Viewpoints: Debt estimates and Medicare plans; Sen. McConnell on fate of health law

Feb 2 2012

The Washington Post: The Dangerous Fiscal Path That Looms
Debt projections released Tuesday by the Congressional Budget Office illustrate three fiscal paths: dangerous, dumb and smart. ... President Obama has called for a balanced solution but has neither proposed serious tax reform nor adequately outlined the ways in which he would get entitlement spending, particularly Medicare, under control. The position of most Republicans, on the presidential campaign trail and in Congress, is wildly less responsible (1/31).

(San Jose) Mercury News: Budget Super Committee's Failure Puts Medical Research At Risk
As a result of the inability of the so-called congressional Super Committee to deliver a budget proposal, lawmakers are required to make $1.2 trillion in cuts, half from defense and half from domestic programs, including research sponsored by the NIH. Reducing our investment in medical research surely would slow the remarkable progress we have made in new fundamental discoveries that can ultimately improve the health of our nation's citizens (Dr. Philip Pizzo, 1/31).

Politico: If Mandate Dies, So Should ACA 
One issue is what the Supreme Court should do with the law if it declares the government requirement for health insurance -; the "individual mandate" -; to be unconstitutional, as we believe it should. If the individual mandate is ruled unconstitutional, the rest of the law should be thrown out, too. The reason is simple: The individual mandate is so central to this misguided law that Congress did not intend for the PPACA to stand without it (Sen. Mitch McConnell (R-Ky.) and Carrie Severino, 1/31).

The Wall Street Journal: Class Warfare
The House votes today on repealing one of the Affordable Care Act's major new subsidy programs, and the referendum deserves more attention than it will probably get. The important point is not merely eliminating one of ObamaCare's worst abuses, but that the entitlement state might shrink for the first time in generations. Known by the acronym Class, the long-term care insurance program for nursing homes and the like was grafted onto the health-care bill mostly to hide that bill's true costs (2/1).

Politico: Repeal CLASS Act Already
In principle, the CLASS Act addresses the real need for improved national approaches to the long-term care needs of an increasingly elderly population. The good news, unfortunately, ends there. It's not good policy. It offers no strategy for a flexible, market-based delivery of valued services to the homes of those needing assistance. Instead, there's another government check, theoretically financed by payroll taxes during the working years. ... This runs a real danger: Only those guaranteed to have the highest bills sign up for the CLASS Act -; and then spending explodes (Douglas Holtz-Eakin, 1/31).

Politico: Implementing Health Reform
But the new health care law now calls for uniform health insurance summaries, available to all consumers starting in 2012. ... Every private health plan is required to provide this summary, so consumers for the first time will be able to compare options on an apples-to-apples basis. This holds true even if the options are from two different employers, or consumers are considering options on an individual basis. We expect a final ruling from the Office of Management and Budget soon. But the real question is: What will the rule, and ultimately the summaries, look like? Though the law is clear, strong objections from certain employer groups cast doubt on what consumers will likely get to see (Lynn Quincy, 1/31). 

The Wall Street Journal: The Wealth Report: Occupy … Your Doctor's Office?
The medical profession, certainly, has its share of corruption, fraud, greed and over-compensation – sometimes at the expense of taxpayers through Medicare and Medicaid. Most voters would agree that medical costs have soared far too high, often benefitting the doctors. Yet using doctors to protest inequality would be a losing proposition. Bankers make for much better targets – even if they're a smaller slice of the 1% (Robert Frank, 1/31).

Denver Post: Preserve Specialized Care
(W)e risk losing the excellence that distinguishes America's health care from others worldwide. ... We fear however, massive health system consolidation and homogenization; a zeal to decrease the testing and number of procedures performed; and the further commoditization of the physician/patient relationship (with providers having such a brief time with patients and families to actually listen to their needs), which will progressively worsen health care delivery and outcomes. Limiting or eliminating access to specialists or second opinions may reverse the astonishing gains we have made in treating some of the most deadly and chronic diseases (Michael Salem, 2/1).

