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We are nearing the grand finale of our long and disheartening election opera, one we dare not ignore because the outcomes matter so much. While the election results will not be determined by public reactions to the Affordable Care Act, the ACA’s fate will be mightily determined by Tuesday’s outcomes. What have we learned about our collective health future over the past 18 months and what might this mean for our health system’s future? (John McDonogh, 11/7)

The ACA marketplaces aren’t the only health insurance markets to have faced turmoil. As we document in a recent report for the Robert Wood Johnson Foundation, the Medicare Advantage (MA) markets were roiled with health plan exits in the late 1990s and early 2000s. Between 1998 and 2002, close to 50 percent of MA plans cancelled their contracts, causing between 300,000 and 1,000,000 Medicare beneficiaries annually to lose their private plans. ... How government officials – primarily from the George W. Bush Administration and a Republican Congress – responded to that crisis could hold lessons for policymakers’ response to developments in the ACA’s marketplaces. (Sabrina Corlette and Jack Hoadley, 11/7)

Many people have to wait too long to see a doctor. And it could get worse. If, as many people believe, we have a shortage of doctors in the United States, then it follows that we can fix this only by training and hiring more physicians. As with almost everything in our health care system, though, it’s complicated. Some people think there’s no shortage at all — just a poor distribution of the doctors we have. (Aaron E. Carroll, 11/7)

As I rode my bike home the morning after finishing my first 28-hour shift at the hospital where I had just started as an intern, I made a confident turn onto a one-way street. But I was going the wrong way, smack into the path of a car heading in the right direction. Luckily, everyone was fine:  The driver honked, I swerved, then made it home and fell asleep. When I woke up that evening, I was shaken by the certainty with which I had biked directly into oncoming traffic. What other unsafe things could I have done after being awake for more than a day? ... The work schedule of medical residents and interns (first-year residents) is the subject of a fierce debate in academic medicine. Some say that making medical decisions after being awake for long periods is not good for patients or their doctors. Others argue that long shifts help interns and residents become better doctors by understanding the course of patients’ illnesses. At the center of this issue is a question for which we have surprisingly little data: What is best for our patients? (Mara Gordon, 11/7)

Caring for an aging parent is no easy task. ... That’s why having an engaged community that provides resources and support for older adults and the family members taking care of them is so important. Many communities in the East Bay have these resources and support systems already in place, but many residents don’t know about them. (Eileen Nevitt, 11/7)

This Veterans Day, Tennesseans will stand united in saluting our nation's heroes for their service to our country. However, many may not know that thousands of our state's veterans are living every day without access to healthcare coverage. Some are surprised to learn not all veterans are able to access healthcare through the Veterans Affairs (VA) system. Even for those who have access to VA care, there may be additional fees for treatment of a non-service related illness or injury. Here in Tennessee, there are an estimated 24,000 veterans struggling without healthcare, and they deserve a comprehensive coverage solution. (Adam Nickas, 11/7)

Regular readers already know that I am opposed to the statewide ballot measure, which would legalize recreational use of marijuana. I don’t like it because I fear the costs will outweigh the benefits, in particular the impact on our state budget, which already is stitched together with Band-Aids. ... Now a different side of me wants to make an appeal: the child of the ’80s who grew up with Nancy Reagan’s “Just Say No” to drugs seared in my brain. (Shirley Leung, 11/7)

As an eating disorder therapist, I hear from virtual pen pals who are so distressed by the measure of things — pounds lost and regained, dress sizes before and after kids, calories consumed and burned -– that they email me to save them from themselves. I offer therapy for local clients and Skype eating-awareness training for those who live farther away. But even when I can’t help, I exchange unsecured emails as willingly as I once answered phone calls. ... At least I did, until early last January. ... Only in hindsight can I see this e-relationship for what it became: an exemplary case about the pitfalls of treatment-related email. (Jean Fain, 11/7)