�鶹Ů��

The Senate is on track to advance legislation to prevent the government from shutting down after a midnight Wednesday deadline, but a wrinkle remains. Majority Leader Mitch McConnell has moved to strip the measure of a provision that would cancel federal funding of Planned Parenthood. McConnell's move has rankled conservatives such as Sen. Ted Cruz, R-Texas, and tea partyers in the House who want the taxpayer money withheld from the women's health care provider after the release of secret videos in which Planned Parenthood officials discussed the transfer of fetal tissue to researchers. (9/28)

House Republicans are coalescing around a plan to avert a government shutdown over Planned Parenthood — just in time for the Oct. 1 deadline. At the same meeting where Speaker John Boehner (R-Ohio) announced his coming resignation, House GOP leaders on Friday said they are planning a vote on a short-term spending bill that will continue to fund Planned Parenthood. (Ferris and Sullivan, 9/28)

The Republican schism will resurface quickly Monday, as Congress begins voting on whether to fund the government past Wednesday night, when money is due to run out. The turmoil in his party – underscored in a closed door meeting Thursday where conservatives said they’d challenge him – was a key reason Boehner accelerated his secret plan to step down. The diehards won’t back a budget unless Planned Parenthood is stripped of federal funding, and may have the votes to get their way. They see too much eagerness among Republican leaders to give in. (Lightman and Douglas, 9/25)

But Cruz’s supporters see the showdown in Congress over Planned Parenthood and the budget — which kicks into high gear this week and could stretch into the winter, on the cusp of voting in early states — as a critical opening for the first-term lawmaker. With the spotlight focused on Congress, they say, it will allow Cruz to make a sustained case to tea party and evangelical voters that he’s the one candidate doing battle in the trenches for their causes, just as many of them are picking a horse in the race. The goal, he and allies stop just short of saying, is to expose his chief competitors for the outsider mantle as pretenders by comparison. (Everett and Glueck, 9/28)

The House is considering a vote this week to create a special panel to investigate Planned Parenthood — the most direct move by congressional Republicans to probe allegations of improper fetal tissue sales by the group. The subcommittee would fall under the jurisdiction of the influential Energy and Commerce Committee. It was announced over the weekend by Rep. Marsha Blackburn (R-Tenn.), who would serve as the panel’s chairwoman. (French, 9/28)

Minority Leader Nancy Pelosi (D-Calif.) is bashing House Republicans’ plans to create a select committee focused on investigating Planned Parenthood after the release of controversial videos about the group’s handling of fetal tissue. “The Speaker’s resignation has not yet broken Republicans’ fevered obsession with shutting down government at the expense of women’s health,” she said in a statement Saturday, noting Friday’s news that Speaker John Boehner will depart after October. (Kamisar, 9/26)

The undercover videos were made over more than two years, yet Planned Parenthood was taken by surprise when the first one was posted online in July. ... Immediately the organization was caught in a storm of internal confusion and defensiveness. There was disquiet among Democratic allies as Republicans, who control Congress and many state capitols, charged that the nonprofit organization was criminally “profiteering in baby parts.” A new video surfaced almost every Tuesday. But Planned Parenthood has fought back and managed to put some opponents on the defensive after gathering information from its affiliates; hiring lawyers, crisis managers and video experts to document deceptive edits; and working to solidify support among donors, Democrats and, according to polls, a majority of Americans. (Calmes, 9/26)

Nearly seven in 10 Americans — 69 percent — oppose shutting down the government over funding for Planned Parenthood, according to the results of a new national Quinnipiac University poll released Monday. Just 23 percent support closing the government over the dispute. Even among Republicans, a majority of 56 percent to 36 percent opposes a shutdown due to Planned Parenthood. (Gass, 9/28)

About seven in 10 voters, including a majority of Republicans, oppose shutting down the government over the recent dispute about funding for Planned Parenthood, according to a Quinnipiac poll released Monday. Sixty-nine percent said they would oppose “shutting down the government over differences about federal government funding to Planned Parenthood,” compared to 23 percent who said they would support it, the poll said. (Sherfinski, 9/28)

In his first one-on-one interview since his resignation announcement, Speaker John Boehner blasted right-wing lawmakers and groups as “false prophets” who “whip people into a frenzy” to make legislative demands that “are never going to happen.” The Ohio Republican also declared on CBS’ Face the Nation Sunday that there won’t be a government shutdown this week, though he’s “sure” it will take Democratic votes to pass a temporary funding extension. (Zapler, 9/27)

