Viewpoints: Insurers, Mergers And Obamacare; Doctors Should Talk To Patients About Guns

The Wall Street Journal: ObamaCare And Big Insurance
Politicians tend to be most enraged by the problems they cause, and the liberal fury against insurance mergers is a classic of the genre. ObamaCare was designed to create government-directed oligopolies, but now its authors claim to be alarmed by less competition. Last week federal and 11 state antitrust regulators filed a double lawsuit to block the pending $54 billion insurance tie-up between Anthem and Cigna and the $37 billion acquisition of Humana by Aetna. The mergers would reduce the national commercial insurers to three from five, and Attorney General Loretta Lynch says the government won’t cede such “tremendous power” over health care to a more concentrated industry. (7/24)

The New York Times: When Health Insurers Merge Consumers Often Lose
A wave of mergers in many sectors of the economy over the last several decades has significantly reduced competition and hurt consumers. That’s why the lawsuits filed last week by the Department of Justice and state attorneys general in federal court challenging two big heath insurance mergers were so important. Antitrust officials say Aetna’s $37 billion acquisition of Humana and Anthem’s $54 billion purchase of Cigna will reduce the number of large national health insurers to three, from five today. (7/25)

Modern Healthcare: Don't Shed Tears For Health Insurers
A superficial reading of the latest headlines about the health insurance industry suggests it is facing serious problems. Rates on the Obamacare exchanges are set to rise at double-digit rates next year. California, a bellwether state, announced an average premium increase of 13.4% for 2017. UnitedHealth Group, the nation's largest insurer, has pulled out of most markets. (Merrill Goozner, 7/23)

Reuters: Doctors Should Be Able To Ask Patients About Guns
It is part of my job as a physician to ask patients about behaviors that may affect their health. Examples are smoking, drinking and wearing bicycle helmets. But if I were practicing in Florida, I might be legally restrained from asking whether they own a gun and, if so, whether it is stored safely. In addition, unlike, say, an embarrassing medical problem, any information regarding gun ownership cannot be entered into the patient’s medical record. This law, like recent attempts to block women’s access to abortion clinics in Texas, represents misappropriation and misuse of health concerns to advance other political agendas. (Michael Rosenbaum, 7/24)

Modern Healthcare: You Thought Obamacare Was A Big Deal? Take A Look At The GOP's Proposed Medicare Overhaul
In its 2016 platform released this week, the Republican Party took a political risk by embracing House Speaker Paul Ryan's longstanding proposal to convert the highly popular Medicare program from a defined-benefit system into a defined-contribution, “premium support” model. It's not surprising that the proposal wasn't mentioned by Republican presidential nominee Donald Trump at the GOP national convention, since he repeatedly has promised during the campaign that he wouldn't touch Medicare. (Harris Meyer, 7/22)

The Wall Street Journal: Telemedicine Runs Into Crony Doctoring
Telemedicine has made exciting advances in recent years. Remote access to experts lets patients in stroke, neonatal and intensive-care units get better treatment at a lower cost than ever before. In rural communities, the technology improves timely access to care and reduces expensive medevac trips. Remote-monitoring technology lets patients with chronic conditions live at home rather than in an assisted-living facility. Yet while telemedicine can connect a patient in rural Idaho with top specialists in New York, it often runs into a brick wall at state lines. Instead of welcoming the benefits of telemedicine, state governments and entrenched interests use licensing laws to make it difficult for out-of-state experts to offer remote care. (Shirley Svorny, 7/22)

The New York Times: Nursing Home Residents Still Vulnerable To Abuse
People entering nursing homes need to know that all reasonable safeguards are in place to ensure quality care. But federal rules to be finalized soon fail to hold nursing homes truly accountable to patients, their families or the law. At issue are arbitration clauses in nursing home contracts that require consumers to settle any disputes that arise over products or services through private arbitration rather than through lawsuits. Corporations of all sorts love forced arbitration because it overwhelmingly tilts in their favor and shields them from liability. But in the process, it denies justice to consumers, investors, patients and others who find they have no legal recourse when wronged. (7/25)

