Daily Health Policy Report

Wednesday, April 18, 2012

Last updated: Wed, Apr 18

KHN Original Reporting & Guest Opinion

Capitol Hill Watch

Health Reform


Campaign 2012

Health Care Marketplace

State Watch

Editorials and Opinions

KHN Original Reporting & Guest Opinion

Community Health Centers Under Pressure To Improve Care

Kaiser Health News staff writer Phil Galewitz, working in collaboration with USA Today's Paul Monies, reports: "After doubling the number of patients served in the past decade to more than 20 million people a year, the mostly privately run, nonprofit centers are coming under increased pressure as they gear up for a major expansion under the health care law. Beginning in 2014, about 30 million Americans are expected to gain health coverage, half through Medicaid, the state-federal insurance program for the poor.  Congress authorized $10 billion to expand the centers' capacity on the assumption many of the newly covered would seek care there" (Galewitz and Monies, 4/17). Check out the sidebar, Rural Georgia Center Relies On Educators, Electronic Records To Improve Care (Galewitz, 4/17); a related video; and an interactive chart.

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Health On The Hill: Medicare's Payment Change For Physicians

Kaiser Health News staff writers Mary Agnes Carey and Jordan Rau discuss Medicare's transition to compensating doctors based on the quality of the medical care they provide (4/17). Watch the video or read the transcript.

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Capsules: Smart Shopping Can Relieve Pain From Dentists' Charges

No on Kaiser Health News' blog, consumer columnist Michelle Andrews reports: "Dental coverage often maxes out at just a few thousand dollars a year or less and typically covers only half of the cost of major procedures like crowns and root canals. Getting a reliable estimate of prices in your area can be critical if you want to keep a lid on costs. A free consumer website may provide the information you need" (Andrews, 4/17). Check out what else is on the blog.

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Political Cartoon: 'Convertible Position?'

Kaiser Health News provides a fresh take on health policy developments with "Convertible Position?" by Mike Smith.

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


Did the Supremes look
up from the health law to watch
the shuttle fly by?

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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Capitol Hill Watch

Health Law Part Of Budget Machinations Taking Place On Both Sides Of The Capitol

Senate Budget Committee Chairman Kent Conrad, D-N.D., is rolling out the final budget blueprint of his career. It takes a different position on the health law than the House GOP's measure.

The New York Times: Senate Budget Panel To Take Up Deficit Plan
Unlike the budget plan passed in the House, Mr. Conrad's outline would not touch the president's health care law, but it would phase out the employer tax deduction for health care and include additional health care cuts (Weisman, 4/17).

Politico: Kent Conrad's Budget Signals What's Wrong With Congress
The ideological divide in Congress has stymied [Copnrad's] centrist instincts: Republicans refuse to put tax hikes on the table, and Conrad's fellow Democrats decry any changes to entitlements, like Medicare and Social Security (Wong, 4/18).

Politico Pro: Conrad: Simpson-Bowles Plan Is Bid For Eventual Consensus
The Senate's top budget guru on Tuesday said he's introducing the so-called "Simpson-Bowles" deficit report with hopes of building a bipartisan consensus before the end of the year. ... [The Simpson-Bowles plan includes] cost-sharing for Medicare beneficiaries, cuts to Medicare providers, new policy for so-called "dual eligibles" in Medicare and Medicaid and a long-term "doc fix" (Haberkorn, 4/17).

Meanwhile, on the House side, there's more budget action as Rep. Paul Ryan, R-Wis., defended his plan's treatment of the safety net.

Los Angeles Times: Republicans Approve Paul Ryan's Budget (Again) In The House
GOP leaders are advancing the House Republican budget and its proposed changes to Medicare despite opposition in the Democratic-led Senate by using used a relatively obscure procedural move -- tucking it alongside an unrelated bill that would allow the importation of trophy polar bears (Mascaro, 4/17).

The Associated Press: Food Stamps, Federal Pensions Face GOP Cuts
Republicans controlling the House are targeting food stamps, federal employee pensions, tax breaks for illegal immigrants and subsidies under President Barack Obama's health care law in a multifaceted drive to swap cuts to domestic programs for big Pentagon cuts scheduled next year (Taylor, 4/18).

