Longer Looks: KHN’s Best Health Policy Picks From Thought-Provoking Publications

A new weekly feature, which will provide a selection of thought-provoking articles from a variety of sources. If you have seen anything you think we should include, please let us know: KHNnews@kff.org, and please put "Worth Reading" in the subject line.

Newsweek / The Center for Public Integrity: The Mammogram Hustle
Hospitals and clinics nationwide have spent billions buying digital-mammography units since 2000, when General Electric sold the first one in the U.S. Unfortunately, although the newer technology might be better at detecting breast tumors in younger women, it has not been proven to improve breast-cancer detection or health outcomes in women 65 and older ... Yet despite the lack of evidence that digital mammograms are superior for older women, political pressure has forced Medicare to pay health-care providers more for them. That is one factor pushing more doctors to buy the digital systems and bill Medicare for their use, driving up health-care costs. That triumph has come at a steep cost to the nation's health-care budget and, possibly, to women's health (Joe Eaton, Elizabeth Lucas and David Donald, 1/30).  

Governing: Medicaid, Incentives And The Future Of Federalism
Federal health-care programs have been carrots, with inducements to encourage everyone to play Obama's health-care reform was built on the premise that this vegetarian federalism wasn't working well enough -- too many Americans were left without health insurance -- so the program requires individuals to buy insurance. The federal government merely created the mandate, set the basic rules and put the states in the tough position of having to build and manage the exchanges where uninsured individuals would buy their coverage. The states, in subtle but critical ways, moved out of the produce aisle of carrots to the hardware aisle of sticks. If the carrots aren't working and the sticks might be unconstitutional, where does that leave us? (Donald F. Kettl, February, 2011). 

National Review : Waivers For Favors: Big Labor's Obamacare Escape Hatch
President Obama's storytellers recently launched a White House blog series called "Voices of Health Reform," where "readers can meet average Americans already benefiting from the health reform law." I propose a new White House series: "Voices of Health Reform Waivers," where taxpayers can meet all the politically connected unions benefiting from exclusive get-out-of-Obamacare passes - after squandering millions of their workers' dues to lobby for the job-killing, private-insurance-sabotaging law from which they are now exempt (Michelle Malkin, 1/28).

Slate: Health Care Ruling: WTF?
White House aides tried to dispatch the ruling with two arguments: First, this was just one of many rulings, and not all of them have been unfavorable. Second, the judge's weak ruling was politically motivated. This is a pretty standard response-nothing to see here-but it comes at a time when the White House is trying afresh to not let unplanned events knock it off its intended path. The president says he doesn't want to relitigate the past, but he knows the health care issue must be managed, and in his State of the Union address he told Republicans he was open to tweaking the bill (John Dickerson, 1/31).

Governing : The Nation's Only Health Insurance Commissioner Takes On The Health-Care System
If proximity were a reliable guide to power, you would think Blue Cross & Blue Shield of Rhode Island has it and that Christopher Koller, the state's health insurance commissioner, does not. Blue Cross & Blue Shield (BCBS) occupies space in a $125 million office tower that sits at the foot of Capitol Hill in Providence. Koller's offices are in Cranston, nine miles south of the capital. ... Yet sit down with Blue Cross Blue Shield of Rhode Island CEO James Purcell, and you'll hear a very different assessment of the balance of power between the office of Christopher Koller, the state's health insurance commissioner, and the state's $3 billion commercial health insurance industry (John Buntin, February, 2011).