The Wall Street Journal: Why Are They Trying To Make Us Kill Our Patients?
I am an oncologist/hematologist who has been practicing in California, primarily at Eisenhower Medical Center in Rancho Mirage, for 39 years. It has been my privilege to have treated and cared for more than 16,000 patients with cancer or blood diseases and to have provided pain relief and comfort for the dying. I am also one of six concerned physicians who, along with the American Academy of Medical Ethics, have sued in a California Superior Court to try to block as unconstitutional the state’s Physician Assisted Suicide law, which went into effect on June 9. More recently, a group of doctors and health-care professionals in Vermont joined a lawsuit filed July 19 to try to block the way that state’s 2013 assisted suicide law is being interpreted and misapplied. (Philip B. Dreisbach, 7/24)

The Washington Post: The Wrong Way To Fight Disease
By inaction, Congress has left federal, state and local public health agencies scrambling to find resources to cope with the Zika virus carried by mosquitoes, for which there is no vaccine or effective cure. The virus is a serious threat to pregnant women, because it can lead to birth defects. It was irresponsible of Congress to leave town for the summer with President Obama’s $1.9 billion request up in the air. It also underscores a larger problem: The system for financing public health emergencies is flawed. (7/24)

The Washington Post: Return Of RAM: Another Year Without Health Care For Virginians
On a muggy summer day last year, I drove up the winding roads of Coeburn Mountain (sometimes called Wise Mountain, depending on which of those towns you call home). The founder of Remote Area Medical, Stan Brock, known around here as the Appalachia messiah, was coming to town again. I wanted to see what it was like to wait in a RAM line, as my grandfather, my friends and my neighbors have. It was foreboding. No one should feel like that, especially at a festive fairground, even when it morphs into a field hospital in the holler for the 17th time. (Matt Skeens, 7/22)

The New York Times' Upshot: You Probably Don’t Need Dental X-Rays Every Year
My dental hygienist complimented me on the health of my teeth and gums. Then she said something that you, too, have undoubtedly heard while sitting back in the dentist chair. “Would you like bitewing X-rays? It’s been a year since your last ones. Your insurance will cover them annually.” The easy answer was: “Yes. Bring on the bitewings!” They are, after all, painless, don’t take much time, and, as I was reminded, would not cost me a penny because they are covered by my insurance. But the easy answer isn’t necessarily the right one. Do I need bitewing X-rays every year? (Austin Frakt, 7/25)

Los Angeles Times: Should We Pay Women To Donate Their Eggs For Research? No, And Here's Why.
"Not everything in life is for sale, nor should it be.” That’s what California Gov. Jerry Brown said in 2013 when he vetoed a bill allowing women to be paid to donate their eggs for scientific research. “In medical procedures of this kind,” he added, “the long-term risks are not adequately known. Putting thousands of dollars on the table only compounds the problem.” But bad ideas don’t always die in Sacramento; they just hibernate. The proposal to repeal a 2006 ban on any payment beyond reimbursement for time and travel expenses is back this year, with barely a single word changed from the 2013 measure. Passed by the Assembly in April by a 65-3 vote, it will be taken up by the Senate after lawmakers return from vacation next month. (Michael Hiltzik, 7/22)

Raleigh News & Observer: Like Mental Health Reform, NC Medicaid Changes Would Be Disastrous
Over 10 years ago, I was chairman of the Mental Health Committee of the N.C. Pediatric Society and intimately involved in the early stages of reform, working with state government officials to try to make the best decisions we could. Because the mental health care delivery system was extremely expensive, North Carolina decided to get out of the mental health business by privatizing delivery. It would dismantle the system of government-run Area Programs and replace them with privately run Local Management Entities. The state was excellent at tearing down the infrastructure for mental health care delivery. The private sector, however, was not so good at replacing it. (David A Horowitz, 7/24)

Milwaukee Journal Sentinel: The Cancer Moonshot Summit And What It Takes To Cure Cancer
On June 29, more than 350 oncologists, researchers, data and technology experts, clinical laboratory organizations, cancer patients, patient advocates and others involved in cancer research and patient care were in Washington, D.C., for the National Cancer Moonshot Summit at the invitation-only summit hosted by Vice President Joe Biden. Aurora Cancer Care was among those invited to be a part of the discussion to find a cure. ... As a guest at the summit, I can tell you we're taking great strides in the battle, and two particular strategies discussed at the event are paramount to our efforts to beat cancer — molecular genetic testing and clinical trials. (James L. Weese, 7/24)