Viewpoints: GOP could fix broken health law; crisis tests whether government is capable of offering benefits through complex system; Rubio's cynical attack

Nov 21 2013

The Wall Street Journal: How The GOP Should Fix ObamaCare
Republicans are the only ones who can fix President Obama's broken promise now. The problem is simply stated. Millions will be losing their individual insurance policies that they were promised they could keep. ... What can be done is Congress creating a new option in the form of a national health insurance charter under which insurers could design new low-cost policies free of mandated benefits imposed by ObamaCare (Holman W. Jenkins Jr. 11/19).

The New York Times: The Obamacare Crisis
Health care as a necessity comes only after food, shelter and income security. The mismanagement of the website HealthCare.gov and the cancellation of millions of policies pushes an underlying question out into the open: is the federal government capable of managing the provision of a fundamental service through an extraordinarily complex system? (Thomas B. Edsall, 11/19). 

Los Angeles Times: Rubio Takes The Prize On Obamacare Attacks
Step forward, Sen. Marco Rubio (R-Fla.)! You've won the prize for cynical attacks on Obamacare. In fact, keep the trophy -- you've retired it! We're talking, of course, about your proposal to repeal the provisions of the Affordable Care Act providing for "risk corridors." As we explained last month, risk corridors are a feature of the law designed to protect insurers that end up with a disproportionate share of sicker, costlier customers. ... Since the risk corridors protect the revenues of insurers in the exchanges, repealing them would drive insurers out of the exchanges and thus destroy this central feature of Obamacare. The fact that the insurance industry was awarded this central role in Obamacare largely to please conservatives like yourself -- that's why the so-called public option was dropped -- is what put your proposal over the top on cynicism points (Michael Hiltzik, 11/19).

Los Angeles Times: Obama's Reversal Of Fortune
When it comes to his healthcare law, President Obama faces a political version of what insurance folks call "adverse selection": All the bad news is sticking to him and most of the good news is sticking to someone else. Adverse selection, as we've been hearing lately, is what happens when a health insurance plan attracts too many sick people and not enough healthy ones. The plan's costs go up, its rates rise, healthy people drop out and, before you know it, you're in what actuaries call a death spiral. Obama isn't at that point yet. But the self-inflicted damage he has suffered in the last month is serious and likely to be enduring (Doyle McManus, 11/20).

The New York Times' Taking Note: No Budget, Because HealthCare.gov
After they were blamed for causing a disastrous shutdown, many Republicans seemed to want to get the year's budget fights behind them. As of a few weeks ago, some of them seemed open to relieving the sequester, which is widely hated by lawmakers in both parties, and Congressional appropriators thought they had a chance to enact real spending bills instead of running the government with yet another continuing resolution. But that's looking increasingly unlikely, and the reason is the uproar over the first six weeks of health care reform. Republicans are convinced that they are benefiting from the disastrous rollout of the new law (David Firestone, 11/19).

Los Angeles Times: Obamacare: Battle Of The Risk Pools
The Times' Maeve Reston on Monday dove into the fight that supporters and opponents of the 2010 healthcare law are waging for the hearts and minds of young adults, a constituency crucial to the new state insurance exchanges created by the law. Unless plenty of younger and healthier people sign up for coverage at the exchanges, insurers selling policies there could get stuck with too many customers who run up large medical bills. That, in turn, could drive up premiums faster, leading fewer healthy people to carry coverage, and so on in a vicious spiral (Jon Healey, 11/19).

Bloomberg: Coding Geeks Can't Save Obamacare
A recent news item reported that three programmers, all in their 20s, had whipped up an alternative to the U.S. health-insurance exchange system and claimed it was much more effective than the government's system. The legend of the 20-something coding genius is so powerful that a major news organization seemed to accept that it should be this simple to fix the exchanges. Of course it isn't, and boasts such as this are masking the complexity of the challenge (Norman Matloff, 11/19).

The Washington Post: The GOP's Scary-Movie Strategy
House Republican leaders could not have been more blatant in their attempts to frighten Americans if they had emerged from their weekly meeting wearing hockey masks and carrying chainsaws. "The American people are very, very worried," Majority Leader Eric Cantor (R-Va.) proclaimed to the cameras after emerging from Republicans' gathering Tuesday morning. "Moms and dads are worried that they're going to lose their health-care plan. . . . Individuals who are going onto the HealthCare.gov Web site are beginning to fear that perhaps their identity will be stolen." ... It was all I could do to keep my knees from knocking as I stood in an alcove in the Capitol basement (Dana Milbank, 11/19).

Bloomberg: Obamacare Shows How Americans Are Becoming Jerks
New Gallup poll numbers show Americans increasingly dispute the idea that government has a responsibility to make sure everybody can get health insurance. It's tempting to see that as an indictment against Obamacare, but it might just mean more Americans are becoming jerks (Christopher Flavelle, 11/19).

Los Angeles Times: Drew Altman, Obamacare's Ref
He might have become a doctor like his father, but a grad school (Harvard) summer job researching health policy changed all that. Now as the head of the Kaiser Family Foundation, Drew Altman deals not with lab numbers for a few patients but with healthcare data for millions. For years he headed up state and federal programs on welfare reform, homelessness and Medicaid. Since 1991, he's shaped the Menlo Park-based foundation as "a trusted source of information in a healthcare world dominated by vested interests." With Obamacare stumbling out of the gate, the foundation has been marshaling its data on behalf of consumers and providers to clear the fog of policy (Morrison, 11/19).

On other issues -

The New York Times' Economix: How The Safety Net Held Up In The Recession
Finally, some kind words for government. Robert A. Moffitt, an economist at Johns Hopkins University, says in a new paper that the country's social safety net did a good job during the recession, expanding by half a trillion dollars. Mr. Moffitt looked at means-tested programs including food stamps, Medicaid, unemployment benefits and the earned income tax credit to determine the increase between 2007 and 2010 (Shaila Dewan, 11/19). 

ProPublica: Five Takeaways: Why Doctors Stay Mum About Mistakes Their Colleagues Make
As I wrote this earlier month, doctors often know when a patient has been the victim of a medical error – sometimes before the patient does. But too often they don't say anything about the mistakes, according to a recent report in The New England Journal of Medicine (Marshall Allen, 11/19).