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The Justice Department’s approval of the $69 billion merger between CVS Health and Aetna on Wednesday caps a wave of consolidation among giant health care players that could leave American consumers with less control over their medical care and prescription drugs. The approval marks the close of an era, during which powerful pharmacy benefit managers brokered drug prices among pharmaceutical companies, insurers and employers. (Abelson, 10/10)

The Justice Department on Wednesday approved the deal on the condition that Aetna moves ahead with its plan to sell its Medicare Part D prescription drug plan business, resolving some anti-monopoly issues. (10/10)

"Today's settlement resolves competition concerns posed by this transaction and preserves competition in the sale of Medicare Part D prescription drug plans for individuals," Assistant Attorney General Makan Delrahim, who leads the Justice Department's antitrust division, said in the announcement. "The divestitures required here allow for the creation of an integrated pharmacy and health benefits company that has the potential to generate benefits by improving the quality and lowering the costs of the healthcare services that American consumers can obtain." (Livingston, 10/10)

CVS said that it already had gotten “many” of the state approvals it needs. “We are pleased to have reached an agreement with the Justice Department that maintains the strategic benefits and value creation potential of our combination with Aetna,” said CVS’s chief executive, Larry Merlo. “We are now working to complete the remaining state reviews.” Aetna rival Cigna Corp. has already gotten Justice Department antitrust clearance for its acquisition of Express Scripts Holding Co. , which also brings together a major health insurer with a pharmacy-benefit manager. (Wilde Mathews and Maidenberg, 10/10)

The tie-up will allow CVS — whose retail pharmacy business serves 5 million customers a day — to turn more of its brick-and-mortar locations into front-line clinics for basic medical services and patient monitoring. By deepening its knowledge of and relationships with patients, CVS has said the combination could help Americans stick with medication regimens and stay out of the hospital. (Fung, 10/10)

Aetna and CVS have argued that a merger would improve health-care outcomes and reduce costs immediately. They have plans to turn CVS’s 10,000 pharmacies and clinics into community-based sites of care with nurses and other health professionals available to give diagnoses or do lab work. The merger also means that there will no longer be any independent pharmacy benefit managers in the U.S. (Hellmann, 10/10) 

Consolidation has increased across health care among hospitals, drugmakers and insurers, though some previous deals were thwarted by antitrust issues. The Cigna and CVS deals came only after the Justice Department blocked Cigna and Aetna from merging with rival health insurers last year. Completion of the CVS-Aetna deal could put pressure on rivals to come up with their own deals. Walgreens Boots Alliance Inc. is the U.S.’s last remaining giant standalone pharmacy chain, and its deal-friendly CEO, Stefano Pessina, has spoken about bringing together pieces of the medical supply chain. Walgreens holds a 26 percent stake in drug distributor AmerisourceBergen Corp., which helps supply Walgreens stores, and last winter the companies held early discussions about about a merger, according to reports at the time. (McLaughlin and Langreth, 10/10)

The Department of Justice’s blessing for CVS Health’s takeover of Aetna will have ripple effects that go far beyond the candy racks at your local drugstore. ... Although CVS still needs some state approvals, the Department of Justice agreement was the big milestone — a key victory for chief executive Larry Merlo and his leadership team. (Chesto, 10/10)

President Donald Trump is stepping up his attack on Democrats over a health care proposal called Medicare for All, claiming it “would end Medicare as we know it and take away benefits that seniors have paid for their entire lives.” Trump, omitting any mention of improved benefits for seniors that Democrats promise, writes in an op-ed published Wednesday in USA Today, “The Democrats’ plan means that after a life of hard work and sacrifice, seniors would no longer be able to depend on the benefits they were promised.” (Miller, 10/10)

President Trump wrote an opinion article for USA Today on Oct. 10 regarding proposals to expand Medicare to all Americans — known as Medicare-for-All — in which almost every sentence contained a misleading statement or a falsehood. Many of these are claims we have already debunked. Presumably, the president is aware of our fact checks — he even links to two — but chose to ignore the facts in service of a campaign-style op-ed. Medicare-for-All is a complex subject, and serious questions could be raised about the cost and how a transition from today’s health-care system would be financed. Trump correctly notes that studies have estimated that the program — under the version promoted by Sen. Bernie Sanders (I-Vt.) — would add $36 trillion in costs to the federal government over 10 years. (Kessler, 10/10)

