Not Your Typical Presidential Debate Forum For Obama, Romney


Official photographic portrait of US President...

Official photographic portrait of US President Barack Obama (born 4 August 1961; assumed office 20 January 2009) (Photo credit: Wikipedia)

By Peggy Girshman

September 27th, 2012, 11:01 AM

There’s nothing unusual about the way The New England Journal of Medicine displays the “Perspective” section this week: In dueling columns, under an original article on a “novel androgen-receptor blocker” for prostate cancer. But the authors of two of the perspectives are far from typical: B. Obama and M. Romney.

The introduction to both is basic:

The editors asked the Democratic and Republican presidential nominees, President Barack Obama and former Massachusetts Governor Mitt Romney, to describe their health care platforms and their visions for the future of American health care. Their statements follow.

And though the audience is far different from those at typical campaign stops, both candidates brought out familiar points.

Mitt Romney promises to repeal the health law and to replace it:

In the health care system that I envision, costs will be brought under control not because a board of bureaucrats decrees it but because everyone — providers, insurers, and patients — has incentives to do it. Families will have the option of keeping their employer-sponsored coverage, but they will also be empowered to enjoy the greater choice, portability, and security of purchasing their own insurance plans. As a result, they will be price-sensitive, quality-conscious, and able to seek out the features they want. Insurers will have to compete for their business. And providers will find themselves operating in a context where cost and price finally matter. Competition among providers and choice among consumers has always been the formula for better quality at lower cost, and it can succeed in health care as well.

Romney says he would make no changes to Medicare for today’s beneficiaries or those enrolled for the next 10 years and he advocates for Medicaid block grants to the states.

Obama promotes the features of the health law that have already proved popular, such as beginning to close the Medicare prescription drug doughnut hole and coverage for young adults on their parents’ insurance plans. And he promises:

If I am elected for a second term, I will follow through on all the work we have started together to implement the Affordable Care Act. I have also been clear that additional steps are needed. We need a permanent fix to Medicare’s flawed payment formula that threatens physicians’ reimbursement, rather than the temporary measures that Congress continues to send to my desk. I support medical malpractice reform to prevent needless lawsuits without placing arbitrary caps that do nothing to lower the cost of care.  I also know we must continue to support life-sciences research and ensure that our regulatory system helps bring new treatments and tools to pharmacies, doctors’ offices, and hospitals across the country

Obama and Romney both provided the standard NEJM disclosure form, a typical way scientific journals ensure that readers know about any funding source or conflicts of interest.

This entry was posted on Thursday, September 27th, 2012 at 11:01 am.

Congressman Poe and Governor Mitt Romney

Congressman Poe and Governor Mitt Romney (Photo credit: Wikipedia)

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Obama, Romney Spar Over Medicare, Health Reform Policies


Official photographic portrait of US President...

Official photographic portrait of US President Barack Obama (born 4 August 1961; assumed office 20 January 2009) (Photo credit: Wikipedia)

Topics: Health Costs, Insurance, Medicare, Medicaid, Health Reform, States, Politics

Sep 28, 2012

News outlets offer a variety of coverage on these issues – including how Medicare is playing in the polls and what motivates senior voters. And a new Families USA study offers a critical assessment of Mitt Romney‘s health policies.

The Washington Post: Medicare Working To Boost Obama In Swing States, Poll Finds
Voters in three critical swing states broadly oppose the far-reaching changes to Medicare -associated with the Republican presidential ticket and, by big margins, prefer President Obama to handle the issue, according to new state polls by The Washington Post and the Kaiser Family Foundation. For seniors in Florida, Ohio and Virginia, Medicare rivals the economy as a top voting issue (Aizenman, Cohen and Craighill, 9/27).

The Associated Press/ABC News: Older Voters Look Beyond Medicare, Social Security
Who wins the trust of seniors … will be a deciding factor in the presidential election. That should be good news for Mitt Romney, because those 65 and older have backed the Republican candidate in both of the last two presidential elections. But President Barack Obama has been pounding Romney and his running mate, Rep. Paul Ryan, on their plan for Medicare. Those attacks are starting to bear fruit for Obama, who is gaining ground among seniors in two key battlegrounds: Florida and Ohio. Still, Romney has the edge nationally among seniors — in no small part thanks to seniors’ concerns about Obama’s handling of the economy (Lederman, 9/27).

