Congress must enact a sweeping overhaul of the US healthcare system by the end of this year or risk waiting at least another four years to get the job done, says Charles Grassley, who as the Senate Finance Committee's top Republican will help write healthcare legislation, though acknowledging some senators favor putting off the overhaul while lawmakers grapple with the financial crisis. But he said such a move could sink the revamp of the $2.5 trillion healthcare industry that President Barack Obama said is essential to promote long-term US economic growth. "If it isn't done this year, it won't be done for the next four years," Grassley told reporters at a briefing, saying election politics will put off any meaningful action. It is a giant legislative undertaking and already Republicans and Democrats are split on a central issue of whether a government plan should be one of the insurance options available to consumers. Grassley said compromise on that issue will be difficult.

SENATOR URGES HEALTHCARE OVERHAUL THIS YEAR By Donna Smith Mar 19 - Reuters Health Information 2009

The head of Kellogg Co, whose company lost nearly $70 MIL in products from a recent peanut recall, will tell lawmakers the US food safety system must be overhauled with a focus on prevention. David Mackay, chief executive of Kellogg, said in prepared remarks for a congressional hearing the country needs an authority within the Department of Health and Human Services devoted solely to food safety. "We believe the key is to focus on prevention, so that potential sources of contamination are identified and properly addressed before they become actual food safety problems," he said. President Barack Obama has organized a panel to improve food safety laws. He blamed the recent outbreak partly on outdated food safety laws and underfunding and understaffing at FDA.

Mar 19 - By Christopher Doering Reuters Health Information 2009

Most patients never talk about price when getting a drug prescription from their doctor, and few confront the actual price of their drugs before it's time to pay at the pharmacy, according to a poll y Consumers Union. The group is urging doctors and patients to factor in the price of drugs when deciding on treatments. They're pointing to generics, which in many cases are just as effective and safe for the fraction of the price of a brand-name alternative. Just 4% of those polled discussed price when getting a drug prescription from their doctor; as many as 60% of those polled learned about the price of their drugs for the first time at the pharmacy register. Consumers Union is backing an Obama administration plan to boost research directly comparing the effectiveness of different drugs, devices, and other treatments. The hope is to find less-expensive treatments or tests that work as well as the more expensive versions.

PATIENTS, DOCTORS DON'T DISCUSS RX PRICES from WebMD a health information Web site for patients Todd Zwillich March 17, 2009

President Barack Obama chose public health and biological threat expert Dr. Margaret Hamburg to run the troubled US Food and Drug Administration and announced a Cabinet-level food safety group. Obama also outlined measures to keep diseased cows from entering the food supply and promised to increase the number of FDA food inspectors and modernize food safety labs. He selected Baltimore Health Commissioner Dr. Joshua Sharfstein to serve as Hamburg's principal deputy. Hamburg is a former New York City health chief and she worked on policy issues in President Clinton's health department. She has experience on topics ranging from AIDS to reduction of biological threats. "Dr. Hamburg brings to this vital position not only a reputation of integrity but a record of achievement in making Americans safer and more secure," Obama said in his weekly radio address. If confirmed by the Senate, Hamburg will take over an agency battered by a string of often deadly food poisoning and drug safety issues, including an ongoing outbreak of salmonella in peanut products that forced the largest food recall in US history. The choice signals the FDA's priority under the Obama administration will be safety, [rather than] speeding through drug approvals.

OBAMA PICKS FDA CHIEF, STARTS FOOD SAFETY PANEL Mar 16 -By Lisa Richwine Reuters Health Information 2009

After 2 national emergency physician groups took the unusual action of separately voicing concerns about emergency department (ED) policies at a large Chicago hospital -policies they believe could reduce patient access and quality of care -the hospital has said it will reconsider its policies. At the center of the controversy is the University of Chicago Medical Center, which recently announced reorganization plans, including reducing the number of inpatient beds available to emergency patients by more than 30 and expanding efforts to redirect to other hospitals and clinics those ED patients who do not need emergency care. The tertiary care hospital, which has a high percentage of Medicaid patients, reported that about one third of the patients who come to its ED have nonurgent conditions. The medical center had said the changes, along with other cost-cutting measures, were needed to "meet today's financial challenges." The University of Chicago Medical Center has decided to halt plans to redirect patients deemed nonurgent from its ED to other facilities,. The move came after external and internal protests of the plans. "The concern of the American College of Emergency Physicians is that [more and more] hospitals across the country are taking measures that fulfill the letter of the law for EMTALA but decrease care for patients," said Dr. Gardner, an emergency physician at the University of Texas Medical Branch at Galveston.

