Viewpoints: More on Medicare's 'hard choices'; elderly and anti-psychotics; Calif. insurance rate hikes

Jun 2 2011

The Wall Street Journal: Our Current Time For Choosing
Unless we make hard decisions now, in less than a decade every dollar of federal revenue will go to covering the costs of Medicare, Social Security and interest payments on our debt. ... I admire Congressman Paul Ryan's honest attempt to save Medicare. Those who disagree with his approach incur a moral responsibility to propose reforms that would ensure Medicare's ability to meet its responsibilities to retirees without imposing an unaffordable tax burden on future generations of Americans (Jon Huntsman, 5/31). 

The New York Times: Who Needs Health Care Reform?
Republican alternatives to the health care reform law mostly involve making people pay more for their insurance and medical care on the theory that having more "skin in the game" will lead them to use medical care more sparingly. [Two] studies show that most of the uninsured have very little skin to put in the game (5/31).

The Washington Post: 'Paul' And 'Barack' Talk Medicare
When it comes to Medicare, the one thing everyone agrees on is that it's time for an "adult conversation." So let's listen in on two imaginary participants — "Paul" and "Barack." Disclaimer: This conversation is a work of fiction. Any resemblance to actual political figures is, unfortunately, purely coincidental (Ruth Marcus, 5/31). 

The Miami Herald: Congress Is Fiddling While Medicare Goes Bankrupt
It's dead wrong to draw the conclusion from the Senate vote and the House race in New York that the country will just have to put up with a national healthcare plan for seniors that creates lopsided deficits forever because no one can do anything about it. ... Ultimately, no deal is possible until Republicans and Democrats agree on a bipartisan solution. The sooner both sides realize that and stop making false claims about each other's plans, the sooner a deal can be achieved (5/28).

Forbes: Medicare Vouchers Won't Reduce Health Spending
The House Republican plan to replace Medicare with vouchers could lower national health spending in only one of two ways: Either seniors would respond to higher out-of-pocket costs by using less—or more efficient-health care, or private insurance companies would ration their care for them. In effect, insurance company bureaucrats would replace those government bureaucrats so disparaged by House Republicans (Howard Gleckman, 5/31).

Minneapolis Star Tribune: Medicare's Hard Truths
The reality is that neither party has a serious solution to Medicare's impending hospitalization fund insolvency -- estimates for which were recently pushed up to 2024, from 2029. Ryan's plan would simply shift costs to the elderly. Democrats took small steps in the health reform law to rein in costs, but much more needs to be done. Shared sacrifice is the only solution (5/31). 

Los Angeles Times: Health Insurers Use Scare Tactics To Block Regulation Of Rate Increases 
The companies cite bogus figures to fight a bill that would give California officials prior-approval authority over premium hikes. And they're trying to convince the public that the measure would actually cost people money (Michael Hiltzik, 6/1). 

San Jose Mercury News: Health Insurance Rates Need A Watchdog In California 
In 2010, the five largest health insurers in the United States made $11.7 billion. In that same year, medical costs increased by less than 10 percent. So what did Anthem Blue Cross, owned by the nation's biggest insurer, WellPoint, decide was a fair rate increase for Californians that year? How does 39 percent sound? That's the sort of outrage that led Assemblyman Mike Feuer to introduce AB 52, giving the state's insurance commissioner the power to review premium rate hikes by insurers. The bill is heading for a floor vote Thursday, and it's a further outrage that the outcome is in doubt (5/31). 

CNN: Cause For Alarm: Antipsychotic Drugs For Nursing Home Patients 
A newly released report from my office -- the Office of the Inspector General for the Department of Health and Human Services -- makes clear just how crucial it is for families to monitor and ask questions about medications that such patients receive. The report found that too often, elderly residents are prescribed antipsychotic drugs in ways that violate government standards for unnecessary drug use (Daniel Levinson, 5/31). 

CNN: In Defense Of Antipsychotic Drugs For Dementia
It is true that we psychiatrists are far too quick to reach for our prescription pads, and that the pharmaceutical industry has, in many cases, illegally manipulated our prescribing habits. ... But in this particular case, the Office of the Inspector General has it wrong, and Levinson's statements on behalf of Health and Human Services reflect an astonishingly poor understanding of the workings of medical care in general and psychiatric care in particular. Although it's true that a prescription for antipsychotics to treat agitation in dementia is "off-label," this hardly means they are ineffective or that Medicare claims for these drugs are "erroneous" (Dr. Daniel Carlat, 5/31). 

Des Moines Register: More Need To Help Protect Our Elderly
Sen. Charles Grassley recently sent a letter to the administrator of the U.S. Centers for Medicare and Medicaid Services. He wants some answers after a federal report Grassley requested found many nursing home residents with dementia are given antipsychotic drugs. ... Grassley is right to ask questions of the agency. But keeping seniors safe is a responsibility that extends far beyond CMS -- from the halls of Congress to state legislatures to nursing home workers in rural Iowa (6/1). 

Rochester Democrat and Chronicle: Cost-Saving Plans Threaten Vital Clinical Programs 
Much of the decision-making in managed-care organizations involves risk avoidance, and people with intellectual and developmental disabilities are also likely to have other serious chronic illnesses that require care coordination and medical interventions. Moreover, doctors and other health providers familiar with the population are not often recruited to be part of managed-care organizations (Dr. Arnold Birenbaum, 5/31).

The Sacramento Bee: Hospital Infections Too Deadly To Ignore
As statutes go, Nile's Law should have been a snap to implement. The 2008 law, approved by a combined vote in the Legislature of 114-4, is aimed at informing consumers about a serious health threat. … The effort to inform the public about hospital infections stumbled during Arnold Schwarzenegger's administration. Now it's Gov. Jerry Brown's responsibility. Excuses about lack of money and short-handed staff are just that, excuses (6/1). 

The Times of Trenton: Health Care Law Makes Medicaid Reform Urgent 
One of the most underreported provisions of the Patient Protection and Affordable Care Act (PPACA) is its vast expansion of Medicaid eligibility. Whether or not one agrees with the law, it is inarguable that when full implementation occurs in 2014, our state's resources will be stretched even further: Up to 500,000 additional New Jerseyans will become eligible for Medicaid (Paula V. Tyahla, 5/31).