The New York Times: Obama Fills In Blanks Of Romney’s Plans, And GOP Sees Falsehoods
The Obama campaign has run advertisements charging that Mitt Romney’s Medicare plan “could raise seniors’ costs up to $6,400 a year” … The outdated charge that future Medicare beneficiaries could face $6,400 in higher costs comes from an analysis of an old proposal by Mr. Romney’s running mate, Representative Paul D. Ryan, that has since been revised (Cooper, 9/27).

Politico: What Obama Isn’t Saying About Medicare
As Woodward explains in “The Price of Politics,” Obama was willing to make significant changes to the cherished federal health care plan for seniors last year as part of a grand bargain with congressional Republicans. And 2011 was hardly the first time Obama considered confronting the costly and popular program; it’s also highly likely it won’t be the last if he’s reelected (Martin, 9/27).

Los Angeles Times: Obama And Romney Campaigns Take Battle To Virginia
Both candidates are heavily targeting women in Virginia, particularly in the northern suburbs of Washington, where Romney campaigned Thursday. Democrats are accusing Republicans of waging a “war on women” by targeting reproductive rights. They point to a measure that failed in the Virginia Legislature this year that would have required trans-vaginal ultrasounds before a woman could have an abortion. … Outside groups are also weighing in, airing ads that feature Romney’s vow this year to eliminate funding for Planned Parenthood (Mehta, Reston and Memoli, 9/27).

CQ HealthBeat: Families USA Report Says Americans Would Pay More, Be Less Likely To Have Coverage Under Romney
Tens of millions more people would be uninsured and Americans would pay thousands of dollars more each year for their coverage under Mitt Romney’s health proposals than under President Obama’s health care law, according to a report released Thursday by Families USA, the left-leaning group that strongly backs the overhaul. Entitled “ObamaCare versus RomneyCare versus RomneyCandidateCare,” the report compares the health care law with the Massachusetts overhaul passed when Romney was the state’s governor and to proposals he has laid out as the Republican candidate for president (Bunis, 9/27).

The Hill: Study: Families Would Pay More For Health Care Under Romney
Families would pay nearly twice as much for non-group health insurance under a President Romney than under President Obama, according to a new report from the liberal advocacy group Families USA. The study found that Mitt Romney’s pledges to repeal the 2010 healthcare law, create a health insurance tax deduction and block-grant Medicaid would result in higher coverage costs and more uninsured Americans (Viebeck, 9/27).

Health News Florida: Economists Prefer Former Romney
In Florida, the number of uninsured would grow by 500,000 by the end of Romney’s first term, instead of dropping by 2.5 million if President Barack Obama is re-elected and the Affordable Care Act takes full effect, they said. The [Families USA] report was written by economists who helped design or implement the Massachusetts Health Insurance Law, signed by then-Gov. Romney in 2006 (Gentry, 9/27).

Also in the news –

Los Angeles Times: Paul Ryan Does Not Need To Be Unmuzzled, Paul Ryan Says
[T]he Wisconsin congressman pointed out that he has concentrated his efforts on interviews with regional reporters … But Ryan has not avoided places where he is likely to encounter hostile crowds. Last week, he gave a speech to the national AARP convention in New Orleans, where he was booed for advocating the repeal of the president’s healthcare law and the restructuring of Medicare for future retirees (Abcarian, 9/27).

This is part of Kaiser Health News’ Daily Report – a summary of health policy coverage from more than 300 news organizations. The full summary of the day’s news can be found here and you can sign up for e-mail subscriptions to the Daily Report here. In addition, our staff of reporters and correspondents file original stories each day, which you can find on our home page.

Romney

Romney (Photo credit: Talk Radio News Service)

Research Roundup: Saving Money With Hospital Observation Units


Topics: Medicare, Health Costs, Delivery of Care, Health Disparities, Hospitals, Quality, Public Health

Sep 28, 2012

Each week KHN reporter Ankita Rao compiles a selection of recently-released health policy studies and briefs.

