First Edition: August 12, 2019

Kaiser Health News: To Save Money, American Patients And Surgeons Meet In Cancun
Donna Ferguson awoke in the resort city of Cancun before sunrise on a sweltering Saturday in July. She wasn’t headed to the beach. Instead, she walked down a short hallway from her Sheraton hotel and into Galenia Hospital. A little later that morning, a surgeon, Dr. Thomas Parisi, who had flown in from Wisconsin the day before, stood by Ferguson’s hospital bed and used a black marker to note which knee needed repair. “I’m ready,” Ferguson, 56, told him just before being taken to the operating room for her total knee replacement. For this surgery, she would not only receive free care but would receive a check when she got home. (Galewitz, 8/12)

Kaiser Health News: Class-Action Lawsuit Seeks To Let Medicare Patients Appeal Gap In Nursing Home Coverage
Medicare paid for Betty Gordon’s knee replacement surgery in March, but the 72-year-old former high school teacher needed a nursing home stay and care at home to recover. Yet Medicare wouldn’t pay for that. So Gordon is stuck with a $ 7,000 bill she can’t afford — and, as if that were not bad enough, she can’t appeal. The reasons Medicare won’t pay have frustrated the Rhode Island woman and many others trapped in the maze of regulations surrounding something called “observation care.” (Jaffe, 8/12)

Kaiser Health News: How #MeToo Is Changing Sex Ed Policies — Even In Red States
The 2019 state legislative season is producing a bumper crop of sex education bills across the U.S., with at least 79 bills introduced in the legislatures of 32 states and the District of Columbia, according to a recent report by the Guttmacher Institute, a sexual and reproductive health research and advocacy organization. Most of the bills have been aimed at expanding youth education around healthy sexuality and relationships — and reducing the reach of the abstinence-only ideology that had become part of many sex ed classes over the past four decades. (Landman, 8/12)

California Healthline: Charity Care Spending By Hospitals Plunges
California hospitals are providing significantly less free and discounted care to low-income patients since the Affordable Care Act took effect. As a proportion of their operating expenses, the state’s general acute-care hospitals spent less than half on these patients in 2017 than they did in 2013, according to data the hospitals reported to California’s Office of Statewide Health Planning and Development. The biggest decline in charity care spending occurred from 2013 to 2015, when it dropped from just over 2% to just under 1%. The spending has continued to decline, though less dramatically, since then. (Rowan, 8/12)

The Associated Press: Democratic Hopefuls Take Aim At Insurer And Pharma Profits
Sen. Bernie Sanders and other progressives seeking the Democratic presidential nomination are zeroing in on pharmaceutical and insurer profits, money they say would be better spent providing health care for everyone under “Medicare for All.” Their idea: Health care dollars from government programs, employers and families that are going into the pockets of investors instead could be used to pay for services. If people want a health care system that will not bankrupt them, “the answer is to get rid of the profiteering of the drug companies and the insurance companies (and) move to Medicare for All,” Sanders said during the recent Democratic debates. But research by The Associated Press suggests those dollars might not go so far. While there’s no single ledger for drugmakers and insurers, the AP found major companies had about $ 97 billion in profits last year. That wouldn’t even cover a couple of weeks in a health care system that costs $ 3.6 trillion a year. (Alonso-Zaldivar and Murphy, 8/11)

NPR: Top Republican Pushes Drug Bill That Divides GOP, But Trump Wants Win On Issue
Back home in Iowa for the August recess, Senate Finance Chairman Chuck Grassley is making the case in this conservative state for a sweeping drug bill, even though many in his party do not support it. “One of the few times, if it isn’t the only time, that I’ve been chairman of various committees that I haven’t had at least a majority of Republicans on my side,” Grassley conceded at a town hall meeting in Aurelia this week, but he added: “It’s probably more valuable to have the president on your side.” For 39 years and counting, the Republican senator has traveled to all 99 counties in his home state every year to meet with constituents, and this year the high cost of prescription drugs has come up in nearly all of them. (Davis, 8/9)

