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With all the controversy that seems to surround healthcare in the news these days, it's reassuring to know Medicare Part D is performing well both administratively and in patient service. Since its inception ten years ago, the program consistently runs under its projected budget, costing 45 percent less than Congressional Budget Office estimates. In addition, nine out of ten beneficiaries say they're satisfied with their coverage. (Sherry Williams, 10/9)

During a week when 179 lawmakers including one Democrat called on the CMS to “stop experimenting with Americans' health” with mandatory payment reforms, the CMS announced without fanfare or opposition that it will allow some of the nation's leading insurers selling Medicare Advantage plans to use value-based insurance design in as many as 10 states starting in 2018. OK, it's only a pilot. But VBID remains one of the most promising reforms to health insurance to come along in decades. Medicare beneficiaries in VBID-style plans will be paying lower co-pays and deductibles for high-value healthcare services. (Merrill Goozner, 10/8)

Permit us to interrupt the presidential candidates’ Twitter blasts with a serious request: Please devote some time ... to health, science, technology and related matters. Debates should explore new topics, not just rehash the attacks and talking points heard in every interview and stump speech. ... Medicine deserves some frank appraisals from both candidates. How will they provide leadership to handle disease outbreaks like Zika and help those suffering from mental illness or opiate addiction? Diseases kill far more people than terrorists do. Research into scientific areas deserves more federal funding. Who will make sure NASA, the Centers for Disease Control and Prevention and other agencies have adequate resources to keep America at the forefront of innovation? (10/8)

Given its name, you’d expect the federal 340B Drug Discount Program to save money for the American health system. When it comes to cancer, though, it’s actually a major driver increasing costs, according to a report from the Community Oncology Alliance. The program was created in 1992 to financially support so-called safety net hospitals that provide charity care to poor and underserved patients. ... But “creative uses” of 340B have contributed to increasing the cost of cancer care, boosted revenues for hospitals (which charge more for cancer care than community oncology practices), and expanded the use of hospital outpatient cancer services. (Debra Patt, 10/7)

The Affordable Care Act is a revolutionary piece of legislation that addressed a major need: expanding Americans’ ability to access the health care system. This imperfect and embattled law now covers 90 percent of citizens and brought about a reasonable change in the way medical providers do business so they would squarely focus on better health outcomes. In addition, ACA ended the practice of denying a patient insurance coverage because of a pre-existing condition and elevated the role of preventive care. ... However, uncertainty persists about the law due to repeated efforts to repeal it.The solution requires bipartisan cooperation to fix what is wrong with the law and grow its promise of making Americans healthier and reducing health care costs. (David Plazas, 10/9)

You probably have no idea what your surgery will cost — and good luck trying to find out. But once it exceeds the out-of-pocket limit on your insurance, you don’t care. You won’t walk over to Chevy for a cheaper price. The result is a fun-house mirror reflection of free market economics. People don’t understand what they’re buying, and insurance is paying most of the bill. So medical providers don’t really have to compete on quality or price.The things they do compete on — convenience, whiz-bang technology, heart-tugging TV ads — push prices up, not down. (Jim Gallagher, 10/9)

California’s ballot initiative process traditionally has been a laboratory for new methods of campaign deceit. Novel examples of hypocrisy, misrepresentation, deliberate errors of commission and omission all have been paraded past the voters, often lubricated by millions of dollars in corporate funding. That’s not the case with Proposition 56, a November ballot measure that would more than triple the state tax on cigarettes and levy excise taxes on e-cigarettes for the first time. (Michael Hiltzik, 10/7)

The state Commerce Department recently announced that consumers who buy health insurance on their own will face average rate increases of 50 to 67 percent for 2017. While just 5 percent of Minnesotans buy health insurance on their own instead of getting it through their jobs or public programs such as Medicare, some people simply won’t be able to afford health insurance. Financial aid to instantly discount monthly premiums is available through MNsure, but not everyone qualifies. The Star Tribune Editorial Board has called for a special session to provide immediate relief to people potentially priced out of this market. (10/7)

In August, a medical student at the Icahn School of Medicine at Mount Sinai in New York jumped out of an eighth-story window to her death. Stories like this are too common among budding doctors across the United States. In May, a medical student at the University of Southern California took his own life. At the University of California at San Diego, a third-year medical student killed himself last year. Two years ago, when I was a medical student at Harvard, a fellow student died of suicide. (Nathaniel Morris, 10/9)

In 44 states a jail or prison holds more mentally ill individuals than the largest state psychiatric hospital, reports the Treatment Advocacy Center. The total includes Nebraska. For example, in the Douglas County Jail about 20 percent of inmates, or about 290, would have a serious mental illness, based on national statistics, TAC said. (10/10)

You may have read or heard about the study debunking the five-second rule. It said that no matter how fast you pick up food that falls on the floor, you will pick up bacteria with it. Our continued focus on this threat has long baffled me. Why are we so worried about the floor? So many other things are more dangerous than that. (Aaron E. Carroll, 10/10)

A truly dedicated anti-garden fanatic could, of course, just call in the bulldozers. But this will make it more difficult, expensive and noticeable to do so. By itself, this is a mildly amusing instance of a political figure trying to reach into the future and prop up her own legacy. But it’s actually an example of a much bigger political phenomenon, one that matters a great deal for both our political system and our economy. (Megan McArdle, 10/7)