Viewpoints: Obamacare Is Not Repealed; Puerto Rico’s Water Needs; Keeping Humanity In Medicine
A selection of opinions on health care from around the country.
No, Trump Hasn’t ‘Essentially Repealed Obamacare’
In July and again in September, Republicans narrowly failed to repeal the Affordable Care Act. But their newly passed tax legislation included a provision getting rid of Obamacare’s mandate requiring Americans to buy insurance, and President Donald Trump immediately declared victory in the partisan health care wars. “When the individual mandate is being repealed, that means Obamacare is being repealed,” he crowed at a Cabinet meeting on Wednesday. “We have essentially repealed Obamacare.” Well, no. The individual mandate is only part of Obamacare. (Michael Grunwald, 12/20)
The Washington Post:
FEMA Says Most Of Puerto Rico Has Potable Water. That Can’t Be True.
The weeks after Hurricane Maria hit Puerto Rico brought remarkable images of people desperate to find clean water, drinking from hazardous Superfund sites and thrusting containers under makeshift spigots on the sides of mountains. According to the Federal Emergency Management Agency, this particular problem has subsided now, more than three months after the storm: FEMA’s official statistics on Puerto Rico, which rely on data provided by the territory, suggest that 95 percent of Puerto Ricans now have access to potable water. That just isn’t possible. (Mekela Panditharatne, 12/21)
What This Computer Needs Is A Physician
The nationwide implementation of electronic medical records (EMRs) resulted in many unanticipated consequences, even as these systems enabled most of a patient’s data to be gathered in one place and made those data readily accessible to clinicians caring for that patient. The redundancy of the notes, the burden of alerts, and the overflowing inbox has led to the “4000 keystroke a day” problem and has contributed to, and perhaps even accelerated, physician reports of symptoms of burnout. ... The lessons learned with the EMR should serve as a guide as artificial intelligence and machine learning are developed to help process and creatively use the vast amounts of data being generated in the health care system. (Abraham Verghese, Nigam H. Shah and Robert A. Harrington, 12/20)
Is Your Doctor Happy? Here’s Why It’s Worth Finding Out
When you think about what makes a good doctor, a number of factors likely come to mind: bedside manner, a doctor’s availability, where they did their training, and how well they are able to address your concerns and treat your illnesses. You probably don’t think about physician burnout, a syndrome characterized by exhaustion, depersonalization, and reduced effectiveness, that has risen significantly over the past decade and has been experienced by almost half of all physicians sometime during their career. (Nisha Mehta, 12/21)
Is Single Payer The Answer For The US Health Care System?
[A] single-payer system could easily provide for universal coverage, but so could less-comprehensive reforms, if the public would support subsidies and compulsion. Single payer might improve health outcomes by providing more equal access to medical care, but attention to the social determinants of health might be a more effective way to improve health. The strongest case for single payer is its potential to control the cost of care. The current fragmented system of financing care precludes such control. (Victor R. Fuchs, 12/18)
Canada As Single-Payer Exemplar For Universal Health Care In The United States
Perhaps because of Canada’s adjacency and close relationship with the United States, many policy makers and health care advocates in both nations still seem preoccupied with each other’s systems. Canadians of all political persuasions affirm the superiority of their health care systems by drawing comparisons with the costs and inequities of the US health care system. US opponents of single-payer reforms often demonize Canadian health care, even as US proponents extol their northern neighbor’s approach. This Viewpoint argues that the constant overemphasis on Canada is unhelpful to advancing the cause of universal and equitable access to health care for US citizens. (C. David Naylor, 12/18)
Los Angeles Times:
Marijuana Businesses Are Awash With Cash. California Wants To Help Get That Money Into Banks
One of the biggest problems facing California cannabis businesses, regulators and law enforcement officials once recreational marijuana sales become legal on Jan. 1 is what to do about all the cash that is expected to change hands. With marijuana still illegal under federal law, most marijuana businesses can’t open bank accounts or accept credit card transactions — financial services companies refuse to serve them for fear being penalized by federal regulators for handling money from drug sales. That means marijuana transactions are typically done in cash. (12/22)
The New England Journal of Medicine:
The Regulatory Accountability Act Of 2017 — Implications For FDA Regulation And Public Health
Last spring, Congress took a substantial step toward making regulation by federal agencies more difficult in all areas, including health. The Regulatory Accountability Act — which passed through the committee phase in the Senate in May, after the House of Representatives passed a similar bill — has been described by proponents as a way to reverse the increasing volume of regulatory requirements. ... But the bill would pursue its deregulatory aims by imposing onerous requirements on rulemaking, which we believe could have potentially disastrous consequences for the Food and Drug Administration (FDA) and other agencies that protect public health and safety. (Jonathan J. Darrow, Erin C. Fuse Brown and Aaron S. Kesselheim, 12/20)