Viewpoints: Conservative legal path on health law; Romney's plans for Medicare and vets; States moving on reform

Nov 14 2011

The New York Times: Affirmation of Health Care Reform
A federal appeals court in the District of Columbia endorsed the constitutionality of health care reform this week in an opinion as notable for its authorship as for its legal reasoning. The majority opinion in the 2-to-1 decision was written by Judge Laurence Silberman, a stalwart of conservative jurisprudence whose views are said to be enormously influential in conservative legal circles (11/11).

Bloomberg: Conservative Health Care Split Offers Court A Path
Nonetheless, it has become clear that there is no longer a unified Republican position that the mandatory coverage provision is unconstitutional. A generation gap has emerged in the conservative ranks; and some sophisticated conservatives are proposing fallback options that would allow Justice Kennedy and his colleagues to defer the issue altogether (Noah Feldman, 11/13).

The Los Angeles Times: The Medicare Trap
With enough funding to maintain the current level of coverage for seniors, a premium support approach like the one GOP presidential candidate Mitt Romney recently outlined, which would let people opt to buy coverage from Medicare or private insurers, is worth considering. Requiring Medicare to compete for customers with private insurers could promote more innovative and efficient ways to deliver and pay for medical services (11/12). 

Arizona Republic: Romney Medicare Reform A Good Rx
Mitt Romney recently stepped more bravely into the entitlement-reform minefield. He basically endorsed Congressman Paul Ryan's plan to transform Medicare from a program that pays for the medical bills of seniors to one that gives them financial support to purchase health insurance. This is not as radical of a reform as depicted by opponents (Robert Robb, 11/12).

The New York Times: Vouchers For Veterans
American health care is remarkably diverse. In terms of how care is paid for and delivered, many of us effectively live in Canada, some live in Switzerland, some live in Britain, and some live in the unregulated market of conservative dreams. One result of this diversity is that we have plenty of home-grown evidence about what works and what doesn't. Naturally, then, politicians -; Republicans in particular -; are determined to scrap what works and promote what doesn't. And that brings me to Mitt Romney's latest really bad idea, unveiled on Veterans Day: to partially privatize the Veterans Health Administration (Paul Krugman, 11/13).

Minneapolis Star Tribune: The GOP And Health Care Reform
All of these Republican administrations -; and others -; are executing a nifty two-step dance. They denounce the Affordable Care Act to the cheers of activists, while they capitalize on its new funding, new authority and ample discretion to adapt it to their distinctive circumstances and ideas…. After decades of bipartisan hard work, Minnesota is idly sitting by as other states gorge themselves on our state's labors. … In the quest for conservative purity, this approach may set back conservatism as they abandon the field of play to the single-payer states and to Republican states that may not be as prepared as Minnesota to develop the strongest alternative (Lawrence R. Jacobs, 11/12).

Arizona Republic: A Welcome Mat For 'Obamacare' In Ariz.
President Obama's health care reform law gives states an option: Establish insurance "exchanges" by 2014, or the secretary of Health and Human Services will establish one for them. Incredibly, some policymakers who oppose the federal law are choosing to implement these exchanges anyway (Diane Cohen, 11/13).

Modern Healthcare: Challenging Journey Ahead
We are rapidly approaching the halfway point between enactment and implementation of the most sweeping provisions of the Patient Protection and Affordable Care Act. While many changes are already under way, the work ahead for the public and private sectors is both daunting and thrilling. It also is abundantly clear that this reformation remains essential (John Colmers, 11/14).

Modern Healthcare: On A Collision Course
As we've been reporting for weeks now, it's clear that health care spending is in the [super committee's] cross hairs. Some cuts are obviously in order given the magnitude of the projections for Medicare and Medicaid outlays in the decades ahead. But the outlook has grown more pessimistic concerning the hit that providers face as a result of proposed cuts to federal health care programs (David May, 11/14).

Boston Globe: Defense Cuts Affect Jobs, But Other Cuts Are Worse
Big cuts in Medicare and Medicaid will be far more damaging to the Massachusetts economy than reducing our far-flung network of military bases throughout the world (Barney Frank, 11/12).

Milwaukee Journal Sentinel: Cuts to Medicaid Hurt The Poor
Wisconsin must come to grips with rising health care costs, but cost savings are not the same thing as cost shifting. Very much like Medicare, which is also under attack at the national level, the primary reason BadgerCare has become harder to afford is the lack of effective action on the overall cost of health care. Shifting unaffordable health insurance costs onto those least able to afford it does not reduce health care costs. Slashing BadgerCare actually increases the cost of private insurance, which will end up footing much of the bill for emergency room visits and other uncompensated care for the newly uninsured and underinsured (Robert Kraig, 11/12).

Reuters: Wal-Mart Will See You Now
With the possible exception of the federal government, no organization is in a better position to reverse health care's hyperinflation than Wal-Mart. If that sounds crazy, let me explain. As Ezra Klein recently pointed out in a Washington Post graphic, it's not the age or obesity of the population that is driving health care costs. Nor does it have much to do with alcohol or even malpractice costs. Rather, as the many cost comparisons in the presentation below show, we simply pay more for the same items when compared to other countries (Dave Chase, 11/11).

