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For a patient’s knee replacement, Medicare will pay a hospital $17,000. The same hospital can get more than twice as much, or about $37,000, for the same surgery on a patient with private insurance. Or take another example: One hospital would get about $4,200 from Medicare for removing someone’s gallbladder. The same hospital would get $7,400 from commercial insurers. The yawning gap between payments to hospitals by Medicare and by private health insurers for the same medical services may prove the biggest obstacle for advocates of “Medicare for all,” a government-run system. (Ableson, 4/21)

UnitedHealth Group has been a stock market darling for much of the past decade, dependably churning out earnings increases and rewarding shareholders with staggering returns. Its latest quarterly report, issued on Tuesday, was superb, as expected. Earnings per share jumped 24 percent. Based on the news about the diversified health service company’s fundamental businesses, you might have expected its stock price to rise. Nope. UnitedHealth’s share price dropped 4 percent that day and almost 2 percent the next. And, along with much of the health care sector, it has been on a downward trend for the past few months. (Sommer, 4/19)

President Trump and Republicans in Congress say they are committed to protecting people with pre-existing medical conditions. But patients with cancer, diabetes and H.I.V., for example, would have significantly less protection under Republican proposals than under the Affordable Care Act. The proposals may provide some political cover for Republicans on an issue likely to figure prominently in the 2020 elections. But a close inspection of the Republican bills shows that their protections are undercut by a combination of imprecise language, explicit exceptions and “rules of construction” that explain how the legislation is to be interpreted. (Pear, 4/20)

The nonpartisan Congressional Budget Office will factor new consumer and employer preferences in its estimate of how proposed legislation will impact insurance coverage and premiums. The agency's new insurance model aims to address longstanding complaints from Republicans on how the CBO makes pivotal estimates on the impact of new legislation, especially surrounding the repeal of the Affordable Care Act. (King, 4/19)

Kansas will allow its state Farm Bureau to offer health care coverage that doesn't satisfy the Affordable Care Act after Democratic Gov. Laura Kelly on Friday declined to block a Republican-backed effort to circumvent former President Barack Obama's signature health care law. Kelly allowed an insurance bill to become law without her signature, and it includes provisions that will exempt the bureau from state insurance regulations in the health care coverage it offers to its members. (Hanna, 4/19)

In recent years, many Illinois consumers were socked with steep price increases when buying health insurance on the Obamacare exchange. A bill that’s gaining traction in Springfield, however, could prevent that. The bill would give the Illinois Department of Insurance the power to say no to certain sky-high price increases proposed by insurance companies for plans sold to individuals and small businesses. The bill wouldn’t apply to plans offered by large employers. (Schencker, 4/22)

Emergency department visits have continued to rise even as more Americans gained health insurance after the Affordable Care Act came into play, according to a new study. ED visits increased by 2.3 million a year between 2006 and 2016, with the proportion of uninsured ED visits relatively unchanged from 2006 to 2013, making up between 14% and 16% of visits, the study published Friday in JAMA Network Open found. (Johnson, 4/19)

There are 41 accountable care organizations in the CMS' Next Generation ACO Model for 2019, which represents a substantial decline from 2018 when 51 organizations were in the model. Data updated on CMS' site this week shows that 12 ACOs that participated in 2018 have either left or were booted from the program for the 2019 performance year. The latest exodus of participants comes after the model lost seven ACOs in March 2018, bringing the total number of participants in 2018 down from an initial 58 to 51. (Castellucci, 4/19)

Two tenured scientists at a renowned cancer hospital in Houston have resigned, and the hospital is seeking to fire a third, in connection with an investigation into possible foreign attempts to take advantage of its federally funded research, the authorities said. The departures are one of the first publicly revealed outcomes of dozens of similar investigations nationwide, as federal officials have increasingly warned of foreign exploitation of American-backed research — particularly from the Chinese. (Zaveri, 4/22)

"As stewards of taxpayer dollars invested in biomedical research, we have an obligation to follow up," Pisters said. MD Anderson received $148 million in NIH grants last year. The center provided internal documents to the Chronicle regarding the cases but the names of the scientists were redacted. The newspaper said all three are ethnically Chinese. Two of them resigned ahead of termination proceedings and the third is challenging the dismissal. (4/20)

