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The Trump administration is considering reversing long-standing policy to make it easier to deport U.S. legal permanent residents who have used public benefits, part of an effort to restrict immigration by low-income people. A Department of Justice draft regulation, seen by Reuters, dramatically expands the category of people who could be subject to deportation on the grounds that they use benefits. Currently, those legal permanent residents who are declared to be a "public charge," or primarily dependent on the government for subsistence, can be deported - but in practice, this is very rare. (Torbati, 5/3)

Former White House Chief of Staff John F. Kelly has joined the board of the conglomerate that operates the largest facility for migrant children in the country, the company announced Friday. Caliburn International's CEO James Van Dusen confirmed the appointment of the former Trump cabinet member in a news release. (Gomez Licon, 5/3)

Caliburn owns Comprehensive Health Services Inc, a private, for-profit company that runs a facility for unaccompanied migrant children in Homestead, Florida, some 35 miles south of Miami. The site became a heated topic of debate, as immigration advocates and Democratic legislators complained many traumatized children who fled violence and poverty in their home countries were held in the institutionalized setting for too long before being released to sponsoring families who could better care for them. (5/3)

A faith-based chain of clinics that won $5.1 million federal family planning funds by positioning itself as an alternative to Planned Parenthood now unexpectedly finds itself faced with the prospect of offering contraception and counseling that includes discussing abortion — activities antithetical to its very existence. The nonprofit Obria Group received the Title X grant in March as a sweeping Trump administration revamp of the program was churning forward. New rules would, among other things, bar health providers in the program from offering or referring patients for abortions — a restriction critics call a "gag rule." Since then, a series of federal court injunctions have frozen the changes, prompting abortion-rights groups to demand Obria comply with existing standards. (Colliver, 5/3)

The leadership of the National Institutes of Health has reversed course and will allow two senior doctors to speak with federal investigators regarding patient-safety issues in a nationwide trial of treatment for the bloodstream infection sepsis. The NIH, the U.S. government’s premier health-research agency, has been blocking the two critical-care doctors from speaking with government investigators about safety issues in the study of 2,320 patients. The NIH’s stance, which has led to a dispute with dozens of its senior researchers over medical freedom of speech, was detailed by The Wall Street Journal earlier this week. An NIH spokeswoman said Friday the NIH has reversed its position. (Burton, 5/3)

VA Secretary Robert Wilkie on Thursday set out new proposals to cut federally funded union time as the Veterans Affairs Department looks to renegotiate its collective bargaining agreement. The proposals include an annual cap on the time all union workers can get paid by the VA to perform union work to 10,000 hours per year. Another provision would give "frontline supervisors" more authority over workers. (Luthi, 5/3)

Kaiser Health News: FDA To End Program That Hid Millions Of Reports On Faulty Medical Devices

The Food and Drug Administration announced it is shutting down its controversial “alternative summary reporting” program and ending its decades-long practice of allowing medical device makers to conceal millions of reports of harm and malfunctions from the general public. The agency said it will open past records to the public within weeks. (Jewett, 5/3)

Sen. Cory Booker (D-N.J.) on Sunday said he supports the progressive "Medicare for All" health care plan, but noted that he is a "pragmatist" who is interested in looking for more "immediate" reforms to the system. "I stand by supporting 'Medicare for All' but I’m also that pragmatist," Booker, a 2020 presidential candidate,  told CNN's Jake Tapper on "State of the Union." "I’m going to find the immediate things that we can do. I’m telling you right now we’re not going to pull health insurance from 150 million Americans that have private insurance, who like their insurance." (Birnbaum, 5/5)

Booker's comments underscore the tensions playing out in the 2020 Democratic presidential primary between progressives pushing sweeping economic proposals and moderates saying that more incremental moves will be necessary if the party wins back executive power in Washington. Booker is one of several 2020 contenders co-sponsoring the Medicare for All bill introduced by Sen. Bernie Sanders (I-Vt.). That legislation would expand government-run health coverage and shrink private health insurance. Sanders is polling ahead of most other Democrats running for president. (Warmbrodt, 5/5)

Tennessee is charging ahead to become the first state in the nation to ask the Trump administration for Medicaid funding in a lump sum — a radical overhaul of the entitlement program that critics warn could force major cutbacks in health coverage for low-income people. State Republican lawmakers on Thursday, emboldened by the Trump administration’s promise to provide states with more flexibility to run their Medicaid programs, approved legislation requiring Tennessee to submit a Medicaid block grant plan to the federal government within six months. The legislation now goes to Republican Gov. Bill Lee, who will sign the bill, a spokesperson said. (Pradhan, 5/3)

