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The Republicans seem determined to "repeal and replace"Obamacare. They simply cannot bring themselves to consider fixing what they have come to revile. Being against the president's namesake legislation has been a big winner in at least two out of the past three elections. But now that Republicans are in charge of the Congress, just attacking Obamacare won't work. They have to put something on the table. (Robert Laszewski, 1/14)

Health insurance reform can and should be fixed. Obamacare is an overregulated monster of an insurance marketplace reform that violates a basic marketplace rule ­­­­–– it doesn't meet most customers' needs because of its individual mandate and penalties, its limited choices, high deductibles, still high premiums and narrow provider networks. But there are many parts of it that should be kept and built upon. (Robert Laszewski, 1/14)

On Medicaid expansion, Sen. Charles Scott needs to get on board or get out of the way. At the moment, the Casper Republican is trying to play the spoiler. He's lambasting a reasonable expansion plan as some lunatic European-like scheme and pushing his own expansion version, a retread of a plan Scott long has pushed but the state doesn't want. It's a tired, dog-whistle approach, and we expect better from Scott. We're not the only ones who feel this way. (1/14)

The Affordable Care Act is raising costs, restricting patient choice and doctor freedom, and putting bureaucrats in the treatment room. It isn’t good—but it’s here to stay, largely intact, at least until a Republican president can work with a Republican-controlled Congress. But that doesn’t mean nothing can be done. The onus is now on physicians to innovate and improve patient outcomes within the restrictive confines of an ObamaCare world. (Gerard J. Gianoli, 1/14)

After rising for a decade, the number of Americans experiencing financial distress from their medical bills has started to decline, a new survey has found. The result provides new evidence that the Affordable Care Act, by providing uninsured people with health insurance, is also improving their financial security, a major goal of the law. (Margot Sanger-Katz, 1/15)

The real problem in the out-years comes with automatic spending that makes up the biggest portion of the federal budget. Social Security and Medicare are popular middle-class programs, and it’s politically risky for Republicans to tinker with them. The GOP usually tries to root out waste and fraud in welfare programs aimed at helping the poor; but in the process, Republicans are often accused of being insensitive to the needs of the poor. Yet you can’t balance the budget by not touching entitlements. (John Feehery, 1/14)

Eli Lilly charges more than $13,000 a month for Cyramza, the newest drug to treat stomach cancer. The latest medicine for lung cancer, Novartis’s Zykadia, costs almost $14,000 a month. Amgen’s Blincyto, for leukemia, will cost $64,000 a month. Why? Drug manufacturers blame high prices on the complexity of biology, government regulations and shareholder expectations for high profit margins. In other words, they say, they are hamstrung. But there’s a simpler explanation. (Peter B. Bach, 1/14)

University of Pennsylvania bioethicist Dr. Ezekiel Emanuel struck again the other day with a recommendation that many Americans might see as a message from the Ivory Tower: Skip your annual physical because it's “worthless.” This after the healthcare reform law he played a role in crafting made such exams available to many Americans free of charge under their insurance. ... Actually, there are practical reasons why such exams are necessary, at least for now. (Harris Meyer, 1/14)