Viewpoints: Assessing the Oregon Medicaid experiment; health insurance hysteria; in Florida, 'toxic politics' beats out common sense

May 7 2013

The Washington Post: Here's What The Oregon Medicaid Study Really Said
So here's what happened in the first two years of the Oregon Medicaid experiment: Medicaid proved itself good health insurance. The people who got Medicaid used more health care, and seem to have done so smartly -; they got preventive care, they got their diabetes diagnosed and began managing it, they treated their depression, and so on. But the health care itself didn't work as well as we hoped -; at least not in terms of cutting rates of hypertension and cholesterol (Ezra Klein, 5/2).

The New York Times: What Health Insurance Doesn't Do
As liberals have been extremely quick to point out, these findings do not necessarily make a case against the new health care law, which includes a big Medicaid expansion as well as subsidies for private insurance. After all, the first purpose of insurance is economic protection, and the Oregon data shows that expanding coverage does indeed protect people from ruinous medical expenses. The links between insurance, medicine and health may be impressively mysterious, but staving off medical bankruptcies among low-income Americans is not a small policy achievement. This is true. But it's also true that the health care law was sold, in part, with the promise (made by judicious wonks as well as overreaching politicians) that it would save tens of thousands of American lives each year (Ross Douthat, 5/4).

Bloomberg: Yes, The Oregon Health Study Matters
But the lesson of the Oregon Health Study is nonetheless that there's cost-effectiveness information out there that Medicaid and other health insurers aren't exploiting. And even though conservatives have generally done a terrible job of explaining why, conservative ideas about increasing consumer direction in health care could help to exploit that information and make health care more cost-effective -- without repealing Obamacare or stopping the Medicaid expansion (Josh Barro, 5/3).

The Wall Street Journal: An ObamaCare Penalty On Hospitals
Under the Affordable Care Act's Hospital Readmissions Reduction Program, hospitals that readmit "excessive" numbers of Medicare patients within 30 days of discharge now face significant penalties. The maximum penalty is 1% of a hospital's Medicare reimbursement, but that will increase to 3% in 2015. That may not sound like a lot, but for hospitals already struggling financially-;especially those serving the poor-;losing 1%-3% of their Medicare reimbursements could put them out of business (Stephen Soumerai and Ross Koppel, 5/5). 

Bloomberg: Beware Of Hysteria Over New Health Insurance Rates
Last month, Maryland made public the premiums that health insurers want to charge next year under the Affordable Care Act, one of the first states to do so. Premiums for non-employer health-insurance coverage were eye-popping, with a proposed average increase of 25 percent. As insurers submit their proposals in every state this spring, a pattern of such large premium increases may emerge. And opponents of the 2010 health-care law will pounce. But the news media and the public shouldn't succumb to their hysteria (Topher Spiro, 5/5).

The Wall Street Journal: A Jobs Fillip
One big negative in the April report is the increase in part-time employment. ... All of this suggests that ObamaCare is beginning to skew hiring patterns. Employers will soon have to offer health-insurance or pay a penalty for full-time workers, which the health law defines as anyone who works at least 30 hours a week. Many small businesses appear to be limiting their employees to fewer than 30 hours, perhaps with job-sharing or even by splitting employees with other employers (5/3). 

Miami Herald: On Medicaid, GOP Politics Trumps Common Sense
Surely the people of Florida had a right to expect that during the 60 days of the annual legislative session lawmakers would find a way to accept the federal government's offer of $51 billion over the next decade to expand Medicaid. And yet House Republicans, led by Speaker Will Weatherford, R-Wesley Chapel, failed to reach a workable compromise with their counterparts in the Republican-led Senate, effectively killing any deal for now and leaving Florida's uninsured in jeopardy. This is a huge loss for the people of Florida, the triumph of toxic politics over common sense (5/4).

Tampa Bay Times: The Legislature's $51 Billion Failure
They PURRED like cats, listened to an auto-reader named Mary speed-read bills and honored golfer Jack Nicklaus. They raised university tuition, outlawed Internet sweepstakes cafes and banned texting while driving. They gave state workers raises for the first time in seven years and spent millions on pet projects such as a rowing center in Sarasota, a Bay of Pigs museum in Miami and an aquarium in Clearwater. But state lawmakers refused to accept $51 billion in federal money to provide health care to 1 million uninsured Floridians, and that leaves a permanent stain on the 2013 Florida Legislature (5/3).

New Orleans Times Picayune: Expanding Medicaid Is Crucial For Louisiana Residents
Gov. Jindal argues that over a decade Louisiana might have to spend $1.7 billion on the expansion, that Medicaid is inefficient and that there are too many uncertainties. He also says that too many Louisianians would be dependent on the government for health care under the expansion. Frankly, none of that is persuasive (5/5).

Toledo Blade: Drop The Teacup, Lawmakers, And Expand Medicaid
The Republicans who control Ohio's General Assembly are making an instructive choice. They are denying health insurance to hundreds of thousands of working-poor Ohioans -; and defying the governor of their party -; so they can pander to the hard-right bloc of GOP voters. These lawmakers are betting that they will be rewarded, not punished, at the polls next year for working against the best interests of the state and its taxpayers. And given the way Ohio rigs its legislative elections, that calculation may be smart politics, even though it's terrible public policy (David Kushma, 5/4).

Boston Globe: Health Insurance: A Painfully Long Wait
One million hours. That's how much time new Harvard research suggests psychiatrists spend each year obtaining insurance approval to hospitalize suicidal or mentally ill patients. That translates into time taken away from patient care but also, more importantly, means patients in crisis are stuck in emergency rooms for a median of 8.5 hours, more than twice the length for most other admissions. This bureaucratic roadblock needs to be streamlined (5/6)

The New York Times' Opinionator: How Colonoscopies Are Like Home Renovations
So what should contractors do? They could promptly repair every problem the moment a homeowner identifies it. But that would be costly and seems unlikely. Perhaps instead they should consider picking something the homeowner really cares about and exceeding expectations on that one repair -; but only at the very, very end. One friend told me that her contractor gave her an espresso machine when the job was finished. Even if she ultimately paid for the gift, her memories of the experience were sweeter than mine. The good thing is that, like a colonoscopy, once the remodeling is over, you won't need another one for years (Ezekiel J. Emanuel, 5/6).