KHN Morning Briefing

Summaries of health policy coverage from major news organizations

Viewpoints: Health Law Debate On Contraceptive Coverage; Cuccinelli: No Investigators For Medicaid Fraud; 50 Years After The Famed Report On Smoking

Los Angeles Times: The Little Sisters Of The Poor Vs. Obamacare
The Little Sisters of the Poor, an organization of Roman Catholic nuns that runs nursing homes around the country, is testing the contraceptive coverage mandate of the Affordable Care Act. Last week, we're sorry to say, the nuns won a temporary reprieve from Supreme Court Justice Sonia Sotomayor. Under the law, most employers are required to provide their employees with health insurance that covers birth control. But the Obama administration agreed to a compromise for nonprofit religious groups that object to contraception, exempting them from paying for such coverage. Instead, insurers agreed to absorb the cost. All the religious organization has to do is fill out a simple form attesting to its situation. Unfortunately, even that was too much for the Little Sisters of the Poor (1/7). 

The Washington Post: Hooey And Hype Over The Birth-Control Mandate
You'll be hearing a lot in coming months about the Obamacare requirement that health-care plans offer no-cost contraceptive coverage. Much of what you hear will be wrong, either (from opponents of the mandate) overstating the infringement on religious freedom or (from supporters) exaggerating the impact of excluding coverage for birth control. Herewith, my guide for the soon-to-be-perplexed (Ruth Marcus, 1/7).

The Washington Post: Should You Be Scared To Use
The House Republicans' bill would require the government to notify victims of any illegal security breach in the [Affordable Care Act's] systems within two business days. If that makes sense for, though, why not require the same of other sensitive federal systems, too? If Republicans want to pass useful policy, rather than simply throw another bomb at the ACA, they should detach their proposal from anti-Obamacare politics and vote on a broader federal transparency requirement, or even renew their push for more ambitious federal cybersecurity reforms. ... It would be unfortunate, though, if Republicans succeeded in scaring Americans away from enrolling in health insurance plans, undoubtedly a goal for some (1/7). 

The Washington Post: It's Obamacare All The Time For Republicans
A reporter from the Cedar Rapids (Iowa) Gazette asked [Republican National Committee Chairman Reince] Priebus if "Obamacare is going to be the Johnny-one-note campaign for Republicans" in which "every issue that comes up, you're going to respond with Obamacare." Or, he inquired, "is there more to what Republicans want in 2014?" "The answer is Obamacare," Priebus said, before adding a "just kidding." But he wasn't really kidding (Dana Milbank, 1/7).

The Wall Street Journal: Fast Times At Obamacare High
The worst must be over for the Affordable Care Act because its boosters are taking credit for trends that began long before the law passed. Maybe ObamaCare should also get retroactive political credit for the germ theory of disease. All the back-slapping is over Monday's report by federal actuaries that U.S. public and private health spending rose only modestly in 2012, growing 3.7% to $2.8 trillion. Because the economy grew somewhat faster, health spending as a share of GDP fell to 17.2% from 17.3% in 2011. The real lesson in these numbers is that faster economic growth solves most fiscal ills (1/7). 

Richmond Times-Dispatch: Medicaid Expansion Is Wrong For Virginia
One fact that has been missing from the public discussion about whether or not to expand Medicaid is that there will be an explosion of fraud with any such expansion, and unfortunately, as a practical matter, there will be no one to investigate or prosecute that fraud within Virginia state government, and only nine people in the federal government. Those nine are already tasked with pursuing Medicare fraud in Virginia, thus they have no meaningful ability to police the new wave of fraud that would come with the proposed expansion of Medicaid (Virginia Attorney General Ken Cuccinelli, 1/8).

The Fiscal Times: When Will We Finally Know What Our Health Care Really Costs?
The government announced this week that health care spending rose only modestly in 2012, the fourth year in a row of low growth. The numbers released by the Centers for Medicare & Medicaid Services offer a broad overview of the $2.8 trillion spent on everything from hospitals and clinics to drugs and dentists. They don’t, however, fully address a lingering enigma for American consumers: How much does our care really cost? (John F. Wasik, 1/8).

