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Morning Briefing

Summaries of health policy coverage from major news organizations

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Thursday, Feb 4 2016

Full Issue

Viewpoints: Can Both Parties Be Happy With The ACA?; The Pros Of The Cadillac Tax

A selection of opinions on health care from around the country.

Last month, majorities in Congress voted to repeal the Affordable Care Act. Not surprisingly, President Obama vetoed the repeal bill, and the Republican Congress was unable to override the president鈥檚 veto. As former leaders in Congress, we have a message for both sides in this debate: It鈥檚 time to give the states a chance. (Newt Gingrich and Tom Daschle, 2/3)

Since the Affordable Care Act (ACA) was passed in 2010, our health care system has changed for the better. The uninsured rate has fallen by 45%, and for the first time, more than 9 in 10 Americans have health insurance. Health care spending per beneficiary has grown more slowly in both the private and public sectors, and we鈥檝e seen promising improvements in health care quality, including lower rates of hospital-acquired conditions and hospital readmissions 鈥 a sign that we are not just cutting costs but also delivering greater value. (James Furman and Matthew Fiedler, 2/3)

Opponents of the Affordable Care Act (ACA) have been claiming that the law would be a job killer since its passage, and the claims have not subsided with time. Some supporters of the ACA also worry about the possibility of unintended employment consequences. In addition, the Congressional Budget Office (CBO) projected that the ACA would have negative employment effects. However, predictions that the ACA would substantially reduce employment, and shift millions of workers from full-time to part-time work, have not been borne out. Instead we have a growing body of empirical evidence, including two new studies in the most recent issue of Health Affairs and analyses we have released, that the ACA has had little, if any, adverse effect on employment. (Bowen Garrett and Robert Kaestner, 2/3)

Two studies published in the most recent Health Affairs journal raise questions about the contention that the Affordable Care Act (ACA) will reduce employment, wages, and hours worked by employees. The study by Gooptu and colleagues examined the effects of the law鈥檚 Medicaid expansion on employment and found no statistically significant effect through March 2015. A related study by Moriya and colleagues examined the subsidy structure provided to households getting health insurance through the ACA鈥檚 exchanges and similarly found no discernible effect on levels of part-time employment for employees eligible for these subsidies. These studies provide useful new information, but they do not mean, as some reporting on them seems to suggest, that there is nothing to worry about with respect to the ACA鈥檚 effects on labor markets. (Joseph Antos and James Capretta, 2/3)

Listening to the political debate about health care, and in conversations with patients and health professionals across the country, I get the sense that some people that feel their choice of doctors鈥揳nd hospitals鈥搃s threatened and that people are losing their regular doctors as insurers narrow provider networks to lower costs. Critics have blamed the Affordable Care Act; in a recent campaign rally in Iowa, Sen. Ted Cruz charged that Obamacare is 鈥渢aking our doctors.鈥 Data from the Kaiser Family Foundation鈥檚 January health-tracking poll, however, indicate that this problem is smaller than conventional wisdom and critics have suggested. (Drew Altman, 2/4)

Are house calls really dead, as we suggested in a blog post Monday? Dr. Michael Oppenheim begs to differ. Oppenheim, 76, has spent virtually his entire career making house calls in Los Angeles. The core of his practice is serving as an on-call doctor for hotels and for travel insurance companies whose foreign subscribers fall ill while visiting here. But he also does shifts for Heal, a new Uber-like service that dispatches doctors to homes at a charge of $99 per visit to patients without insurance to cover the house call. (Michael Hilzik, 2/2)

So-called 鈥渟urprise medical bills鈥 are a head-scratching phenomenon that one might expect to see in the satirical website The Onion than as part of a serious policy discussion. Take the case of a recent report from Montana Public Radio about an air ambulance trip for a 2-year-old girl with a heart condition who had to be transported to a hospital 600 miles away. It turns out that the air ambulance company was not in the network for the family鈥檚 health insurance plan. They ended up with a bill for $56鈥000. (Larry Levitt, 2/3)

But there is less distance between Sanders and Clinton than meets the eye. Their sharpest programmatic differences (other than on Sanders鈥檚 mixed gun-control record) are over his sweeping ideas: breaking up the largest banks, establishing a single-payer health-care system and providing universal free college education. These disagreements are closely connected to their competing theories of change. Clinton believes in change through incremental steps: toughening financial regulation, building on Obamacare, expanding access to scholarships and grants without making college free for everyone. One-step-at-a-time reform is the best way to reach a larger goal, she believes. And proposals that are too big are doomed to fail 鈥 politically for sure, and probably substantively as well. (E.J.Dionne Jr., 2/3)

There鈥檚 new reason to think the numbers in the Bernie Sanders health care plan don鈥檛 add up. On Wednesday, the Center for a Responsible Federal Budget, a nonpartisan Washington think tank, released an analysis of Sanders鈥 proposal to replace existing health insurance arrangements with a single, government-run plan that would look something like Medicare. (Jonathan Cohn, 2/3)

In opining on Bernie Sanders health care plan, columnist Megan McArdle asks, But don t single-payer systems cost less? Then she answers her own question in the negative: Not unless you have a plan to make health care workers accept less pay ... . She neglects the important question of overhead. (Waldman, 2/3)

Like any service provider or business, Planned Parenthood has the right to expect that an application to conduct a legal activity will be addressed professionally and expeditiously by the appropriate state agency. And Kentuckians, regardless of their personal feelings about abortion, have every right to expect Bevin to respect the rule of law, rather than try to bend it to his will. (2/3)

On Wednesday, officials from Michigan and the federal Environmental Protection Agency were called before a House committee to explain how they let the drinking water in Flint become poisoned by lead. Also testifying before the committee was a mother of four whose tap water has been so contaminated since early 2015 that her family has had to use bottled water for drinking and cooking and has often showered at friends鈥 homes outside the city. (2/4)

On Jan. 23, as the cleanup from Winter Storm Jonas began outside of my apartment on the Upper West Side of Manhattan, a patient posed a seemingly straightforward question to me: Should I cancel my upcoming trip to Florida? This woman was concerned about potentially contracting the Zika virus 鈥 a mosquito-borne illness known to cause fever, rash, joint paints, and, it appears, a devastating birth defect called microcephaly. In theory, I was the right person to ask. I鈥檓 an infectious disease specialist at NewYork-Presbyterian Hospital and my research focuses on the ethical implications of medical decision-making. But this case was tricky because the patient was in her first trimester of pregnancy, and more importantly, she happened to be my wife. (Matt McCarthy, 2/2)

The governor's order gives new authority and responsibility to Florida's embattled surgeon general, Dr. John Armstrong, which he must wield wisely. He is charged with determining the resources his Department of Health needs from the state and the federal Centers for Disease Control and Prevention to protect the public. He is also to direct Agriculture Commissioner Adam Putnam to spray for mosquitoes in residential areas of the four counties. (2/3)

This is part of the Morning Briefing, a summary of health policy coverage from major news organizations. Sign up for an email subscription.
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