CQ HealthBeat: Welfare Overhaul Points The Way For New Changes To Safety Net, Ryan Says
Rejecting President Obama’s recent charge that his budget plan amounts to "social Darwinism," House Budget Committee Chairman Paul D. Ryan said at a hearing on Tuesday that the welfare system overhaul of the 1990s demonstrates that new changes to the safety net need not harm poor people. Ryan said that his House-passed budget, which would convert Medicaid into a block grant program, "treats all Americans with respect and dignity" (Reichard, 4/17).

Modern Healthcare: Ryan Defends Budget At Safety Net Hearing
But in his opening remarks, Rep. Chris Van Hollen (D-Md.) said work incentives that led to welfare reform in 1996 are not relevant to Medicaid in particular. “First, it is a program that provides healthcare coverage to those left behind by the private insurance market,” Van Hollen said. “Second, two-thirds, or 66%, of Medicaid spending is for senior citizens and people too disabled to work, while another 20% is for children" (Zigmond, 4/17).

The Hill: House Panel To Save $43.9 Billion On Health Law Subsidies
The tax-writing House Ways and Means Committee will mark up legislation on Wednesday that saves $43.9 billion over a decade by requiring people to pay back any excess insurance subsidies they receive under President Obama's healthcare reform law, the panel announced Tuesday. ... [Under the Ryan budget] the committee is instructed to identify policies that cut the deficit by $53 billion between 2013 and 2022. Most of those savings would come from requiring people to pay back insurance subsidies if the government determined they received too much based on their income threshold (Pecquet, 4/17).

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Health Reform

Post-SCOTUS Scenario: Could Health Law-Created Jobs Go Away?

News coverage and Republicans are noting the number and type of jobs that have been added to the federal payroll as part of the health law. 

Politico: Jobs, Funding Related To Health Care Law At Risk
If the Supreme Court pulls the plug on health reform, winding it down could be almost as contentious as building it up in the first place. ... It's likely that some in the health reform workforce would get reabsorbed into other Health and Human Services offices, where a number worked prior to the health law's passage two years ago. But some could end up without a job — and without their health benefits (Feder, 4/17).

The Hill: GOP Slams Federal Jobs Created To Implement Obama's Health Law
Republicans argued Tuesday that the Obama administration has hired droves of new bureaucrats to implement the administration's healthcare reform law. The Joint Economic Committee, led by Sen. Jim DeMint (R-S.C.), said Tuesday that the Health and Human Services Department has swelled because of "ObamaCare." Employment at HHS has grown by 11 percent under President Obama, the JEC said (Baker, 4/17).

Meanwhile, on Capitol Hill, there is continued scrutiny of the White House's communications strategy:   

Politico Pro: GOP Moves Ahead On ACA Messaging Probe
Republicans on the House Energy and Commerce Committee said Tuesday that the White House messaging strategy behind the health care reform law is more expansive than publicly known and most of the law was crafted behind closed doors. ... The memo is a sign that Republicans hope to keep the storylines of White House-industry collaboration and secret negotiations alive — and keep reminding the public about it — as an election-year theme (Haberkorn, 4/17).

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Official Provides Details, Dates For PCORI's Research Priorities

The COO of the Patient Centered Outcomes Research Institute offered insights into what appears to be a busy agenda, according to two subscription publications. 

CQ HealthBeat: PCORI Official Forecasts Busy Agenda
The Patient Centered Outcomes Research Institute (PCORI) was created by the 2010 health care law. Its mission is to fund research that will give patients and medical providers better information about what works best in medicine, including studies comparing different ways of caring for or preventing a disease. The institute's COO, Anne Beal, said that before the end of April, PCORI officials will tell the public how it plans to prioritize different types of research (Adams, 4/17).

Modern Healthcare: PCORI Funding Announcements Expected In May
Dr. Joe Selby, PCORI's executive director, Dr. Anne Beal, the organization's chief operating officer, and Lori Frank, a PCORI scientist, co-authored [an article], which appeared in a comparative effectiveness-themed issue of JAMA. In it, they outlined PCORI's previously released national priorities and research agenda, and they also emphasized the need for greater patient and clinician involvement in the research process (McKinney, 4/17).

