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The Geisinger Health Plan, run by one of the nation’s top-rated health care organizations, foresees medical costs increasing next year by 7.5 percent for people buying insurance under the Affordable Care Act. So when Geisinger requested a rate increase of 40 percent for 2017, consumer advocates were amazed. And Kurt J. Wrobel, Geisinger’s chief actuary, found himself, along with other members of his profession, in the middle of the health care wars still raging in this political year. Actuaries normally toil far from the limelight, anonymous technicians stereotyped as dull and boring. But as they crunch the numbers for their Affordable Care Act business, their calculations are feeding a roaring national debate over insurance premiums, widely used to gauge the success of President Obama’s health care law. (Pear, 6/9)

Health and Human Services (HHS) Secretary Sylvia Mathews Burwell on Thursday sought to calm the nerves of health insurers increasingly in doubt about the fate of the ObamaCare marketplace. (Ferris 6/9)

The U.S. Department of Health and Human Services on Thursday trotted out insurance executives who have found success selling health plans to individuals via the online insurance exchanges, a key part of the Affordable Care Act. (Liss 6/9)

Alaska, one of the reddest states in the country, is essentially bailing out its insurance market to prevent Obamacare from collapsing. A bill passed by the heavily GOP state Legislature to shore up its lone surviving Obamacare insurer is awaiting the signature of Gov. Bill Walker, a Republican-turned-independent who was endorsed two years ago by former vice presidential candidate Sarah Palin. The legislation, originally proposed by Walker, sets up a $55 million fund — financed through an existing tax on all insurance companies — to subsidize enrollees’ costs as the state struggles with Obamacare price spikes and an exodus by all but one insurance company. (Pradhan, 6/10)

As stewards of a hospital that serves a large Medicaid population, executives with MetroHealth have supported the Affordable Care Act, which expanded insurance coverage to hundreds of thousands of low-income Ohioans. But that doesn't mean they don't see flaws in the landmark law. On Wednesday, the health system rolled out a program aimed in part at catering to people unhappy with the cost and complexities of their Obamacare plans. The program, called Select Direct, will allow patients to get primary care services by paying a fixed monthly fee. (Ross, 6/9)

Nearly 200,000 people have signed up for Medicaid in the first week of Louisiana’s expanded health care eligibility, state officials say. ... Enrollment began June 1, and the latest tally released Wednesday — 197,026 — includes thousands who have been reached through the Louisiana Department of Health partnering with other groups that serve the working poor and low-income families and have similar eligibility requirements. (Crisp, 6/8)

The state has received more than 130 comments on its plan to extend Medicaid to fewer than 16,000 Utahns — and many of those commenters still are calling for full-scale expansion. After years of debate and protests over Medicaid expansion, the state legislature this year passed — and the governor signed — a small-scale plan. Initially estimated to expand coverage to about 16,000 people, the current proposal would cover only about 9,000 to 11,000 of the poorest Utahns. (Stuckey, 6/9)

Gov. Jay Nixon signed legislation on Thursday that could expand Medicaid eligibility for Missourians who are elderly or living with a disability. For decades, Missourians who were elderly, blind or disabled could only have $1,000 or less in savings. The bill Nixon signed would gradually raise that asset limit to $5,000 for an unmarried person and $10,000 for a married couple. (Bouscaren and Rosenbaum 6/9)

Missouri seniors, the blind and those with disabilities soon will be able to save more money but still qualify for Medicaid health care benefits under a new law signed Thursday by Gov. Jay Nixon. The idea behind the bill, which passed with bipartisan support in the GOP-led Legislature, is to allow people who receive health care through the state program to keep more in savings that could help pay for unexpected expenses. Nixon said the new law will help “thousands of Missourians live more independent lives.” (6/9)

Hospital costs for uncompensated care have decreased in states that opted to expand Medicaid under the Affordable Care Act, but have remained stagnant in the states that have not, a report released today by the Kaiser Family Foundation says. Uncompensated care is how hospitals measure the care provided throughout the year for which they don’t receive any payment, which can lead to hospitals incurring bad debt. Total uncompensated care in 2013 cost $34.9 billions in hospitals nationwide, with about $16.7 billion incurring in states that expanded the program and $18.1 billion in states that did not. In 2014, total costs fell to $28.9 billion nationwide, falling about 17 percent. Nearly all the decrease occurred in expansion states, the report says. (McIntire, 6/9)

