Viewpoints: A nurse finds getting coordinated care for her husband challenging; Iowa legislator outlines problems with Medicaid; Researcher's quest to save experiments after sandy

May 10 2013

Los Angeles Times: After Hospital Care, The Test Begins
In 2011, my husband, Eric, a trial attorney, was felled by a brain stem stroke just before he was to board a flight at O'Hare in Chicago. He was just 53 years old with no prior health conditions or problems. From the outset, we knew his recovery and rehabilitation would be long and difficult. We didn't know that his transition to post-hospital medical care would be just as challenging. I'm the dean and a professor at the Jefferson School of Nursing at Thomas Jefferson University in Philadelphia, and I'm a registered nurse. I thought my training and access to resources would aid in managing my husband's care. Instead, our experience showed me the many flaws in the world of medical "care coordination" and "transition management" (Beth Ann Swan, 5/9).

The Washington Post: A More Transparent Battle With Bird Flu
This variant, known as H7N9, has not reached U.S. shores, but it is a reminder of the unpredictable nature of influenza. It might cause a pandemic, or settle into a slow burn for years, or simply die out. At this stage, no one knows. The uncertainty ought to remind us of past lessons about infectious disease and globalization, which remain as urgent as ever (5/8).

Journal of the American Medical Association: ACA Implementation Starts To Get Real
President Obama spoke extensively about implementation of the Affordable Care Act (ACA) during his recent press conference, particularly about what it means for people. …The President's comments come amid reports that the American people remain confused about how the ACA (or "Obamacare") will work. People will come to understand much more about the law as federal, state, and private outreach campaigns kick into high gear this summer, but now may be a good time to review how different segments of the public will (and will not) be affected by the ACA (Larry Levitt, 5/8).

Health Policy Solutions (a Colo. news service): Get Covered Or Run For Cover
I would have been more comfortable if the Obamacare debate had centered on two other issues. One is how do we bend the cost curve?  No one has been able to show  how this will get done.  I suspect we will crash through the 20 percent of GDP ceiling soon. Keep it up and eventually half the population will be caring for the other half. The only question is which half will be paying taxes. The other question that has been ignored is -; tell me again -; how does the exchange create a competitive marketplace? (Francis M. Miller, 5/8).

Des Moines Register: Healthy Iowa Plan Better For Low-Income Residents
I have the privilege of guiding the legislation pertaining to the Healthy Iowa Plan, the alternative to Medicaid expansion, in the Iowa House. ... The Healthy Iowa Plan is a better option than Medicaid expansion at keeping low-income Iowans healthy while sustaining a thriving economy. It incentivizes members to take an active role in their own health and health plans, using modern accountability techniques, regional structures, local primary care facilities and personal reward health incentive accounts. Medicaid needs an overhaul and we all know it (State Rep. Walt Rogers, 5/7).

Reuters: Putting A Price On Illness
Today, the federal Centers for Medicaid and Medicaid Services released a trove of seemingly basic data to the public for the first time: the prices American hospitals charge Medicare for the 100 most common inpatient procedures. ... This data might make the American healthcare market a bit more transparent, but it's still far from rational. In March, Ezra Klein noted that there's no semblance of coherence among the prices insurers themselves pay for common procedures, devices and pills; each insurer negotiates their own pricing deals for these things with healthcare providers. Sadly, the only constant is that Americans pay far more than other countries for the same basic, relatively routine medical care -; with worse outcomes (Ryan McCarthy, 5/7). 

New England Journal Of Medicine: Saving Specimens After Sandy
On a Friday 6 months ago, a hurricane and two storms were on course to converge over New York. In preparation at the laboratory that day, we made contingency plans in case of a power outage. Three of us would come in as soon as it was safe to check the freezers and incubators. Our laboratories were on the 18th floor of the Veterans Affairs (VA) New York Harbor Healthcare System, part of the New York University (NYU) School of Medicine complex on the banks of the East River in Manhattan. Here, our group was working on the development of HIV vaccines and new diagnostic tests for tuberculosis. The news Sunday was that the confluence of the storms, a full moon, and an unusually high tide were going to result in a tidal storm surge on Monday evening (Susan Zoller-Pazner, 5/8). 

New England Journal Of Medicine: Improving Obesity Prevention At The Local Level – Emerging Opportunities
Thanks to a coalescence of available scientific evidence and new regulatory possibilities, there is currently substantial opportunity for local innovation in addressing the public health problem of obesity. One promising example stems from a recent federal obesity-prevention initiative: the menu-labeling provisions of the Affordable Care Act (ACA), which require chain restaurants operating 20 or more locations to provide calorie information on their menus and menu boards, along with a statement addressing daily recommended caloric intake (Sara Bleich and Lainie Rutkow, 5/9).