Viewpoints: S.C. House race spotlights Dems' discomfort with health law; Cannon, Cohn offer contrasting views of Medicaid study

May 3 2013

The Wall Street Journal: Democrats Dissing ObamaCare
The media tittering over Mrs. Colbert Busch's decision to publicly slap the former Republican governor over his extramarital affair obscured the more notable political comment of the night. That moment came when Mrs. Colbert Busch slammed her own party's health-care law: "Obamacare is extremely problematic, it is expensive, it is a $500 billion [higher] cost than we originally anticipated, it's cutting into Medicare benefits and it's having companies lay off their employees because they are worried about the cost of it. That is extremely problematic, it needs an enormous fix." South Carolina's first district is a conservative place-;it voted overwhelmingly for Mitt Romney in last year's election-;so Mrs. Colbert Busch has every political reason to distance herself from her party and its health law. Yet she becomes one of the first Democrats to attempt to win an election on the back of criticism of her president's signature achievement (Kimberley A. Strassel, 5/1). 

New England Journal of Medicine: Protecting Finances And Improving Access To Care With Medicaid    
On the eve of a substantial expansion in health insurance coverage through the implementation of the Affordable Care Act (ACA), there is still much to learn about the effects of health insurance -; particularly about the effects of Medicaid coverage. ... We hope and expect that virtually all states will expand Medicaid coverage in short order. ... However, although a delay in expansion is clearly bad news for low-income people, the good news for health service researchers is that variation in the timing of the Medicaid expansion will provide an opportunity to more fully assess the effects of insurance expansion on health (Richard Kronick and Dr. Andrew B. Bindman, 5/2).

Real Clear Politics: Oregon Study Throws a Stop Sign in Front of ObamaCare's Medicaid Expansion
Today, the nation's top health economists released a study that throws a huge "STOP" sign in front of ObamaCare's Medicaid expansion. ... Consistent with lackluster results from the first year, the OHIE's second-year results found no evidence that Medicaid improves the physical health of enrollees. There were some modest improvements in depression and financial strain–but it is likely those gains could be achieved at a much lower cost than through an extremely expensive program like Medicaid (Michael Cannon, 5/2).

The New Republic: The New Study That Republicans Who Reject Medicaid Must Read
By now, you're probably familiar with the controversy over the Medicaid expansion. ... But Republicans and their allies frequently make another argument-;that the program doesn't do much good. Some go farther, and argue that people on Medicaid actually end up worse off than people with no insurance at all. That's where the new study comes in. Opponents of the expansion think the results back up their arguments. ... I think they are reading very selectively. The evidence does call into question one important claim liberals have made about Medicaid-;and liberals who make that claim need to start qualifying it. But the study validates two other arugments that defenders of Medicaid make. Both of these arguments are equally important (Jonathan Cohn, 5/2).

Des Moines Register: Branstad Plan Still Pales Next To Medicaid
The Senate knows expanding Medicaid makes sense. It is a time-tested program with low administrative costs and an existing infrastructure. ... The governor was alone in his opposition to expansion until House Republicans fell in line. Now they are supporting his alternative, which will insure fewer Iowans, leave millions of dollars of federal Medicaid aid on the table and cost Iowa taxpayers $156 million -; including money siphoned away from the property taxes in all 99 counties. Numerous questions remain about where an Iowan could go for health care under the Healthy Iowa Plan (5/2).

The Fiscal Times: Unravel Obamacare And You Get A Train Wreck
As 2014 draws ever closer, and the true scale of the problems of ObamaCare become apparent, expect more Democratic incumbents to commiserate with their constituents about the "extremely problematic" "train wreck" they imposed on them.  They had better not expect the voters to let them off the hook, however, no matter how many times Obama tells them they have nothing to worry about (Edward Morrissey, 5/2).

Politico: President Obama's New Budget Drops Key Reform
There is a lot not to like in the new budget recently released by President Barack Obama. The nearly $1 trillion in higher taxes would only serve to impede economic growth, and the failure to reform entitlement programs leaves them on the path to insolvency. Those are all bad, no doubt, but what was also quite unfortunate was the removal of a laudable reform that had been included in the White House's preceding two budgets that was perhaps the only provision in any of Obama's budgets that conservatives in Congress should welcome with open arms. The reform we are referring to is the adjustment in Federal Medical Assistance Percentages, the formula which determines the rates at which the federal government provides Medicaid funds to the states (Grover G. Norquist and Patrick Gleason, 5/2).

The New York Times: Exorbitant Prices For Leukemia Drugs
In a commentary published online by Blood, the journal of the American Society of Hematology, the experts questioned the morality of charging "astronomical" prices that may deprive some needy patients of access to drugs and could undermine the financial sustainability of the American health care system (5/1).

JAMA: The Clash Between Industry And Civil Society Over Generic Drugs
On April 1, India's Supreme Court ruled against drug company Novartis regarding its claim for a patent on the lucrative and widely used cancer drug imatinib (marketed by Novartis as Gleevec in the United States and as Glivec elsewhere). To many, this high-profile 7-year legal battle, Novartis v Union of India, epitomized a vexed relationship between health advocates and the pharmaceutical industry (Lawrence Gostin, 5/1).

Bloomberg: Smile, Doctor, You're On Candid Camera!
Doctors could use video cameras to record all their procedures. As Martin Makary, a surgeon at the Johns Hopkins School of Medicine and Bloomberg School of Public Health, recently argued in the Journal of the American Medical Association, this would improve doctors' performance and enable them to be fully transparent with patients about their work. Unfortunately, there is a legal barrier to filming medicine. Simply put, videos would provide a whole new level of evidence in malpractice lawsuits, and a rich hunting ground for trial lawyers on the lookout for big game. The health-care law could have removed this barrier by including provisions to reform medical-malpractice laws. That omission has been a missed opportunity (Ford Vox, 5/1).

New England Journal of Medicine: Discrimination at the Doctor's Office
Recent years have seen some highly publicized examples of doctors who reject patients not because of time constraints or limited expertise but on far more questionable grounds, including the patient's sexual orientation, parents' unwillingness to vaccinate (in surveys, as many as 30% of pediatricians say they have asked families to leave their practice for this reason), and most recently, the patient's weight. ... patients are likely to be discriminated against not because of their impairment (if any), which would be irrelevant at the doctor's office, but simply because of their appearance or physical characteristics ... although we should condemn all types of invidious discrimination against patients, we should be particularly vigilant against the sort of subtle discrimination that can fly under the radar (Holly Fernandez Lynch, 5/2).

New England Journal of Medicine: Distributions Of Industry Payments To Massachusetts Physicians
The federal Physician Payment Sunshine Act will soon require manufacturers to report most payments to physicians and teaching hospitals on a national level. ... Descriptors for the type of relationship will be included as well, although the ones currently used in Massachusetts are of limited value, since the dominant category of "compensation for bona fide services" encompasses legitimate scientific as well as more controversial marketing relationships. ... the transparency offered by state or federal disclosure databases could be used in the future to explore relationships between financial interactions and health care outcomes or costs. (Dr. Aaron S. Kesselheim, Christopher T. Robertson, Kent Siri, Puneet Batra and Jessica M. Franklin, 5/2).

NPR's Double Take 'Toons: Obamacare Stop Or Start?
Even as more parts of the Affordable Care Act are implemented, 42 percent of Americans are unaware that the law is still in effect, according to a recent Kaiser Family Foundation poll. Eric Allie predicts they're in for a nasty surprise, while Nick Anderson thinks the law's opponents are fighting a losing battle.