Viewpoints: Predicting 2018’s Key Policy Debates; The U.S.’s Health Care Spending Habit

The Washington Post: Five Things We’ll Be Arguing About In 2018
Key Republicans, especially House Speaker Paul D. Ryan (Wis.), have made it clear that cutting social insurance and safety net programs is their primary goal this year. (President Trump’s made some noise about infrastructure, but I don’t see it; there’s no real plan and little appetite among his caucus for more spending.) Senate Majority Leader Mitch McConnell (Ky.) has thrown cold water on cuts to Medicare or Social Security (or, as they call it: “entitlement reform”), but that doesn’t mean they won’t go after poverty programs. Along with cutting spending, one of their main arguments will be for adding work requirements to Medicaid and nutritional support. (Jared Bernstein, 1/2)

The New York Times: Why The U.S. Spends So Much More Than Other Nations On Health Care
The United States spends almost twice as much on health care, as a percentage of its economy, as other advanced industrialized countries — totaling $3.3 trillion, or 17.9 percent of gross domestic product in 2016. But a few decades ago American health care spending was much closer to that of peer nations. What happened? (Austin Frakt and Aaron E. Carroll, 1/2)

The Washington Post: States Can Fix Republicans’ Obamacare Mess
Republicans have ripped a big hole in Obamacare. But there is a way to avoid chaos in the health-insurance markets on which millions of Americans depend, if states act quickly to undo the damage. ... There is a relatively simple solution, if states are willing to embrace it. They can fill the gap by passing their own individual mandates that apply within their borders, keeping the essential elements of the Obamacare system intact as far as their jurisdiction extends. In fact, states could make Obamacare work better than it had before, applying a larger penalty than the relatively small one that people have so far faced for skipping out on their responsibility to keep themselves covered. This would encourage more young and healthy people to enter the insurance market, thereby restraining premiums and boosting enrollment. (1/1)

Chicago Tribune: Why You Should Make End-Of-Life Care Decisions Now
Modern medicine has developed the God-like power to stabilize the vital signs that spiral out of control as a person approaches death, and to then keep that person alive despite her inability to breathe, eat or drink. It wields this power liberally. But the American health care system never taught the public that preventing a natural death often results in a wholly unnatural life. (Kristen McConnell, 1/1)

Los Angeles Times: Allowing Employers A 'Moral Exemption' From Offering Birth Control Coverage Is Immoral
In the tortured history of birth control coverage under the ACA, the government has made change after change to placate employers who objected on religious grounds to covering birth control. Now, the Trump administration has essentially neutered the mandate entirely, allowing any employer with any religious or moral objection to refuse to offer birth control coverage — without any requirement that they allow their insurance company to make an accommodation. It is unjust and un-economical to deprive women of easy and affordable access to birth control. (1/2)

The Washington Post: The Trump Administration’s Disturbing Fight To Stop Teenagers From Getting Abortions
Jane Poe is the pseudonym of a 17-year-old girl who crossed the border from Mexico into the United States this fall. ... she discovered she was pregnant while in a government-funded shelter for undocumented minors, and that the pregnancy was the result of rape. She asked for an abortion and said she would hurt herself if she didn’t receive one. The Office of Refugee Resettlement (ORR), which oversaw Poe’s shelter, refused to allow it. Last month, Poe finally was able to get an abortion after an order by a federal judge. She is one of three teenage girls whose abortions the Trump administration has fought in court to block. Each time, it has failed, but there will surely be others in Poe’s position. (Quinta Jurecic, 12/31)

The Wall Street Journal: Why Tax Hospitals? It’s A Medicaid Shell Game
When Connecticut faced a budget shortfall of $2.2 billion, or 11%, this year, it helped close the gap by almost doubling its tax on hospitals, to $900 million. Taxing hospitals sounds strange, especially since most are nonprofits. It also would seem to increase their costs and, thus, the cost of care—much of which, thanks to Medicaid, is borne by the state that levies the tax. Yet 42 states tax hospitals. Why? One answer is the perverse incentives built into the Medicaid law. When a state returns tax money to hospitals through Medicaid “supplemental payments,” it qualifies for matching funds from Washington. (Red Jahncke, 12/29)

St. Louis Post-Dispatch: Medicaid's Advances Fight Deadly Disease
In an exciting development, Missouri Medicaid (MO HealthNet) recently lifted restrictions on treatment of chronic hepatitis C, which will enable many low-income Missourians to access curative treatment. Hepatitis C can lead to severe liver disease, liver cancer and death, killing thousands of Americans each year. Hepatitis C is a blood-borne virus that can be transmitted through blood transfusion, occasionally through sexual contact, sharing needles, or in some cases from mothers to children at the time of childbirth. Others at increased risk of infection include health care workers and first responders who may encounter infected blood from needle-sticks. (Joel Ferber and Bruce R. Bacon, 1/1)

Lexington Herald Leader: Who Will Care For Kentucky’s Children?
Lawmakers in 2017 examined the crisis — that word is no exaggeration — that the opioid epidemic is inflicting on Kentucky’s children. The only problem with ideas recently offered by two legislative committees is that they cost money that Kentucky does not have. The federal government would send aid to clean up and rebuild from a natural disaster. But despite President Donald Trump’s declaration of a public health emergency, too little help has arrived in response to this man-made disaster, one that was abetted by the reluctance of U.S. Drug Enforcement Administration lawyers to punish pharmaceutical companies for supplying volumes of addictive painkillers so huge that they were clearly bound for illegal diversion. (12/29)

The Charlotte Observer: Cardinal Debacle Exposes A Broken N.C. Mental Health Care System
Providing mental health care to children is a profound responsibility that demands the highest standards of professionalism, accountability, and compassion. We believe that a strong system of high-quality, accessible, community-based mental health programs will mean healthier children and families, and, ultimately, a stronger Charlotte. Most importantly, we know that our children can’t wait. Their future depends on us to get it right – right now. So when we hear about excessive salaries and learn that over $6 million in public funding was spent on executive severance packages at Cardinal Innovations instead of on the mental health needs of our children, we are outraged. (Bob Simmons and Michelle Hughes, 12/29)

The Kansas City Star: A 2018 Agenda For Missouri Lawmakers: Ethics Reform, Transportation, Health Care
Lawmakers should develop a prescription drug monitoring program that works. The opioid crisis has ravaged parts of the state, yet Missouri is behind in its efforts to combat the scourge. [Missouri Gov. Eric] Greitens’ drug monitoring program is too watered down to be effective in rural counties, where the drug crisis grows each day. (12/31)

Los Angeles Times: The Lack Of Health Research Into Marijuana Makes It Hard To Tell People Whether It Is Safe
In advance of the legalization of recreational marijuana sales on Jan. 1, there have been lots of debates over the details of the cannabis business. How many feet should pot shops be from schools or daycare centers? How many acres may a marijuana farmer cultivate? Who should be eligible for a license to sell and who shouldn't? But there’s been much less discussion over an equally important question raised by the end of prohibition in California: What is the right public health message to send to adults who can now legally buy and use marijuana? (12/27)