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It is a tough summer for Senate Republicans, who are trying to combine a long-promised repeal of the Affordable Care Act with a replacement that has, in legislation drafted so far, been as popular as sunburn. Protesters have held sit-ins at Senate offices, phone lines have been jammed and editorial writers have blasted their states’ congressional delegations. Planes have even flown admonitory, if occasionally poorly conceived, banners over state capitals. Republican senators have had to decide whether public appearances would be fruitful or the crowds hostile. Many lawmakers seem to have given up on town hall-style meetings and parades. Others are still braving them, knowing they may get an earful on the health care bills. (Robertson, Philipps, Bidgood and Cochrane, 7/4)

For the 15th year, Sen. Susan Collins (R-Maine) spent July 4 marching through this town of 1,331, a short boat ride away from Canada. She walked and waved, next to marching bands and Shriner-driven lobster boats. Her constituents cheered — and then asked whether she would vote against repealing the Affordable Care Act. “There was only one issue. That’s unusual. It’s usually a wide range of issues,” Collins said in an interview after the parade. “I heard, over and over again, encouragement for my stand against the current version of the Senate and House health-care bills. People were thanking me, over and over again. ‘Thank you, Susan!’ ‘Stay strong, Susan!’ ” (Weigel, Carpenter and O'Malley, 7/4)

As she sat at the right hand of President Trump at the White House this week, US Senator Susan Collins’s prominent position on a white-hot national stage could hardly have been more conspicuous. And to hundreds of Mainers who want New England’s only Senate Republican to more forcefully wield her blend of quirky independence as a bipartisan beacon, the seating chart in the executive mansion could not have been more hopeful. (Farragher, 6/30)

Critics of GOP plans in Congress to overhaul the Obama health law tried to put Republicans on the defensive on Tuesday at various parades around the nation marking Independence Day, as Republicans in Congress continue to look for a deal on a Senate health care bill, and opponents try their best to derail those legislative efforts. (Dupree, 7/4)

While the House and Senate are not in legislative session in Washington, D.C. this week, the clock keeps ticking on GOP efforts to overhaul the Obama health law, as top Republicans are hoping the week away from the halls of the U.S. Capitol will allow them to thread the needle, and find a deal that can muster a bare majority of votes for approval of a health care bill. (Dupree, 7/2)

Senator Dean Heller’s biting denunciation of the Republican health care bill last week infuriated the White House and helped unravel his party’s attempt to repeal the Affordable Care Act days before a vote was expected in the Senate. Now Mr. Heller is facing an intense backlash in Nevada, his home state, where there is talk of a primary race challenge against him next year and a pair of the state’s wealthiest Republican donors are fuming. (Martin and Vogel, 6/30)

A town hall meeting held by U.S. Sen. Bill Cassidy to talk about flood recovery in Louisiana's capital city was at times derailed Friday by people trying to pressure the Republican to vote against the Senate GOP's proposed rewrite of the national health care bill. (6/30)

A day before Sen. Ted Cruz heads to a town hall in McKinney, the Texas Republican heard from protesters in McAllen who oppose the Senate's attempts to repeal and replace the Affordable Care Act. (Cardona, 7/4)

Speaking on the back deck of a home in South Richmond, [Republican gubernatorial candidate Ed] Gillespie called Friday for the state to loosen restrictions on “consumer grade fireworks,” now prohibited in the state because of public safety concerns... However, Gillespie declined to take a definitive position on the Better Care Reconciliation Act, introduced by U.S. Senate Republican leaders a week ago but delayed until after the holiday in part because of concerns about its effect on state Medicaid programs. (Martz, 6/30)

That sure didn’t go as planned. Indiana Republicans called for people to share “Obamacare horror stories” on social media, but the only horror many people expressed was at the idea of losing it if the GOP repeal plan passes Congress. (Mazza, 7/4)

Republican senators are confronting a political challenge that is increasingly hard to ignore as they engage with voters during the July Fourth recess: Under their health-care overhaul, average premiums for a midlevel insurance plan would jump by 20% next January. (Armour and Peterson, 7/4)

With few Senate Republicans up for reelection in 2018, Democrats and other groups looking to defeat the GOP's plan to repeal Obamacare are looking to 2020 to pressure politically vulnerable senators. Save My Care, a progressive group dedicated to defeating repeal attempts, is out with new surveys from the Democratic firm Public Policy Polling showing the GOP proposal, which would cut Medicaid funding and repeal Obamacare's tax increases, is deeply unpopular in Iowa, North Carolina and Colorado — three swing states where Republican Senate wins in 2014 helped the GOP gain control of the chamber. (Robillard, 7/3)

In firm control of the federal government, President Donald Trump and his Republican Party have so far failed to deliver on core campaign promises on health care, taxes and infrastructure. But in New York's Trump Tower cafe, the Gentry family blames Congress, not the president. (7/3)

Republican senators back home on recess this week are hearing from some influential critics of their health-law effort: GOP governors, many of whom are urging them to push back on the legislation because it would cut Medicaid funding. (Peterson and Hackman, 7/3)

In today’s political climate, it’s rare to find bipartisanship. But as President Trump calls on Senate Republicans to pass a bill in the coming weeks that would overhaul the Affordable Care Act, governors from both sides of the aisle are unified in opposition. (Lee, 7/2)

Nevada Gov. Brian Sandoval may as well be the Senate’s 53rd Republican. GOP leaders are trying to win over the popular moderate and outspoken Obamacare repeal critic, believing his strong influence over Sen. Dean Heller in the health care debate could get them one vote closer to victory. (Haberkorn and Pradhan, 7/3)

Ohio Gov. John Kasich (R) lectured congressional leaders of his party on Sunday for being shortsighted, disingenuous and, ultimately, doomed to be forgotten by history if they persist with their approach to health-care legislation. “Sometimes my party asks too much,” Kasich said on ABC's “This Week,” saying he and others would not be fooled by “efforts to try to buy people off” with little fixes to the Senate bill to increase spending to combat opioid addiction or give more financial support to low-income people seeking health coverage. (Demirjian, 7/2)

An additional $45 billion to help combat opioid addiction in the Senate Republican Obamacare repeal and replacement bill isn't enough, Ohio Gov. John Kasich said Sunday. In an interview on ABC's "This Week," Kasich, who was a contender for the 2016 Republican presidential nomination, called the extra money, which would be spent over a decade, "not enough" to stem the opioid crisis. (O'Brien, 7/2)

