Viewpoints: Doctors And Electronic Health Records; Consequences Of Refusing Medicaid
A selection of opinions on health care from around the country.
The Washington Post:
Why Doctors Quit, Chapter 2
I rarely do follow-up columns. I’m averaging one every 10 years. And while my last such exercise resulted in a written apology from the White House (for accusing me of making up facts over its removal of Churchill’s bust), today’s is not a complaint. It’s merely a recognition that the huge response elicited by last week’s column, “Why doctors quit ,” warrants both rebuttal and clarification. (Charles Krauthammer, 6/4)
Tampa Bay Times:
Accepting Medicaid Expansion Money Comes Down To 12 House Votes
Perhaps a dozen votes, give or take. That is roughly how many more votes are needed Friday for the Florida House to accept Medicaid expansion money to help provide health coverage for hundreds of thousands of low-income Floridians. Surely among 81 House Republicans there are 12 more who are willing to rise above partisan politics and vote for a conservative plan that is financially and morally responsible. (6/4)
The Tampa Tribune:
A Fair Alternative To Medicaid
The Florida House is scheduled to vote today on a Senate plan to expand health insurance opportunities for the working poor, and all indications are Republican House members will meekly go along with their leadership’s unbending and politically driven opposition to the measure. And that’s shameful. We hope members have the spine to do what’s best for the people of Florida. (6/5)
Houston Chronicle:
Refusing Medicaid Expansion Has Consequences
In Florida they're at least fighting about it. Expanding Medicaid, that is. Not so in Texas. Held hostage by lawmakers afflicted with extreme ideological sclerosis when it comes to anything related to the federal Affordable Care Act, the issue didn't even come up in the just-concluded legislative session. ... What's outrageous about the mulishness of Texas lawmakers is that taxpayers pay twice to provide health care to the poor, once in federal taxes that never return to the state after they're bundled off to Washington and yet again through property taxes. Other states, including those with Republican leadership, have managed to customize Medicaid expansion, however grudgingly. (6/4)
Jackson (Miss.) Free Press:
Refusing Medicaid: 'Far-Reaching Consequences'
What a new report says is that Mississippians would benefit greatly from the expansion of Medicaid. But what the report really means is that Mississippians—and the rest of the country—are suffering great harm by the state's refusal to expand Medicaid. ... In Mississippi, expanding Medicaid would provide an additional 139,000 people with insurance, the lack of which is a major barrier to people going to the doctor. Increasing health-care access would also mean 19,800 fewer people would struggle with paying their bills due to high medical costs. The overall physical and mental health of people living in Mississippi would also improve, the report finds. (R.L. Nave and Zachary Oren Smith, 6/4)
Bloomberg:
Obamacare's Unlikely Supporters: Utah Cops
Police chiefs and sheriffs who run local jails in states that haven’t expanded Medicaid are coming out in favor of Obamacare on the grounds that it could help drug addicts and people with mental illness get help before they commit crimes. ... Jim Winder, the elected sheriff of Salt Lake County, says 15 percent to 18 percent of the 40,000 people booked each year into the county jail—Utah’s largest—are severely mentally ill, about the same as the national rate. He spends $3 million to $5 million a year on psychotropic medication, out of a budget just shy of $90 million. Even if inmates have private insurance, the jail picks up the tab for them while they’re locked up. It often takes days or weeks to stabilize them, and many are arrested again soon after release. “I’ve got people who we’re booking 150 times a year,” says Winder, a Democrat serving his third term. “If people think for a moment we’re not paying for this, they are sadly mistaken.” (John Tozzi, 6/5)
The Nashville Tennessean:
Let’s Advance Health Equity Across Nashville
Health and illness are unsettlingly unfair. It is bad enough when a grim diagnosis or an untimely death strikes a family member or friend at random. The unfairness is worse when disease and early death are not random, but predictable and preventable.
One of the strongest predictors of an early death, sadly, is where you live. In many ways, your ZIP code impacts your health more profoundly than your genetic code. Nashville is not unique in this, but our data are striking: Some neighborhoods in Davidson County have premature death rates four to six times higher than others. Is this acceptable? (Nashville Public Health Department Director William S. Paul, 6/4)
The Columbus (Ohio) Dispatch:
Health-Care Workers Need Outlet For Stress
As society begins to better understand the toll taken by psychological and emotional stress — on military warriors, police and firefighters, crime victims and others — it makes sense to extend that understanding to those who work in hospitals.
Hospital-based nurses, social workers, clergy members and doctors see some of the greatest pain and tragedy that life can offer. Even as they are shaken and heartbroken by what they see and know, their job is to not only to perform skilled work competently, but to be bastions of comfort and calm for the patients and loved ones in the midst of crisis. (6/5)
Beaumont Enterprise:
Beaumont Hospitals Need Funding Boost To Help Care For The Poor
The Beaumont City Council has faced some tough calls over the years, but its upcoming decision about helping local hospitals is not one of them. Acting on a new law passed by the Legislature, the council should create a Municipal Local Provider Participation Fund that could deliver about $20 million in federal aid to the hospitals in the current year. (6/4)
The Wall Street Journal:
Cholera’s Fresh Attack In Haiti
The fight against the cholera epidemic in Haiti, by far the world’s worst in recent years, has been a hard slog. Still, the number of new cases had fallen precipitously, to just 1,000 per month for much of 2014 from an average in 2011 of nearly 30,000 per month. But a recent spike — to about 1,000 new cases per week — is a grim reminder of how much is left to do to eradicate an illness that was virtually unknown in Haiti until U.N. peacekeepers from Nepal introduced it in 2010. (6/4)
The New England Journal of Medicine:
The 21st Century Cures Act — Will It Take Us Back In Time?
In May 2015, the 21st Century Cures Act was introduced in the U.S. House of Representatives, with the goal of promoting the development and speeding the approval of new drugs and devices. ... An underlying premise of the bill is the need to accelerate approval for new products, but this process is already quite efficient. A third of new drugs are currently approved on the basis of a single pivotal trial; the median size for all pivotal trials is just 760 patients. More than two thirds of new drugs are approved on the basis of studies lasting 6 months or less — a potential problem for medications designed to be taken for a lifetime. Once the Food and Drug Administration (FDA) starts its review, it approves new medications about as quickly as any regulatory agency in the world. (Jerry Avorn and Aaron S. Kesselheim, 6/3)
JAMA:
Quality Indicators For Physical And Behavioral Health Care Integration
Earlier this year, Secretary Sylvia Burwell of the US Department of Health and Human Services announced measurable goals and a timeline to move the US health care system “toward paying providers based on the quality, rather than the quantity of care they give patients.” In April, Congress passed the Medicare Access and CHIP Reauthorization Act of 2015 (HR 2) to repeal the sustainable growth rate formula and develop options for alternative, value-based payment models for Medicare. These initiatives are in pursuit of the “triple aim” of better health care quality, improved population health, and more affordable health care. Achieving these goals will require a robust set of quality metrics that are especially focused on high-need/high-cost patient populations. The interface of behavioral (including mental health and substance use conditions) and general health care is an especially promising area for leveraging change of the status quo. (Matthew L. Goldman, Brigitta Spaeth-Rublee and Harold Alan Pincus, 6/4)