KHN Morning Briefing

Summaries of health policy coverage from major news organizations.

Viewpoints: Sebelius’ Departure Will Not End Health Law Divide; Democrats Losing Voters’ ‘Trust’ On Medicare

The Wall Street Journal’s Capital Journal: Sebelius Exits, But Health-Care War Endures
The resignation of Kathleen Sebelius signals the departure of the official who, fairly or not, had become the face of the deep and bitter partisan divide over Obamacare. But the Health and Human Services secretary's departure won't do much to close that divide. Instead, the Affordable Care Act now is entrenched as the most deeply divisive social program in recent memory, and it figures to stay that way through the November election and beyond (Gerald F. Seib, 4/10). 

Vox: Kathleen Sebelius Is Resigning Because Obamacare Has Won
Obamacare has won. And that's why Secretary of Health and Human Services Kathleen Sebelius can resign. Calls for Sebelius's resignation were almost constant after Obamacare's catastrophic launch. The problem wasn't just that Sebelius had presided over the construction of a fantastically expensive web site that flatly didn't work. It was that she didn't know healthcare.gov was going to instantly, systemically fail. ... The White House says Sebelius notified the President in March that "she felt confident in the trajectory for enrollment and implementation," and that once open enrollment ended, "it would be the right time to transition the Department to new leadership." In other words, the law has won its survival (Ezra Klein, 4/10).

The Wall Street Journal: Sebelius And Accountability
It would be nice to think that Kathleen Sebelius's resignation, leaked late Thursday, is a case of accountability in government. But that isn't the way this government now works, if it ever did. The departure of the secretary of Health and Human Services who presided over ObamaCare's rollout debacle is best understood as one more attempt to dodge political responsibility (4/10). 

Fox News: Sebelius Resigns: Democrats Have Their Scapegoat, They Can Blame ObamaCare Failures On HHS Chief
Last week, President Obama ran a victory lap claiming seven million signups for ObamaCare. It was the goal they wanted and, to no one's surprise, the White House claims it reached the goal. Outside, objective surveys beg to differ. As the president ran his victory lap, Sebelius was there running with him. Then she resigned — not forced out White House staffers claim. In fact, during the past week it appears the White House has lined up every left wing mouthpiece it could find to spin this news (Erick Erickson, 4/11).

The New York Times: Health Care Nightmares
When it comes to health reform, Republicans suffer from delusions of disaster. They know, just know, that the Affordable Care Act is doomed to utter failure, so failure is what they see, never mind the facts on the ground. Thus, on Tuesday, Mitch McConnell, the Senate minority leader, dismissed the push for pay equity as an attempt to "change the subject from the nightmare of Obamacare"; on the same day, the nonpartisan RAND Corporation released a study estimating "a net gain of 9.3 million in the number of American adults with health insurance coverage from September 2013 to mid-March 2014" (Paul Krugman, 4/10).

The Wall Street Journal: Live Free Or ObamaCare
The political left favors "single payer" health care, but that concept has new meaning in New Hampshire this year as just one insurer was willing to participate in ObamaCare. Thus the spectacle of Democratic Senator Jeanne Shaheen beseeching the feds to save her re-election from her own law. The Granite State Senator rode the 2008 Obama wave to become the deciding 60th vote for the law's passage, but now Ms. Shaheen must defend the mess it has made of her state's insurance markets. She's cashing in all her government chits amid a statewide uproar as patient access to hospitals and other providers has declined (4/10). 

Bloomberg: Medicare Has Become A Problem For Democrats
Voters are used to trusting Democrats on Medicare. But there are signs that this trust is eroding because of Medicare cuts in the Affordable Care Act and Republican efforts to highlight those cuts. The latest evidence of this change came this week, when the Barack Obama administration backed away from its proposal to cut payments to insurers who offer coverage through the Medicare Advantage program. About 14 million seniors participate in this generally popular program, which allows beneficiaries to get their benefits through a private health plan (Lanhee Chen, 4/10).

Houston Chronicle: Hispanics Remain Unequal When It Comes To Health Care
This week's commemoration of the 50th anniversary of the Civil Rights Act at the LBJ Presidential Library in Austin serves as a reminder that politics and history shape the nation's health care delivery system. Our forefathers wrote that "all men are created equal, that they are endowed by their Creator with certain unalienable rights, that among these are life, liberty and the pursuit of happiness." But does everyone have a right to the same level of "happiness?" And is health security among these unalienable rights? (Jacqueline Angel, 4/9).

Deseret News: Utah's Medicaid Reform Has Been A Quiet Success
Lost in the nearly two-year debate over whether Utah should expand its Medicaid program has been the successful rollout of Utah's Medicaid Accountable Care Organizations (ACOs). The Medicaid ACOs are worth another look (Dan Liljenquist, 4/10).

