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The health care discussion in the 2020 Democratic primary race isn’t doing justice to the health care issues that will face Americans and their next president. At a time when U.S. life expectancy has declined for three years in a row, opioids and mental health crises are nearly ubiquitous, and access to affordable care is increasingly dependent on your race, your employer or where you live, these candidates are well-positioned to provide a different vision for the future.Yet they are fixated a single question — and it’s not the very important question of whether every American should have guaranteed access to affordable care. On that, they all agree. No, they are arguing endlessly about the subsidiary question of “how” universal coverage would be achieved: with or without the availability of private employer-based insurance. (Andy Slavitt, 10/8)

President Trump sabotaged the health-care system. Separately, he’s sabotaged the immigration system. And now, in a presidential twofer, on Friday night the administration found a way to sabotage both simultaneously. Unable to repeal Obamacare, the Trump administration has worked to make it less functional and more expensive. It has done this by zeroing out the individual mandate, expanding the availability of cheap but worthless junk insurance and curtailing the annual open-enrollment period, among other actions. (Catherine Rampell, 10/7)

Even a divided America can agree on this goal: a health system that is cheaper but doesn’t sacrifice quality. In other words, just get rid of the waste. A new study, published Monday in JAMA, finds that roughly 20 percent to 25 percent of American health care spending is wasteful. It’s a startling number but not a new finding. What is surprising is how little we know about how to prevent it. (Austin Frakt, 10/7)