Daily Health Policy Report

Wednesday, November 28, 2012

Last updated: Wed, Nov 28

KHN Original Reporting & Guest Opinion

Fiscal Cliff

Health Reform

Capitol Hill Watch

Public Health & Education

Health Care Marketplace

Coverage & Access

Health Care Fraud & Abuse

State Watch

Editorials and Opinions

KHN Original Reporting & Guest Opinion

Hospitals Offer Wide Array Of Services To Keep Patients From Needing To Return

Kaiser Health News staff writer Jordan Rau, working in collaboration with The New York Times, reports: "In the past, the only thing a patient was sure to get after a hospital stay was a bill. But as Medicare cracks down on high readmission rates, hospitals are dispatching nurses, transportation, culturally specific diet tips, free medications and even bathroom scales to patients deemed at risk of relapsing" (Rau, 11/27). Read the story and check out this related story.

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Capsules: Hospitals Get New Grades On Safety

Now on Kaiser Health News' blog, Jordan Rau reports: "The Leapfrog Group is out with its second round of hospital safety ratings, and what a difference a few months has made. In the results released Wednesday, 103 hospitals that Leapfrog had given a 'C' or lower in its first round of ratings in June got an 'A' in the updated Hospital Safety Score, based on more recent data and a slightly tweaked methodology" (Rau, 11/26). Check out what else is on the blog.

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Political Cartoon: 'Q.E.D.?'

Kaiser Health News provides a fresh take on health policy developments with 'Q.E.D.?' by Chuck Legge.

Meanwhile, here is today's health policy haiku:


Readmission rates
Don't tell the entire story 
Other measures count
by Janice Lynch Schuster

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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Fiscal Cliff

Party Lines On Entitlement Programs Play Role In 'Fiscal Cliff' Negotiations

Congressional leaders signal they are making progress in "fiscal cliff" talks. Rep. Tom Cole, R-Okla., urged his party to back an immediate extension of Bush-era tax cuts for households earning less than $250,000 and focus on tax breaks for higher-income people later. Meanwhile, Sen. Dick Durbin, D-Ill, said that Medicare and other federal health care programs should be part of long-term solutions, but not a short-term deal.

The New York Times: House Republican Urges Party To Yield On Tax Cuts For Most Earners
Democrats said they would not accept cuts to Medicare or Medicaid as part of the upfront "down payment" on deficit reduction that would be passed next month along with a broader framework on tax and entitlement changes to be worked over in 2013. In a speech at the liberal Center for American Progress, Mr. Durbin still expressed confidence that beneath all the public posturing, the White House and Speaker John A. Boehner, Republican of Ohio, were making progress toward averting the so-called fiscal cliff. … Mr. Durbin said that Medicare should not be tapped for that upfront down payment but that federal health care programs should be part of next year's deliberations. And he opened the door for money-saving adjustments to Mr. Obama’s signature health care law (Weisman, 11/27).

Los Angeles Times: Senate's No.2 Democrat Calls For Cuts To Social Safety Net
A top Democrat pressured fellow progressives Tuesday to consider long-term changes to the social safety net, even as the party digs in for a fight to save Medicare and other government programs from deep budget cuts. As closed-door talks continue with the hope of a year-end deal, President Obama will travel to a Pennsylvania toy store this week to pressure Congress to extend the expiring tax cuts for the middle class, while letting those for the wealthiest 2% of Americans expire (Mascaro and Parsons, 11/27).

USA Today: Durbin Outlines Liberal Plan To Avert 'Fiscal Cliff'
Sen. Richard Durbin, D-Ill., is optimistic President Obama and congressional leaders will reach a deal to avert the "fiscal cliff" of tax hikes and spending cuts at the end of the year only if Republicans relent on their opposition to raising individual tax rates on the wealthy (Page, 11/27).

Bloomberg: Durbin Says Deficit-Reduction Talks Can Include Medicare
Deficit-reduction talks can include savings from Medicare without raising the eligibility age or turning it into a voucher program, said Richard Durbin, the Senate’s second-ranking Democrat. Still, proposals to address the long-term solvency of Medicare and Social Security shouldn’t be part of the current short-term negotiations to avert the year-end fiscal cliff, Durbin said in remarks prepared for his speech today in Washington. Though he didn’t deliver that portion of his prepared speech, he told reporters he stood by the full text (Rubin, 11/27).

