KHN Morning Briefing

Summaries of health policy coverage from major news organizations

Viewpoints: Obamacare Has Resisted Death Throes Before; Website Success Stories From 3 Governors; Health Law Taking A Toll On Choice Of Doctors In Medicare Advantage

The New York Times: The Three Burials of Obamacare
The first time Obamacare seemed finished, doomed, doornail-dead, the voters of Massachusetts played the would-be executioner. In January 2010, they sent a pickup-driving Republican to the Senate to fill Ted Kennedy’s seat, apparently depriving the health care bill of its crucial 60th vote and sending Democrats scrambling for a Plan B. ... the deeper force at work, the reason that these near-death experiences keep happening, isn't a website or a broken presidential promise. It's a problem inherent to contemporary liberalism, which is that liberals' proudest achievement, the modern welfare state, tends to resist, corrupt and baffle their efforts at comprehensive reform (Ross Douthat, 11/16).

The Washington Post: The Sinking Ship Of Obamacare
Let's recap: If you like your insurance policy, you can keep it. No, wait. If you liked your policy, it was probably worthless anyway. Scratch that. If your junk policy was canceled and you still want it, you can keep it. Er, get it back. Whatever (Kathleen Parker, 11/16).

The New York Times: The Shame Of American Health Care
Even as Americans struggle with the changes required by health care reform, an international survey released last week by the Commonwealth Fund, a research organization, shows why change is so necessary. The report found that by virtually all measures of cost, access to care and ease of dealing with insurance problems, Americans fared poorly compared with people in other advanced countries (11/17). 

The Washington Post: How We Got Obamacare To Work
Sure, having functioning Web sites for our health-care exchanges makes the job of meeting the enormous demand for affordable coverage much easier, but each of our state Web sites has had its share of technical glitches. As we have demonstrated on a near-daily basis, Web sites can continually be improved to meet consumers' needs. The Affordable Care Act has been successful in our states because our political and community leaders grasped the importance of expanding health-care coverage and have avoided the temptation to use health-care reform as a political football (Gov. Jay Inslee, D-Wash., Gov. Steve Beshear, D-Ky., and Gov. Dannel P. Malloy, D-Conn., 11/17). 

The Wall Street Journal: ObamaCare's Union Favor
The Affordable Care Act's greatest hits keep coming, and one that hasn't received enough attention is a looming favor for President Obama's friends in Big Labor. Millions of Americans are losing their plans and paying more for health care, and doctors are being forced out of insurance networks, but a lucky few may soon get relief (11/17). 

USA Today: Insurance Industry Readied While Obama Slept
On Thursday, President Obama announced that he was giving insurance companies the option of continuing health insurance policies they have already canceled. Given the political trouble he has been in over these cancellations, and much of the Obamacare rollout, that is smart politics. But that is the only thing smart thing about this (Robert Laszewski, 11/15). 

Los Angeles Times: The LA Times Editorial Board’s Lonely Defense Of Obamacare
Here's something you don't see every day: the Los Angeles Times editorial board parting company with President Obama on Obamacare. OK, so I'm exaggerating. The Times' board criticized several aspects of the 2010 Patient Protection and Affordable Care Act as it worked its way through Congress, particularly on the cost-containment front. Nevertheless, because the board supported the law's passage and embraced many of its specific reforms, some right-of-center readers accused The Times' "looney left" editorial writers of acting as cheerleaders for the president (Jon Healey, 11/15).

The Seattle Times: Washington State Right To Forge Ahead With Health Policies
Washington Insurance Commissioner Mike Kreidler is right not to allow canceled health insurance plans to be extended into 2014, even though it means turning down President Obama's offer (11/17).

Politico: Who Needs
In the weeks since Oct. 1, [Dr. Stephen P.] Morse has done what it seems the federal government could not. He built a simple, user-friendly, anonymous shopping tool that compiles pricing information from all of the plans on the state and federal health insurance exchanges and provides custom, premium readouts according to age, location, tobacco use and income. ... And Morse’s isn’t the only alternative out there., a start-up consumer finance website, has an even more elegant anonymous shopping tool that lists premium and subsidy calculations along with cost-sharing options that can be compared across plans (Andrew Steinmetz and Ezekiel Emanuel, 11/15).

Bloomberg: Obamacare's Latest Victim: Immigration Reform
Unwilling or unable to follow the Senate's bipartisan effort -- Tea Party intransigence is stronger, and more consequential, in the House -- Boehner appears to have decided to take time off from the nettlesome issue of immigration reform to return to House Republicans' old standby: attacking Obamacare. If the Patient Protection and Affordable Care Act’s troubles continue, Republicans hope to ride the Democrats’ pain to victory in the 2014 midterm elections. If those troubles begin to ease, however, and Obamacare gradually gains its footing, the House leadership will find itself back in familiar territory -- scrambling for another excuse to avoid legislating on a substantively complex and politically difficult issue (11/15).

