The New York Times: In Likely Spending Plan, Congress Readies Blows To Obama’s Health Care Law
The legislation will also suspend a tax on medical devices for two years. The device tax, which took effect in 2013, will be suspended through 2017. Congress also agreed to suspend for one year a tax on health insurance providers. The tax applies to insurance purchased by individuals, families and many businesses, as well as to private plans that manage care for millions of Medicare and Medicaid beneficiaries. (Pear, 12/16)

The Associated Press: Led By GOP, House Poised To Renew Over $600B In Tax Cuts
Although House Minority Leader Nancy Pelosi was leading a Democratic charge against the tax measure, GOP leaders seemed certain to push it through the chamber Thursday. That would set the stage for House passage Friday. (Fram, 12/17)

CNN: What's In The 2,000-Page Bill Congress Dropped In The Middle Of The Night?
Republicans have tried to repeal Obamacare and have it overturned in the courts -- to no avail. So in an era of divided government, the best the GOP could hope for was a compromise measure to chip away at it. The spending bill would suspend the implementation of two key Obamacare-related taxes for two years. (Berman, Sloan, Kopan and Barrett, 12/16)

Politico: 2,200 Pages, $1.8 Trillion, Dead Of Night
Say what you will about past efforts to dismantle Obamacare, there was broad bipartisan agreement to delay or pause three major taxes in the Democratic health care law. The two-year pauses on the Cadillac tax and medical device tax, along with a one-year break in the health insurance tax, will subtract about $35 billion in funding for the ACA. (Becker, 12/16)

The Washington Post: Here’s What Made It Into Congress’ Big Spending And Tax Bills
The $1.1 trillion spending bill is packed with policy riders that will upset or excite Democrats, Republicans and various special interest groups. Leaders also released a $650 billion tax package that will extend nearly 50 tax breaks for businesses and individuals and stall portions of the Affordable Care Act. (DeBonis and Snell, 12/16)

NBC News: House Democrats Have Concerns Over Details In Trillion-Dollar Spending Deal
House Democrats are raising concerns about the deal struck late Tuesday night on a $1.1 trillion dollar spending bill, legislation that would avert a government shutdown and fund government through October of 2016. ... The Affordable Care Act will also be impacted by these two deals. [House Speaker Paul] Ryan announced tonight the Omnibus will include delaying a provision in the ACA — known as the "Cadillac tax," a tax on high-cost healthcare plans — for two years. And in the tax extender package, there will be a two-year suspension of the medical device tax. (Moe and Thorp, 12/16)

In other Capitol Hill news -

The Associated Press: House Delays Vote Targeting Planned Parenthood, Health Law
Republican leaders have decided to delay until January a House vote to unravel President Barack Obama’s health care overhaul and block federal money for Planned Parenthood, hoping to increase attention on their drive against two of conservatives’ favorite targets. The measure has already cleared the Senate, and House passage seems assured. (Fram, 12/16)

The Wall Street Journal: Spending Deal’s Adjustments To Health Law Seen As Step To Permanent Change
Industry groups trying to repeal the Cadillac tax as well as supporters who are working to preserve it say they see the two-year delay as a step toward axing the tax. (Radnofsky, 12/16)

The Washington Post: Congress To Delay ACA’S ‘Cadillac’ Tax On Pricey Health Plans Until 2020
The congressional Joint Committee on Taxation has estimated that the tax would bring in $2.2 billion in 2018 and $7.2 billion in 2019. Its revenue would balloon after that, totaling an estimated $91 billion by 2025. ... Peter Orszag, President Barack Obama’s first director of the Office of Management and Budget, said that “the big concern with delay is, it’s not a delay, it becomes a rolling permanent deferral.” (Goldstein, 12/16)

The Associated Press: Workers Unlikely To See Relief From Delay Of Health Plan Tax
Don’t expect to see much relief from rising costs for workplace health coverage under a federal budget deal that postpones a widely feared tax on generous insurance plans, experts say. The so-called Cadillac tax, which would be delayed two-years in the proposed deal, meant to discourage extravagant coverage and help keep costs in check. (Alonso-Zaldivar, 12/16)

