KHN Morning Briefing

Summaries of health policy coverage from major news organizations

Viewpoints: How Dems Should Run On Obamacare; A $54,000 Copter Ride

The New York Times: How To Run On Health Reform
The Republican attack machine, fueled by millions of dollars from the Koch brothers, has Democrats so rattled about the health reform law that many don’t want to talk about it. They’re happy to run on equal pay for women, or a higher minimum wage, or immigration reform — all of which provide important contrasts with a do-nothing Republican Party — but they haven’t said much about the biggest social accomplishment of the Obama administration. ... voters need to be reminded that government programs can improve life for all Americans. When one of those programs begins to do its job, its authors shouldn’t be afraid to say so (4/18).

The New York Times: Obamacare Versus The Wusses 
Not a day goes by without some prominent Republican politician or pundit insisting that the enrollment numbers are phony, that more people are losing insurance than gaining it, etc. ... I guess that what gets me is the — to use the technical term — wussiness of it all. Isn’t there any space on the right for people who sell themselves as tough-minded, who condemn Obamacare on principle but warn their followers that it’s not on the verge of collapse? Is the whole party so insecure, so unable to handle the truth, that it automatically shoots anyone bearing bad news? And the answer appears to be yes (Paul Krugman, 4/19).

Bloomberg: Obama's Good News Isn't Getting Across
The Senate leadership and White House staff have started to meet each week to develop a coordinated economic message for the fall. They have a ways to go. Politicians see the same poll numbers the news media does. In a recent Wall Street Journal-NBC News poll, the sentiment about the economy showed no positive movement. A Bloomberg national survey last month indicated more pessimism than a year before about the economy, job growth and housing. A majority said they thought health-care costs were getting worse and gave Obama negative marks on health care and the economy (Albert R. Hunt, 4/20).

The Washington Post: The Glorious Obamacare Reckoning Fades Away
On balance, Obamacare will probably remain a net negative for Dems. But with Republicans beginning to voice support for its general goals, increasingly acknowledging the law’s beneficiaries, and continuing to struggle with their stances on repeal and on the Medicaid expansions in their states, the law could turn into more of a political wash than anything else, leaving behind races that end up being about candidates, local issues, and the economy (Greg Sargent, 4/18).

The New York Times: Obamacare Bashing Or Bust
The health care law is a staggering achievement by this president and the Democrats and is likely to be viewed by history as such, but Republican opposition to it has been so vociferous and unrelenting that the president has been hard pressed to find a message that can overcome it. ... The Republican plan is simply to hold tight to last year’s disapproval and drag it forward to this year’s election. And that just might work. Democrats have so fumbled the selling of the health care law’s advantages, both moral and economic — faltering and stammering when they should have been steadfast and resolute — that they have acquiesced the debate to Republican opposition (Charles M. Blow, 4/18).

The Wall Street Journal: Courts Should Stay Out Of Political Fact-Checking 
The U.S. Supreme Court will hear oral arguments on April 22 in Susan B. Anthony List v. Driehaus, a case raising important constitutional questions about laws that purport to prohibit "false" political statements. ... The Susan B. Anthony List and the Coalition Opposed to Additional Spending and Taxes—the two advocacy organizations that are petitioners in this case—wanted to criticize Rep. Steve Driehaus (D., Ohio), for his 2010 vote in favor of the Affordable Care Act. The groups believe that the law includes taxpayer-funded abortion because (among other things) it subsidizes insurance plans that may include abortion coverage (Michael A. Carvin and Yaakov M. Roth, 4/18).

Los Angeles Times: My $54,000 Helicopter Ride
One of the benefits of the Affordable Care Act that President Obama often touts is the limit it places on medical bills: no more than $6,350 annually per insured individual ... The insurance industry's idea of an "out-of-pocket maximum," however, doesn't deliver on the promise implicit in its name ... Once you reach it, your insurer will cover 100% of the cost only of the essential health benefits covered by the plan, and out-of-network services are exempt (except for emergency treatments). That's a troubling thought, considering how many insurers are reducing the number of doctors and hospitals in their plans (Jon Healey, 4/20). 

Journal of the American Medical Association: Pediatric Euthanasia In Belgium
What the [new Belgian] law does not consider, however, is that adults choose euthanasia for reasons that go beyond pain. For adults, the decision to end their life can be based upon the fear of a loss of control, not wanting to burden others, or the desire not to spend their final days of life fully sedated. These desires might be supported by the experience they have had witnessing a loved one express a loss of dignity or because they understand what terminal sedation is and wish to refuse it. Children, however, lack the intellectual capacity to develop a sophisticated preference against palliative interventions of last resort (Andrew M. Siegel, Dominic A. Sisti and Arthur L. Caplan, 4/17). 