CHICAGO HOSPITAL TO HALT NEW EMERGENCY DEPARTMENT POLICIES AFTER CRITICISM March 16, 2009 Kathleen Louden Medscape Medical News 2009

US business leaders urged lawmakers to act quickly on healthcare reform, saying American companies were losing out to other countries with cheaper healthcare and healthier workers. The Business Roundtable, which represents the largest US corporations, released a study showing that for every $100 spent in the United States on healthcare, a group of five leading economic competitors -- Canada, Japan, Germany, the United Kingdom and France -- spend about 63 cents. "While today's economic challenges span the globe, companies in other countries may be better able to weather the storm in part because the value that their healthcare systems deliver," said Business Roundtable Chairman Harold McGraw. "This is a boiling frog issue -- how long can you stay in the water before you get boiled to death. "We're looking at close to double-digit increases in healthcare costs going into the future."

US BUSINESS LEADERS SAY HOBBLED BY HEALTHCARE COSTS Mar 13 - By Donna Smith Reuters Health Information 2009

Former President Bill Clinton said the political and economic environment was more favorable to comprehensive US healthcare reform than during his failed effort in the early 1990s. "We have a simpler, clearer path to the future than we did when I was there," Clinton said. "Now you've got the small business community wanting something new. The physicians were divided last time. They're united in believing we need reform," Clinton added. "And a number of the health insurance companies have said they are willing to move toward universal coverage." US healthcare costs have grown to $2.5 trillion annually and the ranks of the uninsured have swollen to 46 million people. [EINO: Or 87 million, one out of three non-senior adults, during the 2007-08 period.]

ENVIRONMENT RIGHT FOR US HEALTH REFORM: BILL CLINTON Mar 12 - by Peter Cooney Reuters Health Information 2009

A big new public health insurance program envisioned by President Barack Obama is shaping up as one of the most contentious issues in his drive to overhaul the US healthcare system. Even before a plan emerges, some Republicans and the insurance industry are expressing concern about any new public health insurance program. And conservative policy experts are trying to shape the debate by calling such a move a step toward "socialized medicine." Obama last year proposed "a new public plan based on benefits available to members of Congress that will allow individuals and small businesses to buy affordable health coverage." It is part of an initiative to cut the number of uninsured while improving healthcare quality and controlling costs that are forecast to reach $2.5 trillion this year. "It's a Trojan Horse for national health insurance where you basically rig the competition against private health insurance and you set up the economic incentives to encourage employers to dump people into the public plan," Moffit said speaking for the Heritage Foundation.

OBAMA'S PUBLIC HEALTH INSURANCE IDEA DRAWS FIRE Mar 12 - By Will Dunham Reuters Health Information 2009 Editing by Maggie Fox

A healthcare overhaul that achieves small cost savings each year could have a big impact on the US economy and federal budget in the long run, White House budget director Peter Orszag told Congress. "If we could reduce the rate of health care spending growth by 1 percent a year... the power of compound interest is so strong that, after 50 years, we would reduce health care spending as a share of the economy by 20 percent or so," he said. "We should put a health care bill on the president's desk by July 4," Senate Finance Committee Chairman Max Baucus said. Waxman, who will play a major role in writing the legislation, told an American Medical Association meeting that he wants a government insurance program to be part of the mix of plans available to consumers. "Give people a place to go to get good accessible affordable and regulated coverage through a private plan or, if they prefer, through a public alternative," Waxman said. "The choice would be theirs." Missouri Rep Roy Blunt expressed doubts about a new government insurance program. One similar to the Medicare program for ages 65 and up that would cover people below that age would have unfair advantages over private insurers to the point that they would be unable to compete, Blunt said.

BIG IMPACT FROM SMALL HEALTH SAVINGS: WHITE HOUSE Mar 11 - By Donna Smith Reuters Health Information 2009

Cheap drugs imported into the USA to bring costs down must meet FDA safety and efficacy standards, White House budget director Peter Orszag said on Tuesday. President Barack Obama's administration is pressing for Congress to allow people to buy inexpensive drugs from other countries to try and lower healthcare costs, but drug makers complain this could leave the country open to substandard products.

