�Թϲ�����

President Trump, who has repeatedly assailed pharmaceutical companies for the high cost of prescription medications in the United States, nominated on Monday a former executive of one of the nation’s largest drug companies to be secretary of health and human services, which has responsibility for regulating the pharmaceutical industry. Mr. Trump announced his choice of Alex M. Azar II, a former president of the American division of Eli Lilly and a health official in the George W. Bush administration, on Twitter while traveling in Asia. (Shear, 11/13)

If confirmed, Alex Azar would oversee a $1 trillion department responsible for major health insurance programs, including "Obamacare," as well as medical research, food and drug safety, and public health. The nomination of Azar is unusual because Health and Human Services secretaries have come from the ranks of elected officials such as governors, leaders in academia and medicine, or top executive branch managers — not industries regulated by the department. (Alonso-Zaldivar, 11/13)

Azar also favors moving authority to the states over Medicaid, the program that provides health care to the poor, elderly and disabled. That means turning over the program to the states to make them "better stewards of the money," he said in an interview at a February conference on YouTube. "It turns these sovereign states and governors from supplicants to the HHS secretary into people running their own health insurance system for the poor." He said at the time that HHS could use its regulatory powers to allow states to customize the rules around Medicaid. (Kodjak, 11/13)

The choice of a detail-oriented lawyer familiar with the workings of the federal government drew praise from Republicans, who said that Mr. Azar would bring significant institutional knowledge to the job. Some consumer groups criticized Mr. Azar’s pharmaceuticals background, saying he might neglect to focus on lowering drug costs. Democrats also said they would press broad objections to the administration’s desire to overturn the ACA during his confirmation process. (Armour and Radnofsky, 11/13)

In announcing his decision on Monday, Trump tweeted that Azar “will be a star for better healthcare and lower drug prices!” He has a close rapport with the department’s top political appointees as well as Vice President Pence. Azar has been highly critical of the Affordable Care Act, saying in interviews in recent months that the law was “certainly circling the drain” and that many of its problems “were entirely predictable as a matter of economic and individual behavior.” (Eilperin and Goldstein, 11/13)

Azar’s pharmaceutical industry background prompted immediate questions about potential conflicts of interest and criticism from Democrats, who expressed concern about how he will handle Obamacare and whether he will be tough on drug makers. (Rosenberg, 11/13)

The drug executive President Donald Trump has picked to lead the Department Health and Human Services isn’t likely to shy away from the topic of sky-high medication prices -- but it may be insurers and drug plans that feel the heat as much as his former industry. (Edney, Hopkins and Rausch, 11/14)

[A]mong many of those those well-versed in healthcare policy, Azar's pick was seen as heartening. Andy Slavitt, who oversaw Medicare, Medicaid and insurance markets during the Obama administration, said that while he differed with any Trump pick over "political values…realistically, it could have been a helluva lot worse." "He's somebody who has been a career civil servant; he has a lot of respect for the people in the department and that's a good start," Slavitt said. (Decker, 11/13)

The nomination of Alex Azar to be the next HHS secretary suggests the department will continue to shun Obamacare and reduce the federal government's role in various parts of the health sector. The former Eli Lilly executive and top health official in the George W. Bush administration has said Obamacare is hopelessly broken and spoken in glowing terms about the U.S. drug industry, noting in May that "any country on earth would like to have the biopharmaceutical industry that we have here in the U.S.” (Pradhan, 11/13)

President Donald Trump has nominated Alex Azar as the next secretary of the Department of Health and Human Services. If Azar is confirmed by the Senate, it’ll be a return trip for him. He was deputy secretary of HHS under the George W. Bush administration. Then he took a break, to work as a top executive at the drug maker Eli Lilly. This swinging back and forth between the public and private sector is not unusual. It’s known as the revolving door — you work in government for a while, then go to work for the industry you used to regulate. Then, sometimes you go back to government. There have been concerns about it ever since the days of Alexander Hamilton. The revolving door really started swinging in the 1800s. “The first federal regulatory body was the Interstate Commerce Commission," said Matthew Mitchell, an economist at the Mercatus Center at George Mason University. "They had former railway men that were working there.” (Marshall-Genzer, 11/13)

