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Morning Briefing

Summaries of health policy coverage from major news organizations

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Tuesday, Oct 28 2014

Full Issue

Viewpoints: Panic And Ebola; Elton John On AIDS Crisis; Insurers Fight Calif. Proposition

A selection of opinions on health care from around the country.

With widespread accusations of repeated errors rampant in the media, it is easy to see how the public may feel the systems response to the Ebola threat is one big mess. ... But finger pointing can backfire and lead to even more mistakes being made. Consider how much worse healthcare would be if these mistakes were kept under wraps, as would undoubtedly have been the case as recently as 15 years ago. Hospital culture has since changed to encourage transparency. Transparency especially about errors is vital to the delivery of quality healthcare, because acknowledging an error gives hospitals the chance to prevent a recurrence. ( Joan Bregstein, 10/27)

A 14th-century weapon is not the best defense against a 21st-century illness. That's not simply common sense, it's also the scientific consensus, and why public officials in the U.S. are wrong to insist on mandatory quarantines for health workers returning from Ebola-afflicted West Africa. (10/27)

The widely varying responses between New York and Dallas tell us a lot about the nations uneven preparedness for a deadly disease outbreak. So far, with Ebola, we seem to be dodging the contagion bullet, but mainly because the virus is not easily transmitted. Yet what if this had been a more infectious kind of virus? What kind of a nationwide contagion might we be facing now, all because of a few missteps in Dallas, or if New York City hadnt had proactive measures in place to deal with its first Ebola victim? (Stephen E. Flynn, 10/26)

In the face of Ebola, what's needed most are cool heads and swift, decisive action. Over the weekend, the governors of New York and New Jersey got the swift part down pat, but in their rush to impose a quarantine, they made a hash of it. The governors Andrew Cuomo and Chris Christie seem to have ignored the impact of their actions on the people being quarantined, some of whom are health workers who risked their lives to fight Ebola in Africa, as well as the quarantine's effect on the essential U.S. effort to control the disease at the source. (10/27)

Last Friday, the governors of New York, New Jersey and Illinois announced that U.S. health care workers returning from West Africa who had direct contact with Ebola patients will be placed under quarantine for 21 days upon arrival at airports in their states. Even though New Jersey Gov. Chris Christie and New York Gov. Andrew Cuomo have softened their stance in recent days, some continue to call for a strict 21-day quarantine of all those returning from Guinea, Liberia and Sierra Leone. Such a policy would likely lead to unintended negative consequences. (Rick Sacra, 10/27)

One of the profound challenges of our age is how to evaluate risk from complex threats. At one level, experts provide scientific facts about, say, the transmissibility of a disease, and they can quantify the prospects for contagion. At another level, human emotions measure risk with irrational but powerful gut feelings. ... Maintaining public confidence is a big part of protecting public health. The decision over the weekend to quarantine a nurse, Kaci Hickox, who had returned to New Jersey from working in Sierra Leone with the charity Doctors Without Borders, overreached. (10/27)

The governors of a number of states, including New York and New Jersey, recently imposed 21-day quarantines on health care workers returning to the United States from regions of the world where they may have cared for patients with Ebola virus disease. We understand their motivation for this policy to protect the citizens of their states from contracting this often-fatal illness. This approach, however, is not scientifically based, is unfair and unwise, and will impede essential efforts to stop these awful outbreaks of Ebola disease at their source, which is the only satisfactory goal. The governors' action is like driving a carpet tack with a sledgehammer: it gets the job done but overall is more destructive than beneficial. (Jeffrey M. Drazen, Rupa Kanapathipillai, Edward W. Campion, Eric J. Rubin, Scott M. Hammer, Stephen Morrissey and Lindsey R. Baden, 10/27)

Current U.S. efforts to defeat Ebola at the source are rightly a top priority, but the question remains: How do we get there? While the threat on American soil remains relatively small, the fact is that the Ebola outbreak is far from contained in Africa. Funneling travel from West African destinations through a small number of airports, creating new protective guidelines for medical personnel, and designating more hospital isolation units are not the only answers. The key is a refocused effort at home - host to some of today's brightest scientific minds - to develop a vaccine or drug to halt the spread. However, this has been hampered by the federal government's commitment to biomedical research, which can be described as tepid at best. (Russel E. Kaufman, 10/27)

Gov. Andrew Cuomos Ebola quarantine policy is drawing strong opposition from people who work closely with him on another infectious disease: AIDS. New York States imposition of a 21-day quarantine on health workers who have had contact with Ebola patients in West Africa is not supported by scientific evidence and may have consequences that are the antithesis of effective public health policy, according to a letter released Monday with signatures from over 100 H.I.V. activists, researchers and clinicians. (Josh Barro, 10/27)

But as engaged as the gay community and civil rights activists have been in the fight for marriage equality, we have lost ground on the fight that so intensely galvanized the gay community to begin with: H.I.V. and AIDS. We need the same coalition that brought about marriage equality from gay activists, human rights champions and social justice advocates to legal experts and courageous policy makers to address the spiraling AIDS crisis again. (Elton John, 10/27)

A confession: I am a health economist, and I cannot rationally select a health plan. I buy health insurance through the Federal Employees Health Benefits Program, or F.E.H.B.P., which is very similar to the Affordable Care Acts exchanges. Like the exchanges, the federal employee program runs an online marketplace with a choice of plans, which vary by region. (Austin Frakt, 10/27)

A year in, hows the Affordable Care Act doing? Thats the question a team of Times reporters has examined in a series of stories and charts running today. Next month, the Affordable Care Acts second year of open enrollment will begin, and with it an appropriate focus on the operational performance of Healthcare.gov and state marketplaces. (Margot Sanger-Katz, 10/27)

The Kaiser Family Foundation's latest issue brief on Medicaid offers new evidence on the fiscal implications for states that have opted out of the Medicaid expansion available under the Affordable Care Act. Opting out, the foundation says, is very costly. The bottom line: Governors and state legislators who opted out of expansion should be quarantined to keep them from hurting their residents, and their states' budgets. (Michael Hiltzik, 10/27)

A direct attack on the insurers' bottom lines, [Proposition 45] would give the state insurance commissioner the same veto power over rate hikes for individual and small-group health plans that Proposition 103 gave the commissioner over auto and home policies. Blue Shield, Kaiser and other health insurers have contributed more than $55 million directly to the No on 45 campaign fund, which reports its receipts and expenditures to the California secretary of state. Now, proponents of Proposition 45 are trying to turn the insurers' opposition into a selling point for the measure. (Jon Healey, 10/27)

Do we need better food labels? Thats the argument of public health experts interviewed by food and health writer Jane Brody. Its too hard, they say, to tell exactly what youre eating all the time, which contributes to the nations rising tide of obesity. Color me skeptical. (Megan McArdle, 10/27)

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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