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On expanding health coverage, Democrats’ 2020 hopefuls have agreed to disagree. Joe Biden says he would let people buy into Medicare and will build upon the Affordable Care Act, signed into law while he was vice president. Sen. Bernie Sanders of Vermont backs a government-run system called Medicare for All that would replace private insurance. Sen. Kamala Harris of California wants Medicare for All too, but would keep some pieces of the current setup including employer-based coverage. (Armour and Hughes, 4/30)

Joe Biden on Monday endorsed a public option that would allow all Americans to buy into a Medicare-like health insurance plan, as allies of both the former vice president and 2020 presidential rival Sen. Bernie Sanders (I-Vt.) begin to debate the Democratic Party’s health-care agenda. “Whether you’re covered through your employer or on your own or not, you should have the choice to buy into a public option plan for Medicare — your choice,” Biden said during a campaign event in Pittsburgh. “If the insurance company isn’t doing right by you, you should have another choice.” (Stein, 4/29)

That Biden is stopping short of Sanders’s plan is not surprising given that the former vice president is expected to run in a more moderate lane than Sanders’s progressive approach. The move, though, could still open Biden up to disappointment from some Medicare for All supporters in the primary. Biden’s position is similar to that of fellow candidates such as former Rep. Beto O’Rourke (D-Texas) and South Bend, Ind., Mayor Pete Buttigieg (D), who has called for "Medicare for all who want it." (Sullivan, 4/29)

Speaker Nancy Pelosi is guiding House Democrats along a narrow path as she seeks to convince party progressives that the idea of providing Medicare for everyone in the U.S. is being taken seriously, while assuring moderates that the House won’t move too far, too fast. The House on Tuesday will gavel in the first-ever hearing on a sweeping Medicare for All proposal, an idea that’s energized the Democratic left, which is pushing to make it a central part of the 2020 campaigns for the White House and Congress. (Wasson and Ruoff, 4/30)

Through Medicare, the U.S. health-insurance program created in 1965 to help older Americans afford their medical bills, the government helps 1-in-5 citizens pay for doctor visits, blood tests, prescription drugs, stays in hospitals or nursing facilities, and hospice care. Why not offer those benefits to everybody? “Medicare for All” has emerged as a rallying cry among potential challengers to President Donald Trump’s 2020 re-election bid, though it means different things to different people. (Tozzi and Parnass, 4/29)

Three and a half years after then-Gov. Peter Shumlin of Vermont signed into law a vision for the nation’s first single-payer health system, his small team was still struggling to find a way to pay for it. With a deadline bearing down, they worked through a frozen, mid-December weekend, trying one computer model Friday night, another Saturday night, yet another Sunday morning. If they kept going, the governor asked his exhausted team on Monday, could they arrive at a tax plan that would be politically palatable? No, they told him. They could not. (Goldstein, 4/29)

A crowd of roughly 200 progressive protestors planted themselves on the ground in the middle of a normally bumper-to-bumper four-lane corridor here Monday with a firm message for the drug industry: get out of our way. The crowd wasn’t there — in front of the trade association PhRMA’s headquarters — to protest a specific drug’s price spike or an unsafe drug. Instead, they were seated in solidarity with the speaker at the front of the crowd: Ady Barkan, a 34-year old activist with ALS confined to a wheelchair. (Florko, 4/29)

When she ponders U.S. healthcare, Democratic Rep. Debbie Dingell thinks about how the automakers of her native Detroit had to become "healthcare providers who happened to make cars." She thinks a lot about employer insurance, the unwieldy bedrock of the American system. She knows all about it from her decades of working for the Michigan auto industry and—most recently—from navigating hospitals during late husband and legendary congressman John Dingell's illness. (Luthi, 4/29)

Measles continues to spread in the United States, federal health officials said on Monday, surpassing 700 cases this year as health officials around the country sought aggressive action to stem the worst outbreak in decades. In New York, an epicenter of the outbreak, city officials closed two more schools for Orthodox Jewish children for failing to comply with an order to exclude unvaccinated children. (McNeil, 4/29)

“We are very concerned about the recent troubling rise in cases of measles,” Azar said in a briefing with reporters. Measles is not a harmless illness but one with deadly consequences that most people, even doctors, have never seen because it was eliminated in 2000. “Vaccine-preventable diseases belong in the history books, not in our emergency rooms. The suffering we are seeing today is completely avoidable. Vaccines are safe because they are among the most-studied medical products we have,” Azar said. (Sun, 4/29)

