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Morning Briefing

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Monday, Aug 24 2015

Full Issue

Viewpoints: Dueling Views On Alaska's Medicaid Expansion; Treating Breast Cancer

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

Our great state is facing some serious challenges. Meanwhile, members of the Legislative Council have chosen to sue me for accepting federal money to provide health care for low-income, working Alaskans. Since July 16 when I announced my intent to accept the money, not a day has gone by without someone approaching me to thank me or share a personal story. ... I am disappointed members of the Legislative Council chose to 鈥渄efend the power of the purse鈥 over the will and needs of the people. At a time when the state is facing a $3.5 billion deficit, 10 legislators chose to spend $450,000 to hire an outside law firm to block what more than 60 percent of Alaskans want; they chose to sue to prevent $145 million in federal dollars from being injected into our economy to provide lifesaving care for our fellow Alaskans. (Alaska Gov. Bill Walker, 8/22)

While the left revs up its propaganda machine to decry the Legislative Council鈥檚 correct -- sublimely correct -- decision to sue the pants off Gov. Bill Walker for embracing Barack Obama鈥檚 penchant for ignoring constitutional strictures and playing overlord, the rest of us should be thanking our lucky stars. Perhaps the folks in black robes can pound a stake into the heart of Walker鈥檚 misbegotten drive to bankrupt Alaska by expanding Medicaid, a program that eventually will cost billions, just as the state wades through its cash reserves and teeters above a very deep fiscal abyss. (Paul Jenkins, 8/22)

The employer mandate does not apply to employers with fewer than 50 employees. According to the Treasury, approximately 96% of employers are small businesses with fewer than 50 FTE workers which means they are exempt from the employer responsibility provisions. This is good news for small businesses, but that doesn鈥檛 make the health care question go away. The reality is that many small businesses still do provide health care for their employees, either out of a sense of responsibility or out of a desire to attract quality candidates (or both). So how can small businesses make that happen? It鈥檚 not enough to simply pay for coverage. Depending on how you pay for those plans, you can find yourself in trouble (it can be tough to avoid the gotchas). (Kelly Phillips Erb, 8/22)

A new study published in JAMA Oncology raises doubts about the value of surgery for breast lesions at the earliest stages of cancer. The conclusions were based on data from women with ductal carcinoma in situ, or D.C.I.S., and add to the confusion surrounding diagnosis and treatment of breast cancer. What should women do with this latest knowledge? (8/21)

The drug has many names: flibanserin, Addyi, Ectris, Girosa or, colloquially, "pink Viagra." Whatever you want to call the long-in-the-making libido pill for women, it recently gained FDA approval despite "serious, serious safety concerns" and benefits that are "modest, maybe less than modest." But as a science-driven sex educator, I am less troubled by the risk of low blood pressure and fainting than I am by the drug maker's reinforcement of an outdated, scientifically invalid model of sexual desire. (Emily Nagoski, 8/23)

A British government agency has issued a bullish assessment of the value of electronic cigarettes in helping people to quit smoking. It found that e-cigarettes can reduce the health risks of smoking by 95 percent because they deliver nicotine to satisfy an addiction, but far fewer harmful chemicals than regular cigarettes. It also found little evidence that large numbers of consumers who had never smoked were taking up e-cigarettes. That seemed to challenge the notion that e-cigarettes would be a gateway to more dangerous products. But the study is hardly definitive; experts in America have drawn different conclusions on usage and on the gateway issue. (8/24)

Ms. M was not the patient I thought I would reminisce about for months after she had passed away, but her difficult death clung to me. She was miserable, mean, fetid and foulmouthed. She clawed at my hands as I tried to place my stethoscope on her chest and spat in my face as I bowed my head to listen to her heart. In between vivid hallucinations and violent outbursts, she cursed and told me I knew nothing. Tormented by pain, Ms. M died alone, except for the doctors and nurses who had found their way into her life by chance after others had long ago pulled away and left her forgotten. (Brittany A. Bettendorf, 8/21)

If there is one health myth that will not die, it is this: You should drink eight glasses of water a day. It鈥檚 just not true. There is no science behind it. ... I was a co-author of a paper back in 2007 in the BMJ on medical myths. The first myth was that people should drink at least eight 8-ounce glasses of water a day. This paper got more media attention (even in The Times) than pretty much any other research I鈥檝e ever done. It made no difference. When, two years later, we published a book on medical myths that once again debunked the idea that we need eight glasses of water a day, I thought it would persuade people to stop worrying. I was wrong again. (Aaron E. Carroll, 8/24)

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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