KHN Morning Briefing

Summaries of health policy coverage from major news organizations.

Kaiser Health News Original Stories

Political Cartoon: 'Weak At The Sees?'

Kaiser Health News provides a fresh take on health policy developments with "Political Cartoon: 'Weak At The Sees?'" by Dave Coverly, Speed Bump.

Here's today's health policy haiku:

DON'T MESS WITH MITCH McCONNELL

Some rogue amendments
And a real Senate smackdown
Tough days on the Hill.

If you have a health policy haiku to share, please Contact Us and let us know if you want us to include your name. Keep in mind that we give extra points if you link back to a KHN original story.

Health Law Issues And Implementation

Covered California Sets 4% Hike For 2016 Premiums

News outlets report that the increase in health care premium costs for Obamacare plans will be felt the most by residents of the Bay Area and other northern parts of the state. Other states will experience rate boosts between 10 percent and 40 percent.

The New York Times: Average Rise On Insurance Seen At 4% In California
Health insurance rates will rise next year by an average of just 4 percent in California, one of the few states that actively negotiate prices, state officials said Monday. In other states, insurers, including Blue Cross and Blue Shield, have requested rate increases of 10 percent to 40 percent or more. New customers under the Affordable Care Act turned out to be sicker than expected, many insurers have said. Some insurers reported financial losses on their exchange business, saying they paid out more in claims than they collected in premiums. (Pear, 7/27)

Los Angeles Times: Obamacare Rates To Rise 4% In California For 2016
The modest price increases for 2016 may be welcome news for many of the 1.3 million Californians who buy individual policies through the state marketplace, known as Covered California. California's rates are a key barometer of how the Affordable Care Act is working nationwide, and the results indicate that industry giants Anthem and Kaiser Permanente are eager to compete for customers in the nation's biggest Obamacare market. (Terhune, 7/27)

The Associated Press: Covered California: Cost Of Coverage Increasing
The average increase in Southern California is 1.8 percent, for a total of $296 a month, compared to 7 percent, or a total of $384 a month, in Northern California. Southern Californians can get better rates because the region has more provider competition. The exchange also added two new participants for the first time — UnitedHealthcare, the nation's largest health insurer, and a New York startup called Oscar. Lee said California's 2016 rates are proof that the Affordable Care Act is working in the state. He credited California's aggressive approach on haggling with insurers. (Lin, 7/27)

The San Jose Mercury News: Obamacare: Bay Area Residents Will See Higher Covered California Premiums In 2016
Covered California, the state's health insurance exchange, on Monday boasted a second straight year of modest rate hikes next year for the majority of its customers, but one region of the state won't have it so easy: the Bay Area. While average premiums will rise only 4 percent statewide, rates will climb as high as 12.8 percent in Santa Cruz County, 7 percent in Santa Clara County and more than 6 percent in Alameda and San Mateo counties, exchange officials revealed. (Seipel, 7/27)

Marketplace

Just-Approved Cholesterol Drug Could Offer Millions A Pricey New Medication Option

The drug, Praluent, has demonstrated the power to drive down levels of LDL cholesterol to numbers almost never seen in adults. Its cost is $14,600 a year.

USA Today: FDA Approves New Cholesterol Drug - At $14,600 A Year
Up to 10 million Americans will soon have a new option for lowering their cholesterol – at a price of $14,600 a year. The Food and Drug Administration surprised much of the medical community Friday by broadly approving a new cholesterol drug for a vast potential patient population. The agency approved Praluent for people with an inherited condition that causes very high levels of LDL, or bad cholesterol, as well as for the millions of Americans who have had heart attacks, strokes or other types of heart disease and whose LDL is higher than it should be. (Szabo, 7/27)

The New York Times: Praluent Looks Cheap To Those With Extreme Cholesterol
The newly approved cholesterol-lowering drug, Praluent, is powerful almost beyond belief. It can drive levels of LDL cholesterol, the dangerous kind, into the 20s or even the teens, numbers almost never before seen in adults. In general, it lowers cholesterol by 50 percent to 70 percent, compared with 25 percent to 55 percent with statins. The $14,600 yearly price of the drug, which is injected under the skin once every two weeks, is a stunner. Yet for some patients, that might actually be a bargain. (Kolata, 7/27)

