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Morning Briefing

Summaries of health policy coverage from major news organizations

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Thursday, Jan 23 2020

51视频 Health News Original Stories 2

  • In-Home Teeth-Straightening Business Is Booming 鈥 But Better Brace Yourself
  • Patients Want A 'Good Death' At Home, But Hospice Care Can Badly Strain Families

Medicare 1

  • Trump Hints He May Be Open To Cutting Medicare, Safety-Net Programs In Shift From 2016 Campaign Promises

Women鈥檚 Health 2

  • Trump To Become First President To Speak In Person At March For Life Event
  • Federal Women's Health Funding Restored To Texas In Sign That States Can Exclude Abortion Providers From Aid

Public Health 5

  • Wuhan Coronavirus: A Look At The Patients, A City In Quarantine, WHO's Hesitation On Emergency Designation, And More
  • U.S. 'Not Nearly As Prepared As We Need To Be' For Big Pandemic, Experts Say As Coronavirus Looms On Horizon
  • Wave Of State-Level Bills Restricting Medical Care For Transgender Teens Reignites Polarizing Debate On Issue
  • This West Virginia Town Was Embarrassed After It Earned Designation Of Most Obese U.S. City. But Things Are Looking Up.
  • Study Reveals Long-Lasting, Wide-Ranging Negative Health Effects Of Those Who Have Been In Foster System

Pharmaceuticals 1

  • Insurers To Invest $55M In Making Cheaper Versions Of Expensive Generic Drugs In Sign Of Growing Frustration

Administration News 1

  • At Height Of Feud Between Azar And Verma, White House Advisers Drew Up List Of Replacements

Marketplace 1

  • Industry Roundup: J&J Posts Earnings Above Estimates; Critics Bash Short-Term Health Plans; Mergers Edge Toward Finish Line

Capitol Watch 1

  • House Lawmakers To Haul Juul, Other Companies Into Hearings To Grill Them On Youth Vaping Epidemic

Government Policy 1

  • 'He Grew A Lot': Migrant Parents Who Were Deported Under Trump Reunited With Children

Opioid Crisis 1

  • St. Louis Tries To Step Up To Compensate For Missouri's Lack Of A Prescription Drug Monitoring Database

State Watch 1

  • State Highlights: The Job Of Counting The Homeless In California; Virginia Senate Green-Lights 'Red Flag' Gun Law

Health Policy Research 1

  • Research Roundup: Low-Carb And Low-Fat Diets, Physician Burnout, Gender Disparities In Pay, And More

Editorials And Opinions 1

  • Viewpoints: Efforts To Curb A Pandemic Rely On How Much People Trust Their Government; Will Trump Actually Tackle Entitlement Reform?

From 51视频 Health News - Latest Stories:

51视频 Health News Original Stories

In-Home Teeth-Straightening Business Is Booming 鈥 But Better Brace Yourself

SmileDirectClub and similar startup companies say they provide these services at what can be thousands of dollars less than office-visit teeth straightening, but proof is lacking and patients can be left with no recourse if problems arise. ( Julie Appleby and Victoria Knight , 1/23 )

Patients Want A 'Good Death' At Home, But Hospice Care Can Badly Strain Families

Fewer Americans are dying in a hospital, under the close supervision of doctors and nurses. That trend has been boosted by an expanded Medicare benefit that helps people live out their final days at home in hospice care. But as home hospice grows, so has the burden on families left to provide much of the care. ( Blake Farmer, Nashville Public Radio , 1/23 )

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Summaries Of The News:

Medicare

Trump Hints He May Be Open To Cutting Medicare, Safety-Net Programs In Shift From 2016 Campaign Promises

鈥淎t the right time, we will take a look at that. You know, that鈥檚 actually the easiest of all things, if you look,鈥 President Donald Trump said in response to a question whether cuts to programs like Medicare and Social Security were on the table. The statement was a departure from the last election when Trump tapped into the popularity of the two programs while wooing voters.

President Trump suggested on Wednesday that he would be willing to consider cuts to social safety-net programs like Medicare to reduce the federal deficit if he wins a second term, an apparent shift from his 2016 campaign promise to protect funding for such entitlements. The president made the comments on the sidelines of the World Economic Forum in Davos, Switzerland. Despite promises to reduce the federal budget deficit, it has ballooned under Mr. Trump鈥檚 watch as a result of sweeping tax cuts and additional government spending. (Rappeport and Haberman, 1/22)

Speaking with CNBC from the World Economic Forum in Davos, Switzerland, Trump said tackling entitlement spending is 鈥渢he easiest of all things鈥 and seemed to suggest higher economic growth would make it simpler to cut spending on those programs. Those comments come amid a heated debate in the Democratic presidential primary over former vice president Joe Biden鈥檚 record on Social Security, just days before the Iowa caucuses. 鈥淎t the right time, we will take a look at that. You know, that鈥檚 actually the easiest of all things, if you look,鈥 Trump said. He later added when asked about entitlements: 鈥淲ell, we鈥檙e going 鈥 we鈥檙e going to look. We also have assets that we鈥檝e never had. I mean, we鈥檝e never had growth like this.鈥 (Stein and Viser, 1/22)

Early in his presidential campaign, Trump said he was a different sort of Republican, one who would not cut Social Security, Medicare or Medicaid. The Medicaid promise was ultimately abandoned. The unsuccessful Republican drive to repeal 鈥淥bamacare鈥 would have also limited future federal spending on that federal-state health insurance program for low-income people. More recently, Trump鈥檚 2020 budget called for deep cuts in Medicare payments to hospitals. (Alonso-Zaldivar and Madhani, 1/22)

Why it matters: Trump shied away from committing to cuts to social safety-net programs like Medicare, Medicaid and Social Security during his 2016 campaign. But his willingness to consider such measures now marks a shift that would likely appeal to the deficit hawks in the Republican Party. (Perano, 1/22)

Democratic presidential candidates Bernie Sanders and Pete Buttigieg criticized the president. "Over and over, Donald Trump promised Americans that he would not cut Social Security and Medicare. He lied," Sanders wrote on Twitter. "When we win, we're not going to just protect Social Security and Medicare, we're going to expand them." (Collins and Jackson, 1/22)

President Donald Trump returned to the World Economic Forum in Davos, Switzerland, touting sustained growth in the American economy as well as his his recent trade agreements with Mexico and Canada, and China. On Wednesday, the president, who is undergoing an impeachment trial in the Senate, sat down with CNBC鈥檚 Joe Kernen to discuss trade, the U.S. economy and much more, including the president鈥檚 persistent complaints about the Federal Reserve鈥檚 rate policy. (Calia, 1/22)

Women鈥檚 Health

Trump To Become First President To Speak In Person At March For Life Event

Although in the past, President Donald Trump described himself as "pro-choice," since he ran his 2016 campaign he's ardently courted supporters within the antiabortion movement. The announcement comes just a few days after the Susan B. Anthony List and its affiliated super PAC said it would spend $52 million to help the president鈥檚 reelection.

President Trump announced Wednesday that he will attend Friday鈥檚 March for Life, the annual gathering of antiabortion protesters to commemorate the anniversary of Roe v. Wade, the Supreme Court鈥檚 landmark abortion decision. While other presidents have addressed the annual rally by phone or sent video greetings, Trump would be the first to speak to the crowd in person. (Bailey, 1/22)

Mr. Trump, who has spoken to the group via video in past years, said in a tweet Wednesday afternoon: 鈥淪ee you on Friday...Big Crowd!鈥 The White House confirmed he would attend. 鈥淲e are so excited for him to experience in person how passionate our marchers are about life and protecting the unborn,鈥澛爏aid聽March for Life President Jeanne Mancini in a statement.聽鈥淧resident Trump and his administration have been consistent champions for life and their support for the March for Life has been unwavering.鈥 (Lucey, 1/22)

No president has personally attended the march in its 47-year history. Past Republican presidents might have been inclined to attend, but either on the advice of staff or their own instincts saw it as a step too far and instead showed their support in less visible ways, like through remote messages or by meeting with activists. Mr. Trump, who once called himself 鈥渧ery pro-choice,鈥 has until now addressed the group only remotely and welcomed some marchers at the White House. (Crowly, 1/22)

Trump has appealed to evangelical and conservative voters by cutting off funding for services and organizations that provide abortions and touting the appointment of pro-life judges. He has repeatedly hammered Democrats for supporting late-term abortion, seizing on proposals in New York and Virginia that would have allowed third-trimester abortions in certain cases where the fetus or mother's health is at risk. (Samuels, 1/22)

The number of Americans who support abortion in all or most cases has climbed up 61%, according to the Pew Research Center. A majority of Americans say they're likely to vote for political candidates who believe abortion should be outlawed after the first three months of pregnancy, according to a new Marist poll commissioned by the Knights of Columbus. (Linton, 1/22)

The Rev. Bjorn Lundberg will escort busloads of his parishioners to Washington on Friday for this year鈥檚 March for Life. They won鈥檛 be stopping at Starbucks on the way. The coffee giant is not aligned with their cause, Lundberg says. As a Catholic priest who leads a 9,500-member parish in Winchester, Va., he stopped patronizing Starbucks when he learned the chain matches its employees鈥 charitable donations, including to Planned Parenthood and other nonprofit groups that support abortion access. (Zauzmer, 1/22)

Anti-abortion activists聽from Arizona are headed out to Washington D.C. to represent the state in the 47th annual national March for Life.The march began in 1974 and promotesanti-abortion education across the nation. Arizona Life Coalition led the state march, called the聽Arizona for Life March and Rally, on Jan. 18 in downtown Phoenix. Thousands attended, and executive director Garrett Riley said the march was a success with more people attending than the last event in 2018. (Stoney, 1/22)

Meanwhile, in Virginia 鈥

Virginia Democrats on Wednesday began to dismantle abortion restrictions erected by Republicans over the past decade, pushing an omnibus bill to the House floor on a 12-to-9 party-line vote. The bill would expand the categories of health professionals who can perform abortions, remove requirements for ultrasounds and waiting periods and eliminate rules that made some clinics ineligible to perform the procedure. (Sullivan, 1/22)

Federal Women's Health Funding Restored To Texas In Sign That States Can Exclude Abortion Providers From Aid

The funding for Texas was cut during the Obama administration after the state Legislature excluded Planned Parenthood from the Healthy Texas Women program. Other conservative states are watching the outcome of the decision as they consider excluding abortion providers from their programs as well.

