Daily Health Policy Report

Wednesday, April 11, 2012

Last updated: Wed, Apr 11

KHN Original Reporting & Guest Opinion

Health Reform

Administration News

Capitol Hill Watch

Public Health & Education

Campaign 2012


Health Care Fraud & Abuse

Coverage & Access

State Watch

Editorials and Opinions

KHN Original Reporting & Guest Opinion

ACOs Multiply As Medicare Announces 27 New Ones

Kaiser Health News staff writers Jenny Gold and Christian Torres report: "Despite uncertainty over how the Supreme Court will rule on the health law, a key provision intended to help transform the delivery of care is moving ahead. The Obama administration announced Tuesday that 27 health systems have been selected to participate in Medicare's Shared Savings Program, which offers financial incentives for physicians, hospitals and other health care providers to team up in 'accountable care organizations'" (Gold and Torres, 4/10). Read the story.

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Capsules: Bloggers Stew Over Obama's Warning On 'Judicial Activism'; Study: Dental Therapists Thrive On A Global Scale

Now on Kaiser Health News' blog, Andrew Villegas checks the blogosphere's temperature and writes: "Nearly any comment from a sitting president can elicit negative feedback from opponents. But when a president takes on the Supreme Court — and raises questions about the proper role of the judiciary vis-a-vis Congress – the response can be swift and loud." Also on the blog, Shefali S. Kulkarni reports on a new study examining whether dental therapists can help address access issues - especially for children. Check out what else is on the blog.

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Political Cartoon: 'Jurist Prudence?'

Kaiser Health News provides a fresh take on health policy developments with "Jurist Prudence?" by Nick Anderson.

Meanwhile, here's today's health policy haiku:


You fall off ladder
Break your leg, no insurance
We all pay your bill
-Dena Fox

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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Health Reform

27 Health Systems Selected For Shared Savings ACO Program

The Obama administration estimates that, with the addition of these health systems to the health law  program, 375,000 Medicare beneficiaries in 18 states will get their health care through accountable care organizations.  

Kaiser Health News: ACOs Multiply As Medicare Announces 27 New Ones
Despite uncertainty over how the Supreme Court will rule on the health law, a key provision intended to help transform the delivery of care is moving ahead. The Obama administration announced Tuesday that 27 health systems have been selected to participate in Medicare's Shared Savings Program, which offers financial incentives for physicians, hospitals and other health care providers to team up in "accountable care organizations" (Gold and Torres, 4/10). 

The Hill: More Than 1 Million Medicare Beneficiaries Enrolled In Health Law Savings Program
More than one million Medicare beneficiaries are now enrolled in programs of the healthcare reform law that aim to reward doctors and hospitals for working together to improve the coordination and quality of care while saving money, the Obama administration announced Tuesday. Twenty-seven so-called "Accountable Care Organizations" have signed contracts with the Medicare agency to serve 375,000 beneficiaries in 18 states, the Medicare agency announced. The organizations are located in Arizona, California, Connecticut, Florida, Georgia, Illinois, Kentucky, Massachusetts, Mississippi, New Hampshire, New Jersey, New York, North Carolina, Pennsylvania, South Carolina, Texas, Vermont and Wisconsin (Pecquet, 4/10).

Modern Healthcare: CMS Picks 27 ACO Participants For Shared-Savings Program
The CMS designated 27 healthcare entities in 18 states as the first Medicare Shared Savings Program accountable care organizations, which are one of the healthcare law's most anticipated payment and delivery reforms. The entities aim to create financial incentives for physicians, hospitals, and other healthcare providers to better coordinate care and improve the health of Medicare beneficiaries while lowering their costs (Daly, 4/10).

Politico Pro: Early ACO Numbers Leave Future Uncertain
Delivery system reform experts say it is still too soon to tell whether the accountable care organization program will be embraced by providers even after Tuesday's announcement that 27 health systems will enroll in the Medicare Shared Savings Program. When CMS unveiled the final rule in October, it projected that anywhere from 50 to 270 health systems would enroll in the Medicare Shared Savings Program during the first four years of the contract period. ... They're still far short of this ball park, and that could draw a lot of speculation because health care analysts don't have a lot of other ways to tell how successful the ACO program will be (Feder and Smith, 4/11).

