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Oscar Health was going to be a new kind of insurance company. Started in 2012, just in time to offer plans to people buying insurance under the new federal health care law, the business promised to use technology to push less costly care and more consumer-friendly coverage. “We’re trying to build something that’s going to turn the industry on its head,” Joshua Kushner, one of the company’s founders, said in 2014, as Oscar began to enroll its first customers. These days, though, Oscar is more of a case study in how brutally tough it is to keep a business above water in the state marketplaces created under the Affordable Care Act. (Abelson, 6/19)

Startup Oscar Insurance Corp. wants to be more than just a health insurer. The company is laying the groundwork to start a health center in New York where its members can see primary-care doctors, according to a job listing on Oscar’s website. The insurer is seeking a doctor to lead the project, with the job beginning in September. Running a clinic would be Oscar’s latest effort to adjust its strategy as it confronts massive losses on sales of Obamacare policies. The company already has been narrowing its network of doctors and hospitals in New York, and the clinic could give it more control over the care its members receive. (Tracer, 6/17)

Seasonal agricultural workers were just finishing a meal after a long day of planting sweet potato seeds when Julie Pittman pulled up to their camp. Pittman, a paralegal with the Farmworker Unit of Legal Aid of North Carolina, worked to get their attention. The health care law that passed in 2010 requires you to have health insurance, she said, speaking in Spanish. If you don't get it, she said, you could be fined. "Cuánto cuesta?" asked a worker, wanting to know the cost. In the United States legally through the H-2A visa program, these farmworkers, like most American citizens and legal residents, must be insured. But reaching them is an uphill battle. (Cancino, 6/20)

When Don Verrilli wins at the Supreme Court, he wins big. In his five years as the top lawyer representing the United States, Verrilli won cases on marriage equality, immigration law and the legality of President Barack Obama's health care law -- twice. He has also lost in big ways. (Melber, 6/17)

After a brutal two years in which they lost a collective $253.3 million, Oregon's health insurers are again seeking double-digit price hikes in 2017. As tentatively approved by state regulators, All ten companies offering individual health policies will raise rates in 2017, from 9.8 percent for Health Net Health Plan of Oregon to 17.9 percent for Regence BlueCross BlueShield of Oregon to 29.3 percent for Moda Health Plan. (Manning, 6/17)

Louisiana is the 31st state—and the first in the Deep South—to extend Medicaid coverage under the Affordable Care Act to adults with incomes up to 138% of poverty. The expansion, fully supported by the federal government through this year, will be partly paid for in future years by fees levied on Louisiana hospitals, estimated at $27 million in the first year and $120 million by year five. ... Enacting the expansion may have been the easy part. Now Louisiana policymakers, providers and health plans face major challenges in redesigning a largely out-of-date healthcare delivery system that still relies heavily on fee-for-service payment, and in improving health behaviors in one of the nation's poorest and sickest states. (Meyer, 6/18)

Just as new research highlights the economic advantages of expanding Medicaid, medical organizations have entered the fight for expansion, arguing that, for many, it could be a matter of life and death. Chris Hansen, president of the American Cancer Society Cancer Action Network, recently sent letters to Gov. Terry McAuliffe, House Speaker William J. Howell, R-Stafford, and Sen. Stephen D. Newman, R-Lynchburg, the president pro tem of his chamber. In the letters, Hansen offers to help identify a way in which Virginia can become the 32nd state in the U.S. to accept federal funds and expand coverage to uninsured Virginians, an effort that has been thwarted by the General Assembly. (Demeria, 6/19)

A race is on to court legislators in the "maybe" column on Medicaid expansion. Gov. Dennis Daugaard's office needs to convince 54 legislators — 36 in the House and 18 in the Senate — to back his plan to expand the health insurance program to cover an additional 50,000 needy South Dakotans. It won't be easy. (Ferguson, 6/18)

