Health Care Reform

Throughout the heroic struggle in Congress to provide a "public option" in health insurance, one question never seems to get answered: Why are we so intent on protecting the private option? The "public option," as followers of the debate know, is a government-sponsored health plan that would be available as an alternative to, and in competition with, the for-profit health insurance industry, otherwise known as the private option.

President Obama, struggling to discredit bogus charges that his healthcare overhaul would create "death panels," soon could face another emotionally charged obstacle -- a plan to trim the federal subsidy for a program used by nearly a quarter of Medicare beneficiaries. The program, known as Medicare Advantage, pays insurance companies a hefty premium to enroll senior citizens and provide their medical services through managed-care networks. But whether the higher payments are worth it is a matter of dispute.

The American Medical Assn., after 60 years of opposing any government overhaul of healthcare, is now lobbying and advertising to win public support for President Obama's sweeping plan -- a proposal that promises hundreds of billions of dollars for America's doctors. Of all the interest groups that have won favorable terms in closed-door negotiations this year, the association representing the nation's physicians may have taken home the biggest prizes, including an agreement to stop planned cuts in Medicare payments that are worth $228 billion to doctors over 10 years.

Capping months of work, House Democratic leaders on Tuesday introduced their plan for a sweeping remake of the nation's healthcare system. Among the provisions in the 1,018-page bill: creation of a new government insurance option, increased regulation of the insurance industry and other steps to ensure near-universal medical coverage for the first time in U.S. history. The bill would also set out new initiatives to begin curbing costs in a healthcare system that is expected to consume nearly $2.

They led the most powerful forces in healthcare -- the trade groups representing doctors, insurance companies, hospitals and drug makers. Any one of them could stall, if not derail, President Obama's hopes of overhauling the U.S. healthcare system. Instead, they stood with Obama before TV cameras at the White House and pledged their cooperation. For Obama, the show of unity gave momentum to perhaps his most ambitious domestic goal.

The genius of modern marketing is pouring old material into new packaging. Over the years this has given us yogurt in tubes, prechopped salad greens in cellophane bags and, most recently, the health insurance industry's new image as a friend of reform.

With House leaders struggling to reach agreement on healthcare legislation, aiming toward a possible vote this week, a new hurdle has emerged: abortion. Some conservative Democrats are threatening to pull their support from the massive healthcare bill unless their concerns over potential federal funding of abortion procedures are met. They fear that the Obama administration will take advantage of an expanded government role in healthcare to increase the availability of abortions nationwide.

In an age when Americans compare hotel rooms, cars and even prospective mates with the click of a mouse, helping people identify the most cost-effective medical care seems like common sense. But when President Obama included money in his economic stimulus plan to do just that, he set off one of the sharpest, and most unexpected, political fights of his young administration. Though Obama prevailed -- securing $1.

Senior House Democrats on Friday introduced their plan for reshaping the nation's healthcare system, calling for a new government insurance option, a new mandate on employers to provide coverage and a new guarantee of subsidized healthcare for the poor. The draft -- the fullest presentation so far of congressional liberals' vision for overhauling medical care -- offered few indications of how such a plan would be financed. The price tag is expected to top $1 trillion.

The broad outlines of the $3.5-trillion spending blueprint that Congress approved this week hews closely to President Obama's spending targets and pays homage to his ambitious agenda. But the fine print contains a sobering warning about his marquee initiatives on healthcare, energy, education and economic recovery. Congress' message: We can't do it all at once.