Viewpoints: Burwell Shifts Tone On Supreme Court Case; Need For New CMS Director

The New York Times' The Upshot: Health Secretary Says There’s No Backup Plan If Supreme Court Rules Against Law
Next week, the Supreme Court hears arguments in a case that could upend Obamacare insurance coverage for millions of people. Tuesday, the Secretary of Health and Human Services said there was little the administration could do to limit the impact of such a ruling. ... The message represented a shift in tone from Ms. Burwell, who has been asked repeatedly by reporters and members of Congress what the administration would do in the aftermath of such a decision. ... The new message is consistent with her previous stance, but considerably more alarmist in tone. (Margot Sanger-Katz, 2/24)

The Wall Street Journal's Washington Wire: When CMS Director’s Post Opens — Again — Will Obama Step Up?
When Marilyn Tavenner steps down as head of the Centers for Medicare and Medicaid Services this month, one of the federal government’s most powerful positions will once again come open. History and President Barack Obama’s actions toward the post suggest that finding a replacement might prove difficult. Before Ms. Tavenner was confirmed in May 2013, CMS had gone without a permanent, Senate-confirmed administrator for nearly seven years. (Chris Jacobs, 2/24)

The New York Times: Is That Really A Five-Star Nursing Home?
Consumers will be able to get more accurate ratings of nursing homes under a revised system that the federal government put into effect on Friday. The change is a step toward ensuring that a five-star rating really means that the home provides exemplary service and is not simply inflating its scores by lying about its performance. Perhaps, not surprisingly, the overall ratings of nearly a third of the nation’s nursing homes dropped under the new rules. (2/25)

The Wall Street Journal's Washington Wire: Medicare Spending Cuts And Hospital Productivity Gains
To keep nurses and doctors in health care, and prevent them from shifting to information technology or other sectors, hospitals must pay more and more. This, argued economist William Baumol, is why average costs in labor-intensive industries (such as health care or education) rise over time: They have to compete with other industries experiencing productivity growth. The result for health care? Higher costs but little productivity growth. This matters for Medicare. When the Affordable Care Act was passed, it was financed in part by planned reductions to future increases in payments to Medicare providers, including hospitals, skilled nursing facilities, and home health agencies. By 2019, the reductions would amount to $575 billion in savings, and in 2014, Medicare spending was reduced by $54 billion, according to the Congressional Budget Office. (Drew Altman and Dana Goldman, 2/25)

The Wall Street Journal: The Misbegotten Crusade Against E-Cigarettes
But as I talked to many e-cigarette users, known as “vapers,” conducted research (Journal of Public Health Policy, 2011) and reviewed a growing body of scientific evidence, I became convinced that e-cigarettes have dramatic potential for reducing disease and death caused by smoking. Yet many in the antismoking movement—in which I have been involved for decades—are conducting a misleading campaign against these products. And this campaign may be doing harm to public health. (Michael B. Siegel, 2/24)

The New York Times' Taking Note: Why Does Cuomo Want To Shutter New York’s Doctor Report Card Site?
You need a good doctor. You try the Internet. It is baffling. The rankings seem better suited to restaurants—three stars, four stars. Comments from patients can be nothing short of ridiculous. ... For the last few years, however, New York State has provided patients with some unvarnished relief. It came in the form of a website called nydoctorprofile.com. That website has been carrying information, good and bad, about most New York doctors. Not only does it provide basic details—where a doctor was trained, any board-certified specialties, whether Medicaid is okay. It also lists any court judgments for malpractice or any loss of medical privileges or criminal convictions. ... Now Gov. Andrew Cuomo wants to close the site, arguing that it costs too much at $1.2 million a year. (Eleanor Randolph, 2/24)

The New York Times: A Disease Doctors Refuse To See
Too often, doctors don’t understand chronic fatigue syndrome. They don’t know how to diagnose it, and they frequently even believe that patients with the disease are just whining or suffering from psychological problems. This needs to change. That was the message from the Institute of Medicine’s recent report on the illness, which proposed new criteria to diagnose it and recommended ditching the syndrome’s confusing and demeaning name. The proposed alternative: systemic exertion intolerance disease, or S.E.I.D. (Julie Rehmeyer, 2/25)

The New York Times' The Opinionator: When The System Fails
The patient, whom I’ll call Mohammed, was an American citizen, fully employed with health insurance, although with limited English language skills and health literacy. I had been his primary care doctor for seven years, and he came to me about two years ago with a lesion on his scalp after hitting his head on the door. I didn’t know exactly what it was, although my best guess was some sort of post-traumatic injury. I sent him to surgery for another opinion. The surgeon concurred with my diagnosis, but scheduled a biopsy. What I didn’t know was that Mohammed didn’t return for the planned procedure. He was struggling as a new single parent to his two young children who had just arrived from a war-torn African country, while his wife was left behind, her visa delayed by bureaucratic obstacles. He had deferred the biopsy because of his life circumstances without understanding the significance, and without catching anyone’s attention. The ball was dropped, and he fell through the cracks in the mighty apparatus. (Sondra S. Crosby, 2/25)