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The U.S. health-care system has been squeezing the country's middle class for years. The passage of the Affordable Care Act has relieved some of the pressure, but there's much more to do. With or without Obamacare, the issues are the same: access and cost. If losing your job also means losing your health insurance, you face a whole new kind of economic insecurity. And even if you have good insurance through your employer and aren't afraid of losing it, the ever-rising cost of health care is steadily eating away at your wages. The assurance of adequate coverage and better cost control would make a real difference to Americans of ordinary means. (5/13)

It would be a historic irony if the argument the U.S. Supreme Court adopted in 2012 to derail federally enforced expansion of Medicaid — leaving nearly 4 million low-income Americans without health coverage — now came to the rescue of government-subsidized insurance for 7.7 million Americans. (Bob Egelko, 5/13)

Florida Gov. Rick Scott sued the federal government late last month for threatening to withhold more than $1 billion in Medicaid funds due the state under a waiver program first approved in 2005. And in Texas the Obama administration is threatening to cancel a five-year, $29-billion Medicaid waiver approved in 2011. What’s going on? The Obama administration says that expanding Medicaid under the Affordable Care Act would be a better way to accomplish the goals of the waivers. In other words, the feds are attempting to force the hand of these states, which have declined to expand Medicaid. (John Daniel Davidson, 5/13)

The Obama administration is desperate for a national leader like Florida to expand Obamacare, hoping it will set off a chain reaction to convince leaders in other states to fall in line. So, frustrated with its lack of success in convincing conservatives to give up their principled opposition to Obamacare, the administration has moved on to a new tactic: Sopranos-style blackmail. (Jonathan Ingram and Josh Archambault, 5/13)

Rick Scott has a problem. He has 840,000 working poor in the state that don’t have health insurance. But heck, if they’re really sick they can go to the emergency room. For the past nine years the state has taken billions in federal funds to reimburse hospitals for uncompensated or charity care. Apparently Gov. Scott is comfortable with that arrangement. But he has known for two years that these Low Income Pool funds, better known as LIP, were going away. (Paula Dockery, 5/13)

MinnesotaCare no longer serves the low-income children and their parents for whom it was designed 23 years ago. Those folks are almost all on Medicaid now. The program now primarily covers low- and middle-income adults. The 2 percent provider tax that funds the program is set to expire. ... Minnesota taxpayers pick up the majority of the 93 percent of costs not paid by enrollees. ... MNsure has failed to meet enrollment numbers and has made life worse for many Minnesotans who struggle with a broken website, clogged call centers and overburdened county offices. ... Minnesota just approved another $90 million in spending on MNsure on top of the $200 million already spent. That’s why we think MinnesotaCare and MNsure should be combined into one program that is paid for and works better. The plan provides choices for families and better reimbursement for hospitals, and Minnesota will save over $1 billion over four years. (State Rep. Matt Dean, 5/14)

California is serving as the national model for President Barack Obama's health care reforms, but that won't continue unless the state does something about its abysmal Medi-Cal reimbursement rates for doctors and hospitals caring for the 12 million Californians with Medi-Cal coverage. Gov. Jerry Brown has a golden opportunity to fix the problem Thursday when he unveils his May revised budget plan. But don't hold your breath. Despite expectations that he will have billions of dollars at his disposal because of California's booming economy, the governor has to date shown zero inclination to raise rates that rank among the worst in the nation. (5/13)

It's been more than three months since a mentally ill woman, Natasha McKenna, died after she was shot four times with a Taser stun gun by a guard in the Fairfax County jail. Since her death on Feb. 8, county officials have offered repeated assurances that a full investigation is underway, and that the facts surrounding the guards’ struggle with Ms. McKenna — which was recorded in full on video — will be laid bare. (5/13)

A draft recommendation from the U.S. Preventive Services Task Force last month echoes a similar recommendation made in the fall of 2009. Namely, the task force recommends mammogram screening every two years for women ages 50 to 74 but does not recommend universal screening before age 50: “The decision to start regular, biennial screening mammography before the age of 50 years should be an individual one and take patient context into account.” (Chris Jacobs, 5/13)

Legally, the act of aiding or abetting the death of another has been considered a felony. Ethically, physician assistance in the death of a patient has been contrary to the precepts of bioethics, and in earlier times physicians took an oath that they would not provide any deadly substance to patients. The passage of this law in 2008 in Washington has opened a new window on this practice and served as a reminder to physicians that many feel we are not doing a good enough job in caring for the dying by providing excellent palliative care at the end of life. This is a new day for physicians. (Thomas R. McCormick, 5/13)

Calcified bureaucrats within Veterans Affairs are not alone blocking efforts to reform the agency's health-care system. They have allies in the leaders of veterans organizations. Some are understandable, if misguided. The American Legion defends the status quo because the group is invested in it, claiming credit for creating the VA. Far more puzzling is the resistance of the Disabled American Veterans, whose members would benefit greatly from a slimmed-down, more focused VA. (Editorial Board, 5/13)

Under the new policy, men must abstain from having sex with other men for 12 months before they can donate blood. To me, this year-long period of abstinence does not make sense, nor will it help to address the problems we face today. It is important to have as many eligible blood donors as possible because the commitment from the general public to donate is sometimes forgotten as we get wrapped up in our daily routines. As a result, our nation continues to struggle in maintaining life-saving blood supplies in many areas and hospitals. Under the new policy, we will continue to have these issues as gay men remain limited as to when they can donate, so the pool of potential donors will not grow significantly. (Manny Alvarez, 5/13)

In Sunday's Health section of the Inquirer, reporter Ilene Raymond Rush interviewed the dean of Temple's medical school, Arthur Feldman. The dean tried to advance an agenda of academic empire building by bemoaning the fact that medical students today receive less research training than in the past. It requires that sort of exceptionally self-serving, academic nonsense to induce one of the exceedingly rare cases where this writer can quote William F. Buckley favorably. The late conservative publicist once said he'd rather be governed by the first 1,000 people in the Boston telephone directory instead of the Harvard faculty. Although Buckley's sentiment may be appropriate for any number of issues, its implicit derision of academic self-righteousness seems particularly apt here. (Daniel Hoffman, 5/13)

The next methamphetamine surge isn’t looming around the corner — it is here right now. Methamphetamine use in the Twin Cities has reached the same level it was at in 2005, at the peak of our first epidemic. According to the new report, “Drug Abuse Trends in Minneapolis/St. Paul: 2015,” released last week by Drug Abuse Dialogues, 2,593 people entered treatment in the Twin Cities for addiction to methamphetamine in 2014 (about 12 percent of total treatment admissions), compared with 2,465 in 2005. Law enforcement authorities have had their hands full as well. (Carol Falkowski, 5/13)

How often have you tried to ignore an ache or pain by telling yourself, “Maybe if I do nothing, it’ll go away.” Sometimes that works, but wishful thinking isn’t the best way to take care of yourself. Medicare’s new emphasis on preventive care acknowledges that. A few years ago, Medicare mostly concerned itself with paying for your treatment after you got sick. Now, it’s also focused on helping you stay healthy and avoid diseases and illnesses in the first place. People with Medicare are entitled to a broad range of exams, lab tests and screenings to detect health problems early, when they’re most treatable or curable. (Bob Moos, 5/14)