Bernie Sanders' "Medicare for all" plan seems even less likely now that he's all but out of the race for the Democratic presidential nomination, but there's a way that he and Hillary Clinton could still find common ground on government-sponsored health care. It's a "public option" for states to set up their own insurance plans that compete against private industry. Sanders helped to pass the federal legislation that would allow it, and Clinton, the presumptive Democratic presidential nominee, says if elected she'd work with interested governors to implement it. (Alonso-Zaldivar and Gram, 6/20)

[A] new ad features a 1998 clip of Hillary Clinton speaking about the Children’s Health Insurance Program (CHIP) signed into law by her husband, then-President Bill Clinton. The ad is an interesting example of how images and words can be assembled to present an image of leadership, while giving a misleading impression about what exactly happened. ... Given the facts about CHIP and the reporting at the time, you could assemble a somewhat less favorable account about Clinton’s role in creating CHIP. The ad is correct that about 8 million low-income children receive health care through the program. But it’s questionable that she played a key leadership role to creating CHIP. (Kessler, 6/20)

Hillary Clinton’s health plans show a willingness to take on industry groups to shift costs away from consumers, health care experts on both the right and the left agree. They also say that the Affordable Care Act laid the foundation for Clinton’s consumer-centered proposals. Everything becomes simpler after that major health overhaul. ... Clinton’s general support of the Obama administration’s Medicare drug reimbursement plan may be her most controversial policy stance, and it has real implications should she become president. (Many of her other policy ideas would require Congress’s support, which is far from guaranteed should Republicans retain control of either the House or the Senate.) (Owens, 6/20)

U.S. antitrust regulators have privately expressed concerns about Anthem Inc.’s $48 billion proposed acquisition of Cigna Corp., and are skeptical that the health insurers can offer concessions that would fully preserve competition in the industry, according to people familiar with the matter. Company representatives met June 10 in Washington with Justice Department staffers and representatives of more than a dozen state attorneys general, the people said. At the meeting, government officials outlined their worries about combining two of the nation’s top health insurers, the people said. (Hoffman, Kendall and Wilde Mathews, 6/19)

As doctors treated the horrific injuries of victims shot in the Pulse nightclub massacre here, a mistaken report of a gunman nearby forced officials to briefly lock down the emergency room; the medical staff shoved heavy X-ray machines against the doors, creating a makeshift barricade in a treatment bay. Emergency room physicians ran low on tubes needed to reinflate the lungs of patients shot in the chest. The doctors scrambled to make sense of gunshot wounds because paramedics had rushed victims in with no time to assess their conditions. The hospital’s emergency preparedness manager, asleep at home, received an urgent email but did not respond until awakened by text. (Stolberg and Grady, 6/19)

Up to 1 in 5 people may be dying unnecessarily from car crashes, gunshots or other injuries, a stark conclusion from government advisers who say where you live shouldn’t determine if you survive. The findings take on new urgency amid the increasing threat of mass casualties like the massacre in Orlando. The Orlando shooting happened just blocks from a major trauma care hospital, an accident of geography that undoubtedly saved lives. But Friday’s call to action found that swaths of the country don’t have fast access to top care, and it urges establishing a national system that puts the military’s battlefield expertise to work at home. (Neergaard, 6/18)

Tens of thousands of American lives could be saved each year with a concerted national effort to emulate what top military and civilian trauma centers are doing, a prestigious panel of top medical experts reported Friday. “It is time for a national goal owned by the nation’s leaders: zero preventable deaths after injury,” said a committee from the National Academies of Sciences, Engineering and Medicine in an ambitious report released six days after the nation’s worst mass shooting took place in Orlando, Florida, ending 49 lives and injuring 53. Citing the U.S. Army’s 75th Ranger Regiment’s performance in Afghanistan and Iraq, the report praised the special operations force for its successes in treating combat casualties under difficult conditions while virtually eliminating preventable deaths. (Bluth, 6/17)

Lost in the emotional debate about public safety and Second Amendment rights is evidence-based data to inform policy. The American Medical Association, the nation's largest doctors society, this week acknowledged gun violence as a public health issue and pledged it would lobby Congress to lift a 20-year ban on federally funded research on gun violence. (Johnson, 6/18)

