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
Hundreds Of Hospitals Struggle To Improve Patient Satisfaction
Pleasing patients has become more important to hospitals as Medicare takes consumers views into account when setting payments. Most hospitals are getting better, but others have not improved since the government started publishing ratings six years ago.
The Boss May Be Able To Force You To Buy Company Insurance
Employment experts say firms can require workers to take the coverage that is offered.
Mental Health Privacy Questions Arise In Rape Case At University Of Oregon
In a lawsuit over a rape case involving three basketball players, the university accessed a student鈥檚 mental health records detailing treatment she received at the campus clinic.
Summaries Of The News:
Health Law
CBO Again Lowers Health Law's Cost Estimates
The Congressional Budget Office on Monday again lowered its estimate of the cost of the Affordable Care Act, citing slow growth of health insurance premiums as a major factor. Just since January, the budget office said, it has reduced its estimate of the 10-year cost of federal insurance subsidies by 20 percent, and its estimate of new Medicaid costs attributable to the law has come down by 8 percent. (Pear, 3/9)
Nearly five years after President Barack Obama signed the Affordable Care Act into law, federal budget scorekeepers have sharply revised down the projected costs of the bill. In the latest projection, published by the nonpartisan Congressional Budget Office on Monday, the major insurance provisions of the law will cost the government 11% less than they forecast six weeks ago, reducing the taxpayer tab by $142 billion over the coming decade. (Timiraos, 3/9)
The nonpartisan Congressional Budget Office attributed the savings to spending on medical care in coming years that will not be as great as previously forecast. As a result, the agency said, insurers are not expected to charge Americans as much for coverage, and the government will save on subsidies for low- and moderate-income people. What鈥檚 more, the CBO has concluded that companies are not canceling health insurance policies as often as had been anticipated earlier this year. Fewer Americans consequently are planning to sign up for insurance under the Affordable Care Act, generating more taxpayer savings. (Ehrenfreund and Somashekhar, 3/9)
Slowing health care costs are driving down the price tag of President Barack Obama's health overhaul, just as the Supreme Court is weighing whether to strike a key part of the law. Estimates released Monday reduce the projected cost to taxpayers by $142 billion over the next decade. That's an 11 percent drop from previous estimates. (Ohlemacher, 3/9)
As the Supreme Court considers the fate of government subsidies to millions of consumers receiving coverage under the Affordable Care Act, a nonpartisan budget analysis found Monday that projected costs of President Obama's signature healthcare program continued to fall. Just in time for Washington's annual fight over government spending, the Congressional Budget Office issued its revised outlook for the projected costs of implementing the act. As it has previously, the budget office found that the program is proving to be less expensive than previously expected. Here's a look at some of its latest findings. (Mascaro, 3/9)
The president's landmark health reform law will cost $506 billion for the coming five fiscal years, according to updated projections from the Congressional Budget Office, released Monday. That's 29% less than the agency's projection back in March 2010. (Luhby, 3/9)
Washington budgeteers have some good news for Obamacare and its impact on the federal deficit. The non-partisan Congressional Budget Office along with the Joint Committee on Taxation have revised the cost of the Affordable Care Act down to $1.21 trillion over the next decade. That鈥檚 an 11 percent reduction, or roughly $143 billion less than the $1.34 trillion the agency had projected in January. (Ehley, 3/9)
Spending on the insurance coverage provisions of the Affordable Care Act is projected to be $142 billion lower than the figure arrived at six weeks ago, according to the Congressional Budget Office. That's primarily due to reduced enrollment projected for exchange plans and Medicaid, as well as lower than anticipated premium costs. But while spending on exchange subsidies is expected to be much lower, so, too, is revenue from the ACA's controversial excise tax on health plans with generous benefits, the CBO said. (Demko and Herman, 3/9)
Obamacare鈥檚 insurance provisions will cost about 11 percent less than anticipated and cover fewer people than was estimated just months ago, the Congressional Budget Office reported on Monday. (Faler, 3/9)
