Viewpoints: WSJ Says GOP 'Kamikaze' Defunding Mission Will Not Go Well; Taxing Medicare Benefits; Problems With Penn. State's Wellness Program

The Wall Street Journal: The Power Of 218
These critics [like Heritage Action and the Club for Growth] portrayed the Boehner plan as a sellout because of a campaign that captured the imagination of some conservatives this summer: Republicans must threaten to crash their Zeros into the aircraft carrier of ObamaCare. Their demand is that the House pair the "must pass" CR or the debt limit with defunding the health-care bill. Kamikaze missions rarely turn out well, least of all for the pilots. The problem is that Mr. Obama is never, ever going to unwind his signature legacy project of national health care. Ideology aside, it would end his Presidency politically. And if Republicans insist that any spending bill must defund ObamaCare, then a showdown is inevitable that shuts down much of the government. Republicans will claim that Democrats are the ones shutting it down to preserve ObamaCare. Voters may see it differently given the media's liberal sympathies and because the repeal-or-bust crowd provoked the confrontation (9/16). 

CNN: The Real Problems With Obamacare
Good news: We're not going to war in Syria, at least not right away. Bad news: We're headed to a battle inside Congress that will pose its own grave threat to the U.S. and world economy. The most conservative Republicans in Congress are threatening to force default on the nation's obligations unless the president agrees to defund Obamacare. Less conservative Republicans prefer a milder version of the threat: not default, but merely shutting down the government (David Frum, 9/16).  

The Washington Post: Virginia's Next Governor Will Determine Whether Most Abortion Clinics Close
Virginia Attorney General Ken Cuccinelli II (R) was instrumental in ensuring that new regulations will result in the closure of many of the state’s abortion clinics. Two of the busiest, in Northern Virginia and Norfolk, already have closed. If Mr. Cuccinelli is elected governor in November, most of the remaining 18 clinics are likely to shut their doors within months (9/16). 

The Kansas City Star: It's Time To See Obamacare In Action
It's here.  In two weeks the nation will take the first concrete steps in a long-delayed experiment to overhaul its health care system. On Oct. 1, the online exchanges where the uninsured can shop for insurance will open…But let’s now get to it. After all the yanking — the congressional fighting, the court decisions and the constant criticism over the individual mandate and more — let's all stand aside and see whether this thing will work (Keith Chrostowski, 9/16).

Bloomberg: Obamacare Doctor Rationing Begins In California
The latest bad news for the Affordable Care Act comes from California, a state that the Obama administration has consistently pointed to as an important indicator of the law’s success. President Barack Obama even traveled to the Golden State in June to tout the health-care law’s success at "pushing down costs" for consumers. Unfortunately, several analyses have recently revealed that because of Obamacare individual health insurance premiums are headed anywhere but down for California residents (Lanhee Chen, 9/16).

The New York Times' Economix: Taxing Medicare Benefits
In my continuing series on tax expenditures, this week I want to discuss another form of income that few people recognize as being "income" – the nontaxation of Medicare benefits. First, few people probably think of any government benefits as income in any sense of the term. But if one gets back benefits far in excess of what one pays into a program like Medicare, then one is receiving income (Bruce Bartlett, 9/17). 

USA Today: Increase Alzheimer's Research Funding
It's time we launched a serious war on Alzheimer's disease. Right now, we're pursuing a "national plan to address" Alzheimer's, passed by Congress two years ago. It's a timid plan, having produced a lot of bureaucratic boilerplate but only a paltry increase in federal funding for research into the insidious disease. It includes a goal of being able to prevent and treat Alzheimer's by 2025, but without the means to achieve that goal. Why is it so difficult to get the war launched? (Don Campbell, 9/16).