The Senate leadership’s efforts to salvage the Republican health care bill have focused in part on adding $45 billion for states to spend on opioid addiction treatment. That is a big pot of money. But addiction specialists said it was drastically short of what would be needed to make up for the legislation’s deep cuts to Medicaid, which has provided treatment for hundreds of thousands of people caught up in a national epidemic of opioid abuse. (Goodnough, 6/30)

The Indiana Republican Party posed a question to Facebook on Monday: "What's your Obamacare horror story? Let us know." The responses were unexpected. "My sister finally has access to affordable quality care and treatment for her diabetes." "My father's small business was able to insure its employees for the first time ever. #thanksObama" "Love Obamacare!" (Martin, 7/4)

President Donald Trump is making a weekend push to get a Republican Senate bill to repeal and replace former President Barack Obama's health care law "across the finish line," Trump's top legislative aide said Sunday, maintaining that a repeal-only option also remained in play if Republicans can't reach agreement. Marc Short, the White House's legislative director, said Trump was making calls to wavering senators and insisted they were "getting close" on passing a bill. (Yen, 7/2)

U.S. President Donald Trump urged Republican senators in a tweet on Friday to repeal Obamacare immediately if they cannot agree on a new plan to replace it, muddying the waters as congressional leaders struggle for consensus on healthcare legislation. ... The White House said later that Trump was still "fully committed" to pushing the Republican draft healthcare bill through the Senate, although it was looking at every option for repealing and replacing Obamacare. (Chiacu and Cornwell, 7/1)

Conservative Republicans on Friday revived a proposal to speedily repeal the Affordable Care Act and come up with a replacement later, a surprise move reflecting the fractured state of the Senate GOP and the frustration felt by some conservatives about the pace of the Republican health-care push. (Radnofsky, 7/1)

President Donald Trump’s campaign to undermine, starve and dismantle Obamacare has hit a critical phase. Public support for replacing the Affordable Care Act is slipping and both the Republican House and Senate health bills are deeply unpopular. (Pugh, 7/5)

Repealing the health law without a replacement would kick about 18 million Americans off of health coverage in the first year — and reach 26 million a few years later, according to a CBO analysis of a 2015 bill to repeal the health law without a replacement... Repealing the entire law would remove subsidies, cut coverage, take away protections for pre-existing conditions and send premiums skyrocketing. (Haberkorn, 6/30)

As the Senate gears up to vote on the GOP bill to overhaul the Affordable Care Act, the White House is publishing statistics to criticize the current health law. The White House published a “Repeal and Replace Obamacare” website, rife with numbers and graphics, and is posting various statistics through its Twitter account. (Lee, 7/5)

Top Trump administration officials insisted Sunday that the odds of passing health-care legislation when the Senate returns to Washington next week remain high, but others in the GOP charged that the bill’s problems require more than a quick fix. Health and Human Services Secretary Tom Price and White House legislative affairs director Marc Short are fighting off a tide of discontent that has been exacerbated in recent days by President Trump’s tweet that the Senate could simply repeal the Affordable Care Act and replace it later if it cannot pass the pending measure. (Demirjian, 7/2)

As Republicans return to their home districts to sell a flailing health-care bill, liberal groups are using the congressional recess to build opposition. They believe tens of thousands of phone calls, emails and in-person pushes will force on-the-fence senators to reject the legislation for good. The fresh activism is coming with encouragement from Democratic lawmakers who are mired in the minority and have been mostly left to watch as Republicans struggle to reshape the nation’s laws to their liking. (O'Keefe and Weigel, 7/2)

Vermont Sen. Bernie Sanders has delayed his single-payer health care bill in order to leverage his national platform against the Republican health care proposal. In an exclusive interview, Sanders answered questions about the health care bill, a federal investigation into the now-defunct Burlington College and President Trump's attacks on the news media. (McCullum, 7/3)

Senate Majority Leader Mitch McConnell has delayed until after the July 4 congressional recess a vote on the Senate Republican bill to repeal the Affordable Care Act. That means that when Congress returns next week, a vote could happen soon after if negotiations on changes to the bill are successful. The timing will depend on when lawmakers get an updated nonpartisan analysis of the latest version of the bill. Here’s what to expect as the debate moves forward. (Jamerson, 7/4)

Congressional Republicans and Trump administration officials were at odds Sunday over how close the Senate is to a deal on an Obamacare repeal package and what the legislation should look like — an indication that the upper chamber may be further from agreement than some politicians let on. “We are getting close,” Marc Short, President Donald Trump’s director of legislative affairs, said on “Fox News Sunday.” The White House is making calls this weekend to “try and get the Senate package across the finish line,” Short added. (Karlin-Smith, 7/2)

Senate Republicans will seek to make progress on their stalled ObamaCare repeal bill in the coming week--this time away from Washington and back in their states for recess. (Sullivan, 7/3)

Just because it was the weekend leading into the Independence Day holiday doesn't mean there weren't developments for Republicans' plans to repeal and replace the Affordable Care Act. (Mattingly, 7/3)

Senate Majority Leader Mitch McConnell (R-Ky.) is in the pressure cooker as Republicans seek to deliver on the healthcare reforms they’ve been promising voters for years. (Bolton, 7/5)

Republican lawmakers have their own version of the facts about the impact of their replacement for the Affordable Care Act. Here is an assessment. (Qiu, 7/3)

Frances Isbell has spinal muscular atrophy, a genetic disorder that has left her unable to walk or even roll over in bed. But Ms. Isbell has a personal care assistant through Medicaid, and the help allowed her to go to law school at the University of Alabama here. She will graduate next month. She hopes to become a disability rights lawyer — “I’d love to see her on the Supreme Court someday,” her aide, Christy Robertson, said, tearing up with emotion as Ms. Isbell prepared to study for the bar exam in her apartment last week — but staying independent will be crucial to her professional future. (Goodnough, 7/1)

One of the unintended effects of the Senate’s Obamacare repeal bill would be to slash money that pays for a project popular among Republicans — using long-distance video hookups called telemedicine to connect sick kids in rural schools to big-city medical experts. (Pittman, 7/3)

Barb and Louie Emerson live in the Finger Lakes region of New York and they have their share of health problems... Due to their low income, the couple qualify for Medicaid under the Affordable Care Act’s expansion of the program. (Jaspers, 7/4)

The Senate health care bill, if it becomes law, would set in motion a massive rollback of Medicaid funding beginning in three years. But even some Republican supporters acknowledge the full cuts might never happen. Instead, they say it could become another Washington fiscal cliff, where lawmakers go to the brink of radical spending changes only to pull back — or have their successors pull back — just before the point of inflicting real pain in the face of intense pressure. (Haberkorn and Pradhan, 7/3)

