�Թϲ�����

While the early advocates for the liberal prescription of opioids are no longer vocal, there continue to be insidious incentives to prescribe opioids. For instance, physician reimbursement is now closely linked to patient satisfaction surveys. There is deep concern in the medical community that overprescribing may be occurring as a function of the desire to optimize patient satisfaction. How do we start to make things better? (Brian D. Sites and Matthew A. Davis, 8/1)

The opioid crisis in Missouri has reached epidemic portions. It is the No. 1 public health crisis that we face. In 2016, there were 908 opioid- or heroin-related deaths in the state, a 35 percent increase over 2015. Every day, two babies are born in Missouri addicted to opioids. And the numbers are rising. Gov. Eric Greitens is leading the Missouri government in the fight against this modern-day plague. Two recent actions stand out as being innovative in our efforts to save live. (Randall W. Williams, 8/1)

Digging Ohio out from under the opioid-addiction scourge that is killing eight people in the state every day won’t be nearly as easy as falling victim to it was. But it’s good to see the state and local communities working steadily, one idea at a time, to fix the damage and change the culture. (8/2)

Preventing infections in the first place will also reduce the need for antibiotics. That’s where vaccines come in as an important part of the solution. Vaccines are an icon of prevention, well-regarded as one of the best buys in health. With immunization averting up to 3 million deaths annually, no health intervention better embodies the old adage that an ounce of prevention is worth a pound of cure. But in the context of the global trend in antibiotic resistance, we have been undervaluing all that vaccines offer to both individuals and communities. (Bruce Gellin, 8/1)

Thousands of 7th- and 12th-grade Iowa students are not supposed to attend school this fall if they are not vaccinated against meningitis. Though classes start in a few weeks, about 4,000 students in Polk County have not been immunized, according to local health officials. And Iowa has 98 more counties. (8/1)

Believers in the quest to make America great again should consider where there’s evidence things are going down the tubes. There’s hardly a more dismal example than the national decline in sperm production. Last week, scientists published a study confirming that sperm counts are half what they were in the early 1970s -- and not just in America, but in Europe, Australia and New Zealand, too. The more alarmist accounts warned that the human race is teetering on the brink of extinction. (Faye Flam, 8/1)

Democrats will fund anti-choice candidates in conservative districts, Representative Ben Ray Luján, chairman of the Democratic Congressional Campaign Committee, said in an interview this week, citing the party’s need to build “a broad coalition” to win control of Congress in 2018. “There is not a litmus test for Democratic candidates,” Luján told The Hill. “As we look at candidates across the country, you need to make sure you have candidates that fit the district, that can win in these districts across America.” (Lindy West, 8/2)

Encouraged by President Trump’s abysmal approval ratings and dysfunction in the Republican-controlled Congress, Democrats are entertaining scenarios of recapturing control of Capitol Hill in 2018 — and key to that scenario is coaxing back voters who supported Trump in 2016. Part of that strategy is a message heavy on economics and light on identity politics, but it also involves recruiting candidates in swing districts who might depart from liberal orthodoxy on social issues. (Michael McGough, 8/1)

Yet, based on recent testing data, San Jose Unified appears to only take the presence of lead in drinking water seriously if there’s at least 15 times the pediatricians’ standard, and then only if the taps test high for lead at least twice. This is a problem because a 15 parts per billion threshold for action is not a safety standard for kids. (Jason Pfeifle, 8/1)

SB 349 by Sen. Ricardo Lara would establish the strictest-in-the-nation staffing minimums for nurses and technicians in dialysis clinics, where patients in kidney failure have their blood cleansed several times a week. It may sound humanitarian, but it’s a craven play for union support in the senator’s run for Insurance Commissioner next year. (8/1)

Public health advocates should be jumping for joy at the U.S. Food and Drug Administration’s announcement that it would explore ways to reduce nicotine levels in conventional cigarettes to non-addictive levels. Such a policy could save millions of lives if it caused the estimated 36.5 million Americans who smoke regularly to lose interest in lighting up. Smoking may be on the wane, but it is still the leading cause of preventable death in the United States, according to the Centers for Disease Control and Prevention. (8/1)