KHN Morning Briefing

Summaries of health policy coverage from major news organizations

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Viewpoints: Reducing Special Enrollments; The Health Law’s Efforts To Cut Readmissions

A selection of opinions from around the country.

Los Angeles Times: Obamacare 'Gaming' Update: Feds, California Tighten Up On Documentation For Special Enrollments
The notion that mobs of Americans are actively plotting to cheat the Affordable Care Act by waiting until they get sick and then finding an excuse to sign up for health insurance is cherished by two groups: anti-Obamacare conservatives and insurance companies. As we've pointed out in the past, neither group has actually come up with data to substantiate their claim that this produces huge losses in the individual exchange market. But there plainly are good reasons to close any loopholes. (Michael Hiltzik, 2/24)

The Huffington Post: Here's How Obamacare Is Keeping People Out Of The Hospital
The Affordable Care Act was supposed to keep hospital patients from returning after discharge because of medical complications and poor follow-up care. For something like a half-million people over the last five years, the law appears to have done just that -- although the evidence, as usual, isn't quite definitive. (Jonathan Cohn, 2/24)

The Wall Street Journal's Washington Wire: Medicare-For-All Vs. Single Payer: The Impact Of Labels
Sen. Bernie Sanders describes his health-care proposal as a Medicare-for-all, single-payer plan. The plan, however, would not expand the current Medicare program but replace it, along with Medicaid, private insurance, and other programs with what might be described as a Medicare-like, government-run single-payer plan. New polling shows why Mr. Sanders’s label works well politically in the primary campaign: Among Democrats, the term “Medicare-for-all” generates a much more enthusiastic reaction than does “single-payer.” With this discussion still mostly at the stage of broad concepts and messaging, language matters. (Drew Altman, 2/25)

The Des Moines Register: Halt Devastating Medicaid Plan
Concerns of participants, providers, and all stakeholders engaged in the Medicaid system make it clear that Iowa’s rush to privatize Medicaid does not fulfill the [League of Women Voters of Iowa's] priority for quality healthcare. (Deborah Ann Turner, 2/23)

The New York Times: The Secret Side Of Donald Trump
Today we will consider the upside of Donald Trump. O.K., it was never huge. Possibly not even nugget-size. But people, wasn’t there a moment when you thought that he could think outside the normal conservative box? True, his riff against the power of big political donors was just another way to brag about being rich. And he was awful on … so very many things. But once in a while, as Trump ranted about the Republican insiders, some actual outsider remarks did pop up. Don’t mess with Social Security. Planned Parenthood is a good thing. And everybody ought to have health care. (Gail Collins, 2/25)

STAT: Why Health Care Needs A Steve Jobs-Style Disruptor
Few industries yearn for a Jobs-style disruption as much as health care does today. With its labyrinths of regulation, deeply entrenched and antiquated information systems, and monopolies built upon thrones of indifference to the consumer experience, the health care industry has chained itself to archaic and inefficient processes while resisting its own rescue. (Damon Ramsey, 2/24)

JAMA: Consensus Plans Emerge To Tackle Long-Term Care Costs
As I’ve noted in a previous JAMA Forum post, there has been a determined and serious effort in recent years by a broad range of organizations and analysts to find a consensus approach to the growing problem of financing long-term care in the United States. These efforts have just resulted in 2 major reports, released in February. (Stuart Butler, 2/24)

The New England Journal Of Medicine: Leaping Without Looking — Duty Hours, Autonomy, And The Risks Of Research And Practice
The Flexibility in Duty Hour Requirements for Surgical Trainees (FIRST) trial ... compared 59 surgical training programs randomly assigned to an ACGME-compliant schedule with 58 granted flexibility in designing shift lengths (still within an 80-hour workweek). The ongoing Individualized Comparative Effectiveness of Models Optimizing Safety and Resident Education (iCOMPARE) trial involves internal medicine programs. ... neither required consent of residents or patients. That consent waiver has drawn criticism from Public Citizen and the American Medical Student Association, which in open letters to the Office for Human Research Protections (OHRP) accuse the investigators of “egregious ethical and regulatory violations.” The allegations, focused primarily on “serious health risks” to residents from long shifts, are dizzyingly tautological. (Lisa Rosenbaum, 2/25)

Modern Healthcare: Lowering The Barriers To Primary Care
Though the nation still faces a shortage of primary-care physicians, regulatory and payment roadblocks to delivering that basic service in less expensive ways are finally starting to come down.The key is expanded access to telehealth technologies and shifting more primary care to alternative practice models. (Merrill Goozner, 2/20)

The Seattle Times: Black Health Requires Dose Of Medical Humanity
I just read “Black Man in a White Coat: A Doctor’s Reflections on Race and Medicine,” a book that revolves around the idea that being a black American is bad for your health. Every day the news bears that out. Wednesday it was a story saying the federal government estimates one in two black gay/bisexual men in the U.S. will be diagnosed with HIV, versus fewer than one in 11 white gay/bisexual men. Name the malady and the news for black folks likely will be bleak. (Jerry Large, 2/24)

The Hill: Zika, Ebola, Other Public Health Crises -- We Need A Better Plan
Today, the United States Senate is holding hearings to respond to the potential threat of the Zika virus. This is part of a pattern that repeats every few years when an outbreak of disease occurs someplace in the world. As the media coverage increases, public panic grows and in response Congress scrambles to deal with the possible threat, appropriating billions of dollars in emergency funding. Then, as media coverage fades, public panic recedes and Avian flu, Swine flu, Ebola and the others fade from public consciousness. (Sen. Bill Cassidy, R-La., 2/24)

The New York Times' Taking Note: The Might-Have-Beens Of Marijuana
Former Attorney General Eric Holder, in a newly released interview conducted after he left office, said he was in favor of reclassifying marijuana as something less than a Schedule I controlled substance comparable to heroin. This was hailed as encouraging news by marijuana enthusiasts who immediately asked why Mr. Holder didn’t push for this change when he was running the Justice Department. (Francis X. Clines, 2/24)

The New York Times: Governors Unite In The War Against Opioids
State governments are at the front lines of the country’s epidemic of drug overdose deaths. That’s why it is important that the National Governors Association says it will come up with protocols for dispensing prescription painkillers that are among the biggest sources of addiction and abuse in the country. The protocols, or guidelines, would restrict how and under what circumstances doctors could prescribe a category of pain drugs known as opioids. They might, for example, impose limits on how many pills doctors could prescribe to patients who have had minor surgery or dental procedures. (2/24)

Louisville Courier-Journal: Oxycontin Maker's Kentucky Legacy
President Obama has asked Congress for $1.1 billion to fight opioid and heroin abuse. Most of the money will be spent on new treatment facilities and programs to prevent overdoses and illegal sales. The case of Kentucky and Purdue Pharma suggests that the role of pharmaceutical companies in opioid abuse needs attention. In December, Purdue settled a lawsuit with Kentucky, agreeing to pay $24 million for misleading doctors and patients in its marketing of OxyContin, but admitted no wrongdoing. (Ron Formisano, 2/24)

The Washington Post: Where The Prescription For Autism Can Be Death
Now, however, doctors from elsewhere are starting to apply independent scrutiny to the increasingly common euthanasia of Holland’s mentally ill, and their findings are not so reassuring. To the contrary. According to an analysis of 66 of the 110 cases from 2011 to 2014, by psychiatrist Scott Kim of the National Institutes of Health and two colleagues, Dutch psychiatric patients were often euthanized despite disagreement among consulting physicians as to whether they met legal criteria. In 37 cases, patients refused possibly beneficial treatment, and doctors proceeded anyway. (Charles Lane, 2/24)

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