KHN Original Reporting & Guest Opinion
Kaiser Health News
consumer columnist Michelle Andrews writes: “How much leeway do employers and insurers have in deciding whether they’ll cover contraceptives without charge and in determining which methods make the cut? Not much, as it turns out, but that hasn’t stopped some from trying. Kaiser Health News readers still write in regularly describing battles they’re waging to get the birth control coverage they’re entitled to” (Andrews, 8/22). Read the article
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Kaiser Health News provides a fresh take on health policy developments with "Phantom Pain?" by Chris Wildt.
Meanwhile, here's today's haiku:
OUT OF BALANCE
Needed: docs for old
But no one wants to pay them
Health care paradox
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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The Huffington Post breaks down the good and bad news surrounding what people may pay next year for coverage in the wake of the health law. Meanwhile, Modern Healthcare takes a look at how the Obama administration decision to let people keep health coverage that didn't comply with the overhaul's standards is impacting premium rates.
Huffington Post: Here's What's Going On With Obamacare Premium Increases
Health insurance premiums are going to skyrocket under Obamacare next year, maybe even double! No, wait -- they're only increasing a little, and less than before Obamacare! No, wait -- they're … decreasing in some places? The crucial question about the second year of enrollment on the Affordable Care Act's health insurance exchanges is: How much will coverage cost? Actual prices won't be available in most states until the exchanges open Nov. 15, or shortly before that, so consumers are left to sort through political spin and preliminary reports that don't make things any clearer. So what's going on? First, most people will pay more for health insurance next year. ... The good news is that available information indicates the doomsayers were wrong, and premiums under President Barack Obama's health care law aren't going through the roof (Young, 8/21).
Modern Healthcare: People Keeping Noncompliant Plans; Rate Impact Varies By State
When the Obama administration in November 2013 decided to allow states to decide if individuals could keep noncompliant insurance plans, speculation began about what effect that decision would have on premiums and enrollment for plans that did comply with provisions of the Patient Protection and Affordable Care Act. Subsequently, the administration this March gave states the option of a maximum two-year extension into 2016. Early indications of how many individuals opted to keep those plans have begun to emerge as have signs of the effect on premiums. As with so much else related to the ACA, the results depend on what state is being discussed. Twenty-five states are allowing noncompliant plans to continue through 2015, which creates a continuing impact for insurers attempting to formulate premium levels in 2014, according to data compiled by America's Health Insurance Plans, an insurer trade group. Twenty-one states are taking the full extension option, through 2016, according to AHIP (Tahir, 8/21).
Also in the news, the Denver Post tracks the total number of cancelled health plans in Colorado while the Seattle Times offers reports on how the Washington state exchange is doing, and the CT Mirror checks in on what's ahead in terms of enrollment assistance.
Denver Post: Colorado Says 2,100 Health Plans Were Canceled In Last Two Months
The Colorado Division of Insurance has reported that there were about 2,100 health-plan cancellations in the state over the past two months, bringing this year's total to more than 6,150. The division reported the figures for June 15-Aug. 15 to Senate Minority Leader Bill Cadman last week. Senate Republicans have requested monthly on the numbers. Since 2013, there have been about 340,000 policy cancelations in Colorado. Many customers received notices last fall as the Affordable Care Act was rolling out (Draper, 8/21).
Seattle Times: Healthplanfinder: ‘Moderately Effective,’ Could Improve
How does Washington’s online exchange marketplace compare with those in other states? As part of an ongoing study, the nonprofit Urban Institute assessed how well state exchanges created under the Affordable Care Act provide the sort of information consumers want to know about insurance plans they’re considering buying. The report — Physician Network Transparency: How Easy Is It for Consumers to Know What They Are Buying? — gives Washington’s wahealthplanfinder.org creditable marks. At the same time, the report notes room for improvement. The report judged Washington’s site to be in the “moderately effective” group, which also included Colorado and Oregon. On the lower end of the transparency scale were the District of Columbia and Rhode Island. Top scorers were California, Healthcare.gov, Massachusetts and Minnesota (Marshall and Ostrom, 8/21).
