Viewpoints: Ryan’s Options–And Challenges; Fighting Opioid Drugs; Paying Egg Donors

The Wall Street Journal: The Ryan Stakes: He Can Lead, But Will Enough Republicans Follow?
Republicans say they’re waiting to see if Paul Ryan will decide to lead them as House Speaker, but the better way to think about this is whether Republicans will follow Mr. Ryan if he does accept what amounts to a draft by most of the GOP conference. ... Mr. Ryan is part of the GOP’s modern growth wing, which was founded by Jack Kemp and Ronald Reagan. He has impeccable conservative policy credentials, having pushed budget and tax reform in the Tom DeLay era before the tea party existed. In 2011 he promoted Medicare reform, the most perilous issue in politics, and he rallied both House and Senate Republicans to vote for it. The left targeted Mr. Ryan’s blueprints precisely because they threaten the entitlement state. (10/20)

Forbes: If The Freedom Caucus And Paul Ryan Agree, Here's What The New House Speaker Will Do
[A] Paul Ryan-led House could work harder to put forth a replacement to Obamacare, and work with the Senate to send meaningful entitlement reform to the President’s desk. Ryan has in fact been working on an Obamacare replacement plan for some time, and has reached across the aisle to propose bipartisan Medicare reforms with Oregon Sen. Ron Wyden (D.) ... I feel for Paul Ryan. He knows there’s a good chance that his term as Speaker could go down in flames. But he also has an opportunity: to show that Republicans can govern in the political environment of the internet age. As Ronald Reagan might have advised him: If not him, who? If not now, when? (Avik Roy, 10/20)

The Philadelphia Inquirer: Of Cadillacs, Coinsurance And The ACA's Tax On Expensive Insurance Policies
There has recently been considerable criticism of the ACA’s “Cadillac tax,” which imposes a 40% levy on the excess premiums of high-cost group health plans. These are expensive plans with low cost sharing, access to the most expensive providers, and few limits on access to costly new technologies. I signed onto the statement of dozens of economists supporting the tax—not as ideal but as better than staying with the status quo. My reasons are somewhat different from those generally expressed in the debate. (Mark V. Pauly, 10/20)

The Washington Post: The CDC’s Promising Plan To Curb America’s Opioid Dependence
Horrific as it is for the victims, drug addiction’s impact reverberates beyond them, to include families, friends, whole communities. Thanks to a new Washington Post-University of Maryland poll, we can begin to quantify those wider consequences in our area. Nearly 3 in 10 Marylanders say they have a close friend or family member who was or is addicted to opiates such as prescription pain pills or heroin. The figures range from 4 in 10 in Baltimore to 1 in 6 in Montgomery County; but whether in the city or the suburbs, these numbers are far too high and fully warrant Gov. Larry Hogan’s (R) promise to focus on the problem. (10/20)

Huffington Post: 'Game-Changer' Study Says There's A Better Way To Treat Schizophrenia
A groundbreaking new study adds to a growing body of evidence that people with schizophrenia can do much better if they get the right treatment at the right time. ... A key focus of early intervention, as the name suggests, is to reach patients shortly after they first experience serious psychotic symptoms, like hearing voices or having delusions about conspiracies. That doesn’t typically happen today. It can take a year or more between the onset of psychosis and treatment. ... In countries like Australia and the United Kingdom, early intervention is becoming the standard of care -- thanks in part to decisions by government officials to pay for services through their national health insurance systems. In the U.S, with its patchwork insurance system and history of underfunding mental health care, early intervention is generally available only through small pilot programs that operate out of academic research centers and reach a fraction of the potential population. (Jonathan Cohn, 10/20)

The New York Times: Paying For Egg Donations
Should a woman who donates eggs to help people with fertility problems conceive a child be able to charge as much as she can get in a free-market transaction? Or are there ethical reasons to limit her reimbursement? That is the issue raised in a federal lawsuit that accuses two professional societies and the fertility clinics associated with them of illegal price-fixing that limits donor compensation. A federal judge in northern California has ruled that the claim can move forward and certified it as a class action, which could go to trial next year. (10/21)

USA Today: Physician-Assisted Suicide Laws Grant Dignity: Our View
Retired real estate agent Charles Selsberg, 77, was not what anyone would call an activist. But ravaged by Lou Gehrig’s disease in his dying days, Selsberg made a public plea to the Colorado legislature to legalize physician-assisted suicide. “Living with this disease is a cruelty we wouldn’t tolerate for a pet,” Selsberg wrote with his daughter’s help in a commentary for The Denver Post last year. ... Out of decency and respect for the wishes of people suffering excruciating declines, doctors should be legally allowed to assist terminally ill patients end their lives, with strict safeguards against abuse. A Gallup Poll last May found that nearly 70% of Americans agree. (10/20)

USA Today: The Vulnerable Will Be The Victims: Opposing View
California required legislative sleight of hand to pass physician-assisted suicide in a special legislative session that bypassed committee votes. This broke a string of defeats — even in liberal states such as Massachusetts, Connecticut, New Jersey and previously in California. ... Oregon reports that pain doesn’t even make the top five reasons people seek doctor-assisted suicide. Instead, people are afraid of losing autonomy and dignity. Notably, they’re afraid of becoming a burden on others. In the face of a youth-worshiping country that marginalizes the sick and dying, we should resist making the vulnerable feel like a burden — not make it easier for them to kill themselves. Dignity doesn’t come from the illusion of power and control, but from mutual dependence and love. (Charles C. Camosy, 10/20)

The Philadelphia Inquirer: Dramatic Change To Medical Culture
California has joined four other states allowing physicians to write lethal prescriptions that dying patients can administer to themselves. Oregon was the first, blazing that trail in 1997. But with only five state "victories" in nearly 20 years, you can't really call physician-assisted suicide legislation a trend. Indeed, there is a lot of public resistance to it. Why? There is widespread concern that embracing physician-assisted suicide will change the culture of medicine and the nature of the doctor-patient relationship, as well as undermine the country's longstanding value for the sanctity of life. (Merrill Matthews, 10/20)