Viewpoints: Nothing in health care is free; Obamacare opponents lack facts; 'Nurse Jackie' and the ER

Jul 1 2014

Los Angeles Times: Mandating Preventive Care Without Co-Pays Is Good, But It's Not 'Free'
The Department of Health and Human Services released a report Friday declaring that 76 million Americans with private insurance became eligible for more preventive services with no out-of-pocket fees as a result of the 2010 healthcare law, the Patient Protection and Affordable Care Act (a.k.a. Obamacare). Because Democrats are counting on female voters to help them at the polls in November, the report highlighted how women had been helped by that aspect of Obamacare. "Altogether, a total of 48.5 million women are estimated to benefit from free preventive services," it stated. But as new HHS Secretary Sylvia Burwell surely knows, given her time as deputy director of President Clinton's Office of Management and Budget, there is no such thing as "free" services, particularly not in the world of healthcare (By Jon Healey, 6/27).

The New York Times: The Eggs And Us
Both Hobby Lobby and the personhood movement mark a turning point in our long, grueling national battle over reproductive rights. Many Americans are repelled by late-term abortion, but they don't necessarily feel the same emotional affinity for a fertilized egg. The fact that this is actually a debate about theological dogma gets a lot clearer when you're closer to the start of the gestational saga (Gail Collins, 6/27).

Los Angeles Times: Healthcare Debate Lacks Factual Arguments Against Obamacare
Americans have always been a politically contentious lot. But one topic seems to produce more pure vitriol than any other: the Affordable Care Act. I posted an item on my Times blog, the Economy Hub, citing new statistics indicating that the act has materially reduced the ranks of the uninsured, kept premiums moderate and seemed likely to keep rate increases modest next year. I sought agreement that, given these developments, "Obamacare is working." I didn't get it. What I got instead was an unexampled outpouring of angry, vulgar and bitter emails, almost none of them bearing even the slightest attempt to counter my statistics with alternative facts. ... What accounts for the pungent rancor? Here's a rundown (Michael Hiltzik, 6/27).

Los Angeles Times: I Doubted Heritage Could Run A 'Straight' News Site. I Was Right.
And this week, [the Heritage Foundation's news website] the Daily Signal proudly unburdened itself of a major investigation of the Affordable Care Act that proves our point. It's chock-full of bogus numbers, basic misunderstandings and tendentious verbiage. The piece is headlined "Obamacare Exchanges are 'Disappointing' With Fewer than 4 Million Newly Insured. The Government Hoped for 26 Million." Misleading on both counts (Michael Hiltzik, 6/27).

The Washington Post: Terry McAuliffe, Virginia Democrats Should Learn Lessons From Defeat On Medicaid
Virginia Democrats are right to be furious that Republicans used a sleazy job offer and a parliamentary gimmick to block Gov. Terry McAuliffe's top goal of expanding medical insurance for the state's working poor. Rejecting both compassion and common sense, the GOP went to extraordinary lengths to ensure that Virginia would refuse $2 billion a year in federal funding just because the money was tainted by association with dreaded Obamacare. But after the Democrats have finished gnashing their teeth, they should study the lessons from this major defeat and figure out how to win the contest in the end (Robert McCartney, 6/28). 

The Wall Street Journal: On Medicaid Expansion, Red States Will Be Watching Red States
Since the Supreme Court made expanding Medicaid optional for states under the Affordable Care Act, 26 states have expanded Medicaid. Three of the 24 states that have not–Indiana, Utah and Pennsylvania–are considering expanding via federal waivers that they are negotiating with the Obama administration. ... If Indiana, Pennsylvania and Utah reach agreement with the administration and move ahead, that would bring to 10 the number of states with Republican governors that have expanded Medicaid. ... Republican governors and legislators will be watching the red states that have expanded Medicaid especially closely. They will want to know if those states are benefiting economically from their new federal funding; how the expansion has affected their state budgets; if their hospitals and counties are less stressed with the federal government paying more of their bills for serving the uninsured; and if Republican elected officials have been hurt or helped politically by their decision to expand (Drew Altman, 6/30).

And on other health topics -

USA Today: Can former P&G CEO Clean Up VA? Our View
On Friday, the White House issued a broadly damning report on the VA, all the more remarkable considering that the administration has been in charge of the agency for the past six years. And today, President Obama will nominate a man to clean up the mess. Robert "Bob" McDonald, a West Point graduate and the former chief executive of Procter & Gamble, lacks experience in health care, which surely will slow him down. But his experience running a sprawling, private-sector institution should give him an edge over the succession of military commanders and career bureaucrats who have headed the troubled agency. If confirmed by the Senate, McDonald will need every ounce of his reputed managerial abilities to turn around the VA's vast national network of 1,700 hospitals, clinics and other facilities (6/29).