The Associated Press: Trump Administration Moves To Enforce Abortion Restriction
Moving ahead despite objections, the Trump administration on Friday set a timetable for federally funded family clinics to comply with a new rule that bars them from referring women for abortions. The action is part of a series of efforts to remake government policy on reproductive health to please conservatives who are a key part of President Donald Trump’s political base. Religious conservatives see the family planning program as providing an indirect subsidy to Planned Parenthood, which runs family planning clinics and is also a major abortion provider. (Alonso-Zaldivar, 8/9)

The New York Times: Surgeons Labored To Save The Wounded In El Paso Mass Shooting
The tragedy in El Paso on Saturday, carried out by a gunman armed with an AK-47-style rifle, and another deadly massacre on Sunday in Dayton, Ohio, in which the gunman used an AR-15-style pistol modified to act as a rifle, can be measured in death tolls — 22 in El Paso and nine in Dayton. But the damage done by such weapons is witnessed most clearly by members of the medical staff who care for the wounded. The story of their lifesaving labors at the El Paso hospital, the only one in a 270-mile radius prepared to treat complex trauma patients, is one of heroics in the face of violence, and of the doctors and nurses, who, once the adrenaline rush died down, struggled to live with the horror of what they had experienced. (Kolata, 8/9)

USA Today: For 2020 Democrats, Hammering On Gun Control Comes With Upside: Energized, Angry Activists
In the aftermath of this month’s mass shooting rampages by heavily-armed young men in El Paso and Dayton, Democrats are looking to galvanize the gun control movement’s energy and make American grief over the seemingly endless scourge of mass killings a central issue of the campaign for the White House.And the success of federal and gubernatorial candidates who put gun policy front-and-center during the 2018 election cycle, as well as changing demographics of where Democratic votes come from, is impacting how politicians approach gun safety.

The Wall Street Journal: Iowa Is Ground Zero For Gun Debate As Presidential Hopefuls Weigh In
Beau Hicks said he spoke with his teenage daughter before they arrived Saturday at the Iowa State Fair about how to react in an active-shooter situation. “We shouldn’t have to be nervous in a crowd,” he said. “That’s what makes me mad, when there are things we can do.” One week after mass shootings in Texas and Ohio shocked the nation, such conversations are becoming more common. (McCormick and Parti, 8/10)

NPR: Elizabeth Warren’s New Plan On Guns Has A Goal: Reduce Gun Deaths By 80%
Massachusetts Sen. Elizabeth Warren introduced a sweeping gun control plan Saturday with the goal of reducing gun deaths by 80% through executive action and legislation. “You’ve got to start with a goal. I haven’t heard anybody else talk about a goal,” Warren said in an interview with The NPR Politics Podcast. … Announcing her plan, Warren said the first step toward meeting her goal is immediate administrative action, which includes a range of ideas such as requiring background checks, investigating the NRA, and revoking licenses for gun dealers who break the law. (Khalid, 8/10)

The Associated Press: O’Rourke Says He Supports National Gun Licensing Program
Beto O’Rourke is joining a number of his Democratic presidential rivals in support of a national gun licensing program. The former Texas congressman said Sunday on CNN’s “State of the Union” that states that require gun licensing, mandate universal background checks or stop the sales of assault-style weapons are saving lives. He says it makes sense to “adopt these solutions nationally.” O’Rourke has remained in his hometown of El Paso, Texas, since shortly after a gunman killed 22 people at a Walmart store on Aug. 3. Law enforcement officials say the suspect had an AK-47 rifle and was targeting Mexicans. (8/11)

The Washington Post: Why One Family Mourning El Paso Victims Chose To Meet With Trump
Tito Anchondo wishes people would stop politicizing his family’s tragedy. Anchondo, who lost his beloved brother and sister-in-law in the rampage by an El Paso Walmart on Saturday, said he wanted to take his orphaned nephew to University Medical Center on Wednesday to meet the president and first lady. The 2-month-old suffered two broken fingers in the shooting but survived after his parents, Andre and Jordan Anchondo, shielded him from the gunfire and were slain themselves. (Bever and Moore, 8/9)

NPR: Americans Largely Support Gun Restrictions To ‘Do Something’ About Gun Violence
What is clear, from public opinion polling, is that Americans believe gun violence is a problem, and they support more restrictions on guns. … There is public support for universal background checks for gun purchases, extreme risk protection orders (also called red flag laws), gun licensing, assault-weapons bans and bans on high-capacity magazines. But many of these issues are hotly polarizing. While they mostly enjoy support from Democrats and independents, Republicans are not always on board. (Montanaro, 8/10)

