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Six weeks after Deborah Zwaschka-Blansfield had the lower half of her left leg amputated, she received some news from the nursing home where she was recovering: Her insurance would no longer pay, and it was time to move on. The home wanted to release her to a homeless shelter or pay for a week in a motel. “That is not safe for me,” said Ms. Zwaschka-Blansfield, 59, who cannot walk and had hoped to stay in the home, north of Sacramento, until she could do more things for herself — like getting up if she fell. (Bernard and Pear, 2/22)

Many nursing home residents are unaware of their rights. So when these individuals face the threat of eviction, legal advocates say, many of them do not even realize they have the right to challenge their discharge. Below is a list of several of those rights under federal law along with tips from lawyers and advocates who work on behalf of nursing home residents. (Bernard and Pear, 2/22)

Lawmakers on the Senate aging and long-term care committee got a startling and intimate look Wednesday at the abuse and maltreatment seniors and vulnerable adults have suffered at facilities that are supposed to be overseen by the state. One after another, for nearly two hours, family members told their horrific, graphic stories to a group of lawmakers who listened, stunned. (Magan, 2/21)

Dozens of elderly abuse victims and their family members urged lawmakers on Wednesday to overhaul the state’s system for regulating senior care homes, saying current laws are poorly enforced and perpetrators are not adequately punished. Their calls for action came during an emotional, two-hour Senate committee hearing on the state’s handling of elder abuse complaints in senior homes. Leaders of the committee called the hearing to give victims and their relatives an opportunity to tell their stories of abuse. (Serres, 2/21)

One by one at the White House on Wednesday afternoon, survivors of school shootings and family members of victims shared their stories and their calls to action. The extraordinary public exchange with the president gave voice to an intensely emotional debate over how to respond to the latest gun massacre in an American school. (Davis, 2/21)

“I’m pissed,” said Andrew Pollack, whose 18-year-old daughter, Meadow, was killed at Stoneman Douglas. “I’m not going to see my daughter again. She’s not here. She’s at North Lauderdale in King David Cemetery. That’s where I go to see my kid now. ”Mr. Pollack said school safety needed to be the first priority, and then gun laws could be debated later. “How many schools, how many children have to get shot?” he said. (Nicholas and Bender, 2/21)

President Trump leaned forward and listened intently for nearly an hour Wednesday afternoon as students, parents and teachers begged him to do something, anything, to prevent a mass shooting from happening at another school. The group offered a wide variety of suggestions — bolster school security, drill students on what to do during a shooting and raise the age at which someone can buy an assault rifle — but in the end, the president remained focused on the solution he often proposes after a mass shooting: increasing the number of people with guns so they can quickly stop shooters with lethal force. (Johnson and Wagner, 2/21)

U.S. President Donald Trump said on Wednesday his administration would emphasize background checks and mental health in an effort to deal with gun violence in schools after last week's mass shooting at a Florida high school. (Mason, 2/21)

Since the shooting, the president has been looking for a way to take action on guns in response to cries from gun-control advocates and emotional students, whose images have been plastered across television screens around the clock, without alienating his pro-gun base, which he courted with promises to support the Second Amendment. In response to remarks by the families at the listening session, he floated some new ideas, surprising some White House aides, including reopening some of the mental institutions shuttered in the 1970s to house worrisome teens who have not committed any crimes, and arming teachers or other school officials — controversial views that he would have difficulty garnering support for on Capitol Hill. (Johnson and Lima, 2/21)

The spokeswoman for the N.R.A., Dana Loesch, offering the group’s first public comments after a shooting last week at a Florida high school, strongly defended the gun advocacy group’s positions in front of students and teachers from Marjory Stoneman Douglas High School. “People who are crazy should not be able to get firearms,” she said, insisting that enforcement of mental health laws, not new gun restrictions, would prevent future massacres. Mr. Rubio, Republican of Florida, also drew the ire of the crowd for refusing to support a ban on assault weapons and for saying that he intended to continue accepting money from the N.R.A. and other groups that support his pro-gun agenda. (Shear, 2/21)

