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Morning Briefing

Summaries of health policy coverage from major news organizations

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Tuesday, Sep 19 2023

麻豆女优 Health News Original Stories 3

  • With Its Two Doctors Planning to Retire, an Alabama Town Patches Together Health Care Options
  • Save Billions or Stick With Humira? Drug Brokers Steer Americans to the Costly Choice
  • Florida Gov. Ron DeSantis Injects Presidential Politics Into the Covid Vaccine Debate
  • Political Cartoon: 'Hang Ten Healthcare'

Note To Readers

After Roe V. Wade 1

  • Abortions Restart In Wisconsin 鈥 And Appointments Are Fully Booked

Medicare 1

  • Lobbying Push Targets CMS Plan To Cut Physician Pay For Some Providers

Vaccines and Covid Treatments 1

  • Despite Warnings, New Covid Shot Prices Are Surprising Some

Covid-19 1

  • Covid BA.2.86 Spreads Across States, But Outnumbered By Other Variants

Health Industry 1

  • 'Historic' Health Care Worker Strike At Kaiser Permanente Looms After Vote

Capitol Watch 1

  • House GOP's Stopgap Funding Plan Opposed By Own Members, Senate Dems

Pharmaceuticals 1

  • Med Dosage Errors Among Young People With ADHD Have Soared: Study

Opioid Crisis 1

  • Drugmaker Mallinckrodt May Be Considering Exiting Opioid Business

Public Health 1

  • Research Shows Obesity As A Cardiac Death Factor Has Been Rising

State Watch 1

  • Judge Blocks California Youth Online Safety Law On Constitutional Grounds

Editorials And Opinions 1

  • Viewpoints: Self-Care Doesn't Appear To Be Working; Alabama Will Try Cruel New Execution Method

From 麻豆女优 Health News - Latest Stories:

麻豆女优 Health News Original Stories

With Its Two Doctors Planning to Retire, an Alabama Town Patches Together Health Care Options

LaFayette and other rural areas of the country tend to have high rates of health problems but not enough doctors. Many are adapting by investing in nontraditional prevention and treatment options. ( Arielle Zionts , 9/19 )

Save Billions or Stick With Humira? Drug Brokers Steer Americans to the Costly Choice

Thousands of patients with autoimmune diseases who rely on Humira, with a list price of $6,600 a month, could get financial relief from new low-cost rivals. So far, the pharmacy benefit managers that control drug prices in America have not delivered on those savings. ( Arthur Allen , 9/19 )

Florida Gov. Ron DeSantis Injects Presidential Politics Into the Covid Vaccine Debate

Losing ground in the Republican primary, Gov. Ron DeSantis of Florida and his top medical advisers dismissed the recent federal recommendation that almost everyone get an updated covid shot. ( Phil Galewitz and Daniel Chang , 9/18 )

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Political Cartoon: 'Hang Ten Healthcare'

麻豆女优 Health News provides a fresh take on health policy developments with "Political Cartoon: 'Hang Ten Healthcare'" by Danny Shanahan.

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Note To Readers

麻豆女优 Health News is on TikTok! Watch our videos and follow along as we break down health care headlines and policy.

Summaries Of The News:

After Roe V. Wade

Abortions Restart In Wisconsin 鈥 And Appointments Are Fully Booked

The state halted abortions 15 months ago when Roe v. Wade was struck down. Planned Parenthood offered abortions Monday at clinics in Madison and Milwaukee; every appointment was filled within 24 hours of announcing the news, AP reported. Other abortion news is from Florida and Indiana.

Planned Parenthood resumed offering abortion services in Wisconsin on Monday after halting them for more than a year since the U.S. Supreme Court overturned Roe v. Wade. Providers across the state stopped offering abortions following the June 2022 decision, fearing enforcement of an 1849 state law that appears to ban the procedure but had previously been nullified by the 1973 Roe ruling. A judge ruled last month that the 144-year-old law doesn鈥檛 apply to medical abortions. (Venhuizen, 9/18)

Pointing to recent comments made by Gov. Ron DeSantis, Senate Minority Leader Lauren Book on Friday filed a bill aimed at preventing women from being charged with crimes after obtaining abortions. A law signed by DeSantis in April would prohibit abortions after six weeks of pregnancy. The law says "any person who willfully performs or actively participates in a termination of pregnancy" in violation of the law would face felony charges. (9/18)

A complaint filed Monday alleges that Indiana Attorney General Todd Rokita violated professional conduct rules in statements he made about a doctor who performed an abortion on a 10-year-old rape victim last year. The Indiana Supreme Court鈥檚 disciplinary commission references an interview Rokita gave in July 2022 about Dr. Caitlin Bernard on a Fox News show, The Indianapolis Star reported. (9/18)

