�鶹Ů��

The fierce struggle to enact and carry out the Affordable Care Act was supposed to put an end to 75 years of fighting for a health care system to insure all Americans. Instead, the law’s troubles could make it just a way station on the road to another, more stable health care system, the shape of which could be determined on Election Day. Seeing a lack of competition in many of the health law’s online insurance marketplaces, Hillary Clinton, President Obama and much of the Democratic Party are calling for more government, not less. (Pear, 10/2)

The Obama administration has ended a bid to ban the sale of bare-bones health plans after losing a court fight on the issue this summer. Government lawyers told a federal court earlier this month they would accept its decision that they had overstepped by seeking to effectively end so-called fixed indemnity plans, which are low-cost but pay out only set cash amounts for medical events such as a hospital visit or prescription purchase. (Radnofsky, 9/30)

Minnesota's individual health care market is in "an emergency situation," the state's top industry regulator said Friday, noting that it took the approval of massive rate increases to persuade all its remaining insurance companies not to pull out for next year. (Potter, 9/30)

Minnesota’s commerce commissioner called for reforms to strengthen the federal marketplace Friday after announcing monthly premium increases of at least 50 percent for 2017. “While federal tax credits will help make monthly premiums more affordable for many Minnesotans, these rising insurance rates are both unsustainable and unfair,” Minnesota Commerce Commissioner Mike Rothman said in a statement. “Middle-class Minnesotans in particular are being crushed by the heavy burden of these costs. ..." The state improved monthly premium increases between 50 percent and 67 percent for the seven insurers offering plans on the state’s exchange, MNsure, in 2017. Approximately 250,000 in the state purchase insurance through the state’s marketplace, about 5 percent of the state’s population. (McIntire, 9/30)

Minnesota’s individual insurance market is in danger of collapse, Commerce Commissioner Mike Rothman said Friday as he announced massive premium increases for 2017 plans. (Montgomery, 9/30)

Common Ground Healthcare Cooperative said Friday it has received a capital infusion that will enable it to remain in business and continue to sell health plans next year. The cooperative said that under terms of its agreement, it could not disclose the source or amount of the financing it received. (Boulton, 9/30)

People might be forgiven for thinking that the Affordable Care Act is the federal government's boldest intrusion into the private business of health care. But few know about a 70-year-old law that is responsible for the construction of much of our health system's infrastructure. The law's latest anniversary came and went without much notice in August. (Schumann, 10/2)

When the Arkansas insurance commissioner weighed the merits of a hospital’s billing complaint against United Healthcare, her interactions with one of the nation’s largest health insurers extended far beyond her department’s hearing room. During months of deliberations, Commissioner Julie Benafield Bowman met repeatedly with United Healthcare lawyers and lobbyists over lunch and drinks at venues such as the Country Club of Little Rock. ... Nearly two years later, ... she was working for United Healthcare, having joined at least three of her predecessors representing insurers in Arkansas. ... An investigation by the Center for Public Integrity found that half of the 109 state insurance commissioners who have left their posts in the past decade have gone on to work for the industry they used to regulate. (Mishak, 10/2)

The judge who will rule on whether the government may stop health insurer Anthem from buying competitor Cigna said Friday that she was considering splitting the trial into phases. Judge Amy Berman Jackson of the U.S. District Court for the District of Columbia said that she was mulling hearing separately about the effect of the merger on the national market in one phase and on local markets in a second phase with a potential decision after the first set of arguments. (Bartz, 9/30)

The Supreme Court of New Jersey declined to review a case this week that alleges state regulators shouldn't have allowed Horizon Blue Cross and Blue Shield to relegate hospitals to a tiered network. The decision by the higher court deals a blow to the three hospitals part of the suit. (Castellucci, 9/30)

This year, for the first time, a majority threshold was crossed as 51 percent of American workers have a deductible of at least $1,000. That compares with just 10 percent a decade ago, according to the Kaiser Family Foundation's 2016 annual health benefits survey released in September. Not only has the number of plans with deductibles grown, so, too, has the amount patients must come up with before coverage kicks in. Today, the average deductible in individual plans that have one is $1,478. In 2006, according to Kaiser, it was $584. (Deam, 10/1)

