Axios Vitals

Big tech platforms have a persistent problem with inaccurate anti-vaccination content, and they're under mounting pressure to do something about it, Axios' Sara Fischer and Kia Kokalitcheva write this morning.

The big picture: Tech companies prefer not to serve as content arbiters, but the real-world harm in this case — namely, measles outbreaks — is prompting at least some companies to take a second look at anti-vaccine messaging.

What they're doing:

• YouTube: announced last month it will reduce recommendations for content that could misinform users, including videos promoting a phony miracle cure for a serious illness, as well as "certain types of anti-vaccination videos," the company says.
• Google already has systems in place to prioritize results from authoritative sources when people search sensitive topics like health information, the company said.
• Facebook says it has "taken steps to reduce the distribution of health-related misinformation," and that undefined additional steps will be announced soon.
• Pinterest says it's blocking results for searches like "vaccine" or "vaccination" altogether, but an Axios search for "autism vaccine" still returned a slew of results.

Go deeper.

Purdue Pharma intentionally decided not to correct doctors' misperceptions about the strength of OxyContin, according to a deposition obtained by ProPublica.

• The deposition includes a 1997 email exchange between Michael Friedman, Purdue's top marketing executive, and Richard Sackler, whose family founded and controlled Purdue.
• Friedman at one point noted that doctors were mistaken about the drug's potency. "We are well aware of the view held by many physicians that oxycodone is weaker than morphine," he wrote. "I do not plan to do anything about that.”
• “I agree with you,” Sackler replied.

Why it matters: There's a mountain of evidence piling up, even in public, that suggests the Sackler family knew its product was highly addictive, but blew past any concerns about that fact in search of higher and higher profits, helping to create the opioid epidemic.

• A filing from Massachusetts' attorney general said the Sackler family knew people were becoming dependent on OxyContin, but had a plan in place to shift the blame onto those addicted patients.

Related: Former FDA commissioner David Kessler told "60 Minutes" that the agency shouldn't have allowed opioids to be marketed for long-term use.

• "We don't know whether the drugs are safe and effective for chronic use," Kessler says. "The rigorous kind of scientific research the agency should be relying on is not there."
• The interview airs Sunday.

A nonprofit company in Michigan filed a lawsuit this week against Blue Cross Blue Shield of Michigan, Axios' Bob Herman reports, alleging the health insurance company "illegally skimmed" extra money from the company in the form of "hidden fees."

Why it matters: Most employers are self-insured, including the one in this lawsuit, which means they pay workers' medical claims and hire insurers to do back-end work. But hiring insurers also leads to other various fees for employers, some of which may go unnoticed.

This isn't a new legal problem for BCBS of Michigan. Hundreds of companies in the state have sued the insurer over hidden fees, which were secretly embedded in hospital and physician claims between 1994 and 2012. A 2014 federal ruling said BCBS of Michigan violated federal employment benefits law.

• "They stole money from people. That's been determined in court," said Aaron Phelps, the attorney for the plaintiffs.
• Phelps believes this particular scheme was unique to Michigan, but he said "insurance companies in general are creative in finding ways to rip people off."

What they're saying: "This lawsuit dates back to issues from more than 20 years ago and pre-date many of us at Blue Cross," a BCBS of Michigan spokeswoman said in a statement. "We are of course disappointed when parties go to court because we prefer to resolve these matters by working with customers."

The bottom line: If you are a self-insured company, it won't hurt to audit your health insurance provider for any omitted charges.

The New York Times reports that experts from the U.S. played a role in the Chinese government's use of DNA samples to keep tabs on its Uighur population — the largely Muslim ethnic group whose members the government has also forced into camps.

Details, per the NYT:

• Almost 36 million people took part in a DNA testing program in Xinjiang, the part of China where the government's campaign against Uighurs is most pronounced.
• Those tests weren't used for health screenings, as advertised, but as part of an effort to keep track of the ethnic minority population. Many Uighurs were coerced into giving the samples.

An American company, Thermo Fisher, supplied the equipment the Chinese government used to conduct the testing, per the Times.

• China accounted for 10% of the company's business in 2017, and American officials have criticized the company previously for its willingness to sell China equipment that could be used for tracking and monitoring.
• Thermo Fisher said this week that it would stop selling equipment in Xinjiang, but not the rest of China.
• China also relied on DNA samples from Yale geneticist Kenneth Kidd to help perfect its technology and prove that it could effectively use DNA to identify Uighurs.
• Kidd told the NYT he didn't know that had happened, and that he was "not particularly happy" with the way his data had been used.

Roughly 4 Medicare beneficiaries die every minute, according to new data from the Centers for Medicare & Medicaid Services.

Yes, but: More Americans continue to enroll in the program, totaling 58.5 million people in 2017. Ever-increasing enrollments are due in large part to the sustained influx of baby boomers and increasing life expectancy.