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Monday, Nov 16 2015

Full Issue

Viewpoints: Tough Issues For FDA Nominee; A Mother's Questions For Ben Carson

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

As a US Senate committee meets on Tuesday to consider Dr. Robert Califf for the top job at the Food and Drug Administration, an open question remains whether he is biased toward industry. Califf is held in high regard by drug makers and academics alike. A cardiologist by training, he spent years as a professor at the Duke University School of Medicine and is one of the most influential biomedical authors in the world. ... Califf was the founding director of the Duke Clinical Research Institute, which conducts studies for companies. Last year, six drug makers 鈥 including Merck and Novartis 鈥 partly supported his salary .... No other commissioner in the recent past has held such close ties to pharmaceutical manufacturers. (Ed Silverman, 11/16)

President Obama鈥檚 nominee to lead the Food and Drug Administration has a long history of close ties to industries the agency regulates. At Dr. Robert Califf鈥檚 confirmation hearing on Tuesday, senators will need to ask whether those connections will influence his judgment about the safety or effectiveness of prescription drugs. (11/16)

[Ben Carson's] warm, self-assured voice spoke to me, in a campaign robo-call, to tell me everything he is eager to do for the country. ... I wondered if he remembered me: the woman in the hallway outside the operating room at Johns Hopkins Hospital, the one who grabbed his hands and kissed them when he told me the tumor was removed and my 10-year-old daughter would be just fine. ... On his recorded call, he promised to turn his talents toward what ails the United States; from saving the economy to stopping terrorists and 鈥 鈥渇or heaven鈥檚 sake!鈥 鈥 repealing 鈥淥bamacare so you can make your own health-care choices.鈥 ... I鈥檝e wanted to talk to him about exactly this for eight years. Because Ben Carson the doctor saved my daughter鈥檚 life, but now I worry that Ben Carson the president could put others鈥 lives in jeopardy. (Bethany Karn, 11/13)

November 2015 marks the beginning of the third enrollment for the purchase of health coverage under the Affordable Care Act (ACA), or ObamaCare. Many on the right contend that the ACA represents an unacceptable government intrusion into private markets and that the tax credits, or subsidies, under ObamaCare are yet another government welfare program destined to promote learned helplessness and dependency. Although that line of thinking makes for great political fodder, in reality, we are all recipients of government largesse. Let's begin with employer-sponsored health insurance, the flagship of our voluntary private health insurance system and where about 150 million of us (including members of Congress) get health coverage. (Carolyn Long Engelhard, 11/16)

Now it鈥檚 time to calculate my insurance choice for next year by adding the chances of another emergency to the variables of monthly premiums and individual deductibles while factoring in the complexities of a Health Savings Account and tax ramifications. Is this algebra or geometry? All I know is there ain鈥檛 no Pythagorean theorem to solve it. ... A large reason it鈥檚 this complicated, costly and exasperating is because we refuse to just cover everyone. ... It鈥檚 unfathomable that critics seem unwilling to acknowledge that they are paying for others anyway. They are paying for it in headline-grabbing higher insurance premiums. They are paying for it in $100 IV bags in the ER. They are paying for it in Affordable Care Act subsidies. And they are paying for it when a beloved son leaves $1 million in unpaid medical bills that must be absorbed in 100 hidden ways when a $1,000 colonoscopy might have saved his life had he been able to be insured. (Burgetta Eplin Wheeler, 11/12)

For all the talk about new opportunities for consumers to make their own healthcare decisions, much remains out of their control. Nowhere is that more evident than in the prescription drug market, where stratospheric prices can sometimes keep patients from obtaining lifesaving therapies. That's why major drug companies have instituted programs to cover co-pays or other cost-sharing burdens for needy patients. And it's why Amgen Inc. has triggered an uproar among cardiology specialists for imposing unusually onerous preconditions on its program to provide financial help for patients prescribed Repatha, a new drug that treats chronic high LDL cholesterol (that's the "bad" cholesterol). Repatha costs more than $14,000 a year; many of its users are likely to need it all their lives. (Hiltzik, 11/13)

Congressional Republicans are facing a slight problem in their drive to send an Obamacare repeal bill to the president's desk that bypasses the Senate filibuster process: Some Senate Republicans from states that have expanded Medicaid under the law don't want to repeal its big Medicaid expansion, according to the Hill newspaper. ... they would be voting to preserve federally subsidized health insurance for poor people while yanking it away from working- and middle-class people who receive premium subsidies for private exchange plans. That's highly problematic for politicians who tout their support for the hard-working middle class. (Harris Meyer, 11/13)

In a positive signal from Congress, bipartisan majorities in both houses are on record as approving permanent renewal and financing of the emergency health care and compensation programs needed by thousands of first responders to the 9/11 attacks who are suffering illnesses as a result of their labors at the devastated sites. Unfortunately, just as this filibuster-proof momentum gathers force, two House committees have made moves to crimp the programs with lower funding and an extension of only five years, despite a strong majority view that the programs should not have an end date. (11/14)

The GOP鈥檚 softening on drug addiction has quickly become one of the most striking themes of the 2016 campaign, even if it gets less attention than illegal immigration or repealing Obamacare. Suddenly, in a crowded and topsy-turvy primary season that seems to be rewarding outsiders who have torn up the political script, a number of Republicans are dispensing with the antiseptic bios and have found that voters are engaging with the messiest episodes of their lives. What鈥檚 going on here? This is not a coincidence, or parallel 鈥渕essaging.鈥 In fact, if you look under the hood, you鈥檒l find this is a convergence of important trends in both political style and demographics that could signal a rewrite of the American playbook on drugs and crime. (Jeff Greenfield, 11/12)

Democratic and Republican politicians seem to agree on one big issue: government policy needs to be reformed to offer alternatives to incarceration for drug offenders. ... As an addiction psychiatrist, I fully agree with the president and others that treatment is far preferable to jail for a drug-involved offender. Of course, the incarceration-to-treatment diversion isn鈥檛 a new idea. As early as 1919, cities operated short-lived morphine maintenance clinics that were supported by local police departments to deal with heroin and morphine users. But we know from experience that referral to treatment alone isn鈥檛 enough. (Sally L. Satel, 11/13)

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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