Reuters: Senior Democrat Durbin Urges Talks On Medicare
Dick Durbin, a senior Senate Democrat and close ally of President Barack Obama, urged fellow liberals on Tuesday to consider reforming Medicare and Medicaid, the U.S. healthcare programs they have long fought to shield from spending cuts. The timing of his message - just as Democrats and Republicans struggling to avoid the "fiscal cliff," looming early next year - and its prominence may signal that Democratic leaders and the White House will discuss social programs at the fiscal policy negotiating table (Dixon and Ferraro and Morgan, 11/27).

The Wall Street Journal: Democrats Harden Budget Positions
The White House and congressional Democrats hardened their budget positions on Tuesday and signaled they are prepared for partisan jockeying before any agreement to block impending spending cuts and tax increases can be reached with Republicans. Sen. Dick Durbin (D., Ill.), a rare liberal who has supported changes in Medicare and other entitlements as part of a broad budget deal, made clear he wouldn't back them under a short-term agreement to avoid the fiscal cliff (Hook and Lee, 11/27).

The Associated Press/Washington Post: Senate Democrats Divided Over Cuts To Benefit Programs, Raising Roadblock To Any Fiscal Deal
Deep divisions among Senate Democrats over whether cuts to popular benefit programs like Medicare and Medicaid should be part of a plan to slow the government's mushrooming debt pose a big obstacle to a deal for avoiding a potentially economy-crushing "fiscal cliff," even if Republicans agree to raise taxes (11/28).

Politico: Democrats Talk Tough On Entitlements In Fiscal Cliff Debate
Congressional Democrats are starting to draw a much tougher line on entitlements in the increasingly messy fiscal cliff talks, warning Republicans to keep their hands off Social Security and Medicare benefits. Democrats also say they'll refuse to look at GOP calls to dramatically slash Medicaid. And for them to even entertain any changes to Medicare and Medicaid, they say the price is for Republicans to agree to far higher taxes than they have flirted with so far (Raju, 11/27).

Los Angeles Times: Reid, McConnell Clash On 'Fiscal Cliff,' Filibuster Rules
Asked about Sen. Richard Durbin's (D-Ill.) comments earlier in the day calling for major entitlement programs to remain open to negotiations, Reid partially agreed with his colleague. … Despite his complaints about Republican stonewalling, Reid said that he's still optimistic that a deal can be reached before the end of the year, when automatic federal tax hikes and spending cuts would kick in (Little, 11/27).

CQ HealthBeat: Labor Lobbies Hill On Entitlements, Bush Tax Cuts
AFL-CIO leaders orchestrated a "lobby fly-in day" Tuesday on Capitol Hill, with local labor leaders and their advocates from 33 states visiting lawmakers to urge them to refuse benefit cuts to Medicare, Medicaid and Social Security and to let the 2001 and 2003 tax cuts expire for the top 2 percent of American earners. The effort coincided with a report the AFL-CIO issued that lists the number of people per state who currently get their health coverage through Medicaid. The report also highlights the amount of money Medicare, Medicaid and Social Security pump into each state’s economy and the economic costs to individuals if the Medicare eligibility age were increased (11/27).

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Health Reform

Politico Examines Lawsuits Against Contraception Policy; Ariz.'s Brewer Wants More Details On Exchanges

Many suits have been filed against the Obama administration's policy to require most employers to cover contraception in health plans under the health law. At the same time, there are still many questions about the exchanges that are also part of the law.

Politico: Obamacare's Many Contraception Lawsuits
Dozens of lawsuits have been filed in protest of the Obama administration's policy that most employers include no-cost coverage of FDA-approved prescription contraceptives in health plans. ... Here's a rundown on who is suing — and the big legal issues at stake (Smith, 11/28).

The Associated Press: Brewer Seeks More Info On Health Care Law Before Making Decision
Just days after giving governors more time to declare whether states would commit to running online marketplaces for subsidized health coverage, the Obama administration released hundreds of pages of proposed rules on required benefits and other aspects of implementing the federal health law. But Arizona Gov. Jan Brewer still has important unanswered questions about the health exchange, particularly about how a federally created exchange would work if the state were to choose that option, Brewer health policy adviser Don Hughes told The Associated Press (11/27).

