Â鶹ŮÓÅ

Once again, Congress seems set to prove it can be bipartisan — when the challenge involves caving in to special interests. Republicans and Democrats look set to repeal the Affordable Care Act’s medical device tax, a 2.3 percent excise on manufacturers of everything from sutures to pacemakers to MRI machines. The winners would be an influential lobby and rank hypocrisy. The loser would be the country. (1/29)

In seeking to dismantle the Affordable Care Act piece by piece, congressional Republicans have placed a high priority on repealing a tax on medical devices that would raise some $29 billion over the next 10 years to help ensure that health reform will not increase the deficit. Repealing the tax is a terrible idea that has been given a veneer of respectability by support from liberal Democrats in states with large concentrations of device manufacturers. They include Senator Elizabeth Warren of Massachusetts, Senators Amy Klobuchar and Al Franken of Minnesota and Representative Ron Kind of Wisconsin, among others. President Obama ought to veto any bill that eliminates the tax. (1/30)

Millions of Americans could find their health-insurance plans endangered if the Supreme Court rules this summer that President Barack Obama's administration has broken the law in subsidizing them. The administration created this problem by pushing through a poorly written statute and lawlessly implementing it. But congressional Republicans nonetheless should step up and solve the problem -- and they should do it in a way that hastens the end of Obamacare. ... Republicans could, for example, offer to authorize the subsidies everywhere, but only through the end of this presidency and in return for some changes to the law. Or they could offer a health-insurance alternative of their own that enables the people affected to get affordable coverage. (Ramesh Ponnuru, 1/29)

Indiana's plan to use Medicaid expansion funds was approved by the federal government on Tuesday, bringing the total number of participating states to 28. ... Once upon a time, former House Speaker Will Weatherford complained about the federal government's inflexibility. Well, it turns out D.C. is quite flexible on this issue. Arkansas, Indiana, Iowa and Michigan have all gotten waivers to use federal funds for health coverage outside the traditional Medicaid model. So now, incoming House Speaker Steve Crisafulli, R-Merritt Island, is saying the House is philosophically opposed to expanding a broken system. Yet, once again, federal officials have allowed states to use funds to create their own health care systems. (John Romano, 1/28)

It’s understandable that attention is heavily focused these days on imagining alternative futures for the Affordable Care Act (ACA) after the US Supreme Court renders its decision in King v Burwell, expected this June. (This case challenges the legality of making tax subsidies available for people to buy health insurance through the federal exchange in states that have decided not to run their own exchanges.) But it’s also time to look hard at Medicaid, the joint federal-state program for lower-income Americans. Whatever happens to the ACA, Medicaid needs urgent attention—and some basic rethinking. (Stuart Butler, 1/29)

At this time, the future of the existing CO-OP program remains promising if uncertain. According to this view, some CO-OPs may falter. The recent default of CoOpportunity Health, the CO-OP serving the states of Iowa and Nebraska, is supportive of this outlook. Other CO-OPs may experience a significant growth spurt replete with the related attendant benefits. The latter outcome hinges on the appeal of the CO-OP construct, functional online exchanges, and priced-to-compete multiyear products. Growth by way of entry into the mid-size and large group markets must also be considered. In the final analysis, the CO-OPs will have to prove their effectiveness and value in the marketplace. (Allan M. Joseph and Eli Y. Adashi, 1/29)

Earlier this month, the Centers for Disease Control and Prevention announced that the United States is making modest progress in bringing down rates of hospital-acquired infections. Progress is good, but modest is not. Hospital-acquired infection is one of the country’s leading causes of death, killing 75,000 people per year — more than car accidents and breast cancer combined. As antibiotic resistance increases, we are already seeing infections no drugs can cure. And these infections are preventable. Still, one in 25 patients who goes into the hospital without an infection will get one there. (Rosenberg, 1/30)

Health and Human Services Secretary Sylvia Burwell announced this week that, through the Affordable Care Act (ACA), Medicare would be taking drastic steps to assure that doctors are paid not for visits and procedures, but rather for the value of their work. The truth is that we cannot measure quality. Medicare's quality indicators often diverge sharply from true quality geriatric care, yet it is our compliance with those numbers that will now determine our salary. Rather than having time to talk to my patients, I often find myself madly typing notes into a computer and filling out reams of paperwork to comply with Medicare's regulations, and ordering tests and using drugs to comply with Medicare's quality indicators. (Andy Lazris, 1/29)

Representative Tim Ryan, an Ohio Democrat who previously opposed abortion rights, has officially changed sides. He’s very welcome in the pro-choice camp. With reproductive freedom under attack in the Republican-led Congress and in G.O.P.-controlled state legislatures around the country, the embattled cause needs all the new supporters it can get. (Dorothy J. Samuels, 1/29)

If there's a silver lining in the ongoing outbreak of measles linked to infected and unvaccinated visitors to Disneyland during the holidays, it's that the crisis may spur state lawmakers to reverse the trend expanding exemptions from mandatory childhood immunizations. Two public health experts have just weighed in with a timely look at the legislative landscape and lawmakers' options. Y. Tony Yang of George Mason University and Ross. D. Silverman of Indiana University, writing in the Journal of the American Medical Assn., report that until recently, legislative initiatives across the country have tended toward expanding exemptions from vaccination mandates. (Michael Hiltzik, 1/29)

As more information begins to emerge about e-cigarettes, they are looking less and less like benign alternatives to traditional smoking. Teenagers are apparently taking up the so-called vaping habit in droves, and now we're also learning that the exhaled vapor contains multiple harmful chemicals. That is reason enough for California to follow the lead of many municipalities by prohibiting vaping in workplaces, restaurants and other indoor gathering places, and to take stronger steps to prevent teens from buying e-cigarettes. (1/29)

The term “precision medicine’’ is one that most Americans had likely never heard before President Barack Obama’s State of the Union address, but it is an area of exciting promise in biomedical research that will eventually improve health outcomes and potentially reduce healthcare costs. The concept revolves around understanding the specific genetic changes that underlie such diseases as cancer, diabetes and cystic fibrosis. (Carlos Moreno, 1/30)