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We spent hours interviewing the enormous Democratic presidential field on subjects ranging from climate change and border control to fast food and personal humiliation. And while many Democrats agree on a broad set of political ideas, there were some telling differences and disclosures that emerged from our conversations. Here are a few of our takeaways. (Burns and Ember, 6/19)

Single-payer health care is a dividing line in the race, separating Democrats who want to replace the private insurance system from those who favor improving it. Some candidates — like Bernie Sanders and Michael Bennet — picked a clear side. Others, like Elizabeth Warren and Kamala Harris, took a middle path. (6/19)

The still-growing field of Democratic candidates running for Senate seats in 2020 looks a lot like the Democratic candidates who ran for the House in 2018. While the race is very early, prominent candidates in several races share some key characteristics. Several are military veterans or small-business owners, and the announcement videos each emphasize health care. Many veterans and national security professionals won competitive House seats for Democrats in 2018, and health care was a central issue in the 2018 midterms. (Duehren, 6/18)

If Donald Trump weren’t president of the United States, Dr. Leana Wen might not be the head of Planned Parenthood. Wen, 36, almost didn’t return the call when Planned Parenthood’s search committee approached her about potentially replacing departing President Cecile Richards. She was a new mom serving as Baltimore’s health commissioner, considered by some one of the best public health advocates in the U.S. (Hellmann, 6/18)

President Trump delivered a fierce denunciation of the news media, the political establishment and what he called his radical opponents on Tuesday as he opened his re-election campaign in front of a huge crowd of raucous supporters by evoking the dark messaging and personal grievances that animated his 2016 victory. ... At times, Mr. Trump seemed like any other incumbent president, ticking off a laundry list of claimed accomplishments on veterans’ health care, funding for the military, abandoning the Paris climate accords and defending gun rights. The frenzied crowd seemed to lose some of its passion during those moments. (Haberman, Karni and Shear, 6/18)

Trump and other Republicans say they'll have a plan to preserve protections for people with pre-existing conditions, but the White House has provided no details. Obama's law requires insurers to take all applicants, regardless of medical history, and patients with health problems pay the same standard premiums as healthy ones. Bills supported in 2017 by Trump and congressional Republicans to repeal the law would have undermined those protections by pushing up costs for people with pre-existing conditions. (Woodward and Yen, 6/18)

President Trump at his 2020 campaign kickoff rally on Tuesday took credit for passing a veteran's health care bill that was signed into law by former President Obama. "We passed VA Choice," he said, referring to a bill that allows veterans to seek health options outside the Veterans Affairs-run system. "You go out now, you get a doctor, you fix yourself up, the doctor sends us the bill, we pay for it. And you know what? It doesn't matter because the life and the veteran is more important, but we also happen to save a lot of money doing that." (Frazin, 6/18)

Many Americans remain confused about the impact “Medicare for All” will have on the health care system, according to a new poll. This month's Kaiser Family Foundation Health Tracking poll found that majorities of Americans are unaware of the kind of dramatic changes that Medicare for All would entail. (Weixel, 6/18)

Most Americans think that ‘Medicare for All’ will drive up income taxes, according to a survey from the Kaiser Family Foundation, ahead of the Democratic presidential debates next week. While health care is a leading topic on the minds of Democrats and left-leaning independents before the debates kick off next Wednesday, 78% of U.S. citizens surveyed across party lines believe that a single payer system, known as Medicare for All, would drive taxes higher, according to the poll. (Flanagan, 6/18)

White House officials have soured on HHS Secretary Alex Azar, a deepening quarrel that threatens to derail President Donald Trump’s health care agenda as he gears up for his 2020 reelection campaign. The divide has led to stalled projects, disputes over Medicaid and fetal tissue research, duplicated work on Trump’s drug pricing priorities — and bitter personal attacks, say a dozen current and former White House and HHS officials as well as multiple other people familiar with the conversations. (Diamond, Kumar, Pradhan and Cancryn, 6/18)

The CMS has agreed to settle appeals from inpatient rehabilitation facilities regarding denied Medicare claims. The settlement ends a two-year dispute with the inpatient rehabilitation industry after they were frequently denied Medicare claims for a variety of reasons, including if the patient missed a few minutes of their minimum time for daily therapy. Medicare would only pay for the therapy if beneficiaries participated at least three hours a day. (Castellucci, 6/18)

The chair of the Senate health committee showed his support for the so-called "network matching" policy to end surprise medical bills, a proposal sharply opposed by specialty physician groups and the hospitals that employ them. In a committee hearing on Tuesday, Sen. Lamar Alexander (R-Tenn.) said the policy, under which hospitals would have to guarantee to their patients that any doctor they see is in-network, is the one he "instinctively liked the best." (Luthi, 6/18)

Providers such as doctors and payers such as insurers agree that there should be an end to surprise medical bills — a hot-button issue that President Donald Trump wants to address through legislation this summer. But their disagreement over how to settle payment disputes has been the central sticking point in negotiations over a ban on surprise bills. Alexander declined to tell reporters if he would move forward with the in-network guarantee approach. “We’ll see,” he said after the hearing. Sen. Patty Murray, D-Wash., the panel’s top Democrat, similarly declined to say if she supports an in-network guarantee. Washington Governor Jay Inslee, a Democrat who is seeking the party’s White House nomination, signed legislation last month with a different approach to banning surprise bills, which would use a third-party arbitrator if a payer and provider could not agree on payment. (McIntire, 6/18)

Kaiser Health News: Senators Agree Surprise Medical Bills Must Go. But How?

