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With the advent of the Affordable Care Act, the share of Americans convinced that health care is a right shrank from a majority to a minority. This shift in public opinion is a major victory for the Republican Party. It is part of a larger trend: a steady decline in support for redistributive government policies. Emmanuel Saez, an economics professor at Berkeley and one of the nation’s premier experts on inequality, is a co-author of a study that confirms this trend, which has been developing over the last four decades. A separate study, “The Structure of Inequality and Americans’ Attitudes Toward Redistribution,” found that as inequality increases, so does ideological conservatism in the electorate. (Thomas B. Edsall, 4/15)

It is widely held that the dopiest anti-Obamacare lawsuit is King vs. Burwell, a conservative contrivance that tortures four words in the Affordable Care Act to assert that consumer healthcare subsidies in three dozen states should be invalidated. But the Supreme Court has taken up King for a ruling, which implies that at least four justices think the assertion is worthy of consideration. (A decision is due early this summer.) That leaves a lawsuit entitled Johnson vs. U.S. Office of Payroll Management holding the crown. On Tuesday, however, the Chicago-based U.S. Court of Appeals for the 7th Circuit tossed the case with a horselaugh, so its reign may be ending. (Michael Hiltzik, 4/15)

For a while now, I’ve been saying that the most important Obamacare deadline this year was not the end of open enrollment on the exchanges, but April 15. That’s when lots of people find out that they owe money to the government -- either because they didn’t have insurance and therefore get hit with the individual mandate penalty, or because they found out they received too much in subsidies and now owe money to the government. So how’s it going? As with many things about this law, it’s hard to tell. (Megan McArdle, 4/15)

In the five years since the passage of ObamaCare, the battle over the law has not abated. One popular salvo is the supposedly objective “let’s just see how it is working” analysis carried out by the law’s supporters. There are two tricks common to this line of reasoning. (Cliff Asness, 4/15)

No single fact can settle the long-running debate of whether public or private health insurance is preferable. But by one basic metric, the rate of increase in per capita spending, public insurance has an edge. The Federal Office of the Actuary in the Centers for Medicare and Medicaid Services has charted the annual rate of increase in spending for Medicare, Medicaid, and private health insurance. ... by cumulative growth in per capita spending, Medicare and Medicaid have generally grown more slowly than private insurance and are projected to continue doing so through 2023. Per capita spending is an especially useful measure for comparing public and private health insurance spending because it shows how much Medicare, Medicaid, and private insurers spend on each person irrespective of the number of people covered. (Drew Altman, 4/16)

Gov. Rick Scott and Florida House Republicans love to complain about government wasting money, particularly when they are focused on Washington. Yet they demand that the Obama administration keep sending money to cover hospital charity care and oppose helping low-income Floridians buy private health insurance. It is an indefensible position at odds with their support for fiscal restraint and private market solutions, but partisan politics has clouded their vision and put the health of nearly 1 million residents at risk. (4/15)

You really should be paying attention to the ongoing battle over the Medicaid expansion in Florida. If supporters of Obamacare get their way, it could help weaken the blockade of opposition that conservatives have successfully used to stall the expansion in multiple states this year, after it seemed to be progressing last year. (Greg Sargent, 4/15)

Missouri is facing a health care crisis, one that is threatening both urban and rural communities. Hardworking families cannot afford health insurance, hospitals are struggling to keep their doors open, and services for low-income Missourians are being cut or eliminated. Meanwhile, bureaucrats in Washington, D.C., and our legislators in Jefferson City are blocking common-sense solutions to protect our vital health care safety net. ... Unfortunately, anger over Obamacare has confused the issue. (Christopher S. Bond, 4/15)

If the Tennessee General Assembly had passed Gov. Bill Haslam's plan to extend insurance coverage to the working poor, about $3.1 million would have been spent today at doctor's offices, pharmacies and hospitals big and small across the state. ... The Insure Tennessee plan proposed by Haslam, and rejected by a fearful legislature with little debate, is one of the best economic stimulus programs for small towns and rural communities in this state that can be conceived. ... No matter the scorn that is being heaped on legislators now, they are not going to bring the Insure Tennessee plan to a vote before the session ends in a couple of weeks. But we would hope that legislators pay more than lip service to a summer study and that they talk to a broad swath of their constituents when they go home. (Frank Daniels III, 4/15)