The president's op-ed column flubbed some facts and omitted some key context: Trump put the cost of "Medicare for All" at $32.6 trillion over 10 years, calling it an "astonishing" figure. He actually underestimated the expected cost. He cited the added cost to the federal government of taking over private insurance, as estimated by Blahous. The total cost of the new system would be even higher. Trump said Democrats have already "harmed seniors by slashing Medicare" to pay for President Barack Obama's health care overhaul. He neglected to mention that when Republicans later won control of Congress, they kept in their own budgets the Obama Medicare cuts that they had campaigned against. (Alonso-Zaldivar, 10/11)

Trump notes that as a candidate, he "promised that we would protect coverage for patients with pre-existing conditions." In fact, Trump and his fellow Republicans tried — unsuccessfully — to repeal the Affordable Care Act, which guarantees insurance coverage for people with pre-existing conditions. GOP plans would leave it up to the states to craft alternative protections. In addition, Republican attorneys general have sued to overturn Obamacare's protections, and the Trump administration has declined to defend them. America's Health Insurance Plans, the trade group for the insurance industry, warns that ending the Obamacare guarantee could result in hardship for the estimated 130 million Americans under 65 with pre-existing conditions. (Horsley, 10/10)

Trump: Medicare for All would "take away benefits that seniors have paid for their entire lives." This is a "horrible mischaracterization of the proposal," said Linda Blumberg of the Urban Institute. Medicare for All would actually give an expanded version of traditional Medicare to everyone, with broader coverage -- including items such as dental and vision care -- while eliminating virtually all out of pocket costs, she said. (Greenberg and Jacobson, 10/10)

Meanwhile, Democrats slam Trump's op-ed and its contentious talking points that Republicans are unifying around on the midterm election campaign trail —

The op-ed also comes after Speaker Paul Ryan (R-Wis.) made similar criticisms on Tuesday of Medicare for all, saying that it shows that the Democratic Party has “gone off the rails." (Burke, 10/10)

Senate Democratic Leader Charles Schumer (N.Y.) said President Trump’s USA Today op-ed ripping “Medicare for all” was full of misinformation meant to deliberately mislead the public. “The American people deserve better than smears and sabotage,” Schumer said in a statement. “All of the false and misleading words in the world can’t cover up the truth: President Trump and Republicans in Congress are forcing millions of Americans to pay more for health insurance and trying to rip away protections for people with pre-existing conditions.” (Weixel, 10/10)

Sen. Bernie Sanders (I-Vt.) on Wednesday hit back against an op-ed by President Trump attacking Sanders’s signature "Medicare for all" proposal, saying Trump’s piece is filled with “blatant lies.” “Bottom line is he's trying to frighten seniors and suggest that Medicare for all would cut back the benefits they have,” Sanders told reporters. “The truth is it would expand the benefits that they have.” (Sullivan, 10/10)

The GOP is hammering Democratic challengers in swing districts over a plan putting the government in full control of the health care system, betting that voter backlash over the multi-trillion dollar proposal will tip crucial House races to Republicans. There’s just one problem: Few of the targeted Democrats actually support such a plan. (Cancryn, 10/10)

A long-shot bid to derail the Trump administration’s expansion of short-term health plans died in the Senate on Wednesday, even with Sen. Susan Collins providing the lone Republican vote for the resolution. The Senate vote ended in a 50-50 tie, falling short of the majority needed to pass the measure reversing new regulations allowing insurers to sell skimpy health plans outside the Obamacare markets for up to a year, rather than the previous limit of three months. (Cancryn and Ollstein, 10/10)

But by pushing ahead, Democrats made Republicans cast a health care vote that Democrats could wield in campaign ads for next month's midterm elections, in which they hope to topple the GOP's 51-49 Senate majority. The vote was also aimed at refocusing people away from the Senate's nasty battle over confirming Brett Kavanaugh to the Supreme Court, which both sides say has transformed indifferent conservative voters into motivated ones — for now. (Fram, 10/11)

But by forcing a roll call on what they term “junk” plans, Democrats managed to put a spotlight on a key issue they argue will cut their way in the election by appealing to voters in both parties. Only one Republican, Susan Collins of Maine, voted with them. In a speech on the Senate floor, Baldwin pointed to a plan sold in her state that she said does not cover hospital care on a Friday or Saturday. “So, it will just be your bad luck if you happen to get sick and need health care on the weekend,” she said. (Sullivan and Wagner, 10/10)

