Viewpoints: Could expanding mental health services curb gun violence?; Opinions on other aspects of health law

Dec 20 2012

USA Today: 6 Ways To Stop Gun Madness
President Obama said he would use whatever powers his office holds to address this violence. ... Currently, nearly half of all gun sales in the U.S. are conducted without a background check. Criminals, the mentally ill, minors and domestic abusers are all prohibited from purchasing guns, but they all can do so as easily as attending a gun show or going online. ... Fixing the background check system also requires the federal government to compel states to submit all necessary records on felons, domestic abusers, the seriously mentally ill and others to the background check system (New York Mayor Michael Bloomberg, 12/19). 

The Wall Street Journal: Reflecting On Mental Illness After Newtown
Four years ago, my colleague, Nathan Koppel, and I wrote a front-page article about William Bruce, a young man with paranoid schizophrenia who bludgeoned his mother to death with a hatchet. ... Bruce's sad tale illustrates why it's so hard to get help for someone who is so sick: People who are mentally ill often suffer from agnosia, or a lack of insight into the illness; they don't believe they are sick. Family members or parents may not comprehend the extent of the illness or may not be able to control their loved one and get him help. Resources for people with mental illness are scarce and hard to access (Elizabeth Bernstein, 12/19).

The Houston Chronicle: Take The Wiser Approach To Mental Health Funding
As Texans, we can act right away to try to prevent the next tragedy. We can convince state lawmakers to stop cutting the funding for mental health treatment for those who must rely on public services. I have always said that an investment in mental health services, especially out-patient care, is an investment in public safety (Adrian Garcia, 12/19).

Politico: Affordable Care Act Fills Need In Mental Health Care
A provision [in the health law] that passed with unanimous support requires that starting in 2014, health insurance plans cover mental health and addiction services as part of the essential benefits. As a result of these historic changes, approximately 68 million Americans will have access to lifesaving mental health and addiction treatment services. Furthermore, these services, which have been misunderstood and marginalized for so long, will finally be fully integrated as part of a comprehensive approach to health care. That is, if the law is implemented as intended. The far-reaching impact of this change cannot be overestimated (Former Reps. Patrick Kennedy and Jim Ramstad, 12/19).

The Boston Globe: Expansion Of Medicaid May Prevent Future Tragedies
Limiting the availability of assault weapons is an obvious and necessary step to reducing the future likelihood of mass shootings like the one in Connecticut. But so is maintaining and improving mental health care services, which have been severely strained in recent years (and in some areas reduced) and are further threatened by the fallout from a recent Supreme Court decision and the incipient deal to avert the fiscal cliff. The linchpin is Medicaid. Though mainly thought of as a safety-net program for the poor, Medicaid provides about half of state mental-health budgets (Joshua Green, 12/19).

The New England Journal of Medicine: Medicaid Expansion Opt-Outs and Uncompensated Care 
With the number of uninsured people projected to drop by half, policymakers anticipated a substantial decrease in the uncompensated care provided at acute care hospitals. Consequently, beginning in 2014 the ACA initiates a series of payment reductions under the Medicare and Medicaid Disproportionate Share Hospital (DSH) programs. ... without either federal changes to DSH formulas or a full expansion of affordable coverage to the uninsured with incomes below the poverty line, states forgoing the Medicaid expansion are likely to leave a substantial uncompensated-care burden on hospitals (John A. Graves, 12/20).

The New England Journal of Medicine: Religious Freedom And Women's Health -; The Litigation On Contraception
Perhaps the most interesting question, however, is whether the [health law's contraception coverage] requirement substantially burdens the religious beliefs of employers. Two courts have observed that the rule does not require employers to use contraceptives or even to approve of their use. ... Employers object, however, that they should not have to pay for services that they consider to be morally wrong. The question of whose interests and beliefs -; those of the employer or those of the employee -; ought to determine access to contraception benefits is one that the courts, and no doubt ultimately the Supreme Court, will have to decide (Timothy Stoltzfus Jost, 12/19).

The Wall Street Journal: 'Obamacare' Rollout: What Companies Need To Know
Two questions come up every time I speak to companies about President Obama's health care law, now called "Obamacare" by detractors and supporters alike. First, "Will it be repealed?" And second, "Can't I just drop coverage and plan to pay the penalty?" Many executives have not tackled the question they need to focus on very soon, "What will it take to comply with the new law?" (Kate Barton, 12/19).

News outlets also offered editorials and columns exploring elements of the health care system -

Bloomberg: Lure More Doctors Into Primary Care With 'Medical Homes'
By 2025, the U.S. will require 52,000 more nonspecialist physicians than it has now. This is mainly because there will be more Americans, especially older ones. The increased number of insured people will only worsen the problem. … No simple solution is possible because this predicament is knitted into American health care -- an insurance-driven, government-subsidized system in which general practitioners' time and attention isn't priced as high as specialists' surgeries and procedures. … What's needed are clerkships in community primary care that give students a strong team experience, and that last as long as a year, so they can learn the rewards of getting to know their patients (12/18).

The Philadelphia Inquirer: Community Health Workers: A New Healthcare Workforce For The Era Of Health Reform
The current American health-care system, with its focus on delivering expensive treatments to well-insured individuals, is ripe for a [revolution]. There is a largely untapped workforce with the potential to lead such a revolution in the health-care market -; the too-often unheralded community health workers. Community health workers are lay people trained by medical and public health professionals to provide a range of health-related services in their communities, and who help patients live better by supporting behaviors that impact their health (Matt O'Brien, 12/19).

The Lund Report: A Healthcare Odyssey Without Electronic Health Records
In a pre-health reform world without interoperable electronic health records (EHR), or a patient-centered provider collaborative model, my healthcare experiences over the last year or so are all too common.  As a biomedical informatician and healthcare attorney, I will ... offer some initial thoughts on how interoperable EHRs, and a patient-centered provider collaborative model can afford a greater quality of care, in a more cost-effective manner, with less angst and less time on the part of a patient  (Paul DeMuro, 12/20).