Two Congressional plans, one from each side of the political spectrum, are competing to blow up the current healthcare system. Here experts examine one of them—the left’s bid to replace private insurers with a government-run single-payer plan labeled “Medicare for All.” Alternatives may include bolstering the Affordable Care Act, or getting rid of it completely.
Dr. Paul Ginsburg, Director, USC-Brookings Schaeffer Initiative for Health Policy
Deborah Burger, RN, President, National Nurses United
Dr. Ken Thorpe, Professor of Health Policy, Emory University
Lauren Crawford Shaver, Executive Director, Partnership for America’s Health Care Future
With the opioid epidemic continuing to take many lives every year, people are concerned with how to stop it. In order to help counter this epidemic, Medicare has taken steps to implement limits on the prescriptions of opioids. However, the Medicare proposal has left doctors wondering if these new limits will do more harm than good for patients.
Currently, the United States is experiencing the second wave of the opioid epidemic. Dr. Anna Lembke, Associate Professor and Chief of Addiction Medicine at Stanford University School of Medicine, explains that opioid addiction arises from the prescription of these medications as a go-to for doctors even if the medical condition does not necessarily call for it. Furthermore, Dr. Sally Satel, an addiction psychiatrist and lecturer at Yale University School of Medicine and Resident Scholar at American Enterprise Institute, states that another issue is not just the prescribing of opioid medications, but the over-prescribing. In many cases, a doctor will prescribe a patient an unnecessary amount of opioids, but this often leads to leftover medication that tends to get into the hands of people who are likely to abuse it. So, one way that Medicare is working to counteract this is by regulating the quantity and overall dose of opioids that are allowed to be prescribed to a patient. Dr. Satel explains that by limiting the number of pills allowed when refilling a prescription, not only will it decrease the number of leftover pills, but it will also guarantee that those who benefit from opioids continue to take them appropriately. Along with this, Dr. Lembke states that this limit on the number allowed to be prescribed is important because doctors most likely would not limit their prescriptions enough to a point that would allow for a decrease in the epidemic. With this regulation, the number of leftover pills being circulated outside of who they were prescribed to will decrease which will allow for a drop in the number of people addicted to prescription opioids.
The proposed Medicare regulations also came with a second leg to it. This other guideline would cut-off any doctor from prescribing a high-dose of opioid medications. However, Dr. Satel explains that many pain physicians had problems with this regulation because it would make it extremely difficult for patients who do benefit from these prescriptions, and use them properly, to have access to them. So, when the final Medicare proposal was released, this second guideline was altered to allow physicians to prescribe high-doses of opioid medications, but it gave pharmacists the power to override a high-dose request that seemed unnecessary.
While these Medicare limits are a step in the right direction for managing the opioid epidemic, there is still much that can be done to improve it. For instance, other medical treatments should be made more accessible through Medicare, explains Dr. Lembke. It’s important to reduce the access to opioids. However, it is also important to facilitate the use of other medical treatments to help with pain. Improvements are being made in the healthcare system to stop the opioid epidemic, but those who benefit from opioid prescriptions should not have to suffer.
Dr. Anna Lembke, Associate Professor and Chief of Addiction Medicine at Stanford University School of Medicine
Dr. Sally Satel, addiction psychiatrist and lecturer at Yale University School of Medicine, and Resident Scholar at American Enterprise Institute
New limits on Medicare prescriptions of opioids are controversial, as some doctors believe patients could suffer more pain. Others believe the limits will achieve a much needed brake on the temptation to overprescribe while allowing legitimate treatment. Experts discuss.
Curing Chronic Sinusitis
Many people confuse allergies, colds, and sinus infections. A physician specializing in these maladies describes the differences, and the new ways sinusitis can be treated.
Approximately 14% of Americans live in a rural area and require access to local hospitals, but many rural hospitals struggle to keep their doors open, citing such financial pressures as the upkeep of equipment and technology.
Dr. Carrie Henning-Smith, a Research Associate at the University of Minnesota, says rural hospitals rely on government funding from programs like Medicare and Medicaid, however neither program cannot fully support the upkeep of buildings and the care of the patients. Although Medicare and Medicaid provide funding, 40% of rural hospitals still operate with a large loss.
Michael Topchik, Director of the Chartis Center for Rural Health, projects that if the current administration cuts Medicaid funding, 15 million recipients will lose health benefits. In addition, Medicaid cuts will drastically affect rural hospitals. Eighty rural hospitals have closed since 2010, and many more could be at risk in the years to come. Closing these rural hospitals would lead to a loss of 35,000 jobs and a $4 billion drag on domestic product. In addition, the residents of rural areas would have to travel long distances to get access to basic health care when they might need it most.
Dr. Carrie Henning-Smith, Research Associate, University of Minnesota Rural Health Research Center
Michael Topchik, Director, Chartis Center for Rural Health
Dr. Daniel Derksen, Director, University of Arizona Center for Rural Health
The incoming Trump Administration and Congressional Republicans have made “repeal and replacement” of the Affordable Care Act one of their primary goals. But there are many options in how it might be replaced, and some popular aspects of Obamacare will likely remain. Experts discuss likely scenarios and how they would affect Medicaid, Medicare, insurance exchanges and the overall market.