First Edition: April 15, 2013

Today's headlines include reports about the Medicare provisions in the budget plan released last week by President Barack Obama as well as previews of the Supreme Court's consideration of arguments regarding whether human genes can be patented.  

Kaiser Health News: Doctor-Owned Hospitals Prosper Under Health Law
Kaiser Health News staff writer Jordan Rau reports: "Doctor-owned hospitals are earning many of the largest bonuses from the federal health law's new quality programs, even as the law halts their growth" (Rau, 4/12). Read the story.

Kaiser Health News: Capsules: Programs Help Independent Artists Access Health Care
Now on Kaiser Health News' blog, Ankita Rao reports: "Freelance artists are part of the estimated 15 million people who are currently self-employed, according to a U.S. Department of Labor 2012 estimate. … Programs like Springboard and the Freelancers' Union co-ops help a community that Hunt said is often underinsured because many artists have low incomes -; between $12,500 and about $25,000 -; especially when they are not yet established" (Rao, 4/15). Check out what else is on the blog.

Kaiser Health News also tracked weekend health policy headlines, including reports about Health and Human Services Secretary Kathleen Sebelius' Friday appearance before a congressional committee (4/12) and the latest on how Virginia's abortion restrictions fit into a national trend (4/13).

The Associated Press: Upper-Income Seniors' Medicare Hike
President Barack Obama's plan to raise Medicare premiums for upper-income seniors would create five new income brackets to squeeze more revenue for the government from the top tiers of retirees, the administration revealed Friday. First details of the plan emerged after Health and Human Services Secretary Kathleen Sebelius testified to Congress on the president's budget .... Currently, single beneficiaries making more than $85,000 a year and couples earning more than $170,000 pay higher premiums. Obama's plan would raise the premiums themselves and also freeze adjustments for inflation until 1 in 4 Medicare recipients were paying the higher charges. Right now, the higher monthly charges hit only about 1 in 20 Medicare recipients (Alonso-Zaldivar, 4/12).

The Associated Press: Medicare Hike Could Also Hit Some In Middle Class
Retired as a city worker, Sheila Pugach lives in a modest home on a quiet street in Albuquerque, N.M., and drives an 18-year-old Subaru. Pugach doesn't see herself as upper-income by any stretch, but President Barack Obama's budget would raise her Medicare premiums and those of other comfortably retired seniors, adding to a surcharge that already costs some 2 million beneficiaries hundreds of dollars a year each. ... Obama's budget would change Medicare's upper-income premiums in several ways ... the plan would create five new income brackets to squeeze more revenue from the top tiers of retirees (Alonso-Zaldivar, 4/12).

USA Today: Health Care Providers Want Faster Changes In Payments
Health care providers are pushing the federal government to scrap the payment plan for medical services, preferring instead one payment for a patient's entire care instead of separate fees for each item. Instead of fee-for-service medicine, in which a provider receives a payment for every test, procedure and visit, providers want the government -; or states or private payers -; to pay for treatment as a whole. In theory, physicians would provide treatments that have been proven to work but are also cost-effective (Kennedy, 4/14).

The New York Times: Obama Sees Insurers; Health Law Is Subject
President Obama met with insurance industry executives at the White House on Friday to coordinate the introduction this fall of the insurance marketplaces at the heart of the national health care law, and to discuss so-called rate shock if the industry sharply raises premiums. "We're all in this together," Mr. Obama told the executives, … Among attendees from the industry, which stands to get millions more customers, were Karen M. Ignagni, the head of a trade association for the insurance industry; Chet Burrell of CareFirst BlueCross BlueShield; David M. Cordani of the Cigna Corporation; Scott P. Serota of the BlueCross BlueShield Association, a federation of local Blue Cross and Blue Shield companies; and Joseph R. Swedish of WellPoint (Calmes, 4/12).

