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Senate Republicans are closing in on a bill to repeal President Barack Obama’s signature health care law, diverging from the House on pre-existing medical conditions and maintaining federal subsidies that proponents see as essential to stabilizing insurance markets around the country. The changes appear largely designed to appeal to Republican senators who hail from states where the Affordable Care Act is popular and who were critical of the House bill, which would eliminate insurance for millions of Americans covered under the current law, according to the Congressional Budget Office. But the revisions may well alienate the Senate’s most conservative members, who are eager to rein in the growth of Medicaid and are unlikely to support a bill that does not roll back large components of the current law. (Steinhauer and Pear, 6/7)

Senate Majority Leader Mitch McConnell is proposing to keep in place Obamacare’s protection against higher health-insurance premiums for people with pre-existing conditions when they buy individual coverage, said a Republican aide familiar with the recommendation. The idea was discussed in a closed-door Senate GOP meeting Tuesday, said the aide, who spoke on condition of anonymity. Republicans in the chamber are working to craft a more modest health-care bill than a House measure that nonpartisan analysts said would cause premiums to skyrocket for many older, poorer and sicker Americans and result in 23 million fewer people with coverage over a decade. (Litvan, 6/7)

Senate Republicans are considering keeping some Obamacare taxes for a few more years to pay for their own repeal bill. Many want to make their repeal plan more generous than the House’s effort but are struggling to come up with ways to pay for it. The dilemma is how to balance the expensive effort to drive down premiums with a desire to scrap taxes that would raise money. (Haberkorn, Everett and Cancryn, 6/7)

GOP moderates in the Senate are open to ending federal funding for ObamaCare’s Medicaid expansion, but want a longer deadline for ending the additional funding than their leadership has proposed. Sens. Rob Portman (R-Ohio) and Shelley Moore Capito (R-W.Va.) have proposed a seven-year phase-out of federal funding for the Medicaid expansion, beginning in 2020 and ending in 2027. Senate Majority Leader Mitch McConnell (R-Ky.) proposed a shorter, three-year phase-out that would end in 2023 at the Senate lunch on Tuesday. (Roubein and Sullivan, 6/7)

Senate Republicans on Thursday are expected to keep negotiating over competing Medicaid proposals, including one to phase out higher payments for the expansion of the program starting in three years and another that would give states seven years to adjust to the end of the payments promised in the health care law. The health law (PL 111-148, PL 111-152) provided higher payments to states for people who signed up under the expanded version of Medicaid than for people who qualify under traditional Medicaid. Senate Majority Leader Mitch McConnell of Kentucky reportedly suggested phasing out funding for people who sign up for the expanded program starting in 2020, reducing them to the normal matching rate in 2023. (Young, 6/7)

Democrats say Republicans may still face hurdles to moving a revised version of the House-passed health care bill in the Senate, despite an optimistic Tuesday pronouncement from the Budget Committee. They cite a clarifying email sent by Parliamentarian Elizabeth MacDonough Tuesday evening, in which she said her earlier finding was less sweeping than it might have seemed. It was the second of two emails sent by MacDonough. (Krawzak, 6/7)

The event Wednesday on an airport tarmac in Cincinnati was just the latest opportunity for the White House to disparage and undercut a law it officially must carry out. Standing in front of Air Force One along with two small-business owners, President Trump recounted how they “have had their lives completely upended by the disaster known as Obamacare.” One saw her choice of doctors shrink while her premiums and out-of-pocket costs rose, he said. The other has curtailed new investments in his company to maintain employees’ health benefits. “The coverage is horrendous,” the president declared, ticking off insurers’ recent decisions to pull out of federal marketplaces in Ohio, Kentucky and elsewhere. “Obamacare is in a total death spiral. The problems will only get worse if Congress fails to act.” (Eilperin and Phillip, 6/7)

"We're having no help; it's only obstruction from the Democrats. The Democrats are destroying health care in this country,” Trump said. (Weixel, 6/7)

