First Edition: February 13, 2012

Feb 13 2012

Today's early morning highlights from the major news organizations preview President Barack Obama's budget, which will be released today, and examine the lingering controversy over mandates on contraceptive coverage.

Kaiser Health News: Experts Question Medicare's Effort To Rate Hospitals' Patient Safety Records
KHN reporter Jordan Rau, in collaboration with The Washington Post and the The Boston Globe, writes: "Medicare's first public effort to identify hospitals with patient safety problems has pinpointed many prestigious teaching institutions around the nation, raising concerns about quality at these places but also bolstering objections that the government's  measurements are skewed" (Rau, 2/12).

Kaiser Health News: FAQ: The Obama Administration's Compromise On Contraception Benefits
Kaiser Health News reporter Mary Agnes Carey writes: "The Obama administration, stung by fierce opposition from Catholic leaders to a new rule requiring that insurance plans offer free contraception, announced it is revising the regulations so that religious-affiliated groups don't have to pay for the coverage. But President Barack Obama insisted that all women must still be covered" (Carey, 2/10).

The Wall Street Journal: Budget Sets Stage For Year-End Clash
President Barack Obama's budget plan, to be released Monday, will serve both as an outline of his re-election campaign message and a blueprint of the White House strategy for another clash looming after the November elections. At year's end, the president and Congress face several major deadlines: the scheduled expiration of Bush-era tax cuts, $1.2 trillion in politically unpopular spending cuts-;half of which would fall on defense spending-;and the likely need to raise the federal borrowing limit. Medicare doctors also will face a large pay cut if Congress doesn't change the formula for their payments. ... Mr. Obama's budget plan will offer an alternative course: replace the scheduled year-end spending cuts with a combination of tax increases on the wealthy and some modest reductions to Medicare and Medicaid (Paletta and Meckler, 2/13).

The Washington Post: Jacob Lew Defends Obama's Spending Plan
White House Chief of Staff Jacob J. Lew on Sunday dismissed Republican criticism of President Obama's latest spending plan, arguing that it charts a long-term strategy for tackling the national debt while offering a short-term boost to the recovering economy. ... An additional $360 billion would come from trimming spending on federal health programs, such as Medicare and Medicaid, the biggest drivers of future borrowing. Those savings would come primarily from cuts to providers, including drug companies, rather than the sort of broad restructuring that many analysts say will be necessary to control costs. House Budget Committee Chairman Paul Ryan (R-Wis.) has criticized Obama for failing to offer a long-term cost-control strategy, such as his proposal to privatize Medicare for future retirees, which has come under fierce attack by Democrats (Montgomery, 2/12).

Los Angeles Times: Obama Budget Is Preview Of Election Battle
House Republicans are expected to offer a budget that renews their call for a major overhaul of Medicare, although it is not clear whether they will endorse the voucher program proposed last year by House Budget Committee Chairman Paul D. Ryan (R-Wis.). ... But the president's budget, like his previous proposals, steers clear of major changes. Ryan's Medicare proposal became a forceful weapon for Democrats last year, and many lawmakers on Capitol Hill have urged the White House not to undercut that issue. Obama's budget will repeat a call for $360 billion in reductions to Medicare and Medicaid, administration officials said, but avoid broader changes to the programs (Hennessey and Parsons, 2/13).

Politico: Obama's Budget Meant As Challenge
(T)he budget rollout in Washington will show a fourth year of $1 trillion-plus deficits and a 2013 shortfall of $901 billion -; nearly twice the share of GDP that Obama predicted four years ago. The debate was already under way Sunday morning as White House chief of staff Jack Lew sparred across the television screen with House Budget Committee Chairman Paul Ryan, a Wisconsin Republican who at 42 is almost exactly the age Lew was when he oversaw the most recent balanced budgets in the 1990s during the Clinton administration (Rogers, 2/13)

The New York Times: Obama Faces Task of Selling Dueling Budget Ideas
In Congress, Democrats and Republicans continue to negotiate over a package that would extend a temporary two-percentage-point cut in workers' payroll taxes through this year, along with unemployment compensation for those out of work for more than six months and a delay in a scheduled deep reduction in Medicare reimbursements to doctors. "I do believe this will be extended," Representative Paul D. Ryan, the Republican chairman of the House Budget Committee, said on the ABC program "This Week." The two sides are split over how to offset the cost of the package, but lawmakers who worked over the weekend reported making progress (Calmes, 2/12).

