Viewpoints: Yes, Link Between Mental Illness, Mass Killings Exists; Short-Term Plans Might Aid ACA’s Future

Editorial pages look at these health care issues and others.

Los Angeles Times: Actually, There Is A Clear Link Between Mass Shootings And Mental Illness

"Repeat after me: Mass shooters are not disproportionately mentally ill." This is the opening line of a meme that's been circulating in the aftermath of the shooting in Parkland, Fla. But this and other efforts to downplay the role of mental illness in mass shootings are simply misleading. There is a clear relationship between mental illness and mass public shootings. At the broadest level, peer-reviewed research has shown that individuals with major mental disorders (those that substantially interfere with life activities) are more likely to commit violent acts, especially if they abuse drugs. (Grant Duwe and Michael Rocque, 2/23)

Forbes: Trump Administration Restores An Escape Valve From Obamacare's Insurance Regulations

Adding in the new Obamacare escape valve is good policy, but it also means that there will be fewer people agitating for dramatic changes to our health care system. And that bodes poorly for those who remain committed to the GOP’s slogan of “repeal.” (Avik Roy, 2/22)

The Washington Post: Democrats Are Now Firmly Behind Single-Payer. Thanks, Trump And Republicans.

Today, the Center for American Progress released a single-payer health plan (or thereabouts), planting a significant marker in the evolution of the Democratic Party, and eventually perhaps the American health-care system. And we have President Trump and the Republicans to thank for it. (Paul Waldman, 2/22)

The Hill: On ObamaCare, Republicans In Congress Should Follow Trump

The Trump administration clearly has not given up on the fight to repeal ObamaCare. The Department of Health and Human Services announced a new proposed rule this week to expand the availability of short-term, limited-duration health insurance plans, showing the Trump administration is still serious about gutting ObamaCare. The question is why are congressional Republicans not following President Trump’s lead? (Jenny Beth Martin, 2/22)

The Hill: Removal Of The Health Insurance Mandate Could Impact Our Larger Health Care System

We begin 2018 with a major change settling into the health-care industry: The removal of the individual mandate, which required all Americans to acquire health insurance coverage or risk paying a penalty. ...At this stage, it’s important for the health-care industry as a whole to talk about these changes and start to come to some consensus about them. Health-care providers will need to be on the same page as we move on to determine what can be done as an industry to mitigate the impacts of this change, and to fill the gaps in health care that it may well create.(Karen Schechter, 2/21)

Stat: Medicaid Work Requirements Are Bad For Patients And Physicians

Employment should not be a prerequisite to receive medical treatment or coverage, though some states are trying to make that happen. As a physician, I am deeply concerned by several states’ decisions to submit Medicaid waiver applications that would require enrollees to work, search for work, or volunteer in order to qualify for government health coverage. (Jack Ende, 2/22)

New England Journal of Medicine: Broken Hearts And Opened Eyes

Why does it take mass shootings to move our collective outrage? This phenomenon is not just explained by news sensationalism piquing our voyeuristic interest. As physicians and public health advocates, we give priority in our efforts, research, clinical care, and time to threats that pose the most risk to health; one measure of that risk is the number of lives threatened. But unseen risks are more challenging to measure, and when widely distributed, they may be spread in such a thin layer that they are barely perceptible. (Charles A. Morris and Jonathan B. Miller, 2/20)

The Hill: Undercutting The Immunization Program Puts Both Lives And Dollars At Risk

On Monday, President Trump released his proposed Fiscal Year 2019 budget. It notes an impressive achievement: For every $1 the Centers for Medicare and Medicaid Services (CMS) spends on preventing fraud and abuse, the agency saves $5. Whenever you can spend money to save money in government, it’s a no brainer for policymakers. Unfortunately, that rationale seems to have escaped the President on the issue of vaccination. (Amy Pisani, 2/22)

New England Journal of Medicine: Federal Right-To-Try Legislation — Threatening The FDA’s Public Health Mission

A bill passed by the Senate would sharply curtail the FDA’s oversight of access to investigational drugs. Although its impact would probably be limited, the motivation behind it threatens to weaken the FDA’s ability to pursue its public health mission. (Steve Joffe, Holly Fernandez Lynch, 2/22)

Stat: Benzodiazepines: Our Other Prescription Drug Epidemic

We need to pay more attention to America’s other prescription drug problem — the hidden epidemic of benzodiazepine use and abuse. Between 1996 and 2013, the number of adults who filled a benzodiazepine prescription increased by 67 percent, from 8.1 million to 13.5 million. Unlike opioid prescribing, which peaked in 2012 and has decreased nearly 20 percent since then, benzodiazepine prescribing continues to rise. The risk of overdose death goes up nearly fourfold when benzodiazepines are combined with opioids, yet rates of co-prescribing benzodiazepines and opioids nearly doubled between 2001 and 2013. Overdose deaths involving benzodiazepines increased more than sevenfold between 1999 and 2015. (Anna Lembke, 2/22)

New England Journal of Medicine: Our Other Prescription Drug Problem

The Food and Drug Administration (FDA) has approved benzodiazepines for a diverse set of clinical indications, including anxiety, insomnia, seizures, and acute alcohol withdrawal. These drugs are also prescribed off-label for many other conditions, such as restless legs syndrome and depression. (Anna Lembke, Jennifer Papac and Keith Humphreys, 2/22)

New England Journal of Medicine: Controlling The Swing Of The Opioid Pendulum

Well before the opioid crisis was recognized and attention was directed to opioid-related deaths, clinicians cited issues related to opioids as a principal reason why they didn’t enjoy caring for patients with chronic pain. Now, many physicians and advanced care practitioners (nurse practitioners and physician assistants) have decided that the risk associated with prescribing opioids is too high. Some clinics, particularly in locations with high rates of opioid misuse, have established policies of not prescribing opioids at all. The reasons for such policies are complex. (George Comerci, Joanna Katzman and Daniel Duhigg, 2/22)

Cleveland Plain Dealer: Can Digital Innovations Help Fight Health Inequality?

A 2017 study, based on respondents' self-assessment of personal health and health care, showed that the United States has among the highest income-based health disparities in the world (only Chile and Portugal reported a wider gulf). Another recent study showed that differences in life expectancy across income groups increased over the 2001-2014 period. While the evidence for the rising health inequity may be indisputable, there seems to be less clarity on the remedies. (Satish Nambisan and Priya Nambisan, 2/22)

The Wichita Eagle: Kansas Wise To Colyer's Abortion Move

Recently, Gov. Jeff Colyer and select state representatives announced their goal to amend the Kansas constitution, taking away the right to abortion care.First, a brief history lesson is in order. Abortion is a federally protected right under Roe vs. Wade, which was decided by the U.S. Supreme Court in 1973. Roe determined, 45 years ago, that the right to privacy be extended to people who need access to abortion care. After Roe was handed down, countless lives of women, who otherwise would have senselessly died due to unsafe conditions, were saved. (Julie A. Burkhart, 2/23)

This is part of the KHN Morning Briefing, a summary of health policy coverage from major news organizations. Sign up for an email subscription