There was also broad support among the witnesses for some of the legislation’s transparency measures, especially the creation of a nongovernmental nonprofit organization to collect claims data from private health plans, Medicare and some states to create what’s called an all-payer claims database. That could help policymakers better understand the true cost of care, these experts told the committee. (Bluth, 6/18)

Kaiser Health News: ‘An Arm And A Leg’: Can You Shop Around For A Lower-Priced MRI?

An MRI is one of those standard tests that doctors order routinely. But the price you’ll pay can be unpredictable. Sometimes the price tag depends on where you live: It could reach $10,000 in San Francisco. Or be as low as $1,000 in St. Louis — if you’re willing to haggle. And the kind of imaging center you choose often makes a difference: Was it a fancy specialty hospital linked to a university or a standalone facility at the mall? (Weissmann, 6/19)

The Democratic-controlled House voted Tuesday night to block President Donald Trump's move to restrict transgender men and women from military service. The House passed, by a 243-183 vote, an amendment to block Trump's transgender ban from remaining in effect. The move still faces an uphill battle and a Trump veto threat against the underlying $1 trillion spending bill, which includes the military budget. (Taylor, 6/18)

During debate on a $1 trillion spending package, lawmakers voted 243-183 to adopt an amendment from Rep. Jackie Speier (D-Calif.) to block funding to implement the new policy, which Democrats slammed as discriminatory and arbitrary. "The president and his administration wrongfully argue that it's about military readiness and unit cohesion, but these arguments are the same ones that were made to keep the military racially segregated," said Rep. Anthony Brown (D-Md.). (O'Brien, 6/19)

The House is poised to pass spending legislation on Wednesday that includes the Hyde Amendment, the decades-old ban on federal abortion funding that recently created an uproar in the Democratic race for the White House. Weeks after former Vice President Joe Biden flip-flopped from supporter to opponent of the amendment under heavy pressure from his party’s liberal base, the Democratic House will vote in favor of a package that retains Hyde — which progressives say disproportionately hurts poor and minority women. (Hellmann, 6/19)

The House passed a health care bill late Tuesday that would authorize funding for multiple expiring Medicaid programs. Finding a long-term solution to pay for some of these programs has proven difficult, despite general bipartisan support for the programs themselves. The bill (HR 3253) next goes to the Senate. By a vote of 371-46, House members passed the bipartisan bill package, which would update community mental health pilot programs and renew authority for programs that would help patients move out of assisted living, defray costs for individuals whose spouses are in long-term care, and prevent Medicaid fraud. (Raman and Siddons, 6/18)

Sen. Elizabeth Warren (D-Mass.) and Rep. Deb Haaland (D-N.M.) introduced legislation Tuesday that would use federal funds to establish universal child care. The Universal Child Care and Early Learning Act seeks to combat the rise of rising child care costs in the face of stagnated wages with a focus on low-income families. The bicameral bill is cosponsored by Sens. Cory Booker (D-N.J.) — like Warren, a 2020 White House hopeful — and Jeff Merkley (D-Ore.) and Democratic Reps. Barbara Lee (Calif.), Mark Pocan (Wis.), Jamie Raskin (Md.), John Larson (Conn.), Grace Meng (N.Y.) and Stephen Horsford (Nev.), as well as Del. Eleanor Holmes Norton (D-D.C.). (Axelrod, 6/18)

Comedian Jon Stewart delivered a searing response Monday night to Senate Majority Leader Mitch McConnell (R-Ky.), who said earlier in the day that he didn’t know why the former host of “The Daily Show” was “all bent out of shape” over the future of the September 11th Victim Compensation Fund. “I’m bent out of shape for them,” Stewart said during an appearance on “The Late Show With Stephen Colbert,” referencing the victims and first responders who were injured or became ill because of the 9/11 attacks. “These are the first heroes and veterans and victims of the great trillions of dollars war on terror, and they’re currently still suffering and dying and in terrible need.” (Chiu, 6/18)

California public health officials would have oversight of doctors and schools with high numbers of medical exemptions for vaccinations under a legislative compromise announced Tuesday. Gov. Gavin Newsom and the bill's author disclosed the deal aimed at cracking down on fraudulent exemptions issued by sympathetic doctors. The updated measure by Sen. Richard Pan removes a provision that would have required health officials to consider every exemption requested and expands the criteria for granting exemptions. (Thompson, 6/18)

The measure still would make it easier for the Medical Board of California to investigate and sanction physicians who write medical exemptions that don’t conform with accepted medical standards. (Barry-Jester, 6/18)

“The Governor would like to thank Dr. Pan for his leadership and for partnering with the Administration on these amendments,” said Health and Human Services Secretary Mark Ghaly, referring to Sen. Richard Pan, in a statement. These amendments, Ghaly added, will ensure the bill “protects the doctor-patient relationship, strengthens the state’s ability to target doctors who abuse the medical exemption process and gives state public health officials the tools to identify and protect schools and communities where herd immunity is in danger.” (Gutierrez, 6/18)

Parents are given additional power under the amendments, because they can appeal decisions made by public health officials who might revoke or deny medical exemptions. “I want to thank Gov. Newsom for his leadership on children’s health and standing up for science and the importance of vaccination by supporting SB 276,” Pan said in a Tuesday statement regarding the amendments. “I appreciate that the governor has worked with me in crafting a California solution to halting the abuse of medical exemptions that endanger our children.” (Wiley and Bollag, 6/18)

Declining confidence in government institutions is feeding a growing mistrust of vaccination around the world, according to a report out today based on the largest global survey of attitudes in science and health. The Wellcome Trust report, which relies on 2018 interviews with at least 1,000 people in each of 142 countries, shows that income inequality, lower education levels and lack of confidence in government contribute to mistrust of science. (Allen, 6/19)

