Viewpoints: Boehner's 'truthful gaffe' on health law; Larry Kramer's AIDS crusade; costly drugs

Apr 29 2014

Bloomberg: Boehner's Truthful Gaffe On Obamacare
Although "repeal and replace" has been the Republican position on Obamacare since 2010, "replace" has been there mainly because it polled well. Republicans were satisfied with the health-care status quo in 2009, and would have been glad to repeal Obamacare to return to it. As Steve Benen points out, Republicans voted for just-plain-repeal many times. ... The "replace" component never quite shows up. Flat-out repeal was a coherent policy position in fall 2010, when the Affordable Care Act was in its infancy. Now, however, reform has become a vigorous preschooler, and everyone has bought new furniture, moved to a different neighborhood, and otherwise rearranged their lives in ways that aren't going to go away if reform suddenly disappeared. Flat-out repeal is policy nonsense and has been for months, and Boehner has revealed that he knows it (Jonathan Bernstein, 4/25).

The New York Times: How To Get Better Insurance Data, Without Encouraging Conspiracy Theories
It has been a week since opponents of health-care reform accused the Obama administration of conspiring with the Census Bureau to undercount the number of uninsured Americans in an attempt to make the Affordable Care Act look more successful than it really is. It was one of the wackier attacks on the A.C.A. And yet it has gained some traction, of sorts. No one in his or her right mind is endorsing the conspiracy theory. But in the aftermath of the accusations, a handful of senators are calling on the bureau to modify its survey method. That would be fine, if they were advocating for true advancements in the bureau's already impressive statistics-gathering. Unfortunately, they seem more intent on satisfying the conspiracy theorists than in getting the best data possible (Teresa Tritch, 4/25).

New Orleans Time-Picayune: Louisiana Residents Understand Need For Medicaid Expansion, Why Don't Elected Leaders?
Every Louisiana resident will suffer the repercussions of Gov. Jindal's stubborn refusal to accept the $16 billion in new Medicaid money. Our federal tax dollars will go to fund something somewhere else, instead of being sent back to Louisiana. Hospitals and doctors will wind up treating the uninsured in emergency rooms and swallowing the cost. An estimated 15,600 new health care-related jobs that could strengthen Louisiana's economy won't materialize. The Jindal administration's arguments against the Medicaid expansion are weak and getting weaker (4/27).

The Richmond Times-Dispatch: McAuliffe Could Go It Alone On Health Care
As the health care fight enters its fourth month -; and with neither the Senate nor the House of Delegates budging -; there is continuing speculation that McAuliffe will take matters into his own hands: He would bypass the General Assembly altogether, issuing an executive order directing the Medicaid agency to craft and carry out a plan for bringing 400,000 uninsured Virginians under Obamacare. Such a step by McAuliffe would be dramatic. It would be high-risk, possibly triggering a paralyzing political brawl with Republicans and, maybe, a legal one. It could be high-reward, allowing McAuliffe to seize victory on his marquee issue and ensuring Democrats the support of thousands of registered -; and healthier -; voters, even those in GOP territory (Jeff E. Schapiro, 4/27).

Des Moines Register: Health Care System Can Learn Lessons From Iowa Dentists
Thanks to advances in molecular medicine, genetics, risk assessments and other areas of research, health care in general (including dental care) is being transformed from a system of treating disease in a reactive, one-size-fits-all manner to one that provides predictive, proactive, preventive and personalized care. Though the techniques and technology dentists use is ever-changing, the dental care model -; regular preventive care visits and cleanings has proven successful. ... Reducing procedures is one way the health care system can learn from the dental community. For more than 40 years we have evidence of how important it is to make the move from treating patients when they're sick to helping them when they're well. This transition will be crucial for the long-term success of the health care industry (Jeff Russell, 4/28). 

The New York Times: New York's Medicaid Challenge
New York State will receive a welcome infusion of $8 billion in federal funds over the next five years to improve the delivery of health care for the state's poorest residents while saving billions in unnecessary hospital and emergency room costs. The money will be allocated to providers throughout the state, but it could be especially helpful in salvaging and reshaping failing hospitals in Brooklyn whose threatened closures have sparked community protests and brought pledges of assistance from Mayor Bill de Blasio and Gov. Andrew Cuomo (4/25).

Arizona Republic: Medicaid Ruling Restores Integrity To Legislative Process
Last week, the Arizona Court of Appeals resuscitated Proposition 108, a critical voter-enacted constitutional protection that requires a two-thirds legislative supermajority to levy new taxes and fees. A trial court had previously ruled that 36 legislators who voted against a massive new tax to fund the state's Medicaid expansion lacked the standing to enforce this provision in court, even though the tax became law with the approval of only a simple majority of legislators. The unanimous decision restored the lawsuit and, more importantly, the integrity of the legislative process (Christina Sandefur, 4/27).

