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Morning Briefing

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Monday, Mar 25 2019

Full Issue

Viewpoints: Trump's Medicare Plan Isn't The Only One That Requires Cuts; Lessons On The Value Of Caregivers And The Lack Of Support For Them

Opinion writers weigh in on these health care topics and others.

The budget President Trump proposed this month is bad news for Medicare-for-all. That鈥檚 not so much because of what is in the plan, but rather because of the reactions it has provoked. Democrats have attacked the president for allegedly proposing $850 billion in Medicare cuts. Actually, $270 billion of that total is not a cut at all 鈥 just an accounting quirk, and the result of moving pieces of current Medicare spending to a different part of the federal health-care budget. The remaining $500聽billion to $600 billion or so in cuts sound scary, particularly when health-care interest groups say they would be 鈥渄evastating鈥 and 鈥済ut Medicare.鈥 But they would not. (3/23)

Last year, one of my best friends learned he had cancer. In many respects he was lucky. He had great insurance. He had enough money. Partly because one of his friends (me) is well connected in the health care system, he got excellent care. So this is not a story about how the system failed, or how people need insurance or access. He had those. He got the care. This is the United States health care system at its peak performance. But I was utterly floored by how hard it all was. (Aaron E. Carroll, 3/25)

A聽widely reported聽study published this week in the British journal聽The Lancet聽alleges聽that an estimated 30 to 50 percent of psychosis cases in Europe are due to cannabis exposure, and that exposure to elevated levels of THC increases this risk. But a careful reading of the study鈥檚 findings raises far more questions than answers. (Paul Armentano, 3/24)

The patient appeared to be dying. She had chronic lung disease, and she had been told she had little reserve left and had barely survived on home oxygen for the past few years. Each time she picked up a lung infection, the buzzards circled closer. Now she had tripped, fallen, broken a bone, had surgery, and her subsequent infection seemed to have pushed her past the point of no return. Still, I held off the palliative care/comfort care team for as long as I could, and she rallied. Everyone saw how tough she was and a fighter and praised my intervention, but it just wasn鈥檛 enough in the end and she died.I was reminded of the role I had played with that end-stage lung patient recently when a mechanical device wielding a video screen was rolled into an intensive care unit of a Kaiser Permanente hospital in California so that a doctor could remotely tell his patient that the lung scan showed no lung reserve left and he was a goner. (Marc Siegel, 3/23)

The Food and Drug Administration last week approved the first-ever drug specifically for postpartum depression. The drug, Zulresso, a synthetic form of a hormone produced in the brain, acts quickly, and its effects can last for a month, but there鈥檚 a catch. Until a pill version is approved, the patient has to be hospitalized for 60 hours and receive the drug by IV. She can鈥檛 be home with her new baby because the drug may cause dizziness and unconsciousness. The price is also dizzying: $34,000 per treatment. (Elisa Albert and Jennifer Block, 3/24)

Burnout is one of the biggest problems physicians face today. We believe that addressing it early 鈥 in medical school 鈥 through coaching gives physicians the tools they need to maintain balance and meaning in their personal and professional lives.We say that after reading comments from participants in our coaching program, 鈥淎 Whole New Doctor,鈥 developed at Georgetown University School of Medicine. This program, born almost by chance, provides executive coaching and leadership training to medical students, who are exactly the right audience for it. (Margaret Cary, Jack Penner and JP Mikhaiel, 3/25)

California faces a shortage of 4,100 primary care doctors in the next decade, according to a study by the California Future Health Workforce Commission. Left unchecked, this shortage of doctors could mean long waits and less care as Boomers enter their golden years. (3/23)

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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