The rate at which young Americans took their own lives reached a high-water mark in 2017, driven by a sharp rise in suicides among older teenage boys, according to new research. In that year alone, suicide claimed the lives of 5,016 males and 1,225 females between 15 and 24 in the United States, researchers reported Tuesday in the Journal of the American Medical Assn. (Healy, 6/18)

The study by Harvard Medical School researchers shows that from 2000 to 2017, the suicide rate rose by 47 percent among teens age 15 to 19 and 36 percent among those 20 to 24. That’s well above the 30 percent increase seen across all age groups. Although the trend of soaring youth suicides is well known, the report provides the first breakdown of this group by age and sex over several years. And it reveals a recent, abrupt spike. (Freyer, 6/18)

In 2017, there were 47 percent more suicides among people aged 15 to 19 than in the year 2000. Overall, there are 36 percent more people aged 20 to 24 living in the U.S. today than at the turn of the century. With more than 6,200 suicides among people aged 15 to 24, suicide ranked as the second-leading cause of death for people in that age group in 2017, trailing behind deaths from unintentional motor vehicle accidents, which claimed 6,697 lives. (Frazee and Morales, 6/18)

"Previous studies talked more of an increase in female suicide, but what we’re showing is that rates among males are also increasing rapidly," Oren Miron, the study's lead author and a research associate in biomedical informatics at Harvard Medical School, told NBC News. (Edwards, 6/18)

The research also did not examine factors behind the increase in suicide rates. "Future studies should examine possible contributing factors and attempt to develop prevention measures by understanding the causes for the decrease in suicides found in the late 1990s," the researchers wrote. (Howard, 6/18)

A popular diabetes drug sometimes taken to slow aging may diminish some of the expected health benefits of aerobic exercise in healthy older adults, according to a new report. The drug, metformin, can blunt certain physical changes from exercise that normally help people to age well. The results raise questions about the relationship of pills and physical activity in healthy aging and also whether we know enough about how drugs and exercise interact. The results are particularly disconcerting given that healthy, active people may be considering taking the drug to slow aging. (Reynolds, 6/19)

Preschoolers on government food aid have grown a little less pudgy, a new study found, offering fresh evidence that previous signs of declining childhood obesity rates in the U.S. weren't a fluke. Obesity rates dropped steadily to about 14% in 2016 — the latest data available — from 16% in 2010, a team from the Centers for Disease Control and Prevention reported Tuesday in the Journal of the American Medical Assn. (Tanner, 6/18)

Despite the availability of vaccines, the flu still kills tens of thousands of people in the U.S. each year, and hundreds of thousands more worldwide. But public health officials fear that an even graver threat lies ahead: the emergence of a new, much more deadly flu virus. (Brangham and Wellford, 6/18)

Liquid biopsies have been a long time coming. After more than two decades of research, the first of these blood tests — which can reveal the presence of cancer-causing genetic mutations the way a tissue sample can — has finally been approved for helping physicians make treatment decisions for cancer patients. But the bigger ambition for these tests, being pursued by several dozen companies, is using them to screen people and detect cancer early — before it spreads — by analyzing bits of DNA and other molecules shed by tumor cells. (Chakradhar, 6/19)

A 26-year-old Starbucks barista in the suburbs of Tampa known as Vayne Myers has suffered from anxiety ever since he was a child. A co-worker suggested he try an emotional support animal. So Mr. Myers bought a duck and named it Primadonna. The snow-white bird has worked wonders for his state of mind. “Whenever I felt like I didn’t matter in the world,” he said, Primadonna would waddle over and remind him that “something does love you.” (Stockman, 6/18)

Pot use in pregnancy has doubled among U.S. women and is most common during the first trimester, government research shows. Overall, 7% of pregnant women, or 1 in 14, said they used marijuana in the past month. That's from a nationally representative health survey in 2016-17 and compares with a little over 3% in 2002-03. (Tanner, 6/18)

An online pharmacy told U.S. regulators it found another cancer-causing chemical in widely prescribed blood-pressure pills, raising new questions about a complex global web of companies that produces medicine for millions of people. A solvent called dimethylformamide was discovered in the drug valsartan made by several companies, including Swiss pharmaceutical giant Novartis AG, according to a filing last week to the Food and Drug Administration by New Haven, Connecticut-based Valisure. (Edney, 6/18)

Kaiser Health News: Why You Should Take A Peek At Your Doctor’s Notes On Your Health

When Pamela DeSalvo read the clinical note from her doctor’s visit, the words on the page hit her hard: “clinically morbidly obese.” She knew she was overweight, but seeing those three words together shocked her. It also inspired her to start losing weight.“ I needed to see it in black and white, what I actually in my heart already knew. It forced me to get honest with myself,” DeSalvo said.“Reading that note saved my life.” Studies show that, indeed, reading your doctor’s notes can improve your health. (Knight, 6/19)

Missouri's case for not renewing the license of its lone remaining abortion clinic includes a claim that three "failed abortions" there required additional surgeries and another led to life-threatening complications for the mother, according to a now-sealed court filing that Planned Parenthood alleges state officials made public in violation of patient privacy laws. (6/18)

Gov. John Bel Edwards, the only Democratic governor in the Deep South, said Tuesday that he’s not concerned about losing support among his party’s voters in Louisiana because of a strict abortion ban he signed into law. The governor, seeking a second term on the October ballot, said he knows some people “were disappointed” that he supported the ban on abortion when a fetal heartbeat is detected — as early as six weeks into a pregnancy. (Deslatte, 6/18)

