Viewpoints: Obamacare still has more challenges; GOP needs to help make law work; census change is not Obama's decision

Apr 18 2014

Los Angeles Times: No Need For A Rush To Judgment On Obamacare
The first open enrollment period under the Affordable Care Act ended this week with roughly 7.5 million people obtaining policies through the new state insurance exchanges, including more than 1.3 million at Covered California. That's an amazing and welcome result, considering how badly many of the exchanges stumbled when sign-ups began in October. Nevertheless, it's far too early to judge the success or failure of the healthcare law, given that key tests of the program's sustainability have yet to be passed (4/16). 

Des Moines Register: Focus Needs To Be Making Obamacare Work
Assuming [Sylvia Mathews Burwell] is confirmed for the position, she should avoid getting mired down in the politics of Obamacare. While she must work to gain public support for the law, her focus must be on working through the problems faced by some consumers, state agencies and businesses. She will have to continue to negotiate with states like Iowa that implemented complicated alternatives to expanding Medicaid. The next HHS director must focus on moving forward. And members of Congress need to do the same. Some politicians don't seem to understand that Obamacare isn't about one person. It's not about the president. It's not about Sebelius. And it's not about Chuck Grassley. It's about creating a health care system in this country that works for everyone, including the more than 7 million Americans who have recently gained coverage under the law (4/16).

The New York Times' Economix blog: Stealth Taxes Are Still Income Taxes
For most Americans, the individual income tax returns they have filed over the last days and weeks are not much different than they were 10 years ago. But, in fact, taxes have changed dramatically over that period, behind the scenes and in support of health reform (Casey B. Mulligan, 4/16). 

The New York Times' Taking Note: The Birth Of A Conspiracy Theory
For years now some on the right have speculated that the Obama administration is trying to politicize the national census. Yesterday, Noah Rothman argued on Mediaite that the theory was proven correct by a New York Times article about changes in the way the Census Bureau plans to ask about health insurance coverage. ... But the article that Mr. Rothman cites, by Robert Pear, doesn't support the theory. Mr. Pear reports that census statisticians had been trying to change the questions about health insurance for more than a decade (in other words, before Mr. Obama was president) because … wait for it … the old questions were not accurate (Andrew Rosenthal, 4/16). 

The Fiscal Times: Obamacare: Kill Or Cure For Health Care Job Market?
During the Great Recession and in the years that followed, the job market in the U.S. had its legs taken out from under it. Millions of jobs disappeared, across virtually every sector of the economy but one. Throughout even the worst months of the crisis, the health care sector added jobs as reliably as sunrise and sunset. Last year, however, even as the broader economy showed signs of slowly reviving itself, the health care sector began to stumble (Rob Garver, 4/17).

Newark Star-Ledger: Medicaid Recipients May Have Their Estates Billed Down The Road
Opponents have nicknamed one provision of Medicaid the "Obamacare death debt." They are referring to the Medicaid Estate Recovery Program. And while it does exist, it predates Obamacare by two decades. The Medicaid Estate Recover Program is how the federal government is repaid for money it spent on a lengthy stay in the nursing home. If someone was on Medicaid, the government can, in some instances, put a lien on his estate after his death (Kathleen O'Brien, 4/16).

On other health issues -

The Washington Post: Mental Health Care In The U.S. Needs A Check-Up 
The Affordable Care Act has significantly increased insurance coverage for mental health care. But that may not be enough to expand access to sparse mental-health-care resources. Besides, the government is already spending billions on mental illness treatment; it has an interest in making sure taxpayers get results. Rep. Tim Murphy (R-Pa.) has a bill that would do so. The Helping Families in Mental Health Crisis Act is more comprehensive than other recent efforts to reform the system and perhaps has the brightest prospects in a divided Congress (4/16). 

The Washington Post: Heed Massachusetts's Cry For Help In Opioid Regulation
Massachusetts has lost its bid to ban a new prescription opioid pain medication known as Zohydro. A federal judge ruled Tuesday that only the Food and Drug Administration can decide what medications are safe and effective enough for sale in the United States. As a matter of law, the judge, Rya Zobel, was almost certainly correct; Congress has had supremacy in this particular field ever since the 1906 Pure Food and Drug Act. As a matter of policy and morality, however, Massachusetts and its Democratic governor, Deval Patrick, were in the right (Charles Lane, 4/16). 

The Wall Street Journal: California's Malpractice Ruse
One of California's few emollients for employers is its limit on "pain and suffering" medical liability judgments, which has improved access to medical care and held down health costs. But look out: Plaintiffs lawyers abetted by Attorney General Kamala Harris are now trying to gut the cap with a ballot initiative dressed in patient-protection garb (4/16). 

The Dallas Morning News: Making Dallas A Healthy Place To Live
Dallas County provides a number of complex public health challenges that are seen by the thousands of Parkland employees as opportunities to make meaningful impact in the lives of our residents. We have one of the highest uninsured rates in the country. Dallas County's population is becoming older and more diverse, creating the need to rethink how we deliver services and maintain cultural competency among our health care professionals. Disparities found within southern Dallas County and pockets of northern suburban areas mean we must do more to reach residents living in parts of the county known as health care deserts (Fred Cerise, 4/16).

The Fiscal Times: Medicare Advantage Isn't Reducing Health Care Costs
Bowing to election-year and industry pressures, the Obama administration this month quietly rescinded cuts to the Medicare Advantage program and boosted subsidies to insurers. If the administration, and Congress for that matter, were serious about attacking health care costs, this was a turn into a blind alley (John F. Wasik, 4/16).

Deseret News: 'Progress Indeed' In The Unusually High Medicare Charges Cases
The late Supreme Court Justice William O. Douglas famously stated, "Sunlight is the best disinfectant." Last week, the Centers for Medicare & Medicaid Services (CMS), in a historic move, applied the transparency disinfectant to the ailing Medicare program by publishing comprehensive physician payment data for the first time in nearly 35 years. Release of this information is a boon for taxpayers, a treasure trove for researchers, and a nightmare for physicians involved in demonstrably wasteful, fraudulent or abusive Medicare billing practices. It is a triumph for transparency that I applaud wholeheartedly (Dan Liljenquist, 4/17).

The New England Journal Of Medicine: Abolishing Mammography Screening Programs? A View From The Swiss Medical Board
It is easy to promote mammography screening if the majority of women believe that it prevents or reduces the risk of getting breast cancer and saves many lives through early detection of aggressive tumors. We would be in favor of mammography screening if these beliefs were valid. Unfortunately, they are not, and we believe that women need to be told so. From an ethical perspective, a public health program that does not clearly produce more benefits than harms is hard to justify (Nikola Biller-Andorno and Peter Jüni, 4/16).

The New England Journal Of Medicine: Comparative Effectiveness Questions In Oncology
The high price of cancer drugs is unsustainable, and the need for less costly alternatives is greatest in cases where the benefit of new therapies is marginal (i.e., the cost-effectiveness ratio is mostly unfavorable). The five comparisons that we highlight suggest an underappreciated consequence of the prices themselves: high prices protect a drug's market share, precluding challenges from cheaper alternatives. ... The realization that prices threaten comparative effectiveness trials of cancer drugs provides yet another challenge to the research community -; but one that we believe we must be ready to confront (Sham Mailankody and Vinay Prasad, 4/17).