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The Trump administration's Medicare chief on Wednesday slammed Sen. Bernie Sanders' call for a national health plan, saying "Medicare for All" would undermine care for seniors and become "Medicare for None." The broadside from Medicare and Medicaid administrator Seema Verma came in a San Francisco speech that coincides with a focus on health care in contentious midterm congressional elections. (7/25)

"Ideas like 'Medicare for all' would only serve to hurt and divert focus from seniors,” Verma said. Verma said the focus of Medicare should be on seniors and disabled individuals and that expanding the program to cover younger, healthier people will drain the program of funding and deprive seniors of the coverage they need. “By choosing a socialized system, you are giving the government complete control over the decisions pertaining to your care or whether you receive care at all. It would be the furthest thing from patient-centric care,” Verma said. (Weixel, 7/25)

Thirty-three of the 57 Democrats who won primaries in swing districts this year expressed support some form of Medicare for all, according to data from the Progressive Change Campaign Committee. Nearly two-thirds of that group use the term in their campaign materials and just over a quarter are running in districts that President Donald Trump won. Verma said the focus of Medicare should be on seniors and disabled individuals, and she is concerned that moving millions more people into the program will cause the program to unravel as its finite funds would dry up. Earlier this year, the White House estimated that the Medicare trust fund will be insolvent by 2026, three years earlier than prior estimates. (Dickson, 7/25)

Stepping into the land of the Trump resistance, Seema Verma flatly rejected California’s pursuit of single-payer health care as unworkable and dismissed the Affordable Care Act as too flawed to ever succeed. Speaking Wednesday at the Commonwealth Club here, the administrator of the Centers for Medicare & Medicaid Services said she supports granting states flexibility on health care but indicated she would not give California the leeway it would need to spend federal money on a single-payer system. (Terhune, 7/26)

The debate over single payer in California has played a central role in the state's gubernatorial election. Expanding health care to all residents is a key campaign goal for Lt. Gov. Gavin Newsom, the leading candidate. A single payer bill passed the Senate last year but has remained stalled in the Assembly. (Colliver and Cancryn, 7/25)

In a massive outpatient payment rule, the CMS on Wednesday proposed expanding its site neutral payment policy to clinic visits, a move that could save the agency hundreds of millions of dollars. Clinic visits, or checkups, are the most common service billed under the outpatient pay rule. The CMS often pays more for the same type of clinic visit in the hospital outpatient setting than in the physician office setting. (Dickson, 7/25)

One year ago, with the flick of his thumb, Sen. John McCain (R-Ariz.) foiled the Republican Party’s quest to undo the Affordable Care Act and fulfill a seven-year promise to remake the health-care system. Now, three months from the midterm elections, health care remains a gaping political vulnerability for the GOP. Although Republicans have been unable to produce an alternative to the law, they have succeed in undoing key provisions that critics say are leading to rising premiums for individual buyers of health insurance. (DeBonis and Goldstein, 7/25)

A majority of the public says they hold the Trump administration and Congress accountable for any problems with ObamaCare because they have made changes to the law, according to a poll released Wednesday. The Kaiser Family Foundation tracking poll found that a majority of those surveyed — 58 percent — said they hold the administration and Republican members of Congress responsible for any problems with the ACA moving forward, since they have made a number of changes to the law. (Hellmann, 7/25)

Anthem Inc reported a better-than-expected profit on Wednesday, driven by higher premiums and lower patient medical costs even as fewer people enrolled in its insurance plans. Enrollment fell about 2.2 percent to 39.5 million members at the end of the quarter, hit by a decline in the number of people signing up for Medicaid as well as for its Obamacare plans. (Banerjee and Mathias, 7/25)

The House on Wednesday passed a measure to delay ObamaCare’s health insurance tax for two years and expand Health Savings Accounts, part of a GOP effort to try to lower premiums. The bill, which passed 242-176, is part of a Republican effort to blunt Democratic attacks on the GOP for rising premiums – a key argument in the midterm elections this year. (Sullivan, 7/25)

The votes come on the heels of Tuesday's House passage of a bill (HR 184) that would repeal the medical device tax and ahead of the House’s August recess, offering Republicans a health care message to point to when talking with constituents over the next few weeks. Republicans are touting the bills as a way to put Americans in greater control of their health spending as health care costs continue to rise. Health savings accounts, which are paired with high deductible health plans, allow people who maintain them to contribute pre-tax earnings to them each year and save for medical expenses. (McIntire, 7/25)

