Viewpoints: Medicare cuts & partisan politics; Colorado health exchange; NEJM on family planning

The Wall Street Journal: The Other Medicare Cutters
The debate over Paul Ryan's Medicare reform ideas has largely been healthy, even amid the liberal distortions. But why has there been so little scrutiny of President Obama's new Medicare proposal? Anyone worrying about more individual choice and responsibility in health care might be interested to learn that the alternative is turning every one of these decisions over to a 15-member central committee (4/20). 

MinnPost: Tax and Medicare Poll Results That May Have Repubs Squirming Today
The Ryan idea is relatively new to most Americans. There will be big arguments about how to describe it accurately (although the [Washington] Post poll did not adopt any of the highly-charged words that Dems will use, like "privatize" or phrases like "end Medicare as we know it.") And who knows what various respondents think it meant by "a program of defined benefits." Perhaps they are just responding - and responding negatively - to any change in Medicare's structure. But the frame that Obama has constructed for the basic choice that America will have to make is something like this: Would you rather cut Medicare or raise taxes on rich people? (Eric Black, 4/20).

New England Journal of Medicine: Hard Choices — Alternatives For Reining In Medicare And Medicaid Spending 
Reducing growth in Medicare and Medicaid spending will be painful, however we achieve it. The Ryan plan rests on the notion that patients are in the best position to control costs.  ... The administration's plan is rooted in the view that the federal government should retain its role as guarantor of a defined benefit. ... Debate over these options should recognize the inherent trade-offs among the certainty of cost control, the likelihood of achieving cost savings while preserving as much high-value care as possible, and the risk that the most vulnerable Americans will pay the highest price for fiscal discipline (Meredith B. Rosenthal, 4/20).

Politico: Rep. Mike Rogers's Bill Undermines Health Reform
Consider Rep. Mike Rogers (R-Mich.) and his proposed Access to Professional Health Insurance Advisers Act. ... it undermines one key consumer protection created by last year's Affordable Care Act. That provision establishes a minimum medical loss ratio. It requires that health insurers in the individual and small group market spend at least 80 percent of their premium revenue (after taxes) on health care and quality improvement expenses. ... The Rogers bill would take commissions out of insurer administrative costs for purposes of the MLR calculation — passing the cost directly to consumers. Insurers would likely keep their overhead at 20 percent, and add broker compensation on the top, increasing premiums dramatically (Timothy Stoltzfus Jost, 4/20).

The Fiscal Times: Health Reform Assumes its Role as a Punching Bag
Remember death panels? Politicians have found a new reason to use the health care reform law as a punching bag. The Independent Payments Advisory Board (IPAB) will be a 15-member expert panel appointed by the president and approved by the Senate that is charged with coming up with ways of cutting Medicare spending when payments grow significantly faster than the rest of the economy. ... It's hard to take seriously complaints from politicians that an independent board set up by Congress will usurp the power of Congress. One of the reasons Medicare costs are out of control is that every effort to rein in spending in one Congress is usually overturned by subsequent Congresses (Merrill Goozner, 4/20).

New England Journal of Medicine: Family Planning As A Cost-Saving Preventive Health Service 
An Institute of Medicine panel is now deliberating over which services should be included in this category and will make recommendations to the Department of Health and Human Services later this year. It is our hope that the committee will support inclusion of family-planning services in the array of preventive care services. Contraception is the quintessential preventive care service: offering women and men the means with which to plan the timing of their children's births is fundamental to the health of families and society (Drs. Kelly Cleland, Jeffrey F. Peipert, Carolyn Westhoff, Scott Spear, and James Trussell, 4/20).

The New York Times: The New Anti-Abortion Math
One of the best family-planning efforts in Texas is the Women's Health Program, which provides an annual health exam and a year's worth of contraceptives to poor women. For every dollar the state puts into the plan, the federal government provides $9. The state estimates the pregnancies averted would reduce its Medicaid bill by more than $36 million next year. But when a budget expert told the Texas House Committee on Human Services that the program saved money, he was laced into by Representative Jodie Laubenberg for using "government math" (Gail Collins, 4/20).

(Colorado) Health Policy Solutions: Opinion: A Critical Moment To Oppose Health Exchange
Proponents argue exchanges will create an insurance marketplace where insurers and consumers can interact in an open and competitive market with convenient comparisons and easy shopping. Most activists for limited government and health care freedom see a different picture: Lucy holding the football and beckoning gullible Charlie Brown for one more kick. There are good reasons for such wholesome pessimism (State Sen. Shawn Mitchell, 4/20).