KHN Morning Briefing

Summaries of health policy coverage from major news organizations

Viewpoints: AIDS Spread In U.S. South; Abortion Opponents Battle In Ariz.; GOP’s Costly Effort To Kill Health Law

Los Angeles Times: AIDS – The South's Shame
More than 30 years into the AIDS epidemic, a combination of safe-sex education and a new generation of pharmaceuticals has left many Americans convinced that HIV/AIDS is a problem that has been, if not solved, at least addressed. But that's certainly not true in the American South, which accounts for nearly 50% of all new HIV infections in the United States (Lisa Biagiotti, 7/26).

McClatchy Newspapers: We Need To Be More Strongly Committed To End AIDS
On July 23, at the 19th annual International AIDS Conference, held in Washington, D.C., Secretary of State Hillary Clinton said the Obama administration is committed to creating an "AIDS-free generation." But we're a long way from that here at home - especially in the black community. African Americans represent half of all new HIV/AIDS cases in the United States. And if black America were a country, it would have the 16th-highest HIV/AIDS epidemic rate in the world. The biggest obstacle is the myth that AIDS is cured (Akilah Bolden-Monifa, 7/25).

Baltimore Sun: AIDS Conference Reflects Baltimore's Strategy For Containing The Epidemic
The city wants to launch a … public health campaign aimed at gay and bisexual black men, but it has had difficulty persuading the Maryland Transit Authority to allow the display of some ad posters in the city buses it operates. One poster, aimed at the underground gay "ballroom" subculture in which young gay men compete in elaborate, costumed dance contests, has been deemed inappropriate by the MTA because it's slogan — "HAVE BALLS. GET TESTED." — contains a double entendre that transit officials rejected as too risque. … At a time when the whole world is focused on testing, treatment and prevention as the front lines of the global struggle against AIDS, Baltimore should be leading the effort to find and identify those most at risk. It shouldn't have to fight the MTA on top of the disease in order to get its message out (7/25).

The New York Times: Anti-Abortionists On Trial
The state-by-state assault on women’s rights and the Constitution by Republicans faced an important challenge on Wednesday in Phoenix, where plaintiffs in a federal lawsuit are trying to block an extreme Arizona anti-abortion law from taking effect next week (7/25).

Des Moines Register: Report Trips Up GOP On Health Reform
Opponents of the health reform law say it will drive up the federal deficit and debt. Presidential candidate Mitt Romney claims it will do so by "trillions" of dollars. … There's one problem: Repealing the law will make the federal government’s financial situation worse. That little nugget of truth comes this week from the nonpartisan Congressional Budget Office (7/25).

Milwaukee Journal Sentinel: Repeal Health Care Law? Go Ahead, Bust The Budget
The American way of health care with its historical emphasis on a fee-for-service model that encourages quantity over quality needs to change. And the best way to start is by building on the ideas expressed in the new health care law - and improving those ideas as experience dictates. Simply repealing the law without a good alternative would be the real budget buster (7/25).

Houston Chronicle: U.S. Lifestyles to Blame For High Health Costs
The conclusion drawn by many, and especially supporters of the ACA, is that this higher cost is evidence of an inefficient delivery system. That may be, but there are other, and I would argue more cogent, reasons why our health care tab is so much higher. ... There is no doubt that our health care costs are on an unsustainable trajectory. The effect the ACA will have on that trajectory is anyone's guess. But I seriously doubt it is going to have much effect on Americans' dietary habits, the incidence of diabetes, our penchant for cosmetic surgery or our cultural choices around end-of-life decisions (Bill King, 7/25).

Journal of the American Medical Association: The Battle For Control Of Medical Care
Suppose you could change the entire spectrum of care for the patients in your practice so that it matches what you believe to be best: people get the care they need when they need it, and care that is wasteful or duplicative is eliminated. As a result of this, people would receive higher-quality medicine. Would medical spending rise or fall? I have asked this question to a large number of physicians, in groups large and small. The sample is an informal one, to be sure, but the conclusions are common: the typical doctor guesses that medical spending would fall by 25% to 40% if the medical system worked better (David M. Cutler, 7/25).