The Senate on Wednesday defeated a Democratic measure to overrule President Trump’s expansion of non-ObamaCare insurance plans as Democrats seek to highlight health care ahead of the midterm elections. The Democratic measure would have overruled Trump’s expansion of short-term health insurance plans, which do not have to cover people with pre-existing conditions or cover a range of health services like mental health or prescription drugs. (Sullivan, 10/10)

Governor Charlie Baker said Wednesday he will vote against a ballot question that would limit the number of patients assigned to hospital nurses at one time. He cited an independent state watchdog agency’s report that determined the measure could cost the Massachusetts health care system more than $900 million a year if voters pass it in November. (Miller, 10/10)

A new poll suggests that support for a ballot question to regulate nurse staffing is waning, with a majority of voters surveyed last week saying they plan to vote against the measure on Election Day. Fifty-one percent of likely voters said they opposed the ballot question, while 43 percent supported it, according to the new UMass Lowell/Boston Globe poll. (Dayal McCluskey, 10/10)

The first car arrived around 3:30 a.m., more than six hours before the weekly “help center” opened at a local church. David Brooks, a 72-year-old retired General Motors laborer, was in the second car in the queue, and passed the time by sleeping in the back seat of his refurbished 1997 Chevy Santa Fe, as has become his Thursday routine since 2014 — the last time his Flint community trusted its water. (Herndon, 10/11)

Health care has emerged as the most contentious issue in the Minnesota's governor's race, as both candidates grapple with the bedeviling details of a system that is worrying to patients and phenomenally expensive to taxpayers. Republican nominee Jeff Johnson and U.S. Rep. Tim Walz both say that all Minnesotans — even those with pre-existing conditions — should have access to affordable health care. (Coolican and Howatt, 10/10)

Kaiser Health News: Will Maine Voters Decide To Make Aging In Place Affordable?
As Election Day draws near, a ballot initiative in Maine to provide universal home care is shining a spotlight on the inadequacies of the nation’s long-term care system. The essential problem: Although most older adults want to live at home when their health starts to decline or they become frail, programs that help them do so are narrow in scope, fragmented and poorly funded. (Graham, 10/11)

In the latest sign of insurers’ improved fortunes in the Affordable Care Act business, Centene Corp. will start selling ACA plans in four new states next year and add new counties in six others. The announcement by Centene, which said it is already the largest enroller of ACA-plan customers, comes amid growing evidence that the health-law markets are steadying after years of turmoil, despite continued regulatory changes and a major legal challenge. (Wilde Mathews, 10/10)

In other health law news —

Consumers who buy health insurance on Illinois’ Obamacare exchange for next year will see slightly lower prices, on average, for the most popular plans — but it’s unclear whether the decline in premiums will be enough to keep people buying them. Starting next year, consumers no longer will face penalties for not buying insurance. They also will have new options, including the ability to use short-term plans, purchased outside the exchange, for a longer period of time. Short-term plans are often cheaper than exchange plans though they may not offer as much coverage. (Schencker, 10/10)

A proposed rule issued by the Trump administration Wednesday would penalize legal immigrants for using government benefits like Medicaid, alarming a wide range of healthcare and public health organizations. Leaders of many healthcare organizations, including the American Hospital Association, America's Essential Hospitals, the American Academy of Family Physicians, and the American Academy of Pediatrics, warn that the proposed rule would hurt public health efforts and reduce their ability to serve millions of low-income children and families. They have joined a broad coalition of advocacy groups seeking to block the rule. (Meyer, 10/10)

A coalition of 50 House Democrats introduced a bill on Tuesday that would prevent any federal funds from being used to implement a proposed Trump administration rule that would make it harder for legal immigrants who receive public assistance to obtain permanent U.S. residence. The rule traces back to 19th century legislation that bars immigrants into the U.S. who are so poor that they might become a "public charge" and hence a drain on government resources. The rule has been reinterpreted many times since. (DeChalus, 10/10)

