According to an analysis from the Los Angeles Times, the states with the greatest need to expand Medicaid also, unfortunately, have Republican leaders who are refusing to participate. This opposition could leave millions of the nation's poorest residents without insurance coverage, and will likely widen the divide between the nation's healthiest and sickest states.

Colon cancer deaths in states opposing Medicaid expansion, for example, are an average of 16% higher than in pro-expansion states, according to a Los Angeles Times analysis of state health data.

Deaths from breast cancer are 8% higher on average in anti-expansion states. And adults under 65 are 40% more likely on average to have lost six or more teeth from decay, infection or gum disease.

Medicaid by itself may not close those gaps, which also reflect income and education disparities. And the program's conservative critics, who contend it could ultimately sap state budgets, say poor Americans would be better helped by alternative strategies, including limits on government medical aid to encourage people to take responsibility for their own healthcare.

"Government assistance should not be an entitlement. Government assistance should not be a lifestyle," said Michigan House Speaker Jase Bolger, a Republican who has called for a complete overhaul of the state's Medicaid program, including a four-year limit on benefits for nondisabled adults. "Government assistance should be a temporary hand up. It should be a way to improve people's lives, not trap them in dependency."

Yet most state leaders who are fighting the Medicaid expansion have advanced few alternative plans to tackle their states' health shortfalls. That means that, at least in the short term, America's unhealthiest states could fall even further behind as the Affordable Care Act is implemented.

"Many states may be missing a real opportunity to reduce some of the big differences we see across the country in health," said Cathy Schoen, a health economist at the nonprofit Commonwealth Fund who has studied variations between states.

Residents of many of those states, those in the Deep South, would really love to see Medicaid expansion, a new survey suggests. Families USA polled in Alabama, Georgia, Louisiana, Mississippi and South Carolina -- places where the Medicaid expansion would cover millions of uninsured people -- and found that 62 percent of respondents support Medicaid expansion.

Not all Republican led states will be left behind; several high-profile conservative Republican governors, including John Kasich (Ohio), Rick Scott (Fla.), Jan Brewer (Ariz.) and Chris Christie (N.J.) have supported the expansion.

Arizona’s abortion law is unconstitutional, according to a federal appeals court. About a year ago, the state banned abortions after 20 weeks of pregnancy except in medical emergencies. But a circuit court now ruled that the government has no right to ban an abortion before a fetus “is viable.” The judge said the state “may not proscribe a woman from electing abortion, nor may it impose an undue burden on her choice through regulation.” Time will tell what this ruling means—particularly in other states with tough abortion restrictions such as North Dakota, which has banned abortions after six weeks of pregnancy.

The Hill:

“Today’s decision is a huge victory in the fight to protect women’s fundamental reproductive rights, and it should send a clear message to anti-choice politicians that their attempts to deprive pregnant women of critical health care are clearly unconstitutional and will not hold up in court," said Sally Northup, president of the Center for Reproductive Rights.

On October 1st, 25 million uninsured Americans will be able to sign up for health insurance through new health insurance marketplaces.

Don't be fooled by extremist members of Congress and their pointless efforts to repeal the healthcare law. Obamacare is the law of the land and on October 1st of this year, 25 million uninsured Americans will be able to enroll in health insurance plans through the newly created health insurance marketplaces.

Obamacare has already delivered benefits to 100 million Americans by:

- Providing preventive health services like well child visits, cancer screenings
and annual checkups at no additional cost;

- Allowing young adults to stay on a parent’s health insurance plan if they’re
under 26;

- Saving seniors on prescription medicines if they participate in Medicare;

- Providing coverage for people with pre-existing conditions; and

- Ending the worst insurance company abuses like charging women more than men for
the same coverage and putting arbitrary dollar limits on care.

Health insurance coverage will begin on January 1, 2014. Make sure everyone you know who is uninsured understands that healthcare access is close at hand.

Get started by watching this enrollment video. Then share it with your family, friends and colleagues.

H/T SEIU.org

Wendell Potter, senior analyst for the Center for Public Integrity and former head of public relations for CIGNA, joins Current TV’s John Fugelsang to weigh in on recently released Medicare data that reveals drastic disparities in what different hospitals charge for the same procedure.

“Medicare probably pays what is a reasonable amount of money for some of these procedures,” Potter says. “Hospitals have gone into debt, they get the latest bells and whistles that they don’t really need because the hospital across town has it so you’ve had kind of an arms race among hospitals to have all the equipment that in many cases is just a surplus of equipment, it’s a duplication of services.”

Current TV’s John Fugelsang, Salon.com staff writer Irin Carmon, and comedians Elayne Boosler and Lizz Winstead consider a spate of extremely restrictive abortion laws that have passed or are being considered in states across the country. Some, like a proposed law in Arkansas and another in North Dakota, directly violate Roe v. Wade by banning abortions before viability.

“The majority of Americans want abortion to be safe and legal,” says Carmon. But the restrictions that are being passed are not medically necessary, so why do people support them? “If you ask people why they’re passing (these restrictions), their particular end is to ban abortion, not make women safer.”

