The San Jose Mercury News: Obamacare: Are Covered California's Numbers Plateauing?
With Covered California's announcement Wednesday that 1.57 million Californians selected health plans during its third open enrollment period, at least one health care expert believes that the nation's bellwether state in implementing the Affordable Care Act is now essentially running in place. Although the latest numbers don't say how many people have paid for their plan to complete their enrollment -- the only figure that really counts and which will be available in a few months -- some experts say that the net gain from last year's 1.3 million total could be minimal. (Seipel, 2/17)

Kaiser Health News: California Marketplace May Require Insurers To Pay Agent Commissions
California’s health exchange may require its health plans to pay sales commissions to insurance agents to keep insurers from shunning the sickest and costliest patients. Covered California is working on a proposal that would force the plans to pay commissions effective next year, said Executive Director Peter Lee. The proposed rules could apply to regular and special enrollment periods, and would leave the specific commission amount or percentage up to insurers, he said. The issue is expected to be discussed Thursday at Covered California’s monthly board meeting. (Terhune, 2/18)

The Associated Press: Data Shows MNsure Shoppers Are Getting Older
Consumers buying health insurance through MNsure are getting older, according to data released Wednesday from the latest round of open enrollment, a troubling sign that could mean increasing costs. The state's health insurance exchange celebrated meeting its goals for private coverage signups after enrollment closed at the end of January, finally hitting a critical goal after two years of setbacks. But the details behind those numbers show the share of residents 55 and older who bought insurance through MNsure have jumped by 7 percent since 2015, while the pool of younger enrollees shrank. (Potter, 2/17)

The Richmond Times-Dispatch: Faith Leaders Still Pursuing Medicaid Expansion
Budgets are moral documents, faith leaders said Wednesday as they implored legislators drafting the state’s two year-spending plan to change their minds and expand Medicaid. (Smith, 2/17)

Georgia Health News: A Small, Surprising Step Toward A Big Change In Health Coverage?
The bill may not get very far this year, with time running out in the General Assembly session and without the fiscal impact yet studied. But a Senate health committee broke new ground Wednesday by holding a legislative hearing on a proposal, Senate Bill 368, that would create a Medicaid expansion alternative in Georgia. (Miller, 2/17)

The Wall Street Journal: Democratic Economists Say Bernie Sanders’s Math Doesn’t Add Up
Four leading Democratic economists sharply criticized Sen. Bernie Sanders for citing “extreme claims” about the economic effects of his campaign proposals, the latest in a stream of critiques from Democrats over details of his platform. Criticism has also been directed at Mr. Sanders’s plan for a single-payer, government-run health-care plan, with critics saying he underestimates the costs of providing health care to all Americans and overestimates the revenue his plan would generate. (Timiraos and Meckler, 2/17)

The Dallas Morning News: Trump Speaks In MSNBC Town Hall To Counter Cruz, Rubio Appearance On CNN
When asked if all Americans would have access to health care, as they are supposed to under the Affordable Care Act, [Donald] Trump said that he would work out a deal with hospitals and communities. (Wise, 2/17)

NBC News: Trump On Sanders: 'We're Very Similar' In This Way
Consider a political outsider who is tapping into voter anger, delivering a populist message and drawing raucous thousands to rallies. He wants the hedge fund managers to pay more taxes and argues that there should be health care for everyone. Sound familiar? (Timm, 2/17)

Meanwhile, media outlets fact check the candidates' health care claims —

The Washington Post's Fact Checker: Trump’s Truly Absurd Claim He Would Save $300 Billion A Year On Prescription Drugs
Reining in the cost of prescription drugs has become a major issue in the 2016 presidential campaign. Both former secretary of state Hillary Clinton and Sen. Bernie Sanders (D-Vt.) have proposed detailed plans to control prescription-drug prices, with both calling for Medicare to negotiate directly with prescription-drug companies to get lower prices. Republican candidates have also decried high prescription-drug costs, though generally their policy proposals have been thinner. Developer Donald Trump ... also says he wants to allow Medicare to negotiate directly with drug companies. In fact, he makes the bold claim that he would save $300 billion a year. Is this even remotely possible? (Kessler, 2/18)

