Good morning ... The Senate Finance Committee begins marking up its tax overhaul this week, so hopefully we won't have to wonder much longer whether Republicans will try to repeal the individual mandate as part of that effort. (I'm betting they won't, but I've been wrong before.)
This might be a little bit off the beaten path for Vitals, but it's a critical reminder of why we all spend so much time and energy on health care in the first place.
Kevin Menes was the doctor in charge of the emergency room at Sunrise Hospital in Las Vegas on the night of the deadliest mass shooting in American history. He's written a piece in Emergency Physicians Monthly describing how he and his colleagues handled that night — how they prepared, how they adapted and how they managed to process 215 victims with gunshot wounds (known as "GSWs" in medical jargon) in just a few hours.
You should read the whole thing, but here are some of the most incredible excerpts:
The bottom line: "We had dispositioned almost all 215 patients by about 5 o'clock in the morning, just a little more than seven hours after the ordeal began. That's about 30 GSWs per hour. I couldn't believe that we saved that many people in that short amount of time ... We did everything we could."
"Silver" plans are still the most popular offerings in the Affordable Care Act's exchanges, but are losing some ground both to cheaper "bronze" plans and more generous "gold" plans early in this very wacky enrollment season, according to the latest data from the enrollment website HealthSherpa.
The details: HealthSherpa says it signed up 25,000 people in the first week of this open enrollment period. Here's the breakdown of which plans those consumers chose, and how those results compare to the first week of last year's enrollment window:
How it works: Silver plans have traditionally been the most popular, but this year is weird. As a side effect of President Trump cutting off the ACA's cost-sharing subsidies, many consumers' subsidies will now cover the entire premium for a bronze plan, and in some cases gold plans are actually cheaper than silver.
What's next: Silver plans could take a bigger hit as healthier and more cost-conscious consumers come into the market closer to the end of the sign-up window.
It's been a brutal year for Community Health Systems. My colleague Bob Herman notes it didn't get a whole lot better in the third quarter, and Wall Street is souring even more on the hospital chain, which has buckled under low patient admissions and sold off hospitals to chip away at its debt.
The latest: Short sellers are surrounding CHS' stock and bonds like piranhas. CHS' stock has fallen almost 20% this month. And last week, Fitch Ratings downgraded CHS' debt to a junk rating of CCC — meaning investors are taking a questionable gamble that CHS' hospitals will bounce back. Fitch analysts also believe "there is a likelihood that the company will violate the (debt) covenants in 2018," which fueled a selloff last week in CHS' bonds.
Looking ahead: Keep tabs on Franklin Templeton. The giant investment firm holds a substantial portion of CHS' debt that comes due in 2019, 2020 and 2022.
Go deeper: How CHS got to this point
Microsoft co-founder Bill Gates today is announcing a $50 million investment in Alzheimer's research. The money will go to the Dementia Discovery Fund, and it's a personal investment — not part of the Gates Foundation. Pharmaceutical companies tend to focus on the two most prominent theories of how Alzheimer's develops, and the DDF "complements their work by supporting startups as they explore less mainstream approaches to treating dementia," Gates said in his announcement.
What we're watching this week: Two HELP Committee hearings: Tuesday on gene editing and Wednesday on Surgeon General Jerome Adams' testimony on "encouraging healthy communities."
Senate Appropriations subcommittee hearing Wednesday on the VA's efforts to combat opioid overuse.
Kentucky men's basketball plays Kansas on Tuesday and East Tennessee State on Friday. (Hey, you wanted to know what I'm watching.)
What's on your radar? I'd love to hear your tips and feedback: firstname.lastname@example.org.