Daily Health Policy Report

Monday, May 14, 2012

Last updated: Mon, May 14

KHN Original Reporting & Guest Opinion

Health Reform

Campaign 2012

Capitol Hill Watch

Medicare

Health Care Marketplace

Coverage & Access

Public Health & Education

State Watch

Editorials and Opinions

KHN Original Reporting & Guest Opinion

Doctors And Insurers Are Key To Fighting Obesity

Reporting for Kaiser Health News, in collaboration with The Washington Post, Judith Graham writes: "Just over 40 percent of adult patients in commercial HMOs had documented BMI measurements in 2009 and 2010, according to a survey by the National Committee for Quality Assurance, an organization that evaluates health plans. That figure falls to 12 percent for patients in commercial PPOs, a more common type of plan" (Graham, 5/12). Read the story.

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Political Cartoon: 'Sticker Shock'

Kaiser Health News provides a fresh take on health policy developments with "Sticker Shock" by Steve Kelley and Jeff Parker.

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

WHO THINKS THIS TIME MIGHT BE DIFFERENT?

Ditch the SGR?
There is now a proposal.
Is the 'doc fix' in?
-Anonymous

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

Rule Requires Insurers To Credit Health Law When Issuing Consumer Rebates

The rule, which was finalized Friday, will result in an estimated $1.3 billion in rebates for nearly 16 million Americans.

The Wall Street Journal: Insurers Must Credit Rebates To Health Law
Health-insurance companies must tell customers who get a premium rebate this summer that the check is the result of the Obama administration's health-care law, according to federal guidelines released Friday. The move is the latest sign the Obama administration is trying to draw attention to the law's benefits before the fall elections, even though the law faces an uncertain future (Radnofsky, 5/11).

The Hill: Report: Health Law Rule To Yield $1.3 Billion In Insurance Rebates
A rule created by the 2010 healthcare law and finalized Friday will yield about $1.3 billion in insurance rebates for nearly 16 million Americans, according to estimates by the Kaiser Family Foundation. The rule, known as the medical loss ratio (MLR), mandates that insurers spend roughly 80 percent of all premiums on healthcare rather than on marketing, executive bonuses or other administrative costs (Viebeck, 5/11).

Modern Healthcare: Insurers Must Also Report When They Do Meet MLR Target, Rule Says
The notice may be sent in the same mailing with other notices—and may be provided electronically—but it must be displayed in 14-point, bold type on the front of the plan document, insurance policy or certificate, or in a separate notice, the regulation noted (Zigmond, 5/11).

Related, from KHN: Final Rule Issued On Consumer Rebates And Notification (Appleby, 5/11)

Other health law implementation news includes reports that some states are dragging their feet on health exchanges, but members of Congress may find themselves using these marketplaces -

The Washington Post: Republican State Officials Stall On Setting Up Health Insurance Marketplaces
In about two dozen states across the country, the insurance marketplaces at the heart of the 2010 health-care law remain in limbo, with Republican governors or lawmakers who oppose the statute refusing to act until the Supreme Court decides its constitutionality (Aizenman, 5/12).

The Washington Post: As Maryland Goes Full Steam Ahead On Health Reform Law, Virginia Takes Pragmatic Path
Although deep-blue Maryland remains a leader among states enthusiastically preparing for the health-care overhaul, Republican-led Virginia is no longer the standard-bearer for “Obamacare” recalcitrance. ... Virginia has been grudgingly but diligently laying the foundation for a law that it hopes will go away (Vozzella, 5/12).

The Philadelphia Inquirer: Congress May Get Tough Medicine From Health Bill
In one little-known feature of the law, however, members of Congress would have to leave the generous federal plan and obtain their coverage through online insurance exchanges, or markets, if the law is upheld. The law mandates the establishment of exchanges in each of the states as a means for consumers to shop for health coverage (Mondics, 5/13).