A measles outbreak that sickened more than 70 people, mostly children, in the Pacific Northwest is finally over even as the total number of cases nationwide continues to spike to near-record levels , officials said Monday. Six weeks have passed without a new infection in southwest Washington state, where the outbreak began on Jan. 3, said Dr. Alan Melnick, head of the Clark County public health department. (Flaccus, 4/29)

The Clark County measles outbreak is officially over, public health authorities announced Monday morning. That marks 42 days -- two cycles of a measles infection -- without a new case. The largest outbreak in the Northwest since measles was eliminated in 2000 and one of the largest in the country during a year of record-setting measles cases, the outbreak on the border cost public health authorities nearly $1 million and lasted 75 days. (Harbarger, 4/29)

Federal officials said Monday they are concerned that the measles virus could gain a foothold again in the U.S. if current outbreaks—particularly one in New York City under way since last October—aren’t brought to heel. The disease was officially eliminated from the U.S. in 2000, meaning that it stopped circulating continuously. “Vaccine-preventable diseases belong in the history books, not our emergency rooms,” U.S. Health and Human Services Secretary Alex Azar said in a telephone briefing. The vast majority of this year’s measles cases involve children who haven’t been vaccinated, Mr. Azar said, but they also include some adults who were vaccinated. (McKay, 4/29)

CDC Director Dr. Robert Redfield said the agency was working with local and state health departments and healthcare providers to promote CDC vaccination recommendations. Treating measles with supportive care can be very expensive, costing an average of $32,000 per case, Messonnier said. (Johnson, 4/29)

Nancy Messonnier, director of the CDC’s National Center for Immunization and Respiratory Diseases, said the outbreaks won’t stop unless community members, health officials and other groups like rabbinical associations work together to identify unvaccinated people at risk of infection. “We should expect to see additional cases. These outbreaks can end with all groups working together, but we can expect to see additional cases before this is over,” Messonnier said. (Weixel, 4/29)

Much of the spread so far this year has occurred in groups of people who were either not immunized or underimmunized and part of close-knit groups, the CDC reported. In fact, such cases account for 88% of the total thus far this year. (Branswell, 4/29)

HHS Secretary Alex Azar said Monday that a measles outbreak had infected at least 704 people, the highest number recorded in 25 years, and praised President Donald Trump for urging U.S. parents to vaccinate their children after years of stating that vaccines cause autism. Azar said Trump's statements during the 2016 campaign linking vaccination to autism were based on a “debate about this issue but it’s been settled. The scientific community generated definitive information so we can reassure every parent there is no link.” (Allen, 4/29)

Officials in New York closed more schools, issued more fines and lobbied the Legislature to eliminate religious exemptions for required vaccinations as part of efforts to contain a measles outbreak. Federal officials have reported 704 measles cases so far in the U.S. since Jan. 1. New York City and suburban Rockland County account for the majority of the cases, almost all among members of Orthodox Jewish communities. (Carola, 4/29)

Almost two-thirds of the nearly 800 students, faculty and staff members who were quarantined following exposure to the measles virus at two Los Angeles universities have been cleared to resume normal activities. The quarantine marked one of the most sweeping efforts by authorities to contain the nation’s measles outbreak, where cases have reached a 25-year high. (4/29)

Los Angeles County officials dealing with a measles outbreak say they expect that more people will be diagnosed with the illness in the coming weeks, while the nation stares down what will likely be its worst measles year in decades. But where are these cases coming from? The U.S. declared measles eliminated in 2000, and the virus does not regularly circulate here. (Karlamangla, 4/29)

The Democrats who control the Colorado Senate are starting to prioritize bills as time runs out for the 2019 legislative session, and a controversial bill on childhood vaccinations isn’t on the high-priority list. “We have a handful of bills that we absolutely want to make sure happen by Friday at midnight,” Senate Majority Leader Steve Fenberg, D-Boulder, said during a meeting with reporters Monday. “And then we have a list of bills that we hope can happen, but they’re not absolutely must-dos.” (Staver, 4/29)

