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Alex M. Azar II, the secretary of health and human services, denied on Wednesday that Trump administration policies were driving up health insurance costs, which many experts expect to surge again in 2019. Mr. Azar, testifying before a House committee, vigorously disputed suggestions by Democrats that President Trump had sabotaged Affordable Care Act marketplaces, where millions of people obtain insurance subsidized by the federal government. (Pear, 6/6)

Kaiser Health News: HHS To Allow Insurers’ Workaround On 2019 Prices
Federal officials will not block insurance companies from again using a workaround to cushion a steep rise in health premiums caused by President Donald Trump’s cancellation of a program established under the Affordable Care Act, Health and Human Services Secretary Alex Azar announced Wednesday. The technique — called “silver loading” because it pushed price increases onto the silver-level plans in the ACA marketplaces — was used by many states for 2018 policies. But federal officials had hinted they might bar the practice next year. (Rovner, 6/7)

HHS Secretary Alex Azar told lawmakers they should draft legislation to update and fix the Medicare wage index. The index, which was created in the 1980s, sets payments to hospitals as adjusted for market conditions, such as the differences in hospital wage rates among labor markets. It also takes into account the cost of living. Increasingly, rural hospitals in areas where the cost of living tends to be lower cite the index as a reason for closures. (Dickson, 6/6)

And in other health law news —

Senate Democrats are pushing Republicans to use the new time they have because of the cancellation of the August recess, announced by Majority Leader Mitch McConnell (R-Ky.) this week, to talk about rising health-care costs ahead of the midterms. Senate Minority Leader Charles Schumer (D-N.Y.) said in a letter to McConnell released Wednesday that the GOP leader should dedicate August to "considering legislation that would lower the cost of health care and prescription drugs." (Hellmann, 6/6)

Sen. Bill Cassidy, co-author of a high-profile Obamacare repeal bill, isn’t so sure Congress should take another crack at undoing the law this year. But he said lawmakers should move on legislation to make health care more affordable. "We should have another vote, absolutely … if we've got the ability to lower the cost to the average American who's purchasing insurance," the Louisiana Republican, who’s pushing a new set of health care proposals, told POLITICO's Pulse Check podcast. (Diamond, 6/6)

President Donald Trump signed a bill into law Wednesday that will give veterans more freedom to see doctors outside the troubled Veterans Affairs system, a major shift aimed at reducing wait times and improving care by steering more patients to the private sector. At a Rose Garden event at the White House, Trump praised the legislation as fulfilling his pledge to fix the Department of Veterans Affairs by bringing accountability and providing private care to veterans whenever they feel unhappy with government-run health care. (Yen, 6/6)

“The VA Mission Act authorizes and expansion of veterans’ access to private health care, but the bill does not reserve federal money to pay for it. A group of powerful Senate committee chairmen from both parties aims to remedy that by advancing a separate measure for the new $50 billion law, saying this is the best way to ensure the new programs give veterans access to medical care. But the White House has been lobbying Republicans to vote the plan down, instead asking Congress to pay for veterans programs by cutting spending elsewhere. (Werner and Rein, 6/6)

One of the central purposes of the law is to replace emergency legislation called the Choice Act, which was passed after a VA wait-time scandal sparked demand to change the department and give veterans more choice for their health care. Congress pushed through the Choice Act in 2014, mandating that the VA implement it within 90 days, which set the program up for failure, said Rep. Phil Roe (R., Tenn.), the chairman of the House Committee on Veterans’ Affairs. Earlier this week, a Government Accountability Office report said the VA “cannot determine whether the Choice Program has helped to achieve the goal of alleviating veterans’ wait times for care.” “We started this four years ago,” Mr. Roe said. “It’s one of the most sweeping pieces of legislation we’ve passed since I’ve been” in Congress, he said. (Kesling, 6/6)

President Donald Trump’s vendetta against Sen. Jon Tester took a snippy turn today when the Democratic senator from Montana was left off the invite list for a White House signing of a VA bill that he had co-written. Although the VA Mission Act passed 92-5 in the Senate and 347-70 in the House, there were no Democrats at Trump's side. Tester, the ranking member on the Senate Veterans Affairs committee, wasn’t even in the room. (Allen, 6/6)

Working out the details of exactly how and when that will happen is now up to agency officials tasked with drawing up regulations under the law. If confirmed, Trump’s pick to become the VA secretary, Robert Wilkie, would lead that effort. Criteria to be considered include wait times for VA appointments, quality of VA care and distance from a VA facility. (Slack and Wagner, 6/6)

