Viewpoints: New Ideas On Measures To Tackle Obesity; How (Not) To Use Food Stamps And The Toll Stress Takes
A selection of opinions on health care issues from around the country.
Reimagining Obesity In 2018: A JAMA Theme Issue On Obesity
Six years ago, when JAMA last published a theme issue on obesity, there was optimism that progress was being made in preventing and treating obesity. As time has passed, so too has the optimism, as reports continued to show that the prevalence of obesity was increasing and, most important, rapidly increasing in children. A year and a half ago, there was a call to reconsider obesity and view it in new ways with the hope of better managing this very consequential clinical problem. In response, JAMA has revisited obesity in the form of a theme issue. (Edward H. Livingston, 1/18)
Food Stamps Should Be Spent On Food, Not Soda
If they ever finish arguing about immigration and the budget, members of Congress can be expected to turn to food stamps, which conservative Republicans want to cut and Democrats don't. For their own sake and to promote public health, both sides might want to focus on a simple reform that deserves bipartisan support: Require that food stamps be used for food. (1/17)
Extraordinary Stress And Pessimism Take A Grim Toll
Life expectancy in the U.S. declined slightly in 2016, as it did in 2015, and — at least as important — the overall trends continue to mask increasing disparities across socioeconomic groups. Carol Graham of the Brookings Institution helps explain why. Her important new book is the empirical version of "Hillbilly Elegy." I have long suspected that stress and lack of hope are to blame for widening the gap in life expectancy between lower and higher earners. Graham uses survey data to support this explanation, documenting striking differences in stress and optimism across segments of the population. (Peter R. Orszag, 1/17)
What’s Ahead In Health Policy For 2018?
I have decided to join what seems to be a national pastime: predicting in January what will happen in health policy during the course of the year. This year, such forecasting may be easier than is typical; not much health-related legislation (or any other substantive legislation) is likely to pass in 2018, partly because it is a midterm election year for Congressional seats, and partly because the balance of Republican vs Democrat votes in Senate has shifted from 52 to 48 to an even closer 51 to 49 split after Doug Jones (D, Alabama) won a seat in Senate in December. (Gail Wilensky, 1/17)
The Washington Post:
Is Trump’s Doctor Okay?
Examining the White House physician’s briefing on President Trump’s physical, I was alarmed — not about the president’s health, but the doctor’s. Rear Adm. Ronny Jackson was so effusive in extolling the totally amazing, surpassingly marvelous, superbly stupendous and extremely awesome health of the president that the doctor sounded almost Trumpian. "The president’s overall health is excellent,” he said, repeating “excellent” eight times: “Hands down, there’s no question that he is in the excellent range. . . . I put out in the statement that the president’s health is excellent, because his overall health is excellent. . . . Overall, he has very, very good health. Excellent health.” (Dana Milbank, 1/17)
The Wall Street Journal:
Sanders Proposes Medicare For None
Sen. Bernie Sanders will hold an online town-hall meeting next Tuesday regarding his single-payer health-care legislation. Mr. Sanders calls it “Medicare for All.” But the text of the bill itself reveals a more accurate name: Medicare for None. The Orwellian way in which Mr. Sanders characterizes his plan speaks to the larger problem facing the left, whose plans for health care remain so radical that speaking of them honestly would prompt instant repulsion from most voters. (Chris Jacobs, 1/17)
Three Ways To Cut — And Improve — Medicare
The Republicans are right. We should cut Medicare. And I know how: Keep Medicare’s funding for actual health care but eliminate bureaucratic waste, profits, and the expensive and preposterous ban on negotiating drug prices. In other words, get rid of Part C and Part D and absorb the extra features into traditional Medicare. (Ed Weisbart, 1/17)
A Work Requirement For Medicaid Isn't 'Cruel'
They were attacking the Trump administration’s decision last week to allow states to impose work requirements on Medicaid beneficiaries. But far from being a “cruel” action designed to inflict “pain” on the vulnerable, the administration’s decision is completely reasonable. Let’s start with the facts. First, the work requirements are targeted for able-bodied adults of working age. They do not apply to the elderly, to pregnant women or to the disabled. In addition, “work” is construed broadly to include community service, education, job training, volunteer service and treatment for substance abuse, among other potential forms of community engagement or self-betterment. (Michael R. Strain, 1/17)
Don’t Add A Work Requirement To Medicaid
The last thing Washington state should do is accept the Trump administration’s invitation to add a work requirement to Medicaid. Contrary to an administration letter, working itself does not help improve the health of poor people. Medicaid health insurance can help ailing people get healthy enough to work. (1/16)
The Washington Post:
Medicaid Is An Effective, Efficient Program, Highly Valued By Its Beneficiaries. And Yet, Republicans Are Relentlessly Trying To Cut It.
