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Health-policy experts have long debated whether better outcomes and lower costs are achieved by putting more consumer “skin in the game” or by changing how providers such as hospitals and doctors are paid. It doesn’t have to be one or the other, but it’s becoming increasingly clear that if forced to choose, we should focus mostly on the incentives for providers. (Peter R. Orszag, 10/31)

Health care is routinely cited by voters as their top issue as they head to the polls next Tuesday, and rightly so — the midterms could help decide whether many Americans will have access to care and how much it will cost. Mr. Hawley is only one of many candidates on both sides of the aisle eager to convince them that he’s in their corner. Given that interest, it’s worth clarifying the record on these issues so voters are informed heading into the polls. Will Republicans try to repeal the Affordable Care Act again? Will Democrats push hard toward a single-payer system — and, if so, what will that mean for employer-based insurance and Medicare as we know it? And which party will be more likely to protect Americans with pre-existing medical conditions from insurance discrimination? (10/31)

On Thursday, the Affordable Care Act health-insurance exchanges open for the sixth year. A well-kept secret about them is hiding in plain sight: Despite the Trump administration’s best sabotage efforts, the exchanges are succeeding. Indeed, by almost every metric, the exchanges are now stable and even thriving. Just days before an election in which health care is a top issue, this important point has been almost totally ignored. (Ezekiel Emanuel, 10/31)

Earnings are now in at most of the biggest pharmaceutical firms, and one thing is clear from their results: One of President Donald Trump's most visible efforts to strong-arm them on prices hasn't caused much pain. (Max Nisen, 10/31)

To be truly effective, our pain treatment programs and our policies should be evidence-based. They should be patient-centered. And, as one component of patient-centeredness, they should be accessible to those who need them. Three examples of ways to increase patient access to pain care include integrating foundational pain education into the trainings of all health-care clinicians, preserving access to physician-prescribed medication (including opioids when appropriate) and providing digital behavioral pain medicine to patients who cannot easily access in-person treatment. (Beth Darnall, 10/31)

Today, 200 Americans likely will die from a drug overdose. Most of them will die alone. The government's modern-day response to our nation's overdose epidemic has been woefully inadequate. Rather than relying on medical science, our leaders have been influenced by the same misguided approaches that undergirded the “war on drugs” in the 1980s — fear, stigma and racism. We need a smarter strategy that reduces harm and saves lives. This starts with prosecutors ending the criminal crackdown on drug users — pushing for treatment instead of pressing charges; encouraging law enforcement to change street approaches; and, most of all, calling for the development of overdose prevention sites where people can consume substances under supervision, get clean needles, and get access to treatment and counseling. (Miriam Aroni Krinsky and Dan Satterberg, 11/1)

In short, the Trump administration is relying upon a historical falsehood in saying that the definition of sex is old and well established, and it moreover relies upon specific historical interpretations of sex that no longer reflect scientific consensus. Historically speaking, biological sex has never had a stable definition. (Tom Butcher, 10/31)

Illinois’ experience with tightly controlled medical marijuana production and sales is worth deeper study by Missouri. If medical marijuana is legalized here after Tuesday, Missouri officials should consider a visit to Springfield, armed with that big question: Having done this, what would you have done differently? (10/31)

As voters in Michigan and North Dakota head to the polls Tuesday to weigh whether marijuana should be legal for recreational use, they don’t have much definitive data to help make this difficult choice.Although marijuana has been sold legally in Colorado and Washington state since 2014, conclusions about its effect on public health and safety are either limited or mixed. ...While legalizing sales remains a tough choice, some changes in the nation’s policies are clearly needed: Harsh criminal penalties for personal use should be abandoned. And medicinal use — already legal in 31 states and up for a vote in Missouri and Utah on Tuesday — makes sense, as long as laws are not so loose that anyone can get a prescription. (10/31)