Daily Health Policy Report

Monday, October 8, 2012

Last updated: Mon, Oct 8

KHN Original Reporting & Guest Opinion

Campaign 2012

Health Reform


Capitol Hill Watch

Health Care Marketplace

Public Health & Education

State Watch

Editorials and Opinions

KHN Original Reporting & Guest Opinion

Critical Decisions Await Patient, Family Members When Medicare Deadline Looms

Kaiser Health News staff writer Sarah Varney, working in collaboration with NPR, reports: "When a spouse or parent signs up for Medicare, it is often perplexing – and unnerving – for the rest of the family who may have grown used to cushy employer-sponsored coverage. For example, young adults up to age 26, who were covered under their parent's insurance, are no longer covered when their parent moves to Medicare" (Varney, 10/8). Read the story.

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Capsules: Study: Most Seniors' ER Visits Could Be Avoided

Now on Kaiser Health News' blog, Phil Galewitz reports: "Nearly 60 percent of Medicare beneficiary visits to emergency rooms and 25 percent of their hospital admissions were 'potentially preventable'–  had patients received better care at home or in outpatient settings —  according to results of a study released Friday by a congressional advisory board" (Galewitz, 10/5). Check out what else is on the blog.

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Political Cartoon: 'Nothing Between You And Your Doctor?'

Kaiser Health News provides a fresh take on health policy developments with "Nothing Between You And Your Doctor?" by Arend Van Dam.

Meanwhile, here is today's health policy haikus:


Health policy talk
fuels campaign advertising.
Will it have impact?


If you have a health policy haiku to share, please send it to us at http://www.kaiserhealthnews.org/ContactUs.aspx and let us know if you want to include your name. Keep in mind that we give extra points if you link back to a KHN original story.

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Campaign 2012

Presidential Candidates Focus Message On Medicare, Health Law

GOP presidential hopeful Mitt Romney campaigned in Florida and blasted the health law as a threat to seniors while President Barack Obama attempted to highlight Romney's changes in position. 

The New York Times: Romney Works To Build Momentum In Florida, A State Critical To Victory
With polls showing the race even tighter in Florida than in other battleground states, Mr. Romney tailored his message for maximum appeal, including by painting "Obamacare" as a threat to Florida seniors who rely on Medicare. The health care overhaul would mean "$44 billion of cuts right here in Florida" to Medicare, Mr. Romney said, offering an interpretation that Democrats strongly reject. He added that about "540,000 of our seniors that have Medicare Advantage would lose Medicare Advantage here in Florida" (Gabriel, 10/7).

Los Angeles Times: Obama Chides Romney On Taxes But Acknowledges He Debated Poorly
President Obama mocked Mitt Romney on Sunday night for shifting his positions in the first nationally televised debate and added that his foe was not offering "change," but a "relapse" to failed GOP policies. … In Florida, Romney sought to appeal to moderate voters by saying that he would do everything in his power "to make us more united as a people" and that, if elected president, he would seek out Democrats as legislative partners. Romney said he would try to find like-minded Democrats in Washington to work with him on issues like education, Medicare and taxes (Memoli and Mehta, 10/7).

Los Angeles Times: Romney, Focusing On Crucial Florida, Shows A More Personal Side
Both campaigns have been appealing to seniors, who are among the highest-propensity voters here. During a visit to Jacksonville during the summer, Obama argued that Romney's vow to repeal the Democrats' new healthcare law would cause 200,000 Floridians to pay more for prescription drugs, and he accused Romney of trying to turn Medicare into a voucher program. … Romney accuses Obama of distorting his plan, noting that it would affect only those under 55, and that future seniors could choose traditional Medicare, though he has not been specific about their level of benefits. The former Massachusetts governor has focused on a $716-billion cut from Medicare to help pay for the new healthcare law (Reston, 10/6).

Also in the headlines, news outlets analyze specific health policies advocated by candidates and how they are playing on the campaign trail.

