KHN Morning Briefing

Summaries of health policy coverage from major news organizations

Viewpoints: N.D. Abortion Law Is ‘Repressive And Extreme;’ States Identify ‘Promising’ Ideas To Overhaul Medical Malpractice

Los Angeles Times: Subverting Reproductive Rights: North Dakota's Dubious Honor
Late last week, the North Dakota legislature passed a bill that would ban a woman from having an abortion as soon as the heartbeat of the fetus is detected, which can happen as early as six weeks into a pregnancy. If Republican Gov. Jack Dalrymple signs it into law, North Dakota will have the ignominious distinction of being the most restrictive state in the country on abortion. A measure to ban abortions so early — at a point when many women don't yet know they're pregnant — is not only repressive and extreme but also likely to be struck down in the courts (3/19). 

Los Angeles Times: Is Prime Healthcare Settling Scores With Union?
In recent years, Prime Healthcare has built a reputation as a take-no-prisoners company willing to run roughshod over patients and employees alike in its quest for profits — $283 million on revenue of $1.6 billion in 2010, according to a financial statement filed with the Securities and Exchange Commission. ... The company has picked a courtroom fight with the Service Employees International Union, which represents about 1,200 workers at three of its hospitals — filing a lawsuit asserting that the union and Kaiser Foundation Health Plan conspired to drive Prime out of the Southern California hospital market. The lawsuit contained the remarkable assertion that the SEIU and Kaiser aimed to hurt Prime by agreeing on higher wages and increased nurse staffing ratios at Kaiser (Michael Hiltzik, 3/19).

The New York Times' Opinionator: Banning The Big Gulp Ban
Neither I nor anyone else I've read on last week's judicial stay of New York City's "Big Gulp Ban" is a lawyer. (We call it the Big Gulp Ban, though in fact it famously would not have banned 7-Eleven's massive drinks.) But I doubt that our Board of Health was being "capricious" or "arbitrary" — those were the words of the ruling justice, Milton A. Tingling — when it decided last September, by a vote of 8 to 0 (you read that right), to forbid the sale, where it could, of super-size sugary drinks. … Nor do the proposers of the ban, Mayor Bloomberg and the health commissioner, Thomas Farley, seem like capricious guys to me (Mark Bittman, 3/19).

The Wall Street Journal: Kicking The Malpractice Tort Out Of Court
March 23 marks the third anniversary of the passage of the most controversial legislation in a generation, the Affordable Care Act, better known as ObamaCare. As the federal law moves toward a more thorough implementation next year, states are grappling with the costs and obligations imposed on them, such as the need to establish health-insurance "exchanges" where low-income workers can obtain coverage. Some states are also searching for ways, outside the scope of ObamaCare, to improve health care and lower costs. A promising idea that is gaining traction is to completely overhaul medical malpractice by kicking it out of courtrooms (Wayne W. Oliver, 3/19).

Bloomberg: Medicare Cost Slowdown Could Close U.S. Budget Gap
New evidence that the slowdown in health care costs over the past five years is happening not only because of a weak economy comes from the Economic Report of the President, released last week by the President's Council of Economic Advisers. If the slowdown were to continue in the future, the report shows, Medicare spending would basically remain flat as a share of the economy. Nevertheless, new data suggest Medicare spending growth may be picking up a bit. So it's important to take more aggressive action to improve value in health care (Peter Orszag, 3/19).

Minneapolis Star Tribune: Minnesota Health Insurance Exchange Done Wrong
When the Affordable Care Act (ACA), also known as Obamacare, was passed in Washington, it was done with the members of one party taking over and doing it all their way. In Minnesota, we said we could do better. But when the time came for Minnesota to lead the way, those in one party took over and did it all their way. We could have done better. ... As the exchange adds a hoped-for 300,000 people to the insurance rolls (subsidized with borrowed federal money), the rest of those who buy insurance are certain to pay more (Jim Abeler, 3/19).

Detroit Free Press: Mental Health Act A Big Step Toward Getting People Help
Less controversial is the proposed Excellence in Mental Health Act of 2013, which could bring Medicaid-funded mental health services to 1.5 million Americans. The act, co-sponsored by U.S. Sen. Debbie Stabenow, a Michigan Democrat, is in response to President Barack Obama's call to action in the wake of the Newtown, Conn., shootings late last year. We support the passage of this act. Of the roughly 4.8 million Americans who struggled with mood disorders, an estimated one-third don't receive treatment. This bill would take an important step toward bridging this gap (3/19). 

Journal of the American Medical Association: Health Services Innovation: The Time Is Now
Biomedical innovation has improved prevention, diagnosis, and treatment resulting in reduction in mortality for most diseases. However, health and health care disparities remain across the lifespan because these advances have not been matched by advances in delivering care, patient engagement, adherence, or access to these advanced care strategies. Clinicians interested in these failures have an opportunity to make health systems more effective by bringing their insights and creativity to developing innovations in care delivery (Dr. Barry Zuckerman, Dr. Peter A. Margolis and Dr. Kedar S. Mate, 3/20).

Journal of the American Medical Association: Educating Physicians About Responsible Management of Finite Resources
Physicians are principal gatekeepers who decide when, how, and what health care services are delivered, with some estimates that at least 60% of health care costs are determined or influenced by physicians. Despite the enormous resources at stake, physicians receive little education in how to manage and steward finite resources, making formal education of physicians in "program integrity" an essential component of medical professionalism (Dr. Shantanu Agrawal, Dr. Julie Taitsman and Dr. Christine Cassel, 3/20).

Journal of the American Medical Association: Can Accountable Care Organizations Improve Population Health? Should They Try? 
The number of accountable care organizations (ACOs) increased rapidly during 2012. There are now more than 250. This increase is likely to accelerate. ... The goals for ACOs are well known: to control health care costs, to drive quality in health care, and to improve population health. ... Many ACOs appear to interpret their responsibility for population health in medical terms—that is, as a responsibility to provide preventive care for all their patients and care management for their patients with serious chronic diseases. This is a major step forward from the traditional model in medical care, which has been to focus on whatever patients appear in the physician's office, while the patient is in the office. However, it falls far short of working to improve the health of the population in a geographic area (Dr. Douglas J. Noble and Dr. Lawrence P. Casalino, 3/20). 

Journal of the American Medical Association: Bridging The Divide Between Health And Health Care
The US health care system can do a better job of providing patient care while moderating the rate of increase in cost, but it can do little about improving overall population health. This is because health care delivery accounts for only 10% of preventable deaths, with the remainder attributable to personal behaviors, social and environmental determinants, and genetic predisposition. As currently constituted, the health care delivery system has little direct control over these other factors. However, consensus is developing that truly controlling health care costs and improving the overall health of the American people will require a much closer partnership, permeable boundaries, and increased interdependence among the health care delivery system, the public health sector, and the community development and social service sectors (Stephen M. Shortell, 3/20).

Health Policy Solutions (a Colo. news service): Medicare Part D Helps Seniors, Keeps Costs Down
Colorado's seniors are benefiting as never before from prescription drugs that are saving and prolonging their lives—and uplifting the quality of those lives. And believe it or not, a federal program -- Medicare Part D -- has played a pivotal role in that success. Part D saves U.S. taxpayers billions of dollars, stimulates investment in breakthrough pharmaceutical research, and is immensely popular among some 30 million Americans who take advantage of it. It's not often you can say that about any government effort, and Medicare's singularly successful Part D program represents a distinct exception (Margie Ball Cook, 3/19).

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