Viewpoints: Michelle Obama Makes A Business Case For Healthy Food; Orszag Weighs Reforms To Medical Malpractice This is part of the KHN Morning Briefing, a summary of health policy coverage from major news organizations. Sign up for an email subscription. The Wall Street Journal: The Business Case For Healthier Food Options For years, America’s childhood obesity crisis was viewed as an insurmountable problem, one that was too complicated and too entrenched to ever really solve. According to the conventional wisdom, healthy food simply didn’t sell—the demand wasn’t there and higher profits were found elsewhere—so it just wasn’t worth the investment. But thanks to businesses across the country, today we are proving the conventional wisdom wrong (Michelle Obama, 2/27). Politico: Under ACA, Employer Mandate Could Mean Fewer Jobs With the employer mandate, Obamacare puts the nation’s job creators between a rock and a hard place. Despite the gentle sounding title, the Shared Responsibility provision actually takes the two parties who should be making decisions about employer-sponsored health coverage (the employer and the employee) completely out of the equation. Beginning in 2014, large employers must provide a prescribed level of health care coverage to all full-time employees or potentially pay a hefty penalty. While this may sound relatively straightforward, it is anything but (Dan Danner, Bruce Josten, Matthew Shay and Dirk Von Dongen, 2/27).Bloomberg: To Fix U.S. Budget, Reform Medical Malpractice Law The sequestration that is about to take effect imposes too much austerity too soon, does so in a nonsensical way, and yet does little to improve the long-term U.S. fiscal picture. Far more beneficial would be to make sure that the deceleration in health costs we have been enjoying continues. This is why medical-malpractice reform, although far from a panacea, is worth trying (Peter Orszag, 2/27). The Wall Street Journal’s Political Diary: The Jersey Doughboy Chris Christie just can’t help himself, can he? Whenever the feds are offering dough—and it’s free—he’s got to have some. The New Jersey governor yesterday embraced the ObamaCare Medicaid expansion on the grounds that if New Jersey doesn’t help itself to the Medicaid pie, other states would just take its share (Allysia Finley, 2/27). JAMA: State Health Exchanges, A Skeptical Public, And The Role Of Health Care ProfessionalsAlthough there is concern that some insurance companies may decide it’s too unprofitable for them to participate in the exchanges, the most pressing challenge for most of the exchanges will be meeting their enrollment goals. And that’s where health care professionals come in. Primary care practices, community health centers, and emergency rooms provide crucial opportunities for uninsured patients to learn about getting covered at a low cost—and, in some cases, for free. As trusted sources, physicians and nurses—and all health care professionals—hold the keys to raising awareness about the exchanges (Diana Mason, 2/27). Medpage Today: Zero Tolerance For Medical Error? Think Again!After only a couple of incidents, the federal government grounded this newest, most technically sophisticated (Boeing 787 “Dreamliner”) airliner until the problem was fully understood, the deficiency corrected, and the risk to passengers and crew minimized. Shouldn’t we address surgical “never events”, which affect 4,160 patients each year, with the same urgency and gravity that we address the potential risk to 210-270 passengers of travelling in the “Dreamliner”? (Dr. David Nash, 2/27).Oregonian: Boost Oregon’s Childhood Vaccination Rates By Trying Washington’s TechniqueOregon could wait for an epidemic. The state could retain its casual approach to childhood vaccinations and keep its ranking as the nation’s worst for protecting children against terrible and preventable diseases. Or, Oregon could follow Washington’s lead and take one simple step to improve its childhood vaccination rates — and do so without infringing on anyone’s religious liberty. The choice is clear. Oregon should pass a Senate bill under consideration that would require parents who withhold mandatory vaccines from their children to get a doctor’s signature showing that they have been informed of the risks and benefits (2/27). Los Angeles Times: Critiquing The Stem Cell Board After years of resisting all criticisms of its operations, the California Institute for Regenerative Medicine is finally listening — a little. It spent $700,000 for an outside, high-level review that complimented the stem cell agency for funding an excellent portfolio of research projects, but also raised serious objections to the agency’s structure, which the review said was likely to lead to financial conflicts of interest (2/27). And The New England Journal of Medicine hosted several columns on the issue of open access in scientific journals.The New England Journal of Medicine: Protecting Patient Privacy And Data Security Too often, unauthorized people succeed in extracting protected information from health care providers. Invasion of privacy also affects noncelebrities, when anyone seeks health information the patient has not chosen to share. More often, though, scam artists seek patients’ billing information for financial gain. The patient’s insurance identifier is then used by an uninsured person to obtain medical services or by a fraudulent health care provider to bill for medical services that were never rendered. Data security breaches and medical identity theft are growing concerns, with thousands of cases reported each year. The Centers for Medicare and Medicaid Services (CMS) tracks nearly 300,000 compromised Medicare-beneficiary numbers (Dr. Julie K. Taitsman, Christi Macrina Grimm and Dr. Shantanu Agrawal, 2/27). The New England Journal of Medicine: For the Sake Of Inquiry And Knowledge — The Inevitability Of Open Access It’s difficult to have a measured conversation about open access — the term widely used to refer to unrestricted online access to articles published in scholarly journals. People who believe that free and unrestricted access to peer-reviewed journal articles will undermine the viability of scholarly journal publishing disagree sharply with those who believe that only open access can expedite research advances and ensure the availability of that same scholarly literature. Arguments for and against open access tend to focus on implementation details, ignoring the powerful motivations underlying the phenomenon. … There is no doubt that the public interests vested in funding agencies, universities, libraries, and authors, together with the power and reach of the Internet, have created a compelling and necessary momentum for open access. It won’t be easy, and it won’t be inexpensive, but it is only a matter of time (Ann J. Wolpert, 2/27).The New England Journal of Medicine: Open But Not Free — Publishing In The 21st Century Open-access publishing has gained traction over the past 10 years because of the success of the PLOS and BioMed Central families of journals. The annual volume of articles published in open-access journals has increased from 20,702 in 2000 to 340,130 in 2011 — accounting for 17% of all articles published in 2011.4 These articles were published in 6713 journals with full and immediate open access; 49% of them were published in journals requiring an author fee. The growth in open-access publishing has encouraged professional societies, commercial publishers, and even funders to launch new open-access journals. There is, however, a cost associated with this openness — a cost that may reduce the funds available for research. PubMed Central diverts approximately $4 million from the NIH budget in order to collect, process, and convert NIH-funded manuscripts into PubMed Central’s archival format (Martin Frank, 2/27). The New England Journal of Medicine: The Downside Of Open-Access Publishing Most of the new open-access journals state that they are international, scientific, or scholarly peer-reviewed journals and offer quick turnaround times. … Of course, the terms “international,” “scientific,” “peer-reviewed,” “journal,” “article,” “editor,” and “publisher” do not have copyrighted or patented definitions and can have varied meanings, especially in the Internet age. Must an article be different from a submitted paper? Isn’t everything published online automatically international? Is there anything wrong with a situation in which the editor and publisher are just one person who has set up a website where researchers can submit their papers and pay a fee to have them laid out in a professional way and made available to all interested parties? Isn’t it a good thing that this vast number of new publishers and journals will make it possible to get all research — whatever its quality level — into the public domain? Perhaps. But describing a simple online-posting service as “an international, scientific, peer-reviewed journal” leads authors and readers to believe that they are submitting to or reading something they aren’t (Dr. Charlotte Haug, 2/27).