State officials revealed that the full number of poor elderly or disabled Georgians they are slated to drop from Medicaid rolls is 30,000, much more than what they reported earlier this month. They say the Medicaid system sent out warnings to almost all of them, though, and received no response. (Hart, 6/18)

A group seeking a public vote on whether to expand Medicaid to tens of thousands of low-income Oklahomans first must clear a legal challenge spearheaded by a conservative think tank that has long opposed expansion. The Oklahoma Supreme Court heard arguments Tuesday on whether the group can proceed with gathering the nearly 178,000 signatures they will need to get the question on the ballot. The Oklahoma Council of Public Affairs think tank is challenging the proposal, arguing the proposed ballot language doesn't accurately describe what the measure does. (6/18)

The results from a Montana Healthcare Foundation report that aimed to reduce health care costs associated with Montana homelessness were shared at the Billings Hotel and Convention center Tuesday. “We created models of how Medicaid waivers and system designs could be used to re-imagine how Medicaid can support the most vulnerable members of Montana communities,” Ted Madden, the foundation’s CEO, said. (Lagge, 6/18)

When someone’s heart stops beating, there is little time to waste. Half of the people hit by cardiac arrest are outside a hospital, and more than 90% of them die unless they are lucky enough to be near a bystander who can start CPR or call 911. What if the bystander was a smartphone or a digital assistant like Amazon’s Alexa? Researchers from the University of Washington tested that idea, training their digital tool to alert such devices to the gasping sounds  — called agonal breathing — that about half of people make shortly after cardiac arrest. Their proof-of-concept study appears Wednesday in NPJ Digital Medicine. (Cai, 6/19)

Artificial intelligence is often hailed as a great catalyst of medical innovation, a way to find cures to diseases that have confounded doctors and make health care more efficient, personalized, and accessible. But what if it turns out to be poison? Jonathan Zittrain, a Harvard Law School professor, posed that question during a conference in Boston Tuesday that examined the use of AI to accelerate the delivery of precision medicine to the masses. ...In health care, Zittrain said, AI is particularly problematic because of how easily it can be duped into reaching false conclusions. As an example, he showed an image of a cat that a Google algorithm had correctly categorized as a tabby cat. On the next slide was a nearly identical picture of the cat, with only a few pixels changed, and Google was 100 percent positive that the image on the screen was guacamole. (Ross, 6/19)

Long-term use of prescription opioids for chronic pain is more common among people who are overweight or obese, a new study finds. As a group, these individuals are more likely to use prescription opioids for pain in the back, joints, muscles and nerves, researchers write in the journal Pain. Andrew Stokes of the Boston University School of Public Health and colleagues analyzed data for more than 25,000 participants in the National Health and Nutrition Examination Surveys, ages 35 to 79, to understand the relationship between obesity and prescription opioid use. (Crist, 6/18)

A former Oklahoma State Supreme Court justice will attempt to resolve a dispute over how to disburse an $85 million settlement of a state lawsuit with Teva Pharmaceuticals. Cleveland Count District Judge Thad Balkman said Monday that retired Judge Steven Taylor will serve as special master to help find a way to handle the funds arising from a lawsuit that accused drug companies of contributing to the opioid epidemic. (6/18)

The New Hampshire Department of Corrections will expand its use of medicine in the state’s prisons to assist inmates who are trying to overcome opioid and alcohol use disorders. The department announced Monday that its health care team has started the expansion at Northern New Hampshire Correctional Facility in Berlin, which opened an intensive structured treatment unit in 2014. Officials said residents of the Berlin facility were screened on June 6 to determine whether they were eligible for the new program. (6/18)

A San Quentin inmate convicted of murdering a law enforcement officer died in April after overdosing on heroin, the Marin County coroner's office said Monday. It marks at least the third fatal overdose of a California death row inmate over a five-month span. (Goldberg, 6/18)

Since as early as the 1960s, defense lawyers have introduced the idea that people accused of violent crimes against lesbian, gay, bisexual and transgender people had acted in a state of temporary insanity caused and justified by their victim’s sexual orientation or gender identity. The legal strategy, known as the “gay panic” or “transgender panic” defenses, was not always effective, and as attitudes toward L.G.B.T. people shifted, it was used less often. But it has still been deployed in recent years by lawyers hoping to win a jury’s sympathy, lessen a defendant’s charges or shorten a sentence. (Gold, 6/19)

In the tense aftermath of last year’s massacre in Parkland, Fla., prosecutors around the country vowed to go after any student who made threats against schools, hoping to keep their communities from suffering a similar fate. Now, some are moving away from the zero-tolerance approach, saying they want to avoid overcharging students in school threat cases that don’t turn out to be serious. “Obviously, we’re all petrified of the next school shooter. But our mission should be to protect kids, not arrest kids,” said John Jordan, chief juvenile prosecutor for the district attorney of Harris County, Texas, which includes Houston. (Frosch and Hobbs, 6/19)

A cancer patient sued UCLA and Dr. James Heaps on Tuesday, accusing the former campus gynecologist of repeatedly sexual assaulting her during her two years of treatment. The 44-year-old woman was battling mesothelioma when, in October 2015, she went to Heaps for surgery, she said. During four visits that stretch to June 2017, the woman alleges Heaps abused his position of trust to improperly touch her clitoris repeatedly, fondle her breasts and squeeze her nipples — all under the guise of medical examination. (Winton, 6/18)

Iowa Gov. Kim Reynolds asked the director of the state's largest agency to resign because she "wanted to go in a new direction at the Department of Human Services," her spokesman said Tuesday. ...Jerry Foxhoven, the former head of the human services agency, resigned Monday at Reynolds' behest. Democrats used the exit to offer fresh criticism of Iowa's controversial privatized Medicaid system, which is run by national insurance companies but is overseen by the agency. Garrett declined to comment Tuesday on what direction Reynolds wants for the agency. The Republican governor was in North Carolina on Tuesday for a workforce-related event, but she was expected to have public events in Iowa on Wednesday. (Rodriguez, 6/18)