Industry groups say they’ll continue their hard press to secure a Senate vote to repeal a tax on medical device manufacturers this year. The House voted, 283-132, on Tuesday to repeal the 2.3 percent excise tax on medical device manufacturers levied under the 2010 health care law (PL 111-148, PL 111-152), but the Senate hasn’t indicated any plans to take up the legislation. (McIntire, 7/25)

Homeland Security officials may have neglected to give a choice to as many as three-quarters of all migrant parents removed from the United States about leaving their children behind, contradicting repeated public assurances from Homeland Security Secretary Kirstjen Nielsen. The Trump administration failed to document consent in most such cases, an administration official told POLITICO. That lapse increased the number of departed parents whom officials must now find and contact about whether they wish to be reunited with their children, and, if so, figure out the logistics of how to bring them together. The revelation threatens to delay reunifications one day ahead of a court-ordered deadline to return most migrant children to their parents. (Hesson, Rayasam and Diamond, 7/25)

Maria Marroquin Perdomo fretted as she waited with her 11-year-old son, Abisai, in the New Orleans International Airport. A day earlier, the mother and son had been reunited in Texas after being separated by U.S. immigration officials for more than a month, an ordeal that followed a harrowing journey from Honduras. Now they awaited another reunion: With the father Abisai had not seen in person since he was an infant. (Thevenot and Elliott, 7/25)

Employees at two Arizona facilities housing migrant children separated from their parents at the border have been accused of inappropriate contact with minors on at least two occasions since 2015, including an incident that led to a conviction for sexual abuse, police records show. The reports were made at Southwest Key's Glendale and Tucson facilities and predate the Trump administration's "zero tolerance" policy that led to the separation of families that illegally crossed the U.S.-Mexico border. (Philip, 7/25)

Since 2011, a year when Kentucky was flooded with 371 million doses of opioid painkillers, state officials have cracked down on pain clinics, sued pharmaceutical companies and limited how many pills doctors can prescribe. The result is nearly 100 million fewer opioid prescriptions in 2017 — and an 11.5 percent increase in drug overdose deaths. (Beam, 7/25)

CMS is proposing new changes to payment policies for hospital outpatient departments and ambulatory surgical centers in 2019 to address the opioid crisis. Medicare would pay more for non-opioid pain management drugs used in surgical procedures at ambulatory surgery centers. (Karlin-Smith, 7/25)

While most celebrities tend to hide their struggles with drugs and battles with depression, Demi Lovato not only acknowledged her issues, she’s shared them with the world. Lovato has been an open book since she announced in 2010 that she was checking into a rehabilitation center to deal with an eating disorder, self-mutilation and other issues. Over the next eight years, she became a role model and bona fide pop star, releasing multi-platinum songs and albums that range from playful to serious with lyrical content about her battles with drugs and alcohol. (Fekadu, 7/25)

A southern Missouri paramedic has pleaded guilty to stealing opioids and filling the empty vials with saline solution. The Springfield News-Leader reports that 30-year-old Zachary McCleary pleaded guilty Monday to tampering with a consumer product. Prosecutors say 18 patients in Barton County alone reported getting salt water instead of painkillers because of McCleary's actions. (7/25)

Jackson County has joined the parade of local governments suing a slew of large companies connected to the opioid industry. The county, represented by William Lee Dameron of Williams Dierks Dameron LLC, filed suit Wednesday in federal court, accusing opioid manufacturers, drug distributors and pharmacies of creating a “public health epidemic” by using deceptive marketing and evading regulations on selling controlled substances. (Marso and Ryan, 7/25)

As Tennesseans have grappled with the opioid crisis, Williamson County residents haven't sat unaffected. According to the latest data from the Tennessee Department of Health, 26 people in Williamson County died from a drug overdose in 2016. Of those who died, 19 suffered from an opioid overdose.  (West, 7/25)

Lowering blood pressure more than usually recommended not only helps prevent heart problems, it also cuts the risk of mental decline that often leads to Alzheimer's disease, a major study finds. It's the first time a single step has been clearly shown to help prevent a dreaded condition that has had people trying crossword puzzles, diet supplements and a host of other things in hope of keeping their mind sharp. (7/25)