The Wall Street Journal: Patients Seeking Alternatives To Statins May Undergo Rigorous Vetting
The new drugs are expensive. And unlike a much cheaper class of pills called statins—which are proven to reduce cardiovascular risk—the jury is still out on whether the new drugs reduce serious events like heart attacks. For these reasons, many insurers plan to require rigorous evaluations before authorizing prescriptions, to make sure patients can’t get their cholesterol down with statins. An estimated 10% to 25% of people who have tried statins report having muscle pain, which limits the dose they can tolerate or precludes them from taking a statin at all. Doctors who specialize in the condition, known as statin intolerance, say by changing statins or trying other strategies, many patients initially considered intolerant can end up taking a statin after all—which is the aim of payers who plan to aggressively challenge claims of statin intolerance. (Winslow, 7/27)

Teva Agrees To Allergan Purchase; Price Tag Set At $40B

The Israeli company will acquire Allergan's generic drug business and, if approved, the deal will place Teva among the largest drug companies in the world.

Marketplace: Teva Agrees To Buy Allergan For $40 Billion
The world’s largest manufacturer of generic drugs, Teva, has bagged some big game. Monday morning, the company announced that it has agreed to buy Allergan’s generic business for a little more than $40 billion. If approved, the deal places Teva amongst the largest drug companies on the planet. (Gorenstein, 7/27)

Reuters: Teva To Buy Allergan Generic Business For $40.5B, Drops Mylan Bid
Israel's Teva Pharmaceutical Industries will pay $40.5 billion in cash and stock for Allergan's generic drugs business, solidifying Teva's position as the world's No. 1 maker of generics while freeing Allergan to focus on branded drugs, paying down debt and potential "transformational" acquisitions. The deal, the largest in Israel's corporate history, allows Teva stronger economies of scale, crucial in the low-margin generic drugs business. Teva , which dropped its hostile pursuit of Mylan, will likely have to sell off some drugs to allay antitrust concerns. (Cohen and Scheer, 7/27)

Meanwhile, the big picture -

The Associated Press: Analysts Expect More Tie-Ups In Generic Drug Business
Analysts say they expect more tie-ups are coming in the generic drug industry in the wake of Teva’s mammoth deal for the generic drug business of Allergan. The Dutch drugmaker Mylan, which had resisted Teva’s advances for three months, is pressing ahead with its offer for Irish drug and ingredients maker Perrigo. Teva withdrew its offer for Mylan on Monday as it announced its alternative deal. (7/27)

Capitol Hill Watch

Recent Insurer Mergers Trigger Capitol Hill Concerns About Reduced Competition

The House Judiciary Committee is planning two hearings in September to discuss these worries. Meanwhile, another House panel contemplates an overhaul of how Medicare pays hospitals for short-term stays. And a Kansas congressman throws his support behind the so-called "health care compact."

Reuters: U.S. House Panel To Hold Hearings On Competition In Health Care
The U.S. House of Representatives Judiciary Committee is planning two hearings for September to discuss concerns about reduced competition in the healthcare industry, lawmakers from both parties said. In July, insurer Aetna said it would buy rival Humana for $33 billion, while Anthem said it would buy Cigna for $54.2 billion. The dual deals would effectively lower the number of major U.S. health insurers from five to three. (Bartz, 7/27)

Politico Pro: Ways And Means Plans Hospital Payment Overhaul
Republican lawmakers on a powerful House committee are planning a comprehensive overhaul clearing up how Medicare pays hospitals for short-term patient stays, but hospitals opposing the effort say a recent proposal from the Obama administration offers a much better solution. (Mershon, 7/27)