Vice President Mike Pence is exerting growing influence over the American health care system, overseeing the appointments of more than a half-dozen allies and former aides to positions driving the White House's health agenda. On Monday President Donald Trump nominated Alex Azar, a former Indianapolis-based drug executive and longtime Pence supporter as HHS secretary. If confirmed, Azar would join an Indiana brain trust that already includes CMS Administrator Seema Verma and Surgeon General Jerome Adams. Two of Verma’s top deputies — Medicaid director Brian Neale and deputy chief of staff Brady Brookes — are former Pence hands as well, as is HHS’ top spokesman, Matt Lloyd. (Cancryn, 11/13)

The Supreme Court on Monday agreed to hear two cases on the limits of the First Amendment’s protection of free speech. One asks whether California may require “crisis pregnancy centers” to provide information about abortion. The other is a challenge to a Minnesota law that forbids wearing political buttons, badges and other insignia at polling places. The California case, National Institute of Family and Life Advocates v. Becerra, No. 16-1140, concerns a state law that requires centers operated by opponents of abortion to provide women with information about the availability of the procedure. The centers seek to persuade women to choose parenting or adoption. (Liptak, 11/13)

The justices said Monday they will review the centers’ complaint that the new law, pushed by an abortion-rights group, forces them to provide information about abortion and other services. Lower courts had allowed the law to take effect. Unlicensed centers also must inform clients of their status. (Sherman, 11/13)

“Forcing anyone to provide free advertising for the abortion industry is unthinkable — especially when it’s the government doing the forcing,” said Kevin Theriot, a lawyer for Alliance Defending Freedom, a religious conservative group representing the clinics. (Egelko, 11/13)

In taking the case on, the Supreme Court justices limited their participation to one question: “Whether the disclosures required by the California Reproductive FACT Act violate the protections set forth in the Free Speech Clause of the First Amendment, applicable to the States through the Fourteenth Amendment.” (Chappell, 11/13)

California’s Democratic Gov. Jerry Brown signed the abortion-clinic measure in 2015 and it took effect last year. The law, the Reproductive FACT Act, requires certain licensed pregnancy-related centers to post notices and include disclaimers in their literature advising patients that Medi-Cal, the state’s version of Medicaid, covers abortions for eligible low-income residents. It also requires unlicensed facilities to disclose that they don’t have a license. The Legislature said the law was necessary because the targeted facilities, in their efforts to discourage abortions, “often confuse [and] misinform women” about their rights and available benefits. Lawmakers said the dissemination of accurate information was hindered by so-called crisis pregnancy centers that offered women some services but discourage abortion. (Kendall and Bravin, 11/13)

The case presents a clash between the state's power to regulate the medical profession and the Constitution's protection for the freedom of speech. Historically, states have had broad authority to regulate physicians and medical providers to protect patients from fraud and sub-standard care. But in recent years, doctors have sued and won claims that state lawmakers had gone too far and were wrongly interfering with the doctor-patient relationship. (Savage, 11/13)

When Phil Yates walked into a tiny strip mall storefront last month, he was hopeful he might walk out with an affordable health insurance plan. Here in the Volunteer State, the 61-year-old retiree had a decent shot: Another 61-year-old retiree could have walked into that same office and enrolled in a relatively basic plan for as little as $283 per month, far less than the $860 a month Yates paid this year for an Obamacare plan. (Mershon, 11/13)

For years, red states have effectively been subsidizing part of health insurance for blue states. By declining to expand their Medicaid programs as part of the Affordable Care Act, many of those states have passed up tens of billions of federal dollars they could have used to offer health coverage to more poor residents. That means that taxpayers in Texas are helping to fund treatment for patients with opioid addiction in Vermont, while Texans with opioid problems may have no such option. (Sanger-Katz and Quealy, 11/13)

Let the negotiations begin. The Senate Republican tax bill differs in a lot of ways from the House version. And one chief difference is the deduction for medical expenses. It’s left alone in the Senate bill. House Republicans want it gone. (Singletary, 11/13)

As Republican lawmakers worked on Monday toward a delicate compromise on a $1.5 trillion tax cut, President Trump threw himself back into the discussion, suggesting that Republicans could reduce taxes even further by repealing the Affordable Care Act’s mandate that most people have health insurance. (Rappeport and Kaplan, 11/13)

