KHN Morning Briefing

Summaries of health policy coverage from major news organizations

Viewpoints: Sebelius Hearing Is A ‘Grudge Spectacle;’ Obama’s ‘Politically Convenient Falsehood’ About Coverage

The New York Times: Grudge Spectacle
The Obamacare hearings before the House Energy and Commerce Committee are a grudge spectacle. They aren't about fixing problems but affixing blame. They want to make the problems with into a problem with "government health care" (Charles M. Blow, 10/30).

Politico: The Obamacare Whiners
Henry Waxman made a plea at the end of Wednesday’s House hearing grilling of Health and Human Services Secretary Kathleen Sebelius. The California Democrat and liberal lion asked Republicans to reach across the aisle to work with Democrats to improve Obamacare. Yes, Henry Waxman, who has made a career of ideological witch hunts and smash-mouth partisanship, wants a cease-fire over Obamacare, or so he says. ... It's a little late to get or expect any Republican buy-in, though. That would have required serious compromise back in 2009, when Democrats, at the high tide of their power in the Obama era, saw no reason to make any (Rich Lowry, 10/30).

Bloomberg: Obama's Foolish Promise About Obamacare
Americans are beginning to realize that under the Patient Protection and Affordable Care Act, many people will in fact not be able to keep their current insurance plans. That reflects poorly on President Barack Obama. But it doesn't necessarily reflect badly on Obamacare (10/30).

The New York Times' Taking Note: The Uproar Over Insurance 'Cancellation' Letters
Kathleen Sebelius, the Health and Human Services secretary, took a lot of grief Wednesday from Republicans on the House Energy and Commerce Committee who were outraged that some people's individual insurance policies had been "cancelled" because of health care reform. Some of the rants bordered on the comical. Cory Gardner, Republican of Colorado, brandished his "cancellation" letter and demanded that Ms. Sebelius nullify the health law for all residents of his congressional district (David Firestone, 10/30). 

The Wall Street Journal: You Can Keep Your Health Plan*
President Obama has intoned "if you like your health plan, you can keep your health plan" hundreds if not thousands of times. Sometimes he has even added that "no one will take it away, no matter what" or "nothing will change, period." But now that reality is repudiating the President's unequivocal promise, Democrats want you to know that there was always a secret footnote: If you're losing a health plan you liked, the President didn't mean your plan (10/30).

The Wall Street Journal: The President's Broken Health-Care Promises
Either Mr. Obama's staff did not know about the CBO estimates (hardly likely), or they did not care the president was routinely offering a politically convenient falsehood (seems right), or they did not have the fortitude to tell the president that what he was saying wasn't true (also probably so). Neither ignorance, arrogance nor sycophancy is an excuse for such presidential dissembling. This is a serious breach of trust with the American people (Karl Rove, 10/30).

Los Angeles Times: Democrats Scramble To Cancel Insurance Cancellations
One of the arguments made for the 2010 healthcare law was that it attacked the problem of underinsurance -- the threadbare policies that offered such poor coverage, they allowed millions of Americans to be bankrupted by medical bills. Now, however, Democrats are confronting the fact that the law they wrote is forcing thousands of people to lose their current insurance plans because the coverage doesn't meet the new standards. It's a perfect example of the road to political hell being paved by good intentions (Jon Healey, 10/30).

Los Angeles Times: Obamacare Hysteria: Don't Believe The Canceled Insurance Hype
Obamacare's critics are going to town on the cancellation letters millions of Americans are receiving from their health insurers, informing them that their health plans won't conform to the new federal standards for health coverage as of Jan. 1. We're supposed to be scandalized by this, since President Obama himself assured everyone that if they liked their insurance they'd be able to keep it. And people just love plans that in some cases cost just $50 a month. At that price, what's not to love? Back in March, Consumer Reports published a study of many of these plans and placed them in a special category: "junk health insurance." Some plans, the magazine declared, may be worse than none at all (Michael Hiltzik, 10/30).

