KHN Morning Briefing

Summaries of health policy coverage from major news organizations.

Viewpoints: Rove Says Job Losses Growing Under Health Law; GOP Strategists Say Health Overhaul Is Aiding Their Path To White House; Mich. Senators Who Opposed Medicaid Expansion Gave Themselves Lifetime Medical Benefits

The Wall Street Journal: ObamaCare For Everything
Thousands of American higher-education administrators will spend part of Labor Day weekend trying to plumb the meaning of the ideas President Obama dropped on them last week to "reform" the American college and university system. Given the political genome of college administrators nowadays, they'll try to make the Obama plan work. But for the handful who want to preserve and protect their hallowed institutions, here's a recommendation: Drop by the nearest medical school for a chat with the doctors about how it's going with the Affordable Care Act, aka ObamaCare (Daniel Henninger, 8/28). 

The Wall Street Journal: Here Comes The Unaffordable Careless Act
Harvard (and later Columbia) sociologist Robert K. Merton wrote in 1936 about the "unanticipated consequences of purposive social action." Pity that Barack Obama, an alumnus of both universities, either never read or took to heart Merton's warnings. It would have saved Americans a lot of misery. The president certainly did not promote the Affordable Care Act by promising it would mean more part-time and fewer full-time jobs. Yet that is one of its unanticipated consequences (Karl Rove, 8/28). 

The New York Times' Opinionator: Can Republicans Paint The White House Red?
[Republican strategist Stuart Stevens] argues that a successful 2016 Republican presidential scenario can be credibly pieced together. ... [P]ublic discontent with Obamacare grows. Young voters, a key to recent Democratic victories, bristle over the requirement to buy insurance or pay a fine. Corporate plans cut spousal coverage. Businesses replace full-time workers with part-timers, ineligible for benefits. Health insurance premiums continue to rise faster than inflation. The discontent with the Affordable Care Act on the part of the three major unions – the Teamsters, United Food and Commercial Workers and Unite-Here – spreads throughout the labor movement. Glitches in rolling out the massive new healthcare program increase public opposition (the regulations governing the hiring of healthcare "navigators" to help consumers enroll total an estimated 13,900 words in the Federal Register). Increasing numbers of people cannot keep either their current doctor or their healthcare plan (Thomas B. Edsall, 8/28).

Detroit Free Press: These Senators Voted Against Medicaid, But For Lifetime Health Care For Themselves
Some Republicans bristled that [Gov. Rick] Snyder’s Medicaid expansion passed despite the opposition of a majority of the GOP lawmakers in both houses. ... As for protecting future generations from the burden of entitlement spending, consider that every one of the 18 Republican senators who opposed extending health care eligibility to Michigan's working poor — every one! — voted in November 2011 for legislation to make sure that every incumbent Republican senator except Colbeck (and every Democratic incumbent except state Sen. Vince Gregory, D-Southfield), would enjoy lifetime medical benefits (Brian Dickerson, 8/28).

The Washington Post: Health-Care Costs Are A Civil Rights Issue
In 1963, when Martin Luther King, Jr. gave his "I Have A Dream" speech, America spent 5.5 percent of gross domestic product on health care. Today we spend 18 percent, while most other wealthy nations spend 10 to 12 percent through systems that deliver equal or better health outcomes. In a $16 trillion economy, our excess health-care spending — that is, money we devote to health care that plainly isn't needed for quality care — thus comes to a staggering $1 trillion a year (Matt Miller, 8/28).

The New York Times' Taking Note: Abortion Rights Arithmetic
In case you weren't already alarmed by the barrage of state laws and regulations aimed at curtailing women's constitutionally protected right to an abortion, we now have a concrete understanding of their actual impact. Earlier this week, Laura Bassett reported on a Huffington Post national survey of state health departments, abortion clinics and local abortion-focused advocacy groups (Dorothy J. Samuels, 8/28). 

The Wall Street Journal: Wounded Vets Deserve Better
On Aug. 22, Secretary of Veterans Affairs Eric Shinseki said that the department has reduced a backlog of disability claims by 20% to some 773,000 cases, including about 480,000 that have been pending for more than 125 days. Yet no number of new claims processors will be skilled enough, no computer fast enough or shortcut quick enough to deal with the ever-rising tide of claims unless the VA refocuses on the kind of care the system was designed to deliver. The enumeration of benefits has evolved far beyond the nation's obligation to those who became ill or injured while in service. It is time to return to original principles (Anthony Principi, 8/28). 

JAMA: Fixing Disjointed Chronic Care
The US health care system does many things very well. But one thing it doesn't do well is coordinate care over time and between sectors. Whenever a patient transitions from hospital to home or from hospital to nursing home or hospice, he or she is likely to end up confused and to encounter care glitches and perverse financial incentives. While the US health care system does a better job coordinating between sectors during illness episodes, better coordination between sectors over time is needed for Americans with lengthy illnesses (Stuart Butler, 8/28).

The New England Journal of Medicine: Coordination Versus Competition In Health Care Reform
Many current proposals to increase the value of care delivered in the U.S. health care system focus on improved coordination — and with good reason. Badly coordinated care, duplicated efforts, bungled handoffs, and failures to follow up result in too much care for some patients, too little care for others, and the wrong care for many. A host of current reform efforts aim to reduce these inefficiencies in both public and private markets. ... These laudable efforts, however, may unintentionally be at odds with another strategy for improving value: promoting competition in health care markets (Katherine Baicker and Helen Levy, 8/29).

The New England Journal of Medicine: Prescription-Drug Coupons — No Such Thing As A Free Lunch
It has famously been said that "there is no such thing as a free lunch." Drug coupons are no exception to this rule. Everyone likes to save money, and coupons for essential therapies may be helpful for certain patients, particularly those with life-threatening conditions for which there are not reasonable generic substitutes. However, the majority of drug coupons are for therapies for which lower-cost and potentially equally effective alternatives exist. Physicians need to talk to their commercially insured patients about the implications of drug-coupon use and make sure that their inclination to reduce short-term out-of-pocket spending doesn't come at the cost of higher long-term expenses for themselves and society (Drs. Joseph S. Ross and Aaron S. Kesselheim, 8/28).

Fiscal Times 4 Signs Health Care Costs Are Still Out Of Control
Telling most working families that health care costs keep rising every year is like saying there are clouds in the sky. It’s simply an accepted fact. Yet when we delve into the details of why and how health care costs are climbing – often well beyond the ability of families to keep pace – the picture becomes even more troubling. It provides yet another reason to pursue meaningful reforms (John F. Wasik, 8/28).

This is part of the KHN Morning Briefing, a summary of health policy coverage from major news organizations. Sign up for an email subscription.