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Almost 950,000 new customers selected health coverage on HealthCare.gov outside of the open-enrollment period after they became eligible due to changes such as losing their employer-provided insurance or having a baby, according to a government report on the federal health insurance exchange. With the new consumers who enrolled during the year due to changes in their circumstances, the Obama administration remains on track to meet its goal of 9.1 million to 9.9 million people who have paid for coverage through the insurance exchanges by the end of 2015. (Armour, 8/13)

Nearly a million people signed up for health insurance under the Affordable Care Act even after the official enrollment season ended, helping push the share of uninsured Americans below 10 percent and underscoring how hard it could be for Republicans to dismantle the program. The Health and Human Services Department said Thursday that 943,934 new customers had signed up since open enrollment ended on Feb. 22, benefiting from “special enrollment periods” keyed to life changes and other circumstances. (Alonso-Zaldivar, 8/13)

Nearly 1 million people signed up for health insurance on the Obamacare exchanges this spring, outside of the scheduled enrollment season, because of special circumstances, the Obama administration said Thursday. About 944,000 people chose health care plans on HealthCare.gov between Feb. 23 — shortly after the last enrollment season ended — and June 30. During that time, people were eligible to sign up if they had a qualifying life event, such as aging off a parent’s health plan. HHS also opened up a short window to enroll during tax season. (Haberkorn, 8/13)

MNsure has hired the non-profit company Consumers' Checkbook to help improve the shopping experience on its website. The Washington D.C.-based company has a lot of experience providing price and service comparison tools, and has worked on other state health insurance exchanges. (8/13)

Scott Walker said Thursday he knows and likes John Kasich and Chris Christie, but the Wisconsin governor said that unlike the chief executives of Ohio and New Jersey, he didn’t accept Affordable Care Act Medicaid expansion dollars. ... Walker said Kasich is “a good guy” and has “a solid record in Ohio.” “There’s a couple of differences between me and any of the other governors on the (debate) stage the other night, meaning Gov. Christie and Gov. Kasich,” he said. “I didn’t take the Medicaid expansion under Obamacare,” as Kasich and Christie did. “I think that’s important to a lot of Republicans -- that I didn’t further Obamacare." (DiStaso, 8/13)

But what [Ohio Gov. John Kasich] is not saying is just as revealing. During the event, at a country club in a Democratic-leaning part of the state, he dispatched a question about whether he would support legalized abortion in cases of rape, incest and when the life of the woman is in jeopardy with a single word — “Yes” — cutting off discussion of an issue that has addled some of his opponents. ... Mr. Kasich says he is most animated by what he calls “people in the shadows,” those with mental illness, developmental disabilities and in at-risk minority communities. (Martin, 8/13)

GOP presidential hopeful Carly Fiorina said Thursday that parents should not be forced to vaccinate their children against diseases like measles and mumps, although she added that public school systems can forbid unvaccinated children from attending. "When in doubt, it is always the parent's choice," Fiorina said during a town hall in an agricultural building in rural Iowa on Thursday evening. "When in doubt, it must always be the parent's choice." (Johnson, 8/13)

GOP presidential candidate Dr. Ben Carson on Wednesday accused Planned Parenthood of disproportionately opening clinics in black neighborhoods as a way to “control that population.” In an interview with Fox News late Wednesday, Carson claimed Planned Parenthood’s founder, Margaret Sanger, was a racist who intentionally opened abortion clinics in predominately black neighborhoods. (Ferris, 8/13)

Republican presidential candidate Ben Carson on Thursday defended his past use of tissue from aborted fetuses for medical research even as he continued to criticize Planned Parenthood. The retired neurosurgeon said his research, which took place in 1992, does not conflict with his call to defund Planned Parenthood after several undercover videos surfaced that purportedly show officials with the organization working with research companies using tissue from aborted fetuses. Jen Gunter, an obstetrician-gynecologist, wrote on her blog that Carson had co-authored an academic paper published in Hum Pathol, in which he described working with material "from two fetuses aborted in the ninth and 17th week of gestation." (Scott and Spodak, 8/13)

Ben Carson doesn't deny using fetal tissue from aborted fetuses for medical research in the early 1990s. But the way in which the former Johns Hopkins neurosurgeon received and used the tissue is very different from how Planned Parenthood obtains and sells its fetal tissue, he claims. (Phillips, 8/13)