The San Francisco Board of Supervisors on Tuesday unanimously voted to ban the sale of e-cigarettes in city limits if they are not approved by the Food and Drug Administration (FDA). The decision brings San Francisco one step closer to becoming the first U.S. city to ban the sale and distribution of e-cigarettes. A final vote is required before it becomes law. (Daugherty, 6/18)

House and Senate budget writers on Tuesday agreed to meet Gov. Chris Sununu halfway on his proposal for a new forensic psychiatric hospital to serve some of the state’s most challenging mental health patients. In the second day of a three-day budget conference between House and Senate members, both sides agreed to include the Senate proposal for a $17.5 million, 25-bed Secure Psychiatric Unit on the grounds of New Hampshire Hospital, the state’s existing psychiatric hospital in Concord. (Solomon, 6/18)

The Federal Trade Commission on Tuesday heard several experts sound off on their concerns about the newly formed Ballad Health and the regulatory framework that permitted the merger to form the health system. The FTC publicly opposed the 2018 merger to form Ballad. It hosted a workshop in Washington, D.C., to examine the impact of states' certificates of public advantage on healthcare price, quality, access and innovation. One session focused specifically on Ballad, whose 10-year COPA was approved in January 2018 and the merger finalized the following month. (Bannow, 6/18)

Three Twin Cities health systems reached tentative contracts with their nurses after HealthEast agreed Tuesday to allow nurses to close unsafe or understaffed units and Fairview Health and Methodist Hospital in St. Louis Park agreed to pay raises and other benefits. Nurses will vote on the contracts this month, but negotiators with their union, the Minnesota Nurses Association, said they addressed key issues, including protections against workplace violence. (Olson, 6/18)

In a November 2014 email included in the report, a Cooper Health executive acknowledged that the hospital did not intend to leave New Jersey but was “quietly” seeking a lease quote for office space in Philadelphia to satisfy the tax break program’s legal requirements. The email from Cooper vice president Andrew Bush to a realty firm in the Philadelphia area suggested that the hospital had decided to move its administrative offices to Camden but needed a quote on a cheaper space across the river to qualify for the breaks. (Pillets and Solomon, 6/18)

The CEOs of Lifespan and Care New England said they were committed to getting back to the table for a new round of merger talks. Brown University president Christina Paxson said she was looking forward to having more conversations. Even Partners HealthCare, the Massachusetts giant that had been trying to acquire Care New England for the past two years, agreed to step back and give the Rhode Island companies space. (McGowan, 6/19)

Fourteen months into a widespread outbreak of hepatitis A, Mecklenburg County continues to see new cases of the viral infection. North Carolina, and Mecklenburg County in particular, is part of a national trend—since 2017, 22 states have reported hepatitis A outbreaks, according to the Centers for Disease Control and Prevention. ...Across the country, over 19,000 cases have been identified. About 57 percent of those resulted in hospitalizations and 185 people have died from complications associated with the disease, which is often sexually transmitted but can also be linked to improperly handled food if an infected preparer does not wash their hands. (Duong, 6/19)

Investigators have largely cleared a hospital for how it dealt with a Chicago woman accused of cutting a baby from his mother's womb and claiming him as her own, despite questions from the victims' family over why it took the hospital more than two weeks to tell child services that the woman had shown no signs of having just given birth. (6/18)

Sacramento’s UC Davis Children’s Hospital and Shriners Hospital for Children — Northern California ranked among the top 10 medical institutions in the United States for children to get orthopedic care, according to an annual survey released Tuesday by U.S. News & World Report magazine. Shriners and UC Davis ranked at No. 8 on the 2019-2020 list, but they have consistently ranked in the top 50 hospitals on the U.S. (Anderson, 6/18)

A pair of local state lawmakers are calling for legal changes in response to the ongoing issues at the troubled Cuyahoga County Jail, which has been plagued by poor health care, inmate deaths, staffing issues and lax state inspections. Lakewood state Sen. Nickie Antonio and Parma state Rep. Jeff Crossman, both Democrats, said Tuesday they’re working on jail accountability legislation that would complement reforms imposed by Republican Gov. Mike DeWine. (Tobias, 6/18)

About one in 10 households in Massachusetts struggles with food insecurity, or not having consistent access to enough food for a healthy and active lifestyle, leading to $1.9 billion in annual health care costs that could be avoided, the report said. Though Massachusetts has programs that try to address the issue of food insecurity and inaccessibility of fresh foods, the report said access to food as medicine programs remains limited in the state and across the country. (Young, 6/18)

The KIDS COUNT Data Book for 2019, released Monday, measures children on education, economic well-being, health, and family and community. Georgia has come a long way from a ranking of 48th in 1990, the report said. Georgia’s health care rankings in two other recent reports, though, languish in the 40s among states. (Miller, 6/18)

She was among more than 100 people arrested for trespassing at five Portland hospitals and the metro area’s psychiatric emergency department from the summer of 2017 through the summer of 2018, according to a report released Tuesday. In 94 percent of the cases – representing 133 of the 142 times hospitals called police about an “unwanted person,’’ the subject of the call ended up arrested and booked into jail. (Bernstein, 6/18)

An increase in sexually transmitted diseases across the country isn’t as surprising to health professionals as is the insight that rates of STDs are rising more in rural areas than in urban areas. Health officials are working to educate rural residents about the dangers of unprotected sex and to make residents aware that STDs are present in their area. (Carey, 6/19)