By Charles Ornstein, ProPublica

This story was co-published with The Washington Post.

My father, sister and I sat in the near-empty Chinese restaurant, picking at our plates, unable to avoid the question that we'd gathered to discuss: When was it time to let Mom die?

It had been a grueling day at the hospital, watching — praying — for any sign that my mother would emerge from her coma. Three days earlier she'd been admitted for nausea; she had a nasty cough and was having trouble keeping food down. But while a nurse tried to insert a nasogastric tube, her heart stopped. She required CPR for nine minutes. Even before I flew into town, a ventilator was breathing for her, and intravenous medication was keeping her blood pressure steady. Hour after hour, my father, my sister and I tried talking to her, playing her favorite songs, encouraging her to squeeze our hands or open her eyes.

Doctors couldn't tell us exactly what had gone wrong, but the prognosis was grim, and they suggested that we consider removing her from the breathing machine. And so, that January evening, we drove to a nearby restaurant in suburban Detroit for an inevitable family meeting.

My father and sister looked to me for my thoughts. In our family, after all, I'm the go-to guy for all things medical. I've been a health-care reporter for 15 years: at the Dallas Morning News, the Los Angeles Times and now ProPublica. And since I have a relatively good grasp on America's complex health-care system, I was the one to help my parents sign up for their Medicare drug plans, research new diagnoses and question doctors about their recommended treatments.

In this situation, like so many before, I was expected to have some answers. Yet none of my years of reporting had prepared me for this moment, this decision. In fact, I began to question some of my assumptions about the health-care system.

I've long observed, and sometimes chronicled, the nasty policy battles surrounding end-of-life care. And like many health journalists, I rolled my eyes when I heard the phrase "death panels" used to describe a 2009 congressional proposal that would have allowed Medicare to reimburse physicians who provided counseling to patients about living wills and advance directives. The frenzy, whipped up by conservative politicians and talk show hosts, forced the authors of the Affordable Care Act to strip out that provision before the bill became law.

Continue reading »

Thousands of demonstrators marched through the streets of 16 Spanish cities Sunday to protest plans to privatize parts of their public health care system, with some questioning the government’s motives.

It was the third “white tide” demonstration in Madrid, named after the color of the medical scrubs many protesters wear. But it was the first time cities other than the capital took part, including Barcelona, Cuenca, Murcia, Pamplona, Toledo and Zaragoza. Protesters marched carrying banners saying “Public health is not to be sold, it’s to be defended.”

Health care and education are administered by Spain’s 17 semiautonomous regions. Some indebted ones, like Madrid, have announced the privatization of some services, with many people openly suspicious that the move is more a political-motivated ploy than an attempt to cut costs.

"White Coat" protesters march in protest in Madrid.

Americans are "far" unhealthier than their counterparts in Canada, Australia, Japan, Britain, France, Portugal, Italy and Germany and eight other countries, according to a study from the National Academy of Sciences.

These findings come even though here in the U.S. we spend $8,600 a year per person on healthcare, which is more than twice as much Britain, France and Sweden, "even with their universal healthcare systems."

NBC News:

“The size of the health disadvantage was pretty stunning,” Woolf told reporters in a telephone briefing.

Americans did worse in nine areas: infant mortality; injury and homicide rates; teen pregnancy and sexually transmitted diseases; the AIDS virus; drug abuse; obesity and diabetes; heart disease; lung disease; and disabilities.

And many of these affect young people, not the elderly. Americans are seven times more likely to be murdered than people in the other countries, and 20 times more likely to be killed by a gun.

"I don't think most parents know that, on average, infants, children, and adolescents in the U.S. die younger and have greater rates of illness and injury than youth in other countries,” Woolf said.

“For many years, Americans have been dying at younger ages than people in almost all other high-income countries,” the expert panel wrote.

We also have a higher infant mortality rate than the other countries, with 32.7 deaths per 100,000. Other countries have infant mortality rates between 15 and 25 deaths per 100,000.

The report wasn't all bad for the U.S., Americans have lower death rates from cancer, the No. 2 cause of death, and do better at controlling blood pressure and cholesterol. “Americans who reach age 75 can expect to live longer than people in the peer countries,” the report reads.

The experts who wrote the report suggested that our culture here in the U.S. has much to do with the negative findings, and suggested that "policymakers" take action to reverse the trend.

In a revealing interview with The Wall Street Journal, House Speaker John Boehner discussed the conversations he had with President Obama during closed-door fiscal-cliff negotiations. Appearing to have a case of battle fatigue after weeks of negotiations, at one point in the interview Boehner said "I need this job like I need a hole in the head." He says he was most shocked by Obama saying that Washington doesn’t have a spending problem. The speaker, just entering his second term, also explained his notorious “Go f--k yourself” snap at Senate Majority Leader Harry Reid. “I was in Ohio, and Harry’s on the Senate floor calling me a dictator and all kinds of nasty things. You know, I don’t lose my temper. I never do. But I was shocked at what Harry was saying about me,” he said. Boehner also discussed his decision to vote for the Senate tax package, saying a "no" vote would do "serious damage to the economy.”