The (Jackson, Miss.) Clarion Ledger: Republicans Refuse To Acknowledge Obamacare's Success
Republican leadership in Mississippi still seems content to ignore what's happening on the health care reform front. It's as though we live on a different planet, that ACA is for somebody else, not us. We'll see before too long. ... Now it's obvious to thousands of religious leaders and medical professionals in Mississippi that Bryant and his GOP cohorts have failed in their goal to kill President Obama’s signature law. They have succeeded only in denying organized health care coverage to 300,000 of the state’s working poor (Bill Minor, 4/10). 

On other health care topics -

The New York Times: Abusing Both Medicare And Politics
Campaign finance reformers have long warned that the growing power of big money in politics would produce a giant scandal. But those scandals happen every day, and the trading of campaign donations for political favors has steadily eroded public trust in Washington. The latest illustration of that can be seen in the connection between Medicare fraud and "super PAC" abuse (4/10). 

The New York Times: The Tobacco Ties That Bind
I don't smoke, but if during the day I wanted to buy cigarettes, I could walk into the CVS pharmacy across the street from my office, or the Walgreens two blocks away, and get them. They're kept right behind the cash register. But beginning this fall, that is going to change. CVS pharmacies will stop sales of all tobacco products. Walgreens, well, won't. So, here's a quiz. Which chain do you think is more heavily celebrated on the website of the American Cancer Society? Well, it's not CVS. Instead, testimonials and profiles hailing Walgreens abound. There is a glowing profile of the Walgreens chief executive that focuses on his tireless efforts to promote healthy living in his workplace and stores. There is no mention of the tobacco sales at the front of those stores (Peter B. Bach, 4/10). 

The Washington Post: The Truth About Who Really Pays For Medicare
Yes, seniors paid into Social Security and Medicare during the years they worked, if they worked. But they generally receive much more out of the entitlement system than they paid into it (Catherine Rampell, 4/10).

The Washington Post: Gun Violence As A Public Health Issue
With last month’s controversy over Vivek Murthy's nomination for surgeon general still fresh, the nation's second-largest physicians group reaffirmed Thursday that it considers firearm violence a public health issue and issued a wide-ranging set of recommendations to address the deaths and injuries caused by guns. The timing appears to be coincidental. But like Murthy — whose nomination was blocked in large part by a National Rifle Association offensive over his views on guns — the American College of Physicians believes doctors must take action against the 32,000 deaths and 74,000 injuries caused by guns in the United States each year (Lenny Bernstein, 4/10). 

WBUR: Second Opinion: Doc Says Blue Cross Opioid Policy Is Flawed
The Blue Cross Blue Shield of Massachusetts opioid management program was implemented to provide members with "appropriate pain care" and reduce the risk of opioid addiction and diversion. In a recent Boston Globe report they claim "very significant success" with this program after 18 months because they have cut opioid prescriptions by 6.6 million pills. Is this really a measure of success and if so, for whom? It likely saves Blue Cross money but has it successfully achieved their program's stated goals? (Daniel P. Alford, 4/10).

The New England Journal of Medicine: Same-Sex Marriage — A Prescription For Better Health
Although the most central issues raised by the public discourse regarding marriage are moral and rights-oriented, there are also health-related issues at stake: legalizing same-sex marriage can improve health and access to health care for LGBT people. A 2011 report by the Institute of Medicine on the health of LGBT persons identified substantial disparities in health and access to health care for sexual and gender minorities. Many LGBT people of all ages report worse physical and mental health outcomes than heterosexual and non-transgender populations, largely as a result of the stress caused by being a member of a stigmatized minority group or because of discrimination due to sexual orientation or gender nonconformity (Gilbert Gonzales, 4/10).

The New England Journal of Medicine: Redesigning Surgical Decision Making For High-Risk Patients
One third of elderly Americans undergo surgery during the last 12 months of their lives, most of them within the last month. Yet three quarters of seriously ill patients say they would not choose life-sustaining treatment if they knew the outcome would be survival with severe cognitive or functional impairment. ... Typically, decisions are made after a discussion between a surgeon and the patient and perhaps the patient's spouse, partner, child, or caregiver. ... Yet this approach may be suboptimal for many high-risk elderly patients facing decisions about major surgery. Patients may not always be presented with all treatment options, including watchful waiting, medical treatment, less invasive surgical options, or percutaneous approaches (Drs. Laurent G. Glance, Turner M. Osler and Mark D. Neuman, 4/10).

The Journal of the American Medical Association: Health Reform And Physician-Led Accountable Care
Physicians see opportunities every day to improve quality and lower costs, but in a recent survey, the vast majority of physicians reported that they should not be expected to play a central role in controlling costs. They expressed this view even though most also reported that the best ways to control health care costs are through promoting continuity of care, using cost-effective treatments, chronic disease care coordination, prevention and adhering to clinical guidelines—all of which are controlled or influenced by physicians (Drs. Farzad Mostashari, Darshak Sanghavi and Mark McClellan (4/10).

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