Morning Briefing
Summaries of health policy coverage from major news organizations
From 麻豆女优 Health News - Latest Stories:
麻豆女优 Health News Original Stories
Alaskans Face Tough Choices Because Of High Insurance Costs
The highest Obamacare insurance rates in the country are in Alaska. Though most people get a subsidy to help defray the cost, those who don鈥檛 are increasingly wondering if they should cancel their health insurance.
California And Federal Officials Reach Deal On Medicaid Reforms
A "conceptual agreement" worth $6.2 billion comes as a relief to California public hospitals, just as an earlier Medicaid agreement was set to expire.
A Med School Teaches Science And Data Mining
At NYU medical school, students learn to access huge troves of data to become doctors who understand the health care system, and individual ailments, better.
It鈥檚 Open Enrollment Time: What To Know About Obamacare Costs
KHN's Mary Agnes Carey appeared on PBS NewsHour to talk about open enrollment season to buy health insurance coverage on healthcare.gov and online state marketplaces.
Summaries Of The News:
Health Law
Health Law's Third Open Enrollment Season Begins
The Affordable Care Act鈥檚 third open enrollment season got under way, with a new array of health plans that show how the law鈥檚 influence is starting to transform the insurance industry. Sunday鈥檚 kickoff appeared to go relatively smoothly, with little evidence of technical glitches at HealthCare.gov as consumers started to shop for coverage that will take effect in 2016. (Wilde Mathews, 11/1)
The government's insurance website is faster and easier to use, but as a third sign-up season gets underway, President Barack Obama's health care law is approaching limits. Enrollment on the federal and state exchanges began Sunday. While the law's expanded coverage has reduced the uninsured rate to a historic low of about 9 percent, the gains will be harder in 2016. (Johnson and Alonso-Zaldivar, 11/2)
In Tennessee, the state insurance commissioner approved a 36 percent rate increase for the largest health insurer in the state鈥檚 individual marketplace. In Iowa, the commissioner approved rate increases averaging 29 percent for the state鈥檚 dominant insurer. Health insurance consumers logging into HealthCare.gov on Sunday for the first day of the Affordable Care Act鈥檚 third open enrollment season may be in for sticker shock, unless they are willing to shop around. Federal officials acknowledged on Friday that many people would need to pick new plans to avoid substantial increases in premiums. (Pear and Goodnough, 10/30)
The Obama administration was expecting a slow sign-up pace Sunday because of the weekend timing but is gearing up for brisker enrollment in the weeks to come. Open enrollment for new and returning customers on the federal marketplace HealthCare.gov and most state-run exchanges runs through Jan. 31. (Armour, 11/1)
[T]he ripple effects of change stemming from the law and its signature marketplaces are being felt in almost every corner of the health-care system. Consumers this week start signing up for new coverage on the marketplaces, one of the most high-profile changes the law has brought to the health-care industry. (Wilde Mathews, 11/1)
Consumers shopping on the federal health exchange for 2016 plans will still be able to pick from about five insurance companies, but there will be fewer plans on average to choose from, federal health officials said Friday. About 90% of consumers who return to Healthcare.gov will have plans from three or more insurers to choose from for 2016 coverage, Department of Health and Human Services officials said. (O'Donnell, 10/30)
Less overt drama surrounds this third year鈥檚 enrollment season, compared with the inaugural season, when HealthCare.gov and some state-run exchanges suffered massive computer defects, as well as last fall, when a pending Supreme Court case threatened to block federal subsidies that help consumers in more than three dozen states buy ACA coverage. Still, big questions linger: Of the estimated 10.5 million uninsured people who are eligible to get coverage on the exchanges, how many can be persuaded to buy health plans? And how many of nearly 10 million existing customers will renew coverage 鈥 and at what price? (Goldstein, 11/1)
Sign-up season started Sunday for health insurance under the Affordable Care Act, or Obamacare, now in year 3. Premiums are going up an average of 7.5 percent, but they could be much higher depending on where you live. (Duncan, 10/31)