Like many transgender teens, Jenn Brewer faced bullying when she came out. Some classmates called her "tranny," and a few teachers refused to address the 13-year-old by anything other than her male birth name, she said. But she and her family found that the biggest difficulty came from her father's employer: the U.S. military. Jenn's father is an Army staff sergeant at Virginia's Fort Belvoir, and his military health insurance refused to cover private counseling to support the changes his daughter was embracing. (Finley, 10/2)

If a medical bill shows up, don’t pay it right away. At least that’s the advice of some experts who say you should closely review all your medical billing information for any errors first. The American Medical Association estimates that 7.1 percent of bills paid by commercial health insurers contain errors, while others estimate errors are far more common than that.(Sell, 10/2)

Only about six in 10 Americans in that age group get the flu shot. While that’s higher than the overall national average of 46 percent, it’s below the Centers for Disease Control’s target of 70 percent flu vaccine coverage, according to new data from the CDC. The reason that health officials are concerned about older adults is that they’re more likely to be hospitalized or die as a result of catching the flu. Even months after they’ve recovered, older adults who’ve had the flu remain at higher risk of a heart attack or stroke. (Braverman, 9/30)

Congress took nearly eight months to send money to help fight a dire public health threat. Now that lawmakers have approved $1.1 billion, health officials say the funds can't arrive quickly enough to make up for lost time. "The point is to make sure that it reaches the local health department,” said Dallas County Health Director Zach Thompson. “When it gets down to it, all public health is local when you are responding to an outbreak.” (Sun and Dennis, 9/30)

A measure signed into law by President Obama includes money to help combat the Zika virus. Florida is expected to be one of the areas to get a large amount of the funds. That’s in addition to the millions of dollars in state money Governor Rick Scott has already set aside in the Zika fight. But, questions now remain about when and how the funds will be distributed to help affected Floridians. (Cordner, 9/30)

Men who may have been exposed to the Zika virus should wait at least six months before trying to conceive a child with a partner, regardless of whether they ever had any symptoms, federal health officials are recommending. The Centers for Disease Control and Prevention had previously recommended that only men with Zika symptoms had to wait that long. Those who may have been exposed to Zika but never developed any symptoms were told to hold off on trying to conceive for just eight weeks. (Stein, 9/30)

The Centers for Disease Control and Prevention says couples with possible Zika risk should wait much longer before trying to get pregnant. The agency said Friday that couples in which the man has possibly been exposed to Zika but is not displaying symptoms should wait six months before trying to get pregnant, rather than eight weeks as the agency previously advised. (McIntire, 9/30)

The Centers for Disease Control and Prevention (CDC) is stepping up its warnings about the Zika virus for couples trying to become pregnant. CDC officials said Friday that women should wait at least six months before trying to get pregnant if their partner has possible Zika exposure. The previous recommendation had been eight weeks. (Ferris, 9/30)

Serious complications are rare among children infected with the Zika virus after birth, federal health researchers concluded in a study published on Friday — a rare bright spot in the unfolding story of the epidemic. (Saint Louis and McNeil, 9/30)

Three new travel-related Zika cases in Orange County were confirmed by the state health department on Friday, bringing the county's total to 84. Since earlier this year, Osceola County has reported 30 travel-related Zika cases, while Seminole has reported 21 and Lake has reported 3. (Miller, 10/3)

Zika wasn't even on Dr. Sankar Swaminathan's mind when he first examined a severely ill 73-year-old man in a Salt Lake City hospital in June. The patient had just returned from a visit to Mexico when he suddenly fell violently ill. "We were not thinking about Zika at all because Zika usually does not cause severe illness, in fact it almost never does," says Swaminathan, chief of the division of infectious diseases at the University of Utah. (Beaubien, 9/30)

As summer melts away, one traditional feature was absent this year, nighttime mosquito fogging truck trips noisily sputtering up and down Newnan streets. The city of Newnan has been spraying for mosquitoes for many years. Exactly how many years seems to be lost in the mists of time, but it has been at least 25 years. But late in the summer of 2015, the city quietly suspended its “low volume fogging” mosquito control program in response to a campaign by No Spray Newnan, a group of local residents who advocated for a better way to control mosquitoes, and asked for their own yards not to be sprayed. (Campbell, 10/1)

