Good morning. Vitals will be off tomorrow and Friday for Thanksgiving. I hope you all enjoy the holiday with your family, friends and food, and I am grateful for this newsletter community.
Situational awareness: Health and Human Services Secretary Alex Azar and CMS administrator Seema Verma are feuding, Politico reports, and it's impacting major policy initiatives.
Today's word count is 925, or <4 minutes.
Illustration: Sarah Grillo/Axios
The Senate's drug pricing bill would likely be better for the pharmaceutical industry than either President Trump's agenda or House Speaker Nancy Pelosi's, Axios' Bob Herman reports.
Between the lines: Industry opposes anything that would hurt its bottom line, but of those three proposals, the Senate's "is a positive tradeoff," analyst Ronny Gal of AllianceBernstein wrote to investors this week.
Between the lines: The Senate bill could take some political heat off the industry, while Pelosi's bill and Trump's proposal to tie Medicare's prices to international prices would make bigger changes to the actual system.
How it works: The international pricing index and Senate bill both only focus on Medicare, but would change different parts of Medicare.
Both of those proposals pale in comparison to Pelosi's bill, which would limit prices in all insurance plans, including the most lucrative commercial business.
The White House hasn't weighed in on how to resolve the debate over surprise medical bills, but Joe Grogan, head of the Domestic Policy Council, had some choice words about ads being run by private equity-backed groups:
"The advertisements that are targeting members on this and are being run by the private equity groups who are using the arbitrage on surprise medical billing should make every American and member want to puke," Grogan told me.
Background: Although he didn't name Doctor Patient Unity, the group has become infamous for spending more than $28 million on ads opposing what was, over the summer, Congress' leading approach to the issue.
The other side: "Doctor Patient Unity represents tens of thousands of doctors across the country who understand the importance of preserving access to life-saving medical care," said Greg Blair, a spokesman for the group.
Illustration: Sarah Grillo/Axios
As we all gear up to eat a lot of food over the next few days, here's a relevant story: Some Latin American governments are taking strong action to tackle the region's obesity epidemic, my colleague Rashaan Ayesh reports.
The big picture: "One country and one strategy at a time, the region has pushed back against sugary beverages and ultra-processed foods in an effort to escape the obesity epidemic that has overtaken the United States," the Washington Post writes.
Why it matters: Childhood obesity is becoming an issue in both rich and poor countries.
Case in point: The Chilean government has passed restrictions on how and when companies can market unhealthy food to children, WashPost reports.
Life expectancy for Americans ages 25 to 64 has not kept pace with other wealthy countries, decreasing for the third year in a row, a comprehensive study published Tuesday in JAMA shows.
Why it matters: Death rates among young and middle-age adults stemmed mostly from suicide, drug overdose, obesity and liver disease, Axios' Marisa Fernandez writes.
By the numbers: Researchers looked at mortality data from the past 60 years. Death rates of people ages 25 to 34 jumped 29% from 2010 to 2017.
Several opioid manufacturers and drug distributors are facing criminal investigations from the Department of Justice about whether they intentionally skirted federal law by not monitoring the flow of potent painkiller pills, the Wall Street Journal reports.
Why it matters: Purdue Pharma has already been ensnared in criminal probes, and now federal prosecutors are casting a wider net to determine the level of alleged wrongdoing that has resulted in tens of thousands of overdose deaths, Bob writes.
Details: At least six companies are being investigated: Teva, Mallinckrodt, Johnson & Johnson, Amneal Pharmaceuticals, AmerisourceBergen and McKesson, per WSJ.
Meanwhile, the judge presiding over the giant consolidated opioids case in Ohio announced yesterday that the trial against pharmacy defendants will be held Oct., 13, 2020.