It’s one of the most common tests in medicine, and it is performed millions of times a year around the country. Should a metabolic blood panel test cost $11 or $952? Both of these are real, negotiated prices, paid by health insurance companies to laboratories in Jackson, Miss., and El Paso in 2016. New data, analyzing the health insurance claims of 34 million Americans covered by large commercial insurance companies, shows that enormous swings in price for identical services are common in health care. In just one market — Tampa, Fla. — the most expensive blood test costs 40 times as much as the least expensive one. (Sanger-Katz, 4/30)

Kaiser Health News: Summer Bummer: A Young Camper’s $142,938 Snakebite

It was dusk as Oakley Yoder and the other summer camp kids hiked back to their tents at Illinois’ Jackson Falls last July. As the group approached a mound of boulders blocking the path, Oakley, then 9, didn’t see the lurking snake — until it bit a toe on her right foot. “I was really scared,” Oakley said. “I thought that I could either get paralyzed or could actually die.”Her camp counselors suspected it was a copperhead and knew they needed to get her medical attention as soon as they could. (Heredia Rodriguez, 4/30)

At least two lawsuits have been filed against UnitedHealthcare in the last two months alleging the insurance company improperly denied patients coverage for a certain type of cancer treatment that insurers have long been reluctant to pay for. On Monday, U.S. District Judge Robert Scola recused himself from deciding one of the lawsuits filed this month in Miami because of personal experience with the cancer treatment, writing in an order of recusal that denying a patient the treatment "is immoral and barbaric." (Livinggston, 4/29)

As price becomes an increasingly important factor in where people seek care, many academic medical centers will have to transform their high-cost structures to remain viable, according to new research. Half of 1,250 consumers surveyed said they would not pay more for specialty medical care at an academic medical center, PricewaterhouseCooper's Health Research Institute found. Many academic institutions recognize that the status quo is unsustainable and are merging or affiliating with other providers to better manage lower-acuity care. (Kacik, 4/29)

House Democrats moved Monday to block a new Trump administration rule aimed at restricting health-care providers from promoting abortions. Democrats included language in a newly released spending bill that would prevent the rule — termed a “gag rule” by critics — from taking effect, although it was already stayed by a federal judge. Democrats also included $50 million for gun violence research in the legislation released Monday, a massive spending bill for the departments of Labor, Education, and Health and Human Services. The two parties have been fighting over this issue for years, with Republicans using spending bills when they controlled the House to effectively block gun violence research by the Centers for Disease Control and Prevention. (Werner, 4/29)

“We’re going to keep the administration from trying to shut the doors of Planned Parenthood, which they’ve been trying to do since day one,” said Rep. Lois Frankel (D-Fla.), a member of the House Appropriations Committee. (Hellmann, 4/29)

U.S. District Judge Michael J. McShane on Monday granted the second nationwide preliminary injunction against new federal restrictions that bar taxpayer-funded family planning clinics from referring patients to abortion providers or from being housed in the same place as abortion services. The judge signaled from the bench last week that he planned to grant the injunction sought by 20 states, including Oregon, as well as the District of Columbia, Planned Parenthood and the American Medical Association. (Bernstein, 4/29)

The ruling by U.S. District Judge Michael McShane in Eugene, Oregon, was the second nationwide injunction by a federal judge in the Pacific Northwest against the U.S. Department of Health and Human Services attempt to implement new rules beginning Friday in the so-called Title X program. It provides comprehensive family planning and related preventive health services for low-income families or uninsured people. (4/29)

"At worst, it is a ham-fisted approach to health policy that recklessly disregards the health outcomes of women, families, and communities. In the guise of 'program integrity,' the Gag Rule prevents doctors from behaving like informed professionals,” McShane wrote. “It prevents counselors from providing comprehensive counseling. It prevents low-income women from making an informed and independent medical decision.” (Budryk, 4/29)

Alabama lawmakers are set to debate a bill that would ban almost all abortions in the state. The House of Representatives on Tuesday will debate the proposal to make performing an abortion a felony. The bill contains an exemption for the mother's health but not for rape or incest. The legislation is purposely designed to conflict with the 1973 Roe v. Wade Supreme Court decision legalizing abortion nationally. (4/30)

House Democrats on Monday proposed $50 million in funding for federal agencies to study gun violence prevention. A draft measure released by House Appropriations Committee Chairwoman Nita Lowey (D-N.Y.) calls for the Centers for Disease Control and Prevention (CDC) and the National Institutes of Health to study firearm injury and mortality prevention. (Hellmann, 4/29)