Also, the Post examined ways to meet the ACA's increased demand for health care -

The Washington Post: Nurse Practitioners Look To Fill Gap With Expected Spike In Demand For Health Services
President Obama's health-care law is expected to expand health insurance to 32 million Americans over the next decade. Health policy experts anticipate that the wave of new insurance subscribers will lead to a spike in demand for medical services (Kliff, 5/13).

Lastly, the Los Angeles Times revisits the Solicitor General's year -

Los Angeles Times: Healthcare Case Capped A Rough Year For Solicitor General
His worst moment came as he rose to defend President Obama's healthcare law and its requirement that all Americans have health insurance or pay a tax penalty. His voice sounding weak, Verrilli paused after his second sentence and coughed (Savage, 5/12).

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Campaign 2012

GOP's Medicare Plan Has Some Candidates Playing Defense

The budget plan advanced by Rep. Paul Ryan, R-Wis., has become a hot topic in many congressional races. One example is the Illinois race between Rep. Joe Walsh, a Republican, and Democratic challenger and Iraqi war veteran Tammy Duckworth.

The Washington Post: Ryan Budget Still An Issue In Congressional Races
The issue in question is the budget proposal issued by House Budget Committee Chairman Paul Ryan (R-Wis.), and what it does to Medicare in particular. More than a year after the proposal's initial release, Republican candidates continue to find themselves on the defensive about what the plan will actually do, and Democrats continue to make claims about the dire consequences if it were to become law (O'Keefe, 5/13).

Chicago Sun-Times: In First Debate, Congressional Rivals Walsh And Duckworth Tangle Over Medicare
In the first debate of what could be one of the hottest congressional races in the country, Republican Rep. Joe Walsh and Iraqi War veteran Tammy Duckworth, accused each other of wanting to end Medicare. Walsh voted for Rep. Paul Ryan's budget which Walsh said is the only plan on the table to save Medicare. Duckworth said the Wisconsin Republican's budget "guts" the troubled program. Walsh and Duckworth also clashed on gay marriage and contraception (Pallasch, 5/11).

The Associated Press: Dems, GOP Using Popular Bills To Hurt Other Party
Shortly after the House voted April 27 to approve the GOP student loan bill, paid for by cutting Obama's health overhaul and supported by just 13 Democrats, Republicans sent news releases to dozens of congressional districts. Democrats decided "protecting the Democrats' government takeover of health care was more important than helping future college graduates," the releases said. Democrats argued it was wrong to cut health care programs to keep student loan interest rates from growing (Fram, 5/14).

Meanwhile, the Obama administration continues to focus on the politics of women's health issues -

The Associated Press: Women Ponder How They Became A Campaign Issue
Everybody, it seems, is talking about women in this campaign — what they should do, how they should act, who they should be in society. But do women see themselves reflected in the dialogue — or is the mirror of political rhetoric distorting their concerns? How, exactly, is all this talk about women playing among women? (Arrillaga, 5/12).

Denver Post: HHS Secretary Sebelius Meets With Denver Women To Discuss Health Care
U.S. Secretary of Health and Human Services Kathleen Sebelius sat on a living room couch in a Denver home Friday and discussed preventive care and Colorado's health-exchange program with local women... This is the fifth city this year where Sebelius has held a Women's Living Room Discussion — sessions meant to highlight the beneficial aspects of the Affordable Care Act. The conversation repeatedly circled back to preventive health (Painter, 5/12).

Fox News: White House Pushes ObamaCare-Themed E-Cards For Mother's Day
Not even Mother's Day could be shielded from election-year politics. The White House on Sunday released specially tailored e-cards touting the benefits for moms of the federal health care overhaul, urging people to send the card around to "show some appreciation for the mom in your life." The e-card, posted on the White House website for any and all to download and share, is titled: "Happy Mother's Day From The Affordable Care Act." It goes on to say, "Being a mom isn't a pre-existing condition."…The card says that while insurers before the overhaul could "deny coverage for women with pre-existing conditions like breast cancer or pregnancy," they will be prohibited from denying coverage over any pre-existing condition starting in 2014 (5/13).

