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Recently, CMS introduced its latest payment reform proposal, titled the “Primary Care Initiative.” This is the latest in a long line of federal schemes to try to rein in the cost of medical care and introduce appropriate incentives. Sadly, despite its many efforts, CMS and federal lawmakers have continued to miss the elephant in the room: Regardless of the model CMS imposes, whenever third parties manage transactions, as health insurance companies and governments currently do throughout our health-care system, many normal market forces are hopelessly distorted. (Dr. Chad Savage, 5/17)

Forty years ago, 134 countries pledged to assure “Health For All” by the year 2000. They failed to deliver on that pledge. Today, at least 400 million people have no access to basic medical care, and 40% of the world’s population lacks social security protection. Health is a human right. Humanity’s failure to provide universal health coverage (UHC) is a violation of this right and must be addressed as a top priority. But it won’t truly happen unless the ability to detect illnesses and outbreaks is made an integral part of it. (Madhukar Pai, Catharina Boehme and Ilona Kickbusch, 5/20)

Health-care policy is often portrayed as a fight between government and insurance companies. But one of the most effective cost-saving measures is to cut out both and allow patients to deal directly with doctors. If Todd Gibbons from Poulsbo, Wash., has an aching shoulder or needs a physical, he can call and schedule an appointment on a day’s notice, maybe the same day. His physician is also available for phone consultations and even makes house calls. It all costs Mr. Gibbons $150 a month to cover his family of five. (John Carlson, 5/19)

Many people know by now that the United States spends much more on health care than any other country, and that health outcomes are not a lot better (and in many instances worse). That raises the question: Is our health care spending actually worth it? It’s tricky to figure out the extent of the roles that the environment, genetics and social support play in improving health. Nevertheless, the best evidence tells us that health care is still very valuable, even at U.S. prices. (Austin Frakt, 5/20)

House Democrats last week voted to reverse a Trump Administration rule that the left has branded as promoting “junk insurance.” So note that the vote arrives the same week as a fresh analysis about how short-term health insurance can be a better option than ObamaCare. The Trump Administration last year allowed for short-term, limited-duration health insurance that can last up to a year. Plans can be renewed up to 36 months without new medical underwriting, which can protect against higher premiums if someone falls sick. The Obama Administration limited short-term insurance to three months to force everyone into the ObamaCare exchanges. The Trump crowd thought short-term plans could be viable for relatively healthy folks who earn too much for subsidies and are soaked by Affordable Care Act prices. (5/19)

Imagine that you need surgery to correct a serious condition. You have health insurance, so you begin the process of getting your insurer to approve the operation. It does. A month later, as you are on the road to recovery, you get a bill for the full cost of the surgery and related expenses. When you contact your insurer to determine the next steps, you’re horrified to hear that the company has changed its mind and denied your claim, so it won’t be covering the surgery after all. (Liz Helms, 5/17)

The nation’s opioid epidemic was the furthest thing from my mind on the sweltering Washington afternoon in late July that turned out to be the last time I saw my brother pitch a baseball. A small crowd of parents erupted in a roar as Jonathan, then 17, dropped a devastating curveball for the final out of an all-star game. As a brother, beaming with pride, I admired the self-control and poise Jonathan showed as he confidently strode off the mound. (James "LJ" Winnefeld, 5/17)

Supervised Injection Facilities (SIFs) would provide people more support and clinical care in those most vulnerable moments. SIFs are facilities where people can use drugs under clinical supervision. None currently exist in the United States (with the exception of one underground SIF), but they’ve operated for years in Canada, Europe and Australia. Advocates and lawmakers in the U.S. want to establish SIFs here, too. (Sarah Ruth Bates, 5/17)

In 2018, American women gave birth to the fewest number of children since 1986, according to U.S. government data released last week. The decline since 2007, when a record 4.2 million children were born, has been precipitous. Births have declined every year since then but one, falling to 3.8 million. That amounts to a fertility rate of 1.7 children per American woman in her lifetime -- well below the rate of 2.1 necessary to maintain a stable population. (Adam Minter, 5/19)

The Centers for Disease Control and Prevention (CDC) has just released its latest statistics on U.S. births. Boring, you say. Not so. Historic birth patterns tell us a lot about where the country has been — and where it might be going. We are now experiencing some of the lowest birth figures ever. In 2018, U.S. births totaled 3.78 million , the lowest figure in 32 years. Even worse was the so-called replacement rate: the average number of children each woman must have to stabilize the population, disregarding immigration. (Robert J. Samuelson, 5/19)

When Alex Trebek, the longtime “Jeopardy” host, revealed to the world that he’d been diagnosed with Stage 4 pancreatic cancer this spring, his statement echoed the words of many patients I’ve treated. “I’m going to fight this,” Trebek promised. “I plan to beat the low survival statistics for this disease.” Though I mourned his diagnosis, I also winced at his use of the familiar language of “fighting” and “beating” cancer. As a palliative care physician, I know patients can find it empowering to describe their approach to illness as a battle. But others have shown me that the language of “fighting” a disease or “giving up” is a toxic binary. It divides the sick into winners and losers — those who beat cancer and those whom cancer beats. (Sunita Puri, 5/19)

For decades, millions of patients have been taking a daily aspirin in an attempt to prevent hearts attacks and strokes. But in March 2019, the American College of Cardiology and the American Heart Association released guidelines declaring healthy adults with an average risk for heart disease receive no overall benefit from a daily aspirin. In simple terms, aspirin, or acetylsalicylic acid, is now “low-value medical care.” (Inderveer Mahal, 5/19)

When advocates for legalizing marijuana in California drafted Proposition 64, they made an important concession to win the support — or at least minimize the opposition — of local government and law enforcement groups: Cities and counties, they said, would be allowed to ban marijuana-related businesses entirely if they chose to. That guarantee of local control was a central promise of the proposition. But now, some legislators want to reverse it and force local governments to accept pot stores against their will. It’s an unfair bait-and-switch tactic that should not be approved. (5/18)

Patrick McCarthy retired last year after a decade touching the lives of at-risk youth as president and chief executive of the Annie E. Casey Foundation in Baltimore. In December, Patrick’s co-workers threw a farewell party for their boss at the downtown headquarters. Colleagues offered testimonials. The mayor spoke. Among the guests were a dozen of Patrick’s “running” pals from the Baltimore Pacemakers — a ragtag group of semi-athletes who regularly pound out the miles on Baltimore’s city streets. Most seemed only vaguely aware that the gathering marked an end to something. To our group, it felt like a beginning. (Mark Hyman, 5/18)

It’s a popular and perhaps dangerous belief, reinforced by that inescapable Christmas classic “It’s a Wonderful Life,” that winter is the peak season for suicide. Yet experts have known since the late 1800s that it’s not true: More people take their own lives in the spring months than in other times of the year. No definitive explanations have emerged for why this is so. I can offer an unscientific one from my own experience. For those who are trapped in despair, spring can feel like an affront, the gulf between outer and inner worlds too wide to cross. The poet Edna St. Vincent Millay hinted as much in her poem “Spring,” which asks, “To what purpose, April, do you return again?” (Mary Cregan, 5/18)