KHN Morning Briefing

Summaries of health policy coverage from major news organizations.

Viewpoints: The Debate At AOL About A Baby’s Medical Costs; Gov. Jindal Says Economy’s Verdict On Health Law Is Not Good

Slate: My Baby and AOL's Bottom Line
Late last week, Tim Armstrong, the chief executive officer of AOL, landed himself in a media firestorm when he held a town hall with employees to explain why he was paring their retirement benefits. After initially blaming Obamacare for driving up the company’s health care costs, he pointed the finger at an unlikely target: babies. Specifically, my baby. ... ... She weighed 1 pound, 9 ounces. ... I take issue with how he reduced my daughter to a "distressed baby" who cost the company too much money. How he blamed the saving of her life for his decision to scale back employee benefits. How he exposed the most searing experience of our lives, one that my husband and I still struggle to discuss with anyone but each other, for no other purpose than an absurd justification for corporate cost-cutting (Deanna Fei, 2/9).

Los Angeles Times: AOL Takes 'Blame Obamacare' To A New Level
As we observed back in December, one of the solid benefits the Affordable Care Act has brought to business leaders is to give them a convenient scapegoat for their own management problems. AOL's chairman and CEO, Tim Armstrong, this week raised that practice to an art form. In the process he blamed a couple of the company's employees, bizarrely, for their high medical costs. ... what is Armstrong talking about? He didn't specify, which is reason itself to believe he's blowing smoke. As a large employer, AOL doesn't face any new healthcare mandates under the Affordable Care Act, except to allow employees to keep children on their health plans up to age 26. But that's an incremental cost (Michael Hiltzik, 2/8). 

CNN: AOL's Excuses? Two Sick Babies And Obamacare
Here's why two newborns and the costs of Obamacare are unlikely to be the reasons that AOL changed its 401(k) program. ... Although it's convenient for employers to blame Obamacare for any instability or changes to health-care spending, the fact remains that the cost of maternity or other benefits spread over a large insured population is minimal. ... Blaming two new mothers for these sweeping benefit cuts is an awful way to treat employees who are already facing the worst of all possible scenarios: a very sick child (Dylan Roby, 2/8).

Los Angeles Times: Obamacare: It's A Net Gain For The Economy
The recent Congressional Budget Office report on healthcare reform has lots of good news. Insurance premiums are lower than anticipated, the Affordable Care Act will cost $9 billion less than previously estimated and the provision designed to buffer insurance companies from risk will actually raise revenue, not function as any sort of federal government bailout. But the good news has not gotten much attention because the CBO also projected that, within the next several years, healthcare reform may reduce employment and worker hours by the equivalent of about 2 million full-time positions (Jonathan Gruber, 2/9). 

Politico Magazine: Obamacare Is Anything But Compassionate
The verdict is in, and it's not good: Obamacare is rippling through the U.S. economy with vast implications for American prosperity. On Friday, we learned that the Obama economy has hit stall speed, with a paltry 113,000 jobs added in January. Two days earlier, we learned the president's health care law is discouraging Americans from working, according to an analysis by the nonpartisan Congressional Budget Office. The report makes for bracing reading. The law will reduce the labor supply by the equivalent of 2.3 million full-time workers, the CBO says — up from an estimated 800,000 just three years ago (Louisiana Gov. Bobby Jindal, 2/9).

Politico: Why Do Republicans Want Us to Work All the Time?
This week, America's political class has been consumed by an intense, vitriolic debate over a single number: 2.5 million. That's the amount by which, according to the Congressional Budget Office, President Obama's signature health care law will effectively reduce the U.S. work force over the next decade. The initial Republican reaction was predictable: Pundits filled the airwaves, Cassandra-like, to paint Obamacare as the ultimate job killer. Never mind that, reading the fine print, it's clear the CBO was talking about workers voluntarily reducing their hours in response to the law—not getting laid off or seeing their shifts scaled back (Benjamin Kline Hunnicutt, 2/7).

