�鶹Ů��

The recent election of Donald Trump as President of the United States has created substantial uncertainty about the future of U.S. health policy. The incoming administration has sent mixed signals about the Affordable Care Act (ACA) — embracing some aspects of the law while campaigning against it and pledging to repeal it. The provisions that may be repealed or modified and the new policies that may be enacted are still unknown. The perspectives of primary care physicians (PCPs) on the potential repeal of the ACA are important for informing the public debate, given PCPs’ central role in the health care system. (Craig Evan Pollack, Katrina Armstrong and David Grande, 1/25)

With a single memorandum, President Trump may well have made it harder for health workers around the world to fight cancer, H.I.V., Zika and Ebola. The memorandum, signed on Monday, reinstates and expands a policy barring health organizations abroad, many of which provide an array of services, from receiving federal funds if they even talk to women about abortion as a method of family planning. (1/26)

Reinstating the “gag rule” is largely a politically symbolic maneuver in terms of directly blocking abortions, because U.S. foreign aid has not been used to perform abortions since the 1970s. But reinstatement will have real impacts, including on the International Planned Parenthood Federation, which estimated it will lose about $100 million over a two- to three-year period for services in 20 poor countries. (John Welch, 1/26)

That other march happens Friday — the one held every year on the anniversary of Roe v. Wade — and though the March for Life usually gets the kind of cursory, condescending coverage otherwise reserved for an astrologers convention, I’m confident my colleagues will see that this year is different. ... The official position of the pro-life lobby is that President Donald Trump is about to give them everything they ever wanted. But like any group that’s almost half of the population, pro-lifers are not a monolith on what it is they want, and some activists have argued even after Trump’s election that he’s so clearly the antithesis of all they hold dear that he’ll be the movement’s undoing: “This was an absolutely terrible election for the pro-life movement,” wrote Fordham theologian Charles Camosy. (Melinda Henneberger, 1/26)

As his first act in office, Donald Trump fulfilled his campaign promise to dismantle Obamacare. But whatever the Affordable Care Act’s shortcomings are, there’s no plan to replace it. Repeal will have a catastrophic impact on health care. Millions of uninsured people will wait until they get sick and then use emergency rooms as their primary care providers. (Carl Hammerschlag, 1/26)

The Congressional Budget Office (CBO), at the request of Senate Democrats, recently released a report estimating the effects of a reconciliation bill passed in 2015 but vetoed by President Obama (HR 3762). The bill would repeal the Affordable Care Act’s (ACA) individual and employer mandates and, after a two-year delay, repeal the ACA’s Medicaid expansion and subsidies for insurance purchased on the ACA exchanges. The predicted results are dire but no one should pay too much attention. No one is proposing re-passing HR 3762 without other measures and CBO’s predictions are simply not believable. (Joel Zinberg, 1/26)

As the debate over repeal of the Affordable Care Act (ACA) takes center stage in U.S. politics, it’s important to keep in mind that the law is not a single policy. Though popularly derided by its opponents as the monolithic “Obamacare,” the ACA is a multifaceted law with several distinct components — subsidized health insurance exchanges, individual and employer mandates, regulations of the individual insurance market including a defined package of essential benefits, and Medicaid expansion. While opposition to several of these elements remains nearly unanimous among conservatives — in particular, the mandates and an approach to federal regulation perceived as one-size-fits-all — the picture is more nuanced when it comes to the underlying expansion of insurance, particularly through Medicaid. (Benjamin D. Sommers and Arnold M. Epstein, 1/25)

You won’t find anyone else more determined than this physician to repeal ObamaCare right away. We should not slow down repeal but rather speed up replacement. That’s why I have introduced legislation this week to replace it with a plan that relies on freedom to deliver more options, better care and lower costs. There is absolutely no excuse for not voting on a replacement plan the same day as we repeal ObamaCare. (Sen. Rand Paul, R-Ky., 1/26)

While I doubt Price did anything illegal, he clearly acted unethically, ignoring the kind of conflicts of interest that would get most of us fired. The one stock I didn't dwell on was the one that's gotten the most attention: Innate Immunotherapeutics, a tiny Australian penny stock. ... When I asked around about Innate Immunotherapeutics, I found several skeptics who thought the company was, let's just say, a little fishy. They pointed to the fact that a key research report was commissioned by the company, that [CEO Simon] Wilkinson has no previous biotech experience and that the company seems more focused on its stock price than its drug development. The company has made it clear to investors that it hopes to sell itself to a bigger pharma company if the clinical trial proves successful. (Joe Nocera, 1/26)

In these first days of the Trump Administration, there is a great deal of uncertainty, but it’s clear that healthcare will remain in the spotlight. Repealing and replacing “Obamacare” is still at the top of the Republican party’s—and President Trump’s—agenda. (Lygeia Ricciardi, 1/26)

Should patients’ cognitive function be weighed in the allocation of scarce organs? This question has been raised by several highly publicized cases that, on October 12, 2016, culminated in 30 members of the U.S. Congress petitioning the Department of Health and Human Services to “issue guidance on organ transplant discrimination with regards to persons with disabilities.” In one such case, Amelia Rivera, a 3-year-old with Wolf–Hirschhorn syndrome, was denied a kidney transplant in 2012 because of her severe cognitive impairment. She later received a kidney after her mother successfully coordinated an online campaign. That same year, Paul Corby, a 23-year-old with autism, was permanently denied heart transplantation. (Scott D. Halpern and David Goldberg, 1/25)

In 1997, a few hundred people who responded to a job posting in a Pittsburgh newspaper agreed to let researchers spray their nostrils with a rhinovirus known to cause the common cold. The people would then be quarantined in hotel rooms for five days and monitored for symptoms. In return they’d get $800. “Hey, it’s a job,” some presumably said. Compensation may also have come from the knowledge that, as they sat alone piling up tissues, they were contributing to scientific understanding of our social-microbial ecosystem. The researchers wanted to investigate a seemingly basic question: Why do some people get more colds than others? (James Hamblin, 1/27)