KHN Morning Briefing

Summaries of health policy coverage from major news organizations

Viewpoints: GOP’s ‘Charge Into The Fixed Bayonets;’ Republican Health Plan Is Superior To Obama’s; Congressional Hypocrisy On Its Health Policy

The Wall Street Journal: The Cruz Campaign Against Obamacare
So House Republicans have passed and sent to the Senate a budget that includes no funding for the Affordable Care Act, setting up a political showdown that could result in a government shutdown. We wish the GOP luck, since we support the policy if not the strategy. But however this charge into the fixed bayonets turns out, we hope the folks who planned it will take responsibility for what happens now (9/23).

The Washington Post: Obamacare's Real Danger For The GOP Is That It Will Succeed
To understand the crisis in Washington, tune out the histrionics and look at the big picture: Republicans are threatening to shut down the federal government — and perhaps even refuse to let the Treasury pay its creditors — in a desperate, last-ditch attempt to keep millions of Americans from getting health insurance. Seriously. That's what all the yelling and screaming is about. As my grandmother used to say, it's hard to know whether to laugh or cry (Eugene Robinson, 9/23).

Politico: The GOP's Reckless Stunt
The civil war that has been raging within the Republican Party is over. And now that the House has voted to shut down the government unless Obamacare is defunded, it's official: The Tea Party has won — the far right is calling the shots. This extreme faction and its captives in the GOP are so focused on undermining President Barack Obama and his plans to boost the economy and improve access to health care for all Americans that they’re willing to drive the nation over the cliff (Rep. Debbie Wasserman Schultz, D-Fla., 9/23).

Los Angeles Times: Ted Cruz's Defunding Strategy Runs Into Reality And Harry Reid
Sens. Ted Cruz (R-Texas) and Mike Lee (R-Utah) find themselves in the curious position this week of encouraging their GOP colleagues to filibuster the stopgap government funding (and Obamacare defunding) resolution that they urged the House to pass (Jon Healey, 9/23).

The New York Times' Taking Note: Sabotaging Health Care, One Lie At A Time
A Koch-brothers funded conservative group, Generation Opportunity, is out with a wildly misleading, pernicious set of ads aimed at sabotaging the Affordable Care Act by discouraging young people from signing up for health insurance exchanges (Juliet Lapidos, 9/23).

The New York Times' The Conscience Of A Liberal: Attack Of The Killer Hipsters
Never mind the polls showing approval of Obamacare moving one way or the other; they are all being taken in an environment where people are amazingly ignorant about the law, with a large minority believing that it has been repealed. What matters is how the thing works — and that, in turn, depends crucially on sufficient numbers of young, currently uninsured people signing up for the exchanges. Advocates will try to get those people signed up; Republicans will try to convince them not to. So how are the two sides' chances (Paul Krugman, 9/23).

Bloomberg: A Serious Republican Health Care Plan
House Republicans are starting to fill in the details of what health care policies they would prefer over Obamacare. The 175 conservative representatives in the Republican Study Committee released a plan last week. It's a good start, but there's room for improvement. ... Even with these flaws, though, the Republican plan is superior to Obamacare. It’s less coercive. It requires fewer taxes. It doesn't have as much potential to reduce full-time employment. And it's more likely to control costs, relying as it does on the power of competition rather than the guidance of Washington-based experts (Ramesh Ponnuru, 9/23).

Forbes: Yes, Obamacare's Exchanges Will Narrow Your Choice Of Doctors -- And That's A Good Thing
Yesterday, Robert Pear of the New York Times discussed an emerging concern with Obamacare’s soon-to-be-online health insurance exchanges. "Many insurers," he writes, "are significantly limiting the choices of doctors and hospitals available to consumers" in the market. Many critics of the health law made note of the news, holding President Obama to account for his repeated promise that "if you like your doctor, you can keep your doctor." But here's the twist: it's actually a good thing that insurers are forcing hospitals and doctors to compete on price. Indeed, these "narrow networks" may be one of Obamacare’s best features (Avik Roy, 9/24).