The Associated Press: Gay Marriage, Abortion Back In Campaign Spotlight
Abortion and gay marriage. For years, they've been lumped together as the paramount wedge issues of U.S. politics — hot-button topics in the vortex of sexuality, personal freedom and public policy. Yet these two divisive issues, prominent as ever this election season and still firing up the liberal and conservative bases of the two major parties, are evolving in intriguingly different ways. Partisans are taking care not to overstate how much the issues have in common (Crary, 5/12).

And Politico provides additional coverage of the "changing of the guard" at NARAL -

Politico: Changing Of The Guard Amid 'War On Women'
There's a changing of the guard right in the midst of the "war on women." When Nancy Keenan announced Thursday that she will step down as chief of NARAL Pro-Choice America, she made much the same argument that EMILY's List founder Ellen Malcolm did in moving aside at the end of 2010: The women's movement needs fresh blood. So, the baby boomers are out. Sandra Fluke and the Twitterati are in (Allen, 5/11).

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Capitol Hill Watch

Congress Wrestles With Medical Research Funding, FDA Approval Processes

Medical research advocates warn Congress about the dire impact that automatic spending cuts scheduled to take effect in January would have on efforts to control disease and develop life-saving treatments. Also in the news, how the concept of "fast-track" Food and Drug Administration approvals is playing on Capitol Hill.

The Hill: Advocates Warn Automatic Cuts Would Hit Medical Research
Automatic federal spending cuts set to take effect in January would threaten U.S. leadership in the field of medical research, risk the spread of disease and delay treatments for patients, a report out Friday warned. Advocates with Research!America argued that sacrificing research investments for deficit reduction would also be a bad economic move (Viebeck, 5/11).

The Fiscal Times: FDA Cuts A Deal To Fast Track Drugs And Devices
In sections of the bill that deal with regulations at the agency, Congress plans to give companies working on drugs for life-threatening conditions an easier pathway to accelerated approval, a classification created in the early 1990s during the AIDS crisis. Accelerated approval, which is based on so-called surrogate markers that are likely to lead to better outcomes, postpones definitive clinical trials proving effectiveness until after the drug hits the market. ... The device industry achieves its major goals in the bill through subtraction (Goozner, 5/11).

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Medicare

Professional Services Company To Buy Largest Private Medicare Exchange In U.S.

Reuters/Chicago Tribune: Towers Watson & Co To Buy Largest Private Medicare Exchange
Towers Watson & Co , a New York-headquartered professional services company, said on Sunday it would buy Extend Health Inc, operator of the largest private Medicare exchange in the United States, to boost its health benefits offering for employers (Roumeliotis, 5/13).

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Health Care Marketplace

Accretive Gives Detailed Response To Sen. Franken Inquiry

The Minnesota attorney general says the company has some overly-aggressive billing and collection practices.

(St. Paul) Pioneer Press: Accretive Health Issues Report In Response To Minnesota Attorney General’s Allegations
The embattled Chicago firm that was the subject last month of a scathing report by Minnesota's attorney general has issued its own report designed to "set the record straight," the company said Friday, May 11. The 29-page report was released by Sen. Al Franken, D-Minn., because it features answers to a lengthy set of questions he issued last month. Franken questioned Accretive Health after Attorney General Lori Swanson issued her report alleging overly aggressive billing and collection tactics by Accretive Health and one of its local customers, the Fairview health system (Snowbeck, 5/11).

Minneapolis Star Tribune: In Response To Franken Query, Billing Firm Again Denies Pressuring Patients  In a 29-page response to a series of questions posed by U.S. Sen. Al Franken, Accretive almost entirely dismissed Swanson's report, but did offer a caveat. "Several questions ask if Accretive Health is aware of any information suggesting that something occurred. These questions are very broad and could be misread as seeking answers based upon perfect knowledge of the actions of every employee throughout the company," read a footnote in the report (Mitchell, 5/12).