Health Affairs: Making Greater Use Of Dedicated Hospital Observation Units For Many Short-Stay Patients Could Save $3.1 Billion A Year
The authors write: “Using observation units in hospitals to provide care to certain patients can be more efficient than admitting them to the hospital and can result in shorter lengths-of-stay and lower costs. However, such units are present in only about one-third of US hospitals. … Using a systematic literature review, national survey data, and a simulation model, we estimated that if hospitals without observation units had them in place, the average cost savings per patient would be $1,572, annual hospital savings would be $4.6 million, and national cost savings would be $3.1 billion” (Baugh et al., 9/26).

Journal of the American Medical Association: Total Knee Arthoplasty Volume, Utilization, and Outcomes Among Medicare Beneficiaries, 1991-2010
“Between 1991 and 2010 annual primary [total knee replacement] volume increased 161.5% from 93,230 to 243,802,” according to this study which specifically evaluated trends in the Medicare population. The cost of the procedure is approximately $15,000 and succeeds in “safely reducing pain and improving functional status”. Researchers found that increases in “TKA volume have been driven by both increases in the number of Medicare enrollees and in per capita utilization. We also observed decreases in hospital [length of stay] that were accompanied by increases in hospital readmission rates” (Cram et al., 9/26).

Archives of Internal Medicine: Geographic Variation in Outpatient Antibiotic Prescribing Among Older Adults
By examining Medicare Part D records, researchers found a significant relationship between location and antibiotic use. The rate of patients using antibiotics per quarter was highest in the South, 21.4 percent, compared to 19.2 percent in the Midwest and 17.4 in the West. The drugs had been primarily prescribed for bacterial pneumonia, acute nasopharyngitis, and other acute respiratory tract infections. The Northeast, which had the highest prevalence of bacterial pneumonia, had the lowest rates antibiotic use. The authors concluded: “Areas with high rates of antibiotic use may benefit from targeted programs to reduce unnecessary prescription. Quality improvement programs can set attainable targets using the low-prescribing areas as a reference” (Zhang, Steinman and Kaplan, 9/24).

The Milbank Quarterly: Fundamental Causes of Colorectal Cancer Mortality: The Implications of Informational Diffusion
Colorectal cancer deaths, which will claim an estimated 52,857 lives this year, can be prevented through removing polyps, radiation and chemotherapy if identified through timely screening. But researchers found that there are socioeconomic disparities in mortality rates. By examining death and “diffusion of information” data in counties from 1968 to 2008, they found that southern states tend to have the worst outcome, because of their lower socioeconomic demographics. The authors noted that the “impact of socioeconomic status (SES) on colorectal cancer mortality is substantial and its protective impact increases over time.” The disparity is attributed to access to information that authors said could be mitigated through “aggressive colorectal cancer screenings, better treatment protocols” and publicizing screening recommendations (Wang et al., 9/2012).

The Commonwealth Fund: As CareFirst Tweaks The Medical Home, Doctors Flock and Costs Dip
CareFirst BlueCross BlueShield launched one of the country’s largest medical home programs in January 2011. Now they are targeting small clinics, especially in rural areas, to join a network. Doctors in the CareFirst model are grouped together, sometimes across several practices, to communicate about screening, access and effectiveness and controling costs. If one medical home is prescribing more tests than another, they are “educated about community norms.” CareFirst has recorded a 1.5 percent drop in medical expenses, or a $40 million savings, of which roughly $22 to $23 million is to be paid back to providers (Schilling, 9/25).

This is part of Kaiser Health News‘ Daily Report – a summary of health policy coverage from more than 300 news organizations. The full summary of the day’s news can be found here and you can sign up for e-mail subscriptions to the Daily Report here. In addition, our staff of reporters and correspondents file original stories each day, which you can find on our home page.

English: Dr. Christa Maar, CEO of Felix Burda ...

English: Dr. Christa Maar, CEO of Felix Burda Foundation, at the the Foundations Press Conference regarding the German Colorectal Cancer Awareness Month March 2009 on 17.02.2009 in Munich. Deutsch: Dr. Christa Maar, Vorstand Felix Burda Stiftung, bei Pressekonferenz zum Darmkrebsmonat März am 17.02.09 in München. (c) Felix Burda Stiftung. (Photo credit: Wikipedia)

State Highlights: Free Calif. Health Care Clinic A Big Draw


Topics: States, Uninsured, Health Reform, Delivery of Care, Aging, Women’s Health, Insurance, Marketplace

Sep 28, 2012

A selection of health policy stories from California and North Carolina.