Bloomberg: Romney's Preexisting Conditions Put 36 Million At Risk
Mitt Romney vows he'll extend health insurance to people with preexisting medical conditions, a pledge that comes with few details and strings attached. The Republican presidential nominee says he would shield workers who have coverage from being dropped if they change jobs. Romney's plan doesn't explain what it would do for many others, such as those with ailments seeking coverage for the first time. Without specifics, he would leave it to the states to find solutions for everyone not covered under his proposal. Health-policy specialists say the plan echoes protections in a 1996 U.S. law and doesn't show how it would help at least 36 million sick people at risk of being denied coverage (Faler, 10/8).

Politico: Romney's Pre-Existing Condition Plan: A Tweak And A Handoff To The States
Mitt Romney's campaign wants you to ignore all the annoying questions about his plan to cover people with pre-existing conditions. The policy, it says, is "clear and consistent." It hasn't been clear enough, though, to allow the Romney campaign to shake the lingering questions — from the Obama campaign but also from independent fact-checkers — about whether Romney would do anything that the law doesn't already require, and whether he would cover anyone who isn't already covered. The Obama campaign has already put out a Web ad saying Romney's plan is no plan. And President Barack Obama himself poked fun at the Romney campaign for having to fact-check and pull back their own candidate's claims. "That's rough," he said at a rally in Virginia Friday (Kenen, 10/5).

CNN: Longtime Republicans Torn Between Party Loyalty And Obamacare
Jill Thacker was dying for a cup of coffee when she recently ran into a 7-Eleven convenience store. To her pleasant surprise, the coffee was free -- as long as she would commit to drinking it in either a red Mitt Romney cup or a blue Barack Obama cup. "Which are you going to choose, Mom?" her son asked. Which, indeed. A gun-owning, big-government-hating Republican, Thacker's every instinct told her to buy a Romney cup. But Thacker, 56, and her daughter have asthma -- a pre-existing condition -- and with Obama as president they'll be guaranteed the ability to buy insurance. Thacker stood in the 7-Eleven and stared at the red and blue cups, stymied by the choice they represented. Perhaps no other election has posed such a difficult personal decision for some conservatives: How do you vote if you're ideologically conservative, but you're benefiting, or stand to benefit, from the Affordable Care Act, often referred to as "Obamacare"?  (Cohen, 10/7).

Milwaukee Journal Sentinel: Romney Favors Health Care Competition, Gives Few Details
As governor of Massachusetts, Mitt Romney oversaw the most ambitious revamping of a health care system by any state in the country. As a presidential candidate, he contends that's how health care reform should be handled: state by state. Romney has provided few specifics on what the federal government would do to help states expand coverage for uninsured Americans or make the health care system more efficient. But he has made clear he thinks that competition and giving consumers the ability to choose among a variety of health plans and providers can lead to better quality at a lower cost. "The general approach is there," said Nina Owcharenko, a policy analyst with the Heritage Foundation, a conservative policy and research organization. "But the details -- I guess we will just have to wait and see" (Boulton, 10/7).

Los Angeles Times: Obama's Healthcare Law: Historic Reform And Signature Failure
As the president seeks reelection, the Affordable Care Act, passed in 2010, stands as a historic achievement, ending a decades-long quest by Democrats — and some Republicans — to guarantee healthcare to all Americans. At the same time, Obama's inability to bring the parties together represents a signature failure. The president, who promised to break Washington's partisan stalemate, would sign the most consequential legislation in modern history passed by only one party (Levey, 10/6).

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Feisty Campaign Ads, Debates In Congressional Races Take On Health Policy Themes

News outlets also report on how health policies are playing in specific contests, such as Senate campaigns in Connecticut, Arizona and Wisconsin, as well as the Bilbray-Peters House race in California.   

The Associated Press: Senate Race Ads Focus On Medicare, Obamacare, Debt
For critical Senate races, Republicans are turning to the playbook that served them so well in the 2010 elections. They're saturating the airwaves with political ads detailing the perils of "Obamacare" and the nation's growing debt. Democrats have added Medicare to the equation, trying to make the case that revamping the government health care program for older people would virtually destroy it. ...  Each state has distinct differences that shape the messages of each race (Freking, 10/7).

The New York Times: A Feisty Debate Between Candidates In Connecticut Senate Race
Later, as the two sparred over Social Security and Medicare, [Republican] Ms. [Linda] McMahon cited a repeatedly debunked claim that the president cut $716 billion from Medicare. [Democrat] Mr. [Christopher] Murphy, in response, seized on the opportunity to press a point that the president missed last week. "President Obama let Mitt Romney get away with the $700 billion lie, and I’m not going to let Linda McMahon get away with it," he said (Grynbaum, 10/7).

