First Edition: October 21, 2009

As Senate Democrats wrestle with a doctor payment bill separate from sweeping health care reform proposals, the public plan, public opinion and health care costs continue to be a Capitol Hill focus.

Dr. John Kitzhaber's Unorthodox Ideas On Reforming Health Care When Dr. John Kitzhaber was president of the Oregon Senate, the state's languishing economy was tightening the screws on Medicaid outlays. But Kitzhaber, a Democrat, and others wanted to find a way to avoid having to drop residents from the federal-state health program for the poor and disabled, and they came up with a radical idea (Kaiser Health News).

White House Relies On Core Healthcare Team Peter R. Orszag, the White House official steeped in budget detail, is now so at home in the Capitol that he freely grabs Coke Zeros from the Senate Finance Committee's private stash when he talks healthcare costs with aides (Los Angeles Times).

Advocates Urge Action Now To 'fix' Medicare Doctor Payments Legislation to "fix" Medicare's physician payment formula has stalled in the Senate, just days after Majority Leader Harry Reid, D-Nev., announced his intent to fast-track the measure (Kaiser Health News).

Senate Democrats Hit Snag With Doctor Payment Bill In the face of solid Republican opposition, Senate Democrats on Tuesday backed down from their effort to increase Medicare payments to doctors without offsetting any of the cost over the next 10 years. It was the first skirmish in a larger partisan battle over President Obama's effort to remake the health care system in a fiscally responsible way (The New York Times).

Who Will Rein In Healthcare Costs? Don't Look To Congress. As Congress grapples with how to rein in the high cost of healthcare in America, the option of outsourcing hard decisions to a new, independent commission is gaining momentum. Backers say a commission with a mandate to improve America's healthcare delivery system and rein in unsustainable costs could be a game-changer (The Christian Science Monitor).

Fight Over Medicare Cuts Plays Into Larger Debate Senators battled Tuesday over legislation to forestall a cut in Medicare payments to doctors, trying to seize the advantage in the larger health debate (The Wall Street Journal).

Dem Thumbs Down To Reid Doctors Deal A group of Senate Democrats is threatening to derail a deal Majority Leader Harry Reid offered to doctors in exchange for their support of President Barack Obama's healthcare initiative (The Hill).

Liberals Increase Pressure For Public Insurance Plan In Health Bill Senate Majority Leader Harry M. Reid is facing intensifying pressure from liberal lawmakers to revive a proposed government insurance plan before health-care reform legislation reaches the Senate floor, amid signs that moderate Democrats may be warming to the idea (The Washington Post).

Pelosi To Stick With Liberals On Public Health Insurance Option House Speaker Nancy Pelosi is sticking with the liberal wing of her party on healthcare by choosing to go to the House floor with a public option based on Medicare, according to Democratic sources (The Hill).

Pelosi Pushes Strong Public Option Speaker Nancy Pelosi told Democrats Tuesday night that she wants to move forward with the more liberal version of a House health reform bill that would peg government-run coverage to Medicare - setting up a clash with moderates in her caucus who oppose the plan (Politico).

Watching Washington: Who Care What The Public Says About Public Option? The Washington Post has headlined a story about a poll it took with ABC News showing that the "public option" feature of the health care debate is supported by a clear majority of Americans. But does that mean the public option will be in the final bill? Don't bet on it (NPR).

Poll: Americans Skittish Over Health Changes Americans are increasingly worried about the cost and quality of medical care that could result from President Obama's effort to revamp health care, but a majority still trust him more than Republicans to change the system, a USA TODAY/Gallup Poll shows (USA Today).

Medicare For Everyone Say hello to "Medicare Part E" — as in, "Medicare for Everyone." House Democrats are looking at re-branding the public health insurance option as Medicare, an established government healthcare program that is better known than the public option (The Hill).

AP Source: House Dems Trim Health Bill To $871B House Democrats are aiming to scale back the cost of their health care bill to well below President Barack Obama's preferred price tag by giving the government a strong hand in selling insurance in competition with the private market (The Associated Press).

Dems Eye Insurance Industry's Antitrust Protection Top Senate Democrats intend to try to strip the health insurance industry of its exemption from federal antitrust laws as part of the debate over health care, according to congressional officials, the latest evidence of a deepening struggle over President Barack Obama's top domestic priority (The Associated Press).

Drug Coupons Hide True Costs From Consumers As he makes his case for overhauling the American health care system, President Obama has used the analogy of patients getting a choice between a blue pill and a red pill. The blue pill is just as effective as the red pill, but costs half as much. If everyone would just choose the blue pill, the analogy goes, we could save our health care system a lot of money (NPR).

Medicare Drug Planners Now Lobbyists, With Billions At Stake Four years ago, a group of lawmakers and aides crafted Medicare Part D, the prescription drug program for seniors that has produced billions of dollars of profits for pharmaceutical companies. Today, at least 25 of those key players are back, but this time they're lobbyists, trying to persuade their former colleagues to protect the lucrative system during the health care reform negotiations (ProPublica and CBS News).

Health Insurer Tries To Avoid Owning Up To Error Who should pay when a health insurer screws up? Not the insurer, apparently (Los Angeles Times).

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