Health Care

When the Supreme Court upheld the Affordable Care Act and President Obama won reelection last year, the die was cast: "Obamacare" became the law of the land. While Republican players want to re-litigate the issue, the new federal guarantee of health-care insurance for every American family is here to stay. Until Republicans embrace this reality - and persuade the voters that they can deliver universal coverage on far better terms - the Party of Lincoln will never sustain a comeback.

New Jerseyans who live in different communities use hospitals at widely different rates, and those differences could pave the way to improving health care and reducing costs, according to a new report by Rutgers University researchers. The report, focused on use patterns in low-income communities and opportunities for better care and lower costs, found wide variations in how many avoidable ER visits residents make. The reason that this information is so valuable, according to coauthor Joel Cantor, director of the Rutgers Center for State Health Policy, is that it opens up the possibility that communities that rely heavily on hospitals for primary care can learn from those who make fewer trips to the ER. For example, the report found that Camden residents had more than three times as many avoidable visits to emergency departments than did residents of the Union City-West New York-North Bergen region.

NEW YORK - Investors just can't get past Europe. Renewed worries about the long-running debt crisis weighed on the Dow Jones industrial average Wednesday and held the Standard & Poor's 500 index back from reaching an all-time high. Investors are watching to see whether Cyprus can shore up its banking system. They are also keeping an eye on Italy, where political parties are struggling to form a new government in the eurozone's third-largest economy. The Dow fell 33.49 points to close at 14,526.16, a loss of 0.2 percent.

Job security just a signature away A clear majority of City Council this month voted in favor of earned sick leave for Philadelphia's workers and families. Now, we and nearly 180,000 working Philadelphians await Mayor Nutter's signature on this legislation. Our city's economy is on the rebound thanks to the hard work of tens of thousands in the restaurant, health care, child care, and hospitality industries. They deserve to earn sick pay so they don't have to lose a day's wages or put the public's health at risk by coming to work sick.

The debate about health care in America unfortunately obscures some important areas of agreement. But the noise also masks some fundamental differences of opinion about the role of government in health care. Let's start with areas of agreement. Polls show clearly that most Americans believe that every lawful resident of this country should be able to count on some basic level of health care. And most accept that those of us able to assist others have an obligation to do so. But we differ on the role of government in determining the level of that obligation and in shaping the system.

Look no further than Steven Brill's "Why Medical Bills Are Killing Us," in the March 4 issue of Time, to see why there is little role, if any, for the marketplace in health care. Simply put, government must be a key player if we are ever to rein in runaway health-care costs. Brill presents a bill-by-bill description of the staggering costs associated with hospital care: An uninsured patient billed $7,997.54 for a stress test using a radioactive dye (Medicare reimbursement rate for this procedure is $554)

Stuart Butler and David Nash will discuss the federal government's role in health care at the inaugural forum of the Civil Discourse Project on Thursday 7:30 p.m. at Beth Sholom Congregation, 8231 Old York Road, Elkins Park. Pre-registation is required at www.CivilDiscourseProject.org or 215-887-1342. Join the conversation on Twitter, @CivilDiscourse1 or on Facebook, Bernard Wolfman Civil Discourse Project.

By Kathleen Sebelius This week marks the third anniversary of the Patient Protection and Affordable Care Act. For Pennsylvanians, that means a health-care system that is stronger than it was three years ago, and a future that looks even brighter. Pennsylvanians who have health insurance have benefited from market reforms and consumer protections under the law. Preventive services like mammograms and flu shots are newly accessible to 3.2 million people with private plans. More than 220,000 of the state's Medicare beneficiaries have saved an average of $753 on their medications.

NEWCOURTLAND, a company that specializes in housing and health care for senior citizens, has received $10 million in tax-credit funding to build affordable housing in Tioga. The financing will help NewCourtland build a 60-unit, seven-story apartment building at the former Stanley Blacker suit factory on Allegheny Avenue near 19th Street. It will be the second phase of a planned campus for elderly housing and health care - the latest project in a building boom of sorts in what had been a deteriorating section of the city.

Independence Blue Cross is hiring 100 nurses as health coaches this year, to intensify attention on members with certain chronic conditions, Richard Snyder, the health insurer's chief medical officer, said. The health coaches will be the "go-to" people at IBC for members in the program, Snyder said in a panel discussion Thursday at a meeting of the Philadelphia Health IT Circle. "This consistency ensures patient-centered coaching that is individualized and coordinated," Snyder said.