Viewpoints: 'The best thing George W. Bush did as president;' Finding less harmful health cuts; Navigating the future of Medicaid

Jul 28 2012

The Washington Post: George W. Bush's Greatest Legacy
This is a moment for all Americans to be proud of the best thing George W. Bush did as president: launching an initiative to combat AIDS in Africa that has saved millions of lives. All week, more than 20,000 delegates from around the world have been attending the 19th International AIDS Conference here in Washington. They look like any other group of conventioneers, laden with satchels and garlanded with name tags. But some of these men and women would be dead if not for Bush's foresight and compassion (Eugene Robinson, 7/26).

The Washington Post: An Opportunity To End The AIDS Pandemic
I was honored to deliver the opening scientific plenary lecture Monday at the 19th International AIDS Conference in Washington. The last time the meeting took place here was 25 years ago, and the mood was entirely different. In 1987, our scientific knowledge about this exploding epidemic was in its infancy. What has since been accomplished emboldened the organizers to make this year's conference theme "Turning the Tide Together" -; and allowed me to speak of a possible end to the AIDS pandemic (Anthony S. Fauci, 7/26).

USA Today: AIDS And Its Last Obstacle
In the 31 years since the first cases of AIDS were discovered in the United States, science has advanced so far that infected people -; who once faced a death sentence -; can live to near their normal life expectancy. Proper treatment not only can keep them healthy but also can make them virtually non-contagious. That finding, in a study last year, means that AIDS can someday be eradicated if everyone infected with HIV gets treated. But that's the tough part. The greatest obstacle is an abysmal health care delivery system (7/25). 

The Washington Post: Cutting U.S. Health-Care Costs Doesn't Have To Be Harmful
Now that the Supreme Court has found the Affordable Care Act's individual mandate constitutional, there is a danger that we will revert to our old health-care politics -; Republicans warning about "death panels" and socialized medicine, and Democrats wanting more tax revenue to protect Medicare. All of that misses the point (Bryan R. Lawrence, 7/26).

Journal of the American Medical Association: Bill Would Gut Patient-Centered Outcomes Research
We spent about $2.6 trillion on health care in 2010. For all that, we have a system that isn't close to universal and that by many measures is often shockingly low in quality. It would seem that it might be in the best interest of the health care system in general to reduce spending and improve quality. More than any other NIH agency, AHRQ is specifically dedicated to these goals (Aaron E. Carroll, 7/26).

Boston Globe: Power Of Big-Name Hospitals Calls For A Scalpel, Not An Ax
In the final days of the 18-month effort to pass health care cost containment legislation, state lawmakers have been making an intense 11th-hour attempt to address the market power of big, influential hospitals and hospital networks. Yet the House and Senate haven't found common ground there -; and their inability to do so shows just how complex the issue is (7/27).

Arizona Republic: It's Still Too Early To Raise State Spending
State revenue is up more than 6 percent over last year, stronger than anticipated. … If we have that much surplus dough, [some] ask, why are we still cutting education spending and putting a freeze on enrollments in low-income health-care programs and child-care subsidies? At first blush, that's a reasonable question. But there's a reasonable and important answer. In May, the temporary sales tax expires. And a year from December, the Medicaid freeze on childless adults up to 100 percent of the federal poverty level expires (Robert Robb, 7/27).

Georgia Health News: Ignore The Scare Tactics On ACA
Opponents of the Affordable Care Act have stepped up their misinformation campaign about the law now that the U.S. Supreme Court has upheld it. There are all sorts of false numbers and dire predictions about what the act will cost and what it will and won't do that are circulating on the Internet, being posted on Facebook, political blogs and making their way into print. Now we see that Gov. Nathan Deal's office is backing away from the prediction that expanding the state's Medicaid program to cover more Georgians without insurance would bankrupt the state. Indeed, the opposite is true (Pat Gardner, 7/26).

Detroit Free Press: Privatizing Prison Health Care Must Include Stronger State Oversight
Despite the evidence, the administration of Gov. Rick Snyder continues to regard privatizing government services as a panacea for controlling state spending. The latest, and largest, example is a call for bids on providing medical services -- physical and mental -- to all 43,000 state prisoners. It could be the largest privatization of state government services in Michigan history. The contract, depending on how the bidding goes, could replace the work of 1,300 state employees. Privatizing health care inside prisons, hidden from the public, contains enormous risks -- all the more so because prisoners have no political constituency (7/27).

New England Journal of Medicine: The Supreme Court And The Future of Medicaid
But some states may press the administration to interpret the expansion as a simple state option, allowing them to cover some portion of the expansion group and not others. This approach has no support in the law and would invite states to leave the most vulnerable members of the expansion group -; adults without children -; exposed to the worst sort of discriminatory exclusion. The administration may be pressured to enter into negotiations with each state, using its waiver authority. The ACA specifically amended the Medicaid waiver process to ensure that it was used for genuine research, not political horse trading. One can only hope that the states will come to their senses and we all will be spared the spectacle of federal and state governments struggling over the lives and health of the poorest among us (Timothy Stoltzfus Jost and Sara Rosenbaum, 7/26).

New England Journal of Medicine: Getting The Methods Right -; The Foundation Of Patient-Centered Outcomes Research
Health care in the United States has changed dramatically over the past several decades. Today, patients have more options than ever. Making the right choices, whether for prevention, diagnosis, or treatment, requires a critical appraisal of the potential benefits and harms of the options, within the context of the patient's characteristics, conditions, and preferences. Many of these choices are available thanks to advances in medical research. Yet most patients and many clinicians find research somewhat mysterious (Dr. Sherine E. Gabriel and Sharon-Lise T. Normand, 7/26).