KHN Morning Briefing

Summaries of health policy coverage from major news organizations

Viewpoints: Michael Moore Finds Health Law Affordability ‘A Cruel Joke’; Can More Marketing Help Sell Insurance?

The New York Times: The Obamacare We Deserve 
Now that the individual mandate is officially here, let me begin with an admission: Obamacare is awful. That is the dirty little secret many liberals have avoided saying out loud for fear of aiding the president's enemies, at a time when the ideal of universal health care needed all the support it could get. ... For many people, the "affordable" part of the Affordable Care Act risks being a cruel joke. ... And yet -- I would be remiss if I didn't say this -- Obamacare is a godsend (Michael Moore, 12/31/13). 

The Washington Post's Plum Line: The 'Wingnut Hole' Measured: 5 Million Without Insurance Thanks To GOP Refusal
Because of the decision on Obamacare by the Supreme Court, which left the decision to expand Medicaid (a key part of Obamacare) up to the individual states, most Republican-controlled states refused said expansion, leaving substantial portions of the citizenry in the lurch. ... How many Americans will go without health insurance simply because the GOP dislikes the president? Well, happy 2014, dear readers: initial estimates are in, and we have 5 million lucky winners! (Ryan Cooper, 12/31/13).

The New Republic: We Don't Know If Obamacare Is Working Well. But We Know It's Working.
But nobody ever promised that Obamacare would solve all of the health care system's ills -- or that it would come without costs of its own. The goal has always been to make insurance more widely available, so that more people had access to care and protection from crippling medical bills, while beginning the difficult work of reengineering medical care to make it more efficient. The new enrollment numbers should give us new reason to think it will (Jonathan Cohn, 12/29/13).

Bloomberg: If 2013 Was Hard On Obamacare, Just Wait For 2014 
[P]eople shouldn't have been surprised that the law was so hard to implement and spawned so much bad press -- in fact, it was designed so that the law's more politically unpopular provisions would take effect only after the 2012 elections. ... Millions of Americans in the individual market being dropped from their existing plans is directly related to Obamacare's essential health benefits requirement, which mandates coverage across 10 categories and goes into effect in 2014 (Lanhee Chen, 12/30/13).

The New York Times: Obamacare Not A Total Disaster, Continued
Perceptions about health reform are in an interesting place. Just about everyone on the right is still living in October, the annus horribilis of Obamacare (yes, I know it was just a month, and I don't care), and is waiting to move in for the kill after the whole thing collapses. Meanwhile, a funny thing has been happening: enrollments surged this month, to such an extent that the original expectation of 7 million people signed up via the exchanges by the end of March no longer looks crazy (Paul Krugman, 12/30/13).

USA Today: Why Obamacare Surprise? 
Why are we being flooded with stories of people expressing surprise about the costs associated with Obamacare enrollment or purchasing individual plans that conform to the law's requirements? Don't tell me it's because you believed Obama when he made all those promises about blah, blah, blah. ... at least four years ago I started asking my doctors -- primary care and specialists -- what they thought Obama's vision of health care reform would lead to (Don Campbell, 12/25/13).

The Washington Post: The Obamacare Obama Gets
[T]he president signed up for Obamacare coverage he does not intend to use, skipped the disastrous Web site he forced millions of Americans to navigate, had someone else do the paperwork for him, chose the cheapest possible plan to avoid the premiums he is imposing on others and waited until the last possible moment to decide whether he wanted to cough up $400 a month as a symbolic show of solidarity. ... Will the president agree to give up his free military health care when his presidency is over? Will Obama live under Obamacare once he is a private citizen? If you believe he will, you probably still think you can keep your doctor (Marc Thiessen, 12/30/13). 

The Washington Post: Obamacare Needs More Enrollees To Work Well
It's still unclear how well the Affordable Care Act will function. But on Wednesday, the law started working for a good chunk of those it was designed to help. The formerly uninsured who signed up for health-care plans under its provisions are now able to use their new coverage. ... Consequently, the overriding task is to increase enrollment, particularly among target populations. That's not only for the well-being of those who will get coverage but also because insurers need enough healthy people paying into the system to offset the costs of the sick. They based their 2014 offerings and premiums on estimates of what that balance would look like; if the estimates fail to match reality, financing the system could be a challenge. Halfway through the open-enrollment period, it's past time for a sustained publicity blitz (1/1). 

