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Challengers in two politically tinged cases before the Supreme Court this week face the seemingly insurmountable problem of being unable to count to five — as in five votes. The death of Justice Antonin Scalia has deprived conservatives of a reliable vote on a range of issues, including the design of congressional districts in Virginia and the Obama administration's effort to accommodate faith-based groups that object to paying for contraceptives as part of their health insurance plans. (Sherman, 3/18)

The Supreme Court on March 23 will weigh how far the government has to go to accommodate religiously affiliated employers that object to including contraception in workers’ insurance plans. The issues has been brewing since shortly after the Affordable Care Act was signed into law in 2010. Here is a timeline. (Radnofsky, 3/18)

It’s often pitched as an insurance policy for your health insurance policy.The product, known as critical illness insurance, promises to pay a lump sum, anywhere from $5,000 to $100,000, after someone receives some sort of dreaded diagnosis, like cancer, a heart attack or a stroke. And the coverage is not terribly expensive; if you are in your 40s, it might cost $25 to $50 a month. These policies have become increasingly popular, partly because they are being marketed as a way to provide another layer of financial support now that consumers are shouldering an ever-rising share of medical expenses out of pocket. ... But some consumer advocates and health policy analysts have questioned whether these policies are worth the expense, partly because they are so narrowly focused. (Bernard, 3/19)

Cancer is a health crisis that for many sets off a financial crisis. In a study done by Virginia Commonwealth University School of Pharmacy researchers, nearly one-third of cancer survivors reported that their illness had caused financial problems. The patients who reported the most financial problems also reported more physical and mental health problems. Having health insurance was not a guarantee that a person would not face money problems. (Smith, 3/18)

Because patients get billed by individual providers, a patient can go in-network but still get hit with an out-of-network charge. ... The inadvertent out-of-network bills are called “balance billing” because patients pay the difference between the insurance plan's out-of-network benefits and the provider's rack-rate charge, which is often considerably higher than the negotiated amount with an insurer. Some insurance plans offer little to no out-of-network coverage. Hospitals encourage the doctors to accept the same insurance plans and networks as the hospital — but it’s not required. (Fletcher, 3/18)

When it comes to health issues that need immediate attention but aren’t life-threatening, more Americans are turning to urgent-care centers—and traditional health-care providers are getting into the game. Over the past two years, hospital chains and insurance companies have snapped up urgent-care centers in a spate of mergers and acquisitions. Health systems, too, are moving into this space, striking joint ventures with independent urgent-care operators, says Tom Charland, chief executive of consulting firm Merchant Medicine. (Landro, 3/20)

Dr. Sam Kim works for Heal, a Los Angeles-based start-up that allows patients in several California counties to order doctor house calls through a smartphone app. Similar companies exist in other parts of the country, including Pager in New York City and Mend in Dallas. Health advocates generally support using technology to make medical care more convenient. As these companies grow, however, some question the return of the house call. A century ago, most medical visits were in the patient's home. But cities got bigger and doctors began using more equipment, therefore it made sense for them to not travel more than 10 steps from patient room to patient room. (Karlamangla, 3/19)

A rapidly expanding medical program for low-income first-time mothers combines social services with the latest in brain science. The Nurse-Family Partnership provides in-home advice on health and parenting, which can lead to improved cognitive development and language skills for their children, who are showing up to school better prepared for learning. Special correspondent Cat Wise reports. (3/18)

Kevin Ochoa’s family is getting unusual help in answering a vexing riddle: Why is he having so much trouble breathing? The Des Moines sixth-grader suffers severe asthma attacks, which routinely send him to the hospital. The situation is frightening, painful and expensive. Last week, a team of experts came to his south-side home to help figure out if something there was triggering Kevin’s lung spasms. (Leys, 3/18)

Johnson & Johnson is settling a series of legal claims and lawsuits alleging that its now-discontinued hysterectomy device harmed women by spreading an undetected hidden cancer, according to court documents and plaintiff lawyers with knowledge of the settlements. An estimated 100 cases have either been filed—or readied for lawsuits—against J&J’s Ethicon unit related to a device known as the laparoscopic power morcellator, said Paul Pennock, a plaintiff lawyer and co-lead counsel on the steering committee for consolidated litigation under way in a Kansas City, Kan., federal court. (Levitz, 3/18)

