Viewpoints: Young people could spark needed entitlement changes; Priebus demands that Sebelius go; GOP's 'absurd debate' on Hill health coverage

The New York Times: Sorry, Kids. We Ate It All.
Eventually this shutdown crisis will end. And eventually the two parties will make another stab at a deal on taxes, investments and entitlements. But there's one outcome from such negotiations that I can absolutely guarantee: Seniors, Wall Street and unions will all have their say and their interests protected. So the most likely result will be more tinkering around the edges, as our politicians run for the hills the minute someone accuses them of "fixing the deficit on the backs of the elderly" or creating "death panels" to sensibly allocate end-of-life health care. Could this time be different? Short of an economic meltdown, there is only one thing that might produce meaningful change: a mass movement for tax, spending and entitlement reform led by the cohort that is the least organized but will be the most affected if we don't think long term -; today's young people (Thomas L. Friedman, 10/15). 

Los Angeles Times: Chipping Away At Obamacare: The Endgame In DC
The 2010 Patient Protection and Affordable Care Act, a.k.a. Obamacare, remains an issue in the endgame over ending the latest fiscal crisis in Washington -- just not a major one. But of course, the House and Senate disagree on what tweaks to make to the law that tea party-affiliated Republicans were so eager to defund (Jon Healey, 10/15). 

The Fiscal Times: Obamacare Taught Millennials To Distrust Big Government
With government programs spreading like an algae bloom and threatening our solvency, some pushback from the next generation could head off fiscal Armageddon. Today's young people just need a little more convincing that the feds don't have all the answers. That's where the Obamacare roll-out may be helpful. It is horrific, and for the most mundane reason imaginable – bad software. For a millennial, that's like a Tesla being disabled by faulty tires. Software and coding are the bread and butter products of today.  Nothing could have cast a greater pall over President Obama's signature healthcare initiative than screwing up the programming. Why would those all-important young people have confidence in a program of marginal appeal when the administration flubs the basics? (Liz Peek, 10/16).

The Fiscal Times: My Obamacare Odyssey: New Week, Same (Rotten) Result
I've tried to remain patient and work through the myriad system crashes and cul-de-sacs. The government has admitted that it didn't have enough capacity to deal with tens of millions of people searching for policies. In a way, that's good for the future of the ACA, since it shows robust demand. But not being able to get into the HealthCare.gov system is both frustrating and politically volatile. The ACA will live or die based on whether Americans can eventually obtain affordable coverage that serves their needs (John F. Wasik, 10/16).

Politico: Opinion: It's Time To Fire Secretary Sebelius
The Obama administration continues making excuses for Health and Human Services Secretary Kathleen Sebelius and the people who spent hundreds of millions of taxpayer dollars on a site that does not work. How much more money will her department waste -; and how much time will Americans waste on the website -; before the administration admits they have a problem? In a business, someone would be held accountable for such a large-scale disaster. When pressed on her failures, Sebelius repeats her favorite line: "We had some early glitches." A glitch, says Merriam-Webster, is "temporary" and "minor." For two weeks, the Obamacare website has hardly functioned. That's not minor or temporary. That's not a glitch; that's a systemic failure (Reince Priebus, 10/15).

Bloomberg: Congress's Absurd Debate Over Its Obamacare 'Exemption'
Obamacare created state health-insurance exchanges expressly for people who don't get coverage through their employers. At the insistence of Republican Senator Charles Grassley, it made one exception when the law was written: Members of Congress and their staffs would also have to use the exchanges. (The idea seems to have been to embarrass Democrats by forcing them to object to the idea. Instead, they embraced it.) That created a wrinkle: The law did not say whether the government, which pays the premiums for congressional staff, could keep paying them for exchange-based coverage. So when the Office of Personnel Management, which handles employee benefits for Congress, ruled that the government could continue paying the premiums for members and staff, it wasn't creating an exemption; it was trying to make sense of one that Republicans had already made. Yet for Republicans, the idea that Congress would get special treatment, whatever the reason, was grounds for a new attack on Obamacare (10/15).

Cleveland Plain Dealer: In His Quest For Ohio Medicaid Expansion, Kasich Borrows An End-Run From Obama's Playbook
Obamacare is a nationwide program designed to increase government dependency to roughly 100 percent of the population. It's going to make health insurance more expensive everywhere. It's going to degrade medical care everywhere. It's going to be -; already is -; a bureaucratic nightmare everywhere. Sick people, young people and taxpaying people are going to get it in the neck. Everywhere. There's nothing hard about the math: The more recipients and bureaucrats added to a giveaway program, the more that program is going to cost. A bigger Medicaid is inescapably a more expensive Medicaid. Whether the state or the feds are collecting for it, the result for taxpayers everywhere is the same. And it's not a good result (Kevin O'Brien, 10/15).

On other topics --

The New York Times: Should You Eat Chicken?
In recent weeks, salmonella on chicken has officially sickened more than 300 people (the Centers for Disease Control says there are 25 illnesses for every one reported, so maybe 7,500) and hospitalized more than 40 percent of them, in part because antibiotics aren't working. Industry's reaction has been predictably disappointing: the chicken from the processors in question -; Foster Farms -; is still being shipped into the market. Regulators' responses have been limited: the same chicken in question is still being sold. Until the Food Safety and Inspection Service (F.S.I.S.) of the Department of Agriculture (U.S.D.A.) can get its act together and start assuring us (Mark Bittman. 10/15).

Journal of the American Medical Association: Should Health Care Systems Become Insurers?
Incentives under the Affordable Care Act (ACA) are spurring increasing numbers of health care systems to assume the risk of paying for patient care, blurring the boundaries between care delivery organizations and insurers. New arrangements such as bundled payments, value-based purchasing, and accountable care organizations (ACOs) transfer financial risk from payers to health care systems. The union of payer and care delivery functions may engender opportunities for health systems to invest in prevention and more comprehensive, coordinated, patient-centered care (Dr. Nirav R. Shah and Dr. Dave A. Chokshi, 10/16).