Viewpoints: Democrats Undermine ‘Cadillac Tax’; Clinton’s Conservative Bent; End-Of-Life Needs

The Huffington Post: The Biggest Blow To Obamacare Yet Could Come From Democrats
Congress is on the brink of taking a big bite out of the Affordable Care Act, after more than five years of mostly futile efforts by Republicans to weaken or repeal the law. Both houses now seem intent on approving a two-year delay in the introduction of the law’s “Cadillac tax” -- a controversial levy on expensive health insurance plans -- as part of must-pass legislation now moving through Congress. But while Republicans are happily supporting the delay as a blow to Obamacare, multiple sources privy to negotiations say it's the Democratic leaders in Congress, responding to pressure from labor unions, who have insisted on acting now. (Jonathan Cohn and Jeffrey Young, 12/8)

Real Clear Policy: The Senate's Historic ACA Vote
Last week, the U.S. Senate approved legislation that would repeal the majority of Obamacare. The bill will almost certainly pass the House. From there, it will go to the president's desk, where it faces an even more certain veto. Even so, we are witnessing a historic moment. The House and Senate have held dozens of votes to repeal Obamacare in whole or in part. Congressional Republicans have even worked with President Obama to repeal or curtail portions of the law. But while full-repeal legislation has passed the House, nothing like the bill that just passed the Senate has come anywhere near the president's desk. (Michael F. Cannon, 12/8)

Forbes: Hillary Clinton: The Conservative Obamacare Reformer
Individual tax credits to help pay for healthcare expenses have long been a mainstay of conservative healthcare reform. Whether solely as premium supports or as a combination of premium and HSA credits, the idea of giving people money to purchase healthcare or health insurance is a core pillar of any serious conservative healthcare reform. And it looks like Hillary Clinton might be embracing the tax credit approach. In a recent proposal (which is incomplete thus far), the presidential candidate offered support for a tax credit to help pay for out-of-pocket costs. While this might be pure politics to distinguish herself from Bernie Sanders’ single-payer proposals, the idea has serious merits. (Yevgeniy Feyman, 12/9)

Los Angeles Times: One-Sixth Of Americans Have Trouble Paying Medical Bills. That's Good News.
The U.S. government reported Tuesday that some 44.5 million Americans experienced problems paying their medical bills in the first half of this year. That may not sound encouraging, but perspective is everything: In 2011, the figure was 56.5 million. Overall, the percentage of people living in families facing trouble with their medical bills fell to 16.5% in the first six months of 2015 from 21.3% in 2011. The reason for the steady, linear drop in financial stress in strain from medical bills is inescapable. It's the Affordable Care Act. (Michael Hiltzik, 12/8)

Real Clear Health: Congress Must Stop The Flow Of Corporate Welfare To Insurers
This could be a very merry Christmas for Blue Cross and Blue Shield (BCBS) of Texas. The Obama administration wants to stuff its stocking with $257,172,917.34 – at your expense – to compensate the company for losing scads of money last year selling Obamacare policies in the Lone Star State. That would bring that single company’s total corporate welfare haul for the 2014 plan year to $843.3 million. That is, unless Congress decides this week to play the Grinch that stole the corporate welfare Christmas. (Doug Badger, 12/8)

New Orleans Times-Picayune: Louisiana Legislators Getting On Board The Medicaid Expansion Train
John Bel Edwards may not officially have the badge just yet, but clearly there's a new sheriff in town. How else do you explain the warp speed reversal by legislators on the subject of Medicaid expansion in Louisiana? Edwards, the governor-elect who loses the "elect" title Jan. 11, has made it clear he wants to expand Medicaid to more than 300,000 uninsured state citizens, and legislators — as they're wont to do — are doing everything necessary to make the Democrat's campaign pledge a reality. So after years of just saying "no" to the expansion of Obamacare under the rule of Gov. Bobby Jindal, the Republican-controlled Legislature is now screaming, "hurry up and go." (J.R. Ball, 12/8)