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Doughnut Hole Is Trouble Spot For Seniors On Heart Drugs, Researchers Find

A study documents that beneficiaries with cardiovascular conditions who reach the annual gap in coverage for prescription drugs, known as the doughnut hole, are more likely to stop taking their drugs because of the costs.

NPR's SHOTS blog: Seniors In Medicare 'Doughnut Hole' More Likely To Stop Heart Drugs
Medicare patients who reach the annual gap in coverage for prescription drugs known as the "doughnut hole" are 57 percent more likely than those with continuous insurance coverage to stop taking drugs for heart-related conditions such as high blood pressure or heart disease. That's the result of a study by researchers from the Harvard Medical School, Boston's Brigham and Women's Hospital, and CVS Caremark, the drugstore chain. It's in the latest issue of the journal Circulation: Cardiovascular Quality and Outcomes (Rovner, 4/17).

MedPage Today: Heart Meds May Get Lost in Part D Coverage Gap
Medicare drug plan enrollees with cardiovascular conditions who enter the so-called doughnut hole without financial backup are at risk of discontinuing their medications, researchers found. Entering the gap in coverage in which Medicare Part D beneficiaries must pay 100% of their drug costs was associated with a 57% greater risk of discontinuing cardiovascular drugs, according to Jennifer Polinski, ScD, MPH, of Brigham and Women's Hospital in Boston, and colleagues (Page, 4/17).

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Campaign 2012

Poll Explores Women's Presidential Election Concerns

A new Reuters/Ipsos Poll found that 52 percent of women surveyed viewed President Barack Obama as stronger on health care, which was the second most pressing election concern. Meanwhile, Michelle Obama makes a pitch to women at a fundraiser.

Reuters: Obama Easily Beating Romney Among U.S. Women: Reuters/Ipsos Poll
Fifty-two percent rated Obama as stronger on healthcare, while only 32 percent said Romney was stronger... A majority of women voters - 51 percent - rated jobs and the economy as their most pressing election concern, by far the most commonly cited issue. Healthcare, at 16 percent, came second (Zengerle, 4/17).

The Wall Street Journal's Washington Wire: Michelle Obama Makes Pitch To Women At A Tennessee Fundraiser
In making her case to women, the first lady also pointed out provisions in the president's health care reform law that help women, including a requirement that  insurers cover mammograms and prenatal care at no extra cost. The law is now under review at the Supreme Court (Lee, 4/17).

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Health Care Marketplace

Supreme Court Ruling Gives Generic Drug Makers A Victory

The Supreme Court handed generic drug companies a victory with its Tuesday decision.

The Wall Street Journal: Supreme Court Sides With Generic Drug Makers
The U.S. Supreme Court handed a victory to generic-drug companies Tuesday, ruling they can file certain legal counterclaims against brand-drug companies in an effort to get their cheaper copycat medicines on the market. The court, in an opinion written by Justice Elena Kagan, ruled unanimously that generic-drug makers should be allowed to challenge the way brand-name manufacturers describe their patents to the Food and Drug Administration (Kendall, 4/17).

Politico Pro: SCOTUS Rules In Favor Of Generic Drug Companies
The U.S. Supreme Court ruled unanimously in favor of generic drug companies Tuesday, giving them a legal weapon to fight overly broad patent claims by brand-name competitors. Generic manufacturers said brand-name companies were hurting their ability to compete by submitting drug applications to the FDA with inaccurate, overly broad patent information. Drug companies must submit patent "use codes," which identify and describe the product, with their application. The FDA doesn't attempt to verify the code information but uses it to approve drug applications (Smith, 4/17).

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Report: More Patients Turning To Social Media For Medical Advice

According to a new report, a third of consumers use social media to seek medical information, leading some to say that providers and insurers should utilize the media more to better interact with patients about their conditions.

Los Angeles Times: Consumers Using Social Media For Medical Information, Report Says
One-third of consumers are using Facebook, Twitter and other social media sites to seek medical information, discuss symptoms and express their opinions about doctors, drugs and health insurers, according to a new report. These latest results from PwC’s Health Research Institute underscore the need for health care providers and insurance companies to engage more with consumers online since they are increasingly making medical decisions based on the information they find there (Terhune, 4/17).