Rubio, who throughout his career has been a scripted and risk-averse politician, had thrust himself into a volatile and deeply personal discussion. Then, he took another unexpected step. He endorsed raising the age requirement for buying a rifle. Later, he said he was “reconsidering” his opposition to placing new limits on high-capacity magazines. In doing so, Rubio stepped away from the pillars of the powerful gun rights movement that have long influenced the actions of most Republican members of Congress, including himself. (Sullivan and O'Keefe, 2/22)

Seven days after the killing of 17 students and school staff members in Florida, Republican state leaders are facing pressure unlike any they have experienced before to pass legislation addressing gun violence. On Wednesday, swarms of student protesters carrying signs and boxes of petitions stormed the Florida Capitol, pleading with lawmakers to pass tougher gun control in the wake of the deadly shooting at a Broward County school last week. (Turkewitz and Burns, 2/21)

In America’s national debate over guns, Florida is having a moment. From the grieving students swarming Tallahassee Wednesday to the public grilling of Sen. Marco Rubio at a CNN forum Wednesday night, Florida — long a proving ground for national gun policy — is again at the center of the storm in the wake of last week’s mass shooting at Marjory Stoneman Douglas High School in suburban Fort Lauderdale. (Caputo, 2/21)

It was a day of tense exchanges, emotion-packed speeches and confrontation as lawmakers, students and parents sparred on Wednesday over what to do about shootings in American schools. From the nation’s capital to Florida’s State House, people affected by gun violence delivered pain-laced addresses to crowds of passionate supporters, and President Trump listened to a group he had summoned to discuss the problem. There was also some poignant symbolism. (Haag and Stevens, 2/21)

A group of House Democrats is calling on Speaker Paul Ryan (R-Wis.) to take up a bill to repeal restrictions on gun violence research at the Centers for Disease Control and Prevention (CDC). The push to lift the restriction has gained new attention in the wake of the school shooting last week in Florida. (Sullivan, 2/21)

Kaiser Health News: After Shooting, ‘Honor How Kids Want To Deal With Their Feelings’

With so much coverage of last week’s grisly school shooting in Parkland, Fla., students, parents and others are struggling to cope. Christine Sylvest, a child psychologist in Rockville, Md., has a unique perspective. She grew up in Coral Springs, Fla., and attended Marjory Stoneman Douglas High School, the site of the shooting that left 17 people dead. She moved with her family to Ashburn, Va., before her senior year in 1995. “For me, this was my high school,” she said in an interview with Kaiser Health News on Wednesday. “I can image being in that hallway, and I can only imagine the horror.” (Galewitz, 2/22)

Each year, Georgia provides the FBI with the records of thousands of Georgians who have been involuntarily committed for mental health treatment. Their names are added to the National Instant Background Check System that gun sellers check before a sale. (Cook, 2/21)

President Trump’s nominee to lead the Indian Health Service has withdrawn his name from consideration for the position, a spokeswoman for the Department of Health and Humans Services said Wednesday. The withdrawal of the nominee, Robert Weaver, follows Wall Street Journal reports that said he had inaccurately represented his qualifications to the Senate Committee on Indian Affairs after his nomination in October. Mr. Weaver joins a growing list of Trump nominees who have withdrawn from consideration after questions arose about their fitness for their assigned posts. (Baumgaertner, 2/22)

The move by Robert Weaver, a former insurance broker, comes after The Wall Street Journal published two articles earlier this year in which former colleagues alleged he had in some cases exaggerated his work experience and left a former employer in financial disarray. In one case, Mr. Weaver said he had held leadership roles at a large hospital; however, some of his former colleagues and supervisors said his role there was as a registration clerk. (Frosch and Weaver, 2/21)

Weaver came to the administration’s attention after a meeting last February with his congressman, Rep. Markwayne Mullin, an Oklahoma Republican who is leading a bipartisan House task force to examine IHS. Mullin suggested to Weaver that he should apply for the job, and starting last March Weaver made monthly $500 contributions to the Trump campaign until October, when he was formally nominated for the position. Weaver only disclosed the initial $500 contribution in his paperwork for the Senate’s Indian Affairs Committee, which was handling his nomination. (Siddons, 2/21)