DRUG IMPORTS MUST MEET STANDARDS, WHITE HOUSE SAYS Mar 10 - Reuters Health Information 2009

The Obama administration moved formally to rescind a Bush administration rule to protect health workers who refuse to provide services and information on moral grounds, which had inflamed abortion-rights advocates. The rule took effect hours before President Barack Obama took office in January, and opponents say the previous administration rushed it through in a last-minute push in a bid to deny patients not only abortion rights, but also contraception and other care. Bush administration officials said it merely reflected laws passed by Congress and was meant to prevent discrimination against people based on their religious or moral beliefs and to protect healthcare workers who do not want to perform abortions.

US MOVES TO RESCIND HEALTHCARE "CONSCIENCE" RULE Mar 09 - By Maggie Fox Reuters Health Information 2009

President Obama is lifting the Bush administration's restrictions on federally funded human embryonic stem cell research. However, the president will let Congress decide whether the long-standing legislative ban on federal financing for human embryo experiments should also be overturned, according to The New York Times. President Obama's announcement could lead to reconsideration of the ban on Capitol Hill, something that would have been unthinkable when President George W. Bush was in office. The ban, known as the Dickey-Wicker amendment, became law in 1996. It specifically bans the use of tax dollars to create human embryos, a routine practice in private fertility clinics, or to use them in research, where they are destroyed, discarded, or otherwise subjected to injury. In 2001, President Bush ordered that tax dollars could be used for studies on a limited number of stem cell lines already extracted from embryos, provided that federal researchers did not do the extraction themselves. He twice vetoed legislation that would have expanded his 2001 policy.

OBAMA LIFTS BAN ON FEDERAL FUNDS FOR STEM CELL RESEARCH March 9, 2009 Fran Lowry Medscape Medical News 2009

President Barack Obama cast his sweeping health care reform plans in terms of help for the faltering economy at a White House forum. The president told a group of lawmakers, doctors, health industry representatives, and patient advocates that controlling health costs was vital to getting American households and businesses back on their feet. He said the administration will seek to enact new laws expanding health coverage and controlling costs "by the end of this year." "By a wide margin, the biggest threat to our nation's balance sheet is the skyrocketing cost of health care. It's not even close," the president told the group in an East Room speech at the beginning of the conference. Obama has already proposed to set aside more than $630 billion over the next decade to help fund reform efforts, which could include subsidized insurance for middle-income people who can't afford premiums and an expanded coverage through Medicaid or Medicare. Beyond that, reform plans remain sketchy. Lawmakers from both parties met with White House officials, business CEOs, consumer advocates, and medical society presidents to air their priorities in front of TV cameras.

OBAMA PUSHES FOR HEALTH REFORM AT SUMMIT March 5, 2009 Todd Zwillich WebMD Health News 2009

The United States government appears to be mismanaging healthcare budgets for cancer patients and, at the same time, continues to encourage a for-profit healthcare system, according to a series of reports in the March issue of the Lancet Oncology. A consequence of this system is that thousands of oncology patients may be unable to complete ongoing cancer treatment because of cost. The current economic downturn might also be having an effect on cancer care, especially for patients who have lost their jobs and, thus, employment-related health insurance. The Stimulus Bill, signed by President Obama on February 17, allocated $10 billion to the National Institutes of Health (NIH) for research and $87 billion for Medicaid. However, as the Lancet Oncology points out, unemployed individuals are not included in the Medicaid system. Even though access to Medicaid was originally planned for the unemployed, this provision was written out of the final bill. And, a proposal to provide coverage for former employees with government-subsidized insurance for up to 1 year was reduced to 9 months. Cancer patients are just 1 part of the equation, and the real problems affect the healthcare system across the board. Although it is still too soon to tell what effect the economic downturn will have on cancer care, there is a concern that people will forgo screening. When people feel financial pressure, they tend to cut back on preventive services, explained Dr. Brody. "They cut back indiscriminately on needed and unneeded services -so they will then be at risk of avoiding useful screening and perhaps, then, having a later diagnosis."

RECESSION AMPLIFIES HEALTHCARE WOES FOR CANCER PATIENTS Roxanne Nelson March 5, 2009 Medscape Medical News 2009 & Lancet Oncol. 2009;10:197-199, 212-213.

A third of Americans under age 65 -- 86.7 million people -- went without health insurance at some point during the past two years, according to a report released on Wednesday. The report from the advocacy group Families USA showed that the lack of access to health insurance in the USA is more widespread than government statistics suggest. Of 262 million Americans under 65, 33 percent were uninsured at some point during those two years, according to the report. This included 60.1 million adults and 26.6 million children and teens up to age 18, according to the report. Among those uninsured, 75 percent had no coverage for at least six months and 60 percent for at least nine months, according to the report based on survey data from the US Census Bureau and Agency for Healthcare Research and Quality. About 52 percent of individuals and families with incomes between the official poverty line and twice the poverty line - $21,200 to $42,400 of annual income for a family of four - were uninsured at some point during 2007 and 2008. The government's most recent official estimate, based on Census Bureau figures, put the number of uninsured at 45.7 million in 2007. But that figure included only those who had no coverage for the entire year (continuously Jan 1 - Dec 31).