Journal of the American Medical Association: Specialization In Medicine
Today, most individual physicians and surgeons are trained and qualified to provide only some kinds of care. Thus, the physician workforce has differentiated into a heterogeneous group of professionals. In 1960, there were only 18 specialty boards and a handful of subspecialties in the United States, but by 2011 there were 158 specialties and subspecialties. ... These differences raise the question of how much medical specialization is good for society. ... The criteria for certifying a new subspecialty appear to have been largely technology driven. There has been no requirement for empirical evidence that creating a specialty will do more good than harm (Dr. Allan S. Detsky, Stephen R. Gauthier and Victor R. Fuchs, 2/1).

The New York Times: Opinionator: Finally, Good News About School Lunches
Thirty-two million kids -; 10 percent of the American population, and the future of the country -; are about to start eating better. That's the bottom line of the new Department of Agriculture (U.S.D.A.) guidelines for government-subsidized school meals, announced last week. The new rules are the first changes to the program in 15 years, and come as part of the Healthy Hunger-Free Kids Act (Mark Bittman, 1/31).

Kaiser Health News: Taking Steps To Overcome Alzheimer's Disease
More than 10,000 baby boomers turn 65 each day -- that's one every eight seconds, a pattern expected to continue until 2029. As these baby boomers age, one of out of eight of them will develop Alzheimer's -- a devastating, costly, heartbreaking disease. It is time for a national strategic plan to address this disease, which today is the sixth leading cause of death and the only one among the top 10 causes without a way to cure, prevent or even slow its progression (Robert Egge, 2/1).

Kaiser Health News: The National Alzheimer's Plan: An Opportunity For Action
The National Alzheimer's Project Act provides an historic opportunity to develop and act on a comprehensive approach to the detection of memory disorders and the management of Alzheimer's disease. ... But the draft framework is somewhat vague even as it contains excellent goals and begins to focus the minds and resources of key stakeholders on these issues (Dr. Rachelle S. Doody, 2/1).

HealthyCal: Helping Californians Access, Afford And Adhere To Quality Health Care Will Have Dramatic Benefits
Difficult economic times are forcing many Californians to make difficult choices every day about whether to continue taking medication or to feed their families and pay rent, while many Californians are simply unable to afford quality health care. Governor Brown's recently proposed budget cuts, including reducing reimbursement rates and shifting more Californians into managed care, will make the strain even greater (Eric Glassman, 1/31).

Boston Globe: On Health Care, Legislature Shouldn't Hurt Its Own Reform
Even before this year's grand debate about containing health care costs begins on Beacon Hill, a pointed disagreement has broken out among key players in the state health care arena. The health plans fear that legislative meddling is opening holes in the very cost-controlling arrangements that a recent law required, while legislators contend they are simply looking out for individuals who might be hurt by policy changes. There is nothing wrong with trying to minimize disruptions on patients from changes to their insurance plans, but the recent proposal to give certain patients the right to keep receiving treatment at higher-cost hospitals is too broadly written (2/1).

Houston Chronicle: Time For Some Innovative Thinking In The War On Cancer
Instead of concentrating all of our funding on research to develop weapons of mass destruction against cancer, we could use more funds to identify the risk factors that lead to cancer's development and ways to intervene before cancer arises. And we know many of these already: smoking, obesity, radiation, sexually transmitted diseases and asbestos exposure far outweigh innate genetic syndromes as causes of human cancer. We have some choices to make (Dr. Leonard A. Zwelling, 1/31). 

The Sacramento Bee: State Must Grapple With Aging Prisoners
A new report issued last Friday, "Old Behind Bars: The Aging Prison Population in the United States" by Human Rights Watch, puts the California situation in national perspective. In 1990, California state prisoners age 55 or older were a manageable 2.1 percent of the prison population. In 2009, they were 7.1 percent – taking up 38 percent of prison medical beds. By 2019, the state expects older prisoners to be 15 percent of the prison population. … Dealing with geriatric populations behind bars is costly, especially since prisoners are not eligible for federal health insurance programs for the elderly – Medicare and Medicaid. The state picks up the tab (2/1).