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Medicare administrators served doctors and hospitals a pair of big payment cuts late Thursday. Doctors will see a 3.4% decrease to a key factor determining their base Medicare pay next year, officials announced in a final rule. That’s virtually unchanged from what administrators proposed this summer. (Goldman, 11/3)

Physicians will be hit with a 1.25% reduction in Medicare reimbursements next year under a final rule the Centers for Medicare and Medicaid Services issued Thursday. The American Medical Association and other doctor groups sharply criticized the proposed rule CMS published in July, which contained the same pay cut, and have taken their case to Congress that Medicare fees for physicians should not be reduced. (Bennett, 11/2)

Medicare officials are moving forward with a plan to claw back money from certain hospitals to try to remedy overpayments struck down by the Supreme Court, they announced Thursday. A federal court ordered the Department of Health and Human Services to compensate hospitals that receive discounted drugs through the 340B program for billions of dollars of underpayments, but the money had already gone out to hospitals that didn’t participate in the program. (Cohrs, 11/2)

Providers participating in the 340B drug discount program will receive approximately $9 billion to compensate them for reductions in previous years under a final rule the Health and Human Services Department and the Centers for Medicare and Medicaid Services published Thursday. ... About 1,700 hospitals are due to receive funds by Jan. 1. But because federal law requires this spending to be budget-neutral, CMS offset the cost by reducing reimbursements for other outpatient products and services by $7.8 billion. (Kacik and Bennett, 11/2)

�鶹Ů�� Health News: Medicare Expands The Roster Of Available Mental Health Professionals 

Lynn Cooper was going through an awful time. After losing her job in 2019, she became deeply depressed. Then the covid-19 pandemic hit, and her anxiety went through the roof. Then her cherished therapist — a marriage and family counselor — told Cooper she couldn’t see her once Cooper turned 65 and joined Medicare. “I was stunned,” said Cooper, who lives in Pittsburgh and depends on counseling to maintain her psychological balance. “I’ve always had the best health insurance a person could have. Then I turned 65 and went on Medicare, and suddenly I had trouble getting mental health services.” (Graham, 11/3)

�鶹Ů�� Health News: Biden Pick To Lead Social Security Pledges Action On ‘Heartbreaking’ Clawbacks

President Joe Biden’s nominee to head the Social Security Administration on Thursday promised senators that he would address hardships the agency has caused by trying to recoup billions of dollars it mistakenly overpays beneficiaries each year. At his confirmation hearing on Thursday, Democratic former Maryland Gov. Martin O’Malley said he would “absolutely prioritize” reducing overpayments and improving the appeals process for millions of people asked to repay money, often years later. (Hilzenrath and Fleischer, 11/3)

Fewer high school students are vaping this year, the government reported Thursday. In a survey, 10% of high school students said they had used electronic cigarettes in the previous month, down from 14% last year. Use of any tobacco product — including cigarettes and cigars — also fell among high schoolers, according to the Centers for Disease Control and Prevention report. (Stobbe and Perrone, 11/2)

Although the number of high schoolers who are currently using tobacco decreased, the rate of middle schoolers who used at least one tobacco product increased from 4.5% to 6.6% in the past year. (Chernikoff, 11/2)

One thing is clear about underage e-cigarette use: Adolescents like flavors. About 90 percent of the students who reported vaping said they used flavored products, citing favorites that tasted like fruit and candy. Teenagers identified Elf Bar and Esco Bar as their favorite brands, well-known for flavors like strawberry kiwi and watermelon ice. Public health advocates in California recognized the allure, leading to a yearslong fight to pass a ban on flavored tobacco products, which took effect in December. It quickly led to falling sales, according to data from the C.D.C. Foundation. (Jewett, 11/2)

Only half of people eligible for the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) receive benefits from it, a new United States Department of Agriculture (USDA) report has found. The report, released Friday, said that despite 12.1 million Americans being eligible for the program in 2021, only 6.2 million received benefits, or 51 percent. (Suter, 11/3)