The Washington Post: Kathleen Sebelius Vs. A Party Without A Brain
It was their big chance to flambé the secretary of health and human services and the person who has overseen the disastrous launch of Obamacare. Instead, they wound up casting her as Judy Garland's Dorothy. "In 'The Wizard of Oz,' there is a great line," [Rep. Joe] Barton, one of the first Republican questioners, informed Sebelius, a former two-term governor of Kansas (Dana Milbank, 10/30).

The Washington Post: Eight Sebelius Takeaways
In the semi-disastrous testimony of Health and Human Services (HHS) Secretary Kathleen Sebelius — with such doozies on as, "The Web site never crashed. It is functional, but at a very slow speed and very low reliability," with a split scene of the site down — there was more than a new batch of gotcha moments for the Republicans to gloat about. There is a fundamental assumption critical to not only Obamacare, but also to the liberal welfare state more generally, namely that it requires a sophisticated and competent bureaucracy. In its collapse and in the testimony of Sebelius, we saw that this assumption may simply be wrong. Forget ideology for a moment. If the liberal welfare state can't run its own creations, it is not sustainable (Jennifer Rubin, 10/30).

The Washington Post: Is Obamacare A Job Killer? Yes And No.
Is the Affordable Care Act (ACA), also known as Obamacare, a job killer? Along with the fate of, this question stalks the ACA. Critics — including me — say yes. We argue that businesses will try to avoid the requirement to provide health insurance to workers by changing their employment practices. This would include cutting hours to ensure that workers are "part time" under the ACA, exempting them from coverage. The Obama administration says the facts don't justify the fears. In a study, the White House Council of Economic Advisers found "no economy-wide evidence . . . [of] increasing part-time employment" tied to Obamacare. Who’s right? Maybe we both are (Robert J. Samuelson, 10/30).

Bloomberg: Obamacare's Biggest Threat Isn't The Website
This past weekend, thinking enough time had passed for the kinks to be ironed out, I installed the latest versions of Apple Inc.’s operating systems on my laptop and iPhone. Trying to sync the phone after this was accomplished, I became trapped in what I’ll call an upgrade death spiral. With each failed attempt, vast chunks of my music vanished. ... Yet a few days and a great deal of hassle later - - wipe this, reset that -- the devices seem to be communicating amicably again. ... Perhaps you’ve heard the rollout of the government’s health-insurance website hasn't gone so well, either. That’s so shocking. The world’s most successful and admired maker of computers and software can’t create new information technology without driving its customers crazy now and then, but one expects so much more from the federal government. In due course, the bugs will be fixed and the site will work. There’s still time to get it right, and, provided the shambles doesn't drag on too long, it’s unlikely to do much harm to the economics of the reform (Clive Crook, 10/30).

JAMA: With A Bumpier Rollout Than Expected, Better Transparency Needed On Health Insurance Exchanges
As we all now know, the start-up of the federally run insurance exchange websites and the first few weeks that the exchanges have been operating have been extremely bumpy—certainly bumpier than anyone (including me) had been predicting (Gail Wilensky, 10/30).

Health Policy Solutions (a Colo. news service): Rep. Polis Needs To Recall His Commitment To Health Care Justice
Solutions last week reported that U.S. Congressman Jared Polis, D-Boulder, will seek waivers from the Affordable Care Act/Obamacare insurance purchase mandate for his constituents living in some of the mountain towns.  These waivers would relieve many people from paying the high premiums for health insurance coverage available on the ACA exchanges that reflect the mountain counties’ overall wealth and health care costs. Many of the people who most need coverage in those communities cannot afford the high premiums. Rep. Polis is forgetting the simplest and most humane way to solve this problem is not to waive the requirement to purchase insurance coverage (Donna Smith, 10/30).

The Wall Street Journal: The Affordable Care Act Is A Socialist Ponzi Scheme
As a writer of 24 books mostly on health and wellness and by using my celebrity to get to the best and brightest doctors, scientists and medical professionals in the alternative and integrative health-care world, I have come to the following conclusions: First of all, let's call affordable health care what it really is: It’s socialized medicine (Suzanne Somers, 10/28).

