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Four weeks from today, Republicans will try to hold on to the House of Representatives with a message that buries the tea party movement deep underground: Keep us in charge, and we won't touch Medicare or Social Security. In TV spots, Republican candidates promise that they'll protect entitlements and save the most popular parts of the Affordable Care Act. In attack ads, the National Republican Congressional Committee warns that Democrats "support cutting $800 billion from Medicare." In debates, Republican candidates argue that Democrats who favor Medicare-for-all would bring about "Medicare for None." (Weigel, 10/9)

With control of Congress at stake in next month’s midterm elections, Democrats have a rare opportunity to gain a foothold against President Trump’s Republican Party. But if they come up short, it may be in part because of a failure to pursue a key group of voters. It’s a constituency that makes up 13 percent of the voting population, enjoys high voter turnout and is especially concentrated in some decisive swing states. That group is military veterans — and in the battle for their votes, the Democratic Party lags far behind the Republicans. According to organizers on both sides of the contest, the Democratic National Committee seems to be pursuing a strategy that focuses on running veterans as candidates instead of organizing to reach veteran voters — the D.N.C. tried that approach more than a decade ago, and it didn’t work. (Craven, 10/10)

Democrat gubernatorial candidate Karl Dean said Tuesday he would happily sign Medicaid expansion into law in Tennessee, while his opponent Republican Bill Lee countered he would oppose such efforts. The two top candidates detailed their positions during the second gubernatorial debate at the Toy F. Reid Employee Center in Kingsport. Similar to the first debate, Dean and Lee refrained from aggressively attacking each other in an overall tame event — with Lee even making a point to thank Dean’s positive tone throughout the campaign during the opening remarks. (Kruesi, 10/9)

For the second time in as many weeks, Republican Bill Lee and Democrat Karl Dean made their cases to Tennessee voters on Tuesday while remaining polite at an East Tennessee gubernatorial debate. ... Rather than take federal money to cover more residents under TennCare, Lee said the state should focus on a way to lower the cost of health care. Dean responded, insisting that Republicans in the legislature, after declining to hear Republican Gov. Bill Haslam’s Medicaid expansion plan in 2015, had not proposed a solution to solve the problem of unaffordable health care. (Ebert and Allison, 10/9)

Republican Sen. Susan Collins landed herself at the top of Democrats’ 2020 target list when she voted to confirm Brett Kavanaugh to the Supreme Court. Now, Democrats just have to find someone who can beat her in Maine. Whoever runs against Collins in the next election will be well-funded, thanks to a small-dollar rage-donating spree that put over $4 million in escrow for Collins’ 2020 opponent since she supported Kavanaugh. But that support is about to run up against the unique record of New England’s last remaining Republican senator, who has won by increasing margins in three straight reelection campaigns with a broad centrist coalition, including independents and Democrats who appreciate Collins’ bipartisan streak on issues such as Obamacare repeal. (Arkin, 10/9)

Cecile Richards is keeping the door open to a bid for public office. When asked whether she’s ever thought about running, the former Planned Parenthood president told POLITICO’s Anna Palmer that she has “thought about it.” (Flores, 10/10)

In a television ad released Tuesday, Colin Allred criticizes incumbent Republican Pete Sessions for voting for a health care plan that would have allowed states to develop health care plans without protections for residents with pre-existing conditions. In the ad titled "listening," Allred alludes to a March 18, 2017, raucous town hall meeting where Sessions chided the crowd for not listening. (Jeffers, 10/9)

The California Republican Party spent $5.8 million against two November ballot measures that would expand rent control and limit profits for dialysis clinics after accepting a similar amount of money from business interests. The money paid for “member communication” opposing Propositions 8 and 10, according to campaign reports filed over the last few weeks. (Luna, 10/8)

John Cox stood on a presidential debate stage and told the audience that he was glad abortion wasn’t legal in 1955. If it had been, he said, he wouldn’t have been born. “I wouldn’t be standing here before you today. This is personal to me,” Cox said in the 2007 GOP presidential primary debate, explaining that his biological father walked out on his mother. (Young, 10/9)

The 2018 Ohio Health Issues Poll, conducted for the health-education nonprofit Interact for Health, found sizeable majorities of Ohioans holding favorable opinions of the government health program for children and low-income adults. Seven in 10 Ohio adults had a favorable opinion of Medicaid, and when the responses were analyzed by political affiliation, nearly six in 10 Republicans and independents held a somewhat or very favorable view. (Saker, 10/9)

Nine states have legalized marijuana for so-called recreational use since 2012, including eight at the ballot box. Thirty-one states have authorized the drug for medical purposes. Four states have marijuana ballot questions this fall . Here's a look at them. (10/9)

