Longer looks: Falling teen birth rate; the right to pain relief; limiting access to Sovaldi

KHN's Shefali Luthra finds interesting reads from around the Web.

Aeon Magazine: How New Orleans Became America's Ground Zero For HIV
An infectious disease doctor at Tulane University, [MarkAlain] Dery treats people living with HIV in New Orleans and Baton Rouge, the two largest cities in the southern state of Louisiana, which itself has the fourth-highest rate of HIV in the United States, just behind New York, Florida and Maryland. In the cities, it's worse. Baton Rouge ranks number one among US metropolitan regions for AIDS ... Louisiana's HIV epidemic is a direct consequence of its severe social conditions (Jessica Wapner, 8/15).

Vox: The Mystery Of The Falling Teen Birth Rate
For five years now, America's teen birth rate has plummeted at an unprecedented rate, falling faster and faster. Between 2007 and 2013, the number of babies born to teens annually fell by 38.4 percent, according to research firm Demographics Intelligence. This drop occurred in tandem with steep declines in the abortion rate. That suggests that the drop isn't the product of more teenagers terminating pregnancies. More simply, fewer girls are getting pregnant (Sarah Kliff, 8/20).

The Atlantic: Who Has A Right To Pain Relief?
Physical pain is not merely a private struggle. Pain is also a problem of representation and trust, of rights and responsibilities, and a source of tension between individual and community. Perhaps not surprisingly, efforts to manage it give rise to a chronic American condition: an intimate, unknowable experience co-opted by special interests. Pain, in short, is political. That is the argument Keith Wailoo, a Princeton historian of medicine and public policy scholar, makes in Pain: A Political History, which sets out to show "how the powerful question of other people's pain became a recurring site for political battle" (Rebecca Davis O'Brien, 8/18).

NPR: Cardiologist Speaks From The Heart About America's Medical System
[Sandeep] Jauhar's new memoir, Doctored: The Disillusionment of an American Physician, is about how doctors are growing increasingly discontent with their profession. And they're facing more pressures: As the number of patients they're expected to see increases, so does the amount of paperwork. While some doctors who perform a lot of procedures may be paid too much, he writes, many doctors, such as primary care physicians, aren't paid enough (Terry Gross, 8/19).

Governing: The Risky Business Of Limiting Medicaid Access To Sovaldi
As states limit Medicaid coverage of an extremely expensive but potentially game-changing hepatitis C medication, it's becoming clear that their actions will have legal consequences. But what's less clear is which side will win. Since the drug Sovaldi got approval from the U.S. Food and Drug Administration (FDA) late last year, it's generated headlines and sparked Congressional inquiries into its high cost ($84,000 on average for a 12-week treatment) as well as its effectiveness ... States typically have to cover drugs from makers that participate in Medicaid's drug rebate program, which includes Gilead Sciences, the company that sells Sovaldi. According to the company, 47 states are covering the drug for their Medicaid populations. But in order to limit its use, about half are enforcing "prior authorization" (Chris Kardish, 8/19).

Modern Healthcare: Without Medicaid Expansion, Some Hospitals Suffer
Across the country, hospitals in Medicaid expansion states are seeing deep reductions in their uninsured volume and the amount of uncompensated care they deliver. That's not happening in nonexpansion states, which is why hospital leaders in those states continue to push elected officials to accept federal Medicaid money to cover more of their residents. The contrasting approaches to expanding Medicaid are starting to produce two separate and unequal healthcare systems in America-;one where a growing percentage of the population has insurance and providers are getting paid, and the other where the uninsured rate remains high and hospitals and doctors struggle with providing care for patients who have no way of paying their bills (Beth Kutscher, 8/16).

Politico Magazine: The Secret Committee Behind Our Soaring Health Care Costs
In 2012, national health care spending in the United States reached $2.8 trillion, or more than 17 percent of the country's gross domestic product -; more than any other industrialized country. And yet overall our citizens aren't healthier than those in other industrialized countries. Of course, there are a million complicated reasons for this: Generally speaking, prices in the United States are just higher than those in other countries… Another explanation, debated by experts in health policy circles but less known to the public, lies with a secretive committee run by the American Medical Association (AMA) which, with the assent of the government, has enormous power to determine Medicare prices by assessing the relative value of the services that physicians perform (Katie Jennings, 8/20).