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….the Massachusetts vote is a loud and clear signal that the American people hate this legislation. Barack Obama came into office assuming that economic distress would move most Americans to favor big-government legislation. It turns out that’s not so. Not when Democratic bills would take away the health insurance most of them are content with. Not when it’s the product of backroom deals and blatant political bribery.

But Scott Brown’s victory was not just a rejection of Democrats’ health care plans. Brown also stoutly opposed the Democrats’ cap-and-trade legislation to reduce carbon emissions. He spoke out strongly for trying terrorists like the Christmas bomber in military tribunals, not in the civil court system where lawyers would advise them to quit talking. He talked about cutting taxes rather than raising them as Democrats are preparing to do.

Brown’s victory represents a rejection of Obama administration policies that were a departure from those of the Bush administration. In contrast, on Afghanistan, where Obama is stepping up the fight, Brown backed Obama while his hapless left-wing opponent Martha Coakley was forced (her word) to oppose it to win dovish votes in the Democratic primary.

Democrats will be tempted to dismiss Brown’s victory as a triumph of an appealing candidate and the rejection of an opponent who proved to be a dud. But Brown would never have been competitive if Americans generally favored the policies of the Obama administration and congressional Democratic leaders. In that case, even a dud would have trounced the man who drives a truck.

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Republicans scored an historic victory overnight that put President Barack Obama’s agenda in jeopardy exactly a year after he took power – and could kill health-care reform.

A little-known Republican state legislator came from a 30-percentage point deficit to win Edward Kennedy’s old seat in the US Senate in Massachusetts in what appeared to be a massive protest vote against the party that controls both chambers of Congress and the White House.

“This is a huge wake-up call for the Democrats, for the Obama Administration and the country. America is fed up of the arrogance coming from Washington,” said Andy Card, White House chief of staff in the George W. Bush Administration.

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From here:

In many ways the campaign in Massachusetts became a referendum not only on health care reform but also on the openness and integrity of our government process. It is vital that we restore the respect of the American people in our system of government and in our leaders. To that end, I believe it would only be fair and prudent that we suspend further votes on health care legislation until Senator-elect Brown is seated.

The White House’s announcement yesterday that it will schedule its State of the Union address for next Wednesday, January 27th, an earlier date than most insiders expected, is surely not coincidental and reflects a desire to pressure the House into voting for the Senate’s version of the health care bill almost immediately, assuming that Scott Brown defeats Martha Coakley in Massachusetts tonight.

The pitch that the White House and Nancy Pelosi will make to the Democratic members of the House is a difficult one and will need to be extremely well executed, but is likely to consist of one or more of the following arguments….

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The uncertainty surrounding the suddenly-too-close-to-call Massachusetts Senate special election, as well as its high stakes, has political handicappers and strategists wondering if maybe they’ve seen this one before – in 1991, when long-shot Democrat Harris Wofford seized on the health care issue to pull off a shocking Pennsylvania special election victory that sent tremors across the political landscape.

It’s hard not to notice the similarities between the 1991 Senate special election and the current Massachusetts Senate contest.

Much like Republican Scott Brown in Massachusetts, Wofford, a little-known Democrat who had been appointed to the late Republican Sen. John Heinz’s seat, began the race as a distinct underdog, and few expected he would be able to overcome former Gov. Dick Thornburgh, who left his post as U.S. attorney general to run for the seat.

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Read it all. I see over on Intrade that Brown is up to 70 and Coakley is down to 30. It will be stunning if it holds–KSH.

Even if Democrats lose the Jan. 19 special election to pick a new Massachusetts senator, Congress may still pass a health-care overhaul by using a process called reconciliation, a top House Democrat said.

That procedure requires 51 votes rather than the 60 needed to prevent Republicans from blocking votes on President Barack Obama’s top legislative priorities. That supermajority is at risk as the Massachusetts race has tightened.

“Even before Massachusetts and that race was on the radar screen, we prepared for the process of using reconciliation,” said Chris Van Hollen of Maryland, chairman of the Democratic Congressional Campaign Committee.

“Getting health-care reform passed is important,” Van Hollen said in an interview on Bloomberg Television’s “Political Capital with Al Hunt,” airing this weekend. “Reconciliation is an option.”

