Viewpoints: GOP’s Surprising Entitlement Message; Court May Revisit Medicaid In Fla. Case
A selection of opinions on health care from around the country.
The Wall Street Journal's Washington Wire:
The Case For Testing Medicare Premium Support
The House-Senate budget conference report released last Wednesday included several interesting nuggets. Among the most surprising was the lack of explicit language endorsing the concept of premium support reforms to Medicare. Conservatives have voiced support for premium support for years—most notably in the entitlement reform proposals from then-House Budget Committee Chairman Paul Ryan—but legislative progress has been limited. (Chris Jacobs, 5/7)
The Washington Post's Plum LIne:
What If A 2016 GOP Candidate Told The Truth About Obamacare?
If you’re a Republican presidential candidate, there aren’t too many ways you can distinguish yourself from your primary opponents on the issue of health care — I hate Obamacare, you hate Obamacare, we all hate Obamacare. But maybe there’s another way, for someone who has the courage to shift his rhetoric and present themselves as a bold truth-teller. (Paul Waldman, 5/7)
The Wall Street Journal's Washington Wire:
An Obamacare Lesson For Small Health Insurers?
In 2011, analysts were speculating that Assurant Health might exit the insurance business, the Milwaukee Journal Sentinel reported last week. So the recent news that Assurant’s parent company was looking to “sell or shut down” the insurance carrier by year’s end was not a total surprise. The issue now is whether its demise holds larger lessons about Obamacare’s impact on insurance markets. (Chris Jacobs, 5/7)
National Journal:
Will The Supreme Court Revisit Part Of Its Landmark Obamacare Decision?
Many have dismissed Rick Scott's lawsuit against the Obama administration over Medicaid funding as meritless, but the Florida governor might actually be doing everybody a favor. The case could help answer a huge constitutional question left over from the 2012 Supreme Court decision on Obamacare. ... what [Chief Justice John] Roberts didn't say in his ruling was where exactly the line is that separates the federal government's lawful discretion to persuade states to participate in a program from such illegal intimidation. He explicitly avoided creating a definitive test for it. ... If the Florida case gets to the high court, it would give the justices a chance to be a little more precise. (Dylan Scott, 5/7)
Alaska Dispatch News:
No Balm In Alaska If Lawmakers Stay Hard-Hearted On Medicaid Expansion
With Alaska's new minimum wage, an Alaskan working full time would earn roughly $18,000 a year and fall $2,500, or 286 working hours, short of federal subsidies for health insurance. This person would have to spend approximately $6,000 for health insurance. In contrast, an Alaskan earning $22,000 a year can purchase health insurance for less than $1,000. This kind of an inequity cries out for a response from our elected leaders. (Pastor Max Lopez-Cepero and Fr. Fred Bugarin, 5/7)
Arizona Republic:
Regular Mammograms Save Lives. Period
Despite what the U.S. Preventive Services Task Force said recently in its draft recommendations, oncologists, surgeons and radiologists like us who specialize in breast cancer know patients are living longer because new technology is discovering cancer at earlier, more treatable stages. The task force's draft advised against breast cancer screening for any woman aged 40-49 unless her physician had reviewed her individual medical history, assessed screenings' risks and benefits, and then recommended a mammogram. For women aged 50-74, the task force weakly endorsed screening mammograms, but only every other year. If the draft is approved, insurance companies now required to cover annual screening may no longer provide that coverage. (Drs. Linda Greer, Coral Quiet and Lise Walker, 5/5)
The Miami Herald:
Don't Limit Mammogram Screening
I was relieved when at age 41, my first-ever mammogram came back clean. However, the report did indicate I was at risk for calcification buildups. Though not abnormal, that alert made me more vigilant about breast health self-awareness. Indeed just six weeks later I found a lump in my breast during a routine self-exam, and shortly thereafter I was diagnosed with breast cancer. (Rep. Debbie Wasserman Schultz, D-Fla., 5/7)
JAMA:
Unrest In Baltimore: The Role Of Public Health
There are many ways to understand what is happening in Baltimore and, to varying degrees, across the United States. The problems reflect a long-standing dysfunctional relationship between law enforcement and citizens, structural poverty, and the legacy of discrimination in housing and finance policy. The problems also deeply engage public health—in addressing immediate needs, in understanding the basis of unrest, and in shaping long-term solutions. (Leana S. Wen and Joshua M. Sharfstein, 5/7)
New England Journal Of Medicine:
The Children's Cliff — Extending CHIP
CHIP enjoys political advantages that give it a strong bipartisan foundation: insuring children is a popular cause, the costs of doing so are modest, the program's block-grant structure and state flexibility appeal to conservatives, and it has a strong constituency among state officials. ... CHIP, in other words, is not Obamacare, and the bipartisan coalition behind it remains largely intact. ... The bipartisanship that underlay CHIP's extension and [Medicare doctor payment] reform does not, however, mark the emergence of new, less polarizing health care politics. That Congress can agree on the necessity of continuing insurance coverage for children and payments to doctors seeing Medicare patients does not mean that Democrats and Republicans see eye to eye on other issues. (Jonathan Oberlander and David K. Jones, 5/6)
New England Journal Of Medicine:
Revisiting The Commercial–Academic Interface
Over the past two decades, largely because of a few widely publicized episodes of unacceptable behavior by the pharmaceutical and biotechnology industry, many medical journal editors (including me) have made it harder and harder for people who have received industry payments or items of financial value to write editorials or review articles. The concern has been that such people have been bought by the drug companies. Having received industry money, the argument goes, even an acknowledged world expert can no longer provide untainted advice. But is this divide between academic researchers and industry in our best interest? I think not. (Jeffrey M. Drazen, 5/7)
New England Journal Of Medicine:
Progress And Hurdles For Follow-On Biologics
Biologics have provided major advances in the treatment of cancer, rheumatologic disease, and other conditions. Though they account for less than 1% of all prescriptions dispensed in the United States, expenditures on them amount to 28% of prescription-drug spending, and both their use and their cost are forecast to grow sharply. ... The introduction of generic versions of small-molecule drugs can reduce prices by 90% from the brand-name version, which has saved U.S. consumers more than $1.5 trillion over the past decade. Cost savings for biologic drugs, however, are inherently limited because they are more complex and therefore harder to produce than small-molecule drugs. This complexity raises the cost of development and reduces the number of potential market entrants. (Ameet Sarpatwari, Jerry Avorn and Aaron S. Kesselheim, 5/6)
JAMA Psychiatry:
Depression And Suicide Among Physician Trainees
In the first 2 months of the 2014-2015 academic year, 2 New York City medical interns died in apparent suicides. In response, an intern from Yale School of Medicine wrote an op–ed in the New York Times highlighting the link between medical training and isolation, depression, and suicide among trainees. Physician suicide is a common occurrence. According to the American Foundation for Suicide Prevention, 300 to 400 physicians commit suicide each year, approximately 1 physician per day. Medical training involves numerous risk factors for mental illness, such as role transition, decreased sleep, relocation resulting in fewer available support systems, and feelings of isolation. A substantial body of evidence has demonstrated that trainees in particular are at high risk for depression and suicidal thinking, but many training programs have not been able to identify and provide treatment for these residents and fellows in a systematic way. (Matthew L. Goldman, Ravi N. Shah and Carol A. Bernstein, 5/7)
