KHN Morning Briefing

Summaries of health policy coverage from major news organizations

Viewpoints: ‘Namby-Pamby’ Democratic Budget Offer; Murray Argues Her Plan Is Responsible; Officials Can Force Hospitals To Fix Pricing For Uninsured

USA Today: Democratic Budget Namby-Pamby Opening Bid: Over View
In the absence of an emergency, Washington can and should bring its budget into balance, even though that requires doing what politicians despise: for Republicans, raising taxes; for Democrats, curbing the rapid growth in benefit programs such as Medicare and Social Security that already make up three-fifths of federal spending. The Murray budget neither balances the budget nor reins in entitlements. Its one-to-one ratio of spending cuts to tax increases might sound balanced, but the spending cuts are not actual reductions. They are merely reductions in the expected rate of growth (3/14).

USA Today: Patty Murray: Our Budget Is Balanced, Fair
The highest priority of the Senate budget is protecting our economic recovery and laying down a strong foundation for broad-based economic growth. It responsibly replaces the harmful cuts from sequestration that threaten 750,000 jobs this year alone. And it invests in infrastructure, education and innovation to make sure businesses and families can compete and win in the 21st century economy. Our budget also strengthens and protects Medicare and other programs seniors and families depend on, because we don't think they should have to bear the burden of deficit reduction alone. Our budget also tackles our deficit and debt responsibly (Sen. Patty Murray, D-Wash., 3/14).

The Washington Post: The Democrats' Complacent Budget Plan
It is on the issue of entitlements that the Democrats' document really disappoints. There is literally nothing -- not a word -- suggestive of trimming Social Security, whether through greater means-testing, a more realistic inflation adjustment or reforming disability benefits. The document's fuzzy call for $275 billion in "health savings" is $125 billion less than the number President Obama has floated. As for the coming flow of baby boomers into Medicare, the Democrats declare that "new retirees deserve the same promise of quality, affordable health care from which their parents have benefitted — and it is the position of the Senate Budget that they ought to get it." There's plenty of excoriation for the GOP "premium support" plan. But there's no explanation of how the Democrats would pay for their "promise" -- nary a hint of the many cost-saving reforms that would extend Medicare's life without embracing the GOP plan (3/14).

The Wall Street Journal: Replacing Max Baucus
The bill manages the unique achievement of offering no net nondefense spending cuts and no entitlement reform worth the name, while proposing to raise $1.5 trillion in new tax revenue in such a way that would ruin the prospects for bipartisan tax reform. This budget has no chance of becoming law as long as Republicans run the House, but as a statement of Democratic intentions it deserves more attention (3/14).

Los Angeles Times: GOP's Effort To Roll Back Health Care Reforms Is Bad Policy
Republican lawmakers, in their budget proposal released this week, showed they're determined to roll back President Obama's health care reforms, deny coverage to millions, limit treatment of the poor and essentially hand Medicare over to private insurers. ... "There are goods and services that the private market does a very good job of providing," said Mindy Marks, an associate professor of economics at UC Riverside. "Health care isn't one of them" (David Lazarus, 3/14). 

Los Angeles Times: The Medicare Debate We Need
One criticism of the Medicare overhaul that House Budget Committee Chairman Paul D. Ryan (R-Wis.) has championed is that it would shift more and more of the program's costs onto seniors. In the latest version of his plan, Ryan acknowledges that capping the growth of the program could, in fact, make health insurance more expensive for some retirees. But that's part of the point of the change, which would concentrate Medicare spending on the poorest and sickest seniors (3/14). 