Two of three Medicaid beneficiaries in Georgia are children. The national average is lower, with 43 percent of Medicaid beneficiaries being kids, but the numbers are still huge. So when cuts to the government program are proposed, as is the case with Republican health care legislation in Congress, many pediatricians become alarmed. (Miller, 7/4)

Oh, those charts. President Donald Trump passed one around on Twitter in recent days, and it showing spending on Medicaid rising for years in the future under the stalled Republican health care bill. You'd never know from his chart's mountain-climbing line , or his rhetoric, that the bill would inflict deep cuts in the program. (7/1)

The health care legislation under discussion in the Senate could allow states to remove some of the Affordable Care Act's consumer protections — including the prohibition that keeps insurers from limiting how much they'll pay for medically needy, expensive patients. Clara Hardy's parents worry about the Senate bill for just this reason. (Olgin, 6/30)

If Senate GOP leaders have their way, the check may not be in the mail. Many consumers collected unexpected rebates after the Affordable Care Act became law, possibly with a note explaining why: Their insurer spent more of their revenue from premiums on administration and profits than the law allowed, so it was payback time. More than $2.4 billion has been returned to customers since the provision went into effect in 2011, averaging about $138 per family in 2015. (Appleby, 7/5)

The Senate’s push to repeal the Affordable Care Act has bogged down in the face of a deep divide among Republicans, and some senators are expressing vastly disparate reservations about what the bill does and does not do. But there is another contentious element of the plan, found in both the House and Senate versions, that has received scant attention in Washington, mostly because it affects only one state: New York. (Foderaro, 7/3)

There’s much talk on Capitol Hill about the tax cuts included in the Republican health plans, but unless you are a frequent user of tanning beds or have personal wealth that puts you in the top 1 percent, you might not feel much effect from them. Specifically, both the House and the Senate plan would change or eliminate more than a dozen taxes that were levied to help pay for the Affordable Care Act’s insurance subsidies and to bolster Medicare and expand Medicaid. Republicans and other ACA critics have argued the taxes are onerous on businesses and families. (Appleby, 7/5)

North Texas’ hospitals and health systems are prudently watching and waiting as congressional leaders continue the prickly debate about the future of the nation’s health care law. (Rice, 6/30)

A proposal by Sen. Ted Cruz to let insurers provide less comprehensive coverage under the Senate health care bill could lead to an explosion of limited-benefit “junk insurance” in states that weaken consumer protections in the Affordable Care Act. (Pugh 6/30)

Health insurers are nervous about a new deregulation proposal by Texas Sen. Ted Cruz that could be added to the Senate Republicans' struggling legislation to repeal and replace the Affordable Care Act. (Meyer, 6/30)

When you pull into Hugo, a town 100 miles east of Denver on Highway 287, you're greeted by one grocery store, one restaurant, one liquor store, one historic railroad roundhouse, two bars and a single antique store by the name of Main Street Mama's. (Daley, 7/1)

Nationwide, about 80 rural hospitals have closed since 2010, according to the Chartis Center for Rural Health. Another 673 rural hospitals are in danger of shutting their doors. Many providers worry that the newly proposed health care legislation -- and in particular its proposed cuts to Medicaid -- could push a number of hospitals over the edge. (Nedelman, 7/1)

The doctor is in. But he's the only one for miles. (Hillyard, 7/2)

Congress is moving to prevent the Internal Revenue Service from enforcing one of the more unpopular provisions of the Affordable Care Act, which requires most Americans to have health insurance or pay a tax penalty. The plan is separate from Republican efforts to repeal the health care law, and appears more likely to be adopted because it would be written into the annual spending bill for the Treasury and the I.R.S. (Pear, 7/3)

More than 1,370 counties now have only one insurer that will sell on the Affordable Care Act exchanges next year, while about 40 have none, an analysis of the latest data by the Robert Wood Johnson Foundation and USA TODAY shows. (O'Donnell, 7/2)

A New York-based insurance company, Oscar Health, announced last week it will sell individual health plans in Nashville in 2018. This is welcome news for many local healthcare consumers, who were down to just one choice for individual health insurance. (Tolbert, 6/30)

Hundreds of thousands of consumers across the country are getting letters from insurers warning that their health plans bought under the Affordable Care Act will be terminated at year-end, raising alarm at a politically sensitive moment when Senate Republicans are struggling to craft their own health-care legislation. (Wilde Mathews and Evans, 6/30)

Health insurer Centene Corp. said Friday that the nearly 40 Missouri counties where it will launch coverage on Affordable Care Act insurance exchanges next year include roughly two dozen that would otherwise have been without an insurer. Missouri-based Centene Corp.'s announcement Friday came 17 days after it said it would foray into the Missouri exchanges even as others are either withdrawing from such markets or proposing steep price hikes to remain. Consumer rights advocates celebrated the announcement, saying something is better than nothing. (6/30)

By the time Elvis Rosado was 25, he was addicted to opioids and serving time in jail for selling drugs to support his habit. "I was like, 'I have to kick this, I have to break this,' " he says. For Rosado, who lives in Philadelphia, drugs had become a way to disassociate from "the reality that was life." He'd wake up physically needing the drugs to function. (Gordon, 7/3)

The yellow pills had already killed four before landing in Brian Hargett’s lab last month. They were clearly counterfeit — the letters P-E-R-C-O-C-E-T were as crooked as the dealer who had peddled them throughout central Georgia — but now his chemists had to figure out exactly what they were. And fast. Lives were still at stake; health officials wanted to alert the public about the phony pills. First, though, they had to know what was in them. (Blau, 7/5)

The companies that manufacture and distribute highly addictive painkillers are facing a barrage of lawsuits for the toll their product has taken on communities across the country as the worst drug epidemic in U.S. history continues to escalate. Within the past year, at least 25 states, cities and counties have filed civil cases against manufacturers, distributors and large drugstore chains that make up the $13 billion-a-year opioid industry. (Higham and Bernstein, 7/4)

Among the troubling developments of the nation's opioid crisis: a large number of babies born prenatally exposed to opioids. On a recent reporting trip, we visited Trinity Hospital in Steubenville, Ohio, where according to the acting CEO, 1 in 5 babies are born with prenatal opioid exposure. Other hospitals report as many as 1 in 8 newborns exposed to opioids in the womb. (Siegel and Cheung, 6/30)

Experts agree that the powerful synthetic opioid fentanyl and its even deadlier relatives pose potential hazards to police and emergency responders who come in contact with the drugs. But there is also concern that the risks are being overblown, potentially creating unnecessary stress for emergency workers. (McCullough, 6/30)

