Viewpoints: Obamacare is already working; George W. Bush on 'personal responsibility'; Medicaid expansion and the mentally ill

May 31 2013

The New York Times: Is Obamacare Too Complicated to Succeed? 
The Affordable Care Act has been under siege since before it even had a name. Some on the right saw it as government overreach. Some on the left considered it better for insurance companies than for consumers. As many of the law's provisions take effect over the next year, we're hearing from both sides all over again. This time the theme is that the law is too complex. ... Read the discussion (5/29). 

Bloomberg: One Way Obamacare May Already Be Working
There was a time when all anyone in Washington wanted to talk about was "bending the health-care cost curve." Forget covering the uninsured -- the ultimate test of the Affordable Care Act would be the trajectory of health care costs. But Washington has a short memory. That whole "curve" thing was years ago. ... Yet quietly, the cost curve has begun to bend (Ezra Klein, 5/29).

New England Journal Of Medicine: Failure To Launch? The Independent Payment Advisory Board's Uncertain Prospects
Controversy has followed the Independent Payment Advisory Board (IPAB) since its inception. The Affordable Care Act (ACA) established the IPAB as a 15-member, nonelected board. Among other duties, the IPAB is empowered to recommend changes to Medicare if projected per-beneficiary spending growth exceeds specified targets. ... Regardless of the IPAB's future, one thing is clear: rather than removing politics from Medicare, the board's difficult early journey has underscored just how entrenched politics are in health care policy (Jonathan Oberlander and Marisa Morrison, 5/29). 

CNN: Myths About Obamacare
This is a critical time for the law. For better or worse, the Republican Party, for the most part, stands in total opposition to Obamacare. ... they believe that letting the law fail, spectacularly, is the quickest way to get rid of that. Because of this, few, if any, opponents of the law are willing to make any concessions or changes to it at all. This is a relatively new thing when it comes to major legislation. Past laws on this scale, including the Children's Health Insurance Program, Medicare, and Social Security were amended and changed years and even months after being passed (Dr. Aaron Carroll, 5/29). 

Washington Post:  Wonkbook:  As Obamacare Starts, Health Insurers Are Just Guessing
Each week brings new data from a new state on the premiums insurers intend to charge on the exchanges. Some weeks bring revised data from old states. But it's worth stepping back and keeping two things in mind. The first is that all these numbers are simply guesses. Really. That's it. California's numbers are guesses. Maryland's numbers are guesses. Oregon's numbers are guesses. Vermont's numbers are just guesses. Everyone is just guessing (Ezra Klein and Evan Soltas, 5/30).

Fox News: George W. Bush Vision's For Health
Do you ever wonder how long our current president of the United States will continue to blame the prior administration for our current economy and blame the Iraq War for our current foreign policy concerns? For a study in contrasts, I spent some time last week with our most recent former president, George W. Bush, ...  It was clear that he believes that preventing disease by staying fit is the place to start, but emphasized, "there's no law you can pass to get people off the couch." Bush's emphasis is on a personal responsibility for health rather than extending an expensive, easily overused and comprehensive insurance program to more and more people (Dr. Marc Siegel, 5/28).

The Washington Post: Getting D.C. Children The Mental Health They Need 
The Children's Law Center has estimated that at least 5,000 District children are going without needed mental health services, with consequences ranging from truancy to crime to unemployment. It's important that the District raise the grade on getting these children the help they require (5/29).

Columbus Dispatch: Medicaid Expansion Crucial To Mentally Ill 
Ohio's mentally ill will be among those hurt most if lawmakers refuse to expand Medicaid under the federal health care law. A report being released today by the National Alliance for Mental Illness found 1 in 4 Ohioans who would gain subsidized health coverage suffer from mental illness. Ohio is among 16 states still undecided about expansion, and of those, only one has a higher rate -- Nebraska, where 30 percent have mental illness (Catherine Candisky, 5/30).

Raleigh News & Observer: NC Senate Budget Plan Pushes Pregnant Women Out Of Medicaid 
Largely unnoticed and unremarked in the budget recently passed by the N.C. Senate was a troubling reduction in the eligibility of pregnant women for the state's Medicaid program. While Republicans have made it clear they don't want to accept federal money to expand the state's Medicaid program under the Affordable Care Act, this attempt to cut eligibility levels for women currently on Medicaid marks a new effort to limit health options for low-income North Carolinians (Adam Searing, 5/30).

New England Journal Of Medicine: The Sunshine Act -- Effects On Physicians 
The new Physician Payments Sunshine Act requires public reporting of payments to physicians and teaching hospitals from pharmaceutical and medical device companies, as well as reporting of certain ownership interests. ... It will allow more informed and engaged health care consumers to choose physicians using this information along with publicly available quality and resource-utilization data. The program seeks to balance the value of data transparency against its possible effects on innovation or CME (Dr. Shantanu Agrawal, Niall Brennan and Dr. Peter Budetti, 5/30).

CNN: Bring Medical Misdeeds Into The Light
By the time he was finally arrested in late 2003, Charles Cullen, a nurse, had murdered at least 40 patients, and perhaps hundreds, in nine different hospitals and a nursing home in Pennsylvania and New Jersey. ... His victims were chosen indiscriminately: a priest, a recovering breast cancer patient, even a teenager. These were not mercy killings. Many of Cullen's victims were improving and on the verge of being discharged from the hospital. ... This ought to be shocking. But can any of us who work in hospitals and academic medical centers honestly say, "This could never happen at my institution"? I doubt it (Dr. Carl Elliot, 5/30).

Health Policy Solutions (a Colo. news service): Spend Money On Universal Care Not Costly Exchange
The complexity of implementing and understanding the reforms required under the federal Affordable Care Act (ACA) also known as Obamacare, has become more apparent in recent days. Health Care for All Colorado, the state's leading advocacy group for a universal public single-payer system, contends that this complexity will lead not only to unnecessary confusion for patients and caregivers but also to increased costs for premiums and other administrative costs that will continue to drive the cost of health care ever higher (Dr. Thomas Gottlieb, 5/29).