Senate Democrats vote to bring health care bill to floor for debate

Also today we have in the incredibly bad timing award we have new guidelines coming out today for cervical cancer screening that says women should delay their first Pap test until they turn 21, and should be screened less often than recommended in the past.

This comes just days after a firestorm has erupted after new guidelines for mammograms were announced.

The negative reaction led Health and Human Services Secretary Kathleen Sebelius to back off big time, saying  on Wednesday that women should continue getting regular  mammograms starting at age 40.

Sebelius issued her statement following a government panel's recommendation on Monday, that said most women don't need mammograms in their 40s and should get one every two years starting at 50.  She said, "The task force does "not set federal policy and they don't determine what services are covered by the federal government."

That in turn led Washington Post columnist Steven Pearlstein to blast her in his column today, writing that the controversy is "likely to  set back efforts to dramatically increase research into what really works and what doesn't, and use the results to revamp the way medical care is delivered and paid for."

Pearlstein writes that to him, this has "death panels" redux written all over it.  That is, how politicians and the media can distort an important discussion on end of life care because it gets hijacked by paranoia and mistrust.

True, but it doesn't seem to be a winner politically, does it?

Pearlstein says that Sebelius should have said that she was going to delay implementation of the recommendations for a year as more research and discussion continues.  He also writes:

The political argument from the White House was that it was necessary to duck this fight over evidence-based medicine in order to save it. The better approach would have been to see this as one of those teachable moments that could be used to reaffirm the entire rationale for reform. For while debate continues over whether some women may be getting too many mammograms, there is evidence that there are women who, because they lack insurance, are getting too few -- and dying unnecessarily as a result. What health reform is about is correcting that imbalance while devising new mechanisms for improving health outcomes and getting better control over costs.

Whether it's chancing luck or not, Senate Majority Leader Harry Reid  tomorrow night will attempt to replicate what his equal in the House, Nancy Pelosi was able to do two Saturday nights ago : That is, get the minimum number of members of Congress  to shut off the first Republican efforts to block action on their health care bill that was unveiled late Wednesday night.

It should be emphasized that tomorrow's vote is not on whether to approve the Senate's $848 billion plan spread out over 10 years - it's to begin debate.

But whether that will be enough for some centrist Democrats, such as Arkansas's Blanche Lincoln, Nebraska's Ben Nelson, and Louisiana's Mary Landrieu is still unclear at this point.  Though one can't accuse Reid of doing whatever it takes to acquire their votes.

As the NY Times reports:

the measure that emerged from Mr. Reid’s office contained a special $100 million in Medicaid money for “certain states recovering from a major disaster,” a designation that analysts said clearly applied to Louisiana and perhaps only Louisiana.

The Wall Street Journal is reporting that business groups, some of whom were "encouraged" by the bill that the Senate Finance Committee (Remember the Baucus bill and the near daily speculation about what would Olympia Snowe do?)  passed in October and hoped that it would form the basis of the final legislation.  But apparently they're now bent out of shape because Reid has included a public option in the bill that was completed this week.

We've already heard from Joe Lieberman and the Republicans about how horrific a public option would be.  But it makes one wonder if they've read the Congressional Budget Office's analysis of the Senate bill, which says that because they believe at least one third of the states (and there is a proposed constitutional amendment to include Florida in this) would 'opt out' of a public option, that it would only cover 3 to 4 million people.  From the CBO:

"CBO's analysis took into account the probability that some states would opt not to allow the public plan to be offered to their residents. Rather than trying to judge which states might opt out, CBO applied a probability recognizing that public opinion is divided regarding the desirability of a public plan and that some states might have difficulty enacting legislation to opt out. Overall, CBO's assessment was that about two-thirds of the population would be expected to have a public plan available in their state."

Makes you wonder what all the fuss was about, doesn't it?

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