Viewpoints: Outrage at mistaken report on Hill health coverage; Two views of Florida's option on Medicaid

May 2 2013

The New York Times' Economix: Health Coverage Worthy Of A Senator
Because members of Congress are accustomed to high-quality medical care provided to them through federal employee benefit programs, one might expect that they would push for top quality care to be delivered through the exchanges too. That is one reason why an (ultimately unfounded) report that the Grassley amendment might be reversed prompted so much outrage. (What's actually at issue is uncertainty over whether the employer contributions in the current health plan for those on Capitol Hill can be applied to coverage through the exchanges.)  But the possibility that middle-class families could obtain care that is both top quality – good enough for your senator – and subsidized creates a number of economic problems (Casey B. Mulligan, 5/1).

The New York Times: The Republican Health Policy Trainwreck
A few weeks ago, Ezra Klein and Ben Domenech had a fairly detailed back-and-forth -; culminating in this mano-a-mano exchange -; about whether a Republican or conservative alternative to Obamacare actually exists. You can read or watch them go at it and form your own judgment, but I think the answer is pretty straightforward: A conservative alternative or alternatives, yes; an alternative that Republican lawmakers are ready to vote for, no (Ross Douthat, 4/30).

The Wall Street Journal: States Can Save Taxpayers $609 Billion
As the battle over Medicaid expansion rages in the states, supporters of expansion have dusted off an age-old favorite in making the case for taking federal dollars. They say: If our state doesn't take the money, those dollars will go to some other state instead. Happily, in this instance that is not true (Christian Corieri, 4/30).

Forbes: Florida Senate Republicans Vote to Expand Obamacare And Medicaid, Rejecting House's Free-Market Alternative
On April 11, the GOP-controlled Florida House of Representatives passed an innovative, consumer-driven replacement for Obamacare's Medicaid expansion, one that could be a national template for free-market health reform. But Republicans in the state Senate rejected the House plan, electing instead to expand Medicaid, as Obamacare prescribes. Senate Republicans' inexplicable decision makes it likely that free-market reform will fail in Florida, an outcome that could easily have been avoided (Avik Roy, 5/1).

Tampa Bay Times: Weatherford Should Allow Open Vote On Medicaid Expansion
Florida has three days to measure up to Arkansas. In Arkansas, a Republican-led legislature and a Democratic governor agreed to accept federal Medicaid expansion money to help buy private insurance for low-income residents. In Florida, the state Senate on Tuesday overwhelmingly voted for a similar plan that has been endorsed by Republican Gov. Rick Scott. It is a conservative, fiscally responsible approach, and the House should approve it before the regular session ends Friday (4/30).

Kansas City Star: Brownback Still Mum On Medicaid Growth, But Solid On Biolab
Everybody does this sometimes. We decide by not making a decision. So it seems to be with Kansas Gov. Sam Brownback and Medicaid expansion. For months Brownback has been mysterious about whether he'll be one of the Republican governors who want to insure more low-income people, or stay on the sidelines with governors like his pal, Rick Perry of Texas. Brownback still hasn't said one way or the other. But it's getting late in the session to convince a reluctant Legislature to accept an expansion and add the federal Medicaid funds to the budget (Barbara Shelly, 4/30). 

Bloomberg: Medicare Should Pay For Patients, Not Treatments
Given the partisan divide in Congress, I don't hold out too much hope that the comprehensive-payment strategy will become law anytime soon, just because it makes sense and has support from thought leaders from both parties. Given the central role of health costs in our fiscal future, however, we would be smart to get rid of sequestration, which hurts short-term economic growth but does little to reduce America's long-term budget deficit. Instead, we should enact this type of Medicare payment reform (Peter Orszag, 4/30).

Journal of the American Medical Association: The Boston Marathon Response: Why Did It Work So Well?
Overall, only 3 people were killed by these explosive devices, and all 3 died before reaching the hospital. Not one patient who arrived at a hospital subsequently died. How did this happen? This astoundingly high survival rate, despite the nature and severity of the injuries, is a tribute to the courageous and rapid response of bystanders and first responders, expert field triage, rapid transportation of injured persons, and the skills and coordination of the receiving hospital trauma teams. It is also, however, the product of a confluence of deliberate actions stretching back to September 11, 2001, augmented by a series of providential but not random events (Drs. Ron M. Walls and Michael J. Zinner, 4/30). 

Reuters: Learning From Breast Cancer
Americans are bad at statistics. When it comes to breast cancer, they massively overestimate the probability that early diagnosis and treatment will lead to a cure, while they also massively underestimate the probability that an undetected cancer will turn out to be harmless. They're bad at pathology: they're easily convinced that something called ductal carcinoma in situ (DCIS) is a form of cancer, for instance, partly because the cancer industry insists on referring to it as "Stage Zero" cancer. They're bad at biology: they think that it's physics, basically, and that cancers are discrete, localized growths which start small and get bigger, and that the earlier you find and treat them, in large part by physically cutting them out of the body, the more likely you are to be cured (Felix Salmon, 4/30).

Reuters: The Red-State Attack On Abortion Rights
This has been a big month for abortion rights. In North Dakota, where there is only one abortion clinic, a District Court judge voided a two-year-old set of state restrictions on the use of medications to induce first-trimester abortions. And in Mississippi last Monday, a federal judge blocked some elements of state law intended to shut down the state's only abortion clinic. But make no mistake: The competition to shut down "the last clinics" in states with only one clinic is ongoing (Quart, 4/30).

San Francisco Chronicle: Be Prudent In Diagnosing, Medicating ADHD
Among all the changes that are about to happen in the way doctors diagnose psychiatric problems, I'm most concerned about the ones that could lead to adults and teens being misdiagnosed with attention deficit hyperactivity disorder, or ADHD. The Diagnostic and Statistical Manual of Mental Disorders is the guide by which most doctors make a diagnosis. The newest edition, the DSM-5, includes a number of changes and will be published in May. ADHD is a behavioral syndrome that is characterized by multiple symptoms of inattention or hyperactivity (Dr. Winston Chung, 4/30).

Philadelphia Inquirer: Mandatory Vaccination Saves Lives
Vaccines save lives. It has been proven time and time again for diseases ranging from polio to measles to the flu. The more people a community has who are vaccinated, the healthier it is. Those who remain unvaccinated leave themselves susceptible to serious infectious diseases. This puts everyone else at risk. That is why every state mandates that children receive vaccinations against a number of diseases, including polio and measles, as a condition of entering school. If vaccination rates were to significantly decline, the United States could face a public health crisis (Erica Cohen, 5/1).