Viewpoints: The Health Law And Its Legal Challenges; Insurer Losses And Risk Pools; Congress And The Zika Debate
A selection of opinions on health care from around the country.
The New England Journal Of Medicine:
A Legal Setback For The Affordable Care Act
“Time after time, the president has chosen to ignore the will of the American people and re-write federal law on his own without a vote of Congress. That’s not the way our system of government was designed to work.” With these words, Speaker of the House John Boehner (R-OH) announced in late 2014 that the House of Representatives had filed a lawsuit challenging one of the major struts of the Affordable Care Act (ACA). The Obama administration, the House alleged, was illegally reimbursing health plans for reducing the out-of-pocket spending of their low-income enrollees. (Nicholas Bagley, 6/1)
The New England Journal Of Medicine:
The ACA And Risk Pools — Insurer Losses In The Setting Of Noncompliant Plans
The viability of health insurance exchanges established under the Affordable Care Act is in doubt. One important factor is the government's decision to allow noncompliant insurance plans to continue operating, which shrank the ACA's intended insurance risk pools. (John Hsu, 6/2)
USA Today:
Congress Fiddles, Zika Spreads: Our View
You’d think if there’s one thing Congress could reach rapid bipartisan agreement on, it’s money to fight Zika. But no, not this Congress. Members fled Washington last week for their Memorial Day break without approving funding to fight the mosquito-borne virus, even as Thomas Frieden, director of the Centers for Disease Control and Prevention, warned that “speed is critical. A day, a week, a month can make all of the difference.” (5/31)
USA Today:
Rep. Tom Cole: Don’t Worry, We’ll Fund Zika Fight
Rest assured. The Zika emergency response will be funded, and immediate needs are already being funded. The issue now is whether the funding will be paid for or irresponsibly added to the national credit card. That’s where Republicans disagree with Democrats and the administration. (Rep. Tom Cole, R-Okla., 5/31)
Modern Healthcare:
Ryan Bets On Trump Pushing For Medicare And Medicaid Cuts
Without using the word endorse, House Speaker Paul Ryan announced in a newspaper op-ed Thursday that he will be voting for presumptive Republican presidential nominee Donald Trump in November. He said he feels confident that a President Trump would carry out the Republican policy agenda. Last month, I raised the question of whether Trump would follow the politically risky healthcare policy path Ryan has blazed on Medicare, Medicaid and other big issues. The House speaker apparently has concluded that he would. (Harris Meyer, 6/2)
JAMA:
Why Many Medicare Beneficiaries Cling To An Allegedly Worse Deal
Under the Medicare Prescription Drug, Improvement and Modernization Act of 2003, Congress granted private Medicare Advantage health plans more money per Medicare beneficiary than it granted traditional, government-run Medicare. In other words, the per beneficiary cost paid by the US taxpayers was higher for those enrolled in the private plans than for those enrolled under the traditional, government-run Medicare program. (Uwe Reinhardt, 6/1)
The New England Journal Of Medicine:
Reimbursing Wisely? CMS’s Trial Of Medicare Part B Drug Payment Reform
The Affordable Care Act (ACA) aims to tie incentives to better health rather than more health care. Toward that end, by 2018 the Centers for Medicare and Medicaid Services (CMS) intends to link the majority of its reimbursement to value-based incentives. Recently, CMS announced the Medicare Part B Drug Payment Model,1 a national policy experiment to determine how alternative incentive structures affect physicians’ prescribing behavior. (Deborah Schrag, 6/2)
New Orleans Times-Picayune:
With Medicaid Expansion, 'A Better Quality Of Life For Our People': Editorial
The benefits promise to be tremendous. The expansion is expected to provide health care to a total of 375,000 uninsured Louisiana residents, one-third of them in New Orleans. Under the expansion, families can make up to 138 percent of the poverty level. An estimated 70 percent of people who will be added to the Medicaid rolls are working but have no insurance through their jobs and can't afford to purchase it. (6/2)
The Charlotte Observer:
We Doctors Seek Tricky Balance On Opioids
