Viewpoints: Mass. experience may not be true test for national health law; 'Dishonest' campaign by medical device makers

May 23 2013

The New York Times: Economix: Massachusetts Employees Will Keep Their Health Plans
Massachusetts is often held up as a window into America's health insurance future, because it embarked on what came to be called the Romneycare reform six years ago. Like the Affordable Care Act provisions going into effect nationwide next year, Romneycare aimed to increase the fraction of the population with health insurance by imposing mandates on employers and employees and by subsidizing health insurance plans for middle-class families without employer plans. ... The details and dollar amounts in the Massachusetts health care law differ from the national Affordable Care Act, and for that reason alone I hesitate to infer too much from the Massachusetts experience (Casey B. Mulligan, 5/22). 

The National Review: It's Not 'Universal Coverage'
This history of Obamacare's political origins makes it all the more ironic that Obamacare, from what we now know, should not be considered a "universal coverage" plan, even by the benchmark the administration was using in 2009. Estimates from the Congressional Budget Office (CBO) point to this conclusion. In its latest assessment of the law, released in conjunction with new budget projections, the CBO indicates that the number of uninsured residents in the United States will never fall below 31 million -- three million more uninsured people than was estimated for the non-mandate plan President Obama rejected -- and that the insured will never be as much as 90 percent of the population (James C. Capretta, 5/21).

The Hill: Treat Nonprofit Health Care Fairly
For decades, unions have negotiated high quality, affordable health insurance through nonprofit Taft-Hartley plans -- one of the few reliable private providers for lower income individuals. ... In addition to being a long-standing and successful provider, these plans have been models of efficiency, achieving better cost savings than for-profit insurance carriers with medical loss ratios often exceeding 90 percent. That means 90 cents out of every dollar go to patient care. ... But as currently interpreted, the ACA would block these plans from the law's benefits (such as the subsidy for lower-income individuals and families) while subjecting them to the law's penalties (like the $63 per insured person to subsidize Big Insurance). This creates unstoppable incentives for employers to reduce weekly hours for workers currently on our plans and push them onto the exchanges where many will pay higher costs for poorer insurance with a more limited network of providers (Joseph T. Hansen, 5/20).

Los Angeles Times: Why The Medical Device Tax Needs To Stay
The chief drawback of a law as complex as the Affordable Care Act, the health insurance reform measure passed in 2010, is that it provides self-interested opponents a multitude of places to stick a wedge in and hammer away. But you'd be hard-pressed to find a campaign against the ACA as narrow-minded and dishonest as the one mounted by medical device manufacturers (Michael Hiltzik, 5/21). 

Fox News: 5 Reasons The Government Is Not Prepared To Handle ObamaCare
The recent turn of events with the Obama Administration and a lack of transparency are a significant red flag to the impending catastrophe of how the proposed changes under the Affordable Care Act could be the next ensuing disaster. … The emerging IRS scandals,  as they pertain to the multiple crises of the Obama Administration, are an ominous sign for how these very mistakes will impact the outcome of how the Affordable Care Act is implemented, and ultimately the lives of every American consumer (Dr. Sreedhar Potarazu, 5/21). 

Fox News: Americans Beware – ObamaCare Expands How The IRS Can Hurt You
Most of us interact with the Internal Revenue Service once a year at tax time.  But President Obama's Affordable Care Act health law puts us under the IRS's thumb all the time. The IRS has a history of using leaks and delays to punish people based on their politics. The latest is news that the IRS delayed processing requests for tax exempt status from the Obama administration's conservative critics, and even leaked information about them to the press (Betsy McCaughey, 5/20). 

Des Moines Register: Possible Medicaid Compromise Is Encouraging
(Iowa Gov. Terry) Branstad indicated he would be willing to accept a form of Medicaid expansion if it came with assurances that if the federal government reduces funding for the program in the future, Iowans would not be left picking up the cost. On Tuesday, Sen. Jack Hatch, D-Des Moines, said legislative leaders and the governor's staff have been meeting frequently and may have a deal soon. The final, compromise plan should capture the maximum amount of federal money available, insure Iowans earning up to 138 percent of poverty level and be able to gain approval by the federal government. Whether elected officials are successful remains to be seen, but there is more hope now than there was a week ago (5/21).

Des Moines Register: Broader Medicaid Wouldn't Produce A Healthier Iowa
Bluntly, expanding Medicaid coverage would only make its recipients "feel better," but not actually be better. That makes Medicaid a very expensive feel-good program. Expanding Medicaid lives up to the name of the Affordable Care Act -- it gives "affordable care," nothing more. And the financial protection afforded Medicaid recipients is most effective in protecting against "catastrophic" health expenditures (Bob Williams, 5/21).