The Associated Press: Budget Deal Cues Up 2-Year Freeze To Medical Device Tax
A federal budget proposal brought good news Wednesday for Minnesota's medical device companies by freezing for two years a tax on products like pacemakers and ventilators that they have long opposed. The package of tax cuts and spending cued up for final votes in Congress this week would suspend the 2.3 percent excise tax on those devices, ultrasound machines and more that took effect in 2013 as part of the funding mechanism for President Barack Obama's health care law. (Potter, 12/16)

The New York Times: In Likely Spending Plan, Congress Readies Blows To Obama’s Health Care Law
The legislation will also suspend a tax on medical devices for two years. The device tax, which took effect in 2013, will be suspended through 2017. Congress also agreed to suspend for one year a tax on health insurance providers. The tax applies to insurance purchased by individuals, families and many businesses, as well as to private plans that manage care for millions of Medicare and Medicaid beneficiaries. (Pear, 12/16)

McClatchy: GOP Pushes For More Money For National Institutes Of Health
The National Institutes of Health could see its biggest budget increase in more than a decade as part of a $1.1 trillion spending bill Congress will vote on Friday. Sen. Roy Blunt of Missouri, Rep. Kevin Yoder of Kansas and other conservatives in Congress spearheaded the push to boost NIH’s funding by $2 billion – a billion more than requested by the Obama administration. (Wise, 12/16)

USA Today: Spending Bill Delays Controversial Health Law Taxes, Boosts Health Funding
Public health groups were pleased with other health-related provisions in the spending bill, such as funding to combat antibiotic resistance and the restoration of most of the money for HHS’ Agency for Healthcare Research and Quality. (Ungar and O'Donnell, 12/16)

Bloomberg: Congress Offers Health Aid To Puerto Rico In Spending Bill
Lawmakers agreed to extend health aid to Puerto Rico as part of a $1.1 trillion spending bill that they're racing to approve this week, which would mark the first step by Congress to help the Caribbean island cope with an escalating debt crisis. The legislation would increase payments to hospitals on the island and provide bonus Medicare payments to doctors and medical facilities that adopt electronic health record-keeping, according to the text of the bill posted early Wednesday on the House website. The spending measure is part of a fiscal plan that would avert a U.S. government shutdown and revive a series of expired tax breaks. (Miller, Wasson and Rowley, 12/16)

The Washington Post's Wonkblog: Congress Offers No Lifeline As Puerto Rico Heads Toward Default
Drowning in $73 billion of debt, Puerto Rico had hoped Congress would cast it a lifeline in the end-of-the-year spending bill. Instead, the territory got next to nothing. The omnibus bill did include some good news for Puerto Rico, in the form of enhanced Medicare reimbursement rates that are projected to bring in more than $900 million to the island’s faltering health-care system over the next decade. But that is small consolation for Puerto Rico. (Mufson and Fletcher, 12/16)

The Associated Press: Arkansas Panel Backs Governor's Push To Change Medicaid Plan
Arkansas lawmakers on Wednesday endorsed Gov. Asa Hutchinson's plan to add new restrictions to the state's hybrid Medicaid expansion — a move that the Republican governor said would help in negotiating changes to a program providing coverage to more than 200,000 people. The legislative panel looking at the program's future stopped short of endorsing specific proposals to meet Hutchinson's goal to cut as much as $60 million in annual state funding to Medicaid to make up for the cost when Arkansas begins paying a portion of the expanded coverage. (DeMillo, 12/16)

KUAR (Little Rock, Ark.): Arkansas Republicans Vote To Continue Medicaid Expansion While Seeking Reforms
Arkansas’s Republican Governor Asa Hutchinson is moving forward with Medicaid expansion and seeking federal approval for new adjustments to what has been known as the private option. The Health Care Task Force endorsed Hutchinson’s proposal Wednesday. The governor entered the healthcare task force meeting with a show of support from the Republican controlled legislature. Hutchinson acknowledged his plan to continue Medicaid expansion – in some form – doesn’t fit neatly with decisions other conservative states made about the Affordable Care Act provision. (Kauffman, 12/16)

USA Today: State-By-State Data Show Bigger 2016 Exchange Premium, Deductible Jumps
Consumers buying health insurance through federal and state exchanges will see their monthly premiums for the popular silver-level plans jump by an average of more than 11%, while also likely facing higher deductibles, a new analysis of exchange data by the Robert Wood Johnson Foundation shows. (O'Donnell, 12/16)

