Viewpoints: Fund CHIP; media overdrive on Ebola; slowdown in Medicare costs

Los Angeles Times: Children's Health Insurance Program Deserves Funding
In what may be a hopelessly quixotic effort, supporters of the federal Children's Health Insurance Program are trying to persuade Congress to renew its funding almost a year in advance -; and in a lame-duck session. Nevertheless, lawmakers ought to heed that call. The program plugs a troubling gap between Medicaid and the Affordable Care Act's subsidized plans, and states need to know whether they can count on federal funding or whether they will have to spend far more dollars of their own (10/21). 

The New York Times: The Democratic Panic
But one of the reasons for [President Obama's] unpopularity is that nervous members of his own party have done a poor job of defending his policies over the nearly six years of his presidency, allowing a Republican narrative of failure to take hold. … Similarly, the Affordable Care Act, one of the most far-reaching and beneficial laws to have been passed by Congress in years, gets little respect even among the Democratic candidates who voted for it. Though none support the Republican position of repeal, most talk about the need to "fix" the health law, as if it were a wreck alongside the road rather than a vehicle providing millions of people with health coverage (10/21).

Bloomberg: Republicans Who Secretly Love Obamacare
Here's a conundrum for Republicans this year: The Affordable Care Act remains unpopular, especially with the Republican base, but as the law has taken effect a number of provisions are embraced by voters. Republican candidates across the country, facing this contradiction, have a solution: repeal Obamacare, but keep the popular parts. Never mind this isn't possible; if you get rid of the whole the parts go, too, and few political opponents have proposed an alternative (Albert R. Hunt, 10/21). 

The Washington Post's Right Turn: GOP 2016 Contenders: Repeal Obamacare, Reform Medicaid
[Ohio Gov. John] Kasich, however, is correct that one can be for repealing Obamacare and still support states' expansion of Medicaid. But other governors should be forewarned: You better be crystal clear about what you want to do (Jennifer Rubin, 10/21).

USA Today: In Ebola Outbreak, Worry About The Right Things
If you spend enough of your day watching certain cable news outlets without an appropriate degree of skepticism, you easily could become convinced that an Ebola epidemic is imminent, that we are all at tremendous risk of infection. This is extremely unlikely to be true, but while we should not be panicking about the threat of Ebola, we should be panicking about the apparent inability of our institutions to respond appropriately to a genuine public health problem (Duncan Black, 10/21).

Politico: The Hottest Zone: How The Media Stoked The U.S. Ebola Panic.
The irony, at least for Americans, is that only two people have become infected on U.S. soil, and only one of all those treated here has died, while the list of Americans affected by other (more mundane) major health threats is much longer. The press, however, has turned Ebola coverage into a self-perpetuating frenzy. The media keeps making waves and then surfs them in every direction. No question there's an overwrought panic over Ebola in the United States, and no question the media has played a major role in generating that panic (Tara Haelle, 10/21).

Politico: Are Hospitals More Deadly Than Ebola?
We've all been horrified by the medical blunders made in dealing with Ebola in the United States-;from sending home a patient who was showing symptoms and had recently travelled to West Africa to relying on inadequate protocols or protection that led to the infection of two of his nurses. It's awful, but we shouldn't be surprised. These types of hospital mistakes-;caused by knowledge gaps, carelessness, unpreparedness or a combination of all-;by my estimate kill between 210,000 and 440,000 people in the United States every year (John T. James, 10/21).

Bloomberg: Let People Shop For Health Care
If people knew the prices of medical treatments, and if they paid partly from their own pockets, they might shop around and save money. This stands to reason, and a new study in the Journal of the American Medical Association shows it's true. This comes as very encouraging news for the wider effort to keep going the profound deceleration in health costs we've seen over the past several years (Peter R. Orszag, 10/21).

Health Affairs: The $500 Billion Medicare Slowdown: A Story About Part D
A great deal of analysis has been published on the causes of the health care spending slowdown system-wide -; including in the pages of Health Affairs. Much attention in particular has focused on the remarkable slowdown in Medicare spending over the past few years, and rightfully so: Spending per beneficiary actually shrank (!) by one percent this year (or grew only one percent if one removes the effects of temporary policy changes). Yet the disproportionate role played by prescription drug spending (or Part D) has seemingly escaped notice. Despite constituting barely more than 10 percent of Medicare spending, our analysis shows that Part D has accounted for over 60 percent of the slowdown in Medicare benefits since 2011 (beyond the sequestration contained in the 2011 Budget Control Act). (Loren Adler and Adam Rosenberg, 10/21).

JAMA Internal Medicine: Lowering Medical Costs Through The Sharing Of Savings By Physicians And Patients
Current approaches to controlling health care costs have strengths and weaknesses. We propose an alternative, "inclusive shared savings," that aims to lower medical costs through savings that are shared by physicians and patients. Inclusive shared savings may be particularly attractive in situations in which treatments, such as those for gastric cancer, are similar in clinical effectiveness and have modest differences in convenience but substantially differ in cost. Inclusive shared savings incorporates features of typical insurance coverage, shared savings, and value-based insurance design (Harald Schmidt and Ezekiel J. Emanuel, 10/20).