Eight years after Texas lost federal dollars over barring Planned Parenthood in a women鈥檚 health program, the Trump administration Wednesday allowed the state to resume getting as much as $350 million in another reversal of an Obama-era decision. Texas can receive the money over the next five years while still excluding Planned Parenthood from a state program called Healthy Texas Women that offers family planning and health services, such as pregnancy tests and breast cancer exams, to low-income families. (Weber, 1/22)

The Wednesday announcement from the Trump administration reverses an Obama-era decision to cut federal women鈥檚 health funding to Texas starting in 2013. That came as punishment after the Texas Legislature excluded Planned Parenthood from the Healthy Texas Women program in 2011 because of the organization鈥檚 affiliation with abortion providers, though the women鈥檚 health program does not fund abortion. "The Lone Star State is once again in partnership with the federal government to provide meaningful family planning and health services while fostering a culture of life," Gov. Greg Abbott said in a Wednesday statement. (Walters, 1/22)

As part of its ongoing effort to defund Planned Parenthood, Texas kicked the organization out of its low-income Medicaid women鈥檚 health program in 2013, a move that the Obama administration found to be in violation of federal law. Rather than include Planned Parenthood in the program, Texas opted to leave millions in federal funding on the table, instead creating its own state-funded replacement program now called Healthy Texas Women. With Trump in office, state officials hoped they鈥檇 have an ideological ally, and in 2017 filed an 1115 Medicaid Waiver request to restore the federal funds without including abortion providers or their affiliates.聽(Novack, 1/22)

The state applied for the Medicaid waiver in 2017. The state Health and Human Services Commission said the agreement for the state to receive about $350 million in federal funds over five years was reached on Wednesday. The federal government will contribute an average of $69 million to the program each year while the state provides an average of about $20 million per year. 鈥淲ith Governor Abbott鈥檚 strong leadership, we continue making significant strides in improving access to women鈥檚 health and family planning services in Texas,鈥 said Courtney N. Phillips, HHS executive commissioner. (Mendez, 1/22)

Texas officials were able to obtain the federal funding by undergoing a process called the 1115 demonstration waiver, in which states can bypass Medicaid rules to receive funding if they can show they will improve health care for residents. But state officials didn鈥檛 sufficiently demonstrate that they would achieve those goals because the state doesn鈥檛 plan on changing eligibility of the program or expanding services, according to policy experts who have opposed the exclusion of Planned Parenthood from the women鈥檚 health program. (Chang, 1/22)

The long-awaited decision from HHS could pave the way for other conservative states to exclude abortion providers from their federally-funded family planning programs. While federal law already prohibits federal funding from paying for abortions in most circumstances, opponents argue any money that flows to Planned Parenthood or other abortion providers can indirectly support the procedure. (Hellmann, 1/22)

Public Health

Wuhan Coronavirus: A Look At The Patients, A City In Quarantine, WHO's Hesitation On Emergency Designation, And More

Media outlets offer broad coverage of the virus that China is working to contain during a busy travel season. Although the illness has caused at least 17 deaths so far, most of those patients were older men with previous health ailments.

When the man finally went to a hospital, he had been sick for a week. It was Dec. 26, and Mr. Zeng, 61, was weak with a cough. He got worse. A day later he was transferred to intensive care and on Dec. 30 he was put on a ventilator to help his deteriorating ability to breathe. He was moved to another hospital and attached to another machine that oxygenated his blood. Still he got worse, and on Jan. 9, his heart stopped. Mr. Zeng, who the authorities have only identified by his last name, became the first confirmed death from the new coronavirus that emerged in the central city of Wuhan and has spread around the country and beyond. (Ramzy, 1/23)

Several people who鈥檝e died from a new virus in China didn鈥檛 display symptoms of fever, potentially complicating global efforts to check for infected travelers as they arrive at airports and other travel hubs. Details released by China鈥檚 National Health Commission show five of the 17 people who died after being infected with novel coronavirus displayed other symptoms such as breathing difficulty, chest tightness and coughing. The joint-oldest victim, an 89-year-old male, was suffering from drowsiness and incontinence, as well as a fever. He sought medical help on Jan. 5 and died on Jan. 18. He had pre-existing conditions, including hypertension. (Davies and Tan, 1/22)

In closing off Wuhan, a city of more than 11 million people, China is deploying a centuries-old public health tactic to prevent the spread of infectious disease 鈥 this time, a mysterious respiratory infection caused by a coronavirus. Experts said the stunning scale of the shutdown, isolating a major urban transit hub larger than New York City, was without precedent. (Levenson, 1/22)

China is putting on lockdown a city of 11 million people considered the epicenter of a new coronavirus outbreak that has killed 17 and infected nearly 600, as health authorities around the world scramble to prevent a global pandemic. Health officials fear the transmission rate will accelerate as hundreds of millions of Chinese travel at home and abroad during week-long holidays for Lunar New Year, which begins on Saturday. (Chen and Lee, 1/23)

All outbound trains and bus services from Wuhan 鈥 larger than any city in the United States 鈥 were suspended starting at 10聽a.m. Thursday, causing chaos for some of the 400聽million people hitting the road for the Lunar New Year holiday, which officially begins Friday. Armed police guarded the entrance to Wuhan's biggest railway station, less than a mile from the market where the virus originated, to stop people trying to get onto the last trains out of the city. (Fifield and Sun, 1/22)

The quarantine comes at a troublesome time for the roughly 400 million people who are traveling in China for the Lunar New Year festival, which begins Saturday. Almost 25 million passengers were expected to travel through the three main stations of China Railway鈥檚 Wuhan branch, and the number of flights to and from the airport were expected to increase from 600 to 800 each day. Even before the quarantine, authorities had required people to wear medical masks in public places. Many stores had sold out on Wednesday. (Iati and Thebault, 1/22)

Dozens of cases have been identified in other major Chinese cities, including Beijing, Shanghai and Guangzhou, with cases also appearing in Japan, Thailand, South Korea, Taiwan and the United States. A man in Washington state was the first person in the U.S. to have a confirmed case of the virus. The Centers for Disease Control and Prevention (CDC) said Tuesday that the 30-year-old man had recently traveled from Wuhan. 聽(Axelrod, 1/22)

The SARS disaster was supposed to drag China into a new era of openness and responsibility. The deadly disease rippled across the world 17 years ago, abetted by a Chinese government that covered up its spread. As the scope of it became clear, China鈥檚 journalists, intellectuals and other critics helped shame Beijing into opening up about the problem. 鈥淪ARS has been our country鈥檚 9/11,鈥 said Xu Zhiyuan, then a young newspaper columnist and a fierce critic of the government鈥檚 handling of SARS, in a 2003 interview with The New York Times. 鈥淚t has forced us to pay attention to the real meaning of globalization.鈥 (Yuan, 1/22)

A new coronavirus that has killed at least 17 people in China and spread to several other countries is already putting global measures designed to fend off epidemics to the test. The looming question is whether the international community will try to stem its spread by implementing what it learned during the deadly outbreak of severe acute respiratory syndrome, or SARS, between 2002 and 2004, which also began in China. At the time, China denied the existence of the SARS virus, even as it spread across the country and abroad, eventually killing more than 770 people worldwide. (Noack and O'Grady, 1/22)

A number of Chinese listed companies - ranging from biotech firms, drugmakers, mask producers and thermometer manufacturers - announced efforts in response to a national call to fight the outbreak of the Wuhan coronavirus. The new, flu-like virus, first discovered in the central Chinese city of Wuhan, has killed 17 and infected nearly 600 people. Cases have been detected in other major population centers, including Beijing and Shanghai, as well as overseas, triggering a public scramble for face masks and flu medicines. (1/23)

Surgical masks flew off shelves, travelers canceled plans and rumors flooded social media as the number of confirmed infections of a new, pneumonia-causing coronavirus topped 500 cases across China. In drugstores and at airports, and on the online marketplaces increasingly at the heart of Chinese commerce, fear and confusion manifested themselves in shortages or long lines for suddenly scarce products promising protection from the deadly but still largely mysterious respiratory disease. (Wernau, 1/22)

Investors fixated on the mysterious pneumonia-causing virus that originated in China are looking to past viral outbreaks to assess how bad the damage could be on the economy and markets this time around. Seventeen people have died, with more than 500 confirmed cases of the coronavirus that authorities say is spreading between people primarily through the respiratory tract. Federal health officials said Tuesday a man in Washington state has the first case to be confirmed in the U.S. (Russolillo and Chiu, 1/22)

