Viewpoints: Wis. Medicaid dilemma; an army doc's Rx for cutting costs; Rep. Boren on repeal

The New York Times: Government By The Week
These slipshod exercises in governance were choreographed by House Republicans, who knew that neither the Senate nor President Obama would ever accept their original proposal to gut nonsecurity discretionary spending with $61 billion in cuts through September, including riders to end financing for Planned Parenthood and the health care law. They had hoped to use the pressure of a potential shutdown to achieve much of their goal, but, so far, all they have accomplished is a cut of about $10 billion, mostly from earmarks or programs that the president himself proposed to cut (3/15). 

Politico: Why I Voted To Repeal Health Reform
We are one year removed from the passage of the Affordable Care Act and nearly two months past a vote in the House to repeal it. Since that first vote was cast, my constituents remind me at every town hall meeting I hold that they are overwhelmingly opposed to this law. ... The most disappointing aspect of the health care reform debate is the fact that a majority of Americans support several reforms that Congress could have addressed in a bipartisan and incremental way (Rep. Dan Boren, 3/16). 

The Hill: Reforming Defense Healthcare
Twenty years ago, a small group of us proposed an alternative to the plan that still prevails today. ... we conducted pilot programs — Gateway to Care — that showed that we could provide managed healthcare services more effectively and efficiently as physician leaders.  ... In contrast, military healthcare currently suffers from split responsibilities between military providers, the services, and insurance carriers; obstacles in sharing data between the provider groups; and complicated financial arrangements. It is cumbersome, complicated and directly contributes to the exorbitant increases in cost (Brig. Gen. Stephen N. Xenakis, M.D., U.S. Army, retired, 3/15).

Kaiser Health News: The 'Missing Link' In ACOs: Patients 
Regulations will soon be released providing insight into how health care entities and networks qualifying as ACOs will be compensated by Medicare for "bending the cost curve" and improving care. It's commonly held that these systems will lead to better treatment for individuals, improved population-wide health and lower costs. ... But is it realistic to leverage the success of these organizations on physician incentives alone?  (Mark Lutes and Joel Brill, 3/15).

The Des Moines Register: State Workers Should Pay Toward Health Insurance
Eighty-four percent of state employees in Iowa pay no premiums for their health insurance. This costs the state $530 million annually. This is nearly 10 percent of the state budget in Iowa. This is not picking on state employees. … The state offers an insurance program to its employees that is simply fiscally irresponsible and not at all consistent with private-sector practices. … House File 525 opens up the collective bargaining law so that the negotiations can occur on state employees' health insurance (State Rep. Peter Cownie, 3/15).

CNN: Don't Cut Medicaid, Fund It Better 
[States] need not cover adults without children. ... Moreover, although parents can get coverage, the levels can be surprisingly low. For instance, a couple with a child who live in Arkansas and make $3,200 a year are too "rich" for Medicaid. You read that correctly. Even for parents, Medicaid doesn't go nearly far enough. ... Yes, we can cut Medicaid and make the state budgets look better in the short term. But we will be cutting from a program that is already short on funds and protecting those who really might not be able to protect themselves (Dr. Aaron Carroll, 3/15). 

Milwaukee Journal Sentinel: Medicaid Debate, By The Numbers
Under Gov. Scott Walker's proposed budget, the Department of Health Services stands out as one of the few agencies that will receive a substantial increase in state funding. ... Once incorporated into the DHS budget, about 86% of this new revenue will go toward Medicaid programs such as BadgerCare, FamilyCare and SeniorCare. In other words, nearly all new general revenue collected by the state over the next two years will go to Medicaid. Yet, we still have a $500 million budget gap that must be closed. ... Federal officials have advised states that we can simply drop certain eligibility groups and optional benefits. That is not the path we want to take (Dennis Smith, secretary of the Wisconsin Department of Health Services, 3/15).

USA Today: We Can't Afford To Neglect Dementia Research
Almost 13% of those 65 and older already have Alzheimer's disease, which is only one of many forms of dementia. As the Baby Boomers age, the number will increase astronomically.  This coming, unprecedented surge threatens to overwhelm individuals, families, medical systems and budgets. Years ago, we undertook a massive research campaign for HIV/AIDS, successfully developing treatment and prevention strategies. If we are to avert the looming catastrophe posed by dementia, we must increase research funding for it in the same way (Ruth Bettelheim, 3/15). 

The Des Moines Register: A Real Reduction In The Cost Of Health Care
That title is not out of a fiction novel. It could happen right here in our time. A few weeks ago, both the Obama Administration and the US House made major moves to begin limiting the outlandish awards being handed out by some juries in medical malpractice cases. This area has long been a trial lawyers' playground and each of us is paying the price (Art Smith, 3/15).