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D’ashon, a Texas toddler with severe birth defects, needed 24/7 nursing care to keep his breathing tube clean and to prevent him from pulling it out. His foster mother asked Superior HealthPlan, the insurance carrier that provides Medicaid services to the state’s 30,000 foster children, for additional nursing hours, according to a Dallas Morning News investigation. Superior said no, even after D’ashon’s doctors and nurses said that it was a matter of life or death. ...As a wealthy and politically powerful company gambles lives for profit, Texas officials look the other way, the Morning News reporters tell us. This is the sorry state of what passes for good-enough care for patients who depend on Medicaid, among the most vital safety nets for the American poor and disadvantaged, in the second most populous state. (6/6)

Another annual report is out from the Social Security and Medicare trustees. Which means it is the solemn duty of every economics columnist to acquaint their readers with some frightening numbers. Thanks to the Great Recession, the taxes paid into the Social Security program began to exceed the money flowing out in 2010.  But that is a permanent condition, not a recession-only shortfall; until taxes are raised or benefits are cut, the system will never return to balance. As more baby boomers retire, starting in 2022 we will begin to empty out the “trust fund,” which is supposed to buffer this imbalance. In 2034, it will be exhausted; under current law, benefits will then be slashed by 23 percent. (Megan McArdle, 6/6)

So another congressional session is half over and, we’re told, is likely to go by without a mention of the moose on the American table, our preposterously out-of-control federal debt. It’s not as though the stakes are high: just our standard of living, national security, all the discretionary activities of government, and literally our future as an autonomous, self-governing people. Every honest observer knows what will cause the coming crunch, so aptly termed by Erskine Bowles as “the most predictable crisis in history”: the runaway autopilot programs we call “entitlements.” Without changes there, no combination of other measures can come close to preventing the reckoning. (Mitch Daniels, 6/6)

Elizabeth Warren is still sparring with academics over a paper she published in 2005. The latest round came on Wednesday, in The New England Journal of Medicine, where she and her co-authors critiqued a recent paper that argued that medical problems cause a much smaller share of personal bankruptcies than many people think. One of the reasons many people think medical bills cause so many bankruptcies is Elizabeth Warren, now a United States senator and possible Democratic presidential candidate. (Margot Sanger-Katz, 6/6)

Dobkin et al. have made an important contribution in clarifying the relationship between health shocks and economic risk; like us, they have shown that health crises have major economic consequences for families and that even the insured are not adequately protected. However, in their Perspective article (March 22 issue), they mischaracterize our studies implicating medical problems as contributors to approximately 60% of personal bankruptcies, and their claim that medical bankruptcies are uncommon rests on methodologic choices that do not capture all medical causes of bankruptcy. (David U. Himmelstein, Steffie Woolhandler and Sen. Elizabeth Warren, 6/7)

Readmission rates are broadly accepted by payers and policymakers as a measure of hospital quality. But with providers increasingly relying on observation stays as an alternative to inpatient care, readmission measures may be omitting a key part of the quality equation. (Amber K. Sabbatini and Brad Wright)

In the fight for free-market principles in the health insurance market, there is one policy in particular that all conservatives can agree on: the expansion of health savings accounts (HSAs). These accounts allow consumers to save their own money tax-free to be used for medical expenses, putting individuals in charge of their own health care dollars. (Adam Brandon, 6/7)