Viewpoints: Predictions Of Rising Premiums; Health Law Anniversary

The Arizona Republic: Sebelius' Latest "Glitch": Slow-Rising Insurance Costs
No one challenges reality like Kathleen Sebelius, who assured the world on Sept. 30, 2013 that the Affordable Care Act website would be open for business the next day. "We're very excited about tomorrow," Sebelius said. "Shutdown or no shutdown, we're ready to go." The rollout was an epic catastrophe, of course. Even now, it is difficult to find a parallel to the enormity of the belly flop it made (Doug MacEachern, 3/20).

Forbes: 4 Reasons Why Obamacare Exchange Premiums May 'Double In Some Parts Of The Country' In 2015
As we reach the end of the first year of enrollment in Obamacare’s subsidized health insurance exchanges, we’ve been trying to solve a couple of mysteries. First: how many people who have signed up for coverage were previously uninsured? Second: will the botched rollout and design flaws lead to even higher health insurance costs next year? We’re starting to get indications from insurers that premiums on the exchanges will go up significantly in 2015 (Avik Roy, 3/20).

The New York Times' Room For Debate: The Health Care Law's Checkup 
Four years ago, President Obama signed the Affordable Care Act into law. Is the law working? What needs to be fixed? And what is beyond repair? (3/20).

The Washington Post: The GOP's Need For Creative Policy 
Over the past several years, increases in insurance premiums have averaged nearly 6 percent. Because of the rocky launch, age distribution and delayed provisions of Obamacare exchanges, insurance company officials expect far larger premium increases this spring — in the double digits, if not the triple digits, in many places. This is an administration that learns nothing. Rather than preparing people for increased premiums, and trying to explain the additional benefits of the new system, it says, in effect: If you like your current health insurance premium, you can keep your current health insurance premium (Michael Gerson, 3/20).

New England Journal of Medicine: Vivek Murthy For Surgeon General 
On February 27, a bipartisan group of senators on the Health, Education, Labor, and Pensions (HELP) Committee approved [Vivek] Murthy's nomination for surgeon general and forwarded it for a vote by the full Senate. But now, astonishingly, the nomination appears to be in jeopardy and may be delayed or withdrawn altogether. How could this have happened to such a distinguished and highly qualified nominee? The answer lies with the National Rifle Association (NRA). It is of great concern to us and to many other members of the health care community that Murthy's nomination is in jeopardy because of NRA opposition. The NRA opposes Murthy solely on the grounds that he has advocated reasonable and mainstream forms of gun regulation (Gregory D. Curfman, Stephen Morrissey, Debra Malina and Jeffrey M. Drazen, 3/20).

Roll Call: Why We Are Fighting For The Birth Control Benefit
As we approach March 25, when the Supreme Court will hear oral arguments in two cases challenging the birth control benefit, Planned Parenthood Federation of America is pressing the pedal to the metal to make sure every American knows that this benefit is basic health care for women (Dana E. Singiser, 3/20).

The Washington Post: Fox News's Bret Baier Corrects Obamacare Mistake
Fox News anchor Bret Baier screwed up on Tuesday night’s edition of his acclaimed show, "Special Report." As part of a "checkup" series on Obamacare, Baier took a close look at those who would remain uninsured after the March 31 enrollment deadline expires. ... Among those who’d be left out of the party, Baier continued, were indigent folks in Republican-led states that had opted out of the Obama administration’s Medicaid expansion. Such individuals faced a certain double jeopardy, in Baier’s formulation: "For those people, they not only face the prospect of not having health insurance coverage despite Obamacare, but now they will have to pay a penalty because of it." Untrue. The law provides a hardship exemption for those people. No penalty. To his eternal credit, Baier cleared up the matter on last night’s program (Eric Wemple, 3/20).

The Washington Post: Dueling Maps Of Abortion Protesters, Providers Push Battle Into Personal Territory
Is it fair to post an online database of names, photos, home addresses and telephone numbers of abortion protesters? A Maryland-based group, Voice of Choice, did just that: It created an online map of more than 150 protesters across the nation who target doctors and health centers that provide legal abortions, complete with all the personal information it could find on each one. The map is nearly identical to one that opponents of abortion rights have at AbortionDocs.org, which pinpoints doctors and clinics. ... The truth is, none of this should be handled this way (Petula Dvorak, 3/20).

Los Angeles Times: Three Genetic Parents -- For One Healthy Baby
Since January, a new California law allows for a child to have more than two legal parents. But children are still limited to two genetic parents. That could change soon, if the Food and Drug Administration approves human clinical trials for a technique known as mitochondrial replacement, which would enable a child to inherit DNA from three parents. News of the pending application has caused a kind of panic not seen since Dolly the sheep was cloned, raising the possibility of a single genetic parent. But far from being the end of the human race as we know it, the technique might be a way to prevent hundreds of mitochondrial-linked diseases, which affect about one in 5,000 people (Judith Daar and Erez Aloni, 3/21).

Los Angeles Times: We Can't Afford Not To Spend More Money On Alzheimer's Research
A study by researchers at Rand Corp. and other institutions calculated that the direct cost of care for people with Alzheimer's and other dementia in 2010 was $109 billion. In comparison, healthcare costs for people with heart disease was $102 billion; for people with cancer, it was $77 billion. Yet cancer research will be allocated an estimated $5.4 billion this year in federal funds, and heart disease will get $1.2 billion — while research on Alzheimer's and other dementias comes in at only a fraction of that, at $666 million. It's time to substantially increase that budget (3/19).

The New York Times: TV Lowers Birthrate (Seriously) 
In the struggle to break cycles of poverty, experts have been searching for decades for ways to lower America’s astronomical birthrate among teenagers. We’ve tried virginity pledges, condoms and sex education. And, finally, we have a winner, a tool that has been remarkably effective in cutting teenage births. It’s “16 and Pregnant,” a reality show on MTV that has been a huge hit, spawning spinoffs like the “Teen Mom” franchise. These shows remind youthful viewers that babies cry and vomit, scream in the middle of the night and poop with abandon (Nicholas Kristof, 3/19).

New England Journal of Medicine: Graded Autonomy In Medical Education — Managing Things That Go Bump In The Night
Traditionally, physician training has followed the apprenticeship model: students, residents, and clinical fellows participate in delivering medical services to patients under the supervision of accredited professionals. This hierarchical system offers trainees graded responsibility, enabling them to learn their trade by performing increasingly complex functions over time and experiencing gradual reductions in supervision. Whether by design or not, the middle of the night has historically been the time when trainees were able — and indeed required — to practice more independently. ... This model ... was called into question by the death of Libby Zion in a New York emergency department in 1984. ... studies suggest that newer resident-training approaches entailing reduced work hours and curtailed autonomy may not achieve the goal of improving the safety of patients today (Scott D. Halpern and Allan S. Detsky, 3/20).

The Oregonian: Bruce Goldberg Goes, But Oregon's Health Care Challenges Remain
If Bruce Goldberg's resignation as Oregon Health Authority director wasn't inevitable before this week, it certainly became so with Thursday's release of a damning outside review of Cover Oregon's technology debacle. This report identified Rocky King, Bruce Goldberg and Carolyn Lawson as the three key decision-makers in the state's ambitious project to create a customized online health insurance exchange. King, the folksy head of Cover Oregon, and Carolyn Lawson, the hard-driving IT director imported from California, both resigned months ago. Goldberg, a respected figure in Oregon health care, was next. This housecleaning is a necessary part of holding state leaders accountable for bungling the rollout of a key government initiative (3/20).

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