Viewpoints: Health overhaul helps ease inequality issues; nuns triumph over health law; deinstitutionalization's mental health legacy

Jan 28 2014

The Washington Post: Making Progress On Inequality
Intense as it is, the current debate over rising income inequality is hardly new. ... The good news is that there's more good news than one might expect. ... In addition to avoiding making things worse, the country has adopted, at least in part, several of the policy improvements we thought made sense eight years ago. Most prominent among these was President Obama's health-care reform, which, for all its problems, promises to ease the health-care cost squeeze on middle- and lower-income Americans (1/25). 

The Washington Post: No, Obamacare Isn't A 'Bailout' For Insurers
The term "bailout" is back. Specifically, Republicans are calling a feature of the Affordable Care Act -; the risk corridor funds designed to share losses if insurance companies have greater than expected losses -; a "bailout." ... Usually bailouts are put into place to prevent a situation in which the failure of one firm leads to problems or a collapse for the economy as a whole. ... So should the Affordable Care Act's risk corridors be considered "bailouts"? (Mike Konczal, 1/25).

The Wall Street Journal: A Victory For The Little Sisters
The New Year's Eve emergency injunction protecting the Little Sisters of the Poor from ObamaCare's birth-control mandate was unusual enough. The Supreme Court rarely grants such relief, and the order was issued by liberal Justice Sonia Sotomayor. But the permanent stay pending appeal, issued late Friday by the full Supreme Court with no recorded dissent, was rarer still-;and a rebuke to the Obama Administration's bullying conception of religious liberty (1/26). 

The Washington Post: In Virginia, Ideology Trumps Facts On Medicaid
Whether Virginia opts to expand Medicaid or not, poor and uninsured patients will continue to seek medical care, and many of them will do so at state expense. It is a triumph of ideological purity over budgetary prudence for lawmakers in Richmond to insist on spurning federal funds that would only relieve the burden on taxpayers and, in the process, provide a safety net for up to 400,000 Virginians who lack insurance coverage (1/24).

The Star Tribune: MinnesotaCare May Be Undercut By Federal Policy
The administration can ill afford more questions about the law's rollout, particularly in states such as Minnesota, where the health care community has embraced the ACA's potential. That's why it's critical that the administration move quickly to prevent federal payment policies from penalizing Minnesota for modernizing its pioneering MinnesotaCare program and having some of the nation's most affordable insurance premiums on its new MNsure marketplace. The decline in expected federal revenue is a key reason why the net state cost of MinnesotaCare is expected to increase by $517 million for 2016-17, compared with estimates from the last legislative session (1/24).

USA Today: How Americans Can Kill Obamacare, Legalize Pot 
In his excellent book, Two Cheers For Anarchism, Professor James Scott writes: "One need not have an actual conspiracy to achieve the practical effects of a conspiracy. More regimes have been brought, piecemeal, to their knees by what was once called 'Irish Democracy,' the silent, dogged resistance." ... That seems to be happening right now, in two very different areas. In one area, we have the refusal of people to sign up for Obamacare in anything like the numbers that were predicted, or needed to make it work. ... Meanwhile, on the marijuana front, the people of states like Colorado are engaging in an odd, 21st century variety of nullification (Glenn Harlan Reynolds, 1/26). 

And on other issues -

The New York Times: How Long Have I Got Left?
As soon as the CT scan was done, I began reviewing the images. The diagnosis was immediate: Masses matting the lungs and deforming the spine. Cancer. In my neurosurgical training, I had reviewed hundreds of scans for fellow doctors to see if surgery offered any hope. I'd scribble in the chart "Widely metastatic disease -; no role for surgery," and move on. But this scan was different: It was my own. ... One would think, then, that when my oncologist sat by my bedside to meet me, I would not immediately demand information on survival statistics. But now that I had traversed the line from doctor to patient, I had the same yearning for the numbers all patients ask for (Dr. Paul Kalanithi, 1/24). 

The New York Times: For The Mentally Ill, It's Worse
On the one hand, many mentally ill people were able to lead fuller, richer lives thanks to the deinstitutionalization movement. But as [Susan] Sheehan's book illustrates, there were also many people for whom the drugs did not have a pronounced effect -; or who stopped taking the drugs as soon as they left the hospital. Yet there were no longer enough hospital beds for them, hence the need for hospitals to drug them up and move them out (Joe Nocera, 1/24).

USA Today: Abortion Buffer Zone Harms Women
Eleanor McCullen stands on Boston sidewalks to let women know that they have alternatives to abortion. She makes her offers in normal conversational tones, speaking with eye contact and a smile. Unfortunately, she is now forced to call out her message from behind lines painted on the ground. ...  If we are serious about protecting a woman's "right to choose," then we ought to protect her right to engage in conversation about alternative choices on the public sidewalk (Mary Ann Glendon, 1/26).

The New York Times: A Formula For Repelling Women Voters
Yet the ideological tide rolls on. States dominated by Republicans continue to enact new abortion restriction. The Republican National Committee last week heard Mike Huckabee, the former governor of Arkansas, suggest that Democrats favor universal access to free contraception because they think women "cannot control their libido" without the help of "Uncle Sugar." And this week, the Republican-led House is expected to pass the deceptively named No Taxpayer Funding for Abortion Act (1/26).

The Washington Post: New Health Center Offers Convenience, Affordability, Respect In Poor D.C. Community
Vanessa Herndon, 59, wasn't sure what to expect Thursday when she became one of the first patients to take advantage of the spanking new, four-story health center in one of the District's poorest, most neglected neighborhoods. Herndon was thrilled that the clinic was within walking distance of her apartment, but she has had many bad experiences with doctors and hospitals. This time, she came away impressed and grateful (Robert McCarthy, 1/25).