White House Chief of Staff John F. Kelly intends to meet with the nation’s leading veterans advocates next week amid ongoing anxiety that there is a desire by some of President Trump’s political appointees to oust Veterans Affairs Secretary David Shulkin, according to people familiar with the matter. The impending White House meeting follows a private gathering Tuesday of the top officials from 12 veterans service organizations (VSOs), including the American Legion, VFW and Disabled Veterans of America. These groups represent millions of former service members and their families, forming one of Trump’s core constituencies. (Wax-Thibodeaux, 2/21)

White House officials have told Veterans Affairs Secretary David Shulkin that his job is safe, according to people familiar with the matter who indicated Tuesday that President Trump decided to “stomach the story” about Shulkin’s alleged misuse of taxpayer money during a 10-day trip to Europe. The president’s decision was communicated to Shulkin by White House Chief of Staff John F. Kelly, according to an administration official who, like others interviewed, spoke on the condition of anonymity to discuss the situation candidly. Trump “personally likes Shulkin,” the official said, cautioning, however, that “if other stuff comes out, this could change, but for now, he’s safe.” (Wax-Thibodeaux, Rein and Dawsey, 2/20)

A major liberal policy group is raising the ante on the health care debate with a new plan that builds on Medicare to guarantee coverage for all. Called "Medicare Extra for All," the proposal to be released Thursday by the Center for American Progress gives politically energized Democrats more options to achieve a long-sought goal. (Alonso-Zaldivar, 2/22)

To help steady its struggling health care exchange, Maryland is considering steps some other states have taken to stabilize insurance markets: revive a sort of insurance for insurers. State lawmakers held hearings on a variety of health care proposals on Wednesday, including one that calls for what’s known as reinsurance, which protects insurers against very high claims. Sen. Thomas Middleton, a Democrat who is sponsoring the bill, said his measure would create a Band-Aid to secure the individual market this year to keep rates down and lay the groundwork for a long-time solution. (Witte, 2/21)

One of the most militantly anti-Obamacare governors, Wisconsin’s Scott Walker, is making strengthening the health care law a key plank of his reelection platform as Republicans fret over potential losses in November. ... It’s a startling turnabout for a chief executive who has repeatedly called for repealing and replacing the health law. (Pradhan, 2/21)

New provisional data released this month by the Centers for Disease Control and Prevention shows that drug overdose deaths declined in 14 states during the 12-month period that ended July 2017, a potentially hopeful sign that policies aimed at curbing the death toll may be working. In an opioid epidemic that began in the late 1990s, drug deaths have been climbing steadily every year, in nearly every state. A break in that trend, even if limited to just 14 states, has prompted cautious optimism among some public health experts. (Vestal, 2/22)

The Food and Drug Administration (FDA) on Wednesday announced a recall of dietary supplements that contain kratom, a herb the agency has classified as an opioid. FDA Commissioner Scott Gottlieb also urged manufacturers to stop selling products intended for human consumption if they contain kratom. (Hellmann, 2/21)

The first major addiction treatment funding to reach the Granite State since President Obama signed it into law in 2016 will be a $2.7 million federal grant for Dartmouth-Hitchcock Medical Center to treat pregnant women using opioids. “Today is an historic moment because now I feel that New Hampshire is not only going to address the opioid epidemic that we face but we are going to lead the rest of the country out of it,” U.S. Rep. Annie Kuster declared at the Family Willows substance use treatment center at Families in Transition in Manchester. (Steinhauser, 2/21)

House Energy and Commerce Committee Chairman Greg Walden (R-Ore.) is aiming to get a House vote on opioid epidemic legislation by Memorial Day. The panel is gearing up to begin work Feb. 28 on bills aimed at curbing the prescription painkiller and heroin epidemic plaguing the country, as overdose deaths from opioid use jumped nearly 28 percent from 2015 to 2016. (Roubein, 2/20)