The Cincinnati Enquirer: Fact Check: Kasich's Medicaid Expansion Exceeded Projected Costs
Gov. John Kasich's expansion of Medicaid services to lower-income Ohioans — over the objections of GOP lawmakers — hasn't won him many friends among conservatives. (Balmert, 2/17)

The Associated Press: Hospital Pays Thousands To End Attack Known As ‘Ransomware’
A Los Angeles hospital paid a ransom in bitcoins equivalent to about $17,000 to hackers who infiltrated and disabled its computer network, the medical center’s chief executive said Wednesday. It was in the best interest of Hollywood Presbyterian Medical Center to pay the ransom of 40 bitcoins — currently worth $16,664 dollars — after the network infiltration that began Feb. 5, CEO Allen Stefanek said in a statement. (Dalton, 2/17)

Los Angeles Times: Hollywood Hospital Pays $17,000 In Bitcoins To Hackers Who Took Control Of Computers
“The malware locks systems by encrypting files and demanding ransom to obtain the decryption key. The quickest and most efficient way to restore our systems and administrative functions was to pay the ransom and obtain the decryption key,” Hollywood Presbyterian CEO Allen Stefanek said. “In the best interest of restoring normal operations, we did this.” Stefanek said patient care was never compromised, nor were hospital records. (Winton, 2/17)

Modern Healthcare: Hospital Pays Hackers $17,000 To Unlock EHRs Frozen In 'Ransomware' Attack
Healthcare organizations, along with small businesses and schools, make good targets for ransomware attacks because they don't typically have the sophisticated backup systems and other resilience measures that are typical at large corporations, said Lillian Ablon, a cybersecurity expert with the RAND Corp., a California think tank. For example, two smaller healthcare organizations—a three-physician surgical practice in 2012 and an 18-bed critical-access hospital in 2014—were hit by ransomware attacks. The smaller ransom amount in the Hollywood Presbyterian case is more in line with customary ransomware demands, according to security experts. The demands typically track with the nuisance value of not having to restore databases and computer systems. (Conn, 2/17)

Modern Healthcare: Feds Wrap Up National Probe Into Cardiac Devices; 51 More Hospitals Settle
Another 51 hospitals will pay the government to get out from under a federal probe into the suspected overuse of implantable cardiac defibrillators. The U.S. Justice Department said the settlements announced Wednesday, which tally to $23 million, mark the “final stage” of the far-reaching investigation. More than 500 hospitals in all have settled with the government in connection with the investigation. (Schencker, 2/17)

The Associated Press: DOJ: Wisconsin Hospitals Part Of Cardiac Device Settlement
The U.S. Attorney's office says a Wisconsin health care network and some of its hospitals are part of a settlement over cardiac devices implanted in Medicare patients. The Department of Justice said Wednesday it has reached settlements with 51 hospitals in 15 states for more than $23 million. The settlements resolve allegations that the cardiac devices were implanted in violation of Medicare coverage requirements. (2/18)

CBS: Dignity Health Pays $5.9M To Settle False Claims Act Allegations
San Francisco-based Dignity Health settled with the U.S. Department of Justice for $5.9 million to resolve False Claims Act allegations that they improperly billed Medicare for implantation of cardiac devices, Justice Department officials announced Wednesday. Dignity Health, and its 18 affiliated hospitals were among the most recent batch of 51 hospitals nationwide to settle with the Justice Department. In 2015, the department settled with 457 hospitals for more than $250 million. The final 51 hospitals will pay the Justice Department more than $23 million. (Albarazi, 2/17)

The New York Times: A Novel Plan For Health Care: Cutting Costs, Not Raising Them
As employees know all too well, health insurance companies have one surefire way to lower costs: Ask their customers to pay more. Intermountain Healthcare, a nonprofit health system in Salt Lake City, is trying something virtually unheard-of: promising to sharply cut costs rather than pass them on. Its new health plan, SelectHealth Share, is guaranteeing to hold yearly rate increases to one-third to one-half less than what many employers across the country typically face. (Abelson, 2/17)