The Associated Press: Gun-Control Backers Concerned About Changing Federal Courts
California has some of the toughest gun laws in the nation, including a ban on the type of high-capacity ammunition magazines used in some of the nation’s deadliest mass shootings. How long those types of laws will stand is a growing concern among gun control advocates in California and elsewhere. A federal judiciary that is becoming increasingly conservative under President Donald Trump and the Republican-controlled U.S. Senate has gun control advocates on edge. They worry that federal courts, especially if Trump wins a second term next year and Republicans hold the Senate, will take such an expansive view of Second Amendment rights that they might overturn strict gun control laws enacted in Democratic-leaning states. (Thompson, 8/11)

The New York Times: The Impact Of Racism On Children’s Health
This month the American Academy of Pediatrics put out its first policy statement on how racism affects the health and development of children and adolescents. “Racism is a significant social determinant of health clearly prevalent in our society now,” said Dr. Maria Trent, a professor of pediatrics at Johns Hopkins School of Medicine, who was one of the co-authors of the statement. (Klass, 8/12)

PBS NewsHour: After Ferguson, Black Men Still Face The Highest Risk Of Being Killed By Police
Five years after Michael Brown’s death in Ferguson, Missouri, launched a national conversation about race and police brutality, black men are still more likely to die by police violence than white men. According to a study published this week in the Proceedings of the National Academies of Sciences, over the course of a lifetime, black men face a one in 1,000 risk of being killed during an encounter with police, a rate much higher than that of white men. (Santhanam, 8/9)

NPR: From Pain To Purpose: 5 Ways To Cope In The Wake Of Trauma
Could it happen here? It’s a question a lot of people ask in the wake of a traumatic event. Even if you’re not directly connected to the events in El Paso, Gilroy or Dayton, chances are you’ve felt the weight of them. “People do feel traumatized,” says family therapist Jonathan Vickburg, of Cedars Sinai in Los Angeles. The idea that an act of violence could happen anywhere makes us anxious. People may think twice about attending a music festival or walking into a WalMart. (Aubrey, 8/11)

The Associated Press: What’s On School Menus This Fall? Trade Mitigation
School lunch menus already have Meatless Mondays and Taco Tuesdays. Now some may get Trade Mitigation Thursdays. This fall, some U.S. school cafeterias are expecting shipments of free food, one little known consequence of President Donald Trump’s trade disputes. The products are coming from the Department of Agriculture, which is giving away the $ 1.2 billion in foods it’s buying to help farmers hurt by trade negotiations. (Choi, 8/11)

Reuters: U.S. Lawmakers Push Back Against Possible Trump Foreign Aid Cuts
Republican and Democratic foreign policy leaders in the U.S. Congress came out on Friday against a Trump administration review of foreign aid that critics fear could lead to sharp cuts in funds for global health, peacekeeping and other programs. The chairmen and ranking members of the Senate Foreign Relations Committee and House of Representatives Foreign Affairs Committee urged the heads of President Donald Trump’s Office of Management and Budget to make the money – up to $ 4 billion – available right away. (Zengerle, 8/9)

The New York Times: In Echo Of Flint Lead Crisis, Newark Offers Bottled Water
For more than a year, Newark officials denied the city had a widespread lead problem with its drinking water. Then, in an abrupt shift last fall, New Jersey’s largest city began giving out water filters to some residents. On Sunday — two days after a scathing letter from the E.P.A. raised concerns about the safety of the city’s drinking water — officials said they would start offering bottled water to residents.(Fitzsimmons, 8/11)

The Associated Press: EPA: Newark Should Provide Bottled Water Due To Lead
The governor of New jersey and the mayor of Newark have vowed to provide bottled water to city residents with lead service lines after tests indicate filters may not be protecting them against elevated lead levels. Gov. Phil Murphy and Mayor Ras Baraka said, however, in a statement Sunday evening that the city and state “will need support and assistance from the federal government” to provide and distribute water to affected residents. And the Democratic leaders said long-term water distribution could affect the city’s corrosion control treatment launched in May, since for the system to work properly residents must keep city water flowing through their pipes. (8/11)