The Kansas Health Institute News Service: Pompeo Agrees To Co-sponsor Health Care Compact Resolution
Kansas 4th District Congressman Mike Pompeo has agreed to co-sponsor a joint resolution that would allow states to form a health care compact and, potentially, circumvent parts of the Affordable Care Act. “Mike has agreed to be a part of the health care compact because he views it as one of the last remaining opportunities to protect Kansans from the disaster that is the Affordable Care Act,” Heather Denker, a spokesperson for Pompeo’s office, said in an email. Pompeo, she said, believes the Affordable Care Act, also known as Obamacare, will “drive up costs for the poorest people in Kansas and diminish access, especially in the rural areas of Kansas.” (Ranney, 7/27)

McConnell Confronts A Restive GOP Caucus

Angst among lawmakers is taking the form of amendments to repeal the health law or defund Planned Parenthood, but they don't always fit in with Senate Majority Leader Mitch McConnell's plans for broader legislation.

Politico: Mitch McConnell Summons Restive Republicans For ‘Combative’ Sitdown
Senate Majority Leader Mitch McConnell got his hands on something he believed to be damning: An email from Sen. Mike Lee’s aide to conservative activists plotting to use an Obamacare vote as a political weapon. So McConnell quickly summoned the GOP to a closed-door session in the Senate’s Mansfield Room Monday night. ... The sitdown appeared to be an effort by McConnell to impose order in his caucus after days of infighting, initiated by [Sen. Ted] Cruz, who accused McConnell of “lying” in a hard-charging series of floor speeches and public statements. Cruz, along with Lee, have sought to use arcane Senate procedures to force through simple majority votes on a range of conservative causes — to take a hard line on Iran, defund Planned Parenthood and repeal Obamacare. (Raju, 7/27)

The Washington Post: Lee Backs Down From Obamacare Amendment, After Staffer E-Mails Outside Groups
Conservative Sen. Mike Lee backed down on Monday from a controversial plan to demand a simple-majority vote to repeal Obamacare, following a meeting in which he apologized to Senate Majority Leader Mitch McConnell for the actions of a Lee staffer. Lee abandoned his plan after first offering to give up in exchange for a later repeal vote as part of budget reconciliation and failing to find support from leadership. (Snell and Kane, 7/27)

Politico: Senate Smackdown: Ted Cruz, Mike Lee Efforts Squelched By Leaders
So when Cruz came to the floor looking for at least 11 senators to agree to hold a roll-call vote, only three raised their hands. McConnell, sitting at his desk, turned around and peered at Cruz, who looked stunned at what had just happened. The Senate dispensed with his effort by a voice vote and quickly moved on, doing the same to Sen. Mike Lee (R-Utah), a Cruz ally who sought to use arcane procedures to force a vote on defunding Planned Parenthood. It all went down in an instant, but the message was clear: If Cruz doesn’t want to play nice with his Republican colleagues, they will respond in kind. (Raju and Everett, 7/27)

Rand Paul Pursues Vote On Defunding Planned Parenthood Before The August Break

Meanwhile, the organization confirmed Monday that its website has been hacked by anti-abortion activists.

The Washington Post: Rand Paul Says The GOP Can Defund Planned Parenthood Before The Recess
As Congress races toward its long summer recess, Sen. Rand Paul (R-Ky.) is confident that he’ll get a vote to bar any taxpayer funds going to Planned Parenthood. “There’s a nationwide movement that we’ve been leading,” Paul said in an interview, after participating in a town hall with military veterans. “We will probably send a million emails out on this subject. I think by motivating the grassroots, there’s a very good chance we’ll get a vote on this.” (Weigel. 7/27)

The Washington Post: Planned Parenthood’s Web Site On The Defense After Hacking Claims
Planned Parenthood has been swept up in a storm of controversy in recent weeks, after an antiabortion group started to release undercover videos of officials at the organization discussing how it provides organs from aborted fetuses for research. Now, even the group’s Web site is on the defense. Hackers who say they oppose Planned Parenthood claim to have posted a database associated with the organization’s Web site as well as the names and e-mail addresses of employees online. (Ohlheiser and Peterson, 7/27)