Obamacare Enrollment Tally Climbs To 11.7 Million
Nearly 11.7 million people signed up for health coverage in state and federal marketplaces under the Affordable Care Act, the Obama administration said Monday. The latest numbers on the second year of open enrollment are a tangible sign the health law is effective, Health and Human Services Secretary Sylvia Mathews Burwell said Monday during a White House event to thank stakeholders who helped during the sign-up period. (Armour, 3/9)
Nearly 11.7 million people were enrolled in an Obamacare plan through Feb. 22, Health and Human Services Secretary Sylvia Burwell said Monday. That number will continue to increase because of extended enrollment periods through April for those who learn of the penalties for not having health care while they are doing their taxes. But as of now, Burwell said more than half of those who signed up were new customers. (O'Donnell, 3/9)
News outlets also report state-specific enrollment numbers -
California fell short of its second-year enrollment goal for Obamacare, but don't blame insurance agents. They accounted for 43% of new enrollment in Covered California, the state's health insurance exchange. That compares with 30% of people who enrolled themselves online or 10% who turned to a certified enrollment counselor or navigator. (Terhune, 3/9)
The Maryland Health Exchange reported Monday that 289,131 people enrolled in private and government-funded plans during open enrollment that ended Feb. 28. The exchange, where under the Affordable Care Act people who don't receive insurance through an employer can get a health plan, enrolled 122,778 people in private plans and 166,353 in Medicaid. (McDaniels, 3/9)
Fla. Senate Panel To Consider Controversial Medicaid Expansion Plan
A Senate committee will consider a controversial plan Tuesday that would extend federally subsidized health insurance to more than 800,000 poor Floridians 鈥 but require a waiver from the federal government to pay for it. The proposal (SPB 7044) would establish a state-run private insurance exchange available to Florida residents who earn less than $16,000 in annual income, or $33,000 for a family of four. Beneficiaries would be required to work or attend school, and pay monthly premiums. (McGrory, 3/9)
Senator Pete Kelly, a Fairbanks Republican, previewed a bill he is planning to introduce this week to reform the current Medicaid system. He said the bill won鈥檛 include a provision to expand Medicaid, he said during a press conference this morning. A group of Anchorage religious leaders and lay people are in Juneau to try to convince him and other skeptical lawmakers to change their minds on the issue. (Feidt, 3/9)
Legislative Democrats Monday blasted Republicans for killing Gov. Steve Bullock鈥檚 Medicaid-expansion proposal in committee last Friday night, saying procedural rules were violated -- but stopped short of trying to overturn the action on the House floor. House Minority Leader Chuck Hunter, D-Helena, rose on the floor to object to a committee report killing the Medicaid-expansion bill, saying Republicans on the House Human Services Committee improperly voted before Democrats could debate or amend the bill. (Dennison, 3/9)
Supporters of Medicaid expansion in Montana aren鈥檛 being honest about its long-term cost to the state, which is more than $50 million a year by 2021, a Republican state senator says. 鈥淚t鈥檚 dishonest to the public 鈥 to portray that Medicaid expansion will save the state money,鈥 said Sen. Fred Thomas, R-Stevensville. Thomas, who has been working on GOP alternatives to Democratic Gov. Steve Bullock鈥檚 proposal to expand Medicaid, said accepting federal money now for a full expansion to cover up to 70,000 low-income Montanans will mean growing additional costs for the state in the long term. (Dennison, 3/9)
Capitol Hill leaders are talking compromise on health care. Lawmakers said Monday they're hopeful, even as the clock winds down on the 2015 legislative session, that the Senate and governor can strike a compromise with the House over Medicaid expansion. House Majority Leader Jim Dunnigan, R-Taylorsville, said he wants to reach "common ground" with the Senate. "The time frame is dwindling," he said. "But there is still time." (Moulton, 3/9)
The thousands of Pennsylvanians who are now receiving subsidized health coverage though former Gov. Tom Corbett鈥檚 鈥淗ealthy PA鈥 program will be transferred to the state鈥檚 traditional Medicaid plan by Sept. 1, according to the state Department of Human Services. There will be no gaps in coverage during the shift, the department said. (Toland, 3/10)