CQ HealthBeat: Report: Social Media Increasingly Influential In Health Care
A patient at the Headache Center at a Philadelphia hospital complained on Twitter about his long wait to be seen. The director of social media at Thomas Jefferson University Hospitals saw the tweet and texted the hospital marketing staff to check out the waiting room. Within minutes they were able to determine the patient hadn't been helped because he hadn't signed in to a computer kiosk. This anecdote, related in a new report on social media and health by consultant PwC, shows just one way in which people's online sharing of health information is increasingly having an impact on medical care (Norman, 4/17).

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State Watch

Texas Asks Feds To Fund Women's Health Program Through October

Texas is asking the federal government to continue funding its Women's Health Program for five more months - through October - to give the state time to take over the program.

The Associated Press: Texas Seeks Fund Extension For Women's Health Plan
Texas officials have asked for more time to phase out federal funding for a women's health program after federal officials said it was illegal for the state to ban Planned Parenthood from participating in it, according to documents released Tuesday. ... Federal officials proposed phasing out funding for the program by September, but Texas' Medicaid director Billy Millwee said Tuesday the state needs more time (Tomlinson, 4/17).

Houston Chronicle: State Says It Is Ready To Take Over Women's Health Program In Nov.
The federal government provides 90 percent of the funding for the existing program, which provides health screening and contraceptives to low-income women. The federal Centers for Medicare and Medicaid Services has said it will phase out that funding following passage last year of a bill that would bar providers affiliated with abortion providers, even if those clinics do not provide abortions. Medicaid rules prohibit such a ban (Fikac and Kever, 4/17). 

The Dallas Morning News: State Asks Feds For More Time To Set Up Women’s Health Program 
The highly respected Women's Health Program costs about $35 million annually and provides cancer, diabetes and cholesterol screenings, as well as contraception, to about 130,000 low-income, uninsured women (Hoppe, 4/17).

The Texas Tribune: Texas Outlines Future Plans for Women's Health Program
So far, HHSC reports that the program has saved the government millions of dollars that would have been spent on Medicaid births. CMS requested the transition plan after it rejected the state’s enforcement of a rule that excludes Planned Parenthood from being part of the program, even though the funding went to Planned Parenthood’s family-planning clinics that do not perform abortions. State officials in the Legislature and Gov. Rick Perry have said their affiliations and willingness to refer patients for abortions are enough to disqualify them from the program (Tan, 4/17).

In the meantime, three Planned Parenthood branches in Texas are mulling a merger --

The Texas Tribune: Texas Planned Parenthood Branches Will Vote on Merger
The boards of three regional Planned Parenthood branches — North Texas, Central Texas and the Capital Region — will vote today on a proposed merger designed to form a $29 million-per-year mega-organization with 26 clinics. ... It would provide birth control for 103,000 people and perform an estimated 8,500 abortions per year, in addition to screening tens of thousands of people for breast and cervical cancers and sexually transmitted infections (Ramshaw, 4/18).

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State Roundup: Mass. Seeks To Improve Medical Malpractice System

News outlets also report on health policy developments from a number of states including Nebraska, Florida, Minnesota, Kansas and California.

Boston Globe: Mass. Hospitals Promise Openness, Apologies
Seven Massachusetts hospitals plan to offer patients harmed by medical errors a prompt apology and financial settlements before they resort to lawsuits, part of a major new initiative to improve the state's cumbersome medical malpractice system. A coalition of physician, hospital, and patient groups planned to release details Wednesday of the initiative, called "Road Map to Reform,"’ which they predict will increase reporting of medical mistakes and cut down on lengthy litigation that drives up health care costs and fuels distrust between caregivers and patients (Kowalczyk, 4/18).

WBUR: Mass. Docs Eye New Approach To Malpractice Claims
Three major hospitals in Massachusetts are launching an experiment aimed at reducing costly malpractice lawsuits and encouraging doctors to acknowledge medical errors. The Massachusetts Medical Society on Wednesday plans to announce the initiative called Disclosure, Apology and Offer. The program calls for hospitals to disclose to patients and promptly investigate possible mistakes (4/18). 