The study showed that using common medications to reduce systolic blood pressure to below 120 reduced the risk of mild cognitive impairment by about 19% compared with lowering to less than 140—the standard target until a few years ago. Mild cognitive impairment is a slight but noticeable decline in memory and other thinking skills and is considered a potential precursor to dementia. It increases a patient’s risk of Alzheimer’s disease, the dementia-causing disorder that affects about 5.7 million Americans. (Loftus, 7/25)

The findings, which are expected to be published later this year, could provide a relatively easy way to lower the rate of Alzheimer’s dementia, which in the United States is 10 percent of people 65 and older. “For many years now, we’ve observed that people with lower blood pressure, even if it’s achieved through medication, have a lower risk for developing dementia,” said Jeff Williamson, professor of internal medicine and epidemiology and chief of geriatric medicine at Wake Forest School of Medicine in Winston-Salem, N.C., who presented the study. “Now, for the first time in history, we have something to say if you lower your blood pressure you can lower your risk for mild cognitive impairment and dementia.” (Bahrampour, 7/25)

Systolic blood pressure is the amount of pressure in a person’s arteries during the contraction of her heart muscle. Because it is the highest pressure to which the blood vessels are subjected, systolic blood pressure is thought to have the most detrimental impact on the delicate capillaries that nourish the brain as well as the kidneys, heart and liver. In large populations, lowering that reading to 120 already has been found to reduce rates of cardiovascular disease and kidney failure. (Healy, 7/25)

For the first time in history, researchers have found medicine that can reduce the risk of memory loss and dementia in your golden years. Even better, most forms of the treatment are available in safe, inexpensive generic formulations. The twist? These drugs have been around for decades, since they’re widely used to lower blood pressure and ward off heart disease. (Cortez, 7/25)

A handful of Alzheimer’s patients signed up for a bold experiment: They let scientists beam sound waves into the brain to temporarily jiggle an opening in its protective shield. The so-called blood-brain barrier prevents germs and other damaging substances from leaching in through the bloodstream — but it can block drugs for Alzheimer’s, brain tumors and other neurologic diseases, too. Canadian researchers on Wednesday reported early hints that technology called focused ultrasound can safely poke holes in that barrier — holes that quickly sealed back up — a step toward one day using the non-invasive device to push brain treatments through. (Neergaard, 7/25)

Dr. Paul Turek was on his way to speak to employees at a cryptocurrency investment firm one recent afternoon about a growing anxiety for the men in the office: what’s going on with their sperm? Is there enough? Is the existing supply satisfactory? Are we men enough? “They’re worried, right?” Dr. Turek said. “And we’re O.K. with the worry.” (Bowles, 7/25)

As the world discovered in 2016, the seemingly benign Zika virus is capable of inflicting life-altering damage when it finds its way into the developing brains of fetuses. Now scientists hope to harness that horrible potential as a weapon to fight cancer. Several research groups are exploring whether Zika viruses could be unleashed on cancers, effectively wiping out the dangerous cells of a brain or central nervous system cancer. One group, at Nemours Children’s Hospital in Orlando, published findings of early-stage work Wednesday in the journal PLOS One. (Branswell, 7/25)

There was a time — several months after J.J. Hanson was diagnosed with terminal brain cancer, but several years before he died from it — when, he once said, he might have considered ending it all. The husband and father said in 2015 that the previous year, he learned that he had a Grade 4 brain tumor called glioblastoma multiforme and was given four months to live. He had been fighting the cancer, but now, sick in bed and worried about becoming a burden to his family, he was lost in his thoughts. (Bever, 7/25)

Chris Ferrari was just 18 the first time he balanced a rocket launcher on his right shoulder and aimed it at a practice target. "Your adrenaline's going and you're trying to focus on getting that round to hit, and then you go to squeeze that trigger and, you know." Boom! (Hamilton, 7/25)

Shortly after the young woman walks into Howard Gurr’s psychology practice, she is taken to a beach and encouraged to relax. She is helped to feel calm and let go of her worries. Dr. Gurr then changes course, bringing his patient to a restaurant or other place that is a source of anxiety. Dr. Gurr doesn’t change offices every day. He’s a therapist who is using virtual-reality scenery to tackle the anxieties and body-image issues of patients with eating disorders like anorexia, bulimia and binge eating. (Colville, 7/25)