For those women who are considering terminating their pregnancies, a new chatbot called Charley aims to help them start the process of getting an abortion. The chatbot, which launched on Sept. 12, is available on Charley鈥檚 website, greeting visitors with the message, "Need an abortion? Let鈥檚 get started." On its website, Charley is described as "designed by abortion experts, made for abortion seekers." (Rudy, 9/19)

In other reproductive health news 鈥

A randomized study of 40,000 women with extremely dense breast tissue found that those who had mammograms followed by magnetic resonance imaging (MRI) scans had more tumors detected than with mammography alone. The research, published in The New England Journal of Medicine, also found that supplemental MRI screening was much more effective at detecting so-called interval cancers, growths that would become symptomatic before the next routine screening. (Cohen and James, 9/19)

The artificial womb, a device aiming to save infants born way too soon, is inching closer to being tested in humans. The technology is close enough to reality that the Food and Drug Administration has decided to convene a two-day panel starting Tuesday to discuss how to best evaluate safety and effectiveness, as well as the ethical quandaries in running clinical trials. The second day will be closed to the public to shield trade secrets. (Lawrence, 9/19)

Medicare

Lobbying Push Targets CMS Plan To Cut Physician Pay For Some Providers

CMS faces pressure from some health care providers to revise its proposed rule that would reduce Medicare physician fees for some specialists in order to boost payments for primary care physicians. Other Medicare news relates to savings programs, drug price negotiations, scams, and more.

Providers want the Centers for Medicare and Medicaid Services to reconsider cutting physician pay and avoid financial repercussions that could force them to scale back care. Comments healthcare industry groups wrote in response to the Medicare physician fee schedule proposed rule for 2024, which CMS issued in July, object to the agency's plan to reduce doctor pay 1.25% next year. (Berryman, 9/18)

The Centers for Medicare and Medicaid Services wants聽to make it easier for millions of older adults and people with disabilities to attain Medicare coverage. The agency issued a final rule Monday that aims to streamline the enrollment and renewal process for Medicare Savings Programs by reducing administrative burdens on聽states and eligible individuals.聽(Berryman, 9/18)

Florida has more people on Medicare than any other state except one. Almost one in four people who call Florida home rely on the federal government health insurance plan. Thanks to the Inflation Reduction Act, Medicare will now be able to bargain over prices for the first 10 drugs covered by the plan. Those drugs include Entresto for heart failure, Enbrel for arthritis, Eliquis and Xarelto to help prevent blood clots, and Jardiance, Januvia, and Farxiga for Type 2 diabetes. (Pinos, 9/18)

KSL Investigators have been hearing from Utahns that COVID-19 test kits are showing up in their mailboxes, out-of-the-blue. They didn鈥檛 want them. They didn鈥檛 order them. But these test kits have been showing up regardless. Turns out, they are part of a scam that first targeted Medicare and may now be targeting you. (Gephardt and Schrage, 9/18)

Seniors are becoming increasingly overburdened by marketing efforts from private Medicare plans, and low-income beneficiaries are twice as likely to file complaints regarding fraudulent phone calls compared to high-income counterparts, according to a study from The Commonwealth Fund. (Tong, 9/19)

Vaccines and Covid Treatments

Despite Warnings, New Covid Shot Prices Are Surprising Some

Covid vaccines were free until the pandemic public health emergency ended. Even though some pharmacies have signs for "free" shots, insurers and patients are being billed for them. Meanwhile, Pfizer expects 1 in 4 in the U.S. will get shots this year.

When Glen Cote of Acton drove to his appointment at CVS for the new COVID-19 vaccine, he was shocked to receive a text on his phone minutes before his appointment, letting him know that the vaccine would cost $190.99. "Nightmare is the first word that comes to mind," he explained to WBZ-TV. Cote is covered by MassHealth, the state's program for Medicaid. (Rex, 9/19)

More on the vaccine rollout 鈥

Pfizer expects 24% of the U.S. population, or about 82 million people, to receive COVID-19 shots this year, CFO David Denton said at a conference on Monday, reiterating the vaccine maker's estimates from earlier this year. (9/18)

聽Every year since 2010, the US Centers for Disease Control and Prevention has recommended that everyone in the country ages 6 months and older receive a flu vaccine. But that has resulted in just fewer than half of all adults and about 58% of kids getting the shot each year, according to CDC data. (Tirrell, 9/19)