Many people shopping for health coverage this weekend on the websites created by Obamacare are going to see double-digit percentage increases in their premiums. That鈥檚 still not enough for some insurers. Anthem Inc. says there remain competitors in the government-run marketplace offering premiums that aren鈥檛 enough to profitably provide the coverage patients will require. Prices in some areas probably will have to climb in 2017 and even 2018 to reach levels that make sense, according to Chief Financial Officer Wayne Deveydt. Meantime, Anthem will sacrifice market share to keep its plans profitable, he said. (Tracer, 10/30)
Those who do shop for insurance on the marketplaces will mostly see higher premium costs for 2016 compared to prices paid this year. According to HHS, premiums for a benchmark insurance plan will rise by an average of 7.5 percent in the 37 healthcare.gov states. But premium changes vary widely from state to state, and even within states, so in many cases consumers will be hit with much higher increases, while in some cases costs will be lower than this year. Furthermore, rising subsidies will protect many lower income shoppers from these price increases. (Eisenhower, 11/2)
KHN鈥檚 Mary Agnes Carey appeared on PBS NewsHour to talk about the impending open enrollment season to buy health insurance coverage on healthcare.gov and online state marketplaces. Watch the video. (10/30)
States Implement Strategies To Reach Uninsured People During Insurance Sign-Up Season
As the Affordable Care Act's third open-enrollment season kicks off Sunday, health care experts around the nation will be closely watching whether Covered California gains more traction -- and signups -- than it did in 2015. The Golden State's health care exchange was the country's darling in the first year of Obamacare, getting 1.1 million uninsured people to enroll in private plans in 2014. But that total inched up to only 1.3 million this year. (Seipel, 10/31)
The head of California鈥檚 health insurance exchange toured Los Angeles by bus Sunday, seeking to publicize the Affordable Care Act鈥檚 potential benefits among Southern Californians, many of them Latino, who officials say have failed to take advantage of the law. On the first day of this year鈥檚 open-enrollment period for federally subsidized health plans, the tour鈥檚 first stop 鈥 in East L.A. at the nonprofit care provider AltaMed Health Services 鈥 previewed what state officials say will be an overarching strategy as they seek to boost enrollment in the third year of the state-run marketplace, called Covered California. (Jamison, 11/1)
Residents will have three months during open enrollment to sign up for the exchange. Covered California has 1.3 million consumers, about 90% of whom receive subsidies to help cover their premiums. About 4 million Californians remain uninsured. Of those, officials estimate that 1.4 million would qualify for Medi-Cal, the state's Medicaid program for low-income residents, and 750,000 others would be eligible for subsidies toward private health insurance. (Sewell, 11/31)
Officials at Access Health CT, the state's health insurance exchange, plan to base their efforts to reach the uninsured more heavily on reaching "influencers," community leaders who hold sway with those who still haven't gotten coverage and can point them to a place to sign up. (Levin Becker, 11/2)
In rural Borden County, 12 people signed up for Obamacare this year. Livid over the government telling them they must buy something and loath to take anything that looks like a 鈥渉andout,鈥 the uninsured here are likely to stay that way. As Obamacare鈥檚 third open enrollment season began Sunday, this rock-solid conservative community of about 650 people offers a window into the challenges health law advocates face to expand coverage around the country. (Pradhan, 11/2)
Today begins the three-month open-enrollment period for marketplace coverage in 2016. An estimated 9.4 million to 11.4 million Americans are expected to sign up 鈥 and actually pay 鈥 for insurance through the marketplaces, which are entering their third year. Hundreds of thousands of uninsured and re-enrolling Ohioans have some important homework awaiting them. (Sutherly, 11/1)
Fewer health plan choices are being offered on the federal exchange, while PPOs, or preferred provider organization plans, for individuals and families have been drastically reduced or even have disappeared in some Texas markets. PPOs historically have been the most popular type of health insurance in Texas because they provide some out-of-network benefits and don鈥檛 require referrals to see specialists. (O'Hare, 10/30)
