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Morning Briefing

Summaries of health policy coverage from major news organizations

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Friday, May 18 2018

Full Issue

Viewpoints: Tougher Work Rules For Poor People Getting SNAP Creates Fatter Government; Get Med Students Up To Speed On Addiction Treatment

Opinion writers look at these and other health topics.

Leave it to Congress to take food away from 2 million poor people and somehow save no money in the process. The House farm bill, scheduled for a vote Friday, contains a major overhaul to the Supplemental Nutrition Assistance Program (commonly known as food stamps). In many ways, the legislation 鈥 which, in a break with tradition, was written entirely by Republicans 鈥 contains objectives shared by people on both sides of the aisle. These include helping low-income people find more stable work and encouraging noncustodial parents to contribute financially to their kids鈥 upbringing. However noble such goals are, though, the actual consequence of the bill would be a gigantic, expensive new government bureaucracy 鈥 one that eats up nearly all the 鈥渟avings鈥 from kicking people off food stamps, according to Congressional Budget Office estimates. (Catherine Rampell, 5/17)

Unemployment is at a record low. The U.S. economy has logged nine straight years of slow-but-steady growth. Yet somehow, 40 million Americans need help from the government just to put food on the table. Although that figure is down from its post-recession peak of 47.6 million in 2013, it's still far above where it was in 2007, when only 26 million Americans were enrolled in food stamps (formally known as the Supplemental Nutrition Assistance Program). Congressional Republicans are right to believe that there's something terribly out of whack here. How can so many Americans have jobs yet so many still qualify for food stamps? But their solution 鈥 adding tougher work requirements to the program 鈥 rests on a faulty premise that people are gaming the system, rather than the reality that so many of the jobs added since the recession are low-wage. (5/18)

Heart attacks and opioid overdoses are both acute exacerbations of chronic medical illnesses and are seen daily in emergency departments across the nation. While every medical student graduates with the preparation needed to treat heart disease, fewer than 6 percent of physicians in the U.S. are trained and certified to prescribe buprenorphine, a medication that has been scientifically proven to halve the overdose death risk for patients with opioid addiction. (Helen Jack, Siver Sundaram and Melanie Fritz, 5/17)

It was a scheduling mishap that led Kourtnaye Sturgeon to help save someone鈥檚 life. About four months ago, Sturgeon drove to downtown Indianapolis for a meeting. She was a week early. 鈥淚 wasn鈥檛 supposed to be there,鈥 she said. Heading back to the office, she saw people gathered around a car that had veered to the side of the road. Sturgeon pulled over to see if she could help. A man told her there was nothing she could do, Sturgeon said. Two men had overdosed on opioids and appeared to be dead. 鈥淚 kind of recall saying, 鈥楴o man, I鈥檝e got Narcan,鈥欌 she said, referring to the brand-name version of the overdose antidote Naloxone. 鈥淲hich sounds so silly, but I鈥檓 pretty sure that鈥檚 what came out.鈥 Sturgeon had the drug with her because she works for Overdose Lifeline, a non-profit devoted to distributing naloxone. She sprayed a dose of the drug up the driver鈥檚 nose, and waited for it to take effect. About a minute later, she said, the paramedics showed up. (Jake Harper, 5/17)

Health insurers are beginning to announce their 2019 premium increases for the dwindling number of Americans who participate in ObamaCare exchanges and it isn鈥檛 a pretty picture.Most increases in Virginia and Maryland appear to be in the 20 percent to 35 percent range, through CareFirst BlueCross BlueShield. The insurer also is seeking a 91 percent increase for its PPO plans in Maryland and a 64 percent increase in Virginia for 4,500 members, who participate in the exchange. The left is claiming the premium hikes are President Donald Trump鈥檚 fault. But under ObamaCare the individual health insurance market began to collapse long before Trump became a factor. (Merrill Matthews, 5/17)

If you are young and on medication, and the approval of your peers is your life nutrient, then an unsightly side-effect 鈥 in this case, drooling 鈥 is unacceptable. Fortunately, there is a common and generic treatment; according to GoodRX, it costs $23 a month. I phoned it into the patient鈥檚 pharmacy. A day later, the pharmacy called: Insurance had rejected the claim. I called the insurance line and spoke to a pleasant representative. She explained that my patient would need to try three other medications for peptic ulcer disease first. The patient didn鈥檛 have peptic ulcer disease; she had schizophrenia. Salivation was a side-effect of the only drug that had helped her. I filled out a Prior Authorization form with details. (Elissa Ely, 5/17) 聽

