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Aetna’s decision to withdraw, in 2017, from 11 of the 15 states where it is currently offering plans on the Affordable Care Act’s exchanges is another clear signal, coming as it does in the wake of many other insurer withdrawals, that the insurance marketplaces are financially unstable. Because of unworkable federal rules, the exchanges are increasingly unable to offer a choice of attractive, affordable health plans. (Joseph Antos and James Capretta, 10/11)

Donald Trump derided the Affordable Care Act in the second presidential debate as a “total disaster.” One inarguable success of the 2010 health-care law has been to drive the rate of uninsured Americans to a historic low. That sizeable shift makes it significant that a plurality of the public thinks the uninsured rate is unchanged and that the number of people who know the uninsured rate is at its low point is nearly the same as the number of people who mistakenly think the rate is at an all-time high. (Drew Altman, 10/12)

Very quietly, on the Friday before a long federal holiday weekend, Mylan last week paid $465 million to stifle government allegations that it had systematically overcharged Medicaid for its notorious EpiPen medical device. This sum is, amazingly, well more than twice the $185 million paid by Wells Fargo over charges that its bankers systematically ripped off and stole the identities of their clients, but it hasn’t received an iota of the attention of the Wells scandal. Let’s redress the balance just a bit. (Michael Hiltzik, 10/11)

The United Nations General Assembly sounded the alarm last month on superbugs, antibiotic-resistant organisms that are cropping up with disturbing frequency around the world and rendering formerly tamed foes into new threats. Among them: a new strain of drug-resistant tuberculosis and an E.coli that’s impervious to the strongest medicine we’ve got. The bacteria that cause gonorrhea may soon be untreatable by all current antibiotics too. ... So good for the U.N. for making this a high-level international priority. And good for the Los Angeles County officials who announced plans last week to require hospitals to report when patients are infected with carbapenem-resistant enterobacteriaceae, or CRE. ... And good for Sen. Jerry Hill (D-San Mateo) for reviving his effort to get hospitals to report drug-resistant microbes. (10/12)

Hillary Clinton, responding to Trump’s excoriations of the Affordable Care Act (ACA), a.k.a. Obamacare, noted in a single line that Medicare is exactly the kind of “single-payer” system generally proffered by ACA opponents as the ultimate horror. But there’s a problem with the argument: there is no horror of Medicare. Even conservative Republicans with any hope of keeping their offices are champions of it. You cannot threaten much of anything about Medicare and hope to keep your job in the government. (David L. Katz, 10/11)

One of the iron laws of public policy is that regulatory agencies have an irresistible tendency to push the limits of their power and authority. ... We saw a classic example of that recently when the Health Policy Commission inserted itself into Boston Children’s Hospital’s determination of need application to upgrade its facilities. ... Children’s Hospital is one of the preeminent pediatric medical centers in the nation, drawing research dollars, patients, and talent from across the world. It is an integral part of the crown jewel of the Massachusetts economy .... The HPC has an important role to play as Massachusetts undergoes major changes in the health care marketplace, but its credibility depends on choosing wisely where it exercises its authority. (Mike Widmer, 10/12)

Today, in 21 states and Washington, D.C., nurse practitioners can administer a wide range of care and prescribe drugs — services they are educated and trained to provide. The remaining states, though, require that physicians oversee the work of these nurses, and those laws extend to VA facilities. In those states, veterans and consumers alike endure longer waits to receive care. Access — getting health care when and where it is needed — has been our country’s main problem in giving veterans the excellent care they deserve. The need has been painfully obvious in the notoriously long times that some veterans must wait to receive health care, delays that have led to deaths. (Catherine Georges, 10/11)

Let’s start with a simple idea: Everyone is entitled to respect, especially when we disagree. It’s a concept that touches the bedrock of our freedom. (Michele Smith and Brian Hopkins, 10/11)

One out of three adults over 65 years old lives alone, and social isolation is on the rise, right alongside other related statistics, such as depression, alcohol abuse and suicide. The numbers are staggering. Studies also directly link isolation and loneliness with poor health and early death, and they are major predictors of seniors needing long-term care and entering nursing homes, according to the British Columbia Ministry of Health research. (Jennifer Keiser, 10/11)

As cancer treatments improve, ... millions more will have to learn to live a life forever altered by cancer. As nurses trained to help cancer survivors, we see the challenges they face every day. Yet we draw hope in knowing that those challenges can be addressed. Living with cancer does not have to mean losing quality of life. As awareness grows, so will the ranks of those who learn to enjoy life after a cancer diagnosis. (Janet Snapp and Dori Klemanski, 10/11)

My goal is to raise awareness about metastatic breast cancer. Most people don’t know there’s no cure for it, and that misunderstanding creates a whole different set of challenges for the men and women living with it. We often feel exhausted and excluded from the conversation about breast cancer prevention and detection. We live every day knowing the cancer is still in us. (Carol Chaoui, 10/11)