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If you’ve heard anything about the upcoming budget battle, it’s probably that Republicans want to dramatically slash spending. Yay, fiscal conservatism! What you may not know is that many of their desired funding cuts would increase deficits in the long run. Here’s why. You know how you’re supposed to go to the doctor for preventive care so you don’t get really sick later on? Some government spending programs serve a similar purpose. (Catherine Rampell, 9/3)

A week earlier, my pregnant wife, Jennifer, had undergone a routine prenatal ultrasound that revealed “soft markers” suggestive of genetic abnormalities. Now we were in the consultation room awaiting the results of the amniocentesis, which would conclusively determine whether our daughter would be born with Down syndrome. ... Hammering home the momentous difficulties that would await us as parents was clearly a tactical move by the doctor to push us toward an abortion. That abortion is not the exception, but rather the expectation in cases of Down syndrome, is not limited to medical professionals. Though precise numbers are unavailable, at least two-thirds and as many as 90 percent of fetuses found to have Down syndrome in utero are aborted. (Mark Lawrence Schrad, 9/4)

Americans eat more than 50 pounds of beef per person each year. That’s a lot of beef. It’s also a lot of risk, because about half — or more than two billion pounds — is ground beef, which can too easily harbor dangerous bacteria. ... But as a new report points out, there is more the Department of Agriculture and the Food and Drug Administration can do to keep Americans safe and some simple things consumers could do themselves. (9/4)

A bill that would more than triple the California cigarette tax was gaining little traction in the Legislature until it received a push forward from Gov. Jerry Brown's special legislative session on funding healthcare for the poor. The additional $2-per-pack tax imposed by the bill would initially raise $1.5 billion a year. A well-crafted cigarette tax is a thing of beauty. Not only does it raise revenue, but it helps reduce smoking rates and deters teenagers from developing a cigarette habit, preventing many premature deaths. California, whose cigarette taxes are in the bottom third nationwide, is overdue for an increase. But more than six months after the bill's earliest hearings, the "well-crafted" part is still missing. (9/3)

On April 16, 2015 President Barack Obama signed the Medicare Access and CHIP Reauthorization Act (MACRA) which, among other things, finally repeals the Sustainable Growth Rate (SGR) mechanism of updating fees to the Physician Fee Schedule (PFS). The SGR had been blamed for causing instability and uncertainty among physicians for over a decade and led to 17 overrides of scheduled fee cuts, at a cost well in excess of $150 billion. The passage of MACRA, however, raises new questions about where the U.S. health care system is headed in the post-SGR world of payment and delivery reform. (John O'Shea, 9/3)

One Monday morning, rounding on a patient who needed relatively urgent coronary-artery bypass surgery, a newly appointed cardiologist in New York asked the team to call a surgical consult .... “We can't call today,” the cardiology fellow explained patiently. “Dr. X. is taking consults. He wouldn't touch our patient with a 10-foot pole.” The fellow scrutinized the call schedule. “The only surgeon who might take him isn't on until Wednesday.” In New York, one of a handful of states where outcomes of cardiac surgery and percutaneous coronary intervention (PCI) have been publicly reported for some years, such situations are not uncommon. Although the aim of report cards was to motivate proceduralists to improve quality, they seem instead to have motivated avoidance of the sickest patients. (Lisa Rosenbaum, 9/2)