In January, Marjorie Dannenfelser and nine other antiabortion activists urged Iowa voters to support anyone but Donald Trump. Now she is fully backing the Republican nominee, chairing the pro-life coalition of a man the activists said “cannot be trusted.” The dramatic about-face for Dannenfelser and other religious and social conservatives who were once leery of supporting a brash, thrice-married New Yorker who supported abortion rights and called Holy Communion a “little cracker” is due in large part to one man: Indiana Gov. Mike Pence. (Zezima, 10/1)

As part of a legislatively ordered restructuring of Texas health agencies, the state health commission has begun advertising for someone to fill a new executive job overseeing “women’s education services” — including abstinence education and counseling on alternatives to abortion. The position could pay six figures. The new Director of Women’s Education Services would be part of the newly formed Women’s Education Services Unit, according to a job listing posted to the health agency's website, responsible for overseeing three hot-button programs previously run by a sister agency — abstinence education, abortion alternatives and funding for judicial bypass proceedings for minors seeking abortion. (Ura, 9/30)

Japanese biologist Yoshinori Ohsumi was awarded the 2016 Nobel Prize in Medicine on Monday for discovering and elucidating a key mechanism in our body's defense system that involves degrading and recycling parts of cells. Known as autophagy, this process plays an important role in cancer, Alzheimer's, type 2 diabetes, birth defects from Zika virus and numerous other devastating diseases. (Cha, 10/3)

According to statement from the Nobel prize committee, Ohsumi's work opened the path to understanding how cells adapt to starvation or respond to infection. Mutations in the genes that control the process of autophagy can lead to several conditions, including cancer and neurological disease. Each Nobel prize is worth about $930,000. In most years, the prize is shared among two or more scientists. This year's prize goes to Ohsumi alone. (Stein, 10/3)

The man entered the Red Robin restaurant inside the Staten Island Mall two minutes after 6 p.m. on a Friday. He walked straight past the booths and tables and entered the men’s room. A manager would find him there seven minutes later, lying on the floor with a needle and foaming at the mouth. His name was Jonathan Ayers, 27, and he was declared dead within the hour that evening, Sept. 9, apparently of a heroin overdose. (Wilson, 10/2)

Some prominent politicians — think Donald Trump — say that to fight the nation's drug problems, we need to put up more walls. Michael Botticelli believes in tearing them down. "In the past, we’ve criminalized people with addiction," the White House drug czar told POLITICO's "Pulse Check" podcast, arguing that aggressive prosecution of some drug users was "really bad public policy." Instead, he says the nation needs a kinder, gentler approach to fighting drug misuse — and as a recovering alcoholic, Botticelli argues he's just the man for the job. (Diamond, 9/30)

For all the attention on young people caught in the grip of the nation's opioid addiction epidemic, the spotlight has missed the growing population of older Americans quietly living, and increasingly dying, as addicts. (Cohn, 10/1)

Drugmakers that produce painkillers and allied advocacy groups have sent more than $1 million in political contributions to candidates for state office in New Jersey over the last 10 years – part of what a joint investigation by The Associated Press and the Center for Public Integrity found to be a 50-state strategy to kill or weaken measures aimed at stemming the tide of prescription opioids. Limiting the amount of opioids a physician can prescribe to seven-day supplies is seen as a way to cut into the heroin and painkiller epidemic. (Serrano, 9/30)

As of September 30, a relatively unknown herbal supplement called kratom will likely join the ranks of Schedule 1 drugs in the U.S. — alongside drugs like heroin, LSD and marijuana. This supplement has been traditionally used in Southeast Asia, but has recently gained popularity in the United States as a way to manage opioid withdrawal or chronic pain without the use of prescription medications. Researchers and people using the herb decry the DEA’s move to criminalize it, which they say will stall research and deprive many Americans of a presumably harmless substitute to stronger prescription painkillers. (Smith, 9/30)

As millions of Americans battle alcohol abuse problems each year, public health officials suggest that two often overlooked medications might offer relief to some. More than 18 million people abuse or are dependent on alcohol, yet a key study funded by the federal government reported last year that only 20 percent will ever receive treatment of any kind. In fact, just slightly more than 1 million seek any type of formal help, ranging from a meeting with a counselor or a doctor to entering a specialized treatment program. (Yasinski, 10/3)

