Viewpoints: Ebola myths; Sen. McCain's 'opportunistic alarmism'; Gov. Jindal on CDC's misspent resources

Oct 14 2014

The Washington Post: Five Myths About Ebola
Hubris is the greatest danger in wealthy countries -; a sort of smug assumption that advanced technologies and emergency-preparedness plans guarantee that Ebola and other germs will not spread. It was hubris that left Toronto's top hospitals battling SARS in 2003, long after the virus was conquered in poorer Vietnam. It was hubris that led the World Health Assembly in 2013 to cut the WHO's outbreak-response budget in favor of more programs to treat cancer and heart disease. And it is hubris that causes politicians to routinely slash public health budgets every time the microbes seem under control, only to cry out in desperation when a new epidemic appears (Laurie Garrett, 10/10).

The New York Times: How To Quarantine Against Ebola
One feature of the tragic case of Thomas Eric Duncan, the first traveler known to have carried the Ebola virus into the United States, rankles me as a physician: Even if every system in place to identify suspected carriers had been working perfectly, he may have still set off a mini-epidemic in Dallas (Siddhartha Mukherjee, 10/12).

Los Angeles Times: Why Don't We Have An Ebola 'Czar,' Sen. McCain? Because Of The NRA
Donning the mantle of the nation's scaremonger-in-chief, Sen. John McCain, R-Ariz., appeared Sunday morning on CNN to weigh in on the latest Ebola news. ... Prompted by [CNN's Candy] Crowley, McCain complained, "We were told there would never be a case of Ebola in the United States and obviously that's not correct." He said, "There has to be some kind of czar" to manage the disease in the U.S. "I'd like to know who's in charge, among other things." These statements are evidence as good as you'll ever find of the viral outbreak of fatuous misinformation and opportunistic alarmism that has reduced governing in Washington to a bedridden wreck. Let's unpack them (Michael Hiltzik, 10/12).

Politico: The Facts About Ebola Funding
In a paid speech last week, former Secretary of State Hillary Clinton attempted to link spending restraints enacted by Congress-;and signed into law by President Obama-;to the fight against Ebola. Secretary Clinton claimed that the spending reductions mandated under sequestration "are really beginning to hurt," citing the fight against Ebola: "The CDC [Centers for Disease Control and Prevention] is another example on the response to Ebola-;they're working heroically, but they don't have the resources they used to have." Her argument, like those made by others, misses the point. In recent years, the CDC has received significant amounts of funding. Unfortunately, however, many of those funds have been diverted away from programs that can fight infectious diseases, and toward programs far afield from the CDC's original purpose. Consider the Prevention and Public Health Fund, a new series of annual mandatory appropriations created by Obamacare (La. Gov. Bobby Jindal, 10/12).

USA Today: What Ebola Error In Dallas Shows
Diagnostic errors -; such as when a patient seeks attention and is turned away because of a failure to collect or appreciate a crucial piece of information -; are the most common type of medical mistake. They contribute to up to 80,000 deaths a year in the U.S. Errors of this type can be fatal, such as when the error involves a missed heart attack, stroke, or serious infection. But in an Ebola outbreak, the consequences can be much more severe because they can affect so many more people (Robert Wachter, 10/12). 

On other health care topics -

USA Today: Obamacare Is In Hiding Until After The Election
The second Obamacare open enrollment is scheduled to begin on November 15th and end on February 15th. Instead of learning critical lessons from the mistakes of the first open enrollment fiasco, the Obama administration appears to be trying to silence potential critics (Robert Laszewski, 10/12).

The Hill: Both Parties Are Keeping Americans In The Dark About Healthcare Reform
Substantial majorities of Americans say they want specific health insurance reforms. According to pollsters, most Americans want rules to keep insurance companies from refusing to cover sick people or charging them more. They want government to help make insurance accessible and affordable for small businesses and families. Most applaud free preventive care -; including contraception -; as well as improvements in Medicare prescript. Here's the irony: Most Americans do not know these changes are actually included in the Patient Protection and Affordable Care Act (ACA) that has been law since 2010 (Theda Skocpol and Colleen Grogan, 10/13).