This is not a diagnostic of Omar Mateen. The motivations of the shooter who killed 49 people at a gay club in Orlando are complex and unclear. ... The homophobic nature of the attack is clear. But whether Mateen was expressing some form of internalized homophobia about his own sexual attractions is not. Leaving Mateen aside, researchers have found that homophobia is more pronounced in individuals with an unacknowledged attraction to the same sex, particularly people who grew up with controlling, authoritarian parents who made clear that such desires were unacceptable. (Dembosky, 6/17)

There are alarming signs the Zika virus is spreading rapidly in Puerto Rico, the Centers for Disease Control and Prevention reported Friday. Blood banks on the island have seen a steady rise in the portion of donations that have to be rejected because they contain Zika virus. Last week, 1.1 percent of the donated units were contaminated. (Branswell, 6/17)

Dozens or hundreds of babies in Puerto Rico could develop severe birth defects because of Zika, based on how an outbreak is playing out there, a top US health official said Friday. The island territory has been screening blood donations for the virus since April. Last month’s results suggest there’s been a rapid increase in infections, and officials expect cases to increase through the summer. (Stobbe, 6/17)

"Based on the best info available, Zika is increasing rapidly in Puerto Rico," [Centers for Disease Control Director Dr. Tom] Frieden said. "The importance of this is that thousands of pregnant women could become infected, which could lead to dozens or hundreds of babies born with microcephaly." Microcephaly is a birth defect in which the baby is born with a small head and brain, which often leads to serious developmental delays or even death. (LaMotte, 6/17)

Only a small fraction of contraceptives donated in Puerto Rico to prevent Zika-related birth defects are expected to get to the women who need them this month, public health officials told Reuters. The donations - tens of thousands of intrauterine devices and birth control pill packs - came from major healthcare companies as the virus spreads rapidly through the island. (Mincer, 6/20)

As the Zika virus swept north from Brazil into the Caribbean, bringing with it frightening risks for pregnant women and their unborn children, United States health officials decided in February that all expectant women who had visited the countries affected should be tested for the disease. But after the guidelines were put in place, public health officials and doctors in New York City found that large numbers of women, many uninsured or low-income immigrants from the Caribbean and Latin America, were not being screened and tested in a systematic way. (Santora, 6/17)

Entrepreneurs across the country are rushing to turn fears of the Zika virus into a sales tool, flooding the market with a slew of products, some of them unproven and questionable, that promise to keep consumers safe. (Robbins, 6/19)

Hologic Inc won emergency U.S. authorization to sell its Zika test, expanding the number of public and private labs that can test for the virus as health officials brace for a rise this summer in the number of infections. The U.S. Food and Drug Administration granted emergency use authorization for the company's Aptima test to detect Zika virus in human serum and plasma specimens. The test will be available for use immediately in every U.S. state as well as Puerto Rico and U.S. territories, the company said. (Clarke, 6/17)

Saron Wyatt pointed to the secluded end of her small street in Houston's impoverished Fifth Ward, where a mound of old tires keeps popping up. Always a trashy nuisance, it's now a growing danger. Tires collect water and become prime breeding grounds for mosquitoes — especially the ones that spread Zika virus disease and other tropical mosquito-borne illnesses. (Merchant and Stobbe, 6/20)

Amid torrential rains, temperatures soaring above 90 and congressional bickering over cash to fight the Zika virus, mosquito control officers in the Deep South are scrambling to balance preparations for a disease that may not arrive against a deadly foe that hasn’t left. State and local officials in communities from Florida to Texas are hard-pressed just to fund control of mosquito-borne West Nile virus, an endemic disease that last year caused 119 deaths across the country, along with 1,300 cases of brain disease like meningitis and paralysis. (Allen, 6/17)

Florida Surgeon General Dr. Celeste Philip was in Fort Lauderdale Thursday to give a presentation on the state’s Zika plans to the Broward legislative delegation. Philip said that when people get tested for a Zika diagnosis, mosquito control is alerted to where they live—before the test results come back. “This has been pointed to as a national model,” Philip told the delegation. (Mack, 6/17)