IN PAST 2 YEARS, 87 MILLION IN US WENT UNINSURED Mar 04 - By Will Dunham Reuters Health Information 2009

The term integrative medicine "is a little like showing someone a Rorschach blot and asking, what do you see," said Harvey V. Fineberg, MD. Integrative medicine extends across the whole spectrum of interventions, Dr. Fineberg said, keeping health and restoring health. It thinks about the coordination of care across the spectrum of services. At its most basic, integrative medicine "is the embodiment of patient-centered care." "Finally, it conveys an openness to multiple modalities of care," both traditional and nontraditional, said Dr. Fineberg. The standard for evidence should be consistent, demanding no more or no less, "open to a variety of modalities, so long as they work."

IOM INTEGRATIVE MEDICINE SUMMIT: NEW PARADIGM IN HEALTHCARE NEEDED Bob Roehr March 4, 2009 Medscape Medical News 2009

US President Barack Obama has chosen Nancy-Ann DeParle to be the head of the newly created White House Office on Health Reform. At the same time he announced the nomination of Kansas Governor Kathleen Sebelius as Secretary of Health and Human Services. S DeParle has had in-depth experience with healthcare from diverse angles. Most prominently she ran Medicare and Medicaid as head of the Health Care Financing Administration (HCFA), now called the Centers for Medicare and Medicaid Services, from 1997 to 2000. The White House touts her accomplishments during that time as implementing the Balanced Budget Act (BBA), which modernized Medicare's payment systems and extended the life of the Medicare Trust Fund; cutting the Medicare payment error rate in half; and launching Medicare's first comprehensive education effort, including Medicare.gov and 1-800-Medicare. Since that time she has moved to the private sector, serving as senior advisor to JPMorgan Partners, LLC, and then as managing director for healthcare for CCMP Capital Advisors, an investment firm with offices in New York City. CCMP's portfolio includes CareMore Medical Enterprises, Hanger Orthopedic Group, Medquest Associates, and National Surgical Care. DeParle has also been on the boards of companies including MedcoHealth Solutions Inc; Noble Environmental Power, LLC; Boston Scientific Corporation; MedQuest, Inc.; Accredo Health, Inc; Cerner Corporation; Triad Hospitals, Inc; DaVita, Inc; and Guidant Corp, according to CCMP information. "My impression is that the White House is going to leave the details to the Congress, which makes some sense given the backlash that occurred when the Clinton Administration attempted to send forward a very, very detailed program."

HEALTH FINANCE EXPERT NAMED HEALTH REFORM CZAR March 4, 2009 Kathryn Foxhall Medscape Medical News 2009

US President Barack Obama has been vague about details of his healthcare reform efforts, but he provided a hint of one direction he could take -- community health centers. As he announced the nominations of his two top health executives, Obama highlighted the allocation of $155 million to 126 community health centers as part of the $787 billion economic stimulus package. "These health centers will expand access to care by helping people in need -- many with no health insurance -- obtain access to comprehensive primary and preventive health care services," Obama told a news conference. "That helps relieve the burden on emergency rooms across the country, which have become primary care clinics for too many who lack coverage -- often at taxpayer expense." The Health and Human Services Department said the money would create 5,500 new jobs and help provide health care to an estimated 750,000 low-income Americans.

OBAMA PUSHES CENTERS AS ONE FOCUS OF HEALTH REFORM By Maggie Fox Mar 03 - Reuters Health Information 2009

US President Barack Obama's budget backs a plan to allow people to buy cheaper medicines from other countries, which typically offer lower prices than the United States. "The Budget supports the FDA's new efforts to allow Americans to buy safe and effective drugs from other countries," said the plan, released on Thursday. It was not immediately clear what new efforts the FDA was taking to allow such importation, and an agency spokesman could not immediately be reached for comment. The FDA under the Bush administration opposed such a plan. Countries such as Canada can sell medicines for less because their governments help control prices.

