KHN Morning Briefing

Summaries of health policy coverage from major news organizations

Viewpoints: GOP’s ‘Cynical’ Lawsuit Against Obama; Debt Crisis Is Not Over

Los Angeles Times: Just How Cynical Can The House Get In Attacking Obama?
There's not much that Republicans like about the 2010 Affordable Care Act, but one thing they particularly dislike is the requirement that employers with 50 or more full-time workers provide comprehensive health insurance. So it's only natural that House Republicans would now be seeking to sue the president for not implementing that mandate on time. Wait, what? (Jon Healey, 7/16). 

The Washington Post: A Lawsuit With Little Merit
Rep. Pete Sessions, the House Rules Committee chairman who led Wednesday's hearing on Republicans' plans to sue President Obama, presented the legal credentials that have put him in this position of responsibility. "I'm an Eagle Scout," the Texas Republican told his colleagues. "I studied the merit badges that we took about governance, about cities, states, the national government" (Dana Milbank, 7/16).

Politico: Obama's Hilarious Lawlessness
The lawsuit against the president undertaken by House Speaker John Boehner targets the serial delay of Obamacare’s employer mandate, just one of a number of seat-of-the-pants delays and alterations in the law. According to the text of the Affordable Care Act, the mandate was supposed to go into effect on Jan. 1, 2014. The administration nonetheless delayed it for an entire year via a Treasury Department blog post in July 2013. Before his adoring audiences, the president says he has to act because Congress won't. In this case, Congress was happy to act. In fact, the House passed a bill to delay the mandate until Jan. 1, 2015. President Obama threatened to veto it (Rich Lowry, 7/16).

The Wall Street Journal: How To Run Against ObamaCare
Liberal columnists and Democratic strategists have taken to arguing that ObamaCare is working and no longer a political negative, implying that Democratic candidates should tout it on the campaign trail. Republicans should pray they do, assuming the GOP knows how to respond. As presidential scholar George Edwards III observed in his 2012 book "Overreach," the Affordable Care Act is "perhaps the least popular major domestic policy passed in the last century." It remains so today. A June 3 Fox News poll found 38% were "glad the health care law passed" while 55% "wish it had never passed." Only 29% thought "the country is better off" with the law while 44% said America was "worse off" (Karl Rove, 7/16).

The New York Times' Taking Note: The Moderate Revolution In Kansas
A surprising political revolt is now brewing in Kansas. ... But the group's bill of particulars against [Gov. Sam] Brownback — a mini-Declaration of Independence for moderates — goes far beyond what it calls a "reckless tax experiment" that actually raised middle-class taxes and pushing the state's economy below all of its neighbors. It points out that the governor's refusal to expand Medicaid had hurt Kansas hospitals and driven people out of rural counties (David Firestone, 7/16). 

The New York Times' The Upshot: The Global Slowdown In Medical Costs
We tend to think of health care as a local good. Most people use the doctor or hospital in their neighborhood. China does not export medical care. Health and life spans differ from country to country, even county to county. But when it comes to health care spending, the picture is starting to look more global. After decades when health spending in the United States grew much faster than it did in other Western countries, a new pattern has emerged in the last two decades. And it has become particularly pronounced since the economic crisis. The rate of health cost growth has slowed substantially since 2000 in every high-income country, including the United States, Canada, Britain, France, Germany and Switzerland, according to data from the Organization for Economic Cooperation and Development (Margot Sanger-Katz, 7/16).

The Washington Post: No, Washington Hasn't Solved The Country's Debt Problem
Washington has taken an indefinite break from the budget debate that marked the early part of this decade. No one's expecting a grand bargain any time soon. ... Deficits have come down from their historic highs during the Great Recession and its aftermath. Health-care costs have not risen as quickly in the last few years, helping to right the country’s fiscal balance and making the long-term budget outlook a bit more manageable. But the Congressional Budget Office (CBO) on Tuesday rained on this bipartisan parade. In its latest long-term budget projection, the country's arbiter of all things fiscal warned that federal spending remains dangerously unsustainable in the long term. Over the next 25 years, mandatory spending on entitlement programs such as Medicare is set to rise to 14 percent of gross domestic product, double the average over the past several decades (7/16). 

The Wall Street Journal’s Washington Wire: CBO Forecast Points Up The Need For Entitlement Reform
The Congressional Budget Office’s annual long-term budget forecast prompted numerous news articles about a potential slowdown in the growth of health spending and what that would mean for Medicare and other programs. But federal entitlement spending in the short and medium term will be defined much more by the demographics of an aging population–10,000 baby boomers reach retirement age every day–than by whether policymakers can bend the proverbial cost curve in health care (Chris Jacobs, 7/16).

USA Today: Why $1,000 A Pill? Our View
In the good-news/bad-news world of blockbuster drugs, the latest is the launch of Sovaldi, a drug to treat hepatitis C. Sovaldi comes with a cure rate as high as 90% for a disease that afflicts 3 million people in the United States, and with fewer complications than previous treatments. But it also comes with a scary side effect: a price of $1,000 a pill (7/16). 