President Donald Trump on Monday again pressed House and Senate Republican lawmakers to use tax overhaul legislation to end the 2010 health care law’s individual insurance mandate, something neither chamber’s plan includes. Tweeting just before midnight in Manila, Philippines, Trump laid down a marker for House and Senate Republicans as they continue work on their separate bills. The president wrote that he is “proud of the Rep. House & Senate for working so hard on cutting taxes {& reform.} We’re getting close!” (Bennett, 11/13)

Jonathan Bey hurt his back while repairing buoys at sea in the Coast Guard, and after he was discharged, he filed what he thought would be a routine request for veterans disability benefits. That was 34 years ago. After repeated denials by the Department of Veterans Affairs, appeals by Mr. Bey, and more than a couple of letters saying that the department had lost his files, Mr. Bey is still waiting. (Philipps, 11/13)

A Phoenix-based company that oversees about half of the private medical care for America's veterans is looking to extend its contract even as documents reveal it overbilled the government by tens of millions of dollars. In addition: It's the target of a federal grand jury investigation. The company, TriWest Healthcare Alliance, has multi-billion-dollar contracts with the Department of Veterans Affairs to administer private health-care appointments for ex-military personnel in Arizona and 27 other states. (Wagner, 11/13)

The prices of health care services have long been opaque to the average person. Individuals often don’t know whether they are being overcharged or not. But recent efforts by health insurers, state legislatures and private firms have begun to reveal more information about the cost of care for consumers. Still, the picture is not always crystal clear. As comparative information on health care prices has become more available in recent years, Atlanta and Georgia typically rank below the national averages. But a new comparison of hospital outpatient costs shows the opposite about metro Atlanta — with its hospitals ranking above the national average, and indeed among the most costly in the nation. (Miller, 11/13)

The deadliest mass shooting in modern U.S. history is adding to soaring costs for insurance companies, which are already taking a beating this year from an onslaught of hurricanes, earthquakes and wildfires. The industry may have to shell out more than $1 billion for the Las Vegas massacre, insurance executives say. Acts of a solo gunman, who killed almost 60 people and injured about 500 others when he fired into the crowd of a country music festival last month from his Mandalay Bay hotel room, have resulted in multiple lawsuits. Victims have accused the hotel and its owner, MGM Resorts International, and concert promoter Live Nation Entertainment Inc., of failing to protect people at the event. (Levitt and Vasak, 11/10)

Although Medicare doesn't cover general custodial nursing home care -- such as help with daily living, administering medicine, etc. -- it does pay for prescribed follow-up treatment in a skilled nursing facility with specialized care. To qualify for this benefit, though, Medicare patients must have previously stayed in a hospital for three days, not counting the day of discharge. Because [Mary] Higgins had been in the hospital five days, she and [Regina] Titus figured everything was all set. Except for one big problem: Higgins was admitted to the hospital under "observation" status. (Konrad, 11/13)

Twice this year, Wendy Harrop has gotten medical care that normally would have meant a trip to an urgent care clinic. The first time was for a sinus infection, the second for a spider bite. Both times she got the care she needed — and saved time and money. The service she used enables anyone to get medical care for simple conditions from a doctor or a nurse practitioner by telephone or, better still, by video chat using a computer, tablet or smartphone. ... Harrop’s experience shows why telehealth, particularly so-called virtual visits, is on its way to becoming an integral part of primary care. (Boulton, 11/13)

In an opioid overdose epidemic that killed more than 53,000 Americans last year and shows no signs of relenting, nearly every community in the nation is fortifying its public health, emergency medical and law enforcement response. But with limited resources, it’s essential to target efforts where they are needed most, said Washington/Baltimore HIDTA deputy director Jeff Beeson. (Vestal, 11/14)

The middle-aged couple in the station wagon went shopping at a New Jersey Walmart on a warm night in August. They stopped for dinner at an IHOP on the way home. And when they arrived at their apartment building in a quiet residential section of Queens, the narcotics agents following them got a warrant to go inside. They found several suitcases loaded with brick-shaped bundles of what appeared to be heroin. But lab tests determined that most of it — 141 pounds — was pure fentanyl, a synthetic and supremely dangerous opioid 50 times more powerful than heroin. (Miroff, 11/13)

