On science blogs this week: Supreme

BROADCAST NEWS ABOUT OBAMACARE: CONTRADICTORY CONVERSATION ON CONSTITUTIONAL CONVOLUTION. Both CNN and Fox News got the Supreme Court's decision to mostly uphold Obamacare completely wrong because they didn't read far enough into the decision written by Chief Justice John Roberts.

Fox News declares that Obamacare is unconstitutional.

If they had, they would have seen that, while Roberts did declare the legislation unconstitutional under the commerce clause, which everybody thought was the major point of contention, he also said the law was acceptable because the penalty for flouting its requirement to buy health insurance (aka the individual mandate) wasn't really a penalty. Roberts has declared it a tax, and points out that the power to impose taxes rightfully belongs to Congress.

Gary Schwitzer was his usual scathing self at HealthNewsReview. The hallmark of TV news, he said, is that being first is more important than being correct. He also presented several juicy bits — clips, erroneous tweets, and an excerpt from Jon Stewart's take on The Daily Show.

At Media Nation, Dan Kennedy called it a whopper. Which was mild compared to Megan Garber at The Atlantic, who chortled through her account of what she called Obama's Dewey-Defeats-Truman moment. If you understand that reference to the 1948 Presidential election, you will get a kick out of a funny photo pastiche floating around the 'Net and captured by Schwitzer and also at the Nieman Journalism Lab as part of Mark Coddington's roundup of commentary on the broadcast news fiasco. (Scroll down to the second item.)

Dewey defeats Truman!

CNN bore the brunt of the scorn. Which wasn't really fair, since Fox News made the same mistake. I guess the difference is a backhanded compliment to CNN. We have higher expectations for them. We don't expect Fox News to get it right. In making its correction, Fox not only offered no apology, it continued to insist that it reported accurately as news came in: first the declaration that the commerce clause did not support the mandate, and later that the mandate was valid under Congress's power to tax.

As a result of these examples of the dangers of rushing to judgement, destined, no doubt, to be enshrined in journalism classes forevermore, I learned two useful new things and pass them on to you. (1) I learned that Politwoops is a site that reports on politicans who delete their tweets. On Thursday morning there were a lot of them, as Republicans watching their favorite network tweeted the erroneous news that the individual mandate was dead. And then scrambled to delete their tweets. Isn't it fascinating, but perhaps also dispiriting, that the volume of political misspeaks on Twitter alone is large enough to command its own site? (2) I also learned a new word: chyron, which is the lower third of a TV screen, the area where stations run their bulletins and captions and announcements and such.

SELECTED INFORMATIVE LINKS ABOUT THE SUPREME COURT DECISION. SCOTUSblog has a menu of links to its coverage here. Much of it is intensive legal analysis, but Amy Howe has written a long explanation and analysis of the decision in plain English.

The text of the decision is something other than plain English, but it can be had here, of course, at the New York Times. Find the timeline for when the various provisions of the Affordable Care Act (ACA, aka Obamacare) take effect here

THE OBAMACARE PROGNOSTICATION RECORD: NOT GOOD. Forecasts about what the decision would be are a lovely illustration of the increasingly well-established scientific truth that people believe what they want to believe, and damn the facts. The right wing predicted that the Supremes (or enough of them anyway) would strike down Obamacare, and the gloomy left wing thought the right had it right. But the pundits were wrong, almost to a man. A woman got it right: Linda Greenhouse, long an expert legal analyst at the Times. She forecast last March that the court would uphold the law, a prediction she repeated the day before the decision was handed down. She even got the rationale correct: she argued that Roberts was always reluctant to override Congress's actions. And that's what he said in his opinion.

THE TAXING POLITICS OF OBAMACARE. Among the prognistications about what happens next was Marcia Angell's thoughtful but gloomy post at HuffPo. Angell, former editor of The New England Journal of Medicine, is an emphatic cheerleader for a single-payer system. She had this to say:

Be careful what you wish for. Democrats on a victory lap should watch their step, because John Roberts may have given Mitt Romney a gift. The impact on the health system will be much smaller than the political fallout, because with or without Obamacare, the American health system will continue to unravel — quickly if Romney is elected, slowly if Obama is re-elected.

Obamacare insurance coverage of the now-uninsured, Angell argues, will not be nearly so universal as has been claimed. That's because the penalty for ignoring the individual mandate to buy insurance — the one that Roberts says is a tax — is small. Many people will choose to pay it rather than sign on for the much costlier health insurance premiums.

Contrast Angell's predictions with another doc's HuffPo blog. Elaine Schattner waxed rhapsodic about Roberts's "out-of-the-box thoughtful approach." And then piled the encomiums higher and higher; it was, she said

the kind of morally-grounded stance we could use more of in politics, medicine and other professional fields.