The Associated Press: Report: Calls To VA Suicide Hotline Went To Voicemail
A suicide hotline operated by the Department of Veterans Affairs allowed crisis calls to go into voicemail, and callers did not always receive immediate assistance, according to a report by the agency's internal watchdog. The report by the VA's office of inspector general says calls to the suicide hotline have increased dramatically in recent years, as veterans increasingly seek services following prolonged wars in Iraq and Afghanistan and the aging of Vietnam-era veterans. (2/17)

The Arizona Republic: U.S. Senators Probe Phoenix VA Whistleblower Case
Two of the most powerful members of the U.S. Senate have called on the Department of Veterans Affairs to end retaliation against an Arizona whistleblower who exposed a breakdown in mental-health care at the Phoenix VA hospital. (Wagner, 2/17)

The Associated Press: VA Officials Say Albany Hospital Director Still Terminated
Department of Veterans Affairs officials are standing by removal of their Albany medical center's director despite an oversight board's ruling that terminating her was too severe a punishment. Merit Systems Protection Board Administrative Law Judge Arthur Joseph two weeks ago ordered Linda Weiss' removal cancelled. (Virtanen, 2/18)

The Associated Press: Ohio Senators Urge Quick Action On Cincinnati VA Probe
Ohio's U.S. senators on Wednesday urged quick federal action to probe allegations about mismanagement and declining veterans' care at the Cincinnati VA hospital. Sen. Rob Portman, of the Cincinnati area, commented on a WCPO-TV and Scripps News Washington Bureau report that nearly three dozen current and former medical center employees have expressed urgent concerns about quality of care. They blame cost-cutting and other practices they said have reduced access to care and raised safety questions. (Sewell, 2/17)

And fights by two different couples against the VA's policy on in vitro fertilization coverage are profiled —

NPR: For Fertility Treatment, Wounded Veterans Have To Pay The Bill
The Pentagon's health care system for active duty troops covers IVF. The Department of Veterans Affairs for veterans doesn't. A law passed in 1992 made it illegal for the VA to pay for IVF, which some people oppose because embryos are often destroyed in the process. In the decades since Congress banned IVF for the VA, the procedure has become much more common. And about 1,400 troops came back from Iraq and Afghanistan with severe injuries to their reproductive organs. Thousands more have head injuries, paralysis or other conditions that make IVF their best option. (Lawrence, 2/17)

CBS News: Couple Fights To Change Law Preventing IVF Coverage For Vets
A current law that is the product of anti-abortion politics prohibits the Department of Veterans Affairs from covering the cost of in vitro fertilization for any of the estimated 1,800 veterans who have suffered damage to their reproductive organs. (Martin, 2/17)

USA Today: To Treat Or Not? Question Looms For Elderly And Sick
Millions of families in our aging nation face [a] delicate decision about when to use life-extending but potentially-grueling treatment on the elderly and sick — and the medical world is responding. This year for the first time, Medicare began reimbursing doctors for having end-of-life discussions as a separate, billable service. And health experts are increasingly examining the issue, with three recent end-of-life studies in the Journal of the American Medical Association among the growing body of research. (Ungar, 2/17)

The Associated Press: For Some, Desire To Work Past 65 Can Often Be Problematic
Earl Johnston was 12 when he got his first job, a paper route that he quickly expanded by "buying out" additional routes from other, less industrious boys. After high school, he enrolled in a program to become an industrial electrician. Like many people in the prime of their working life Johnston, now 56, always thought he would have plenty set aside for retirement, and if he didn't, he could always work a little longer. "At least up to 65," he thought. What Johnston didn't plan for was the degenerative spinal condition that made being on his feet for a 12-hour shift all but impossible. (Allington, 2/18)

The Washington Post: Mexico Confirms Zika Virus Cases In Pregnant Women As Pope Francis Exits The Country
The spread of the Zika virus, which has accelerated debates over contraception and abortion in Latin American countries that have been hit hardest, continues in Mexico, where Pope Francis has spent the past week. Mexico’s health department said on Tuesday it has confirmed six pregnant women who are infected with the virus, which came as the pope was about to leave the region after a six-day trip to Central America. The pontiff did not mention the virus during his trip, and the Vatican has yet to issue a statement on the issue. (Pulliam Bailey, 2/17)