Republican legislators across the country are rallying behind President Donald Trump's efforts to link Democrats with "infanticide," daring Democratic governors to veto "born alive" bills animating the party's base before the 2020 elections. Bills approved by GOP-run legislatures in Montana and North Carolina this week would penalize health care providers for failing to care for an infant who survives an abortion attempt. The measures, which are also winding through legislatures in Texas and elsewhere, are being pushed by anti-abortion groups that quickly seized on bills in New York and Virginia aimed at loosening restrictions on third-trimester abortions. (Rayasam and Goldberg, 4/20)

A federal judge blocked part of an Ohio law late Thursday that bans the abortion method of dilation and evacuation in most cases, adding to a list of restrictions on the procedure that are or soon could be in legal limbo. Senior U.S. District Judge Michael Barrett in Cincinnati ordered the state not to bring criminal charges against doctors who perform the D&E procedure under most circumstances until the case can be fully litigated. Other parts of the law were allowed to proceed. (4/19)

The legislation would create a new section of Florida law that would create a parental “bill of rights,” which would establish parents’ authority to direct “the education and care” of their child as well as their “moral and religious training.” It would also broadly give parents a say in any healthcare decisions their children make through their schools or even private providers: including if minors seek help from a counselor. (Koh and Mahoney, 4/21)

A faith-based pregnancy center in Willimantic has asked a federal judge for an injunction against a controversial Hartford ordinance that requires the religious facility and others like it to disclose whether their staff carry medical licenses. The challenge to the local ordinance comes at the same time lawmakers are considering imposing similar rules on a statewide basis. (Carlesso, 4/19)

A student group at Brandeis University celebrated the unveiling of a new health and wellness vending machine on campus last week that gives people immediate access to products like Plan B, the emergency contraceptive used to prevent pregnancy after having unprotected sex. After more than a year of logistics and planning, the group Brandeis Pro-Choice, which “promotes reproductive rights” for students, has turned on the Wellness Vending Machine in the Waltham school’s Shapiro Campus Center. (Annear, 4/19)

There are the Sacklers, the family that controls Purdue Pharma, the maker of OxyContin. There are the doctors who ran pill mills, and the rogue pharmacists who churned out opioid orders by the thousands. But the daunting financial muscle that has driven the spread of prescription opioids in the United States comes from the distributors — companies that act as middlemen, trucking medications of all kinds from vast warehouses to hospitals, clinics and drugstores. The industry’s giants, Cardinal Health, McKesson and AmerisourceBergen, are all among the 15 largest American companies by revenue. (Hakim, Rashbaum and Rabin, 4/22)

U.S. regulators have approved the first generic nasal spray version of Narcan, a drug that reverses opioid overdoses. The Food and Drug Administration on Friday OK'd naloxone spray from Israel's Teva Pharmaceuticals. Naloxone has been sold as a nasal spray in the U.S. since 2016 under the brand name Narcan. Pharmacists can dispense it without a prescription. It is also sold as a generic or brand-name drug in automatic injectors, prefilled syringes and vials. (4/19)

Robin Wallace thought her years of working as a counselor in addiction treatment gave her a decent understanding of the system. She has worked in private and state programs in Massachusetts and with people who were involuntarily committed to treatment. So in 2017, as her 33-year-old son, Sean Wallace, continued to struggle with heroin use — after years of coping with mental health issues and substance use — she thought she was making the right choice in forcing him into treatment. (Becker, 4/20)

A pharmacist in Celina, Tenn., was one of 60 people indicted on charges of opioid-related crimes this week, in a multistate sting. John Polston was charged with 21 counts of filling medically unnecessary narcotic prescriptions. He was also Gail Gray's pharmacist and the person she relied on to regularly fill her opioid prescriptions. "I take pain medicine first thing in the morning. I'm usually up most of the night with pain," she says. "I hurt all the time." (Farmer, 4/19)

They were supposed to be novel pain treatment and future blockbusters. Instead it appears that hopes for a class of medicines called NGF inhibitors are increasingly dim. Pfizer (PFE) and Eli Lilly (LLY) announced late Thursday that their experimental NGF inhibitor didn’t meet its goals in a trial meant to support approval by the Food and Drug Administration. And, more damning, patients who got the drug had significantly more issues of joint damage — the big risk tied to NGF treatments — than those who got over-the-counter pain pills like ibuprofen. (Garde, 4/19)