Twelve years ago, a dotcom millionaire stood at a patient advocacy group’s board meeting and made an offer. I’ll give you $1 million, he said. But only if you commit to getting an artificial pancreas on the market. (Robbins, 10/3)

Nancy Warren's eyes snapped open at 2 a.m. one recent night. She automatically looked over at her phone, where she could see a continual display of her sister's blood-sugar reading. (Akman, 10/2)

Want to be smarter? More focused? Free of memory problems as you age? If so, don't count on brain games to help you. That's the conclusion of an exhaustive evaluation of the scientific literature on brain training games and programs. It was published Monday in the journal Psychological Science in the Public Interest. (Hamilton, 10/3)

Rini Kramer-Carter has tried everything to pull herself out of her dark emotional hole: individual therapy, support groups, tai chi and numerous antidepressants. The 73-year-old musician rattles off the list: Prozac, Cymbalta, Lexapro. “I’ve been on a bunch,” she said. “I still cry all the time.” She has what’s known as “treatment-resistant depression. (Gorman, 10/3)

Ask Caltech microbiologist Dianne Newman what she does for a living, and she’ll answer with a chuckle: “I study weird forms of metabolism.” She has spent a career studying the strange ways in which microscopic organisms get the food and energy they need in environments without oxygen — a quest that has taken her from geology to biology and from Earth’s most ancient origins to the pathogens of today. (Blakemore, 9/30)

When people go to the dentist, they generally expect to leave in better health than when they walked in. But the water that dentists use to rinse teeth sometimes carries infectious bacteria. The Orange County Health Care Agency in California says that nearly two dozen children who received so-called baby root canals, or pulpotomies, are thought to have developed dangerous bacterial infections. Dentists perform pulpotomies to remove infected pulp inside a baby tooth so the rest of the tooth can be spared. (Ross, 9/30)

The county’s Health Care Agency on Friday put the number of children who contracted serious dental infections at an Anaheim clinic at 25. The agency said the 25 patients, whose ages range from 3 to 9, were all hospitalized at some point. The affected children underwent pulpotomies, or baby tooth root canals, at Children’s Dental Group in Anaheim between April 6 and July 28. Earlier this week, the Health Care Agency said six children remain hospitalized. (Bharath, 10/1)

Open wide. There’s a host of researchers peering inside your mouth, and you may be surprised at what they hope to find. They’re looking for a connection between gum disease and illnesses such as breast cancer and even dementia. (Levingston, 10/1)

Maintaining oral health means following advice so familiar it’s almost boring: Brush for two minutes twice a day with a fluoride toothpaste. Clean between teeth once a day with floss, a small brush or pick. And visit your dentist regularly. (The American Dental Association, commenting on recent reports that evidence doesn’t support flossing, says that doesn’t mean such cleaning isn’t effective.) (Levingston, 10/1)

An older, unemployed man with chronic back pain recently visited Dr. Robert Devereaux, a family physician in this Southwest corner of Virginia. Devereaux recalled that months earlier, during a routine exam, he found crushed fragments of painkiller pills inside the patient’s nose. Though he refused to prescribe more, Devereaux worries that the man is still getting the drugs and has not recognized his problem or gotten treatment for his addiction. (Luthra, 10/3)

A $320,538 grant from the United States Department of Agriculture is helping Baxter Regional Medical Center reduce its readmission rate while implementing a Complex Care Management, allowing staff members to better manage patients' care. The Baxter Bulletin reports that the grant was primarily developed around the telehealth, a remote patient monitoring device that will be placed into patients' home. The telehealth device will benefit patients who are high-risk to return to the hospital, such as the ones who've suffered from pneumonia, a heart attack, congestive heart failure and others. (Louis, 10/1)

The Marin Healthcare District and Prima Medical Foundation are notifying more than 5,000 patients that some of their medical data was lost due to a glitch that followed a ransomware attack in August. Prima Medical Foundation supports the Prima Medical Group, many of whose doctors work closely with Marin General Hospital. The computer records of Marin Medical Practice Concepts, a Novato company that provides medical billing and electronic medical records services to many Marin physicians, were hacked on July 26. (Halstead, 9/30)

