaid and food stamps) is tied to that line, millions could lose health care coverage and/or have to go hungry.

The New York Times: Trump Administration Seeks to Redefine Formula for Calculating Poverty

Pharma companies are going to start to have to include list prices in their TV ads under a new rule that’s central to the Trump administration’s war on high drug costs. While most people think, in general, it’s a good step, many doubt it will accomplish much. It’s not as if sick consumers can then go negotiate a different price, as they would with cars.

As Ben Wakana, the executive director of Patients for Affordable Drug Prices, told NPR: “Drug companies have been shamed about their price increases for years. They appear to be completely comfortable with the shame as long as it is bringing them in the billions of dollars a year that they make from their outrageous prices.”

NPR: New Rule for Drugmakers: Disclose Drugs’ List Prices in TV Ads

Drug prices were a hot topic this week (and most weeks, amiright?), with the Senate Finance Committee holding a hearing on the idea of setting an international price index. Other countries set lower prices and “we look like chumps,” said Sen. John Kennedy (R-La.).

Modern Healthcare: GOP Senators Warn Drug Price Controls Could Come

And, yup, there’s still more news: Despite HHS Secretary Alex Azar’s concerns about safety, Trump backed Florida’s plan to import drugs from other countries. The kicker here: Florida will surely be a battleground state in the 2020 election, and drug prices routinely top voters’ list of concerns. The potential for a winning talking point is huge.

The Associated Press: Trump Backs Fla. Plan to Import Lower-Cost Meds From Abroad

In somewhat tangential news, Gilead announced it will donate its drug that reduces the risk of HIV transmission for up to 200,000 people a year. The price of the life-changing medication has long been a barrier to the goal of ending HIV transmissions, and many advocates were thrilled with the decision. Still, others were disappointed, saying that will cover only a fifth of what the country needs.

The Associated Press: Drugmaker Will Donate Meds for US Push to End HIV Epidemic

But everyone was cheering a new study out of Europe. Out of nearly 1,000 gay male couples where one partner had HIV and was taking antiretroviral drugs, there were zero cases of HIV transmission even without the use of condoms.

Reuters: AIDS Drugs Prevent Sexual Transmission of HIV in Gay Men

Fed up with the strategy to slowly chip away at abortion rights, Alabama lawmakers are poised to go all in. The legislation (which was almost up for a vote this week, but was delayed because of a ruckus over rape and incest amendments) would effectively ban all abortions and criminalize the act of performing the procedure. The supporters of the bill aren’t being coy at all about their intention: They want to challenge Roe v. Wade with a simple, “clean bill” on the legality of abortions.

The New York Times: As States Race to Limit Abortions, Alabama Goes Further, Seeking to Outlaw Most of Them

And over in Georgia, abortion rights advocates have one message to Republican Gov. Brian Kemp, who just signed a heartbeat bill: “We will see you, sir, in court.”

The Associated Press: Opponents of Georgia Abortion Ban Promise Court Challenge

On a sad note: Legendary New York Times reporter Robert Pear passed away this week from complications of a stroke. Although I did not have the pleasure of meeting or working with him, his byline became a familiar friend of mine. He has shaped my world for the past several years with the stories he continuously broke. It is a loss for journalism, for health care and for the people he helped through the light he shined on Washington.

His last story is a perfect example of that: looking at legislation that carried promises of helping people with preexisting conditions but failed to live up to them.

The New York Times: Robert Pear, Who Covered Washington for 45 Years, Dies at 69

The New York Times: Republicans Offer Health Care Bills to Protect Patients (and Themselves)

In the miscellaneous files of the week:

• Traditionally, HHS has received, on average, one complaint related to “conscience” violations from health care workers per year. Last year, that rose to 343. What on earth happened? (Hint: It does not mean the problem actually worsened.)

NPR: Why Are Health Care Workers’ Religious and Moral Conscience Complaints Rising?

• It might seem like the anti-vaccination movement is a new phenomenon spurred on by social media, but there’s a long history of resistance in the country. And it’s not as random as it might appear at first. Usually, it’s tied to time periods that are marked by great resentment toward government.

Los Angeles Times: Why the Measles Outbreak Has Roots in Today’s Political Polarization

• Stories about student heroes stopping mass shooters and dying in the process highlight just how grim our reality has become as young people find themselves thrust into violence.

The New York Times: Colorado School Shooting Victim Died Trying to Stop the Gunman

• Not only is the United States’ maternal mortality rate abysmal, a new study finds that many of those deaths — 60%! — are preventable. What’s more, African American and American Indian/Alaska Native women are three times more likely to die from pregnancy and childbirth than white women.

