Viewpoints: Young Adult Enrollment Is Encouraging; Work Injuries Often Unreported
A selection of opinions on health care from around the country.
Bloomberg:
One And A Half Cheers For Obamacare
Politics aside, the success of Obamacare has always depended mainly on economics: If it can’t attract the right mix of customers, the program is doomed. On this score, the latest figures from the Department of Health and Human Services are encouraging, even if it's too soon to declare victory. More young people -- who on average are in good health, and who help defray the cost of insuring the sick -- are enrolling in Obamacare. Almost 1 million new customers age 34 or younger had signed up for coverage starting Jan. 1, 2016, an increase of almost 50 percent compared with the same period last year. (12/22)
The Tennessean:
Will 2016 Be The Year For Medicaid Expansion?
Whether it's the 2015 year in review or 2016 year ahead, there is no bigger subject for Tennessee health care than Medicaid expansion. Hundreds of thousands of Tennesseans receive no health coverage, although the federal government has agreed to pay for it. Tennessee hospitals take Medicare cuts that eliminate their operating margins, but the payback in increased Medicaid coverage has evaporated. The Tennessee Assembly can't stomach a politically unpopular president, but their working class and health care constituents wonder, do you have a better plan? (Richard Cowart, 12/22)
news@JAMA:
Replacing The Affordable Care Act And Other Suggested Reforms
A group of health policy analysts (the 3 of us plus 7 others ...) have collaborated on a set of proposals for replacing the Affordable Care Act (ACA) and also reforming other major portions of health care delivery, such as the tax treatment of employer-sponsored health insurance, Medicaid, Medicare, and Health Savings Accounts. Because so much attention has been paid to the repeal of the ACA by those who have opposed it, we believe it is important to focus on a serious proposal that could both replace this law and provide additional measures of reform, especially to the health care entitlement programs. (Joseph Antos, James Capretta and Gail Wilensky, 12/22)
The Richmond Times-Dispatch:
Progress On Health-Care Reform
A state committee tasked with reforming Virginia’s onerous regulation of medical providers recently decided to punt on the issue. It offered a series of suggestions for minimal changes to improve the Certificate of Public Need Law. But tweaking a bad law to make it slightly less bad falls far short of what’s needed: wholesale repeal. Fortunately, three state lawmakers are stepping in where the committee feared to tread. The COPN system restricts investments in new medical facilities and equipment. This limits consumer choice, restricts supply, and drives up costs — to the detriment of the public. (12/22)
The Washington Post:
Bartenders Get Injured All The Time — And Their Employers Rarely Provide Insurance
Many workers in the industry have ... injury horror stories. [Bartender Willy] Shine got lucky. He had health insurance or was covered by workman’s comp for the most serious incidents. But most workers aren’t that fortunate, and many on-the-job injuries go untreated and unreported. As a result, the non-fatal injury rate published by the Bureau of Labor Statistics is deceptively low. According to its data, only 3.6 of every 100 full-time workers in the industry will face an injury. “Everything is underreported,” said Saru Jayaraman, co-director of worker advocacy group Restaurant Opportunity Centers United and director of the Food Labor Research Center at the University of California at Berkley. “There’s such an overwhelming acceptance by workers on what is normal and acceptable and tolerable in our industry. You’re made to feel that it just goes with the job.” (Clair McLafferty, 12/22)
JAMA:
Making Physical Activity Counseling A Priority In Clinical Practice
Given the overwhelming evidence of benefits from physical activity and the vital role of health professionals in motivating behavior change, the lack of physical activity counseling in clinical settings represents a lost opportunity to improve the health and well-being of patients, and with minimal cost. In this Viewpoint, we hope to motivate physicians and other health care practitioners to include physical activity counseling in patient encounters and provide tools for efficiently integrating this activity into busy clinical settings with constant time pressures. (Kathy Berra, James Rippe and JoAnn E. Manson, 12/22)
Health Affairs:
Evaluating A New Era In Medicare Hospice And End-Of-Life Policy
January 1, 2016 will see three big policy changes in Medicare end-of-life policy. Attributing any changes in the overall Medicare program to the hospice reimbursement changes or the payment for advanced care planning will be a nontrivial exercise. Three areas need more attention. First, determining what level of evidence is “good enough” is a key concept that needs more clarity if we are to increase our evidence base in policymaking. Observational studies will be needed to answer questions that are not amenable to traditional clinical trials. ... Second, we will need good proxies for advance care planning payments that will allow for comparison with beneficiaries not participating in such discussions in Medicare claims. ... Finally, there will presumably be a full-scale evaluation of the Medicare Care Choices Model demonstration project as there have been with other CMMI projects. (Donald Taylor, Nrupen Bhavsar, Matthew Harker and Cordt Kassner, 12/22)