Vivek Ramaswamy said he regrets taking the two doses of the Covid-19 vaccine he鈥檚 received. He also said at a recent campaign stop that he and his wife, surgeon Apoorva Ramaswamy, 鈥渄isagree on things sometimes,鈥 and that鈥檚 OK. One of those things is their feelings about the Covid-19 vaccine, Apoorva Ramaswamy told NBC News in an interview. Dr. Ramaswamy, who is a laryngologist at Ohio State University, said she has no regrets about taking the jabs to protect against Covid, putting her decision in terms of her responsibility to the patients she sees.聽(Tabet and Koretski, 9/18)

麻豆女优 Health News: Florida Gov. Ron DeSantis Injects Presidential Politics Into The Covid Vaccine Debate聽

As Americans consider whether to take advice from federal health officials and get an updated covid vaccine, Florida Gov. Ron DeSantis is drumming the message that ignited his national political career: Ignore what the federal government tells you about covid-19. Last week 鈥 as polling showed him running a distant second to Donald Trump for the Republican presidential nomination 鈥 DeSantis convened a virtual roundtable featuring a panel of covid vaccine skeptics. Their mission: to swat away the FDA鈥檚 findings that the new shots are safe and effective for those 6 months and older. (Galewitz and Chang, 9/18)

Dr. Peter Hotez is no stranger to controversy. A pediatric infectious disease specialist at Baylor College of Medicine in Houston, Hotez began taking on the anti-vaccine movement when his now-adult daughter was a child. Activists blamed her autism and that of others on vaccines. Hotez, who develops vaccines for neglected tropical diseases, didn't buy it. He took them on directly in his 2020 book "Vaccines Did Not Cause Rachel's Autism: My Journey as a Vaccine Scientist, Pediatrician, and Autism Dad." (Weintraub, 9/19)

In covid vaccine research 鈥

A new observational study from Canadian researchers reveals that COVID vaccination after long COVID was tied to fewer symptoms, increased well-being, and less inflammation. The study, based on participants in Montreal, is published in the International Journal of Infectious Diseases. Long COVID, or post-COVID condition (PCC), is a major emerging public health issue, as 10% to 30% of COVID-19 patients who are not hospitalized, and 50% to 70% hospitalized patients, experience an array of symptoms lasting more than 12 weeks after acute infection. (Soucheray, 9/18)

A new study in JAMA estimates that the original single-strain Pfizer/BioNTech COVID-19 vaccine conferred 33% protection against COVID-19 emergency department (ED) and urgent care (UC) visits for children younger than 5 years during Omicron variant predominance. Researchers from Kaiser Permanente and Pfizer conducted a test-negative case-control study among 24,261 patients aged 6 months to 4 years diagnosed as having an acute respiratory infection (ACI) and tested for SARS-CoV-2 at Kaiser Permanente Southern California from July 2022 to May 2023. Of all children, 48% were seen in the ED, 29% visited the UC, and 23% were outpatients. (Van Beusekom, 9/18)

Covid-19

Covid BA.2.86 Spreads Across States, But Outnumbered By Other Variants

The variant is a "highly mutated" version of covid and has now been found in 10 states. It remains a rare source of covid cases, though, being outnumbered by other dominant variants. Meanwhile, the CDC has updated its map showing where covid is spreading through the U.S. population.

People across at least 10 states have now been infected by BA.2.86, a highly mutated variant of the virus that causes COVID-19 that authorities have been closely tracking. According to data tallied from the global virus database GISAID, labs have reported finding BA.2.86 in samples from Colorado, Maryland, Michigan, New York, Ohio, Oregon, Pennsylvania, Texas, Virginia and Washington. Estimates suggest BA.2.86 still remains a small fraction of new COVID-19 cases nationwide.聽(Tin, 9/18)

Map data updated by the CDC on Monday reveals that the percentage of positive COVID tests dropped slightly overall across the nation for the week ending September 9, falling from 14.4 percent to 14.3 percent. The data is based on the results of 50,579 nucleic acid amplification tests, which are different than the antigen tests typical sold for home testing. Positivity rates were significantly higher than average in two out of 10 regions that the CDC uses to group states. In region six鈥攃onsisting of Texas, Arkansas, Louisiana, New Mexico and Oklahoma鈥攖he positivity rate was 17.3 percent. In region seven鈥攃overing Iowa, Kansas, Missouri and Nebraska鈥16.4 percent of tests were coming back positive. (Slisco, 9/18)

Reported numbers of new COVID-19 cases in Florida decreased during the past two weeks after steadily increasing this summer, according to Florida Department of Health data released Friday. (9/18)

The Centers for Disease Control and Prevention (CDC) today noted that COVID-19 hospitalizations are up 8.7% and deaths up 4.5% in the most recent reporting week, though numbers are still quite low. Roughly 18,900 Americans were hospitalized for the virus in the first week of September, the CDC said, a number not seen since mid-March. Parts of Montana, Texas, Alabama, and Florida have seen significant increases in virus activity, but the CDC notes that fewer jurisdictions are reporting data in regular intervals. (Soucheray, 9/15)

