Mark Mardell reports from Chicago on the president’s current standing.

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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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It’s inherently risky for any charismatic politician to legislate. To act is to choose and to choose is to disappoint the expectations of many who had poured their hopes into the empty vessel — of which candidate Obama was the greatest representative in recent American political history.

Obama did not just act, however. He acted ideologically. To his credit, Obama didn’t just come to Washington to be someone. Like Reagan, he came to Washington to do something — to introduce a powerful social democratic stream into America’s deeply and historically individualist polity.

Perhaps Obama thought he’d been sent to the White House to do just that. If so, he vastly over-read his mandate. His own electoral success — twinned with handy victories and large majorities in both houses of Congress — was a referendum on his predecessor’s governance and the post-Lehman financial collapse. It was not an endorsement of European-style social democracy.

Hence the resistance. Hence the fall. The system may not always work, but it does take its revenge.

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And as the international community continues to respond, I do believe that America has a continued responsibility to act. Our nation has a unique capacity to reach out quickly and broadly and to deliver assistance that can save lives.

That responsibility obviously is magnified when the devastation that’s been suffered is so near to us. Haitians are our neighbors in the Americas, and for Americans they are family and friends. It’s characteristic of the American people to help others in time of such severe need. That’s the spirit that we will need to sustain this effort as it goes forward. There are going to be many difficult days ahead.

So, so many people are in need of assistance. The port continues to be closed, and the roads are damaged. Food is scarce and so is water. It will take time to establish distribution points so that we can ensure that resources are delivered safely and effectively and in an orderly fashion.

But I want the people of Haiti to know that we will do what it takes to save lives and to help them get back on their feet. In this effort I want to thank our people on the ground — our men and women in uniform, who have moved so swiftly; our civilians and embassy staff, many of whom suffered their own losses in this tragedy; and those members of search and rescue teams from Florida and California and Virginia who have left their homes and their families behind to help others. To all of them I want you to know that you demonstrate the courage and decency of the American people, and we are extraordinarily proud of you.

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Geithner defended the fee against criticism from some bank officials, who say it is about politics and not economics. Those critics note that some institutions that paid back Troubled Asset Relief Program money ”” or never took any ”” will be taxed along with other banks.

“We’re doing what is fair, and what is just, and what is economically sensible and what we have a legal obligation to do, which is to make sure that we hold the American people harmless from the cost of the financial crisis and that we collect back from the financial industry that benefited from the financial rescue the ultimate costs of what it took to solve this crisis,” Geithner says. “That’s the sensible, fair thing to do.”

Geithner says the program was designed to apply to the largest financial institutions that benefited the most from the rescue.

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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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President Obama set the U.S. government Wednesday on a massive rescue and relief operation in the devastated capital of Haiti, ordering the rapid mobilization of military and diplomatic assistance, and pledging an aggressive effort to save the lives of those caught in Tuesday’s earthquake.

Naval ships steamed south and flights began shuttling search-and-rescue teams to dig through rubble in Port-au-Prince. Military aircraft flew over the island, mapping the destruction, while U.S. officials coordinated the efforts of non-governmental aid agencies. Coast Guard helicopters began flying seriously wounded Americans from the island nation’s U.S. Embassy to the U.S. military base at Guantanamo Bay, Cuba., about 200 miles away.

“With just a few hundred miles of ocean between us and a long history that binds us together, Haitians are neighbors of the Americas and here at home,” Obama said, calling the earthquake an “especially cruel and incomprehensible tragedy.”

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Alan Blinder, a former Federal Reserve vice chairman who is an economics professor at Princeton University, talks with Bloomberg’s Mark Crumpton and Julie Hyman about the outlook for an overhaul of financial regulation in the U.S. Blinder also discusses the Financial Crisis Inquiry Commission.

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A federal spending surge of more than $20 billion for roads and bridges in President Barack Obama’s first stimulus has had no effect on local unemployment rates, raising questions about his argument for billions more to address an “urgent need to accelerate job growth.”