Politico: Tax Standoff Remains After Weekend Talks
A weekend of talks between the two top tax writers in Congress failed to bridge gaping partisan differences over the payroll tax cut package, increasing the odds of another Washington showdown ahead of an end-of-the-month deadline. Senate Finance Committee Chairman Max Baucus (D-Mont.) and House Ways and Means Chairman Dave Camp (R-Mich.) traded offers throughout the weekend in an attempt to cut a deal on extending the payroll tax holiday and jobless benefits for millions of Americans -; along with avoiding a rate cut for physicians who treat Medicare patients (Sherman and Raju, 2/13).

The Wall Street Journal: Contraceptive Plan Still Draws Heat
At masses across the country Sunday, Roman Catholic priests blasted the Obama administration's compromise on contraceptive insurance coverage, a sign the White House's backtrack late last week did little to defuse the controversy. The new policy requires religious employers such as universities and charities to cover contraception in employee health plans but shifts the responsibility for paying for it away from the employer and on to its health-insurance provider. Previously, the administration had required all employers apart from churches to cover contraception in their employee-insurance plans (Adamy, 2/13).

Los Angeles Times: Key Republican Promises Fight Over Birth Control Coverage
Senate Minority Leader Mitch McConnell (R-Ky.) vowed Sunday to fight the administration's requirement that insurers provide contraceptive coverage for faith-based employers.
McConnell said on CBS' "Face the Nation" that he would press legislation to exempt all employers from providing insurance coverage for contraceptives if they have religious or moral objections (Savage, 2/12).

The Associated Press: Top Republican Wants Vote On Birth Control Mandate
Conservatives said Sunday the flap surrounding President Barack Obama's birth control mandate was far from over ... "It's riddled with constitutional problems," McConnell said of Obama's broader health-care plan. "And this is what happens when the government tries to take over health care and tries to interfere with your religious beliefs." ... [Rick Santorum said:] "They are forcing religious organizations, either directly or indirectly, to pay for something that they find is a deeply, morally, you know, wrong thing. And this is not what the government should be doing" (Flaherty, 2/12).

Politico: Why Dems Keep Stepping On Health Care Landmines
Somehow, the Democrats just can't seem to keep reproductive politics from hijacking the health care debate. They almost lost the health reform bill a couple of times over abortion, as anti-abortion Democrats came close to derailing the bill during the 2009 House debate and then again during the final passage in 2010. ... It's a predictable fight, and Democrats have always had to find ways to navigate the divide as they push to expand health coverage. But lately, some Democrats say, the Obama administration and party leaders haven't been listening to the other side as well as they used to (Nather, 2/10).

The Wall Street Journal: Catholic Bishops Oppose Compromise On Birth-Control Insurance
The bishops had earlier expressed cautious optimism about the announcement, saying that it was "a first step in the right direction" but that they would have to study it. ... The bishops also said that the current structure of the proposal meant that if an employee and insurer agreed to add contraception coverage to a health plan, it would still be financed in the same way as the rest of the coverage offered by the employer  (Radnofsky, 2/12).

Politico: Bishops Call Obama's Contraception Compromise 'Unacceptable'
[T]hey made it clear that a "lack of clear protection for key stakeholders -; for self-insured religious employers; for religious and secular for-profit employers; for secular non-profit employers; for religious insurers; and for individuals -; is unacceptable and must be corrected." ... A senior administration official told POLITICO on Saturday that the White House didn't expect to win the support of the bishops with Friday's updated policy (Haberkorn, 2/12).