Democratic Gov. Laura Kelly's effort to expand Medicaid in Kansas this year died Saturday when enough moderate Republicans bowed to the wishes of the GOP-controlled Legislature's conservative leaders and ended an impasse that had tied up the state budget. The House voted 79-45 in favor of an $18.4 billion spending blueprint for state government for the budget year beginning in July. Democrats and moderate Republicans held the budget hostage Friday and much of Saturday, hoping to force the Senate to vote on an expansion plan passed by the House and favored by Kelly. (Hanna, 5/4)

Kansas lawmakers who support expanding Medicaid blocked passage of the next state budget Friday in a high-stakes standoff designed to force the Legislature's conservative Republican leaders to allow an expansion plan backed by Democratic Gov. Laura Kelly. Kelly's election last year raised hopes that Kansas would join 36 other states that have expanded Medicaid or seen voters pass ballot initiatives. (Hanna, 5/3)

Gov. Kim Reynolds has signed a budget bill that prohibits the use of Medicaid funding to pay for sex-reassignment surgery. The Republican governor signed the Health and Human Services funding bill on Friday and opted not to issue a line item veto of the ban on public funding for such surgeries. Conservative Republicans added the prohibition in the closing days of the Legislature, saying it was a response to a recent Iowa Supreme Court decision that said the state couldn't deny two transgender women Medicaid coverage for sex-reassignment surgery. (5/3)

Johnson & Johnson, one of the world’s largest health-care conglomerates, nurtures a family-friendly image as it sells Band-Aids and baby shampoo, soaps and skin creams. “We are responsible to the communities in which we live and work and to the world community as well,” reads a sentence in the company credo, written in 1943 by Robert Wood Johnson, a member of the company’s founding family. But, by connecting it to an epidemic that has ravaged the country for two decades, Oklahoma’s attorney general plans to expose another side of the company when the first major state trial of the opioid era begins later this month. (Bernstein, 5/4)

This week, a federal appeals court addressed the right to treatment for an inmate who suffers from opioid addiction, a move that legal advocates say could have wide repercussions. The United States Court of Appeals for the First Circuit in Boston ruled that a rural Maine jail must provide Brenda Smith with medication for her opioid use disorder. One of her attorneys, Emma Bond, a staff attorney with the ACLU of Maine, says the new ruling has the potential to create a "big signal" for jails across the country and combat the social barriers preventing incarcerated people from receiving treatment. (Arnold, 5/4)

Buprenorphine can be prescribed by both doctors and nurses who have taken specific training and received a license from the Drug Enforcement Administration. ...In California, however, the role of nurses is limited: They can prescribe the medicine, but only under the oversight of a doctor. That requirement is controversial. Some say it is an extra hurdle that restricts access to medications, while others say it is an appropriate limit of a nurse's scope of care. (Klivans, 5/3)

Plans passed by the House and Senate to respond to Minnesota's epidemic of opioid abuse overlap in many areas. ... But as public deliberations resume Monday with a House-Senate conference committee, a key sticking point remains. Lawmakers are struggling with how the fees are structured. (Bakst, 5/6)

Dubbed the Milwaukee Overdose Response Initiative, the effort puts into practice the recommendations of the Milwaukee City-County Heroin, Opioid, and Cocaine Task Force. It aims to save lives by finding trends in data while also providing more direct avenues to treatment and providing in-school education. (Dirr, 5/3)

Experts say people use substances and behaviors associated with eating disorder to self-treat underlying, often undiagnosed, mental health issues. However, there’s an overall lack of eating disorder specialists in North Carolina and even fewer who are equipped to treat co-occurring disorders, even as there’s a dire need. In the U.S., about 20 million women and 10 million men will experience an eating disorder at some point, according to the association. (Knopf, 5/6)

A European study of nearly 1,000 gay male couples who had sex without condoms – where one partner had HIV and was taking antiretroviral drugs to suppress it - has found the treatment can prevent sexual transmission of the virus. After eight years of follow-up of the so-called serodifferent couples, the study found no cases at all of HIV transmission within couples. (5/3)