The problems of opioid abuse – both prescription and illegal drugs – are well documented. But the solutions are not always simple, particularly when balancing the need to manage a patient’s pain with the addictive qualities of certain medications and the potential for abuse or even diversion. When prescribed and monitored appropriately, opioids offer much-needed relief. For years, physicians were emphatically urged to control their patients’ pain, measuring pain as “the fifth vital sign.” As a result, physicians tried to provide appropriate relief to mitigate their patients’ suffering. (Rhett Brown, 6/2)
Bloomberg:
Fight To Save Antibiotics
For once, the headlines about the latest health scare are not hyperbole: The end of the Antibiotics Era may be nigh. Staving it off will require fast and creative thinking not only in medical science, but also in public policy. Public-health officials were horrified but not surprised to find a Pennsylvania woman who had an infection with the same kind of drug resistance first identified last fall on farms in China. The E. coli found in the woman carried the same genetic mechanism of resistance to colistin -- a last-resort antibiotic -- that was discovered in Chinese livestock that were routinely fed the drug. And this mechanism is easily spread from one bug to another. (6/2)
The New England Journal Of Medicine:
Biomarker Tests For Molecularly Targeted Therapies — The Key To Unlocking Precision Medicine
As the promise and the pitfalls of precision medicine gain increasing attention,1,2 enthusiasm about the field has been heightened by a rapid reduction in the cost of high-throughput genomic sequencing and a dramatic increase in the identification of potential molecular targets for therapy. Biomarker tests for molecularly targeted therapies can help physicians to select the most effective therapy for a patient’s condition and avoid treatments that could be ineffective or harmful. If precision medicine is to reach its potential, such biomarker tests will have to be developed in a timely fashion. (Gary H. Lyman and Harold L. Moses, 6/1)
The New York Times:
Let Smokers See the Warning They Need
Five years ago this month, the Food and Drug Administration released some striking images of the damage that smoking can do. These stark and disturbing pictures dominated the news cycle, as millions of Americans got a glimpse of the unvarnished truth. In one, healthy lungs were juxtaposed with blackened and diseased ones that had been poisoned by tobacco. Another photo zoomed in on a human mouth, the teeth stained and rotted, and the lower lip abscessed. Yet another showed a women wailing in pain from the deadly effects of secondhand smoking. The F.D.A.’s message to the public was that tobacco companies would soon be required to include such images on every pack of cigarettes. Kathleen Sebelius, the secretary of health and human services at the time, welcomed the move. (Joanna Cohen, 6/3)
JAMA:
Priorities For Improving Hearing Health Care For Adults
Perceptions of hearing loss by health care professionals and society are often based on the notion that hearing loss is an inevitable and relatively inconsequential part of aging despite increasing evidence of the detrimental effect that hearing loss can have on cognitive, social, and physical functioning. In parallel, few adults with hearing loss understand the options and pathways for seeking hearing health care, and front-line health care professionals receive little training about how to screen, refer, or educate patients on hearing loss. ... Efforts to strengthen cross-disciplinary training of individuals in both the hearing sciences and public health (silos that historically have had little interaction) are needed to advance research at the interface of these fields and to support broad-based public information campaigns to educate consumers. (Frank R. Lin, William R. Hazzard and Dan G. Blazer, 6/2)
Vox:
Unpaid, Stressed, And Confused: Patients Are The Health Care System's Free Labor
I have spent the past year of my life managing a chronic foot injury. My left foot started hurting after a run last May, and, well, it never really stopped. At best, the injury lies dormant for a few weeks, barely bothering me. At worst, it can cause intense pain to walk my dog down the block. So I've spent the past year in doctors' offices, in MRI scanners, and in late-night Google search sessions trying to understand what went wrong and how to fix it. (Sarah Kliff, 6/1)