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Parsing The Impact Of The High Court's Health Law Arguments

A new Washington Post/ABC poll uncovered skepticism among Americans about whether the health law decision expected from the Supreme Court justices in June will be rooted "on the basis of the law." The poll also found that public support for the overhaul hit an all-time low, with the mandate being a bigger sticking point than ever. Meanwhile, according to The Associated Press, some of these views may be the result of "misconceptions" that resulted from the oral arguments.  

The Washington Post: Poll: More Americans Expect Supreme Court's Health-Care Decision To Be Political
More Americans think Supreme Court justices will be acting mainly on their partisan political views than on a neutral reading of the law when they decide the constitutionality of President Obama's health care law, according to a new Washington Post-ABC News poll. Half of the public expects the justices to rule mainly based on their "partisan political views," while fewer, 40 percent, expect their decisions to be rooted primarily "on the basis of the law" (Barnes and Clement, 4/11).

ABC: New Low In Support For Health Law; Half Expect Justices To Go Political
Last month's hearings on the constitutionality of health care reform didn't help its popularity: Public support for Barack Obama's signature domestic legislation has hit a new low in the latest ABC News/Washington Post poll, with criticism of the individual mandate as high as ever. Half the public, moreover, thinks the U.S. Supreme Court will rule on the legislation on the basis of the justices' partisan political views rather than the law. Fewer, 40 percent, think impartial legal analysis will carry the day, with the rest unsure. Fifty-three percent of Americans now oppose the law overall, while just 39 percent support it -- the latter the lowest in more than a dozen ABC/Post polls since August 2009 (Holyk, 4/11).

The Associated Press: Supreme Court Misunderstanding On Health Overhaul?
A possible misunderstanding about President Barack Obama's health care overhaul could cloud Supreme Court deliberations on its fate, leaving the impression that the law's insurance requirement is more onerous than it actually is. During the recent oral arguments some of the justices and the lawyers appearing before them seemed to be under the impression that the law does not allow most consumers to buy low-cost, stripped-down insurance to satisfy its controversial coverage requirement. In fact, the law provides for a cheaper "bronze" plan that is broadly similar to today's so-called catastrophic coverage policies for individuals, several insurance experts said (Alonso-Zaldivar, 4/11).

The Associated Press/Chicago Tribune: Misconceptions Seen In Health Care Reform Arguments
During the recent oral arguments some of the justices and the lawyers appearing before them seemed to be under the impression that the law does not allow most consumers to buy low-cost, stripped-down insurance to satisfy its controversial coverage requirement. In fact, the law provides for a cheaper "bronze" plan that is broadly similar to today's so-called catastrophic coverage policies for individuals, several insurance experts said (4/10).

Also, Health and Human Services Secretary Kathleen Sebelius will be in Wisconsin today to talk about the law --

MSNBC: Health And Human Services Secretary Visits Wisconsin
The Health and Human Services Secretary is visiting Milwaukee to meet with senior citizens. Secretary Kathleen Sebelius is expected to discuss President Barack Obama's health care overhaul and Medicare at the Washington Park Senior Center Wednesday morning. The overhaul is the signature domestic achievement of Obama's term and already a prominent source of debate in the presidential campaign. It's now being considered by the Supreme Court. The justices will decide whether to strike down part or all of the law, including its centerpiece requirement that nearly all Americans carry insurance or pay a penalty (4/11).

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Hospitals Step Up Efforts To Control Spending

The Fiscal Times: Hospitals Launch New Push To Slash Labor Costs
Faced with the prospect that the Affordable Care Act's Medicare cost control measures will remain in place even if the Supreme Court rules its individual mandate and other insurance reforms are unconstitutional, hospital and physician groups are stepping up their efforts to control spending with a special emphasis on limiting labor costs. The pressure has become especially acute in states like Arizona, where the leading hospital system now treats more patients on low-paying Medicaid than those who have private insurance. Arizona has been hit hard by the downturn in real estate and other lingering after effects of the Great Recession (Goozner, 4/10).

