Viewpoints: ‘Passing The Buck’ On Medicaid; Sharing Patient Records; Rick Scott’s Lawsuit
A selection of opinions on health care from around the country.
The Washington Post:
Passing The Buck And Hurting The Poor
Limiting federal funding on Medicaid spending would indisputably accomplish one objective: Limiting federal funding on Medicaid spending. But that’s it. It won’t make the growing costs of the program magically disappear. It would just dump them onto someone else’s doorstep, in this case the states’, which are likely less equipped to deal with complex management and cost control given their smaller scale. State governments would either have to contribute more of their own funds or, more likely, institute deep cuts to poor beneficiaries and the providers that serve them. Medicaid already spends so little per beneficiary — about 27 percent less for children, and 20 percent less for adults, than private insurance does on similar patients — that further cuts would almost certainly cause providers to exit the program, reducing access to care. (Catherine Rampell, 4/16)
The Washington Post:
Are Medicare Improvements Finally On The Horizon?
On the plus side, Congress did away with an outmoded and increasingly unrealistic formula for reimbursing doctors that had necessitated time-consuming annual “doc fixes.” And yes, lawmakers achieved this long-postponed reform on a bipartisan, bicameral basis, with the White House on board as well. But the legislation is hardly the hammer blow for fiscal responsibility that supporters claim; in fact, it will add $141 billion to the projected deficit over the next decade because the two parties could not agree on enough offsetting savings elsewhere within Medicare. ... Nevertheless, there is a kernel or two of incipient structural reform tucked into the measure. (4/16)
Bloomberg:
Entitlement: Why The U.S. Can't Keep Costs Down
Here’s why it’s hard for the U.S. government to keep its costs down: Seniors and the very poor are entitled by law to almost half its money. Congress can trim other expenses, and automatic budget cuts and the cessation of two U.S. wars have slowed spending growth. But Social Security, Medicare and Medicaid are exempt from budget wrangling and are growing. (Toluse Olorunnipa and Roger Runningen, 4/16)
The New York Times:
Roadblocks To Sharing Medical Records
The ability to transfer electronic medical records from one doctor or hospital to another is essential to the smooth functioning of the health care system and to providing the best possible care to patients. Yet all too often these transfers are being blocked by developers of heath information technology or greedy medical centers that refuse to send records to rival providers. (4/16)
The Washington Post Plum Line:
Rick Scott Has An Easy Way Out Of His Medicaid Mess
[Florida Gov. Rick] Scott is demanding that the federal government continue the LIP program, and is professing outrage that the feds may withdraw funding that would give “poor families access to the safety net health care services they need.” But he won’t accept the Medicaid expansion money that might accomplish that goal more effectively: LIP money does not give people insurance; it largely pays hospitals for care sought by people who can’t pay for it. Scott claims the feds might not make good on their promise to fund the Medicaid expansion, but Scott previously backed the expansion, and state Senate Republicans say their proposal to expand Medicaid would explicitly end the program if the feds reneged. (Greg Sargent, 4/16)
Arizona Republic:
New Arizona Law Puts Subsidized Health Insurance At Risk
[Gov. Doug] Ducey last week signed House Bill 2643, which forbids Arizona setting up its own Affordable Care Act health exchange. The bill has little immediate impact on the Arizona residents who get coverage through the federal marketplace, but it could have a big impact in a few months. In June, the U.S. Supreme Court is expected to rule in King vs. Burwell, a case that examines whether subsidies are allowed for people who buy health insurance through the federal marketplace or should be limited to states that run their own insurance exchanges. (Alltucker, 4/16)
Los Angeles Times:
A Sensible Cap On Costly Prescription Drugs
To help [patients with chronic medical conditions] spread out their bills in a more manageable way, the state's insurance exchange, Covered California, may require insurers to cap the monthly cost of each expensive specialty prescription at $500. That's a step in the right direction, but it doesn't go far enough to make sure those ailing Californians can afford the medicines they need. Lowering the cap to $200 would provide significantly more help, and given the limited number of people who need the help, the cost to other policyholders is expected to be minimal, according to a report by an independent actuary. (4/16)
New England Journal of Medicine:
Protection Or Harm? Suppressing Substance-Use Data
What if it were impossible to closely study a disease affecting 1 in 11 Americans over 11 years of age — a disease that's associated with more than 60,000 deaths in the United States each year .... These questions are not rhetorical. In an unannounced break with long-standing practice, the Centers for Medicare and Medicaid Services (CMS) began in late 2013 to withhold from research data sets any Medicare or Medicaid claim with a substance-use–disorder diagnosis or related procedure code. This move — the result of privacy-protection concerns — affects about 4.5% of inpatient Medicare claims and about 8% of inpatient Medicaid claims from key research files ... impeding a wide range of research evaluating policies and practices intended to improve care for patients with substance-use disorders. (Austin B. Frakt and Nicholas Bagley, 4/16)