CQ Healthbeat: NIH, CDC Push Lawmakers To Fund Zika Request Promptly
Top federal health officials warned Congress Wednesday that they will not be able to effectively carry out a long-term response to the escalating Zika virus crisis if lawmakers don’t provide additional cash – quickly. The National Institutes of Health and Centers for Disease Control and Prevention chiefs also outlined steps that are already underway to combat the emerging Zika virus as they wait for lawmakers to act on an emergency funding request. (Zanona, 2/17)

The Detroit Free Press: Lead In Flint Man's Blood Is 5 Times What's Toxic
Aaron Stinson shook his head and wiped the sweat from his brow as he sat in a brown, oversized sofa chair in the living room of his aunt's Flint home. Excessive sweating, fatigue and severe headaches are just a handful of inexplicable symptoms he has experienced over the last six months, seemingly out of nowhere. (Stafford, 2/18)

The Detroit News: CFO: Flint Will Run Out Of Cash Without Water Bill Help
Flint’s water fund could run out of cash by summer without $30 million in residential assistance from the state, and even then could be insolvent by the end of the year, according to the city’s chief financial officer. “The city lacks the financial resources to provide any relief to customers on its own,” CFO Jody Lundquist said Wednesday in testimony before the House Appropriations Committee. “At the current rate of collections, the city’s water fund is projected to run out of cash by this summer. (Oosting, 2/17)

And, with all the uncertainty created from the Flint crisis, health professionals elsewhere are struggling with their push to get people to chose safe tap water over sugary drinks —

Kaiser Health News: Selling The Health Benefits Of Tap Water, In An Age Of Flint
Colorado Public Radio's John Daley, in partnership with Kaiser Health News and NPR, reports: The water crisis in Flint, Michigan, is making some public health messages harder to get across — namely, in most communities, the tap water is perfectly safe. And it is so much healthier than sugary drinks. It’s a message Dr. Patty Braun, a pediatrician and oral health specialist at Denver Health, spends a lot of time on in Denver, even before lead was found in the water system of Flint. (Daley, 2/18)

Modern Healthcare: FDA Grossly Underestimated Harm From Permanent Contraceptive Essure, Lawmaker Says
A U.S. congressman and a patient advocacy group said Wednesday a permanent contraception device linked to thousands of adverse events has led to far more fetal deaths than previously reported and that doctors performing the procedure received illegal kickbacks. Rep. Mike Fitzpatrick (R-Pa.) said in a conference call with reporters that he found it troubling that the U.S. Food and Drug Administration did not act on the complaints it had received until thousands of women who said they had been harmed by the device started publicly announcing their concerns. (Muchmore, 2/17)

WXYZ: U.S. Rep Alleges Hundreds Of Fetal Deaths Linked To Essure, Kickbacks Related To Birth Control Device
A US Congressman says a controversial birth control device has caused hundreds more fetal deaths than the FDA has publicly reported. For years, the 7 Investigators have been exposing the health problems that women say Essure has caused, many of them telling us the device has ruined their lives. (Catallo, 2/17)

In other FDA news —

The New York Times: F.D.A. Deals Setback To Catalyst In Race For Drug Approval
A Florida company involved in an unusual race for approval of a drug that treats a rare neuromuscular condition had a setback on Wednesday, after federal regulators said they needed more information before deciding whether to approve it. The drug treats a disease called Lambert-Eaton myasthenic syndrome, and for years was given away by a New Jersey company, Jacobus Pharmaceutical, under an obscure federal drug provision. It never had formal approval from the Food and Drug Administration. (Tavernise, 2/17)

The New York Times: Testosterone Gel Has Modest Benefits For Men, Study Says
More than a million men have smeared testosterone gels on their bodies in recent years, hoping it would rejuvenate them, energize them, and increase their libido. But until now, there has never been a rigorous study asking if there were any real benefits to testosterone therapy for healthy men with so-called low T. The first results of such research were published Wednesday in The New England Journal of Medicine. Although it found at best modest benefits, mostly in sexual functioning, it is a landmark study, said Dr. Eric S. Orwoll, a professor of medicine at Oregon Health and Science University, because it provides the first credible data on testosterone’s effects on some of the problems it is thought to resolve. (Kolata, 2/17)