Trump cited skyrocketing insurance premiums, 86 percent in Ohio and 75 percent Kentucky. That statement is true – with key caveats. Premiums in the individual markets have risen, but most people get insurance from their employers, not the individual market. Those numbers also do not take into account tax credits low-income people get when they buy insurance on the exchange. (Sparling and Shesgreen, 6/7)

Mr. Trump’s comments came on the heels of lawmakers’ return to Washington Monday, and a White House visit with GOP congressional leaders on Tuesday in which the president said he was confident Senate Majority Leader Mitch McConnell (R., Ky.) could “get a bill across the finish line this summer” that would overturn much of the 2010 health law and enact Republican measures in its place. (Radnofsky, Armour and Peterson, 6/7)

President Donald Trump is increasingly invested in Senate passage of a bill to repeal Obamacare, realizing that a successful vote in the upper chamber will provide a major boost to his domestic agenda, say Republicans who have spent time with him recently. (Everett and Dawsey, 6/7)

President Donald Trump sought Wednesday to give new life to a Republican health-care bill that's facing uncertain prospects in Congress, using a speech about infrastructure in Cincinnati to go after "Obamacare," too. He mangled some facts and repeated familiar exaggerations. A look at a few of them. (Alonso-Zaldivar, 6/7)

Obamacare markets are undergoing a slow-motion meltdown as Republicans stoke a climate of uncertainty while struggling to agree on their own plan for overhauling American health care. The steady march of insurers that have announced plans to exit marketplaces in recent weeks leaves Obamacare customers in wide swaths of the country with potentially no options for purchasing subsidized coverage in 2018. In the latest and most significant blow, Anthem this week announced it will pull out of Ohio next year, leaving at least 18 counties without an insurer selling Obamacare plans. (Demko, 6/8)

With uncertainty threatening the Affordable Care Act, states including Connecticut are making attempts — some more extensive than others — to keep insurers in their health care exchanges. Some states, including Alaska and Minnesota, have used an Affordable Care Act provision to establish reinsurance programs to try to stabilize wobbly insurance markets. (Radelat, 6/7)

The future of the Georgia Obamacare exchange market looks a hair shakier early this week following disconcerting news from Ohio and Washington, D.C. ... Analysts suspected Blue Cross might pull out, leaving many rural Georgia patients without affordable insurance. So people who depend on such insurance were buoyed recently when  Blue Cross filed plans to remain in Georgia. The company’s decision is not final, however. (Hart, 6/7)

Anthem Inc.’s decision to quit Ohio’s Obamacare market will leave 13,000 people without any coverage option under the program next year. That number may rise to 300,000 if the health insurer follows suit in the rest of the states where it sells. Anthem, which currently oversees Affordable Care Act plans for about 1.1 million people in 14 states, is one of the largest of the multistate insurers that hasn’t pulled back sharply from selling individual plans in the ACA. In April, it said it was “assessing our market footprint in 2018,” and on Tuesday the company said it would leave Ohio. (Edney, Tracer and Recht, 6/7)

Health insurers in New York are seeking another year of hefty premium increases for their Affordable Care Act plans, adding fuel to the debate over the law’s future. Insurers are seeking to boost their premiums 16.6 percent on average for 2018, the state Department of Financial Services said Wednesday. While that’s not as high as the 18 percent hike they requested last year, it’s still a substantial increase in cost for New Yorkers who don’t get help from subsidies under Obamacare. (Tracer, 6/7)

In his high-stakes strategy to overhaul the federal health law, President Donald Trump is threatening to upend the individual health insurance market with several key policies. But if the market actually breaks, could anyone put it back together again? The question is more than theoretical. The Trump administration has already acted to depress enrollment in Affordable Care Act plans, has instructed the IRS to back off enforcement of the requirement that most people have health insurance or pay a penalty and threatened to withhold billions of dollars owed to insurance companies. All of those actions make it more difficult for insurers to enroll the healthy people needed to offset the costs of the sick who make it a priority to have coverage. (Rovner, 6/8)

The Office of Government Ethics on Wednesday released copies of nearly a dozen ethics waivers for officials working at federal agencies, showing which members of President Donald Trump’s administration are allowed to work on issues they handled before joining the government. (Ballhaus, 6/7)