Boehner referred, as he has in the past, to the ill-fated 2013 shutdown over funding of the Patient Protection and Affordable Care Act, a.k.a. Obamacare: "This plan never had a chance," he said, but he blamed outside forces for leading Republicans down an ill-advised path: "We got groups here in town, members of the House and Senate here in town, who whip people into a frenzy believing they can accomplish things that they know — they know! — are never going to happen." (DeBonis, 9/27)

In his first major interview since announcing his pending resignation, House Speaker John A. Boehner vowed Sunday that there will be no government shutdown at the end of the month — adding that he will impanel a select committee to investigate Planned Parenthood after "undercover" videos renewed outrage among conservatives about government funding for the women's health provider. (Lowery and DeBonis, 9/27)

John Boehner, who made a surprise announcement Friday that he will resign as House speaker, leaves behind a health care legacy that includes a long-sought overhaul of how Medicare pays doctors and spearheading a pending lawsuit that could still hobble Obamacare. (Demko, 9/25)

The House will likely carry on with its lawsuit against the Obama administration over the Affordable Care Act without John Boehner, who plans to step down as House speaker next month. But his resignation probably means that hopes for legislative tweaks to the law are dead for now. Boehner (R-Ohio) disclosed his plans first to fellow Republicans and then during a news conference Friday afternoon. (Schencker, 9/25)

The nation’s biggest nonprofit health insurer spawned by the Affordable Care Act has been ordered to shut down as it reels toward insolvency, disrupting coverage for more than 200,000 New York state residents and becoming the fourth such co-op to collapse in recent months. The action Friday to force Health Republic Insurance of New York out of business was a coordinated maneuver by state regulators and by federal health officials, who have been trying to nurture fledgling co-ops while dealing with the reality that most are hemorrhaging red ink. (Goldstein, 9/25)

The insurer lost about $52.7 million in the first six months of this year, on top of a $77.5 million loss in 2014, according to regulatory filings. ... The shuttering of Health Republic, at least the fourth to falter among the ACA’s original 23 co-ops around the country, reflects the losses many insurers are seeing in their business related to the health law’s exchanges, which are particularly acute for small plans without deep pockets or diversified lines of business. (Wilde Mathews, 9/25)

The Department of Financial Services said Friday that current individual coverage should continue through Dec. 31 for 108,000 people, most of whom signed up through the New York Health Exchange. DFS and the state Health Department said existing small group plans also remain in effect, covering another 101,500 people. Most of those policies were bought outside the exchange established under the federal Affordable Care Act. The agencies said they will evaluate how to proceed with those policies based on Health Republic's ongoing financial results. (Virtanen, 9/25)

Government officials are shutting down a nonprofit health insurer in New York set up under Obamacare because of its financial struggles, the latest blow to the healthcare law’s nonprofit plans. State regulators and the federal Centers for Medicare and Medicaid Services announced on Friday that they are winding down the co-op operations of the insurer, called Health Republic. (Sullivan, 9/25)

Health Republic Insurance of New York will close up shop by year-end, marking one of the biggest blows to the Affordable Care Act's co-op program to date. Health Republic is the largest not-for-profit co-op in the country with approximately 200,000 members as of this past spring, or roughly one-fifth of all people enrolled in a co-op health plan. But like almost all of the other co-ops, which have been seeded with loans from the ACA, Health Republic was losing money after it attracted some of the sickest and costliest members in its market. (Herman, 9/25)

The Internal Revenue Service may have allowed scores of insurers to avoid paying millions of dollars in taxes and penalties under a provision of the Affordable Care Act, according to a new report by a Treasury Department inspector general. (Pianin, 9/25)

The White House has said it will focus this year’s enrollment push on the remaining uninsured. So it’s worth taking a closer look at who those people were. Most of them — about 56 percent — fell into three major groups that were widely expected to have high uninsurance rates: immigrants, young adults and people in the so-called Medicaid gap. But that still left more than 14 million Americans who don’t have insurance and don’t fall into any of these categories. ... Without immigrants and people in the Medicaid gap, the total number of uninsured is about 22 million people, more than a third of whom are young adults ages 19 to 34. (Barry-Jester and Casselman, 9/28)

Rep. Elijah E. Cummings says he believes affordable health care for all Americans is an achievable goal, and cites President Obama’s signature law as a good start. Addressing an audience of hundreds of people Saturday at the Chase Brexton Charm Ball, the longtime Maryland Democrat said the “first step was the Affordable Care Act. We must be clear to not mistake a comma for a period.” (Althoff, 9/27)

