KHN Morning Briefing

Summaries of health policy coverage from major news organizations

Viewpoints: Don’t Blame Insurers For Health System Problems; Obama’s ‘Management Failure;’ Texas Abortion Case Heads To Court

Bloomberg: What Liberals Don't Get About Single Payer
[The] problem with the Affordable Care Act isn't the insurance industry. In fact, the main benefits of nationalized health care can be achieved in systems with hundreds, even thousands, of for-profit insurers. ... The dirty truth about American health care is that it costs more not because insurers are so powerful, but because they're so weak. ... It's health-care providers -- not insurers -- who have too much power in the U.S. system. As a result, they have the most to lose if health-care prices fall. But, as is often the case, political power flows in part from popularity. So politicians who routinely rail against for-profit insurers are scared to criticize -- much less legislate against -- for-profit hospitals, doctors or device manufacturers (though drug companies come in for a drubbing now and then). These are the people who work every day to save our lives, even if they make us pay dearly for the privilege (Ezra Klein, 1/8).

The Washington Post: Will Health Costs Continue Slowing?
Call it the $2.8 trillion enigma. That's the amount Americans spent on health care in 2012. The good news is that health spending slowed unexpectedly for the fourth consecutive year. The enigma is that no one really knows why. Despite many theories, there's no expert consensus. Runaway health spending is a huge national problem. It has squeezed take-home pay (employers channel more compensation to health insurance and less to salary) and is crowding out other programs — schools, defense, regulation, police — at the federal and state levels. If the slowdown is temporary, then all these problems remain. But if there's a permanent shift, then the nation's economic and budget outlook has significantly improved (Robert J. Samuelson, 1/8). 

The Washington Post: Despite What Critics Say, Obamacare Is Working
Despite the treasured right-wing talking points, it's increasingly clear that Obamacare is a success. Moreover, in places where Obamacare is not succeeding, it's also clear that the right wing is to blame. Well, it's clear to any who look at the state-by-state numbers of the newly insured. A whole lot of Americans will have to look, however, for the program's success to redound to Democrats’ advantage (Harold Meyerson, 1/8). 

The Wall Street Journal: Obama The Management Failure
The prime example of the president's management gap has been ObamaCare. By handing off the framing of the legislation to Congress, Mr. Obama repeated the rookie mistake he made with the stimulus bill, which became a bloated porkfest. The health-care program that emerged from Capitol Hill with no Republican support is a Rube Goldberg monstrosity, an administrative nightmare. Given ObamaCare's complexity, a seasoned executive would have bird-dogged every stage of its creation and rollout, with obsessive attention to the testing of the sign-up computer programs, the public's first encounter with his signature initiative. There would be go/no-go inflection points and backup timetables, cold-eyed performance reviews and abrupt dismissals. And, in the worst case, a plan to put everything on hold for a year to sort out all the problems (Edward Kosner, 1/8). 

The Wall Street Journal: ObamaCare's Rude Awakening For The Young
President Barack Obama won PolitiFact's 2013 "Lie of The Year" for claiming, that "if you like your health care plan, you can keep it." Instead of being ashamed, members of his administration appear to have been inspired by the award. Take the statement by Department of Health and Human Services' National Press Secretary for Health Care, Joanne Peters. On Jan. 2, the Journal quoted her as saying ObamaCare "is making health insurance more affordable for young adults" (Karl Rove, 1/8). 

Bloomberg: Democrats And Republicans Are Both Wrong On Obamacare Politics
Top Republicans privately recognize that repeatedly trying to repeal the Affordable Care Act is no longer a winning strategy. For Democrats, there is the risk that new problems will emerge within a program that still lacks strong leadership. They may also find that history doesn't support their calculation that the health-care law will redound to their political advantage as more benefits kick in (Albert R. Hunt, 1/8). 

JAMA: The End Of The Beginning For The Affordable Care Act
It's now halftime for the launch of the Affordable Care Act (ACA). People seeking coverage to begin on January 1 had to enroll between October 1 and the end of 2013, but they can continue enrolling until March 31, when the open enrollment period for 2014 ends. As Winston Churchill might have described it, it's the "end of the beginning" (Larry Levitt, 1/8).

And on other issues -

The New York Times: Abortion Restrictions In Texas And Beyond
The tenuous state of women's basic right to make their own childbearing decisions was made clear on Monday when a federal appeals court in New Orleans heard arguments on a new abortion restriction enacted in July in Texas — one that requires doctors who perform abortions to have admitting privileges at a nearby hospital (1/8). 

USA Today: 23andMe's Rush To Market Irresponsible
Pretty soon, you'll be able to swab your nose or mouth at home and be able to find out whether you have the flu, instead of having to trek, with fever and chills, all the way to the doctor's office. ... Home health testing is the future. You can already find out whether you are ovulating, measure your blood alcohol level, test yourself for the presence of illegal drugs, check your cholesterol or blood sugar, even find out whether you might have HIV or hepatitis C, all in the comfort of your own home and all approved by the Food and Drug Administration. But as the company 23andMe has recently shown us, there is a responsible way to approach home health testing and a sketchy way — which can serve as a lesson for future home-testing entrepreneurs (Katherine Chretien, 1/8). 

USA Today: Our View: War On Smoking, At 50, Turns To Teens
The war on smoking, now five decades old and counting, is one of the nation's greatest public health success stories — but not for everyone. As a whole, the country has made amazing progress. In 1964, four in ten adults in the U.S. smoked; today fewer than two in ten do. But some states — Kentucky, South Dakota and Alabama, to name just a few — seem to have missed the message that smoking is deadly (1/8). 

USA Today: High Cigarette Tax Hurts The Poor: Opposing View 
Kentucky is a woefully unhealthy state. Even Bluegrass residents admit that their smoking rate — the nation's highest — significantly contributes to this sickly state of affairs. Still, the claim that the remedy to such an unhealthy vice is to tax it out of existence has many Kentuckians scratching their heads (Jim Waters, 1/8).

Medpage Today: A New Year: Time To Get Lean!
"Lean" is not about the stats! It is a philosophy to reduce variation and to make customer-focused, data-driven decisions. What does "lean" mean? Lean principles are found in: The approaches of Kaizen, a Japanese term embodied by efforts at continuous improvement. Six Sigma, a methodology with tools to improve capabilities of business processes. The DMAIC (Define, Measure, Analyze, Improve, Control) process, an incremental process improvement via structured problem solving. When translated to health care, the principles can reduce denials, improve patient satisfaction and staff morale, and, most importantly, eliminate bottlenecks in practice operations (Rosemarie Nelson, 1/8).

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