A new study by Georgetown University’s Health Policy Institute found stark differences between states that have expanded Medicaid eligibility under the Affordable Care Act and those — like Kansas and Missouri — that haven’t. (Thompson 6/9)

The Senate Appropriations Committee on Thursday advanced its health spending bill to the Senate floor, drawing bipartisan support for the measure for the first time in seven years. (Sullivan 6/9)

A recently introduced bill could establish a program that would train healthcare providers to identify and aid human trafficking victims. The legislation, introduced Wednesday in the U.S. House of Representatives, would direct the Department of Health and Human Services to train providers in hospitals and clinics to better identify patients who are being trafficked. The pilot program would be known as "Stop, Observe, Ask and Respond to Health and Wellness Training. The act would expand on current efforts to give healthcare providers the basic training needed to identify human trafficking victims and provide appropriate treatment. (6/9)

Energy and Commerce Committee Chairman Fred Upton (R-Mich.) is expressing skepticism about the idea of attaching a mental health bill to the conference committee working on opioid legislation. (Sullivan 6/9)

North Carolina’s largest health system faces allegations that it quashed competition with demands that insurers not steer consumers to rivals, in the latest sign of antitrust scrutiny across the consolidating health-care sector. The U.S. Justice Department and North Carolina Attorney General Roy Cooper filed a civil antitrust case against Carolinas HealthCare System on Thursday, alleging the system used the market power of its 10 hospitals in and around Charlotte, N.C., to win concessions from commercial insurers that stifled competition on hospital price and quality. (Evans, 6/9)

The U.S. Justice Department is suing North Carolina's largest healthcare system, saying it illegally imposes contract requirements on insurers that reduce competition. (Schencker 6/9)

The Food and Drug Administration did not force a recall of tainted peanut butter that caused salmonella poisoning in 14 people until 165 days after confirming the contamination, the agency’s watchdog said in report released Thursday. And in a similarly alarming case, it took the government 81 days to recall a variety of cheese products made by a Virginia firm — after eight people had fallen ill from a bacteria in the food and a baby died. This lax approach to food safety put consumers “at risk of illness or death” after testing showed the food was potentially hazardous, investigators for Inspector General Daniel R. Levinson at the Department of Health and Human Services, the FDA’s parent agency, wrote in a rare urgent warning. The “early alert” called the issue a “significant matter” that “requires FDA’s immediate attention.” (Rein, 6/9)

Federal health officials failed to force a recall of peanut butter and almond products for three months after advanced DNA testing confirmed salmonella contamination, government investigators reported Thursday. Despite new legal powers to compel recalls and sophisticated technology to fingerprint pathogens, the Food and Drug Administration allowed some food-safety investigations to drag on, placing consumers in jeopardy of death or serious illness, according to the inspector general's office at the Department of Health and Human Services. (6/9)

The Food and Drug Administration often moves too slowly on food recalls, letting companies take their time in recalling contaminated food and leaving the public uninformed and in danger, a government report found Thursday. For example, it took the maker of Hispanic-style cheese more than two months to recall listeria-contaminated products, the Office of Inspector General (OIG) at the Health and Human Services Department found. One baby died and two women miscarried because of listeria infections caused by that contaminated cheese. (Fox, 6/9)

Mergers have become commonplace as hospital mega-chains increasingly dominate the American health-care market. But these deals often go unscrutinized by state regulators, who fail to address potential risks to patients losing access to care, according to a new report released today. MergerWatch, which analyzes the hospital industry and opposes faith-based health care restrictions, surveyed health care statutes and regulations in all 50 states and the District of Columbia. It found that only 10 states require government review before hospital facilities and services can be shut down. Only eight states and the District of Columbia mandate regulatory review when hospitals enter into more informal partnerships rather than full-scale mergers, closing a loophole that exists in other states for deals to pass with minimal state oversight. (Lee 6/9)