Managing chronic pain can be particularly difficult for people in rural areas because of the necessity of frequent doctor visits. Volunteers in rural Wyoming are trying to help. (Mullen, 6/18)

When Andrew Archuleta’s bladder cancer returned two years ago, his doctor prescribed periodic treatments of a powerful immunotherapy designed to stave off another recurrence. But the latest round, scheduled for May, was abruptly canceled because of a severe shortage of the drug. “I keep calling the clinic and saying, ‘Is my treatment still canceled?’ and they say, ‘Yes,’ ” said the 65-year-old Colorado resident. Now he fears the cancer might come back in an even more aggressive form, endangering his bladder — or even his life, if the disease were to spread. With his anxiety and blood pressure rising, he temporarily took Prozac. (McGinley, 6/18)

It can be hard to find common ground in Washington these days, but furor over drug prices could be one exception. Many Americans continue to struggle to pay for the prescription medicines they need. And rising drug costs are a problem for insurers and taxpayers, too — treatments for some rare diseases are topping $2 million. As the presidential election heats up, politicians from both parties are eager to show they are doing something about a hot populist issue, and bipartisan solutions are beginning to take shape. (Thomas, 6/16)

As their minivan rolled north, they felt their nerves kick in — but they kept on driving. At the wheel: Lija Greenseid, a rule-abiding Minnesota mom steering her Mazda5 on a cross-border drug run. Her daughter, who is 13, has Type 1 diabetes and needs insulin. In the United States, it can cost hundreds of dollars per vial. In Canada, you can buy it without a prescription for a tenth of that price. (Rauhala, 6/16)

The United States has some of the highest prescription drug prices in the world, and this summer, Democratic House leadership will unveil a plan to fix that — though questions remain about just how effective this measure will be. Reducing prescription drug prices was a key plank of House Democrats’ platform during the 2018 midterms. More than six months into their term, however, a concrete bill has yet to emerge from House leadership on the subject, and early excerpts Speaker Nancy Pelosi has floated have spurred progressive concern. (Zhou, 6/17)

There’s a fight brewing over legislation meant to rein in the over-patenting of drugs. Drug makers are trying to gut a bill from Sens. John Cornyn (R-Texas) and Richard Blumenthal (D-Conn.) that would open up drug makers to Federal Trade Commission lawsuits when they’re suspected of product hopping (where drug makers introduce a new, slightly tweaked version of a drug to thwart competition) and patent thicketing (where drug makers file dozens or even hundreds of patents on a single drug to keep competitors off the market well beyond the exclusivity period awarded by the FDA). (Florko, 6/18)

A group of Democratic senators this week introduced the Affordable Medications Act, legislation that aims to cut prescription drug prices. Rising costs are a big issue for patients like Maryanne Perry, who depends on a prescription inhaler for her chronic lung disease (COPD). "Climbing a flight of stairs, by the time you get up you're literally huffing and puffing and gasping for air," Perry said. (Lapook, 6/14)

In the latest indication of how some people are struggling to afford their medicines, a new survey finds that 18% of people who have diabetes around the world rationed their insulin at least once last year, but this occurred among nearly 26% of people with diabetes in the U.S. And while 70% reported having some coverage for their costs, two-thirds noted they have no financial support for the remaining out-of-pocket costs. In the U.S., 89% of people with diabetes had health care coverage, but 79% had no other form of assistance. Just 5.5% received government assistance, according to the survey by T1 International, a patient advocacy group that focuses on Type 1 diabetes. (Silverman, 6/19)

Bluebird Bio (BLUE) won’t be selling the world’s most expensive drug. The second priciest? Yup. Zynteglo, the one-and-done gene therapy for beta thalassemia newly approved in Europe, will carry a price tag of $1.8 million, Bluebird announced Friday. Only Zolgensma, the Novartis gene therapy for spinal muscular atrophy, is priced higher, at $2.1 million. The companies offering gene replacement treatments for rare diseases have all faced criticism about the ultra-premium pricing. All have justified the high cost of their therapies, claiming that these potentially curative medicines save patients, insurers, and the overall healthcare system money by reducing overall cost of medical expenses over time. (Feuerstein, 6/14)

In Florida, Gov. Ron DeSantis signed a bill last week that, if federal authorities give it their go-ahead — still a very big if — would allow his state to import prescription drugs from Canada. That makes Florida the third state to pass such a law, joining Vermont and Colorado. More such legislative attempts are in the works. "There have been 27 different bills proposed across the country this year," says Trish Riley, the executive director of the National Academy for State Health Policy. "I think that it's an approach that makes sense to states. It's something they can do now to help their citizens." (Simmons-Duffin, 6/18)

Missouri prison authorities have offered an effective cure for chronic hepatitis C to only 15 of the 4,590 inmates who have been diagnosed with the viral infection. That’s according to the ACLU of Missouri, which sought an emergency court order Monday to force the Missouri Department of Corrections and its medical provider, Corizon LLC, to begin testing and treating inmates with the condition. (Margolies, 6/18)

Retired city workers sued in federal court Monday to stop Cincinnati from ending insurance coverage for their Viagra prescriptions. The move comes less than two weeks after City Manager Patrick Duhaney notified City Council that he planned to eliminate coverage of erectile dysfunction medication in hopes of saving about $425,000 a year. (Horn, 6/17)

Gilead Sciences, the maker of the PrEP pill Truvada, has raised the price by 45% since the drug received FDA approval for preventing HIV infection six years ago, according to an article in the online journal Healthline. Currently, a month’s supply costs between $1,600 and $2,000 without insurance. Facing mounting criticism, in May, Gilead agreed to donate Truvada to up to 200,000 uninsured people a year until 2025., according to a CNBC story. (Washington, 6/14)

