Viewpoints: Girding For A 'Beloved' Medicare Fight; Two Views About Health Law's Employer Mandate; Doctors Fear 'SGR Cliff'

The Wall Street Journal: The Republican Tax Panic
(I)t's a shame that Republicans are playing into Mr. Obama's hands, negotiating in public among themselves, ... Tennessee Senator Bob Corker made the case for this strategic retreat on "Fox News Sunday," arguing that if Republicans raise tax rates as Mr. Obama wants, "the focus then shifts to entitlements and maybe it puts us in a place where we actually can do something that really saves the nation." But what is the evidence in the last four years, or even since the election, that Mr. Obama won't pocket that victory and then refuse to offer any but token changes on entitlements? (12/9).

Los Angeles Times: Medicare, The Beloved Budget Buster
While President Obama spars with congressional Republicans over whether to raise taxes, advocates for the elderly have been girding for a fight that promises to be at least as intense: what to do about the rising cost of Medicare, the federal health insurance program for the elderly and disabled. ... In fact, it is the single biggest factor in the deficit over the long run. And with multiple forces driving up costs, there's no easy way to solve the budget problems it presents (12/9).

The New York Times: How Medicare Is Misrepresented
[Doctors] generally believe they can manage their patients’ care properly without outside interference into their clinical decisions. ... This can explain why critics of traditional Medicare delicately but nonsensically prefer to decry it as being fee for service rather than as free-choice-of-providers insurance or unmanaged-care insurance (Uwe E. Reinhardt, 12/7).

Los Angeles Times: Lift The Debt Ceiling, Permanently
To anyone with little or no faith in Washington's willingness to tame the growth in Medicare, the debt ceiling might seem like a badly needed fail-safe against runaway entitlements. That would be true if refusing to lift the debt ceiling caused less damage than letting benefit programs continue to grow on autopilot. And as significant a problem as Medicare (and to a lesser extent, Medicaid) may prove to be eventually, defaulting on U.S. debts would inflict a much larger and more immediate toll on the economy (Jon Healey, 12/8).

The Wall Street Journal: Obama's Historic Budget Opportunity 
Unless the president pushes to slow the growth of spending, he will fail to strike a deal, undermine U.S. growth prospects and ultimately erode America's safety-net programs. ... A deal should also match Medicare's eligibility age with Social Security's, so these programs retain their principal purpose of assisting retirees, instead of slipping into general subsidies (Robert B. Zoellick, 12/9). 

USA Today: 'Employer Mandate' Attacks Leave Sour Taste 
Let's cool the coffee before it scalds. Yes, the employer mandate will add to some companies' costs of doing business, and those costs no doubt will be passed along to customers. Papa John's says the price of a pizza could increase 11 cents to 14 cents per pie. But is that such a terrible price to pay to ensure that some of the nation's hardest working, lowest paid employees will get health coverage they've never had? (12/9). 

USA Today: Opposing View: Businesses Face Wrenching Choice 
[M]oney that must go toward increased benefits or non-tax deductible penalties will crowd out wage increases and business investment. The realities that smaller employers, in particular, face under this mandate are both economical and emotional, with the consequences of their choices impacting both their employees' well-being and their ability to stay in business (Dan Danner, 12/9).

Roll Call: Doctors: We Gave At The Office, And Then Some
At least once a year, I am taken to a precipice known as the SGR cliff, which mandates that reimbursement rates are reduced by significant levels unless Congress steps in with its "doc fix" and staves off the cut. This year is no different. The SGR rate will be cut by nearly 27 percent on Jan. 1 unless Congress acts. ... For more and more physicians, these multiple and repeated cliffs give us no choice but to limit the number of Medicare patients we see. Like it or not, this is rationing of care (Dr. Alex Valadka, 12/9).

The Medicare NewsGroup: Medicare Doctor Reimbursement Battle Heats Up In Earnest
Doctors have been arguing for years that their payments from Medicare have been too low, particularly in high-cost urban areas. Even the "geographic adjustments" that Medicare has come up with ... have come under fire from the AMA as being outdated. Medicare must tread carefully on this issue, however, because if it pegs reimbursement rates too low in rural areas, it runs a greater risk of losing doctors where they are in short supply (John Wasik, 10/7).

Health Policy Solutions (a Colo. news service): Informed Patients Essential For Better Health Care
You would think that in areas of the country where high-tech services are provided to more people, that health would be better than in areas where they are provided less frequently. Surprisingly, that is not the case. In fact, areas that use more high-end medical technology often have worse health outcomes. How can this be? (Dr. David Downs, 12/8).

The Philadelphia Inquirer: Electronic Records Can Streamline Patient Care
The patient says he has been suffering from more asthma attacks, so a natural question is: Has he been faithfully taking his daily medicine? In another era, physicians would have to rely solely on the patient or the parent for that kind of information. Increasingly, these days they also can see on a computer screen if the pharmacy has provided a refill (Tom Avril, 12/10).

WBUR: Cognoscenti: Do Screening Mammograms Do More Harm Than Good? 
Although experts agree that diagnostic mammograms are beneficial (cases where there is a breast lump or other symptoms), there is much controversy about screening mammograms, which are performed on women with no signs of cancer. Mammograms detect breast cancer, although many people believe mistakenly that they prevent breast cancer. We now know that the mortality benefits remain quite small (Judy Norsigian, 12/10).

Detroit Free Press: In The Making In Lansing, A Disaster For Women's Health Care Choices
In the pile of poorly planned, badly executed ideas the Legislature seems determined to make law during its lame-duck session are two with the potential for devastating consequences for Michigan women: One bill would allow physicians and other health care providers to refuse to provide services to patients when there's a "moral" or "conscientious" objection, and allow employers to refuse to pay for services on the same grounds; another three-bill package would require women seeking insurance through Michigan’s soon-to-exist health care exchange — part of federal health care reform — to purchase an optional abortion insurance rider to have such services covered (12/7).

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