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If the price of your morning Starbucks fix jumped from $3.45 to $142, you'd probably take your business to Dunkin' Donuts or swear off caffeine altogether. But patients who rely on a drug called Daraprim don't have the option of discontinuing their meds or switching to another brand. And last month, the price of Daraprim jumped from $13.50 a pill to $750. That's an increase of more than 5,000 percent. (9/27)

A year ago, a senior-citizen friend of mine was admitted to a hospital there. “I should have listened to my neighbors and never come to this place,” my friend complained. What disappointed her so much about the hospital? Was it a cleanliness problem, rude staff, or a high infection rate? No, she liked the hospital overall—and indeed it’s a high performer on standard indicators of quality. The hospital’s fatal flaw: dinner wasn’t served until 7 p.m. I actually had the opportunity to speak to the chief executive of that hospital, who said he’d heard similar feedback but it wasn’t a big issue on his radar. This was surprising to me. Shouldn’t customers dominate the executive’s radar? (Leah Binder, 9/26)

Drug companies say high prices are necessary to cover their research and development costs, enabling them to discover innovative new medicines. Turing says it planned to use the profits from Daraprim’s higher price to fund research into better treatments for toxoplasmosis. But in fact, Daraprim illustrates the way most drugs are priced: They are invented not by the companies that sell them now but by someone else. Then, like big fish swallowing little fish, larger companies either buy small firms outright or license promising drugs from them. Very often, the original discovery occurs in a university lab with public funding from the National Institutes of Health (NIH). (Marcia Angell, 9/25)

Pharmaceutical companies are taking a lot of reflected heat in the uproar over the 5,000% price hike for a drug needed by AIDS patients. But so far, the industry's method of making sure that low-income patients get access to high-priced drugs has avoided the spotlight. That's too bad because it deserves a lot of scrutiny. We're talking about "patient-assistance programs," through which drugmakers cover patient co-pays or other costs for their expensive medicines. These programs, which are estimated to cover some 300 drugs and cost the industry $4 billion a year — firm figures are carefully guarded by the industry — are detested by insurers, healthcare economists and government agencies. That's because they're often marketing schemes dressed up to look like altruism. (Michael Hiltzik, 9/25)

Spending on pharmaceuticals is surging again, up 13% in 2014. Surveys show the public is increasingly concerned about the affordability of drugs. Part of the reason for their high costs is the advent of precision (or personalized) medicine, which is producing a new generation of powerful drugs tailored to the genetics of individual patients. (David Blumenthal, 9/26)

Critics of Medicaid expansion in Virginia who reference Kentucky’s experience with federal health care reform should beware: Our success undercuts your whole opposition. Having proved from the beginning that health care reform is both the right thing and the smart thing do, Kentucky has become the poster child for why states should expand Medicaid. The core tenet of health care reform is helping families and saving lives. Not vague political theory, but helping people. That’s what we’re doing in Kentucky. It’s a Christian thing. (Ky. Gov. Steve Beshear, 9/27)

There is only one guaranteed way to get fired from the Department of Veterans Affairs. Falsifying records won’t do it. Prescribing obsolete drugs won’t do it. Cutting all manner of corners on health and safety is, at worst, going to get you a reprimand. No, the only sure-fire way to get canned at the VA is to report any of these matters to authorities who might do something about it. (Jonah Goldberg, 9/27)

Year after year, the emergency department where I practice medicine continues to see more patients. What’s going on? One reason has been identified: no timely access to a primary-care provider. ... But that’s only part of the situation. .... Patients are vulnerable—they get hurt; they are old; they are young; they are weak; they are bleeding; they have collapsed. Health-care economists, administrators and process managers opine that patients without “true emergencies” should be directed to family doctors, urgent-care centers and outpatient clinics. ... That might sound reasonable but ignores what patients experience and perceive. Remember: You can’t teach patients economics lessons when they don’t feel well. (Paul S. Auerbach, 9/25)

And now comes the life-expectancy gap. It may change the national conversation over Social Security and an aging society — for the worse. We all know that the United States is aging, but probably few of us know how skewed the process is in favor of the middle and upper-middle classes. Among men, life expectancy has improved substantially for the richest 60 percent. But for the poorest 40 percent, gains are tiny or nonexistent. Changes for women reflect similar trends, though less sharp. (Robert J. Samuelson, 9/27)