Also 鈥

Despite the recent warning of a new variant from the US Centers for Disease Control and Prevention, cases of COVID-19 are noticeably weaker than previous waves, a top NYC doctor has said. 鈥淛ust about everyone who I鈥檝e seen has had really mild symptoms,鈥 Dr. Erick Eiting, who is vice chair of operations for emergency medicine at聽Mount聽Sinai聽Downtown, told NBC News. The outlet also reported that the virus has become so light it is hard to tell apart from allergies or just a common cold.鈥 The only way that we knew that it was COVID was because we happened to be testing them,鈥 Eiting added, noting that current symptoms mostly include congestion, some sneezing and a mild sore throat. (Mitchell, 9/18)

Some people are speculating that rapid tests have lost their ability to detect some of the newer coronavirus variants, but experts say it鈥檚 not the case. (Goodman, 9/18)

Claim: 鈥淭he CDC has just quietly admitted that over 99% of reported 鈥楥ovid deaths' were faked in order to scare the public into taking the experimental Covid jab,鈥 the post reads. 鈥... According to the CDC's Covid dashboard, just 1.7% of the 324 'Covid deaths' registered in the week ending August 19 had Covid as the primary cause of death." ... False: The post misrepresents the data on the Centers for Disease Control and Prevention website. The source actually said that COVID-19 deaths accounted for just 1.7% of all deaths from all causes in the U.S. that week. It has since been updated to 1.6%. (Trela, 9/18)

Variant-driven COVID-19 cases are increasing and a few U.S. schools and businesses have temporarily reinstated mask mandates to mitigate the virus鈥 spread. Now, some are sounding the alarm that more severe restrictions are on the horizon. "They鈥檙e gonna bring back draconian lockdowns. They鈥檙e gonna bring back the tortuous mask mandates in schools," one person said in an Aug. 21 TikTok video. "They鈥檙e gonna bring back the injection mandates. They鈥檙e gonna close down churches, they鈥檙e gonna close down small businesses." (Swann, 9/18)

Health Industry

'Historic' Health Care Worker Strike At Kaiser Permanente Looms After Vote

Maryland, Virginia, and Washington, D.C. Kaiser Permanente employees voted to authorize a strike against unfair labor practices, after recent votes by 68,000 staff members in California, Colorado, Oregon, and Southwest Washington. Also in the news: hospital mergers, environmental sustainability, and more. (Note: 麻豆女优 Health News is not affiliated with Kaiser Permanente.)

The possibility of a historic health care worker strike inched closer to reality Monday after the union representing Kaiser Permanente employees in Maryland, Virginia and Washington, D.C., announced their members had voted last week to authorize a work stoppage to protest unfair labor practices if a labor agreement isn鈥檛 reached by Sept. 30. The vote, which concluded on Saturday, follows strike authorization votes by nearly 65,000 Kaiser employees in California, Colorado, Oregon and Southwest Washington in the past two weeks, the Coalition of Kaiser Permanente Unions said in a news release. (Roberts, 9/18)

In other health industry news 鈥

Comments to antitrust regulators lay bare Americans鈥 anger and disillusionment over consolidation鈥檚 effects on all sectors of the economy, but especially health care. A 24-year-old wrote that after his hometown hospital in Indiana merged with a bigger group, his mom, who worked there, found it harder to provide good care amid staff cuts and reduced support. An internal medicine doctor in Wisconsin said after his hospital merged, colleagues were fired, drug shortages got worse, and prices skyrocketed. (Bannow, 9/18)

Beginning Jan. 1, the voluntary program will certify hospitals that prioritize environmental sustainability as a strategic goal and allocate resources to reduce greenhouse gas emissions. The initiative comes as the Joint Commission overhauls its accreditation standards to alleviate administrative burdens on healthcare organizations while making space for new strategic priorities. (Hartnett, 9/18)

Since the federal government pushed the use of electronic health records in 2009, there has been a race among vendors to sell the software solutions to health systems. The cost of EHR installation varies by hospital and health system but it can be run more than a $1 billion for larger organizations. For example, Boston-based Mass General Brigham, formerly known as Partners Healthcare, and Rochester, Minnesota-based Mayo Clinic both reportedly spent more than $1 billion to install Epic Systems' product. (Perna, 9/18)

Employers girding themselves for an especially pricey health care benefits season this fall are pushing back harder in negotiations, armed with new price transparency data and emboldened by increased industry scrutiny. (Reed, 9/19)