Many years ago, as a fledgling social worker in New York City, one of us (JB) helped a single mom with a young son suffering from asthma get Medicaid coverage for her son. When I told her the news, she cried with relief. As young, privileged white guy, I was surprised by her reaction. I soon came to understand it. For this mother, as for millions of other low-income people, Medicaid coverage means access to health coverage for a sick child or a family member with a chronic illness, or long-term care for an elderly parent. (Jarred Bernstein and Hannah Katch, 1/17)
The New York Times:
When States Make It Harder To Enroll, Even Eligible People Drop Medicaid
In 2003, Washington State was facing a budget crisis and wanted to reduce spending on Medicaid. Instead of requiring people to establish their eligibility annually, the legislature began requiring them to do so twice a year, and added some paperwork. It worked: Enrollment in the health insurance program fell by more than 40,000 children in a year. In the early 2000s, Louisiana wanted to maximize the number of eligible children who signed up for coverage, so officials simplified the sign-up process. It also worked: Enrollment surged, and the number of administrative cancellations fell by 20 percentage points. (Margot Sanger-Katz, 1/18)
St. Louis Post Dispatch:
Semi-Good News On Kids' Health Care Program In Missouri. Why Not Share It?
For at least 25,000 Missouri children and their parents, the question of when their coverage under the Children’s Health Insurance Program could end is a matter of pressing consequence. Will it be at the end of February, as a study by Georgetown University’s Health Policy Institute estimates? Or the end of March, as the Medicaid and CHIP Access Commission reckons? Or is it June, as the state official in charge of the program told a conference in December? When the Post-Dispatch’s Samantha Liss put the question to the state Department of Social Services, she got a vague but encouraging emailed reply: “CHIP ending is not an imminent issue in Missouri.” (1/17)
Getting To Zero Alcohol-Impaired Driving Fatalities: An Insider's View
A significant amount of progress has been made in reducing alcohol-impaired driving fatalities since the 1980s, yet progress began stalling in 2009 and fatalities started increasing again in 2015. Despite diminishing attention to this persistent, completely preventable issue, alcohol-impaired driving is by far the leading cause of motor vehicle fatalities. Among developed nations, the U.S. has the highest proportion of alcohol-impaired driving fatalities. This is unacceptable. (M. Kit Delgado, 1/17)
It's Time To Levy Penalties For Failing To Report Clinical Trial Results
As STAT recently reported, trial sponsors had disclosed only 72 percent of required results on ClinicalTrials.gov as of September 2017, and 40 percent of those reports were made after the legal deadline. On the plus side, this reflects a positive trend, compared to 58 percent compliance two years earlier, prompted in large part by “naming and shaming,” as well as some attention from Congress and then-Vice President Joe Biden. Nevertheless, even the upswing still leaves quite a bit of the glass empty: Results from more than 1 in 4 trials have still not been properly reported. The ethical consequences are substantial, and the government should be using its considerable enforcement authority to put an end to it. But it isn’t. (Holly Fernandez Lynch, 1/17)
Don't Leave Community Health Centers In Limbo
Last year was hard for the California Primary Care Association. ...As if that wasn’t enough, Congress failed to reauthorize federal funding for the community health center program by the Sept. 30 deadline, despite traditional bipartisan support. Health centers, which could lose 70 percent of their federal funding, are in a state of limbo. (Carmela Castellano-Garcia, 1/17)
Los Angeles Times:
AIDS Services Foundation Rebrands, Expands, Leaving Longtime Supporters Unhappy
Laguna Beach residents Al Roberts and Ken Jillson founded AIDS Services Foundation (ASF) in 1985, eventually turning it into one of the county’s most respected HIV/AIDS nonprofit organizations. But the organization has changed its name to Radiant Health Centers — and some longtime board members are displeased. Mark Gonzales, vice president of Radiant’s board of directors, tells me the name change is part of “expanding services.” (Barbara Venezia, 1/18)
San Jose Mercury News:
Too Many Young Children Drowning In Home Pools
Drowning is the second leading cause of death for California children 1 to 4 years old, behind birth defects, according to both the federal Centers for Disease Control and the state Department of Public Health. And most of those drownings occur in home swimming pools. (Nadina Riggsbee, 1/17)