The Wall Street Journal: The Hypocrisy Of Congress's Gold-Plated Health Care
Today, elected officials need to be reminded of these truths. Under pressure from Congress, the White House has carved out a special exemption for Congress and its staffers from Obamacare—the law it recently deemed necessary for the entire country. No Republicans voted for Obamacare. Yet it appears that some of them support the exemption President Obama approved on his own—so they would not have to go on record with a vote for or against it (William Bennett and Christopher Beach, 9/23). 

The Wall Street Journal: Obama's Debt-Ceiling Stonewall
The national debt, if left unchecked, will eclipse our entire economic output in a mere 25 years, outstripping private investment and threatening the nation's economic health. That is the prognosis Congress's nonpartisan budget scorekeeper, the Congressional Budget Office, reported last week. The rising debt is being driven by the skyrocketing costs of America's largest entitlement programs—Medicare, Medicaid and Social Security. CBO found that "federal spending for the major health care programs and Social Security would increase to a total of 14 percent of GDP by 2038, twice the 7 percent average of the past 40 years" (Sen. Orrin Hatch, R-Utah, 9/23).

USA Today: Affordable Care In 7 Days: Our View
Most Americans are at least vaguely aware that Obamacare will require almost every citizen to have health insurance, but that starts to get real a week from Tuesday. The mandate itself doesn't take effect until January, but anyone who doesn't already get insurance at work or through government programs such as Medicare and Medicaid will be able to start signing up for private policies under the new law on Oct. 1 (9/23).

USA Today: The Not Affordable Care Act: Opposing View
Imagine that Congress passed a law requiring all cars sold in America to use hybrid engines. If you're concerned about our consumption of fossil fuels, such a law might sound great. However, as anyone who has shopped for a car knows, hybrid cars are much more expensive than conventional ones. Obamacare is doing something similar to health insurance, especially for people who buy it on their own (Avik Roy, 9/23).

The New York Times: Home Care In The Home Stretch
For nearly 40 years, home-care workers, wrongly labeled "companions," have been denied basic federal labor protections, including the right to be paid at least the minimum wage and time and a half for overtime (9/23).

Des Moines Register: Finally, Respect For Home Health Care Workers
"You can wake up at 5 in the morning, care for somebody every minute of the day, take the late bus home at night, and still make less than the minimum wage," said President Barack Obama in 2011. He was talking about the nearly 2 million workers who travel to the homes of elderly and disabled people to provide care (9/23).

Los Angeles Times: Putting A Price Tag On Contacting Your Medical Specialist
So-called concierge medicine — doctors asking their patients to pay an extra fee just to remain under their care — has been around for a while. It's an offensive idea, but I get it, especially when it comes to family practitioners who look after a patient's general well-being. The medical marketplace has room for both Corollas and Cadillacs. Yet when it comes to medical specialists, such as cardiologists, things seem different (David Lazarus, 9/23). 

The New Republic: Startling New Map: 92 Percent Of New HIV Cases Are In 25 Percent Of Counties
These maps from AIDSVu, a group that turns annual HIV infection rates data from the U.S. Centers for Disease Control (CDC) into interactive displays, show exactly where new cases were diagnosed between 2008 and 2011—information that the CDC has never mapped before, and which has big implications for public health. ... The maps display cases by county, and in major cities, by zip code; they show that 92 percent of new diagnoses between 2008 and 2011 took place in just 25 percent of U.S. counties (Caplan-Bricker, 9/24).

Journal of the American Medical Association: The Value Of Sharing Treatment Decision Making With Patients
The growing emphasis on patient-centered care is increasing the demand on physicians' time and effort to more fully engage patients and their families in treatment decision making. Thus, it is important to understand the potential effects of shared decision making (SDM) with patients on the outcomes of clinical encounters. ... The increasing expectations about the role of SDM in clinical and health policy warrant closer scrutiny of the evidence (Dr. Steven J. Katz and Sarah Hawley, 9/23).

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