First Edition: May 31, 2011

Today's headlines include articles on the federal efforts to improve hospital quality, the politics of Medicare and the move by some GOP governors to set up health exchanges.

Kaiser Health News: Hospitals Face New Pressure To Cut Infection Rates
Reporting for Kaiser Health News, in collaboration with NPR, Sarah Varney writes: "Under laws in more than two dozen states and new Medicare rules that went into effect earlier this year, hospitals are required to report infections, risking their reputations as sterile sanctuaries, or pay a penalty. That's left hospital administrators weighing the cost of 'fessing up against the cost of fines. For Clark Todd, CEO of Pacific Hospital in Long Beach, there's only one way to go: "If we hide from the public then the tendency to keep the status quo is stronger than ever," he said. "And that's just not going to get the job done" (Varney, 5/28).

Kaiser Health News: Fact Check: Pat Boone On The Ryan Plan
Kaiser Health News staff writer Marilyn Werber Serafini reports: "As some Republicans distance themselves from the unpopular House-passed budget that would radically change the Medicare program, the conservative seniors group 60 Plus isn't backing off. ... 60 Plus' celebrity spokesman, crooner Pat Boone, today released a statement promising to "lace up my white shoes and spread the news far and wide that this administration is trying to mislead and scare seniors." The Medicare proposal would raise the eligibility age to 67 and convert the program from a government-run, guaranteed-benefit system to one in which seniors get a set amount of money to buy private health insurance. ... Here's a look at some of Boone's claims" (Werber Serafini, 5/27).

Kaiser Health News: Insuring Your Health: The Use Of Freestanding Emergency Departments Is Growing
In her latest Kaiser Health News consumer column, Michelle Andrews writes: "Emergency departments are struggling to keep up with demand, serving a growing number of people at the same time that their numbers are shrinking. One increasingly popular option to improve access to services is the freestanding emergency department, a facility that, as its name suggests, isn't physically located with a hospital (Andrews, 5/31).

The New York Times: Medicare Plan For Payments Irks Hospitals
For the first time in its history, Medicare will soon track spending on millions of individual beneficiaries, reward hospitals that hold down costs and penalize those whose patients prove most expensive. The administration plans to establish "Medicare spending per beneficiary" as a new measure of hospital performance, just like the mortality rate for heart attack patients and the infection rate for surgery patients (Pear, 5/31).

The Associated Press: Getting Personal: Feds Pursue Top Execs In Health Care Fraud Cases Previously Settled For Cash
It's getting personal now. In a shift still evolving, federal enforcers are targeting individual executives in health care fraud cases that used to be aimed at impersonal corporations. The new tactic is raising the anxiety level — and risks — for corporate honchos at drug companies, medical device manufacturers, nursing home chains and other major health care enterprises that deal with Medicare and Medicaid (Alonso-Zaldivar, 5/31).

The New York Times: Surprise Victory In New York Invigorates Democrats Looking To 2012
Sal Pace, the Democratic leader of the State House in Colorado, was already preparing to run for Congress in a district captured by Republicans last year, but his party's special election victory last week in a conservative district in upstate New York made the decision all the easier. "The New York race confirmed what I thought citizens would feel about Medicare," said Mr. Pace, who is expecting to soon begin a campaign to oust Representative Scott Tipton, a freshman Republican, in southwestern Colorado. "People are very hesitant to end Medicare as we know it" (Hulse, 5/30).

National Journal: Republicans Lay Out New Way To Talk About Medicare
Republicans say they know the party bungled its message on Medicare and that, if it wants to dull its impact, it needs to find a new way to talk about a program that many voters are highly protective of. ... It's a daunting enough challenge ... They have two ways to do it: one, emphasize to voters that if the Republican plan isn't adopted, there won't be any Medicare in the near future because the program will become insolvent. Second, dust off attacks from 2010 and tell voters that Democrats, when they passed their health care bill, are the only party to cut the program for seniors already on it (Roarty, 5/29).

The New York Times: Seeing The Advantage In Delaying A Solution
Soon enough, Democrats will have to identify new Medicare cuts they can support. But don't expect them to come this spring, not after the Medicare plan put forward by House Republicans became the centerpiece of the Democrats' strategy to recover from disastrous 2010 midterm elections. The Democrats' first answer, Medicare spending cuts contained in Mr. Obama's health care law, won't satisfy partisan adversaries who see the law as a budget-busting monstrosity. ... The Democrats' second answer: ratchet up the savings mechanisms in the health care law (Harwood, 5/29).