Should both chambers of Congress approve, it would mark the first time the agency has received funding to research the issue since lawmakers effectively banned it in the mid-1990s. The so-called Dickey amendment directed the CDC not to “advocate or promote gun control,” which had a chilling effect on firearms research. (Hallerman, 4/29)

House appropriators are proposing an $8.5 billion increase to HHS’ budget as part of their fiscal 2020 spending bill, defying calls from President Donald Trump to slash funding to the department. The draft plan would boost the HHS budget to $99 billion and target new spending for a series of major public health priorities, including research on gun violence. (Cancryn, 4/29)

The House Appropriations Committee on Monday released the text of a bill that would provide $189.8 billion for the departments of Labor, Health and Human Services, and Education in fiscal 2020, providing an increase of $11.7 billion compared to fiscal 2019. The Appropriations Labor-HHS-Education Subcommittee plans to mark up the bill on Tuesday, kicking off its work for this spending cycle with the largest discretionary funding measure outside of the Defense Department. (Bacon and Siddons, 4/29)

House Democrats' fiscal 2020 spending plan for HHS targets several aspects of the Trump administration's controversial border policy, including the agency's stewardship of unaccompanied migrant children and those separated from their families. The spending draft, which is unlikely to pass muster with the Republican-controlled Senate, bars the administration from housing child migrants in "soft-sided dormitories" critics have called "tent cities" in border states, or in unlicensed facilities set up to deal with the massive influx of refugees seeking asylum. (Ollstein, 4/29)

With just a few weeks to go before its June 6 launch, lawmakers, providers, and advocates are wary about the Veterans Affairs Department’s ability to roll out an expanded private-care program for veterans on schedule without experiencing major glitches like the last time. They fear the 9.2 million veterans eligible for VA-paid healthcare will continue having trouble accessing timely, high-quality care outside of Veterans Affairs hospitals and clinics. (Meyer, 4/27)

Interviews with veterans at the VA Lakeside Clinic in Chicago in mid-April produced mixed views about the quality and accessibility of VA medical services. Most wanted the option to receive care from private-sector providers when needed, even though surveys show veterans nationally express trust in VA medical services and increasingly are using them. (Meyer, 4/27)

Supervised drug-injection sites are gaining traction in half a dozen U.S. cities, setting off a legal battle and intensifying public debate over the controversial concept. Supervised sites—also known as safe-consumption sites—are places where individuals can use drugs they’ve already purchased, with sterile supplies, under the supervision of trained personnel. In the event of an overdose, staff can administer the antidote naloxone. (Miller Rubin, 4/29)

Eighteen state public health directors, a growing group of physicians, and a prominent member of Congress are pushing a dramatic expansion of substance use treatment by posing a simple question: Why can’t doctors who prescribe opioids also prescribe drugs to treat opioid addiction? Their push to deregulate use of buprenorphine, which is used to lessen opioid cravings and withdrawal symptoms, would represent a fundamental shift in U.S. addiction treatment. The medication — and addiction medicine in general — are highly regulated, largely due to fears that opioid-based treatment drugs like buprenorphine and methadone could be misused. (Facher, 4/30)

A federal jury will be able to hear from a doctor who spent decades advocating for broader use of powerful prescription painkillers before turning against the opioid industry. A special court master had ruled earlier this month that the testimony of Dr. Russell Portenoy, a professor at Albert Einstein College of Medicine in New York, would not be allowed at the first federal trial against drugmakers over the toll of opioids. The reason was that attorneys representing the local governments suing the industry had failed to disclose for nearly a year that Portenoy was cooperating with them. (Mulvihill, 4/29)

Recent surveys, including one by the NAS, cited “disturbingly” high rates of harassment in medical school—for men and women. The report said “20-50 percent of women students” said they had experienced “sexually harassing behavior perpetrated by faculty [or] staff.” In one study, about half of female medical school students at Penn State University reported being sexually harassed by faculty or staff. An investigation at the University of Texas found 47 percent of female medical school students there had been harassed, versus 22 percent for women students across the university as a whole.  (Fisk, 4/30)

Suicides among U.S. kids aged 10 to 17 jumped to a 19-year high in the month following the release of a popular TV series that depicted a girl ending her life, researchers said. The study published Monday can't prove that the Netflix show "13 Reasons Why" was the cause, but there were 195 more youth suicides than would have been expected in the nine months following the show's March 2017 release, given historical and seasonal suicide trends, the study estimated. (4/29)

