Viewpoints: Obama's budget, birth control choices; Planning hospital readmissions to save

Feb 15 2012

The New York Times: A Responsible Budget
In poll after poll, the public has made clear that it prefers the president's approach of rebuilding the economy now and tackling the deficit when the fundamentals are stronger. While Republicans have counted on voters blaming Mr. Obama for the hard times, some are beginning to worry that they will be blamed for their obstructionism. That was clear on Monday when House leaders announced that they would agree to Mr. Obama's proposal to extend the payroll tax cut for the rest of this year without insisting on drastic cuts elsewhere to pay for it. ... Unlike Republicans, Mr. Obama would trim only slightly from growth in Medicare and Medicaid (2/13).

The Washington Post: Obama's Budget Falls Short, But It Beats Many Alternatives
To reduce debt, the first order of business must be Medicare. As he recommended with his debt reduction package last fall, Mr. Obama would introduce useful changes such as a premium surcharge for new Medicare beneficiaries who purchase first-dollar Medigap coverage. Still, most of the envisioned cuts fall on Medicare providers and do not go far enough to restructure the system (2/13).

The Wall Street Journal: The Amazing Obama Budget
His budget also proposes no meaningful reforms in entitlements, which are the fastest growing part of the budget and will grow even faster once ObamaCare really kicks in (2/14).

USA Today: Editorial: Obama's Budget Plan Leaves Debt Bomb Ticking
Everyone serious in Washington knows that the key to defusing the debt bomb is a "grand bargain" that combines cuts in the big entitlement programs with tax increases, and not just on the rich. As long as Republicans remain intransigent on taxes and Democrats balk on entitlement reform, the deficits will keep piling up (2/13).

USA Today: Opposing View: President's Budget Makes Many Tough Choices
Two weeks ago, President Obama outlined in his State of the Union address a blueprint for an economy built to last -; where everyone gets a fair shot, everyone does their fair share, and everyone plays by the same rules so that there are good jobs that pay well and there is security for the middle class (Jeff Zients, 2/13).

The Chicago Tribune: Free Government-Imposed Health Care For All?
Yes, the Obama administration's fiat that religious institutions and now insurance companies -; a difference without a distinction -; must pay for contraceptives raises profound constitutional and religious liberty issues. But why government should be able to dictate whether we pay for every "preventive care" medical service that comes along has been pushed out of sight. It's accepted as a given by so many that it has taken on aspects of holy writ (Dennis Byrne, 2/14).

The Washington Post: Obama's Epic Blunder On Birth-Control Mandate
The initial policy was a disaster. The partial retreat was more skilled. Obama's goal was not resolution but obfuscation. The contraceptive mandate was shifted from Catholic employers to insurance companies. Instead of being forced to buy an insurance product that violates their beliefs, religious institutions will be forced to buy an insurance product that contributes to the profits and viability of a company that is federally mandated to violate their beliefs. Creative accounting, it seems, can cover a multitude of sins (2/13).

Los Angeles Times: Birth-control Flap Shows The Need To Abort Employer-Based Health Care
Our employer-based health care system -; a historical anomaly -; is more trouble than it's worth. Yes, it provides coverage for about 55 percent of the population, according to the Census Bureau, and polls show that most of those with employer-provided insurance are happy with their plans. But the number of people with employer-based coverage is steadily shrinking. In 2000, 64% of Americans were insured through their jobs (David Lazarus, 2/14).

Reuters: U.S. 'Pro-life' And 'Pro-choice' Extremists, You Don't Speak For Me
"Pro-life" and "pro-choice" extremists, you don't speak for me. And, by the way, you don't happen to speak for the majority of the American people either. Over the past few weeks, the hot button issue of abortion rights in the United States has once again drawn national and sustained media attention in two events that almost seemed scripted to galvanize the certain on both sides (Elizabeth E. Evans, 2/13).

Des Moines Register: Removing The Health Care Mandate Is The Only Complete Solution
The Catholic bishops have long supported access to life-affirming health care for all and the conscience rights of everyone involved in the complex process of providing that health care. That is why we raised two serious objections to the "preventive services" regulation issued by the U.S. Department of Health and Human Services (HHS) in August 2011. We objected to the rule forcing private health plans -; nationwide, by the stroke of a bureaucrat's pen -; to cover sterilization and contraception, including drugs that may cause abortion. The other mandated "preventive services" prevent disease, and pregnancy is not a disease. Moreover, forcing plans to cover abortifacients violates existing federal conscience laws. Therefore, we called for rescission of the mandate (U.S. Conference of Catholic Bishops, 2/13).

Des Moines Register: Bishop Pates' Letter Misses The Mark On Contraception Rule
Bishop Richard Pates of the Des Moines Diocese takes a position that is anything but "guided by wisdom and inspired by courage" on the issue of health insurance coverage for employees of institutions affiliated with the Catholic Church (Pates' letter to church members, "At Stake: Freedom of Religion, Freedom of Conscience," Feb. 8). His decision to denounce the requirement that all employers provide contraception coverage to their employees at no cost, on the ground that the rule jeopardizes religious freedom, is shortsighted (Peter Leo, 2/13).