Also 鈥

When she saw her daughter for the first time after a 2016 dental procedure, Courissa Clark said she couldn鈥檛 understand why her 4-year-old, Nevaeh Hall, was unresponsive. Earlier that day, Nevaeh had seizures while receiving dental work, according to court documents. Instead of seeking emergency medical services, the dentist, Bethaniel Jefferson, gave the child more sedatives to try to calm her down, documents allege. (Melnick, 9/19)

DocGo, a mobile health services company, appointed Lee Bienstock as CEO on Monday and replaced former CEO Anthony Capone, who resigned on Friday.聽Capone resigned after acknowledging his academic credentials were falsified. In an emailed statement, a DocGo spokesperson said Capone was stepping down for personal reasons. (Turner, 9/18)

麻豆女优 Health News: With Its Two Doctors Planning To Retire, An Alabama Town Patches Together Health Care Options聽

Charity Hodge had mixed feelings when she spotted a Facebook post announcing that her longtime primary care doctor was ready to retire after decades of serving their rural community. 鈥淚 was like, 鈥極h my gosh, no!鈥欌 Hodge recalled while sitting in an exam room on a July afternoon, waiting to see the physician, Terry Vester. 鈥淲ell, I鈥檓 happy for the retirement part, but that鈥檚 my favorite doctor, so I鈥檓 crying on the inside.鈥 (Zionts, 9/19)

Capitol Watch

House GOP's Stopgap Funding Plan Opposed By Own Members, Senate Dems

A Republican House bill to extend federal government funding for an additional 30 days past the Sept. 30 deadline faces stiff opposition from a handful of House conservatives. Even if it passed, Senate Democrats say they do not support such a measure.

Tensions in the House GOP over how to avoid 鈥 or not avoid 鈥 a potential government shutdown are coming to a boil, with frustrations spilling over into public jabs and airing of grievances without a clear path forward to fund the government past Sept. 30. 鈥淚t鈥檚 an unmitigated disaster right now on the majority side,鈥 Rep. Steve Womack (R-Ark.), an appropriator,聽said on MSNBC聽on Monday. 鈥淚鈥檓 fearful of what this leads to.鈥 Republicans are bitterly divided on a short-term stopgap bill that would fund the government through Oct. 31. The measure includes an 8 percent cut to everything but Defense and Veterans Affairs,聽along with the bulk of the House GOP鈥檚 border crackdown bill.聽(Brooks and Schnell, 9/18)

Democrats controlling the Senate have no interest in the 30-day continuing resolution House Republicans unveiled Sunday night, which cuts most domestic agencies by more than 8 percent and would impose a range of border-related restrictions that President Joe Biden has already threatened to veto.聽But the Senate itself is tied in knots over appropriations, with a $279 billion, three-bill fiscal 2024 spending package stymied by procedural objections to considering more than just the base bill for the Department of Veterans Affairs and military construction projects.聽(Quigley, 9/18)

A bill to increase health care price transparency was pulled from the House floor this week after some top Democrats signaled they would oppose the legislation. The bill, the "Lower Costs, More Transparency Act," was being brought up under a fast-track process that requires a two-thirds vote. Some key Democrats like Rep. Bobby Scott (D-Va.), the top Democrat on the Education and Workforce Committee, had signaled they would oppose the bill, meaning it could have lacked enough votes to pass under a suspension of the rules. (Wu, 9/18)

In other health news from Capitol Hill 鈥

Rep. Jennifer Wexton (D-Va.) announced on Monday that she will not seek reelection after receiving an updated, more serious diagnosis of progressive supranuclear palsy. Wexton revealed in April that she鈥檇 been diagnosed with Parkinson鈥檚 Disease, saying at the time that she hoped to continue serving 鈥渇or many years to come.鈥 But she sought additional testing after she had not been making the progress 鈥渢o manage my symptoms that I had hoped,鈥 Wexton, 55, said in a statement, leading to the new diagnosis of PSP, which she called 鈥渁 kind of Parkinson鈥檚 on steroids.鈥 The two conditions are often confused when first diagnosing a patient because they have similar symptoms. (Frazier, 9/18)

Rep. Adam Smith (D-Wash.) knew when he hit rock bottom. 鈥淚 woke up one morning in early April of 2016 and seriously considered the possibility that I might never be able to get out of bed,鈥 he opens his recent memoir, 鈥淟ost and Broken,鈥 which details the six years in which 鈥渃rippling anxiety鈥 and chronic pain dominated his life even as he bounced back and forth from the Capitol to northern Seattle, the district he has represented for nearly three decades. (Owermohle, 9/19)

Pharmaceuticals

Med Dosage Errors Among Young People With ADHD Have Soared: Study

The study warns that over the past two decades, errors involving ADHD medications rose by almost 300% in people under 20 鈥 mostly in cases of taking a medication twice. Separately, a study on MDMA as a treatment for PTSD could result in consideration for FDA approval by 2024.