Democrats are fighting to derail the White House’s push for cheaper, less-robust health plans, seeking to leverage the issue for advantage over the Republicans ahead of the mid-term elections. The fight over shorter-term plans—which went on sale this month and are free from many Affordable Care Act requirements—is emerging as a proxy for the broader battle over health care. Democrats say the proliferation of such plans will raise premiums for older and less healthy people by letting healthier consumers out of coverage that complies with the ACA. Republicans say the effect won’t be significant and that all consumers will benefit by having more choice. (Armour, 10/9)

Senate Democrats are planning to force a vote this week on a resolution that would overturn the Trump administration’s expansion of short-term health insurance plans. Sen. Tammy Baldwin, D-Wis., in late August introduced a disapproval resolution (S J Res 63) that would reverse the administration’s rule expanding the duration of the plans, which are not required to comply with all the regulations of the 2010 health law. On Tuesday, she filed a discharge petition, signed by 47 senators, exceeding the 30 minimum needed to bypass committee action and bring the resolution to a floor vote. (McIntire, 10/9)

The measure appears headed for defeat after Sen. Lisa Murkowski (R-Alaska), a key swing vote, said she would oppose the Democratic measure, with her office noting that while short-term plans are “not ideal” she wants Alaskans to have options for cheaper coverage. Sen. Susan Collins (R-Maine) said she is undecided, but Democrats would need another Republican vote beyond Collins. Democrats maintain that even a failed vote will help them bring the issue of pre-existing conditions to the fore ahead of next month’s elections. The legislation is sponsored by Sen. Tammy Baldwin (D-Wis.), who is up for reelection this year, and has the support of all 49 members of the Senate Democratic Caucus, meaning supporters need two GOP votes to pass it. (Sullivan, 10/10)

The Trump administration is planning hours-long downtimes for maintenance on healthcare.gov during the coming ObamaCare sign-up period. The administration drew criticism for a similar move last year from advocates who said the downtime would hinder efforts to sign people up for coverage, but the administration counters that maintenance downtime happens every year and is designed to occur during the slowest periods on the site. (Sullivan, 10/9)

A bipartisan group of Senators on Tuesday asked the Trump administration to focus more on reducing deaths caused by pregnancy complications. The 14 senators, led by Tom Carper (D-Del.), Bill Nelson (D-Fla.), Tim Scott (R-S.C.) and Shelley Moore Capito (R-W.Va.), wrote to Health and Human Services Secretary Alex Azar asking that the agency "focus on strategies to reduce maternal mortality rates in the United States." (Hellmann, 10/9)

In other maternal health news —

Female athletes seem to be able to exercise safely and intensively both before and during pregnancy without increasing their risk for birth-related complications, even if they are trekking up Mount Everest, according to two eye-opening new studies. Together, the new research undercuts widely held beliefs about strenuous physical training and pregnancy. (Reynolds, 10/10)

If you're a first-time mother and you opt for epidural anesthesia during labor, your doctor may suggest you wait about an hour after your cervix is completely dilated before you start trying to push the baby down the birth canal. But a study published Tuesday in JAMA, the flagship journal of the American Medical Association, suggests that might not be the best advice. (Neighmond, 10/9)

Dark circles formed like warning signs beneath Yu Fen Wang’s eyes as she worked 12-hour graveyard shifts in a Queens maternity center that operated on the margins of legality. Her family said she had grown gaunt, could not sleep and told her husband she no longer wanted to live. (Robbins and Goldbaum, 10/10)

The end of the fight over Brett Kavanaugh's Supreme Court nomination sets up a new battleground over abortion rights, and activists on both sides of the issue are gearing up for what's likely to be a series of contentious battles from the high court to state legislatures. Planned Parenthood is unveiling a new strategy designed to prepare for the possibility of a nation without the federal protections for abortion rights outlined in the 1973 Roe v. Wade decision. (McCammon, 10/10)

The first time Mark shot up “Philly dope” was in the summer of 2017, with his girlfriend, Sarah. They had been on their way from Massachusetts to South Carolina, hoping to get clean there and find someplace cheap to live. The plan was to detox slowly on the way. In New Jersey, they needed to buy more drugs, just enough to make it to Myrtle Beach. Mark got out his phone and Googled “really bad drug areas.” A neighborhood in Philadelphia came up: Kensington. (Percy, 10/10)

Tony Simpson, an entrepreneurial engineer, had grown increasingly concerned about Campbell County, Tenn., where he grew up and still lived. Despite a reasonably solid manufacturing base, as well as scenic lakes and hills that attract tourists, the Appalachian region he calls home was beset by a depressed economy and high rates of incarceration, largely fueled by drug and alcohol addiction. (Rosen, 10/9)