The risk of transmitting HIV from someone being treated effectively to their partner has been entirely eliminated, according to new study that could signal a possible end to the AIDS epidemic. The study published in the Lancet medical journal looked at transmission rates from 1,000 male couples in Europe where one of the partners was HIV negative and the other was receiving treatment to suppress the virus. The study found no cases where HIV was transmitted to the HIV-negative partner during unprotected sex. Only 15 men were infected with HIV during the study, but researchers found this occurred only when the person had had sex with someone other than their partner who was not being treated. (Clark, 5/3)

Over eight years of follow-up in the study, 15 HIV-negative men became infected with HIV, but none of the viruses screened in the newly infected partner was genetically linked to the HIV virus that had infected their main partners, ruling out any within-couple HIV transmissions. Underlining the human impact of the study’s findings, the researchers estimate that effective antiretroviral therapy prevented about 472 HIV transmissions during the eight years of the study. (Neville and Craggs Mersinoglu, 5/3)

If everyone in the world with HIV knew their status and had access to effective treatment, no new cases would occur, the study suggests. Alison Rodger, a professor at University College London who co-led the research, told CNN's Hala Gorani that if everyone in the world had access to the right treatment, the virus could be eliminated. "We've got a way to go to get people easier access to testing and treatment, but if we could get global coverage, then we could really make headway in eliminating the virus," she said. (Mackintosh, 5/3)

It’s called the clinical global impressions of improvement, or CGI-I, and it’s a seven-point scale doctors use to score whether patients are generally improving. According to Ovid, that makes it ideal for a disease like Angelman, in which patients’ symptoms can dramatically vary in both type and severity. One may struggle to sleep but be able to walk; another might be virtually immobile but have some speech skills. (Garde, 5/6)

Scientists are setting a new course in their quest to treat Alzheimer's disease. The shift comes out of necessity. A series of expensive failures with experimental drugs aimed at a toxic protein called amyloid-beta have led to a change in approach. The most recent disappointment came in March, when drugmaker Biogen and its partner Eisai announced they were halting two large clinical trials of an amyloid drug called aducanumab. (Hamilton, 5/3)

The Food and Drug Administration has approved the first vaccine for dengue, Dengvaxia, but placed significant restrictions on its use because the vaccine has been shown to put some people at heightened risk for a severe form of the disease. In clearing the vaccine, the agency acknowledged the serious public health benefit of slowing a disease that affects hundreds of millions of people around the world. The decision may also help a struggling product whose use has stalled because of concerns over its possible risks. (Thomas, 5/3)

The U.S. Food and Drug Administration just approved one of the most sought after vaccines in recent decades. It's the world's first vaccine to prevent dengue fever — a disease so painful that its nickname is "breakbone fever." The vaccine, called Dengvaxia, is aimed at helping children in Puerto Rico and other U.S. territories where dengue is a problem. (Doucleff, 5/3)

In early 2001, Joe Ng boarded a ship in the Azores to collect samples of mud. It wasn’t just any old boat: It was the Akademik Mstislav Keldysh, the 401-foot Russian research vessel used by filmmaker James Cameron to help capture deep-sea footage for the blockbuster film “Titanic.” And it wasn’t just any kind of mud: It was samples from a hydrothermal vent field thousands of feet below the Atlantic Ocean’s surface where some of the world’s tiniest and toughest organisms flourished. The $50,000 ticket bought Ng, a molecular biologist, roughly two weeks at sea. Afterward, Ng traveled back to Huntsville, Ala., with an insulated lunch cooler stuffed with plastic sandwich bags of mud. Back in his lab, he occasionally subjected these “extremophiles” — a word derived from Latin (extreme) and Greek (love) — to various tests. (Blau, 5/5)

Statin drugs like Lipitor and Crestor significantly reduce the risk for cardiovascular disease, rigorous studies have shown. But a “real-world” analysis published in Heart suggests that in practice about half of patients do not benefit from them. British researchers studied 165,411 patients free of cardiovascular disease who started statin therapy between 1990 and 2016. They measured their LDL levels (the “bad” cholesterol) before the study began and again after 24 months, and then followed them for an average of six years. (Bakalar, 5/3)

