Viewpoints: Scrutinizing The Cadillac Tax; Spiraling Drug Prices; Battling Gun Violence

The Wall Street Journal: Tax On Expensive Health Insurance Plans Could Cut Care Along With Costs
The Affordable Care Act took enormous strides toward providing access to health-care coverage to the tens of millions of uninsured Americans and reining in the skyrocketing costs of health care that heavily pressured households and public budgets, addressing what we consider the most glaring shortcomings of the U.S. health system. When it comes to cost control, however, the policy virtue of one provision of the ACA–the excise tax on high-cost employer-sponsored health insurance plans, frequently called the Cadillac tax–is often overstated. (Josh Bivens and Elise Gould, 10/2)

The Wall Street Journal: Why The Health Care ‘Cadillac Tax’ Is Really Under Fire
Love it or hate it, the Affordable Care Act was at least paid for. That was something of a triumph after years in which a new prescription drug program, massive tax cuts, and multiple wars were not paid for. And that’s why bipartisan efforts to repeal the “Cadillac tax”–a provision to help pay for the Affordable Care Act–are so troubling. ... the real reason politicians on the left and right don’t like the Cadillac tax is not that it won’t work well enough but that it will work too well in controlling health-care costs. That presents a problem for entrenched interests that rely on ever growing health-care benefits. Remember how health-care reform was supposed to help control costs? Well, this tax is a big part of that equation. (Maya MacGuineas, 10/2)

Bloomberg: Clinton Runs On Obamacare Benefits, Not Costs
Democrats writing the Affordable Care Act in 2009 took Congressional Budget Office cost estimates seriously, and changed their bill to ensure it was projected to lower the federal budget. Meanwhile, Republicans have spent the last six years attacking every funding mechanism and other cost of the law while in most cases promising that their (still unseen) alternative would somehow provide all the benefits that the reform has brought. Every Republican politician claims the conservative alternative to Obamacare will cover those with pre-existing conditions, for example, but not one of them has suggested how to pay for it. So it was a surprise when [Hillary] Clinton came out this week for repeal of the “Cadillac tax” -- the Obamacare provision that tries to cut overall health-care spending by limiting the current tax advantages for gold-plated employer-linked health insurance. (Jonathan Bernstein, 10/2)

The New York Times: The Candidates On Health Care
While the Republican presidential candidates have been busy railing against Obamacare, the two leading contenders for the Democratic nomination have staked out radically different ideas on how to improve the American health care system. Hillary Rodham Clinton has proposed adding useful consumer protections to the Affordable Care Act. Senator Bernie Sanders wants to create a single-payer system that would essentially expand Medicare to cover people of all ages. (10/2)

The Philadelphia Inquirer: Trump Health Care Plan Not Yet Coherent
Guess who supports universal health coverage? "Everybody's got to be covered," Donald Trump declared on CBS's 60 Minutes last weekend. The Donald, always full of surprises, promised, "I am going to take care of everybody. I don't care if it costs me votes or not." Courageous words, indeed. Trump, along with all of his opponents for the Republican presidential nomination, calls for repealing Obamacare. But unlike most of the others, he has gone so far as to put forth a plan to replace it. (Robert I. Field, 10/4)

The Washington Post: Appeal House V. Burwell
As general counsel of the House of Representatives in 2008, I brought the first successful lawsuit by the chamber against the executive branch. But I do not celebrate the recent House victory in federal District Court allowing it to proceed with its ill-considered litigation over appropriations under the Affordable Care Act, known colloquially as Obamacare. If not overturned, this decision could have seriously adverse consequences for our democracy, as well as for millions of needy Americans. (Irvin B. Nathan, 10/4)

Los Angeles Times: How A $500 UCLA Hospital Copay Turned Into A $3,900 Bill — For 1 Injection
[Michael Krival's] 9-year-old daughter was diagnosed by a UCLA specialist with a hormone disorder. She was prescribed a series of injections of a specialty drug called Lupron Depot. ... Krival said ... they received a written estimate from the hospital that their copay would be $500 for the first shot. ... The bill arrived this month. Krival's copay wasn't $500. It was $3,908.71. ... "What they did was literally a bait and switch," he said. There's the crux of it: Patients are placed at a significant disadvantage by a healthcare market that lacks clear pricing, and often are denied the opportunity to choose more affordable options. (David Lazarus, 10/2)

The Philadelphia Inquirer: Pricey Pills And The Law That Makes Them So
Turing Pharmaceuticals' recent decision to raise the price of a drug from $13.50 to $750 per pill, a 5,455 percent increase, was viewed as nothing but corporate greed. But the issue is not morality. The focus of attention should be on the drug industry's monopoly pricing power and how it might be offset through unified consumer buying power. With Medicare turning 50 this year and its costs continuing to rise, it's an opportune time to allow the federal government to negotiate drug prices. (Joel L. Naroff, 10/4)

The Philadelphia Inquirer: U.S. Public Complains About Drug Prices But Takes No Action
Drug prices are rising faster than most other health care costs and while surveys show that the American public resents the situation – 73 percent now favor price controls – the costs still keep going up. It seems that unaffordable medications have now taken their place in American life alongside deranged mass murderers with firearms and enormous disparities of income and wealth. The American public despises all those trends, but not enough to fix any of them. For starters it is worth asking why the U.S. pays two to three times more for the same drugs than other advanced nations? In most cases a few basic factors account for it. (Daniel R. Hoffman, 10/5)

