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President Obama has published an essay on Obamacare in The Journal of the American Medical Association. While it hit a lot of the Affordable Care Act’s high points, it was also pretty frank that the health law has some weaknesses that need to be fixed. Margot Sanger-Katz and Reed Abelson, two New York Times reporters who have been covering Obamacare, discuss the policy changes that the president wants. (Reed Abelson and Margot Sanger-Katz, 7/13)

Last month, House Speaker Paul Ryan unveiled the GOP’s comprehensive plan for health reform. It included 30-odd pages of constructive proposals for replacing Obamacare, reforming entitlements, and promoting innovation. But the plan was also notable for what it didn’t contain: a clear plan to tackle the high and rising price of branded prescription drugs. Like objects in the rear-view mirror, drug prices are a bigger problem than they seem. (Avik Roy, 7/12)

In April 2009, my daughter Kira’s supervisor called me one morning to say she hadn’t shown up to work. I went to her apartment and found her lying on her couch, turning blue. ... Her biggest health problem was a torn ACL, not exactly a life-threatening condition. Her doctor prescribed her propoxyphene, the generic form of the painkiller Darvon, while she awaited ACL surgery. My husband and I didn’t think it was a big deal. Kira died just a few days after she started taking the drug. (Tammy Gilbert, 7/13)

Medicare needs to better serve a population of older adults who live longer and with more chronic conditions than they did in the 1960s. Medicare’s fee-for-service acute care model may have worked well in the days when treating heart attacks and strokes were a primary focus of health care. But in the past half-century, medical science has turned heart disease and even some cancers into chronic conditions. Unfortunately, these advances have also made it possible for more of us to live long enough to show symptoms of dementia. Roughly 90 percent of Medicare dollars are spent on seniors with chronic conditions. Those profound changes require a model of care that fully integrates medical treatment with personal assistance and social supports. (Howard Gleckman, 7/13)

As the world’s worst Ebola epidemic fades in the rearview mirror of history, it’s worth remembering what happened and the key lessons learned. ... Quick action taken by Congress to provide desperately needed funding and other resources was critical to CDC’s ability to stop Ebola and build safeguards needed to prevent an Ebola resurgence. Yet no such action has yet been taken on Zika, despite the dire threat the virus poses to pregnant women and their developing fetuses. (Thomas R. Frieden, 7/13)

We can probably admit that the spectacle of a totally dysfunctional Congress has its entertaining aspects ... But the point comes when Congress needs to act in an emergency. Then the fun’s over. That point is now, and the emergency is the spread of the Zika virus. (Michael Hiltzik, 7/13)

Imagine a virus for which there is no vaccine that can be sexually transmitted and lead to devastating birth defects. Imagine also that a powerful tool is available to combat it. You would expect — even demand — that policymakers immediately make that tool as widely available as possible. That virus, the Zika virus, is here today. But Republicans in Congress are ignoring medical science by trying to restrict access to family planning, a proven form of protection from Zika’s harms, as part of their ongoing and dangerous crusade against women’s health care providers. (Dawn Laguens, 7/14)

A federal appeals court has ordered Utah Governor Gary Herbert to reinstate contracts with the state's Planned Parenthood chapter. Herbert had unilaterally suspended the funds after the release last summer of misleading videos that purported to show unrelated Planned Parenthood officers discussing the sale of fetal tissue. The court said Herbert had likely violated the Utah chapter’s free association rights and the right to abortion itself. The decision, reversing a federal district court judge based in Utah, is a useful reminder of why regional appeals courts are so valuable. (Noah Feldman, 7/13)

Republican legislators in Missouri think they can punish abortion providers, mainly Planned Parenthood, by rejecting $8.3 million in federal funding for women’s health clinics. The result, however, is to punish low-income women by endangering their health care access. (7/13)

Precision medicine, a promising new approach to treating and preventing disease, will require thousands, or even millions, of us to provide samples for genetic research. So how much privacy are we willing to give up in the name of cutting-edge science? And do we care about the kinds of research that will be done with our donations? (Raymond G. De Vries and Tom Tomlinson, 7/13)

Visibility of transgender people and support for transgender rights have increased dramatically in recent years. ... Despite these shifts, transgender people still face substantial discrimination. ... The 2008–2009 U.S. National Transgender Discrimination Survey revealed that 28% of transgender adults experienced harassment in medical settings, 19% reported being refused care, and 28% postponed care because of discrimination; 50% of those who received care reported having to teach their clinicians about transgender care. Transgender people need clinicians who can provide proper health care. (Mark A. Schuster, Sari L. Reisner and Sarah E. Onorato, 7/14)

[T]he US Department of Health and Human Services (HHS) recently published a final regulation that amends the Health Insurance Portability and Accountability Act (HIPAA) Privacy Rule to enable disclosures to the federal background check system under specified circumstances .... [It authorizes] certain disclosures [but] tailored the permission in recognition of the importance of encouraging individuals to seek psychiatric care. Notably, the rule limits: (1) who can make such disclosures ... (2) to whom the disclosures may be made ... and (3) what may be disclosed .... The rule balances important values, including the public safety function of the NICS and the confidentiality of care, on which patients’ willingness to undergo psychiatric treatment often hinges. (Charles G. Kels, Jennifer A. Bernstein and Y. Tony Yang, 7/13)

Faced with an issue as important as revamping the nation's mental health system, Congress has largely failed to get those struggling with mental health issues the help they require. Last week marked a sea change in our nation's mental health debate. In one of those rare moments when bipartisanship defeats political inertia, the House voted 422-2 for HR 2646, the Helping Families in Mental Health Crisis Act. (7/13)

Some legislative incumbents and candidates act as if the governor’s budget-balancing is just responsible fiscal management, without pain or other consequences. Those on the front line of community mental health in Kansas have a different view ... The Brownback administration’s 4 percent cut to Medicaid reimbursements as of July 1 is among the causes for concern. But the state also ended a short-lived “health homes” pilot program that had coordinated care for some mentally ill people with chronic medical problems, and a Medicaid mental health screening program (objected to by federal officials) that aimed to guide some patients into community-based rather than inpatient treatment. (Rhonda Holman, 7/13)

For those of us in the Utah Legislature who have opposed Medicaid expansion, the biggest stumbling block has always been the potential burden it places on our state and our taxpayers. There is no budget certainty with such an arrangement, and the danger becomes even greater when we realize that once we commit, we are obligated to pay whatever the costs may be, but the federal government can, at any time, change the rules as it has done over and over since the implementation of the ACA. (Utah House Speaker Greg Hughes, 7/13)

California voters have been duped, defrauded and double-crossed twice, and now they’re being fed an outrageously disingenuous lie to cover it up. Earlier this month, a judge blocked an attempt by Oakland-based Service Employees International Union-United Healthcare Workers West to place on the November ballot an initiative to limit the pay of nonprofit hospital executives. Why did the judge block it? (Sal Rosselli, 7/13)

It is a common misperception that once school is out for the summer, psychiatrists who treat attention-deficit/ hyperactivity disorder can slow down a bit. In fact, the summer months are a critically important time for ADHD treatment and shouldn’t be overlooked. We all believe that summer for kids should be filled with time at the beach, camping and other fun activities. But for a child coping with ADHD, the symptoms don’t just disappear when the last bell of the school year rings. These kids continue to have problems paying attention and controlling their behavior. (Mary Burns, 7/13)