Preston Grundy started drinking at 14 to escape from his depression. He soon moved on to marijuana, Xanax, Adderall and cocaine, smoking pot when he woke each day and snorting pills in the bathroom between classes. The Brooklyn Park, Minnesota, teen went to treatment, but quickly relapsed upon returning to school, where he had constant access to drug dealers. Now 18, Grundy has been clean for 17 months and will begin college this fall to study social work and chemical dependency counseling. He credits his switch to a recovery school, PEASE Academy in Minneapolis, which he attends with about 60 other teens trying to beat addiction and where he says he wouldn't be able to find drugs if he tried. (6/19)

As federal and state regulators rush to curtail access to drugs that have claimed thousands of lives, the rules they’ve enacted fall hard on people who legitimately need relief from pain. In an atmosphere of heightened concern about opioids, patients in pain face reluctant doctors, wary pharmacists, and the frequent demand to prove that they are not addicts. (Freyer, 6/18)

The Obama administration is pressing GOP leaders to devote more funding to the fight against addiction before Congress sends its major opioids bill to the president’s desk this summer. The head of the White House’s drug policy office, Michael Botticelli, joined Management and Budget Director Shaun Donovan in a call to action Friday to approve a fully funded opioids bill — an approach that was backed by a majority of senators on the floor this week. (Ferris, 6/19)

Zac Talbott sees the irony of running an opioid treatment program from a former doctor's office. ... Outpatient clinics like the one Talbott co-owns dispense drugs like methadone and buprenorphine, which are legal synthetic opioids that block cravings and withdrawal symptoms. ... More than 1,200 people died of an overdose in Georgia in 2014, according to the Centers for Disease Control and Prevention, with opioid drugs frequently implicated in those deaths. That's a 10 percent increase over the previous year. So Talbott is outraged that Georgia has put a one-year moratorium on issuing licenses to clinics that use medicine to treat people addicted to heroin or painkillers. "We're in the middle of an opioid addiction and overdose epidemic," Talbott said. "You just think about that for a minute." (Eloy, 6/20)

The U.S. Senators representing Missouri and Illinois are playing an active role in congressional efforts to combat the opioid epidemic. Roy Blunt (R-MO), Claire McCaskill (D-MO), Dick Durbin (D-Ill) and Mark Kirk (R-Ill) all voted for the popular Comprehensive Addiction Recovery Act known as CARA. (Phillips, 6/20)

A Wisconsin convenience store owner who said he has lost more than 30 customers to overdoses is speaking out against the heroin epidemic by posting signs on his store warning of the dangers of drugs. Dick Hiers said he posted the signs to raise awareness about the problem, Sheboygan Press Media reported. Hiers has posted about a dozen different signs on the Northeast Standard BP station in Sheboygan, Wisconsin, including "Heroin is killing people — help wanted" and "Wake up! Your kids are dying — heroin." (6/19)

As New Hampshire stares down a heroin and opioid crisis, corrections officials and lawmakers are seeking new ways to keep drugs out of jail cells as visitors and inmates continually find ways to smuggle them in. While drugs in jails have always been an issue, officials say the present crisis is bringing new challenges and, at some facilities, a higher volume of drugs. (6/19)

Despite dramatic declines in childhood lead poisoning over the past few decades, the United States is doing too little to prevent new poisonings, the nation’s leading group of pediatricians said Monday. The statement from the American Academy of Pediatrics, published in the journal Pediatrics, comes at a time when lead is receiving renewed public attention, largely due to the apparent poisoning of thousands of children who drank contaminated water in Flint, Mich. (Painter, 6/20)

When lead was taken out of products like paint and gasoline, levels of the metal in the blood of U.S. children dropped. But the American Academy of Pediatrics says the problem is not over. "Most existing lead standards fail to protect children," members of the AAP's environmental health council report in a statement published Monday in the journal Pediatrics. Standards for the amount of lead that can be present in paint, water, dust and soil are not based on health standards, the pediatricians say, but instead on what's been feasible to attain. Such standards, they write, create "an illusion of safety." (Bichell, 6/20)