The Food and Drug Administration is striving to assess the scope of the danger from medical devices that sometimes produce erroneous readings of how quickly patients’ blood tends to clot when they are taking anticoagulant medicines such as warfarin. The small mobile devices, used in patients’ homes and in doctors’ offices, have malfunctioned in thousands of cases over the years, according to the FDA. (Burton, 3/18)

On an inexorable march across the hemisphere, the Zika virus has begun spreading through Puerto Rico, now the United States’ front line in a looming epidemic. The outbreak is expected to be worse here than anywhere else in the country. The island, a warm, wet paradise veined with gritty poverty, is the ideal environment for the mosquitoes carrying the virus. The landscape is littered with abandoned houses and discarded tires that are perfect breeding grounds for the insects. Some homes and schools lack window screens and air-conditioning, exposing residents to almost constant bites. (McNeil, Jr., 3/20)

If brokered conventions and third-party insurgencies aren’t enough, consider the chaos that Zika could bring to the United States this summer. If the mosquito-borne virus linked to birth defects hits big — and that’s a big if — it could stir a panic like Ebola, set off an epidemic of finger-pointing and create new fear and acrimony over reproductive rights, global warming and immigration, all at the height of a presidential campaign. (Allen, 3/19)

The United States is warning of the risk of Zika virus in Cuba just as President Barack Obama heads to the country. The Centers for Disease Control and Prevention says it's adding Cuba to its travel notice for Zika. The notice warns travelers they are at risk of contracting the virus. Zika is spread though bites from a specific mosquito and is believed to carry particular risk for birth defects. The CDC advises pregnant women not to travel to places with Zika. (Lederman, 3/19)

The state’s first case of Zika virus was confirmed in a person who traveled to a Zika-affected area and returned earlier this month, according to the state Department of Public Health. The patient, aged 60 to 69, had a skin rash, conjunctivitis, headache, fatigue, chills and muscle aches, and is now recovering, according to the health department. (Levin Becker, 3/18)

Fund the fight against Zika. Now. That was the unified message coming Friday from Hillary Clinton, House Minority Leader Nancy Pelosi, and other top Democrats, who pressed for a swift vote in Congress to approve emergency funds to fight the Zika virus. (Nather, 3/18)

General Mills’ announcement on Friday that it will start labeling products that contain genetically modified ingredients to comply with a Vermont law shows food companies might be throwing in the towel, even as they hold out hope Congress will find a national solution. Tiny Vermont is the first state to require such labeling, effective July 1. Its fellow New England states of Maine and Connecticut have passed laws that require such labeling if other nearby states put one into effect. The U.S. Senate voted 48-49 Wednesday against a bill that would have blocked such state laws. (Rathke, 3/19)

General Mills said Friday it will start labeling products across the country that contain genetically modified ingredients to comply with a law set to go into effect in Vermont. The maker of Cheerios and Yoplait said it is impractical to label its products for just one state. And with no deal yet for national legislation on GMO labeling, the company said it decided to add the disclosures required by Vermont starting in July to products throughout the U.S. (Choi and Jalonick, 3/18)

General Mills Inc. is changing its labels nationwide to indicate whether its foods contain genetically modified organisms, ahead of a Vermont law that will mandate it as of July. “The complexity and the cost of having one system for Vermont and one for everywhere else is untenable,” Jeff Harmening, the company’s chief operating officer of U.S. retail, said in an interview. He said he is still hopeful that Congress will pass a national law that would supersede such state laws, but the company had to move ahead to comply with Vermont. (Gasparro, 3/18)

Children drinking from water fountains at the nation’s schools — especially in aging facilities with lead pipes and fixtures — might be unwittingly exposing themselves to high levels of lead, which is known to cause brain damage and developmental problems including impulsive behavior, poor language skills and trouble remembering new information. Under federal law, the vast majority of schools don’t have to test the water flowing out of their taps and drinking fountains, and many states and districts also do not mandate water testing at schools. Even when districts do test their water, they don’t always tell parents about the problems they find. (Brown, 3/18)

