Viewpoints: A 'gift' to Amgen; Obama omits talk of grand bargain; Defending physician pay

The New York Times: Amgen Gets A Gift From Congress
For a disheartening example of how intense lobbying and financial contributions can distort the legislative process in Washington, consider what happened to the "fiscal cliff" bill approved three weeks ago by Congress. Senators who play a major role in federal health care financing were happy to help Amgen, the world's largest biotechnology company, evade Medicare cost-cutting controls (1/22).

Los Angeles Times: Obama, A More Ardent Advocate
Obama reaffirmed his belief in a muscular federal government and the importance of "collective action" to enhance education and infrastructure. He rejected the belief that "America must choose between caring for the generation that built this country and investing in the generation that will build its future." We appreciate Obama's vigilance in protecting the social safety net, but we hope he isn't abandoning any effort to reach a "grand bargain" with Republicans that would put Social Security and Medicare on a path to long-term solvency (1/22). 

The Wall Street Journal: We The Government
On that theme, the speech was especially striking for including a specific defense of the federal entitlement programs that everyone knows must be reformed. Mr. Obama cited "Medicare, and Medicaid, and Social Security" by name as "the commitments we make to each other." Typically, such programmatic specificity is reserved for State of the Union speeches. Mr. Obama almost seemed to be elevating them to Constitutional rights (1/21).

The Washington Post: Obama: No Patsy Now
What does this mean, substantively? Ah: "The commitments we make to each other through Medicare, and Medicaid, and Social Security -; these things do not sap our initiative; they strengthen us. They do not make us a nation of takers; they free us to take the risks that make this country great." Loose translation: Entitlement reform will not be topping the president's second-term agenda. What it means beyond this is any palm reader's guess. We understand that we're not a nation of takers (as Paul Ryan once regrettably put it), but how entitlement programs that far exceed our ability to pay for them "free us to take the risks that make this country great" is gobbledygook of the first order (Kathleen Parker, 1/22).

The Washington Post: Obama's Unapologetic Inaugural Address
Obama will be seen as combative in his direct refutation of certain conservative ideas, and it was especially good to see him argue -; in a passage that rather pointedly alluded to Paul Ryan's worldview -; that social insurance programs encourage rather than discourage risk-taking and make us a more, not less, dynamic society. "The commitments we make to each other -; through Medicare, and Medicaid, and Social Security -; these things do not sap our initiative; they strengthen us," he said. "They do not make us a nation of takers; they free us to take the risks that make this country great." This is one of the most important arguments liberals have made since FDR's time, and in the face of an aggressive attack now on the very idea of a social insurance state, it was important that Obama make it again (E.J. Dionne Jr., 1/21).

Los Angeles Times: Roe Vs. Wade Turns 40
Forty years ago Tuesday, the Supreme Court ruled that women had a constitutional right to an abortion. This one sweeping decision transformed abortion from what was often a secret, illicit and dangerous act, sometimes crudely self-inflicted, into a generally legal and safe procedure. But it also turned abortion, always an emotional issue, into one of society's most divisive (1/22). 

The Washington Post: Chipping Away At Roe V. Wade
Over the past 40 years, state legislatures across the country have managed to place a slew of impediments, inconveniences and indignities between women and their right to choose (Katrina vanden Heuvel, 1/22).

Bloomberg: Use Profit Motive To Improve Health Care
The fundamental problem with the U.S. health-care system, many people argue, is that medicine can't operate well on the profit motive. It is a social good, and profit-driven behaviors undermine efforts to provide high-quality care. It's true that our private health-care system provides care that is extraordinarily expensive, excessive, wasteful, patient-unfriendly and often dangerously sloppy. But the problem with this argument is that for-profit and nonprofit providers alike produce the same bad result. The profit motive itself doesn't seem to be the differentiator (David Goldhill, 1/21).

Philadelphia Inquirer: Physicians Are Not Overpaid
Everyone likes to complain about how much money doctors make. Many people hear the word "physician" and equate it with a mansion, BMW, and lavish vacation. But physicians don't make nearly as much as you think. After finishing high school, physicians spend a minimum of 11 years in training. Specialized physicians train even longer, sometimes for as long as 20 years. These are years spent making no money while in school, or making very little money during residency and fellowship. And by the time these individuals are "real" physicians, they are already in their mid-to-late thirties and have spent years struggling financially to support themselves and their families. … So, you think doctors are in it for the money? If they once were, they aren't anymore. Nearly half of all physicians regret going into medicine. And when asked whether they feel they are adequately compensated, only 51% of physicians say yes (Erica Cohen, 1/23).

Medpage Today: Patient Safety And The Ethics Of EMR Implementation
We should acknowledge that there might be cause, ethically, to deploy a technology that truly benefits patients at some cost. After all, you have to break a few eggs to make a good omelet. If interoperability of (electronic medical record) systems between facilities were commonplace and clinical data were shared with ease while patient privacy was vigorously upheld flawlessly, the cost of these systems might be ethically justified. But the promise of improved efficiencies to our healthcare system, improved patient safety and (especially) reduced costs for our healthcare system remain elusive. More importantly, these goals remain unproven (Dr. Wes Fisher, 1/22).

Sacramento Bee: Save Programs That Help Create Healthy Communities
California Field Poll results released Tuesday from 12 California counties show that 94 percent of surveyed registered voters see obesity in the United States as a serious problem. And they think we need to do more to address it, along with other chronic diseases. They want more help – from local governments, civic leaders, our legislators and businesses. They want more investments in the infrastructure that supports health: in parks, safe streets, and smoke-free environments. Meanwhile, in Washington, lawmakers from across the country are set to slash public health funding that supports these kinds of efforts as part of the sequester (Mary Pittman, 1/23).

The Houston Chronicle: Texas Facing Mental Health Crisis
Here in Texas, we do a woeful job of serving our citizens with mental health problems. More than 4.3 million Texans, including 1.2 million children, live with some form of mental health disorder. Yet, according to the Kaiser Family Foundation, Texas has fallen to the 51st place in per capita funding for mental health services. That puts us behind even Washington, D.C. The national average for state spending on mental health services is $109 per capita. Texas shamelessly spends $36 (State Rep. Sylvester Turner, 1/22).