KHN Morning Briefing

Summaries of health policy coverage from major news organizations

Viewpoints: Website Is Like ‘A Patient Bleeding From Self-Inflicted Wounds;’ Remembering Patients Who Never Had Care And The Need For Health Law

USA Today: Obamacare's Critics Justified: Our View
Obamacare is starting to resemble a patient bleeding from self-inflicted wounds. A month after launch, the online health exchanges where individuals are supposed to shop for insurance remain slow or unusable, except in states that opted to run their own marketplaces and did a more competent job than the administration. As if that weren't trouble enough, critics are justifiably mocking President Obama for his repeated, untrue promise that if people liked their health plans, they could keep them. Oops. Hundreds of thousands of people are getting termination notices for plans that don't meet the strict new requirements of the Affordable Care Act. Presumably, not all those people disliked their plans (11/3). 

USA Today: Rep. Fred Upton: Let People Keep Their Coverage
Implementation of the president's health care law has generated confusion and concern. That's not what health reform should be about. Americans deserve to know that in times of need, they will have the coverage and care that they want, need and can afford. That is why the law's broken promises matter. "We'll lower premiums by up to $2,500 for a typical family per year" has been replaced with premium increases as high as 400%. Administration officials insisted the law would be ready Oct. 1, but a month later the website still does not work and has questionable security (Rep. Fred Upton, R-Mich., 11/3).

USA Today: White House: Affordable Care Act Adds Many Protections
Recently, some Americans with insurance they bought on their own have received notices suggesting that, because of this law, their plan may be canceled. The individual market has historically had few standards. Thousands of Americans were dropped every year and countless others were denied access to coverage altogether due to minor medical conditions. On average, premiums for those who re-upped in these plans rose about 15% annually — and when they couldn't pay the bills and became uninsured, everyone else picked up the tab. If you owned one of these plans before this law took effect, you can keep it. That was the president's promise. But since the law passed, many people left these plans. New plans or so-called grandfathered plans that downgraded coverage must adopt the new consumer protections. Some news outlets reported this as insurers cutting people loose. But that's not true. The ACA requires these plans to be replaced with quality, comprehensive coverage. That was a central promise of the law, too (Chris Jennings, 11/3).

The New York Times: Insurance Policies Not Worth Keeping
Indeed, in all the furor, people forget how terrible many of the soon-to-be-abandoned policies were. Some had deductibles as high as $10,000 or $25,000 and required large co-pays after that, and some didn’t cover hospital care. This overblown controversy has also obscured the crux of what health care reform is trying to do, which is to guarantee that everyone can buy insurance without being turned away or charged exorbitant rates for pre-existing conditions and that everyone can receive benefits that really protect them against financial or medical disaster, not illusory benefits that prove inadequate when a crisis strikes (11/2).

The New York Times: This Is Why We Need Obamacare
The biggest health care crisis in America right now is not the inexcusably messy rollout of Obamacare. No, far more serious is the kind of catastrophe facing people like Richard Streeter, 47, a truck driver and recreational vehicle repairman in Eugene, Ore. His problem isn't Obamacare, but a tumor in his colon that may kill him because Obamacare didn't come quite soon enough. Streeter had health insurance for decades, but beginning in 2008 his employer no longer offered it as an option. He says he tried to buy individual health insurance but, as a lifelong smoker in his late 40s, couldn't find anything affordable — so he took a terrible chance and did without (Nicholas D. Kristof, 11/2).

The Wall Street Journal: Politics Counts: Clues In Early Traffic To
Traffic numbers for compiled by the web analytics firm comScore show visits climbed last week after dropping from the first week’s 5.3 million unique visitors. Visitors dropped to 2.4 million in the second week, and 1.6 million in the third before rising to 2.3 million last week. Those numbers are not a good start, but they may indicate something other than a catastrophe (Dante Chinni, 11/1).

