KHN Morning Briefing

Summaries of health policy coverage from major news organizations.

Viewpoints: Protect The FDA’s Regulatory Efforts; Generic Drug ‘Shenanigans;’ Does Ryan Not Understand The 2012 Election?

The Wall Street Journal: The Best Prescription For Pre-Emption
On Tuesday, the Supreme Court will hear arguments in Mutual Pharmaceutical v. Bartlett, a case about the ability of consumers to bring lawsuits against the makers of generic drugs. A central issue is the Food and Drug Administration's doctrine of federal "pre-emption," meaning that state tort law cannot trump FDA regulation. In Bartlett, the manufacturer is being sued for selling an allegedly flawed drug that was nevertheless approved by the FDA, which also regulated the manufacturer's exact formula. The pre-emption doctrine … was established to protect the agency's ability and authority to regulate the safety and effectiveness of drugs nationwide. The left detested pre-emption, since it impeded the ability of trial lawyers to bring big dollar lawsuits in state courts challenging FDA regulatory decisions (Tevi Troy, 3/18).

Los Angeles Times: Prescription Needed To Remedy Generic Drug Pricing Shenanigans
Wanda Ferrin fills her husband's prescription for the generic antibiotic doxycycline at a Target in Simi Valley. For years, the medication has cost her $6 a month. In February, however, the price tripled to $18 for 30 pills. And this month, it skyrocketed to $133. This is noteworthy enough. But what happened next makes the entire business of drug pricing a study in lunacy (David Lazarus, 3/18).

Milwaukee Journal Sentinel: A New Ryan Budget That Looks A Lot Like The Others
We're tempted to ask U.S. Rep. Paul Ryan: What part about losing the 2012 presidential election didn't you understand? ... The new spending plan, like the others Ryan has written, would make big changes to Medicare and Medicaid, cut tax rates on individuals and corporations, and reduce the size of domestic spending programs over time. The plan would restructure Medicare by paying subsidies to the insured rather than paying directly for medical services. Medicaid would become a block grant program. It repeals Obamacare while leaving in place Obamacare's taxes. ... continuing to call for a repeal of the Affordable Care Act is the height of folly (3/17).

Bloomberg: Paul Ryan's Budget Won't Help Republicans Win
Now that (Rep. Paul Ryan's budget plan is) advancing a version of Medicare reform with fewer risks for seniors, that slow phase-in makes less sense. And the plan should raise co-pays, especially for the affluent, which would also lighten the burden on younger people. A budget that reduced spending on those older than 55 would make it possible to bring the government's long-term debt to a manageable level while allowing for a higher (and more realistic) level of Medicaid spending than the Ryan budget includes. The House Republicans should have been bolder on health care, too. Their new budget envisions the repeal of President Barack Obama's health-care law but outlines no replacement for it, which is rather odd for a document that purports to provide a Republican vision for the future of the welfare state (Ramesh Ponnuru, 3/18).

The New York Times: Paul Ryan's Ax Isn't Sharp Enough
As a family doctor for more than 30 years, I understand that we must look for savings in our health care system too. I recently co-sponsored legislation that would convert Medicaid and the Children's Health Insurance Program into state-managed programs through a single federal block grant. This would save approximately $2 trillion over 10 years by capping federal funding at 2012 levels for the next 10 years and giving states an incentive to seek out and eliminate waste, fraud and abuse. ... We must repeal Obamacare — including the associated taxes, which the Ryan budget leaves intact by assuming the enactment of tax reform later on. We’ll replace it with a market-based health care system devoid of government involvement and managed by patients and their doctors. … If we get government out of the way and put Medicare in patients’ hands by increasing contribution limits to health savings accounts, it will transform Medicare into a more flexible premium assistance program (Rep. Paul C. Broun Jr., R-Ga., 3/18).