A new study in the Journal of Pediatrics finds errors involving ADHD medications in kids have risen sharply over the past two decades. Researchers at Nationwide Children's Hospital in Ohio studied national poison data from 2000 through 2021 and found that errors involving ADHD medications increased by almost 300% in people under 20 during that period.聽Two-thirds of the cases occurred in kids ages 6 to 12. The most common error was accidentally taking or being given mediation twice, followed by taking someone else's medication or taking the wrong medication.聽(Marshall, 9/18)

In other pharmaceutical updates 鈥

A new study published last week suggests the psychedelic drug MDMA, also known as Ecstasy or Molly, can reduce symptoms of post-traumatic stress disorder, and some expect the treatment to be approved by 2024. The Multidisciplinary Association for Psychedelic Studies (MAPS), a non-profit research and educational organization that was formed in 1986 and focuses on the medical, legal and cultural contexts for how people can benefit from the "careful" uses of psychedelics and marijuana, sponsored the study. (Wehner, 9/18)

People taking the drug and similar medications will hit an inevitable, and necessary, plateau. Here鈥檚 why. (Blum, 9/18)

麻豆女优 Health News: Save Billions Or Stick With Humira? Drug Brokers Steer Americans To The Costly Choice聽

Tennessee last year spent $48 million on a single drug, Humira 鈥 about $62,000 for each of the 775 patients who were covered by its employee health insurance program and receiving the treatment. So when nine Humira knockoffs, known as biosimilars, hit the market for as little as $995 a month, the opportunity for savings appeared ample and immediate. But it isn鈥檛 here yet. Makers of biosimilars must still work within a health care system in which basic economics rarely seems to hold sway. (Allen, 9/19)

Opioid Crisis

Drugmaker Mallinckrodt May Be Considering Exiting Opioid Business

The pharmaceutical maker is one of the largest U.S. producers of prescription opioids, the Wall Street Journal reminds us, and it's in talks with its investors about selling a portion or all of its business units. Meanwhile, in San Francisco, fentanyl overdose deaths are rising again.

Pharmaceutical manufacturer Mallinckrodt, one of America鈥檚 largest producers of prescription opioids, is in talks with its major investors about selling some or all of the company鈥檚 business units, potentially leading to its exit from the opioid business, according to people familiar with the discussions. (Saeedy, 9/18)

More on the opioid crisis 鈥

The numbers underscore how San Francisco officials continue to struggle to address the devastation of fentanyl on the city鈥檚 streets聽鈥 a crisis that Health Director Dr. Grant Colfax called 鈥渄istressing.鈥 The last figures indicate people are dying from fentanyl overdoses at a rate of nearly three people a day. Colfax and and other health leaders on Monday announced a renewed push to urge people struggling with addiction to seek treatment. (Ho and Leonard, 9/18)

A kilogram of fentanyl was found near mats that children used for napping at a Bronx day care site where one toddler died and three other children were hospitalized last week, the police said on Monday night. Chief Joseph Kenny, the Police Department鈥檚 chief of detectives, explained just how close to the children the potent narcotic was: 鈥淚t was laid underneath a mat where the children had been sleeping earlier,鈥 he said at a news conference, where he joined Mayor Eric Adams and other city officials. (Kilgannon and Shanahan, 9/18)

In August, the New Mexico attorney general unveiled a campaign warning unsheltered people from 鈥渂eing lured鈥 into traveling across state lines 鈥渢o illegitimate recovery facilities.鈥 The Blackfeet Nation in Montana in July declared a state of emergency aimed at helping displaced members, while one of the state鈥檚 senators, Jon Tester (D), demanded an investigation from the federal agency that oversees Medicaid services. (Ovalle, 9/18)

Five years after public health officials first asked for it, Narcan finally hit store shelves this month 鈥 a potentially pivotal moment in the fight to counter the country鈥檚 stubbornly high death toll from heroin, fentanyl and pain pills. Now, anyone can buy the opioid overdose reversal drug without a prescription. But it almost didn鈥檛 happen. Narcan鈥檚 maker, Emergent BioSolutions, for years refused to allow its blockbuster drug to be sold over the counter (known as OTC), frustrating health experts and workers on the epidemic鈥檚 front lines who saw making Narcan and other naloxone-based medicines easier to buy as a way to save lives. (Frankel, 9/18)

Public Health

Research Shows Obesity As A Cardiac Death Factor Has Been Rising

Research published in the Journal of the American Heart Association finds the number of adult American deaths from heart disease with obesity cited as a factor soared between 1999 and 2020. Meanwhile, CNN reports on WHO efforts to promote proper treatment for hypertension.

