�Թϲ�����

When you’re the party in power, you can take credit for things you may not have had much to do with, such as a strong economy. You might also be blamed for problems you didn’t have much to do with, such as a sudden recession. But can you avoid blame for problems you definitely made worse? When it comes to health care, that’s what Republicans are hoping to pull off this November. As much attention as we all give to the latest outrage from President Trump, polls have repeatedly shown health care to be at or near the top of the public’s agenda when it comes to the midterm elections. Republicans are clearly nervous: They are planning symbolic votes in the House on the same old GOP health-care ideas (health savings accounts!) as a way of dealing with Democratic attacks on the issue. (Paul Waldman, 7/19)

To the long list of lies President Trump thinks he can make true just by repeating them (“The largest audience ever,” “North Korea has agreed to denuclearization,” “I didn’t criticize the prime minister”), we can now add this: “Our war on poverty is largely over, and a success.”That’s the verbatim conclusion of a new study produced by Trump’s Council of Economic Advisors in order to justify new work requirements on Medicaid, public housing, and food stamp recipients. Never mind that 32 percent of all Medicaid dollars go to nursing home patients, and nearly half of food stamp recipients are children — neither population likely to punch a time clock anytime soon. And never mind that able-bodied adults without children already must work for their food stamps. The Trump administration is gunning for federal safety net programs, and if it takes denying the existence of 45 million Americans in poverty to rationalize their disintegration, so be it. (Renée Loth, 7/20)

Last week, the Trump administration delivered another major blow to the Affordable Care Act by drastically cutting funding for “navigators” — counselors at nonprofits who help people enroll in health insurance. Next year, total North Carolina navigator funding will drop a jaw-dropping 84 percent, from more than $3 million to $500,000. (By Madison Hardee and Brendan Riley, 7/19)

A new survey sponsored by the University of Utah Health suggests doctors aren’t to blame for skyrocketing health care costs. Instead, accountability for outsized bills and fees should fall, in large part, with the web of pharmaceutical and insurance companies. Regardless of which side of the health care industry one falls, more transparency and competition must thrive to provide Americans with affordable health care. The survey, done with the help of the New England Journal of Medicine's Catalyst, is a commendable first step in the University of Utah Health’s mission to define the value of health care in America. Finding the true cost of administering care to patients may do much to suppress the rising tide of expensive drugs and procedures. The results of the survey turn a common myth on its head. (7/19)

The National Guideline Clearinghouse is a federal database intended to help doctors answer almost any medical question you can think of: Can this emergency room patient tolerate a procedure that normally requires an empty stomach? Does that patient need a stent? Which antibiotic should this patient be started on? If that sounds like a small matter, it isn’t. The sheer volume of medical information now within a few clicks’ reach can make it difficult, even for doctors, to separate wheat from chaff. Clinical guidelines based on careful consideration and solid impartial research can be difficult to tell apart from those based on weak data, or rooted in a clear conflict of interest (usually a financial stake in whatever treatment they are promoting). The clearinghouse, which not only vets countless sources of medical information but also makes its results easily searchable, is regarded as the most dependable repository of its kind in the world. On Monday, the Department of Health and Human Services took it offline, the latest casualty in an administration determined to eliminate science from the government’s agenda. (7/19)

Recently, the House Ways and Means Subcommittee on Health has been considering ways to expand consumer-directed health plans (CDHPs). These plans — which essentially balance high deductibles with Health Savings Accounts (HSAs) — are a step in the right direction. (Tracy Miller, 7/19)

House Republicans want to pass a bill delaying ObamaCare’s 40% excise tax on high-cost employer plans—the “Cadillac tax”—by another year, to 2023. GOP hostility to this tax is a mistake. Keeping it would promote market-based health care more than killing it. (James C. Capretta, 7/ 19)

At some point, Americans will probably be unwilling to pay higher taxes or increase borrowing to fund public health care programs. But policymakers should have no illusions about how easy it will be to reduce growth in Medicare and Medicaid spending. (Michael E. Chernew and Austin B. Frakt, 7/18)

Mind-robbing Alzheimer’s disease, the leading cause of dementia in the United States, usually starts quietly and largely hidden from view. Its manifestations range from mild symptoms such as forgetting important dates and events to requiring round-the-clock care and help with daily living activities such as walking, eating, and bathing. By the time Alzheimer’s is diagnosed, it’s generally too late to do much to halt it. One goal of the Medicare annual wellness visit is to improve the detection of early stages of cognitive impairment, an Alzheimer’s precursor. Yet a study we recently conducted suggests that the wellness visit has fallen short of doing this. We believe the visit would work better if physicians were given more specific guidance on how to detect cognitive impairment, and what steps to take for follow-up diagnostic assessment and care. (Noam Kirson, Urvi Desai and Nicole Fowler, 7/20)

Missouri Gov. Mike Parson has created an unnecessary mess by vetoing money for an obscure but important health program in the state. The state legislature must override the veto in September, or the health of hundreds of Missourians will be at risk. (7/19)