Viewpoints: Ryan’s Big Failure: Not Cutting Health Care Costs; GOP Mounts End Run Around Obamacare Even While ACA’s Popularity Grows

Los Angeles Times: Paul Ryan Came In As A 'Young Gun' With Big Ideas. He'll Leave As A Pushover
But when it came to translating ideas into law, many of Ryan's ambitious proposals never made it past the roadmap stage. That's particularly true of his signature issue, entitlement reform. Members of Congress who were ready and willing to vote for nonbinding, conceptual 10-year plans to wind down the federal deficit by slashing tens of billions of dollars from Medicare and safety-net programs weren't quite so eager to take up the legislation necessary to put such changes into law. ...Instead, Ryan's main accomplishments as speaker — slashing tax rates and busting open the budget caps he helped negotiate in 2011 — are the legislative equivalent of skipping dinner and going straight to dessert. Such costly acts of largesse are a piece of cake in comparison to the tough work of overhauling immigration laws or reining in healthcare costs.(4/11)

St. Louis Post Dispatch: Paul Ryan, Budget Hawk Turned Deficit Buster, Pulls The Rip Cord
The good news, such as it is, is that Ryan won’t be around to argue that the deficits he helped create must be fixed by cutting Medicare and Medicaid. Ryan made his reputation as a policy wonk with lengthy “road maps” designed to reform entitlement programs. His ideas included turning Medicaid into a capped block grant program and giving seniors vouchers for private health insurance in place of traditional Medicare. He wasn’t wrong that growth in health care spending is driving the nation’s budget problems. He was wrong in thinking that tax cuts heavily weighted to wealthy Americans and corporations would create enough growth to pay for themselves and everything else the government has to do. (4/11)

The New York Times: Republicans Couldn’t Knock Down Obamacare. So They’re Finding Ways Around It.
The Trump administration has always seen Obamacare as an abominable roadblock to the less regulated insurance market it prefers. Last year, it tried to knock it down and failed. Now, it’s building a set of detours. More customers who want to avoid buying health insurance can now find a way out of the law’s individual-mandate penalty, which will disappear completely next year. Those who want skimpy plans not covering maternity care or bills exceeding a set annual amount may soon have that option in many states — provided they don’t have pre-existing conditions. (Margot Sanger-Katz, 4/11)

Axios: The Left Is Getting More Active On Health Care
Activism and political protest is on the rise on the left in the U.S., and support for the Affordable Care Act is one of the biggest issues motivating the protesters, according to the latest survey on activism and protest by the Kaiser Family Foundation and the Washington Post. Why it matters: It's a reversal from the last election cycle, when public opinion about the ACA was more negative than positive and Tea Party protests against the ACA were commonplace. It's clear that the political energy in health is switching from right to left. (Drew Altman, 4/12)

The Wall Street Journal: Do What Works To Help Welfare Recipients Work
President Trump issued an executive order Tuesday encouraging federal agencies to adopt more-stringent work requirements for various welfare programs. What can Congress do to encourage work? Two possibilities are increasing the minimum wage and expanding the earned-income tax credit. My recent research shows that these two policies can have very different, and perhaps unintended, effects on the ability to become economically self-sufficient over time. (David Neumark, 4/11)

The Wall Street Journal: Working On Food Stamps
A common refrain from businesses is that they can’t find enough workers. The unemployment rate is a low 4.1%, but one reason for the shortage are government benefits that corrode a culture of work. So credit to House Republicans for trying to fix disincentives in food stamps amid what are sure to be nasty and dishonest attacks. (4/11)

USA Today: Food Stamp Work Requirements Will Lift Americans Out Of Poverty
People want to believe the American dream is attainable. That’s why we need to shift the conversation on poverty in this country from one focused purely on benefits to one about improving futures. And as the House Agriculture Committee releases its new farm bill — legislation that governs the policy for our nation’s nutrition programs — that is precisely what we aim to do. Our proposal is straightforward: help those on the Supplemental Nutrition Assistance Program (SNAP) who are work-capable find employment to support their households. (Rep. Mike Conaway and Lee Bowes, 4/12)

NH Times Union: What Trump Gets Right And Wrong About Opioid Crisis
President Trump has it partially right on the opioid crisis, specifically with his plans to hold drug companies responsible and increase spending on treatment. But like much of America, the President has it wrong on the root causes of addiction and just how we should attack it. The death penalty won’t deter drug dealers. And scary TV ads won’t deter addicts. Addiction doesn’t listen to reason and drug dealers don’t decide whether to make money or not based on the potential penalty they could face if caught. We need to start thinking about addiction differently. (Eric Spofford, 4/11)