Medicaid patients enrolling through the state health insurance exchange are taking too much of its resources, exchange board members said Monday, but state officials propose an even tighter partnership. The federal policy of "no wrong door" was meant to be a single online portal for the uninsured that would seamlessly determine their eligibility for either Medicaid or private insurance with tax subsidies they purchased on the exchange. (Draper, 3/9)
Millions in new cost overruns and escalating finger-pointing between Colorado鈥檚 Medicaid bosses and health exchange managers spurred the exchange board on Monday to vote for its own 鈥渆nd-to-end鈥 audit, while the governor鈥檚 office is launching a new round of talks between top officials. (Kerwin McCrimmon, 3/9)
As Cover Oregon goes away under a bill signed last week, so will the job of Aaron Patnode, the executive director hired last summer to put the health insurance exchange's troubles behind it. (Budnick, 3/9)
Supreme Court Orders New Look At Notre Dame's Contraceptive Challenge
The Supreme Court has revived the University of Notre Dame's effort to shield itself from an Obama administration policy to ensure all female employees are provided a full range of contraceptives, including those who work for religious schools and colleges. The administration says Catholic colleges need not provide or pay for the disputed contraceptives themselves, but they must at least notify their insurer or the government so the coverage can be provided separately. (Savage, 3/9)
Notre Dame is among dozens of religious organizations that have challenged a compromise in the Affordable Care Act offered by the Obama administration to faith-based groups. The compromise attempts to create a buffer for faith-based groups that oppose birth control, while ensuring that women still can obtain contraceptives free of charge. The federal appeals court in Chicago ruled against Notre Dame, but that occurred before the Supreme Court decided the Hobby Lobby case in favor of corporations with similar objections. (3/9)
The U.S. Supreme Court on Monday revived the University of Notre Dame's religious objections to the requirement for contraception coverage under President Barack Obama's healthcare law, throwing out a lower court decision in favor of the federal government. The justices asked the 7th U.S. Circuit Court of Appeals to reconsider its decision against the South Bend, Indiana-based Roman Catholic university in light of the June 2014 Supreme Court ruling that allowed certain privately owned corporations to seek exemptions from the provision. (Hurley, 3/9)
A local order of nuns that has sued the federal government over a contraception coverage requirement under Obamacare found hope in a ruling Monday by the U.S. Supreme Court, which backed the University of Notre Dame in a similar action. The Little Sisters of the Poor, an international order of Catholic nuns with U.S. headquarters in Catonsville, is one of hundreds of groups fighting the requirement on religious grounds. (Savage and Knezevich, 3/9)
The Supreme Court on Monday tossed out a lower court鈥檚 ruling that required the University of Notre Dame to cover all forms of birth control for its employees under ObamaCare. The ruling from the Supreme Court gives new life to an appeal from Notre Dame, which has sought an exemption from ObamaCare鈥檚 contraception mandate because of its religious ties. (Ferris, 3/9)
Study Finds Many Marketplace Plans Don't Meet Mental Health Parity Rules
Insurance coverage for mental and physical illness remains unequal despite promises that Obamacare would help level the playing field, mental health advocates and researchers say. A new study by the Johns Hopkins Bloomberg School of Public Health found that consumer information on a quarter of the Obamacare plans that researchers examined appeared to go against a federal "parity" law designed to stop discrimination in coverage for people with mental health or addiction problems. (Ungar and O'Donnell, 3/9)
The Obama administration says it does not have a contingency plan if the U.S. Supreme Court rules against federal tax subsidies in King v. Burwell. But lawmakers in at least nine states are proposing backstop measures that legal experts say could work. (Vestal, 3/10)
Jeb Bush says that Obamacare is a 鈥渕onstrosity鈥 and wants the government to focus instead on a catastrophic coverage plan to help people who experience costly medical crises. The potential Republican 2016 presidential contender said that he doesn鈥檛 see Obamacare being repealed before President Barack Obama leaves office. But once it is, he wants to see a different plan. (Haberkorn, 3/9)
HHS is considering yet another Obamacare delay, this time of the law鈥檚 2016 expansion of the small group market. The U.S. Chamber of Commerce and the insurers鈥 trade association, among others, have asked HHS Secretary Sylvia Mathews Burwell for a two-year delay in broadening that market to businesses with up to 99 employees. It currently includes employers with fewer than 50 workers. (Norman, 3/9)