The World Health Organization on Wednesday delayed a decision on whether to declare the ongoing outbreak of a novel virus that originated in China a global health emergency, with agency officials saying they needed more information to reach a consensus.Following a meeting of a WHO emergency committee, Tedros Adhanom Ghebreyesus, the WHO鈥檚 director-general, said he had asked the committee to continue the discussion Thursday. 鈥淭his is an evolving and complex situation,鈥 said Tedros, as he is known. He said declaring the outbreak a public health emergency of international concern, or PHEIC, was a decision 鈥淚鈥檓 only prepared to make with appropriate consideration of all the evidence.鈥 (Joseph, 1/22)

The Director-General of the World Health Organization, Tedros Adhanom Ghebreyesus tweeted: "The decision about whether or not to declare a public health emergency of international concern on new #coronavirus is one I take extremely seriously, and one I am only prepared to make with appropriate consideration of all the evidence." (Valero, 1/22)

Health officials expanded travel restrictions beyond the epicenter of a SARS-like virus outbreak that鈥檚 killed at least 17 and infected hundreds in China while spreading around the world. After travel from the central city of Wuhan was halted, nearby Huanggang suspended bus services and closed public sites including movie theaters, the local government said Thursday. Another city, Ezhou, also imposed restrictions, according to municipal officials. The dramatic steps came as pressure grows on China to contain the outbreak. (Bloomberg News, 1/22)

A new strain of coronavirus 鈥 named 2019-nCoV 鈥 has been discovered in China. Viruses in the coronavirus category can cause fever, breathing difficulties, pneumonia and diarrhea. Some are potentially fatal. Others can cause the relatively mild common cold.Here is a look at the most well-known coronaviruses: what they have in common and how they differ. (Huang, 1/22)

In Wuhan, the central Chinese city that鈥檚 ground zero of the deadly new virus spreading through the country, a sense of fear is rapidly taking hold. On Thursday morning, the city鈥檚 some 11 million residents woke to learn it鈥檚 now in lockdown, with public transport halted, flights out canceled and trains not running right on the eve of the Lunar New Year holiday that traditionally unites families for days of feasting. It鈥檚 a dramatic escalation for Wuhan, which has found itself at the epicenter of a potentially global health crisis after a market selling freshly slaughtered meat and live animals was identified as the source of an outbreak that鈥檚 killed 17 people and infected hundreds. (Bloomberg News, 1/22)

A map created by U.S. researchers is tracking in real-time a virus in China that has sickened hundreds of people and resulted in at least 17 deaths. Novel coronavirus, which is linked to an outbreak of pneumonia, has global public health officials concerned about its potential to spread around the world. (Santhanam, 1/22)

U.S. 'Not Nearly As Prepared As We Need To Be' For Big Pandemic, Experts Say As Coronavirus Looms On Horizon

The country has made big leaps in preparedness since the anthrax scare of 2001, but the United States still has a ways to go. Meanwhile, health officials scramble to contain the coronavirus after diagnosing the first U.S. patient with the illness. And a top NIH official says human trials for a vaccine could begin within three months.

A Liberian man walked into a Dallas emergency room in September 2014, at the height of the West African Ebola epidemic, complaining of high fever, abdominal pain and other symptoms of the fearsome virus. He was sent home with acetaminophen and a diagnosis of a sinus infection. Two weeks later, Thomas Eric Duncan was dead, two nurses who attended him were infected with Ebola and the shortcomings of U.S. preparations for a viral epidemic were vividly exposed. (Bernstein and Sun, 1/22)

Of all the alarming aspects of the rapidly spreading new virus out Wuhan, China, this is perhaps the most alarming: A single patient has infected 14 health care workers. That's what's called a "super spreader," and disease detectives are hot on that patient's trail. It's one element to stopping the spread of this coronavirus that's killed 17 people and infected more than 500 in five different countries, including the United States. (Cohen, 1/23)

Health officials scrambled on Wednesday to contact more than a dozen people who may have been exposed to the United States鈥 first case of the Wuhan coronavirus, even as regulators sought to assure the public there was little risk from an illness that has rapidly spread across Asia, killing at least 17 people. The patient, a man in his 30s who fell ill after traveling to China, has cooperated in helping public health workers trace his path from the Wuhan region of China to his home in Snohomish County, Wash., north of Seattle, health officials said. (Baker, 1/22)

Health officials said Wednesday they are actively monitoring 16 people who came into close contact with the traveler to China who became the first U.S. resident with a new and potentially deadly virus. The man, identified as a Snohomish County, Washington, resident is in his 30s, was in good condition and wasn't considered a threat to the public. (1/22)

A Snohomish County man who was diagnosed Monday with the newly discovered Wuhan coronavirus after a trip to China had close contact with at least 16 people after arriving at Seattle-Tacoma International Airport on Jan. 15, health officials said Wednesday afternoon. The man has the United States鈥 first confirmed case of the mysterious respiratory infection, which has killed at least 17 people and infected at least 500 since December. In addition to Wuhan, China, patients have been identified in Beijing, Shanghai and Shenzhen, as well as Taiwan, Japan, Thailand and South Korea. The patient, a man in his 30s who lives alone, had been traveling solo in Wuhan since November. (Blethen, 1/22)

Health workers are being told to be on the lookout for new cases and to ask patients whether they鈥檝e traveled to China recently 鈥 or come into contact with someone who has. Advisories are being sent through electronic medical records, internal hospital newsletters and daily huddles before shifts begin, according to Nancy Foster, the American Hospital Association鈥檚 vice president of quality and patient safety. (Ehley, Roubein and Owermohle, 1/22)

Airlines and passengers are on guard against a new flu-like virus that originated in Wuhan, China. Here's an explainer on the airline industry's response to the outbreak so far and its potential financial exposure compared to SARS in 2003, which killed nearly 800 people. (Freed, 1/23)

A Northern Virginia middle school canceled a seven-day visit by 21 Chinese students and their chaperones on the day they arrived in the United States because of fears over a new coronavirus circulating in China, according to a school letter emailed to parents Wednesday afternoon. (Heim, 1/22)

The pneumonia-causing virus, which is spreading rapidly in China and beyond, is currently being identified as 2019-nCoV, shorthand for a novel or new (i.e. 鈥渘鈥) coronavirus (CoV) that was first detected in 2019. The disease it causes doesn鈥檛 yet have a name, either, though Wuhan SARS or Wu Flu are among of the options being thrown around on the internet. None of these is likely to be the virus鈥 or the disease鈥檚 permanent name. They almost certainly would be unacceptable to the Chinese, and to the World Health Organization, which discourages the use of place names in the naming of diseases. As for the virus, the longer it spreads the less novel it becomes. 2019-nCoV is a bit like calling a daughter 鈥渢he girl born in 2019.鈥 Given that another daughter might be born in 2021, a name that might more easily distinguish between the two is probably in order. (Branswell, 1/23)

A top official at聽the National Institutes of Health (NIH) said Wednesday that human trials for a vaccine to counter a new strain of coronavirus behind an outbreak of viral pneumonia in China could begin within three months. In an interview with Bloomberg Law, the director of NIH's National Institute of Allergy and Infectious Diseases said that his agency is working with Cambridge, Mass.-based biotech company聽Moderna Inc. to develop a vaccine for the disease. 鈥淲e鈥檙e already working on it," Anthony Fauci told Bloomberg. "And hopefully in a period of about three months, we鈥檒l be able to start a phase聽one trial in humans." (Bowden, 1/22)

U.S. equity futures fluctuated while European stocks edged lower and Asian shares slumped on Thursday amid lingering concerns that a virus spreading from China to other countries could become a drag on global growth. Treasuries climbed and crude oil fell. (White, 1/22)

Wave Of State-Level Bills Restricting Medical Care For Transgender Teens Reignites Polarizing Debate On Issue

More than half a dozen states are considering legislation that would penalize doctors for performing certain treatments for transgender patients. The speed and number of state bills has mobilized activists, suicide prevention groups and civil rights organizations. In 2018, the American Academy of Pediatrics released a policy statement that recommended giving youths 鈥渁ccess to comprehensive gender-affirming and developmentally appropriate health care,鈥 while noting the benefits and risks of using hormones that delay puberty.