A prominent U.S. lawmaker may be upset that AbbVie (ABBV) ties the bonus given chief executive Richard Gonzalez to sales of the Humira rheumatoid arthritis treatment, but most shareholders seem unconcerned. At the drug maker’s annual meeting on Friday, an overwhelming majority of stockholders rejected a proposal that would have required AbbVie to compile an annual report on how pricing is used to set executive compensation, according to a coalition of faith-based investor groups that submitted the proposal. On a preliminary basis, 69% of shareholders voted down the proposal. (Silverman, 5/3)

To fight the biggest measles outbreak in the U.S. in more than a quarter-century, public-health officials have tried robocalls, vaccination audits, vaccination orders and $1,000 fines. This is the standard playbook and it hasn’t worked to stop the disease’s spread. Now, officials are increasingly counting on an informal network of community groups, religious leaders and local medical practitioners. Blima Marcus, a 34-year-old oncology nurse practitioner, is working to counter antivaccination messages that have taken root in New York City’s insular ultra-Orthodox Jewish communities where measles has spread. (McKay and West, 5/5)

U.S. doctors are tapping into their electronic medical records to identify unvaccinated patients and potentially infected individuals to help contain the worst U.S. measles outbreak in 25 years. New York's NYU Langone Health network of hospitals and medical offices treats patients from both Rockland County and Brooklyn, two epicenters of the outbreak. It has built alerts into its electronic medical records system to notify doctors and nurses that a patient lives in an outbreak area, based on their Zip code. (Steenhuysen, 5/5)

Most of the measles cases during the recent historic outbreak have occurred in children, but adults in high risk environments – like UCLA or California State University, Los Angeles, where people were exposed to the virus – may need to get another dose of the vaccine, according to the the Centers for Disease Control and Prevention. Adults born before 1957, when the vaccine was introduced, are assumed to have immunity from the disease. But adults born between 1957 and 1989 may have received only one, potentially weaker, dose or no doses. (Jasper, 5/3)

A 40-year-old pregnant woman who fears catching measles on the New York City subway walks eight miles round trip from her home in Brooklyn to her job in Manhattan. Two New Jersey parents who don’t agree about vaccines and are now getting divorced have asked a judge to make a ruling on if their children should be vaccinated. As measles cases in the United States have risen to 700, affecting 22 states, Americans who are fearful the disease will reach them are taking strong measures to defend themselves. (Moore, 5/3)

Doctors give a lot of very good advice. Over the years, my primary care doctors have suggested better eating habits, more exercise, improved sleep hygiene, not carrying such a heavy shoulder bag, even exercises to improve my posture. The problem is, I am not sure I have ever made any changes in my behavior as a direct result. That would not come as a surprise to Ken Resnicow, a professor at the University of Michigan School of Public Health. “Finger-wagging doesn’t work,” he said. (Klass, 5/6)

A 5-year-old girl was brought to the emergency room at Evelina London Children’s Hospital with itchy, rather unsightly sores on both legs. She had recently returned from a weekslong trip to Sierra Leone, and the lesions, which first appeared three weeks into her stay there, had become larger and ulcerated. Diagnosis: cutaneous diphtheria, a disease rarely seen in many industrialized countries, including Britain and the United States, where most children are protected by the diphtheria toxoid vaccine, DTaP, and a booster shot of the tetanus-diphtheria-pertussis vaccine, Tdap. (Brody, 5/6)

This year, London’s Southwark Playhouse announced the cast of a new play, “All in a Row.” It was instantly clear this would not be a typical family drama. The play unfolds the night before social services separates a boy named Laurence from his family. Unlike the other three characters, Laurence, a nonverbal autistic and sometimes aggressive 11-year-old, would be portrayed by a child-size puppet. When the play opened, a reviewer for the Guardian newspaper awarded it four stars, saying it had “warmth and truth.” On Twitter and beyond, theatergoers also offered praise. (Opar, 5/5)

Scientists who recently announced an experimental genetic test that can help predict obesity got immediate pushback from other researchers, who wonder whether it is really useful. The story behind this back-and-forth is, at its core, a question of when it's worth diving deep into DNA databanks when there's no obvious way to put that information into use. The basic facts are not in dispute. Human behavior and our obesity-promoting environment have led to a surge in this condition over the past few decades. Today about 40% of American adults are obese and even more are overweight. (Harris, 5/6)