The conversation around gun violence in the U.S. usually focuses on homicides, urban crime and mass shootings. But the overwhelming majority of gun deaths in America don't involve bad guys with guns. They're caused by people deliberately harming themselves. (Mann, 7/26)

Dutch doctors were trying to answer a simple question about a popular drug: Could the active ingredient in Viagra be used to help a particular group of at-risk babies often born tiny and premature with slim chances of survival? The study had already been conducted in New Zealand and Australia, according to Amsterdam Universitair Medische Centra (University Medical Center), which headed the latest trial. The Dutch component involved some 183 pregnant women who suffered from fetal growth restriction, where an underdeveloped placenta can’t get enough oxygen or nutrients to a gestating baby. (Wootson, 7/25)

“I would hope that within a very few years … instead of this being a seven-day wonder this will become a fairly commonplace affair.” Those prescient words were spoken by Robert Edwards, a 52-year-old Cambridge physician on July 25, 1978, when he announced the wondrous birth of baby girl who was the first to be conceived outside the body. Louise Joy Brown, born healthy and screaming at 5 pounds 12 ounces, made headlines around the world and gave new hope to infertile couples everywhere. Scientists “hailed it as a momentous medical achievement,” according to the New York Daily News. “The jubilation was tempered, however, by warnings over the morality and ethics of producing human life in the laboratory.” (Cha, 7/25)

It used to be that big-name health care officials and executives on their way out of power would take a cozy perch at a university. Now? More and more of them are landing at Google companies. Dr. Toby Cosgrove, the longtime president and CEO of Cleveland Clinic, is the latest health care bigwig to pick Google as a landing pad. He’ll become an executive adviser to Google Cloud’s team working on health care and life sciences, the company announced recently. (Robbins, 7/26)

Sylvia Mathews Burwell, the former HHS secretary and current American University president, reflects on her work in the Obama administration, the fate of the Affordable Care Act and her new challenges in higher ed. (7/25)

Before now, University of Iowa Hospitals in Iowa City had the only psychiatry training program in the state — and it could not keep up with demand. The result has been a worsening shortage of psychiatrists, forcing many Iowa patients to wait weeks or even months for an appointment. Several Iowa hospitals have closed their mental health units in recent years, citing a lack of qualified staff, including psychiatrists. Experts say the main problem used to be that few young doctors wanted to be psychiatrists. That’s no longer true. The past several years have seen a surge of medical school graduates wanting to join the specialty — but there aren’t nearly enough psychiatric training programs to take them. (Leys, 7/25)

Greater New Orleans residents on Wednesday evening (July 25) will get their initial look at a first-of-its-kind economic development district proposed for the central business district that will be centered around the abandoned Charity Hospital. A meeting being organized by the Greater New Orleans Foundation, which is leading the public engagement effort for the "Spirit of Charity Innovation District," will hold a community workshop to help residents envision what the district will look like. Design Jones LLC is assisting GNOF with a strategic plan for the district, and is helping gather public input for what it will look like. (Litten, 7/25)

Ascension will close its 283-bed hospital in Washington D.C. by the end of the year as it looks to replace its acute-care services with more ambulatory services, the nation's largest Catholic health system announced Wednesday. St. Louis-based Ascension said Providence Health System, which includes the hospital and a network of ambulatory sites in D.C. and Maryland, will focus on telehealth, primary and urgent care, home care, community-based behavioral care and senior care as well as population health. (Kacik, 7/25)

Confusion is growing in the remote Surprise Valley region of northeastern California as locals wonder whether a Denver entrepreneur will make good on his pledge to save their bankrupt rural hospital. Surprise Valley Community Hospital, located in Cedarville, Calif., was featured in a June 6 California Healthline story illustrating the plight of strapped rural hospitals and controversial efforts by some to stay solvent through laboratory billing for patients never treated on-site. (Ostrov, 7/25)

With trial just three months away, prosecutors have added another big name to their growing witness list in the alleged $200 million health care fraud involving Forest Park Medical Center — a hospital once hailed as a successful new industry model. Alan Andrew Beauchamp, a Forest Park co-founder who managed the hospital, has agreed to plead guilty in the case. He says in the plea documents that he recruited high-volume specialty doctors and paid them millions of dollars in bribes and kickbacks to perform their surgeries at the now-defunct Dallas hospital. (Krause, 7/24)