Los Angeles Times: San Diego's Bilbray-Peters Race Reflects New State Of Politics
Much like their parties' presidential candidates, Bilbray and Peters each positions himself as the true defender of Medicare ... Although he avoids the word "voucher," Bilbray says it is time to give younger Americans the chance to choose their own retirement medical plan, much like members of Congress. ... The budget ideas of Rep. Paul Ryan (R-Wisconsin), the GOP's vice presidential candidate, a plan that Bilbray endorses, would leave the elderly without decent healthcare by substituting vouchers, Peters told a backyard gathering (Perry, 10/8).

The Associated Press: Arizona Getting To Know Carmona In Senate race 
[Republican nominee Jeff] Flake cites health care as exhibit A. Flake voted against the Democratic-led effort to expand health insurance coverage and would vote to repeal it if he's elected. [Democrat Richard] Carmona, who served as surgeon general under Republican former President George W. Bush, has made it hard to discern where he stands on the law (Freking, 10/8).

Milwaukee Journal Sentinel: Health Care At Center Of Baldwin-Thompson Senate Race
[Health care] has been at the heart of the political careers of former Gov. Tommy Thompson and U.S. Rep. Tammy Baldwin, and in this campaign the two candidates have clashed on questions of health care costs and coverage. Thompson, a Republican, wants to repeal the health care law known as "Obamacare." Baldwin, a Democrat, voted for it and has advocated going further. The two also have opposing ideas about the future of Medicare, and they blame each other for contributing to the financial difficulties of that health care program for seniors (Stein and Marley, 10/6).

The Associated Press: Tommy Thompson Says He Won't Eliminate Medicare
Thompson also tried to distance himself from Republican vice presidential hopeful Paul Ryan's plan to overhaul Medicare by introducing a voucher-like plan that future retirees could use to buy private health insurance. "The Tommy Thompson plan once again innovation that will make Medicare protected for people forever in this country," Thompson said. ... Baldwin spokesman John Kraus emailed a statement Friday, accusing Thompson of working with drug companies when he was Health and Human Services Secretary under President George W. Bush to make it illegal negotiate lower drug prices. (Antlfinger, 10/5).

Meanwhile,  Politico Pro reports on PAC spending -  

Politico Pro: Hospital PAC Spends On House Races
The American Hospital Association's PAC is continuing to pour money into House races, putting more than $1.4 million into seven races — six Republicans and one Democrat. The spending was disclosed in filings to the Federal Election Commission Friday as required by law. The group is funding television and radio ads in support of Reps. Chris Gibson (R-N.Y.), Charles Boustany (R-La.), Lois Capps (D-Calif.), Cathy McMorris Rodgers (R-Wash.), Richard Hanna (R- N.Y.), Tom Reed (R-N.Y.) and James W. Gerlach (R-Pa.) (Haberkorn, 10/5).

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Health Reform

Progress, Obstacles and Lawsuits Affecting Health Law Implementation

Roadblocks confront federal officials implementing parts of the health law including insurance exchanges, a free contraception coverage rule and the board designed to slow Medicare spending growth.

CQ HealthBeat: On Exchanges: CMS Official Sees Progress On State Marketplaces But Final Tally Yet To Come
A Centers for Medicare and Medicaid Services bureaucrat painted a bright picture of brisk action and state-federal cooperation on state exchange implementation at an insurers' meeting on Friday. But an exchange official from Arkansas ... outlined the reality and complications on the ground. In Arkansas, even with a Democratic governor and Democratic legislature, a state-federal partnership will be the most that state officials will be able to muster prior to federal deadlines, given the vocal Republican minority opposed to any exchanges. States face a Nov. 16 deadline for submitting a blueprint application to the Department of Health and Human Services (Norman, 10/5).

CQ HealthBeat: Battle Over Contraception Rule Continues In Appeals Court
The Becket Fund for Religious Liberty on Friday filed an appeal in federal court of a decision dismissing two lawsuits that challenged a federal rule on contraception. Lawyers for the fund said it's the first time the fight over the Department of Health and Human Services birth control coverage requirement has made its way into a federal appeals court. More than 30 suits are pending in federal courts (Norman, 10/5).