New Hampshire is in the throes of a drug epidemic driven by prescription opiods and heroin. "The state of New Hampshire loses a citizen to an overdose death about every day," said Tym Rourke, chair of the New Hampshire Governor's Commission on Alcohol and Drug Abuse. In New Hampshire, a recent poll about the most important problems facing the state found drug abuse ranks second. That puts it ahead of education, taxes and the state budget. And now politicians visiting the first-in-the-nation primary state are paying attention — in part because so many voters are bringing it up. (Keith, 8/14)

When the former head of the U.S. government’s health insurance programs was hired in July to run a lobby that had spent tens of millions of dollars trying to derail Obamacare, it was more than just another spin of Washington’s revolving door. Marilyn Tavenner, former administrator of the Centers for Medicare and Medicaid Services, became chief executive of America’s Health Insurance Plans, the industry’s main lobbying group, which is known as AHIP. As the latest of a half-dozen prominent architects and overseers of Obamacare to move into the health industry, her move signified growing ties between health insurers and Democrats despite battles over the Affordable Care Act. (MacGillis, 8/13)

Let’s say you’re having trouble reading this. The words are a little fuzzy. You might need glasses or a new prescription. So you call to make an appointment for an eye exam and ask how much the visit will cost. You’re going to pay for the appointment because your insurance plan has a deductible that you haven’t met. Seems like a simple question, but be prepared: There’s a good chance you won’t get a simple answer. (Bebinger, 8/14)

One of the health law’s key protections was to cap how much consumers can be required to pay out of pocket for medical care each year. Now some employers say the administration is unfairly changing the rules that determine how those limits are applied, and they’re worried it will cost them more. (Andrews, 8/14)

Patients who have insurance and go to in-network hospitals may still wind up with unexpected bills. It happens when doctors are out of network and don't take a patient's insurance. In those instances, patients may owe the balance between what the provider charges and what the insurance plan is willing to pay. It's often referred to as surprise billing, a form of balance billing, and it's a situation that Michael Trost of Dingmans Ferry, Pa. encountered this past spring. An unanticipated trip to an in-network hospital and the subsequent surgery from an out-of-network doctor resulted in a surprise bill of $32,325. (Gordon, 8/13)

CMS recently issued a report on the practice of "balance billing" -- under which health care providers charge qualified Medicare beneficiaries (QMBs) a share of the cost of care, such as copayments. That practice is illegal, CMS officials said. Seniors and people with disabilities are considered QMBs if their incomes are less than federal poverty level and they have limited assets. States are required through Medicaid to cover some of the QMBs' Medicare Part B premiums and the per-service cost-sharing, such as copayments. (Gorn, 8/13)

Congressional debate over the annual defense policy measure often centers on hot-button issues such as the future of the military prison at Guantanamo Bay, the fate of huge weapons systems and whether to lift budget caps. This year, a dispute over a bread-and-butter matter -- how to pay for the rising cost of prescription drugs -- may be most vexing of all for lawmakers who are trying to close a deal on the bill, H.R. 1735, that would authorize more than $620 billion in defense-related spending. At issue are benefits for the estimated 9.6 million users of the Pentagon's Tricare health system and resulting profits for retail drugstores including those run by CVS Health Corp., Walgreens Boots Alliance Inc. and Rite Aid Corp. (Wasson, 8/13)

A new study says that if the Pentagon allows transgender people to serve in the U.S. military, the cost of providing specialized medical care to them would be relatively minimal. Defense Secretary Ash Carter announced last month that the Pentagon would study how to dismantle a ban on transgender people from serving in the military, essentially paving the way for the ban to be lifted formally as early as December. One of the factors the Pentagon is considering is the cost of administering health care to service members who require specialized medical treatment or surgery as they undergo a sex change. (Lubold, 8/13)

Ohio’s total Medicaid spending was nearly $2 billion below estimates for the fiscal year that ended in June, despite more newly eligible enrollees under an expansion of the program, according to a new report. The report released Wednesday shows total Medicaid spending was $23.5 billion — 7.6 percent less than projected. Medicaid Director John McCarthy told The Columbus Dispatch that recent initiatives contributed to the savings, such as shorter nursing-home stays, expanded home-based care for seniors, expanded managed care and capitated reimbursement policies, or pay per patient rather than per patient visit. (8/13)

