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House Energy and Commerce Chairman Fred Upton along with Senate Finance Chairman Orin Hatch and Senator Richard Burr have outlined what will be the leading Republican alternative to Obamacare. They have offered lots of good ideas. But by insisting on repealing and replacing Obamacare they have also refused to fix it and muddied the waters by giving people a huge and complicated take it or leave it health care plan of their own. (Robert Laszewski, 2/15)

While several Republicans in Congress have offered serious proposals to replace Obamacare, debating a wholesale replacement of the Affordable Care Act would take months, even years. But it is essential for Congress to move fast on a short-term solution. About 85 percent of people who bought plans on the exchanges receive subsidies, and most could not afford the policies without them. If fewer people are enrolled and new enrollments decline, premiums will rise, leading to the breakdown of the exchange markets. ... Fortunately, there is a way out, one that President Obama, forced by the court to the negotiating table, might be willing to accept. (Grace-Marie Turner and Diana Furchtgott-Roth, 2/13)

Obamacare's goal to expand access to health care has been only half a success: More Americans have insurance, but a rise in cost sharing means fewer can use it. Copayments -- those predetermined charges you pay at the doctor's office -- are a big part of the problem. In recent years, they've risen to the point where they no longer work as they're meant to. (2/16)

Obamacare's employer mandate requires firms that employ 50 or more people to pay for group coverage of employees who work at least 30 hours a week. Republicans have long criticized this as a de facto tax that will drive companies to reduce hours for part-timers; that is, those who can least afford the lost income. So there was a bit of an uproar when Buzzfeed reported that part-time employees of Staples, the office-supply chain, believe that the company is strictly enforcing a post-Obamacare rule against any part-timer putting in more than 25 hours per week. (2/14)

It isn't exactly surprising that all four individual plaintiffs in the King v. Burwell case have dubious legal standing to pursue their challenge to Obamacare's premium subsidies before the U.S. Supreme Court, as the Wall Street Journal has reported. Similar legal standing questions arose in 2011 about the two individual plaintiffs challenging the constitutionality of the Affordable Care Act in the case that ultimately led to the Supreme Court narrowly upholding the law in 2012. ... The irony is that all four of the plaintiffs in the pending case and at least one of the plaintiffs in the earlier case are people who very likely would benefit from Obamacare's premium subsidies to make coverage affordable and its rules against insurers' denying coverage based on pre-existing conditions. (Harris Meyer, 2/13)

The debate over ObamaCare has obscured another important example of government meddling in medicine. Starting this year, physicians like myself who treat Medicare patients must adopt electronic health records, known as EHRs, which are digital versions of a patient’s paper charts. If doctors do not comply, our reimbursement rates will be cut by 1%, rising to a maximum of 5% by the end of the decade. I am an unwilling participant in this program. In my experience, EHRs harm patients more than they help. (Jeffrey A. Singer, 2/16)

It seems impossible to believe that smoking is even more harmful to health than we had thought. Yet that is exactly what a large and authoritative study published last week has revealed. The findings provide stark evidence that the need to reduce smoking is more important than ever. ... The latest surgeon general’s report in 2014 estimated that there are 480,000 deaths each year in the United States from 21 diseases caused by smoking, including 12 types of cancer, acute myeloid leukemia, diabetes, heart disease, stroke and atherosclerosis. Now comes evidence that the toll is actually much worse than that. A study by researchers at the American Cancer Society, the National Cancer Institute and four universities — published in The New England Journal of Medicine on Wednesday — adds several more diseases and 60,000 deaths a year to the total. (2/14)

Most discussion about PTSD thus far has been about fear and the conquering of fear. But, over the past few years, more people have come to understand PTSD is also about exile — moral exile. We don’t think about it much, but in civilian life we live enmeshed in a fabric of moral practices and evaluations. We try to practice kindness and to cause no pain. People who have been to war have left this universe behind. That’s because war — no matter how justified or unjustified, noble or ignoble — is always a crime. It involves accidental killings, capricious death for one but not another, tainted situations where every choice is murderously wrong. (David Brooks, 2/17)

We believe so strongly that vitamins are always good for us, and that the more we get the better, that we fail to notice that food marketers use synthetic vitamins to sell unhealthful products. Not only have we become dependent on these synthetic vitamins to keep ourselves safe from deficiencies, but the eating habits they encourage are having disastrous consequences on our health. (Catherine Price, 2/14)

If you or a loved one is having a heart attack, your most pressing concerns probably include how quickly you can get to the hospital and the quality of care you’ll receive. You’re probably not thinking about the hospital’s board room, even though quality of care for heart attacks and many other conditions may be determined in large part by decisions made there. Several studies show that hospital boards can improve quality and can make decisions associated with reduced mortality rates. But not all boards do so. (Austin Frakt, 2/16)

My father was one in 5 million. That’s the probability of getting polio after being in contact with someone who has received the oral polio vaccine. I got the vaccine as an infant. And somehow the weakened form of the virus within it managed to infect my father. He spent nine months in intensive care, eventually becoming entirely paralyzed except for one eyelid with which he agonizingly communicated with my mother. A year after I was born, he was dead. As the debate over vaccines rages on, it’s difficult for me not to identify, at least in part, with the fears that drive parents to not vaccinate their children. (Nuria Sheehan, 2/12)