A House-Senate committee is scheduled to meet Monday to discuss how and whether to move forward with the Alaska Legislature’s lawsuit to stop Gov. Bill Walker from unilaterally expanding the Medicaid health care program. ... The original committee vote authorizing the Legislature’s lawsuit was 10 to 1, with all the members of the Republican-led House and Senate majorities in favor. But at least one Republican member of the Legislative Council, Anchorage Rep. Mike Hawker, says he hopes to steer his colleagues away from the lawsuit at Monday’s meeting. (Herz, 9/27)

Thousands of Minnesotans who buy health insurance on their own are bracing for final word on whether their premiums will spike next year. On Thursday, the Minnesota Department of Commerce is scheduled to release 2016 rates for shoppers who buy individual policies. (Snowbeck, 9/28)

And so the right’s case against the chief justice is thin, said Steven R. Shapiro, the legal director of the American Civil Liberties Union. “The reaction is almost entirely due to the two health care decisions,” he said, “and there is nothing else in his record that should be disappointing.” In 2012, Chief Justice Roberts wrote the majority opinion rejecting a constitutional challenge to a central feature of President Obama’s health care law, the Affordable Care Act. In June, he wrote the majority opinion allowing nationwide tax subsidies under the law. Those rulings were unpopular with the right, but they do not provide much evidence that Chief Justice Roberts has turned into a liberal, said Brianne Gorod, a lawyer with the Constitutional Accountability Center, a liberal group that has issued a series of reports assessing the chief justice’s decade on the court. (Liptak, 9/28)

When a divided Supreme Court handed down six major rulings in the last week of June, Chief Justice John G. Roberts Jr. came down firmly on the conservative side in five of them. ... as Roberts this week marks the 10th anniversary of becoming chief justice, he finds himself in the crosshairs of right-leaning pundits and GOP presidential hopefuls who brand him a disappointment and openly question his conservative credentials because of the one case of the six in which he voted with the court’s liberals. The decision marked the second time Roberts had voted to uphold President Obama’s healthcare law. ... Heading into an election year, the attacks on Roberts appear to reflect shifting views on the right about the court and the proper role for the justices. (Savage, 9/25)

Religion, birth control and President Barack Obama's health care overhaul are about to collide at the Supreme Court yet again. Faith-affiliated charities, colleges and hospitals that oppose some or all contraception as immoral are battling the administration over rules that allow them to opt out of covering the contraceptives for women that are among a range of preventive services required to be in health plans at no extra cost. (9/27)

Hillary Clinton and Bernie Sanders have a seemingly simple way to lower the high cost of drugs in the U.S.: Let Medicare flex its gigantic muscles and negotiate lower prices with drug manufacturers. When Congress overhauled Medicare in 2003 to pay for prescription drugs, lawmakers banned the agency from negotiating with drug companies as a concession to the pharmaceutical industry. Instead, the insurers who cover the roughly 42 million enrollees in Medicare's Part D drug program obtain their own discounts. (Luhby, 9/27)

For decades, most new pharmaceuticals were shepherded from early-stage research to consumer sales by one company. But as big drugmakers increasingly cede research to startups, venture capitalists have been stepping in to pull together teams of scientists, senior executives, and supporting managers and staff to work on a single development project. (Weisman, 9/27)

From 2008 through 2014, average prices for the most widely used brand-name drugs jumped 128 percent, according to prescription benefit manager Express Scripts Holding Co. In 2014, it estimated that total U.S. prescription drug spending increased 13 percent. Reasons include increasing research costs, insufficient competition and drug shortages. ... While it's clear drug prices are rising, many patients don't understand why. Here are six of the top reasons. (Johnson, 9/25)

This week, a roiling controversy was ignited after Turing Pharmaceuticals chief executive Martin Shkreli hiked the price for his drug Daraprim by a mind-boggling 4,000 percent. The major pharmaceutical and biotech industry groups have portrayed Shkreli's actions as totally repugnant and the work of just one company, acting alone, with a flippant young chief executive who doesn't reflect the broader values, practices, or trends of other companies. But it's not .... while Shkreli's price increase was over-the-top extravagant, the overall trend for other brand name drugs is in the same direction: up. (Johnson, 9/25)