Bloomberg: A Conservative Cure For Obamacare
The reality is that large constituencies are in place to work to preserve Obamacare. States that have embraced the law's Medicaid expansion -- about half -- will fight tooth and nail to keep huge new federal subsidies in place. And the conservatives who are lambasting the disastrous rollout should realize that the electorate that is uninsured, getting large subsidies and generally older will also fight to keep their newly minted policies. ... What strategy, then, would move us closer to the patient-and consumer-focused health-care system that conservatives desire while also recognizing the facts on the ground? The answer might be simple: Propose changes that will make plans more affordable and drive enhanced competition among insurers and providers. In other words, make Obamacare a Trojan horse for conservative health-care reform (Paul Howard and Yevgeniy Feyman, 11/18).

Forbes: Do You Like Your Doctor? Obamacare Drives UnitedHealth To Downsize Its Medicare Physician Networks
Over the past two weeks, there’s been a lot of coverage of the President’s misleading promise that “If you like your plan, you can keep your plan. No matter what. Period.” But we mustn’t forget that there was a second part to that promise: “If you like your doctor, you will be keep your doctor. Period.” It turns out that isn’t necessarily true, either. On Saturday, the Wall Street Journal reported that, due to Obamacare’s cuts to Medicare Advantage, among other factors, UnitedHealth expects its network of physicians “to be 85 percent to 90 percent of its current size by the end of 2014.” The result? Some retirees enrolled in Medicare Advantage will need to find new doctors. And it’s a trend that could accelerate in future years (Avik Roy, 11/18). 

The New Republic: People Complaining About Obamacare Insurance Cancellations Want To Get Something For Nothing
What did people think when they heard President Obama say that no one would have to give up their current health care arrangements if they preferred to keep them? This is not to excuse Obama, but anyone who knew anything at all about the two-year-long debate about health care reform should have known that what he said wasn’t true. This applies especially to the pundits and Republican politicians who now react with such horror and mock surprise (Michael Kinsley, 11/17).

MinnPost: As Health-Insurance Problems Keep Arising, Vermont Offers A Ray Of Hope
I am a cancer survivor. After being diagnosed with breast cancer last year, I chose to undergo medical treatment in the country of Colombia in South America. I received first-class treatment – surgery, chemotherapy and radiation – at a fraction of what it would cost in the United States. Since I have been uninsurable in the U.S. because of pre-existing conditions, I went to another country for treatment rather than paying the shamefully high costs of care in this one. I have been following the implementation of the Affordable Care Act with great personal interest. I am extremely grateful that I will be able to get health-care coverage next year (Debra Axness, 11/18).

On other issues -

The New York Times: Why Doctors Don't Take Sick Days
So most doctors ignore their symptoms and resist taking the day off unless they are sick enough to be hospitalized in the next bed over. This, of course, is ridiculous behavior on the part of medical professionals who would never recommend such nonsense to their patients. Medical workers with respiratory infections are contagious. ... What explains this toxic brew of denial, ignorance and bravado? Part of it is a professional but often exaggerated sense of responsibility to colleagues and patients (Dr. Danielle Ofri, 11/15).

The New York Times: Alzheimer's Anxiety
All of us are afraid of Alzheimer's. ... So it’s only natural that, in recent years, people have trumpeted the development of a new test that can measure the presence of beta-amyloid — the protein clumps in the brain that are one of the hallmarks of Alzheimer's dementia. ... In September, Medicare announced that it would pay for the test — which costs between $3,000 and $5,000 and is often not covered by private insurance — but only if the patient was part of a randomized, controlled trial, which is the only way to definitively determine the value of the scan. ... Alzheimer's disease is scary. But that is no reason for society to waste a lot of money on a test that really doesn't help (Dr. Ezekiel J. Emanuel, 11/16).

The New York Times' Room For Debate: When Medical Experts Disagree
Guidelines released last week by the American Heart Association and the American College of Cardiology could transform the way cholesterol-lowering statin medicines, like Lipitor, ... are used. But despite the pedigree of the recommendations, some physicians objected to them. ... This isn't the first time respected authorities have disagreed on medical recommendations. How should doctors and patients react to new findings that come out about health concerns? How do you know whom to trust? (11/17).

Los Angeles Times: AIDS Healthcare Foundation Vs. LA Country
Critics of the [AIDS Healthcare Foundation], citing the county audits, have expressed concern that the nonprofit is oriented more toward self-promotion than treating and combating sexually transmitted disease. Medical staff have criticized its management and are involved in a union organizing drive. "We're David," AHF President Michael Weinstein insists. "The county is Goliath." Los Angeles County is indeed more than a bit Goliath-like in its size — and even, to some (like the brutally beaten jail inmates), a bully. Fixing its problems will require some heat. But the AHF appears to be bringing only heat, and leaving the light behind (11/17).

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