OBAMA'S US BUDGET SUPPORTS DRUG IMPORT PLAN Feb 26 - Medscape Reuters Health Information 2009

Health spending will hit $2.5 trillion this year, devouring 17.6% of the economy, as the White House and Congress consider major changes to the healthcare system, US government economists. The Centers for Medicare and Medicaid Services, known as CMS, forecast that the share of the economy devoted to health spending will jump a full percentage point from 2008. That would mark the biggest one-year increase recorded since the government began tracking the data in 1960. Thanks to the recession, public health spending in programs such as the Medicaid program for the poor is ballooning, while private health insurance spending is slowing as more people lose employer-provided coverage, CMS reported. The United States spends more on healthcare than any other country, but its system is widely considered inefficient and it lags many other nations in key quality measures. Past efforts to make major healthcare changes have died in Congress. Growth in public health spending this year is projected to hit 7.4%, amounting to $1.2 trillion, largely due to growth in Medicaid enrollment and spending, the report said.

HEALTH SPENDING TAKES RISING SHARE OF US ECONOMY By Will Dunham Feb 24 - Reuters Health Information 2009

US employers expect increases in health care costs will stay at a steady 6 percent this year, twice the rate of inflation. The survey of 489 large US employers also showed that more plan to offer consumer-directed health plans in 2010 to try to control cost increases. Watson Wyatt and the National Business Group on Health found that 51% of companies now offer workers a consumer-directed health plan, up from 47 percent in 2008. These plans invite workers to choose insurance services with a menu that usually also makes costs clear.

US EMPLOYERS EXPECT STEADY RISE IN HEALTH COSTS By Maggie Fox Reuters Health Information 2009

Methods to improve and transform the way US healthcare is provided by front-line clinicians are highlighted in a commentary published in the February 18 issue of JAMA. Recommended strategies include quality measurement, health information technology (HIT), comparative effectiveness of devices and medication, quality improvement collaborative, learning networks, and clinician training. The most important measures that should be implemented to improve US healthcare, according to Dr. Conway, are risk-adjusted outcome measures, measures that encompass episodes of care and focus on care coordination, and efficiency measures.

JAMA COMMENTARY HIGHLIGHTS HOW TO IMPROVE US HEALTHCARE Laurie Barclay, MD February 20, 2009 JAMA. 2009;301:763-765. Medscape Medical News 2009

When President Barack Obama made his quick dash up to Ottawa, it's too bad he didn't suffer a gastrointestinal attack, or slip on some ice and twist an ankle or something. Canadians have complete freedom to choose their physicians. There has for years been a huge ongoing propaganda campaign by US health care companies and their lobbies to denigrate Canada's system, but the big truth that they cannot deny is that it is loved by Canadians. The best evidence of this: Despite years of conservative governments in Canada, and in the various provinces, no political leader has ever tried to re-privatize health care in Canada. Clearly such an effort would be political suicide, so popular is the system there. As Canadian resident Joe Sotham explains, "In Canada we complain about wait list length, and the reality is that there is rationing, but everyone gets care and nobody is bankrupted, no HMO clerk stands in the way of treatment. We treat health care like a fundamental right. I took my cat to the vet last year and got a 3-page, $1,875 bill. My comment was 'this must be what it's like in the States for people.'"

AMERICA'S STUPID HEALTH CARE DEBATE Keeping Some Ideas Off the Table by Dave Lindorff Published on Sunday, March 1, 2009 by CommonDreams.org

It hasn't been a good year so far in terms of preventing regulatory failures at Southern manufacturing plants. The nation is still reeling from a massive salmonella outbreak linked to peanut products from the Peanut Corporation of America's plant in Blakely, Ga., that has sickened sickened some 666 people and may have contributed to nine deaths. More than 2,000 peanut products have been recalled. The deadly outbreak was fueled by poor oversight by food safety regulators and a slow response by federal agencies, experts say. AM2PAT is accused of skipping sterilization testing of its syringes in 2007 and shipping contaminated needles filled with the blood-thinner Heparin and saline solution. Along with five deaths, AM2PAT's contaminated syringes sickened some 300 people, causing a variety of severe injuries, including spinal meningitis and permanent brain damage. In the case of the North Carolina plant, the FDA was aware of problems as early as 2005, but not until December 2007 did the agency issue recall notices on the tainted syringes. An FDA warning letter cited AM2PAT in August 2005 for nine serious violations at its Raleigh, N.C. manufacturing facility, including poor documentation of sterility tests; insufficient efforts to maintain a sterile environment; and unqualified workers.