Fox News: Health Exchanges Are Coming: Here's How To Plan
Health exchanges are scheduled to go live in 2014 as instituted by the Patient Protection and Affordable Care Act (PPACA), which means health insurance companies will be competing for business. For the 30 million Americans currently uninsured and wanting health insurance, these exchanges will offer affordable health care as well as a variety of choices in terms of the providers and plans. "Consumers are going to have more access to health insurance choices then they have had historically," says Michael Thompson, principal, human resource services at accounting firm PwC. "Options will range from lower-cost less coverage plans to very rich plans" (Fuscaldo, 11/27).

Meanwhile, some groups see economic opportunities under the law -

Bloomberg: Tech Workers See Opportunity As Health-Care Law Kicks In
John Tricas said he heard opportunity knocking and learned networking software two decades ago, when it was the "next big thing." Now he senses a similar opening as the health-care overhaul law takes effect…. With President Barack Obama's re-election ensuring that his 2010 law will be implemented, companies are scouting for workers like Tricas to fill hundreds of thousands of jobs in everything from running records systems to creating and servicing new insurance exchanges and entering thousands of additional codes for health-care treatments (Green and Pettypiece, 11/28).

St. Louis Beacon: Chiropractors Hope Affordable Care Act Levels Field For Treatment, Reimbursements
Last spring, Missouri lawmakers rejected a bill allowing licensed chiropractors to get reimbursed for services provided to Medicaid-eligible patients. By summer, Illinois lawmakers had voted to eliminate adult chiropractic care from Medicaid services to close a state budget deficit. Chiropractors are hoping the Affordable Care Act will make it easier for them to expand their services through insurance reimbursements (Joiner, 11/27).

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Capitol Hill Watch

Naked AIDS Protesters Arrested In Boehner's Congressional Office

Seven people took their clothes off in a House office building Tuesday to protest cuts to AIDS funding, and three women were arrested. The group was joined by dozens of other -- clothed -- protesters.

Los Angeles Times: AIDS Activists Stage Naked Protest On Capitol Hill
Seven protesters disrobed in the office of House Speaker John Boehner Tuesday afternoon as part of a staged protest against cuts to funding for AIDS programs. Their bodies painted with slogans such as "AIDS cuts kill," the group stood in Boehner's office for about 20 minutes until the protest was broken up by Capitol Police, according to Sahil Kapur, a reporter for Talking Points Memo, who witnessed the protest and posted a continuous stream of tweets and photos (Geiger, 11/27).

The Associated Press/Washington Post: AIDS Activists Arrested After Disrobing In House Speaker Boehner's Office Lobby
Three women AIDS activists saying they wanted to highlight the "naked truth" about potential spending cuts in HIV programs were arrested Tuesday after taking their clothes off in the lobby of House Speaker John Boehner's office. The trio had the words "AIDS cuts kill" painted on their bodies and had linked arms with four men who also disrobed as part of the protest. The nude protesters, along with dozens of other clothed demonstrators chanted slogans, including: "People with AIDS are under attack. What do we do? Fight back" (11/27).

The Hill: Protesters Strip Down In Boehner's Office
Multiple protesters stripped naked in Speaker John Boehner's (R-Ohio) office on Tuesday afternoon to protest possible cuts to AIDS research. The protest occurred in Boehner's office in the Longworth House Office Building, not the Speaker's office where he works in the Capitol. Boehner's office confirmed that he was not in the office at the time. A spokesman for the U.S. Capitol Police said that three protesters were arrested, all female. They are charged with lewd and indecent acts based on D.C.'s disorderly conduct code (Cohn, 11/27).

In other news, Sen. John McCain is coming under fire for comments on abortion, and the Senate Finance Committee readies for an HHS confirmation hearing.

The Hill: Anti-Abortion-Rights Groups Slam McCain
Sen. John McCain (R-Ariz.) is drawing sharp rebuke on the right for saying that Republicans should "leave the [abortion] issue alone." The Susan B. Anthony (SBA) List and Personhood USA, both groups that oppose abortion rights, attacked McCain after he spoke about the issue on "Fox News Sunday." "As far as young women are concerned, absolutely, I don't think anybody like me — I can state my position on abortion, but, other than that, leave the issue alone," McCain said. On Tuesday, the SBA List called on McCain to rethink his comment in light of his stated opposition to abortion rights (Viebeck, 11/27).