Customers can begin buying plans on HealthCare.gov starting on Nov. 1 and do so through Jan. 31, 2016. Rates for individual health plans went up an average of 7.5 percent nationally. Within that not-too-alarming average are outliers. Some states saw their average rate go down; others saw a big percentage leap from a reasonable starting price. For instance, Boise, Idaho, saw a 30 percent spike in premiums from about $210 to $273 a month. But Alaska is a special case. It has the highest premiums in the country, and it has seen some of the highest percentage increases over the past two years. That makes paying for insurance especially difficult for families like the Ebbessons. (Feidt, 10/30)
As the nation enters the third year of coverage under President Barack Obama's health care law, officials in Washington state say there are still hundreds of thousands of people who could be getting free or low-cost insurance. But they won't get that discount if they don't go online and check out Washington Healthplanfinder. (Blankinship, 10/31)
As the third year of Healthcare.gov gets underway, an estimated 90,000 people in the St. Louis region are still uninsured and eligible to buy health insurance on the federal marketplace, according to the Centers for Medicaid and Medicare Services. Effort for AIDS counselors like Sade Singleton have spent the past few months leading up to enrollment doing outreach and health literacy presentations throughout the region. Last year, the nonprofit helped about 700 people sign up for health insurance in St. Louis. (Bouscaren, 1/1)
And on the Medicaid expansion front -
While still awaiting federal approval of the state's plan to expand Medicaid to tens of thousands of Montanans, health care officials have been busy working to get everything into place under the assumption it'll happen soon. ... Montana has requested the federal government approve a pair of waivers to federal insurance requirements by Sunday to coincide with the start of open enrollment for the Affordable Care Act health insurance marketplace, although there is no approval deadline for the Centers for Medicare and Medicaid Services. "We continue to be cautiously optimistic we will receive approval on our plan to bring our tax dollars back from the federal government and extend health insurance coverage to more than 70,000 Montanans," said Tim Crowe, Bullock's communications director. (Benoit, 11/1)
Why Are The Health Law's Co-Ops Failing?
As open enrollment begins for the health exchanges, one development that's turning into a concern is the collapse of a number of alternative insurance plans known as co-ops. Mary Agnes Carey of Kaiser Health News joins Judy Woodruff to answer real Americans鈥 questions about shopping for coverage.
A low-cost health insurance co-op that covers about one in three Arizonans that have an Affordable Care Act marketplace plan won't be allowed to sell health plans Sunday 鈥 the opening day consumers can purchase insurance 鈥 after the state of Arizona and the federal government took action against the entity. (Alltucker, 10/31)
Capitol Watch
New Speaker Paul Ryan On The Issues
As chairman of the House Ways and Means Committee, and the Budget panel before that, Rep. Paul Ryan (R., Wis.) has dealt with some of the most contentious issues not only in the House, but also within the Republican Party, where spending and the reach of government are often flash points. Here鈥檚 where he stands on some key issues. ... Voted to repeal the Affordable Care Act and says Republicans should replace it with a plan that has fewer coverage mandates, allows insurance sales across state lines and provides tax credits to help people purchase insurance. ... Mr. Ryan鈥檚 most contentious proposal called for overhauling Medicare to allow Americans who turn 65 in the future to choose between private insurance plans with government support for premiums or staying in traditional Medicare, though their costs could rise. (11/1)
Paul Ryan doesn't believe Planned Parenthood should get one "red cent" from taxpayers -- but he cautioned Sunday against expectations that he'll be able to pull federal funding for the organization now that he's House speaker. (Scott, 11/1)
Marketplace
Merck CEO Embarks On Drug Cost Information Campaign
