KHN Morning Briefing

Summaries of health policy coverage from major news organizations

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Viewpoints: A Federal Reprieve From Calorie Counting; Fair Trade Protections For Medical Innovation; Exploring Conflicts Of Interest In Medicine

A selection of public health opinions from around the country.

The Wall Street Journal: With Liberty And Pizza For All
The Food and Drug Administration announced on Monday that the agency would delay a May 5 enforcement date for a rule that requires restaurants with more than 20 locations to post calorie counts on menu boards, ostensibly to encourage healthy choices and prevent a patchwork of state labeling schemes. The mandate was included in the Affordable Care Act in 2010. (5/3)

The Wall Street Journal: The Soda Tax Class Revolt
The progressive mind is forever telling people how to run their lives, but every so often the people tell them to get lost. That’s what the voters did Tuesday in Santa Fe, New Mexico as the hoi polloi revolted against an attempt to tax sugary drinks. Mayor Javier Gonzales, enlightened progressive that he is, proposed the levy of two cents an ounce on sugar-sweetened beverages. That’s roughly 25 cents for a 12 ounce Coke. The tax would have been one of the nation’s highest, on par with the socialist nirvana of Boulder, Colorado. (5/4)

RealClear Health: Lives Depend On A Fair Trade Protecting US Medical Innovation
America is the undisputed leader in biopharmaceuticals and medical innovation, at least for now. In countries around the world, governments are taking steps to weaken their U.S. competitors while advancing their own domestic industries – hampering continued investment in innovative new therapies for patients. This is why it is so vital that America’s trade negotiators ensure that we enter into deals with true reciprocity and tough enforcement – something echoed by both the recently released Special 301 Report and President Trump’s April 29 executive order targeting trade abusers. We are happy to compete on a level playing field, but we have to do so with our eyes wide open – recognizing that other countries may not always share our commitment to fair play. (Stephen J. Ubl, 5/4)

Stat: The Surgeon General'S Dismissal Should Alarm All Doctors
The day after being fired, Murthy confirmed on Facebook that he had refused to abandon his commitment to “a healthier and more compassionate America.” Faced with a conflict between personal or career interest and the interests of his patient — the American population — he chose principle over paycheck, like a doctor should. On Wednesday, seven US senators wrote to President Trump asking why Murthy was removed from his position before his term had expired “in light of (the) Administration’s pattern of politically motivated and ethically questionable personnel decisions.” Had it been his stance on gun control? Criminal drug policy? Affordable health care? Or was he dismissed for being the kind of fellow who joined forces with Elmo to debunk the anti-vaccination myths President Trump has given credence to? The public needs to know why Murthy was asked to resign. Doctors do, too. We are often at the intersection of politics, ethics, and health and, when confronted by a conflict of interest, should act like Murthy. (Hakique Virani, 5/3)

The Columbus Dispatch: Should Everything Ride On Democrat’s Position On Abortion?
America’s Democrats are having a bit of an identity crisis, which isn’t surprising given their loss of both the White House and Congress. But with little going right for the Democratic Party, its leaders and stalwarts really can’t afford to squander an opportunity by looking insincere or uninformed, as a recent internal dust-up makes them appear. Broadly speaking, the divide is over whether to back candidates who don’t share the party’s pledged commitment to reproductive choice. That’s a legitimate area of debate, to which many of us would answer a simple no. At a time when abortion rights are being eroded with new state restrictions, funding cuts to Planned Parenthood and a conservative new Supreme Court justice who has yet to show how far he’d go, Democrats must fight to preserve a woman’s right to decide when or if to become a mother. Especially as the Republican Party shows no room for choice. (Rekha Basu, 5/4)

