President Obama's Optimism

Today, in a press conference at the White House, President Obama made his first remarks about the health reform law since the Supreme Court arguments. He says he thinks the Supreme Court will uphold the law, and here's why:

First and foremost, he made the case that precedent was on his side, noting that two staunchly conservative lower court justices had agreed that penalizing people who didn't purchase insurance coverage was within Congress' power under the commerce clause.

Secondly, the president underscored the issues that would arise from repealing the legislative components of the law that had already been implemented. He noted that millions of children have been given insurance coverage under the law, that changes have been made to Medicare's prescription drug program and that insurance industry reforms have already been put in place.

"This is not an abstract argument," he declared. "People's lives are affected by the lack of availability of health care, the in-affordability of health care, their inability to get health car because of pre-existing conditions ... I think the American people understand and I think that the justices should understand that in the absence of the individual mandate, you cannot have a mechanism to insure that people with preexisting conditions can actually get health care."

"So there not only is an economic element to this, and a legal element to this, there is also a human element to this," he added.

The most forceful of the president's points was the third. Overturning the health care law, he argued, would resemble the very type of judicial activism that conservatives have routinely lamented. The Affordable Care Act passed both chambers of Congress and was signed into law by the president. To ignore such a definitive legislative stamp of approval would be a form of judicial overreach, Obama argued.

"Ultimately I am confident that the Supreme Court will not take what would be an unprecedented, extraordinary step of overturning a law that was passed by a strong majority of a democratically elected Congress," the president concluded. "And I just remind conservative commentators that for years what we have heard is that the biggest problem on the bench was judicial activism or a lack of judicial restraint; that an unelected group of people would somehow overturn a duly constituted and passed law. Well, this is a good example. And I'm pretty confident that this court will recognize that and not take that step."

I hope he's right. Jennifer

Breaking News

Federal antitrust regulators on Monday approved a $29 billion merger creating

the nation's largest manager of prescription drug benefits despite widespread

congressional objections. Express Scripts and Medco Health Solutions

immediately announced the completion of their merger after the Federal Trade

Commission gave its approval. More than 80 members of Congress, lobbied by

pharmacies in their districts, have weighed in against the merger and

raised concerns that it could lead to fewer choices for consumers

(Pecquet, 4/2).

I suspect that this is not a good thing for patients since this merged company will own a huge part of the mail order pharmacy market -- and they were impossible to deal with before. It's very disappointing that this merger was approved. Jennifer

Manic Monday Morning

Today's the day the 2012 Handbook comes from the printer. Can't wait -- and you shouldn't either! We already have an order for 100, so get yours before we run out!

Now that I spent a week blogging about the Supreme Court to the exclusion of other health news, I think I've decided to focus these blog posts a bit more. So you won't get every health-related story -- just the ones that I think are interesting, or that I think you would think are interesting. We're going for quality rather than quantity for a little while. Let's see how it goes.

VP Biden predicts the Supreme Court will uphold the health reform law. I don't know -- I still want to believe he's right, but last week was tough. What he is right about, though, is that millions of people already are getting the benefits of the law, and rolling that back does nobody any favors. He's also right when he says that the GOP -- including the presidential candidates -- have not suggested any alternatives. So if the Court strikes down the whole law, do we just go back to the way things were? Most states have enacted provisions responding to the federal law -- what happens to those if the Court strikes down the law? WaPo says the GOP's ads saying health reform has driven up the cost of premiums is way wrong -- but what about all the people who hear this but don't read WaPo? More analysis of last week's arguments here and here. Here are "four likely scenarios" from Politico. And five key questions for the Supreme Court from the Hill. And this is sort of amusing -- Tweets from pundits on the health reform argument.

Some states seem ready to pick up the mantle and pass health reform on the state level. Other states can't seem to make up their minds -- CT first said yes and then said no.

Increasingly, employers are tying health insurance to whether you smoke, are obese, have high cholesterol, and blood pressure. It's bad enough that people with chronic illnesses can't get individual insurance, but now they're going to pay more for employer-sponsored insurance, too? Other insurers are paying rebates for going to the cheapest sources for medical care. But do we sacrifice quality when we judge by price alone?

The wonderful Dr. Pauline Chen writes about when less treatment is more. Sometimes, more conservative treatment is the best way to go. So, for example, when a woman presented with a blockage due to scar tissue, the surgeon chose an NG tube and IV nutrition for a week instead of surgery. But still, patients get treatments that have questionable benefits -- radiation for breast cancer, which contributes little to mortality, but even though the studies showing that are strong, treatment continues. One driver is finances -- you don't get paid for not treating. And another driver is patients -- we want our doctors to DO something. We may be wrong about that, though.

That's it for this Monday morning. Have you ordered your copy of the 2012 Know Your Rights Handbook? If you want to be an empowered patient, get your copy today! Jennifer

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Jonathan Cohn: The Supreme Court on Trial

I can't pass up posting yet another piece about the Supreme Court arguments, this from the truly great Jonathan Cohn. He argues quite convincingly that the Court should be worried about its own legitimacy if it is so activist as to strike down the health reform law. He says: "Their job is to determine whether a law is constitutional, not whether a law is wise." Go Jonathan! Jennifer

One More

I have one more opinion piece for you. I found it to be really powerful. Does it move you, too? Jennifer

A couple of opinion pieces on health reform

Of course, there are and endless number of opinion pieces on health reform this week. I'd like to bring two of them to your attention.

First, my good friend, Dean Jeremy Paul of UConn Law School, explains why the emotional part of the argument -- the government shouldn't force me to buy something I don't want -- really has nothing to do with Commerce Clause analysis.

Second, Paul Krugman talks about the politicization of the Supreme Court.

Both are worth a read if you get a moment. Jennifer