The Washington Post: The GOP And The Budget Boilerplate Gap
Ryan's budget proposal is similar to his previous two in both strengths and failures. It deserves everlasting fiduciary fame for proposing a plausible Medicare reform plan. … And yet . . . the refusal to consider additional revenue and the delayed implementation of proposed Medicare reform result in impossible reductions in Medicaid and discretionary spending. These elements of the budget proposal summarize the ideological predispositions of House Republicans rather than address objective economic needs, humanitarian requirements or even GOP political imperatives. Congressional Democrats, in turn, have emerged from nearly four years of budgetary silence with their own ideological caricature -- a proposal combining heavy taxes, budgetary gimmicks, a net increase in spending and a strident refusal to consider meaningful entitlement reform. The silence was more responsible (Michael Gerson, 3/14). 

The Washington Post: Obama Has To Be Dealmaker In Chief
It's true that there are times when presidential intervention in delicate congressional negotiations can be counterproductive. It's certainly true that there are times when congressional Democrats have advised the White House to butt out. But leading through diffidence is not a traditional presidential strategy, nor is there much reason to expect it to produce results. In the end, as Obama himself understands and has told the other side, he is the one who is going to have to sell the notion of unpopular changes -- curbing Medicare spending, reducing Social Security benefits or curtailing popular tax breaks -- to a nation that says it wants a balanced bargain but may balk when that bargain is translated into painful specifics. After all, Obama is the only dealmaker with no reelection worries (Ruth Marcus, 3/14). 

The New York Times' Economix: What Hospitals Charge The Uninsured
It is noteworthy that in its critique of Mr. Brill's work, the [American Hospital Association] statement is completely silent on this central issue of his report. A fair question one may ask leaders of the industry is this: Even if one grants that American hospitals must juggle their financing in the midst of a sea of price discrimination, should uninsured, sick, middle-class Americans serve as the proper tax base from which to recoup the negative margins imposed on them by some payers, notably by public payers? My answer is "No," and I am proud to say that when luck put in my way an opportunity to act on that view, I did (Uwe E. Reinhardt, 3/15).

The Wall Street Journal: The Doctor Won't See You Now. He's Clocked Out
Big government likes big providers. That's why ObamaCare is gradually making the local doctor-owned medical practice a relic. In the not too distant future, most physicians will be hourly wage earners, likely employed by a hospital chain. Why? Because when doctors practice in small offices, it is hard for Washington to regulate what they do. There are too many of them, and the government is too remote. It is far easier for federal agencies to regulate physicians if they work for big hospitals. So ObamaCare shifts money to favor the delivery of outpatient care through hospital-owned networks (Scott Gottlieb, 3/14). 

Georgia Health News: With Cancer Research Making Giant Strides, It's Wrong To Cut Budgets
We are at a point in the fight against cancer where decades of discoveries are translating into new diagnostic and treatment tools at an accelerated rate. Unfortunately, this comes at a time when the agencies that fund cancer research face dire cutbacks. Because Congress must make difficult decisions on what to cut, I went to Washington this week to speak to a committee of lawmakers about the relationship of the National Institutes of Health (NIH) to our nation's cancer centers. I felt it was important to offer tangible proof of the great strides that have been made in treating cancer because of NIH-funded research (Dr. Walter Curran, 3/14).

Health Policy Solutions (a Colo. news service): Sex Ed A Matter Of Public Health, Not Politics
In 2007, Colorado passed a law stating that if sexual health education is offered as part of a school’s curriculum, then it must be comprehensive in nature. In other words, education provided to youth must include information about abstinence in addition to the prevention of pregnancy and sexually transmitted diseases through condom and contraceptive use. However many school districts have elected to either not teach sex education due, in part, to the lack of resources or because they find the current legal guideline too vague and confusing -- making it extremely difficult to fully implement (Vicki Cowart, 3/14).

Health Policy Solutions (a Colo. news service): How Medicaid Expansion Harms Patients
Medicaid expansion would limit access to care for the significant fraction of the currently uninsured who would otherwise be eligible for federal premium subsidies under Obamacare. It raises costs for state taxpayers, increases costs for people who are hospitalized and prevents state insurers from collecting millions of dollars in federal subsidy money. Naturally, the Colorado Hospital Association favors it (Linda Gorman, 3/14).

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