Longer looks: A Medicare compromise; improving mental health policies

Jul 1 2011

Every week, Kaiser Health News reporter Jessica Marcy selects interesting reading from around the Web.

Time: What If There Was A Reasonable Compromise On Medicare?
Sen. Joe Lieberman has found an ally for the middle-of-the-road Medicare reform proposal he laid out a few weeks ago. On Tuesday, the independent Senator from Connecticut and conservative Republican Tom Coburn unveiled a tweaked version of Lieberman's plan. They hope to build a coalition of support for the proposal, which they say could save $600 billion over the next ten years. The plan won't save Medicare for all future generations, but it's full of reasonable ideas that could gain bipartisan support - if politics don't stand in the way (Kate Pickert, 6/29).

Government Executive: OPM Improves Health Database Security
The Office of Personnel Management has beefed up the security of federal employee health information collected to help improve the government's insurance program, but some data could remain at risk, according to privacy experts. OPM in October 2010 announced plans for a database tool to track and evaluate the quality and cost of services provided through the Federal Employees Health Benefits Program. The agency earlier this month issued revised notices addressing concerns that the database -- which would store information such as the enrollee's name, Social Security number, employment details, health care providers, medical diagnoses and insurance coverage -- could violate patient privacy (Emily Long, 6/28).

CQ Weekly: Fifty Ways To Run Your Medicaid Program
If you are a poor person on Medicaid in Delaware, better floss. Medicaid provides no dental coverage there. In Nebraska, though, you'd be covered for a root canal. … Hearing aids? Speech therapy? Managed care? Fee for service? All that depends on the state you are in. Yet despite that variation, documented by state websites and the Kaiser Family Foundation, Medicaid's "inflexibility" is the meme of the moment as health care spending undergoes scrutiny in the debate about cutting the deficit. Whether they are advocating turning Medicaid into a block grant, or rolling back "maintenance of effort requirements" written into the 2010 health law, Republicans in particular are depicting Medicaid as a one-size-fits-all program that costs too much and hampers innovation, creativity and all-around good government in the states (Joanne Kenen, 6/27).

Hospitals & Health Networks: The Most Difficult Budget Year
The challenges facing Yakima reflect the harsh reality of the budget crisis in Washington state and throughout the country as state governments, trying to cope with decreased revenues from the worst recession since the 1930s, look for ways to make up for a 10 percent cut in tax receipts. The last three fiscal years have been grueling, but the reduced revenue caused by the economic downturn—and in some states, new tax cuts—was partially offset by one-time money from the federal government's economic-stimulus package. That money is gone though, and according to the nonpartisan Center on Budget and Policy Priorities, fiscal 2012 will be one of state's most difficult budget years on record. When fiscal 2012 budgets were proposed in the spring, 44 states and the District of Columbia projected budget shortfalls which, combined, totaled $112 billion (Randy Edwards, June 2011).

National Review: Bureaucratic Insanity
Some federal-budget cutters claim that we have already picked all the low-hanging fruit. Those of us who work in Washington know better, although it is not considered polite to say so. One counterexample is SAMHSA, a federal health agency distinguished by the fact that the health of its clients would improve if it went out of business. The acronym stands for the Substance Abuse and Mental Health Services Administration, a $3.6 billion component of the Department of Health and Human Services. … When looking for low-hanging fruit, then, budget analysts should peer closely at SAMHSA, whose branches are touching the ground (E. Fuller Torrey, 6/20).

Mother Jones: Kansas Sued Over Abortion Clinic Guidelines
Two weeks ago, the Kansas Department of Health and Environment issued a new set of stringent guidelines for abortion clinics. Under the new requirements, the three remaining clinics in the state would have to make enormous structural changes to their buildings and obtain new certifications in just two weeks or face possible closure. These types of laws are known as Targeted Regulation of Abortion Providers (TRAP) laws, and critics say they're intended to make it almost impossible for clinics to operate. But despite the new rules, abortion rights activists aren't giving up: On Tuesday, the Center for Reproductive Rights (CRR) filed a federal lawsuit on behalf of one of the remaining Kansas clinics, the Center for Women's Health, which is run by a father/daughter duo who practice in Overland Park (Maddie Oatman, 6/28).