Max Tillitt's parents thought they were close to saving him. Their son had struggled for years with mental health problems and substance use, products of a violent hit during a junior year high school football practice that left him with a concussion and neck injury so bad he couldn't play anymore. It changed Max, creating behavioral problems that got him kicked out of school and mixed up with people who opened doors to marijuana, prescription painkillers and heroin. The young man who'd grown up looking out for others in need needed help. When Max was 21, the Tillitts thought they found an answer, a treatment center where their son finally seemed to be recovering. And they had insurance to cover it — a UnitedHealth plan they thought would pay for Max's treatment costs until doctors pronounced him well. UnitedHealth, however, had its own methods to decide how much was enough. (Roth, 4/22)

UnitedHealth Group is trying to grow in the crowded digital health market by rolling out new features for employers while expanding its downtown Minneapolis workforce to about 140 workers. For several years, employer health plans have hired its Rally Health division to provide a digital platform where workers can track their progress toward incentives in company-sponsored wellness programs. Now, UnitedHealth says employers can more easily access tools for finding doctors, comparing procedure costs, learning about insurance benefits and, in a few cases, scheduling appointments.��(Snowbeck, 4/20)

E-cigarette companies that the FDA has already threatened for appealing to teens may land in more hot water with new campaigns that target older adults, say public health advocates and House Democrats. After the FDA told them to stop pitching in a way that attracted teens, Juul and other companies have begun flooding television, radio and print media with ads that tout their potential to help adults quit traditional cigarettes. But they don’t have the data to back up such claims, say researchers, and the new ads might confuse teens even more. (Owermohle, 4/19)

Public health and anti-tobacco advocates are no longer facing fierce opposition from the tobacco industry in their push to raise the legal purchasing age from 18 to 21. The reversal, prompted in large part by rising youth vaping rates, means tobacco companies such as Altria are now on the front line pushing “Tobacco 21” legislation in state legislatures and on Capitol Hill in an effort to stave off stronger regulations that could have disastrous effects on the industry, including bans on the sale of flavored tobacco products that are appealing to kids. (Hellmann, 4/20)

Present your driver’s license to be scanned and verified. Have your photograph taken. Pass your belongings through a metal detector. Welcome to your child’s school. Twenty years after the Columbine High School shooting, a school visit can feel like going to the airport. See-through backpacks and armed officers are common sights on campus. So are “run, hide, fight” trainings, full of tips on how to survive an active shooter. Some days might bring lockdown drills that students are not told in advance are rehearsals, not real threats. And in rare cases, the adult teaching algebra or social studies might be armed. (Goldstein, 4/20)

The survivors walked their children through hallways that had once been filled with violence. This is where we hid from the gunmen, they told their children. That is where the gunmen entered the school, they added. This is how we escaped. Twenty years after two students attacked Columbine High School in Littleton, Colo., killing 12 of their peers and one teacher and marking the beginning of an era of school threats and mass shootings, Columbine’s survivors are now parents. (Turkewitz, 4/20)

San Jose police Sgt. Sean Morgan, one of SJPD’s chief school liaisons for the 10th largest city in the country, said his department receives reports of threats to schools as frequently as three times a week, and on a few occasions twice in a day. Each must be investigated. (Salonga and Savidge, 4/20)

Accidental suffocation is a leading cause of injury deaths in U.S. infants and common scenarios involve blankets, bed-sharing with parents and other unsafe sleep practices, an analysis of government data found. These deaths "are entirely preventable. That's the most important point," said Dr. Fern Hauck, a co-author and University of Virginia expert in infant deaths. (Tanner, 4/22)

After Ann’s daughter was born, the infant cried a lot because of acid reflux. “When she wouldn’t stop, I got angry. I felt like a monster,” said Ann, who requested that she be identified only by her middle name because of privacy concerns. At first, the new mother chalked up her irritability and guilty feelings to stress and sleep deprivation, but when the worrisome feelings lingered, Ann knew something was wrong. (Fraga, 4/20)

It’s no secret that the United States lags the rest of the developed world when it comes to policies that support mothers and families. As former President Barack Obama put it in 2014: “Family leave. Child care. Flexibility. These aren’t frills. They’re basic needs. They shouldn’t be bonuses. They should be the bottom line. ”Five years and little progress later, we’re learning more and more about the toll inflexible work cultures have on new and expectant mothers. Last fall, a New York Times investigation exposed the devastating cost of pregnancy discrimination on women in physically demanding jobs. (Salam, 4/19)

