Viewpoints: Revamp Medicare’s 3-Day Hospital Rule; Setting A Fair Price For Specialty Drugs
A selection of opinions on health care from around the country.
Pittsburgh Post-Gazette:
Worn-Out Rule: Medicare Should Rethink Its 3-Day Hospital Stay
Fifty years ago hospital stays were longer, patient outcomes weren’t as good and health care in general was riskier business. So why does Medicare cling to a rule from 1965 that requires people to stay in the hospital for three days as an inpatient before being transferred to a skilled nursing care facility? That’s the question being raised by a study that was published last week in the journal Health Affairs and led by Amal N. Trivedi, a professor at Brown University. (8/14)
The Washington Post's Right Turn:
Underestimating Kasich At Their Peril
The MSM discounted him because he ran before and didn’t win, is not heavily financed and does not fit the model of a Republican conservative. His opponents don’t take him seriously because he has a “Medicaid” problem, they intone (he expanded Medicaid, a no-no in conservative circles), and has a somewhat hyper-active personality, deemed, they sniff, not presidential. Well, lo and behold, he had a terrific debate outing and is surging in the polls. What’s his secret? (Jennifer Rubin, 8/13)
The New York Times' The Upshot:
Donald Trump, Moderate Republican
Instead of promoting his ideological purity, he notes that policy choices are circumstance-specific. For example, he’s not a priori opposed to single-payer health care. “It works in Canada,” he said at the first Republican presidential debate on Aug. 6. “It works incredibly well in Scotland.” Even in the United States, “it could have worked in a different age,” but it wouldn’t work very well right now, he said. So instead, he’d replace Obamacare with “something terrific,” which would take care of people who can’t afford health insurance. (Josh Barro, 8/14)
The New York Times:
Trump’s Economic Muddle
At times, Mr. Trump goes on the attack without actually disagreeing. The Affordable Care Act should be abolished, but his suggested replacement bears considerable resemblance to President Obama’s plan. He has pushed for even greater involvement by government in health care, praising the single-payer models of Canada and Scotland. I guess a foolish inconsistency can also be the hobgoblin of a big mind. (Steven Rattner, 8/14)
news@JAMA:
Probing Our Moral Values In Health Care: The Pricing Of Specialty Drugs
The government faces a tricky trade-off in bringing countervailing power to the market for specialty drugs, weighing the social opportunity costs of ever-higher health spending vs the reality that prices of new drugs should be high enough to encourage private investors to foster medical innovation. Investors’ compensation should help them not only recover their outlays for developing new products but also include a premium for assuming the financial risk that such investments may not pay off. A lively debate can be had over how high that compensation for financial risk should be. When considering the financial risks of investors, one might gain some perspective through contemplating how we compensate others who assume risk on society’s behalf, such as police officers, firefighters, or members of the armed forces. (Uwe Reinhardt, 8/13)
The New York Times' Opinionator:
Zen And The Art Of Dying Well
What is the “right” way to die? We’re experiencing a zeitgeist moment about that. “Being Mortal: Medicine and What Matters in the End,” by Atul Gawande, is a best-selling book. Videos by Brittany Maynard, a 29-year-old who wanted to die in a way of her own choosing, went viral last year. ... What if the most promising way to fix the system is to actually do less for the dying? That’s what the not-for-profit Zen Hospice Project has been trying to prove through a fascinating, small-scale experiment in San Francisco’s Hayes Valley neighborhood. (Courtney E. Martin, 8/14)
Huffington Post:
New Report Confirms What The GOP Won't Admit: Obamacare Is Working
When Republicans carry on about what a “disaster” the Affordable Care Act is, they rarely acknowledge that the law is helping millions of people get health insurance. But we don’t need Republicans to tell us these things. We have data. And now we have some more. The U.S. Centers for Disease Control and Prevention on Wednesday released the latest results of the National Health Interview Survey. According to the survey, just 9.2 percent of the population, or about 29 million people, had no coverage during the first three months of 2015. That’s down from 11.5 percent in 2014, 14.4 percent in 2013, and 16 percent back in 2010. (Jonathan Cohn, 8/12)
JAMA:
The Potential Hazards Of Hospital Consolidation
With the current most substantial consolidation of health care in US history, the concerning implications of the trend of hospital consolidation on quality, access, and price must be carefully considered. ... 85% of US hospitals pay no taxes because they are designated as nonprofit organizations serving a public good. Hospitals can set prices that are ultimately passed on to others in the form of escalating insurance deductibles and taxes. The good work of integrated hospitals should continue to create networks of coordinated care, while at the same time, physicians and patients should insist that hospitals compete on transparent prices and quality outcomes. Achieving this goal is an important prerequisite to a functional health care system. (Tim Xu, Albert W. Wu and Martin A. Makary, 8/13)
The New England Journal:
The Paternalism Preference — Choosing Unshared Decision Making
Patients are exhorted to empower themselves with information to make wise choices, whether selecting hospitals or deciding how they'll die. ... Clearly, patients should have access to all available information, from their medical records to anticipated costs of care. But that it's wrong to deny anyone information doesn't make it right to always provide as much as possible. Might there, in fact, be such a thing in medicine as Too Much Information? (Lisa Rosenbaum, 8/12)