The Hill: Planned Parenthood Confirms Attack From Anti-Abortion Hackers
Planned Parenthood confirmed Monday that anti-abortion hackers have attempted to infiltrate the organization, potentially exposing sensitive data on their employees. Dawn Laguens, Planned Parenthood executive vice president, called the incident a “gross invasion of privacy” that could put staff at risk. (Bennett, 7/27)

Reuters: Planned Parenthood Investigating Claims Of Website Hack
Planned Parenthood called on the FBI and the U.S. Department of Justice on Monday for help managing cybersecurity, following a report that the reproductive healthcare group's website had been hacked by anti-abortion activists. The organization has come under scrutiny since the release of two secretly recorded videos earlier this month that critics said showed it was involved in the illegal sale of aborted fetal tissue for medical research. (Cassella, 7/27)

Meanwhile, the state attorney general and state legislators in Texas are involved in an inquiry regarding the fetal tissue research issue highlighted in the controversial videos -

The Texas Tribune: Lawmakers Reviewing Video In Texas Planned Parenthood Inquiry
Legislators on the Senate Health and Human Services Committee are being offered the chance to view a video obtained by the Texas Attorney General's Office as part of its inquiry into Planned Parenthood's practices regarding fetal tissue donation. A spokesman for Republican Committee Chairman Charles Schwertner confirmed that lawmakers on the committee and their staffers are "currently reviewing the video and gathering all the relevant facts" ahead of a Wednesday hearing on Planned Parenthood's "business practices" when it comes to fetal tissue. (Ura, 7/27)

The Texas Tribune: Anti-Abortion Group Visited Planned Parenthood In Houston
The anti-abortion group behind two undercover videos of Planned Parenthood executives discussing fetal tissue donation visited one of the organization’s clinics in Houston, Planned Parenthood officials said Sunday. Two people “fraudulently representing themselves” as research executives and providing fake California driver's licenses toured the Planned Parenthood facility in April “under the guise of discussing tissue research with our clinic research staff,” said Planned Parenthood Gulf Coast spokeswoman Rochelle Tafolla. (Ura, 7/27)

And the New York Times digs into the dispute, which has raised questions about fetal tissue buyers and sellers, what the tissue is used for and what is allowed under the law -

The New York Times: Fetal Tissue From Abortions For Research Is Traded In A Gray Zone
Videos released by an anti-abortion group during the last two weeks have drawn attention to a little-known practice: the buying, selling and research use of fetal tissue acquired from abortion clinics. The group behind the tapes accuses Planned Parenthood of selling fetal tissue for profit — which is illegal and which Planned Parenthood denies doing. House Republicans plan to investigate. This may be just one more battle in the nation’s long war over abortion, but the dispute has raised questions about who the buyers and sellers are, what fetal tissue is used for and what the law allows. (Grady and St. Fleur, 7/27)

Quality

Patients With Chronic Illnesses Are Benefitting From Coordinated Care At Home

News outlets also examine other trends in medical care, including the expanded roles of nurse practitioners and physician assistants, how some new mothers are missing out on advice regarding breastfeeding and SIDS, new guidance about depression screenings and continued efforts to destigmatize mental illness.

PBS NewsHour: How Coordinated Care Gives Patients The Freedom To Stay At Home
Betty Valdez has chronic lung disease, known as COPD, high blood pressure, kidney disease, arthritis and diabetes. Remembering when to take her 20-plus medications is difficult. Getting up from a chair is a significant obstacle, making any regular exercise unlikely. With a primary care provider and help at home, maintaining her current health would be a challenge. Without them, the 65-year-old Valdez spent a lot of time in the emergency room. (Pelcyger, 7/27)

USA Today: EKGs, X-Rays And Heart Procedures -- The Role Of Non-Physicians Grows
Nurse practitioners and physician assistants are a fast-growing part of the medical marketplace, getting paid more often for procedures people generally associate with doctors, such as electrocardiograms, pelvic exams and even helping with heart bypasses, a USA TODAY analysis of federal data finds. Medicare billing records show 15% more nurse practitioners and 11% more physician assistants received payments in 2013 than in 2012 for all types of care. During that same year, the number of general practice physicians paid by the insurance program for the elderly and disabled dropped by 5%. (Ungar and Hoyer, 7/27)

