Viewpoints: David Brooks' formula to avoid Cliff; Krugman says control costs, don't cut coverage

The New York Times: The Truly Grand Bargain
Republicans should go to the White House and say they are willing to see top tax rates go up to 36 percent or 37 percent and they are willing to forgo a debt-ceiling fight for this year. This is a big political concession, but it's not much of an economic one. … In return, Republicans should also ask for some medium-size entitlement cuts as part of the fiscal cliff down payment. ... But the big demand would be this: That on March 15, 2013, both parties would introduce leader-endorsed tax and entitlement reform bills in Congress that would bring the debt down to 60 percent of G.D.P. by 2024 and 40 percent by 2037, as scored by the Congressional Budget Office (David Brooks, 12/3).

The New York Times: The House Makes An Offer
The proposal ... purports to raise $800 billion in revenue over a decade by ending deductions and loopholes, while allowing the Bush-era tax cuts for the rich to continue. It would cut $1.2 trillion in spending, half of which would come from Medicare, Medicaid, and other health programs, including an increase in the Medicare eligibility age to 67. Another $600 billion would be cut from other unspecified spending (12/3).

The New York Times: It's Health Care Costs, Stupid 
The point is that if you want to control Medicare costs, you can't do it by kicking a small number of relatively young seniors off the program; to control costs, you have to, you know, control costs. And the truth is that we know a lot about how to do that -; after all, every other advanced country has much lower health costs than we do, and even within the U.S., the VHA and even Medicaid are much better at controlling costs than Medicare, and even more so relative to private insurance. The key is having a health insurance system that can say no -; no, we won't pay premium prices for drugs that are little if any better, we won't pay for medical procedures that yield little or no benefit (Paul Krugman, 12/3). 

The New York Times' Opinionator: From All Sides, Fiscal Plans Fall Far Short Of What's Needed
We don't yet know whether our economy will take the icy plunge off the fiscal cliff, but do we know this: At present course and speed, any budget deal that emerges from the intense brinkmanship now under way would fall short of every sensible ambition for fiscal reform (Steven Rattner, 12/3).

The Washington Post: In 'Cliff Talks,' Obama On Brink Of Disaster
While Obama was inviting Republicans to capitulate aboard the USS Missouri, Senate Majority Leader Harry Reid and 32 other Senate Democrats signed a letter declaring, "We will oppose including Social Security cuts for future or current beneficiaries in any deficit reduction package." Not in a year-end package, mind you, but in any package. 14 Senate Democrats wrote a letter opposing any changes to Medicare or Medicaid as well. It will be hard for Obama and the Democrats to blame the GOP for taking us over the fiscal cliff when they are the ones cheering for going over the edge (Marc A. Thiessen, 12/3).

Kansas City Star: Why Medicare And Medicaid Remain Popular Programs
They say Social Security is the third rail of American politics: Touch it and you die. That extends to Medicare and even Medicaid as well. I'd like to take this opportunity to remind President Barack Obama and members of both parties in Congress of why that is. If you are an ordinary American worker, you might be unlucky enough to learn a new buzzword in the health care industry: memory care. It refers to the health care assistance some older people need to do basic things like take the correct pills at the right time or remember whether they already ate lunch. This care is incredibly expensive -; several thousand dollars a month in a live-in facility (Mary Sanchez, 12/3)

The Washington Post: Extending Leadership On Disability Issues
Today, the United States has an opportunity to show leadership and reduce the challenges that millions of disabled people around the world face every day: The Senate can vote to join the U.N. treaty on rights for people with disabilities. By encouraging other nations to strengthen their own accessibility laws, we can improve the lives of our 56.7 million disabled U.S. citizens, including 5.5 million disabled veterans like me, when we travel and work abroad. Many of those opposing this treaty claim to support military veterans, but a vote against ratifying this treaty undercuts that support (Dan Berschinski, 12/3).

The Wall Street Journal: Doctor Dissident
At 20 minutes after-hours, a handful of patients sit in the front office of Vladimir Gressel's multi-specialty practice. A few seniors, a young man and a mother and daughter are still waiting to see one of the clinic's two GPs or its cardiologist, podiatrist or orthopedic surgeon. They will not, however, be seeing Dr. Gressel, the physiatrist who co-owns and manages East Shore Medical. The Belarus-born doctor took a hiatus five months ago from treating patients. Now, facing four more years of President Obama, he's considering a permanent end to his doctoring days, at least in this country (Anne Jolis, 12/3).

The Dallas Morning News: Parkland Must Prove Reforms Are Effective In Practice
Today is an important day for Parkland Health & Hospital System officials. They will tell their Board of Managers that 91 percent of the action items in their Corrective Action Plan have been completed and 95 percent are on schedule to make deadline…. The question now for Parkland officials is whether they can turn their reforms from checklists to reality. In effect, they are most of the way through the written portion of their exam. What follows is more critical: proving that those plans actually work in practice and are hard-wired throughout their organization (12/3).

The Seattle Times: Physicians Group's Compelling Case For Over-The-Counter Birth Control
In recent news reports, the FDA has signaled a willingness to explore the issue, even if no drugmakers have publicly expressed interest. They must consider cost, whether the insured would still be covered and the role of pharmacists. The bottom line is that access to family planning is essential to ensure children in Washington are born when their parents are ready (12/3).

WBUR: Cognoscenti: The Pill Without A Prescription: It's Time
Contraception, as everybody knows by now, was a hot button political issue this fall. (Haven't we fought this fight already?) But perhaps, given the election results, the time is finally nigh to come to our collective senses and do as the ob/gyns recommend – make birth control pills available to women of any age, any time, at any pharmacy, no doctor visit or prescription needed (Judy Foreman, 12/3).

The Arizona Central: Brewer Move OK For Now
Citing high anticipated costs and other reservations, Gov. Jan Brewer declined the option to create an Arizona-based online health-care exchange under the new Affordable Care Act. By doing so, Brewer is ceding control over Arizona's health-care marketplace to the federal government -- not a good idea, overall. Still, the governor's reasons for declining to set up the exchange are defensible. Should it prove to be in Arizona's better interests in the years to come to establish its own exchange, the decision is not irrevocable (12/4).

Medpage Today: The Medical Home
But in my mind, the single most important factor is the absence of good information readily available in the settings of what is often labeled today as "the medical home." Notice there are two ingredients in that formula. When I started my television career 40 years ago, there was a paucity of good health information readily available to the public. Today there is a lot of good information but, unfortunately, it is often lost in the tsunami of information pouring over the public. So a key factor in controlling healthcare costs and avoiding unnecessary care is helping people find – and trust – good information (Dr. Timothy Johnson, 12/3).

San Jose Mercury News: Chronically Ill Californians In Danger Of Going Over Cliff
As Americans turn their focus from the recent elections to the talks over federal deficit reduction and the "fiscal cliff," millions of chronically ill California patients face a very real threat. If Congress does not act now, more than $1 trillion in automatic federal budget cuts will begin Jan. 2, and access to care for California patients living with arthritis, mental illness, autoimmune disorders and countless other conditions will be imperiled (Monica L. Johnson, 12/3). 

http://www.kaiserhealthnews.orgThis article was reprinted from with permission from the Henry J. Kaiser Family Foundation. Kaiser Health News, an editorially independent news service, is a program of the Kaiser Family Foundation, a nonpartisan health care policy research organization unaffiliated with Kaiser Permanente.



The opinions expressed here are the views of the writer and do not necessarily reflect the views and opinions of News-Medical.Net.
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