Other news on the epidemic comes out of Maryland and Connecticut —

When Larry Hogan ran for governor four years ago, he vowed to urgently address what he called Maryland’s “heroin epidemic.” ...But upon taking office in January 2015, Hogan did not immediately declare a formal emergency. Instead, he set up a statewide task force that worked for a year to deliver 33 recommendations. As administration officials rolled out the strategies during 2016, opioid fatalities mounted to 1,856 people that year — a death count that ranked Maryland fourth among the 50 states for such per-capita drug fatalities. In all, 5,533 Marylanders died of opioid-related overdoses from the start of Hogan’s term through March 2018, a period of three years and three months. That’s more than the 5,019 who died during [Former Gov. Martin] O’Malley’s eight years in office. (Donovan, 10/10)

Kelly is one of 416 people over the past three years who have been admitted into TPP for substance use disorder, said Michael Hines, assistant director for adult probation and bail services in the Court Support Services Division of the judicial branch. People are admitted to the program immediately following arrest, which means they are not arraigned on charges until they have completed treatment. (Werth, 10/9)

It’s been five years since Congress gave FDA sweeping authority to regulate compounding, but lawmakers — many of whom wrote that law — still don’t think FDA is properly regulating the growing industry. The problem is, lawmakers can’t seem to agree on the tack the agency should take. And they’re not the only ones pulling FDA in different directions. (Florko, 10/10)

In other news involving the FDA —

Amid regulatory concerns over counterfeit medicines, one of the largest U.S. wholesalers failed to follow proper procedures after being notified by customers that illegitimate products had been shipped, according to a recent inspection by the Food and Drug Administration. Specifically, McKesson (MCK) failed to identify and then quarantine “suspect or illegitimate” products. The wholesaler also did not retain samples or promptly notify other customers there was reason to believe illegitimate products were shipped. (Silverman, 10/9)

A little-known nonprofit established by Congress over 10 years ago to help the Food and Drug Administration work with the private sector is still struggling with a basic question: Where is the cash? The Reagan-Udall Foundation for the FDA is supposed to act as a liaison between the FDA itself and drug companies, researchers, nonprofits, or other businesses with regulated products who might want to support a project to make the agency’s job easier. It has raised just under $15 million during its first decade, according to the foundation. (Swetlitz, 10/8)

In early June, the Washington office of Representative Pramila Jayapal began to hear rumors about the women. They had crossed into Texas, where Border Patrol officers promptly arrested them. But now the women were somewhere around Seattle, the city Jayapal represents. Her staff made calls. Usually, undocumented immigrants in the area were held at the Northwest Detention Center, a private facility operated under a contract with Immigration and Customs Enforcement. But the detention center had not received the women. There were too many of them for ICE to house. Instead, as Jayapal learned on June 7, the mothers were now inmates at a Bureau of Prisons facility near the Seattle-Tacoma airport. (Draper, 10/10)

Federal drug-trafficking prosecutions along the southwestern border plunged to their lowest level in nearly two decades this summer as the Trump administration launched a “zero tolerance” crackdown on illegal immigration that separated thousands of children from their parents. The decision to prosecute everyone caught entering the USA illegally flooded federal courts with thousands of cases, most of them involving minor immigration violations that resulted in no jail time and a $10 fee. As prosecutors and border agents raced to bring those immigrants to court, the number of people they charged under drug-trafficking laws dropped by 30 percent along the border – and in some places far more steeply than that, a USA TODAY review of court dockets and Justice Department records found. (Heath, 10/10)

And news comes out of Arizona as well —

Staff members at a Southwest Key shelter for unaccompanied migrant children in Youngtown physically abused three children, according to allegations detailed by federal officials on Tuesday. The federal contractor fired the staffers after the Sept. 18 incident, according to a statement from the U.S. Department of Health and Human Services. (Philip, 10/9)

U.S. healthcare companies had soaked up $23.4 billion this year in venture capital funding as of Sept. 30, already well surpassing the sector's funding in all of 2017, and making up nearly 28% of total U.S. venture capital funding so far in 2018. That's according to Pitchbook's quarterly report examining venture capital spending in the third quarter of 2018. Last year, healthcare services and systems, healthcare devices and supplies and pharma and biotech amassed $20.5 billion in venture capital funding, with pharma and biotech capturing far and away the largest share of those dollars. Pharma and biotech has made up 62% of venture capital funding so far in 2018. (Bannow, 10/9)

In other industry news —

Trinity Health, Adventist Health System and Tenet hospitals are among those opting into a new federal bundled-pay initiative that aims to improve patient care in both hospitals and post-acute care while lowering overall costs. In all, 1,299 entities have signed agreements with the CMS to participate in the Bundled Payments for Care Improvement Advanced model. The participating entities will receive bundled payments for certain episodes of care as an alternative to fee-for-service payments that reward only the volume of care delivered. (Dickson, 10/9)

