Viewpoints: Protect Pregnant Women’s Jobs; Eye-Opening Calorie Counts; Return Of Measles

Los Angeles Times: Supreme Court Should Affirm The Rights Of Pregnant Workers
In September 2006, a pregnant woman named Peggy Young sent her bosses at United Parcel Service a doctor's note advising her not to lift anything heavier than 20 pounds for the first 20 weeks of her pregnancy, and then no more than 10 pounds until she gave birth. ... Young was told she couldn't continue to work as a delivery driver while pregnant. UPS also rejected Young's request for a temporary reassignment to duties with less physical stress. ... Women should not be penalized or forced out of the workplace simply because they become pregnant. UPS, in fact, has come around to that position. It now offers light-duty accommodations to pregnant women who need them. At the very least, the Supreme Court should rule that pregnant women deserve to be treated as well as workers who are injured on the job. (12/3)

Los Angeles Times: Will Supreme Court Endorse Discrimination Against Pregnant Workers?
In some ways, the pregnancy discrimination case argued today at the U.S. Supreme Court has turned out to be a beautiful thing. Groups that are usually at each other’s throats over reproductive rights are working together to persuade the justices that women should not be penalized by their employers when a pregnancy temporarily limits their ability to perform all aspects of a job. (Robin Abcarian, 12/3)

Los Angeles Times: How Big Is The Supreme Court Threat To The ACA? Very Big.
Some experts have counseled a zen-like patience while awaiting the Supreme Court's consideration of the King case, which involves federal subsidies for Affordable Care Act insurance plans and is expected to yield a decision sometime in July. We've observed that the prospect of subsidies being overturned in as many as three dozen states could or should spur action in those states, or in Congress, to head off the consequences. Julie Rovner of Kaiser Health News has made her own tour d'horizon of expert opinion, and finds that things may not be so simple. An adverse ruling by the Court could be very hard to counteract in the affected states, she finds. That's worrisome, especially because the data showing the effects of the ACA are very encouraging. (Michael Hiltzik, 12/3)

The New York Times' The Upshot: Good News Inside The Health Spending Numbers
Inside the continuing slowdown in the growth in health spending is evidence that the American health care system may be changing in ways that could make it more affordable in the years to come. (Margot Sanger-Katz, 12/3)

The Wall Street Journal: The Two Faces Of Chuck Schumer
Whatever else might be said of him, Chuck Schumer is not in the habit of self-immolation. But progressives have been lining up to vilify New York’s senior senator as the Democratic Party’s village idiot for saying before Thanksgiving that ObamaCare was a political mistake. He even said that focusing on health care, the party’s magic mountain, was “the wrong problem.” David Axelrod accused Sen. Schumer of being, ugh, a professional politician, whose “abiding principle” is how to win elections. That’s an understatement. (Daniel Henninger, 12/3)

Los Angeles Times: Did Obamacare Destroy The Democratic Party? Another Look
Was heathcare reform a fatal political blunder by the Democratic Party? That thesis of Sen. Charles Schumer of New York, the third-ranking Democrat in the Senate, received a respectful airing this week from the veteran political journalist and New York Times columnist Thomas B. Edsall. Edsall observes that hostility to Obamacare from white voters is a menacing counterweight to the party's demographic advantages in the next presidential election. "Whatever you think of Senator Schumer," he writes, "you begin to understand why he spoke out as forcefully as he did." (Michael Hiltzik, 12/3)

The Wall Street Journal: A Bad Provision Even By ObamaCare Standards
In the four years since the Affordable Care Act was passed, health care in our country has become more complicated and expensive. The law has many troubling aspects, but the Independent Payment Advisory Board is among the worst and most dangerous. This is why, on Thursday, several members of the House will file an amicus brief asking the U.S. Supreme Court to take up Coons v. Lew. This lawsuit, filed by the Goldwater Institute on behalf of Dr. Eric Novack, an orthopedic surgeon, and Nick Coons, an Arizona businessman, challenges the constitutionality of IPAB. (Sen. Tom Coburn, R-Okla., and Rep. Phil Roe, R-Tenn., 12/3)