NPR: Unusual Alliances Form In Nebraska's Prenatal Care Debate
In Republican-dominated Nebraska, government leaders often line up together, but lately a political tornado has ripped through this orderly scene. A political showdown over taxpayer funding of prenatal care for illegal immigrants has produced some unusual political splits and alliances in the statehouse of the Cornhusker State (Knapp, 4/18).

Politico Pro: Alabama Official Wins GOP Support On Exchange
An exchange bill is poised to pass the Health Committee of the Alabama House with the support of all its Republican members, according to its sponsor, state Rep. Greg Wren (R-Montgomery). The committee will vote on the bill Wednesday. Last year, Wren's fellow Republicans balked because they wanted to wait for the Supreme Court to act first. This time Wren said he convinced them that enacting an exchange bill is "a safety net" to protect Alabama from a federal exchange if the law is upheld. And he included an automatic sunset provision, which would void the exchange if the Supreme Court strikes the exchange provisions or Congress repeals or defunds them (Feder and Millman, 4/17).

Modern Healthcare: Fla. Governor's Veto List Includes Health Care Funding
Florida Gov. Rick Scott has released his final veto list for the 2012-13 General Appropriations Act, including cuts to health care funding. ... The total 2012-13 budget for health and human services passed by the Legislature was $29.9 billion, of which Scott vetoed items totaling more than $27.5 million. The vetoed items included $3.4 million that would have provided exemptions from inpatient and outpatient reimbursement ceilings for facilities classified as sole community hospitals (Kutscher, 4/17).

(St. Paul) Pioneer Press: At The Capitol: State Senator Seeks Hearing On Commissioner's Handling Of Payment
A state senator is seeking an oversight hearing in the Senate to determine whether the state's human-services commissioner broke laws when responding to inquiries about a $30 million payment last year from a Minneapolis-based HMO.  In a letter distributed Tuesday, April 17, Sean Nienow, R-Cambridge, said commissioner Lucinda Jesson withheld an important July letter from two parties investigating the payment -- the state's legislative auditor and U.S. Sen. Charles Grassley, R-Iowa. Grassley obtained the letter from the Centers for Medicaid and Medicare Services and released it last week. It shows that a federal official at the time believed some of the $30 million paid by the UCare health plan should be shared with the federal government (Snowbeck, 4/17).

Kansas Health Institute News: KanCare Waiver Request To Be Ready Soon, Officials Say
The waiver application needed for Gov. Sam Brownback's proposed Medicaid makeover is nearly complete and could be filed with federal officials before the month is up, Brownback administration officials said today. ... Earlier this year, administration officials told legislators they believed they would not need to file a full application with CMS but instead could negotiate with the agency based on the brief concept paper they submitted in late January outlining the changes they would like to make to the Kansas Medicaid program (Shields, 4/17).

HealthyCal: County Aims to Stop Mental Health Stigma
The first time Stacy Gannon called the cops on herself, she was in the middle of a psychotic delusion. ... In Sacramento County -- where Gannon spent several years cycling in and out of treatment facilities -- the Department of Health and Human Services recently launched Stop Stigma Sacramento, a million-dollar, yearlong anti-stigma program and ad campaign. The program aims to change negative attitudes and false beliefs about mental illness with the help of billboards, radio spots, a speakers’ bureau and a dedicated, multilingual website (Bass, 4/17).

WBUR's CommonHealth blog: 10 Ways That Mass. Payment Reform Could Go Wrong
[Dr. Robert Galvin, the CEO of Equity Healthcare and a nationally known thinker on how to improve health care's] ... nuanced presentation struck me as by no means a blanket endorsement of global payments for everyone, everywhere. In fact, there was a decidedly Cassandra-like tone to it. He warned about the dangers of a "one size fits all" mentality, and of letting health care institutions get "too big to fail" (Goldberg, 4/17). 

St. Louis Beacon: New Program Lowers Health Care Costs For Needy
Like many other independent contractors, Doug Mitchell and Susan Gottschall say they earn enough to pay their bills but not enough to afford health insurance. But their access to affordable medical care may be about to change. Over the weekend they heard about a new program through which some local health centers will allow certain uninsured St. Louis and St. Louis County residents to get access to health services at unbelievably inexpensive rates — ranging from 50 cents to $3 for doctor visits, dental visits and generic prescription drugs (Joiner, 4/17). 