When Tori Geib learned she had terminal metastatic breast cancer in 2016 on the week of her 30th birthday, she was automatically booked to see a palliative care coach at Ohio State University Comprehensive Cancer Center in Columbus. There, in addition to receiving a targeted therapy pill to slow the spread of the cancer, she was offered a host of services that she says shaped her quality of life for the next three years: acupuncture, pastoral comfort, nutrition advice and pain expertise to control her nausea and back pain because the cancer had spread to her spine. She also saw a mental health counselor who helped her come to terms with the brutality of her diagnosis. (Richards, 5/6)

Feel like you're living under a rain cloud? Life not going your way? Lots of us have a bit of Eeyore's angst and gloom. But here's the good news (sorry to be so cheery): You can be taught to have a more positive attitude. And — if you work at it — a positive outlook can lead to less anxiety and depression. The latest evidence comes from a new study of caregivers — all of whom had the stressful job of taking care of a loved one with dementia. The study found that following a five-week course, participants' depression scores decreased by 16 percent and their anxiety scores decreased by 14 percent. The findings were published in the current issue of Health Psychology. (Aubrey, 5/5)

People didn’t talk much about sex in the 1980s — at least not openly. So when a pint-size former Israeli sniper with a thick German accent began saying things like “premature ejaculation” and enter “from behind” on local radio — and later, television — people listened (closely). Dr. Ruth banned the word “frigid” on her show. She schooled Conan O’Brien on why “blue balls” was sexist — it’s a phrase for which there is no female equivalent — and suggested they create a companion term for women: “blue lips.” “It never caught on,” she said this week. (Bennett, 5/3)

More than 1,000 people have died from Ebola in eastern Congo since August, the country’s health minister said on Friday, the second-worst outbreak of the disease in history behind the West African one in 2014-16 that killed more than 11,300. The toll came as hostility toward health workers continued to hamper efforts to contain the virus. Health Minister Oly Ilunga said that four deaths in the outbreak’s center, Katwa, had helped push the death toll to 1,008. Two more deaths were reported in the city of Butembo. The outbreak was declared almost nine months ago. (5/4)

For several months last spring and summer, my teen daughter, Caroline, experienced near-daily bouts of depression and debilitating panic attacks. During those episodes, she became extremely agitated, sobbing uncontrollably and aggressively rebuffing my attempts to comfort or reason with her. My daughter was in a dark place, and I was worried. But I have excellent health insurance, and I thought that would help me find a good therapist. (Wolfson, 5/3)

Healthcare hiring fell in April, which shouldn't come as a surprise following March's unusually strong jobs report. Hiring in the healthcare sector declined 45% in April, having added 27,000 jobs, according to the U.S. Bureau of Labor Statistics' newest jobs report, released Friday. That's compared with March's 49,100 new hires, a number that approached December 2018's historic high. (Bannow, 5/3)

A big player in health care wants federal officials to scrutinize the proposed $17.3 billion acquisition of Tampa-based WellCare Health Plans by Centene Corp. of St. Louis. In a letter this week, the American Hospital Association urged the anti-trust division of the U.S. Department of Justice to investigate the proposed merger "because it threatens to reduce competition in delivery of Medicaid managed care and Medicare Advantage services to tens of millions of consumers across broad swaths of the country." (Danielson, 5/3)

Kaiser Health News: A Boat Crushed His Face, Then Plastic Surgeons Hit Him With $167,000 In Bills

Bob Ensor didn’t see the boom swinging violently toward him as he cleaned a sailboat in dry dock on a spring day two years ago. But he heard the crack as it hit him in the face. He was transported by ambulance to an in-network hospital near his home in Middletown, N.J., where initial X-rays showed his nose was broken as were several bones of his left eye socket. The emergency physician summoned the on-call plastic surgeon, who admitted him to the hospital and scheduled him for surgery the next day. (Andrews, 5/6)

Arizona is seeing a surge in hepatitis A cases, mostly in the Tucson area but also in metro Phoenix, health officials say. The outbreak of the viral disease that affects the liver began in November and cases have continued to rise since then despite efforts to step up vaccinations. The Arizona Republic reports the outbreak could take months to rein in. (5/5)

Nursing homes receive a fixed amount of state aid for Medicaid patients, who make up the majority of the facilities’ patient pool. For the last decade, that level of aid has barely budged. If a plan to raise the state’s minimum wage to $15 an hour, up from $10.10, succeeds this year, nursing home operators – wedged between rising labor costs and stagnant funding – say they may be forced to lay off staff or trim benefits to come up with the additional money for the organizations’ lowest paid employees. (Carlesso, 5/6)