The New York Times: The Biggest Questions Awaiting The Supreme Court
When the Supreme Court’s most recent term ended in June, same-sex marriage was legal nationwide, and two major pieces of federal legislation — the Affordable Care Act and the Fair Housing Act — remained intact, despite carefully coordinated legal attacks meant to destroy them. The court’s new term, which starts Monday, will jump right back into high-profile constitutional battles like voting rights, affirmative action and the death penalty, as well as a new attack on public-sector labor unions. And the justices may well agree to take up issues of abortion and contraception again, in cases that could further strip away reproductive rights. The decisions last term showed a court willing to take into account the effects of the law on individual lives. This term, the justices have many opportunities to show that same type of awareness. (10/5)

The New York Times: A New Way To Tackle Gun Deaths
It’s time for a new approach to gun violence. We’re angry, but we also need to be smart. And frankly, liberal efforts, such as the assault weapons ban, were poorly designed and saved few lives, while brazen talk about banning guns just sparked a backlash that empowered the National Rifle Association. What we need is an evidence-based public health approach — the same model we use to reduce deaths from other potentially dangerous things around us, from swimming pools to cigarettes. We’re not going to eliminate guns in America, so we need to figure out how to coexist with them. (Nicholas Kristof, 10/3)

The Washington Post's Wonkblog: If You Want Mental Health Services To Prevent Violence, Medicaid Expansion Is Critical
Oregon’s mass homicide sparked the usual debate about whether guns or mental health is the best focus in preventing atrocities. ... Many conservatives place greater emphasis on the mental health system. In some ways, this rhetoric is misplaced. The fraction of American violence attributable to severe mental illness is quite low, on the order of five percent. We must also avoid reinforcing cruel stereotypes regarding millions of Americans who live with major depression, bipolar disorders, or related conditions. Still, it’s always wise to consider how our mental health systems could treat people more effectively, and more-reliably keep weapons away from dangerous individuals. (Harold Pollack, 10/2)

Sioux City Argus Leader: Governor’s Medicaid Expansion Plan Worth Pursuing
Gov. Dennis Daugaard is pursuing a plan to expand Medicaid coverage to more than 48,000 South Dakotans. Daugaard traveled to Washington, D.C. last week to meet with Health and Human Services Secretary Sylvia Burwell and outline the expansion proposal. Preliminary response from federal officials has been positive and we urge him and other officials to continue to work together to make the plan a reality. (10/3)

The Charlotte Observer: Lack Of Medicaid Expansion In NC A Scourge Upon Our Morality
Five years ago, Congress passed the Affordable Care Act, including Medicaid expansion that became effective in January 2014. Our legislature and governor’s willful rejection of expansion has cost North Carolina up to $6 billion in income and 50,000 new jobs and caused 4,000 to 5,000 North Carolinians to die unnecessarily and many more to become ill, stay ill or be diagnosed with later, more advanced diseases. Further delays will cost another $21 billion, 43,000 jobs and 10,000 lives by 2020. Now, like hot air balloon salesmen approaching the Wright brothers at Kitty Hawk, come the General Assembly and governor with a move to privatize Medicaid, passed and signed amid claims it will provide more consistent care and put some controls in the system, predictions that will prove untrue. (Kenneth J. Fortier, 10/3)

The Washington Post: Jamycheal Mitchell’s Ghastly Death
For want of an available bed in a state psychiatric hospital, Jamycheal Mitchell,a mentally ill young man in Virginia who shoplifted a soda and two snacks worth $5.05 from a 7-Eleven, wasted away behind bars for four months, all but ignored by jail staff who should have noticed his catastrophically deteriorating health. Incoherent, emaciated and filthy, he died in his cell in August. Police are now investigating. Mr. Mitchell’s ghastly death, at age 24, is all the more senseless given that the closest state psychiatric facility, Eastern State Hospital, in Williamsburg, should have had a bed available for him. (10/3)

The New York Times' Upshot: The Decline Of ‘Big Soda’
Five years ago, Mayor Michael A. Nutter proposed a tax on soda in Philadelphia, and the industry rose up to beat it back. ... The obvious lesson from Philadelphia is that the soda industry is winning the policy battles over the future of its product. But the bigger picture is that soda companies are losing the war. Even as anti-obesity campaigners like Mr. Nutter have failed to pass taxes, they have accomplished something larger. In the course of the fight, they have reminded people that soda is not a very healthy product. (Margot Sanger-Katz, 10/2)

Bloomberg: The Job Of The Future Is ... Home Health Care
The BLS has projected that by 2022 there will be 1.9 million home health care workers, making it the fastest growing industry in the land over the coming years, just ahead of the not entirely dissimilar categories of individual and family services and outpatient, laboratory and other ambulatory care services. You could say, then, that home health care services is the defining industry of our age. .... Jobs in home health care pay worse than average, and 87 percent are held by women. (Justin Fox, 10/2)

The New York Times: The Tools To Fight H.I.V.
Medical leaders have the knowledge and the tools to greatly curtail the global AIDS epidemic within the next 15 years. The question is whether the nations of the world will invest the resources to do it. The World Health Organization recommended last week that millions more people be given antiviral drugs than are now getting them. The agency recommended that everyone already infected with H.I.V., the virus that causes AIDS, be given three antiviral drugs the minute they are diagnosed, much earlier than current practices. And they recommended that uninfected people at high risk of becoming infected be given a pill containing two antiviral drugs to protect them from the virus. (10/4)