NPR: No Safe Drinking Water On Reservation Leaves Thousands Improvising
The Warm Springs Indian Reservation in Central Oregon has been without safe drinking water all summer, and some people have no running water at all. In May, a burst pipe led to a cascade of infrastructure failures. That leaves around 4,000 people improvising for survival. … The [ad-hoc water distribution] center runs on donations, and it might distribute 3,000 gallons of water a day, plus other supplies like bleach wipes, plastic plates, utensils, and commodes, said Danny Martinez, emergency manager for the Confederated Tribes of Warm Springs. (Cureton, 8/10)

The Associated Press: EPA Won’t Approve Warning Labels For Roundup Chemical
The Trump administration says it won’t approve warning labels for products that contain glyphosate, a move aimed at California as it fights one of the world’s largest agriculture companies about the potentially cancer-causing chemical. California requires warning labels on glyphosate products — widely known as the weed killer Roundup — because the International Agency for Research on Cancer has said it is “probably carcinogenic.” The U.S. Environmental Protection Agency disagrees, saying its research shows the chemical poses no risks to public health. (Beam, 8/9)

Los Angeles Times: VA Cuts Off Van Nuys Assisted Living Home That Reported Visit To Veteran Who Had Died 
Federal officials pulled veterans from a Van Nuys assisted living home after finding that the facility had reported a social worker visiting a veteran who had been dead for four days, according to a report released Thursday. The investigation by the U.S. Department of Veterans Affairs also found serious medication errors at the California Villa home. A 100-year-old veteran with sepsis was denied prescribed antibiotics because they were “not covered by Medicare” and ended up hospitalized a second time, the report said. (Holland, 8/9)

The Associated Press: To Boost Workforce, Medical Schools Try To Sell Rural Life
On a field trip to the Birthplace of Country Music Museum, Ashish Bibireddy put on headphones and scrolled through a jukebox of music from an influential 1927 recording session. Bibireddy and nine other medical students had already been biking and rafting on their visit to rural Appalachia organized by a nearby medical college. But it wasn’t just casual sightseeing; the tour was part of a concerted effort to attract a new generation of doctors to rural areas struggling with health care shortages. The Quillen College of Medicine at East Tennessee State University is among a small group of medical schools across the U.S. with programs dedicated to bolstering the number of primary care doctors in rural communities. (Thanawala, 8/9)

Los Angeles Times: Sexual Misconduct Allegations Against California Doctors Rise Sharply Since #MeToo Era Began
Late last year, the Medical Board of California stripped the doctor, Bayard Allmond, 84, of his license to practice. Allmond is part of a growing wave of California doctors who have faced sexual misconduct allegations in the last two years. (Karlamangla, 8/12)

The Wall Street Journal: What The AMA Stands For Now
Under a new president, Patrice Harris, the American Medical Association made a splash in the reproductive-rights debate in June by suing North Dakota to block two abortion-related laws. One of those laws requires physicians to tell patients that medication-induced abortions can be reversed in some instances, which the suit says is false; the other requires doctors to tell patients that an abortion terminates “the life of a whole, separate, unique living human being.” The AMA also has recently taken positions on some topics, such as climate change and body-worn cameras in law enforcement, that aren’t traditionally associated with medicine. Dr. Harris, who will serve a one-year term as president, spoke to The Wall Street Journal about the AMA’s advocacy efforts, health-care reform and diversity in the profession. (Abbott, 8/11)

Stat: Q&A: The FDA’s Digital Health Chief On How To Regulate AI Products
The Food and Drug Administration has allowed medical devices that rely on artificial intelligence algorithms onto the market, but so far, the agency has given the green light only to devices with “locked algorithms” — those that remain the same as the product is used until they’re updated by the manufacturer. Systems with algorithms that evolve and sharpen on their own, however, are already in development. (Joseph 8/9)

