Viewpoints: Another fight on healthcare coming; Artificial intelligence in the hospital

Huffington Post: Democrats Say They Will Fight Trump Over Health Insurance Subsidies
Get ready for another big congressional fight over Obamacare. The flashpoint this time is a key funding stream for the program ― one that subsidizes insurers so they can offer low-income consumers plans with reduced out-of-pocket expenses. President Donald Trump suggested in a Wednesday Wall Street Journal interview that he and other Republicans might cut off the funds. Now Democrats are saying they’ll fight this by demanding that Congress include the money as part of a spending bill that is supposed to keep the government running past April. (Jonathan Cohn, 4/13)

The New York Times: Can Trump Take Health Care Hostage?
Three weeks have passed since the Trumpcare debacle. After eight years spent denouncing the Affordable Care Act, the G.O.P. finally found itself in a position to do what it had promised, and deliver something better. But it couldn’t. And Republicans, President Trump very much included, had nobody but themselves to blame. (Paul Krugman, 4/14)

The New York Times: Explaining The Health Payments That Trump Is Threatening To End
Cost-sharing reductions seem like an arcane aspect of the Affordable Care Act, but they could now make or break the Obamacare insurance marketplaces. Even President Trump is talking about them, as a possible bargaining chip for a new health bill. (Reed Abelson and Margot Sanger-Katz, 4/14)

Bloomberg: Trump’s Obamacare Obsession Must Die
In an interview with Fox Business that aired on Wednesday, President Donald Trump said it’s been “misreported” that his administration has failed in its efforts reform health care. He suggested that his party’s reforms will result in $900 billion in government savings, and that an ACA repeal will come before an attempt at tax reform. Hospitals and Medicaid insurers, stocks that are most exposed to changes to the ACA, saw shares fall once again yesterday. A repeal is still unlikely, despite the President’s continuing optimism. But continuing to tilt at that windmill doesn’t enable tax reform, it renders it more distant and difficult to count on. That’s a bigger issue than repeal for much of the health care sector. (Max Nisen, 4/13)

The Washington Post: Republicans Can’t Find A Way To Repeal Obamacare Because Too Many Of Them Secretly Love It
Republicans haven’t been able to replace Obamacare, because they think the problem with it, metaphorically speaking, is that the food is terrible and the portions are too small. That, of course, is what Woody Allen had to say about life in “Annie Hall.” But the same kind of contradiction — you hate something, and want more of it — is why Republicans haven’t been able to agree on anything other than that they want to be able to say that they repealed Obamacare. (Matt O’Brien, 4/14)

Los Angeles Times: Insurance CEOs Haven’t Been Speaking Up For Obamacare — Except For One
President Trump and congressional Republicans finally goaded the health insurance industry into defending the Affordable Care Act this week — sort of. But the industry’s pusillanimous response to the GOP’s point-blank threat to Obamacare’s survival is a reminder that health insurance companies, which have made hundreds of millions of dollars from the law, have in many ways been its worst enemies. (Michael Hiltzik, 4/13)

The New England Journal of Medicine: Physicians, Firearms, And Free Speech — Overturning Florida’s Firearm-Safety Gag Rule
In February, the full U.S. Court of Appeals for the Eleventh Circuit issued its long-awaited ruling in Wollschlaeger v. Governor, State of Florida, invalidating parts of Florida’s Firearm Owners’ Privacy Act (FOPA) and affirming that the First Amendment applies to the speech between physicians and patients. The decision ensures that physicians may continue to make efforts to protect their patients from gun-related injuries, many of which are fatal and which in aggregate account for approximately as many deaths annually as do motor vehicle accidents. (Wendy E. Parmet, Jason A. Smith and Matthew Miller, 4/12)

Stat: ‘Beautiful Babies’ Will Die Without Global HIV Funding
President Trump was moved to launch an attack on an air base in Syria in part because of images he saw of the youngest victims of Syrian dictator Bashar al-Assad’s most recent chemical assault on civilians. “Even beautiful babies were cruelly murdered in this very barbaric attack. No child of God should ever suffer such horror,” Trump said while explaining the strike, as if he were learning of such atrocities being committed at the hands of the Assad regime for the first time. While I commend his rare public display of empathy, I hope he will give the same direct and forceful action to avert the deaths of hundreds of thousands of children a year from HIV/AIDS. (C. Nicholas Cuneo, 4/13)

Stat: Artificial Intelligence: Coming Soon To A Hospital Near You
Human intelligence has long powered hospitals and health care. We rely on doctors, nurses, and a variety of other clinicians to solve problems and create new solutions. Advances in artificial intelligence are now making it possible to apply this form of computer-based “thinking” to health care. As the chief technology officer for a new state-of-the-art advanced medical learning facility, I have been closely watching developments in artificial intelligence. Here are three areas — training, surgical robots, and data mining — in which I believe it will begin making a difference sooner rather than later. (Roger Smith, 4/13)

The Wall Street Journal: Why Hospitals Need To Stop Boarding Patients In Emergency Rooms
Just after World War II, there were 1.4 million hospital beds available in the U.S. The most recent estimates show fewer than 900,000 beds, even though the nation’s population has grown by 120% over the same period. Better care delivery, technology, and changing financial incentives have driven much of this decrease, with hospitals continuing to downsize their staff and operations, making for less-flexible bed management. Also shrinking in number are emergency rooms (ERs), even while demand increases. … In the past few decades, an additional burden has been placed on the ER with major implications for patient care: boarding. (Howard Forman, 4/11)

The Wall Street Journal: What Being A Doctor Did–And Didn’t–Teach Me About Leadership
I spent 11 years after medical school training for my first career as a surgeon and scientist, and received little formal preparation for my eventual career as an institutional leader. Extensive training makes sense for a role in which you literally hold patients’ lives in your hands. But beyond the necessary technical skills, becoming a surgeon is a matter of absorbing deep and urgent responsibility for another’s life into a core part of yourself. In some ways, that training has helped me in my current administrative role. … Other lessons don’t translate as readily. (Lloyd B. Minor, 4/11)

The New England Journal of Medicine: Lessons From Standing Rock — Of Water, Racism, And Solidarity
Having followed the events at Standing Rock, North Dakota, I was drawn to go there during Thanksgiving week — amazed by the unlikely fact that a tribe suffering from poverty and health disparities could take such a principled, powerful stand, galvanizing attention for environmental justice and the perfidy of continued carbon exploitation. I thought experiencing Standing Rock, and perhaps contributing, could teach me something about caring for the [traditional Navajo, or] Diné in Chinle. … The Standing Rock movement is about both environmental justice and racism: it aims to protect Native American lands, reduce exploitation of carbon-based energy to slow climate change, and defend access to safe water for a vulnerable community. … Medicine has a proud history of water protection. (David Goldberg, 4/13)