The CT Mirror: Future Of Obamacare Enrollment Assistance Still Being Determined
Eva Bermudez was one of nearly 300 people tasked with helping the uninsured get covered as Obamacare rolled out last fall. Her job might have seemed easy compared to those of her counterparts. An organizer with the union CSEA SEIU Local 2001, Bermudez focused her efforts on union members, many of whom had technological experience, Internet access and the ability to sign up for coverage online or by telephone. Even so, they came to her for help (Becker, 8/21).
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News outlets look at Democratic Sen. Mark Pryor's promotion of the health law in a campaign ad as a sign the law may be less radioactive. Meanwhile, Politico notes that 30 of the 34 House Democrats who voted against the law are no longer in office as the partisanship that it engendered grows.
The Associated Press: Democrats Reframe Debate On Health Care
One of the most vulnerable Senate Democrats is standing by his vote for President Barack Obama's health care law, a fresh sign that the unpopular mandate may be losing some of its political punch. In an ad released this week, two-term Arkansas Sen. Mark Pryor says he voted for a law that prevents insurers from canceling policies if someone gets sick, as he did 18 years ago when he was diagnosed with cancer. That prohibition on ending policies is one of the more popular elements of the 4-year-old law that Pryor never mentions by its official name — the Affordable Care Act (Cassata, 8/22).
The Hill: Dems Find Obamacare Ammo
Vulnerable Democrats are finding ways to tout ObamaCare in an election cycle where the unpopular law was expected to be a liability for their party. The most overt emphasis on healthcare came this week, when Sen. Mark Pryor (D-Ark.) debuted an ad centered on his 1996 bout with cancer and his vote for the 2010 legislation, which protects people with pre-existing medical conditions from losing insurance coverage. "No one should be fighting an insurance company while you're fighting for your life," Pryor says in the ad while sitting next to his father, David Pryor, a beloved former senator in Arkansas (Viebeck, 8/22).
Politico: Only 4 Anti-Obamacare House Dems Left For Fall Elections
Thirty-four House Democrats bucked their party to vote against Obamacare when it passed in 2010. Today, only four of those lawmakers are still in office and running for reelection this fall. The dramatic downsize underscores not only how consequential the health care law vote was but how quickly moderate Democrats have been eliminated on Capitol Hill. Even those who opposed the law had trouble surviving the highly partisan atmosphere it helped to create (Haberkorn, 8/22).
Another health-related issue is also coming up on the campaign trail -
The Hill: Groups Attack Vulnerable Dems On Late-Term Abortion Bill
Anti-abortion groups are campaigning against three Democratic senators in key battleground states who oppose a ban on late-term abortions. A coalition of groups including Concerned Women for America, Family Research Council Action, Students for Life of America and the Susan B. Anthony List is traveling to the home states of Sens. Mark Udall (Colo.), Kay Hagan (N.C.) and Mark Pryor (Ark.) to hit them for opposing a bill banning abortions after five months. Last year the House passed the Pain-Capable Unborn Child Protection Act. Sen. Lindsey Graham (R-S.C.) has picked it up in the Senate, but the bill has not seen any traction (Al-Faruque, 8/21).
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Health Care Marketplace
In its first few years, Medicare's Part D prescription drug program helped seniors pay for their medications, but that trend appears to be reversing, researchers found. Meanwhile, drugmakers fight over the rules for naming cheaper versions of biologic drugs.
The New York Times' The New Old Age: Part D Gains May Be Eroding
[I]n its first few years, national data shows, Part D did help elderly Medicare beneficiaries make modest progress. Out-of-pocket costs decreased. Better able to afford their medications, seniors were less likely to stop taking them for financial reasons. And they were less likely to do without other basic needs — like food and heat — in order to pay for drugs. "I expected that to keep going,” said Jeanne Madden, a health policy analyst at Harvard Medical School. Instead, as she and a team researchers from Harvard and the University of Massachusetts report in the most recent issue of Health Affairs, those downward trends took a U-turn in 2009. "Things improved after Part D, continued to improve for a few years, and then reversed," she said in an interview (Span, 8/21).
