Longer looks: Making Romneycare work for other states; primary care's new challenge; Boston Marathon first responders continuing battle

Oct 18 2013

Every week reporter Ankita Rao selects interesting reading from around the Web.

The Boston Globe: Exporting Romneycare
Had any of the several hundred VIPs funneling into Faneuil Hall assumed they were headed to a run-of-the-mill legislative bill signing, the two banners greeting them inside would have instantly disabused them of the notion: "MAKING HISTORY IN HEALTH CARE" they read in foot-high letters. And on this day, the boast just happened to be true. It was April 12, 2006, and Governor Mitt Romney was going to sign the nation's first universal health care program -; known as Romneycare -; into law. … Not even Massachusetts health reform's staunchest supporters would argue the system is perfect. We had the highest health care costs before reform, and we still do. That's no small thing. But the law is fulfilling its primary mission of expanding access. ... So far, Romneycare has brought health insurance to 439,000 previously uninsured people in Massachusetts. The big question now is whether Obama-care can do something similar for the more than 47 million uninsured Americans everywhere else (James Cronin, 10/13).

The Atlantic: How Primary Care Can Handle 15 Million Newly Insured Patients
As debate about Obamacare rages, some proportion of the 48 million uninsured Americans are gradually enrolling in health insurance, some for the first time in their lives. But then what? Will health care spending rise as a result of this coverage expansion? Are we just adding more people to the rolls of an already overburdened system? Answering these questions requires focusing on the linchpin of the United States' health system: primary care. Our concept of primary care is undergoing a historic reinvention (Dave Chokshi, 10/15).

The New York Times: The Dangers Of Pseudoscience
It is precisely in the area of medical treatments that the science-pseudoscience divide is most critical, and where the role of philosophers in clarifying things may be most relevant. Our colleague Stephen T. Asma raised the issue in a recent Stone column ("The Enigma of Chinese Medicine"), pointing out that some traditional Chinese remedies (like drinking fresh turtle blood to alleviate cold symptoms) may in fact work, and therefore should not be dismissed as pseudoscience. This, however, risks confusing the possible effectiveness of folk remedies with the arbitrary theoretical-metaphysical baggage attached to it. There is no question that some folk remedies do work. The active ingredient of aspirin, for example, is derived from willow bark, which had been known to have beneficial effects since the time of Hippocrates. There is also no mystery about how this happens: people have more or less randomly tried solutions to their health problems for millennia, sometimes stumbling upon something useful. What makes the use of aspirin "scientific," however, is that we have validated its effectiveness through properly controlled trials, isolated the active ingredient, and understood the biochemical pathways through which it has its effects (Massimo Pigliucci and Maarten Boudry, 10/10).

The Boston Globe: First Responders Still In Grip Of Marathon's Horror
The trigger can be unpredictable, but when the flashbacks come, they feel like spasms, rippling through her mind and body, rending her as she relives that day with harrowing clarity. They take Nicole Fluet McGerald back behind the thin canvas walls of the medical tent, where she hears the thud of the two Boston Marathon bombs. She feels sealed in, trapped, an easy target. She braces for a third blast, expecting to die. … Six months after the Marathon bombings, the terror of that long, frantic afternoon on Boylston Street still haunts many of those who treated the wounded (David Abel, 10/15).

ProPublica: Health Care Sign-Ups: This Is What Transparency Looks Like
Since the federal health insurance exchange has launched, top federal officials have told interviewers that they do not know how many people have been able to enroll using the healthcare.gov website. In an interview with the Associated Press on Oct. 4, President Obama said: "Well, I don't have the numbers yet." Then, appearing on the Daily Show on Oct. 8, the Health and Human Services Secretary Kathleen Sebelius said she didn't have the information either. "I can't tell you because I don't know." Some states, including California, New York and Colorado, are running their own health insurance marketplaces for their residents. But the Centers for Medicare and Medicaid Services (CMS) is handling enrollment for 30-plus states, including Texas, Georgia and Florida, which decided not to set up their own exchanges (Charles Ornstein, 10/14).