But I wonder if canny politics wasn't the driving force behind Roberts's decision to declare that the individual mandate is constitutional because the penalty for violating it is actually a tax. Roberts used that rationale, ostensibly, to uphold the law. But he also gave the opposition a powerful club for hammering Obamacare. If the tax label sticks, opponents can claim that the ACA imposes a new tax on the middle class, and that won't do anything to increase Obamacare's popularity.

WHAT'S NEXT FOR OBAMACARE? At the NPR Blog Shots, Mary Alice Carey and Padmananda Rama sum up where the Affordable Care Act is in its implementation and, now that it's definitely the law of the land, where it's headed. There are dozens of provisions and at least some of them will bring profound changes.

Take, for example, a requirement that's effective August 1, which says that insurance plans must cover birth control. Yesterday Planned Parenthood said Obamacare would provide the greatest improvement in women's health care in a generation. 17 million women will have health insurance for the first time. From a press release:

the law will provide access to birth control and cancer screenings without co-pays, guaranteed direct access to ob/gyn providers without referrals, and an end to discriminatory practices against women, such as charging women higher premiums and denying coverage for “pre-existing conditions.”

Also at Shots, Julie Rovner points out that Obamacare puts much of the burden for implementation on the states and gives us a glimpse of just how complex it's going to be. This is great news for science and medical writers. It will generate lots of things to write about because each state will approach this task differently.

The part of Obamacare that the Supremes struck down was the requirement that Medicaid, the government medical care program for the poor, be extended to 17 million additional Americans. That's now optional. At JAMA Forum, Aaron E. Carroll describes the Medicaid decision. Since the Feds will pay for all that expansion for the first few years and 90% thereafter, most states are expected to sign up, and some may even save money in the long run. Some, however, will run screaming. At Wonkblog, Sara Kliff explains how the states will make that decision.

IMPACTS ON OBSCURE CORNERS OF SCIENCE AND MEDICAL WRITING. There will be big effects on non-obvious corners of health care and, therefore, science and medical writing. Here are a couple, but I'm guessing more will be revealed in the coming weeks.

Something I'll bet you didn't know about the ACA is that it creates a fast-track approval process for products that are “biosimilar” (read: interchangeable) with biological products that the Food and Drug Administration has licensed already. At Patent Docs, a blog about pharma patent law, James DeGiulio — greatly relieved that the provision survived — provides analysis and a peek into the future of generic drugs. This is, of course, potentially huge.

Obamacare will be a boon to other medical research also, as Bob Grant explains at Naturally Selected. The areas include

the creation of a translational research initiative at the National Institutes of Health called the Cures Acceleration Network; the launch of the Physician Payment Sunshine Act, which would require pharmaceutical and device makers to disclose all payments greater than $10 to physicians, and a push to increase funding for comparative effectiveness research.

Another provision you may not know about, but which could have salutary long-term consequences for American health, is an ACA requirement that chain restaurants with more than 20 outlets must provide calorie information about their foodstuffs. The stipulation applies to vending machines too. At Food Politics, Marion Nestle explains.

So, is Justice Scalia right as well as right? Is the next step a government mandate declaring that everybody must buy broccoli?

AND FINALLY, SUPREME COURT/OBAMACARE HUMOR. Here's a selection of jokey stuff from Ezra Klein at Wonkblog. Not all are at the comical pinnacle, but the Obama-Biden drive-by is pretty funny. I am also amused by this one, but don't know why. I guess the magic is in the text, not the photo. Maybe you can explain to me why Ned Stark is germane.

Thanks to Obamacare, Ned Stark lives!

ONCE MORE, HIGGS BOSON NEWS. At Cosmic Variance, Sean Carroll (the physics one) tells us that CERN scientists in Switzerland will be celebrating the 4th of July next Wednesday by letting loose long-anticipated fireworks. They are holding a seminar where they are expected to maybe probably perhaps announce that they have maybe probably perhaps found the Higgs boson. Or maybe not. As you will recall, we have mentioned this here before. Carroll's lips are sealed.

At Physicsworld.com, James Dacey says the reason for the seminar is political. CERN, he speculates, wants to reserve a momentous announcement for home turf in Switzerland, rather than revealing their findings in Australia at the major particle-physics conference, ICHEP, which begins on the 4th too. OTOH, Dacey seesaws, maybe the announcement won't be quite as momentous as that after all.

For a very clear very basic summary of what the search for the Higgs particle is all about and how researchers look for it, see this post by Faye Flam at Planet of the Apes. I could do with a lot less cattiness, but this bout of preciousness is unusual for Flam. She's one of the best science journalists/bloggers around, and the only one I know of who's taken on the challenging assignment of teaching the general public about evolution in a daily newspaper. Sometimes you have to cut Cat People some slack. I have been one. They can't help it.

June 29, 2012

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