�鶹Ů��

Nearly six years have elapsed since Obamacare became law. The Supreme Court has upheld the foundations of the law — twice. Lawmakers tried dozens of times to repeal the law — and failed every time. President Obama was reelected after a campaign that focused in large part on the Affordable Care Act. More than 17 million people gained health-care coverage. But, like Captain Ahab and the white whale, congressional Republicans continue their quest to repeal the law. (Dana Milbank, 12/2)

With the traditional attack points on the Affordable Care Act having faded away--most enrollees were already insured (wrong), millions of people lost their coverage and couldn't replace it (wrong), etc.--Obamacare's critics have been looking for new ones. An up-and-coming star of this firmament is the notion that Americans are "gaming" the system by waiting until they're sick to enroll in an individual policy, then dropping it as soon as they're cured. (Michael Hiltzik, 12/2)

An estimated 17 million uninsured have been covered by the Affordable Care Act. As that number grows in the coming years, it could have political implications: How will the newly insured behave at the ballot box? Will they vote? Will they become a Democratic constituency? The ACA may be an issue in the 2016 elections, but the newly insured are unlikely to become an important electoral factor themselves. (Drew Altman, 12/3)

Drugmakers are facing a torrent of criticism from healthcare providers, patient advocates, politicians, and insurers over the high prices of their prescription drug products. ... But largely overlooked in the legitimate uproar over high drug prices is the pharmaceutical industry's valid counterattack against insurers. The industry says policymakers should focus their scrutiny on insurers that are designing benefit plans with high deductibles for prescription drug coverage. (Harris Meyer, 12/3)

Predictably, the killing rampage at a Colorado Springs Planned Parenthood facility has prompted a political scrimmage of the usual sort. From the pro-choice front, we hear that pro-lifers and Republican rhetoric made the killer do it. Or, at least, they created an environment in which a deranged person might become unhinged. From the pro-life trenches, we hear, There they go again, blaming the messenger. (Kathleen Parker, 12/1)

A task force appointed by Gov. Larry Hogan to look into how Maryland can reduce the number of heroin overdose deaths released a wide-ranging series of recommendations yesterday that included both expanded access to treatment for addicts and tougher law enforcement measures against drug dealers and gangs. The 11 members of the panel, chaired by Lt. Gov. Boyd Rutherford, acknowledged that there are no quick or easy solutions to overdose deaths and that a coordinated, multifaceted approach is needed to address them. But their final report offered few specifics regarding how large an effort will be needed to make a dent in the problem or how much it would cost. (12/2)

Chances are someone close to you is obese or overweight; just look at the statistics. Worldwide, obesity has nearly doubled since 1980. Worldwide, more than 1.4 billion adults 20 and older are overweight, and of those, 500 million are obese. In the United States, more than two-thirds of adults and one-third of children ages 6 to 19 are overweight or obese. And obesity rates are higher in Baltimore than the national average: According to the Centers for Disease Control, almost 40 percent of Baltimoreans are overweight and almost 30 percent are obese. (Bruce Y. Lee, 12/2)

Transforming primary care was encoded into the Affordable Care Act as a central part of reforming how health care is delivered. Major investments supported enhanced reimbursement for primary care, community health center expansion, and multipayer partnerships for practice transformation. ... An Agency for Healthcare Research and Quality synthesis report of 14 grants to study primary care transformation revealed few overarching “pearls.” Instead, the success of transformation depended on context. (Dave A. Chokshi, 12/1)

Over the past decade, U.S. health departments, community organizations, and health care providers have expanded HIV screening and targeted testing, and as a result a greater proportion of HIV-infected people are now aware of their infection; the number of reported new diagnoses of HIV infection has decreased; and people with HIV infection are living longer. ... Despite this progress, most people living with HIV infection in the United States are not receiving antiretroviral treatment (ART); notification of partners of infected people remains the exception rather than the norm; and several high-risk behaviors have become more common. ... Although surveillance has improved, data-driven targeted interventions are not being rapidly and effectively implemented in most geographic areas. Much more progress is possible through further application of public health principles by public health departments and the health care system and, most important, through closer integration of health care and public health action. (Thomas R. Frieden, Kathryn E. Foti and Jonathan Mermin, 12/3)

[B]etween 2000 and 2014, the rollout of ART saved an estimated 7.8 million lives worldwide. Despite this success, the timing of ART initiation has remained the subject of intense debate. As with any therapy, clinicians and their patients weighed ART's benefits against its risks, and the results of that calculus seemed to depend on the patient's stage of illness. ... Today, a series of well-designed efficacy studies conducted over a period of more than a decade has fundamentally changed this discussion. (Anthony S. Fauci and Hilary D. Marston, 12/3)