Viewpoints: Wheaton injunction muddies court's ruling on contraceptives; Boston hospital merger problems; advice for new VA chief

Jul 8 2014

Los Angeles Times: The Supreme Court's Muddy New Ruling On The Contraceptive Mandate
In a bizarre attempt to have it both ways, the Supreme Court held that a small evangelical Protestant college in Illinois did not have to include contraceptive coverage in employee health insurance even though it didn't fill out the paperwork the government required for claiming an exemption. ... Clearly, the Hobby Lobby ruling wasn't the end of the story as far as the Supreme Court and the contraceptive mandate. But as the court demonstrated Thursday on Wheaton's injunction, sometimes the steps it takes appear larger than they really are (Jon Healey, 7/3).

The Wall Street Journal: The Wheaton Overreaction
Our guess is that Supreme Court Justice Sonia Sotomayor may come to regret her furious dissent last week to a simple Court order granting a temporary religious liberty reprieve to Wheaton College from having to obey ObamaCare's contraception mandate. She and the two other female Justices accused the Court's majority of all sorts of legal offenses, not least dishonesty (7/6). 

Los Angeles Times: Does America Have The Political Maturity For Single-Payer Healthcare?
Responding to my post about how the Supreme Court's Hobby Lobby ruling demonstrates the necessity of a single-payer healthcare system, Ezra Klein raises the specter of unrestrained political interference in healthcare decisions. "A Republican-led government could decide that taxpayer dollars shouldn't be going to cover contraception at all, and then a single-payer system means no one's insurance covers contraception," he wrote. This is "one of single-payer's real problems." This is an important issue. Americans gain nothing if they evict insurance bureaucrats from the operating room only to make room for preening politicians. But experience -- in the U.S. and abroad -- suggests that Klein's concern is overwrought (Michael Hiltzik, 7/3).

Forbes: Does Hobby Lobby Signal The End Of Employer Sponsored Health Insurance?
Even if the Supreme Court avoids the minefield that Justice Ginsburg referenced in her dissent, the controversial decision has definitely thrown open Pandora's proverbial box. If not legally, certainly in the mind of public opinion. Perhaps the biggest single fault line is the accident of American history ‒ Employer Sponsored Insurance (ESI). Even President Obama has openly acknowledged this artifact of legislation dating back to World War II. ... Today, the battle lines that appear to be forming around ESI aren't just employers with strong religious convictions either. Many employees are equally frustrated by personal privacy issues and cost-shifting that are now attached to their employer's health benefits (Dan Munro, 7/6).

The Washington Post: Relax, Hobby Lobby Won't Take Away Anyone's Birth Control
Virtually all of the criticism of the Supreme Court's Hobby Lobby decision has assumed that women who work for Hobby Lobby and other religious businesses will lose their free contraceptives. That's false. ... In this case, the government argued that the right to free exercise of religion was not implicated at all in a merchant's religiously motivated conduct. This time it lost that argument 5 to 2. So if one is looking for winners and losers in this case, one should count the decision as a significant victory for religious liberty, a substantial defeat for the government, and no less than a draw for women's rights (Kevin Baine, 7/5).

The New York Times: A Company Liberals Could Love
Of course I'm talking about Hobby Lobby, the Christian-owned craft store that's currently playing the role of liberalism's public enemy No. 1, for its successful suit against the Obama administration's mandate requiring coverage for contraceptives, sterilization and potential abortifacients. But this isn't just a point about the company's particular virtues. The entire conflict between religious liberty and cultural liberalism has created an interesting situation in our politics: The political left is expending a remarkable amount of energy trying to fine, vilify and bring to heel organizations -; charities, hospitals, schools and mission-infused businesses -; whose commitments they might under other circumstances extol (Ross Douthat, 7/5).

The Washington Post: No, The Supreme Court's Hobby Lobby Decision Is Not Based Upon A Scientific Mistake
Among the criticisms of the Supreme Court's decision last week in Burwell v. Hobby Lobby is that it is "anti-science." Specifically, many charge that the majority's decision in favor of two companies that objected to paying for a handful of contraceptive methods lacked any scientific basis. ... These critics are mistaken. There are reasonable arguments to be made against the Supreme Court's Hobby Lobby decision, but the charge that the decision is based on science fiction is not among them (Jonathan H. Adler, 7/6).