The New York Times: What We Can Learn From Third-World Health Care
With all the most advanced technology and equipment, spending far more on health care than any other nation — a whopping $2.6 trillion annually, or over 17 percent of our gross domestic product — the United States consistently underperforms on some of the most important health indicators. Our infant mortality rates, for example, are worse than those in countries like Hungary, Cuba and Slovenia. Our life expectancy rates are not much better; in global rankings, we sit within spitting distance of Cuba, Chile and Libya. This quality conundrum dogs us, even as our best and brightest have tried to imagine a more cost-efficient system (Dr. Pauline W. Chen, 7/26). 

The New York Times: The Story So Far
History may someday settle on one of the competing and contradictory narratives now running rampant within the virtual Beltway to explain the decision by Chief Justice John G. Roberts Jr. to save the Affordable Care Act. Since that day seems far off, here in quick summary are the emerging story lines (Linda Greenhouse, 7/25).

Boston Globe: Health Reform Bill Needs To Protect Community Hospitals
From world-class teaching hospitals and cancer research centers to neighborhood health clinics and community hospitals, Massachusetts' healthcare providers come in all shapes and sizes. And just as doctors know that what works for one patient doesn’t necessarily work for another, the Massachusetts Legislature must realize that regulations aimed at containing healthcare costs can't be a one-size-fits-all approach (Michael V. Sack and Kevin F. Smith, 7/25).

The Billings Gazette: Consider Options To Cover Montana's Uninsured
Since the Supreme Court ruled that Medicaid expansion is optional for states, Montana leaders ought to negotiate with the federal government for flexibility. Maybe the state can set up an adult program similar to CHIP. Perhaps, the state could do a pilot program enrolling some low-income adults in private insurance plans with low out-of-pocket costs and the state paying the premiums. Most Montana Medicaid spending is on elderly and disabled people. Montanan's uninsured are predominantly young adults who will cost much less per person than the Medicaid population already covered (7/24).

Sacramento Bee: Should States Opt Out Of Medicaid Expansion In Health Care Reform? Yes.
It's probably too much to ask Gov. Jerry Brown and a Democratic Legislature to rethink what, at a superficial glance, looks like a pretty deal for states. But the proposed Medicaid expansion under Obamacare harbors risks that California and other struggling state governments can ill afford. ... What's to stop a Congress facing ever-greater pressure to cut the budget deficit and control a multitrillion-dollar debt from reducing Medicaid subsidies further, placing an even heavier burden on the states? (Ben Boychuck, 7/26).

Sacramento Bee: Should States Opt Out Of Medicaid Expansion In Health Care Reform? No.
It would be a cruel joke, indeed, if holdout states abandoned childless adults who have little or no income. ... The federal government will pick up 100 percent of the cost for the newly eligible individuals the first three years; that rate gradually decreases to 90 percent by 2020. That's a whole lot better than the 50 percent to 83 percent the federal government pays today – and every state finds it beneficial to participate (Pia Lopez, 7/26).

Baltimore Sun: Flexibility Needed For Affordable Care Act Medicaid Requirement
Twenty million Americans live at or below the federal poverty line and are uninsured. The Supreme Court ruling on the Affordable Care Act (ACA) could leave many without access to affordable health insurance — but only if we let ideological warfare triumph over practical policy solutions. The court upheld the Medicaid expansion under the ACA as constitutional but stated that the federal government cannot punish states that opt out of this provision by taking away existing Medicaid funding for current enrollees. Some state officials now say that they plan to opt out of the Medicaid expansion. In the ongoing theatrics and shrill debates over health reform, it is hard but necessary to declare a ceasefire and develop a "peace plan" (Jack Meyer and Karoline Mortensen, 7/25).

The Lund Report:  Good News And Bad News For Oregon’s Dual Eligibles
Two weeks ago, Oregon was granted a federal waiver to conduct a demonstration that will change our state’s Medicaid managed care model to a coordinated care delivery model. This waiver firmly sets Oregon on the course to better health care and to take advantage of the 2013 Medicaid expansion financing available in the Affordable Care Act. But it also harbors a not-so-good option for our state's most vulnerable, or those individuals who are eligible for both Medicaid and Medicare coverage, often referred to as dual-eligible patients (Chris Bouneff, 7/25).

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