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Sometimes a cogent attack on a worthy target ends up making the target stronger. That may be happening with last week's letter signed by 10 physicians urging Columbia University to sever its ties with Dr. Mehmet Oz, who has made a fortune promoting quack nostrums to his huge television audience. Oz's TV producers say he'll be devoting a large portion of a forthcoming "Dr. Oz" show, probably Thursday's, to a counterattack. Of the doctors behind the letter, the producers say, "We plan to show America who these authors are, because discussion of health topics should be free of intimidation." (Michael Hiltzik, 4/20)

California is in the midst of a dispute between parents who want to exempt their children from some or all of the vaccinations required for admission to public and private schools and a medical establishment that believes, with good reason, that vaccines can protect the students from the harm caused by infectious diseases and reduce the risk of transmitting the diseases from schools to the broader community. A sensible bill pending in the Legislature would eliminate exemptions based on a parent’s “personal belief” that the vaccines might harm a child and allow exemptions only for students with medical conditions that would make vaccination unsafe. (4/20)

It was a sure bet that if health-care costs fell after the Affordable Care Act was passed, we’d see people writing articles about how the law had finally gotten health-care costs under control. And so it has come to pass, and so a number of readers have written me to ask whether this is actually true. The short answer is that I’m far from convinced. (Megan McArdle, 4/20)

Tax season has come and gone with no great outbreak of protest about the Affordable Care Act’s least popular provision: the individual mandate. ... The one-two punch of the mandate and repayments at tax time might have produced a public backlash–but it has not. One reason may be that the public was prepared–that between news media coverage of these issues and government officials and organizations involved in enrollment outreach talking about them often enough that paying the penalty or making a repayment was not “news” when tax season arrived. The government also offered a special extended enrollment period to people who were facing the penalty but didn’t know about it and were still uninsured. Even though a very modest number of people took advantage of it this, it may also have helped to diffuse the issue. (Drew Altman, 4/21)

Cost-shifting is standard terminology in health care finance classes. Simply put, it means rolling up the uncompensated costs of care into the price or insurance premium of those who actually pay for health care. ... The reality is that cost-shifting is a more efficient way to pay for the uninsured than Medicaid. Filtering your health care dollars through a government agency will peel off a significant percentage of your dollars to pay for government overhead but will not reduce the cost of health care, increase access, or increase health care outcomes. (Brent A. Fisher, 4/19)

Access to quality and affordable healthcare should be a right and not a privilege. To date, 29 states, including the District of Columbia, have made the critically important decision to expand Medicaid. I urge the State of Alabama to expand Medicaid without delay. Alabama's reluctance to expand Medicaid has placed access to quality health care out of reach for too many of our state's working poor families and individuals. (Rep. Terri Sewell, D-Ala., 4/20)

Under the governor’s plan for Medicaid modernization, the state and federal governments will spend more than $4 billion to manage and implement health services for Iowans on Medicaid. This is one-half of the state’s entire budget. The governor has claimed that the state will save $51 million in the first six months of managed care. These savings must be devoted to ensuring that the transition to managed care is carefully planned, taxpayer money is effectively spent and services are maintained. ... To date, the governor has not explained to Iowans how he intends to make the managed care companies accountable and responsible. This should alarm us all. (Jane Hudson, 4/20)

Of all the complex rules that plague fee-for-service Medicare, few are harder to understand and potentially more important for seniors than observation status. By now, many older adults have heard the phrase. But they are still not clear what it means. A new study by AARP sheds some light on the consequences for seniors of hospital observation stays. But they turn out to be a muddle, in part because Medicare pays for hundreds of millions of dollars of skilled nursing facility care that probably should be billed to patients. The AARP study, written by Keith Lind and Claire Noel-Miller of AARP’s Public Policy Institute and Lan Zhao and Claudia Schur of the consulting firm Social & Scientific Systems, finds the rules are a complex mess, and it is impossible for patients to predict whether an observation stay is financially more or less beneficial than an admission. (Howard Gleckman, 4/20)