Viewpoints: The missing debate on women; The true cost of care; Fair wages for home health aides

The Washington Post: The Debate On Women We Should  Be Having
The Centers for Disease Control and Prevention just reported that the nation's teen pregnancy rate is at an all-time low. Increased contraceptive use appears to have played a significant role in the decline. The Guttmacher Institute estimates that without Title X services, hundreds of thousands more teenagers would become pregnant every year. Why does (GOP presidential candidate Mitt) Romney think eliminating the federal money for family planning -; $327 million annually -; is wise? (Ruth Marcus, 4/13).

Politico: For Most Moms, Work Is Not A Choice 
Perhaps the popularity of "Mad Men," has political operatives confused about what matters to Americans today. Despite Republicans best efforts to make it so, 2012 is not like the 1980s and definitely not the 1940s. Debates about contraception and made-up mommy wars are strikingly out of step with modern life. ... Productivity and the health and soul of our country can be improved by work place policies that value families (Tara McGuinness, 4/14).

The New York Times: Why Medical Bills Are A Mystery
Rising health care costs are busting the federal budget as well as those of states, counties and municipalities. Policy makers and health care leaders have spent decades trying to figure out what to do about this. Yet their solutions are failing because of a fundamental and largely unrecognized problem: We don't know what it costs to deliver health care to individual patients, much less how those costs compare to the outcomes achieved (Robert S. Kaplan and Micheal E. Porter, 4/14).

JAMA: The Debate Over How To Rein In Medicare Costs
There's a lot of resistance to direct budget controls on Medicare spending among seniors and health care professionals. But there's also been a growing and bipartisan consensus among policy makers that we must switch from Medicare's open-ended, benefit-driven spending dynamic (which covers a defined set of benefits, no matter the cost) to a fixed budget of some form. That's because it is impossible to see how we can solve our debt and deficit problems without a tighter, predictable Medicare budget (Stuart Butler, 4/13).

The Washington Post: Ombudsman: Debating The Cost Of Obamacare
So why does a modest and short Post story about the health reform law become a blockbuster online? And what does that say about our reactive, partisan, hyperventilating media culture? ... The crux of the argument is over how the CBO "scores," or counts, the projected savings to Medicare, obtained by a set of arcane reforms that are projected to save about $575 billion over 10 years (Patrick B. Pexton, 4/13).

The New York Times: Ducking The Crisis In Medicare
Nestled within the many commendable aspects of President Obama's health care plan -; including the individual mandate -; sits a problem that has gone virtually unnoticed by commentators obsessed with the Supreme Court's review of the law: how to pay for it. About 65 percent of the cost of the Obama health care law is supposed to be met by Medicare expense reductions and tax increases totaling roughly $1 trillion over 10 years. The deficiency with this plan is that it amounts to double-counting, using urgently needed Medicare economies to finance the new law (Steven Rattner, 4/13).

Bloomberg: Ignore Long-Term Forecasts Assuming No Medicare Fix
We should put essentially zero weight on the precise numbers in any 65-year forecast, and we certainly shouldn't make dramatic or disruptive changes today because some form of straight-line projection implies that health care will eat the economy. There is an undeniable problem with health care, but this is more about the way the entire medical industry operates, not just what the government spends…. Of course, rising health-care costs are unsustainable, but here's a bold prediction: We'll fix it (Simon Johnson, 4/15).

Denver Post: The House-Planned Budget Proposal Would Abolish Medicare
Right now, 47 million Americans enjoy Medicare and the peace of mind of its guarantee, including over 600,000 here in Colorado. But a radical plan that has already passed the Republican-controlled U.S. House undermines that security and would abolish Medicare as we know it. House Budget Committee Chairman Paul Ryan's Medicare "reform" proposal would end the Medicare guarantee while increasing costs to seniors (Rep. Diana DeGette, D-Colo., 4/15).

Denver Post: House Plan Protects Medicare
The 2011 Medicare Trustee report estimates that the Medicare Hospital Insurance trust fund, for inpatient hospital and related care, will go bankrupt in 2024, five years earlier than estimated in the previous report. Also, in the 2011 report, the trustees estimated Medicare's unfunded liabilities to total $24.6 trillion. No doubt, we need to preserve and to protect Medicare, and to do that requires more than simply defending "Medicare as we know it." Members of Congress from both sides of the aisle clearly recognize that if we do nothing, "Medicare as we know it" will not be there for future generations (Rep. Mike Coffman, R-Colo., 4/15).

The Baltimore Sun: What About Single-Payer?
President Barack Obama's vision for health-care reform could have resulted in a much better law had it not been for congressional decrees at the start that a single-payer system was "off the table." But guess what has appeared back on the table during the thoughtful pondering of the problem by the Supreme Court? … Good sense about what the Constitution means may carry the legal day. But even if the Affordable Care Act is struck down, we must move forward with the intent of the law: to make the purpose of medical coverage to create good health (Dr. James Burdick, 4/16).

