Viewpoints: Upton Says GOP Health Ideas Overlooked; Tying Insurance To Jobs Is A Bad Idea

Fox News: Mr. Obama, Republicans Do Have Health Care Solutions
In a troubling denial of reality, President Obama now claims that Republicans have no ideas when it comes to health care, saying "they don't have an agenda to provide health insurance to people at affordable rates." But Republicans do have answers – a lot of them (Rep. Fred Upton, R-Mich., 8/27).

Des Moines Register: Why Tie Insurance To Jobs?
In many households, one spouse buys health insurance through a job for the entire family. Now United Parcel Service Inc. has announced it intends to cut this coverage for working spouses of nonunion employees next year. ... Denying insurance to workers' spouses will certainly create a financial burden for families. ... Now the family needs to purchase two policies to cover both adults in the home. Also, the health insurance offered by the spouse's employer may not cover needed services or may impose higher co-payments and deductibles. Unfortunately, this is how things work in a country that has tied health insurance to employment. We have long recognized that is a bad idea (8/27).

The Wall Street Journal: Medicaid Reform That Works
Medicaid's annual price tag has exploded to $250 billion and is expected to rise even faster once ObamaCare expands the rolls by 30 million. So everyone wants to reduce costs, which is why liberal Rhode Island is the place to look (8/27). 

Miami Herald: State Errs In Obstructing Affordable Care Act
Gov. Rick Scott and the Cabinet are going out of their way to throw a monkey wrench into the process. Last week, they raised phony questions about privacy protection involving the "navigators" who will educate consumers about the new healthcare options and walk them through the enrollment process. This is nonsense. The navigators must comply with privacy and security standards and will not obtain consumers' information without their consent. Why is the Cabinet suddenly taking an interest in the welfare of health-insurance consumers? If the state cared at all, it would have set up its own insurance exchange and backed the effort to the hilt. Instead, it refused. The latest questions seem to be part of a larger effort by Gov. Scott and like-minded political allies to obstruct the process at every turn (8/25).

The Washington Post: Taxing Issues With The Affordable Care Act
Much has been made of the financial hammer that will fall on people who can afford to pay for health care under the Affordable Care Act but choose to forgo coverage. Starting next year, individuals and their dependents are required to have minimum essential health insurance unless they qualify for an exemption. That's why you are hearing so much about the new health-care exchanges, which will have open enrollment from Oct. 1 to March 31 (Michelle Singletary, 8/27). 

Forbes: Medicare's Independent Payment Advisory Board
If we are to avoid the political brinkmanship that has characterized past negotiations over the budget (the fiscal cliff debacle comes to mind) Congress must decide what programs can and should be cut–and they need to do it fast. ... For instance, one program that is up for debate is Medicare's Independent Payment Advisory Board, or IPAB. IPAB was created in 2010 following the implementation of President Obama’s Patient Protection and Affordable Care Act, and is a fifteen-member Government agency tasked with reducing Medicare costs while retaining quality of care. The debate over IPAB has been fierce, and both Republicans and a number of prominent Democrats have come out against the panel. However, despite this, President Obama, in making his requests for the 2014 budget, has proposed that the Independent Payment Advisory Board's authority only be increased (Doug Schoen, 8/27).

Forbes: How Much Will Your Life Be Worth Under Obamacare?
How much will your life be worth to the federal government under ObamaCare? Less than you might think. We can make an educated guess by looking at which medical screening tests the government U.S. Preventive Services Task Force (USPSTF) considers worthwhile. ... Patients (in consultation with their doctors) should be free to decide for themselves whether a medical test or treatment is worth it to them, based on their specific personal and economic circumstances (Paul Hsieh, 8/28). 

The New Republic: Rand Paul's Dangerous Lasik Obsession
Nobody has a "right" to health care, [Sen. Rand Paul] says, because that would mean people have a right to commandeer the labor of those who provide care. ... Of course, Paul is also making a practical argument. With less government interference and regulation, and more people paying for services directly rather than through insurance, the market would bring down prices on its own—and medical care would become more affordable for everybody. As proof, he points to a procedure ophthalmologists know well: Lasik, the laser eye surgery that eliminates the need for glasses or contact lenses. ... Libertarians and conservatives love to cite Lasik. But Lasik tells you almost nothing about the rest of the health care system (Jonathan Cohn, 8/28).

JAMA Internal Medicine: Directing Resources To Where They Are The Most Needed
Today we have highly effective antiretroviral treatment for human immunodeficiency virus (HIV) and a much better marker of how our patients are doing: the HIV viral load. Patients with undetectable virus in their blood are likely to do well as long as they keep taking their medication. The first sign of trouble is an elevated viral load. ... So, if CD4 counts are no longer driving treatment decisions in stable patients who are virally suppressed while receiving antiretroviral treatment, why do we still order these tests? Because it is our habit, and our patients expect it. Although ordering the test likely causes little harm to our patients (unnecessary anxiety if there is a false-negative drop in the count), the tests are expensive (Dr. Mitchell H. Katz, 8/26).

JAMA Internal Medicine: Policing Online Professionalism
It is hard to argue with concerns about the proper use of social media by medical students, residents, and senior physicians. In many instances, medical professionals have posted clearly offensive and inappropriate material. Yet the rush to police online behavior obscures the fact that similar issues have been debated for centuries. To what degree is proper "etiquette" part of a physician's duty? What elements of physicians' private and public lives are patients entitled to know? Should the rights of physicians outside work be more restricted than those of people with other jobs? Revisiting this history may help to develop guidance and regulations that foster professionalism but that do not unfairly restrict the online activities of doctors (Dr. Barron H. Lerner, 8/26).

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