The Associated Press: Librarians Facing New Tasks Say Crisis Isn’t In The Catalog
As libraries nationwide contend with a surge in patrons seeking refuge in the stacks because of poverty, drug addiction or mental illness, a growing number of institutions have social workers on staff. It’s the latest step in an evolution that libraries have been dealing with for years as homelessness and the opioid crisis reach emergency levels and patrons have come to rely on libraries as free, safe spaces open to all. (Swenson, 8/9)

The Wall Street Journal: Allscripts Reaches Tentative Agreement Over Federal Probes
Allscripts Healthcare Solutions Inc. has reached a tentative $ 145 million agreement to resolve civil and criminal federal investigations into the business practices of one of its recently acquired companies. The federal investigations revolve around Practice Fusion Inc.’s software certification, compliance with anti-kickback regulations and related business practices, according to securities filings. No additional details were given. Health-care information-technology company Allscripts acquired the electronic-health-records company last year. (Armental, 8/9)

The Wall Street Journal: Rite Aid Names Heyward Donigan As CEO
Rite Aid Corp. appointed Heyward Donigan as chief executive, saying her experience leading health-care companies would help the pharmacy chain confront competition that has hurt sales and prompted job cuts. (Haddon, 8/12)

The Associated Press: Region Hit Hard By Opioids Embraces Jail-Based Treatment
As western Massachusetts struggles with a dramatic spike in fatal overdoses, officials are embracing a controversial solution: sending men who have not committed any crimes to jails and prisons for court-ordered addiction treatment. Hampden County Sheriff Nick Cocchi has designated a wing of his jail for the treatment of men civilly committed for substance abuse reasons. It’s the only facility in western Massachusetts housing the men, and just one of three in the entire state for men. (Marcello, 8/9)

The Associated Press: Alleged Online Opioid Drug Kingpin To Stand Trial In Utah
As America’s opioid crisis spiraled into a fentanyl epidemic, prosecutors say one young Utah man made himself a drug kingpin by creating counterfeit prescription painkillers laced with the deadly drug and mailing them to homes across the United States. Former Eagle Scout Aaron Shamo, 29, will stand trial beginning Monday on allegations that he and a small group of fellow millennials ran a multimillion-dollar empire from the basement of his suburban Salt Lake City home by trafficking hundreds of thousands of pills containing fentanyl, the potent synthetic opioid that has exacerbated the country’s overdose epidemic in recent years. (Whitehurst and Galofaro, 8/12)

The Associated Press: Vaccines, Guns, Housing Bills Await California Legislature
California lawmakers return to work on Monday with one month left to pass bills before adjourning for the year. The Legislature was busy before the July recess, passing a $ 214.8 billion operating budget and setting up funds to pay future wildfire victims and clean up drinking water. But lawmakers still have lots to do before they adjourn on Sept. 13. Here are a few bills they will consider over the next month. (Beam and Thompson, 8/11)

The Associated Press: Kansas Anti-Vaccine Groups Say Membership Numbers Surging
A Kansas anti-vaccination group says its membership is growing dramatically since the state added two new vaccination requirements for children returning to school this fall. (8/11)

The Associated Press: NYC Medical Data Breach Linked To About 10,000 Patients
The personal information of about 10,000 New York ambulance patients was involved in a data breach linked to the city’s emergency medical services. The Fire Department of New York acknowledged Friday that the data was contained in an EMS employee’s personal hard drive, reported missing in March. (8/9)

The Associated Press: Site Allows Consumers To Compare Health Care Cost, Quality
Consumers, businesses and health care providers will be able to compare the cost and quality of medical care at Connecticut hospitals and provider networks online. The Connecticut Office of Health Strategy has launched HealthscoreCT.com , which includes a quality scorecard and a cost estimator that is scheduled to be released at the end of September. (8/11)

The Washington Post: Food Poisoning Information Is Available Here
Most people are all too familiar with the gut-wrenching sensation of food poisoning. But what can your symptoms reveal about the potential bug that made your body revolt — and how can you protect yourself next time? The Centers for Disease Control and Prevention maintains a helpful food safety page online so you can sidestep food poisoning. It’s packed with info about the ailment: what causes it, how to tell if you’ve got it and how to prevent it. (Blakemore, 8/10)

