Viewpoints: 'Celebrating' enrollment numbers; Maryland's website 'debacle;' abortion battle moves again to high court

Jan 15 2014

Bloomberg: Everyone Can Celebrate New Obamacare Numbers
Today the federal government released the most comprehensive data yet about who signed up for Obamacare through Dec. 28. There's reason to cheer for both the law's supporters and its detractors. ... Today's numbers don't settle the question of whether the administration will hit its goals for enrollment in the exchanges, measured either in raw numbers or demographic breakdown. But they show that those goals are within reach (Christopher Flavelle, 1/13).

The Washington Post: Maryland's Health Web Site Debacle: A Scandal Of Incompentence
No one can look at The Washington Post's exhaustive investigation into the construction, rollout and crash of the Maryland health insurance exchange and walk away with any measure of confidence in government. How could this epic bungling have happened in a state that often oozes self-satisfaction with its progressive policies, led by a governor who considers himself a 2016 presidential contender? (Petula Dvorak, 1/13).

The Wall Street Journal: A Legal Poison Pill For ObamaCare
The  Obama administration is in the habit of selectively enforcing the law. It has justified this practice as an expedient to bypass congressional "dysfunction" and preserve the president's signature achievement, the Affordable Care Act. Yet that strategy may backfire on both counts. The administration's nonenforcement gambit promises only to prolong the current legislative stalemate while preparing the way for a broader rollback of the ACA (Brian Callanan, 1/13).

The New York Times: Abortion Rights: Uphold Buffer Zones
Abortion is one of the most emotionally fraught issues in American society, and public discussion often turns into an attack on the women who choose to exercise their constitutionally protected rights. ... On Wednesday, in McCullen v. Coakley, the Supreme Court is scheduled to consider whether [a Massachusetts law that creates a buffer zone around abortion clinics] violates the protesters' free speech rights under the First Amendment. While that is the legal question before the court, the broader issue at stake is protecting women's access to abortion, which is under assault around the country by lawmakers and protesters alike (1/13).

The New York Times: Abortion Rights: A Good Ruling Stands
The Supreme Court made a good call, announced on Monday, not to review a 2013 ruling by the United States Court of Appeals for the Ninth Circuit, which struck down Arizona's 20-week abortion ban as unconstitutional. For women in Arizona, the appellate ruling is critically important in protecting their reproductive rights (1/13).

Politico: R&D Funding Is The Best Medicine
American innovation, badly damaged last year by federal budget tightening and the across-the-board cuts known as sequestration, appears to be getting partial relief with the bipartisan budget deals struck last month and Monday night. The progress is praiseworthy, but it will not counteract the decades-long decline in federal funding for research and development that is so essential to our economic future and critical to accelerating treatments for today's major health care challenges, including Alzheimer's, diabetes, heart disease and cancer (Dr. Paul Stoffels and Alan I. Leshner, 1/13).

Bloomberg: Right, Wrong And Rubio On Poverty
The way to defeat poverty in America, Republican Senator Marco Rubio says, is to let the states lead the fight. ... A more fundamental rejoinder to Rubio's plan is that the nature and causes of poverty don't vary from state to state nearly as much as the political will to alleviate it does. The best illustration of this is the expansion of Medicaid under the Affordable Care Act: Only half the states have agreed to take new federal money to provide Medicaid for more people. That level of disregard for the vulnerable doesn't bode well for letting states control more such programs (1/13).

Bloomberg: Is There A Right Way To Have Cancer?
Cancer is one of those subjects like diet or child-rearing where everyone seems to have a strong opinion about the right way to do things. In [Lisa Bonchek] Adams's case, two prominent columnists -- Emma Keller of the Guardian and her husband, Bill Keller of the New York Times -- wrote articles that, while hedged with all sorts of qualifications, made it clear that they didn't condone her approach. The Internet exploded with disapproval of their disapproval (Virginia Postrel, 1/13).

WBUR: Project Louise: Flunking The Fitness Test And Getting Down To Work
It's still a bit early to declare that I'm getting into a groove, but … well, I think I can at least see the groove from here. Project Louise had a busy week: an official "fitness assessment" with my new trainer, Rick DiScipio, followed a couple of days later by my first training session with him; a two-hour meeting with my strategy coach, Allison Rimm, to outline my strategic vision and "set an intention" for the coming year; a "hot yoga" session that my friends Sara and Susan talked me into (spoiler alert: I only thought I was going to die – but you'll have to wait a week to hear more about that); and, yay me, not one but three separate visits to the gym, complete with aerobic workouts (Louise Kennedy, 1/13).

WBUR: Beyond Blame: Yes, Too Many C-Sections, But No, Not Bad Moms
I am not a bad mother because I had a Cesarean section. If you had one, neither are you. ... I hated hearing from moms who felt like we belittled their experience by suggesting that there are too many C-sections. Our point in the series was to alert everyone to the range of C-section rates and to help mothers be more aware of the factors that lead to a C-section (Martha Bebinger, 1/13).

Health Policy Solutions (a Colo. news service): Conversations With Consumers Provide Insights On New Marketplace
Health Coverage Guides are playing a critical, impartial role in helping Coloradans navigate what we all know is one of the most challenging decisions one can make: What is the right health insurance for me? Many consumers after a session with a Health Coverage Guide expressed that they were relieved to have a trained professional walk them through the process of browsing and applying for coverage. "People get confused about the process until they talk with a guide," said a guide in northern Colorado (Lisa Ritland, 1/14). 

Health Policy Solutions (a Colo. news service): Colorado Providers – Importers Or Exporters Of Services?
Beginning in 2014, large national employers including Wal-Mart and Lowes, will begin offering their employees the opportunity to travel to national Centers of Excellence (CoE's) for total hip and total knee replacements. If the employee travels to the CoE for care, they will have no out of pocket costs for any of their treatment and all travel and meal expenses, for the employees and a "helper/companion", will be paid for by the employer. There are no Colorado providers on this CoE list and, as a result, Colorado will begin exporting some of its most profitable medical procedures beyond its borders beginning next month (Bob Kershner, 1/14). 

Health Policy Solutions (a Colo. news service): There's More Than One Way To Slice An Apple – And Calculate Readmissions
Hospitals have access to their own readmission data, but that's typically where their information ends. The Colorado All Payer Claims Database now has new ways of looking at readmissions that will give hospitals and health systems deeper insights into readmissions across the state and in their own facilities like never before. Separate Medicaid and commercial insurance readmission rates are also now publicly available for comparison across Colorado – giving us the ability to break down readmissions by coverage type, service line and geography. This level of data transparency is a critical part of eliminating unnecessary hospital readmissions for a safer, healthier, and less expensive health care system (Kristin Paulson, 1/14).

Journal of the American Medical Association: Medicare Physician Payment Reform
There are several reasons physician payment reform legislation is moving forward now. One widely cited reason is the much lower budgetary cost of a permanent fix: since last year, the 10-year cost of replacing the current SGR declined by more than half, from $297 billion to $117 billion .... The other, perhaps less appreciated reason is that support among physician groups is growing for alternatives to both the short-term SGR patches and RBRVS. Many primary care and specialty groups have been developing and in some cases implementing the kinds of payment reforms (Drs. Mark McClellan, Kavita Patel and Darshak Sanghavi, 1/13).