Viewpoints: What now for deficit cutters; Berwick's replacement

Nov 28 2011

Los Angeles Times: The Super Committee That Wasn't
There's already a bipartisan group of senators, the maverick "Gang of Six," that is volunteering to produce a new compromise package. ... The Gang of Six plan won't make anybody happy. It's modeled on the bipartisan proposal offered last year by former Sen. Alan Simpson (R-Wyo.) and former Clinton Chief of Staff Erskine Bowles. It includes tax increases bigger than most Republicans say they'll accept, and cuts in future Medicare and Social Security payments that liberal Democrats find abhorrent. ... But it's the best starting point we have (Doyle McManus, 11/27).

The Washington Post: A Grim Diagnosis For Our Ailing Health Care System
Even had it succeeded, the super committee would have failed. Ultimately, the only way to control federal spending and deficits is to suppress the upward spiral of health costs. These are already the budget's largest single expense (27 percent in 2010, compared with 20 percent for defense), and their continued rapid growth, combined with the scheduled introduction of Obamacare, will soon bring them to nearly one-third. The super committee didn't have the time or staff to solve a problem as contentious and complex as health care (Robert J. Samuelson, 11/27).

Forbes: What the Super Committee Failure Means for Senior Health Programs 
The super committee's failure may have delayed the inevitable, but medical care, long-term care, and supportive services for seniors remain prime targets in an era of tight budgets. Supporters would do well to use their reprieve to plan for how they'll respond to cuts that are sure to come (Howard Gleckman, 11/23).

The Washington Post: The Super Committee Failed Because Republicans Refused To Compromise 
While strongly opposing Republican proposals to end the Medicare guarantee and force seniors into the private insurance market without adequate support, we [Democrats] were prepared to put on the table all the Medicare and Medicaid reforms recommended by Simpson-Bowles. In total, the mandatory health care savings proposed by the major Democratic plan equaled those in Simpson-Bowles (Rep. Chris Van Hollen, 11/27). 

The Washington Post: The Super Committee Failed Because Democrats Insisted On $1 Trillion In New Taxes
We do not choose to add more to the blame game for failure of the Joint Select Committee on Deficit Reduction, but one Democratic talking point needs debunking: that the talks failed because of Republicans' attachment to the Bush tax cuts. The untold story of the negotiations is the significance of the Republican offer of fundamental tax reform. It is critical to understand the interplay between the proposal (dubbed the "Toomey plan") and existing tax law (Jon Kyl, Rob Portman, Pat Toomey, Jeb Hensarling, Fred Upton and Dave Camp, 11/25).

Reuters: The Super Committee Fails So Let's Go On A Spending Spree
Beyond looming demands for more tax cuts and benefits, Medicare payments to physicians are scheduled to decline by 27 percent in January. The financing of Obama's health care package is predicated on enormous Medicare savings down the road, so a Medicare payment cut in January sounds like good news. But there's already a move afoot to cancel the cut (Gregg Easterbrook, 11/23).

Denver Post: Congress, Don't Fail Us This Time
Even as Americans digest the super committee's failure to reach a deficit reduction agreement, another tough budgeting task looms for Congress. Federal lawmakers must take on the impending expiration of federal payroll tax cuts, an unemployment benefit extension and the so-called Medicare doc fix. They cannot fail this time. The country's fragile economy can ill afford such a hit (11/25).

The New York Times: A Vacancy That Needs To Be Filled
Now that Congressional Republicans will no longer have Dr. Donald Berwick to demonize as head of the federal agency that runs Medicare and Medicaid, is it too much to hope that they will declare a cease-fire and allow quick confirmation of his proposed successor? (11/27).  

USA Today: Why Contraception Mandate Should Be Scrapped
The administration should resist the recently reported calls by some liberal Democrats to impose this sweeping and intrusive mandate, which goes well beyond any existing state law requirements dealing with contraception coverage. The rules also clearly conflict with both the moral convictions and religious obligations of many individuals, insurers and employers (Richard W. Garnett, 11/27).

The New York Times: Battling Over Birth Control
The contraceptives mandate is one of the administration's proud achievements. Weakening it should not even be on President Obama's radar screen (11/24).

New England Journal of Medicine: Making Sense Of The New Cervical Screening Guidelines
There is general agreement that in well-screened, low-risk women with no history of cancer or high-grade precancerous lesions, there comes a point when additional screening confers little added benefit. ... Health care is a limited resource, and providing the best care at the best price will become increasingly important. ... [E]ven with the best consensus guidelines, some clinical judgment and personalized attention to each patient remains necessary (Dr. Sarah Feldman, 11/23).

The New York Times Economix Blog: The Supreme Court And Health Care
For decades Americans have been served, in the print media and on television, with sorry vignettes of fellow Americans who have seen their health-insurance premiums increased or lost their insurance coverage altogether because illness struck or were denied coverage because of pre-existing medical conditions. ... Sometime in 2012, ... the Supreme Court will decide whether Americans will just have to live with that problem (Uwe E. Reinhardt, 11/25).

The New York Times: Still Fighting Against AIDS
The latest report from the United Nations agency in charge of the global fight against AIDS reveals substantial success by some measures and stagnation by others. The challenge, in tough times, that must be met is to find enough resources to capitalize on scientific breakthroughs and keep the campaign moving forward (11/27).

