First Edition: January 25, 2011

Today's health policy headlines include speculation about what President Barack Obama will say during tonight's State of The Union address and how the GOP will respond to it.

Kaiser Health News: Psst, Mr. President, A little Advice on Your SOTU Remarks
Kaiser Health News reporter Jenny Gold asked nine health policy experts to share their views on what points they would like President Obama to make in his speech (Gold, 1/24).

Kaiser Health News: Insuring Your Health: Should Infertility Treatment Be Considered Essential?
In her latest Kaiser Health News consumer column, Michelle Andrews writes: "Is health insurance coverage of infertility treatments an essential benefit to help people manage a medical disorder? Or is it a life-enhancing benefit, nice to have perhaps but not essential because it doesn't sustain a person's life? A panel of experts convened by the Institute of Medicine is wrestling with this and other issues raised by the new health-care law" (Andrews, 1/24).

Kaiser Health News Column: The Health Law's Co-op Program: A Political Divide Or The Affordable Alternative Consumers Need?
In this KHN column, Sabrina Corlette writes: "On Jan. 13,  the newly formed advisory board to the Consumer Operated and Oriented Plan Program met for the first time to consider how to make co-ops a viable coverage option for individuals and small businesses. They've got a tough job ahead of them, and there are considerable obstacles -- some posed by the legislation itself -- to turning this into a successful program. But there are reasons for tempered optimism" (1/25).

Kaiser Health News Column: What Will President Obama Say About Medicare?
In his latest KHN column, John Goodman writes: "When President Barack Obama addresses the nation in his State of the Union message, the big topic on the minds of many in the public policy community will be out of control entitlement spending. Will the president follow the lead of Christine Romer, the former head of his Council for Economic Advisors, and endorse the recommendations of his own bipartisan deficit commission, chaired by former Sen. Alan Simpson, R-Wyo., and former Clinton White House aide Erskine Bowles? Or will he punt?" (1/25).

Politico: A State Of The Union Challenge: Health Reform
President Barack Obama will have two challenges when he talks about his signature health care law Tuesday night: Get the public back on his side, and don't spend too much time on it. It will be Obama's first State of the Union address since he signed health care reform into law in March, and the public is still deeply divided over his biggest legislative accomplishment. Anything he says will be picked apart by groups on the left and the right - not to mention the entire health care industry - for clues about how strongly he'll stand behind the law (Nather, 1/25).

The New York Times: Republicans' Budget Man Draws Fire
But now Representative Paul Ryan of Wisconsin, the Republican point man on spending cuts and designated responder to the State of the Union address, has emerged as the latest chew toy among Democrats. They spent Monday beginning a campaign to portray him as the architect of fiscal policies that they view as unwise and hope will prove unpopular among voters, including plans to partially privatize Social Security and Medicare (Steinhauer and Herszenhorn, 1/24).

The Wall Street Journal: Ryan Is Republican Point Man
In elevating Mr. Ryan, Republican leaders are taking what Democrats believe is a political risk. He has written an anti-deficit plan that includes politically explosive ideas—replacing Medicare with vouchers and allowing some workers to invest Social Security taxes in private accounts—that go beyond what even many Republicans are prepared to embrace. But conservatives counter that the 2010 election outcome showed he is precisely the kind of political figure to put forth as the face of the Republican Party (Hook, 1/25).

Los Angeles Times: Insurers Are Scouring Social Media For Evidence Of Fraud
Social-networking websites such as Facebook and MySpace have become the go-to places where employers, college admissions officers and divorce lawyers can do background checks. Armed with the information, police have caught fugitives, lawyers have discredited witnesses and companies have discovered perfect-on-paper applicants engaged in illegal or simply embarrassing behavior. And now insurance companies are exploiting the free, easily accessible websites. Such sites have become the latest tools in detecting fraud, which the industry says costs the U.S. as much as $80 billion a year and accounts for 3% to 10% of total annual healthcare spending (Li, 1/24).

The Washington Post: U.S. Recovers $4 Billion From Health-Care Fraud Cases
The government recaptured a record $4 billion last year from pharmaceutical companies, hospitals, doctors, nursing homes and other providers of care that defrauded federal health-care programs, the Obama administration reported Monday (Goldstein, 1/24).

Los Angeles Times: Blowing The Whistle On Drug Firms
But it wasn't filling prescriptions that made Ven-A-Care of the Florida Keys Inc. such a success. Tiny Ven-A-Care has developed a lucrative niche market: blowing the whistle on drug companies that overcharge Medicare and Medicaid — and collecting tens of millions of dollars in reward money (Zajac, 1/24).