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Here’s a simplified explanation of how Medicaid expansion is funded. Imagine an optional program available to 10 members for a shekel a year. All the members will share in the funding regardless of whether they participate. If five members participate, the cost of five shekels is divided among the members at a cost of half a shekel each. In other words, the non-participating members send their half-shekel to the participants. If all members sign up for the optional program, the cost for each goes up to a shekel each, and all receive the benefits of the program. (3/12)

The future of the local public mental health agencies that have successfully served this population for decades is now in jeopardy thanks to Gov. Rick Snyder’s latest annual budget proposal, which would would transfer mental health funding to for-profit health insurance firms. (Hair, 3/12)

Everyone is in favor of value-based reimbursement in healthcare, right? If you're still wearing those rose-colored glasses, take a closer look at last week's reaction to Medicare's proposal to test new ways of paying for drugs administered in physician offices and hospital outpatient departments. (Merrill Goozner, 3/12)

Arizona has the highest rate of uninsured children among the families who would benefit most from the restoration of the program. Restoration would allow KidsCare to once again bring health care to children whose families make too much to qualify for the state’s Medicaid program, but too little to buy insurance on their own. These are children of the working poor. (3/12)

More than a year after I led the fight in Congress to pass major bipartisan legislation that enacted the most significant VA reform in a decade, the system is still not working for our veterans. I am frustrated and outraged by the slow nature of change at the VA. I know our veterans are, too. (John McCain, 3/13)

When California lawmakers voted last week to raise the smoking age from 18 to 21, the debate featured optimistic rhetoric that fines and bans would sharply reduce the number of young adults buying or using tobacco. This seemingly common-sense approach, however, doesn't work. There is virtually no systematic research showing that increasing the smoking age prevents a teen from picking up the habit. The Institute of Medicine acknowledged as much in a 2015 report, even as it optimistically projected a 12% decline in adult smokers if the minimum legal age for buying tobacco were 21 nationwide. (Mike Males, 3/11)

Late last year while playing tennis I reached up to serve and I felt a painful pop in my shoulder. The inflammation got worse over the next few months. Now anytime I try to put my arm above my head, pain shoots up my arm. I often wake up at night with an agonizing throb in my shoulder. So I finally and reluctantly went to the orthopedic surgeon and he said that I had a rotator cuff tear and I probably would need surgery. Ugh. He scheduled me for an MRI but the day I was set to go, the hospital called to tell me my insurance company declined to pay for the scans. The insurance company, CIGNA, tersely sent me a note: “You will need to complete six weeks of conservative treatment, such as physical therapy and anti-inflammatory medication. Once that has been completed and you have been re-evaluated, we can try to have the MRI re-authorized.” Gee, thanks. You guys are the best. (Stephen Moore, 3/13)

Now lawmakers at the state level are joining in on the demagoguery, with legislation that would punish employers for bad federal tax policy. In response to Pfizer’s November announcement that it is buying Allergen and moving its headquarters to Ireland, where the 12.5 percent corporate rate is less than one half of the 35 percent imposed by the United States, the New Jersey Assembly passed legislation that prohibits inverted companies from receiving state contracts or development tax credits. (Grover G. Norquist and Patrick Gleason, 3/14)

The forefront of the healthcare profession is a continually moving target. But what isn't changing are the characteristics that distinguish excellent leaders: They invest in themselves, in others and in their communities. The need for healthcare executives to invest in and expand their professional competencies and leadership capabilities has never been greater. (Edward Lamb, 3/12)

In 1999 Brandi Chastain scored the winning shootout goal in the World Cup soccer final against China, then stripped off her jersey and sank to her knees in exultation, arms thrust skyward. Another image of Chastain recently emerged: Now 47, a mother and a coach, the soccer star announced that at death she will donate her brain to the Concussion Legacy Foundation at Boston University, where researchers study chronic traumatic encephalopathy, the degenerative brain disease linked to concussions and head trauma. (3/11)

In the Land of the Falling Moms, every obstacle beckons with a kind of gravity. The curled corner of a rug. The slightly raised entryway. The uneven sidewalk. The slick tile. In the Land of the Falling Moms, the difference between upright and upended is measured in inches, but the consequences are calculated in months. (Stephen J. Lyons, 3/11)

Almost every day seems to bring more bad news about the Zika virus: babies born with malformed brains; adults suffering the progressive paralysis of Guillain-Barré syndrome; Americans diagnosed after traveling to the tropics; active transmission of the disease in U.S. territories. Several companies are working on a vaccine, but primarily because of regulatory requirements none is likely to become commercially available before the end of the decade. (John J. Cohrssen and Henry I. MIller, 3/13)