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Happy Friday! Today is the day I’m going to challenge you to stretch those creative muscles and enter our Halloween Health Care Haiku Competition. Yes, it is going to be exactly as awesome as it sounds! The entries are already pouring in, check out the rules here. To kick things off, KHN’s very own talented and brilliant haiku master-in-residence Stephanie Stapleton wrote this one: “Goblins wear white coats, and not much is spookier, than the health system.”

Now on to what you might have missed this week.

Democrats packed themselves onto a crowded stage this week for what already feels like the umpteenth debate but was only the fourth or the sixth (depending if you count the two-nighters separately).

Going by the amount of heat she took, it seems safe to say Sen. Elizabeth Warren (D-Mass.) is considered by her rivals to be one of the race’s front-runners. With that spotlight, though, comes a target on her back.

South Bend Mayor Pete Buttigieg and Sen. Amy Klobuchar (D-Minn.) – who are both vying to become the alternative for former Vice President Joe Biden’s moderate voters – were particularly sharp in their demands for Warren to reckon with the costs of “Medicare for All.” The question of how she would pay for such a plan has been one she’s been managing to dodge, but her rivals tried to hold her feet to the fire on Tuesday. “At least Bernie’s being honest,” Klobuchar said at one point in reference to Sen. Bernie Sanders’ (I-Vt.) admission that the proposal will raise taxes.

FWIW: Despite being pressed to answer the direct question: “Will you raise taxes on the middle class to pay for it? Yes or no?” Warren still didn’t let herself be pinned down. Something that, the day after the debate, Biden jumped on as well.

Health care is possibly the broadest (or at least one of the broader) topics that the candidates could talk about, and yet all it seems they’ve been discussing at the debates is health care coverage. Friends, you are not alone if you’re frustrated by not seeing a more diverse range of questions. Even Sen. Kamala Harris (D-Calif.) was fed-up enough to redirect the conversation toward abortion rights and reproductive health. Considering it’s such a viscerally hot-topic at the moment, the omission seems glaring.

But it’s not just reproductive health that the moderators could ask about. Axios came up with at least four great questions that I think a lot of people in the field would like to have answered. Like: Many of the things that make people sick are not the fault of bad health care — they’re social factors like poverty, low-quality housing, etc. Should it be part of the health care system’s job to address them? (Hint, hint moderators.)

Don’t get me wrong, there were a few other health-related moments beyond “Medicare for All” bickering… including one of the more heated exchanges of the night. Beto O’Rourke said Democrats need to be courageous in their policies and not be scared of polls, to which Buttigieg responded: “I don’t need lessons from you on courage.”

Meanwhile, amid all this focus on “Medicare for All,” a new study counsels that there are many paths toward universal coverage—it doesn’t have to be “Medicare for All” or bust.


A big decision on the constitutionality of the health law is expected to drop sometime in the coming weeks. Although in theory, the Trump administration wants a certain outcome, if the court decides the ACA is unconstitutional, it could be a big ole headache for the White House heading into 2020. A ruling like that could not only foster confusion right around open enrollment, but also allow the Democrats to re-frame the health narrative in a way that could appeal to independent and moderate voters more than the current back and forth about “Medicare for All.”


Rep. Elijah Cummings (D-Md.) passed away this week at 68 from complications of longstanding health problems. House Speaker Nancy Pelosi (D-Calif.) announced that she’ll be renaming her signature drug pricing policy after Cummings as he was a long-time champion of reigning in such costs.

Some might remember that it was Cummings who took Martin Shkreli, of “pharma bro” fame” to task at a hearing.

“It’s not funny, Mr. Shkreli,” Cummings said as Shkreli smirked. “People are dying, and they’re getting sicker and sicker.”

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In a high-stakes, eleventh hour gambit Judge Dan A. Polster is summoning the drug CEOs involved in the massive, nationwide opioid trial to try to agree to a massive $50 billion settlement. Although the talks center around the big players involved — like AmerisourceBergen, Cardinal Health and McKesson — plaintiffs’ lawyers say they hope such a deal would have a domino effect on the remaining defendants.

Although the reports seem hopeful, those familiar with the talks say that the cities and counties are hesitant because they’re worried they’re not going to see their fair share of the money.

(This is as of press time! It’s happening today, so there could be developments depending when your read this—ah, the excitement of live news!)

In a sea of heartbreaking stories on the opioid epidemic, this one stands out. The Washington Post took a look at West Virginia’s crisis and how court victories against drug companies aren’t really the panacea they’re sometimes made out to be.


These two court stories feel like they happened ages ago, but really it was just last Friday post-Breeze. If you caught them happening in real time, there’s nothing to update, but I wanted to make sure I included them for anyone who wasn’t glued to their computer on a Friday evening.


This binge-worthy story needs no other introduction than the one ProPublica already wrote for it, so I’m going to quote them: “Welcome to Coffeyville, Kansas, where the judge has no law degree, debt collectors get a cut of the bail, and Americans are watching their lives — and liberty — disappear in the pursuit of medical debt collection.”

And, on a related note, if you’ve missed my colleague Jay Hancock’s coverage of UVA’s lawsuits against their patients, make sure to check out all the developments here.


Meanwhile, in the miscellaneous story file this week:

— Melody Petersen of LAT won the holy cannoli award this week with her investigation into the practice of harvesting body parts—and the coroners that go along with it. My face when reading the entirety of the article was an exact replica of the “shocked and distressed” emoji.

— Deaths, poor quality of care, and other problems have absolutely plagued the Indian Health Service for years, and Native Americans are sick of it. They want to take over running their own health care system, but the task would be daunting.

— You can’t swing a cat these days without hitting some new CBD product. It seems inevitable that that kind of lucrative, thriving marketplace would draw pharma’s attention. Here’s a look at what companies are developing new drugs to tap into those profits. (PSA: but don’t actually swing any cats, please.)

— If you want a fentanyl drug ring story that reads like a thriller, check this article out.


That’s it from me! Have a great weekend and don’t forget to get your flu shot!

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