Viewpoints: Health law guarantees and UPS; 'delay coalition' offers GOP new playbook; Mayor Bloomberg urges Obama not to 'cave' on tobacco

Aug 26 2013

Bloomberg: What's Obamacare Got To Do With It?
It's not entirely clear why United Parcel Service Inc. (UPS) is blaming the Affordable Care Act for its decision to drop 15,000 of its workers' spouses from the company's health-insurance plan. ... It's possible, of course, that UPS is using the health-care law as a smokescreen for cutting costs it wanted to cut anyway. And at one point its internal memo takes an abnormal interest in other people's business. "Since the Affordable Care Act requires employers to provide affordable coverage," it reads, "we believe your spouse should be covered by their own employer." Duly noted, UPS. Also to note: The very law the company cites is helping to save people money on health care. It would be a lot harder for UPS to cut coverage to employees' spouses if those spouses were to be left without coverage at all (8/22).

Louisville Courier-Journal: UPS And Health Plans 
While the news may come as a surprise to workers at "Big Brown," known for its generous benefits including health coverage, it's not a particularly surprising trend in the workplace where more employers are prodding employees whose spouses can get coverage elsewhere to do so. ... But before the critics of health care reform get too riled up, they should consider findings of the Kaiser-USA Today report that noted other companies have taken similar steps -; unrelated to health reform -; as employers seek to curb health care costs. Well before the Affordable Care Act was enacted in 2010, employers had begun efforts to cuts costs by getting spouses off the plan if the spouse had health coverage available elsewhere (8/22).

Forbes: Delta Air Lines: Next Year, Our Health Care Costs Will Increase By 'Nearly $100 Million'
We know that Obamacare will significantly increase the cost of individually-purchased health insurance in nearly every part of the country. But we've generally assumed that disruptions in the market for employer-sponsored health insurance will be less severe. In particular, large employers who self-insure should be exempt from most of Obamacare's most onerous regulations. It turns out, however, that even America's largest companies face higher costs due to the health law. A recently-leaked letter from Delta Air Lines to the Obama administration states that the "cost of providing health care to our employees will increase by nearly $100,000,000 next year," much of it due to Obamacare (Avik Roy, 8/22). 

Forbes: Obamacare Is Really, Really Bad For You, Especially If You're Young
Starting next year, the Affordable Care Act will severely weaken the link between health insurance premiums and age-related risks. Health insurance companies won't be allowed to charge older people any more than three times what they charge younger people for premiums. This is bad news for the young (Rituparna Basu, 8/21).

The New Republic: Karl Rove Is Half-Right About Republicans And Health Care
"Republicans," [Karl Rove] writes today in the Wall Street Journal, "have plenty of sensible ideas to make health coverage more accessible and more affordable." Actually Rove is at least half-right. Republicans do have plenty of ideas. But they are not the kind of ideas that would come anywhere close to achieving universal coverage, at least in the way most people understand it. At best, Republican proposals would make insurance a bit cheaper, mostly for people who are healthy and need coverage the least. At worst, these ideas would make coverage less accessible for people with pre-existing conditions-;and leave more of the insured exposed to crippling medical bills (Jonathan Cohn, 8/22).

The New York Times: The Conscience Of A Liberal: Karl Rove Shouldn't Pretend He Understands Health Policy
Not surprisingly, what Rove actually does is demonstrate his party's intellectual bankruptcy. It's always helpful here to keep your eye on the problem of Americans with preexisting conditions. That's the best starting point for understanding why Obamacare has to look the way it does; it's also often the best way to see what's wrong with alleged Republican solutions (Paul Krugman, 8/22).

The Washington Post: GOP In Fantasy Land
The make-believe crusade by publicity-hound Republicans to somehow stop Obamacare is one of the most cynical political exercises we've seen in many years. And that, my friends, is saying something. Charlatans are peddling the fantasy that somehow they can prevent the Patient Protection and Affordable Care Act from becoming what it already is: the law of the land (Eugene Robinson, 8/22). 

The Wall Street Journal: A New Strategy To Take On ObamaCare 
Maybe there's hope for progress against the president's health-care law after all. The question of how the GOP should handle ObamaCare has of late been dominated by those who want the party to strip funding from the law, then shut down the government unless President Obama agrees. ... That's changing. A swelling coalition of conservative activists-;card-carrying members of the "repeal ObamaCare" campaign-;are lighting up the movement with a different approach. The plan aims to leverage public support, play on Democrat weaknesses, and, most notably, sidestep a shutdown fight that would damage the GOP even as it failed to kill the law. Meet the "Delay coalition" (Kimberley Strassel, 8/22). 

Baltimore Sun: Delay In ACA's Employer Mandate Nothing To Celebrate
The glee with which Republicans greeted the delay in the employer coverage provision of the Affordable Care Act is heartless. Although it is politically motivated, such reveling will prove to be a political obstacle to Republican election chances in 2014. President Barack Obama's health care law is not going away. A groundswell of public opinion will welcome the reforms now under way to help correct the fundamental inequities in America's health care system (James F. Burdik, 8/22).