On Monday, Lucas blew lawmakers a kiss as they heard testimony on a bill that aims to combat the increasing number of babies like him who are born with symptoms of drug withdrawal, known as neonatal abstinence syndrome. ...The bill, sponsored by state Rep. Jered Taylor, a Nixa Republican, would make it a felony if a pregnant woman takes narcotic drugs or controlled substances without a prescription. (Weinberg, 2/21)

Federal investigators this month identified the largest cluster of advanced black lung cases ever officially recorded. More than 400 coal miners frequenting three clinics in southwestern Virginia between 2013 and 2017 were found to have complicated black lung disease, an extreme form characterized by dense masses of scar tissue in the lungs. (Popovich, 2/22)

He wanted me to see the boxes. They were piled six or seven high, and there were so many stacks on the shelves it was hard to take them in all at once. The other aisles of the Virginia Beach Police Department’s evidence storage unit were filled with guns and knives, hard drives and cash piles — objects that had been used to do terrible things to people. But these boxes — rape kits — contained what was left on a person’s body when something terrible had already been done. “I wanted you to see that each one is a victim,” said Lt. Patrick Harris, who had brought me here. “Each one has a name and a story behind it.” (Contrera, 2/20)

Health care providers who treat children who experience traumatic brain injuries would benefit from more training and better coordination across the health care delivery system, a report to Congress from the Centers for Disease Control and Prevention released Wednesday says. Traumatic brain injuries in children is a “significant public health burden” in the U.S., according to the report. Its effects can be “chronic and disabling,” but there is little information on its scope, it says. (McIntire, 2/21)

This story of a man who nearly died in the hospital actually started in the woods of Washington's Cascade Mountains last summer. "I was cutting for a logging outfit up on these rock cliffs and I felled a 150-foot fir tree into [some] maple trees," says Kristopher Kelly, a 51-year-old lumberjack. The maples "had a bunch of dead tops — they call 'em widow makers," Kelly says. "You don't want to get under them because they'll make you a widow." And when the top of the fir tree crashed into those maples, he says, the butt of the tree he had just felled bounced back toward him. (Harris, 2/21)

Night-shift work is linked to an increased risk for Type 2 diabetes, a new study has found. British researchers used a large health database to compare diabetes prevalence in 47,286 night-shift workers with that of 224,928 day workers. (Bakalar, 2/21)

Other amputees have been fitted with brain-controlled hands, but [Ron] Currier is the first to connect these signals with the LUKE Arm, a new prosthesis developed through a public-private partnership involving Albuquerque; Dean Kamen, the New Hampshire engineer who invented the Segway scooter; and the US departments of Defense and Veterans Affairs. (MacQuarrie, 2/22)

A company that provides health care for inmates at the Milwaukee County jail faces criminal charges because employees lied about checking on a man who died of dehydration, prosecutors said Wednesday. The Milwaukee District Attorney's Office charged Miami-based Armor Correctional Health Services Inc. with seven misdemeanor counts of intentionally falsifying health records. The company is the latest defendant to be charged in the death of 38-year-old Terrill Thomas, who spent seven days without water in his cell as punishment in April 2016. (2/21)

The criminal complaint, filed Wednesday, alleges Armor Correctional employees "engaged in a pattern and practice of intentionally falsifying entries in inmate patient health care records." When investigators compared inmates' medical records with jail surveillance footage, they saw Armor Correctional employees walking past cells without stopping or never showing up at all, despite notes that they had checked on inmates. (Luthern, 2/21)

New Jersey's new Democratic governor signed legislation Wednesday setting aside about $7.5 million for family-planning and women's health, reversing course on former Republican Gov. Chris Christie's handling of the issue. It's the first bill that Gov. Phil Murphy has signed into law since succeeding Christie, who vetoed the spending throughout his two terms. (2/21)