An Associated Press analysis of stimulus spending found that it didn’t matter if a lot of money was spent on highways or none at all: Local unemployment rates rose and fell regardless. And the stimulus spending only barely helped the beleaguered construction industry, the analysis showed.

With the nation’s unemployment rate at 10 percent and expected to rise, Obama wants a second stimulus bill from Congress including billions of additional dollars for roads and bridges ”” projects the president says are “at the heart of our effort to accelerate job growth.”

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In the wake of the failed Christmas Day airplane bombing and the killing a few days later of seven CIA operatives in Afghanistan, Washington is, as it was after the Sept. 11, 2001, attacks, obsessed with “dots” — and our inability to connect them. “The U.S. government had sufficient information to have uncovered this plot and potentially disrupt the Christmas Day attack, but our intelligence community failed to connect those dots,” the president said Tuesday.

But for all the talk, two key dots have yet to be connected: Umar Farouk Abdulmutallab, the alleged Northwest Airlines Flight 253 attacker, and Humam Khalil Abu-Mulal al-Balawi, the trusted CIA informant turned assassin. Although a 23-year-old Nigerian engineering student and a 36-year-old Jordanian physician would seem to have little in common, they both exemplify a new grand strategy that al-Qaeda has been successfully pursuing for at least a year.

Throughout 2008 and 2009, U.S. officials repeatedly trumpeted al-Qaeda’s demise. In a May 2008 interview with The Washington Post, then-CIA Director Michael Hayden heralded the group’s “near strategic defeat.” And the intensified aerial drone attacks that President Obama authorized against al-Qaeda targets in Pakistan last year were widely celebrated for having killed over half of its remaining senior leadership.

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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.

President Barack Obama suggested Thursday he would not fire anyone for the attempted Christmas airline attack, saying it appears the security lapses that led to the near-disaster were not the fault of a single individual or institution. “Ultimately the buck stops with me,” said the commander in chief.

He declared anew that the government had the information to prevent the botched attack but failed to piece it together. He announced a range of changes designed to fix that, including wider and quicker distribution of intelligence reports, stronger analysis of them and new terror watch list rules.

But, added Obama, “When the system fails, it is my responsibility.”

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President Obama said Tuesday that the United States government had sufficient information to uncover the terror plot to bring down an airplane on Christmas Day, but intelligence officials “failed to connect those dots” that would have prevented the young Nigerian man from boarding the plane in Amsterdam.

“This was not a failure to collect intelligence, it was a failure to integrate and understand the intelligence that we already had,” Mr. Obama said after a two-hour meeting with his national security team at the White House. He added, “We have to do better, we will do better and we have to do it quickly. American lives are on the line.”

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Unfortunately, growth caused by an inventory bounce is a one-shot affair unless underlying sources of demand, such as consumer spending and long-term investment, pick up.

Which brings us to the still grim fundamentals of the economic situation.

During the good years of the last decade, such as they were, growth was driven by a housing boom and a consumer spending surge. Neither is coming back. There can’t be a new housing boom while the nation is still strewn with vacant houses and apartments left behind by the previous boom, and consumers ”” who are $11 trillion poorer than they were before the housing bust ”” are in no position to return to the buy-now-save-never habits of yore.

What’s left? A boom in business investment would be really helpful right now. But it’s hard to see where such a boom would come from: industry is awash in excess capacity, and commercial rents are plunging in the face of a huge oversupply of office space.

Can exports come to the rescue? For a while, a falling U.S. trade deficit helped cushion the economic slump. But the deficit is widening again, in part because China and other surplus countries are refusing to let their currencies adjust.

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What has happened, however, makes next year more fraught with challenges and danger than ever in dealing with Iran.

First, Iran was caught (again) cheating and lying about its nuclear program, especially when U.S. and other intelligence agencies revealed a new undeclared uranium enrichment facility near Qom, an installation the Iranians had tried to keep secret. So persistent has been the Iranian policy of deceit and of on-again, off-again co-operation that Mohamed ElBaradei, the outgoing head of the International Atomic Energy Agency, lost his legendary patience with Iran and denounced the country’s approach.