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Administration News

The White House Reacts To Claim That Health Law Would Add To Deficit

The White House criticized the findings of a report by a conservative economist who serves as a trustee overseeing Medicare and Social Security finances, saying they represented a partisan analysis.

Politico: Battle Brewing Over Cost Of Health Care Law?
A GOP trustee on the board overseeing Medicare financing is set to release a report on Tuesday concluding that the health care law will add $340 billion in costs, The Washington Post reports. The report, by conservative policy analyst Charles Blahous, spurred the White House late Monday night to issue a prebuttal of sorts, claiming Blahous is using some form of "new math" and that the law will actually decrease the deficit. "In another attempt to refight the battles of the past, one former Bush Administration official is wrongly claiming that some of the savings in the Affordable Care Act are 'double-counted' and that the law actually increases the deficit. This claim is false," Jeanne Lambrew, deputy assistant to the president for health policy wrote in a White House blog post (Slack, 4/10).

ABC: White House Blasts Obama-Appointed Republican Health Care Economist
The White House has unleashed a torrent of criticism on a leading conservative economist  -- approved by President Obama in 2010 as a Republican trustee overseeing Medicare and Social Security finances -- for concluding in a new study that the Affordable Care Act will add to the deficit instead of reduce it. Charles Blahous, a former economic adviser to George W. Bush on retirement security issues and deputy director of the National Economic Council, says in a report released today that, contrary to other independent estimates, the health law will add $340 billion to the deficit (Dwyer, 4/10).

Politico Pro: W.H. Blasts Claim That ACA Will Add To Deficit
The White House hit back hard Tuesday against a report by a Republican Medicare trustee that argues the health care reform law will add between $340 billion and $530 billion to the deficit over the next decade. White House press secretary Jay Carney said the study was "obviously a partisan analysis" and pointed out that the report's author, Chuck Blahous, served as an economic adviser to President George W. Bush. He said President Barack Obama does not agree with Blahous’s views even though he named Blahous to the Medicare Board of Trustees (Feder, 4/10).

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Capitol Hill Watch

Families USA: Ryan Budget Health Cuts Would Tally $3 Trillion

The Hill: Report: Health Cuts In Ryan Budget Would Approach $3 Trillion
Health care cuts in House Republicans' budget -- not including their controversial Medicare overhaul -- would add up to nearly $3 trillion, according to a new report from the advocacy group Families USA. Families USA, a prominent supporter of President Obama's health care law, tallied the state-by-state cost of changes proposed in Rep. Paul Ryan's (R-Wis.) budget outline, which passed the House with only 10 Republican defections (Baker, 4/10).

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Public Health & Education

IOM Report: Tax Medical Care, Double Public Health Spending

An Institute of Medicine panel recommended a new tax on medical care to generate more funding for public health initiatives to help prevent disease.

The Wall Street Journal: Report Urges New Tax On Medical Care
An influential federal advisory body called for levying a new tax on medical care to finance improvements to public-health services in the U.S. A report Tuesday from the Institute of Medicine says the U.S. health system has a "fixation" on clinical care, or treating people when they get sick, rather than preventing them from getting ill in the first place. More money from reliable sources is needed to fix the problem, said the report, which calls for the U.S. to close a gap in life expectancy with other high-income nations within 20 years (Radnofsky, 4/10).

NPR: Panel Proposes A New Tax To Pay For Public Health
It may sound counterintuitive, but a panel of experts from the Institute of Medicine has concluded that the best way to slow the nation's breakneck spending on medical care is to impose a tax on every health care transaction. That tax -- amount TBD, but possibly a half-percent or so -- would go to replenish the coffers of the nation's state and local public health agencies. In so doing, according to the IOM panel, the public health workforce could renew its historic role in looking at population rather than individual health care, and thus "offer efficient and effective approaches to improving the nation's health" (Rovner, 4/10).