The Washington Post: U.S. Bishops Blast Obama's Contraception Compromise
The bishops' broadside is evidence that Obama's effort to limit the damage from this unusually complicated moral, legal, medical and financial issue isn't necessarily working. .. An administration official not authorized to speak on the record expressed little surprise at the bishops' statement, which if anything represents a hardening of their position. "We never anticipated that this announcement would win the endorsement of an organization that opposed health reform from the very beginning," the official said. "But we believe it's the right way to fully address concerns about religious liberty and ensure women get the coverage they need" (Brown, 2/11).

CBS News: Insurers Respond Cautiously To Contraceptive Plan
America's Health Insurance Plans focused its statement on concerns about the precedent President Obama's announcement may create: "Health plans have long offered contraceptive coverage to employers as part of comprehensive, preventive benefits that aim to improve patient health and reduce health care cost growth. We are concerned about the precedent this proposed rule would set."... Aetna responded to a request for comment by saying the company needed time to process what the news meant in practical terms (Levin-Epstein, 2/10).

The Wall Street Journal: Romney And Birth Control: A Shift
Mitt Romney has said the Obama administration is intruding on religious freedom by moving to require religious–affiliated employers to cover contraception services in their health insurance plans. When confronted with a similar law as governor of Massachusetts, Mr. Romney didn't raise objections on religious or moral grounds, say people who worked in his administration or in health care interest groups there. Rather, he viewed the contraception requirement more in economic terms, as only one of many costly "mandates'' that some believed were driving up the price of insurance and suppressing competition, according to these people (Nicholas, 2/13).

The New York Times: Romney's Path To 'Pro-Life' Position On Abortion
From the moment he left business for politics, the issue of abortion has bedeviled Mitt Romney. ... He tangled with President Obama last week over whether religiously affiliated hospitals should be required to provide free contraceptives -; "abortive pills," Mr. Romney called them. ... The comments reflect Mr. Romney's evolution from abortion rights advocate to abortion foe; gone was any trace of the candidate for governor who, 10 years ago, answered a Planned Parenthood questionnaire by saying he backed "state funding of abortion services" under Medicaid (Stolberg, 2/11).

NPR: Health Care In Massachusetts: 'Abject Failure' Or Work In Progress?
Romney is now a GOP presidential contender, and that's made the Massachusetts universal health care law a political football. Romney's rival Rick Santorum recently called it "an abject failure." But "Romneycare," as Santorum and others call it, isn't controversial in its home state (Knox, 2/13).

The Washington Post: The Health Reform Law's Biggest Threat: 30,000 Too Few Doctors
On a chilly afternoon at a community clinic in Southeast Washington, three young doctors are busily laying the foundation for the health-care law's success. ... They are primary-care residents at Children's National Medical Center. A third of their class has more than $200,000 each in student loan debt. At the end of residency, they can stay in primary care and earn $29.58 an hour. Or they can specialize and make $74.45 an hour. ... The Obama administration -; and, arguably, the American health-care system -; desperately needs them to choose primary care (Kliff, 2/11).

The New York Times: Hospitals Flout Charity Aid Law
New York's charity care system, partly financed by an 8.95 percent surcharge on hospital bills, is one of the most complicated in the nation, but many states have wrestled with aggressive debt collection by hospitals in recent years. Like New York, several passed laws curbing hospitals' pursuit of unpaid bills, including Illinois, California and Minnesota. But a new study of New York hospitals' practices and state records finds that most medical centers are violating the rules without consequences, even as the state government ignores glaring problems in the hospitals' own reports (Bernstein, 2/12).

The New York Times: Most Expect To Give More Than They Receive, Poll Finds
A majority of Americans say they expect to pay more in federal taxes over their lifetime than they will ever receive in benefits from the government, according to a recent New York Times poll. At the same time, the taxes Americans pay today are not keeping pace with the growing costs of government. Medicare is the program projected to add the most to federal spending over the next decade, likely increasing the government's annual budget deficits. But only one in five Americans surveyed named Medicare as the fastest-growing benefits program (Kopicki, 2/11).