Lead poisoning has long been linked to lower IQs, behavioral problems and other disabilities - but more recently, scientists have used to it explain patterns of violent crime in the United States and around the world. While the past 50 years have seen vast improvements in lead regulation, the side effects of exposure are grave and still present. (Perrym, 6/17)

The nation’s leading cancer doctors are pushing pediatricians and other providers to help increase use of the HPV vaccine, which studies show could help avert tens of thousands of cancer cases during young Americans’ lives. Yet a decade after its controversial introduction, the vaccine remains stubbornly underused even as some of those diseases surge. The vaccine’s low uptake among preteens and adolescents belies its universally acknowledged effectiveness in preventing the most common sexually transmitted infections linked to the human papillomavirus. (McGinley, 6/19)

A big new survey of benefits from the Society for Human Resource Management found that employers are cooling toward certain wellness benefits. Originally designed to cut employers’ health costs, benefits like on-site flu shots, 24-hour nurse hot lines, health coaching and insurance-premium discounts for weight loss all have declined over the past year, the study found. As employers begin to analyze return-on-investment and participation data, they “may be taking a step back,” said Evren Esen, director of survey programs at SHRM, the world’s largest society for human-resources professionals. (Silverman, 6/20)

Seventeen years ago, U.S. Secretary of Health and Human Services Donna Shalala sounded the alarm on a crisis that was leaving millions of ill children without proper care. The problem, outlined in a report on the country's mental health system, was a "dearth" of child psychiatrists that forced primary care doctors to treat mentally ill youngsters, a "triage" environment that it said needed to change. It hasn't. (Brown, Zhang and Schuppe, 6/18)

As many as 2 million concussions from sports or play activities occur in U.S. children and teens each year and many receive no treatment, a new study suggests. The estimate is based on 2013 data from emergency room visits, hospitalizations, doctor visits, concussion reports made to high school athletic trainers, and information from previous concussion studies. (Tanner, 6/20)

Randy Curtis was in second grade when he and his parents got devastating news from a specialist in blood disorders. Curtis had merely fallen and bumped his knee, but he remembers the doctor's words: " 'You know, these kids don't really live past 13.' " "So, I went back to school the next day," Curtis remembers, "and told my math teacher, 'I don't have to learn this stuff. I'm going to be dead!' " But, he was wrong. (McClurg, 6/20)

The up-and-coming pediatrician kept persisting for her brother. He got sick with pulmonary tuberculosis in college and died in China after the disease progressed to TB meningitis, attacking his brain. (Mellon, 6/19)

[Polycystic Ovary Syndrome] is linked to heart disease, diabetes and other health problems. As many as 5 million women in the United States may have it, including girls as young as 11. But many women don’t know they have PCOS, for a variety of reasons. There is no single diagnostic test for the condition and some of its symptoms — such as high cholesterol and acne — can be mistaken for signs of something else. (Cuda, 6/19)

A quiet shift is taking place in how women obtain birth control. A growing assortment of new apps and websites now make it possible to get prescription contraceptives without going to the doctor. The development has potential to be more than just a convenience for women already on birth control. Public health experts hope it will encourage more to start, or restart, using contraception and help reduce the country’s stubbornly high rate of unintended pregnancies, as well as the rate of abortions. (Belluck, 6/19)

Florida taxpayers are on the hook for tens of thousands of dollars in legal fees for the state's failed attempt to fine four abortion clinics accused of performing second-trimester abortions without proper licenses. (Menzel, 6/17)

Thirteen cases remain to be decided at the Supreme Court this month, but all eyes are on three of them. With the tumultuous 2015-16 term marked by Justice Antonin Scalia's death winding down, decisions on access to abortion, the use of affirmative action in college admissions, and the fate of millions of undocumented immigrants will determine whether the evenly-divided court tilted liberal or conservative. ... Another case from Texas challenges a state law that imposed major restrictions on abortion clinics, ostensibly to protect women's health. The law requires clinics to meet the same standards as ambulatory surgical centers and forces doctors to have admitting privileges at nearby hospitals — rules that threaten to leave only nine fully functioning abortion clinics in a state with 5.4 million women of reproductive age. (Wolf, 6/19)