Capitol Watch
New GOP Push: Restore OTC Drugs As Eligible For Health Savings Accounts
Rep. Lynn Jenkins is pushing a bipartisan $5 billion change to the health care law that would restore over-the-counter drugs as eligible expenses for health savings accounts. Jenkins, vice chairman of the Republican Conference, predicted broad bipartisan support for her new proposal (HR 1270), co-sponsored by Democrat Ron Kind of Wisconsin. (Ota, 3/9)
Sens. Rand Paul, Cory Booker and Kirsten Gillibrand will introduce on Tuesday a Senate bill that would legalize medical marijuana under federal law, another possible step towards relaxation of once strict policies toward the drug. (Everett, 3/9)
With the medical billing system in the United States on track for a major conversion, physician-lawmakers in Congress are calling for help for doctors whose cash flows may be disrupted during this transition to the ICD-10 codes. There's a drive underway to have the Centers for Medicare and Medicaid Services offer some accommodations for doctors as an Oct. 1 deadline for the code switchover nears. (Young, 2/9)
Oklahoma Gov. Mary Fallin (R) on Monday endorsed an idea put forward by some congressional Republicans to help soften the impact of a Supreme Court ruling against part of Obamacare. (Sullivan, 3/9)
Sebelius Spoke With Feds Regarding Menendez Investigation
Former Health and Human Services Secretary Kathleen Sebelius offered new details about a private meeting with Sen. Bob Menendez at the center of a criminal probe into the senator鈥檚 actions 鈥 and revealed for the first time she spoke with federal authorities about the matter. In an interview with POLITICO on Monday, Sebelius said that she disputed the New Jersey Democrat鈥檚 assertions three years ago that the federal government had uneven billing practices that unfairly hurt a company owned by Salomon Melgen, a close friend and political benefactor of the senator. (Raju, 3/10)
A criminal prosecution of Sen. Bob Menendez would represent a major test for a Justice Department anti-corruption unit that recently scored the conviction of a former Virginia governor, but endured humbling setbacks in cases against two former U.S. senators. The New Jersey Democrat is expected to face criminal charges in the coming weeks over his ties to a Florida eye doctor who is also a longtime friend and political donor, a person familiar with the matter told The Associated Press. Menendez denied wrongdoing and said he has served honorably in his more than 20 years in Congress. (3/9)
Quality
Hospitals Struggle To Improve Patient Satisfaction Scores
In April, the government will begin boiling down the patient feedback into a five-star rating for hospitals. Federal officials say they hope that will make it easier for consumers to digest the information now available on Medicare鈥檚 Hospital Compare website. Hospitals say judging them on a one-to-five scale is too simplistic. Nationally, the hospital industry has improved in all the areas the surveys track, including clean and quiet their rooms are and how well doctors and nurses communicate. But hundreds of hospitals have not made headway in boosting their ratings, federal records show. (Rau, 3/10)
Letting patients see their medical records while they鈥檙e in the hospital might ease worry and confusion without extra work for doctors and nurses, a small study suggests. (Rapaport, 3/9)
And on the topic of drug costs -
Prescription-drug spending rose more than 12% last year in the U.S., the biggest annual increase in over a decade, according to a report by the nation鈥檚 largest pharmacy benefit manager. The increase was driven in large part by soaring demand for expensive new hepatitis C treatments and price increases for diabetes and cancer drugs. (Walker, 3/10)
Veterans' Health Care
Advocates Complain Of Continued Poor-Quality VA Care
When Tim Kuncl shattered his shinbone after falling from his Puyallup home鈥檚 rooftop while hanging Christmas lights in 2011, he trusted that his local Veterans Affairs hospital would return him to health. But more than three years and three surgeries later, the 45-year-old Coast Guard veteran鈥檚 confidence in VA health care has also been smashed. Many veterans agree with local VA officials鈥 assessment that waiting times for appointments at Puget Sound facilities have dropped. Still, some vets and their advocates contend quicker visits are masking deeper problems of understaffing, inexperienced doctors and poor care quality. (Kamb, 3/9)
Meanwhile, the VA releases an opiate management tool and the skyrocketing price of an antidote to heroin overdoses raises concerns.
