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It is a tribute to the resilience of the United States’ public and private institutions that, despite President Trump’s incoherent management, the country has, by many measures, continued to improve, notching its lowest unemployment rate since 2000 in the latest federal employment update. But the effects of the president’s underinformed instincts, enabled by the ideologues in his administration, are beginning to show up in some of the numbers, representing real pain that Americans are suffering for Mr. Trump’s deficient leadership. (5/6)

The administration of Donald Trump — who had a child out of wedlock after cheating on his first wife, and is in a legal battle with a porn star who says she had sex with him not long after his third wife gave birth — is promoting abstinence with a zeal perhaps never before seen from the federal government. Mr. Trump’s Department of Health and Human Services is quietly advancing an anti-science, ideological agenda. The department last year prematurely ended grants to some teen pregnancy prevention programs, claiming weak evidence of success. More recently, it set new funding rules that favor an abstinence-only approach. In reality, programs that use creative ways to educate teenagers about contraception are one reason teen pregnancy in the United States has plummeted in recent years. (5/5)

Summer is coming. And if you think a warm-weather surge of mosquitoes and ticks is not as frightening as the fictional winter’s White Walkers from “Game of Thrones,” you haven’t read this week’s report by the Centers for Disease Control and Prevention on the rapidly escalating danger of infectious diseases spread by insects. The CDC’s key findings: The number of Americans infected with such diseases, including Zika, West Nile and Lyme, has more than tripled in a decade, jumping from about 30,000 cases a year in 2006 to almost 100,000 in 2016. This total includes nine types of infections never before seen in the United States, including Zika and chikungunya. Looking ahead, 80 percent of state and local health departments are not ready for the insect-borne threat we are facing in just a few weeks. (Ronald A. Klain, 5/4)

Today, an estimated 12 million to 15 million Americans have have sequenced their DNA using one of a few commercial companies such as Ancestry.com or 23AndMe. ...This means that we could be entering an era in which it becomes possible to find every rapist, every killer who leaves behind a genetic trace. (S.I. Rosenbaum, 5/4)

We should have known. The news that Donald Trump dictated his own medical report — despite it being signed by his personal physician Dr. Harold Bornstein — hardly comes as a surprise. In all my years studying, teaching and practicing medicine, I have never heard any doctor say “astonishingly excellent,” or call anyone or anything “unequivocally” the healthiest. (Dhruv Khullar, 5/4)

Here’s a simple idea to help lower health-care costs: publish prices. A bipartisan group of state lawmakers in Colorado is pushing a bill to do precisely that. The Comprehensive Health Care Billing Transparency Act would allow Coloradans to see the true price of any health service they use—exams, procedures, prescriptions—before they undertake treatment. If passed, the legislation would mandate that hospitals and other facilities disclose the base fees they charge for specific services “before applying any discounts, rebates, or other charge adjustment mechanisms.” Every bill sent to a patient would need to include an itemized list, which would allow patients to see if a service had been marked up. By making such information available upfront, the legislation would reintroduce competition to Colorado’s opaque health-care markets. (Tom Coburn, 5/4)

Massachusetts, long a beacon in health care access and among the first states to expand its Medicaid program (a.k.a. MassHealth) substantially in the 1990s, is trying a new approach to rein in costs for that program and it is one worthy of support: creating a closed drug formulary. (Gerard A. Vitti, 5/6)

We are told “we can’t afford a single-payer system.” The real truth is that we spend so much per person for health care, that just spending the same amount in a single-payer system we can provide better care than any of the other countries of the world and care for everyone, not just three-fourths of our population. (Herbert H. Keyser, 5/5)

On Saturday, a group of Christians will gather in Washington for the Freedom March, an event that organizers describe as “a celebration of freedom from homosexuality and transgenderism.” The march will feature speakers like Elizabeth Johnston, the woman behind the Activist Mommy, a right-wing Facebook page with over 500,000 followers. And it’s gaining attention because Luis Javier Ruiz, a survivor of the Pulse shooting in Orlando, Fla., in which Omar Matteen killed 49 people at a gay nightclub in 2015, will be in attendance. (Julie Rodgers, 5/5)

The FDA is cracking down on the sale of e-cigarettes to kids in light of the growing popularity of the vaping device JUUL. Simultaneously, the FDA supports the use of these much less harmful products for smokers who use them to replace smoking deadly cigarettes. Both can be achieved in a balanced fashion without panic. Protecting youth can go hand in glove with saving the lives of the 40 million smokers who will die prematurely if they cannot quit or switch to substantially less harmful alternative products like e-cigarettes. (David Abrams, 5/5)

Needle exchange programs have a controversial history, but medical experts and multiple studies have long acknowledged them for reducing harm when it comes to injection drug use. There have been repeated failed attempts to get such a program going for more than a decade, but now a local task force set up to combat the opioid epidemic is hoping to resurrect the idea. It has much merit. (5/5)

If my sons, Jack and Nick, had known about the risk of misusing prescription medication, they would have made a difference choice that night. They did not know that prescription drugs could kill them. (Becky Savage, 5/4)

In the final hours of the 2017 Iowa legislative session, a bill was passed authorizing the sale and manufacturing of medical cannabis in the state of Iowa. This monumental legislation finally gave Iowans who battle disease and pain an alternative medication to traditional pharmaceutical drugs, including opioids that are now crippling many in our state. The original legislation limited Tetrahydrocannabinol (THC) to 3 percent. This cap on THC will benefit few; for most, it will fail to provide the relief the legislation ultimately promised. Hundreds of advocates, ordinary citizens and terminal patients throughout Iowa have lobbied the Iowa Legislature for years, expressing compassionate stories of suffering and uncontrollable pain. But without removing the THC cap, those suffering will be unable to receive the medicine they need in an affordable and practical way. (R.W. Nelson, 5/4)

In one respect, the “Crisis of Care” described by Dispatch reporter Rita Price in a series of stories last Sunday and Monday is simple: The pay for workers who provide direct care for people with disabilities is so low and the responsibilities so high that not enough people are willing to do it. If only fixing it were as simple. Such caregivers, called direct-support professionals or DSPs, generally are paid through Medicaid waivers. Medicaid is the monster devouring state budgets around the country including in Ohio, and very few lawmakers are interested in spending a dime more on it, for anything. But that can’t be the final word for the tens of thousands of Ohioans with developmental disabilities who need reliable, competent care to live safely at home. (5/6)

Getting older is scary, especially if you reach a point where you’re forced to rely on others for help at home or in a care facility. Sadly, senior citizens and other vulnerable adults in this position are particularly susceptible to physical and emotional abuse, neglect and financial exploitation. Elder abuse is a growing problem only getting worse as our population ages. Research indicates that thousands of elderly adults are harmed in the United States each and every day. ... I recently introduced a plan to help improve the reporting of abuse through a detailed form provided to law enforcement who are called to investigate situations involving frail and vulnerable adults. (Jim Runestad, 5/6)