Longer looks: Obamacare in the midterm campaign; watching Ebola mutate; lessons on dying

Oct 24 2014

Each week, KHN's Shefali Luthra finds interesting reads from around the Web.

The Economist: Obamacare And The Midterms
According to Kantar Media, a firm that tracks political advertising, health care is the main subject of campaign ads, especially Republican ones. Obamacare is unpopular-;over half of Americans disapprove of it. Republicans talk about it constantly on the campaign trail, though not as intemperately as they did during their own party's primaries. Democrats scarcely mention it (10/18).

The New Yorker: The Ebola Wars: How Genomics Research Can Help Contain The Outbreak
Within the inner sleeve of an Ebola particle, invisible even to a powerful microscope, is a strand of RNA, the molecule that contains the virus's genetic code, or genome. The code is contained in nucleotide bases, or letters, of the RNA. These letters, ordered in their proper sequence, make up the complete set of instructions that enables the virus to make copies of itself. A sample of the Ebola now raging in West Africa has, by recent count, 18,959 letters of code in its genome; this is a small genome, by the measure of living things. Viruses like Ebola, which use RNA for their genetic code, are prone to making errors in the code as they multiply; these are called mutations. Right now, the virus's code is changing. As Ebola enters a deepening relationship with the human species, the question of how it is mutating has significance for every person on earth (Richard Preston, 10/21).

Vox: 9 Lessons Atul Gawande Taught Me About Dying
When I was a kid, I had an overwhelming fear of death. It was the kind of terror that you can't be talked down from, the kind of terror you can only hope to eventually learn to ignore. I became compulsive about avoiding the subject. I would close books when it came up. I would leave rooms when it was discussed. I developed obsessive mental protocols to manage the fear. When I would hear the word "death," I would automatically think, "no death," as if casting a counterspell. "Dying?" "No dying." "Dead?" "No dead." Death was too big a topic to simply ignore. It had to be banished. It had to be fought. I have an easier time talking about death now, but I wouldn't call it a favored topic. So I was a bit apprehensive when I sat down to talk with Atul Gawande (Ezra Klein, 10/21).

The Atlantic: When Health Ignorance Is Bliss
You can't tell that Katrina Walker has a 50 percent chance of having a disease that could kill her in the next couple of decades. The 28-year-old Michigan native likes to paint, read, and watch hockey; she recently posted on Facebook looking for manicure recommendations; she's married, without kids, and is an activity assistant at a skilled nursing center. Walker might also have Huntington's disease, a degenerative disease that her mom has, giving her a 50 percent chance of having the Huntington's gene. Huntington's causes nerve cells in the brain to break down, and typically hits between the ages of 30 and 50, starting with mood changes and depression. In its latest stage it can cause an inability to speak or make voluntary movements. Most people diagnosed with Huntington's die from complications of the disease, such as choking and pneumonia, on average 10 to 20 years after the onset of symptoms. Walker could take a test to find out if she has the gene, but she hasn't yet (Jon Fortenbury, 10/21).

Modern Healthcare: At Home With The Specialist: Oncologists And Other Specialists Launching Patient-Centered Medical Homes
Despite tensions between primary care and specialist groups, a growing number of specialist practices, insurers and health systems are moving toward the specialist-based medical home model. But much depends on more insurers paying for the extra services. The NCQA's patient-centered medical home recognition program has about 8,400 participants, mostly primary-care practices. Its Patient-Centered Specialty Practice recognition program, launched in March 2013, has gotten off to a slow start, however. Tampa, Fla.-based HealthPoint Medical Group was the first to gain recognition in February. Thirty other specialty practices have since followed. The list includes 10 oncology, four endocrinology and two cardiology groups (Andis Robeznieks, 10/18).