Scientists are ramping up research on the possible health effects of a large group of common but little-understood chemicals used in water-resistant clothing, stain-resistant furniture, nonstick cookware and many other consumer products. Per- and polyfluoroalkyl substances are generally referred to by their plural acronym, PFAS. PFAS are resistant to water, oil and heat, and their use has expanded rapidly since they were developed by companies in the mid-20th century. Today, PFAS' nonstick qualities make them useful in products as diverse as food wrappers, umbrellas, tents, carpets and firefighting foam. The chemicals are also used in the manufacture of plastic and rubber and in insulation for wiring. (Hersher, 4/22)

When Yondje Choi was told she would need a face mask for an upcoming trip to South Korea, Ms. Choi, a 31-year-old New Yorker, was shocked. “I knew air pollution is a major problem in Beijing, but I didn’t know it was this bad here,” she said last month in Seoul. While China takes a bulk of the heat when it comes to unhealthy levels of air quality, air pollution is a major issue throughout Asia and beyond, even to Europe and North America. Without research and self-care, even short-term visitors may feel the effects. Here are some precautions you can take to help you breathe easier. (Yoon, 4/21)

Marcus Overton isn’t a stranger to emergency rooms—and he doesn’t like them. “They’re chaotic and loud,” says the 75-year-old San Diego resident, who battles diabetes and heart-valve problems. “They usually put you in a bed, pull a curtain around you, and you wait.” But last month, the former actor and arts administrator sought treatment for shortness of breath at an ER designed for elderly patients and their families. It was a wholly different experience. (Howard, 4/21)

About a quarter of the nation’s 40 million family caregivers live with the fear that they will make a mistake on vital medical tasks such as giving injections or caring for wounds that could harm their loved ones, according to an AARP report released this week. (Anderson, 4/22)

Three months ago, this flu season was shaping up to be short and mild in the U.S. But a surprising second viral wave has made it the longest in 10 years. This flu season has been officially going for 21 weeks, according to reports collected through last week and released Friday by the Centers for Disease Control and Prevention. That makes it among the longest seen since the government started tracking flu season duration more than 20 years ago. Some experts likened the unusual double waves to having two different flu seasons compressed, back-to-back, into one. (4/19)

When family physician Jenna Fox signed on for a yearlong advanced obstetrics fellowship after her residency to learn to deliver babies, she knew she'd need to practice as many cesarean sections as possible. The problem was, she also knew C-sections aren't always good for patients. Many women's health experts argue they're often unnecessary and increase health risks for mom and baby. Doctors are working to decrease high C-section rates in hospitals around the country. Fox and her colleagues on the labor and delivery floor at the University of Rochester try hard to prevent them, particularly primary C-sections, when a woman needs one for her first baby. (Gordon, 4/19)

If you know someone struggling with despair, depression or thoughts of suicide, you may be wondering how to help. Most Americans say that they understand that suicide is preventable and that they would act to help someone they know who is at risk, according to a national survey conducted by the American Foundation for Suicide Prevention and the National Action Alliance for Suicide Prevention in 2018. (Chatterjee, 4/20)

One of the most important benefits of exercise is in how it reduces our risk of developing a number of types of cancer — especially colorectal cancer, which according to some estimates is the malignancy most influenced by physical activity. But how workouts guard against colon cancer remains largely unknown. Physical activity speeds the movement of waste through the intestines, as anyone who has had to hunt for a bathroom during a workout knows. But this does not seem to fully account for the protective effects of exercise. Instead, a small study published in February in The Journal of Physiology suggests we should also look to changes in our bloodstream after exercise. (Reynolds, 4/22)

The University of California, Los Angeles, psychiatry researcher and her colleagues are testing whether virtual reality can curb anhedonia, a symptom of depression and other serious mental health conditions that’s marked by a lack of interest or ability to feel pleasure. They’re putting patients into pleasant scenarios — like a stroll through a sun-soaked forest while piano music plays — and coaching them to pay close attention to the positive parts.The idea is to help patients learn to plan positive activities, take part in them, and soak up the good feelings in the process. (Thielking, 4/22)

Once more, Humpty Dumpty took a great fall last month when a new study linked egg consumption to cardiovascular disease. What follows may — or may not — put Humpty back together again, especially for egg lovers who cheered the latest dietary guidelines that seemed to exonerate this popular cholesterol-rich food. While suggesting that Americans “eat as little dietary cholesterol as possible,” the guidelines’ scientific report in 2015 stated “cholesterol is not a nutrient of concern for overconsumption.” (Brody, 4/22)

