Viewpoints: Obama's 'talk of tough choices'; Championing personal responsibility

The New York Times: President Obama's Second Chance
And he clearly laid out a vision for governing squarely at odds with the one that Mr. Romney has, but was hidden from view at last week's Republican convention in Tampa, Fla. He promised deficit reduction "without sticking it to the middle class"; to enact a reformed tax code that raises rates on income above $250,000 to where it was under Mr. Clinton; to preserve middle-class deductions; to "never turn Medicare into a voucher." Mr. Obama explicitly shifted from his 2008 appeal of hope and change to talk of tough choices and tough paths (9/6).

Christian Science-Monitor: Obamacare Champions Personal Responsibility. The States That Hate It Don't.
At the Democratic National Convention this week, Democrats have defended and reclaimed Obamacare as one of President Obama's signature achievements. (See Bill Clinton's rousing endorsement last night.) But some Americans seem to be under the impression that the health-care law is a step away from personal responsibility, a step toward socialized medicine. That's certainly the message they got from the Republican National Convention last week. As knowledgeable columnists and health care experts have pointed out, the opposite is the case. It is the pre-Obamacare system that involves free-riding: A patient who shows up in the emergency room is treated even if uninsured, but the hospital has to pass the cost on to the rest of us (Jeffrey Frankel, 9/6).

The New York Times' Taking Note: The Dangerous Center
During the "grand bargain" discussions with House Republicans to avert the debt-ceiling crisis last year, Mr. Obama reportedly agreed to cuts of more than $1 trillion from Medicare over 20 years, in part by raising the eligibility age and in part by cutting benefits. He was willing to accept cuts of nearly $400 billion from Medicaid and other health care programs. And he agreed to a less generous formula for Social Security benefits. The deal famously fell apart when the two sides could not agree on how much new tax revenue would be part of the bargain, so the precise nature of the entitlement cuts was never hammered out. But Mr. Obama's willingness to even consider such enormous reductions was worrisome (David Firestone, 9/6).

Minneapolis Star Tribune: In U.S. Today, No Margin For Illness
This diligent, responsible American woman was pauperized simply because she had the indecency to get terminally ill. No other industrialized country in the Western world penalizes its middle class in such a way. No other civilized nation demands that people who work hard, act financially responsible and save what they can -- in my aunt's case, an inordinate amount, given her income -- must eventually turn over a lifetime of earnings and accomplishment to the health care industry, if they get seriously ill and require long-term care (Frank Domurad, 9/6).

Forbes: Should Health Care Rationing Be Mandatory?
We discuss rationing in this country like it is a dirty word. Rationing is alive and well in this country, but the approach we take makes no sense. ... England's health care system would never fly here because it is totally government run, however, they have a fair and objective system of rationing agreed to by most people. I think we could learn something from their methods. Here are some thoughts to try on for size: Form a large committee of interested and educated individuals -- patients, physicians, other health care professionals, administrators, pharmaceutical representatives, device manufacturers, and insurance company representatives who will look at what tests and treatments benefit society as a whole and are cost effective. These essential services will be paid for by all government and private insurance (Carolyn McClanahan, 9/6).

JAMA: What Is Health Care Cost Containment
With the Republican convention over and the Democratic convention under way, we will no doubt continue to hear charges and countercharges between the parties about who can be trusted to save Medicare. I am not going to adjudicate that issue here. However, what is striking about this debate is that we seem to have lost the ability to distinguish between reducing health care benefits (which virtually everyone purports to be against) and controlling costs (which everyone appears to be for) (Larry Levitt, 9/6).

WBUR: Advocates: Children's Mental Health Care In Mass. Still Treated Unequally
Four years ago, we stood beside Governor Deval Patrick as he signed the landmark Act Relative to Children's Mental Health before a throng of advocates who had championed reform of the children's mental health system. This law, and its companion legislation, An Act Relative to Mental Health Parity, represented significant milestones in caring for the estimated 100,000 children who needed, but were not receiving, mental health care. But despite this legislation's promise and some accomplishments, these laws have not yet achieved the most important transformation of the system: full equity between physical and mental health (Marylou Sudders and Lisa Lambert, 9/6).

Modern Physician: Blog: In Ore., Training Medical Residents For A New Practice Environment
If the patient-centered medical home supported by per-member, per-month care-management fees becomes the standard primary-care practice model, then Oregon Health & Sciences University in Portland can claim to be its first training ground. When the CMS announced the names of the 500 participants in its four-year Comprehensive Primary Care Initiative, the list included three OHSU primary-care clinics where residents are trained (Andis Robeznieks, 9/6).

Houston Chronicle: County Brings Common Sense To Mental Health
Though administrators don't want it that way, the Harris County jail is a de facto mental hospital. Almost 25 percent of its inmates, many of them nonviolent, suffer from mental illness requiring psychotropic medicines. That's why Sheriff Adrian Garcia and Harris County commissioners merit attention for modernizing the county's approach to nonviolent residents involved in emergency calls (9/6).