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Most of the 275 million Americans with health benefits probably see the logo on the corner of their insurance card and think that’s who has them covered. But for almost 100 million of them—the majority of Americans who get coverage through work—the true insurer is noted somewhere else: on their business card. It’s called self-insurance, and the Obama administration seems interested in curtailing the practice to shore up the Affordable Care Act’s health-insurance exchanges. (Mike Ferguson, 9/2)

One of the signs of real leadership is the ability to change course when it becomes clear a mistake has been made. One would hope, now that Judge Frank Pfiffner has been affirmed by the Alaska Supreme Court, that rather than wasting hundreds of thousands more of taxpayer’s dollars, in a time of budgetary crisis, the Legislative Council would drop its ill-considered litigation against Medicaid expansion. After reading the rejection grounds articulated in Pfiffner’s opinion, any litigant would hesitate before proceeding further. And it’s not like Pfiffner, appointed by Gov. Sean Parnell, is some kind of liberal. (John Havelock, 9/2)

The governor of Texas was angry about a health plan leader's demand that he expand Medicaid to low-income, uninsured adults under the Affordable Care Act because he hates Obamacare. But behind the scenes, he and his aides were trying to convince the Obama administration to keep sending Texas billions of dollars in supplemental Medicaid funding to finance care for low-income, uninsured Texans—while continuing to insist he didn't want or need a Medicaid expansion that would extend coverage to more than 1 million Texans. If that sounds like a contradiction, welcome to the continuing political battle over the ACA and Medicaid expansion that has hospitals caught squarely in the middle. (Harris Meyer, 9/2)

Donald Trump is expected to release a tax plan in the next few weeks. What will it say? ... First, the good news for anti-tax conservatives: He has identified three areas in which he wants to cut taxes. ... This promise of a tax cut fits with Mr. Trump’s more unconstrained view of fiscal policy. While other Republicans (and many Democrats) warn about the long-term fiscal gap, he insists that cuts in Social Security, Medicare and Medicaid are unnecessary. “I’m going to make us so rich you don’t have to do those things,” he said in April. (Josh Barro, 9/2)

On my first trip to New Hampshire this spring, a retired doctor spoke up. ... He said his biggest worry was the rising tide of heroin addiction in the state, following a wave of prescription drug abuse. To be candid, I didn’t expect what came next. In state after state, this issue came up again and again — from so many people, from all walks of life, in small towns and big cities. ... This is not new. We’re not just now “discovering” this problem. But we should be saying enough is enough. It’s time we recognize as a nation that for too long, we have had a quiet epidemic on our hands. Plain and simple, drug and alcohol addiction is a disease, not a moral failing — and we must treat it as such. (Hillary Clinton, 9/1)

When Americans were giddily drenching themselves with ice water during the “ice bucket challenge” a year ago, the cognoscenti rolled their eyes. The aim of the ice bucket challenge was to raise money to combat A.L.S., also known as Lou Gehrig’s disease, a neurodegenerative ailment that affects some 15,000 Americans and usually leads to death within five years. But commentators scoffed: One on Time.com declared it “problematic in almost every way.” Critics sniped that the challenge wasted water and cannibalized contributions to better causes that affect more people. ... But now we have evidence that the ice bucket challenge may have worked. (Nicholas Kristof, 9/3)

The current Planned Parenthood fight, one of the most disturbing battles over women’s health in recent years, has been riddled with inaccuracies. A particularly damaging one is the assertion that the nation’s community health centers could pick up the slack if Planned Parenthood is defunded. I have worked with community health centers for nearly 40 years, and no one believes more strongly than I do in their ability to transform the primary health care landscape in medically underserved low-income communities. But a claim that community health centers readily can absorb the loss of Planned Parenthood clinics amounts to a gross misrepresentation of what even the best community health centers in the country would be able to do were Planned Parenthood to lose over 40 percent of its operating revenues overnight as the result of a ban on federal funding. (Sara Rosenbaum, 9/2)

Today patient satisfaction is being dissected and analyzed many different ways by physician offices, hospitals, and Accountable Care Organizations (ACOs), driven largely by the Centers for Medicare and Medicaid Services (CMS) and a policy to tie reimbursement to patient perceptions and compliance with clinical performance guidelines. My question is this: Where are PAs, who are on the front lines of patient care, in this discussion and effort? My concern is that our profession is often overlooked by health leaders in patient satisfaction surveys. Yet we are major contributors to efforts to improve satisfaction goals. (Dawn Morton-Rias, 9/2)

Failure to rescue (FTR), the death rate among patients with postoperative complications, is an emerging surgical quality metric that has received increased focus in the last several years. Medicare has begun publicly reporting FTR on Hospital Compare, and the National Quality Forum has endorsed 3 separate FTR measures. Despite this great promise and rapid adoption, considerably less attention has been paid to the way in which FTR is measured and what the measurement of FTR is intended to achieve. Despite the surge in interest within the surgical community in the last several years, current FTR measures have remained largely unchanged. (Elliot Wakeam and Joseph A. Hyder, 9/2)