Viewpoints: Threat to drug development; GOP's Obamacare criticism tempered; finding doctors for seniors

Aug 21 2014

The Wall Street Journal: The Medical Innovation Threat
An invasive species has been introduced into the U.S. health innovation ecosystem, with a growing danger of permanent damage to the development of specialty drugs. The relentless assault on the price of Sovaldi is becoming a threat to the 30-year political balance that has energized the biomedical revolution (8/19).

Bloomberg: Obamacare Fades Right On Schedule
Obamacare is fading as a campaign issue. It hasn't disappeared entirely. But after totally dominating the ad landscape in the spring, Obamacare has dropped to just another issue in Republican ads. Health-care has also plummeted in polling on issues important to voters in this cycle. And as Greg Sargent has been documenting, Republican candidates have shifted to a more nuanced position -- they still almost all say they support repeal, but they weasel around the idea that various ACA programs and benefits will be included in that supposed repeal (Jonathan Bernstein, 8/19). 

The New York Times' The Conscience Of A Liberal: Beyond The Lies
The reason is fairly obvious, although it's not considered nice to state it bluntly: the attack on Obamacare depended almost entirely on lies, and those lies are becoming unsustainable now that the law is actually working. No, there aren't any death panels; no, huge numbers of Americans aren't losing coverage or finding their health costs soaring; no, jobs aren't being killed in vast numbers. A few relatively affluent, healthy people are paying more for coverage; a few high-income taxpayers are paying more in taxes; a much larger number of Americans are getting coverage that was previously unavailable and/or unaffordable; and most people are seeing no difference at all, except that they no longer have to fear what happens if they lose their current coverage (Paul Krugman, 8/19). 

The Fiscal Times: 6 Reasons Obamacare Can Win The Senate For The GOP
That ever happened to Obamacare -- the unpopular healthcare bill that was to be the Republicans big weapon as they battled for control of the Senate this fall? For sure, the Affordable Care Act has been pushed to the sidelines by the chaos in Iraq, Russia's invasion of Ukraine, the surge in Central American minors across our border, the Veterans Administration scandal, the pestilential virus rampaging across the computers of the federal government, and so much more. … Now, the GOP should circle back (Liz Peek, 8/20).

Bangor Daily News: Maine Props Up 'Two Americas' With No Medicaid Expansion
The Affordable Care Act, as originally passed, holds tremendous promise to decrease health care costs and increase insurance coverage rates across rural states like Maine. But federal court opinions and repeated vetoes of Medicaid expansion are putting all that into jeopardy. Already, data is pointing to widening disparities between the states embracing health reform and those that have resisted -; in the numbers of uninsured, in new health care jobs and in the finances of local hospitals (Christy Daggett, 8/19).

The Washington Post's The Volokh Conspiracy: Constitutional Challenge To IPAB Dismissed, But Could Return
The U.S. Court of Appeals for the Ninth Circuit dismissed as unripe a challenge to the Independent Payment Advisory Board (IPAB). This Board was created by the PPACA to help control health care costs. Specifically, IPAB is authorized to develop self-executing recommendations for limits on Medicare reimbursement rates and other cost controls should the rate of Medicare spending growth exceed a specified target. In this case the plaintiffs argued that IPAB violates the non-delegation doctrine (Jonathan H. Adler, 8/19).

Bloomberg: Why Can't The Pentagon Stop Smoking?
Even the most oblivious member of Congress knows that smoking is bad for you. As it turns out, it's even worse for you if you happen to be a soldier. So why would Congress insist that the Pentagon sell cigarettes -- at a discount, no less? The rationale has long been that members of the military have to smoke because their jobs are so stressful (8/19).

Bloomberg: Wanted: More Doctors For Old People
One of the most glaring paradoxes in the U.S. health-care system is the persistent shortage of geriatricians. You've got a group of patients that is growing, and for whom the federal government guarantees health-care coverage. Yet slots in geriatrics programs go begging while people crowd into surgical specialties (Megan McArdle, 8/19).

JAMA Internal Medicine: Cancer Screening In Older Persons
Cancer screening in the 21st century ... is losing its luster. Increasing evidence suggests that many modalities of cancer screening may be far less beneficial than first thought. Screenings that used to be straightforwardly recommended, such as the prostate-specific antigen test, are now discouraged by many experts. Emerging mammography data show that we need to regularly reexamine even our most stalwart screening standards. Our sense of wonder has evolved into a sense of skepticism: Now we wonder whether screening tests are helping or hurting our patients. ... It is particularly important to question screening strategies for older persons (Dr. Cary P. Gross, 8/18).

JAMA Pediatrics: An Ethically Appropriate Strategy To Combat Obesity And Food Insecurity 
Doug Rauch, former president of Trader Joe's grocery chain, announced his plans for the Urban Food Initiative (UFI). The goals are to address obesity, food insecurity, and food waste by opening nonprofit supermarkets in low-income neighborhoods and providing nutritious low-cost foods. To accomplish this, he proposed selling food gathered from the 11% of fresh produce and perishables that are discarded from other supermarkets, some of which is near or past the sell-by date. ... some have questioned whether the ethics of selling food that is near or past the sell-by date or best-by date to individuals living in low-income neighborhoods are objectionable. ... the UFI offers an innovative approach to combat obesity and food insecurity. ... The store's food will not be harmful, and the initiative is an ethically appropriate strategy to prevent obesity and food insecurity (Drs. Deepak Palakshappa, Genevieve Daftary and Chris Feudtner, 8/18).