Across the country, 104 small-town hospitals have closed since 2010, raising concerns that rural Americans are losing access to critical services, from obstetrics to X-rays to chemotherapy. Minnesota lost Lakeside Medical Center in Pine City and Albany Area Medical Center in that period, but still retains the third-highest number of rural hospitals in the nation. The billion-dollar question — literally, considering the economic impact of rural hospitals — is whether Minnesota has managed to insulate itself from the closure wave or just delayed the inevitable for a cluster of money-losing facilities that are barely hanging on. (Olson, 5/5)

Mount Sinai Health System and Holy Name Medical Center—a 361-bed hospital in Teaneck, N.J.—have inked an affiliation agreement. They will focus on coordinating oncology and cardiology service lines, the institutions said, as well as on genetic research, physician development and recruitment, and potentially graduate medical education. (5/3)

After 15 inmate suicides in 15 months, a federal judge ruled Saturday that Alabama is putting prisoners in danger by failing to provide adequate suicide-prevention measures. U.S. District Judge Myron Thompson wrote that there are "severe and systemic inadequacies" in the Alabama Department of Corrections' care of inmates and the facts behind recent suicides show that unconstitutional conditions persist in state prisons. (5/4)

Protesters gathered at the Arizona Capitol on Friday afternoon, demanding the firing of Arizona Department of Corrections Director Charles Ryan, and saying that the state's prison system has a "culture of cruelty." ...The event came three days after groups representing both Arizona prison guards and inmates came together to denounce what they called an "avalanche of negligence" in the state's prison system. (Westfall, 5/3)

Florida lawmakers approved a health insurance bill Wednesday that would require insurers to keep covering pre-existing conditions if the Affordable Care Act disappears, though the bill would not keep protections in the federal law to control how much those patients can be charged. The bill, SB 322, which the House approved by a 70-42 vote after the Senate passed it last week, would also expand short-term and association health plans and change requirements for “essential health benefits” covered by insurers, regardless of the status of the Affordable Care Act. (Koh, 5/2)

A judge on Friday rejected a six-month freeze in the involuntary manslaughter case of Michigan's former health director, who is accused of failing to timely warn the public about a Legionnaires' disease outbreak during the Flint water crisis. A new team of prosecutors said it needed more time to assess and collect evidence after learning about 23 boxes of records in a state basement. But Judge Joseph Farah said the discovery has no practical impact on his next step in the case. (5/3)

For months, UPTE-CWA members have voiced job security concerns over a UC Davis Health plan to team up with Kindred Healthcare to build an in-patient rehabilitation hospital at the Aggie Square development in Sacramento. In complaints filed in late April, the union said it has since learned the UC system has outsourcing contracts that will put many more workers’ jobs in peril. (Anderson, 5/6)

New research from Iowa State University scientists found western Iowa has the state’s largest presence of a type of mosquito that carries West Nile Virus. Scientists are watching to see whether standing water from March’s flooding will bring more mosquitoes and the risk of the virus to western Iowa this summer. (Peikes, 5/3)

As the University of Maryland Medical System faces fallout from a scandal involving lucrative contracts awarded to its board members, including Catherine Pugh, who has since resigned from the board and as Baltimore’s mayor, the system’s flagship hospital has made a move to charge its patients more. The University of Maryland Medical Center asked state regulators for permission to boost billing by $75 million a year, a nearly 5 percent increase. It’s the largest increase requested by any hospital since the state began capping hospitals’ budgets in recent years under a federally sanctioned program to control health care spending. (Cohn, 5/6)

Moving beyond the typical adult day care center approach, a new facility is opening next month that will provide day services for adults that focus on health and wellness. In addition to social activities, Nashua Adult Day Health will offer seniors a variety of health-oriented services that are often difficult to find in one organization under one roof, said Kyle Worth, founder and executive director of the program. (Houghton, 5/4)

Since January, an advisory committee for the State Medical Board of Ohio has studied the five ailments and whether medical marijuana could help. The three other conditions under consideration are anxiety, autism spectrum disorder and opioid use disorder, the formal term that the medical board uses for opioid addiction. (Saker, 5/5)

Bernie Sanders sells Medicare for All as a simple idea: “You will have a card which has Medicare on it, you’ll go to any doctor that you want, you’ll go to any hospital that you want.” So the Congressional Budget Office provided a public service last week by describing, albeit in thick and cautious bureaucratese, what it would really take to float BernieCare. Democrats asked CBO to lay out some parameters of how to set up single-payer, hoping to elude analysis of any one bill in Congress. (5/5)