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The White House has reached a tentative agreement with labor leaders to tax high-cost health insurance policies, sources said Thursday. The agreement clears one of the last major obstacles on the path to final passage of comprehensive health care legislation.

White House press secretary Robert Gibbs said health care negotiators are “very, very close” to an overall deal and hope to have resolved most of their differences by day’s end. But White House officials privately cautioned that their optimism does not mean that a final health care deal will be formally announced Thursday.

Four labor negotiators briefed lawmakers on the parameters of the deal at a luncheon at the Capitol. Lawmakers said the agreement would raise the cost of unusually generous health policies and ignore secondary coverage, such as vision and dental plans. Health plans negotiated as part of collective-bargaining agreements would be exempt for two years after the 2013 effective date, giving labor leaders time to negotiate new contracts.

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David Walker, chief executive officer at Peter G Peterson Foundation and former U.S. Comptroller, talks with Bloomberg’s Carol Massar and Matt Miller about the U.S. financial crisis.

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A potential wave of new regulation and higher taxes may be scaring many businesses from hiring, prolonging any rebound in employment, say business groups and economists.

The prospect of increased federal and state regulation and taxes has been particularly disruptive to the hiring plans of small- and medium-sized businesses, which have historically generated about two-thirds of the nation’s jobs.

“I don’t really see the private sector hiring much in the next few months,” says Brian Bethune, an economist at Global Insight. “For the small-business sector there is just too much uncertainty about what happens beyond 2010.”

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Michael Sertic, a college senior studying economics, is young and healthy, and he doesn’t want the government forcing him to buy health insurance.

He is among a group of people on both the right and the left ends of the political spectrum who object to proposals in Congress that would compel nearly every American to buy health insurance or face a fine.

“I happen to believe it’s unconstitutional. Government shouldn’t be forcing someone to pay for someone else’s health care,” said Sertic, 24, a member of Students for Liberty, a club at California State University, Sacramento, that espouses libertarian values.

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Passage of the health-care bill will be, for the administration, a catastrophic victory. If it is voted through in time for the State of the Union Address, as President Obama hopes, half the chamber will rise to their feet and cheer. They will be cheering their own demise.

If health care does not pass, it will also be a disaster, but only for the administration, not the country. Critics will say, “You didn’t even waste our time successfully.”

What a blunder this thing has been, win or lose, what a miscalculation on the part of the president. The administration misjudged the mood and the moment. Mr. Obama ran, won, was sworn in and began his work under the spirit of 2008””expansive, part dreamy and part hubristic. But as soon as he was inaugurated ,the president ran into the spirit of 2009””more dug in, more anxious, more bottom-line””and didn’t notice. At the exact moment the public was announcing it worried about jobs first and debt and deficits second, the administration decided to devote its first year to health care, which no one was talking about. The great recession changed everything, but not right away.

In a way Mr. Obama made the same mistake President Bush did on immigration, producing a big, mammoth, comprehensive bill when the public mood was for small, discrete steps in what might reasonably seem the right direction.

Read it all from today’s Wall Street Journal.

As this debate moves toward conclusion, it is crucial that we remember why we’re trying to provide quality, affordable health care to Virginia’s families. In March 2009, the Episcopal Church published its position on health reform in a booklet titled “Promoting Health Care for All.” The booklet was circulated by the Episcopal Public Policy Network, and includes this quote from the Book of Common Prayer:

“Almighty and most merciful God, we remember before you all poor and neglected persons whom it would be easy for us to forget: the homeless and the destitute, the old and the sick, and all who have none to care for them. Help us to heal those who are broken in body and spirit, and to turn their sorrow into joy. Grant this, Father, for the love of your Son, who for our sake became poor, Jesus Christ our Lord. Amen.”

But the Episcopal Church is not alone. In June 2009 other Christians have also declared that health reform was an urgent priority in a press release: “The health of our neighbors and the wholeness of the nation now require that all segments of our society join in finding a solution to this national challenge.”

Recently, the Episcopal Diocese of Virginia supported a resolution reiterating “the Gospel message of concern for others which extends to concern for their physical health as well as spiritual well being.”