People living in areas where the Zika virus is circulating should consider delaying pregnancy to avoid having babies with birth defects, the World Health Organization has concluded. The advice affects millions of couples in 46 countries across Latin America and the Caribbean where Zika transmission is occurring or expected. ... At the moment, Puerto Rico, the United States Virgin Islands and American Samoa are the only parts of the United States with local transmission of the virus. But clusters of cases are expected to appear in Florida and along the Gulf Coast this summer. (McNeil, 6/9)

In response to the WHO's new guidelines, the CDC said health care providers should discuss Zika's risks and how to prevent infection, and provide information about contraception. "As part of their pregnancy planning and counseling with their health care providers, some women and their partners residing in areas with active Zika virus transmission might decide to delay pregnancy," the agency said in a statement. (Neergaard, 6/10)

The WHO quietly released the guidelines Tuesday, though they received little attention until the agency issued an update on Thursday. It’s the first time the WHO has updated its Zika health recommendations since February. It’s a controversial move that stands in contrast with the strong insistence by U.S. health officials not to weigh in on the issue. White House spokesman Josh Earnest said as recently as May 11 that the federal government did not plan to issue specific guidance on what he said was an “intensely personal” decision. (Ferris 6/9)

The White House intensified its coordination with the predominantly Republican governors who lead the states most threatened by Zika on Thursday afternoon, sharing the administration’s freshly completed action plan with the executives in a conference call on Thursday afternoon. Governors, especially those from Gulf Coast states, have been watching the debate over emergency supplemental funding with increasing alarm. As Congress moves toward reconciling a $1.1 billion Senate measure and a $622.1 million House version that taps unused Ebola funds, flooding in Texas and a tropical storm in Florida have opened up what’s likely to be a soggy summer. That means lots of ideal breeding grounds for the Aedes aegypti mosquitos who carry the Zika virus. (Wheaton, 6/9)

Sen. Marco Rubio is pushing lawmakers to meet President Obama's request for $1.9 billion to fight the Zika virus as they prepare to merge competing proposals. (Carney 6/9)

Sen. Marco Rubio is an outlier among Republicans when it comes to funding to fight the Zika virus. And in a new letter Thursday evening, the Florida Republican continued what appears to be an uphill battle to get the full level of assistance pushed by the Obama administration. ... Rubio's letter asked the 33 members of a House-Senate conference committee, which will attempt to negotiate a final bill, to consider going above and beyond the dollar amount suggested by either the House or Senate. (Lesniewski, 6/9)

The top Senate Republican health care appropriator, who is expected to play a key role in Zika conference negotiations, hopes the carrot of finishing talks on how to fund the fight to combat the virus will bring House Republicans on board with the Senate’s bill. Sen. Roy Blunt (R-Mo.) said Thursday he thought it would be possible to convince House Republicans to agree to the Senate’s $1.1 billion legislation, in part because it would settle the question of how to fund the fight against Zika, a topic of discussion on Capitol Hill for the past four months. And the Senate bill comes with the added bonus of funding that fight until September 2017. (McIntire, 6/9)

Epidemics can spread in days and weeks, and the sooner that Congress acts on Zika funding the better, a top U.S health official said Thursday. ... "I know that there are people of good will in both houses of Congress, in both parties, who understand it's an emergency, who want to make it happen," Frieden said. "Congress did the right thing with Ebola, and I'm hopeful they'll do the right thing in Zika. The sooner they do it, the better it's going to be." (Foody, 6/9)

A United States laboratory researcher was back at work after contracting the Zika virus by pricking herself with a needle during an experiment last month, broadcaster ABC News said on Thursday. There is no vaccine or treatment for Zika, which is a close cousin of diseases such as dengue and chikungunya, and causes mild fever, rash and red eyes. An estimated 80 percent of those infected have no symptoms. (O'Brien, 6/10)

