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Morning Briefing

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Monday, May 28 2018

Full Issue

Viewpoints: In Commitment To Veterans' Special Needs, Be Wary Of Using Private Doctors

Editorial pages focus on these and other health care issues.

Veterans like me need managed, culturally competent medical care, in a safe community that respects them. Private doctors do not understand the complexity of service-related health problems. (Howard L. Hibbard and Marcela Davison Avil矇s, 5/25)

In the course of my active military career, I had troops under my command on three deployments to Iraq and Afghanistan. I have lost more of my soldiers to suicide than I lost in combat. That may sound shocking to you it is shocking to me. But I have yet to meet a veteran of Iraq or Afghanistan who doesnt know someone who took their own life. That is staggering. I can recite the numbers. An estimated 20 veterans commit suicide every day, losses that are piled upon the nearly 7,000 US troops that have been killed in our ongoing conflicts in Iraq and Afghanistan. (Jack Hammond, 5/28)

Americas veterans have served our country and protected our freedoms, sometimes at the expense of their own well-being and health. They have sacrificed while fighting our adversaries, and that sacrifice continues beyond their active duty status. Adversaries are still pursuing veterans and their personal information in cyberspace. The area where veterans are perhaps the most vulnerable is the health care sector. Nation-states, criminals, and hacktivists go after their personally identifiable information (PII), and some of the most robust and sensitive PII are medical records and insurance information. (Sarah Geary, 5/27)

In 2009, my husband had an emergency spinal-fusion operation to prevent permanent nerve damage caused by a ruptured disk. I was rolling the I.V. pole while he pushed a walker around the hospital corridor when I got an urgent call from a friend: Dont let them give him pain pills, she said. I told her the nurses were giving him oxycodone on a schedule because the drug works better to prevent pain than to knock it back once its out of control. She was insistent: Well, get him off it as fast as you can when you get home. Mom was addicted within a week of her back surgery, and shes been addicted ever since. We cant get her off it. (Margaret Renkl, 5/28)

Its a sunny spring day in Judge Alan Lemonss courtroom, but it is hard to feel optimistic. A screen next to his bench shows a set of slides, each with a picture of a young mother and a brief description of why she will be appearing this morning. Two numbers on each slide tell the real story: the ages of her children and the number of days she has been sober. Sometimes the numbers are quite low. Child age: 3 months; days sober: 81. Several of these women were using drugs while pregnant and lost custody after giving birth. Judge Lemons runs whats called a family drug court here in Scioto County, where the rate of opioid overdose is among the nations highest. He is hoping that this unconventional model of justice will help parents kick their habit, allowing them to reunite sooner with their children. (Naomi Schaefer Riley, 5/25)

As part of the mental health division of one of the largest safety-net health care systems in the Midwest, we come face to face with the opioid crisis and the lives it claims every day. One important lesson we have learned in treating people with substance use disorders is that we cant just rely on an excellent clinical team we also need lawyers to help address critical social issues that arise for our patients during recovery. (Gregory M. Singleton and Jay Chaudhary, 5/29)

Alex Azar will soon make his most consequential decision as health and human services secretary. President Trump has asked HHS to expand health-insurance protections in a way that could make coverage more affordable and improve the outlook for Obama Cares risk pools. Whether Mr. Azar will oblige is uncertain. Some officials dont understand that Mr. Trumps request would expand consumer protections, or mistakenly believe HHS lacks the authority to grant it. The need for action is clear, as ObamaCare premiums keep skyrocketing. Rate hikes as high as 91% will hit many consumers just before Election Day. Maryland insurance commissioner Al Redmer warns ObamaCare is in a death spiral. So-called short-term health plans, exempt from ObamaCares extensive regulations, are providing relief. Such plans often cost 70% less, offer a broader choice of providers, and free consumers to enroll anytime and purchase only the coverage they need. (Michael Cannon, 5/28)

Not only have many public health interventions in the United States been hugely successful, but theyve also saved more money than theyve cost. And yet Americans spend relatively little money in that domain and far more on medical care that returns less value for its costs. Instead of continually complaining about how much is being spent on health care with little to show for it, maybe we should direct more of that money to public health. (Aaron E. Carroll and Austin Frakt, 5/28)

In a victory for patient rights, the House passed the Trickett Wendler, Frank Mongiello, Jordan McLinn, and Matthew Bellina Right to Try Act. The bill removes the Food and Drug Administration (FDA) as an obstacle for incurable, dying patients who want to try promising experimental medicines that have passed initial safety testing. The bill has been forwarded to President Trump for signature. The president, who has been a strong supporter of the legislation, will soon sign it into law. (Roger D. Kelin, 5/26)

With the usual ballyhoo, the White House said on May 11 that President Donald Trump would announce his long-delayed plans to reduce the costs of prescription drugs. When Trump began speaking at 2:08 p.m., stock prices on Standard & Poors pharmaceutical sector dropped. By the time he finished speaking, the sector was soaring. Big Pharma was very happy with Trumps speech. It contained nothing that will threaten its enormous profits nor anything that will slow down relentless price increases. As president-elect, Trump accused drug companies of getting away with murder. As president, Trump has become an accessory to that murder. It was yet another broken populist campaign promise, joining great health care, putting coal miners back to work, a trillion-dollar infrastructure plan and more. Trump has kept his promise to crack down on immigrants and move the U.S. Embassy to Jerusalem, but his economic populism has proved to be a mirage. (5/27)

Nearly 40 years ago, when prophylactic double mastectomies did not generate the reassuring headlines they do today, I had both of my breasts removed. It was a decision that began in tragedy and fear but unfolded into health and healing. It was the right decision, and I want to explain why. Today genetic testing offers information indispensable to making informed medical decisions about treatments and risk reducing options. Not all breast cancers are hereditary (10 percent or less). But for patients at high risk because of family history or genetic make up, such information can be lifesaving. (Ruth O. Selig, 5/28)

Of the afflictions routinely visiting the tropics, Zika virus is surely one of the most alarming. A contagion known mostly for fever and chills took on a deadly new face in Brazil in 2015, when it was linked to severe brain deformities in newborns, including a spike in infant microcephaly, or babies with undersized craniums. And all of this was unfolding amid Brazils gathering fiscal chaos, which undercut funding for science even as public health authorities were scrambling to contain other mosquito-borne illnesses such as dengue fever, chikungunya and a resurgent centuries-old menace, yellow fever. So who would have thought that such a scourge could be turned into a treatment? Yet Zikas destructive powers were precisely what caught the attention of geneticists and biological researchers at the University of Sao Paulo, known as USP. (Mac Margolis, 5/25)

Last month, Governor Charlie Baker reluctantly signed a sweeping criminal justice overhaul into law. Now hes trying to weaken a key provision, a compassionate release measure allowing some of the sickest and most incapacitated inmates to leave prison before they die.Lawmakers should reject the governors efforts. Compassionate release is the right thing to do, and it could save Massachusetts taxpayers millions of dollars to boot. (Christopher Burrell, 5/27)

If Arizona wants to keep children out of the child welfare system, it should make alleviating poverty a public policy priority. The evidence is in the areas of Maricopa County with the highest number of children being removed from their homes. (Linda Valdez, 5/27)

The Arizona Supreme Court struck down a 2012 law that allowed the state to criminally charge students with medical marijuana cards if they had or used pot on campus. The law didn't "further the purpose" of the medical marijuana law voters approved in 2010, the court ruled, and that made it unconstitutional. (5/26)

This is part of the Morning Briefing, a summary of health policy coverage from major news organizations. Sign up for an email subscription.
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