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The Mayo Clinic, praised by President Barack Obama as a national model for efficient health care, will stop accepting Medicare patients as of tomorrow at one of its primary-care clinics in Arizona, saying the U.S. government pays too little.

More than 3,000 patients eligible for Medicare, the government’s largest health-insurance program, will be forced to pay cash if they want to continue seeing their doctors at a Mayo family clinic in Glendale, northwest of Phoenix, said Michael Yardley, a Mayo spokesman. The decision, which Yardley called a two-year pilot project, won’t affect other Mayo facilities in Arizona, Florida and Minnesota.

Obama in June cited the nonprofit Rochester, Minnesota-based Mayo Clinic and the Cleveland Clinic in Ohio for offering “the highest quality care at costs well below the national norm.” Mayo’s move to drop Medicare patients may be copied by family doctors, some of whom have stopped accepting new patients from the program, said Lori Heim, president of the American Academy of Family Physicians, in a telephone interview yesterday.

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MR. GREGORY: Well, let, let’s talk about the status quo, Mayor Bloomberg. Something you’ve thought a lot about is how much do we spend on individuals in this country for health care, and what’s the result on the other side? What’s life expectancy? And let’s just put these numbers up here, because they’re pretty striking. The United States spends more than most other countries, by a whole lot, $7200-plus per individual. And yet, the life expectancy is 78, far younger than countries that spend far less per person.

MAYOR MICHAEL BLOOMBERG (I): Well, we’re unwilling to ask the question, what we’re getting for our money? And I think both sides of that graph you just showed really talk about it. We are spending more than we can afford. We will go bankrupt if we keep increasing medical costs at the rate we’ve been doing it. And life expectancy, arguably the primary purpose of government is to increase life expectancy, and we are not doing that. Instead, we talk about other things, some laudable, some desperately that we have to do. And I will say, I’ve given the president a lot of credit for taking on the issue; but it’s Congress that’s writing this legislation, and they are not willing to go near the things that will contain costs, which is immigration reform, tort reform, asking the question of whether or not we can afford certain tests and whether they really are cost beneficial. And we are not willing to work on the preventive things, fighting obesity, smoking, those kinds of things, or crime in the streets, which is another big influence on our life expectancy. But we’re just not willing to talk those tough issues.

Read it all (start toward the bottom of the page).

American presidents, it is often said, have about a year to make their mark ”“ enact a major piece of legislation that then shapes and defines the rest of their term in office. Failure to choose the right weapons, or the right turf, can be fatal.

Barack Obama has at times struggled to find a cause he can truly make his own. He seemed to take on too many issues at once, from Middle Eastern peace to climate change, without demonstrating that he had a clear strategy to carry them through. With the Senate’s passage of his bitterly contested healthcare bill, the clouds have lifted a little. Just in time for the Christmas break, the President can afford to wipe the sweat from his brow and contemplate his holiday with some satisfaction.

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The final vote was 60-39 and came along party lines (as did each of the first five procedural votes that took place earlier this week).

Senator Jim Bunning (R-KY) was the lone Senator not to vote.

Thursday’s vote — which comes on the first Senate session on Dec. 24 in more than five decades — will bring Democrats closer than ever to realizing their 70-year-old goal of universal health coverage.

For the first time, most Americans would be required to obtain health insurance, either through their employer or via new, government-regulated exchanges. Those who can’t afford insurance plans would receive federal subsidies. And Medicaid would be vastly expanded to reach millions of low-income children and adults.

Difficult issues must be still resolved in final negotiations with the House, which has passed more liberal health-care reform legislation, and those talks could stretch through January and perhaps into February, Democratic leaders said. But Democrats are increasingly confident that President Obama would sign a bill into law in early 2010.

“Health care reform is not a matter of ‘if,’ ” White House spokesman Robert Gibbs told reporters Wednesday. “Health care reform now is a matter of ‘when.’ ”

Senate Majority Leader Harry Reid declared after Wednesday’s vote that: “We stand on the doorstep of history.” But he declined to speculate about negotiations with the House.