Talking drug prices with President Barack Obama was just the start. Merck & Co.鈥檚 chief executive officer says he鈥檚 on a campaign to change a perception most Americans have: that pharmaceutical companies charge too much for their drugs. Ken Frazier has been roaming the halls of Washington, a short trip from Merck headquarters in New Jersey, to make the case that the drug industry relies on a few precious years of high prices to fund research before its medications lose their patents. (Koons, 10/30)
There is a new price surge in the pharmaceutical industry鈥攏ot for medications, instead for a limited number of government-issued vouchers that drug makers, including AbbVie Inc. and Sanofi SA, are buying to speed products to market. Legal provisions enacted in 2007 and 2012 require the U.S. Food and Drug Administration to issue 鈥減riority review vouchers鈥 as rewards to developers of drugs for rare pediatric conditions or tropical diseases, such as malaria. Congress intended the vouchers to encourage more research into underfunded diseases. Companies receive them when the FDA approves their drug for sale and can redeem them to speed FDA consideration of a subsequent drug for any disease. (Loftus, 11/1)
After seeing its stock price soar, Valeant Pharmaceuticals of Canada is now under pressure and its shares are down more than 60 percent. Several hedge funds that are principal investors in the high-flying, high-profit company, are fiercely defending it against allegations of improper business and accounting practices. (Hartman, 10/30)
And CVS forecasts lower profits after acquiring Target's pharmacy business --
CVS Health Corp (CVS.N) gave a disappointing profit forecast for 2016, hurt by costs related to the acquisition of Target Corp's pharmacies and as its own pharmacy benefits management business expands in low-margin Medicare and Medicaid plans. The drugstore operator's profit missed analysts' estimates for the first time in six quarters, as its $10-billion Omnicare acquisition failed to offset pressure from lower reimbursement rates and new low-margin generic drugs. (Ramakrishnan, 10/30)
Campaign 2016
Trump Rolls Out Plan To Reform Veteran's Health Care
Billed as 鈥渢he Trump Plan鈥 in keeping with the billionaire developer鈥檚 habit of naming things after himself, the initiative would allow veterans to get medical care from any doctors or medical facilities that accept Medicare. It also would give veterans education benefits, business loans, job training and placement services to ease their transition from battlefield to civilian life. The plan was cheered by veterans in the crowd, which the campaign estimated at more than 5,000. (Vozzella, 10/31)
Republican presidential candidate Donald Trump released a plan on Saturday aimed at overhauling the Department of Veterans Affairs and improving veterans' health care and employment services. Under Trump's plan, eligible veterans would be able to bring their veterans' identification cards to any private doctor or facility that accepts Medicare and be able to receive immediate treatment. The change, he said, would help improve wait times and services by adding competition. (Colvin, 11/1)
Donald Trump proposed a series of reforms to the U.S. Department of Veteran's Affairs on Saturday, delving deep into the specifics of his plan for nearly half an hour at a rally in Virginia before releasing the documents online a few hours later. (Vitali, 10/31)
Republican presidential candidate Donald Trump made a new pitch Saturday to veterans, promising them that he鈥檒l take on the 鈥渃orrupt鈥 and "incompetent鈥 Department of Veterans Affairs. Trump told a crowd of supporters in front of the U.S.S. Wisconsin in Norfolk, Va., that the department is mismanaged and "not efficient. (Snyder, 10/31)
Veteran health is also a campaign issue for Hillary Clinton, as is her role in shaping the 2010 health law聽鈥
Several readers asked us to fact-check this claim, which drew sharp backlash from veterans groups and both Republican and Democratic lawmakers. Clinton is referring to the VA scandal that unfolded in 2014 after whistleblowers alleged that dozens of veterans died at the Phoenix VA while waiting for medical care. The VA Office of Inspector General later acknowledged that wait lists may have contributed to the veterans鈥 deaths. Patient and appointment record falsification and manipulations were then found to be a systemic, years-long problem. (Lee, 11/2)
Neera Tanden, a former Obama administration senior adviser on health-care reform, was working to push the impression that many of the health-care ideas proposed by the administration were in fact part of Clinton鈥檚 2008 campaign platform, according to e-mail correspondence released Friday between her and the former secretary of state. (DelReal, 10/30)
