�鶹Ů��

Since the election, I, among others, have pointed out that Donald Trump would not be able to keep his promise of repealing the rest of Obamacare while protecting people with “preexisting conditions.” To do so would still require everyone to buy insurance — the controversial “individual mandate”— while still requiring insurers to offer policies to anyone who wants to buy one at the standard “community” rate. It would be wrong, however, for Democrats to jump from that observation to the conclusion that there aren’t other ways to structure a health insurance market to achieve near-universal coverage at affordable prices. Republicans have proposed a number of credible reform ideas that could preserve most of the gains from the Affordable Care Act while restructuring the system to better conform to conservative, market-oriented principles. A few would even make the system more efficient and more progressive. (Steven Pearlstein, 11/20)

The reality is that Republicans on Capitol Hill and the Trump team see that their own heads could roll. Republican voters, having been told that ObamaCare is a disaster, expect quick action. They wonder how hard is it to throw dirt on the grave and accept the cheers of a grateful nation. The problem for the GOP executioner in Washington is that, once the deed is done, Trump will have to take responsibility for creating a better plan for American healthcare — especially for the more than 20 million people who will lose health insurance once ObamaCare is buried. (Juan Williams, 11/21)

With Obamacare repeal-and-replace on the table, a favorite healthcare “reform” of Republicans and conservatives is about to have another day in the sun: health savings accounts. They sound good — tax-exempt personal slush funds that can be used to pay out-of-pocket medical expenses — but for the average person they’re almost useless and for the healthcare system they’re potentially disastrous. (Michael Hiltzik, 11/18)

It seems reports of Obamacare’s impending death may have been greatly exaggerated. In a wonderful irony, that good news comes from the mouth of our president-elect. (Rich Barlow, 11/18)

No one knows exactly what Donald Trump’s pledge to “repeal and replace” the Affordable Care Act means. The hints, however, are troubling. No state has embraced the ACA — Obamacare — more enthusiastically and successfully than California. And no state has more to lose with Trumpcare. (Gerald F. Kominski, 11/18)

More than 600,000 people [in Washington] also gained coverage through an expansion of Medicaid — more than double the amount predicted. The money spent on uncompensated care in our state has plummeted from $2.3 billion to $1.2 billion. And our friends and neighbors struggling with an illness can no longer be denied health insurance. Since its passage, Congress has voted more than 60 times to repeal the entire law. It has never voted to amend or repair it nor proposed a replacement. For years, we’ve heard the Republican mantra “repeal and replace.” Now, with the recent election, they get their chance. (Washington Insurance Commissioner Mike Kreidler, 11/18)

If you are one of the more than 50,000 Nashvillians not on Medicare who has non-group BlueCross BlueShield of Tennessee health coverage, you have probably received a termination letter indicating your coverage will lapse at the end of this year. That letter should have told you that BlueCross’ individual plan members have had more health needs than anticipated, leading to financial losses. Based on this and other uncertainties, the company has decided to pull out of the Nashville, Memphis and Knoxville regions. (Alex Tolbert, 11/20)

With the publication Thursday of a comprehensive 428-page report on drug and alcohol misuse, Surgeon General Vivek H. Murthy has added his voice to those calling for a more vigorous, better informed approach to addiction in the United States. Dr. Murthy emphasizes the need for a public-health-based approach to the problem, one that offers sufferers less moralizing and more medically based treatment options; fortunately, that seems already to be the emerging consensus, one of the few things Republicans and Democrats agree on. Backed by the authority of Dr. Murthy’s office, the document is likely to become a standard reference; a 1964 report on smoking and health by an earlier surgeon general, Dr. Luther Terry, became a cultural milestone. (11/19)

An investigation was launched back in 2012 to determine the nature of the relationship between medical organizations setting guidelines for prescribing opioids and the manufacturers who sell them. The members of the Senate Finance Committee initiating the investigation included Max Baucus (D-Mont.) and Chuck Grassley (R-Iowa), who astutely pointed out the disturbing epidemic and wanted to understand who was behind it. ... Sens. Baucus and Grassley left the Senate Finance Committee before the investigation report was released. They were replaced by Orrin Hatch (R-Utah) and Ron Wyden (D-Ore.) who still have not released the report despite pressure from public health advocacy groups. (Dana Connolly, 11/17)

Indeed, the plight of mental health patients held behind bars is a growing, national calamity. Thanks to the shuttering of state psychiatric hospitals and a collective failure to fund community mental health programs, the percentage of state prisoners with a mental illness has soared to more than half, according to the Urban Institute. (Michael Rezendes, 11/19)

Gov. Matt Bevin and Kentucky lawmakers face significant challenges as they weigh competing priorities for state funding. Education. Underfunded pensions. Roads. All important – and all deserving of attention for the impact they have on Kentuckians. But there’s another serious problem that state leaders simply can’t ignore: the mounting crisis of diabetes. Nearly half a million adults in Kentucky have diabetes. There are thousands not yet diagnosed. (11/20)

Just like the various systems of the body are interconnected, integrated care approaches also help manage diabetes by managing disease in other areas of the body. Diabetics face an increased risk for periodontal disease, an infection and inflammation of the gums which can lead to tenderness and tooth loss. Inflammation in the mouth can then make blood sugar management more challenging, leading to a cycle of patient health concerns and potential escalating cost. (Collette Manning, 11/18)

If successful, Ms. Wetzel’s lawsuit could set a legal precedent establishing the responsibility of housing providers to actively address discrimination based on gender orientation and sexual identity under the federal Fair Housing Act. The law states — vaguely — that discrimination based on “sex” is prohibited. “It’s one of the first opportunities for a court to apply the Fair Housing Act to the kinds of harassment that L.G.B.T. people experience,” said Karen L. Loewy, a senior lawyer at Lambda Legal, which brought the case. (Mark Miller, 11/18)

On a walk in the park, she fell face first and broke her nose. In the middle of the night, she tried to get to the bathroom but fell and crashed through closet doors. Multiple infections, along with heart and kidney disease, landed her in the hospital, where her dementia raged and she didn’t always recognize loved ones. She got better and they sent her home, but in her mind, something is wrong. (Steve Lopez, 11/19)