Viewpoints: High-cost drugs and Medicare; pitfalls for ACOs; federal funding fix for nursing homes

USA Today: Ration Health Care With Medicare Cuts
Life-extending drugs debut frequently, and they usually seem exorbitantly expensive when weighed against their promise of adding a few weeks or months of life to someone with a terminal illness. In these prostate-cancer cases, one new drug costs $5,000 a month, another $8,000 every three weeks and a third $93,000 for a full course of treatment. The costs in this instance are even more relevant because most of them would be paid by Medicare. This, in turn, raises hard questions about public policy, ethics and moral judgments that Americans are going to have to face even as elected officials in Washington try to avoid them (Don Campbell, 8/9).  

The Journal of the American Medical Association: Implementing Accountable Care Organizations
Hospitals and physician organizations will need to forge new relationships and take on new responsibilities. Success will require adaptation and change, learning quickly from mistakes, and developing an ability to transfer knowledge among participating entities. ... we discuss 10 potential mistakes that organizations may experience in becoming ACOs (Sara Singer and Stephen M. Shortell, 8/9).  

The Journal of the American Medical Association: Equality-in-Quality In The Era Of The Affordable Care Act
Although efforts to improve health care quality are squarely in the sights of the ACA, disparities seem to fall in its programmatic blind spot. On both philosophical and empirical grounds, the highest-quality health care will not be realized unless inequalities are also addressed. Individuals deserve health care that is not only of high quality, but of equally high quality for all (Drs. Matthew M. Davis and Jennifer K. Walter, 8/9).   

The Journal of the American Medical Association: Insurance Expansion And Health Literacy
Recent estimates suggest that more than half (53%) of currently uninsured adults—those who will become newly insured under the ACA—have "below basic" or "basic" literacy skills. Such individuals have difficulty with tasks such as finding the date of a physician's visit on an appointment slip or explaining why someone should have a medical test using information from a clearly written pamphlet. Individuals with low health literacy are less likely to actively participate in health care decision making and more likely to struggle with health management tasks and to face significant challenges navigating the health system (Laurie T. Martin and Dr. Ruth M. Parker, 8/9).  

The Journal of the American Medical Association: The Individual Mandate And Patient-Centered Care
The potential influence of the individual mandate on the patient-physician relationship is underappreciated. Patients with insurance are more likely to have physicians routinely involved in coordinating their care. ... In the end, the health of patients relies on the health of the system providing their care, so it is imperative to get it right (Drs. Scott A. Berkowitz and Edward D. Miller, 8/10).   

The Fiscal Times: 4 Liberal Myths That Distort The Deficit Debate 
[E]ntitlement outlays threaten our outlook. Standard & Poor's noted last fall that unless the government initiates reforms, Social Security and Medicare will literally eat us alive. By 2035, age-related pensions, Social Security, Medicare and other payments will account for 16.3 percent of GDP, up from 10.8 percent in 2010. If no actions are taken, debt will climb to 229 percent of GDP by 2035 (Liz Peek, 8/10).   

Des Moines Register: Feds' Reimbursement Change Need Not Harm Nursing Home Care
The federal government is fixing a mistake it made last year. The Centers for Medicare and Medicaid Services is reducing payments to nursing homes by 11.1 percent to correct for "an unintended spike in payments." The news was met with complaints from the industry that quality of care will suffer. It was also met with complaints from Wall Street. Stock prices of large nursing home operators plummeted. ... The places caring for the elderly and disabled — and relying heavily on government payments to do so — should not be viewed as profit-centers in the first place. Unfortunately, they have been (8/9).    

Minneapolis Star Tribune: The Modified Flat Tax: A Model For Fairness
The idea comes back every few years, championed by conservatives (former House Majority Leader Dick Armey, R-Texas; Sen. Richard Shelby, R-Ala.; Republican presidential candidate Jon Huntsman) and occasionally by a liberal (Democratic Gov. Jerry Brown of California). It's the flat tax, and maybe it's time to look again. Could a modified flat federal personal income tax -- heralded as simple, uniform and fair -- move the debate beyond "tax the rich" and "no new taxes"? Could it look like this? (Robert Franklin, 8/9).   

Minneapolis Star Tribune: A Call To Action On Economy 
It is often said that we need America's political parties to work together better. But they are skillfully working together -- to block progress on the debt. Republicans prevent revenue increases; Democrats resist cuts in entitlement benefits. Without both, the future will be grim. ... there is nothing mysterious about the shape of such a plan. It must put taxes, Medicare, Social Security, defense and everything else on the table. The hard fact that must be faced is that any real remedy will be unpopular (8/9).    

The Philadelphia Inquirer: Obama Taking The Lead On Women's Health 
In Pennsylvania, Republican legislators have proposed a variety of bills, including one requiring women's clinics that perform abortions to have hospital-grade elevators and wider hallways. Such stringent requirements would make running some clinics financially impossible. The Obama administration should be applauded on its new health guidelines. It is hoped that misguided efforts to stop national health-care reform won't throw women back to the Stone Age (8/10). 

Houston Chronicle: Community Health Centers Can Help Close The Care Gap 
Nationwide, community health centers operate more than 7,900 locations and serve more than 20 million patients, the majority of whom have low incomes, are uninsured or publicly insured and are members of racial/ethnic minority groups. As a Houstonian and executive director of Legacy Community Health Services, I can tell you that the data on community health centers will defy your preconceived notions of what it means to provide comprehensive primary and preventive health care (Katy Caldwell, 8/9).   

Forbes: Medicare Actuary: Obamacare Will Triple The Growth Rate Of Net Insurance Costs
Remember when the President promised that Obamacare would reduce the cost of health insurance? "Under [our] plan, if you like your current health insurance, nothing changes, except your costs will go down by as much as $2,500 per year," said Obama in 2008. ... Well, the Office of the Actuary in the Centers for Medicare and Medicaid Services recently put out its annual projections of national health care spending. And, contrary to the President, the actuaries find that Obamacare will dramatically increase the near-term growth rate of health care costs (Avik Roy, 8/9).