Viewpoints: Tea party missing the lesson; health care not an ordinary market; Va.'s Medicaid battle

Jun 9 2014

The New York Times: Tea Party Dead-Enders
But the Tea Party does have something to show for its five years of annoyance: Ted Cruz, senator from Texas. Cruz is probably best known for reading "Green Eggs and Ham" on the floor of the Senate during a 21-hour talkathon designed to ensure his place as the most hated man in that august chamber. But Cruz, in trying to kill funding for the Affordable Care Act, missed the point of the Dr. Seuss classic: don't criticize something until you actually try it. And now that more than eight million Americans are trying insurance that won't deprive them of health care just because they got sick, green eggs and ham is likely to be a dish served cold to Cruz (Timothy Egan, 6/5). 

Bloomberg: Why Freakonomics Freaks Me Out
"Freakonomics" authors Steven Levitt and Stephen Dubner tell a story in their new book, "Think Like a Freak," about meeting David Cameron before he became the U.K. prime minister. They tried to make him see the folly of the taxpayer-funded National Health Service, through which people get treatments free of charge. ... As Levitt, a professor of economics at the University of Chicago, summed it up: "It doesn't take a whole lot of smarts or a whole lot of blind faith in markets to recognize that when you don't charge people for things (including health care), they will consume too much of it." ... [Cameron is] intelligent enough to know a juvenile ideological argument when he sees one, even if it's made by someone who ought to know better. Economists have understood for years that medical services aren't simple "goods" such as apples or automobiles, and that free markets for such things don't work very well (Mark Buchanan, 6/5).

The Wall Street Journal: How Much Political Coverage Of The Health-Care Law Is Too Much?
With primaries underway and the midterms approaching, coverage of the Affordable Care Act will increasingly focus on politics. Many political reporters may take temporary control of the health-care beat during the leadup to November. News organizations should consider: How much Affordable Care Act political coverage is too much? Already, the public says that coverage of the ACA is mostly about politics rather than what the law means for people. The question Americans most want answered is not how much the ACA mattered in some Senate or House race but: What does the law mean for me and my family? (Drew Altman, 6/5).

The Washington Post: Virginia Gov. Terry McAuliffe Shouldn't Try To Impose Medicaid Expansion Unilaterally
Having failed to schmooze Republicans into broadening Medicaid coverage as he promised, Virginia Gov. Terry McAuliffe (D) is studying whether he might unilaterally expand the program without legislative approval. Don't do it, Terry. It's awfully tempting. But the price is too high (Robert McCartney, 6/4). 

Virginian-Pilot: Hospitals Face Bill In Medicaid Battle
For years, hospitals have received tax credits and payments for providing charity care to poor, uninsured patients. For many hospitals, it amounts to millions of dollars, the difference between a profit and a loss. But now that more people are supposed to have insurance under the Affordable Care Act, those federal subsidies will start to disappear. ... Virginia's decision not to expand Medicaid means people who could have qualified for insurance won't have it. They'll continue to rely on charity care that hospitals will be forced to reduce, unless lawmakers devote more state funds to cover the costs. As The New York Times recently reported, this trap puts hospitals in the awkward position of deciding whether to continue charity care (6/6). 

MinnPost: A Battle Looms Over Health Plans Secret Price Data
Amid the debates of the 2014 session of the Minnesota Legislature, one item flew below the media's radar even though hundreds of millions of dollars are at stake. It's a straightforward question: Should HMOs that contract with the state of Minnesota to deliver Medical Assistance, MinnesotaCare and similar programs have to disclose what they pay hospitals and doctors? The issue pertains to four HMOs, also known as Health Plans, which are Blue Cross/Blue Shield (Blue Plus division), Medica, HealthPartners, and UCare (Buddy Robinson, 6/5).

On other health care issues -

Los Angeles Times: Hospital's Healthcare Fee Causes Nothing But Headaches
The arthritis in Jill Smith's knees can make walking unbearable. So she receives injections of an expensive pain medicine called Orthovisc once or twice a year. ... What makes her joints creak is the $546 tacked on to her bill by St. John's Health Center to cover -; well, that's not exactly clear. ... The dubiousness of the charge becomes even more profound when you consider that the injections take only a few minutes. Sit down, get a shot, go home. And, you may be asking, why is St. John's cutting itself in for a piece of the action? Smith's doctor isn't at the hospital. If it were any other industry, we'd call this a rip-off. In healthcare, it's business as usual (David Lazarus, 6/5). 

The San Francisco Chronicle: Voluntary Mental Health Services Will Deliver Better Outcomes
San Franciscans recognize that we are not doing enough to provide effective services for people with mental health conditions. Proponents of AB1421 (often called Laura's Law), including The Chronicle, advocate for its forced outpatient provisions. ... We agree with The Chronicle, the San Francisco Board of Supervisors and most people in San Francisco communities that we should radically improve mental health services and ensure they reach more people in need. ... Voluntary services are far more likely to deliver on these promises, especially new outstanding services developed in our state (Eduardo Vega and Catherine Blakemore, 6/5).

JAMA: Is Keeping Firearms Out Of Hands Of Mentally Ill Answer To Gun Violence
The cultural divide over firearms in the United States is cavernous and appears unbridgeable. There seems to be no common ground, but increasingly there is one shared position: improving identification of mentally ill individuals while restricting their access to firearms. The public overwhelmingly supports limiting firearm access to persons with mental illness, which is consistent with the National Rifle Association's position that "guns don't kill people; people kill people." The problem is that focusing solely or primarily on persons with mental illness will not quell firearm violence. (In the case of suicide attempts-;a major factor in gun injuries and deaths-;the link with mental illness, particularly depression, is stronger. But even here firearm restrictions have a powerful effect in reducing harms to vulnerable individuals) (Lawrence Gostin, 6/5).

Health Affairs: The Cost Of A Cure: Medicare's Role In Treating Hepatitis C
Sovaldi's price tag has drawn attention in part because an estimated 3 million Americans have the hepatitis C virus and could be considered candidates for new drugs. Patients will clearly benefit from a long-awaited cure, and public and private payers could potentially see a reduction in health care spending over the long term if Sovaldi successfully cures this disease and fewer patients require high-cost liver transplants. But private insurers and public programs will face significant budgetary pressures if a large number of patients receive this treatment at current prices. ... The cost to Medicare may be substantial. Based on our analysis of the National Health and Nutrition Examination Survey (NHANES), 350,000 Medicare beneficiaries have hepatitis C, although less than half of them are aware they have the disease (Tricia Neuman, Jack Hoadley and Juliette Cubanski, 6/5).