USA Today: Pregnancy and Childbirth Deaths Are Largely Preventable, CDC Says

• Beneath the bright, tantalizing promises of the stem cell industry (targeted at the most desperate patients) festers a dark underbelly of greed and profit.

ProPublica: The Birth-Tissue Profiteers

Have a great weekend, and remember, as National Nurses Week wraps up, to hug (or otherwise appropriately thank) the nurses in your life. Their job can be quite tough.

Kaiser Health News


Must-Reads Of The Week From Brianna Labuskes

Happy Friday! Here’s the story, of a lovely lady … who is not happy that a 50-year-old episode of “The Brady Bunch” is being used by the anti-vaccination movement to downplay the seriousness of the measles outbreak. “If you have to get sick, sure can’t beat the measles,” the character Marcia says when the whole family comes down with it. Maureen McCormick does not share her character’s lighthearted approach.

Now here’s what else you may have missed this week.

A much-anticipated Congressional Budget Office paper on the cost of a single-payer system shied away from offering concrete projections on some key details … like the cost of a single-payer system. That’s understandable: The office notes there are too many unsettled variables to predict a price tag, and, what’s more, nothing on this scope has been attempted before. The bottom line is that the report contains sound bites for each side to use, and more questions than answers. And perhaps that captures the reality of the issue far better than any number ever could.

The New York Times: ‘Medicare for All’ Gets Much-Awaited Report. Both Sides Can Claim Victory.

It was a busy week for “Medicare-for-all,” which also got its first House hearing in at least a decade. Although it was inherently performative — a way for House Speaker Nancy Pelosi to fulfill a promise to her progressive wing without fear of the legislation actually moving forward — the hearing itself was light on firebrand rhetoric and heavy on substance. My favorite part of it all was that several reporters couldn’t help but mention in their coverage how small and physically uncomfortable the room was.

The New York Times: Gingerly, Democrats Give ‘Medicare for All’ an Official Moment

Now that former vice president Joe Biden has officially tossed his hat in the 2020 ring, it’s become more clear that one of the main fault lines in the crowded Democratic field is going to come down to health care. Biden has joined with the party’s moderate wing in supporting a Medicare buy-in option, putting him at odds with the progressives.

The Wall Street Journal: Medicare for All or Obamacare Tweaks? Democrats Pepper Voters With Health Plans

We finally have a verdict in the (sensational and fascinating) case against Insys, the maker of a powerful fentanyl spray, and its founder, John Kapoor. If you’ve lost track of the details of this one, here are a few of the highlights: The company had a stripper-turned-sales rep give a physician a lap dance, created a video of employees dancing and rapping around an executive dressed as the product, had a help line in which every call “included lies and misrepresentations” in order to improve its bottom line, and more. After three weeks of deliberations, a jury found Kapoor guilty of racketeering conspiracy.

The Associated Press: Pharmaceutical Exec Guilty of Bribing Doctors to Push Opioid

Experts expect the verdict to be one in a long line of decisions as those at the heart of the opioid crisis are facing their days in court. And speaking of which, McKesson, a giant drug distributor, settled with West Virginia this week over allegations that it willfully funneled millions of drugs into a tiny county in the state. Boone County, W.Va. — with a population of fewer than 25,000! — received 1.2 million doses of hydrocodone and oxycodone from 2007 to 2012, the lawsuit claimed. State leaders say the company put profit over people when it failed to take proper action over the suspicious orders.

Reuters: McKesson to Pay $ 37 Million to Resolve West Virginia Opioid Lawsuit

The Trump administration finalized newly expanded conscience rules that make it easier for medical professionals to opt out of providing health care procedures — such as abortion or sterilization — on the basis of religious or moral objections. Although religious groups hailed the changes, advocates for marginalized groups said the rule will make life more difficult for women and LGBTQ patients, who already struggle to find quality care.

Politico: Trump Strengthens Protections for Religious Health Workers

“We’re drowning.” That quote from a Los Angeles Times story seems to perfectly sum up the mood on the ground for Americans across the country who are desperately struggling to pay for health insurance — even ones who have employer-sponsored plans. In the past 12 years, annual deductibles in job-based health plans have nearly quadrupled and now average more than $ 1,300. Families are cutting back on food, moving in with family and friends, couponing to the extreme, turning toward crowdfunding just to pay medical bills. And these stories aren’t the exception. One in 6 Americans who get insurance through their jobs say they’ve had to make “difficult sacrifices” to pay for health care. It’s looking more and more like a crisis each day.

Los Angeles Times: Health Insurance Deductibles Soar, Leaving Americans With Unaffordable Bills

And here are some of the problem’s roots: An analysis looked at a common blood test that most of us have probably gotten and found that the cost for it can vary from $ 11 to nearly $ 1,000. Part of it has to do with the location (of course, cities are going to be more expensive), but the range far outpaces the price tag differences for things like ketchup or construction materials.

