SpaceX’s reusable Falcon 9 rockets have been grounded by the Federal Aviation Administration for the second time in two months after one of them caught fire, fell over and exploded upon its return to Earth this week.

The decision by the agency could further delay the historic Polaris Dawn mission, which will feature the first space walk by civilians. The crew, in a SpaceX Dragon capsule, will be sent to space by a Falcon 9, the company’s workhorse rocket.

The five-day mission was originally set to blast off Monday but has been delayed repeatedly for various reasons, including a leaking launch-pad helium line and unfavorable weather off the coast of Florida, where the capsule will splash down on return.

The Falcon 9 that failed blasted off early Wednesday morning from the Cape Canaveral Space Force Station and launched 21 satellites into orbit as part of SpaceX’s Starlink constellation, which provides space-based internet service.

The second-stage of the rocket burned up in the atmosphere as planned, while an engine that is part of the first-stage booster reignited to power a controlled landing on an uncrewed barge in the ocean. Video of Wednesday’s flight shows the returning stage touching down on the ship and falling over while partially engulfed in flames.

SpaceX said that the first stage had completed 22 launches and returns before the accident. The mishap also ended a streak of 267 successful returns for the Falcon 9 program, which has sharply lower launch costs due its reusable stage.

In announcing the grounding, the FAA noted Wednesday that while “no public injuries or public property damage have been reported” it was “requiring an investigation.”

Last month, the Falcon 9 was grounded for two weeks after the second-stage engine misfired mid-flight due to what was later determined to be a liquid oxygen leak in a line leading to a pressure sensor. The mishap occurred July 11 during an attempt to launch a payload of 20 Starlink satellites. The satellites did not reach their intended orbit and burned up in the atmosphere.

The Falcon 9 has been critical in establishing SpaceX’s Starlink satellite broadband network. It also handles commercial payloads and launches the company’s Dragon capsules, which carry cargo and astronauts to the International Space Station.

The Falcon 9 has launched a total 365 missions, according to SpaceX.

The Polaris Dawn mission is being funded by Jared Isaacman, a fintech billionaire who will serve as commander of a crew of four, including two SpaceX employees. On their third day in space, Isaacman and a second crew member are scheduled to carry out the first commercial space walk.

They will be testing a new generation of mobile space suits that SpaceX says will be necessary to colonize the moon and Mars.

The Falcon 9 also is scheduled next month to launch a Crew Dragon capsule to the International Space Station, where two NASA astronauts have been stranded since June due to problems with Boeing’s Starliner spacecraft. They are scheduled to return to earth on the Crew Dragon in February.

The Dodgers are giving away a second Shohei Ohtani bobblehead doll on Wednesday, this one with Ohtani holding his dog Decoy. In May, when the Dodgers staged their first Ohtani bobblehead night, fans lined up outside Dodger Stadium hours before game time, with the gates to the parking lot still closed.

The demand for all things Ohtani has sent season-ticket prices soaring, just like one of his majestic home runs. As of Monday afternoon, the Dodgers were selling tickets to Wednesday’s game for a minimum of $131 and to Thursday’s game — against the same opponent, the Baltimore Orioles — for a minimum of $36.

It takes a lot of money to get that free bobblehead. However, in an illustration of a policy embraced by the Dodgers and most other major league teams, you could pay all that money and still not get that free bobblehead.

The Dodgers say they have 40,000 bobbleheads to give away. They sold 53,527 tickets to the first Ohtani bobblehead night.

“Why do that,” asked Andy Dolich, a marketing expert and formerly a top executive for the Oakland Athletics, San Francisco 49ers, Memphis Grizzlies and Washington Capitals, “when the promotional concept is to put a smile on someone’s face?”

The San Diego Padres, like the Dodgers, limit most giveaways to the first 40,000 fans. The Angels generally provide giveaways to the first 25,000 fans. The Arizona Diamondbacks adjust their limit depending on the promotion, but most commonly distribute giveaways to the first 20,000 fans.

“I get it,” Diamondbacks president Derrick Hall said. “When I was a kid and I went to Dodger Stadium, I definitely had to get the batting glove every year, but I never feared not getting one.”

What has changed, Hall said, is that the increase in the number of giveaway dates has made the total cost of giveaways more prohibitive.

“It’s really just a budget issue,” Hall said. “That’s all it is. Teams have so many more promotions than they used to.”

For one, Dodgers president Stan Kasten said, the corporate sponsors that cover the cost of most giveaways may not have the budget for 53,000 promotional items.

