Viewpoints: Clinton's rousing support for Medicare, health law; Thalidomide and the struggle for an abortion; Arkansas health innovations

Sep 7 2012

The Washington Post: Bill Clinton's Tutorial On The Need For Government
Clinton, once known for the strategy of "triangulation" between the parties, was among the speakers who answered Patrick's call. He assailed Romney and Paul Ryan for falsehoods on welfare and Medicare, dismantling one Tampa argument after another. Offering a vision of "shared responsibilities, shared prosperity [and] a shared sense of community," he stoutly defended Obama's health care law, student loan reforms, rescue of the auto industry, commitments to community colleges and job training, and budget proposals (E.J. Dionne Jr. 9/5).

The New York Times' Taking Note: What The Democrats Didn't Say
For all the enthusiasm there was one thing Democrats didn't talk about much, and it just happens to be the main purpose of the law: providing health coverage for 30 million uninsured people, many of them poor. Democrats have been glossing over this essential fact since the law was written. The Obama administration and its Congressional allies were afraid their opponents would accuse them of creating another social program for the poor, so they added a large number of other (very significant) benefits to the law to make sure the middle class felt its impact (David Firestone, 9/5). 

The New York Times: The Better Economic Question
The contradiction between the plain facts of the data and the tepid feel of the recovery suggests that the recession created a more important question than the simplistic "are you better off?" Voters should ask themselves -- and their leaders -- how to keep this and future generations better off. How to prevent future recessions. How to design a tax code that promotes fairness and reduces inequality. How to make sure a safety net is in place for those who inevitably need more help. And when the question is phrased like that -- looking forward rather than backward -- it becomes obvious that the Republicans' answer is inadequate (9/5). 

The New York Times' Opinionator: The Arkansas Innovation
Mention medical innovation, and you might think of the biotech corridor around Boston, or the profusion of companies developing wireless medical technologies in San Diego. But one of the most important hotbeds of new approaches to medicine is … : Arkansas. The state has a vision for changing the way Arkansans pay for health care. It is moving toward ending "fee-for-service" payments, in which each procedure a patient undergoes for a single medical condition is billed separately. Instead, the costs of all the hospitalizations, office visits, tests and treatments will be rolled into one "episode-based" or "bundled" payment (Ezekiel J. Emanuel, 9/5). 

The New York Times' Opinionator: A Never-Ending Story
[A recent article] reported that the German pharmaceutical company that had once made thalidomide, a sedative that 50 years ago led to deformed or missing limbs in thousands of babies whose mothers took it during pregnancy, had issued an "apology" to the drug's victims. The route that led me from there to thoughts of the Republican platform ran through one of the most compelling stories in pre-Roe v. Wade America: the story of Sherri Chessen, a mother of four young children who left the United States for Sweden in order to obtain a legal abortion after learning, to her horror, the consequences of the pill she had taken to help with morning sickness early in a much-wanted pregnancy. ... Abortion was illegal in every state, and Arizona, like most states, had an exception only for abortions necessary to save a woman's life (Linda Greenhouse, 9/5).

Bloomberg: How Democrats Lost Their Way On Abortion
Why has the party removed the sentence "Abortion should be safe, legal, and rare" from its platform? ... Abortion won't be a defining issue for Democrats this election, but the party's more militant posture guarantees that bipartisanship is still a long way off. On this issue, we can't get along. But it wouldn't hurt to put the word  "rare" back in the platform (Margaret Carlson, 9/5).

Journal of the American Medical Association: The Political Third Rail Of Controlling The Soaring Costs Of Health Care
As the 2012 presidential election approaches, the political debates on health care reform are consistently confused, often conflating the critical dimensions of any well-functioning health care system: access, equity, cost, quality, and choice. The Obama administration's health reform law, the Affordable Care Act (ACA), addresses each of these key dimensions but at its core revolves around access -- and access was also the factor most at play in the Supreme Court's decision on the ACA. A factor that is now dominating the political debates, particularly with respect to the contentious question of Medicare reform, is the issue of cost (Lawrence O. Gostin, 9/5).

The New England Journal of Medicine: Health Insurance -- Motivated Disability Enrollment and the ACA
The United States relies on employer-based health insurance to cover working-age adults and their families. As a result, Americans who are unable to engage in full-time work because of a chronic health condition must not only seek out wage replacement but also pursue alternative sources of health insurance. ... However, purchasing private insurance is rarely an option, owing to high costs and structural barriers such as lifetime spending caps, waiting periods, and exclusions of preexisting conditions from coverage. Disabled workers often apply for public financial disability benefits in part to obtain public health insurance -- a uniquely American phenomenon that we call health insurance–motivated disability enrollment (HIMDE). We believe that HIMDE is an important driver of the unsustainable growth in enrollment in public assistance programs for people with disabilities (Jae Kennedy and Elizabeth Blodgett, 9/5). 

The New England Journal of Medicine: From Sick Care to Health Care -- Reengineering Prevention into the U.S. System
Although the United States pays more for medical care than any other country, problems abound in our health care system. Unsustainable costs, poor outcomes, frequent medical errors, poor patient satisfaction, and worsening health disparities all point to a need for transformative change. 1 Simultaneously, we face widening epidemics of obesity and chronic disease. Cardiovascular disease, cancer, and diabetes now cause 70 percent of U.S. deaths and account for nearly 75 percent of health care expenditures. 2 Unfortunately, many modifiable risk factors for chronic diseases are not being addressed adequately. A prevention model, focused on forestalling the development of disease before symptoms or life-threatening events occur, is the best solution to the current crisis (Drs. Farshad Fani Marvasti and Randall S. Stafford, 9/5).