Reuters: Not All New Mothers In U.S. Get Advice On Breastfeeding Infant Care
Despite medical evidence showing the benefits of breastfeeding and how to prevent cot deaths, some doctors are not passing on the information to new mothers in the United States, researchers said on Monday. In a survey of more than 1,000 new mothers funded by the National Institutes of Health, they found that about 20 percent of women did not receive guidance on breastfeeding or on placing infants to sleep on their backs to reduce the risk of sudden infant death syndrome (SIDS). (7/27)

Reuters: Primary Care Doctors Should Screen For Depression
U.S. adults should be screened for depression, according to a proposal from a government-backed panel of medical experts. With this proposal, the U.S. Preventive Services Task Force broadens its 2009 recommendation that adults be screened in doctors' offices if staff-assisted depression care is available. (Seaman, 7/27)

The Associated Press: Experts Warn: Most Mentally Ill People Are Not Violent
Each time mental illness is cited as a possible factor in a high-profile mass killing in the United States, there’s a collective sigh among mental health professionals here. Even as they see an opportunity for serious discussions of problems and remedies, they also worry about setbacks to their efforts to destigmatize mental illness. “Most people who suffer from mental illness are not violent, and most violent acts are committed by people who are not mentally ill,” said Dr. Renee Binder, president of the American Psychiatric Association. If, hypothetically, everyone with mental illness were locked up, “you might think you were safe, but you are not,” Binder said. (7/27)

Public Health And Education

FDA Says Doctors Should Consider Limiting MRIs As Agency Investigates Risks To Brain

The Food and Drug Administration issued the safety announcement as it looks into whether contrast-imaging drugs that contain the heavy metal gadolinium leave brain deposits after repeated MRIs. Meanwhile, a new report suggests that drug makers delay filing reports with the FDA in cases of a drug-related illness or death.

ProPublica: FDA Determines Whether MRI Drugs Accumulate In Brain Tissue
The Food and Drug Administration announced today it is investigating the risk of brain deposits for patients who are given repeated MRIs using imaging drugs that contain a heavy metal. The FDA did not announce any label changes for the nine medicines that contain the metal, gadolinium, saying there was a “need for additional information.” However, “to reduce the potential for gadolinium accumulation,” the safety announcement asked health care professionals to “consider limiting” their use and to reexamine “the necessity of repetitive” MRIs involving these drugs. (Gerth, 7/27)

The Philadelphia Inquirer: Drug Makers May Delay Reporting Patient Harms To FDA: Study
Drug companies may be endangering the lives of patients by not promptly reporting cases of drug-related illness or death to federal regulators, a new report suggests. About 10 percent of cases where a drug does serious harm to a person are not reported to the U.S. Food and Drug Administration within the required 15-day period, the new analysis reveals. (Thompson, 7/27)

State Watch

State Highlights: UMass Health Care Plans Tech Upgrade; Fla. Medicaid Managed Care Insurers Seek Pay Raise

Health care stories are reported from Massachusetts, Florida, New Jersey, Georgia, California, North Carolina, Colorado, Connecticut, Tennessee and Illinois.

The Boston Globe: UMass Health Care Plans Big Patient Record Upgrade
UMass Memorial Health Care will spend $700 million over the next decade to upgrade its patient records and information technology systems, its chief executive, Dr. Eric W. Dickson, said Monday. Central Massachusetts’ largest health network has agreed to buy clinical and billing software programs from Epic Systems Corp. of Verona, Wis., the country’s biggest vendor of electronic health record systems, Dickson told the Globe. (Dayal McCluskey, 7/27)

The Associated Press: Florida Medicaid Plans Seek Raise From State Amid Losses
Insurers participating in Florida's new Medicaid managed care program say they've lost $542 million through 2014 and want the state to raise their rates. But after losing major federal funding for hospitals, Gov. Rick Scott doesn't want to use any more state money for the Medicaid program. Scott and the insurers are locked in intense negotiations that could undermine the fledgling program that gives federal funds to private health insurance companies to oversee medical care for poor and disabled people instead of reimbursing doctors and hospitals for each service. (7/27)

