Viewpoints: Insurers’ Health Law Secret; How Scalia’s Death Impacts Pending Cases
A selection of opinions on health care from around the country.
Los Angeles Times:
Dirty Little Secret: Insurers Actually Are Making A Mint From Obamacare
For months now, headlines about the Affordable Care Act have focused on complaints from big insurers that they haven't been making money from individual insurance plans mandated by the act. Here's what they haven't been saying so loudly: They're making scads of money from Obamacare — so much that almost universally, they're expanding their participation. What's the catch? The big profits have come not from the insurance exchanges, but via the ACA's Medicaid expansion, in which the largest insurers have been playing a major role. (Michael Hiltzik, 2/16)
Bloomberg:
Scalia's Death Probably Flips Big Cases
How will the death of Justice Antonin Scalia affect the major cases before the U.S. Supreme Court this term, all of which are expected to be decided by the end of June? The answer doesn’t depend entirely on how Scalia would’ve voted. It also depends on a necessary rule of procedure: When the Supreme Court is divided equally, it upholds the decision below. ... The Texas abortion case to be argued March 2, Whole Woman’s Health v. Hellerstedt, is an anomaly. The 5th Circuit upheld the law despite its effect of closing down most of the abortion clinics in the state. Kennedy was expected to be the deciding vote, and he still will be. If he votes to uphold the decision below, the tally will almost certainly be 4-4. If he votes to strike it down, it’ll be 5-3. Either way, he makes the call. (Noah Feldman, 2/16)
The Baltimore Sun:
The Health Care Gap
Beginning last August, student journalists from the University of Maryland's Philip Merrill College of Journalism in partnership with the non-profit Kaiser Health News were dispatched to West Baltimore to answer this simple question: In a city with some of the finest health institutions in the world, how could there be such enormous disparities in health outcomes? (2/16)
Forbes:
Biden Was Right: Medicaid Provider Taxes A 'Scam' That Should Be Scrapped
Provider taxes demonstrate the worst aspect of our nation’s health care entitlement programs (Medicare, Medicaid, and the Affordable Care Act)—complicated rules and subsidies that profit special interest groups and empower government bureaucracies with too little benefit for patients most in need and taxpayers. (Brian Blase, 2/16)
JAMA:
Embrace The Complexity The US Preventive Services Task Force Recommendation On Screening For Autism Spectrum Disorder
In this issue of JAMA, the US Preventive Services Task Force (USPSTF) presents final recommendations for screening children aged 18 to 30 months for autism spectrum disorder (ASD). Autism spectrum disorder can be responsible for significant, long-term impairment in social interaction, communication, and functional capacity. Emerging evidence suggests that early intensive behavioral therapy has the potential to improve outcomes. The prevalence of ASD has increased in recent years and is estimated to be as high as 1 in 68 children, suggesting that improving long-term outcomes could have substantial societal impact. (Michael Silverstein and Jenny Radesky, 2/16)
JAMA:
Ensuring The Quality Of Quality Metrics For Emergency Care
Every year in the United States there are more than 136 million total visits to emergency departments (EDs). Approximately 20% of adult patients who seek ED care will be hospitalized, and the rest will be treated and discharged, usually to home. However, a proportion of patients who are discharged from the ED will soon return for additional ED care, usually related to the problem treated at the previous visit or on occasion for new symptoms. Depending on location, payer mix, and acuity of illness, rates of return visits to the ED range from 7.5% to 22.4% between 3 days and 30 days. (James G. Adams, 2/16)
The New York Times Room For Debate:
Prosecuting Doctors In Prescription Drug Overdose Deaths
Deaths from drug overdoses have exploded around the country, fueled in part by addiction to prescription painkillers. Earlier this month, a Los Angeles doctor was sentenced to 30 years to life in prison after being convicted of murder in the overdose deaths of patients for whom she overprescribed such drugs. It was apparently the first such conviction in the United States. Some say the prosecution will make the medical community hesitant to prescribe opioids to patients who need them. (2/17)
Modern Healthcare:
The Latrogenic Roots Of The Opioid Epidemic
The opioid abuse epidemic has become a major issue on the campaign trail because the number of people who die each year from opioid overdoses is approaching 30,000. But it's important to note that nearly two-thirds of those deaths are due to overdoses of prescription opioids, not heroin. (Merrill Goozner, 2/13)
Detroit Free Press:
Snyder's Resignation Would Be No Victory
With no end to Flint’s water emergency in sight, a lot of Michiganders — most genuinely furious, some sensing political opportunity — are demanding Gov. Rick Snyder’s recall or resignation for his role in the crisis. And I suspect there have been mornings when either prospect looked attractive to Snyder, who has seen himself demoted from everyone’s favorite vice presidential prospect to poisoner-in-chief in little more than an eye-blink. But I wish some of those howling for Snyder’s scalp would explain how his abrupt departure would accelerate relief to Flint's beleaguered residents or hasten the reversal of the regulatory neglect that precipitated the city’s ongoing public health emergency. (Brian Dickerson, 1/15)
Forbes:
Texas Health System Solving Uncoordinated Post-Acute Care
As the $1 trillion shift from volume to value is rapidly becoming reality, health systems are responding. The first reality that hits health systems is that the old model of the hospitals as the center of the healthcare universe has led to a catastrophic misalignment of population health resources. Even patients who are heavy utilizers (aka Hot Spotters) spend 99+% of their lives outside the hospital. The handwriting on the wall couldn’t be clearer for forward-looking health executives: They must develop a sound strategy for addressing that other 99+% of the patient’s life. (Dave Chase, 2/16)