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[Robert] SIEGEL: Mr. President, some people have faulted this whole process for not focusing enough on how medicine is practiced in the U.S. and our appetite for lots of tests and the like. I want to ask about a recent, coincidental event, which would be the new guidelines on mammography. They suggested that we’ve been testing too much and it would be better to get tested less. There was an outcry. Your own secretary of HHS backed away from the new recommendations. What does that say to you about how best practices can actually be instituted in the country?

{President] OBAMA: Well, I think what it says, No. 1, is that we still have a tendency to think that more medicine is often ”” is automatically better medicine. And that’s just not the case. Inside this reform bill that I’m pushing is a provision that has a panel of experts ”” doctors, medical experts ”” who are going to look at all these practices to start changing how we think about medicine.

SIEGEL: Will politicians defer to their judgments ”” to their scientific judgments?

OBAMA: Well, one of my goals is to make sure that doctors and scientists are giving the best information possible to other doctors who are seeing patients. Look, if you talk to most health care economists right now, they will tell you that every good idea out there, when it comes to improving quality of care and reducing costs of care, are embedded in this bill. It’s not going to happen overnight because we’re going to have to change both how doctors think about health care and how patients think about health care.

And there are going to be millions of small decisions all across the country and interactions between doctors and patients that, over time, change the trajectory of our health care system. The important point is that we’re getting started in this process. And I’m actually very confident that the average person is going to say to themselves, if, right now, I’m taking and paying for five tests and my doctor tells me that I only need one, that person’s going to want to take one ”” save some money and save some time. But they need some validation. They need somebody who’s giving them the better information. And we have set up a system where, year after year, best practices are going to get disseminated across the country.

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The Senate’s healthcare bill is fatally flawed, a senior Democrat atop a powerful committee said on Wednesday.

Rep. Louise Slaughter (D-N.Y.), the chairwoman of the House Rules Committee and co-chairwoman of the Congressional Pro-Choice Caucus, said that the Senate’s bill is so flawed that it’s unlikely to be resolved in conference with the bill to have passed the House.

“The Senate health care bill is not worthy of the historic vote that the House took a month ago,” Slaughter wrote in an opinion piece for CNN’s website.

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The Ronald Reagan U.C.L.A. Medical Center, one of the nation’s most highly regarded academic hospitals, has earned a reputation as a place where doctors will go to virtually any length and expense to try to save a patient’s life.

“If you come into this hospital, we’re not going to let you die,” said Dr. David T. Feinberg, the hospital system’s chief executive.

Yet that ethos has made the medical center a prime target for critics in the Obama administration and elsewhere who talk about how much money the nation wastes on needless tests and futile procedures. They like to note that U.C.L.A. is perennially near the top of widely cited data, compiled by researchers at Dartmouth, ranking medical centers that spend the most on end-of-life care but seem to have no better results than hospitals spending much less.

Listening to the critics, Dr. J. Thomas Rosenthal, the chief medical officer of the U.C.L.A. Health System, says his hospital has started re-examining its high-intensity approach to medicine. But the more U.C.L.A.’s doctors study the issue, the more they recognize a difficult truth: It can be hard, sometimes impossible, to know which critically ill patients will benefit and which will not.

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Rep. Bart Stupak (D-Mich.) said the White House and the Democratic leadership in the House of Representatives have been pressuring him not to speak out on the “compromise” abortion language in the Senate version of the health care bill.

“They think I shouldn’t be expressing my views on this bill until they get a chance to try to sell me the language,” Stupak told CNSNews.com in an interview on Tuesday. “Well, I don’t need anyone to sell me the language. I can read it. I’ve seen it. I’ve worked with it. I know what it says. I don’t need to have a conference with the White House. I have the legislation in front of me here.”

The Michigan Democrat succeeded last month in getting 64 House Democrats to join him in attaching his pro-life amendment to the House version of the health-care bill. The “Stupak amendment,” as the provision is known, would prohibit the federal government from allocating taxpayer money to pay for any part of any health insurance plan that covers abortion except in cases of rape, incest, or when the life of the mother is in danger.

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Americans will feel the pain before the gain from the health care overhaul Democrats are close to pushing through Congress.

