Viewpoints: Confronting A New Epidemic; Abortion Arguments; AMA’s Stand On Billing

The Washington Post: Fighting MERS, Again
The world is relearning a painful lesson in combating infectious disease: an outbreak caused by a virus or by bacteria is not only a challenge for medicine but also demands a rapid response based on real information, good detective work and a certain alacrity. Ebola showed how a small outbreak can mushroom into a global concern. Now the same dynamics are playing out in South Korea, struggling with the sudden appearance of the Middle East respiratory syndrome, or MERS, a coronavirus for which there is no known vaccine or effective treatment. (6/12)

Los Angeles Times: Affordability Is Key To Access To Contraception
In the 50 years since Griswold vs. Connecticut — in which the U.S. Supreme Court struck down a Connecticut law banning contraception for married couples — the right to birth control for all has become a cornerstone of women's healthcare and reproductive freedom. But making it affordable to all women has not been easy. ... Now there are new efforts to make it easier for some oral contraceptives to be to be sold over the counter, like aspirin, rather than by prescription only. Wouldn't that guarantee the most accessibility? Theoretically, yes, but not if women are stuck buying it without benefit of insurance. (6/14)

The Washington Post: Antiabortion Advocates Have A Logic Problem
What led [Sen. Lindsey] Graham to believe himself on history’s side was his introduction of legislation banning all abortions after five months. But while the verdict of the ages has yet to be returned, Graham, a GOP presidential candidate, certainly is not on the right side of logic. The procedures Graham seeks to ban account for less than 1.5 percent of all abortions in the United States, and those are often the most difficult cases, such as the woman who discovers late in pregnancy that she has cancer. ... By contrast, if Graham were to support efforts to make contraception cheaper and more widely available, the number of abortions would almost certainly plummet. Alas, politics gets in the way. (Dana Milbank, 6/14)

The Washington Post: How A New Generation Of Activists Is Trying To Make Abortion Normal
But in this new moment in history, “abortion” is back. The coded language of the older guard is giving way to frank talk from a younger generation of activists, who cut their teeth in LGBT work and online feminist spaces. Advocating “choice” didn’t stop the recent wave of losses for reproductive rights. Today, activists are realizing that the only way to erase the stigma is to talk about it. ... Younger activists are shaping the dialogue, taking cues from the Internet, where conversational norms reward unabashed honesty about the female experience — sometimes to maximal shock value. (Jill Filipovic, 6/12)

Modern Healthcare: New AMA Leader Rejects Growing Movement To Regulate Out-Of-Network Doc Bills
Insurers, hospitals, and physicians likely recognize that out-of-network billing is a looming public relations nightmare, particularly with more Americans in health plans with limited provider networks. States that recently have adopted or considered measures to protect patients from surprise out-of-network bills include New York, Texas, and Florida. Nevertheless, the American Medical Association's new president-elect, Dr. Steven Stack, an emergency physician in Lexington, Ky., told Modern Healthcare last week that the problem is mostly or entirely the fault of insurers. He argued that current state legislative and regulatory efforts “misrepresent” the problem. “The real crux of the problem is health insurers are refusing to pay fair market rates for the care and services provided,” he said. (Harris Meyer, 6/14)

The Washington Post: Reforming Workers Comp
The federal government spent $2.8 billion compensating employees, including U.S. Postal Service workers, who make up by far the largest group of workers’ comp claimants, for work-related illness and injury in the year ending June 30, 2014 (the most recent year for which data exist). Unquestionably, this is a vital government responsibility, but the law governing federal workers’ comp has not been fundamentally revised in four decades — and there is mounting evidence, presented most recently in a report from the Postal Service’s inspector general, that the program operates much less efficiently than it could or should. (6/13)

The Washington Post: Doctors Don’t Actually Know How Often You Should See Them
As doctors, we usually base the timing of follow-up visits on some mix of habit and a gestalt of patient need, all within the arbitrary structure of the lunar calendar. Not surprisingly, then, Dartmouth researchers have shown that visit rates vary tremendously. ... Patients tend to have more visits per year if they are sicker, the study found, but also if they live in an area with more doctors or with doctors who tend to ask patients to come in more often, even when adjusting for factors such as health status. What the patient prefers seems to have no significant association with visit rates. The timing of follow-up visits, in other words, has tended to fall under the art, rather than the science, of medicine. (Ishani Ganguli, 6/12)

The Wall Street Journal: When Treating Pain Brings A Criminal Indictment
Federal drug-enforcement officials have made it a serious felony for doctors to overprescribe painkillers or, as the applicable law states, to prescribe controlled substances “other than for a legitimate medical purpose and in the usual course of professional practice.” But the line between legitimate and illegitimate prescription—as drawn by the Drug Enforcement Administration (DEA) and the Justice Department—is far from clear. This puts physicians in great legal jeopardy, and too often leaves their patients to suffer needless agony. (Harvey Silverglate, 6/12)

The New York Times: When Playing A Patient Is Part Of The Training
Students training to be doctors and other health care professionals need practice, and at some schools, that means practicing on other students. But examining and being examined by classmates brings up significant privacy issues that schools need to address. (6/12)

The New York Times: The Toxic Legacy Of Lead Paint
It is the convention to use an electric sander before painting exteriors of old houses in New Orleans. Some of the old paint contains lead. If that dust gets on the hands of infants, and their hands reach their mouths, it can adversely affect their brain development. Remarkably, this seems to trouble almost no one, except for two groups of people: the scientists who for years have tried to raise awareness of the menace, and the parents of children with elevated levels of lead in their blood. (Thomas Beller, 6/13)

The Philadelphia Inquirer: Fix Medicaid Policy On IUDs
Imagine a woman in labor goes to the hospital with a delivery plan she made in consultation with her obstetrician; yes to antibiotics in labor; no to epidural for pain control; yes to neonatal circumcision; and yes to having an intrauterine device (IUD) placed immediately after childbirth. Along with contraceptive implants, IUDs are a form of long-acting, reversible contraception (LARC) that is safe, effective and convenient, and whether placed after childbirth or at any other point. And more and more, obstetricians are offering placement of IUDs and implants while women are admitted to the hospital for childbirth. Despite the woman's wishes, she does not get the IUD she wanted. Due to the way insurers pay for long-acting methods, hospitals often don't have IUDs and implants readily available. (Pooja Mehta and Melissa Weiler Gerber, 6/12)

MinnPost: Too Many U.S. Women Are Dying During Childbirth. The Problem Is Not Paperwork.
I’ve written here many times about how American women are dying during pregnancy and childbirth at twice the rate they were 30 years ago. The U.S. Centers for Disease Control and Prevention (CDC) reports that pregnancy-related deaths increased from 7.2 deaths per 100,000 live births in 1987 to 17.8 deaths per 100,000 live births in 2011. A Lancet study published last year put the 2013 U.S. maternal death rate even higher, at 18.5 deaths per 100,000 live births. That, of course, is a shocking and disturbing trend. But, according to an article published online this week in Scientific American, much of that sharp increase in the pregnancy-related death rate may be the result of a change in how death certificates are filled out today compared to 30 years ago. (Susan Perry, 6/12)