The Hill: Report Calls For Doubling Nation's Public Health Spending
The United States spends more on health care but lags behind the rest of the industrialized world in life expectancy and childhood mortality because the government "chronically" underfunds public health systems, the Institute of Medicine argues in a new report out Tuesday. The report calls for doubling federal spending on public health from $11.6 billion to $24 billion a year "as a starting point to meet the needs of public health departments." The report points out that Americans spent $8,086 per person in medical care in 2009 versus $251 in public health spending (Pecquet, 4/10).

Modern Healthcare: IOM Urges HHS To Set New Life-Expectancy, Health-Spending Goals
HHS should set new goals for life expectancy and per-person health spending in the U.S. to help the country achieve better health outcomes, according to new study from the Institute of Medicine. Those recommendations are among several the IOM included in a 236-page report that is the third and last in a series related to public health. In 2009, the Robert Wood Johnson Foundation asked the IOM to establish a committee that would evaluate measurement, the law, and funding about public health (Zigmond, 4/10).

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Campaign 2012

Santorum -- Who Propelled Criticism Of Romney's Health Law Record -- Suspends Race

The former Pennsylvania senator didn't immediately endorse his opponent. Meanwhile, Politico details Newt Gingrich's latest comments comparing health care and makeup.

The New York Times: For Santorum, a Hard Road to Harmony With Romney
For more than four months, (Rick) Santorum has been the public face of the most searing assessments of (Mitt) Romney’s character and record. And despite Mr. Santorum’s decision to suspend his campaign Tuesday, it will take time for that acerbic commentary to fade. ... Mr. Santorum called Mr. Romney "uniquely disqualified" to be the Republican nominee because of his health care record. "He created the blueprint for Obamacare and advocated for exactly what Obamacare is, which is a mandated health insurance program," Mr. Santorum said (Shear, 4/11).

Politico: Newt: Health Care Is Just Like Makeup
From the file of strange analogies on the campaign trail, Newt Gingrich told a group of North Carolina high school students yesterday that modern health care is just like applying makeup: Gingrich told the students the more scientists knew about individuals, the more personalized heath care should be. Gingrich went into detail about skin tones and hair color, possibly taking tips from his wife, Callista, who was campaigning alone in New York City. "Think about it, if you're going to go out on Friday and you're going to put on makeup, each of you has a different skin tone and you have different hair color and you may want to create a different effect. If you’re going to church you probably wear one level of makeup, if you're going out on a date, you may wear a different level of makeup. ..." Gingrich said. "We're going to be able to have very personalized medicine, just the way we have personalized makeup" (Schultheis, 4/10).

Meanwhile, in his Utah Senate race, GOP incumbent Orrin Hatch is getting a boost from the nursing home industry.

The Associated Press: Influence Game: Nursing Homes Come To Hatch's Aid
A trade group representing nursing homes has given the Utah Republican Party $175,000 over the past year, money that could help Sen. Orrin Hatch stave off a tea party challenge and win re-election. If he does, and if the Republicans take over the Senate, Hatch stands to chair the committee that has jurisdiction over the tens of billions of Medicare and Medicaid dollars that flow annually to nursing homes (Loftin and Freking, 4/11).

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Berwick: Six Categories Represent 20% Of Nation's Health Care Expenditures

Modern Healthcare: Berwick Targets Waste In Healthcare Expenditures
In an article in the April 11 issue of the Journal of the American Medical Association, Dr. Donald Berwick, former CMS administrator and current senior fellow at the Center for American Progress, and Andrew Hackbarth, an assistant policy analyst for the RAND Corp., listed six categories of waste they say represent more than 20% of the nation's ever-increasing healthcare expenditures... Those six areas—fraud and abuse, poor care coordination, failures of care delivery, overtreatment, administrative complexity and overpricing of services—represent enormous opportunities for cost-cutting and improvement, the authors said (McKinney, 4/10).

