Viewpoints: Mass. Health Law Trips Up Even Bosses Offering Insurance; Traumatic Brain Disease May Be Complicating Veterans' Recoveries

Boston Globe: Cut Health Bills For All
[Ronn] Garry is an owner of Tropical Foods, the independent Roxbury market that has anchored Dudley Square for 36 years. He has 70 employees, 45 of them full time. The 2006 [health] law says he has to offer those full-time employees health insurance, cover at least 33 percent of their premiums, and get a quarter of them to take up his offer. Otherwise, he must pay a fine, called a Fair Share Contribution: $295 for every worker. ... Fair enough. But Garry has a problem. Even though he offers health insurance and pays 50 percent of his employees' premiums, he can't get 25 percent to sign up. Two workers short of the threshold, he has been fined: About $29,000, including thousands in penalties (Yvonne Abraham, 4/26).

The New York Times: Veterans And Brain Disease
That story is devastatingly common, but the autopsy of this young man's brain may have been historic. It revealed something startling that may shed light on the epidemic of suicides and other troubles experienced by veterans of wars in Iraq and Afghanistan. His brain had been physically changed by a disease called chronic traumatic encephalopathy, or C.T.E. (Nicholas D. Kristof, 4/25). 

Politico: Social Security Trustees: We're Going Broke
Here's some bad news: The latest report of the Social Security and Medicare trustees shows an unfunded liability for both programs of $63 trillion. ... The actual liability is almost twice what the government is reporting (John C. Goodman, 4/25).

Des Moines Register: Outlook Is Not As Bleak As You Think
Another year. Another bleak report on the finances of government programs providing income and health insurance to millions of Americans. Social Security will empty its trust fund in 2033, three years sooner than trustees projected one year ago. Medicare will deplete its hospital trust fund in a dozen years. Improving the solvency of these programs is not as difficult as some political leaders make it sound. They just need to muster some backbone and vow to embrace, rather than dismantle, programs every American who plans on getting older should care about (4/25).

Fortune: We're Having The Wrong Debate About Rising Health Care Costs
Today the top causes of death are noncommunicable diseases that result mostly from the way we live --coronary artery disease, hypertension, diabetes, some cancers. Medical researchers call them lifestyle diseases. What's important from a policy perspective is not just that these diseases cause the most deaths, but also that they cause the most spending. The great majority of America's staggering $2.6 trillion health care tab (as of 2010) was spent treating lifestyle diseases. While we rightly worry about health care costs rising 8% or 9% a year, we spend well over 50% of our costs on diseases caused mostly by the way we choose to behave (Geoff Golvin, 4/25).

Des Moines Register: U.S. Nuns Are Under Attack -- From The Pope
The Catholic church has launched disciplinary action against the Leadership Conference of Women Religious, which represents about 80 percent of the 57,000 U.S. nuns. The church avers the nuns have not been loud enough in speaking out against gay marriage, abortion and women's ordination. The Vatican's Congregation for the Doctrine of the Faith claims the nuns are pushing "radical feminist themes incompatible with the Catholic faith." This comes following the contraception controversy (Steffen Schmidt, 4/25).

The Fiscal Times: The Extreme Leftward March Of The Democrats
Consider the state of the Blue Dog Democrat coalition in the House. … At the height of their power, the Blue Dog caucus had 54 members and wielded considerable clout – or so voters assumed. The Obamacare debate stripped that fantasy from the electorate. Instead of forcing the Obama administration to moderate its approach to health-insurance reform, the Blue Dogs rolled over and played dead (Edward Morrissey 4/26).

The New York Times: A Database To Curb Abuse
The use and abuse in this country of powerful pain medications has spiraled upward in recent years. A report by New York's attorney general, Eric Schneiderman, showed prescriptions in the state for oxycodone, the active ingredient in OxyContin, rose a remarkable 82 percent from 2007 to 2010, and nearly 17 percent for hydrocodone, the main ingredient in Vicodin (4/25).

The Kansas City Star: Our Unhealthy Obsession With Body Image
Imagine walking around with a tube that goes through your nose and passes through your esophagus, right down into your stomach. … Last week, the New York Times ran a story about crash-dieting brides willing to undergo the 10-day K-E diet that costs $1,500 and requires a doctor's supervision. It's an eyebrow-raising trend, but we know where it stems from. The pressure on brides and women in general to look a certain way is not imaginary (Jenee Osterheldt, 4/26).

Des Moines Register: Abortion Legal, But Often Not Option For Poor
Before it adjourns, the Iowa Legislature will have to decide whether to make it even harder for low-income women on Medicaid to get crisis abortions covered. The state already refuses Medicaid payment for routine abortions. Under a bill passed by the Republican-controlled House, the state would also refuse payment when the pregnancy resulted from rape or incest. ... But the cost alone, which ranges from $500 to $1,500, depending on the stage, can make abortions in Iowa inaccessible to the women who can least afford to add a child (Rekha Basu, 4/25).

The Dallas Morning News: Parkland's Massive Challenge Found In Monitors' Plan
Now that our investigative reporting team has seen the Corrective Action Plan — which Parkland officials, in typical bunker-think, tried to keep secret — the public should have a better idea about how massive and at what cost. The stakes are nothing short of the survival of Dallas County's public hospital system…. Close enough isn't going to be good enough, as it shouldn't be when people's lives are at stake. A few fixes here or there won't meet the standard; the transformation must be precisely that (4/25).

The Sacramento Bee: Nurses Union Puts Politics Ahead Of Health
State Sen. Lois Wolk wants to encourage – not require – that health care workers get annual flu vaccinations if they come into contact with patients in hospitals. No right-thinking person could possibly oppose her legislation. But in our dysfunctional Capitol, public health has become a contested issue. Too often, lobbyists place the interests of the organizations they represent ahead of what's best for the rest of us (Dan Morain, 4/25).

New England Journal of Medicine: Performance Improvement in Health Care — Seizing the Moment
We have an unprecedented opportunity to create a high-performance health system in the United States. Recent statutes ... provide the federal government with important powers for catalyzing improvement in service delivery. These new powers touch all the critical levers for advancing health system performance: payment policy, organization and infrastructure, public health, and essential information for health care decision making. ... [But federal] budget deficits and rising health care expenditures create pressures to quickly adopt simple expedients, such as cuts in benefits and provider payments. At the same time, the very number and diversity of available forms of authority, each with its own legal quirks and restrictions, creates huge conceptual and logistic complexity (Dr. David Blumenthal, 4/25).

New England Journal of Medicine: Implications for ACOs of Variations in Spending Growth
The Medicare Pioneer and Shared Savings Accountable Care Organization (ACO) programs offer health care provider organizations contracts with Medicare whereby the organizations assume financial risk and are rewarded for providing high-quality care at lower cost. ACO spending targets will be determined on the basis of baseline Medicare spending for assigned populations, projected forward by average increases in national Medicare spending. The stated rationale for using national spending growth factors is to exert greater downward pressure on organizations in regions with high spending and rapid spending growth, while permitting greater savings in regions with low spending and slow growth to support organizational investments in infrastructure (Dr. J. Michael McWilliams and Zirui Song, 4/25).

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