Viewpoints: Taking the deficit seriously; despite low numbers, high-risk pools are succeeding

The Washington Post: How Serious Are We Really About The Deficit?
The deficit debate, now fully engaged, is also an evaluation of political seriousness. House Republican leaders have passed the test, supporting a politically risky budget that changes Medicare into a premium-support program and eventually returns federal spending to sustainable levels (Michael Gerson, 4/27).

The Wall Street Journal: Why The 2025 Budget Matters Today
It seems strange that the big budget discussion focuses on issues such as Medicare, Medicaid and Social Security reforms, whose fiscal impacts are decades away. Why do we need to fix the 2025 budget today? Two words: bond market (John H. Cochrane, 4/28).

The New England Journal of Medicine: High-Risk Pools — Merely A Stopgap Reform
To provide some interim relief for the least-healthy Americans, the (federal health law) established a program of temporary high-risk insurance pools, the Pre-Existing Condition Insurance Plans (PCIPs). This program provides federal support for insurance pools enrolling only people with medical conditions that have prevented them from obtaining nongroup health insurance. ... enrollment has been low — there were only 12,437 enrollees as of February 1, 2011. ... This low participation level, however, should not be seen as a sign of the potential failure of the forthcoming comprehensive reforms; rather, it highlights the need for broad-based sharing of risk, combined with sufficient financial support from the government (Linda J. Blumberg, 4/27).

Des Moines Register: Guest Opinion: Health Reform Law Hurts Insurance Agents, Small Businesses
This month, the federal government announced that unemployment has barely budged in the last two months. More than 13 million people remain out of work. Yet several self-proclaimed "consumer advocates" are leading the charge in support of a provision of the federal health care law that could eliminate jobs throughout the country. At issue is the law's "medical loss ratio" (MLR), which requires insurers to spend 80 to 85 percent of premiums on claims. Fortunately, several lawmakers and the National Association of Insurance Commissioners are considering a job-saving tweak to the health care law that would exclude brokers' commissions when calculating the MLR (Janet Trautwein, 4/27).

The Washington Post: Maryland Makes The Right Move To Curb Prescription Drug Abuse
Maryland's policy is on its way to much-needed correction. This month, the General Assembly approved a PDMP (prescription drug monitoring programs) bill proposed by Gov. Martin O'Malley (D). It would help deter abuse while protecting doctors from unwarranted legal liability. Under the law, which Mr. O'Malley will sign on May 10, health-care providers must report prescriptions of federally controlled substances to the state — but law enforcement can gain access to the records only with a subpoena. This is a major victory for common sense and public health, and it will increase the pressure on the last few states that do not have operational PDMPs to follow suit (4/27).

The New England Journal of Medicine: Prescriptions, Privacy, And The First Amendment
On April 26, the Supreme Court heard oral arguments in a case that, when it is decided this spring, will have important repercussions for the practice of medicine. ... [W]e are strong proponents of First Amendment protection for speakers who attempt to communicate important evidence-based health information or advocate for patients' and physicians' rights. But, ... the sale of physicians' confidential prescribing information puts patients' highly private medical information at risk. Why should this information be sold to data-mining and drug companies as a commodity, when it offers no benefit to patients and their physicians? This undesirable practice is nothing more than commercial conduct — not speech — and it is not in the best interest of the health of the American people (Dr.Gregory D. Curfman, Stephen Morrissey and Dr. Jeffrey M. Drazen, 4/27).