The Washington Post’s Wonkblog: A Drug Naming Dispute, With Billions On The Line
In health care, even how you name something can become a debate with billions of dollars on the line. With a new wave of cheaper versions of biologic drugs expected to soon become available in the United States, the health-care industry is still fighting over key ground rules for these drugs — more than four years after the Affordable Care Act cleared a pathway for this new drug classification. That includes what names these copy-cat version of biologic drugs should actually go by (Millman, 8/21).
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The Washington Post examines the deaths of some hospice patients who were not close to death but who received large doses of powerful pain-killers.
The Washington Post: As More Hospices Enroll Patients Who Aren't Dying, Questions About Lethal Doses Arise
The hospice industry in the United States is booming and for good reason, many experts say. Hospice care can offer terminally ill patients a far better way to live out their dying days, and many vouch for its value. But the boom has been accompanied by what appears to be a surge in hospices enrolling patients who aren't close to death, and at least in some cases, this practice can expose the patients to the more powerful pain-killers that are routinely used by hospice providers. Hospices see higher revenues by recruiting new patients and profit more when they are not near death (Whoriskey, 8/21).
The Washington Post: End-Of-Life Care: An Industry With Soaring Profits, Funded By Taxpayers
But what happens when hospices, in part to improve profits, attempt to care for people who aren’t terminally ill? Whoriskey wrote about a 77-year-old North Carolina man, Clinard “Bud” Coffey, who entered hospice care for pain management — and died two weeks later. ... Before you consider hospice care, know the facts (Paquette, 8/21).
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A selection of health policy stories from Florida, Oregon, California, New York, Missouri, Iowa, Illinois, Massachusetts, Minnesota and New Jersey.
The Associated Press: One-Third In Florida Chose Medicaid Plan
Only about one-third of Medicaid recipients transitioning into managed care statewide chose their own health insurance plans. Enrollment for the general population started in May and ended in August. Consumers received a letter in the mail two months before enrollment and were given at least 30 days to choose an insurance plan. Those who did not choose a plan were automatically enrolled into a plan by state health officials (Kennedy, 8/21).
The Oregonian: Oregon Health Reforms Threatened By New Federal Directive, Officials Say
Federal officials have thrown a wrench into the state's high-stakes reforms to the Oregon Health Plan, threatening a program that serves one in four Oregonians. A new directive could eventually even force the state to return hundreds of millions of dollars received from the federal government -- money that's already largely spent. The federal agency that holds the purse strings for care of nearly 1 million low-income Oregon Health Plan members recently harshly criticized the state's system for distributing money to regional coordinated care organizations under the reforms (Budnick, 8/21).
The Washington Post: One Of The Nation’s Most Expensive Ballot Campaigns Is Heating Up
California is the location of what ... may become the two most expensive ballot campaigns of this election cycle and one of them is heating up this week. Proposition 46 pits doctors against trial lawyers in a battle over raising the limit on malpractice payouts, a fight that has already raised $61.5 million on both sides. The vast majority of the money -- roughly $56 million, according to Ballotpedia -- has been raised by groups opposed to the measure, financed by professional associations and large insurance companies. This week, the group that has raised more than 99 percent of that money is launching its first TV and radio ads in English and Spanish (Chokshi, 8/21).
The Associated Press: NY City Council Passes Bill On Rikers Transparency
The City Council on Thursday passed a bill that would force correction officials to publish information about Rikers Island jail inmates in solitary confinement, including any injuries suffered behind bars and the state of their mental health. The legislation awaits the signature of Mayor Bill de Blasio, who supports it (8/21).
St. Louis Post-Dispatch: Hospital Mistakes Get Harder For Missouri Patients To Find
Medicare has stopped providing information about eight serious medical errors in hospitals, including wrong blood type transfusions, patient falls and foreign objects left in patients’ bodies after surgery. The count of medical errors for each hospital was recently removed from the federal agency’s Hospital Compare website, in part because the data were considered inaccurate. The agency is working on new ways to collect and present the information, according to a Medicare spokesman. Other poor outcomes, including bed sores, blood clots and catheter infections, are still included on the website (Bernhard, 8/21).
