�鶹Ů��

Donald Trump says Paul Ryan is wrong about Social Security and Medicare. The Republican speaker of the House wants to “knock Medicare way down,” according to Trump, and do the same to Social Security. Trump says this approach would cost Republicans the election, and also be unfair to people who have paid into these programs. (Ramesh Ponnuru, 4/21)

The best book I’ve read to help understand the underlying dynamics of healthcare’s under-performance is David Goldhill’s “Catastrophic Care: Why Everything We Know About Health Care is Wrong.” Goldhill goes into great depth on the destructive dynamics of having what he calls “surrogates” — i.e., insurance companies — between us and clinicians. It’s not the simplistic demonization of insurance companies one often sees. In fact, Goldhill argues that health plans are acting quite rationally within an irrational set of circumstances. (Dave Chase, 4/19)

I have said “yes” many times in my life. I said “yes” as a young woman, when I felt God was calling me to serve the elderly poor. I have said “yes” since then, day and night, to accompanying men and women in their last hours before God calls them to Himself. Last week, I said “yes” to an unexpected solution that the Supreme Court proposed to the case involving our religious order. Following oral arguments last month, the justices took an unusual step: They asked if there were ways for the government to provide contraceptives and other services to our employees without involving our health plan and violating our conscience. The government, in its response, said that it would not consider alternative options. (Loraine Maguire, 4/21)

Had your blood drawn lately? If not chances are good you will soon. About 10 billion tests are done every year on our blood. Diagnostic blood tests are a huge component of American health care, costing $73 billion a year—roughly $10 billion of which comes from Medicare and Medicaid. Not only do blood tests cost a fortune, the results of these tests determine a huge proportion of what happens next to patients. Whether you get a prescription, undergo further testing, enter the hospital, begin chemotherapy and hundreds of other decisions rely on the results of testing your blood. (Dr. Arthur L. Caplan, 4/20)

When CVS Health in February began taking over pharmacy operations at more than 1,600 Target stores, CVS Pharmacy President Helena Foulkes called the changeover "an important milestone." "Our heart is in every prescription we fill, and providing accessible, supportive and personalized healthcare is part of our DNA," she said. (David Lazarus, 4/22)

No government agency controls the fate of more people than the Food and Drug Administration, which has the power to deny children a treatment that could help them walk. The FDA is reviewing an experimental drug for muscular dystrophy, and the outcome could determine the quality of life for thousands—and whether companies continue to invest in curing rare diseases. (4/21)

Alyson Williams, an immigrant from Trinidad and Tobago who lives in Dorchester, has always known one profession: taking care of the elderly. When she was 19, her grandmother fell prey to the usual depredations of old age. “She raised me; she took care of me growing up. Then she got sick. I felt like I owed her, had so much gratitude for what’s she had done for me that I said, ‘I’m going to take care of her.’” Now, Williams, who’s in her early 40s, is a certified nursing assistant and has been working at Marina Bay Skilled Nursing Center for the last three years. (4/22)

The link between the Zika virus and microcephaly in babies was confirmed last week by scientists at the Centers for Disease Control and Prevention, the latest in a series of increasingly troubling revelations about the mosquito-borne disease. First, it’s not just mosquito-borne; it can also be passed among humans via sexual contact. Since symptoms are so mild, if present at all, many carriers of the virus might pass it along without realizing they were infected. (4/22)

Since 2000, more than 20,000 Ohioans have taken their lives. That’s appalling on its face, but even worse is that, unlike other leading causes of death, suicide is considered 100 percent preventable. With public awareness, early intervention and an effective mental-health system, people could be helped before they ever reached the point of contemplating suicide, or stopped if they are on the verge. (4/22)

Mary, who is 24 but looks barely 18, has already experienced more than enough betrayal for any lifetime. Shyly but deliberately, she told of feeling sick at 16 and being diagnosed with HIV. After her mother — her only provider — was sent to prison, an aunt took Mary in, but forced her to sleep in an open-walled shed behind the house. Then she was raped by a boyfriend. “I went home crying and bleeding,” she recalled. Mary told no one, fearing she would be turned out on the street. “I kept quiet, by myself.” Four months later, she learned she was pregnant. (Michael Gerson, 4/21)