And in other news —

Caring for Miami’s uninsured residents is hard enough for Dr. Fred Anderson without his also having to worry about placing immigrant patients in jeopardy of being separated from their families and losing their access to free and low-cost healthcare. But with the Trump administration’s posting of a proposed rule Wednesday that would deny citizenship to immigrants who use certain public benefits, such as food stamps, housing assistance and Medicaid, Anderson said it has become much more difficult for him to do his job. (Chang, 10/10)

Senate Judiciary Committee Chairman Chuck Grassley asked the Federal Trade Commission to investigate whether contracts between insurers and hospital systems are limiting competition and pushing up health-care costs. The letter, sent Wednesday by the Iowa Republican, cited a recent article in The Wall Street Journal that documented secret contract terms that some hospital systems use to protect their business and block efforts to curb costs. Those provisions can require health plans include costly hospital systems and prohibit steering patients toward less-expensive rivals. The contracts can also add extra fees and prevent exclusion of doctors and hospitals based on quality or cost. (Wilde Mathews, 10/10)

Citing a September report from the Wall Street Journal, Grassley urged FTC Chair Joseph Simons to give the agency's perspective on whether secretive inter-industry ties are exacerbating rising healthcare costs. In 2016, healthcare accounted for nearly one-fifth of the U.S. gross domestic product, or about $3.3 trillion. "Spending is projected to grow at an average rate of 5.5% per year and reach $5.7 trillion by 2026," Grassley wrote. "The last thing American patients and consumers need at this time is a healthcare system that permits or encourages anti-competitive agreements that hinder access to lower cost care." (Luthi,10/10)

Hurricane Michael could push this season’s toxic red tide inland, exposing more people to the dangerous health effects of a record algae bloom that has bedeviled much of Florida’s coast. The hurricane is expected to generate a storm surge as great as 14 feet along parts of the Florida Panhandle, where it made landfall early Wednesday afternoon. That part of the coast that has seen some of the worst concentrations this year of red tide, a variety of algae that kills fish and releases toxins that cause respiratory symptoms in humans similar to tear gas. (Flavelle, 10/10)

For the second time in a month, Georgia health officials are preparing to assist people affected by a major hurricane. But Hurricane Michael, which was pounding the Florida Panhandle on Wednesday, threatens to inflict broader damage in Georgia than did Hurricane Florence, which hit mainly the Carolinas a month ago. (Miller and Dyer, 10/10)

There's never a good time for a hurricane. But if you're a healthcare provider, October is a particularly bad time. October marks the beginning of the fourth quarter for companies whose fiscal years run from Jan. 1 through Dec. 31. It's typically a good quarter financially because many patients have met their health insurance deductibles and flock to providers for elective procedures they wouldn't have gotten earlier in the year. (Bannow, 10/10)

In Philadelphia, a battle between local officials and the Trump administration is heating up. In defiance of threats from the Justice Department, public health advocates in Philadelphia have launched a nonprofit to run a facility to allow people to use illegal drugs under medical supervision. It is the most concrete step yet the city has taken toward eventually opening a so-called supervised injection site. (Allyn, 10/10)

In other news on the crisis —

The number of opioid-overdose deaths in St. Louis and surrounding counties continued to rise in 2017, although the increase wasn’t as steep as in previous years. There were 760 opioid-related fatalities last year in St. Louis, St. Louis County and eight surrounding counties, a 7 percent increase from 2016, according to the St. Louis-based National Council on Alcoholism and Drug Dependence. (Fentem, 10/10)

Bayer AG's Monsanto unit received a tentative ruling for a new trial on the $250 million in punitive damages awarded by a jury to a groundskeeper who alleged the company's glyphosate-based weed killers, including Roundup, caused his cancer. According to a Wednesday court filing in San Francisco's Superior Court of California, Judge Suzanne Bolanos was considering whether to grant the company's motion for a new trial on the punitive damages. (Christie and Burger, 10/10)

If finalized, Judge Suzanne Ramos Bolanos’s ruling would grant a motion by Bayer arguing that sum wasn’t justified and that the evidence didn’t prove the company intended to harm the plaintiff. It isn’t clear when the judge may finalize the ruling, issued ahead of a court hearing Wednesday. (Bunge, 10/10)

The youngster's mysterious symptoms stumped every expert his parents consulted: No diagnosis explained why he couldn't sit up on his own, or why he'd frequently choke, or his neurologic and intestinal abnormalities. Then they turned to a new national network that aims to diagnose the rarest of rare diseases — and learned Will Kilquist is the only person known in the world, so far, to harbor one particular genetic mutation that triggered all those health problems. (Neergaard, 10/10)

