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In making his case for universal health care, Senator Bernie Sanders has reignited a debate over whether the U.S. should have a single-payer system. It would simplify the administration of health insurance, but his proposal is nevertheless ill-advised -- not least because it’s possible to simplify billing and claims processing in health care without making such an extreme change. (Peter R. Orszag and Timothy G. Ferris, 1/21)

So Bernie Sanders has a health-care plan. It sounds wonderful. It covers everything, from dental to long-term care. There will be no co-pays or deductibles. You will not have to hassle with an insurer over what’s covered. There’s just one small problem, which is how Sanders is planning to pay for this. Yes, his health care plan lays out revenue estimates in great detail. But the revenue estimates and the cost estimates are perhaps just a trifle too rosy for me to take seriously. (Megan McArdle, 1/20)

If you’ve successfully landed on the beaches, but your forces are still taking heavy fire, what do you do? Do you concentrate on trying to hold the line and make further advances or do you sit in a circle and design a better landing craft? The problem with Bernie Sanders’ health care vision isn’t the vision. His raw outline for a greatly simplified and less expensive health-care system is excellent in theory. The problem is the politics — the reality of which battle-scarred Hillary Clinton clearly has the better grasp. (Froma Harrop, 1/20)

Bernie Sanders is a democratic socialist who thinks the United States needs a "political revolution." His plan to replace our health insurance system with "Medicare for All" is in some ways a dramatic break with the status quo. But it rests on an old and thoroughly conventional formula: Promise voters that they will get more and better health care without paying for it. Simply expanding Medicare to include everyone would be a big enough step. But Sanders' plan is to Medicare what a Tesla is to a Toyota. (Steve Chapman, 1/20)

Gov. Matt Bevin of Kentucky is dismantling the state’s highly successful exchange on which people buy private health insurance policies or enroll in Medicaid under the Affordable Care Act. His shortsighted and pointless show of defiance against the Obama administration’s health care reforms could harm thousands of people in Kentucky, who may fall between the cracks as the state shifts their coverage from its own exchange, known as Kynect, to the federally run exchange at HealthCare.gov. (1/21)

As Iowa’s 118 community hospitals and 71,000 hospital employees work daily to bring healing and wellness to all Iowans, the state’s reckless rush toward privatization of the Medicaid program has been a source of extreme concern. Most concerning are the myths about privatization perpetuated by our own governor, including during his interview with the Des Moines Register editorial board, as he tries to promote what is simply a bad idea for Iowa and, especially, for 560,000 vulnerable Iowans who depend on Medicaid. (Kirk Norris, 1/20)

In his final State of the Union address, President Obama said he would put Vice President Biden in charge of a “moonshot” program to conquer cancer with the same level of effort that went into the Apollo lunar missions. Some cancer researchers say the idea of curing cancer with a massive government program relies on an outmoded, simplistic model of the disease. But even if a “victory” against cancer is unrealistic, how can government best be used to reduce its threat and lethalness? (1/19)

Unlike dietary supplements, which were explicitly excluded from rigorous FDA regulation in 1994, homeopathic products can actually be substantially regulated by the FDA, since the Food, Drug, and Cosmetic Act allows them to be sold as “therapeutic.” We believe that, at minimum, regulators should reconsider the way homeopathic drugs are marketed, so that consumers who are seeking conventional medicines at pharmacies don’t become confused. In August, the FTC submitted comments to the FDA recommending that the agencies better harmonize their approaches to regulating homeopathic products and their advertising. ... The recent actions by the FDA and FTC may finally signal the end of homeopathic drugs’ century-long evasion of regulatory scrutiny. (Scott H. Podolsky and Aaron S. Kesselheim, 1/21)

The aerial view of the concept of data sharing is beautiful. What could be better than having high-quality information carefully reexamined for the possibility that new nuggets of useful data are lying there, previously unseen? The potential for leveraging existing results for even more benefit pays appropriate increased tribute to the patients who put themselves at risk to generate the data. The moral imperative to honor their collective sacrifice is the trump card that takes this trick. However, many of us who have actually conducted clinical research, managed clinical studies and data collection and analysis, and curated data sets have concerns about the details. (Dan L. Longo and Jeffrey M. Drazen, 1/21)

As patients strive to manage their own health and illnesses, many wonder how to get a copy of their health data to share with their physicians, load into apps, donate to researchers, link to their genomic data, or have on hand just in case. To seek diagnosis or better care, many patients are taking steps outside traditional doctor–patient relationships. Some join 23andMe to obtain genetic information. Others bring data to the Undiagnosed Diseases Network at the National Institutes of Health (NIH). Patients are coalescing with others with the same disease in what the Patient Centered Outcomes Research Institute calls patient-powered research networks. But such patients have found no easy way to get copies of their electronic health records (EHRs). (Kenneth D. Mandl and Isaac S. Kohane, 1/21)

Managing the care of high-cost patients is a key concern of physicians and health systems that are forming accountable care organizations (ACOs) and entering into alternative payment contracts tying reimbursement to performance on cost trends and quality measures. The logic is simple: given that a small percentage of patients (often those with complex or multiple medical conditions) account for the majority of health care spending, directing additional resources and services toward patients who are likely to incur high costs and experience poor outcomes ... Can tactics honed among the elderly be successfully applied to other high-cost populations? (Brian W. Powers and Sreekanth K. Chaguturu, 1/21)