Politico: Finance Preparing For Hearing On Schultz For HHS Post
The Senate Finance Committee is preparing to hold a confirmation hearing before the end of the year for the general counsel of the Department of Health and Human Services, sources on Capitol Hill and K Street tell Politico. William B. Schultz was nominated to the post in April. Schultz's nomination hearing is likely to move as part of a pack of Obama nominees that has sat largely idle in the Senate since well before the election. Senate Republicans and Democrats are negotiating on how to move a set of nominees ahead. Schultz's papers and taxes were vetted by Republican and Democratic committee staffers before Thanksgiving in anticipation of a solo hearing or joint hearing with other Finance nominees, sources tell Politico (Haberkorn, 11/27).

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Public Health & Education

Preventive Mammogram Recommendations Could Result In Missed Cancer, Study Says

A new study has found that U.S. Preventive Services Task Force recommendations that women over 50 get mammograms only every two years -- instead of every year -- could result in missed breast cancer.

Reuters: Study Leaves Women With Conflicting Advice On Mammograms
Controversial U.S. guidelines for mammography issued in 2009, calling for screening every two years rather than annually for women over 50 years old, can result in breast cancers being missed, according to U.S. researchers studying the hotly debated topic. This latest study assessing the impact of revised guidelines issued by the U.S. Preventive Services Task Force three years ago comes on the back of a chilling analysis published last week in the New England Journal of Medicine (Sherman, 11/27).

Modern Healthcare: Studies Question Revised Mammography Guidelines
The revised mammography screening guidelines issued by the U.S. Preventive Services Task Force three years ago may result in missed cancers and declines in screening, according to two studies presented at the Radiological Society of North America's annual meeting this week in Chicago. Both studies looked at changes in mammography screening data following the task force's controversial recommendations in 2009. The U.S. [Preventive] Services Task Force said women should begin routine screening at age 50, instead of age 40. The guidelines also recommended that women undergo routine screening every two years instead of every year and routine screening should end when women are 74 years old (Lee, 11/27).

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Health Care Marketplace

Doctors' Pay Growth Lags Behind Other Health Care Professionals

A study published in the Journal of the American Medical Association takes a look at how physicians are faring financially, while a second study, this one appearing in the Archives of Internal Medicine, examines how they are doing emotionally.

Reuters: Salary Growth Lagging For Primary Care Doctors
Despite rising spending on health care in the United States, primary care doctors don't seem to be reaping the rewards on their paychecks, a new study suggests. The findings could have implications for what some predictions say will be a primary care shortage in some parts of the country in the coming years (Pittman, 11/27).

Medpage Today: Docs' Pay Grows Slower Than Nurses' Salaries
Physicians' wages grew less than other health care professionals over a 15-year period, but still remain high, researchers found. Surveys of various workers in health care-related fields from 1987 to 2010 showed that, compared with measures from 1987 to 1990, physicians' salaries increased an average 9.6 percent from 2006 to 2010, according to Seth Seabury, PhD, of the RAND Corporation in Santa Monica, Calif., and colleagues. During that same period, professionals from other fields -- including dentists, pharmacists, and registered nurses -- saw their salaries increase by an average 44 percent, they wrote in a research letter in the Journal of the American Medical Association online (Petrochko, 11/27).

Medscape: Why Are MDs Burning Out In Record Numbers?
Physicians who feel a sense of burnout, take heart -- you're not alone. A recent study of 7288 doctors published in the Archives of Internal Medicine showed that nearly one half -- 46 percent -- reported at least 1 symptom of burnout, as measured by the Maslach Burnout Inventory. According to physician Paul Griner, MD, author of The Power of Patient Stories: Learning Moments in Medicine, the figure is especially alarming considering that burnout can lead to inadequate assessment of patients and misdiagnoses. Further, a recent study published in General Hospital Psychiatry suggested that job stress, coupled with inadequate treatment for mental illness, may account for the higher than average suicide rate among US physicians (Melville, 11/27).

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Cost Increases For Branded Drugs Outpace Inflation

Reuters: U.S. Price Hikes On Branded Drugs Far Outpace 2012 Inflation
U.S. price increases on popular branded drugs in the past year have been more than six times the overall rate of inflation for consumer goods, while spending on specialty medications is up nearly 23 percent, according to data compiled by Express Scripts for its first quarterly drug trend report (Berkrot, 11/28).