The Washington Post: Free Genes From Patent Restrictions
Jolie's news highlights an arcane but increasingly important question of patent law. As the sequencing of the human genome has expanded the ability to test for such genetic susceptibilities, is the discovery of the gene itself a patentable invention? (Ruth Marcus, 5/21). 

The Seattle Times: Is Catholic Church Taking Over Health Care In Washington
Lord knows our schools have problems. But suppose we tried to solve them by doing something radical -- say, turning the schools over to the Catholic Church. … If put to a vote, this plan would crater. Most of us aren't Catholic, so I'm guessing we'd never go along with letting the creeds of that one faith run something as universal as education. So why are we allowing it with health care? (Danny Westneat, 5/21).

Miami Herald: Stopping Medicare Fraud
Miami has long had the sorry reputation for being the nation's leader in Medicare fraud, with seemingly just about anybody -- from convicted felons to, well, actors -- allegedly cashing in on what's supposed to be a medical safety net for the country's elderly and disabled. How can this happen? And keep on happening? ... But another part of Medicare, the administration arm that certifies that care givers who tap into Medicare reimbursements are actually qualified to do so and then verifies that they actually deliver the services they vouch for, must be much more diligent. Especially so in fraud capitals like Miami where it's so easy to find an abundance of seniors, some of whom are achingly vulnerable to crooks and cons (5/19).

JAMA: Value of Unique Device Identification in the Digital Health Infrastructure
In recent years, high-profile cases of medical device failure resulting in patient harm -- such as implantable cardioverter-defibrillator leads and metal-on-metal hip implants -- have received substantial attention both in the medical literature and popular press. These examples illustrate the need for a more effective system of monitoring device performance and protecting patient safety (Drs. Natalia A. Wilson and Joseph Drozda, 5/21).

JAMA Pediatrics: Stunting The Growth Of Child Health Research
A recent comprehensive assessment concluded that "lack of research, poor research, and poorly reported research" greatly limit child health research. Children participate in medical research at rates less than one-half those of adults, perhaps attributable to inadequate opportunities, ineffective recruitment strategies, and parents' greater concerns about their children's safety than their own in research settings. Meanwhile, health care spending on children declines every year as a share of national expenditures, causing concern that investment in child health research will decline as well (Dr. Matthew M. Davis, 5/20).

JAMA Internal Medicine: Evaluating Health System Processes With Randomized Controlled Trials
Health system processes shape and define health care and the medical experience of patients, health care practitioners, and society at large. These processes range from targeted mandates, such as gown and glove precautions for patient contact or automated computer alerts, to wider choices, such as deciding how to respond to medical emergencies, how to use (or not use) performance metrics or patient satisfaction surveys, what new health care facilities to build, or even how to finance health care costs and medical insurance. Given their unquestionable importance, we contend that health system processes should be routinely evaluated with randomized controlled trials (Drs. John P. A. Ioannidis and Vinay Prasad, 5/20).

The Medicare NewsGroup: Does Medicare Overpay Private Plans? The Debate Heats Up
The debate on whether Medicare Advantage (MA) is reducing health care costs is intensifying. A recently released analysis of government data by America's Health Insurance Plans (AHIP), the main health insurance lobby, found that seniors enrolled in MA plans in California and Nevada had better health outcomes than patients enrolled in Traditional Medicare. … Given the growing toxic environment in Washington and the fact that MA has become a political football, it's unlikely that the CMS or Congress will act before the 2014 elections, delaying a closer look (John Wasik, 5/21).

Health Policy Solutions (a Colo. news service): The Year Of Mental Health At The Colorado Legislature
In addition to other health care reforms (Medicaid expansion, improved parity for behavioral health coverage) two historic pieces of behavioral health legislation moved forward this year. One deals with Colorado's civil commitment laws -- statutes long overdue for a 21st century update. The other is a bill that includes over $20 million in funding to create a statewide behavioral health crisis response system. The governor signed both bills into law at the Jefferson Center for Mental Health on May 16 (Michael Lott-Manier, 5/21).

WBUR: Cognoscenti: Your Patient Is Your Partner: Collaboration Creates The Best Medical Outcomes
In a recent interview, physician and noted social activist Dr. Paul Farmer gave this advice to graduating medical professionals: their real impact will come when they work in teams. As the co-founder of Partners in Health and a champion of improving health in underserved communities, Farmer's work is built on building partnerships and applying successes and lessons learned to new frameworks (Laurie Edwards, 5/22).