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The announcements this week by California Sen. Kamala Harris and South Bend, Ind., Mayor Pete Buttigieg that they are seeking their party’s nomination for president in the 2020 election brings the number of Democratic candidates — so far — to nine. But as far as health care is concerned, it’s already 2021 for them. How is that possible? Because presidential candidates are formulating their health care positions right now and, if elected, those positions will heavily influence any health care reform the future president makes in 2021. (David Blumenthal, 1/25)

It’s a good thing Canadians are so polite; they spend an unbelievable amount of time waiting in line. In 2018, the typical Canadian patient faced a median wait of almost 20 weeks for treatment from a specialist after referral from a general practitioner, according to a new report from the Vancouver-based Fraser Institute. ...Voters ought to ask themselves a different set of questions than (U.S. Sen. Bernie) Sanders and (U.S. Rep. Alexandria) Ocasio-Cortez offer. How could nations as wealthy as Canada and the United Kingdom subject their populations to such abysmal medical care? And how can we prevent such a system from taking root here? ( Sally C. Pipes, 1/24)

Images of mothers running with their children — some of whom do not even have shoes on their feet — away from the militarized border lingered in our collective memory as agents fired tear gas at teenagers and toddlers earlier this month. ...A recent review of case studies and epidemiological studies confirmed that tear gas agents can cause lung, skin, eye, cardiovascular and gastrointestinal injuries and issues, including choking and vomiting of blood. (Akemi Piatt, 1/24)

Having a baby at a UT Health Tyler hospital in Tyler, Texas, will cost a family $19,147.11, according to that facility’s newly posted price transparency guide. That’s a vaginal delivery with no complicating diagnosis. For a caesarian section, the price goes up to $31,644.38.Of course, that’s not what people pay. It’s just what the hospital has posted, in order to comply with a new law that went into effect Jan. 1. As the hospital notes on its website, “billing for medical services is a complex issue and the charges listed in our hospital chargemaster do not provide a complete picture of what you may actually pay.” (David Balat, 1/24)

As an internist who treats hundreds of recalcitrant smokers a year, I was desperate for useful quitting techniques. I finally found a successful approach. In most cases a nicotine patch during the day, combined with e-cigarettes when the urge for tobacco hits, works best. Vaping is less dangerous than cigarette smoking, but it isn’t harmless, and the long-term health effects aren’t yet known. The American Society of Clinical Oncology, American Association for Cancer Research and American Heart Association have all expressed concerns about e-cigarettes. (Marc Siegel, 1/24)

While health inequities are pervasive, they’re not inevitable. A health care system made by and for people who look like me – a middle-aged, college-educated white guy – must change to better meet the needs of everyone. ...The first step is to acknowledge the truth. While nearly everyone goes into health care to help others, the system isn’t immune to the racial bias, injustice and inequality that strains other social, economic and political aspects of American life. (Patrick Allen, 1/21)

Gov. Jared Polis took bold action Wednesday to pursue lower prices and better access to health care, signing an executive order that creates the “Office of Saving People Money on Health Care. ”It’s an anti-mission creep name, never letting anyone forget the charter. The Gazette’s editorial board has long maintained hope Polis would use his substantial entrepreneurial skills to solve big problems. (1/25)

The attorney general and state health officials unveiled the Dose of Reality website this week to provide information about opioid abuse, including locations where people can turn in unused medications so the pills don’t fall into the wrong hands. Such online information is helpful, but it’s not enough. If lawmakers want to make gains against addiction, they need to put more money toward treating and preventing drug abuse. (1/24)

We’ve said before that there’s no need to rush to legalize recreational marijuana, and it bears repeating now. Gov. J.B. Pritzker has promised to move swiftly on legalization. This Editorial Board remains skeptical.  We’re not necessarily opposed to legalization. But we want to see more definitive answers to pressing questions about the impact on public health, public safety and more before we’re convinced that any potential benefits outweigh the risks. (1/24)

Water issues are notoriously difficult for California governors. Just look at former Gov. Jerry Brown’s floundering tunnels proposal for the Sacramento-San Joaquin River Delta. Yet two factors suggest that Gov. Gavin Newsom must make water a priority. First, California needs more climate-resistant water supplies. Climate change is making California’s weather more extreme. For the past decade, most years have brought drought or the risk of catastrophic floods. (George Miller, 1/23)