Houston Chronicle: Lung-Cancer Screening Can Save Patients' Lives
In an article published in the June issue of the New England Journal of Medicine, new research showed that lung cancer deaths were definitively reduced when patients received screening CT chest scans. … Some screening procedures offer more definitive answers than others. Colon cancer screening, for example, has clearly proven vastly effective in saving lives. I believe this new lung cancer screening study presents that same kind of clarity (Dr. Maurice Willis, 11/25).

Houston Chronicle: Tort Reform Resulting In Better Care For Texans
We are blessed in Texas with leaders who had the foresight and political will to support common-sense changes that are working for Texas. The numbers are indisputable, and the national acclaim is steady and warranted. But as civil justice issues continue to draw the ire of relentless opponents of common-sense reforms, we can only hope that the personal injury lawyer attack agenda is revealed for what it really is: a self-serving effort to undermine the smart reforms that have curbed the litigation lottery in Texas (Dr. Thomas Wilder, 11/24).

Dallas Morning News: Money, Training Key To Improving Parkland's Psych ER
Part of the answer is for Parkland to recruit more skilled psychiatric workers. That effort will require money, which is not easy to come by in today's economy. But Parkland's current practice of paying psychiatric emergency room workers less than the hospital pays its parking lot attendants and some clerks will not yield staffers with the right expertise (11/24).

Detroit Free Press: After Closing Psychiatric Hospitals, Michigan Incarcerates Mentally Ill
Wayne County Sheriff Benny Napoleon spoke for most sheriffs when he said, during a community meeting earlier this year, that his jail had become his county's largest mental health care institution. Over the last two decades, changes in state policy and big cuts in funding for community mental health care have pushed hundreds of thousands of mentally ill people into county jails and state prisons. Between 1987 and 2003, Michigan closed three-quarters of its 16 state psychiatric hospitals, including Northville in suburban Detroit. The state now provides the sixth-lowest number of psychiatric beds per capita in the nation, reports the Treatment Advocacy Center (Jeff Gerritt, 11/27).

Forbes: Consumer Driven Health Care Proponents Finally Proven Wrong
Meet Grand Junction, Colorado, home of superior medical treatment for an entire community while ranking sixth from the bottom in the nation when it comes to costs per patient. ... Consumer driven health care proponents argue that placing the responsibility on the individual to pay for a larger share of their health care expenditures results in greater competition as consumers "shop" for the best prices and make fewer visits to the doctor as a result of having to pay a greater share of the cost of their visits. Yet, Grand Junction, Colorado has discovered that it is exactly the opposite that is dramatically bringing down costs in their part of the country (Rick Unger, 11/27).

Des Moines Register: From Charitable Origins To 'Wall Street Values'
In protests from New York to Des Moines, the central concern is the same: [G]reed has corrupted our culture. Industries have grown so large and rich that they have usurped our government through political influence. Their executives own more and more of our nation's wealth. Though this state of affairs conjures images of huge, profitable corporations, we might also consider many hospitals (and other care facilities) for inclusion (Dean Lerner, 11/26).

Denver Post: A Critical First Step Toward Tackling Drug Shortages
As an important first step to begin to tackle this crisis, I have introduced bipartisan legislation to provide an early warning system, enhancing communications among all relevant stakeholders when shortages occur. The bill requires manufacturers to notify the FDA of shortages -; including discontinuances or production interruptions -; promptly. Information on those shortages, including the expected duration, would then be posted on the FDA website and distributed to health care providers and organizations (Rep. Diana DeGette, 11/25).

Reuters: As Open Enrollment Winds Down, Grab What's Yours
To really crank up your compensation, you don't have to confront your boss with any ultimatums. You just have to crack open your employee handbook. If raises might offer a potential 3 percent boost, employee benefits represent 10 times that amount of your total compensation. For private-sector workers, benefits now comprise 29.6 percent of what you're taking home -; even if you don't realize it. And if you're a government staffer, that number spikes even higher, at 34.6 percent (Chris Taylor, 11/23).

Minneapolis Star Tribune: In Times Of Health, Insurance Seemed Optional
If health care would have been accorded to me as easily in the United States as it was in Italy, I might have opted to treat my breast cancer before it moved to my bones. … Although it is too late for me, I hope that the mandated health insurance will be upheld in the courts. Universal coverage is a good first step in helping to reduce the costs and to bring down the barriers so American citizens can receive the simple human right that people, even tourists, in other developed countries receive as a matter of course: medical care when they need it (Katherine Morrow, 11/25).

Modern Healthcare: No Solutions Here
Vendors nowadays offer their customers services that they invariably label "solutions." The American political establishment, especially Congress, peddles solutions that are in reality, problems -; huge ones. That became painfully evident to health care professionals and just about everyone else with the failure of the wildly misnamed super committee to reach a deficit-reduction deal. Now providers are left facing Medicare cuts, including a 27 percent whack to physician payments, as well as a raft of painful reductions in discretionary health spending (Neil McLaughlin, 11/28).

Boston Globe: Medicaid Has A Problem, But Block Grants Won't Solve It
It's become a consensus position among the Republican presidential candidates that Medicaid, a federal entitlement program best known for providing health care to the poor, should be turned over to the states as a block-grant program. States know their own needs, the logic goes, and will use fixed grants creatively and efficiency -; as opposed to a federal bureaucracy that writes checks on behalf of all who qualify. But if only it were that simple (11/25).