The New York Times: They Want It to Be Secret: How a Common Blood Test Can Cost $ 11 or Almost $ 1,000

Only a handful of months ago, Medicaid work requirements seemed like an unstoppable train gaining speed. But the fervor for those policies has cooled following some damning court rulings and a shift in political calculations after seeing them in practice. Their future is less clear these days.

Stateline: Medicaid Work Requirements Hit Roadblocks

In the miscellaneous file for the week:

• Were you left scratching your head about why Senate Majority Leader Mitch McConnell, a longtime tobacco ally, supported a bill that would raise the smoking age to 21? Public health experts say that’s because age measures are a win for Big Tobacco. The legislation directs attention away from measures like increasing taxes and banning flavored products — which are more painful to the industry.

Politico: McConnell Plan to Hike Smoking Age Could Be Win for Tobacco Companies

• From the “Department of Things That Are Both Surprising and Make Total Sense Once You Hear About Them”: Guantanamo Bay is starting to have to deal with end-of-life care for the terrorists who are detained there. “A lot of my guys are prediabetic,” said Rear Adm. John C. Ring, the commander of the center. “Am I going to need dialysis down here? I don’t know. Someone’s got to tell me that. Are we going to do complex cancer care down here? I don’t know.”

The New York Times: Guantanamo Bay As Nursing Home: Military Envisions Hospice Care As Terrorism Suspects Age

• A study offers data that substantiates public health advocates’ worst fears about the show “13 Reasons Why”: Suicides among kids ages 10 to 17 jumped to a 19-year high in the month following the debut of the series.

The Associated Press: Study: Kids’ Suicides Spiked After Netflix’s ’13 Reasons’

• The National Institutes of Health is blocking two of its doctors from speaking to investigators who are raising questions over the freedom researchers are afforded to critique the work of colleagues.

The Wall Street Journal: NIH Blocks Two Doctors From Speaking Out to Investigators

• Medical school is brutal enough, but for women, it’s even tougher as they navigate a high-stakes environment where the power imbalance with instructors has created a breeding ground for inappropriate conduct.

Bloomberg: America’s Medical Profession Has a Sexual Harassment Problem

• A court ruled that Caster Semenya, an Olympic gold medalist, would have to take medication to lower her natural levels of testosterone if she wants to compete. Health experts say the courts got the science wrong.

The Washington Post: Caster Semenya Ruling Uses an Unscientific Definition of Who Is Female, Critics Say

If you are a regular reader of The Breeze, you’ll know about my crippling fear of the threat of superbugs, so I’m going to continue to drag you guys along with my paranoia and suggest you read about how experts say we need to incentivize the development of new drugs to thwart the looming threat! Have a great, superbug-free weekend!

Kaiser Health News


Must-Reads Of The Week From Brianna Labuskes

Happy Friday, where yours truly is recovering from seeing “Avengers: Endgame” last night. If you’re still emotionally fragile, as I am, I deliver a distraction in the form of health policy and political news. You’re welcome.

All right, here’s what you may have missed!

The opioid epidemic was top of mind this week, with President Donald Trump speaking at a summit held in Atlanta to address the crisis. Trump made big promises about “smashing the grip of addiction” in the U.S., but experts weren’t impressed by the rhetoric. In perhaps my favorite quote of the week, Brandeis University’s Andrew Kolodny said to the NYT: “It’s like pointing to a burning building, saying there is an emergency, then not calling the fire department.”

The New York Times: Trump Declares Commitment to Ending Opioid Crisis ‘Once and for All’

Big Pharma bore the brunt of the president’s blame at the summit, but the drug companies themselves are just one part of the puzzle of the epidemic. Another one that has flown largely under the radar (until now): the distributors. The financial giants at the heart of the crisis are on their way to facing a reckoning like the ones Purdue and Johnson & Johnson are dealing with.

That was seen earlier this week when, in a first-of-its-kind prosecution, officials hit the Rochester Drug Cooperative with charges of conspiring to distribute drugs, conspiracy to defraud the United States and failing to file suspicious-order reports. Prosecutors say that the company’s executives had shipped tens of millions of oxycodone pills and fentanyl products to pharmacies they knew were distributing drugs illegally and that they ignored other red flags in the face of high profits.

The New York Times: For First Time, Pharmaceutical Distributor Faces Federal Criminal Charges Over Opioid Crisis

The New York Times: The Giants at the Heart of the Opioid Crisis

Trump’s controversial changes to Title X family planning funding (a new policy that critics blast as a “gag rule” that targets Planned Parenthood) were blocked by two separate judges this week. The judges did not mince words. In Oregon, Judge Michael McShane blasted the rules as an “arrogant” and “ham-fisted” way for the government to dictate a woman’s health care decisions; while in Washington state, Judge Stanley Bastian — who issued a nationwide injunction — deemed them a violation of “the ethical standards of health care professions.” The changes were set to take effect May 3.