Los Angeles Times: Suzanne Somers Should Disavow Her Lame Argument Against Obamacare
In a much-mocked essay published by the Wall Street Journal on Monday, the 67-year-old self-help author and star of the 1970s TV show "Three’s Company" [Suzanne Somers] held forth on what she believes are the evils of Obamacare and the terrible effects it will have on retirees. She didn’t really use facts, as such, or even logic, as such. Instead, using personal anecdotes about relatives and friends in Canada, a misremembered newsmagazine headline and apparently fabricated quotes by Stalin and Churchill, she maintained that Obamacare is a "socialist Ponzi scheme" (Robin Abcarian, 10/30).

On other health topics -

USA Today: Budget Negotiators Avoiding Big Benefits: Our View
Washington has yet to address the main threat to the nation's solvency: the growth in entitlement programs. Big ones such as Medicare, Medicaid and Social Security. And smaller ones such as food stamps, farm subsides, and benefits for federal workers and military retirees. These programs account for nearly two-thirds of federal spending, which is why the House and Senate budget negotiators who belatedly began work Wednesday need to go where the money is. Instead, they are downplaying prospects for a "grand bargain" that combines significant entitlement restraint with tax simplification. They are focusing on a small-ball approach that averts another government shutdown and undoes some of the more harmful effects of sequestration, the automatic budget cuts that are overwhelmingly targeted on the one-third of federal money that's not spent on benefit programs. This minimalist outcome would be another failure in a long line of failures (10/30). 

USA Today: Sen. Bernie Sanders: Don't Cut The Big Benefit Programs
At a time when almost all new income created is going to the top 1% and when the gap between the very rich and everybody else is growing wider, we must not balance the budget on the backs of the most vulnerable people in our country: working families, the elderly, children, the sick and the poor. We must not cut Social Security, Medicare or Medicaid (Sen. Bernie Sanders, I-Vt., 10/30).

The Washington Post: Budget Talks Bring Diminished Expectations
For the most part, however, revenue is not indispensable to achieve the task at hand: a short-term deal that avoids most or all of the sequester — which would otherwise drive the spending rate down to $967 billion — while re-allocating spending among defense and non-defense programs. This could be paid for by savings in entitlement programs not subject to the sequester, such as federal retirement, farm subsidies or even tweaks to Medicare such as higher premiums for upper-income seniors — a $5 billion per year item that Mr. Obama, like Mr. Ryan, has previously embraced (10/30).

The Wall Street Journal: One Quick Fix to Ease The Coming Doctor Shortage
Ryan Scully wanted to be a doctor from the moment he began volunteering as a paramedic and firefighter during his freshman year of college. In medical school at George Washington University, he passed all of his preclinical and clinical requirements, as well as two national licensing exams required of all medical students. Just before graduation in 2012, though, he learned that he had not been accepted into a residency training program necessary for gaining his certification as a practicing physician. He would receive his M.D. degree in May with the rest of his class—but without a hospital training spot, he could not practice medicine (Atul Nakhasi, 10/30). 

The New England Journal of Medicine: State Politics And The Fate Of The Safety Net
Only 2% of acute care hospitals nationwide are safety-net facilities, but they provide 20% of uncompensated care to the uninsured. ....The Medicaid Disproportionate Share Hospital (DSH) program was established to help defray their costs for uncompensated care. ... Because the Affordable Care Act (ACA) was expected to dramatically expand insurance coverage, safety-net hospitals were expected to need less DSH money. ... if the state governments that refused to expand Medicaid also refuse to rethink their approach to allocating DSH funds, there will be little money left to sustain their safety-net hospitals when the cuts deepen in 2017. The cascade of service reductions and facility closures that this could trigger would have sweeping consequences. Safeguarding the safety net in such politically perilous times will require creative rulemaking by CMS. The proposed DSH rule is a good start, but much remains to be done (Dr. Katherine Neuhausen, Michael Spivey and Dr. Arthur L. Kellermann, 10/31). 

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