Viewpoints: CHIP On ‘Brink Of Elimination’; Trump’s Silence On Drug Prices; Tracing Opioids

The New York Times: Please Save Kids’ Health Care
Nearly nine million children across the country receive health care services through the Children’s Health Insurance Program, enacted with bipartisan congressional support in 1997 to provide health care coverage for children from eligible families with low and moderate incomes. In our four states — Massachusetts, Montana, Nevada and Oregon — more than 300,000 children rely on the program, known as CHIP. But any day now, if Congress doesn’t act, these kids could lose the health care they depend on. (Governors Charlie Baker, Kate Brown, Steve Bullock and Brian Sandoval, 12/7)

The New York Times: The Republican War On Children
The Children’s Health Insurance Program, or CHIP, is basically a piece of Medicaid targeted on young Americans. It was introduced in 1997, with bipartisan support. Last year it covered 8.9 million kids. But its funding expired more than two months ago. Republicans keep saying they’ll restore the money, but they keep finding reasons not to do it .... What’s the problem? The other day Senator Orrin Hatch, asked about the program (which he helped create), once again insisted that it will be funded — but without saying when or how (and there don’t seem to be any signs of movement on the issue). And he further declared, “The reason CHIP’s having trouble is that we don’t have money anymore.” Then he voted for an immense tax cut. (Paul Krugman, 12/7)

Los Angeles Times: Trump Is Mum On Report Showing How We Can Reduce Sky-High Drug Prices
Hard as it may be to believe, there’s a yawning chasm between Trump’s words and deeds when it comes to drug prices. He’s been a consistent critic of the drug industry since before taking office. He declared a year ago: “I’m going to bring down drug prices. I don’t like what’s happened with drug prices.”... To date, he hasn’t announced a single initiative along these lines. But he has nominated a former drug-company executive, Alex Azar, to serve as health secretary. While head of U.S. operations for Eli Lilly & Co., Azar more than doubled the price of insulin, a life-saving medication for millions of people with diabetes (including me). (David Lazarus, 12/8)

Louisville (Ky.) Courier-Journal: DEA Should Be Forced To Show Which Drug Distributors Flood Cities With Pain Pills
Congress should demand that the Drug Enforcement Administration release data from its ARCOS system, which monitors the flow of controlled substances from their point of manufacture through commercial distribution channels to point of sale or distribution. This information is critical for local authorities to address the opioid epidemic ravaging our communities. In December 2016, the Charleston Gazette-Mail obtained previously confidential ARCOS records sent by the DEA to the office of the West Virginia attorney general. ... Despite a rising opioid-related death toll during that time, drug wholesalers “showered the state with 780 million hydrocodone and oxycodone pills, while 1,728 West Virginians fatally overdosed on those two painkillers.” In one example, a single pharmacy in a town of just 392 people received 9 million pain pills in just two years. (Mike O'Connell, 12/7)

The New England Journal of Medicine: Medicaid Coverage For Family Planning — Can The Courts Stop The States From Excluding Planned Parenthood?
In August 2017, the U.S. Court of Appeals for the Eighth Circuit (which includes Arkansas, Iowa, Minnesota, Missouri, Nebraska, North Dakota, and South Dakota) decided Does v. Gillespie, a case involving Arkansas’ efforts to exclude Planned Parenthood from its Medicaid program. The decision focuses on a fundamental, threshold question of law that must be answered before the courts can intervene when unlawful state conduct threatens the welfare of thousands of Medicaid beneficiaries: Can the courts halt the injury before it occurs? In a major departure from other appeals court decisions involving the exclusion of Planned Parenthood, the Does court said “no.” If the U.S. Supreme Court allows Does to stand, other states may try to follow suit at a time of heightened tension over Medicaid funding for Planned Parenthood. (Sara Rosenbaum, 12/7)

The New England Journal of Medicine: How To Think About “Medicare For All”
In April 1946, President Harry Truman introduced a single-payer health plan and met the same reaction that would greet Senator Bernie Sanders (I-VT) and his colleagues when they proposed “Medicare for All” in September 2017. “It is believed by competent Congressional observers to have little chance of approval,” reported the New York Times back in 1949. ... but 13 years later President Lyndon Johnson signed the Truman revision into law as Medicare, declaring that the United States was finally harvesting “the seeds of compassion and duty” that his predecessor had sown. A proposal with no chance in one era had become law in another. Medicare proved so popular that it came to be a third rail of American politics — dangerous to touch. What lessons does Truman’s success hold for today’s “no chance” Medicare for All? (James A. Morone, 12/7)

The New England Journal of Medicine: Which Road To Universal Coverage?
Incremental approaches cannot promise to transform the whole health care system. But they do offer a way to chip away at the ranks of the uninsured without upending coverage of more than 90% of Americans. For example, from 1988 through 1993, a succession of individually modest legislative changes in Medicaid, enacted through the efforts of senior congressional Democrats such as Henry Waxman (D-CA) and signed by Republican President George H.W. Bush, supported an 11-million-person increase in Medicaid enrollment. In a similar fashion, extensions of Medicare, Medicaid, and ACA tax credits could expand coverage to many, if not all, of the currently uninsured. (Henry J. Aaron, 12/7)

Bloomberg: Congress Moves Backward On Gun Safety
After failing to pass any gun safety legislation for a decade, and after witnessing two of the most deadly shootings in U.S. history in consecutive months, the House of Representatives has finally taken up the issue -- and made matters even worse. The House on Wednesday passed a bill requiring states that permit individuals to carry concealed guns to allow out-of-state residents to do so as well, if they can legally carry in their home state. It's an idea long supported by the gun lobby, and it poses real dangers to the public. (12/6)

The New England Journal of Medicine: Hepatitis A Outbreak In California — Addressing The Root Cause
On October 13, 2017, Governor Jerry Brown of California declared a state of emergency in response to a hepatitis A outbreak that began in the homeless population in San Diego. ... Homeless people’s often-poor underlying health, high prevalence of risky health-related behaviors, and poor access to nonemergency health care increase their susceptibility to infectious disease and heighten its severity and complicate disease control. In response to the recent hepatitis outbreak, there has been a campaign to vaccinate and educate people at risk and to provide portable hygiene facilities, disinfected with bleach, in areas where homeless people congregate. These responses, though laudable and likely to contain the outbreak, will not alter its underlying causes. (Margot Kushel, 12/6)

The New York Times: Should Medicine Discard Race?
Professor Yudell belongs to a growing chorus of scholars and researchers who argue that in science at least, we need to push past the race concept and, where possible, scrap it entirely. Professor [Michael] Yudell and others contend that instead of talking about race, we should talk about ancestry (which, unlike “race,” refers to one’s genetic heritage, not innate qualities); or the specific gene variants that, like the sickle cell trait, affect disease risk; or environmental factors like poverty or diet that affect some groups more than others. (Moises Velasquez-Manoff, 12/8)