Officials in Cuyahoga County in northern Ohio, where nearly 200 people have died of heroin and fentanyl overdoses so far this year, are asking the federal government to help them combat an accelerating drug epidemic that reached new heights last month. A total of 45 people died of heroin and fentanyl overdoses in and around Cleveland in May, with 15 such deaths occurring over the final week of the month. The county is asking for additional funds and increased access to naloxone, which can reverse an overdose, as well as changes to Medicaid reimbursement rules so hospitals can treat more people with drug addictions. (Maher and Kamp, 6/9)

Overdose deaths from the powerful synthetic opioid that killed rock legend Prince in April increased 83 percent in Maryland last year, according to the state’s Department of Health and Mental Hygiene. The latest data on Maryland overdose deaths, which the department released Thursday, showed 340 fentanyl-related fatalities in 2015, compared with 186 the previous year. The rise continues an alarming trend that began in 2013. Since that year, the number of fentanyl-related deaths has increased ­12-fold. (Hicks, 6/9)

A new 25-point strategy for dealing with New York's heroin and opioid problem calls for limiting prescriptions, boosting treatment and greater support for those trying to stay clean. Gov. Andrew Cuomo released the recommendations Thursday. They now go to the state Legislature, which is expected to approve a comprehensive plan to combat the rise in heroin and opioid addiction before ending the 2016 session next week. The proposals announced by Cuomo include changes in insurance rules to encourage addicts to get help, greater funding for treatment, new training for doctors who prescribe opioids, new rules to limit acute pain medication to seven-day prescriptions, and expanded access to overdose antidotes. (6/9)

From 2006 to 2011, the number of newborns in withdrawal more than doubled in New Hampshire, and hospitals say the problem is only getting worse. (Ganley and Brindley 6/9)

Accidents are killing more Americans each year, increasingly from overdoses and falls. A new report from the National Safety Council said that in 2014, more than 136,000 Americans died accidentally. That’s up 4.2 percent from the year before and a jump of 15.5 percent over a decade. And the accident rate has risen despite a 22 percent plunge in car crash deaths since 2005. Overdose and accidental poisonings are up 78 percent over a decade — pushing aside car crashes as the No. 1 accidental killer in the U.S. (Borenstein, 6/9)

Sharon Belvin's nightmare with cancer began in 2004, when she was just 22. Belvin was an avid runner, but said she suddenly found she couldn't climb the stairs without "a lot of difficulty breathing." Eventually, after months of fruitless treatments for lung ailments like bronchitis, she was diagnosed with melanoma — a very serious skin cancer. It had already spread to her lungs, and the prognosis was grim. She had about a 50-50 chance of surviving the next six months. (Davis and Palca, 6/9)

Idiopathic hypersomnia patients sleep for excessively long periods — generally more than 11 hours at a stretch — but even after awakening in daytime hours often find themselves slipping back into slumber. (Simpson 6/9)

In early 2012, a neuropathologist named Daniel Perl was examining a slide of human brain tissue when he saw something odd and unfamiliar in the wormlike squiggles and folds. It looked like brown dust; a distinctive pattern of tiny scars. Perl was intrigued. At 69, he had examined 20,000 brains over a four-decade career, focusing mostly on Alzheimer’s and other degenerative disorders. He had peered through his microscope at countless malformed proteins and twisted axons. He knew as much about the biology of brain disease as just about anyone on earth. But he had never seen anything like this. The brain under Perl’s microscope belonged to an American soldier who had been five feet away when a suicide bomber detonated his belt of explosives in 2009. (Worth, 6/10)

They are among war’s invisible wounds: the emotional and cognitive problems that many troops experience years after combat explosions sent huge shock waves through their brains. Whereas the link between concussions and post-traumatic stress disorder has become clearer in recent years, a specific connection between PTSD and blast waves has remained elusive. Now, a prominent neuropathologist who researches brain injuries among military personnel says his team has identified evidence of tissue damage caused by blasts alone, not by concussions or other injuries. The team’s study was published on Thursday in The Lancet Neurology. (Schwarz, 6/9)

