Viewpoints: A missing contraception question, Obama's budget blind spot, NEJM on Medicare Advantage

The New York Times: The Opinionator: Who Decided That This Election Should Be About Sex?
David Brooks and Gail Collins discuss the surprising role debates over contraception, abortion and unwed mothers have played so far in the campaign (2/22).

The Washington Post: The Missing Contraception Question
Can we please get one moment of contraceptive clarity Wednesday night in what may be the final big GOP debate of the year? All it will take is a simple line of questioning pressed by moderator John King (Matt Miller, 2/22).

The Washington Post: Virginia Gov. McDonnell's Abortion Crucible 
Gov. Robert McDonnell and some of his fellow Virginia Republicans are shocked, shocked. It turns out that legislation mandating a costly, coercive, medically unnecessary ultrasound procedure would be physically invasive and personally offensive for thousands of women seeking abortions in the state (2/22).

McClatchy: GOP Goes Back To The 1960s On Birth Control
Ignoring years of public-opinion polls, the GOP is boldly marching backwards into the 1960s to question whether contraception is a legitimate health-care benefit. The target, as always, is President Obama. He issued an executive mandate requiring that free birth control be included in health plans provided to employees of schools, charities and hospitals connected to religiously affiliated institutions. Although the mandate excludes churches, Roman Catholic bishops are in a huff, saying the contraception provision violates the First Amendment and "freedom of religion" (Carl Hiaasen, 2/23).

McClatchy: Catholic Women Must Speak Out
The use of birth control is against Catholic teaching, a sin and part of "a culture of death," as New York's Archbishop Timothy M. Dolan has said. But the majority of Roman Catholic women - 98 percent according to one poll - have used birth control. Like me, many such women have received periodic fundraising letters from the church usually addressed to the woman of the house. They've enrolled their children in Catholic schools and watched their children participate in the sacraments. ... Of 100 Catholic women friends and acquaintances I could name, 99 use artificial birth control. But have we spoken out? No. Instead, we have spoken to each other (Maura Casey, 2/23).

Los Angeles Times: Obama's Budget Blind Spot
On the spending side, the president calls for cuts across a wide range of programs, but his plan is also rife with gimmicks. He touts a 10-year "deficit reduction" of $850 billion from our reduced roles in Iraq and Afghanistan, but virtually nobody believes the country intended to spend that money. … Notably, the budget does nothing to restructure entitlements -; Medicare, Social Security, Medicaid. A leadership budget would focus less on minor program changes and more on major reforms to combat the coming fiscal crisis driven by runaway entitlement spending (David M. Primo, 2/22).

The Washington Post: Mitt Romney's Tax Proposal May Not Be Narrative Campaign Wants
What's important, as Hubbard correctly says, is the story the figures tell about a Romney administration. And that goes something like this: Under a Romney presidency, there would be a major redistribution -; or perhaps it should be called a re-redistribution -; from low-income people who depend on government programs such as Medicaid to higher-income folks who pay taxes (Ezra Klein, 2/22).

The Wall Street Journal: Health Care's Coming Price Revolution
The old-line Marxists used to talk about "heightening the contradictions" of capitalism to make things worse and hasten the revolution. One of the great ironies of the Affordable Care Act is that it may be doing just that (Joseph Rago, 2/23).

The Wall Street Journal: A Tax Reform to Restore America's Prosperity
Higher-income Americans who receive the greatest benefit from rate cuts will see the most significant limits. Middle-income Americans will continue to enjoy tax benefits that favor important priorities such as home ownership, charitable giving, health care, and savings. The result will be a pro-growth tax code that still raises the necessary revenue, retains the existing progressivity, and ensures that middle-income Americans will see real tax relief ( Mitt Romney, 2/23).

The Wall Street Journal: Romney's Tax Reboot
Mr. Romney made the mistake yesterday of distinguishing between deductions for "middle-income families," which he said would be preserved, and for the "top 1 percent," which he said would be on the table. This sounds like a pollster's bad advice. It merely plays into Mr. Obama's class-war theme when Mr. Romney should be stressing growth. But at least Mr. Romney says all deductions would be on the reform table, including those for mortgage interest, state and local taxes and health care (2/23).

Boston Globe: Big Cases On High Court Docket Highlight Need To Allow Cameras
When the Supreme Court announced on Tuesday that it would reconsider its position on affirmative action at public universities - a legal flashpoint since the 1970s - it caught the attention of millions of Americans. With a test of President Obama's health care overhaul already on the docket for April, the coming term promises to be one of the most consequential in memory. It would be a fine chance for the public to learn how the Constitution is applied to legal disputes, and to demystify the court. But the court's own rectitude - emblemized by its refusal to allow cameras to record public hearings - is getting in the way (2/23).

