Viewpoints: Medicare options and politics; high costs of care; health disparities

The Wall Street Journal: Medicare As We've Known It Isn't An Option
The Democratic Party is urging Americans to choose Medicare as we've always known it rather than a new plan by Rep. Paul Ryan (R., Wis.) that would enroll seniors in private health insurance beginning in 2022. This choice is a hoax: Medicare as we've always known it is already gone. It was eviscerated by President Obama's health law. Yet if the president and the Democratic Party successfully bamboozle voters, they may win back independents and registered Democrats who voted for Republicans in 2010. The 2012 election could turn on this falsehood (Betsy McCaughey, 4/27).

The Chicago Tribune: Mediscare Part Two: The Democrats Return Fire
The commercial is amusing. It's a 30-second spot recently released by the Democratic Congressional Campaign Committee that imagines what senior citizens will have to do to earn the extra $12,500 a year the ad says they'll need to pay for their health care under the budget plan passed earlier this month by House Republicans (Eric Zorn, 4/27).

Kaiser Health News: GOP Budget: Time Travel Back To When Seniors Couldn't Afford Health Care
The idea of high medical bills forcing the elderly to give up their dignity, or more, is hardly far-fetched. And if you don't want to take my word for it, perhaps you should listen to John Barclay and a little bit of history (Jonathan Cohn, 4/26).

The Washington Post: The Plum Line: Could Paul Ryan Become A Victim Of His Own Plan?
Could the Ryan budget spell serious trouble for ... Paul Ryan? House Republicans have given an extraordinary amount of leeway to House Budget Chair Paul Ryan so far during the 112th Congress. To begin with, they rewrote House rules to give Ryan additional authority. And then they adopted his budget only a week after it was unveiled, with very little scrutiny. They have since been taking grief in their districts for the Medicare cuts in that budget (Greg Sargent, 4/26).

The Philadelphia Inquirer / Philadelphia Daily News: The Truth About Medicare Changes: Higher Costs For Seniors
Republicans in the U.S. House of Representatives voted two weeks ago to end Medicare as we know it. And now, poor things, they are having trouble explaining themselves to their constituents. Republican members of Congress were to meet today to discuss how to explain their vote for a budget proposal authored by U.S. Rep. Paul Ryan, R-Wisc., that includes a plan to radically restructure Medicare and Medicaid while -- you guessed it -- lowering taxes on the rich even further (4/27).

The Fiscal Times: Health Care Vouchers vs. Program Cuts by Experts
We know what works for health care cost control. Other countries deliver universal care at lower costs and similar quality, and I believe that once we've tried other avenues that fail, this is where we will end. There will be lots of false starts, delays and dead-ends along the way — and a voucher program, if pursued, is one of those dead ends (Mark Thoma, 4/26).

Des Moines Register: State Must Be More Rigorous On Inspections
According to an investigation by Register reporter Clark Kauffman, many facilities providing health care are subject to little to no state oversight. This should be yet another wake-up call to Iowa lawmakers about the need for adequate government regulation in places entrusted with the health and lives of Iowans. The population is aging. The health reform law will get more Americans insured. The inevitable result: More people will be seeking health services. The private sector is evolving to accommodate increased demand. As is frequently the case, the government is two steps behind in providing regulation. It's an embarrassment and it puts Iowans at risk for infections, inadequate treatment, and death (4/26). 

Archives of Internal Medicine: Personal Reflections On The High Cost Of American Medical Care
In the long run, reining in costs will require mobilizing political forces that can withstand the inevitable claims of rationing sure to come from the industries currently benefiting from the 17% of the economy spent on health care, and from consumers who have come to expect unlimited access to what they feel they need. Until there exist sufficient countervailing forces so that a comprehensive, multipronged strategy could be implemented, politicians and health policy experts will continue to embrace tepid and ultimately ineffective solutions that may sound good in theory but will fall short in practice (Dr. Steven A. Schroeder, 4/25).

The Journal of the American Medical Association: Accountable Care Organizations And Health Care Disparities
The process of creating ACOs may reinforce racial/ethnic differences in sites of care by further concentrating patients from certain racial/ethnic groups within particular health care organizations. ... Although not explicitly selecting patients by race, ethnicity, or socioeconomic status, the current reality is that profitability in health care is strongly correlated with caring for fewer low-income patients and low-income patients are disproportionately not white. To the degree that the creation of an ACO enables wealthy practices to preferentially align with one another, this process has the potential to further concentrate wealth and racial/ethnic groups within certain ACOs (Dr. Craig Evan Pollack and Dr. Katrina Armstrong, 4/27).

Willamette (Oregon) Week: Rouge Of The Week: Senate Health Care Reform Subcommittee
When President Obama and Congressional Democrats caved last year and passed a health reform bill without a public option, the best hope left for reining in runaway healthcare costs fell to state-run insurance exchanges. The Oregon Health Authority last year began gathering input on how best to run an exchange program, as required of all states by 2014 under federal health-insurance reform. But like doctors removing the wrong limb, a key Legislative committee botched key portions of the bill that would have best protected individuals, families and small businesses—making the Senate Subcommittee on Health Care Reform this week's Rogue (4/27).