Des Moines Register: Cancer Society: Iowa Should Target Tanning Beds, Tobacco
The American Cancer Society wants Iowa legislators to take stronger action against tobacco and tanning beds. The national group on Thursday released an annual report card, which said Iowa met just three of 12 benchmarks for fighting cancer.The report noted that Iowa lawmakers increased spending on anti-tobacco programs by $100,000, to $5.1 million. But it said that level is only 17 percent of what federal experts recommend. "It certainly doesn't come close to what tobacco companies are spending to market their products," Jen Schulte, Iowa government relations director for the group's Cancer Action Network, said in a prepared statement (Leys, 8/21).
ProPublica: In California, Some Efforts To Toughen Oversight Of Assisted Living Falter
California legislators and activists say attempts to reform the state's troubled assisted living industry are being obstructed — and they are placing much of the blame on the administration of Democratic Gov. Jerry Brown. Early this year lawmakers began crafting more than a dozen bills intended to strengthen California's oversight of the state's roughly 7,700 assisted living facilities, which provide housing and day-to-day help to seniors and people with disabilities (Thompson, 8/21).
Chicago Sun Times: Cubs Cut Grounds Crew’s Hours To Avoid Paying Health Benefits
Thanks a lot, Obama. Add the Affordable Care Act – or, specifically, the big-business Cubs’ response to it – to the causes behind Tuesday night’s tarp fiasco and rare successful protest by the San Francisco Giants. The staffing issues that hamstrung the grounds crew Tuesday during a mad dash with the tarp under a sudden rainstorm were created in part by a wide-ranging reorganization last winter of game-day personnel, job descriptions and work limits designed to keep the seasonal workers – including much of the grounds crew – under 130 hours per month, according to numerous sources with direct knowledge. That’s the full-time worker definition under “Obamacare,” which requires employer-provided health care benefits for “big businesses” such as a major league team (Wittenmyer, 8/21).
The Boston Globe: ‘Concierge Medicine’ Service Says Rival Has Monopoly
Two companies are battling in court over the Greater Boston market for premium health care services known as “concierge medicine,” a lucrative business that is growing nationally even as the broader industry comes under pressure to control costs. Concierge practices charge patients annual fees -- typically about $1,500 to $1,800 -- for quick access to, and more time with, their doctors. The national leader in concierge medicine, MDVIP Inc. of Florida, dominates the Boston market. Its smaller competitor, SignatureMD Inc. of California, has sued to break MDVIP’s grip in Boston and other metropolitan areas (McCluskey, 8/22).
The Boston Globe: At Health Care Forum, Coakley Defends Partners Deal
Under attack from gubernatorial rivals at a forum Wednesday night, Attorney General Martha Coakley defended her decision to allow Partners HealthCare to acquire South Shore Hospital and Hallmark Health System instead of filing a lawsuit to stop the merger. She said the agreement -- which still must be approved by a judge -- would help “put a net over the bigness of Partners” and reduce the rise of health care costs (Miller, 8/21).
Minnesota Public Radio: Health Care Success Cuts Revenue To Uptown Clinic, Forcing It To Close
A clinic in Minneapolis that provides medical care to thousands of uninsured and underinsured people is closing its doors next week, in large part because more people are obtaining health insurance through the Affordable Care Act and seeking care elsewhere. When the Neighborhood Involvement Program shuts down Aug. 29, the 3,000 patients that visit its Uptown clinic will be without a medical provider. But its dental and mental health clinics, as well as its senior and youth programs, will continue operating in Uptown (Sepic, 8/22).
Politico Pro: Study Looks At Impact Of Massachusetts Individual Mandate
The individual mandate obligates people to buy health insurance, although whether it actually drives down uninsured rates remains unclear. Yet researchers are increasingly able to isolate the areas where it is making a difference, drawing lessons from the Massachusetts experience under Romneycare. The latest numbers were discussed Thursday during a webinar sponsored by the University of Minnesota’s State Health Access Data Assistance Center (Wheaton, 8/21).
The Wall Street Journal’s CFO Journal: A Patient-Focused Health Care CFO
In the health care industry, CFOs have to preserve or improve patient care while meeting financial goals. Robert Glenning, chief financial officer for Hackensack University Health Network, which runs the largest hospital in New Jersey with 10,000 employees, spoke to CFO Journal’s John Kester about how the he prioritizes saving patients over saving money and how the Affordable Care Act is affecting the hospital business (Kester, 8/22).