There's some relief in the latest snapshot of opioid overdose deaths in Massachusetts, as an estimated 167 fewer residents died in the first nine months of 2017, as compared with the same period last year. The estimated 10 percent drop in deaths is included in a third quarter report from the Baker administration, which is tracking and presenting near-real-time data on the state's opioid epidemic. (Bebinger, 11/13)

Caroline Toth Bernstein has a pretty convenient commute to her 6-year-old son Oscar’s school every morning. They walk a couple of blocks to Orchard Gardens K-8 Pilot School on Albany Street in Boston. But in that short journey, she has been spotting something that disturbs her: an orange cap lying in the grass. “I’ve trained myself to look for the orange caps for the [hypodermic] needles, because if there’s a cap, there’s probably a needle nearby,” Toth Bernstein explained. ... Orchard Gardens near Boston Medical Center is in the heart of what some call "Ground Zero" for the opioid epidemic in the city. (Becker and Amer, 11/14)

Kristin, an active drug user, is homeless. That makes her up to 30 times more likely to die after an heroin of fentanyl overdose, according to data analyzed by the Massachusetts Department of Public Health. Kristin has beaten the odds so far, but a tour of the small urban tent community in Greater Boston where she stores things and often stays illustrates the risks. ... "Isn't it baffling that there is this grimy, filthy, intriguing underground world amongst such a beautiful place," Kristin says. "It really blows my mind." (Bebinger, 11/14)

Billionaire Bill Gates is personally investing $50 million to help fund research to find a treatment for Alzheimer’s disease, a type of dementia Gates says has struck members of his own family. There is no cure for Alzheimer’s, which destroys memory and other mental processes, so Gates said he is investing his own money in the Dementia Discovery Fund, a private-public partnership to search for a solution. (Bever, 11/13)

Today, the philanthropist and co-founder of Microsoft announced he is investing $50 million in the Dementia Discovery Fund to accelerate research and progress in tackling the disease, which affects more than five million Americans. The investment is a personal one, not part of the foundation's work. Gates spoke with Marketplace Morning Report host David Brancaccio about why he's optimistic about a breakthrough. (Brancaccio, 11/13)

It's one of the holy grails of science: a cure for Alzheimer's. Currently, there is no treatment to stop the disease, let alone slow its progression. And billionaire Bill Gates thinks he will change that. "I believe there is a solution," he told me without hesitation. "Any type of treatment would be a huge advance from where we are today," he said, but "the long-term goal has got to be cure." (Gupta, 11/14)

With rapidly rising numbers of people suffering from Alzheimer’s and other forms of dementia, the disease is taking a growing emotional and financial toll as people live longer, Gates told Reuters in an interview. “It’s a huge problem, a growing problem, and the scale of the tragedy - even for the people who stay alive - is very high,” he said. Despite decades of scientific research, there is no treatment that can slow the progression of Alzheimer‘s. Current drugs can do no more than ease some of the symptoms. (Kelland, 11/13)

Just a few years after the introduction of a reliable cure for hepatitis C, this city has launched a campaign built on shoe leather and shrewd epidemiology to eliminate the virus. Health workers are expanding testing and searching the streets for homeless patients who don’t pick up their medication. Clinicians are training more doctors to treat infections. Patients can store their medications at a syringe exchange. (Joseph, 11/14)

The nation’s leading heart experts on Monday issued new guidelines for high blood pressure that mean tens of millions more Americans will meet the criteria for the condition, and will need to change their lifestyles or take medicines to treat it. Under the guidelines, formulated by the American Heart Association and the American College of Cardiology, the number of men under age 45 with a diagnosis of high blood pressure will triple, and the prevalence among women under age 45 will double. (Kolata, 11/13)

Leading heart health experts tightened the guidelines for high blood pressure Monday, a change that will sharply increase the number of U.S. adults considered hypertensive in the hope that they, and their doctors, will address the deadly condition sooner. The American Heart Association, the American College of Cardiology and nine other groups redefined high blood pressure as a reading of 130 over 80, down from 140 over 90. The change, the first in 14 years, means that 46 percent of U.S. adults, many of them under the age of 45, now will be considered hypertensive. Under the previous guideline, 32 percent of U.S. adults had high blood pressure. (Bernstein and Cha, 11/13)

