Viewpoints: Lessons Learned About New Cures For Cancer; Finally, Some Positive Signs For Gun Safety

The New York Times: The Problem With Miracle Cancer Cures
Much has been written about the promise of these treatments, as well as their staggering costs — many cost several hundred thousand dollars a year. But what strikes me most about them is that, by blurring the line between cure and comfort — and between hope and hopelessness — they have disrupted the fragile equilibrium that we doctors have long taken for granted. ... Sadly, for some patients, a cure will prove elusive. As we continue to chase progress in cancer, let’s be sure that we don’t rob dying patients of a smaller, more subtle miracle: a death with dignity and grace, relatively free from pain and discomfort. (Robert M. Wachter, 4/19)

The Washington Post: The Ground Is Shifting On Gun Control. Vermont Is A Sign.
The day after the Parkland school shooting focused renewed attention on the issue of gun violence, Vermont Gov. Phil Scott (R) reiterated his opposition to any new restrictions on gun ownership. But just 24 hours later, Mr. Scott announced a change of heart. Now he has signed major gun violence prevention legislation. It is a notable step for a state that historically has had some of the weakest gun laws in the country, and another encouraging sign of how the ground is shifting on gun control. (4/19)

Boston Globe: Gun Safety Takes A Step Forward On Beacon Hill
Here’s some good news for the mothers and students who have been working the State House halls and phones — and indeed, for anyone who cares about effective gun laws. A key legislative committee recently gave its stamp of approval to legislation to allow guns to be taken temporarily from owners deemed at risk of harming themselves or others. (4/20)

WBUR: Endangering Children In God’s Name
Hundreds of protesters threw a tantrum recently as a Garden State legislative panel approved a bill making it harder to get religious exemptions from student vaccinations. The bill, which must be passed by the full legislature, would require notarized documentation of how vaccination "would violate, contradict, or otherwise be inconsistent with [a] tenet or practice” of a family’s faith. (Rich Barlow, 4/20)

The Washington Post: The Next Big Thing For Democrats: Medicare For All
When the Affordable Care Act was being created in 2009, many liberals who weren’t too excited about the form it was taking hoped that eventually it could evolve into something more to their liking. They told themselves that the ACA’s reforms may have kept private health insurance central, but over time it could be modified to inch closer to the kind of universal system enjoyed by citizens of every other industrialized country. Ironically, precisely because Republicans took over the government eight years later and began an attack on the ACA, we may get to that point a lot quicker than liberals anticipated. (Paul Waldman, 4/19)

The Hill: Medicaid Is Crucial To Seniors And Awareness Is Crucial To The Program's Survival
April is Medicaid Awareness Month, but many Americans are truly unaware of what the program does for seniors. Medicaid is typically viewed as a health insurance program for the poor, which, of course, it is. But it also provides crucial supports for older Americans. Medicaid covers nearly 7 million seniors and more than 8.5 million “near seniors” aged 50-64. One in five Medicare beneficiaries (known as “dual eligibles”) also have Medicaid coverage to help pay premiums and co-pays. ...Unfortunately, Medicaid has been under siege in Congress ever since the ACA was enacted. When the majority party took control of all branches of government in 2017, they tried relentlessly to gut the program — starting with Obamacare repeal legislation all the way through President Trump’s first two budgets and various House GOP budget proposals. (Max Richtman, 4/19)

USA Today: Ask Ronny Jackson How To Ensure Veterans Get Good Private Health Care
President Trump this week officially nominated Rear Adm. Ronny Jackson, the White House physician, to be secretary of Veterans Affairs. Before they vote on whether to confirm him, senators need to focus on what should be at the center of any discussion surrounding the Department of Veterans Affairs: veterans. Right now, a top priority at VA is reforming its Veterans Choice Program, which allows veterans to get care from private providers in their communities rather than from the VA. In some ways, this option makes sense — half of all vets report that they want or need to use providers in their community. But a vital first step is to make sure health care providers are ready for the job. Right now, the overwhelming majority are not. (Derek Coy, 4/19)

The Hill: Personalized Interactions Are The Future Of Health Care
The Senate Committee on Veterans’ Affairs is deciding next week whether to confirm President Donald Trump’s nominee for the Secretary of the Department of Veterans Affairs (VA), Navy Rear Adm. Ronny Jackson. The confirmation vote comes amid major efforts to reform the department to better serve our nation’s veterans. ... As we look to the future and for ways to improve healthcare for all Americans, including our veterans, technology will play a significant part in bridging these gaps. But technological advances alone are not enough; we must also invest in solutions that are personalized and patient-centered to improve the health of millions. (Mazi Rasulniam, 4/19)