Republican Speaker Mike Johnson, more so than previous Speaker Kevin McCarthy, is a proponent of more hard-line GOP efforts to overhaul the Supplemental Nutrition Assistance Program, the country’s largest anti-hunger program that serves 41 million low-income Americans. As a senior member of the conservative-leaning Republican Study Committee, Johnson backed proposals to roll back food aid expansions under Biden and block states from exempting some work requirements for SNAP, formerly known as food stamps. In 2018, Johnson referred to SNAP as “our nation’s most broken and bloated welfare program.” (Hill, 11/2)

Treasure Dowell has called Missouri’s social services department three times a day for nearly a month and has yet to speak to a human being. Sometimes she is automatically disconnected hours before the call center closes because it has reached capacity for the day. Other times she waits hours, her phone on speaker atop the kitchen counter, playing the hold music and occasional queue updates, while she watches her kids, only for the line to disconnect. ... An in-person or phone interview is required to enroll or be re-certified in the Supplemental Nutrition Assistance Program. (Bates, 11/3)

The US Food and Drug Administration has proposed revoking its regulation authorizing the nationwide use of brominated vegetable oil, or BVO, as an additive in food. The FDA’s decision comes after California banned the ingredient in October by passing the California Food Safety Act, the first state law in the United States to ban brominated vegetable oil. The additive is already banned in Europe and Japan. (Rogers, 11/2)

A federal appeals court on Thursday is tossing the Environmental Protection Agency’s (EPA) ban on a pesticide that has been linked to brain damage in children. The decision from the 8th Circuit Court of Appeals to send the rule back to the agency does not preclude the agency from reinstating the ban in the future. But it said the EPA needs to give greater consideration to whether there are cases where the pesticide, called chlorpyrifos, could be used safely. Chlorpyrifos has been used as an insecticide, protecting crops like soybeans, broccoli, cauliflower and fruit trees. (Frazin, 11/2)

Cambridge-based Biobot Analytics conducts sewage tests in hundreds of communities nationwide to track the spread of COVID and other diseases. But the company found itself out in the cold in September after the US Centers for Disease Control and Prevention gave its waste-water testing contract to Verily Life Sciences, a medical data subsidiary of tech giant Alphabet, the parent company of Google. (Bray, 11/2)

The COVID-19 pandemic caused Americans collective trauma, which predisposes to mental illness and chronic illnesses, according to a new online survey from the American Psychological Association (APA).The Harris Poll surveyed 3,185 US adults nationwide for the Stress in America 2023 report from August 4 to 26. (Van Beusekom, 11/2)

A few lines in a Senate appropriations proposal could force U.S. officials to confront a deadly threat they ignored for years: Counterfeit, fentanyl-laced painkillers sold at pharmacies in Mexico. If approved, Secretary of State Antony J. Blinken would have 90 days to draft a report that would — for the first time — reveal key details about overdoses caused by fake pills sold in Mexican drug stores. (Sheets and Blakinger, 11/2)

Gov. Glenn Youngkin (R) issued an executive order requiring school districts to notify parents of any drug overdoses in the school system within 24 hours after the Loudoun County Sheriff’s Office announced that nine students at one school overdosed. The sheriff’s office said that nine students at Park View High School overdosed in October and early November. All of the overdoses were nonfatal and appeared to involve fentanyl. (Elwood and Jouvenal, 11/2)

On a mid-September night two years ago, three friends from Johnson County sat in front of their school laptops and connected through an online video chat program. From each of their homes, they took the drug they had purchased for 30 bucks a pill. Soon, one of them, a gregarious red-headed senior at Shawnee Mission East High School, began to rock back and forth. Her friends sensed she wasn’t feeling well. (Bauer and Thomas, 11/2)

A new report shows that death rates for people under 40 are surging across the United States, including parts of the Mountain West. In New Mexico, there were about 188 deaths per 100,000 people in that age group in 2022 – the highest rate in the nation, according to Stateline. The nonprofit news service analyzed data from the Centers for Disease Control and Prevention. (Roedel, 11/2)

The five Massachusetts opioid treatment clinics where Ruth Potee works bend over backward to make methadone treatment easy and accessible for the people they serve. But Potee worries it isn’t enough. The clinics have doctors on hand 12 hours a day to start new patients on methadone, which is considered the gold standard for opioid use disorder treatment. (Hellmann, 11/2)