The Hill: Obstacles For Obama's Health Panel
Obama and Mitt Romney spent a lot of time during Wednesday's debate talking about the Independent Payment Advisory Board (IPAB), ... Obama described it as a panel of experts leveraging Medicare's purchasing power to bring down health care costs, while Romney cast it as a band of faceless bureaucrats whose decisions will ultimately undermine seniors' access to care. Health policy experts say the IPAB won't turn out to be as sinister as Romney described it, but it also might not be as effective as Obama envisions. In fact, it could be a struggle to even get the board up and running (Baker, 10/6).

Already, a study says that a major part of the health law -- accountable care organizations -- saved little money when applied to providers caring for patients with one health condition -- diabetes:

Medpage Today: Study: No Health Care Savings With ACOs
Accountable care organizations (ACOs) that improved diabetes outcomes by as much as 10 percent achieved minimal or no cost savings, results of a published simulation showed. The simulation found that a 10 percent clinical improvement would create just 1.22 percent in savings for Parts A and B -- well below the level needed to trigger savings sharing, results published online in Health Affairs showed. ... the savings must exceed 2 percent in a given year (Pittman, 10/7).

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MedPAC Staffers Recommend Allowing Geographically Based Medicare Physician Payments To Proceed

These pay reductions have long been frozen, but that freeze is set to expire on Dec. 31. MedPAC has yet to vote on the issue. Meanwhile, a pair of KHN stories examine separate Medicare issues, including the difficult decisions in play as a family member enrolls in the program, as well as the details of a study about seniors' ER visits.  

Modern Healthcare: Let Geographic Doc-Pay Cuts Proceed, Say MedPAC Staffers
The staff of Congress' primary Medicare advisory body recommended allowing long-frozen geographically based payment cuts for physicians to go into effect. The draft recommendations, on which the Medicare Payment Advisory Commission has yet to vote, applied to the program's system for supplementing or cutting physician payments based on a comparison of costs in the area in which they practice to a national average. A legislative freeze on the cuts side of that equation is scheduled to expire Dec. 31 (Daly, 10/7).

Kaiser Health News: Critical Decisions Await Patient, Family Members When Medicare Deadline Looms
When a spouse or parent signs up for Medicare, it is often perplexing -- and unnerving -- for the rest of the family who may have grown used to cushy employer-sponsored coverage. For example, young adults up to age 26, who were covered under their parent's insurance, are no longer covered when their parent moves to Medicare (Varney, 10/8). 

Kaiser Health News: Capsules: Study: Most Seniors' ER Visits Could Be Avoided
Nearly 60 percent of Medicare beneficiary visits to emergency rooms and 25 percent of their hospital admissions were 'potentially preventable' -- had patients received better care at home or in outpatient settings -- according to results of a study released Friday by a congressional advisory board (Galewitz, 10/5). 

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Capitol Hill Watch

New Legislation Proposed To Improve Seniors' Care Coordination

The bill backed by Rep. Allyson Schwartz, D-Pa., and Sen. John Kerry, D-Mass., would promote better coordination between medical and social services for elderly people by building on the Older Americans Act.

The Hill: Kerry, Schwartz Propose Better Care Coordination For Seniors
New legislation from Rep. Allyson Schwartz (D-Pa.) and Sen. John Kerry (D-Mass.) would promote better coordination between medical and social services for the elderly. The bill builds on the Older Americans Act, which established a variety of services for seniors such as home-delivered meals, transportation and legal assistance. Dubbed the Care Coordination for Older Americans Act, the new measure would ensure that an elderly diabetic, for example, is provided meals in collaboration with a doctor. "Preventable and highly manageable chronic diseases consume 75 percent of health care costs making it vital that we find common-sense solutions to ensure that seniors can better manage their chronic diseases," said Schwartz in a statement (Viebeck, 10/5).