A dangerous form of a synthetic opioid can now be legally seized by police, thanks to a new “emergency rule” passed last week, the Georgia Bureau of Investigation announced Monday. The drug, tetrahydrofuran fentanyl, is an analogue of the synthetic opioid fentanyl, and can be absorbed through the skin, according to the GBI. (Capelouto, 7/3)

Because the for-profit center in Whitehall accepts Medicaid — making its services available to low-income central Ohioans — Braking Point also must abide by an obscure, 50-year-old federal rule that says community-based mental-health and addiction treatment centers can’t receive Medicaid funding if they have more than 16 beds. ... Today, critics who want the 16-bed rule lifted — including some lawmakers — say it’s an obstacle to care in the midst of an opioid epidemic that saw at least 4,100 Ohioans die by unintentional overdose last year. (Price, 7/2)

The Maryland Medicaid Program is rolling out two initiatives aimed at fighting the opioid crisis. The initiatives officially start on Saturday. The state is reforming policies to curb opioid prescribing in the Medicaid program. It’s encouraging health-care providers to consider non-opioids as first-line treatment of patients with chronic pain. It’s also urging providers to conduct thorough screening before prescribing opioids and to refer patients to treatment when they have a substance abuse disorder. (7/1)

It's a cruel reversal of fortunes for Florida, which from 2010 to 2013 witnessed the steady decline of opioid deaths as the state closed "pill mills" — pain clinics that recklessly handed out drug prescriptions. After the crackdown, those addicted to the shrinking supply of prescription painkillers searched for alternatives. (Auslen, 6/30)

It may be the most palatable advice you will ever get from a doctor: Have a glass of wine, a beer or a cocktail every day, and you just might prevent a heart attack and live longer. But the mantra that moderate drinking is good for the heart has never been put to a rigorous scientific test, and new research has linked even modest alcohol consumption to increases in breast cancer and changes in the brain. That has not stopped the alcoholic beverage industry from promoting the alcohol-is-good-for-you message by supporting scientific meetings and nurturing budding researchers in the field. (Rabin, 7/3)

If black infants born in the United States had all of the health and medical benefits enjoyed by white infants, nearly 4,000 fewer of them would die each year, new research suggests. That would amount to a nearly 60% decrease in the number of black infants that die each year. Instead, black babies are nearly 2.5 times more likely than white babies to die during their first year of life. (Kaplan, 7/3)

If you’ve got seasonal allergies, come spring (and sometimes all the way through fall), you sneeze, you itch, your nose runs and feels as though it’s stuffed with marbles. You’ve probably tried almost every over-the-counter remedy out there and maybe some prescription drugs to get relief: nasal sprays, allergy pills, injections and even saline solutions you pour into your nose from a little pot. (Karidis, 7/1)

Tom Patterson should have died during those weeks in March 2016 when he lay comatose, a lethal strain of ­multi-drug-resistant bacteria raging through his body. Antibiotics proved useless, and his doctors were grim. They were losing him. He should have died, but he didn’t. Instead, in desperation, a novel approach — giving him infusions of bacteria-killing viruses known as bacteriophages — saved his life. (Cimons, 7/2)

In 1915, British scientist Frederick Twort saw something weird happening to the bacteria that had invaded his viral cultures: They were disappearing, a sign they had been destroyed. Two years later, French-Canadian microbiologist Félix d’ Hérelle observed the same phenomenon in his own lab. Both researchers, working independently, concluded that the viruses they had been growing were killing the bacteria. It was an astonishing discovery, because no one had any idea that viruses had that kind of power. (Cimons, 7/2)

Science relies on the careful collection and analysis of facts. Science also benefits from human judgment, but that intuition isn't necessarily reliable. A study finds that scientists did a poor job forecasting whether a successful experiment would work on a second try. That matters, because scientists can waste a lot of time if they read the results from another lab and eagerly chase after bum leads. (Harris, 7/4)

A therapy-animal trend grips the United States. The San Francisco airport now deploys a pig to calm frazzled travelers. Universities nationwide bring dogs (and a donkey) onto campus to soothe students during finals. Llamas comfort hospital patients, pooches provide succor at disaster sites and horses are used to treat sex addiction. And that duck on a plane? It might be an emotional-support animal prescribed by a mental health professional. (Brulliard, 7/2)

A rise in hepatitis C cases has led to the arrests of tattoo artists in southwest Virginia. The Roanoke Times reported Sunday that more people could be charged as the investigation continues. Police in Pulaski, Virginia, arrested four men in June for unlicensed tattooing, a misdemeanor offense. Hepatitis is a viral infection that can damage people’s livers, sometimes fatally. (7/2)

As coastlines recede with global warming, so-called heat islands are growing... For residents of these islands, health risks rise with the heat. (Bebinger, 7/5)

When Maya Terrell saw the anti-smoking television commercial, she knew she would never try a cigarette. It featured an ex-smoker with a hole in her throat where her larynx used to be. “I was like, ‘Never!’” recalled Terrell, 18. “I was scared.” (Browning, 7/5)

An effort to create a government-paid health care system for all Californians has morphed into a massive fight between Democrats at the Capitol and a nurses union, with insults, death threats and violent imagery of backstabbing directed at the legislative leader who pulled the plug on the bill. In an unusual move, the Assembly Democratic caucus issued a statement Friday condemning what they called bullying tactics used against Assembly Speaker Anthony Rendon, D-Paramount (Los Angeles County). (Gutierrez, 6/30)

Practically everyone in the South Bronx knows about the place at Grand Concourse and East 173rd Street. You can pick up scratch-off lottery tickets there. You can grab a bacon, egg and cheese on a roll on your way to work. You can go to Sunday Mass. You can also go there for medical care .... These are just some of the ways that residents of one of the most poverty-stricken communities in the nation interact with the roughly 4,000 doctors, nurses, cafe countermen and others who work at Bronx-Lebanon Hospital Center, one of the biggest employers in the Bronx and the scene of a horrific rampage last week. (Stewart and Wang, 7/4)

He is still trying to convince the VBA that his service caused his PTSD. He said the compensation and pension — or C&P — exam that the VBA relies on to help make medical decisions lasted only 45 minutes and the examiner never asked about the events that he believes triggered his PTSD. (O'Connor, 7/2)

Republican Gov. Rick Snyder vetoed legislation on Friday to require Michigan to create and sell an anti-abortion fundraising license plate, saying the bill is too politically contentious and would have divided residents. The measure approved by the GOP-controlled Legislature would have required the "Choose Life" plate to be issued by next June. (6/30)

