KHN Morning Briefing

Summaries of health policy coverage from major news organizations

Viewpoints: Medicaid’s Role In Lowering Uninsured Rate; Need To Protect Physicians ‘Compelled By Conscience’ To Provide Abortions

The New York Times: Fewer Uninsured People
The number of Americans who lack health insurance declined last year, the first drop since 2007. This is, in large part, the result of the health care reform law and better coverage under public programs like Medicaid. This also shows why repealing the health care law or revamping and shrinking Medicaid, as many Republicans want to do, would be disastrous moves (9/12). 

The Wall Street Journal: Grim Census 'Progress'
The share of the population without health insurance did fall modestly ... which liberals are attempting to use as evidence that the Affordable Care Act is working, though the law doesn't kick in until 2014. But even if these claims were true, the problem is that the gains came largely by government crowding out private insurance. Some 3.9 million people on net joined the public rolls, led by a jump in Medicaid enrollment of 2.3 million, while the number of individuals with normal insurance rose by about 800,000 (9/12).

Journal of the American Medical Association: Outcome Of 2012 Election Will Likely Affect Medicaid Far More Than Medicare
Medicaid covers more people than Medicare does. ... It’s important to remember that although the focus is often on “block granting,” the savings projected to come from Medicaid in the Republican proposal are a result only of this drastically reduced spending. There’s no “innovation” driving them. They will have real consequences, and they’re not hard to predict (Dr. Aaron Carroll, 9/12).

The Denver Post: Preventive Care Is The Key
Recent news about the number of people in this country who have out-of-control high blood pressure was astonishing — some 36 million Americans. That condition poses terrible risks for cardiovascular disease, but the real shame in the numbers is that 89 percent of those people reported having regular access to health care. The statistic is one of many that points out the need for better preventative care and a greater awareness of the risks of not seeking treatment and changing their lifestyles. And let's be candid: This is about cost, too (9/13).

New England Journal of Medicine: Recognizing Conscience In Abortion Provision
The exercise of conscience in health care is generally considered synonymous with refusal to participate in contested medical services, especially abortion. This depiction neglects the fact that the provision of abortion care is also conscience-based. The persistent failure to recognize abortion provision as "conscientious" has resulted in laws that do not protect caregivers who are compelled by conscience to provide abortion services, contributes to the ongoing stigmatization of abortion providers, and leaves theoretical and practical blind spots in bioethics with respect to positive claims of conscience (Dr. Lisa H. Harris, 9/12). 

New England Journal of Medicine: There Is More To Life Than Death
Physicians and patients alike crave certainty. ... In clinical decision analysis, the outcome that is generally measured is death. ... Basing decisions on the outcome of death ignores vital dimensions of life that are not easily quantified. There are real complexities and uncertainties that we all, patients and physicians alike, confront in weighing risk and benefit. Wrestling with these uncertainties requires nuanced and individualized judgment. It is neither ignorant nor irrational to question the wisdom of expert recommendations that are sweeping and generic (Drs. Pamela Hartzband and Jerome Groopman, 9/12).

New England Journal of Medicine: Punishing Health Care Fraud — Is The GSK Settlement Sufficient?
On July 2, 2012, the Department of Justice announced the largest settlement ever in a case of health care fraud in the United States. GlaxoSmithKline (GSK) agreed to plead guilty to three criminal counts and settle civil charges brought under various federal statutes; the company will pay a total of $3 billion to the federal government and participating states. ... Despite the size of the fine and civil settlements, it would be a mistake to assume that GSK was an outlier in the global pharmaceutical and medical-device industries. ... questions remain about the efficacy of fines and corporate integrity agreements in deterring corporate misbehavior (Kevin Outterson, 9/12).

Detroit Free Press: Don't Ignore All The Empty Hospital Beds
Challenges occasionally arise to Michigan's Certificate of Need process for new medical facilities, which has worked well for decades. It's no surprise that with term-limited lawmakers, the challenges are likely to become more frequent. ... "If you build it, they will come" is not the appropriate mantra for reining in health care costs in this country (9/13).

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