The Philadelphia Inquirer: 'Santorum Of Pennsylvania': 14th Century Public Health Hero
Unlike SNL's Theodoric of York, who at least tried to help people, even as he prescribed bleeding, leeching, worming, boar's vomit, the Caladrius bird, and hanging one upside down from a gibbet to fight illness, Rick Santorum of Pennsylvania only has proscriptions for what ails us, proscriptions that threaten to return us to the unscientific and uncaring days of yore when science and medicine were based on superstition. Questioning his cures, Theodoric of York-; who fictionally lived in the century before the European Renaissance (and popped up in Steve Martin skits in the 1970s) -; wondered whether we should test our "assumptions analytically through experimentation and the scientific method" (Michael Yudell, 2/22).

The Houston Chronicle: Texas Can Lead The Way On Medicaid Reform
The innovation allowed under today's Medicaid program will never come close to closing the gap for the demands on state tax dollars for this federal health care program for the poor. Medicaid is in desperate need of overhaul….Texas has the opportunity to lead the reform movement by pursuing the waiver for an aggressive block grant as envisioned in the legislation (Arlene Wohlgemuth, 2/22).

The Minneapolis Star Tribune: Know The Full Story About Health Plans
The editorial focused on one program. The state groups three programs -- Medicaid, MinnesotaCare and the old General Assistance Medical Care -- into one contract. It's a package deal and must be scrutinized as such…..The editorial focused on one year. But insurance financing is cyclical, containing highs and lows from year to year. The average profit over the past five years for all state public programs is 1.6 percent of revenue, less than the margins reported in the editorial for both Michigan and Wisconsin (Julie Brunner, 2/22).

The Miami-Herald: Here's Crazy: Reducing Money To Treat Mental Illness in Florida
Thank God for Texas. Else we'd rank as the most barbaric backwater in the nation. Even infamously unenlightened states like Mississippi, Alabama and South Carolina spend more per capita on mental health than Florida. Joe Negron aims to fix that. The powerful state senator from Hobe Sound, who oversees the Budget Subcommittee on Health and Human Services Appropriations, has pushed a $76.1 million reduction in the state's mental health services budget through the Senate. Another $31.6 million would come out of the state's substance abuse treatment programs….Most of the financial burden will land on local governments. The real costs of Negron's cuts will be borne by county jails and public hospital emergency rooms (Fred Grimm, 2/22).

McClatchy: Medical Research Funding Cuts Could Be Hazardous To America's Health
President Obama's budget recommendation to freeze funding for the National Institutes of Health is shortsighted. The NIH is the largest supporter of medical research in the world. But with a frozen budget, the research that could reduce chronic diseases disproportionately affecting minority populations will slow considerably (Louis W. Sullivan, 2/23).

Chicago Sun-Times: Quinn's Right -; It's Time To Tackle Medicaid, Pensions
He proposed cutting Medicaid expenditures by $2.7 billion. And, here again, he dared to list the various unpopular measures that might be necessary to hit that target. "To reduce cost pressures," he said, "we need to reconsider the groups who are eligible for Medicaid, the services we cover under the program, the utilization of these services and the way and amount we pay for them." We heard a stir in the offices of the Illinois State Medical Society. Actually, they faxed us a statement after the speech. "Patching Illinois' budget shortfall on the backs of physicians is bad fiscal policy," the doctors said. They might be right. But when a state finds itself in such dire financial shape, there are no good fiscal policies, certainly no palatable ones (2/22).

New England Journal of Medicine: Colonoscopy as a Triage Screening Test 
[C]olonoscopy can be used to stratify patients according to their risk of colorectal cancer. An appealing concept would be to use colonoscopy as a triage screening test, offering it once for everybody at 60 years of age and using the results to classify persons as having a low risk of colorectal cancer ... or a high risk, ... with strict surveillance for the latter group but no further screening for the former (Drs. Michael Bretthauer and Mette Kalager, 2/22). 

New England Journal of Medicine: The Medicare Advantage Success Story -; Looking Beyond The Cost Difference
[M]any policymakers seem to be overlooking the lessons of what may be the greatest source of innovation in care delivery in Medicare: Medicare Advantage ... Medicare Advantage plans innovate along many dimensions. ... They select providers for their networks and set providers' payment rates strategically. Whereas traditional Medicare offers a one-size-fits-all benefit, Medicare Advantage plans apply on-the-ground knowledge in tailoring benefits (Jeet S. Guram and Robert E. Moffit, 2/22).

New England Journal of Medicine: Medicare Advantage -; Lessons for Medicare's Future 
[In general, Medicare's experience with private plans strongly suggests that hard decisions cannot be avoided merely by shifting to a different system. Private plans are not inherently more efficient than the those provided by the public sector. ... Studies comparing Medicare Advantage plans with traditional Medicare in terms of quality of care are limited, but their results do not justify a large differential in payment based on quality (Marsha Gold, 2/22).