Viewpoints: Jeb Bush’s Confusing Statements On Medicare; The Clash Over Fetal Tissue
A selection of opinions on health care from around the country.
Bloomberg:
Jeb Bush's Struggle To Say What He Means Continues
During a forum sponsored by Americans for Prosperity, the influential conservative group backed by David and Charles Koch, Jeb Bush told the audience that he wants to "phase out" Medicare. ... here the trouble is of Bush's own causing. The "new program" he was talking about may well have been Medicare with more means testing, and a higher retirement age. But that language is at best imprecise, particularly for a debate, as Bush himself noted, that easily can be distorted. (Michael C. Bender, 7/24)
The Washington Post:
The Price Of Fetal Parts
Planned Parenthood’s reaction to the release of a clandestinely recorded conversation about the sale of fetal body parts was highly revealing. After protesting that it did nothing illegal, it apologized for the “tone” of one of its senior directors. ... The Planned Parenthood revelations will have an effect. Perhaps not on government funding, given the Democratic Party’s unwavering support and the president wishing it divine guidance. Planned Parenthood might escape legal jeopardy as well, given the loophole in the law banning the sale of fetal parts that permits compensation for expenses (shipping and handling, as it were). But these revelations will have an effect on public perceptions. (Charles Krauthammer, 7/23)
The Chicago Tribune:
Planned Parenthood's Awkward Clash
If the reason for the sting was unease about how fetal tissue is obtained at Planned Parenthood clinics, then there are reasons for concern. In the videos, there are hints that abortion procedures might be altered to obtain particular tissue and there is some unseemly haggling over the processing fees. The solution to these concerns is to reaffirm that Planned Parenthood clinics are getting sound consent from women who donate, that procedures are being done solely with the health and safety of women in mind and that fees are clearly set every year, reasonable for the work involved and not subject to negotiation. Of course that is not the point of the sting. The point of the sting is to bring enough shame onto Planned Parenthood so that it is defunded, so that it cannot offer elective abortions. (Arthur L. Caplan, 7/23)
The Wall Street Journal:
Bristol-Myers’ Pricey Pipeline
Bristol-Myers Squibb’s cancer pipeline is the envy of the industry. But drug-pricing pressures—especially from health-insurer consolidation including the expected Anthem deal for Cigna—could keep shareholders from reaping its full benefits. (Charley Grant, 7/23)
The Chicago Tribune:
For People With Disabilities, 25 Years Under ADA Has Opened A New World
One day when I was 23 years old, back in 1977, I was hanging out at Lake Michigan when my friend's dog knocked my shoes in the lake. I dove in to retrieve them and broke my neck, leaving me paralyzed from the chest down. It didn't take long to realize my world had changed. People immediately treated me differently because of my wheelchair — I lost my job as a nurse, I lost my home, I lost my health insurance. I couldn't use public transit, and I couldn't get into many public places without entering through the service entrance — that happened more times than I care to remember. America in 1977 was a completely different country for those with disabilities. (Marca Bristo, 7/23)
The Washington Post:
Why I Wrote The Americans With Disabilities Act
The ADA was a response to an appalling problem: widespread, systemic, inhumane discrimination against people with disabilities. In 1971, a New York judge described people with disabilities as “the most discriminated [against] minority in our nation.” Large numbers of children with disabilities were systematically excluded from American public schools. ... State residential treatment institutions for people with disabilities were generally abysmal. ... Most public transportation systems made few, if any, accommodations for persons with disabilities, resulting in a transportation infrastructure that was almost totally unusable by people with mobility or visual impairments. ... People with disabilities were routinely denied rights that most members of our society take for granted, including the right to vote. (Robert L. Burgdorf Jr., 7/24)
USA Today:
Reeve: Disabilities Battle Is Not Over
Civil rights issues have dominated headlines this year, each deserving of attention. But there is one issue that tends to be overshadowed year after year — one that impacts the largest minority group in the U.S., the disability community. For many decades, entire cities and communities were inaccessible, from restaurants to public transportation and even sidewalks. The world was full of obstacles that restricted independent living for millions of Americans. I witnessed this world from a young age. (Will Reeve, 7/23)