You take off your clothes, and put on a thin cotton gown. You sit on a padded table covered with a crisp white piece of paper that crackles every time you move. Your bare feet dangle. You stare at the walls and wait. And wait. Then the doctor walks in. If the doctor is a man, he comes in with a female chaperone. The doctor tells you to lie back, put your legs in the metal stirrups on either side of the table and scoot down. Toward him. (Robin Abcarian, 5/17)

For the second time in less than a year, the University of Southern California is drawing scrutiny not just for the alleged misconduct of one of its doctors, but also for the way campus leaders handled the situation. Any organization the size of USC is bound to have problematic employees. The issue is how the organization responds: Is it bad luck? Bad supervision? Or a bad organizational culture? (5/17)

One year ago, Tywon Salters, a convicted robber and car thief who鈥檇 been on parole, was in the Kane County Jail on new charges that would have likely sent him back to prison. Salters, of Chicago, ate a piece of his jail sandal and was taken to nearby Delnor Hospital for treatment. He was there five days. On the fifth day, he overpowered a Kane County sheriff鈥檚 deputy and took the deputy鈥檚 gun. He took two nurses hostage and tortured them. He raped one of the nurses for hours before he was shot to death by police. (John Kass, 5/17)

In the days since Gov. Reynolds signed SF 359 into law, attempting to make abortions after 6 weeks of pregnancy illegal in Iowa, I鈥檝e had many women express sympathy for me, assuming my future employment is at the front of my mind. I assure you, it鈥檚 not. Every time a woman has expressed her concern for me, I find my mind turning to Luke 23:28-30:聽鈥淒aughters of Jerusalem, weep not for me but for yourselves and your children ... For if men do these things while the trees are green, what will happen when it is dry?鈥 The tribulation Planned Parenthood may experience as a result of SF 359 is not my immediate concern. My concern is for the women Planned Parenthood cares for and for the children of Iowa who will have their futures changed by this despicable attempt to control women鈥檚 bodies at the most fundamental level.聽(Katie Spicka, 5/17)

Short-sighted thinking by Ohio officials imperils聽a wildly successful mental-health program for kids (Greater Cleveland's PEP Connections) and could mean Ohio is missing out on Medicaid prescription coverage savings.聽At the root of both issues appears to be the $100 million or more in extra annual taxes Ohio can get by using Medicaid managed care programs. (5/18)

I thought the smell in my neighborhood in southwest Detroit was normal. It wasn鈥檛. After years of working on the right to breathe clean air, we are now being faced with the biggest setback in oversight over polluting industry. The state and the Republican-led Legislature is proposing to give Gov. Rick Snyder the power to appoint a panel to rewrite the Michigan Department of Environmental Quality rules, and another to veto permit decisions made by MDEQ.Get this. The appointees who can veto permit decisions will be engineers, not public health officials. They are not qualified to protect public health, safety and welfare. Such a move would be catastrophic for our public health. Like our MDEQ director, the board members likely would come from the very industries environmental permits are supposed to regulate. (Rashida Tlaib, 5/17)

On September 20, 2017, Hurricane Maria made landfall in Puerto Rico. In the wake of this devastating storm, more than 1000 people died and tens of thousands were displaced from their homes. In early 2018, one-third of Puerto Rico remained without electricity. Before the hurricane crippled infrastructure and created a humanitarian crisis, 33% of Puerto Rico鈥檚 gross domestic product came from its pharmaceutical sector, with approximately 50 firms producing medications and 40 making medical devices. The multifaceted response by both the US Food and Drug Administration (FDA) and hospital systems to the ongoing national shortage of normal saline makes clear how a storm hitting 1000 miles off Florida鈥檚 coast can affect public health across the United States. (Chana A.聽Sacks, Aaron S.聽Kesselheim and Michael聽Fralick,聽5/14)

Let鈥檚 talk about this 鈥渉ead tax鈥 on large businesses 鈥 those with gross revenue above $20 million 鈥 that the Seattle City Council unanimously passed聽this week to help deal with the city鈥檚 worsening homelessness problem. ...But the reason I want to talk about it comes from the question raised by two tax analysts 鈥 Steve Rosenthal and Richard Auxier (R&A) 鈥 in this commentary on the idea: 鈥淗ow are fiscally constrained cities supposed to find revenue as their populations and services grow?鈥 (Jared Bernstein, 5/16)

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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