Kaiser Health News also provided a roundup over the weekend on news about the GOP plans for Medicare changes and the comments from Republicans and Democrats on the Sunday morning talk shows on the subject. 

Politico: Republican Governors Move Ahead On Health Exchanges
A small but growing number of prominent, Republican governors — including Mitch Daniels and Haley Barbour — are taking the lead to shape a key component of the health care overhaul their party fought so hard to kill. It's a delicate balancing act for Republicans who, on the one hand, oppose federal health reform, even challenging its constitutionality in federal court, and, on the other hand, are pragmatically trying to control as much of the implementation process as they can (Kliff,5/31).

Los Angeles Times: Many In GOP Who Oppose Health Insurance Requirement Used To Favor It
Until the healthcare law passed last year, requiring medical insurance had a long history as a mainstream GOP idea. It was promoted by conservative policy experts at places like the Heritage Foundation more than 20 years ago. In the 1990s, the concept was championed by Republicans on Capitol Hill. ... Former Wyoming Sen. Alan Simpson, a conservative Republican who backed the Chafee bill in 2003, said many in his party seem to have adopted an approach that he described as, "Let's forget what we need to do and see if we can stick it to the Democrats … or stick it to the president" (Levey, 5/28).

Politico: Woman's Coverage Could Hurt ACA Lawsuit
Jann DeMars is suing the federal government, arguing that she doesn't make enough money to be able to meet the health care overhaul's requirement to buy insurance. But she may have hurt her case by voluntarily buying insurance while her suit is being appealed. Just days before her appeal is to be heard in a federal appeals court in Cincinnati, the Obama administration is now asking the court to throw out the case. DeMars is one of several plaintiffs in the lawsuit brought by the Thomas More Law Center (Haberkorn, 5/27).

USA Today: High-Deductible Insurance Plans Are Gaining Popularity
Last year, Tina Holwin Hodges' healthy family switched to a high-deductible health insurance plan and were able to save $100 a month on their monthly premiums, which seemed like a bargain. Then her daughter Cailee spent three days in the hospital with a viral infection, her daughter Heather went in for a cardiac workup, her husband had hand surgery after being out of work for a year, and she injured her back and couldn't work for three months. Hodges found that her family plan with a $2,400 deductible and a $11,900 maximum on out-of-pocket spending was too much of a burden (Kennedy, 5/30).

The New York Times: Breaches Lead To Push To Protect Medical Data
Federal health officials call it the Wall of Shame. It's a government Web page that lists nearly 300 hospitals, doctors and insurance companies that have reported significant breaches of medical privacy in the last couple of years. Such lapses, frightening to consumers, could impede the Obama administration's effort to shift the nation to electronic health care records (Freudenheim, 5/30).

The New York Times: Under An Arizona Plan, Smokers And The Obese Would Pay Medicaid Fee
Arizona, like many other states, says it is no longer able to finance its Medicaid program adequately. As part of a plan to cut costs, the state has proposed imposing a $50 fee on childless adults on Medicaid who are either obese or who smoke. In Arizona, almost half of all Medicaid recipients smoke; while the number of obese people is unclear, about one in four Arizonans is overweight, according to the Centers for Disease Control and Prevention. The state's plan must ultimately be approved by the federal government. Monica Coury, spokeswoman for Arizona's Medicaid program, discusses (Williams, 5/31).

The New York Times: Administration Opposes Challenges To Medicaid Cuts
Medicaid recipients and health care providers cannot sue state officials to challenge cuts in Medicaid payments, even if such cuts compromise access to health care for poor people, the Obama administration has told the Supreme Court. ... Federal law says Medicaid rates must be "sufficient to enlist enough providers" so that Medicaid recipients have access to care to the same extent as the general population in an area. In a friend-of-the court brief filed Thursday in the Supreme Court, the Justice Department said that no federal law allowed private individuals to sue states to enforce this standard (Pear, 5/28).