A few unusual symptoms helped Allison Fite eventually figure out that she had a little-known disease shared by 1 to 1.5 million Americans. She has asthma, a loss of smell and taste, and a strong, adverse reaction to alcohol. "Before I could finish [a drink], I started to get these really bad headaches," she says. "I really am allergic to fun." And she had nasal polyps, which are benign growths in the sinus cavities. When she was 20, she had them surgically removed for the first time. At age 25, she flew back from where she was living in Thailand to the U.S. for a second operation. But this time the polyps reappeared even faster, a mere eight weeks after the surgery. ... But the doctor mentioned that aspirin can cause nasal polyps. This was Fite's first real clue about her illness. It's called aspirin-exacerbated respiratory disease, or AERD. (Chen, 3/21)

Count RoseMary Lee among the fortunate ones. When Lee suffered a stroke a few weeks ago, she was rushed to a hospital with an advanced stroke program and she received state-of-the-art care. Two days later, Lee, 79, was back home in Gladstone, and back to normal. “It’s amazing how it worked,” Lee said. Amazing, yes. But it happens far less often than it should, many doctors say. (Bavley, 3/20)

Dianne Muncey's doctor first talked with her about prediabetes in 2013. With a family history of Type 2 diabetes and blood glucose levels that had been creeping up for years, the doctor explained that Muncey was at high risk for diabetes herself. She was told to lose some weight, exercise and change her diet, but was given no specific instructions on exactly how to do that. She was on her own. "And, I just didn't do it," said Muncey, a retired teacher's assistant from Tampa, whose parents and four siblings had Type 2 diabetes. "They didn't give me any guide or a plan to follow, just general recommendations." (Maher, 3/17)

About half the seafood that people eat around the world now comes from farms, but efforts to make fish a sustainable food source by raising it in a tank could be reducing its main nutritional selling point. Omega-3 fatty acids found naturally in fish have been shown to improve cardiovascular health and possibly stave off other maladies such as cancer. However, levels of those fats likely are being altered by a shift from feed made from fish meal and oil to plant-based feed, according to an analysis by researchers at the Johns Hopkins Bloomberg School of Public Health. (3/19)

Before the New Hampshire medical examiner’s office had even finished counting the number of drug deaths in 2015, the 2016 numbers were already rolling in. The latest numbers released this year show 10 deaths confirmed so far in 2016 with 86 more pending. Last year, 428 people died from drug overdoses, with eight cases still pending. (Nilsen, 3/20)

Here's how I knew I liked Patti Trabosh. It goes back to the very first time I called her out of the blue to ask whether I might profile her family for a story on opioid addiction. The very first words out of her mouth were, "I'm pissed off!" Trabosh went on to explain why she was angry. First, it was the struggle to find a bed in a drug treatment program for her 22-year-old son Nikko Adam. He had become addicted to prescription painkillers and then heroin when he was still in high school. He'd been in rehab twice before, and relapsed both times. Once she found an available treatment slot, it was the seemingly endless and maddening battles with her insurance company, trying to get them to cover Nikko's treatment. (Block, 3/19)

When Amy found out that she was pregnant, she wasted no time seeking an abortion. Her husband had just lost his job and the couple had been kicked out of their house, forcing their family of five to move in with his parents. But she found that getting an appointment for an abortion proved almost as stressful as the unwanted pregnancy. The number of abortion clinics in Texas has shrunk by half since a 2013 state law imposed new regulations that many said they found impossible to meet. The United States Supreme Court is considering the constitutionality of that law and whether it creates too much of a burden on women seeking an abortion. (Goodnough, 3/18)

To some, New Mexico is a Wild West haven for abortions. For others, the state is a refuge from a wave of legal assaults nationwide on a woman’s right to choose. Abortions among New Mexico residents, especially women ages 19 and younger, are down dramatically since 2010, but the number of out-of-state women coming here for abortions has doubled in the past three years, according to newly compiled state data. (Heild, 3/20)

Legislation that would mandate Oklahoma’s public schools to teach that life begins at conception may fail not because of its controversial nature but because the suddenly financially strapped state could have trouble paying for the course materials. The National Right to Life Committee backs the Oklahoma bill and calls it the first of its kind in the nation. Under it, public high schools would be required to provide the information “for the purpose of achieving an abortion-free society.” Parents would be able to pull their children from the classes, and none of the state funding could be used for abortion counseling or sex education. (Talley, 3/19)