A new UCLA Center for Health Policy Research study reveals that we Californians are directly or indirectly spending a mind-numbing $367.5 billion a year on our physical well-being, equal to 15 percent of the state’s $2.5 trillion economy. That makes it, by a huge margin, our largest industry, dwarfing such high-profile California mainstays as movies, agriculture, aerospace and tourism. The $50 billion film industry, for instance, is scarcely one-seventh the size. (Walters, 10/1)

Urgent care clinics are proliferating across the Twin Cities as patients footing a bigger share of their medical bills hunt for convenience. Up to 19 new urgent care centers will be rolled out across Minnesota by the end of next year by the Optum unit of Minnetonka-based UnitedHealth Group, bringing a 20 percent increase in the state from just one provider. Hospitals and clinics that have been offering urgent care for several years also are promising expansions, setting up a battle to retain patients and capture new business. (Snowbeck, 10/1)

When Stacey Nee delivered her second child, nurses talked to her about breastfeeding, safe sleeping practices, and postpartum depression, but she took note of what they did not mention: the potentially angry emotions, even dangerous actions, that can be stirred by a chronically crying baby. The omission was particularly jarring to Nee, who works at the Children’s Trust in Boston, an agency that helped implement a 2006 state law calling on maternity wards to train parents, before discharge, about the dangers of shaken-baby syndrome. (Wen, 9/30)

Many thousands of Californians are dying every year from infections they caught while in hospitals. But you’d never know that from their death certificates. Sharley McMullen of Manhattan Beach came down with a fever just hours after being wheeled out of a Torrance Memorial Medical Center operating room on May 4, 2014. A missionary’s daughter who worked as a secretary at Cape Canaveral, Fla., at the height of the space race, McMullen, 72, was there for treatment of a bleeding stomach ulcer. Soon, though, she was fighting for her life. (Petersen, 10/2)

Kansas recorded its lowest-ever infant mortality rate in 2015, when 230 infants died before their first birthday, according to the Kansas Department of Health and Environment. (Thompson, 9/30)

The Massachusetts Department of Public Health has recommended a planned $1 billion clinical building at Boston Children's Hospital be approved. In a statement released Friday, DPH says its staff has determined the proposed building "meets the regulatory requirements and includes many positive aspects to improve care for the children and families the hospital serves. "The agency's Public Health Council will vote on the project on Oct. 20. (Jolicoeur, 9/30)

Massachusetts health regulators said Friday that Boston Children’s Hospital should be allowed to go forward with a $1 billion expansion project, a recommendation that seeks to support one of the state’s premier hospitals without undermining efforts to control medical spending. The staff at the Department of Public Health recommended approval of the plan to build an 11-story building in Longwood and an eight-story outpatient clinic in Brookline. The expansion has sparked controversy over its potential to drive up health care costs. (Dayal McCluskey, 9/30)

Gov. Jerry Brown signed off on a variety of bills in September that aim to protect patients and health care consumers. The following laws are set to go into effect in 2017. (Ibarra, 10/3)

National Breast Cancer Awareness Month starts Saturday, and clinics around Sacramento will be offering free breast cancer screenings to promote early detection of the disease. A mammography screening can help reduce the likelihood of death from breast cancer among women ages 40 to 74, especially for those older than 50, according to the National Cancer Institute. (Caiola, 9/30)

State health investigators are intensifying efforts to pinpoint the source of the Hopkins outbreak of Legionnaires’ disease even as three new cases were confirmed Friday. The outbreak has now sickened 23 people and led to one death. After weeks of testing and disease tracking, epidemiologists at the Minnesota Department of Health still have not found ground zero of the outbreak, but they are looking at a likely culprit. (Howatt, 10/1)

North Carolina has fallen behind in the quality of and access to its health care system, according to a new survey by the personal-finance website Wallet Hub. One of the state’s leading health economists said it’s not surprising given some of the economics of North Carolina and the fact that its residents have some of the highest rates of obesity, diabetes and heart disease in the United States. (Hoban, 9/30)

