Viewpoints: Mass. Needs Funding To Fight Opioid Epidemic; Health Care For LGBT Americans

Boston Globe: No Retreat On Funding For Opioid Epidemic 
Now is not the time for Governor Charlie Baker to slash funding for substance abuse treatment in Massachusetts. In 2015, there were 1,574 confirmed accidental opioid deaths, a 20 percent increase over the previous year’s 1,383. As of September, the state’s opioid epidemic claimed another 1,005 people, with an additional estimated, or unconfirmed, 392 to 470 deaths. (12/15)

The Huffington Post: Furthering Healthcare For LGBT Americans
Last week, as part of national LGBT Week of Action for Healthcare Enrollment, Secretary of Health and Human Services Sylvia Burwell, Director of the White House Office of National Drug Control Policy Michael Botticelli, and I held a phone conference with members of the LGBT community to discuss the importance of enrolling in healthcare coverage. The open enrollment period to purchase 2017 health insurance through the Health Insurance Marketplace runs through January 31st, but the deadline for coverage starting January 1st is December 15th. People who need coverage should check out their options — most HealthCare.gov consumers can gain coverage for less than $75 per month. (Valerie Jarrett, 12/15)

Sacramento Bee: Telemedicine The Cure For Rural Areas 
Digital health innovations and applications, including virtual doctor’s appointments and smartphone health apps, can help us live better and longer lives. But many rural Californians don’t have access to these services as access to broadband internet and access to health care is rapidly becoming one and the same. (Eric Brown, 12/15)

Boston Globe: My Wife And I Grappled With A Possible Abortion 
Earlier this week, the Ohio state legislature passed a bill that would ban all abortions after 20 weeks, with a very narrow exception for the health of the mother (since Ohio begins the clock with fertilization and not the traditional method of counting the weeks from the last menstrual cycle, it is in reality a 22-week ban). The rationale for the legislation is that at 20 weeks a fetus can feel pain, though there’s no serious medical evidence to support that conclusion. But the Ohio law would represent a significant shift from previous Supreme Court rulings that allowed abortions to occur before the fetus was “viable” (i.e., could live outside the womb), which is around 24 to 26 weeks. (Michael Cohen, 12/15)

The New England Journal Of Medicine: Population Health — A Bipartisan Agenda For The Incoming Administration From State Leaders
The common goal of health policy leaders at the level of state government in the United States is promoting the health and well-being of all populations to the greatest extent possible within fixed resource constraints. Our health is affected by our physical and social environments, our genes, our economic and educational opportunities, and to a much lesser degree, the medical care we receive. State leaders understand that as a society we are spending our health care dollars in the wrong ways for the wrong things — emphasizing treatment over prevention and medical care over social services. (Christopher F. Koller, Thomas Alexander and Susan Birch, 12/14)

Stat: This Boy With A Rare Disease Got A Life-Changing Drug. Why Can’t All Kids?
The research community is on the cusp of unlocking vital treatments for many rare diseases, as well as many common disorders that burden our society. The funding called for in the [21st Century Cures Act], as well as changes to the approval processes, will speed the discovery and translation of this work to improve lives now and in the future. (David J. Bailey, 12/15)

Arizona Republic: Dental Therapists Wrong Answer To Access Problem
Being poor should not subject people to a different standard of health care. That is why, in my eight years leading the Maricopa Integrated Health System, I worked to improve clinical quality, train more doctors  and improve equipment and facilities. And it is why I oppose the creation of dental therapists in Arizona, the wrong answer to the real problem of access to dental care. An effort is underway to push this experimental, one-size-fits all solution. (Betsey Bayless, 12/15)

The New England Journal Of Medicine: Regulating Off-Label Promotion — A Critical Test
In 2012, the U.S. Court of Appeals for the Second Circuit handed down a landmark decision in the case of pharmaceutical sales representative Alfred Caronia. The Food and Drug Administration (FDA) had approved sodium oxybate (Xyrem) for treating narcolepsy, but Caronia promoted it for a wide range of nonapproved (off-label) indications, including insomnia, Parkinson’s disease, and fibromyalgia. Off-label use is common, especially in specialties such as oncology, in which it may even be considered the standard of care. However, surveys have revealed that supporting evidence is lacking for a majority of off-label uses of medical products. The uses Caronia proposed were not based on high-quality data and were likely to cause patients substantial harm. (Christopher Robertson and Aaron S. Kesselheim, 12/15)

The Hill: New Poll Reveals Americans Don’t Want Insurers To Limit Treatment Decisions
As the new administration and Congress look to improve our health care system, they must ensure addressing health insurance barriers many Americans face in accessing prescribed treatment remains a top priority. Federal and state policymakers now have an opportunity to improve care if they listen to the patient voice. A new poll, conducted by the Alliance for the Adoptions of Innovation in Medicine (Aimed Alliance) in conjunction with David Binder Research, shows that many Americans hold their health insurers to high standards and expect to receive quality care—conveying a disconnect between expectations and reality. (Stacey L. Worthy, 12/15)

The New England Journal Of Medicine: Medicare Payment For Behavioral Health Integration
Integrating behavioral health care with primary care is now widely considered an effective strategy for improving outcomes for the many millions of Americans with mental or behavioral health conditions. Uptake of behavioral health integration (BHI) has remained limited, however, largely because BHI has not been paid for separately, which has left primary care clinicians without a clear business model for incorporating these services into their practice. But on January 1, 2017, the Centers for Medicare and Medicaid Services (CMS) will begin paying clinicians separately for the BHI services they provide to Medicare beneficiaries. (Matthew J. Press, Ryan Howe, Michael Schoenbaum, Sean Cavanaugh, Ann Marshall, Lindsey Baldwin and Patrick H. Conway, 12/14)

The New England Journal Of Medicine: NIH Policy On Single-IRB Review — A New Era In Multicenter Studies
Review of the ethics of multicenter clinical studies is typically conducted by the institutional review board (IRB) of each participating center. Extensive evidence suggests that the current practice is costly, is unnecessarily duplicative, and delays commencement of research. The U.S. government has permitted single-IRB review and other streamlined review models since 1991, but few investigators have taken advantage of those options. (Ann-Margret Ervin, Holly A. Taylor and Stephan Ehrhardt, 12/15)