The Orlando Sentinel: Office Of Insurance Regulation: Change Plans If You Signed Up For Cigna Or Preferred Medical Plan In Marketplace
The Florida Office of Insurance Regulation issued an alert on Wednesday for consumers who may have signed up for Cigna or Preferred Medical Plan health insurance through the Affordable Care Act Marketplace, because the two companies won't provide Marketplace coverage in 2016. The office "strongly urged" consumers "to take action immediately and select another plan, if they have not already done so, by visiting healthcare.gov," the office said in a news release. (Miller, 12/16)

The Houston Chronicle: High Demand, Loss Of Plans Leave Many Scrambling For Insurance
Val Holeman of Missouri City measures her days by the number of phone calls she makes, the time she spends on hold, the Internet searches, the rumors she chases, all to find insurance that will cover the treatment keeping her son alive. (Deam, 12/16)

The Philadelphia Inquirer: Encouraging Latinos To Get Health Coverage
Maria Farias has been without health insurance since 2011, when her husband lost his job. The Port Richmond resident, who is from Paraguay, relies on a public health center, where she pays $10 to see a doctor, because she doesn't think she can afford nearly $300 a month for insurance. "I'm still thinking about how I can get health insurance," Farias, 45, said Sunday at a festival celebrating the Feast of Our Lady of Guadalupe, a major event for Latino Catholics. (Brubaker, 12/15)

Meanwhile, Barron's examines how long-term health law fundamentals could impact the health care sector -

Barron's: Managed Care And Health Care Facilities 'Between A Rock And A Hard Place': Credit Suisse
Credit Suisse’s Scott Fidel and Dana Nentin initiated coverage of a number of managed care and health care facility companies Wednesday, noting that the sector is “between a rock and a hard place” as politics and fundamentals cloud the picture for 2016. They write that while 2013-2015 saw optimism from investors, thanks to the Affordable Care Act and an “unprecedented” M&A cycle in the industry. However, they write that the “rapidly deteriorating fundamentals in the public exchanges and lack of additional Medicaid expansions entering 2016” challenge the bull case based on the ACA, and long-term fundamentals will be increasingly challenged. (Rivas, 12/16)

Bloomberg: Shkreli, CEO Reviled For Drug Price Gouging, Arrested On Securities Fraud Charges
A boyish drug company entrepreneur, who rocketed to infamy by jacking up the price of a life-saving pill from $13.50 to $750, was arrested by federal agents at his Manhattan home early Thursday morning on securities fraud related to a firm he founded. Martin Shkreli, 32, ignited a firestorm over drug prices in September and became a symbol of defiant greed. (Smythe and Geiger, 12/17)

USA Today: Report: CEO Criticized For Gouging Drug Prices Arrested
Martin Shkreli, a drug company entrepreneur previously criticized for raising the price of life-saving drugs such as those used to fight HIV and cancer, was arrested early Thursday in New York on securities fraud, according to media reports. (Bomey and Hjelmgaard, 12/17)

Politico Pro: Big Pharma Gets Data For Discounts
Attention patients! The side effects of your discounted drugs may include drowsiness, nausea — and a loss of privacy. Drug companies are increasingly offering price discounts and subsidies to patients in exchange for their medical data. The details of that exchange can be easy to miss: They're in the fine print. (Tahir, 12/17)

STAT: Rebates From Generic Drugs Would Have Saved Medicaid $1.4B, Report Finds
A new report finds that Medicaid could have saved $1.4 billion over the past decade if companies were required to offer rebates whenever prices for best-selling generic drugs exceeded the inflation rate. (Silverman, 12/17)

The Baltimore Sun: Industry Funds 6 Times The Clinical Trials Than Feds Do, Research Shows
The drug and device industry now funds six times more clinical trials than the federal government, according to Johns Hopkins University researchers. That means companies with financial interests in the studies now have more control over what doctors and patients learn about new treatments. Clinical trials test new therapies on humans for safety and effectiveness before they are approved for wide use. (Cohn, 12/16)

And CVS issues its 2016 earnings forecast -

The Associated Press: CVS Health Hikes Low End Of 2016 Forecast Range, Dividend
CVS Health hiked its dividend, tightened its 2016 earnings forecast and repeated its message of patience, as the nation’s second largest drugstore chain laid out its growth expectations on Wednesday. Acquisitions and other business gains will help boost revenue next year, but it will take a few months for some of that to trickle down to the bottom line. (Murphy, 12/16)

