Viewpoints: Republican patient takes GOP health message to task; the deadlines the administration has missed

Forbes: Unpublished CRS Memo: Obama Administration Has Missed Half Of Obamacare's Legally Imposed Implementation Deadlines
In recent months, President Obama and his subordinates have waived or delayed a number of Obamacare's notable features, such as the law's employer mandate, and its procedures for protecting taxpayers from fraud and identity theft. Earlier this month, in that context, I obtained a heretofore-unpublished memorandum from the Congressional Research Service. The CRS, Congress' non-partisan in-house think tank, compiled 82 deadlines that the Affordable Care Act mandates upon the first three years of its own implementation. Remarkably, it turns out that the White House has missed half of the deadlines legally required by the ACA (Avik Roy, 8/18).

The Fiscal Times: How Functional Illiteracy Could Doom Obamacare
The troubles for Obamacare continue to mount. The White House has delayed the employer mandate. Those implementing the program said some computer exchanges are not expected to be ready in time. ... The underlying and perhaps most pressing concern is also the most difficult to solve: Much of the nation is simply health care illiterate and unable to understand the complex health choices the Obama administration is expected to offer starting Oct. 1 (David Francis, 8/19).

The Wall Street Journal's Political Diary: The ObamaCare Slush Fund
Last week, the Obama administration revealed that three Planned Parenthood affiliates would be among the groups receiving federal dollars to educate Americans about the Affordable Care Act. The announcement did not go unnoticed by conservative Republicans who want to defund ObamaCare. ... The latest Navigator funds are certain to intensify such investigations into the cozy relationship between groups that lobby for ObamaCare, such as Planned Parenthood, and groups that then get funds for carrying out the law (Stephen Moore, 8/19). 

The New Republic: A Republican Cancer Survivor Sends His Party A Message On Obamacare
Lots of people have been telling Republican Party leaders that simply opposing Obamacare isn't enough-;that they need to develop an alternative. But few can offer such advice with the authority, or the insight, of Clint Murphy. One reason is that Murphy, 38, used to work in Republican politics. The other reason is that Murphy is a cancer survivor-;and that, because of pre-existing conditions, he has apparently struggled finding health insurance. "When you say you're against it," Murphy wrote on his Facebook page, in an open letter to Republicans, "you're saying that you don't want people like me to have health insurance." Murphy, who lives in Georgia, told the full version of his story to Jim Galloway, a columnist of the Atlanta Journal-Constitution (Jonathan Cohn, 8/19).

The (Milwaukee) Journal Sentinel: Obamacare: A Prescription For Fraud
Ever wonder why government programs are so rife with waste, fraud and abuse? Consider what's been happening with the Affordable Care Act. The administration recently announced that it was reducing by 50% -; from 30 hours down to 20 -; the required training for the law's navigators, individuals paid to help Americans enroll in the health care act's new entitlements (Chris Jacobs, 8/19).

The Washington Post: Progress On Obesity, But The War Is Far From Over
The Centers for Disease Control and Prevention (CDC) reported this month that the obesity rate dropped among younger, poor children in 19 states and territories between 2008 and 2011. ... Only three states saw increases. (Not enough data were collected in 10 states.) No place saw its rate decline by more than a percentage point, but the results are still striking. Public-health advocates have worried for years that the United States was entering an age of obesity, the American waistline inexorably expanding and along with it the prevalence of diabetes, heart conditions, joint trouble, even cancer. Now it seems the country may be reaching a plateau, even among at-risk children (8/19).

Bloomberg: The Huge But Essential Cost Of Lung Scans
The lung-cancer screening that the U.S. Preventive Services Task Force is now recommending could add at least $3 billion annually in new costs to the already burdened U.S. health-care system. That should worry the Barack Obama administration and anyone else concerned with the system's stability. On the other hand, the new recommendation, still in draft form, could save 20,000 lives a year. And policy makers could recoup some of the cost by limiting liability for doctors who follow the guidelines in good faith (Ford Vox, 8/19).

The New York Times: College Prep, This Time For Health
To me, the strangest thing about my son's college health forms was that they did not require my signature. From a medical point of view, an 18-year-old is a legal adult. Yes, parents may offer up pithy remarks about who is actually an adult, and in what sense, and who pays the bills. But when children head off to college, responsibility for their health unmistakably shifts. They must take care of themselves, in every sense, and now is the time to talk about how (Dr. Perri Klass, 8/19). 

JAMA Pediatrics: Adolescent Health Care Transition in Transition
The adolescent transition to adult care is embedded in a larger life course transition to the independence and responsibilities of adulthood, the period fraught with risk and challenge. ... Perhaps most distressing of all is emerging research suggesting that the health status of young adults with a variety of chronic conditions may deteriorate soon after they graduate from pediatric care. In some instances, use of emergency departments, hospitalizations, and even mortality increase (Dr. W. Carl Cooley, 8/19).

JAMA Internal Medicine: The Future of Medicare Supplemental Insurance 
Most Medicare beneficiaries 65 years or older have insurance that supplements Medicare or that replaces it entirely, generally with a more comprehensive set of benefits than those provided under the traditional Medicare program. Approximately 20% purchase Medigap coverage. Others get additional protection from retiree health benefits, Medicaid, or managed care plans called Medicare Advantage. ... the current Medicare benefit package, with its gaps in coverage and the array of deductibles and coinsurance provisions, is less than what most seniors want. This peculiar structure reflects the same problems that plague many aspects of traditional Medicare. Medicare is an insurance program that is modeled after the way insurance was provided in the mid-1960s (Gail Wilensky, 8/19).

JAMA Internal Medicine: Completing the Play Or Dropping The Ball? The Case For Comprehensive Patient-Centered Discharge Planning
In summary, having a team and setting dedicated to the discharge process has the potential to improve overall hospital quality, efficiency, and patient throughput, as well as transitions in care. If acute care physicians are confident that the patient will get needed medication, education, and follow-up care, the discharge center might even alleviate the need for hospitalization and/or allow for earlier discharge for some patients. The concept builds on evidence-based programs designed for older adults (Dr. Karin Verlaine Rhodes, 8/19).

JAMA Internal Medicine: Secondary Use Of Health Information: Are We Asking The Right Question?
Rather than "Why risk alarming our patients by using their health care data for research?" perhaps we should be asking, "Why is our first obligation not to ensure that our patients' data are used for research as they wish and expect them to be used?" Every institution must enforce strict data security and protection of patient confidentiality and patient directives, but these requirements should be no more unexpected than meticulous hand washing before examining each patient (Dr. Isaac S. Kohane, 8/19).