The Washington Post: Progressives' Budget Merits A Closer Look
Ryan’s budget is cruel, deceptive and incomplete. Even as the Affordable Care Act and Medicare expansion are being embraced by reality-based Republican governors (or those, such as Florida’s Rick Scott, who are experiencing a momentary bout of poll-induced realism), Ryan stubbornly ignores Congressional Budget Office evidence that the ACA decreases the deficit. Even at a moment when we need the safety net more than ever, Ryan wants to shred and slash programs including Medicare, Medicaid, food stamps and domestic violence prevention. And even as Ryan coasts on his unearned reputation as a serious wonk, his budget math is full of holes (Katrina vanden Heuvel, 3/18).

Houston Chronicle: The Case For A Texas Solution
The Texas Medicaid program as it presently exists has reached an unsustainable capacity. The current network of hospitals and physicians who care for our state's Medicaid population has reached a true breaking point. They can no longer welcome new patients under the existing model of coverage. ... It is true that Texas stands to gain coverage for a significant number of now-uninsured residents through any healthcare expansion, but an expansion of Medicaid also results in an expansion of patient need. As it stands, only about 30 percent of Texas physicians are willing to accept new Medicaid patients. Without reforms, those new patients will still find the Texas health care system inaccessible for preventive and primary care, leaving them seeking care in emergency rooms at a continued high cost to Texas taxpayers. The state's existing system is broken, and placing more pressure on an already broken system sets us up for a crisis (State Rep. John Zerwas, 3/17). 

Seattle Times: Expand Medicaid Under The Affordable Care Act To Improve Mental-Health Care
Our mental-health system has gaping holes and we cannot continue to ignore them. In our work at Downtown Emergency Service Center we see these holes reflected every day in the people who fall through them. Our mission is to provide the kind of care that helps people get back on their feet and find stability. Expanding Medicaid access to 250,000 people in our state under the Affordable Care Act will (Bill Hobson and Paul Tipps, 3/18).

The New York Times: A Cure, In Essence, For HIV In Some Adults
Two weeks ago, American doctors reported that they had "functionally" cured a baby infected with H.I.V., the virus that causes AIDS, with an aggressive treatment of drugs starting some 30 hours after the baby was born. Experts hailed the feat but cautioned that the findings might have little relevance to adults. Now French researchers have identified 14 adults whose treatments with antiviral drugs began within a couple of months of infection, continued for one to seven and a half years, and then stopped (3/18).

The Washington Post: Why Should Food Stamps Pay For Junk Food?
What really caught my attention, though, were the photographs that showed what some SNAP recipients bought with their government-funded debit cards: Cheetos Puffs, a one-ounce handful of which contains 10 grams of fat; a box containing two dozen 12-ounce cans of Fanta Orange soda, each of which contains 44 grams of sugar; a carton of six-ounce Capri Sun drink pouches, each of which contains 16 grams of sugar. In short, this immense nutrition program pays for a lot of stuff that is the opposite of nutritious (Charles Lane, 3/18).

WBUR: Cognoscenti: Medical School Debt And The Potential Impact On Patient Care
As we waited for an operating room before my recent knee surgery, I lay on a gurney making small talk with the five doctors and nurses who surrounded me. My anesthesia had just started to kick in when one of the doctors mentioned his eye-popping student debt. His admission prompted his colleagues to chime in with what they owed. They were all resigned to the fact that borrowing insane amounts of money was required to pursue a medical profession. As I fell into a deep sleep, I tallied their collective student loans in my head; about a half-million dollars in unpaid debt went into the operating room with me that day. Tuition and fees at public medical schools increased by an average of 133 percent  between 1984 and 2004. At private schools, costs went up by 50 percent in the same period (Bob Hildreth, 3/19).

Journal of the American Medical Association: Ushering In A New Era Of Open Science Through Data Sharing
A wall surrounds much of these clinical research data, sequestering knowledge, impeding the free flow of information, and obscuring a clear view of the totality of evidence relevant to many research questions and clinical decisions. Nearly half of clinical research trials are never published. Moreover, publications are often incomplete, selectively reporting favorable outcomes and infrequently reporting relevant safety findings. Motivations and explanations for this phenomenon vary, but whether intended or not, selective publication distorts the medical evidence and inhibits the flow of information that is vital to decision making by patients and their clinicians (Dr. Joseph S. Ross and Dr. Harlan M. Krumholz, 3/18).

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