A January AARP Texas report found the quality of the state's nursing homes on average was “shamefully poor"... Meanwhile, the state’s Department of Aging and Disability Services, which regulates long-term care facilities, identified some 17,466 violations over the course of fiscal year 2015, but only took enforcement action — everything from fines to license revocations and denials — in 40 cases. (Evans, 7/3)

Cassie Valera knew early on that she wanted to be a nurse. (Rice, 7/4)

West Nile virus has been detected in mosquitoes in Milwaukee, city health officials said Friday. Though there have been no confirmed cases of people being sickened by West Nile in Milwaukee this year, residents should take steps to protect themselves against mosquito bites, city Health Commissioner Bevan K. Baker said. (Garza, 6/30)

Dying patients want quicker access to experimental drugs that could extend their lives, and 37 states, including Minnesota, have enacted laws since 2014 granting that wish... The laws allow the use of drugs and devices that have passed preliminary FDA safety tests but haven’t been approved for use. (Keen, 7/4)

Barry Cadden, owner of the defunct New England Compounding Center, was sentenced Monday for what one law enforcement official described as “one of the worst public health crises in this country’s history.” Evidence indicated that Cadden authorized the compounding of medications in unsanitary conditions with expired ingredients, and the bulk dispensing of those medications without valid prescriptions. (Olson, 6/30)

The two-year state budget approved by lawmakers Friday will boost spending for Washington’s mental-health system and kick-start an overhaul of Western State Hospital. (Orenstein, 7/3)

One alderman's proposal to overhaul the city's recommendations for avoiding lead exposure in drinking water is receiving a tepid response from the Milwaukee Health Department and some local medical experts.The resolution by Ald. Tony Zielinski would direct the Health Department to "immediately recommend that to avoid potential lead exposure, women of childbearing age and children under the age of 6 should not drink unfiltered water and that children under the age of 6 should be tested for lead." (Spicuzza, 7/2)

Just a day after the General Assembly overturned Gov. Roy Cooper’s budget veto, lawmakers wrapped up their work and headed home for an entire month. With a number of bills left incomplete and issues such as Supreme Court-ordered redistricting ahead of them, legislators left Raleigh on June 29, agreeing to return for a few days in early August and promising to return in September too. (Hoban, Asmalash and Knopf, 6/30)

California residents choosing legal assisted suicide are disproportionately white and well-educated, new figures show... Of the 111 individuals, 87 percent were at least 60 years old and 44 percent relied solely on Medicare for health insurance. (Xu, 6/30)

The Texas Supreme Court on Friday sided with same-sex marriage opponents who argued that the city of Houston should not have extended its benefits policy to married same-sex couples. The court threw out a lower court ruling that had favored the benefits and sent the case back to a lower court. (Kelly, 6/30)

New malware that has swept through computers in more than 60 countries has disrupted medical transcription services at some Wisconsin hospitals. The malware called NotPetya recently hit Nuance Communications, a voice transcription service for health care providers, including Wisconsin-based Aurora Health Care, ThedaCare and Bellin Health. (Barrett, 7/1)

Milwaukee County corrections operations face the prospect of an outside audit, fines or an order forcing reduction of its inmate population if health care staffing inside the facility does not improve, a civil rights attorney said. The attorney from the Wisconsin American Civil Liberties Union spoke at a court hearing this week as part of a long-running civil case settlement with inmates who sued Milwaukee County over jail staffing and health care in the facility. (Hovorka, 6/30)

The city-county collaborative First Year Cleveland on Thursday released its three-year plan to improve the region's abysmal infant mortality rate, which is among the highest in the nation. In 2015, 155 Cuyahoga County babies died before reaching their first birthday, giving the county an infant mortality rate of 10.5 deaths per 1,000 live births, almost double the national rate. (Zeltner, 6/30)

Glendale Adventist Medical Center’s recent partnership with a nonprofit group is designed to make access and delivery of electronic medical records more efficient for those in its network. Glendale Adventist and White Memorial Medical Center — both part of the health system called Adventist Health — have signed two-year contracts with the Los Angeles Network for Enhanced Services, or LANES, an L.A. County-based nonprofit that provides a platform for the exchange of electronic patient data among public and private healthcare providers. (Landa, 7/3)

It’s been two years since the first Minnesotans picked up prescriptions for medical marijuana. The program that launched on July 1, 2015, with a handful of patients had 6,184 active participants as of Friday. That’s modest by comparison to other state programs, but it tops state lawmakers’ goal of 5,000 within the first few years. (Brooks, 7/1)

Taylor Sabky spent this past Mother’s Day in shock, absorbing the news that her toddler, Purnell, was dying. He’d been diagnosed days before with Niemann-Pick type A — an ultra-rare genetic disease that typically kills children by age 3. It was inconceivable...Rare diseases are increasingly attractive to biopharma companies, which can charge premium prices if they come up with a therapy. (One drug that just hit the market is priced at $750,000 for the first year of treatment.) But before they’ll invest heavily in a field, companies want to see compelling early-stage science. (Keshavan, 6/30)

In this city on the east bank of the Mississippi River, Rebekah Gee, Louisiana’s health secretary, presides over what she calls the “public-health-crisis cradle” of America. Poverty and poor health collide here to produce some of the nation’s worst rates of obesity, premature birth and other maladies. Those problems are deep-rooted and hard to solve. The easy one, at least in theory, is hepatitis C, a liver-damaging virus frequently contracted by injection-drug users that can cause cirrhosis and cancer. (Johnson, 7/3)

Donald Jones used to pay at least $500 a month for a brand-name drug, Gleevec, that’s kept his leukemia at bay for five years. Lately, he’s been paying almost as much for a generic version of the same pill. It’s not supposed to work that way. For decades in the U.S., generic drugs have been cheap, effective alternatives to expensive brand-name treatments. That’s changing with drugs like Gleevec, Novartis AG’s household-name cancer treatment. Generic forms of the drug can cost $150 or more a pill. (Langreth, 6/30)

Adecade ago, a big push began to force drug makers to disclose payments to doctors for speaking, consulting, travel, and research. The campaign was controversial, but reflected concerns that medical practice and research may be unduly influenced by financial ties, and it ultimately led to the creation of a federal database that collects industry payments. Now, though, a group of researchers sought to quantify the extent to which such efforts may have had on actual prescribing. And they found a drop in prescriptions for three types of widely used medicines in Massachusetts, a state that was among the first to require companies to report payments. The law went into effect in July 2009, a few years before the OpenPayments federal database. (Silverman, 6/29)

