Viewpoints: CBO’s Surprising Findings; Medicaid Enrollees Feel Powerless

A selection of opinions on health care from across the nation.


The Wall Street Journal:
Blame-Sharing On ObamaCare


The oracles at the Congressional Budget Office this week descended from Delphi to predict 20% premium increases if the Trump Administration ends illegal Obama Care subsidies for insurers, and Democrats are happy to agree. Yet a careful reading of the report reveals some surprising results that are far less ominous and for consumers mostly benign. CBO and the Joint Committee on Taxation analyze what would happen if the Trump Administration cut off “cost-sharing” subsidies, which are government payments to insurers that defray deductibles and co-pays for certain people below 250% of the poverty line. (8/16)


San Antonio Press-Express:
Free Market Not The Health Care Panacea


It is arguable that some business-type approaches are aspects of a health care system, and I suspect they are incorporated even in countries with universal or purported “socialist” health care system. Nonetheless, I would like [Sen. John] Cornyn and [Sen. Ted] Cruz or like-minded colleagues to name one developed country where a free market health care system is established that works for everyone or even the majority. (Juan H. Flores, 8/16)


The Washington Post:
People Who Get Medicaid Are Made To Feel Powerless. That Pushes Them Out Of Politics And Toward Fatalism.


During the debate over the Republicans’ unsuccessful push to repeal and replace Obamacare this summer, thousands of activists across the country held rallies, attended town hall meetings and staged protests in an effort to stop the GOP. News coverage regularly featured protesters from the disability community, many of whom would have been affected by potential cuts to Medicaid. … But very few of the 70 million low-income and disabled Americans who receive Medicaid benefits actually participated in the debates, despite the fact that changes to the federal program could have had fundamental consequences for their lives. … people enrolled in Medicaid often feel stigmatized by the system. They can be frustrated by differences in the way the program is administered across states and even local communities. As a result, they disengage from politics. (Jamila Michener, 8/17)


Oregonian:
Insurers Are Setting Patients Up For Failure


Thomas Edison once said, “I have not failed. I’ve just found 10,000 ways that won’t work.” While his words illustrated an insatiable passion to invent new technologies like the light bulb, a larger idea belies a fatal flaw we’re seeing insurance companies apply to modern medicine. Through a practice called step therapy or fail first, insurers demand failure upon the people whose lives they’ve been entrusted. (David Russo, 8/16)


NPR:
How Doctors Deal With Hate, Racism And Their Own Biases


The events that unfolded in Charlottesville last weekend are a stark reminder of how far we haven’t come as a nation. Like so many Americans, I am horrified that white supremacist and neo-Nazi adherents have recently found sanction to put hateful ideologies more overtly on display. … For doctors, public emergencies bring to mind ethical duties and dilemmas that never go away. Current events compel us to examine our core beliefs and do a gut-check of our own ethical standards and sense of professionalism. (John Henning Schumann, 8/16)


Morning Consult:
Missouri, The ‘Show Me (The Money)’ State


Up until recently, Missouri was the only state without a Prescription Drug Monitoring Program for opioids. The good news is that’s changing — sort of. Last month, Gov. Eric Greitens issued an executive order creating one. The governor’s order directs the state Department of Health and Senior Services to build a database, which will be designed to help identify suspicious patterns of prescriptions of controlled substances — including opioids. Good news? Seems to be, until you look into the details — where the devil resides. (Peter Pitts, 8/17)


Bloomberg:
Take The Addiction Out Of Smoking


Imagine a world in which teenagers who experiment with cigarettes never make a habit of smoking them. This is a future the Food and Drug Administration envisions with its bold new plan to rid cigarettes of most of their nicotine, the substance that makes them so highly addictive. It’s an intriguing idea, potentially one of the best to come along in the decades-old fight against smoking — which still kills almost half a million Americans a year. (8/16)


The New England Journal of Medicine:
A Nicotine-Focused Framework For Public Health


With the tools provided to the Food and Drug Administration (FDA) under the Family Smoking Prevention and Tobacco Control Act of 2009, the agency has taken consequential steps to prevent sales of tobacco products to children, expand the science base for understanding traditional and newer tobacco products, and conduct public education campaigns. But the agency needs to do more to protect Americans; in particular, we must shape a regulatory framework that reduces their use of combustible cigarettes. (Scott Gottlieb and Mitchell Zeller, 8/16)


The New England Journal of Medicine:
Saying Goodbye To Lectures In Medical School — Paradigm Shift Or Passing Fad?


“Become a doctor, no lectures required.” This headline about the University of Vermont’s proposed new approach to medical education generated considerable controversy. Although this proposed change is more drastic than the curriculum reform taking place at other medical schools, the movement away from traditional lecture-based courses has been under way in U.S. medical schools for more than three decades. … But are the newest proposed changes evidence-based, or are they merely the latest fad in medical education? (Richard M. Schwartzstein and David H. Roberts, 8/17)


The New England Journal of Medicine:
Medical Education In The Era Of Alternative Facts


Students currently entering U.S. medical schools arrive in an era of increasing distrust of large institutions, expanded use of social media for information, a political lexicon in which uncomfortable facts are derided as “fake news” while fabrications masquerade as reality, and the erosion of truth that such trends entail. The challenges for medical education are imminent and formidable. How do we, as teachers, merit the trust of future physicians? How do we pass on to them science’s preeminent legacy of propelling advances in understanding, preventing, and curing illnesses? How do we instill in them a lifelong appreciation for the importance of hypothesis testing, peer review, and critical analysis of research? (Richard P. Wenzel, 8/17)


This is part of the KHN Morning Briefing, a summary of health policy coverage from major news organizations. Sign up for an email subscription.

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