It was a late winter night in 1966 and a fully loaded B-52 bomber on a Cold War nuclear patrol had collided with a refueling jet high over the Spanish coast, freeing four hydrogen bombs that went tumbling toward a farming village called Palomares, a patchwork of small fields and tile-roofed white houses in an out-of-the-way corner of Spain’s rugged southern coast that had changed little since Roman times. It was one of the biggest nuclear accidents in history, and the United States wanted it cleaned up quickly and quietly. But if the men getting onto buses were told anything about the Air Force’s plan for them to clean up spilled radioactive material, it was usually, “Don’t worry.” (Philipps, 6/19)

The Department of Veterans Affairs will no longer use its authority to fire senior executives in an expedited manner — dropping a key portion of a law Congress passed two years ago in response to a nationwide scandal over long wait times for veterans seeking medical care. Deputy VA Secretary Sloan Gibson said the agency was forced to abandon the new authority after the Justice Department said it would no longer defend the provision in court. (Daly, 6/17)

Veterans whose injuries have left them unable to conceive children may soon be getting long-sought help as congressional negotiations on legislation funding the Department of Veterans Affairs near a close. At issue is a Senate-passed measure that would lift a 1992 law that prohibits the VA from paying for infertility treatments, such as in-vitro fertilization. The measure, by Sen. Patty Murray, D-Wash., enjoys bipartisan support but there appears to be lingering resistance from anti-abortion forces who are opposed because IVF treatments result in the destruction of fertilized embryos. (Taylor, 6/17)

The state’s Medicaid application backlog has more than quadrupled in size because of inaccurate reports. Kansas thought it had lowered the backlog to 3,480 people; it’s now up to 15,393. Of the new total, 10,961 applicants have been waiting for more than 45 days for the state to process their applications. (Dunn, 6/17)

The $122.5 billion state budget approved this week by California lawmakers will fund a variety of health-related efforts, including training of primary care physicians, dental care for school children and medical interpreters for Medi-Cal, the government-funded insurance program for people with low incomes. But big-ticket health items such as higher payments to Medi-Cal providers and potential Medi-Cal coverage for undocumented adults didn’t make it into the budget agreement for next fiscal year that’s now awaiting the governor’s signature. (Bartolone, 6/20)

About 4,800 nurses are striking five Allina Health hospitals in the Twin Cities. The one-week walkout began as expected at 7 a.m. Sunday morning. The hospitals affected by the contract dispute are: Abbott Northwestern and the Phillips Eye Institute in Minneapolis; United in St. Paul; Mercy in Coon Rapids; and Unity in Fridley. Allina Health has said it would continue operating the facilities as normal with nearly 1,500 replacement nurses. Sunday afternoon at a press briefing, Allina president and CEO Dr. Penny Wheeler said that the hospitals were as busy as they would be on a typical June Sunday, although some services at Unity Hospital in Fridley had been scaled back in anticipation of the strike. (MPR Staff, 6/19)

About 4,800 nurses at five Minneapolis-area hospitals began a weeklong strike Sunday over a contract impasse. Members of the Minnesota Nurses Association began striking at 7 a.m. at the hospitals, all operated by Allina Health. The main dispute is over Allina's effort to switch union nurses to the same health insurance plans as more than 30,000 other Allina employees that carry lower monthly premiums but higher out-of-pocket costs. (6/19)

The weeklong walkout of 5,000 Minnesota Nurses Association members from Allina Health’s five hospitals began Sunday. Nurses on strike expressed concerns over the transition. While the day did not go entirely as planned, hospital officials say the quality of patient care continues to be maintained. (Ngo, 6/19)