Republican state lawmakers have filed a wave of bills that would ban medical professionals from treating transgender teens with hormones and sex reassignment surgery, reigniting a polarizing national debate over the rights of transgender youths and the government鈥檚 reach into doctors鈥 offices. More than half a dozen statehouses are considering bills that would penalize medical professionals 鈥 and, in at least one case, parents 鈥 who give young people access to puberty-blocking medicines and other treatments. (Wax-Thibodeaux and Schmidt, 1/22)

A proposal to ban doctors from prescribing hormones or performing sex-reassignment surgery for transgender youth in South Dakota cleared a committee vote on Wednesday, the first state to take action on a wave of bills that restrict medical interventions affecting young people鈥檚 gender expression. The bill makes it a misdemeanor for doctors to provide puberty blockers or other treatments affecting gender expression to children under the age of 16, carrying a maximum penalty of one year in jail and a fine of up to $2,000. (Wax-Thibodeaux and Schmidt, 1/22)

Supporters told the committee that the medical practices described in the bill aren't based on objective science, while opponents, many of them doctors, warned that the bill could negatively affect transgender children in South Dakota and force doctors to decide聽between treating a patient and going to jail. Bill sponsor Rep. Fred Deutsch, and many of the bill's supporters, told the committee that a diagnosis of gender dysphoria is based on a person's feelings rather than objective science. Bill supporters also referred repeatedly to the medical practices the bill would prohibit as "medical experiments."聽(Kaczke, 1/22)

Transgender youth have a much greater risk of suicide, according to the US Centers for Disease Control and Prevention. However, if they have access to a puberty blocker, their chances of suicide and mental health problems in the immediate term and down the road decline significantly, a new study finds. This year, at least six states are trying to restrict transgender kids from getting gender reassignment treatments. The study, the first of its kind to examine access to pubertal suppression and suicidality, was published Thursday in the medical journal Pediatrics. The research comes as a handful of states are considering placing restrictions on transgender health care. (Christensen, 1/23)

This West Virginia Town Was Embarrassed After It Earned Designation Of Most Obese U.S. City. But Things Are Looking Up.

Public health officials in Huntington, West Virginia, began making changes after a bit of national shaming. Small but concerted efforts have started to change the tide for the town. In other food health news: a look at how Michael Bloomberg got New York City to eat its veggies, food stamps in Baltimore, and more.

Over a decade ago, Huntington, West Virginia, endured a dose of civic fat shaming when the city was labeled the most obese in the nation. Forty Five percent of the almost 49,000 residents were considered overweight. A hundred percent of the town was appalled at the title. It didn鈥檛 help the reputation of the city when a British celebrity chef turned up to lecture the public schools on their lunchroom fare and quiz children who could not identify basic vegetables. But in the end, it wasn鈥檛 an outsider鈥檚 intervention that turned the city around. (Dawson, 1/23)

A Columbia University study published in 2014, found that Green Carts provided high quality fresh produce to neighborhoods with low consumption and availability and created an 鈥渆conomically viable and sustainable program.鈥滶ster Fuchs, a professor of international and public affairs and political science who co-authored the study, concluded that the carts were penetrating the targeted population鈥攊t was serving low-income people for a lower cost, and they were eating more fresh produce. A subsequent 2015 city study found that the number of adults who reported not eating fruits or vegetables the previous day had decreased from 2002 to 2012, which 鈥渕ay be in part to due to the Green Carts.鈥 (Dawson, 1/23)

As many as 15,000 people in Baltimore could see their food stamp benefits slashed under a new Trump administration rule that tightens eligibility requirements. Maryland recently joined more than a dozen states in suing to block the U.S. Department of Agriculture from moving forward with the cuts to the Supplemental Nutrition Assistance Program. But should the rule go into effect as planned this spring, it would have a devastating impact on Baltimore鈥檚 economy and the health of its residents, city officials wrote in a declaration of support for the plaintiffs鈥 request for a preliminary injunction. (Richman, 1/23)

The newly built, 3,300-square-foot space, which opened Friday, provides a commercial kitchen for small, home-based food entrepreneurs, land to grow fresh produce and a place to package leftover food retrieved from some local schools to redistribute to low-income residents in affordable housing complexes. The "food hub" is the culmination of nearly a decade of planning and collaboration between the Alameda County Sheriff鈥檚 Office, the nonprofit Alameda County Deputy Sheriffs鈥 Activities League and All IN Alameda County, a countywide initiative aimed at combating poverty. (Hellerstein, 1/22)

Study Reveals Long-Lasting, Wide-Ranging Negative Health Effects Of Those Who Have Been In Foster System

The analysis is 鈥渢he latest in a long, long line of studies showing the harm done to children when they are consigned to the chaos of foster care," said Richard Wexler of the National Coalition for Child Protection Reform. In other public health news: smoking, chronic loneliness, tech and wildfire safety, ancient DNA, a fly's brain, hospice care, and more.

Americans who have spent time in foster care are far more likely than other adults to lack a college degree, health insurance and a stable health care provider, according to a new federal analysis that is unprecedented in its scope. One striking finding in the report: Less than 5% of men who have been in foster care hold bachelor鈥檚 degrees, compared with 31% of other men. (Crary 1/22)

It goes without saying that cigarettes and surgery are not a winning combination. Scores of studies have shown that patients who use tobacco have poorer post-surgical outcomes. But many doctors give smokers conflicting advice on the ideal length of time they should go cold turkey before their operations. A new report released this week by the World Health Organization seeks to provide some clarity. Patients who quit smoking at least four weeks before an operation, the study found, have substantially improved outcomes, with fewer post-surgical infections and a reduced probability that they will have to return to the hospital for additional care. (Jacobs, 1/22)

When U-Haul announced it would stop hiring nicotine users in the states where it could, the reactions were decidedly mixed. 鈥淕ood for U-Haul! Nicotine is a drug. 鈥 It just happens to be legal!鈥 wrote one Facebook commenter. 鈥淚鈥檓 not [a] smoker, but I don鈥檛 think being a smoker should keep you from employment,鈥 wrote another. (Siegel, 1/22)

More than three in five Americans are lonely, with more and more people reporting feeling like they are left out, poorly understood and lacking companionship, according to a new survey released Thursday. Workplace culture and conditions may contribute to Americans' loneliness. And loneliness may be on the rise. The report, led by the health insurer Cigna, found a 7% rise in loneliness since 2018, when the survey was first conducted. (Renken, 1/23)

The findings have big implications for employers.聽Lonely workers are twice as likely to miss a day of work due to illness and think about quitting their job more than twice as often as non-lonely workers. More than one聽in聽10 lonely workers say their work is not as good as it should be. "It's important that we remember to give employees the opportunities to engage with others,聽to make sure we're聽not creating work environments that make聽loneliness worse," said Nemecek. (O'Donnell, 1/23)

For three years running, California鈥檚 wildfires have sent plumes of smoke across Silicon Valley. So far, though, that hasn't spurred much tech innovation aimed at addressing extreme-weather disasters associated with climate change. It's true that tech companies from enterprise software-maker Salesforce to financial-technology firm Stripe have pushed to dramatically reduce their climate impact. (1/22)

In October 2015, scientists reconstructed the genome of a 4,500-year-old man who lived in Ethiopia. It was the first time that anyone had created a complete genetic snapshot of an African from an ancient skeleton. Since then, other researchers have recovered DNA from skeletons unearthed in other regions of the continent. Now researchers have found the first genetic material from West Africa. On Wednesday a team reported that they had recovered DNA from four individuals in Cameroon, dating back as far as 8,000 years. (Zimmer, 1/22)

After 12 years and more than $40 million, an eclectic team of 100 biologists, computer scientists, and neuronal proofreaders announced on Wednesday that they have mapped the 鈥渃onnectome鈥 in the central region of the poppy-seed-sized brain of a fruit fly, working out the precise meanderings of 25,000 neurons and their 20 million connections. The neural map covers one-third of the fly brain, making it the largest connectome, or wiring diagram, ever worked out; besides its 20 million synapses, the precise characterization of more than 4,000 cell types makes it the most detailed. All told, the feat by researchers at Google and the Janelia Research Campus of the Howard Hughes Medical Institute amounts to a big 鈥渢old you so鈥 to skeptics who said it couldn鈥檛 be done this soon, this inexpensively, or this well. (Begley, 1/22)

Kaiser Health News: Patients Want A 鈥楪ood Death鈥 At Home, But Hospice Care Can Badly Strain Families

鈥淚鈥檓 not anti-hospice at all,鈥 said Joy Johnston, who relocated to New Mexico years ago at age 40 to care for her dying mother. 鈥淏ut I think people aren鈥檛 prepared for all the effort that it takes to give someone a good death at home.鈥 Surveys show dying at home is what most Americans say they want. But it鈥檚 鈥渘ot all it鈥檚 cracked up to be,鈥 said Johnston, a caregiver advocate and writer from Atlanta. (Farmer, 1/23)

It was a milestone moment in Big Tech鈥檚 incursion into medicine. The health care arms of Amazon, Microsoft, and Apple have yet to speak at J.P. Morgan. During the presentation, Conrad detailed the company鈥檚 numerous projects, including a partnership with diabetes giant Dexcom to make a low-cost, disposable glucose monitor. (Things got tense, there.) Mega and Lee were enthusiastic about the attention for the company, and the potential for bringing a tech company mindset to health care. (Brodwin and Herper, 1/22)

Addiction experts say women in recovery often have different needs and obstacles than men, and accommodating them is important at a time when research shows women are drinking more, and in higher amounts. The stakes are high: A report released earlier this month by the National Institute on Alcohol Abuse and Alcoholism shows alcohol-related deaths in the U.S. overall are climbing, especially among women. (Thayer, 1/22)

Pharmaceuticals

Insurers To Invest $55M In Making Cheaper Versions Of Expensive Generic Drugs In Sign Of Growing Frustration

The Blue Cross Blue Shield Association and 18 of its member organizations are teaming up with Civica Rx, a nonprofit that is already selling drugs used in hospitals to health systems. The move comes not long after California Gov. Gavin Newsom floated a similar proposal, in which the state would contract with outside manufacturers to sell generic drugs under a California label.

