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Sympathetic plaintiffs make good headlines, but they often make bad law. That’s the case at the Supreme Court on Wednesday, where the Justices will consider whether UPS illegally discriminated when it didn’t go far enough to accommodate a pregnant employee’s work restrictions. In Peggy Young v. United Parcel Service, Ms. Young is a longtime UPS employee and delivery truck driver who in 2006 asked the company to reassign her temporarily when a midwife told her she shouldn’t be lifting more than 20 pounds. UPS declined, on grounds that the company’s pregnancy-neutral policies provide special allowances for those injured on the job but not those whose disabilities happen outside the workplace. (12/2)

When the Supreme Court hears argument in a major pregnancy discrimination case on Wednesday, Justice Ruth Bader Ginsburg will be returning to familiar legal terrain. In the 1970s, Justice Ginsburg was a pioneering litigator working for women’s equality as the founding director of the ACLU’s Women’s Rights Project. One aim was combating pregnancy discrimination and the resulting denial of equal opportunity and equal status in society. (Dorothy J. Samuels, 12/2)

Peggy Young’s Supreme Court case sounds like a throwback to the “Mad Men” era, when employers weren’t expected — or required — to welcome women in general and pregnant women in particular. Unfortunately, Young’s situation reflects the reality, especially for lower-wage workers, that many companies continue to balk at reasonable accommodations for pregnant employees. (Ruth Marcus, 12/2)

Young didn't ask for a new or special accommodation, only that the "lighter duty" accommodation provided to others should have been available to her. The plain language of the [Pregnancy Discrimination Act in 1977] requires employers to provide pregnant workers with the "same" accommodations that they provide to other employees who have "a similar ability or inability to work." The court has the opportunity to wipe away the judicial gloss and apply the act as written. Thirty–six years after the act was enacted, it's time that the law was fairly applied to fulfill its goal to assist working women who want a family, too. The court may not be able to fix, in one case, all of the negative cultural fallout of [Roe v. Wade], but at least it can fairly apply the legal remedy that Congress enacted. (Clarke D. Forsythe, 12/2)

It’s not often that a politician provokes conflict within the ranks of his party’s core supporters. [Sen. Charles] Schumer did just that in a National Press Club speech on Nov. 25, three weeks after devastating Democratic losses in Senate, House, gubernatorial and state legislative elections. According to Schumer, President Obama and his party suffered defeat last month in large part because of the strategic decision to press for enactment of the Affordable Care Act soon after Obama won the presidency. (Thomas B. Edsall, 12/2)

So how should we account for the apparently widespread perception of higher costs under Obamacare? There are at least two answers. The first, [Kaiser Family Foundation's Gary] Claxton said, is that although average premiums aren't rising any faster, the premiums differ less from company to company. Before the law was passed, those premiums were based in part on the health and age of the employees using the plan, which meant that employers with younger or healthier workers could pay significantly less. ... The second explanation has nothing to do with premiums; it attributes rising costs to the way employers attempt to shift premiums to workers. On that count, the numbers are clear: Workers are getting hit harder than they have in years. (Christopher Flavelle, 12/2)

A line buried in a Heritage Foundation policy paper issued just before the November elections hinted at a major fissure point in discussions surrounding a conservative alternative to Obamacare. The distinctions it raised could shape the form of any health-care alternatives the Republican-led Congress considers next year. (Chris Jacobs, 12/2)

When a new patient between the ages of 18 and 25 arrives at my office, he or she generally has a specific request: a physical exam as clearance for football season, a refill of an asthma inhaler, reassurance that a sore throat isn’t strep. These young men and women are healthy and don’t expect to be asked very much, or little beyond the usual waiting room questionnaire. My job, as I see it, is not only to respond to any requests or questions, but also to ask them about the things 18- to 25-year-olds do: attend college (or consider it), search for employment, separate from (or return to live with) parents, find romantic partners, shrug off one-night stands, run out of money, feel confused or depressed or anxious, experiment with drugs and alcohol. (Michael Stein, 12/1)

Long-acting reversible contraceptive (LARC) methods are gaining greater popularity in the United States as both patients and health care professionals become educated about their high contraceptive efficacy, relatively few contraindications, and ease of use. In fact, LARC is recommended by the American Congress of Obstetricians and Gynecologists and the American Academy of Pediatrics as a first-line contraceptive option for adolescents. ... However, few primary care clinicians, especially those outside of family medicine, have received the procedural women’s health training necessary to offer these highly effective contraceptive methods. Despite an upsurge of interest in LARC, there is no standardized LARC training in pediatric residency programs or adolescent medicine fellowships. This lack of training poses one of many barriers to young women trying to access these methods. (Drs. Julia Potter, Atsuko Koyama, and Mandy S. Coles, 12/1)

Whenever I write about mammography, I receive letters from women who tell me that a mammogram saved their life. Some of them are correct, but the inconvenient truth is that most of them are actually victims of overdiagnosis. In every decade studied—40s, 50s, and 60s—a mammogram is more likely to “cure” me of a harmless cancer (by subjecting me to life-disrupting and potentially harmful treatments like chemotherapy and radiation) than it is to prevent me from dying of breast cancer. For me, that’s a deal breaker. ... Looking at the numbers, it’s clear that the risk of a mammogram leading to unnecessary diagnosis and treatment for breast cancer is tiny, but the chance of a mammogram saving my life is even more miniscule. (Christie Aschwanden, 12/1)

Many patients may believe that we would not offer a test if it isn’t needed. Our efforts to “offer” are often perceived by patients as an endorsement of the test or procedure. ... It’s time we get beyond a “cookbook” approach of simply offering mammograms. It may seem like the safe bet, to offer it so we don't “miss” breast cancer. Yet finding breast cancer or having a false-positive test result can be a stressful and traumatic experience. Quality of life and patients’ values and preferences must be considered. After age 75 years, or, in this case, 83 years, would detection and treatment of cancer improve quality of life? Is the risk of a false-positive test result worth the benefit a mammogram might offer at this age? This is a decision each patient can make for herself, but only if she understands the tradeoffs. (Tom Bartol, 12/1)