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In February, U.S. Sen. Bill Nelson became one of the first voices in Washington to warn against the threat posed by Zika. He wanted the Obama administration to appoint a “Zika czar” to coordinate the government’s response to the virus. Unfortunately, few listened. Many even scoffed at what they considered his unduly alarmist outlook. (5/18)

Surely the Obama administration could find a way to provide contraception to women without involving a group of Catholic nuns. This has been the refrain of the administration's critics since 2012, when it announced that most employers would have to offer health coverage that included contraceptives. The Supreme Court has just unanimously made the same point as the critics, if in softer language. (Ramesh Ponnuru, 5/18)

The justices of the Supreme Court have taken an important step that should result in protecting the religious liberty of all Americans. With their new order in the case of Zubik v. Burwell, they have, in effect, ordered the government to come up with an accommodation to the Obamacare Health and Human Services mandate that does not force religious non-profit groups to violate our faith. (Frank Pavone, 5/17)

Whatever faults Obamacare may have — and it's been no panacea for the shortcomings of health care in this country — even its harshest critics must recognize those 16 million to 17 million people (depending on whose estimates one uses) who have received a literal lifeline from health care reform. (5/18)

The upcoming California primary offers an opportunity for Sen. Bernie Sanders to add substance to his call for a single-payer health care system with little risk of losing voters because broad support exists here for universal health care. Indeed, our California Legislature approved such a plan and I am the nurse who wrote it. I applaud Sanders for injecting meaningful health reform into the campaign and offer six policies to better define his plan and provide a foundation for negotiating the Democratic Party platform at the convention. (Judy Spelman, 5/17)

There are few more wasteful and counterproductive endeavors on Capitol Hill than the Republican bloc's efforts to undermine the Affordable Care Act. Two lawsuits point to how the cost of these efforts is destined to trickle down to innocent consumers. No, we're not talking about the more than 60 times the GOP voted to repeal all or part of the law. We're talking about its efforts to block funding for essential provisions of Obamacare designed to help patients and insurance customers. (Michael Hiltzik, 5/18)

For the past two years, I have begun to bridge my two worlds: my PhD training as a sociologist specializing in discrimination and racial and health disparities and that of a physician, a budding psychiatrist. I have begun to examine medical trainee experiences of discrimination based on race, gender, and sexual orientation. I hope to document the accumulation of microaggressions that underrepresented trainees experience during their training and demonstrate the impact this has on their mental health and well-being. (Roberto E. Montenegro, 5/17)

The internal mechanisms of the Washington lobbying game were inadvertently placed on public display Tuesday during a House committee hearing on an Obama Administration move to reduce prescription drug costs. Two witnesses opposing the proposal, ostensibly from two different interest groups, somehow submitted statements that contained identical passages. They were outed by Rep. Jan Schakowsky (D-Ill.), who said she found the similarities "very curious." (Michael Hiltzik, 5/18)

The right of patients to be informed about care decisions in clinical practice is yet again under scrutiny, both in the United States and around the world. The well-ingrained ethical-legal process of informed consent, so fundamental to patient autonomy—or the patient’s right to self-determination—was the subject of a 2015 UK Supreme Court case (Montgomery v Lanarkshire Health Board).1 In that case, a woman with insulin-dependent diabetes, claimed that her obstetrician failed to communicate the risk of shoulder dystocia during vaginal delivery (a complication associated with fetal macrosomia) that ultimately resulted in severe fetal brain anoxia. She claimed that had she received full information about the risks, she would have opted for a cesarean delivery. Yet the treating obstetrician (and other expert physicians called to trial) claimed that the ensuing risk was very small and thus appropriately not communicated because a cesarean delivery is not in the maternal interest. The obstetrician reported that “…had I raised it [the risks of shoulder dystocia] with her then yes, she would have no doubt requested a caesarean section, as would any diabetic today. (Erica S. Spatz, Harlan M. Krumholz and Benjamin W. Moulton, 5/17)

By law, patients have a right to obtain electronic copies of their medical records, but should they also have a right to access those records by using software applications of their choosing? It was a question Tuesday that divided two federal panels reviewing the use of application programming interfaces in healthcare. Their lack of consensus means the decision is still up for debate. (Joseph Conn, 5/18)

If my recent experience is any gauge, many health care professionals and hospitals don’t pay enough attention to family caregivers. But states are beginning to pass laws to ensure that they do so, and some of the presidential candidates are talking about expanding the Family and Medical Leave benefit. (Mason, 5/18)

Experts estimate a shortage of 20,000 primary care providers in the next few years. Advanced practice nurses could fill this void, but state regulations often stand in their way. (Rudner, 5/18)

No government -- federal or state — can afford to ignore the nation’s destructive opioid abuse epidemic, and Maryland’s is no exception. The recently concluded General Assembly session resulted in a significant step forward, in the form of a bill requiring that all prescribers of opioids participate in the state’s Prescription Drug Monitoring Program (PDMP) as a condition of their state licenses. In essence, a PDMP is a database that tracks patients’ past access to prescription opioids, enabling physicians to confirm or deny suspicions that a particular patient might be “doctor shopping” to fuel an addiction. With appropriate privacy protections, the programs may also help authorities identify doctors who are engaged in inappropriate or even illegal practices. (5/18)

The contrast is striking – and frustrating. While Oklahoma is now working on a plan to expand Medicaid, Kansas refused to even hold a hearing on the issue this legislative session. While Oklahoma wants to provide health insurance to about 175,000 of its citizens, Gov. Sam Brownback just cut funding to Medicaid – which could make life even harder for low-income Kansans. (Phillip Brownlee, 5/19)

Fighting the inappropriate prescribing of opioid painkillers has been a priority for the North Carolina Medical Board for at least the past decade, but we can and should do more. The Observer’s story accurately noted that NCMB is expanding its efforts to investigate potentially unsafe opioid prescribing. However, increased enforcement is just one aspect of the board’s efforts. We believe the best way to address inappropriate prescribing is to prevent it. (Dr. Pascal O. Udekwu, 5/18)

You know Colorado has a serious problem taking care of people experiencing a mental health emergency when the legislature passes a bill to extend the period they can be involuntarily warehoused in a jail. (5/18)

It's 1 a.m. A young mother approaches me during my hospital shift. She asks if her 2-year-old son will survive the night. He has been given a diagnosis of severe tuberculous meningitis, months after her husband was found to have drug-resistant TB. We suspect the child acquired the infection from his father. The mother was tormented by guilt and worried about her child’s future. The disease usually affects the lungs, but it can also strike the brain, kidneys and other parts of the body. How do I tell the mother that the fluid in her baby’s brain is terribly elevated and we need to drill holes into his skull to release the pressure? How do I tell her that, if he survives, he will probably have some brain damage and that the prospects that he’ll be able to lead an independent life are questionable? (Uvistra Naidoo, 5/19)