Viewpoints: Kasich’s Compassionate Conservatism; Medicare’s Hospice Care Plan

The Washington Post: Mr. Kasich Brings A Compassionate Touch To GOP Race
GOP voters looking for harder ideological edges won’t find them in [Ohio Gov. John] Kasich. Though he stresses his belief in personal responsibility, he frequently talks about the importance of empathy and public policy that helps those on the margins. Whereas some GOP governors boast about clamping down on the working poor, he insists that “we’re not going to bang you over the head because you’re trying to get ahead.” ... As governor, Mr. Kasich accepted federal funds to expand his state’s Medicaid program, a policy that helps ... the truly disadvantaged. Many GOP governors, including some in the presidential race, did the opposite, sacrificing the well-being of their constituents to anti-Obamacare extremism. (7/21)

The Washington Post's Right Turn: What You See With John Kasich Is What You Get
He arguably has achieved more than any other sitting governor in the race. As he said, he began with an $8 billion budget gap, balanced the budget and built up the rainy day fund from 89 cents (yes, cents) to more than $2 billion. During his tenure, he created more than 350,000 jobs. (Over a slightly different time span, New Jersey created about 170,000 jobs under Gov. Chris Christie and Wisconsin created about 155,000 under Gov. Scott Walker.) He boasts of $5 billion in tax cuts, “the largest in the country.” Fiscal conservatives, however, will never forget his expansion of Medicaid, which he insists brought money back to Ohio and was needed to help the poor in his state. Nevertheless, add to his list of accomplishments nursing care reform, drug rehabilitation efforts, education reform and steps to make the state more business-friendly, and you have an impressive record. (Jennifer Rubin, 7/21)

The Wall Street Journal: The Case For Kasich
Less consistent with this resume is Mr. Kasich’s 2013 decision to participate in ObamaCare’s Medicaid expansion. When Republicans in the Ohio legislature tried to block this gambit, Mr. Kasich imposed new Medicaid unilaterally through an executive panel. He then became the leading Republican evangelist for ObamaCare’s Medicaid expansion and accused anyone who disagreed with him of bad faith—literally. ... If increasing the reach of federal health care is the ticket into heaven, then the Almighty is selling at a discount. Medicaid’s quality of care, access to physicians and outcomes continue to decline. Meanwhile, Medicaid spending will consume 49% of Ohio general revenue funds in 2016, 51% in 2017. Yet Mr. Kasich often says that national Republicans who care about such details are waging “a war on the poor.” (7/21)

news@JAMA: Looking For Balance In Health Plan Networks
Choosing a health plan in the newly created health insurance exchanges has become technically smoother. But in many ways, it seems that the reduction in glitches has been traded for an overwhelming array of network choices. The proliferation of insurance plans that offer “narrow, ultra-narrow, limited, high-value, high-performance or skinny networks” that include or exclude specific clinicians and hospitals highlights both troublesome problems in the quest to improve the US health care system, as well as promising solutions. Such networks predate the Affordable Care Act (ACA), with roots in many employer-sponsored plans in the 1990s attempting to constrain costs in a managed care–conscious era. (Kavita Patel, 7/21)

USA Today: Crush Planned Parenthood
Planned Parenthood head Cecile Richards apologized last week for the uncompassionate tone her senior director of medical research, Deborah Nucatola, used to explain the process by which she harvests aborted body parts to be provided for medical research. Nucatola had been caught on an undercover video talking to anti-abortion activists posing as representatives of a biological tissue procurement company. The abortion doctor said, “I’d say a lot of people want liver,” and “a lot of people want intact hearts these days.” Explaining how she could perform later-term abortions to aid the harvesting of such intact organs, she said, “We’ve been very good at getting heart, lung, liver, because we know that, so I’m not gonna crush that part, I’m gonna basically crush below, I’m gonna crush above, and I’m gonna see if I can get it all intact.” (Kirsten Powers, 7/21)

The New York Times: The Campaign Of Deception Against Planned Parenthood
A hidden-camera video released last week purported to show that Planned Parenthood illegally sells tissue from aborted fetuses. It shows nothing of the sort. But it is the latest in a series of unrelenting attacks on Planned Parenthood, which offers health care services to millions of people every year. The politicians howling to defund Planned Parenthood care nothing about the truth here, being perfectly willing to undermine women’s reproductive rights any way they can. (7/22)

The New York Times' The Upshot: Medicare To Try A Blend Of Hospice Care And Treatment
Most older Americans close to death have to make a difficult choice: continue with traditional medical treatment or switch to hospice care, which focuses not on a cure but on easing their remaining days. Now, Medicare is testing a third alternative: both. (Margot Sanger-Katz, 7/22)

The New York Times: Giving Doctors Grades
One summer day 14 years ago, when I was a new cardiology fellow, my colleagues and I were discussing the case of an elderly man with worsening chest pains who had been transferred to our hospital to have coronary bypass surgery. We studied the information in his file: On an angiogram, his coronary arteries looked like sausage links, sectioned off by tight blockages. He had diabetes, high blood pressure and poor kidney function, and in the past he had suffered a heart attack and a stroke. Could the surgeons safely operate? (Sandeep Jauhar, 7/22)

The Denver Post: Celebrating 25 Years Of Progress With The ADA
This year marks the 25th anniversary of the Americans with Disabilities Act (ADA), which was signed into law on July 26, 1990. This historic, groundbreaking legislation has improved the lives of people with disabilities in many ways big and small, while bringing the issues of access and inclusion to the forefront of our national consciousness. Prior to the disability rights movement, even the most basic aspects of daily life were unattainable for many Americans. The lack of fundamental access to city streets, buildings and restrooms, or public transportation — which most of us take for granted — prevented people with disabilities from fully engaging in their communities. (Sue Birch and Jed Ziegenhagen, 7/21)

MinnPost: You May Not Need That Pacemaker: The Growing Problem Of Unnecessary Care
Forbes published a pointed commentary recently on the topic of unnecessary health care, one of the most serious problems facing our current healthcare system. This issue is one that all of us need to be aware of each time we interact with our doctors and the healthcare system — if we want our medical care to help rather than harm. (Susan Perry, 7/21)

JAMA: The Safety Of Prescription Drugs
Drug safety challenges have bedeviled the US Food and Drug Administration (FDA) for many years, and for good reason. The phased approach to drug development is primarily geared to establishing evidence of efficacy. ... However, it may not be until after approval, when the medication is used by as many as hundreds of thousands of patients, that rare but serious adverse events appear or there is sufficient statistical power to determine whether the drug increases rates of more common potential adverse outcomes .... It may not be feasible for the FDA to reconcile all competing interests and opinions about complex questions of drug safety. A more realistic goal is a rigorous, fair, and transparent framework that will make drug safety less a recurrent crisis and more just another difficult task facing a very important agency. (Joshua M. Sharfstein and Aaron S. Kesselheim, 7/21)

JAMA: How The New Neuroscience Will Advance Medicine
An estimated 100 million people in the United States will experience a serious brain disorder at some point in their lives—ranging from autism in childhood, to mood disorders and addiction in adults, to neurodegenerative disease and stroke later in life. Medicine lacks cures or even effective treatments for many of these tragic diseases, in part because of limited understanding of their causes and effects in the brain. This Viewpoint will describe recent advances in neuroscience and genetics that are providing a new view of brain function in health and disease. As these areas progress, neurology and psychiatry should see targeted treatments based on an understanding of the biological processes underlying brain disorders. (Cornelia I. Bargmann, 7/21)