Viewpoints: GOP's 2015 Obamacare opportunities; the need for community health workers; WHO's Ebola response

Aug 30 2014

The Washington Post's Plum Line: Another Big Boost For Obamacare
In another sign that the politics of Obamacare continue to shift, the Medicaid expansion is now all but certain to come to another big state whose Republican governor had previously resisted it: Pennsylvania. ... The details of the final deal will matter. But broadly speaking this looks like another sign of just how hard it is for Republican governors in non-deep-red states to resist the expansion -; and of how the politics of this issue continue to change (Greg Sargent, 8/28).

Bloomberg: The Republican Obamacare Battle Plan For 2015
Public opinion suggests people are more interested in "fixing" Obamacare than in completely scrapping it; and by 2015, almost 25 million Americans will be relying on it for health coverage. Those are reasons Republicans should aim to reform or replace portions of the Affordable Care Act .... At the end of the day, congressional Republicans have a chance to show they are prepared not just to oppose Obamacare but also to pass policies to help lower health-care costs, expand access to affordable private coverage and improve the system generally. All of these efforts should begin with the states (Lanhee Chen, 8/28).

The New York Times: Is 'Obamacare' No Longer A Big Deal?
It looks as though Republicans are no longer betting on the Affordable Care Act as a surefire political weapon. The Upshot reported on Wednesday that, in the summer of 2013, lawmakers churned out 530 news releases using the term "Obamacare." So far this summer, in advance of the mid-terms when one might expect that number to go up, it's fallen dramatically, to 138 (Juliet Lapidos, 8/28).

The New York Times: What Doctors Can't Do
Many poor countries use [community health workers] on an enormous scale -; in rural areas, where doctors and nurses are scarce, a C.H.W. often serves as the doctor. In the United States, their role is different. ... They're chosen for their ability to listen, support and encourage, without judgment. ... This is a crucial role in a country where vast numbers of people are sick with chronic lifestyle-related diseases. Doctors can't help patients change their behavior in the 15 minutes they spend with each patient. But community health workers can (Tina Rosenberg, 8/28).

The New York Times: An Ominous Ebola Forecast
The World Health Organization warned on Thursday that the Ebola epidemic in West Africa, already the largest outbreak ever recorded, is going to get much worse over the next six months, the shortest window in which it might conceivably be brought under control. By then, the organization said, the virus could infect more than 20,000 people, almost seven times the current number of reported cases. It is a frightening prospect that requires an urgent infusion of aid from public and private donors around the world (8/28).

Los Angeles Times: WHO's Misplaced Ebola Priority
The World Health Organization is nothing if not opportunistic, impulsively jumping on every public health issue that makes the front page. And, of course, it always calls for lots more money to throw at the disease-of-the-month. The latest on WHO's radar is the Ebola virus outbreak in West Africa, which has tallied about 1,500 cases. To address it, WHO wants more than $430 million ... in a world of limited healthcare resources, we need to make hard decisions that will deliver high-impact outcomes for the most people at the least cost (Dr. Henry I. Miller, 8/28).

The Washington Post's Federal Diary: VA Is Looking For A Few Good Doctors And Nurses
One of the first steps to rebuilding confidence in the scandal-plagued Department of Veterans Affairs is getting enough of the right people to do the job. VA Secretary Robert A. McDonald is trying to do that by launching a new recruitment effort to boost the number of medical professionals. ... Working against him is an agency image that has been battered by a series of congressional hearings and reports about employees gaming the system to make it appear vets were getting care much sooner that they really did (Joe Davidson, 8/28).

JAMA: The PCORI Perspective On Patient-Centered Outcomes Research
The Patient-Centered Outcomes Research Institute (PCORI) was established as part of the US Patient Protection and Affordable Care Act of 2010 to fund patient-centered comparative clinical effectiveness research, extending the concept of patient-centeredness from health care delivery to health care research. In the United States, patient-centered outcomes research is new and not defined in the legislation, and the rationale is unclear to many. In this Viewpoint, we address 2 related questions: What does patient-centeredness in research mean? Why conduct patient-centered outcomes research? (Lori Frank, Drs. Ethan Basch and Joe V. Selby, 8/28).