Los Angeles Times: Yes, Men Should Pay For Pregnancy Coverage, And Here's Why
Anti-Obamacare conservatives are chuckling over an exchange from the House's grilling of Health and Human Services Secretary Kathleen Sebelius on Wednesday morning, in which Rep. Renee Ellmers (R-N.C.) challenged Sebelius to explain why men should have to pay for maternity coverage in their health insurance plans. "To the best of your knowledge, has a man ever delivered a baby?" Ellmers asked. Ellmers and her cheering section seem to think this was hilarious, a conclusive, slam-dunk, let-me-hear-a-rimshot punchline. "Ellmers was on her 'A' game," the deep thinkers over at Breitbart decided. The reality is, of course, that Ellmers' question revealed only her profound ignorance about how health insurance works, and her lack of desire to learn. And that goes for everyone else who thought this was a smart, telling blow (Michael Hiltzik, 11/1).

The Washington Post: Want To Keep People Out Of The Hospital? Make Sure They Have A Place To Live.
In Illinois' Medicaid program last year, 3.2 percent of patients accounted for half of all spending. The top 0.15 percent – 4,500 people in a program covering 3.2 million people – required annual expenditures upward of $285,000 each. In the health-policy world, these heavy spenders are known as "frequent fliers:" patients with severe conditions, disabilities and life problems whose complex care accounts for such a disproportionate share of the medical economy. However the health-reform debate proceeds in Washington, improving the quality and economy of care provided to this concentrated group will remain a central challenge (Harold Pollack, 11/2).

The Wall Street Journal: You Also Can't Keep Your Doctor
For almost seven years I have fought and survived stage-4 gallbladder cancer, with a five-year survival rate of less than 2% after diagnosis. I am a determined fighter and extremely lucky. But this luck may have just run out: My affordable, lifesaving medical insurance policy has been canceled effective Dec. 31. My choice is to get coverage through the government health exchange and lose access to my cancer doctors, or pay much more for insurance outside the exchange (the quotes average 40% to 50% more) for the privilege of starting over with an unfamiliar insurance company and impaired benefits (Edie Littlefield Sundby, 11/3). 

USA Today: Obama Got Carried Away With Health Care Reform
But the inability of the world's most lavishly funded government to produce a working website after more than three years of effort ought surely to encourage caution about its ability to administer the plan that the website was simply intended to enroll people for (Glenn Harlan Reynolds, 11/3).

The Washington Post: The Noise Around Obamacare
Opponents of Obamacare want government to let the market do what the market does. ... If the market generates vast inequalities, this must be because such inequalities maximize efficiency. Thus, foes of the new health-care law aren't against it because its Web site worked badly or because the president once said that everybody could keep their current policies when it turned out that some in the small individual insurance market got cancellation notices. For those trying to kill the law, such noise is designed to distract attention from what they really think, which is that we should let non-elderly Americans sink or swim in the insurance arrangements that existed before Obamacare (E.J. Dionne Jr., 11/3).

Bloomberg: Where Would Obamacare Be With Romney At The Wheel
With President Barack Obama invoking Mitt Romney to defend the Patient Protection and Affordable Care Act this week in Boston, it's worth considering what U.S. health-care policy would look like today if Romney had won the presidency a year ago. The answer: very different in many important ways, but frustratingly similar in others (Lanhee Chen, 11/1).

Bloomberg: Health Consumers Finding Out They Were Sold A Lemon
A lot of folks with employer-sponsored insurance are also going to see their insurance changed, though not quite as quickly. And not "The benefits will get so much more awesome!" but "The Cadillac tax kicked in and we had to drop most of our plans except for the ones with high deductibles." A friend who sits on the benefits committees of two organizations says that their experts predict that pretty much all plans will end up being of the "consumer-driven" (read: high-deductible) model once the so-called Cadillac tax kicks in (Megan McArdle, 11/1).

The Boston Globe: Obama’s Rosy Speech At Faneuil Hall Isn’t Enough
President Obama came to Massachusetts looking for love and preaching bipartisanship as he tries to fix the debacle known as the rollout of his signature health care law. Love, he got. An adoring crowd assembled at Faneuil Hall cheered his plea for compromise and patience. Bipartisanship is another matter (Vennochi, 11/3).

