Viewpoints: Trump And Obamacare; What Will Become Of Medicare?

Bloomberg: Trump's Warning On Obamacare 
Trump says he wants to replace Obamacare (most of it, anyway) with some arrangement of longstanding Republican proposals. Those include expanding health savings accounts, which let people set aside money tax-free; letting people buy health insurance across state lines, even if doesn’t comply with their own state’s rules; and creating state-run, high-risk pools of subsidized insurance for people who can’t buy private coverage. ... Those proposals, taken by themselves, aren’t objectionable. The question is whether they amount to a “replacement” of Obamacare. And that question turns on a deeper one about the goal of health-care reform. (11/15)

Bloomberg: Obamacare: What's Working, What Isn't
The Republican president-elect has vowed to move quickly to repeal Obamacare, which he has repeatedly called “a total disaster,” and replace it with a more modest plan. Democrats in the Senate say they'll do their best to block any bill to tear down President Barack Obama’s signature achievement. Before that fight is fully joined, it’s worth reviewing what the law has and hasn’t done to meet its sweeping goals: to give more people health insurance while reshaping a medical system that spends more and delivers less than that of any other wealthy country. (Zachary Tracer, 11/15)

RealClear Health: Raising The Insured Rate Without Obamacare
In 2010 President Obama bucked popular opinion and the unanimous opposition of the Republican Party to fundamentally change the U.S. healthcare system by passing the Affordable Care Act (ACA), popularly known as Obamacare. The primary rationale for the legislation was to lower the number of Americans who lacked health insurance coverage. In that regard the ACA was a success — an estimated 20 million Americans have gained health insurance (although the White House had originally predicted 32 million would gain coverage). But an article in the New England Journal of Medicine by one of the legislation’s chief architects, economist Jonathan Gruber, holds an important message for the next president — much of the reduction in the uninsured could have been accomplished without the upheaval of the ACA. (Joel Zinberg, 11/16)

Modern Healthcare: Belying Their Rapid-Repeal Rhetoric, Republicans Worry About ACA Political Fallout
No one knows for sure what President-elect Donald Trump and congressional Republican leaders are going to do about repealing and replacing the Affordable Care Act when they take power in January. But that isn't stopping everyone from speculating non-stop and offering advice. (Harris Meyer, 11/14)

The Washington Post: Paul Ryan’s Plan To Phase Out Medicare Is Just What Democrats Need
Democrats have been feeling many emotions over the last week — anguish, fear, rage, and despair, for starters. Now that their heads are clearing enough to begin asking themselves how they can mount an effective opposition to Donald Trump and the Republican Congress over the next four years. One of the first tasks is to find a battle to fight. It isn’t enough to just pick up the paper or check the internet in the morning and be horrified at whatever new appointments Trump is contemplating; for Democrats to regain their focus, they need a specific controversy around which they can organize and potentially notch a win. And it looks like they may have found it. I’m speaking of Paul Ryan’s wish to privatize Medicare, or phase it out, depending on how you want to look at it. (Paul Waldman, 11/15)

Stat: True Value-Based Care Is A Trillion-Dollar Unicorn For The Health Care Industry
Value-based care isn’t a new concept. But it’s been used a bit bashfully, traditionally referring to carrot-and-stick-based incentive payments and penalties for physicians. Today these pale in comparison to the fee-for-service care that rewards reactive, episodic, paternalistic care — and lots of it. Here’s what I mean by true value-based care: fully capitated payment contracts in which a lump sum of money is available to treat a patient over the course of a year. No penalties or incentives, simply ownership of the total cost of care and the total cost of outcomes. The better the care, the more money the organization bearing the risk receives. This is how to best reward exceedingly efficient, effective health care. (Chris Storer, 11/15)

Louisville Courier-Journal: Diabetes Is Beating Us
Statistics show that one out of every eight or nine of us in Kentucky has diabetes. Tens of thousands more are on track to get it. The crisis here, which is a pandemic around the world, begs for action. Great health care professionals give special care to people and families with diabetes every day. We honor them during this month of diabetes awareness. (Bob Babbage and Stewart Perry, 11/15)

Orlando Sentinel: Put Patients Above Politics: Medical Marijuana In Florida 
The Florida Department of Health has intimated that, come January, patients who did not previously qualify, but do under Amendment 2, will be able to access medical cannabis very quickly. What remains unclear is both how that will work and if the existing "Dispensing Organizations" — a term that doesn't exist in Amendment 2 — will be able to fulfill even that initial demand. (Michael Bronstein, 11/16)

Miami Herald: Medical Marijuana Needs A ‘Road Map’
Like many of my neighbors, I was among the 6.5 million Floridians who voted to legalize medical marijuana on Nov. 8. People suffering from chronic illness should have access to a substance proven to relieve symptoms. As an elected official responsible for protecting the public’s health, quality of life and economy, I believe we must welcome medical marijuana in Miami Beach sensibly and safely. (Ricky Arriola, 11/15)

Boston Globe: 5 Ways To Fix The Bad Pot Law Just Passed
Congratulations Massachusetts, we just passed one of the worst pot bills in the country. ... Here’s the problem, which my colleague Joan Vennochi also warned about: This is a law written by the marijuana industry, and it’s got their best interests, not ours, in mind. (Shirley Leung, 11/16)

Orlando Sentinel: PTSD Clinic For Vets Running Out Of Funds 
This week, the struggles are apparent at a UCF clinic where psychologists are having remarkable success helping veterans deal with the psychological scars of war — but who fear for the clinic's future. The clinic, you see, is running out of money. (Scott Maxwell, 11/16)