Viewpoints: Jobs and 'Obamacare;' jurisdictional barriers to health law challenges; reforming provider payment

Oct 7 2011

The Washington Post: Ask Republicans About Jobs, They'll Answer About Obamacare
By most of the usual measures, President Obama has no business being reelected. Here's why he might be anyway. On Wednesday morning, as Senate Democratic leaders were scrambling to find a way to enact part of Obama's jobs bill, a dozen Republican lawmakers assembled outside the Capitol to complain about ... health-care reform (Dana Milbank, 10/5).

New England Journal of Medicine: Not So Fast -; Jurisdictional Barriers To The ACA Litigation
The Affordable Care Act (ACA) has been under attack in the federal courts for the entire 18 months of its existence. ... Most cases claim that Congress exceeded its constitutional authority in enacting the ACA, but the Constitution also limits the authority of the federal courts. Article III allows federal courts to hear only "cases . . . [or] controversies" over which Congress has given them jurisdiction. The Supreme Court is acutely aware of these limits. ... All the litigants -; the Obama administration, the states, and the private litigants -; want a definitive ruling on the question of whether Congress constitutionally adopted the minimum-coverage requirement. But first the courts must decide whether they can constitutionally decide this question. The jurisdictional issues are sufficiently cloudy at this point that it is difficult to predict how the Supreme Court will resolve them (Timothy Stoltfus Jost and Mark A. Hall, 10/6).

New England Journal of Medicine: Reforming Provider Payment -; The Price Side Of The Equation
There's no question that slowing the growth of Medicare and Medicaid spending is essential to long-term reduction of the federal deficit, but one result of further reductions in rates might be more cost shifting by those providers with leverage. Although many private payers share the enthusiasm for reforming provider payment, they realize that attempts to encourage hospitals, physicians, and other providers to integrate and align to improve care coordination are likely to lead to greater consolidation among providers, increased market power, and higher prices (Paul B. Ginsburg, 10/6).

New England Journal of Medicine: The Uncertain Future of Medicare And Graduate Medical Education
Medicare's GME support escaped unscathed in the recent wrangling over the debt ceiling, but it may well be a target again as the new congressional deficit-cutting committee identifies ways to reduce the federal deficit by $1.2 trillion over the next decade. Of its 12 members, Senator John Kerry (D-MA) has been the most outspoken advocate of maintaining Medicare's current level of GME support. Defending that position against the competing claims for the federal dollar of an array of other stakeholders may prove a tall order in the quest for deficit reduction (John K. Iglehart, 10/6).

Roll Call: Batliner: Expand Dental Care For Underserved Areas
A year ago, Maxine Brings Him Back-Janis and I, both American Indians who have provided dental care on the Pine Ridge Indian Reservation in the past, went there to assess oral health conditions. The shocking details of what we encountered are reported in the just-released October issue of Health Affairs: 90 percent of adults and children had active decay, a percentage three times that typically found in the United States. ... There are too few dentists on the reservation, and the distances are too great to ensure these kids can regularly get basic dental services. Ten dentists work in three locations to serve 30,000 people. ... Virtually every state in the country has a dental shortage area, and close to 50 million people can't get dental care in their own communities (Terry Batliner, 10/6).

Detroit Free Press: In Catastrophic Auto Accidents, Victims Need Unlimited Insurance Coverage
Since my initial injury, thanks to benefits provided under the auto no-fault system, I have been able to live at home, relying on in-home care, some of which is provided by my mother and my husband. Without this care, paid for with insurance benefits, I would be forced to overburden my family or live in an assisted care facility. ... I'm forced to consider this frightening "what-if" scenario because insurance companies are attempting to push legislation (HB 4936 and SB 649) through the Michigan Legislature that would deny such care to future Michigan accident victims and could reduce benefits to those of us already injured (Erica Nader Coulston, 10/6).

The Atlanta Journal-Constitution: Winning The Battle Against Teen Pregnancy Starts With Adults
If you ask people about the certainties in life, somewhere in the conversation death and taxes will be mentioned. In Texas, there's a good chance teen pregnancy will also be thrown into the mix. … One major change that needs to be made: Stop the finger-pointing at teens and start demanding that adults take responsibility and have the political courage to address this public health emergency. It is the adults who need to lead this effort (David Wiley, 10/5).

Des Moines Register: It's Time to Bring 'Occupy Wall Street' to Iowa
There has been a phenomenal outpouring of support across the country in the past week for a tough, tenacious and genuinely populist response to the ongoing economic crisis.  What started as a movement to occupy Wall Street has mushroomed into a national call to action for distressed homeowners, scapegoated union workers, underemployed youth and everyday Americans from all walks of life who have taken a hard look at our political system and economy and realized that they're not set up to work for us. ...  Meanwhile, politicians in Washington are stuck quibbling over cuts to Social Security, Medicare, and Medicaid -; ignoring the harsh reality that we would have no deficit if we had single-payer health care and we stopped fighting two wars -; and refusing to find real solutions to make Wall Street pay for the mess it caused (Hugh Espey, 10/5).

Milwaukee Journal Sentinel: Sensible Guidelines
A bipartisan bill in the state Legislature would create new guidelines for head injuries and rules for how young athletes who are injured must be handled. We support the bill and urge passage. The legislation would require guidelines for coaches, athletes and their parents on the risk of concussion and head injury. It would require athletes suspected of having such injuries to be removed from an activity immediately and would block their return until they had been cleared by a health care provider with expertise in such injuries (10/5).

Denver Post: Republicans On State Health Exchange Board Are Providing Due Oversight
As one of the five Republican members of the legislative oversight committee for the Colorado Health Benefits Exchange, I believe your editorial slamming Republican lawmakers is highly misleading. The five Senate and House Republicans on the Health Exchange Board's oversight committee are not "politicking" when we ask valid questions about a $22 million grant application. We are simply fulfilling our oversight obligations as spelled out in Senate Bill 200 (State Sen. Kevin Lundberg, 10/6).

The Washington Post: Nurses' Prescription For Healing Our Economy
If you want to know just how bad things are for those hit hardest by the Great Recession, ask a nurse: They see more young men suffering heart attacks, more anxiety in children, and more ulcers and stomach illnesses in people of all ages. Financial struggles are forcing more patients to forgo necessary medicines and treatments. ... Given this widespread hardship and pain, it makes sense that nurses who are on the frontlines in our communities every day are leading an effort to hold Wall Street accountable for causing these economic troubles while raising hundreds of billions of dollars for vital human needs (Katrina vanden Heuvel, 10/4).