Medical advances are allowing surgeries that once required several days in the hospital to now offer one-day outpatient surgeries, including hip replacements. The Bedford Ambulatory Surgical Center touts quick, safe and less expensive hip-replacement surgeries, with doctors there expecting the amount of procedures to double this year. (Houghton, 6/19)

Vermont has become one of several states working to make sure vasectomies are among the birth control options couples can afford. Gov. Peter Shumlin last month signed into law a bill that adds vasectomies to the list of procedures that most health insurance coverage in Vermont must pay for. (Sananes, 6/18)

Every day, sheriff’s deputies and ambulance drivers transport Iowans hundreds of miles to find open psychiatric beds. Local hospitals could handle more of those emergency cases if they weren’t backed up with other patients overdue to be released. Hospital leaders say the bottleneck is worsening, and they blame it on a lack of options for patients who need supervision short of full hospitalization. (Leys, 6/19)

Most people with mental illness experience it first during those years. Indeed, the most critical time — and hardest time — to reach people who are vulnerable to severe mental illness is during their teen and early adult years. (Robertson, 6/17)

Home health providers in Texas will be the testing ground for a new initiative that Medicare says will help cut down on fraud in the $83 billion industry. The plan is to eliminate the “pay and chase” method that left the federal health insurer to investigate instances of fraud and abuse after claims were paid by Medicare. (Rice, 6/17)

Although many of the details surrounding Lee County’s plan to build a $50 million, 50-bed hospital on the property now occupied by Grand Island Golf Club are still unknown, it appears one of the parties involved is one of the nation’s foremost developers of medical and health care facilities. Henry Johnson, chief strategy officer of Marietta’s Freese Johnson LLC, confirmed Friday that his company “has been engaged” to build the new hospital. Johnson said that due to the many nuances of the project, and the fact that everything is still in the early stages, he could not share specific details about the county’s future hospital. (McEwen, 6/18)

After five years of quiet but rapid growth making equipment for the marijuana industry in other states, Apeks Supercritical is ready to ramp up business in Ohio. With passage of a state medical-marijuana law that takes effect Sept. 8, the company not only expects to see a jump in manufacturing orders, but it also plans to get into the business as a marijuana processor. (Johnson, 6/20)

They may be called “synthetic marijuana,” but the only thing synthetic cannabinoid products known by names such as “spice” and "K2" have with the active ingredients in real marijuana is that they bind to the same receptors in the brain. There are hundreds – if not thousands – of synthetic chemicals that are sold as legal highs around the U.S. The chemicals are sprayed on plant material and marked “not for human consumption” and “herbal increase.” But those who sell them and those who buy them know what they are for. (Campbell, 6/19)

The critical care team making rounds — my team for today — stops abruptly in front of the next patient room, and I hear my co-resident present the story: The 18-year-old patient suffered a gunshot wound to the face. The circumstances of the shooting aren’t clear, but we heard it had something to do with “gang violence.” And we continue listening to the presentation: an update on any changes in the patient’s status that happened overnight, his vital signs over the past 24 hours, the input of different specialists, and, finally, the treatment plan for the day. (Milly Turakhia, 6/20)

It's important that we spend more government funds on behavioral health, emergency preparedness and anti-terror surveillance, of course. But as the FBI's multiple investigations of Mateen revealed, no surveillance program can ever catch someone acting on their own when their life trajectory has taken him or her to a place where they have lost contact with what it means to be human. What we can do—what we must do—is make it more difficult for someone in the midst of their descent into madness to make innocent civilians pay with their lives. That's why at a minimum, Congress—and anyone running for Congress—should declare that we have a public health emergency that requires an immediate ban on the manufacture, sale and resale of semi-automatic weapons to civilians. (Merrill Goozner, 6/18)