The New York Times: Even Critics Of Safety Net Increasingly Depend On It
There is little poverty here in Chisago County, northeast of Minneapolis, where cheap housing for commuters is gradually replacing farmland. ... Dozens of benefits programs provided an average of $6,583 for each man, woman and child in the county in 2009, a 69 percent increase from 2000 after adjusting for inflation. ... Older people get most of the benefits, primarily through Social Security and Medicare, but aid for the rest of the population has increased about as quickly through programs for the disabled, the unemployed, veterans and children (Applebaum and Gebeloff, 2/11).

The New York Times: Supply Of A Cancer Drug May Run Out Within Weeks 
A crucial medicine to treat childhood leukemia is in such short supply that hospitals across the country may exhaust their stores within the next two weeks, leaving hundreds and perhaps thousands of children at risk of dying from a largely curable disease, federal officials and cancer doctors say. Methotrexate is used to treat childhood leukemia and rheumatoid arthritis (Harris, 2/10).

ABC News: Critical Shortage Of Children's Leukemia Drug
President Obama issued an executive order in October 2011 to reduce the dire shortage. The order instructed the Food and Drug Administration to broaden reporting of potential drug shortages, expedite regulatory reviews that can help prevent shortages, and examine whether potential shortages have led to price gouging. The drug shortage has compromised or delayed care for some patients and may have led to otherwise preventable deaths (Salahi, 2/10).

The Wall Street Journal: Alzheimer's Families Clamor For Drug
In the wake of research suggesting a skin-cancer drug may have benefits in treating Alzheimer's disease, physicians and advocacy groups are getting a flurry of calls from patients seeking to use the drug off-label. The clamor underscores how urgently patients want solutions to the rising tide of Alzheimer's. But experts caution that more research is needed to determine whether the drug, bexarotene, is effective in humans at all, not to mention what the dosage should be (Wang, 2/11).

The Wall Street Journal: Preventive Tests Covered By Medicare
Thanks to the health-care law, Medicare now covers the full cost of an expanding list of preventive services. On Jan. 1, the private, federally subsidized Medicare Advantage plans that cover 25% of those in the federal health-care program began offering the same coverage. All Medicare recipients can now obtain almost two dozen preventive services without owing co-payments or deductibles, including mammograms, annual flu vaccines and an annual "wellness" examination (Tergesen, 2/12).

The Associated Press: Nearly 1 In 20 US Adults Over 50 Have Fake Knees 
More than 4 million Americans over 50 have artificial knees, according to a new study. ... "These data are sobering because we didn't know what an army of people we've created over the last decade," said study author Elena Losina, co-director of the Orthopedics and Arthritis Center for Outcomes Research at Harvard's Brigham and Women's Hospital. ... Artificial knees also wear out after a period of time, so as the operations are increasingly done on younger Americans, many will live long enough to almost certainly need a second or even third knee replacement (Tanner, 2/10).

ABC News: Knee Replacements Double in 10 Years, Study Says
Advances in technology and improvements in surgical techniques have made the surgery more successful in recent years, although patients run the risk of infections and scar tissue development after the surgery. The procedure requires several days in the hospital, weeks of rehabilitation and costs about $40,000 (Gann, 2/10).

USA Today: Baby Boomers' Demand, Expectations For New Knees Soar
Revisions are more costly, complicated and risky, the report notes. They cost about $27,000, compared with the original surgery (about $20,000) and are riskier and more complicated. Most are covered by insurance, according to the American Academy of Orthopaedic Surgeons. Losina says the report will help the nation grasp the "substantial health burden" posed by those with knee replacements. The principal diagnosis is osteoarthritis. Despite manufacturers' suggestions that some prosthetic joints will last 30-plus years, Losina says there are no studies to support those claims (Lloyd, 2/10).