Earlier this month, dignitaries gathered at Arkansas State University in Jonesboro to cut the ribbon on a new medical school, only the second in a state with a dire shortage of doctors....The Arkansas initiative is one of several that states are undertaking to address a doctor shortage that is going to get worse in much of the nation, especially in states with large rural areas or high concentrations of minorities. (Ollove 6/10)

Doctors-in-training learn a lot about the workings of the human body during medical school and residency. But many are taught next to nothing about the workings of the health care system. One university in Washington, D.C., is trying to change that. The three-week fellowship in health policy for medical residents is run jointly by the George Washington University schools of medicine and public health. In addition to hearing lectures from policy experts in and around the nation’s capital, the residents take field trips to Capitol Hill, the Supreme Court, other federal and local health-related agencies, as well as local health care facilities. (Rovner, 6/10)

For doctors and nurses, hand hygiene is supposed to be as intuitive as breathing. But is this behavior really second-nature, or do health care workers need supervision to keep their hand cleaning habits on target? (Barzilay, 6/10)

As a law went into effect Thursday allowing physicians to prescribe medicines to terminally ill patients to hasten their deaths, a group of doctors tried to overturn it in court. The Life Legal Defense Foundation, American Academy of Medical Ethics and several physicians have filed a lawsuit in Riverside County Superior Court claiming that the state’s new aid-in-dying law is unconstitutional. The End of Life Option Act allows patients with less than six months to live to obtain medicines from their doctor that would kill them. On Thursday, California became one of five states in the U.S. where the practice is legal. (Karlamangla, 6/9)

On the day California's controversial right-to-die law went into effect, opponents on Thursday headed to court to try to stop it. The day before, six doctors and the American Academy of Medical Ethics had filed a lawsuit in Riverside County challenging the state's new End of Life Option Act. (Seipel, 6/9)

California on Thursday became the fifth state to allow terminally ill patients to legally obtain drugs that will end their lives. With the implementation of the End of Life Option Act, Californians with six months or less to live now can request a prescription for lethal medications from their doctors. But obtaining a prescription won’t be easy or quick, and some people may not meet the law’s many requirements. (Bazar, 6/9)

On Thursday, California became the fourth state in the country to put in effect a law allowing assisted suicide for the terminally ill, what has come to be known as aid in dying. Lawmakers here approved the legislation last year, after Brittany Maynard, a 29-year-old schoolteacher who had brain cancer, received international attention for her decision to move to Oregon, where terminally ill patients have been allowed to take drugs to die since 1997. Oregon was the first state to pass an assisted suicide law, and was followed by Washington and Vermont. Under a Montana court ruling, doctors cannot be prosecuted for helping terminally ill patients die, as long as the patient makes a written request. With the California law, 16 percent of the country’s population has a legal option for terminally ill patients to determine the moment of their death, up from 4 percent. (Medina, 6/9)

The 5th Circuit Court of Appeals ruled parts of the state's licensing statute unconstitutional earlier this year following a challenge by Austin attorney and academic Mary Louise Serafine. (Rocha, 6/9)

Unionized hospitalists at PeaceHealth Sacred Heart Medical Center at Riverbend plan a one-day picket this month, an action that management calls surprising given progress toward the group's first contract. (Barkholz 6/9)

New York's Assembly has passed legislation to require that health education in schools includes mental health. A companion bill is poised for a Senate vote. It would take effect in July 2018. Lawmakers have inserted similar requirements in the law concerning health education about alcohol, drugs, tobacco, and the prevention and detection of cancers. (6/9)

State workers and their union called on the Hogan administration Thursday to hire more staff and improve training at mental health care facilities, pointing to injuries employees have suffered as a result of assaults by patients. (Dresser 6/9)

Shadowing doctors, attending lectures and working in labs at MetroHealth Medical Center will be a major part of the new "School of Science and Health" that MetroHealth is creating this summer with the Cleveland school district. (O'Donnell, 6/9)

Pinal County’s outbreak, believed to have started at an immigration-detention center in nearby Eloy, is the county's second in consecutive years. So far, it has been confined to the Eloy Detention Center. Fourteen cases had been confirmed as of Tuesday — 10 detainees and four detention-center employees. (Alltucker, 6/9)