Los Angeles Times: Free Health Care Clinic At LA Sports Arena Draws 4,800
Many of the 4,800 people seeking care at the annual massive free clinic this weekend will become eligible for health insurance in 2014 when the national law takes effect. Organizers said raising awareness about the health care changes is crucial (Gorman, 9/27).

San Francisco Chronicle: Law May Encourage Mammogram Alternatives
A new law that will require California doctors to tell women if they have highly dense breast tissue is expected to increase demand for alternatives to mammography to screen patients for breast cancer. The potential market is huge: About 40 percent of women have tissue that is dense enough that cancer may be missed through conventional mammography. The law says that beginning in April, patients must be told a “range of screening options” are available, but it does not specify those methods or require health insurers to cover them (Colliver, 9/27).

California Healthline: New Attention To End-Of-Life Care
Partnership HealthPlan of California, a health insurer covering roughly 200,000 Medi-Cal beneficiaries in six Northern California counties, has decided to offer the optional benefit of palliative care to its members. … The state doesn’t currently offer the enhanced benefit, in part due to budget concerns, but [Partnership HealthPlan’s medical director] said the cost of palliative care is offset by less necessity to provide other types of care that may not actually benefit the patient or the family, he said (Gorn, 9/28).

North Carolina Health News: Public Health Workers Express Frustration With New Law
With the passage of a new law this past year, county public health agencies could look very different — and some public health professionals are making their unhappiness about it known. At a meeting of the N.C. Public Health Association last week at the New Bern Convention Center, state Sen. Fletcher Hartsell (R-Cabarrus) was forced to defend a bill he shepherded through during this year’s legislative session that allows county boards of commissioners to disband local boards of health and assume their powers. The new law also allows for county commissioners to consolidate public health and social services agencies, and creates incentives for smaller counties to join together to provide services across county lines (Hoban, 9/27).

This is part of Kaiser Health News‘ Daily Report – a summary of health policy coverage from more than 300 news organizations. The full summary of the day’s news can be found here and you can sign up for e-mail subscriptions to the Daily Report here. In addition, our staff of reporters and correspondents file original stories each day, which you can find on our home page.

English: California OPA Health Care Quality Re...

English: California OPA Health Care Quality Report Card on HMOs for 2009 (Photo credit: Wikipedia)

Liberal Christians Protest Hobby Lobby Lawsuit Over Contraception Coverage Mandate


texas our texas

texas our texas (Photo credit: jmtimages)

Topics: Women’s Health, States, Health Reform, Politics

Sep 28, 2012

A group of liberal Christian activists are protesting Hobby Lobby‘s decision to sue the Obama administration over its contraception coverage mandate in the health law.

The Associated Press/Washington Post: Liberal Oklahoma Pastors Protest Hobby Lobby Suit Challenging Coverage Of Morning-After Pill
Christian activists attempted Thursday to deliver a petition to Hobby Lobby criticizing its challenge to a portion of the new federal health care law, but guards at the company’s headquarters turned them away. … Schmitz said more than 80,000 people had signed copies of a petition circulated nationwide by Faithful America, an online Christian group, and UltraViolet, which promotes women’s rights. Schmitz said he intends to mail the petition to the company. Lawyers representing Hobby Lobby this month sued the federal government claiming it should not be forced to provide workers with health insurance that covers the morning-after and week-after pills (9/27).

Elsewhere, fallout from Texas’ budget cuts for family funding services has forced several clinics to close —

Houston Chronicle: Family Planning Clinics Hard Hit By Budget Cuts
About 15 percent of Houston-area clinics that received state funding for family planning services closed their doors because of budget cuts last fiscal year, and another 30 percent have reduced service hours, according to a study published this week. Following a political firestorm in the 2011 legislative session, state family planning funds were cut from $111.5 million to $37.9 million for the biennium, cutting services to as many as 180,000 women in Texas a year, according to state health department officials. The number of clinics funded by the Texas Department of State Health Services has dropped from 300 to 136 since the Legislature slashed funding, state officials said (Radcliffe, 9/27).