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Health Care Fraud & Abuse

Tenet To Pay $43M To Settle Medicare Overbilling Claims

The settlement ends an investigation into allegations the Dallas-based hospital operator overbilled Medicare for treating patients at certain inpatient rehabilitation centers.

The Wall Street Journal: Tenet Healthcare To Pay $42.75 Million To Settle Allegations
Tenet Healthcare Corp. will pay $42.75 million to settle allegations that it overcharged the federal Medicare program, the Justice Department said Tuesday. The deal resolves civil allegations under the False Claims Act that Tenet overbilled for services provided at various inpatient rehabilitation facilities (Kendall, 4/10).

Reuters: Tenet To Pay Almost $43 Million To Settle False Claims
Tenet Healthcare Corp has agreed to pay almost $43 million to settle allegations that it overbilled the federal Medicare health care program for treating patients at certain rehabilitation facilities, the Justice Department said on Tuesday. The company was accused of improperly billing Medicare between May 2005 and December 2007 for treating people at inpatient rehabilitation facilities when they did not qualify for such an admission, the Justice Department said (4/10).

The Associated Press: Tenet Pays $43M To Settle Medicare Billing Inquiry
Hospital operator Tenet Healthcare Corp. has agreed to pay $42.8 million to resolve allegations it overbilled Medicare for the treatment of patients who needed intense inpatient rehabilitation. The Dallas company said Tuesday that the settlement resolves inquiries by the U.S. Department of Justice, Department of Health and Human Services and the U.S. Attorney's Office for the Northern District of Georgia (4/10).

Modern Healthcare: Tenet To Pay $43 Million In Medicare Fraud Settlement
Tenet Healthcare Corp. has agreed to pay a record $43 million to the U.S. Justice Department to settle allegations that from 2005 to 2007, its hospitals overcharged Medicare by admitting patients who did not qualify for costly inpatient rehabilitation services. HHS Inspector General Daniel Levinson said in a statement that the Dallas-based for-profit hospital operator disclosed the overbillings to the federal government as was required under a previous corporate integrity agreement between HHS and Tenet (Carlson, 4/10).

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Coverage & Access

Shinseki: VA Pushing To Improve Vets' Access To Care

New Hampshire Public Radio: VA Secretary Says He Is Pushing For Better Health Care Access For Vets
US Veterans Affairs Secretary Eric Shinseki was in New Hampshire Tuesday to visit the site of the new Veterans Center in Hooksett. The new center, which will be completed in August, is part of an effort by the VA to help Vets gain better access to medical care and mental health counseling. Shinseki also discussed the new mobile Vet Center -- a van which will help Vets in rural New Hampshire and Vermont get connected to medical care through telemedicine and referrals as well as provide mental health counseling on site. Shinseki says a major problem for the VA is the huge backlog of benefit claims. Currently in New Hampshire Vets wait more than 6 months to get their claims processed (Gotbaum, 4/10).

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Global Review Offers Vote Of Confidence For Dental Therapists

A report released Tuesday suggests that, based on a worldwide review, dental therapists could help the U.S. address some of its difficulties with access to dental care.  

Medscape: Dental Therapists Supported By Large Kellogg Review
A review of more than 1100 reports from around the world suggests that dental therapists have offered safe and cost-effective dental care in most countries where they practice. … Kellogg and other philanthropic and public health organizations argue that midlevel providers (those with skills between those of dentists and hygienists) should be licensed more broadly in the United States because they would make dentistry more affordable by charging less than dentists for their services. The American Dental Association and many other organizations of dentists have opposed licensing anyone other than dentists to prepare or extract teeth or do any other irreversible procedure, arguing that only dentists are trained well enough to do these procedures safely (Harrison, 4/10).

Kaiser Health News: Capsules: Study: Dental Therapists Thrive On A Global Scale
Today a report released by the the W.K. Kellogg Foundation looks at 26 nations and territories' experiences with mid-level dental therapists, and found that they provide good quality, cost-effective care and, in many countries, provide improved access to care for children (Kulkarni, 4/10).