The Department of Veterans Affairs announced a new computer tool Monday aimed at helping doctors better monitor their patients' use of prescription drugs, as the agency continues investigating claims of narcotic overprescribing and retaliatory behavior at the VA hospital in Tomah. The program, called the opioid therapy risk report, provides information about appropriate dosages for patients experiencing pain symptoms. (Ferguson, 3/9)
Price hikes are curtailing access to a popular form of an antidote to heroin overdoses, with costs doubling in the past year and the manufacturer's stock price rising by 70 percent since it went public. Advocates fear the higher cost of naloxone, often sold in the U.S. under the brand name Narcan, will ultimately lead to the deaths of addicts who could have been saved if they'd had access to the drug. (Matheson and Welsh-Huggins, 3/9)
State Watch
State Highlights: Ore. Bills Promote Transparency; Minn. Lawmakers Move To Update Nursing Home Funding Mechanism
Two bills before the Oregon Legislature aim to inform consumers about health care pricing. One bill would require extensive pricing information while the other would provide patients with median prices that would not be insurance-specific. (Terry, 3/9)
A state bill would use a little creative financing to provide round-the-clock medical coverage to farm workers in the Salinas Valley and around the state. The bill would establish the Care of Agricultural Workers Fund, a pilot program that would be in place for up to three years and pay for 鈥渕edical, surgical, and hospital treatment for occupational and nonoccupational injuries and illnesses incurred by agricultural workers.鈥 (Robledo, 3/9)
Just five weeks after its plans to merge with a big suburban hospital were rebuffed, the state鈥檚 most powerful health system is moving to complete an acquisition of a smaller doctors group that will strengthen its foothold in the Eastern Massachusetts medical market. (Dayal McCluskey, 3/10)
State officials are in the midst of dropping a large number of Medi-Cal beneficiaries. It's the Medi-Cal renewal process -- every year, beneficiaries are required to re-enroll to continue receiving the benefit. (Gorn, 3/9)
In tiny towns across Minnesota, nursing homes are stretching limited state funds until it comes time to cut some service or shut down entirely. Lawmakers and industry groups are moving to replace a decades-old funding mechanism for nursing facilities they say falls far short of the actual cost of caring for seniors. It's an emotional issue that combines caring for the elderly with a sharper interest on rural Minnesota, where facilities are losing millions of dollars, and politicians are taking notice. (Potter, 3/9)
The Legislature is reconsidering an effort to impose a moratorium on nursing home construction in most of Indiana, a plan similar to one that failed a year ago following private lobbying by a Republican lawmaker whose family business faced losing millions of dollars. The proposed three-year moratorium would largely prohibit the Indiana Department of Health from giving licenses for new nursing homes, except for counties with occupancy rates greater than 90 percent. It wouldn't prevent construction of about two dozen new facilities that have submitted plans to state agencies or construction of assisted living centers. (Davies, 3/9)
The thousands of Pennsylvanians who are now receiving subsidized health coverage though former Gov. Tom Corbett鈥檚 鈥淗ealthy PA鈥 program will be transferred to the state鈥檚 traditional Medicaid plan by Sept. 1, according to the state Department of Human Services. There will be no gaps in coverage during the shift, the department said. (Toland, 3/9)
Former Ravens linebacker O.J. Brigance plans to urge state lawmakers to vote against right-to-die legislation in Annapolis, lending a prominent voice to one of the most controversial issues facing the General Assembly this year. (Cox, 3/9)
The budget issue that has most rattled the General Assembly this year involves the proposed elimination of health insurance for 11,500 part-time school employees, mainly bus drivers and cafeteria workers. Gov. Nathan Deal, defending the insurance cut for these 鈥渘on-certificate鈥 school workers, argued that it鈥檚 a matter of fairness to other state employees who work part time but don鈥檛 qualify for benefits. (Miller, 3/9)
