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Potpourri

  • The High Price of Failing America’s Costliest Patients New York Times by Dhruv Khullar —It’s well known that the country’s staggering health care costs are not evenly distributed. Just 1 percent of patients account for 20 percent of costs, and 5 percent of the population accounts for nearly half the nation’s health care spending. But exactly who these patients are — and how we can better meet their needs — is less clear. "We can’t make the system work unless we do better with this population," said David Blumenthal, a health policy expert and president of the Commonwealth Fund. "It’s important from a humane standpoint — these are our friends, our family. But it’s also important from a cost standpoint, and the effect on taxpayers."

  • Is Health Care a Right? The New Yorker by Atul Gawande — Is health care a right? The United States remains the only developed country in the world unable to come to agreement on an answer. Earlier this year, I was visiting Athens, Ohio, the town in the Appalachian foothills where I grew up. The battle over whether to repeal, replace, or repair the Affordable Care Act raged then, as it continues to rage now. So I began asking people whether they thought that health care was a right. The responses were always interesting....Two sets of values are in tension. We want to reward work, ingenuity, self-reliance. And we want to protect the weak and the vulnerable—not least because, over time, we all become the weak and vulnerable, unable to get by without the help of others. Finding the balance is not a matter of achieving policy perfection; whatever program we devise, some people will put in more and some will take out more. Progress ultimately depends on whether we can build and sustain the belief that collective action genuinely results in collective benefit. No policy will be possible otherwise.

  • Whatever Happened to the National Emergency on Opioid Abuse? St. Louis Post-Dispatch — There are 29 active national emergencies in place today in the United States. The latest is the one that President Donald Trump declared on Aug. 10: "The opioid crisis is an emergency, and I am saying, officially, right now, it is an emergency. It's a national emergency. We're going to spend a lot of time, a lot of effort and a lot of money on the opioid crisis. It is a serious problem the likes of which we have never had." In spite of Trump's penchant for hyperbole, this declaration was a wise decision and came in response to draft recommendations of a presidential commission Trump appointed last spring. Unfortunately, it's been six weeks since the emergency was declared, and the only step the administration has taken is to form a public-private partnership on the issue with some of the drug companies that have profited mightily from the addiction crisis.

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