The Washington Post: Trump Abortion ‘Gag’ Rule Blocked by Federal Judge

The Associated Press: US Judge in Oregon to Block New Trump Abortion Policy

LGBTQ advocates are braced for a new rule change expected soon from the Trump administration, which they say will strip away protections baked into the health law for transgender patients. At issue is whether the word “sex” (when it comes to defining discrimination) includes gender identity — which is how the Obama administration implemented it. Without the protections in place, insurers could refuse to pay for pricey and/or complicated transition-related procedures for transgender patients, and doctors could deny them care unrelated to their gender identities.

Politico: HHS Nearing Plan to Roll Back Transgender Protections

In a long-expected move, former Vice President Joe Biden tossed his hat in the ring for the 2020 campaign. But what does his plan on health care look like? The truth is, we don’t know. Will he stick to defending his buddy’s (aka former President Barack Obama) signature domestic achievement (which he famously called a big … deal) or will he drift left with the progressive wing of the race? He’s been pretty quiet on the issue — which voters have repeatedly ranked at the top of their priority lists. Vox looks back on his history with health care.

Vox: No One Knows What Joe Biden Thinks About Health Care

Biden (and others) might find a new poll about what Americans want Congress to focus on worth checking out. Although “Medicare-for-all” is the buzz phrase you can’t escape on the campaign trail, many people just want lawmakers to find a way to address high drug costs, preserve preexisting conditions protections and cushion patients from surprise medical bills.

The Washington Post: Americans Are More Focused on Health Costs Than Medicare-for-All, Poll Shows

And my be-on-the-lookout warning for next week: The Congressional Budget Office is slated to release a new report on single-payer health care.

It’s finally official: The number of measles cases this year has swept past 2014’s record. Although I’m relieved to no longer have to torture headlines with “likely to become” or “expected to be” qualifiers, the fact that there are still eight months to go in the year has everyone worried about what that final total will look like. The record that still stands, for now, is 963 cases in 1994.

The Associated Press: US Measles Cases Hit Highest Mark in 25 Years

Meanwhile, as the outbreak rages on, advocates are wondering why there have been crickets coming from the White House. Trump has been mostly absent from the conversation among many public health and state officials across the country. But some view his silence as a blessing because, in the past, he has voiced doubts about vaccination strategies.

Stat: As Calls for Measles Vaccination Rise, It’s Crickets From the White House

Big Pharma’s track record is riddled with stories of dubious morality and lies for the sake of profit. So advocates are left struggling with the question: How do you convince parents who have been burned before by drug companies that, in the case of vaccines, it’s the right choice to trust the industry? With public disdain and anger toward pharma bubbling up, in general, it’s an uphill battle.

USA Today: Measles Outbreak, Vaccinations: Distrust in Big Pharma Plays a Role

In the miscellaneous file for the week:

• A story that made me go “whoa” (literally out loud): A renowned cancer hospital in Houston ousted three of its scientists over espionage concerns as part of a string of investigations nationwide. More could be coming as federal officials have increasingly been warned of foreign exploitation of American-backed research — particularly from the Chinese.

The New York Times: Wary of Chinese Espionage, Houston Cancer Center Chose to Fire 3 Scientists

• Walgreens announced it will raise the age it allows customers to purchase tobacco products to 21. While this move cheered public health activists, the timing of it (coming just weeks after it was the main target of an FDA crackdown on sales to minors) is … notable, to say the least.

The New York Times: Walgreens Raises Tobacco-Buying Age to 21, Strengthening a Consensus

• Two cool developments related to speech coincidentally came out this week. The first is that scientists found a way to analyze the speech patterns of people who may be suffering from PTSD — a notoriously tricky thing to diagnosis (because oftentimes those who have it will try to hide their symptoms). Interestingly, the results surprised the researchers: They had been expecting more agitated speech patterns but, instead, found that flat, atonal speech was what they needed to be on the lookout for.

The New York Times: The Military Wants Better Tests for PTSD. Speech Analysis Could Be the Answer.

• And scientists may have found a way to turn brain signals into understandable speech. This would be a huge breakthrough for people who can’t speak because of strokes, neurodegenerative diseases, accidents and other reasons.

The New York Times: Scientists Create Speech From Brain Signals

Apparently we Americans are very stressed-out. So I’m going to tell you to have a relaxing weekend, and please listen to that advice!

Kaiser Health News