Kaiser Health News: ‘Soft’ Social Skills Might Prevent A Hard Knocks Life
Academic learning is usually in the spotlight at school, but teaching elementary-age students “soft” skills like self-control and how to get along with others might help to keep at-risk kids out of criminal trouble in the future, a study finds. (Shallcross, 12/17)

St. Louis Public Radio: The Holiday Season Is Not 'The Most Wonderful Time Of The Year' For All
The bustle of office parties, gift-giving and family get-togethers are usually part of the build-up to a joyful holiday season but, for some, the season sometimes brings with it a feeling of sadness. In fact, the holiday blues are not all that uncommon at all. Tim Bono, assistant dean and lecturer in psychology at Washington University, joined “St. Louis on the Air” on Wednesday to discuss these feelings of depression during the holidays—as well as what to do if you know someone who seems a bit more down during this time of year. (Moffitt, 12/16)

St. Louis Public Radio: Early Childhood Depression Alters The Developing Brain, Wash U Study Suggests
Depression very early in life can affect the way a child’s brain develops. A new study by researchers at Washington University is the first to link early childhood depression to physical changes in the developing brain. As part of the research, Washington University child psychiatrist Dr. Joan Luby and her colleagues followed the development of approximately 200 St. Louis-area children for up to 11 years, giving them behavioral assessments and a series of three brain scans. About half of the children had episodes of depression, most starting when they were only 3 to 6 years old. (Lacapra, 12/16)

In patient care news, long delays during breast cancer treatment and less-intensive physical therapy after joint replacement surgery take a toll -

The Philadelphia Inquirer: Long Delays In Breast Cancer Treatment Can Be Deadly
Excessive delays in breast cancer treatment may compromise patients' survival, according to two major studies published Thursday in JAMA Oncology. What's more, the women most likely to experience long delays were black or Hispanic, and one analysis found a correlation with lower incomes. (McCullough, 12/12)

The Philadelphia Inquirer: More Joint-Replacement Patients Are Skipping Physical Therapy
People who got joint replacements only a few years ago might be surprised by what happens now after patients get their new hips and knees. Now that new payment schemes encourage surgeons and hospitals to pay more attention to the cost and effectiveness of the care patients get when they leave the hospital, postsurgical rehab has become a target for cuts. Where - and how - joint-replacement patients get physical therapy is changing rapidly. Far fewer are going to inpatient facilities for rehab. A growing number are skipping home care and going straight to outpatient therapy. Some hip and knee patients are getting no professional physical therapy at all. (Burling, 12/13)

California Healthline: Hospital Buyer Agrees To AG Conditions
BlueMountain Capital Management agreed this week to the terms set out by California Attorney General Kamala Harris (D), clearing the way for six hospitals owned by Daughters of Charity to be sold for $100 million, along with $160 million in loans to the six hospitals for system improvements. (Gorn, 12/16)

The Boston Globe: State Commission To Scrutinize Beth Israel Affiliate
The state Health Policy Commission voted Wednesday to scrutinize the growth plans of a large hospital network affiliated with Beth Israel Deaconess Medical Center. The network, called Beth Israel Deaconess Care Organization, or BIDCO, is seeking affiliations with New England Baptist Hospital of Boston and MetroWest Medical Center of Framingham. BIDCO already includes seven hospitals and is the second-largest health care provider network in Massachusetts, with 11 percent of hospital discharges, the commission said. (Dayal McCluskey, 12/16)

The Associated Press: Construction To Begin Soon On State Mental Health Hospital
State officials said Wednesday that they will break ground early next year on a nearly $120 million hospital that will serve as the flagship institution of Indiana's mental health system. The 159-bed Indiana Neuro-Diagnostic Institute will replace Larue D. Carter Memorial Hospital, which state officials described as "deteriorating." The cost of construction, which is slated to begin in April, will be paid for with money borrowed by the state. (Slodysko, 12/16)

The Chicago Tribune reports on penalties faced by some Illinois hospitals for patient infections and injuries -

The Chicago Tribune: 23 Illinois Hospitals Penalized For Infection Rates, Injuries
Twenty-three Illinois hospitals will be penalized a total of about $12 million next year for high rates of patient infections and injuries. They ranked as the worst performers for a range of problems including postoperative hip fractures, blood infections, urinary tract infections and accidental cuts and punctures that patients acquired after visiting the hospitals, according to data from the federal Centers for Medicare & Medicaid Services. (Russell, 12/16)