Of the 263,000 nonfarm payroll jobs that the Bureau of Labor Statistics estimates were created in April, 27,000 were in health care. This is not really news: Since the beginning of 2015, the average monthly gain in health-care jobs has been 28,959. Since 2010, it’s been 23,893; since 2000, it’s been 24,041; since 1990, it’s been 23,709. Only four of the 351 months since January 1990 have seen declines in health-care employment. (Justin Fox, 5/3)

The Democratic presidential hopefuls are brawling over so-called “Medicare for All.” No doubt, a good number of Americans can be helped by expanding insurance coverage, but debate based on a bumper-sticker slogan is not a plan for improvement. In late 2008 I met with then President-elect Barack Obama as part of a group of retired generals and admirals. I pointedly told him he needed to drill down on the mechanics of how we treat patients, as well as how that treatment gets paid for. He brushed me aside with a comment that his plan was going to fix everything. (Stephen N. Xenakis, 5/4)

When the last recession plunged the state government into a multibillion-dollar hole, California lawmakers were forced to cut deeply into numerous valuable programs just to make ends meet. Many of those cuts were penny-wise and pound-foolish, however, especially the ones in safety-net programs like subsidized child-care that helped low-income families stay in the workforce. So as the economy improved, lawmakers and former Gov. Jerry Brown slowly pieced the state’s safety net back together again. But some important benefits have yet to be restored, a full decade after the recession ended. (5/4)

With a waiver, Georgia could enroll some patients in private plans and fund accounts from which they pay out-of-pocket expenses and, ideally, aggregate contributions from other sources such as employers, family and charities. The state could contract with a provider at a flat, per capita rate to cover others in an exclusive network; this is essentially the oft-discussed “Grady waiver.” (Kyle Wingfield, 5/4)

State lawmakers are currently considering a bill that would endanger the health of all Ohioans, especially the health and well-being of our children. Babies and children cannot advocate for themselves, so it is important that we speak for them. (Aparna Bole And Kristie Ross, 5/5)

As a hospital pediatrician, I was heartbroken to care for my first patient with measles. Despite knowing intellectually that, due to poor vaccine uptake, this completely preventable disease would make a resurgence in my career, the severity of the illness still took me by surprise. There is a striking difference between textbook descriptions of rash, fever and pneumonia; and seeing a small child connected to a breathing tube to help her damaged lungs obtain air. Like most physicians, I was hit by a wave of emotion- anger at the opportunistic anti-vaccine lobby for causing so much unneeded suffering, fear for the long term effects including brain damage and death that this girl might suffer and above all else, sadness that so many innocent children will continue to be hurt. (Rebekah Diamond, 5/5)

When I first began using the “virus” analogy to describe the rapid spread of misinformation and its potential to do serious harm, I didn’t realize how fitting, or timely, that comparison would become. The recent outbreaks of measles, one of the most contagious diseases in the world, make that connection alarmingly real. (Alan C. Miller, 5/3)

Academics depict the peer-review process as the gold standard for intellectual honesty, ensuring published scholarly work is unbiased and accurate. But ideological conformity makes peer review a far thinner defense than advertised.In January I published a book about the mental-health and violence risks of cannabis. Several dozen scholars signed a petition expressing in unison their objection to my work. Thus I’ve recently spent an inordinate amount of time reading papers seeking to prove that marijuana is a cure-all whose deleterious consequences are a figment of our collective imagination. The shoddiness of much of the work has shocked me. (Alex Berenson, 5/5)

When the Food and Drug Administration announced last month that it couldn’t guarantee the long-term safety and efficacy of vaginal mesh products — medical devices that have been on the market for decades — the collective response from tens of thousands of women harmed by the products sounded something like this: Duh. The mesh, which is used to hold pelvic organs in place when muscles become too weak to do the job, has long been tied to life-altering injuries, including nearly 80 deaths as of 2018. In the past decade, seven companies have spent a collective $8 billion to resolve more than 100,000 patient claims — making litigation over vaginal mesh (or pelvic mesh, as it is sometimes called) one of the largest mass tort cases in United States history. (5/4)

