Parsing Policies: Work Requirements Are Only Serving To Provide An Excuse For Republicans Who Want To Take Away Poor People’s Insurance

The Washington Post: The GOP’s Cruelty Toward The Poor Is Paying Dividends In Suffering
The most significant part of the Affordable Care Act, itself the most significant piece of social legislation passed in decades, was its expansion of Medicaid. The idea was that no one should go without health insurance because they can’t afford it, so the program was expanded to cover millions of Americans who, though extremely poor, weren’t eligible under the often restrictive rules set by states. But the fact that so many people now get insurance from the government stuck in Republicans’ craws. They quite literally would rather see someone go without health coverage than see them get that coverage from the government, and ever since it went into effect they’ve been trying to undo it. (Paul Waldman, 9/13)

JAMA: Medicaid Work Requirements—English Poor Law Revisited
In 1563, Elizabethan English law distinguished between the deserving poor, or those who wanted to work but could not because of infirmity or lack of available work, and the idle poor, or those who were judged able to work but would not. While the deserving poor were to be aided, the idle poor were to be punished. Four hundred fifty years later, the United States is still debating which of the poor are deserving and what they are deserving of. One of the current battlegrounds is work requirements for Medicaid recipients to receive health insurance benefits. The Centers for Medicare and Medicaid Services (CMS) announced a new policy in 2018 supporting state efforts to make work or other community engagement a requirement for Medicaid coverage. Thus far, 11 states have submitted work-requirement policies and CMS has approved 4 such waivers. (Dave A. Chokshi and Mitchell H. Katz, 9/10)

Milwaukee Journal Sentinel: We Can Have 'Medicare For All' With Consumer Choice. Here's How.
The Sanders plan of taxpayer-paid single-payer health care will not work for three reasons. It is built on a model of Medicare from a quarter-century ago; Medicare today is different. Medicare in 2018 no longer a single-payer plan — despite the attraction of that political slogan. (Thomas Heftly, 9/13)

Bloomberg: Chinese Researchers Are Outperforming Americans In Science
Thirty years ago in December, the modern exchange of scholars between the U.S. and China began. Since then, Chinese academics have become the most prolific global contributors to publications in physical sciences, engineering and math. Recent attempts by the U.S. to curtail academic collaboration are unlikely to change this trend. For decades, China's growth was driven by shifting workers from agriculture to manufacturing. As the country started to approach the so-called Lewis turning point, when such shifts no longer raise overall productivity, the government made an increasingly concerted effort to build the scientific base to provide another vector for growth. The results of those efforts are showing up in both the rankings of Chinese universities (11 of the top 100 globally) and in scholarly output. (Peter R. Orszag, 9/12)

JAMA: Inappropriate Behavior By Patients And Their Families—Call It Out
Recently, I was the hospital attending physician on service when the team admitted an elderly patient. Despite the obvious end-of-life status, the family wanted everything done to keep the patient alive. They made unrealistic demands, were disrespectful, and at times were outright hostile. They did not want to work with the medical student, who was Muslim. They also did not want to work with the intern, whom they felt was not a real physician. The senior resident, despite being from a neighboring US state, was not allowed to touch the patient because the family believed that the resident’s skin was too dark for an American. To say that this family was disappointed when they learned that I, the attending physician, was a woman would be an understatement. After a brief introduction, I let the family know that we work as a team, and they would be working with all of us. Later when I discussed this out-of-the-ordinary behavior with the team, I asked, “What did you do when you recognized the disrespectful behavior from this family?” (Amy Nicole Cowan, 9/10)