State officials are planning to distribute 50,000 prescription drug deactivation pouches as part of a $1.2 million federal campaign against drug misuse. The goal is to give people a convenient way to dispose of unused or expired opioids, or other prescription drugs, so they’re not misused and do not pollute the environment. (Dwyer, 11/2)

The babies are born with small heads, underdeveloped jawbones, conjoined toes and rounded, “rocker-bottom” feet. Physicians at Nemours Children’s Health say they all have one thing in common: They were exposed in utero to significant amounts of fentanyl, a dangerous synthetic opioid. In a new study, the authors say they’ve identified 10 such babies so far, describing their constellation of symptoms as a “novel syndrome associated with prenatal fentanyl exposure.” (Avril and Whelan, 11/2)

Substance use disorder afflicts many Americans — in 2021, 46.3 million people in the United States age 12 or older were addicted to alcohol or drugs such as opioids and stimulants. Now scientists are studying a promising and surprisingly familiar therapy that can help reset the brain and stem the cravings of addiction. The treatment is low-intensity focused ultrasound or LIFU, a noninvasive brain stimulation therapy. Researchers at the University of Virginia are running the first pilot study to evaluate the effectiveness of ultrasound to treat cocaine use disorder. Nearby at the West Virginia University School of Medicine, ultrasound is being studied to primarily treat opioid use disorder, but also addiction to a number of substances including patient cravings for a number of substances, including alcohol, cannabis, methamphetamine and cocaine. (Jones, 11/2)

It took 15 entries into rehab before the late actor Matthew Perry found long-term sobriety, he wrote in his memoir, “Friends, Lovers and the Big Terrible Thing.” And after his death, loved ones and fans alike are honoring his commitment to recovery. (Holcombe, 11/2)

A divided Indiana Supreme Court on Thursday publicly reprimanded Republican Attorney General Todd Rokita for statements he made about a doctor in the state who performed an abortion on a 10-year-old rape victim from Ohio. The court found that Rokita violated professional conduct rules for lawyers when he described Dr. Caitlin Bernard in a July 2022 Fox News interview as an "abortion activist acting as a doctor" who had failed to report past child abuse cases. (Thomas, 11/2)

In his own statement to The Post, Rokita on Thursday doubled down on his criticism of Bernard, challenging “any objective Hoosier to conclude that she isn’t an ‘abortion activist,’ as I stated.” He referred to his comments on Fox News as “truthful,” adding that he could have fought over his “16-word answer” but opted to “save a lot of taxpayer money and distraction.” “In order to resolve this, I was required to sign an affidavit without any modifications,” Rokita said. (Paul, 11/3)

Sen. Tommy Tuberville’s spokesperson asked anti-abortion groups to "make clear" GOP senators risk primary challenges if they support an effort to overcome his military holds over a Pentagon abortion policy, according to an email obtained by POLITICO. The email, written by Tuberville’s communications director Steven Stafford from his Senate email address, made clear that the Alabama Republican’s staff is worried that at least nine Republicans might join with Democrats to pass a resolution that would allow the Senate to bypass Tuberville's holds. It was sent on Oct. 26, after news broke that senators were going to release a resolution that would allow the Senate to more easily stop Tuberville’s holds on more than 300 nominees up for military promotions. (Everett, 11/2)

On Tuesday, Ohioans will vote on whether to amend the state constitution to enshrine the right to abortion. But powerful anti-abortion forces are arguing that the amendment will go beyond guaranteeing access to the procedure to imperil parents’ rights when it comes to abortion and even gender-affirming care. Experts and abortion rights supporters say these claims are spreading misinformation about the proposed amendment. (Sherman, 11/3)

Election Day is nearly here, and while off-year political races receive a fraction of the attention compared with presidential elections, some of Tuesday’s contests will be intensely watched. At stake are two southern governorships, control of the Virginia General Assembly and abortion access in Ohio. National Democrats and Republicans, seeking to build momentum moving toward next November, will be eyeing those results for signals about 2024. (Vigdor, 11/1)