A major group of insurers said it would invest $55 million to create cheaper versions of expensive generic drugs for which there is little competition, in a further sign of dissatisfaction with the pharmaceutical industry鈥檚 price-setting practices. The decision by the Blue Cross Blue Shield Association and 18 of its member organizations, which insure about 40 million people, is part of a partnership agreement with Civica Rx, a nonprofit that is already selling drugs used in hospitals to health systems around the country. (Thomas, 1/23)

The new subsidiary will build on Civica's innovative model that has made some physician-administered generic drugs available at more than 1,200 hospitals across the country, according to Maureen Sullivan, chief strategy and innovation officer at the Blue Cross and Blue Shield Association. "We are solving a different business problem, but it is still showing how different private-sector stakeholders can come together to deliver lower-cost prescription drugs," Sullivan said. (Cohrs, 1/22)

The goal is to provide a salve to rising prices and shortages caused by either manufacturing disruptions or a dwindling number of suppliers, according to Martin VanTrieste, who runs Civica Rx. The same concerns prompted the nonprofit to initially strike deals with generic companies to produce 18 injectable medicines for hospitals. With that success, Civica Rx is now turning to a new market. (Silverman, 1/23)

The move 鈥 the latest salvo in the escalating battle to control drug prices 鈥 highlights the failure of the Trump administration and Congress to deliver relief for millions of Americans struggling to afford their medications. The announcement also comes as the state of California is exploring its own drug manufacturing plan. Neither effort would affect the high price of branded pharmaceuticals, which is the largest driver of U.S. drug spending. (Levey, 1/22)

In other pharmaceutical news 鈥

The powerful trade group representing the prescription drug industry spent a record-high $29 million lobbying Congress in 2019, according to disclosure reports released Tuesday.聽That is a 5 percent increase over what the Pharmaceutical Research and Manufacturers of America (PhRMA) spent in 2018,聽marking the most it has spent on lobbying in a single year.聽Despite anger from lawmakers and the Trump administration over rising prescription drug costs, the industry ended 2019 mostly unscathed as Congress failed to pass any legislation to lower聽prices for consumers.聽(Hellmann, 1/22)

Administration News

At Height Of Feud Between Azar And Verma, White House Advisers Drew Up List Of Replacements

Advisers were braced for HHS Secretary Alex Azar or CMS Administrator Seema Verma to abruptly leave the Trump administration as they waged an increasingly public and personal feud last year. The issue has since seemed to simmer down. In other HHS and CMS news, a new study looks at what Medicare paid for undelivered post-op visits in 2018.

White House officials drew up a short list of potential replacements for Health and Human Services Secretary Alex Azar and Medicare chief Seema Verma at the height of their contentious feud in case either was forced out late last year, three people with knowledge of the exercise told POLITICO. The officials developed the list days after the increasingly personal clash between Azar and Verma spilled into public view following a Nov. 26 POLITICO report that first detailed their rift. Two people with knowledge stressed that the names were not shared with President Donald Trump and that Azar and Verma are expected to remain in their roles through at least the rest of Trump鈥檚 first term. (Diamond and Cancryn, 1/22)

A new CMS-funded study suggests surgeons are overpaid for certain bundled procedures and proposes a solution it says could save the agency billions of dollars annually. The New England Journal of Medicine report found that just a fraction of post-operative visits the CMS pays for as part of procedure bundles actually take place. The report says reducing the payments accordingly would have saved Medicare $2.6 billion in 2018 by decreasing payments for 10- and 90-day global procedures by 28%. The findings have "huge" implications for physician revenue, but also for Medicare patients, who face a 20% co-pay under Medicare Part B, which includes post-operative visits, said Andrew Mulcahy, lead author of the study and senior health policy researcher with RAND Corp. (Bannow, 1/22)

And in Medicaid news from the states 鈥

The state will conduct a comprehensive review of its Medicaid reimbursement rates for treatment of mental health and substance abuse as well as for adults with intellectual disabilities and developmental disorders. ... Nonprofits that provide services for some of the most vulnerable Mainers 鈥 including those with intellectual and developmental disorders and mental health conditions 鈥 have complained for years that services are at risk because reimbursement rates are so low. (Lawlor, 1/21)

A Senate health panel on Tuesday split along party lines as Republicans pushed through a measure to permanently eliminate a 90-day period that seniors and disabled people previously had to apply for Florida's Medicaid program. The legislation would put in law changes lawmakers made as a way to save money in the state鈥檚 main safety-net health care program. (Sexton, 1/22)

Marketplace

Industry Roundup: J&J Posts Earnings Above Estimates; Critics Bash Short-Term Health Plans; Mergers Edge Toward Finish Line

Although Johnson & Johnson posted better than expected earnings, its sales fell short of estimates. Some of the company鈥檚 most lucrative medicines face competition from generics and biosimilars. Other news on the health industry focuses on short-term plans, mergers, a teeth-straightening business, a hospital's efforts to retain patients, and more.

Higher prescription drug sales and lower legal costs drove Johnson & Johnson's fourth-quarter profit 32% higher. The world's biggest maker of health care products on Wednesday reported net income of $4.01 billion, or $1.50 per share. That's up from $3.04 billion, or $1.12, a year earlier. (1/22)

J&J鈥檚 fourth-quarter adjusted earnings topped Wall Street estimates, but its sales fell just short of expectations. J&J shares declined 1.1% to $147.63 in morning trading Wednesday. Alex Gorsky, chief executive of the New Jersey-based health-products company, told analysts on a conference call the company鈥檚 performance was strong in 2019, especially in light of challenges including 鈥渢oday鈥檚 litigious environment鈥濃攁 reference to lawsuits against J&J over the safety and marketing of various products such as opioids and baby powder. (Sebastian and Loftus, 1/22)

Johnson & Johnson posted weaker-than-expected sales in the final quarter of 2019, raising the stakes for the health-care conglomerate as it banks on new cancer and immunology drugs to replace a group of aging blockbusters.Some of the company鈥檚 most lucrative medicines are facing competition from generics and biosimilars. Arthritis drug Remicade鈥檚 sales fell more than 16% from a year earlier in the quarter, while Zytiga, an older treatment for prostate cancer, saw a nearly 14% decline. (Griffin, 1/22)

Consumers who bought short-term health insurance thinking they had found a better deal than 鈥淥bamacare鈥 during the open enrollment season may be in for a shock when they show up at their doctor鈥檚 office this year. The low-cost plans aren't required to cover basics such as prescription drugs or maternity care. (Kennedy, 1/22)

Health insurers Centene Corp. and WellCare Health Plans said they expect to close their $17 billion merger on Thursday, creating one of the largest providers of government-sponsored health plans with roughly 22 million members. The insurers announced late Tuesday that they have cleared all the necessary regulatory hurdles to close the deal, including passing a review by the U.S. Justice Department. The companies previously entered agreements to divest parts of their businesses in several locations, all of which will be completed this week. (Livingston, 1/22)

鈥淎t the time, going to CVS was like a business, you order your medicine and everything else, and you leave,鈥 Phillips said. A year later, his CVS in Spring is still standing, as is he, cane-free. Phillips now comes to the store weekly to attend free yoga classes and learn about new ways to manage his illnesses at the drugstore鈥檚 CVS HealthHUB, an expanded offering of health care services being rolled out to Houston-area CVS stores.The HealthHUBs are designed to feel like a doctor鈥檚 office, with touch screens to manage patient check-ins and tables for employees to explain CVS products and healthier living plans. It is part of a broader foray by the Woonsocket, R.I.-based pharmacy retailer into the health care space. (Wu, 1/23)

Kaiser Health News: In-Home Teeth-Straightening Business Is Booming 鈥 But Better Brace Yourself

Though Anna Rosemond, now 33, had braces when she was young, a couple of years ago she noticed her teeth were again starting to crowd. So when she saw a Groupon deal for SmileDirectClub, she jumped on it. 鈥淚 thought, 鈥楾his looks like a really cool way to do braces,鈥欌 said Rosemond, who made her own teeth impressions with putty and used a 鈥渟mile stretcher鈥 鈥 a device that pulls apart the lips and cheeks 鈥 to take pictures of her mouth. A few weeks after she submitted the items, plastic aligners arrived in the mail, beginning what the company describes as Rosemond鈥檚 鈥渟mile journey.鈥 (Appleby and Knight, 1/23)

CommonSpirit Health will become the latest health system to drop the dual CEO model when longtime CEO Kevin Lofton retires this summer. When he steps down June 30, Lofton will have served 17 years as CEO of Catholic Health Initiatives, the predecessor organization that merged with Dignity Health on Feb. 1, 2019 to form Chicago-based CommonSpirit, a massive not-for-profit system with 142 hospitals. (Bannow, 1/22)

Patient volume is on the rise at Little Company of Mary Hospital in Evergreen Park, Ill., as it prepares to join Peoria, Ill.-based OSF HealthCare. At a time when many community hospitals are struggling to attract patients amid increased competition, the 298-bed hospital鈥攚hich will become OSF HealthCare Little Company of Mary Medical Center when the deal closes Feb. 1鈥攊s seeing more demand. (Goldberg, 1/22)

In America, poverty is linked to shorter lifespans. The wealthiest 1% of Americans live more than a decade longer than the poorest 1%, and that gap has grown wider in recent years. The medical community is increasingly examining the role that poverty and difficult social circumstances play in illness. Some people are asking whether the health care system could do more to address the things that influence people鈥檚 health beyond their medical care. This week on Prognosis, we look at one startup that鈥檚 trying to redesign care for some of the most vulnerable patients, taking into account the complex realities of their lives. The company is trying to improve care for people and communities whom the medical system often fails 鈥 and it believes that fixing those failures will not only make people healthier, it will also save money. (Tozzi, 1/23)

Capitol Watch

House Lawmakers To Haul Juul, Other Companies Into Hearings To Grill Them On Youth Vaping Epidemic

Many of the companies are also subjects of multiple congressional investigations into marketing and business practices that allegedly target young people.

