President Confident Health Law Will Stand
By MARK LANDLER
WASHINGTON — President Obama declared Monday that he was confident the Supreme Court would uphold his health care law, saying it would be an “unprecedented, extraordinary” step to overturn legislation passed by the “strong majority of a democratically elected Congress.”
In his first public comments since court questioning last week suggested that it might find the Affordable Care Act unconstitutional, Mr. Obama offered both a robust defense of the law and a barbed warning to justices thinking of striking it down.
“For years what we’ve heard is the biggest problem on the bench was judicial activism or the lack of judicial restraint, that an unelected group of people would somehow overturn a duly constituted and passed law,” Mr. Obama said after meeting at the White House with the leaders of Mexico and Canada.
“Well, there’s a good example,” he continued, “and I’m pretty confident that this court will recognize that, and not take that step.”
The ABC’s of the Health Care Law and Its Future
By GINA KOLATA
After the contentious arguments before the Supreme Court last week, the future of President Obama’s Affordable Care Act is far from certain. The legislation is enormously complex, with thousands of pages of provisions, but at its center is a controversial requirement that all Americans purchase health insurance. The justices will decide whether the so-called individual mandate is constitutional, and if not, whether the entire law must be overturned.
We spoke to Jonathan Oberlander, author of “The Political Life of Medicare” and a professor of social medicine and health policy and management at the University of North Carolina, Chapel Hill, about the law and its future. This conversation has been condensed and edited for space.
Doctor Panels Recommend Fewer Tests for Patients
By RONI CARYN RABIN
In a move likely to alter treatment standards in hospitals and doctors’ offices nationwide, a group of nine medical specialty boards plans to recommend on Wednesday that doctors perform 45 common tests and procedures less often, and to urge patients to question these services if they are offered. Eight other specialty boards are preparing to follow suit with additional lists of procedures their members should perform far less often.
The recommendations represent an unusually frank acknowledgment by physicians that many profitable tests and procedures are performed unnecessarily and may harm patients. By some estimates, unnecessary treatment constitutes one-third of medical spending in the United States.
“Overuse is one of the most serious crises in American medicine,” said Dr. Lawrence Smith, physician-in-chief at North Shore-LIJ Health System and dean of the Hofstra North Shore-LIJ School of Medicine, who was not involved in the initiative. “Many people have thought that the organizations most resistant to this idea would be the specialty organizations, so this is a very powerful message.”
Looking Ahead, Republicans Examine Options in Health Care Fight
By ROBERT PEAR and JONATHAN WEISMAN
WASHINGTON — Republican lawmakers who have spent two years railing against President Obama’s health care law are beginning to devise alternatives so they can be ready if the Supreme Courtforces the issue of the uninsured back into the center of political debate.
“If Obamacare goes away, it doesn’t mean that the problem of how you deliver health care affordably and get good access goes away,” Representative Greg Walden, Republican of Oregon, said. “Those are the issues that are back before us.”
Republicans say they will have to make good on their pledge to replace the health care law if the Supreme Court strikes down any significant parts of it. They remain optimistic about the possibility of a court victory, even as they begin thinking more seriously about what would follow.
White House and the F.D.A. Often at Odds
Nancy-Ann DeParle, the whip-smart and sometimes caustic White House deputy chief of staff, picked up The Wall Street Journal one summer day in 2010 and got an unwelcome shock. The Food and Drug Administration was proposing as part of the new health care law to require that movie theaters post calorie counts for popcorn — and this was the first she had heard of it.
In the F.D.A.’s view, the law called for moviegoers to know that many a buttery bucket of popcorn had more calories than two Big Macs, but Ms. DeParle, President Obama’s chief health adviser, thought the requirement was unnecessary and would probably be lampooned on Fox News as an especially silly example of the government intrusions that conservatives often mocked as the nanny state.
Dr. Margaret A. Hamburg, the F.D.A. commissioner appointed by Mr. Obama, soon heard about the White House’s displeasure and called Ms. DeParle at home one evening, people with knowledge of the call confirmed. The women had a decidedly chilly conversation. Within days, the F.D.A., an agency charged with protecting public health, backed down and dropped the notion of calorie counts for foods served in movie theaters and on airplanes.
Similar tussles have erupted between top administration officials and the F.D.A. over issues from the regulation of sunscreens and asthma inhalers to the enforcement of an agency decision on a drug to prevent premature births.