KHN Morning Briefing

Summaries of health policy coverage from major news organizations.

Viewpoints: The Battle Over One Woman’s Medical Story; Why Mass. Didn’t See A Wave Of Cancellations; Politicians’ Love Of Anecdotes

The Wall Street Journal: Edie Sundby’s Choice
Edie Littlefield Sundby may not have thought she'd ignite a national debate when the stage-4 cancer survivor asked us to publish her Monday op-ed on losing her oncologist due to the Affordable Care Act. But she certainly has, and it's important to understand why. Mrs. Sundby and millions like her must be denied their medical choices if ObamaCare is going to work as its liberal planners intend (11/6).

Los Angeles Times: A Closer Look At The WSJ's Newest Obamacare Horror Story
The most prominent example of Obamacare victimization being offered at the moment comes from Edie Littlefield Sundby of San Diego, a businesswoman who related in a Wall Street Journal op-ed earlier this week how Obamacare is threatening her life by depriving her of access to her cancer doctors. … There's no reason to doubt Sundby's dilemma in trying to continue her current treatment, or her conviction that her survival is the product of her particular lineup of doctors and hospitals. (Though her earlier interviews certainly suggest that her spirit, her tenacity, and the support of her husband may have had a lot to do with her survival.) But what Sundby, 62, addresses in her op-ed is the question of whether Obamacare places her health at risk. There the evidence doesn't look so clear. In fact, there are signs that the Affordable Care Act might help save her (Michael Hiltzik, 11/6).

CNN: Bloomberg Could Fix Obamacare
Liberals and conservatives don't agree on much these days, but many agree on this: The Department of Health and Human Services' HealthCare.gov rollout has been a debacle. That's reason enough for President Obama to replace agency Secretary Kathleen Sebelius, and he should go with an unconventional choice: New York Mayor Michael Bloomberg. ... The ongoing fiasco has not only dealt a body blow to the Affordable Care Act, it has set back the entire progressive project of good, smart government by failing so ridiculously on one of its most visible public initiatives (Michael Zuckerman, 11/5).

The Boston Globe: Why Obamacare Can’t Replicate Mass.
If the Affordable Care Act was modeled on the Massachusetts health reform, why was the rollout of the Commonwealth’s program in 2006 smooth while the launch of Obamacare is so buggy? The answers speak volumes about what prevents Americans from getting efficient health care reform (Robert Kuttner, 11/6).

The Washington Post: At Obamacare Hearings, Governing By Anecdote
It did not sound good for Sen. Pat Toomey. "I'm a two-time breast cancer survivor and I’m facing the loss of insurance," the Pennsylvania Republican declared Wednesday at a Senate Finance Committee hearing on the health-care law. "Three years ago, I was diagnosed with multiple sclerosis," he added. ... Happily for Toomey, he was not describing his own maladies. He was reading e-mails sent by his constituents. But the senator has contracted a dangerous condition that can cause people to have impaired judgment. It's called governing by anecdote — and it's spreading (Dana Milbank, 11/6).

The Washington Post's The Plum Line: Ignore The Spin War About Obamacare. It's Irrelevant. Rinse, Repeat.
So you thought Republicans had finally given up on "repeal and replace" as their slogan about the Affordable Care Act? It seemed to be dead and buried more than a year ago. But this is one that just can't stay buried. In a new op ed piece, Paul Ryan claims that, yes, Republicans still intend to use the "republican remedy" of winning elections so that they can, yes, "repeal and replace Obamacare." It’s back! (Jonathan Bernstein, 11/6). 

The Wall Street Journal: How ObamaCare Rips Off The 'Young Healthies'
When ObamaCare is under attack, its defenders retreat to several well-worn claims. Among them is a provision that compels insurance companies to allow parents to keep their "children" ages of 21 to 26 on their family policies. Yet this part of the Affordable Care Act was not engineered in response to any noticeable interest group. Instead, political considerations are responsible for the provision—which is an unnecessary and a deceptive ripoff of the "young healthies" (Carl Schramm, 11/6). 

The Wall Street Journal: ObamaCare Goes Hollywood For Hispanics
With a disastrous ObamaCare website rollout and millions of Americans being kicked off their health-insurance plans, it's clear things aren't going well for the president's signature legislation. This week saw fresh evidence of how worried ObamaCare supporters are: news of an effort to use Hollywood story lines to send a message to Hispanics that they should sign up. It's not the first time promoters of government programs have used TV and radio programming to win over the country's largest minority group (Mike Gonzalez, 11/6). 

Bloomberg: Obamacare’s Defects Are The Price Of Bad Politics
The rollout of Obamacare could hardly have gone worse. To understand what happened and judge whether things might improve, notice that the problems fall into three fairly distinct categories: defects in the plan, defects in its initial execution and defects in the way it was sold. In the end, only the first will matter (Clive Crook, 11/6).