The Wall Street Journal: Paperwork Fees Add Up
Need a doctor to fill out a health form for your child's summer camp, school or day care? It may cost you extra. As many primary-care doctors struggle to cover the growing costs of running their practices, some are charging patients extra for completing paperwork outside of a regular office visit (Gerencher, 5/29).

The New York Times: As Physicians' Jobs Change, So Do Their Politics
There are no national surveys that track doctors' political leanings, but as more doctors move from business owner to shift worker, their historic alliance with the Republican Party is weakening from Maine as well as South Dakota, Arizona and Oregon, according to doctors' advocates in those and other states. That change could have a profound effect on the nation's health care debate. Indeed, after opposing almost every major health overhaul proposal for nearly a century, the American Medical Association supported President Obama's legislation last year because the new law would provide health insurance to the vast majority of the nation's uninsured, improve competition and choice in insurance, and promote prevention and wellness, the group said (Harris, 5/30).

The New York Times: Tuning In To Patients' Cries For Help
Whether it's a request for ice water, help getting to the bathroom or a plea for pain relief, an unanswered call light leaves hospital patients feeling helpless and frustrated. And for nurses, often the first responders to these calls, the situation is frustrating too: Short staffing and a heavy workload often make it impossible to respond as quickly as they would like. Now some hospitals around the country are starting programs to deal with the problem (Parker-Pope, 5/30).

The Washington Post: Tough Decisions About Money And Treatment Are Ahead As AIDS Turns 30
The AIDS epidemic turns 30 next month. What began as a fatal new plague has become a treatable, if still incurable, chronic illness. That change counts as a triumph by any measure, but it also poses an unusually difficult question for the next 30 years: How many people do we want to save from a death by AIDS — and who's going to pay for it? (Brown, 5/30).

The New York Times: 30 Years In, We Are Still Learning From AIDS
As AIDS has become entrenched in the United States and elsewhere, a new generation has grown up with little if any knowledge of those dark early days. But they are worth recalling, as a cautionary tale about the effects of the bafflement and fear that can surround an unknown disease and as a reminder of the sweeping changes in medical practice that the epidemic has brought about (Altman, 5/30).

The Washington Post: NIH Human Clinical Trials Look For Causes And Cures For Disease
NIH is conducting nearly 1,500 trials at its Clinical Center and is budgeted to spend about $10 billion on clinical research this year, with about $3 billion of that specifically for trials. The center is the largest hospital in the world dedicated to these human studies. Their topics range from obesity to rare blood diseases to cerebral palsy, and they represent only a small fraction of the trials conducted in the United States. Still, they are unique because many of the diseases being studied are too rare, or the treatment is too much of a gamble, for pharmaceutical companies, biotech firms or universities to pursue (Hambleton, 5/30).

Los Angeles Times: Woman Selling 'Suicide Kits' Reignites Right-To-Die Debate
Sharlotte Hydorn peddles a product touted for its deadly simplicity. Inside her butterfly-decorated boxes are clear plastic bags and medical-grade tubing. A customer places the bag over his head, connects the tubing from the bag to a helium tank, turns the valve and breathes. The so-called suicide kit asphyxiates a customer within minutes (Marosi, 5/30).

Los Angeles Times: California Authorities Deny State's First Medical Parole Case
A quadriplegic inmate serving a 150-year term for kidnapping, beating and raping a San Diego woman in 1998 will not be released to the care of family members under a new law, parole board rules (Perry, 5/30).

USA Today: Business Travel Takes Toll On Workers' Health
Now, a recently published study backs up business trekkers like (business traveler Judith) Briles who've long suspected life on the road was negatively affecting their health. The study, which analyzed data gathered from roughly 13,000 workers, found that those who traveled more than 20 nights a month were 2.61 times more likely to report they were in poor or fair health than those on the road one to six days a month. And they were 1.92 times as likely to be obese, a condition that can lead to diabetes and heart disease (Jones, 5/30).

NPR: Egg Freezing Puts The Biological Clock On Hold
As more women postpone motherhood into their 30s, even 40s, they're hitting that age-old constraint: the biological clock. Now, technology is dangling the possibility that women can stop that clock, at least for a while (Ludden, 5/31).

Kaiser Health News has a roundup of several stories from the weekend about the quality of care at VA hospitals.