Viewpoints: Questioning the tales of Obamacare woes; Republic replacement MIA; 'mixed messages' on mammograms

Feb 28 2014

The New York Times' The Conscience Of A Liberal: A General Theory Of Obamacare Fiction
Conservatives appear to be really upset that liberals are actually taking on the facts in the anti-Obamacare ads they've been running. How dare you question whether the people in these ads are giving an accurate picture -; they're suffering! (Paul Krugman, 2/26). 

The Fiscal Times: Obamacare Victims Are 'Liars' Says Top Democrat
Every politician wanted to connect to the pain of Americans, even in good economic times, and especially during and after the Great Recession. The biggest political attack against Mitt Romney in the 2012 presidential election related to the exposure of his remarks about the "47 percent" and how out of touch it made the wealthy Republican nominee to the plight of the struggling working classes.  That was then … this is now. Instead of feeling your pain, Harry Reid stood on the Senate floor to tell millions of Americans impacted by skyrocketing premiums, incompetent administration, and policy cancellations from the implementation of the Affordable Care Act that they don't really feel pain at all (Edward Morrissey, 2/27).

Los Angeles Times: Another Attempt At Obamacare 'Reform' Blows Up
It's encouraging to see critics actually trying to fix what they see as flaws in the Affordable Care Act-- and disappointing when they do it so ineptly that they make the problem they're addressing much worse. That's what's happened with the proposed Save American Workers Act, introduced late last year by Rep. Todd Young (R-Ind.) Young's target was the healthcare law's provision that defines full-time work as 30 hours a week. ... As its actual contents, the CBO said, they would increase the number of uninsured people in the U.S. by somewhere between 500,000 and 1 million; many of them would lose their employer-paid coverage. The bill also would blow a hole in the federal budget, increasing the deficit by about $73 billion over 10 years (Michael Hiltzik, 2/26). 

Bloomberg: Republican Replacement For Obamacare Still MIA
A Catch of the Day for Jonathan Chait, who has been tracking the always-not-quite-here "replace" part of the Republican "repeal and replace" health-care reform story. He notes that the latest cycle began with a straightforward promise in January that a replace bill would make it to the House floor this year. That was followed by a backtrack from working to "finalize" that bill to, now, gathering ideas for when they "may have an opportunity" to get to that replace bill (Jonathan Bernstein, 2/26).

The Washington Post's The Plum Line: Americans Know There's No GOP 'Alternative' To Obamacare
Obamacare is a disaster for Democrats, and a certain winner for Republicans. That's what we keep hearing, anyway. So why does it look as if the percentage of Americans who favor repeal may have actually shrunk since its rollout problems began? (Greg Sargent, 2/26).

The Washington Post: A Medicaid Cave-In? The Va. House Has Lots Of Practice
For 11 years, Republican candidates for the Virginia House of Delegates have done the following: get elected on a campaign promise to oppose certain key legislation, then go back on that promise a few months after taking office. Are they setting up another U-turn? (Norman Leahy and Paul Goldman, 2/26). 

New Hampshire Union Leader: Medicaid Expansion: Who's Really At Fault?
Conservatives are understandably unhappy with the emerging legislative compromise that expands Medicaid in New Hampshire. Those looking for someone to blame should focus on the right people: Gov. Maggie Hassan and her Democratic enablers in the Legislature (2/26).

News@JAMA: JAMA Forum: The Affordable Care Act And Emergency Care Visits: Why Choose The Emergency Department?
Why would anyone want to go to an ED if there were an alternative? That's the question I asked myself when reports emerged that decreasing the ranks of the uninsured actually increased ED visits. These findings are of particular concern to those who supported the Affordable Care Act's (ACA) mandate for coverage, arguing that it would decrease health care expenses overall by providing the uninsured with nonemergency options for care, including access to primary care and preventive services (Diana Mason, 2/26).

And on other health issues -

The Wall Street Journal: Making Sense Out Of The Mixed Messages On Mammograms
Every three or four years, a "new" announcement about the usefulness of mammograms leads to a flurry of news reports. Most recently making the rounds is an update of one Canadian study that suggested mammograms do not reduce breast cancer mortality. Mammogram studies continue to yield competing results, which has led some countries such as Switzerland to discontinue recommending their regular use. Women are left to worry whether to undergo a procedure debated among doctors, expert panels and advocacy groups (Drs. Ezekiel J. Emanuel and Daniel F. Hayes, 2/26). 

The New England Journal Of Medicine: The Calculus Of Cures 
Bringing a drug from bench to bedside is a risky and expensive proposition. ... As venture-capital investors, we evaluate projects along four primary dimensions: development costs, selling costs, differentiation of the drug relative to current treatments, and incidence and prevalence of the targeted disease ... While scientists work hard to increase the rate of scientific discovery, the rest of us should do our part to improve the other variables that figure into the calculus of which cures are brought to market. Such improvement would be good for patients and would represent good economic policy, since drug prices could be lowered even as investors generated the returns necessary to finance more discoveries (Dr. Robert Kocher and Bryan Roberts, 2/26).

JAMA: Confronting The Stigma Of Opioid Use Disorder-;And Its Treatment
Increasing numbers of overdoses from prescription opioids and a more recent increase in heroin-associated fatalities have caused heartbreak in communities across the country. More than 30 000 deaths from unintentional drug overdose were reported in the United States in 2010, the most recent year for which data are available. Given the severity of this national epidemic, it is time to confront the stigma associated with opioid use disorder and its treatment with medications. By limiting the availability of care and by discouraging people who use opioids from seeking effective services, this stigma is impeding progress in reducing the toll of overdose (Drs. Yngvild Olsen and Joshua M. Sharfstein, 2/26).

The Fiscal Times: The 'Doc Fix' Is In, And Cost Controls Are Out Again
Despite a recent slowing in the growth of health care expenditures, it remains a Herculean battle to rein in medical spending in the U.S. A number of forces are aligned against lowering costs. Growth in the economy will certainly put upward pressure on prices, combined with the aging of the population. And the private sector will have little incentive to control costs without a powerful public mandate, which the Affordable Care Act lacks (John F. Wasik, 2/26).

Fox News: Dr. Manny: Why Dr. Vivek Murthy Is Not Qualified To Be Surgeon General
But in my humble opinion, the latest nominee for U.S. surgeon general, Dr. Vivek Murthy, does not qualify to be our nation's doctor. My criticism is based largely on Murthy's level of clinical experience. Murthy is 36 years old and, to his credit, received his medical degree from Yale School of Medicine, one of the most prestigious medical school programs in the country. This is certainly an achievement that I can't claim. But a medical school does not a doctor make (Dr. Manny Alvarez, 2/26).