This is part of Kaiser Health News‘ Daily Report – a summary of health policy coverage from more than 300 news organizations. The full summary of the day’s news can be found here and you can sign up for e-mail subscriptions to the Daily Report here. In addition, our staff of reporters and correspondents file original stories each day, which you can find on our home page.

English: Hobby Lobby store in Stow, Ohio

English: Hobby Lobby store in Stow, Ohio (Photo credit: Wikipedia)

Maryland Sets Insurance Marketplace Plan Benchmark; Other State Health Law News


Topics: States, Health Reform, Marketplace, Insurance, Politics

Sep 28, 2012

In Maryland, a board sets a state employee health plan as the benchmark for others in the marketplace. In the meantime, New Mexico examines what it has to gain from a Medicaid expansion, and Virginians give a thumbs down to the health law.

The Associated Press/Washington Post: Md. Health Reform Panel Approves State Health Plan As Benchmark In Health Care Reform
A Maryland panel working on implementing federal health care reform voted Thursday to use the state employee health plan as a benchmark for other plans that will be available to small businesses and individuals for two years, starting in 2014 (9/27).

The Associated Press: Report: NM Gains Initially With Medicaid Expansion
New Mexico’s costs of expanding Medicaid under the federal health care overhaul will be offset initially by additional tax revenues because of increased spending on medical services, according to a legislative committee analysis released Thursday. The Legislative Finance Committee released its staff projections as lawmakers began to consider what will be one of the biggest issues confronting Gov. Susana Martinez and the Legislature next year (Massey, 9/27).

Politico Pro: Poll: Virginia Opposes Health Care Law
Virginia voters are poised to deliver a photo-finish on Election Day, but they’re decisive about one thing: the Affordable Care Act is a bad deal for the Old Dominion. A Suffolk University poll released Thursday shows that 51 percent of Virginians call the law “generally bad,” while just 38 percent believe it’s “generally good.” Eleven percent remain undecided. By the same token, 50 percent of Virginians oppose a law signed by Republican Gov. Bob McDonnell requiring women seeking an abortion to undergo an ultrasound. Just 33 percent support that measure and 15 percent were undecided, according to the poll (Cheney, 9/27).

This is part of Kaiser Health News‘ Daily Report – a summary of health policy coverage from more than 300 news organizations. The full summary of the day’s news can be found here and you can sign up for e-mail subscriptions to the Daily Report here. In addition, our staff of reporters and correspondents file original stories each day, which you can find on our home page.

Bill Clinton made health care reform one of th...

Bill Clinton made health care reform one of the highest priorities of his administration. He asked the First Lady to chair the Task Force on National Health Care Reform. (Photo credit: Wikipedia)

Report: States, Feds Collected $30B In Fraud Settlements In 20 Years


President Obama Announces $30-billion Expansio...

President Obama Announces $30-billion Expansion of War on Cancer (Photo credit: Madison Guy)

Topics: Health Costs, Marketplace, Medicaid, States

Sep 28, 2012

A new report finds federal and state authorities have collected more than $30 billion from drug company fraud settlements in the last 20 years.

The Associated Press/Washington Post: Public Citizen Advocacy Group Tracks Rise In Pharmaceutical Settlements With State Governments
Federal and state prosecutors have collected more than $30 billion from drug companies for alleged fraud and illegal marketing over the last 20 years, according to a new report by consumer advocacy group Public Citizen (9/27).

Kaiser Health News: Capsules: Study: States, Feds Recover Billions In Medicaid Drug Fraud Settlements
Now on Kaiser Health News’ blog, Mary Agnes Carey reports on states and the federal government recovering funds from Medicaid drug fraud settlements: “Eager for revenues, states are settling more cases than ever — and at record amounts — with drug makers accused of defrauding Medicaid programs, according to a new analysis from the consumer group Public Citizen” (Carey, 9/27).

This is part of Kaiser Health News’ Daily Report – a summary of health policy coverage from more than 300 news organizations. The full summary of the day’s news can be found here and you can sign up for e-mail subscriptions to the Daily Report here. In addition, our staff of reporters and correspondents file original stories each day, which you can find on our home page.

Faith, Fraud & Minimum Wage

Faith, Fraud & Minimum Wage (Photo credit: Wikipedia)