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Health Policy Research
Each week, KHN compiles a selection of recently released health policy studies and briefs.
Urban Insitute/RWJF: Physician Network Transparency: How Easy Is It for Consumers to Know What They Are Buying?
Urban Institute researchers studied nine marketplace websites (California, Colorado, Connecticut, District of Columbia, Massachusetts, Minnesota, Oregon, Rhode Island and Washington) ... Most websites studied did not list plan (e.g. HMO) or network (e.g., narrow or tiered) type. Only three of nine websites studied embedded provider directories for each plan on the Marketplace website. The remaining websites diverted consumers to insurance company websites in order to access provider directories. This report shows that states need to make improvements in the clarity, accessibility and functionality of their online insurance marketplaces to make them more consumer-friendly and transparent (Blumberg, Peters, Wengle, and Arnesen, 8/21).
JAMA Surgery: Effect Of Minimally Invasive Surgery On The Risk For Surgical Site Infections
Surgical site infection (SSI) represents the second most common cause of hospital-acquired infection .... We abstracted the data [from the American College of Surgeons National Surgical Quality Improvement Program database] on 30-day SSIs and compared patients undergoing open procedures and MIS [minimally invasive surgery] .... MIS was associated with lower rates of postoperative SSIs in patients undergoing MIS vs open procedures for appendectomy (3.8% vs 7.0%), colectomy (9.3% vs 15.0%), hysterectomy (1.8% vs 3.9%), and radical prostatectomy (1.0% vs 2.4%) (Gandaglia et al., 8/20).
JAMA Internal Medicine: Patients' Understanding Of Their Hospitalizations And Association With Satisfaction
A total of 177 eligible internal medicine patients who had 2 or more medical conditions, 2 or more medical procedures, and 2 or more days of hospital stay between June 2012 and February 2013 were interviewed on the day of discharge. Patients were ... asked to (1) list all their medical diagnoses, (2) identify the indications for their medications from the discharge instruction sheet, and (3) identify the tests and/or procedures they underwent from a list of common tests and procedures provided. ... Patients’ shared understanding with their physicians in the domains of diagnosis, medication indications, and tests and/or procedures was suboptimal, yet patients' perceived understanding and their satisfaction with the quality of communication they received was fairly high (Kebede et al., 8/18).
Kaiser Family Foundation: Medicare Part D In Its Ninth Year: The 2014 Marketplace And Key Trends, 2006-2014
Growth in average monthly Part D premiums has essentially flattened since 2010 after rising about 10 percent annually before then. Rising use of generic drugs, triggered by patent expirations for many popular brand-name drugs, has been a major factor in slowing premium growth—paralleling slower prescription drug spending growth in the broader health system. ... In 2014, more than 37 million Medicare beneficiaries are enrolled in Medicare drug plans, an increase of 2 million compared to 2013 and 15 million since 2006. ... In 2014, about three-fourths of all plans ... use five cost-sharing tiers .... Only 5 percent of PDP enrollees are in plans with the highest star ratings (4 stars or more) (Hoadley, Cubanski et al., 8/18).
The Commonwealth Fund: Arkansas: A Leading Laboratory For Health Care Payment And Delivery System Reform
In crafting their [Medicaid] reform strategies, states can learn from early innovators. This issue brief focuses on one such state: Arkansas. Insights and lessons from the Arkansas Health Care Payment Improvement Initiative (AHCPII) suggest that progress is best gained through an inclusive, deliberative process facilitated by committed leadership, a shared agreement on root problems and opportunities for improvement, and a strategy grounded in the state’s particular health care landscape (Bachrach, du Pont and Lipson, 8/19)
Here is a selection of news coverage of other recent research:
news@JAMA: Using Antipsychotics For Elderly Patients Boosts Kidney Risks
Older adults treated with atypical antipsychotics are at increased risk of kidney injury, according to a study published today in the Annals of Internal Medicine. The findings add to previous evidence that this class of drugs is risky for older adults. Although atypical antipsychotics are commonly prescribed for older adults to treat agitation and other behavioral symptoms of dementia, the US Food and Drug Administration has not approved the drug for this purpose. In fact, since 2005 the agency has warned that use of these drugs to treat older adults with dementia was associated with a 2-fold increased risk of death (Kuehn, 8/18).
