Viewpoints: Congress must put entitlements on 'more sustainable path;' Reading, writing and mental health screenings

Feb 1 2013

Los Angeles Times: Playing With Fiscal Fire
What's needed now is a clear, achievable plan to bring the debt and deficit under control for the long term. A crucial part of any such plan is promoting a more vigorous economy, possibly by simplifying the federal tax code. Another important piece is putting entitlements on a more sustainable path, reducing the drain on the Treasury. That means expanding on the 2010 healthcare law's efforts to increase efficiency, quality and innovation in healthcare. But if Congress is determined to cut federal spending now at all costs, it may be chagrined to find how much it costs the economy (1/31).

The Washington Post: Obamacare: A Starting Point For GOP Revival
The Republicans, at least sentient ones, have figured out that talking in abstractions ("free-market capitalism") and slogans ("rule of law!") may be soothing for fellow conservatives but largely falls on deaf ears in a wider electorate. Likewise, opposing tax increases, opposing Obamacare and opposing compromise aren't going to capture the imagination or earn the respect of non-ideological voters. Any political hack can vote no on the "fiscal cliff," oppose immigration reform and demand a repeal of Obamacare; none of those actions, however, will advance conservatism nor earn the GOP more support (Jennifer Rubin, 1/30).

The New England Journal of Medicine: After Newtown -; Public Opinion On Gun Policy And Mental Illness 
Gun policies with the highest support included those related to persons with mental illness. The majority of Americans apparently also support increasing government spending on mental health treatment as a strategy for reducing gun violence. Given the data on public attitudes about persons with mental illness, it is worth thinking carefully about how to implement effective gun-violence–prevention measures without exacerbating stigma or discouraging people from seeking treatment (Colleen L. Barry, Emma E. McGinty, Jon S. Vernick and Daniel W. Webster, 1/30).

USA Today: Mental Health Screening For Kids
Children can't enroll in school without a doctor's verification of good health, and many districts also require visits to dentists and eye doctors. The Newtown school massacre has focused attention on dealing with mental health. A key step should be adding mental health screenings to the list of required checkups. Such screening is rarely done and represents a huge unmet need: Best estimates suggest that fewer than 2% of schools have a systematic mental health screening program (Rahil Briggs, 1/30).

The Wall Street Journal: When Hospitals Become Killers
Last week, public-health researchers released alarming data in the journal Infection Control and Hospital Epidemiology showing that the same germ that swept through the NIH is invading hospitals across the country. Researchers writing this month in another medical journal, Emerging Infectious Diseases, warn that CRK poses "a major threat to public health" (Betsy McCaughey, 1/30).

The Medicare NewsGroup: Medical Equipment, Devices Still A Ripe Area For Abuse
Knee replacements. Coronary stents. Artificial hips. A veritable hardware store of human replacement parts. It's likely that Medicare is paying too much for these items, costing taxpayers tens of billions of dollars each year, but money can't be saved until the program overhauls its purchasing practices in this expensive expense category. The greatest source of expense for medical devices is in the area of implantable medical devices, or IMDs. As America's baby boomer generation ages, seniors are getting joint replacements and coronary stents at an increasingly higher rate (John Wasik, 1/30).

Politico: The Drug Patent's Real Challenge
"Reverse payment" or "pay for delay" patent settlements between brand and generic drug manufacturers are a classic example of how legislation enacted with good intentions can produce bad public policy (Alfred Engelberg, 1/30).

Health Policy Solutions (a Colo. news service): All Payer Claims Database Designed To Reduce Costs, Improve Health Care
Health care is full of acronyms. One of them is the APCD, or All Payer Claims Database. That's a mouthful that describes a simple goal – creating a system that will allow Coloradans to compare prices and data on health care. Compiling and sharing this data is designed, in the long run, to reduce costs and improve the quality of care. Currently, this secure database has information on costs and health care usage for about 2 million Coloradans with private insurance and Medicaid coverage. When fully implemented, it will include data from almost 90 percent of all Coloradans that have insurance coverage (Bob Semro, 1/30). 

Kansas City Star: Catholic Church Tests Its Reach In Health Care Debate
Bystanders love a good brawl. Make it between people not normally viewed as combative and the crowd gathers, primed for the rumble. No surprise, then, when people jumped at the animosity between Bishop Robert Finn and the Kansas City-based National Catholic Reporter. ... Those tensions are the tip of this iceberg. Faith-based pushback to health care reform is where eyes and ears should focus. That's the building battle that will affect people far beyond the Catholic faith (Mary Sanchez, 1/30). 

The New England Journal of Medicine: Use of Health IT For Higher-Value Critical Care
With an aging population and ever-growing demand for critical care, some observers worry that the number of staffed ICU beds will become increasingly inadequate. ... Nevertheless, relatively little effort has been devoted to what could be the most promising approach to the problem: the application of advances in health information technology (HIT) to triage decisions (Lena M. Chen, Edward H. Kennedy, Anne Sales and Timothy P. Hofer, 1/30).

The Lund Report: What Interoperable EHRs Might Have Done To Improve The Patient Care Experience
You will recall in my article last December, about my healthcare experience outside of Oregon, that both the ear doctor and the neurosurgeon professed to have electronic health records (EHRs). The ear doctor advised that he was using the aircraft control type headset to dictate into my medical record, by pushing the button in his ear. When I corrected him, he would re-dictate the correction. The neurosurgeon was complaining about a most popular vendor's EHR, why it did not work for him and the inflexible nature of the product and the company. I mentioned that I had heard that the company thought it was preferable to make no or very little changes for clinicians because it could reduce errors. Neither I nor the clinician seemed to understand this concept, particularly if the physician had to design his or her own workaround or the EHR was not really useful to him (Paul DeMuro, 1/30).