USA Today: Return VA To Its Core Mission: Another View
If there's one thing all Americans can agree on, it's that we owe our veterans the care they need to treat injuries suffered while serving their county. But Congress and the organized veterans groups have stretched that vital mission into massive bureaucracy that builds and owns hospitals, hires doctors and provides care directly to millions of veterans, regardless of whether their illnesses are service-related. In the wake of the Veterans Affairs scandal, we may be tempted to believe that the system can be fixed by changing leaders or simply spending more money. But spending for the VA health system has risen eight times faster since 2007 than the number of unique patients. And the problems go back decades (Michael Tanner, 6/29).

The New York Times: Anthrax? That's Not The Real Worry
Officials at the Centers for Disease Control and Prevention recently discovered that at least 75 workers there had been exposed to possible anthrax infection. We should be glad that it was only anthrax. Anthrax is a dangerous but noncontagious bacterium; the risk to the exposed workers is real, but there is no danger of transmission to others. Much more troubling would be an accidental exposure to a dangerous, contagious pathogen. And unfortunately, that's also quite possible (Marc Lipstitch, 6/29). 

The New York Times: House Hypocrisy On Insider Trading
[A] federal judge in New York has ordered a hearing this week for an explanation from the [House Ways and Means] committee and the staff member suspected of leaking to a lobbyist nonpublic information he heard last year about pending Medicare rate increases. According to the commission, the lobbyist passed this valuable word along to a health care brokerage firm that quickly issued a private alert to clients. A suspicious spike in trading of shares profitable to the clients occurred before the government made its Medicare decision public. This is clearly a case worth pursuing if the law known as the Stock (Stop Trading on Congressional Knowledge) Act is to be a credible tool against corruption on Capitol Hill and in numerous executive agencies also covered (6/29).

The New York Times: Pushback On Home Care
The salvos keep coming from opponents of a new federal rule to ensure that home care workers are paid at least the minimum wage and time and a half for overtime. The rule, many years in the making, reverses a misguided policy from 1974 that has long denied home care workers those basic wage protections. ... Now comes another challenge: Three groups that represent home care agencies have filed a lawsuit in federal court to stop the new rule on the grounds that the department exceeded its authority and did not follow proper procedures. That's a stretch (6/29).

The New York Times: What 'Nurse Jackie' Gets Right About The E.R.
Despite the fact that Jackie is a seriously flawed human being, the show itself is a standout portrayal of nursing, when TV almost always gets nursing wrong. Nurse Jackie, played by the gifted Edie Falco, has enviable clinical judgment and an unshakable commitment to patients. But, like many addicts, she lies and sometimes steals to maintain her habit. ... But I praise the show because its clinical portrayals of nursing are realistic and mostly positive, in contrast to almost every other medical program on television. TV hospitals are almost exclusively staffed by doctors. ... In real hospitals, those jobs are almost always done by nurses, and "Nurse Jackie," true to its name, shows that (Theresa Brown, 6/28).

The New York Times: The Trauma Of Parenthood
This is the ideology of modern parenting, and it can lead to unnecessary feelings of guilt and shame, for it ignores an inconvenient truth: that many women and men experience significant psychological distress in response to becoming a parent and that much of this distress isn't caused by a hormonal epiphenomenon of the birth process. It is driven instead in large measure by the objectively bleak circumstances new parents often face. That you love your child is not always sufficient to counteract this reality (Finkel, 6/27).

The Wall Street Journal: Life Lessons From Dad: Caring For An Elderly Parent
My father was born and died at home. Nearly 91 years separated those two days, as did a lifetime of significant experiences, including one Great Depression, one World War, one wife, three children, and one year at my house, where he, accompanied by my mother, went through hospice during his struggle with dementia. Our family's experience was hardly unique. ... As our population ages, tens of millions of Americans will be called on to care for stricken parents. Over 15 million nonprofessionals are estimated to provide Alzheimer's care alone. What can families expect? (Dave Shiflett, 6/27).

The New York Times' Motherlode blog: The Battle Over Vaccinating Grandparents
Our midwife recommended that because of a resurgence in cases of whooping cough, I get vaccinated during pregnancy. In addition, she suggested I ask family members who were going to be in frequent contact with our baby, including my husband and our parents, to make sure their shots were up-to-date. My request sparked a firestorm in my family. My in-laws and my mother agreed to the vaccine. But my dad? He refused (Kim Conte, 6/29).

The Washington Post: West Africa Can't Manage The Ebola Outbreak
An alarming report released last week by Doctors Without Borders said that West Africa's current Ebola outbreak is "out of control." That should shock the governments of Guinea, Sierra Leone and Liberia into action. It marks a frightening moment for a disease that has been contained numerous times before (6/29).