Public Health
Risk Of Dying From Breast Cancer Grows For Black Women
Breast cancer is now as common among black women in the U.S. as it is in white women, a new report found, and black women are more likely to die from the disease. Dr. Otis Brawley, the chief medical and scientific officer for the American Cancer Society, joins Hari Sreenivasan from Atlanta to discuss. (10/31)
With all the recent controversy over how often women should get mammograms, you might not realize that breast cancer is becoming an ever more-survivable disease. But, alas, that鈥檚 not the case among black women in this country. Historically they鈥檝e had the highest risk of dying if they get breast cancer among any ethnic group. And now, data from the American Cancer Society show that African-Americans have nearly caught up with whites over the past three years in their risk of getting breast cancer in the first place. (Knox, 10/30)
State Watch
Health Care Issues Play A Key Role In Hotly Contested Kentucky Governor's Race
Yet if the go-it-alone style of Mr. Bevin, 48, is rattling Republicans, Mr. Conway, 46, is not exactly exciting Democrats. Party leaders praise him as smart and steady, but his shy nature makes voters think he is aloof; friends say he is happier talking policy than politicking. His big challenge is to distance himself from President Obama, whose health care law and efforts to regulate the coal industry make him hugely unpopular here. (Stolberg, 10/30)
Though Kentucky has become reliably Republican in federal elections, Democrats have won every governor鈥檚 race except one since the 1970s, aligning themselves with an electorate that generally is centrist on economic issues and conservative on social ones. The state鈥檚 creation of a health-insurance exchange under the Affordable Care Act has been popular, while polls show a majority of Kentucky voters remain opposed to gay marriage. Registered Democrats outnumber Republicans in the state, 1.7 million to 1.3 million, but the GOP has made gains. (Campo-Flores, 10/30)
Kentucky has drawn interest not only for having an open gubernatorial seat but for being one of only a few states in the country where political power is divided. Democrats control statewide offices and the state House, while Republicans dominate the state Senate and the congressional delegation. The governor's race has turned into a referendum on President Barack Obama's signature health care law, and the results could affect the health insurance of more than half a million people. Beshear used an executive order to expand the state's Medicaid program to cover an additional 400,000 Kentucky residents and create a health exchange, where more than 100,000 people have purchased discounted health plans with the help of federal subsidies. (11/1)
State Highlights: Iowa Medicaid Privatization Plans Under The Microscope; Fla. Lawmaker Pushes Bill To Allow P.A.s, Some Nurses To Prescribe Drugs
Gov. Terry Branstad's effort to privatize Iowa's Medicaid program continues to move forward, though critics are raising questions about the projected cost savings, how contracts have been awarded and just how the change would impact patients. On Tuesday a special legislative oversight committee will hold the first of two scheduled hearings to review the privatization plans. Branstad said the move to private management will mean more streamlined service at a lower cost, but many involved in the Medicaid system 鈥 including patients and health care providers 鈥 are less sure. (Lucey, 11/1)
A new bill would allow physician assistants and nurses with advanced training to write prescriptions. Representative Cary Pigman is again pushing to open prescribing rights to midlevel practitioners. The move has failed in recent years due to pushback from doctors. But the Avon Park Republican says the move could help provide more care in rural and underserved areas. (Payne, 11/1)
Startup companies with ideas for improving health care in Arkansas will get a chance to pitch their products to investors under a program announced Friday that organizers compared to the popular television reality show "Shark Tank." Baptist Health, which operates eight hospitals in Arkansas, and the Arkansas Regional Innovation Hub announced it was launching HubX-LifeSciences, touted as the first such privately funded and industry-specific program in the state. (DeMillo, 10/30)