Bloomberg: Was Obamacare The Big Election Issue?
Bloomberg View columnists Margaret Carlson and Ramesh Ponnuru met online to chat about the elections in Virginia, New Jersey and Alabama and the continuing mishaps of the Patient Protection and Affordable Care Act. Below is a lightly edited transcript (Margaret Carlson and Ramesh Ponnuru, 11/6).

USA Today: Health Care Needs A Steve Jobs
At some point, a freewheeling United States gave birth to the most innovative health care system in human history. American doctors have continuously introduced medical miracles. But today, every young health care professional ought to ask, "Can we keep it up?" Anyone who has witnessed the Obamacare meltdown can be forgiven for wondering, too (Robert Graboyes, 11/6). 

The New York Times: Getting Government Technology Right
The problems with the federal health insurance website have highlighted the need for broad reform in how the government uses technology to deliver public services (11/6).

The Washington Post: Clunker Progressivism
Barack Obama's presidency has become a feast of failures whose proliferation protects their author from close scrutiny of any one of them. Now, however, we can revisit one of the first and see it as a harbinger of progressivism's downward stumble to HealthCare.gov (George F. Will, 11/6). 

The San Francisco Chronicle:  Out With The Old, In With Obamacare
The math for the Affordable Care Act in California is stark: Kick 1 million Californians off the private health care plans they already have at the end of the year so that a million Californians can enroll in subsidized Obamacare plans. Another million or so can stay in their old plans, and the state will sign up an additional 1.1 million for Medi-Cal. The losers are Californians, many of them Obama voters, who run their own shops and did the right thing by buying private health care, probably after Obamacare passed. If they are among the two-thirds of private policyholders expected not to qualify for federal subsidies, they face an ugly case of rate shock (Debra J. Saunders, 11/6).

Virginian-Pilot: 47,000 Reasons To Expand Medicaid
The financial cost of refusing to expand Medicaid is overshadowed by the human toll. As The Pilot's Amy Jeter recently reported, Virginia's intransigence ensures that about 47,000 people here in South Hampton Roads will continue to be denied coverage. They earn less than 138 percent of the federal poverty level - about $15,415 for one person, and $31,809 for a family of four -- making them ineligible to receive the subsidies better-paid people can receive to buy insurance (11/7).

And on other issues -

Los Angeles Times: The Lyme Disease Battle
There is a subculture in America you may know little about. Its members are haunted by a slender, twisting, tick-borne germ known as Borrelia burgdorferi, the microbe responsible for Lyme disease, and they are trying desperately to warn us that we are all at risk of contracting a debilitating, chronic illness characterized by joint pain, fatigue, mood disorders and a long list of other symptoms. Arrayed against these true believers are most of the mainstream scientists who study B. burgdorferi. Although they acknowledge that Lyme disease is a genuine illness that humans can get from being bitten by infected ticks, and that those who are not treated promptly can develop worse symptoms, they don't believe that infection leads to a chronic condition (Wendy Orent, 11/7).

The New York Times’ Opinionator: Treating The Village To Cure The Disease
In communities across Africa, health workers are going house to house with medicine to combat lymphatic filariasis, or L.F., which is the world's second-largest cause of chronic disability. They make sure the children are old enough, the women aren't pregnant and no one is seriously ill. Then people take two pills while the health worker watches. She writes down their names in her ledger (Jason Silverstein, 11/6).

The New England Journal of Medicine: Grading A Physician's Value — The Misapplication Of Performance Measurement
Perhaps the only health policy issue on which Republicans and Democrats agree is the need to move from volume-based to value-based payment for health care providers. Rather than paying for activity, the aspirational goal is to pay for outcomes that take into account quality and costs. In keeping with this notion of paying for value rather than volume, the Affordable Care Act (ACA) created the "value-based payment modifier," or "value modifier," a pay-for-performance approach for physicians who actively participate in Medicare. By 2017, physicians will be rewarded or penalized on the basis of the relative calculated value of the care they provide to Medicare beneficiaries. Although we agree that value-based payment is appropriate as a concept, the practical reality is that the Centers for Medicare and Medicaid Services (CMS), despite heroic efforts, cannot accurately measure any physician's overall value, now or in the foreseeable future (Drs. Robert A. Berenson and Deborah R. Kaye, 11/6).

The New England Journal of Medicine: Medicare's Physician Value-Based Payment Modifier — Will The Tectonic Shift Create Waves?
Given the challenges entailed by a much-needed tectonic shift toward value-oriented physician payment, it made sense for the ACA to require CMS to introduce an incentive program with familiar design elements, quality measures, and attribution methods. But the [Physician Value-Based Payment Modifier] cannot be effective until a broader base of physicians is fully engaged, potentially controversial issues related to accountability and attribution are addressed, and stakeholders gain the necessary experience in improving care quality and cost in real-world settings (Dr. Alyna T. Chien and Meredith B. Rosenthal, 11/6).

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