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Coverage & Access

CBO: Expanding Health, Other Benefits For Domestic Partners Would Have Little Impact On Federal Employee Program Costs

The Washington Post's Federal Eye: Benefits Expansion For Domestic Partners Would Have Small Impact On Costs, CBO Says
Extending federal employee health insurance and retirement survivor benefits to same-sex domestic partners would have a relatively small impact on the number of people covered and on the cost of those programs, according to an analysis done for Congress. A Congressional Budget Office cost estimate released Monday examined a bill to make those partners eligible for the full range of benefits that apply to opposite-sex spouses of federal employees and retirees (Yoder, 11/27).

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Health Care Fraud & Abuse

HHS Office Of The Inspector General Recovers A Record-Setting $5.2B In Fiscal 2012

Modern Healthcare: OIG Sets Record In Funds Recovered
HHS' office of the inspector general this year continued its steady march upward in the number of new criminal cases it helped file and the amount of misspent federal healthcare dollars it recovered, setting five-year records in both categories, figures show. The office helped to recoup $5.2 billion in expected HHS "receivables" stemming from investigations its auditors and officials were involved with in fiscal 2012, according to the HHS OIG Semiannual Report to Congress (PDF) summarizing results of the fiscal year ended Sept. 30. Expected HHS receivables averaged $4.2 billion a year between 2008 and 2012, according to annual reports from those years (Carlson, 11/27).

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State Watch

States Confront Menu Of Medicaid Changes

A two-year payment hike for primary care doctors who treat Medicaid patients, called for by the health care law, might not happen without a struggle in Florida. Meanwhile, Kansas waits to hear back from the feds on its proposal to change Medicaid, and New Hampshire officials seek more money for their program.

CQ HealthBeat: Medicaid Payment Rates To Florida Primary Docs May Not Rise Without A Fight
What appeared to be a straightforward -- if temporary -- increase in how much Medicaid pays primary care doctors might not happen without a struggle in the state of Florida. In a letter Tuesday, Rep. Cathy Castor, D-Fla., urged Republican Gov. Rick Scott to heed a Jan. 1 deadline for putting the increase in place. ... The health care law funds a two-year increase in Medicaid payment rates to primary care doctors so they match Medicare levels. But observers say it’s not clear that Scott is going to cooperate. There has been considerable back and forth in the state over whether the governor or legislature has to give the go-ahead, observers say (Reichard, 11/27).

Kansas Health Institute News: Still No Word From Federal Officials On KanCare
With little more than a month remaining before the scheduled launch of KanCare, state officials say they still have not heard from federal authorities when -- or if -- they will receive the needed approvals for Gov. Sam Brownback's plan to remake the Kansas Medicaid program…. [Dr. Robert Moser, head of the Kansas Department of Health and Environment] said state officials still see no reason to have a back-up plan prepared in the event the waiver request is rejected or partially rejected or is not approved in time to start KanCare on Jan. 1, as the Brownback administration plans. And he said federal officials had not asked for one (Shields, 11/14).

The Associated Press: NH Health Agency Seeks $321M More In Next Budget
New Hampshire's biggest agency asked Tuesday for $321 million more from state tax sources in the two-year state budget Gov.-elect Maggie Hassan must present to lawmakers in February. Health and Human Services Commissioner Nicholas Toumpas testified at a hearing on the request that one of the biggest increases is due to a change in how the state pays nursing homes for Medicaid care (Love, 11/27).

And states continue to consider the health law's Medicaid expansion --

The Associated Press: Spokesman Says Medicaid Shouldn't Be About Economy
A spokesman for Mississippi's Medicaid program is questioning the notion that expanding the federal-state health insurance program is the way to spur economic growth. Francis X. Rullan says he's speaking only for himself in this instance. But he says it's not a good idea to base an economic development effort on the dependency of a large group of poor or disabled people (Amy, 11/27).

The Lund Report: Oregon Could Reduce Uninsured By 51 Percent Under Medicaid Expansion
Just as Oregon and other states are weighing whether to expand Medicaid, a step made optional by the Supreme Court's June 2012 ruling on the Affordable Care Act (ACA), findings from a new study detailing Medicaid expansion impacts on states may help inform their choices. In Oregon, according to the study -- released by the Kaiser Family Foundation on Nov. 26 and carried out by Urban Institute researchers -- if the state opts to expand Medicaid the ACA will cut the number of uninsured Oregonians by more than 51 percent. This figure is greater than the 47.6 percent reduction in uninsured that the nation as a whole would see if all states expand Medicaid. The ACA, with Medicaid expansion to cover adults at 138 percent of the federal poverty level, the floor set by the ACA and the expansion level researchers used, would constitute "a major impact on Oregon's insurance coverage," said one of the study authors, Matthew Buettgens (Rubin, 11/28).