Lance Leggitt helped collect $400,000 in fees last year while working as a lobbyist to try to influence Medicare policy at the Department of Health and Human Services — an agency where he now serves as chief of staff. Under an executive order signed by President Trump in January, lobbyists were banned from that kind of government work. But Mr. Leggitt is among a half dozen officials across the federal government who have been granted special waivers to disregard ethics rules, according to a new set of documents released Wednesday. (Lipton and Ivory, 6/7)

At the Department of Health and Human Services, at least five former lobbyists other than Leggitt have been tapped to serve. They include Keagan Lenihan, a senior adviser to Secretary Tom Price who last year lobbied on Medicare and Medicaid issues for McKesson Corporation, a pharmaceutical distributor. (Gold and Eilperin, 6/7)

Rep. Chris Collins (R-N.Y.) has boasted about how much money he’s made for other members of Congress by tipping them off to an Australia-based pharmaceutical company in which he is the largest stockholder, two GOP lawmakers told The Hill. Collins, President Trump’s chief defender and unofficial spokesman on Capitol Hill, told a group of House GOP colleagues over dinner earlier this year that he had urged colleagues to invest in Innate Immunotherapeutics and made them plenty of money in the process, said one GOP lawmaker who was present for the conversation. (Wong, 6/8)

Eric Hargan, a Chicago lawyer nominated for the No. 2 job at the federal Health and Human Services Department, declined Wednesday at a Senate hearing to say whether he would keep parts of the Affordable Care Act. "That's a subject of a lot of dispute here on Capitol Hill," he said. The Senate Finance Committee is weighing Hargan's nomination but didn't vote to advance his name to the Senate floor during Wednesday's hearing. Still, Republican committee Chairman Sen. Orrin Hatch of Utah called him an "excellent pick," likely setting the stage for his approval. (Skiba, 6/7)

The House Energy and Commerce Committee advanced a bill reauthorizing FDA user fee programs for drugs and medical devices in a unanimous 54-0 vote this afternoon. The panel considered several controversial proposals dealing with marketing and importation. (Griffiths, 6/7)

[Rep. Andy] Harris is without question uniquely knowledgeable on NIH issues. He is a former Johns Hopkins research physician whose work the agency funded for a decade. One study, on the “cerebrovascular effects of intravenous dopamine infusions in fetal sheep,” is published in the Journal of Applied Physiology. He has also kept a close eye on the federal government’s research arm. But in the months following President Trump’s inauguration, he has pursued what is perhaps an unexpected mission given his background: changing the way the NIH spends its money. (Facher, 6/8)

Doug Melton, one of the nation’s top stem cell scientists, juggles research and other programs at his Harvard University lab, which is funded by a half-dozen grants from the National Institutes of Health — the federal agency that has long been the engine for US biomedical research. But like other senior scientists in the Boston area, he stands to lose some of that funding under a proposed NIH cap on the number of grants it awards to individual labs. (Weisman, 6/7)

The House will vote next week on Senate-passed legislation to make firing employees easier for the troubled Department of Veterans Affairs, as the department sought to speed forward on initiatives urged by President Donald Trump to expand private care and boost accountability. Testifying before a Senate panel, VA Secretary David Shulkin urged Congress to act by this fall on additional legislation to give veterans broader access to private doctors. The plan to eliminate administrative restrictions and give the program more money immediately prompted Senate Democrats to criticize aspects of it as unacceptable "privatization." (6/7)

If enacted, it will be the first law passed in years to beef up VA accountability. The legislation was inspired by horror stories coming out of the department — including the VA's struggle to dismiss a psychiatrist caught watching pornography while seeing a patient. It’s also part of an ongoing effort to overhaul the VA culture, which came under intense scrutiny three years ago amid reports that veterans were waiting months or sometimes years to receive care. VA Secretary Eric Shinseki resigned over the matter, and ever since, Congress has tried to steady the troubled agency. (Bade and O'Brien, 6/7)