Physicians, once among the most trusted professionals in the United States, now face a credibility crisis. Only one-third of Americans say they have a great deal of trust in physicians, down from around two-thirds in the 1970s. This lack of trust is leading to a burgeoning appetite for medical misinformation, causing many Americans to avoid vaccines and cholesterol-lowering statins. To quell this rising tide, I believe that my physician colleagues and I should learn from the most trusted professionals in America for 16 straight years: nurses. (Haider Warraich, 5/6)

While constitutional lawyers, ethicists and theologians — in descending order of importance in the abortion debate — have been arguing in the 46 years since the Supreme Court attempted to settle the debate, some technologists have been making a consequential contribution to it. They have developed machines that produce increasingly vivid sonograms of fetal development. This concreteness partially explains the intensification of the debate. ...The “heartbeat bills” are wholesome provocations: One of their aims is to provoke thinking about the moral dimension of extinguishing a being with a visibly beating heart. Furthermore, pro-life people are being provoked in different ways.(George Will, 5/3)

These mix-ups often have at their center patient, family and health-care provider misunderstanding regarding the meaning of a single term: “do not resuscitate,” (DNR) for short. The term DNR means that a patient should not receive cardiopulmonary resuscitation (CPR) in the event of cardiopulmonary arrest (i.e., when the patient has died; is unresponsive, has no pulse and is not breathing).But many patients and health-care providers misinterpret a DNR order to mean that no life support should be given in the event of clinical deterioration (i.e., the patient has not yet died but is getting much sicker). (Amber Barnato, 5/5)

I write this as I’m about to give birth to my baby girl. I’m full of excitement and disbelief at how much I already love this tiny stranger poking my rib cage. But I’m also tormented by a deep-seated fear. I’m terrified that my daughter will inherit my eating disorder, that my own decades-long struggle with anorexia will ruin my child’s life. Of course, parents don't cause eating disorders. Although they used to be the main object of blame, increasing evidence suggests the real culprits are things such as altered neurological function, certain personality traits (including perfectionism, rigidity and tunnel-vision toward goals), and the way semi-starvation changes the brain. (Kate Willskey, 5/4)

The Democratic Republic of Congo (DRC) is experiencing the second largest Ebola outbreak in history. This week has been the worst by far, with more than 100 new cases in the last 5 days. Since the outbreak began last summer, there have been more than 1,500 cases, with just over 1,000 deaths. (Tom Inglesby and Jennifer Nuzzo, 5/3)

On Wednesday, the Court of Arbitration for Sport ruled that female athletes with naturally elevated levels of testosterone could not compete as women unless they made efforts to reduce the hormone in their bodies. The ruling came in a case brought by the middle-distance runner Caster Semenya against the International Association of Athletics Federations that challenged longstanding myths about the presumed masculinity of testosterone and its role in the body. Her loss demonstrates just how entrenched those myths have become. (Katrina Karkazis and Rebecca M Jordan-Young, 5/3)

Pan, D-Sacramento, is a pediatrician with a master’s in public health from Harvard. His legislation, which passed the Senate Health Committee on April 24, would have public health officials — rather than doctors — decide who qualifies for a medical exemption to being vaccinated. The bill is needed to close a loophole in Pan’s 2015 law that eliminated the personal belief exemption and gave California some of the toughest immunization legislation in the nation. (5/5)

The consequences of limited access to hormonal contraception are unplanned pregnancies. Unsurprisingly, the women who cannot afford doctors’ visits to obtain birth control cannot afford the medical costs associated with pregnancy. As a result, the government frequently foots the shockingly large tab for their medical care. In fact, in 2010, Texas pregnancies cost taxpayers $2.9 billion. (Marc Hyden and Courtney M. Joslin, 5/3)

As a physician practicing on L.A.’s skid row, I’ve seen a lot of deaths among homeless people, but this one broke my heart. My outreach nurse announced the news after a call from the coroner’s office: There’d been another death on skid row. “Who now?” I asked. Her answer was devastating. It was J, whose full name I am not using to protect her privacy. As a physician practicing on L.A.’s skid row, I’ve seen a lot of deaths among homeless people, but this one broke my heart. (Susan Partovi, 5/4)

After the county decreased mental health services in 2009, the average number of daily psychiatric evaluations in the emergency department nearly tripled within the first year, according to a study published in the Annals of Emergency Medicine. Also, the average length of stay in the emergency department for patients in a mental health crisis increased by more than 50 percent during the same period. (Lorin Scher, 5/5)