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One of the remarkable aspects of the politics of health reform is the way conservatives — even relatively mild, seemingly informed conservatives — have managed to keep believing that Obamacare is unraveling, despite the repeated failure of disaster predictions to come true. ... Anyway, it’s really helpful to have this new report from the Commonwealth Fund comparing actual performance with pre-implementation predictions. ... On enrollments: fewer people than expected signed up for the exchanges, but an important reason was that fewer employers than expected ended coverage and moved their employees into the individual market. (Paul Krugman, 12/23)

Martin Shkreli, the former hedge fund manager turned pharmaceutical CEO who was arrested last week, has been described as a sociopath and worse. In reality, he’s a brasher and larger version of what others in finance and in corporate suites do all the time. Federal prosecutors are charging him with conning wealthy investors. Lying to investors is illegal, of course, but it’s perfectly normal to use hype to lure rich investors into hedge funds. And the line between the two isn’t always distinct. (Robert Reich, 12/23)

Hillary Clinton this week promised to cure Alzheimer’s disease inside of a decade—even as she bemoans the tragedy of the Hepatitis C cures that are on the market today because she feels the prices are too high. That isn’t the only contradiction—or outright falsehood—dominating the political debate over pharmaceuticals. (12/23)

A growing number of medical students today are tacking on a business degree. Since 1993 the number of MD/MBA programs has ballooned from six to about 65, representing nearly half of all U.S. medical schools. The majority of MD/MBA students will complete a medical residency and use their business training to lead physicians and manage hospitals or other healthcare systems. Yet here at Stanford, where I am one of 18 such dual-degree candidates, some of my peers are considering joining digital health startups instead. We are surrounded by an explosion of such opportunities, propelled by more than $2 billion of venture capital funding in the first half of 2015. (Rich Joseph, 12/23)

In October, Centers for Medicare and Medicaid Services announced that doctors would be able to bill Medicare for end-of-life counseling starting in 2016. The decision encourages physicians to talk to their patients about advance directives, which helps individuals to express their preferences regarding end-of-life care and can ease the emotional toll on loved ones responsible for making difficult decisions on the patient's behalf. However, insurance providers and the medical community must also expand end-of-life care discussions to younger adults, who arguably have the most to lose. (Yoo Jung Kim, 12/23)

It’s impossible to know the depth of the drug addiction crisis that has affected the lives of so many people here in New Hampshire and across the country. Legal opioids – improperly used or illegally obtained – are just one side of this multifaceted issue in the current problem of prescription drug abuse. Working as a physician, every day I see patients with a diversity of pain issues. ... Health care providers now find themselves in the progressively precarious position of trying to provide safe and effective patient care, while feeling the pressure of perceived governmental oversight and scrutiny. In this environment and in the attempt to reach a balance, one question that deserves attention is: What is being done to increase access to medication specifically designed to treat pain and prevent abuse before it starts? (Dr. George Lantz, 12/23)