The number of U.S. adults who died of heart disease and whose death record cited obesity as a contributing factor was three times greater in 2020 than in 1999, according to research published in the Journal of the American Heart Association. (Searing, 9/18)

The dangerous effects of high blood pressure are highlighted in a new report by the World Health Organization that identifies the condition as one of the world鈥檚 leading risk factors for death and disability. Published Tuesday, WHO鈥檚 first report on the global impact of high blood pressure, also known as hypertension, offers recommendations on ways to combat the 鈥渟ilent killer.鈥 (Musa, 9/19)

An estimated one in three adults worldwide live with hypertension but most people with the risky cardiovascular condition are not adequately treated, according to a new report by the World Health Organization. A 2020 study published in The Lancet found high blood pressure is 鈥渢he single most important risk factor for early death,鈥 the WHO report says. Hypertension, or high blood pressure, leads to an estimated 10 million deaths every year, but almost half of adults with high blood pressure don鈥檛 know they have it. (Amenabar, 9/19)

In other health and wellness news 鈥

Doing puzzles, playing memory-boosting games, taking classes and reading are activities that we often turn to for help keeping our brains sharp. But research is showing that what you eat, how often you exercise and the type of exercise you do can help lower your risk of dementia to a greater extent than previously thought. ... And living a healthy lifestyle can produce brain benefits no matter what your age. (Lee, 9/18)

Is morning the best time of day to exercise? Research published Tuesday in the journal Obesity finds that early morning activity 鈥 between 7 a.m. and 9 a.m. 鈥 could help with weight loss.聽鈥淢y cautious suggestion from this study is that if we choose to exercise in the early morning, before we eat, we can potentially lose more weight compared to exercise at other times of the day,鈥 said lead researcher Tongyu Ma, a research assistant professor at The Hong Kong Polytechnic University. (Sullivan, 9/19)

With the start of a new school year comes the inevitable battle to get kids back into a healthy bedtime routine. In many cases, this likely means resetting boundaries on screen use, especially late in the evenings. But imposing and enforcing those rules can be easier said than done. A growing body of research is finding strong links between sleep, mental health and screen time in teens and tweens 鈥 the term for pre-adolescent children around the ages of 10 to 12. Amid an unprecedented mental health crisis in which some 42% of adolescents in the U.S. are suffering from mental health issues, teens are also getting too little sleep. (Chen, 9/19)

Several years ago, another dad reached out to me after reading my work about being a stay-at-home dad. He was married, had two toddlers and was not coping well. He couldn鈥檛 find another person to talk to outside his family. He didn鈥檛 say it, because most of us men won鈥檛, but fatherhood was taking a toll on his mental health and self-worth. He felt alone 鈥 but not because he didn鈥檛 have a good relationship with his significant other. He told me it was because he didn鈥檛 have friends. (Carpenter, 9/18)

On gambling and addiction 鈥

The prospects of enacting soon an overdue North Carolina budget, permitting more state-sanctioned gambling and implementing Medicaid expansion stayed uncertain Monday as Republicans suggested dividing the topics between two bills. But most Democratic colleagues sound unwilling to provide the necessary votes. Action for passing a two-year state government spending plan idled last week when House Republicans said they didn鈥檛 have enough votes to pass the budget on their own if it contained language that would authorize four additional casinos and legalize video gambling machines statewide. (Robertson, 9/18)

Phil Mickelson, the golf great whose issues with gambling have made headlines throughout the years, took to social media on Monday to share details about his addiction, and to offer a warning to potential bettors ahead of this year鈥檚 N.F.L. season. As the 2023-24 football season kicked off in earnest, Mickelson posted on X to say that he would not be gambling on any games. 鈥淚 crossed the line of moderation and into addiction which isn鈥檛 any fun at all,鈥 said Mickelson, who has won six major golf tournaments. (Lindner, 9/18)

State Watch

Judge Blocks California Youth Online Safety Law On Constitutional Grounds

The temporary block happened because the California Age-Appropriate Design Code probably violates the First Amendment, the Washington Post explains. Modeled after UK legislation, it would require digital platforms to verify, before launch, if their products could harm young people.

