KHN Morning Briefing

Summaries of health policy coverage from major news organizations.

Viewpoints: Obama’s ‘Diatribe’ On Ryan Budget; President ‘Recovers’ On Statements About The Court; Other Health Care Mandates

The Wall Street Journal: Paul Ryan's Hunger Games
If there's a Laffer Curve for Presidential invective—some point at which dishonest political abuse yields diminishing returns—the White House political team must not think their boss has hit it. Even in this hyperpartisan age, President Obama's speech to the Associated Press yesterday was a parody of the form. This was a diatribe that managed to invoke "Social Darwinism" and "a Trojan Horse" in the same paragraph, amid the other high crimes that Mr. Obama says Paul Ryan wants to commit (4/3).

The New York Times: Calling Radicalism By Its Name
The speech was immediately attacked by the House speaker, John Boehner, for failing to deal with the debt crisis, but Mr. Obama pointed out how hollow that charge has become. "That argument might have a shred of credibility were it not for their proposal to also spend $4.6 trillion over the next decade on lower tax rates," he said. The math is, in fact, quite simple: cutting both taxes and the deficit can mean only more sacrifice from the middle class and the poor, ending the promise of Medicare and Medicaid. Over the long term, the deficit can be brought down through a combination of cuts and new revenues; doing so immediately, as Mr. Romney and his party want to do, would reverse the fragile recovery (4/3). 

The New York Times’ The Loyal Opposition: Exit Bad Obama, Enter Good Obama
President Obama's comments yesterday on the Supreme Court and health care reform were utterly inept, but he recovered today. The president's speech on the economy was a powerful argument against the calculated cruelty of the Republicans' failed economic policies. … Medicaid would be gutted, Medicare would be turned into a voucher program – but the Republicans would still cut taxes by $4.6 trillion over the next decade. The cuts, as usual, would mostly benefit the wealthy (Andrew Rosenthal, 4/3).

The Washington Post: President Obama's Reversal On The High Court
President Obama's comments Monday about the Supreme Court were jarring. If the court were to strike down the health-care law, Mr. Obama said, it would be a blatant example of judicial activism. … Well, not exactly, and the comments strayed perilously close to a preemptive strike on the court's legitimacy if it were to declare the individual mandate unconstitutional. Which is why Mr. Obama was wise to revise and extend his remarks Tuesday in comments to newspaper editors. Mr. Obama was more careful in the details and tone of his critique (4/3).

Chicago Tribune: Taking On The Court
It's another matter altogether, though, for a president to predict the outcome of a Supreme Court decision. Barack Obama did just that the other day in the Rose Garden, expressing his confidence that justices in the end will declare his health care act constitutional. They're hardly going to be swayed either way by what he says, however (Jules Witcover, 4/4).

Boston Globe: Better To Take The High Road
Maybe because every other constitutional professor in the country has been interviewed about last week’s Supreme Court oral arguments on the health care overhaul, President Obama -- himself a former professor -- just couldn't help himself. His comments on the case, during a news conference with leaders from Mexico and Canada, were a pointed warning to the court that invalidating his signature piece of legislation would be an "unprecedented, extraordinary" act of judicial activism. Yet while Obama is right to worry about a waning sense of judicial restraint among the court's most conservative members, he still should have taken the high road and left it to his lawyers to defend the law (4/4).

Des Moines Register: An Ironic Claim Of Judicial Activism
The U.S. solicitor general last week argued the government's case for the constitutionality of the new Affordable Care Act while standing at a lectern before the nine justices of U.S. Supreme Court. On Monday, President Barack Obama made his case to the court using what one of his predecessors referred to as a "bully" pulpit. ... It was a fairly remarkable pitch from a sitting president while the Supreme Court has a case under consideration. President Franklin D. Roosevelt had a famous war with the court over his New Deal laws, but at least he usually waited to criticize the court until after it had ruled (4/3).

CNN: Epic Failure By Washington Sets Us Adrift
There are plenty of ways to game the upcoming Supreme Court decision on health care reform, and they've all been said: President Obama loses in court, he wins with his base. Or it's a severe blow, potentially fatal. Or Republicans benefit if they win, because they were "right" all along. Or the GOP loses, because it has to figure out what to offer for health care instead. And so it goes. But there's something else going on here, and it's more meaningful than some short-term political skirmishing. This Supreme Court case is the Waterloo for political polarization, because it underscores something we should have known all along: Great changes in national public policy should never be erected on slender partisan majorities (Gloria Borger, 4/4).

Times Of Trenton (New Jersey): Obama’s Health Care Reform—A Big Swing And A Miss
Instead of encouraging states to improve health care at reduced costs for taxpayers, the Obama administration has decided to force states to enroll more patients in Medicaid without concern for costs. In New Jersey, these mandates entailed a 40 percent increase of enrollees at an estimated cost of more than $900 million from 2014 to 2020, when all of the act’s increases are implemented (Amy H. Handlin, 4/4).

The Wall Street Journal: Obama's Mandate Flashback
President Obama joined the liberal security detail yesterday that is attempting to protect his new health-care entitlement by threatening the Supreme Court with political blowback, and no surprise there. But given that political memory only lasts for days and sometimes weeks, recall the relatively recent vintage of Mr. Obama's support for the individual mandate. Yesterday he was extolling the mandate's "human element," yet just a few years ago his predictions of the end of human freedom would make the staunchest tea partier blush (Joseph Rago, 4/3).