Five leading e-cigarette companies will be dragged before Congress early next month, according to a Wednesday afternoon announcement from Rep. Diana DeGette (D-Colo.).聽It鈥檒l be the first chance for lawmakers on both sides of the aisle to question or scold many of these companies for their alleged role in fueling the growing youth vaping epidemic. Five companies, Juul, Logic, NJOY, Fontem, which makes the product 鈥渂lu,鈥 and Reynolds American, which makes 鈥淰USE,鈥 will testify on Feb. 5. It鈥檚 the latest in a spate of bad news for the beleaguered industry, which has been staring down the possibility of the government banning flavored e-cigarettes altogether. (Florko, 1/22)

Five of the country鈥檚 largest e-cigarette manufacturers聽are slated to聽testify before a House subcommittee about their role in allegedly promoting the youth vaping epidemic. Rep. Diana DeGette (D-Colo.), chairwoman of the House Energy and Commerce Oversight and Investigations Subcommittee, said Juul, Logic, NJOY, Fontem (blu) and Reynolds American Inc. are scheduled to testify on Feb. 5. The companies represent 97 percent of the total U.S. e-cigarette market, she said.聽(Weixel, 1/22)

Meanwhile, in Florida 鈥

Florida would tighten tobacco and vaping regulations as smoking, chewing tobacco and using electronic cigarettes would be off limits for anyone under age 21, under a bill that started moving forward Tuesday in the Senate. Members of the Senate Health Policy Committee unanimously approved a measure (SB 810) that would make it illegal for people under 21 to use tobacco products no matter the delivery system, consistent with a new federal law. (Sexton, 1/22)

Government Policy

'He Grew A Lot': Migrant Parents Who Were Deported Under Trump Reunited With Children

Nine parents who were separated from their children for over a year reunited with them in the United States. The emotional scene was a small slice of the emotional fallout that's come from the zero-tolerance policies that have separated thousands of children from their parents in recent years.

Nine parents who were deported as the Trump administration separated thousands of migrant families landed back into the U.S. late Wednesday to reunite with children they had not seen in a year and a half. The group arrived at Los Angeles International Airport from Guatemala City in a trip arranged under the order of a federal judge who found the U.S. government had unlawfully prevented them from seeking asylum. An asylum advocate confirmed the nine parents were all aboard the flight. (1/23)

In other news 鈥

Francisco 鈥 not his real name 鈥 is one of 952 unaccompanied minors who were picked up by federal authorities during the fiscal year that ended on Sept. 30, 2019 and released in Connecticut to relatives, friends or other sponsors, according to federal data. That鈥檚 almost triple the previous year, when there were 332, and more than quadruple the number in 2015, when 206 unaccompanied children came to the state. The percentage increase in the arrival of unaccompanied minors in Connecticut is higher than the national average, which almost doubled in the past two years. (Megan, 1/23)

Opioid Crisis

St. Louis Tries To Step Up To Compensate For Missouri's Lack Of A Prescription Drug Monitoring Database

The county unveiled new online resources, but it is still limited by what it can offer Missouri doctors who don't have the luxury of a statewide database like the rest of the country. Opioid news comes out of Massachusetts and Ohio, as well.

The St. Louis County Department of Public Health unveiled new online resources Wednesday designed to connect doctors with information on opioids, pain management and substance abuse. The toolkit is the latest addition to the county鈥檚 prescription drug monitoring program, which was established in the absence of a statewide program. (Farzan, 1/22)

A former pharmaceutical executive and one-time stripper was sentenced to a year and a day in federal prison Wednesday for her role in a conspiracy to bribe health care providers to prescribe a highly addictive opioid painkiller, far less than the six years prosecutors recommended. A lawyer for Sunrise Lee, former regional director for Arizona-based Insys Therapeutics, had recommended no incarceration, arguing in federal court in Boston that prosecutors had included Lee in the case simply to exploit her 鈥渟alacious鈥 background. Lee鈥檚 lawyer, Peter Horstmann, also contended Insys鈥檚 decision to hire the former stripper was the 鈥渘ext unethical but logical step鈥 by an industry that has been criticized for recruiting attractive young women as sales representatives to woo doctors to prescribe certain drugs. (Saltzman, 1/22)

The owner of a now-shuttered for-profit Ohio addiction treatment company was sentenced Wednesday to 7 1/2 years in federal prison for a scheme that prosecutors said led to $48 million in fraudulent Medicaid billings. Ryan Sheridan, 39, of Leetonia worked with others to defraud the federal government through Braking Point Recovery Center. The company provided detox, outpatient treatment, day treatment and sober-living services. (Heisig, 1/22)

State Watch

State Highlights: The Job Of Counting The Homeless In California; Virginia Senate Green-Lights 'Red Flag' Gun Law

Media outlets report on news from California, Virginia, Colorado Massachusetts, Iowa, Illinois, North Carolina, Georgia, Connecticut, Washington, Louisiana, New York, Ohio, Minnesota, Pennsylvania, New Hampshire and Texas.

The hand-drawn thermometer on the wall had just jumped to 7,100, assuring everyone in the command center that this year鈥檚 homeless count would have enough volunteers. But for Clementina Verjan, in charge of every count since the Los Angeles Homeless Services Authority began conducting them in 2005, that didn鈥檛 mean all was well. She knew it would be next to impossible to spread that many people across Los Angeles County in an even manner. Some locations would have too many volunteers and some would have too few. (Smith, 1/22)

California Governor Gavin Newsom, stepping up his bid to enlist U.S. government help to combat homelessness, has urged the Trump administration to open up surplus federal property for construction of more low-cost housing across the state. Newsom's request came in a letter on Tuesday to U.S. Housing and Urban Development (HUD) Secretary Ben Carson, who rejected pleas from California in September for more money to fight homelessness but has since adopted a more cooperative stance on the issue. (1/23)

The Virginia Senate on Wednesday passed a "red flag" law that would allow authorities to temporarily seize the firearm of someone deemed a threat, a measure that was strongly opposed by gun rights advocates who swarmed the streets around the state Capitol on Monday. The bill passed on a party-line vote of 21-19, with every Democrat in favor and every Republican against. Debate grew unusually sharp as some GOP senators suggested that the bill would violate the Second Amendment鈥檚 right to bear arms. (Schneider, 1/22)

After school bus driver Carole Ann Etheridge dropped off 31 middle and high school students in Walton County, Georgia, one August morning in 2017, she was summoned to the principal鈥檚 office. A worried parent had contacted the school system after getting a text from her child on the bus, who said Etheridge was driving erratically and had crossed the center line into oncoming traffic. The school resource officer, Walton Sheriff鈥檚 Office Lt. Charlie Rodriguez, gave Etheridge an initial breath test that showed she had a blood alcohol level of .089 鈥 more than twice the legal limit for commercial drivers. She failed field sobriety tests and was arrested on charges of DUI and child endangerment, according to a police report. In a formal breath test a few hours later, she blew a .048. The Etheridge case was one of 118 since 2015 that Stateline identified in which a school bus driver was arrested or cited by police on suspicion of driving a bus impaired by alcohol or drugs. Hundreds of other drivers have failed random testing while on duty. (Bergal, 1/23)

State Sen. Brittany Pettersen made history late Sunday when she gave birth to her son, becoming the first state lawmaker in Colorado history to give birth during the course of a legislative session. ... The Colorado legislature doesn鈥檛 have a maternity leave policy, meaning that the Senate Democratic Caucus will have to adapt to accommodate Pettersen. She cannot vote remotely, and thus plans to return to the Capitol as soon as possible 鈥 with Davis 鈥 to take votes on the floor. (Paul, 1/21)

The state child advocate鈥檚 office said that the local group homes run by Communities for People were poorly supervised and showed little to no accounting for the services promised to the troubled adolescents in their care. A three-month investigation into the Providence group homes found 鈥渋ncomplete and substandard鈥 files and medication records, lack of supervision and unprofessional staff, sexual activity between youths, and, at one home, not enough food. (Milkovits, 1/22)

An聽investigation into possible human experimentation at a state-run institution in southwest Iowa that provides care to聽people with severe disabilities has expanded to include an additional state regulatory board. The Iowa Board of Medicine, which licenses聽physicians and regulates the practice of medicine in the state, notified the Iowa Department of Human Services on Jan. 16 that it聽is reviewing "any studies or experiments conducted" at the Glenwood Resource Center. (Rodriguez, 1/22)

January is cervical cancer awareness month and Williams is just one of many women whom the new initiative Equal Hope (formerly known as the Metropolitan Chicago Breast Cancer Task Force) aims to help. Created in 2008, the health equity nonprofit network of health care providers, community leaders and advocates led efforts to reduce breast cancer deaths for the city鈥檚 African American female population (down from a 62 percent death gap to a 39 percent gap over the past decade). The group is now setting its sights on eliminating cervical cancer disparities and ultimately eradicating the disease in Chicagoland, according to Anne Marie Murphy, executive director of Equal Hope. (Rockett, 1/23)