Sioux Falls (S.D.) Argus Leader: Medicaid Expansion And Obamacare
Amid all the mumbo-jumbo budget talk on Tuesday, there came a white flag. Dennis Daugaard, the state’s second-term governor, was the one holding the flag. Near the end of an annual budget address that went about one hour and ten minutes, Daugaard talked about a plan to expand Medicaid, the state/federal health program for the poor. For nearly six years now, Republicans have fought – seemingly to the last man – to overturn the Affordable Care Act, also known as Obamacare. They’ve failed at every level. (Jonathan Ellis, 12/8)

The New York Times' Opinonator: Imagine A Medicare ‘Part Q’ For Quality At The End Of Life
My father, and others like him, suffered because, at the tail end of life, Medicare continues to pay well for fix-it treatments focused unrealistically on cure and underpays for care and desperately needed home support. In his last six years, it paid more than $80,000, all told, for treatments that included a hernia repair, a pacemaker, and $24,000 for the injectable drug Lucentis which, sadly, failed to arrest the macular degeneration that was robbing him of sight. It covered a series of ambulance rides, emergency room visits and a hospital stay after he fell repeatedly on throw rugs and down the stairs, once breaking his wrist, falling on my mother, and leaving her black and blue from toe to hip. But it paid very little for home health aides to give my mother respite and cut off, far too soon, the speech and physical therapies that helped maintain his ability to function and take pleasure in life. Under fee-for-service medicine, Medicare paid to patch him up after he fell but not to keep him from falling. (Katy Butler, 12/9)

The New York Times' Opinionator: Decriminalizing Drugs: When Treatment Replaces Prison
If one of my children were a drug addict, what would I want for him? I would want what any parent would: for his addiction to be treated as a health problem, not a criminal matter, and for him to have every kind of help possible to get him off drugs. Until that happened, I would want him to be able to manage his addiction and live a normal life by taking methadone or another substitute opioid. And until that happened, for him to stay as safe as possible from overdosing, developing H.I.V., or going to prison, which would irrevocably alter the course of his post-addiction life. (Tina Rosenberg, 121/8)

The New York Times: No Reason To Exclude Transgender Medical Care
A decade ago, when she was starting to transition genders, the artist known as Our Lady J steeled herself as she called endocrinologists, seeking one who would prescribe hormones. “I couldn’t find a doctor,” said the classical pianist and singer, who is currently a writer for the television series “Transparent.” “I was treated like a freak.” Since then, the medical community in the United States has resoundingly concluded that transgender care — which includes hormone replacement therapy, counseling and surgical procedures — is medically necessary and should be covered by insurance. (12/9)

Forbes: Explaining The Decline, Fall (And Possible Rebirth) Of Doctors' House Calls
“Connected care” refers to a large and growing portfolio of digital tools, from video consultations with psychiatrists to in-home sensors passively detecting when a senior falls to devices that measure diabetics’ blood glucose and send messages to their families’ or doctors’ smartphones when intervention might be needed. ... However, we should not fall into the trap of all-or-nothing thinking, expecting patients only to see their doctors either in the office or remotely. With a little creativity, we can envision mobile health technology leading to the restoration of an almost forgotten medical tradition: The house call. (John Graham, 12/9)

The New York Times: For Immigrants, America Is Still More Welcoming Than Europe
The United States has some of the most hostile policies toward an immigrant population found in the developed world. Start with the special police forces dedicated to persecuting and deporting over a quarter of the nation’s immigrants, the estimated 11 million who entered the country without authorization. Then there is the lack of labor laws to shield them from wage theft and perilous jobs. And don’t get me started on America’s stingy social insurance: even legal permanent residents are barred from a host of government programs, including Medicaid, food stamps and other welfare programs. (Eduardo Porter, 12/8)

JAMA: Merging The Health System And Education Silos To Better Educate Future Physicians
The Affordable Care Act (ACA) is shifting physician reimbursement from volume to value. Academic medical centers (AMCs) are responsible for educating future physicians so that they will acquire the skills to practice value-based care. However, the linkages between the leaders of health systems and leaders of residency education may be tenuous, primarily because these leaders exist in separate silos in AMCs. (Reshma Gupta and Vineet M. Arora, 12/8)