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Payment for treatments come from a fragmented sector that includes individual insurers, big employers, Medicare, Medicaid and others. Particular payers may cover patients for only a few years before they move to another insurer or program. As a result, the entity paying the big bill for any enrollee's hepatitis C treatment may just be saving money for someone else. That's why there's still heavy resistance from insurers to the high price of the hepatitis C drugs. (Michael Hiltzik, 1/15)

Both Bernie Sanders and Hillary Clinton are pushing for lower prescription drug prices as part of their campaigns. Debates about whether and how to reduce drug prices aren’t new. But they rarely lead to legislative success. Still, the mere threat of government price controls may have a moderating effect on drug prices. There’s strong evidence it did so as the ill-fated Clinton administration health plan was being developed in the early 1990s. Today, with the high price of drugs and proposals to address them so prominent in the news, there are early signs it may do so again. (Austin Frakt, 1/18)

In his State of the Union address on Tuesday, President Obama called for America to become “the country that cures cancer once and for all.” As a three-time cancer survivor (metastatic colon, metastatic melanoma and metastatic prostate), I can tell you that this “moonshot,” as Vice President Joe Biden first called it, is a bold goal—but one within our grasp. ... Ironically, we’re handicapping ourselves in the war on cancer, in part because of a web of privacy regulations like the Health Insurance Portability and Accountability Act. HIPAA makes it difficult for researchers to tap into large caches of clinical and genomic data shared across multiple institutions or firms, and then share their findings more broadly. (Tom Coburn, 1/14)

TWO of our most vital industries, health care and education, have become increasingly subjected to metrics and measurements. Of course, we need to hold professionals accountable. But the focus on numbers has gone too far. We’re hitting the targets, but missing the point. ... Even some of the measurement behemoths are now voicing second thoughts. Last fall, the Joint Commission, the major accreditor of American hospitals, announced that it was suspending its annual rating of hospitals. (Robert M. Wachter, 1/16)

President Obama announced that last Tuesday’s State of the Union speech would be different: not the usual list of legislative New Year’s resolutions but a long-range look at structural challenges facing a rapidly changing nation. ... Conspicuously absent from the president’s message, though, was an issue so vital, and so unavoidable, that the president could have devoted the entire evening to it. We refer to the aging of the American population and the attendant need to support tens of millions of retirees in the coming decades without neglecting other pressing social needs. (1/16)

Starting this year, Medicare will, for the first time ever, reimburse physicians for having end-of-life discussions with terminally ill patients. In the ideal scenarios, doctors ask patients to identify how and where they want to spend those final days, and then recommend the best options. Question is, will physicians, as a result, be motivated to initiate more of these crucial conversations? Will patients? And will this long-overdue reform ultimately improve, both clinically and economically, how well the U.S. health care system delivers end-of-life care? Nobody knows for sure. But this much is certain: Many physicians have received no training along these lines. (Michael Nisco, 1/15)

Health care experts are starting to pay more attention to the violence that can envelop inner-city life. The Centers for Medicare and Medicaid Services announced $157 million in funding recently for programs that link people to social services that address issues including adequate housing, food and interpersonal violence. (Jayne O'Donnell, 1/18)

What’s behind this newfound willingness on [GOP presidential] candidates’ part to talk about the personal toll of addiction? New Hampshire, and the sobering statistics on drug overdoses there, is probably part of the answer. Every day, 44 people in the United States die as a result of overdose on prescription painkillers. Every day, nearly 7,000 people are treated in emergency rooms for abusing painkillers. Overdose deaths have been creeping upward since the beginning of the 21st century — especially deaths from opiate abuse. In New Hampshire, overdose deaths linked to opiate abuse have more than doubled over the past two years. (Emma Roller, 1/19)

Montgomery County, [Maryland] which consistently ranks as one of the nation’s healthiest and wealthiest counties, has significant racial health inequities. In 2014, according to the annual Infant Mortality in Maryland report, the infant mortality rate in Montgomery County stood at 4.8 per 1,000 births. Among white county residents, the rate stood at 3.6, but it was 8.3 for African Americans in the county. (Laura Jenkins, 1/15)

C-sections save lives — when needed. But the enormous variation in rates, with very little variation in outcomes, shows that a great many of them aren’t necessary. In the last 15 years, the rate of C-section has gone up by 50 percent in the United States. According to Jeffrey Ecker, chairman of the American Congress of Obstetricians and Gynecologists’ committee on obstetric practice, that rise “has not been paralleled by any important fall in rates of things like cerebral palsy” — in other words, outcomes that C-sections are often performed to prevent. (Tina Rosenberg, 1/19)

The debate over whether it’s safer for a healthy woman to have a baby at home or in the hospital just tilted a bit in favor of hospital deliveries. The risks in both cases are very low, but a new study suggests that the risk to babies could be higher for out-of-hospital births. A study, based on data from Oregon and published in the New England Journal of Medicine in December, found that the risk of a baby dying was 3.9 per 1,000 births for deliveries at home or in birth centers, versus 1.8 deaths per 1,000 births in hospitals. (1/18)