The Oklahoma Board of Pharmacy fired its executive director Wednesday after state investigators confirmed she is the target of a bribery probe involving text messages exchanged with a top lawyer involved in writing the state's new medical marijuana rules. The board unanimously voted to fire Chelsea Church following a closed-door meeting in Oklahoma City. The special meeting was called after the online news agency Nondoc reported on a series of text messages in which Church appears to offer Department of Health attorney Julia Ezell a higher paying job at the agency in exchange for medical marijuana rules favorable to pharmacists. (7/25)

Texas has almost a dozen medical schools, but it also has a rural healthcare worker shortage. The Texas Higher Education Coordinating Board is set to vote Thursday on whether to approve another medical school. (Hart, 7/25)

A handful of communities identified by an environmental watchdog have reduced their levels of a dangerous chemical in their drinking water supply, according to the Minnesota Department of Health. Using data from 2010-2015, the D.C.-based Environmental Working Group found trichloroethylene (TCE) in the drinking water supplies of 15 Minnesota communities, though only five exceeded the state limit of 0.4 parts per billion during that time. (Richert, 7/25)

The scandal surrounding the three-decade tenure of Dr. George Tyndall, a former gynecologist at the University of Southern California, continued to grow this week as more than 50 additional women sued the university, saying it had failed to protect them from sexual abuse and harassment by Dr. Tyndall. The lawsuits, filed on Monday in Los Angeles Superior Court against both Dr. Tyndall and U.S.C., claim that the university concealed years of complaints against Dr. Tyndall’s “sexually charged and deviant comments and behavior” and “allowed him many years of unfettered sexual access to young female students.” (Zaveri, 7/25)

One day doctors might analyze the heart with a better predictive tool that helps them decide the best treatment for patients sooner thanks to cardiovascular research now being done at the University of Texas at Dallas. And maybe that work could lead to better coronary stents that help patients avoid more surgery down the line, said Heather Hayenga, an assistant professor who is leading the research. (Ayala, 7/25)

The House just passed a bill to create a 9-1-1 type service nationwide for suicide prevention. This change could be especially important for our region, which has some of the highest suicide rates in the country. (Budner, 7/25)

The Ohio Renal Association is asking the state Supreme Court to shut down a ballot proposal that would cap how much for-profit dialysis companies can charge patients. The association wants a court order or judgement invalidating the entire initiative petition. (Hancock, 7/25)

Nearly two years after two workers drowned in a flooded trench at a South End construction site, state lawmakers are moving forward with a bill that would require companies seeking large government contracts to disclose workplace safety violations. ...The measure would require any company offering goods or services worth more than $50,000 to state or local governments to disclose if it had received a citation, notice, decision, or civil judgment from the federal Occupational Safety and Health Administration in the previous four years. (Halper, 7/26)

A former top administrator at the Minnesota Department of Health alleges she was wrongfully fired last year in retaliation for raising concerns about a hostile work environment. Nancy A. Omondi, a former director of the department’s health regulation division, said she repeatedly attempted to notify senior leaders at the agency of a pattern of harassment, bullying and discrimination at the division she oversaw, according to a lawsuit filed Wednesday in Ramsey County District Court. In response, Omondi said, she was verbally berated, reprimanded and ultimately terminated last November from her position at the health department. (Serres, 7/25)

A requirement in the school safety bill passed after the Parkland shooting is raising privacy concerns. The law requires new students who are initially registering in a district to disclose any referrals to mental health services. (Ochoa, 7/25)

Ohio children who are not ready for kindergarten have a hard time catching up over the years, with their scores in third grade reading and eighth grade math continuing to lag, according to a study released Wednesday. The report, by the education advocacy organization Groundwork Ohio, found poverty is often tied to insufficient kindergarten readiness. (Hancock, 7/25)

LaSalle Investment Management has added a fourth property to its Houston portfolio with the purchase of the prized Memorial Hermann Medical Plaza adjacent to the Texas Medical Center. The seller, a partnership of Mischer Healthcare, Memorial Hermann Health System and other private investors, opened the 28-story medical office building at 6400 Fannin at North MacGregor in 2007. (Feser, 7/26)

The state almost certainly won’t be the next one to legalize recreational marijuana use. But there are signs that both the public opinion and political calculus on pot are shifting in Texas, with advocates hopeful that those shifts could yield significant progress during next year’s legislative session. (Samuels, 7/26)

