Viewpoints: Indian health service takes big cuts; labor 'mutiny' over health law; Gov. Jindal says Medicaid expansion would have moved privately insured to Medicaid

Jul 25 2013

The New York Times: Abandoned In Indian Country
It's an old American story: malign policies hatched in Washington leading to pain and death in Indian country. It was true in the 19th century. It is true now, at a time when Congress, heedless of its solemn treaty obligations to Indian tribes, is allowing the across-the-board budget cuts known as the sequester to threaten the health, safety and education of Indians across the nation. ... One of the most important is the Indian Health Service, which serves about two million people on reservations and is grossly underfinanced even in good times. It routinely runs out of money halfway through the year. Though Medicare, Medicaid and veterans' health were exempted from sequestration cuts, the Indian Health Service was not (7/23).

The New York Times' Economix: The New Economics Of Part-Time Employment, Continued
A revised definition of part-time employment may have some popular appeal, but it will not repair the Affordable Care Act's disincentives for full-time employment or its extra costs for taxpayers (Casey Mulligan, 7/24). 

The Wall Street Journal: Obama's New York Model
President Obama has found a new example for the pending wonders of his health-care reform-;New York. In his latest sales pitch last week, he declared that insurance rates in New York's ObamaCare exchange "will be at least 50% lower next year than they are today. Think about that: 50% lower." ... The real news is that New York ruined its individual insurance market two decades ago by imposing the same regulations that ObamaCare is about to impose on every other state (7/23).

The Wall Street Journal's Political Diary: Labor Vs. ObamaCare
The labor union mutiny against the Affordable Care Act expanded Thursday with a letter to President Obama from the head of the Laborers' International Union of North America, which represents more than 500,000 workers in construction and other industries. Echoing a similar appeal by three top union chiefs the previous week, union president Terry O'Sullivan wrote that ObamaCare will have "destructive consequences" for health plans that cover millions of workers and their families (Alexander Kazam, 7/23).

New Orleans Times-Picayune: Gov. Bobby Jindal: Why I Opposed Medicaid Expansion
First, as a general principle, we should not move people from private insurance onto government-run programs. It seems a matter of common sense that we should want to encourage self-sufficiency and target taxpayer spending only for those most in need. But Medicaid expansion would have moved up to 171,000 Louisianians off private insurance and stopped another 77,000 people from obtaining private insurance. To cover 214,000 low-income uninsured people in Louisiana, Obamacare would add more than twice that number -- more than 450,000 people -- to the Medicaid rolls. This makes no sense (Louisiana Gov. Bobby Jindal, 7/23).  

Health Policy Solutions (a Colo. news service): Not So Invincible – Young People Confused About Obamacare
Contrary to what many in the media may believe, young people do care about the implementation of Obamacare, the Affordable Care Act (ACA). But just like many other people in America, many of us may be confused about its provisions and which may apply to us and how. Though I am a senior at Boston University, and have studied health policy, I acknowledge that I do not understand everything I may need to know about the new law (Danielle Robbio, 7/24).

CNN: Will Obamacare Help Primary Care?
You're wiped out, eating too much, your chest feels funny when you climb stairs, sex isn't working well, you can't wait for a drink and your spouse is looking at you warily. But you just bought health insurance online from a health exchange. Now, before you head for an ER, if only you could find a doctor. ... Primary care doctors -- the pediatricians, family doctors and internists who constitute the foundation of our medical system -- are also in trouble (Dr. Tom Delbanco, 7/23).

Tampa Bay Times: Fed Must Save Children From State Apathy
The federal government took the only recourse available by finally asking the courts to end Florida's shameful practice of warehousing disabled children in nursing homes. For two years, Gov. Rick Scott's administration has made clear that it had no intention of changing course on a policy that punishes children with complex medical needs and keeps them from their homes, families and communities. If Florida won't comply with the antidiscrimination laws, then it falls to the federal government and the courts (7/23).

Bloomberg: How Republicans Can Help Us Grow Old Gracefully
If you thought the fight over Obamacare was bruising, brace yourself for the coming battle over long-term-care insurance. Demographic pressure and ill-fitting public programs make the current approach unsustainable, whether we like it or not. ... A better option is for the U.S. to follow the lead of almost every other developed country and create a social insurance plan for long-term care, in which the government collects premiums from the working-age population and uses the money to fund care for those who qualify (7/23).

The Seattle Times: Feds Make A Hash Of State's Mental-Health System
The U.S. Centers for Medicaid and Medicare Services informed the state of Washington that the state's outpatient mental-health system violated federal procurement laws, as articulated in OMB Circular A-87. Hope that didn't lose you. That accountant-speak is bone-dry. ... "Now wait a minute," longtime readers will say, "haven't you spent a lot of time arguing that health insurance doesn't necessarily make us any healthier? (7/22).

The Lund Report: Optimism Abounds In Cover Oregon Land – Is It Real?
Oregonians have been led to expect that they will receive large subsidies to help pay the cost of their personal health insurance now that health insurance is required. We also know they have been told that if they like their current insurance policy, they can keep it. Sounds good on the surface, but if we dig a little deeper we find that both statements don't hold much weight (John Gridley, 7/23).

Georgia Health News: Palliative And Hospice Care Help Make Life Livable
A hundred years ago, the average life expectancy in the United States was just under 50 years. Today it's nearly 80 years – a true testament to the benefits of modern medical advances. The development of highly effective treatments and technologies significantly extended Americans lives. However, these technological treatments can also affect quality of life, and not always for the better (Dr. Victor Alvarez, 7/23).

Minneapolis Star Tribune: Want Better Health Care? Be Pushy
I've been a physician for 35 years. During the most recent 25, I've devoted time to practice improvement and population health initiatives. In part, this involved helping individuals to be healthier. It also involved helping the care delivery system explore how to make care more effective, more efficient and more satisfying to patients (the combination labeled "the triple aim") (Dr. Charles J. Fazio, 7/23).

Bloomberg: What My Dog Taught Me About Health Insurance
Last February, on Valentine's Day, the Official Blog Spouse and I took custody of an eight-week-old bullmastiff puppy named Fitzgerald. The first thing we did was to drive him home from Indiana and install him in the Stately McSuderman McMansion. The second thing we did was to buy him pet health insurance. "Now wait a minute," longtime readers will say, "haven't you spent a lot of time arguing that health insurance doesn't necessarily make us any healthier?" (Megan McArdle, 7/23).

JAMA: The Critical Role of Caregivers in Achieving Patient-Centered Care
Achieving high-quality, cost-effective medical care remains an elusive goal of the US health care system, but there is widespread agreement that patient-centered care will be a key ingredient.1 Yet for frail elders and patients with advanced illness, many of whom have multiple chronic diseases, patient-centered care is impossible without caregiver involvement. Although advocacy groups such as the National Alliance for Caregivers have long endorsed attention to family members and prominent research organizations such as the newly created Patient-Centered Outcomes Research Institute mention families in their research agendas, the critical role of caregivers deserves considerably more attention from clinicians (Dr. Muriel R. Gillick, 7/22).

JAMA: Who Owns Human Genes?
The [Supreme Court's] compromise ruling acknowledged difficult issues in a simmering controversy. Granting commercial rights over naturally occurring biological products seemed unethical because industry should not be able to control access to unaltered materials found in nature. However, failure to afford intellectual property protection could stifle innovation, robbing entrepreneurs of financial incentives for discovery. Myriad lost the exclusive right to isolate the BRCA1 and BRCA2 genes of individuals, but maintained the right to its unique method of synthetically creating BRCA cDNA to produce and market its tests (Lawrence O. Gostin, 7/22).