Viewpoints: Medicaid Work Requirements Are Brazen; Lessons From Opioid Crisis On Caring
Opinion writers focus on these and other health topics.
Health Affairs:
Will Federal Courts Uphold Trump Administration Medicaid Waiver Approvals? The Case For Skepticism
[O]ver its 50-plus year history, Medicaid waiver authority was almost exclusively used to expand Medicaid eligibility and benefits rather than to restrict them, or to try a different approach to delivering existing benefits. ... The [recent] approvals in Kentucky and Indiana, and possible pending approvals in other states, base their legal claim to be promoting the objectives of the Medicaid program on a far more brazen and cynical premise. The waiver approvals assert that taking away Medicaid from statutorily eligible individuals can act as an incentive that ultimately improves health: either by forcing the beneficiary to get a job to stay insured in the case of work requirements, or by “educating beneficiaries on enrollment requirements” in the case of lockouts from eligibility for beneficiaries who fail to complete an annual renewal or inform the state of income changes. (Eliot Fishman, 2/15)
New England Journal of Medicine:
Caring For Ms. L. — Overcoming My Fear Of Treating Opioid Use Disorder
One of my colleagues started Ms. L. on buprenorphine treatment. When I saw her again for her diabetes, a space had opened between us. Then she didn’t show up to her next appointment. I called her and sent a letter, but she didn’t show up to the next one either. Months passed, and then a year. The night I found out that Ms. L. had died of an overdose, a heavy, wet snow was falling throughout the city, dampening the sound of traffic. ...What if I had treated her myself, instead of referring her? I don’t flatter myself that I could have provided her better care — I had complete confidence in my colleague. But Ms. L. and I had had a relationship. She had trusted me. And I’d turned her away.In the ensuing months, I earned my waiver to prescribe buprenorphine. I still harbored apprehensions about caring for patients with addiction, but I also knew that I could not turn away another Ms. L. I now care for a small panel of patients with OUD. (Audrey M. Provenzano, 2/14)
Stat:
Collective Action Needed To Stem Burnout And Restore Clinician Well-Being
Every day, as people from all walks of life deal with burnout, they often turn to health care professionals for help. Yet the very people who dedicate their lives to keeping others healthy are the ones increasingly suffering from burnout. More than half of U.S. physicians report significant symptoms of burnout — that’s more than double the rates among professionals in other fields. If we want our nation’s health to flourish, we need to care for those who care for us. (Victor J. Dzau, 2/15)
New England Journal of Medicine:
Does CVS–Aetna Spell The End Of Business As Usual?
Another day, another mega-deal — or so it seems. But the proposed $70 billion merger of CVS and Aetna would be the largest deal ever in the health care sector outside pharmaceutical company mergers and among the 20 largest deals in history. So this seems an appropriate occasion to pause and consider what it might mean for the health care delivery system. (Leemore S. Dafny, 2/15)
New England Journal of Medicine:
When The CHIPs Are Down — Health Coverage And Care At Risk For U.S. Children
Congress failed to reauthorize the Children’s Health Insurance Program (CHIP) last fall, causing uncertainty and worry for families and state CHIP directors alike. After a period of stopgap funding, CHIP was reauthorized for 6 years in late January. (Lisa C. Dubay and Genevieve Kenney, 2/14)
New England Journal of Medicine:
Medical Devices In The Real World
Recent legislation directs the FDA to consider how best to use real-world evidence to ensure device safety and effectiveness while accelerating access to new technologies. But rigorous observational statistical methods are needed to mitigate limitations of such data. (Frederic S. Resnic and Michael E. Matheny, 2/15)
Des Moines Register:
Medicaid Bill Demonizes Low-Income Iowans With Delays, Drug Tests, Work Requirements
Actually Medicaid is not a “state welfare program.” It is a health insurance program largely funded by the federal government. Providing coverage to people helps ensure they have the care they need to be physically and mentally well enough to hold a job. It ensures health providers are paid to care for otherwise uninsured Iowans. ... The majority of able-bodied adults on Medicaid already have jobs, and many of them have full-time jobs. They are still poor enough to qualify for Medicaid. So we hope they would not be expected to pay for the drug use assessment [state Sen. Tom] Greene wants them to undergo. If illegal drug use is suspected, the individual “shall agree to participate in testing for illegal drugs,” according to the bill. (2/14)
The Roanoke (Va.) Times:
The Next Step For Rebuilding Southwest Virginia’s Economy
Too many Southwest Virginia families struggle for access to health care often out-of-reach due to cost. As a result, preventable health concerns often become serious problems causing employees to miss work and families to suffer even greater financial strain. It is time to act. Yes, many in the General Assembly have been reluctant to accept the “free” money from Washington to expand the government-run Medicaid system. ... Our neighbors in the Commonwealth of Kentucky recently enacted, with the support of the Trump Administration, the nation’s first requirement that able bodied adults receiving Medicaid assistance should work or seek opportunities to gain the work skills necessary to find and secure a job. ... This model is a path forward, and one we can support. (Del. Terry Kilgore, 2/15)
San Jose Mercury News:
Ban California Kids From Pop Warner Football
California sports advocates can no longer ignore this grim reality: Tackle football puts young children at risk of permanent brain damage. Safer alternatives, including flag football, exist. It’s time that California did away with the high-impact sport for kids until they reach high school. A good case can even be made that tackle football should be banned at all public schools. (2/15)
