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House Speaker Paul Ryan's plan to phase out Medicare is nothing new. But now, under a Trump presidency and with both houses of Congress in Republican hands, it looks like he could finally make it happen, possibly within months. Back in 2011, as a U.S. representative for Wisconsin's 1st Congressional District, Ryan floated a plan to turn Medicare into a "premium support" program. The "premium support" would be a payment that would let you buy insurance from private insurers. But you won't get full coverage. (Mike Moffitt, 11/14)

Bursting with the policymaking power that control of both houses of Congress and the White House gives Republicans, House Speaker Paul D. Ryan (R-Wis.) has lost no time in teeing up a favorite goal: gutting Medicare. In an interview with Fox News Channel last Thursday, Ryan said: “Obamacare rewrote Medicare … so if you’re going to repeal and replace Obamacare, you have to address those issues as well. … What people don’t realize is that Medicare is going broke, that Medicare is going to have price controls. … So you have to deal with those issues if you’re going to repeal and replace Obamacare. Medicare has got some serious problems because of Obamacare. Those things are part of our plan to replace Obamacare.” (Michael Hiltzik, 11/14)

Interviewed over the weekend on Fox News’s Special Report, House Speaker Paul Ryan hinted that the Republican Party’s longstanding promise to “repeal and replace” Obamacare will be fused with his own enduring goal of privatizing Medicare and replacing it with a cash subsidy that almost certainly won’t be adequate to cover senior health care costs. Ryan’s appearance was a preview of the horrors we can expect from the newly emboldened GOP-controlled Congress, which is going to put pressure on Donald Trump to sign a raft of conservative legislative priorities. (Jeet Heer, 11/14)

But one shining example of bipartisan agreement is the desire to move away from fee-for-service medicine to a value-based system. Rather than focus on the number of tests, scans, and medical procedures that can be ordered, the aim is to pay for better care instead of simply paying for more. (Ceci Connolly, 11/14)

The roughly 100,000 Minnesotans buying unsubsidized health insurance from MNsure don’t need any stats or charts to tell them Minnesota’s individual market is in a crisis. Their premiums are going up by an average of 59 percent, their plan options have narrowed and many of them have been kicked off their old plan when Blue Cross Blue Shield left the market. But the stats tell a stark tale nonetheless — and Minnesota policymakers are paying very close attention as they try to find a way to end the crisis and help Minnesotans get good, affordable health insurance. (David Montgomery, 11/14)

Tim Keck, acting secretary of the Kansas Department for Aging and Disability Services, recently wrote a commentary stating that the safety net for the disabled in Kansas is strong (Oct. 24 Opinion). As the parent and guardian of an adult son whose disability is on the autism spectrum, I disagree. Keck said more people have received dental care under KanCare. My son’s care coordinator gave me a list of about 30 dentists. I started calling and found no dentist who would take an additional adult KanCare patient. I was told it was too hard to get reimbursement and the amount of reimbursement just wasn’t worth it. (Kay Soltz, 11/14)

When you stroll up to virtually any meat counter in any grocery, the “freshly slaughtered” color of red stares back at you. But for many of those products, that deep color is a troubling ruse – a fiction maintained only by the addition of nitrates and nitrites. (Nathan Donley, 11/14)

Many female physicians who choose to have children are fighting an uphill battle. The current model of medical education and training, after all, was designed exclusively for men more than a century ago. It consists of a rigid curriculum with a tight timeline for rotations, boards, and fellowships, to say nothing of the 80-hour duty weeks and, at times, punishing schedules. But is that the best way to fill the ranks of tomorrow’s clinicians? (Chloe K. Fox, 11/13)

If an infectious disease was killing 7 million people a year, it would be ludicrous to work to allay its impact decades from now rather than taking immediate action against it. Yet that is exactly how we are approaching the causes of climate change, which are both immediate and long-term killers. This week’s “airpocalypse” in New Delhi shows just how urgently action is needed to prevent the air pollution that is not only damaging our planet and human health in the long term but killing millions of people around the world in the present. (David J. Hunter and Francesca Dominici, 11/14)