Los Angeles Times: 1,500 Calories In A Salad? New Calorie Posting Rules Will Be Eye-Openers
It's 's not always easy for restaurant-goers to figure out which options are the least fattening. Some diners at a California Pizza Kitchen, for example, might order the Moroccan-spiced chicken salad rather than a pizza, unaware that the salad packs 1,500 calories — three-fourths of the recommended allowance of calories for the average adult in an entire day. Few people would guess that pretty much any pizza on the CPK menu has significantly fewer calories, or that the restaurant offers a different salad with chicken that contains about half as many. (12/3)

The New York Times: Mental Illness And Guns At Newtown
The tragedy of the 20 schoolchildren and six educators massacred in Newtown, Conn., two years ago has only deepened with a state investigation’s finding that the mother of Adam Lanza, the 20-year-old shooter, rejected recommendations from psychiatric experts that her son be treated with medication and intense therapy for obsessive-compulsive disorder, anxiety and anorexia in years before the carnage at Sandy Hook Elementary School. (12/3)

The Wall Street Journal: The Measles Outbreak Coming Near You
I was working on the hospital infectious-disease service when our team was asked to see a young girl with a mysterious illness that no one had been able to diagnose. She had come to the emergency room with a fever and runny nose and had a rash spreading across her body. ... But when the senior doctor on our team, Frank Berkowitz, an expert in pediatric infections—arrived at her room, he knew the diagnosis immediately: She had measles. ... Measles is making a terrifying comeback in the U.S., with some 600 cases reported this year, more than in any year in the past two decades. There are two reasons: the ease of international travel, and an increasing number of people refusing vaccinations, usually on behalf of their children. (Haider Javed Warraich, 12/3)

The (Columbia, S.C.) State: Medicaid’s New Dental Plan Will Improve Overall Health
Volunteer dentists and hygienists at the Dental Access Days clinic saw more than 1,400 patients and gave away more than $950,000 in care. If not for these free care clinics, many of these individuals would be seeking help at hospital emergency departments. Between 1.3 percent and 2.7 percent of all ER visits nationwide that don’t result in a hospital admission are dental emergencies, according to a 2010 Health Resources and Services Administration report. ... On Monday, the S.C. Department of Health and Human Services implemented an adult preventive dental benefit for members age 21 and older who have full Healthy Connections benefits. Covered services include preventive care such as cleanings, minor fillings and x-rays. These most common services help catch disease early and keep mouths healthy. (Rebekah Matthews, 12/4)

news@JAMA: Choosing Wisely: Changing Clinicians, Patients Or Policies?
As a nurse, I know to rely on primary care providers who understand my health risks and will talk with me about what tests and treatments I should avoid, as well as those I need. But what do people do who are not health professionals? Choosing Wisely (www.choosingwisely.org), an initiative of the American Board of Internal Medicine Foundation, is designed to spark conversations among patients, physicians, and other health professionals about appropriate tests and procedures—those “supported by evidence, not duplicative of other tests or procedures already received, free from harm, and truly necessary.” That sounds like common sense, but our system doesn’t always support a common-sense approach. (Diana Mason, 12/3)

The New England Journal Of Medicine: Clinic–Community Linkages For High-Value Care
Although complex interactions between neighborhood-level determinants of health and individual patient characteristics occur primarily outside the delivery system, they have a profound effect on how patients interact with the system and ultimately on the quality of the care they receive and their health outcomes. The likelihood of hospital readmissions, for example, depends more on characteristics of individual patients and the surrounding community than on features of the discharging hospital. A promising approach to achieving this linkage is community-based performance measurement — reporting and acting on clinical performance measures at the community level, rather than at the level of delivery-system units such as hospitals or physicians. (Drs. Thomas D. Sequist, and Elsie M. Taveras, 12/4)

The New England Journal Of Medicine: Reimagining Quality Measurement
[T]he time has come to reimagine quality measurement. ... quality measurement should be integrated with care delivery rather than existing as a parallel, separate enterprise; it should acknowledge and address the challenges that confront doctors every day — common and uncommon diseases, patients with multiple coexisting illnesses, and efficient management of symptoms even when diagnosis is uncertain; and it should reflect individual patients' preferences and goals for treatment (Elizabeth A. McGlynn, Eric C. Schneider and Eve A. Kerr, 12/4)