Could tweaking the microbiome optimize the way immunotherapy works in cancer patients? A recent study from MD Anderson Cancer Center found that a microbiome padded with specific “good bacteria” could improve the efficacy of certain immunotherapies. (Keshavan, 11/14)

Women are less likely than men to get CPR from a bystander and more likely to die, a new study suggests, and researchers think reluctance to touch a woman’s chest might be one reason. Only 39 percent of women suffering cardiac arrest in a public place were given CPR versus 45 percent of men, and men were 23 percent more likely to survive, the study found. (11/13)

Heart patients have worried that they may die suddenly from having sex, but a new study suggests they probably won’t. Researchers found that less than 1 percent of people who experienced sudden cardiac arrest were having, or just had, sex. Now Sumeet Chugh, one of the study’s authors, has some “happy news” to tell his nervous patients. (Silverman, 11/13)

If there is one point of agreement among the 300 teams from 42 countries that participated in this year’s synthetic biology Olympics in Boston, it is probably this: The microbes that nature made are a good starting point, but we can do better. Begun as an independent study course at the Massachusetts Institute of Technology in 2003, the iGEM (International Genetically Engineered Machines) Jamboree is now a global competition that culminates a year or more of experiments by teams of high schoolers, undergraduates, and graduate students aimed at producing such “machines.” (Begley, 11/14)

Philadelphia has drawn national attention for its sweetened-drinks tax and how it is cutting into sales of the beverages. But a new study finds that all across the nation, people have been drinking less soda and sugary beverages for years, a change that could be helping some manage their weight. (Schaefer, 11/13)

Every year, hundreds of residents at senior care centers around the state are assaulted, raped or robbed in crimes that leave lasting trauma and pain for the victims and their families. Yet the vast majority of these crimes are never resolved, and the perpetrators never punished, because state regulators lack the staff and expertise to investigate them. And thousands of complaints are simply ignored. State records examined by the Star Tribune show the scale of the failure. Last year alone, the Minnesota Department of Health received 25,226 allegations of neglect, physical abuse, unexplained serious injuries, and thefts in state-licensed homes for the elderly. Ninety-seven percent were never investigated. (Serres, 11/12)

On the afternoon of June 14, 2014, Grayce Braaten was napping in her bed at the Cedar Cottage home in Bemidji when a nurse’s aide spotted an elderly man kneeling beside her, fondling her genital area underneath her sheets. A manager at the home called Braaten immediately. He expected swift justice. Yet weeks passed, and then months. Nothing happened. ... That excruciating wait for justice is common in such cases across Minnesota. (Serres, 11/13)

Minnesota is failing to investigate thousands of cases every year of what is now the most widespread form of physical abuse in senior care homes: resident-on-resident violence. The state Department of Health has received more than 20,000 complaints in the past five years alleging aggressive behavior by residents, including head-butting, punching, shoving and sexual groping. Most of them were never investigated by the agency charged with protecting vulnerable seniors in licensed care facilities, state records show. (Serres, 11/14)

The federal government is investigating a security lapse that exposed the personal information of more than 700 patients at Cook County Health and Hospitals System this year. (Schenckner, 11/13)

About 1,000 patients die in the United States each day because of preventable hospital errors, according to the Leapfrog Group, a national nonprofit organization that compiles an annual survey on hospital performance. The Leapfrog Hospital Safety Grade assigns letter grades to hospitals based on their record of patient safety. ... We wanted to see how local hospitals compare on safety issues, so we chose those in a 25-mile radius of downtown San Francisco. Of 26 hospitals, seven received A's, seven earned B's, another seven got C's and five were marked D's. (Moffitt, 11/14)

Beth Israel Deaconess Medical Center plans to construct a new 10-story patient care building, its largest such project in more than 20 years. The building in Boston’s Longwood Medical Area would house private patient rooms, operating rooms, and imaging facilities, and it would include a rooftop landing pad for medical helicopters, according to a letter hospital officials filed with the Boston Planning & Development Agency. The building would have 345,000 square feet of space and would be located on the western end of the hospital campus. (Dayal McCluskey, 11/14)