Gun violence is increasingly seen as a public health problem -- an issue that could benefit from aggressive prevention and education campaigns. Many physicians and nurses are on board with this .... "We see them almost every day, I was just on call yesterday and I had two; one survived and one did not," said trauma surgeon Sandra Medinilla. She works at Christiana Care Health System's Christiana Hospital in Newark -- where most of the gunshot victims from Wilmington are treated. ... Medinilla and other doctors and nurses at this facility are volunteering their time for an unusual program to prevent more violence. (Scott, 6/7)

After three years of waiting, victims of notorious cancer doctor Farid Fata can start filing claims to seek reimbursement for medical costs and other expenses incurred because of the oncologist, who is serving 45 years in prison for intentionally misdiagnosing or mistreating patients. (Baldas 6/10)

To assess trends in this national discourse [on mental illness], we studied the volume and content of a random sample of 400 news stories about mental illness from the period 1995–2014. ... The most frequently mentioned topic across the study period was violence (55 percent overall) divided into categories of interpersonal violence or self-directed (suicide) violence, followed by stories about any type of treatment for mental illness (47 percent). Fewer news stories, only 14 percent, described successful treatment for or recovery from mental illness. The news media’s continued emphasis on interpersonal violence is highly disproportionate to actual rates of violence among those with mental illnesses. (McGinty, 6/3)

The rapid growth of antipsychotic medication use among publicly insured children in the early and mid-2000s spurred new state efforts to monitor and improve prescription behavior. A starting point for many oversight initiatives was the foster care system, where most of the children are insured publicly through Medicaid. ... we analyzed patterns and trends in antipsychotic treatment of Medicaid-insured children in foster care and those in Medicaid but not in foster care. We found that the trend of rapidly increasing use of antipsychotics appears to have ceased since 2008. Children in foster care treated with antipsychotic medications are now more likely than other Medicaid-insured children to receive psychosocial interventions and metabolic monitoring for the side effects of the medications. However, challenges persist in increasing safety monitoring and access to psychosocial treatment. (Crystal, 6/6)

Snacking is a complex behavior that may be influenced by entertainment media. ... Three episodes each of the 25 most popular shows [among adolescents] were coded for food-related content, including healthfulness, portion size, screen time use, setting, and social context. We also analyzed the characteristics of characters involved in eating incidents, the show type, and the show rating. ... Almost half of food incidents on television shows were snacks. Snacks were significantly more likely than meals to be “mostly unhealthy” .... Young characters and those coded as being of low socioeconomic status or overweight were overrepresented in snacking incidents. Sitcoms and shows rated for a youth audience were significantly more likely to portray snacking than were shows for adult audiences. (Eisenberg, 5/19)

This report is based on findings from the 2016 Kaiser Family Foundation survey of Health Insurance Marketplace Assister Programs and Brokers. ... Assister Programs combined helped an estimated 5.3 million consumers during the third Open Enrollment, roughly a 10% decline from last year. This decline is significant in light of concerns over the slowing rate of annual Marketplace enrollment growth. ... Enrollment assistance shifted toward renewing consumers in 2016, though most who sought in-person help still were uninsured. ... Overall 79% of Programs said they could serve everyone who sought help throughout OE3, but 21% had to turn some away during surge weeks in December and January. ... Significant numbers of Assister Programs (37%) and brokers (53%) said most clients had questions about health plans that were not answered by information on the Marketplace web site. (Pollitz, Tolbert and Semanskee, 6/8)

Putting graphic pictorial health warnings on cigarette packages was required by a law passed in 2009, but a tobacco company convinced a federal appellate court to delay implementation, claiming there was no evidence that pictures helped people quit. Now a randomized controlled trial, published in JAMA Internal Medicine, has provided the evidence. (Bakalar, 6/8)

In middle age, black Americans are four times more likely to die of stroke than whites, a U.S. study suggests. But the reason doesn’t appear to be differences in care after a stroke. Instead, it’s because African-Americans have more strokes at age 45 and throughout middle age, the study found. (Rapaport, 6/8)