In most elections, the primary is the season for partisanship and appealing to the party’s most ideological voters. Candidates slide to the center — appealing, in theory, to a broader electorate with a more moderate message — as they shift into a general election. But even before most of the votes were counted, two of the candidates running to be the next governor of California — Gavin Newsom, the Democratic lieutenant governor, and John Cox, a Republican businessman — made clear that they were inclined to stay in their ideological corners. (Nagourney and Fuller, 6/6)

In the California governor’s race, Democratic front-runner Gavin Newsom quickly sought to cast the November contest as a referendum on Trump and his effort to undo much of President Barack Obama’s legacy, particularly on health care. A series of Trump tweets endorsing Republican candidate John Cox, a multimillionaire real estate investor, helped propel the political outsider to the general election. “It looks like voters will have a real choice — between a governor who will stand up to Donald Trump and a foot soldier in his war on California,” Newsom said Tuesday night to supporters in San Francisco. (Terhune, Bartolone, Ibarra and Matthews, 6/7)

Health care had been front-and-center in the governor’s race — at least between the top two Democrats, Mr. Newsom and Mr. Villaraigosa. Mr. Newsom has supported single-payer health care for all residents, while Mr. Villaraigosa has raised questions about how to pay for it. The divide has mirrored the split within the Democratic Party, with the most progressive leaders — which in addition to Mr. Newsom includes Mr. De Leon — making the issue an important part of their platform, and moderates raising questions about where the money will come from. Given the high cost of universal health care, and no reasonable way to pay for it without increasing taxes, “it’s more of an aspiration,” Mr. Baldassare said. “The belief is, yes, it’s a good idea. And then the question is, how do we pay for it?” (Arango and Medina, 6/6)

Lt. Gov. Gavin Newsom's victory speech promised plenty as he moved into position Tuesday to become California's next Democratic governor. As it became clear that he and Republican John Cox would face off in November, he called for a universal health care system. (Hart, 6/6)

Meanwhile, in Michigan —

A former physician and Detroit health director who is running for governor of Michigan, released his plan for a statewide universal health-care system on Wednesday.“ Michicare is our plan to take back healthcare from the insurance companies and put it back in the hands of the people and the providers who serve them,” Abdul El-Sayed (D) said in a press release. (Sanchez, 6/6)

Despite a $12 million ad blizzard by a giant tobacco company, voters in San Francisco resoundingly supported a new ban on the selling of flavored tobacco products, including vaping liquids packaged as candies and juice boxes, and menthol cigarettes. The measure, known as Proposition E, is said to be the most restrictive in the country, and health groups predicted it could serve as a model for other communities. (Hoffman, 6/6)

The San Francisco city supervisors approved the ordinance last year, but opponents got enough signatures to place the question on the ballot. The vote Tuesday puts to rest what has become a long and expensive battle, with tobacco company R.J. Reynolds contributing nearly $12 million against the measure. On the other side, supporters of the measure were funded almost entirely by former New York City Mayor Michael Bloomberg, who contributed at least $1.8 million. Matthew Myers, president of the Campaign for Tobacco-Free Kids, called the vote "a truly historic victory for kids and health over the tobacco industry." (Hellmann and Wilson, 6/6)

Tobacco and public health interests spent millions of dollars ahead of the closely watched referendum, which came as the FDA explores new limits on flavored tobacco and grapples with the challenge of regulating products like e-cigarettes that some argue are a safer alternative and can wean smokers off traditional smoking products. (Colliver, 6/6)

The R.J. Reynolds Tobacco Company spent nearly $13 million on a campaign to stop the ban. The company sells the nation’s best-selling menthol cigarette. All that money was appalling to Patrick Reynolds, his grandfather founded the company, but he's now an anti-tobacco advocate because he lost his father to emphysema. (McClurg, 6/6)

The Trump administration is preparing to release a sweeping plan for reorganizing the federal government that includes a major consolidation of welfare programs — and a renaming of the Health and Human Services Department. The report, set to be released in the coming weeks by the White House Office of Management and Budget, seeks to move safety-net programs, including food stamps, into HHS, two sources with knowledge of the plan told POLITICO. The plan would also propose changing the name of the sprawling department, while separately seeking cuts at the U.S. Agency for International Development and the State Department. (Bottemiller Evich and Restuccia, 6/6)

In other news —

The GOP-controlled House is moving ahead on a White House plan to cut almost $15 billion in leftover spending, scheduling a vote after President Donald Trump took to Twitter to sell the idea. A spokesman for House Majority Leader Kevin McCarthy said Wednesday that the House will vote Thursday night on the measure, which had appeared to languish after Trump submitted it last month. The measure faces long odds in the Senate despite being immune to a Democratic filibuster. (Taylor, 6/6)

