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Morning Briefing

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Monday, May 13 2019

Full Issue

Viewpoints: Latest White House Proposal Promises To Cut Programs For The Poor; Society Needs To Chime In Since Government Isn't Addressing Health Disparities

Opinion writers weigh in on these health topics and others.

The "chained CPI" is a good idea, despite its obscure, vaguely scary name. CPI stands for consumer price index, and chained refers not to some sort of punishment but to the fact that, for technical reasons, it is more closely linked to peoples buying habits than the version of the CPI the government usually uses to adjust various key program benchmarks for annual inflation. Even good ideas can have bad applications, though, and so it is with the announcement Tuesday that the White House is considering a new rule that would require using the chained CPI to inflation-adjust the official poverty line, currently $25,750 for a family of four. This is crucial because a familys receipt of subsidized housing, food-buying assistance and Medicaid can be determined by whether its income puts it below or above the poverty line, and by how much. (5/10)

There seems to be a disparity in how we view and define health disparities in the United States.Despite advances in the understanding and treatment of cancer and other diseases, the availability of appropriate health care still eludes large portions of our population and the current patchwork system of providing health services is not reaching many people who could benefit from what may be available, but not necessarily obtainable. (Nancy G. Brinker and Eric T. Rosenthal, 5/11)

Attorneys spend millions of dollars each year on ads to recruit people who may have been injured by a drug or device. Some of these fear-mongering ads frighten people to stop taking medications that can help prevent life-threatening problems like blood clots.Its time these ads come with a warning.Given their television-viewing habits, older adults are easy targets for such ads and infomercials. The Nielsen Company reports that adults aged 65 and older spend an average of seven hours a day in front of the TV. And they often absorb the message. (F. Roosevelt Gilliam III and Susan Peschin, 5/13)

For House Democrats, this will be health-care week. How many voters will notice? The answer will be instructive about how the constitutional crisis that is upon us will affect action on every other problem voters expect their government to confront. President Trump is engaged, as is his way, in a two-faced game. He says that by demanding the Mueller reports evidence of obstruction of justice, Democrats are mounting a vendetta that will prevent Washington from governing. (E.J. Dionne, 5/12)

Imagine yourself stuck in the hospital. Would you rather your doctors be well-rested, with a limit on how many hours they can work? Or would you rather they work longer shifts, seeing you through the critical hours of your illness and with fewer handoffs of your care? That's the choice being reexamined after a study published in March in the The New England Journal of Medicine found that longer shifts for medical residents were just as safe as shorter shifts. (Clayton Dalton, 5/10)

Obamacare gave most low-income people Medicaid coverage, extending the health-care plan to the poor and near-poor. But when they are jailed or imprisoned, an old federal law means their Medicaid coverage disappears. This callous policy must change. The problem is not that those in custody would get no health care while locked up. The Supreme Court ruled that jails and prisons must provide health services to those they are holding, because they are wards of the state. (5/12)

Among my first memories as a doctor was a disheveled man, barely older than me, handcuffed to a hospital bed, vomiting a thin brown liquid into a pale pink bucket. Between retches, he sobbed and shook violently. Driving his many medical and legal problems, I later learned, was an addiction to opioid painkillers. Driving his current misery was withdrawal. (Dhruv Khullar, 5/11)

When President George W. Bush appointed me as the nations first health information "czar" in 2004, my top priority was to ensure that Americans had access to their personal health information. ...Giving people their health information has been a priority for every president and health information leader since President Bush, but we havent made progress. (David J. Brailer, 5/11)

As we report Friday in JAMA Network Open, in almost every doctors practice we found the same pattern. Patients seen earlier in the day were more likely to have their doctors order cancer screening tests. At 8 a.m., for example, 64% of women eligible for breast cancer screening left their appointments with an order for a mammogram. That declined to 48% by 5 p.m. We saw a similar pattern for colon cancer screening: At 8 a.m., 37% of those eligible left with colonoscopy orders compared to 23% by 5 p.m. (Mitesh Patel, 5/10)

The 34-year-old man lay in his ICU bed for over a month dependent on a breathing tube and artificial respirator to stay alive. The patient knew his life hung in the balance, as he was a physician himself. Some days the suffering was so intense that he contemplated ways he could unplug the machine on his own. Now, nearly 50 years later, that patient, Edward Viner, an oncologist who served as chief of the Department of Medicine at Cooper University Health Care in New Jersey for more than two decades, reflects on how he was able to survive such a harrowing experience. (Stephen Trzeciak and Anthony Mazzarelli, 5/12)

In the classic 1967 film The Graduate, young Benjamin Braddock was given one word of advice for his future: plastics. In that spirit, Id like to offer Dr. Ned Sharpless, the new acting commissioner of the Food and Drug Administration, two words of advice for the future of the FDA: data standards.Like many other experts, I grow increasingly alarmed by the slow progress in the development, implementation, and acceptance of data standards for clinical trials. As the clock ticks, the capital costs and the human costs of inaction are mounting. No matter where my work takes me, I always return to the urgent need for data standards. (Sam Volchenboum, 5/13)

Heart palpitations. Dizziness. Nausea. Numbness. Trouble breathing. Chest pains. An all-encompassing feeling of dread. Heart attack? No, for many people these are the unpleasant symptoms of something much more mundane, a panic attack. They often seem to appear out of the blue. And the first time in particular, before you know whats happening, they can be terrifying. (Cara McDonough, 5/11)

Around the world, childhood hunger is increasing for the first time in decades, and we are facing potential intergenerational losses as a result. As youre reading this, there is a bipartisan effort in Congress to reach more of these children by deepening support for the McGovern-Dole International Food for Education and Child Nutrition Program. We urge support for this bipartisan effort.The McGovern-Dole Program is one of the most effective tools to fight childhood hunger that we have in our toolkit. (Richard Leach and Former Sen. Bob Dole, 11/12)

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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