The Associated Press: Hospitals Sue New Jersey Over Camden Paramedic Charge
Two New Jersey hospital chains are suing the state over a New Jersey law that could result in a major change in paramedic service in Camden. Virtua, which operates paramedic services in Camden and Burlington counties, said a law signed this month by Gov. Chris Christie violates the state constitution as "special legislation" aimed at benefiting just one community. The law gives hospitals with Level 1 trauma centers the right to run ambulance and paramedic services in their host communities. (7/27)

The Philadelphia Inquirer: Virtua Sues N.J. To Thwart EMS Takeover By Cooper
Virtua Health Inc. sued the State of New Jersey on Monday to block a law, signed earlier this month by Gov. Christie, that transfers control of emergency medical services in Camden to Cooper University Hospital. Virtua, which currently provides the advanced life support, or paramedic, portion of those services, contends that the law gives Cooper an "exclusive privilege" without any rational medical basis, thereby violating the state constitution. (Avril and Boren, 7/27)

Georgia Health News: Health Data Breach Affects Thousands
About 3,000 Georgians have been told that some of their health information was inadvertently disclosed. The data breach affected clients in the Community Care Services Program, which helps people at risk of nursing home placement to remain in their communities. (Miller, 7/27)

Reuters: Following Patent Loss, UnitedHealth Sued On Antitrust Claims
Nearly four months after a California healthcare software company won a patent infringement verdict against UnitedHealth Group, it filed a new lawsuit alleging the insurance giant obtained its patents fraudulently and violated federal antitrust laws. San Mateo, California-based Cave Consulting Group and it's attorney Richard Brophy of Armstrong Teasdale launched the new complaint on Friday in the U.S. District Court for the Northern District of California against UnitedHealth's OptumInsight subsidiary, which also makes healthcare-related software. (Chung, 7/27)

The Associated Press: Judge Tosses Lawsuit Seeking Fatal Drugs For Terminally Ill
A judge on Monday dismissed a lawsuit against the state on behalf of three terminally ill Californians seeking doctor-prescribed fatal medication. San Diego Superior Court Judge Gregory Pollack said his court is not unsympathetic to their plight but lawmakers — not a judge — would need to change the law barring such prescriptions. Pollack said in his written ruling that the current law that makes it a felony to assist a suicide in any way is constitutional and so he does not have the power to suspend its enforcement. (Watson, 7/27)

The Associated Press: Report: Medicare Could Help NC Save On Retiree Benefits
Legislative researchers say North Carolina can save up to $64 million annually by switching health costs to federally-funded Medicare Advantage plans, but they caution that additional action is needed to close the state's unfunded liability. A report released Monday by the Program Evaluation Division of the General Assembly says the state would need to provide around $2.2 billion more each year to be on track to fully fund an estimated $25.5 billion shortfall in covering long-term benefits to retired state employees. (7/27)

The Associated Press: Audit: Special Needs Reimbursements Misused By Schools
State audit says Robeson County's school system used $3 million meant for special needs students for other purposes — and other districts may have made a similar mistake. The audit issued Monday says for three fiscal years starting in 2011, the school system did not use about $1 million per year in Medicaid reimbursements to provide services for special-needs students as required. (7/27)

The Denver Post: Colorado Transgender Woman Challenges Aetna's Denial Of Coverage
A Colorado transgender woman's insurance company has denied her coverage for gender reassignment surgery she says is medically necessary and should be ensured by state law and policy. Ashlyn Trider, 33, said Aetna Life Insurance Company's refusal to pay for gender reassignment surgery prescribed by her doctor violates Colorado law. The Transgender Legal Defense Fund & Education Fund has demanded Aetna reverse its decision. (Draper, 7/27)