“And, when you get there early, you have the opportunity to do other kinds of shopping, whether it’s food or merchandise,” Kasten said. “It also helps with traffic and things like that.

“We try to make all our fans happy. Most fans, when there is a limit and they come late, I think they understand.”

The Angels declined to make an executive available for comment, but a spokesman said the team tries to ensure every fan that arrives by first pitch can get that game’s giveaway item.

The Shohei Ohtani and Decoy bobblehead doll that will be given to fans attending Wednesday’s game between the Dodgers and Baltimore Orioles at Dodger Stadium.

(Los Angeles Dodgers)

The Padres list seating capacity at 40,222, not including a grass and turf park behind center field that can accommodate another 6,000 fans. The Padres’ giveaway limit: 40,000.

“That number covers our fixed seating capacity and estimated turnstile attendance for nearly every giveaway game,” Chief Executive Erik Greupner said, “ensuring that all ticket holders will receive a promo item.”

Hall said the Diamondbacks make adjustments for the most popular items. A replica National League championship ring was supposed to be limited to the first 30,000 fans, but the team actually distributed almost 40,000.

“We wanted to make sure we had a surplus so, if someone didn’t get one, we could take care of them,” he said.

Kasten said the Dodgers and other teams try to accommodate fans with extenuating circumstances.

The challenge on nights like an Ohtani bobblehead night is to take care of the actual fans rather than the speculators that buy the ticket in order to make money selling the item on eBay.

On Monday, the bobbleheads given away in May were selling in the range of $500 and up, with the ones scheduled for Wednesday already available for around $200.

Still, given that ticket prices are so high because of the bobblehead giveaway, Dolich said the Dodgers would be wise to take care of every customer — not just the one who lines up hours in advance and resells the bobblehead before first pitch, but the one with kids who might not be able to arrive before the bobblehead supply runs out.

“You absolutely cannot alienate that last person,” Dolich said, “the family that comes from Encino just for that night, with 8-year-old twins, and it’s, ‘Sorry, we’re done.’ ”

It’s rare — miraculously rare — that a drug can have such a pronounced effect that its immediate benefits translate into healthcare savings for years, even decades. To the wonder drugs Harvoni and Sovaldi, which wipe out hepatitis C, we can now add the weight-loss medicine Ozempic and its cousins Wegovy, Mounjaro and Zepbound.

These drugs have shown remarkable effectiveness in reducing obesity. That points to long-term reductions in users’ vulnerability to the whole spectrum of obesity-related medical conditions, including diabetes, cardiovascular disease, bad knees and sleep apnea.

They appear to work on other unhealthful dependencies such as narcotic and alcohol addiction, and possibly even on Alzheimer’s.

Yet millions of Americans are unable to access these drugs, thanks to the two big, interrelated flaws in our healthcare system: unrestrained pricing by drug companies and the economics of health insurance.

We’ll explore how these factors work to deny access to drugs that address America’s No. 1 health malady. But first, a look at the seriousness of the obesity epidemic.

Weight is typically measured by the body mass index, or BMI, which correlates weight with height. Roughly speaking (and not accounting for differences between males and females), a “healthy” weight for a 5-foot-10-inch person is reckoned by the Centers for Disease Control and Prevention to be 128 to 173 pounds, which translates to a BMI of between 18.4 and 24.9.

Between 173 and 208 pounds places that person in the “overweight” category and heavier than that is judged to be “obese,” defined as a BMI of 30 or higher. Those with a BMI of 40 or higher, or 278 pounds for a 5-foot-10 adult, are “severely obese.”

America has been getting more obese over time, according to the CDC. In 1960, about 31.5% of U.S. adults were overweight; in 2017, the latest period tracked by the agency, the figure was 30.3%. In 1960, however, 13.4% of adults were obese and 0.9% severely obese; by 2017, about 42.8% of adults were obese and 9.6% severely obese.

The rate of obesity among children — about 20% — is especially worrisome. Obese children are more likely than those with healthy weights to have high blood pressure and diabetes, and more likely to be obese in adulthood.

The toll this epidemic takes on the economy is horrific. Obesity and its consequences cost the U.S. healthcare system nearly $173 billion a year, the CDC estimates.