Des Moines Register: Contraceptive Decision Good For All Women
In a state and nation where almost half of all pregnancies are unintended, access to birth control is an urgent health care issue. That's why the initial recommendation by the federal government's Institute of Medicine that basic health insurance cover preventive care, including birth control methods, without a co-pay or deductible made so much sense. That is the health care policy that the Obama administration is working to implement. How this policy applies to women employed at Catholic hospitals and universities became a political football last week. Fortunately, women didn't wind up the losers in the rough and tumble game (Sally Pederson, 2/13).

Des Moines Register: Where Has The Birth Control Furor Been?
Health insurance should cover basic services and medications, including birth control. One of the goals of federal health reform is to make sure it does. Yet some Catholic leaders have objected to a government requirement that policies pay for contraceptives. They say it "infringes on the liberty and conscience" of employers who provide insurance to workers and have a religious objection to the medication. After much public attention, on Friday President Barack Obama announced Catholic institutions do not have to use their own money to pay for the medication. Instead, insurance companies will take care of it. The administration knows insurance companies have no problem with this for the same reason almost all pay for contraceptives now: The cost of birth control is less than the costs associated with a pregnancy (2/13).

Politico: Obama's High Price For Birth Control
President Barack Obama's decision requiring that Catholic institutions offer health plans with free birth control may cost him far more than the Catholic vote. Obama's edict, a curtailment of freedom that can result from his type of regulatory regime and statist interventions, could ultimately threaten his entire reelection. It may also set off alarms in the corridors of the Supreme Court, which now has six Catholic justices. Including one, Anthony Kennedy, who is considered the crucial swing vote in deciding the constitutionality of Obama's health reform law. If the court strikes down the insurance mandate, the entire law is likely to collapse -; and Obama's most significant achievement will disappear. The birth control rule is not an anomaly in the health care law that somehow sprang out of the measure and ignited a firestorm. It flows naturally from the legislation itself. The law is unique in that it commands individuals to engage in a specific behavior – getting health insurance coverage -; and punishes those who refuse (Keith Koffler, 2/14).

Archives of Internal Medicine: Planned Readmissions: A Potential Solution
As a result of the Patient Protection and Affordable Care Act (hereinafter, "ACA"), the Centers for Medicare and Medicaid Services (CMS) will be targeting avoidable readmissions to improve quality and reduce Medicare spending. ... A more sustainable option is to create a planned readmission code that could be used to prospectively indicate a planned procedure. At the time of discharge, hospitals would need to provide specific diagnosis and procedure codes for the planned readmission procedure on the discharge paperwork as well as the date and location of the planned readmission (Dr. Scott A. Berkowitz and Gerard F. Anderson, 2/13).

Chicago Sun-Times: Take A New Look At Cost Of Keeping Old Prisoners
A new study by Human Rights Watch reports that American prisons are fast becoming geriatric facilities, with the number of prisoners 55 and older growing at a rate six times that of the rest of the prison population. The Illinois Department of Corrections spends about $428 million a year -; about a third of its budget -; on older inmates. We're frankly torn on what to do about this problem, but feel surely it deserves greater attention. Fortunately, a state panel, the Sentencing Policy Advisory Council, is collecting data on the issue (2/13).

McClatchy: Raising A Healthier Generation Of Americans
As the United States moves toward rebuilding its economy and ensuring the long-term strength of our middle class, we're mindful of the wise words of President Harry Truman: "In the long view, no nation is healthier than its children." By that measure, we have some work to do, and we're tackling it head on. Over the last three decades, obesity rates have tripled. Today one in three children is at risk for preventable diseases such as diabetes and heart disease due to being overweight. If left unaddressed, health experts tell us that our current generation of children may actually have a shorter lifespan than their parents. To confront this, the U.S. Department of Agriculture has taken significant strides to help make sure America's children are eating better and leading healthier lives (Tom Vilsack, 2/13).

Milwaukee Journal Sentinel: What Doctor Shortage Means For Wisconsin
Most do not want to recognize that health care is rationed. It is done so by lack of insurance. Health reform is expected to rectify that, but it will exacerbate a new form of rationing: The doctor is not in (Jacob, 2/13).

The Sacramento Bee: Dental Plan For Poor Kids Is A Mess
In 1994, Sacramento was chosen to test a new dental health care model, "geographic managed care." Under it, dental plans that contract with the state receive a set amount of money, $12 per child assigned to them per month. Managed care is supposed to be cheaper than traditional fee-for-service and more comprehensive because it covers preventive as well as emergency services. Apparently no one from the state bothered to monitor the program to make sure children were getting the services for which the state paid. … Last year, Sacramento ranked third worst in the state in the number of dentist visits per child enrolled in Medi-Cal. Sacramento was dead last in percentage of poor kids seen by dentists in the previous three years (2/14).