Viewpoints: Where Medicaid Goes From Here; How Best To Fix The Health System

The Wall Street Journal: Give Medicaid Dollars Directly To Patients
As Republicans take another crack at devising a plan to replace ObamaCare, here’s an idea they should consider: Give each Medicaid patient a health savings account — and put $7,000 in it every year. Under ObamaCare, Medicaid has become the only option for millions of Americans. But that doesn’t mean much if the doctors in their communities don’t accept new patients through the program — and 30% of physicians don’t. (Justin Haskins and Michael Hamilton, 4/13)

The Atlantic: How GOP Voters Are Getting In The Way Of A Medicaid Rollback
President Trump on Wednesday signaled his determination to mount another drive to repeal the Affordable Care Act, but he faces a surprising obstacle: unexpectedly widespread Republican resistance to cutting Medicaid. That hesitation, following decades of GOP efforts to retrench the program, powerfully demonstrates how the party’s growing reliance on economically strained and older white voters is disrupting its ideological compass. (Ronald Brownstein, 4/13)

The Washington Post: What The Freedom Caucus Stands For
Rep. Mark Meadows, a North Carolina Republican, is an unlikely object of the caterwauling recently directed at him and the House Freedom Caucus he leads. The vituperation was occasioned by the HFC’s role rescuing Republicans from embracing an unpopular first draft of legislation to replace Obamacare. ... Although just a little over two years old, the HFC signals a revival of congressional resistance to the dangerous waxing of executive power under presidents of both parties. The HFC is a rarity, a heartening political development: People giving priority to their legislative craft and institution rather than to a president of their party barking at them. (George Will, 4/12)

Sacramento Bee: Here’s A Bipartisan Approach Of Simple Fixes To Reform Health Care 
If Obamacare is here “for the foreseeable future,” as [House Speaker Paul] Ryan forecasts, there are some simple fixes that can make a big difference. For the 20 million Americans who depend on the individual health insurance marketplace for their coverage, inaction is unacceptable. (John Kabateck and David Panush, 4/12)

JAMA: Vital Directions And National Will
If the United States had undertaken road building or space exploration in the same way it is chasing health system reform, there would be neither an interstate highway system nor footprints on the moon. The successes depended on clear, bold, shared aims; strong investments in technical mastery; continuity of purpose over time; and continual learning at a large scale — not to mention considerable celebration. Health care reform has had none of these. The reasons for the difference are many. The National Aeronautics and Space Administration (NASA) undoubtedly faced political headwinds, but they were not gale force, because NASA was not dealing with $3 trillion of the US economy, a panoply of stakeholders with financial interests in the status quo of health care, professional fragmentation, or a viciously complicated legacy payment system designed by no one at all. (Donald M Berwick, 4/11)

The Des Moines Register: Branstad's Private Medicaid 'Success' That Wasn't
Gov. Terry Branstad doesn’t have much to say about problems caused by his privatization of Medicaid. Low-income Iowans report losing health services. Providers are not being paid by managed care companies. The origins of the governor’s “savings” estimates remain a mystery. Taxpayers don’t understand why they’re bailing out for-profit insurers contracted with the state. (4/12)

The New York Times: Answer To Better Health Care: Behavioral Economics?
Consider the following. I’m a physician at the end of more than a decade of training. I’ve dissected cadavers in anatomy lab. I’ve pored over tomes on the physiology of disease. I’ve treated thousands of patients with ailments as varied as hemorrhoids and cancer. And yet the way I care for patients often has less to do with the medical science I’ve spent my career absorbing than with habits, environmental cues and other subtle nudges that I think little about. (Dhruv Khullar, 4/13)

The Wall Street Journal: Cut This One Regulation–And Save $500 Million In Health-Care Costs
Johns Hopkins ophthalmologist Oliver Schein has found a simple way to save a half a billion dollars a year from our country’s health-care bill, with no negative effect on patient health.  The only thing standing in the way is a stubborn government requirement. (Peter Pronovost, 4/11)

JAMA: The Evidence-Based Metaphor
It’s a situation that many pediatricians encounter on a regular basis: a parent who is resistant to the idea of childhood vaccinations for a son or daughter. The only difference here is that Jeremy isn’t really an anxious parent but a standardized patient—an actor trained to re-create this scenario—and I’m not a physician but a medical student. We’re in the midst of an OSCE, an “objective structured clinical examination,” designed to train medical students in the real-life practice of medicine. (Brit Trogen, 4/11)

RealClear Health: It’s Time To Check The Safety, Not Price, Of Imported Drugs
In December 2016, the Government Accountability Office released its report on the Food and Drug Administration’s oversight of foreign drug production. Strikingly, the report found that most FDA infractions occur in overseas pharmaceutical production sites, primarily in India, while a third of all production locations go without any oversight at all. (Roger Bate, 4/13)

Cleveland Plain Dealer: Saving Babies' Lives In The Cleveland Area - How Can The Region Address This Persistent Problem? Talk It Out
A preliminary dive into the data surrounding infant mortality in the Cleveland area reveals some disturbing trends: a shockingly high level of prematurity contributing to early infant deaths, and evidence that many young mothers aren't accessing the prenatal care they need. (4/12)

Lexington Herald Leader: Volunteer Group Offers Support For Parkinson’s Patients, Families
“You have Parkinson’s disease.” Hundreds of residents in the Lexington community have heard those words. Delivered to me by a neurologist five years ago, they were shocking and bred all sorts of questions. Was this disease terminal? How could it be me? Was there a cure? How would I tell my family, friends and co-workers? (David M. Smith, 4/12)

JAMA Forum: Hunger, Health, And Compassion
The juxtaposition of headlines must have sent shivers down the spines of the global humanitarian and human rights communities. Even as headlines warned of 20 million people in Africa and the Mideast facing starvation, the Trump Administration was proposing unprecedented cuts in foreign assistance. While the drastic cuts may not come to pass, US values of compassion are being eroded. Secretary of State Rex Tillerson warned other countries to provide a larger share of assistance. Perhaps signaling what is to come, in the first quarter of 2017, US contributions to humanitarian appeals decreased by nearly one-half from the level for 2016. And even small cuts to humanitarian assistance are more than the world’s most desperate people can afford, with United Nations humanitarian appeals already routinely underfunded. (Lawrence Gostin, 4/12)