Boston Globe: As Rate Of C-Sections Rises, Change In Culture Is Needed
Caesarean sections are on the rise, both nationally and in Massachusetts, but many of them are avoidable. ... To change a dynamic in which obstetricians recommend surgery over vaginal birth too often, hospitals will have to take a larger role in creating a culture that favors waiting labor out -; while policymakers will have to do more to protect doctors from malpractice suits (11/13).

Chicago Tribune: Mississippi Makes A Big Statement
Opponents argued -; and voters apparently agreed -; that conferring personhood upon a fertilized egg would have far-reaching implications, affecting not only a woman's right to an abortion but also her right to use birth control, get pregnant through in-vitro fertilization, or receive treatment in the event of pregnancy complications. And yet, isn't that exactly what anti-abortion forces have always argued, life begins at conception? It is telling that, given a chance to enshrine that belief into law (and confront all the new moral conundrums that would entail), Mississippi rejected it instead (Leonard Pitts, 11/12).

Roll Call: Planned Parenthood Is A Responsible Provider
Nationally, one in every five women has turned to Planned Parenthood at some time in her life for professional, nonjudgmental and confidential care -; a statistic that underscores the trust women place in Planned Parenthood. ... In addition to providing essential health care, we have a strong record of fiscal responsibility. We follow all local, state and federal laws and comply with all regulations applicable to the receipt and use of federal and state funds. ... (Rep. Cliff) Stearns' probe has been widely criticized by abortion-rights supporters. ... We are confident that any fair-minded person will see through this politically motivated investigation (Peter Durkin, 11/14).

McClatchy: Putting Religious Group's Campaign Against Contraception Into Context
Remarkably, contraception has recently come under attack with new vigor. Earlier this year, the House of Representatives voted to eliminate Title X, the federal program that makes contraception accessible to low-income people throughout the country, and to defund Planned Parenthood's family planning work. Mississippi was contemplating a constitutional amendment that would outright ban some of the most common forms of birth control. And now, important new federal guidelines that will ensure insurance plans include coverage of contraception are being targeted (Sarah Lipton-Lubet, 11/13).

MSNBC: Vatican Push For Adult Stem Cells Can't Neglect Good Science
The Vatican this week reiterated that it has entered into an unusual partnership aimed at boosting use of adult stem cells to treat disease, rather than focusing on research into embryonic stem cells. Church leaders explicitly endorsed the work of New York-based NeoStem Inc. as part of the Vatican's recently announced $1 million, five-year initiative to direct research toward adult stem cell therapies and away from embryonic stem cell use. … Will the scientific or investment community in America or around the world take the suggestions of the pious and devout -; but scientifically rather undistinguished – seriously (Art Caplan, 11/13)?

Houston Chronicle: We Should (And Could) Be More Healthy
An important new survey reveals that 20 percent of Houstonians are in poor or fair health. … We fervently hope our local leaders -; health officials, educators, legislators, the business community, philanthropists -; can find the resources to truly make this survey a model for the country. We are a resourceful, innovative community. Surely we can do better for our neediest, least healthy neighbors (11/11).

Houston Chronicle: Texas Will Need 10,000 New Physicians Over The Next 10 Years: True Or False?
Texas is now close to the bottom at 42nd in doctors per population and its share of the projected shortage is 10,000. … Does Texas need more physicians, especially in rural areas? Probably. Does Texas need 10,000 more physicians in the next 10 years? Probably not (Arthur Garson Jr. and Carolyn Long Engelhard, 11/11).

New Orleans Times-Picayune: Beware Use Of Data To Ration Health Care
Comparative effectiveness research is an important type of research that pits different medical treatments against one another to measure which are most effective for patients. ... I hope local doctors and patients will appear at the Patient Centered Outcomes and Research Institute's public comment periods on Monday and Tuesday to remind its Board of Governors to stay true to their mission: providing "patient-centered CER" to the American people and helping ensure that lawmakers respect the well-intended provision in the Affordable Care Act meant to prevent the use of CER to ration health care (Dr. Donald Palmisano, 11/11).

The New York Times: A Singer's Search for an AIDS Cure
Today, we're at the most interesting and opportune time in the history of the epidemic, but it's the most perilous as well. Research has given us some spectacular advances. We now have extraordinary tools at our disposal, including a microbicide that reduces a woman's risk of acquiring H.I.V. and a pill that helps prevent its acquisition in gay men. ... But it takes money to distribute these tools (Kevin Robert Frost, 11/14).

The Connecticut Mirror: Exchange Board Lacks True Consumer Representation
I spend all day every day talking to and working for patients with chronic illnesses. ... What I see first-hand on a daily basis allows me to predict what the needs of patients will be as they seek to purchase insurance through the exchange. ... It's not enough to have good intentions; without real world experience working with consumers, the exchange board members will not anticipate and address consumers' needs (Jennifer Jaff, 11/11).

Denver Post: The Nation's Healthiest State Can Be Colorado
The vision of Colorado being the healthiest state in the nation is a bold one. More importantly, it's achievable. By understanding physical and mental health, education and jobs as inter-related investments, each dependent on the other, we can turn this bold vision into an exciting reality. While a focus on physical and mental health is important, we at the Colorado Health Foundation understand that our state and the nation can only make real progress if kids are well educated and people are working (Anne Warhover, 11/12).