Morning Briefing
Summaries of health policy coverage from major news organizations
Viewpoints: Where Medicaid Goes From Here; How Best To Fix The Health System
As Republicans take another crack at devising a plan to replace ObamaCare, here鈥檚 an idea they should consider: Give each Medicaid patient a health savings account 鈥 and put $7,000 in it every year. Under ObamaCare, Medicaid has become the only option for millions of Americans. But that doesn鈥檛 mean much if the doctors in their communities don鈥檛 accept new patients through the program 鈥 and 30% of physicians don鈥檛. (Justin Haskins and Michael Hamilton, 4/13)
President Trump on Wednesday signaled his determination to mount another drive to repeal the Affordable Care Act, but he faces a surprising obstacle: unexpectedly widespread Republican resistance to cutting Medicaid. That hesitation, following decades of GOP efforts to retrench the program, powerfully demonstrates how the party鈥檚 growing reliance on economically strained and older white voters is disrupting its ideological compass. (Ronald Brownstein, 4/13)
Rep. Mark Meadows, a North Carolina Republican, is an unlikely object of the caterwauling recently directed at him and the House Freedom Caucus he leads. The vituperation was occasioned by the HFC鈥檚 role rescuing Republicans from embracing an unpopular first draft of legislation to replace Obamacare. ... Although just a little over two years old, the HFC signals a revival of congressional resistance to the dangerous waxing of executive power under presidents of both parties. The HFC is a rarity, a heartening political development: People giving priority to their legislative craft and institution rather than to a president of their party barking at them. (George Will, 4/12)
If Obamacare is here 鈥渇or the foreseeable future,鈥 as [House Speaker Paul] Ryan forecasts, there are some simple fixes that can make a big difference. For the 20 million Americans who depend on the individual health insurance marketplace for their coverage, inaction is unacceptable. (John Kabateck and David Panush, 4/12)
If the United States had undertaken road building or space exploration in the same way it is chasing health system reform, there would be neither an interstate highway system nor footprints on the moon. The successes depended on clear, bold, shared aims; strong investments in technical mastery; continuity of purpose over time; and continual learning at a large scale 鈥 not to mention considerable celebration. Health care reform has had none of these. The reasons for the difference are many. The National Aeronautics and Space Administration (NASA) undoubtedly faced political headwinds, but they were not gale force, because NASA was not dealing with $3 trillion of the US economy, a panoply of stakeholders with financial interests in the status quo of health care, professional fragmentation, or a viciously complicated legacy payment system designed by no one at all. (Donald M Berwick, 4/11)
Gov. Terry Branstad doesn鈥檛 have much to say about problems caused by his privatization of Medicaid. Low-income Iowans report losing health services. Providers are not being paid by managed care companies. The origins of the governor鈥檚 鈥渟avings鈥 estimates remain a mystery. Taxpayers don鈥檛 understand why they鈥檙e bailing out for-profit insurers contracted with the state. (4/12)
Consider the following. I鈥檓 a physician at the end of more than a decade of training. I鈥檝e dissected cadavers in anatomy lab. I鈥檝e pored over tomes on the physiology of disease. I鈥檝e treated thousands of patients with ailments as varied as hemorrhoids and cancer. And yet the way I care for patients often has less to do with the medical science I鈥檝e spent my career absorbing than with habits, environmental cues and other subtle nudges that I think little about. (Dhruv Khullar, 4/13)
Johns Hopkins ophthalmologist Oliver Schein has found a simple way to save a half a billion dollars a year from our country鈥檚 health-care bill, with no negative effect on patient health. 聽The only thing standing in the way is a stubborn government requirement. (Peter Pronovost, 4/11)
It鈥檚 a situation that many pediatricians encounter on a regular basis: a parent who is resistant to the idea of childhood vaccinations for a son or daughter. The only difference here is that Jeremy isn鈥檛 really an anxious parent but a standardized patient鈥攁n actor trained to re-create this scenario鈥攁nd I鈥檓 not a physician but a medical student. We鈥檙e in the midst of an OSCE, an 鈥渙bjective structured clinical examination,鈥 designed to train medical students in the real-life practice of medicine. (Brit Trogen, 4/11)
In December 2016, the Government Accountability Office released its report on the Food and Drug Administration鈥檚 oversight of foreign drug production. Strikingly, the report found that most FDA infractions occur in overseas pharmaceutical production sites, primarily in India, while a third of all production locations go without any oversight at all. (Roger Bate, 4/13)
A preliminary dive into the data surrounding infant mortality in the Cleveland area reveals some disturbing trends: a shockingly high level of prematurity contributing to early infant deaths, and evidence that many young mothers aren't accessing the prenatal care they need. (4/12)
鈥淵ou have Parkinson鈥檚 disease.鈥 Hundreds of residents in the Lexington community have heard those words. Delivered to me by a neurologist five years ago, they were shocking and bred all sorts of questions. Was this disease terminal? How could it be me? Was there a cure? How would I tell my family, friends and co-workers? (David M. Smith, 4/12)
The juxtaposition of headlines must have sent shivers down the spines of the global humanitarian and human rights communities. Even as headlines warned of 20 million people in Africa and the Mideast facing starvation, the Trump Administration was proposing unprecedented cuts in foreign assistance. While the drastic cuts may not come to pass, US values of compassion are being eroded. Secretary of State Rex Tillerson warned other countries to provide a larger share of assistance. Perhaps signaling what is to come, in the first quarter of 2017, US contributions to humanitarian appeals decreased by nearly one-half from the level for 2016. And even small cuts to humanitarian assistance are more than the world鈥檚 most desperate people can afford, with United Nations humanitarian appeals already routinely underfunded. (Lawrence Gostin, 4/12)