It used to be that whatever else happened with the General Fund, legislators would give the Alabama Medicaid Agency the funding it requested. But legislators are discussing the possibility of passing a budget without the full amount of Medicaid’s requested funding, a move that could doom regional care organizations (RCOs) which the Legislature approved in 2013 in the hopes of slowing the growth in health care costs. That has Medicaid and health care groups concerned about major consequences for Alabama’s health care system, which depends on the program, and the loss of hundreds of millions of dollars from the federal government to implement RCOs. (Lyman, 3/18)

At a time when most states are paying private insurers to provide health care for their Medicaid recipients, Connecticut says it has saved money and improved care by going the opposite way. In 2012, Connecticut fired the companies that were running Husky, as its Medicaid system is known, and returned to a more traditional “fee-for-service” arrangement where the state reimburses doctors and hospitals directly. (Beck, 3/18)

The Democratic members of New Mexico’s congressional delegation have introduced legislation containing safeguards for Medicaid consumers and providers when fraud is alleged. The bill was prompted by the 2013 shakeup in New Mexico’s behavioral health system, which the Democrats in a news release called “reckless” and “a manufactured crisis.” Republican Gov. Susana Martinez’s administration abruptly halted Medicaid funding to 15 providers in June 2013, alleging they overbilled and may have committed fraud. Arizona companies were brought in to replace them, and many of the New Mexico nonprofits were driven out of the behavioral health business. (Baker, 3/20)

The 2013 audit alleged providers mishandled $36 million in Medicaid funding. An investigation by the state attorney general found some regulatory violations but no pattern of fraud. Investigations into two of the nonprofits are ongoing. State officials have vowed to recoup what they classify as millions of dollars in misspent funds. They have pointed to accusations that one of the companies lent public money to its CEO to buy a private plane. Some nonprofits have fired back with lawsuits, saying the state failed to give them a chance to answer concerns about the use of Medicaid money. (Montoya Bryan, 3/18)

New Jersey Gov. Chris Christie proposed a two-year moratorium Friday to stop local governments from collecting property taxes from nonprofit hospitals. Mr. Christie’s proposal comes nearly nine months after a court ruling paved the way for localities to pursue these taxes. The hospitals have maintained that their nonprofit status exempts them from paying property taxes. The governor said he would advance legislation to put on hold municipalities’ legal efforts to recover the property taxes from the hospitals. (Haddon, 3/18)

Florida Hospital Orlando had to stop admitting patients, put elective surgeries on hold and divert ambulances from its emergency department earlier this week when it went over capacity. "In my 24 years I have never seen us close the emergency department and stop doing elective surgeries," the hospital's chief medical officer, Dr. Neil Finkler, said Friday. (Miller, 3/18)

D.C. Mayor Muriel E. Bowser’s choice to lead the District’s public psychiatric institution had only one other hospital stint on his résumé: chief executive of a hospital on an Indian reservation where emergency services were halted because they posed a risk to patients, according to federal and tribal officials. James Edward Kyle, 50, who took over as chief executive of St. Elizabeths Hospital in Southeast Washington on March 2, also was found unqualified for a job at the University of the District of Columbia after regulators discovered he lacked the proper credentials, according to records kept by the District’s Board of Nursing. (Nirappil, 3/18)

Presence Health is likely to lay off workers and leave hundreds of job openings unfilled after posting a bigger-than-expected operating loss in 2015. “Although our liquidity is secure and we have a strong balance sheet, we are committed to improving our operations in 2016,” Michael Englehart, Presence Health president and chief executive, said in a statement Thursday. (3/19)

The Brown administration this week formally asked the U.S. government to sign off on a revamped tax on health plans that has the primary goal of continuing to pull in more than $1 billion in federal money. (Miller, 3/18)

The scribbled, cryptic doctor's prescription is headed toward eradication in New York, where the nation's toughest paperless-prescribing requirement takes effect this month. Instead of handing patients slips of paper, physicians soon must electronically send orders directly to pharmacies for everything from antibiotics to cholesterol pills to painkillers, with some exceptions. Otherwise, prescribers face the possibility of fines, license loss or even jail. The requirement is meant to fight painkiller abuse, reduce errors and expand a practice that doctors and patients often find convenient. But physicians say digital scripts can present roadblocks for some patients and doctors shouldn't have to fear punishment over a prescription format. (3/19)