Missouri's Republican governor on Wednesday said he will convene a special legislative session next week to consider new abortion regulations and counter a local St. Louis law he said made it an "abortion sanctuary city." The session, set to start on Monday, will seek stricter regulations on abortion clinics, including requiring annual inspections and that clinics adopt plans for potential medical complications, Governor Eric Greitens said in a statement. (Kenning, 6/7)

Kansas Gov. Sam Brownback signed a bill Wednesday morning requiring abortion providers to give patients information listing their credentials, any disciplinary actions meted out against them and whether they have malpractice insurance. The bill also requires the information to be provided at least 24 hours before a procedure and printed on white paper in black 12-point, Times New Roman font. Supporters of Senate Bill 83, called the Disclose Act, say the latter requirements are needed to make the information readable — although the Legislature itself prints its documents in 10-point type. (Margolies, 6/7)

It’s no secret that he has narcolepsy, the condition defined by sudden bouts of sleep. He lists it as part of his personal history, intriguing his fans enough that “How does George Church manage his narcolepsy?” is a question on Quora, a question-and-answer website. But because he has never discussed it in depth, the question has gone unanswered. STAT is happy to step into the breach: He doesn’t eat from 6 a.m. to 6 p.m., and stands whenever possible. “I have to constantly shift my weight and balance,” stimulating the nervous system in a way that prevents nodding off, the 6-foot-5 Church said. (Begley, 6/8)

Scientists say they may have solved a big medical mystery: why mammograms don't save more lives. A study involving thousands of breast cancer cases, released Wednesday, concludes that a significant proportion of tumors detected through mammography are not small because they are found early. Instead, the tumors are small because they are biologically prone to slow growth. (Stein, 6/7)

In cases of melanoma, the most serious form of skin cancer, doctors will determine its spread by examining a lymph node. If malignant cells are found, the standard treatment is to surgically remove all the lymph nodes in the same area. But a clinical trial has now called this procedure into question. (Bakalar, 6/7)

The idea that fathers have a sweet spot for their daughters and are stricter with their sons is something of a cliche. Researcher Jennifer Mascaro wanted to find out to what extent this was true. So she persuaded 52 new dads to give her an intensely intimate glimpse at 48 hours of their lives through recording devices that documented interactions with their children, who were ages 1 to 2. Mascaro and her colleagues at Emory University and the University of Arizona took apart each exchange and coded them to see whether there were any patterns based on the children's genders. The differences were startling. (Cha, 6/7)

Most of us have heard the advice not to eat right before bedtime, lest those late-night calories get stored as fat. But so far, this conventional wisdom has few long-term studies to back it up. New research from the University of Pennsylvania suggests that cutting off food early may indeed be good practice. Nine adults spent eight weeks eating a regular diet on an early schedule: three meals and two snacks between 8 a.m. and 7 p.m. The participants then took a two-week break, followed by eight weeks on a later eating schedule: the same amount of food, consumed from noon until 11 p.m. (Avril, 6/7)

The small yellow pills look like prescription drugs from a pharmacy, but Georgia authorities say they're anything but.In recent days, the drugs — which are purchased on the street — have led to dozens of overdoses and as many as four deaths in south and central Georgia, state health officials told the Atlanta Journal-Constitution. As the number of overdoses increases, authorities say they're scrambling to keep pace. The state is already battling a growing opioid crisis, authorities say. On Wednesday, the Georgia Bureau of Investigation reported six additional overdose cases potentially related to the drug. (Holley, 6/7)

California’s End of Life Option Act went into effect on June 9, 2016. The law created a process for dying patients to ask their doctors for a lethal prescription that the patients can then ingest privately, at home. Since then, at least 500 Californians have received life-ending prescriptions, according to newly released data collected by Compassion and Choices, an advocacy group that promotes aid-in-dying laws nationwide. (O'Neill, 6/7)

Gov. Nathan Deal announced Wednesday the creation of a commission charged with providing recommendations to improve state mental health services for children. The panel is composed of government leaders, children’s advocates and health care experts. (Members are listed below.) It is tasked with submitting a report to Deal on Sept. 1 on potential improvements to Medicaid services, and on ways to increase access to care for uninsured kids. (Miller, 6/7)

