Longer Looks: Conservatives Vs. Liberals On Medicare - Who's Winning?

Every week, Kaiser Health News reporter Jessica Marcy selects interesting reading from around the Web.

The Atlantic: Why You Should Listen To The Affordable Care Act Appeal
What you really need to know is that Tuesday was a great day in court for supporters of the Care Act and a very tough one for its opponents. That dynamic (which had to do with a random drawing of judges) could easily change within the next six weeks or so when the 11th Circuit, the 6th Circuit, and the 3rd Circuit also hold their oral arguments on Care Act appeals. Either way, we are one step closer to the end of all of this, and you can bet that the justices were paying attention up the road a bit from Richmond (Andrew Cohen, 5/10).

The New Republic: Good Omens
Richmond, Virginia, may be the heart of the old confederacy. But it's also the place where the federal government eventually indicted Jefferson Davis for treason. A plaque commemorating that event sits outside the entrance to the Fourth Circuit Court of Appeals—an omen for what transpired inside the courthouse on Tuesday, where three judges considered a pair of lawsuits from Virginians challenging an abuse of federal authority. The alleged abuse in this case is the individual mandate of the Affordable Care Act (ACA). The other, more significant omen was the selection of the judges. Of the circuit's 14 judges, a computer randomly selected two who had been appointed by President Obama and one who had appointed by President Clinton (Michael Fitzgerald, 5/11).

American Spectator: Fiscal Conservatives Are Winning
This is the week for bold, conservative, budget-related proposals, with major announcements from the Heritage Foundation, from Speaker John Boehner, and from a group of Republican senators led by Pennsylvania's Pat Toomey. Very good. ... [The Heritage plan] would adopt much of House Budget Chairman Paul Ryan's plan to turn Medicaid into a block grant program (with added flexibility to the states) and to turn Medicare for future retirees (phased in) into a "premium support" program that would put authority and choice into individual hands. ... All these ideas are basically sound (Quin Hillyer, 5/11).

The Nation: How Town Hall Protests Against Paul Ryan's Plan Changed The Medicare Debate
The town hall protests across the country shook the GOP.  And the particular protests in Ryan's Wisconsin district had a two-fold impact: A. They pierced Ryan's image of invincibility. He had long peddled a claim that he could win with these ideas in working-class areas. ... B. They made Medicare an issue in Wisconsin and nationally -- even New York where, in a special election for an open U.S. House seat (John Nichols, 5/7).

Governing: Nonprofits Seek Relief And Support From States
In these days of budget constraints and defunding debates, the health and welfare of nonprofits is a significant issue for states. Health and human services nonprofits deliver crucial services to the most vulnerable populations -- in essence acting as shadow government agencies on the front lines of service provision. Many of the services they provide are meant to head off worse and more expensive problems down the road. According to a recent study on the nonprofit sector by the Urban Institute, 33,000 nonprofit health and human services agencies now operate nationwide, working under nearly 200,000 contracts and grants to provide everything from housing and youth counseling to job training and elder care. In some states like Maine, nonprofits provide nearly 100 percent of the state's health and human services (Jonathan Walters, May 2011).

Slate: When A Home Birth Ends In Tragedy, Can The Midwife Go To Jail?
Many midwives involved in home-birth deaths avoid manslaughter charges. Last week, a midwife named Karen Carr pleaded guilty to two felonies for her role in a Virginia home birth and was sentenced to a few days in jail and less than $10,000 in fines and restitution. Considering the punishment she risked at trial, the plea deal seemed like a wise one: she had been indicted on a slew of charges ... Carr is either a compassionate professional who believes in a pregnant woman's autonomy or an ideologue who acted as if she was above the law. But what is the law? Is a midwife criminally liable for a birth that goes wrong? And how often are midwives actually prosecuted? (Libby Copeland, 5/9).

Time: Does The ADHD Drug Shortage Herald A Crackdown On Stimulants?
[P]atients, pharmacists and manufacturers are reporting a serious shortage of medications to treat attention deficit hyperactivity disorder (ADHD) due to a hold in 2010 by the DEA on the drugs' main ingredients. Given the crackdown on doctors who overprescribe pain drugs like Oxycontin and widespread concerns about the use of illegal methamphetamine, I've long wondered why a similar assault was never launched on prescribers of amphetamines. After all, some prescription drugs for ADHD actually contain methamphetamine — the same exact drug that is reported to damage the brain, cause cognitive impairment and be irresistibly addictive (Maia Szalavitz, 5/11).

The Atlantic: Perverse Incentives
Though the recession has blunted overall demand for cosmetic surgeries, one subcategory appears to be entering a growth phase … expanding field of "cosmetic-gyn"—elective surgeries for women seeking to "rejuvenate" and/or "beautify" their vaginas. … Cosmetic-gyn is part of a broader trend in medicine, away from the traditional model of insurer-reimbursed, professionally sanctioned procedures and toward a simple fee-for-service model. The surgeries themselves are controversial: in 2007, the American Congress of Obstetricians and Gynecologists issued an opinion advising against vaginal cosmetic procedures. … As a practical matter, this rejection by medical gatekeepers means that, for now at least, cosmetic-gyn has virtually no oversight and no credentialing requirements (Marie Myung-Ok Lee, June, 2011).

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