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Among the holy grails of would-be healthcare reformers, the holiest and grailiest quest is for the "empowered consumer." This creature, armed with discernment about his or her medical needs and free choice of doctors and hospitals, will bring us to the paradise of low-cost medical care and uncompromisingly good health. Too bad that in the real world, empowered consumers and "consumer-driven healthcare," the instrument through which they achieve these goals, are mythical. ... The empowered consumer is a star of the latest conservative alternative to the Affordable Care Act, issued earlier this month by the American Enterprise Institute. (Michael Hiltzik, 12/14)

As part of his push for the Affordable Care Act in 2009, President Obama came to Central High School [in Grand Junction, Colo.] to laud this community as a model of better, cheaper health care. “You’re getting better results while wasting less money,” he told the crowd. His visit had come amid similar praise from television broadcasts, a documentary film and a much-read New Yorker article. All of the attention stemmed from academic work showing that Grand Junction spent far less money on Medicare treatments – with no apparent detriment to people’s health. The lesson seemed obvious: If the rest of the country became more like Grand Junction, this nation’s notoriously high medical costs would fall. But a new study casts doubt on that simple message. (Kevin Quealy and Margot Sanger-Katz, 12/15)

There's a Cuban American first-term senator running for president who has done more than any Republican to stop the Affordable Care Act. No, I'm not talking about Ted Cruz, R-Texas. I'm talking about Marco Rubio, R-Fla. The battle against President Barack Obama's health care act has been Cruz's signature struggle. In 2013, Cruz took to the Senate floor and promised to speak out against the Affordable Care Act, also known as Obamacare, "until I am no longer able to stand." ... But while the shutdown may have helped boost Cruz into the top tier of Republican presidential contenders, it had zero impact on undermining Obamacare. Rubio, by contrast, didn’t read Dr. Seuss on the Senate floor, but he has quietly pushed Obamacare into what may prove to be a death spiral. (Marc A. Thiessen, 12/14)

Like it or not, someone other than your doctor is in the business of recommending your medical treatments. That job falls to a little-known group called the U.S. Preventive Services Task Force. It has been the subject of increasing controversy, not because it guides decisions, but because some of its recommendations have shifted from encouraging expensive and expansive screening to discouraging its overuse. As with many things in medicine, it’s much more popular to do stuff than to tell people “no.” (Aaron E. Carroll, 12/14)

Despite bipartisan approval and popular support, a bill assisting first responders who have illnesses resulting from 9/11 has been stalled by Republican leaders in Congress. The James Zadroga 9/11 Health and Compensation Act of 2010 provides emergency medical care, monitoring and compensation programs to thousands of first responders nationwide, but will expire this month unless Congress acts. (Phoebe Lett, 12/14)

As the abuse of opioids, including prescription painkillers and heroin, has risen in Tennessee, the number of babies born dependent on drugs has skyrocketed, increasing fifteenfold during the last 10 years. In an effort to combat this troubling trend, the state approved a controversial new law in 2014 to allow women who give birth to babies “harmed by” illegal drug usage to be charged with misdemeanor assault. ... Legislators saw the law as a way to push women into getting treatment. But that's not what is happening, say critics .... They say the law has had the perverse effect of making pregnant women afraid to get prenatal care, lest they be arrested down the road. (12/14)

Every few years we are told about a new “drug plague” in which the drug use of pregnant women supposedly dooms their children – unless, of course, we take the children away. The media said it about crack, and they were wrong. They said it about methamphetamines and they were wrong. Now there’s a new epidemic of hype around pregnant women who use drugs both legal and illegal, from heroin to prescription painkillers. Those stories are wrong, too. (Richard Wexler, 12/14)

I’ve spent much of the last year in constant pain – all because my health insurance company decided it wouldn’t cover the medication that my doctor prescribed to treat my chronic rheumatoid arthritis. I was diagnosed early last year after collapsing at work. My doctor prescribed a biologic infusion treatment, but my health insurer required me to first fail on six other drugs before I could gain access to the biologic. (Arloishia Israel, 12/14)

It’s a quick drive from Scottsdale to south Phoenix, but when it comes to health the two communities are worlds apart. If you are born in Scottsdale, you can expect to see your 85th birthday. In south Phoenix, children are likely to only reach their 71st. (Suzanne Pfister, 12/14)