The Wall Street Journal: Q&A: Small Business Health Exchanges
The Obama administration recently revealed plans to delay part of a program designed to make health insurance more affordable for small employers. If you're a small-business owner, what does this mean for you? For starters, the initiative is called Small Business Health Options Program, or SHOP. It's an insurance marketplace, or "exchange," for businesses with 100 or fewer full-time-equivalent employees. Each state will have one starting next year. Some states will run their own exchanges, while others will be run in part or entirely by the federal government (Needleman, 4/12).

The Wall Street Journal: As America Ages, Shortage Of Help Hits Nursing Homes
A labor shortage is worsening in one of the nation's fastest-growing occupations-;taking care of the elderly and disabled-;just as baby boomers head into old age. Nursing homes and operators of agencies providing home-care services already are straining to find enough so-called direct-care workers, who help the elderly or disabled with such things as eating and bathing. They also face looming retirements in the current workforce, in which one-fifth of workers are 55 years old or older (Hagerty, 4/14).

The New York Times: Debating The Effectiveness Of Remotely Monitoring Intensive Care Patients
More than a decade ago, this kind of tele-ICU command center was trumpeted by its creators as the new standard in critical care, a way to save lives and money by stretching the skills of an inadequate pool of intensivists to help oversee more of the country's sickest patients. Today, with the growth of such systems stalled at about 10 percent of ICU patients nationwide, and wildly contradictory studies about the results, no one can say with authority if, or under what circumstances, tele-ICUs deliver on their promises (Bernstein, 4/14).

Politico: Critics Question White House Mental Health Fix
The Obama Administration is trying to revamp how the government approaches mental health issues in the security clearance process -; but security and mental health experts say the proposed fix may open the door to new problems. Last month, the administration officially proposed rewording the standard mental-health question asked of all those applying for or renewing a clearance to handle classified information (Gerstein, 4/15).

NPR: Supreme Court Asks: Can Human Genes Be Patented?
Same-sex marriage got huge headlines at the Supreme Court last month, but in the world of science and medicine, the case being argued on Monday is far more important. The lawsuit deals with a truly 21st century issue -; whether human genes may be patented. Myriad Genetics, a Utah biotechnology company, discovered and isolated two genes -; BRCA 1 and BRCA 2 -; that are highly associated with hereditary breast and ovarian cancer. Myriad patented its discovery, giving it a 20-year monopoly over use of the genes for research, diagnostics and treatment. A group of researchers, medical groups and patients sued, challenging the patent as invalid (Totenberg, 4/15).

The New York Times: Justices Consider Whether Patents On Genes Are Valid
The Supreme Court is poised to take up the highly charged question of whether human genes can be patented. But another question could trump it: Has the field of genetics moved so far so fast that whatever the court decides, it has come too late to the issue? (Pollack, 4/14).

The Associated Press/Washington Post: Supreme Court To Hear Arguments Over Whether Human Genes Can Be Patented
DNA may be the building block of life, but can something taken from it also be the building block of a multimillion-dollar medical monopoly? The Supreme Court grapples Monday with the question of whether human genes can be patented. Its ultimate answer could reshape U.S. medical research, the fight against diseases like breast and ovarian cancer and the multi-billion dollar medical and biotechnology business (4/15).

The Wall Street Journal: Generic OxyContin Pains The FDA
The first patent on OxyContin expires Tuesday, a milestone in the history of one of the most powerful and abused painkillers on the market. But it could be quite some time before generic versions of the drug are available (Martin, 4/14).

Politico: Virginia Adopts Stricter Rules For Abortion Clinics
The Virginia Board of Health gave final approval to a sweeping set of regulations for abortion clinics Friday. Abortion-rights supporters say the regulations -; which would require many clinics in the state to undergo costly renovations to stay in business -; have one goal: to put abortion clinics out of existence (Smith, 4/15).

The New York Times: Experiment in Oregon Gives Medicaid Very Local Roots
Under an agreement signed with the Obama administration last year, and just now taking shape, Oregon and the federal government have wagered $1.9 billion that -; through a hyper-local focus on Medicaid -; the state can show both improved health outcomes for low-income Medicaid populations and a lower rate of spending growth than the rest of the nation. If Oregon fails on either front, the consequences are grave, potentially tens of millions of dollars in penalties a year (Johnson, 4/12).