KHN Morning Briefing

Summaries of health policy coverage from major news organizations

Viewpoints: U.S. ‘Designed For Stalemate’; Tea Party’s Last Stand?; ‘War Over Obamacare’ Not Over

The Washington Post: The 'Non-Essential' Parts Of Government That Shut Down Are Actually Quite Essential
Though the big social insurance programs are still running, many federal programs that directly target those in the most need are either empty or running on fumes. ... The growth of the modern state is tied to the awareness of public issues in health and the need to address them. The state has a responsibility to provide responses to a wide range of public issues including pollution, clean air and water, sanitation and epidemics, because there’s no way individuals alone can do this. Yet this state is not showing up for work these days (Mike Konczal, 10/6). 

The Washington Post: Why Are We Still Fighting Over Obamacare? Because America Was Designed For Stalemate
The health-care law is no doubt a flawed piece of legislation, like any bill written to satisfy the demands of legions of lobbyists and interest groups. But only in America can a government mandate to buy something that is good for you in any case be characterized as an intolerable intrusion on individual liberty. ... The House Republicans see themselves as a beleaguered minority, standing on core principles like the brave abolitionists opposing slavery before the Civil War. ... But while the showdown over the Affordable Care Act makes America exceptional among contemporary democracies, it is also perfectly consistent with our history (Francis Fukuyama, 10/4).

The Washington Post: Shutdown: The Tea Party's Last Stand
If the nation is lucky, this October will mark the beginning of the end of the tea party. ... People who knew better followed Sen. Ted Cruz down a path of confrontation over Obamacare. Yet even before the shutdown began, Republicans stopped talking about an outright repeal of Obamacare, as House Speaker John Boehner’s ever-changing demands demonstrated (E.J. Dionne Jr., 10/6).

The Wall Street Journal: Now Obama Rescues The GOP
Both sides made big mistakes the past 10 days. The Republicans' mistake was to force a shutdown over the defunding of ObamaCare. "Defunding" isn't even a word they can win on, never mind a concept. The dark side of their brand is that they're always "defunding," they’re always trying to take away and not adding, they're all about cutting and never expanding. You should never play to the dark side of your brand. "Delay" would have been better—better as sheer policy, more in line with the anxieties of the public, and more in line with the needs of the administration. We saw what happened this week when they didn’t delay: the embarrassing, nonstop glitch that is ruining ObamaCare’s brand. But the White House this week has made an equally dramatic and consequential mistake, and it is balancing out the Republicans' mistake. The Democratic mistake is the punitive, crude, pain-bringing shutting down of things that everyone knows don’t have to be shut down—the World War II memorial, the Iwo Jima memorial, parks, landmarks, etc. (Peggy Noonan, 10/6).

The Wall Street Journal: Kentuckians For Obamacare?
"More than 6 million people [nationwide] visited the website the day it opened; nearly 200,000 people picked up the phone and called the call center," said the president. "In Kentucky alone—this is a state where—I didn't win Kentucky. So I know they weren't doing it for me. In Kentucky, nearly 11,000 people applied for new insurance plans in the first two days—just in one state, Kentucky." It's true that Kentucky had among the fewest exchange glitches during this week's rollout. But if ObamaCare is so popular in the Blue Grass State, why doesn't Democratic Senate candidate Alison Grimes, who is challenging Senate Minority Leader Mitch McConnell next year, want to talk about it? (Jason L. Riley, 10/6).

The New York Times: The Boehner Bunglers
To see what I’m talking about, consider the report in Sunday’s Times about the origins of the current crisis. Early this year, it turns out, some of the usual suspects — the Koch brothers, the political arm of the Heritage Foundation and others — plotted strategy in the wake of Republican electoral defeat. Did they talk about rethinking ideas that voters had soundly rejected? No, they talked extortion, insisting that the threat of a shutdown would induce President Obama to abandon health reform. This was crazy talk. After all, health reform is Mr. Obama’s signature domestic achievement (Paul Krugman, 10/6).

The Los Angeles Times: The Unsettled Healthcare Law
Last week's glitch-filled rollout of Obamacare's health exchange websites, combined with Republicans' furious refusal to accept the program as what President Obama calls "settled law," confirmed something political strategists in both parties had already predicted: The war over Obamacare is far from over (Doyle McManus, 10/6).

