Viewpoints: Abortion and birth control issues in N.C. Senate race; replacing Obamacare; cancellations

The New York Times: Why North Carolina's Senate Race Has A Wide Gender Gap
But on Wednesday in Charlotte, Kay Hagan stood without hesitation next to Janet Colm, chief executive of the Planned Parenthood Action Fund of Central North Carolina, and proudly bashed her opponent, Thom Tillis, for reducing women's rights on abortion and birth control. … Ms. Hagan needs women to show up at the polls on Nov. 4, maybe more so than candidates in other races. She has been running even with or a few points ahead of Mr. Tillis in a swing state that is better educated and more urbanized than Louisiana, and some polls have given her an advantage of as much as 20 percentage points over Mr. Tillis among women, the biggest gender gap in any Senate race (David Firestone, 10/16). 

Politico Magazine: 4 Rules For Replacing Obamacare
The Affordable Care Act remains extremely unpopular with voters for a whole host of reasons. It has raised premiums for millions of people, forced millions more out of their insurance plans and away from the doctors that they liked and were told they could keep, and is cutting Medicare and raising taxes to pay for a massive new entitlement program. If a sizeable number of anti-Obamacare candidates win, they will rightfully believe they have a mandate from their voters to take some action (Lanhee J. Chen and James C. Capretta, 10/16).

USA Today: Obamacare Cancellations, Again: Column
Last fall, millions of Americans breathed a sigh of relief when Obamacare didn't cancel their health care plans. Now they're holding their breath once again. Hundreds of thousands of Americans will soon receive cancellation letters affecting their 2015 health care plans -; and that number may quickly rise into the millions. This wave of cancellations will fall into two categories. The first group hit will be in the individual market, the same group that suffered through at least 6.3 million cancellation letters last year. They will almost certainly be joined by millions of people in the small-employer market, which has 40 million plans and will be under Obamacare's control starting next year (Tim Phillips, 10/16). 

USA Today: Web Essay: Health Reform's Impact On Medicare
Seniors and other Medicare beneficiaries should be aware that this year – perhaps more than any year in the past – is an important one to pay attention to their Medicare coverage options during the Open Enrollment Period (Oct. 15-Dec. 7). And that's because of the Affordable Care Act (ACA). The ACA brings with it notable changes to Medicare, from more preventive care benefits to changes in costs, and beneficiaries need to understand both the upside and downside of such changes to best evaluate their options during the Open Enrollment Period (Jennifer Cohen-Smith, 10/17). 

USA Today: Health Research Needs Boost From Bold Innovators
In 1998, I went to the doctor so fatigued I was unable to get out of bed. He sent me home diagnosed with multiple sclerosis but without so much as a treatment plan, a prescription or what I needed most: hope. Come back when it gets worse, he said, the medical equivalent of a pat on the head. In the years since, I have found other doctors and new treatments that enabled me to reclaim my life. But progress has come at an agonizing, incremental pace. The 50 million people worldwide who suffer from neurologic diseases are as frustrated as I am (Ann Romney, 10/16). 

Los Angeles Times: Why Ezekiel Emanuel Is Wrong To 'Hope' For Death At 75
Emanuel's subject is our inability to accept the inevitability of decline and death. He disavows any intention to set forth general principles either for individuals or American society: "I am not saying that those who want to live as long as possible are unethical or wrong," he writes. "I'm not even trying to convince anyone I'm right. ... And I am not advocating 75 as the official statistic of a complete, good life in order to save resources, ration health care, or address public-policy issues arising from the increases in life expectancy" (Michael Hiltzik, 10/16). 

The New England Journal of Medicine: Data Sharing, Year 1 -; Access To Data from Industry-Sponsored Clinical Trials
There has been considerable interest of late in increasing the transparency of clinical trials, including increasing access to the raw data from trials sponsored by the pharmaceutical industry. Since May 2013, investigators have been able to request access to deidentified patient-level data from clinical trials sponsored by GlaxoSmithKline, subject to review and oversight by an independent review panel. As the members of this panel, we now have more than 12 months of experience with this initiative -; and can report that it has been a productive and successful first step (Brian L. Strom, Marc Buyse, John Hughes, and Bartha M. Knoppers, 10/16).

The New England Journal of Medicine: Diversity Dynamics -; Challenges To A Representative U.S. Medical Workforce
In an era when the proportion of the U.S. population that is nonwhite has surged to 37%, two notable trends are shaping the composition of the physician workforce: the "overwhelming majority" of medical school graduates continue to be white, and the number of black men completing medical school has been trending downward since 1997. By comparison, medical school graduates of Hispanic and Asian descent have increased in number and as a percentage of total graduates. Although the Obama administration trumpets its support for improving opportunities for minority young people -; and specifically black men -; it has dismayed medical educators for 3 years running by proposing elimination of the Health Careers Opportunity Program (HCOP), which aims to increase diversity in the health professions (John K. Iglehart, 10/16).

The New England Journal of Medicine: The New Diversity In Medical Education
And as we aim to translate earlier versions of diversity into something serving medicine's core missions, it's worth remembering that, as with the mother from my pediatrics rotation, I've often quickly built a rapport with a patient simply because we were both black. But all diversity, visual or not, holds value. It's not just a numbers game or an annual administrative experiment. Diversity is a process that exists outside the admissions cycle and promotional photos (Mark A. Attiah, 10/16).

The Wall Street Journal: Philadelphia School Failure
Last week the Philadelphia School Reform Commission mandated that teachers chip in between 5% to 13% toward health-care premiums on a sliding scale based on salary. Teachers will pay each month an average of $49 for single coverage and $139 for a family. Government workers on average cover 15% of their premiums while private workers pay about 25%. The teachers union calls this "union-busting." Yet the commission, which runs the Philly schools and includes three Democrats and two Republicans, unanimously backed the cost-sharing as a last resort when unions failed to negotiate a new contract (10/16).