MORE REGULATORY FAILURE: FDA DIDN'T INSPECT SYRINGE PLANT DESPITE COMPLAINTS By Desiree Evans on February 27, 2009 7:18 AM

After spending two years and more than $20 million to promote the idea, collaborators in the Divided We Fail coalition -a project of the seniors lobby AARP, the service workers' union, and groups representing small business and the Fortune 500 -are indeed divided over key elements of how to fix health care. Its members agree that something should be done to revamp health care in the United States, and there's consensus on a vague set of general principles that include making coverage more accessible, affordable and efficient. But they differ over important details, including what roles the government and private businesses should play. There's a fight brewing between private insurers and consumer groups over how to ensure that everyone is covered. Insurers say they'll agree to accept any patient regardless of pre-existing health conditions -but only if everyone is required to buy coverage. Consumer groups say that would turn the government into a collection agency for private insurance companies.

THE INFLUENCE GAME: LABOR AND BUSINESS, JOINED IN HEALTH CARE CAUSE, NOW AT ODDS ON SPECIFICS By Julie Hirschfeld Davis February 16, 2009 Chicago Tribune

If you buy medicine through Medicare's prescription drug program, you could be paying too much. The taxpayers who finance Medicare aren't doing too well, either. Insurance companies involved in the Medicare prescription drug benefit have overcharged subscribers and taxpayers by several billion dollars, according to the inspector general for the Department of Health and Human Services. Eighty percent of the participating insurance companies owe the program an estimated $4.4 billion for 2006 alone. Medicare (under the Bush Admin), however, has been slow to do something about it. In fact, the agency doesn't even know how much money the insurance companies owe taxpayers because it hasn't begun most of the financial audits needed to determine that. A quarter of all bid audits done for the years 2006 and 2007 had errors that resulted in higher profits for the insurance companies, higher costs for Medicare and higher premiums or fewer benefits for the beneficiaries. Some administrative and marketing costs also were "unreasonably high."

INSURERS OVERCHARGED MEDICARE FOR PRESCRIPTIONS By David Goldstein February 1, 2009 The Miami Herald

The recession may restrain growth in medical expenses this year as fewer people visit doctors, buy drugs or have surgery, helping health insurers such as WellPoint Inc. WellPoint, which covers one in nine Americans, rose the most in four weeks after reporting that medical expenses climbed less than 8% in the fourth quarter. The increase was at the low end of a forecast given in October, and the report sparked a rally for managed-care companies. During an economic slump, people who are worried about costs hesitate to tend to their health needs because of out-of-pocket expenses. The US entered a recession in December 2007, and the economy suffered the biggest job losses last year since the end of World War II. "Many analysts, me included, think that the recession will lead to lower health-care utilization, which could benefit managed-care companies or at least help stabilize their margins," said Matt Perry, an analyst with Wachovia Securities Inc., in a note to clients today.

RECESSION SLOWS MEDICAL INFLATION, HELPING INSURERS By Avram Goldstein Bloomberg.com January 28, 2009

As President Obama prepares to push for an overhaul of the medical system, providers of U.S.-backed health plans for the elderly are raising prices. Humana Inc., Health Net Inc., and nearly 200 other providers increased 2009 premiums by 13% on average, or more than five times as much as last year, for people who use Medicare Advantage, according to Avalere Health, a consulting company in Washington. "Medicare Advantage is a rip-off," said Relman, 85, also a professor emeritus at Harvard Medical School in Boston. "I cannot see that they do anything better than public insurance does, and they do a lot of things worse." Medicare will spend 14% more this year, on average, for Advantage enrollees than for beneficiaries with basic coverage.

MEDICARE ADVANTAGE PRICES RISE AS OVERHAUL PLAN NEARS By Avram Goldstein Bloomberg News

Congress is poised for a battle over whether an ambitious health-care overhaul should include a new government-run health plan to compete with private companies in the effort to cover the uninsured. The proposal for a public health plan inspires passion on both sides, as it gets to the heart of what government's role should be in the health-care system. The matter is likely to come to a head first in the Senate Finance Committee, where Chairman Max Baucus (D., Mont.) has pledged to write a bipartisan bill. His partner, Sen. Charles Grassley of Iowa, the top Republican on the panel, is adamantly opposed to the provision for a public health-care plan. Insurance companies strongly oppose a public plan, said Karen Ignagni, president of the industry lobby group. "It's a very short step to a Medicare-like program for all Americans in a single-payer system," she said.

HEALTH-CARE BATTLE SET TO FOCUS ON PUBLIC PLAN By LAURA MECKLER March 24, 2009 The Wall Street Journal Digital Network