[Lauren Kilgore] Her husband had always used a $12,000 copay card from the drug manufacturer to pay for his medication. The insurance company would apply the payment to their $6,500 deductible, helping them meet their out-of-pocket obligation for the year. But this time, the pharmacy said the payment could not be used toward their deductible. They would have to pay their entire deductible before the pharmacy would fill the medication again. (Ochoa, 6/13)

A pair of lawmakers has asked the Government Accountability Office to review how the U.S. Department of Health and Human Services manages patents and licenses for medicines that were discovered, at least in part, with taxpayer dollars. The move by Sen. Debbie Stabenow (D-Mich.) and Rep. Elijah Cummings (D-Md.) follows a ruckus over a pricey Gilead Sciences (GILD) pill for treating and preventing HIV and the role federal government may have played in discovering the medicine, which is called Truvada. (Silverman, 6/18)

Merck is searching for small and midsize deals, including more transactions aimed at expanding its portfolio of cancer treatments beyond the company’s top-selling product Keytruda, according to people familiar with the matter. Merck has been buying cancer drugmakers with promising therapies and technologies. This month, Merck bought Tilos Therapeutics Inc. for $773 million. In May, it agreed to acquire Peloton Therapeutics Inc. for $1.1 billion. (Hopkins, 6/19)

Pfizer said Monday morning that it will spend $11.4 billion in cash to purchase Array BioPharma, a Boulder, Colo.-based biotech known not only for developing its own medicines but as being a top choice among biotechnology firms that need to synthesize new drugs. Pfizer said it will keep Array open as a new research site for the company.The deal values Array at $48 in cash per share. Array shares rose 60% to $47.40 in pre-market trading; Pfizer shares dipped 0.1% to $47.20. (Herper, 6/17)

A fact of life for health-care companies, as well as patients: Good health care costs money. Pfizer is paying more than $10 billion in cash to acquire Array BioPharma , ARRY 56.94% a biotech focused on developing cancer treatments. That is more than a 60% premium to last Friday’s closing price. And since Array generated just $35 million in product sales in its most recent quarter, Pfizer said Monday it doesn’t expect the deal to add to earnings until 2022. S&P Global Ratings said Monday it expects to lower Pfizer’s credit rating to AA- when the deal closes later this year. (Charley Grant, 6/17)

Doing things one at a time in drug development is not a luxury that GlaxoSmithKline can afford any longer, the head of pharmaceuticals at Britain's largest drugmaker told Reuters. Luke Miels, who joined GSK in September 2017 after a contract dispute with his former employer AstraZeneca, said picking the most promising projects and developing them quickly now takes precedence over spreading the risk of failure. (6/17)

Americans like to be known for our can-do spirit. We view ourselves as optimists who can figure out a way around any obstacle. So let’s hear it for a group of problem solvers who figured out how to take those tropes, and use them to demonstrate the horror of the financial succubus that passes for our nation’s health-care system. The Post’s Emily Rauhala reported this weekend on Lija Greenseid, the mother of a 13-year-old daughter with Type 1 diabetes. Greenseid organized a caravan of people to drive to Canada to purchase insulin for themselves or their loved ones. The people on the trip say they are all but forced to take this action by the surging and unpredictable price of insulin in the United States. (Helaine Olen, 6/18)

Healthy competition from generic drugs is often held up as a “cure” for high drug prices — a shared concern across rich and developing countries alike. For many low- and middle-income countries, however, a new report from the Center for Global Development that we co-authored shows that global markets for generic medicines are failing, leaving the poorest patients without safe and affordable essential medicines. (Rachel Silverman and Amanda Glassman, 6/17)

If we truly want to lower prescription drug prices for all Americans, the number one solution is allowing Medicare to negotiate directly with Big Pharma. While it’s true that there are several commendable proposals to address the problem — including greater transparency, regulating Pharmacy Benefit Managers, promoting more generic competition, and importing drugs from Canada – Medicare must be empowered to engage in price negotiations with drug-makers. It’s an idea President Trump supported during the 2016 campaign, but has yet to embrace in office. (Max Richtman, 6/14)

Eight in 10 Americans believe prescription drug costs are too high, according to a Kaiser Family Foundation poll. Given this widespread frustration, it's easy to see why the Trump administration has made reducing the cost of medicines a top priority. HHS officials claim to have a solution — changing which parts of the Medicare program pay for certain drugs. It’s a change for the worse. (Peter Pitts, 6/18)

As politicians and policymakers debate effective ways to rein in rising health care costs, biosimilars represent an obvious solution for saving billions of dollars a year. These products offer the same safety and effectiveness as the reference biologics they are designed to match. So why aren’t they being embraced by patients, physicians, and payers? Blame that in part on misinformation about these products — some of it coming from the pharmaceutical industry — and the lack of market preparation to support the uptake of biosimilars in the U.S. (Hillel P. Cohen and Dorothy McCabe, 6/19)

Biohaven Pharmaceutical Holding Co. has rapidly transformed from one of biotech’s darlings into a cautionary tale of overheated M&A hype. Shares of the developer of migraine treatments surged in April after Bloomberg News reported that the company was considering a sale;  the stock then took another leg up earlier this month when Biohaven canceled plans to attend a Goldman Sachs health-care conference, fueling speculation a takeover was imminent. All those gains evaporated this week when the company instead announced that it was selling more shares, something that wouldn’t happen if a deal was in sight. (Max Nisen, 6/18)

