Viewpoints: Medicare’s Cost Cutting; Paying For Obamacare; Warren Misguided In Pharma Plan
A selection of opinions on health care from around the country.
Bloomberg:
The Cost-Cutting Power Of Medicare
The Department of Health and Human Services' action today to set a timetable for moving Medicare away from fee-for-service payments is commendable and timely. ... Why is this important? Because after years of slow cost growth, health care is reaching a crucial tipping point. In fiscal year 2014, inflation-adjusted Medicare spending per beneficiary actually declined compared with the previous year. Yet the next year or two will determine whether the recent era of slow cost growth becomes the new normal, or instead is reversed. (Peter R. Orszag, 1/26)
The Wall Street Journal's Washington Wire:
Spending Debate: Partisan Divide On Deficit Problem Signals More Tension Ahead
In its annual economic outlook, the nonpartisan [Congressional Budget Office] said the federal budget deficit will shrink this year to its lowest level since 2007 .... Then, the kind of bad deficit news that has been the norm in recent years kicks back in. As a result of Baby Boomers leaving the work force and snapping up federal retirement benefits, as well as CBO estimates that long-term economic growth will remain weak by historic standards, the estimated deficit starts to climb again in 2017. ... In the latest Wall Street Journal/NBC News poll, released just last week, there was a stark partisan difference in the importance attached to making further deficit reductions. Among Republicans, 84% cited cutting the deficit as one of their absolute top priorities for this year .... Among Democrats, though, cutting the deficit further is a much lower priority. Only 53% of Democrats cited it as an absolute priority this year. That put it below creating jobs, defeating the Islamic State, reducing income inequality, increasing the minimum wage and fixing and keeping the new health-care law. (Gerald Seib, 1/26)
The Wall Street Journal's Washington Wire:
Why Data On Health-Care Price Variation Doesn’t Itself Solve The Problem
The Blue Cross and Blue Shield Association (BCBSA) last week put out one of the best reports I have seen on price U.S. in health services. The report documents “extreme price variation” across the country for knee and hip replacements. It called for arming consumers with more price information but stopped there; it did not suggest there was anything large insurers—such as Blue Cross–could do about the problem themselves or call for greater government action. The association examined hip and knee replacements in 64 markets across the country and found more than a threefold difference in the average cost of knee and hip replacements across markets. Perhaps even more startling, the analysis found that prices within markets can vary by as much as 313%. (Drew Altman, 1/27)
The Wall Street Journal's Washington Wire:
Who’s Going To Pay For This Obamacare Wish List?
I wrote in this space last June that supporters of the president’s health-care law had not made many specific suggestions about how to amend or otherwise change the Affordable Care Act. Last week, the advocacy group Families USA attempted to change that, releasing its “Health Reform 2.0” agenda of how to expand on Obamacare. But the paper also raises an important question for the law’s supporters—including presidential candidates running in 2016: How to pay for the myriad promises that liberal groups want to add to the health-care agenda? (Chris Jacobs, 1/26)
Los Angeles Times:
This Conservative Op-Ed Confirms The Immorality Of Repealing Obamacare
Rarely do conservative opponents of the Affordable Care Act acknowledge the real human consequences of their campaign to overturn the healthcare reform law. But an astonishing op-ed published Friday by the Washington Post does just that. Its author, Michael R. Strain of the American Enterprise Institute, argues that even though the result of repeal is that some Obamacare beneficiaries may die from losing their insurance, that outcome is moral. As the Post's editors succinctly and accurately headlined the piece: "End Obamacare, and people could die. That's okay." (Michael Hiltzik, 1/26)
The Wall Street Journal:
‘Ordinary Contract Principles’
Sometimes the Supreme Court’s most important contribution resembles the job of a baseball catcher who stops wild pitches from heading to the stands. An example came Monday when the High Court unanimously blocked an attempt to rewrite a contract to make retiree health benefits a lifetime obligation. In M&G Polymers v. Tackett, retired employees and their union claimed that the company that had taken over their previous employer couldn’t renegotiate the terms of retiree health care even after the collective-bargaining deal expired. The Sixth Circuit Court of Appeals sided with the retirees based on an expansive interpretation of contract law that Justice Clarence Thomas took apart piece by piece. (1/26)
Bloomberg:
Big Pharma Is A Pointless Target For Warren
Senator Elizabeth Warren has a modest proposal for pharmaceutical companies that get fined by the Food and Drug Administration for rule violations: a sort of "swear jar" that will require them to give money to the National Institutes of Health every time they break the FDA's rules .... There are a few problems with Warren's proposal, starting with the fact that it seems to assume that the NIH is the ultimate source of all those Big Pharma profits, which is why some of those profits should be transferred to the NIH to fund "the next generation of medical research." In fact, academic research -- most of it presumably NIH-funded -- accounts for only about a quarter of new drugs. The majority are discovered by pharma or biotech firms. (Megan McArdle, 1/26)
The Wall Street Journal:
Fear Measles, Not Vaccines
A measles outbreak traced to the Disneyland theme park in California has infected nearly 70 people since December. Even before this alarming episode, 2014 saw the worst U.S. measles outbreak in two decades. What else happened last year? More than 13,000 parents nationwide claimed on forms that vaccinating their children from preventable diseases like measles violated their “personal beliefs.” (Marc Siegel, 1/26)
The Baltimore Sun:
A Risky Cut To Medicaid
Of all the major spending cuts Gov. Larry Hogan proposed in his budget, the easiest one for him politically may be the $160 million he's seeking to trim out of the Medicaid program. The reason is not just the cynical one, that Medicaid is a Democratic issue and that the people who rely on it probably didn't vote for him anyway, though there may be some truth to that. Rather, the reason Mr. Hogan isn't taking much heat for it so far is that he's merely continuing a cut former Gov. Martin O'Malley enacted through the Board of Public Works earlier this month. Even the state medical society, while opposed to the policy, is holding its fire where Mr. Hogan is concerned and pinning the blame on his predecessor. But it's one cut that could prove penny wise, pound foolish. (1/26)
The Denver Post:
Leadville Hospital Needs A Savior
St. Vincent, Leadville's only hospital, is dying. Most medical services have been eliminated, although the emergency room, three patient rooms and ambulance services are still functioning, according to Karen Reinhart, hospital director of community relations. The boiler and pipes have been breaking, and staff members have left. Without some miracle, St. Vincent will disappear, leaving Lake County without a hospital and forcing residents to drive 33 dangerous mountain miles to the nearest hospital in Frisco. (Tom Noel, 1/26)
JAMA:
Mandatory Use Of Prescription Drug Monitoring Programs
The United States is in the midst of a prescription opioid overdose and abuse epidemic. The rate of fatal prescription drug overdoses involving opioids almost quadrupled from 1.4 deaths/100 000 people in 1999 to 5.4 deaths/100 000 people in 2011. ... Prescription drug monitoring program mandates are a proliferating policy tool. It will be critical to strike a balance between addressing legitimate practitioner concerns and retaining features fundamental to mandate efficacy. System imperfections, such as the lack of real-time, interstate data and lack of full integration into clinical workflow, are important drawbacks that should be addressed. However, these limitations do not render PDMPs useless, nor should they block mandates altogether. (Rebecca L. Haffajee, Anupam B. Jena and Scott G. Weiner, 1/26)