行动，以公益慈善的名义

总是有人说，这个社会很令人失望。然而，一味地感叹世风日下的人，要么是为自己准备随波逐流扯起幌子，要么是感受着“举世皆浊我独清”来聊以自慰。事实上，善良和责任感永远是乐活族都该有的品质。慈善和公益已经渐渐为公众所关注，但慈善晚宴和捐款箱决不是它们的全部意义。不要以为只有大牌明星和成功企业家才能成为慈善公益活动的主角，草根乐活族的你我，只要常怀爱心，一样可以理想主义地，温暖世界。 我们需要的是勇敢而不做作地大喊一声：     

Premium subsidies,the mandate,and Medicaid expansion: Coverage effects of the Affordable Care Act

Using premium subsidies for private coverage, an individual mandate, and Medicaid expansion, the Affordable Care Act (ACA) has increased insurance coverage. We provide the first comprehensive assessment of these provisions’ effects, using the 2012–2015 American Community Survey and a triple-difference estimation strategy that exploits variation by income, geography, and time. Overall, our model explains 60% of the coverage gains in 2014–2015. We find that coverage was moderately responsive to price subsidies, with larger gains in state-based insurance exchanges than the federal exchange. The individual mandate's exemptions and penalties had little impact on coverage rates. The law increased Medicaid among individuals gaining eligibility under the ACA and among previously-eligible populations (“woodwork effect”) even in non-expansion states, with no resulting reductions in private insurance. Overall, exchange premium subsidies produced 40% of the coverage gains explained by our ACA policy measures, and Medicaid the other 60%, of which 1/2 occurred among previously-eligible individuals.     

HPV Vaccination's Second Act: Promotion, Competition, and Compulsion

Developments regarding human papillomavirus (HPV) vaccines will transform HPV vaccination in the United States while simultaneously raising several new policy and ethical concerns.Policymakers, vaccine manufacturers, and the public health community must now respond to the presence of competing vaccines that are similar but distinct, particularly with respect to genital wart prevention and the benefits of vaccinating males. This work arises in the shadow of the contentious introduction of the HPV vaccine Gardasil (Merck & Co, Inc, Whitehouse Station, NJ) in 2006, particularly the opposition to efforts in many states to require the vaccine for school attendance.I review the current status of HPV vaccine policy in the United States and examine issues of public health ethics and policy central to ongoing and future HPV vaccination programs.Recent developments regarding human papillomavirus (HPV) vaccines signal the beginning of a new era in cervical cancer prevention. The October 2009 licensure of a second vaccine, Cervarix (GlaxoSmithKline, Philadelphia, PA), for females and the expanded approval of the first vaccine, Gardasil (Merck & Co, Inc, Whitehouse Station, NJ), for use by both genders create new opportunities to further reduce the burden of cervical cancer and other HPV-related diseases. However, as the introduction of Gardasil in 2006 revealed, HPV vaccine policy can be extremely contentious, and vaccination overall remains a source of considerable controversy.As this next phase of HPV vaccination efforts begins, policymakers, public health officials, and vaccine manufacturers have the opportunity to avoid repeating the mistakes that plagued the arrival of Gardasil while building on its successes. Doing so, and addressing the new ethical and policy challenges that result from having two similar yet distinct vaccines, will be critical to the long-term success of HPV vaccination programs in the United States and worldwide.