A national network of “disease detectives” has cracked the complicated medical mysteries of more than 130 patients with rare, previously unidentified diseases, though the bulk of the cases that come to them remain unsolved, according to an analysis of the network released Wednesday. The Undiagnosed Diseases Network — which now has 12 clinics nationwide, including one at Stanford — has a solve rate of about 35 percent, according to the analysis, published in the New England Journal of Medicine. (Allday, 10/10)

As ketamine clinics pop up across the U.S. to offer experimental infusions for depression, anxiety, and a slew of other conditions, training programs to teach providers how to run these businesses have also started to appear. They promise to teach everyone from anesthesiologists to advanced practice nurses the ins and outs of ketamine, which has been used for decades as an anesthetic but is still under study as a therapy for psychiatric disorders. (Thielking, 10/11)

The top ranking Democrat on the Senate health committee has “a number of concerns” with how the Food and Drug Administration might regulate medical software such as smartphone apps. “It is essential that changes to FDA’s regulatory framework are done in compliance with the current statutory framework and do not compromise public safety,” the senators wrote in a letter to the FDA Wednesday. (Swetlitz, 10/10)

If you are one of the 5.7 million Americans who ends up in the intensive care unit each year, you are at high risk of developing long-term mental effects like dementia and confusion. These mental problems can be as pronounced as those experienced by people with Alzheimer's disease or a traumatic brain injury and many patients never fully recover. But research shows you are less likely to suffer those effects if the doctors and nurses follow a procedure that's gaining ground in ICUs nationwide. (Harris, 10/10)

Mental disorders are estimated to cost the global community nearly $2.5 trillion each year — and those costs are increasing.Unlike costly physical illnesses like cancer, where expenses are largely hospital-based, mental health costs are often indirect, such as not being able to work. (Samuelson, 10/10)

New long-term data on Genentech’s groundbreaking drug for multiple sclerosis, the first approved for the most aggressive form of the condition, shows it has continued to work — and that patients who started the drug earlier got the most benefit. Genentech will be presenting the data, which covers years’ worth of open-label extension studies of the drug, at the 34th Congress of the European Committee for the Treatment and Research in Multiple Sclerosis in Berlin, which begins Wednesday. (Sheridan, 10/10)

The human population has reached 7.6 billion and could number 9 billion or 10 billion by midcentury. All those people will need to eat. A sobering report published Wednesday in the journal Nature argues that a sustainable food system that doesn’t ravage the environment is going to require dramatic reforms, including a radical change in dietary habits. To be specific: Cheeseburgers are out, and fruits and veggies are in. (Achenbach, 10/10)

Researchers at UC San Francisco have unveiled the largest searchable database of immunology data, gathered from 10,000 people of various ages, ethnicity, and backgrounds. It could lead to more effective treatments for a wide range of immune disorders. (Ahmed, 10/10)

In the early stages of a fetus’s development in the womb, two embryological structures move to either side of the spine, just below the ribs, and form a pair of bean-shaped organs that will be the kidneys. But in extremely rare cases, the two structures fuse in the middle, forming one kidney. And instead of moving up toward the ribs, it sinks to the pelvic area. Its odd, disc-like shape has given rise to a buffet of food names. Scientists call it a pancake kidney because it’s flat. It’s also called a cake kidney, a doughnut kidney, a shield kidney and a lump kidney. (Phillips, 10/10)

Months after appointing its first minister for loneliness, Britain named a minister for suicide prevention as part of a new push to tackle mental health issues. Prime Minister Theresa May on Wednesday announced the appointment of the health minister Jackie Doyle-Price to the new role. She will lead government efforts to cut the number of suicides and overcome the stigma that prevents people with mental health problems from seeking help. (Yeginsu, 10/10)

Health authorities in the United States said this week that they were investigating an unusual spike in cases of a rare condition that causes limb paralysis and severe muscle weakness in children.Since mid-September, six cases of the condition, acute flaccid myelitis, in children under 10 years old have been reported to the Minnesota Department of Health, the agency said. Another two possible cases are pending confirmation, officials said. (Hauser, 10/10)