On other health issues -

The New York Times: The Risks Of Hospital Mergers
In retrospect, it looks as if Massachusetts made a serious mistake in 1994 when it let its two most prestigious (and costly) hospitals -; Massachusetts General Hospital and Brigham and Women's Hospital, both affiliated with Harvard -; merge into a single system known as Partners HealthCare. Investigations by the state attorney general's office have documented that the merger gave the hospitals enormous market leverage to drive up health care costs in the Boston area by demanding high reimbursements from insurers that were unrelated to the quality or complexity of care delivered. Now, belatedly, Attorney General Martha Coakley is trying to rein in the hospitals with a negotiated agreement that would at least slow the increases in Partners' prices and limit the number of physician practices it can gobble up, albeit only temporarily (7/6).

The New York Times: When Beliefs And Facts Collide
[M]ore people know what scientists think about high-profile scientific controversies than polls suggest; they just aren't willing to endorse the consensus when it contradicts their political or religious views. This finding helps us understand why my colleagues and I have found that factual and scientific evidence is often ineffective at reducing misperceptions and can even backfire on issues like weapons of mass destruction, health care reform and vaccines. With science as with politics, identity often trumps the facts (Brendan Nyhan, 7/5).

Los Angeles Times: Same Surgery, Different Price: Patient Gets $15,000 Bill Second Time
It would be nice if Americans could declare independence from loony medical bills. But that day isn't here. Bill Erickson can attest to that. In 2010, he had his right knee replaced after "lots of abuse" as a high school and college baseball coach. His insurer, Anthem Blue Cross, apparently covered everything. Erickson, 64, had his left knee replaced last year. "Same doctor, same hospital, same procedure," he told me. But not the same medical bill (David Lazarus, 7/3). 

Los Angeles Times: Aging Parents, Scary Home
People have been growing old and dim forever, so we figured there must be experts to guide us. We asked around and learned that the person we wanted was called a geriatric social worker in elder care management. We made an appointment with one. My brother and I felt instant relief: A professional was coming to the rescue! Our hero talked slowly for someone charging $100 an hour (Amy Goldman Koss, 7/5).

The New York Times' The Upshot: Gingrich's Correct Prediction About Medicare's Future
On Oct. 24, 1995, Newt Gingrich made an assertion about what would happen to Medicare if its beneficiaries could choose between it and private plans. Medicare is "going to wither on the vine because we think people are voluntarily going to leave it -; voluntarily." Though he later walked this statement back, many observers viewed it as an attack on the program. In fact, over the nearly two decades since, Mr. Gingrich's claim has undergone something of a test -; and it has largely passed it (Austin Frakt, 7/7).

The Arizona Republic/USA Today: Advice For New VA Chief
Mr. Robert McDonald: We admire your courage. In accepting this nomination, you are about to confront one of the most daunting challenges in all of federal governance: reforming the VA hospital system. You face three great challenges (7/6). 

Bloomberg: Ritalin May Be Sabotaging Your Kids
Over the past 20 years, mental disabilities have overtaken physical disabilities as the leading limitation on children's activities. Today, attention deficit hyperactivity disorder is three times more likely than asthma to disable an American child. An often difficult question for parents is whether to put their child with ADHD on either Ritalin or Adderall .... Ritalin and Adderall can be essential, life-changing treatments for many children. But for some, the benefits are not so clear (Janet Currie & Mark Stabile, 7/3).

Journal of the American Medical Association: Patient Referrals: A Linchpin For Increasing The Value Of Care
The success of accountable care organizations (ACOs) under global payment may depend in part on a common yet poorly understood clinical decision: the patient referral in the outpatient setting. Fundamental to collaboration among physicians and other health care professionals, patient referrals have been largely ignored in the payment reform debate (Zirui Song, Thomas D. Sequist and Michael L. Barnett, 7/3).