No, the Trump administration did not declare victory in the war on poverty, as recent media coverage and a chorus of mocking pundits have suggested. Instead, the White House, subsequently bolstered by the recommendations of its Council of Economic Advisers, moved to expand the sort of dignity-enhancing work requirements for welfare recipients that was pioneered — with bipartisan support and to wide acclaim — during the Clinton administration. Trump’s executive order gave secretaries in the appropriate departments 90 days to review existing programs and recommend changes. In 1996, President Bill Clinton and a Republican-controlled Congress collaborated on the Personal Responsibility and Work Opportunity Act. The law aimed to reduce dependency by requiring non-disabled working-age recipients to find a job within 24 months of starting to receive cash welfare payments. President Trump is taking a page from that welfare-reform playbook, seeking ways to add or strengthen work requirements for noncash benefits such as Medicaid, housing assistance and the Supplemental Nutrition Assistance Program, or SNAP, also known as food stamps. (Ron Haskins, 7/25)

ObamaCare made it more difficult for health insurers to turn a profit on individual plans, since it prohibited them from charging consumers more based on their medical risks. But the law also created a huge growth opportunity for insurers: Medicaid. Over the past decade, federal and state spending on Medicaid has nearly doubled to $570 billion—roughly as much as the revenues of United Health, CVS, Anthem, Aetna and Humana put together. California alone will spend nearly $100 billion on Medicaid this year. (Allysia Finley, 7/25)

Business groups that have long advocated for association health plans (AHPs) just learned a valuable lesson: Beware of politicians bearing gifts. Recently, the Trump administration finalized a U.S. Department of Labor rule that will allow groups of businesses to band together to buy insurance across state lines. President Trump claimed this rule would save small businesses “massive amounts of money” and lead to better health coverage for small firms. Now that the rule is final, however, some longtime supporters of association health plans are disappointed.The National Federation of Independent Businesses (NFIB) said it won’t be making an AHP available to its more than 300,000 members, reportedly because it feels the plans would require too much financial investment for too little return. (John Arensmeyer, 7/25)

For nearly a decade, Republicans have opposed the Affordable Care Act (ACA). They have fought Obamacare in Congress, the courts, and the states and, since 2017, from the White House. Given the scope, intensity, and duration of this campaign, it is worth considering what it has achieved. ...The ACA is stuck in purgatory, beyond comprehensive repeal but subject to a war of attrition that jeopardizes its gains. Such a campaign poses risks for Republicans. The politics of health care have fundamentally changed. Tens of millions of Americans are ACA beneficiaries; taking away their coverage and consumer protections is difficult. And as the party in power, Republicans are now responsible for Obamacare’s problems, which the Trump administration’s policies may worsen. (Jonathan Oberlander, 7/25)

CHICAGO — For nearly five decades, the Title X family planning program has provided much needed funding for reproductive health care for millions of uninsured and underinsured people, covering basic services from cancer screenings to contraception to treatment for sexually transmitted infections. Now, the Trump administration is proposing a so-called domestic gag rule that would strictly limit how clinics that get this funding can refer patients for safe, legal abortions. Under the proposal, clinics will face a choice: either adhere to unacceptable restrictions on how they practice medicine or be cut off from funding that allows them to provide for millions of patients. As a board-certified obstetrician-gynecologist, I can attest that this proposal is bad medicine; as a medical ethicist, I can also affirm it is an assault on both the patient-provider relationship and the autonomy of patients and health care providers. (Julie Chor, 7/25)

The Trump administration recently floated ideas to cut the cost of drugs for those enrolled in Medicare. Among these was a proposal to shift some physician-administered drugs from Medicare’s Part B (which pays more for drugs that cost more, even if cheaper options exist), to its Part D (where price reductions for drugs can be negotiated, by steering patients to cost-effective alternatives). Part D’s payment structure has helped reduce the cost of Medicare’s prescription drug benefit well below the levels projected when it was established in 2003. Yet a reinsurance provision in the design of Part D is gradually eliminating incentives to control the program’s drug costs. (Chris Pope, 7/25)

Broad delivery-system restructuring requires changing the dominant method of health care payment. But many commercial health plans have been slow to adopt alternative payment models, largely because their biggest customers — self-insured employers — haven’t demanded it. (Robert E. Mechanic and Robert S. Galvin, 7/26)