For the first time in over a decade, the death rate in the United States is getting worse, the Centers for Disease Control and Prevention has reported. The news is the latest in a string of headlines about the shortening lives of Americans, particularly the white middle-aged. “Disparity in Life Spans of the Rich and the Poor Is Growing.” “White Americans Are Dying Younger as Drug and Alcohol Abuse Rises.” “U.S. Suicide Rate Surges to a 30-Year High.” But there are happier trends that have received a lot less attention: The health of American children is improving sharply, and the health gap between the rich and the poor among children and young adults is shrinking. The research suggests that future generations of Americans may not reach old age with the same ailments and inequalities as today’s older Americans. (Margot Sanger-Katz, 6/17)

The so-called superbug recently discovered for the first time in a woman in Pennsylvania hasn’t reached the Midwest, but the fact that the bacteria is resistant to antibiotics of last resort is a super-cause for concern. The E. coli bacteria possessed the gene known as mcr-1, which makes it resistant to antibiotic colistin, a drug used to fight dangerous types of superbugs that can withstand other antibiotics. (6/19)

An expert panel convened by the World Health Organization just declared that there is no scientific basis for canceling, postponing or moving the 28th Summer Olympics in Rio de Janeiro in August or the Paralympics in September because of the Zika outbreak. While many of us experts have expressed concerns about how WHO handled Ebola and other outbreaks, this time WHO got it right. (Ashish K. Jha, 6/19)

Just when you’re fed up with the U.S. Congress (approval rating: 11 percent) comes word that it has passed and sent to the president an overhaul of the 1976 Toxic Chemicals and Substances Act, generally regarded as the weakest environmental law on the books. And it only took 10 years. The Environmental Protection Agency is now free to begin testing 64,000 household chemicals to determine how dangerous some of them are. But lest the EPA get carried away with its new powers, the new law restricts the agency to testing only 20 chemicals at a time, with a maximum testing period of seven years. (6/19)

In a major overhaul of U.S. regulation of toxic chemicals, Congress last week passed the Frank R. Lautenberg Chemical Safety for the 21st Century Act, the largest piece of environmental legislation passed in the United States since 1990. ... The bill amends the 1976 Toxic Substances Control Act (TSCA), which has been called the “lapdog” of American environmental law because of its weak controls on hazardous chemicals. The new bill, named after the late New Jersey senator who championed the legislation, passed on a bipartisan basis with support from the chemical industry. (Noah M. Sachs, 6/16)

It’s time, St. Paul, to weigh in at a pivotal point in the months-long drive toward a city-government mandate that would require employers to give workers paid leave for their own health and safety needs or those of family members. We consider it a bad idea, overreach by local government and a threat to jobs and job growth in the capital city. (6/19)

While the breast-feeding initiation rates cited are spot-on (78 percent of mothers initiating breast-feeding), the hand-wringing about their inadequacy is not. These statistics do not take into account the deeply personal reasons the remaining 22 percent do not breast-feed from birth - women who have undergone mastectomies, women on certain contraindicated or borderline medications, and women who have histories of sexual trauma, to name a few. (Suzanne Barston, 6/19)

During the war, before I was born, Al had sprayed Agent Orange along riverbanks in Vietnam, often soaking his uniform in the herbicide. The exposure, he wrote, had caused him serious health problems, including a neurological disorder, and he believed it also might have harmed me. (Stephen M. Katz, 6/17)

Medical marijuana is a smokin' hot issue in Ohio. Last year voters rejected Issue 3, a proposed constitutional amendment that would have legalized marijuana, as the measure was perceived by voters to be a thinly veiled attempt to enrich a small group of investors, who were also bankrolling the ballot initiative. (Michael Kirsch, 6/19)

The Coca-Cola Co. used to claim things go better with Coke. On Thursday, the Philadelphia City Council decided that’s particularly true of taxes. The city’s new 1.5-cents-per-ounce surcharge on sodas and other sweetened drinks is a sensible step toward discouraging sugar consumption, if only a first step. With the passage of its soda tax, Philadelphia will start charging citizens extra for buying waistline-widening beverages. Philadelphia’s policy may have won enactment because, unlike many failed proposals across the country, it channels revenue into a specific and popular cause: universal prekindergarten. Berkeley, Calif., which has a similar soda surcharge, also earmarks the money, in its case to community gardens and health programs. (6/19)