Viewpoints: Evidence, Spending And How The U.S. Health System Ranks; The GOP’s ‘Efficiency Paradox’
A selection of opinions on health care from around the country.
The New England Journal Of Medicine:
From Last To First — Could The U.S. Health Care System Become The Best In The World?
Many Americans believe that the United States has the best health care system in the world, but surprisingly little evidence supports that belief. On the contrary, since 2004, reports from the Commonwealth Fund have consistently ranked the performance of the U.S. health care system last among high-income countries, despite the fact that we spend far more on health care than these other countries .... These reports — based on recent Commonwealth Fund surveys of primary care doctors and the general population, as well as data on health outcomes gathered by international organizations — reveal several reasons why, despite offering some of the most specialized, technically advanced treatments in the world, U.S. health care fails to achieve the level of performance of the health care systems of other high-income countries. An understanding of these reasons may point the way to essential improvements. (Eric C. Schneider and David Squires, 9/7)
The Efficiency Paradox: Republican Orthodoxy And Health Care Reform
Republican efforts at health care reform have been and will continue to be, undermined by the same fundamental reality: the basic economic concept of efficiency. Republican rhetoric on health care reform centers on a core conservative orthodoxy: that efficient markets, free of government interference or regulation, invariably solve societal ills. Simply put, Health and Human Services Secretary Tom Price and many other proponents of the Republicans’ approach to health care argue that an unfettered free market structure will lead to lower premiums, engender greater access to care, lower overall health care costs, and--through competition--lead to both better coverage and better health care outcomes. (Dennis R. Bullock, 9/8)
The New England Journal Of Medicine:
The HITECH Era And The Path Forward
The [Health Information Technology for Economic and Clinical Health (HITECH) Act] spurred rapid progress toward digitizing the health care delivery system, which has experienced a dramatic transformation as a result of concerted efforts by both public and private sectors. We believe we’re at an inflection point in terms of the capability to share research results, clinical guidelines, and patient data seamlessly and securely. The federal government’s actions to date have set the stage for an expanding role for health information technology (IT) in improved care delivery. (Vindell Washington, Karen DeSalvo, Farzad Mostashari and David Blumenthal, 9/7)
The New England Journal Of Medicine:
The HITECH Era In Retrospect
At a high level, the Health Information Technology for Economic and Clinical Health (HITECH) Act of 2009 accomplished something miraculous: the vast majority of U.S. hospitals and physicians are now active users of electronic health record (EHR) systems. No other sector of the U.S. economy of similar size (one sixth of the gross domestic product) and complexity (more than 5000 hospitals and more than 500,000 physicians) has undergone such rapid computerization. Along the way, however, we lost the hearts and minds of clinicians. We overwhelmed them with confusing layers of regulations. We tried to drive cultural change with legislation. We expected interoperability without first building the enabling tools. In a sense, we gave clinicians suboptimal cars, didn’t build roads, and then blamed them for not driving. (John D. Halamka and Micky Tripathi, 9/7)
My Medical Training Didn't Prepare Me To Be An Ambassador To Nightmares
Escorting those left behind, parent or spouse or sibling or friend, into a world that most of us can’t even imagine without shivering might be the toughest task in emergency medicine. I’d rather not be an ambassador to nightmares. But when I don’t have a choice, I try to do it with compassion and care. That requires a degree of openness and vulnerability, and that means my fears and emotional reactions will enter into the process. There’s no hiding behind a white coat. Through the years it hasn’t become easier. And I hope it never does. (Jay Baruch, 9/7)
'Designer Babies' Won't Be A Fad. It's Too Hard To Create Them.
The recent news that scientists have successfully edited a human embryo to fix a potentially lethal heart defect is an exciting medical and biotechnological advance. However, the cases for and against human embryo editing are both full of hype. (Alex Berezow and Ben Locwin, 9/8)
Why Can't More American Women Access Medications For Preterm Birth?
There are two medications that prevent preterm birth, the most common cause of perinatal death in the U.S. One costs 16 cents a week, one $285. Poor black women aren’t getting either. ... The medical community can do better to reduce this racial disparity, but doing so requires focused interventions directed toward those women most likely to benefit. (Jodi Frances Abbott, 9/7)
Lexington Herald Leader:
When Money And Politics Dictate Public-Health Policy, People Die
It seems like I wake up every morning to news that someone in Lexington has been shot. Recent killings have included pregnant women and toddlers. This epidemic of gun violence has got to stop. I’m talking about all the gun violence: the mass murderers who shoot up elementary schools, the toddlers who accidentally shoot their siblings, the teenagers who take their own lives with their parents’ guns — all of it. (Shelly Roberts Bendall, 9/7)
The Mercury News:
Californians Deserve Transparency In Prescription Drug Pricing
Californians now pay more for their prescription drugs than they do for their doctors. The state spent a whopping $4 billion on drugs in 2015, and pharmaceutical companies are pushing another 12 percent increase in 2017. The Legislature has to pass state Sen. Ed Hernandez’ SB 17 and force drug makers to provide information about how they price their products. (9/7)
The Des Moines Register:
Reynolds, Branstad Have Inflicted Lasting Damage On Iowans
Your policies have decimated our state budget, degraded our environment, injured Medicaid beneficiaries, victimized disabled and mentally ill Iowans, assaulted education and the Regents Institutions, privatized government functions that were better and more economically handled internally, gutted the state's workforce, failed to protect children, shuttered valuable state institutions, caused lawsuits against the state costing millions of taxpayer dollars, and the list goes on. (Dean Lerner, 9/6)
Sex Education Is Threatened Under Trump's Budget. It's Time To Speak Out
When you were in school, what did you learn about sex? This question is always a conversation-starter. Every time I ask, I’m struck by the diversity of answers I receive – even graduates of the same high school class may have drastically different experiences. (Kim Greene, 9/7)
Los Angeles Times:
If Teenagers Get More Sleep, California Could Gain Billions
Sleep deprivation among teenagers should be regarded as a public health epidemic. Only about 60% of teenagers get the eight to 10 hours of sleep a night recommended by sleep scientists and pediatricians. A major reason teens aren’t getting enough sleep isn’t hormones, their busy social lives, too much homework or too much screen time. It’s actually a matter of public policy. (Wendy M. Troxel and Marco Hafner, 9/7)