Viewpoints: Geithner, Bowles, Simpson, Ryan, Vladeck, Wilensky on health spending and the deficit

The Washington Post: Compromise Achieved, Reform's The Next Chapter
The agreement sets up a powerful mechanism for agreement on tax reforms to strengthen growth, and entitlement reforms to strengthen programs such as Medicare. A congressional committee with fast-track authority will have a Nov. 23 deadline to recommend a balanced package of long-term reforms to produce $1.5 trillion in additional deficit reduction (Timothy Geithner, 8/2).

The New York Times: A Crisis Merely Postponed 
We should ask more of health care providers and drug companies through adjustments in payment formulas and increased drug rebates for Medicaid and Medicare, more from beneficiaries through more rational cost-sharing rules that discourage the overutilization of care, and more from lawyers through tort reform. And we need to cap growth in the long run. ...  We were co-chairmen of a similar bipartisan group on debt reduction last year, and titled our final report "The Moment of Truth." Of all our prescriptions, the most pertinent today is the one alluded to in the title: we must act now (Erskine B. Bowles and Alan K. Simpson, 8/2). 

Related from KHN: Health Care Recommendations From Previous Bipartisan Deficit-Reduction Groups.

Los Angeles Times: Debt Ceiling Deal Ignores Real Driver Of Deficits: Healthcare Costs 
[T]he Congressional Budget Office has found that without any changes to current law, government spending outside of debt service and such mandatory programs as Social Security, Medicare and Medicaid will gradually decline over the next decade from 12.3% of gross domestic product today to 8.3%. … More than half of the trend is an artifact of the aging of the American population, which is a factor we pretty much have to live with. The rest is due to what the CBO terms "excess cost growth," or our failure to get healthcare costs under control (Michael Hiltzik, 8/2).  

The Wall Street Journal: Another Crisis Wasted
We know politics is the art of the possible, but one lesson of the debt-ceiling outcome is the folly of "grand bargains" that consist of spending cuts to be defined later or imposed on beneficiaries decades down the road. We should have learned this when ObamaCare pretended to finance itself with illusory cuts to Medicare. ... A crisis is wasted unless it delivers structural reform (Holman W. Jenkins, Jr., 8/2).

Dallas Morning News: Congress Fails To Make Hard Spending Choices
Lawmakers repeatedly have ignored the recommendations of more than a dozen other panels given responsibility to remedy the nation's fiscal problems, including the landmark Grace Commission, in 1982 to 1984, and the bipartisan Simpson-Bowles fiscal reform commission created by President Barack Obama just last year. Also, the automatic "trigger" cuts are far from responsible debt reduction, which requires more than just axing programs at a set percentage. Fundamental changes are needed in entitlement programs, which are consuming a bigger, crippling portion of the federal budget (8/2). 

The Wall Street Journal: Where's Your Budget, Mr. President?
Ever since they abused the budget process to jam their health-care takeover through Congress last year, the Democrats have simply done away with serious budgeting altogether. ... they don't want to commit publicly to the kind of tax increases and health-care rationing that would be required to sustain their archaic vision of government. … In the years ahead, spending on programs such as Medicare, Medicaid and the Democrats' new health-care entitlements is projected to skyrocket relative to the size of the economy, even as federal spending on everything else is projected to decline (Rep. Paul Ryan, 8/3). 

Kaiser Health News: Different Takes: What's Next For Medicare Cost Controls? Vladeck And Wilensky Offer Their Views
During the course of negotiations to raise the debt ceiling, proposals to reduce Medicare costs had an on-again, off-again presence at the table. We asked Bruce Vladeck and Gail Wilensky which of these ideas could have a positive or negative impact on the program. Bruce Vladeck: [O]ne especially pernicious proposal appears to have increasing traction among both politicians and policy analysts: the prohibition of first-dollar coverage in Medicare supplemental insurance, whether purchased in the individual markets or provided as a retiree benefit (8/2). Gail Wilensky: The question of whether to involve Medicare beneficiaries more directly in strategies that slow spending is being discussed more explicitly than it has been in the past (8/2).  

USA Today: Q & A With NIH Chief: Medicine's Future Is Here
Dr. Francis Collins sees a world of possibilities with medicine and the light-speed advances that await mankind. A universal flu shot? Ending the HIV epidemic in the U.S.? A human genome map as part of everyday patient care? Why not? The physician-geneticist, guiding hand of the international Human Genome Project and current director of the National Institutes of Health, recently discussed these and other issues ... "The cost of a complete human genome sequence (of an individual) is about $8,000. We'll be under $1,000 in the next five years, and you only have to do this once. It would make this field of pharmacogenomics a more rapid reality — the ability to predict the right drug at the right dose for the right person, instead of doing the one-size-fits-all prescribing" (8/2). 

Houston Chronicle: Mandate Took Its Time Getting Here
Excuse me if I don't applaud, drop to my knees and kiss President Barack Obama's size 13½ wingtips for the generous benefit he and the federal government will soon bestow on all Americans with a uterus. Sure, it's a great thing that his administration plans to mandate that new insurance plans cover all FDA-accepted forms of birth control, with no co-pays. It's just a tad late (Lisa Falkenberg, 8/2). 

San Francisco Chronicle: The Affordable Care Act's Birth Control Option
The move to include contraception is a much-needed bow to reality long missing from the national conversation about women and public health. That discussion has fallen hostage to abortion politics to the point where ideology trumps science, marginalizing the health concerns of most women (8/2).

Los Angeles Times: AIDS Divides The Globe
At the International AIDS Society's annual meeting in Rome last month, there was a lot of good news. Chief among it was the presentation of solid evidence that antiretroviral therapy does more than treat HIV — it can also prevent the virus. … But amid all the good news, one stubborn fact was hard to ignore: AIDS remains a metaphor for inequality (Michel Sidibe, 8/3).