Modern Healthcare: In Letter To Franken, Accretive Denies Violating EMTALA
Collectors had access to an "easily understood description of the diagnosis code” for patients, the company said. Accounting software used by Fairview prior to its Accretive contract taking effect did not restrict access to patient information but the company began to limit its employees' access eight months into the Fairview contract, Accretive said (Evans, 5/12).

Meanwhile --

(St. Paul) Pioneer Press: Fairview U Hospital Visited By Investigators In Wake Of Accretive Furor
The federal agency that runs Medicare is investigating whether the University of Minnesota Medical Center, Fairview violated federal law with its billing and collection practices in the emergency room (Snowbeck, 5/11). 

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Online Information Offers Insights Into Hospitals' Track Records

Los Angeles Times: Hospital Ratings, Track Records Available Online
Using data from government agencies and private watchdogs, several websites provide consumer information on hospitals (Wilson, 5/13).

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Coverage & Access

Health Coverage Changes Prompt Aging, Disabled Care Concerns

NPR examines a new way to combat Alzheimer's -- with storytelling. In the meantime, health care changes to programs and budgets have some worried about how they will affect the aging and those with disabilities.  

NPR: Alzheimer's Patients Turn To Stories Instead Of Memories
Storytelling is one of the most ancient forms of communication -- it's how we learn about the world. It turns out that for people with dementia, storytelling can be therapeutic. It gives people who don't communicate well a chance to communicate. And you don't need any training to run a session (Silberner, 5/14).

HealthyCal: The Health Perils Of Aging: Lonely and Sick
Social isolation and its common offspring -- loneliness -- became a political hot potato when California recently cut back on its adult day health care program, disqualifying 20 percent of the state's older and disabled citizens from its attendance rolls. Families who depended on the centers for medical supervision and social interaction suddenly had to scramble to find new programs to care for these relatives. For seniors with or without families, this often meant more time home alone. ... Loneliness can increase ... blood pressure, limit the body's ability to fight off illness, and has been linked to higher death rates (Perry, 5/13). 

North Carolina Health News: NC Creates A Dilemma For The Grahams
Nancy Graham is 37 and has a developmental disability, the result of a genetic disease called Tay-Sachs, that's slowly eating away at her nervous system. ... The Grahams say they worry about the changes coming to Smoky Mountain Center ... If the Graham's moved Nancy to a nursing home, the state would pay more for her care, and they believe she wouldn't get care that's as good as what they provide. But, the Grahams are being given fewer services to use for Nancy's care because she lives at home (Wilson, 5/11). 

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U.S. Falling Behind In Global Effort To Guarantee Health Coverage

Los Angeles Times: Global Push To Guarantee Health Coverage Leaves U.S. Behind
Even as Americans debate whether to scrap President Obama's healthcare law and its promise of guaranteed health coverage, many far less affluent nations are moving in the opposite direction — to provide medical insurance to all citizens. China, after years of underfunding healthcare, is on track to complete a three-year, $124-billion initiative projected to cover more than 90% of the nation's residents (Levey, 5/12).

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Public Health & Education

Doctors Turn To Blood Pressure Tests In Kids, BMI Tests In Adults To Fight Obesity

Doctors and insurers are considering how best to combat obesity in America including screening kids early via blood pressure checks and using body mass index tests in adults to monitor weight and potential problems.

NPR: Doctors' Due Diligence: Measuring Kids' Blood Pressure
There have been hints that the obesity epidemic's rise has slowed a bit among certain populations, but for the most part, it continues to dominate American health. One third of children and teenagers are now overweight or obese. And researchers forecast as many as half of our nation's population could be obese -- not overweight but obese -- by 2030 (Neighmond, 5/14).

Kaiser Health News: Doctors And Insurers Are Key To Fighting Obesity
Just over 40 percent of adult patients in commercial HMOs had documented BMI measurements in 2009 and 2010, according to a survey by the National Committee for Quality Assurance, an organization that evaluates health plans. That figure falls to 12 percent for patients in commercial PPOs, a more common type of plan (Graham, 5/12). 

