Viewpoints: Will 'Rate Shock' Grow?; Krugman Says GOP Spite Is Driving Opposition To Medicaid Expansion; Determining Who Owns Genes

The New York Times: Why Rate Shock Might Matter
Any plausible health care reform, the various conservative alternatives to Obamacare included, would necessarily have losers as well as winners, and as far as potential losers go single young men with above-average incomes are not precisely the country's most disadvantaged demographic. If you think the current system is flawless, then I suppose any rate increase anywhere is a strike against health care reform. But conservative and libertarian wonks don’t think the system is flawless. ... The unanswered question, though, is whether that "a little more" will actually be — or gradually become — a lot. And that's what's getting left out of some of the liberal brush-offs ... of the "rate shock" issue (Ross Douthat, 6/6). 

The New York Times: The Spite Club
Sure enough, a number of Republican-dominated states seem set to reject Medicaid expansion, at least at first. And why would they do this? They won't save money. On the contrary, they will hurt their own budgets and damage their own economies. Nor will Medicaid rejectionism serve any clear political purpose. As I'll explain later, it will probably hurt Republicans for years to come. No, the only way to understand the refusal to expand Medicaid is as an act of sheer spite. And the cost of that spite won't just come in the form of lost dollars; it will also come in the form of gratuitous hardship for some of our most vulnerable citizens (Paul Krugman, 6/6). 

The Wall Street Journal: Michigan's Medicaid Maelstrom
The Wolverine State is one of several still sitting on the fence when it comes to the ObamaCare expansion of Medicaid. Michael Reitz of the Mackinac Center, a conservative think tank, tells us that he is increasingly worried that "Republicans may be on the brink of caving on Medicaid." ... An idea gaining traction is to accept the Medicaid dollars but place a four-year lifetime cap on eligibility for able-bodied adults. After four years on the program, Michigan residents would be cut off from any further benefits. Another Republican reform would allow health savings accounts for Medicaid patients as a way to save money. Some Republicans are also demanding a "cancellation" policy that would allow the state to take the money now but opt out of the Medicaid expansion later if costs escalate out of control. Until 2017, the federal government covers 100 percent of the costs (Stephen Moore, 6/6).

Bangor Daily News: Medicaid Expansion In Hands Of Seven GOP Lawmakers
We have tried to present reasonable arguments to Maine's Republican lawmakers to urge them to accept federal funding to expand Medicaid. We have emphasized the good financial deal Maine is projected to get, according to independent, outside analyses. We have highlighted the obvious, practical health reasons why tens of thousands more Mainers should have access to care. We criticized lawmakers when they blocked a previous Medicaid expansion proposal. ... There is still a little time, however, for a few Republicans to stand up for their communities' poorest — on whose doors they've knocked and asked for votes. It will take only 12 Republicans in the House and Senate for the bill to be veto-proof; five are already on board (6/5).

USA Today: Retiree Benefits And ObamaCare Collide
Oct. 1, 2013 is a focus of increasing anxiety in this country. That's the date when enrollments begin for the federally run health insurance exchanges, created under the Affordable Care Act (ACA). No one really knows what to expect, but it could be far worse than advertised — and for a reason that has more to do with the federal deficit than health care. ... Amid all these concerns and speculations, almost no attention is being paid to the opportunity that the ACA's insurance exchanges could represent for state and local governments' retiree health care programs. It's time to think about it because the consequences could be far-reaching (David Walker, 6/6).

Fox News: Is America Prepared For The Coming ObamaCare Disaster?
For years I have been writing about the failures of the UK's National Health Service (NHS) as a warning for what the Affordable Care Act (aka ObamaCare) will do to health care here in the U.S. London's Daily Mail has chronicled the growing problems with the NHS, which include declining quality of care and availability of services coupled with increased costs. This is what is in store for us, if Congress does not repeal ObamaCare (Cal Thomas, 6/6).

National Journal: Separate And Unequal Access To Health Care?
Segregation is still real. Although black-white segregation has, overall, declined steadily since the 1970s, major American metros remain split into black and white areas. … One of those consequences is the disparity when it comes to health care between blacks and whites. The fact that black patients have poorer outcomes in surgery has been well documented. ... Recently, researchers at the University of Michigan sought a more-rounded answer to the problem. Their results, published in the journal Health Affairs, highlights a frustrating contradiction. While black patients live closer to high-quality facilities, they are still more likely to get care in low-quality facilities (Brian Resnick, 6/5).

The New York Times Room For Debate: Can The Human Blueprint Have Owners?
The Supreme Court is expected to decide soon whether human genes can be patented. The case involves patents by Myriad Genetics on the BRCA1 and BRCA2 genes, which, when mutated, heighten a woman's risk of getting cancer. Because of the patents on these genes, which Myriad isolated, the company controls all testing for the mutations. ... Should companies be allowed to patent genes? Read the discussion (6/6).

Tampa Bay Times: Paying Too Much For Too Little Health Care
Exotic prescription drugs and extraordinary end-of-life efforts are not the only factors driving up the cost of health care. It turns out that routine procedures such as colonoscopies cost far more in the United States than in other countries, and vary widely in price. In Tampa, for example, patients pay from $980 to $3,496 in out-of-pocket and insurance costs for a colonoscopy. There is no legitimate reason for such wide differences, and bringing health care costs under control will require increased efforts by consumers and government to demand more openness about pricing and to comparative shop (6/6).

JAMA: Eliminating Wasteful, Unnecessary Care Is The Best Way To Preserve Medicare
The release this past week of the Medicare Trustees' report was met with widespread enthusiasm among health economists and supporters of the federal health reforms in the Affordable Care Act (ACA). … Reduced Medicare spending might be a small silver lining of the recession, but it is not a strategy anyone would pursue to preserve the program (Andrew Bindman, 6/6).

Roll Call: Message To Congress: Immigrants Pay More Than Their 'Fair Share' Of Medicare
Immigrants don't just pick our fruit, deliver our take-out food and design our computers — they pay for our medical care. As Congress debates immigration reform, some would have us believe that immigrants are draining the Treasury. But it turns out that closing the borders would deplete Medicare's trust fund (Steffie Woolhander and David U. Himmelstein, 6/6). 

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