Los Angeles Times: Touches Of Home Help Venice Clinic Put Young Patients At Ease
The Lou Colen Children's Health and Wellness Center is part of a network of free clinics that have historically served uninsured patients in Los Angeles County. Though this branch — which opened in Del Rey last month — still treats many low-income families, its patient-friendly design and services reflect a shift in the way clinics across the nation are delivering healthcare. (Karlamangla, 7/27)

The Connecticut Mirror: Trying To Break The Cycle That Creates Health Care ‘Super-Users’
Ken knows there were many signs of how bad things got when he was drinking. Like the people who told him they were worried – the woman at the bank he’d done business with back when he was a successful mortgage broker, the officer manager at his doctor’s office, the friend who kicked him out of his home, saying he didn’t want to watch Ken kill himself. (Levin Becker, 7/28)

The Associated Press: More Illinois Residents Feel Pain As Budget Impasse Drags On
But the budget impasse is hitting a growing number of people, as social service agencies don't get promised payments, programs are reduced or eliminated and some agencies close their doors. The agencies estimate tens of thousands — most of them low-income working parents, seniors, people with disabilities and immigrants — have become the collateral damage in an ideological battle between the newly elected governor and Democrats that could go on for months. (Burnett, 7/27)

Reuters: Medical Properties To Buy Private Hospital Operator For $900M
Real estate investment trust Medical Properties Trust Inc said on Monday it would buy privately held Capella Holdings Inc, owner of hospital operator Capella Healthcare Inc, for $900 million in cash. Based in Franklin, Tennessee, Capella Healthcare owns and/or operates acute care and specialty hospital facilities in six states and is one of the 10 largest for-profit acute care hospital operators in the United States based on revenue, Medical Properties Trust said. (7/27)

Editorials And Opinions

Viewpoints: The Health Law At Work In Calif.; 'Prescription' For Social Security Disability Insurance

A selection of opinions on health care from around the country.

Los Angeles Times: Obamacare Works In California. Here's Why.
Early reports that 2016 health insurance premiums would increase in double digits brought out the usual cadre of critics to claim — once again — that Obamacare is not financially sustainable. These proposed premiums were neither finalized nor did they reflect the full picture of rates in most states. We now have the full picture in California, where we are proving that health insurance exchanges can keep prices in check. Residents who enroll through Covered California, our statewide exchange, will see only modest 4% increases in 2016. Those selecting the lowest-priced plans actually will save 4.5%. (Peter V. Lee and James C.Robinson, 7/27)

The Washington Post: A Wise Prescription For Social Security Disability Insurance
By this time next year, a crucial federal safety-net program could be out of cash, or almost out of cash. We refer to Social Security Disability Insurance (SSDI), which paid benefits to 9 million disabled workers (and 2 million of their dependents) in 2014, at a total annual cost of $141 billion. There’s no mystery why this has happened: Growth in beneficiaries has outstripped the accumulation of payroll taxes in the Social Security trust fund dedicated to disability benefits. There’s also no doubt about what will happen if Congress fails to act: a sudden 19 percent benefit cut, possibly right in the middle of the 2016 election campaign. (7/27)

Los Angeles Times: Firms Should Stop Pretending That High-Profile Mergers Will Benefit Consumers
It makes you wonder: Has there ever been a high-profile merger that's resulted in lower prices or higher quality for consumers? In the wake of several big deals in recent days, I put that question to dozens of business professors, economists and lawyers specializing in mergers and antitrust issues. These are people who study and track this sort of thing for a living. Not one was able to cite a single big-ticket merger that irrefutably benefited consumers in a long-term, demonstrable way. Not one. ... On Monday, Israel's Teva Pharmaceutical Industries, a leading maker of generic drugs, said it's buying Allergan's generic drug unit. Meanwhile, health insurer Anthem is buying rival Cigna, creating the country's biggest health-insurance company. (David Lazarus, 7/28)

The Wall Street Journal's Washington Wire: Who’s Right On Health Care Cost Projections?
The sustainability of the U.S. fiscal outlook depends on the path of health costs, particularly Medicare, the health insurance program for the elderly and disabled. If health costs continue to rise more rapidly than gross domestic product, then Medicare will be increasingly unaffordable. The recent slowdown in Medicare spending has been touted as evidence that the health cost curve has finally “bent” and that the Medicare financing problem can be managed with modest changes in policy. (Louise Sheiner, 7/27)