The New York Times: Will Saving On Health Care Hurt The Economy?
Lost in all the debate last week about whether or not the Affordable Care Act will hurt the economy is the fact that health care is already imposing a drag on growth. The health care sector has repeatedly helped to pull the economy from recession in recent decades, but this time around it is lagging behind the recovery. ... Spending less on health care is a longstanding goal of pretty much everyone who doesn't work in the health care industry (Binyamin Appelbaum, 2/8).

The New York Times: Leaving Work Behind
 [The Congressional Budget Office predicted] that by 2021, the equivalent of 2.3 million full-time workers — most of them low-wage — could disappear from the American economy. ... it’s easy to envision cases where the ability to reduce one's working hours would be an unmitigated good — for ailing near-retirees, for parents of young children. At the same time, though, the design of Obamacare — Medicaid expansion, subsidies for comprehensive rather than catastrophic coverage, and then the way the subsidy disappears if you get a raise or take a higher-paying job — makes the work disincentive much more substantial (Ross Douthat, 2/8).

The Wall Street Journal: The Economist Who Exposed ObamaCare
[M]ore than anyone, [University of Chicago economist Carey Mulligan] is responsible for the still-raging furor over the Congressional Budget Office's conclusion that ObamaCare will, in fact, harm growth and jobs. ... Mr. Mulligan is uncomfortable speculating about whether the benefits of this shift outweigh the costs. ... One major risk is slower economic growth over time as people leave the workforce and contribute less to national prosperity. Another is that social programs with high marginal rates end up perpetuating the problems they're supposed to be alleviating (Joseph Rago, 2/8).

The Washington Post: Virginia Should Climb Onboard Medicaid Expansion
New Hampshire looks like it will be the next state to assent to the obvious and accept buckets of federal money to offer its poor citizens health-care coverage. Finally, a bare majority of states will have made this no-brainer of a policy choice, implementing the section of Affordable Care Act (ACA) meant to help low-income Americans. Every time another state joins the ranks of the rational, it should embarrass states such as Virginia, which still hold out in blinkered opposition to anything related to Obamacare, no matter how good a deal this provision is for them (2/9). 

The Washington Post: The End Of Government
The cause is no mystery. An aging population and higher health spending automatically increase budget outlays, which induce the president and Congress to curb spending on almost everything else, from defense to food stamps. Over the next decade, all the government's projected program growth stems from Social Security and health care, including the Affordable Care Act. By 2024, everything else will represent only 7.4 percent of national income (gross domestic product), the lowest share since at least 1940, says Douglas Elmendorf, head of the Congressional Budget Office (Robert J. Samuelson, 2/9). 

The Washington Post: Obama's Blind Spot On Religious Liberty
Without a hint of irony, the president lamented eroding protections of religious liberty around the world. Just not, apparently, in America. Nary a mention of the legal challenges to religious liberty now in play between this administration and the Catholic Church and other religious groups, as well as private businesses that contest the contraceptive mandate in Obamacare. Missing was any mention of Hobby Lobby or the Little Sisters of the Poor — whose cases have recently reached the U.S. Supreme Court and that reveal the Obama administration’s willingness to challenge, rather than protect, religious liberty in this country (Kathleen Parker, 2/7).

Reuters: What Unites Democrats? Republicans!
Today's Democratic Party is smaller (Southern whites are largely gone) but far more coherent. What was amazing was that Democrats held together to pass the new healthcare law without a single Republican vote during President Barack Obama’s first two years in office. Democrats couldn’t do that during President Bill Clinton’s first two years when they had similar majorities in Congress. Why the sudden surge of Democratic Party discipline in 2009 and 2010? The answer: Republicans. The Tea Party’s radicalization of the GOP ended up splitting Republicans and unifying Democrats (Bill Schneider, 2/7).

Concord (N.H.) Monitor: Medicaid Deal Is Welcome News – Finally!
But state Senate leaders announced last week that they’d come to terms on a bipartisan deal to use the federal money available to help poor residents buy private insurance policies. So far, details have not been released. ... the breakthrough is welcome news indeed. ... But it remains too early to cross this legislation off the state's to-do list. In Arkansas, which pioneered the approach New Hampshire is considering, Republican support has waned, and the state may well reverse course. And in New Hampshire, a conservative group called the Republican Liberty Caucus is urging politicians to sign its anti-Obamacare pledge, which includes opposition to expanding Medicaid through the use of federal money, "regardless of how those funds are allocated." Part of the group's rationale: "Obamacare is the gateway drug to full socialism." Please. Granting poor residents access to health care is good public policy: good for individuals, good for the economy (2/9).