The Associated Press: Study Finds Testosterone Gel Is No Fountain Of Youth
A landmark study suggests that testosterone treatment is no fountain of youth, finding mostly modest improvement in the sex lives, walking strength and mood of a select group of older men. The researchers emphasized that the findings pertain only to use of testosterone gel by men 65 and older with low hormone levels and related symptoms; whether similar benefits would occur in younger men or with testosterone pills, patches or shots is unknown. (Tanner, 2/17)

NPR: Study Shows Extra Testosterone Might Help Some Older Men
After a year, [says endocrinologist Dr. Peter Snyder, who led the study] though the benefits were only moderate, it was clear that mood and physical activity had improved among the group that had been getting a boost of testosterone. And the biggest improvement, he says, was in sexual function. "Testosterone improved sexual activity, sexual desire and improved erectile function," Snyder says. (Neighmond, 2/17)

The Seattle Times: Lawsuit Targets Medicaid Policy That Limits Spendy Hepatitis C Drugs
Two weeks after suing private insurers for improperly denying costly drugs to patients with hepatitis C infections, Seattle lawyers have expanded the fight to Washington state’s Medicaid provider. A class-action lawsuit filed this week on behalf of two Apple Health clients — and nearly 28,000 others with the liver-damaging disease — seeks to force the Health Care Authority (HCA) to change a policy that limits the spendy drugs to only the sickest patients. (Aleccia, 2/17)

The Connecticut Mirror: Malloy Seeks To Cut Legislative Authority Over Medicaid Changes
Gov. Dannel P. Malloy’s administration is seeking to eliminate legislators’ authority over certain attempts to make changes to Medicaid and other federally funded assistance programs – an authority legislators recently used to block a controversial administration proposal. (Levin Becker, 2/18)

The Boston Globe: Tufts Health Plan Revises Autism Treatment Policies After Settlement
Tufts Health Plan will revise its coverage policies and pay a $90,000 fine after settling allegations from the attorney general’s office that the health insurer restricted treatment for autism services. Attorney General Maura Healey said Tufts violated autism insurance, mental health parity, and consumer protection laws when it restricted access to applied behavioral analysis (ABA) therapy, a treatment for autism spectrum disorders. (Dayal McCluskey, 2/17)

The Boston Globe: Amid Probe, Home Care Agency Cuts Most Staffers
A Worcester home health care agency that is the target of a fraud investigation says it laid off most of its workers, disrupting services for hundreds of patients, after the state cut off payments. The Massachusetts attorney general’s office is investigating Compassionate Homecare Inc. for allegedly filing false claims and defrauding the state’s Medicaid program, known as MassHealth, the Globe reported earlier this month. In December, MassHealth officials took the unusual step of suspending payments to the company because of the allegations. (Dayal McCluskey, 2/17)

The Chicago Tribune: U. Of C. Commits To Adult Trauma Service, Wants To Expand Hospital
The University of Chicago is using its commitment to bring adult trauma services to the South Side to win state approval of a significant expansion of the Hyde Park medical center. University of Chicago Medicine plans to announce Thursday that it would like to increase the size of its 617-bed hospital by 188 beds, a 30 percent increase. The new beds are needed to reduce overcrowding at the hospital and improve access to care for patients with complex conditions such as cancer and heart disease, said Sharon O'Keefe, president of the medical center. (Sachdev, 2/18)

USA Today/Indianapolis Star: Indiana Medical-Waste Firm Fined For Handling Fetal Tissue
A medical-waste company here has been fined for accepting fetal tissue, amplifying calls from anti-abortion advocates to restrict how fetal remains are handled. MedAssure Services, a private medical-waste disposal company based in Farmingdale, N.J., that operates in a dozen states, accepted three to six 31-gallon containers a week during the past four years from Pathology Services, a Missouri lab that services Planned Parenthood, a women's health and abortion provider. Some of those containers contained fetal tissue, in violation of the company's solid waste permit, according to a settlement the company signed Tuesday with the Indiana Department of Environmental Management. (Cook, 2/17)