The deaths of 64 people and sickening of nearly 800 due to criminal negligence by employees of the New England Compounding Center in 2012 marked a profound failure of state and federal regulatory enforcement.That horrific episode led to Congress including in the Drug Quality and Security Act of 2013 provisions to create a more robust regulatory framework for compounding pharmacies — both small, local compounding pharmacies and larger distributors. The legislation instructed the FDA to create regulations within parameters set by Congress that would assure patient safety while permitting local compounders to continue to meet patient needs by providing customized compounded medications using FDA-approved substances. (Scott Bruner, 6/19)

Seniors in the United States are facing a drug affordability crisis. While overall spending on medicines remains relatively flat, patient costs continue to rise. Last month, IQVIA published a new report that noted nearly 20 percent of Medicare patients pay more than $500 out-of-pocket per year for prescription drugs, compared to only 8 percent of patients in commercial plans. (Justin McCarthy, 6/16)

In an effort to lower prescription drug costs, California lawmakers have sought ways to ease the high cost for patients suffering from life-threatening and chronic conditions, including cancer and many others. Recent legislation in California has helped increase transparency around prices, but more action is needed. The U.S. Department of Health and Human Services recently proposed an action that deserves support. Prescription drug rebates, intended by drug manufacturers for consumers, but most commonly swept up by middlemen, are rightfully under the microscope. (Ray Adler, 6/15)

Pfizer Inc. is demonstrating once again how expensive it is for pharma firms to buy their way to growth. The company announced Monday morning that it’s paying almost $11 billion for cancer drugmaker Array Biopharma Inc. The deal would bolster Pfizer’s cancer portfolio and add medicines that could meaningfully augment sales and profit. But the company isn’t getting much of a bargain, and its recent track record with a similar deal is a cautionary tale for investors. (Max Nisen, 6/17)

A fact of life for health-care companies, as well as patients: Good health care costs money. Pfizer is paying more than $10 billion in cash to acquire Array BioPharma , ARRY 56.94% a biotech focused on developing cancer treatments. That is more than a 60% premium to last Friday’s closing price. And since Array generated just $35 million in product sales in its most recent quarter, Pfizer said Monday it doesn’t expect the deal to add to earnings until 2022. S&P Global Ratings said Monday it expects to lower Pfizer’s credit rating to AA- when the deal closes later this year. (Charley Grant, 6/17)

Donald Trump has just declared that he’ll unveil a health care proposal in the near future, and let’s hope he does, for that would be a highly instructive enterprise. ...Here’s where an understanding of public policy possibilities comes in handy. Possessed of that, one can say with near certainty that nothing Trump proposes will: (1) keep comparable levels of the population insured while (2) making health care coverage much better and (3) much cheaper. (Lehigh, 6/18)

Several of the Democratic presidential candidates, including Sens. Bernie Sanders (I-Vt.), Kamala D. Harris (D-Calif.) and Elizabeth Warren (D-Mass.), have supported Medicare-for-all, which essentially would abolish private health insurance, including employer-provided health-care coverage. They might want think twice about such a plan’s popularity — once voters figure out what it is. The Kaiser Family Foundation’s latest poll finds that voters really don’t understand how their coverage would change. “For example, majorities say people would continue to pay deductibles and co-pays (69 percent) and continue to pay premiums (54 percent) under a Medicare-for-all plan. (Jennifer Rubin, 6/18)

Drug trafficking is one of the biggest and deadliest threats facing the United States. The federal government has a responsibility to help states combat this epidemic — and that means stopping the spread of this drug at the source, something states alone cannot easily do because the source is often not in America but rather in countries like China. (Sens. Chuck Schumer and Tom Cotton, 6/18)

Recent news that random bad luck plays a big role in cancer has been misinterpreted as bad news, when it's actually very useful in helping humanity understand what cancer is and what can be done to prevent it. New experiments attempt to quantify findings from 2015 and 2017 that showed random “bad luck” was a major factor in the development of cancer – along with inherited genetic predispositions and environmental carcinogens. An independent team this month showed that normal tissue is roiling with clusters of mutated cells, some of which have genetic errors common in cancer. This fits well with the current understanding that cancer starts when cells acquire a combination of genetic mutations that allows them to grow out of control. (Faye Flam, 6/18)

The House Ways and Means Committee recently held a hearing about universal coverage, examining incremental and more sweeping Medicare for All style strategies for getting to universal coverage. That means one way or another everyone would be covered, right? (Drew Altman, 6/19)

American children as young as second graders are reportedly vaping. This is a horrifying sign that an intervention needs to end what appears to be a juvenile obsession with electronic cigarettes, or e-cigarettes.  State Rep. Marjorie Decker (D-Mass.) is apparently determined to fight against the rapid rise in youth e-cigarette use, proposing a bill recently for a 75 percent excise tax on the wholesale price of vaping products and e-cigarettes. House Democrats recently began investigating e-cigarette leader Juul Labs and its marketing strategies to children to young adults. (Mary Heitschmidt, 6/18)

Everyone who cares about abortion has reason to be genuinely alarmed right now. Pro-choice Democrats are watching Republicans put new abortion restrictions into place in a variety of red states, including a new Alabama law that bans almost all abortions, even in the cases of rape and incest. And pro-life Republicans are watching Democrats in blue states like Illinois, Vermont and Nevada pass laws that expand access to abortion rather than playing defense. Former vice president Joe Biden, the polling leader in the Democratic primary, recently dropped his long-standing support for the Hyde Amendment, a provision that keeps federal funds from being spent on to abortion. (David Byler, 6/18)

The new abortion ban in Missouri and the licensing restrictions with Planned Parenthood are serious and devastating to women’s health, and they are detrimental to the well-being of young people. (Katie Plax , 6/13)