Longer looks: Is American medicine destroying itself?

Every week, Kaiser Health News reporter Jessica Marcy selects interesting reading from around the Web.

The New York Times Magazine: The Reincarnation Of Pro-Life
Ever since Republicans took control of half the country's statehouses this year, the anti-abortion movement has won one victory after another. At least 64 new anti-abortion laws have passed, with more than 30 of them in April alone. The campaign is the largest in history and also the most creative. Virginia started regulating abortion clinics as if they were hospitals. Utah, Nebraska and several other states have stopped private health insurers from covering abortions, with rare exceptions. ... [But] lawyers representing [the abortion rights] side have been challenging the laws that hurt women most — which are also the ones most likely to sway public opinion back to their side (Emily Bazelon, 5/27).

Politifact: Barbara Boxer Says Medicare Overhead Is Far Lower Than Private Insurers' Overhead
Amid a fierce debate over the future of Medicare, Sen. Barbara Boxer, D-Calif., recently compared the administrative costs for the government-run program with the costs for private insurers. … Boxer's comment cuts to the core of whether a government-run program like Medicare has advantages over one in which private insurers take a primary role. ...  There is some disagreement over how much Medicare pays in overhead. It could be a few percentage points higher than the 1 to 2 percent that Boxer cites. But Boxer's numbers are defensible since they come straight from the Medicare trustees' report. Meanwhile, Boxer's 20 percent-to-30 percent figure for the private sector is more squishy. ... we rate her statement Half True (Louis Jacobson, 5/24).

Columbia Journalism Review: Medicare's Real Cost Problem
By now we're getting kind of tired of the same old/same old Medicare discourse. The typical article goes like this: Will Ryan's plan cost Republicans votes? Pity the poor frosh in Congress who have faced angry voters in town hall meetings. Lots of he said/she said. A predictable nut graph: Dems charge that Republicans will end Medicare as we know it; the GOP counters that they only want to change it—or, to use Luntzian language, "save, preserve, and strengthen" Medicare. What's missing are stories about why Medicare has a cost problem in the first place—the program's reluctance or inability to say "no" to health care providers and sellers of medical technology who generally get their way in deciding whether the government will pay for something (Trudy Lieberman, 5/31).

Mother Jones: Vermont Passes Single-Payer Health Care, World Doesn't End
As Gov. Peter Shumlin took his spot on the granite steps of the Vermont State House, a row of people fanned out behind him wearing bright red t-shirts proclaiming, "Health care is a human right." The slogan sounded noble, and wildly unrealistic. Until the governor spoke. "We gather here today to launch the first single-payer health care system in America," began Shumlin, a Democrat who has been governor barely four months. ... Moments later, the governor made history, signing a law that sets Vermont on a course to provide health care for all of its 620,000 citizens through a European-style single payer system called Green Mountain Care. … The push for single payer system in Vermont was built slowly and methodically over the last decade, but has moved with remarkable speed since Shumlin took office in January (David Goodman, 5/30).

The New Yorker: Romney's Dilemma
On April 12, 2006, Governor Mitt Romney, of Massachusetts, signed the most significant bill of his career: a law requiring every citizen in his state to buy health insurance. Romney had accomplished a longtime Democratic goal—universal health insurance—by combining three conservative policies. Massachusetts would help the uninsured buy private insurance; it would create a deregulated online marketplace; and it would require that everyone carry insurance. … Romney has tried to maintain support for his greatest achievement, while arguing it bears no resemblance to Obama's national program. Romney's argument becomes strained, however, when he pronounces that the individual mandate is the ideal solution at the state level but tyrannical when imposed at the federal level. Still, Romney's real problem is not just that he supported a mandate, but that he showed Democrats the political and procedural path to passing a universal-health-care bill in America (Ryan Lizza, 6/5).

The New Republic: How American Medicine Is Destroying Itself
For nearly a century, but especially since the end of World War II, the medical profession has been waging an unrelenting war against disease—most notably cancer, heart disease, and stroke. The ongoing campaign has led to a steady and rarely questioned increase in the disease-research budget of the National Institutes of Health (NIH). It has also led to a sea change in the way Americans think about medicine in their own lives: We now view all diseases as things to be conquered. Underlying these changes have been several assumptions: that medical advances are essentially unlimited; that none of the major lethal diseases is in theory incurable; and that progress is economically affordable if well managed. But what if all this turns out not to be true? (Daniel Callahan and Sherwin B. Nuland, 5/19).

National Journal: Republican States Hardest Hit Under Medicaid Block Grants
Giving states greater control over Medicaid means far fewer federal dollars for Republican states, according to an analysis by consulting firm Avalere Health. While the GOP's proposed changes to the Medicare program are currently the political weapon of choice for Democrats, Medicaid changes under the budget plan passed by House Republicans could mean 20 to 30 percent drops in estimated federal Medicaid funding for conservative states over the next 10 years. That's because the budget plan passed by the Republican House would tie Medicaid spending to a formula that pays states on a per capita basis. States that are already covering more people beyond the required Medicaid population—typically more-liberal states—would get more money from the federal government (Meghan McCarthy, 5/31).

Related, earlier story from KHN: Study Details How GOP Budget Plan Would Cut States' Medicaid Funding (Galewitz, 5/10).