The Wall Street Journal:
A Win For Vaccines, But Worries Remain
In a growing number of states, parents can no longer refuse to immunize their children due to conflicting “personal beliefs”—at least not if they want their children to attend school. California recently joined West Virginia and Mississippi in requiring a medical exemption from a physician to permit a child to enter school without being immunized. Gov. Jerry Brown signed the controversial bill, SB277, last month. Most of us rejoice, yet there is still reason to worry that exemptions will proliferate along with preventable diseases. Particularly if doctors feed their patients’ fears and offer easy exemptions with few questions asked. (Nina Shapiro, 7/23)
The New England Journal of Medicine:
Shifting Vaccination Politics — The End Of Personal-Belief Exemptions In California
It's not often that California, West Virginia, and Mississippi are politically aligned, but that unlikely trio formed on June 25, 2015, when California Governor Jerry Brown signed into law Senate Bill (SB) 277, substantially narrowing exceptions to school-entry vaccination mandates. With that law, California becomes the third state to disallow exemptions based on both religious and philosophical beliefs; only medical exemptions remain. The move represents a stunning victory for public health that affects not only California schoolchildren but also the prospects for strengthening vaccination requirements nationwide. (Michelle M. Mello, David M. Studdert and Wendy E. Parmet, 7/22)
Los Angeles Times:
Will The Legislature Inadvertently Invite More Medical Tourists?
California is already a magnet for birth tourism. Now, health analyst Robert Laszewski writes, the California Legislature could make the state a magnet for medical tourists who sign up for insurance, get an expensive procedure done at one of the state's famous medical centers, then drop their coverage and head home. It's a powerful critique, but Laszewski downplays one important fact: Foreign nationals can do that already, and not just in California. (Jon Healey, 7/23)
The New York Times:
Choosing How We Die
In 1975 Shirley Dinnerstein, a 64-year-old Massachusetts woman, learned she had Alzheimer’s disease. Three years later she was in an “essentially vegetative state,” according to her case records, and a court was deciding whether to honor her previously expressed wish not to be resuscitated if she died. The court ruled in her favor, establishing, for the first time, that patients’ care choices at the end of life could be officially documented in the medical record without being validated in court. (Theresa Brown, 7/24)
The New England Journal of Medicine:
The Expansion Of Retail Clinics — Corporate Titans Vs. Organized Medicine
In a tumultuous era of change propelled by public health policies and private entrepreneurial activity, the spread of retail clinics offering basic primary care, walk-in visits, extended hours, and lower prices than a doctor's office or emergency department is unsettling the medical profession, especially family physicians and pediatricians. Most U.S. retail clinics are owned and operated by vast corporate enterprises and staffed by advanced practice nurses and physician assistants. Although relatively few assessments have been conducted of the quality of care in such clinics, some peer-reviewed studies indicate that they deliver their circumscribed set of services at least as well as physicians' offices do. Nevertheless, primary care physician groups have raised concerns about both the care at these clinics and their potential for disrupting patients' continuity of care. (John K. Iglehart, 7/23)
JAMA:
Treatment Decision Making And Genetic Testing For Breast Cancer
Rates of genetic testing for women with diagnosed breast cancer appear to be increasing substantially. More than one-fourth of patients diagnosed today undergo testing, multiple-gene sequencing panels are replacing testing limited to BRCA1/2 mutations, and genetic counselors report ordering more tests. Within the next few years it is likely that most patients with newly diagnosed breast cancer will undergo genetic testing to inform their risk of developing a subsequent cancer. There is already a widening gap between the availability of more expansive genetic testing and the relative importance of results to treatment decisions. (Steven J. Katz, Allison W. Kurian and Monica Morrow, 7/23)