Morning Briefing
Summaries of health policy coverage from major news organizations
Viewpoints: Trump, Clinton And Thoughts About Health Care; Changing Views On Disability
Forbes: Divided On Obamacare, Trump And Clinton Both Threaten Medical Innovation
The recently announced 25 percent rise in Obamacare health insurance premiums has brought renewed attention to health policy. As this is my last column before Election Day, it is time to review how the presidential candidates would address the continuing challenge of skyrocketing health costs. (John Graham, 11/2)
Los Angeles Times: Hey, Democrats — Donald Trump Has Some Good Ideas For Healthcare Reform
Donald Trump and running mate Mike Pence talked about their plans for the U.S. healthcare system again this week, beginning where Republicans usually begin: by calling for the complete repeal of the 2010 Patient Protection and Affordable Care Act, better known as Obamacare. But to get where they say they want to go — providing more affordable health coverage for more Americans — they would be better off skipping that step and moving on to other elements of their plan. That’s because their overall plan isn't fundamentally sound, but several of its planks could help shore up weaknesses in Obamacare. (Jon Healey, 11/3)
Cleveland Plain Dealer: Blunt The Suicide Risk Among Medical Students With More Mental Health, Other Supports
Medical students are more at risk of committing suicide than their same-aged peers given that they are 15 percent to 30 percent more likely to meet the diagnostic criteria for depression. (Lisa M. Meeks, 11/2)
The New York Times: Trump Probably Avoided His Medicare Taxes, Too
In the final debate, Hillary Clinton said she would secure Social Security and Medicare by raising taxes on high-income earners, including herself and her opponent, Donald J. Trump, “assuming he can’t figure out how to get out of it.” As we’ve learned in the past few weeks, Mr. Trump has used all kinds of extravagant maneuvers to get out of paying taxes. Without Mr. Trump’s returns, we can’t know for certain whether he figured out a way to get out of paying into Medicare and Social Security. But we have some clues. (Fred T. Goldberg and Michael J. Graetz, 11/2)
JAMA: Moving From Disability To Possibility
When I was in the first grade, an astute teacher noticed that I had trouble seeing the blackboard. This finding was quickly confirmed by a vision test. Formal evaluation by an ophthalmologist revealed that I had a rare degenerative retinal disease. Worse than that diagnosis was the ophthalmologist’s devastating prognosis for my life: attending college would be very challenging, sports and certain activities would be difficult or impossible, and it was unlikely that I would ever have a professional career. (Kurt R. Herzer, 11/1)
JAMA: The New CMS Hospital Quality Star Ratings
On July 27, 2016, the Centers for Medicare & Medicaid Services (CMS) released the controversial Overall Hospital Quality Star Ratings, despite concerns raised by hospitals and Congress that CMS had not provided enough details regarding the methodology, shared the underlying data, or responded adequately to comments from various stakeholders. Federal legislation has now been introduced to have CMS take down the Star Ratings. ... It is especially important that CMS’ rating system demonstrate merit, given its potential influence. However, the CMS Star Ratings have several shortcomings, with the potential risk of doing more harm than good unless careful revision is undertaken. (Karl Y. Bilimoria and Cynthia Barnard, 11/1)
Boston Globe: Medicine Has A Long History Of Failing Black People. Let’s Change That
As in policing, African-American health has historically been at the mercy of white power and privilege. Perhaps the most infamous abuse remains the 40-year-long Tuskegee “study,” during which the United States Public Health Service dishonestly withheld medical treatment from black sharecroppers ravaged by syphilis, simply to observe how the disease progressed. When the truth was finally revealed in the 1970s and the program ended, the deception of researchers only confirmed the suspicion many blacks held toward medical institutions. (Sushrut Jangi, 11/2)
JAMA Forum: Partnering With Nurses To Transform Primary Care
Thomas Sinsky, MD, a primary care internist in Iowa, was burning out. The complexity and intensity of work required for each patient seemed to grow exponentially over the years. The demands of managing prevention, acute and chronic illnesses, phone calls, emails, faxes, prescriptions, forms, and quality measures left him exhausted and unsatisfied. Fortunately, working along with his wife, a fellow internist, and their nurses, they were able to transform their practice into a team-based care model. (Diana Mason, 11/1)
RealClear Health: Increasing ACA Premiums: The Real Drivers Of Cost Aren't Being Addressed
With political candidates sparring about the 25 percent increased premiums for Affordable Care Act (ACA) insurance plans, the questions of why has this occurred and how we can ameliorate it are bouncing around the media. As a primary care doctor, the answers to these questions reveal themselves every day in my office. While it is convenient to demonize the ACA, insurance companies, and even Big Pharma, the actual cause is related to flawed assumptions and rules within our health care delivery system. One just has to see where insurance pays its money to understand how to fix the problem. (Andy Lazris, 11/2)
Modern Healthcare: As Enrollment Opens, Some Consumers Look For Loopholes To Avoid Higher Premiums
Now, because of the rising 2017 rates, most of [insurance broker David] Taxer's clients who have incomes too high to qualify for ACA premium tax credits are buying cheaper, short-term health plans that do not comply with ACA rules. In the Portland area, rates for these plans, which can run for up to 364 days, are $500 to $600 a month, about half the price of ACA-compliant plans, whose premiums are up 10% to 30% for 2017. These short-term plans often have broader provider networks. But insurers can turn down applicants with pre-existing health conditions, and the benefits can be much more limited than in ACA-compliant plans. Consumer advocates warn that such products offer tenuous financial protection. (Harris Meyer, 11/2)
JAMA: Opioids Out, Cannabis In
With the current nationwide epidemic of opioid abuse, dependence, and fatalities, clinicians are being asked by federal agencies and professional societies to control their prescribing of narcotic medications for pain. Federal guidelines emphasize tapering, discontinuing, and limiting initiation of these drugs except in provision of end-of-life care. Reducing reliance on opioids, however, is a massive task. According to one estimate, more than 650 000 opioid prescriptions are dispensed each day in the United States. Unless the nation develops an increased tolerance to chronic pain, reduction in opioid prescribing leaves a vacuum that will be filled with other therapies. (Esther K. Choo, Sarah W. Feldstein Ewing and Travis I. Lovejoy, 11/1)
St. Louis Post-Dispatch: Amendment 3: A Choice Between Cheap Cigarettes Or Kids
Unfortunately, there is a considerable amount of inaccurate information being circulated about Amendment 3, the initiative petition to increase investments in early childhood health and education through a 60-cent-per-pack increase on cigarettes. ... The primary opposition to Amendment 3 is being driven by the cheap cigarette industry and for good reason. They have a lot to lose. They are being subsidized by Missouri’s taxpayers to the tune of $80 million every year. (Melissa Randol, 11/3)