The Washington Post: Tendon Surgery Sheds Light On The Lack Of Clarity In Some Out-Of-Network Pricing
Spurred on by competition on the new Affordable Care Act exchanges, health insurers are moving to pare down their provider networks .... Docs are busy selling out their practices to hospitals that can negotiate better rates for their services .... And together, hospitals and large medical groups are joining "accountable care" networks in which, like insurers, they agree to provide all of a family's medical needs for a fixed annual fee. It's one reason -; perhaps a big reason -; why medical costs have begun to level off in recent years. But it's not without its trade-offs (Steven Pearlstein, 10/11).

Los Angeles Times: The 5 Rules On How To Kill A Consumer-Friendly Initiative
There are six statewide measures before voters on Nov. 4, but it's the battle over Proposition 45 where the techniques of anti-consumer influence are most openly exposed for examination. ... The measure would allow the state insurance commissioner, an elected official, to set health insurance rates. This is a power that the insurance commissioner already has over auto and property/casualty insurers, and that insurance regulators have over health insurance in 35 states and the District of Columbia. Proposition 45 is abominated by the insurance industry, which has provided virtually all of the $37 million collected to fight the initiative. The measure's backers have collected or spent about $3.6 million (Michael Hiltzik, 10/10).

Bloomberg: Midterm Voters Drown In Dark Money
Crossroads GPS has assailed the Democratic Senator Mark Udall for shortchanging Colorado residents with his votes on health insurance; Patriot Majority USA has gone after the Republican Senate candidate in Arkansas, Tom Cotton, as being a supposed shill of the insurance industry and opposing a farm bill. This is standard fare in the American midterm elections, where spending could exceed $5 billion and outside groups specialize in attack ads. ... This is dark money, which allows both sides to set up supposed social welfare organizations that are a front for political partisans (Albert R. Hunt, 10/12).

The Washington Post: Stem-Cell Research's Potential Worth Supporting
On Thursday, a group of Harvard researchers announced that they had effectively cured diabetes in lab mice using human embryonic stem cells. The team painstakingly exposed stem cells to various chemicals until they figured out which ingredients to use and in which order, finally inducing undifferentiated stem cells to become beta cells, which specialize in detecting rises in blood sugar and releasing insulin in response. Beta cells are nature's natural insulin pumps, but they are much better at finely tuning blood sugar than artificial insulin delivery methods. The Harvard scientists transplanted the beta cells they created into diabetic mice, which were asymptomatic within 10 days. This dramatic result is particularly promising for victims of type I diabetes (10/11).

The New York Times: The Last Right
On Nov. 1, barring the medically unexpected or a change of heart, a young woman named Brittany Maynard will ingest a lethal prescription and die by suicide. Maynard is 29, recently married and is suffering from terminal brain cancer. After deciding against hospice care -; fearing, she wrote in a CNN op-ed, a combination of pain, personality changes, and the loss of basic mental and physical functions -; she and her husband moved from California to Oregon, one of five states that permit physician-assisted suicide. ... The future of the assisted suicide debate may depend, in part, on whether Tippetts's case for the worth of what can seem like pointless suffering can be made either without her theological perspective, or by a liberalism more open to metaphysical arguments than the left is today (Ross Douthat, 10/12).

Toledo Blade: Tighten Medicaid Rules
A new report by the U.S. Department of Health and Human Services proposes improvements that states could make to their Medicaid systems, many of them without raising costs. Ohio Medicaid officials should pay attention. In some respects, Ohio's Medicaid rules are among the strongest in the country. ... But in other areas, Ohio falls woefully behind. A patient's maximum wait time to see a primary care physician is 42 days, one of the highest limits in the country. For specialists, there is no maximum wait time, even if the need is urgent. Ohio also has no maximum ratio of Medicaid patients to provider. Both of these standards must improve if the state is serious about guaranteeing access to care for Medicaid enrollees, especially now that Gov. John Kasich has expanded Medicaid eligibility under the federal Affordable Care Act (10/13).