Second, President Mahmoud Ahmadinejad’s election was obviously a rigged affair. The result has been an even greater grip on government and the economy of the Revolutionary Guards and the special police, the Basij, both under the control of the Supreme religious leader Ayatollah Ali Khamenei. A mixture of political thuggery, institutionalized corruption, religious inflexibility and a morbid suspicion of the West now permeates the Iranian government.

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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.

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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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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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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 Obama administration said Monday it would begin levying hefty fines against U.S. airlines for subjecting domestic passengers to lengthy tarmac delays, the government’s latest response to a series of high-profile incidents.

The new rule adopted by the Department of Transportation sets fines of as much as $27,500 a passenger when airlines leave fliers stuck on a plane on the ground for more than three hours. Based on a delayed plane carrying 120 passengers, the fine could be as much as $3.3 million. The rule would apply to planes with more than 30 seats.

The Transportation Department has rarely issued fines for tarmac delays. The first case in recent memory came last month when the DOT fined Continental Airlines Inc. and ExpressJet Holdings Inc. $50,000 each, and levied a $75,000 fine against Mesaba Airlines.

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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 health-care debate in the Senate has, thankfully, returned to the paramount issue of cost. Unfortunately, the most obvious, time-tested and feasible approach to providing high-quality care at reasonable cost remains excluded from consideration.

The irony is that President Obama and a number of legislators have lauded the work of approximately 30 health-care organizations, caring for about 6 percent of the population, that for decades have provided care reliably better than average at lower cost. These are the “group employed models,” or GEMs, such as Geisinger Health System, the Marshfield Clinic, Kaiser Permanente, the Mayo Clinic and the Cleveland Clinic. Two of these GEMs — the Cleveland Clinic and the Mayo Clinic — have been ranked among U.S. News and World Report’s top five hospitals in the country. And shouldn’t all Americans have access to such better and cheaper care?

Most health-care organizations are run on a “fee-for-service” model. GEM organizations are different in that their physicians are employed, they are physician-led, and they work closely together and share information.

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Obama’s overhaul would also change how private firms insure workers. Perhaps 18 million workers could lose coverage and 16 million gain it, as companies adapt to new regulations and subsidies, estimates The Lewin Group, a consulting firm. Private insurers argue that premiums in the individual and small group markets, where many workers would end up, might rise an extra 25% to 50% over a decade.

The administration and the CBO disagree. The dispute underlines the bills’ immense uncertainties. As for cost control, even generous estimates have health spending growing faster than the economy. Changing that is the first imperative of sensible policy.

So Obama’s plan amounts to this: partial coverage of the uninsured; modest improvements (possibly) in their health; sizable budgetary costs worsening a bleak outlook; significant, unpredictable changes in insurance markets; weak spending control. This is a bad bargain. Benefits are overstated, costs understated.

This legislation is a monstrosity; the country would be worse for its passage. What it’s become is an exercise in political symbolism: Obama’s self-indulgent crusade to seize the liberal holy grail of “universal coverage.” What it’s not is leadership.

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David Axelrod, an adviser to President Barack Obama, predicted health-care legislation would pass “soon,” after Senate Democrats on Saturday secured the 60 votes needed to clear a path for quick Senate passage of the measure.

“We’re right on the one-yard line” with Senate Democrats reaching a deal, Mr. Axelrod said on CNN’s “State of the Union” which aired Sunday. “I believe this is going to happen soon”¦. People understand we’re on the doorstep of doing something really historic that will help the American people and strengthen our country for the long run.”

Senate Majority leader Harry Reid secured the pivotal 60th vote after a late-night deal on abortion coverage locked in the support of Nebraska Sen. Ben Nelson. The agreement capped weeks of negotiations aimed at building consensus on the White House-backed initiative.

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