“Suicide is a problem worldwide, and it’s so hard to knock these rates down,” said Lisa M. Horowitz, a staff scientist in the National Institute of Mental Health’s Intramural Research Program, and an author of the paper. “The last thing we need is something that increases them.” In a statement, a Netflix spokesperson said: “We’ve just seen this study and are looking into the research, which conflicts with last week’s study from the University of Pennsylvania,” which focused on young adults. “This is a critically important topic and we have worked hard to ensure that we handle this sensitive issue responsibly.” (Carey, 4/29)

In the month following the show's debut in March 2017, there was a 28.9% increase in suicide among Americans aged 10-17, said the study, published Monday in the Journal of the American Academy of Child and Adolescent Psychiatry. The number of suicides was greater than that seen in any single month over the five-year period researchers examined. (Schwartz, 4/30)

Kimberly Noble, a neuroscientist, holds up a blue and red cap dotted with electrodes that rest on a toddler’s scalp to measure electrical activity in the brain. It is one of the tools her team will use to answer a complex question: Can monthly cash payments to low-income mothers foster the growth of their babies’ brains and cognitive abilities? Dr. Noble, based at Teachers College, Columbia University, thinks so. (Brody, 4/29)

Turkish Airlines brought in Dr. Mehmet Oz, host and producer of “The Dr. Oz Show.” Singapore Airlines turned to Dr. Richard Carmona, a former United States surgeon general who is now chief of health innovation at the resort spa Canyon Ranch. Air France works with its own medical aviation doctor and psychologist. Airlines have long vied to offer the most front-of-plane amenities. More recently, the competition has moved to a new area: in-flight wellness programs meant to help passengers ward off the effects of air travel, especially on nonstop long-haul and the newer ultra-long-haul flights, with meditation apps, exercises, better blankets and bedding, herbal teas and healthier meals. (Garfinkel, 4/29)

A consumer advocacy group has filed a lawsuit against the Food and Drug Administration for failing to act on a petition filed three years ago demanding the agency place serious warnings on a handful of drugs used to treat Parkinson’s disease that have been blamed for compulsive behaviors. These include sudden sexual urges, compulsive eating and shopping, and pathological gambling. (Silverman, 4/29)

A language gap is making it harder for U.S. health officials to measure a teen-vaping epidemic. For some young people who use the popular vaping device sold by Juul Labs Inc., “juuling” is a verb in its own right. Antitobacco groups and health officials worry that has led to confusion when pollsters go out into the field to quiz teens on their nicotine habits for an annual government survey that plays an important role in shaping tobacco policies. This year for the first time, the poll will specifically mention Juul as an example of an e-cigarette. (Edney, 4/29)

Men are notoriously bad patients. Compared with women, they avoid going to the doctor, skip more recommended screenings and practice riskier behavior. They also die about five years sooner, live with more years of bad health and have higher suicide rates. Now, with growing recognition that treating preventable causes of death and disability could close the medical gender gap, the health-care industry is mounting a new push to get men the care they need. (Landro, 4/29)

Why have women have been living longer than men everywhere in the world since the mid-19th century? To find out, Esteban Ortiz-Ospina, an economist at the Oxford Martin School at the University of Oxford, dug through statistics collected through various sources, including the global Human Mortality Database. (Mitchell, 4/29)

With more and more common medications losing their ability to fight dangerous infections, and few new drugs in the pipeline, the world is facing an imminent crisis that could lead to millions of deaths, a surge in global poverty and an even wider gap between rich and poor countries, the United Nations warned in a report on Monday. Drug-resistant infections already claim 700,000 lives a year, including 230,000 deaths from drug-resistant tuberculosis, the report said. (Jacobs, 4/29)

Cubicles have arrived in the emergency room. Hospitals across the country, rethinking how they use precious ER space, are creating more compact examination and treatment areas for ER patients with less-acute ills—a move that also frees up space for patients with more serious problems and reduces the expense of building larger ERs. By being smarter about using space, the ERs aim to see more patients, in less time, without having to expand. (Sadick, 4/29)

