Viewpoints: Working For Benefits; Fears For A Pill To Prevent HIV; Possible Medicaid Strategy For Virginia

The New York Times: Cutting The Poor Out Of Welfare
[Economist Robert] Moffitt noted in an email that "the work incentives in the government safety net have greatly increased over the last 20 years: less welfare payments if you don't work, and much greater government payments if you do." The 2010 enactment of the Affordable Care Act reinforced the pattern of rewarding those above the official poverty line. The A.C.A.'s major provisions make everyone earning from 100 to 138 percent of poverty level income eligible for Medicaid (in states that sign on to the program) and grant subsidies for the purchase of health insurance to those making from 138 percent to 400 percent of poverty level income (Thomas B. Edsall, 6/17).

The New York Times' Room For Debate: Is A Pill Enough To Fight H.I.V.?
New federal guidelines urge gay men and others who have unprotected sex to take a daily dose of the drug Truvada, a regimen called pre-exposure prophylaxis (PrEP), to curb H.I.V. infections and AIDS. Is promoting the use of the antiviral drug a good public health strategy, or will it encourage more to have unprotected sex? (6/17). 

Los Angeles Times: The U.S. Healthcare System: Worst In The Developed World
The U.S. healthcare system notched another dubious honor in a new comparison of its quality to the systems of 10 other developed countries: its rank was dead last. The new study by the Commonwealth Fund ranks the U.S. against seven wealthy European countries and Canada, Australia and New Zealand. It's a follow-up of previous surveys published in 2010, 2007, 2006 and 2004, in all of which the U.S. also ranked last (Michael Hiltzik, 6/17). 

Los Angeles Times: A Better Way To Cure What Ails Us
Annual spending on healthcare in America totals nearly $9,000 per person, accounting for more than 17% of the U.S. economy. Yet, on some of the most basic medical interventions, we're failing. Sometimes patients are overtreated, particularly with antibiotics and prescription opiates. But a problem that may be even bigger, from my vantage point, is undertreatment. Some highly effective medicines for potentially deadly conditions aren't being used nearly often enough (Tom Frieden, 6/17).

The Wall Street Journal: Medicare's Puzzling Refusal To Cover Lung-Cancer Screening
If you could save thousands of lives, would you do it? That's the question Medicare officials are now considering—whether to approve lung-cancer screening for Medicare beneficiaries, which we estimate could save 14,000 lives each year in that group alone. Most patients are discovered with lung cancer at a stage already too late for a cure, and cancer screening for early detection has been recommended for other common cancers for decades. The procedure has turned thousands of people into survivors rather than victims. It is not clear why Medicare does not cover lung-cancer screening like it does for breast, colon and prostate cancer—all far less lethal. But the issue is especially acute since nearly 70% of lung cancer occurs in the Medicare population (Douglas E. Wood and Ella A Kazerooni, 6/17). 

The Wall Street Journal’s Washington Wire: Who Would Pay for This Medicaid Expansion?
Even as states continue to debate the costs of expanding Medicaid under the Affordable Care Act, some in the medical field are proposing new commitments for the program. Last week Politico reported on a letter to Congress by several physician groups asking that increased reimbursements for primary-care physicians participating in Medicaid be extended. ... The proposal raises several questions, including whether states would cover any of the cost of extending the increased payments (Chris Jacobs, 6/17). 

The Richmond Times-Dispatch: Schapiro: McAuliffe Has Another Card To Play On Health Care
Gov. Terry McAuliffe has made no secret of his distaste for the manner in which his Republican predecessor, Bob McDonnell, went about financing a highway that would link Petersburg and Suffolk. The project is supposed to be a back door for trucks into the Port of Hampton Roads. McAuliffe depicts it as a frontal assault on the wallets of taxpayers, costing $1.4 billion, about a quarter of which has already been spent with nary an inch of asphalt poured. And it may never happen because the federal government is blocking the road as a threat to rapidly diminishing wetlands. That said, the Road to Nowhere, as detractors call the new U.S. 460, may provide McAuliffe a path out of his jam over health care (Jeff E. Schapiro, 6/17). 

Anchorage Daily News: Medicaid Gaps In Alaska Not As Big As Has Been Claimed
In November 2013, when [Gov. Sean Parnell] announced that he would not be seeking Medicaid expansion in 2014, he asked me to analyze Alaska's health care safety net. ... Through a combination of tribal health organizations, community health clinics and federally qualified health centers, public health centers and hospitals, Alaskans without health insurance can access comprehensive care in more than 200 Alaska communities. Gaps exist but they are more limited than what has been reported in the media or claimed by political advocacy groups (William J. Struer, 6/17).

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