Georgia Health News: The Burden Of Obesity: Film Lays It On The Line 
Vivia Armstrong responded to an ad about obesity a couple of years ago. At the time, Armstrong, living in southwest Atlanta, knew all about weight problems. Being heavy is the only kind of life she has ever known. She described her struggle to GHN in an interview (Miller, 5/11). 

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State Watch

Governors Seek Allies For Medicaid, Health Program Budget Cuts, Changes

In response to struggling state budgets, governors in California, Illinois, Kansas and Louisiana are looking for allies to support cuts and changes to their Medicaid and other health care programs.

Sacramento Bee: Brown: California Budget Deficit Rises To $16 Billion
In a gloomy preview of his May budget release, Gov. Jerry Brown said Saturday that California's deficit has mushroomed to $16 billion, nearly $7 billion higher than he last estimated. The Democratic governor blamed a slow economic recovery, as well as federal judges and administrators who blocked cuts to health care for the poor. Brown had previously pegged the deficit at $9.2 billion (Yamamura, 5/13).

The Associated Press/Chicago Sun-Times: Quinn Finds Unlikely Allies In Business Community
Gov. Pat Quinn built his career on populism and consumer advocacy. But, in the middle of what might be his defining political moment, he finds himself in an unlikely alliance with major Illinois business groups in a battle against unions and advocates for the poor. Quinn has proposed sharp cuts in both Medicaid and pensions for government workers to save billions in expenses the state can't afford to pay. In that, he for the most part has the support of the state's business community (Mercer, 5/13).

Kansas Health Institute News: CMS Posts KanCare Proposal, Invites Public Comment 
Gov. Sam Brownback's plan for overhauling the state’s Medicaid program has been posted on the Centers for Medicare and Medicaid Services website. The Thursday posting marks the start of a 30-day public comment period on the CMS website. ... Under KanCare, virtually all the state's 380,000 Medicaid beneficiaries would be auto-assigned to one of three managed care plans run by private insurance companies, starting Jan. 1, 2013 (Ranney, 5/11). 

California Healthline: New Budget to Hit Health Care Programs? 
Now that the state is staring at the business end of a $16 billion deficit -- almost $7 billion greater than January estimates -- many in the health care community are certain that safety-net programs could be cut even further (Gorn, 5/14). 

New Orleans Times-Picayune: Louisiana House Puts Budget Cuts In Bobby Jindal Administration's Hands 
The $25 billion spending package now puts a total of about $300 million in unspecified cuts in the hands of administration officials, who said the representatives were largely calling for cuts in areas where there was no more fat to trim. The bulk of the reductions will likely fall on higher education and health care, which have already taken hard hits from midyear cuts and other reductions but also represent the largest areas of discretionary spending (Adelson, 5/12). 

In the meantime, Medicaid's transition to managed care in Kentucky suffers growing pains -- and lawsuits --

Modern Healthcare: Transitional Woes
As states increasingly turn to managed care to control Medicaid costs, a pair of lawsuits in Kentucky shows the growing pains that can complicate the transition. Appalachian Regional Healthcare, Lexington, is suing the state of Kentucky and two Medicaid contractors in a move that speaks to deeper seated concerns about the adoption of a statewide managed-care program last year (Kutscher, 5/12).

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Ariz. Gov. Signs Bill Allowing Employers To Opt Out Of Covering Contraception

Iowa lawmakers are the latest to consider defunding Planned Parenthood over the organization's performance of abortions, though the proposal died on the last day of the legislative session. Elsewhere, Arizona Gov. Jan Brewer signs a bill allowing some religious employers to opt out of covering contraception in their insurance plans.

Des Moines Register: Political Spin On Legislative Session Will Now Ensue
Another highly contentious issue involved a proposal to eliminate state money going to Planned Parenthood for women's health programs. Republicans dislike the organization's role in performing abortions and wanted to cut off all money to the group, even funds designated for such things as cancer screenings. The impasse with Democrats went on for weeks and ultimately was resolved in the Democrats' favor during the final day of the legislative session. Some Republicans say that outcome could rear its head again in the party's primary races (Clayworth and Noble, 5/12).

