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Republicans in Congress are plowing ahead on tax reform, and one obstacle is the complexity of Senate budget rules that limit how much taxes can be cut. The good news is that for once Washington’s fiscal fictions could be deployed to improve policy by repealing ObamaCare’s individual mandate as part of tax reform. The Senate Finance Committee on Thursday released the details of its tax proposal, which includes a permanent 20% corporate rate and more. Senators Pat Toomey and Bob Corker cut a budget deal to allow for $1.5 trillion in net tax cuts over 10 years without accounting for faster economic growth (and more revenues) as a result of reform. (11/12)

If you were deliberately trying to design the most arbitrary, painful and pointless tax possible, how would you go about it? First, you would structure it to inflate the cost of an essential product. Then, you’d create exemptions so vast that only 5% of taxpayers were subject to it. You might even ensure that it hit people only when they were particularly vulnerable—like when they’d lost a job. Finally, you would use it to drive enrollment in entitlements, so that it increased the federal deficit by $338 billion. (Chris Pope, 11/12)

The pharmaceutical industry was listed as one of the “Contributors to the Current Crisis” in the final report of President Trump’s Commission on Combating Drug Addiction and the Opioid Crisis. The report cites decades of aggressive marketing and industry-sponsored physician “conferences” aimed at expanding opioid use by minimizing the dangers of addiction. Lawsuits by state attorneys general, counties and local jurisdictions allege that the industry fostered the epidemic by overpromoting its products, while raking in billions as Americans became addicted and overdosed. “To this day,” the commission says, “the opioid pharmaceutical industry influences the nation’s response to the crisis.” (11/10)

Over the past decade, Medicaid spending has grown at an annual rate of 8.9 percent — far faster than the budget as a whole (although that has grown plenty, too). ...Officials hope a new approach will keep it from hitting one-fourth of the budget. They intend to shift thousands of beneficiaries from the traditional fee-for-service model to a managed-care system conducted through private insurance companies. (11/11)

Will “virtual medicine” transform the American health-care system? Will the latest computer-based technologies—apps, wearables, remote monitors and other high-tech devices—make Americans healthier? That’s the promise made by tech gurus, who see a future in which doctors and patients alike track health problems in real time, monitor changing conditions and ensure both healthy habits and compliance with drug and therapy regimens. (Ezekiel J. Emanuel, 11/10)

Most doctors are not geniuses, but even geniuses make mistakes. As a diagnostician myself, I’d like to believe I’ve made some good, even great, diagnoses in my day. But patients need to spend more time focusing on a more important issue — physician error. (Vinita Parkash, 11/13)

Where “DFCS” was once a four-letter word, the Division now actively seeks to become a regular part of community conversations—even the difficult ones—because families are less likely to fall through the cracks when communities are actively engaged in their success. (Bobby Cagle, 11/11)