The drug industry chose a new top lobbyist Friday to help pharmaceutical companies defend themselves against criticism from patients, doctors and government officials who say they are charging exorbitant prices for many medicines. The lobbyist, Stephen J. Ubl, will become president and chief executive of Pharmaceutical Research and Manufacturers of America, a trade group that represents companies like Amgen, Eli Lilly, Johnson & Johnson, Merck and Pfizer. For the last 10 years, Mr. Ubl has been the top lobbyist for medical device makers. He has led efforts to persuade Congress to repeal a tax on medical devices imposed by the Affordable Care Act. Mr. Ubl, 46, is well known in Washington for his deep knowledge of health policy, shrewd political instincts and low-key manner that sets him apart from many lobbyists. (Pear, 9/25)

A late slump in health care stocks pushed the market to its third weekly loss this month. ... Shares of drug makers began their slide Monday when Democratic presidential front-runner Hillary Rodham Clinton pledged to stop "price gouging" in the industry. The healthcare sector, a longtime favorite of investors, ended Friday with its worst weekly performance in more than four years. Biotechnology shares in the S&P 500 plunged during the week, pushing the overall healthcare index down 5.8%, its worst week since August 2011. Vertex Pharmaceuticals, which focuses on developing drugs for cystic fibrosis and viral infections, was the biggest decliner in the index Friday, dropping $7.83, or 7%, to $103.20. (9/25)

A unit of Johnson & Johnson that makes artificial hips has accused a surgical funding company of seeking excessive profits from financing surgery for patients suing over the devices. The claim by DePuy Orthopaedics marks the first time that a device maker in the multibillion-dollar litigation over faulty hip replacements has publicly raised concerns about the controversial business of surgical funding, which has increasingly become a part of mass litigation over medical devices. (9/28)

Doctors, hospitals and insurers are bracing for possible disruptions on Oct. 1 when the U.S. health-care system switches to a massive new set of codes for describing illnesses and injuries. Under the new system, cardiologists will have not one but 845 codes for angioplasty. Dermatologists will need to specify which of eight kinds of acne a patient has. Gastroenterologists who don’t know what’s causing a patient’s stomachache will be asked to specify where the pain is and what other symptoms are present—gas? eructation (belching)?—since there is a separate code for each. (Beck, 9/27)

In 2016, after years of controversy, Medicare plans to begin reimbursing doctors for having discussions with patients about what type of medical care they want and don’t want near the end of their lives. Private insurers are likely to follow, some experts say, meaning voluntary end-of-life counseling could soon become a part of standard medical care. (Sadick, 9/27)

Physician and researcher Hardeep Singh probes one of the most vexing issues in medicine: diagnostic errors. As chief of health policy, quality and informatics at Houston’s Michael E. DeBakey VA Medical Center and an associate professor of medicine at Baylor College of Medicine, Dr. Singh measures the human toll of such mistakes and investigates how technology can help clinicians avoid making them. ... He answered questions from The Wall Street Journal about what doctors and patients can do to make sure they get to the bottom of the diagnostic puzzle. (Landro, 9/26)

More elderly across the nation are aging at home for a variety of reasons: they prefer to and are healthy enough to stay; they can’t afford other options such as assisted living; and states in some cases have imposed policies to limit nursing home stays paid for by Medicaid, which is a major funder of long-term institutional health care for older Americans. But aging in place is proving difficult in places where the population is growing older, supportive services are scarce, houses are in disrepair and younger people who can assist have moved away. As a result, elderly people who live at home are having to rely more on neighbors—who sometimes are elderly, too—and local nonprofits and public agencies are starting to feel the strain from increasing requests for help. (Levitz, 9/25)

The story of America's aging population is to a great extent the story of people like Ms. Kornblum, one in which friends or family members step in to provide informal care, usually without training, and at great expense in terms of personal time and money. According to the Institute of Medicine, a division of the National Academies of Sciences, Engineering and Medicine, unpaid caregivers provide 90 percent of long-term care for the old or disabled. Like old age itself, the job arrives unbidden and with little in the way of guidance, to be managed more than mastered. Mr. Sorensen’s fall and the events leading up to it show how tenuous such care can be. (Leland, 9/25)

Deep inside a 70-year-old water-treatment plant, drinking water for Iowa's capital city is cleansed of harmful nitrates that come from the state's famously rich farmland. Without Des Moines Water Works, the central Iowa region of 500,000 people that it serves wouldn't have a thriving economy. But after decades of ceaseless service, the utility is confronting an array of problems: Water mains are cracking open hundreds of times every year. Rivers that provide its source water are increasingly polluted. And the city doesn't know how it will afford a $150 million treatment plant at a time when revenues are down and maintenance costs are up. (Foley, 9/26)