Spokesman Review: Washington Legislature Needs To Close Medicaid Funding Gap
Health care reform addressed [the problem of finding doctors for Medicaid patients] by putting Medicaid rates for primary care services on a par with Medicare rates. This improved funding allowed primary care providers to take on new Medicaid patients and cover overhead expenses in their practices. The problem is there is a six-month funding gap where Medicaid rates will be reduced back to their original rate due to differences in the federal and state funding calendars. The Legislature must address this gap in the current supplemental budget (Dr. Brian Seppi, 2/8).

The Baltimore Sun: Health Insurance Bill Arrives With A Higher Price Tag Than Expected
When the bill arrived from CareFirst BlueCross BlueShield, I expected to open it and see that I owed $250 by March 15. Instead it was for $286. That's $36 more than Maryland health exchange website showed my insurance plan would cost (Meredith Cohn, 2/8).

And on other issues -

The New York Times: Inside A Mental Hospital Called Jail
The largest mental health center in America is a huge compound here in Chicago, with thousands of people suffering from manias, psychoses and other disorders, all surrounded by high fences and barbed wire. Just one thing: It's a jail. ... Psychiatric disorders are the only kind of sickness that we as a society regularly respond to not with sympathy but with handcuffs and incarceration. ... In the 1800s, Dorothea Dix led a campaign against the imprisonment of the mentally ill, leading to far-reaching reforms and the establishment of mental hospitals. Now we as a society have, in effect, returned to the 1800s (Nicholas Kristof, 2/8).

The New York Times: Lost in Clinical Translation
A classic "Far Side" cartoon shows a man talking forcefully to his dog. The man says: "Okay, Ginger! I've had it! You stay out of the garbage!" But the dog hears only: "Blah blah Ginger blah blah blah blah blah blah blah blah Ginger …" As a nurse, I often worry that patients' comprehension of doctors and nurses is equally limited — except what the patient hears from us is: "Blah blah blah Heart Attack blah blah blah Cancer." ... Ill health is frightening, the treatments we offer can be scary, and stress and anxiety make people poor listeners. Our high-tech scans and fast-paced care save lives, but we need to make time for the human issues that pull at every patient's heart (Theresa Brown, 2/9).

Bloomberg: How To Slow Heroin's Comeback
Yet the attention generated by [Philip Seymour] Hoffman's death is a reminder that heroin use is making something of a comeback nationwide, even though its use is still very rare compared with cocaine or methamphetamine. ... The new legal requirement that substance abuse treatment get parity with other diseases in insurance coverage, plus expanded insurance coverage under Obamacare, will make treatment more available. Substitution therapies (methadone and buprenorphine) for opiate addiction are valuable tools, but only if the treatment system and the criminal justice system are willing to follow the evidence rather than “just say no” prejudices (Mark A.R. Kleiman and Lowry Heussler, 2/7).

The Boston Globe: Doctors Unprepared For Medical Marijuana
Now that medical marijuana is legal in Massachusetts and licenses have been awarded for the first 20 dispensaries, you'd guess that my practice is busily preparing to meet the demands of patients seeking marijuana for several debilitating conditions including chemotherapy-related nausea and AIDS-related weight loss. You'd guess wrong. Since Massachusetts voters approved legalization in 2012, I've received no special training (required for physicians to certify patients as eligible for marijuana treatment), been invited to no seminars or lectures, and have little more information than that which the state has provided to my fellow citizens (Suzanne Koven, 2/10).

PBS NewsHour: Why Do Americans Spend So Much On Pharmaceuticals?
The United States spends almost $1,000 per person per year on pharmaceuticals. That’s around 40 percent more than the next highest spender, Canada, and more than twice as much as than countries like France and Germany spend. So why does the U.S. spend so much? Is it because Americans take more medicines or because they pay higher prices? Can Americans afford the drugs they need? And will the Affordable Care Act change anything? (Valerie Paris, 2/7).

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