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State Roundup: Big Insurance Premium Hikes Sought In Calif., Conn.

A selection of health policy stories from California, Connecticut, Georgia and Oregon.

Los Angeles Times: Anthem Blue Cross Seeks To Raise Individual Policyholders Rates
California's largest for-profit health insurer, Anthem Blue Cross, is seeking to raise rates an average of 18 percent for more than 630,000 individual policyholders, drawing scrutiny from regulators and the ire of consumers already struggling with soaring premiums. Some Anthem customers may see rates rise as much as 25 percent in February under the company's proposal at a time when medical inflation is running at historic lows nationwide (Terhune, 11/28).

CT Mirror: As Enrollment Falls, Charter Oak Health Plan Premiums Rise
Because she's self-employed, Donna Faulknor spent years buying her own health insurance. She figures she's paid more for coverage than her mortgage. But when the premiums hit four figures for a plan with a $10,000 deductible, she and her husband joined the ranks of Connecticut's uninsured. Eventually, they turned to the state's Charter Oak Health Plan, which offered coverage for $307 a month. She dropped the plan when the monthly cost rose to $446 last fall, but a health scare convinced her it was worth struggling to pay for the program. Now the state is again raising the monthly cost (Levin Becker, 11/27).

California Watch: Lawsuit Targets Nursing Home Management, State Regulators
State regulators allow nursing home companies to siphon money away from patient care to pad corporate profits, alleges a lawsuit filed by a longtime foe of the industry. Glendale attorney Russ Balisok, who has made a career of suing nursing homes, brought the suit seeking to invalidate parts of state law that allow nursing facilities to contract out their own management. ... Country Villa provided a statement that it is in full compliance with state authorities and federal law (Evans, 11/28).

Georgia Health News: Insurer Halts Medicare Advantage Sales In Georgia
A Florida-based health insurer has agreed to halt the sale of new Medicare Advantage plans in Georgia amid state regulators' concerns over the company's finances. Universal Health Care currently has about 25,000 Georgians in its Advantage plans ... Insurance Commissioner Ralph Hudgens, who signed a consent order with the company Nov. 15, cited Universal’s net loss of $27 million in 2011 and its loss of $22.1 million in the first six months of this year as triggering his move to halt sales (Miller, 11/27).

Modern Healthcare: Calif. System Seeks To Launch Health Plan
MemorialCare Health System, Fountain Valley, Calif., is planning to launch its own health plan following the acquisition of certain assets of Universal Care, Long Beach, Calif. ... The plan will support Medi-Cal beneficiaries and participate in the California Children's Services demonstration project that focuses on pediatric patients with ongoing medical conditions (Kutscher, 11/27).

California Healthline: Rescheduling Special Session In January Shouldn’t Change Discussion
The one-month delay in the legislative special session on health care should not affect the content of the discussion, according to Assembly member Richard Pan (D-Sacramento), who chairs the Assembly Committee on Health. ... In August, Gov. Jerry Brown (D) announced he would convene a special session in the Legislature after the national election in November, to address elements of the Affordable Care Act (Gorn, 11/28).

The Oregonian: Oregon Health Officials Explore Disparities In Lesbian, Gay, Bisexual, Transgender Communities
In its newest edition of CD Summary, the Oregon Health Authority, Public Health Division, explores health disparities experienced by those who identify as lesbian, gay, bisexual or transgender, versus those who identify as heterosexual (Muldoon, 11/27).

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Editorials and Opinions

Viewpoints: Republicans Offer 'Nonconcessions' In Fiscal Talks; Obama Must Lead Democrats To Entitlement Cuts

The New York Times: Still Dodging Reality On Taxes
Congressional Republicans seem to think they are being flexible on taxes simply because a few of them have grudgingly admitted that some new revenues can be part of the current fiscal negotiations. We're unimpressed. … In exchange for these nonconcessions, Republicans want vast cuts in Medicare, Medicaid and other programs that benefit the middle class and the poor (11/27). 

