Viewpoints: Wilensky on bipartisan Medicare reform; Mass. 2006 health law and 2012 GOP politics; Reinstating advanced care planning

Mar 9 2012

The Wall Street Journal's Political Diary: Exit Poll Statistic Of The Year
The Super Tuesday exit polls yielded a mountain of data in 10 states, but the most telling single statistic may have been in Massachusetts, which Mitt Romney won in a largely uncontested rout. Yet believe it or not, he still lost on health care. The exit poll asked voters their opinion of the "Massachusetts Health Care Law," with the options of Did Not Go Far Enough, About Right and Went Too Far. Remarkably, 51% said the bill went too far, while only 37% said it was about right, and 6% said not far enough. ... the result reveals how unpopular government-mandated health care is, even in its Massachusetts birthplace (Paul A. Gigot, 3/7).

The Wall Street Journal: Santorum And Freedom 
[W]hen he tore into ObamaCare, his mostly working-class audience exploded into applause and cries of "Rick! Rick! Rick!" Mr. Santorum didn't get this response by discussing health-insurance exchanges and guaranteed issue. He told these people that ObamaCare "is usurping your rights. It is creating a culture of dependency." ... His call for repeal produced the explosion  (Daniel Henninger, 3/8).

The Washington Post: A GOP Campaign That No One Seems Able To Win
The fact that none of (Mitt) Romney's opponents had turned up the July 2009 op-ed he penned for USA Today, in which he called for a national health insurance plan that included an individual mandate -; a column that all but neutralizes any Romney attack on Obamacare -; is further confirmation that their campaign operations are stunningly incompetent (Harold Meyerson, 3/7).

Modern Healthcare: Over The Top And Into The Political Woods
For nearly a year now, Democrats have repeated a phrase ad nauseam to describe their take on House Budget Committee Chairman Paul Ryan's plan to privatize the Medicare program. "It's the end of Medicare as we know it," they've said. After listening to some remarks that GOP presidential hopeful Rick Santorum gave last night, I wonder if he might steal that phrase and make it his own. ... like: "Obamacare: The end of freedom as we know it" (Jessica Zigmond, 3/8).

Boston Globe: Taking Measure Of Health And Wealth
Because of Romney's leadership in Massachusetts, Ann Romney could not be denied health insurance because of a pre-existing condition [MS]. In other states, she could be. That would change under the national health care reform act. ... Does Romney really want to stop that, as he salutes the right by promising to repeal Obamacare? (Joan Vennochi, 3/8).

Journal of the American Medical Association: Seven Provocative Principles For Health Care Reform
This Viewpoint accordingly sets out 7 principles for broad health care reform ... There is no perfect health care system. ... Simplicity in legislation and regulation trumps complexity. The more changes that are made concurrently, the greater the risk of unintended consequences.  ... Every efficient health care system imposes caps on spending and engages in strategic rationing (Dr. C. David Naylor and Karline Treurnicht Naylor, 3/7).

New England Journal of Medicine: Directions For Bipartisan Medicare Reform
Even those who most celebrate Medicare's success in expanding seniors' access to care generally agree that the program provides too much uncoordinated, fragmented care to a population primarily characterized by chronic disease. There are important differences of perspective regarding how best to transform the delivery system and who should lead that transformation, but the disillusionment and frustration with the current reimbursement system could not be stronger. ... areas of agreement are developing, even in these most partisan of times. Sometimes it's important to celebrate even these small, interim successes (Gail R. Wilensky, 3/7).

New England Journal of Medicine: Slower Growth In Medicare Spending -; Is This The New Normal?
On the whole, we do not believe that the recent slowdown in Medicare spending growth is a fluke. There has been a long-term trend toward tighter Medicare payment policy, and policy changes that began in the middle of the 2000s have continued that tightening. ... We see a combination of reformed delivery of care and broader units of payment as having the potential to allow providers to generate savings through steps that are less threatening to quality of care and access than are cuts in payment rates (Chapin White and Paul B. Ginsburg, 3/7).

The Kansas City Star: Stop The Rush Toward Risky Medicaid Change
A sizable and bipartisan group of Kansas lawmakers on Wednesday called on Gov. Sam Brownback and Lt. Gov. Jeff Colyer to slow down their plans to hand the care of the state's Medicaid patients over to private insurance companies....  coordinated care, if done well, could prevent hospitalizations and nursing home stays and serve patients better. But the fears of lawmakers, medical professionals and defenders of vulnerable Kansas citizens are well-founded. A six-month delay and some sensitivity to the needs of disabled citizens are not too much to ask (3/7). 

Georgia Health News: Challenge For Pharma Firms: Funding For HIV Research
[D]espite the continuing importance of developing HIV vaccines, a range of research groups and small biopharma companies are finding challenges in obtaining the amount of funding that is required to conduct effective research and clinical trials. ... there are certain factors behind the roadblocks currently faced by small biopharma companies engaged in HIV/AIDS vaccine research.  An enhanced recognition of these and other factors could lead to a more suitable level of funding for a disease that still threatens millions worldwide (Robert McNally, 3/7).

The Seattle Times: K-12 Health-Insurance Reforms Are Part Of Long-Term State Budget Stability
Washington's pernicious state budget deficits will persist until known, expensive problems are boldly confronted. A prime example is the cozy system that provides health insurance and other benefits for teachers and other public-school employees. A credible alternative exists, and it is being fiercely resisted (3/7).

The Seattle Times: Planning For Old Age At A Premium
Care is expensive. I had no idea how costly until my wife and I began to deal with parents who needed it. ...There are good places out there, but they're harder to get into and usually cost more. Some of the most desirable places take Medicaid clients, but placements are limited. ... he problem of what to do with old people who need help is a creation of modern society that we haven't committed ourselves to solving (Jerry Large, 3/7).

Journal of the American Medical Association: The Retreat From Advanced Care Planning
To repair the harm done by discussion of death panels and by the administration's apparent retreat on this issue, this important patient need must be depoliticized. This is an opportunity for medical organizations to advocate for something other than higher reimbursements and reduced administrative burdens for their members. Medical organizations and patient advocacy groups should demand that politicians across the spectrum stay out of the patient-physician relationship. These groups also should encourage interested patients to participate in advanced care planning, recognizing that not every patient will want to do so (Dr. Mary E. Tinetti, 3/7).

Journal of the American Medical Association: Time To Revise The Approach to Determining Cardiopulmonary Resuscitation Status
In US hospitals, cardiopulmonary resuscitation (CPR) is the de facto default option-;patients must "opt out" by requesting or consenting to a do-not-attempt-resuscitation order. Despite its worthy intent, requiring all patients or their surrogates to consent to a do-not-attempt-resuscitation order to avoid CPR has resulted in an ethically unjustifiable practice that exposes many patients to substantial harms (Dr. Craig D. Blinderman, Dr. Eric L. Krakauer and Mildred Z. Solomon, 3/7).