The [Charlie Baker] governor has said little publicly and repeatedly rejected interview requests from the Globe over the past year in connection with the Spotlight series “The Desperate and the Dead,” which documented the large number of police shootings and violent crimes involving people with untreated mental illness. Plus, critics say his proposals fall far short of the sweeping changes that are needed to address years of cuts and neglect that have severely hampered the mental health care system. (Wallack, Russell, Helman and Cramer, 6/7)

California's Democratic-controlled state Senate advanced a bill that would establish a $400 billion, tax-supported public health plan that would cover all residents, including undocumented immigrants. The bill would eliminate private insurance. There would be no co-pays or deductibles. Observers say the measure is unlikely to be enacted because it would require a big tax increase, and all tax increases require a two-thirds super-majority in both chambers of California's Legislature. (Lee, 6/7)

Orthopedic surgeons at Massachusetts General Hospital repeatedly kept patients waiting under anesthesia longer — sometimes more than an hour longer — than was medically necessary or safe, as they juggled two or even three simultaneous operations, according to a federal lawsuit that alleges frequent billing fraud at the prestigious hospital. Dr. Lisa Wollman, a former anesthesiologist at Mass. General, alleges in the lawsuit that at least five surgeons endangered patients by regularly performing simultaneous surgeries. (Saltzman and Wallack, 6/7)

Virginia Mason Medical Center has adopted a new consent-for-surgery process that informs patients about the prospect of overlapping procedures. Virginia Mason joins Swedish Health, which began testing a new form for neurosurgery patients last month, and the University of Washington, which began using a new form in April. In the past, consent forms from all three institutions spoke generally about the role played by care teams and assistants but didn’t say that surgeons may be running multiple operating rooms at the same time. (Baker, 6/7)

The discovery of a newborn baby found abandoned in a Tempe grocery-store parking lot on Sunday has prompted organizations to remind the public of a long-standing Arizona law that establishes designated areas to safely relinquish the care of a newborn. The Arizona Safe Baby Haven Law was passed in 2001. It says a person can leave their newborn child at a designated location, like a fire station or a hospital, and not face criminal charges as long as the child is less than 3 days old and appears to be unharmed, according to Damien Johnson, director of the Arizona Safe Baby Haven Foundation. (Frank, 6/7)

Joplin city leaders and school officials held a ribbon cutting ceremony for the new Kansas City University of Medicine and Bioscience campus on Tuesday. Built near the site of what was the parking lot of the old Saint John’s Regional Medical Center, which was destroyed in a 2011 tornado that killed 161 people, the new medical school was described as a “phoenix rising from the ashes.” Like the KCUMB medical school in Kansas City, the Joplin school will teach osteopathic medicine, which supporters describe as a more “holistic” approach to health than that practiced by the majority of doctors and nurses. (Smith, 6/7)

The Department of Community Health said this week that it has “an open investigation’’ of Edna Warren’s death. The GBI recently arrested Hakim Ogunkunle, 43. Newnan Health and Rehabilitation had reported to local law enforcement that Warren, 98, had suffered a broken leg after physical contact with the certified nursing assistant. (Miller, 6/7)

Child welfare workers will have more options to house older and often hard-to-place foster kids through a deal approved Wednesday between Hillsborough County and Eckerd Kids, the agency that runs child welfare in Tampa Bay. Under the agreement, Eckerd will be able to place children age 10 and up in two cottages at the county-run Lake Magdalene group foster home in Carrollwood until they get a longer-term placement. (O'Donnell, 6/7)

For five years, Oregon Health officials used a “dummy” Social Security number to help thousands of teenagers register for free contraceptive care. Turns out, that was no dummy, but the number of an actual person from Minnesota. The Oregon Health Authority began using a dummy number in 2010 for teenagers who did not give their Social Security numbers for care in that state. Medical clinics were directed to enter in the dummy number as a placeholder. A vendor had provided the dummy number. (Chavey, 6/7)