The Wall Street Journal: Mississippi Law Tightens Requirements For Abortion Providers
Mississippi enacted a law Monday that calls for strict new requirements for abortion providers, the latest of several recent state laws pushed by abortion opponents. The law, signed by Gov. Phil Bryant, requires doctors performing abortions to have admitting privileges at a local hospital and to be board-certified in obstetrics and gynecology or be eligible to be certified, meaning the physician has completed training in the specialty. It is set to go into effect July 1 (McWhirter and Mathews, 4/17).

Arizona Republic: Cardiologists Fined $100,000 For Internet Privacy Violations
The federal government has fined a Phoenix and Prescott cardiac surgeon medical practice $100,000 for posting patients' clinical and surgical appointment information on an Internet calendar that was available to the public. Phoenix Cardiac Surgery has agreed to pay the penalty to settle the Health Insurance Portability and Accountability Act (HIPAA) violations and take steps to safeguard the health information of its patients, according to the Department of Health and Human Services (Alltucker, 4/17).

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Editorials and Opinions

Perspectives: What Is The Role For Comparative Effectiveness Research?

The Journal of the American Medical Association devoted this week's issue to the topic of comparative effectiveness and how it should be used in medicine.

Journal of the American Medical Association: Is It Time For Medicine-Based Evidence?
Although (evidence-based medicine) involves finding as well as evaluating evidence, and even though more recent considerations of EBM have modified prior rigid approaches, a generation of clinicians has been taught that randomized controlled trials (RCTs) can find truth, whereas observational studies are inherently flawed. ... In a medicine-based evidence approach, the primary emphasis is on clinically relevant issues of who and where were the patients, what and why were the treatments, and when and how were the outcomes assessed—as well as an assessment of validity and generalizability considered together and denoted as accuracy. Thus, in contrast to an emphasis in EBM on hierarchies of research design, medicine-based evidence is both rigorous and patient-centered (Dr. John Concato,4/17).

Journal of the American Medical Association: Comparative Effectiveness Research
Comparative effectiveness research is not new, even if the term is, but the enthusiasm and funding directed toward CER are well placed. ... Yet, whatever it is called, and whether based on RCTs, observational studies, decision analyses, or other research methods, the basic tenets of making comparisons between viable options rather than inappropriate but marketable comparisons with placebo, trying to estimate effect sizes in realistic settings, and ensuring that the patient perspective is incorporated in research and in treatment, are paramount (Drs. Robert M. Golub and Phil B. Fontanarosa, 4/17).

Journal of the American Medical Association: The Patient-Centered Outcomes Research Institute (PCORI) National Priorities For Research And Initial Research Agenda
The proposition that greater involvement of patients, clinicians, and others in the research process could help reorient the clinical research enterprise, reduce clinical uncertainty, and speed adoption of meaningful findings holds great promise, but remains to be tested. PCORI will test this hypothesis. The underlying imperative is to improve patients' care experience, decision making, and health outcomes (Dr. Joe V. Selby, Dr. Anne C. Beal and Lori Frank, 4/17).

Journal of the American Medical Association: Risk Models And Patient-Centered Evidence
A fundamental contradiction of evidence-based medicine (EBM) is that evidence is derived from groups, whereas medicine is applied to individuals. Inferring individual effects from average group effects is an example of the fallacy of division. Even in a randomized trial, benefit in a summary result does not imply that the probability of benefitting outweighs the risk of harm for all (or even most) patients within the trial (Dr. David M. Kent and Nilay D. Shah, 4/17).

Journal of the American Medical Association: Continuous Patient Engagement In Comparative Effectiveness Research
Experiences with patient engagement in research, including community-based participatory research, suggest that success hinges on patients being interested and emotionally involved in the research question and understanding their role in the (comparative effectiveness research) process (C. Daniel Mullins, Abdulla M. Abdulhalim and Danielle C. Lavallee, 4/17).

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Viewpoints: Insurance Regulation A 'Special Interest'?; Washington's Wrong Health Care Battle; Will The Health Law Turn Us Into Part-Time Employees?