"What stunned House Speaker John Boehner more than anything else during his prolonged closed-door budget negotiations with Barack Obama was this revelation: "At one point several weeks ago," Mr. Boehner says, "the president said to me, 'We don't have a spending problem.' "

"I am talking to Mr. Boehner in his office on the second floor of the Capitol, 72 hours after the historic House vote to take America off the so-called fiscal cliff by making permanent the Bush tax cuts on most Americans, but also to raise taxes on high earners. In the interim, Mr. Boehner had been elected to serve his second term as speaker of the House. Throughout our hourlong conversation, as is his custom, he takes long drags on one cigarette after another."

"Mr. Boehner looks battle weary from five weeks of grappling with the White House. He's frustrated that the final deal failed to make progress toward his primary goal of "making a down payment on solving the debt crisis and setting a path to get real entitlement reform." At one point he grimly says: "I need this job like I need a hole in the head."'

"The president's insistence that Washington doesn't have a spending problem, Mr. Boehner says, is predicated on the belief that massive federal deficits stem from what Mr. Obama called "a health-care problem." Mr. Boehner says that after he recovered from his astonishment—"They blame all of the fiscal woes on our health-care system"—he replied: "Clearly we have a health-care problem, which is about to get worse with ObamaCare. But, Mr. President, we have a very serious spending problem." He repeated this message so often, he says, that toward the end of the negotiations, the president became irritated and said: "I'm getting tired of hearing you say that."'

"With the two sides so far from agreeing even on the nature of the country's fiscal challenge, making progress on how to address it was difficult. Mr. Boehner became so agitated with the lack of progress that he cursed at Senate Majority Leader Harry Reid. "Those days after Christmas," he explains, "I was in Ohio, and Harry's on the Senate floor calling me a dictator and all kinds of nasty things. You know, I don't lose my temper. I never do. But I was shocked at what Harry was saying about me. I came back to town. Saw Harry at the White House. And that was when that was said," he says, referring to a pointed "go [blank] yourself" addressed to Mr. Reid."

"Mr. Boehner confirms that at one critical juncture he asked Mr. Obama, after conceding on $800 billion in new taxes, "What am I getting?" and the president replied: "You don't get anything for it. I'm taking that anyway."'

And here you have the latest go-to Republican talking point, "But, Mr. President, we have a very serious spending problem."

Yet in the last year in the Budget Control Act, and the 2011 spring budget deal to avert a shutdown, Congress actually cut $1.5 trillion in spending. After reduced interest payments due to a smaller debt are factored in, a good deal more than $1.5 trillion is cut from spending. The interest savings amount to about $250 billion, bringing the total deficit reduction achieved to date to more than $1.7 trillion. And before that, there was the $700 billion in reduced Medicare spending passed in the Affordable Care Act in 2010.

We have indeed already confronted the "spending problem."

Not that this will keep the GOP from trying to do away with those pesky "entitlements."

In endorsing President Obama this morning, Colin Powell slammed Mitt Romney’s foreign policy as a “moving target.” He said Romney hasn’t thought through national security issues, which is why he’s espousing the “very, very strong neo-conservative views” of his advisers and tried to change all of his extreme positions in the final presidential debate. Powell also cited the President’s leadership on job creation, immigration, education, and health care as reasons for endorsing the President.

"You know, I voted for him in 2008 and I plan to stick with him in 2012, and I'll be voting for he and Vice President Joe Biden next month," he said on CBS' "This Morning."

POWELL: I signed on for a long patrol with President Obama and I don't think this is the time to make such a sudden change. And not only am I not comfortable with what Governor Romney is proposing for his economic plan, I have concerns about his views on foreign policy. The Governor, who was speaking on Monday night at the debate, was saying things that were quite different from what he said earlier. So I'm not quite sure which Governor Romney we would be getting with respect to foreign policy.

O’DONNELL: What concerns do you have about Governor Romney's foreign policy?

POWELL: Well, it's hard to fix it. I mean, it's a moving target. One day he has a certain strong view about staying in Afghanistan, but then on Monday night he agrees with the withdrawal. Same thing in Iraq. On almost every issue that was discussed on Monday night, Governor Romney agreed with the President with some nuances. But this is quite a different set of foreign policy views than he had earlier in the campaign. And my concern, which I've expressed previously in a public way, is that sometimes I don't sense that he has thought through these issues as thoroughly as he should have, and he gets advice from his campaign staff that he then has to adjust to modify as he goes along.

ROSE: Are you concerned about the people that are advising Governor Romney?

POWELL: I think there's some very, very strong neo-conservative views that are presented by the Governor that I have some trouble with. There are other issues as well, not just the economy and foreign policy. I'm more comfortable with President Obama and his administration when it comes to issues like what are we going to do about climate, what are we going to do about immigration? What are we going to do about education? Lots of things like that. I do not want to see the new Obamacare plan thrown off the table. It has issues, you have to fix some things in that plan. But what I see when I look at that plan is 30 million of our fellow citizens will now be covered by insurance. And I think that's good. We're one of the few nations in the world, with our size, population and wealth, that does not have universal health care.