Viewpoints: Defining ‘Essential Benefits;’ ‘Super Committee’ Special Pleadings; Limiting Consumer Choice In Prescriptions
The New England Journal Of Medicine: Defining Essential Health Benefits — The View From The IOM Committee
The IOM report acknowledges that "the determination of the (essential health benefits) is a politically and socially charged endeavor." ... From its beginning, the panel agreed unanimously that if the long-standing problem of rising health care costs is not addressed more aggressively, the (federal health law's) goals of reducing the uninsured population (49.9 million people, or 16.3% of the population, in 2010, according to the U.S. Census Bureau) and offering meaningful benefits could be undermined (John K. Iglehart, 10/7).
The New York Times: Not Their Job
The American Medical Association and other physicians' organizations have asked the Congressional "super committee" on deficit reduction to impose limits on malpractice lawsuits. The committee has far bigger problems to tackle, and its task of finding $1.2 trillion in deficit savings will be difficult enough. It needs to be wary of getting dragged into this and other such special pleadings (10/6).
The Journal of the American Medical Association: Mandatory HPV Vaccination And Political Debate
Mandatory (human papillomavirus) vaccination received additional attention during a recent debate among Republican presidential candidates. ... Comments such as these could cause parents to decide not to have their children vaccinated, thereby potentially leading to preventable illness and perhaps even death. The scientific evidence demonstrates that population-based HPV vaccination is safe and effective, justifying widespread adoption of the vaccine. The question is whether a state mandate would increase vaccination rates or result in a backlash not only against HPV vaccination but also wider childhood vaccinations. Given the political divisiveness, states should launch health education campaigns before resorting to compulsion (Lawrence O. Gostin, 10/6).
Los Angeles Times: Walgreen Battle Over Drug Prices Will Limit Consumer Choice
Darby Ziegler stopped by her local Walgreens drugstore in Huntington Beach the other day to refill a prescription. She got her meds — and some surprising news. Beginning Jan. 1, Walgreens will no longer fill prescriptions for Anthem Blue Cross members, meaning that they'll have to switch to another drugstore if they want their insurance to keep covering their meds (David Lazarus, 10/7).
Milwaukee Journal Sentinel: Physicians Will Be Partners In Reducing Costs
U.S. consumers pay much more for health care than people in other industrialized nations. … Physicians have a key role in these decisions and should lead efforts to contain health care costs. In fact, recently it has been proposed that provision of high-value, cost-conscious care be established as a required competency for physicians. By virtue of their position in society, both as stewards of their patients' health and as professionals who understand health care decisions and their consequences, physicians are uniquely qualified. They can reduce costs in their daily patient care activities and also should play a leading role in national policy decisions (Richard E. Rieselbach, Richard A. Dart and Steven B. Pearson, 10/6).
The Philadelphia Inquirer: PhillyInc: At Children's Hospital, The Picture Of Health
With Children's Hospital of Philadelphia kicking off construction of its latest primary-care center in West Philadelphia on Thursday, I got to wondering how it's doing at a time of financial uncertainty for nonprofit hospitals. After all, Moody's Investors Service has been warning for more than a year that hospital finances nationwide are stressed and that more credit downgrades may follow. ... Yet, as measured by revenue growth, the 155-year-old institution is doing better than fine. According to its recently released financial statements for the fiscal year ended June 30, Children's Hospital reported $1.84 billion in total revenue compared with $1.72 billion for its previous year (Mike Armstrong, 10/7).
McClatchy: Withholding Funding Will Derail Badly Needed Reforms
If Congress withholds the funding needed to fulfill the federal government's new responsibilities under the (Affordable Care Act), it would — in all likelihood — seriously slow, or worse, stall the positive momentum we are beginning to see. Such a decision would do nothing to heal our very serious health-care woes and could easily backfire and make a bad situation even worse. It may come as a surprise to some, but no one is entirely happy with the ACA. This may be the best thing about the new law (Eric Wright, 10/6).
Los Angeles Times: Health Care Reform Law: What's The Big Deal?
I'm not an attorney, so I cannot help the federal judges struggling to figure out whether the individual insurance mandate in President Obama's health care law violates the interstate commerce clause of the U.S. Constitution. But as a taxpayer (and formerly a professor of public policy), it's hard for me to understand what all the fuss is about (William D. Leach, 10/7).
Politico: Freeze The Affordable Care Act
While I was Florida's attorney general last year, I initiated and led a multi-state lawsuit challenging the constitutionality of President Barack Obama’s health care law. The Supreme Court will most likely rule on the case next year. Meanwhile, the costs of implementing the Patient Protection and Affordable Care Act have been escalating and are predicted to continue to rise as its provisions gradually go into effect. That's why Congress should pass a bill introduced this week by Rep. Sam Johnson (R-Texas) to hit the pause button and freeze the law where it stands. This would halt the implementation process until we can determine the law's actual impact (Bill McCollum, 10/7).
Roll Call: Mertz: Medicare Cuts Will Hurt People And Economy
Clinical laboratory testing guides 70 percent of health care decisions. Yet such testing — to identify and manage diseases ranging from cancer to diabetes — amounts to less than 2 percent of Medicare spending. Why, then, would the government want to slap a new co-pay on Medicare recipients for their lab tests — plus jam their mailboxes with millions of new bills, forms and confusion? Just such a proposal has been under serious consideration in Congress, and may well be on the table as it decides how to slash billions of dollars of federal spending as part of the debt ceiling agreement. This proposal is penny-wise and pound-foolish (Alan Mertz, 10/6).
Des Moines Register: Congress Should Fight Medicare Abuse
In an ideal world, health care providers would be solely focused on delivering the best care to patients. In this country, however, they also focus on the best ways to bill insurers. Some companies have perfected the latter. Four major home-health companies are overbilling Medicare, according to a report released Monday by Sen. Chuck Grassley and the Senate Finance Committee. (Three of these companies operate or have partnerships in Iowa) (10/6).