KHN Morning Briefing

Summaries of health policy coverage from major news organizations

Viewpoints: Health Care ‘Price Gouging;’ Health Law Pushing Employers To Cut Workers’ Hours; Medicare Spending Must Be Tamed

The Wall Street Journal's Corporate Intelligence: America's Doctors Feel The Heat
Steven Brill's cover story on the Looking Glass world of healthcare pricing may be the longest article Time Magazine has ever published, but more importantly, it is a fresh sign that the medical-industrial complex should be worried as the deadline for launching Obamacare rolls closer (Joseph B. White, 2/22).

Bloomberg: Bringing Down Health-Care Costs Isn't Always Complicated
Accustomed as we are to thinking of hospitals as beneficent providers of lifesaving and often charitable care, it comes as a shock to learn how many are engaging in, not to put too fine a point on it, price gouging. As Steven Brill shows in his cover story in this weeks' Time magazine, nonprofit hospitals, even more than for-profit ones, chase 12 percent profit margins with eye-popping markups on everything from cardio stress tests to gauze pads (2/24).

Reuters: Don't Let Doctors' Incomes Derail Healthcare-Cost Reform
In his conclusion, Brill says — again, without adducing any evidence whatsoever — that "we've squeezed the doctors who don't own their own clinics, don't work as drug or device consultants or don't otherwise game a system that is so game able". It's a bit weird, the degree to which Brill cares so greatly about keeping doctors' salaries high: he certainly doesn’t think the same way about teachers (Felix Salmon, 2/24).

Slate: Steven Brill's Opus on Health Care
The analytic core of the article shows that when it comes to hospital prices, who pays determines how high the price is. When an individual patient comes through the door of a hospital for treatment, he or she is subjected to wild price gouging. ... No insurer worth anything would actually pay the crazy-high rates hospitals charge to individuals. But in most markets, the hospitals have more bargaining leverage than the insurance companies, so there's still ample gouging. The best bargainer of all is Medicare, which is huge and can force hospitals to accept something much closer to marginal cost pricing, although even this is undermined in key areas (prescription drugs, for example) by interest group lobbying (Matthew Yglesias, 2/22). 

The New York Times: Overcoming Obstacles To Better Health Care
Unfortunately, no single change will transform our health care delivery system into one that we can afford. We are going to have to try lots of new approaches that depart from standard practices. I have several suggestions that I think would help, including an experiment that would require a change in either state or federal regulations: giving some high-quality health care providers the opportunity to practice in a world without malpractice lawsuits (Richard H. Thaler, 2/23).

The Wall Street Journal: ObamaCare And The '29ers'
Welcome to the strange new world of small-business hiring under ObamaCare. The law requires firms with 50 or more "full-time equivalent workers" to offer health plans to employees who work more than 30 hours a week. (The law says "equivalent" because two 15 hour a week workers equal one full-time worker.) Employers that pass the 50-employee threshold and don't offer insurance face a $2,000 penalty for each uncovered worker beyond 30 employees. So by hiring the 50th worker, the firm pays a penalty on the previous 20 as well (2/22).

USA Today: Medicare Spending Makes Me Ill
I'm no expert on Medicare, but I've seen enough recently of what it's paying for to gain a clear and troubling insight into why it's projected to go broke in just 11 more years. What I've witnessed makes me want to scream a plea that when the politicians in Washington debate entitlement reform in the coming weeks, they'll muster enough backbone to do something about it (Don Campbell, 2/24).

Los Angeles Times: D.C. Doubles Down On The Sequester
Most Americans do want to cut federal spending in general. But when it comes to individual programs, they want to protect them. The Pew poll found that a majority favored cuts in only one area: foreign aid. Most respondents didn't want cuts in education, healthcare, unemployment benefits or defense. That's why the administration has offered deliberately dramatic forecasts of what spending cuts could mean, from canceled military operations and reduced Border Patrol surveillance to fewer AIDS tests, fewer children in Head Start and even potential meat (Doyle McManus, 2/24).

The New York Times: Violent, Drunk and Holding a Gun
But a focus on mass murder, while critical, does not get at the broader issue of gun violence, including the hundreds of single-victim murders, suicides, nonfatal shootings and other gun crimes that occur daily in the United States. And focusing on the mentally ill, most of whom are not violent, overlooks people who are at demonstrably increased risk of committing violent crimes but are not barred by federal law from buying and having guns. These would include people who have been convicted of violent misdemeanors including assaults, and those who are alcohol abusers. Unless guns are also kept from these high-risk people, preventable gun violence will continue (2/23).

The New York Times: The Next Frontier Is Inside Your Brain
The Obama administration is planning a multiyear research effort to produce an "activity map" that would show in unprecedented detail the workings of the human brain, the most complex organ in the body. It is a breathtaking goal at a time when Washington, hobbled by partisan gridlock and deficit worries, seems unable to launch any major new programs (Philip M. Boffey, 2/23).

Arizona Republic: Flawed System Needs Reform
Severely troubled. Addicted. Emotionally unstable. These words describe some of Arizona's most challenged youths. In-depth reporting by The Arizona Republic's Craig Harris and Rob O'Dell and, earlier, Channel 12's Wendy Halloran found the residential treatment centers where some of these kids wind up have their own challenges. In their series of investigative stories that concludes today, Harris and O’Dell found lax oversight, poor record-keeping, and a lack of transparency about what goes on inside the facilities. There are also questions about whether residential treatment is the best option for these troubled kids  (2/23). 

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