California’s insurance exchange is threatening to cut hospitals from its networks for poor performance or high costs, a novel proposal that is drawing heavy fire from medical providers and insurers. The goal is to boost the overall quality of patient care and make coverage more affordable, said Peter Lee, executive director of the Covered California exchange. “The first few years were about getting people in the door for coverage,” said Lee, a key figure in the rollout of the federal health law. “We are now shifting our attention to changing the underlying delivery system to make it more cost effective and higher quality. We don’t want to throw anyone out, but we don’t want to pay for bad quality care either.” (Chad Terhune, 3/21)

HealthSpan has struck an agreement with Lake Health Inc. to provide medical services to communities east of Cleveland where many of the insurer's medical offices are due to close at the end of the month. The agreement allows HealthSpan members to immediately make appointments at all Lake Health facilities and with more than 250 physicians who work for the health system in Northeast Ohio. (Ross, 3/18)

Mishra Keller skirted a state law when she chose to deliver her second child at home with the help of a midwife, given that the trained birthing professionals have been barred from practicing since 1987 in Illinois. Keller, a holistic health coach in Evanston, disagrees with the state's stance, saying that midwives are a "good resource." ''With the right training, they can help people have positive outcomes," Keller said. (Lisenby, 3/20)

Amid a flurry of legislation to pass in the final days of spring state legislative sessions last week, nurses won two more victories in a long war for independence. For decades, most of the country has required physician oversight for nurses to conduct certain procedures, and especially to prescribe drugs. But that’s slowly changing, as the nation’s health-care needs rise, and nurses fight for the right to practice everything they learned in school. (DePillis, 3/18)

A union has sued [New York's] Thruway Authority challenging increased health care costs for about 1,500 retirees. CSEA says the authority told retirees in December that effective April 1 they would have to pay 6 percent more in personal contributions to their health care premiums. The union says that fails to honor the obligations to retirees covered by contracts between CSEA and the Thruway. (3/19)

Scripps Florida scientists in Jupiter have received a $1.4 million grant from the U.S. Department of Defense to study new ways to block breast cancer. Donald G. Phinney, Scripps scientist and acting chairman of the Department of Molecular Therapeutics, is the principal investigator on the new three-year grant. He said Scripps will be targeting a class of molecules known as microRNA that play a pivotal role in breast cancer. (Pounds, 3/18)

Connecticut is weighing whether to join a growing number of states that have required universities to adopt policies for sexual interactions known as affirmative-consent. A proposal before state legislators would create a so-called “yes-means-yes” standard that would be used when investigating sexual-assault complaints. The push comes as an alleged sexual-misconduct case has shaken up Yale University, in New Haven, with the captain of the men’s basketball team expelled after a campus committee ruled he had violated the school’s policies on sexual conduct. (De Avila, 3/18)

A study has found high rates of drug and alcohol abuse and dependency among some who went through Cook County's juvenile detention center. The Northwestern Medicine study found more than 90 percent of males and nearly 80 percent of females in the study were diagnosed with a "substance abuse disorder" at some point in their lives. The study was published Thursday in the American Journal of Public Health. (3/20)

A downtown development boom has brought pricey lofts, condos, nightspots and galleries to the center of the city and pushed homeless people into skid row, an area of some 40 city blocks where tents, cardboard boxes and people sleeping in the open air still line the sidewalks. Even though shelters, soup kitchens and social service agencies dominate the neighborhood, there are more people than shelter beds, and many people who simply refuse to go inside. People live their lives on the street in close quarters where sanitation is spotty. (Urevich, 3/21)

Sister Theresa Keller clicks the heels of her gray suede shoes together. "There's no place like home. There's no place like home," she says chuckling as she sits in her office tucked away at Siouxland Community Health Center. Plastered above a diploma on a wall are two posters featuring Glinda the Good Witch and Dorothy from the American film classic "The Wizard of Oz." After nearly 40 years away from home, Keller, an advanced registered nurse practitioner, returned last fall to Sioux City to live and work. (Butz, 3/20)

For a year, state Senator Jason M. Lewis maintained strict neutrality as he studied marijuana legalization — interviewing 50-plus experts, scouring the research, and observing firsthand a state where it is legal. But now he is speaking out against the expected November referendum in Massachusetts. (Miller, 3/20)

