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Monday, Jul 30 2018

Full Issue

Viewpoints: Lessons On The Opioid Epidemic, Caesarean Risks

Opinion writers express views on these and other health topics.

Just after midnight on July 10, Judy Rosa woke and saw the light and heard the TV still on in the finished basement of her Seabrook Beach, N.H., home. She called to her son, Philip, to turn them off. But something made her go downstairs herself, where she found Philip dead of a drug overdose. Yet his obituary a week later was unusual. It did not say Philip died 鈥渟uddenly鈥 or 鈥渦nexpectedly.鈥 No, the obituary read: 鈥淧hilip J. Carnovale, 32, of Boca Raton, Fl., lost his courageous battle with addiction Tuesday, July 10, 2018.鈥 Explaining the choice to reveal Philip鈥檚 addiction, Rosa said, 鈥淚t鈥檚 about awareness.鈥欌 (Margery Eagan, 7/30)

In 1976, a young, first-time mother entered the hospital in spontaneous labor. She had not missed any prenatal visits, those visits had revealed no abnormalities, her pregnancy was full-term, and she carried one fetus positioned headfirst. In other words, hers was a prototypical low-risk pregnancy. She felt great. Then a physician ruptured her amniotic sac, hastening labor. 鈥淚 went,鈥 she told me years later, 鈥渇rom feeling nothing to being totally in excruciating pain.鈥 A nurse attached her to what was then a relatively new device 鈥 an electronic fetal monitor. Physicians reviewed the monitor strip and told the mother she had to make a decision, and fast. 鈥淭hey said either that I would die, or my baby would die, or both of us would die, if I didn鈥檛 have a caesarean. They said her heart was in distress.鈥 At about 10.5% of births, caesareans were far less common in the United States in 1976 than they are today, when almost one in three births is by caesarean section. (Jacqueline H. Wolf, 7/29)

聽This week Robert Wilkie was聽confirmed聽as Secretary of Veterans Affairs. I had the honor of serving under him as Director of VA鈥檚 Center for Women Veterans during his brief tenure as Acting Secretary and recognize the vast array of urgent聽issues聽that will immediately require his attention once he is sworn in聽鈥撀爊ot least of which is calming the personnel churn that has plagued the department in recent months. Among these matters is determining whether VA should amend its regulation on providing medical care for transgender veterans. As part of his nomination process, Wilkie said if he were to be confirmed, VA鈥檚 policy on providing care to transgender veterans聽鈥渨ill remain unchanged.鈥澛燭his would be good news if VA currently provided all medically necessary care to transgender veterans; however,聽it does not.聽(Kayla Williams, 7/29)

Reports of bipartisanship鈥檚 demise may be a little bit exaggerated, because if there鈥檚 one thing Republicans and Democrats can still occasionally agree on, it鈥檚 cutting taxes or increasing spending, especially to the benefit of favored industries, and charging the cost to the national debt. Irresponsibility, in other words, has a broad constituency. Case in point: the House of Representatives鈥 283-to-132 vote Tuesday to eliminate permanently the 2.3 percent excise tax on the medical device industry鈥檚 revenues. Fifty-seven of the 283 鈥測eas鈥 came from the blue side of the aisle. (7/29)

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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