Chipotle Mexican Grill Inc said on Sunday it had closed all its restaurants in two West Coast markets due to a reported outbreak of E. coli bacteria that is being investigated by the company and health authorities. "After being notified by health department officials in the Seattle (Wash.) and Portland, Ore. areas that they were investigating approximately 20 cases of E. coli, including people who ate at six of our restaurants in those areas, we immediately closed all of our restaurants in the area out of an abundance of caution," Chipotle said in an emailed statement. (Pierson and Baertlein, 11/1)
When Raychelle Black moved to Atlantic City in October 2013, she was at a low point 鈥 both of her parents had died in the previous year, and she had lost her family home in New York City. Then Sandy struck, and she lost nearly all of her remaining possessions when her new home was flooded. But it wasn鈥檛 until several months later, through a visit to her primary-care provider 鈥 a Southern Jersey Family Medical Centers鈥 clinic 鈥 that she learned she had depression. (Kitchenman, 10/30)
In July 2014, Ellen Engelson's leg broke spontaneously, weakened from radiation treatments years before. She lives in Key West, so she went to the emergency room at the only hospital within 50 miles. But because her leg needed specialized care, she had to get to a hospital on the mainland. (Klingener, 10/30)
A police program in northern Massachusetts that helps fast-track heroin addicts into treatment is catching on in other states and showing signs of reducing crimes associated with addiction. Gloucester police say dozens of departments in nine states have taken a page from their ANGEL program, which gives addicts a chance to make treatment rather than arrest the first response they get from police. (Marcelo, 11/1)
Dr. Robert Gore was stirred awake one morning in July by an urgent phone call from work. That was not unusual, given his job in the emergency department at Kings County Hospital Center in Brooklyn, a level-one trauma center that provides the highest level of care. Still, his years of skillful, coolheaded practice, of stopping bleeding and saving lives, had not prepared him for what he heard. (Gonzalez, 11/1)
As a member of the International Cannabinoid Research Society, a collector of antique marijuana apothecary jars, the founder of an industrial hemp business and 鈥渁 pot smoker consistently for 47 years,鈥 Don Wirtshafter, an Ohio lawyer, has fought for decades to make marijuana legal, calling it 鈥渕y life鈥檚 work.鈥 But when Ohio voters go to the polls Tuesday to consider a constitutional amendment to allow marijuana for both medical and personal use, Mr. Wirtshafter will vote against it. (Smith and Stolberg, 11/1)
Editorials And Opinions
Views On Health Enrollment: One Employer's Experience; Cost-Shifting; Beware Bush's Plan
ObamaCare expanded coverage in 2014 to the extent that it gave people free or nearly free insurance. That goal could have been accomplished without the Affordable Care Act. To justify its existence, ObamaCare must make affordable private insurance available to a broad cross-section of uninsured Americans who are ineligible for Medicaid. But with fewer people buying insurance through the exchanges, the economics aren鈥檛 holding up. ... At our company, CKE Restaurants, we offer eligible employees ObamaCare-compliant coverage. We used federal guidelines and set our employee monthly contribution for the least expensive Bronze plan at $1,116 a year, or about 25% of the annual premium. The company pays the rest, and the deductible is $5,500. But even when next year鈥檚 higher penalty kicks in鈥2.5% of income above $10,000鈥攁n employee would need to earn more than $50,000 a year for the penalty to exceed the premium. ... Of our company鈥檚 5,453 eligible employees, only 420 enrolled. Our experience isn鈥檛 unique, according to press reports. (Andy Puzder, 11/1)
In the big picture, the data on health care costs looks positive as Americans prepare to choose insurance plans for 2016. People in employer-sponsored programs saw their premiums increase a manageable average of 4 percent last year, according to a nationwide survey. The federal government estimates that eight of 10 Americans who enroll in the Affordable Care Act鈥檚 insurance exchange will pay less than $100 a month next year after receiving tax credits. ... But for many people in the trenches, the picture is much less bright. Consumers understand that premiums are relatively stable only because cost-sharing measures are at all-time highs. Their paychecks may not show big increases for health insurance, but they are carrying large deductibles and paying more in co-pays for doctor鈥檚 visits and prescription drugs. (10/30)
