Viewpoints: Relatively few face insurance cancellations; new doctor payment site is 'impenetrable'

Oct 8 2014

The New York Times' The Upshot: Health Plan Cancellations Are Coming, But For Relatively Few
People are starting to get letters telling them their health insurance plans have been canceled because of the Affordable Care Act. Because the letters will go out just before the midterm congressional elections, they are likely to get a lot of attention. There have been several stories this past week. But the people affected will represent only a small fraction of the population with health insurance (Margot Sanger-Katz, (10/6). 

The New York Times' Room For Debate: Expanding The Right To Die
Some readers who commented on a Room for Debate forum about the dismal state of elder care said they wanted to be able to end their lives on their own terms to avoid a drawn-out, onerous death. A 29-year-old woman with terminal brain cancer has announced a campaign to support physician-assisted suicide leading up to her own death next month. Since Oregon became the first state to legalize physician-assisted suicide for terminally ill patients, Montana, New Mexico, Vermont and Washington have permitted it. Should the right to die be expanded further, and if so, what should the standards be? (10/6).

Arizona Republic: The Hail Mary Pass On The Ballot -- Prop. 303
On the November ballot this year is something called a "Right to Try" proposal. It is Proposition 303, and if approved by the voters it will allow very ill patients to get access to experimental drugs after all other medical options fail. … If you were to rely on campaign commercials (and squawking hacks like me), you'd believe that next month's election is a series of choices between the lesser of two evils. And you would be correct. Mostly. But not entirely (EJ Montini, 10/6).

Los Angeles Times: No On Proposition 46
Proposition 46 is a combination platter of healthcare-related proposals, each of which tries to accomplish something meaningful for California consumers. One provision would increase compensation for people harmed by careless or reckless healthcare providers. A second aims to protect hospital patients against doctors who are substance abusers. And a third seeks to curb over-prescribing of opioids and other dangerous medications. But as worthwhile as these goals may be, the methods the measure would use to achieve them are too flawed to be enacted into law (10/6). 

The Washington Post: States Not Expanding Medicaid Hobble The Fight Against HIV/AIDS
As we begin to worry about the possibility of an Ebola epidemic taking hold in the United States, we must not forget the epidemic already firmly rooted here. The HIV/AIDS epidemic has raged for more than 30 years in this country with more than 1.1 million people in the U.S. living with HIV/AIDS and African Americans experiencing "the most severe burden of HIV," according to the Centers for Disease Control. While a positive diagnosis no longer means guaranteed death, it does mean a life of expensive medications and care to manage the chronic disease. Lack of awareness and of access to care continue to help spread an infection that is relatively easy to avoid (Jonathan Capehart, 10/6). 

The Wall Street Journal's Washington Wire: In Some States, A Cost Crunch Over Expanded Health Benefits
Obamacare raised individual market insurance premiums by mandating additional benefits, but some states now view these stronger insurance requirements not as a ceiling but as a new floor. Yet by imposing new mandates that will raise premiums further, their actions may make the Affordable Care Act increasingly unaffordable for consumers-;and for the taxpayers funding insurance subsidies (Chris Jacobs, 10/6).

Sacramento Bee: Ask Emily: New California Laws That Will -- Or Won't -- Make Health Coverage Easier
It has been quite a year. More than 3 million of you signed up for new health coverage in California. But many of you couldn't find doctors who accepted your plans. Some of you were charged hundreds or thousands of dollars for desperately needed prescription medications. And let's not forget Medi-Cal, where legions waited for months to find out if your applications had been processed or couldn't get help when complicated (and high-stakes) renewal forms landed in your mailboxes. ... I'll explain which new laws will – or won't – make your health coverage easier to use (Emily Bazar, 10/7).

McClatchy/Chicago Tribune: How Much Are Docs Collecting From Health Care Companies?
The Obama administration last week launched its Open Payments online database, which is supposed to enable the public to follow the medical money. You'll find it at cms.gov/openpayments. It works like a charm -- if you're a software engineer with time on your hands. For anyone else, it's pretty much an impenetrable maze. There's no button, for instance, to "find your doctor." Before you click on "explore the data," you had better pack a lunch (10/6). 

Journal of the American Medical Association: The Ebola Outbreak, Fragile Health Systems, And Quality As A Cure
Yet if the Ebola virus surfaced in Boston or Toronto, there is little doubt that their health systems, despite shortcomings, could effectively contain and then eliminate the disease with far lower case-fatality rates than those reported now in West Africa. Why the disparity when there is no proven drug or vaccine available? The answer lies not with the virus, but in the collective failure to ensure the availability of adequate health care staff, resources, and systems required for the delivery of high-quality health care services. The Ebola epidemic has placed this failure into stark relief, exposing the pathology of chronic neglect amid broad global inequalities (Drs. Andrew S. Boozary, Paul E. Farmer and Ashish K. Jha, 10/6).

Health News Colorado: Narrowing Provider Networks Can Lead To Lower Premiums
Insurance companies have routinely made changes in networks, but in recent years, insurers have increasingly restricted the number of hospitals and doctors they do business with to keep premiums lower. It's a business decision, and it's all about cost. Provider-based costs are the single biggest contributor to premium prices. The better an insurance company manages those costs, the lower its premiums will be. And the lower the premiums, the more competitive it is in the marketplace. Changes in networks can be unsettling for consumers, but the practice is old hat to most longtime insurance customers. According to many industry studies, lower premiums are generally more important to policyholders than a broad choice of hospitals or doctors (Bob Semro, 10/6).