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Morning Briefing

Summaries of health policy coverage from major news organizations

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Friday, Oct 31 2014

Full Issue

Viewpoints: Ebola Errors; McConnell's Mixed Message; Shifts In Mental Health Care

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

The battle to contain Ebola has not been pretty. The developed world let the disease fester in West Africa until it became a global threat, and when 鈥 inevitably 鈥 the first case arrived in the United States, it was greeted with a disturbing mix of incompetence and panic. ... The whole train of events is embarrassing. But there is another way to look at it as well. Pretty much everything that could go wrong did go wrong; the virus was given every chance to spread. Yet it has not. (10/30)

We've learned from the Ebola outbreak of 2014 that to stop pandemics, we must regulate the transport of host and virus alike. Public transmission and cellular invasion depend on the unimpeded traffic of people across borders and viruses across cell membranes. Barring the traffic of people across the Atlantic from Liberia would certainly have prevented the first three cases of Ebola in the United States. Blocking the traffic of virus in human cells would have prevented thousands of cases worldwide. (Gerald Weissmann, 10/30)

Public fury is building as Maine authorities try to maintain quarantine for an asymptomatic nurse returning from caring for Ebola patients in West Africa. While the nurse, Kaci Hickox, insists she poses no risk to others, since even Ebola-infected persons are not contagious prior to developing symptoms 鈥 a position that is supported by the CDC, the NIH, the WHO, and many of the world's leading Ebola experts 鈥攐thers believe that she is expressing willful disregard for the health of the general public. (Elizabeth Oelsner, 10/30)

In a rare fit of realism on Tuesday, Senator Mitch McConnell, the Republican leader, admitted he would be unable to repeal the Affordable Care Act if Republicans win the Senate next week and he becomes majority leader. That would take 60 votes, he said, and no one thinks Republicans will get that many. But conservatives reacted with anger to what they considered a demonstration of weakness, and on Thursday Mr. McConnell was forced to backtrack. Yes, his spokesman told The Washington Examiner, Mr. McConnell remains 鈥渃ommitted to the full repeal of Obamacare鈥 with only a simple majority, through a parliamentary procedure known as reconciliation. (10/30)

For the activist far right 鈥 already brimming with fear, anxiety and ire to spare 鈥 GOP candidates promise to obliterate Obama鈥檚 most significant achievement, the Affordable Care Act. This pledge has always been shamefully dishonest. Even if Republicans capture the Senate and manage to pass one of the umpteen House bills repealing all or part of Obamacare, the president will simply veto the measure. ... Republicans talk about 鈥渞epeal and replace鈥 but feel no obligation to elaborate on the 鈥渞eplace鈥 part. If they were being honest, they would admit that the need to keep the consumer-friendly parts of Obamacare. (Eugene Robinson, 10/30)

The GOP is amending its pro-life policy constructs to ensure that no woman who doesn鈥檛 want to be pregnant ends up so鈥揳dding practical and empathetic policies likely to reframe women鈥檚 views of Republicans in ways that could be consequential next week and in 2016. (Juleanna Glover, 10/31)

California last considered right-to-die legislation in 2007. But now, the case of Brittany Maynard, a Californian who moved to Oregon so that she could painlessly end her life, may help persuade the Legislature to try again. (10/30)

Six state propositions are on the ballot and none are sexy. All are snoozers. But each is significant. Some, in fact, are game-changers. Why else would the medical profession and insurance companies be spending well over $100 million to beat back Propositions 45 and 46? (George Skelton, 10/30)

The federal government is pushing two initiatives that will radically change how mental health services are delivered. Both are long overdue. So why, as the father of an adult son with a mental illness, am I skeptical? ... If the Justice Department is going to force states under Olmstead to empty group homes, the federal government must guarantee that suitable housing is available. We should not repeat the debacle of unplanned deinstitutionalization. If the government pushes a shift to private insurance, it must define acceptable community care. (Pete Earley, 10/30)

What鈥檚 the most common chronic childhood disease in the United States? It鈥檚 worth remembering on Halloween that the answer is tooth decay, which is five times more common than asthma and 20 times more common than diabetes. Tooth decay affects children from all backgrounds, but it鈥檚 concentrated among low-income and rural populations, who have the most difficulty accessing and affording dental care. (David Bornstein, 10/30)

Despite rapid growth, the success of the ACO movement is far from certain. The performance of ACOs to date has been promising but not overwhelming. Although some ACOs have gained a substantial return on their investment in improving the health of their patients, many have not. Furthermore, unless and until a high percentage of their patients 鈥 including privately insured patients 鈥 are covered by ACO contracts, hospitals and physicians will be in the difficult position of dealing with diametrically opposed sets of payment incentives. ... The ACO movement is unlikely to succeed unless health insurance plans dramatically increase their number of ACO contracts and unless CMS modifies specifications for its ACO programs 鈥 a course that the agency is considering. (Lawrence P. Casalino, 10/30)

A growing demand for transparency has brought innovation in many areas of health care. In a video roundtable, three expert panels discuss the benefits and the challenges of these innovations, examining transparency in provider-driven quality data, in pricing, and in medical records. (10/30)

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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