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State Watch

State Roundup: Calif. Essential Benefits Bill Progresses; Where Are The Doc Waits

A selection of health policy news from California, Arizona, New York, Iowa, Florida and Minnesota.

California Healthline: Essential Health Benefit Bill Clears Committee
[California Assemblyman Bill Monning, chair of the Assembly Committee on Health] introduced AB 1453, which laid out a plan for what essential benefits will be covered in California under the Affordable Care Act. The proposed set of benefits is modeled on the Kaiser small group HMO plan. … The federal government requires states to choose essential benefits in 10 broad categories. In California, that process looked daunting because of the many health care mandates passed by the Legislature, including coverage of autism. This package includes all current California mandates -- including autism coverage -- and everything in the package fits the federal profile as well, which means there would be no extra mandate costs to the state, Monning said. … The bill passed committee, and now heads to Appropriations (Gorn, 4/11).

Reuters: Arizona Lawmakers Vote To Ban Late-Term Abortions
Arizona state lawmakers gave final legislative approval on Tuesday to a bill that would ban most abortions after 20 weeks of pregnancy, handing Republicans their latest win in ongoing national efforts to impose greater restrictions on abortion. The measure, passed in the state House of Representatives by a 37-22 vote, would bar health care professionals from performing abortions after 20 weeks, except in the case of a medical emergency. The bill now goes to the state's Republican governor for approval (Schwartz, 4/10).

The Associated Press: Ariz. House OKs Ban On Abortions After 20 Weeks
The Arizona Legislature has approved an anti-abortion bill that includes generally banning abortions after 20 weeks of pregnancy. The House's vote of 37-22 on Tuesday sends the bill to Gov. Jan Brewer, a Republican who has signed previous anti-abortion legislation (Davenport, 4/10).

The New York Times: Even Without New Contracts, Many Public Employees Get Raises
In Westchester County, where all eight labor contracts have expired, the executive, Robert P. Astorino, a Republican, has sought to have union members pay a share of their health care costs. But in December, the county's largest union, the Civil Service Employees Association, balked and declared negotiations at an impasse (Hakim, 4/10). 

Fox Business: Where Do Patients Wait The Longest?
According to a recent analysis by Vitals.com of more than 700,000 physicians' offices, Wisconsin doctors have the shortest average wait time of 15 minutes. Patients in Mississippi face the longest time with 25 minutes and four seconds of flipping through magazines, filling out forms and trying not to catch the cold of the person next to you (Fuscaldo, 4/10).

Arizona Republic: 7 Arizona Doctors Lose Medicaid Contracts
The state's Medicaid program said it has terminated the contracts of seven doctors who were top prescribers of powerful pain pills and mental-health prescription drugs. Their dismissals were made public as the result of an ongoing probe by U.S. Sen. Charles Grassley, R-Iowa, of drug-prescribing patterns in Medicaid programs across the country. Medicaid programs, which provide health care to the nation's poor, reimburse doctors and practitioners. Grassley's probe centers on health-care professionals who prescribe large amounts of pain pills and psychiatric drugs (Alltucker, 4/10).

Des Moines Register: Communication Is Key To Better Health Care
Patients and health care providers can learn ways to better communicate with each other as part of the state’s first-ever health literacy conference this week. ... Iowa Health Systems has worked on health literacy since 2003 and joined forces with other organizations to form Health Literacy Iowa about 18 months ago. Iowa Health has teams raising health literacy awareness among all staff to improve the care environment and make patients feel comfortable asking questions (Villanueva-Whitman, 4/10).

Sunshine State News/News Service of Florida: Appeals Court Rejects Huge Award in Tobacco Death Case
An appeals court Monday rejected a North Florida jury's call for R.J. Reynolds Tobacco Co. to pay $79.2 million to the daughter of a dead smoker -- overturning what could have been the largest verdict in a barrage of lawsuits against cigarette makers (Saunders, 4/10).