USA Today: Hepatitis C Drug Worth The Price: Opposing View
If you know how this disease can ravage a patient's body, how painful, lengthy and only partially effective previous treatments were — as well as how expensive it is to care for patients who aren't cured — then you can begin to understand the true personal, clinical and public health value of sofosbuvir. Additionally, by curing patients, this medicine helps to stop the transmission of an infectious disease. When you take into consideration that it works better than other treatments, in half the time, for a comparable price — and will save money for our health care system in the long run — then it's difficult for me to understand why it has come under such disproportionate criticism (Sammy Saab, 7/16). 

WBUR: On The Road With Project Louise, Marveling 'Who Is This Person?'
In my previous job, I spent a fair amount of time on the road each summer, traveling to theaters in the Berkshires and on Cape Cod. (Hey, somebody had to do it.) And I gained weight – because, I told myself, it was impossible not to gain weight when I was traveling so much, eating road food and going to restaurants and so on. Well, that was just plain wrong. I realized that this weekend, when a family event put me on the highway for an eight-hour road trip. (Sixteen, actually, if we’re talking round trip.) And I am here to tell you that, even on the New Jersey Turnpike, you do not have to eat junk (Louise Kennedy, 7/16).

Journal of the American Medical Association: Quality Reporting That Addresses Disparities In Health Care
More than a decade has passed since the landmark Institute of Medicine report Unequal Treatment documented the sizeable and pervasive disparities that affect the US health care system. Yet there has been little evidence of progress toward eliminating, or even reducing, these inequities in care. Furthermore, there is increasing concern that existing policy efforts designed to improve quality may, in fact, worsen disparities in care. Most recently, the Medicare pay-for-performance effort with the largest financial penalties, the Hospital Readmissions Reduction Program, was found to disproportionately penalize safety-net facilities that primarily care for disadvantaged and poor populations (Ashish K. Jha and Alan M. Zaslavsky, 7/16).

Journal of the American Medical Association: Professional Organizations' Role In Supporting Physicians To Improve Value In Health Care
Some of the [federal health] law’s provisions, such as the Physician Value-Based Modifier (PVBM), will include financial incentives that directly affect individual clinicians, thus providing an external force for engaging physicians in efforts to improve health care value. Despite this looming mandate—PVBM will go in effect in 2015 for large physician groups and in 2017 for all physicians—some physicians may lack the tools and motivation necessary to improve the value of their individual care delivery. Notably, the current system does not compel high-value care. Not only is mitigating waste and judiciously ordering tests and referrals disincentivized in the fee-for-service system, doing so is more cognitively taxing and there is a perceived increased risk of legal repercussions (Leah Marcotte, Christopher Moriates and Arnold Milstein, 7/16).

Journal of the American Medical Association: Advancing Telecare For Pain Treatment In Primary Care
Chronic musculoskeletal pain accounts for an estimated 60 million ambulatory care visits in the United States each year and significantly impairs quality of life. Management of chronic musculoskeletal pain is frequently frustrating, both for patients and for their primary care physicians. ... However, in the absence of effective systems for implementing evidence-based approaches for treating chronic pain, improved awareness of pain has resulted in increased and sometimes indiscriminate prescribing of chronic opioids, with harmful effects. Because of the high prevalence of chronic pain and the limited capacity of specialty pain clinics, effective interventions are needed that can be safely and widely implemented by primary care practices (Michael E. Ohl and Gary E. Rosenthal, 7/16).

The New England Journal Of Medicine: Money, Sex, And Religion — The Supreme Court's ACA Sequel
The majority decision, written by Justice Samuel Alito, is a setback for both the ACA's foundational goal of access to universal health care and for women's health care specifically. It is also especially worrisome that abortion is again at the center of the continuing debate over the implementation of the ACA and that the challenge of abortion has been expanded to include birth control. ... Our incremental, fragmented, and incomplete health insurance system means that different Americans have different access to health care on the basis of their income, employment status, age, and sex. The decision in Hobby Lobby unravels only one more thread, perhaps, but it tugs on a quilt that is already inequitable and uneven (George J. Annas,  Theodore W. Ruger and Jennifer Prah Ruger, 7/16).

The New England Journal Of Medicine: Culturally And Linguistically Appropriate Services — Advancing Health With CLAS
Currently, about 20% of the U.S. population speaks a language other than English at home, and 9% has limited English proficiency. By 2050, the United States will be a "majority minority" nation, with more than half the population coming from racial or ethnic minority backgrounds. Diversity is even greater when dimensions such as geography, socioeconomic status, disability status, sexual orientation, and gender identity are considered. Attention to these trends is critical for ensuring that health disparities narrow, rather than widen, in the future. ... Advancing health with CLAS can help us attain the high-quality system of care and prevention that all people, regardless of background, need and deserve (Dr. Howard K. Koh, Dr. J. Nadine Gracia, and Mayra E. Alvarez,  7/17).

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