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Thursday, Feb 11 2016

Full Issue

Viewpoints: Conservatives And The Cancer Moonshot; The Challenges Of Getting To Universal Health Care

A selection of opinions on health care from around the country.

Last Monday, the White House announced the formation of its Cancer Moonshot Task Force, a follow-up to President Obama鈥檚 State of the Union exhortation to 鈥渕ake America the country that cures cancer once and for all.鈥 At the time, the president鈥檚 announcement elicited snickers from many on the right concerned about expansive government programs that promise more than they can deliver. But conservatives who worry about the government鈥檚 role in combating cancer are missing a key part of the picture: When it comes to making big gains against cancer, it鈥檚 not about central planners generating solutions from whole cloth; it鈥檚 about making sure nothing gets in the way of the cutting-edge treatments that are already within our reach. (Paul Howard, 2/8)

Both Democratic presidential candidates are calling for universal health coverage, though they disagree sharply on how to get there. Here鈥檚 the bottom line: There is no single program or policy likely to achieve full coverage of the complex collection of subgroups who make up the remaining uninsured in the U.S. except for a single-payer strategy. But Sen. Bernie Sanders has acknowledged that single-payer health care is not politically feasible in the foreseeable future and has said that it is unlikely without, among other things, campaign finance reform first. (Drew Altman, 2/11)

How frequent is the practice of 鈥渇iring鈥 patients? Research is sparse, but one recent survey found that one-fifth of pediatricians said they had dismissed families for refusing childhood immunizations. If you Google 鈥渇iring patients,鈥 you鈥檒l find discussions about whether physicians and group practices can fire patients, under what circumstances, and how physicians can do so ethically and legally. (Diana Mason, 2/10)

The single biggest threat to the survival of the Affordable Care Act (ACA) is not the Republican-led legislative effort to repeal it. Nor is it inadequate enrollment. It is inaction by the administration's own agency that is tasked with implementing Obamacare: the Centers for Medicare and Medicaid Services (CMS), a division of the Department of Health and Human Services (HHS). (Peter Beilenson, 2/10)

In 2011, football quarterback Peyton Manning went on the road to seek out stem-cell 鈥渢reatment鈥 for his neck. He wasn鈥檛 alone: many high-profile athletes and desperate (but less famous) patients left the United States seeking interventions available in countries with less rigorous regulation. They didn鈥檛 necessarily know what kind of cells they were getting, whether there was any evidence the intervention worked, or whether anyone understood the risks they were taking. So why did they do it? (R. Alta Charo, 2/10)

A new proposal for expanding Medicaid is smart and Kansas-focused. It also addresses objections to expansion raised by Gov. Sam Brownback and some lawmakers. But GOP leaders in Topeka are still resistant, blocking an attempt Wednesday by Rep. Jim Ward, D-Wichita, to force a House vote on expansion. Senate Bill 371 and House Bill 2633 are based on an expansion plan developed by the Kansas Hospital Association. It was modeled after Indiana鈥檚 law and contains several requirements and reforms championed by free-market conservatives. (Phillip Brownlee, 2/10)

Iowa lawmakers should stop trying to micromanage the practice of medicine in this state. Our elected officials are not researchers or scientists or even physicians. Yet they too often want to require that health providers order specific tests or provide specific notifications to patients. The latest offender is Senate File 2057. This bill requires all babies born in Iowa to be tested for cytomegalovirus. Known as CMV, the congenital virus can result in hearing loss and developmental disabilities. Sen. Janet Petersen, D-Des Moines, who introduced the bill, has a constituent who gave birth to an infant with CMV. (2/10)

The dangers of lead exposure have been recognized for millennia. In the first century a.d., Dioscorides observed in his De Materia Medica that 鈥渓ead makes the mind give way.鈥 The first industrial hygiene act passed in the colonies, in 1723, prohibited the use of lead in the apparatus used to distill rum, because 鈥渢he strong liquors and spirits that are distilld through leaden heads or pipes are judged on good grounds to be unwholsom and hurtful.鈥 More recently, large amounts of lead were used to boost the octane rating of gasoline and improve the performance of paint. One would be challenged to design a better strategy for maximizing population exposure to a poison than to have it emitted by a ubiquitous mobile source and to line the surfaces of dwellings with it. (David C. Bellinger, 2/10)

Rivers that aren't being monitored often enough for us to know whether the fish are safe to eat. Air-monitoring equipment that鈥檚 so broken-down that officials don鈥檛 know whether it鈥檚 safe to issue permits for new industry. Underground storage tanks and abandoned gold mines that aren鈥檛 being cleaned up to stop gasoline and acid and metals from leaching into the groundwater. And the giant hazardous waste dump on the shore of Lake Marion that we can鈥檛 even monitor properly, much less shore up to prevent water contamination of unimaginable proportions. It shouldn鈥檛 surprise anyone that the state Department of Health and Environmental Control 鈥 the agency charged with making sure we have clean water to drink and clean air to breathe and that the people who cook our meals and provide our medical care don鈥檛 infect us 鈥 says it doesn鈥檛 have the money to do its job. (2/10)

The American medical establishment instructs pregnant women to not drink alcohol, and those who ignore this advice 鈥 like those who do not breast-feed their children 鈥 are subject to social shaming. Is the circle of shame about to get a lot bigger? Citing the dangers of fetal alcohol spectrum disorder, the Centers for Disease Control last week released an advisory that directs women of childbearing age to abstain from alcohol entirely unless they are on birth control. This recommendation, which unduly burdens women between the ages of about 15 and 44, is deeply troubling on both scientific and ethical grounds. (Rebecca Kukla, 2/10)

The argument in support of CONs is straightforward. The restrictions on competition fostered by such laws provide a way for hospitals to collect more money from some patients, in order to subsidize care for those who can't afford it 鈥 a kind of backdoor socialism in which the private sector takes on the role of redistributor of income. But research by Chris Coopman and Thomas Stratmann at the Fairfax, Va.-based Mercatus Center at George Mason University, a free-market think tank, debunks the theory that CONs provide a boost to charity care. (John Bicknell, 2/11)

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