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President Obama has an opportunity to win a positive legacy in health care. Although his attempt at payment reform, Obamacare, has failed in public opinion, he is also encouraging important initiatives in medical innovation. The Cancer Moonshot and Precision Medicine Initiative represent investments in innovation that can bring big payoffs. However, they will not succeed fully unless the Food and Drug Administration allows patients access to new therapies. Legislation modernizing the FDA, the 21st Century Cures Act, is being fumbled inches away from the Congressional end zone. Presidential leadership is needed. (John Graham, 9/22)

It’s easy to assume that greed is solely to blame for runaway drug prices — and companies like Mylan do nothing to challenge that perception. The reality, however, is more complicated. When [Mylan Chief Executive Healther] Bresch talked about drug prices and access existing “in a balance,” she was referring to what the pharmaceutical industry calls value-based pricing. This is what you get when you price a drug not just commensurate with its research and development, production and marketing, but also reflecting the drug’s importance to patients. And that’s a very slippery concept. (David Lazarus, 9/23)

Hope is a necessity, especially when you have a rare disease in your family. My family lives with one of the 7,000 rare diseases without a cure, so our one true hope is for a treatment that increases the quality of life of our children. That hope relies on a strong government/industry partnership. This partnership began in earnest in 1984 with the passage of the Orphan Drug Act, and must be strengthened by the Rare Pediatric Disease Priority Review Voucher Program, an incentive for drug development that is set to expire on Sept. 30. (Brett Kopelan, 9/22)

Even if the experimental drug isn’t a cure, there’s reason to believe something like it might ward off Alzheimer’s disease in healthy people, sort of the way statins are thought to prevent heart attacks. And preventive therapy for the brain could help avert what many experts see as an impending disaster: By 2050, there will be 32 million people over the age of 80 in the U.S., and unless something big changes, about 16 million will have Alzheimer’s disease. (Faye Flam, 9/22)

Last month, the Obama administration declared a public health emergency in Puerto Rico to cope with the spread of the Zika virus. There’s no question that Zika poses a threat to public health, but its magnitude is uncertain. In contrast, we know that the opioid epidemic is killing more than 500 Americans a week and harming thousands more. Why isn’t that a public health emergency, too? (Benjamin Bearnot and Mark Eisenberg, 9/22)

In Maryland, heroin-related deaths tripled from 2011 to 2015, rising from 247 to 748. There has also been an alarming spike in deaths from the synthetic opioid fentanyl, rising 105 percent during the first quarter of 2016 as compared to 2015. Increases in overdose deaths have been reported throughout the state, including western and central Maryland and the Eastern Shore. It is essential to alert people about the dangers of opiate use, whether obtained through prescriptions or on the street. Everyone is at risk if they are not informed. (Rod J. Rosenstein, U.S. attorney in Maryland, and Brian E. Frosh, Maryland's attorney general, 9/22)

[Hillary] Clinton actually wants to double down on Obamacare, even after seeing public support for the health law tumble. She wants to create another big government "public option" health insurance plan. The "option" would have unlimited calls on taxpayer dollars and government force and would quickly drive remaining private insurers out of the market, leaving people with only the "choice" of a government-run health plan. The idea might have more traction were it not for the experience of a similar experiment the nonprofit, citizen-run health insurance cooperatives concocted by Obamacare. The co-op program cost taxpayers $2.4 billion, but 17 of the 23 state co-ops have failed, forcing hundreds of thousands of people to scramble to find new policies. (Grace-Marie Turner, 9/22)

In 2014 I met a young mother of three from Waukesha, Wis. Her name was Trickett Wendler, and she had the degenerative nerve disease amyotrophic lateral sclerosis (ALS). Before her diagnosis, Trickett was living a normal life and looking forward to a bright future. ALS robbed her of her dreams and took away her body’s ability to function. She died on March 18, 2015. Like their mother and grandfather, Trickett’s children are genetically predisposed to ALS. Trickett was prescribed the same medications her father was given in the 1990s. Her husband Tim prays that better treatments will be developed if, God forbid, one of his children must fight this horrible disease. (Sen. Ron Johnson, R-Wis., 9/22)

The Medical Oncology Association of Southern California and the California Nurses Association oppose Assembly Bill 1668, by Ian Calderon, D-Whittier. We agree that it is in the best interest of terminally ill Californians and their loved ones that the governor veto this bill again. The misleadingly named bill would not give patients a real right to try experimental drugs. Rather, it would give them a “right” to request access to drugs in development at pharmaceutical companies. But there is no obligation for a company to grant a patient’s request. (Alison Bateman-House, Arthur Caplan and Lisa Kearns, 9/22)

Often, when I discuss the obesity crisis in the United States, especially when I’m pointing out another failed effort to help people change their eating habits, it’s as if there’s nothing we can do. But sometimes it’s actually more that there’s nothing we will do. ... The Supplemental Nutrition Assistance Program (SNAP), colloquially known as food stamps, provides aid to poor families in the United States so that they can buy food. ... In studies, people who receive SNAP tend to be more obese than those who don’t. This has led some to call for a reduction in benefits, arguing that the program is causing obesity. It’s more likely that we need to change the behavioral economics of food, not the aid we supply. (Aaron E. Carroll, 9/22)

In House of Representatives v. Burwell, the House challenged the legality of subsidies the Obama administration paid to insurers. Judge Rosemary M. Collyer ruled that the House as an institution had standing and that the payments were made without an appropriation. Currently, the case is on appeal to the U.S. Court of Appeals for the D.C. Circuit. Though the litigation has had unexpected success in the courts, its origin was rocky. As I discuss in Chapter 23 of “Unraveled,” one of the most difficult aspects the case was finding an attorney to take it — or, more precisely, an attorney whose law firm would allow him keep the case. (Josh Blackman, 9/22)