A U.S. medical team was screening more Americans who work in a southern Chinese city as the State Department confirmed evacuating a number of government workers who experienced unexplained health issues like those that have hurt U.S. personnel in Cuba and China. The evacuations of the workers in Guangzhou followed medical testing that revealed they might have been affected. State Department spokeswoman Heather Nauert said "a number of individuals" have been brought to the U.S. but didn't say how many were affected or evacuated. One case in Guangzhou had been disclosed last month. (Chan and Kang, 6/7)

For months, American officials have been worried that their diplomats have been subjected to targeted attacks involving odd sounds, leading to symptoms similar to those “following concussion or minor traumatic brain injury,” the State Department says. The cases in China have broadened a medical mystery that started in 2016, when American Embassy employees and their family members began falling ill in Havana. In all, 24 of them were stricken with headaches, nausea, hearing loss, cognitive issues and other symptoms after saying they heard odd sounds. The issue has roiled relations with Cuba, which immediately fell under suspicion, and led the United States to expel Cuban diplomats. (Myers and Perlez, 6/6)

A Chinese government investigation has shed no light on why a U.S. diplomat fell ill at the consulate in Guangzhou after hearing mysterious sounds, an official said Thursday. On Wednesday, the State Department said it was evacuating several more Americans from Guangzhou for further health screenings. That follows the initial evacuation of a government employee, who had reported hearing strange noises in his apartment and exhibiting symptoms of brain injury. (Denyer and Morello, 6/7)

Researchers have hazarded several theories for what happened in Havana. One team at the University of Michigan said in March that the symptoms may have been the result, not of a deliberate attack, but of sound distortion caused by ultrasonic surveillance devices placed too close together. On Tuesday, Secretary of State Mike Pompeo said in a statement that he planned to set up a Heath Incidents Response Task Force to respond to unexplained health problems affecting U.S. diplomats and their family members living abroad. (Chin, 6/7)

The scenes in the political ads play out in almost the same order: A heartbreaking story about someone who can’t seem to stop taking drugs. A grim statistic about opioids. And then a somber pitch from a candidate promising solutions. More and more, politicians in competitive races are using emotional pleas about opioid abuse to woo voters. In states like Wisconsin, where hundreds of people are dying of opioid overdoses every year, candidates are talking about drugs in stump speeches, on Facebook and in ads. (Smith, 6/7)

The House will vote on legislation aimed at fighting the opioid epidemic next week, House Majority Leader Kevin McCarthy (R-Calif.) announced Wednesday. The chamber will vote on dozens of bills over a period of two weeks. ... One of the more far-reaching measures lifts some limits on Medicaid paying for care at treatment facilities for people with opioid addiction, something known the IMD exclusion, a long-held goal for many advocates. (Sullivan, 6/6)

As legislation to address the opioid epidemic gains momentum, drug makers, insurers, and other interest groups are engaging in a concerted drive to tailor the bills to their liking. The effort, in some cases, has resulted in lawmakers softening, or entirely backing off, some of their most far-reaching proposals. Members of Congress have advanced dozens of bipartisan bills that advocates say are needed, commonsense steps to address the public health crisis. Later this month, the House is likely to consider legislation that would speed approvals for non-opioid painkillers, strengthen drug enforcement programs, improve care for children impacted by addiction, strive to reduce prescription levels, and improve prescription monitoring programs. (Facher, 6/7)

Health and Human Services Secretary Alex Azar addressed questions Wednesday from House lawmakers in both parties about the administration's approach to the opioid addiction crisis. The discussion took place as House Majority Leader Kevin McCarthy, R-Calif., announced the chamber plans to move next week on opioid legislation. McCarthy expects the floor debate to require about a week and a half. A number of panels, led by the House Energy and Commerce and the Ways and Means panels, have been working on opioids-related legislation.  (Raman, 6/6)

And in other news —

None of the New Orleans agencies that use Naloxone to reverse the effects of opioid overdoses will be affected by a voluntary recall of the drug, according to Mayor LaToya Cantrell's office. The drug maker Hospira, Inc. said on Monday (June 4) that it was voluntarily recalling the single-use cartridge syringe system because of "loose particulate matter on the plunger that has the low potential to cause local irritation and internal allergic reactions," according to a press release issued by the U.S. Food and Drug Administration. (Clark, 6/6)