Can a mirror help people who are unhappy with their bodies feel better about themselves? A review of studies on the subject says it can, with the right help. Mirror exposure therapy is a relatively new psychological approach in which participants observe themselves in a full-length mirror and talk about their bodies with the guidance of a therapist. (Oliver, 4/29)

Iron is one of the major chemical elements on Earth, and a proper level of it in the human body is necessary for life. Most Americans have probably heard about iron deficiency, a serious problem for many poorly nourished people. But hemochromatosis, which is sort of the opposite condition, is less known.Hemochromatosis causes the body to store too much iron, which can lead to serious health problems. (Thomas, 4/29)

It began with occasional tiredness, dizziness and tinnitus. I later developed heart palpitations, odd sensations in my extremities, and shortness of breath. As time went on, I also experienced anxiety, feeling faint and brain fog. Add to the list insomnia, as I became afraid to fall sleep because I sometimes awoke with what felt like a surge of electrical charges throughout my body, or with my arms and legs completely numb. (Hawkins-Simons, 4/29)

Health plans are gathering more than just medical data on members. With the help of data-analytics companies, they are now making use of information such as how much people earn, how often they travel and even if they have a pet. These efforts are the result of a confluence of two trends: first, the rising recognition that social factors have a significant impact on health, and, second, a shift toward value-based care in medicine, where providers are rewarded for keeping patients healthy. By integrating medical data with personal information and applying analytics to it, insurers and health providers are hoping to identify patients at high risk of an illness or hospitalization and intervene to prevent it. (Gormley, 4/29)

Divorce can bring out the worst in parents who are already accustomed to bickering with each other. Even an argument about whether a kid should join a soccer team—and who will pay—can end up in a courtroom. To minimize discord and unnecessary court time, family-law judges increasingly order warring parents to use co-parenting apps. The new tools may not solve every problem, but experts say they can ease the stress on children caught in the crossfire. (Jargon, 4/30)

At a roundtable meeting Wednesday seven CEOs of rural North Carolina hospitals explained to Gov. Roy Cooper and state Health and Human Services Sec. Mandy Cohen that expanding Medicaid would help their institutions keep the doors open. There were some common elements to all their stories. For starters, all of their hospitals are operating on thin margins. The group nodded in agreement as each talked about excessive use of their emergency departments and the uncompensated care resulting from ED patients who were uninsured or unable to pay. (Knopf, 4/29)

Just days away from ending their legislative session, both chambers in the Tennessee legislature appear close to a consensus on a $38.5 billion budget, including fully funding a Medicaid waiver for disabled children. While the Senate last week proposed funding only a portion of the Katie Beckett waiver program — citing concerns about the House's plan to use revenue from expanded online sales tax collection — a key Senate committee on Monday moved to fully fund the $27 million program through other revenue sources, along with the entirety of the House's budget. (Allison, 4/29)

Covering children and teens who are undocumented costs the state more than $360 million a year. Newsom’s proposal would add $260 million to the bill. But advocates argue it would be a cost-effective investment in preventive and primary care services that can identify problems such as diabetes early and reduce costly services as people get older. (Bollag, 4/29)

A special prosecutor who spent three years leading a criminal investigation of the Flint water scandal has been fired, officials announced Monday, apparently part of the fallout from the recent discovery of 23 boxes of records in the basement of a state building. Todd Flood’s contract was terminated on April 16. The Michigan attorney general’s office told a judge about the records on Friday as it seeks a six-month freeze in the case against Michigan’s former health director, Nick Lyon, who is charged with involuntary manslaughter. (White, 4/29)

Many obstacles remain before passage, but provisions a state House subcommittee’s proposal could bring more spending money to North Carolinians in assisted living, as well as more help for those who receive community-based services such as Meals on Wheels. Among the highest-profile measures from the NC Health and Human Services appropriations subcommittee is a proposal to increase spending money from $46 to $70 monthly for people using public assistance who live in adult care centers, or assisted living. Coverage of the personal needs allowance, or PNA, has brought accounts of strapped residents, including women in residential care who have sold sex to meet expenses, a detail that drew recognition from state long-term ombudsmen. (Goldsmith, 4/29)

Five people were hospitalized after a fight broke out at a Utah youth psychiatric center that took officers from several police agencies about an hour to bring under control, police said Monday. Another 20 people, including three staffers, were treated at the scene for minor injuries in the melee Sunday night at the Red Rock Canyon School residential treatment center in the small southwestern Utah city St. George, authorities said. Most of the injuries were bumps and bruises but one person required staples after being hit in the back of the head with a blunt object, said St. George police Officer Tiffany Atkin. (4/29)

