Viewpoints: GOP's hope to end deficits in 10 years will mean 'dramatic cuts' in entitlements; Mass. health overhaul brings need for more taxes

Los Angeles Times: Paul Ryan's Next Budget: More Of The Same – A Lot More
Ryan has a daunting new assignment that may make that message even more difficult to sell. He's been charged by House Speaker John A. Boehner with drawing up a new budget that will erase the federal deficit within 10 years (the first Ryan budget, written in 2011, needed 30 years) solely through spending cuts -- no new tax revenues allowed. That means Ryan's next budget will require even more dramatic cuts in "entitlements" -- Medicare, Medicaid and Social Security -- than the last one (Doyle McManus, 1/23).

The New York Times: A Debt Crisis Averted, For Now
If the House actually wants to put forth a balanced budget over the next 10 years, as Mr. Boehner vowed to do on Wednesday, let the public see what that really means: unimaginable cuts and changes to Medicare and Medicaid, and the elimination of scores of popular and vital programs that benefit both the poor and the middle class. Up to now, Republicans have been understandably wary of specifying how that would be done without raising taxes (1/23). 

The New York Times' Opinionator: When Paying It Forward Pays Us Back
Many of the most effective (social programs) are not a mere expense to be trimmed off a budget; they often can and do save considerable money for society. ... One such example is the Transitional Care Model (TCM), which provides planning and home follow-up by trained nurses for chronically ill Medicare patients during and after hospitalization. The TCM illustrates a key point. Often, to save money you need to change systems, or add new functions, not just cut things (David Bornstein, 1/23). 

The Wall Street Journal: The RomneyCare Bill Comes Due
The health reform that Mitt Romney passed in 2006 in Massachusetts presaged President Obama's, and its results are showing what we can expect nationwide. The latest warning comes in a huge new tax increase proposed by Governor Deval Patrick. Last week the second-term Democrat followed his party's recent habit and proposed an increase in the state's single-rate income tax ... The lesson for voters is that universal health care is going to have universally large costs. The middle class will pay the bill, as they are starting to do in Massachusetts (1/23).

The Washington Post: Obama's Mainstream Pitch
Obama's address was firmly in the mainstream ... The speech sounded so robustly liberal not because the president or his party has changed but because the Republican Party has, moving far outside the norms of American political thought. ... But in a world in which Republicans have endorsed a budget that would eviscerate Medicaid and turn it into a block grant and that would change Medicare into a voucher program whose value would quickly be overtaken by inflation, protecting the integrity of these programs suddenly sounds bold. Note that Obama did not say these programs were immune from reform (Kenneth S. Baer, 1/23). 

JAMA: Embracing (or Not) The Medicaid Expansion 
[I]t's important to keep things in perspective. Many are worried that if the law is not implemented immediately and fully, then it will fail. This certainly wasn't the case with the original passage of Medicaid in 1965. Only 26 signed up in the first year after Medicaid began; it wasn't until about 18 years later, in 1982, that the last state, Arizona, agreed to participate. That didn't prevent Medicaid from becoming as American as apple pie (Dr. Aaron E. Carroll, 1/23).

The New York Times' Opinionator: Misconceptions 
Last year alone, 19 state legislatures enacted a total of 43 new restrictions on access to abortion (six states accounted for more than half the new restrictions, with the ever-reliable Arizona leading the pack with seven).  ... At the time I graduated from high school, a year before the Supreme Court decided Griswold v. Connecticut, not only was abortion still illegal in my home state, but so was birth control, even for married couples. Every time I drove by the building, and especially this week, I think to myself that despite all the worries and perturbations of the last 40 years, there's progress (Linda Greenhouse, 1/23).

Medpage Today: WANTED: 'EMR 3.0' For Dummies
Like most of my colleagues, I can tick off at least five or six large "pioneer" corporations – companies like Epic, Cerner, Allscripts, Siemens – in the forefront of the technology explosion that yielded important tools for advancing the field of electronic medical records (EMRs). Although research into their impact on quality of care and patient safety remains modest and is often controversial, these tools have eliminated considerable issues related to poor physician handwriting and have greatly improved internal and external provider communications and reporting (Dr. David Nash, 1/23).

Palm Beach Post: Let State Deny Greed-Based Health Insurance Increases
Though medical costs have slowed as fewer Americans seek health care because of the economy, insurance premiums in some states are rising as high as 25 percent. Critics blame the Affordable Care Act, even though key provisions don't take effect until next year. In fact, Obamacare is only partly responsible. Insurers get most blame as they seek maximum profits before the health care landscape drastically changes (Rhonda Swan, 1/23).

The New England Journal of Medicine: The Underside of the Silver Tsunami -; Older Adults and Mental Health Care
Approximately 5.6 million to 8 million Americans 65 years of age or older have mental health or substance-use disorders, and the Institute of Medicine (IOM) estimates that their numbers will reach 10.1 million to 14.4 million by 2030. ... Older adults with mental health disorders have greater disability than those with physical illness alone, as well as poorer health outcomes and higher rates of hospitalization and emergency department visits, resulting in per-person costs that are 47% to more than 200% higher. Yet mental health services account for only 1% of Medicare expenditures (Dr. Stephen J. Bartels and John A. Naslund, 1/23).

The New England Journal of Medicine: A Different Model -; Medical Care in Cuba
Any visitor can see that Cuba remains far from a developed country in basic infrastructure such as roads, housing, plumbing, and sanitation. Nonetheless, Cubans are beginning to face the same health problems the developed world faces, with increasing rates of coronary disease and obesity and an aging population (11.7% of Cubans are now 65 years of age or older). Their unusual health care system addresses those problems in ways that grew out of Cuba's peculiar political and economic history, but the system they have created -; with a physician for everyone, an early focus on prevention, and clear attention to community health -; may inform progress in other countries as well (Dr. Edward W. Campion and Stephen Morrissey, 1/23).