Opioids are a mainstay of pain relief for cancer patients, so it may not be surprising that many feel victimized by efforts to curb the nation’s opioid addiction epidemic by limiting access to prescription painkillers. But the doctors and nurses who care for those patients are also caught in the middle of the crisis, two University of Pennsylvania experts argue in a recent opinion piece in JAMA Oncology. (McCullough, 6/7)

The powerhouse opioid fentanyl has drenched the drug supply in Greater Cincinnati, dwarfing the presence of heroin sold on the streets. More than 90 percent of drugs analyzed at the Hamilton County crime lab through May 3 this year have had the synthetic opiate in them. (DeMio, 6/6)

Recent research is promising: States where medical marijuana is legal have had fewer opioid deaths. But experts caution that it’s too early yet to declare marijuana a solution to the opioid epidemic. (Mendez, 6/6)

Athenahealth Inc. Chief Executive Officer Jonathan Bush is stepping down after a series of allegations about misconduct involving women, clearing the way for a potential sale of the $6.3 billion health-technology company he co-founded more than two decades ago. Bush, 49, a nephew of former President George H.W. Bush, had faced challenges on two fronts. Elliott Management Corp., an activist hedge fund, early last month proposed buying the company for $160 a share, saying it had been mismanaged and would be better off under private ownership. Then, last week it was reported by Bloomberg and others that Bush had faced complaints of inappropriate behavior with female employees, had physically assaulted his now ex-wife more than a decade ago and had made comments at a 2017 industry event about wanting to “jump down on’’ one of his female employees “and do inappropriate things.” (Ockerman and Deveau, 6/6)

Athenahealth said in a statement that it is searching for CEO candidates. For now, Chief Financial Officer Marc Levine will take on additional leadership responsibilities. The company also named Jeff Immelt, former chairman and CEO of General Electric, as executive chairman. "We approach this process with an open mind and a commitment to continuing to strengthen the company—including its rich data asset, platform strategy and culture of innovation," Immelt said in a statement. "We are fully focused on serving the best interests of our shareholders, employees and clients." (6/6)

CVS Health on Wednesday announced the management team chosen to lead the company after its merger with insurer Aetna closes. Under $69 billion deal, which was first announced in December and still must secure approval from state and federal regulators, Aetna will become a stand-alone business unit within pharmacy giant CVS. The deal is expected to close in the second half of 2018. Several Aetna executives were tapped for management roles at the combined company. (Livingston, 6/6)

Industrial-equipment maker Fortive Corp. FTV 0.89% has made a $2.7 billion offer to buy Advanced Sterilization Products from a Johnson & Johnson JNJ 1.08% unit. Fortive said Wednesday that the provider of sterilization and disinfection products would help it increase revenue and expand its positions in attractive markets, Chief Executive James Lico said in prepared remarks. (Barba, 6/6)

The husband of the designer Kate Spade, who died of what police characterized as suicide, said on Wednesday that she had suffered from severe depression and acknowledged that they had been living apart for the last 10 months. The husband, Andy Spade, said there were no plans to divorce. Mr. Spade was speaking publicly for the first time since her death was announced on Tuesday. Kate Spade, with her husband and business partner, built an idea about a handbag into what became a billion dollar brand, marked by an optimism that resonated deeply with many women for almost three decades. (Friedman, 6/6)

Grieving deeply, Kate Spade's older sister told The Star on Tuesday that her famous designer sister suffered debilitating mental illness for the last three or four years and was self-medicating with alcohol. Spade's apparent suicide on Tuesday, at age 55 inside the bedroom of her New York Park Avenue apartment, "was not unexpected by me," Reta Saffo, Spade's older sister by two years, told The Star by email from her house in Santa Fe, New Mexico. Family members struggled mightily to help Spade but to little avail, she said. "Sometimes you simply cannot SAVE people from themselves!" she wrote. Spade seemed concerned how hospitalization might harm the image of the "happy-go-lucky" Kate Spade brand, she said. She saw how her sister seemed fixated on Robin Williams on the day, in August 2014, that he committed suicide by hanging. (Eric Adle, 6/6)

Spade, who said that he and his wife had been living in separate apartments for the past 10 months, added that the two had spoken the night before her death and that “she sounded happy.” “There was no indication and no warning that she would do this,” he said. “It was a complete shock. And it clearly wasn’t her. There were personal demons she was battling.” (Rosenberg, 6/6)

The 55-year-old designer’s troubled inner life contrasts with the image she presented to the world. She was a fashion icon. She and her husband had sold their company for enough money to live a luxurious life. She had taken a decade off from the fashion business to raise a daughter and recently returned to the work she loved, designing sleek yet cheerful handbags and shoes. “Sometimes you know how people visually never grow old? She was one of those people,” said Stan Herman, a New York fashion designer and longtime friend of Ms. Spade. (Kapner and Kanno-Youngs, 6/6)