The Washington Post: Mr. Obama's Time To Lead On Entitlements
Democrats, meanwhile, are sounding more and more maximalist in resisting spending cuts. Many insist that Social Security, Medicare, Medicaid and education — pretty much everything except the Pentagon — are untouchable. … Mr. Obama ran on a clear platform of increasing taxes on the wealthy. But he was clear on something else, too: Deficit reduction must be "balanced," including spending cuts as well as tax increases. Since 60 percent of the federal budget goes to entitlement programs such as Medicare, Medicaid and Social Security, there's no way to achieve balance without slowing the rate of increase of those programs (11/27).

The Washington Post: Teetering Over The 'Fiscal Cliff' 
After the kumbaya White House meeting Friday with congressional leaders, it took until the following Monday evening for Republicans to return to the White House with an initial offer. It was, in a word, pathetic. As described to me by several sources with direct knowledge, the "bargain" was that all the Bush tax cuts would be extended. … In return for the vague promise of future revenue, the defense-spending sequester would be canceled, the age for Medicare eligibility would rise and changes would be made to the formula for calculating increases in Social Security benefits. Cuts now, revenue later. Sound familiar? (Ruth Marcus, 11/27).

The Wall Street Journal: Why $16 Trillion Only Hints At The True U.S. Debt
A decade and a half ago, both of us served on President Clinton's Bipartisan Commission on Entitlement and Tax Reform, the forerunner to President Obama's recent National Commission on Fiscal Responsibility and Reform. In 1994 we predicted that, unless something was done to control runaway entitlement spending, Medicare and Social Security would eventually go bankrupt or confront severe benefit cuts. Eighteen years later, nothing has been done. Why? (Chris Cox and Bill Archer, 11/26).

The Wall Street Journal: Lots Of Talk, Little Action On Medicare Fraud
The Obama administration could be doing far more to protect seniors who rely on the Medicare and Medicaid programs—and to protect taxpayers, whose dollars are wasted by the billions. Behind the flashy press conferences and announcements, the reality is that some administration antifraud efforts in these programs are actually losing money, while others are producing few palpable results (George LeMieux, 11/27).

The Wall Street Journal: Hope And Exchange
ObamaCare is due to land in a mere 10 months—about 300 days—and the Administration is not even close to ready, so naturally the political and media classes are attacking the Governors and state legislators who decline to help out. Mostly Republicans, they're facing a torrent of abuse in Washington and pressure from health lobbies at home. But the real story is that Democrats are reaping the GOP buy-in they earned (11/27).

The Denver Post: Paying For Health Care When You Get Older
One of the things we thought about when I finished graduate work was what was going to happen to us when we got old. My father would die within the next five years. He was a supporter of right-to-die organizations and after suffering for many years from osteoarthritis of the spine took his own life, dying peacefully at home. My mother was determined to never be in a nursing home, but spent the last three years of her life in a nursing home, dying at 103. Those 43 months cost almost $300,000 (David Steiner, 11/27).

The Boston Globe: A Free Market Will Help Fix Health Care
Neurologists are about to feel the sting of the Affordable Care Act. Beginning Jan. 1, Medicare will be paying them less for electrodiagnostic procedures used in identifying and treating a wide range of nerve and muscle disorders. ...  With a long-term unfunded liability of $38 trillion, Medicare will go broke if it isn’t fixed, and compelling providers to accept lower fees is how Obamacare proposes to fix it. Yet if government technocrats could keep health care affordable by paying doctors and hospitals predetermined fees for each service they provide, Medicare wouldn’t be going broke in the first place (Jeff Jacoby, 11/28).  

Kansas City Star: Don’t Sacrifice Public Health To Budget Shortfalls
In communities across the country, we are seeing more people change the way they care for their health by limiting tobacco use, eating healthier and becoming more physically active with the support of public health programs. ... Yet, it’s hard to believe that in a nation that holds such promise, nearly 1 million Americans are still dying every year from diseases that could be prevented. Our recent advances are being dangerously, and perhaps irrevocably, compromised by recent budget cuts to proven community-based health programs (Bert Malone, 11/27).

Kansas City Star: Savings Possible With State Medicaid Expansions
More evidence that state lawmakers should get the data before rejecting out of hand an expansion of Medicaid limits comes in a new report from the Kaiser Commission on Medicaid and the Uninsured. ... Medicaid expansions up to the limits called for in the federal health care law will not be overly burdensome for either Missouri or Kansas, and both states may actually see savings and revenues from complying with the law (Barb Shelly, 11/27).


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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.