First Edition: April 4, 2011

Today's health policy news coverage includes reports about Republican lawmakers' plans to make dramatic changes to Medicare and Medicaid as they seek to cut $4 trillion from the budget over the next 10 years.

Kaiser Health News: GOP Proposals On Medicare Could Shift Costs To Beneficiaries
Kaiser Health News staff writer Mary Agnes Carey reports: "Amid the buzz about a possible government shutdown over this year's budget looms a more difficult question: What to do about entitlement programs, especially Medicare? ... Republican leaders have called for a major overhaul of Medicare, a $520 billion program that covers nearly 47 million older and disabled Americans. Given the political peril involved in tampering with Medicare, the question is: How serious are the Republicans? The answer: Plenty serious" (Carey, 4/3).

Kaiser Health News: ACOs Spell Gold Rush For Health Care Consultants
Bara Vaida, writing for Kaiser Health News  and working in collaboration with The Washington Post,  reports: "For months, said Washington health-care attorney Rene Quashie, his phone has been 'ringing off the hook,' with hospital and doctor clients wanting advice on how to reorganize themselves to get new Medicare bonuses under the health-care law. Handling such questions, said Quashie, an associate with the firm Drinker Biddle & Reath, is sure to be 'a growth area' for his firm. And a lucrative one. From Washington to California, the year-old health law, with its layers of complexity, is setting off a gold rush for high-priced lawyers and consultants" (Vaida, 4/2).

The New York Times: House Republicans Propose $4 Trillion In Cuts Over Decade
House Republicans plan this week to propose more than $4 trillion in federal spending reductions over the next decade by reshaping popular programs like Medicare, the Budget Committee chairman said Sunday in opening a new front in the intensifying budget wars (Hulse, 4/3).

Los Angeles Times: House Republican Budget Plan Would Revamp Medicare
Pressing their differences with President Obama, House Republicans will propose a 2012 federal budget Tuesday that includes an overhaul of Medicare and Medicaid and would aim to chop at least $4 trillion from the federal deficit over the next decade. House Budget Committee Chairman Paul D. Ryan's broad overview of the plan, which he described Sunday, is the clearest picture yet of how the party plans to reduce government spending over the long term. It also telegraphs the central role the issue will play in the GOP's pitch to voters in 2012 (Hennessy, 4/4).

The Wall Street Journal: GOP Aim: Cut $4 Trillion
The plan would essentially end Medicare, which now pays most of the health-care bills for 48 million elderly and disabled Americans, as a program that directly pays those bills. Mr. Ryan and other conservatives say this is necessary because of the program's soaring costs. Medicare cost $396.5 billion in 2010 and is projected to rise to $502.8 billion in 2016 (Bendavid, 4/4).

USA Today: GOP Budget Plan To Cut More Than $4 Trillion
Discussing entitlements, (Rep. Paul Ryan) said the plan would change Medicare, the federal health care plan for seniors, by creating a "premium support" system that allows seniors "to pick the (private health) plan of their choosing, and then Medicare subsidizes that plan." However, the plan would allow Americans who are now 55 and older to keep the current Medicare programs (McCoy, 4/4).

USA Today: Larger Debt Debate Looms On The Hill
Their efforts represent the most serious assault on federal deficits since a 1997 deal between President Clinton and a Republican Congress led to four years of surpluses. Since then, a decade of tax cuts, wars and recessions have sent the nation deeper and deeper into debt (Wolf, 4/4).

A longer listing from the weekend of news reports on Rep. Ryan's comments is posted on KHN.

The New York Times: Cuts Leave Patients With Medicaid Cards, But No Specialist to See
Eight-year-old Draven Smith was expelled from school last year for disruptive behavior, and he is being expelled again this year. But his mother and his pediatrician cannot find a mental health specialist to treat him because he is on Medicaid, and the program, which provides health coverage for the poor, pays doctors so little that many refuse to take its patients. The problem is common here and across the country, especially as states, scrambling to balance their budgets, look for cuts in Medicaid, which is one of their biggest expenditures (Pear, 4/1). 
 
The New York Times: More Physicians Say No To Endless Workdays
Even as a girl, Dr. Kate Dewar seemed destined to inherit the small-town medical practice of her grandfather and father. At 4, she could explain how to insert a pulmonary catheter. At 12, she could suture a gash. And when she entered medical school, she and her father talked eagerly about practicing together. But when she finishes residency this summer, Dr. Dewar, 31, will not be going home. Instead, she will take a job as a salaried emergency room doctor at a hospital in Elmira, N.Y., two hours away. An important reason is that she prefers the fast pace and interesting puzzles of emergency medicine, but another reason is that on Feb. 7 she gave birth to twins, and she cannot imagine raising them while working as hard as her father did (Harris, 4/1).

Los Angeles Times: A Shift Toward Smaller Health Insurance Networks
Thousands of employers in California and across the country are slashing expensive doctors and hospitals from their insurance rosters in a move to hold down rising healthcare costs — a trend that is gaining favor with corporate bosses, if not the rank and file (Helfand, 4/3).

The Wall Street Journal: Big Blue's Tiny Bug Zapper
Researchers at International Business Machines Corp. said they developed a tiny drug, called a nanoparticle, that in test-tube experiments showed promise as a weapon against dangerous superbugs that have become resistant to antibiotics (Winslow and Tibken, 4/4).

The Boston Globe: Middle East, Check. Now About That Health Care Law?
It was billed as a foreign policy address, but it didn't take long before the most prominent issue that could haunt Mitt Romney's presidential campaign came up. The first question from the audience after his 24-minute address yesterday before the Republican Jewish Coalition (in Las Vegas) was not about Israel or unrest in the Middle East. It was about Romney's health care plan in Massachusetts. Romney largely defended the rationale of the Massachusetts plan, but he sought to distinguish it from President Obama's national plan by casting it as an issue of states' rights (Viser,4/3).

Politico: Mitt Romney Defends Massachusetts Health Care Law In Las Vegas Speech
Mitt Romney directly addressed the Obama administration's backhanded plaudits of his Massachusetts health care law Saturday, defending the law's controversial individual mandate for the first time and promising that it wouldn't impede an aggressive attack on the president and his health care policy. "I will take [President Barack Obama] head on and aggressively if I'm the nominee," Romney told about 150 members of the Republican Jewish Coalition in town for their winter meeting (Hunt, 4/3).

The New York Times: Tipping The Odds For A Maker Of Heart Implants
Las Vegas is a city of few sure bets. But there are overwhelming odds on one thing — the brand of heart device that patients at a major hospital get. Within the last few years, a little known company called Biotronik has cornered the market on pacemakers and defibrillators at the University Medical Center of Southern Nevada (Meier, 4/2).

The Associated Press/Chicago Tribune: Government Appeals Judge's Health Care Ruling
The federal health care overhaul's core requirement to make virtually all citizens buy health insurance or face tax penalties is constitutional because Congress has the authority to regulate interstate business, the Justice Department said in its appeal of a ruling that struck down the Obama administration's signature legislation. The government's 62-page motion filed Friday to the 11th Circuit Court of Appeals argued that Congress had the power to enact the overhaul's minimum coverage requirements because it is a "rational means of regulating the way participants in the health care market pay for their services" (Bluestein, 4/3).

Over the weekend, Kaiser Health News also posted reports  from major news organizations on new rules from the Obama administration for chain restaurants and other food services for listing calorie counts.