Dr. Ted Abernathy has fundamentally changed the way his medical practice operates. Now, patients know the nurses and receptionists as well as their physicians. Day-to-day tasks are distributed among the staff to streamline operations, freeing up time that providers can then spend with patients. It took more than year for Abernathy’s practice, Midlothian-based Pediatric & Adolescent Health Partners, to achieve certification as a patient-centered medical home, a philosophy of care that calls for a coordination among providers and staff that is always focused on the patient. (Demeria, 10/1)

A Worcester-based home health agency and three people involved with the company have been indicted by a grand jury for allegedly defrauding the state’s Medicaid program of more than $800,000. Compassionate Homecare Inc. provided nursing and other services for low-income patients on the government program known here as MassHealth. The agency is accused of conducting “numerous fraudulent schemes” and billing the state for providing services to patients who didn’t need them, and for services that were never authorized by a doctor, in violation of rules. (Dayal McCluskey, 9/30)

About 12 years ago, Nancy Menchhofer’s husband was diagnosed with Alzheimer’s at the age of 59. When she moved him to a care facility five years ago, it was the hardest thing she had ever done. Menchhofer visits him once a week and feeds him lunch. He doesn’t know who she is or why she’s there. (Munz, 10/2)

A 16-year-old boy who was sexually abused while under anesthesia at Stanford Health Care is suing the hospital system for negligence. The lawsuit, filed in San Mateo County Superior Court on Thursday, alleges that some Stanford employees did not report what they saw and hospital officials should have known the abuser had a “proclivity to have inappropriate sexual contact” because of past encounters. The suit also stated some Stanford leaders fostered a toxic environment by allowing a group of managers to band together and look out for each other, including the abuser, while retaliating against those who spoke out. (Lee, 9/30)

Almost without exception, when a student who’s being abused by a parent or caregiver goes to any school in Iowa, every teacher, counselor and building administrator knows what to do. But that's not necessarily the case if the same student reports she or he has been sexually assaulted by another student or staff member, a Des Moines Register survey of 25 school districts suggests. (Rood, 10/2)

ith the Legislature only in session for three weeks after its summer break, there weren't a whole lot of bills for Gov. Rick Snyder to sign. But he did sign long-stalled bills to regulate and tax the medical marijuana industry. The bills will allow communities to decide whether and where they want medical marijuana dispensaries located in their towns. The bills also provide for licensing fees, annual assessments and a 3% tax on retail gross income of dispensaries. (Gray, 10/1)

Four years after Massachusetts residents — including voters in Hopkinton, Seekonk, and Southborough — overwhelmingly approved legalizing marijuana for medical use, dispensaries have become the ultimate not-in-my-backyard symbol in many towns. Just seven dispensaries have cleared local hurdles and opened since voters backed medical marijuana in 2012. Yet the law put no restrictions on the number of dispensaries allowed after the first year. (Lazar, 10/3)

We keep reading that Donald Trump poses a unique threat to constitutional norms if he’s elected. His liberal critics would have more credibility if they called out the Obama Administration for its current (not potential) abuses of power, and here’s an opportunity: The Administration is crafting an illegal bailout to prop up the President’s health-care law. (9/30)

It was a case of the dog that didn’t bark. For 90 minutes on Monday, Donald Trump and Hillary Clinton clashed in their first presidential debate on a full range of issues. But meriting not a single mention? Obamacare. The Affordable Care Act ripped apart the nation and dominated political argument for several years. But now, six years after enactment, Obamacare isn’t on the radar screen during this election. And for good reason: The predicted apocalypse has not occurred. (Dana Milbank, 9/30)

The Affordable Care Act delivered another shock to Nebraskans when Blue Cross Blue Shield announced that it no longer could afford to sell health insurance through the federal marketplace exchange. The announcement is the third in a series of blows to the health care system in the state. Earlier this year UnitedHealth Group announced it would no longer sell individual exchange policies. Prior to that CoOpportunity Health, which operated in Nebraska, collapsed and its customers had to find coverage elsewhere. (10/1)

The problem is, there is no way a “public option” could be sustainable – both as “public” and as an “option.” The reason is, any public plan would have to operate on the basis one of the following two principles, and each one excludes either the sustainability, or its ability to remain an “option.” These principles are: 1. The program must be self-supporting; that is, health care costs and administrative costs must be paid for out of premiums received (except possible for taxpayer-funded start-up costs). 2. The program must continue to exist, and be available to all customers who want it in all parts of the country, at “affordable” prices. (Robert Book, 9/30)

