Longer looks: The Obama memos on health reform, Romney's Medicare mistake?, Flu 2012

Jan 27 2012

Each week, Jessica Marcy selects interesting in-depth health policy reading from around the web.

The New Yorker: The Obama Memos: The Making Of A Post-Post-Partisan Presidency
The President's caution, and his concern about business, can be seen in the way he dealt with major interest groups. ... His health-insurance bill was crafted by building support from a delicate alliance of interest groups, and Obama personally guided the effort. On July 1, 2009, his top health-care adviser, Nancy-Ann DeParle, submitted a detailed nine-page policy memo asking whether the White House should consider including medical-malpractice reform in the legislation. ... "Obviously, we shouldn't do anything that weighs down the overall effort," Obama wrote back, in his characteristically cautious and reasonable style, "but if this helps the AMA stay on board, we should explore it" (Ryan Lizza, 1/30).

National Review: Inside The Obamacare Spin Zone
Last week, the White House issued a new "study" on the supposed progress states have made in implementing the "health exchanges" that are central to constructing the Obamacare system. … Upon closer inspection, it's clear that many of the 28 states that are supposedly "on their way" really aren't "on their way." ... A more accurate description of what is going on would go like this: The bluest of blue states (and the District of Columbia) are, not surprisingly, moving ahead with Obamacare implementation, and are at various stages in the process. ... the administration can rightly claim 15 states are more or less playing ball with them. But with the other 35 states, the picture is very, very different (James C. Capretta, 1/23).

The Daily Beast: Mitt Romney Has Signed Paul Ryan's Suicide Note
Romney in December for the first time expressed unequivocal support for the Ryan plan-;and the end of the Medicare guarantee for those now under 55. Would a President Romney do such a thing? Would Congress really ultimately go along with it? Probably not and certainly not. But can President Obama credibly allege that a President Romney might do it? And will those allegations exact an electoral cost? If the answers to those questions prove to be "yes," conservative critics will blame Romney for his "weakness" as a candidate. But the real weakness will be that Romney acceded to those conservatives' pressure to co-sign Paul Ryan's suicide note (David Frum, 1/20).

The Washington Post: After The death Of Jack Kevorkian, Lawrence Egbert Is The New Public Face Of American Assisted Suicide
(Lawrence) Egbert estimates he has been present for 100 suicides in the past 15 years, a figure that puts him in the same league with the famed assisted-suicide maverick Jack Kevorkian, who claimed to have helped more than 130 people die. ….  It has been more than 17 years since Oregon voters passed a ballot initiative approving the nation's first assisted-suicide law for terminally ill patients. Only one other state -; Washington -; has legalized the procedure, and the American Medical Association remains firmly opposed(Manuel Roig-Franzia, 1/19).

American Medical News: Hospital Employment Pits Work Rules Against Physician Rights
[W]ith physician employment on the rise and a push toward greater integration among hospitals and physicians amid health system reform, the line between medical staff rights and hospital employment obligations is becoming increasingly blurred. And not knowing how to navigate such murky waters before getting hired could sink a physician, experts warn. … If quality or safety issues arise, for example, or if a physician has benefited from an exclusive contract, and in either scenario the doctor leaves or is terminated, hospitals must be able to replace the doctor for continuity of care (Amy Lynn Sorrel, 1/23).

The Daily Beast: Flu Season 2012: Why Is No One Getting Sick?
We have lived for a few years amid a torrent of reports about the clear and imminent danger of epidemic flu (avian, swine, novel H1N1, whatever). States have passed laws requiring vaccinations for some groups and have stockpiled antiviral flu medications. ... here we are in late January, when people should be hacking and sneezing and aching, and flu activity is, according to the Centers for Disease Control and Prevention, at "relatively low" levels.  ... Flu epidemics are notoriously hard to predict and track. ... In fact, what we are seeing here is the dark secret of medicine and public health: the fact that we usually have no clue why something, good or bad, is happening (Kent Sepkowitz, 1/23).