Many people are unaware of marijuana addiction. But in the public health and medical communities, it is a well-defined disorder that includes physical withdrawal symptoms, cravings and psychological dependence. Many say it is on the rise, perhaps because of the increasing potency of genetically engineered plants and the use of concentrated products, or because more marijuana users are partaking multiple times a day. ...Although estimates of the number of people who have ever tried marijuana or who use it regularly vary widely from survey to survey, the federal government and the marijuana industry tend to agree that total marijuana use has remained relatively constant over the past decade. Increased use in the past three years has been slight, despite increased commercial availability in states that have legalized it. (Vestal, 6/6)

Kaiser Health News: With The Rise Of Legal Weed, Drug Education Moves From ‘Don’t’ To ‘Delay’
California legalized marijuana in 2016, and this past New Year’s Eve eager customers lined up in the darkness outside medical marijuana dispensaries across the state, ready to start shopping at the stroke of midnight. The effect has gone beyond the cannabis cash register. Everyone has seen the ads or heard the chatter — and that includes minors, though marijuana remains illegal for those under 21. (Feibel, 6/7)

Early signs suggest that an Ebola outbreak in Congo, which has killed 27 people since erupting in a remote rural village two months ago, is being contained before it can spread further. Fifty-eight suspected or confirmed cases have been documented in the Equateur Province, a few hundred miles up the Congo River from the capital, Kinshasa. In recent days, two more victims have died, and five new suspected cases — all of whom had contact with someone else with the virus — have been identified. (Wilson, 6/6)

The more years of schooling you have, the higher your risk for nearsightedness. Observational studies have suggested a link between education and myopia. But a new study used a genetic technique called Mendelian randomization to minimize the effect of several variables and provide stronger evidence of cause and effect. (Bakalar, 6/6)

In a clinic on a side street in Kiev, the capital of Ukraine, doctors are doing something that, as far as is publicly known, is being done nowhere else in the world: using DNA from three different people to create babies for women who are infertile. "If you can help these families to achieve their own babies, why it must be forbidden?" Dr. Valery Zukin, director of the Nadiya Clinic, asks as he peers over his glasses. "It is a dream to want to have a genetic connection with a baby." (Stein, 6/6)

On the third floor of a big Soviet-era apartment building in Kharkiv, Ukraine, the mother of one of the world's first babies created with DNA from three different people cracks open her door. "Hello; my name is Tamara," she whispers, to avoid waking her son from his nap. Her name isn't really Tamara. She asked me to call her that to protect her family's privacy. She knows how unusual — and controversial — her baby might be to some people. (Stein, 6/6)

Big tobacco hoped a promising start for a new cigarette alternative in Japan could be replicated elsewhere, but slowing sales there have sparked concerns about whether smokers the world over will switch. Japan’s smoking culture and love of gadgets have made it a test market for Philip Morris International Inc. and other big tobacco companies for new devices that mimic the sensation of smoking but heat the tobacco rather than burn it. (Chaudhuri and Fujikawa, 6/6)

Hepatitis C patients are routinely being denied access to life-saving medication at a time when the liver disease is on the rise, especially among intravenous drug users, according to new analysis by researchers at the University of Pennsylvania’s Perelman School of Medicine. ...Half of patients with private insurance were denied coverage for the pill regimen, which can cost tens of thousands of dollars, according to a review of thousands of prescription claims between January 2016 and April 2017. (Gantz, 6/6)

Liver specialists say there’s a form of hepatitis that is sneaking up on about 12 percent of the U.S. population, an estimated 25 million Americans, and they want to urge primary-care providers to send patients for testing earlier in the game. Called nonalcoholic steatohepatitis, or NASH for short, it does not result from drug use, alcoholism, sexual contact, water contaminants or viruses. Rather this particular liver condition occurs when too much fat is stored in liver cells. (Anderson, 6/7)

Apatient comes into a hospital emergency department, troubled by chest pain that comes and goes. The doctor asks some questions, draws on clinical experience, and orders a test to rule out — or in — a heart attack. That test could be a stress test that tracks the patient with an electrocardiogram while running on a treadmill. Or it could be a more specific but also more invasive test: an angiography that reveals blocked coronary arteries on X-ray after the patient has been injected with dye. (Cooney, 6/6)

