Viewpoints: Medical professionals and near misses; Two tea partiers diverge on Medicaid expansion; Obamacare's 'death by a thousand cuts'

The New York Times: My Near Miss
A near miss, like any error, is an opportunity to examine how mistakes are made and what changes might prevent them. Yet we have no idea how many near misses there are. Many experts feel that near-miss errors dwarf the number of known errors, a number that is already too high for comfort. (According to a 2006 report, medication errors alone injure an estimated 1.5 million patients a year.) But the instinct for most medical professionals is to keep these shameful mistakes to ourselves (Danielle Ofri, 5/28).

The New York Times: Tough Politics, Easy Math
No two governors better represent the Tea Party ethos than Governors Rick Perry of Texas and Jan Brewer of Arizona. As required by the rigid ideology of the far right, the two are pretty much in sync on the major issues of the day -; like gun control. But there's one big exception to that rule: How the two governors are handling the Medicaid expansion provision in the health care reform law (Andrew Rosenthal, 5/28). 

Boston Globe: Obamacare Is Facing Death By A Thousand Cuts
Outright repeal is one way to sabotage health care reform, but most opponents recognize they don't have the votes for that, let alone enough to override a certain presidential veto. Of course, this has not prevented House Republicans from voting three dozen times to repeal health care reform. A 37th attempt took place earlier this month. All of this represents nothing more than political grandstanding. Since they haven't been able to achieve an outright repeal, Republicans are also working to thwart implementation (Michael E. Capuano, 5/29). 

Atlanta Journal Constitution: Small Firms Prefer To Risk Financial Ruin Than Follow Obamacare
How desperate are small businesses for alternatives to Obamacare? This desperate, according to a report in the Wall Street Journal: "UnitedHealth Group Inc. and Humana Inc. will begin offering smaller employers -- including firms with as few as 10 members in UnitedHealth's case -- the option of so-called self-insurance in some markets later this year. Self-insured businesses pay their workers' medical costs directly, instead of joining a traditional managed-care plan. Usually, they hire benefits firms or insurance companies just to administer their plans (Kyle Wingfield, 5/28).

Los Angeles Times: The IRS And Medical Records, Part 2
My last post, which attempted to rebut claims that Obamacare would have the Internal Revenue Service reviewing personal medical records, wasn't as reassuring to some readers as I'd hoped. In fact, several said the proof of the agency's interest in medical records was already out there, in the form of a class-action lawsuit filed this year that claims the IRS seized "at least 6 million identifiable medical records" belonging to about 10 million Americans. ... If the complaint accurately depicts what happened at the company, it's an unnerving portrayal of agents abusing power. But it still raises the question of why the IRS would want the medical records of a somewhat random assortment of individuals. The agency doesn't need them to have leverage over taxpayers, considering the sensitive financial data it amasses and the penalties it can impose. And if it wanted to check whether people were deducting nonexistent medical expenses, it could simply demand to see the bills for the expenses they were deducting (Jon Healy, 5/28).

The Medicare NewsGroup: Seniors Could Get Hurt By Paying More For Medicare Out Of Pocket
At this point, it's a nettlesome political question to ask who will make the bigger sacrifice in reforming Medicare spending. Will the burden largely fall upon providers, as the Obama administration has proposed? Or will the costs be passed along to beneficiaries, as conservatives have suggested in offering voucher-style plans? This debate is worth closely watching as few in Washington want to revert to life before Medicare, when old-age poverty was much more prevalent (John Wasik, 5/28).

Los Angeles Times: Alan Trounson, California's Dr. Stem Cell
In 2004, with President George W. Bush dead set against stem cell research, California just went ahead and did it. Voters made stem cell research a state constitutional right, and endorsed $3 billion in bond sales for 10 years to cement the deal. CIRM, the California Institute for Regenerative Medicine created under Proposition 71, has become a world center for stem cell research, and its president is Australian Alan Trounson, a pioneer in in vitro fertilization. As Proposition 71 approaches its 10-year anniversary, Trounson offers a prognosis (Patt Morrison, 5/29).

WBUR: Here & Now: Should Parents Be Liable If Unvaccinated Children Sicken Others? (Audio)
A measles outbreak in the New York is prompting bioethicist Art Caplan to wonder about the consequences of parents choosing not to vaccinate their children. He argues that parents should have the right to not vaccinate, but they should also expect to be sued if their child gets someone else sick (5/28).