State public health officials Wednesday imposed new conditions on the planned merger of Beth Israel Deaconess Medical Center and Lahey Health aimed at requiring the hospitals to contain costs and maintain access to low-income patients. Officials said the conditions were necessary after the state Health Policy Commission reported in September that the transaction could raise spending significantly — at least $128.4 million to $170.8 million per year — by allowing the merging hospitals to charge more for their services. (Dayal McCluskey, 10/10)

The merger of Beth Israel Deaconess Medical Center and Lahey Health would create the state's second health care giant, almost on a par with Partners HealthCare. The council gave the merger a green light but included conditions aimed at keeping costs down and protecting health care access for lower-income patients. (Goldberg, 10/10)

One person has died of Legionnaires’ disease in a cluster of 16 cases in the Manhattan neighborhood of Washington Heights, New York City health officials confirmed on Wednesday. The city’s Department of Health and Mental Hygiene said in a phone call with reporters on Wednesday that seven people remain hospitalized due to the outbreak, seven have been discharged from the hospital and one person was seen on an outpatient basis. Health officials have said that the ages of those stricken range from 40 to over 80 years old. (West, 10/10)

Ohio’s 91 domestic-violence deaths over the past year provide case for believing survivors, group says. Though statewide figures decreased slightly from the prior year, Franklin County’s numbers climbed to 16, up from 11 in 2016-17. (Price, 10/10)

Kansas City and St. Louis have some of the worst-rated nursing homes in the country, while Topeka, Overland Park and Wichita have some of the best. That’s according to rankings published by FamilyAssets, a New York-based company that offers assessments and planning for people seeking home health care services. The rankings are based on hundreds of thousands of customer reviews across the web, according to FamilyAssets. The company looked at the prevalence of “bad” reviews (1 or 2 stars) and “good” ones (4 or 5 stars) and ignored average ones. (Margolies, 10/10)

The on-again, off-again access for Sacramento Medi-Cal patients to UC Davis Medical Center and its affiliated clinics is open once more for some patients, in light of a new agreement between UC Davis Health and the insurer Health Net. The health system and the insurer struck a deal that will allow as many as 5,000 people enrolled in Health Net’s Medi-Cal plan in Sacramento County to receive primary care and other medical services through UC Davis Health, according to an announcement by the university. The deal comes about three years after UC Davis and Health Net canceled a previous primary care contract covering Medi-Cal enrollees. (Waters, 10/10)

Kaiser Permanente Colorado, the largest insurer in the state, says skyrocketing hospital prices are the main reason it has recorded losses of $65 million in the last three years, forcing a top-to-bottom review of operations that will herald a more confrontational approach with hospitals. Ron Vance, Kaiser’s new president of its Colorado operations, did not rule out filing antitrust lawsuits against those Colorado hospitals he contends have “refused to enter into reasonable contracts” with Kaiser. (Osher, 10/10)

Federal agents seized items from the Hmong Village in St. Paul on Wednesday as part of an investigation into medications sold at the market. The market, near Lake Phalen on the city's east side, features individual vendors selling everything from dresses to food. (Yuen, 10/10)

City Council could approve legislation Monday (Oct. 15) raising the minimum age to purchase tobacco, "e-cigs" and other nicotine "vape" products from 18 to 21. If passed, it would not take effect until January 2019. (Jewell, 10/10)

The Food and Drug Administration has declared e-cigarette use by young people an "epidemic" and Tempe high school student Brach Drew agrees. ... Drew and fellow members of his school's anti-vape committee recently helped create a new Tempe Union High School District campaign called "Vanish the Vape," which emphasizes that the use of e-cigarettes results in school suspension in addition to health consequences. (Innes, 10/10)

A Louisiana-based home health and hospice company says it’s buying a nationwide hospice company based in New Jersey, and will become the nation’s third-largest hospice provider. Amedisys, Inc. of Baton Rouge said Wednesday that it is buying Compassionate Care Hospice of Parsippany, New Jersey, for $340 million. (10/10)

Three women filed a federal lawsuit against Huntington Memorial Hospital and one of its longest-serving obstetricians Wednesday, alleging that the physician subjected them to unwanted sexual remarks during exams in the 1990s. The suit in U.S. District Court in Los Angeles comes a week after The Times reported that Dr. Patrick Sutton had been accused of sexual misconduct by five other patients. Sutton, 64, settled four of those accusations without admitting any sexual wrongdoing, and he has said through a lawyer that he plans to contest the fifth pending complaint. (Ryan and Hamilton, 10/10)