Pioneer Press: Minnesota Blue Cross Announces Executive Appointments
Blue Cross and Blue Shield of Minnesota announced Tuesday, April 10, a series of new executive appointments to its leadership team. Among other changes, James Eppel becomes the company's chief operating officer, the Eagan-based health insurance company said. Eppel previously served as the company's senior vice president of health management and commercial markets (Snowbeck, 4/10).

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Editorials and Opinions

Viewpoints: Santorum Pushed Romney On Health Care; GOP's 'Classic Male Mistake'; ACOs And The Anti-Trust Challenge

The Wall Street Journal: Santorum's Strong Run
The Pennsylvanian was also by far the most effective Republican critic of RomneyCare. When he stood on stage in a debate and took apart the Massachusetts health law as a prototype for ObamaCare, Mr. Romney realized he couldn't coast to the nomination. That's when the former Massachusetts Governor came out with his own tax cut and tax reform plan to appeal to economic conservatives (4/10).

Boston Globe: Court Women Voters With Facts, Policy
The GOP is making a classic male mistake. As they try to repair their party's rocky relationship with women, Republicans are launching a charm offensive rather than addressing the issues responsible for the tensions. ... What really matters is what a candidate and his party stand for. And that's a problem at both the presidential and the senatorial level. I'm not talking just about flashpoints like the recent controversy over insurance coverage for contraception. Or, for all the attention it gets, abortion, where there really isn't much of a gender gap (Scot Lehigh, 4/11).

The New York Times: Double Dose Of Harm
House Republicans combined two ill-conceived health care measures into a single bill and passed it on a largely party-line vote last month. One measure repealed an independent board that is one of the major cost-control measures in the health care reform law. The other imposed restrictions on medical malpractice awards that would limit the ability of patients who have been grievously harmed to receive fair compensation for their injuries (4/10).

Los Angeles Times: Healthcare: An Emergency Care Mandate Isn't Enough
In his April 8 Op-Ed article on the individual mandate, the aspect of the federal healthcare reform law that requires everyone to have coverage, William Voegeli advances a false dichotomy. He states that while it may be legitimate to require people to carry health insurance that would cover the costs of their care were they to be hit by a bus, it is illegitimate to require them to carry insurance coverage that will cover substance abuse treatment or dental care for their children (Micah Weinberg, 4/10).

San Jose Mercury News: The Path To Reducing America's Health Care Costs
President Barack Obama's health care reforms offer Americans the best chance to start getting a handle on out-of-control medical costs. If you don't believe the president, then ask the nonpartisan Government Accountability Office. The GAO reported last week that health care costs will go up considerably if the Supreme Court, as expected, rejects the reforms. It would be a shame because these initial reforms are just the first step toward attacking the problem of skyrocketing medical costs, as even the president admits (4/10).

Boston Globe: Health-Care Reform Is No Budget-Buster
The latest attack on the Affordable Care Act, otherwise known as Obamacare, is the claim that its long-term cost has suddenly spiked from around $1 trillion to $1.7 trillion. Because the new figure is plucked from a March Congressional Budget Office estimate, opponents of the law contend that the agency's analysis shows it will be a budgetary disaster. But as with so many assertions by critics of Obamacare, this one is misleading. Or as the CBO puts it: "Some of the commentary . . . has suggested that CBO and [the Joint Committee on Taxation] have changed their estimates of the effects of the ACA to a significant degree. That's not our perspective" (4/11).

Houston Chronicle: Obama Is Wrong On Facts, Law In Health Reform Case
If the Supreme Court concludes that Obamacare similarly exceeds Congress' authority under the Commerce Clause, it won't break any new ground. Instead, the court would be taking seriously its duty to uphold the constitutional limits on Congress' authority. The high court should ignore the president's badgering and fulfill its duty to preserve the constitutional framework that has long protected all Americans against excessive encroachments by the executive and legislative branches of government (Greg Abbott, 4/10).

Milwaukee Journal Sentinel: Health Care Law Has Already Helped Millions
Since the health care law took effect, millions of Americans already have begun to benefit. And that's especially true for seniors…. Here's the best news: Even as Medicare is getting stronger, many beneficiaries have seen their premiums fall (Kathleen Sebelius, 4/10).