The Ohio Hospital Association and state lawmakers are working to combat Anthem Blue Cross Blue Shield's new practice, which could leave Ohio policyholders with thousands of dollars in ER bills, according to Thursday morning's Capitol Letter, cleveland.com's daily Statehouse newsletter. Anthem began denying non-emergency claims Jan. 1 in response to rising visits to the ER that can be 10 times as costly as an urgent care center, said Jeff Blunt, an Anthem spokesman. (Hancock, 2/22)

Like other parents of adult children with autism and other developmental disabilities, Michael and Jennifer Myers had long anguished over how to forge a path for their son after he left school and many support services went away. A generation ago, parents of children with disabilities pushed for protections in the school system. Today’s parents are pressing to integrate their children into jobs in health care, retail and information technology. They are part of a burgeoning national movement, increasingly encouraged by state and federal government policies, to get more people with developmentally disabilities into the workplace. (Wenger, 2/22)

A sexual assault on a patient in Hibbing is among 341 “adverse health events” that occurred at Minnesota hospitals and surgical centers between October 2016 and October 2017, according to an annual report released Thursday. The events ranged from falls resulting in serious injury to pressure sores to “surgery/other invasive procedure performed on wrong patient,” according to the report compiled by the Minnesota Department of Health. The statewide number of the 29 categories the state tracks was up for the fourth straight year, noted state Health Commissioner Jan Malcolm in a news conference. (Lundy, 2/22)

Minnesota health officials say the number of cases of seriously flawed medical care in hospitals and surgery centers has been rising over the last four years. These errors are referred to "adverse events" and state officials say they should occur rarely at most. (Zdechlik, 2/22)

Mayo Clinic earnings jumped by nearly 50 percent last year as the Rochester-based health care system lost less money on Medicaid patients while benefiting from more philanthropy, strong investment returns and efficiency gains. The improved financial performance with Medicaid came after Mayo’s chief executive encouraged workers to “prioritize” patients with private insurance in certain cases, rather than government insurance programs, according to a Star Tribune report last year. (Snowbeck, 2/21)

A federal judge is likely to sentence a prominent Florida eye doctor once accused of bribing Democratic Sen. Bob Menendez of New Jersey to about two decades in prison Thursday for stealing $73 million from Medicare by convincing elderly patients to undergo excruciating tests and treatments they didn't need for diseases they didn't have. (2/22)

Mercy Health and Bon Secours Health System plan to merge to form a 43-hospital entity that serves seven states, the organizations announced Wednesday. The combined system would have $8 billion in net operating revenue and $293 million in operating income. More than 57,000 associates and 2,100 employed physicians and advance practice clinicians would work in more than 1,000 locations across the East Coast, Ohio and Kentucky, including more than 50 home health agencies, hospices, skilled-nursing and assisted-living facilities. (Kacik, 2/21)

Marriottsville-based Bon Secours Health System announced Wednesday that it is merging with Mercy Health of Ohio to create a Catholic health system that will span seven states. The merger, expected to be completed by the end of the year, will create the fifth largest Catholic health system in the country, with $8 billion in operating revenue and 43 hospitals (McDaniels, 2/21)

A hospital district in Pilot Knob, Missouri, filed for protection from its creditors Wednesday, marking the second municipal bankruptcy of the year. The Iron County Hospital District, which owns a local hospital, listed liabilities between $10 and $50 million and assets between $1 million and $10 million. The district has about $6.5 million in bonds outstanding, said Daniel Doyle, a lawyer at Lashly & Baer who is representing the district. (Albright, 2/21)

Health officials are notifying people in three counties that they may have been exposed to tuberculosis, a potentially fatal bacterial disease, through a healthcare worker.   The worker may have had contact with more than 600 people while working in three facilities — two hospitals and a senior rehabilitation and long-term care facility —  in Oakland, Livingston and Washtenaw counties between May 1, 2017 and Jan. 31, 2018, according to the Michigan Department of Health and Human Services. (Patterson and Zaniewski, 2/21)