But since Dynak鈥檚 baby arrived just before summer break, district officials didn鈥檛 allow her to use up to 30 days of paid leave when work resumed in August, according to a lawsuit filed on Dynak鈥檚 behalf by her union, the Illinois Education Association. As a result, Dynak lost about $8,000 in wages when she took 12 weeks off during the next school year, all unpaid, through the Family and Medical Leave Act, court records in the case state.Dynak鈥檚 case, which has the potential to affect parental leave policies for thousands of school employees across Illinois, reached the state Supreme Court on Wednesday, with both sides making oral arguments about whether the 30 days of paid sick leave must begin right after a birth or whether it starts on the soonest subsequent workday. (Cherney, 1/22)

More than 8,000 service workers at the University of California announced Wednesday that they have negotiated a tentative contract agreement with their employer, ending one of the university system鈥檚 longest-running labor dispute. The union did not immediately provide details on the agreement, but it released a statement saying that the agreement would lift labor standards and curtail outsourcing. (Anderson, 1/22)

Many of North Carolina鈥檚 school children in rural and low-wage areas who have never seen a dentist could have greater access to oral health care soon. On Jan. 16, the legislative rules review commission adopted a long-telegraphed change to scope of practice rules for North Carolina dental hygienists, an amendment that goes into effect on Feb. 1. The commission鈥檚 approval came after the North Carolina State Board of Dental Examiners unanimously approved the suggested amendment, which was several years in the making. (Blythe, 1/23)

Gov. Brian Kemp Tuesday unveiled the specifics of a crackdown on human trafficking he proposed in more broad terms in last week鈥檚 State of the State address to the General Assembly.Kemp asked the legislature to support three bills that would tighten restrictions in existing state law targeting human traffickers and, in one case, implement a federal rule promulgated last year by the U.S. Department of Transportation. (Williams, 1/22)

Gov. Ned Lamont used his executive authority Wednesday to direct the state鈥檚 Office of Health Strategy to come up with annual benchmarks for the growing cost of health care 鈥 and require providers, insurers and others in the industry to report their yearly price increases. The order is a transparency measure designed to expose the hospitals, medical practices and insurance companies whose costs soar beyond the state-imposed targets. (Carlesso, 1/22)

Comprehensive sexual-health education inched closer to becoming a mandate for all Washington public schools Wednesday as the state Senate resurrected legislation that failed last year. Dividing along party lines, senators voted 28-21 to advance Senate Bill 5395 to the House, where a similar bill would require every Washington school district to teach some form of sex education in kindergarten through 12th grade. Opponents of SB 5395 鈥 which maintains parents鈥 rights to opt their children out of such instruction 鈥 argued the legislation strips local school boards of the opportunity to work with families to set their own standards for sex education. (Morton, 1/22)

Doorways, an interfaith nonprofit that provides housing services for people living with HIV/AIDS, plans to build a $7 million, 50-apartment campus in the Jeff-Vander-Lou neighborhood.鈥淭his campus will give us a new headquarters in addition to 50 new housing units in the first phase,鈥 said Doorways President and CEO Opal Jones. (Barker, 1/23)

The 20-year-old computer-aided dispatch system that forms the guts of Chicago鈥檚 911 center will be replaced by a $75 million upgrade that is expected to dramatically improve both the speed and quality of emergency response. After years of planning, City Hall has chosen TriTech Software Systems to install the complex software and hardware systems that will allow Chicago to comply with a 2020 deadline to make the switch to, what鈥檚 known as 鈥淣ext Generation 911.鈥 When the three-year transition is completed, people who live, work and play in Chicago will finally have the ability to send texts, photos and videos from emergency scenes, improving the quality of the city鈥檚 response. (Spielman, 1/22)

After a 15-month construction period, the new behavioral health center is almost finished. Officials expect construction on the top three floors of the five-story building to be completed over the next two months.The facility is the only psychiatric program in the Gulf Coast region for children and teens with mental health issues and will replace an older facility on the hospital's 17-acre Uptown campus.聽(Woodruff, 1/22)

Two surgeons have accused a New York state-run university and its medical school of retaliating against them for reporting concerns to senior management about patient safety and deaths in the institution鈥檚 heart-surgery and organ-transplant programs. The accusations, made in lawsuits filed in December and January in state court in Brooklyn, name as defendants the State University of New York and SUNY Downstate Health Sciences University. (West, 1/22)

The Ohio Supreme Court on Wednesday suspended two Cuyahoga County lawyers who tried to collect $1 million in legal fees from the family of a teenage suicide victim as part of a wrongful death case on which the lawyers did about 15 hours of work. Attorneys Mark D. Amaddio of Beachwood and John J. Wargo of Berea tried to pressure the girl鈥檚 father into paying the fee by threatening to ask a judge to remove his name from his daughter鈥檚 estate in the county鈥檚 probate court, according to court records. (Shaffer, 1/22)

The board of East Jefferson General Hospital took no action Wednesday on a proposed deal with LCMC Health to sell or lease the publicly owned hospital, even after close to two hours of closed-door discussions. However, the board called a special meeting for Tuesday.聽Board members were tight-lipped as they exited, but an email earlier in the day to EJGH employees noted that the board would begin considering a 鈥減roposed partnership鈥 with the private New Orleans-based hospital operator. (Roberts, 1/22)

Senate Democrats will propose legislation in the 2020 legislative session to extend the statute of limitations for civil sexual assault cases. 鈥淔or far too long in our state, our civil court system has denied access to justice for victims of sexual abuse,鈥 said Sen. Mae Flexer, D-Killingly, adding that the proposal would 鈥渕ake sure that all victims of sexual abuse, regardless of how long ago that abuse occurred, can come forward and make their case, and if the evidence is there, they will get justice.鈥 (Lyons, 1/22)

More than 15 years ago, Minneapolis Public Schools program helped pioneer a national model of bringing community mental health care directly to its students. Today, most of the public schools in Minneapolis 鈥 more than 50 of them 鈥 have a therapist on site, and many other districts, like Elijah鈥檚, have followed suit. (Roth, 1/23)

A school-based telemedicine program was launched in the county in 2017, and it has since shut down.Four Habersham County schools 鈥 Cornelia Elementary, Wilbanks Middle School, South Habersham Middle School and Habersham Ninth Grade Academy 鈥 ended their telehealth programs last year.That lack of success may seem surprising, but it isn鈥檛 unique, according to the findings of a December state report. (Jones and Miller, 1/22)

Brian O鈥橬eill, the Main Line developer who founded the substance abuse treatment chain Recovery Centers of America, plans to develop a $1.1 billion cell and gene therapy manufacturing facility in King of Prussia. The company, which O鈥橬eill has named the Center for Breakthrough Medicines, is part of the Discovery Labs, a 1.6 million-square-foot, $500 million biotechnology, health-care, and life sciences office complex he is building in an industrial section of King of Prussia. The center will claim 680,000 square feet of the Discovery Labs. (Park, 1/23)

The Executive Council has voted unanimously to confirm the CEO of New Hampshire Hospital to lead the state's Health and Human Services Department. Lori Shibinette succeeds Jeff Meyers, who resigned late last year after almost four years in what many consider the most challenging job in state government. (Rogers, 1/22)

Since recreational weed went on sale in Illinois three weeks ago, long lines have formed outside dispensaries, stores have established buying limits and some have run out of product. All that was expected, based on what鈥檚 happened as other states legalized cannabis. But there鈥檚 also been a less anticipated result: More people want medical marijuana cards. More than 2,570 people applied for medical cards between Jan. 1, when recreational sales started, and Jan. 17, according to the Illinois Department of Public Health. That鈥檚 a nearly 34% increase over Dec. 1 though 17. Included in that uptick, analysts said, are people interested in using marijuana for medical purposes now that recreational sales are legal. The increase also is driven by consumers looking for a way around sky-high taxes attached to some products. (Marotti, 1/21)

The decades-long campaign to coax Georgia motorists and their passengers to buckle up could culminate in a new law this year requiring everyone in a vehicle to wear seat belts. Current state law does not require adults to buckle up in the back seat. But a state Senate committee has recommended legislation that would end that exemption. (Wickert, 1/22)

Dallas County reported its 11th flu-related death of the 2019-20 season Wednesday. The patient was a 34-year-old Dallas County resident who did not have any underlying medical conditions, according to the county鈥檚 Health and Human Services department. The department did not release the patient鈥檚 name, citing privacy reasons. Health officials are working to determine whether two additional deaths 鈥 both children 鈥 were caused by the flu. (Steele, 1/22)

Health Policy Research

Research Roundup: Low-Carb And Low-Fat Diets, Physician Burnout, Gender Disparities In Pay, And More

Each week, KHN compiles a selection of recently released health policy studies and briefs.