E-cigarette maker Juul is ramping up its Washington lobbying operation as it tries to head off potential regulatory threats from the Trump administration and Congress. The company has been under scrutiny from Food and Drug Administration (FDA) regulators and lawmakers from both parties amid a massive surge in popularity for its products among teens. (Weixel, 10/10)

Meanwhile, the company crossed an important financial threshold four times faster than Facebook had —

If it seems like seeing people vape on devices that look like USB flash drives came seemingly out of nowhere, you’re absolutely right. It’s the ubiquity of the e-cigarette, known as the Juul, that has led its manufacturer to achieve a milestone faster than any other startup in history – including Facebook. (Guzman, 10/9)

Sshh, turn down the volume. The World Health Organization wants to make the planet a quieter place and says taking out those earbuds is a good place to start. For the first time, the WHO has released guidelines on how noise from leisure activities, especially listening to music through earbuds, can be harmful to health. (Sugden, 10/9)

Environmental noise is among the "top environmental risks to health," according to the WHO report. More than 100 million Europeans are affected by road traffic noise alone each year. "Noise continues to be a concern," noted Dr. Dorota Jarosińska, program manager for living and working environments at the WHO regional office for Europe. Is air pollution tied to higher dementia risk? The new guidelines are "an important update," given the evidence and links to health problems, said Stephen Stansfeld, professor at Barts and Queen Mary University of London and chair of the Guideline Development Group, an independent organization that advised WHO on the guidelines. (Avramova, 10/9)

One in three teenagers say they know someone their age who has been hit, punched, choked or otherwise physically hurt by their partner. The Centers for Disease Control and Prevention says one in three young women will be abused before they reach 25 years old. Such statistics prompted the domestic violence prevention group Saving Promise to launch a campaign Monday to raise awareness of the effects of the abuse, especially on people in their preteens to their 20s. (O'Donnell, 10/8) 

New research has found that patients who spent more time with therapy dogs increased their risk of contracting the superbug MRSA—a warning to hospitals that haven't examined policies surrounding the popular programs. The Associated Press first reported that researchers from Johns Hopkins Bloomberg School of Public Health last week unveiled the unpublished limited study. Co-author Dr. Meghan Davis, a veterinarian and assistant professor of Environmental Health and Engineering at Johns Hopkins, was looking at the potential for human-to-human transmission of pathogens during dog therapy support visits. (Johnson, 10/9)

Three men with Type 2 diabetes used "intermittent fasting" to reverse their dependence on insulin, according to a report published Tuesday -- but you shouldn't try it without medical supervision, experts say. The new case report says the three patients also lost weight, and their HbA1Cs, a measure of blood sugar levels, improved. "People are focused on giving drugs to Type 2 diabetes, but it's a dietary disease," said study author Dr. Jason Fung, medical director of the Intensive Dietary Management Program in Toronto. (Nedelman, 10/9)

Science, medicine, and academia are increasingly grappling with obstacles that can block women from advancing their careers and feeling comfortable in the workplace. Women in science say change is urgently needed — from the board room to the lab bench. That was the message at a panel on the path forward for women in science on Tuesday, convened by STAT and hosted at the Broad Institute of MIT and Harvard in Cambridge, Mass. The event was part of the annual HUBweek festival, founded by The Boston Globe, Harvard, Massachusetts General Hospital, and MIT. (Thielking, 10/10)

A promising but controversial new approach to treating blood cancer could be in trouble in the earliest innings of human testing after Celgene pulled the plug on a trailblazing clinical trial. On Monday, Celgene (CELG) terminated a Phase 1 study of CC-90002, which targets a protein that helps cancer cells stay out of the immune system’s crosshairs. In an update to ClinicalTrials.gov, Celgene said it canceled the CC-90002 study because early results “did not offer a sufficiently encouraging profile” to move forward. (Garde, 10/9)

Role-playing games with actors — like those portraying the Carlsons in a simulation drill at the University of Massachusetts Medical School last week — teach students how to talk about end-of-life care with compassion, but also realism. The simulations, along with lectures, group discussions, and shadowing physicians talking to gravely ill patients, also help them find out what’s most important to dying patients and incorporate that into their care plans. (Weisman, 10/9)

Acute flaccid myelitis, or AFM, is a rare, but serious condition which typically causes weakness, even paralysis in the arms and legs, and facial drooping. ... Although there's currently no vaccine or treatment, says Hallberg, there are very few cases of AFM. (Hallberg, 10/9)