Archives of Ophthalmology: Comparative Effectiveness: Insights On Treatment Options For Open-Angle Glaucoma
While the Patient Protection and Affordable Care Act has made comparative effectiveness research well known and establishes a framework for federal involvement, funding, and oversight, the law does not address how research results should be incorporated into medical practice. Without translation, comparative effectiveness research represents an unfulfilled promise for improving quality of care, while reducing our nation's health care expenditures, which are the highest per capita in the world. As we wrestle with the evolving changes in the health care environment during the next few years, ensuring that we have usable data including costs to help guide decision making among treatment alternatives becomes ever more important (Alan R. Morse and Dr. Paul P. Lee, 4/10).

Journal of the American Medical Association: Accountable Care Organizations And Antitrust
Accountable care organizations represent a major experiment in health care delivery and financing. Two major questions remain unanswered. How can clinical integration be encouraged while preventing excessive antitrust risk; and how can cost shifting from federal to private payers be mitigated? ... A significant challenge will be in those instances for which there is evidence of increased prices due to market power of large ACOs but also evidence of increased efficiencies in care coordination and patient experience with their care (Richard M. Scheffler, Stephen M. Shortell and Gail R. Wilensky, 4/11).

Journal of the American Medical Association: Eliminating Waste In US Health Care
The need is urgent to bring US health care costs into a sustainable range for both public and private payers. Commonly, programs to contain costs use cuts, such as reductions in payment levels, benefit structures, and eligibility. A less harmful strategy would reduce waste, not value-added care. The opportunity is immense (Dr. Donald M. Berwick and Andrew D. Hackbarth, 4/11).

Los Angeles Times: LA Moves The Needle
The first cases of HIV identified anywhere in the world are widely thought to have been in Los Angeles in 1981. Since then, 45,000 Angelenos have contracted HIV and nearly half have died due to the disease. As terrible as that statistic is, we can look back over the last 30 years with considerable pride because Los Angeles' courageous response to the epidemic also saved many lives. We now know how much worse things would have been had local elected leaders not braved controversy to support one of the most effective HIV prevention tools we have: needle exchange (Shoshanna Scholar, 4/10).

The New York Times: Room For Debate: Why Do Americans Balk At Euthanasia Laws?
Why is euthanasia more controversial in the United States than, for instance, in the Netherlands? What would need to change before the U.S. would legalize physician-assisted suicide? (4/10).

The Kansas City Star: 'Pink Slime' And Our Cheap Beef Economy
To the legion of Americans running away from a hamburger additive as fast as a startled Angus, Kansas Gov. Sam Brownback is here to tell you: "It's beef, dude." Technically, he’s right. … But dude, we're talking about salvaged scraps, simmered at low heat and spun at high speed to remove the fat, then spritzed with ammonia to kill bacteria. It may pass bureaucratic muster, but it's not what consumers are used to thinking of as beef (Barbara Shelly, 4/10).

The Kansas City Star: Combined Police, City Health Plan Will Save KC Millions
Give Police Chief Darryl Forté of Kansas City credit for helping push through approval of a unified health insurance plan with City Hall over the objections of some of his officers and command staff. Forté fortunately isn't a defender of the status quo in the Police Department, a world in which police consider themselves special without the obligation to cooperate with city officials. Instead, Forté said Monday that he wants his department to seek out ways to become more efficient (4/10).

The Kansas City Star: Energy Drinks Healthy? Hardly!
As a practicing dentist in Kansas City for 25-plus years, I've become increasingly alarmed by widespread decay in the under-30 set. Far too young for unnecessary dental bills, pain, infection and potential loss of teeth. … According to a study in the journal Dentistry, teeth soaked in energy drinks for 14 days fared worse than teeth soaked in fitness water, soft drinks and other beverages. Of all the drinks in the experiment, the highest acidity levels are found in energy drinks (Ellen Sheridan, 4/10).

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Stephanie Stapleton

Andrew Villegas

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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.