Many of the nation's water-supply systems need expensive improvements. And in the West and elsewhere, utilities are focused on finding enough water to meet demand. Although the problems are complex, experts generally agree on some basic solutions. (9/25)

The largest federal aid program for improving the nation's drinking water systems has struggled to spend money in a timely fashion despite demand for assistance that far exceeds the amount available, a review by The Associated Press shows. Project delays, poor management by some states and structural problems have contributed to nearly $1.1 billion in congressional appropriations sitting unspent in Drinking Water State Revolving Fund accounts as of Aug. 1. (Foley, 9/26)

Farm fertilizers, discarded pharmaceuticals, industrial chemicals and even saltwater from rising oceans are seeping into many of the aquifers, reservoirs and rivers that supply Americans with drinking water. Combating these growing threats means cities and towns must tap new water sources, upgrade aging treatment plants and install miles of pipeline, at tremendous cost. (Seewer, 9/25)

Oklahoma's Center for Reproductive Rights on Friday asked the state Supreme Court to stop a law the group's lawyers say unfairly targets physicians and medical facilities that provide abortions. The law goes into effect Nov. 1 and lawyers for the group say it mainly sets an array of rules against providing abortions to minors and includes unconstitutional provisions that permit searches without a warrant of abortion providers. (Brandes, 9/25)

In a battle over patient privacy and public records, an anti-abortion group wants the 911 transcripts and ambulance reports from the St. Louis Fire Department’s emergency calls to the Planned Parenthood clinic in the Central West End. Deborah Myers of Operation Rescue, based in Wichita, Kan., sued the fire department last year seeking the reports, citing the Missouri Sunshine Law that governs access to public records. The group commonly uses 911 call records on abortion clinics nationwide to look for information that might bolster complaints they file with state health departments. (Bernhard, 9/28)

Supreme Court justices will meet behind closed doors Monday to start the process of deciding which cases to take up this term, with all eyes on a challenge to a Texas abortion law that could roil the presidential race just months before voters go to the polls.The case, Whole Woman’s Health v. Cole, centers on a series of far-reaching restrictions on Texas abortion providers and clinics, which led to the closure of about half of the state’s abortion facilities. It promises to be the most significant abortion case in at least two decades, and could inject divisive social issues into the presidential race at a key moment (Haberkorn, 9/27)

At a Cook County board meeting this month, Dr. Tatyana Kagan stood to address the commissioners. It was the first time she had attended a meeting. Kagan works in the pediatric emergency room at Stroger Hospital and came to object to the hospital's plan to consolidate the pediatric ER with the main ER. Reading from a speech, Kagan said the creation of a single emergency department would harm quality of care, subjecting children and their guardians to long waits and the sometimes chaotic atmosphere of the adult ER. (Sachdev, 9/25)

The test results inside Marymount Hospital's clinical laboratory were a patchwork of scribbled notes and white-out. In some instances, new results were written on top of the white-out. In others, the words "change" or "RERUN" were written and circled. The notations were evidence of a severe violation: the Cleveland Clinic-owned lab was improperly altering tests designed to verify the accuracy of its results, according to a report by federal investigators. (Ross, 9/25)

In a quiet but competitive building boom, Minnesota hospitals and health systems are spending millions of dollars on clinics and medical services that beckon an increasingly important group of patients: Women. The projects, which total more than $136 million over the last five years, include swank new maternity suites but reach well beyond obstetrics and gynecology to include cancer care, mammography, mental health and even acupuncture and massage. (Howatt, 9/27)

For trauma workers like Jonathan Bartels, a nurse who has worked in emergency care and palliative care, witnessing death over and over again takes a toll. Over time, they can become numb or burned out. But about two years ago, after Bartels and his team at the University of Virginia Medical Center in Charlottesville tried and failed to resuscitate a patient, something happened. (Lofton, 9/28)

Hudson River Health Care is one of the largest health care providers outside New York City. It has 29 health centers across 10 counties, and sees 135,000 patients in a given year. Given the number of patients it sees, one would expect HRHCare to play an integral role in the state’s plans to reform the Medicaid program. In fact, its role will vary, and will depend on its partners. (Goldberg, 9/28)

Recent lawsuits detail allegations of fraud and unethical or illegal medical practices against three of the four corporations in line to manage Iowa’s $4.2 billion annual Medicaid program, a Des Moines Register investigation has found. (Clayworth, 9/27)

