Viewpoints: Parsing newest reports of coverage gains; 'scientific fraudsters'

Jul 14 2014

The New York Times: Early Returns On Health Care Reform
It will take a while to understand fully how the Affordable Care Act affects the quality of health care and access to doctors in this country. But a new survey offers encouraging reviews from people who signed up for private plans or Medicaid during the first enrollment period from October 2013 through March 2014 (7/10). 

The New York Times: The State Of Obamacare
The Commonwealth Fund has a new study out on Obamacare enrollment, estimating that about 9.5 million people gained coverage through Medicaid and the exchanges; this is roughly in line with some previous estimates but perhaps slightly more encouraging for the law's supporters (Ross Douthat, 7/10). 

Bloomberg: Success Kills Another Obamacare Myth
The Affordable Care Act was designed to achieve two goals, according to its advocates: it was supposed to increase the number of people with health insurance, and to cut health care costs. Increasingly, the former looks like a solid achievement, and there are increasing signs the latter is being accomplished, too, though it isn't clear the ACA deserves the credit (Jonathan Bernstein, 7/10). 

Bloomberg: The Court Case That Could Kill Obamacare
The Affordable Care Act has overcome a Supreme Court challenge, persistent Republican opposition and the initial dysfunction of its own website. It could still fall victim to another foe: its own language. Any day now, a federal court may rule that in 36 states, the federal government can't offer tax credits to people who buy insurance on Obamacare's exchanges. That's because the law, as written, authorizes those tax credits only in states that have set up exchanges -- and most states refused to do so (Ramesh Ponnuru, 7/10).

Los Angeles Times: Hey Liberals, There's A Logistical Problem With Your Hobby Lobby Boycott
There's a big problem with all this boycott mania: There's almost no Venn-diagram overlap between the nearly 18,000 people who "like" the boycott's Facebook page so far and the consumer base that actually shops at Hobby Lobby. Crafts customers -- people who make their own quilts, soaps, scrapbooks, Christmas wreaths and kids' Halloween costumes -- are certainly overwhelmingly women. But they also tend to be stay-at-home moms (who else has the time?), and it's safe to say that a large percentage of them are religiously and probably politically conservative. Dressing up like an IUD doesn't do it for them. In fact, the whole idea that an employer should be obliged to pay for someone else's birth control, period, probably sticks in the craws of many of them. What's wrong with buying your own contraceptives? (Charlotte Allen, 7/10). 

The Wall Street Journal: A Minimally Invasive Approach To Health-Care Reform
Minimally invasive surgery using a fiber-optic camera and small incisions rather than traditional "open" surgery significantly reduces costly surgical complications. That's been known for some time. But a study that my Johns Hopkins University colleagues and I recently conducted has found that it is still surprisingly common for patients in the U.S. not to be given that surgical option (Marty Makary, 7/10). 

On other health issues --

The New York Times: Crack Down On Scientific Fraudsters
Even though research misconduct is far from rare, Dr. Han's case was unusual in that he had to resign. Criminal charges against scientists who commit fraud are even more uncommon. In fact, according to a study published last year, "most investigators who engage in wrongdoing, even serious wrongdoing, continue to conduct research at their institutions." As part of our reporting, we've written about multiple academic researchers who have been found guilty of misconduct and then have gone on to work at pharmaceutical giants. Unusual, too, is the fact that Iowa State has agreed to reimburse the government about $500,000 to cover several years of Dr. Han's salary and that the National Institutes of Health has decided to withhold another $1.4 million that it had promised the university as part of the grant (Adam Marcus and Ivan Oransky, 7/10). 

USA Today: VA Manufactured Its Own Doctor Shortage
Why was the situation so dire that veterans faced months-long waits to see Veterans Affairs physicians? It's not exactly a secret that the VA faces a severe shortage of physicians. More than 800 job openings are listed on the VA website. There are many reasons why it is so hard to recruit physicians to work for the VA, including challenging patients, dwindling financial resources and uncompetitive salaries (Greg Siskind, 7/10). 

New England Journal of Medicine: Drug Companies' Patient-Assistance Programs -- Helping Patients Or Profits?
Assistance programs are a triple boon for manufacturers. They increase demand, allow companies to charge higher prices, and provide public-relations benefits. ... [But Medicare and other payers] worry that patient-assistance programs discourage patients from using generic drugs and other less costly alternatives to new, patent-protected therapies. ... Pharmaceutical manufacturers and patient-advocacy groups are seeking clarification from the DHHS about the legality of patient-assistance programs' providing aid to exchange enrollees. Given the high cost of many new drugs, the DHHS's approach to patient-assistance programs will strike many people as cold and insensitive, but I believe that the DHHS is absolutely right to limit the scope of these programs. Patient-assistance programs help individual patients but are associated with hidden costs for insurers and taxpayers. Cost sharing will accomplish nothing more than cost shifting if assistance programs shield patients from costs (David H. Howard, 7/10).