When people living with HIV walk out of prison, they leave with up to a month's worth of HIV medication in their pockets. What they don't necessarily leave with is access to health care or the services that will keep them healthy in the long term. That is one of the findings of a study published Tuesday in PLoS Medicine. The study was among the first to follow people with HIV from jail or prison back into the community. What they found was that most people — more than half — fell out of care within three years of leaving prison. (Boerner, 10/9)

Breast cancer in younger women tends to be a more aggressive cancer, researchers say, because it’s often diagnosed later, is farther along when found and insurance companies set minimum ages on mammograms, which can deter detection. In addition, because the numbers are relatively small, some doctors don’t always jump to cancer as a conclusion in younger women. (Powell, 10/10)

Doctors have gradually come to realize that people who survive a serious brush with death in the intensive care unit are likely to develop potentially serious problems with their memory and thinking processes. This dementia, a side-effect of intensive medical care, can be permanent. And it affects as many as half of all people who are rushed to the ICU after a medical emergency. Considering that 5.7 million Americans end up in intensive care every year, this is a major problem which, until recently, has been poorly appreciated by medical caregivers. (Harris, 10/10)

Amid an unfolding ethics crisis at a prominent New York cancer center, Boston hospitals are warning doctors that they must publicly disclose all their financial relationships with pharmaceutical and device companies. ...The hospitals’ actions were triggered by a series of lapses at Memorial Sloan Kettering Cancer Center in New York City, including the failure of its chief medical officer to disclose millions of dollars in payments from pharmaceutical and other companies. (Kowalczyk, 10/9)

A San Francisco jury's $289 million verdict in favor of a school groundskeeper who says Roundup weed killer caused his cancer will face its first court test Wednesday. Agribusiness giant Monsanto will argue at a hearing that Judge Suzanne Bolanos should throw out the verdict in favor of DeWayne Johnson. Attorneys for the company say Johnson failed to prove that Roundup or similar herbicides caused his lymphoma, and presented no evidence that Monsanto executives were malicious in marketing Roundup. Bolanos was not expected to rule immediately. (10/10)

Nine of the 16 health systems in Connecticut ended 2017 in the black, according to a report by the state Office of Health Strategy. Collectively, the systems took in about $14.2 billion in the fiscal year that ended on Sept. 30, 2017. (Rigg, 10/9)

I sat down with Dr. Paul Linde, who for a quarter-century worked in the psychiatric emergency room at San Francisco General Hospital before leaving to work part-time as a primary care psychiatrist. He described San Francisco’s revolving door for mentally ill homeless people, the shortage of treatment beds and how California’s newly passed law strengthening the conservatorship program might help. (Knight, 10/9)

Mayor Tom Barrett and Health Commissioner Jeanette Kowalik are calling on faith leaders to help them combat infant deaths in Milwaukee. Barrett and Kowalik spoke Tuesday at an event celebrating that more than 30 local churches have become "Strong Baby Sanctuaries," where pregnant women and new families can find information on community resources. (Spicuzza, 10/9)

New York City Mayor Bill de Blasio on Tuesday signed into law a bill that will create a third gender option on birth certificates. Under the new law, birth certificates can list gender as “male,” “female” or “X,” allowing people who don’t identify as either male or female to better reflect their identities. (Honan, 10/9)

Walgreens is changing the benefits it offers employees and eliminating health insurance for most of its eligible retirees, just months after announcing it would boost hourly wages for store employees. Starting in 2019, employees of the Deerfield-based drugstore chain won’t qualify for paid time off unless they work at least 30 hours a week, said Walgreens spokesman Brian Faith. Currently, employees can qualify for paid time off if they work at least 20 hours a week. (Schencker, 10/9)

After Florence, dozens of water and sewer systems  throughout North Carolina are struggling. Many have been struggling since Matthew, two years ago. Dozens more were underwater before either storm hit, with shrinking economies and populations that make it difficult for them to cover routine expenses and service the debt on their water and sewer infrastructure. (Ross, 10/10)

California chiropractors allege in a lawsuit filed in San Francisco Superior Court that an aggressive middleman in the workers’ compensation arena is employing a novel kickback scheme to steer patients to providers willing to share more of their fees with the company. Sacramento-based California Chiropractic Association asserted in its court complaint that One Call Care Management is violating business and professions codes that have gotten health care practitioners prosecuted for fraud. (Anderson, 10/9)

The Colorado Department of Health is investigating an unprecedented outbreak of rare viral infections with neurological complications among young children, state officials announced Tuesday. State health officials, in conjunction with the experts at the Centers for Disease Control and Prevention, said they have found 41 cases of enterovirus A71 infections in children this year — a majority of them in the Denver area. (Tabachnik, 10/9)