To lower costs and improve billing for patients who need ground ambulance services, federal lawmakers should ban surprise bills, limit patient cost-sharing and make bills easier to understand, according to a committee formed by Congress to explore how to tackle these issues. ... The public is invited to comment on what Congress should do to address ground ambulance billing through Nov. 15. The committee will deliver a report with all recommendations, distinguishing those that received a majority vote of support, to Congress in early 2024. (Santhanam, 11/2)

A new Minnesota law requires hospitals to check if patients are eligible for financial assistance before referring medical debt for collections. It's a move that supporters of the change say will ensure people know what help is available and may relieve them of the burden of steep healthcare costs. The provisions took effect Wednesday. (Cummings, 11/2)

�鶹Ů�� Health News: Medical Debt Is Disappearing From Americans’ Credit Reports, Lifting Scores 

The share of American consumers with medical debt on their credit reports has declined dramatically over the past year as major credit rating agencies removed small unpaid bills and debts that were less than a year old, according to a new analysis from the nonprofit Urban Institute. At the same time, millions of Americans have seen their credit scores improve, making it easier for many to get a job, rent an apartment, or get a car. (Levey, 11/2)

�鶹Ů�� Health News: �鶹Ů�� Health News' 'What the Health?': For ACA Plans, It’s Time To Shop Around

In most states, open enrollment for plans on the Affordable Care Act exchange — also known as Obamacare — began Nov. 1 and lasts until Dec. 15, though some states go longer. With premiums expected to increase by a median of 6%, consumers who get their health coverage through the federal or state ACA marketplaces are encouraged to shop around. Because of enhanced subsidies and cost-sharing assistance, they might save money by switching plans. Meanwhile, Ohio is yet again an election-year battleground state. A ballot issue that would provide constitutional protection to reproductive health decisions has become a flashpoint for misinformation and message testing. (11/2)

MacKenzie Scott’s Yield Giving charity has awarded $5 million to the Siouxland Community Health Center in Sioux City. Scott, the ex-wife of Amazon’s Jeff Bezos, pledged in 2019 to give more than half of her billions to charity following her divorce. (Brummer, 11/2)

Liberty Hospital, a public hospital serving the northern suburbs of Kansas City, Missouri, has remained independent since opening nearly 50 years ago. That time may be about to end. The hospital, a 200-bed facility with 1,900 employees and managed by the county, is close to signing a non-binding letter of intent to affiliate with Kansas City, Kansas-based University of Kansas Health System. (Kacik, 11/2)

BJC HealthCare has reached a much-anticipated agreement for a new Affordable Care Act insurance plan under Aetna, beginning Jan. 1. The deal will come as a relief to BJC patients who are signing up for ACA plans as the federal open enrollment period kicks off this week. The previous carrier of individual marketplace plans covering BJC — Cigna, which offered them under the brand "Cigna Connect" — is exiting Missouri's ACA marketplace in 2024. (Merrilees, 11/2)

UCHealth's merger with Parkview Health System will close Dec. 1, the nonprofit providers announced Thursday. The deal was originally expected to close in mid-2023 but got delayed by what the health systems described as "regulatory matters." UCHealth of Aurora, Colorado, and Pueblo, Colorado-based Parkview Health System signed a letter of intent to merge in October 2022 and came to agreement on the transaction in January. (Hudson, 11/2)

HCA Midwest Health extended its partnership with Kansas City University, becoming the latest health system to try to bolster the workforce pipeline through higher-education affiliations. The seven-hospital division of for-profit hospital chain HCA Healthcare extended its physician training partnership Wednesday with the largest medical school in Missouri. It builds on an existing partnership between the two organizations that has been in place for many years, a spokesperson from the university said. (Kacik, 11/2)

Novo Nordisk and Eli Lilly reported booming sales Thursday from the new generation of diabetes and weight-loss drugs they’ve pioneered, as both drugmakers continue to scramble to keep up with demand. Denmark-based Novo reported $8.4 billion in revenue in the past three months — a 29 percent increase from a year ago — with its blockbuster drugs Ozempic and Wegovy accounting for more than half of sales. Lilly, based in Indianapolis, posted revenue of $9.5 billion for the latest quarter, a 37 percent increase, boosted by fast-growing sales of Mounjaro. (Gilbert, 11/2)

