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Paul Krugman tweeted about health care costs last week, suggesting excess-cost growth is ending. The point is significant. For decades, public and private health-care spending have grown significantly faster than the economy as a whole, a phenomenon known as excess-cost growth. Krugman’s tweet and a chart he attached from the Kaiser Family Foundation both suggest that growth has ended. If this is the case, then fear of a looming Medicare crisis is overblown, and Republican enthusiasm for cuts in Social Security, Medicaid and Medicare is misplaced on two counts. (Karl W. Smith, 1/11)

Unfortunately, no one in the federal government has taken the lead to support the testing of new approaches to this epidemic. Such an effort would include new ways to prevent the illicit use of prescription drugs and to establish methods of treating addiction. The President’s Commission on Combating Opioid Drug Addiction and the Opioid Crisis has come up with nearly 60 recommendations that are thoughtful and useful, but responsibility falls across so many federal agencies that little progress is likely to result. In times of crisis, major change can happen. But this requires central leadership. The administration needs to put under one authority all of the programs and funding sources focused on drug abuse now spread among more than a dozen agencies. (David A. Kessler, 1/10)

Perhaps the most important question in deciding how to respond to the U.S. opioid epidemic is whether it's primarily caused by social and economic factors, as some allege, or simply by an increased availability of drugs. Some recent U.S. research, as well as European data, shows that the latter is more likely -- that people use dangerous drugs because they can rather than because they're victims of economic ills. (Leonid Bershidsky, 1/10)

By now perhaps you’ve heard that Republicans in Congress are denying health care to poor children, because what else would those robber barons do? The debate over funding the children’s health-insurance program could benefit from a fact or two, not least about political cynicism. The program known as CHIP was passed in the 1990s to offer health insurance to children in low- and middle-income families that earn too much to qualify for Medicaid. CHIP expired Sept. 30, but states have had unspent money in the interim, and Congress freed up for more in last month’s budget deal. None of the some nine million beneficiaries have lost insurance, and the program enjoys bipartisan support. This has not stopped press stories about children who will be denied care. (1/10)

Funding a bipartisan effort to secure children’s health should not be bartered in exchange for other actions, so we urge Congress to pass a clean CHIP funding bill. ... Now is not the time for lawmakers to shirk their responsibilities; now is the time to take their obligation of public service as seriously as parents and physicians take the welfare and health of our children. (Dean Blumberg and Peter Manzo, 1/10)

Gov. Sam Brownback leaves as his legacy two experiments: massive tax cuts for businesses and the wealthy and privatized Medicaid he dubbed KanCare. Both failed. But another round of tax cuts is not coming. KanCare 2.0 is. Tim Wood, executive director of Interhab, a lobbying group for I/DD service providers, said many problems with KanCare 1.0 have yet to be solved. Despite this, Brownback still submitted version 2.0 to the federal Center for Medicare and Medicaid Services. (David P. Rundle, 1/11)

Since the early 1990s, Tennessee has participated in the federal government’s State Health Insurance Assistance Program, or SHIP, a program funded through the Tennessee Commission on Aging and Disability and administered locally by the Greater Nashville Regional Council. Along with the support of volunteers, professionals at GNRC are trained to understand the complexities of Medicare, know how to assess a client’s situation, and have the experience to guide them one‐on‐one through the process of signing up for benefits. ... Funding for SHIP is on unstable ground as the proposed federal budget threatens to eliminate more than $52 million in discretionary funding for this important service. This valuable program helps many across Middle Tennessee and the nation, and if you know someone who needs help with Medicare, I encourage you to contact your Congressional members to express support for SHIP. (Ken Moore, 1/8)

While a revolution against cultures of sexual harassment and inequality has swept through Wall Street, Silicon Valley, Hollywood and other work environments, one field so far has escaped the reckoning: medicine. Could that be about to change? That's the question pondered by Reshma Jagsi, a professor of radiation oncology at the University of Michigan and director of its Center for Bioethics and Social Sciences. Jagsi was the lead author of a 2014 survey on sexual harassment and gender bias in academic medicine that is getting new attention today. (Michael Hiltzik, 1/10)

This year’s flu season is shaping up to be a bad one. Much of the country endured a bitterly cold stretch, causing more people to be crowded together inside. The strain that has been most pervasive, H3N2, is nastier than most. And, we’re being told, the vaccine this year is particularly ineffective. That last fact has had many people wondering if they should still get a flu shot. If you read no further in this column, know this: The answer is yes, you should still get a flu shot. The flu season typically peaks December through February but can last until May, and it usually takes about two weeks for the shot’s immunity to kick in. (Aaron E. Carroll, 1/11)

On my pediatrics rotation in medical school, several residents told me they worked with children in part because they sometimes found themselves judging adults: Did they do drugs? Were they fat? Why did they drink so much? The idea that Americans should take personal responsibility for their health has recently received renewed attention. Vice President Mike Pence has argued for “bringing freedom and individual responsibility back to American health care.” (Dhruv Khullar, 1/10)

The numbers are startling. Since 1988, the obesity rate in Iowa has increased from 14 percent to 32 percent. Harvard's T.H. Chan School of Public Health reports that by the time today's kids are 35, half will be obese. Obesity continues to be one of the costliest conditions among health-insured consumers in Iowa. These problems are not unique to Iowa. The U.S. is experiencing an unsustainable disease burden; more than 133 million Americans, or 45 percent of the population, have at least one chronic condition. Chronic diseases are the leading cause of death and disability in the U.S. Iowa’s statistics are particularly troubling – we rank No. 39 for obesity and No. 28 for inactivity. When a problem looms large, such as the state of our health, we can do two things: 1) Sit back, do nothing and wait for things to deteriorate further, or 2) We can get moving, get healthy and take back our well-being. (Chuck Long and Dr. Amy Michelle Willcockson, 1/11)

On the spectrum of customer perception, health insurers rank closer to cable television companies than to retailers. There are plenty of reasons for that, including the fact that health insurance executives run their businesses with a deeply ingrained tendency toward conservative decision-making and incremental change. But if they are to keep pace with CVS, let alone Amazon, they’ll have to make bold investments, embrace change, and move fast. (Mark Nathan, 1/10)