Good morning. Today's word count is 912 words, or ~3.5 minutes.
The past decade has seen enormous growth in health care costs paid by both employees and employers, creating the context for some of today's biggest political debates as well as teeing up more problems for the future.
The big picture: Health spending by families who get their insurance from large employers has grown 2 times faster than wages over the last decade, driven partially by the rise in deductibles, according to a new brief by the Kaiser Family Foundation.
Why it matters: People are paying higher premiums for insurance that leaves them on the hook for more of their bills.
What we're watching: There are signs that the system is nearing a breaking point.
The bottom line: The current trajectory isn't sustainable.
There is one psychiatrist in eastern Montana — the state with the highest suicide rate in the country, Bloomberg Businessweek reports in a deep dive worthy of your time.
Between the lines: Psychiatrists are often paid less than other doctors, they struggle with insurance reimbursement, and the job can be incredibly stressful.
Why it matters: Suicide rates are spiking, especially in rural areas, which have a seen a 52% increase in suicides since 1999 compared to urban areas' 15% increase. And rural life isn't getting any easier.
Go deeper: The rural America death spiral
Photo: David Butow/Corbis via Getty Images
The FDA is trying again to add graphic warnings to cigarette packages to discourage smoking, including images of neck tumors, diseased lungs and feet with amputated toes, AP reports.
Situational awareness: The agency has made a similar effort before, but it was defeated in court in 2012 after tobacco companies argued that it violated their free speech rights.
The federal government will soon begin assigning quality ratings to insurance plans sold through the Affordable Care Act’s exchanges, my colleague Sam Baker reports. They’ll be graded using the same 1-to-5-star ranking used for Medicare Advantage plans.
Details: Plans will be graded on medical care, member experience and plan administration, the Centers for Medicare & Medicaid Services said, beginning in the next enrollment period.
Sam’s thought bubble: MA’s star ratings have given plans clear metrics to chase, and critics say insurers can game the system, at least at the margins.
In a world where getting a second doctor's opinion is perfectly normal, it can be extremely difficult to find the line between differences in professional opinions and intentional misdiagnosing, as the Atlantic's Olga Khazan points out.
The bottom line: The pediatric neurologist's case "shines a light on the grim world of health-care fraud—specifically, the growing number of doctors who are accused of performing unnecessary procedures, sometimes for their own personal gain," Khazan writes.
The American Medical Association has left the Partnership for America's Health Care Future, a coalition of health industry groups that are leading the fight against Democrats' plans to expand Medicare.
What they're saying: Politico reports that the AMA left because the coalition had expanded its opposition beyond single-payer Medicare for All to include more incremental reforms, like a public option.
My thought bubble: It makes sense that a public option would be divisive among health industry groups. On one hand, it decreases the number of uninsured, which is good for providers and for public health.