Novo Nordisk and Eli Lilly both expect juggernaut sales for their diabetes and weight-loss drugs to extend into coming years - limited only by their availability. The two companies have been the primary beneficiaries of the global boom in obesity drugs, ballooning their market values and reshaping expectations not just in the healthcare industry, but also for sellers of sugary snacks, nutritional aids and packaged foods. (Fick and Satija, 11/2)

The majority of U.S. patients with health insurance coverage taking Novo Nordisk's powerful weight-loss drug Wegovy are paying less than $25 per month, a senior executive said on Thursday. Doug Langa, Novo's vice president for North America, said most major pharmacy benefit managers (PBMs) and health plans were covering the hugely popular weekly injection. (11/2)

An important Phase 3 trial has shown that a new drug that targets gonorrhea works as well as the last existing antibiotic to treat the sexually transmitted infection, results that could lead to licensure of the first new treatment for gonorrhea in decades. (Branswell, 11/1)

Treating some pneumonia patients with the antibiotic doxycycline instead of the more commonly prescribed azithromycin can reduce the risk of Clostridioides difficile infection by up to 45%, according to a study yesterday in the American Journal of Infection Control. Using broad spectrum antibiotics to treat pneumonia is standard practice in US hospitals, but it raises the risk of patients acquiring C diff infections (CDI), which cause roughly 30,000 US deaths each year. (Soucheray, 11/2)

A revolutionary manner of precisely delivering radiation therapy to cancer patients while minimizing collateral damage is being rolled out by scientists at Sandia National Laboratories in Livermore. The scientists have created a patch that can stop damage to healthy tissue by detecting any misplaced radiation from body movement and halting the dosage being delivered to the patient. (Castaneda, 11/2)

Hormone replacement therapy may protect the female brain from Alzheimer’s disease and dementia — if hormones are taken in the 40s and 50s when menopausal symptoms begin, according to a recent meta-analysis. The degree of protection appears to differ by hormone type, the report found. (LaMotte, 11/2)

To hear Sarepta CEO Doug Ingram tell it, the results Monday afternoon from a large trial of its gene therapy for Duchenne muscular dystrophy marked a clear medical breakthrough. “A massive win,” he told investors, that could lead to its approval for all patients with the fatal muscle-wasting disease regardless of age. And yet the rest of the Duchenne community was more cautious in its enthusiasm. The study — the most rigorous test to date of a technology 30 years in the making — had technically failed, as so many had before it. (Mast and Feuerstein, 11/1)

The idea that cancer can hijack brain plasticity — subverting supple connections in the healthy brain that ordinarily lead to learning and memory formation — is gaining traction. (Cooney, 11/1)

A former Pennsylvania nurse who had been accused of killing two patients with doses of insulin faces more murder charges and has confessed to trying to kill 19 additional people at several locations, the authorities said Thursday. In May, Heather Pressdee, 41, admitted to the authorities that she had intended to kill three patients in her care with insulin doses, resulting in her arrest on two counts of murder and one count of attempted murder. (Mayorquin, 11/3)

If you want to fix the nursing shortage, you've got to fix the workplace, American Nurses Association members told Congress this week. In a broad push to advance key priorities, the organization sent more than two dozen nurses to Capitol Hill Monday and Tuesday to push for violence prevention laws, money for training and greater responsibility for nurses, then followed up Wednesday by formally endorsing legislation to mandate minimum staffing levels at hospitals. (McAuliff, 11/2)

There is a persistent shortage of primary care doctors in the rural United States. Specialists, like OB-GYNs and endocrinologists, are even harder to access. According to the National Rural Health Association, there are only 30 specialists for every 100,000 residents in rural areas, compared to 263 per 100,000 in urban communities. (Empinado, 11/2)

Fairview Health Services will trim its workforce by about 250 jobs by year's end, the nonprofit system said Thursday. Most of the affected roles, which represent less than 1% of the workforce, are part-time and in "select positions throughout the system," Fairview said. Employees will receive job search assistance and be priority candidates for open positions, it said. (Hudson, 11/2)