Kaiser Health News: Facebook Live: Sorting Out The Truth About Vitamins
Did you remember to take your vitamins? For more than half of Americans who take vitamin supplements — 68 percent of whom are 65 or older — this is a regular, even daily, question. But whether it’s vitamin E, vitamin D, fish oil or folic acid, among others, how much of a difference do they really make in terms of fending off chronic illnesses and helping people stay healthy? KHN senior correspondent Liz Szabo will explore some of the fact and fiction associated with vitamin regimens and whether early reports of potential benefits tends to outpace scientific evidence. (6/6)

Kaiser Health News: Listen: What You Need To Know About The News On Breast Cancer And Chemo
KHN senior correspondent Liz Szabo discusses the news that as many as 70 percent of women with early-stage breast cancer may not need chemotherapy. Szabo joined host Joshua Johnson and two cancer experts on WAMU’s radio show “1A” on Tuesday. (6/7)

Despite the remarkable progress that medicine has made treating some varieties of cancer, one common form remains nearly as deadly as it was four decades ago: lung cancer. ... The disease is the leading cause of cancer death in men and women in the United States, killing about 154,000 people each year, more than those who die from breast, colorectal, and prostate cancer combined. On Wednesday, Boston University and the health care giant Johnson & Johnson announced a five-year collaboration that they hope will change that. (Saltzman, 6/6)

Boston University is pairing with Johnson & Johnson to help fight lung cancer. School officials announced Wednesday the company will pay for a new lung center at the university where researchers will work to prevent and cure the disease. It's part of a five-year research partnership between the school and Johnson & Johnson Innovation, a development arm of the New Jersey-based health care products company. (6/6)

The voices are sobbing at times. Panicked. Fearful. A 911 dispatcher tries to calm one caller down. “Hello? Are you at the Route 91?” the dispatcher asks. “I’m going for my boyfriend who is at Route 91,” the woman says. “He’s hiding inside of a cooler.” “OK, you tell him to stay hunkered down. We don’t have this thing contained yet and we need to get everyone — just tell him to stay put, OK?” the dispatcher responds. (Montero, 6/6)

New Jersey lawmakers are set to vote on a half-dozen measures to tighten the state's already-strict gun laws. The Democratic-led Assembly and Senate have scheduled votes for Thursday on bills that began advancing after the fatal high school shooting in Parkland, Florida, in February that left 17 people dead. Democratic Gov. Phil Murphy has said he supports the measures, as part of a promise for more "sensible" gun-control. (6/7)

A former vice dean of University of Southern California’s medical school testified he feared the then-dean, Dr. Carmen Puliafito, “could be doing drugs” before Puliafito abruptly quit in 2016. Dr. Henri Ford’s testimony at a state Medical Board hearing marks the first suggestion that any USC administrator had suspicions about Puliafito’s possible drug use, the Los Angeles Times reported Wednesday. Ford said he expressed concerns about Puliafito’s general well-being to the university’s provost. (6/6)

A nurse at the Brockton hospital last winter administered the drug, a nonsteroidal anti-inflammatory, to the patient, who suffered a life-threatening reaction and had to be transferred to the intensive care unit, according to a federal and state inspection report obtained by the Globe. ...The phenomenon is a growing concern at hospitals nationwide as technology revolutionizes how patients’ medical information is collected and circulated among providers. (Kowalczyk, 6/6)

If the city complies with a recent court order, it will have to ensure that as many as 400 Cleveland homes with lead hazards are placarded with warning signs by June 23, according to state records obtained by The Plain Dealer. The exact number of homes requiring an order to vacate is unclear, but state records show that as of May 23, the date of the court's order, city and state lead investigators had issued orders to remediate lead hazards to the owners of at least 503 Cleveland homes. (Dissell and Zeltner, 6/6)

The Kansas Department of Health and Environment said Wednesday that the threat caused by an outbreak that began in a Johnson County daycare in March has passed after 22 people in three counties were infected. ...It was the most cases of measles Kansas has had in a year since 1990. (Marso, 6/6)

The New Hampshire Department of Administrative Services (DAS) is proposing a sweeping overhaul of the state’s retiree health care plan, seeking to switch users into a Medicare program that officials say could help the state save $11.8 million through 2020. The proposal, presented to the Executive Council on Wednesday, would move the state’s 9,600 Medicare-eligible public retirees off their present plan – a state-funded program called “Medicomp” – and onto a federal initiative known as Medicare Advantage. (DeWitt, 6/7)

A deaf Slidell resident has filed a lawsuit in federal court against a Hammond-based nursing home who she said did not provide her adequate access to an American Sign Language interpreter during her stay. Under the Affordable Care Act, nursing homes, hospitals, health plans, clinics, physicians and other providers have to offer "qualified interpreters" to limited English proficient patients. Although interpreters are not required to be certified, they have to have some training to be considered qualified and need to be fluent in either language. (Clark, 6/6)