Also in the news, President Barack Obama signed a measure amending the Food and Drug Administration User-Fee Law --

Modern Healthcare: Obama Signs Bill Amending FDA User-Fee Law
President Barack Obama signed legislation Friday that will amend the Food and Drug Administration's user-fee law to ensure that a new program intended to improve approval times for generic drugs can begin. The FDA User Fee Correction Act, which was passed by the House and Senate last month before Congress adjourned, addresses the industry's concern that the government's temporary funding measure would delay implementation of the generic user-fee program. The FDA collects millions of dollars in user fees from the pharmaceutical and medical device industries each year in exchange for using the funding to improve the drug and device approval process (Lee, 10/6).

Finally, four House Republican leaders want hospitals' electronic medical records payments suspended over potential waste --

Center for Public Integrity: House Republicans Demand Suspension Of Electronic Medical Records Program
Four Republican House leaders want federal officials to suspend payments to hospitals and doctors who switch from paper to electronic health records, arguing the program may be wasting billions of tax dollars and doing little to improve the quality of medical care (Schulte, 10/5).

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Health Care Marketplace

How The Health Law Could Play Into Consumers' Decisions During Open Enrollment Season

Fiscal Times: Open Enrollment And Obamacare: What You Need To Know
While health care is still a hot issue in the election, in the coming months consumers will be facing a health insurance decision of their own: open enrollment. That’s the period, usually in the last quarter of the year, when workers with insurance can change coverage options without having to prove their health status. While the majority of provisions in the Obama administration’s Affordable Care Act (ACA) don’t take hold until 2014, a handful have already been rolled out and more will be implemented in 2013. For employees, their companies, and insurers, the law means new choices and responsibilities in the upcoming open enrollment period (Yoder, 10/8).

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UnitedHealth To Buy Brazilian Health Insurer

Bloomberg: UnitedHealth Will Buy Brazilian Insurer Amil For $4.9 Billion
UnitedHealth Group Inc. (UNH), the biggest U.S. health insurance company, agreed to pay about $4.9 billion to buy 90 percent of Amil Participacoes SA (AMIL3), a Brazil-based insurer and hospitals operator that gives the American company a stake in the world’s second-biggest emerging economy. The deal will take place in two steps, UnitedHealth said in a statement today. In the fourth quarter, once it has regulatory approval, UnitedHealth will buy about 60 percent of Amil’s outstanding shares from controlling shareholders and management. In the first half of next year it will make a public offer for the remaining 30 percent, according to the release (Nussbaum, 10/8).

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Public Health & Education

Loose Oversight May Be To Blame In Meningitis Outbreak

The New York Times: Scant Oversight Of Drug Maker In Fatal Meningitis Outbreak
The rising toll — 7 dead, 57 ill and thousands potentially exposed — has cast a harsh light on the loose regulations that legal experts say allowed a company to sell 17,676 vials of an unsafe drug to pain clinics in 23 states. ... some doctors and clinics have turned away from major drug manufacturers and have taken their business to so-called compounding pharmacies, like New England Compounding, which mix up batches of drugs on their own, often for much lower prices than major manufacturers charge — and with little of the federal oversight of drug safety and quality that is routine for the big companies Grady, Pollack and Tavernise, 10/6). 

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State Watch

Medicaid News: Florida Program Caught Between Feds And State Efforts

The Department of Health and Human Services and Florida officials negotiate changes to the state's Medicaid plan. In the meantime, Arkansas doctors offer a cautious endorsement as the state tries "episodic" payments for some common conditions.

The Associated Press: Fla. Medicaid Program In Limbo
Millions of uninsured Florida families and health care providers are in a purgatory of sorts. Gov. Rick Scott and the Republican-led Legislature want to privatize the state's Medicaid program, but need the Obama administration's permission. The Obama administration wants to make more low-income Floridians eligible for Medicaid, but needs Scott and the Legislature to agree. The sides have been negotiating a package deal for more than a year and won't comment (Kennedy, 10/7).

Medpage Today: Medicaid: Docs Cautious About Arkansas Payment Plan
Doctors in Arkansas who treat Medicaid patients are trying their best to put on a happy face about a program there designed to reward quality and move away from a traditional fee-for-service payment model. The cost-sharing program, which started this week and involves Medicaid and some of the state's largest private insurers, will determine if a provider reaches quality and cost targets based on historical models. The Health Care Payment Improvement Initiative, on which Arkansas Medicaid is partnering with two private insurers -- Arkansas Blue Cross and Blue Shield and Arkansas QualChoice -- rewards doctors who manage care and costs well but also withholds reimbursement for those who exceed historical cost levels (Pittman, 10/5).

