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The real potential for change this year comes instead from the Affordable Care Act’s quieter half, its expansion of Medicaid to cover a larger subset of low-income Americans. If things go well for Democrats in November as many expect — with congressional wins providing momentum down ticket and on statewide ballots — that will set the stage for Medicaid expansion to, well, expand. The chance that more states will embrace the program offers a much more concrete and likely way toward greater health coverage than a near-term exchange resurgence, let alone Medicare For All, which won’t be a serious policy possibility until at least 2020. (Max Nisen, 9/11)

Under a government-controlled health care system the government is the only payer. As a result the political party in power would be able to set the prices they are willing to pay and limit the services they are willing to reimburse and dictate the bureaucratic rules for payment. Most importantly what is missing is choice. Health care is not one size fits all and the insurance options that work for a family of four will not be the same as for a young entrepreneur or a couple nearing retirement. The role of the health insurance agent is to help individuals, families, and businesses chose the insurance that is the best for them. However, in order to do this there needs to be a robust and competitive health insurance market that allows for innovation and customization. (Keith Wright, 9/11)

Have we forgotten that pollution kills? Apparently the Trump administration has or never actually believed that pollution is a serious threat to our health and well-being. Let’s be reminded that pollution through toxic chemicals, fine particulate matter, and indirectly through greenhouse gasses contributes to cancers, respiratory conditions including asthma and COPD exacerbations, heart disease, birth defects, developmental problems in children, brain and nervous system damage, and ultimately premature death. The Trump administration has rolled back or proposed reversal of more than 60 Environmental Protection Agency regulations benefiting industry at the expense of human health. What is good for business sometimes is really bad for health. We might as well rename the EPA as the Industrial Protection Agency. (Richard Feldman, 9/11)

The concept of free innovation has entered the technology lexicon, particularly when it comes to health care. The term refers to innovations developed in creators’ personal time and unprotected by patent or copyright. Hundreds of examples are visible on platforms like Arduino and Hackaday.Free innovation is a variation on the decentralized supply and demand found in traditional markets. As in some other unconventional markets, it’s driven by motives besides the immediate monetary rewards directly attributable to product distribution. (Some indirect monetary rewards, like advertisements on a development site, sale of user data, or payoffs from resume-building, might be part of the equation.) Why is free innovation gaining traction now in the health space? At least five features of the contemporary economy contribute to the trend. (Robert Graboyes and Sara Rogers, 9/11)

Less than 5 percent of OB-GYNs practicing in Sacramento, Calif., are under age 40. West Texas can’t recruit enough psychiatrists to meet the region’s needs. All but two of Alabama’s rural counties need more primary care physicians.For most Americans, the physician shortage feels familiar: months to get an appointment, hours in the waiting room, and a visit so quick you barely scratch the surface. But it’s only going to get worse. (Elsa Pearson and Austin Frakt, 9/11)

The U.S. government’s nutrition advice since 1980 has mainly been to increase consumption of carbohydrates and avoid fats. Despite following this advice for nearly four decades, Americans are sicker and fatter than ever. Such a record of failure should have discredited the nutrition establishment. Yet defenders of the nutrition status quo continue to mislead the public and put Americans’ health at risk. A widely reported study last month purported to show that carbohydrates are essential to longevity and that low-carb diets are “linked to early death,” as a USA Today headline put it. The study, published in the Lancet Public Health journal, is the nutrition elite’s response to the challenge coming from a fast-growing body of evidence demonstrating the health benefits of low-carb eating. (Nina Teicholz, 9/11)

The CRISPR patent dispute between the University of California, Berkeley, and the Broad Institute is finally over. As almost everyone following the case predicted, the U.S. Court of Appeals for the Federal Circuit affirmed Monday the U.S. patent office’s decision that there was “no interference-in-fact” between UC Berkeley’s patent application and more than a dozen Broad patents. In plain English: Broad researcher Feng Zhang’s CRISPR patents were sufficiently inventive over the UC Berkeley’s patent applications with Jennifer Doudna and Emmanuelle Charpentier. Many scientists disagree with the decision, believing that it fails to comport with how molecular biology is actually practiced. I agree with them. But that doesn’t make the Federal Circuit’s decision wrong. In fact, I think its decision is absolutely correct. (Jacob S. Sherkow, 9/11)

Sept. 12 marks two years since the funeral of my 15-month-old son, Liam. He had been in a stroller, being pushed through a pedestrian crosswalk in suburban Los Angeles by my sister-in-law, who was 15 years old at the time. She had done everything right: pressed the button, waited for the lights to change and then started walking. Other cars stopped, but one didn’t. Police later estimated that the car was going 35 to 40 mph as it smashed into Liam and my sister-in-law. The car was driven by a 72-year-old woman. She was drunk and behind the wheel at 3:30 in the afternoon. (Marcus Kowal, 9/11)

With the White House declaring the opioid epidemic a national public health emergency earlier this year, the discussion rages on across the country about how exactly to solve this growing problem. Much of that discussion is now shifting to the specialized drug treatment facilities that help those battling this deadly disease. (Salvatore G. Rotella, 9/11)

About 72,000 Americans died from drug overdoses in 2017. That’s nearly 200 people per day — more than the number of people killed in car accidents. Fatal overdoses have been on the rise in recent years, due in large part to the proliferation of tremendously dangerous synthetic opioids such as fentanyl, and it’s a safe bet that the daily death rate will be higher again by the end of this year. ...Last month, the Legislature gave its blessing to a proposal under which San Francisco would be allowed to open one safe injection facility on a three-year trial basis. It was a scaled-back version of a controversial bill that gave the same permission to seven other counties, including Los Angeles. That bill stalled a year earlier after a contentious legislative battle. The narrower bill is now on the desk of Gov. Jerry Brown. He should sign it, despite the threat leveled by Deputy U.S. Atty. Gen. Rod Rosenstein in an op-ed in the New York Times in August, the day after the Legislature approved the bill. (9/12)

Kentucky is on an avoidable pathway to bankruptcy. There are at least two reasons for conservatives to support eliminating Medicaid expansion to help fix this problem. The first is simple arithmetic. Since just after the implementation of the Great Society, government entities have explored incalculable theories on how to restrain growing health care costs. They have all failed. In the last 50 years, health care spending has outpaced GDP growth by nearly 2.5 percent annually, making a massive difference over time. In 1960, health spending as a share of GDP was approximately 5 percent. By 2013, the year before Kentucky adopted Medicaid expansion, health care spending had grown to 17.4 percent of GDP. By 2025, health care spending will rise to nearly 20 percent of GDP. (Jordan Harris, 9/11)