The Charlotte Observer: Happy 50th To The Medicare Program
What do these recent news stories in the Observer have in common? An insurance agent connives to sell Affordable Care Act policies to homeless people by encouraging them to report inflated incomes. His clients/victims discover they can’t afford their deductibles nor can they any longer receive medications or other services earmarked for the uninsured. Health care advocates across the state call on Governor McCrory to develop a plan for Medicaid expansion, noting that hundreds of thousands of North Carolinians would benefit significantly, at little cost to the state. A benefit concert is held to pay mounting medical bills for an artist severely injured when struck by a car. (Saxe, 7/27)

The Philadelphia Tribune: Pharma Distorts Facts To Keep Medicare From Negotiating Drug Prices
In 1967, Richard S. Harris wrote a four-part series for The New Yorker, describing how Medicare came to be enacted. The leading opponent of that legislation was the American Medical Association. The AMA's central argument against this valuable piece of legislation was its contention that government-supported health care would pave the way to the horror of socialized medicine. The principal spokesman for the AMA’s fear-mongering claptrap was a Hollywood B-movie actor and TV pitchman named Ronald Reagen. According to one of the lawmakers who spoke to Harris, the way it turned out was that, "the docs just cried socialism once too often and after a while, people stopped believing them." (Hoffman, 7/27)

USA Today: How Disability Law Went Nuts: Column
Good intentions are no excuse for perpetual legal chaos. The Americans with Disabilities Act promised a bright new era of equality and freedom. Instead, it has spawned endless lawsuits and absurd federal decrees while harming some of the people it sought to relieve. The 1990 ADA defined disability as “a physical or mental impairment that substantially limits one or more of the major life activities” — a far broader definition that what previously prevailed in the statute book. In 2008, Congress vastly expanded that definition to include people with diabetes, depression, heart disease, or cancer, as well as people who have significant troubles standing, lifting, bending, reading, concentrating, thinking and communicating. (James Bovard, 7/27)

Politico: Why Can’t Washington Build A Website?
The American taxpayer is paying $80 billion per year for federal information technology. But if you ask anyone who’s applied for veterans healthcare, or searched for a job on USAjobs.gov, or tried to explore small business resources on BusinessUSA.gov, you’ll wonder where that $80 billion went. They’re encountering websites that are confusing, complicated, and not mobile-friendly. Modernizing government isn’t sexy, but is incredibly important — especially given the pressure of budgets and the rapid evolution of consumer-facing technology. As a country, we risk falling behind. (Nick Sinai and Matt LIra, 7/27)

The Wall Street Journal's Washington Wire: A Little-Noticed Win In Global HIV Treatment
Many Americans are skeptical about foreign aid because they believe a large share of U.S. assistance is lost to corruption. When it comes to global health, as the chart above shows, 83% of Americans say corruption and misuse of funds is a barrier to improving health in developing nations, and 43% say it is the most important barrier. Corruption is a problem. World Bank President Jim Kim has called it “public enemy number one.” So it was of no small consequence when UNAIDS announced this month that the global goal adopted in 2011 of getting 15 million people on HIV antiretroviral treatment by the end of 2015 had been met nine months early. (Drew Altman, 7/27)

The New York Times: What I Learned At The Weed Dispensary
In the past year I’ve talked to dozens of these patients in states where medical marijuana is legal, as well as in Colorado, Washington and Oregon, which allow recreational use. Many people with serious illnesses turn to medical marijuana because they’re not getting the careful, comprehensive treatment they need for symptoms like pain or nausea or anxiety. That was certainly true for Robin, whose physicians didn’t seem to have the time or the skills to help her. As a palliative care physician, every day I see firsthand the suffering my patients have experienced, and the lengths to which they’ve gone to manage their symptoms and control their lives. (David Caserett, 7/28)