The brain has many more functions, which makes it notoriously difficult to assess the brain’s physical performance in the hospital emergency room, on the sidelines of an athletic event or during long-duration space travel. But a new system developed by a Hennepin County Medical Center neurosurgeon may be on the cusp of assessing brain function in real time in all of those locations. (Carlson, 6/7)

The Virginia Home for Boys and Girls will host three free Youth Mental Health First Aid training sessions later this year... The mental health “first aid” training helps adults understand how to recognize the symptoms of a mental health crisis, how to approach someone experiencing them, and how to interact and support them, she said. (Kleiner, 6/7)

Next fall, Bellevue, Renton and Vashon Island each will open one school-based health center, offering an array of services from annual checkups to behavioral counseling — far more than the school nurses of old used to do. Nationally, the use of such school-based clinics has increased rapidly, particularly in rural areas where families may lack a regular pediatrician, or might have to drive an hour for children’s basic medical care. Not surprisingly, lack of a nearby doctor results in high absenteeism. (Rowe, 6/7)

Hamilton County partnered with the state and the U.S. Department of Agriculture’s Food and Nutrition Service in this first-of-its-kind partnership meant to elevate food assistance recipients. The National Association of Counties President Bryan Deslodge called it “one of the best innovations in county government.” (Knight, 6/7)

No more than 19 medical marijuana dispensaries will be allowed to open in unincorporated parts of Hillsborough County. County commissioners voted on Wednesday to cap the number of dispensaries based on population and also approved rules for how those dispensaries are chosen. (Ochoa, 6/7)

When Brian Reedy wanted to market his Berks County plastic surgery practice, he turned to Facebook Live and put his face – and body – on the line. In a series of live streaming videos, Reedy, a board-certified plastic surgeon who sports a muscled physique and not much apparent body fat, undergoes DualSculpting (a nonsurgical way to remove fat) and receives Botox injections. It’s all in the name of introducing viewers, especially men, to the benefits of nonsurgical cosmetic procedures and – not incidentally – to  advertise his wares. (Rush, 6/7)

State lawmakers reached an agreement to make medical marijuana available in Florida, ending an impasse that derailed the issue last month. Reached Tuesday night after weeks of closed-door negotiations, the deal affirms the will of 71 percent of voters who approved a constitutional amendment in November's election that allowed patients with a host of conditions access to the drug. (Auslen, 6/7)

Writing a bill that could impact the health care coverage of so many Americans without even a whiff of transparency is policy-making at its absolute worst. That the basis for this effort is the oft-repeated Republican lie that Americans need to be rescued from access to affordable health care coverage provided by Obamacare makes it so much worse. (Michael Cohen, 6/7)

Our system of healthcare delivery has been so corrupted by money and power that it can no longer exist in its present form. Greedy thieves have priced themselves out of the market. The two-lane roads and biased-ply tyres of our current healthcare system must be replaced by a modern free-flowing system of affordable healthcare, where doctors are once again in charge of the practice of medicine. (James Baker, 6/7)

Despite many assertions to the contrary, Senate leaders are now saying they want to vote on the replacement bill for Obamacare before the month is out. Front and center is the planned transformation of America’s Medicaid program, which covers 20 percent of Americans and provides the backbone of America’s health care system. (Simon Haeder, 6/8)

The Trump administration believes there are two types of people in the country: givers and takers. Givers are taxpayers and takers are people who receive benefits from the government paid for by taxpayers. President Trump's budget director, Mick Mulvaney invoked this description while introducing the administration's budget proposal, which cuts $800 billion from Medicaid over the next decade. This description will sound hollow to millions of middle-class families whose elderly and disabled relatives depend on Medicaid to provide long-term care services and medical care. (Katherine Swartz, 6/7)

As the debate continues over Republican efforts to replace Obamacare, some of the most apocalyptic rhetoric from the left relates to the GOP’s effort at long-term entitlement reform: a per-capita cap on future Medicaid spending. But the Congressional Budget Office has refused to estimate exactly what the impact of the per-capita reform might be. Why? (Avik Roy, 6/8)