Coloradans have always been pioneers. With an innovative spirit, we’ve had the courage to overcome adversity, seize opportunity, and turn bold visions into reality. Today, with ColoradoCare, we’re on the frontier of a health care revolution. (Irene Aguilar, 9/30)

Marijuana is a complicated issue. I support its medicinal use and have introduced federal legislation to make it easier to research and potentially bring marijuana-derived medicines to the market with FDA approval... But Proposition 64 would allow marijuana of any strength to be sold. (Dianne Feinstein, 10/1)

Everyone knows that tobacco kills, but still, the numbers are staggering. In California alone, some 40,000 adults die each year as a result of smoking or secondhand smoke, and the amount spent annually on healthcare directly related to tobacco exceeds $13 billion. Nationally, the death toll is 480,000. Americans, for better or worse, have decided that this nasty, lethal drug should remain legal. So government’s approach is to discourage smoking where it can. It restricts advertising, requires warnings on cigarette packs, bars sales to minors — and, most effectively, it levies “sin taxes” designed to make smoking prohibitively expensive. (9/30)

There is ample evidence from around the country that has proven regular and significant increases in tobacco taxes, like the $1.50 increase per cigarette pack supported by the American Cancer Society Cancer Action Network and other public health groups, are necessary to ensure the state will benefit fully from a public-health standpoint. Tobacco tax increases of less than $1 per pack have far less impact on teen- and adult-smoking rates because the tobacco industry can easily offset the smaller cost increases through temporary price cuts, coupons and other promotional discounting. (Pam Pilgrim, 9/30)

We are a nation of patsies when it comes to health care. We’re paying roughly twice what other wealthy nations pay for medical care that seems no better. (Jim Gallagher, 10/2)

Regulators have been playing a vast and costly game of whack-a-mole since the creation of Medicare and Medicaid 40 years ago. Regulators decide we’re spending too much on something, and reduce or disallow that spending. That budget line item duly drops, and yet health-care spending does not, because some other category has risen to compensate. ... The latest hotness in cost control is called “all payer.” The idea is that without such a system, hospitals and doctors exploit pricing disparities between various categories of payer, with governments generally paying less and private insurers paying more. ... Vermont, having tried and failed to build a single-payer system, is now prepared to embark on a new experiment with all-payer. (Megan McArdle, 9/30)

Serious candidates for office don’t normally shun golden opportunities to outline their policies for an attentive audience. So when the New England Journal of Medicine invited the two top presidential candidates to describe their goals and plans for American healthcare in their administrations, Hillary Clinton jumped at the chance. Donald Trump didn’t respond at all. (Michael Hiltzik, 9/30)

When Donald Trump challenged Hillary Clinton to a medical records disclosure throwdown not long ago, my colleague Margot Sanger-Katz wrote an article pointing out that there’s often no such thing as a complete medical dossier on anyone. After all, most of us have seen many doctors over many decades, with details scattered hither and yon. Tracking them down would be a nightmare, the specialists in medical records and technology say. But that kind of quest is my kind of fun. (Ron Lieber, 9/30)

Springsteen has long been committed to social justice; in writing about depression, he has perhaps undertaken a new cause, one that seeks to combat the stereotypes and stigmas about mental illness that still exist today. Struggles with mental illness are common and familiar among rock and pop stars. They include Beyoncé, Eric Clapton, Kurt Cobain, Sheryl Crow, Janet Jackson, Billy Joel, Jon Bon Jovi, Alicia Keys, Lady Gaga, John Lennon, Alanis Morissette and Brian Wilson. ... The medical literature, though limited, strongly indicates that being a rock star is a high-stress lifestyle. But Springsteen’s disclosure is arguably unique because his image runs counter to stereotypes of depression. (Alex Lubet, 10/3)

He said he had come to the emergency room to preach. I encouraged him to check into the hospital for care. He refused, and I considered my options. I could allow him to leave, or I could admit him involuntarily. I knew, though, that if we gave him antipsychotic medication, he would realize that he was a homeless man with AIDS. Would he rather stay a prophet? Did he have the right to choose psychosis? Did I have the right to choose for him? (Irene Hurford, 10/1)

