Viewpoints: Obamacare News, Single-Payer Debates And Other Health Reform Buzz Words; Medicare’s Doctor Payment Overhaul
A selection of opinions from around the country.
The New York Times' Upshot:
News About Obamacare Has Been Bad Lately. How Bad?
Ever since passage of the Affordable Care Act, a fierce debate has been waged over whether the law would work as advertised. While advocates promised that the design of new insurance markets would transform the way consumers buy health insurance, critics warned that the new market would never succeed. Reed Abelson and Margot Sanger-Katz have had front-row seats to the debate, and the two reporters took a few minutes to discuss when — and if — the market would stabilize. (Reed Abelson and Margot Sanger-Katz, 4/13)
Bloomberg:
Obama's Health-Care Act Encounters Another Bump In The Road
Well, the hammer has fallen: The largest health insurer in the U.S. has started pulling out of select Obamacare exchanges.
(Megan McArdle, 4/13)
The New England Journal Of Medicine:
The Virtues And Vices Of Single-Payer Health Care
The 2016 U.S. presidential campaign has produced many surprises. One unexpected turn is the reemergence of single-payer health insurance on the public agenda. Senator Bernie Sanders has made Medicare for All a centerpiece of his platform. His opponent for the Democratic party’s presidential nomination, former Secretary of State Hillary Clinton, has criticized Sanders’s plan as unrealistic. An old debate has thus reopened. What are the virtues and vices of single-payer reform? Is it a realistic option for the United States or a political impossibility? (Jonathan Oberlander, 4/14)
Bloomberg:
Doctor-Pay Reform Crawls At The Speed Of Medicare
Paying doctors a fee for each service they provide gives them incentive to offer the maximum number of treatments, as well as pay less attention to how well patients recover. This is why the Barack Obama administration -- and just about everyone else -- wants to change the way doctors get paid. (4/13)
Forbes:
Let's Pay For Cures Like We Pay For Homes
If we paid for homes or college education the way that we pay for curative drugs, much fewer Americans would own a home and America’s tertiary education attainment rate wouldn’t be fifth highest in the OECD. So despite the problems in our student loan system, and the (obvious) concerns about promoting too much home ownership, perhaps our pharmaceutical reimbursement systems can benefit from some outside “disruption.” (Yevgenly Feyman, 4/13)
The Wall Street Journal:
What Paul Ryan’s Stance On 2016 Means For Health Care
The decision by House Speaker Paul Ryan to bow out of any attempt to draft him as the Republican presidential nominee in Cleveland and press ahead with his domestic policy agenda could be significant for health care. The next big debate might not be about Republican proposals to repeal and replace the Affordable Care Act. It might focus more on the future of the two largest public health-care programs, Medicare and Medicaid. As the chart above shows, Medicare covered 55 million and Medicaid covered 66 million people in 2015 at a cost of more than $1 trillion. Together, they represented 23% of the federal budget. (Drew Altman, 4/13)
JAMA:
Medicare’s Vision For Advanced Primary Care
Consistent with the goals of the Affordable Care Act and the Medicare Access and CHIP Reauthorization Act of 2015, the Centers for Medicare & Medicaid Services (CMS) is increasingly paying for health care through alternative payment models that reward value and quality.1 These models include accountable care organizations, bundled payments, and advanced primary care medical homes. In this Viewpoint, we focus on advanced primary care medical homes. (Laura L. Sessums, Sarah J. McHugh and Rahul Rajkumar, 4/11)
The New York Times:
The Abortion Map Today
In his smart opinion piece last week, “A Mason-Dixon Line of Progress,” Timothy Egan noted the “retreat to bigotry” sweeping across the old South as politicians clinging to the past (under the banner of religious freedom) line up to authorize discrimination against gay people. The column prompted me to think about whether the battlegrounds in the never-ending abortion wars display a similar geographic concentration. The answer is that to a startling degree they don’t. The battleground is much bigger. With the exception of the West Coast and most (but not all) of the Northeast, recently enacted abortion restrictions can be found almost everywhere. (Linda Greenhouse, 4/13)
The New England Journal Of Medicine:
Seamless Oncology-Drug Development
For more than half a century, the clinical development of anticancer drugs has followed a predictable and orderly set of sequential stages: phase 1 trials were designed to determine the drug’s safety, tolerability, and dose; phase 2 trials then explored the drug’s activity in a variety of cancers; and phase 3 trials compared the new drug with existing treatments and served as the basis for regulatory approval. Advances in our understanding of cancer biology in the past decade have led to both development of more effective drugs and improved patient selection made possible by early biomarker discovery and companion diagnostic development. Desire for early access to transformative new anticancer drugs has resulted in increased demand for patient entry into first-in-human trials, as well as calls for expediting the drug development and approval process. The three distinct sequential phases of drug development have therefore become increasingly blurred. (Tatiana M. Prowell, Marc R. Theoret and Richard Pazdur, 4/13)
Modern Healthcare:
Arkansas Governor Uses Highway Funding As A Chip To Protect Medicaid Expansion
Supporters of Arkansas' Medicaid expansion say it's worth preserving for the sake of improving people's health and shoring up hospitals' finances. A pivotal group of Republican state lawmakers isn't buying that. But Gov. Asa Hutchinson is betting they will be swayed by the prospect of rutted roads. (Harris Meyer, 4/13)
The Boston Globe:
Don’t Deny Hepatitis C Patients A Cure
How do you justify withholding a wonder drug from patients infected with a liver-killing virus until the disease starts to ravage their bodies? Why, in other words, do they have to become seriously ill before receiving help? Although biomedical advances have given rise to a new class of drugs that can cure hepatitis C, which is often fatal, a basic socioeconomic problem remains to be solved: Because of the high cost of the medicine, many public and private health insurers restrict access to treatment until the onset of liver damage. It’s a short-sighted approach that causes suffering and is at odds with a basic tenet of modern medicine — early intervention. (4/14)
The Wall Street Journal:
The Orphan Drug Act’s Successes Outweigh Its Failures
Thirty-three years ago ago, the U.S. Congress passed the Orphan Drug Act, which was signed into law by President Reagan. This act provided incentives for the development and commercialization of drugs to treat orphan or rare diseases, defined as those illnesses affecting fewer than 200,000 individuals. In the decade prior to its passage, 10 such drugs became available. After the act’s signing, 400 novel therapies entered the market. In the past year (2015) alone, the Food and Drug Administration approved 21 new entities. (Howard Forman, 4/13)
The Chicago Sun-Times:
Treating Mentally Ill As Criminals Destroys Lives, Wastes Money
“We don’t do hospitals. We do jail.” That, we are told, is what a Chicago police sergeant said in 2012 when the parents of man who was exhibiting bizarre and aggressive behavior asked the police to take their son to a hospital. (4/13)
The Concord Monitor:
Our Turn: Emergency Room Is No Place To Treat Mental Illness
Imagine rushing an acutely ill friend or loved one to a local emergency room, having your worst fears confirmed by the doctor, and then being told that it could be days before they can be admitted to the right hospital for treatment because of a waiting list. In the meantime, the critically ill person is left in or near the emergency room receiving less than adequate care and treatment for several more days. (John Broderick and Ken Norton, 4/14)
Forbes:
Digital Health Funding Defies Expectations
Investors have not had their fill of digital health deals, according to new fundraising reports from Rock Health and Startup Health, two outfits which have led the digital health revolution and produce complementary reports on how much capital is flowing into the sector. While other sectors have wobbled recently, digital health (which was only defined as a market five or six years ago) continues to attract venture capital. (John Graham, 4/13)