Viewpoints: Giving states responsibility for 'essential benefits'; The cost of proton beam treatment; Health spending in 2012

Jan 3 2012

The New York Times: 'Essential Benefits' and Health Reform
The Obama administration surprised supporters and critics when it decided to let states define the "essential health benefits" that must be provided to their citizens under health care reform. ... Federal health officials will need to monitor developments during the transition period to make sure consumers and employers can easily compare the benefit packages offered by private insurers. In the long run, it would seem best to move toward a system in which all Americans enjoy the same benefits with only limited state-by-state adjustments (1/1).

The New York Times: It Costs More, But Is It Worth More?
If you want to know what is wrong with American health care today, exhibit A might be the two new proton beam treatment facilities the Mayo Clinic has begun building, one in Minnesota, the other in Arizona, at a cost of more than $180 million each. They are part of a medical arms race for proton beam machines, which could cost taxpayers billions of dollars for a treatment that, in many cases, appears to be no better than cheaper alternatives (Ezekial J. Emanuel and Steven D. Pearson, 1/2).

Des Moines Register: GOP Is Trying To Undo Gains In Health Care For Us
As the Iowa caucuses near, residents are scanning a field of candidates to find those differences that will earn a candidate their vote. Unfortunately for Iowans -; as well as the rest of the nation -; the Republican candidates vying for their party's nomination have one position in common: they all agree they would undo the gains this nation has made in the past two generations in making health care affordable and accessible to more and more Americans (Ron Pollack, 12/30). 

Des Moines Register: There's A Disconnect Between Public And Pols On Social Security, Medicare
Whether it's privatization proposals such as Social Security private accounts or Medicare vouchers, which would force seniors to pay a growing share of their health care costs, the Republican Party's front-runners for president seem uniformly out of touch with the average American's view on Social Security and Medicare (Max Richtman, 12/30)

The National Review: The Medicare Debate
Yes, the manner in which health care is delivered to patients in this country is fragmented, uncoordinated, full of waste and excess, and not responsive enough to patient concerns and wishes. But what's the primary cause of all of these problems? As research has shown, it's Medicare, and most especially Medicare's dominant "fee-for-service" insurance model (James C. Capretta, 12/27).

The Wall Street Journal: The Spenders Won 2011
The news is that after accounting for last-minute unemployment insurance extensions, "emergency" spending and higher Medicare physician payments, total federal outlays are estimated to be $3.65 trillion in fiscal 2012, up slightly from $3.6 trillion in 2011. The last year has seen no major reforms in any of the big entitlement programs-;Medicare, Medicaid or Social Security. Spending on food stamps alone is scheduled to reach $80 billion in 2012, more than double the amount as recently as 2007 (1/3).

Bloomberg: Tongue-Depressor Tax Will Harm Jobs, Innovation
A year from now, the federal government will start collecting a new tax on medical devices from tongue depressors to imaging machines, thanks to the sweeping health-care overhaul that Democrats enacted in the spring of 2010…. Medical-device companies employ more than 400,000 Americans. Their wages are higher than the national average. The U.S. is a net exporter of medical devices. The tax will change these numbers for the worse (Ramesh Ponnuru, 1/2).

CNN: Why Health Care Competition Won't Work
A proposal by Rep. Paul Ryan and Sen. Ron Wyden to allow those who retire in the future to chose between Medicare and private health care insurance for seniors is the latest addition to the drive to increase competition in health care. ... But research shows that competition in health care cannot be made to work effectively. As patients, we are just not equipped to absorb and process the information needed to make healthy choices on our own (Amitai Etzioni, 12/27).

Los Angeles Times: Medicare Reform: This Could Work
[Sen. Ron Wyden, D-Ore., and Rep. Paul Ryan, R-Wis.,] have teamed up to offer a bold and politically risky plan that could help slow the rate of growth of premiums and bring more innovation to the health insurance market without dismantling one of the federal government's most popular programs.  ... the country can't afford Medicare as we know it today, and last year's healthcare reform law started the process of changing it. The Wyden-Ryan plan is a promising addition to that effort (12/28). 

The New York Times: Wyden-Ryan's Unrealistic Assumptions
Mr. Ryan and Mr. Wyden say their system would control the growth of Medicare spending better than the current system by encouraging more efficient cost-sensitive decision-making by both providers and consumers. This incentive argument has considerable analytical appeal, especially among economists – competition usually reduces costs in most markets. But the markets for insurance and health services are not like most markets, and there is scant evidence to support the Ryan-Wyden assertion (Laura D'Andrea Tyson, 12/30).