This is now the third year that the Affordable Care Act鈥檚 marketplaces are open for business. The prices in year one were actually lower than many experts had predicted and, in year two, they rose only a tiny bit. This year is a different story. They are clearly rising more quickly, as analysts and insurance officials predicted this past spring. There are a few reasons for the acceleration, but the most important is that many insurers initially set their premiums too low. They assumed the pool of beneficiaries would be larger and healthier than what they actually got. Now they are adjusting. (Jonathan Cohn, 10/31)
It鈥檚 open enrollment season for almost every kind of health insurance in America. Millions of Americans using Medicare plans, employer-sponsored health insurance or Affordable Care Act marketplaces select health plans each fall. Many consumers face numerous options, and research shows that they make many mistakes, often paying more than they need to. Some err by selecting deductibles that are too low. Lower deductibles can be a fine choice for some consumers, but trying to save money with a lower deductible can be a poor choice if a person pays even more in premiums. For instance, at one large American company in 2010, employees could reduce their deductible by $250 鈥 to $750 from $1,000 鈥 by paying $500 more in premiums. Trading $500 for $250 is clearly a bad deal for the consumer. (Austin Frakt, 11/1)
Jeb Bush released a health-care plan last month that would disassemble Obamacare鈥檚 鈥渢hree-legged stool鈥 鈥 its federal mandate requiring all individuals to carry health insurance, its ban on insurance companies denying or pricing out people with preexisting conditions, and its subsidies to help people buy coverage. In its place, he would assemble a flimsier one. (11/1)
Viewpoints: Problems With GOP Tax Plans; Pass The Mental Health Bills
The Republican presidential candidates were full of tax talk at this week鈥檚 debate. But none has a tax plan coherent enough to be the basis of a substantive discussion, let alone one that could meet the nation鈥檚 challenges. ... The only way the Republican candidates could ever pay for such large tax cuts would be by slashing big spending programs, namely, Medicare and Social Security. All of these candidates deny fiscal reality. In the next 10 years, revenues will need to increase by 40 percent simply to keep federal spending even, per capita, with inflation and population growth. Additional revenues will be needed to pay for health care for the elderly, transportation systems and other obligations, as well as for newer challenges, including climate change. (10/30)
Republicans need to promise economic miracles as a way to sell policies that overwhelmingly favor the donor class. It would be nice, for variety鈥檚 sake, if even one major G.O.P. candidate would come out against big tax cuts for the 1 percent. But none have, and all of the major players have called for cuts that would subtract trillions from revenue. To make up for this lost revenue, it would be necessary to make sharp cuts in big programs 鈥 that is, in Social Security and/or Medicare. But Americans overwhelmingly believe that the wealthy pay less than their fair share of taxes, and even Republicans are closely divided on the issue. And the public wants to see Social Security expanded, not cut. So how can a politician sell the tax-cut agenda? (Paul Krugman, 11/2)
Carson wants to end Medicare and replace it with health savings accounts, and that pretty much makes him unelectable, although he鈥檚 now backing away from his position. So my hunch is that the betting markets are right and that Senator Marco Rubio will ultimately emerge as the nominee. But maybe the more interesting question is what Carson says about America. He seems to see his rise as an indication that America needs not so much social programs as firmer character. (Nicholas Kristof, 10/31)
It is a riddle. Republicans running for the party鈥檚 presidential nomination continue to push cuts in Medicare spending even as Republican voters oppose cuts in Medicare spending. Seventy-seven percent of Medicare beneficiaries are white and 84 percent are over 65, according to recent studies. Those older white Americans 鈥渢ilt heavily Republican,鈥 according to the Pew Research Center鈥檚 poll findings. So why do Republican politicians keep bringing up the idea of cutting or eliminating Medicare, a losing proposition among every voting group, including Republicans? (Juan Williams, 11/2)