Arizona Republic: Brewer Signs Arizona Bill On Contraception Coverage
Gov. Jan Brewer signed into law Friday a measure allowing some religious employers to opt out of covering prescription contraceptives as part of their health-care plans. House Bill 2625 applies only to "religiously affiliated" employers, which are defined as non-profit groups that primarily employ and serve individuals of the same religion or religiously motivated organizations with articles of incorporation clearly stating that religious beliefs are central to the organization's operating principles (Rau, 5/11).

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State Roundup: Health Jobs Brighten Local Economies, But Workers Pay More For Care

A roundup of health policy news from California, Pennsylvania, Arizona, Massachusetts, Florida and Colorado.

Los Angeles Times: Healthcare Jobs Fuel Revival In Pittsburgh
About 1 in 5 private-sector employees works in health services, which has replaced manufacturing as the region's powerhouse. It's a transformation happening across the U.S., but many worry about long-term side effects (Lee, 5/13).

Arizona Republic: Arizona Funding Will Restore Help For Mentally Ill
New state funding for Arizonans with serious mental illnesses returns some of the services they lost two years ago and paves the way for a temporary agreement in a decades-old class-action lawsuit. The budget for the fiscal year that begins July 1, which Gov. Jan Brewer signed Monday, includes $38.7 million to restore housing, counseling and other services to people with serious mental illnesses who don't qualify for Medicaid (Reinhart, 5/11).

Boston Globe: Employers Shift More Health Costs To Workers
An analysis by the Division of Health Care Finance and Policy found that 27 percent of people in Massachusetts who got insurance through the small-group market at the end of 2010 were in a plan with a lower "actuarial value,"’ meaning the deductibles and copayments were among the highest on the market. That was up from 2 percent in the first quarter of 2008 (Conaboy, 5/14).

Earlier, related KHN story: Quick Facts About High-Deductible Health Plans (Kulkarni, 4/27)

Modern Healthcare: Tweaking The System
Massachusetts hospitals support the state's new efforts to transform the way that healthcare is paid for, but are concerned officials may attempt to slow spending too fast ... lawmakers in Massachusetts introduced bills in the House and the Senate that would encourage a move away from a fee-for-service system and align the state's healthcare cost growth with its gross state product (Lee, 5/12). 

California Watch: Lawmakers: Health Care Districts Must Unleash Bank Accounts
California lawmakers are moving to crack down on taxpayer-funded health care districts that have banked tens of millions of dollars at the expense of funding community-health projects. A bill moving through the Legislature targets the spending habits of these little-known governmental agencies that were created to run hospitals, which many of them no longer do (Mieszkowski, 5/14). 

Sacramento Bee: Tough Sell For Tobacco Taxes In California
In the past decade, red and blue states alike, from Mississippi to New York, have approved more than 100 tobacco tax hikes in a desperate hunt for budget revenue. But not one has passed in California, whose 87-cent cigarette tax dropped from third-highest in the nation in 1999 to 33rd today despite the state's ongoing budget woes. That confounds health advocates (Yamamura, 5/14).

Denver Post: TriWest Healthcare Challenges Loss Of $20 Billion Pentagon Contract
TriWest Healthcare Alliance, the health insurer carrying more than 200,000 veterans and service members in Colorado, lost its contract with the Department of Defense for next year and is challenging the decision. UnitedHealthcare recently beat out TriWest in a bid for another five-year, $20 billion contract to serve clients of Tricare, the U.S. military's health program, in 20 Western states (Sherry, 5/12). 

The Miami Herald: University Of Miami Job Cuts Could Have Major Impact On Research, Innovation
The Miller School of Medicine has lost $18 million so far this fiscal year, sees dire financial problems ahead and already terminated 180 temporary employees in March before Tuesday’s announcement that it is laying off up to 800 full-time employees this month. President Donna Shalala said last week that, as a result of the cuts, the medical school would stop supporting much “unfunded” research — work that isn’t backed by outside grants from organizations such as the National Institutes of Health (Dorschner, 5/12).