The idea that we can give — over a course of days or weeks — a profoundly transformative medicine has radical implications for how we pay for therapies and create incentives for a new generation of cures. ...At the American Society of Clinical Oncology meeting, it became clearer than ever that we are already living in in the “tomorrow” of biomedical research. We must now create the tomorrow of health care financing to account for these innovations.(Robert W. Dubois, 7/25)

Physicians on the front lines of health care today are sometimes described as going to battle. It’s an apt metaphor. Physicians, like combat soldiers, often face a profound and unrecognized threat to their well-being: moral injury. Moral injury is frequently mischaracterized. In combat veterans it is diagnosed as post-traumatic stress; among physicians it’s portrayed as burnout. But without understanding the critical difference between burnout and moral injury, the wounds will never heal and physicians and patients alike will continue to suffer the consequences. (Simon G. Talbot and Wendy Dean, 7/26)

It’s hard not to cheer when a drug is shown to have a very real potential to help patients with Alzheimer’s disease — a common, devastating, and currently uncurable condition. But some restraint is needed when reacting to the results released late Wednesday for the treatment being developed by Biogen Inc. and Eisai Co. The drug, BAN2401, was shown to significantly slow cognitive decline after 18 months of treatment at a high dose — depending on how you measure it. Regardless of the qualifier, this is absolutely a promising outcome and the data is better than I, a skeptic on Alzheimer’s studies, expected in some respects. But there’s much more testing to be done before anyone can be sure about this result, and it will take a long time. (Max Nisen, 7/25)

The other day The New York Times and a few other outlets ran with a story that was unusual, maybe even unprecedented, for highlighting a social science study that failed to show any sort of irrationality or self-delusion in its subjects. There were no signs that mysterious, unconscious cues were wreaking havoc on people’s decision making. The study, a survey of women who had recently had eggs frozen, revealed decisions that were well-informed, reasonable and rational. The women were single for the most part, and wanted to increase their odds of getting pregnant if they found a suitable co-parent in the future. Stories about people acting reasonably don’t often make headlines, but the appeal here was that the research countered a stereotype often attached to women with careers: that they’re postponing having families so they can advance up the corporate ladder. And why not use science to contrast reality with stereotypes? (Faye Flam, 7/25)

There have recently been a few minor stories about the closing of Comprehensive Pain Specialists clinics across the region due to financial issues and a federal criminal investigation. Some have even mentioned that around 50,000 pain patients are now without a pain management doctor. If this were 50,000 cancer patients not receiving treatment in the weeks to come, it would be headline news. People would be up in arms over that denial of care. If you, or somebody you love, have not been directly impacted by long-term chronic pain, then you are very fortunate. But keep in mind that we are all just one car accident away from that condition. (Meredith Lawrence, 7/25)

Having torn migrant children from their families with no idea how they would be reunited — and almost no record-keeping that would facilitate reunions — the Trump administration is now laboring heroically to repair what it has broken. By “heroically,” we mean only that lower-ranking officials — most of them blameless in the mess created by Attorney General Jeff Sessions, who proclaimed the “zero tolerance” policy that sundered families, and Homeland Security Secretary Kirstjen Nielsen, who oversaw the policy’s enforcement — are racing to meet a court-ordered deadline to reunify more than 2,500 children with their parents by Thursday. Hundreds of bureaucrats have spent weeks trying to match separated children with their parents, hamstrung by the absence of data that was either never recorded or inadvertently destroyed. The fact that Mr. Sessions, Ms. Nielsen and the lieutenants who serve them never anticipated this eventuality speaks to their callousness. (7/25)

Now, the administration has announced that the Food and Drug Administration will consider a procedure under which, if a drug maker hikes the price of a generic drug — and there’s no ready substitute on the domestic market — the FDA would allow foreign substitutes into the country. ...Because they often lack adequate substitutes to compete with them in the market, many generics have soared in price of late. (Rich Barlow, 7/26)

July 28th marks the one year anniversary of the FDA’s landmark announcement to embark on what it called a “new comprehensive plan for tobacco and nicotine regulation” that “places nicotine, and the issue of addiction, at the center of the agency’s tobacco regulation efforts.” (Jeff Stier, 7/26)