Proposed taxes and fees on upper-income earners, insurers, even tanning parlors, take effect quickly. So would Medicare cuts.

Benefits, such as subsidies for lower middle-income households, consumer protections for all and eliminating the prescription coverage gap for seniors, come gradually.

“There’s going to be an expectations gap, no question about that,” said Drew Altman, president of the nonpartisan Kaiser Family Foundation. “People are going to see their premiums and out-of-pocket costs go up before the tangible benefits kick in.”

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[U.S. House Majority Whip Jim] Clyburn said the high-profile deal that Nebraska Sen. Ben Nelson reached to have the federal government pay 100 percent for Medicaid expansion in his state will help land South Carolina a better deal during the conference negotiations.

Nelson was given the perk in return for agreeing to vote for the bill. Nelson’s vote all but assures the bill’s final passage later this week.

Other states would receive reimbursements worth 91 percent. Clyburn said he will be a party to the conference negotiations and he will push for states to receive a 95 percent return for the life of the bill, but he cannot guarantee he will get it.

“Rather than carping on this, I think it opens the door for other states to demonstrate need for similar treatment when you get to the conference,” Clyburn said.

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The State of the Union typically takes place on the third Tuesday of January, which would be Jan. 19.

But it’s unclear whether negotiators will be able to smooth out significant disagreements in such a short time.

Congress traditionally does not reconvene until the week of the president’s address but leaders may bring their colleagues back to work early to get a jumpstart on remaining legislative work before election-year politics begins to intervene….

[Max] Baucus said differences over how to pay for new federal health insurance subsidies and limits on abortion coverage are two of the biggest obstacles.

The House legislation would pay for a large portion of its benefits by imposing a tax surcharge on individuals who earn more than $500,000 and families earning over $1 million.

The Senate bill would instead tax high-cost insurance plans and raise the Medicare payroll tax on individuals earning over $200,000 and families earning more than $250,000.

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The manager’s amendment is light years removed from the Stupak-Pitts Amendment that was approved by the House of Representatives on November 8 by a bipartisan vote of 240-194. The new abortion language solves none of the fundamental abortion-related problems with the Senate bill, and it actually creates some new abortion-related problems.

NRLC will score the upcoming roll call votes on cloture on the Reid manager’s amendment, and on the underlying bill, as votes in favor of legislation to allow the federal government to subsidize private insurance plans that cover abortion on demand, to oversee multi-state plans that cover elective abortions, and to empower federal officials to mandate that private health plans cover abortions even if they do not accept subsidized enrollees, among other problems.

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Bishops William F. Murphy of Rockville Centre, N.Y., and John C. Wester of Salt Lake City, who chair the committees on Domestic Justice and Human Development and on Migration, respectively, joined Cardinal DiNardo in the Dec. 19 statement.

Although praising the manager’s amendment for including Casey’s expansion of adoption tax credits and assistance for pregnant women, the statement cited two remaining problems:

— “It does not seem to allow purchasers who exercise freedom of choice or of conscience to ‘opt out’ of abortion coverage in federally subsidized health plans that include such coverage. Instead it will require purchasers of such plans to pay a distinct fee or surcharge which is extracted solely to help pay for other people’s abortions.

— “The government agency that currently manages health coverage for federal employees will promote and help subsidize multi-state health plans that include elective abortions, contrary to longstanding law governing this agency.”

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The healthcare reform bill that will go to the vote on the US Senate floor this week falls well short of Barack Obama’s original vision.

As the president took office at the beginning of this year, he laid out a plan for reform including a robust “public option” for a nationwide government-backed scheme that would inject a bolt of competition into the inefficient medical insurance market.

Instead, he is set next month to sign into law a bill that, while dramatically expanding healthcare insurance coverage, will largely leave insurance in the hands of private companies.

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The American Medical Association today endorsed the $871 billion, 10-year Senate health care bill.

“This bill advances many of our priority issues for achieving the vision of a health system that works for patients and physicians,” Cecil Wilson, the association’s president-elect, said in a statement he read at a news conference attended by several Democratic senators.

Sen. Chris Dodd, D-Conn., who attended the news conference, called the endorsement “the most important,” because of the “fundamental relationship between a patient and his doctor.”

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