Viewpoints: If not the health law, then what?; Shifting Medicare costs isn't enough

Chicago Tribune: Reforming Health Reform
When President Barack Obama's health care reform was making its way through Congress, Republicans and other opponents registered plenty of criticisms: It was too generous, too inflexible and too centralized. But such concerns were brushed aside in the push to get a bill passed. Today, it's harder to ignore those flaws. Implementation of the program has brought tougher challenges than the administration led Americans to expect. So it has been obliged to make some major concessions to reality (12/20).

The Dallas Morning News: GOP's Calls For Obamacare's Repeal Mean It's Time To Get Serious On Health Care Alternatives
All of the Republican candidates for president have promised to overturn the 2010 Affordable Care Act, otherwise known as "Obamacare." House Republicans have already voted to repeal it. But there haven't been many suggestions for a different path for an affordable health care system available to all Americans. Newt Gingrich, citing the work of John Goodman of the Dallas-based National Center for Policy Analysis, has urged an alternative to the 2010 law's mandate that all Americans buy health insurance (Jim Landers, 12/19).

The New York Times: For Medicare, We Must Cut Costs, Not Shift Them
So if premium support plans aren't the answer, what should be done about Medicare? To address the root of the cost problem, we must change how we pay doctors and hospitals. We must move away from fee-for-service payments to bundled payments that include all the costs of caring for a patient, thereby encouraging providers to keep patients healthy and avoid unnecessary services. Medicare should announce that it will make this change by Jan. 1, 2022, and that it will begin by switching to bundled payments for cardiac and orthopedic surgery within one year and for cancer patients within five (Ezekiel J. Emanuel, 12/19).

San Francisco Chronicle: Reform Medicare Before It's Too Late
With Medicare projected to run out of money in 2024, at least (Sen. Ron Wyden and Rep. Paul Ryan) are talking about changing a system that is unsustainable. Republicans maintain that only market competition can curb rising health care costs that have outpaced inflation. Wyden-Ryan allows that competition, but in a regulated framework that requires private plans to provide benefits on a par with Medicare coverage (12/19).

Los Angeles Times: Boehner's Brinksmanship
It's only fitting that House Speaker John A. Boehner (R-Ohio) would close the year with one more act of brinksmanship. Boehner announced Sunday that he opposed the bipartisan deal in the Senate on a stopgap extension of soon-to-expire payroll tax cuts, unemployment benefits and Medicare payment rates for physicians -; a deal that he reportedly urged his caucus to accept, only to have other members of his leadership team oppose it. The Senate proposal was far from perfect, but it gave the House GOP a clear win on what supposedly was its top priority: the Keystone XL pipeline project. By not accepting the deal, House Republicans show again that they're unable or unwilling to stop moving the goal posts (12/20).

San Jose Mercury News: Help Iraq Veterans Succeed When They Get Home
More than 2 million Americans have served in Iraq or Afghanistan …. Many will need treatment for depression or post-traumatic stress. It's far better -- and far cheaper -- to spend money on helping veterans become productive members of society than it is to allow them to slide into poverty and homelessness. When that happens, health care and other services will cost far more in public dollars and human misery (12/18).

Houston Chronicle: Texas Faces Critical Shortage Of Primary-Care Providers
Texas needs thousands of primary-care providers over the coming years to ensure that its fast-growing, underserved population has access to basic health care and doesn't end up going someplace far more expensive for treatment, such as an emergency room. Texas faces a shortage of primary-care doctors for several reasons. One is the Patient Protection and Affordable Care Act. As a result of the act, starting in 2014 the demand for health care will go up because more and more people will be eligible for the Medicaid program. ... Another contributing factor is that doctors are being forced to leave the state to complete their residency training (Bill Hammond, 12/19).

Journal of the American Medical Association: Science, Politics, And Over-the-Counter Emergency Contraception
Federal agencies know that decisions involving sexual matters are often controversial. But virtually no one foresaw the extraordinary reversal of an FDA decision about drug approval by a secretary in President Barack Obama's cabinet, a decision the president said that he fully supported. ... As the presidential election of November 2012 approaches, it is perhaps not surprising that HHS Secretary Sebelius and President Obama are now part of the continuing saga of over-the-counter emergency contraception in the United States. ... The decision has set an unfortunate precedent (Dr. Robert Steinbrook, 12/19).

Houston Chronicle: Another Local Medicare Fraud Scheme Exposed
Chronicle reporter Terri Langford has once again performed a valuable service by continuing to expose the massive fraud schemes that exploit Houston's weak and sick and cost Medicare and taxpayers millions of dollars…. But the positive news is that these indictments are the result of a large collaboration of many Texas and federal agencies that have been working together for several years on Medicare fraud in Houston. We appreciate their efforts in this long, distasteful saga, and we appreciate the public service of Langford and reporters like her who keep us well informed (12/19).

California Healthline: How Can California Make Most Of Telehealth Law
For the second half of the 20th century, California was a leader on several fronts of health care's evolution. California innovations and maturations in integrated delivery, managed care, stem cell research and electronic health records often set the agenda for national trends. Now California is poised to do it again with a 21st century innovation -- telehealth. New state legislation (AB 415) passed this fall has the potential to move two-way audio-visual technology out of the realm of wonky oddity and into the mainstream, according to some industry experts. … We asked experts what California policymakers and health care providers can do to make the transition proceed smoothly and effectively (12/19).