Boston Globe: Massachusetts Cuts County Jails' HIV Programs
The state has eliminated more than $1 million for HIV testing and education in county jails ... Sheriffs warned that the cuts will lead to eliminating staff who educate inmates about the virus; curtailing HIV testing within the jails; and ending visits by infectious disease doctors who monitor inmates’ health (Cramer, 5/14).
 

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Editorials and Opinions

Viewpoints: Approving Drugs Quickly; Berwick: In Health Care, Cheaper Can Mean Better; Health Costs 'Persistent' Concern

The Washington Post: Approving Drugs Quickly
For about 20 years, the Food and Drug Administration (FDA) has charged pharmaceutical companies "user fees" for reviewing drug-approval applications. The revenue allows the FDA to hire more evaluators, which allows useful drugs to reach patients faster. Now the Prescription Drug User Fee Act needs reauthorization, as it does every five years. Legislators should not dillydally (5/13).

Boston Globe: In Health Care, Cheaper Can Mean Better
An Irish adage says: "When you come to a wall that is too high to climb, throw your hat over the wall, and then go get your hat." That's what Massachusetts started with its 2006 law requiring just about everyone to get coverage and arranging to make that coverage affordable. Now, it’s time to get the hat. Legislation to contain costs is the necessary sequel. Reducing costs won't just rescue health care; it will also help rescue our schools, our roads, our museums, our wages, and the competitiveness of our corporations; that’s because every additional nickel we spend on health care comes from somewhere else -- somewhere also important (Donald M. Berwick, 5/14).

Boston Globe: On Beacon Hill, Some Good Ideas, Some Overreach On Health Care
After many months of work, the House and the Senate have now both unveiled plans to contain the cost of health care in Massachusetts. The Senate legislation is mostly a worthwhile effort; despite a number of laudable provisions, the House bill is marred by regulatory overreach. But both have important areas of common ground that should help keep care affordable — as long as both chambers are willing to compromise and scale back (5/14).

Boston Globe: Why Not Let The Bake Sale Crumble?
Defenders of the school bake sale, rejoice! The Massachusetts Legislature is stepping in to save your homemade lemon squares from the horrors of government overreach! That was the triumphant news from Beacon Hill this week, after a loud and predictable brouhaha over rules handed down by the state Department of Public Health. ... So goes another round in the battle over obesity: a problem, not of concept, but execution (Joanna Weiss, 5/13).

Roll Call: Trautwein: Health Care Affordability Is Persistent Concern
The Supreme Court is not expected to rule until late June on the constitutionality of the individual mandate and the fate of the 2010 health care law, but no matter what decision is handed down, the affordability of health care coverage remains an unmet and enduring challenge. Rising health care costs are the most significant barriers to access to health care coverage, for both families and those employers who offer health insurance to almost 157 million Americans.  From 2000 to 2011, average annual health insurance premiums more than doubled for employers, from $4,819 to $10,944, according to the Kaiser Family Foundation (Neil Trautwein, 5/14).

Arizona Republic: Heading Off A Doctor Shortage
Arizona needs to confront a problem. You need to help design a solution. There's a big hole in the pipeline between medical school and a physician's office near you. If it's not fixed, you could find yourself facing a long wait for a doctor's appointment. "The iceberg is coming," says Dr. Stuart D. Flynn, dean of the University of Arizona College of Medicine - Phoenix. Arizona's impending doctor shortage "is real," he says (5/12).

Reuters: Will Puerto Rico’s Governor Part Ways With Grover Norquist?
As part of their effort to stave off the impending, automatic cuts to the defense budget, House Republicans passed legislation that kills a special provision of the Affordable Care Act increasing Medicaid grants to Puerto Rico. Faced with the threat of losing billions of dollars in federal payments each year, [Governor Luis] Fortuño now seems to think that lower federal spending is not that appealing. He pushed back on these cuts in an op-ed on CNN.com (Cate Long, 5/11).

