KHN Morning Briefing

Summaries of health policy coverage from major news organizations.

Viewpoints: Campaigning Won’t Help Solve Health Care Problems; Health Law Sought ‘Sturdier Safety Net;’ Court’s Decision On Contraception Benefit ‘Goes Wrong Way’

The Washington Post: Rhetoric Vs. Reality
The Obamacare Web site doesn't work. Hundreds of thousands of insured Americans are seeing their plans summarily terminated. Millions more face the same prospect next year. Confronted with a crisis of governance, how does President Obama respond? He campaigns (Charles Krauthammer, 11/7).

The New York Times: Evaluations: Different Kinds Of Health Care Disruption 
Last week, amid the ongoing coverage of rising premiums and cancelled plans, the health care law's defenders took a new tack, arguing that the most plausible conservative alternatives to Obamacare would involve even more disruption of existing arrangements — with the implication being, then, that Republican outrage over "rate shock" is either straightforwardly cynical or else a sign that the G.O.P. would never, ever be willing to embrace a reform that disrupts the status quo at all (Ross Douthat, 11/7). 

The Washington Post: Obamacare: Weaving A Sturdier Safety Net
This is not to excuse President Obama for peddling a misleading claim or to excuse those of us in the news business for failing to press him on it earlier. The president's weaselly rewording of his pledge — "What we said was you can keep it if it hasn't changed since the law passed" — insults anyone who heard what he said repeatedly. Yet there was always an unstated asterisk to the presidential promise. Existing plans would be grandfathered in and not subject to the heightened requirements (i.e., better benefits) of the Affordable Care Act (Ruth Marcus, 11/7).

The New Republic: It's True: Obamacare Will Force Some People To Pay More For The Same Coverage
But some of the people getting cancellation notices had generous coverage—not the "junk insurance" that, as President Obama now acknolwedges, the new law prohibits. ... They will pay more for insurance next year but they won't get more for it. Some will actually get less. ... a system that discriminates against some people inevitably discriminates in favor of others. If you had asthma or diabetes or had survived cancer, you basically couldn't get coverage in the old market. If you had a less severe condition—maybe you had a bad bone break last year—you might be able to get coverage but with related services, like physical therapy, excluded. But if you were in good health, you could get insurance. And precisely because you seemed like a good risk, insurers were willing to give you a pretty good price—at least by the standards of American health insurance (Jonathan Cohn, 11/7).

Forbes: Fact-Checking The President's Kind-Of Sort-Of 'Apology' For Obamacare-Driven Insurance Cancellations
What makes Obamacare such a deeply flawed piece of work is not that it disrupts our existing arrangements, but that it disrupts those arrangements by forcing people to buy costlier coverage. And not only does Obamacare force people to buy costlier coverage, it most significantly punishes a population that is already disadvantaged in our current system: people of average income who buy coverage on their own, and don’t benefit from the heavy subsidies enjoyed by people with government- or employer-sponsored insurance. Critics of the President are right to hold him accountable for the inexcusable deception contained in his "like your plan, keep your plan" pledge. But if they in turn promise unrelenting fealty to the status quo, they will doom any efforts to reform our health care system in a better way (Avik Roy, 11/8).

Bloomberg: Fear Of Mooching Threatens Obamacare
The U.S. has spent four years arguing about the political, legal and technological impediments to Obamacare. We may have missed an even higher barrier: the American stigma around feeling like a freeloader (Christopher Flavelle, 11/7).

JAMA: Remodeling Health Care Requires A Care Coordinator
President Obama has appointed management consultant Jeffrey Zients to ensure repair of the [federal health] website as soon as possible. One of the first actions taken by [Jeffrey] Zients was to hire Quality Software Services "to manage the overall effort like a general contractor on a home improvement project." ... Zients’ comment indicates that the failure of HealthCare.Gov could be attributed, at least in part, to a lack of coordination among multiple software companies with areas of highly technical specialty expertise. In many ways, the lack of coordination in building the federal health insurance marketplace website parallels the same lack of coordination in the delivery of US health care (Andrew Bindman, 11/7).

USA Today: Sebelius, You're Not Fired!
On Oct. 1, millions of citizens came face to face with one of the greatest blunders of our generation. After almost half a billion dollars spent on the computer registration system for Obamacare, the website coughed, sputtered and appeared to descend into an immediate coma as millions tried to log on. One reason is that the Obama administration never fully tested it. For many, the greatest surprise was not that the government spent wildly on a defective system, but that the failure did not result in a single termination. While the agency's top technology officer, Tony Trenkle, wisely is retiring, the appearance of the still employed Health and Human Services Secretary Kathleen Sebelius at a congressional hearing this week led many to ask a reasonable question: What does it take to lose a government job? (Jonathan Turley, 11/7).

The New York Times: Religion, Contraception And Bosses' Rights
The federal health care law's mandate that employer health plans cover birth control has sparked dozens of lawsuits by secular, for-profit companies and their owners seeking to be exempted on religious grounds from having to comply. At this point, a handful of federal appeals courts have ruled on the question, with a few correctly rejecting the specious religious liberty claims. The latest ruling, issued last week, goes the wrong way (11/7).

The National Review: Hold the Line On Medicaid
[Gov. Rick] Perry and the Texas legislature have made the right decision. To begin with, Medicaid is a terrible program. It provides few if any measurable health-care benefits, and a number of studies — not from right-wing think tanks, but from the Annals of Surgery, among others — have suggested that it has negative effects on the health outcomes of its so-called beneficiaries. From overall hospital deaths (University of Virginia study) to certain cancers (University of Pennsylvania study) to vascular disease (Columbia-Cornell study), Medicaid patients do no better, and often do worse, than those with no insurance at all; their outcomes reliably lag those of patients in private insurance. And their access to health care is far from guaranteed: Doctors do not want to see Medicaid patients, for reasons of reimbursement and bureaucratic hassle (11/8).

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