Since 2017, 12 families a day on average have been evicted from their homes in Travis County. Many people had lost a job, experienced a medical emergency or had a roommate leave without notice. According to an analysis of five years of eviction data by KUT, the threat of eviction in Travis County is nearly three times more common than reported by Eviction Lab, a new project to publish nationwide eviction data. (McGlinchy, 10/10)

They're employees of the city and state, homeless service providers, and the local public health commission and housing authority. They've been working for the last three years toward a goal of eliminating chronic homelessness in the city by the end of 2018. (Joliocoeur, 10/9)

Cannabis cafes where consumers could enjoy marijuana together may be coming to a small number of Massachusetts cities and towns chosen to participate in a Cannabis Control Commission pilot program, marijuana regulators said Tuesday — though they cautioned that such businesses are unlikely to open for months or even years. Commissioners said they would partner with a handful of municipalities that want to host “social consumption” businesses. (Adams, 10/10)

Today there’s essentially one model for drug production: make as much as possible. But J. Christopher Love, a professor of chemical engineering at the Massachusetts Institute of Technology, has spent the last five years pursuing a different vision: a desktop drug manufacturing process that would be fast and nimble enough to help combat a small disease outbreak, treat an unusual cancer, or replace a rare enzyme. He’s not there yet, but in a paper published this week in Nature Biotechnology, Love and his colleagues showed that they can produce thousands of doses of clinical-quality biologically based drugs in about three days. (Weintraub, 10/4)

In recent months, controversy over the Ohio Medicaid program has provided a rare window into some of the fees paid to pharmacy benefit managers and the subsequent effect on prescription drug costs. Now, an audit finds a new twist: A managed care plan that contracted with the state program collected $20 million through a curious arrangement that has raised concern among state officials. (Silverman, 10/5)

Kaiser Health News: No More Secrets: Congress Bans Pharmacist ‘Gag Orders’ On Drug Prices
For years, most pharmacists couldn’t give customers even a clue about an easy way to save money on prescription drugs. But the restraints are coming off. When the cash price for a prescription is less than what you would pay using your insurance plan, pharmacists will no longer have to keep that a secret. (Jaffe, 10/10)

Democratic candidate for governor Tony Evers would seek to lower prescription drug prices by creating a new state board that would have the authority to review price hikes and impose fines on drug makers for "excessive" increases. The plan Evers released Monday also would require drug companies to justify large price increases, make the state’s prescription drug program for seniors cover flu shots and allow importing drugs from Canada. (Beck, 10/8)

The team that discovered that Ohio taxpayers were overcharged up to $186 million for Medicaid prescription drugs last year has uncovered an additional $20 million that might have been wasted to fund services for which taxpayers already were paying. And state Medicaid officials initially did not want that information made public. (Schladen and Sullivan, 10/7)

Perrigo Co. has hired a former food and tobacco industry executive to lead the company, less than a year after the drugmaker picked a pharmaceutical and health care manufacturer veteran to lead a turnaround effort. (Armental and Nakrosis, 10/8)

Kessler, 59, is the former CEO of Lorillard Tobacco Co. He replaces Uwe Roehrhoff, who was appointed president and CEO in January to replace John Hendrickson. Perrigo has been trying to turn itself around after a 16 percent decline in the shares in the past 12 months. It’s in the process of separating its prescription drugs business and refocusing on consumer health products such as an over-the-counter version of heartburn drug Nexium. The separation will be completed by year-end, and options include a sale or merger. (Hopkins, 10/8)

Pfizer Inc. assigned new leadership roles and jobs to a range of top executives, as the drugmaker prepares for Albert Bourla to begin his tenure as chief executive in January. Earlier this month, Pfizer said its CEO, Ian Read, would leave the job after eight years to make way for Mr. Bourla, who currently serves as chief operating officer. (Maidenberg, 10/9)

Doctors, when surveyed, say they are opposed to the very idea of skewing their prescribing practice in favor of companies giving them money. The problem is, they still take lots of money in the form of honoraria, speaking fees, research grants, and outright gifts from pharmaceutical and medical device companies. Research suggests they can then fail to recognize that they’ve been influenced. (Faye Flam, 10/4)

Seeking to recover from sensational marketing scandals, GlaxoSmithKline did something unexpected five years ago — the company promised it would no longer pay doctors to promote its medicines, which had been a long-standing industry practice. The move came not long after Glaxo paid $3 billion in fines in the U.S. for illegal marketing and kickbacks, among other things, and also followed reports the company showered doctors and government officials in China with bribes. With its announcement, Glaxo won praise for setting a new tone and raised hopes other drug makers would follow suit. (Ed Silverman, 10/10)

