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Good morning. It's Wednesday, Dec. 6, and we're covering a widening ground offensive in southern Gaza, CVS' prescription drug-pricing overhaul, and much more. First time reading? Sign up here.


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Need To Know

Israel Expands Offensive

Israeli forces have entered Gaza's second-largest city of Khan Younis as Israel's ground offensive expands into the south. Officials say the latest fighting between Israel and Hamas has been the most intense since the war began two months ago as Israel seeks to dismantle what it says is Hamas' last major stronghold. Israel reportedly has made preparations to flood Gaza's tunnels with seawater as part of efforts to destroy an underground tunnel system used by Hamas. 


More than 1.87 million Palestinians—roughly 80% of Gaza's population—have been displaced from their homes so far, according to the UN. The death toll in Gaza has risen to at least 15,800, according to the Hamas-run Health Ministry; the death toll in Israel stands near 1,400. At least 137 of the more than 240 hostages Hamas abducted in its Oct. 7 attack remain captive. 


Separately, the US State Department announced it is imposing a visa ban on dozens of Israeli settlers and Palestinians who are believed to have been involved in attacks against each other in the West Bank. Gaza and the West Bank are separated by about 30 miles (see map). 


See updates on the war here. See the war in maps here.


CVS Drug Cost Overhaul

CVS Health yesterday announced major changes to how it will price its prescription drugs—a move observers say could increase transparency in the industry. The announcement comes amid growing government scrutiny of the current mazelike US drug-pricing system, which results in the world's highest per capita out-of-pocket spending on prescription drugs (see data). 


Under the CostVantage plan set to take effect in early 2024, pharmacies will be reimbursed the drug manufacturer's list price in addition to a standard markup and a dispensing fee. For decades, drug prices have been determined by an opaque, complex proprietary process generally overseen by pharmacy benefit managers, an intermediary historically tasked with finding the lowest cost for consumers (see history). CVS expects the move to reduce drug prices in many cases while acknowledging the price of some drugs could increase. 


The news follows the Biden administration's announcement of price caps on 10 prescription drugs in August designed to offset costs to consumers.


US Math Scores Slip

Math scores for American 15-year-olds dropped to an all-time low between 2018 and 2022, according to the latest results of an international exam, the first large-scale study marking the pandemic's impact on education. The Program for International Student Assessment, representing 620,000 students throughout 81 education systems in 38 countries, compares math, reading, and science academic performance.


The US saw a 13-point drop in its average math score—from 478 (of 1,000) in 2018 to 465 in 2022—with one in three students scoring below the basic level of proficiency. US reading and science scores stayed mostly even. The US ranked sixth in reading, 10th in science, and 26th in math among participating countries, an improvement from 2018 (largely because of declines in other countries). See US results here


Overall, the average math score across participating countries fell by 15 points—the equivalent of three-quarters of a year of learning. International reading scores fell by 11 points, while science scores remained relatively steady. See global results here

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In The Know

Sports, Entertainment, & Culture

In partnership with Wine Enthusiast

> Time magazine names Inter Miami star Lionel Messi as its 2023 Athlete of the Year (More) | Cleveland Guardians win top pick in 2024 MLB Draft; see full draft lottery results (More)

> Denny Laine, Rock & Roll Hall of Fame musician who was a founding member of The Moody Blues and Wings, dies at 79 (More) | Multidisciplinary artist Jesse Darling wins 2023 Turner Prize, widely considered most prestigious award for British artists (More)

> NCAA proposes new athletics subdivision that would allow certain schools autonomy to directly compensate student-athletes (More)

From our partners: Uncork joy this year with Wine Enthusiast! Find "Wine"derful gifts for everyone on your list, upgrade your sipping space during their Holiday Cellar Sale, and unwrap savings with their 12 Days of Deals through December 15. Special Offer: 15% OFF your first order. Use code “1440” at checkout (exclusions apply).


Science & Technology

> IBM and Meta (Facebook) launch AI Alliance to focus on collaborative open-source AI research and development with nearly 50 other organizations; partners include Intel, Oracle, NASA, and others (More)

> Engineers demonstrate under-the-skin implant to treat Type 1 diabetes by secreting insulin into the body; may offer a replacement for insulin pumps and injections (More)

> 3D eye scans may allow early diagnosis of kidney disease, study finds; decreased kidney function affects tiny blood vessels in the eye, leading to thinning of the retina (More)


Business & Markets

> US stock markets close mixed (S&P 500 -0.1%, Dow -0.2%, Nasdaq +0.3%) as US 10-year Treasury yield falls below 4.2%, the lowest level since August (More) | Apple's market capitalization closes above $3T (More)

> US job openings fall to 8.7 million in October, below analyst estimates and the lowest level since March 2021 (More

> US Supreme Court considers challenge to 2017 tax law's one-time repatriation tax on the proportionate earnings of Americans who own at least 10% of controlled foreign corporations (More) | JetBlue Airways, Spirit Airlines wrap testimony in antitrust trial over proposed $3.8B merger (More) | See our previous write-up (More


Politics & World Affairs

> Sen. Tommy Tuberville (R-AL) releases block on military promotions for three-star positions and below following monthslong protest over Defense Department abortion policies; about 10 four-star promotions remain on hold (More) | Rep. Patrick McHenry (R, NC-10), who served as interim speaker of the House, to resign at end of term (More)

> Fourth GOP primary debate scheduled for tonight (8 pm ET, NewsNation); former Govs. Nikki Haley (SC) and Chris Christie (NJ), Gov. Ron DeSantis (FL), and entrepreneur Vivek Ramaswamy to participate (More)

> One person killed, flood warnings issued as atmospheric river weather phenomenon passes over the Pacific Northwest; up to 8 inches of rain in 24 hours reported in some parts of Washington (More)

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Historybook: 13th Amendment of the US Constitution is ratified, abolishing slavery (1865); Washington Monument completed (1884); Hollywood actress Agnes Moorehead born (1900); NBA star Giannis Antetokounmpo born (1994); NASA photographs suggest presence of liquid on Mars (2006).

"Fear of life closes off more opportunities for us than fear of death ever does."

- Agnes Moorehead

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