Viewpoints: Wis. vote cements walker plan to raise state workers' health costs; Treating addiction; Obama's silence on insurance mandate

Jun 7 2012

Chicago Tribune: Wisconsin Speaks. Again.
Many of those voters also expect that, going forward, the dividends for Wisconsin residents, their school districts and other governments will continue to grow. As old labor contracts expire, public officials will write into the new contracts the other Walker-inspired personnel provisions -; such as higher (but still relatively inexpensive) employees' contributions to their pension and health plans -; that have lowered government expenses. New labor pacts, that is, should keep reducing government costs across Wisconsin (6/6).

The New York Times: The D.S.M. Gets Addiction Right
When we say that someone is "addicted" to a behavior like gambling or eating or playing video games, what does that mean? Are such compulsions really akin to dependencies like drug and alcohol addiction -; or is that just loose talk? This question arose recently after the committee writing the latest edition of the Diagnostic and Statistical Manual of Mental Disorders (D.S.M.), the standard reference work for psychiatric illnesses, announced updated definitions of substance abuse and addiction, including a new category of "behavioral addictions" (Howard Markel, 6/5).

The New York Times: Evolution's Sweet Tooth
Of all the indignant responses to Mayor Michael R. Bloomberg's plan to ban the sale of giant servings of soft drinks in New York City, libertarian objections seem the most worthy of serious attention. People have certain rights, this argument goes, including the right to drink lots of soda, to eat junk food, to gain weight and to avoid exercise. If Mr. Bloomberg can ban the sale of sugar-laden soda of more than 16 ounces, will he next ban triple scoops of ice cream and large portions of French fries and limit sales of Big Macs to one per order? Why not ban obesity itself? (Daniel E. Lieberman, 6/5).

The New York Times: Disney Takes On Obesity
The Walt Disney Company deserves applause for its plan to impose strict standards on food advertising aimed at young children on Disney-owned television channels, radio stations and Web sites. The standards, based on federal guidelines, should eliminate junk-food ads on children's programs and could set an example for other companies and advertisers to follow (6/5).

Chicago Tribune: Gulp! Another Intrusion By The Nanny State
There are things the law cannot do. And if that seems a self-evident observation, well, you may want to think again in light of last week's headlines out of New York: It seems the mayor wants to ban the Big Gulp (Leonard Pitts, 6/6).

The Washington Post: The Rise Of Noodge Government
Judging the wisdom of New York Mayor Michael Bloomberg's (I) ban on super-size sugary sodas depends on where you draw the line between nudge government and noodge government. Nudge government makes sense. It harnesses human nature to steer citizens to smarter -- choices (Ruth Marcus, 6/5).

The Washington Post's Post Partisan: Yep, The CBO's Debt Numbers Are Still Scary
Hordes of retiring boomers would take their toll on the Treasury, but the big budget-killer would be rapid per-patient health-care cost inflation, which has outpaced economic growth by an average of 1.6 percentage points every year since the mid 1980s. In other words, unless Congress enacts truly massive tax increases, something about how the government delivers health care must change (Stephen Stromberg, 6/5).

The Wall Street Journal: Why Obama Strikes Out In Court
As the world awaits the Supreme Court's ruling on ObamaCare, there's a larger story that the pundits are missing: the court's rejection of the Obama administration's increasingly extreme claims on behalf of unlimited federal power. … If the government loses in the health-care or immigration cases, it won't be because its lawyers had a bad day in court or because the justices ruled based on their political preferences. It will be because the Obama administration continues to make legal arguments that don't pass the smell test (Ilya Shapiro, 6/5).

Politico: Speak Out To Defend Your Agenda, Mr. President 
Indeed, if anything, the president has been far too reluctant to talk to the American people. Consider the Affordable Care Act. If the individual mandate is lost, the president's failure to talk enough about the health care law over the past 2½ years will be a leading cause. ... If the president had seized the initiative, the legal challenge to the individual mandate would have been far less likely to succeed. It would certainly have been far more difficult for the central argument against the mandate to break into the legal mainstream (William Yeomans, 6/5).