As IA Health Link enters its second year, state leaders will evaluate how well it delivers on its goals. Iowa’s bold vision included improving health, saving taxpayer dollars, and creating a better system for enrollees. IA Health Link is making remarkable progress toward each of these objectives. (Rhys Jones, 6/7)

Health insurance giant Anthem Inc. didn’t cite President Trump when it announced Tuesday that it was withdrawing from the Obamacare marketplace in Ohio, leaving the marketplace with no insurer in at least 18 counties. But Anthem pointed the finger right at him — and at the Republicans in Congress who are trying to “repeal and replace” the 2010 healthcare law. (Jon Healy, 6/7)

When I heard Golden State Warriors head coach Steve Kerr will not join his team on opening night of the NBA finals for health reasons, I thought “Oh my, he must have something serious.” Well he did, but it was not a virus or heart plaque—it was the endemic problem of too much medical care. Kerr, who had a series of operations for chronic back pain, was disabled by his most recent surgery. “I can tell you if you’re listening out there, stay away from back surgery,” Kerr said. “I can say that from the bottom of my heart. Rehab, rehab, rehab. Don’t let anyone get in there.” A recommendation Stanford spine surgeon Dr. Robert Aptekar called “good advice”. (Marty Makary, 6/8)

The phenomenon of aesthetic expression is not unique to physics. Athletes often describe competitive victories in terms of “pretty” (they won because they performed well) or “ugly” (they won despite not performing well), implying that while “a win is a win,” they prefer the former. Physicians too are filled with a similar pleasure when we practice elegant medicine. For example, patients, their families, and other physicians are always impressed when an internist connects a few seemingly unrelated findings into one unifying diagnosis. Surgeons value grace and finesse in an operation, leading to few wasted knife strokes and shorter procedure times. Discoveries of simple yet elegant solutions to vexing problems, like the finding that Helicobacter pylori causes a significant amount of peptic ulcer disease, are hailed as breakthroughs. (Shaurya Taran and Allan S. Detsky, 6/6)

We know Amazon has a knack for disruption—over the years it has upended countless brick and mortar bookstores and other major players in the retail industry. The e-commerce behemoth may be at it again, making headlines for its interest in breaking into the pharmacy market in the United States. But delivery of prescription medications to the home already exists for patients with chronic and even acute conditions, while patient portals already give patients online access to payments and prescription refills. So how might we expect Amazon to set itself apart from the competition and grow in the pharmacy space? If it stays true to the tenets of Disruptive Innovation, expect it to further expand its capabilities around healthcare in the home—just as it has kept book, grocery, and other retail shoppers at home over the years. (Ryan Marling, 6/7)

One of the most popular — and successful — aspects of the Affordable Care Act has been the access it has given women to no-cost birth control. Not only has it saved women millions of dollars, but also the increased use of birth control has corresponded to significant drops in the rates of unintended pregnancies and abortions. It is troubling, then, that the Trump administration is either so shortsighted or so ideologically driven that it is reportedly considering a rule change that would cause hundreds of thousands of women to lose vital health-care coverage. (6/7)

Dear Gov. Bevin, Can we talk? You have made no secret of your wish to do away with abortions in Kentucky. While we wage that dispute in the courts, there’s another conversation I’d love to have with you. It’s about a way to prevent the need for abortion. And it can have pretty amazing and far-reaching ramifications for many of your constituents’ personal lives, our communities and Kentucky’s economic health. (Kim Greene, 6/7)

Recently, lawmakers in Madison introduced the Privacy Protection and Gender Identity Anti-Discrimination Act, a bill that would update our state law to include comprehensive protections for transgender people from discrimination. Our current law lacks explicit protections for individuals who are transgender or gender nonconforming from being fired from their job, denied a home or refused services at a business simply because of who they are. (Milwaukee Mayor Tom Barrett, 6/7)

Kathy Anderson’s heart was severely damaged by medicine she was prescribed while pregnant with twin girls. The damage wasn’t evident until after her daughters were born. Within a couple of weeks, she was given only a slim chance of survival. Her doctors knew her only option was a heart transplant. This was in 1987, the 30-year anniversary of the surgery that saved Kathy’s life. (Glen A Franklin, 6/7)