Beginning a decade ago, staff at Harbor-UCLA Medical Center started to report the same high-ranking doctor, alleging jarring sexual comments and retaliatory behavior that routinely raised alarms inside the renowned teaching hospital. Maria Garibay, then a medical secretary, told human resources in 2013 that her boss, Dr. Louis Kwong, the head of orthopedics, would openly discuss with his staff how the women he operated on under anesthesia “would groom their pubic areas,” according to her written complaint reviewed by The Times. Los Angeles County, which runs the public hospital in West Carson, found the complaint unsubstantiated. (Ellis, 11/3)

More than half the top executives at Arizona's largest nonprofit and public health systems who were leading their organizations during the deadly worldwide COVID-19 pandemic got pay hikes during those tumultuous years. Peter Fine, who has headed Phoenix-based Banner Health since 2000, was the highest paid nonprofit hospital CEO in Arizona in 2021, according to IRS records. Banner Health is the state's largest private employer and one of the country's largest health systems. (Innes, 11/3)

Walgreens Boots Alliance Inc.’s chain of medical clinics is trimming employee bonuses and retirement fund matches amid a broader push to reduce expenses at the drugstore giant. VillageMD, the primary-care provider majority-owned by Walgreens, won’t give bonuses to most employees for this year, although front-line clinic staff who see patients will receive bonuses “reduced from historical amounts,” according to a memo to staff viewed by Bloomberg. The unit plans to resume bonuses in 2024 as finances improve, VillageMD Chief Executive Officer Tim Barry said in the memo dated Nov. 1. (Tozzi, 11/2)

More than 40% of adults in the United States are unaware they have -- and therefore are not being treated for -- high cholesterol, according to a new study. For the study, published in JAMA Cardiology, researchers from institutions in New York, Texas, Louisiana, Pakistan and Egypt looked at data from the National Health and Nutrition Examination Survey between 1999 and 2020 examining patients at least ages 20 and older with cholesterol levels above 160 mg/dL (milligrams per deciliter). (Kekatos and Jain, 11/3)

Seasonal Affective Disorder is a type of depression linked to chemical changes triggered by lack of daylight and sleep changes. About 6% of Americans are officially diagnosed, with milder cases for about 20% of the population. "They notice how that one hour time change can impact their health," said Dr. Christina Zhang, medical director at MiDoctor Health. "Tired, weakness, lack of energy, poor sleep." (Carlin, 11/2)

Results published last week in the Frontiers journal showed that listening to your favorite tunes can reduce the perception of pain as much as taking an Advil. Now, in a second phase of the study, researchers are studying brain activity to determine which parts of the mind create that relieved perception. (Melnick, 11/2)

The problem isn’t only that we’re practicing less. Technology has changed the way we use our hands. Also, the more time we spend on our devices, the greater the probability of problems with our hands and wrists, such as pain, weakness and nerve changes. “It’s like going to the gym,” said Mellissa Prunty, an occupational therapist at Brunel University London and chair of the National Handwriting Association in the United Kingdom. “When you write for long periods of time but you don’t do it often, you are going to feel tired and fatigued.” (Rich, 11/2)

We "fall back" and switch our clocks to standard time on Sunday, and a number of sleep experts want to stay in that time zone permanently. While lawmakers have pushed to make it daylight saving time all the time, a number of scientists and researchers say standard time is more aligned with our body clocks — and "daylight saving" time is not only a misnomer but harmful. (Mallenbaum, 11/2)

What your parents didn't tell you about pulling an all-nighter? It might just ease depression for several days. At least, that's what researchers found happened to mice in a study published in the journal Neuron Thursday. Most people who've stayed up all night know the "tired and wired" feeling they get the next day. Even after these changes wear off, sleep loss can have a strong antidepressant effect in people that lasts several days. (Barber, Scott, Shapiro, Carlson, and Contreras, 11/3)

