Viewpoints: VA Controversy Showcases Problems With Government Health Care; Location Matters For Transplants The Wall Street Journal: The Government Health-Care Model President Obama addressed the Veterans Affairs scandal on Wednesday, saying he’s waiting for an Inspector General “audit” of what went wrong. And the press corps is debating whether VA Secretary Eric Shinseki should be fired. These are sideshows. The real story of the VA scandal is the failure of what liberals have long hailed as the model of government health care (5/22). The Washington Post: The VA Scandal Will Stick With The Obama Administration President Obama’s VA scandal is the most serious and damaging of his presidency. It is the Obama administration in sum and in miniature: incompetent management of a health system, defended by crude media manipulation. Each of these elements deserves some unpacking. The incompetence comes in the aftermath of HealthCare.gov — the Technicolor failure of technocratic liberalism. Again, the White House is shocked, saddened and angered by the management fiasco of a manager under its direct control. In both cases, a presidential priority was badly mishandled over a period of years, and the president seems to have learned about it on cable news. Obama has defended himself by assuming the role of an outraged bystander — which, when it comes to leadership, is more of a self-indictment than a defense (Michael Gerson, 5/22). Bloomberg: Trust The Data? Not When It’s The VA’s People may have died while on secret waiting lists for care at VA hospitals, which is why President Barack Obama was forced to address the allegations yesterday — and why they may yet claim the job of Eric Shinseki, secretary of Veterans Affairs. Shinseki is an honorable public servant, and calls for his resignation are premature. It’s the VA’s data that can no longer be trusted (5/22). The Washington Post: How VA Scandals Have Made The VA Better Throughout its history, the VA’s very public failures have shaped its development as profoundly as its successes. If there is any silver lining to our current outrage, it is that in the past, acts of negligence or corruption have led to dramatic improvements in the care veterans receive (Colin Moore, 5/22). Los Angeles Times: Another Week, Another Administration Fix For Obamacare Would the Obama administration please pick its poison? The Times’ Noam Levey reported Wednesday that the administration has quietly solidified Obamacare’s guarantee against excessive health insurer losses, drawing a new round of complaints from critics about a potential taxpayer bailout. It was yet another example of how the administration’s efforts over the last two years to soften the law’s impact have caused other problems to ripple through the system, leading to more short-term fixes that trigger yet more challenges. The latest issue concerns “risk corridors,” a mechanism that Congress used to help insurers manage some of the uncertainty created by the Affordable Care Act’s reforms (Jon Healey, 5/22). The New York Times: Where You Live Matters for Lifesaving Liver Transplants Following the age-old adage that practice makes perfect, such policies limit where patients can undergo certain complex treatments or procedures to the centers that have the expertise to do them most efficiently. Patients end up being channeled to those centers, which in turn helps the clinicians there become even more adept and swift, thus ensuring quality of care and, potentially, significant cost savings as well. It appears to be a winning situation for both doctors and patients. … There have been critics, however. They contend that patients who live far away from these so-called centers of excellence might not be as likely to get the care they need and, as a result, could fare worse than patients who live close by (Dr. Pauline Chen, 5/22).The Wall Street Journal: Mammograms Save Lives There is a disconcerting effort afoot to reduce a woman’s access to mammography screening for breast cancer by making it seem useless or even harmful. The movement dates to November 2009, during the debate over the Affordable Care Act, when the U.S. Preventive Services Task Force, which reports to Congress, dropped its recommendation for mammography screening for women in their 40s and instead recommended screening starting at age 50. … Remarkably, this new recommendation came even though the task force’s own computer models showed that as many as 100,000 women then in their 30s, whose lives could be saved by annual screening starting at 40, would eventually die from breast cancer as a result of waiting until 50 (Daniel B. Kopans, 5/22). The New York Times: The Politics Of Breastfeeding Some parents swear by it, while others feel defeated by it. But breastfeeding is always creating controversy, whether it’s dividing passengers on airplanes, attracting male fans, or bringing a community together. That said, a recent report questions the efficacy of the practice, fueling the ongoing tension between breastfeeding advocates and parents who are more comfortable with or prefer formula. Why does this debate incite so much anxiety and competition? (5/22). The New York Times: You’re Never Too Old To Be Studied When older patients seek health care, they are unwittingly enrolling in an experiment: Will medical procedures that have been proved effective mainly on the young also help the elderly? Doctors are often in the dark about whether certain drugs, procedures and tests will benefit older adults, because these patients are routinely excluded from medical research. A systematic review in The Journal of the American Medical Association in 2007 looked at randomized controlled trials published in high-impact medical journals between 1994 and 2006, and found that close to 40 percent excluded individuals over the age of 65 (Donna Zulman and Keith Humphreys, 5/22). The Washington Post: How Many Patients Should Your Doctor See Each Day? In light of the allegations that some Veterans Affairs Department health clinics used elaborate schemes to hide the records of patients who had waited months for care, I began to wonder what a normal caseload would look like for an average physician outside the VA system. And if your doctor has a larger-than-average caseload, is he or she able to give you the attention you need? The numbers are pretty stunning. A 2012 article in the Annals of Family Medicine noted that the average primary-care physician has about 2,300 patients on his “panel”— that is, the total under his or her care. Worse, it said that each physician would have to “spend 21.7 hours per day to provide all recommended acute, chronic and preventive care for a panel of 2,500 patients” (Lenny Bernstein, 5/22). Los Angeles Times: This Bill Isn’t The Way To Help Immigrants Afford Healthcare The 2010 healthcare reform law sought to extend coverage to millions of uninsured Americans, not just to improve their care but also to promote a more efficient healthcare system. The law left out one large group of uninsured people, however: those who were living in the country illegally. State Sen. Ricardo Lara (D-Bell Gardens) wants to rectify that omission by providing subsidized insurance policies for noncitizen Californians with low incomes. Bringing everyone under the insurance umbrella is the right long-term goal, but Lara’s bill isn’t the right way to achieve it (5/22). Los Angeles Times: Soda Warning Labels: The Cons Outweigh The Pros Now the question is whether this is enough reason to pass a bill — SB 1000, to be exact — that would require warning labels on sodas akin to those that have been required for 50 years on cigarette packages. This is a sensitive issue legally as well as nutritionally. It’s one thing to require nutrition and ingredients information on food so that consumers can make wise decisions, and sodas already provide clear information about their sugar calories and, in most cases, long list of artificial ingredients. But demanding that a company use its own container to advertise against itself goes a step further, into dicey territory. We do that with cigarettes, but their danger could not have been clearer. And cigarettes never did contain ingredients lists, not that most consumers would have known what to make of such a list (Karen Klein, 5/22). This is part of the KHN Morning Briefing, a summary of health policy coverage from major news organizations. Sign up for an email subscription.