Fox News: Marketing Is Causing Obamacare’s Problems
It is only when products flop do intelligent individuals realize the importance of marketing. The problem with many product failures is that decision makers often forget just what marketing is -- the art and science of satisfying customer needs. This means, no matter what others think,  marketing does not get people to buy what they do not want. And for this reason, the Affordable Care Act's (Obamacare) destiny can only be product failure because it does not satisfy the needs of most Americans (John Tantillo, 1/1).

The Dallas Morning News: Rick Perry: You Can't Dress Up The Failures Of Obamacare
The promise and potential I normally greet each New Year with is, this year, being tested by a great sense of peril as Americans face the full brunt of the disastrous impacts of Obamacare in 2014. The delays, deceit and debacles that marked Obamacare's rollout in 2013 show no signs of slowing in the new year. People all across the country have witnessed what a disaster this program has been from its earliest stages, ranging from the $600 million website debacle to the sad fact that President Barack Obama flat-out deceived the American people when he promised that those who like their coverage could keep it. To stem the bleeding, the administration is resorting to arbitrary delays for some Obamacare mandates, which only inject more confusion into the marketplace and with consumers (Texas Gov. Rick Perry, 1/1).

The Dallas Morning News: Kathleen Sebelius: Jan. 1 A Milestone For Better Health Care For Americans
As we wish our friends and family a happy, healthy New Year, these words have renewed meaning in 2014. Tomorrow, Jan. 1, will mark a new day in health care for millions of families and individuals throughout Texas. Starting tomorrow, it will be against the law for insurance companies to deny you coverage or charge you more because of a pre-existing medical condition like diabetes, high-blood pressure or asthma. And they will no longer be able to drop you from coverage just because you get sick or get into an accident (Health and Human Services Secretary Kathleen Sebelius, 12/31/13).

The New England Journal of Medicine: Physicians And The (Woman's) Body Politic
For two decades, legislatures have been encroaching on the realm of medicine. Heedless of medical ethics or evidence-based standards of care, they have been declaring medical "facts," specifying or forbidding medical procedures, and dictating to doctors what they must say to their patients. Roe v. Wade was not only about a woman's right to abortion. It was also about the right to her physician's medical judgment and best care, unconstrained by partisan strategies. It is not only women's bodies that are being held hostage to politics; it is also the hearts, minds, and professional pride of their physicians (R. Alta Charo, 1/1).

The New York Times: Room For Debate: Thinking Beyond The Pill
A recent Vanity Fair article exposed the risks of using NuvaRing, a relatively new form of contraception for women. More than 50 years after its introduction, the birth control pill -- and altering hormonal levels in general -- still seems to be the best contraceptive available. Has progress on developing new birth control methods stalled? What can be done to promote innovation? (1/1). 

The Wall Street Journal: Critics Of 'Me-Too Drugs' Need To Take A Chill Pill
It now takes 10-15 years for a pharmaceutical company to get a new drug approved, and on average the cost exceeds $1 billion. There is a lengthy process of laboratory, animal and clinical studies, and then regulatory review, to establish safety and effectiveness according to government standards. Arguably, that is more than enough (Henry I. Miller, 1/1). 

WBUR: Project Louise: Facing The Scale And Setting Goals
OK, so here is the truth I promised to share last week: I weigh 189 pounds. That's a pound more than I was figuring when I told you my BMI was 29.4. At this weight and my height (5 feet 7 inches), my BMI is 29.6. I guess I'm happy that I still haven’t quite tipped over into "obese" (BMI of 30 or more), but let's not quibble here, shall we? There’s no ducking it: I weigh more than I should, and more than I can admit without a deep sense of shame (Louise Kennedy, 12/30/13).

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