St. Louis Beacon: ACA Is Much More Than Individual Mandate
As we await the Supreme Court's decision on the constitutionality of the Affordable Care Act (aka Obamacare), it may be useful to review some of its more positive features. ... Some rail against the idea of government bureaucrats enforcing government health care. But, today, bureaucrats at insurance companies call many of the shots (Lana Stein, 4/16). 

The New York Times: Keeping A Promise To Home Care Aides
Evelyn Coke, who died in 2009 at age 74, was a home care aide whose case for fair pay went to the Supreme Court in 2007, where she lost 9 to 0. At issue were federal rules that define home care aides as "companions," a label that exempts employers from having to pay minimum wage and time-and-a-half for overtime. The justices said that only Congress or the Labor Department could change the rules (4/15).

The Wall Street Journal: Toward A 21st-Century FDA
When I was commissioner of the Food and Drug Administration (FDA) from 2005 to 2009, I saw firsthand how regenerative medicine offered a cure for kidney and heart failure and other chronic conditions like diabetes. Researchers used stem cells to grow cells and tissues to replace failing organs. ... Breakthroughs for humans were and still are a long way off. They have been stalled by regulatory uncertainty, because the FDA doesn't have the scientific tools and resources to review complex innovations more expeditiously and pioneer regulatory pathways for state-of-the-art therapies that defy current agency conventions (Andrew Von Eschenbach, 4/15).

The Philadelphia Inquirer: Mental Health Cuts Will Be Costly
Gov. Corbett's proposed budget would weaken the state's social safety net in many ways. The harshest impact will be on people with mental illness. The governor proposes reducing funding for behavioral health services by almost $200 million. But the belief that this will save the state money is an illusion (William S. Dinwiddie, 4/16).

Des Moines Register: Consensus Is 'Activist' Label Is Stupid
If the court does find part or all of the health care reform legislation unconstitutional, it will be doing its job. The court's job is to interpret the Constitution, and the role of the judiciary in our constitutional process should be respected whether you agree or disagree with a ruling. Still, it is hard to fathom how Republican leaders and other conservatives could keep a straight face while criticizing Obama on the "judicial activism" charge. After all, they have made a cottage industry of denouncing "unelected" judges (4/14).

Minneapolis Star Tribune: Tough Choices On Your Health Start Today
We see confusion among family members who struggle about whether the decisions they make for a loved one are right. ... No one, given the choice, would choose these awful moments for the people they love. And fortunately, the decision to create an advance directive is an easy one to make. We've made progress in advance directive adoption in recent years, but we have much more work to do (Brian Rank, Penny Wheeler and Steven Connelly, 4/15).

Houston Chronicle: Texas Children Need Health Insurance
We understand that tough times call for sacrifices. But when we see the dramatic difference that health insurance makes to the lives and health of our children, we wonder how effective these cuts are, even financially, not to mention in human terms: the tremendous costs to taxpayers of all those emergency room visits and the fact that we are handicapping so many of our kids' development. For every dollar earned by a college graduate in Texas, dropouts can expect to make only about 36 cents. We should be doing better than this: As our legislators look to a new session next January, we hope they will see fit to revisit, and revise, these draconian measures (4/13).

The Sacramento Bee: Big Tobacco Fires Up Anti-Tax Effort
Cigarette makers Altria and R.J. Reynolds will spend tens of millions of dollars telling us why Proposition 29, the latest attempt by anti-smokers to raise tobacco taxes, is a terrible idea. ... People who might ordinarily support the tax hike won't have much reason to go to the polls in June. Many will find reasons to vote against it, courtesy of tobacco-funded ads. The $441 million fund for research is one reason to vote for Proposition 29, so long as the money stays in California. If that's not reason enough, here's another: The tobacco industry doesn't want it (Dan Morain, 4/15).

The Sacramento Bee: Region's Hospitals Need To Collaborate To Advance Cancer Screening, Treatment
We are privileged in the Greater Sacramento region, a health care hub for much of Northern California, to have one of the nation's 44 comprehensive cancer centers. With that prestigious designation comes great opportunity – and great responsibility. ... The entire medical community in our region should capitalize on the status of the newly renamed UC Davis Comprehensive Cancer Center, now in the top tier of cancer centers nationwide – as the Boston area did in the late 1990s. There, a seven-member consortium brought together the resources of Harvard Medical School and area hospitals in the fight against cancer (4/15).

Medscape: 140 Character Communication With Patients
From cases that I have followed up on from instant care clinics the health care providers commonly appear unconcerned with not having any background on patients when they treat a 78 year old with pneumonia the same way they would treat an 18 year old. ... There is the very real risk that the understanding gained will quickly fade back into the background static, nothing retained, nothing gained (Dr. Greg Hood, 4/16).