The Plain Dealer, October 11, 2013

The Cleveland Clinic's recent news that it would soon cut staff, seeking to save $330 million, brought immediate reaction: This is what happens under Obamacare. This was the sentiment in Tennessee, too, when Vanderbilt University's medical center announced cuts. And certain elements were true, say health care and hospital analysts who note how changes in the way hospital get paid under the Affordable Care Act will affect their bottom line. But they say the criticism, voiced by commentators and scores of other critics of health-care reform, lacked context or failed to explain how other forces – including a U.S. Supreme Court ruling and decisions made in Washington, Columbus and other state capitals since the act passed – are playing a direct role in the hospitals' worries.

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