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Having waited years for the chance to repeal Obamacare, Republicans will finally have the opportunity in 2017. With the GOP controlling the White House, the Senate and the House of Representatives, the party can drive a stake through the Patient Protection and Affordable Care Act without a single Democratic vote — much as Democrats passed it in 2010 without a single Republican in support. But repealing the ACA is one thing, improving the U.S. healthcare system quite another. The current GOP strategy will almost certainly make millions of Americans worse off than they are today, and even worse off than they were before the ACA (better known as “Obamacare”) was passed. (12/20)

Over the past few weeks, a stream of data has revealed the desperation of an almost catatonic America, taking place outside of the dominant media corridors and conversations. For example, according to the Centers for Disease Control (CDC), deaths in 2015 from heroin abuse surpassed deaths from gun homicides, an unprecedented phenomenon for a country seen as more addicted to its firearms. Total opioid deaths, including overdoses of prescription drugs like OxyContin and synthetic opiates like fentanyl, hit 33,092 last year. One-third of users of these drugs for more than two months report a physical dependency, which suggests that the mortality rate will rise. (David Dayen, 12/20)

As deaths from opioid overdoses continue to rise, the 21st Century Cures Act has provided a billion dollars over the next two years to states for opioid prevention and treatment programs. The new funding is sorely needed. To really be effective, the solutions to this epidemic, as with any drug epidemic, need to deal both with the suppliers and the users. (Drew Altman, 12/19)

In a study that is sure to rile male doctors, Harvard researchers have found that female doctors who care for elderly hospitalized patients get better results. Patients cared for by women were less likely to die or return to the hospital after discharge. ... So why is there a gender-based difference in physicians' care? The authors admit that they are "unable to identify exactly why female physicians have better outcomes than male physicians." We don't pretend to know for sure, but as married doctors, we have our hunches. We talked it over and here are our thoughts about the research. (John Henning Schumann and Sarah-Anne Henning Schumann, 12/19)

You probably know where to pump the cheapest gas and how to get price comparisons online in seconds for headphones and cars. But how would you find the best deal on an M.R.I. or a knee replacement? No idea, right? This lack of price transparency in health care has been cited as one of the reasons we spend too much on it. It’s easy to overpay. Health care prices vary tremendously. And there is no established relationship with quality. (Austin Frakt, 12/19)

The burden of health care costs has been a national challenge for the last 50 years. Costs have consistently grown faster than the rest of the economy and, as a consequence, have crowded out other discretionary spending by government and employers while creating progressive hardship for individuals, particularly the low-income employed. These facts are unquestioned, but as we prepare to act on local remedies it is important to consider where our state stands on the national spectrum. (David Torchiana, 12/19)

The U.S. Health and Human Services Department’s Office of the Inspector General released a report Wednesday that showed the number of questionable short-term hospital stays decreased and outpatient treatment has become more common since the government’s 2013 rule change. But it also suggests that Medicare paid almost $2.9 billion that year for inpatient stays that lasted less than two nights -- charges that might be inappropriate under the revised policy. ... The findings reflect the complex nature of the program. (Lilo H. Stainton, 12/20)

After years spent fighting to defend and protect the Affordable Care Act, the Obama administration took action that violates the central tenets of its signature health care law. The about-face came in a regulation handed down last week by the Centers for Medicare and Medicaid Services that tacitly allows insurers to discriminate against dialysis patients based solely on their health condition. (Hrant Jamgochian, 12/19)

A recent study in the Journal of the American Medical Association concludes that 27 percent of medical students around the world exhibit symptoms of depression and 11 percent have thought of taking their own lives. ... It raises important questions about both medical education and the way medicine is practiced today, particularly the many non-patient-care-related demands on a physician’s attention. There are at least two ways to explain the high rates of depression among medical students. One focuses on the people who are attracted to careers in medicine. Perhaps medical students are more perfectionistic than others and more liable to become discouraged when they make mistakes. It is also possible that medical students are especially compassionate and more liable to become depressed by frequent contact with suffering. (Richard Gunderman, 12/19)

For years, I’ve taught in nursing programs and conducted research studies on to make better use of nurses in our health care system, particularly nurse practitioners in primary care. But it wasn’t until I found myself in a Boston ambulance several years ago that I really got a true look at America’s grim health care reality. (Lusine Poghosyan, 12/20)

It seems that the narrative that's taken hold in this country regarding abortion is that it is a selfish, heartless, and irresponsible act conducted by women who do not want the inconvenience of raising a child. Maybe that's because women often don't talk about their own abortions, or why they had them. (Jeanne Bauer, 12/19)

Earlier this month, Ohio legislators passed two extreme abortion restrictions. One would have banned abortion after a fetal heartbeat could be detected, as early as six weeks into a pregnancy. That bill passed by Ohio legislators would have prevented Ohio's abortion clinics from providing abortion care to about 97 percent of the women they serve, thereby banning nearly all abortions in the state. Ohio Gov. John Kasich vetoed it last week. (Ushma Upadhyay, 12/19)

In 1964, the U.S. surgeon general announced a definitive link between tobacco use and cancer. Despite this and mountains of additional evidence, the use of tobacco products remains the No. 1 cause of preventable death in the United States, killing more than 480,000 annually. Additionally, tobacco use is estimated to cost more than $300 billion per year in direct health care costs and lost productivity in the United States. So why is it, more than 50 years after this causal link was proven, there are still some who question the wisdom of public policies designed to protect all Americans from this public health hazard? (Brian Donohue, 12/19)

If published research and data were freely accessible and reusable by researchers of diverse interests, urgently needed solutions could be greatly accelerated. Scientists could quickly cross-check important studies, catching potentially consequential mistakes. Medical providers could access the latest technical guidance, improving patient care. And students around the world could build on each other’s work. With openness, good ideas could truly come from anyone, anywhere. (Richard Wilder and Melissa Levine, 12/19)

Ever since researchers with the legendary Framingham Heart Study created the first calculator to gauge the chances of having a heart attack, such tools have become a routine part of medicine. But the results aren’t as straightforward to interpret as the answers you used to get from your old high-school graphing calculator. The problem has to do with the challenge of interpreting the concept of risk. (Michael Pencina, 12/19)