Politico Pro: Arkansas Tests New Approach To Payments
With a wary nod from the state's doctors, Arkansas has launched an effort to control its health care costs that officials hope will transform its system within a few years. In the initiative begun this month, Arkansas's Medicaid program and two of the state's largest insurers -- Arkansas Blue Cross Blue Shield and QualChoice -- are partnering to introduce "episodic" payments for common conditions. They include upper respiratory infections, hip and knee replacements, attention deficit/hyperactivity disorder, congestive heart failure and perinatal care (Cheney, 10/8).

And Pennsylvania officials suspend a co-pay plan for autism services in its Medicaid program.

Inquirer: Pa. Suspends Autism Co-Pay Plan
State welfare officials have put on hold a plan to force thousands of parents of children with autism and other disabilities to begin paying part of the cost of services that had been provided via Medicaid. Instead of the planned co-pays, the agency said it would pursue federal approval to charge families a monthly premium on a sliding scale (Worden, 10/6).

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State Roundup: Texas Docs Turn To Politics; Calif. Legislative Action On Health

News outlets provide health care news from California, Montana and Texas.

The Texas Tribune: For Doctors In Politics, Medicine Often Trumps Party
The state's largest doctors association says it can't remember a time when so many Texas physicians held elected office in Texas. But sometimes their medical backgrounds put them at odds with members of their own party (Bernier, 10/8).

The Associated Press: Health Care Fight Exposes GOP Fissures In States
An acrimonious debate over the federal health care overhaul is seeping into state capitols, creating fissures among Republicans as the tea party movement reasserts its influence in GOP-controlled areas. States face decisions about setting up online health insurance marketplaces, and a mid-November deadline for declaring their intentions has sparked conflicts between governors and legislators across the country (Hanna, 10/7).

The Associated Press: (Montana) Ballot Questions Range From Marijuana To Abortion
Montana voters who head to the polls next month to choose a president may be surprised to also find ballot questions on medical marijuana, abortion, illegal immigrants, whether corporations are people and health insurance mandates. Those five measures have been overshadowed in a packed ballot that also includes high-stakes U.S. Senate and governor's races, an open congressional seat and a lengthy list of legislative and judicial candidates (Volz, 10/7).

California Watch: Mixed Results For Legislation Linked To Medical Care, Fraud
In the week following Gov. Jerry Brown's deadline for passing or vetoing hundreds of bills, those affected are examining successes and defeats that touch on cancer care, emergency rooms, prescribing, elder care and compensation to victims of corporate fraud. Those celebrating include a group of elder advocates who sought more autonomy for the state's elder care ombudsman (Jewett, 10/5). 

Los Angeles Times: A Sampling Of California's New Health Insurance Laws
Gov. Jerry Brown signed into law last week a set of measures aimed at preparing California for coming changes in how consumers get health care insurance. Some of the laws: To head off deceptive marketing attempts, AB 1761 bans unauthorized individuals and businesses from claiming to represent the California Health Benefit Exchange, the new central marketplace for buying insurance that goes into effect in 2014. Beginning in 2014, under AB 792, Californians who lose their health insurance because of job loss, divorce or legal separation will receive information about reduced-cost plans available through the health exchange and no-cost coverage from Medi-Cal (Wilson, 10/7).

California Healthline: Legislature Receives Final Plan For Duals Project
This was a big week for the state Department of Health Care Services, which on Monday submitted its final version of the strategic plan for the Coordinated Care Initiative -- a project in which the state eventually plans to move on million seniors and disabled "dual eligible" Californians to Medi-Cal managed care plans. Dual-eligibles are eligible for both the Medicare and Medi-Cal programs. By meshing the two funding sources and patient services, the state plans to improve the quality of care while also saving money. Initially, the duals demonstration project will start with eight California counties (Alameda, Los Angeles, Orange, Riverside, San Bernardino, San Diego, San Mateo and Santa Clara counties) and the approximately 700,000 dual-eligibles in those counties (Gorn, 10/5).