The Detroit News: Deal Should Lead To State Rights On Pot
President Donald Trump is apparently overriding his attorney general on interfering with state marijuana laws, and in doing so provided some clarity for Michigan voters who may be considering a recreational pot measure on the November ballot.In a deal reached with Colorado Sen. Cory Gardner, Trump pledged to stop Attorney General Jeff Sessions from voiding an Obama-era policy to not meddle with states that had legalized marijuana use.Gardner, a Republican member of the Judiciary Committee, had for three months been blocking Trump’s judicial nominees to protest Session’s intentions. Recreational use of pot is legal under Colorado state law. Trump also said he would back a federal bill that would establish a state’s right to set its own laws on marijuana use. (4/19)

USA Today: Opioid Deaths Are Preventable. We Need To Fight It Like A Disease.
News about the opioid crisis keeps getting worse. Simple solutions haven’t changed the epidemic’s course.The number of deaths has continued to increase, driven by an influx of illicit fentanyl that is laced into counterfeit pain pills, heroin and other illegal drugs. To effectively treat this evolving public health crisis, we must recognize opioid addiction for what it is. Opioid addiction is an emergency. Just as providing first aid for cardiac arrest requires a defibrillator and first aid for severe bleeding requires a tourniquet, first aid for an opioid overdose requires naloxone. Last year, Alaska Governor Bill Walker declared the state’s opioid epidemic a public health emergency and made naloxone more readily available to all Alaskans. The U.S. Surgeon General’s recent Health Advisory calls for increasing the drug’s public availability: Too often, it is not available when needed. And just as other emergencies follow first aid with immediate medical care, the same strategy should be used for opioid addiction. (Jay C. Butler, 4/19)

The New York Times: Standing Up At Your Desk Could Make You Smarter
This is an odd admission for a psychiatrist to make, but I’ve never been very good at sitting still. I’m antsy in my chair and jump at any opportunity to escape it. When I’m trying to work out a difficult problem, I often stand and move about the office. We’ve known for a while that sitting for long stretches of every day has myriad health consequences, like a higher risk of heart disease and diabetes, that culminate in a higher mortality rate. But now a new study has found that sitting is also bad for your brain. And it might be the case that lots of exercise is not enough to save you if you’re a couch potato the rest of the time. (Richard A. Friedman, 4/19)

Detroit News: No Free Water For Nestlé. Water For Flint.
Two recent water-related decisions from our state government highlight a clear and concerning disconnect between the way in which our state treats its residents and how it rewards giant corporate business. In the same week that the state granted Nestlé the right to profit off our most valuable natural resource, it announced that the people of Flint would no longer receive free bottled water. While the outcome and timing of these decisions is absurd, it’s even more troubling that the majority of Republicans in Lansing and the Republican caucus in D.C. don’t seem to care. (Dan Haberman, 4/19)

New England Journal of Medicine: Gene Therapy In Patients With Transfusion-Dependent β-Thalassemia
Donor availability and transplantation-related risks limit the broad use of allogeneic hematopoietic-cell transplantation in patients with transfusion-dependent β-thalassemia. After previously establishing that lentiviral transfer of a marked β-globin (βA-T87Q) gene could substitute for long-term red-cell transfusions in a patient with β-thalassemia, we wanted to evaluate the safety and efficacy of such gene therapy in patients with transfusion-dependent β-thalassemia. ...Gene therapy with autologous CD34+ cells transduced with the BB305 vector reduced or eliminated the need for long-term red-cell transfusions in 22 patients with severe β-thalassemia without serious adverse events related to the drug product. (Alexis A. Thompson, Mark C. Walters, Janet Kwiatkowski, John E.J. Rasko, Jean-Antoine Ribeil, Suradej Hongeng, Elisa Magrin, Gary J. Schiller, Emmanuel Payen, Michaela Semeraro, Despina Moshous and Francois Lefrere, 4/19)

JAMA: New Prevention Guidelines For Falls And Fractures—Looking Beyond The Letters
In this week’s issue of JAMA are the updated US Preventive Services Task Force (USPSTF) recommendations on vitamin D, calcium, or combined supplementation for the primary prevention of fractures in community-dwelling adults and for falls prevention in community-dwelling adults, as well as accompanying evidence reports. Overall, the summary recommendations have not changed much compared with previous recommendations released in 2013 and 2012. The major change is the downgrade of the vitamin D supplementation recommendation for preventing falls from being a B grade (recommended based on high certainty of moderate benefit or on moderate certainty of moderate to substantial benefit) to a D grade (recommended against based on moderate or high certainty of no benefit or that harms outweigh the benefit). (David Reuben, 4/19 )