Viewpoints: Medicaid Surges — In States That Didn’t Expand The Program; Mumps In The NHL
A selection of opinions on health care from around the country.
The New York Times' The Upshot:
Medicaid Rolls Surge Under Affordable Care Act
In Idaho, the number of people who signed up for Medicaid has jumped by 13.4 percent. In Georgia, it’s up 12.9 percent. In North Carolina, the rate has climbed 12.4 percent. None of those states opted to expand their Medicaid programs as part of the Affordable Care Act, but all have seen substantial enrollment increases in state health insurance. (Margot Sanger-Katz, 12/118)
The Wall Street Journal:
A GOP Strategy Begins To Emerge
One result of these unforced errors is the glimmer of the strategy that Republicans appear to be concocting for the next few years. It isn’t rooted in the fury that brought in the 2010 tea party wave, or shutdown politics or grand bargains. It isn’t about ObamaCare repeal, or Medicare overhaul. It is more measured, more aimed at incremental achievement. Slow as it has been to gel, we’re beginning to see the framework take shape. (Kimberley A. Strassel, 12/18)
Bloomberg:
Obamacare Isn't As Divisive As You Thought
Yes, as political scientist Matthew Dickinson mentioned in a recent post, some studies purport to show that Obamacare, specifically, cost Democrats quite a few seats in 2010 (I don’t think anyone has run numbers for 2014 yet). But I’ve been very skeptical of that finding. In particular, it’s extremely likely that if Democrats had ignored health care in 2009-2010 some other program would have symbolically done the same work. That is, Republicans would have replaced attacks on Obamacare with additional attacks on the stimulus, bailouts or Dodd-Frank. But really, voters were just reacting to Obama, his job performance and the economy. (Jonathan Bernstein, 12/18)
JAMA:
In Defense Of The Employer Mandate
After 2 delays, section 1513 of the Affordable Care Act (ACA)—shared responsibility for employers—is finally slated to go into effect on January 1, 2015. The so-called employer mandate requires large employers to offer affordable “minimum-value” health insurance to full-time employees and their dependents (to age 26 years) or be subject to annual penalties if at least 1 employee receives premium tax credits for the purchase of individual health insurance via an exchange. Designed to maintain employer-sponsored coverage and to offset the public cost of subsidies to eligible employees in need of health insurance, the employer mandate constitutes an important component of the ACA. However, in the wake of the recent midterm elections, this provision is likely to be singled out for repeal by the newly elected Republican-controlled Congress. (John E. McDonough and Eli Y. Adashi, 12/18)
New England Journal of Medicine:
Medicaid Payments And Access To Care
With more than 66 million beneficiaries, Medicaid is the United States' largest insurer, and its impact on health insurance coverage, access to care, and the health of the poor has been substantial. But historically, Medicaid has faced a major challenge — a relatively low rate of physician participation. ... Extensive research suggests that many factors contribute to low physician participation: complex program requirements, payment delays, and concerns about managing the care of patients with high levels of health and social risk. But research also shows that low fees play a key role and that substantial payment increases may be needed to alter physicians' behavior. (Sara Rosenbaum, 12/18)
The New York Times:
Insurance Fairness For Transgender People
Gov. Andrew Cuomo advanced the cause of civil rights last week by declaring an end to a routine form of discrimination against transgender New Yorkers. New York law requires insurance policies sold in the state to cover the diagnosis and treatment of psychological disorders. In a letter sent to insurance companies, Mr. Cuomo said insurers will no longer be allowed to exclude from that coverage hormone treatments, gender reassignment surgery or other steps deemed medically necessary by a doctor for a patient with gender dysphoria. (12/18)
Bloomberg:
How Hockey Got The Mumps
Over the past two months, the National Hockey League has experienced a baffling outbreak of mumps. Thirteen players are said to have it, and there's no telling when the outbreak will end. It is a story that seems to have stepped from the mid-20th century. ... We cannot know for sure, but it is not unreasonable to speculate that the outbreak among hockey players may be related to lower vaccination rates in Canada, spurred by the anti-vaccination movement. At the very least, it's clear that those who do not vaccinate their children, or themselves, are endangering not only their own families but strangers as well. (Cass R. Sunstein, 12/18)
The Washington Post:
Morbid Obesity Is A Disability. Employers Should Start Treating It That Way.
Job interviews are an uncomfortable experience for most people. But for people like me who suffer from morbid obesity, they are especially grueling. It’s hard to impress someone when you’re the fat applicant. There’s the added challenge of sustaining an engaging conversation as a potential future employer walks you around the premises, a hike that leaves you winded. After that, you have to squeeze into a tiny chair and present your credentials, maintaining a charming demeanor as the blood circulation to the lower half of your body is cut off. I went through this process over and over again while I was searching for a job. I did land one eventually, as a manager in one of the world’s leading business schools. But my problems didn’t end there. ... It is clear to me that morbid obesity — defined as having a body mass index above 40 — is often a disability, irrelevant of the cause. But in many legal systems, that’s still an unanswered question. (Helen Leahey, 12/18)
The Washington Post:
A Global Conspiracy Of Health
In the category of stunning, heartening, woefully underreported good news: In 2000, an estimated 9.9 million children around the world died before age 5. In 2013, the figure was 6.3 million. That is 3.6 million fewer deaths, even as the world’s population increased by about 1 billion. (Michael Gerson, 12/18)
New England Journal of Medicine:
Panic, Paranoia, And Public Health — The AIDS Epidemic's Lessons For Ebola
For those of us who lived through the early days of the U.S. AIDS epidemic, the current national panic over Ebola brings back some very bad memories. The toxic mix of scientific ignorance and paranoia on display in the reaction to the return of health care workers from the front lines of the fight against Ebola in West Africa, the amplification of these reactions by politicians and the media, and the fear-driven suspicion and shunning of whole classes of people are all reminiscent of the response to the emergence of AIDS in the 1980s. (Gregg Gonsalves and Peter Staley, 12/18)