In 2012, the Department of Veterans Affairs announced an initiative to hire an additional 1,600 mental health professionals. Two years later, it announced another initiative to expand further the ranks. Last year, Congress passed, and the president signed, the Clay Hunt Suicide Prevention for American Veterans Act, named after a decorated Marine who killed himself in 2011 after struggling with PTSD. But the bottom line is that despite these initiatives, the VA has not been able to expand its services to meet the need—and the tragic loss of life continues. ... the time is long overdue to face an essential fact: Suicides by veterans have continued unabated, and the VA has not been able to meet the needs of those it serves. It is time for Congress and the administration to take ownership of this issue. (Robert M. Morgenthau, 10/2)

Over the past year, there have been several reports indicating America's health status has taken a turn for the worse. Life expectancy for white women took a small but unexpected dip in 2014, the Centers for Disease Control and Prevention reported last April. And nearly a year ago, a paper from two leading economists revealed that life expectancy for whites has been declining for nearly two decades, with almost all of the decrease concentrated among men and women without a college education. (Merrill Goozner, 10/1)

There’s an outbreak of a hidden epidemic — unaffordable employer-based health insurance, especially for low-income workers — at Harvard, a place where it should never occur. As medical students at Harvard, we were deeply troubled to learn that our university was proposing changes to dining workers’ health plans that would make essential health care unaffordable. After months of negotiation, the dining workers’ union voted to authorize a strike, which will launch on Wednesday if a deal is not reached. The campus has rallied around the workers, circulating a petition of support signed by 2,500 students, including us, in advance of federal mediation held earlier this week. In the dining workers’ fight with Harvard, we see a microcosm of current challenges for health insurance across America. (Micah Johnson and Sanjay Kishore, 9/30)

Oncologists can only capture a pixelated snapshot of their patients’ health because, on average, they see patients undergoing chemotherapy for only eight minutes every third week. Can we make use of the missing 30,000 minutes in between doctor’s visits? (Peter Kuhn, 9/30)

“Obamacare never reached pets,” said Doug Hirsch, co-chief executive of Santa Monica’s GoodRX, a price-comparison website for prescription meds that also includes drugs taken by dogs and cats. “They’re very much bearing the brunt of high drug prices.” Pet owners will spend nearly $63 billion this year, according to the American Pet Products Assn. Such expenditures — including food, supplies, toys, over-the-counter medications and veterinary care — topped $60 billion for the first time last year. (David Lazarus, 9/30)

Starting on Nov. 28, placing yourself or your loved one in a nursing home will no longer require signing away your legal rights. Under a breakthrough ruling on Wednesday, regulators for Medicare and Medicaid have barred nursing homes that receive federal funding from requiring residents to agree in advance to resolve disputes in arbitration, instead of in court. The end of pre-dispute arbitration clauses in nursing home contracts means the end of a pervasive practice that has long shielded nursing homes from liability for claims involving neglect, abuse, harassment, assault and wrongful death. (Teresa Tritch, 9/30)

Bill Gates and Abraham Lincoln are in agreement. Gates, whose foundation funds the development and distribution of new medicines in the developing world, said the U.S. system “is better than most other systems one can imagine …. The drug companies are turning out miracles, and we need their R&D budgets to stay strong. They need to see the opportunity.” It turns out that Mr. Gates is in good company. Lincoln, the only U.S. President to hold a patent, called the IP system, “the fuel of interest which fires man’s genius.” (Carol Adelman and Jeremiah Norris, 10/3)

The security of medical data is increasingly under threat, especially as health systems across the United States convert patients’ thick paper files into electronic medical records; the U.S. Government Accountability Office reported last month that health data breaches exposed 113 million patients’ records to potential theft and fraud in 2015 alone. (Mary F. E. Ebeling, 10/3)

Sadly, very few people understand – or want to believe – how much good nutrition plays a critical role in their quality of life. They follow the latest fad hoping for the fastest results when science tells us that slow and steady wins the race. It’s rare for people to seek out the expert advice of a registered dietitian for personalized information on how to integrate science-based, simple changes for better health. (Lisa Andrews, 9/30)