A researcher who was awarded a $2 million dollar grant last year from the Cancer Prevention and Research Institute of Texas intentionally falsified data in previously published studies, according to the federal agency that oversees misconduct in research. The Office of Research Integrity said in a report this week that Colleen Skau selectively omitted data, overstated numbers and falsified measurements that were included in studies published in the official journal of the National Academy of Sciences in 2015 and the peer-reviewed research journal Cell in 2016 . At the time, she was a postdoctoral researcher at the National Institutes of Health. (Rice, 2/21)

Last year, Americana musician Elizabeth Cook teamed up with Yazoo Brewing Company to create El Lagarto, a beer with benefits. El Lagarto was released last October in conjunction with Nashville's inaugural "Heal the Music Day." Half of the beer's sales revenue was earmarked for the Music Health Alliance, a local nonprofit that helps members of the music industry access health care. (Thanki, 2/21)

Google fired a disabled, queer, transgender engineer for opposing discrimination, harassment and white supremacy among his fellow Googlers, a lawsuit filed Wednesday alleged. The site reliability engineer, Tim Chevalier, claimed in the suit that the Mountain View tech giant’s workplace culture was discriminatory toward minorities. (Baron, 2/21)

A Georgia House panel approved a measure Wednesday that would allow a “modified risk’’ tobacco product to have a tax that’s half of what exists now for cigarettes sold in the state. The FDA has yet to approve such a product to be sold in the U.S. — or to be marketed as being less harmful. (Miller, 2/21)

One of the state's first marijuana pharmacies is looking to open in Metairie nearly two years after Louisiana lawmakers authorized the use of medical marijuana for certain conditions. The Rx Greenhouse last month got preliminary approval from the state Pharmacy Board and plans to be operational by Sept. 1, according to CEO Dr. Sajal Roy, who is also a pharmacist. (Bacon-Blood, 2/21)

Responding to pleas from 11 big-city mayors grappling with the alarming rise of homelessness, California lawmakers on Wednesday announced two proposals that would devote over half of the state’s $6.1 billion budget surplus to the crisis. A bipartisan bill from Assemblyman Phil Ting, D-San Francisco, and backed by Republican Assemblyman Brian Maienschein of San Diego, calls for a one-time infusion of $1.5 billion in matching funds for cities. (Murphy, 2/21)

Massachusetts should consider creating a state-run bank to serve recreational marijuana companies, the state’s top cannabis official suggested Wednesday, warning that an all-cash industry would create security risks and regulatory headaches. With recreational pot sales scheduled to begin in July, Cannabis Control Commission chairman Steve Hoffman said no local banks or credit unions have committed to providing financial services to recreational marijuana shops and other licensed cannabis operations, wary they will run afoul of federal restrictions. (Adams, 2/22)

The federal deficit is big and getting bigger. President Trump’s budget estimates a deficit of nearly $900 billion for 2018 and nearly $1 trillion (with total spending of $4.4 trillion) for 2019. Its balance sheet reveals that the public debt will reach $15.7 trillion by October. This works out to $48,081.61 for every man, woman and child in the U.S. That doesn’t count unfunded liabilities, reported by the Social Security and Medicare Trustees, that are four times the current public debt. How did the federal government’s finances degenerate this far? ...If you’re seeking the reason for the federal government’s chronic budget deficits and crushing national debt, look no further than entitlement programs. (John F. Cogan, 2/21)

Having failed in its effort to have Congress repeal the Affordable Care Act, the Trump administration has been relentlessly trying to destroy the health care law on its own. The latest move in that demolition derby came this week, when officials proposed giving insurance companies more leeway to sell junk health plans. (2/21)

The Trump administration got one thing right in its proposal to loosen Affordable Care Act regulations so insurers could sell skimpier health plans that don't offer the full range of ACA-mandated benefits. It's true, as the White House says, that Obamacare plans can be too expensive for some buyers — those with household incomes exceeding 400% of the federal poverty level, or $48,560 for an individual and $100,400 for a family of four. (Michael Hiltzik, 2/21)