The state’s main health care agency has all but ruled out Grady Health System’s “waiver’’ proposal to cover more uninsured Georgians. ... Such a move would fall far short of Medicaid expansion under the Affordable Care, which would increase the number of low-income people eligible for the Medicaid program. More than half the states have approved expansion, but Georgia leaders say it would be too costly. (Miller, 8/13)

An effort by state officials to keep Kansans with non-traumatic brain injuries from participating in a special Medicaid program is making it harder for those who qualify for the services to get them, advocates say. At issue is a little-known Medicaid program that helps people suffering from brain injuries caused by external trauma, such as car accidents, falls or assaults. It’s a Traumatic Brain Injury (TBI) waiver program, meaning it’s primarily designed to provide services to people in their homes and communities rather than institutions. Over the last five years the number of Kansans served by the TBI waiver has been as low as 643 and as high as 748. In addition to things like personal care and meal delivery for those who need it, the waiver also provides a host of rehabilitative services. (Marso, 8/13)

Asked about his continuing opposition to Medicaid expansion, [Kansas Gov. Sam] Brownback downplayed the importance of the issue, telling reporters that innovation is more important to hospital finances than the billions of additional federal dollars that expansion would provide. Tom Bell, the president and CEO of the hospital association, disagreed and told the governor so late last week in a strongly worded letter, which, among other things, said that expansion and innovation are complementary goals. (Marso, 8/13)

A federal judge on Thursday ruled that Maine’s Department of Health and Human Services missed the deadline to appeal a decision intended to cut off Medicaid reimbursement for patients at Riverview Psychiatric Center in Augusta. Riverview lost its certification from the federal Centers for Medicare and Medicaid Services in September 2013 due to a range of issues, the most serious of which involved the use of Tasers and restraints on patients. (Harrison, 8/13)

A nursing facility chain in Iowa that was accused of submitting inaccurate cost reports for Medicaid payments will pay more than $415,000 as part of a settlement. The U.S. Attorney's Office for the southern and northern districts of Iowa said in a news release Thursday that Signature Care Centers, LLC, and its seven related nursing facilities in Iowa have agreed to pay the money to resolve civil allegations involving Medicaid overpayments for the 2008 and 2010 fiscal years. (8/13)

Public health agencies and drug treatment centers nationwide are scrambling to battle an explosive increase in cases of hepatitis C, a scourge they believe stems at least in part from a surge in intravenous heroin use. In response, authorities are instituting or considering needle exchange programs but are often stymied by geography — many cases are in rural areas — and the cost of treatment in tight times. In Washington County, at the nation's eastern edge, the rate of the acute form of hepatitis C last year was the highest in a state that was already more than triple the national average. The problem, health officials there agree, is spurred by the surge in the use of heroin and other injectable drugs and the sharing of needles to get high. (Whittle, 8/13)

The young woman nursing a fresh black eye has come to the police station in this old fishing city for help. But she's not looking to report a crime or seek someone's arrest. She wants help kicking her heroin addiction. "It was better than the alternative," says the woman, in her mid-20s, as she waits wearily for her ride to a detox center, following a long night that involved a stint in the emergency room, wrestling with the early pains of withdrawal and, finally, sleep in a police holding cell. Gloucester is taking a novel approach to the war on drugs, making the police station a first stop for addicts on the road to recovery. Under a policy launched in June, heroin and opioid addicts who voluntarily turn themselves in at the station are fast-tracked into treatment services through a team of police officers, volunteers and trained clinicians. (Marcelo, 8/13)

Baltimore's top health official went to court Thursday to give out prescriptions for a medication that prevents overdoses as the city continues to look for innovative ways to curb rising deaths from heroin use. Dr. Leana Wen gave out the prescriptions for naloxone to 30 drug offenders at the Baltimore City Adult Drug Treatment Court, where they get drug treatment and academic and vocational training in lieu of traditional jail time.If administered properly, the life-saving drug quickly reverses the effects of overdose from opiod drugs such as heroin. (McDaniels, 8/13)

News from Kentucky and New Jersey along with campaigns in other states have rekindled interest in California efforts to force physicians to use the Controlled Substance Utilization Review and Evaluation System -- California's electronic monitoring system known as CURES. (Lauer, 8/13)