The real point is that today鈥檚 mega-griping about the drug industry comes from politicians unhappy with drug companies for following the incentives that politicians create for them. Mega-griping is already descending on a bruited merger between Pfizer and the Ireland鈥檚 Allergan, all for incentives made in Washington. The U.S. tax code鈥檚 treatment of international profits provides a giant motive for Pfizer to transfer its corporate headquarters abroad. The expense and risk of bringing new drugs to market under the FDA is a reason the duo prefer to market the hell out of existing drugs like Viagra and Botox. The plague of third-party payership encouraged by the tax code, Medicare, Medicaid and ObamaCare helps make it possible for the industry to hike prices without losing sales. (Holman W. Jenkins Jr., 10/30)
Mass shooting after mass shooting, Democrats call for more gun regulations while Republicans stress the importance of improving mental-health care. Both are necessary. Yet the depressing result of this partisan routine has been that nothing happens on either issue. That might soon change, at least on the mental-health front. Solid, bipartisan mental-health bills are poised to move in both chambers. They should be passed, reconciled and signed into law. (11/1)
The leading Republican candidate for president tells heartbreaking stories of violence committed by a few Mexican immigrants as evidence that they are rapists, murderers, criminals, and drug dealers. He depends on outrage and fear to gain support for building a 2,000-mile fence and detaining and deporting millions of individuals. A similar tactic is being used to influence national policies about people with serious mental illnesses in the wake of well-publicized mass murders. The intention is to cause fear by linking violence and mental illness, and then blaming the illnesses and the mental-health system for the problems. The proposed solutions? A return to asylums; more involuntary outpatient commitment; attacks on a federal agency that has spearheaded advances in mental-health policies and services; and challenges to the nation's emphasis on protecting the rights and freedoms of all citizens. (Mark Salzer, 11/1)
Every few months, I do an Internet search for my name, as recommended by a media-savvy colleague. In the past I鈥檝e found myself in all the predictable places 鈥 among a list of doctors who graduated from my residency program, on my employer鈥檚 Web site, in various social-media posts. But in the stillness of a warm evening this past August, after putting my daughter to bed, I found myself in a new and terrifying place: an anti-choice Web site that claims I am part of an 鈥渁bortion cartel.鈥 In addition to my office address and links to find my medical license numbers, it features several photos of me. In one of the photos, taken from social media, I鈥檓 holding my then-15-month-old daughter. (Diane J. Horvath-Cosper, 10/29)
Beginning in January, the taxpayer-funded Medicare program will pay health-care professionals to counsel the elderly as they choose to pursue or reject life-preserving medical treatment. Sadly, most health-care professionals are unlikely to act as neutral assistants. Cost pressures, combined with an increasingly pervasive ideological commitment to avoiding 鈥減oor quality of life,鈥 will result in the subtle 鈥 or not-so-subtle 鈥 鈥渘udging鈥 of those who are most vulnerable to accept premature death. (Burke Balch, 11/1)
If you want information on a hospital's infection rate, call the hospital and ask to speak to someone in the infection control department. Ask: What is the hospital's infection rate and how does it compare with the national average? What is the infection rate for your surgical procedure and how does it compare with the national average? Is the hospital having any cluster or outbreak of certain infections such as MRSA or c. difficile? For the first two questions, ask for specific percentages. Don't accept just "as good as." If the first person you reach cannot answer these questions, ask who can. (Maryanne McGuckin, 11/1)
People struggling against Alzheimer鈥檚 disease 鈥 either as those who have it, their caregivers, advocacy groups or researchers 鈥 got a tremendous boost this week from President Barack Obama. The Oval Office support is long overdue. Obama joined other presidents, proclaiming November 2015 as National Alzheimer鈥檚 Disease Awareness month. 鈥淭his November, let us focus our nation's attention on the challenges posed by Alzheimer's disease, which families across America courageously face every day,鈥 Obama said. (Lewis Diuguid, 10/31)