Health officials in Contra Costa County sounded a warning Thursday to anyone who has spent time in a Pacheco casino over the past five years that they were exposed to tuberculosis and should be tested. Contra Costa Health Services officials in a statement said that recent genetic testing revealed several related cases since 2018 among staff and customers at the California Grand Casino, located in the 5900 block of Pacheco Boulevard. Of 11 confirmed TB cases, 10 were linked genetically, and the majority were linked with the casino’s staff and customers. (Hurd, 11/2)

For the second time in 2 weeks, California has reported a local dengue case, this time involving a patient from Long Beach, city officials announced yesterday. The patient has recovered at home, and no other illnesses have been detected. The Long Beach health department is carefully monitoring the situation and has alerted health providers to be aware of dengue symptoms. In a statement, Mayor Rex Richardson urged people to remove standing water from their property and to help control mosquitoes in neighborhoods. Officials also urged the public to avoid bites from Aedes mosquitoes. (Schnirring, 11/2)

The Supreme Court of Alabama has authorized state officials to proceed with what would be the first execution of a prisoner in the U.S. using asphyxiation by nitrogen gas. In August, Alabama Attorney General Steve Marshall, a Republican, asked the court to allow the state to proceed with gassing Kenneth Smith, who was convicted of murder in 1996, using a face mask connected to a cylinder of nitrogen intended to deprive him of oxygen. Smith, 58, is one of only two people alive in the U.S. to have survived an execution attempt after Alabama botched his previously scheduled execution by lethal injection in November when multiple attempts to insert an intravenous line into a vein failed. (Allen, 11/2)

There's a set of skills that only decades in the emergency room can teach you. Dr. Joshua Schiller, Director of Social Emergency Medicine at Maimonides Health, will be leading a team of seven emergency physicians to Ukraine on Saturday to share life-saving skills to medical students and professionals in the war-torn country. "One of the things that brought me into medicine was trying to figure out how to connect to the world in a way that makes it better," Schiller says. (Kliger, 11/2)

Using sidewalks as exam rooms and heavy red duffle bags as medical supply closets, volunteer medics spend their Saturdays caring for the growing number of migrants arriving in Chicago without a place to live. Mostly students in training, they go to police stations where migrants are first housed, prescribing antibiotics, distributing prenatal vitamins and assessing for serious health issues. These student doctors, nurses and physician assistants are the front line of health care for asylum-seekers in the nation’s third-largest city, filling a gap in Chicago’s haphazard response. (Tareen, 11/2)

A poll worker in Williamson County had a heart attack Monday while working at an early voting site. County officials initially blamed the medical emergency on a tense interaction with a voter fraud activist and poll watcher, but on Thursday retracted the accusation after the activist threatened legal action. (Contreras, 11/2)

�鶹Ů�� Health News: States Reconsider Religious Exemptions For Vaccinations In Child Care 

More than half the children who attend Munchkin Land Daycare near Billings, Montana, have special needs or compromised immune systems. The kids, who range in age from 4 months to 9 years, have conditions that include fetal alcohol syndrome, cystic fibrosis, and Down syndrome, according to owner Sheryl Hutzenbiler. “These families came to me knowing we could offer them a safe and healthy environment,” Hutzenbiler said. Part of ensuring that healthy environment is having a strong vaccination policy, she said, especially for those who are immunocompromised or too young to receive the full slate of childhood vaccines. (Volz, 11/3)

Robert Card displayed a textbook set of warning signs: He was hearing voices. He told people that he was planning violence. And his behavior had markedly changed in the months leading up to the mass shooting he carried out last week. His family, his superiors in the military and the local police knew all of this. Yet no one stopped him. His killing of 18 people with an assault-style rifle in Lewiston, Maine, points to how shortcomings in the mental health system, weak laws and a reluctance to threaten personal liberties can derail even concerted attempts to thwart violence in a country awash in guns. (Dewan, Bogel-Burroughs and Marcius, 11/2)

Managing diabetes is difficult enough with health insurance. Doing it without insurance can feel impossible. The disease—the nation’s costliest chronic condition and especially prevalent among the poorest Americans—demands daily care and resources to keep it under control. Left untreated, it mushrooms through the body’s blood vessels, damaging organs and limbs and leaving behind a trail of disability and premature death. (Krisberg and Levitan, 11/1)