Public health advocates based at Northeastern University on Monday initiated a class action lawsuit against e-cigarette titan Juul Labs, demanding that the company fund a statewide treatment program for teenagers who begin using the company’s e-cigarettes before age 18 and want to quit. This is one of the first lawsuits in the country asking for this type of action from Juul, the company facing criticism — and a rash of lawsuits — for marketing to young people. (Kempe, 4/29)

Arizona legislation backed by the nation's biggest cigarette maker and e-cigarette giant Juul would raise to 21 the legal age to purchase tobacco, but opponents say the measure favors the tobacco industry and would set the fight against smoking and cancer back decades. Supporters call the proposal, backed by the parent company of Philip Morris USA, a compromise and credit the industry for getting ahead of efforts to further regulate e-cigarette use and tobacco. (Náñez, 4/29)

State lawmakers approved sweeping healthcare changes Monday that will overturn long-standing regulations on building or expanding hospitals and allow the state to pursue importing foreign drugs, as well as make several other changes long sought by conservatives in the Legislature. The votes signal success for several agenda items House Speaker José Oliva, R-Miami Lakes, has outlined in healthcare this session, and the bills are expected to become law as they head now to Gov. Ron DeSantis’ desk. (Koh, 4/29)

NewQuest Properties, a Houston-based commercial real estate firm specializing in developing and leasing shopping centers, has launched a division focusing on healthcare and wellness, a response to the "retailization" of the medical industry as it moves to bring patient care close to residential neighborhoods. The new group aims to expand the firm's healthcare portfolio, as well as provide commercial real estate services to healthcare providers, developers and investors. (Sarnoff, 4/29)

Operating income held steady last year at Fairview Health Services as the Minneapolis-based operator of hospitals and clinics continues to work on improving financial results from its HealthEast business in the east metro. The 2018 numbers fit with the broader trend of stabilization in revenue and expense for nonprofit health care systems across the country, said Hayes Batson, the Fairview chief financial officer, in an interview. (Snowbeck, 4/29)

A 37-year-old prisoner died suddenly at Michigan's only women's prison on Friday after complaining about a bee sting, officials confirmed Monday. Lisa Marie Johnston was taken to the hospital on Wednesday after complaining about being stung by a bee and suffering an apparent severe allergic reaction, Corrections Department spokesman Chris Gautz said. She was discharged from St. Joseph Mercy Health System in Ann Arbor on Friday and had been back at Women's Huron Valley Correctional Facility only about two hours when she collapsed and soon died, Gautz said. (Egan, 4/29)

With food allergies on the rise, parents and doctors are struggling to understand what causes them and how to prevent them. Research from the U.S. Centers for Disease Control and Prevention shows that food allergies in children increased 18 percent between 1997 and 2007. (D'Souza, 4/29)

The Forest Park Medical Center federal bribery and kickback trial in Dallas resulted in landmark convictions against the hospital's managers and doctors. It also exposed Texas' longstanding failure to police medical kickbacks under state law. Texas authorities have never enforced the state's version of the federal anti-kickback law, according to testimony in the trial. And when faced with a key opportunity to do so — against those same doctors and owners at a different hospital — state investigators came up empty. (Krause, 4/29)

Today brings the first-ever hearing in Congress on the idea that the U.S. government should provide “Medicare for all.” And it isn’t a moment too soon. Already seven separate bills to expand Medicare have been introduced. And most of the 21 people vying for the Democratic Party’s presidential nomination have come out in favor of vastly broadening it.Legislation isn’t imminent. Even so, opening the official discussion will be useful if it can show the country what’s at stake — and just how disruptive to the U.S. health-care system a full-fledged conversion to a single-payer system would be. (4/30)

Covering all uninsured Americans, and replacing our wasteful, often incomprehensible patchwork of insurance with comprehensive, no-cost coverage under a trusted public program is indeed tantalizing. ...But there are risks in “Medicare for all.” First, major service bottlenecks are sure to arise, as 20 million uninsured Americans gain coverage — or 30 million, if immigrants’ advocates win the battle — and another 210 million move from the cost-sharing of the current Medicare and private insurance systems to free medical care. (Michael Stein and Jon Kingsdale, 4/30)

