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A co-worker struggling to make ends meet comes to you with a problem. The price of admission to a dear colleague’s retirement party at an upscale establishment is beyond her means, though not yours. You both feel obliged to attend. She’d rather bring some refreshments to a conference room than spend what she cannot afford on a lavish event. You like the idea of a grand send-off for your retiring colleague. There can be only one party. ... A similar, underrecognized conundrum arises in health insurance. (Nicholas Bagley and Austin Frakt, 12/5)

Federal employees and retirees can be excused for feeling as though they’re getting soaked by what has been described as a “perfect storm” hitting their health benefits. This storm has been brewing for months, but its effects are especially noticeable now that the month-long “open season” to change selections for the Federal Employees Health Benefits Program (FEHBP) will end soon. (Joe Davidson, 12/5)

The problem with bills in Congress that roar toward passage like juggernauts is that they’re especially worthy of close examination, and especially unlikely to get it. That’s the story with the 21st Century Cures Act, which reaches the Senate this week after achieving overwhelming bipartisan support in the House. ... The 21st Century Cures Act is a huge deregulatory giveaway to the pharmaceutical and medical device industry, papered over by new funding for those research initiatives. The punchline is that the regulatory rollback is real, but the funding may not be — it’s subject over the next decade to annual appropriations by Congress that might never come. (Michael Hiltzik, 12/5)

When long-term care policies were introduced a few decades ago, they seemed like an attractive deal. As it turns out, that’s because they were underpricing the insurance. Insurers expected a significant portion of people to drop the insurance every year (meaning that their previously paid premiums would be all profit). Instead, only about 1 percent did. They also underestimated costs. And while typical health insurers don’t have to worry much about interest rates, because they generally pay this year’s health care costs out of this year’s premiums, long-term care insurers need to park the money between taking the premium in and paying the benefits out. The ultra-low interest rates of the last decade have made those investments less profitable, hurting them still further. And state regulators have proved resistant to efforts to raise premiums to make the insurance more actuarially sound. (Megan McArdle, 12/5)

President-elect Trump is calling for major reinvestment in public infrastructure—and any American can understand why. We all know from direct experience that much U.S. infrastructure is in rough condition, and most agree that renewing and advancing our infrastructure, from bridges and airports to the electrical grid, would support economic improvement and supply new jobs. But for the nation’s long-term security, prosperity, competitiveness and health, and for generations of lasting new jobs, we must also rebuild another kind of infrastructure now eroding—by renewing our national commitment to fundamental science. (L. Rafael Reif, 12/5)

Communicating the results of basic science, clinical trials, observational studies, case reports, and the like is essential to the forward movement of science. The peer review system is at the core of this process. It works like this: a journal editor asks outside experts to critique a manuscript and assess its suitability for publication, with or without modifications. Editors use these peer reviews to help determine whether or not to publish a report. ... Two common features of the current peer review system subvert the goals of science, and should be changed: The product of peer reviews generally can’t be seen by the scientific community, and reviewers are almost always anonymous. Although the vast majority of scientists living today have known only this approach, there is no compelling reason to continue using it and many reasons to revise it. (Jeffrey Flier, 12/5)

It’s no secret that Ohio is wrestling with a devastating plague of drug addiction and fatal overdoses, but still it was a shock to learn last week that Ohio led the nation in overdose deaths in 2014. The number of deaths has continued to escalate since then. One of every nine heroin deaths in the country happens in Ohio. (12/6)

A heroin epidemic plagues Ohio. The tragic stories of wasted lives are heartbreaking, and the death tolls staggering. In 2015 alone, a record 3,050 Ohioans died from a heroin overdose. In one 24-hour span, 27 people in Columbus died from heroin and fentanyl abuse. Ohio policymakers desperately need solutions. Incarceration and treatment are the two most common remedies proposed, but both are far from offering a simple cure. (Daniel Dew, 12/3)