Viewpoints: Reflections Of Smoking Study And LBJ’s War On Poverty; Md.’s Gov. Applauds Hospital Pay Changes
The New York Times: Down To The Last Cigarette?
It's hard to remember now just how prevalent smoking used to be. In the mid-1960s, around half the men in the country smoked; for women, the number was 35 percent. People smoked in their offices, smoked in restaurants, smoked on airplanes. Indeed, Paul Billings of the American Lung Association recalls that the airlines often gave passengers small packets of cigarettes when they boarded the plane. But by the 1950s, scientists were beginning to equate cigarettes with lung cancer and other fatal diseases, a linkage the tobacco industry vehemently denied (Joe Nocera, 1/10).
Los Angeles Times: After Waging War On Poverty For 50 Years, Let's Not Surrender
The truth is that the nation's investment in the War on Poverty has yielded huge and lasting gains. That's partially because LBJ's program was not just a plan for financial handouts. It also encompassed a broad approach encompassing "better schools, and better health, and better homes, and better training, and better job opportunities," as he put it in his address on Jan. 8, 1964. LBJ's campaign brought us Head Start (in 1965) as well as Medicare and Medicaid (Michael Hiltzik, 1/12).
The Baltimore Sun: New Md. Health Care Delivery System Will Prioritize Wellness
Beyond the political debates over the Affordable Care Act is a bipartisan consensus about the future of our nation's health care system. Across the political spectrum, officials and experts agree that we must shift from a near exclusive focus on treating people when they get sick to a balanced approach that also promotes health and wellness. Such a shift will both reduce costs for families and small businesses and keep many Americans from dying of preventable causes. ... In Maryland, we are taking a giant step away from this outdated system. We are adopting an innovative approach to setting rates for hospitals — one that supports lower costs, enables better outcomes and creates a better experience for patients. It will also accelerate efforts in support of community health and wellness (Md. Gov. Martin O'Malley, 1/11).
The New England Journal of Medicine: Maryland's All-Payer Approach To Delivery-System Reform
For 5 years beginning in 2014, Maryland will limit the growth of per capita hospital costs for all payers, including the growth of costs of both inpatient and outpatient care, to 3.58%, the 10-year compound annual growth rate of the per capita gross state product. ...The resulting changes should be visible at hospitals throughout Maryland in the form of more coordinated care, a greater emphasis on care transitions, and a renewed focus on prevention. ... a critical challenge for national delivery-system reform is to align payment incentives across multiple payers. ... implementing this model throughout a state with more than 5.8 million people living in urban, suburban, and rural settings will test these reforms in many different environments (Dr. Rahul Rajkumar, Ankit Patel, Karen Murphy, John M. Colmers, Jonathan D. Blum, Drs. Patrick H. Conway, and Joshua M. Sharfstein, 1/10).
The Washington Post: Va. Doesn’t Need Another Mental Health Task Force
Virginians should be embarrassed and angry that a newly appointed state mental health task force convened Tuesday in Richmond. It is the 16th task force asked to investigate the state's mental health system. Are Virginia legislators so dense that they need yet another expert panel to tell them what's wrong? Four major studies, from 1997 through 2000, in Virginia each identified the same problems and made similar recommendations. Yet the system remains a mess. Why? (Pete Earley, 1/10).
The New York Times: Heroic Measures
Lisa Bonchek Adams has spent the last seven years in a fierce and very public cage fight with death. Since a mammogram detected the first toxic seeds of cancer in her left breast when she was 37, she has blogged and tweeted copiously about her contest with the advancing disease. She has tweeted through morphine haze and radiation burn. Even by contemporary standards of social-media self-disclosure, she is a phenomenon. (Last week she tweeted her 165,000th tweet.) A rapt audience of several thousand follows her unsparing narrative of mastectomy, chemotherapy, radiation, biopsies and scans, pumps and drains and catheters, grueling drug trials and grim side effects, along with her posts on how to tell the children, potshots at the breast cancer lobby, poetry and resolute calls to "persevere" (Bill Keller, 1/12).
The New York Times: The Next Frontier In Fertility Treatment
The more than 700,000 transgender people living in the United States have long faced discrimination by health care providers. Over the past 15 years, activists have fought to compel insurers to cover transgender-related health care — from hormone therapy to gender reassignment surgery — or at least be prevented from excluding transgender clients from buying policies for basic services. Finally, starting this month, thanks to the Affordable Care Act, "transsexualism" can no longer be considered a pre-existing condition. What's been left out of the spotlight: having babies. Many Americans have come to accept gay parents; the transgender community is next in line for recognition (Sarah Elizabeth Richards, 1/12).
Philadelphia Inquirer: Time Doesn't Always Heal
Over the past month, the media has been following the untimely deaths of Jahi McMath and Marlise Munoz—two bodies kept on ventilator support despite brain death diagnoses. Much of the discussion surrounding these high-profile cases perpetuates the misconception that brain death is not as final as cardiac death; that somehow these women can recover. Unfortunately, these tragedies highlight the importance of separating specialists from charlatans (Krystyna Dereszowska, 1/13).