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Hardly anyone amongst us has been spared the heartache of seeing someone battle for their life against an incurable disease. In those moments, we invariably ask ourselves: “What more can we do?” Over the last year, members of the House Energy & Commerce Committee have put that question to doctors, patients, experts, and medical innovators across the country, and their input has formed the foundation of a bipartisan initiative called “21st Century Cures.” (House Speaker John Boehner, R-Ohio, 7/9)

The 2010 healthcare reform law was supposed to promote competition among insurers, and for many policyholders it's done just that. These days, though, the insurance industry is going through a wave of mergers that threatens to leave consumers with fewer choices. There's no single motivation behind the mergers, although they all reflect the changing economics of healthcare. ... The obvious risk posed by the current merger wave is that the Medicare Advantage and Medicaid HMO markets in some states could become dominated by a single insurer, raising prices for consumers and potentially driving doctors out. Such problems can be addressed to some degree by ordering the merging companies to sell some operations to rivals in states with too few competitors. The subtler but no less important issue is the threat that consolidation poses to innovation. (7/9)

If any single fact illuminates why reining in health care spending is going to be easier said than done, it might be this: we don't even really know why a typical, low-risk childbirth costs $1,200 at some hospitals and $12,000 at others. In fact, until recently it was unclear how much variation there was in the cost of childbirth in the first place. A new Health Affairs study examined nearly 275,000 low-risk childbirths at 463 hospitals spread across the country and reported the ten-fold spread in the cost of having a baby. The good thing is that widely varying costs like this suggest big opportunities for savings. (Carolyn Johnson, 7/9)

The Obama administration's move this week to promote end-of-life planning is a belated win for Medicare doctors, who will soon be able to bill the program for more of the time they spend counseling patients on that subject. More important, though, it is a win for Medicare patients. There's a reason so many medical professionals want people to go through the process of completing an advance directive -- a set of instructions telling doctors what to do with them in the event they're incapacitated. They want individuals who are faced with crucial decisions about their care to make them for themselves. (Jon Healey, 7/9)

There was a lot about the period leading up to the passage of the Affordable Care Act that was ridiculous and maddening, but perhaps no episode was worse than the controversy over “death panels.” Here you had a small provision of the bill that doctors, patient advocates, and health care experts all agreed would lead to better care, not to mention cost savings. Then Republicans concocted a lie about it, spread that lie as far as they could, and finally saw the provision removed from the final legislation. Well, now Medicare is finally doing what that provision of the ACA would have done. (Paul Waldman, 7/9)

Like most Americans of a certain age, I spend a fair amount of money on health care. Even with good insurance coverage, I still have to shell out a couple thousand bucks every year for assorted issues. I get a bad cold at least twice a year and need to visit the doctor to get antibiotics. That usually means several visits. I also get my cholesterol and blood sugar levels checked every few months. Lately I’ve been getting treatment for a chronic ear infection. And I visit an acupuncturist every two weeks to ease the pain from a cyst on my spine. The doctors I visit do a terrific job. I have no complaints whatsoever about the level of care they provide. My only problem is: Why don’t they ever buy me a free round? (Joe Queenan, 7/9)

My daughter, Rose, was born with a congenital heart defect, what insurance companies before 2014 would have called a “pre-existing condition.” Fortunately, she had insurance as a child, but more than once I thought, “What if she didn’t?” At its best, that euphemism “pre-existing condition” disguised barbaric treatment for the most vulnerable. The Affordable Care Act ended this choice for insurance companies. My daughter just graduated from college and has good affordable health insurance through healthcare.gov. Before she even entered adolescence, I had seen my daughter have two open heart surgeries. The surgeon broke her breast bone, the surgical team stopped her heart and put her on a heart-lung machine. Believe me, I don’t want her to undergo any more surgeries, but I do want my daughter to get the health care she needs to live her life. The Affordable Care Act gives her and many others that freedom. (Kathy Kyle, 7/9)

A couple of weeks ago, right after the U.S. Supreme Court ruled that one faulty sentence in the Affordable Care Act shouldn’t be used to throw the federal law into chaos, I noticed a statement sent via Twitter by U.S. Rep. Ann Wagner, the Republican congresswoman from eastern Missouri. “Today’s SCOTUS decision doesn’t change the fact that Obamacare is deeply flawed and puts an undue burden on Americans,” she said. ... I indulged myself by posting a mildly sarcastic (by Twitter standards) rejoinder to Wagner’s tweet. ... That earned me a cyberspace rebuke from one of Wagner’s supporters, who said: “Consistency of stance is a good thing, right? The media would go bananas if Ann changed her opinion, and yet you mock her.” You know, it really is a brutal world out there, in the frothing sinkholes of social media, talk radio and cable news. And I suppose there would be hell to pay for any member of Congress who announced, “In light of the latest Supreme Court ruling, I will be meeting with members of the party across the aisle to seek common ground on Obamacare going forward.” (Barbara Shelly, 7/9)

Medicaid has grown exponentially since the mid-1980s, during both conservative Republican and liberal Democratic administrations. How has this happened? The answer is rooted in three political variables: interest groups, political culture, and American federalism. (Michael S. Sparer, 7/7)

In the aftermath of King v Burwell, a vital pillar of affordable access remains—subsidies for low- and middle-income individuals. After 2 elections, ongoing legal challenges (including 2 Supreme Court cases), and numerous repeal bills, political divisions should be put aside to ensure the social contract underlying the ACA. In a decent and just society, those who are relatively well-off, young, and healthy make it possible for everyone to access the care they need. If it is too easy for individuals, businesses, and states to opt out of this social bargain, the edifice of affordable care could unravel and with it the promise of a healthier, more secure population. (Lawrence O. Gostin, Mary C. DeBartolo and Daniel A. Hougendobler, 7/9)