A California-based company has bought a Florida medical marijuana operation for $53 million in the latest transaction in what investors hope will be among the nation’s most-lucrative medical pot markets. Under the agreement, the company MedMen will acquire Treadwell Nursery’s five-acre cultivation facility, located in Eustis, and the right to operate 25 dispensaries throughout the state, the maximum currently allowed under Florida law. (Hokrein, 6/6)

D’ashon, a Texas toddler with severe birth defects, needed 24/7 nursing care to keep his breathing tube clean and to prevent him from pulling it out. His foster mother asked Superior HealthPlan, the insurance carrier that provides Medicaid services to the state’s 30,000 foster children, for additional nursing hours, according to a Dallas Morning News investigation. Superior said no, even after D’ashon’s doctors and nurses said that it was a matter of life or death. ...As a wealthy and politically powerful company gambles lives for profit, Texas officials look the other way, the Morning News reporters tell us. This is the sorry state of what passes for good-enough care for patients who depend on Medicaid, among the most vital safety nets for the American poor and disadvantaged, in the second most populous state. (6/6)

Another annual report is out from the Social Security and Medicare trustees. Which means it is the solemn duty of every economics columnist to acquaint their readers with some frightening numbers. Thanks to the Great Recession, the taxes paid into the Social Security program began to exceed the money flowing out in 2010.  But that is a permanent condition, not a recession-only shortfall; until taxes are raised or benefits are cut, the system will never return to balance. As more baby boomers retire, starting in 2022 we will begin to empty out the “trust fund,” which is supposed to buffer this imbalance. In 2034, it will be exhausted; under current law, benefits will then be slashed by 23 percent. (Megan McArdle, 6/6)

So another congressional session is half over and, we’re told, is likely to go by without a mention of the moose on the American table, our preposterously out-of-control federal debt. It’s not as though the stakes are high: just our standard of living, national security, all the discretionary activities of government, and literally our future as an autonomous, self-governing people. Every honest observer knows what will cause the coming crunch, so aptly termed by Erskine Bowles as “the most predictable crisis in history”: the runaway autopilot programs we call “entitlements.” Without changes there, no combination of other measures can come close to preventing the reckoning. (Mitch Daniels, 6/6)

Elizabeth Warren is still sparring with academics over a paper she published in 2005. The latest round came on Wednesday, in The New England Journal of Medicine, where she and her co-authors critiqued a recent paper that argued that medical problems cause a much smaller share of personal bankruptcies than many people think. One of the reasons many people think medical bills cause so many bankruptcies is Elizabeth Warren, now a United States senator and possible Democratic presidential candidate. (Margot Sanger-Katz, 6/6)

Dobkin et al. have made an important contribution in clarifying the relationship between health shocks and economic risk; like us, they have shown that health crises have major economic consequences for families and that even the insured are not adequately protected. However, in their Perspective article (March 22 issue), they mischaracterize our studies implicating medical problems as contributors to approximately 60% of personal bankruptcies, and their claim that medical bankruptcies are uncommon rests on methodologic choices that do not capture all medical causes of bankruptcy. (David U. Himmelstein, Steffie Woolhandler and Sen. Elizabeth Warren, 6/7)

Readmission rates are broadly accepted by payers and policymakers as a measure of hospital quality. But with providers increasingly relying on observation stays as an alternative to inpatient care, readmission measures may be omitting a key part of the quality equation. (Amber K. Sabbatini and Brad Wright)

In the fight for free-market principles in the health insurance market, there is one policy in particular that all conservatives can agree on: the expansion of health savings accounts (HSAs). These accounts allow consumers to save their own money tax-free to be used for medical expenses, putting individuals in charge of their own health care dollars. (Adam Brandon, 6/7)

Early this year, a 28-year-old self-described biohacker named Aaron Traywick injected himself with an alleged herpes vaccine prepared by fellow amateur medical researchers. The injection, which was broadcast on Facebook Live, brought on a volley of criticism and ethical concerns. Only a few months earlier, a colleague at the company Traywick founded, Ascendance Biomedical, injected himself with an alleged gene therapy for HIV. It’s unlikely either of these treatments worked, but they succeeded in proving how easy it’s become for amateurs to experiment with infectious agents and other biological materials that were once restricted to trained professionals. While it’s illegal to sell biohacked therapies or vaccines, or to test them on human subjects, so far at least, the FDA does not explicitly forbid experimenting on yourself. (Faye Flam, 6/5)