As soon as next year, a 40-foot-long, half-million-dollar vehicle customized with examination rooms and a reception area could be parking itself in city neighborhoods that otherwise are devoid of mental health professionals, social workers and child psychologists. The proposal emerged Wednesday at a monthly meeting of clinics, nonprofits, universities, therapists and social welfare agencies, which collectively want to tackle the epidemic of psychological trauma that ravages Milwaukee and cities like it. (Schmid, 10/10)

Outreach workers went tent to tent early Wednesday with offers of homeless services as the city launched a crackdown on encampments around a new shelter in downtown Los Angeles’ El Pueblo historic district. The city plans five-day-a-week cleanups and increased police presence in “special enforcement zones” around a network of 15 shelters it hopes to build by the middle of next year. (Holland, 10/10)

Concerned about the side effects of prescription medication, entrepreneur Angela Ardolino took a holistic approach to treating her nasty case of rheumatoid arthritis. She tried using CDB oil. When it worked for her, she reasoned that it would have similar benefits for her senior schnauzer, Odie, who also suffered from arthritis - but couldn’t find any natural products for pets in the United States. So she set out to make her own. (Baldwin, 10/10)

President Trump lies so frequently that, as the cliche goes, if he says the sky is blue, it’s best to look out your window and confirm that fact. Glenn Kessler of The Post’s Fact Checker says Trump has averaged 8.3 lies per day since taking office. So it’s saying something that, even by Trumpian standards, the president’s op-ed in Wednesday’s USA Today attacking Medicare-for-all and claiming he’ll defend Medicare from the Democrats sets a new standard for mendacity. As Kessler himself points out, Trump’s op-ed is one where “almost every sentence contained a misleading statement or falsehood.” (Helaine Olen, 10/10)

President Donald Trump’s column attacking "Medicare for All" was filled with falsehoods to distract voters from the truth: He and his party are on a wildly unpopular mission to gut Medicare and protections for pre-existing conditions. This year, House Republicans proposed to cut Medicare spending by $537 billion over the next 10 years. For many years, they have proposed to radically privatize Medicare into a voucher system, shifting costs to beneficiaries. (10/10)

At his numerous campaign rallies, President Trump frames the November midterm election in sweeping terms. The Democrats, he has said, want to erase the country’s borders and allow crime to flourish. If they take power, the country will “plunge … into gridlock, poverty and chaos.” What’s more, he claimed on Twitter last week, the fight over Brett M. Kavanaugh’s nomination to the Supreme Court was “having an incredible upward impact on voters.” Republicans not motivated by concerns about the apocalypse that would result from Democrats having slight majorities on Capitol Hill were instead motivated by the Democrats' efforts to block Kavanaugh’s confirmation. (Philip Bump, 10/10)

For political professionals, one of the most bizarre aspects of this bizarre era is the speed at which Vermont socialist Sen. Bernie Sanders has gone from near irrelevance as the Senate’s resident kook to the most influential policy maker in one of America’s two major political parties. Now comes the moment when Democrats who have largely adopted Sanders positions may have to explain them to voters. (James Freeman, 10/10)

In less than four weeks, Americans will go to the polls and choose who will lead us. This time, it’s not hyperbole to say that this is the most important election of our lifetimes. For the past two years, Republicans have had total control over the House, the Senate and the White House. What do they have to show for their leadership? A tax scam that pads the pockets of millionaires and billionaires at the expense of the middle class. (Cheri Bustos, Hakeem Jeffries and David Cicilline, 10/11)

The most enduring legacy of the Affordable Care Act may be emerging now in midterm races across the country, and our health care system may never be the same.For the first time in our history, Americans are agreeing that even if you are sick you should be able to find private health insurance coverage you can afford. Not only do 81 percent of voters now think it should be illegal for insurance companies to deny coverage to people with pre-existing conditions, but both political parties have embraced this central tenet of Obamacare. (David Blumenthal, 10/10)

