�鶹Ů��

I know most of the woman’s doctors. Each one is compassionate, smart and dedicated. Indeed, her diseases were largely under good control. Yet her health was declining, she was missing appointments and she was less and less able to care for herself and her apartment. Several of her clinicians recognized this, but none took action. This was not because of personal or professional failings. Their actions — and inaction — were the inevitable result of their medical training and our medical system’s sometimes myopic focus on medicine at the expense of health. Medical education prioritizes the same specialties today as it did a century ago, when life expectancy in the United States hovered around 50 and when tuberculosis and childbirth were among the leading killers. People in their eighth, ninth and 10th decades are as dissimilar, physiologically and socially, from middle-aged adults as children are. (Louise Aronson, 4/6)

Hospitals know their chances of getting paid plummet as soon as the patient walks out the door. Patients, meanwhile, are often unprepared for paying thousands of dollars for their health insurance deductibles and out-of-pocket ceilings. Yet a patient could face a payment demand for as much as $13,200 even before checking into a hospital. It’s not a happy moment for patients or providers. (Jim Landers, 4/6)

Blaming post-King chaos on Obama and Democrats will obviously be the first thing GOP governors like Walker try to do. But Democrats don’t control Congress anymore. And according to law professor Nicholas Bagley, who has taken a close look at the administration’s options for a forthcoming legal paper, there is little Obama can do on his own. “The Obama administration has no good options for picking up the pieces after an adverse ruling in King,” Bagley tells me. (Greg Sargent, 4/6)

Just when it looked as if Florida might do the right thing and accept federal money to provide health-care coverage for about 800,000 of the state's working poor, Gov. Rick Scott throws a wrench in the works. Scott, who in 2013 backed taking some $51 billion in federal dollars as part of the Affordable Care Act but then did nothing to press the Legislature for action, says he now has doubts. So much for the hard work of Florida's business community, which has lobbied for passage of Senate Bill 7044, an alternative free-market plan being pushed by Senate President Andy Gardiner, R-Orlando. (Sandra Powers, 4/7)

Tomorrow, April 7, scores of Montanans will be at the state Capitol in Helena, hoping to make one last plea to members of the House Human Services Committee to pass a bill expanding Medicaid. This time, their pleas mustn't fall on deaf ears. (4/6)

People without health insurance get health care at the wrong time, in the most expensive manner, and often they get it for free. Free for them, at least, but at a serious cost to the state and to those who purchase health insurance. This is reality, and is the main reason behind the efforts to create a unique, one-of-a-kind solution for Montana. While created by Republicans, this nonpartisan solution is about reform, personal responsibility, and people helping themselves in life. (Republican State Sen. Ed Buttrey, 4/6)

Montana has 125,000 Medicaid recipients, about one out of every eight people who live here. This is up from 77,000 in 2002. The program costs $1.431 billion a year, about $4,200 each spread across all state taxpayers. ... Medicaid is the behemoth overtaking our state budget as well as state budgets all around the country. ... Medicaid is the horse galloping away with state budgets. It needs to be fixed, not expanded. (Republican State Rep. Tom Burnett, 4/6)