The Associated Press: State Agency Fines Hospital In Forcible Removal Case $45,000
Florida's health care agency issued a $45,000 fine to the hospital where a black woman died after being forcibly removed from the emergency room by a white police officer. The Agency for Health Care Administration lists four counts against Calhoun-Liberty Hospital in a 30-page administrative complaint issued Wednesday. Three counts are related to access to emergency care and services, and one is related to the Blountstown hospital's risk management program — patient grievance analysis. (2/17)

Bloomberg: Health Care In America: Cancer, Coverage And Costs
Vivian Lee, chief executive officer at University of Utah Health Care, talks about advances made in the fight against cancer, the state of health care in the United States, and efforts to control health care costs. She speaks on "Bloomberg Surveillance." (1/17)

Iowa Public Radio: Scaled-Back Medical Marijuana Bill Advances
Republicans in the Iowa House have amended a bill to legalize the production and distribution of marijuana in the state. In its more limited form, it cleared two Republican panels and is now eligible for debate in the full House. (Russell, 2/17)

The Associated Press: California Considers Condoms For Porn Actors
Condoms could be coming to porn studios across California if the state agency in charge of enforcing workplace safety adopts proposed new regulations aimed at protecting actors who make adult films. The state Division of Occupational Safety and Health was scheduled to vote on the regulations following a hearing Thursday in Oakland. (Rogers, 2/18)

The Huffington Post: Let's Change The Conversation Around Mental Health
Of course, it's important to remember that most of our veterans don't experience any mental health challenges at all. But the veterans and service members who do struggle are not alone - not by a long shot. In fact, roughly one in five adults - more than 40 million Americans - suffer from a diagnosable mental health condition like depression or anxiety. These conditions affect people of every age and every background: our kids and grandparents, our friends and neighbours. (Michelle Obama, 2/18)

The Columbia State: The State’s Endorsement: Kasich Is The Best Candidate To Break Through DC Gridlock
In a meeting with The State’s editorial board, he said the country’s welfare is more important than adhering to Republican Party ideology. “The party is my vehicle,” he said, “not my master.” ... When many other Republican governors, including South Carolina’s Nikki Haley, rejected extra Medicaid funding under Obamacare, Gov. Kasich accepted the money. He said it was more important to help Ohio’s poor than to stand in stubborn opposition to everything that carries the president’s name. Still, he clings to bedrock GOP positions of cutting federal regulations, reducing federal taxes and fiscal restraint. (2/17)

The New York Times: America’s Stacked Deck
It’s a little bizarre this political season to see wealthy candidates in both parties denouncing our political system for representing mostly the interests of, well, wealthy people. Bizarre, perhaps, and sometimes a tad hypocritical, but also accurate. America’s political system is rigged. The deck is stacked against ordinary people. ... In the solutions domain, a starting point should be to reduce the influence of money in politics. The pharmaceutical industry, for example, has used its lobbying heft — it spent $272,000 in campaign donations per member of Congress last year, and it has more lobbyists than there are members of Congress — to bar the government from bargaining for drug prices in Medicare. That amounts to a $50 billion annual gift to pharmaceutical companies. (Nicholas Kristof, 2/18)

Forbes: Believe It Or Not, The Republican Obamacare Replacement Plan Might Come Together
Earlier this month, Speaker Paul Ryan announced six task forces, each comprised of House Committee Chairmen, to develop a “bold, pro-growth agenda.” What was remarkable was that one of the task forces was on health care reform. Many had thought Congressional Republicans were investing too much time and energy grandstanding Obamacare repeal, and not enough developing a credible alternative. (John Graham, 2/17)

The Los Angeles Times: More Signs That 'Gaming' By The Sick Is Not A Problem In Obamacare
The one common element in assertions that thousands of Americans are "gaming" Obamacare by not signing up for health insurance until they get sick, thereby sticking beleaguered insurance companies with a big bill, is that none of these assertions come attached to any hard numbers. (Michael Hiltzik, 2/17)

New England Journal Of Medicine: How Employers Are Responding To The ACA
The Affordable Care Act (ACA) changed employers’ role in the U.S. health care system. Employer-sponsored insurance, a long-standing system component, provides health coverage for more than 160 million Americans. While preserving the employer-based system, the ACA fundamentally altered it by making the provision of health benefits mandatory rather than voluntary for employers with more than 50 employees and establishing minimum criteria for affordability and coverage. In addition, a “play or pay” model was created, providing employers with an exit: employees would no longer become uninsured if their employers dropped benefits but could instead purchase guaranteed and potentially subsidized insurance through public exchanges. (Robert Gavin, 2/18)

