Today's OpEds: Health reform and long-term care; Health care incentives; Reasons for optimism or repeal and replace?

Reform Eases Long-Term Health Care Woes The San Francisco Chronicle
Our system of long-term care does not provide adequate or coordinated human services and medical treatment for our growing aging population. … Thanks to a provision of the new health care law known as the Community Living Assistance Services and Supports program, tomorrow's continuum of care does not have to be so unforgiving. For the first time, a voluntary public insurance program will be available to help adults and families pay for long-term care services (Bruce Chernof, 7/23).

Ensuring Success Modern Healthcare
Our current healthcare system is full of competent and caring doctors, nurses and other healthcare professionals working hard to do right by their patients. But the system as a whole just isn't delivering what patients or providers need. Dysfunctional incentives create fragmentation and fail to address the underlying drivers of disease. In addition, far too many decisions are now in the hands of insurance companies, not doctors and patients. What we need is an approach to healthcare delivery that is coordinated and patient-centered. And we need to keep people from getting sick in the first place (Health and Human Services Secretary Kathleen Sebelius, 7/26).

Harnessing Health Technology The Baltimore Sun
After more than a year of deliberation, the Centers for Medicare & Medicaid Services recently announced its final rule on the "meaningful use" of health information technology, effectively opening the door for physicians and hospitals to receive more than $18 billion in incentives set aside in last year's massive economic stimulus bill. This is a laudable example of federal recovery spending being matched with a public policy goal that, as of yet, hasn't been achieved by the private sector and market forces: transforming our nation's costly and often inefficient health care delivery system through the widespread adoption of new technology (David Horrocks and Murray Kalish, 7/25).

Reason For Optimism Modern Healthcare
The process by which the Patient Protection and Affordable Care Act became law was quite partisan, but much of the new law is not partisan at all. In fact, I am amazed that, despite the process, Congress managed to finally get the policy goals right (David Durenberger, 7/26).

When A Drug Fails The New York Times
The flameout of an enormously expensive drug to treat advanced breast cancer will pose a critical test for the Food and Drug Administration. Will the agency have the courage to reverse course when a medical treatment that it approved based on preliminary evidence flops badly in follow-up studies? … The F.D.A. has rarely removed drugs that were given accelerated approval and sometimes has failed even to compel completion of follow-up studies. But there are signs it may get tougher (7/25).

Publish Data On Drug Trials - Even When It's Not Flattering The Boston Globe
Lurking beneath some of the biggest prescription drug scandals of our time is the specter of unflattering data that was known to pharmaceutical companies and could have revealed problems sooner had it been made public. Now, an international federation of drug manufacturers, whose members include the industry's main players, has pledged to submit most clinical trial results for publication in peer-reviewed journals, whether the outcome is positive or negative. … But it will work only if there is a concerted effort by companies, journals, and regulators to ensure that all trials are published, and in a timely manner (7/26).

Where Are The Innovators In Health Care Delivery? Kaiser Health News
Almost everyone believes there is an enormous amount of waste and inefficiency in health care. But why is that? In a normal market, wherever there is waste, entrepreneurs are likely to be in hot pursuit — figuring out ways to profit from its elimination by cost-reducing, quality-enhancing innovations. Why isn't this happening in health care? As it turns out, there is a lot of innovation here. But all too often, it's the wrong kind (John Goodman, 7/26).

Reforming Health Care So Doctors Can Take Care Of Patients The Denver Post
For too long, our health care system has been based on a payment structure that incentivizes the quantity rather than the quality and value of care. Neither doctors nor patients benefited from this system, which led to needless tests, higher costs, shorter time with patients, and sometimes harmful medical decisions. … The health reform law takes the first steps to change our payment system to one that allows doctors to provide quality care to their patients without having to worry about whether a patient is funded or their practice's bottom line (Frederick Grover Sr., 7/24).

Something To Repeal And Replace Modern Healthcare
Of course, healthcare reform is now the law of the land. That, everyone must agree—for better or worse—is a fairly significant difference. But as far as the reform rhetoric, the beat goes on. It's essentially the same old song in many circles. … As U.S. healthcare reform rolls out, let the debate continue over how to fine-tune healthcare delivery. But it's the over-the-top rhetoric that deserves to be repealed and replaced (David May, 7/26).

Mental Health Coverage Progresses The Chicago Tribune
At the federal government's insistence, employers are owning up to what many workers have been saying for years: Mental health and substance abuse issues are medical conditions that should be covered by insurance like any other ailment. Under the Mental Health Parity and Addiction Equity Act, passed in 2008 but only now making its way into the workplace, treatment limits for substance abuse and mental health conditions such as depression are being lifted. The change, experts say, should benefit everyone in the workplace (Ann Meyer, 7/26).

Looking Back On 20 Years Of Disability Rights NPR
When I was younger, it was legal to discriminate against people like me. I was born with spinal muscular atrophy. I've always used a wheelchair, and my hands are too weak to scratch an itch. … Now, the ADA's impact is everywhere: wheelchair lifts on city buses, signs in Braille, sign-language interpreters. Many young disabled people are growing up with a marvelous sense of belonging, entitlement and pride I never had. Yes, there is still a long way to go. Yet in redefining the terms of disability, the ADA made us impossible to ignore. So now people should understand we're just part of the human landscape, and we're here to stay (Ben Mattlin, 7/26).

ADA At 20: A Nation Transformed Politico
The Americans with Disabilities Act - signed into law on July 26, 1990 - has been described as the Emancipation Proclamation for people with disabilities. … But at its heart, the ADA is simple. In the words of one activist, this landmark law is about securing for people with disabilities the most fundamental of rights: "the right to live in the world." It ensures they can go places and do things that other Americans take for granted (Sen. Tom Harkin, 7/26).

Pension Envy In California Los Angeles Times
California doesn't have just one pension crisis, it has two. In the public realm, generous pensions and retiree health benefits have triggered a crisis as elected leaders try to square expensive promises with the realities of diminished revenues and investment losses. In California, commitments to retired state workers are now crowding out crucial investments in education, health and infrastructure. In the private realm, it's a lack of pensions that is the problem (Mark Paul and Micah Weinberg, 7/25).

Should Hippocratic Oath Include Pledge Not To Plagiarize? The Seattle Times
Last week, the Los Angeles Times reported on a study that examined the degree to which candidates for ophthalmology residency programs fudged their résumés by exaggerating — or outright inventing — their role in medical research projects. … Researchers from Brigham and Women's Hospital, Massachusetts General Hospital and Harvard Medical School now are addressing a different sort of fraud — plagiarism. They wonder how often aspiring physicians copied the "personal statements" that are an influential part of the application for any residency program (Karen Kaplan, 7/25).

Nibbling Away At Privacy Worcester, Mass., Telegram & Gazette
Is Big Brother watching you? More to the point, could Big(gest) Brother soon be watching your waistline? The federal government is pushing for all Americans' health records to be electronic by 2014. … Last week, the government issued regulations stipulating that Body Mass Index must be calculated and displayed in those electronic health records. … As health care changes unfold, officials and individuals must strive to keep the belt tight on individual privacy. This is more significant than any BMI score will ever be. If you're roly-poly or skinny as a rail, that's between you and your physician, not a bloated and prying Uncle Sam (7/25).

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This article was reprinted from khn.org with permission from the Henry J. Kaiser Family Foundation. Kaiser Health News, an editorially independent news service, is a program of the Kaiser Family Foundation, a nonpartisan health care policy research organization unaffiliated with Kaiser Permanente.