In this cohort study of 37 233 US adults 20 years or older, overall low-carbohydrate and low-fat diets were not associated with total mortality, but a healthy low-carbohydrate diet (lower amounts of low-quality carbohydrates and higher amounts of plant protein and unsaturated fat) and a healthy low-fat diet (lower amounts of saturated fat and higher amounts of high-quality carbohydrates and plant protein) were associated with lower total mortality. (Shan et al, 1/21)

More than 60% of eligible residents participated; burnout rates were >50% in all years and not consistently associated with any demographic or residency characteristics. Cross-sectional associations were significant between burnout and stress, sleepiness, quality of life, mindfulness, self-compassion, empathy, confidence in providing compassionate care (CCC), being on a high-acuity rotation, recent major medical error, recent time off, satisfaction with support and career choice, and attitudes about residency. (Kemper et al, 1/1)

A large literature has documented differences in salary between male and female physicians. While few observers doubt that women earn less, on average, than men do, the extent to which certain factors contribute to the salary difference remains a topic of considerable debate. Using ordinary least squares regression and Oaxaca-Blinder decomposition models for new physicians who accepted positions in patient care for the years 1999鈥2017, we examined how the gender gap in total starting pay evolved and the extent to which preferences in work-life balance factors affect the gap. We found that the physician earnings gap between men and women persisted over the study period. Interestingly, despite important gender differences in preferences for control over work-life balance, such factors had virtually no ability to explain the gender difference in salary. The implication is that there remain unmeasured factors that result in a large pay gap between men and women. (Sasso et al, 1/22)

Integrating work and family commitments can be difficult, especially after the birth, adoption, or placement of a child. Institutional family leave policies have been reviewed at top US medical schools for faculty and resident physicians, but to our knowledge, policies for administrative staff have not been studied. (Vance et al, 1/21)

51视频 has a long history of providing insights into national and state-level reproductive health care policy including a series of public opinion polls examining the experiences and attitudes of the general public and the group most likely to be impacted by such policies 鈥 women between the ages of 18 and 49. In recent years, many states have passed laws restricting access to abortion and the Trump administration has made a number of changes to federal reproductive health policy, including major changes to the federal Title X family planning program. (Kirzinger et al, 1/22)

Pregnancy and breastfeeding are associated with a reduced risk for early menopause, new research suggests. Menopause before age 45 has been linked to osteoporosis, depression, dementia, cardiovascular disease and premature death. It affects about 10 percent of women in the United States. (Bakalar, 1/22)

In a world that encourages inactivity, even our babies may be moving too little, according to an innovative new study of physical activity patterns during a child鈥檚 first year of life. The study, which used tiny activity trackers to monitor babies鈥 movements, found associations between infants鈥 squirming, kicking, crawling or stillness and the levels of fat around their middles, raising provocative questions about just how early any links between inactivity and obesity might begin. (Reynolds, 1/22)

Editorials And Opinions

Viewpoints: Efforts To Curb A Pandemic Rely On How Much People Trust Their Government; Will Trump Actually Tackle Entitlement Reform?

Opinion writers tackle these and other health issues.

When you learn you have a dangerous disease, you need to be able to trust your doctor. When entire populations face a dangerous public health crisis, they need to be able to trust their governments. The latest test of this trust is the outbreak of a previously unknown coronavirus in Wuhan, China. Coronaviruses are respiratory viruses that can lead to illnesses ranging from mild colds to life-threatening pneumonia. Like other viruses, they do not respond to antibiotics. This strain, called 2019-nCoV, is too new for any useful data on mortality (two other coronaviruses, severe acute respiratory syndrome, or SARS, and Middle East respiratory syndrome, or MERS, have been reported to kill about 15 percent and 35 percent of infected people, respectively). (Leana S. Wen, 1/22)

With one confirmed case on U.S. soil, more likely already here and 8,000 visitors from China arriving every day, it is already too late to avoid multiple cases of the dangerous new coronavirus in the United States. We are past the 鈥渋f鈥 question and squarely facing the 鈥渉ow bad will it be鈥 phase of the response. Thus, President Trump failed his first test in dealing with the virus, by brashly asserting that the U.S. government has the coronavirus 鈥渃ompletely under control.鈥 While there is no reason to panic, we simply do not know, with China鈥檚 seventh-largest city under a lockdown, how serious it will become. (Ronald A. Klain and Nicole Lurie, 1/22)

On Sunday, a friend of mine in China wrote an ominous, two-word post on WeChat: 鈥淏roke out.鈥 He meant that a mysterious surge in cases of pneumonia in Wuhan, a city in central China, was, in fact, an outbreak of something more serious. The first case of the Wuhan virus was detected on Dec. 12. Until last Thursday, only 45 cases, with two deaths, all in Wuhan, had been reported, and no health care workers were said to have been infected. The virus was mild, we were told then, with no evidence of human-to-human transmission; all confirmed cases seemed to originate from a food market where live animals are sold. On Jan. 11, local health authorities even suggested that the outbreak was over because they hadn鈥檛 registered any new case since Jan. 3. (Yanzhong Huang, 1/23)

It鈥檚 not often that the New York Times makes President Trump sound better than he is, so perhaps today鈥檚 dispatch from Washington is suitable for framing. The good news is that the United States may finally have a President who is interested in restraining federal spending. But he might not be as interested as the Times says he is. (Freeman, 1/22)

Life and death are what those on both sides of this debate were talking about, while some lawmakers seemed to instead see the purpose of the amendment as 鈥渞estricting the ability of the court鈥 or even drumming up support to make judges more accountable to voters. We鈥檝e said before that the voters should get to decide on this amendment, just as they should get to weigh in on Missouri鈥檚 near-ban on abortion. But if they do 鈥 and putting it on the November ballot would make more sense than putting it on August鈥檚 because turnout would be higher 鈥 we can鈥檛 claim to know what Kansas lawmakers would do if their ability to regulate abortion were fully restored. (1/22)

In less than two months, the Supreme Court will hear its first abortion rights case since the confirmation of Justices Neil M. Gorsuch and Brett M. Kavanaugh. This case could be a major step in chipping away the protections of Roe v. Wade and open the floodgates to restrictions that will effectively block abortion access for 25 million reproductive-age people nationwide. If that happens, the District does not have a law on the books to ensure that access to abortion is protected. The D.C. Council can and needs to move quickly to change that. (Serina Floyd, 1/22)

In 2000, a truck rear-ended my friend Andrea鈥檚 car as she stopped at a crosswalk in a school zone. The truck was going at least 45 miles per hour when it slammed into her. The accident damaged muscles, nerves, and bones from the base of her skull to the bottom of her left leg. It left her with an injured spine, pelvic instability, and significant leg injuries. She has been living with chronic pain ever since. Andrea rarely takes opioids; she says they make her feel incredibly drowsy and often don鈥檛 work well to control her pain. (Daniel S. Goldberg, 1/23)

Imagine unwrapping your favorite candy bar, and as you prepare to take that first delicious bite, you notice that the package says the 230 calories you are about to enjoy can be burned off by walking for 42 minutes or running for 22 minutes. Would that change your mind about eating the treat? Some people wouldn鈥檛 eat the candy bar because of guilt; others might walk to burn off the calories. And of course, some people might not even notice the exercise message, or might not care about the information. That鈥檚 the problem with some public-health interventions: They affect people differently. (Cara Rosenbloom, 1/22)

A shortage of nurses elevated the misery of a woman in my support group during a recent health crisis, she informed us. Because I participate in a clinical trial, in which I am vigilantly monitored in both Bloomington and Indianapolis hospitals, I was surprised. But I quickly began to realize that her ordeal could not possibly be unusual and then to fear that our current health care system is becoming more unfriendly, inhospitable to patients and to nurses as well. (Susan Gubar, 1/22)

Medicine continues to be plagued by an 鈥淥ld Boys鈥 Club鈥 culture. Those who abuse power are protected by colleagues, institutions, titles, money, privilege and more. Pervasive between the lines of medical education is the 鈥渉idden curriculum鈥 or 鈥渢he way things are done around here.鈥 (Abraar Karan, 1/22)

With 2,500 employees, 855,000 square feet and 10 miles of conveyor belts, Amazon's huge Fresno warehouse also has an injury rate triple the industry average. Even though the e-commerce behemoth is bringing jobs to places like Fresno, pressure to meet quotas and keep up with shipping demand is injuring workers across the country. (Mark Fiore, 1/22)

On Monday, the nation honored the towering legacy of the Rev. Dr. Martin Luther King Jr. But the progress he demanded remains unfinished, and nowhere more than in the deeply segregated neighborhoods many of us call home. Dr. King understood that where a person lives determines so many of their opportunities, including access to good jobs, schools, health care, food and safety. Barely a week after Dr. King鈥檚 assassination, Congress passed the Fair Housing Act with overwhelming bipartisan support in recognition of this truth. (Shaun Donovan, 1/22)

Critics of truck tolls in Connecticut are scoffing at the idea that tolls are a baby that anyone could love. But there鈥檚 plenty to celebrate about a proposal that will help Connecticut raise badly needed funds and build a transportation system for the future. Here are three reasons why Connecticut residents and politicians should be shouting their support for the governor鈥檚 truck toll proposal. (Paul Sabin, 1/23)

Twenty years ago this month I stood on the banks of Great Pond, in Rome, Maine, holding my children in my arms. It was New Year鈥檚 Eve. Over the frozen lake, fireworks burst, welcoming the new millennium. Something inside of me struggled to be known. The next morning we climbed French鈥檚 Mountain, in Belgrade. We do that every year, on New Year鈥檚 Day. We ate clementines. (Jennifer Finney Boylan, 1/22)

Cannabis is on the march. Thirty-three states and the District of Columbia have legalized medical marijuana. Eleven states and the District of Columbia have legalized recreational use of cannabis for adults over 21, and others are considering it. More than 37 million Americans use cannabis each year in one form or another: flowers, concentrates, edibles, and the like. (Rosalie Liccardo Pacula, 1/21)

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