KHN Morning Briefing

Summaries of health policy coverage from major news organizations.

Viewpoints: Bishops’ Request For Contraception Exemption May Push Legal Precedent; Maine’s Experiment On Health Care

Los Angeles Times: For Contraceptives, A Catholic Exception? 
43 Roman Catholic organizations have filed lawsuits challenging a ... regulation that requires employers or their health insurers to offer birth control coverage to workers. The plaintiffs say that complying with the regulation would violate their religious freedom. ... A decision also could turn on the meaning of the 1993 Religious Freedom Restoration Act, which allows such exceptions unless restricting religious exercise is justified by a compelling government interest. In our view, increasing preventive care — including the provision of contraceptives, some of which have medical uses beyond birth control — is a compelling interest (5/30).

The Wall Street Journal: Church Is Still Not State
Surely someone inside the administration, perhaps Joe Biden (Archmere Catholic high school, '61), brought this matter up during the comment period preceding the January 20 statement by the Department of Health and Human Services (HHS) that religious institutions, primarily hospitals, would be required to extend insurance coverage to the widest definition of birth-control treatments. The Catholic bishops conference urged the Obama administration not to push them inside this mandate, citing religious belief as what one could call their conscientious objection to it. The backlash among Catholics to the HHS order, across the political spectrum, was an astonishing thing to witness (Daniel Henninger, 5/30).

The Fiscal Times: 5 Pitfalls That Could Block Obama's Reelection
No stumble has been as avoidable as the confrontation provoked by the Obama administration over the HHS contraception and sterilization coverage mandate.  Catholic bishops have pressed for universal health-care coverage in the US for almost a century, and were a natural ally for Obama’s social-justice initiatives.  All that changed when Obama and HHS Secretary Kathleen Sebelius decided that the federal government could define religious expression in such a way that Catholic hospitals, schools, and charities didn't qualify, and therefore could not opt out of the mandate – even when they self-insure, as many do (Edward Morrissey, 5/31).

The Washington Post: Clueless About Medicare
Medicare may be the most sacred government program in the United States — even 76 percent of tea-party supporters oppose cuts to it, a McClatchy-Marist poll found in November. Given its central role in our fiscal challenges, it makes sense to examine why this program is so popular (Bryan R. Lawrence, 5/30).

The Wall Street Journal: Political Diary: The Obama Spending Record
Where Senator Obama did oppose the spending patterns of the Bush years, it was often, as with Medicaid, because Mr. Obama wanted to spend more. Speaking of health care, and given all of this attention on the Obama spending history, it should not be forgotten that the big taxpayer bills generated by ObamaCare are still to come. Is federal spending really the issue that Barack Obama wants at the center of this campaign? (James Freeman, 5/30).

The Wall Street Journal: ObamaCare In Reverse
One tragedy of the Affordable Care Act is that we already know what its regulations will do to insurance markets, because the states have been conducting policy experiments since the 1990s. But we also know from the states that the damage is reversible, as shown by Maine's emerging insurance turnaround (5/30).

Philadelphia Inquirer: Should Pharma Grow, Shrink Or What?
What does it say about an industry when its leading competitors appear fundamentally at odds about whether they should grow bigger, smaller, more diversified or more focused? The rosy view is that the abundance of opportunities offers multiple paths to success and the various Big Pharmas are pursuing these divergent paths to profit. That view, however, is delusional, as a glance at the Big Cap pharma sector will show (Daniel R. Hoffman, 5/30).

Boston Globe: State Lawmakers Must Put Our Bloated Health Care System On A Diet
Despite the economic downturn over the past five years, health care costs in Massachusetts have continued to skyrocket. … The fault for excessive costs lies with everyone from hospitals to insurers, policymakers to consumers. The solutions aren’t simple but must be grounded in the principles of consumer transparency and empowerment, rather than continuing to cede control to the health care industry itself, or asking the government to figure it out (Jon B. Hurst, 5/30).

Boston Globe: Single-Payer Health Care Would Save Billions For Massachusetts
The House and Senate health care proposals would set imaginary limits for spending growth enforced by secret "improvement plans" and wrist slaps for hospitals that overcharge; establish tiered payment schemes to consign the poor and middle class to second-tier hospitals and doctors; push most residents of the Commonwealth into HMOs (oops, we forgot, now they're called "accountable care organizations," or ACOs); and wipe out small doctor’s offices by "bundling" their pay into ACO payments. Apparently the legislators' theory is that forcing health care providers to consolidate cuts costs. Oligopoly saves money? (David U. Himmelstein and Steffie Woolhandler, 5/30).

Minneapolis Star Tribune: Patients Lose When Care Isn't Top Goal
The Fairview Health Services CEO who hired an aggressive outside company to collect debts and lower medical care costs is leaving. But Accretive Health, the contractor brought in by Mark Eustis, and firms like it are only going to play a more prominent role in health care in years to come. ... hospitals across the nation will need to rely more on outside vendors to save on staffing costs and provide expertise in information technology ... That reality is why it is so important to intensely scrutinize what went wrong at Fairview (5/31).

New England Journal of Medicine: Residents' Response To Duty-Hour Regulations — A Follow-Up National Survey
We firmly believe that most residents support some form of duty-hour regulation and would not choose to revert to the Halstedian model (where medical trainees worked 362 days a year and lived in the hospitals in which they trained). However, a one-size-fits-all approach may not be adequate or appropriate for all trainees and training programs. Ultimately, the intended and actual effects of the 2011 ACGME duty-hours requirements may not be aligned (Drs. Brian C. Drolet, Derrick A. Christopher and Staci A. Fischer, 5/31).

New England Journal of Medicine: Home: Palliation For Dying Undocumented Immigrants
Federal funds for the care of undocumented immigrants are available only through emergency Medicaid. The vast majority of these funds are used for pregnant women and children. ... A disturbing problem arises in the care of terminally ill patients. Our hospital, Houston's county hospital, admits a startling number of terminally ill undocumented immigrants with organ failure or severe pain. These patients tend to present at a late stage of their illness and often receive many different regimens of chemotherapy paid for by county funds. But what happens when they are too weak to receive treatment? What happens when they are dying? (Dr. Ricardo Nuila, 5/31).

Healthy Cal: Aging With Dignity And Independence
While we all like to picture ourselves growing older in a healthy way, the reality is that 70 percent of people over the age of 65 will need help with daily activities at some point in their lives — for an average of three years. ... The first step is to build a plan that preserves your choices, dignity and independence, even when you need some help to do so. The second step is to start conversations with the people around you — family and friends, health care and social service providers, legal and financial experts, and others — about what you want and what is important to you in case the need arises. The SCAN Foundation recently produced a guide featuring 10 key areas with conversation starters that can help you (Victoria R. Ballesteros and Athan G. Bezaitis, 5/30).

MinnPost: Two Simple Changes Can Kickstart A Healthier Lifestyle, Study Suggests
Here's some hopeful news for people who are struggling to adopt a more healthful lifestyle: A new study has found that people who made two simple behavioral changes — eating more fruits and vegetables and cutting the amount of time they spend in front of a TV or computer screen — were more likely to experience another potentially healthful change (eating less food with saturated fat). Furthermore, they were highly likely to maintain those new habits months later (Susan Perry, 5/30). 

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