Viewpoints: 'Small-bore' budget deal better than shutdown; Calif. battle on medical malpractice; Obama should turn to health quality

USA Today: Minimalist Budget Deal Beats Another Shutdown: Our View
The bipartisan spending deal announced Tuesday night by Senate Budget Chairman Patty Murray, D-Wash., and House Budget Chairman Paul Ryan, R-Wis., barely qualifies as a tweak. It would not make meaningful progress on reducing projected deficits, ... BY any measure it is a small-bore deal, but it as at least  something -; a toehold that prevents a serious fall and might, optimistically, enable a climb to safety. ... It would also partially undo the inflexible across-the-board spending cuts known as sequestration. Longer term, the accord could signal the beginning of a more constructive relationship in Congress (12/10).

USA Today: Budget Deal A Step Backward: Opposing View
While imperfect, the sequester has proved to be an effective tool in reducing base discretionary spending. Nonetheless, conservatives have expressed a willingness to alter the budget caps established by the 2011 debt ceiling deal in exchange for immediate and substantive structural reforms that significantly reduce spending and address the real drivers of our debt. Unfortunately, the budget agreement struck by Rep. Paul Ryan and Sen. Patty Murray is a step backward (Michael A. Needham, 12/10). 

The Wall Street Journal: A Least Bad Budget Deal
All of this doesn't begin to match the magnitude of America's fiscal challenges, but it is probably the best that the GOP could get considering Washington's current array of political forces. ... The question for Republicans is what happens if this fails? It means more turmoil, more evidence that the GOP can't govern, and the risk of another shutdown. By contrast this deal pushes the budget debate past next November and lets Republicans focus on ObamaCare and its many ills. ... The deal means overall federal spending will not decline in 2014 as it has the last two years (12/10). 

Bloomberg: Now Obama Can Target Health-Care Quality
Indeed, over the past few years, the Congressional Budget Office has lowered by more than $1 trillion its projected estimates of Medicare and Medicaid spending over the next decade. But we are only at the beginning of what is possible. Now, President Obama should step forward with bold national goals. One would be a dollar-and-date target for total health-care savings, based on the above projections for improvements in the quality and coordination of care. Or, to make the goal easily measurable, the president could declare that, starting in 2020, health-care spending per person should rise no faster than general inflation (Dr. Ezekiel Emanuel, Sen. Sheldon Whitehouse, D-R.I., and Peter Orszag, 12/10). 

Los Angeles Times: The Battle Between Doctors And Trial Lawyers Grows More Infantile
California initiative campaigns have a way of reducing all important public policy issues to their lowest intellectual denominators -- and highest financial numerators. The coming battle over the state's medical malpractice limits looks certain to set records in both categories. We've written before about the necessity of modernizing MICRA, the Medical Injury Compensation Reform Act of 1975. Even its drafter acknowledges that it was botched at birth; because its limit of $250,000 on pain-and-suffering recoveries isn't indexed to inflation, it serves merely to shut the courthouse door to the victims of medical malpractice (Michael Hiltzik, 12/10). 

The New York Times' Economix: Conflicting Pressures On Demand For Doctors
But the new law limits payments to physicians and other medical providers. If patients are lucky, the demand for doctors will be low enough that the limits will not matter. But if the new law results in a significant net increase in physician demand, the payment limits will help remind us of Soviet-era limits on the price of bread, with queues and black markets to follow  (Casey B. Mulligan, 12/11). 

The Washington Post's Right Turn: The Deck Is Stacked Against Obamacare
Democrats and their media allies are giving us a bad case of whiplash. Obamacare will work! Obamacare won't matter! Obamacare is going to give millions of people affordable health-care coverage! Of course it's more expensive -; look what you are getting! Yes, these are contradictory spiels, an inevitable consequence of a White House is disarray, if not on the verge of panic. Depending on the spin of the moment ( is fixed! It doesn't matter if it's fixed!), the left-leaning blogosphere twists this way and that, trying to follow the White House's logic (Jennifer Rubin, 12/10). 

The Washington Post's The Plum Line: Another Potential Boost For Obamacare
Opponents of the Affordable Care Act tend to suggest expanded coverage resulting from the law's Medicaid expansion somehow doesn't really count as success. But the law's goal is to expand coverage, and the Medicaid expansion is one of the tools it utilizes to accomplish that. And here's another way the Medicaid expansion could succeed -; continuing to grow the built-in constituencies that will benefit from the Affordable Care Act (Greg Sargent, 12/10).

The Fiscal Times: HealthCare.Gov: Better, But Not Ready For Prime Time
While the White House has insisted that most of the problems with the site are fixed, there are still plenty of bugs that prevent it from doing its intended mission: Linking Americans with affordable private insurance policies. The latest chapter in my two-month-long quest involved trying to bypass the buggy system. Although I was finally able to log on recently after a short respite in the "waiting room," I got bounced to an error page that stated my "identity wasn't verified" (John F. Wasik, 12/11).

Fox News: Dr. Manny: Specialty Doctors Will Be Hard To Find Under ObamaCare
Patients covered by Medicaid often have no choice but to hope their problems are being addressed at these clinics in an adequate manner. So imagine what's going to happen once ObamaCare expands Medicaid enrollment, or better yet, when some basic health plans pick up more patients who are looking for more affordable insurance premiums.  Are you going to be able to easily find a dermatologist, ophthalmologist or orthopedic surgeon – especially during a limited timeframe in which your problems need addressing? I don't think so (Dr. Manny Alvarez, 12/10). 

Georgia Health News: A Win-Win Plan: Protecting Providers, Reducing Costs
In 2010, Congress adopted President Obama's Affordable Care Act (ACA) with the goal of providing access to high-quality, affordable health care. One of the many flaws in the ACA is that it fails to address our broken medical malpractice system. By placing physicians and hospitals at financial and professional risk when an error occurs, our medical tort system increases the cost of health care, because it encourages the practice of defensive medicine. The system also decreases access to compensation for those with minor medical injuries, and interferes with quality improvement measures (Henry N. Goodwin Jr., 12/10).

http://www.kaiserhealthnews.orgThis article was reprinted from with permission from the Henry J. Kaiser Family Foundation. Kaiser Health News, an editorially independent news service, is a program of the Kaiser Family Foundation, a nonpartisan health care policy research organization unaffiliated with Kaiser Permanente.



The opinions expressed here are the views of the writer and do not necessarily reflect the views and opinions of News Medical.
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