Viewpoints: NYT on Medicaid's value; WSJ against exchanges; Chicago Tribune on food deserts

Jul 19 2011

The New York Times: The Value Of Medicaid
Medicaid is under assault these days from nearly every direction. Governors complain that they cannot afford to put up their share of the money. Congressional Republicans led by Paul Ryan want to reduce the federal contribution by $771 billion over the next decade. ...  President Obama has expressed willingness to cut Washington's contribution. ... Expanding Medicaid will increase spending in the short run. But the nation will benefit from a healthier, more productive population that, in the long run, may have less need for costly medical services (7/17). 

The Wall Street Journal: 'Exchange' You Can't Believe In
A poorly designed exchange could send many insurers into a death spiral of unpayable claims, hastening consolidation, reducing competition, and increasing the political demand for government to run everything. This was precisely the goal of many Democrats who wrote the Affordable Care Act, and we suspect it is also HHS's motivation (7/16). 

Politico: A Grand Health Bargain That Cuts Debt 
The goal of this grand health bargain [for health care finance] is to generate trillions in savings through laser-focused policy changes designed to help the government balance its budget in the short term — by increasing revenues and decreasing expenditures. In addition, these policies could help "bend the curve" of health care spending in the long term, by encouraging consumers to be more cost-sensitive (Stephen T. Parente, 7/17).

Atlanta Journal Constitution: Why Can't Our Politicians Handle The Truth?
Oh, many people around these parts [rural Alabama] will tell you that they despise the "guv-mint." But that word is reserved for the policies and agencies — real or imagined — that they oppose: the Environmental Protection Agency and its regulations, the Internal Revenue Service, the presumed secret agency that is readying a plan to confiscate all firearms. But just as polls show that most Americans, including conservatives, support spending on Social Security and Medicare/Medicaid, so do people here. With an aging and needy population, hospitals and physicians depend on Medicare to keep their doors open. Area nursing homes are funded largely by Medicaid (Cynthia Tucker, 7/15).

The Star-Ledger: Gov. Chris Christie's Pension And Health Care Reform A Gift To Liberals 
Christie just pummeled the working poor, cut funds for AIDS drugs, choked off money to the city of Camden, and even moved to close down a center for sexually abused kids. So why would he be considered a savior of anything, beyond tax cuts for the rich? Short answer: Because he got pension and health care reform done. And without that reform, these rising costs would squeeze state and local budgets harder every year, leaving little room for social spending (Tom Moran, 7/17). 

Kaiser Health News: It's Not Just The Money: Cost Control In Cancer Care (Guest Opinion)
Years ago, my father-in-law was diagnosed with advanced lung cancer. At one point, his doctors discussed the possibility of a punishing thoracic surgery. They were unenthusiastic. Yet our family wasn't really ready to give up on the prospect of substantially life-prolonging care. ... We can treat our loved ones, and ultimately ourselves, more effectively, more efficiently, and more decently than we often do (Harold Pollack, 7/17). 

The Baltimore Sun: Will New Regulators Slow Progress On Hospital Costs?
If the nation is ever to get insane health care costs under control, the methods used are likely to be tougher, stronger versions of what's going on in Maryland: Stop certain hospitals and doctors from enriching themselves with unneeded procedures. Pay the system for keeping people healthy and curing the sick, not for performing tests and surgery. Cap prices by administrative decree and force hospitals to be more efficient. So the biggest changes in years at Maryland's price-setting agency for hospitals merit the attention of consumers, employers and everybody else (Jay Hancock, 7/17).

Los Angeles Times: Public Health: Not Vaccinated? Not Acceptable 
You don't get to drive drunk. You don't get to smoke in public places. ... This is not about creating more government to intrude further into our lives. This is about calling on government to do what it's there for in the first place: to protect us from the actions of others when as individuals we can't protect ourselves. It is appropriate, and urgent, that we act to protect public health from those whose choices about vaccines are putting the rest of us at risk: We make them stop (David Ropeik, 7/18). 

Chicago Sun Times: Food Deserts Need More Than Groceries
It shouldn't come as a huge surprise that adding a supermarket or two in a poor neighborhood that has long gone without doesn't radically alter the eating habits of folks who live in those communities. … But that doesn't mean Chicago and other cities should walk away from their food deserts, as we call large and isolated areas that lack a grocery store. Chicago should instead redouble its efforts to eradicate food deserts — as Mayor Rahm Emanuel has pledged to do — and help make it easier and more economical for Chicagoans to choose healthy food (7/17). 

Related, from KHN's Capsules news blog: Supermarkets Can't Alleviate Food Deserts (Kulkarni, 7/15)
 
Houston Chronicle: Beyond Just Numbers: Retirement Of Boomers Has Up Sides As Well As The Much-Advertised Liabilities
The popular wisdom is that the imminent passage of millions of baby boomers into old age, at least as it's legally defined, is a costly zero-sum game for the generations that follow. No question: Some of the raw numbers relating to demands on the public purse for entitlements such as Medicare and Social Security are daunting. But the numbers alone fail to tell fully the human story which is the sum total of billions of individual choices made by tens of millions of boomers with their own hopes, worries and other personal circumstances (7/16). 

The Sacramento Bee: Need To Train Doctors Like Musicians
Frank Davidoff recently wrote in the Annals of Internal Medicine about the similarities between doctors and musicians, suggesting that perhaps medical schools and hospitals should pay closer attention to how musicians are trained. … Musicians are trained to play in orchestras and bands where the music depends upon listening to others so as to coordinate function and timing. Doctors have traditionally been trained as solo performers and are not effective team players (Dr. Michael Wilkes, 7/17).

The Sacramento Bee: Madness, Exhibit A: Prison Doctor's Pay
The man who was the highest-paid California state employee not working for a public university answered his own phone on the first ring, and was more than happy to tell me his side of the story. ... The Los Angeles Times introduced him with this blunt opening paragraph: 'The highest-paid state employee in California last year, a prison surgeon who took home $777,423, has a history of mental illness, was fired once for alleged incompetence and has not been allowed to treat an inmate for six years because medical supervisors don't trust his clinical skills' ... Not that you need more evidence, but Rohlfing's hiring, firing and rehiring is one more illustration of how dysfunctional this state can be (Dan Morain, 7/17).