A federal appeals court said Monday it won't reconsider a ruling that Arkansas can block Medicaid funding to Planned Parenthood, setting up a potential showdown over defunding efforts by conservative states over videos secretly recorded by an anti-abortion group. The 8th U.S. Circuit Court of Appeals denied a request by three Planned Parenthood Great Plains patients to reconsider a three-judge panel's decision upholding the state's defunding decision. (DeMillo, 11/13)

A controversy is brewing at local churches between Catholics whose faith guides their politics and those who favor a wall between church and state, after the archbishop of Boston said late last month that political signature drives are permissible on church property. Mary Collins, who has attended Marlborough’s Immaculate Conception Parish for 15 years, said she was “startled” when it was announced last Sunday that some parishioners would gather signatures in the church lobby after Mass for a measure that would prohibit funding abortions with state dollars. (Fox, Capelouto and Guerra, 11/13)

Whole Woman's Health provided free abortions to 85 women affected by Hurricane Harvey, the clinic said Monday. The procedures, which took place at the clinic's Austin and San Antonio locations, were offered for free to Harvey victims during September. A dozen other women received free consultations through the clinic but did not have abortions performed. (Platoff, 11/13)

A California judge could decide Tuesday if Gloria Single will be reunited with her husband, Bill. She's 83 years old. He's 93. The two have been married for 30 years. They lived in the same nursing home until last March, when Gloria Single was evicted without warning. Her situation isn't unique. Nationwide, eviction is the leading complaint about nursing homes. In California last year, more than 1,500 nursing home residents complained that they were discharged involuntarily. That's an increase of 73 percent since 2011. (Jaffe, 11/13)

The board's ruling says one of the patients experienced respiratory arrest after waking up from breast augmentation surgery in 2013 and died after being taken to a hospital. It says another patient's 2013 death was "likely due to 'trauma' caused by the surgical procedure." Yoho's attorney, Albert Garcia, said that the women died from fat embolisms but he decided to settle with the medical board. (11/13)

A man who says his brother was abused repeatedly by staff at Connecticut's only maximum-security psychiatric hospital urged lawmakers on Monday to look more deeply into the case and make changes at the state-run facility. Al Shehadi said he came forward to give a name to the victim at the center of internal and criminal investigations, to tell his brother's story and to "encourage this committee to continue to investigate what happened." (11/13)

The state medical board has ordered a 30-day suspension for a Visalia plastic surgeon accused of gross negligence and incompetence in the treatment of four patients, including two women who died in 2013. Dr. Robert Alan Yoho, who has had offices in Pasadena and Visalia, cannot practice medicine from Nov. 19 through Dec. 16 under the disciplinary order by the Medical Board of California. The suspension was part of a five-year probation the board imposed. (Anderson, 11/13)

The city of San Diego helped install an aesthetically pleasing structure on its signature waterfront in 2014, designed by an artist to invoke "Jonathan Livingston Seagull," the popular 1970 novella about a seagull who wanted to be special. Its function? A restroom. Its cost? Two million dollars. (Cook, 11/13)

Chemed has paid the U.S. government a record $75 million to settle lawsuits claiming the hospice care provider submitted false claims to Medicare. The settlement resolves allegations that between 2002 and 2013 Chemed subsidiary Vitas knowingly submitted or caused to be submitted false claims to Medicare for services to hospice patients who were not terminally ill. (Coolidge, 11/13)

After months of developing plans for a San Francisco-style “full service” homeless shelter housing 75 men and women under one roof, Sacramento County staff are recommending – at least in the short-term – a plan to put those homeless people in 15 rental homes scattered across the county. (Fletcher, 11/14)

On the first Friday after the North Bay fires swept through Sonoma County, displacing an estimated 100,000 people, Tim Page drove from San Francisco to the Salvation Army in Sonoma County with 2,000 fresh, chef-made breakfasts, courtesy of SF Fights Fire, stacked in the back of his company van. The trip was the first of many made over the next two weeks by Page and his employees at F.E.E.D. Sonoma, a micro-regional produce aggregation and distribution food hub in Sebastopol that functions as a conduit between dozens of small, organic farms and chefs and restaurants across the Bay Area. (Clark, 11/13)