On other issues --

The New York Times: The Missing Piece In The War On AIDS
Most people living with or at risk of HIV still do not have access to prevention, care and treatment. The epidemic continues to ravage families, communities and entire nations. This is particularly true in sub-Saharan Africa, which bears the burden of disease in disproportionate measure, and where HIV/AIDS is the leading cause of death in adults. We must acknowledge that medicines and technology alone are not enough. ... Our strategy, if it is to be successful, must recognize that achieving universal access to care and treatment necessarily means addressing human rights barriers to health services (Ellie Feinglass, 1/7).

Journal of the American Medical Association: Tobacco Control 50 Years After The 1964 Surgeon General's Report
The 50th anniversary of the landmark 1964 surgeon general's report on Smoking and Health marks a time for national recognition, resolve, and reaffirmation. It is important to recognize the persons who courageously completed the report under intense scrutiny while guarding against potential industry interference. It is also important to honor the extraordinary scientific advances in tobacco control in the years since the release of the report—advances that have led to countless lives saved. Ultimately, however, this anniversary must reaffirm the fundamental resolve to end the tobacco epidemic once and for all, and doing so should not take another 50 years (Dr. Steven A. Schroeder and Dr. Howard K. Koh, 1/8).

Journal of the American Medical Association: The War Against Tobacco: 50 Years And Counting
While the overall prevalence of adult smoking in the United States has declined markedly, from about 42% in 1965 to an estimated 18% in 2012 with comparable declines in per capita cigarette consumption, higher smoking rates persist among the poor; the least educated; individuals with mental health, substance abuse, and alcohol diagnoses; the lesbian, gay, bisexual, and transgender community; and Native Americans. Moreover, on any given day, an estimated 3800 US adolescents smoke their first cigarette, 1000 of whom will join the ranks of daily (lifetime) cigarette smokers (Dr. Helene M. Cole and Dr. Michael C. Fiore, 1/8).

Journal of the American Medical Association: Tobacco Control Progress And Potential
However, there are 2 important and concerning surprises in tobacco control. First, even 50 years later, studies are continuing to elucidate new ways tobacco causes death and disability among both smokers and people exposed to secondhand smoke—new diseases it causes or complicates. ... Second, despite progress both in the United States and globally, proven strategies have not been fully implemented to protect children, support smokers who want to quit, and prevent myocardial infarctions, strokes, cancers, and other tragic and expensive health consequences of smoking (Dr. Thomas R. Frieden, 1/8).

Journal of the American Medical Association: Accommodating Bigotry
Despite the United States' inexorable march toward racial, ethnic, and gender equality, it is clear that prejudice persists. What I find difficult to reconcile is how to deal with patient prejudices in a health care system with a growing emphasis on patient-centered care. Does a patient have the right to request or to deny a clinician of a certain race, ethnicity, gender, religion, or sexual orientation? Physician-patient race concordance has emerged in the disparities literature as a factor in differential health outcomes. When patients and physicians share race, visits tend to be longer and patient satisfaction is higher, bolstering the argument that patient preferences (assuming they prefer concordance) should be respected (Meghan Lane-Fall, 1/8).

JAMA Internal Medicine: Moving Toward Evidence-Based Complementary Care
Therapies that lie outside the spectrum of traditional, science-based clinical medicine and surgery are often labeled as complementary or alternative. ... Among complementary measures, meditation has occupied a special position, revered in religious circles and Eastern societies for centuries and rediscovered in the West in the mid-20th century ... studies overall failed to show much benefit from meditation with regard to relief of suffering or improvement in overall health, with the important exception that mindfulness meditation provided a small but possibly meaningful degree of relief from psychological distress .... the phenomenon is causing a collision of opinion in examining rooms and offices as physicians and other health care professionals committed to evidence-based practice encounter patients who are enthusiastically and uncritically incorporating unvalidated measures into their daily lives and into the treatment of their illnesses (Allan H. Goroll, 1/7).

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