County officials from across Maryland packed an information session here Thursday, seeking guidance now that entrepreneurs are scouting locations to grow and sell marijuana for medical use. The General Assembly passed legislation this year and last to revise a 2013 law that had legalized the sale of medical marijuana in the state but was so restrictive that it attracted no proposals. Regulations have been drafted and, unless new snags emerge, people suffering from cancer, epilepsy and other ailments are expected to be able to purchase cannabis to relieve their symptoms by late 2016. (Dresser and Wood, 8/13)

Massachusetts is considering a bill that would give consumers more control over who sees the insurance forms that list their personal health information. If the bill passes, Massachusetts would join four states — California, Colorado, Maryland, and Oregon — that have passed laws addressing the privacy of insurance forms. (Freyer, 8/14)

With New York City’s largest ever outbreak of Legionnaires’ disease apparently waning, the City Council passed a bill on Thursday intended to thwart future spread of the illness. The legislation, which was developed by Mayor Bill de Blasio; the Council speaker, Melissa Mark-Viverito; and Gov. Andrew M. Cuomo, requires building owners to conduct quarterly inspections of cooling towers, which have been pinpointed as the source of the outbreak. Owners must provide annual certification that their towers have been inspected, tested, cleaned and disinfected. The legislation also requires building owners to carry out a maintenance plan and to register any cooling towers, or face fines and potential prison time, depending on the severity of the transgression. (Remnick, 8/13)

Children’s advocates are asking the state Department of Health Care Services to report on more of the quality measures in the hopes that better data can spotlight areas where children aren’t getting adequate health care. (Guzik, 8/13)

Health insurance plans sold in Connecticut will no longer be allowed to limit coverage of medically necessary infertility treatment to people under 40, according to new guidance issued by the Connecticut Insurance Department Thursday. (Levin Becker, 8/13)

A top state official says Iowa is providing better mental health care after an overhaul of the system, though critics question the recent closure of two state-run mental health institutes. Department of Human Services Director Chuck Palmer told an advisory board Wednesday that Iowa’s mental health system was serving more people and providing more modern care. The effort to remake the system began in 2011 and was implemented last year. (8/13)

In a press conference at the General Assembly Wednesday, Belhaven Mayor Paul O’Neal thumped the podium in frustration that Pungo Hospital, located in his town, remains closed after a year. O’Neal was in Raleigh speaking in support of lawmakers who would like to eliminate the state’s certificate of need laws, a complex suite of rules that help state regulators determine the distribution of hospital beds around North Carolina. For months, Republican lawmakers in both chambers of the legislature have been calling for changes to the laws: Senate leader Phil Berger (R-Eden) has indicated his support for doing away with CON altogether. (Hoban, 8/13)

Parents in Illinois citing religious objections in refusing to have their children immunized will have to get a doctor's signature confirming they've been informed of the risks. A bill signed into law this month requires parents of children entering kindergarten and grades six and nine to provide a Certificates of Religious Exemption with a health care provider's signature if they opt out of vaccine requirements. (8/13)

Rowan University has received a federal grant to better prepare New Jersey’s health care workforce to take care of the growing elderly population. The $2.55 million grant will seek new ways to address what has been a persistent problem in the country’s health care system: too few doctors who specialize in taking care of older people. (Diskin, 8/13)

A Synergy Health Centers nursing home in Sunderland, already ranked among the worst in Massachusetts, is being investigated by the state following repeated complaints about patient care. Inspectors from the state Department of Public Health, which oversees nursing homes, spent 12 hours last Thursday at New England Health Center in Western Massachusetts probing a suspected medication error involving two patients, according to a staffer who asked to remain anonymous because the worker was not authorized to speak publicly. (Lazar, 8/14)

The mother of a severely autistic and disabled man was dealt a setback this week when she learned a Lancaster County District Court judge dismissed a lawsuit she hoped would restore her position as his private-duty nurse. Dee Shaffer has filed appeals with the state Department of Health and Human Services and lawsuits in district court after the state reneged on a contract allowing her to be paid to take care of her son's medical needs, rather than have him go to a nursing home. Brian Shaffer, 36, needs a special diet, air filters and care to prevent life-threatening allergic reactions. (Young, 8/13)

