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Without having done much yet, Amazon.com Inc. is already transforming U.S. health care -- and not necessarily for the better. The mere threat of the online giant getting into the health business prompted the country's two largest pharmacy benefit managers -- CVS Health Corp. and Express Scripts Holding Co. -- to join forces with two of its largest insurers, Aetna Inc. and Cigna Corp. These deals will put more U.S. health care under the control of fewer companies. The merging companies say this will lower costs for consumers and the country. But the reality will likely be less rosy and more complicated. (Max Nisen, 3/26)

The American health-care system has a unique problem with paperwork. The sheer number of participants -- doctors, hospitals, clinics, insurance companies, patients -- makes settling payments complicated, time-consuming and really expensive. The share of U.S. health-care spending devoted to administrative costs, including billing, is roughly three times what it is in other affluent countries, and it's a major reason the U.S. spends twice as much on health care. (3/26)

We trust computer technology to solve problems, save time and money, and improve our lives. It has. Why didn’t it work with electronic health records? EHRs are costly, clunky, error prone failures we seem unable to fix. It’s as if we took off in a hastily designed rocket, realize we need to come back, but are stuck in orbit without a reentry plan. (Thomas W. Lagrelius, 3/26)

Pop quiz: What percentage of bankruptcies in the United States are caused by medical bills? If you lived through the debate over passing Obamacare, you probably answered something like “half.” That was the figure in common currency among advocates of health-care reform; then-Sens. Chris Dodd (D-Conn.) and Hillary Clinton (D-N.Y.) were just two of the prominent advocates who used it. Other variants were also popular; Barack Obama, for example, was fond of saying that “the cost of health care now causes a bankruptcy in America every 30 seconds.” (Megan McArdle, 3/26)

Rarely in my lifetime have I seen the type of civic engagement school children and their supporters demonstrated in Washington and other major cities throughout the country this past Saturday. These demonstrations demand our respect. They reveal the broad public support for legislation to minimize the risk of mass killings of school children and others in our society. ...But the demonstrators should seek more effective and more lasting reform. They should demand a repeal of the Second Amendment. (John Paul Stevens, 3/27)

How many times have we heard the advice to “count to three” before doing something impulsive — such as sending an angry text or responding to the president’s tweets? We often regret the things we do or say on the spur of the moment when driven by strong emotions. Many times, we could have saved ourselves from negative consequences if only we had taken a moment for reflection. This is the idea behind establishing a waiting period for handgun purchases. An October 2017 Harvard Business School study found that mandatory waiting periods between the sale of a gun and its arrival save lives. According to the study, states with mandatory waiting periods — regardless of their length — had an average of 17 percent fewer murders and 10 percent fewer suicides. (Raja Krishnamoorthi, 3/26)

Did you know that for every 60-mg caplet of duloxetine dispensed in Ohio through a Medicaid-contracted managed-care company, taxpayers pay a middleman $1.54, but the middleman passes only about 18 cents of that to the pharmacy that supplies the drug and pockets the $1.36 difference? Sen. Bill Coley, R-West Chester, didn’t know, and he’s on the Senate Medicaid Oversight Committee. “We thought there was some nominal fee to PBMs but had no idea (the fees were so large),” Coley said. “It’s ridiculous.” He’s talking about pharmacy benefit managers — private companies that contract with managed-care companies to handle prescriptions — deciding which drugs to cover and how much to reimburse pharmacies for them. (3/27)

In a change from his earlier efforts to enact a ban, Trump’s new order allows the Pentagon to make exceptions allowing some transgender members to serve. The Pentagon hasn’t released official data about how many transgender people are currently serving, but a Rand Corp. study estimated that there are between 1,320 and 6,630 of transgender individuals out of a force of 1.3 million active-duty troops. (3/26)

It's not always easy for teachers and school staff to get to a doctor, some school leaders say. ...So the boards of the three school districts voted this month to team up to open their own employee health clinics, at least one for each district. School leaders expect the move will lower health care costs and make it easier for employees to use the health services they’re offered. (Kristen Taketa, 3/27)

Last June, Assembly Speaker Anthony Rendon unilaterally blocked public hearings, amendments and legislative votes on Senate Bill 562, a Medicare-for-all proposal that had passed the state Senate and that would guarantee health care for all Californians without ever-rising premiums, deductibles and other costs. ...But in a telling admission, lobbyists for the California Medical Association characterized these bills as giving cover to Democrats not to support single payer as proposed by the California Nurses Association. (Deborah Burger, 3/26)