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When Republicans failed to repeal ObamaCare last year, it recalled the old line about snatching defeat from the jaws of victory. That loss, however, should not be allowed to overshadow an important Republican success on health care. Millions of Medicare beneficiaries now get their coverage through private plans under Medicare Advantage—a quiet step forward that brings real benefits. To ensure continued progress, Republicans must resist the temptation to choose short-term savings over long-term reform. (Bobby Jindal, 3/21)

Most Americans would agree that gun violence is one of the defining societal problems of our time. But it is also a public-health problem that we can solve — and we can do it without infringing on the rights of law-abiding citizens to have guns.Science alone won’t be able to solve gun violence, which claimed 38,658 lives in 2016 and injured many more. But viewing gun violence as a public-health problem worthy of research has a lot to offer, and can provide a way forward that brings together advocates on both sides of the gun violence debate. (Victor J. Dzau and Mark Rosenberg, 3/21)

When you get really sick, the medical bills may not be your biggest financial shock. New research shows that for a substantial fraction of Americans, a trip to the hospital can mean a permanent reduction in income. Some people bounce right back, but many never work as much again. On average, people in their 50s who are admitted to the hospital will experience a 20 percent drop in income that persists for years. Over all, income losses dwarfed the direct costs of medical care. (Margot Sanger-Katz, 3/21)

A common, sad sentiment was sounded in the aftermath of Tuesday’s shooting at Great Mills High School in Southern Maryland:“The notion of ‘it can’t happen here’ is no longer a notion,” said St. Mary’s County Sheriff Timothy K. Cameron. “If you don’t think this can happen at your school, you are sadly mistaken,” said St. Mary’s Schools Superintendent James Scott Smith. And from parent Shonita Somerville: “I never thought something like this would happen here. St. Mary’s is a small little place. Now I can say, ‘You think it wouldn’t happen? It can happen to anybody.’ ” (3/21)

Something came awake in them. That has to be the explanation. As they cowered in closets, as they said goodbyes and waited, with gunfire echoing down the halls, to die, something inside stirred itself.And when they didn’t die, when these teenagers left the campus of Marjory Stoneman Douglas High in Parkland alive — something 17 of their classmates and teachers did not do — this newly awakened thing drove them like a truck, and they pulled out their cellphones and got to work. The latest results of that work will coalesce in Saturday’s “March For Our Lives” in Washington. (Leonard Pitts, 3/21)

A Republican governor in a conservative state is willing to fight politically for a civil process to separate the violently mentally ill from guns. Get it done. (Robert Robb, 3/21)

The opioid crisis is a complicated problem, for which President Trump offered his usual simplistic approach Monday. His comments emphasized force and punishment, including, as expected, the death penalty for drug traffickers — as well as an attempt to link the drug crisis to immigration by blaming it on “sanctuary cities” supposedly swarming with foreign drug dealers. He offered no new funding for drug treatment beyond the welcome but still inadequate $6 billion two-year program moving through Congress, though to his credit he recommended repeal of a 1970s-era law that prevents Medicaid from paying for care at large inpatient facilities. One reason the president’s rhetoric was so inappropriate is that the drugs at issue are not all illegal. Illicit heroin and fentanyl use has indeed surged in the past half-decade; those two drugs account for the lion’s share of the 64,000 drug overdose deaths in the United States during 2016, according to the Centers for Disease Control and Prevention (CDC). However, if you eliminated them all, the country would still have a massive problem. The epidemic began two decades ago with legally prescribed opioid analgesics such as oxycodone and hydrocodone. And those drugs caused more than 17,000 overdose deaths in 2016. (3/21)

President Trump made big news in New Hampshire this week with his call for applying the death penalty to big drug dealers — and that only goes to show that bad policy makes for easy headlines. The best explanation of why that’s a thoroughly wrong-headed approach is also the simplest: Western societies don’t execute people for those kinds of crimes. Nor should we start. (3/21)

President Donald Trump has finally outlined a comprehensive approach for dealing with the nation’s opioid crisis. He appears to understand that the issue is complex. But his plan to address it is precisely backward in its priorities, underfunded and vague about how it would be carried out. (3/21)

The Senate HELP Committee hearing last week examining the 340B drug discount program, another example of a well-intentioned government scheme gone awry, shows that Washington is finally getting serious about passing much-needed modernization and reform. (Lindsay Boyd Killen, 3/22)

We may be in the early days of a changing political ideology. For decades, politicians on both sides have espoused the belief that copayments and other out-of-pocket charges are necessary to reduce consumer demand for health care. The simple economic argument goes: If patients “feel” some of the health-care cost, those patients will make more prudent health-care choices and forego unnecessary care. (Christopher Robertson and Victor Laurion, 3/21)

Justin Volpe became an all-too-common statistic. Living in Florida in 2006 without medication for his schizophrenia, he descended into a haze of hallucinations, paranoia and substance abuse — ultimately culminating in an arrest for grand larceny. He was taken to the notorious ninth floor of the Miami-Dade County Jail, the “forgotten floor” for people with serious mental illnesses, where inmates were often kept in crowded, unsanitary and perpetually lit cells. In the United States, more than half of adults with a mental illness and more than 90 percent of adults with a substance-use disorder did not receive treatment in the last year. This public-health crisis has now become a criminal-justice crisis. (Steven Leifman and Miriam Krinsky, 3/21)

Recent estimates indicate that approximately 57% of the 36.7 million people living with HIV worldwide are in care and receiving antiretroviral treatment (ART). Although this represents a 20-fold increase in less than 2 decades in the number of people receiving ART, these findings also demonstrate that the global community is still far from achieving the targets laid out by the Joint United Nations Programme on HIV/AIDS (UNAIDS) called 90-90-90—specifically, 90% of all people living with HIV knowing their status; 90% of those diagnosed receiving sustained ART; and 90% of those receiving ART achieving viral suppression by 2020. Accomplishing this ambitious agenda requires sustainable approaches in countries with the highest burden of HIV. (Ingrid T. Katz, Peter Ehrenkranz and Wafaa El-Sadr, 3/20)

Although the good doctor’s name remains obscure in the history of medicine, every person who has visited their dentist since the 1884 discovery of local anesthesia should thank Dr. Carl Koller, who proposed numbing our gums and other exposed body tissues with cocaine. (Howard Markel, 3/21)

Seventeen years have passed since the US National Academy of Medicine (NAM) (then the Institute of Medicine) published Crossing the Quality Chasm, a major effort to outline an approach to improving health care quality. One of the recommendations for improving care envisioned the broader use of evidenced-based clinical practice guidelines (CPGs) as a pathway toward standardization and improved outcomes. The success of this strategy would depend on the supply of trustworthy CPGs and the demand by both clinicians and organized health systems to deploy those CPGs. Quality metrics derived from CPGs were expected to be guideposts for health systems to gauge performance. (David Grossman, 3/21)

The Missouri GOP is going after welfare recipients again. From dictating how recipients can spend their benefits to barring them from withdrawing cash from ATMs, Missouri Republicans are working overtime to crack down on society’s neediest citizens. Under legislation moving through the General Assembly, those on welfare could no longer buy cigarettes or six-packs with benefit money. While that may sound like a healthy mandate, it also ignores reality, which is that poor citizens also need respites from life’s harsh realities. (3/21)