Mean old Washington is out to get granny again — or at least that’s the impression created by ad campaigns on TV and the Internet, in which seniors warn, in heart-rending terms, of impending “cuts” to the Medicare Advantage program. What’s really going on is pretty routine — though, as is often the case in Washington, routine is not quite the same thing as sensible. (3/20)

Federal officials poked a medical hornet's nest recently with an ambitious attempt to do what many American taxpayers — and patients — demand: tame rising prescription drug costs in Medicare. Officials at the Centers for Medicare and Medicaid Services rolled out a proposal to test new ways of reimbursing doctors who administer drugs in their offices and in hospital outpatient departments. These drugs include cancer medications, antibiotics and certain eye care treatments — about $19 billion a year in Medicare spending. (3/18)

On Wednesday the Supreme Court will hear oral arguments in Little Sisters of the Poor v. Burwell, a landmark case challenging the Department of Health and Human Services contraceptive mandate under the Affordable Care Act. In addition to the Little Sisters of the Poor, an order of Catholic nuns whose mission is to “offer the neediest elderly of every race and religion a home where they will be welcomed as Christ,” the objecting parties include the university I head, the Catholic University of America, the Archdiocese of Washington, and a host of other religious institutions. (John Garvey, 3/20)

Zubik v. Burwell is the Supreme Court’s name for the set of cases more often identified with the Little Sisters of the Poor, a religious order that is also a party to the case. I filed an amicus brief in Zubik on behalf of the Baptist Joint Committee for Religious Liberty. I had never before filed a brief in support of the government in a case about the free exercise of religion. (Douglas Laycock, 3/20)

If the harm that Senate Republicans are inflicting on the nation by refusing to consider filling the Supreme Court vacancy were not already self-evident, a case that the remaining eight justices are hearing on Wednesday drives the point home. The case, Zubik v. Burwell, is a consolidation of seven lawsuits involving women’s access to birth control under the Affordable Care Act. It is the fourth time in four years that the justices have taken up a challenge to the law. (3/21)

State budget cuts to Planned Parenthood, signed into law last month by Gov. John Kasich, won’t affect the organization’s ability to provide birth control to women like Ms. Thurman. But they could put a stop to a Planned Parenthood program that provides free testing and treatment for sexually transmitted infections. And the organization might have to stop offering sex education to teenagers in the juvenile justice system and foster care, and home visits to new moms to help prevent infant mortality. (Anna North, 3/18)

A company with a diverse line of consumer products that are in strong demand nevertheless sees its stock price unravel by 90%. That’s the story of Valeant, the standout corporate drama of the past six months. Most accounts trace the drug company’s problems to an October report by a short seller questioning its accounting for sales through a drug distributor called Philidor, but the stock had already lost more than $100 off its peak $262 share price in the two months before these allegations surfaced. (Holman W. Jenkins Jr., 3/18)

The HouseOversight and Government Reform Committee met last week to witness one of the most common of Washington exercises: buck-passing. Michigan Gov. Rick Snyder (R) testified that “career bureaucrats” were responsible for the disastrous lead poisoning in Flint’s tap water, and he placed another heap of blame on the federal Environmental Protection Agency for failing to act sooner. EPA Administrator Gina McCarthy shot back that the state created the problem and dragged its feet when the EPA started to ask questions. (3/20)

In a hearing this week about the poisonous water in Flint, Mich., Rep. Earl L. “Buddy” Carter (R-Ga.) tried to blame the lead-tainted water on the Obama administration’s Environmental Protection Agency. EPA Administrator Gina McCarthy explained that, under the law Congress passed, states are in charge of enforcing drinking-water standards. (Dana Milbank, 3/18)

The GOP was in serious trouble well before the great crackup of 2016. The Tea Party insurgency exposed serious fault lines on everything from immigration to military spending. The antiabortion wing continues to demand that the party defy its central emphasis on limited government by passing legislation that overrides the autonomy of the individual. Today, only 26 percent of Americans identify as Republicans, and with their inability to reach Latinos and Millennials, things don’t look good for the GOP’s future. If Democrats are paying attention, they could easily capitalize on the dissolution of longstanding coalitions to fatten their own. (Charles Camosy, 3/21)