Every pediatrician knows that it’s important to diagnose autism when a child is as young as possible, because when younger children get help and intensive therapy, their developmental outcomes improve, as measured in everything from improved language, cognition and social skills to normalized brain activity. “The signs and symptoms for most children are there between 12 and 24 months,” said Dr. Paul S. Carbone, an associate professor of pediatrics at the University of Utah and a co-author of “Autism Spectrum Disorder: What Every Parent Needs to Know,” published by the American Academy of Pediatrics. “If we can get them in for evaluation by then, the therapies are available as young as those ages, you can easily start by 2,” he said. “We’d like to give kids the benefit of getting started early.” (Klass, 4/22)

Whitney Bell and Ana Maria Rodriguez sit on the floor in Bell's central Phoenix apartment, comparing notes about the trio of little boys in the room. The women sound like two friends sharing mom stories. And they are friends, but what brought them together was a program Bell and her husband signed up for when she was pregnant with Lawrence, who's now 3. The Healthy Families program gave the young family assistance with everything from where to find diapers to health care, all through regular home visits from Rodriguez. When Bell learned she was pregnant with twins, Healthy Families helped her and her husband in their hunt for a larger apartment. (Pitzl, 4/19)

The result is something clinicians often refer to as Amplified Pain Syndrome, though it's sometimes called  juvenile fibromyalgia or central sensitization syndrome. Because the patients who experience this syndrome don't appear to be ill, the pain is difficult to understand and to treat. But it couldn't be more real to those experiencing it, of whom 80-85% are female. Often, by the time patients receive the diagnosis, the pain has gone on for months or years, and this makes it difficult to estimate just how many people suffer from the problem. [Cara] Hoffart is part of the team in the Rehabilitation for Amplified Pain Syndrome Program at Children's Mercy. It offers intensive physical and occupational therapy, relaxation techniques, stress-management training, and music and therapeutic art in three to four-weeks sessions. (Kniggendorf, 4/19)

Kimberly Ho, a newly minted nurse at Children’s National Medical Center just off a 12-hour overnight shift, struggled to focus on a presentation about working with sexually traumatized children and adolescents. As the picture of a skin infection flashed on the screen, the 22-year-old snapped to attention. The instructor was recounting the story of a teenage patient who had been given an incorrect diagnosis by a doctor in training — a breach of hospital protocol that had caused an uproar. The lecture, aimed at new staff members, emphasized the importance of working within the chain of command. The girl’s actual diagnosis was largely beside the point — except to Ho. (Boodman, 4/20)

It should have been one of the happiest moments of Priscilla Maldonado’s life, but, instead, the 25-year-old mother was terrified. It was New Year’s Day, and she had just delivered her newborn son, Ja’bari. She said she heard her son’s soft cries — and then the hospital room fell silent. No one told her she had a healthy baby boy. No one told her how much he weighed or how long he was. No one brought him to meet his mother and place him on her chest. (Bever, 4/19)

An estimated 40 percent of adults in the U.S. snore. And, men: You tend to out-snore women. (Yes, this may explain why you get kicked or shoved at night!) And despite the myth that snoring is a sign of deep sleep, there's really no upside to it. "Snoring really does not demonstrate anything good," says Erich Voigt, an ear, nose, and throat doctor and sleep specialist at New York University Langone Health. "You can have beautifully deep sleep in a silent sleep." (Aubrey, 4/22)

Kaiser Health News: Listen: Syphilis Spreads Into Rural America

Lauren Weber, one of Kaiser Health News’ new Midwest correspondents, joined St. Louis Public Radio reporter Jeremy Goodwin on “St. Louis on the Air” Friday to discuss how syphilis is making inroads into rural counties across the Midwest and West. In Missouri, the total number of syphilis patients has more than quadrupled since 2012, testing the weakened public health safety net in areas unfamiliar with the potentially deadly infection. Listen to the interview on the St. Louis Public Radio website. (4/19)

A Washington state lawmaker has angered nurses and spawned a flurry of viral hashtags and memes on social media by saying that some nurses may spend a lot of time playing cards in small, rural hospitals. State Sen. Maureen Walsh, a Republican representing College Place, Washington, made the comments this week while debating a Senate bill that would require uninterrupted meal and rest breaks for nurses. The bill would also provide mandatory overtime protections for nurses. (4/20)