Los Angeles Times: Using Abortion As An Excuse To Deny Californians Subsidized Healthcare Is Unnecessary And Cruel
In their zeal to restrict abortion, House Republicans could once again put the federal government on a collision course with California over the rights the state guarantees its residents. The GOP leadership’s healthcare bill, which is headed for a crucial vote this week, would replace the Affordable Care Act’s premium subsidies with new tax credits available to a broader range of Americans. But it would flatly bar the credits from being spent on any policy that covers abortions. And under California law, all insurance policies offered in the state must include such coverage. (5/4)

JAMA: The Complex And Multifaceted Aspects Of Conflicts Of Interest
Judgment and integrity are 2 hallmarks of professionalism. Conflict of interest (COI), bias, and dishonesty represent a spectrum of threats to judgment and integrity. COI, a conflict between a professional responsibility and a personal interest, is at one end of this threat spectrum. COI creates a risk of bias. Bias, a prejudice for or against something, is in the middle of this spectrum. If a COI results in bias, the bias may affect a professional judgment. Dishonesty is deceit or fraud. Dishonesty is at the opposite end of this spectrum from COI. Each of these threats exists on a continuum. COI may be present or perceived. Bias may be conscious or unconscious. Dishonesty may be intentional or unintentional. (William W. Stead, 5/2)

JAMA: Reconsidering Physician–Pharmaceutical Industry Relationships
A fundamental task of physicians is to guide patients through illness, a process that involves collecting information and then seeking balance between the risks and benefits of treatments and between the length and quality of life. The work of physicians draws on an expanding base of medical knowledge, and there is always more to learn than time to read. Understandably, help is appreciated. It is easier when educational opportunities are convenient and enjoyable such as when they are combined with meals brought into clinic by pharmaceutical representatives and others. (Colette DeJong and R. Adams Dudley, 5/2)

JAMA: Conflict Of Interest And Medical Journals
Conflict of interest (COI) affects every aspect of medicine, including clinical care, teaching, and research. According to one definition, “A conflict of interest exists when professional judgment concerning a primary interest (such as patients' welfare or the validity of research) may be influenced by a secondary interest (such as financial gain). Perceptions of conflict of interest are as important as actual conflicts of interest.” Over the past decade, there has been increasing attention to virtually every aspect of COI in medicine, including reports from authoritative national committees, federally mandated reporting of industry payments to physicians, enhanced policies and procedures governing COI at academic medical centers and research institutions, and efforts to harmonize reporting of COI overall and in scientific publications. (Phil Fontanarosa and Howard Bauchner, 5/2)

JAMA: Funding, Institutional Conflicts Of Interest, And Schools Of Public Health Realities And Solutions
Individual researchers are accustomed to declaring conflict of interest (COI), if it exists, when submitting manuscripts for publication or in public presentations. In this Viewpoint we focus on an equally important issue—whole-institution COIs, specifically financial COIs in schools of public health, and address 2 interlinked questions: When does this funding represent an important conflict and what can schools of public health do about it? (Sandro Galea, and Richard Saitz, 5/2)

Stat: 'Information Blocking' Is A Shameful Practice In The Electronic Health Record Industry
I went digital 11 years ago and embraced an electronic health record. In addition to storing vital information about my patients, this technology let me revamp the revenue cycle management of patient payments, share patient data, and more. I bought into the promise of improved efficiency, enhanced connectedness, and even a better experience that comes with most technology, and was happy with my decision. While things aren’t perfect, they’re very good. Yet now I’m being told by the managers of my affiliated group that I and all of the other physicians in the affiliated group must adopt and use the same new electronic health record platform. (Peter Masucci, 5/3)

Chicago Tribune: Regulating And Taxing Marijuana Could Help Solve Illinois Budget Woes
With solutions to Illinois' fiscal crisis seemingly blocked by partisan politics, it's time to start looking at new ideas. That's why we have introduced a bill to legalize the purchase of up to an ounce of marijuana, regulating and taxing it as we already do with alcohol. The revenues would help the worst victims of our budget crisis, such as the elderly and ill who rely on social programs and our state colleges and universities that are leaking students and staff. (Kelly Cassidy and Heather Steans, 5/3)

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