The New York Times: The Angel In Larry Kramer
He understood as well as anybody else did that for Americans in the 1980s to care about AIDS, they had to care about homosexuals, and to care about homosexuals, they had to realize how many they knew and loved. He appreciated the need for visibility, from which so much subsequent progress on so many other fronts flowed (Frank Bruni, 4/26).

The New York Times: For Drugs That Save Lives, A Steep Cost
This month, amid great fanfare, the Food and Drug Administration approved a portable pocket-size device that injects a drug called naloxone to rescue people who become unconscious from overdoses of heroin and other opiates. Wider dissemination of this antidote, long used in emergency rooms and by some first responders, will certainly save lives. ... But there was one question that Evzio's manufacturer has so far declined to answer and that the F.D.A. does not consider in its approval deliberations: How much is it going to cost? (Elizabeth Rosenthal, 4/26).

The Boston Globe: Hepatitis C Cure May Be Costly -; But Also Cost Effective 
Many hepatitis C patients now have the hope of receiving a therapy that can completely cure them of their infection. The drugs just approved by the FDA eradicate the hepatitis C virus from their bodies. This is a cure for not just a few lucky patients, but instead for well over 90 percent of patients. But it remains to be seen how quickly society will be able to bring these new cures to all patients who can benefit. At well over $80,000 per patient, the new therapies for hepatitis C are expensive -; so much so that some insurance companies and state Medicaid officers are bridling at the thought of billions of dollars in extra costs. But given the societal benefit of completely curing patients with expensive and lethal disease, the cost-benefit analysis on these drugs appears straightforward -; insurance and society should pay for these life-saving drugs, since significant chronic disease will be avoided (Dr. Christoph Westphal, 4/27).

The New York Times: Wise Controls On E-Cigarettes
The rapidly growing electronic-cigarette business would finally be brought under regulatory supervision under long-delayed rules proposed by the Food and Drug Administration on Thursday. If the rules go into effect substantially as written, they will lay the foundation to protect the public from devices whose risks and benefits are largely unknown (4/25).

Los Angeles Times: Will The Pro-Vaccine Celebs Please Speak Up?
Celebrities who question the safety of vaccines just won't shut up. It seems like every week there's another famous person spouting some anti-vaccine nonsense, from Jenny McCarthy to Kristin Cavalari to Donald Trump and now, Alicia Silverstone. The continuing spread of misinformation about vaccines by celebs is alarming. And because the power of celebrity is used to sell products and champion social causes, like it or not, what famous people say has influence. So will the pro-vaccine celebrities please stand up? And when they do, like Amanda Peet and Kim Kardashian have done, can the media make a bigger deal out of it? (Susan Rohwer, 4/25). 

The Denver Post:  Issue Of Medicating Colorado Foster Children Over-Simplified
The recent Denver Post series on the treatment with psychotropic medications of youth in foster care evokes concern among the general public, members of the Colorado Child and Adolescent Psychiatric Society and other licensed prescribers, and guardians of children and adolescents receiving mental health treatment. The series failed to acknowledge that youth in foster care often have a higher need for intensive, sometimes emergency, care than do those able to remain in families of origin (Harriet Stern, 4/26).

The Minn Post: Criminalizing Pregnant Women Who Use Illegal Drugs: 'Throwing A Lit Match'
When the Tennessee General Assembly voted last week to criminally prosecute women who use illegal narcotics during pregnancy, it ignored, among other things, the major medical community's longstanding warnings about the negative and counterproductive effects of such punitive measures. The bill, sent to Gov. Bill Haslam for consideration April 16, allows for felony assault charges against a woman "if her child is born addicted to or harmed by the narcotic drug, and the addiction or harm is a result of her illegal use of a narcotic drug taken while pregnant" (Sarah T. Williams, 4/25).

The Boston Globe: In Practice: Illness And Silver Linings
During the recent one-year anniversary of the Boston Marathon bombings, Pat said she identified with the conflicted feelings of survivors who said they wished the attacks had never occurred, yet also cherished the sense of community they'd found with fellow survivors. Pat reminds me that her family had already experienced the unexpected upside of medical misfortune. One of her grandchildren has autism and is nonverbal. She's told me that there is something about this kid that brings out the best in all the other kids, and the adults, too. Makes them more understanding, more compassionate. … the clouds of illness and disability come, not infrequently, with silver linings (Dr. Suzanne Koven, 4/28).