Missouri's taxpayers have been paying for housing a growing number of older prisoners. According to the department's own studies over a decade, the incarcerated prison population age 50 and older has grown. As a group, regardless of age, incarcerated offenders have a higher risk of having major medical issues from their lifestyle choices, like chronic substance abuse. It's a fact Mr. Lombardi recognizes. (White, 3/9)
When Planned Parenthood lawyers go before the Iowa Supreme Court Wednesday, they'll be asking for more than permission to continue using a controversial telemedicine system for dispensing abortion pills. They'll also be asking the justices to declare that the Iowa Constitution protects women's right to abortion. Such a ruling could give Iowa abortion rights proponents a stronger hand in future court battles, an independent legal expert said. (Leys, 3/9)
Google "abortion Columbus" and halfway down the first page is a headline: "Your Right to Choose, Abortion in Columbus." It's for Pregnancy Decision Health Center, or PDHC, a chain of six sites in Ohio's capital whose aim is actually to guide women out of having the procedure. Like many of the thousands of crisis pregnancy centers across the U.S., the PDHC near Ohio State University is right next door to a Planned Parenthood. There's a cozy room for private chats and a larger open space decorated in soothing colors. (Ludden, 3/9)
Planned Parenthood Keystone and its supporters organized the rally in opposition to the University of Scranton's President's plan to remove abortion from faculty and staff health insurance coverage, even in cases of incest, rape, or when a woman's life is at risk.
A Bay Area mother formed a Facebook page where parents could arrange play dates for their children with other vaccinated youngsters. Another mom advocates socially isolating the unvaccinated by asking parents if their child is inoculated before accepting a birthday invitation, or even using the swings at the playground. And an Eagle Rock mom says she now asks about vaccine records when she buys used baby clothing. The fierce debate over childhood vaccines is prompting some parents to take extreme measures to make sure their children are segregated from the unvaccinated. (Foxhall, 3/9)
The privacy of students who get care at university clinics is in doubt after the mental health records of a women who says she was raped at the University of Oregon were accessed by the school in the course of defending itself against a lawsuit. The unidentified student is suing the university for mishandling her assault. She says she was raped by three basketball players last year. The University of Oregon found the players responsible, kicked them off the team and out of school. (Foden-Vencil, 3/9)
When an ambulance responds to a 911 call, crew members will likely ask about symptoms and take the patient's blood pressure. One topic that probably won't come up in the conversation is money. And that might lead to an unpleasant surprise later on. The fees charged by local fire departments and nonprofit hospitals typically run more than $1,000. (Gilbert, 3/9)
Many New Jersey hospitals would see steep declines in the amount they鈥檙e paid in direct state subsidies under Gov. Chris Christie鈥檚 proposed budget, although some would receive more aid. In releasing hospital-by-hospital aid figures on Friday, state Department of Health officials said the overall proposed 23 percent cut in charity care reimbursements was the result of an even greater decline of 43 percent in the amount of charity care that hospitals provided to uninsured state residents last year. (Kitchenman, 3/9)
Editorials And Opinions
Viewpoints: Health Savings Propel Good Deficit News; VA Delays; Medicine, Race And Poverty
Estimates for government health care spending keep coming down. A few months, ago, we wrote about how a slowing trend in Medicare spending had led federal budget forecasters to make drastic reductions in their estimates of the program鈥檚 costs. On Monday, they made similar cuts in their forecast of what the federal government will spend on private insurance premiums. (Margot Sanger-Katz, 3/9)
The expansion of health care insurance can drive the development of new technologies that can drive up health care spending. But it doesn鈥檛 have to. By historical standards, health spending growth has been low since 2002. As the federal and state governments expand health insurance coverage, will this relatively low growth continue? The answer depends in large part on how investments in health care technology are encouraged. (Austin Frakt, 3/9)