Federal prosecutors Monday asked a judge to muzzle so-called "Pharma Bro" Martin Shkreli for the balance of his ongoing conspiracy and fraud trial. Raising concern that Shkreli's in-person and social media criticism and statements about the case risk "tainting the jury," prosecutors asked U.S. District Court Judge Kiyo Matsumoto to limit Shkreli's statements outside the Brooklyn courtroom. (McCoy, 7/3)

Two drug companies raised the price of cancer drugs last week for the second time this year. Amgen Inc. raised the price of its Blincyto by 3.9% on Wednesday, according to Bernstein analyst Ronny Gal, and Teva Pharmaceutical Industries Ltd. raised the price of its Treanda by 4.5% on Saturday. Both Blincyto and Treanda are leukemia drugs, while Treanda is also approved for non-Hodgkin lymphoma. (Court, 7/3)

Soaring costs for dozens of common drugs are forcing Minnesotans to skip or skimp on their medications, causing alarm among doctors who say that the price of prescriptions has become a chronic health problem in and of itself. The cost of doxycycline, a generic antibiotic, rose from 24 cents per unit in 2011 to $2.21 cents in 2015, while the cost of Avonex, a multiple sclerosis drug, increased from $778 to $5,129 per unit, according to a Star Tribune review of the latest Medicare Part D drug spending data. (Olson, 7/1)

The Massachusetts Department of Public Health is preparing a pilot program to screen newborns for a rare but often fatal disease: spinal muscular atrophy, or SMA. Last month, the Missouri Legislature approved a bill directing health officials to screen newborns statewide for the disorder. (Zimmerman, 6/29)

Now that the Food and Drug Administration plans to fast-track generic drug applications in hopes of spurring competition and lowering medicines costs, a key question should be asked: Can the agency follow through? A new government report suggests that — yes, the FDA does have the wherewithal. Thanks to a program in which industry pays fees so the FDA can more readily review drugs and inspect plans, the agency has already been reviewing generic drug applications at a faster clip. In fiscal year 2012, the agency spent 28 months on reviews, but that fell to 14 months by fiscal year 2015, according to a newly released report by the U.S. Government Accountability Office. (Silverman, 6/28)

It’s easy to be outraged by high drug prices. Yet under current circumstances, simply slashing them could make matters worse.That may be hard to see at first. After all, the case against soaring drug prices is being widely and persuasively made. Even the prestigious biology journal Cell recently published a commentary with the provocative title “How Much Longer Will We Put Up With $100,000 Cancer Drugs?” Donald J. Trump once railed that drug companies are “getting away with murder.” (Sendhil Mullainathan, 6/30)

Martin Shkreli isn't actually on trial for buying an obscure antiparasitic drug used by AIDS patients and jacking up the price astronomically, but he might as well be. Three days into Shkreli's trial for alleged securities fraud -- for an issue unrelated to his notorious pharmaceutical price-hike --potential jurors kept circling back to his infamous decision to buy a little-known, little-used drug that was invented before he was born and raise the price overnight, from $13.50 to $750 a pill. (Carolyn Johnson, 6/29)

Virtually all consumers want the most innovative products and services as inexpensively as possible. Nowhere is this more acute than the health care sector, where quality of life — and life itself — is at stake. The news cycle is replete with shock-value stories of prices for medicine, from Martin Shkreli to the EpiPen. While these flashpoint events have already been addressed through public pressure and investigations. They fuel a larger narrative that drug costs are rising too fast. (Steven Tepp, 7/5)

David Hernandez, a 44-year-old restaurant worker and Type 1 diabetic, didn’t have insurance from 2011 through 2014 and often couldn’t afford insulin—a workhorse drug whose list price has risen more than 270 percent over the past decade. As a result of his skimping on dosages, Hernandez in 2011 suffered permanent blindness in his left eye, and three years later he experienced kidney failure. He’s since received a lifesaving kidney transplant covered by Medicare and has drug coverage under a New Jersey program for the disabled. But Hernandez’s eligibility expires next January, at which time he’ll have to pay about $300 a month out of pocket for insulin. “I don’t really have that kind of money,” he says. (Paul Barrett and Robert Langreth, 6/29)

A Des Moines Register editorial last week reported on two Washington lawmakers, a Democrat and a Republican, who each have children with Type 1 diabetes. They are calling on the health industry to explain why insulin is so expensive. The price of insulin has tripled in recent years, even for older forms of the drug. One costing $21 a vial two decades ago has increased to $255. The retail price for many is frequently about $300 per vial, and diabetics commonly use two to six vials per month. (7/4)

Having now decamped to their home sanctuaries for the Fourth of July weekend, Senate Republicans may get a momentary break from the pressure to have to vote on a Trumpcare bill their leadership wants, the President sort-of seems to want—and four-fifths of Americans appear to detest. (Clifton Leaf, 6/30)

As Washington continues to boggle the nation with the complex minutiae of health-care reform, the contours of an actual deal aren’t nearly so mystifying. The success of the GOP effort comes down to one simple question: Will the most conservative members of Congress accept that the politics of health care have changed? Or more simply yet: Will they acknowledge that any reform must include continued protections for pre-existing medical conditions? (Kimberley A. Strassel, 6/29)

Of course, this wavering approach to our health isn’t a problem as long as we realize that medicine is not a perfectly understood science that always offers neat answers. If the politicians who make the laws that deal with who gets access to health care also understand this reality, we would be in decent shape. But those now holding the keys to the gates are painfully unaware of the fickle nature of the beast, and as a result, millions of patients with preexisting conditions will suffer if the proposals Congress is considering to repeal the Affordable Care Act become law. (Elizabeth L. Silver, 7/5)

In today’s corporate America, employees in their 50s and 60s have a reason to feel as vulnerable as a coach. ... Many needing to buy private insurance who have not yet reached the sanctuary of Medicare are out of luck if pre-existing conditions are once again introduced to the purchase of insurance — because most of these folks are no longer in perfect health. (Steve Butler, 7/3)

What is the basis for the argument that poor Americans will be healthier if they are required to pay substantially more for health care? It appears that proponents like [CMS administrator Seema] Verma have looked at research and concluded that having Medicaid is often no better than being uninsured — and thus that any private insurance, even with enormous deductibles, must be better. But our examination of research in this field suggests this kind of thinking is based on a classic misunderstanding: confusing correlation for causation. (Aaron E. Carroll and Austin Frakt, 7/3)

