Today's OpEds: Medicaid and the safety net; Health reform law's impact on long-term care and health costs

Medicaid Deal Keeps The Area Health Care Safety Net Intact St. Louis Post-Dispatch
Late last week, the federal government provided a road map [for how to help those with little access to care] by extending an existing agreement that allows up to $25 million in Medicaid payments to hospitals to be diverted instead to clinics that serve the uninsured. You might think that would be a hard sell for hospitals; after all, they're experiencing sharp growth in the number of uninsured patients they serve. But St. Louis-area hospitals willingly have been sharing those payments with clinics for a decade. Without them, there simply wouldn't be a health care safety net to meet the region's needs (8/1).

Why The Health Reform Repealers Are Wrong Kaiser Health News
The effort to repeal health care reform, all in one fell swoop, seems to be stalling. Instead, the opponents of reform are trying to dismantle it piece by piece. The latest effort came last week, when a group of Republicans in the Senate proposed abolishing the Independent Payment Advisory Board. And therein lies a lesson about the future of American health care--and the two different shapes it could take (Jonathan Cohn, 8/2).

How The US Learned To Love Healthcare Reform The Guardian
Flash back to the debate over Medicare in the 1960s - whose enactment enjoyed its 45th anniversary on Friday. The public was quite evenly divided for and against it, while conservatives pressed fears about 'socialised medicine.' ... Oops. Medicare is overwhelmingly popular today, and most Republicans are loth to admit they ever opposed it. ... Of course, like Medicare and Social Security, the Affordable Care Act will need to be tweaked down the road and require effort to be implemented right. And even the Republicans making noises about repeal know it's here to stay (Sahil Kapur, 8/1).

Obamacare Will Cost You Your Retirement The Washington Examiner
President Obama's tax pledge, which he made as a candidate, couldn't have been any clearer: 'Under my plan, no family making less than $250,000 will see their taxes increase -- not your income taxes, not your payroll taxes, not your capital gains taxes, not any of your taxes.' He even went further than that. He promised that he would lower taxes for just about all of us. 'I will cut taxes ... for 95 percent of all working Americans.' The president broke both these promises as soon as he signed Obamacare into law (Sally Pipes, 8/2).

A Public Home-Care Insurance Cushion The Boston Globe
CLASS [Community Living Assistance Services and Support Act] couldn't come at a more opportune time. … [Under CLASS] it will take only the approval of the patient's own doctor to get most claims approved. The bigger question is whether enough working adults will sign up for CLASS in advance of their senior years to smooth out the risk pool and build up sufficient capital from premiums so that claims (which will average $50 to $75 a day) can be paid without bankrupting the system (Alison Bass and Susan Parkinson, 8/2).

How Will Health Care Reform Impact Family Care Givers? News Enterprise [Kentucky] 
With the health care reform, the family caregiver's life will be impacted, as consumers to their own health care and as advocates, care coordinators, and caregivers for family members and friends. The law makes health care more affordable and accessible, expands access to long-term care services, improves the quality of care and the overall coordination of services provided to patients, and focuses on the training needs of the health care work force (Monica Ruehling, 8/1).

Medicare Physicians Treated Unfairly The Sun Sentinel
As the country begins the process of implementing national health care reform, there is one very blatant, obvious and important health care issue left unaddressed by the Congress… the unfair and outdated method used to pay physicians under the Medicare program, called the 'sustainable growth rate.' Since the passage of the Balanced Budget Act of 1997, physician fees have been tied to Medicare spending for all physician services and the growth rate for the overall economy. If more ill Medicare patients see more physicians, fees are limited. If the economy falters, so will physician reimbursements. No other providers of Medicare services have been treated in such a singularly unfair way (Louis Goodman and Timothy Norbeck, 8/1).

Silence On Bad Doctors Los Angeles Times
Researchers at Massachusetts General Hospital surveyed thousands of physicians in a variety of medical specialties; 17% said they'd had direct, personal knowledge of an impaired or incompetent colleague in their hospital, group or practice in the last three years. ... [D]octors are largely unmonitored. In large part, they are expected to police one another. … In many ways, this approach makes sense. After all, who better to judge the work of one professional than someone with the same training and skills? But without other methods of monitoring in place, many incompetent and impaired physicians are allowed to continue treating patients (Valerie Ulene, 8/2).

Dems Play Politics With 9/11 Workers Politico
In spite of fierce public opposition, the Democrats' sizable House majority secured passage of President Barack Obama's controversial overhaul of the nation's health care system. But this same majority failed Friday in its efforts to create a popular multi-billion dollar health care fund for emergency responders affected by toxic dust and debris in the wake of the Sept. 11 terrorist attack (James Richardson, 8/1).