Under the arrangement, called the Massachusetts Value Alliance, hospitals are working together to slash costs by buying some supplies and services together. By teaming up, they have greater leverage in negotiating prices with vendors that sell equipment, software, and other things hospitals need. (Dayal McCluskey, 4/21)

Health officials in Idaho say anyone who used an on-board restroom during a Greyhound bus trip from Salt Lake City to Boise on April 10 might have been exposed to hepatitis A. The Central District Health Department in Idaho is asking anyone who used the restroom to contact them to get information about potential exposure. The district says riders on the bus from Utah to Idaho who were exposed could receive a vaccine to protect them from the virus through April 23. (4/19)

The Senate Appropriations Committee changed proposals on the “certificate of need” regulatory process, telehealth and prescription-drug importation programs --- all issues that are priorities of House Speaker Jose Oliva. Some of the changes surprised Republican senators, who complained about the sudden revisions. The moves came after Oliva, R-Miami Lakes, told reporters late Wednesday night that his health-care priorities would pass this session. (Sexton, 4/19)

The team is one of seven in Northeast Ohio that has been working since March 1 to design possible solutions for specific challenges facing six disabled Ohio veterans and a former Israeli counter-terrorism unit member. There were some 4.8 million American veterans receiving VA disability compensation at the end of 2018. (Albrecht, 4/21)

On this edition of River to River, host Ben Kieffer talks with Jennifer Zwagerman, Associate Director of the Drake Agricultural Law Center, about how the closing of Jesup's only grocery store is indicative of a larger trend. Zwagerman says that recent grocery store losses in rural communities across Iowa are a serious concern, both in terms of nutrition and food access and for the broader social and economic health of these communities. (Dewey, Harrop and Kieffer, 4/19)

City officials told Milwaukee residents Friday to make sure they have received the measles vaccine. Residents should review their families' immunizations and make sure children have received both doses of the measles vaccine, the city Health Department said. (Carson, 4/19)

Patients who are fed up with the bureaucracy of the health insurance industry are ditching the copays and high deductibles for a different way to get primary care. ... In the Kansas City region, 26 direct primary care, or DPC, clinics have formed the Midwest Direct Primary Care Alliance. It consists of doctors who are opting to leave the traditional fee-for-service practice for a private practice offering patients membership-based healthcare services.(Ruiz, 4/20)

In 2016, Los Angeles voters approved a $1.2-billion bond measure to help fund housing for homeless people, with a goal of 10,000 new units in a decade. Now, after hustling to get as many housing projects started as soon as possible, city officials are coming to the end of the money available through Proposition HHH, and it’s not certain that promise will be kept. The city has committed two-thirds of the bond to secure a little more than half the units the measure was intended to subsidize. (Smith, 4/21)

Eagle County, Colorado, is best known for the world-famous Vail Ski Resort, but the area also has a dark side that it's trying to combat. The county of roughly 55,000 averages one suicide attempt per day, according to public health director Chris Lindley. One in four of its seventh and eighth graders seriously considered suicide last year, according to the most recent Healthy Kids Colorado Survey. Of that group, 16% have made a plan, some in pacts with others. (Bannow, 4/19)

Madison-based Redox Inc. has raised $33 million from investors that will help it grow its network of customers and double its workforce. Redox, which helps healthcare vendors and providers share data, announced the $33 million round in a news release. (Hauer, 4/19)

A former patient has sued San Diego, Calif.-based Sharp HealthCare for allegedly violating her and other patients' privacy after one of its hospitals filmed more than 1,800 surgical procedures including births without patient consent. Amber Snodgrass underwent a caesarean section at Sharp Grossmont Hospital in La Mesa, Calif., in December 2012. She claims she was secretly recorded based on a public statement Sharp HealthCare CEO Chris Howard made in which he admits patients who underwent treatment at Sharp Grossmont's Women's Health Center from July 2012 to June 2013 were filmed without their knowledge. (Castellucci, 4/19)

CMC last week confirmed it was moving forward with plans for building up to a six-story addition and demolishing a nearby strip mall in a project estimated to cost $125 million to $175 million. Harvey Construction in Bedford has ongoing projects with multiple hospitals across the state. ...They include a new four-story medical office building on the Concord Hospital campus. The building will handle “an increased demand for specialty services while providing space to accommodate more patients from beyond the Capital Region,” according to a hospital announcement. (Cousineau, 4/21)