The Associated Press: Iowa Lowers Projected Savings For Privatizing Medicaid
Iowa health officials on Wednesday lowered the state’s projected savings for switching its $4.2 billion Medicaid program to private care, saying its initial estimate was released a year ago. Iowa Department of Human Services Director Chuck Palmer told lawmakers on the Fiscal Committee that the department now estimates it will save about $47 million in the first six months of 2016 with the move to privatization on Jan. 1. That’s a slight decrease from the $51 million that’s been publically used for months. It’s also what the Legislature used to approve its current state budget. (Rodriguez, 12/16)

The Washington Post: McAuliffe To Unveil Budget Plan
Virginia Gov. Terry McAuliffe on Thursday morning plans to unveil a two-year budget proposal that represents his priorities for the second half of his term. In recent weeks he has rolled out some plans, including funding for teachers and economic development incentives, but he left the big question unanswered: Will he try to expand Medicaid for the third consecutive year? (Portnoy, 12/17)

The Boston Globe: Health Costs Outpace Income In State, Report Says
Rising health care costs have outpaced the incomes of Massachusetts families over the past decade, despite efforts by the state to control medical expenses, according to a report released Wednesday. The cost of health insurance grew at twice the rate of incomes, jumping 55 percent from 2005 to 2014, compared to 23 percent for income, according to the report from the Health Policy Commission, a state watchdog agency that monitors health spending. Health insurance costs averaged $19,300 per family last year, consuming about one-fifth of the average family income of $88,000. (Dayal McCluskey, 12/16)

The Miami Herald: Barred From Selling Obamacare Plans, Miami Insurer To Lay Off Employees
A Coral Gables-based health insurance company and dozens of its employees are the latest casualties of a Republican-led legislative gambit in 2014 to undermine the Affordable Care Act — a maneuver for which presidential hopeful and U.S. Sen. Marco Rubio of Florida has taken credit on the campaign trail. Preferred Medical Plan filed notice on Wednesday that the private insurance company intends to lay off 162 employees in February, according to the Florida Department of Economic Opportunity. (Chang, 12/16)

The Associated Press: Navigators Say Health Care Enrollment Still Growing In Maine
The number of Mainers enrolling in health care exchanges under the Affordable Care Act continues to grow even with a decision by one insurance cooperative to stop enrolling new clients. Lewiston-based Maine Community Health Options has the lion’s share of the business on the marketplace created by the health care overhaul, but Harvard Pilgrim and Anthem have good options that’ll remain after Community Health Options stops accepting new enrollments this month, said Janice Daku, who oversees the state’s health care navigators. (Sharp, 12/16)

New Hampshire Public Radio: 342 N.H. Drug Deaths Recorded So Far In 2015, Surpassing Last Year's Total
There have been 342 drug deaths in New Hampshire so far this year, and state officials are expecting the total to surpass 400 by the end of 2015. There were 326 drug deaths in 2014, and nearly 200 the year before. The latest data from the Office of the Chief Medical Examiner shows that more than half of the drug deaths reported through mid-December have involved fentanyl, either on its own or combined with other drugs. It can sometimes take several months for officials to fully review the toxicology results and other aspects of each death, according to the examiner's office. (McDermott, 12/16)

St. Louis Public Radio: Fewer St. Louis Emergency Room Visits By The Uninsured In First Year Of Healthcare.gov
When the Affordable Care Act went into effect, many health-care economists hoped it would reduce the number of emergency room visits made by uninsured people. The idea was that if more people had health insurance, they would be more likely to have access to a primary care doctor and avoid the emergency room. New data released by the St. Louis Regional Health Commission shows that theory might be playing out. In 2014, St. Louis-area emergency rooms saw a 5 percent decrease in visits by people without health insurance. That only represents about 7,000 fewer visits, but it comes after three years of steady increases of the same size or larger. (Bouscaren, 11/16)

Forum News Service: New Minnesota Marijuana Strain More Potent, Could Cut Costs
A new strain of marijuana plant could slash costs for medical cannabis users in Minnesota. Otsego-based Minnesota Medical Solutions, one of two medical cannabis operators in the state, announced the creation of a new strain with a higher cannabidiol (CBD) content than any cannabis plant known. The new strain, named the Katelyn Faith strain, was cultivated through months of germination research, MinnMed CEO Kyle Kingsley said Wednesday at the company's Otsego greenhouse and laboratory. (Jeffries, 12/16)