Well, this seems to make it official: The Trump administration only cares about vertical mergers in media. Or at the very least, it has no problem when it comes to these types of deals and health care. CVS Health Corp.’s $69 billion purchase of insurer Aetna Inc. — the fifth-largest health-care deal ever — got conditional approval from the Department of Justice on Wednesday. The DOJ only requires the already in-progress divestiture of Aetna’s Medicare drug plans in order to approve the deal. The decision comes less than a month after the approval of Cigna Corp.’s purchase of Express Scripts Holding Co., another so-called vertical deal that will join together an insurer and pharmacy benefit manager — not direct competitors, but both players in the health-care process. (Max Nisen, 10/10)

Scrolling down the list of my primary care patients, I wondered who might be affected. A pregnant woman from Cameroon. An elderly woman with brittle bones from the Dominican Republic. A man with cancer from Ecuador. The Trump administration’s proposal to deny green card status to people who use services like food assistance and Medicaid threaten several of my patients with a harrowing choice: their health, or their immigration status. (Douglas Jacobs, 10/10)

The measured poverty rate has remained virtually unchanged only because the Census Bureau doesn’t count most of the transfer payments created since the declaration of the War on Poverty. The bureau measures poverty using what it calls “money income,” which includes earned income and some transfer payments such as Social Security and unemployment insurance. But it excludes food stamps, Medicaid, the portion of Medicare going to low-income families, Children’s Health Insurance, the refundable portion of the earned-income tax credit, at least 87 other means-tested federal payments to individuals, and most means-tested state payments. If government counted these missing $1.5 trillion in annual transfer payments, the poverty rate would be less than 3%. (Phil Gramm and John F. Early, 10/10)

The United States is at a moment of reckoning when it comes to women’s lives and safety. The avalanche of outrage we’re witnessing — brought on by #MeToo moments, stubborn gender pay inequities and unconscionable maternal death rates — has shaken us from our slumber. What matters now is what we do about these systemic failures.Plenty of issues divide us. But prioritizing the health of women, mothers and babies should not be among them. Politics has no place in the maternity ward or the neonatal intensive care unit. (Stacey D. Stewart, 10/11)

I have stopped telling doctors that I am in pain. I have stopped telling doctors that I spend days each month so dizzy I have to sit down, that I miss work because of nausea. I have stopped telling doctors that my birth control is making my day-to-day life hellish. Six years ago — three days after my Paragard IUD was inserted — my knees slammed into the linoleum floor of my kitchen as I fell to the ground in pain, screaming. I got myself to the emergency room, where nurses gave me morphine, Percocet, and nonsteroidal anti-inflammatories. It was not enough to ease my pain. When I told the nurses, they refused to increase my dosage. (Katie Simon, 10/11)

The Biden Cancer Initiative recently hosted a meeting in Washington, D.C., pursuant to former vice president Joe Biden’s campaign to create a better cancer research and care system. As the conference came to a close, I marked the 10th anniversary of my youngest brother’s death from cancer, which came only the month after his first grandchild was born. (Edward Hudgins, 10/10)

Keeping the American people safe is government’s most important duty. After all, we can’t have a strong economy, an effective education system or a functioning democracy if it is not safe to leave your home or walk the streets of your neighborhood. In recent years, this obligation has taken on even greater importance. From 2014 to 2016, violent crime increased by more than 8 percent nationwide, and murders spiked by 21 percent. The increase in the murder rate in 2015 was the largest one-year increase since 1968. (Rod Rosenstein, 10/8)

It was one of those findings that brings on thoughts of the future — both scary and exciting: Scientists showed they could use brain imaging to sort out experienced surgeons from novice students. There’s been a history of extraordinary, often dubious, claims involving brain-imaging studies — everything from finding the seat of love to religion to attachment to one’s iPhone — but this claim looks plausible and potentially useful. Studying expertise this way became possible once there were imaging devices portable enough to monitor peoples’ brain activity while engaged in complex tasks. And so a team of doctors and engineers set up an experiment to monitor the brains of medical students and doctors performing in a simulator developed to test surgical skills. (Faye Flam, 10/10)

The public’s waning faith in science is only partly a reflection of our social and political times. Yes, there are the willfully ignorant people who refuse to admit that climate change is real and caused in large part by human activity, because that would mean giving up gas guzzlers and other polluting comforts of life. Others get their woeful information about vaccines from social media instead of finding out the facts about the billions of lives that have been saved by immunization – half a billion from smallpox alone, compared with the last century before its eradication. (Karin Klein, 10/10)