When it comes to U.S. doctors' paychecks, race and gender may be factors, according to a new study. "Black male physicians earn substantially less than white male physicians, while white and black females have comparable salaries," said senior author Dr. Anupam Jena, of Harvard Medical School in Boston. "Black and white female physicians both have lower incomes than either black or white male physicians." Jena and his colleagues write in the BMJ that there is limited evidence about race-based difference in physician incomes. (Seaman, 6/7)

The federal government’s decision to update food labels last month marked a sea change for consumers: For the first time, beginning in 2018, nutrition labels will be required to list a breakdown of both the total sugars and the added sugars in packaged foods. But is sugar really that bad for you? And is the sugar added to foods really more harmful than the sugars found naturally in foods? We spoke with some top scientists who study sugar and its effects on metabolic health to help answer some common questions about sugar. (O'Connor, 6/8)

Kids who move a lot during their first year of life may end up in the hospital more often than children who stay put in the same home, a recent study suggests. (Rapaport, 6/3)

Five blood tests were performed in March at Torrance Memorial Medical Center. The hospital charged the patient’s insurer, Blue Shield of California, $408. The patient was responsible for paying $269.42. If that were all there was to this -- which it’s not -- you’d be justified in shaking your head and wondering how it could cost more than $80 apiece for blood tests. These weren’t exotic procedures. The tests were for fairly common things such as levels of vitamins D and B12 in the blood. It‘s what happened next, though, that this makes this story particularly interesting. (David Lazarus, 6/10)

Democrats want to guarantee affordable, quality healthcare to all Americans through government subsidies and regulation. Republicans want to reduce total healthcare spending, including government spending on Medicare and Medicaid, through private market mechanisms that allocate healthcare based on price. (Harris Meyer, 6/9)

Had a sinking feeling about the economy of late? It may not be your imagination. Economic indicators have flashed yellow for much of 2016, and the latest jobs report shows further depletion of the work force and a dearth of job creation. That trend, says one major bank, may be attributable to President Barack Obama’s signature legislation. (Edward Morrissey, 6/9)

Being in pain is not merely a matter of being uncomfortable. Pain makes living difficult, and can make any physical activity — working, exercising, visiting a therapist, or cooking a healthy dinner — challenging and sometimes impossible. And, of course, pain affects people mentally and emotionally. How best to treat chronic pain is something of an open question. (Alison Bateman-House and Arthur L. Caplan, 6/9)

While many dying patients will not opt to take advantage of their rights under the End of Life Option Act, others facing a fatal prognosis from a brutal disease or condition will undoubtedly be comforted by the new law. But for some physicians, this is an occasion for trepidation, because helping people die – even when they are terminally ill – is in stark contradiction to the ancient Hippocratic Oath that still guides the profession. “Neither will I administer a poison to anybody when asked to do so, nor will I suggest such a course,” says the original Greek text. (6/9)

Several readers have pointed out to me how fortunate I am to have the resources available to me to assemble the team of doctors, therapists and trainers that have helped me lose nearly 100 pounds in nearly a year. They’re right. I am exceptionally fortunate and greatly aware of that fact. (Daniel P. Finney, 6/9)

What has inexplicably fallen below the radar, however, is the recently-enacted Tennessee law that allows mental health counselors and therapists to decline to care for certain patients if it would violate the clinician's "sincerely held principles." Although this stipulation is non-specific, the law was enacted solely with LGBT patients in mind. (Jeffrey Brauer and Colleen Christmas 6/9)

"We bake our own pastry, gluten is now Satan” reads a knowing sign in San Francisco. The gluten-free diet has now surpassed all others searched for on Google in the United States, beating the South Beach, Atkins and Paleolithic diets along with veganism, low-carb, low-calorie and organic food in terms of Internet interest. Best-selling books tout gluten as the main source of health problems affecting everything from the brain to the belly. It’s the topic of cartoons in the New Yorker and fodder for late-night comedy shows. Movie stars, television personalities and major sports figures all sing the praises of a gluten-free diet. They say it makes them feel healthier, stronger and even happier. (Peter H.R. Green and Rory Jones, 6/9)