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Obamacare ... has been variously justified by the cost to the state of emergency room care; the cost to society of free-riding young folks who don't buy insurance until they get sick; the public health cost of people who don't go to the doctor and get really, expensively sick; an unhealthy workforce that is less productive; and the cost to friends and relatives who have to chip in to cover uninsured medical expenses. I didn't find any of those arguments particularly convincing. (Megan McArdle, 2/17)

As people hear that health spending is beginning to grow more quickly again, many may recall reports they may have read recently about the shockingly high cost of some medical procedure, or how much a hospital CEO is being paid, or what they pay for their own prescription drugs. The prices Americans pay for health services are a big problem, but the culprit behind the renewed growth we are seeing in spending is not the rising price of health services. (Drew Altman, 2/17)

This basically sums up the U.S. health-care system: poor quality and not much to show for it. Other nations keep their people healthy at a much lower price. There is much we can learn from them. In 2013, the U.S. spent over $9,000 to provide health care for each man, woman and child—one-third more per person than any other wealthy nation. Thanks to the recession and the early impact of the Affordable Care Act, expenditures are growing by the slowest rate since 1960. However, we’re leveling off at a very high-cost plateau—$2.9 trillion. (Drew Harris, 2/17)

Being the dean of Harvard Medical School imposes a need to anticipate the ways that science and medical practice will evolve over the coming decades. The reasons should be obvious. We need a medical curriculum that reflects the values and skills physicians will need, the changing ways they will access and employ information, and the health care system within which they will likely operate. On a recent sojourn to Silicon Valley, I had a chance to meet with leaders at Apple and Google, as well as with several aspiring health startups. These meetings clarified and focused my thinking on the ways that health care may be different in 10 to 20 years. (Jeffrey Flier, 2/17)

For years, clinical science has been linking ailing mental health to physical problems. Alcohol addiction can result in cirrhosis of the liver; obesity can be a manifestation of chronic depression rather than merely the result of poor food choices. Back pain could be musculoskeletal or it could be the result of anxiety or stress manifesting in physical pain. The science is clear: It’s time to reintegrate mental health with the rest of health care. (Atul Grover, 2/17)

Last month, three ethicists from the University of Pennsylvania argued in the Journal of the American Medical Association that the movement to deinstitutionalize the mentally ill has been a failure. Deinstitutionalization, they wrote, has in truth been “transinstitutionalization.” As a hospital psychiatrist, I see this every day. Patients with chronic, severe mental illnesses are still in facilities — only now they are in medical hospitals, nursing homes and, increasingly, jails and prisons, places that are less appropriate and more expensive than long-term psychiatric institutions. The ethicists argue that the “way forward includes a return to psychiatric asylums.” And they are right. (Christine Montross, 2/18)

Republicans have been railing against big government for years, but for the past two decades they have all but ignored the growth of one of the nation’s biggest and costliest programs: Social Security Disability Insurance (SSDI). That may be changing. Congressional Republicans are making noises about fundamental reforms, voicing concerns that “malingerers” are swelling the ranks of the beneficiaries .... SSDI is a big target. It provides a monthly check to more than 10 million people at a cost of $140 billion annually in 2013. The program has been growing for years, a surge attributed to a mix of factors, including the increase in Social Security’s full retirement age, the aging of the baby boomers and the growth of women in the workforce (which has increased the pool of possible recipients). (Thomas F. Burke and Jeb Barnes, 2/17)