A judge on Thursday ordered an inmate whose medical treatment has cost Cook County taxpayers more than $1 million released to a secure residential treatment facility to receive much-needed mental health care. Unable to post a $5,000 cash bond, he has languished for months in Cook County Jail on a relatively low-level burglary charge as legal wrangling over his case dragged on. Once a promising basketball prospect, the teen from Chicago's West Englewood neighborhood cracked while in custody, swallowing anything he could get his hands on in his cell: screws, needles, a thumbtack, a 4-inch piece of metal, even strips of leather from restraints, according to jail officials. (Schmadeke, 8/13)

Nearly a third of Wyoming's involuntary psychiatric hospitalizations originated in Natrona County in the 2015 fiscal year, new data shows. Wyoming judges issued 357 involuntary hospital orders during the 2014-15 fiscal year, which ended June 30. Of those, 112 came from Natrona County. A government committee is studying the issue due to rising costs, increased numbers of involuntary commitments and the process’s variation by county. (Hancock, 8/13)

A Republican political operative is launching political broadsides against former Rep. Allyson Schwartz. But he’s not focused on scaring off voters; she’s not running for anything. He’s aiming at her role heading a Medicare Advantage group. Bradley Vasoli, a GOP campaign operative who worked for Schwartz’s unsuccessful opponent back in 2006, Thursday launched a “Beware BMA” campaign to criticize Schwartz and the Better Medicare Alliance, which appointed her president in April. (Mershon, 8/13)

Salt Lake City International Airport already has five smoking rooms between its three terminals, but the airport plans to replace them over time with one master terminal that would include two smoking rooms. Anti-smoking groups say the rooms are a public health risk to travelers, but airport officials contend they allow the airport to contain secondhand smoke. (8/13)

As the population ages, more adults will develop impaired decision-making capacity and have no family members or friends available to make medical decisions on their behalf. In such situations, a professional guardian is often appointed by the court. ... Physicians are well positioned to assist guardians with these decisions and safeguard the rights of the vulnerable persons they represent. ... we analyzed state guardianship statutes and reviewed recent legal cases to characterize the authority of a guardian over choices about end-of-life treatment. We found that most state guardianship statutes have no language about end-of-life decisions. We identified 5 legal cases during the past decade that addressed a guardian’s authority over these decisions, and only 1 case provided a broad framework applicable to clinical practice. (Cohen et al., 8/10)

[T]he use of advanced technologies to overcome infertility and the number of fertility clinics providing [assisted reproductive technology] ART services have increased steadily .... Because more than one embryo might be transferred during a procedure, women who undergo ART procedures, compared with those who conceive naturally, are more likely to deliver multiple birth infants. Multiple births pose substantial risks to both mothers and infants .... This report provides state-specific information .... In most reporting areas, multiples from ART comprised a substantial proportion of all twin, triplet, and higher-order infants born .... Of the four states (Illinois, Massachusetts, New Jersey, and Rhode Island) with comprehensive statewide-mandated health insurance coverage for ART procedures ...., two states (Massachusetts and New Jersey) had rates of ART use exceeding twice the national level. (Sunderam et al, 8/13)

Our objective was to explore the impact of rudeness on the performance of medical teams. ... Twenty-four NICU teams participated in a training simulation involving a preterm infant whose condition acutely deteriorated due to necrotizing enterocolitis. Participants were informed that a foreign expert on team reflexivity in medicine would observe them. Teams were randomly assigned to either exposure to rudeness (in which the expert’s comments included mildly rude statements completely unrelated to the teams’ performance) or control (neutral comments). ... Rudeness had adverse consequences on the diagnostic and procedural performance of the NICU team members. Information-sharing mediated the adverse effect of rudeness on diagnostic performance, and help-seeking mediated the effect of rudeness on procedural performance. (Riskin et al., 8/10)

[M]any factors beyond health insurance influence individuals’ ability to obtain care. ... this analysis examines differences in access to and utilization of care for Black and Hispanic adults compared to White adults among those who are uninsured, enrolled in Medicaid, and privately insured. It is based on data from the 2014 Kaiser Survey of Low-Income Americans. The findings show that, consistent with other research, both Medicaid and private coverage are associated with improvements in access to and utilization of care compared to being uninsured, and these differences generally hold true for White, Black, and Hispanic adults. However, privately insured Black and Hispanic adults fare worse than privately insured White adults along several measures of access to and utilization of care and have less confidence in their ability to afford medical costs. (Artiga et al., 8/6)