The New York Times: The Public Health Crisis Hiding In Our Food
The reason that nearly everyone eats way too much sodium is that our food is loaded with it, and often where we don’t taste or expect it. ... Doctors warn people with high blood pressure to go on a low-salt diet, but that’s virtually impossible in today’s world, because nearly 80 percent of the sodium that Americans eat comes in packaged and restaurant food (whether it’s a bagel, a sandwich or a steak dinner). You can’t take it out. And nearly everyone, not just people with hypertension puzzling over food labels, should be taking in less sodium. The only way to prevent millions of Americans from developing high blood pressure is for companies and restaurants to stop loading up their food with sodium (Dr. Thomas A. Farley, 4/20).

USA Today: Let Medicare Negotiate Drug Prices: Our View
Medicare's "Part B" program pays roughly $20 billion a year for the drugs patients get in doctors' offices and hospital outpatient facilities. There's room for savings in Part B, but the real drug-spending problem is Medicare's "Part D" prescription plan, which began in 2006. Part D already costs about $80 billion a year and is on track to double by 2022 as benefits improve and Baby Boomers retire. ... a significant chunk of that money is wasted on overpayments to drug companies. ... In 2006, when Democrats wanted to change the fledgling law to let Medicare use its enormous leverage to bargain with drug makers, we thought such a step was premature. Eight years later, however, the rosy stories about how well private insurers were keeping prices down turn out to have been exaggerated (4/20).

USA Today: Leave Part D Be: Opposing View
The Congressional Budget Office has repeatedly stated that allowing the government to negotiate prices in Part D would have a negligible impact on federal spending unless Health and Human Services limits access to medicines. Restricting access to medicines would not only fail to contain health care costs, it could also increase the need for other, more expensive health care services while jeopardizing patient health. Part D plans already negotiate significant discounts and rebates on medicines for patients, which is a key factor of the program's success. Even CBO has found that Part D plans have "secured rebates somewhat larger than the average rebates observed in commercial health plans" — often as high as 20% to 30% (John J. Castellani, CEO of PhRMA, 4/20).

The Washington Post: In Stem-Cell Research, Health Benefits Outweigh The Risks Of Copying Humans
For the last few years, the promising field of stem-cell research has focused on a technique that skirts various ethical concerns about the treatment of human embryos and the potential to clone whole human beings. But last week, U.S. and South Korean researchers announced that they went ahead with a different technique, successfully creating stem cells cloned from the normal skin cells of adults. Their work helps to open a new avenue in stem-cell research. But it also could be a step on the way to human reproductive cloning. Some ethical worries are reasonable, but they are not enough reason to hold back this research (4/20).

The Washington Post: Higher Taxes On Cigarettes Make Good Sense
Maryland has one of the highest state-imposed cigarette tax rates in the nation ($2 per pack) and, unsurprisingly, one of the lowest smoking rates. Virginia has the lowest cigarette tax rate in the nation (30 cents per pack); its smoking rate is almost 20 percent higher than Maryland’s. America is well past the debate about the health effects of smoking, but tobacco taxes in many states remain low, thanks largely to the influence of tobacco companies. Yet it is clear that higher cigarette taxes have a direct effect on smoking rates, and they are particularly effective in dissuading young people from taking up the habit (4/20). 

The Chicago Sun-Times: Help Arriving For Jailed Mentally Ill
CountyCare is uniquely positioned to provide coverage to individuals involved in our criminal justice system, because the expanded Medicaid population mirrors the makeup and the needs of a large portion of the people in the Cook County jail. Based on our experience, roughly 20 percent of the people entering the Cook County jail suffer from mental illness, which often coincides with substance abuse. CountyCare gives us an opportunity to provide access to healthcare to people being released from jail, which is in the interest of public health and public safety (Toni Preckwinkle and John Jay Shannon, 4/19).

The Star Tribune: What You Pay? Hard To Say When It's Health Care
In a normal economic marketplace, real “transparency” translates all of those complexities into a simple price, prominently displayed. And then the consumer, spending his or her own money, does what I did — buys some things and not others, and shops around for better deals. ... But we’ve evolved a health care system far too lacking in this genuine kind of transparency and feedback — one where people seldom spend (or withhold) their own money in response to clear prices. Instead, vast bureaucracies, public and private, allocate trillions according to arcane formulas and closed-door negotiations that try to penetrate all the complexities (D.J. Tice, 4/18).

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