The Los Angeles Times: Did The Obamacare Insurance Exchanges Launch Too Soon? [Poll]
With any venture on this scale, there are bound to be unexpected bumps in the road. But critics of the Patient Protection and Affordable Care Act, better known as Obamacare, say that the problems documented by Terhune and his counterparts around the country show that the exchanges simply weren't ready for the roll out -- and providing all the more reason for Congress to delay implementation of the law (Jon Healey, 10/4).

USA Today: U.S. Failure To Pay Bills Hurts Everyone
It might be hard to believe, but there is a dangerous debate underway in Congress right now over whether the United States, the world's strongest economy, should pay all of its bills. ... The United States cannot be put in a position of having to choose which commitments it should meet. How could we possibly decide among supporting our veterans, maintaining food assistance for children in need, or sending Medicare payments to hospitals? (Treasury Secretary Jack Lew, 10/3).

Bloomberg: Washington Trash Talk Won't End Stalemate
What we have here is definitely not a failure to communicate. Throughout the federal government shutdown last week, partisans voiced their contempt, even loathing, for the other side. White House communications director Dan Pfeiffer declared there would be no negotiations "with people with a bomb strapped to their chest." Republican Senator Ted Cruz, who hails from a state where a quarter of the population lacks health insurance, insisted that political chaos was a small price to pay to prevent "the enormous harms that Obamacare is inflicting on millions of Americans." Among the mind-numbing barrage was this tweet promoted by the National Republican Senatorial Committee: "Obamacare Sucks. It Must Be Repealed. Sign the Petition." Even President Barack Obama’s Twitter account succumbed to blunt posting: "Take Note, Obamacare is here to stay," it tweeted on the second day of the shutdown (10/6). 

Bloomberg: Exchanges Will Raise U.S. Health-Care Costs
Ignore the inevitable startup glitches. The new health-insurance exchanges will work just fine -- in the sense that all government health-care programs work: Many people will ultimately become dependent on them for coverage. That won’t mean the exchanges have fulfilled their promise, however (David Goldhill, 10/6). 

Bloomberg: Republican Insurgents Forget Their Political ABCs
"I am not a member of any organized political party," the humorist Will Rogers said. "I am a Democrat." Even Will Rogers would be shocked at the disjointed and self-destructive congressional Republican Party of today. By forcing a government shutdown and possibly a credit default in a few weeks, a minority of rank-and-file Republican members have run roughshod over the leadership. They are pushing a futile effort to kill President Barack Obama’s health-care law, enacted in 2010, upheld by the Supreme Court and hotly debated in last year’s presidential campaign (Albert R. Hunt, 10/6).

And on other topics -

Politico: There Is No War On Women
Earlier this week, Cecile Richards, president of Planned Parenthood, cried wolf once more regarding a "war on women" because House Republicans voted on Saturday to delay Obamacare for a year. She argues that "a narrow group of Republican leaders in the House are pushing to shut down the entire federal government over women’s access to birth control, cancer screenings and other basic health care." ... The truth is that much of this battle is more complicated than Richards chooses to admit. We, as women of faith, are standing our ground against another group of women who seek to force us to subsidize choices we find immoral (Penny Young Nance, 10/4).

The New York Times: Why the Bad Rap on Generic Drugs?
It's been nearly 30 years since Congress kick-started the generic drug industry by passing the Hatch-Waxman Act ...  Many generic drugs cost pennies per pill, yet pack the same punch as brand-name medicines. So why can't they get more respect? ... Some studies have found that lower-income patients — those who could benefit the most from generics — are among the groups that are most skeptical. ... One recent study found that almost 50 percent of doctors held negative views of the quality of generic medications (Katie Thomas, 10/5).

The New York Times: Doctors' Bad Habits
We doctors constantly lament how difficult it is get our patients to change their behavior. We rant about those who won't take their meds, who won't quit smoking, who never exercise. But the truth is, we are equally intransigent when it comes to changing our own behaviors as caregivers. ... I thought about this as I read the latest recommendations from the Choosing Wisely campaign — a project led by the American Board of Internal Medicine to inform doctors and patients about overused and ineffective tests and treatments (Dr. Danielle Ofri, 10/5).

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