Viewpoints: ACOs are doomed to fail; The need to expand Medicaid in Texas; The case against malpractice changes in Iowa

The Wall Street Journal: The Coming Failure Of 'Accountable Care'
Spurred by the Affordable Care Act, hundreds of pilot programs called Accountable Care Organizations have been launched over the past year, affecting tens of millions on Medicare and many who have commercial health insurance. ... The ACO concept is based on assumptions about personal and economic behavior-;by doctors, patients and others-;that aren't realistic. Health-care providers are spending hundreds of millions of dollars to build the technology and infrastructure necessary to establish ACOs. But the country isn't likely to get the improvements in cost, quality and access that it so desperately needs (Clayton Christensen, Jeffrey Flier and Vineeta Vijayaraghavan, 2/18).

The Texas Tribune: Why Texas Should Expand Medicaid
Medicaid expansion is the most important health care opportunity in a generation. The Dallas Regional Chamber of Commerce, Texas Medical Association, Texas Hospital Association, Interfaith Alliance and many others across the business, faith, and healthcare communities recognize this and are advocating for expansion. State leaders can improve public health and our economy by working collaboratively with others to create a Texas plan that will improve the Medicaid delivery system and bring expansion dollars to Texas (Clay Jenkins, 2/19).

The Wall Street Journal: Should States Opt Out Of The Health Law's Medicaid Expansion?
Part of the court's decision made it easier for states not to participate in expanding Medicaid benefits to subsidize health-care coverage for a broader swath of poor Americans. ... States are deciding now, as the law's major provisions take effect in 2014, and state budgets have already been outlined. Ed Haislmaier, a senior research fellow at the Heritage Foundation, in Washington, D.C., argues that states should opt out of the expansion. Taking the view that states should go along with the expansion is Sara Rosenbaum, the Harold and Jane Hirsh professor in the School of Public Health and Health Services at George Washington University, also in Washington (2/18).

The New York Times: Reproductive Rights In New York
New York State once led the nation in advancing women's rights. Gov. Andrew Cuomo wants to re-establish that pre-eminence with an omnibus agenda on women's equality. The most important piece of that agenda would essentially enshrine in state law existing federal protections for abortion rights (2/19). 

The New York Times: Losing My Leg To A Medical Error
I lost my leg because of a preventable error. The loss of a limb is traumatic, and I experience waves of sorrow and regret. I struggle with continual pain in my residual limb, and am trying to learn how to walk with my prosthesis. My work as a physician has been put on hold. For the past two decades I have been studying how to prevent errors in health care, and the irony of my present predicament strengthens my motivation to continue the quest. No one should ever have to experience such preventable harm (Dr. Frederick S. Southwick, 2/19). 

Des Moines Register: Iowa Doesn't Have A Malpractice Crisis
Gov. Terry Branstad says "frivolous" medical malpractice lawsuits make it more difficult for Iowa to recruit and retain physicians. He has asked state lawmakers to require a medical expert to screen cases before they can move forward in court. He also wants to cap the amount of "non-economic" damages juries could award when someone is injured by a doctor. The governor's assertions are not rooted in facts, and the Legislature should not entertain such measures (2/19).

Health Policy Solutions (a Colo. news service): Churning Isn't Just For Butter Anymore
Churning is the policy wonk term for those who qualify and are covered by a public program, like Medicaid, and then have access to a private insurance plan through a new job that offers it or through a family member's coverage, but then lose that coverage and end up back on the public insurance for which they qualify. They churn. And they suffer (Donna Smith, 2/19).

The Fiscal Times: Alzheimer's: A Spending Program All Can Agree On
In the course of President Obama's SOTU litany, his recommitment to spending resources on Alzheimer's research stands out as the one topic that brought applause from both sides of the aisle. It even earned praise from some of Obama's most severe ideological critics. On Fox News, Jim Pinkerton claimed that "Alzheimer's research is a cause Obama and his critics should all support – to save both money and lives." This is exactly right, and it's why bitter political rivals can overlook their cantankerous disputes to join forces. Investing in Alzheimer's research is both a social and economic investment that will pay dividends if we get it right (Michael Hodin, 2/18).

Boston Globe: Sex-Bias Case Has Lessons For The Medical Profession
(Dr. Josef Fischer) is the central figure behind (Beth Israel Deaconess Medical Center's) $7 million settlement with the female former chief of anesthesia, who says he tried to ruin her career because she is a woman. Dr. Carol Warfield's claims, which were backed up by testimony from senior female surgeons, illustrate the dark side of superstar surgeons like Fischer. Historically, the most celebrated surgeons were swashbuckling men who could make snap judgments and act on them without fear of the consequences -; traits that may have contributed to Fischer's lack of concern for his colleagues' feelings (2/20).

Richmond Times Dispatch: At Odds Over A Hospital For Children
In the simplest terms, the issue of a children's hospital is this: A group of 250 strong-minded pediatricians called PACKids -; backed by major pledges from local philanthropists -; thinks Richmond should build a new, free-standing hospital to better care for sick children. (It's an idea that has been growing for several years.) Others say we already have an excellent children's hospital: a full-service operation embedded in a nationally recognized medical college, Virginia Commonwealth University. Still others question whether a standalone hospital can be sustained, when pediatric medicine already makes up an important chunk of existing institutions. Adding investment is a stronger move than reinventing, they add (Tom Silvestri, 2/17).