Opposing views on health law's birthday; Krauthammer calls for compromise with Obama on entitlements, taxes

USA Today: Happy Birthday ObamaCare!
A year ago, the Affordable Care Act's outlook appeared uncertain, with the Supreme Court decision on the law's legality and a contentious election fight over its merits still on the horizon. Today, with both of those events unfolding in favor of the landmark law, ObamaCare continues to take effect, having already achieved so much, yet with so much more to come later this year (Rep. Sander Levin, D-Mich., and Rep. Jim McDermott, D-Wash., 3/21).

USA Today: Affordable Care Act Hasn't Earned Its Name
It was three years ago this weekend that President Obama signed a law that fundamentally changed our nation's healthcare system. While reform was needed, change is only good if it brings with it real reforms that reduce costs and empower individuals and small-business owners in making healthcare choices for themselves, their employees and their families. The Patient Protection and Affordable Care Act (ACA) does neither of those things. Three years later, the law is not living up to its moniker (Dan Danner, Bruce Josten and Mattew Shay, 3/21). 

The Washington Post: The 50 Percent Solution
The proposition that entitlement curbs are the key to maintaining national solvency is widely accepted, though not by many congressional Democrats. President Obama, however, has endorsed it on various occasions. And he could make it happen. If he wants. I remain skeptical that he does. But national solvency is important enough to test this proposition at least once more (Charles Krauthammer, 3/21).

Kansas City Star: Medicaid Expansion Is Still A Big Pill For Missouri GOP
Missouri's Republican legislative leaders used their last few hours before spring break to make it known they are not on board with raising the state's miserly income qualifications for Medicaid. "We do not believe it's prudent to double down on a broken system," said Tom Dempsey, the Republican Senate president pro tem. Medicaid actually works very efficiently for a lot of people, but that's their story and they're sticking with it. This doesn't necessarily mean Republicans won't ultimately expand Medicaid eligibility. Virtually every business group in the state wants them to do so, and Democrats are already sharpening their knives for the campaign season two years hence (Barbara Shelly, 3/21).

The New York Times Opinionator: Burgers, Fries And Lies
So, Mike Ruffer (a Five Guys franchise owner) was brought in as the star witness at a Heritage forum designed to show just how egregious it is that businesses will have to provide health care for their employees, or pay a fine. Right wing media -; Drudge, Breitbart, Fox -; played their part, sounding alarms over a cheeseburger that may cost an additional quarter. But what the Heritage histrionics unintentionally showed was everything that is absurd, wrong and darkly humorous about the American approach to diet and health care economics (Timothy Egan, 3/21).

The New York Times: North Carolina Overreaches
Under the federal Medicaid statute, states must seek reimbursement for medical expenses if the beneficiary also receives money from an insurance company or another third party. This week, the Supreme Court correctly slapped down a North Carolina law that could squeeze far more from beneficiaries than they actually owe (3/21).

Minneapolis Star Tribune: North Dakota Governor Should Veto Abortion Limits
After losing badly at the polls in Mississippi and Colorado, proponents of life-begins-at-conception measures kept shopping for new states that might not only pass a sweeping abortion ban but also conscript taxpayer dollars to fund proponents' grander ambition -; a legal challenge to Roe vs. Wade. Unfortunately, they found an easy mark with money in oil-rich and socially conservative North Dakota (3/21).

Baltimore Sun: Sickening Cuts To NIH
Albert Einstein was 26 when he published his Special Theory of Relativity; James Watson, at age 25, explained the structure of DNA. Here in Baltimore, many great medical achievements were developed by early-career researchers at Johns Hopkins. "The young do not know enough to be prudent," said Pearl Buck. "They attempt the impossible, and achieve it, generation after generation." Today's young American scientists are no less inspired but are discouraged by a perceived lack of opportunity after long, grueling years of training. Unfortunately, the federal budget sequester is turning that perception to reality. We appreciate the nation's long-term fiscal challenges and recognize that overall spending must be cut. Precisely because of these pressures, not in spite of them, we should reallocate priorities to invest in America's future (Michael Milken and Elias Zerhouni, 3/21).

WBUR: CommonHealth: The Big Lesson From Brill's 'Bitter Pill' Story, So Big It's Hard To See
I stopped in to get my car fixed yesterday and found the recent Time issue featuring Steve Brill's mega-story -; Bitter Pill: Why Medical Bills Are Killing Us -; still lingering on the waiting-room table, well-thumbed and dog-eared. For a story about a problem that just about everyone already knew existed, the piece has clearly been having a major impact and sparked widespread discussion. Today, the Cambridge-based Institute for Healthcare Improvement posts a lively and provocative piece that concludes that the current payment system is broken and must be blown up (Carey Goldberg, 3/22).

Journal of the American Medical Association: Pushing the Outpatient Quality Envelope
The rapidly changing payment and delivery system may introduce the risk of many unintended consequences if quality measurement is too myopic. Fortunately, the present era is characterized by more knowledge about quality and more tools to measure quality. Nevertheless, pushing quality measurement for the outpatient setting needs to be a priority for the medical community, and more work must be done to develop, test, and use new measures (Dr. Tara F. Bishop, 3/21).