This month, Congress sent the Patient Right to Know Drug Prices Act and the Know the Lowest Price Act of 2018 to President Trump’s desk for signature. These bills, which were sponsored by Sens. Susan Collins (R-Maine) and Debbie Stabenow (D-Mich.), help protect Medicare patients and those with private insurance from overpaying for prescription drugs by outlawing pharmacy “gag clauses.” (Roger Klein, 10/8)

The Nobel Prize is one of the world’s top honors for recognizing groundbreaking work in science, diplomacy and other fields. But this year’s awards in medicine and chemistry stand out even in august company. The prize in medicine, given Monday to James Allison and Tasuku Honjo, recognized their research on the immune system, which has led to drugs that have changed the treatment outlook for deadly cancers. On Wednesday, George Smith and Gregory Winter were awarded the chemistry prize for work that helped produce AbbVie Inc.’s Humira, the world’s best-selling drug, as well as a number of other of antibody treatments that have helped improve and extend the lives of millions of patients. (Max Nisen, 10/7)

It is difficult to remember now, but prior to the enactment of Medicare Part D in 2003, millions of Americans who relied on Medicare for their health-care coverage, did not have access to a comprehensive prescription drug benefit. My, how times have changed. On Sept. 18, an historic summit was convened to celebrate the 15th anniversary of Part D. Attendees heard from patient advocates, experts and policy makers who have seen firsthand Part D’s life-saving impacts. We were also honored to be joined by the man who signed it into law — President George W. Bush. (Carl Schmid, 10/3)

Pharmaceutical companies produce a pipeline of essential medicines that can make people’s lives longer, happier and more comfortable. Their innovations are respected and appreciated by all of us. Unfortunately, some of the big drug companies price their drugs at unreasonable and unaffordable levels that disproportionately impact those of low-to-moderate incomes and with chronic health challenges. (Miranda Motter, 10/5)

We're out of euphemisms at this point: national emergency, addiction crisis, drug epidemic, "a 9/11 every three weeks." But there’s no mistaking that we’re in the midst of the biggest drug epidemic to ever hit our country – and the death toll is rising. The federal government estimates that over 600,000 Americans have heroin-associated opioid use disorder. The wave of death we’ve already experienced – losses over the next decade on par with the Civil War, or over half a million Americans – is unprecedented. Make no mistake: Ohio is at the center of this. And whether we all know it or not, Cincinnati is an epicenter community. (Navdeep Kang, 10/9)

Tackling the opioid crisis head-on is a daunting task. Innovative approaches have yielded success, but we must be careful to stop short of radical fixes, lest we exacerbate the very problem we are trying to remedy. A delegation of state legislators is going to Portugal to review its decriminalization of opioids this week. Senate President Karen Spilka, in a press release, called the trip a “unique opportunity” to gain insight into “possible solutions” for the ongoing opioid crisis, as well as discussing economic and security issues. (10/9)

Earlier this year, Gov. Tom Wolf accurately described Pennsylvania's opioid epidemic as a "state of emergency." The current addiction crisis requires all of us to respond with urgent, effective, coordinated action. Last week, the Central Pennsylvania business community increased our capabilities to help. Although many people may think of addiction as happening on our streets, it also arrives to work each day. In fact, according to the National Safety Council seven in 10 employers have been directly affected by prescription drug misuse. (George M. Book, 10/8)

While the opioid crisis is taking a hit on our nation’s small businesses, we at the committee will continue to pursue solutions that work for our nation’s small business owners and their employees. Allen likes to say that "a job is the best antidote," and I’d have to agree – that’s why small businesses like hers are so important to overcoming this terrible epidemic. (Steve Chabot, 10/8)

Throughout the year, we have seen Democrats across the country uniting around a new legislative proposal that would end Medicare as we know it and take away benefits that seniors have paid for their entire lives. Dishonestly called “Medicare for All,” the Democratic proposal would establish a government-run, single-payer health care system that eliminates all private and employer-based health care plans and would cost an astonishing $32.6 trillion during its first 10 years. (President Donald J. Trump, 10/10)

Rep. Elijah Cummings says a report he commissioned from the House Committee on Oversight and Government reform shows that if the Trump administration is successful in its legal assault on key provisions of the Affordable Care Act, nearly 170,000 Marylanders could see their premiums skyrocket or could be denied coverage altogether. Hundreds of thousands of older adults and women could be subject to premium increases, too, he argues. Not so, says Rep. Andy Harris. The Trump administration may be joining an effort by ACA-loathing states in litigation aimed at gutting protections for those with pre-existing conditions, but Maryland law contains backup provisions, so no one here is at risk. So who’s right? (10/8)