Financial markets have sent another signal that the coming era of precision or personalized medicine could wind up making cancer care unaffordable for millions of people. AbbVie announced last week that it will purchase a little-known biotechnology firm called Pharmacyclics for the stunning sum of $21 billion. To put that into perspective, Gilead Sciences in 2011 bought Pharmasset, the maker of Sovaldi, for half that price. Somebody is going to have to pay the return on that $21 billion investment. (Merrill Goozner, 3/7)
Do the nearly 1.7 million Texas veterans deserve quality health care? For most of us, this is a no-brainer, but the Department of Veterans Affairs has a harder time answering that question. If the VA is as concerned as the rest of us are with the quality of veterans鈥 care, why are thousands of veterans in Texas still waiting months to see a doctor? (Cody McGregor, 3/9)
Even if the U.S. Supreme Court strikes down the healthcare reform law's premium subsidies, Obamacare will live on in many important ways, a recent New York Times article argued. But would it? Given the awful mess such a ruling would create, why wouldn't Congress and the White House instead repeal the entire law and put an end to the hemorrhaging? (Harris Meyer, 3/9)
You鈥檇 think from the frenzy of anti-abortion regulations that have swept the country in the last few years that Americans have decided abortion should be outlawed. They have not, although it鈥檚 become wildly unfashionable, if not downright revolutionary, to speak of abortion as an unmitigated social good. (Robin Abcarian, 3/9)
Gov. Bill Haslam is right to be taking a second look at budget cuts in case management of adults with mental illness. The impetus for the proposed spending limits is a $10.5 million savings in the 2015-2016 budget sent by the administration to the Legislature. (3/9)
The way Iowa provides health care for its neediest citizens is about to change dramatically, and I am concerned it may lead to lower-quality care at a higher cost to Iowa taxpayers. Some 564,000 low-income Iowans are covered by the state Medicaid program, which costs $4.2 billion per year. ... Currently, Iowa runs its own Medicaid program under a 鈥渇ee-for-service鈥 model for the majority of the Medicaid patients in the state. Gov. Terry Branstad and the director of the Iowa Department of Human Services, Charles Palmer, want to move Iowa Medicaid to a 鈥渕anaged-care鈥 model administered by private companies. (State Rep. John Forbes, 3/9)
Deaths in Ferguson, Missouri; New York City; Sanford, Florida; and other areas have focused international attention on young African American men. In a recent campaign, young African American men draw attention to key overlooked facts that describe their demographic: 1 of 3 goes to college, 3 of 4 are drug free, 5 of 9 have jobs, 7 of 8 are not teenaged fathers, and 11 of 12 finish high school. How can clinicians help address existing health disparities and add to these positive outcomes? (Stephen A. Martin, Kenn Harris and Brian W. Jack, 3/9)
Disparities in health outcomes by race and ethnicity and by income status are persistent and difficult to reduce. For more than a decade, infant mortality rates have been 2 to 3 times higher among African American populations, rates of potentially preventable hospitalization have been substantially higher among African American and Latino populations, and the complications of diabetes have disproportionately afflicted African American and Latino populations. ... A common explanation for long-standing disparities is the challenge of addressing social determinants of health .... At the same time, the increasing appreciation for social determinants can have the perverse effect of undermining the potential role of public health and health care in promoting health equity. It is tempting, when confronted with substantial disparities, for leaders in health to implicate factors beyond their control. (Winston F. Wong, Thomas A. LaVeist and Joshua M. Sharfstein, 3/9)
I spent most of my career at the Boston City Hospital, now known as Boston Medical Center, that has emphasized 鈥渆xceptional care without exception.鈥 At Boston City Hospital the 2 worlds of race and poverty collide on an almost daily basis. Under the 4-decade leadership of 2 pediatric chairs, Joel Alpert, MD, and Barry Zuckerman, MD, and continuing under the current chair Robert Vinci, MD, the Department of Pediatrics expanded the boundaries of traditional medicine. In addition to providing care for medical problems such as asthma, HIV/AIDS, seizures, prematurity, and sickle cell disease, the department is committed to addressing issues of poverty, violence, poor housing, and food insecurity. (Howard Bauchner, 3/9)