Chicago Tribune: Overdose Deaths Are The Product Of Drug Prohibition
During Prohibition, drinkers never knew what they would get when they set out to slake their thirst. Bootleggers often sold products adulterated with industrial alcohol and other toxins. Some 10,000 people were fatally poisoned before America gave up this grand experiment in suppressing vice. So it was a tragedy but not a total surprise when three deaths were reported in Illinois from synthetic marijuana laced with an ingredient (possibly rat poison) that caused severe bleeding. Nationally, in 2015, says the Drug Policy Alliance, “poison control centers received just under 10,000 calls reporting adverse reactions to synthetic cannabinoids, and emergency rooms received tens of thousands of patients.” People consume synthetic cannabis for the same reason people once consumed bathtub gin: Their drug of choice is illegal. (Steve Chapman, 4/11)

JAMA: Association Of Medical And Adult-Use Marijuana Laws With Opioid Prescribing For Medicaid Enrollees
Medical and adult-use marijuana laws have the potential to lower opioid prescribing for Medicaid enrollees, a high-risk population for chronic pain, opioid use disorder, and opioid overdose, and marijuana liberalization may serve as a component of a comprehensive package to tackle the opioid epidemic. (4/2)

JAMA: Association Between US State Medical Cannabis Laws And Opioid Prescribing In The Medicare Part D Population
This longitudinal analysis of Medicare Part D found that prescriptions filled for all opioids decreased by 2.11 million daily doses per year from an average of 23.08 million daily doses per year when a state instituted any medical cannabis law. Prescriptions for all opioids decreased by 3.742 million daily doses per year when medical cannabis dispensaries opened. Meaning: Medical cannabis policies may be one mechanism that can encourage lower prescription opioid use and serve as a harm abatement tool in the opioid crisis. (4/2)

The New York Times: To Save Abortion Rights, We Have To Think Beyond Roe
When Gov. Phil Bryant of Mississippi, a 53-year-old Republican man, delivered his State of the State address in 2014, he said, “On this unfortunate anniversary of Roe v. Wade, my goal is to end abortion in Mississippi.” Last month, Bryant signed into law the Gestational Age Act, which bans abortion after 15 weeks (when the fetus is about four inches long and, according to the pregnancy resource “What to Expect,” “the eyes are moving from the sides of the head to the front of the face”) “except in medical emergency and in cases of severe fetal abnormality,” making no exception for rape or incest. A judge has temporarily blocked the law, citing its “dubious constitutionality.” (Lindy West, 4/11)

Stat: What Facebook's Public Scrutiny Can Teach Us About AI In Health Care
[T]he recent firestorm over Facebook’s involvement in the Cambridge Analytica scandal is less about the data breach and more about the right to privacy and the limits to that right. It is also highlighting the ethical conflicts of implementing artificial intelligence without thoroughly considering societal norms. This scandal has some important bioethics lessons for health care leaders who are building machine learning and artificial intelligence models for clinical decision-making. The biggest bioethical challenge in building these models is how we prevent algorithms from imitating human biases in decision-making. (Junaid Nabi, 4/11)

USA Today: End-Of-Life Care Is The Same Whatever Your Doctor's Political Views
We combined data on political donations made by physicians with data on the type of care they provide to Medicare patients at the end of life, and found no differences in the end-of-life care patients receive depending on the political affiliation of the doctor treating them. Among patients who die in the hospital, patients treated by Republican doctors don’t get more feeding or breathing tubes, don’t receive dialysis more often and don’t have higher end-of-life spending compared to patients treated by Democratic doctors. For patients who survive hospitalization but are expected to die within months, those treated by Democratic doctors aren’t any less likely to be discharged from the hospital directly to hospice care. Total end-of-life medical spending is the same whether doctors are Democrats, Republicans or neither. (Dhruv Khullar and Anupam B. Jena, 4/12)

The Hill: ​An Evidence-Based Approach To The Tobacco Conundrum
The path to successful innovation is never easy, especially in hotly controversial industries.  The Food and Drug Administration (FDA) is now considering whether to approve the first of a new  generation of tobacco products, one designed to heat rather than burn tobacco. This technology produces far less inhalation of harmful chemicals than cigarettes, making it an attractive and safer alternative for current smokers. The purist elites in the tobacco wars of the past 25 years will do anything to prevent advancement and innovation from tobacco companies. Tobacco is harmful, but when blocking the use of less harmful products are the purists tossing the baby out with the bathwater? (Lindsay Mark Lewis, 4/11)