In 2013, overall, 8.4% of primary care physicians reported that they did not accept new patients. However, acceptance varied by the patient's expected payment source: 35% of physicians did not accept new Medicaid patients, 27.7% did not accept new Medicare patients, and 19.3% did not accept new privately insured patients. (8/13)

The Small Business Health Options Program (SHOP) got off to a slow start, , with lower-than-expected enrollment and a public perception problem. This report examines California and Colorado’s small-business marketplaces, which opened on schedule in October 2013. For business owners, employee choice was the most important reason cited for considering SHOP, with ease of administration a distant second. ... Interviews also revealed that business owners consider insurance brokers to be an important source of enrollment assistance. Those in the insurance and policy communities perceived small-business owners to be poorly informed about available tax credits; business owners disagreed, saying the credits were simply not key to their decision to elect SHOP. (Haase, Chase and Gaudette, 8/12)

This analysis examines trends in Medicaid and CHIP eligibility limits .... Eligibility for children and pregnant women has been consistently higher than for parents and other adults over time. The ACA Medicaid expansion narrowed the gap ... but median eligibility limits for parents and other adults still are lower than those for children and pregnant women. Across eligibility groups, the Northeast generally has had the highest median eligibility limits. The South has the lowest median eligibility limits for all groups, except pregnant women, for whom the West has the lowest .... eligibility levels vary substantially across states and across eligibility groups. Eligibility remains higher for pregnant women and children compared to parents and other adults. (Artiga and Cornachione, 8/6)

Integrating behavioral healthcare within primary medical care leads to significant advantages in bettering outcomes in child and adolescent behavioral health, researchers have found. A meta-analysis of randomized clinical trials by Joan Rosenbaum Asarnow, PhD, from the Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, and colleagues showed that youth who had integrated care had a 66% higher probability of having a better outcome than children or adolescents who received usual care .... Results were published online August 10 in JAMA Pediatrics. (Frellick, 8/11)

Environmental cleaning is known to prevent the spread of healthcare-associated infections (HAIs), yet hospital cleaning practices varied, and not much quality data exists on the science of proper environmental cleaning methods, according to a systematic review. Among 80 studies, 49 examined cleaning methods, while 14 evaluated monitoring strategies, and 17 addressed challenges or facilitators to implementation, reported Jennifer Han, MD, of the University of Pennsylvania in Philadelphia, and colleagues. But only five studies were randomized controlled trials -- most simply compared microbial counts before and after cleaning -- and there was a lack of studies on disinfecting methods and monitoring strategies, they wrote in a technical brief in the Annals of Internal Medicine. (Weitering, 8/11)

Even when physician-assisted suicide is legal, doctors often have reservations about helping patients die, two European studies suggest. (Rapaport, 8/10)

Hospitals have a free and powerful tool that they could use more often to help reduce the pain that surgery patients experience: music. Scores of studies over the years have looked at the power of music to ease this kind of pain; an analysis published Wednesday in The Lancet that pulls all those findings together builds a strong case. (Harris, 8/13)

Newly licensed registered nurses (RNs) were likely to work schedules associated with significantly increased risks for occupational injuries, including overtime (61%) or night shifts (44%), according to a major new analysis of occupational injuries published online June 29 in the International Journal of Nursing Studies. (Kelly, 8/10)

Although most physicians acknowledge the complexity of prescribing drugs to pregnant women, they nonetheless prescribe them frequently. More than four of five (82.5%) pregnant women were prescribed at least one medication, and 42.0% were prescribed a drug that is potentially harmful to the developing fetus, researchers found in a large, population-based study. The study, which details the type and timing of medications prescribed to pregnant Medicaid patients, presents a disturbing pattern, according to Kristin Palmsten, ScD, from the University of California, San Diego, in La Jolla, and colleagues. (Pullen, 8/7)

As more kids use mobile phones and surf the web at increasingly younger ages, sexting and Internet safety are becoming bigger childhood health concerns, edging out longtime worries like smoking and teen pregnancy, a new poll suggests. Internet safety rose to become the fourth most commonly identified major problem in the 2015 C.S. Mott Children’s Hospital national poll on children’s health, up from eighth the year before, with 51 percent of adults this year citing it as a top concern. (Rapaport, 8/10)

