Morning Briefing
Summaries of health policy coverage from major news organizations
Viewpoints: Trump And Obamacare; What Will Become Of Medicare?
Trump says he wants to replace Obamacare (most of it, anyway) with some arrangement of longstanding Republican proposals. Those include expanding health savings accounts, which let people set aside money tax-free; letting people buy health insurance across state lines, even if doesn鈥檛 comply with their own state鈥檚 rules; and creating state-run, high-risk pools of subsidized insurance for people who can鈥檛 buy private coverage. ... Those proposals, taken by themselves, aren鈥檛 objectionable. The question is whether they amount to a 鈥渞eplacement鈥 of Obamacare. And that question turns on a deeper one about the goal of health-care reform. (11/15)
The Republican president-elect has vowed to move quickly to repeal Obamacare, which he has repeatedly called 鈥渁 total disaster,鈥 and replace it with a more modest plan. Democrats in the Senate say they'll do their best to block any bill to tear down President Barack Obama鈥檚 signature achievement. Before that fight is fully joined, it鈥檚 worth reviewing what the law has and hasn鈥檛 done to meet its sweeping goals: to give more people health insurance while reshaping a medical system that spends more and delivers less than that of any other wealthy country. (Zachary Tracer, 11/15)
In 2010 President Obama bucked popular opinion and the unanimous opposition of the Republican Party to fundamentally change the U.S. healthcare system by passing the Affordable Care Act (ACA), popularly known as Obamacare. The primary rationale for the legislation was to lower the number of Americans who lacked health insurance coverage. In that regard the ACA was a success 鈥 an estimated 20 million Americans have gained health insurance (although the White House had originally predicted 32 million would gain coverage). But an article in the New England Journal of Medicine by one of the legislation鈥檚 chief architects, economist Jonathan Gruber, holds an important message for the next president 鈥 much of the reduction in the uninsured could have been accomplished without the upheaval of the ACA. (Joel Zinberg, 11/16)
No one knows for sure what President-elect Donald Trump and congressional Republican leaders are going to do about repealing and replacing the Affordable Care Act when they take power in January. But that isn't stopping everyone from speculating non-stop and offering advice. (Harris Meyer, 11/14)
Democrats have been feeling many emotions over the last week 鈥 anguish, fear, rage, and despair, for starters. Now that their heads are clearing enough to begin asking themselves how they can mount an effective opposition to Donald Trump and the Republican Congress over the next four years. One of the first tasks is to find a battle to fight. It isn鈥檛 enough to just pick up the paper or check the internet in the morning and be horrified at whatever new appointments Trump is contemplating; for Democrats to regain their focus, they need a specific controversy around which they can organize and potentially notch a win. And it looks like they may have found it. I鈥檓 speaking of Paul Ryan鈥檚 wish to privatize Medicare, or phase it out, depending on how you want to look at it. (Paul Waldman, 11/15)
Value-based care isn鈥檛 a new concept. But it鈥檚 been used a bit bashfully, traditionally referring to carrot-and-stick-based incentive payments and penalties for physicians. Today these pale in comparison to the fee-for-service care that rewards reactive, episodic, paternalistic care 鈥 and lots of it.聽Here鈥檚 what I mean by true value-based care: fully capitated payment contracts in which a lump sum of money is available to treat a patient over the course of a year. No penalties or incentives, simply ownership of the total cost of care and the total cost of outcomes. The better the care, the more money the organization bearing the risk receives. This is how to best reward exceedingly efficient, effective health care. (Chris Storer, 11/15)
Statistics show that one out of every eight or nine of us in Kentucky has diabetes. Tens of thousands more are on track to get it. The crisis here, which is a pandemic around the world, begs for action. Great health care professionals give special care to people and families with diabetes every day. We honor them during this month of diabetes awareness. (Bob Babbage and Stewart Perry, 11/15)
The Florida Department of Health has intimated that, come January, patients who did not previously qualify, but do under Amendment 2, will be able to access medical cannabis very quickly. What remains unclear is both how that will work and if the existing "Dispensing Organizations" 鈥 a term that doesn't exist in Amendment 2 鈥 will be able to fulfill even that initial demand. (Michael Bronstein, 11/16)
Like many of my neighbors, I was among the 6.5 million Floridians who voted to legalize medical marijuana on Nov. 8. People suffering from chronic illness should have access to a substance proven to relieve symptoms. As an elected official responsible for protecting the public鈥檚 health, quality of life and economy, I believe we must welcome medical marijuana in Miami Beach sensibly and safely. (Ricky Arriola, 11/15)
Congratulations Massachusetts, we just passed one of the worst pot bills聽in the country. ... Here鈥檚 the problem, which my colleague Joan Vennochi also warned about: This is a law written by the marijuana industry, and it鈥檚 got their best interests, not ours, in mind. (Shirley Leung, 11/16)
This week, the struggles are apparent at a UCF clinic where psychologists are having remarkable success helping veterans deal with the psychological scars of war 鈥 but who fear for the clinic's future.聽The clinic, you see, is running out of money. (Scott Maxwell, 11/16)