KHN Morning Briefing

Summaries of health policy coverage from major news organizations

Viewpoints: Mental Health Care For Vets, Perry On Federal Spending, Cain’s Views On Abortion

The New York Times: While Veterans Wait
The Veterans Affairs Department has devoted much effort and money to improve and expand its mental health care, especially for those coming home from Iraq and Afghanistan with post-traumatic stress disorder and brain injuries. But continuing reports of drug dependency, suicides and suicide attempts among veterans and active-duty soldiers suggest that urgent needs remain vast and unmet. So do persistent accounts from veterans who say they spend months waiting for mental health care (10/24). 

The Washington Post: Ending Drug Companies' Pay-For-Delay Deals
An upcoming report by the Federal Trade Commission shows that brand-name pharmaceutical makers continue to cut questionable deals with generic manufacturers that delay the introduction of cheaper drugs onto the market. Such pay-for-delay arrangements hurt consumers and increase costs for federal programs such as Medicare and Medicaid, according to the report, a copy of which was obtained by the editorial board. These deals are not illegal, but they should be (10/24). 

The Wall Street Journal: My Tax And Spending Reform Plan
On Tuesday I will announce my "Cut, Balance and Grow" plan to scrap the current tax code, lower and simplify tax rates, cut spending and balance the federal budget, reform entitlements, and grow jobs and economic opportunity. … ObamaCare, Dodd-Frank and Section 404 of Sarbanes-Oxley must be quickly repealed and, if necessary, replaced by market-oriented, common-sense measures. America must also once and for all face up to entitlement reform (Rick Perry, 10/25).

Des Moines Register: Cain's Refreshing View Soon Disappears
Republican presidential candidate Herman Cain was briefly refreshing on the issue of abortion — before he later went on to "clarify" his views. His initial stance is one other members of his party should adopt. It is in keeping with a core principle they say they embrace: less intrusion of government in Americans' personal lives and health care decisions. During an interview on CNN last week, Cain stated he was opposed to abortion. Yet when asked about cases of rape and incest, he went on to say it's not the government's role to make decisions for people about such a sensitive issue (10/24). 

Forbes: Rationing Hospital Care May Be The Only Way To Keep Medicaid Intact
Facing chronic budget shortfalls, several states are grappling with the uncomfortable proposition of how to match their dwindling Medicaid resources with the vast demands placed on the state-run programs. According to a report in USA Today, several states want to limit the number of days their Medicaid programs would allow recipients to stay in the hospital. ... States defend the actions as a way to balance budgets hammered by the economic downturn and the end of billions of dollars in federal stimulus funds this summer that had helped prop up Medicaid, financed jointly by states and the federal government (Larry Van Horn, 10/24). 

Market Watch: COLA Is Much Ado About Nothing
If you are counting on seniors to help jump-start the economy because of the Social Security cost of living adjustment (COLA) they are scheduled to receive early next year — forget about it! This increase is not as good as it looks. ... To make matters worse, some seniors in the Medicare prescription drug program will actually see their monthly benefit payments shrink. This is because Medicare Part B premiums, which are deducted from Social Security payments, are expected to increase because of soaring health care costs, and the rise could be a double-digit one at that (Irwin Kellner, 10/25).

The Texas Tribune: Guest Column: Better Care, Thanks to Tort Reform
Eight years ago, Texas was in the throes of an epidemic of lawsuit abuse. High numbers of meritless lawsuits, combined with excessive awards, caused doctors' medical liability rates to double within just four years. ... Since 2007, Texas has consistently licensed 60 percent more new doctors each year than occurred in the years predating tort reform (Dr. Howard Marcus, 10/24). 

The Texas Tribune: Guest Column: No Better Care, Thanks to Tort Reform
In 2006, Dr. Howard Marcus wrote that Texas’ 2003 tort reform statute sparked an "amazing turnaround" in which doctors came to Texas in droves, instead of leaving the state as they had before. He was doubly wrong. ... In 2002, Texas had 61 fewer (direct patient care) physicians per 100,000 residents than the average state. In 2010, Texas lagged the average state by a whopping 76.5 doctors per 100,000 residents (Charles M. Silver, 10/24).

Minneapolis Star Tribune: Research On Antidepressant Use Offers Some Surprises
A near 400 percent increase in antidepressant use among Americans makes it hard to argue that the drugs are under-utilized. … But it's not high usage that most worries [study author Laura] Pratt. It's low usage. Her study also found that only one-third of people with severe depression are getting the medication and treatment they need. Many are young, poor or minorities (Gail Rosenblum, 10/24).

(New Orleans) Times-Picayune: Fix Jefferson Community Health Care Centers Clinic Administration
Last year, legislative auditors found numerous financial irregularities at the Jefferson Community Health Care Centers, and officials vowed to fix them. But a new audit has concluded the agency still has "significant deficiencies" in its accounting, and that's appalling (10/24). 

iWatch News: The Staying Power Of Junk Health Insurance
Among those who clearly don’t believe those plans are headed for extinction are the insurance companies that market these highly profitable plans and the employers that buy them — primarily restaurant chains and retailers with high employee turnover. If I were President Obama, I would send one of my aides to the Chicago suburbs later this week to see first-hand just how determined these companies are to continue selling these plans — which are euphemistically called "mini-med" and "limited-benefit policies" — long past 2014 (Wendell Potter, 10/24).

Archives of Internal Medicine: Screening: Comment On "Likelihood That a Woman With Screen-Detected Breast Cancer Has Had Her 'Life Saved' by That Screening"
What can clinicians do to break this cycle of overdiagnosis and combat misinformation about the benefits of medical procedures like mammography generated by survivor stories and celebrity endorsements? (An accompanying study by) Welch and Frankel point out that the appeal of survivor accounts is that they are simple and persuasive: Get tested, get treated, it can save your life — it did mine. ... For women aged between 40 and 50 years or women older than 74 years, where the balance between benefits and harms is a close call or not adequately known, providers should ensure that the patient does not have an overly inflated perception of the benefits of screening" (Dr. Timothy J. Wilt and Melissa R. Partin, 10/24). 

Archives of Internal Medicine: The Decisive Moment: Comment on "Primary Care Utilization and Colorectal Cancer Outcomes Among Medicare Beneficiaries"
It is equally important to confront the looming shortage of (primary care physicians), especially since the number of Americans older than 65 years is projected to double between now and 2030. ... Until the factors that have so effectively driven idealistic young physicians away from primary care for the past 30 years are addressed — income and status inequality, profound work-life imbalance, and a reimbursement system that fails to recognize or reward the onerous burden of care coordination — our workforce crisis will persist. ... in many U.S. health care settings, only 10 percent of physicians are providing "generalist" services (Dr. Asaf Bitton and Dr. Joseph Frolkis, 10/24).

Archives of Internal Medicine: Industry Payments to Physicians
Under provisions of the Patient Protection and Affordable Care Act, drug and medical device manufacturers must publicly disclose gifts and payments to physicians and teaching hospitals, with certain exemptions and provisions for delayed reporting of payments for research or product development. ... With mandatory disclosure of payments and amounts imminent, there should be many new opportunities to better control conflicts of interest in medicine (Dr. Robert Steinbrook, 10/24).

Roll Call: What Happens if the Super Committee Fails?
What happens if, as I and many others increasingly suspect, the super committee isn't able to agree to a deficit reduction plan, if the plan it agrees to is substantially less than what's required ($400 billion is the number being mentioned most often these days) or if — also as I and many believe — the full House and Senate are unable to pass what's recommended? ... The answer is far less than anyone is predicting, promising, threatening or perhaps hoping (Collender, 10/25). 

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