The New York Times: Climate Of Fear: When Part Of A Country Bans Abortion
That has led many women, like Ciara, to travel for abortions, something that can be difficult for those who lack the resources to finance the trip. With some states in the United States — most recently Alabama — passing legislation that mirrors the laws in Northern Ireland, many American women could be just a Supreme Court decision away from finding themselves in a similar position. (Yeginsu, 8/10)

The Washington Post: Caregivers Taunted A 91-Year Old With Dementia On Video, Lawsuit Says. They’ve Been Fired And Charged.
An Illinois family is suing a nursing home and two of its former employees after a video appears to show caregivers taunting a 91-year-old woman. Margaret Collins, who has dementia, does not like hospital gowns and prefers to wear her own clothes, according to a lawsuit filed in Cook County Circuit Court on Wednesday. That’s why she appears so troubled in the video, as a worker continually places the gown on her, and she swings her arms to push it away from her bed. The workers, who the lawsuit alleges knew Collins did not like the gowns, attempted to make her wear the gown and “used their position of power and influence to harass, taunt, bully, degrade and take advantage of Margaret.” (Krakow, 8/11)

The Washington Post: ‘My Entire Scalp Was On Fire’: A Doctor Repeatedly Insisted She Had A Tension Headache. Something More Serious Was Going On.
Galen Warden was lying in a hot bath after a punishing week at her demanding marketing job. Her neck and shoulders were, as usual, in knots, so Warden thought she’d expedite the relaxation that a restorative soak usually delivered by sliding under the water. When she sat up about 30 seconds later, Warden recalled, “it felt like my entire scalp was on fire.” Her face, neck and shoulders were unaffected, but her scalp felt as though it had been doused with acid. It would take nearly three months before the cause of Warden’s unusual symptom, which was repeatedly attributed to a tension headache, was revealed. During that time, the emergence of other symptoms failed to prompt the specialist treating her to reconsider her initial diagnosis. (Boodman, 8/10)

NPR: American With No Medical Training Ran Center For Malnourished Ugandan Kids. 105 Died
Ten years ago, Renee Bach left her home in Virginia to set up a charity to help children in Uganda. One of her first moves was to start a blog chronicling her experiences.Among the most momentous: On a Sunday morning in October 2011, a couple from a village some distance away showed up at Bach’s center carrying a small bundle. … Except Bach was not a doctor. She was a 20-year-old high school graduate with no medical training. And not only was her center not a hospital — at the time it didn’t employ a single doctor. Yet from 2010 through 2015, Bach says, she took in 940 severely malnourished children. And 105 of them died. Now Bach is being sued in Ugandan civil court. (Aizenman, 8/9)

The New York Times: Summer In The City Is Hot, But Some Neighborhoods Suffer More
As the United States suffers through a summer of record-breaking heat, new research shows that temperatures on a scorching summer day can vary as much as 20 degrees across different parts of the same city, with poor or minority neighborhoods often bearing the brunt of that heat. “The heat island effect is often characterized as the city being hotter than surrounding rural areas,” said Vivek Shandas, a professor of urban studies and planning at Portland State University, who led heat mapping projects across the country with help from community volunteers. “We’re saying it’s a little more complicated than that.” (8/9)

The New York Times: Is Your Sleep Cycle Out Of Sync? It May Be Genetic
Early to bed, early to rise — a fine plan for a dairy farmer who has to get up long before dawn to milk the cows. But if you’re someone who works all day with stocks and clients and may want to enjoy an evening out now and then, it would be better not to be getting up at 2 a.m. and have to struggle to stay awake through dinner or a show. Such is the challenge faced by a friend who has what sleep specialists call an advanced sleep phase. Her biological sleep-wake cycle, or circadian rhythm, is out of sync with the demands of the modern world. (Brody, 8/12)

The Wall Street Journal: For Higher Education, Try Taking Courses In Marijuana
At least two U.S. universities have just introduced high-level courses for students interested in a career in the marijuana business. Maryland University’s School of Pharmacy will offer a master’s degree in medical cannabis. Cornell University—an Ivy League school apparently branching out into other leafy plants—has introduced a course called “Cannabis: Biology, Society and Industry.” The Cornell offering will cover everything from cultivating marijuana to marketing it more effectively. The Maryland master’s program will prepare students for careers as pot-savvy health care professionals. (Queenan, 8/9)