Viewpoints: False arguments on deadbeats; fighting cancer without insurance; bridging Louisiana's health funding gap

Feb 25 2014

U.S. News & World Report: Obamacare Won't Cause Society To Collapse
A small war has erupted over the recent Congressional Budget Office report on the employment effects of the Affordable Care Act. Last week, the CBO itself felt compelled to offer a lengthy and detailed rebuttal to the spin that millions of Americans will "lose their jobs" as a result of Obamacare. ... It's undoubtedly true that if you give things to some people, they'll work less. But it's not true in all cases. Unfortunately, this sort of assertion is a staple of anti-government rhetoric: For any government expenditure, it can be shown to have enriched some deadbeat or rip-off artist. But so has the derivatives market. Meanwhile, plenty of people work more when you give them more (Eric Schnurer, 2/22).

The New York Times: Health Care Horror Hooey
Remember the "death tax"? The estate tax is quite literally a millionaire's tax -; a tax that affects only a tiny minority of the population, and is mostly paid by a handful of very wealthy heirs. Nonetheless, right-wingers have successfully convinced many voters that the tax is a cruel burden on ordinary Americans -; that all across the nation small businesses and family farms are being broken up to pay crushing estate tax liabilities. ... And now they're trying a similar campaign against health reform (Paul Krugman, 2/23). 

The Wall Street Journal: Obamacare And My Mother's Cancer Medicine
When my mother was diagnosed with carcinoid cancer in 2005, when she was 49, it came as a lightning shock. ... And then in November, along with millions of other Americans, she lost her health insurance. She'd had a Blue Cross/Blue Shield plan for nearly 20 years. It was expensive, but given that it covered her very expensive treatment, it was a terrific plan. It gave her access to any specialist or surgeon, and to the Sandostatin and other medications that were keeping her alive (Stephen Blackwood, 2/23). 

The Boston Globe: GOP Gets Serious On Health Care
Throughout his time in Congress, [Oklahoma Sen. Tom] Coburn has been a polarizing figure on everything from abortion rights to climate change. His extreme views, such as his claim that a gay "agenda is the greatest threat to our freedom we face," can be offensive and off-putting to many people. Still, his health care proposal -; whatever its merits -; marks a step away from the politics of division and toward the politics of discussion (Nathaniel P. Morris, 2/13).

The Times-Picayune: Medicaid Expansion Could Ease Louisiana's Budget Woes
Gov. Bobby Jindal has a convoluted plan to balance Louisiana's budget next year by borrowing $50 million in cash from the Ernest N. Morial Convention Center in New Orleans to help pay for health care and higher education. ... There's an easier way to bridge the gap in the state budget: Take the $16 billion in additional federal Medicaid money President Obama is offering through the Affordable Care Act (2/23).

The Richmond Times-Dispatch: Medicaid's About People
For more than a year, we have debated whether to expand Virginia's Medicaid program to cover people who earn incomes below 133 percent of the poverty line. That's $15,000 per year for individuals and $31,000 per year for a family of four. To pay for this expansion, Virginia would receive approximately $6.9 billion from the federal government over the next three years. This is money Virginians have and will continue to pay in taxes whether we expand Medicaid or not. Shouldn't that money be spent providing health insurance to approximately 400,000 Virginians, not residents of other states? (Democratic State Del. Jennifer L. McClellan, 2/23).

MSNBC: A Letter To Nate Bell, Who Opposes More Health Care In Arkansas
Last September, the [Arkansas] state Department of Human Services sent out letters to 132,000 households that get food stamps, letting them know that they qualified for expanded Medicaid. Within a month, more than 55,000 people responded, saying they wanted to sign up. That is an enormous response rate. In direct mail terms, it's practically revolutionary. Those people now make up more than half of those enrolled in the Medicaid private option. But should we ask why you'd want to handicap enrollment so much? You say it's because you're a conservative, and you want to limit government spending any way you can. Sure. Except your state estimates that it will save $89 million by expanding Medicaid-;just in the first year. It will save more than $600 million from now through 2021 (Joy-Ann Reid, 2/22).

The Milwaukee Journal Sentinel: Obamacare: Only The First Step Toward Better Health Care
Given the volume of media attention focused on the Obama administration's efforts to expand access to health insurance via the Patient Protection and Affordable Care Act, it's easy to lose track of other priorities that must receive equal attention from stakeholders if we're to become a healthier nation at an affordable cost. Health care spending must consume a smaller portion of public and private spending. Health care spending in the United States has reached $2.8 trillion, or approximately 18% of the gross domestic product. While wealthier nations may elect to spend a greater portion of their GDP on health care, the U.S. currently spends twice as much on health care per capita and 50% more as a share of GDP than other industrialized nations. Despite doing so, our longevity, infant mortality and quality of care trail many other high-income countries (James Karolewicz, 2/22).

And on other health issues -

The New York Times: When Doctors Need To Lie
When I started my medical internship, in 1998, I viewed patient autonomy as an absolute good, an ethical imperative that trumped all others. I had learned in medical school about some of the most infamous breaches of autonomy in the history of medicine. ... I also learned that even well-meaning paternalism can be damaging. The doctor-patient relationship is founded on trust, and any instrument of paternalistic interference not only compromises the relationship but also can erode faith in the profession  (Dr. Sandeep Jauhar, 2/22).

The New York Times: Expand Pre-K, Not A.D.H.D.
The writing is on the chalkboard. Over the next few years, America can count on a major expansion of early childhood education. We embrace this trend, but as health policy researchers, we want to raise a major caveat: Unless we're careful, today's preschool bandwagon could lead straight to an epidemic of 4- and 5-year-olds wrongfully being told that they have attention deficit hyperactivity disorder (Stephen P. Hinshaw and Richard M. Scheffler, 2/23). 

The Boston Globe: Doctors, Patients, And Computer Screens
I turn my chair away from the large computer monitor on my desk. I direct my full attention toward my patient. I think how lucky I am to have a job that involves making intimate connection with other human beings. I think, as my patient confides in me her fears about her health and her worries about her son's addiction and her daughter's shaky marriage: This is why I became a doctor. Suddenly, I'm aware of the time. Twenty minutes into a 30-minute visit and I've entered nothing into the computer! If I don't start typing I'll fall hopelessly behind and keep other patients waiting. ... This is not why I became a doctor (Suzanne Koven, 2/24).

The Milwaukee Journal Sentinel: Don't Wait To Reform Mental Health Care In Milwaukee County
State Rep. Joe Sanfelippo and Sen. Leah Vukmir have proposed legislation that transfers oversight and funding control of Milwaukee County mental health services from Milwaukee County government to a new mental health board. Creating a mental health board with these powers is the essential next step to finally developing a community-based mental health system that we all can be proud of. The Legislature should support this legislation because the county's mental health system is structurally broken, and, at this point, the best way to create a high-quality, cost-effective system is for the state to adopt this legislation (Lynne De Bruin, 2/22).