Viewpoints: Health law fails to control costs; GOP alternative 'worse than Obamacare'

The Wall Street Journal: ObamaCare's Failing Cost Control
A major claim of ObamaCare's political salesmen is that it will reduce U.S. health spending. The heart of this claim is the Accountable Care Organization, or ACO, but already evidence is accumulating that it isn't working. ... If the ACO goes the way of every other previous HHS adventure in false omniscience, government planners will invariably turn to rationing care. Their main tool will be the Independent Payment Advisory Board, a 15-member committee of experts whose decisions are insulated from political oversight. Under ObamaCare, medicine will always be accountable to government, not patients (10/19).

The Washington Post: A Health-Care Plan Worse Than Obamacare
Republicans calling for repeal of the Affordable Care Act, also known as Obamacare, are a dime a dozen. Fewer offer a plan to replace the law with something they claim would work better. To his credit, Virginia's Ed Gillespie, a GOP Senate candidate, is in the more select group. ... Mr. Gillespie's proposal was developed by a conservative group called the 2017 Project .... It is a real plan, which is to be commended. But it would be worse than the Affordable Care Act (10/17). 

USA Today: Ted Cruz: Republican Priorities For 2015
By all signs, Americans are preparing to send Washington a clear message in the 2014 elections. The question is, will Washington listen? ... Here are ten critical priorities for the 2015 Congress: ... We should pass repeal legislation (forcing an Obama veto), and then pass bill after bill to mitigate the harms of Obamacare. Prevent people from having their healthcare plans cancelled, prohibit insurance company bailouts, eliminate the provisions forcing people into part-time work, and repeal the individual mandate (Sen. Ted Cruz, R-Texas, 10/19).

Bloomberg: Question Day: Could Obamacare Be Repealed?
I expect repeal of the Affordable Care Act to be the mandatory position for every Republican presidential candidate. ... Flat-out repeal stopped being a realistic option (along with the political toll it would extract because of the large number of people who are now relying on its benefits, too much has changed for a simple elimination to make sense). But out in Republican primary-land plenty of people believe the fiction that Obamacare has already collapsed on its own. Primary elections are an unlikely venue for educating rank-and-file voters about reality. And even though candidates will probably continue to embrace "repeal and replace" rhetoric, don't expect them to roll out real replacement plans (Jonathan Bernstein, 10/17). 

Los Angeles Times: In The Obamacare Birth-Control Debate, There's A Logical Path
In case you haven't encountered enough illogic in the American healthcare system, consider this: Once a medication has been determined to be safe and effective enough to be available without a prescription, we assume it should no longer be covered by insurance. That doesn't follow, and contraceptives are an important case in point (Daniel Grossman, 10/18). 

Modern Healthcare: Chip Kahn Sees Successes, Missed Opportunities In Health IT
President Barack Obama's January 2009 pledge to "computerize the nation's health records in five years" largely has come to fruition. ... Despite our EHR successes, most hospitals are a "Tower of Babble," with numerous modules and devices unable to talk to each other without costly interfaces, overlays, or, in many cases, a nurse or other healthcare professional serving as a translator, manually transferring or transcribing data from one system to another. It is sobering to realize that hundreds of millions of dollars were spent experimenting on how to get patient X's information from Ohio to Florida, yet we cannot convey data from a digital blood pressure cuff into an EHR three feet away without some type of work-around. This reflects yet another missed opportunity (Chip Kahn, 10/18).

The Washington Post: Best State In America: Maine, For Its Hospitals
When it comes to the facilities that deal with our health, residents in Maine should feel a little less anxious: A recent study found that the state has a higher percentage of top-notch hospitals, as measured by patient safety, than anywhere else in the country (Reid Wilson, 10/17). 

The Washington Post: Let Brittany Maynard's Story Spark A Dialogue About The End Of Your Life
Tragically blindsided by brain cancer and a terminal diagnosis, [Brittany] Maynard has bravely decided to live large, to turn her terrible personal fate into a public story. ... If all the people who watched her video want to do something that truly matters, start a conversation at the kitchen table with the people you love .... Talk about what matters to you at the end of life. Choose someone who will speak for you if you can't speak for yourself. Have that conversation. I am reminded of something else Maynard said. "The thoughts that go through your mind when you find out you have so little time is everything that you need to say to everyone that you love." Don't let the moment pass (Ellen Goodman, 10/17).

The New York Times' Opinionator: Why Doctors Need Stories
If the narrative was striking, so was its inclusion in a medical journal. In the past 20 years, clinical vignettes have lost their standing. For a variety of reasons, including a heightened awareness of medical error and a focus on cost cutting, we have entered an era in which a narrow, demanding version of evidence-based medicine prevails. As a writer who likes to tell stories, I've been made painfully aware of the shift. The inclusion of a single anecdote in a research overview can lead to a reprimand, for reliance on storytelling. My own view is that we need storytelling in medicine, need it for any number of reasons (Peter D. Kramer, 10/18).