When it comes to health care costs, it’s clear: Where you live matters. And in California, the gap is especially sharp between the north and south. Take, for instance, common procedures like a cesarean section or a total knee replacement. The total average price tag for a typical C-section in the four-county Sacramento area is $28,828; in east Los Angeles County, it’s $17,567, according to a health care comparison tool unveiled last week by state officials and Consumer Reports magazine. (Buck, 9/27)

While the Latino population in the U.S. is steadily climbing, to 54 million in 2013, the number of Latino physicians hasn’t kept pace for the past three decades. A 2015 study found that there were 135 Hispanic physicians for every 100,000 Hispanic residents in 1980, but only 105 doctors for every 100,000 Hispanics in 2010. In Dallas County, there are about a million Hispanic residents, and three-fourths of them speak Spanish at home, according to the 2013 census. That’s about 40 percent of the total population, but only 4 percent to 6 percent of area physicians are Hispanic, according to the North Texas doctors group. It’s unclear how many doctors of other ethnicities are fluent in Spanish. (Pineda, 9/27)

Oklahoma ranks 46th among the 50 states and the District of Columbia in funding for mental health issues, according to a new report. The report, funded by the federal Substance Abuse and Mental Health Services Administration, says Oklahoma spends $56.22 per capita on mental health - less than every state and D.C. except Kentucky, Idaho, Florida, Arkansas and Georgia. (9/27)

Connecticut Insurance Commissioner Katharine L. Wade, a former Cigna lobbyist whose husband still works for the company, said she does not intend to recuse herself from considering Anthem’s proposal to buy the Bloomfield insurer. (Levin Becker, 9/25)

A Brooklyn says her Medicaid benefits have been discontinued because she was mistakenly declared dead. Selma Cohen tells WCBS-TV that she received a letter from the city's Bureau of Fraud Investigation that declared her dead. (9/28)

National polls have rated Vermont the least religious state, but there are signs that may not stop some parents from claiming faith to exempt their kids from getting fully vaccinated. Vermont earlier this year passed a law removing the "philosophical exemption" that allowed parents to sign a state Health Department form saying they did not want their children forced to meet the general requirement that they get dozens of shots as a condition of enrolling in school. (9/27)

[T]he 83-year-old longtime Kaiser patient was distraught: The drugs had proved ineffective for her depression, and her next psychiatric appointment was weeks away, a wait she told her family felt interminable. When she stepped off the roof and fell to her death, her suicide stunned onlookers — but was really directed, her husband believes, at her healthcare provider. "She could have jumped anywhere, but she went right to Kaiser," said [Barbara] Ragan's husband, Denny. "It's like sending a message right to them: 'You couldn't take care of me, so here I am.'" The Oakland-based health maintenance organization has battled accusations for more than two years that its mental health services put patients at risk. Now Ragan's suicide has increased scrutiny of the giant healthcare provider, which last year paid a $4-million fine to resolve allegations by the state Department of Managed Health Care that it inadequately treated mental health patients. (Pfeifer, 9/26)

Dr. David Johnson is one of 15 people charged in connection with a scheme that “put greed and money before the care and health of hundreds of patients," according to a bail motion filed by prosecutors Thursday. At Friday's hearing, Deputy Dist. Atty. Dayan Mathai said even after Johnson's arrest last week, his name was used to bill a patient for treatment purportedly done that day. ... Prosecutors said the investigation took five years and that the physician's assistant who performed surgeries, Peter Nelson, had never attended medical school. Patients had been led to believe that the operations would be performed by an orthopedic surgeon, Dr. Munir Uwaydah, 49. (Gerber and Winton, 9/25)

A physician assistant who wasn’t licensed or trained to perform surgery operated on hundreds of patients while the orthopedic surgeon who billed for the procedures schemed with colleagues to hide a massive insurance fraud conspiracy, Los Angeles prosecutors said. Prosecutors opposed reducing bail Friday for 13 people who have pleaded not guilty in the $150 million fraud scheme and outlined the complexity of the operation that spanned a decade and led to unnecessary and scarring surgeries for unwitting patients. (Melley, 9/25)

Two years after Cheshire County received $1.3 million in federal grants for the startup of its felony drug court, officials are preparing for the day those funds run dry. That day is just months away. The future of the well-received program that’s helping address the drug epidemic in New Hampshire is hanging in the balance, county officials said in interviews last week. The drug court costs roughly $384,000 annually, and county officials stress that its future depends on the future of Medicaid expansion in the state. (Dandrea, 9/27)

