KHN Morning Briefing

Summaries of health policy coverage from major news organizations

Viewpoints: Democrats Signaling Problems Ahead On Health Law; GOP’s ‘Harping’ On The Coming Problems Will Help Public’s Expectations

The Wall Street Journal: The Coming ObamaCare Shock
In recent weeks, there have been increasing expressions of concern from surprising quarters about the implementation of ObamaCare. Montana Sen. Max Baucus, a Democrat, called it a "train wreck." A Democratic colleague, West Virginia's Sen. Jay Rockefeller, described the massive Affordable Care Act as "beyond comprehension." Henry Chao, the government's chief technical officer in charge of putting in place the insurance exchanges mandated by the law, was quoted in the Congressional Quarterly as saying "I'm pretty nervous ... Let's just make sure it's not a third-world experience." These individuals are worried for good reason. The unpopular health care law's rollout is going to be rough. It will also administer several price (and other) shocks to tens of millions of Americans (Daniel P. Kessler, 4/29). 

Bloomberg: How Conservatives Are Helping Obamacare
Yuval Levin, among other conservatives, has made an offer to liberals: Let's delay the implementation of Obamacare for a year and make everybody better off. … Liberals, wisely, are saying no. What's funny about this conversation is that conservatives have been accidentally managing expectations for implementation: By harping constantly on what a disaster the rollout is going to be, they will make what actually happens look good by comparison (Josh Barro, 4/29).

The Washington Post: For GOP, Opposition Shouldn't Only Mean Obstruction
Defeating Obama is no longer a sufficient Republican goal. What Mitt Romney couldn’t manage is eventually accomplished by the 22nd Amendment. Instead, Republicans face a series of complicated political tasks. ... There is no economic value or political appeal in austerity for its own sake. One reason the health entitlement crisis is so dangerous is that it progressively squeezes domestic discretionary spending. Republicans need to accompany proposals for structural entitlement reform with creative measures to encourage education, job training and entrepreneurship (Michael Gerson, 4/29).

San Jose Mercury News: Employer Health Programs Can Backfire On Employees
Central to health care reform has been an increased focus on health promotion and prevention programs, including programs based in workplaces commonly referred to as "health and wellness programs." In concept, encouraging employee health and wellness is a great idea. Many of us spend a majority of our waking hours at work and would welcome environments that encourage and support healthy lifestyles. Unfortunately, there is a serious risk that employers might use these workplace programs and incentives to shift health care costs or to discriminate against employees with pre-existing health conditions or other risk factors (Bill Monning, 4/29).

CNN World: Governors Missing The Point On Medicaid
So while a governor or legislator may disagree with Medicaid expansion for philosophical reasons, the claims that the expansion will be a burden on states' economies seem misguided given the full range of projected economic impacts on the states. The fact is that not expanding Medicaid will hurt state economies. This is even true for states that do not have lower-than-average incomes (Carter C. Price, 4/29).

The (Helena, Mt.) Independent Record: The Moderate Majority Worked Hard This Session
Unfortunately, the moderate majority couldn't capitalize on one of the largest economic opportunities this session, Medicaid expansion. On Medicaid, partisanship won the day. Without Medicaid expansion, more than 70,000 Montanans will be without affordable health coverage next year. We'll miss the opportunity to create 14,000 new, good-paying jobs in the medical field. We'll still pay for it through federal taxes, but rather than giving those dollars back to invest in Montana, the federal government will just spend them in other states (Monica J. Lindeen, 4/29).

Health Policy Solutions (a Colo. news service): Health Care Just Around The Corner
The most recent law, the Affordable Care Act of 2010 promises to reshape the health care landscape on a scale not witnessed since Medicare's passage in 1965. Everyone will be required to purchase insurance. Medicaid will be enlarged, and much of the regulation of insurance will be transferred to federal oversight. On the surface it all sounds good until you meet the devil in the details (Francis Miller, 4/29).

The Wall Street Journal: Teeth-Whitening Rules Take A Bite Out of Business
When special interests use government power to limit competition, that is not just a stain on representative government. Now it's also leaving a stain on teeth. According to a new study by our organization, the Institute for Justice, licensed dentists across the country have been lobbying successfully for government-imposed restrictions that create a lucrative monopoly on the field of teeth whitening. Dozens of states have now passed laws, or applied existing ones, to shut out entrepreneurs and thus raise the cost of acquiring a brighter smile (Angela C. Erickson and Paul Sherman, 4/29).

Oregonian: What Price Life? Pushback By OHSU's Brian Druker Against High Drug Costs Should Prod Review
It's one thing to be told you have cancer and a few years to live. It's entirely another to be told Wait, you do have cancer, but a medication that will extend your life by several years is available for $100,000 a year. Reasonable people would scoff at the sum, even though insurance might reduce the out-of-pocket co-pay to, say, $1,400 a month -- for many, another mortgage. But being told you'll die is calamitous on its face and does not produce entirely reasonable behavior. Doing anything to gain those precious years, including selling one's house or canceling retirement, might look necessary if not sane. That's to say nothing of those without insurance or a house or a planned retirement (4/29).

Sacramento Bee: California's Health Turf War Should Cause Fear
Senate Bills 491, 492 and 493 won approval of a Senate committee Monday and we should all be afraid -- very afraid -- because once again, state legislators are voting on "scope of practice." It means that politics -- sometimes raw politics -- are determining which medical practitioner can perform which procedure on which part of the human body, rather than leaving those decisions in the hands of medical experts. It's not a new phenomenon (Dan Walters, 4/30).

Journal of the American Medical Association: Identification Of Physician Impairment
The need to detect and prevent physician impairment must be balanced with the rights of privacy and autonomy. Patients and their family members have a right to be protected from impaired physicians. In other high-risk industries, this right is supported by regulations and surveillance. Shouldn't medicine be the same? A robust system to identify impaired physicians may enhance the professionalism that peer review seeks to protect (Drs. Julius Cuong Pham, Peter J. Pronovost and Gregory E. Skipper, 4/29).

Medpage Today: Rediscovering The Lost Art Of Civil Discourse
Although we still have a long way to go in reducing waste and addressing a medical error rate that, in any other industry, would not be tolerated, positive change is happening as a direct result of the payment reforms (e.g., bundled payments) and new models of care (e.g., medical homes) that are integral to the ACA (Dr. David Nash, 4/29).

The Medicare NewsGroup: Nobel Prize-Winning Economist Becker Has Seminal Ideas That Are Gaining Favor, But Can They Work?
Even with greater price transparency, how would 65- to 69-year-olds effectively negotiate reasonable medical expenses without the bargaining power of a Medicare or an employer? Would insurers come to their rescue? How would policies for this age group be affordably priced? Would policy premiums need to be subsidized in some way by the government, which would nullify the nominal savings of raising the retirement age? While [Nobel-prize-winning economist Gary] Becker's ideas sound logical and hint at a degree of common sense and equity, the political and everyday reality is much more difficult terrain (John Wasik, 4/29).

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