A federal judge on Monday temporarily blocked an online child protection law in California and said it probably violates the Constitution. Under the law, known as the California Age-Appropriate Design Code, digital platforms would have to vet their products before public release to see whether those offerings could harm kids and teens. The law also requires platforms to enable stronger data privacy protections by default for younger users. (Lima, 9/18)

The California Department of Public Health (CDPH) announced $16.3 million in new grants last week to community-led youth suicide prevention projects amid a nationwide surge in reported teen mental health issues. The funding is part of a new media and outreach campaign launched by CDPH that aims to support youth disproportionately impacted by suicide, such as Black, Indigenous and LGBTQ populations. (Chen, 9/18)

On the 'unwinding' of Medicaid 鈥

More than 81,000 Kansans have lost their Medicaid coverage as Kansas ends COVID-19 era extensions, according to data through the end of August released by the Kansas Department of Health and Environment Monday. Nearly three-quarters of those Kansans lost their coverage because they failed to submit paperwork, not because they were deemed ineligible for the program that provides coverage to disabled and low-income Americans. (Bernard, 9/18)

The expiration of a pandemic-era federal provision that prevented states from kicking Medicaid participants off the rolls has left North Carolina with the unprecedented challenge of reviewing the eligibility of more than 2.5 million residents.聽(Baxley, 9/19)

In other health news from across the U.S. 鈥

Almost half of U.S. states have banned or restricted trans youths鈥 access to gender-affirming puberty blockers, hormones, and surgery 鈥 and many of the same states are also targeting trans youths鈥 participation in sports. Twenty-three states ban trans youths from participating in school sports consistent with their gender identity, with some laws focusing on students from kindergarten through 12th grade and others including, or exclusively applying to, students at the collegiate level. The bans may have consequences for the health of trans youth, according to a new perspective by a group of pediatric sports medicine physicians and health services researchers published in JAMA Pediatrics. (Gaffney, 9/19)

Students are back in the classroom 鈥 and school breakfast and lunch are now free in several states. Michigan, Minnesota and Colorado are among six states implementing universal free lunch this year, while several other Midwestern states are taking more gradual steps to expand food access to students. It鈥檚 a shift that鈥檚 occurring across the country, after students, parents and school districts became accustomed to free school meals during the COVID pandemic. (Medlin, 9/18)

A Maryland health care advocacy group announced on Monday that it plans to push state lawmakers to expand the authority of the fledgling Prescription Drug Affordability Board next legislative session. The Maryland Health Care for All! Coalition will prioritize passing legislation to authorize the five-member board to use upper payment limits to make high-cost medications more affordable for all Marylanders 鈥 not just those who work for state and local governments, according to a news release from the coalition. (Roberts, 9/18)

The median time Georgians spent in emergency rooms was 2 hours, 37 minutes last year 鈥 the latest in a steady increase from pre-pandemic times, according to the latest Centers for Medicare & Medicaid Services data. (Dixon and Fitzpatrick, 9/18)

Editorials And Opinions

Viewpoints: Self-Care Doesn't Appear To Be Working; Alabama Will Try Cruel New Execution Method

Editorial writers delve into self-care, death penalty methods, cancer, and more.

Love it or hate it, self-care has transformed from a radical feminist concept into a multibillion-dollar industry. But the wellness boom doesn鈥檛 seem to be making a dent in Americans鈥 stress levels. In 2021, 34 percent of women reported feeling burned out at work, along with 26 percent of men. (Ezra Klein, 9/19)

After botching a series of executions by lethal injection, the State of Alabama is planning to use nitrogen gas to put condemned prisoners to death. The first execution will amount to a human experiment, because neither Alabama nor any other state has ever tried to kill people this way. (Bernard E. Harcourt, 9/18)

There was no stopping the tears. Five and a half months after being diagnosed with pancreatic cancer, six weeks after the last of seven chemotherapy infusions and four days after major surgery,聽the doctor was ready to discharge me from the hospital. (Andy Segal, 9/19)

When a woman first learns she has breast cancer, her mind immediately floods with 鈥渨hat now?鈥 questions as she grapples with how this disease will impact her life. Unfortunately, Black women also have to ask themselves, 鈥淲ill my racial heritage and ethnicity affect the care I receive and chances of survival?鈥 (Nathalie McDowell Johnson, 9/19)

The era of rampant, unconsented, and unregulated online data collection may finally be winding down for consumer health data. But the advances in consumer privacy have not yet fully reached the millions of people with health information related to their drug use, substance use disorder treatment, or recovery. (Jacqueline Seitz, 9/18)

As we stare down the prospect of another government shutdown due to House Republican time-wasting, House Republicans continue to argue that their party is the party for veterans. Their actions say otherwise. Last month, House Republicans jammed through an embarrassing military construction/Veterans Affairs appropriations bill. My Democratic colleagues and I fought for veterans' funding after House Republicans called for 22% cuts to all spending in April. President Joe Biden held the line and reached an agreement with Speaker Kevin McCarthy to fund the VA. (Rep. Mark Takano, D-Calif., 9/18)

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