Since Ohio expanded Medicaid in 2014, many of my patients who were previously uninsured are among the 700,000 Ohioans who can now afford medications and treatments, get their chronic illnesses under control, return to work, and become more engaged in their families and communities. Many of them call the Medicaid expansion a lifesaver. (Dr. James Misak, 7/5)

The dirtiest little secret of the Republicans’ Obamacare repeal campaign is that its genesis has nothing to do with the Affordable Care Act as such, but with a long-cherished desire to gut Medicaid, which predated the ACA by nearly a half-century. (Michael Hiltzik, 7/3)

We still don't know who will ultimately prevail in the debate over the future of American health care: the Republicans who want to overhaul Obamacare, or the Democrats who want to keep it in place. But after weeks of debate, there is one clear winner so far: single-payer health care. (Aaron Blake, 7/1)

Older Americans may be in for a rough ride if the changes Washington politicians are considering come to pass. Because good, explanatory journalism is in short supply and TV shouting matches don't tell you much, I decided to use this space to discuss some of the possible changes that could soon affect millions of people in their 60s and older. (Trudy Lieberman, 7/3)

My wife and I were chatting the other night about Republican efforts to reboot the U.S. healthcare system as a horror movie — stripping health coverage from more than 20 million Americans, boosting premiums for many and gutting Medicaid. She finally brought the conversation home by asking: “What happens if something happens to you?” (David Lazarus, 7/4)

According to widespread media reports, Senate Republicans are considering an amendment to the proposed Better Care Reconciliation Act from Texas Senator Ted Cruz under which, if a health insurer offered at least one Obamacare-like plan with community rating, it could also offer a plan in which healthier people would pay lower rates than the sick. Although this proposal might please conservatives otherwise worried that the BCRA is but "Obamacare-lite" and although it might mollify some moderates -- if you like your Obamacare you can kind of keep it -- it creates an "income cliff." People who need expensive medical care will be far worse off if they make more money. (Seth Chandler, 7/3)

Now it is the Republican Party’s turn to face a health care choice. They can forge ahead with the “repeal” (really just the reform) of Obamacare, notwithstanding the massive unpopularity of the legislation being negotiated in the Senate, on the theory that they’re more insulated than the Democrats were in 2010 (after all, they won their recent special-election squeaker) and that the policy achievement is worth the political pain. Or they take the road the Democrats did not, and retreat to a much smaller bill instead. The case for retreat is stronger than it was for Obama’s party. (Ross Douthat, 7/1)

It’s gut check time for Republicans. For years, they’ve claimed the Affordable Care Act has been choking the economy, thanks in large part to the new taxes the law levied on investors. And for decades, they’ve railed against the evils of taxation, arguing it feeds a bloated government while choking the nation’s economy and infringing on individual freedom. Now that they have the power to actually do something about those loathed tax levies, however, they’re looking a bit wobbly. (Elizabeth Winkler, 6/30)

In arguing for the Senate health-care bill, Majority Leader Mitch McConnell (Ky.) reportedly warned his fellow Republicans that if they didn’t pass it, they’d have to work with Democrats to shore up the Affordable Care Act’s insurance exchanges. It’s true that abandoning ACA repeal would be a big psychological blow for a party that has campaigned on little else for the past four election cycles. But giving up on repeal would open the possibility of meaningful action on health care that could gain the support of a bipartisan congressional majority — and would be popular with the public, too. (David Cutler, 6/30)

The Senate majority leader who worked tirelessly to keep any Republicans from supporting Obamacare is now talking about working with Democrats on his health bill? That’s rich. (7/3)

The Senate won’t be voting on a bill to repeal and replace the Affordable Care Act by July 4. And that’s a good thing. The bill that was moving forward had too many flaws, didn’t fix anything in the ACA and didn’t meet many of President Donald Trump’s promises for health care reform. (Ernst-Ulrich Franzen, 7/2)

If the GOP’s efforts to repeal Obamacare do fail, there’ll be plenty of reasons why. But over the last week, two surprising explanations stand out: the resoluteness of Republican moderates and the strategic failures of Senate majority leader Mitch McConnell. (Michael A. Cohen, 6/30)

Pretend you are that most improbable of combinations — a lovable billionaire. In other words, you’re Warren Buffett. The politicians who worship guys like you have another treat in store: They will cut your most recent tax bill by $679,999, making you even wealthier. But it comes with a price. A fellow American of a certain age making $56,000 a year would have to pay three times more in annual health care premiums — $20,500 — to help finance your windfall. ... Such is the bargain — your health care for my tax cut — that Republicans have proposed with their overhaul of the Affordable Care Act. (Timothy Egan, 6/30)

One key battleground right now is the question of whether GOP leaders will try to woo these moderates by getting rid of the GOP bill’s repeal of one of the ACA’s big taxes on the wealthy: the tax on investment income, which hits top earners. ... But here’s the thing: Even if Republicans do restore the investment tax, it could have a relatively minuscule impact on the overall loss of coverage the GOP bill would produce. Indeed, it might only restore a meager 22 percent of the Medicaid funding, according to one expert I spoke with. (Greg Sargent, 7/3)

The “swamp” is winning. Republicans are now breaking frequent promises to repeal Obamacare. Last week, the Senate Budget Committee rolled out the Better Care Reconciliation Act, the upper chamber’s version of Obamacare repeal. Except the bill only modifies Obamacare subsidies, bails out insurance companies, likely keeps Medicaid expansion and does nothing to lower premiums. (Adam Brandon, 6/30)

Barack Obama inherited a broken health care model and made it worse, unless you count shunting millions of people into Medicaid as a triumph. For all the liberal angst about the Republican House and Senate bills, they are only tinkering with the same unfixable formula. The only genuinely promising reform in the Republican health bills are proposals to nearly double contribution limits for heath savings accounts and allow them to be used to pay for premiums. Enrollment in tax-deductible, investable H.S.A.s has roughly doubled since Obamacare took effect, to about 20 million, because they help cover out-of-pocket costs for low-premium, high-deductible plans. (Bret Stephens, 6/30)

Nearly everything people most dislike about the current health care law would be made worse by the Senate Republicans’ effort to repeal it. And just about everything people like about the law would be unraveled. This paradox helps explain why Republicans are foundering in their seven-year effort to undo the Affordable Care Act, and why for the first time since it was enacted under President Barack Obama, the law is finally popular. (Carolyn Lochhead, 7/1)

Republicans who steadfastly oppose Obamacare should not repeat its greatest mistake. That law was deeply flawed from the beginning because it imposed a major policy reform on the entire country without a single Republican vote. (7/2)