Congress has finally crafted a permanent doc fix, which passed the Senate in a stunning display of bipartisanship, 92-8. This is a good reminder of what we didn’t like about bipartisanship: Congress found agreement so easy because what it agreed to do was not pay the full price tag of this rather expensive fix. On the other hand, it had long been clear that the cuts would never be allowed to take effect, and the things it found to finance its annual gifts to the doctors' lobby were getting increasingly ridiculous, so it’s hard to be too upset. (Megan McArdle, 4/15)

I opened the curtain and found my patient stretched out flat on the recliner, one arm thrown across his eyes. Worried, I reached for his pulse, but then I heard a soft snore. He was sound asleep, before I’d given him any anesthesia. I felt far less relaxed than he seemed to about his upcoming surgery. Thanks to the Affordable Care Act, this man had health insurance for the first time in over a decade, and his diabetes, hypertension, clogged blood vessels and early emphysema — the death threats silently stalking him for years — had finally been identified and treatment had been started. Already an ophthalmologist had discovered that he would most likely go blind without surgery, and every day he delayed put his vision at risk. But you don’t undo 10 years of neglected health in six months. (Carol W. Cassella, 4/15)

I usually think of April as tax month, but it seems to be morphing into National Get Tested Month. Dallas Mavericks owner Mark Cuban advised Twitterers to have their blood tested for everything available -- and to do so every three months. Following her mother's cancer diagnosis, singer Taylor Swift urged her fans to remind their parents to get screening tests. And Arizona Gov. Doug Ducey signed legislation to allow Arizonans to get any lab test without a doctor's order. ... Some might argue that this freedom to test is the path to a healthier society. But the primary effect won't be more health, but rather more medical care. (H. Gilbert Welch, 4/15)

So, as much as physicians must commit to long hours of hard and careful work and practice to deliver best care, they must also commit to always providing ethical care according to the virtues and values of the profession. Mindful self-knowledge may help, but a strong will and moral commitment are required to guard against ethical lapses. The center of medical ethics can be redirected by making explicit the moral nature of ordinary physicians’ work. A very wise ethicist said that medicine has a primary end, “which is healing and helping and which supersedes the doctor’s self-interests.” In today’s environment, it bears re-emphasis that providing the best possible care for patients is a moral mandate encompassing not just resolving ethical dilemmas, but the whole of a physician’s work. (William T. Branch Jr., 4/14)

Cognitive aging is a lifelong process of gradual, ongoing, yet highly variable changes in cognitive function that occur as people get older. ... Cognitive aging is not a disease or a quantifiable level of dysfunction. It is distinct from Alzheimer disease and other neurocognitive and psychiatric disorders that affect older adults’ cognitive health .... An individual and society can be affected by cognitive aging because of 2 issues. First, older adults lose an estimated $2.9 billion a year, directly and indirectly, to financial fraud. ... Second, older adults may develop problems with driving, especially because reaction time is critical and decision making must be at times almost instantaneous. (Drs. Dan G. Blazer, Kristine Yaffe and Jason Karlawish, 4/15)

The Culture of Organs, a book published in 1938 by Nobel Laureate Alexis Carrel and well-known aviator Charles Lindbergh, described how organs could be kept “alive” in culture for months, with the intent to reuse them. Decades later, regenerative medicine, a field of science that aims to restore or establish normal function by replacing or regenerating human cells, tissues, and organs affected by disease, is becoming a reality. The field is a progression of previous efforts to restore function, ranging from prosthetics to organ transplants. Advances in cell biology, biomaterial science, and biological molecule discovery have led to new options for cellular therapies, engineered tissues and organs, and new strategies to stimulate endogenous repair and regeneration. (Anthony Atala and Sean Murphy, 4/14)