The Associated Press/Washington Post: D.C. To Merge Individual Insurance Market With Small Businesses Under New Health Care Law
Small businesses in Washington will be required to buy employee health insurance through a city-run exchange beginning in 2014. The District of Columbia is combining its health care exchange markets for individuals and small businesses that have fewer than 50 employees. The D.C. Health Benefit Exchange Authority voted unanimously Wednesday to combine the health exchanges, despite opposition from businesses. Some said the exchange will lead to higher costs (10/6).

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Editorials and Opinions

Viewpoints: Romney's Views On Health Care Still Mysterious; Treating The Dying Patient

Los Angeles Times: Healthcare Remains A Stumbling Block For Romney
Mitt Romney may know more about healthcare than any other presidential nominee in memory. As governor of Massachusetts, he dove deeply into the subject while creating the most far-reaching state health plan in the country. As president, he would bring an unusual degree of nuance to any discussion of health insurance. In theory, that should thrill Republicans, who have been eager to run against an incumbent who unwittingly gave his name to a healthcare plan, "Obamacare," that has engendered more opposition than support. So why has explaining his position on healthcare been such an ordeal for Romney? (Mitchell Landsberg, 10/6).

Los Angeles Times: Moderate Mitt? Don't Count On It
Who is the real Romney? Only a month from election day and almost 20 years into Mitt Romney's political career, the question is still being asked. Is it Moderate Mitt, the governor of Massachusetts who once championed abortion rights and enacted a state-administered health insurance plan? Or is it Severely Conservative Mitt, the presidential candidate who battered rivals on the right by calling for deeper tax cuts and tougher immigration laws? (Doyle McManus, 10/7).

The Washington Post: Mitt Romney, Health Care and Eco-Womanism
Elections are moral choices. They are an opportunity for a society to say at the ballot box what it values. ... Justice means that every person is able to have that which he or she is due. Since health care is a human right, every person is due quality health care. It should not matter what state a person lives in. Someone living in Mississippi has the same right to health care as a person in Massachusetts (Valerie Elverton Dixon, 10/5).

The New York Times: How To Die
Here in the United States, nothing bedevils our discussion of health care like the question of when and how to withhold it. The Liverpool Pathway (for the Dying Patient) or variations of it are now standard in most British hospitals and in several other countries — but not ours. When I asked one American end-of-life specialist what chance he saw that something of the kind could be replicated here, the answer was immediate: "Zero." There is an obvious reason for that, and a less obvious reason (Bill Keller, 10/7).

NBC News: Daughter Has Right To Die Against Parents' Wishes
When your time comes to die, you probably hope that you will be surrounded by loving family members and friends who will support you and help you leave this earth at peace with one another. Sadly, for 28 year-old SungEun Grace Lee, who is dying in a Long Island hospital, that is not happening (Arthur Caplan, 10/5).

The Wall Street Journal: Please Step Back From The Assisted-Suicide Ledge
In the November elections, voters in Massachusetts will decide on "Question 2," a ballot initiative to allow physicians to prescribe (but not administer) a lethal dose of a toxic drug to assist their patients in committing suicide. Advocates of physician-assisted suicide assure us that this can be a good choice for someone who is dying, or who wants to die. If physician-assisted suicide really represents a good choice, we need to ask: Why should only physicians be able to participate? Why should only physicians be allowed to undermine public trust in their profession through these kinds of death-dealing activities? (Tadeusz Pacholczyk, 10/7). 

The New York Times: The Cancer Lobby
Big Chem apparently worries that you might be confused if you learned that formaldehyde caused cancer of the nose and throat, and perhaps leukemia as well. The industry's strategy is to lobby Congress to cut off money for the Report on Carcinogens, a 500-page consensus document published every two years by the National Institutes of Health, containing the best information about what agents cause cancer. If that sounds like shooting the messenger, well, it is (Nicholas D. Kristof, 10/6).  

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Stephanie Stapleton

Andrew Villegas

Lisa Gillespie
Shefali Luthra

The Kaiser Daily Health Policy Report is published by Kaiser Health News, an editorially independent program of the Kaiser Family Foundation. (c) 2014 Kaiser Health News. All rights reserved.