The Boston Globe: Obama's Bogus Claims Pile Up
Remember Joe Wilson, the South Carolina congressman who yelled “You lie!” during Obama’s health care speech to Congress in 2009? His outburst was inexcusably rude. But in retrospect, it looks increasingly prescient. First, it was the debacle of the health care website. Then it was news that policies were being canceled. Which shoe will be the next to drop? What other Obamacare promise will voters discover was bogus? (Jeff Jacoby, 11/3).

The Denver Post: Website Glitches Symptom Of Larger Problem
There's been a white-hot glare of media coverage of the significant stumbles of the website over the past month. Most of the criticism focuses on the ailing website itself and the government's rather sorry efforts at playing software developer. That's an interesting story, but I think all the cacophony is distracting us from a bigger, more foundational problem that threatens the success of the Affordable Care Act (Dave Maney, 11/3).

And on other health issues -

Los Angeles Times: How Much Are We Willing To Pay For The Pursuit Of Happiness?
It's also an important study, in a political environment where the cost and benefits of social programs are on the table as never before. Social Security and Medicare are again on the table in fiscal negotiations on Capitol Hill. The Affordable Care Act, which represents the largest restructuring of a social service since the 1960s, is being intensely debated in households and news programs across the nation, though invariably not with the depth and understanding it deserves. Radcliff's research suggests that higher levels of social programs produce a happier population and that public policies such as social insurance and strong labor market protections are among the most important factors (Michael Hiltzik, 11/3).

The Washington Post: We Need To Stop Coddling The Elderly
Two analysts at the Federal Reserve Bank of St. Louis have produced an important study that should (but probably won’t) alter the climate for Washington’s stalemated budget debate. The study demolishes the widespread notion that older Americans need exceptional protection against spending cuts because they’re poorer and more vulnerable than everyone else. Coupled with the elderly’s voting power, this perception has intimidated both parties and put Social Security and Medicare, which dominate federal spending, off-limits to any serious discussion or change (Robert J. Samuelson, 11/3). 

The New York Times: Doctor, First Tell Me What It Costs
If an antibiotic would cure your infection, your doctor would probably still warn you about the chance of sun sensitivity before prescribing the pill. But even when the costs of a medical intervention might force patients to choose between paying the bill or keeping up with their mortgages, American physicians rarely discuss that serious side effect with them. One physician recently explained to me that he felt money talk would "violate the doctor-patient relationship." Given how much attention we have been focusing on health care costs and the Affordable Care Act, now is the time to change such thinking (Dr. Peter A. Ubel, 11/3).

Los Angeles Times: Abortion Rights Battle In Texas Is Far From Over
This law is not an attempt to make abortion safer for women, as some Texas officials who support it claim. It's an attempt to chip away at abortion rights. Hopefully the federal appellate court will see through that attempt when it hears the case next year (Carla Hall, 11/1).

The Washington Post: The Truth About Paying The Medicare Part D Penalty
If you do not sign up for Part D when you're first eligible for Medicare Part A and/or Part B, and you didn't have prescription drug coverage that met Medicare's minimum standard, you may have to pay a late enrollment penalty if you eventually decide to join the plan. ... You don't incur a late penalty if you opt out of getting Plan D because you already have creditable prescription coverage or if you participate in the government program called Extra Help. (This is a Medicare program that assists people with limited incomes and financial resources to pay for their prescriptions.) The key word here is "creditable," which means that your plan's coverage is expected to pay on average as much as the standard Medicare prescription drug coverage (Michelle Singletary, 11/1).

The Seattle Times: Taking Care Of Health, Tax Dollars
Sometimes the prevention of health-related problems can also be a way to save money in the long run. Being smart about health care and tax money can go together (Jerry Large, 11/3).

This is part of the KHN Morning Briefing, a summary of health policy coverage from major news organizations. Sign up for an email subscription.