Trade experts are now dissecting the newly announced North American trade deal to determine if President Trump’s “bully” negotiating style will really make a difference to dairy markets or automobile production. Indeed, much attention has been paid to the president’s negotiating style in international trade and foreign relations more generally, especially his cavalier disregard and disrespect for international organizations like the World Trade Organization or strategic alliances like NATO. (Peter G. Lurie, 10/9)

I’ve never been sure what to expect when meeting someone who’s just tried to take his own life. But I’ve learned to stop expecting anything. Sometimes, the person in front of me barely speaks, staring right through me, lost in a deep catatonic depression. Sometimes he or she can’t stop talking, breathlessly describing what happened as if we’re gossiping at brunch after an hour of SoulCycle. (Dhruv Khullar, 10/9)

Everyone feels isolated sometimes, but with one in five Americans chronically lonely, has loneliness reached epidemic proportions? In 1988, the journal Science published a landmark study suggesting isolation was as strong a risk factor for morbidity and mortality as sedentary lifestyle, high blood pressure and smoking or obesity. Since then, loneliness has become an increasing public health concern and health officials are now taking the idea of an epidemic seriously. As the population ages, the burden of social isolation on public health will only increase. (Jonathan Fielding, 10/9)

Justice Brett Kavanaugh, who has spent the last several weeks battling disturbing accusations of sexual violence, is now one of the most powerful people in America. While his appointment to the US Supreme Court is devastating for much of the population, it is easy to forget what a triumphant victory it represents for many others. Upon hearing the news of Kavanaugh's confirmation, a West Virginia city councilman named Eric Barber posted to a private Facebook group: "Better get you're (sic) coat hangers ready liberals." (Holly Thomas, 10/9)

Despite their names, state “departments of correction” in the United States aren’t known for correcting much. More than seven of every 10 prisoners, according to some studies, are arrested again less than four years after they are released. And while recent years have seen the beginning of a national decline in the number of male prisoners, the situation has not improved much for women, who remain incarcerated at stubbornly high levels. (Maurice Chammah, 10/9)

The anatomy laboratory was always freezing. This was our first course as medical students, and we had split ourselves into groups — four students to every cluster. Each of us carried a copy of “Netter’s Anatomy”; by the end of three months in the lab, the volume would become chemically yellowed by formaldehyde, and to leaf through the tawny, crackling pages would be to feel your fingers becoming slowly embalmed. Our group had three men — me, S. and B. — and a woman, G. We “shared” a 60-something female cadaver whose name we knew by only her initials: M.C. She had died, we were told, of metastatic breast cancer. Eventually, as we dissected her body, we would find misshapen deposits of that cancer in her brain, liver and bones. (Siddhartha Mukherjee, 10/10)

Climate change poses a catastrophic threat to our planet's biodiversity, to the integrity of our economic system, and even to the very values on which our shared humanity is built. As the new Intergovernmental Panel on Climate Change (IPCC) report shows, this threat is very real, and we are losing the battle to keep temperature increases close to the Paris Climate Agreement target of 1.5°c. (Ricardo Lagos, 10/9)

A spectacular case of sloppy science came crashing to a close last month. Cornell University’s Brian Wansink, a world-renowned scientist who seized headlines with his research on American eating habits, had many of his papers retracted and resigned from his professorship. Wansink’s fall is not just the tale of a single scientist gone astray. It is, instead, an indictment of an entire type of nutrition science that has led to mistaken dietary advice dispensed to Americans for decades. (Nina Teicholz, 10/9)

The LaCroix brand of fizzy water came seemingly out of nowhere in the last few years, propelling its parent company to nearly $1 billion in annual sales and tripling its profits to $149.8 million since 2015. So perhaps it’s natural that the brand would attract hassles, the way noisy parties attract complaints from the neighbors, followed by a knock on the door from the cops. In this world, there’s no gain without pain. (Michael Hiltzik, 10/9)

With Brett Kavanaugh, and the dark cloud permanently fixed above his head, on the Supreme Court, fury on the left is palpable. Yet even if the battle for his seat is lost, the battle against sexual assault continues. For inspiration on how to move forward, the focus on the role of alcohol in Kavanaugh’s life should compel us to look to the origins of the women’s movement. It was the temperance movement of the 19th and early 20th century, after all, that served as a catalyst for the women’s suffrage movement. It could do the same today for the #MeToo movement. (Bill Scher, 10/9)

The time has come for Congress to explore the merits of creating a federal agency solely dedicated to nutritional science — specifically, the establishment of a National Institute of Nutrition (NIN), under the United States Department of Health and Human Services (HHS). Here’s why. The economic impact of managing diet-related chronic conditions in the United States is estimated at over $1 trillion per year and growing. Yet, the evidence base for making many specific dietary recommendations remains suboptimal and often contradictory. Robust, independent research in nutritional science is an urgent public health priority. (Joon Yun, 10/9)