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Obamacare enrollment has a smoking problem. A new study from the Yale School of Public Health finds that an anti-smoking provision in the health law is discouraging people from signing up for insurance while simultaneously failing to get them to kick the habit. (Sy Mukherjee, 7/7)

Last week we asked the Food and Drug Administration what’s holding up a first-in-class treatment for boys with a rare and lethal form of muscular dystrophy. Still no answer on that. But we understated the promising clinical results from the drug maker, Sarepta Therapeutics, and our error is a chance to note that the statistic captures only part of the therapy’s efficacy. Ten out of 12 boys with Duchenne muscular dystrophy walk after four years of treatment on eteplirsen, which produces a protein called dystrophin. (We mistakenly said it was eight of 10.) A trial with more than 83% of patients walking longer than the disease’s progression would predict is more than marginal progress. It’s a breakthrough. (7/7)

Although brick and mortar stores are a ubiquitous feature of the US consumer landscape, health insurance for individuals is typically sold via phone, mail, computers, brokers, or, newly, “exchanges.” However, Blue Cross Blue Shield of Florida, now known as Florida Blue, broke this mold with 18 retail stores in a do good/do well innovation to reach patients without insurance with health insurance products. The stores also functioned as health care hubs. (Regina E. Herzlinger, 7/5)

It was the talk of joy that surprised me most during my first week of training as a resident physician. Most of orientation was devoted to priming me and my fellow residents for the dual responsibility of being both learners and employees of the Cambridge Health Alliance. Then one of the senior physicians started talking about finding joy in medicine. (Jennifer Adaeze Okwerkwu, 7/8)

ike many aspects of health care, medical education evolves slowly. The modern curriculum is based on the Flexner Report — a review published in 1910. It hasn’t changed much since then. It needs to. As a medical student at Stanford, I’ve seen firsthand the limitations of today’s physician training. We can do better. Here are five reforms that I think would prepare doctors for medicine in the 21st century. (Akhilesh Pathipati, 7/7)

The recent announcement by Vice President Joseph Biden of a cancer cures “moonshot” has brought renewed attention to the goals of 21st-century cancer care. Not since the late President Nixon’s declaration of War on Cancer has so much focus been directed toward the experiences of the 1.66 million persons diagnosed with cancer annually in the United States.1 The framing of this initiative is focused on accelerating scientific progress against cancer as a disease, with little attention to equity2 or to the experience of those living with cancer and its consequences. As billions of dollars are invested in seeking the cure for cancer, attention to the quality of life of people living with cancer and the effect of cancer treatment are at least as important to address and far more achievable in the near term. (Arif H. Kamal, Thomas W. LeBlanc and Diane E. Meier, 7/5)

Two evolving disciplines in medicine have brought new ways of thinking about health and disease. One is palliative care, which focuses on improving the quality of life of patients with serious illnesses and their families. A second is population health, which focuses on improving the health of populations, with a special emphasis on reducing disparities in health outcomes and improving the value of health care. Although palliative care and population health are related, there has been limited discussion about how these 2 disciplines can support and complement each other. This synergy is key to improving the quality of care of frail older persons with chronic, life-limiting illnesses. In this Viewpoint, we describe the potential synergies between these 2 disciplines and propose next steps to foster collaboration. (David Casarett and Joan Teno, 7/5)

It was a squeaker, and a dramatic reversal. Poll after poll had found that a majority of Massachusetts voters would support the 2012 "Death with Dignity" ballot measure allowing terminally ill patients to get doctor-prescribed medications to end their own lives. But in the final days, amid a well-funded opposition TV ad campaign, the picture changed. (Carey Goldberg, 7/7)

As the promise and the pitfalls of precision medicine gain increasing attention,1,2 enthusiasm about the field has been heightened by a rapid reduction in the cost of high-throughput genomic sequencing and a dramatic increase in the identification of potential molecular targets for therapy. Biomarker tests for molecularly targeted therapies can help physicians to select the most effective therapy for a patient's condition and avoid treatments that could be ineffective or harmful. If precision medicine is to reach its potential, such biomarker tests will have to be developed in a timely fashion. (Gary H. Lyman and Harold L. Moses, 7/7)

Several months ago, my wife, Françoise, and I attended something novel for melanoma patients: a survivors’ dinner. People said they wanted to make it an annual gathering. Planning anything that far in advance had been pointless for me. Two years ago, I was about to accept hospice care. When I was first diagnosed in 1996, early surgery was the only reliably successful treatment. Anything more advanced was essentially a death sentence. Over the past five years, a series of revolutionary drugs have given me and many other people a surprisingly hopeful prospect. Nevertheless, the drugs’ development process has often been excruciating for clinical trial participants, and their remarkably high costs limit their value. (Jonathan Friedlaender, 7/2016)

Democrats and officials with Planned Parenthood called Thursday for repealing an abortion law struck down by the U.S. Supreme Court last week. A Republican leader said the effort was a publicity stunt because the law has already been invalidated. ...The ruling makes the law invalid, but abortion supporters told reporters on a conference call that the state should also formally repeal it so it’s off the books. (Patrick Marley, 7/7)

“Safe but legal” abortions are so yesterday. The U.S. Supreme Court has made “unsafe and legal” the new standard in the abortion industry. Last week, the Supreme Court issued a ruling that will put women’s health at risk. The Supreme Court justices reversed the Fifth Circuit Court of Appeals on Whole Woman’s Health v. Hellerstedt in a 5-3 decision. The two main components of this bill: a requirement that abortionist’s have admitting privileges at a hospital within 30 miles of the clinic, and that their facilities meet the same basic health standards as ambulatory surgical centers. (Maggie DeWitte, 7/7)

Zika virus (ZIKV) infection during pregnancy has been linked to birth defects, yet the magnitude of risk remains uncertain. Investigators studying the 2013–2014 Zika outbreak in French Polynesia estimated that the risk of microcephaly due to ZIKV infection in the first trimester of pregnancy was 0.95% (95% confidence interval, 0.34 to 1.91), on the basis of eight microcephaly cases identified retrospectively in a population of approximately 270,000 people with an estimated rate of ZIKV infection of 66%. (Michael A. Johansson, Luis Mier-y-Teran-Romero, Jennita Reefhuis, Suzanne M. Gilboa and Susan L. Hills, 7/7)

For too long, tobacco industry strategies to normalize and glamorize use of their product have perpetuated a preventable epidemic. Although US adult smoking rates declined to 15.1% in 2015, nearly half a million people die annually just from cigarette use in the United States. Projections are that 5.6 million US children alive today will die prematurely from tobacco-related disease. For every tobacco-related death, approximately 30 more individuals live with chronic tobacco-induced disease and disability. (Howard Koh, 7/6)

So what does it mean to view firearm violence as a public health problem? And how does that change the debate Americans are having about gun violence? First, and most importantly, viewing firearms violence as a public health problem means declaring that the current situation is unacceptable, and preventable. (Sandro Galea and Michael Siegel, 7/7)