With Mr. Boehner’s decision to retreat and the right wing claiming victory over his ouster, some Republicans seem to think the right wing might drop the Planned Parenthood fight and approve a budget extension bill this month in order to concentrate on the looming leadership fight. This, of course, would be the height of hypocrisy since far-right Republicans have been howling that defunding Planned Parenthood is a matter of life and death. ... If nothing else, this intramural brawl makes it ever clearer that congressional Republicans are incapable of governing themselves, much less the nation. (9/25)

John Boehner’s resignation as House Speaker, and from his seat in Congress, is an act of personal sacrifice and an education in the limits of political power when government is divided. The question now is whether Republicans will reboot with new leadership, or indulge in more disunity and dysfunction. ... Mr. Boehner made his share of mistakes as Speaker, and the biggest was trusting Mr. Obama to bargain in good faith. He entered solo negotiations with the White House, told his conference to wait and see, and behind closed doors even cut preliminary deals on modest tax and entitlement reform—not once but twice. Mr. Obama suddenly raised his demands each time and then ambushed Mr. Boehner publicly. These double-crosses damaged his credibility among conservatives. (9/25)

The abrupt decision by John A. Boehner to step down as speaker of the House and resign his seat in Congress has elated the bitter-ender conservatives who have made his life miserable for virtually his entire tenure. But it’s bad news for those — including Republican members of Congress — who recognize that Boehner’s right-wing critics were living in a fantasy world. In that parallel universe, the Republican majority could ignore the fact that a Democrat occupied the White House and that the rules of the Senate militated against them enacting their agenda of repealing Obamacare, reversing President Obama’s executive actions on immigration and, more recently, defunding Planned Parenthood. (9/25)

House Speaker John A. Boehner (R-Ohio) insisted on Friday that he was resigning in order to forestall a tough vote on his leadership and “protect the institution” of the House. Protecting the institution, he said, is a speaker’s primary job. We respect his devotion. But a speaker’s primary responsibility is to the nation, not the House. And what the nation needs is a Congress willing to make compromises in the national interest — compromises that Mr. Boehner may have favored but rarely had the stomach to promote. (9/25)

During President Obama’s first two years in office, his party controlled the House and for a time had a supermajority in the Senate. Almost entirely on their own they enacted a nearly $1 trillion stimulus bill, Obamacare and Dodd-Frank financial regulations. Not for the first or last time, alternative suggestions from Republicans were dismissed out of hand. Following that, the American people elected Republicans to the majority in the House. And Mr. Obama’s liberal platform ground to a halt. Spending actually went down. Republicans, led by Speaker Boehner, provided the check and balance voters had demanded. But somewhere along the road, a number of voices on the right began demanding that the Republican Congress not only block Mr. Obama’s agenda but enact a reversal of his policies. (Eric Cantor, 9/25)

But take a look what the House has done this year and it’s not hard to understand conservatives’ frustrations with the Speaker’s leadership: a permanent “doc fix” that increases Medicare spending over the next two decades by $500 billion and took crucial leverage for Medicare reform off the table forever; a House-passed reauthorization of No Child Left Behind despite the objections of conservatives advocating reforms to eliminate Department of Education mandates. Not a single Republican ran on these priorities in 2014 .... After President Obama’s reelection, Speaker Boehner told ABC’s Diane Sawyer that “the election changes” the GOP’s approach to Obamacare. “It’s pretty clear that the president was reelected, Obamacare is the law of the land,” Boehner said. While he might have been previewing the Chamber of Commerce’s new strategy, he certainly wasn’t echoing the sentiment of his rank-and-file members or the party’s conservative base. (Michael A. Needham, 9/25)

[D]uring Barack Obama's presidency, [congressional Republicans] mostly haven't emulated their Gingrich-era predecessors. .... The one policy on which they led was overhauling Medicare, where Representative Paul Ryan got congressional Republicans to support reform and then the party's presidential candidates followed. But in 2014, Republican leaders discouraged candidates from running on ideas of their own and instead urged them to campaign against Obama's. Since taking control of Congress, they haven't voted on conservative proposals to deal with health care, taxes or higher education. They've telegraphed that they're planning to wait for a presidential nominee to supply a platform. While they wait, congressional leaders including Boehner have tried to get budget bills passed on time and acted on the various priorities of business groups. That M.O. inspires neither conservatives nor voters generally. (Ramesh Ponnuru, 9/25)

Why now? Boehner had faced down spitting-mad legislators in his caucus before, as he ricocheted between the establishment and Tea Party members, with the latter preparing to take the country to the brink of a government shutdown this month over their demand to defund Planned Parenthood. Always hungry for Boehner's scalp, the 40 firebrands in his caucus have been aboil over the failure of the party, in control of both Houses, to repeal Obamacare. (Margaret Carlson, 9/25)

