Viewpoints: GOP Putting Repeal Plan In Place For 2017; Gun Violence And Public Health
A selection of opinions on health care from around the country.
National Review:
A Clear Path For Repealing And Replacing Obamacare Is Coming Into View
House and Senate leaders deserve a lot of credit for putting together a bill that repeals much of Obamacare and skillfully navigating it through both chambers using the budget-reconciliation process. That’s no small achievement, though President Obama is sure to veto the bill as soon as it reaches his desk. But it’s likely to be only a partial preview of what could happen in 2017 — if a Republican wins the White House. It is telling that the bill Congress is poised to send to President Obama delays repeal of Obamacare’s Medicaid expansion and health-insurance subsidies for two years. That way, Republican senators could promise their constituents that a replacement for Obamacare would be put in place before the federal funding for their plans was withdrawn. (James C. Capretta, 12/6)
Health Affairs:
The $879 Billion Footnote — And The Financing Path To ACA Repeal
The November 3 election of Matt Bevin as governor of Kentucky will provide an important indication of the seriousness of Republican intentions to undermine and repeal the health insurance expansions of the Affordable Care Act (ACA). Early in Bevin’s campaign, he expressed unambiguous intent to repeal Governor Steve Beshear’s executive order that expanded Medicaid; during the general election campaign, Bevin backpedaled and proposed adopting an Indiana-like Medicaid waiver to require significant enrollee cost sharing and an enrollment freeze. (John McDonough and Max Fletcher, 12/4)
Modern Healthcare:
Tackle Gun Violence Like Other Public Health Problems
San Bernardino, Calif., Colorado Springs, Colo., Roseburg, Ore., Charleston, S.C., Watertown, Conn., Aurora, Colo., Blacksburg, Va. The routinization of mass murder in the U.S. continues apace. The overall statistics may not show an increase in the number of Americans killed by firearms each year. But the horrific nature of recent mass slaughters reveals a tragic truth: The proliferation of guns in our society has been, and continues to be, one of the nation's leading threats to public health. (Merrill Goozner, 12/5)
Health Affairs:
The Impact Of New Hepatitis C Drugs On National Health Spending
Many analysts had predicted ... an increased health spending growth rate for 2014 due to the implementation of the Patient Protection and Affordable Care Act (ACA). ... However, the huge jump in prescription drug spending that occurred in 2014 was unforeseen. In 2013, spending on prescription drugs grew by only 2.4 percent, but in 2014, it skyrocketed to 12.2 percent. Some of this increase in spending on prescription drugs is due to expanded coverage, and some is due to the acceleration in prescription drug prices. A major source of this growth was the introduction of Sovaldi in December 2013, and Harvoni in October 2014. Both are very expensive breakthrough drugs for the treatment of hepatitis C. (Charles Roehrig, 12/7)
Health Affairs:
Nothing (Still) Matters: ERISA Preemption Returns To The Supreme Court
It’s back. After more than a decade without a major health care dispute involving the Employee Retirement Income Security Act of 1974 (ERISA) reaching the United States Supreme Court, the justices heard oral arguments on December 2 in Gobeille v. Liberty Mutual Insurance Co. The case involves a challenge by a national employer that self-insures health coverage for its workforce to the validity of a Vermont law requiring comprehensive health care claims data to be reported to the state’s “All-Payer Claims Database.” Following its progress through the courts reminds me why—throughout the 1990s and into the 2000s—I explained to every class of Health Law students I taught that ERISA was the most important law affecting private health insurance in the United States. (William Sage, 12/7)
The New York Times Upshot:
Your New Medical Team: Algorithms And Physicians
Can machines outperform doctors? Not yet. But in some areas of medicine, they can make the care doctors deliver better. Humans repeatedly fail where computers — or humans behaving a little bit more like computers — can help. Even doctors, some of the smartest and best-trained professionals, can be forgetful, fallible and prone to distraction. These statistics might be disquieting for anyone scheduled for surgery: One in about 100,000 operations is on the wrong body part. In one in 10,000, a foreign object — like a surgical tool — is accidentally left inside the body. Something as simple as a checklist — a very low tech-type of automation — can reduce such errors. (Austin Frakt, 12/7)
JAMA Internal Medicine:
Research In Medical Education And Patient-Centered Outcomes
Can medical education, at any level (undergraduate, graduate, or continuing), be evidence-based? Regardless of the field of research, whether medical education or clinical outcomes, the most compelling form of evidence comes from large, randomized clinical trials (RCTs) or large, prospective cohort studies. When it comes to high-stakes decisions about interventions that will involve large populations, we expect rigorous evidence to guide decision-making. Why would we have different expectations regarding the level of evidence for medical education research than we do for clinical research? (Patrick G. O’Malley and Louis N. Pangaro, 12/7)
