Inside Opinion

What's on the minds of Tacoma News Tribune editorial writers

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Tag: Obamacare


Obama must step up his game on health reform

This editorial will appear in Monday’s print edition.

There is no way to spin the White House’s retreat on the employer mandate as a good omen for the Affordable Care Act.

The mandate – a requirement that companies offer health benefits if they employ 50 or more full-time workers – was supposed to be one of the easier parts of health care reform. It was just a matter of the Treasury Department and Department of Health and Human Services writing regulations and companies providing payroll information.

But employers have been complaining loudly about confusion and costs – and threatening to

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Sticker shock for America’s hospital patients

This editorial will appear in Tuesday’s print edition.

One of the deeper mysteries facing a patient who’s entered the bewildering labyrinth of the hospital world is why – after he’s discharged – those nice people send him a bill high enough to empty his 401k.

Then another bill comes: His insurance has paid an inexplicably low rate, and the hospital is inexplicably satisfied with it.

If he has insurance, that is. If he doesn’t, it may be time to look at that 401k.

The nation’s capricious and incomprehensively high hospital bills came under harsh light last week when the Department of Health and Human Services released a database showing what American hospitals charge for common inpatient services.

Try to compare one hospital’s bills against another and you quickly wind up in Wonderland.

According to HHS, inpatient charges for a joint replacement runs an average of $5,300 in Ada, Okla.; in Monterey Park, Calif., it’s $223,000. Bills can vary wildly even in the same area.

Typical inpatient treatment for heart failure costs from $21,000 to $46,000 at various Denver hospitals, for example.
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Next test for Obamacare: The November election

This editorial will appear in Friday’s print edition.

The U.S. Supreme Court has settled the biggest question about Obamacare: Is it constitutional? Now comes the second question: Is it politically sustainable?

Supporters of the law have complained bitterly of the legal challenge that 26 Republican attorneys general – including Washington’s Rob McKenna – mounted against the Affordable Care Act.

But without the lawsuit, the act’s legality wouldn’t have been settled this soon. There would have been no victory in court on Thursday, and the massive law would still be dogged by the threat of unresolved constitutional issues.

As it happened,

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Unintended (but good) possible consequences of Obamacare

I’ve read a lot of commentary about the Affordable Care Act (“Obamacare”) and the Supreme Court decision, but I haven’t seen much about what might be one of its best consequences – if the legislation survives: job creation.

Eugene Robinson touches on it in his column that appears Friday in the print edition. He writes:

Tying health insurance to the workplace also distorts the labor market and discourages entrepreneurship by forcing some employees to stay where they are – even in dead-end jobs – rather than give up health insurance. For healthy individuals, it is crushingly expensive to buy insurance

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Uninsured freeloaders’ option: Stay out of the ER

This editorial will appear in tomorrow’s print edition.

There are jillions of opinions about the constitutionality of the individual health insurance mandate, but only one of them will ultimately count – the opinion signed by the majority of the justices on the U.S. Supreme Court.

So let’s leave the jurisprudence to the high court – which is hearing arguments on the mandate this week – and look at the law’s logic.

If you believe that humane societies provide medical care for their needy, there are several options. A couple of those options – such as expanding Medicare to younger Americans – are explicitly socialistic. The Democratic Congress of 2010 went for an alternative, so-called Obamacare, that preserved the private health insurance industry.

Covering everyone means covering people regardless of how sick they are. But insurers go broke if they’re required to cover only the sick – whose medical bills are bound to be much higher than their premiums – while free-riders pay nothing until they get sick themselves. To guarantee coverage for pre-existing conditions, nearly all Americans – sick and healthy – must be in the pool.

Hence the mandate to either carry medical coverage or pay a penalty. It’s pretty much where you wind up if you want universal coverage but don’t want to replace private insurance with a Medicare-style government program.
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Repeal ‘Obamacare’? Show us the alternative

This editorial will appear in tomorrow’s print edition.

OK, Republicans, let’s see your health care bill.

The new GOP majority in the U.S. House of Representatives is poised today to repeal last year’s Affordable Care Act (or “Obamacare” – take your pick). It’s an empty gesture as far as lawmaking goes: The Democratic majority in the Senate won’t second the motion, and President Obama certainly wouldn’t sign a repeal of his signature legislation.

But Republicans hope to follow up with piecemeal attacks on the 2010 package that might eventually gut it. The fattest target is the law’s requirement that most Americans carry health insurance. It’s unpopular; it’s also a way to prevent freeloaders from buying insurance after they get sick, then dropping it as soon as they’ve had their babies or their hip replacements.

The Affordable Care Act promises to do the job of extending medical coverage to most Americans, but it is not a work of art. A repeal would be fantastic – if the law were being replaced with something better. The problem is, congressional Republicans aren’t offering a better bill. In fact, they’re offering no bill at all.
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‘Death panels’ are back, and patients will profit

This editorial will appear in tomorrow’s print edition.

President Obama appears to have slipped “death panels” back into federal health care law via executive authority. Good for him.

To paraphrase Mark Twain, there are lies, damn lies and the death panel scare. The ever-inventive Sarah Palin came up with the term last year in a drive to whip up fears about health care reform.

Section 1233 of the health care bill, she said, would allow “Obama’s death panel” to judge whether “my parents or my baby with Down Syndrome” are “worthy of health care.”

Others took up the cry – Section 1233 made a convenient target – and they were so successful that Congress eventually dropped the measure from the reform bill.

Back to the world of facts. Only a certified paranoid could have read the actual text of the section and concluded that someone was trying to pull the plug on grandma. It simply allowed Medicare funding for discussions, every five years, between doctors and patients about their end-of-life options. That’s it.

These conversations happen all the time right now. Patients dying of cancer, for example, already consult with their doctors about what treatments are available, whether they want aggressive medical intervention, what life-sustaining measures they are willing to accept, the value of advance directives and the appointment of health care “proxies” – typically family members – who can make decisions on their behalf if they are incapacitated.
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A flawed bill, but far better than none

This editorial will appear in tomorrow’s print edition.

The so-called Obamacare package now before the U.S. House of Representatives is neither socialism nor – by itself – a solution for what’s wrong with health care in America. We’d prefer to order a different bill, but this is the only one on the menu.

The claim that President Obama and Congress are enacting something like socialized medicine isn’t serious. Britain has socialized medicine: The system is owned by the state, and doctors are government employees.

Canada’s semi-socialized “single-payer” is a hybrid: The government is the insurer, but many doctors remain in private practice. Most liberal Democrats probably wanted something like Canada’s system, but they didn’t get it and they didn’t get even the consolation prize of a government-run “public option.”

The new “reconciliation” bill the House will vote on shortly would leave America’s private insurance industry in place, but with new regulations designed to cover the nation’s uninsured and help the insured keep their coverage. It’s not a conservative, market-oriented plan, but the American health care system has been a creature of heavy regulation for many decades.
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