If the price of your morning Starbucks fix jumped from $3.45 to $142, you'd probably take your business to Dunkin' Donuts or swear off caffeine altogether. But patients who rely on a drug called Daraprim don't have the option of discontinuing their meds or switching to another brand. And last month, the price of Daraprim jumped from $13.50 a pill to $750. That's an increase of more than 5,000 percent. (9/27)

A year ago, a senior-citizen friend of mine was admitted to a hospital there. “I should have listened to my neighbors and never come to this place,” my friend complained. What disappointed her so much about the hospital? Was it a cleanliness problem, rude staff, or a high infection rate? No, she liked the hospital overall—and indeed it’s a high performer on standard indicators of quality. The hospital’s fatal flaw: dinner wasn’t served until 7 p.m. I actually had the opportunity to speak to the chief executive of that hospital, who said he’d heard similar feedback but it wasn’t a big issue on his radar. This was surprising to me. Shouldn’t customers dominate the executive’s radar? (Leah Binder, 9/26)

Drug companies say high prices are necessary to cover their research and development costs, enabling them to discover innovative new medicines. Turing says it planned to use the profits from Daraprim’s higher price to fund research into better treatments for toxoplasmosis. But in fact, Daraprim illustrates the way most drugs are priced: They are invented not by the companies that sell them now but by someone else. Then, like big fish swallowing little fish, larger companies either buy small firms outright or license promising drugs from them. Very often, the original discovery occurs in a university lab with public funding from the National Institutes of Health (NIH). (Marcia Angell, 9/25)

Pharmaceutical companies are taking a lot of reflected heat in the uproar over the 5,000% price hike for a drug needed by AIDS patients. But so far, the industry's method of making sure that low-income patients get access to high-priced drugs has avoided the spotlight. That's too bad because it deserves a lot of scrutiny. We're talking about "patient-assistance programs," through which drugmakers cover patient co-pays or other costs for their expensive medicines. These programs, which are estimated to cover some 300 drugs and cost the industry $4 billion a year — firm figures are carefully guarded by the industry — are detested by insurers, healthcare economists and government agencies. That's because they're often marketing schemes dressed up to look like altruism. (Michael Hiltzik, 9/25)

Spending on pharmaceuticals is surging again, up 13% in 2014. Surveys show the public is increasingly concerned about the affordability of drugs. Part of the reason for their high costs is the advent of precision (or personalized) medicine, which is producing a new generation of powerful drugs tailored to the genetics of individual patients. (David Blumenthal, 9/26)

Critics of Medicaid expansion in Virginia who reference Kentucky’s experience with federal health care reform should beware: Our success undercuts your whole opposition. Having proved from the beginning that health care reform is both the right thing and the smart thing do, Kentucky has become the poster child for why states should expand Medicaid. The core tenet of health care reform is helping families and saving lives. Not vague political theory, but helping people. That’s what we’re doing in Kentucky. It’s a Christian thing. (Ky. Gov. Steve Beshear, 9/27)

There is only one guaranteed way to get fired from the Department of Veterans Affairs. Falsifying records won’t do it. Prescribing obsolete drugs won’t do it. Cutting all manner of corners on health and safety is, at worst, going to get you a reprimand. No, the only sure-fire way to get canned at the VA is to report any of these matters to authorities who might do something about it. (Jonah Goldberg, 9/27)

Year after year, the emergency department where I practice medicine continues to see more patients. What’s going on? One reason has been identified: no timely access to a primary-care provider. ... But that’s only part of the situation. .... Patients are vulnerable—they get hurt; they are old; they are young; they are weak; they are bleeding; they have collapsed. Health-care economists, administrators and process managers opine that patients without “true emergencies” should be directed to family doctors, urgent-care centers and outpatient clinics. ... That might sound reasonable but ignores what patients experience and perceive. Remember: You can’t teach patients economics lessons when they don’t feel well. (Paul S. Auerbach, 9/25)

And now comes the life-expectancy gap. It may change the national conversation over Social Security and an aging society — for the worse. We all know that the United States is aging, but probably few of us know how skewed the process is in favor of the middle and upper-middle classes. Among men, life expectancy has improved substantially for the richest 60 percent. But for the poorest 40 percent, gains are tiny or nonexistent. Changes for women reflect similar trends, though less sharp. (Robert J. Samuelson, 9/27)