CKR Natural Solutions, cofounded by local business owner Kirby Mastrangelo, said in a complaint filed last month in Essex County Superior Court that Amesbury Mayor Ken Gray told the company it needed a special permit from the city’s planning board — a requirement he did not apply to an earlier applicant nor a subsequent one that ultimately was granted a retail marijuana license. Without the special permit, the company said, Gray would not negotiate a host community agreement that would have allowed CKR to apply for a state license and eventually open. (Adams, 4/19)

Singapore’s health care system is sometimes held up as an example of excellence, and as a possible model for what could come next in the United States. When we published the results of an Upshot tournament on which country had the world’s best health system, Singapore was eliminated in the first round, largely because most of the experts had a hard time believing much of what the nation seems to achieve. (Aaron E. Carroll, 4/22)

Now, for the first time in U.S. history, American life expectancy has fallen two years in a row — and one of the causes is another epidemic. This time, however, it is not the “flu” or “mystery” diseases like HIV/AIDs. It is the tragedy of addiction and, in some cases, stupidity in the self-indulgent use of illegal drugs and prescription pain-killers.More Americans — more than 70,000 in 2017, according to U.S. health authorities — die annually from overdoses. That is more than the number of Americans killed during the entire war in Vietnam, from 1961 to 1975.��(Raoul Lowery Contreras, 4/19)

It’s alive! Like something out of Mel Brooks’ “Young Frankenstein,” a group of scientists at the Yale School of Medicine recently tried to revive dead brains from pigs. As reported Wednesday in the journal Nature, by pumping and filtering nutrient-filled fluid through the brains’ blood vessels, the scientists managed to preserve some brain cells that were dying and restore some cellular function.A technological feat, to be sure. Does this call into a question the finality and irreversibility of brain death as death? I think not. (Robby Berman, 4/22)

Every March, a national study comes out showing that Northern Virginia is home to the healthiest counties in Virginia, with Arlington, Loudoun and Fairfax counties and the city of Falls Church reliably at the top of the list of counties (and Alexandria and Prince William County typically not far behind). Northern Virginia should be proud of our overall health and well-being — but also well-informed about what’s missing from the county health rankings story. The rankings are based on averages that mask tremendous disparities in Northern Virginia. (Patricia Mathews, 4/19)

Jails across the nation are crowded with mentally ill inmates who are there because of a broken promise. Over the course of several decades, states closed mental hospitals and vowed to replace them with community-based psychiatric treatment and housing. But the treatment and housing failed to materialize.Now people whose mental health problems go unaddressed get arrested for conduct they often can’t control. They sit in jail, awaiting trial. They are convicted, return to jail, serve a few weeks or months, and are released with no continuing care and often no place to live but the street. With their illnesses still untreated, they offend again, and the cycle repeats. The sick remain sick, the streets and jails fill, the costs mount. (4/22)

Toymakers whose toys injure kids can be sued. Carmakers that put dangerous cars on the highways and kill people can be sued. The U.S. cigarette industry is paying more than $200 billion for the toll of its deadly products. Yet the manufacturers of guns that kill almost 40,000 Americans yearly are protected from liability by federal law. Relatives of the victims of the Sandy Hook Elementary School massacre may have found a way around that injustice, suing in state court over the way the guns are marketed. The Connecticut Supreme Court has ruled their lawsuit can go forward. If it survives a U.S. Supreme Court challenge, it could provide the ammunition America needs to finally make these merchants of death legally responsible for the blood they’ve helped shed. (4/21)

Do people have a right to health care? Over and over again, many Republicans answer no. They have stranded both Kansas and Missouri among just 14 states that refuse expansion of Medicaid to help 450,000 of their poor uninsured citizens. Thirty-six other states and the District of Columbia have approved Medicaid expansion. (Charles Hammer, 4/18)

The 96,000-plus Montanans currently covered by Medicaid expansion can breathe a sigh of relief — along with their families, employers and health care providers. The Legislature finally approved continuation for at least six years of the program that offers needed health care to low-income Montanans regardless of age or disability. Montana hospitals, physicians, nurses, faith leaders, advocates for low-income families and health care organizations produced mountains of data confirming the benefits of Medicaid expansion since it started here in 2016. (4/21)