The New York Times: An Appalling Silence on Gun Control
It was remarkable that the Republican presidential candidates’ debate this week, supposedly focused on keeping Americans safe, was devoid of questions and comments about the public health issue of gun violence. ... when they brought up the mass shooting in San Bernardino, Calif., this month, carried out by a couple found to be inspired by Islamic State violence, the discussion never veered to the easy gun access that enabled those killers — and many others — to commit swift and horrific slaughter of innocent people. (12/17)

The New England Journal of Medicine: Rooting Out Gun Violence
In 2013, the latest year for which the Centers for Disease Control and Prevention (CDC) has data, more than 33,000 people in the United States died from gunshot injuries and more than 84,000 survived with such injuries .... commentators once again marveled at the vast gap between U.S. rates of gun deaths and those in other developed countries, which either have never witnessed the epidemic of gun violence and the kind of mass shootings that are now routine here or have acted effectively to stop them. If any other public health menace were consistently killing and maiming so many Americans, without research, recommendations, and action by the CDC, the public would be outraged. (Debra Malina, Stephen Morrissey, Edward W. Campion, Mary Beth Hamel and Jeffrey M. Drazen, 12/16)

Health Affairs: How Does The Budget Agreement Affect The ACA?
Late in the day on December 15, 2015, House Republicans released the $1.1 trillion Consolidated Appropriations Act for 2016 and a $650 billion tax extenders package. The legislation embodies an agreement among Congressional leaders that will keep the government open through September 2016. The legislation delays taxes enacted to fund the ACA and limits the effectiveness of some of the ACA’s operational provisions. The bills do not, however, fundamentally change the ACA, although a continued restriction on risk corridor funding included in the legislation could reduce insurer participation in the marketplaces and raise prices for consumers. (Timothy Jost, 12/16)

Health Affairs: The Payment Reform Landscape: A Standard Framework To Evaluate Payment Reform Programs
As health care costs continue to rise and the quality of care remains inconsistent, employers, other private and public health care purchasers, health plans, and providers are now experimenting in earnest with reforms to how we deliver and pay for health care. Investment in such efforts will be well worth it if they significantly improve care and make it more affordable. However, despite the flurry of activity in the payment reform space over the last few years, data demonstrating the effectiveness of these reforms are limited. We still have much to learn about which reforms will work and in what context they will successfully produce their intended outcomes. (Suzanne Delbanco, 12/16)

Forbes: One Year Update Of Indiana's Medicaid Expansion
Last January, Indiana Governor Mike Pence reached a deal with the Obama administration to expand Medicaid under Obamacare. After nearly a year of operation, the data is in, and the early outcomes of the program’s rollout are finally setting in. The results so far have been little personal responsibility for enrollees, and higher costs for taxpayers . Other states considering a similar designed expansion should think twice. (Jonathan Ingram and Josh Archambault, 12/17)

Huffington Post: Attention Medicare Recipients And Advocates: Get Face To Face With A New Paperwork Mess
Visiting nurses and other home health professionals are the hidden angels of American health care--they are highly mission driven and in the course of helping people in need they routinely overcome many challenges like bad weather, high crime neighborhoods, traffic conditions, complex health problems and stressed out families--but, they're now confronting a new obstacle, a paperwork mess created by a little known Affordable Care Act (ACA) "face to face" rule. The timing is terrible because home health access and quality is being hurt at the very moment when extra focus on improving home health is needed to prepare for rapidly growing numbers of older Americans. (Steve Landers, 12/16)

The Concord Monitor: A Cure For What's Ailing Health Records
It was the only reliable way to guarantee that the specialist would have our X-rays and medical records when we arrived for our appointment in two weeks, a front-office employee of the practice said. So we left home, drove to a building on the northeast corner of the Concord Hospital campus, found a parking space, crossed the lot, went upstairs and retrieved our records. Then we reversed the process and drove to a building just off the southwest corner of the campus, a distance, as the crow flies, of maybe 400 yards. We did all this on crutches. So much for the ease, convenience, improved medical care and cost savings that resulted from the government’s near-mandatory 2009 requirement that patient health records be stored electronically. It was a promising idea. (12/17)