Viewpoints: DeLauro on discretionary spending 'value'; S&P downgrade's entitlement effects; docs and guns

Politico: The Value Of Discretionary Spending
The deficit reduction plan signed by President Barack Obama last week focused sharply on the narrow slice of the budget labeled as "non-defense discretionary spending." But while this slice has played only a small role in the deficit problem, it plays a very big role in fostering economic growth and meeting the basic needs of American families. ... it includes programs that assist people in need, like meals on wheels and other services for seniors; community health centers, and the supplemental food program for pregnant women, infants and children (Rep. Rosa DeLauro, 8/9).

The New York Times: The Downgrading Of A Debtor Nation 
An economically responsible, politically feasible distribution of the costs of working our way out of the crisis will require higher taxes, a more efficient tax code, and restrained growth of social spending, particularly Medicare. To ignore these realities, and the contentious choices they entail, is merely to postpone the inevitable day of reckoning — and probably to make it worse (Menzie D. Chinn and Jeffrey A Frieden, 8/8). 

Politico: Justifying Social Safety Net Cuts
Let's note, at the start, that this downgrade was absurd. The credit rating of the United States is not in jeopardy.  ...  What's really happening is an attempt by both parties to justify slashing Social Security and Medicare. Republicans have long wanted to roll back the New Deal. What is relatively new is that a Democratic president is now dead-set on cutting these programs as well (Matt Stoller, 8/9).  

San Francisco Chronicle: When Rating Agencies Matter 
[W]e have still done virtually nothing to address the principal threat to the sustainability of the federal finances over the next decade, the explosive growth of health care costs. Indeed, that the same elected officials who got their way in the debt-ceiling talks want to roll back the first step in health care reform adopted in 2010 only dims the prospects further (Barry Eichengreen, 8/8).

The Washington Post: A Secret Weapon To Save Defense
Republicans have a secret weapon: The Democrats failed to exempt Obamacare [from the debt agreement]. According to Sen. John Barrasso (R-Wyo.), "There are at least 15 provisions of the Obama health care law that will find themselves subject to this trigger if the committee is not able to come up with other cuts." That means if Democrats want to gut defense, they may have to accept deep cuts for prevention programs, community health centers, grants to help states set up insurance exchanges and co-ops, and other key Obamacare provisions (Marc A. Thiessen, 8/8).

The Tennessean: Select Committee Will Target Entitlements For Cuts 
[I]f Congress does its job and passes the select committee's recommendations, the arbitrary cuts are avoided. Medicare and Medicaid are not exempt from sequestration, or from consideration by the select committee. If sequestration takes effect, health-care providers should expect a 2 percent cut in all payments. This leaves health-care organizations in the unenviable position of taking cuts from not only the Affordable Care Act, but also the select committee through sequestration. ... Health-care leaders should prepare for a season of aggressive defense of entitlement programs (Richard Cowart, 8/9).

The Fiscal Times: The White House's Careless Language on Entitlements
Earlier in the administration it would have been easy to refute the fear that the administration wants to cut entitlements. President Obama went to the wall to enact a major expansion in the entitlement to health insurance. ... But when the administration calls for "long-term entitlement changes" it seems to be calling for a change in the entitlement itself: the promised protection. ... Surely the administration's leaders must know that the language they are using scares its core supporters to death (Joseph White, 8/8).

NPR/The Weekly Standard: Weekly Standard: Time To Celebrate Health Care?
President Obama issued a proclamation yesterday, hours before Standard & Poor's downgraded America's long-term debt. ... it reads, in part, "I, BARACK OBAMA, President of the United States of America ... do hereby proclaim the week of August 7 through August 13, 2011, as National Health Center Week." ... So, as we "celebrate" this week, we would also do well to remember Obamacare's contribution to it? (Jeffrey H. Anderson, 8/8).

The Miami Herald: ALFs Need More, Not Less, Regulation
Maybe Florida lawmakers eager to change state supervision of assisted living facilities should rely on the famous precept of medical ethics: First, do no harm. Many of the ALFs are chronically troubled facilities. Laws governing state oversight need revision from time to time to ensure that residents remain well protected. ... If nothing else, reformers should fight to protect the Residents Bill of Rights from further erosion. If legislators can't do anything to improve the lives and wellbeing of ALF residents, they should at least stop enabling those who have made some ALFs a synonym for hell (8/8). 

Des Moines Register: Treat, Don't Jail Mentally Ill
Des Moines-area leaders shouldn't let short finances discourage efforts to handle mentally ill people more effectively and humanely, a Texas expert said Monday. "Texas is conservative like Iowa. We don't have any money either," said Leon Evans, president of the Center for Health Care Services in San Antonio. But, he said, his city showed that putting mentally ill people into treatment instead of jail saves millions of dollars and turns around lives (Tony Leys, 8/9). 

Atlanta Journal Constitution: Psst, Big News For Women And Their Insurance
Last Monday, the Obama administration announced that insurance companies will have to provide birth control services to women with no copayment. The new rules also eliminate the copay for other preventive health measures — such as prenatal care, counseling and equipment for breast-feeding — and screenings to detect HIV, gestational diabetes in pregnant women and signs of domestic violence. This long-overdue improvement in the lives of women's reproductive health is brought to you by the Patient Protection and Affordable Care Act, sometimes called Obamacare by those hoping you won't notice that health care reform was a good thing (Connie Schultz, 8/8). 

The New York Times: Gun Query Off Limits For Doctors In Florida
As a primary care physician, I regularly ask patients questions that many people would consider rude, inappropriately nosy or just irrelevant in polite conversation. Do you wear your seat belt? How much alcohol do you usually drink? ... Do you have sexual relations, and if so, with men, women or both? Questions like these have long been a standard part of medical interviewing, and for good reason. The answers may reveal clues about a person's symptoms or physical findings on exam. ... There's one customary question, though, that I'm no longer allowed to ask. In June, Gov. Rick Scott signed a law barring Florida doctors from routinely asking patients if they own a gun (Dr. Erin N. Marcus, 8/8).