Viewpoints: On Judge Vinson's decision; Medicaid and long-term care; Doctors' ennui; Insurers' profits

The Wall Street Journal: The Constitutional Moment
Federal Judge Roger Vinson opens his decision declaring ObamaCare unconstitutional with that citation from Federalist No. 51, written by James Madison in 1788. His exhaustive and erudite opinion is an important moment for American liberty, and yesterday may well stand as the moment the political branches were obliged to return to the government of limited and enumerated powers that the framers envisioned (2/1).  

Politico: Court Raises Stakes On Health Care Law
In the decision, Judge Roger Vinson conceded that it is unusual to throw out an entire statute just because one part is held unconstitutional. Then he did it. ... Conservatives might even have to let up on Obamacare, for a moment, to better explain why judicial activism is suddenly so palatable. ... Monday's decision, however, was surely wrong about one thing. This situation - from the partisan undertow of supposedly philosophical constitutional debates to the controversial power of courts to do what elections cannot - is likely to be repeated (Ari Melber, 2/1).

Politico: Health Care Reform Gasping For Air?
How badly does the ruling hurt the Obama administration's health reform efforts? Is this a sign of how the Supreme Court is likely to rule? Should the Obama administration try to reach a negotiated settlement of sorts with congressional Republicans to salvage at least some portions of the law? Experts, including Kenneth Scott, Stanford Law School professor and Grover Norquist, president of Americans for Tax Reform, weigh in (1/31).

The Wall Street Journal: ObamaCare And The Two Kennedys
When it comes to his health-care initiative, Barack Obama has not been shy about the debt he owes the late Teddy Kennedy. When the president appeared in 2009 before a joint session of Congress, he quoted from a hitherto undisclosed letter Kennedy had written him in his last months. And when he signed that bill into law a few months later, he wore a bracelet that said "Tedstrong." ... Now it appears that President Obama's health-care bill may again need the Kennedy imprimatur. This time, however, the Kennedy is Supreme Court Justice Anthony Kennedy (William McGurn, 2/1).

The Fiscal Times: Health Care Reform Debate: It's Déjà Vu Again
When I was in high school back in 1947, federal involvement in the health of Americans was a debate team topic. … There will always be plenty of self-proclaimed independent-minded individuals who resist the nature of social change (while refusing to acknowledge how they benefit). But their number will lessen, just as the number of staunch opponents of Social Security, unemployment insurance and Medicare did once their value became apparent. (Dr. Sherwin B. Nuland, 1/31).

The New York Times: Essay: Out Of Camelot, Knights In White Coats Lose Way
Today, medicine is just another profession, and doctors have become like everybody else: insecure, discontented and anxious about the future. But while doctors often blame managed care for their situation, managed care didn't create this crisis. It originated from the abandonment of ideals that made managed care necessary in the first place (Dr. Sandeep Jauhar, 1/31).

The Atlanta-Journal Constitution: How To Rein In Medicaid Costs
The federal and state governments should focus on redirecting long-term care provision from nursing homes to home- and community-based care. Home and community-based services (HCBS), such as adult day care or home respite care, potentially offer long-term fiscal relief for Medicaid and improved quality of life for recipients. This year, the national median annual rate for a private nursing home room tipped the scale at $75,000, reaching $62,134 in Atlanta. In contrast, states can fund three individuals in the community for the price of one in a nursing home (Rachel Goldstein, 1/31).

The Seattle Times: Profit Of Nonprofit Health Insurers Should Be Regulated 
Should the profit of a not-for-profit health insurer ever be the subject of regulation? It is not, in Washington. But the state's three dominant insurers — Premera, Regence and Group Health — together have piled up $2.4 billion in surplus, triple their surplus of a decade ago. A question arises of how much is enough (1/28).

San Francisco Chronicle: Redefinition Of Rape In Abortion Act Is Offensive
Drugged, raped, pregnant? Too bad, say some House Republicans...Current law allows federal funds (usually for Medicaid) to be spent on abortions only for women who have been raped or are the victims of incest. We think those restrictions are bad enough, but the new class of House Republicans want more. The No Taxpayer Funding for Abortion Act would outlaw the use of federal funds for abortion except in the case of "forcible rape." The incest exemption would only apply to minors (2/1). 

Des Moines Register: Don't Let Money Cloud The Vision Of Drug Regulators
Letting regulators bring down costs by sacrificing quality of care could have consequences for our entire health system. ... Policymakers and health care professionals should indeed be looking for ways to cut down on costs while preserving the high quality of treatment. But limiting the freedom of physicians to prescribe the drug they believe will be most effective would jeopardize patient health (Dr. Gilbert Ross, 1/31).