In refusing to expand Medicaid under the Affordable Care Act for the past several years, Virginia Republicans seemed intent on sticking it to President Barack Obama and then-Gov. Terry McAuliffe (D). In fact, they stuck it to themselves, losing 15 seats in this past fall’s elections for the House of Delegates, in most cases to Democrats who promised to expand Medicaid. And the GOP really stuck it to hundreds of thousands of poor and mostly employed working Virginians, especially in rural areas, who lack Medicaid coverage. (2/21)

As an addiction psychiatrist, I have watched with serious concern as the opioid crisis has escalated in the United States over the past several years, and overdose deaths have skyrocketed. ...I have also watched a false narrative about this crisis blossom into conventional wisdom: The myth that the epidemic is driven by patients becoming addicted to doctor-prescribed opioids, or painkillers like hydrocodone (e.g., Vicodin) and oxycodone (e.g., Percocet). (Sally Satel, 2/21)

(Editor's note: This week, JAMA republished this editorial from Nov. 14, 2017).  The journals of the JAMA Network are dedicated to improving the health of people across the globe. We do so by addressing the most important public health problems harming people and publishing the best science that can be done. Research on gun violence is important, although Congress over the last 2 decades has placed limits on that science from being conducted. This attempt to suppress research into gun violence resulted in a 64% decline in the number of firearm studies per million citations in SCOPUS between 1998 and 2012. (Howard Bauchner, Frederick P. Rivara, Robert O. Bonow, Neil M. Bressler, Mary L. (Nora) Disis, Stephan Heckers, S. Andrew Josephson, Melina R. Kibbe, Jay F. Piccirillo, Rita F. Redberg, John S. Rhee, June K. Robinson, 2/21)

In a medical mecca like Boston, which is home to three medical schools and many world-class hospitals, you’d think that getting a timely appointment with a primary care physician or specialist would be a breeze. It isn’t. Finding a doctor is even harder in rural and underserved areas. Yet the public debate on health care remains focused on insurance and funding, and largely ignores the undersupply of health care professionals. Access to care means more than adequate insurance. (Jeffrey S. Flier, 2/21)

A key goal of the [United Network for Organ Sharing] Pediatric Committee is to develop evidence-based policies that improve children’s access to organ transplants. That work could be jeopardized by a recent proposal by UNOS leaders to convert the Pediatric Committee — the lone voice for children in transplantation — to an “expert council” that cannot sponsor policy changes. Under the proposal, advocates for children would be incorporated into larger, adult-focused committees. This troubling move might improve efficiency, but at the risk of decreasing children’s access to lifesaving organ transplants. (Evelyn K. Hsu and Jorge D. Reyes, 2/21)

TV reflects and shapes how we think about each other, including our family and neighbors with disabilities. "Born This Way," "The Good Doctor" and "Speechless" offer role models with high expectations for inclusion and success. These positive TV depictions parallel a hopeful trend in our country — as new statistics show 343,483 more people with disabilities joined the American workforce in 2016. This was four times the rate of the previous year. It’s a combination of fighting stigmas, supporting strong public policies and using best practices to lift up the talents of people with disabilities. (Jack Markell, 2/22)

For many physicians, the term administration elicits a negative response. In fact, some administrative tasks and expenses, such as quality improvement personnel, cybersecurity, backup generators, and even parking, are necessary to enhance patient experience and care. Other expenses, most notably related to billing and insurance-related activities, seem less justifiable. In this issue of JAMA, Tseng and colleagues estimated the administrative costs associated with physician billing and insurance-related activities in one large academic medical center with a fully implemented electronic health record (EHR) system. (Vivian S. Lee and Bonnie B. Blanchfield, 2/20)

The way physicians, hospitals, and other health care professionals are paid influences patient care because payment methods affect business models that clinicians and health care facilities use to prioritize investments, establish infrastructure, and design care processes. Fee-for-service medicine and its volume-based financial incentives can lead to overuse of low-value services and suboptimal care. A consensus is emerging among patients, health care professionals, payers, and purchasers that transitioning to alternative payment models (APMs) that better incentivize value for patients is essential for improving the quality and affordability of health care. (Sam Nussbaum, Mark McClellan, Grischa Metlay, 2/20)