Today's OpEds: The Berwick Commentaries, States' Roles In Health Reform, And The Avandia Saga

Berwick: Bigger Than Kagan The Wall Street Journal
Barack Obama's incredible "recess appointment" of Dr. Donald Berwick to head the Centers for Medicare and Medicaid Services (CMS) is probably the most significant domestic-policy personnel decision in a generation. It is more important to the direction of the country than Elena Kagan's nomination to the Supreme Court. … One may agree with these views or not, but for the president to tell the American people they have to simply accept this through anything so flaccid as a recess appointment is beyond outrageous. It isn't acceptable (Daniel Henninger, 7/15).

Facing The Wild West Of Health Care Reform – Donald Berwick, Pioneer The New England Journal Of Medicine
If Berwick can persuade [Rep. Michael] Burgess and other skeptics that the IHI is built on collaborations with health care providers, not regulatory regimes formulated by government, and that he will bring those experiences to bear at the CMS, maybe he will have a chance to translate his private successes into public victories. But no matter what the final outcome, Berwick is taking on a challenging assignment at a tumultuous time in the history of U.S. health care, and he should expect a rough ride (John Iglehart, 7/14).

Recess Appointment Circumvents Public Vetting Roll Call
As Dr. Donald Berwick — President Barack Obama's recent appointee to lead the Centers for Medicare and Medicaid Services — takes office, many questions still remain unanswered about his views on health care. Most importantly, lawmakers would like to understand what Berwick meant when he argued that federal bureaucrats should "ration with eyes open" (Rep. Charles Boustany, 7/15).

Why Governing Americans Is So Hard The Christian Science Monitor
The conventional wisdom is that Americans are fed up with their government. But our demands on policymakers are so inconsistent and irrational that we make governing nearly impossible. We hate big deficits, but oppose the actual tax increases or spending cuts that we need to dam the flood of the red ink. We are furious that government passed an $800 billion stimulus last year, but feel lawmakers are not doing enough to get the economy going. ... And that's just the beginning. Conservatives cry "states rights" when it comes to the new federal law requiring individuals to have health insurance, but are silent about the parallel federal requirement that insurance companies must sell to all comers (Howard Gleckman, 7/14).

Behind The Scenes Of Health Reform: The National Association Of Insurance Commissioners Kaiser Health News
The new health reform act has been widely criticized as a federal government takeover of the health care system. To a remarkable degree, however, the law actually relies on the states to reform health insurance. … The jobs of enforcing the insurance regulations, of operating the health insurance exchanges and generally of regulating insurance are left to the states. Indeed, the health overhaul leaves state insurance law in place, only preempting laws that prevent its application (Timothy Jost, 7/15).

GOP Readies 'Reform' Of Obamacare The Orange County Register
California congressional Republicans are part of a strategic legislative challenge to roll back Obamacare. The effort no doubt will be fruitless this year, but it sets the stage for November electioneering, which could lead to substantive legal challenges in next year's new Congress if the GOP gains significantly, perhaps even winning control of one or both houses (7/14).

The Avandia Sage Continues The New York Times
A panel of expert advisers to the Food and Drug Administration delivered a confusing verdict on Wednesday after two days of hearings on the safety of the diabetes drug Avandia. … The clearest lesson to emerge from the hearings and other recent revelations is that GlaxoSmithKline, the maker of Avandia, can't be trusted to report adverse clinical results fairly (7/14).

Insured, But Living Premium To Premium Minnesota Public Radio
In my lifetime I have spent over $200,000 on health insurance premiums --- more than on anything else: rent, cars, clothing, food or business expenses. I was 13 when my father began his battle with cancer and 15 when he lost it. In those two years I saw how brutal the war with unexpected disease can be and how expensive. So I have done whatever was necessary to make sure that I always had insurance. It has not been easy, and now that I have turned 50 --- putting me in a different insurance age bracket -- I am afraid that it may become impossible (Nancy Donoval, 7/15).

Health Reform Makes Small Businesses Sick Roll Call
I don't know a single person who would deny that businesses face a mountain of paperwork to comply with a whole host of laws, most significantly tax laws. Remarkably, the recently passed health care law will dramatically increase that paperwork mountain unless we stop it (Sen. Mike Johanns, 7/15).

Texas Will Need More Doctors And Nurses The Dallas Morning News
Health care rationing in Texas will be much different by the end of the decade. Demand has been artificially suppressed because of the state's top-ranked uninsured rate. … Health reform fixed the health insurance problem. But insurance is useless if timely care is unavailable. Texas has the most to gain by insurance expansion. And it will experience the greatest aftershock from the resulting demand (Steve Jacob, 7/14).

The Renaissance In HIV Vaccine Development – Future Directions The New England Journal of Medicine
From July 18 through July 23, 2010, delegates from around the globe will convene for the biennial International AIDS Conference in Vienna. They will discuss our current risk of losing the war against the human immunodeficiency virus (HIV). Despite an unprecedented outpouring of resources and proliferation of programs, today, for every two patients who begin receiving treatment for HIV, five people are newly infected. … Among the most exciting developments the delegates will hear about this year are a series of recent advances that collectively represent a renaissance in HIV vaccine development (Wayne Koff and Seth Berkley, 7/14).

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