What good is health insurance coverage if you can’t afford to actually use it? Unfortunately, that’s not a rhetorical question. It’s one facing thousands of Nebraskans who are required to purchase health insurance on the Affordable Care Act’s exchanges. As if rising premiums — which increased by an average of 18 percent in Nebraska this year — weren’t already hard enough, skyrocketing deductibles have rendered many plans “all but useless,” according to a recent report in The New York Times. (Nathan Nascimento, 3/21)

An intriguing and potentially significant piece of health care reform legislation appears to have a clear trajectory to enactment. That’s a credit to its merits and the groundwork done by Sen. Merv Riepe of Ralston, a former hospital and health care manager. The bill clears the way for a new health care model in Nebraska under which patients could contract directly with a physician to pay a monthly retainer fee in exchange for unlimited office visits and an annual physical. (3/19)

Drugs that collect in medicine cabinets are damaging public health and tainting our environment. We need a better way to dispose of them. A proposal before the Cook County Board to require pharmaceutical companies to play a bigger role in the proper disposal of their products would be a significant step forward. On Thursday, the Metropolitan Water Reclamation District went on record in favor of the concept, which is patterned after similar programs set up by counties in California and Washington state. The County Board should follow that recommendation and enact the ordinance when it comes up for a vote next week. (3/20)

Addiction has long been medicine’s unwanted stepchild. Doctors didn’t understand it, didn’t know how to treat it and felt helpless in the face of the wreckage it brought to their patients’ lives. As a result, while providers addressed the consequences of addiction — endocarditis, liver failure, seizures, overdose — they rarely treated the disease itself. That mysterious task has been left to others: counselors, peers in recovery and 12-step programs. (Jessica Gregg, 3/18)

Health care providers fight on numerous fronts every single day. Disease and illness, infections and accidents, short-term care and long-term treatment are all demands on the time and skill of physicians fighting for their patients. Then there are larger battles – the fight for greater patient access, better treatments and the ongoing effort to reduce health disparities for minority populations in America. Fighting on all these fronts takes time, energy and creativity. We believe they are all fights worth fighting. In the United States today, black males are expected to live, on average, nearly 10 years less than white females. This is because of a number of causes. According to U.S. News and World Report, “Health inequality is part of American life, so deeply entangled with other social problems — disparities in income, education, housing, race, gender and even geography — that analysts have trouble saying which factors are cause and which are effect.” (Sean L. Francis, 3/17)

I attended a meeting last week in Savannah, Geogia, along with about 100 pediatrics leaders in North America. The annual conference of the Association of Medical School Pediatric Department Chairs was attended by experts with each accredited medical school in the United States and Canada. The meetings are fascinating, and the agenda usually focuses on the latest developments in pediatric medicine and research. The plight of national funding for child health research is a perennial topic of dinner conversation. (Dr. John Barnard, 3/20)

Everyone knows that eating healthy foods and limiting unhealthy ones is best for optimum health, but what if you cross the line and it becomes an obsession? If someone’s desire to eat clean gets to the point that they develop an actual fear of unhealthy foods it can lead to an eating disorder known as orthorexia. According to the Eating Recovery Center, the national health care system dedicated to the treatment of serious eating disorders, there are more than 30 million people in the Unites States struggling with controlled eating habits including anorexia, bulimia, binge eating and orthorexia. (Hollie Deese, 3/14)

The explosive spread of the Zika virus has captured our attention and dominated headlines. Of particular concern is the possible link between Zika virus infection and microcephaly. Meanwhile, worries about Ebola have diminished, with the World Health Organization declaring an end to the Ebola outbreak in West Africa. The frenzy that the Ebola virus generated in the United States during the fall of 2014 has become a distant memory. What lessons can we learn from our reaction to the Ebola threat, and how can we apply these lessons to Zika and future epidemics? (Puneet Opal and Ameet R. Kini, 3/20)

One of the worst things that can happen to a woman or girl around the world is a fistula, an internal injury caused by childbirth (or occasionally by rape) that leaves her incontinent, humiliated and sometimes stinking. Victims are the lepers of the 21st century, and although the condition is almost entirely preventable, it is suffered by hundreds of thousands of women worldwide. (Nicholas Kristof, 3/19)