Experience with the weight-loss medicines thus far shows that they can cut the rates of obesity-related conditions materially. A five-year study of more than 24,000 nondiabetic but obese subjects published earlier this month by a team of Taiwanese researchers found significant reductions not only in heart disease, hypertension, stroke and kidney failure but in mortality from all causes as well. Those in the control group (not receiving the drug) had a 3.5% annual mortality rate; for those given the drug, it was only 0.75%.

So why would stakeholders in our healthcare system not be beating down the doors to make these drugs more widely available?

The answer, of course, boils down to money.

The estimated cost of Wegovy and similar drugs for insurers, net of bulk discounts provided by manufacturers (Denmark-based Novo Nordisk for Wegovy and Ozempic and Indianapolis-based Eli Lilly for Mounjaro and Zepbound) runs from about $8,600 to $9,100 a year. That’s a big lift for insurers contemplating coverage of drugs for which the public demand can be in the millions.

That might work if insurers could be sure that the long-term savings from their enrollees’ health improvements would save them as much or more. In our fragmented healthcare system, however, they can’t be sure that they’ll still be covering those enrollees in the cost-avoidance period. Customers can move to other insurers or leave the employers who were providing the insurance.

“Insurers routinely don’t see people for more than a few years at a time,” observes David Anderson, an expert in health policy at the University of South Carolina. “This limits the length of time that health gains can be internalized as reduced claims.”

As a result, insurers have been placing obstacles in the way of customers seeking coverage. Some require advance authorization before they’ll pay or limit coverage only to patients with a high BMI. Some insurance plans will cover them only for employees already diagnosed with diabetes, the condition for which these medicines were first developed, but not for weight loss alone.

Insurers administering plans for self-insured employers — large companies and institutions — are probably responding to their clients’ directives.

Some big employers that originally covered the weight-loss drugs have pulled back. The Mayo Clinic has imposed a $20,000 lifetime limit on the coverage for its employees. Purdue University will cover the drugs for employees with BMIs over 30, but requires employees to have lost at least 5% of their body weight after three months to continue coverage.

Others have simply dropped the option altogether. That leaves employees or the uninsured on the hook for the cost of $1,000 or more a month.

The insurer best positioned to pay for the weight-loss drugs and to reap the long-term benefits is Medicare, in which enrollees typically remain for life. Moreover, insurers are generally required to cover drugs considered the standard of care for known conditions.

Unfortunately, Medicare is prohibited by law to cover drugs prescribed specifically for weight loss. It can pay for them only if they’re prescribed for a related condition, such as heart disease or diabetes. For example, Wegovy was added to the standard formulary for Medicare’s Part D prescription benefit after it received approval from the Food and Drug Administration in March for the treatment of heart attack risk.

The popularity and efficacy of the drugs prompted legislators in June to update a measure unsuccessfully introduced in 2014 legalizing Medicare coverage for weight loss alone. The new version would cover mostly those who had been taking a drug for at least a year before joining Medicare, however.

Some experts estimate that expanding coverage of the weight-loss drugs would cost Medicare up to $6.1 billion a year, assuming that 10% of patients eligible for the coverage actually receive prescriptions. That would increase the $120-billion annual cost of Medicare prescriptions (net of enrollee premiums and contributions from state programs) by a little over 5%.

Whether that cost would be fully offset by subsequent healthcare savings for Medicare is unclear. Not every patient prescribed the weight-loss drugs tolerates them well enough to stay on them for even a year, and not all will escape a major health crisis that could have been averted by weight loss alone.

But it seems now that our healthcare system will have to deal with the new class of weight-loss drugs in one way or another. Wegovy and Ozempic are expected to be selected for the next round of Medicare price negotiations, due to take place next year with price reductions effective starting in 2027. Drug industry analysts don’t expect the drugs’ popularity to wane. The market for them reached $6 billion last year, according to Goldman Sachs, which projected that it would grow to $100 billion by 2030.

The weight-loss drugs are by no means the most expensive on the market — that trophy belongs to certain cancer drugs and gene therapies, some of which clock in at several million dollars per treatment. But none of those serve a market anywhere near the potential size of weight-loss treatments.

Unless the U.S. moves toward a single-payer healthcare system and starts to place limits on drug prices, it’s the manufacturers of the weight-loss drugs that will reap most of the benefits. Sales of Wegovy and Ozempic made Novo Nordisk the most valuable European company last year and helped drive an increase in profit at Lilly for the second quarter that ended June 30 by nearly 69% over the year-earlier period.

To put it another way, America’s 20th century healthcare system is coming face to face with a spate of 21st century drugs. Something will have to give.