Viewpoints: Health law is not affordable; narrow doctor networks may not sacrifice quality

The Wall Street Journal: The Myth Of ObamaCare's Affordability
The Affordable Care Act attempts to help low- and middle-income families avoid some of the tough sacrifices that would be necessary to purchase health insurance without assistance. But no program can change the fundamental reality that society itself has to make sacrifices in order to deliver health care to more people. Workers and therefore production have to be taken away from other industries to beef up health care, or the workforce itself has to get bigger, or somehow people have to work more productively. Although the ACA helps specific populations by giving them a bigger slice of the economic pie, the law diminishes the pie itself. It reduces the amount that Americans work, and it makes their work less productive. This slows growth in both personal income and gross domestic product (Casey B. Mulligan, 9/8). 

Los Angeles Times: What Can Be Done About Covered California's Doctor Gap?
The insurance reforms in the 2010 federal healthcare law went into full effect this year, dramatically reducing the number of Californians who don't have health coverage. At the same time, however, some low- and moderate-income residents have struggled to find doctors who'll take their insurance. Their complaints are forcing state officials to investigate the accuracy and adequacy of insurers' networks of medical providers. Though the attention is welcome and overdue, what's really needed is a better approach to consumer protection (9/8). 

Los Angeles Times: What's Behind Health Regulators' Bickering Over Prop. 45?
Tolstoy's line about all unhappy families being unhappy in their own way hardly needs validation from us in the 21st century. But still it would be interesting to see what he'd make of the increasingly bitter division between two state agencies that should be working hand in hand to improve health insurance coverage for Californians: the state's individual health insurance exchange, Covered California; and the Department of Insurance. They've been at odds for months over various aspects of the Affordable Care Act, on which Covered California plays a central role as the state's individual insurance exchange. Lately a new flash point has emerged. It's Proposition 45, the November ballot measure that would grant the state insurance commissioner authority to regulate health insurance rates (Michael Hiltzik, 9/8). 

New Republic: Maybe You Don't Need A Big Doctor Network To Get Good Care
You can save a lot of money on your health insurance premiums. But, to do so, you'll have to enroll in a plan that limits you to a relatively small number of providers. You might have to switch primary care physicians, or drive a long way to see a specialist. And you might not be able to go to that big-time teaching hospital that's always in the news, unless it's an emergency or you need a special kind of treatment. Do you take the deal? These days, lots of people are saying yes to that choice-;and, when they do so, they may not be sacrificing the quality of the care they get. That's the very tentative conclusion of a new study out on Monday (Jonathan Cohn, 9/8).

The New York Times' The Upshot: Doctors' Magical Thinking About Conflicts Of Interest
When the Food and Drug Administration creates an advisory committee to help it decide whether to approve drugs, it often asks academic physicians to serve on the committee as external experts. This is supposed to help the committee render judgments that are unbiased and scientific. Physicians can therefore hold a fair amount of sway in how decisions are made. One would hope that they would be above reproach, coming to the committee's deliberations with equipoise and an open mind. A study published today by Genevieve Pham-Kanter in The Milbank Quarterly brings that assumption into question (Aaron E. Carroll, 9/8). 

WBUR's CommonHealth blog: We're No. 1, Not In A Good Way: Highest Hospital Administrative Costs
When it comes to hospital administrative costs, a new Health Affairs study finds, our country is No. 1 and we're way ahead of the curve -; unfortunately. In the study, researchers analyzed hospital accounting data to compare administrative costs across eight countries: Canada, England, France, Germany, the Netherlands, Scotland, the United States and Wales. They found that administrative costs accounted for more than 25 percent of total U.S. hospital expenditures -; far ahead of the pack. ... Uwe Reinhardt, a health economist and professor at Princeton University, sees high hospital administrative costs as a moral question. "You're pulverizing all this money on something that does not make people better -; doesn't improve their health," he said (Alvin Tran, 9/8).