Bloomberg: Too Many Cancer Screenings Wasted On Those Facing Death
Older patients who aren't expected to live more than another decade are still being screened too often for cancers, causing more harm than good, a study found. More than half of men 65 and older who had a very high risk of dying in nine years were screened for prostate cancer, a slow-moving disease, according to research today in JAMA Internal Medicine. Almost 38 percent of older women with a similar life expectancy were screened for breast cancer and 31 percent were screened for cervical cancer despite some having undergone a hysterectomy, which means they often had no cervix (Ostrow, 8/18).
USA Today: Hospitalizations, Deaths For Heart Disease Fall
Hospitalizations for heart disease and stroke fell by about one-third over the past decade, according to a new study of nearly 34 million Medicare recipients. The number of Medicare patients hospitalized with heart attacks fell 38% from 1999 to 2011, while the number hospitalized with blood-clot-related strokes fell 34%, according to a study in Circulation. Hospitalizations fell 31% for heart failure, which occurs when the heart is too weak to pump efficiently, and 84% for unstable angina, a sudden chest pain that often leads to heart attacks, partly because some of these cases were reclassified as heart attacks (Szabo, 8/18).
Reuters: Preventable Hospital Deaths After Urological Surgery Rising: Study
As more urological surgeries are performed outside hospitals, deaths from preventable complications among men and women getting inpatient surgery have risen, according to a new study. It’s likely that older, sicker and poorer people make up more of the population having inpatient surgery, not that the surgeries are getting more dangerous, researchers say (Doyle, 8/19).
Reuters: Doctors May Be Missing Chances To Talk To Teens About Smoking
Less than a third of teens say their doctors have spoken to them about tobacco use, according to a new study. "Given that tobacco is still the number one preventable cause of death and disease in the U.S., it is surprising that more clinicians are not intervening with adolescent patients to help them avoid or quit tobacco," lead author Gillian L. Schauer, of Carter Consulting, Inc., told Reuters Health. ... She and her colleagues write in the journal Pediatrics that most current smokers started as teenagers or young adults (Doyle, 8/19).
Los Angeles Times: Simple Measures Made Hospital Patients 70% More Likely To Quit Smoking
A free supply of nicotine replacement medication and a handful of automated phone calls made smokers who wanted to quit much more likely to succeed, according to results of a clinical trial published Tuesday in the Journal of the American Medical Assn. ... They estimated that once their 90-day program was set up, it could be maintained at a cost of less than $1,000 per quitter (Kaplan, 8/19).
Reuters: More Evidence Adult Daycare Eases Stress On Dementia Caregivers
The stress of caring for a family member with dementia may take a toll on health over time, but a new study suggests that even one day off can shift caregivers' stress levels back toward normal. Based on measurements of the stress hormone cortisol, researchers found that caregivers had healthier stress responses on days when the dementia patient went to adult daycare. Even anticipation of the day off had an effect on cortisol levels (Lehman, 8/19).
MinnPost: Late In Life Care: Stressful, Complicated World Of Surrogate Decision-Makers
Within 48 hours of being hospitalized, almost half of all adults aged 65 or older will need someone else — a trusted relative or friend — to help them make at least one medical decision, and almost one-fourth will need that surrogate to make all of their medical decisions, according to the findings of a study published earlier this year in JAMA Internal Medicine. The most common decision made by surrogates in the study involved life-sustaining care (Perry, 8/20).
Reuters: Researchers Reverse Autism Symptoms In Mice By Paring Extra Synapses
Although many things have gone wrong in the autistic brain, scientists recently have been focusing on one of the most glaring: a surplus of connections, or synapses. Neuroscientists reported Thursday that, at least in lab mice, a drug that restores the healthy “synaptic pruning” that normally occurs during brain development also reverses autistic-like behaviors such as avoiding social interaction (8/21).