The News & Observer: A Welcome Compromise On Insurance Companies Covering Autism Treatments
[T]hanks to a bill sponsored by state Sen. Tom Apodaca, a Republican from Hendersonville, insurance companies will have to cover the expense for families up to $40,000 a year. Unfortunately, the legislation can’t cover those dependent on Medicaid, the federal-state program for the poor and disabled. There are some other gaps for people with certain types of insurance. (2/17)

New England Journal Of Medicine: Asymmetric Thinking About Return On Investment
Lately, we’ve attended many conferences about providing health care to patients with high medical and social needs — people with chronic illnesses who are frequently readmitted to the hospital. It seems as if every presentation refers to “return on investment” (ROI), which is invariably presented as a constraint — as in “Our program kept people out of the hospital, but we just couldn’t get the ROI to work.” Heads nod understandingly, and then participants move on to other topics. At conferences about providing care for patients with cancer or other acute illnesses, by contrast, we almost never hear the term ROI. Instead, people talk about clinical gains, using understandable and patient-centered terms like “survival.” Though high drug prices are sometimes mentioned, no one ever says the ROI is prohibitive. No one mentions ROI at all. (David A. Asch, Mark V. Pauly, and Ralph W. Muller, 2/18)

The Wall Street Journal: Needed: A Three-Year Medical Degree
The structure of medical school has not fundamentally changed since 1910, when the seminal Flexner Report prescribed nationwide standards for educating doctors. But in the past 30 years, the required training after medical school has increased substantially. Doctors going into a subspecialty such as cardiology or orthopedic surgery now need as many as eight years of postgraduate work, up from five years in 1970. (Robert I. Grossman and Steven B. Abramson, 2/17)

The Washington Post: We Need To Resettle The Children Of Flint
As a pediatrician — and grandfather — I ask myself: What would I do if I had family members raising kids in Flint, Mich., right now? The answer is anything in my power to get them out of that toxic, distressed and struggling city. And if that’s the right answer on a personal basis, it offers a critical insight into what has to be considered on a general policy level for the health and well-being of a community where water for drinking and bathing has been contaminated with lead for almost two years. (Irwin Redlener, 2/17)

JAMA: Flint, Michigan, And The Failure Of Public Agencies
On my first day as health commissioner in Baltimore in December 2005, the chief counsel to the city gave me some advice: When you see a problem, fix it. Don’t let your first instinct be to wonder who caused the problem, or to wait for every possible detail, or to defer to others. He said that the most important question the public will ever have about any problem is whether it has been fixed. And then he added, in an unwavering, deep voice, that fixing the problem is the right thing to do. (Joshua M. Sharfstein, 2/17)

The Baltimore Sun: Another Nightmare Germ
A week after the first Zika infection was reported in Maryland, health officials are mobilizing to combat the mosquito-borne virus that is suspected of causing thousands of birth defects across Latin America and the Caribbean. Researchers have been predicting it was only a matter of time before the virus showed up in the U.S., and cases have already been reported in neighboring Virginia, Delaware and the District of Columbia. Given the urgent need to prevent the virus' spread, the response to an impending public health crisis can't come a moment too soon. (2/17)

STAT: Zika Isn't The Only Mosquito-Borne Virus That Should Worry Us
The attention on Zika may be justified. Or the threat posed to human health by Zika may turn out to have been overhyped. Either way, there are other mosquito-borne viruses that should concern us — and that have largely been overlooked. And these viruses are far more likely to affect broader populations in the United States. (Jeffrey Powell, 2/17)

The Los Angeles Times: With No Reproductive Rights, Many Latin American Women Could Be At The Mercy Of The Zika Virus
Now that researchers have identified a tangible link between the Zika virus and fetal brain deformation, pregnant women and those of childbearing age in the Latin American countries hardest hit by the mosquito-borne virus will have to make tough decisions about their reproductive future. Use birth control? Abstain? Abort if there's evidence of potentially lethal birth defects? Or at least that's how it ought to go. (2/17)