The Kansas City Star: Ryan/Wyden Health Care: Controversy Over Ending Medicare Distracts From Real Issues
Though the plan may provide assistance to people with limited incomes, it remains unclear (to me at least) what the government would do if people elected not to use their vouchers or subsidies to buy insurance. As the gap between the subsidy and the cost of Medicare or private insurance increases, many poor seniors could decide they would rather eat than pay the premium. … From my perspective, the Ryan/Wyden proposal is earnest, but shifting the increasing cost of medical insurance to seniors won't work without real cost containment (George Harris, 1/2).

New England Journal of Medicine: Building The Path To Accountable Care
The recent release of the regulations that will govern the early years of Medicare's implementation of accountable care organizations (ACOs) provides an important moment to reflect on the transition to this new payment model. ... Traditional fee-for-service models will almost certainly see continued cuts in payment rates -; which will make physicians' and other providers' work even more difficult if they remain under this payment model. Additional steps to accelerate the transition toward accountable care offer the public and providers a better and more hopeful path (Dr. Elliott S. Fisher, Dr. Mark B. McClellan and Dana G. Safran, 12/29).

Los Angeles Times: Supreme Court: The Recusal Question
Chief Justice John G. Roberts Jr. has addressed complaints that a member of the Supreme Court has the last word when it comes to deciding whether to participate in cases in which his impartiality is questioned. Roberts' response: Things are fine as they are. ... That confidence, however, is not universally shared (1/3).

The Washington Post: Gloomy Numbers For Obama
(President Obama's) current Gallup approval rating is the lowest ever for any incumbent president at this point in his first term. Obama's ratings on the economy, the issue voters care about most, consistently trail his overall numbers. His top legislative accomplishment -; health-care reform -; remains unpopular. It's 20 points underwater in a December Associated Press-GfK poll (Charles Lane, 1/2).

Miami Herald: America's Failing Healthcare
With South Florida still accounting for one of every three Medicare fraud cases in the nation, prosecutors should continue a full-court press until crooks understand that trying to game the Medicare system leads straight to jail. And the federal government should make sure service is delivered before payment is made. That alone would go a long way towards fixing one of the most vexing and wasteful problems in the realm of healthcare (12/27).

Denver Post: Insurers Should Reward Wellness
This country loves its sin taxes. Look no further than the ample levies on cigarettes and booze for confirmation of that. So, it should follow that when it comes to health insurance, policy makers might look to what amounts to a fat tax, or a high blood pressure tax, right? We think that's the wrong way to approach the issue. There is a difference between incentivizing the good and punishing the bad (1/1).

Boston Globe: A Corporate Culture Of Health (Or Else)
This is the new wave of corporate activism: Looking out for employees' health, in ways that are sometimes gently encouraging, sometimes more coercive. In 2010, at Boston-based insurance broker William Gallagher Associates, employees were asked to fill out a voluntary survey about their health, and got a $50 gift card in return. In 2011, the company offered a set of lab screening tests, free, along with a considerable stick: If employees declined to do the bloodwork, the company would pay a smaller percentage of their health care premiums (Joanna Weiss, 1/1).

Boston Globe: Tiered Coverage, SaveOn Plans Can Boost Cost-Conscious Care
Over time, the best way to reduce health care spending will be for the cost of medical services to figure more prominently in the decisions that doctors and patients make about which services to seek. That transformation is already beginning to occur in Massachusetts. Despite the inevitable turmoil for insurers, providers, and patients alike, the Commonwealth's regulators and policymakers should let the change play out (12/31).

The Detroit Free Press: State Health-Care Exchange Held Hostage In House
The state Senate, grudgingly but responsibly, passed a bill that enables Michigan to begin planning its own health-care exchange. ... Setting the plan in motion now allows the state to apply for federal grants to help cover the costs, and then to hire the expertise for this complex job before other states snap up the most competent firms. … But some House Republicans have been quoted as saying they want to wait for the U.S. Supreme Court to rule on the constitutionality of the individual mandate -- a ruling that may well take until the end of June since oral arguments won't be held until March 26-28 (1/3).

Mercury News: Make Flu Shots Or Masks Mandatory For Hospitals
A statewide survey found only 64.3 percent of hospital employees got a flu vaccination in the 2010-11 season. For health care workers, this isn't just a matter of personal risk. Those poor marks mean patients are being exposed to viruses that can be lethal to them if they're already weakened by other illnesses. Hospitals have a responsibility to make sure their workers get flu shots or, if some employees can't or won't, to require them to wear masks when they're around patients  (1/2).

The Baltimore Sun: On Medical Marijuana, Maryland Should Go Slow
Legalizing medical marijuana would be complicated no matter what approach Maryland takes. The state would have to figure out a way to regulate the growing of marijuana and to ensure its security from farm to user, as well as to make sure patients are legitimately using the drug to treat themselves and not selling it or giving it to others -; a problem with all controlled substances. And the fact that marijuana remains illegal under federal law presents additional complications for all those who would be involved under either scenario (1/3).