Hundreds of residents and officials were on hand Thursday to celebrate the opening of Affinia Healthcare’s newest freestanding primary care clinic, a $7.5 million facility that boasts 23 medical exam rooms, services ranging from dental to behavioral health care, a unique midwifery program and a partnership with the adjacent Emerson YMCA. But it was the clinic’s majority-Black medical team — some who grew up in north St. Louis County, dreaming of one day caring for their neighbors — who stole the show. (Munz, 11/2)

Communities ravaged by America’s opioid epidemic are starting to get their share of a $50 billion pie from legal settlements. Most of that money comes with a requirement that it be used to address the overdose crisis and prevent more deaths. But how? It could mean that places look more like the area around Findlay. Here, conservative Hancock County has built a comprehensive system focused on both treatment and recovery by adding housing, a needle exchange, outreach workers and a community center. (Mulvihill and Johnson, 11/3)

Esther Beukema planned her funeral the way she planned her life: with precision and resolve. She had been hoping for death since adolescence, and now that it was coming, she wanted every detail to be perfect. She chose the music — Adele’s “Easy on Me,” “Bring Me to the Water” by Marco Borsato and Matt Simons, a piano score from Yann Tiersen — and visited the crematorium not far from where she grew up in Soest, about an hour southeast of Amsterdam. Instead of a coffin, she wanted to lie in a wicker basket, so she and her parents picked one out. She assembled a “memory box” filled with cards and mementos for her loved ones. Friends wrote notes on paper butterflies, which Esther read. Her mother, Ellen Beukema, later pinned them to the basket. (Ellin, 11/1)

Tracey Silver-Charan didn’t suspect her new uniform was at fault when she began feeling “violently sick” at work in 2016. A flight attendant for 37 years, she had been through several uniform changes by the time American Airlines introduced new workwear for all its employees in September of that year. But soon she notified her supervisors she was suffering persistent health problems on the job. Whenever she came home from a trip, she’d start to feel better. “I was having severe respiratory distress,” Silver-Charan, a 61-year-old based in Los Angeles, told The Washington Post. “I couldn’t even breathe. And my voice would go hoarse. I would feel like I was going to faint. I got some rashes.” (Andrade, 11/2)

Survey after survey tells us that Americans are struggling. The latest, the American Psychological Association’s annual gauge of stress in the US, reveals that people continue to feel worse than before the pandemic. The question is what to do about it. (Lisa Jarvis, 11/2)

Once the domain of aging TV stars, hawking health products from vitamins to diabetes supplies to a geriatric demographic, A-list celebrity endorsements of health care products are positively trendy. (Christopher Morse, 11/2)

Approximately 16.8 veterans die by suicide daily. The U.S. Department of Veterans Affairs (VA) reported 6,146 veteran suicide deaths in 2020—a 57.3 percent higher suicide rate vis-à-vis non-veteran adults. (Saul Ramirez, 11/2)

’Tis the season — open enrollment season, that is. Since before the Nov. 1 start to the annual open enrollment period, the advertising engines for state health insurance marketplaces, and the federal exchange, healthcare.gov, have been revving up. The nation’s uninsurance rate is down to 7.7% — the lowest it has ever been. While the celebrations of this success are merited, more than 25 million Americans are still uninsured. (Wendy Netter Epstein and Christopher T. Robertson, 11/3)

I was living on the precipice of end-stage disease when I enrolled in the clinical trial that resulted in the historically fast Food and Drug Administration approval for the game-changing cystic fibrosis drug Trikafta. Five years later, the worst parts of my CF are gone. (Gunnar Esiason, 11/3)

Lately, we’ve seen two distinct lines at our hospitals. We would all be healthier if we brought the two lines together. The first line forms every morning before the building opens. Mothers, children, and the disabled clutch passels of documents along the sidewalk. They wait to reauthorize their Medicaid insurance. The second line formed about a decade ago and takes place virtually. Future pediatricians, psychiatrists, and plastic surgeons log on for 30-minute calls seeking entry into residency. They are applying to begin their graduate medical training at our hospitals. (Abraham Nussbaum and Renee Y. Hsia, 11/2)