When a massive refinery outage sent flames, black smoke and toxic gas shooting into the sky from Valero’s Benicia plant last spring, the city’s mayor said the local government had little information about what was going on. Days later Mayor Elizabeth Patterson called for the city to develop regulations that would give Benicia more oversight over the oil giant it hosts. She proposed regulations similar to those in Contra Costa County, home to several refineries, that require oil refining facilities to undergo safety audits and share their risk management plans. ... But six months after one the Bay Area’s worst refinery malfunctions in the last five years, the refinery oversight measure has not moved through the City Council. (Goldberg, 11/14)

As Republicans try to rush a tax bill through Congress, some lawmakers want to use the measure to kill a key piece of the Affordable Care Act. Doing so would free up more dollars for tax cuts, but in the most shortsighted and cynical way: by inducing fewer low- and moderate-income Americans to sign up for health insurance. Oh and yes, it would cause premiums to rise even faster for those who get their insurance coverage through Obamacare. (11/14)

Watching Republicans continue to pull out the stops to end or severely hobble the Affordable Care Act is beginning to feel like watching someone bang their head against a brick wall, over and over. The head is bloody, but the wall is just fine. (Andy Slavitt, 11/13)

The only certainty we have these days regarding the Affordable Care Act is that of uncertainty. We seem to be in a perpetually suspenseful state of chaos with lack of clarity around policies and what will happen next. (Yuri Cunza, 11/13)

The Affordable Care Act, more commonly known as Obamacare, is a perverse twist on the Robin Hood tale. Rather than steal from the rich, Obamacare has taken from the middle class. Prior to ACA, the self-employed middle class had many options for comprehensive insurance. They were largely able to afford their premiums and deductibles, and out of pocket costs were manageable. Most importantly, they were free to choose their own doctors and hospitals from a nationwide provider network. (Martin H. Klein, 11/13)

Ohio hospitals have long been committed to being part of the solution to curtailing health care costs while ensuring quality health care can be delivered efficiently; ultimately leading to a healthier Ohio for all citizens. But hospitals now are facing hundreds of millions of dollars in new Medicaid cuts. Ultimately, patients will be affected. (Dr. Kevin Webb, 11/13)

Goodbye, AmeriHealth Caritas. Don’t let Iowa’s door hit you on the backside after abruptly abandoning your contract with the state to manage the health care of more than 200,000 Medicaid beneficiaries. (11/13)

One reason men and women in business are reluctant to go to Washington is the reception accorded Alex Azar Monday after President Trump said he will nominate the former Eli Lilly & Co. executive to lead the Health and Human Services Department. Mr. Azar was immediately criticized for, well, knowing too much about health care. (11/13)

Last month, Georgia Rep. Betty Price set off a national firestorm when she asked a state health official whether people with HIV could be legally quarantined. ... Price said Friday that HIV/AIDS was never the focus of the committee hearings. Barriers to access to health care was. “I think this is an issue that inserted itself,” she said. “It was not the high point of the mission of the committee.” ... While the prospect of a quarantine might be foolhardy, I know few who would argue that the HIV/AIDS epidemic shouldn’t be included in discussions about barriers to health care and particularly here in Georgia. When it comes to lifetime risk of infection — the likelihood of contracting HIV at some point during one’s life — Georgia ranks third in the nation behind D.C. and Maryland. (Gracie Bonds Staples, 11/14)

As a resident in a training program for primary care physicians, I ask my patients all sorts of highly personal questions aimed at understanding what’s needed to keep them healthy and prevent future disease. I ask how often a patient moves her bowels, whether he has had unprotected sex or used illicit drugs, and more. I never asked my patients if they keep a gun in the home — until the Las Vegas mass shooting prompted me to start. (Priya Joshi, 11/13)

The Trump Administration is knocking down stupid or destructive regulations at a fast clip, though one of the more ridiculous Obama -era directives survives: Last week the Food and Drug Administration issued draft guidance on a long-delayed rule for calorie boards at chain restaurants, and Congress ought to intervene. (11/13)