Fifty years ago hospital stays were longer, patient outcomes weren’t as good and health care in general was riskier business. So why does Medicare cling to a rule from 1965 that requires people to stay in the hospital for three days as an inpatient before being transferred to a skilled nursing care facility? That’s the question being raised by a study that was published last week in the journal Health Affairs and led by Amal N. Trivedi, a professor at Brown University. (8/14)

The MSM discounted him because he ran before and didn’t win, is not heavily financed and does not fit the model of a Republican conservative. His opponents don’t take him seriously because he has a “Medicaid” problem, they intone (he expanded Medicaid, a no-no in conservative circles), and has a somewhat hyper-active personality, deemed, they sniff, not presidential. Well, lo and behold, he had a terrific debate outing and is surging in the polls. What’s his secret? (Jennifer Rubin, 8/13)

Instead of promoting his ideological purity, he notes that policy choices are circumstance-specific. For example, he’s not a priori opposed to single-payer health care. “It works in Canada,” he said at the first Republican presidential debate on Aug. 6. “It works incredibly well in Scotland.” Even in the United States, “it could have worked in a different age,” but it wouldn’t work very well right now, he said. So instead, he’d replace Obamacare with “something terrific,” which would take care of people who can’t afford health insurance. (Josh Barro, 8/14)

At times, Mr. Trump goes on the attack without actually disagreeing. The Affordable Care Act should be abolished, but his suggested replacement bears considerable resemblance to President Obama’s plan. He has pushed for even greater involvement by government in health care, praising the single-payer models of Canada and Scotland. I guess a foolish inconsistency can also be the hobgoblin of a big mind. (Steven Rattner, 8/14)

The government faces a tricky trade-off in bringing countervailing power to the market for specialty drugs, weighing the social opportunity costs of ever-higher health spending vs the reality that prices of new drugs should be high enough to encourage private investors to foster medical innovation. Investors’ compensation should help them not only recover their outlays for developing new products but also include a premium for assuming the financial risk that such investments may not pay off. A lively debate can be had over how high that compensation for financial risk should be. When considering the financial risks of investors, one might gain some perspective through contemplating how we compensate others who assume risk on society’s behalf, such as police officers, firefighters, or members of the armed forces. (Uwe Reinhardt, 8/13)

What is the “right” way to die? We’re experiencing a zeitgeist moment about that. “Being Mortal: Medicine and What Matters in the End,” by Atul Gawande, is a best-selling book. Videos by Brittany Maynard, a 29-year-old who wanted to die in a way of her own choosing, went viral last year. ... What if the most promising way to fix the system is to actually do less for the dying? That’s what the not-for-profit Zen Hospice Project has been trying to prove through a fascinating, small-scale experiment in San Francisco’s Hayes Valley neighborhood. (Courtney E. Martin, 8/14)

When Republicans carry on about what a “disaster” the Affordable Care Act is, they rarely acknowledge that the law is helping millions of people get health insurance. But we don’t need Republicans to tell us these things. We have data. And now we have some more. The U.S. Centers for Disease Control and Prevention on Wednesday released the latest results of the National Health Interview Survey. According to the survey, just 9.2 percent of the population, or about 29 million people, had no coverage during the first three months of 2015. That’s down from 11.5 percent in 2014, 14.4 percent in 2013, and 16 percent back in 2010. (Jonathan Cohn, 8/12)

With the current most substantial consolidation of health care in US history, the concerning implications of the trend of hospital consolidation on quality, access, and price must be carefully considered. ... 85% of US hospitals pay no taxes because they are designated as nonprofit organizations serving a public good. Hospitals can set prices that are ultimately passed on to others in the form of escalating insurance deductibles and taxes. The good work of integrated hospitals should continue to create networks of coordinated care, while at the same time, physicians and patients should insist that hospitals compete on transparent prices and quality outcomes. Achieving this goal is an important prerequisite to a functional health care system. (Tim Xu, Albert W. Wu and Martin A. Makary, 8/13)

Patients are exhorted to empower themselves with information to make wise choices, whether selecting hospitals or deciding how they'll die. ... Clearly, patients should have access to all available information, from their medical records to anticipated costs of care. But that it's wrong to deny anyone information doesn't make it right to always provide as much as possible. Might there, in fact, be such a thing in medicine as Too Much Information? (Lisa Rosenbaum, 8/12)