Los Angeles Times: Insurance Regulation: Who're You Calling A 'Special Interest?'
It takes a certain amount of chutzpah to name a group that opposes government oversight of health  insurance premiums "Californians Against Higher Healthcare Costs." Especially when the group includes the trade associations for doctors and hospitals, two sets of Californians who've contributed mightily to the high cost of health care (Jon Healey, 4/17).

Bloomberg: Washington Stuck Fighting Wrong Health Care Battle
Last week, the Altarum Institute, a research organization based in Ann Arbor, Michigan, reported that the moderation in the growth of health-care costs we have seen over the past few years is continuing: Total health spending rose by less than 4 percent from February 2011 to February 2012. And it’s encouraging to see the progress that doctors, hospitals and other providers are making to improve the value of care ... Instead of examining these changes and finding ways to encourage them, the Washington policy discussion continues to demonstrate its ability to, well, it’s not clear exactly what it does (Peter Orszag, 4/17).

Politico: Combine The Best Of Obama-Ryan, Bowles-Simpson
An ironic consequence of the dueling fiscal plans put forward this year by President Barack Obama and House Budget Committee Chairman Paul Ryan (R-Wis.) is that, taken together, they illustrate why Erskine Bowles and former Sen. Alan Simpson had it right back in December 2010. … No one can expect to get everything they want — with the other side making all the concessions. Moreover, those compromises must involve the thorniest points of contention: health care, Social Security and taxes. They must also add up to substantial and sustained deficit reduction, not just a temporary fix (Robert Bixby, 4/17).

Fox News: Will Obama Care Turn Us Into A Nation Of Part-Time Employees?
As the Supreme Court ponders whether the Obama administration can constitutionally take over the private sector when it comes to health care -- and then order all Americans to buy health insurance -- an unintended consequence is lurking in the government’s unemployment figures. Plagued by fears of explosive costs from mandated healthcare, companies are quietly transitioning much of the American workforce into a nation of part-time employees (Chuck Bentley, 4/17).

The New York Times: A Deft Health Care Move
The refusal of New York’s Republican-led State Senate to establish a health insurance exchange, as required by the federal health reform law, has left the state in a pickle. Gov. Andrew Cuomo was wise to step in with an executive order that will accomplish much the same purpose (4/17).

Minneapolis Star Tribune: Agency Plods On Consumer Info Law
The Obama administration can make up for its fumbled rollout of a landmark consumer protection law -- the Physician Payments Sunshine Act -- by moving swiftly to ensure that national tracking of lucrative industry payments to doctors begins before the end of this year. … The agency owes consumers, as well as drug and device firms, a timetable and an explanation for the delay. Minnesota, a medical-device epicenter, has a critical interest in timely guidance so companies can prepare to follow the new law (4/17).

Boston Globe: Prescription For National Health: Get Patients To Take Their Medicine
Two respected Boston-based institutions recently published articles touching on one of the most expensive problems in health care. They were not describing the wonders of a new drug or a "silver bullet" policy initiative to reduce costs. Rather, they explored something surprisingly basic: getting people to take their medicine. Hospitals today are filled with individuals who could have avoided an in-patient stay if only they had taken their medications as prescribed (Harris A. Berman and Michael Rosenblatt, 4/17).

The Philadelphia Inquirer: Cigarette Labels Should Tell The Truth
When Congress gave the Food and Drug Administration regulatory power over tobacco products, the industry actually promoted the plan. But that support seems to have lasted about as long as a typical smoke break. … Now the tobacco companies are in a pitched legal battle with the FDA over the sensible plan that takes effect this fall to require graphic warnings on half of every cigarette pack, front and back, as a reminder of the deadly consequences of tobacco use (4/18).

Journal of the American Medical Association: Ask Me If I Cleaned My Hands
Indeed, if people like my friend the medical educator or my friend the senior surgeon are reluctant to intervene, how could anyone possibly imagine that patients who are sick and vulnerable can advocate for themselves? The problem of hand cleaning needs to be the primary responsibility of those who work in health care. And I have two ideas about how health care personnel can help each other as well as their patients (Suzanne C. Gordon, 4/17).

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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.