As a pediatric surgeon who operates on sick children, I’m hardly one to forswear risk taking and innovation. But as I prepared to lead an FDA-approved study on a new surgery to treat sleep apnea in children with Down syndrome, I found myself wondering if our disruption-intoxicated culture places too much emphasis on innovation and not enough on the less glamorous preparatory work that must be undertaken to innovate responsibly. Some people shrink from risk taking, which can limit their potential. Others make the opposite mistake: They jump headlong into risk without carefully thinking it through. So-called biohackers inject themselves with untested gene therapies. Thrill-seekers on YouTube sneak into construction sites and climb the steel skeletons of tall buildings apparently without having undertaken planning or practice runs. ...Our culture of innovation today is all about thinking fast. I think we sometimes need to take a deep breath and inhale a big dose of “slow.” (Christopher Hartnick, 6/7)

In much of the commentary, you can hear the myths that many Americans tell themselves about depression, manic behavior and suicide — that it only happens in some families, that it can be fought off by sheer will and that it is the juice fueling so many creative talents. The Star published a difficult-to-read interview with Spade’s older sister, Reta Saffo. Her voice is virtually screaming in pain, anger and frustration. It is the voice of someone who has struggled with a mentally ill family member for years. “I’d come so VERY close to getting her to go in for treatment,” Saffo wrote in an email. She discussed the pressure of keeping up the Kate Spade image, admitting that it was part of the reason that her sister was reticent to seek treatment. Doesn’t society own a bit of that response? After all, it’s fed by a reluctance to understand mental illness, to see its treatment in the same light as we do physical ailments, like breast cancer. (Mary Sanchez, 6/6)

The apparent suicide of fashion designer Kate Spade shows that untreated mental illness can affect anyone — regardless of their gender, the color of their skin, or the size of their bank account. Many news reports found that Spade had been suffering with her mental health for a long time. According to the Kansas City Star, Spade’s older sister said that her suicide was, “was not unexpected by me.” As a practicing psychologist, I find that most people with mental health disorders do not seek out or receive effective health-care services and treatments. (Joan Cook, 6/6)

Like thousands of our physician colleagues, we entered the medical profession to care for our patients when they are sick and to advocate for their needs. We feel compelled to raise serious concerns about proposed changes by the Trump administration to the Title X Family Planning program as they stand to reverse important public health progress and harm many low-income patients. Title X is the only federal program dedicated solely to providing family planning and related health and screening services. It improves the lives of 4 million people a year in all 50 states by funding breast cancer and cervical cancer screening, sexually transmitted disease testing and affordable birth control. Of note, its funds have already been prohibited from being used for abortion services. Established under a Republican president nearly half a century ago, Title X has enjoyed bipartisan support for most of its history. The proposed changes to Title X would have several harmful consequences. (Vivek H. Murthy and Alice T. Chen, 6/6)

Ironically, many of the policies that Trump’s administration are advancing do not actually reduce abortions. The global gag rule, for instance, is associated with increases in the number of abortions that take place in other countries. So it is not preventing abortions, it is simply making them more dangerous and costing an untold number of women’s lives. Likewise, Trump took aim at the successful Teen Pregnancy Prevention Program in a move courts are now calling illegal. (Dawn Huckelbridge, 6/6)

Let the bidding begin for Athenahealth Inc. The health-care technology company on Wednesday said controversial leader and co-founder Jonathan Bush would step down following allegations of inappropriate behavior toward female employees and physical abuse of his ex-wife. Bush, the nephew of President George H.W. Bush, was perceived to be one of the biggest impediments to a sale of Athenahealth. Activist investor Elliott Management Corp. made a $160-a-share takeover bid for the company last month to get the wheels in motion, and Athenahealth has yet to issue a verdict on that particular proposal. (Brooke Sutherland and Max Nisen, 6/6)

This gregarious, confident woman, a “model patient” who had counseled her peers to be honest and candid as they sought care, who had reassured so many others that they would be okay, that she was living proof of that — she had never shared her status with her daughter (or, as I would later learn, any of her family). HIV was still so immense an anguish that one of the most open and free-spirited patients I knew never felt absolved enough to share her status with her loved ones. The burden of being stigmatized affects every aspect of our patients’ capacity to function, to engage in good health care, to adhere to medications, and to participate fully in their own lives as parents, siblings, partners, friends, and employees. (Ila Mulasi, 6/7)

There are substantial gaps in evidence regarding the safety of many drugs in children. Increasingly, studies assessing drug safety can incorporate data obtained in the course of clinical care to generate real-world evidence and help fill these gaps. (Ann W. McMahon and Gerald Dal Pan, 6/7)