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Morning Briefing

Summaries of health policy coverage from major news organizations

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Friday, Jun 12 2020

Full Issue

Viewpoints: Medical World Can't Put Off Becoming Anti-Racist Any Longer; Closing Medicaid Gap Is More Important Now Than Ever

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

Ahmaud Arbery. Breonna Taylor. George Floyd. Tony McDade. For some, their killings illuminate racism’s stronghold on our society for the first time. However, police brutality is part of the epidemic of anti-Black racism initiated when the first slave ships docked on American shores in 1619. (Ayotomiwa Ojo, 6/12)

For physicians, the words “I can’t breathe” are a primal cry for help. As many physicians have left their comfort zones to care for patients with Covid-19–associated respiratory failure, the role of the medical profession in addressing this life-defining need has rarely been clearer. But as George Floyd’s repeated cry of “I can’t breathe” while he was being murdered by a Minneapolis police officer has resounded through the country, the physician’s role has seemed less clear. Police brutality against black people, and the systemic racism of which it is but one lethal manifestation, is a festering public health crisis. Can the medical profession use the tools in its armamentarium to address this deep-rooted disease? (Michele K. Evans, Lisa Rosenbaum, Debra Malina, Stephen Morrissey, and Eric J. Rubin, 6/10)

Nearly 3 months into the coronavirus disease 2019 (COVID-19) pandemic, more than 40 million individuals in the US have filed for unemployment. Without jobs and with lower incomes, millions will lose their health insurance, which will lead to a surge of new enrollees in Medicaid. This is particularly true in the 37 states that implemented Affordable Care Act (ACA) Medicaid expansions, through which most low-income adults other than undocumented or recent immigrants can qualify for coverage. However, in nonexpansion states millions will remain ineligible. Large increases in enrollment during recessions are an essential feature in “countercyclical” programs like Medicaid, meaning tax revenues that support the program decline while expenditures for the program increase. (Benjamin D. Sommers, 6/11)

The American death toll is rising. An unpopular president fears for his re-election chances. The U.S. sends men into space. Down on Earth, the economy is in trouble. Racial tensions boil over into rallies, looting and violent confrontations with police in cities across the nation, intensifying political polarization and widening the generational divide. The president considers invoking the 1807 Insurrection Act, which empowers a president to deploy the armed forces and National Guard in any state. Yes, as writers across the political spectrum such as David Frum, James Fallows, Max Boot, Julian Zelizer and Zachary Karabell have pointed out, 2020 is looking a lot like 1968. For Vietnam, read Covid-19. (Niall Ferguson, 6/10)

For years now, the American psyche has been under siege. Well before COVID-19 arrived, our suicide rate was the highest it’s been since World War II and drug overdoses were killing more people than car accidents. Now, though, we must also contend with a deadly virus, the worst unemployment since the Great Depression and isolating lockdown measures, as well as the national trauma of George Floyd’s horrific death at the hands of police. (Brian Barnett, Andrew Carlo and Bruce Schwartz, 6/11)

Now that the country is slowly emerging from lockdown, we might consider what effect this vast experiment in social isolation has had on not just how we feel but also how we think. Many of my friends and patients have been telling me they feel mentally duller and unfocused — even those who are still busy working and, in some cases, exercising even more than usual. (Richard A. Friedman, 6/11)

After a few days of feeling feverish, exhausted, achy, and having an intermittent sore throat, I feared the worst: Covid-19. I immediately self-quarantined. My husband begged me to call the doctor, but I didn’t see the point, as I knew I would be told to get tested. For me, that medical advice was complicated by my disability. (Bonnielin Swenor, 6/12)

Instead of forcing patients to stand in line at a drugstore to fill their prescriptions, it would be easier and cheaper if these patients could get their meds directly from the doctors prescribing them. No doubt that’s why only six states—Montana, Texas, New York, New Jersey, Massachusetts and New Hampshire—insist on the added cost and delay of forcing patients to make a separate trip to the pharmacy. The Institute for Justice says this is ridiculous and wants to change it. On June 15, IJ will sue in Montana on behalf of three doctors who seek the freedom to dispense “non-controlled medications directly to their patients at cost.” The suit notes that Montana’s ban already allows doctors to dispense in certain cases, such as in emergencies or rural areas where there’s no pharmacy within 10 miles. If doctors are qualified in these cases, what sense does it make to disqualify everyone else based on geography? (6/11)

Millions of Americans have experienced the coronavirus pandemic directly, as they or their loved ones suffered through infection. But for most of us, the experience is defined by weeks and months on end stuck at home. The shut-ins are testing the safety of our home environments. Stress and isolation combined with another feature of American life — easy access to firearms — could form a deadly brew. Last week we released results of a new study — the largest ever on the connection between suicide and handgun ownership — in The New England Journal of Medicine revealing that gun owners were nearly four times as likely to die by suicide than people without guns, even when controlling for gender, age, race and neighborhood. (David Studdert, Matthew Miller and Garen Wintemute, 6/11)

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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