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Editorials and Opinions
The Wall Street Journal: Unemployed By ObamaCare
Most of the political class seems to have decided that ObamaCare is working well enough, the opposition is fading, and the subsidies and regulation are settling in as the latest wing of the entitlement state. This flight from reality can't last forever, especially as the evidence continues to pile up that the law is harming the labor market. On Thursday the Federal Reserve Bank of Philadelphia reported the results of a special business survey on the Affordable Care Act and its influence on employment, compensation and benefits. Liberals claim ObamaCare is of little consequence to jobs, but the Philly Fed went to the source and asked employers qualitative questions about how they are responding in practice (8/21).
Bloomberg: Don't Worry About Losing Your Health Care ... Yet
[E]mployees value the health benefits highly enough to trade off a lot of wages for them. For all the talk about how people are insulated from the cost of their insurance, if you follow union negotiations, you’ll know that when it comes to making explicit trade-offs between more expensive benefits and higher wages, the union representatives very frequently choose the benefits. That suggests that as long as employees are afraid of the exchanges, employers are going to be reluctant to force them there. This effect will probably be weakest at the low end, where the workforce is already struggling to find and keep jobs, but among middle-class people with relatively secure employment, I'd expect relatively little dumping in the near- to medium-term (Megan McArdle, 8/21).
The Washington Post’s Plum Line: Can Dems Defend Expanding Coverage To Poor In Red States?
Ever since embattled Dem Senator Mark Pryor went up with a new ad discussing his cancer and touting his vote for the health law as the right thing to do, critics have pointed out that he failed to name the whole law in the spot, so the ad doesn't really count as a full-throated defense of it. I think that’s a silly standard. But it does raise an interesting question: Can Democrats in difficult states stand behind the goal of expanding coverage to poor people? (Greg Sargent, 8/21).
The Wall Street Journal's Washington Wire: Sen. Mark Pryor Spotlights The Health Law's Rx For Pre-Existing Illnesses
Democrats generally are not campaigning on the Affordable Care Act, but in a new campaign ad Arkansas Sen. Mark Pryor does just that. Some have commented on the fact that Mr. Pryor does not mention the ACA by name in the ad, referring to it as "a law he helped pass." Just as interesting is the part of the law the ad features: its protections for people with pre-existing medical conditions. With all of the focus on the ACA’s rollout problems last fall and the ACA’s coverage expansion, we have not heard much about "pre-x" in some time, but in many respects it's the mega benefit in the law (Drew Altman, 8/21).
The Star Tribune: Hennepin Health Is Delivering Health Care Innovation
The expansive, not-limited-to-the-doctor’s-office approach taken to improve Johnson’s health is a key reason why the Hennepin Health program is among the nation’s most innovative health reform efforts. Now in its third year, the county-led program, which serves some of the metro’s poorest and sickest patients, keeps delivering impressive results. The latest data released by the program underscored why it continues to accrue accolades and should be looked to as a national model. It's also a reminder that the private sector doesn't have a monopoly on health care innovation (8/21).
The Washington Post: The Cure For Cancer That Parents Won't Use
Not so long ago, when my sons still had smooth cheeks and children's voices, I had them vaccinated against human papillomavirus, the most common sexually transmitted disease. It was late 2011, and the Centers for Disease Control and Prevention had just recommended that boys join girls in being vaccinated at age 11 or 12. I was certainly receptive: HPV, as it's commonly called, causes cervical cancer, cancer of the tonsils, cancer of the back of the tongue and, less often, cancers of the vulva, vagina, anus and penis. It seemed important to ensure that my kids were protected. Yet numbers released last month by the CDC show that my sons, now 14 and 15, are among a small minority of adolescent males who have been vaccinated (Meredith Wadman, 8/21).
Bloomberg: Waging War On Hepatitis C
Instead of complaining about how much Sovaldi costs and trying to tamp down its use, why not use the drug to stage a war on hepatitis C? Why not try to get the drug into as many bodies as possible, as fast as possible, with the hope of knocking this horrible disease back down to much lower infection rates? ... The point is, we should be able to come to a deal where we treat more patients, knock down the new infection rate, and give Gilead a nice, fat profit for developing a great drug that saves lives (Megan McArdle, 8/21).
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