Politico: Being Uninsured Is A Mandate, Too
The market for health care services is ubiquitous; the question is whether Congress mandates emergency-room market participation or a rational health insurance market system. The old system is no less a "mandate" than the Affordable Care Act. And let's be honest about where the pre-"Obamacare" emergency-room mandate is coming from. That mandate comes from congressional acts, too — for example, the 1986 Emergency Medical Treatment and Active Labor Act, which requires hospitals to treat anyone needing emergency care regardless of ability to pay. Indeed, Congress has enacted over the years a complex web of authorizing statutes and rules that regulate health care and allow insurance companies to price people out of the market (Jennifer Granholm, 4/3).

The Wall Street Journal: Another Case Against ObamaCare
With all the attention last week on the oral arguments before the Supreme Court, a report on the dire fiscal consequences of ObamaCare was overlooked by many. Republicans on the Senate Budget Committee released an analysis that draws on models from the Centers for Medicare & Medicaid Services and found that "the U.S. health-related unfunded obligations increased by $17 trillion since the law was passed, from $65 trillion to $82 trillion over the next 75 years." Sen. Jeff Sessions of Alabama says this is "more than twice the unfunded liability of Social Security" (Steve Moore, 4/3).

Houston Chronicle: Texas Is Already Reaping The Benefits Of Health Reform
No law is ever perfect and Congress will need to work together in a bipartisan manner to identify areas of health reform that can be improved, but there is no doubt that the health care reform law has already made a significant and beneficial impact on our nation and community. Out of all 50 states, Texas has the greatest need for health care reform. The 2010 census found that Texas has the highest rate of uninsured residents in the U.S., with one in four Texans uninsured (Rep. Gene Green, D-Texas, 4/3).

Reuters: Romney's Second Shot At Healthcare Reform
Even with poor implementation, the Massachusetts law has yielded some positive results, including broadening insurance coverage, especially for minorities, and decreasing premiums for individual purchasers of insurance. Candidate Romney must, however, do more than defend decisions made in Massachusetts as "a state solution to a state problem." The governor should articulate a broader vision that respects and leverages the strengths of our federal political system (Jim Stergios and Josh Archambault, 4/3).

The Washington Post: Are Women Just Not That Into Mitt?
Recent polls show single women under 50 scrambling back into the warm embrace of Barack Obama after a brief flirtation with the Republican boy band — Mitt, Rick, Ron and Newt. Was it something they said about birth control? (Kathleen Parker, 4/3).

USA Today: Schools Dispensing Birth Control
The school moved an adolescent health center that since 1986 had been three blocks from the campus into the school, right next to the guidance office. ... Of all the benefits of the move, the most striking to me and other veteran teachers here on the front lines is that we have not been seeing as many girls making their way down the hallways seven or eight months pregnant (Patrick Welsh, 4/3).

McClatchy: Exercise Pays Dividends
Study after study also show that regular exercise returns great mental health dividends — lowering chances of depression, decreasing anxiety levels, and improving overall mood. … Exercise really does pay dividends for both physical and mental health. And in a time of fiscal austerity, when the strain of prolonged economic hardship weighs heavily on the mental and physical health of so many Americans, the value, efficacy, and cost-effectiveness of physical activity should be recognized and leveraged (Helen Durkin, 4/4).

The Kansas City Star: Loophole In Tobacco Law Could Cost Missouri $1 Billion
Not only does the Missouri legislature foolishly ignore ways to raise revenues for its anemic coffers, its inaction threatens to cost the state hundreds of millions of dollars. Here again, the problem is Missouri’s unique propensity to coddle cigarette manufacturers and vendors. The state's ridiculously low tobacco tax — at 17 cents a pack the nation’s lowest — is only the start of the problem. For years, the legislature has balked at addressing a loophole in a legal settlement among states and tobacco manufacturers. That obstinance has turned Missouri into an open marketplace for smaller manufacturers and put the state in legal jeopardy (4/3).

Archives of Pediatrics and Adolescent Medicine: Expanding The Envelope Of Care
Pediatric cardiac surgery and cardiology care have been transformed during the past 3 decades by tremendous innovation and steady improvements. ... Yet, with expanding capabilities come increasingly demanding choices. The key question is how to enlarge the envelope of care so that children (and their families) receive technically outstanding care ... without crossing a line—admittedly, and yet also essentially, a line based on judgment—and lapsing into doing merely what, technically, can be done to the patient (Drs. Chris Feudtner and Antonio R. Mott, 4/2).

Journal of the American Medical Association: Incentives in Health: Different Prescriptions For Physicians And Patients
There is ample evidence that physicians, who typically fulfill the criteria for being economically rational, are exquisitely sensitive to the incentives they face. Physicians tend to recommend tests and treatments that will provide them with financial benefit. ... On average, compared to physicians paid on a capitated basis, physicians paid for specific procedures tend to recommend more of those procedures. Clearly, if the US health care system is to improve the value of health care spending, it will have to do so, in part, by exploiting this very rationality of physicians and by moving away from payment systems that contribute to excess use of high-cost, low-value services (George Loewenstein, Dr. Kevin G. Volpp and Dr. David A. Asch, 4/4).

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