Journal of the American Medical Association: The 3-Night Hospital Stay and Medicare Coverage for Skilled Nursing Care
According to current Medicare coverage policies, Medicare requires a patient to have been a hospital inpatient for at least 3 consecutive days to receive coverage for rehabilitation in a skilled nursing facility (SNF) after hospital discharge. ... Although there is little empirical evidence that elimination of the 3-night stay rule will improve patient care without increasing Medicare costs, there is justifiable concern that this rule contributes to suboptimal care and increased costs attributable to avoidable hospitalizations. There is a critical need to update payments and policies that address conditions that cause avoidable hospitalizations (Lewis A. Lipsitz, 9/16).

JAMA Pediatrics: Pediatric Faculty Diversity
Academic pediatrics has not kept pace with the changing demographics in the United States population and the children and families we serve. By 2020, the majority of children and adolescents in the United States will come from ethnic minority backgrounds. We will have a new "majority minority" population, with Latino and Asian ethnicities contributing the largest proportion. This change in demographics is significant because health care disparities occur disproportionately in those who will soon make up the largest proportion of the US population. To date, pediatric organizations have not developed national strategies to respond specifically to the ethnic diversity in our pediatric population. Doing so is critical to ensuring excellence in our profession and our professional societies (Dr. Leslie R. Walker and Dr. F. Bruder Stapleton, 9/17).

Forbes: Key Question For Innovators Isn't Where Healthcare Is Going, But When It Will Get There
Almost everyone (across the political spectrum) seems to agree that a fundamental problem with our system is the fee-for-service (FFS) model, which creates perverse incentives and is driving up costs to dangerous levels. Most also believe that the solution will ultimately arrive in the form of a value-based care (VBC) system, where payments will derive in some way from the quality of care provided, rather than the volume. Leaving aside the non-trivial question of whether this is actually possible (i.e. is it realistic, or a fool's errand, to expect to assess outcomes and value at the level of granularity that likely would be required), the question on everyone’s mind is "when?" When will this shift from FFS to VBC occur? (David Shaywitz, 9/15).

Forbes: Why Every Small Employer Should Sign Up For Obamacare's SHOP Exchange
Currently, when employers purchase health insurance through insurance companies, most are required to pay part of the premium for the employee and the employee pays the rest. ... According to the Navigator manual, with the SHOP exchange, the employer does not have to contribute ANYTHING to the cost of the premium – they can pay anywhere between zero and 100% of the premium, and the employee pays the rest. You may be thinking, "Why would I go through the bother of signing my company up for the SHOP exchange if I am not going to pay any of the premium?" Pure and simple – the tax benefit for you and your employees (Carolyn McClanahan, 9/14). 

Fox News: Americans' Personal Data Must Be Kept Safe – Time To Delay Obamacare Exchanges
Just about every week Americans learn about another problem with ObamaCare. Employer mandate? Delayed. Small business health insurance market? Delayed. Automatic enrollment? That's right, delayed. Study after study and expert after expert has sounded the alarm on ObamaCare's failings and the monumental implementation challenges that go with it (Sen. Orrin Hatch, R-Utah, 9/17).

Politico: Why Accountable Health Care Works
A recent White House report suggests that 1963 was also the last time health care inflation rose as slowly as it is rising today. It’s premature to think this trend will continue, and few would doubt that the recession and other economic factors played a role. But there’s more at work here: As a recent paper from Harvard University researchers argues, the price slowdown preceded the recession, and the corresponding decline in spending was more dramatic than a mere drop in incomes would predict (Helen Darling and Susan Devore, 9/16).

Bloomberg: The Feel-Good Promise of Wellness Programs
It has been a tough couple of months for Pennsylvania State University’s new wellness program. ... Beginning this fall, in order to avoid a $100 monthly surcharge for their health insurance, all nonunionized employees will have to submit health-history information via the online database WebMD, complete an annual health exam, and participate in periodic biometric scans that include measurement of cholesterol, blood-sugar and blood-pressure levels, body mass, and waist circumference. ... The $100 a month penalty for noncompliance is more than double the average for such programs. The Affordable Care Act may spur more employers to adopt wellness programs with large penalties; it raises the legal limit on penalties that employers can charge for health-contingent wellness programs to 30 percent of total premium costs (Austin Frakt & Aaron Carroll, 9/16).

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