Kansas City Star: Trying To Sell Selfishness To The 'Young Invincibles'
Obamacare opponents have their eye on 20- and-30-somethings also. If they can persuade enough young adults to stay out of the exchanges, maybe they can tank the entire plan. Or so the reasoning goes. They're arguing that Obamacare will mean extra expenses for some young people. Even with discounts, it may be less costly to pay an annual fine -; provided you stay out of the doctor's office. ... FreedomWorks is telling young people they should refuse to participate in a system that asks something of them so that others can benefit. Never mind that the "subsidies" might be life-saving medical treatments (Barbara Shelly, 8/22).

Fox News: Some Final Warnings About ObamaCare
Each visit to the U.K. brings new horror stories about the National Health Service (NHS). Last month, Sir Bruce Keogh, medical director of the NHS, issued a forensic report, commissioned by the government, which found that 14 underperforming hospitals in England had substandard care, contributing to the needless deaths of nearly 13,000 people since 2005 (Cal Thomas, 8/22).

Bloomberg: Obamacare Rate Shock Isn't What You Think
If the law's age-rating provisions aren't to blame for rate shock, what is? The truth is that premium increases for young adults will be driven by guaranteed-issue and community-rating protections -- in plain English, preventing insurers from denying coverage or basing premiums on health history. Thus, the health-care law's "rate shock" isn't a result of the young subsidizing the old. It's the result of reforming the system so it serves the needs of the sickest and most vulnerable -- something the current individual market fails to do (Adrianna McIntyre & Austin Frakt, 8/22).

Minneapolis Star Tribune: Bemidji Mayor: Paul Bunyan, Babe And MNsure
We like to do things big in Bemidji, and apparently that includes overreacting to the antics of Paul Bunyan and Babe the Blue Ox as unveiled in the new MNsure marketing campaign this week. Paul and Babe have stood in our downtown on the shores of Lake Bemidji since 1937, and they've never given us much trouble -; except when Babe cracked down the middle and had to have major surgery -; and the time Paul wouldn't let go of the Bemidji Curling Team's Olympic bronze medal that was hung around his neck. ... Telling Minnesotans about MNsure is a big job. It takes a big voice. And Paul is just the guy to do it. And if he has to look a little silly in the process, so be it (Rita Albrecht, 8/22).

Detroit News: A Patient-Centered Medicaid Compromise
The most important piece of legislation in Michigan, and perhaps the country, remains idle on the floor of the Michigan Senate: Sen. Patrick Colbeck's Patient Centered Care Act (Senate Bills 459 and 460). ... Fortunately, a crucial component of Colbeck's plan focuses on primary care -; the part of health care that we all interact with the most, and the part that can remove the need for high-cost interventions. ... With direct primary care, patients pay their primary care provider directly, usually on a monthly basis. If a patient is not satisfied with her care, the patient simply takes her direct payment elsewhere (Tom Valenti, 8/22).

The New York Times: Why Is Obama Caving On Tobacco?
Last year I endorsed President Obama for re-election largely because of his commitment to putting science and public health before politics. But now the Obama administration appears to be on the verge of bowing to pressure from a powerful special-interest group, the tobacco industry, in a move that would be a colossal public health mistake and potentially contribute to the deaths of tens of millions of people around the world (New York Mayor Michael R. Bloomberg, 8/22).

Journal of the American Medical Association: Reconsidering The Politics Of Public Health
There is an important and legitimate debate to be had about the appropriate role of regulatory approaches to improve public health. But the political conversation can quickly devolve into caricatures and false choices. Leaders devoted to public health priorities will be the exception rather than the norm unless the health community lays out a clearer path to a politically successful savvy state. This path must directly respond to prevalent and legitimate concerns embodied by nanny state critiques-;while guiding political leadership toward serious and creative approaches to the modern epidemic of lifestyle-related chronic disease (Dr. Dave A. Chokshi and Dr. Nicholas W. Stine, 8/22).

New England Journal of Medicine: Taking Our Medicine -; Improving Adherence In The Accountability Era
Because nonadherence leads to increased complications and hospitalizations, it costs the United States an estimated $100 billion to $290 billion annually. In a health care delivery system where physician payment will increasingly be tied to patient outcomes, nonadherence poses both new challenges and opportunities. ... The Affordable Care Act aims to shift reimbursement from fee for service toward rewarding of improved quality, outcomes, and efficiency. Payment and delivery-system models such as patient-centered medical homes (PCMHs), accountable care organizations (ACOs), and bundled payments encourage greater care coordination by holding providers accountable for total costs and outcomes in their patient populations. ... But will reforms designed to achieve more for less money motivate the development of innovative solutions to nonadherence -; or harm the highest-risk patients? (Dr. Lisa Rosenbaum and Dr. William H. Shrank, 8/22).