Viewpoints: ACOs might replace health insurers; Losing a job while pregnant; Barring smokers from the workplace

The New York Times: The Opinionator: The End Of Health Insurance Companies
Here's a bold prediction for the new year. By 2020, the American health insurance industry will be extinct. Insurance companies will be replaced by accountable care organizations -; groups of doctors, hospitals and other health care providers who come together to provide the full range of medical care for patients (Ezekiel J. Emanuel and Jeffrey B. Liebman, 1/30).

The New York Times: The Shortfall In Cancer Screening
A new federal study found that Americans are getting screened for three major cancers -; breast, cervical and colorectal -; at rates far below national targets. The shortfall is especially high among adults who lack insurance or regular access to a doctor, partly because the recession drove employers to lay off workers or cut health benefits (1/30). 

The New York Times: Pregnant, And Pushed Out Of A Job
Imagine a woman who, seven months into her pregnancy, is fired from her position as a cashier because she needed a few extra bathroom breaks. Or imagine another pregnant employee who was fired from her retail job after giving her supervisors a doctor's note requesting she be allowed to refrain from heavy lifting and climbing ladders during the month and a half before her maternity leave. ... We see this kind of case in our legal clinic all the time. It happens every day to pregnant women in the United States, and it happens thanks to a gap between discrimination laws and disability laws (Dina Bakst, 1/30).

The Washington Post: Obama Plays His Catholic Allies For Fools
In politics, the timing is often the message. On Jan. 20 -; three days before the annual March for Life -; the Obama administration announced its final decision that Catholic universities, hospitals and charities will be compelled to pay for health insurance that covers sterilization, contraceptives and abortifacients (Michael Gerson, 1/30). 

USA Today: Editorial: Not Hiring Smokers Crosses Privacy Line
Baylor Health Care System, one of the Dallas area's largest employers, has taken several savvy steps in its fight against smoking. It has offered free smoking-cessation programs to workers, made its campus smoke-free and slapped a health insurance surcharge on employees who smoke. But on Jan. 1, Baylor went a step too far: It stopped hiring anyone who smokes at work -; or anywhere else (1/30).

USA Today: Opposing View: Why We Won't Hire Smokers
Tobacco is addictive, damaging and deadly, causing 450,000 deaths -; one in every five -; each year in the U.S., often from early heart attacks, chronic lung diseases and cancers. As a health care institution, whose inherent mission is healing the sick and cultivating a healthier community, does it make sense to support a habit that leads to disease, disability and death? At Cleveland Clinic, we don't believe so. That's why we adopted a smoke-free campus in 2005 and why, in 2007, we went further, deciding to no longer hire smokers (Dr. Paul Terpeluk, 1/30).

Milwaukee Journal Sentinel: Improving Patient Care May Also Save Money
There are many reasons for rising health care spending, including a still prevalent fee-for-service mentality, patients' natural desire for top-of-the-line care no matter the outcome and hospital inefficiency. But here are two reasons that could become less of a concern in Wisconsin if a new initiative by the Wisconsin Hospital Association succeeds: hospital-acquired conditions and readmissions. The WHA initiative should both reduce health care spending and improve patient care (1/30).

Medscape: It's Not Too Late To Vaccinate!
Ideally, all providers, including specialists and primary care providers, should both recommend and offer flu vaccines to their patients. If you cannot provide flu shots in your office or clinic, make a concrete referral for your patients to other providers or locations that can (Dr. Joseph Bresee, 1/30).