Baltimore Sun: Planning For The Worst
We Americans cherish our freedom of choice. In light of our ardent individualism, it's puzzling that so few of us make decisions about something almost all of us will face: medical care at the end of our lives. Only about a third of Americans have completed advance directive forms, even though the forms are straightforward, free and legal in every state. While we generally think of an advance directive as a responsibility of the elderly, it is just as essential for younger people. The leading cause of death in those under 35 is accidents and injuries that can trigger complex medical situations (remember Terri Schiavo?), including potential organ donation (Morhaim, 6/6).

Boston Globe: Birth Control Fight Is Still Being Fought
Thursday marks the 47th anniversary of the Supreme Court's decision to make birth control legal in the United States, but the case is still being argued. … Living in a time when the basic definitions of "life" and "death" are increasingly less fixed, it becomes all the more essential that a woman and her doctor are guaranteed the freedom to seek, and to offer, the best possible care (Alexandra Marshall, 6/6).

Boston Globe: Without Patient-Centered Health Plans, Mass. Is Using The Same Tired Script
As the next act of the Massachusetts health care drama plays out on Beacon Hill, the same characters return to the stage with a tired script. The ostensible hero of the production, the patient, is left to watch the tragedy from the back row. Legislation being debated on Beacon Hill ignores patient-centered health plans and health savings accounts, or HSAs, which are lower-premium insurance plans that direct pre-tax dollars into a bank account to cover an individual's current health care and save money for future medical expenses (Josh Archambault, 6/6).

Boston Globe: Hospitals Need To Coordinate Better To Deliver The Best Care -; And Save Money
Leaders on Beacon Hill should know that one of the key factors driving up health care spending is poorly managed and uncoordinated care delivery. Too often, patients are getting treatment from multiple providers that don't talk to each other and lack any incentive to work together to keep costs down. This raises the overall price tag, and doesn't result in better care (Mike Coyne, 6/5).

JAMA: If Accountable Care Organizations Are the Answer, Who Should Create Them?
Who is most able to create and manage this type of organization that can effectively implement both medical and insurance functions? Employers? They would like to bring costs under control while maintaining quality, but most employers have not demonstrated sustained interest or capacity to manage health care for their employees. This task requires knowledge and skills far different from those present in the typical firm (Victor R. Fuchs and Leonard D. Schaeffer, 6/6).

JAMA: Why Accountable Care Organizations Are Not 1990s Managed Care Redux
Many people are concerned that accountable care organizations (ACOs) and other delivery system reforms in the Affordable Care Act will simply bring back the managed care days of the 1990s. These skeptics suspect that payment reforms to control high and increasing costs will simply lead to gate keeping and service denial rather than the promise of care redesign and coordination that removes unnecessary cost and delivers better outcomes (Ezekiel J. Emanuel, 6/6).

Health Policy Solutions (a Colo. news service): Seniors Reap Benefits From Affordable Care Act
Opinions may not change overnight, but the fact is, more and more seniors are benefiting from the law. New figures show that thousands of seniors and disabled Americans are improving their health thanks to expanded preventive care services and saving money on prescription drug prices because of a shrinking "donut hole." It is especially important that seniors learn about the benefits of the ACA because they have been the victims of some of the most egregious misrepresentations about the law (Bob Semro, 6/5).

MinnPost:  Overdiagnosis – And How We Need To Stop Harming The Healthy
The problem of medical overdiagnosis is getting increasing attention -; and not a moment too soon, as noted in a commentary paper published last week in the journal BMJ.  "A burgeoning scientific literature is fueling public concerns that too many people are being overdosed, overtreated, and overdiagnosed," writes Australian journalist and academic researcher Ray Moynihan, Australian epidemiologist Jenny Doust, and Dr. David Henry, CEO of the Institute for Clinical Evaluative Sciences in Toronto, Canada (Perry, 6/5).