Viewpoints: Angelina Jolie on her decision to have a double mastectomy; Justice Ginsburg's 'blind spot' on abortion

The New York Times: My Medical Choice
My doctors estimated that I had an 87 percent risk of breast cancer and a 50 percent risk of ovarian cancer, although the risk is different in the case of each woman. Only a fraction of breast cancers result from an inherited gene mutation. Those with a defect in BRCA1 have a 65 percent risk of getting it, on average. Once I knew that this was my reality, I decided to be proactive and to minimize the risk as much I could. I made a decision to have a preventive double mastectomy. I started with the breasts, as my risk of breast cancer is higher than my risk of ovarian cancer, and the surgery is more complex (Angelina Jolie, 5/14).

Forbes: If You Want to Stop Hospital Harm, Don't Call a Capitalist
The Leapfrog Group has just released its latest report grading the safety of hundreds of individual hospitals, but the real news isn't the "incremental progress." It's how a group started by some of the most powerful corporations in America has quietly devolved into just one more organization hoping press releases produce change. Amid the current enthusiasm for "value-based purchasing" by employers and possible privatization of Medicare, it is worth examining why Leapfrog's initial notion that corporations would spearhead a crackdown on crummy care failed and what we can learn from that publicly unacknowledged failure (Michael Millenson, 5/12).

The New York Times' Taking Note: Ginsburg's Roe V. Wade Blind Spot
Instead, Justice Ginsburg contended, the court prevented the states from working out on their own how best to regulate abortion, short-circuiting the democratic process and provoking an angry "backlash" among conservatives and resistance to Roe that continues to this day. But as the Times editorial page summarized last month, "The real story, as explained by Linda Greenhouse, a former New York Times reporter who now teaches at Yale Law School, and Reva Siegel, a professor there, is that political conflict over abortion was escalating before the Roe decision, and that state progress on decriminalization had reached a standstill in the face of opposition from the Roman Catholic Church" (Lincoln Caplan, 5/13). 

National Review: The Medicaid Deniers
For years, progressives have claimed that they are the party of science. ... But there is at least one area of public policy where the Left has abandoned its rhetorical allegiance to science: health care. For years, studies have shown that patients on Medicaid -; America's government-run insurance program for the poor -; do no better, and sometimes do worse, than those with no insurance at all (Avik Roy, 5/14).

Health Policy Solutions (a Colo. news service): New Evidence Against Colorado Medicaid Expansion
The problem is that the latest research suggests that much of the additional Medicaid spending will be wasted. Results from the Oregon Health Study Group … show that enrolling the able-bodied poor in Medicaid increases annual health spending by $1,172 per person per year without improving blood pressure, cholesterol levels or blood sugar levels. Rates of outpatient surgery, emergency department visits and hospital admissions are also unaffected. … While it is clear that Medicaid benefits the sick and helpless for whom it was originally designed, in the current environment there is little evidence of benefit from expanding Medicaid to cover able-bodied adults. In fact, the opposite may be true (Linda Gorman, 5/13).

Bloomberg/Businessweek: Want to Improve Health Care? Spend Less on It
It's shocking that, in one of the richest countries in the world, millions are still denied access to health care-;and especially preventative services-;because they can't afford coverage. And the pain and disruption associated with paying medical bills is immense. The U.S.'s move toward universal health coverage is a step in the right direction. But the U.S. also needs to get more serious about keeping people out of doctors' offices and hospitals in the first place.  That's the most effective – and by far the cheapest -; path to longer, healthier lives (Charles Kenny, 5/13).

JAMA: Patients' Responsibility To Participate In Decision Making And Research
It is time to reduce the artificial barriers between research on one side and patient care and practice on the other. The path to effective, sustainable patient-centered health care and decision making requires that patients let clinicians know their priorities, understand which strategies are most likely to achieve their priorities, and participate in the research that generates this evidence (Drs. Mary E. Tinetti and Ethan Basch, 5/13).

Boston Globe: Looking Past A Patient's Crimes A Difficult Challenge
It was the first day of a new rotation. I was getting to know my patients, trying to match faces and diagnoses with names on my list. A frail man with end-stage heart failure, Mr. T was too weak to walk and spent most of his time in a reclining chair. He had been in the hospital for weeks with pneumonia, kidney failure, and several other complications. I introduced myself and proceeded to examine him. … No one came to visit him. A few days into the rotation, I found myself reading through his medical record, trying to figure out what his life outside the hospital had been like, and whether there might be a friend or relative able to help care for him after discharge. I was not prepared for what I discovered (Kiran Gupta, 5/13).

WBUR: Cognoscenti: Mental Illness: The View From Within
Amid the search and subsequent capture of Boston Marathon bombing suspect Dzhokhar Tsarnaev, and in the weeks since, I was riddled with fear, dread, and curiosity. I think that range of emotions was fairly common. Perhaps slightly less common was the other emotion I felt: a vague sense of shame. As someone who struggles with mental illness, I was waiting for everyone to start speculating about depression, bipolar disorder or schizophrenia as a possible explanation (Susan Senator, 5/14).