Des Moines Register: Piles Of Crumbs Left At Iowa's Capitol
[Mental health reform] was the most significant achievement of the two-year general assembly. It makes real strides toward resolving a festering problem of decades. Iowa’s 99 disparate and unequal mental health systems will come under one state umbrella, standardizing basic services while keeping local providers. Legislators in coming years will have to work out the bugs and it will be a continual challenge to pay for this system (Kathie Obradovich, 5/12).

CNN: Can We Educate Future Physicians To Be More Human?
The revamped MCAT confronts a problem that’s only getting worse. For all the strides we’ve made through technological innovation, medicine is failing at the very human art of treating patients. Doctors are ill-equipped to deal with factors like diet and poverty, which are now responsible for over half the cases of premature disease and death in the United States. Armed with state-of-the art drugs and machines, they don’t always consider whether using these resources will cause more harm than good. In many cases, it no longer makes much sense to call what physicians and patients have a “relationship” at all (Brooke Holmes, 5/14).

The Fiscal Times: Big Pharma’s Sinking Business Model
[T]he udders on the cash cows that for decades made the industry the most profitable in America are running dry. The insurers who manage Medicare and Medicaid’s drug plans are watching every penny. ... Industry scientists need to focus on unsolved problems like dementia or cancer, not on research that seeks to justify peddling pills to people who don’t really need them (Goozner, 5/11).

Denver Post: Should Congress Enact Taxes On Obesity-Producing Foods? No
Proponents of an American Nanny State have a plan to improve your health: tax sugar and "junk" food so you will eat less of it.  Subsidies for broccoli and beets are close behind.  These plans for bureaucrats and politicians to remake your diet are bad news for four reasons. First, it is no one's business but yours what you eat (Andrew P. Morriss, 5/13).

Denver Post: Should Congress Enact Taxes On Obesity-Producing Foods? Yes
It is time for the federal government to stop subsidizing, with billions of dollars of public tax money, the factory-farmed crops and animal products such as corn, soybeans, cotton, dairy and meat that create the artificially low-prices that prop up the nation's junk food industry. We need to subsidize healthy organic food, not junk food, and promote sustainable food and farming practices, instead of subsidizing factory farms and chemical-intensive farming and food processing (Ronnie Cummins, 5/13).

Arizona Republic: All Arizonans Have To Turn The Tide Against Obesity
Arizona is 15th in the nation for childhood obesity. Two out of every three adults are either overweight or obese. Obesity is expensive -- for society and for individuals. For society, it's financial. Whether it's private insurance, Arizona Health Care Cost Containment System or none at all, the cost is absurd. It's estimated that an obese patient pays $1,400 more in medical bills every year than someone who is a normal weight (Will Humble, 5/13).

Minneapolis Star Tribune: Increase In Infant Deaths Is A Public Health Crisis
State requirements and tougher laws will help, but ultimately it's up to parents and child-care providers to end unsafe sleep practices. They need to protect children in their care and send a strong signal to less-informed caretakers who don't comprehend that infants' lives are at stake (5/13).

Sacramento Bee: Prop. 29: Voting Yes May Save The Life Of Someone You Love
California has the opportunity to lead the way in the battle against all forms of cancer, including lung cancer. Proposition 29 will provide more than $700 million annually for cancer research and smoking prevention. Over time, Proposition 29-funded research will result in better diagnosis and treatment of all cancers – and other diseases related to tobacco – and it may just lead to cures. Proposition 29 will save lives (Timothy J. Howe, 5/12).

Sacramento Bee: Prop. 29: Plan To Raise Millions Is Latest Ballot-Box Budgeting Boondoggle
Winston Churchill once said, "Democracy is the worst form of government except all the others that have been tried." When I was director of Finance, trying to get the state's budget into balance and running up against roadblocks in the Legislature, I had a similar view of our legislative process. Thus, I cannot argue that the state should never raise tobacco taxes (Michael C. Genest, 5/12).

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EDITOR:
Stephanie Stapleton

ASSOCIATE EDITOR:
Andrew Villegas

WRITERS:
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.