Viewpoints: Individual Market Turmoil; Bureaucracies, ‘Creep’ And Medical Decisions
Here's a review of editorials and opinions on a range of public health issues.
The New England Journal Of Medicine:
Turmoil In The Individual Insurance Market — Where It Came From And How To Fix It
In recent weeks, some health insurers have announced that they will not offer individual market coverage in 2018, while others have requested sizable premium increases. In response to this news, President Donald Trump has pronounced the individual market structure created by the Affordable Care Act (ACA) “dead.” Similarly, House Speaker Paul Ryan (R-WI) has claimed that the market is experiencing a “death spiral” reflecting fundamental flaws in the ACA’s design. These claims misdiagnose the situation. The ACA’s individual market structure — though not perfect — is sound and has succeeded in greatly expanding coverage. As 2017 began, the market was poised to leave behind the growing pains of the past few years. Then the President and Congress acted to create needless turmoil. (Henry J. Aaron, Matthew Fiedler, Paul B. Ginsburg, Loren Adler and Alice M. Rivlin, 7/27)
Bloomberg:
How Bureaucracies Creep Into Life-And-Death Medical Decisions
Everyone who has been touched by the case of Charlie Gard is in a terrible position. This 11-month-old British boy, born with an extremely rare mitochondrial DNA disorder that has damaged his brain and left him unable to move his limbs, has been in a hospital for months. Now it appears he will never go home again, not even to die. His parents lost their fight in the British courts to bring him to the U.S. for an experimental treatment, and now they have been denied their request to let his family have his last hours at home. (Megan McArdle, 7/27)
Cincinnati Enquirer:
Republicans Are Sabotaging Obamacare
There are lots of things wrong with the ACA: insurance subsidies were set too low; and the Obama administration let too many people stay on their old plans, limiting new insurance customers and leading to higher rates. ...But our conservative base considers this kind of teamwork blasphemous and insists on complete repeal as the only option. (Phil Heimlich, 7/27)
Milwaukee Journal Sentinel:
A Way Forward On Health Care Reform
Maybe it’s time we as a country candidly acknowledge our deep divisions on health care policy and work to develop a framework on the fundamentals on which we can agree. I don’t believe we will ever get to sustainable, comprehensive reform strategies without a bipartisan approach. (Nick Turkal, 7/27)
Sacramento Bee:
Health Reform: Try Medicare For All
In the short term, Congress should shore up the Affordable Care Act with bipartisan, commonsense improvements, such as a reinsurance program to stabilize the market for high-risk policyholders, legislation to make cost-sharing reductions permanent, and government permission to negotiate for lower prescription drug prices. But in the longer term, the time is right to think about ways to make access to health care truly universal and cover those who are still left behind. (John Garamendi, 7/27)
The Des Moines Register:
Transgender Ban Is An Insult To The Military
The president’s reference to “tremendous medical costs” is nothing but a smokescreen. A Defense Department study conducted by the Rand Corp. pegs the cost of all transgender-related treatments to an annual range of $2.4 million to $8.4 million. That translates to, at the very most, 0.13 percent of the $6.2 billion that the military spends on health care each year. That’s barely over one-tenth of 1 percent. (7/27)
Milwaukee Journal Sentinel:
The Real Motive Behind Trump's Transgender Order
Trump took to his usual public platform on Twitter earlier this week to suddenly announce an outright ban on transgender military service. If implemented, this would fully reverse the Obama era order to allow transgender people to serve openly (they’re already serving, and have been since the beginning). (Emily Mills, 7/27)
Lincoln Journal-Star:
Transgender Military Ban Shameful Act By Trump
Trump later tweeted the U.S. “cannot be burdened with the tremendous medical costs and disruption that transgender in the military would entail.”A report commissioned for the Pentagon in 2016 found transgender-related medical treatment would cost between $2.4 million and $8.4 million annually. In comparison, USA Today estimates Trump exceeded $8.4 million in taxpayer money on his fourth visit to Mar-a-Lago since his inauguration. (His fourth trip to the Florida resort came in early March; he’s made seven such journeys already in his presidency.) Regardless of whatever flimsy justification Trump offers, thousands of Americans who have pledged to fight for their country have now been deemed unworthy to serve by their commander-in-chief, a man whose orders they’ve sworn to uphold at the potential cost of their own lives. ((7/28)
RealClear Health:
Bringing Exercise Into The Discussion On Mental Health
Over the years, many studies have shown the benefits of regular physical activity to mood and mitigating the effects of stress. A 2014 study, in fact, found that for mild to moderate depression, the effect of exercise may be comparable with antidepressant medication and psychotherapy; and for severe depression, exercise seems to be a valuable complementary therapy to the traditional treatments. The study authors clearly state, “Physical exercise is an outstanding opportunity for the treatment of patients who have a mix of mental and physical health problems.” (Helen Durkin, 7/28)
KevinMD:
Who Is Alive: Man Or Machine?
He had cardiomyopathy and CHF for over 20 years. At the time, doctors told him he could die at any time. That was 20 years ago. His EF was 10 percent — barely livable. Two decades later, this admit kept him on a see-saw with respiratory distress, a bad heart, bad lungs, atrial fibrillation with RVR and heart rate in the 140s all day long. He progressed from nasal cannula to Optiflow to 100-percent BiPAP. A Cardizem drip was added to no avail. His next step would be intubation. (Debbie Moore Black, 7/27)
St. Louis Post-Dispatch:
Drug Monitoring In Missouri: It Takes Two
Last year in the St. Louis area alone, more than 700 lives were lost to fatal opioid overdoses. This is a breathtaking number. We lost 712 fathers, sons, mothers, daughters, sisters and friends, and as the death toll climbed, the Missouri Legislature again failed to pass a statewide prescription drug monitoring program. (Howard Weissman, 7/28)