As Democratic presidential candidates disingenuously promote “Medicare for All” recent information suggests these actors time would be far better spent focusing on the welfare of current and future beneficiaries of "Medicare as it Is." On April 22, the Medicare Trustees released their 2019 report on the financial and actuarial status Medicare’s Hospital Insurance (“Part A) and the Supplementary Medical Insurance (“Part B” and “Part D”) Trust Funds. The picture isn’t pretty. (Roger D. Klein, 4/29)

Last year, Americans borrowed approximately $88 billion to pay for health care. One in four of us skipped medical appointments because of concern about costs. Such statistics reflect a trend that has been going on for decades. In 1970, the U.S. spent $74.6 billion on health. By 2000, this figure had risen to around $1.4 trillion and by 2017 it was $3.5 trillion. Not incidentally, medical debt is now the number one cause of personal bankruptcy in the U.S. This question — Are we paying too much for health? — has defined much of the health conversation in the U.S. over the years. Unfortunately, it is the wrong question. Here’s the right one: Is our spending making us healthier? The answer, sadly, is no. (Sandro Galea, 4/30)

For supporters of abortion rights, these are anxious times. President Trump has filled the federal courts, including the Supreme Court, with judges thought to be hostile to legal abortion. And this year, state legislatures have passed a seemingly endless stream of anti-abortion laws. Yet abortion rights supporters shouldn’t feel defeated. In fact, even in the age of Trump, there are many reasons for celebration, as the abortion rights movement is working just as hard — and succeeding at times — to increase abortion access and protect reproductive rights. These promising developments should galvanize supporters and offer important lessons about how to preserve and even expand access to abortion. (David S. Cohen and Carole Joffe, 4/29)

As his (Trump's) raucous crowd booed and screamed, Trump described a hideous scenario that he insists Democrats approve of. “The baby is born,” said Trump. “The mother meets with the doctor, they take care of the baby, they wrap the baby beautifully” — at this, he seemed to mime rocking an infant — “and then the doctor and the mother determine whether or not they will execute the baby.” He made a chopping motion with his hand. (Michelle Goldberg, 4/29)

For a conservative idea, few things are more dangerous and discrediting than the full-on, smothering embrace of President Trump. When he forces himself upon an issue — grabbing it, as it were, by the policy prescription — his approach is familiar. He seizes on a half-heard contention, simplifies it beyond recognition and delivers it with the subtlety and precision of a shotgun blast. This method is one thing when the topic is building a wall; it is another when accusing opponents of endorsing infanticide. (Gerson, 4/29)

The Kansas Supreme Court got it right.In a landmark case — one judge called it “the most significant and far-reaching decision this court has ever made” — a clear majority said Friday that the Kansas Constitution fundamentally protects the right to an abortion.“ This right allows a woman to make her own decisions regarding her body, health, family formation and family life — decisions that can include whether to continue a pregnancy,” the majority said. (4/28)

If insanity is doing the same thing over and over again but expecting different results, then the last decade or so of Alzheimer’s disease drug development has been insane. Three carefully designed, well-executed, and fully resourced trials targeting amyloid protein in the brain as the cause of Alzheimer’s disease have failed. It’s long past time to take a new approach to this mind-robbing disease. (Raymond J. Tesi, 4/30)

President Trump, who has in the past expressed concerns about the possible negative effects of too many childhood vaccines being given over a short period of time, has now reversed course and praised vaccines as important. "They have to get the shots," Trump said Friday as he was departing the White House for a trip to Indiana. "The vaccinations are so important. This is really going around now. They have to get their shots." (Marc Siegel, 4/29)

You forget that they have no neck muscles, that they can’t see beyond a couple of feet, that someone who is now the size of a summer squash may one day pivot and stuff a basketball over your head. You’ve already forgotten the sleepless nights that you had, the marital strife, your uneasy acquaintance with baby poop. You wanted grandkids. Now you’ve got identical twins — boys, born small and early and needy, but healthy enough when they’re finally released from the preemie ward that you start asking the questions you should have asked earlier. (Timothy Egan, 4/26)

House lawmakers succeeded in gutting what would have been Massachusetts’ first serious attempt to control prescription drug prices, which if successful would save the state tens of millions of Medicaid dollars. The state Senate, which will take up the budget rider this spring, simply must do better. (4/26)