First Edition: June 27, 2011

Today's headlines include reports about the status of ongoing deficit negotiations and details about a "stealth" survey on access to doctors.

USA Today: Obama Enters Deficit Negotiations As Default Threat Looms
Little more than five weeks remain before the government runs out of borrowing authority, which could eventually cause delays in contract payments, tax refunds or even Social Security benefits. A default also could spook world financial markets and prompt ratings agencies to lower the United States' triple-A credit rating. Yet the White House and Republicans in Congress remain deeply divided over potential tax increases and cuts to popular entitlement programs, such as Medicare and Medicaid, that could help reduce budget deficits by more than $2trillion over the coming decade (Wolf, 6/27).

Politico: President Obama, Mitch McConnell Square Off On Debt
Monday's White House meeting between President Barack Obama and Senate Minority Leader Mitch McConnell is an important first test for both men, each trying to draw out the other in the face of August's debt ceiling deadline. Democrats argue simple arithmetic dictates that revenues must be added to help fill the gap and get to the $2 trillion-plus target. But having established a foundation, the bigger question is whether both sides should push ahead for a much larger deal encompassing more Medicare reforms and tax revenues (Rogers, 6/26).

The Associated Press: Biden Warns GOP On Debt Ceiling Talks
Vice President Joe Biden said Saturday the Obama administration wouldn't let middle class Americans "carry the whole burden" to break a deadlock over the national debt limit, warning that the Republican approach would only benefit the wealthy. Addressing Ohio Democrats, Biden said there had been great progress in talks with Republican lawmakers on a deficit-reduction plan agreement. But he insisted that his party wouldn't agree to cuts that would undermine the elderly and middle-class workers (Thomas, 6/25).

Politico: For Dems, Health Law Is Chronic Pain
Democrats may be on the offensive against the Republican Medicare plan, but they're not finished playing defense on their health care law. That's the lesson from the latest series of PR crises on the law they've had to deal with, including a survey that suggested many employers would stop offering health coverage and a widely circulated news story that reported 3 million middle-class people could qualify for Medicaid because of the law (Nather, 6/26).

The Wall Street Journal: Overlapping Health Plans Are Double Trouble For Taxpayers
As the U.S. wrestles with rising health expenses, one group of patients stands out for government-paid care that is both ultra-costly and plagued with problems. They are the people who receive both Medicare, the program for those 65 and older or disabled, and Medicaid, the one for the poor. Statistics on these 9.7 million "dual eligibles" are stark (Adamy, 6/ 27).

The New York Times: U.S. Plans Stealth Survey On Access To Doctors
Alarmed by a shortage of primary care doctors, Obama administration officials are recruiting a team of "mystery shoppers" to pose as patients, call doctors' offices and request appointments to see how difficult it is for people to get care when they need it. The administration says the survey will address a "critical public policy problem": the increasing shortage of primary care doctors, including specialists in internal medicine and family practice. It will also try to discover whether doctors are accepting patients with private insurance while turning away those in government health programs that pay lower reimbursement rates (Pear, 6/26).

Politico: Report: Obama Plans Secret Study Of Access To Doctors
A good doctor can be hard to find and, as anyone who's looked for a new primary care physician knows, finding one who's accepting new patients can be next to impossible. But the Obama administration, alarmed by the "critical public policy problem" of a growing shortage of primary care physicians, is embarking on a secret shopper investigation aimed at getting a handle on just how hard it is to get an appointment with a doctor who specializes in internal medicine, The New York Times reported Monday (Epstein, 6/27).

Los Angeles Times: What Happened To The Family Doctor?
Numerous studies have found that when primary care works well, patients are healthier, with better management of chronic diseases and fewer emergency-room visits and hospitalizations. All that saves healthcare dollars too. But many doctors say there is not enough time in a typical 15- to 20-minute office visit to cover all the tests, inquiries and procedures recommended by medical schools, the U.S. Preventive Services Task Force and other organizations — even when dealing with a healthy patient (Delude, 6/27).

The New York Times: Genentech To Appeal To FDA For Breast Cancer Drug
Genentech this week will step up its efforts to keep the drug Avastin available as a treatment for breast cancer, urging the Food and Drug Administration to give it one more chance to prove the medicine works. At a hearing on Tuesday and Wednesday in suburban Washington, Genentech will ask the F.D.A. to reconsider its proposal last December to revoke the approval of Avastin for breast cancer on the grounds that new studies did not confirm that the drug helped patients (Pollack, 6/26).

The Wall Street Journal: Showdown Over Use Of Cancer-Drug Avastin
An unprecedented hearing is set this week for Roche Holding AG's cancer drug Avastin, with Food and Drug Administration scientists fighting to have their decision to revoke Avastin's accelerated approval for breast cancer upheld. The decision by an FDA appeals panel, and ultimately FDA Commissioner Margaret Hamburg, is likely to affect the agency's program to allow conditional approval for potentially life-saving drugs. FDA officials describe Avastin for breast cancer as a classic case of a drug that looked promising but turned out to carry high risk with minimal benefit. They want to pull approval for breast-cancer use after provisionally granting it in 2008 (Mundy, 6/27).

Los Angeles Times: Indiana's Bumpy Road To Privatization
Cohoon's mother, now suffering from Alzheimer's disease, was one of thousands of Indiana residents who abruptly and erroneously lost their welfare, Medicaid or food stamp benefits after Republican Gov. Mitch Daniels privatized the state's public assistance program — the result of an efficiency plan that went awry from the very beginning, the state now admits. Though the $1.37-billion project proved disastrous for many of the state's poor, elderly and disabled, it was a financial bonanza for a handful of firms with ties to Daniels and his political allies, which landed state contracts worth millions. The disparate effects underscore the risks of handing control over public services to the private sector (Gold, Mason and Hamburger, 6/24).

The New York Times: Connecticut Budget Is Upended As State Workers Reject Deal
Connecticut's state workers, in voting results announced on Friday, rejected a deal meant to produce $1.6 billion in labor savings over two years, blowing a gaping hole in the state budget, raising the likelihood of thousands of layoffs and threatening chaos in a state that has largely avoided the rancorous labor issues seen elsewhere. ... The agreement called for wage freezes for two years, followed by 3 percent annual raises for three years and a guarantee of no layoffs for four years, as well as concessions on pensions and health care. ... The opposition centered on suspicions about the health care provisions, particularly fears that the deal would eventually place employees in a new state insurance program, called SustiNet. Union and state officials said health care could not be changed again without employee approval until 2022 (Applebome, 6/24).

The Wall Street Journal: Florida's Scott  Unfazed By The Critics
Gov. Rick Scott swept into office in January vowing to lure businesses, create hundreds of thousands of jobs and make Florida a model of limited government. ‪Less than six months later, the Republican governor and the GOP-dominated legislature have achieved much of the conservative agenda he laid out, including deep budget cuts to reduce a $3.6 billion deficit without raising taxes, pension-system changes and privatizing Medicaid (Campo-Flores, 6/27).

The New York Times: Several States Forbid Abortion After 20 Weeks
On the theory that fetuses can feel pain after 20 weeks (an idea disputed by mainstream medicine), several states have banned abortions later than this (Eckholm, 6/27).

Kaiser Health News tracked weekend news developments, including coverage of a federal judge's ruling that Indiana cannot cut Medicaid funding to Planned Parenthood.