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Morning Briefing

Summaries of health policy coverage from major news organizations

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Wednesday, Feb 10 2016

Full Issue

Viewpoints: Reactions To The 2017 Obama Budget Proposal; The Sanders' Take On Government Programs

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

President Obama's proposed budget for fiscal 2017 met instantaneous rejection from the Republican Congress, unsurprisingly, given that it鈥檚 basically a blueprint for more active government paid for with higher taxes. Though predictable, the GOP鈥檚 refusal to hold a hearing on Mr. Obama鈥檚 budget was gratuitously contemptuous; and it was regrettable in substantive terms, as some of Mr. Obama鈥檚 structural proposals, such as a 28 percent rate cap on individual tax deductions and $375 billion worth of savings in federal health-care spending, merit debate. Congress may grant some of Mr. Obama鈥檚 requests, such as larger tax credits for low-income workers and $1.1 billion in new funding to fight drug addiction. For the most part, though, this document amounts to little more than Mr. Obama鈥檚 final statement of fiscal priorities before his successor takes over 11 months from now. (2/9)

Their decision is more than a break with tradition. It is a new low in Republican efforts to show disdain for Mr. Obama, which disrespects the presidency and, in the process, suffocates debate and impairs governing. Mr. Obama鈥檚 budget proposes to spend $4 trillion in the 2017 fiscal year (slightly more than for 2016). That total would cover recurring expenses, including Medicare and Social Security, as well as new initiatives to fight terrorism, poverty and climate change, while fostering health, education and environmental protection. If Republicans find those efforts objectionable 鈥 as their refusal to even discuss them indicates 鈥 they owe it to their constituents and other Americans to say why. (2/9)

The essence of Mr. Sanders鈥檚 version of liberalism is government programs. Expansive initiatives that provide benefits to 鈥渁 broad cross-class constituency,鈥 as the Harvard political sociologist Theda Skocpol puts it, such as Social Security and Medicare, are not only good policy, they鈥檙e at the heart of liberal politics. They remind citizens of the essential role of government in providing security and economic opportunity. And they anchor voters to the party that backs those programs. ... That鈥檚 the theory, anyway, and it鈥檚 deeply embedded in Mr. Sanders鈥檚 approach. His proposals for single-payer health care, free college tuition and paid family leave financed through a small payroll tax reflect the view that successful programs should be universal and create a connection between individuals and government. (Mark Schmitt, 2/9)

We live in a different time. If the U.S. were to embark on a single-payer system today, as Bernie Sanders proposes, it would not be doing so to expand access鈥攖hough that slogan would still be used鈥攂ut for a very different reason: to deny and limit care in order to control spending. This agenda would be popular with neither patients nor providers, and therefore would be dead in the water鈥攁s liberal authorities, from the New York Times鈥檚 Paul Krugman to Henry J. Aaron of the Brookings Institution, have suddenly discovered an urgency to point out to Democratic voters infatuated with Bernie Sanders. Mr. Sanders knows it too. His socialism is farcical in a country that can鈥檛 afford the entitlements it already has. (Holman W. Jenkins Jr., 2/9)

Is Hillary Clinton recalibrating her position on abortion as she seeks the 2016 Democratic presidential nomination? It sure looks that way. In her last presidential run in 2008, Clinton said that she thought abortion should be 鈥渟afe, legal and rare, and by rare, I mean rare.鈥 She added that abortion 鈥渟hould not in any way be diminished as a moral issue,鈥 and portrayed the choice to have an abortion as a wrenching one for 鈥渁 young woman, her family, her physician and [her] pastor.鈥 (Michael McGough, 2/9)

Melissa Crews has always voted Democratic, though her husband is a staunch Republican. This year, the family split is coming to an end: Melissa is switching sides, and heroin is the principal reason. Crews is board chair at Hope for New Hampshire Recovery, a nonprofit she helped set up last year to battle the state's heroin epidemic. New Hampshire was third in the nation in death rates from overdoses in 2014 (the latest year for which data are available from the Centers for Disease Control and Prevention) and in the top 10 for the use of illicit drugs other than marijuana. People who work for local nonprofits fighting the rising drug use say at least 100,000 of the state's 1.3 million people need help with addictions. (Leonid Bershidsky, 2/9)

It requires a special kind of bigotry to blame black people and Mexicans when whites decide to use drugs. But racial attitudes also drive the current compassion for white drug users. Too bad that empathy wasn't there when addiction was seen as a black thing. (Jones, 2/9)

Media coverage of the primary in New Hampshire has underlined an unwelcome and alarming fact: There is an epidemic in the use of heroin in New Hampshire. How come? Haven鈥檛 we had a war on drugs for the past 40 years? Why hasn鈥檛 it been as effective as the war on smoking? (George P. Shultz, 2/9)

The system for pricing prescription drugs in the U.S. is a bit of a disaster. Our reliance on medical insurance means that pricing is not based on consumer demand or ability to pay. Nor is it exactly based on negotiations with insurers: "Medicare, one of the biggest buyers of prescription drugs, is prohibited from negotiating drug prices with pharmaceutical companies." The "expensive and time-consuming process of getting F.D.A. approval" to sell generic drugs deters competition and allows approved manufacturers to charge whatever prices they want. These are systemic problems, which were created by legislation and regulation, and which demand legislative solutions. So yesterday a House committee convened a hearing to consider these problems and try to come up with a comprehensive solution. (Matt Levine, 2/8)

The axiom of Silicon Valley is that companies that move fast, break things and grow like weeds are winners. The corollary is that some technology startups move too fast and break.The latest Silicon Valley cautionary tale is Zenefits, which makes software to automate human resources chores for small businesses and sells employee health insurance plans. Following reports by BuzzFeed and other news outlets that Zenefits allowed workers to sell insurance even if they didn鈥檛 have state licenses to do so, the company said founder Parker Conrad had stepped down as CEO and as a director. (Shira Ovide, 2/9)

With the Rio Olympics six months away, Brazil is battling an outbreak of Zika virus that has infected an estimated 1.5 million people. The infection is linked to microcephaly, a congenital condition in which babies are typically born with underdeveloped brains. The World Health Organization has declared the Zika outbreak 鈥渁 public health emergency of international concern." ... While Ebola ultimately burned out after claiming the most vulnerable victims, Zika鈥檚 easier transmission, and less-deadly outcome, means it will propagate much more widely. Ebola revealed that after enormous investment in global public health, we remain unprepared to mobilize the basic resources to isolate and contain infectious diseases. (Scott Gottlieb, 2/9)

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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