Planned Parenthood has launched a misleading ad campaign on the issue featuring a woman who self-discovered a lump in her breast and turned to Planned Parenthood. ... The ad makes it seem like Planned Parenthood plays a major role in cancer detection. In reality, they play no such role nationally or in most communities, especially rural areas. (Cathi Herrod and Marorie Dannenfelser, 6/30)

Senate Republicans promised to write a different – if not better — health care bill after the House delivered its widely-criticized attempt at an Affordable Care Act repeal in May. Instead, the Mitch McConnell-led Senate proposes much of the same: a bill, named the Better Care Reconciliation Act, that would provide tax breaks for the wealthy and would hit even harder than the House version those most in need of medical insurance – including rural America, people between the ages of 50 and 60, the sick and the poor. (7/1)

The Republicans who control the White House and Congress have had a lot of trouble agreeing on a health care bill — so it's hard to imagine them coming together around something as momentous as the Declaration of Independence. But not impossible. Let's imagine how the fractious GOP might repeal and replace America's founding document. (Brian Dickerson, 7/5)

The arguments against repealing Obamacare without a plan to replace it are just as strong today as they were in January. Even if you don’t like what’s happening in the markets, you shouldn’t want to increase the population of uninsured Americans by 18 million in a single year, as the Congressional Budget Office has predicted a pure repeal would cause. And you especially wouldn’t want to do that in 2018, when control of the House and Senate are up for grabs. Would you? (Jon Healey, 6/30)

President Trump is more than his own worst enemy. The damage he has inflicted during his first five months in office has undermined Republican congressional leaders, frustrated members of his Cabinet, exasperated top advisers and strained relations with some of the nation’s most important allies. This week’s case study is health care. (Dan Balz, 7/1)

President Trump had tweeted his support of the idea of passing a bill to repeal the Affordable Care Act (that is, Obamacare) over the short term, setting a strict timeline for Congress to figure out a replacement. ... An expert we spoke with by phone Friday, the Brookings Institution’s Matthew Fiedler, made clear that this would not simply set a timer on replacing the existing system. While that clock ticked down, he suggested, the system would already be falling apart. (Philip Bump, 6/30)

Uncertainty over the future of the Affordable Care Act ― and, in particular, the administration’s willingness to manage the program ― has spooked insurers, causing them to seek higher premium increases next year and in some cases withdraw from markets altogether. Tweets like Friday morning’s one won’t exactly dispel those feelings. (Jonathan Cohn, 6/30)

The forced postponement of a Senate vote on repealing and replacing Obamacare magnifies Donald Trump's struggle to demonstrate his fitness to serve as president. His repeated assaults on the health care insurance law and his pledge to get rid of it have dominated his domestic agenda to the point that his entire administration has been stalemated, only five months into his White House tenure. (Jules Witcover, 7/3)

Seeing red, Donald Trump waved the white flag of surrender on Obamacare early Friday morning. The Republican-led Congress isn’t dumb enough to follow his frustrated call for lawmakers to help him repeal the law without a replacement plan attached. That’s why Trump’s tweet — “If Republican Senators are unable to pass what they are working on now, they should immediately REPEAL, and then REPLACE at a later date!” — is more the primal scream of a man in retreat than a serious proposal. But it’s also a reminder that his own party can’t trust him to stick to the plan or back up those who have taken political risks for their shared agenda. (Jonathan Allen, 7/3)

New data have been released contradicting Republican propaganda about the “failing” Affordable Care Act. What may be more embarrassing to the hardliners pushing repeal is that it comes from the government, specifically the Department of Health and Human Services. (Michael Hiltzik, 7/3)

It is no wonder so many myths about health insurance persist. The U.S. health insurance system is opaque and labyrinthine, and at times purposely so. The current debate over whether to repeal major provisions of the Affordable Care Act (ACA), otherwise known as Obamacare, comes down to whether consumers should subsidize services they never expect to use. But who pays for what, and how, is not straightforward. (Alexis Pozen, 6/30)

If Senate Majority Leader Mitch McConnell cannot salvage his party’s effort to repeal and replace the Affordable Care Act, there is still a way forward if he and his Democratic colleagues truly want to fix Obamacare. All they have to do is be willing to compromise — and to acknowledge some history. The failure of the Republicans to agree, so far, on an alternative to Obamacare should not be surprising — because Obamacare was, in fact, the long-standing Republican alternative to the more radical health-care reforms, such as a single-payer system, that Democrats have proposed since the Truman era. (Steven Brill, 6/30)

There is an ongoing terrorist attack happening in Ohio. It has nothing to do with the Islamic State or political anarchists. The weapons in this case come in the form of heroin and other opioids, and the terrorists are the pushers who spread the deadly poison. ... With the FBI reporting that most heroin enters the United States from Mexico, and local officials saying that it then makes its way here through metropolitan drug rings, it’s no wonder that few people in Hillsboro think President Trump’s border security plans are extreme. (Gary Abernathy, 6/30)

Even as a pediatrician, I share some of the blame for the drug abuse epidemic that is now the leading cause of death for people under 50 years old. A significant percentage of those who are now addicted to opioids obtained their first dose from a physician. This is a function of how we are trained. (David Myles, 7/2)

Dr. Robert Pearl has spent his life in medicine — most recently 18 years as executive director and CEO of Kaiser Permanente’s medical group in California, and president and CEO of its mid-Atlantic group. But it was the death of his father, and a simple medical miscommunication, that prompted him to look long and hard at an American medical system that doesn’t always deliver bang for its billions of bucks. In his book, “Mistreated, Why We Think We’re Getting Good Health Care — And Why We’re Usually Wrong,” Pearl lays out his four ways though the morass of American medical practice: integrated, not fractured care; a flat-fee capitated payment system instead of pay-per-treatment; embracing mobile and video medical technology; and most of all, care that’s led by doctors themselves. (Patt Morrision, 7/5)

For more than a year now, the Iowa Department of Human Services has consistently failed to disclose reliable, detailed information on the impact of its controversial Medicaid privatization scheme. Health care providers, legislators and the media have all complained that some of the information that has been disclosed by the state seems unsupported by hard data or appears to be contradicted by other information that’s readily available. (7/2)

In a flurry of bill-signings and statements, Missouri Gov. Eric Greitens cut the wages of thousands of Missouri workers, made it easier to discriminate, blocked help for some 8,000 elderly and disabled residents, hammered Missouri’s beleaguered universities, cut Medicaid payments to health care providers and slashed spending for a department charged with protecting children. ... Punishing Missouri’s most vulnerable citizens — children, the elderly, the poor — isn’t tough. (7/3)